Medicine and Health Sciences Commons^™

Selecting Dcd Recipients Using Predictive Indices, Saif Ganni, Greta Handing, Adrish Anand, Spencer Barrett, Nhu Thao Nguyen Galvan, Christine O'Mahony, John A Goss, Ronald T Cotton, Abbas Rana

Faculty, Staff and Students Publications

UNLABELLED: Donation after circulatory death (DCD) allografts might represent one of the largest untapped sources of liver allografts. Our aim was to identify independent recipient risk factors that predict mortality in DCD allograft recipients to preselect optimal candidates for successful transplantation. Furthermore, we compared the application of our newly constructed DCD Recipient Selector Index (RSI) score to previously developed models to determine superiority in predicting recipient survival.

METHODS: Using the Organ Procurement and Transplantation Network database, we performed univariate and multivariate retrospective analyses on 4228 DCD liver allograft recipients.

RESULTS: We identified 8 significant factors and incorporated them into the …

Impact Of Artificial Intelligence On Colonoscopy Surveillance After Polyp Removal: A Pooled Analysis Of Randomized Trials, Yuichi Mori, Pu Wang, Magnus Løberg, Masashi Misawa, Alessandro Repici, Marco Spadaccini, Loredana Correale, Giulio Antonelli, Honggang Yu, Dexin Gong, Misaki Ishiyama, Shin-Ei Kudo, Shunsuke Kamba, Kazuki Sumiyama, Yutaka Saito, Haruo Nishino, Peixi Liu, Jeremy R Glissen Brown, Nabil M Mansour, Seth A Gross, Mette Kalager, Michael Bretthauer, Douglas K Rex, Prateek Sharma, Tyler M Berzin, Cesare Hassan

Faculty, Staff and Students Publications

Background and aims: Artificial intelligence (AI) tools aimed at improving polyp detection have been shown to increase the adenoma detection rate during colonoscopy. However, it is unknown how increased polyp detection rates by AI affect the burden of patient surveillance after polyp removal.

Methods: We conducted a pooled analysis of 9 randomized controlled trials (5 in China, 2 in Italy, 1 in Japan, and 1 in the United States) comparing colonoscopy with or without AI detection aids. The primary outcome was the proportion of patients recommended to undergo intensive surveillance (ie, 3-year interval). We analyzed intervals for AI and non-AI …

Lobar Pneumonia Presenting As Fever, Headaches, And A Negative Chest Radiograph, David R Rendon, Jason Shiau, Stephanie V Sherman

Faculty, Staff and Students Publications

No abstract provided.

Advancing Diagnostic Equity Through Clinician Engagement, Community Partnerships, And Connected Care, Traber D Giardina, Lechauncy D Woodard, Hardeep Singh

Faculty, Staff and Students Publications

No abstract provided.

The Economic, Mental Health, And Social Stressors During The Covid-19 Pandemic Among Native Americans In South Dakota, Savannah E. Lukkes

Honors Thesis

American Indian/Alaska Native (AI/AN) communities test positive for COVID-19 and experience higher mortality than other racial and ethnic groups. These high rates of vulnerability could be connected to the systemic inequalities that have been experienced for centuries. This study aimed to compare socioeconomic stressors, concerns, and mental health experiences during the early COVID-19 pandemic between AI/AN and non-AIAN populations in South Dakota. The study sample (n=1,586) was grouped by AI/AN and non-AI/AN status based on self-identification of being AI/AN alone or in combination with another race/ethnicity. Participant responses to socioeconomic stressors and concerns (e.g., top concerns, level of concern, self-isolation, …

Acute Necrotizing Encephalopathy In An Infant: A Case Report, Elisamia Ngowi, Zeenat Juneja, Jacqueline Gabone, Maria Bulimba, Mohamedraza Ebrahim, Yaser Abdallah

Paediatrics and Child Health, East Africa

Background: Acute necrotizing encephalopathy is a rare, severe neurological condition, characterized by symmetrical necrotic brain lesions affecting the thalamus, cerebral white matter, brain stem, and cerebellum. Diagnosis relies on characteristic clinical and radiological features.

Methodology: We describe a 10-month-old female infant presenting with multiple seizures following a brief febrile upper respiratory illness.

Findings: MRI of the brain showed bilateral symmetrical abnormal signal intensities involving both thalami and caudate nucleus, consistent with ANE. Management of ANE is symptom-related but high-dose steroids and IVIG have been used.

Conclusion: This case highlights the importance of recognizing ANE beyond its …

Area Deprivation Index And Segregation On The Risk Of Hiv: A U.S. Veteran Case-Control Study, Abiodun O Oluyomi, Angela L Mazul, Yongquan Dong, Donna L White, Christine M Hartman, Peter Richardson, Wenyaw Chan, Jose M Garcia, Jennifer R Kramer, Elizabeth Chiao

2020-Current year OA Pubs

BACKGROUND: Preventing HIV infection remains a critically important tool in the continuing fight against HIV/AIDS. The primary aim is to evaluate the effect and interactions between a composite area-level social determinants of health measure and an area-level measure of residential segregation on the risk of HIV/AIDS in U.S. Veterans.

METHODS: Using the individual-level patient data from the U.S. Department of Veterans Affairs, we constructed a case-control study of veterans living with HIV/AIDS (VLWH) and age-, sex assigned at birth- and index date-matched controls. We geocoded patient's residential address to ascertain their neighborhood and linked their information to two measures of …

The Next Phase In Patient Safety Education: Towards A Standardized, Tools-Based Pathology Patient Safety Curriculum: A Call To Action From The Association Of Pathology Chairs' Residency Program Directors Section Training Residents In Patient Safety Workgroup, Cynthia K Harris, Ronald Jackups Jr, Et Al.

2020-Current year OA Pubs

Patient safety education is a mandated Common Program Requirement of the Accreditation Council for Graduate Medical Education and for the Royal College of Physicians and Surgeons of Canada in all medical residency and fellowship programs. Although many hospitals and healthcare environments have general patient safety education tools for trainees, few to none focus on the unique training milieu of pathologists, including a mix of highly automated and manual error-prone processes, frequent multiplicity of events, and lack of direct patient relationships for error disclosure. We established a national Association of Pathology Chairs-Program Directors Section Workgroup focused on patient safety education for …

Circadian Rhythm Disrupting Behaviours And Cancer Outcomes In Breast Cancer Survivors: A Systematic Review, Kelly D'Cunha, Yikyung Park, Melinda M Protani, Marina M Reeves

2020-Current year OA Pubs

PURPOSE: Circadian rhythm disruptors (e.g., night-shift work) are risk factors for breast cancer, however studies on their association with prognosis is limited. A small but growing body of research suggests that altered sleep patterns and eating behaviours are potential mechanistic links between circadian rhythm disruptors and breast cancer. We therefore systematically summarised literature examining the influence of circadian rhythm disrupting behaviours on cancer outcomes in women with breast cancer.

METHODS: A systematic search of five databases from inception to January 2021 was conducted. Original research published in English, assessing the relationship between post-diagnosis sleep patters and eating behaviours, and breast …

Visual Autism, Margaret Reynolds, Susan M. Culican

2020-Current year OA Pubs

No abstract provided.

Strategies To Prevent Clostridioides Difficile Infections In Acute-Care Hospitals: 2022 Update, Larry K Kociolek, Dale N Gerding, Ruth Carrico, Philip Carling, Curtis J Donskey, Ghinwa Dumyati, David T Kuhar, Vivian G Loo, Lisa L Maragakis, Monika Pogorzelska-Maziarz, Thomas J Sandora, David J Weber, Deborah Yokoe, Erik R Dubberke

2020-Current year OA Pubs

No abstract provided.

Melanoma In A Patient With Dnmt3a Overgrowth Syndrome, David Y Chen, Leslie A Sutton, Sai Mukund Ramakrishnan, Eric J Duncavage, Sharon E Heath, Leigh A Compton, Christopher A Miller, Timothy J Ley

2020-Current year OA Pubs

Alterations in epigenetic regulators are increasingly recognized as early events in tumorigenesis; thus, patients with acquired or inherited variants in epigenetic regulators may be at increased risk for developing multiple types of cancer. DNMT3A overgrowth syndrome (DOS), caused by germline pathogenic variants in the DNA methyltransferase gene

Cis Interactions In The Irf8 Locus Regulate Stage-Dependent Enhancer Activation, Tian-Tian Liu, Feiya Ou, Julia A Belk, Prachi Bagadia, David A Anderson Iii, Vivek Durai, Winnie Yao, Ansuman T Satpathy, Theresa L Murphy, Kenneth M Murphy

2020-Current year OA Pubs

Individual elements within a superenhancer can act in a cooperative or temporal manner, but the underlying mechanisms remain obscure. We recently identified an

Myt1l Is Required For Suppressing Earlier Neuronal Development Programs In The Adult Mouse Brain, Jiayang Chen, Nicole A Fuhler, Kevin K Noguchi, Joseph D Dougherty

2020-Current year OA Pubs

In vitro studies indicate the neurodevelopmental disorder gene myelin transcription factor 1-like (MYT1L) suppresses non-neuronal lineage genes during fibroblast-to-neuron direct differentiation. However, MYT1L's molecular and cellular functions in the adult mammalian brain have not been fully characterized. Here, we found that MYT1L loss leads to up-regulated deep layer (DL) gene expression, corresponding to an increased ratio of DL/UL neurons in the adult mouse cortex. To define potential mechanisms, we conducted Cleavage Under Targets & Release Using Nuclease (CUT&RUN) to map MYT1L binding targets and epigenetic changes following MYT1L loss in mouse developing cortex and adult prefrontal cortex (PFC). We found …

Insights Into The Pathogenesis Of Hereditary Angioedema Using Genetic Sequencing And Recombinant Protein Expression Analyses, Zhen Ren, Shuangxia Zhao, Tiandao Li, H James Wedner, John P Atkinson

2020-Current year OA Pubs

BACKGROUND: The pathogenesis of hereditary angioedema (HAE) type I and type II is linked to defective C1 esterase inhibitor (C1-INH) encoded by the SERPING1 gene. There are substantial variabilities in the clinical presentations of patients with HAE that are not directly correlated to the serum levels of C1-INH. The impact of SERPING1 variants on C1-INH expression, structure, and function is incompletely understood.

OBJECTIVE: To investigate the influence of SERPING1 variants on the C1-INH expression, structure, and function of 20 patients with HAE from 14 families with no prior genetic diagnosis.

METHODS: Patients underwent whole-exome sequencing (WES). If no variants were …

Utilization Of Microwave Ablation As A Novel Approach For Refractory Chylothorax Following Esophagectomy: A Case Report, Khashayar Farahnak, Alejandro De Filippis Falcon, Hailey M Shepherd, Carlos J Guevara, Mayank R Patel, G Alexander Patterson, Varun Puri, Daniel Kreisel, Ruben G Nava

2020-Current year OA Pubs

No abstract provided.

Logistical, Technical, And Radiation Safety Aspects Of Establishing A Radiopharmaceutical Therapy Program: A Case In Lutetium-177 Prostate-Specific Membrane Antigen (Psma) Therapy, Jacqueline E Zoberi, Jose Garcia-Ramirez, David Luechtefeld, Nichole M Maughan, Maxwell Amurao, Reiko Oyama, Brian C Baumann, Hiram A Gay, Jeff M Michalski

2020-Current year OA Pubs

Prostate-specific membrane antigen (PSMA) is a cell surface protein highly expressed in nearly all prostate cancers, with restricted expression in some normal tissues. The differential expression of PSMA from tumor to non-tumor tissue has resulted in the investigation of numerous targeting strategies for therapy of patients with metastatic prostate cancer. In March of 2022, the FDA granted approval for the use of lutetium-177 PSMA-617 (Lu-177-PSMA-617) for patients with PSMA-positive metastatic castration-resistant prostate cancer (mCRPC) who have been treated with androgen receptor pathway inhibition and taxane-based chemotherapy. Therefore, the use of Lu-177-PSMA-617 is expected to increase and become more widespread. Herein, …

Management Of Infusion-Related Reactions (Irrs) In Patients Receiving Amivantamab In The Chrysalis Study, Keunchil Park, Ramaswamy Govindan, Et Al.

2020-Current year OA Pubs

BACKGROUND: Amivantamab, a fully humanized EGFR-MET bispecific antibody, has antitumor activity in diverse EGFR- and MET-driven non-small cell lung cancer (NSCLC) and a safety profile consistent with associated on-target activities. Infusion-related reaction(s) (IRR[s]) are reported commonly with amivantamab. We review IRR and subsequent management in amivantamab-treated patients.

METHODS: Patients treated with the approved dose of intravenous amivantamab (1050 mg, <80 kg; 1400 mg, ≥80 kg) in CHRYSALIS-an ongoing, phase 1 study in advanced EGFR-mutated NSCLC-were included in this analysis. IRR mitigations included split first dose (350 mg, day 1 [D1]; remainder, D2), reduced initial infusion rates with proactive infusion interruption, and steroid premedication before initial dose. For all doses, pre-infusion antihistamines and antipyretics were required. Steroids were optional after the initial dose.

RESULTS: As of 3/30/2021, 380 patients received amivantamab. IRRs were reported in 256 (67%) patients. Signs/symptoms of IRR included chills, dyspnea, flushing, nausea, chest discomfort, and vomiting. Most of the 279 IRRs were grade 1 or 2; grade 3 and 4 …

Mitochondrial Pyruvate Carrier Inhibition Initiates Metabolic Crosstalk To Stimulate Branched Chain Amino Acid Catabolism, Daniel Ferguson, Sophie J Eichler, Nicole K H Yiew, Jerry R Colca, Kevin Cho, Gary J Patti, Trevor M Shew, Andrew J Lutkewitte, Sandip Mukherjee, Kyle S Mccommis, Natalie M Niemi, Brian N Finck

2020-Current year OA Pubs

OBJECTIVE: The mitochondrial pyruvate carrier (MPC) has emerged as a therapeutic target for treating insulin resistance, type 2 diabetes, and nonalcoholic steatohepatitis (NASH). We evaluated whether MPC inhibitors (MPCi) might correct impairments in branched chain amino acid (BCAA) catabolism, which are predictive of developing diabetes and NASH.

METHODS: Circulating BCAA concentrations were measured in people with NASH and type 2 diabetes, who participated in a recent randomized, placebo-controlled Phase IIB clinical trial to test the efficacy and safety of the MPCi MSDC-0602K (EMMINENCE; NCT02784444). In this 52-week trial, patients were randomly assigned to placebo (n = 94) or 250 mg …

Presentation And Prognosis Of Excessive Asymptomatic Atrial Ectopy In Children And Adolescents With Structurally And Functionally Normal Hearts, Thomas R Joyce, James J Joyce, Marye J Gleva, Sunita J Ferns

2020-Current year OA Pubs

Excessive premature atrial complexes (PACs) in pediatric patients with a structurally normal heart are presumed to be benign and self-resolving, but no studies have confirmed this. Adults with excessive PACs, however, are at increased risk for future sustained atrial arrhythmias and cardiovascular morbidity and mortality. Therefore, we sought to evaluate the clinical course of frequent PACs in asymptomatic children. Patients < 21 years old with numerous asymptomatic PACs (>50/24 hours) were retrospectively selected over a 10-year period. Demographics, clinical characteristics, and results of cardiovascular testing were tabulated. Two groups were defined: those with a significant (>20%) reduction in burden of atrial ectopy versus those with an insignificant …

Translingual Neurostimulation Combined With Physical Therapy To Improve Walking And Balance In Multiple Sclerosis (Neuromstrals): Study Protocol For A Randomized Controlled Trial, Michelle Ploughman, Ganeswara Rao Melam, Syamala Buragadda, Keith R Lohse, Fraser Clift, Mark Stefanelli, Michael Levin, Sarah J Donkers

2020-Current year OA Pubs

INTRODUCTION: Physical rehabilitation restores lost function and promotes brain plasticity in people with Multiple Sclerosis (MS). Research groups worldwide are testing the therapeutic effects of combining non-invasive neuromodulation with physical therapy (PT) to further improve functional outcomes in neurological disorders but with mixed results. Whether such devices enhance function is not clear. We present the rationale and study design for a randomized controlled trial evaluating if there is additional benefit to the synergistic pairing of translingual neurostimulation (TLNS) with PT to improve walking and balance in MS.

METHODS AND ANALYSIS: A parallel group [PT + TLNS or PT + Sham], …

Ultrasmall, Elementary And Highly Translational Nanoparticle X-Ray Contrast Media From Amphiphilic Iodinated Statistical Copolymers, Lu Su, Kellie S Dalby, Hannah Luehmann, Sussana A Elkassih, Sangho Cho, Xun He, Lisa Detering, Yen-Nan Lin, Nari Kang, Dennis A Moore, Richard Laforest, Guorong Sun, Yongjian Liu, Karen L Wooley

2020-Current year OA Pubs

To expand the single-dose duration over which noninvasive clinical and preclinical cancer imaging can be conducted with high sensitivity, and well-defined spatial and temporal resolutions, a facile strategy to prepare ultrasmall nanoparticulate X-ray contrast media (nano-XRCM) as dual-modality imaging agents for positron emission tomography (PET) and computed tomography (CT) has been established. Synthesized from controlled copolymerization of triiodobenzoyl ethyl acrylate and oligo(ethylene oxide) acrylate monomers, the amphiphilic statistical iodocopolymers (ICPs) could directly dissolve in water to afford thermodynamically stable solutions with high aqueous iodine concentrations (>140 mg iodine/mL water) and comparable viscosities to conventional small molecule XRCM. The formation …

Multidimensional Poverty Is Associated With Dementia Among Adults In Afghanistan, Jean-Francois Trani, Yiqi Zhu, Soobin Park, Dauod Khuram, Rahim Azami, Monib Rahim Fazal, Ganesh M Babulal

2020-Current year OA Pubs

BACKGROUND: Multidimensional poverty is associated with dementia, but no evidence is available for countries in conflict.

METHODS: A cross-sectional study was conducted in two provinces of Afghanistan between February 15th 2022 and April 20th 2022 among adults age 50 and older. Multidimensional poverty included six dimensions of well-being and 16 indicators of deprivation. The Rowland Universal Dementia Assessment Scale measured dementia. Poverty between adults with and without dementia was examined, adjusting for sex. Associations between dementia and poverty were investigated using multivariate regression model.

FINDINGS: Of the 478 adults included, 89 (52.7%) had mild, and 25 (14.8%) had moderate to …

Baseline Characteristics Of The North American Prodromal Synucleinopathy Cohort, Jonathan E Elliott, Jennifer Mcleland, Susan R Criswell, Yo-El S Ju, Et Al.

2020-Current year OA Pubs

OBJECTIVE: Rapid eye movement (REM) sleep behavior disorder (RBD) is widely considered a prodromal synucleinopathy, as most with RBD develop overt synucleinopathy within ~10 years. Accordingly, RBD offers an opportunity to test potential treatments at the earliest stages of synucleinopathy. The North American Prodromal Synucleinopathy (NAPS) Consortium has created a multisite RBD participant, primarily clinic-based cohort to better understand characteristics at diagnosis, and in future work, identify predictors of phenoconversion, develop synucleinopathy biomarkers, and enable early stage clinical trial enrollment.

METHODS: Participants ≥18 years of age with overnight polysomnogram-confirmed RBD without Parkinson's disease, dementia, multiple system atrophy, or narcolepsy were …

Is Local Review Of Positron Emission Tomography Scans Sufficient In Diffuse Large B-Cell Lymphoma Clinical Trials? A Calgb 50303 Analysis, Pallawi Torka, Levi D Pederson, Michael V Knopp, David Poon, Jun Zhang, Brad S Kahl, Howard R Higley, Gary Kelloff, Jonathan W Friedberg, Lawrence H Schwartz, Wyndham H Wilson, John P Leonard, Nancy L Bartlett, Heiko Schöder, Amy S Ruppert

2020-Current year OA Pubs

BACKGROUND: Quantitative methods of Fluorodeoxyglucose Positron Emission Tomography (FDG-PET) interpretation, including the percent change in FDG uptake from baseline (ΔSUV), are under investigation in lymphoma to overcome challenges associated with visual scoring systems (VSS) such as the Deauville 5-point scale (5-PS).

METHODS: In CALGB 50303, patients with DLBCL received frontline R-CHOP or DA-EPOCH-R, and although there were no significant associations between interim PET responses assessed centrally after cycle 2 (iPET) using 5-PS with progression-free survival (PFS) or overall survival (OS), there were significant associations between central determinations of iPET ∆SUV with PFS/OS. In this patient cohort, we retrospectively compared local …

Lrp6 High Bone Mass Characterized In Two Generations Harboring A Unique Mutation Of Low-Density Lipoprotein Receptor-Related Protein 6, Michael P Whyte, Steven Mumm, Jonathan C Baker, Fan Zhang, Homer Sedighi, Shenghui Duan, Tim Cundy

2020-Current year OA Pubs

Osteoblast Wnt/

Charged Multivesicular Body Protein 4b Forms Complexes With Gap Junction Proteins During Lens Fiber Cell Differentiation, Yuefang Zhou, Thomas M Bennett, Thomas W White, Alan Shiels

2020-Current year OA Pubs

Charged multivesicular body protein 4b (CHMP4B) is a core sub-unit of the endosomal sorting complex required for transport III (ESCRT-III) machinery that serves myriad remodeling and scission processes of biological membranes. Mutation of the human CHMP4B gene underlies rare forms of early-onset lens opacities or cataracts, and CHMP4B is required for lens growth and differentiation in mice. Here, we determine the sub-cellular distribution of CHMP4B in the lens and uncover a novel association with gap junction alpha-3 protein (GJA3) or connexin 46 (Cx46) and GJA8 or Cx50. Immunofluorescence confocal microscopy revealed that CHMP4B localized to cell membranes of elongated fiber …

Using Synthetic Mr Images For Distortion Correction, David F Montez, Andrew N Van, Ryland L Miller, Nicole A Seider, Scott Marek, Annie Zheng, Dillan J Newbold, Kristen Scheidter, Benjamin P Kay, Abhinav K Jha, Aristeidis Sotiras, Timothy O Laumann, Evan M Gordon, Nico U F Dosenbach, Et Al.

2020-Current year OA Pubs

Functional MRI (fMRI) data acquired using echo-planar imaging (EPI) are highly distorted by magnetic field inhomogeneities. Distortion and differences in image contrast between EPI and T1-weighted and T2-weighted (T1w/T2w) images makes their alignment a challenge. Typically, field map data are used to correct EPI distortions. Alignments achieved with field maps can vary greatly and depends on the quality of field map data. However, many public datasets lack field map data entirely. Additionally, reliable field map data is often difficult to acquire in high-motion pediatric or developmental cohorts. To address this, we developed Synth, a software package for distortion correction and …

Extraction Of Clinical Phenotypes For Alzheimer's Disease Dementia From Clinical Notes Using Natural Language Processing, Inez Y Oh, Suzanne E Schindler, Nupur Ghoshal, Albert M Lai, Philip R O Payne, Aditi Gupta

2020-Current year OA Pubs

OBJECTIVES: There is much interest in utilizing clinical data for developing prediction models for Alzheimer's disease (AD) risk, progression, and outcomes. Existing studies have mostly utilized curated research registries, image analysis, and structured electronic health record (EHR) data. However, much critical information resides in relatively inaccessible unstructured clinical notes within the EHR.

MATERIALS AND METHODS: We developed a natural language processing (NLP)-based pipeline to extract AD-related clinical phenotypes, documenting strategies for success and assessing the utility of mining unstructured clinical notes. We evaluated the pipeline against gold-standard manual annotations performed by 2 clinical dementia experts for AD-related clinical phenotypes including …

Potential Uses Of Ai For Perioperative Nursing Handoffs: A Qualitative Study, Christopher Ryan King, Ayanna Shambe, Joanna Abraham

2020-Current year OA Pubs

OBJECTIVE: Situational awareness and anticipatory guidance for nurses receiving a patient after surgery are keys to patient safety. Little work has defined the role of artificial intelligence (AI) to support these functions during nursing handoff communication or patient assessment. We used interviews to better understand how AI could work in this context.

MATERIALS AND METHODS: Eleven nurses participated in semistructured interviews. Mixed inductive-deductive thematic analysis was used to extract major themes and subthemes around roles for AI supporting postoperative nursing.

RESULTS: Five themes were generated from the interviews: (1) nurse understanding of patient condition guides care decisions, (2) handoffs are …