Medicine and Health Sciences Commons^™

Dna Methylation Is Associated With Von Willebrand Factor And Coagulation Factor Viii Plasma Levels: The Atherosclerosis Risk In Communities Study, Julie Hahn, Jan Bressler, Myriam Fornage, Eric Boerwinkle, Nicholas L Smith, Alanna C Morrison, Paul S De Vries

Faculty, Staff and Student Publications

Background: Limited information is available on how DNA methylation of cytosine-phosphate-guanine (CpG) sites across the genome regulate circulating von Willebrand Factor (VWF) and factor VIII (FVIII) levels.

Methods: We performed an epigenome-wide association study to examine the association of leukocyte DNA methylation levels at 483,735 CpG sites with VWF antigen plasma levels and FVIII activity in 2,597 Black and 1,011 White participants from the Atherosclerosis Risk in Communities (ARIC) study. VWF antigen levels and FVIII activity were measured at the baseline exam, while DNA methylation was measured with the Infinium HumanMethylation450 BeadChip array at visit 2 or 3. Discovery analysis …

Pediatric H3 G34-Mutant Diffuse Hemispheric Glioma: Clinical, Imaging And Molecular Prognostic Factors, Mgmt Expression, And Temozolomide Response., Dana Tlais, Qunyu Zhang, Jordan T. Roach, Christopher L. Tinkle, Tong Lin, Xiaoyu Li, Ayatullah Mostafa, Daniel C. Moreira, Rene Y. Mcnall-Knapp, Sarah Z. Rush, Brian H. Le, Sara Sinno, Apeksha Ramnarayan, Kevin Ginn, Sonia Partap, Arzu Onar-Thomas, Larissa V. Furtado, Asim K. Bag, Jason Chiang

Manuscripts, Articles, Book Chapters and Other Papers

Previous studies have demonstrated poor outcomes in pediatric patients with H3 G34-mutant diffuse hemispheric glioma (DHG). However, the biological basis for this therapeutic resistance remains poorly understood. Furthermore, the effectiveness of temozolomide (TMZ) and the role of surgery in pediatric patients remain uncertain. Therefore, we performed a multi-institutional retrospective analysis of the clinical, imaging, and molecular characteristics of 36 pediatric (≤ 18 years) patients with newly diagnosed H3 G34-mutant DHG. The median age of the cohort was 14 years (8-18 years). The median progression-free survival (PFS) was 0.7 years (95% CI 0.4-1.2 years), and the median overall survival (OS) was …

Nursing Practice In Cancer Treatment Decision Making Among Older Adults: A Scoping Review On Behalf Of The International Society Of Geriatric Oncology Nursing, Allied Health, And Scientists Interest Group, Fay J. Strohschein, Hanneke Van Der Wal-Huisman, K. Alix Hayden, Kristen R. Haase, Michelle Hannan, Cindy Kenis, Juan Li, Nikita Nikita, Sophie Pilleron, Tracy Ruegg, Heike Schmidt, Anke Steckelberg, Cassandra Vonnes, Martine Puts

Department of Medical Oncology Faculty Papers

INTRODUCTION: Cancer treatment decision making (CTDM) presents important challenges among older adults due to variation in health and functional status, presence of comorbidities, differing goals/values, quality and quantity of life considerations, and limited inclusion in clinical trials. Nursing standards and guidelines call for competence in supporting CTDM and nurses advocate for greater involvement. However, clear understanding of the existing evidence to inform nursing practice is lacking. We aimed to map and synthesize evidence that provides insight into nursing practice in CTDM among older adults, with attention to nursing roles, required skills and competencies, potential barriers and facilitators, and outcomes studied. …

An Ai Approach To Differentiating Lung Squamous Cell Carcinoma From Metastases Of Other Origins, Mark G Evans, Jennifer Ribeiro, Todd Maney, Anthony Helmstetter, Jennifer Johnson, Anthony Karnezis, Casey Bales, George Sledge, David Spetzler, Ari Vanderwalde, Matthew Oberley, Balazs Halmos, Hossein Borghaei, Farah Abdulla, David Bryant, Fred Hirsch, Hassan Ghani

Department of Medical Oncology Faculty Papers

IMPORTANCE: Distinguishing primary lung squamous cell carcinoma (SCC) from squamous metastases to the lung is a clinical challenge due to histopathologic similarities. Accurate diagnosis is essential to guide treatment decisions.

OBJECTIVE: To assess the utility of an artificial intelligence (AI) approach that includes evaluation of key orthogonal evidence in distinguishing primary lung SCCs from metastatic tumors of other tissue origins.

DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study used GPSai, a tissue-of-origin AI model run automatically on each sample submitted for molecular profiling, to flag potential misdiagnoses among research-eligible cases submitted as lung SCC. Molecularly profiled cases within the Caris Life …

Population Analysis And Immunologic Landscape Of Melanoma In People Living With Hiv, Lindsay Barger, Derek Wang, Ashley Saravia, Valeria Mezzano, Gyles Ward, Cynthia Loomis, Carly Feldman, Madalina Tuluc, Rino Seedor, Peter Gaskill, Anna Coghill, Gita Suneja, Iman Dehzangi, Jennifer Hope, George Jour, Gabriele Romano

Department of Medical Oncology Faculty Papers

PURPOSE: To dissect the clinical and immunologic features of people living with human immunodeficiency virus (HIV; PLWH) diagnosed with melanoma, who have consistently shown worse outcomes than HIV-negative individuals (PLw/oH) with the same cancer.

EXPERIMENTAL DESIGN: We analyzed electronic health records from 1,087 PLWH and 394,437 PLw/oH with melanoma. Demographic and clinical characteristics were compared. Spatial immune transcriptomics (72 immune-related genes) was performed on melanoma tumor samples (n = 11), with downstream validation using multiplex immunofluorescence (mIF; n = 15 PLWH, n = 14 PLw/oH).

RESULTS: PLWH were diagnosed at a younger age, had a greater representation of Hispanic and …

Editorial: Clinical Imaging, Neurophysiological, Neuropathology And Neuroethics Studies On Disorders Of Consciousness, Coma Mechanisms, And Theories Of Consciousness: A Unifying Attempt, Diego Iacono, Manuel Trachsel, Thanh Phan, Charlène Aubinet

Department of Neurology Faculty Papers

No abstract provided.

Regulating Ai In Pediatrics-Is Transparency Enough?, R Brandon Hunter, Kolaleh Eskandanian, Chester J Koh

Faculty, Staff and Students Publications

No abstract provided.

Activin A Secretion By Muscle-Repairing Macrophages Induces Heterotopic Ossification In Mice, Wenqiang Yin, Kazuo Okamoto, Asuka Terashima, Warunee Pluemsakunthai, Takehito Ono, Taku Ito-Kureha, Shizuo Akira, Yoshinobu Hashizume, Roland Baron, Satoshi Ueha, Kouji Matsushima, Martin M Matzuk, Yuji Mishina, Hiroshi Takayanagi

Faculty, Staff and Students Publications

The immune system is not only essential for host defense, but it is also involved in tissue maintenance and disease pathogenesis. Macrophages play a key role in tissue repair, fibrosis, and tumorigenesis, but the mechanisms underlying their multifunctionality have not been fully explored. Here, we identified Mrep (Ly6ChiCX3CR1loPDPN+CD9+) as a crucial subset of macrophages for muscle regeneration after muscle injury. Muscle regeneration required Mrep-derived activin A, which was produced via the TLR4/TIR domain-containing adapter-inducing interferon-β/TANK-binding kinase 1/interferon regulatory factor 3/7 signaling pathway in response to muscle injury. Mrep exerted pathological effects by secreting activin A in a model of genetically …

Cell Type-Specific Gene Regulatory Atlas Prioritizes Drug Targets And Repurposable Medicines In Alzheimer's Disease, Yunxiao Ren, Ming Hu, Yang E Li, Andrew A Pieper, Jeffrey Cummings, Feixiong Cheng

2020-Current year OA Pubs

Alzheimer's disease (AD) is a complex and poorly understood neurodegenerative disorder that lacks sufficiently effective treatments. Computational and integrative analyses that leverage multiomic data provide a promising strategy to uncover disease mechanisms and identify therapeutic opportunities. Here, we develop a cell type-specific regulatory atlas of the human middle temporal gyrus via leveraging single-nucleus RNA-seq (1,197,032 nuclei) and ATAC-seq (740,875 nuclei) data sets from 84 donors across four stages of AD neuropathological change (ADNC). We observe differential gene expression for six major cell types intensified at severe ADNC. Integrating peak-to-gene linkages and motif enrichment analyses, we reconstruct transcription factor (TF)-target gene …

Building Capacity On Hypertension Management In Nigeria, Shivani Mishra, Daphne Lew, Et Al.

2020-Current year OA Pubs

No abstract provided.

Shiga Toxin-Producing Escherichia Coli Outbreak In Canadian Daycare Centers, Mohamed Eltorki, Oluwatimilehin O Ajayi, Jina Seok, Jianling Xie, Francesco A Rizzuti, Byron M Berenger, Phillip I Tarr, Andrew T Pavia, Kate Snedeker, Silviu Grisaru, Otto G Vanderkooi, Linda Chui, Gillian A M Tarr, Gemma Vomiero, Stephen B Freedman

2020-Current year OA Pubs

IMPORTANCE: Shiga toxin-producing Escherichia coli (STEC) infections have significant morbidity, with 15% to 20% of children developing hemolytic uremic syndrome (HUS), more than half of whom require kidney replacement therapy (KRT).

OBJECTIVE: To describe health care resource utilization, clinical outcomes, and outcomes associated with daily laboratory monitoring for thrombotic microangiopathy (TMA) in a large point-source STEC outbreak.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study was conducted among a population-based cohort of individuals exposed to a contaminated food item served in 11 childcare centers in Calgary, Alberta, Canada, on August 29, 2023. Children and adults with confirmed STEC infection linked …

Trends In Mammography Use Among Women Aged 40 To 74 Years In The Us, 2002-2022, Syed Mahfuz Al Hasan, Debbie L Bennett, Adetunji T Toriola

2020-Current year OA Pubs

IMPORTANCE: Understanding how prior policies, systemic factors, and public health events have shaped mammography use among US women is essential for interpreting the 2024 US Preventive Services Task Force (USPSTF) recommendation update and identifying gaps to inform equitable public health strategies.

OBJECTIVE: To analyze mammography use trends in US women aged 40 to 49 and 50 to 74 years from 2002 to 2022 and assess variation by sociodemographic, health care access, behavioral, and geographic factors, including associations with the 2009 USPSTF recommendation and the COVID-19 pandemic.

DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study used data from the Behavioral Risk Factor …

Media Reporting Of The 2024 Us Preventive Services Task Force Mammography Guideline Update, Tamar Parmet, Yue Li, Joseph Cappella, Laura D Scherer, Erika A Waters, Ashley J Housten

2020-Current year OA Pubs

No abstract provided.

The Relationship Between Apparent Potentiation And The Magnitude Of The Control Response, Joe Henry Steinbach, Gustav Akk

2020-Current year OA Pubs

The effect of a potentiating drug on ion channel function is typically evaluated by comparing current responses to the control agonist in the presence and absence of the potentiator. Differences in ratios of responses are then taken as proof of distinct potentiation properties when comparing modulation by different compounds. In these experiments, the concentration of the agonist is typically kept low to generate a small fractional control response. The precise relative magnitude of the control response is, however, not standardized among labs and can range from a concentration producing a response equal to just 2% of maximal (EC2) to over …

Trends And Outcomes Of Alcoholic Acute Pancreatitis In Patients With Alcohol Use Disorder Treated With Naltrexone In The United States: Before And After The Covid-19 Pandemic, Mohammad Zaahid Sheriff, Adrian Lindsey

Faculty Scholarship

Background: The role of naltrexone in improving acute alcoholic pancreatitis (AAP) outcomes in alcohol use disorder (AUD) patients, remains unclear. Aim: We aimed to assess the temporal trends in AAP incidence and the impact of naltrexone use on clinical outcomes in AUD patients. Methods: We conducted a retrospective cohort study using de-identified patient data from the TriNetX database, including all adults (≥ 18 years) diagnosed with AUD. AAP patients were then identified and stratified by naltrexone exposure. The incidence and prevalence of AAP in AUD patients were assessed pre-(March 2015–2019) and post-COVID-19(March 2020–2025). Propensity score matching (PSM) (1:1) was performed …

Study Summary: Exploring Safe & Effective Interpreter Output Ofyoga Concepts In Asl, Dixie Schexnaildre Dhsc

JADARA

Yoga can support mental health, recovery, and provide positive coping strategies. Where language inequities impede access for Deaf individuals, interpreters are thought to facilitate communication. However, the percentage of interpreters trained in safe, effective, or non-triggering yoga interpretation is unknown. Using background and frequency data, this précis of a lengthy descriptive project highlights barriers to yoga programming for the Deaf community. A central finding is only 33% (n = 7) of interpreters had training to ensure emotional and physical safety to yoga participants. While results are assessed cautiously, lack of interpreter training may add to health and recovery programming inequities.

Diagnostic Trends And Service Enhancements In Deaf Mental Health: A Longitudinal Analysis, Kent Schafer, Steve Hamerdinger, Frank Wu, Rie Sakai Bizmark, Charlene Crump

JADARA

A longitudinal study investigated mental health diagnostic trends and patterns among Deaf and Hearing individuals using a comprehensive dataset from Alabama Department of Mental Health spanning 2004-2024 (Deaf=4,547; Hearing=2,056,188). Chi-square analysis revealed significant proportional differences in diagnoses between the groups. Deaf individuals showed significantly higher proportions of psychotic (12.93% vs. 8.33% Hearing), mood (20.76% vs. 18.84% Hearing), and personality (0.58% vs. 0.43% Hearing) disorders. These findings suggest that increased access to specialized and competent mental health services for individuals who are Deaf, particularly following the increase of staffing patterns for the Office of Deaf Services in 2015,contributed to more accurate …

Staying Strong In Practice: Reducing Musculoskeletal Risks In Dentistry, Leslie Hovda Dpt

Metro Denver Dental Society Articulator Magazine

Dentistry’s physical demands and static postures put providers at high risk for musculoskeletal disorders (MSDs), especially in the back, neck, shoulders and wrists. This article Dr. Leslie Hovda, outlines practical ways to reduce strain through proper equipment use, posture optimization and preventive self-care. Applying the “MEDS” approach: mindfulness, exercise, diet, and sleep, can extend career longevity for dental professionals.

The Next Step In Oral Systemic Health: Educating The Public, Gary Pickard

Metro Denver Dental Society Articulator Magazine

Oral inflammation contributes to eight of the ten leading causes of death in the U.S., highlighting the need to integrate oral health into overall healthcare. Despite strong evidence linking gum disease to diabetes, heart disease, and Alzheimer’s, public awareness remains low. This article urges dental professionals to promote preventive care through patient education, saliva and blood pressure screenings and partnerships with medical providers. Initiatives by MDDS and RMDC show how integrated care can improve early detection and overall health outcomes.

Articulator Volume 32, Issue 1

Metro Denver Dental Society Articulator Magazine

The 1st Quarter 2026 issue features articles highlighting insights from the 2026 Rocky Mountain Dental Convention (RMDC) and perspectives on the evolving dental profession. Articles include:

• A reflection from Dr. Byran Savage on this year’s RMDC, celebrating education, innovation and professional connection.
  
  
• Practical strategies from physical therapist, Dr. Leslie Hovda, for reducing musculoskeletal strain and improving ergonomic health for dental professionals.
  
  
• An article from Mr. Gary Pickard of PDS Health exploring the critical link between oral and systemic health and how integrated care can improve chronic disease prevention.
  
  
• Guidance from Ms. Katherine Eitel Belt on having courageous, constructive conversations to …

Update On Colorado Non-Compete Agreements For Dentists, Josh Austin

Metro Denver Dental Society Articulator Magazine

Colorado’s Senate Bill 25-083 (SB 83) makes non-compete and non-solicitation agreements unenforceable for associate dentists, regardless of compensation. While non-competes tied to the sale of a dental practice or minority ownership remain valid if reasonable, most employment-based restrictions are now void. The law also preserves dentists’ rights to inform patients of their new practice and maintains penalties for non-compliance.

The Impact Of Human Myoblasts On Macrophage Polarization In A Coculture Model, Elisabeth Ann Stodola

Biomedical Engineering

Peripheral Artery Disease (PAD) is characterized by the buildup of atherosclerotic plaque in the lower extremities that occludes blood flow, and affects over 200 million people worldwide. Without effective treatment, PAD can lead to claudication, ischemia, ulcers, and gangrene. PAD causes more amputations in the United States than any other condition, and for severe cases that require revascularization, procedures benefit fewer than 50% of patients. This demonstrates a clear need for alternative therapies. Potential therapies for PAD target expansion of collateral blood vessels around the area of occlusion – a process called arteriogenesis to compensate for loss of blood flow …

When A Man Is Stressed, It Replicates In The House”: Kenyan Women’S Perspectives On The Influence Of Male Partners On Perinatal Mental Health Among Women Affected By Hiv, Hellen Moraa, Joan Mutahi, Winnie Atieno, Grace John-Stewart, John Kinuthia, Manasi Kumar, Mary Marwa, Ben Odhiambo, Felix Abuna, Jillian Pintye

Institute for Human Development, East Africa

Mental health conditions are a major public health concern in the African region, where women experience a high prevalence of maternal mental health conditions and limited access to adequate care. This issue is particularly severe among women living with HIV (WLHIV), who face a heightened risk of depression and anxiety. Despite the well-documented association between male partner-related factors and maternal/child health outcomes, their impact on perinatal mental health from the perspective of women is not well understood. We conducted semi-structured interviews and focus group discussions with women affected by HIV. Thematic analysis revealed common sources of mental distress they experienced. …

Clinical Validation Of Targeted Somatic Structural Variant Detection In Pediatric Cancer Via Long-Read Sequencing, Aravindh Nagarajan, Byunggil Yoo, Emily Farrow, John Herriges, Lei Zhang, Elena Repnikova, Tomi Pastinen, Carol J. Saunders, Midhat Farooqi, Lisa Lansdon

Posters

Introduction: Structural variants (SVs) leading to gene fusions are one of the most common classes of driver mutations in pediatric cancer. Clinical SV detection relies on a combination of techniques including karyotyping, FISH, microarray and RNA fusion testing, and, more recently, optical genome mapping. SV detection via long-read genome sequencing (lr-GS) offers the advantage of breakpoint and complex event resolution; however, its implementation has been limited by the lack of an optimized somatic SV caller, among other factors. Here we describe the clinical validation of lr-GS for targeted somatic SV detection in pediatric cancer using Severus, a newly available somatic …

Lessons Learned: Targeted Rna Sequencing As A Tool For Resolving Variants Of Uncertain Significance, Allison Kalinousky, Vitoria Paolillo, Florencia Del Viso, Elena Repnikova, Ana S A Cohen, Joseph Alaimo, Emily Farrow, Carol J. Saunders, Isabelle Thiffault

Posters

Our study demonstrated the utility of RNA studies in providing sufficient evidence to reinterpret VUS in a small cohort of clinically diverse pediatric patients who received ES/GS-based testing. Fifteen patients (68%) received an updated clinical report. Notably, in 59% the RNAseq data resulted in a molecular diagnosis. Moreover, ~47% of our positive variants were not located at splicing junctions, and therefore, would most likely not be flagged as a likely candidate in ES/GS analysis pipelines. While most variants with low TPM in blood failed, two positive variants had TPM less than 0.1, indicating that while TPM values can help narrow …

Stress Management And Resilience Among Students Enrolled In The Entry Level Master Of Science In Nursing (Elmsn) Program, Pius Omolewa, Adekemi Adedipe, Nassrine Noureddine, Destiny Roberts

All Faculty Scholarship

Objectives: The aim of the study was to evaluate the effect of mindfulness exercises on stress management and resilience among ELMSN students. Methods: The study was a quasi-experimental design that used a paired samples t-test to compare pre-test and post-test of students’ scores on both GAD-7 anxiety screening tool and short version of Grit-scale. Statistical tests were conducted with significance set at p < 0.05 (two-sided). All analyses were performed using IBM SPSS Statistics, version 31.0 to compare pre-/post-test scores, determine differences, and statistical significance of interventions among the cohort. And a priori power analysis was conducted to determine the required sample size for a paired samples t-test. With an alpha level of 0.05 and a medium effect size (Cohen’s d = 0.50), a total sample size of N = 34 was determined to be sufficient to achieve a power of 0.80. Results: A convenience sample of 40 students (35 females and 5 males) participated in the study. Students had more anxiety before mindfulness exercises (M = 7.00, SD = 5.5) compared to after the mindfulness exercises (M = 6.2, SD = 3.4), t(39) = 1.41, p = 0.17. The effect size was small, d = 0.22. However, the difference in the students’ anxiety levels after the mindfulness exercises was not statistically significant, with a p-value of 0.17. On the resilience, students were less resilient before mindfulness exercises (M = 3.58, SD …

The Use Of High-Fidelity Simulation In Pre-Licensure Nursing Programs: A Systematic Review, Pius Omolewa, John Bressan, Feng Ping Sarah Lee

All Faculty Scholarship

Aim: This study aimed to evaluate the effectiveness of high-fidelity simulation in prelicensure nursing programs as it relates to the confidence, knowledge, and skills of student nurses. Background: Initiatives to improve the quality of prelicensure education in nursing programs include high-fidelity simulations, but research on their impact on student nurses’ confidence, knowledge, and skills remains limited. Nurses’ confidence in practical settings is essential for quality patient care and therapeutic use of self. Methods: Articles published between 2014-2025 that used experimental and quasi-experimental studies on high-fidelity simulations were searched in EBSCO host, Google Scholar, ProQuest, Medline, and Cumulative Index to Nursing …

Varicella Zoster Encephalitis In An Immunocompetent Middle-Aged Female With Benign Neurological Presentation, Kopalle Bhanu Sriram, Swathi B.S, Bernice Roberts

Digital Journal of Clinical Medicine

Varicella Zoster Virus (VZV) is a neurotropic human herpesvirus that typically presents as herpes zoster following reactivation of latent infection. Central nervous system involvement such as encephalitis is uncommon and is more frequently described in immunocompromised individuals. Increasing use of polymerase chain reaction (PCR)-based diagnostics has enabled improved recognition of VZV-related neurological disease in immunocompetent hosts.

We describe a middle-aged immunocompetent female who presented with a 15-day history of persistent headache associated with vomiting and low-grade fever. Examination revealed vesicular eruptions in the T8–T9 dermatomes, while neurological examination and neuroimaging were normal. Cerebrospinal fluid (CSF) analysis demonstrated lymphocytic pleocytosis, elevated …

The 'Golden Hour': A Geospatial Analysis Of Travel Time To Public Emergency Departments In Kenya, Tushara Surapaneni, Nancy Kinyua, Benjamin Wachira

Emergency Medicine, East Africa

Introduction In Kenya and many other low- and middle-income countries, prehospital care systems are underdeveloped or entirely non-existent, leaving emergency departments (EDs) as the primary point of care for medical emergencies. The aim of this cross-sectional observational study was to use a geographic information system (GIS) to comprehensively analyse access to public EDs in Kenya within 1-hour and 2-hour travel times.

Methods Using open-source GIS software, population, land cover, elevation and road network data were analysed to create maps of 1-hour and 2-hour travel time catchment areas around public EDs in Kenya. Travel time analysis was calculated using AccessMod with …

Differential Effects Of Neighborhood Ambient Pm2.5 Exposure And Social Vulnerability On Cancer-Related Systemic Inflammation By Race In A Large Health Care System Population From 2000 To 2020, Benjamin A. Rybicki, Zihan Lin, Amber L. Pearson

Biological, Geological, and Environmental Faculty Publications

BackgroundThe environment can impact cancer risk both directly, such as through the air we breathe, and indirectly, through the neighborhoods we live in. These risk factors often work in concert but can have disparate effects.MethodsTo understand how air pollution, as measured by ambient particulate matter 2.5 (PM2.5) levels and neighborhood disadvantage based on a geographically assigned social vulnerability index (SVI), may act together to impact cancer risk, we used 2000-2020 statewide cohort data from a large health system based in metropolitan Detroit, MI, USA (n = 245,438). Systemic inflammation was used as a surrogate indicator of cancer risk among study …