Medicine and Health Sciences Commons^™

Association Of Pathogenic/Likely Pathogenic Inherited Cardiomyopathy Variants With Heart Failure: A Topmed Multiancestry Analysis, Naman S Shetty, Mokshad Gaonkar, Akhil Pampana, Nirav Patel, April P Carson, Bernhard Haring, Bruce M Psaty, Charles Kooperberg, Eric Boerwinkle, Jerome I Rotter, João A C Lima, Jorge R Kizer, Lisa Warsinger Martin, Kent D Taylor, Michael E Hall, Myriam Fornage, Sanjiv J Shah, Stephen S Rich, Ramachandran S Vasan, Rami Nassir, Peng Li, Garima Arora, Pankaj Arora

Faculty, Staff and Student Publications

OBJECTIVE: To evaluate the prevalence of pathogenic/likely pathogenic inherited cardiomyopathy variants and their association with heart failure in the (TOPMed) TransOmic for Precision of Medicine cohorts.

METHODS: A retrospective cohort study using the TOPMed cohorts, including multi-ancestry US adults (≥18 years of age) with sequencing data, was conducted. Pathogenic/likely pathogenic inherited cardiomyopathy variant carrier status was determined based on ClinVar variants classified with two or more stars of evidence. Individuals without pathogenic/likely pathogenic variants were used as the reference group. The primary outcome was heart failure , adjudicated by an expert panel. Cox proportional hazards models assessed the association between …

Transforming Preterm Care: The Power Of Small Baby Guidelines In Enhancing Outcomes, Leeann Pavlek, Debra Armbruster, Cecilie Halling, Kaitlyn Hipp, Maria Jebbia, Susan Lopata, Matthew Rysavy, Rebecca Saliga, Sheria Wilson, Claire Beaullieu

Faculty, Staff and Student Publications

As survival rates of extremely preterm (EPT) infants continue to improve, focus has shifted to reduce morbidity and complications in these vulnerable patients. Management of EPT infants presents significant clinical, logistical, and sometimes ethical challenges. Outcomes across centers are highly variable and strongly influenced by the care provided in the early neonatal period. Standardized guidelines, based on published literature and center-specific experiences, play an important role in improving outcomes for EPT infants. Multidisciplinary guidelines provide a framework for clinical management and support a consistent care approach. Guidelines can improve care throughout the entire neonatal intensive care unit (NICU) course, beginning …

Microbial Signals In Primary And Metastatic Brain Tumors, Golnaz Morad, Ashish V Damania, Brenda Melendez, Bharat B Singh, Fabiana J Veguilla, Rebecca A Soto, Yasmine M Hoballah, Pranoti V Sahasrabhojane, Matthew C Wong, Mona M Ahmed, Rene N Rico, Kaitlyn N Lewis, Khalida Wani, Diana D Shamsutdinova, Rossana N Lazcano Segura, Davis R Ingram, Eric A Goethe, Abderrahman Day, Ivonne I Flores, Lauren K Mcdaniel, Manoj Chelvanambi, Sarah B Johnson, Florentia Dimitriou, Pravesh Gupta, Shivangi Oberai, M Anna Zal, Phoebe Doss, Mohamed A Jamal, Eiko Hayase, Chetna Wathoo, Lisa M Norberg, Stephanie L Jenkins, Sara Nass, Joy Gumin, Lihong Long, Jing Yang, Gina R Bradley, Mahesh Prasad Bekal, Antonio G Dono, Pavel S Pichardo-Rojas, Samuel W Andrewes, Leomar Y Ballester, Jillian S Losh, Jiyong Liang, Longfei Huo, Douglas C Nielsen, Brittany C Parker Kerrigan, Priscilla K Brastianos, Natalie Wall Fowlkes, Chia-Chi Chang, Robert R Jenq, Candelaria Gomez-Manzano, Jason T Huse, Michael A Davies, Alexander J Lazar, Krishna P Bhat, Nitin Tandon, Yoshua Esquenazi, Christine B Peterson, Vinay K Puduvalli, Frederick F Lang, Christopher D Johnston, Susan Bullman, Nadim J Ajami, Sherise D Ferguson, Jennifer A Wargo

Faculty, Staff and Student Publications

Gliomas and brain metastases are associated with poor prognosis, necessitating a deeper understanding of brain tumor biology and the development of effective therapeutic strategies. Although our group and others have demonstrated microbial presence in various tumors, recent controversies regarding cancer-type-specific intratumoral microbiota emphasize the importance of rigorous, orthogonal validation. This prospective, multi-institutional study included a total of 243 samples from 221 patients, comprising 168 glioma and brain metastases samples and 75 non-cancerous or tumor-adjacent tissues. Using stringent fluorescence in situ hybridization, immunohistochemistry and high-resolution spatial imaging, we detected intracellular bacterial 16S rRNA and lipopolysaccharides in both glioma and brain metastases …

Exploring Multimodal Large Language Models On Transthoracic Echocardiogram (Tte) Tasks For Cardiovascular Decision Support, Jianfu Li, Yiming Li, Zenan Sun, Evan Yu, Ahmed M Abdelhameed, Weiguo Cao, Haifang Li, Jianping He, Pengze Li, Jingna Feng, Yue Yu, Xinyue Hu, Manqi Li, Rakesh Kumar, Yifang Dang, Fang Li, Shahyar M Gharacholou, Cui Tao

Faculty, Staff and Student Publications

Objective: Multimodal large language models (LLMs) offer new potential for enhancing cardiovascular decision support, particularly in interpreting echocardiographic data. This study systematically evaluates and benchmarks foundation models from diverse domains on echocardiogram-based tasks to assess their effectiveness, limitations and potential in clinical cardiovascular applications.

Methods: We curated three cardiovascular imaging datasets-EchoNet-Dynamic, TMED2, and an expert-annotated echocardiogram (TTE) dataset-to evaluate performance on four critical tasks: (1) cardiac function evaluation through ejection fraction (EF) prediction, (2) cardiac view classification, (3) aortic stenosis (AS) severity assessment, and (4) cardiovascular disease classification. We evaluated six multimodal LLMs: EchoClip (cardiovascular-specific), BiomedGPT and LLaVA-Med (medical-domain), and …

Scaling Up Biomedical Vision-Language Models: Fine-Tuning, Instruction Tuning, And Multi-Modal Learning, Cheng Peng, Kai Zhang, Mengxian Lyu, Hongfang Liu, Lichao Sun, Yonghui Wu

Faculty, Staff and Student Publications

Objective: To advance biomedical vision language model capabilities through scaling up, fine-tuning, and instruction tuning, develop vision-language models with improved performance in handling long text, explore strategies to efficiently adopt vision language models for diverse multi-modal biomedical tasks, and examine the zero-shot learning performance.

Methods: We developed two biomedical vision language models, BiomedGPT-Large and BiomedGPT-XLarge, based on an encoder-decoder-based transformer architecture. We fine-tuned the two models on 23 benchmark datasets from 6 multi-modal biomedical tasks, including one image-only task (image classification), three language-only tasks (text understanding, text summarization, and question answering), and two vision-language tasks (visual question answering and image …

The Mythology Of Polymyositis, Suur Biliciler, Tahseen Mozaffar

Faculty, Staff and Student Publications

Polymyositis (PM) has been in the diagnostic armamentarium in medicine since the mid-nineteenth century. Medicine training puts a heavy emphasis on this diagnosis, and anyone with proximal muscle weakness with elevated serum creatinine kinase is assumed to be PM and a number of patients were rendered this diagnosis without additional testing. This article addresses the historical aspects of the diagnosis of PM and its evolution. We review this literature that addresses the rarity of this diagnosis and rightly puts in perspective in terms of its occurrence in relation to other inflammatory myositides.

Innovations In Thrombectomy Training: A Systematic Review And Expert Recommendations From The Society Of Vascular And Interventional Neurology-Mission Thrombectomy Initiative, Fawaz Al-Mufti, Mohamed Elfil, Abdallah Abbas, Haneen Sabet, Hazem S Ghaith, Ariel Sacknovitz, Ankita Jain, Victor Urrutia, Nabeel Herial, Gabor Toth, Mohamad El-Ghanem, Krishna Amuluru, Viktor C Szeder, Jonathan Crowe, Karol Budohoski, Zurab Nadareishvili, Kaustubh Limaye, Fazeel Siddiqui, Boris Pabon, Ossama Yassin Mansour, Atilla Ozcan Ozdemir, Houman Khosravani, Hamza Shaikh, Nishita Singh, Hesham Masoud, Sushanth R Aroor, Shashvat Desai, Santiago Ortega-Gutierrez, Fredrick Echols, Thanh N Nguyen, Pankajavalli Ramakrishnan, Priyank Khandelwal, Dileep R Yavagal, Kaiz Asif

Faculty, Staff and Student Publications

Background: Mechanical thrombectomy is a critical intervention for patients with acute ischemic stroke with large vessel occlusion. However, significant barriers remain in its widespread implementation, particularly in low- to middle-income countries, including a shortage of trained physicians and limited access to advanced medical technologies. This systematic review and meta-analysis aimed to comprehensively evaluate current mechanical thrombectomy training methodologies and assess their effectiveness in improving procedural skills among neurointerventional teams.

Methods: We conducted a systematic review following Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, searching PubMed, Scopus, and Web of Science. Eight studies were included, with 3 studies eligible …

Consensus Statement On Middle Meningeal Artery Embolization In Chronic Subdural Hematoma Treatment: A Guideline From The Society Of Vascular And Interventional Neurology Guidelines And Practice Standards Committee, Farhan Siddiq, Muhammad Shakir, Thanh N Nguyen, Ameer E Hassan, Mohamad Abdalkader, Cynthia L Kenmuir, David S Liebeskind, Robin Novakovic, Shahram Majidi, Sunil A Sheth, Mohammad El-Ghanem, Santiago Ortega-Gutierrez, Waldo R Guerrero, Amer M Malik

Faculty, Staff and Student Publications

Background: Emerging evidence from observational studies, meta-analyses, and clinical trials has reshaped the treatment landscape of chronic subdural hematoma (CSDH). This guideline provides updated recommendations on diagnosis, patient selection, and medical, surgical, and endovascular management.

Methods: The Society of Vascular and Interventional Neurology Guidelines and Practice Standards committee formed a writing group of interdisciplinary experts to review current literature. Recommendations were based on clinical trial data, observational studies, and expert consensus, following the Society of Vascular and Interventional Neurology Class of Recommendation and Level of Evidence framework.

Results: EMBOLISE (Embolization of the Middle Meningeal Artery With ONYX Liquid Embolic System …

Depression Polygenicity And Disease Activity And Disability Worsening In Multiple Sclerosis, Ali Manouchehrinia, Kathryn C Fitzgerald, Amber Salter, Ruth Ann Marrie, Lars Alfredsson, Charles N Bernstein, James M Bolton, Gary Cutter, John D Fisk, Lesley A Graff, Carol A Hitchon, Jan Hillert, Ingrid Kockum, Yi Lu, Fred D Lublin, Kyla Mckay, Tomas Olsson, Scott Patten, Amit Patki, Hayley Riel, Klementy Shchetynsky, Pernilla Stridh, Hemant K Tiwari, Jerry S Wolinsky, Kaarina Kowalec

Faculty, Staff and Student Publications

Objective: A better understanding of factors associated with multiple sclerosis (MS) disease activity and disability is needed. Given the strong link between comorbid depression and MS disease activity and disability, we aimed to determine whether the depression genetic burden, as modelled using its polygenic score, is associated with MS disease activity and disability worsening.

Methods: In this cohort study, we used samples from neurologist-defined adult people with MS (PwMS) followed in clinical care or during a clinical trial from existing cohorts: Canada, the United States (US), and Sweden with extensive longitudinal phenotypes. We computed the depression polygenic score (PGS) and …

Colorectal-Specific Radiation Dose And Chemotherapy Risk For Subsequent Colorectal Malignancies In Childhood Cancer Survivors: A Childhood Cancer Survivor Study (Ccss) Report, Constance A Owens, Ethan B Ludmir, Qi Liu, Weiyu Qiu, Aashish C Gupta, Susan A Smith, Bastien Rigaud, Kristy K Brock, James E Bates, Taylor G Meyers, Arnold C Paulino, Christine B Peterson, Stephen F Kry, Jop C Teepen, Cécile M Ronckers, Joseph P Neglia, Wendy M Leisenring, Kevin C Oeffinger, Paul C Nathan, Lucie M Turcotte, David C Hodgson, Melissa M Hudson, Leslie L Robison, Chaya S Moskowitz, Gregory T Armstrong, Tara O Henderson, Yutaka Yasui, Rebecca M Howell

Faculty, Staff and Student Publications

Purpose: Among childhood cancer survivors, we evaluated not previously explored relationships between colorectal subsequent malignant neoplasm (SMN) incidence and colorectum-specific radiation dose metrics currently used in radiation therapy (RT) planning and expanded upon previously reported chemotherapy associations.

Methods: The Childhood Cancer Survivor Study (CCSS) includes 5-year survivors of childhood cancer diagnosed between 1970 and 1999. RT was assessed as mean colorectal dose (MCD) and the percent volume (VX Gy) receiving ≥5, 10, 20, 30, and 40 Gy. Chemotherapy was assessed as cumulative doses for procarbazine and platinum agents, cyclophosphamide-equivalent doses for alkylating agents, and doxorubicin-equivalent doses for anthracyclines. Piecewise-exponential models …

Intentional Creation Of Suboptimal, Realistic Dose Distributions, Skylar S Gay, Mary P Gronberg, Raymond Mumme, Beth M Beadle, Anuja Jhingran, Tze Yee Lim, Zhiqian H Yu, Christine Chung, Meena Khan, Chelsea Pinnix, Sanjay Shete, Brent Parker, Tucker J Netherton, Carlos E Cardenas, Laurence E Court

Faculty, Staff and Student Publications

Background: Radiation oncology residents report a lack of understanding and confidence in assessing radiotherapy plan quality. A contributing factor is the environment in which plan review is taught during residency, that is, routine clinical practice, which does not provide ample time for self-guided practice in a low-stakes setting. Expertise in plan review requires diverse case presentation and many examples, which are often not achievable in smaller programs and for less common cancer types. As plan quality affects patient outcomes, it is important to address these pitfalls in the education of residents on plan review.

Purpose: To address the identified pitfalls …

Acute And Chronic Nasal Inflammation Induces Lymphangiogenesis In The Olfactory Mucosa In Mice, Suzuho Komaki, Ryuichi Imai, Yuzuki Sugimoto, Rei Settsu, Aki Obara, Atsuyoshi Shimada, Robert Dantzer, Geoffroy Laumet, Fumiaki Imamura, Sanae Hasegawa-Ishii

Faculty, Staff and Student Publications

Background: Lymphangiogenesis, the formation of new lymphatic vessels, is primarily driven by VEGF-C-mediated activation of VEGFR-3 and plays a critical role in immune regulation and tissue repair. Although lymphangiogenesis has been well documented in various inflamed tissues, its occurrence and spatiotemporal characteristics in the olfactory mucosa during nasal inflammation remain poorly understood. To address this, we investigated the localization and development of lymphatic vessels in a mouse model of both acute and chronic nasal inflammation.

Methods: Acute inflammation was induced by intranasal administration of lipopolysaccharide (LPS; 10 μg per nostril) in 8-week-old male mice, with saline-treated mice as controls. Behavioral …

Outcomes And Patterns Of Relapse Of Npm1 Mutated Acute Myeloid Leukemia Treated With Venetoclax Based Therapies, Wei-Ying Jen, Sanam Loghavi, Alexandre Bazinet, Alex Bataller, Ian Bouligny, Naval G Daver, Ghayas C Issa, Naszrin Arani, Emmanuel Almanza Huante, Abhishek Maiti, Guillermo Montalban-Bravo, Gautam Borthakur, Nicholas J Short, Sherry Pierce, Elias Jabbour, Guillermo Garcia-Manero, Farhad Ravandi, Hagop M Kantarjian, Courtney D Dinardo, Tapan M Kadia

Faculty, Staff and Student Publications

No abstract provided.

A Tour Of Leukemia Progress In 2025, Viewed Through The Md Anderson Leukemia Research Lens, Hagop M Kantarjian, Gautam Borthakur, Naval Daver, Courtney Dinardo, Guillermo Garcia-Manero, Ghayas Issa, Elias Jabbour, Nitin Jain, Tapan Kadia, Sanam Loghavi, Farhad Ravandi, Guilin Tang, Mary Alma Welch, William Wierda

Faculty, Staff and Student Publications

Advances in the prognostication, monitoring, and treatment of both the acute and chronic leukemias have led to drastically improved outcomes over the past 2 decades. With the advent of targeted therapies, including antibodies such as blinatumomab and inotuzumab and small molecule inhibitors, such as the BCR::ABL1 tyrosine kinase inhibitors, Bruton tyrosine kinase inhibitors, and venetoclax, the treatment landscape of leukemia has drastically changed, improving survival outcomes while relying less on overall chemotherapy intensity in many leukemia types. This progress has allowed the categorization of more leukemia types as favorable (i.e., chronic lymphocytic leukemia, younger acute lymphoblastic leukemia [patients younger than …

Brain-Wide Patterns Of Crf Receptor 1 Expression In The Transgenic Crfr1-Cre-2a-Tdtom Rat, Douglas S Engelke, Lierni Ugartemendia, Jonathan Tao, Shivakumar Rajamanikam, Fabricio H Do Monte, Nicholas J Justice

Faculty, Staff and Student Publications

The ability to manipulate neurons that express corticotropin-releasing factor (CRF) or its receptors has led to many new discoveries about how CRF signaling modulates stress-related behaviors in mice. However, similar advances in rats have been limited by the lack of reporter lines targeting CRF receptors, restricting access to behavioral paradigms that are more suitable for, or specific to, rats. Here, we provide an extensive neuroanatomical characterization of a recently generated CRFR1-Cre rat. We show that Cre and tdTomato are expressed in a pattern that closely aligns with previously reported CRFR1 expression patterns, as determined by in situ hybridization in rats …

Probabilistic Template Matching For Detecting Resting-State Functional Mri Language Network In Brain Tumor Patients, Jian Ming Teo, Vinodh A Kumar, Alexander M Khalaf, Kyle R Noll, Sherise D Ferguson, Chibawanye I Ene, Sujit S Prabhu, Max Wintermark, Ho-Ling Liu

Faculty, Staff and Student Publications

Background: Intersubject variation among patients with brain tumors complicates the template matching process for detecting the resting-state (rs) functional MRI (fMRI) language network when using independent component analysis (ICA).

Purpose: This study aimed to develop methods that use a probabilistic language atlas to incorporate intersubject variation in brain tumor patients into the template matching process.

Methods: This retrospective study included 79 patients with brain tumors (average age, 50 ± 15 years) who underwent presurgical task-based (tb)-fMRI and rs-fMRI at clinical 3T scanners. At varying template generation thresholds (τ), binary and probabilistic templates were obtained from the language atlas. A binary …