Medicine and Health Sciences Commons^™

Paroxysmal Cold Hemoglobinuria Associated With Monoclonal B-Cell Lymphocytosis In An Elderly Patient: A Report Of A Rare Case., Summiya Nasim Md, Matthew Bartock Do

PCI Publications and Projects

We report the case of an 86-year-old male with chronic anemia who presented with indirect hyperbilirubinemia, undetectable haptoglobin, and reticulocytosis. The peripheral smear showed no schistocytes. The cold-agglutinin titer was mildly positive, and the Donath-Landsteiner antibody test was positive. Bone marrow biopsy revealed a small CD5⁺ B-cell clone consistent with monoclonal B-cell lymphocytosis (MBL). The patient was diagnosed with paroxysmal cold hemoglobinuria (PCH) associated with MBL and treated with rituximab, achieving clinical stability without transfusion requirement. This case illustrates a rare coexistence of PCH and MBL in an elderly patient and emphasizes the importance of comprehensive hematologic evaluation for unexplained …

Systemic Racism In Canadian Healthcare: A Policy And Equity Analysis, Kola Adegoke, Abimbola Adegoke, Deborah Dawodu, Temitope Kayode

Health & Biomedical Sciences Faculty Publications

Background: In Canadian healthcare, systemic racism subverts commitment to universal coverage by building inequities into the system of governance, regulation, and clinical practice. Although racial disparities have been documented, little attention has been paid to how institutional structures perpetuate these inequities.

Objective: This study critically examines the organizational aspects of racism in the Canadian healthcare system. It aims to identify structural obstacles faced by racialized patients and foreign-trained physicians and to provide policy recommendations grounded in evidence.

Methods: The authors employed a narrative review framework for qualitative analysis of documents. Public inquiries (eg, Truth and Reconciliation Commission and Viens Report), …

Delayed Presentation Of A Retained Colonic Segment In A Child With Intestinal Failure On Teduglutide, Rachel C Bordelon, Sarah J Varalla, Varaha S Tammisetti, Mohamed M Shahin, Amanda Tchakarov, Essam Imseis, Allison L Speer

Faculty, Staff and Student Publications

Teduglutide is a glucagon-like peptide 2 (GLP-2) analogue that was approved by the United States Food and Drug Administration for the treatment of pediatric (>1 year) intestinal failure due to short bowel syndrome in 2019. GLP-2 analogues promote rapid intestinal adaptation, increasing the absorptive capacity of residual intestine after surgical resection to aid the achievement of enteral autonomy or reduce parenteral nutrition requirements. Despite relatively few reported side effects, there is a theoretical risk of proliferative complications. Here we present an intriguing case of a pediatric patient found to have a decade-long retained, discontinuous segment of colon from a …

The Mythology Of Polymyositis, Suur Biliciler, Tahseen Mozaffar

Faculty, Staff and Student Publications

Polymyositis (PM) has been in the diagnostic armamentarium in medicine since the mid-nineteenth century. Medicine training puts a heavy emphasis on this diagnosis, and anyone with proximal muscle weakness with elevated serum creatinine kinase is assumed to be PM and a number of patients were rendered this diagnosis without additional testing. This article addresses the historical aspects of the diagnosis of PM and its evolution. We review this literature that addresses the rarity of this diagnosis and rightly puts in perspective in terms of its occurrence in relation to other inflammatory myositides.

Innovations In Thrombectomy Training: A Systematic Review And Expert Recommendations From The Society Of Vascular And Interventional Neurology-Mission Thrombectomy Initiative, Fawaz Al-Mufti, Mohamed Elfil, Abdallah Abbas, Haneen Sabet, Hazem S Ghaith, Ariel Sacknovitz, Ankita Jain, Victor Urrutia, Nabeel Herial, Gabor Toth, Mohamad El-Ghanem, Krishna Amuluru, Viktor C Szeder, Jonathan Crowe, Karol Budohoski, Zurab Nadareishvili, Kaustubh Limaye, Fazeel Siddiqui, Boris Pabon, Ossama Yassin Mansour, Atilla Ozcan Ozdemir, Houman Khosravani, Hamza Shaikh, Nishita Singh, Hesham Masoud, Sushanth R Aroor, Shashvat Desai, Santiago Ortega-Gutierrez, Fredrick Echols, Thanh N Nguyen, Pankajavalli Ramakrishnan, Priyank Khandelwal, Dileep R Yavagal, Kaiz Asif

Faculty, Staff and Student Publications

Background: Mechanical thrombectomy is a critical intervention for patients with acute ischemic stroke with large vessel occlusion. However, significant barriers remain in its widespread implementation, particularly in low- to middle-income countries, including a shortage of trained physicians and limited access to advanced medical technologies. This systematic review and meta-analysis aimed to comprehensively evaluate current mechanical thrombectomy training methodologies and assess their effectiveness in improving procedural skills among neurointerventional teams.

Methods: We conducted a systematic review following Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, searching PubMed, Scopus, and Web of Science. Eight studies were included, with 3 studies eligible …

Multiomics Reveal Plasma Constituents Associated With Thrombosis Among Trauma Patients Who Do Not Respond To Enoxaparin, Ian S Lacroix, Monika Dzieciatkowska, Francesca Cendali, Kelly Sanders, Charles E Wade, Bryan A Cotton, Mitchell J Cohen, Angelo D'Alessandro, Kirk Hansen, Jessica C Cardenas

Faculty, Staff and Student Publications

Venous thromboembolism (VTE) is among the most common complications affecting patients with severe injuries. Although enoxaparin resistance is common, predicting which patients among this subgroup will develop VTE remains a clinical challenge. The goal of this study was to use multiomics to identify plasma constituents associated with VTE development among trauma patients exhibiting poor responses to enoxaparin. We conducted a secondary analysis of trauma patients at high risk of VTE based on injury characteristics. Plasma was collected daily for the first 8 hospital days. Patients who never responded to enoxaparin were defined as not achieving an anti-factor Xa (FXa) level …

Sweet Syndrome Successfully Treated With Upadacitinib, Valeria Duque-Clavijo, Hung Q Doan, John A Das, Stephen K Tyring

Faculty, Staff and Student Publications

No abstract provided.

Consensus Statement On Middle Meningeal Artery Embolization In Chronic Subdural Hematoma Treatment: A Guideline From The Society Of Vascular And Interventional Neurology Guidelines And Practice Standards Committee, Farhan Siddiq, Muhammad Shakir, Thanh N Nguyen, Ameer E Hassan, Mohamad Abdalkader, Cynthia L Kenmuir, David S Liebeskind, Robin Novakovic, Shahram Majidi, Sunil A Sheth, Mohammad El-Ghanem, Santiago Ortega-Gutierrez, Waldo R Guerrero, Amer M Malik

Faculty, Staff and Student Publications

Background: Emerging evidence from observational studies, meta-analyses, and clinical trials has reshaped the treatment landscape of chronic subdural hematoma (CSDH). This guideline provides updated recommendations on diagnosis, patient selection, and medical, surgical, and endovascular management.

Methods: The Society of Vascular and Interventional Neurology Guidelines and Practice Standards committee formed a writing group of interdisciplinary experts to review current literature. Recommendations were based on clinical trial data, observational studies, and expert consensus, following the Society of Vascular and Interventional Neurology Class of Recommendation and Level of Evidence framework.

Results: EMBOLISE (Embolization of the Middle Meningeal Artery With ONYX Liquid Embolic System …

Depression Polygenicity And Disease Activity And Disability Worsening In Multiple Sclerosis, Ali Manouchehrinia, Kathryn C Fitzgerald, Amber Salter, Ruth Ann Marrie, Lars Alfredsson, Charles N Bernstein, James M Bolton, Gary Cutter, John D Fisk, Lesley A Graff, Carol A Hitchon, Jan Hillert, Ingrid Kockum, Yi Lu, Fred D Lublin, Kyla Mckay, Tomas Olsson, Scott Patten, Amit Patki, Hayley Riel, Klementy Shchetynsky, Pernilla Stridh, Hemant K Tiwari, Jerry S Wolinsky, Kaarina Kowalec

Faculty, Staff and Student Publications

Objective: A better understanding of factors associated with multiple sclerosis (MS) disease activity and disability is needed. Given the strong link between comorbid depression and MS disease activity and disability, we aimed to determine whether the depression genetic burden, as modelled using its polygenic score, is associated with MS disease activity and disability worsening.

Methods: In this cohort study, we used samples from neurologist-defined adult people with MS (PwMS) followed in clinical care or during a clinical trial from existing cohorts: Canada, the United States (US), and Sweden with extensive longitudinal phenotypes. We computed the depression polygenic score (PGS) and …

Characteristics And Outcomes Associated With Multiple Triage Visits Among Patients With Suspected Preterm Labor Or Preterm Premature Rupture Of Membranes, Jameaka L Hamilton, Paula L Mcgee, George R Saade, Rebecca G Clifton, Michael W Varner, Alan T N Tita, Monica Longo, Edward F Bell, Barbara J Stoll, Donna Allard, Ashley Salazar, John M Thorp, Uma M Reddy, Maged M Costantine, Emily S Miller, Dwight J Rouse, Hyagriv N Simhan, Jennifer L Bailit, Lorraine Dugoff, George A Macones, Baha M Sibai

Faculty, Staff and Student Publications

Background: Hospital-based obstetrical triage units frequently serve as an extension to outpatient care. Evaluation of the burden of preterm birth (PTB) typically focuses on the delivery and neonatal periods, while antepartum health care utilization related to risk of PTB is seldom reported.

Objective: To identify the characteristics and outcomes associated with multiple triage visits among patients with suspected preterm labor (PTL) or preterm premature rupture of membranes (pPROM).

Study design: Secondary analysis of a retrospective cohort study of all triage visits from 20 0/7 through 34 6/7 weeks gestation on randomly selected dates in 2019 at 34 hospitals across the …

Transforming Preterm Care: The Power Of Small Baby Guidelines In Enhancing Outcomes, Leeann Pavlek, Debra Armbruster, Cecilie Halling, Kaitlyn Hipp, Maria Jebbia, Susan Lopata, Matthew Rysavy, Rebecca Saliga, Sheria Wilson, Claire Beaullieu

Faculty, Staff and Student Publications

As survival rates of extremely preterm (EPT) infants continue to improve, focus has shifted to reduce morbidity and complications in these vulnerable patients. Management of EPT infants presents significant clinical, logistical, and sometimes ethical challenges. Outcomes across centers are highly variable and strongly influenced by the care provided in the early neonatal period. Standardized guidelines, based on published literature and center-specific experiences, play an important role in improving outcomes for EPT infants. Multidisciplinary guidelines provide a framework for clinical management and support a consistent care approach. Guidelines can improve care throughout the entire neonatal intensive care unit (NICU) course, beginning …

The Distal Acromial Tip Fusion: A Novel Procedure To Mitigate Acromial Stress Fractures In High-Risk Patients Undergoing Reverse Shoulder Arthroplasty, Trevor G Simcox, Jeffrey Dela Cruz, Gennaro Dellicarpini, Wojciech K Dzieza, Itaru Kawashima, Kevin W Farmer, Jonathan O Wright, Thomas W Wright, Joseph J King

Faculty, Staff and Student Publications

Acromion and scapular spine fractures (ASFs) pose significant challenges in the management of patients undergoing reverse total shoulder arthroplasty and there is a pressing need for effective preventive measures. Current predictive factors for ASF include female sex, osteoporosis, older age, and anatomical considerations such as glenoid medialization and acromial morphology. However, surgical options to mitigate ASF risk are limited. In this study, we propose a novel technique: incorporation of distal acromial tip fusion (DATF) during primary reverse total shoulder arthroplasty procedures. DATF involves bony fusion between the undersurface of the anterolateral acromion and the region where the superior rim of …

Prevalence Of Obesity With Confirmed Excess Adiposity In Us Children And Adolescents, Alexandra B Palmer, Kyung Hyun Lee, Rashedeh Roshani, Elizabeth Frankel, Miryoung Lee, Mohammad Y Anwar, Heather M Highland, Kristin L Young, Mariaelisa Graff, Joseph B Mccormick, Susan P Fisher-Hoch, Joyce P Samuel, Jennifer E Below, Kari E North, Penny Gordon-Larsen

Faculty, Staff and Student Publications

No abstract provided.

Functional Ability Profiles In Beta-Propeller Protein-Associated Neurodegeneration (Bpan), Francesco Gavazzi, Samuel R Pierce, Vanessa Smith, Eric Yang, Julie Skorup, Kristy Pucci, Emma Kotes, Allan M Glanzman, Stacy V Cusack, Todd Levy, Holly Dubbs, Emma Wiener, Sarah Woidill, Joseph Vithayathil, Abbas Jawad, Nivedita Thakur, Laura A Adang

Faculty, Staff and Student Publications

Background: Beta-propeller Protein-Associated Neurodegeneration (BPAN) is a rare neurodevelopmental degenerative disorder caused by pathogenic variants in WDR45 leading to brain iron accumulation. Its rarity and complex clinical course make it difficult to select appropriate clinical outcome assessments (COAs). This study evaluates established COAs for feasibility and effectiveness in capturing BPAN's functional ability profiles exploring cognitive, motor, and behavioral features.

Methods: We performed an observational study. Children were recruited as part of the Myelin Disorders Biorepository Project at the Children's Hospital of Philadelphia. We administered the Gross Motor Function Measure-88 (GMFM-88), the Leiter International Performance Scale (Leiter-3), and the Vineland Adaptive …

Priming With Transcutaneous Spinal Direct Current Stimulation Followed By Robotic Exoskeleton Gait Training In Individuals With Spinal Cord Injury: A Case Series, Marcie Kern, Catherine Velasquez-Ignacio, Taimoor Afzal, Shih-Chiao Tseng, Gerard E Francisco, Shuo-Hsiu Chang

Faculty, Staff and Student Publications

Objectives: To investigate the safety and feasibility of repeated transcutaneous spinal direct current stimulation (tsDCS) as priming strategy during exoskeleton-assisted locomotor training in individuals with SCI and evaluate potential neurophysiologic and functional gait changes.

Study design: Case series experimental design.

Setting: Research laboratory at a post-acute rehabilitation hospital.

Participants: Four participants with chronic incomplete SCI.

Interventions: Four participants with chronic incomplete SCI received three weeks of training consisting of two types of interventions after baseline (A): 20-minute tsDCS (anode or cathode) applied over the spinous processes of T10 followed by 20-minute exoskeleton-assisted locomotor training (B, B1, B2) and 20-minute exoskeleton-assisted …

From Reflex Reaction To Rational Action-Personalizing Surgical Antibiotic Prophylaxis, Renee W Green, William D Rieger, Lillian S Kao

Faculty, Staff and Student Publications

No abstract provided.

Artificial Intelligence To Detect Developmental Dysplasia Of Hip: A Systematic Review, Suketu Bhavsar, Bhanu B. Gowda, Maulini Bhavsar, Sanjay Patole, Shripada Rao, Chandra Rath

Research outputs 2022 to 2026

Aim: Deep learning (DL), a branch of artificial intelligence (AI), has been applied to diagnose developmental dysplasia of the hip (DDH) on pelvic radiographs and ultrasound (US) images. This technology can potentially assist in early screening, enable timely intervention and improve cost-effectiveness. We conducted a systematic review to evaluate the diagnostic accuracy of the DL algorithm in detecting DDH. Methods: PubMed, Medline, EMBASE, EMCARE, the clinicaltrials.gov (clinical trial registry), IEEE Xplore and Cochrane Library databases were searched in October 2024. Prospective and retrospective cohort studies that included children (< 16 years) at risk of or suspected to have DDH and reported hip ultrasonography (US) or X-ray images using AI were included. A review was conducted using the guidelines of the Cochrane Collaboration Diagnostic Test Accuracy Working Group. Risk of bias was assessed using the QUADAS-2 tool. Results: Twenty-three studies met inclusion criteria, with 15 (n = 8315) evaluating DDH on US images and eight (n = 7091) on pelvic radiographs. The area under the curve of the included studies ranged from 0.80 to 0.99 for pelvic radiographs and 0.90–0.99 for US images. Sensitivity and specificity for detecting DDH on radiographs ranged from 92.86% to 100% and 95.65% to 99.82%, respectively. For US images, sensitivity ranged from 86.54% to 100% and specificity from 62.5% to 100%. Conclusion: AI demonstrated comparable effectiveness to physicians in detecting DDH. However, limited evaluation on external datasets restricts its generalisability. Further research incorporating diverse datasets and real-world applications is needed to assess its broader clinical impact on DDH diagnosis.

Insights Into Early Adoption And Physician Learning Curve Of Pulsed Field Ablation In The United States., Amin Al-Ahmad, Daniela Hincapie-Tabares, Paul C Zei, Andrea Natale, David Kessler, Joe Gallinghouse, Weeranun Bode, Jose Osorio, Jonathan W Dukes, Robert Eckart, Anish Amin, Yoel Vivas, Luis Mora, Amit Thosani, Joshua Silverstein, Anil Rajendra, Gustavo Morales, Michael Manogue, Joseph Donnelly, Frank Cuoco, Darren Sidney, Robert Brewer, Jason Meyers, Mark D Metzl, Guru Mohanty, Michael Rehorn, Paari Dominic, John D Day, Nischala Nannapaneni, John Costello

OhioHealth Research Institute Articles

BACKGROUND: Pulsed field ablation (PFA) has been available in Europe since 2021. In the United States, PFA became commercially available in 2024, and practice patterns are expected to differ from those in Europe. The objective of this study was to describe acute procedural efficiency and safety outcomes, clinical workflow patterns, and the physician learning curve associated with PFA for paroxysmal and nonparoxysmal atrial fibrillation in the first US real-world registry.

METHODS: DISRUPT-AF (A Registry Based Collaborative to Measure Efficiency, Effectiveness, and Safety of Farapulse PFA Technology for AF) is a prospective, multicenter registry capturing patient-level data on first-time PFA procedures …

Prevalent Vertebral Fracture Is Associated With Incident Cardiovascular Disease Events In Older Individuals Referred For Bone Densitometry, John T. Schousboe, Barret A. Monchka, J. Michael Davidson, Douglas Kimelman, Syed Zulqarnain Gilani, Zaid Ilyas, Siobhan Reid, Joshua R. Lewis, William D. Leslie

Research outputs 2022 to 2026

Background: It is unknown if prevalent vertebral fracture (PVFx) captured on bone density vertebral fracture assessment (VFA) images predicts incident CVD events. Methods: 11,760 individuals (mean [SD] age 75.7 [6.8] years, 94 % female) had VFA contemporaneously with bone densitometry in Manitoba, Canada, between February 2010 and December 2017, of whom 1919 (16.3 %) had ≥1 PVFx. This cohort was followed over a mean (SD) 3.8 (2.3) years for Major Adverse Cardiovascular Events (MACE, composite of hospitalization for myocardial infarction, non-hemorrhagic stroke, or all-cause mortality) and other CVD events (hospitalization for coronary artery disease, congestive heart failure, peripheral vascular disease, …

Cardiac Arrest Events On Australian Beaches, David Reid, Kye Bostwick, Jasmin C. Lawes, Ogilvie Thom, Ned Douglas

Research outputs 2022 to 2026

Background: Surf Life Saving Australia (SLSA) members respond to cardiac arrests near their patrolling location and have successfully resuscitated many community members over the years. In addition, members often act as first responders to cardiac arrest events in community settings, workplaces or through applications such as GoodSAM®. The outcomes achieved are not known after an update to resuscitation guidelines. Objective: We aimed to analyse Surf Life Saving Australia data on cardiopulmonary resuscitation (CPR) and describe the epidemiology and outcomes of cardiac arrest on Australian beaches and factors associated with survival after CPR. Methods: Using SLSA's national Incident Reporting Database held …

An Immunocompromised Patient With Cicatricial Alopecia, Dominique Revan, Victoria Stoj, Sherry Yang

Department of Dermatology and Cutaneous Biology Faculty Papers

Case description: A 37-year-old female with hemophagocytic lymphohistiocytosis presented with sudden onset hair loss that evolved over several hours during admission for neutropenic fever. Examination revealed a well-defined, tender, violaceous alopecic patch with intact follicular ostia (Fig 1). A punch biopsy showed ulcer with nonspecific changes. All fungal, bacterial, and mycobacterial stains were negative. During hospitalization, she was diagnosed with methicillin-resistant staphylococcus aureus (MRSA) bacteremia and discharged on intravenous daptomycin. She presented to the dermatology clinic 1 week later with worsening pain and hair loss, now with loss of follicular ostia.

Porokeratosis Ptychotropica Mimicking A Herpes Simplex Virus Infection, Erin R. Pomerantz, Jayci G. Rhein, Jason B. Lee, Sylvia Hsu

Department of Dermatology and Cutaneous Biology Faculty Papers

Introduction

Porokeratosis encompasses a group of skin disorders characterized by abnormal keratinization, with the defining histologic feature of cornoid lamellae, which are stacks of parakeratotic cells that overlie dyskeratotic keratinocytes. Several subtypes of porokeratosis have been identified, including disseminated superficial actinic porokeratosis, porokeratosis of Mibelli, linear porokeratosis, porokeratosis palmaris et plantaris disseminata, punctate porokeratosis, and porokeratosis ptychotropica (PP).¹ Although risk factors for other forms of porokeratosis, such as UV exposure, immunosuppression, and genetic predisposition, have been identified, PP remains less understood. Clinically, PP typically presents as hyperkeratotic, verrucous plaques found bilaterally in the gluteal cleft and buttocks.^{2, …}

Impact Of Sociodemographic, Clinical, And Intervention Characteristics On Pain Intensity Within A Single Music Therapy Session, Samuel N. Rodgers-Melnick, Douglas Gunzler, Thomas E. Love, Siran M. Koroukian, Mark Beno, Jeffery A. Dusek, Johnie Rose

Faculty Scholarship

Several studies support the efficacy of music therapy (MT) for reducing pain, but few have examined which interventions are most effective or which patients are more likely to respond. This study investigated which sociodemographic, clinical, and intervention characteristics are associated with clinically significant reductions in pain intensity (0–10 numeric rating scale reduction ≥2 units) within a single MT session. We conducted a retrospective review of 2039 MT sessions provided across a large health system among 1203 adult patients reporting pre-session pain ≥4/10, a complete post-session pain score, and a complete pre-session stress score. We employed a multivariable logistic mixed effects …

Progresssive Maculopathy In A Child Resulting From Vitreopapillary Traction On A Congenitally Anomalous Nerve, Ross M. Kennamer-Chapman, Lee M. Jampol, Rithwick Rajagopal

2020-Current year OA Pubs

PURPOSE: To present a case of worsening maculopathy and vision loss because of vitreopapillary traction associated with an anomalous optic nerve head in a pediatric patient successfully managed with pars plana vitrectomy.

METHODS: Retrospective case report.

RESULTS: A 13-year-old boy presented with unilateral maculopathy that slowly progressed over a 4-year period. As his visual acuity declined, he became increasingly symptomatic. The macular pathology occurred in the setting of vitreopapillary traction overlying multiple congenital optic nerve abnormalities, including a myelinated nerve fiber layer and a Bergmeister papilla. After pars plana vitrectomy to alleviate the traction, the patient's macular appearance improved, and …

Perceived Prejudice Or Discrimination In Medical Care Among Us Adults, Inimfon Jackson, Robert Yu, Joël Fokom Domgue, Sanjay Shete

Faculty, Staff and Student Publications

No abstract provided.

Misfolded Amyloid-Beta Conformational Variants (Strains) As Drivers Of Alzheimer's Disease Neuropathology, Salvatore Saieva, Rodrigo Morales

Faculty, Staff and Student Publications

No abstract provided.

Phase 2 Study Of Monotherapy With Pembrolizumab For Advanced Adrenocortical Carcinoma, Brenda Chahla, Bettzy Stephen, Juhee Song, Vania Balderrama-Brondani, Feyza Yaylaci, Matthew T Campbell, Aung Naing, Mouhammed Amir Habra

Faculty, Staff and Student Publications

Introduction: Adrenocortical carcinoma (ACC) is a rare cancer with suboptimal response to chemotherapy. The role of immunotherapy in ACC management is evolving.

Methods: An investigator-initiated, open-label, phase 2 clinical trial was performed to ascertain the activity and safety of monotherapy with pembrolizumab (a humanized monoclonal anti-programmed cell death protein 1 antibody) in patients with advanced ACC. This study was part of a basket clinical trial (ClinicalTrials.gov ID: NCT02721732). Study participants were enrolled from August 15, 2016, until December 7, 2020. Pembrolizumab (200 mg) was administered intravenously every 3 weeks. All other lines of therapy, including mitotane, were stopped before …

Surgical Outcomes With Neoadjuvant Durvalumab Plus Chemotherapy Followed By Adjuvant Durvalumab In Resectable Nsclc, Tetsuya Mitsudomi, John V Heymach, Martin Reck, Janis M Taube, Shugeng Gao, Yoshitsugu Horio, Jian You, Gaofeng Li, Dinh Van Luong, Somcharoen Saeteng, Fumihiro Tanaka, Stefan B Watzka, Laszlo Urban, Zsuzsanna Szalai, Hiroaki Akamatsu, Jin Hyoung Kang, Francisco J Orlandi, Guzel Z Mukhametshina, Andreas Pircher, Carlos Henrique Andrade Teixeira, Mike Aperghis, Gary J Doherty, Ruth Doake, Tamer M Fouad, David Harpole

Faculty, Staff and Student Publications

Introduction: In AEGEAN, perioperative durvalumab plus neoadjuvant chemotherapy, versus neoadjuvant chemotherapy alone, significantly improved event-free survival (p = 0.004) and pathologic complete response (p < 0.001; primary end points; modified intention-to-treat [mITT] population, which excluded patients with known EGFR or ALK aberrations) with a manageable safety profile in patients with resectable (R)-NSCLC. Here, we report surgical outcomes from AEGEAN.

Methods: Patients with treatment-naive R-NSCLC (stage II-IIIB [N2]) and Eastern Cooperative Oncology Group performance status 0 or 1 were randomized (1:1) to platinum-based chemotherapy plus durvalumab or placebo intravenously (every 3 wk, 4 cycles) before surgery, followed by durvalumab or placebo (every 4 wk, 12 cycles). Surgical outcomes were summarized for the mITT population using descriptive statistics.

Results: A total of 737 out of 740 mITT patients received treatment, 366 and 371 in the durvalumab and …

Sars-Cov-2 Mrna Vaccines Sensitize Tumours To Immune Checkpoint Blockade, Adam J Grippin, Christiano Marconi, Sage Copling, Nan Li, Chen Braun, Cole Woody, Elliana Young, Priti Gupta, Min Wang, Annette Wu, Seong Dong Jeong, Dhruvkumar Soni, Frances Weidert, Chao Xie, Eden Goldenberg, Andrew Kim, Chong Zhao, Anna Devries, Paul Castillo, Rishabh Lohray, Michael K Rooney, Benjamin R Schrank, Yifan Wang, Yifan Ma, Enoch Chang, Ramez Kouzy, Kyle Dyson, Jordan Jafarnia, Nina Nariman, Gregory Gladish, Jacob New, Ada Argueta, Diana Amaya, Nagheme Thomas, Andria Doty, Joe Chen, Nikhil Copling, Gabriel Alatrash, Julie Simon, Alicia Bea Davies, William Dennis, Richard Liang, Jeff Lewis, Xiong Wei, Waree Rinsurongkawong, Ara A Vaporciyan, Andrew Johns, D3code Team, Jack Lee, Ji-Hyun Lee, Ryan Sun, Padmanee Sharma, Hai Tran, Jianjun Zhang, Don L Gibbons, Jennifer Wargo, Betty Y S Kim, John V Heymach, Hector R Mendez-Gomez, Wen Jiang, Elias J Sayour, Steven H Lin

Faculty, Staff and Student Publications

Immune checkpoint inhibitors (ICIs) extend survival in many patients with cancer but are ineffective in patients without pre-existing immunity1–9. Although personalized mRNA cancer vaccines sensitize tumours to ICIs by directing immune attacks against preselected antigens, personalized vaccines are limited by complex and time-intensive manufacturing processes10–14. Here we show that mRNA vaccines targeting SARS-CoV-2 also sensitize tumours to ICIs. In preclinical models, SARS-CoV-2 mRNA vaccines led to a substantial increase in type I interferon, enabling innate immune cells to prime CD8+ T cells that target tumour-associated antigens. Concomitant ICI treatment is required for …

Cardiovascular Multimorbidity In Older Adults In The United States By Race And Sex, Michael D Green, Robert J Mentz, Stephen J Greene, Bradley G Hammill, Utibe R Essien, Ying Xian, Erin D Michos, Roland J Thorpe, Matthew E Dupre, Brian Mac Grory, Chi-Tsun Chiu, Emily C O'Brien, Jay B Lusk

Faculty, Staff and Student Publications

Background: It is essential to understand the prevalence of cardiovascular multimorbidity and to recognize disparities by race and sex to promote health equity.

Objectives: The objectives of the study are to investigate disparities in the development and progression of cardiovascular multimorbidity among older adults in the United States and estimate relative life expectancies among patients with cardiovascular multimorbidity.

Methods: This was a nationwide study of a 5% nationwide sample of fee-for-service Medicare beneficiaries aged 65 or older from 2010 to 2020. Multistate survival models were employed to estimate cardiovascular disease (CVD) progression and a microsimulation approach was used to derive …