Medicine and Health Sciences Commons^™

Regression Analysis Of General Mixed Recurrent Event Data, Ryan Sun, Dayu Sun, Liang Zhu, Jianguo Sun

Faculty, Staff and Student Publications

In modern biomedical datasets, it is common for recurrent outcomes data to be collected in an incomplete manner. More specifically, information on recurrent events is routinely recorded as a mixture of recurrent event data, panel count data, and panel binary data; we refer to this structure as general mixed recurrent event data. Although the aforementioned data types are individually well-studied, there does not appear to exist an established approach for regression analysis of the three component combination. Often, ad-hoc measures such as imputation or discarding of data are used to homogenize records prior to the analysis, but such measures lead …

Management Of A Failing Implant Using Guided Bone Regeneration And Esthetic Crown Lengthening In The Esthetic Zone; A Case Report, Bassam M. Kinaia Dds, Ms, Dicoi, Mirranda Kinaia Bs, Roksolana Gala Dds, Ms, Ashleigh Turows Dds, Ms, Anthony L. Neely Dds, Mdentsc, Phd

The Journal of the Michigan Dental Association

A 34-year-old female presented with a failing implant in the esthetic zone. The implant was removed, and the site was reconstructed with guided bone regeneration and a pedicle connective tissue graft. Esthetic crown lengthening was performed on the adjacent teeth to create a harmonious gingival symmetry. Full ceramic crowns were placed on all teeth, including an implant-supported fixed partial denture. Follow-ups at 3, 6, and 12 months showed proper healing with healthy soft tissues and correct bilateral gingival symmetry. The pink and white esthetic scores improved from 8.7 pre-operatively to 19.2 post-final restorations. The patient was pleased with the esthetic …

Climate Change, Malnutrition, And Hiv: The Impact Of Food Insecurity On Hiv Response In Sub-Saharan Africa, Olivia Walshak

Independent Study Project (ISP) Collection

Climate change is a key driver of an unprecedented global food crisis, exacerbated by rising temperatures and the vulnerability of crop yields. Sub-Saharan Africa is particularly susceptible, and case studies demonstrate the fragility of food systems in the region, leading to severe food insecurity and famine in the face of climate shocks.

There are a variety of health implications, particularly the syndemic relationship between malnutrition and HIV. HIV interacts bidirectionally with malnutrition, creating a vicious cycle of poor clinical outcomes. Expanding access to antiretroviral therapy in Sub-Saharan Africa is hindered by rampant food insecurity, including inadequate food intake, reduced dietary …

Hidden Hurdles: Evaluating Informal Barriers To Primary Healthcare Access Among Undocumented Migrants In Switzerland, Arantxa Bonifaz Rosas

Independent Study Project (ISP) Collection

Undocumented migrants face heightened difficulties in accessing healthcare due to a combination of legal, financial, and social challenges. Informal barriers to accessing healthcare further exacerbate poor health outcomes among undocumented migrants. In Switzerland, where undocumented migrants have the right to health insurance, barriers to receiving healthcare continue to restrict their access to essential services, such as primary healthcare (PHC). Employing a meta-analysis approach, this qualitative study aimed to broaden existing research on informal barriers hindering access to PHC for undocumented migrants, with a particular focus on the Swiss context. The identified informal barriers centered around health insurance, fear of deportation, …

The Implications Of Politicizing Global Health Diplomacy In A Multipolar World, Haley Stock

Independent Study Project (ISP) Collection

This research paper is the result of an independent study project that details the implications of politicizing global health diplomacy. With a mixture of interviews, primary sources, and secondary sources, this project aims to explain how and why global health has become entrenched in politics in the world today. This paper explores the intersection between global health and foreign policy and analyzes the extent to which countries use medical interventions to achieve political and economic success. Medical interventions, like vaccines, have become increasingly significant, especially looking back at the recent pandemic. Therefore, this paper will also explore the complex nature …

The Impact Of Pediatric Ckd On Educational And Employment Outcomes., Lyndsay A. Harshman, Ryan C. Ward, Matthew B. Matheson, Anne Dawson, Amy J. Kogon, Marc B. Lande, Stephen J. Molitor, Rebecca J. Johnson, Camille Wilson, Bradley A. Warady, Susan L. Furth, Stephen R. Hooper

Manuscripts, Articles, Book Chapters and Other Papers

KEY POINTS: This study evaluates educational and employment outcomes in patients with pediatric kidney disease and assesses predictors of educational attainment and employment in young adulthood. Despite high rates of high school graduation, nearly 20% of patients with CKD are unemployed or receiving disability at long-term follow-up.

BACKGROUND: Pediatric patients with CKD are at risk for neurocognitive deficits and academic underachievement. This population may be at risk for lower educational attainment and higher rates of unemployment; however, published data have focused on patients with advanced CKD and exist in isolation from assessment of neurocognition and kidney function.

METHODS: Data from …

Outcomes And Discriminatory Accuracy Of The Cha2ds2vasc Score In Atrial Fibrillation And Cancer, Waqas Ullah, Mathew Dimeglio, Daniel Frisch, Rodrigo Bagur, Louise Sun, David Fischman, Andrija Matetic, Bonnie Ky, Mamas Mamas

Division of Cardiology Faculty Papers

Background: Atrial fibrillation (AF) is highly prevalent among cancer patients. The role of traditional risk stratification scores in the context of different cancer types in these patients remains unknown. Objectives: The purpose of this study was to determine the discriminative accuracy of the CHA₂DS₂VASc score for ischemic stroke using receiver operating characteristic and area under the curve. Methods: The National Readmission Database (2015-2019) was used to identify all AF patients stratified by the cancer diagnosis, type, and CHA₂DS₂VASc category (low; moderate; high risk). Outcomes at 30-day readmission were compared between cancer and …

Impact Of Training And Experience On Hearing Loss Health Literacy In Speech-Language Pathologists, Ellen Claire Cooper

Theses and Dissertations

The purpose of this study was to explore general health literacy, hearing loss health literacy, and confidence levels among SLPs with different levels of academic training and on-the-job experience related to hearing loss and to understand how SLPs felt their training and experience contributed to their hearing loss health literacy development. Across two aims, we evaluated predictors of SLPs’ hearing loss health literacy and SLP beliefs of how hearing loss health literacy is gained. The results from this study indicated that SLPs had high levels of general health literacy and but marginal to low levels of hearing loss health literacy. …

Social Network Attributes Associated With Conversations About Smoking And Cessation And Differences By Socioeconomic Status, Victoria Catherine Lambert

Theses and Dissertations

Conversations about smoking and cessation in response to cessation messages appear to encourage quit attempts, yet there is some evidence that smokers with lower income and education have these conversations less often than their counterparts with higher income and education. No research has investigated the social network characteristics that encourage smokers to have these conversations or the mechanisms for SES differences in these conversations. Because social factors play a role in SES disparities in smoking and cessation as well as other health behaviors and outcomes, social network characteristics likely explain some SES differences in conversations about smoking and cessation. The …

Progressive Neurochemical, Neuroinflammatory And Cognitive Deficits In An Experimental Model Of Gulf War Illness, Hannah Elizabeth Burzynski

Theses and Dissertations

Gulf War Illness (GWI) is a multi-symptom illness that presents with cognitive disturbances and immune dysregulation and continues to affect over 25% of Gulf War veterans. While soldiers were exposed to several hazards in the Gulf, the prophylactic use of the acetylcholinesterase inhibitor, pyridostigmine bromide (PB) and war-related stress have been identified as chief factors in GWI pathology. As both PB and stress alter acetylcholine (ACh), a critical mediator of cognition and inflammation, the focus of my dissertation work was investigating the lasting effects of PB and stress on peripheral and central cholinergic signaling. Specifically, I assessed hippocampal-dependent learning and …

A Comparative Analysis Of Adolescent Pregnancy Patient Outcomes In The United States And United Kingdom Healthcare Systems, Liza Hopper

Senior Theses

Individuals all across the world should have equal access to healthcare. However, one’s ability to receive and afford quality care differs between countries. Comparing the differences in healthcare structures in both the UK and the US provides great insight into how certain welfare models affect patient outcomes. In this project, I discuss the functionality of the healthcare systems in the UK and the US. Then, by delving into how they relate to adolescent pregnancy patient outcomes, one can compare how the healthcare policies relate to the patient outcomes of a vulnerable population group. In both countries, adolescent mothers, those who …

Advancing Precision Medicine: Unveiling Disease Trajectories, Decoding Biomarkers, And Tailoring Individual Treatments, Yanfei Wang

Dissertations and Theses (Open Access)

Chronic diseases are not only prevalent but also exert a considerable strain on the healthcare system, individuals, and communities. Nearly half of all Americans suffer from at least one chronic disease, which is still growing. The development of machine learning has brought new directions to chronic disease analysis. Many data scientists have devoted themselves to understanding how a disease progresses over time, which can lead to better patient management, identification of disease stages, and targeted interventions. However, due to the slow progression of chronic disease, symptoms are barely noticed until the disease is advanced, challenging early detection. Meanwhile, chronic diseases …

P16 Expression And Recurrent Cervical Intraepithelial Neoplasia After Cryotherapy Among Women Living With Hiv, Daniel Maina, Michael H. Chung, Marleen Temmerman, Zahir Moloo, Jonathan Wawire, Sharon A. Greene, Elizabeth Unger, Shahin Sayed, Samah Sakr, Nelly Mugo

Pathology, East Africa

Background: The expression of p16 protein, a surrogate marker for high-risk human papillomavirus (hrHPV), is associated with cervical dysplasia. We evaluated correlates of p16 expression at treatment for high-grade cervical lesions and its utility in predicting the recurrence of cervical intraepithelial lesions grade 2 or higher (CIN2+) following cryotherapy among women with HIV.

Methods: This is a subgroup analysis of women with HIV in Kenya with baseline cervical biopsy-confirmed CIN2+ who were randomized to receive cryotherapy and followed every six-months for two-years for biopsy-confirmed recurrence of CIN2+. P16 immunohistochemistry was performed on the baseline cervical biopsy with a positive result …

A Genome-Wide Association Study Of Outcome After Aneurysmal Subarachnoid Haemorrhage: Discovery Analysis, Ben Gaastra, Sheila Alexander, Mark K Bakker, Hemant Bhagat, Philippe Bijlenga, Spiros L Blackburn, Malie K Collins, Sylvain Doré, Christoph J Griessenauer, Philipp Hendrix, Eun Pyo Hong, Isabel C Hostettler, Henry Houlden, Koji Iihara, Jin Pyeong Jeon, Bong Jun Kim, Jiang Li, Sandrine Morel, Paul Nyquist, Dianxu Ren, Ynte M Ruigrok, David Werring, Will Tapper, Ian Galea, Diederik Bulters

Faculty, Staff and Student Publications

Candidate gene studies have identified genetic variants associated with clinical outcomes following aneurysmal subarachnoid haemorrhage (aSAH), but no genome-wide association studies have been performed to date. Here we report the results of the discovery phase of a two-stage genome-wide meta-analysis of outcome after aSAH. We identified 157 independent loci harbouring 756 genetic variants associated with outcome after aSAH (p < 1 × 10⁻⁴), which require validation. A single variant (rs12949158), in SPNS2, achieved genome-wide significance (p = 4.29 × 10⁻⁸) implicating sphingosine-1-phosphate signalling in outcome after aSAH. A large multicentre international effort to recruit samples for validation …

Correction: Sepsis Exacerbates Alzheimer’S Disease Pathophysiology, Modulates The Gut Microbiome, Increases Neuroinflammation And Amyloid Burden, Vijayasree V Giridharan, Celso S G Catumbela, Carlos Henrique R Catalão, Juneyoung Lee, Bhanu P Ganesh, Fabricia Petronilho, Felipe Dal-Pizzol, Rodrigo Morales, Tatiana Barichello

Faculty, Staff and Student Publications

No abstract provided.

Enabling Health Data Sharing With Fine-Grained Privacy, Luca Bonomi, Sepand Gousheh, Liyue Fan

Faculty, Staff and Student Publications

Sharing health data is vital in advancing medical research and transforming knowledge into clinical practice. Meanwhile, protecting the privacy of data contributors is of paramount importance. To that end, several privacy approaches have been proposed to protect individual data contributors in data sharing, including data anonymization and data synthesis techniques. These approaches have shown promising results in providing privacy protection at the dataset level. In this work, we study the privacy challenges in enabling fine-grained privacy in health data sharing. Our work is motivated by recent research findings, in which patients and healthcare providers may have different privacy preferences and …

Gut Microbiome In Patients With Early-Stage And Late-Stage Melanoma, Russell G Witt, Samuel H Cass, Tiffaney Tran, Ashish Damania, Emelie E Nelson, Elizabeth Sirmans, Elizabeth M Burton, Manoj Chelvanambi, Sarah Johnson, Hussein A Tawbi, Jeffrey E Gershenwald, Michael A Davies, Christine Spencer, Aditya Mishra, Matthew C Wong, Nadim J Ajami, Christine B Peterson, Carrie R Daniel, Jennifer A Wargo, Jennifer L Mcquade, Kelly C Nelson

Faculty, Staff and Student Publications

IMPORTANCE: The gut microbiome modulates the immune system and responses to immunotherapy in patients with late-stage melanoma. It is unknown whether fecal microbiota profiles differ between healthy individuals and patients with melanoma or if microbiota profiles differ among patients with different stages of melanoma. Defining gut microbiota profiles in individuals without melanoma and those with early-stage and late-stage melanoma may reveal features associated with disease progression.

OBJECTIVE: To characterize and compare gut microbiota profiles between healthy volunteers and patients with melanoma and between patients with early-stage and late-stage melanoma.

DESIGN, SETTING, AND PARTICIPANTS: This single-site case-control study took place at …

Automated Cellular-Level Dual Global Fusion Of Whole-Slide Imaging For Lung Adenocarcinoma Prognosis, Songhui Diao, Pingjun Chen, Eman Showkatian, Rukhmini Bandyopadhyay, Frank R Rojas, Bo Zhu, Lingzhi Hong, Muhammad Aminu, Maliazurina B Saad, Morteza Salehjahromi, Amgad Muneer, Sheeba J Sujit, Carmen Behrens, Don L Gibbons, John V Heymach, Neda Kalhor, Ignacio I Wistuba, Luisa M Solis Soto, Jianjun Zhang, Wenjian Qin, Jia Wu

Faculty, Staff and Student Publications

Histopathologic whole-slide images (WSI) are generally considered the gold standard for cancer diagnosis and prognosis. Survival prediction based on WSI has recently attracted substantial attention. Nevertheless, it remains a central challenge owing to the inherent difficulties of predicting patient prognosis and effectively extracting informative survival-specific representations from WSI with highly compounded gigapixels. In this study, we present a fully automated cellular-level dual global fusion pipeline for survival prediction. Specifically, the proposed method first describes the composition of different cell populations on WSI. Then, it generates dimension-reduced WSI-embedded maps, allowing for efficient investigation of the tumor microenvironment. In addition, we introduce …

Identifying Significant Correlates Of Purpose In Life In Older Us Military Veterans: Results From The National Health And Resilience In Veterans Study, Ian C Fischer, David B Feldman, Jack Tsai, Ilan Harpaz-Rotem, Katherine A Lucas, Stefan E Schulenberg, Robert H Pietrzak

Faculty, Staff and Student Publications

Objective: Perceived purpose in life (PIL) has been linked to a broad range of adverse physical, mental, and cognitive outcomes. However, limited research has examined factors associated with PIL that can be targeted in prevention and treatment efforts in aging populations at heightened risk of adverse outcomes. Using data from predominantly older US veterans, we sought to identify important correlates of PIL.

Methods: Cross-sectional data were analyzed from the 2019-2020 National Health and Resilience in Veterans Study, which surveyed a nationally representative sample of 4069 US military veterans (Mage = 62.2). Elastic net and relative importance analyses were …

Racial/Ethnic Group Differences In Older Adults' Involvement With Adult Protective Services, Kenneth J Steinman, Jason Burnett, Rebecca Hoffman

Faculty, Staff and Student Publications

This paper represents the first study to focus on quantifying racial/ethnic group differences in older adults' involvement with adult protective services (APS).  Across 3 independent county programs, the rate of APS reports was about twice as high for Black older adults compared to White older adults.  These differences were greater for clients who were older and male but remained similar across allegation type.  The percent of reports validated was slightly but consistently lower for Black clients than for White clients, and a lower percentage of Black clients' cases were closed due to investigation or service refusal. Findings for Hispanic clients …

Correction To “Inhibition Of Hyaluronan Synthesis Attenuates Pulmonary Hypertension Associated With Lung Fibrosis”, Harry Karmouty-Quintana

Faculty, Staff and Student Publications

No abstract provided.

Oligometastatic Parathyroid Carcinoma Presenting As Neck Pain: A Case Report, Katherine M Yu, Duncan J Trimble, Christopher R Conner, Dallas L Sheinberg, Garren M I Low, Karan Saluja, Karl M Schmitt, Ron J Karni

Faculty, Staff and Student Publications

Background: Parathyroid carcinoma (PC) is an exceedingly rare, slow-growing but progressive endocrine malignancy that represents a diagnostic and therapeutic challenge. Vertebral metastasis of PC is remarkable, with only 3 prior cases of spinal metastasis reported in the literature.

Case description: A 62-year-old woman presented with 1 week of neck pain radiating down her right arm. Cervical x-ray revealed a lytic lesion of the C4 vertebral body. Lab work revealed hypercalcemia with an elevated parathyroid hormone level. Computed tomography and magnetic resonance imaging revealed frank destruction of the C4 vertebral body and pedicles by PC. She was treated with corpectomy, mass …

New Insights Into The Neuraminidase-Mediated Hemagglutination Activity Of Influenza A(H3n2) Viruses, Rongyuan Gao, Philippe Noriel Q Pascua, Ha T Nguyen, Anton Chesnokov, Chloe Champion, Vasiliy P Mishin, Dave E Wentworth, Larisa V Gubareva

Faculty, Staff and Student Publications

Influenza virus neuraminidase (NA) can act as a receptor-binding protein, a role commonly attributed to hemagglutinin (HA). In influenza A(H3N2) viruses, three NA amino acid residues have previously been associated with NA-mediated hemagglutination: T148, D151, and more recently, H150. These residues are part of the 150-loop of the NA monomer. Substitutions at 148 and 151 arise from virus propagation in laboratory cell cultures, whereas changes at 150 occurred during virus evolution in the human host. In this study, we examined the effect of natural amino acid polymorphism at position 150 on NA-mediated hemagglutination. Using the A/Puerto Rico/8/34 backbone, we generated …

Kunitz-Type Protease Inhibitor Tfpi2 Remodels Stemness And Immunosuppressive Tumor Microenvironment In Glioblastoma, Lizhi Pang, Madeline Dunterman, Songlin Guo, Fatima Khan, Yang Liu, Erfan Taefi, Atousa Bahrami, Changiz Geula, Wen-Hao Hsu, Craig Horbinski, Charles David James, Peiwen Chen

Faculty, Staff and Student Publications

Glioblastoma (GBM) tumors consist of multiple cell populations, including self-renewing glioblastoma stem cells (GSCs) and immunosuppressive microglia. Here we identified Kunitz-type protease inhibitor TFPI2 as a critical factor connecting these cell populations and their associated GBM hallmarks of stemness and immunosuppression. TFPI2 promotes GSC self-renewal and tumor growth via activation of the c-Jun N-terminal kinase-signal transducer and activator of transcription (STAT)3 pathway. Secreted TFPI2 interacts with its functional receptor CD51 on microglia to trigger the infiltration and immunosuppressive polarization of microglia through activation of STAT6 signaling. Inhibition of the TFPI2-CD51-STAT6 signaling axis activates T cells and synergizes with anti-PD1 therapy …

Selection And Prejudice: Addressing Clinical Trial Disparities With A Review Of Current Shortcomings And Future Directions, Kelsey L Corrigan, Michael K Rooney, Ramez Kouzy, Gohar Manzar, Charles R Thomas, Ethan B Ludmir

Faculty, Staff and Student Publications

Growing evidence has demonstrated significant, persistent, and widespread disparities in cancer clinical trial enrollment across myriad disease sites and target populations. Although mechanisms underlying such disparities are complex and multifactorial, clinical trial eligibility criteria may serve as a key structural barrier to equitable and diverse trial enrollment. In this review, we provide an overview of the data describing historical and current disparities in cancer clinical trial enrollment and subsequently describe several patient-, institution-, and trial-related factors which appear to be key drivers of enrollment inequity, with specific discussion regarding the impact of eligibility criteria. We further describe the landscape of …

Evaluation Of Inactivated Avian Influenza Virus And Newcastle Disease Virus Bivalent Vaccination Program Against Newly Circulated H5n8 And Ndv Strains, Ahmed A Azab, Nahed Yehia, Mohamed Makhareta, Mahmoud Samir, Abdelrahman Shoukry, Ahmed Abd Elhalem Mohamed, Sadeq K Alhag, Afaf S Alwabli, Mohamed T El-Saadony, Khaled A El-Tarabily, Mohamed A Soliman

Faculty, Staff and Student Publications

Avian influenza virus (AIV) and Newcastle disease virus (NDV) are respiratory illness syndromes that have recently been detected in vaccinated flocks and are causing major financial losses in the chicken farming industry. The objective was to evaluate the efficacy of Valley Vac H5Plus NDVg7 vaccine in protecting chickens against the H5N8 and NDV strains that have recently been circulating in comparison with the efficacy of the commercially available bivalent H5+ND7 vaccine. In contrast to the H5+ND7 vaccine, which was made of genetically distinct H5N8/2018 clade 2.3.4.4b genotype group (G5), H9N2/2016, H5N1/2017, and genetically comparable NDV genotype VII 1.1/2019 of the …

The Concise Guide To Pharmacology 2023/24: Enzymes, Stephen P H Alexander, Doriano Fabbro, Eamonn Kelly, Alistair A Mathie, John A Peters, Emma L Veale, Jane F Armstrong, Elena Faccenda, Simon D Harding, Jamie A Davies, Stephanie Annett, Detlev Boison, Kathryn Elisa Burns, Carmen Dessauer, Jurg Gertsch, Nuala Ann Helsby, Angelo A Izzo, Rennolds Ostrom, Andreas Papapetropoulos, Nigel J Pyne, Susan Pyne, Tracy Robson, Roland Seifert, Johannes-Peter Stasch, Csaba Szabo, Mario Van Der Stelt, Albert Van Der Vliet, Val Watts, Szu Shen Wong

Faculty, Staff and Student Publications

The Concise Guide to PHARMACOLOGY 2023/24 is the sixth in this series of biennial publications. The Concise Guide provides concise overviews, mostly in tabular format, of the key properties of approximately 1800 drug targets, and about 6000 interactions with about 3900 ligands. There is an emphasis on selective pharmacology (where available), plus links to the open access knowledgebase source of drug targets and their ligands (www.guidetopharmacology.org), which provides more detailed views of target and ligand properties. Although the Concise Guide constitutes almost 500 pages, the material presented is substantially reduced compared to information and links presented on the website. It …

Continuous Glucose Monitoring Provides Durable Glycemic Benefit In Adolescents And Young Adults With Type 1 Diabetes: 12-Month Follow-Up Results, Kellee M. Miller, Colleen Bauza, Lauren G. Kanapka, Mark A. Clements, Daniel J. Desalvo, Korey Hood, Laurel H. Messer, Jennifer Sherr, Katherine Bergamo, Amy Criego, Emily Freiner, Sarah K. Lyons, Roshanak Monzavi, Wayne V. Moore, Priya Prahalad, Jill H. Simmons, Mark Sulik, R. Paul Wadwa, Ruth S. Weinstock, Steven M. Willi, Kristen Williams, Lori M. Laffel, City Study Group

Manuscripts, Articles, Book Chapters and Other Papers

Objective. To further evaluate glycemic outcomes during the observational extension phase of the Continuous Glucose Monitoring (CGM) Intervention for Teens and Young Adults randomized clinical trial (RCT). Subjects and Methods. Following a 26-week RCT comparing CGM with blood glucose monitoring (BGM) in 153 adolescents and young adults aged 14 to < 25 years old with suboptimally controlled type 1 diabetes, 70 (89%) participants in the BGM group initiated use of CGM (referred to as BGM–CGM cohort), and 70 (95%) participants in the CGM group continued to use of CGM (CGM–CGM cohort) for an additional 26 weeks. Results. In the CGM–CGM cohort, mean hemoglobin A1c (HbA1c) decreased from 8.9% ± 0.9% (74 ± 9.8 mmol/mol) at randomization to 8.3% ± 1.3% (67 ± 14.2 mmol/mol) at 52 weeks (p < 0.001); however, significant improvement in time in target range (TIR) 70–180 mg/dL was not observed from prerandomization (38% ± 13%) to 52 weeks (41% ± 18%). Median percent time < 70 mg/dL decreased from 3.0% before randomization to 1.1% at 52 weeks (p < 0.001). In the BGM–CGM cohort, mean HbA1c decreased from 8.9% ± 1.2% (74 ± 13.1 mmol/mol) before CGM initiation to 8.5% ± 1.3% (69 ± 14.2 mmol/mol) after 26 weeks of CGM use (p < 0.001) and mean TIR increased from 34% ± 12% to 38% ± 15% (p = 0.01). The median percent time < 70 mg/dL decreased from 3.3% before CGM initiation to 1.2% after 26 weeks of CGM use (p < 0.001). No participants discontinued CGM use during the extension phase. Conclusions. This further …

The Emerging Importance Of Mitochondria In White Adipocytes: Neither Last Nor Least, Juan Cai, Fenfen Wang, Mengle Shao

Faculty, Staff and Student Publications

The growing recognition of mitochondria's crucial role in the regulation of white adipose tissue remodeling and energy balance underscores its significance. The marked metabolic diversity of mitochondria provides the molecular and cellular foundation for enabling adipose tissue plasticity in response to various metabolic cues. Effective control of mitochondrial function at the cellular level, not only in thermogenic brown and beige adipocytes but also in energy-storing white adipocytes, exerts a profound influence on adipose homeostasis. Furthermore, mitochondria play a pivotal role in intercellular communication within adipose tissue via production of metabolites with signaling properties. A more comprehensive understanding of mitochondrial regulation …

Assessment Of Sacral Osseous Fixation Pathways For Same-Level Dual Transiliac-Transsacral Screw Insertion, Blake J Schultz, Ryan M Mayer, Kevin D Phelps, Augustine M Saiz, Patrick J Kellam, Jonathan G Eastman, Milton L Routt, Stephen J Warner

Faculty, Staff and Student Publications

Introduction: The purpose of this study is to (1) describe a pre-operative planning technique using non-reformatted CT images for insertion of multiple transiliac-transsacral (TI-TS) screws at a single sacral level, (2) define the parameters of a sacral osseous fixation pathway (OFP) that will allow for insertion of two TI-TS screws at a single level, and (3) identify the incidence of sacral OFPs large enough for dual-screw insertion in a representative patient population.

Methods: Retrospective review at a level-1 academic trauma center of a cohort of patients with unstable pelvic injuries treated with two TI-TS screws in the same sacral OFP, …