Medicine and Health Sciences Commons^™

Development And Implementation Of An Mri-Only Simulation, Planning, And Treatment Workflow For Prostate Radiotherapy Using Synthetic Ct On Mr-Linac, Reza Reiazi, Yao Ding, Sarath Vijayan, Jinzhong Yang, Ergys Subashi, Yao Zhao, Belinda M Lee, Hunter L Emory, Vi T Dinh, Greg L Swiedom, Jie Deng, Mu-Han Lin, Peter Balter, Rajat J Kudchadker, Elaine E Cha, Seungtaek Choi, Yusung Kim, Eun Young Han, Surendra Prajapati

Faculty, Staff and Student Publications

Purpose: We evaluated the feasibility of a magnetic resonance (MR)-only simulation, planning, and treatment (MROSPT) workflow for prostate cancer patients using synthetic computed tomography (sCT) generated from magnetic resonance imaging (MRI) data. By validating sCT-based dose calculations, we aimed to streamline radiotherapy workflows, eliminate the need for CT simulation, and enable reliable clinical implementation of MR-based radiotherapy for MR-linac (MRL).

Methods: We developed a comprehensive workflow encompassing the entire process from initial consultation to treatment delivery. After developing the workflow, a retrospective dosimetric validation study was performed on nine men with prostate cancer. They underwent CT and MRI simulations, and …

Inferring High-Fat Dietary Patterns From Electronic Health Record Data Using Machine Learning, Ya-Yun Yeh, Hsin-Yueh Lin, Jingchuan Guo, Ramon C Sun, Sizun Jiang, Jiang Bian, Hao Dai

Faculty, Staff and Student Publications

Objectives: Electronic health records (EHRs) rarely capture dietary detail, limiting diet-disease research. We aimed to develop machine learning (ML) computable phenotypes to identify high-fat diet (HFD) using variables typically available in EHRs.

Materials and methods: We used National Health and Nutrition Examination Survey (NHANES) 1999-2020 data, where 24-h dietary recall served as ground truth. Dietary fat intake was summarized into a score (0-30) based on percent energy from fat, carbohydrate, and protein; lower scores indicated HFD. We defined HFD at cutoffs of 10, 15, and 20, and trained ML models (Extreme Gradient Boosting, logistic regression, random forest) using EHR-compatible variables …

Implanting Microelectrode Arrays In The Bottom Of The Central Sulcus Targeting Somatosensory Area 3a For Restoration Of Proprioception, Tyler R Johnson, Sarah Moralle, Ziling Luo, Dawn M Taylor

Faculty, Staff and Student Publications

Objective: The long-term goal of this work is to develop a sensorimotor brain-machine interface (BMI) in which intended movements are decoded from the motor cortex and proprioceptive feedback is delivered via intracortical microstimulation of Brodmann's area 3a. A vital step toward this goal is to demonstrate in rhesus macaques a novel surgical approach for the precise and safe implantation of custom-length microelectrode arrays into area 3a at the bottom of the central sulcus.

Methods: Preoperative planning combined high-resolution 7-T MR and CT imaging to generate 3D models of the cortices of 2 subjects. These models were used to fabricate 3D-printed …

Hootation: A Gui And Api Library For Ontology Validation And Verbalization., Muhammad Amith, Xubing Hao, Warren Manuel, Manqi Li, Shun Rao, Kirk Roberts, Hua Xu, Yang Gong, Frank Manion, Cui Tao, Licong Cui

Faculty, Staff and Student Publications

Ontology verbalization refers to the process of translating formal axioms into natural language expressions. The primary objective is to facilitate the review and validation of ontology content by subject matter experts without requiring extensive technical expertise. While previous approaches based on templates or controlled grammar have been effective, they often face limitations in scalability, fluency, and adaptability. To address these issues, we developed Hootation, an open-source software system that supports ontology verbalization through both a graphical user interface and an API library. The tool implements rule-based translation of OWL2 axioms and further incorporates optional Large Language Model (LLM) components for …

Visit-Level Quality Measurement Reveals Missed Opportunities And Overuse In Preventive Oral Health Care, Bunmi Tokede, Suhasini Bangar, Swaroop Gantela, Ryan Brandon, Alfa Yansane, Donald B Rindal, Don Worley, Joel White, Joanna Mullins, Ana Neumann, Todd Johnson, Nicholas Skourtes, Gregory Olson, Janelle Urata, Heather Weidner, Katie Lamberger, Aaron Truong, Heiko Spallek, Elsbeth Kalenderian, Muhammad F Walji

Faculty, Staff and Student Publications

Background: Traditional annual dental quality measures fail to capture real-time care delivery and can mask critical gaps in patient-specific treatment. The authors developed and implemented visit-level adaptations of established caries quality measures to enable actionable, point-of-care assessment.

Methods: The authors conducted a retrospective analysis of 1.09 million dental visits across 400,000 patients (2021-2023) at 4 US institutions using axiUm (Henry Schein Corp) or Epic (Epic Systems) electronic health records. The authors transformed 2 annual measures involving caries risk assessment and risk-based preventive treatment into visit-level metrics using a 2 × 2 matrix framework: action due and performed, due and not …

Medical Aid In Dying: A Narrative Review Of The Recent Academic Literature In The United States., Holland Kaplan, Soraira Pacheco, Keziah M Thomas, Christopher L Ulmschneider, Anjiya Sulaiman, Chandni Lotwala, Derek Dawes, Issa A Hanna, Courtney Nguyen, Caroline G Snider, Gabriel M Aisenberg

Faculty, Staff and Student Publications

Medical aid in dying (MAiD) is a practice in which a healthcare professional provides assistance to a terminally ill patient seeking to end their life. To assess how academic discourse may shape public opinion and policy in the United States, we conducted a narrative review of the literature published between 2020 and 2024. Articles were categorized as supportive, opposing, or neutral, and patterns were examined across authorship, disciplinary focus, and target populations. Our findings reveal that most recent publications adopt supportive or neutral stances toward MAiD, with a slight increase in opposition beginning in 2022. Authorship discipline strongly influenced position, …

Therapeutic Potential Of C1-Inhibitor In Vascular Diseases And Beyond, Linda Sundler Björkman, Harish Eswaran, Steven P Grover

Faculty, Staff and Student Publications

C1INH (C1-inhibitor) is a multifunctional SERPIN (serine protease inhibitor) that functions as a major negative regulator of the complement, coagulation, and kallikrein-kinin systems. C1INH products were originally developed for the treatment of hereditary angioedema associated with C1INH deficiency. A growing body of literature indicates that C1INH products may find utility in the management of several other disease states. In this review, we detail the key biological activities of C1INH and consider the pathophysiological role of C1INH targets in many conditions. The therapeutic potential of exogenous C1INH is highlighted in the settings of thromboembolism, ischemia-reperfusion injury, sepsis, transplantation, and coronavirus disease …

Urinary Biomarkers Of Acute Kidney Injury In Neonates < 25 Weeks’ Gestation: A Pilot Study, Jazmin D Humphreys, Aman Jain, Amir M Khan, Tina O Findley, Mar Romero-Lopez, Sepideh Saroukhani, Rita D Swinford, Matthew A Rysavy

Faculty, Staff and Student Publications

Background: Acute kidney injury (AKI) occurs in 30% of premature neonates and is associated with adverse outcomes that may be mitigated with early detection. Diagnosis of AKI relies on serum creatinine (SCr) which has several limitations, including lack of sensitivity and specificity. There are limited data on the utility of alternative urine biomarkers to predict AKI in neonates born at < 25 weeks' gestation.

Methods: Urine was collected from neonates born at < 25 weeks' gestation during the first postnatal week. Two urine AKI biomarkers, neutrophil gelatinase-associated lipocalin (NGAL) and epidermal growth factor (EGF) were measured. Study participants were prospectively followed to determine development of AKI, defined by the neonatal modified Kidney Disease-Improving Global Outcomes (KDIGO) criteria, during the first postnatal week. The association of NGAL and EGF with AKI was analyzed using mixed-effect linear regression models adjusting for gestational age at birth.

Results: A total of 26 neonates were enrolled in this study. After adjusting for gestational age at birth, the mean difference in log-transformed biomarkers at three time points for urine NGAL and …

Markvcid2 Consortium For Clinical Validation Of Biomarkers Of Cerebral Small Vessel Disease: Validation Framework And Baseline Characteristics, Steven M Greenberg, Marylin S Albert, Hongyu An, Konstantinos Arfanakis, Arnold M Evia, Arvind Caprihan, Andria L Ford, Myriam Fornage, Gregory S Day, Jason D Hinman, Gregory A Jicha, Amir H Kashani, Joel H Kramer, Christian Lachner, Jin-Moo Lee, Peiying Liu, Hanzhang Lu, Pauline Maillard, Ronald C Petersen, Bruce M Psaty, John M Ringman, Gary A Rosenberg, Claudia L Satizabal, Sean I Savitz, Julie A Schneider, Sudha Seshadri, Prashanthi Vemuri, Danny J J Wang, Donna M Wilcock, B Gwen Windham, Rong Zhang, Carissa Tuozzo, Herpreet Singh, Sue Moy, Vilma Okey-Ewurum, Courtney B Page, Hillary Mulder, Pia Kivisäkk, Deborah Blacker, Lidiya Mazina, Karl G Helmer, Kristin Schwab, Lisa M Wruck, Roderick A Corriveau

Faculty, Staff and Student Publications

Objective: To establish a framework for validating candidate biomarkers of cerebral small vessel diseases (SVD) associated with cognitive impairment and characterize individuals enrolled by the MarkVCID2 consortium under this framework.

Methods: Participants age 60 to 90 years were enrolled across 17 MarkVCID2 sites. Recruitment was targeted to enrich in cognitive symptoms (mild dementia, mild cognitive impairment, subjective cognitive decline), defined risk factors (diabetes mellitus, advanced hypertension), and Black/African American, White, and Hispanic/Latino subgroups. Enrolled participants underwent baseline visits that included cognitive testing, multimodal magnetic resonance imaging (MRI), and biofluid collection. Provisional risk for SVD-related cognitive decline was estimated primarily by …

Outcomes Of Witnessed Versus Unwitnessed Patients With Stroke After Endovascular Therapy In The Extended Time Window, Liisa Tomppo, Nicolas Martinez-Majander, Muhammad M Qureshi, Thanh N Nguyen, Raul G Nogueira, Simon Nagel, Jelle Demeestere, Volker Puetz, Hilde Henon, Marta Olive-Gadea, João Pedro Marto, Anne Dusart, Peter A Ringleb, Osama O Zaidat, Diogo C Haussen, Mahmoud H Mohammaden, Mohamad Abdalkader, Jean Raymond, Santiago Ortega-Gutierrez, Sunil A Sheth, Hiroshi Yamagami, João Nuno Ramos, Francois Caparros, Daniel P O Kaiser, Marc Ribo, Sergio Salazar-Marioni, Kanta Tanaka, Pekka Virtanen, Ajit S Puri, James E Siegler, Syed F Zaidi, Mouhammad Jumaa, Eugene Lin, Jordi Mayol, Rita Ventura, Simon Winzer, Piers Klein, Flavio Bellante, Jorge Cespedes, Anke Wouters, Hesham E Masoud, Liqi Shu, Alicia C Castonguay, Christian Herweh, Monica Cheng, Wei Hu, Daniel Roy, Shadi Yaghi, Robin Lemmens, Charlotte Cordonnier, Markus A Möhlenbruch, Daniel Strbian

Faculty, Staff and Student Publications

Background: It remains unclear whether outcomes of patients treated with endovascular thrombectomy with large-vessel occlusion and unwitnessed onset of stroke differ from those with witnessed onset in the extended time window.

Methods: We enrolled patients with anterior circulation large-vessel occlusion (internal carotid artery, M1, or M2 segment of the middle cerebral artery) undergoing endovascular thrombectomy within 6 to 24 hours from the time last seen well, from 2014 to 2022, at 66 sites in Europe, North America, and Asia. Patients with a prestroke modified Rankin Scale score of >3 or age < 18 were excluded. We categorized patients by onset mode as witnessed or unwitnessed. The primary outcome was the modified Rankin Scale shift at 90 days. Secondary outcomes were functional independence, a composite of functional independence or return of Rankin to prestroke level, symptomatic intracranial hemorrhage, mortality, and a composite of severe disability or mortality at 90 days. We applied inverse probability of treatment weighting to compare outcomes between the groups.

Results: Of 5098 patients assessed for eligibility, we included …

Uterine Tachysystole And Associated Outcomes: A Systematic Review And Meta-Analysis, Fabrizio Zullo, Benedetta Licitra, Nandini Raghuraman, Alison G Cahill, Aaron W Roberts, Stephanie Roth, Daniele Di Mascio, Antonella Giancotti, Giuseppe Rizzo, Kristen A Cagino, Hector Mendez-Figueroa, Anthony C Sciscione, Suneet P Chauhan

Faculty, Staff and Student Publications

Objective: To determine whether uterine tachysystole is associated with adverse neonatal and maternal outcomes.

Data sources: A search strategy for PubMed (National Library of Medicine) was created, and the medical librarian translated the search for every database. The search strategy was peer reviewed by another medical librarian following the Peer Review of Electronic Search Strategies checklist. The databases included in this search were PubMed, Embase.com, Cochrane CENTRAL, CINAHL Ultimate, and Scopus; a combination of key words and subject headings was used.

Methods of study selection: Trials of nulliparous or multiparous parturients exposed to uterine tachysystole were included. Included studies compared …

Phase 1b Pilot Study Of Itacitinib With Alemtuzumab In Patients With T-Cell Prolymphocytic Leukemia, Tapan M Kadia, Akhil Jain, Caitlin R Rausch, Alex Bataller, Farhad Ravandi, Elias Jabbour, Wei Qiao, Gautam Borthakur, Nicholas Short, Guillermo Montalban-Bravo, Andres E Quesada, Jan Burger, Alessandra Ferrajoli, William Wierda, Chitra Hosing, Hagop Kantarjian

Faculty, Staff and Student Publications

T-cell prolymphocytic leukemia (T-PLL) is a mature T-cell neoplasm with an aggressive clinical course. Overall prognosis is poor, and treatment relies on alemtuzumab because of inadequate response to conventional chemotherapy. Three-quarters of cases harbor activating mutations in the JAK-STAT pathway (JAK1, JAK3, STAT5B, IL2RG). We report safety and efficacy from a phase 1B study evaluating the combination of the JAK1 inhibitor itacitinib with alemtuzumab. Patients (N = 15) were aged >18 years, with treatment-naïve (n = 8) or relapsed/refractory (n = 7) T-PLL with adequate organ function, European Cooperative Oncology Group Performance Status ≤2, and …

First Report Of Response To Tarlatamab In A Patient With Histologic-Transformed Sclc From Alk-Rearranged Nsclc: Case Report, Kaiwen Wang, Ceylan Altintas Taslic, Patricia De Groot, Mitchell A Parma, Alvaro Guimaraes Paula, Melody Caranto, Komal Shah, Mukulika Bose, Cole Ruoff, Loukia G Karacosta, Lauren A Byers, Carl M Gay, Jianjun Zhang, John V Heymach, Bingnan Zhang

Faculty, Staff and Student Publications

Small cell transformation has been described as a resistance mechanism to targeted therapy treated in patients with EGFR-mutated NSCLC and less often reported with those with other actionable oncogenic alterations, including ALK-rearranged NSCLC. Given lack of standard-of-care treatments for patients with actionable oncogenic alteration NSCLC transformed to SCLC, this remains a challenge and unmet need for treating these patients.

Here, we present a case of a patient with ALK-rearranged NSCLC with transformation to SCLC, who has progressed on several lines of therapies and successfully treated with tarlatamab to elicit and maintain clinical benefit, including intracranial response.

Fireproof: Intricacies Of Microglial Biology, Wei Cao

Faculty, Staff and Student Publications

No abstract provided.

Outcomes Of Therapy-Related Non-Core Binding Factor Acute Myeloid Leukemia With Venetoclax-Based Therapies, Jayastu Senapati, Jennifer Croden, Guillermo Garcia-Manero, Koichi Takahashi, Naval G Daver, Tapan M Kadia, Gautam Borthakur, Nicholas James Short, Elias Jabbour, Fadi Haddad, Jennifer Marvin-Peek, Hussein A Abbas, Prithviraj Bose, Guilin Tang, Sanam Loghavi, Elizabeth J Shpall, Jeremy Ramdial, Uday R Popat, Richard E Champlin, Farhad Ravandi, Hagop M Kantarjian, Courtney D Dinardo

Faculty, Staff and Student Publications

Prognosis in therapy‐related acute myeloid leukemia (T‐AML) remains poor, but understanding outcomes with venetoclax (VEN)‐based therapy is relevant. We retrospectively analyzed 317 adult patients with newly diagnosed T‐AML focusing on lower intensity therapy (LIT) VEN‐containing regimens. Patients with an antecedent myeloid disorder before AML diagnosis were excluded. The median age was 69 years (range 21–92); 50% evaluated patients had a complex karyotype, and 40% evaluated patients had a TP53 mutation. Composite complete response rates were higher with LIT + VEN compared to LIT (58% vs. 40%, P = 0.003) but were similar in intensive chemotherapy (IC) + VEN versus IC …

Circulating Fatty Acid Binding Protein 4 (Fabp-4) Concentrations And Mortality In Individuals With Colorectal Cancer In The European Prospective Investigation Into Cancer And Nutrition Study, Thu Thi Pham, Katharina Nimptsch, Krasimira Aleksandrova, Mazda Jenab, Veronika Fedirko, Anja Olsen, Anne Tjønneland, Claire Cadeau, Gianluca Severi, Matthias B Schulze, Renée Turzanski Fortner, Verena Katzke, Claudia Agnoli, Carlotta Sacerdote, Rosario Tumino, Simona Signoriello, Camino Trobajo-Sanmartín, Jesús-Humberto Gómez, María-Dolores Chirlaque, Maria-Jose Sánchez, Marta Crous-Bou, Anne May, Alicia Heath, Dagfinn Aune, Elisabete Weiderpass, Tobias Pischon

Faculty, Staff and Student Publications

Human fatty acid binding protein‐4 (FABP‐4), a protein elevated in obesity that promotes colon cancer cell invasiveness and metastasis, may be associated with higher mortality in individuals with colorectal cancer (CRC) and may serve as a mediator of the obesity–mortality association in these individuals. We used a causal diagram to inform covariate selection and applied Cox proportional hazards models to estimate hazard ratios (HRs) for CRC‐specific, non‐CRC‐specific, and all‐cause mortality by FABP‐4 levels measured in baseline blood samples from 1371 incident CRC cases from the European Prospective Investigation into Cancer and Nutrition cohort. Competing risk analyses were adapted for CRC …

Hypoglossal Neuropathy In The Pathogenesis Of Fibrosis-Related Late-Radiation Associated Dysphagia: A Correlative Analysis Utilizing Electromyography To Explore The Frequency Of Clinical And Subclinical Neuropathy In A Pilot Dysphagia Trial, Holly Mcmillan, Christine Okoro, Sheila Buoy, Karin Woodman, Nicolaas Anderson, Clifton Fuller, Stephen Y Lai, Katherine Hutcheson

Faculty, Staff and Student Publications

Background: Late radiation-associated dysphagia (late-RAD) commonly presents in patients with signs of hypoglossal neuropathy, with hallmark clinical features including lingual atrophy, deviation, and fasciculation. Gold-standard electromyography (EMG) has not been used to explore the frequency of hypoglossal neuropathy in patients with late-RAD.

Methods: Exploratory post hoc secondary analysis of MANTLE trial (NCT03612531) was completed. The presence of cranial nerve XII (CN XII) neuropathy was classified by (1) features of clinical assessment as well as (2) intramuscular genioglossus EMG pre-MANTLE intervention in disease-free HNC survivors ≥ 2 years post-radiotherapy (RT) with grade ≥ 2 fibrosis and dysphagia.

Results: All …

Impact Of Treatment Interruption On Outcomes In Head And Neck Cancer: Nrg/Rtog Secondary Analysis, Laila A Gharzai, Emily Morris, Matthew J Schipper, Kelley M Kidwell, Phuc Felix Nguyen-Tân, David I Rosenthal, Maura L Gillison, Richard C Jordan, Adam S Garden, Shlomo A Koyfman, Jimmy J Caudell, Dukagjin M Blakaj, Neal E Dunlap, Greg A Krempl, John M Longo, Christopher U Jones, Michael F Gensheimer, Thomas J Galloway, Lyudmila Demora, Quynh-Thu Le, Jennifer L Shah, Krithika Suresh, Michelle Mierzwa

Faculty, Staff and Student Publications

Importance: Historical evidence demonstrated that delays or interruptions in radiotherapy (RT) are associated with poorer oncologic outcomes in head and neck squamous cell carcinoma (HNSCC). Substantial concerns arose during the COVID-19 pandemic, when treatment schedules were frequently disrupted.

Objective: To determine the association of RT interruptions with locoregional failure (LRF) and overall survival (OS).

Design, setting, and participants: This retrospective review and secondary analysis of 3 randomized clinical trials (NRG/RTOG 0129, 0522, and 1016) included patients enrolled in the trials who were treated with RT. Patients with HNSCC were grouped as (1) p16-positive oropharynx (p16+ OPSCC) and (2) p16-negative oropharynx …

Identification Of Raptor And Gli1 As Usp37 Substrates Highlight Its Context-Specific Function In Medulloblastoma Cells, Ashutosh Singh, Donghang Cheng, Amanda R Haltom, Yanwen Yang, Tara Dobson, Rashieda Hatcher, Veena Rajaram, Vidya Gopalakrishnan

Faculty, Staff and Student Publications

The USP37 gene encodes a deubiquitylase (DUB), which catalyzes the proteolytic removal of ubiquitin moieties from proteins to modulate their stability, cellular localization or activity. Its expression is downregulated in a subgroup of medulloblastomas driven by constitutive activation of sonic hedgehog (SHH) signaling. Patients with SHH-driven medulloblastomas with elevated expression of the RE1 silencing transcription factor (REST) and reduced expression of USP37 have poor outcomes. In previous studies, we showed sustained proliferation of SHH-medulloblastoma cells due to blockade of terminal cell cycle exit and neuronal differentiation stemming from a failure in USP37-dependent stabilization of its target, the cyclin-dependent kinase inhibitor …

Introducing A New Frontier In The Journal Of Pediatric Rehabilitation Medicine: An Interdisciplinary Approach Throughout The Lifespan: The Pediatric Brain Injury Section, Michael Green, Glendaliz Bosques, Kimberly Davis, Brenda Eagan-Johnson, Carty Husted

Faculty, Staff and Student Publications

No abstract provided.

Sleep-Disordered Breathing In Newborns After Myelomeningocele Repair, Renée A Shellhaas, Fauziya Hassan, Thornton A Mason, Jagruti Anadkat, Ellen Bendel-Stenzel, Stephanie Eyerly-Webb, Cindy K Jon, Robin M Lloyd, Julie S Moldenhauer, Ramesha Papanna, John E Pascoe, Stefanie Riddle, Regina Reynolds, Brandon G Rocque, Narong Simakajornboon, Marjorie C Treadwell, R Bradley Troxler, Lydia S Youmans, Niko A Kaciroti, Harlan Mccaffery, Hemant A Parmar, Lora Merley, Stephanie Md Rau, Ronald D Chervin, John D E Barks

Faculty, Staff and Student Publications

Background & objective: Sleep-disordered breathing (SDB) may be a remediable contributor to abnormal cognitive outcomes for children with myelomeningocele. We investigated the frequency of SDB among neonates with fetal vs postnatal myelomeningocele repair.

Methods: In this nine-center, prospective, observational study, neonates with myelomeningocele born at more than 30 weeks gestational age underwent a 10-hour bedside polysomnogram at at least 35 weeks postmenstrual age, before hospital discharge. The primary outcome was SDB severity, reflected by the apnea-hypopnea index (AHI; number of respiratory events per hour of sleep). Decisions regarding surgical timing (fetal vs postnatal), technique (open fetal vs fetoscopic approach), and …

Association Of Intended Mode Of Delivery With Neonatal And Maternal Outcomes At 22-25 Weeks Of Gestation, Jameaka L Hamilton, Paula L Mcgee, Baha M Sibai, Michael W Varner, Alan T N Tita, Monica Longo, Edward F Bell, Barbara J Stoll, John M Thorp, Uma M Reddy, Heather A Frey, Emily S Miller, Dwight J Rouse, Hyagriv N Simhan, Jennifer L Bailit, Lorraine Dugoff, George R Saade

Faculty, Staff and Student Publications

Objective: To compare the risk of neonatal and maternal morbidity and mortality among individuals who delivered between 22 and 25 weeks of gestation by intended mode of delivery.

Methods: This was a secondary analysis of an observational cohort including participants with a singleton pregnancy delivered by planned cesarean delivery or after a trial of labor from 22 0/7 to 25 6/7 weeks of gestation. This analysis was limited to those who received both antenatal steroids and neonatal resuscitation. The primary outcome was a composite of neonatal death or severe neonatal morbidity. Secondary outcomes included neonatal mortality and measures of neonatal …

Bayesian Posthoc Trial Analysis Of Cerclage Management In Preterm Prelabor Rupture Of The Membranes, Beth L Pineles, Kyung Hyun Lee, Baha M Sibai

Faculty, Staff and Student Publications

Background: There is inadequate evidence on whether to retain or remove a cervical cerclage after preterm prelabor rupture of the membranes (PPROM). The PROMCerclage trial was the only study to randomize patients to cerclage retention or immediate cerclage removal after PPROM. The trial was terminated early, and results were not statistically significant but the cerclage retention group had shorter latency and more chorioamnionitis. Bayesian post-hoc trial analysis maximizes available clinical trial data by formally integrating information from preexisting studies or prior beliefs into statistical modeling to estimate the probability of a treatment effect.

Objective: To re-analyze published results of the …

Preliminary In Vivo Evaluation Of Coracoclavicular Ligament Mechanics During Shoulder Elevation After Acromioclavicular Joint Reconstruction, Jason Konrath, Sydney Wheaton, Alonso Figueroa, James Gregory, Payam Zandiyeh

Faculty, Staff and Student Publications

Background: Persistent instability and altered scapular mechanics after acromioclavicular joint (ACJ) reconstruction may stem from inadequate replication of native coracoclavicular (CC) ligament function. However, in vivo data on postoperative CC ligament behavior during dynamic shoulder motion remain lacking.

Purpose: To assess in vivo functional distance and timing characteristics of the conoid and trapezoid ligaments during active shoulder elevation after ACJ reconstruction, using dynamic stereo x-ray (DSX) imaging and patient-specific 3-dimensional (3D) models.

Study design: Cross-sectional study; Level of evidence, 3.

Methods: Twelve participants (10 men and 2 women, mean age 39 ± 10 years, mean body mass 92 ± 17 …

Are Fewer Damage Control Laparotomies Associated With A Decrease In The Rate And Severity Of Surgical Site Infections?, Stephanie Martinez Ugarte, Mokunfayo O Fajemisin, Chelsea J Guy-Frank, William D Rieger, Renee W Green, John A Harvin, Lillian S Kao

Faculty, Staff and Student Publications

Background: Damage control laparotomy (DCL) rates have declined and remained low. Given DCL's association with surgical site infections (SSIs), we hypothesize that SSI rates and severity, as per Clavien-Dindo (CD) classification, have decreased concurrently.

Patients and methods: A retrospective study was performed on patients (≥16 y) who underwent trauma laparotomy from January 2011 to December 2020. Patients who survived ≤48 hours were excluded. Data were divided into period 1 (January 2011-December 2015, DCL rates declined) and period 2 (January 2016-December 2020, low DCL rates were sustained). SSIs were defined as per the Centers for Disease Control and Prevention, and severity …

Acta2 Pathogenic Variants Activating Heat Shock Factor 1 And Increasing Cholesterol Biosynthesis In Smooth Muscle Cells Predispose To Early Onset Atherosclerosis, Maura L Boerio, Abhijnan Chattopadhyay, Xue-Yan Duan, Aamuktha Karla, Ernesto Calderon Martinez, Amelie Pinard, Andrew K Morse, Darshan Reddy, Sree Dharma, Walter Velasco-Torrez, Julien Marcadier, Siddharth K Prakash, Sherene Shalhub, Julie De Backer, Richmond Jeremy, Shaine A Morris, Anji T Yetman, Alan C Braverman, Dianna M Milewicz

Faculty, Staff and Student Publications

Background: ACTA2 pathogenic variants predispose to thoracic aortic disease, and a subset of variants lead to early onset atherosclerotic cardiovascular disease (ASCVD). The molecular pathway linking misfolded SMA (α-smooth muscle actin) monomers to augmented atherosclerosis-associated smooth muscle cell phenotypic modulation can be modeled in vitro by stably expressing the ACTA2 p.R149C variant in Acta2-/- smooth muscle cells.

Methods: The Montalcino Aortic Consortium patient registry was used to identify cases with ACTA2 pathogenic/likely pathogenic missense variants. These patients were surveyed, and medical records were reviewed, to identify cases with early onset ASCVD. The variants for these cases, as well as …

Composite Mantle Cell Lymphoma And Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma: A Diagnostic And Therapeutic Challenge, Matthew T Ye, Yaling Yang, M James You

Faculty, Staff and Student Publications

No abstract provided.

How To Prevent Acute Kidney Injury Postoperatively?, Alexander Zarbock, Matthieu Legrand

Faculty, Staff and Student Publications

No abstract provided.

Quantitative Analysis Of Robustness-Based Versus Let-Based Optimization In Intensity-Modulated Proton Therapy For Pediatric Brain Tumors, Fariha Kabir Torsha, Gino Lim, Hadis Moazami Goudarzi, Radhe Mohan, David Grosshans, Wenhua Cao

Faculty, Staff and Student Publications

Purpose: To perform a quantitative analysis of the trade-off between robustness-based and linear energy transfer (LET)-based optimization of intensity-modulated proton therapy for anatomically challenging pediatric brain tumor cases.

Methods: Three pediatric brain tumor patients were included in this study. Three plans were generated for each case based on: (1) nominal optimization, without considering uncertainties and LET; (2) robust optimization, including proton range and patient setup uncertainties; and (3) LET optimization, considering increasing LET in the target and reducing LET in normal tissues. All plans were optimized with individually fine-tuned objective weighing to obtain highest achievable target coverage and meet dose …

The American College Of Radiology Diagnostic Fluoroscopy Dose Index Registry Pilot: Dosimetric Performance And Benchmarking Challenges, Steve D Mann, Donald L Miller, Grant Fong, Allen R Goode, Emily L Marshall, Thomas Nishino, Pavlina Boxx, Liqiang Ren, Celalettin Topbas, Alan H Schoenfeld, Vivek Singh, Jie Zhang

Faculty, Staff and Student Publications

Background: The ACR Diagnostic Fluoroscopy Dose Index Registry (DIR-Fluoro) is expanding to include diagnostic fluoroscopy. Variations in dose reference points and overhead radiography events may introduce unique challenges for benchmarking.

Purpose: To survey the technological status and dosimetric performance of fluoroscopes participating in the DIR-Fluoro pilot project, focusing on longitudinal stability and variability of fluoroscopic dose reporting accuracy across multiple institutions and vendors.

Methods: Sixty-six fluoroscopic systems from nine institutions (24 facilities) were surveyed for facility type, fluoroscope type, image receptor type, age, dose reporting capabilities, and other key features. Of these, 56 were evaluable. Semi-annual measurements assessed reference air …