Medicine and Health Sciences Commons^™

Smoking Habit And Long-Term Colorectal Cancer Incidence By Exome-Wide Mutational And Neoantigen Loads: Evidence Based On The Prospective Cohort Incident-Tumour Biobank Method, Tsuyoshi Hamada, Tomotaka Ugai, Carino Gurjao, Satoko Ugai, Xuehong Zhang, Koichiro Haruki, Yasutoshi Takashima, Naohiko Akimoto, Mai Chan Lau, Kosuke Matsuda, Nobuhiro Nakazawa, Mayu Higashioka, Satoshi Miyahara, Keisuke Kosumi, Yohei Masugi, Li Liu, Yin Cao, Daniel Nevo, Molin Wang, Reiko Nishihara, Sachet A Shukla, Catherine J Wu, Levi A Garraway, Jeffrey A Meyerhardt, Edward L Giovannucci, Jonathan A Nowak, Charles S Fuchs, Andrew T Chan, Mingyang Song, Marios Giannakis, Shuji Ogino

Faculty, Staff and Student Publications

Objective: To test the hypothesis that the association of smoking with long-term colorectal cancer incidence may be stronger for tumours with higher mutational and neoantigen loads.

Methods and analysis: In the Nurses' Health Study (1980-2012) and the Health Professionals Follow-up Study (1986-2012), our novel prospective cohort incident-tumour biobank method (PCIBM) used 3053 incident colorectal carcinoma cases including 752 cases with whole-exome sequencing data. Using the multivariable duplication-method Cox regression model with the inverse probability weighting to adjust for the selection bias due to tissue availability, we assessed a differential association of cigarette smoking with colorectal carcinoma incidence by an exome-wide …

Multimodal Approach In Distinguishing And Managing Uterine Arteriovenous Malformation: A Case Report, Sajeev Sridhar, Roman Sukhovershin, John A Hancock

The Brown Foundation: Institute of Molecular Medicine

Arteriovenous malformations (AVMs) are abnormal vascular connections bypassing the capillary system, categorized as acquired or congenital. Acquired uterine AVMs, often resulting from uterine trauma due to procedures like dilatation and curettage, can be life threatening, necessitating prompt diagnosis and management. Here we present a 34-year-old woman with a history of missed abortion and dilatation and curettage presenting with abnormal uterine bleeding 2 months postprocedure. Although initial transvaginal ultrasound suggested retained products of conception, several modalities were required to accurately diagnose uterine AVM with invasive angiography revealing the culprit vessel. Multimodal imaging approaches are crucial for accurate diagnosis and treatment. This …

Type 2 Diabetes Polygenic Risk Score Interactions With Lifestyle Risk Factors In Black Americans, Ashley W Scadden, Aastha Kakar, Elizabeth M Litkowski, Mariah C Meyer, Nicole D Armstrong, Steven Buyske, Yanwei Cai, Iona Cheng, Burcu F Darst, Myriam Fornage, Mariaelisa Graff, Boya Guo, Christopher A Haiman, Heather M Highland, Charles Kooperberg, Loïc Le Marchand, Kari North, Ulrike Peters, Stephen S Rich, Jerome I Rotter, Vinodh Srinivasasainagendra, Hemant K Tiwari, Stephanie Waldrop, Kristin Young, Sridharan Raghavan, Ethan M Lange, Leslie A Lange, Marguerite R Irvin, Maggie A Stanislawski

The Brown Foundation: Institute of Molecular Medicine

Introduction: Prior work in predominantly European ancestry populations has explained how the risk associated with demographic, lifestyle, and health factors differs with underlying genetic susceptibility to type 2 diabetes (T2D), but less is known about these relationships in Black Americans.

Methods: We used covariate-adjusted logistic regression models of T2D to examine interactions between a published trans-ancestry derived T2D polygenic risk score (PRS) and various demographic, lifestyle, and health-related factors among 28,251 self-identified Black Americans from six cohort studies.

Results: The results are generally consistent with prior work in White populations. The PRS showed a significant interaction with body mass index, …

Enhanced Anticancer Activity Of Novel Pyrimidine Nucleoside Analog In Pancreatic Cancer, Raviteja Bulusu, Joy Okoro, Esther Frimpong, Sunil Krishnan, Saunjoo Yoon, Bo Han, Xue Zhu, Edward Agyare

The Brown Foundation: Institute of Molecular Medicine

This study explores the synthesis, characterization, and therapeutic efficacy of AGY1, AGY2, AGY3, AGY4, and AGY5, which are novel 5-FU analogs designed to improve metabolic stability, prolong half-life, and anti-tumor activity against pancreatic cancer. The 5-FU molecule was chemically modified to bypass dihydropyrimidine dehydrogenase (DPD)-mediated inactivation, enhancing drug retention and increasing lipophilicity for improved cellular uptake. The analog cytotoxic activity was evaluated in 2D monolayer cultures and 3D pancreatic cancer spheroids and organoid models derived from MiaPaCa-2 and PANC-1 cells to simulate a more complex tumor environment. In the 2D model, AGY1, AGY2, AGY3, AGY4, and AGY5 displayed significantly higher …

Rezafungin For Suppressive Therapy Of Candida Auris In A Patient With A Left Ventricular Assist Device (Lvad), Matthew A Stack, Luis Ostrosky-Zeichner, Rodrigo Hasbun, Sun O Park, Jessica Babic, Mona Kapadia

The Brown Foundation: Institute of Molecular Medicine

Introduction: Invasive candidiasis is a common healthcare-associated infection with significant morbidity and mortality. Candida auris in particular has emerged as a problematic and challenging healthcare-associated infection, especially with regards to infections involving left ventricular assist devices (LVADs). There is a paucity of evidence on the best management of these particular types of infections. Rezafungin is a newly-approved echinocandin and an important new tool in the management of invasive candidiasis. We report the novel use of rezafungin for suppressive therapy in a patient with an LVAD-associated C. auris infection.

Case: The patient is a 57-year-old male with a past medical history …

Mechanisms And Environmental Factors Shaping The Ecosystem Of Brain Macrophages, Silvia Penati, Simone Brioschi, Zhangying Cai, Claudia Z Han, Marco Colonna

The Brown Foundation: Institute of Molecular Medicine

Brain macrophages encompass two major populations: microglia in the parenchyma and border-associated macrophages (BAMs) in the extra-parenchymal compartments. These cells play crucial roles in maintaining brain homeostasis and immune surveillance. Microglia and BAMs are phenotypically and epigenetically distinct and exhibit highly specialized functions tailored to their environmental niches. Intriguingly, recent studies have shown that both microglia and BAMs originate from the same myeloid progenitor during yolk sac hematopoiesis, but their developmental fates diverge within the brain. Several works have partially unveiled the mechanisms orchestrating the development of microglia and BAMs in both mice and humans; however, many questions remain unanswered. …

A Systematic Review And Evaluation Of Mobile Health Apps Designed For Parents Who Are Preparing Or Caring For Medically Complex Infants, Anne Chevalier Mckechnie, Nellie Munn Swanson, Ratchada Jantraporn, Kristin M Elgersma, Taylor Iwaszko Wagner, Suhyun Park, Anna Trebilcock

The Brown Foundation: Institute of Molecular Medicine

Background: Parents learning about their children with medical complexity often use numerous health-related resources, including mobile health applications (mHealth apps). mHealth apps could provide broad access to key information and support, lower healthcare costs, and improve care. The quality of mHealth apps for this population has been a concern, but is currently unknown. The objective of this systematic review was to identify and evaluate the quality of publicly available mHealth apps designed for parents who are preparing or caring for medically complex infants.

Methods: A systematic search strategy was applied to identify mHealth apps in the Apple and Google Play …

Reusable Generic Clinical Decision Support System Module For Immunization Recommendations In Resource-Constraint Settings, Samuil Orlioglu, Akash Shanmugan Boobalan, Kojo Abanyie, Richard D Boyce, Hua Min, Yang Gong, Dean F Sittig, Paul Biondich, Adam Wright, Christian Nøhr, Timothy Law, David Robinson, Arild Faxvaag, Nina Hubig, Ronald Gimbel, Lior Rennert, Xia Jing

Faculty, Staff and Student Publications

Clinical decision support systems (CDSS) are routinely employed in clinical settings to improve quality of care, ensure patient safety, and deliver consistent medical care. However, rule-based CDSS, currently available, do not feature reusable rules. In this study, we present CDSS with reusable rules. Our solution includes a common CDSS module, electronic medical record (EMR) specific adapters, CDSS rules written in the clinical quality language (CQL) (derived from CDC immunization recommendations), and patient records in fast healthcare interoperability resources (FHIR) format. The proposed CDSS is entirely browser-based and reachable within the user's EMR interface at the client-side. This helps to avoid …

Exploring The Inequitable Impact Of Data Missingness On Fairness In Machine Learning, Sitao Min, Hafiz Asif, Jaideep Vaidya

Faculty, Staff and Student Publications

Today, data-driven models and artificial intelligence / machine learning underlie decision making in almost all aspects of society. However, significant concerns have been raised over the fairness of such models. While various aspects of algorithmic fairness have been studied, the effect of missing data on fairness remains understudied. This is a significant problem since data in real-world settings is almost never complete, and may often suffer from systemic missingness. This article systematically evaluates how missing data, particularly when correlated with protected classes and outcome variables, affects the fairness of classifiers. Utilizing a comprehensive framework covering various missing data patterns, rates, …

Accessing Facility Electronic Health Record For Payer Utilization Review Review, Betsey Denton

Doctor of Nursing Practice Final Project Abstract

PURPOSE The purpose of this project was to improve the prior authorization process for payer, provider, and patients by reducing the number of medical necessity denials, peer-to-peer calls, appeals, and increasing payer and provider satisfaction.

BACKGROUND A literature review indicated opportunities for improvement in prior authorization processes. Medical necessity denials are issued by payer if clinical documentation is not available for review. Implementation setting was a large academic medical center. Studied populations included patients who are members of a large Medicaid HMO health plan, payer utilization review registered nurses (RN), and hospital utilization review staff. METHODOLOGY Payer RNs began utilizing …

Disposition Outcomes Following Prehospital Use Of Naloxone In A Large Metropolitan City In The United States, James R Langabeer, Christine Bakos-Block, A Sarah Cohen, Ishmam Alam, Bhanumathi Gopal, Marylou Cardenas-Turanzas, Arlo F Weltge, David Persse, Tiffany Champagne-Langabeer

Faculty, Staff and Student Publications

Objectives: During a drug overdose, research suggests individuals may not call 9-1-1 out of fear of criminal justice concerns. Of those that call, research is inconclusive about the disposition of the emergency transport. We evaluated transport outcomes for adults with opioid-related overdose in the Emergency Medical Services (EMS) of a large metropolitan city in the United States.

Methods: We reviewed the EMS incident report database from the patient care record system for years 2018 to 2022. We queried all records, searching for relevant terms, and two reviewers cross-checked the database to identify cases that did not result in death at …

A Scoping Review Of Patient Safety Checklists In Pediatrics, Kawtar Zouaidi, Tate W Miner, Muhammad F Walji, Kristin N Ray, Elsbeth Kalenderian, Donald B Rindal, Katie J Suda

Faculty, Staff and Student Publications

Objective: To examine the utilization and effectiveness of safety checklists in pediatric clinical care.

Methods: A comprehensive literature search was conducted using Medline to identify studies related to the development and/or implementation of patient safety checklists in pediatrics. All study designs were included for citations published through September 2023.

Results: Following abstract and full-text screening, 74 studies remained for data extraction and analysis. Pediatric surgery emerged as the main setting for checklists use (n = 35), followed by Intensive Care Units (n = 21), and Emergency Departments (n = 9). Of the 74 reviewed papers, 37 (50%) designed and developed …

Intestinal Oxygen Utilisation And Cellular Adaptation During Intestinal Ischaemia-Reperfusion Injury, Paraschos Archontakis-Barakakis, Theodoros Mavridis, David-Dimitris Chlorogiannis, Georgios Barakakis, Eleni Laou, Daniel I Sessler, George Gkiokas, Athanasios Chalkias

Faculty, Staff and Student Publications

The gastrointestinal tract can be deranged by ailments including sepsis, trauma and haemorrhage. Ischaemic injury provokes a common constellation of microscopic and macroscopic changes that, together with the paradoxical exacerbation of cellular dysfunction and death following restoration of blood flow, are collectively known as ischaemia-reperfusion injury (IRI). Although much of the gastrointestinal tract is normally hypoxemic, intestinal IRI results when there is inadequate oxygen availability due to poor supply (pathological hypoxia) or abnormal tissue oxygen use and metabolism (dysoxia). Intestinal oxygen uptake usually remains constant over a wide range of blood flows and pressures, with cellular function being substantively compromised …

Rbd Amplicon Sequencing And Evolutionary Analysis Of Sars-Cov-2 Variants From Wastewater Samples, Xingwen Chen, Chunfu Zheng, Fuqing Wu

Faculty, Staff and Student Publications

The surveillance of SARS-CoV-2 is significantly limited by the presence of numerous variants with distinct behaviors driven by rapid evolution. Although the conventional clinical genome sequencing method provides comprehensive data, it has limitations in capturing the epidemiological dynamics of the variants circulating in the community. In this chapter, we describe a protocol using RBD amplicon sequencing of wastewater samples. We present the detailed experimental procedure for wastewater sample processing, robust nested-PCR-based amplification of the target RBD sequence, and library preparation. Moreover, we describe a general pipeline of sequencing data processing and interpretation, showing the epidemiological and evolutionary trends of SARS-CoV-2 …

Shifting Patterns In Primary Care Telehealth Utilization Among Medicare Beneficiaries And Providers, Yunxi Zhang, Lincy S Lal, Saurabh Chandra, John Michael Swint

Faculty, Staff and Student Publications

Introduction: The COVID-19 pandemic accelerated telehealth adoption, but disparities in its utilization persist. This study examines primary care patient sociodemographic characteristics, telehealth utilization patterns, and provider adoptions before and during the pandemic.

Methods: A retrospective cohort study analyzed data from Mississippi Medicare beneficiaries continuously enrolled in Parts A, B, and D who accessed primary care services from 2019 to 2021.

Results: Among 201 677 Medicare beneficiaries accessing primary care, 1364 used telehealth before the pandemic, compared to 73 994 during the pandemic. Telehealth utilization shifted during the pandemic to younger, female, White beneficiaries, and those enrolled in Medicare due to …

Constructing A Conversation-First Dialogue Model For Comprehensive, Evidence-Based Counseling For Hpv Vaccination For Young Adults, Lu Tang, Chenying Weng, Serena Hou, Lara S Savas, Ana C Neumann, Nicole Moore, Jane Hamilton, Daniel Rhee, Cui Tao, Licong Cui, Muhammad Tuan Amith

Faculty, Staff and Student Publications

The human papillomavirus (HPV) vaccine has been shown to prevent several types of cancers; however, vaccination rates remain suboptimal. Effective patient-provider communication is key to promoting vaccination but is often hindered by various clinical barriers. Speech bots could be a promising solution by addressing common barriers and facilitating HPV vaccination uptake. We used a "conversation first" design approach to develop the interaction for speech bots to deliver HPV vaccination counseling to young adults. Two counseling strategies were developed and piloted: motivational interviewing (MI) and the theory-based approaches. Wizard of Oz experiments were conducted with young female adults (n = 24). …

Phenotypic Variation In Disease Severity Among Hospitalized Pediatric Patients With Covid-19: Assessing The Impact Of Covid-19 In The Epico Study, María Camila Sossa-Alarcón, Mónica Paola Gutiérrez, Natalia Becerra, Luz Yessenia Ortegon, María Camila David, Melisa Naranjo Vanegas, Gabriela Friedrich, Pablo Vásquez-Hoyos, María Lucía Mesa-Rubio, Luis Miguel Navarro-Ramirez, Sergio Moreno-Lopez, Olga Lucía Baquero, Luz Marina Mejía, Juan Gabriel Piñeros, Sonia Restrepo-Gualteros, Carlos Álvarez-Moreno, Alejandro Díaz-Díaz, Iván Gutierrez-Tobar, Andrés Camilo Mesa, William Ricardo Bachiller Tuta, Clara Esperanza Galvis Diaz, Martha Africano, José Manuel Nieto, Paola Marsela Pérez Camacho, Claudia Beltrán-Arroyave, Rosalba Vivas Trochez, Irati Gastesi, Cinta Moraleda, Alfredo Tagarro García, Blanca Herrero, Lourdes Calleja, Carlos Grasa, Paula Rodriguez, Susana Melendo, Antoni Soriano-Arandes, Irene Gómez Pastrana, Sonsoles García García, Victoria Fumado, Andrea Ramírez Varela

Faculty, Staff and Student Publications

Objective: To characterize the clinical phenotypes of SARS-CoV-2 infection in hospitalized children as part of the EPICO multicenter cohort study.

Methods: We included hospitalized children with confirmed SARS-CoV-2 infection from Colombian and Spanish institutions to assess disease evolution and outcomes. Cluster analysis was performed to identify clinical phenotypes.

Results: A total of 2318 patients were included (55% male, 36% infants). Five phenotype clusters emerged: Cluster 1 (26.5%): infants without comorbidities, low PICU admissions and mortality; Cluster 2 (18.5%): respiratory comorbidities, high microorganism co-detection and mortality; Cluster 3 (11.5%): fever, gastrointestinal symptoms, high PICU admissions; Cluster 4 (32%): mild unspecific symptoms, …

Organizational Readiness And Implementation Of Colorectal Cancer Screening Evidence-Based Interventions In Federally Qualified Health Centers: A Cross-Sectional Study, Emanuelle M Dias, Timothy J Walker, Bijal A Balasubramanian, Paula M Cuccaro, Lauren Workman, Abraham Wandersman, Maria E Fernandez

Faculty, Staff and Student Publications

Introduction: Evidence-based interventions (EBIs) exist to increase colorectal cancer (CRC) screening, but implementation remains slow in federally qualified health centers (FQHCs). Assessing organizational readiness can improve EBI implementation outcomes, but no studies have quantitatively examined the relation between organizational readiness subcomponents and implementation outcomes. This study examines associations between readiness subcomponents and CRC screening EBI implementation outcomes in FQHCs.

Methods: We used data from an ongoing parent study to develop an organizational readiness measure using the R = MC2 heuristic. We conducted descriptive and cross-sectional analyses using FQHC clinic (n = 57) data across three states. A clinic contact …

Factors Influencing Implementation Of A Self-Measured Blood Pressure Program In Community Health Centers: An Implementation Mapping Approach, Serena A Rodriguez, Fernanda Velasco-Huerta, Mahalia Sampson-Ansah, Ella R Garza, William B Perkison, Patenne D Mathews, Catherine Pulicken, Maria E Fernandez

Faculty, Staff and Student Publications

Objectives: Uncontrolled hypertension is a leading cause of cardiovascular disease, particularly among adults aged 45 years and older. Self-measured blood pressure (SMBP) is an evidence-based intervention that can help patients manage hypertension outside of the clinical setting. We conducted a needs and assets assessment to identify (1) health center adopters and implementers and (2) barriers and facilitators to SMBP adoption and implementation in six community health centers in Texas.

Methods: Data sources included: (1) needs and assets assessment surveys and semi-structured interviews; (2) site visits with participating health centers; and (3) detailed meeting notes and logs. Leaders and administrators from …

Adaptation Using Im Adapt Of An Evidence-Based Lifestyle Intervention To Support The Management Of Metabolic-Dysfunction Associated Steatotic Liver Disease Among Hispanic/Latino Adults, Natalia I Heredia, Sylvia A Ayieko, Serena A Rodriguez, Jessica P Hwang, Lorna H Mcneill, Maria E Fernandez

Faculty, Staff and Student Publications

The high prevalence of metabolic-dysfunction associated steatotic liver disease (MASLD), formerly non-alcoholic fatty liver disease (NAFLD), necessitates the availability of an evidence-based intervention to manage the condition among patients to prevent severe chronic liver disease and other cardiometabolic-related illnesses. IM Adapt (Intervention Mapping for Adaptation) is a systematic approach for planning modifications in interventions to improve fit and potential effectiveness. Following this stepped approach, we conducted interviews with the target population, conducted a literature review, solicited expert advice, and created a logic model describing expected program outcomes for the new population and setting. We searched for, selected, and adapted an …

Co-Creation Of Staff Training To Address Health-Related Social Needs In Emergencies, Linda Highfield, Gayla Ferguson

Faculty, Staff and Student Publications

Background: Health-related social needs (HRSN), such as housing and transportation barriers, contribute to poor health outcomes and increased healthcare costs. Patient navigators help connect patients to community resources, but workforce training gaps are a challenge. The Strengthening Peer AHC Navigation (SPAN) study aimed to enhance navigation training during the COVID-19 Public Health Emergency.

Methods: Using a stakeholder-driven peer planning approach, SPAN co-developed a quality improvement plan for patient navigation training. Training focused on housing and transportation navigation and included didactic sessions, hands-on case studies, and biweekly expert consultations. Self-efficacy surveys measured navigator confidence pre- and post-training, and changes in navigation …

Effects Of High-Intensity Interval Training On Biomarkers And Inflammatory Factors In Patients With Heart Failure: A Meta-Analysis Of Randomized Controlled Trials, Wanting Zhang, Jooyeon Hwang, Beibei Lu, Xin Xu

Faculty, Staff and Student Publications

Background: There is still controversy about the effect of high-intensity interval training (HIIT) on the levels of cardiac and inflammatory biomarkers in patients with heart failure compared with moderate-intensity continuous training (MCT) and conventional healthcare activities. This article is to systematically investigate the effects of HIIT on the levels of cardiac and inflammatory biomarkers in patients with heart failure compared with MCT and conventional healthcare activities.

Methods: A computerized search of databases was conducted with the search year from the establishment of the database, and the screened results were subjected to quality assessment and data extraction, and the data was …

Application Of Multi-Angle Spaceborne Observations In Characterizing The Long-Term Particulate Organic Carbon Pollution In China, Yun Hang, Qiang Pu, Qiao Zhu, Xia Meng, Zhihao Jin, Fengchao Liang, Hezhong Tian, Tiantian Li, Tijian Wang, Junji Cao, Qingyan Fu, Sagnik Dey, Shenshen Li, Kan Huang, Haidong Kan, Xiaoming Shi, Yang Liu

Faculty, Staff and Student Publications

Ambient PM2.5 pollution poses a major risk to public health in China, contributing to significant mortality and morbidity. While overall PM2.5 concentrations have declined in recent years, the changes in PM2.5 chemical constituents remain inadequately understood due to limited ground monitoring networks. We developed a Super Learner model that integrates MISR satellite data, chemistry transport model simulations, and land use information to predict daily OC concentrations across China from 2003 to 2019 at a 10-km spatial resolution. The model achieved high predictive accuracy with a cross-validation R2 of 0.84 and an RMSE of 4.9 μg/m3. Our findings show elevated OC …

Association Between Covid19 Vaccination Uptake And Socio-Demographic Characteristics Among Pregnant Women In Kenya, Sylvia Ayieko, Sarah E Messiah, Kimberly Baker, Christine Markham

Faculty, Staff and Student Publications

Background: Vaccination is considered more cost-effective in controlling the spread of COVID19 compared to other preventative measures. Pregnant women infected with COVID19 were likely to have severe COVID19 complications compared to uninfected women. This study examined the relationship between COVID19 vaccination uptake and socio-demographic characteristics among pregnant women in Kenya.

Methods: We conducted a secondary analysis using data from a pilot study examining COVID19 vaccination uptake among pregnant women in Kenya. We used descriptive analysis to report the proportions and chi 2 to assess if there are any significant differences between groups. Our primary outcome was COVID19 vaccination uptake. We …

A Mixed-Methods Usability Pilot Of A Value-Goal Elicitation Tool In The Inpatient Setting For Older Adults Anticipating Post-Acute Care, Kirstin M Piazza, Caroline Pascal, Syama R Patel, Caroline Sefcik, Marilyn M Schapira, Caroline Madrigal, Katherine C Ritchey, Longyi Yip, Aanand D Naik, Robert E Burke

Faculty, Staff and Student Publications

Age-Friendly Health Systems (AFHS) emphasize aligning care with "What Matters" most to older adults. Hospitalization represents a critical period where value-based goals could shape key decisions about post-acute care transitions. However, few tools designed for eliciting such goals have been adapted for use in the inpatient setting, where the acute nature of care poses unique challenges. This mixed-methods study evaluates the usability of the Health Priorities Primer Tool (HPPT) in older hospitalized adults who anticipate needing post-acute care, aiming to identify necessary adaptations for the inpatient setting. We conducted interviews, observations, and surveys with older hospitalized patients to understand their …

Long Covid Risk Factors And Outcomes Among Solid Organ Transplant Recipients: A Retrospective Cohort Study, Micaela N Sandoval, Linda W Moore, Howard J Huang, Edward A Graviss

Faculty, Staff and Student Publications

Background: Solid organ transplant (SOT) recipients are not only at increased risk of morbidity and mortality due to acute COVID-19 but may also experience poor long-term outcomes due to post-acute COVID-19 syndromes, including long COVID.

Methods: This retrospective, registry-based chart review evaluated graft failure and mortality among SOT recipients diagnosed with COVID-19 at a large, urban transplant center in Houston, Texas, USA. Patient populations were analyzed separately according to their long COVID status at the time of transplant to preserve the temporal relationship between the exposure (long COVID) and the outcome (graft failure or mortality).

Results: In total, 146 (5%, …

Community-Level Factors Influencing The Duration Of Buprenorphine Treatment In Individuals With Opioid Use Disorder: A Cohort Study Using Us Longitudinal Claims Data, Paula A Jaimes-Buitron, Kehe Zhang, Yanmin Gong, Yuanxiong Guo, Cici Bauer, Carolina Vivas-Valencia

Faculty, Staff and Student Publications

Introduction: Buprenorphine is effective in reducing opioid-related morbidity and mortality; however, many patients discontinue treatment prematurely. While previous research has focused on individual-level predictors of retention, the influence of community context remains underexplored. This study aims to examine how community-level factors, such as social vulnerability, availability of buprenorphine-waivered providers and access to behavioural health services, affect the duration of buprenorphine treatment episodes for individuals with opioid use disorder (OUD).

Methods: We conducted a retrospective cohort study using longitudinal claims data from 2006 to 2022. Adults aged 18 and older who initiated buprenorphine treatment for OUD and maintained continuous enrolment were …

Feasibility Of Conducting A Pilot Randomized Trial Of A Mindfulness-Based Intervention Among Sheltered Young Adults Experiencing Homelessness, Diane Santa Maria, Paula Cuccaro, Erica Sibinga, Kimberly Bender, Ethel Jacko, Widumini Liyanage, Jennifer Jones, Stanley Cron

Faculty, Staff and Student Publications

Purpose: Youth experiencing homelessness (YEH) are an underserved and difficult-to-reach population that experiences a disproportionate burden of trauma and stress compared to their housed peers. Prolonged trauma and stress can impact the development of negative emotions, reactive stress responses, and impulsive decision-making, which can lead to risk-taking behaviors. Growing research shows that Mindfulness-Based interventions (MBIs) can improve coping, impulsivity, emotion regulation, and executive function although no MBIs tailored for YEH have been tested.

Methods: We conducted a pilot attention-control randomized trial to test the feasibility and acceptability of an adapted MBI, .b4me (pronounced dot be for me), for …

Large-Vessel Occlusion Stroke Knowledge And Training For Stroke Severity Assessment Among Emergency Medical Services Personnel In The United States, Kaiz S Asif, Robin Novakovic, Thanh N Nguyen, Santiago Ortega-Gutierrez, Youngran Kim, Amanda Jagolino-Cole, Sushanth Aroor, Alicia Castonguay, Prateek Kumar, Ashutosh P Jhadav, Dileep Yavagal, May Nour, Gabor Toth, Maxim Mokin, Sunil A Sheth, Mouhammad A Jumaa, Alhamza Al-Bayati, Mohamed Teleb, Ossama Y Mansour, Shashvat M Desai, Joshua Hartman, David S Liebeskind, Ameer E Hassan, Brijesh P Mehta, Svin Education And Speed Committees

Faculty, Staff and Student Publications

Background: Prehospital identification of large-vessel occlusion (LVO) stroke facilitates the development of a regional triage protocol that could lead to an improvement in intrahospital and interhospital workflows. This requires stroke education of emergency medical services (EMS) personnel to improve stroke recognition, severity assessment, and prenotification. However, the current state of EMS personnel's knowledge of LVO stroke, their training for stroke severity assessment, and their preferences for educational methods are unknown. We conducted a nationwide EMS survey across the United States to glean insights that can inform and customize future EMS educational efforts.

Methods: The Society of Vascular and Interventional Neurology, …

Community Engagement Studios To Improve Racial Diversity And Health Equity In Parkinson’S, Eunyoung Kang, Dominique Woodhouse, Kandace Davis, Jane Q Yap, Peter S Myers, Meghan C Campbell, Yvonne D Hughes, Joyce E Balls-Berry, Erin R Foster

Faculty, Staff and Student Publications

Background: Black or African Americans (AA) with Parkinson's disease (PD) are underrepresented in both care and research and experience significant health disparities. The existing literature provides limited guidance on how to enhance the engagement of AA individuals in PD care and research, particularly from the perspectives of AA patients, care partners, and healthcare providers. This project aimed to (1) describe the use of Community Engagement (CE) Studios as a community-engaged research approach to inform culturally appropriate and inclusive research and (2) examine factors influencing AA engagement in PD-related activities.

Methods: We conducted three CE Studios: one with AA with PD …