Medicine and Health Sciences Commons^™

Camkiiδ Gene Editing- A Base Hit For The Heart, Christopher J Walkey, William R Lagor

Faculty, Staff and Students Publications

No abstract provided.

Cardiac Function, Structural, And Electrical Remodeling By Microgravity Exposure, Mary R Sy, Joshua A Keefe, Jeffrey P Sutton, Xander H T Wehrens

Faculty, Staff and Students Publications

Space medicine is key to the human exploration of outer space and pushes the boundaries of science, technology, and medicine. Because of harsh environmental conditions related to microgravity and other factors and hazards in outer space, astronauts and spaceflight participants face unique health and medical challenges, including those related to the heart. In this review, we summarize the literature regarding the effects of spaceflight on cardiac structure and function. We also provide an in-depth review of the literature regarding the effects of microgravity on cardiac calcium handling. Our review can inform future mechanistic and therapeutic studies and is applicable to …

Unicorn, Hare, Or Tortoise? Using Machine Learning To Predict Working Memory Training Performance, Yi Feng, Anja Pahor, Aaron R Seitz, Dennis L Barbour, Susanne M Jaeggi

2020-Current year OA Pubs

People differ considerably in the extent to which they benefit from working memory (WM) training. Although there is increasing research focusing on individual differences associated with WM training outcomes, we still lack an understanding of which specific individual differences, and in what combination, contribute to inter-individual variations in training trajectories. In the current study, 568 undergraduates completed one of several N-back intervention variants over the course of two weeks. Participants' training trajectories were clustered into three distinct training patterns (high performers, intermediate performers, and low performers). We applied machine-learning algorithms to train a binary tree model to predict individuals' training …

Characterization Of Combined Endoscopies And Aerodigestive Care: An Analysis Of Utilization And Financial Feasibility, Jennifer Brinkmeier, Noor Al-Hammadi, Sumana Shashidhar, Leslie Hinyard, Dhiren Patel

2020-Current year OA Pubs

BACKGROUND: Aerodigestive care is one model of multi-disciplinary care, which is a valuable tool for both providers and patients. Aerodigestive care models are associated with improved outcomes, reduced anesthesia exposure, reduction in hospital admissions, and fewer days of missed work or school. This is the first study to explore national usage and cost trends in combined endoscopy utilization to identify gaps in care and the potential for financial resource optimization.

METHODS: Data from the Healthcare Cost and Utilization Project (HCUP) Kid's Inpatient Sample (KID) was used from 2016 and 2019. Diagnoses and procedures were identified using ICD-10 codes, for patients …

Evolution And Implementation Of Radiographic Response Criteria In Neuro-Oncology, Divya Ramakrishnan, Marc Von Reppert, Mark Krycia, Matthew Sala, Sabine Mueller, Sanjay Aneja, Ali Nabavizadeh, Norbert Galldiks, Philipp Lohmann, Cyrus Raji, Ichiro Ikuta, Fatima Memon, Brent D Weinberg, Mariam S Aboian

2020-Current year OA Pubs

Radiographic response assessment in neuro-oncology is critical in clinical practice and trials. Conventional criteria, such as the MacDonald and response assessment in neuro-oncology (RANO) criteria, rely on bidimensional (2D) measurements of a single tumor cross-section. Although RANO criteria are established for response assessment in clinical trials, there is a critical need to address the complexity of brain tumor treatment response with multiple new approaches being proposed. These include volumetric analysis of tumor compartments, structured MRI reporting systems like the Brain Tumor Reporting and Data System, and standardized approaches to advanced imaging techniques to distinguish tumor response from treatment effects. In …

System-Dependent Image Distortion Related To Gantry Positions Of A 0.35 T Mrgrt: Characterization And The Corresponding Correction, Shanti Marasini, Benjamin Quinn, Mike Cole, Rocco Flores, Taeho Kim

2020-Current year OA Pubs

PURPOSE: MR-guided radiotherapy with high accuracy treatment planning requires addressing MR imaging artifacts that originate from system imperfections. This work presents the characterization and corresponding correction of gantry-related imaging distortions including geometric distortion and isocenter shift in a 0.35 T magnetic resonance imaging (MRI)-guided radiotherapy (MRgRT) system using distortion vector fields (DVFs).

METHODS: Two phantoms, the magnetic resonance imaging distortion in 3D (MRID

RESULTS: Geometric distortion with "mean (± SD) distortion" of 3.2 ± 0.02, 2.9 ± 0.02, and 1.8 ± 0.01 mm and isocenter shift (±SD) of 0.49 ± 0.3, 0.05 ± 0.2, and 0.01 ± 0.03 mm were …

Pattern-Based Target Selection For Treatment Of Irregular Past Tense: A Single-Case Experimental Design For Children With Developmental Language Disorder, Kirsten M. Russell, Amy Wilder, Julie L. Wambaugh

Faculty Publications

Purpose: Many children with developmental language disorder (DLD) demonstrate
difficulty inflecting irregular past tense verbs. We evaluated using phonological-
based patterns (i.e., schemas) to select targets for treatment of irregular verb inflection for children with DLD. We hypothesized this approach would result in acquisition of treated verbs, generalization to untreated verbs within the same phonological schema, and increased use of correct irregular verbs in naturalistic contexts. Method: Treatment was provided to three 7-year-old participants with DLD in the context of multiple baseline designs across behaviors and participants. Phonological schemas included vowel change, final alveolar, and dual change irregular verbs. Treatment …

Evaluation Of A Complexity-Based Morphosyntactic Treatment For Children With Language Disorders Of Mixed Etiologies, Kirsten M. Russell

Faculty Publications

Language disorder is characterized by difficulty with the comprehension and production of different aspects of language. School-aged children with developmental language disorder (DLD) and school-aged children with Down syndrome (DS) demonstrate similar deficits in the area of morphosyntax, which often creates barriers during social interactions and for academic learning. Although affected children may receive intervention, progress can be slow. Selecting appropriate treatment targets is critical for effective intervention. Traditional approaches for selecting treatment targets are based on developmental readiness (i.e., developmental) or functional need (i.e., remedial). However, intervention utilizing targets selected by these methods produce only modest results, despite a …

Association Of Hospital Centrality In Inter-Hospital Patient-Sharing Networks With Patient Mortality And Length Of Stay, Regan W. Bergmark, Ginger Jin, Robert S. Semco, Marc Santolini, Margaret A. Olsen, Amar Dhand

2020-Current year OA Pubs

OBJECTIVE: The interdependence of hospitals is underappreciated in patient outcomes studies. We used a network science approach to foreground this interdependence. Specifically, within two large state-based interhospital networks, we examined the relationship of a hospital's network position with in-hospital mortality and length of stay.

METHODS: We constructed interhospital network graphs using data from the Healthcare Cost and Utilization Project and the American Hospital Association Annual Survey for Florida (2014) and California (2011). The exposure of interest was hospital centrality, defined as weighted degree (sum of all ties to a given hospital from other hospitals). The outcomes were in-hospital mortality and …

Innovations In Hematopoietic Stem-Cell Mobilization: A Review Of The Novel Cxcr4 Inhibitor Motixafortide, Zachary D. Crees, Michael P. Rettig, John F. Dipersio

2020-Current year OA Pubs

Hematopoietic stem-cell transplantation (HCT) and stem-cell-based gene therapies rely on the ability to collect sufficient CD34+ hematopoietic stem and progenitor cells (HSPCs), typically

Examining Decisional Needs And Contextual Factors Influencing Fertility Status Assessment Among Young Female Survivors Of Childhood Cancer: A Sequential Mixed Methods Study Protocol, Brooke Cherven, Nataliya V. Ivankova, Jessica B. Spencer, Anne M. Fitzpatrick, Karen C. Burns, Jenna Demedis, Holly R Hoefgen, Ann C. Mertens, James L. Klosky

2020-Current year OA Pubs

INTRODUCTION: Female cancer survivors who received gonadotoxic cancer treatment are at risk for profound diminished ovarian reserve and/or primary ovarian insufficiency with resulting infertility, which can be associated with distress and decreased quality of life.. Despite prioritizing future parenthood, many survivors are unsure of the impact of their treatment on their future fertility, and little is known about the perceived reproductive health needs and factors associated with receipt of a fertility status assessment (FSA). There is a lack of developmentally appropriate reproductive health decisional support interventions available for emerging adult cancer survivors. This study will explore the perceived reproductive health …

Barriers To And Solutions For Representative Inclusion Across The Lifespan And In Life Course Research: The Need For Structural Competency Highlighted By The Covid-19 Pandemic, Madison N Lecroy, Ebony B Carter, Sarah S Farabi, Dominic N Reeds, Et Al.

2020-Current year OA Pubs

Exclusion of special populations (older adults; pregnant women, children, and adolescents; individuals of lower socioeconomic status and/or who live in rural communities; people from racial and ethnic minority groups; individuals from sexual or gender minority groups; and individuals with disabilities) in research is a pervasive problem, despite efforts and policy changes by the National Institutes of Health and other organizations. These populations are adversely impacted by social determinants of health (SDOH) that reduce access and ability to participate in biomedical research. In March 2020, the Northwestern University Clinical and Translational Sciences Institute hosted the "Lifespan and Life Course Research: integrating …

How Penalizing Substance Use In Pregnancy Affects Treatment And Research: A Qualitative Examination Of Researchers' Perspectives, Seema K Shah, Leishla Perez-Cardona, Khrystyna Helner, Suena H Massey, Ashish Premkumar, Renee Edwards, Elizabeth S Norton, Cynthia E Rogers, Emily S Miller, Christopher D Smyser, Matthew M Davis, Lauren S Wakschlag

2020-Current year OA Pubs

INTRODUCTION: Laws regulating substance use in pregnancy are changing and may have unintended consequences on scientific efforts to address the opioid epidemic. Yet, how these laws affect care and research is poorly understood.

METHODS: We conducted semi-structured qualitative interviews using purposive and snowball sampling of researchers who have engaged pregnant people experiencing substance use. We explored views on laws governing substance use in pregnancy and legal reform possibilities. Interviews were double coded. Data were examined using thematic analysis.

RESULTS: We interviewed 22 researchers (response rate: 71 per cent) and identified four themes: (i) harms of punitive laws, (ii) negative legal …

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

2020-Current year OA Pubs

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

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

2020-Current year OA Pubs

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

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

Nonalcoholic Fatty Liver Disease Is A Risk Factor For Thiopurine Hepatotoxicity In Crohn's Disease, Alvin T George, Matthew Glover, Quazim Alayo, Maria Zulfiqar, Daniel R Ludwig, Matthew A Ciorba, Scott Mchenry, Parakkal Deepak

2020-Current year OA Pubs

BACKGROUND: Patients with Crohn's disease (CD) are predisposed to nonalcoholic fatty liver disease (NAFLD). CD management often includes thiopurines which can promote hepatotoxicity. We aimed to identify the role of NAFLD on the risk of developing liver injury from thiopurines in CD.

METHODS: In this prospective cohort analysis, CD patients at a single center were recruited 6/2017-5/2018. Patients with alternative liver diseases were excluded. The primary outcome was time to elevation of liver enzymes. Patients underwent MRI with assessment of proton density fat fraction (PDFF) on enrollment, where NAFLD was defined as PDFF >5.5%. Statistical analysis was performed using a …

Diabetes-Related Major And Minor Amputation Risk Increased During The Covid-19 Pandemic., Dominick J Casciato, Sara Yancovitz, John Thompson, Steven Anderson, Alex Bischoff, Shauna Ayres, Ian Barron

Heart and Vascular Articles

BACKGROUND: Along with significant case transmission, hospitalizations, and mortality experienced during the global severe acute respiratory syndrome coronavirus 2 pandemic, there existed a disruption in the delivery of health care across multiple specialties. We studied the effect of the pandemic on inpatients with diabetic foot problems in a Level I trauma center in central Ohio.

METHODS: A retrospective chart review of patients necessitating a consultation by the foot and ankle surgery service were reviewed from the first 8 months of 2020. A total of 270 patients met the inclusion criteria and were divided into prepandemic (n = 120) and pandemic …

Case Report: It's Not Always About The Veins; Intervention Of Bilateral May-Thurner Syndrome Secondary To Iliac Aneurysm., Syed H Haq, Sidra R Shah, Jaya Chandra, Pavithra Kannan, Sandeep M Patel

Heart and Vascular Articles

May-Thurner Syndrome (MTS) remains evasive because of the insidiousness and variable etiologies by which it can manifest. In this study, we examine a unique presentation of MTS resulting from compression of both common iliac veins by a right common iliac artery aneurysm that required complex endovascular venous and arterial intervention.

Human Fatalities Resulting From Wild Pig Attacks Worldwide: 2000–2019, John J. Mayer, James E. Garabedian, John C. Kilgo

Human–Wildlife Interactions

Although reported to be rare, human fatalities resulting from wild pig (Sus scrofa) attacks do occur. Toward a better understanding of patterns in fatal wild pig attacks, we synthesized worldwide reports of wild pig attacks on humans between 2000 and 2019. We documented 163 separate reports of fatal wild pig attacks that resulted in 172 human deaths. On average, 8.6 human deaths occurred annually due to wild pig attacks during those 2 decades. The majority of fatal attacks resulted in a single human death; however, there were 6 cases in which an individual fatal attack resulted in 2–4 …

The Path To U.S. National Registration Of A Toxic Bait For The Control Of The Small Indian Mongoose, Carmen C. Antaky, Steven C. Hess, Emily W. Ruell, Israel L. Leinbach, Shane R. Siers, Robert T. Sugihara

Human–Wildlife Interactions

The small Indian mongoose (Urva auropunctata [syn. Herpestes auropunctatus]; mongoose) is a highly invasive species in its introduced range that negatively impacts ecosystems. Mongooses depredate native species, serve as a vector of disease posing a risk to human health, and cause sanitation issues in food processing facilities and public areas. Introduced for biocontrol in the late 1800s in Hawaiʻi and the Caribbean, mongooses currently have well-established populations across multiple islands in both island archipelagos and have invaded numerous other locations throughout the world. The concern of accidental introduction to mongoose-free islands, the difficulty in species detection, and the …

Still, We Thrive: Understanding How Gay, Bisexual, Transgender, And Other Men Who Have Sex With Men (Gbtmsm) Experience Structural Barriers & Facilitators To Wellness, Lucas Gergyek

Theses and Dissertations (Comprehensive)

Historically and concurrently, structural violence has been a significant force influencing the sexual health and broader health of gay, bisexual, transgender and other men who have sex with men (GBTMSM). Yet to date, the majority of projects exploring the health inequities facing GBTMSM have focused on intrapsychic and behavioural factors as most related to poor health outcomes. As well, these studies are sometimes deficits focused, and fail to evaluate how GBTMSM continue to thrive, and maintain positive health. As a result, the ways in which systems and policies underlie and perpetuate health inequities facing GBTMSM have been somewhat obscured. Connectedly, …

Examining The Lived Experiences Of Families With Children With Developmental Disabilities Participating In Recreational Dance Programs, Isabella Seguin

Theses and Dissertations (Comprehensive)

Objective

Families with children with developmental disabilities (DDs) experience effects on family functioning and will often turn to physical activity (e.g., dance) to mitigate these effects. This research examines the lived experiences of families with children with DDs participating in recreational dance programs to understand the myriad of effects on all participants: children with DDs, families, and dance instructors.

Methods

In order to fully understand the lived experiences of participants, phenomenology was used as the theoretical orientation to guide this research. Each case (5 cases, N=19) consisted of a primary parent, a child with a developmental disability, sibling(s) (if applicable), …

Psychological Readiness In Injured Student-Athletes When Returning To Sport, Samantha J. Burelle

Theses and Dissertations (Comprehensive)

The physical component of recovery is pertinent to success in sport performance, yet there has been an increase in awareness of psychological symptoms and psychological distress experienced by injured athletes. Thus, the psychological aspect of injuries and return to sport (RTS) process cannot be ignored. Psychological readiness (PR) is described by Podlog et al. (2015), Donald (2019), and Podlog et al. (2022) as a dynamic psychological process including factors of realistic expectation, confidence, motivation, and focus. PR addresses the psychological component necessary for a successful RTS. Measurement tools have been developed to assess PR, yet not all factors of PR …

Disrupting And Expanding The Discourse: Palliative Care Clinicians' Experiences With Patients' Non-Physical Suffering, Maxxine Rattner

Theses and Dissertations (Comprehensive)

While one of the primary aims of palliative care is to prevent and relieve suffering, both physical and non-physical, research to date has been very limited re: clinicians’ experiences with patients’ non-physical suffering (e.g., suffering that may be psychological, emotional, social, spiritual and/or existential in nature); both how clinicians work with/respond to this kind of suffering in their day-to-day work, and the effect of this aspect of their work on clinicians themselves. No research to date has considered the impact of palliative care’s dominant non-physical suffering discourse — which presents the relief of non-physical suffering as falling along a binary …

An Exploration Of The Link Between Vertebral Endplate Fracture, Velocity, And Health Of The Intervertebral Disc., John Mcmorran

Theses and Dissertations (Comprehensive)

The capacity for fractures to manifest in the growth cartilage of the adolescent human spine is well documented, but much of the knowledge available regarding such fractures remains retrospective and is largely composed of small case series made up of relatively few participants. In-vitro tissue testing has demonstrated that pressurization of the intervertebral disc’s nucleus pulposus significantly contributes to the generation of growth plate fractures. However, a comprehensive biomechanical investigation of the mechanical consequences for the intervertebral disc when exposed to ring apophyseal (growth plate) fractures at different velocities remains to be demonstrated.

The first two experiments of the present …

Accelerated Forgetting In People With Epilepsy: Pathologic Memory Loss, Its Neural Basis, And Potential Therapies, Sarah Ashley Steimel Phd

Dartmouth College Ph.D Dissertations

While forgetting is vital to human functioning, delineating between normative and disordered forgetting can become incredibly complex. This thesis characterizes a pathologic form of forgetting in epilepsy, identifies a neural basis, and investigates the potential of stimulation as a therapeutic tool. Chapter 2 presents a behavioral characterization of the time course of Accelerated Long-Term Forgetting (ALF) in people with epilepsy (PWE). This chapter shows evidence of ALF on a shorter time scale than previous studies, with a differential impact on recall and recognition. Chapter 3 builds upon the work in Chapter 2 by extending ALF time points and investigating the …

Anxiety And Uterine Artery Doppler Flow In A Population Of Pregnant Women Of High Risk Down Syndrome Fetus: A Prospective Cohort Study, Mahboobeh Shirazi, Mehnoosh Torkzaban, Margan Ghaemi, Maryam Moshfeghi, Mahmood Shirazi, Maryam Emadzadeh, Lida Ahmadi, Zahra Khazaeipoor, Sara Mirzaeian

Department of Radiology Faculty Papers

Background: Fetal exposure to maternal anxiety is associated with low birth weight and maternal stress may be led to constriction of uterine arteries. This study compared the relation of anxiety and uterine artery doppler flow indices in pregnant women with the high and low-risk of Down syndrome.

Materials and methods: This prospective cohort study was conducted among pregnant women in the second trimester that were classified as having a high or low risk according to their prenatal aneuploidy screening outcome. The high risk group underwent amniocentesis. Anxiety was initially assessed using the Spielberger State-Anxiety Inventory (STAI) and uterine artery blood …

Contrast-Enhanced Ultrasound Li-Rads: A Pictorial Review, Osama Mahmoud, Ajay Makkena, Corinne E. Wessner, Ji-Bin Liu, John Eisenbrey, Andrej Lyshchik

Department of Radiology Faculty Papers

The American College of Radiology has implemented the Liver Imaging Reporting and Data System (LI-RADS) to help detect, interpret, and guide the management of suspected lesions on surveillance imaging for hepatocellular carcinoma (HCC) in patients with cirrhosis. The classification of indeterminate nodules with a grading algorithm can be used for multiple imaging modalities (US, CT, and MRI) and incorporates multiple imaging features to appropriately classify observations with different likelihood of being HCC. Contrast-enhanced ultrasound (CEUS) LI-RADS has been fully implemented since 2017. The aim of this pictorial article is to provide a comprehensive review of CEUS LI-RADS utilization, discuss its …

Mri-Based Classification Of Idh Mutation And 1p/19q Codeletion Status Of Gliomas Using A 2.5d Hybrid Multi-Task Convolutional Neural Network, Satrajit Chakrabarty, Pamela Lamontagne, Joshua Shimony, Daniel S Marcus, Aristeidis Sotiras

2020-Current year OA Pubs

BACKGROUND: IDH mutation and 1p/19q codeletion status are important prognostic markers for glioma that are currently determined using invasive procedures. Our goal was to develop artificial intelligence-based methods to noninvasively determine molecular alterations from MRI.

METHODS: Pre-operative MRI scans of 2648 glioma patients were collected from Washington University School of Medicine (WUSM;

RESULTS: For IDH, the best-performing model achieved areas under the receiver operating characteristic (AUROC) of 0.925, 0.874, 0.933 and areas under the precision-recall curves (AUPRC) of 0.899, 0.702, 0.853 on the internal, WUSM, and EGD test sets, respectively. For 1p/19q, the best model achieved AUROCs of 0.782, 0.754, …

Necrotic Cardiac Myocytes Skew Macrophage Polarization Towards A Classically Activated Phenotype, Wenlong Jiang, Luigi Adamo, Kenji Lim, Scot J Matkovich, Sarah Evans, Cibele Rocha-Resende, Douglas L. Mann

2020-Current year OA Pubs

Necrotic and dying cells release damage-associated molecular patterns (DAMPs) that can initiate sterile inflammatory responses in the heart. Although macrophages are essential for myocardial repair and regeneration, the effect of DAMPs on macrophage activation remains unclear. To address this gap in knowledge we studied the effect of necrotic cardiac myocyte extracts on primary peritoneal macrophage (PPM) cultures in vitro. We first performed unbiased transcriptomic profiling with RNA-sequencing of PPMs cultured for up to 72 hours in the presence and absence of: 1) necrotic cell extracts (NCEs) from necrotic cardiac myocytes in order to mimic the release of DAMPs; 2) lipopolysaccharide …