Medicine and Health Sciences Commons^™

Sars-Cov-2 Rna-Binding Protein Suppresses Extracellular Mirna Release, Hyejin Mun, Chang Hoon Shin, Qingxuan Fei, Andrea Estefania Lopez Giraldo, Kyoung-Min Choi, Ji Won Lee, Kyungmin Kim, Kyung-Won Min, Leilei Shi, Mark T Bedford, Dong-Chan Kim, Yoo Lim Chun, Seonghyun Ryu, Dongin Kim, Jeong Ho Chang, Ryan T Westrope, Michelle Shay, Edward Nguyen, Junho K Hur, Abigail Agyenda, Nam Chul Kim, Sung-Ung Kang, Woonghee Lee, Je-Hyun Yoon

Faculty, Staff and Student Publications

SARS-CoV-2 is the betacoronavirus causing the COVID-19 pandemic. Although the SARS-CoV-2 genome and transcriptome were reported previously, the function of individual viral proteins is largely unknown. Utilizing biochemical and molecular biology methods, we identified that four SARS-CoV-2 RNA-binding proteins (RBPs) regulate the host RNA metabolism by direct interaction with mature miRNA let-7b revealed by Nuclear Magnetic Resonance spectroscopy (NMR). SARS-CoV-2 RBP Nsp9 primarily binds mature miRNA let-7b, a direct ligand of the Toll-like Receptor 7 (TLR7), one of the potential SARS-CoV-2 therapeutics. Nsp9 suppresses host gene expression possibly by promoting let-7b-mediated silencing of a cellular RNA polymerase, POLR2D. In addition, …

Normalization Of Temperature Effects For Quality Assurance Of Quantitative Prostate Apparent Diffusion Coefficient Imaging Across Multiple Sites, Ken-Pin Hwang, Joshua Yung, R Jason Stafford, Caroline Chung, Aradhana M Venkatesan

Faculty, Staff and Student Publications

Background: Apparent Diffusion Coefficient (ADC) as measured by diffusion weighted imaging is known to negatively correlate with prostate tumor aggressiveness. Heterogeneity in system and protocol performance causes potential variability in ADC acquired across a large scanner network, prompting a need to evaluate quantitative ADC from a prostate-specific MR diffusion protocol as part of quality assurance (QA). Due to the temperature dependence of ADC, repeatability and reproducibility assessments typically require phantoms to maintain a temperature of 0°C, imposing a considerable burden when assessing large numbers of scanners.

Purpose: To develop a QA procedure at room temperature for assessing the reproducibility of …

Addressing Controversy In Fusobacterium Nomenclature: What Exactly Does “F Nucleatum” Refer To?, Martha A Zepeda-Rivera, Floyd E Dewhirst, Susan Bullman, Christopher D Johnston

Faculty, Staff and Student Publications

The F. nucleatum group (sensu lato) is historically composed of four subspecies (F. nucleatum subsp. animalis, F. nucleatum subsp. nucleatum, F. nucleatum subsp. polymorphum, F. nucleatum subsp. vincentii). Although F. nucleatum sensu lato members are typically associated with oral disease, they have recently been shown to disseminate to the gastrointestinal tract and are associated with adverse health conditions such as inflammatory bowel disease and colorectal cancer (CRC). A growing debate over the nomenclature applied to Fusobacterium taxonomy has resulted in different names for these lineages, shifting them from their historic subspecies designations to …

Fusobacterium Sphaericum Sp Nov, Isolated From A Human Colon Tumor Adheres To Colonic Epithelial Cells And Induces Il-8 Secretion, Martha A Zepeda-Rivera, Yannick Eisele, Alexander Baryiames, Hanrui Wu, Claudia Mengoni, Gianmarco Piccinno, Elsa F Mcmahon, Kaitlyn D Lacourse, Dakota S Jones, Hans Hauner, Samuel S Minot, Nicola Segata, Floyd E Dewhirst, Christopher D Johnston, Susan Bullman

Faculty, Staff and Student Publications

Cancerous tissue is a largely unexplored microbial niche that provides a unique environment for the colonization and growth of specific bacterial communities, and with it, the opportunity to identify novel bacterial species. Here, we report distinct features of a novel Fusobacterium species, F. sphaericum sp. nov. (Fs), isolated from primary colon adenocarcinoma tissue. We acquire the complete closed genome and associated methylome of this organism and phylogenetically confirm its classification into the Fusobacterium genus, with F. perfoetens as its closest neighbor. Fs is phenotypically and genetically distinct, with morphological analysis revealing its coccoid shape, that while similar to …

A Review Of Engraftment Assessments Following Fecal Microbiota Transplant, Chloe Herman, Bridget M Barker, Thais F Bartelli, Vidhi Chandra, Rosa Krajmalnik-Brown, Mary Jewell, Le Li, Chen Liao, Florencia Mcallister, Khemlal Nirmalkar, Joao B Xavier, J Gregory Caporaso

Faculty, Staff and Student Publications

Fecal Microbiota Transplant (FMT) is a treatment for recurrent Clostridium difficile infections and is being explored for other clinical applications, from alleviating digestive and neurological disorders, to restoring microbiomes impacted by cancer treatment. Quantifying the extent of engraftment following an FMT is important in understanding a recipient's response to treatment. Engraftment and clinical response need to be investigated independently to evaluate an FMT's role (or lack thereof) in achieving a clinical response. Standardized bioinformatics methodologies for quantifying engraftment extent would not only improve assessment and understanding of FMT outcomes, but also facilitate comparison of FMT results and protocols across studies. …

Privacy-By-Design: Case Studies In Interactive Record Linkage Using A Hybrid Human-Computer System, Hye-Chung Kum, Eric Ragan, Mahin Ramezani, Gurudev Ilangovan, Theodoros Giannouchos, Qinbo Li, Adam D'Souza, Elmer V Bernstam, Jeffrey R Curtis, Alva O Ferdinand, Cason Schmit

Faculty, Staff and Student Publications

Objective: High-quality patient matching from several sources without a common identifier (ID) requires interactive record linkage (RL) using a hybrid human-computer system. MiNDFIRL (MInimum Necessary Disclosure For Interactive Record Linkage) is a hybrid prototype software system that facilitates maximizing linkage accuracy while minimizing information disclosure. We present and evaluate MiNDFIRL using two real-world case studies.

Materials and methods: Two user studies were conducted linking 10,000 data pairs from EHR data and 18,240 unique patient IDs from patient generated data. After automated RL, manual review was conducted by three teams of four reviewers (12 total) using MiNDFIRL to resolve potential matches …

A Contemporary Guide To An International Aortic Super-Fellowship For Surgical Trainees And Surgeons In The United States, Roberto G. Aru, Adam W. Beck, Stéphan Haulon

Department of Surgery Faculty Papers

Fenestrated and branched technology for endovascular aortic repair of the thoracoabdominal aorta and aortic arch has evolved significantly over the last decade. The spectrum of these devices is largely available outside the United States (US), while patient-specific company manufactured devices are limited to ten sites in the US, with ongoing expanding use of market-approved off-the-shelf devices. The necessary environment for appropriate education to ensure safe dissemination of these technologies is limited, and the current centralization of both device availability and skillsets affects trainee education. In order to refine their endovascular treatment algorithm and planning/implantation skillsets at these multidisciplinary aortic centers, …

Real-Time Estimated Sequential Organ Failure Assessment (Sofa) Score With Intervals: Improved Risk Monitoring With Estimated Uncertainty In Health Condition For Patients In Intensive Care Units, Yan He, Qian Luo, Hai Wang, Zhichao Zheng, Haidong Luo, Oon Cheong Ooi

Research Collection Lee Kong Chian School Of Business

Purpose: Real-time risk monitoring is critical but challenging in intensive care units (ICUs) due to the lack of real-time updates for most clinical variables. Although real-time predictions have been integrated into various risk-scoring systems to aid monitoring, existing systems do not address uncertainties in risk assessments. We developed an enhanced risk monitoring framework based on commonly used systems like the Sequential Organ Failure Assessment (SOFA) score by incorporating uncertainties to improve the effectiveness of real-time risk monitoring in ICUs.Methods: This study included 5,351 patients admitted to the Cardiothoracic ICU in the National University Hospital in Singapore. We developed machine learning …

A Prognostic Classification System For Extent Of Resection In Idh-Mutant Grade 2 Glioma: An International, Multicentre, Retrospective Cohort Study With External Validation By The Rano Resect Group, Philipp Karschnia, Jacob S Young, Maarten M J Wijnenga, Tommaso Sciortino, Nico Teske, Alba Corell, Arthur Wagner, Gilbert Youssef, Yae Won Park, Levin Häni, Stephanie T Jünger, Antonio Dono, Felix Ehret, Eduardo E Mendoza Mireles, Nicolas Neidert, Francesco Bruno, Chad A Tuchek, Thijs Van Der Vaart, Marco Rossi, Marco Conti Nibali, Lorenzo Gay, Alfred Gramelt, Nitin Tandon, Sung Soo Ahn, Jong Hee Chang, Michael Weller, Arnaud J P E Vincent, Roland Goldbrunner, Daniel P Cahill, Raymond Y Huang, Andreas Raabe, Bernhard Meyer, Juergen Beck, Annette M Molinaro, Susan M Chang, Michael A Vogelbaum, Roberta Rudà, Einar O Vik-Mo, Jorg Dietrich, Yoshua Esquenazi, Stefan J Grau, Patrick Y Wen, Asgeir S Jakola, Oliver Schnell, Lorenzo Bello, Martin J Van Den Bent, Shawn Hervey-Jumper, Mitchel S Berger, Joerg-Christian Tonn

Faculty, Staff and Student Publications

Background: The efficacy of resection in IDH-mutant grade 2 gliomas remain controversial since terminology for the extent of resection has been inconsistently applied across studies. We aimed to establish a standardised classification for the extent of resection and assess the association between supramaximal resection and survival across molecular subtypes.

Methods: In this international, multicentre, retrospective study, patients aged 18 years and older with newly diagnosed grade 2 IDH-mutant glioma were identified from institutional databases across 16 centres in the USA, Europe, and Asia between between Sept 1, 1993, and May 10, 2024. We used Cox proportional hazard regressions to analyse …

Peripheral Blood Gene Expression Profiling And Prognostic Significance For The Course Of Interstitial Lung Disease In Patients With Systemic Sclerosis, Shervin Assassi, Christopher P Denton, Matthias Zwick, Ramona Schmid, Carina Ittrich, Tobias Litzenburger, Sudha Visvanathan

Faculty, Staff and Student Publications

Objective: We used data from the placebo arm of the Safety and Efficacy of Nintedanib in Systemic Sclerosis (SENSCIS) trial to determine the prognostic/predictive significance of peripheral blood cell (PBC) transcript modules for the course of forced vital capacity (FVC) in patients with systemic sclerosis-associated interstitial lung disease (SSc-ILD) with and without mycophenolate mofetil (MMF) treatment.

Methods: Patients had SSc-ILD with first non-Raynaud symptom within 7 years. MMF treatment was permitted if taken at a stable dose for ≥6 months. PBC RNA samples were taken at baseline. Global RNA sequencing was performed, followed by a modular analysis using 62 curated …

Better Floors, Better Health: A Theory Of Change For An Improved Household Flooring Intervention In Rural Communities In Kwale And Bungoma Counties, Kenya, Stella Kepha, Hugo Legge, Katherine E. Halliday, Victoria Ochwal, Lynne Elson, Jacinta Mwongeli, William E. Oswald, Beatrice Kakoi, James Wambua, Charles Mwandawiro, Ulrike Fillinger, Rachel Pullan, Doris Njomo

All Peer-Reviewed Publications

Background: Household flooring is increasingly being investigated as a determinant of health, however the pathways through which flooring may impact health and wellbeing are not yet well understood. The SABABU study is a cluster-randomised controlled trial evaluating the impact of an improved flooring intervention on soil-transmitted helminthiasis, tungiasis, and enteric infections in Bungoma and Kwale counties, Kenya. This paper presents the findings from a theory of change development process that was undertaken as part of the formative research phase of the SABABU project. Methods: A co-creation workshop (n = 1), stakeholder meetings (n = 2), and community meetings (n = …

Income Inequality And Self-Reported Health: A Difference-In-Differences Study, Kola Adegoke

Health & Biomedical Sciences Faculty Publications

Background: Health disparities in the United States (US) are closely linked to income inequality. While many studies have reported associations between income and health, causal evidence remains limited.

Objective: To estimate the causal effect of income-equalizing state policies, such as minimum wage increases, Medicaid expansion, and Earned Income Tax Credit (EITC) adjustments, on adult self-rated health using a difference-in-differences (DiD) framework.

Methods: Using the Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System (BRFSS) data from 2018 to 2023, a 2-way fixed-effects DiD model was employed to compare changes in the proportion of adults reporting fair or …

Impact Of Propofol Or Sevoflurane On The Renoprotective Effect Of Remote Ischaemic Preconditioning In Cardiac Surgery: The Hypnorenalrip Randomised Clinical Trial, Alexander Zarbock, Ludwig Maximilian Schöne, John A Kellum, Joachim Gerss, Raphael Weiss, Hendrik Booke, Melanie Meersch

Faculty, Staff and Student Publications

Background: Remote ischaemic preconditioning (RIPC) might reduce acute kidney injury after cardiac surgery. Protective effects appear to be restricted to patients with early and transient increases in two cell cycle arrest markers, tissue inhibitor of metalloproteinases-2 (TIMP-2) and insulin-like growth factor-binding protein 7 (IGFBP7), in urine. Studies suggest that propofol can attenuate the preconditioning effect on the myocardium. This study investigated whether propofol diminishes the renoprotective effect associated with the early transient increases in TIMP-2 and IGFBP7.

Methods: This was a single-centre, prospective randomised double-blind 2×2 factorial clinical trial of high-risk patients undergoing cardiac surgery. Patients were randomised to receive …

Contemporary Chronic Limb-Threatening Ischemia Care In The United States-Part 1: A Path Toward Multispecialty Collaboration., Eric A Secemsky, Ehrin J Armstrong, Venita Chandra, Raghu Kolluri, Parag J Patel, Peter A Schneider, Niten Singh

Heart and Vascular Articles

Care for patients with chronic limb-threatening ischemia (CLTI) is complex, and it is most effective when conducted with collaboration across multiple specialties. A recent upward trend in major limb amputation among patients with CLTI warrants a renewed effort to optimize care for this multifaceted condition. The Vascular InterVentional Advances (VIVA) Foundation, a not-for-profit 501(c)(3) organization, convened a Vascular Leaders Forum in 2024 to initiate an open, multispecialty discussion about the state of CLTI care in the United States and current challenges around delivery and access to such care. The forum comprised representatives from vascular surgery, interventional cardiology, interventional radiology, vascular …

Contemporary Chronic Limb-Threatening Ischemia Care In The United States-Part 2: Designing Clinical Device Trials., Eric A Secemsky, Ehrin J Armstrong, Venita Chandra, Raghu Kolluri, Saher S Sabri, Niten Singh

Heart and Vascular Articles

Head-to-head research comparing invasive revascularization strategies for chronic limb-threatening ischemia (CLTI) is sparse, partly due to challenges in conducting randomized controlled trials in the CLTI space. These include the expense of head-to-head trials, optimizing patient selection criteria for real-world applicability, and identifying optimal study end points. The Vascular InterVentional Advances (VIVA) Foundation, a 501(c)(3) not-for-profit organization, convened a Vascular Leaders Forum to initiate an open, multispecialty collaborative discussion of these challenges and ways to optimize the design of medical device trials in CLTI. This article summarizes the current landscape of clinical studies of CLTI revascularization strategies and options for designing …

Allogeneic Bone Marrow-Derived Mesenchymal Stem Cells For Parkinson's Disease: A Randomized Trial., Mya C Schiess, Jessika Suescun, Juan D Martinez-Lemus, Charles Green, Tia S Thomas, Mohammad Shahnawaz, Emily Tharp, Nikunj B Satani, Jerome G Saltarrelli, Christopher Adams, Marie-Francoise Doursout, Vanessa Thyne, Rula Abuamouneh, Elsa M Rodarte, Sean I Savitz, Timothy M Ellmore

Faculty, Staff and Student Publications

Background: Neuroinflammation contributes to Parkinson's disease (PD) progression and motor dysfunction. Allogeneic human mesenchymal stem cells (allo-hMSCs) may reduce neuroinflammation and improve motor symptoms.

Objectives: To evaluate the efficacy of repeated intravenous doses of 10 × 106/kg allo-hMSCs in improving motor symptoms in patients with PD (PwP).

Methods: In this phase 2, randomized, placebo-controlled trial (November 2020-July 2023), mild-to-moderate PwP received either three allo-hMSC infusions, one placebo followed by two allo-hMSC infusions, or three placebo infusions at 18-week intervals. Follow-up lasted 88 weeks. The primary outcome was a >70% posterior probability (PP) of a difference in the proportion of participants …

Prospective Trial Of Cerebrospinal Fluid Filtration After Aneurysmal Subarachnoid Hemorrhage Via Lumbar Catheter Extension (Pillar-Xt), Spiros L Blackburn, Marc A Babi, Andrew W Grande, Omar A Choudhri, Erik F Hauck, Christopher P Kellner, Michael C Giordano, Shivanand P Lad, Aaron R Mccabe

Faculty, Staff and Student Publications

Background: There is a growing consensus that blood in the cerebrospinal fluid (CSF) is deleterious to outcomes in patients with aneurysmal subarachnoid hemorrhage. The extracorporeal filtration of subarachnoid hemorrhage via spinal catheter extension study evaluated the safety, tolerability, and filtration curve of blood and its lysis products from hemorrhagic CSF using the Neurapheresis CSF Management System.

Methods: After aneurysm repair, a dual-lumen intrathecal catheter was inserted into the study participant's spinal canal. CSF was extracorporeally filtered for up to 72 h, removing blood products from the lumbar cistern, and reintroducing filtered CSF to the thoracic subarachnoid space. Neurological examinations were …

Short-Term Preeclampsia Prediction: Cutoff Variations For Sflt-1/Plgf In U.S. Patients With Or Without Hypertensive Disorders, Yaxin Li, Kristen Cagino, Jim Yee, Caroline Andy, Dajana Borova, Ayush Shah, Isla Racine, Tracy B Grossman, Zhen Zhao

Faculty, Staff and Student Publications

Background: Preeclampsia (PE) is a complex disorder with significant maternal and fetal risks. The soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) ratio shows promise as a diagnostic tool, but its adoption in the U.S. remains limited due to the lack of accessible testing platforms, U.S.-based studies, and evidence-based implementation guidelines.

Patients/materials and methods: We conducted a cohort study to evaluate the sFlt-1/PlGF ratio for predicting PE within two weeks among pregnant individuals ≥18 years, ≥20 weeks gestation. Serum samples were obtained from routine prenatal visits or triage evaluations. sFlt-1/PlGF ratios were measured using Roche Elecsys assays, and …

Assessment Of Postoperative Range Of Motion In Pediatric Patients Undergoing Surgical Reduction And Fixation Of Lateral Condyle Fractures, Gabrielle Rogie, Timothy Borden, Lindsay Crawford, Surya Mundluru, Brennan Roper, Rohini Mahajan Vanodia, Shiraz Younas

Faculty, Staff and Student Publications

Purpose: The objective of this study was to evaluate the outcomes of various methods of fixation for pediatric lateral condyle fractures. The null hypothesis was that there would be no difference between the three treatment groups and time of return to the full range of motion.

Method: There were three fixation groups-Algemeinshaft fur osteosynthesegragen (AO) cannulated screws (n = 11), buried Steinmann pins (n = 13), and unburied Steinmann pins (n = 36). Variables evaluated were time to return to full range of motion of the elbow, whether therapy was required, average number of follow-up visits, fracture …

Prone Percutaneous Jungbluth For Reduction Of Irreducible Posterior Pelvic Ring Injuries: A Technical Trick, Joseph M Radley, Jonathan A Copp, Daniel S Gloekler, Jonathan G Eastman

Faculty, Staff and Student Publications

Unstable pelvic ring injuries represent a challenge due to the complex anatomy. Further, surgical access to the pelvic ring is altered by patient positioning in the supine versus prone position. Certain injury patterns present with the posterior pelvis in a fixed displaced position. These injuries can be exceedingly challenging to reduce from a supine position. In the prone position, these injuries can be reduced more directly with an open approach, but this is associated with wound healing complications. The technical trick herein demonstrated a successful technique utilizing a large Jungbluth clamp percutaneously applied to the posterior superior iliac spines with …

Efficacy Of Platelet Rich Plasma Versus Placebo For Improvement In Olfactory Function In Adults With Olfactory Dysfunction: A Systematic Review And Meta-Analysis, Ali B Jafar, Ghabrielle Almeida, Fatima Al Mousawi, Eric Delgado Rendon, Amber U Luong

Faculty, Staff and Student Publications

Background: Olfactory dysfunction significantly impairs quality of life. Conventional treatments such as corticosteroids and olfactory training offer limited and inconsistent efficacy. Platelet-rich plasma (PRP), a biologically active agent, has shown potential regenerative effects in olfactory neuroepithelium. This study systematically evaluates the efficacy of PRP compared to placebo in improving olfactory function.

Methods: A systematic review and meta-analysis was conducted according to PRISMA guidelines and was registered in PROSPERO (CRD 420251045079). The databases searched included PubMed, Scopus, Embase, Central, and Web of Science. Seven studies (four RCTs, three non-RCTs) involving 789 patients were included. Subjective and objective outcomes were extracted and …

Developing Consensus For A More Provider-Friendly Next-Generation Sequencing Molecular Biomarker Report: A Joint Consensus Recommendation Of The Association For Molecular Pathology And College Of American Pathologists, Jane Gibson, Hanadi El Achi, Dana Altenburger, Noah Brown, Amy S Clark, Joshua Coleman, Rajyasree Emmadi, Amber M Fussell, Meera Hameed, Danielle Jordan, Jennifer Laudadio, Anthony Provenzano, Robyn L Temple-Smolkin, Christopher G Suciu

Faculty, Staff and Student Publications

Despite the increasing availability of next-generation sequencing (NGS) gene panel analysis for cancers, published reports suggest underutilization of testing, citing the shortage of credentialed professionals available to assist with the interpretation of test results among the key barriers. Obtaining a multidisciplinary consensus regarding a shared best practice NGS molecular biomarker reporting section template may facilitate introduction and/or increased testing for institutions that adopt similar report structures by improving report effectiveness and efficiency for both health care providers and laboratory professionals, leading to improved patient care. To address this challenge, the Association for Molecular Pathology convened a multidisciplinary collaborative expert working …

Early Identification For Spasticity Patient Referral Needs: An Inter-Rater Reliability Study Of The Post-Stroke Spasticity Referral Tool, Jorg Wissel, Atul Patel, Ganesh Bavikatte, Xiao Li, Sophie L Musson, Elizabeth Torres, Nabilah Alibhai, Tiziana Musacchio, Gerard E Francisco

Faculty, Staff and Student Publications

Background: The post-stroke spasticity (PSS) Referral Tool was developed to assist health care professionals in the early identification of patient referral needs. An inter-rater reliability (IRR) study using videos of patients with different stages of or without predictors of PSS was performed to validate its utility in clinical practice.

Research design and methods: This prospective study had 3 parts: patient video production (Part A); expert panel classification of patient videos into PSS Referral Tool categories (Part B; Urgent Referral [UR; red], Routine Referral [RR; yellow], Periodic Monitoring [PM; green]), and an IRR analysis from global clinician raters (Part C). IRR …

Real-World Disease Burden And Health Care Resource Utilization For Patients With Barth Syndrome, Lindsay Marjoram, Yonglin Huang, Mary Kay Koenig, Bruce H Cohen, Eric Anderson

Faculty, Staff and Student Publications

Background: Barth syndrome (BTHS) is an ultra-rare, X-linked genetic disorder for which there is limited economic data. Because compiling such data that target rare indications is difficult, we assessed real-world data to increase understanding of the cost of BTHS based on disease burden and health care resource utilization (HCRU).

Methods: A search of the published medical literature identified individual case studies and registry data used to assess the burden of disease and potential costs associated with BTHS, including the potential ability of developing treatments to positively impact those costs. In addition, a claims database analysis was conducted to assess HCRU …

Trends In Preservation Rhinoplasty Publications: A Bibliometric Analysis Of Presented Data Originality, Rakan Saadoun, W Katherine Kao, Tang Ho

Faculty, Staff and Student Publications

Background: Recent literature on dorsal preservation rhinoplasty (DPR) has seen a resurgence. This study performs a bibliometric analysis of publications and co-authorships within this research area, considering factors such as gender, country of origin, international collaboration, and the originality of the presented data.

Methods: The PubMed-indexed literature on DPR from 2018 to 2024 was extracted and reviewed, limited to English publications. Descriptive statistics were performed regarding the contributors by gender, country, publishing journal, authorship rank, and department of affiliation. Association tests were used to determine the association between the originality of the data presented and the affiliation's country and department. …

Whipple Disease Initial Presentation As Supraclavicular Lymphadenopathy In A Patient With Rheumatoid Arthritis: A Diagnostic Challenge, Sara E Amin, Swati Gite, Audrey Wanger, Violeta Chavez, Jacob Armstrong, Beenu Thakral, Patricia Navarro, Jennifer Makhoul, Amer Wahed, Navneet Narula, Karan Saluja

Faculty, Staff and Student Publications

Whipple disease is a rare systemic disease caused by Tropheryma whipplei. It can present with a wide range of nonspecific symptoms that might overlap with underlying medical conditions, posing a diagnostic challenge. We present a 61-year-old man with a past medical history of rheumatoid arthritis and chronic inflammatory demyelinating polyneuropathy, who presented with persistent leukocytosis and supraclavicular lymphadenopathy. A positron emission tomography scan revealed hypermetabolic activity in the supraclavicular, abdominal, and pelvic lymph nodes along with a myocardial hypermetabolic lesion, concerning a lymphoproliferative disorder versus sarcoidosis. A supraclavicular lymph node excisional biopsy revealed complete architectural effacement by a diffuse foamy …

A Urine-Based Point-Of-Care Test For Factor Xa Inhibitors In Acute Stroke Management, Prasen R Marella, Jacob A Sambursky, Kriti Bhayana, Asha P Jacob, Varsha Muddasani, Murli Mishra, Alexandra L Czap, James C Grotta

Faculty, Staff and Student Publications

Background: For stroke patients with history of possible Direct Acting Oral Anticoagulant use, clinicians must make treatment decisions without knowledge of whether the patient is therapeutically anticoagulated. A urine-based point-of-care test might help guide these emergency decisions.

Methods: We prospectively enrolled patients with suspected recent factor-Xa-inhibitor (Xai) use being evaluated for acute stroke therapy in an urban teaching hospital. We obtained the urine test and plasma anti-Xa level in parallel with usual clinical management; the treating clinician did not use test results for decision-making but recorded treatment they would have given had they known the urine test was accurate. The …

Nocturnal Oxygen Therapy For Central Sleep Apnea In Patients With Heart Failure: A Multisite, Double-Blind, Sham-Controlled Randomized Clinical Trial (Loft-Hf), Susan Redline, Dongdong Li, Shahrokh Javaheri, Sanjay R Patel, Sairam Parthasarathy, James C Fang, Lee K Brown, Mark Dunlap, M Safwan Badr, Neomi Shah, Luqi Chi, Ruckshanda Majid, Mihaela Teodorescu, Garrick Stewart, Eileen Hsich, Tamar Polonsky, Justin Vader, Maryl R Johnson, Dennis Auckley, Henry Klar Yaggi, Andrew Kao, Ali Azarbarzin, Raichel Alex, Michael Rueschman, Lisa Wolfe, Daniel J Gottlieb, Scott A Sands, Phyllis C Zee, Reena Mehra, Babak Mokhlesi, Rami Khayat, Eldrin F Lewis, William T Abraham, Rui Wang

Faculty, Staff and Student Publications

Rationale: There are insufficient data to inform the management of central sleep apnea (CSA) in patients with heart failure with reduced ejection fraction (HFrEF). Nocturnal oxygen therapy (NOT) has been postulated to benefit CSA patients with HFrEF but has not been rigorously studied. Objectives: To compare NOT with sham NOT (control) in heart failure (HF) patients receiving guideline-based HF therapy on the composite outcome of first occurrence of either mortality due to any cause, a lifesaving cardiovascular intervention, or an unplanned hospitalization for worsening HF, together with other secondary outcomes.

Methods: A multisite, double-blind, sham-controlled randomized clinical trial was conducted …

Combining Pirfenidone With Mycophenolate Mofetil For Systemic Sclerosis-Related Interstitial Lung Disease (Scleroderma Lung Study Iii): An Investigator-Initiated, Multicenter, Randomized, Double-Blind, Placebo-Controlled Phase 2 Trial, Dinesh Khanna, Cathie Spino, Donald P Tashkin, Elana J Bernstein, Jonathan Goldin, Eric C Kleerup, Airi Harui, Grace Ibrahim, Grace Hyun J Kim, Suiyuan Huang, Richard Mclain, Yi-Hsuan Tu, Vivek Nagaraja, Richard M Silver, Virginia D Steen, S Samuel Weigt, Joyce S Lee, Aryeh Fischer, Mary Beth Scholand, Jessica K Gordon, Paul F Dellaripa, Ivan O Rosas, Gary M Hunninghake, Marcin A Trojanowski, Robert W Simms, Jane E Dematte, Vivien M Hsu, Robyn T Domsic, Ganesh Raghu, Maureen D Mayes, Ryan D Boente, Michael D Roth

Faculty, Staff and Student Publications

Objective: Mycophenolate mofetil (MMF) can stabilize or improve lung function in systemic sclerosis-related interstitial lung disease (SSc-ILD). We hypothesized that combining MMF with pirfenidone (PFD) would produce a significantly more rapid and/or greater improvement in lung function.

Methods: A randomized (1:1), double-blind, placebo (PLA)-controlled phase 2 trial was conducted in SSc-ILD in which patients received PFD or PLA (801 mg three times daily) along with MMF (1,500 mg twice daily) for 18 months. The primary outcome was change in percent predicted forced vital capacity (FVC-%). Linear mixed-effects models assessed treatment differences in a modified intention-to-treat population.

Results: Only fifty-one of …

Revisiting Soluble Guanylate Cyclase Pharmacology: Additive Potential Of Stimulators And Activators, Alexandra Petraina, Mahmoud H Elbatreek, Christopher T Neullens, Theodora Saridaki, Vu Thao-Vi Dao, Rebecca D Szepanowski, Emil Martin, Wolfgang Sippl, Ana I Casas, Harald H H W Schmidt

Faculty, Staff and Student Publications

Nitric oxide (NO) is a key gasotransmitter that binds to soluble guanylate cyclase (sGC), thereby stimulating cGMP production. Under disease conditions, reactive oxygen species disrupt this signaling by either: (1) scavenging NO, or (2) promoting heme-free, NO-insensitive apo-sGC due to impaired heme incorporation or oxidative damage. To counteract these conditions, two pharmacological approaches have emerged: sGC stimulators, which allosterically enhance sGC sensitivity to low NO levels; and sGC activators, which directly activate apo-sGC (heme-free sGC) by binding to its empty heme pocket, inducing a conformation that mimics NO-bound sGC. Thus, sGC stimulators are thought to target only sGC. Instead, we …