Digital Commons Network^™

Attachment Style, The Working Alliance, And Client Self-Disclosure In Individual Psychotherapy, Jennifer S. Baar

Dissertations

Client self-disclosure is a core component of the psychotherapy process and increased levels of client self-disclosure have been shown to predict more positive therapeutic outcomes (Pattee & Farber, 2008; Sloan & Kahn, 2005). Similarly, the working alliance and attachment are constructs that have been studied in psychotherapy research and are consistently associated with therapeutic outcomes. Specifically, stronger working alliance ratings and higher levels of secure attachment have been found to predict more positive therapy outcomes (e.g., Flückiger et al., 2018; Mallinckrodt et al., 2005; Sauer et al., 2010). As these three constructs have been found to influence psychotherapy outcomes, the …

Exploring How Therapist Trainees’ Mentalization, Attachment Styles, And The Working Alliance Impact Treatment Outcomes In Psychotherapy, Hanali Gilbert

Dissertations

A burgeoning area of research within the past 30 years has sought to identify which specific therapist factors contribute to differential treatment outcomes (Barkham et al., 2017). The purpose of the current naturalistic study was to explore how two personal characteristics of therapist trainees, mentalization capacity and attachment styles, impact early treatment outcomes at two Midwestern psychology training clinics. This study also examined whether therapist mentalization and the working alliance interacted to influence client outcomes. Therapists completed the Mentalization Scale (MentS; Dimitrijević et al., 2018) and the Experiences in Close Relationships scale (ECR; Brennan et al., 1998), while the Working …

Evaluation Associations As Catalysts For The Professionalization Of Evaluation Practice: A Comparative Case Study Of Brazil, Ghana, Indonesia And Uganda, Amy C. Jersild

Dissertations

Professional associations are recognized as key actors in promoting the development of the evaluation field across the globe. There has been exponential growth of Voluntary Organizations for the Professionalization of Evaluation (VOPEs) in the Global South in the past several decades in response to an evolving international aid agenda and a mobilized international evaluation field intent on supporting the development of national monitoring and evaluation systems and the professionalization of the field. VOPEs have featured as a central actor in the Global Evaluation Agenda, an initiative developed by the international community aimed to promote professionalization of the evaluation field as …

Reduced Product Type Monoid-Module Extensions, Darryl Jent

Dissertations

In 1955, I. M. James introduced the James Construction, a free topological monoid that models the loops on the suspension of a given space. In 1969, S. Y. Husseini generalized this idea to RPT monoids: topological monoids with a free-like monoid structure that can be used to model a broader class of loop spaces. In order to prove that these topological monoids are models of loop spaces, both I. M. James and S. Y. Husseini constructed contractible spaces on which these topological monoids act. We define a topological module as a space equipped with an action by a topological monoid. …

From Total Domination To Graph Coloring, Sawyer Isaac Osborn

Dissertations

A question involving a chess piece called a prince on the 8×8 chessboard leads to a concept in graph theory involving total domination. We say a vertex u in a graph G totally dominates a vertex v if u is adjacent to v. A subset S of the vertex set of a graph G is a total dominating set for G if every vertex in G is totally dominated by at least one vertex of S. If S is a total dominating set of G, then σ_S(v) denotes the number of …

Personal And High-Intensity Gait Factors Associated With Balance And Walking Improvement With Outpatient Stroke Rehabilitation: A Retrospective Study, Heather Staal

Dissertations

Objective: The purpose of this study is to examine the relationships between personal factors and High-Intensity Gait variables and balance and walking improvement in an outpatient stroke population.

Background: Stroke is a leading cause of long-term disability, with persistent gait and balance impairments commonly limiting independence and participation. High-intensity gait training (HIGT) is an evidence-based rehabilitation approach that improves walking outcomes following stroke; however, guidance on how specific training variables are applied in outpatient physical therapy settings remains broad.

Methods: This retrospective observational study analyzes clinical data from outpatient physical therapy episodes in which HIGT is a …

Research Nexus : Volume 38 – 2026, Office Of Research And Graduate Studies

Office of Research and Graduate Studies

• Researcher Spotlight
• Research Milestones & News
• Capacity Building Initiatives
• The Collective Spark: Our Academic Entities, Institutes & Centres at Work
• NIH Updates and Other Resources
• Explore New Funding Opportunities

Emotional Support Through Ai: Venting To Artificial Intelligence Or A Perceived Human May Offer Comparable Emotional Well-Being Benefits, Meilan Hu, Jerlyn Q. H. Ho, Claire Ng, Shermaine S. M. Wong, Andree Hartanto

Research Collection School of Social Sciences

Artificial Intelligence (AI) chatbots are increasingly being explored as sources of informal emotional support, with emerging evidence suggesting that venting to these systems can reduce negative affect. Yet, it remains unclear whether such benefits depend on the responder's perceived identity. Given that emotional relief from venting often hinges on perceived authenticity and emotional validation, this study investigates whether the emotional well-being benefits of venting differ when users believe they are interacting with an AI chatbot versus a human, even when responses are content-matched. In a pre-registered experiment ( N = 279), participants were randomly assigned to either an AI-assisted venting …

“Megadeal” Subsidies, Local Spillovers And Corporate Innovation, Yoojin Lee, Shaphan Ng, Aruhn Venkat

Research Collection School Of Accountancy

We examine whether the largest place-based, firm-specific corporate subsidies (“Megadeals”) awarded by state and local governments affect local firms’ innovation. First, we document that 1) subsidy firms innovate in the subsidized county and 2) subsidy firms bring inventors from other counties into the subsidized county, consistent with subsidy firms generating new knowledge locally. In our main test, we use a stacked cohort design with stringent fixed effects to document that local firms increase patenting following a Megadeal. Cross-sectionally, effects are increasing 1) in subsidy firm innovativeness, 2) in the technological closeness of subsidy firms and local firms, 3) when subsidy …

Beta2-Agonist And Anti-Inflammatory Combination Therapy For Asthma Rescue: A Paradigm Shift In Asthma Care, Neil Skolnik, Jessica Stieritz, Julie Akers, Timothy Hudd, Wendy L. Wright, Ileen Gilbert, Nazrin Yusufova, Bill Cook, Emily Robb, Henry Naddaf

Abington Jefferson Health Papers

The Global Initiative for Asthma (GINA) report and national and international guidelines have shifted away from short-acting beta2-agonist (SABA)-only bronchodilators as first-line asthma rescue therapy, recognizing that both bronchoconstriction and inflammation underlie the increase in symptoms preceding an exacerbation. Instead, the GINA Committee supports strategies to reduce inflammation, such as anti-inflammatory reliever (AIR) therapy (as-needed, low-dose inhaled corticosteroid [ICS]–formoterol or SABA–ICS for symptom relief) and single maintenance and reliever therapy (SMART) or maintenance and reliever therapy (MART; i.e., ICS–formoterol used as both maintenance and as-needed rescue therapy). This narrative review discusses the rationale behind the move toward AIR and SMART …

Polygenic Risk Scores And Hla Class Ii Variants Are Biomarkers Of Corticosteroid Response In Childhood Nephrotic Syndrome., Tiffany Tu, Alejandro Ochoa, Amika Sood, Ashley Dabrik, Megan Chryst-Stangl, Brandon Lane, Guanghong Wu, Frank Donovan, Ursula Harper, Settara Chandrasekharappa, Christopher Esezobor, Adaobi Solarin, David Hooper, Christine Sethna, Sandra Amaral, Mahmoud Kallash, Michelle Rheault, Priya Verghese, Vikas Dharnidharka, Eloise Salmon, Patricia Weng, Tarak Srivastava, Michael E Seifert, Cozumel Pruette, David Selewski, Keisha Gibson, Tracy Hunley, Asiri Abeyagunawardena, Shenal Thalgahagoda, Arvind Bagga, Aditi Sinha, Nicholas Webb, Larry Greenbaum, Ali Gharavi, Krzysztof Kiryluk, Matthias Kretzler, Lisa Guay-Woodford, Simone Sanna-Cherchi, Agnieszka Bierzynska, Ania Koziell, Gavin Welsh, Moin Saleem, Charles Rotimi, Eileen Chambers, Cliburn Chan, Curegn Consortium, Pnrc Glomerular Disease Group, Cibmtr/Nmdp Consortium, Annette Jackson, Adebowale Adeyemo, Rasheed Gbadegesin

Manuscripts, Articles, Book Chapters and Other Papers

INTRODUCTION: Nephrotic syndrome (NS), a common glomerular disease in children, is classified based on response to corticosteroid therapy as either steroid-sensitive nephrotic syndrome (SSNS), or steroid-resistant nephrotic syndrome (SRNS). However, there are no current reliable predictors of therapy response at initial clinical presentation.

METHODS: To evaluate predictors, we conducted genome-wide association studies, developed polygenic risk scores (PRS) for therapy response and analyzed classical HLA alleles in 1,997 children (994 discovery and 1,003 replication/validation cohorts) previously unstudied children with NS and 3,558 ancestry-matched control individuals.

RESULTS: A significant association with HLA loci defined by variants in HLA-DQB1, HLA-DRB1, and HLA-DQA1 were …

Dopamine-Endocannabinoid Crosstalk Drives Exercise-Induced Bidirectional Plasticity In Parkinson's Disease, Federica Campanelli, Gioia Marino, Giuseppina Natale, Maria De Carluccio, Tabitha N. Rodriguez, Michelle Smeyne, Richard Jay Smeyne, Veronica Ghiglieri, Paolo Calabresi

Department of Neuroscience Faculty Papers

Parkinson’s disease (PD) is a neurodegenerative disorder marked by loss of substantia nigra dopaminergic neurons. Epidemiological evidence indicates that lifelong physical activity reduces both PD incidence and slows disease progression. Here, we examine how voluntary exercise induces long-lasting neuroprotection of the corticostriatal function in a murine model of α-synuclein–driven nigrostriatal pathology. In preformed fibril (PFF)-injected mice, long-lasting voluntary wheel running prevents degeneration of nigrostriatal dopaminergic terminals and improves motor performances. Intensive exercise normalizes spontaneous glutamatergic transmission and preserves corticostriatal long-term potentiation (LTP) in striatal spiny projection neurons. Exercise-induced LTP is dependent on activation of dopamine (DA) DA1, GluN2B-expressing NMDA and …

Decentralizing Dementia Research To The Us–Mexico Border: The Rio Grande Valley Ad-Rcmar As A Model For Translational Equity, Gladys E. Maestre, John Blangero, Eron Manusov, Gabriel A. De Erausquin, Francisco Fernandez, Silvia Mejia-Arango, Vincent P. Diego, Juan C. Lopez-Alvarenga, Claudia Alaniz, Neyra García, Rosa V. Pirela, Andrew Tsin, Michael Mahaney

School of Medicine Publications

Translational equity means ensuring that diagnostics, treatments, care models, and prevention strategies are developed and implemented so they work for populations with the greatest burden and least access to care. In Alzheimer's disease and related dementias (ADRD), where most evidence derives from highly educated, non-Hispanic White participants at large academic centers, translational equity is critical to prevent misclassification, limited access, and widening disparities and to ensure that underrepresented communities shape how new knowledge moves into practice. Hispanic and other populations in the United States are disproportionately affected by ADRD yet remain underrepresented in research, with gaps especially pronounced in high-poverty …

Detecting Cognitive Impairment Early In Hispanic And Black Older Adults: Community Voices From South Central Texas, Robin C. Hilsabeck, Stephanie Santiago-Mejias, Tara L. Fletcher, Shanae L. Rhodes, Gladys Maestre, Sudha Seshadri, Neela K. Patel, Fayron R. Epps

School of Medicine Publications

Background: Alzheimer disease and related dementias (ADRD) are more prevalent in Black and Hispanic older adults and are also more likely to be undetected and misdiagnosed. The purpose of this study was to engage with Black and Hispanic communities about interest in and support needed for memory screening.

Methods: Participants were recruited from established community partners of the South Texas Alzheimer's Disease Research Center to engagein a 90-minute listening session. The session was recorded with participants' permission, and a thematic analysis was conducted by 2 independent coders.

Results: Sixteen individuals (81% female, 88% Hispanic or Black) from various perspectives participated …

Understanding And Overcoming Innate And Acquired Mapk Inhibition Resistance In Anaplastic Thyroid Cancer, Peter Y F Zeng, Jalna Meens, Amir Hossein Karimi, Harrison Pan, Matthew J. Cecchini, Laura Jarycki, Sarah B. Ryan, Alice E. Dawson, Mushfiq H. Shaikh, David A. Palma

School of Medicine Publications

Anaplastic thyroid cancer (ATC) is highly lethal. Although patients with the BRAFV600E alteration respond to the type I RAF inhibitor (RAFi) dabrafenib with trametinib, most rapidly develop adaptive or acquired resistance. Here, multi-region whole-genome, high-coverage whole-exome, and single-nuclei RNA sequencing of tumors from ATC patients undergoing type I RAFi and MEKi therapy reveals that reactivation of the mitogen-activated protein kinase (MAPK) pathway, along with immunosuppressive macrophage proliferation, may underlie the development of acquired resistance. Screening of several RAFi reveals that ATC cell lines are exquisitely sensitive to the type II RAFi naporafenib, which inhibits EphA2-mediated MAPK signaling. Further, naporafenib and …

Mapping The Tar Vrna Interaction With Hiv-1 Integrase, Jian Sun, Rahul Yadav, Tolga Catmakas, Luke Fisher, Nicholas C. Fitzkee, Jacques J. Kessl

Faculty Publications

A series of critical interactions within the viral core between viral RNA (vRNA) and HIV-1 Integrase (IN) has previously been reported. In these studies, contact points between vRNA and IN were identified using RNA-seq and MS-based protein foot-printing approaches. Several IN amino acids located in its C-terminal domain (CTD) were found to be essential for vRNA binding, and their alanine substitution severely impacted the correct morphogenesis of the mature viral core. Here, we have used the TAR element to extend these studies by performing a comprehensive mapping of the interaction by deploying RNA crosslinking and NMR methodologies. Together, these approaches …

Pso-Style Social Influence In An Ant Colony Algorithm For Continuous-Domain Optimization, Ashraf M. Abdelbar, Donald C. Wunsch

Electrical and Computer Engineering Faculty Research & Creative Works

ACOR is a well-established Ant Colony Optimization (ACO) algorithm for continuous-domain optimization. In this paper, we propose an extension (which we call ACOR∗) in which several fundamental modifications are made to ACOR's solution construction process, including the incorporation of a social influence mechanism borrowed from Particle Swarm Optimization (PSO). Our modifications to the ACOR algorithm are intended to promote search diversity and combat premature convergence. We experimentally evaluate our proposal in the context of training feedforward neural networks for classification using 65 widely used datasets from the University of California Irvine (UCI) repository, as well as the optimization of several …

Multiplexed Fabry-Pérot High-Temperature Sensing Based On Dispersive Microwave-Photonic Frequency-Time Domain Analysis, Ruimin Jie, Chen Zhu, Bohong Zhang, Koustav Dey, Jie Huang

Electrical and Computer Engineering Faculty Research & Creative Works

We propose and experimentally demonstrate a multiplexed high-temperature Fabry-Pérot (FP) fiber sensing system interrogated by dispersive microwave-photonic frequency-time domain analysis (DM-FTDA). In the proposed architecture, incoherent broadband probing light is modulated by radio-frequency (RF) signals and then reflected by a parallel network of hollow-core photonic crystal fiber FP (HCPCF-FP) sensors. A chirped fiber Bragg grating provides strong dispersion to map the composite FP spectral response into a well-defined microwave transfer function. Unlike conventional optical Fourier-domain multiplexing that requires deliberate cavity-length allocation, the proposed approach achieves multiplexing via delay-dominated discrimination. Distinct delay fibers are assigned to each sensor branch, and an …

Influences On Growth And Survival Of Seedlings Planted In Black Ash Stands Of Northern Michigan And Wisconsin, Seth W. Davenport, Dustin R. Bronson, Kathryn L. Hofmeister, Randall K. Kolka, Grady J. Boyle, Fengjing Liu

Michigan Tech Publications

The invasive emerald ash borer (Agrilus planipennis) is a threat to all North American ash (genus Fraxinus) trees, but wetland ecosystems dominated by black ash (F. nigra) are of particular concern to land managers. The rapid and extensive death of black ash on the landscape causes unprecedented ecological and hydrological impacts to cascade through the ecosystem. A strategy to combat such impacts and maintain these wetlands as forested is to underplant these stands with seedlings of alternative species that are capable of maturing into canopy trees. This study planted seedlings of seven non-ash tree species in black ash wetlands across …

Satellite-Based Forest Structure Metrics As A Predictive Tool For Biodiversity In Hyperdiverse Tropical Forests: A Test Of The Habitat Heterogeneity Hypothesis In The Tropics, David Luther, Marconi Campos-Cerqueira, Aline Medeiros, Aidan Mccarthy, Emilia Roberts, Xiaoxuan Li, Paulo Bobrowiec, Jared Wolfe, Gabriel Augusto Leite, Tomaz Nascimento De Melo, José W. Ribeiro, Thiago Bicudo, Konrad Wessels

Michigan Tech Publications

Tropical forests hold the most species yet face the greatest threats and knowledge gaps. To improve tropical biodiversity knowledge we combined satellite-based LiDAR with in situ bird, mammal, and acoustic soundscape data, via camera and audio recorders, at the Biological Dynamics of Forest Fragments Project in the Amazon rainforest and tested the habitat heterogeneity-diversity hypothesis as a predictor of alpha diversity in tropical forests. GEDI spaceborne LiDAR was used to assess the predictive power of vertical forest structure on acoustic diversity and species diversity in lowland tropical forests. In 4 months, we detected 201 bird and 35 mammal species representing …

Neuromarketing Research Through The Years: A Bibliometric Review Of Technological Advancements And Multisensory Studies, Md Abu Issa Gazi, Md Mustaqim Roshid, Abdul Waaje, Md Bony Yeamin, Rejaul Karim, Mohammad Bin Amin, Abdul Rahman Bin S. Senathirajah, Judit Oláh

Michigan Tech Publications

The current study examines the changes in neuromarketing studies between 2015 and 2024, particularly in the context of new technologies incorporating multisensory interventions. It attempts to identify significant trends, influential texts, and topical developments that shape the field. A bibliometric method was employed to review 307 publications within the study's framework, using the Scopus database. Bookmarked by methods such as keyword co-occurrence, co-citation, cluster analysis, performance analysis, and science mapping techniques, these are implemented using programs like VOSviewer or Biblioshiny. The results show a significant increase in the number of neuromarketing studies, with notable works from Italy, Spain, and the …

Public Attitudes Toward Cascade Genetic Screening In The United States, Hadley Stevens Smith, Emilie S Zoltick, Madison R Hickingbotham, Emily S Bonkowski, Stacey Pereira, Tara A Lavelle, David L Veenstra, Amy L Mcguire, Katherine E Bonini, Leila Jamal

Center for Medical Ethics and Health Policy Staff Publications

Introduction: After a patient receives genetic test results that indicate an actionable health condition, cascade genetic screening (CGS) is the process of evaluating the patient's relatives for a potentially elevated genetic risk of disease. The United States primarily relies on patients to communicate with their relatives, resulting in suboptimal rates of risk communication, familial genetic testing uptake, and risk-reducing interventions. There is ongoing debate about whether and how best to inform relatives of a potentially increased genetic risk.

Methods: We conducted a nationally representative survey of US adults to assess attitudes toward informing at-risk relatives, acceptability of system-mediated communication, and …

An Obligatory Role For Agrp Neurons In Maintaining Body Temperature During Time-Restricted Feeding, Cunjin Su, Jing Cai, Yuanzhong Xu, Benjamin R Arenkiel, Qingchun Tong

The Brown Foundation: Institute of Molecular Medicine

Homeotherms maintain a steady body temperature through thermoregulation, a process critical for survival during fasting, in which the brain has to defend energy-costly body temperature while reducing energy expenditure to conserve energy reserve; however, the neural basis for defending body temperature remains unclear. Here, we demonstrated that AgRP neuron lesion led to lethality during time-restricted feeding on chow but not on HFD, and caused no obvious impact on HFD-induced obesity or obesity-reducing responses to glucagon-like peptide-1 receptor agonism. The lesion disrupted adaptive feeding behaviors during time-restricted feeding and reduced motivational feeding on chow. Notably, the lethality was caused by hypothermia …

Initial Injury Type And Violent Reinjury, Nicholas Szoko, Daphne Lew, Taylor Kaser, Zoe M Miller, Matt Vogel, Michael A Mancini, Lindsay M Kranker, Christopher Behr, Vicki Moran, Rachel Ancona, Kristen Mueller

Faculty, Staff and Students Publications

Importance: Violent injuries are the leading cause of death among children and young adults in the United States. Violent injury may increase the risk of subsequent injury (ie, violent reinjury), but it is unclear how this risk varies across different injury types (eg, blunt assault, stabbing, firearm).

Objective: To describe patterns of violent reinjury across different injury types to inform tailored prevention strategies.

Design, setting, and participants: This multicenter cohort study included patients who presented with violent injuries to 2 adult and 2 pediatric level I trauma centers in St Louis, Missouri, from January 2016 to December 2023.

Exposures: Violent …

The Who Classification Of Genetic Tumour Syndromes: Considerations For Histopathology, Ian A Cree, Mark J Arends, Joseph D Khoury, Erika Re Denton, Anthony J Gill, Alexander J Lazar, Ian M Frayling, Stefan M Pfister, Mark A Rubin, Katia Rm Leite, Raymond Dalgleish, Elspeth A Bruford, Sharon Plon, Ada Hamosh, Michael Francis Walsh, Gabrielle Goldman-Lévy, Harshima Wijesinghe, William D Foulkes, Dilani Lokuhetty

Faculty, Staff and Students Publications

No abstract provided.

Integrated Proteogenomic And Metabolomic Profiling Of Acute Myeloid Leukemias To Identify Molecular Subtypes And Associated Therapy Targets, Shih-Chun A Chu, Yi Hsiao, Chenwei Wang, Jennifer E Kyle, Raghav Jain, Yamei Deng, Marina A Gritsenko, Leanne E Henry, Jonathan T Lei, Yongchao Dou, Bahar Tercan, Zhiao Shi, Mahnoor N Gondal, Chia-Feng Tsai, John M Elizarraras, Rosalie K Chu, Fengchao Yu, Sunil K Joshi, Xiaojun Jing, Daniel A Polasky, Karl K Weitz, Ginny Xiaohe Li, Vanessa L Paurus, Chaevien S Clendinen, Athena A Schepmoes, Priscila M Lalli, Josie G Eder, Javier E Flores, Kelly G Stratton, James C Pino, Camilo Posso, Vladislav A Petyuk, Tyler J Sagendorf, Yuanwei Xu, Omar M Ibrahim, Ronald J Moore, Rui Zhao, Jin Chen, Matthew E Monroe, Mathangi Thiagarajan, Galen Hostetter, Chelsea Newton, Eunkyung An, Ana I Robles, Xu Zhang, Nathan J Edwards, Yin Lu, Hui Zhang, Haitham Abdelhakim, Paul D Piehowski, Mehdi Mesri, Richard D Smith, Chandan Kumar-Sinha, Cristina E Tognon, Jennifer Dunlap, Elie Traer, Li Ding, Jeffrey W Tyner, Arul M Chinnaiyan, Gilbert S Omenn, Karin D Rodland, Saravana M Dhanasekaran, Sara J C Gosline, Alexey I Nesvizhiskii, Bing Zhang, Tao Liu, Marcin P Cieslik, Clinical Proteomic Tumor Analysis Consortium

Faculty, Staff and Students Publications

Acute myeloid leukemia (AML) is a genetically and phenotypically heterogeneous hematological malignancy. Here, to better define this clinically taxing and translationally challenging malignancy, we applied a multiomics approach, consisting of 13 modalities to analyze 173 treatment-naive individuals with AML. By integrating these 'omes', we identified distinct AML subtypes, genotype-phenotype associations, biomarkers and pathobiological mechanisms. Across the spectrum of primitive and committed AML, we found extensive metabolomic and lipidomic reprogramming driven by divergent MYC and mTOR activity. We linked metabolic changes to striking hyperacetylation of mitochondrial proteins in CEBPA-mutant AML. Protein-centric subtyping revealed a distinct NPM1-mutant subset characterized by outlier expression …

Hospice Enrollments From The Emergency Department Feature Short Admissions And High-Acuity Hospice Care, Helen P Knight, Kourosh Ravvaz, Alexander Fiksdal, Lin Shen, Isaac S Chua, Claire K Ankuda, Haiden A Huskamp, Hojjat Salmasian, Joan M Teno, David W Bates

Faculty, Staff and Students Publications

Medicare beneficiaries frequently visit the emergency department (ED) at the end of life, but little is known about the epidemiology of patients admitted to hospice from the ED. We used 100 percent Medicare fee-for-service claims from the period 2018-20 to describe the frequency of direct ED-to-hospice enrollments, associated patient and hospice agency characteristics, and patient outcomes. In this sample, 4.3 percent of initial enrollments in hospice originated from the ED. ED-to-hospice admissions featured short lengths-of-stay (21.7 percent were two days or less) and high rates of general inpatient level of care at the time of enrollment (23.6 percent). The 10 …

Association Of Infection Frequency And Incident Clonal Hematopoiesis Of Indeterminant Potential, Ajibike Lapite, Vernon A Burk, James Decuir, Junichi Ishigami, Seyedmohammad Saadatagah, Pradeep Natarajan, Christie M Ballantyne, Elizabeth A Platz, Katherine Y King

Faculty, Staff and Students Publications

Clonal hematopoiesis of indeterminant potential (CHIP) is an age-related phenomenon associated with increased risk of hematologic malignancy. Preclinical studies have shown that infection is a driver of CHIP; clinical studies in people living with HIV suggest a relationship between chronic infection and CHIP, but the association between infection frequency and incident CHIP in the general population remains unknown. We leveraged the atherosclerosis risk in communities study to design a closed prospective cohort study. CHIP was determined based on whole-exome sequencing at 2 time points 20 years apart. Included were 3,367 individuals without cancer or CHIP at time 1 and without …

Comparison Of Different “Familial Chylomicronemia Syndrome” Clinical Diagnosis Scoring Systems In Patients With Persistent Chylomicronemia, Diane Brisson, Miriam Larouche, Nathalie Laflamme, Seyedmohammad Saadatagah, Jean Bergeron, Christie M Ballantyne, Daniel Gaudet

Faculty, Staff and Students Publications

Background: Chylomicronemia is associated with extreme hypertriglyceridemia and an increased risk of acute pancreatitis and cardiometabolic complications. Rarely, chylomicronemia persists despite control of secondary causes and conventional treatments. The most severe form of persistent chylomicronemia (PC) is familial chylomicronemia syndrome (FCS). Diagnosis scoring systems have been developed to help clinicians differentiate FCS from other causes of chylomicronemia.

Objective: To assess the ability of FCS diagnosis scoring systems to discriminate FCS from other forms of PC.

Methods: This study included 413 Caucasians presenting a history of chylomicronemia, among whom 65 (15.7%) met the criteria of PC. The performance of 3 FCS …

Use Of Plozasiran Across A Spectrum Of Hypertriglyceridemia: Long-Term Efficacy And Safety Data From The Open-Label Extension Period Of Shasta-2 And Muir Trials, Christie M Ballantyne, Alexis Baass, Robert S Rosenson, Robert A Hegele, Stephen J Nicholls, Szilard Vasas, Peter Clifton, Kathryn J Lucas, Denes Pall, Rong Zhou, Nicholas J Leeper, Jennifer Hellawell, Lalitha Aiyer, Gerald F Watts, Daniel Gaudet

Faculty, Staff and Students Publications

Background: Plozasiran, a hepatocyte-targeted siRNA against apolipoprotein C-III, has demonstrated substantial reductions in triglycerides (TGs) and related atherogenic lipoproteins across a spectrum of hypertriglyceridemia (HTG), leading to its approval for familial chylomicronemia syndrome in the United States, and subsequently in Canada and China. Long-term data suggest maintenance of these effects beyond the blinded treatment periods, supporting further evaluation of plozasiran across a broad spectrum of HTG.

Methods: Safety and efficacy were assessed in this open-label extension (OLE) of two phase 2b, randomized, double-blind trials, SHASTA-2 (n = 229) including patients with severe HTG (TG >500 mg/dL) and MUIR ( …