Medicine and Health Sciences Commons^™

Pregnancy-Induced Differential Expression Of Sars-Cov-2 And Influenza A Viral Entry Factors In The Lower Respiratory Tract, Tusar Giri, Santosh Panda, Arvind Palanisamy

2020-Current year OA Pubs

Despite differences in the clinical presentation of coronavirus disease-19 and pandemic influenza in pregnancy, fundamental mechanistic insights are currently lacking because of the difficulty in recruiting critically ill pregnant subjects for research studies. Therefore, to better understand host-pathogen interaction during pregnancy, we performed a series of foundational experiments in pregnant rats at term gestation to assess the expression of host entry factors for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and influenza A virus (IAV) and genes associated with innate immune response in the lower respiratory tract. We report that pregnancy is characterized by a decrease in host factors mediating …

Promis Physical Function And Pain Interference Scores Correlate With The Lower Extremity Toronto Extremity Salvage Score, Julie Jin, Zachery Hong, Lee Rhea, Douglas J. Mcdonald, Regis J. O'Keefe, Cara A. Cipriano

2020-Current year OA Pubs

UNLABELLED: The Toronto Extremity Salvage Score (TESS) and the National Institutes of Health Patient-Reported Outcomes Measurement Information System (PROMIS) are both utilized to measure patient-reported outcomes in adults with musculoskeletal oncologic conditions. However, the relationship between them has not been studied. We sought to describe a link between Lower Extremity (LE) TESS and PROMIS Physical Function (PF) scores, as well as between LE TESS and Pain Interference (PI) scores, to develop a method for converting scores between TESS and PROMIS and to examine whether TESS and PROMIS captured differences in pain and function between clinically relevant subgroups in our population. …

Adherence To And Experiences Of K-12 Students In Modified And Standard Home Quarantine During The Sars-Cov-2 Pandemic In Missouri, Mary Claire Worrell, Sara Malone, Patrick Dawson, Stephanie A. Fritz, Ebony Thomas, Bre Peeler, Catherine Rains, Sarah C. Tinker, John C. Neatherlin, Lisa Barrios, Jon Mooney, Katie Towns, Jason Newland, Johanna S. Salzer

2020-Current year OA Pubs

BACKGROUND: In November 2020, during the SARS-CoV-2 pandemic, Missouri allowed local public health jurisdictions the option to implement a modified quarantine policy allowing kindergarten through 12 (K-12) students with low-risk exposures to continue in-person learning. We assessed adherence to quarantine among participants in modified quarantine and standard home quarantine and the psychosocial impacts of quarantine on students and families.

METHODS: In January-March 2021, as part of an investigation of in-school transmission of SARS-CoV-2, parents of 586 participating K-12 students identified as a close contact with a person with SARS-CoV-2 were sent a survey to assess their activities and psychosocial impacts …

X-Ray And Mr Contrast Bearing Nanoparticles Enhance The Therapeutic Response Of Image-Guided Radiation Therapy For Oral Cancer, Gayatri Sharma, Mir Hadi Razeghi Kondelaji, Guru P. Sharma, Christopher Hansen, Abdul K. Parchur, Shayan Shafiee, Jaidip M. Jagtap, Brian Fish, Carmen Bergom, Eric Paulson, William A. Hall, Heather A. Himburg, Amit Joshi

2020-Current year OA Pubs

INTRODUCTION: Radiation therapy for head and neck squamous cell carcinoma is constrained by radiotoxicity to normal tissue. We demonstrate 100 nm theranostic nanoparticles for image-guided radiation therapy planning and enhancement in rat head and neck squamous cell carcinoma models.

METHODS: PEG conjugated theranostic nanoparticles comprising of Au nanorods coated with Gadolinium oxide layers were tested for radiation therapy enhancement in 2D cultures of OSC-19-GFP-luc cells, and orthotopic tongue xenografts in male immunocompromised Salt sensitive or SS rats via both intratumoral and intravenous delivery. The radiation therapy enhancement mechanism was investigated.

RESULTS: Theranostic nanoparticles demonstrated both X-ray/magnetic resonance contrast in a …

A Pilot Phase Ib Study To Evaluate Tadalafil To Overcome Immunosuppression During Chemoradiotherapy For Idh-Wild-Type Glioblastoma, Subhajit Ghosh, Tanner M Johanns, Milan G Chheda, Eric Liu, Omar Butt, Christopher Abraham, Shahed Badiyan, Yi Huang, David Denardo, Albert H Kim, Dennis Hallahan, Dinesh Thotala, Jiayi Huang

2020-Current year OA Pubs

BACKGROUND: Myeloid-derived suppressor cells (MDSCs) are critical regulators of immunosuppression and radioresistance in glioblastoma (GBM). The primary objective of this pilot phase Ib study was to validate the on-target effect of tadalafil on inhibiting MDSCs in peripheral blood and its safety when combined with chemoradiotherapy in GBM patients.

METHODS: Patients with newly diagnosed IDH-wild-type GBM received radiation therapy (RT) and temozolomide (TMZ) combined with oral tadalafil for 2 months. A historical cohort of 12 GBM patients treated with RT and TMZ was used as the comparison group. The ratio of MDSCs, T cells, and cytokines at week 6 of RT …

Transplantation Of Gut Microbiota From Old Mice Into Young Healthy Mice Reduces Lean Mass But Not Bone Mass, Lina Lawenius, Carrie Cowardin, Jeffrey I Gordon, Et Al.

2020-Current year OA Pubs

Aging is associated with low bone and lean mass as well as alterations in the gut microbiota (GM). In this study, we determined whether the reduced bone mass and relative lean mass observed in old mice could be transferred to healthy young mice by GM transplantation (GMT). GM from old (21-month-old) and young adult (5-month-old) donors was used to colonize germ-free (GF) mice in three separate studies involving still growing 5- or 11-week-old recipients and 17-week-old recipients with minimal bone growth. The GM of the recipient mice was similar to that of the donors, demonstrating successful GMT. GM from old …

Microbiome-Targeting Therapies In The Neonatal Intensive Care Unit: Safety And Efficacy, Anna Deveaux, Jian Ryou, Gautam Dantas, Barbara B Warner, Phillip I Tarr

2020-Current year OA Pubs

Microbiome-targeting therapies have received great attention as approaches to prevent disease in infants born preterm, but their safety and efficacy remain uncertain. Here we summarize the existing literature, focusing on recent meta-analyses and systematic reviews that evaluate the performance of probiotics, prebiotics, and/or synbiotics in clinical trials and studies, emphasizing interventions for which the primary or secondary outcomes were prevention of necrotizing enterocolitis, late-onset sepsis, feeding intolerance, and/or reduction in hospitalization length or all-cause mortality. Current evidence suggests that probiotics and prebiotics are largely safe but conclusions regarding their effectiveness in the neonatal intensive care unit have been mixed. To …

Characterization Of Cerebrospinal Fluid (Csf) Microbiota At The Time Of Initial Surgical Intervention For Children With Hydrocephalus, Shailly Pandey, Kathryn B. Whitlock, Matthew R. Test, Paul Hodor, Christopher E. Pope, David D. Limbrick, Patrick J. Mcdonald, Jason S. Hauptman, Lucas R. Hoffman, Tamara D. Simon, Cerebrospinal Fluid Microbiota In Shunts (Climb) Study Group

2020-Current year OA Pubs

OBJECTIVE: To characterize the microbiota of the cerebrospinal fluid (CSF) from children with hydrocephalus at the time of initial surgical intervention.

STUDY DESIGN: CSF was obtained at initial surgical intervention. One aliquot was stored in skim milk-tryptone-glucose-glycerol (STGG) medium and the second was unprocessed; both were then stored at -70°C. Bacterial growth for CSF samples stored in STGG were subsequently characterized using aerobic and anaerobic culture on blood agar and MALDI-TOF sequencing. All unprocessed CSF samples underwent 16S quantitative polymerase chain reaction (qPCR) sequencing, and a subset underwent standard clinical microbiological culture. CSF with culture growth (either after storage in …

Structural And Biophysical Characterization Of The Secreted, Β-Helical Adhesin Etpa Of Enterotoxigenic Escherichia Coli, Clifford Manyo Ntui, James M. Fleckenstein, Wolf-Dieter Schubert

2020-Current year OA Pubs

Enterotoxigenic Escherichia coli (ETEC) is a diarrhoeal pathogen associated with high morbidity and mortality especially among young children in developing countries. At present, there is no vaccine for ETEC. One candidate vaccine antigen, EtpA, is a conserved secreted adhesin that binds to the tips of flagellae to bridge ETEC to host intestinal glycans. EtpA is exported through a Gram-negative, two-partner secretion system (TPSS, type Vb) comprised of the secreted EtpA passenger (TpsA) protein and EtpB (TpsB) transporter that is integrated into the outer bacterial membrane. TpsA proteins share a conserved, N-terminal TPS domain followed by an extensive C-terminal domain with …

Clinical Characteristics And Outcomes Of Infection With Human T-Lymphotropic Virus In A Non-Endemic Area: A Single Institution Study, Margery Gang, Feng Gao, Sneha Poondru, Theodore Thomas, Lee Ratner

2020-Current year OA Pubs

INTRODUCTION: Understanding of human T-lymphotropic virus (HTLV) remains largely based on epidemiologic and clinical data from endemic areas. Globalization has resulted in migration of persons living with HTLV (PLHTLV) from endemic to non-endemic areas, and a rise of HTLV infection in the United States. Yet, due to the historical rarity of this disease, affected patients are often under- and mis-diagnosed. Thus, we sought to characterize the epidemiology, clinical features, comorbidities, and survival of HTLV-1- or HTLV-2-positive individuals identified in a non-endemic area.

METHODS: Our study was a single institution, retrospective case-control analysis of HTLV-1 or HTLV-2 patients between 1998 and …

Therapeutic Activity Of Lipoxin A4 In Tio2-Induced Arthritis In Mice: Nf-Κb And Nrf2 In Synovial Fluid Leukocytes And Neuronal Trpv1 Mechanisms, Telma Saraiva-Santos, Tiago H Zaninelli, Felipe A Pinho-Ribeiro, Et Al.

2020-Current year OA Pubs

BACKGROUND: Lipoxin A4 (LXA

METHODS: Mice were stimulated with TiO

RESULTS: LXA

CONCLUSION: LXA

T-Cell Redirecting Therapies For B-Cell Non-Hodgkin Lymphoma: Recent Progress And Future Directions, David A Russler-Germain, Armin Ghobadi

2020-Current year OA Pubs

Several key advances in the treatment of B-cell non-Hodgkin lymphoma (B-NHL) over the past two decades have strategically exploited B-cell lineage markers suitable for targeting by immunotherapies. First, the addition of the anti-CD20 monoclonal antibody (mAb) rituximab to a range of standard therapies conferred remarkable outcomes improvements in diverse settings, perhaps most prominently an overall survival advantage in newly diagnosed diffuse large B-cell lymphoma (DLBCL). Subsequently, multiple chimeric antigen receptor (CAR) T-cell therapies targeting CD19 have revolutionized the treatment of relapsed/refractory (rel/ref) DLBCL and are active in other B-NHL subtypes as well. Most recently, the longstanding aspiration to exploit patients' …

Financial Burden Of Men With Localized Prostate Cancer: A Process Paper, Ashley J Housten, Hannah E Rice, Su-Hsin Chang, Allison J L'Hotta, Eric H Kim, Bettina F Drake, Robin Wright-Jones, Mary C Politi

2020-Current year OA Pubs

BACKGROUND: Many individuals undergoing cancer treatment experience substantial financial hardship, often referred to as financial toxicity (FT). Those undergoing prostate cancer treatment may experience FT and its impact can exacerbate disparate health outcomes. Localized prostate cancer treatment options include: radiation, surgery, and/or active surveillance. Quality of life tradeoffs and costs differ between treatment options. In this project, our aim was to quantify direct healthcare costs to support patients and clinicians as they discuss prostate cancer treatment options. We provide the transparent steps to estimate healthcare costs associated with treatment for localized prostate cancer among the privately insured population using a …

Locus Specific Endogenous Retroviral Expression Associated With Alzheimer's Disease, Tyson Dawson, Uzma Rentia, Jessie Sanford, Carlos Cruchaga, John S K Kauwe, Keith A Crandall

2020-Current year OA Pubs

INTRODUCTION: Human endogenous retroviruses (HERVs) are transcriptionally-active remnants of ancient retroviral infections that may play a role in Alzheimer's disease.

METHODS: We combined two, publicly available RNA-Seq datasets with a third, novel dataset for a total cohort of 103 patients with Alzheimer's disease and 45 healthy controls. We use telescope to perform HERV quantification for these samples and simultaneously perform gene expression analysis.

RESULTS: We identify differentially expressed genes and differentially expressed HERVs in Alzheimer's disease patients. Differentially expressed HERVs are scattered throughout the genome; many of them are members of the HERV-K superfamily. A number of HERVs are correlated …

Functional Trajectories During Innate Spinal Cord Repair, Nicholas O Jensen, Brooke Burris, Lili Zhou, Hunter Yamada, Catrina Reyes, Zachary Pincus, Mayssa H Mokalled

2020-Current year OA Pubs

Adult zebrafish are capable of anatomical and functional recovery following severe spinal cord injury. Axon growth, glial bridging and adult neurogenesis are hallmarks of cellular regeneration during spinal cord repair. However, the correlation between these cellular regenerative processes and functional recovery remains to be elucidated. Whereas the majority of established functional regeneration metrics measure swim capacity, we hypothesize that gait quality is more directly related to neurological health. Here, we performed a longitudinal swim tracking study for 60 individual zebrafish spanning 8 weeks of spinal cord regeneration. Multiple swim parameters as well as axonal and glial bridging were integrated. We …

Cell Wall Composition In Cryptococcus Neoformans Is Media Dependent And Alters Host Response, Inducing Protective Immunity, Rajendra Upadhya, Woei C Lam, Camaron R Hole, Joseph G Vasselli, Jennifer K Lodge

2020-Current year OA Pubs

INTRODUCTION:

OBJECTIVE: The purpose of this study was to determine how different media influenced the amount of chitin and chitosan in the cell wall, which in turn impacted the cell wall architecture and host response.

METHODS: Yeast extract, peptone, and dextrose (YPD) and yeast nitrogen base (YNB) are two commonly used media for growing Cryptococcus before use in in vitro or in vivo experiments. As a result,

RESULTS: We observed that the growth of wild-type

CONCLUSION: These findings emphasize the importance of culture media and pH during growth in shaping the content and organization of the

A Universal Neocortical Mask For Centiloid Quantification, Pierrick Bourgeat, Vincent Doré, Christopher C Rowe, Tammie Benzinger, Duygu Tosun, Manu S Goyal, Pamela Lamontagne, Liang Jin, Michael W Weiner, Colin L Masters, Jurgen Fripp, Victor L Villemagne, Alzheimer's Disease Neuroimaging Initiative; Oasis3, Aibl Research Group

2020-Current year OA Pubs

INTRODUCTION: The Centiloid (CL) project was developed to harmonize the quantification of amyloid beta (Aβ) positron emission tomography (PET) scans to a unified scale. The CL neocortical mask was defined using

METHODS: Using data from the Alzheimer's Dementia Onset and Progression in International Cohorts (ADOPIC) study (Australian Imaging Biomarkers and Lifestyle + Alzheimer's Disease Neuroimaging Initiative + Open Access Series of Imaging Studies), age-matched pairs of mild Alzheimer's disease (AD) and healthy controls (HC) were selected:

RESULTS: In the GAAIN dataset, the universal mask led to a small reduction in the variance of the YC, and a small increase in …

Toward A Computational Theory Of Manifold Untangling: From Global Embedding To Local Flattening, Xin Li, Shuo Wang

2020-Current year OA Pubs

It has been hypothesized that the ventral stream processing for object recognition is based on a mechanism called cortically local subspace untangling. A mathematical abstraction of object recognition by the visual cortex is how to untangle the manifolds associated with different object categories. Such a manifold untangling problem is closely related to the celebrated kernel trick in metric space. In this paper, we conjecture that there is a more general solution to manifold untangling in the topological space without artificially defining any distance metric. Geometrically, we can either

Conditional Protein Degradation In Yarrowia Lipolytica Using The Auxin-Inducible Degron, Zhenlin Han, Jessica Maruwan, Yinjie Tang, Wei Wen Su

2020-Current year OA Pubs

Conditional protein degradation is a powerful tool for controlled protein knockdown. The auxin-inducible degron (AID) technology uses a plant auxin to induce depletion of degron-tagged proteins, and it has been shown to be functional in several non-plant eukaryotes. In this study, we demonstrated AID-based protein knockdown in an industrially important oleaginous yeast

A New Measure For Multi-Professional Medical Team Communication: Design And Methodology For Multilingual Measurement Development, Sara Malone, Kim Prewitt, Lara Counts, Douglas A Luke, Et Al.

2020-Current year OA Pubs

BACKGROUND: As implementation science in global health continues to evolve, there is a need for valid and reliable measures that consider diverse linguistic and cultural contexts. A standardized, reproducible process for multilingual measure development may improve accessibility and validity by participants in global health settings. To address this need, we propose a rigorous methodology for multilingual measurement development. We use the example of a novel measure of multi-professional team communication quality, a determinant of implementation efforts.

METHODS: The development and translation of this novel bilingual measure is comprised of seven steps. In this paper, we describe a measure developed in …

Adapting A Mobile App To Support Patients With Anorexia Nervosa Following Post-Acute Care: Perspectives From Eating Disorder Treatment Center Stakeholders, Anneliese Haas, Agatha A Laboe, Claire G Mcginnis, Marie-Laure Firebaugh, Jillian Shah, Anna M Bardone-Cone, Kathleen M Pike, C Barr Taylor, Denise E Wilfley, Ellen E Fitzsimmons-Craft

2020-Current year OA Pubs

INTRODUCTION: Anorexia nervosa (AN) is a harmful, life-threatening illness. Patients with severe AN often receive acute treatment but, upon discharge, experience high relapse rates. Evidence-based, outpatient treatment following acute care is critical to preventing relapse; however, numerous barriers (e.g., location, financial limitations, low availability of providers) preclude individuals from accessing treatment. mHealth technologies may help to address these barriers, but research on such digital approaches for those with AN is limited. Further, such technologies should be developed with all relevant stakeholder input considered from the outset. As such, the present study aimed to garner feedback from eating disorder (ED) treatment …

Carotid Atherosclerotic Plaque Segmentation In Multi-Weighted Mri Using A Two-Stage Neural Network: Advantages Of Training With High-Resolution Imaging And Histology, Ran Li, Jie Zheng, Mohamed A Zayed, Jeffrey E Saffitz, Pamela K Woodard, Abhinav K Jha

2020-Current year OA Pubs

INTRODUCTION: A reliable and automated method to segment and classify carotid artery atherosclerotic plaque components is needed to efficiently analyze multi-weighted magnetic resonance (MR) images to allow their integration into patient risk assessment for ischemic stroke. Certain plaque components such as lipid-rich necrotic core (LRNC) with hemorrhage suggest a greater likelihood of plaque rupture and stroke event. Assessment for presence and extent of LRNC could assist in directing treatment with impact upon patient outcomes.

METHODS: To address the need to accurately determine the presence and extent of plaque components on carotid plaque MRI, we proposed a two-staged deep-learning-based approach that …

Ehealth Technology In Cardiac Exercise Therapeutics For Pediatric Patients With Congenital And Acquired Heart Conditions: A Summary Of Evidence And Future Directions, David A White, Aimee M Layton, Tracy Curran, Naomi Gauthier, William B Orr, Kendra Ward, Meg Vernon, Matthew N Martinez, Malloree C Rice, Katherine Hansen, Megan Prusi, Jesse E Hansen

2020-Current year OA Pubs

Many children and adolescents with congenital and acquired heart disease (CHD) are physically inactive and participate in an insufficient amount of moderate-to-vigorous intensity exercise. Although physical activity (PA) and exercise interventions are effective at improving short- and long-term physiological and psychosocial outcomes in youth with CHD, several barriers including resource limitations, financial costs, and knowledge inhibit widespread implementation and dissemination of these beneficial programs. New and developing eHealth, mHealth, and remote monitoring technologies offer a potentially transformative and cost-effective solution to increase access to PA and exercise programs for youth with CHD, yet little has been written on this topic. …

Implementation Strategies For Occupational Therapists To Advance Goal Setting And Goal Management, Eunyoung Kang, Julie Chen, Erin R Foster

2020-Current year OA Pubs

BACKGROUND: There is a need for an effective evidence-based system to support high-quality goal setting and goal management implementation. We developed a new system for community-based rehabilitation, MyGoals, along with implementation strategies to support occupational therapists (OTs) in its administration. This study evaluates the acceptability, appropriateness, and feasibility of the implementation strategies,

METHODS: This mixed-methods case series study evaluated the MyGoals implementation strategies developed using Implementation Mapping (IM), specifically IM Task 5 - Implementation Outcome Evaluation. Seven OTs and 13 adults with chronic conditions participated in this study. OTs participated in two

RESULTS: Seven OTs participated in this study (mean …

Ube2c Expression Is Elevated In Hepatoblastoma And Correlates With Inferior Patient Survival, Ruth Nousiainen, Katja Eloranta, Noora Isoaho, Stefano Cairo, David B Wilson, Markku Heikinheimo, Marjut Pihlajoki

2020-Current year OA Pubs

Hepatoblastoma (HB) is the most common malignant liver tumor among children. To gain insight into the pathobiology of HB, we performed RNA sequence analysis on 5 patient-derived xenograft lines (HB-243, HB-279, HB-282, HB-284, HB-295) and 1 immortalized cell line (HUH6). Using cultured hepatocytes as a control, we found 2,868 genes that were differentially expressed in all of the HB lines on mRNA level. The most upregulated genes were

Women's Empowerment And Child Nutrition In A Context Of Shifting Livelihoods In Eastern Oromia, Ethiopia, Karah Mechlowitz, Mark J Manary, Et Al.

2020-Current year OA Pubs

Agriculture, and particularly livestock and animal source foods, has been closely linked to improvements in human nutrition. Production, income, and women's empowerment improve household food security and child nutritional outcomes in interacting ways. Khat production in Eastern Ethiopia is changing the economic and livelihood landscape for communities that have traditionally relied upon small-scale mixed agriculture and livestock production. How this shifting livelihood landscape and the empowerment of women in these communities are affecting nutritional outcomes has not been investigated. Using cross-sectional data collected during formative research for the Campylobacter Genomics and Environmental Enteric Dysfunction (CAGED) project, we developed models to …

Identification Of Prok2 Gene Polymorphisms As Predictors Of Methamphetamine Use Disorder Risk And Indicators Of Craving Scale In The Chinese Han Population, Zhao Jiang, Tianxiao Zhang, Wei Han, Jing Xiao, Wenpei Zhang, Xiaochen Wang, Jianing Liu, Ying Yang, Congying Yang, Fanglin Guan, Tao Li, John P Rice

2020-Current year OA Pubs

No abstract provided.

Assessment Of Cochlear Synaptopathy By Electrocochleography To Low Frequencies In A Preclinical Model And Human Subjects, Raymond A Haggerty, Kendall A Hutson, William J Riggs, Kevin D Brown, Harold C Pillsbury, Oliver F Adunka, Craig A Buchman, Douglas C Fitzpatrick

2020-Current year OA Pubs

Cochlear synaptopathy is the loss of synapses between the inner hair cells and the auditory nerve despite survival of sensory hair cells. The findings of extensive cochlear synaptopathy in animals after moderate noise exposures challenged the long-held view that hair cells are the cochlear elements most sensitive to insults that lead to hearing loss. However, cochlear synaptopathy has been difficult to identify in humans. We applied novel algorithms to determine hair cell and neural contributions to electrocochleographic (ECochG) recordings from the round window of animal and human subjects. Gerbils with normal hearing provided training and test sets for a deep …

Non-Canonical Functions Of Ezh2 In Cancer, Sarah M Zimmerman, Phyo Nay Lin, George P Souroullas

2020-Current year OA Pubs

Mutations in chromatin modifying genes frequently occur in many kinds of cancer. Most mechanistic studies focus on their canonical functions, while therapeutic approaches target their enzymatic activity. Recent studies, however, demonstrate that non-canonical functions of chromatin modifiers may be equally important and therapeutically actionable in different types of cancer. One epigenetic regulator that demonstrates such a dual role in cancer is the histone methyltransferase EZH2. EZH2 is a core component of the polycomb repressive complex 2 (PRC2), which plays a crucial role in cell identity, differentiation, proliferation, stemness and plasticity. While much of the regulatory functions and oncogenic activity of …

Role Of Cardiopulmonary Interactions In Development Of Ventilator-Induced Lung Injury-Experimental Evidence And Clinical Implications, Neel Shah, Bhushan H Katira

2020-Current year OA Pubs

Ventilator-induced lung injury (VILI) impacts outcomes in ARDS and optimization of ventilatory strategies improves survival. Decades of research has identified various mechanisms of VILI, largely focusing on airspace forces of plateau pressure, tidal volume and driving pressure. Experimental evidence indicates the role of adverse cardiopulmonary interaction during mechanical ventilation, contributing to VILI genesis mostly by modulating pulmonary vascular dynamics. Under passive mechanical ventilation, high transpulmonary pressure increases afterload on right heart while high pleural pressure reduces the RV preload. Together, they can result in swings of pulmonary vascular flow and pressure. Altered vascular flow and pressure result in increased vascular …