Medicine and Health Sciences Commons^™

Nature-Inspired Metaheuristics For Optimizing Dose-Finding And Computationally Challenging Clinical Trial Designs, Weng Kee Wong, Yevgen Ryeznik, Oleksandr Sverdlov, Ping-Yang Chen, Xinying Fang, Ray-Bing Chen, Shouhao Zhou, J Jack Lee

Faculty, Staff and Student Publications

Metaheuristics are commonly used in computer science and engineering to solve optimization problems, but their potential applications in clinical trial design have remained largely unexplored. This article provides a brief overview of metaheuristics and reviews their limited use in clinical trial settings. We focus on nature-inspired metaheuristics and apply one of its exemplary algorithms, the particle swarm optimization (PSO) algorithm, to find phase I/II designs that jointly consider toxicity and efficacy. As a specific application, we demonstrate the utility of PSO in designing optimal dose-finding studies to estimate the optimal biological dose (OBD) for a continuation-ratio model with four parameters …

Optimization Of Mhealth Behavioral Interventions For Patients With Chronic Lymphocytic Leukemia: The Health4cll Study, Che Young Lee, Max J Gordon, Melissa M Markofski, Emily C Lavoy, Susan K Peterson, Liang Li, Sara Fares, Miranda Baum, Margaret Pace, Danielle Walsh, Alessandra Ferrajoli, Karen Basen-Engquist

Faculty, Staff and Student Publications

Purpose: This pilot study of a diet and physical activity intervention (HEALTH4CLL) was conducted to reduce fatigue and improve physical function (PF) in patients with chronic lymphocytic leukemia (CLL).

Methods: The HEALTH4CLL study used a randomized factorial design based on the multiphase optimization strategy (MOST). Patients received diet, exercise, and body weight management instructional materials plus a Fitbit and were randomized to undergo one of 16 combinations of 4 evidence-based mHealth intervention strategies over 16 weeks. Patients' fatigue, PF, health-related quality of life, behavior changes, and program satisfaction and retention were assessed. Paired t-tests were used to examine changes in …

Nanotechnology For Immuno-Oncology, Adam J Grippin, Daeyong Lee, Eileen E Parkes, Wen Jiang, Betty Y S Kim

Faculty, Staff and Student Publications

Although the first generation of cancer immunotherapeutics produced unprecedented improvements in clinical outcomes for individuals with cancer, novel strategies to increase treatment specificity, delivery efficiency and pharmacokinetics are still needed. In this Review, we describe the potential advantages and current limitations of nanomaterials for cancer immunotherapy and highlight rational uses of nanosystems to generate potent and durable antitumor immune responses. We close with a review of the current state of clinical development of nanomedicine for cancer immunotherapy.

White Matter Abnormalities And Cognition In Aging And Alzheimer Disease, Christopher Peter, Aditi Sathe, Niranjana Shashikumar, Kimberly R Pechman, Abigail W Workmeister, T Bryan Jackson, Yuankai Huo, Shubhabrata Mukherjee, Jesse Mez, Logan C Dumitrescu, Katherine A Gifford, Corey J Bolton, Leslie S Gaynor, Shannon L Risacher, Lori L Beason-Held, Yang An, Konstantinos Arfanakis, Guray Erus, Christos Davatzikos, Duygu Tosun-Turgut, Mohamad Habes, Di Wang, Arthur W Toga, Paul M Thompson, Panpan Zhang, Kurt G Schilling, Marilyn Albert, Walter Kukull, Sarah A Biber, Bennett A Landman, Barbara B Bendlin, Sterling C Johnson, Julie Schneider, Lisa L Barnes, David A Bennett, Angela L Jefferson, Susan M Resnick, Andrew J Saykin, Paul K Crane, Michael L Cuccaro, Timothy J Hohman, Derek B Archer, Dimitrios Zaras, Yisu Yang, Alaina Durant, Praitayini Kanakaraj, Michael E Kim, Chenyu Gao, Nancy R Newlin, Karthik Ramadass, Nazirah Mohd Khairi, Zhiyuan Li, Tianyuan Yao, Seo-Eun Choi, Brandon Klinedinst, Michael L Lee, Phoebe Scollard, Emily H Trittschuh, Elizabeth A Sanders

Faculty, Staff and Student Publications

Importance: There has yet to be a large-scale study quantifying the association between white matter microstructure and cognitive performance and decline in aging and Alzheimer disease (AD).

Objective: To investigate the associations between tract-specific white matter microstructure and cognitive performance and decline in aging and AD-related cognitive impairment.

Design setting and participants: This prognostic study of aging and AD, a secondary data analysis of multisite cohort studies, acquired data from 9 cohorts between September 2002 and November 2022. Participants were eligible if they had diffusion-weighted magnetic resonance imaging (dMRI) data, domain-specific cognitive composite z scores, demographic and clinical data, were …

Complete Response To Trastuzumab-Deruxtecan (Enhertu, T-Dxd) In Her2-Positive Stage Ivb Uterine Carcinosarcoma, Michael Kim, Amma Asare, Jamie L Dockery, Nadia Hameed, Travis T Sims

Faculty, Staff and Student Publications

Objectives: To report a case of complete response to trastuzumab-deruxtecan (T-DXd) in a patient with HER2-positive stage IVB uterine carcinosarcoma, and to contextualize this within evolving therapy for HER2-positive gynecologic malignancies.

Methods: We present the clinical course of a 62-year-old woman with a history of multiple prior malignancies, diagnosed with stage IVB uterine carcinosarcoma exhibiting HER2 overexpression. Following optimal cytoreductive surgery and first-line carboplatin, paclitaxel, and trastuzumab, the patient developed platinum-resistant recurrence. She was subsequently treated with T-DXd, and received serial imaging and clinical monitoring.

Results: The patient achieved a partial response by cycle 4 of T-DXd, with subsequent scans …

Mitophagy’S Impacts On Cancer And Neurodegenerative Diseases: Implications For Future Therapies, Jason Huang, Vincent Truong Pham, Shaozi Fu, Gang Huang, Ya-Guang Liu, Lei Zheng

Faculty, Staff and Student Publications

Substantial evidence supports an inverse relationship between cancer and neurodegenerative diseases (NDDs), but few studies investigate the biological mechanisms underlying this phenomenon. While previous explanations-such as inflammation, reactive oxygen species (ROS), genetic mutations, and cell death-remain significant, they ultimately converge on mitophagy. This review identifies mitophagy as a pivotal factor in the development of both cancer and NDDs, while also evaluating specific mechanisms and processes to clarify how mitophagy connects these opposing disease trajectories. By examining these factors, we aim to uncover the underlying mechanisms that explain the inverse relationship between cancer and NDDs, which will help develop therapeutic strategies …

Gd3 Synthase Drives Resistance To P53-Induced Apoptosis In Breast Cancer By Modulating Mitochondrial Function, Vivek Anand, Fouad El-Dana, Natalia Baran, Jenny Borgman, Zheng Yin, Hong Zhao, Stephen T Wong, Michael Andreeff, V Lokesh Battula

Faculty, Staff and Student Publications

TP53 mutations are common in breast cancer (BC) and are associated with poor prognosis. GD3 synthase (GD3S/ST8SIA1), a gene associated with breast cancer stem cells, is upregulated in tumors with p53 mutations. However, the functional relationship between GD3S and p53 is unknown. Here, we show that GD3S levels are highest in breast tumors with specific p53 mutations. Functional studies revealed that wild-type (WT) p53 inhibits GD3S expression, whereas mutation in p53 enhances GD3S expression by upregulating GD3S promoter activity. Moreover, we found that GD3S inhibits wild-type p53-induced apoptosis in BC cells, while BC cells harboring gain-of-function p53 mutations are dependent …

Pparγ-Induced Upregulation Of Fatty Acid Metabolism Confers Resistance To Venetoclax And Decitabine Therapy In Aml, Kotoko Yamatani, Tatsuro Watanabe, Kaori Saito, Abdullah Khasawneh, Abhishek Maiti, Zhihong Zeng, Kala Hayes, Shinya Kimura, Courtney D Dinardo, Xiaoping Su, Shuko Nojiri, Yasushi Okazaki, Michael Andreeff, Marina Konopleva, Yoko Tabe

Faculty, Staff and Student Publications

The combination of the B-cell lymphoma 2 (BCL2) inhibitor venetoclax (VEN) and the hypomethylating agent decitabine (DEC; VEN/DEC) constitutes a primary therapeutic strategy for treating older adults with acute myeloid leukemia (AML). However, a notable subset of patients exhibits resistance to VEN/DEC, demonstrating either no disease response or relapse after initial remission. This study aimed to elucidate the molecular mechanisms underlying this resistance through analyses of gene expression and DNA methylation profiles. We conducted comprehensive RNA sequencing analysis and DNA methylation profiling on AML samples from 35 patients undergoing VEN/DEC therapy. The RNA sequencing analysis revealed that several genes related …

Inhibition Of Methylthioadenosine Phosphorylase Protects From Experimental Acute Kidney Injury, Afaf Saliba, Yidong Chen, Jonathan W Nelson, Abhinav Vetcha, Wei Wei Wang, Li Kang, Nagarjunachary Ragi, Soumya Maity, Hamid Rabb, W Brian Reeves, Kumar Sharma

Faculty, Staff and Student Publications

Methylthioadenosine phosphorylase (MTAP) is a key enzyme in purine metabolism that may influence cellular responses to injury. We evaluated the effects of prophylactic MTAP inhibition in mouse models of ischemia-reperfusion and cisplatin-induced acute kidney injury (AKI). MTAP inhibition was confirmed by accumulation of methylthioadenosine (MTA). Treated mice showed reduced renal injury and decreased tubular damage. Transcriptomic analysis revealed protection from inflammatory and stress pathways, while maintaining oxidative phosphorylation, fatty acid metabolism, and epithelial integrity-related genes. Analysis of human single-cell RNA-seq data from the Kidney Precision Medicine Project indicated that MTAP is highly expressed in kidney injury marker-positive adaptive proximal tubule …

Transcriptomic Analysis Of Localized High-Risk Prostate Cancer Improves Prognostication And Identifies Benefit From Adding Docetaxel To Definitive Radiotherapy With Androgen Suppression In The Nrg Oncology/Rtog 0521 Phase 3 Trial, Ryan M Phillips, James A Proudfoot, Elai Davicioni, Yang Liu, Daniel E Spratt, Jeff M Simko, Robert B Den, Alan Pollack, Seth A Rosenthal, A Oliver Sartor, Christopher J Sweeney, Gerhardt Attard, Leslie Longoria, Samir Patel, Michael W Straza, Jason A Efstathiou, Amit B Shah, Karen E Hoffman, Joseph P Rodgers, Howard M Sandler, Felix Y Feng, Phuoc T Tran

Faculty, Staff and Student Publications

Background and objective: NRG/RTOG 0521 randomized men with high-risk localized prostate cancer (PC) to androgen suppression (AS) and definitive radiotherapy (RT) ± docetaxel-based chemotherapy (CT). The overall survival (OS) benefit with CT initially reported was lost on longer follow-up. The Decipher genomic classifier (GC) measures multiple transcripts relevant to docetaxel action. Basal/luminal differentiation portends differential response to AS and CT for high-risk localized and metastatic hormone-sensitive PC. We validated the Decipher GC in pretreatment biopsy samples for risk stratification and examined basal-luminal subtyping to predict docetaxel response.

Methods: Decipher GC scores and basal-luminal cellular subtypes were generated for specimens from …

Early Treatment Engagement And Long-Term Smoking Abstinence Among Women With Cervical Intraepithelial Neoplasia Or Cervical Cancer, Charles E Hoogland, Steven K Sutton, Bethany Shorey Fennell, Vani N Simmons, Christine Vinci, Issam El Naqa, Ramzi G Salloum, Sanjay S Shete, Timothy Hembree, Damon J Vidrine, Jennifer I Vidrine

Faculty, Staff and Student Publications

Introduction: Cancer survivors who quit smoking have improved treatment response and decreased mortality. Although data indicate that greater tobacco cessation treatment engagement leads to better cessation outcomes in cancer survivors, little is known about how different tobacco treatment engagement patterns influence long-term cessation success. To help address this issue, this study examined how tobacco treatment engagement patterns predict cessation outcomes through 18 months and identified baseline participant characteristics predictive of treatment engagement patterns.

Methods: Data from a smoking-cessation RCT among women with a history of cervical intraepithelial neoplasia or cervical cancer comparing a 12-month, 6-session motivation and problem solving phone …

Associations Between Prostate Cancer And Dementia: A Nationwide Study In Sweden, Casey Crump, Pär Stattin, James D Brooks, Jan Sundquist, Jingkai Wei, Weiva Sieh, Kristina Sundquist

Faculty, Staff and Student Publications

Background and objective: Prostate cancer (PC) and dementia may commonly co-occur; yet, prior evidence for bidirectional associations is inconsistent. This study aims to determine the associations between PC and dementia in large population-based studies, which may further inform clinical care.

Methods: To assess the dementia risk in men with PC, a national cohort study was conducted in 178 746 men diagnosed with PC in 1998-2017 and 1 787 460 age-matched control men in Sweden without prior dementia. Cox regression was used to estimate hazard ratios (HRs) for Alzheimer's disease (AD) and vascular dementia (VaD) through 2018. Subanalyses explored differences by …

Blood-Red And Flaming And True, Kate Gaskin

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

Blood-Red and Flaming and True contains poems that explore the immense feelings of love and loss tied to the relationship between parent and child. They chronicle my experience raising a neurodivergent child, as well as undergoing infant loss and navigating a U.S. medical system that is renowned for putting women and people capable of giving birth—especially BIPOC—at greater risk than other countries with similar resources. Through poems that inhabit a variety of forms, I sift through grief and joy while attempting to tap into the sublime state that underlies extreme loss and love. Throughout, I investigate how lyric poetry is …

Determining The Attitudes And Knowledge Related To Sexual Health And Activity Related To Practitioner Action, Kelsey Alt, Callie Honaker, Abby Nichols, Jacob Greenfield, Diana Davis

Graduate Student Scholarship

Background: Research has found that many Occupational Therapy practitioners lack confidence, competence, and fear discussing sexual health and activity with their patients, despite many patients wanting to discuss the topic (Rose & Hughes, 2018). This previous knowledge leads to the purpose of this study, to determine if continuing education on topics related to sexual health and activity increases OTPs’ confidence, competence, and sense of importance in addressing this with patients (Rabathaly & Chattu, 2019). Methods: This study assessed pre- and post-data for each participant'scompleted course survey in the sequence of the continuing education class. All participants were de-identified …

A Comprehensive Narrative Review Of The Challenges Surrounding Cutaneous Scc., Sarah C Beach, Austin S Cusick, Aaron S Farberg, Shannon C Trotter

Ambulatory and Primary Care Articles

Cutaneous squamous cell carcinoma (cSCC) is the second most common nonmelanoma skin cancer (NMSC) and is predominantly found in the head and neck region. With an annual increase in NMSC diagnoses, cSCC presents significant diagnostic and therapeutic challenges. This review discusses the many risk factors for the development of cSCC, outlines the criteria for defining high-risk cSCC, and examines treatment approaches of these tumors based on risk stratification. While most cSCCs are treatable with surgical excision, approximately 5% metastasize, with head and neck cSCC showing poor prognosis once metastasis occurs. High-risk cSCCs, which are more likely to recur or metastasize, …

Supervised Machine-Based Learning And Computational Analysis To Reveal Unique Molecular Signatures Associated With Wound Healing And Fibrotic Outcomes To Lens Injury, Catherine Lalman, Kylie R. Stabler, Yimin Yang, Janice L Walker

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Posterior capsule opacification (PCO), a frequent complication of cataract surgery, arises from dysregulated wound healing and fibrotic transformation of residual lens epithelial cells. While transcriptomic and machine learning (ML) approaches have elucidated fibrosis-related pathways in other tissues, the molecular divergence between regenerative and fibrotic outcomes in the lens remains unclear. Here, we used an ex vivo chick lens injury model to simulate post-surgical conditions, collecting RNA from lenses undergoing either regenerative wound healing or fibrosis between days 1–3 post-injury. Bulk RNA sequencing data were normalized, log-transformed, and subjected to univariate filtering prior to training LASSO, SVM, and RF ML models …

Sinus Tarsi Versus Extended Lateral Approach For Displaced Intra-Articular Calcaneal Fractures: A Single Surgeon's Experience, Philip K Lim, Adam J Miller, Justin Haghverdian, Ramzy Meremikwu, M Kareem Shaath, John W Munz

Faculty, Staff and Student Publications

Background

The aim of the study is to investigate the differences between the extensile lateral (EL) and sinus tarsi (ST) approaches for the treatment of displaced intra-articular calcaneus fractures as treated by a single surgeon.

Methods

A retrospective cohort study performed at a Level 1 trauma center. One hundred twenty-nine consecutive intra-articular calcaneus fractures from 2011 to 2018 that were surgically treated by a single surgeon. Primary outcomes were time to surgery, operative time, postoperative restoration of the critical angle of Gissane, postoperative wound complications, and need for unplanned re-operation.

Results

Patient characteristics, including demographics, mechanism of injury, and fracture …

Syncope As The First Clue To A Congenital Heart Defect, Ravi Soni, Victoria Morris, Benjamin Karfunkle

Faculty, Staff and Student Publications

No abstract provided.

Does Midbrain Atrophy Distinguish Progressive Supranuclear Palsy From Frontotemporal Dementia?, Mauro César Quintão E Silva Cunningham, Sarah Teixeira Camargos, Vinícius Ribeiro Jeunon, Natalia Pessoa Rocha, Antônio Lúcio Teixeira, Thiago De Oliveira Maciel, Elisa De Paula França Resende, Francisco Eduardo Costa Cardoso, Paulo Caramelli, Leonardo Cruz De Souza

Faculty, Staff and Student Publications

Background: The diagnostic value of midbrain atrophy for distinguishing behavioral variant frontotemporal dementia (bvFTD) from progressive supranuclear palsy (PSP) is unclear.

Objective: To investigate whether measures of midbrain atrophy differentiate PSP from bvFTD.

Methods: We included four groups: healthy controls (n = 19), PSP-Richardson syndrome (n = 20), bvFTD (n = 19) and Parkinson's disease (PD; n = 12). The following quantitative and qualitative measures were calculated: Hummingbird sign rating scale [HBS-RS], global midbrain atrophy [GMA], midbrain area, midbrain/pons ratio, the Magnetic Resonance Parkinsonism Index (MRPI), the MRPI 2.0 and brainstem volume.

Results: Compared to controls, PSP and bvFTD had …

A Systematic Clinical Framework For Postimplantation Monitoring In Thalamic Neuromodulation: Insights From Twiddler's Syndrome, Shalin Shah, Ganne Chaitanya, Jeston Chin, Nicholas Delcimmuto, Jay R Gavvala

Faculty, Staff and Student Publications

This case described a 25-year-old pregnant woman with refractory multifocal epilepsy, diagnosed in 2020 and treated with bilateral thalamic deep brain stimulation (DBS) targeting the centromedian and pulvinar nuclei. Prior to DBS, she experienced daily focal seizures, often progressing to generalized tonic-clonic seizures despite optimal medication. Presurgical evaluations revealed multifocal epilepsy with right hemispheric involvement and diffuse band heterotopia. Given the extensive neurophysiological and radiographic findings, DBS was chosen over resective surgery. Following implantation in December 2023, initial stimulation settings resulted in some seizure control but also development of new symptoms, including shock-like sensations down her neck. After 43 seizure-free …

Large-Scale Copy Number Variant Analysis In Genes Linked To Parkinson’S Disease, Zied Landoulsi, Katja Lohmann, Eva-Juliane Vollstedt, Emily Wedgwood-Benn, Lisa-Marie Niestroj, Björn-Hergen Laabs, Sebastian Sendel, Alexander Balck, Max Borsche, Dennis Lal, Anne Grünewald, Norbert Brüggemann, Andre Franke, Andrew Hicks, Meike Kasten, Kirsten E Zeuner, Lara M Lange, Wolfgang Lieb, Brit Mollenhauer, Heike Pawlack, Peter P Pramstaller, Amke Caliebe, Inke R König, Patrick May, Christine Klein

Faculty, Staff and Student Publications

Genetic studies of Parkinson's disease (PD) have focused on single nucleotide variants (SNVs), with limited attention to copy number variants (CNVs). This study investigates CNVs in PD using candidate PD-related genes and genome-wide approaches. We identified CNVs from the ProtectMove project genotyping data of 2364 PD patients and 2909 controls using PennCNV. We validated 119 of 137 detected CNVs in PD-related genes (87%) using MLPA/qPCR, including 104 in PRKN, six in PARK7, four in SNCA, and others in LRRK2, RAB32, and VPS35. CNVs were present in 2.4% of patients and 1.5% of controls. Notably, 0.9% of patients carried potentially disease-causing …

Sex Differences In Etiologies, Risk Factors, And Outcomes Among Young Adult Patients With Acute Ischemic Stroke, Ekta G Shah, Manish Bhojwani, Kelly Chang, Deepa Dongarwar, Nicole R Gonzales, Erica Jones, Audrey Sarah Cohen, Anjail Z Sharrief

Faculty, Staff and Student Publications

Background: The incidence of ischemic stroke is increasing among young adults. Several studies have demonstrated sex differences in risk and outcomes; however, findings are inconsistent. We sought to evaluate sex differences in stroke risk factors, etiology, and disposition in a diverse cohort of patients admitted to a comprehensive stroke center for evaluation.

Methods: We conducted a retrospective study of patients 18-45 years admitted between January 1, 2015 and September 30, 2021 with an acute ischemic stroke. Patient demographics, risk factors, and disposition were extracted from our institutional inpatient stroke registry and inpatient electronic medical record. Stroke etiology was assigned based …

Poor Correlation Between Inflammatory And Brain Injury Biomarkers After Neonatal Intraventricular Hemorrhage: A Pilot Study, Ankit Agarwal, Miriam Zamorano, Aidan Collier, Braden Oldham, Kaleigh Riggs-Harpur, Thao L Nguyen, David I Sandberg, Stephen A Fletcher, Manish N Shah, Brandon A Miller

Faculty, Staff and Student Publications

Background: This study investigated changes in hemoglobin and neuroinflammatory and brain injury biomarkers (tumor necrosis factor-alpha [TNF-α] and glial fibrillary acidic protein [GFAP]) in early stages of cerebrospinal fluid (CSF) diversion in preterm neonates with intraventricular hemorrhage (IVH). We hypothesized that patients with higher CSF hemoglobin levels would have higher TNF-α and GFAP levels.

Methods: This prospective study included infants with grade 3 or 4 IVH. All had ventricular reservoirs that were placed following standard neurosurgical care. The first CSF sample was collected on the day of reservoir placement. Subsequent samples were from clinically indicated CSF withdraws to decompress ventricles. …

Traumatic Brain Injury And Risk Of Malignant Brain Tumors In Civilian Populations, Sandro Marini, Amr R Alwakeal, Hunter Mills, Joshua D Bernstock, Ahmad Mashlah, Muhammad T Hassan, Jakob Gerstl, Farid Radmanesh, Gundolf Schenk, Sharat Israni, Rachel Grashow, E Antonio Chiocca, Cathra Halabi, Anthony Digiorgio, Stephen T Magill, Geoffrey T Manley, Saef Izzy, Ross Zafonte

Faculty, Staff and Student Publications

Importance: A 2024 US study reported that veterans of the Iraq and Afghanistan wars affected by traumatic brain injury (TBI) had an increased risk of developing brain tumors. However, studies among civilians have shown conflicting results and have not replicated the association between TBI and brain tumor risk.

Objective: To examine whether history of TBI in US adult civilians is associated with a risk of subsequent development of malignant brain tumors.

Design, setting, and participants: This retrospective cohort study used data from a tertiary academic medical center (Mass General Brigham [MGB]) patient data registry encompassing January 1, 2000, to January …

The Effect Of Maternal Antioxidant Vitamin Supplementation On Maternal And Cord Blood Adiponectin Concentrations, Jessica L Pippen, Paula Mcgee, James M Roberts, Leslie Myatt, Michael W Varner, Alan T N Tita, Ronald J Wapner, John M Thorp, Brian M Mercer, Beth A Plunkett, Sean C Blackwell, Anthony Sciscione, George R Saade

Faculty, Staff and Student Publications

Adiponectin is a hormone that modulates glucose regulation and fatty acid oxidation. Low adiponectin concentration has been associated with increased insulin resistance. Studies show a beneficial effect of vitamin E supplementation on insulin sensitivity. We aimed to investigate the association of prenatal antioxidant supplementation with increased adiponectin concentrations in pregnant participants and their newborn infants.Secondary analysis of a randomized control trial of prenatal vitamin C and E supplementation to prevent preeclampsia in low-risk nulliparous participants. Plasma of participants at time of randomization (9-16 weeks gestation) and delivery, and neonatal cord blood were analyzed by specific enzyme-linked immunosorbent assay for adiponectin …

Effectiveness And Safety Of Chronic Diuretic Use In Older Adults: An Umbrella Review Of Recently Published Systematic Reviews And Meta-Analyses Of Randomized-Controlled Trials, Eveline Van Poelgeest, Konstantinos Prokopidis, Tuğba Erdogan, Min Ji Kwak, Karolina Piotrowicz, Luca Paoletti, Annette Eidam, Fatma Özge Kayhan Koçak, Birkan Ilhan, Alessia Beccacece, George Soulis, Serdar Özkök, Gulistan Bahat, Eva Topinková, Joost Daams, M Louis Handoko, Parag Goyal, Jerzy Gąsowski, Antonio Cherubini, Nicola Veronese, Giuseppe Dario Testa, Wade Thompson, Nathalie Van Der Velde, European Geriatric Medicine Society Special Interest Groups Of I. Pharmacology; Ii. Cardiovascular Disease And Iii. Systematic Review And Meta-Analysis

Faculty, Staff and Student Publications

Background: Healthcare providers should balance the potential risks and benefits of chronic diuretic use, particularly in older adults, as with age, diuretic benefits may decline and risks increase. A comprehensive synthesis and critical evaluation of the available evidence on chronic diuretic treatment effects is currently lacking.

Methods: We conducted an umbrella review of systematic reviews and meta-analyses published since 2018 on health outcomes associated with diuretic use in randomized-controlled trials (RCTs). We conducted random-effects meta-analysis for pooled effect estimates and narratively summarized data that could not be pooled.

Results: We included 741 effect estimations from 117 systematic reviews (SRs) on …

Telepathology In Hematopathology Diagnostics: A Collaboration Between The Ho Chi Minh City Oncology Hospital And The University Of Texas Health-Mcgovern Medical School, Uyen Ly, Quang Nguyen, Dang Nguyen, Tu Thai, Binh Le, Duong Gion, Alexander Banerjee, Brenda Mai, Amer Wahed, Andy Nguyen

Faculty, Staff and Student Publications

Digital pathology in the form of whole-slide imaging has been used to support diagnostic consultation through telepathology. Previous studies have mostly addressed the technical aspects of telepathology and general pathology consultation. In this study, we focus on our experience at the University of Texas Health-McGovern Medical School in Houston, Texas, in providing hematopathology consultation to the Pathology Department at the Ho Chi Minh City Oncology Hospital in Vietnam. Over a 32-month period, 71 hematopathology cases were submitted for telepathology. Consensus was reached for a definitive diagnosis in 97% of all cases. Diagnostic efficiency significantly improved with average turnaround times reduced …

Elbow Interpositional Arthroplasty Using An Achilles Tendon Allograft: A Case Report., Matthew Glazier, Morgan Turnow, Hunter Pharis, Taylor Manes, Hayden Schuette, Stephen Wiseman

Surgery Articles

INTRODUCTION: The treatment of post-traumatic elbow arthritis poses a significant challenge for orthopedic surgeons, especially in young active patients. Total elbow arthroplasty is often the recommended treatment option in older patients; however, interpositional arthroplasty remains a viable option in high-demand patients.

CASE REPORT: We report a case of a 50-year-old male who presented after the development of post-traumatic arthritis of the elbow after multiple prior surgeries. He was treated with an interpositional arthroplasty using an Achilles tendon graft and allowed immediate range of motion as tolerated in a hinged elbow brace without the use of any form of distraction external …

Epidemiology Of Shoulder Dislocations In The United States From 1990 To 2019: A Temporal Study Using The Global Burden Of Disease Database., Gabrielle Dykhouse, Ambrose Loc T Ngo, Phillip C Mckegg, Peter B Spencer, Arsalaan Sayyed, Taylor J Manes, Morgan Turnow, Nathaniel Long

Surgery Articles

Introduction The shoulder joint is a common site for joint dislocation, with many individuals suffering from recurrent dislocations following treatment. The purpose of this study was to evaluate the epidemiology of shoulder dislocations in the United States from 1990 to 2019. Methods The Global Burden of Disease database was utilized to collect epidemiological data on shoulder dislocations in the United States (U.S.) from 1990 to 2019. These data included age-standardized rates of years lived with disability (YLDs), prevalence rates, and incidence rates per 100,000 people. Using the U.S. Census Bureau definitions, the data were stratified into four regions: the Northeast, …

Exploring High-Dose Olanzapine For Psychosis In An Adolescent With Treatment-Resistant Schizophrenia, Shaurya Aggarwal, Shweta P Sahu, Puja Shah, Micah J Knobles

Faculty, Staff and Student Publications

High-dose olanzapine has shown efficacy in treating adult patients with treatment-resistant schizophrenia, though evidence in adolescents remains limited. This report describes the case of a 17-year-old male patient with treatment-resistant schizophrenia who showed significant clinical improvement with a supratherapeutic dose of orally disintegrating olanzapine. The patient, with a 16-month history of schizophrenia and multiple hospitalizations, presented with acute psychosis and aggression after medication non-adherence. Following failed trials of paliperidone and standard-dose olanzapine, and unable to initiate clozapine due to blood draw refusal, the patient was gradually titrated to 50 mg daily of orally disintegrating olanzapine (20 mg early morning, 30 …