Digital Commons Network^™

Heart Failure-Type Symptom Scores In Chronic Kidney Disease: The Importance Of Body Mass Index, Nisha Bansal, Vijay Nambi, Harold I Feldman, Michael G Shlipak, Sankar D Navaneethan

Faculty, Staff and Students Publications

Objectives: This analysis sought to determine factors (including adiposity-related factors) most associated with HF-type symptoms (fatigue, shortness of breath, and edema) in adults with chronic kidney disease (CKD).

Background: Symptom burden impairs quality of life in CKD, especially symptoms that overlap with HF. These symptoms are common regardless of clinical HF diagnosis, and may be affected by subtle cardiac dysfunction, kidney dysfunction, and other factors. We used machine learning to investigate cross-sectional relationships of clinical variables with symptom scores in a CKD cohort.

Methods: Participants in the Chronic Renal Insufficiency Cohort (CRIC) with a baseline modified Kansas City Cardiomyopathy Questionnaire …

Azithromycin Use Increases The Risk Of Sudden Cardiac Death In Patients With Hemodialysis-Dependent Kidney Failure, Sana M Al-Khatib, M Alan Brookhart, David J Weber, Wolfgang C Winkelmayer, Jennifer E Flythe

Faculty, Staff and Students Publications

Azithromycin is an antibiotic with QT-prolonging potential commonly prescribed to individuals receiving hemodialysis. Hemodialysis patients have a high prevalence of clinical conditions, such as structural heart disease, that can enhance the pro-arrhythmic effects azithromycin, but were excluded from prior investigations evaluating the cardiac safety of azithromycin. Using data from the United States Renal Data System (2007–2017), we conducted two cohort studies to examine the cardiac safety of azithromycin relative to amoxicillin-based antibiotics (amoxicillin, amoxicillin/clavulanic acid) and levofloxacin (a fluoroquinolone antibiotic known to prolong the QT-interval) in the hemodialysis population. The primary outcome was five-day sudden cardiac death. Using inverse probability …

From World War Ii To Covid-19: A Historical Perspective On The American Medical Supply Chain

Faculty, Staff and Students Publications

COVID-19 is the latest episode of shortages of critical medical supplies. Historically and to the present day, medical supplies have been sourced from single regions in the world, thus rendering the supply chain vulnerable to a myriad of harmful circumstances. We argue that shortages in medications related and unrelated to COVID have illustrated the need for the United States to diversify its medical supply sources before future pandemics, political crises, or natural disasters occur.

The Association Of Baseline Plasma Sars-Cov-2 Nucleocapsid Antigen Level And Outcomes In Patients Hospitalized With Covid-19, Katy Shaw-Saliba, Robin L Dewar, Neil R Aggarwal, Abdel G Babiker, Weizhong Chang, Nila J Dharan, Victoria J Davey, Elizabeth S Higgs, Norman Gerry, Adit A Ginde, J W Awori Hayanga, Helene Highbarger, Jeroen L Highbarger, Mamta K Jain, Virginia Kan, Kami Kim, Perrine Lallemand, Bradley G Leshnower, Joseph K Lutaakome, Gail Matthews, Ahmad Mourad, Eleftherios Mylonakis, Ven Natarajan, Maria L Padilla, Lavannya M Pandit, Roger Paredes, Sarah Pett, Srikanth Ramachandruni, M Tauseef Rehman, Brad T Sherman, D Clark Files, Samuel M Brown, Michael A Matthay, B Taylor Thompson, James D Neaton, H Clifford Lane, Jens D Lundgren

Faculty, Staff and Students Publications

BACKGROUND: Levels of plasma SARS-CoV-2 nucleocapsid (N) antigen may be an important biomarker in patients with COVID-19 and enhance our understanding of the pathogenesis of COVID-19.

OBJECTIVE: To evaluate whether levels of plasma antigen can predict short-term clinical outcomes and identify clinical and viral factors associated with plasma antigen levels in hospitalized patients with SARS-CoV-2.

DESIGN: Cross-sectional study of baseline plasma antigen level from 2540 participants enrolled in the TICO (Therapeutics for Inpatients With COVID-19) platform trial from August 2020 to November 2021, with additional data on day 5 outcome and time to discharge.

SETTING: 114 centers in 10 countries. …

First Steps: Primary Outcomes Of A Randomized, Stepped-Care Behavioral Clinical Trial For Parents Of Young Children With New-Onset Type 1 Diabetes, Tom Hildebrandt, Christine H Wang, John R Barber, Lauren Clary, Katherine Gallagher, Wendy Levy, Fran Cogen, Celia Henderson, Lefkothea Karaviti, Randi Streisand

Faculty, Staff and Students Publications

OBJECTIVE: Despite the emotional challenges of parental adjustment to a child's type 1 diabetes diagnosis and the unique complexities of early childhood, there are few programs designed to meet the needs of parents of young children at new onset. This study evaluated First STEPS (Study of Type 1 in Early childhood and Parenting Support), a stepped-care behavioral intervention designed to support parents' psychosocial functioning and promote children's glycemic outcomes.

RESEARCH DESIGN AND METHODS: Using a two-site randomized clinical trial design, parents (n = 157) of children aged 1-6 years completed baseline data within 2 months of diabetes diagnosis and were …

Multi-Tasking Memcapacitive Networks, Dat Tran, Christof Teuscher

Electrical and Computer Engineering Faculty Publications and Presentations

Recent studies have shown that networks of memcapacitive devices provide an ideal computing platform of low power consumption for reservoir computing systems. Random, crossbar, or small-world power-law (SWPL) structures are common topologies for reservoir substrates to compute single tasks. However, neurological studies have shown that the interconnections of cortical brain regions associated with different functions form a rich-club structure. This structure allows human brains to perform multiple activities simultaneously. So far, memcapacitive reservoirs can perform only single tasks. Here, we propose, for the first time, cluster networks functioning as memcapacitive reservoirs to perform multiple tasks simultaneously. Our results illustrate that …

Reliable Mode Tracking For Gradient-Based Optimization With Dynamic Stability Constraints, Taylor Mcdonnell, Andrew Ning

Faculty Publications

In order to construct mode-specific flutter constraints for use in gradient-based multidisciplinary design optimization frameworks, mode tracking must be used to associate the current iteration's modes with the modes corresponding to each constraint function. Existing mode tracking methods, however, do not provide a method by which to ensure the accuracy of mode associations, making them unsuitable for use in situations where obtaining correct mode associations is critical. To remedy this issue, a new mode tracking method is presented which incorporates backtracking logic in order to maintain an arbitrarily high degree of confidence in mode correlations during gradient-based optimization and/or during …

Youth Transitions Advisory Council 2022 Annual Report, Tennessee. Commission On Children And Youth.

Youth Transitions Advisory Council

No abstract provided.

Screening And Assessment Of Cancer-Related Fatigue: An Executive Summary And Road Map For Clinical Implementation, Joy C. Cohn, Shana Harrington Pt, Ph.D., Jeannette Q. Lee, Daniel Malone, Mary Insana Fisher

Faculty Publications

Background:

Cancer-related fatigue (CRF) prevalence is reported as high as 90%. Cancer-related fatigue is multidimensional and associated with lower health-related quality of life. Effective screening and assessment are dependent upon use of valid, reliable, and clinically feasible measures. This Executive Summary of the Screening and Assessment of Cancer-related Fatigue Clinical Practice Guideline provides recommendations for best measures to screen and assess for CRF based on the quality and level of evidence, psychometric strength of the tools, and clinical utility.

Methods:

After a systematic review of the literature, studies evaluating CRF measurement tools were assessed for quality; data extraction included psychometrics …

Anxiolytics For Bronchodilation: Refinements To Gaba, Ajay P Nayak, Steven S An

Department of Medicine Faculty Papers

No abstract provided.

Radiotherapy For Elderly Patients With Glioblastoma: An Assessment Of Hypofractionation And Modern Treatment Techniques, Jennifer K. Matsui, Jiayi Huang, Et Al.

2020-Current year OA Pubs

Glioblastoma (GBM) is a disease with a poor prognosis. For decades, radiotherapy has played a critical role in the management of GBM. The standard of care radiation prescription is 60 Gy in 30 fractions, but landmark trials have historically excluded patients older than 70 years. Currently, there is considerable variation in the management of elderly patients with GBM. Shortened radiation treatment (hypofractionated) regimens have been explored since conventional treatment schedules are lengthy and many elderly patients have functional, cognitive, and social limitations. Clinical trials have demonstrated the effectiveness of hypofractionated radiotherapy (40 Gy in 15 fractions) to treat elderly or …

Newborn Mid-Upper Arm Circumference Identifies Low-Birth Weight And Vulnerable Infants: A Secondary Analysis, D Taylor Hendrixson, Patrick N Lasowski, Aminata Shamit Koroma, Mark J Manary

2020-Current year OA Pubs

BACKGROUND: Low birth weight (LBW) infants are at increased risk of morbidity and mortality. Identification of LBW may not occur in settings where access to reliable scales is limited. Mid-upper arm circumference (MUAC) may be an accessible, low-cost measure to identify LBW and vulnerable infants.

OBJECTIVES: We explored the validity of newborn MUAC in identifying LBW and vulnerable newborns in rural Sierra Leone.

METHODS: This study was a secondary analysis of infant data from a randomized controlled clinical trial of supplementary food and anti-infective therapies compared with standard care for undernourished pregnant women. Data for singleton liveborn infants with birth …

Targeting Pim2 By Jp11646 Results In Significant Antitumor Effects In Solid Tumors, Eriko Katsuta, Malgorzata Gil-Moore, Justine Moore, Mohamed Yousif, Alex A Adjei, Yi Ding, Justin Caserta, Carmen M Baldino, Kelvin P Lee, Irwin H Gelman, Kazuaki Takabe, Mateusz Opyrchal

2020-Current year OA Pubs

Proviral integration of Moloney virus 2 (PIM2) is a pro‑survival factor of cancer cells and a possible therapeutic target in hematological malignancies. However, the attempts at inhibiting PIM2 have yielded underwhelming results in early clinical trials on hematological malignancies. Recently, a novel pan‑PIM inhibitor, JP11646, was developed. The present study examined the utility of targeting PIM2 in multiple solid cancers and investigated the antitumor efficacy and the mechanisms of action of JP11646. When PIM2 expression was compared between normal and cancer tissues in publicly available datasets, PIM2 was found to be overexpressed in several types of solid cancers. PIM2 ectopic …

Multi-Modulated Frequency Domain High Density Diffuse Optical Tomography, Guy A. Perkins, Adam T. Eggebrecht, Hamid Dehghani

2020-Current year OA Pubs

No abstract provided.

Paediatrician's Guide To Post-Operative Care For Functionally Univentricular Chd: A Review, Christina Ronai, Sarosh P Batlivala, Quang-Tuyen Nguyen, Markus S Renno, Lindsay Arthur, Julie Glickstein, Jonathan N Johnson, Jacob R Miller, Carolyn A Altman, Elif Seda Selamet Tierney

2020-Current year OA Pubs

IMPORTANCE: Single ventricle CHD affects about 5 out of 100,000 newborns, resulting in complex anatomy often requiring multiple, staged palliative surgeries. Paediatricians are an essential part of the team that cares for children with single ventricle CHD. These patients often encounter their paediatrician first when a complication arises, so it is critical to ensure the paediatrician is knowledgeable of these issues to provide optimal care.

OBSERVATIONS: We reviewed the subtypes of single ventricle heart disease and the various palliative surgeries these patients undergo. We then searched the literature to detail the general paediatrician's approach to single ventricle patients at different …

A Saturated Map Of Common Genetic Variants Associated With Human Height, Loïc Yengo, E Warwick Daw, Lihua Wang, Mary F. Feitosa, Michael A. Province, Dabeeru C. Rao, Adam E. Locke, Et Al.

2020-Current year OA Pubs

No abstract provided.

Quantitative Single-Cell Analysis Of Leishmania Major Amastigote Differentiation Demonstrates Variably Extended Expression Of The Lipophosphoglycan (Lpg) Virulence Factor In Different Host Cell Types, Michael A. Mandell, Wandy L. Beatty, Stephen M. Beverley

2020-Current year OA Pubs

Immediately following their deposition into the mammalian host by an infected sand fly vector, Leishmania parasites encounter and are engulfed by a variety of cell types. From there, parasites may transit to other cell types, primarily macrophages or dendritic cells, where they replicate and induce pathology. During this time, Leishmania cells undergo a dramatic transformation from the motile non-replicating metacyclic stage to the non-motile replicative amastigote stage, a differentiative process that can be termed amastigogenesis. To follow this at the single cell level, we identified a suite of experimental 'landmarks' delineating different stages of amastigogenesis qualitatively or quantitatively, including new …

The Inner Nuclear Membrane Protein Nemp1 Supports Nuclear Envelope Openings And Enucleation Of Erythroblasts, Didier Hodzic, Jun Wu, Karen Krchma, Andrea Jurisicova, Yonit Tsatskis, Yijie Liu, Peng Ji, Kyunghee Choi, Helen Mcneill

2020-Current year OA Pubs

Nuclear envelope membrane proteins (NEMPs) are a conserved family of nuclear envelope (NE) proteins that reside within the inner nuclear membrane (INM). Even though Nemp1 knockout (KO) mice are overtly normal, they display a pronounced splenomegaly. This phenotype and recent reports describing a requirement for NE openings during erythroblasts terminal maturation led us to examine a potential role for Nemp1 in erythropoiesis. Here, we report that Nemp1 KO mice show peripheral blood defects, anemia in neonates, ineffective erythropoiesis, splenomegaly, and stress erythropoiesis. The erythroid lineage of Nemp1 KO mice is overrepresented until the pronounced apoptosis of polychromatophilic erythroblasts. We show …

Choline, Dha, And Diarrheal Disease Associated With Growth Faltering In A Case-Control Study, Jenna N Diaz, Sherlie Jean Louis Dulience, Noah Wolthausen, Xuntian Jiang, Emmanuel Gyimah, Francesca J Marhône Pierre, F Matthew Kuhlmann, Lora L Iannotti

2020-Current year OA Pubs

BACKGROUND: Children with recurrent infectious diarrhea are susceptible to growth faltering. DHA and choline may play a role in this relationship due to their involvement in lipid metabolism, gut immunity, and inflammatory pathways.

OBJECTIVES: This study aimed to characterize the contributions made by DHA and choline status and enteric damage in young children in the association between diarrheal illness and child growth.

METHODS: A longitudinal case-control study was conducted among children aged 6-36 mo (

RESULTS: At baseline, mean plasma DHA concentrations (1.03 µg/mL; 95% CI: 0.91, 1.15) were not significantly different between cases and controls, nor was there a …

Impact Of Updated Clinical Practice Guidelines On Outpatient Treatment For Clostridioides Difficile Infection And Associated Clinical Outcomes, Erik R Dubberke, Justin T Puckett, Engels N Obi, Sachin Kamal-Bahl, Kaushal Desai, Bruce Stuart, Jalpa A Doshi

2020-Current year OA Pubs

BACKGROUND: The 2017 Infectious Diseases Society of America/Society for Healthcare Epidemiology of America (IDSA/SHEA)

METHODS: A pre-post study design was employed using Medicare data. CDI treatment utilization and clinical outcomes (4- and 8-week sustained response, CDI recurrence) were compared between patients indexed from April-September 2017 (preguideline period) and those indexed from April-September 2018 (postguideline period). Clinical outcomes associated with fidaxomicin versus vancomycin were compared using propensity score-matched analyses.

RESULTS: From the pre- to postguideline period, metronidazole use decreased (initial CDI: 81.2% to 53.5%; recurrent CDI: 49.7% to 27.6%) while vancomycin (initial CDI: 17.9% to 44.9%; recurrent CDI: 48.1% to 66.4%) …

Health-Related Quality Of Life In Older Patients With Heart Failure From Before To Early After Advanced Surgical Therapies: Findings From The Sustain-It Study, Kathleen L. Grady, Justin Hartupee, Et Al.

2020-Current year OA Pubs

BACKGROUND: Restoring health-related quality of life (HRQOL) is a therapeutic goal for older patients with advanced heart failure. We aimed to describe change in HRQOL in older patients (60-80 years) awaiting heart transplantation (HT) with or without pretransplant mechanical circulatory support (MCS) or scheduled for long-term MCS, if ineligible for HT, from before to 6 months after these surgeries and identify factors associated with change.

METHODS: Patients from 13 US sites completed the EuroQol 5-dimension 3L questionnaire and Kansas City Cardiomyopathy Questionnaire-12 at baseline and 3 and 6 months after HT or long-term MCS. Analyses included univariate comparisons and multivariable …

The Gut Microbial Metabolic Capacity Of Microbiome-Humanized Vs. Wild Type Rodents Reveals A Likely Dual Role Of Intestinal Bacteria In Hepato-Intestinal Schistosomiasis, Alba Cortés, John Martin, Bruce A. Rosa, Klara A. Stark, Simon Clare, Catherine Mccarthy, Katherine Harcourt, Cordelia Brandt, Charlotte Tolley, Trevor D. Lawley, Makedonka Mitreva, Matthew Berriman, Gabriel Rinaldi, Cinzia Cantacessi

2020-Current year OA Pubs

Increasing evidence shows that the host gut microbiota might be involved in the immunological cascade that culminates with the formation of tissue granulomas underlying the pathophysiology of hepato-intestinal schistosomiasis. In this study, we investigated the impact of Schistosoma mansoni infection on the gut microbial composition and functional potential of both wild type and microbiome-humanized mice. In spite of substantial differences in microbiome composition at baseline, selected pathways were consistently affected by parasite infection. The gut microbiomes of infected mice of both lines displayed, amongst other features, enhanced capacity for tryptophan and butyrate production, which might be linked to the activation …

January 6, Ambiguously Inciting Speech, And The Overt-Acts Rule, Alan Z. Rozenshtein, Jed Handelsman Shugerman

Faculty Scholarship

A prosecution of Donald Trump for his role in the January 6 attack on the Capitol would have to address whether the First Amendment protects the inflammatory remarks he made at the “Stop the Steal” rally. A prosecution based solely on the content of Trump’s speech—whether for incitement, insurrection, or obstruction—would face serious constitutional difficulties under Brandenburg v. Ohio’s dual requirements of intent and likely imminence. But a prosecution need not rely solely on the content of Trump’s speech. It can also look to Trump’s actions: his order to the remove the magnetometers from the entrances to the rally and …

Overcoming The Peremptory's Greatest Challenge, Brian A. Wilson

Faculty Scholarship

Four decades after the Supreme Judicial Court ("SJC") first proscribed certain group-based peremptory challenges, eradicating unlawful discrimination in jury selection has gained renewed interest. Yet so long as Massachusetts retains the inherently flawed three-step "Batson-Soares" test, lawyers seeking to exclude jurors for impermissible reasons will proceed virtually undeterred.

The solution is not to abolish peremptory challenges, as Arizona did in 2022. When exercised lawfully, they enable litigants to remove jurors they legitimately perceive as biased where a challenge for cause, due to its narrow scope, legally cannot. Eliminating peremptories would provide the parties little opportunity to influence who decides the …

Friends, Foes, Or Fellow-Travelers: Italian Fascism And The Catholic Church, Cale Gressman

Armstrong Undergraduate Journal of History

What was the relationship between Italian Fascism and the Catholic Church? Drawing on both primary sources including speeches, encyclical letters, and newspaper articles and significant amounts of secondary sources, this paper argues that the relationship between the two factions was one of “cohabitation” with both sides cooperating in areas of mutual interest, such as solving the Roman Question, anti-Bolshevism, and the maintenance of traditional family and gender values. Overall, the Catholic Church can be described as “fellow-travelers” with Italian Fascism.

Gray Counters For Non-Volatile Memories, Arockia David Roy Kulandai, John Rose, Thomas Schwarz

Computer Science Faculty Research and Publications

New technologies for non-volatile memories combine the speed and byte addressability of current memory technologies with the low cost, density, and non-volatility of current storage technologies. They use energy only when writing or reading data. While some newer technologies have practically unlimited endurance, others, such as Phase Change Memory do not. However, this limited endurance surpasses that of solid state drives by several orders of magnitude. They can be integrated into the current memory storage hierarchy as a replacement for DRAM. To manage limited endurance, age-based wear leveling divides the memory into pages and counts the number of writes to …

Comments On Preliminary Draft 8 [Black Letter And Comments], Jane C. Ginsburg

Faculty Scholarship

PD8 represents a great deal of labor, for which the Reporters deserve recognition. As detailed below, however, PD8’s occasional departures from or omissions of statutory text may not only be misleading or confusing, but – as has been the case with prior drafts – often have the result, if not the purpose, of whittling down the scope of copyright protection. In addition to identifying those instances and explaining their consequences, the following comments will suggest clarifications to some of the Comments and Illustrations.

Herbicide Spray Drift From Ground And Aerial Applications: Implications For Potential Pollinator Foraging Sources, Thomas R. Butts, Bradley K. Fritz, K. Badou-Jeremie Kouame, Jason K. Norsworthy, L. Tom Barber, W. Jeremy Ross, Gus M. Lorenz, Benjamin C. Thrash, Nicholas R. Bateman, John J. Adamczyk

Crop, Soil and Environmental Sciences Faculty Publications and Presentations

A field spray drift experiment using florpyrauxifen-benzyl was conducted to measure drift from commercial ground and aerial applications, evaluate soybean [Glycine max (L.) Merr.] impacts, and compare to United States Environmental Protection Agency (US EPA) drift models. Collected field data were consistent with US EPA model predictions. Generally, with both systems applying a Coarse spray in a 13-kph average wind speed, the aerial application had a 5.0- to 8.6-fold increase in drift compared to the ground application, and subsequently, a 1.7- to 3.6-fold increase in downwind soybean injury. Soybean reproductive structures were severely reduced following herbicide exposure, potentially negatively …

Psychiatric Polygenic Risk Scores: Child And Adolescent Psychiatrists’ Knowledge, Attitudes, And Experiences, Stacey Pereira, Katrina A Muñoz, Brent J Small, Takahiro Soda, Laura N Torgerson, Clarissa E Sanchez, Jehannine Austin, Eric A Storch, Gabriel Lázaro-Muñoz

Center for Medical Ethics and Health Policy Staff Publications

Psychiatric polygenic risk scores (PRS) have potential utility in psychiatric care and prevention, but there are concerns about their implementation. We surveyed 960 US-based practicing child and adolescent psychiatrists' (CAP) about their experiences, perspectives, and potential uses of psychiatric PRS. While 23% of CAP reported that they had never heard of PRS, 10 % of respondents have had a patient/family bring PRS to them and 4% have generated PRS for patients. Though 25% stated they would request PRS if a patient/caregiver asked, 35% indicated that nothing would prompt them to request PRS. Most respondents (54%) believed psychiatric PRS are currently …

Potential Interactions Between Cerebellar Dysfunction And Sleep Disturbances In Dystonia, Luis E Salazar Leon, Roy V Sillitoe

Duncan NRI Faculty and Staff Publications

Dystonia is the third most common movement disorder. It causes debilitating twisting postures that are accompanied by repetitive and sometimes intermittent co- or over-contractions of agonist and antagonist muscles. Historically diagnosed as a basal ganglia disorder, dystonia is increasingly considered a network disorder involving various brain regions including the cerebellum. In certain etiologies of dystonia, aberrant motor activity is generated in the cerebellum and the abnormal signals then propagate through a "dystonia circuit" that includes the thalamus, basal ganglia, and cerebral cortex. Importantly, it has been reported that non-motor defects can accompany the motor symptoms; while their severity is not …