Medicine and Health Sciences Commons^™

Clinical And Angiographic Success And Safety Comparison Of Coronary Intravascular Lithotripsy: An Updated Meta-Analysis, Yasar Sattar, Talal Almas, Junaid Arshad, Mohamed Zghouzi, Waqas Ullah, Tanveer Mir, Mohamed O Mohamed, Islam Y Elgendy, Wael Aljaroudi, Anand Prasad, Richard Shlofmitz, Mamas A Mamas, Dean J Kereiakes, M Chadi Alraies

Department of Medicine Faculty Papers

Background: Intravascular lithotripsy (IVL) can be used to assist stent deployment in severe coronary artery calcifications (CAC).

Methods: Studies employing IVL for CAC lesions were included. The primary outcomes included clinical and angiographic success. The secondary outcomes, including lumen gain, maximum calcium thickness, and calcium angle at the final angiography site, minimal lumen area site, and minimal stent area site, were analyzed by the random-effects model to calculate the pooled standardized mean difference. Tertiary outcomes included safety event ratios.

Results: Seven studies (760 patients) were included. The primary outcomes: pooled clinical and angiographic success event ratio parentage of IVL was …

Curriculum Development By Design Thinking: Analyzing A Program For Social Determinants Of Health Screening By Pre-Clerkship Medical Students., Ari M Fish, J Matthew Fields, Deborah Ziring, Gina Mccoy, Paula Ostroff, Geoffrey Hayden

Department of Emergency Medicine Faculty Papers

Problem: Health systems science (HSS) curricula in medical schools facilitate an understanding of social determinants of health (SDOH) and their impact on health outcomes. After implementation of an experiential, patient-centered program based around SDOH screening, however, our medical college noted poor student receptivity and engagement. In order to improve the program, we chose a design thinking approach based on the perceived value of actively engaging learners in the design of education. The role of design thinking in curricular quality improvement, however, remains unclear.

Intervention: We sought to determine if a current educational model for SDOH screening could be improved by …

Increased Drp1 Promotes Autophagy And Escc Progression By Mtdna Stress Mediated Cgas-Sting Pathway., Yujia Li, Hui Chen, Qi Yang, Lixin Wan, Jing Zhao, Yuanyuan Wu, Jiaxin Wang, Yating Yang, Menglan Niu, Hongliang Liu, Junqi Liu, Hushan Yang, Shaogui Wan, Yanming Wang, Dengke Bao

Department of Medical Oncology Faculty Papers

Background: Mitochondrial dynamics homeostasis is important for cell metabolism, growth, proliferation, and immune responses. The critical GTPase for mitochondrial fission, Drp1 is frequently upregulated in many cancers and is closely implicated in tumorigenesis. However, the mechanism underling Drp1 to influence tumor progression is largely unknown, especially in esophageal squamous cell carcinoma (ESCC).

Methods: Immunohistochemistry was used to examine Drp1 and LC3B expression in tissues of ESCC patients. Autophagic vesicles were investigated by transmission electron microscopy. Fluorescent LC3B puncta and mitochondrial nucleoid were observed by fluorescent and confocal microscopy. Mitochondrial function was evaluated by mitochondrial membrane potential, ROS and ATP levels. …

Viral Ejection Proteins: Mosaically Conserved, Conformational Gymnasts, Nicholas A. Swanson, Chun-Feng Hou, Gino Cingolani

Department of Biochemistry and Molecular Biology Faculty Papers

Bacterial viruses (or bacteriophages) have developed formidable ways to deliver their genetic information inside bacteria, overcoming the complexity of the bacterial-cell envelope. In short-tailed phages of the Podoviridae superfamily, genome ejection is mediated by a set of mysterious internal virion proteins, also called ejection or pilot proteins, which are required for infectivity. The ejection proteins are challenging to study due to their plastic structures and transient assembly and have remained less characterized than classical components such as the phage coat protein or terminase subunit. However, a spate of recent cryo-EM structures has elucidated key features underscoring these proteins’ assembly and …

C1q/Tnf-Related Protein 3 Prevents Diabetic Retinopathy Via Ampk-Dependent Stabilization Of Blood–Retinal Barrier Tight Junctions, Zheyi Yan, Chunfang Wang, Zhijun Meng, Lu Gan, Rui Guo, Jing Liu, Wayne Bond Lau, Dina Xie, Jianli Zhao, Bernard Lopez, Theodore Christopher, Ulhas P. Naik, Xin-Liang Ma, Yajing Wang

Department of Medicine Faculty Papers

Background The impairment of the inner blood–retinal barrier (iBRB) increases the pathological development of diabetic retinopathy (DR), a severe complication in diabetic patients. Identifying approaches to preserving iBRB integrity and function is a significant challenge in DR. C1q/tumor necrosis factor-related protein-3 (CTRP3) is a newly discovered adipokine and a vital biomarker, predicting DR severity. We sought to determine whether and how CTRP3 affects the pathological development of non-proliferative diabetic retinopathy (NPDR). Methods To clarify the pathophysiologic progress of the blood–retinal barrier in NPDR and explore its potential mechanism, a mouse Type 2 diabetic model of diabetic retinopathy was used. The …

Ghost Mitochondria Drive Metastasis Through Adaptive Gcn2/Akt Therapeutic Vulnerability, Jagadish C Ghosh, Michela Perego, Ekta Agarwal, Irene Bertolini, Yuan Wang, Aaron R Goldman, Hsin-Yao Tang, Andrew V Kossenkov, Catherine J Libby, Lucia R Languino, Edward F Plow, Annamaria Morotti, Luisa Ottobrini, Marco Locatelli, David W Speicher, M Cecilia Caino, Joel Cassel, Joseph M Salvino, Marie E Robert, Valentina Vaira, Dario C Altieri

Department of Cancer Biology Faculty Papers

Cancer metabolism, including in mitochondria, is a disease hallmark and therapeutic target, but its regulation is poorly understood. Here, we show that many human tumors have heterogeneous and often reduced levels of Mic60, or Mitofilin, an essential scaffold of mitochondrial structure. Despite a catastrophic collapse of mitochondrial integrity, loss of bioenergetics, and oxidative damage, tumors with Mic60 depletion slow down cell proliferation, evade cell death, and activate a nuclear gene expression program of innate immunity and cytokine/chemokine signaling. In turn, this induces epithelial-mesenchymal transition (EMT), activates tumor cell movements through exaggerated mitochondrial dynamics, and promotes metastatic dissemination in vivo. In …

Patient And Provider Experiences With Cbt-I Administered In-Person Or Via Telemedicine: A Randomized Non-Inferiority Trial, Rachel E. Granberg, Arianna Heyer, Philip R. Gehrman, Paul W. Gunter, Nathan A. Hoff, Amanda Guth, Matthew S. Kayser, Samuel Kuna, Rosemary Frasso

College of Population Health Faculty Papers

Cognitive behavioral therapy for insomnia (CBT-I) is an effective treatment in adults. However, access to care is limited. One potential solution is telemedicine. Though synchronous video-based telemedicine CBT-I has been shown to be non-inferior to in-person treatment, there is no study to date that evaluates patient and provider experiences with video-based treatment. Our study team evaluated patient and provider perceptions of CBT-I delivered via telemedicine versus an in-person format. As part of a larger randomized control trial, we interviewed patients and providers in both arms of the study (in-person and via telemedicine). 20 minute interviews were conducted over the phone …

Four Faces Of Cell-Surface Hla Class-I: Their Antigenic And Immunogenic Divergence Generating Novel Targets For Vaccines, Mepur H Ravindranath, Narendranath M Ravindranath, Senthamil R Selvan, Edward J Filippone, Carly J Amato-Menker, Fatiha El Hilali

Department of Medicine Faculty Papers

Leukocyte cell-surface HLA-I molecules, involved in antigen presentation of peptides to CD8+ T-cells, consist of a heavy chain (HC) non-covalently linked to β2-microglobulin (β2m) (Face-1). The HC amino acid composition varies across all six isoforms of HLA-I, while that of β2m remains the same. Each HLA-allele differs in one or more amino acid sequences on the HC α1 and α2 helices, while several sequences among the three helices are conserved. HCs without β2m (Face-2) are also observed on human cells activated by malignancy, viral transformation, and cytokine or chemokine-mediated inflammation. In the absence of β2m, the monomeric Face-2 exposes immunogenic …

Transitions Of Care: Completeness Of The Interoperability Data Standard For Communication From Home Health Care To Primary Care., Edgar Chou, Paulina S Sockolow

Department of Medicine Faculty Papers

Data sharing is necessary to address communication deficits along the transitions of care among community settings. Evidence-based practice supports home healthcare (HHC) patients to see their primary care team within the first two weeks of hospital discharge to reduce rehospitalization risk. A small subset of patient data collected at HHC admission is mandated to be transmitted to primary care, predominantly by fax. Using qualitative analysis, we assessed completeness of the United States Core Data for Interoperability (USCDI) interoperability standard, as compared to the patient data collected by the primary care team (topics) and HHC (classes) during the initial visit; and …

Response Of Astrocyte Subpopulations Following Spinal Cord Injury, R Vivian Allahyari, Nicolette M Heinsinger, Daniel Hwang, David A Jaffe, Javad Rasouli, Stephanie Shiers, Samantha J Thomas, Theodore J Price, A M Rostami, Angelo C Lepore

Department of Neuroscience Faculty Papers

There is growing appreciation for astrocyte heterogeneity both across and within central nervous system (CNS) regions, as well as between intact and diseased states. Recent work identified multiple astrocyte subpopulations in mature brain. Interestingly, one subpopulation (Population C) was shown to possess significantly enhanced synaptogenic properties in vitro, as compared with other astrocyte subpopulations of adult cortex and spinal cord. Following spinal cord injury (SCI), damaged neurons lose synaptic connections with neuronal partners, resulting in persistent functional loss. We determined whether SCI induces an enhanced synaptomodulatory astrocyte phenotype by shifting toward a greater proportion of Population C cells and/or increasing …

Response Of Astrocyte Subpopulations Following Spinal Cord Injury., R Vivian Allahyari, Nicolette M Heinsinger, Daniel Hwang, David A Jaffe, Javad Rasouli, Stephanie Shiers, Samantha J Thomas, Theodore J Price, Abdolmohamad Rostami, Angelo C Lepore

Farber Institute for Neuroscience Faculty Papers

There is growing appreciation for astrocyte heterogeneity both across and within central nervous system (CNS) regions, as well as between intact and diseased states. Recent work identified multiple astrocyte subpopulations in mature brain. Interestingly, one subpopulation (Population C) was shown to possess significantly enhanced synaptogenic properties in vitro, as compared with other astrocyte subpopulations of adult cortex and spinal cord. Following spinal cord injury (SCI), damaged neurons lose synaptic connections with neuronal partners, resulting in persistent functional loss. We determined whether SCI induces an enhanced synaptomodulatory astrocyte phenotype by shifting toward a greater proportion of Population C cells and/or increasing …

Breastfeeding Awareness And Empowerment (Bae): A Black Women-Led Approach To Promoting A Multigenerational Culture Of Health, Rebecca Duncan, Jabina Coleman, Sharon Herring, Meg Kawan, Christy Santoro, Meghana Atre, Aleigha Mason, Shawana S Moore, Aparna Kumar

College of Nursing Faculty Papers & Presentations

(1) Background: Critical gaps in the U.S. healthcare system perpetuate adverse reproductive health outcomes for Black people. Grounded in reproductive justice and trauma-informed care, Breastfeeding Awareness and Empowerment (BAE) has developed a program titled BAE Cafe to directly address these gaps by providing community-based lactation and perinatal mental health support. A literature review identified key programmatic gaps, namely, access to knowledge relevant to troubleshooting breastfeeding, peer support, community support and healthcare system support, and system-level factors that impede families and communities from accessing lactation support. (2) Methods: This paper describes BAE Cafe through a group process observation and participant survey. …

Abi1 Mediates Airway Smooth Muscle Cell Proliferation And Airway Remodeling Via Jak2/Stat3 Signaling, Ruping Wang, Yinna Wang, Guoning Liao, Bohao Chen, Reynold A. Panettieri, Jr., Raymond B. Penn, Albany Medical College

Center for Translational Medicine Faculty Papers

Asthma is a complex pulmonary disorder with multiple pathological mechanisms. A key pathological feature of chronic asthma is airway remodeling, which is largely attributed to airway smooth muscle (ASM) hyperplasia that contributes to thickening of the airway wall and further drives asthma pathology. The cellular processes that mediate ASM cell proliferation are not completely elucidated. Using multiple approaches, we demonstrate that the adapter protein Abi1 (Abelson interactor 1) is upregulated in ∼50% of ASM cell cultures derived from patients with asthma. Loss-of-function studies demonstrate that Abi1 regulates the activation of Jak2 (Janus kinase 2) and STAT3 (signal transducers and activators …

Blood-Brain Barrier Disruption Mediated By Ffa1 Receptor-Evidence Using Miniscope, Kristen L Lindenau, Jeffrey L Barr, Christopher R Higgins, Kevin T Sporici, Eugen Brailoiu, G Cristina Brailoiu

College of Pharmacy Faculty Papers

Omega-3 polyunsaturated fatty acids (n-3 PUFAs), obtained from diet and dietary supplements, have been tested in clinical trials for the prevention or treatment of several diseases. n-3 PUFAs exert their effects by activation of free fatty acid (FFA) receptors. FFA1 receptor, expressed in the pancreas and brain, is activated by medium- to long-chain fatty acids. Despite some beneficial effects on cognition, the effects of n-3 PUFAs on the blood-brain barrier (BBB) are not clearly understood. We examined the effects of FFA1 activation on BBB permeability in vitro, using rat brain microvascular endothelial cells (RBMVEC), and in vivo, by assessing Evans …

Challenges And Opportunities For Immunotherapeutic Intervention Against Myeloid Immunosuppression In Glioblastoma, Mark A Exley, Samantha Garcia, Amelia Zellander, Jenny Zilberberg, David W. Andrews

Department of Neurosurgery Faculty Papers

Glioblastoma multiforme (GBM), the most common and deadly brain cancer, exemplifies the paradigm that cancers grow with help from an immunosuppressive tumor microenvironment (TME). In general, TME includes a large contribution from various myeloid lineage-derived cell types, including (in the brain) altered pathogenic microglia as well as monocyte-macrophages (Macs), myeloid-derived suppressor cells (MDSC) and dendritic cell (DC) populations. Each can have protective roles, but has, by definition, been coopted by the tumor in patients with progressive disease. However, evidence demonstrates that myeloid immunosuppressive activities can be reversed in different ways, leading to enthusiasm for this therapeutic approach, both alone and …

Evanescent - Issue 3

Evanescent

Evanescent: A Journal of Literary Medicine is the journal of the Eakins Writers’ Workshop, which also sponsors the Drs. Theresa and Charles Yeo Writing Prize. The Eakins Writers’ Workshop is supported by the Jefferson Center for Injury Research and Prevention.

Contents:

• Letters From The Editors
• Struggle/Growth
• The Drs. Theresa and Charles Yeo Writing Prize: First Place
• Stasis/Change
• The Drs. Theresa and Charles Yeo Writing Prize: Second Place
• Vulnerability/Strength
• The Drs. Theresa and Charles Yeo Writing Prize: Third Place
• Wonder/Wisdom
• Gratitude/Insight
• Afterword
• List of Contributors

A Randomized Study Of Lenvatinib 18 Mg Vs 24 Mg In Patients With Radioiodine-Refractory Differentiated Thyroid Cancer, Marcia S Brose, Yury Panaseykin, Bhavana Konda, Christelle De La Fouchardiere, Brett G M Hughes, Andrew G Gianoukakis, Young Joo Park, Ilia Romanov, Monika K Krzyzanowska, Sophie Leboulleux, Terri A Binder, Corina Dutcus, Ran Xie, Matthew H Taylor

Department of Medical Oncology Faculty Papers

Background: Lenvatinib is a multikinase inhibitor approved to treat radioiodine-refractory differentiated thyroid cancer (RR-DTC) at a starting dose of 24 mg/day. This study explored, in a double-blinded fashion, whether a starting dose of 18 mg/day would provide comparable efficacy with reduced toxicity.

Methods: Patients with RR-DTC were randomized to lenvatinib 24 mg/day or 18 mg/day. The primary efficacy endpoint was objective response rate as of week 24 (ORRwk24); the odds ratio noninferiority margin was 0.4. The primary safety endpoint was frequency of grade ≥3 treatment-emergent adverse events (TEAEs) as of week 24. Tumors were assessed using RECIST v1.1. TEAEs were …

Acute Left Atrial Compression After Ventricular Assist Device Placement, Max Rug Ruge, Tal Zivan, Ron Leong, Eric Feduska, Mahek Shah, J. Eduardo Rame, Howard Massey, René J Alvarez, Yevgeniy Brailvosky, Indranee Rajapreyar

Division of Internal Medicine Faculty Papers & Presentations

Highlights:

• Pump thrombosis commonly presents with hemolysis and device parameter fluctuations.
• Left atrial compression presents similarly to pump thrombosis but with no device fluctuations.
• Reference standard imaging test for ventricular device thrombus is contrast-enhanced CT.

Nanoscale Rules Governing The Organization Of Glutamate Receptors In Spine Synapses Are Subunit Specific, Martin Hruska, Rachel E Cain, Matthew B Dalva

Department of Neuroscience Faculty Papers

Heterotetrameric glutamate receptors are essential for the development, function, and plasticity of spine synapses but how they are organized to achieve this is not known. Here we show that the nanoscale organization of glutamate receptors containing specific subunits define distinct subsynaptic features. Glutamate receptors containing GluA2 or GluN1 subunits establish nanomodular elements precisely positioned relative to Synaptotagmin-1 positive presynaptic release sites that scale with spine size. Glutamate receptors containing GluA1 or GluN2B specify features that exhibit flexibility: GluA1-subunit containing AMPARs are found in larger spines, while GluN2B-subunit containing NMDARs are enriched in the smallest spines with neither following a strict …

Dna-Pkcs: A Targetable Protumorigenic Protein Kinase., Emanuela Dylgjeri, Karen E Knudsen

Department of Cancer Biology Faculty Papers

DNA-dependent protein kinase catalytic subunit (DNA-PKcs) is a pleiotropic protein kinase that plays critical roles in cellular processes fundamental to cancer. DNA-PKcs expression and activity are frequently deregulated in multiple hematologic and solid tumors and have been tightly linked to poor outcome. Given the potentially influential role of DNA-PKcs in cancer development and progression, therapeutic targeting of this kinase is being tested in preclinical and clinical settings. This review summarizes the latest advances in the field, providing a comprehensive discussion of DNA-PKcs functions in cancer and an update on the clinical assessment of DNA-PK inhibitors in cancer therapy.

A Prospective Cohort Study Of The Clinical Predictors Of Bacteremia In Under-Five Children With Acute Undifferentiated Fever Attending A Secondary Health Facility In Northwestern Nigeria, Taofik Oluwaseun Ogunkunle, Timothy Olanrewaju Adedoyin, Samuel Kolade Ernest, Fatimah Hassan-Hanga, Abdulazeez Imam, Rasaq Olaosebikan, Stephen K Obaro

Department of Pharmacology and Experimental Therapeutics Faculty Papers

Background: Children with acute febrile illness with no localizing signs often receive antibiotics empirically in most resource-poor settings. However, little is known about the burden of bacteremia in this category of patients, and an appraisal is thus warranted. This will guide clinical practice and promote rational antibiotics use.

Methods: We prospectively followed up 140 under-five children who presented with acute undifferentiated fever at the emergency/outpatient pediatric unit of a secondary healthcare facility. Baseline clinical and laboratory information was obtained and documented in a structured questionnaire. We compared baseline characteristics between participants with bacteremia and those without bacteremia. We further fitted …

29 M 6 A-Rna Methylation (Epitranscriptomic) Regulators Are Regulated In 41 Diseases Including Atherosclerosis And Tumors Potentially Via Ros Regulation - 102 Transcriptomic Dataset Analyses, Ming Liu, Keman Xu, Fatma Saaoud, Ying Shao, Ruijing Zhang, Yifan Lu, Yu Sun, Charles Drummer Iv, Li Li, Sheng Wu, Satya P Kunapuli, Gerard J Criner, Jianxin Sun, Huimin Shan, Xiaohua Jiang, Hong Wang, Xiaofeng Yang

Center for Translational Medicine Faculty Papers

We performed a database mining on 102 transcriptomic datasets for the expressions of 29 m6A-RNA methylation (epitranscriptomic) regulators (m6A-RMRs) in 41 diseases and cancers and made significant findings: (1) a few m6A-RMRs were upregulated; and most m6A-RMRs were downregulated in sepsis, acute respiratory distress syndrome, shock, and trauma; (2) half of 29 m6A-RMRs were downregulated in atherosclerosis; (3) inflammatory bowel disease and rheumatoid arthritis modulated m6A-RMRs more than lupus and psoriasis; (4) some organ failures shared eight upregulated m6A-RMRs; end-stage renal failure (ESRF) downregulated 85% of m6A-RMRs; (5) Middle-East respiratory syndrome coronavirus infections modulated m6A-RMRs the most among viral infections; …

Successful Treatment With Daptomycin Of Mrsa Empyema Complicated By Right-Sided Loculated Pleural Effusion Refractory To Vancomycin, Ava Torjani, Dylan Selbst, Joshua Hamsher, Sahaj Mujumdar, Andie Belkoff, Luis Taboada

Division of Internal Medicine Faculty Papers & Presentations

Empyema is a serious complication of pneumonia and has been reported to have a mortality rate of 8.7%. For methicillin-resistant Staphylococcus aureus (MRSA) empyema, treatment includes drainage and specific antibiotics such as vancomycin and linezolid. Strikingly, there are increasing incidences of empyema refractory to vancomycin and linezolid. Despite being inactivated in the lung parenchyma by pulmonary surfactant, daptomycin can penetrate the pleural space and may be better at treating MRSA empyema than vancomycin and linezolid. Some case reports have shown that daptomycin has been used to successfully treat MRSA empyema refractory to linezolid and vancomycin-resistant enterococcus (VRE) empyema. Here, we …

Coronary Revascularization Versus Optimal Medical Therapy In Renal Transplant Candidates With Coronary Artery Disease: A Systematic Review And Meta-Analysis., Muhammad U Siddiqui, Joey Junarta, Gregary D. Marhefka

Department of Medicine Faculty Papers

Background Coronary artery disease (CAD) is highly prevalent in patients with chronic kidney disease and is a common cause of mortality in end-stage renal disease. Thus, patients with end-stage renal disease are routinely screened for CAD before renal transplantation. The usefulness of revascularization before transplantation remains unclear. We hypothesize that there is no difference in all-cause and cardiovascular mortality in waitlisted renal transplant candidates with CAD who underwent revascularization versus those treated with optimal medical therapy before transplantation. Methods and Results This meta-analysis was reported according to the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. MEDLINE, Scopus, and …

Coinfections In Patients With Cancer And Covid-19: A Covid-19 And Cancer Consortium (Ccc19) Study, Gowri Satyanarayana, Kyle T Enriquez, Tianyi Sun, Elizabeth J Klein, Maheen Abidi, Shailesh M Advani, Joy Awosika, Ziad Bakouny, Babar Bashir, Stephanie Berg, Marilia Bernardes, Pamela C Egan, Arielle Elkrief, Lawrence E Feldman, Christopher R Friese, Shipra Goel, Cyndi Gonzalez Gomez, Keith L Grant, Elizabeth A Griffiths, Shuchi Gulati, Shilpa Gupta, Clara Hwang, Jayanshu Jain, Chinmay Jani, Anna Kaltsas, Anup Kasi, Hina Khan, Natalie Knox, Vadim S Koshkin, Daniel H Kwon, Chris Labaki, Gary H Lyman, Rana R Mckay, Christopher Mcnair, Gayathri Nagaraj, Elizabeth S Nakasone, Ryan Nguyen, Taylor K Nonato, Adam J Olszewski, Orestis A Panagiotou, Matthew Puc, Pedram Razavi, Elizabeth V Robilotti, Miriam Santos-Dutra, Andrew L Schmidt, Dimpy P Shah, Sumit A Shah, Kendra Vieira, Lisa B Weissmann, Trisha M Wise-Draper, Ulysses Wu, Julie Tsu-Yu Wu, Toni K Choueiri, Sanjay Mishra, Jeremy L Warner, Benjamin French, Dimitrios Farmakiotis

Department of Medical Oncology Faculty Papers

Background: The frequency of coinfections and their association with outcomes have not been adequately studied among patients with cancer and coronavirus disease 2019 (COVID-19), a high-risk group for coinfection.

Methods: We included adult (≥18 years) patients with active or prior hematologic or invasive solid malignancies and laboratory-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infection, using data from the COVID-19 and Cancer Consortium (CCC19, NCT04354701). We captured coinfections within ±2 weeks from diagnosis of COVID-19, identified factors cross-sectionally associated with risk of coinfection, and quantified the association of coinfections with 30-day mortality.

Results: Among 8765 patients (hospitalized or not; median …

Cerebral Blood Flow And Brain Functional Connectivity Changes In Older Adults Participating In A Mindfulness-Based Stress Reduction Program, Aleeze Sattar Moss, Diane K. Reibel, Nancy Wintering, Faezeh Vedaei, Hannah Porter, Mohsen Khosravi, Justin Heholt, M. Alizadeh, Feroze Mohamed, Andrew B. Newberg

Department of Radiology Faculty Papers

There is a growing interest in the potential beneficial effects of mindfulness meditation training in protecting against age-related physical, emotional, and cognitive decline. The current prospective, single-center, single-arm study investigated if functional magnetic resonance imaging-based changes in cerebral blood flow and brain functional connectivity could be observed in 11 elderly adults (mean age 79) after participation in a Mindfulness-Based Stress Reduction (MBSR) program. The results showed significantly (p < 0.05) altered cerebral blood flow and functional connectivity in the cingulate gyrus, limbic structures, and subregions of the temporal and frontal lobes, similar to findings of other meditation-related studies in younger populations. Furthermore, these changes were also associated with significant improvements in depression symptoms. This study suggests that the MBSR program can potentially modify cerebral blood flow and connectivity in this population.

Treatment Of Nonsurgical Refractory Back Pain With High-Frequency Spinal Cord Stimulation At 10 Khz: 12-Month Results Of A Pragmatic, Multicenter, Randomized Controlled Trial., Leonardo Kapural, Jessica Jameson, Curtis Johnson, Daniel Kloster, Aaron Calodney, Peter Kosek, Julie Pilitsis, Markus Bendel, Erika Petersen, Chengyuan Wu, Taissa Cherry, Shivanand P Lad, Cong Yu, Dawood Sayed, Johnathan Goree, Mark K Lyons, Andrew Sack, Diana Bruce, Frances Rubenstein, Rose Province-Azalde, David Caraway, Naresh P Patel

Department of Neurosurgery Faculty Papers

Objective: Spinal cord stimulation (SCS) at 10 kHz (10-kHz SCS) is a safe and effective therapy for treatment of chronic low-back pain. However, it is unclear from existing evidence whether these findings can be generalized to patients with chronic back pain that is refractory to conventional medical management (CMM) and who have no history of spine surgery and are not acceptable candidates for spine surgery. The authors have termed this condition "nonsurgical refractory back pain" (NSRBP) and conducted a multicenter, randomized controlled trial to compare CMM with and without 10-kHz SCS in this population.

Methods: Patients with NSRBP, as defined …

Differences In Clinical And Functional Outcomes Between Osteochondral Allograft Transplantation And Autologous Chondrocyte Implantation For The Treatment Of Focal Articular Cartilage Defects, John R Matthews, Joseph Brutico, Daniel Abraham, Jeremy Heard, Bradford Tucker, Fotios Tjoumakaris, Kevin Freedman

Rothman Institute Papers

Background: Articular cartilage pathology can result from a spectrum of origins, including trauma, osteochondritis dissecans, avascular necrosis, or degenerative joint disease.

Purpose: To compare the differences in clinical and patient-reported outcomes after autologous chondrocyte implantation (ACI) versus osteochondral allograft transplantation (OCA) in patients with focal articular cartilage defects without underlying bone loss.

Study design: Cohort study; Level of evidence, 3.

Methods: A retrospective review identified patients who underwent ACI or OCA between 2008 and 2016 for isolated grades 3 and 4 articular cartilage defects without underlying bone loss. Outcome measures included the Knee injury and Osteoarthritis Outcome Score for Joint …

"1,000 Conversations I'D Rather Have Than That One:" A Qualitative Study Of Prescriber Experiences With Opioids And The Impact Of A Prescription Drug Monitoring Program., Jillian Zavodnick, Alexis Wickersham, Alison Petok, Brooke Worster, Amy Leader

Department of Medicine Faculty Papers

BACKGROUND: Prescription Drug Monitoring Programs (PDMPs) have shown impacts on a number of opioid-related outcomes but their role in clinician emotional experience of opioid prescribing has not been studied.

OBJECTIVES: This study explores the impact of PDMPs on clinician attitudes toward and comfort with opioid prescribing, their satisfaction with patient interactions involving discussion of opioid prescriptions, and their recognition of opioid use disorder (OUD) and ability to refer patients to treatment.

METHODS: Researchers conducted semi-structured interviews with five physicians and two nurse practitioners from a variety of specialties and practice environments.

RESULTS: Many participants reported negative emotions surrounding opioid-related patient …

Sudden Hearing Loss: Wrs Importance And Timing Of Medical Intervention, Irina Linkov Middleton, Alexandra Costlow, Molly Wolfson, Midori Wakabayashi, Tingting Zhan

Jefferson Health - Northeast Posters (formerly Aria Health Posters)

Objective: The aim of this study was to evaluate recovery in hearing acuity of idiopathic sudden sensorineural hearing loss (ISSNHL) based on timing of onset to determine how late is too late to medically intervene.

Study Design: A retrospective chart review was conducted in patients previously treated for primary complaint of sudden hearing loss (HL). Participants meeting inclusion criteria were analyzed based on timing of onset to service date, age, gender, associated ear, associated symptoms as well as recovery in pure tone average (PTA) and recovery in word recognition scores (WRS).

Setting: All patients seeking treatment for SSNHL were seen …