Medicine and Health Sciences Commons^™

The Role Of Epigenetic Mechanisms In The Long-Term Effects Of Early-Life Adversity And Mother-Infant Relationship On Physiology And Behavior Of Offspring In Laboratory Rats And Mice

Faculty, Staff and Students Publications

Maternal care during the early postnatal period of altricial mammals is a key factor in the survival and adaptation of offspring to environmental conditions. Natural variations in maternal care and experimental manipulations with maternal-child relationships modeling early-life adversity (ELA) in laboratory rats and mice have a strong long-term influence on the physiology and behavior of offspring in rats and mice. This literature review is devoted to the latest research on the role of epigenetic mechanisms in these effects of ELA and mother-infant relationship, with a focus on the regulation of hypothalamic-pituitary-adrenal axis and brain-derived neurotrophic factor. An important part of …

Clinical And Echocardiographic Findings Of Intraoperative Inferior Vena Cava Obstruction Following Orthotopic Heart Transplantation, Premal Trivedi

Faculty, Staff and Students Publications

No abstract provided.

Myocardial Edema, Inflammation, And Injury In Human Heart Donated After Circulatory Death Are Sensitive To Warm Ischemia And Subsequent Cold Storage, Aladdein Mattar, Camila Hochman-Mendez, Todd K Rosengart, Kenneth K Liao

Faculty, Staff and Students Publications

Background: Single-dose del Nido solution was recently used in human donation after circulatory death (DCD) heart procurement. We compared the effect of del Nido cardioplegia on myocardial edema, inflammatory response, and injury in human DCD hearts and human donation after brain death (DBD) hearts with different warm ischemic times (WIT) and subsequent cold saline storage times (CST).

Methods: A total of 24 human hearts, including 6 in the DBD group and 18 in the DCD group-were procured for the research study. The DCD group was divided into 3 subgroups based on WIT: 20, 40, and ≥60 minutes. All hearts received …

Functional Vision In Patients With Biallelic Ush2a Variants, Lassana Samarakoon, Jacque L Duncan, Allison R Ayala, Isabelle Audo, Chris Bradley, Janet K Cheetham, Gislin Dagnelie, Todd A Durham, Carel B Hoyng, Nieraj Jain, Kanishka T Jayasundera, Mark E Pennesi, Christina Y Weng, Foundation Fighting Blindness Consortium Investigator Group

Faculty, Staff and Students Publications

Purpose: To describe functional vision (FV) and investigate the relationship between FV, visual acuity (VA), and hill of vision (VTOT) at baseline in patients with biallelic USH2A variants.

Design: Multicenter, international, cross-sectional study.

Methods: In individuals with biallelic disease-causing variants in USH2A, clinical diagnosis of Usher syndrome type 2 (USH2) or autosomal recessive nonsyndromic retinitis pigmentosa (ARRP) was based on history of hearing loss and audiology examinations. The VALVVFQ-48 was administered verbally to participants ≥18 years old. VA was measured in both eyes; VTOT was determined from static perimetry in the study eye (better VA). FV scores were calculated using …

Increased Frequency Of Chd1 Deletions In Prostate Cancers Of African American Men Is Associated With Rapid Disease Progression Without Inducing Homologous Recombination Deficiency, Hua Li, Pranshu Sahgal, Jia Zhou, Zsofia Sztupinszki, Denise Young, Darryl Nuosome, Claire Kuo, Jiji Jiang, Yongmei Chen, Reinhard Ebner, Isabell Sesterhenn, Joel Moncur, Gregory Chesnut, Gyorgy Petrovics, Gregory T Klus, Gábor Valcz, Pier Nuzzo, Dezso Ribli, Judit Börcsök, Aurél Prósz, Marcin Krzystanek, Thomas Ried, Dávid Szüts, Kinza Rizwan, Salma Kaochar, Shailja Pathania, Alan D'Andrea, István Csabai, Shib Srivastava, Matthew Freedman, Albert Dobi, Sandor Spisak

Faculty, Staff and Students Publications

We analyzed genomic data derived from the prostate cancer of African and European American men in order to identify differences that may contribute to racial disparity of outcome and that could also define novel therapeutic strategies.

In addition to analyzing patient derived next generation sequencing data, we performed FISH based confirmatory studies of Chromodomain helicase DNA-binding protein 1 (CHD1) loss on prostate cancer tissue microarrays. We created CRISPR edited, CHD1 deficient prostate cancer cell lines for genomic, drug sensitivity and functional homologous recombination (HR) activity analysis.

We found that subclonal deletion of CHD1 is nearly three times as …

Immunologic Basis For Development Of Keratoconjunctivitis Sicca In Systemic Autoimmune Diseases: Role Of Innate Immune Sensors, Jerry Y Niederkorn, Robert Fox, Margarita Calonge, Christof Scheid, Stephen C Pflugfelder

Faculty, Staff and Students Publications

The literature is filled with citations reporting an increased incidence of chronic dry eye disease, also known as keratoconjunctivitis sicca, in patients with systemic autoimmune diseases such as rheumatoid arthritis, Sjögren's Syndrome, systemic sclerosis and lupus. As the most environmentally exposed mucosal surface of the body, the conjunctiva constantly responds to environmental challenges which are typically self limited, but when persistent and unresolved may provoke pathogenic innate and adaptive immune reactions. Our understanding of the pathophysiological mechanisms by which systemic autoimmune diseases cause dry eye inducing ocular surface inflammation continues to evolve. Conjunctival immune tone responds to self or foreign …

The Impact Of Cognitive Behavioral Therapy On Sleep Problems In Autistic Children With Co-Occurring Anxiety, Andrew G Gusick, Ariel M Lyons-Warren, Robin P Goin-Kochel, Chaya Murali, Leandra N Berry, Eric A Storch

Faculty, Staff and Students Publications

Purpose: This study seeks to examine the relationship between anxiety-symptom severity and sleep behaviors in autistic children receiving cognitive behavioral therapy (CBT).

Methods: We conducted a secondary-data analysis from a sample of 93 autistic youth, 4 to 14 years, participating in 24 weeks of CBT. Clinicians completed the Pediatric Anxiety Rating Scale (PARS) and parents completed the Children's Sleep Habits Questionnaire, Abbreviated/Short Form (CSHQ-SF) at baseline, mid-treatment, post-treatment and 3 months post-treatment. Mediation analysis evaluated the role of anxiety symptoms in mediating the effect of time in treatment on sleep.

Results: There was a negative association between time in treatment …

Neurocritical Care And Neuromonitoring Considerations In Acute Pediatric Spinal Cord Injury

Faculty, Staff and Students Publications

Management of pediatric spinal cord injury (SCI) is an essential skill for all pediatric neurocritical care physicians. In this review, we focus on the evaluation and management of pediatric SCI, highlight a novel framework for the monitoring of such patients in the intensive care unit (ICU), and introduce advancements in critical care techniques in monitoring and management. The initial evaluation and characterization of SCI is crucial for improving outcomes as well as prognostication. While physical examination and imaging are the main stays of the work-up, we propose the use of somatosensory evoked potentials (SSEPs) and transcranial magnetic stimulation (TMS) for …

Less Contrast, More Clarity, Innovative Visualization Technique For Management Of Multiple Colorectal Liver Metastases Using Microwave Ablation Through A Portal Venous Acces

Faculty, Staff and Students Publications

Colorectal cancer, a leading cause of cancer-related deaths, often results in liver metastases, with about half of patients affected. For those ineligibles for surgery, percutaneous microwave ablation (MWA) offers a viable alternative. Conventionally, visualizing liver lesions prior to MWA demands significant IV contrast, often needing repeated sessions. We introduce a technique using minimal IV contrast to treat multiple metastatic lesions simultaneously. A case of a 47-year-old male with stage 4 colorectal adenocarcinoma and multiple liver metastases is presented. Instead of the typical 100-150 cc of IV contrast, our method used just 25 cc, successfully ablating 6 hepatic metastases in 1 …

Preparing Nursing Students To Manage Acculturative Stress Experienced During Study Abroad Experiences: Novel Use Of Immersive Simulation And Cognitive Behavioral Strategies, Theresa Schnable, Christine A. Schindler, Jeffrey D. Roche, Karli Webster, Christopher E. Larkee, Maharaj Singh, John F. Ladisa

College of Nursing Faculty Research and Publications

This pilot study adds to the understanding of interventions to manage acculturative stress experienced during undergraduate study abroad programs. It was designed to evaluate the impact of cognitive behavioral strategy training combined with intentional practice during mixed reality (MR) simulations on acculturative stress. Participants included a convenience sample of undergraduate nursing students enrolled in a faculty-led study abroad course. Students participated in two MR simulations within a virtual environment over back-to-back days. Simulations were written by nursing faculty experts to reproduce realistic clinical situations students may encounter while studying in Peru. The Generalized Self-Efficacy Scale, State-Trait Anxiety Inventory, and Slater-Usoh-Steed …

Delayed Onset Of Neonatal Compartment Syndrome Associated With Compound Fetal Presentation, Nicholas Manini, Hayato Unno

Department of Medicine Faculty Papers

Neonatal compartment syndrome, although rare, has a classic presentation with sentinel skin findings and development of swelling, erythema, and tenderness of the affected extremity. Neonatal compartment syndrome requires prompt surgical intervention to preserve the affected limb and ensure its normal growth and development. Our patient was born at term via vaginal delivery complicated by a compound presentation involving the left upper extremity. No physical exam abnormalities were noted at birth, but she developed signs of neonatal compartment syndrome by 15 h of life. She was surgically treated at 22 h of life and recovered well. At one year of age, …

Editorial: Endocrine Regulation Of Mineral Ions And Their Relevance To Metabolic Diseases, Mor-Li Hartman, Mohammed S. Razzaque

School of Medicine Publications

No abstract provided.

Achieving Procedural Parity In Managing Access To Genomic And Related Health Data: A Global Survey Of Data Access Committee Members, Jonathan Lawson, Vasiliki Rahimzadeh, Jinyoung Baek, Edward S Dove

Center for Medical Ethics and Health Policy Staff Publications

Data access committees (DACs) are critical players in the data sharing ecosystem. DACs review requests for access to data held in one or more repositories and where specific constraints determine how the data may be used and by whom. Our team surveyed DAC members affiliated with genomic data repositories worldwide to understand standard processes and procedures, operational metrics, bottlenecks, and efficiencies, as well as their perspectives on possible improvements to quality review. We found that DAC operations and systemic issues were common across repositories globally. In general, DAC members endeavored to achieve an appropriate balance of review efficiency, quality, and …

Optimizing Single T-Cell Transcriptomic Discrimination Of Atopic Dermatitis Versus Psoriasis Vulgaris, Mark A Taylor, Abdullah El Kurdi, Ashley Hailer, Sijia Wang, Michelle Yuan, Sumanta Mukhopadhyay, Tina Bhutani, Jeffrey P North, Raymond J Cho, Jeffrey B Cheng

Staff and Researcher Publications

No abstract provided.

European Society Of Coloproctology Guideline On Training In Robotic Colorectal Surgery (2024), Samson Tou, Stephanie Au, Cillian Clancy, Steven Clarke, Danielle Collins, Frances Dixon, Elizabeth Dreher, Christina Fleming, Anthony G Gallagher, Marcos Gomez-Ruiz, Jos Kleijnen, Yasuko Maeda, Katie Rollins, Klaus E Matzel

Staff and Researcher Publications

No abstract provided.

The Role Of Between-Session Homework In Cognitive-Behavioral Therapy For Comorbid Obsessive-Compulsive Disorder And Autism: A Case Vignette, Molly J Church, Katie H Mangen, Jordan T Stiede, Samuel D Spencer, Eric A Storch

Center for Medical Ethics and Health Policy Staff Publications

Objective: Cognitive-behavioral therapy (CBT), which includes a decided emphasis on exposure and response/ritual prevention (ERP) and between-session practice of treatment principles, has consistently demonstrated efficacy for the treatment of obsessive-compulsive disorder (OCD) and is a gold standard, recommended first-line treatment. CBT with ERP has been successfully adapted to fit the needs of autistic individuals with OCD. The present article provides a brief overview of CBT for OCD and outlines special considerations and adaptations needed when working with patients with OCD and comorbid autism, with an emphasis on the importance of between-session homework.

Method: A case vignette is presented.

Results: This …

Genetic Researchers' Use Of And Interest In Research With Diverse Ancestral Groups, Kaitlyn Jaffe, Amanda K Greene, Luyun Chen, Kerry A Ryan, Chris Krenz, J Scott Roberts, Brian J Zikmund-Fisher, Amy L Mcguire, J Denard Thomas, Erica E Marsh, Kayte Spector-Bagdady

Center for Medical Ethics and Health Policy Staff Publications

Importance: Genetic researchers must have access to databases populated with data from diverse ancestral groups to ensure research is generalizable or targeted for historically excluded communities.

Objective: To determine genetic researchers' interest in doing research with diverse ancestral populations, which database stewards offer adequate samples, and additional facilitators for use of diverse ancestral data.

Design, setting, and participants: This survey study was conducted from June to December 2022 and was part of an exploratory sequential mixed-methods project in which previous qualitative results informed survey design. Eligible participants included genetic researchers who held US academic affiliations and conducted research using human …

Effectiveness Of Cord Blood As A Strategy To Rule Out Conjugated Hyperbilirubinemia

Faculty, Staff and Students Publications

Early detection of biliary atresia is crucial for timely intervention and improved outcomes in infants with elevated conjugated bilirubin levels. This study aims to investigate the viability of cord blood gas analysis as a novel method for assessing conjugated bilirubin levels. Infants with high heel stick levels also showed elevated cord blood bilirubin levels, indicating that cord blood testing could replace the need for repeat heel stick tests, especially benefiting low birth weight infants. Ongoing research, including larger cohorts and alternative bilirubin measurement methods, will further validate this innovative screening approach. Infants with biliary atresia have high conjugated bilirubin levels …

Outcomes Of Extracorporeal Cardiopulmonary Resuscitation For In-Hospital Cardiac Arrest Among Children With Noncardiac Illness Categories, Jessica S Alvey, Jonathan A Race, Lillian Su, Javier J Lasa, Julia C Slovis, Tia T Raymond, Ryan Coleman, Bradley J Barney, Todd J Kilbaugh, Alexis A Topjian, Robert M Sutton, Ryan W Morgan

Faculty, Staff and Students Publications

Objectives: The objective of this study was to determine the association of the use of extracorporeal cardiopulmonary resuscitation (ECPR) with survival to hospital discharge in pediatric patients with a noncardiac illness category. A secondary objective was to report on trends in ECPR usage in this population for 20 years.

Design: Retrospective multicenter cohort study.

Setting: Hospitals contributing data to the American Heart Association's Get With The Guidelines-Resuscitation registry between 2000 and 2021.

Patients: Children (< 18 yr) with noncardiac illness category who received greater than or equal to 30 minutes of cardiopulmonary resuscitation (CPR) for in-hospital cardiac arrest.

Interventions: None.

Measurements and main results: Propensity score weighting balanced ECPR and conventional CPR (CCPR) groups on hospital and patient characteristics. Multivariable logistic regression incorporating …

The Power And Promise Of Patient-Derived Xenografts Of Human Breast Cancer

Faculty, Staff and Students Publications

In 2016, a group of researchers engaged in the development of patient-derived xenografts (PDXs) of human breast cancer provided a comprehensive review of the state of the field. In that review, they summarized the clinical problem that PDXs might address, the technical approaches to their generation (including a discussion of host animals and transplant conditions tested), and presented transplantation success (take) rates across groups and across transplantation conditions. At the time, there were just over 500 unique PDX models created by these investigators representing all three clinically defined subtypes (ER

Icosapent Ethyl Following Acute Coronary Syndrome: The Reduce-It Trial, Eliot A Brinton, Terry A Jacobson, Steven B Ketchum, Lixia Jiao, Armando Lira Pineda, Ralph T Doyle, Jean Claude Tardif, Christie M Ballantyne, Ph Gabriel Steg

Faculty, Staff and Students Publications

No abstract provided.

Frailty Status Modifies The Efficacy Of Icd Therapy For Primary Prevention Among Patients With Hf, Lajjaben Patel, Shyon Parsa, Traci Betts, Gordon R Reeves, Robert J Mentz, Daniel E Forman, Mehdi Razavi, Mohammad Saeed, Dalane W Kitzman, Ambarish Pandey

Faculty, Staff and Students Publications

Background: Implantable cardioverter-defibrillator (ICD) therapy is recommended to reduce mortality risk in patients with heart failure with reduced ejection fraction (HFrEF). Frailty is common among patients with HFrEF and is associated with increased mortality risk. Whether the therapeutic efficacy of ICD is consistent among frail and nonfrail patients with HFrEF remains unclear.

Objectives: The aim of this study was to evaluate the effect modification of baseline frailty burden on ICD efficacy for primary prevention among participants of the SCD-HeFT (Sudden Cardiac Death in Heart Failure Trial).

Methods: Participants in SCD-HeFT with HFrEF randomized to ICD vs placebo were included. Baseline …

Impact Of Insulin Sensitivity And Β-Cell Function Over Time On Glycemic Outcomes In The Glycemia Reduction Approaches In Diabetes: A Comparative Effectiveness Study (Grade): Differential Treatment Effects Of Dual Therapy, Ashok Balasubramanyam, Richard M Bergenstal, Joshua Barzilay, Cyrus Desouza, Ralph A Defronzo, Tom Elasy, Jonathan Krakoff, Steven E Kahn, Neda Rasouli, Willy M Valencia, William I Sivitz, Grade Research Group

Faculty, Staff and Students Publications

Objective: To compare the effects of insulin sensitivity and β-cell function over time on HbA1c and durability of glycemic control in response to dual therapy.

Research design and methods: GRADE participants were randomized to glimepiride (n = 1,254), liraglutide (n = 1,262), or sitagliptin (n = 1,268) added to baseline metformin and followed for mean ± SD 5.0 ± 1.3 years, with HbA1c assessed quarterly and oral glucose tolerance tests at baseline, 1, 3, and 5 years. We related time-varying insulin sensitivity (HOMA 2 of insulin sensitivity [HOMA2-%S]) and early (0-30 min) and total (0-120 min) C-peptide (CP) responses to …

Deep-Learning-Based Image Super-Resolution Of An End-Expandable Optical Fiber Probe For Application In Esophageal Cancer Diagnostics, Richa Shukla, Shaleen Vasavada, Sharmila Anandasabapathy, Mark A Anastasio, Elena Petrova

Faculty, Staff and Students Publications

SIGNIFICANCE: Endoscopic screening for esophageal cancer (EC) may enable early cancer diagnosis and treatment. While optical microendoscopic technology has shown promise in improving specificity, the limited field of view (

AIM: To improve the efficiency of endoscopic screening, we propose a novel concept of end-expandable endoscopic optical fiber probe for larger field of visualization and for the first time evaluate a deep-learning-based image super-resolution (DL-SR) method to overcome the issue of limited sampling capability.

APPROACH: To demonstrate feasibility of the end-expandable optical fiber probe, DL-SR was applied on simulated low-resolution microendoscopic images to generate super-resolved (SR) ones. Varying the degradation …

Re-Evaluation Of The Methodology For Estimating The Us Specialty Physician Workforce, Aidan Delisle, Michael Dill, Jason Y Park, James M Crawford, Michael B Cohen, Rebecca L Johnson, Donald S Karcher, Thomas M Wheeler, Stanley J Robboy

Faculty, Staff and Students Publications

Increasing pursuit of subspecialized training has quietly revolutionized physician training, but the potential impact on physician workforce estimates has not previously been recognized. The Physicians Specialty Data Reports of the Association of American Medical Colleges, derived from specialty designations in the American Medical Association (AMA) Physician Professional Data (PPD), are the reference source for US physician workforce estimates; by 2020, the report for pathologists was an undercount of 39% when compared with the PPD. Most of the difference was due to the omission of pathology subspecialty designations. The rest resulted from reliance on only the first of the AMA PPD's …

Sensory Experiences Questionnaire Unravels Differences In Sensory Profiles Between Mecp2-Related Disorders, Holly K Harris, Ariel M Lyons-Warren

Faculty, Staff and Students Publications

The methyl CpG-binding protein-2 (MECP2) gene is located on the Xq28 region. Loss of function mutations or increased copies of MECP2 result in Rett syndrome (RTT) and MECP2 duplication syndrome (MDS), respectively. Individuals with both disorders exhibit overlapping autism symptoms, yet few studies have dissected the differences between these gene dosage sensitive disorders. Further, research examining sensory processing patterns in persons with RTT and MDS is largely absent. Thus, the goal of this study was to analyze and compare sensory processing patterns in persons with RTT and MDS. Towards this goal, caregivers of 50 female individuals with RTT and 122 …

The Influence Of Home Versus Clinic Anal Human Papillomavirus Sampling On High-Resolution Anoscopy Uptake In The Prevent Anal Cancer Self-Swab Study, Elizabeth Y Chiao, Jennifer S Smith, Bridgett Brzezinski, Alan G Nyitray

Faculty, Staff and Student Publications

Background Anal cancer disproportionately affects sexual and gender minority individuals living with HIV. High-resolution anoscopy (HRA) is an in-clinic procedure to detect precancerous anal lesions and cancer, yet prospective data on factors associated with HRA attendance are lacking. We examined whether anal HPV sampling at home versus in a clinic impacts HRA uptake and assessed HRA acceptability. Methods Sexual and gender minority individuals were randomised to home-based self-sampling or clinical sampling. All were asked to attend in-clinic HRA 1year later. We regressed HRA attendance on study arm using multivariable Poisson regression and assessed HRA acceptability using χ 2 tests. Results …

A Polygenic Risk Score Of Atrial Fibrillation Improves Prediction Of Lifetime Risk For Heart Failure, Traci Bartz, Ron C Hoogeveen, Alanna C Morrison, Christie M Ballantyne, Josef Coresh, Eric Boerwinkle, Bruce M Psaty, Amil M Shah, Bing Yu

Faculty, Staff and Student Publications

AIMS: Heart failure (HF) has shared genetic architecture with its risk factors: atrial fibrillation (AF), body mass index (BMI), coronary heart disease (CHD), systolic blood pressure (SBP), and type 2 diabetes (T2D). We aim to assess the association and risk prediction performance of risk-factor polygenic risk scores (PRSs) for incident HF and its subtypes in bi-racial populations.

METHODS AND RESULTS: Five PRSs were constructed for AF, BMI, CHD, SBP, and T2D in White participants of the Atherosclerosis Risk in Communities (ARIC) study. The associations between PRSs and incident HF and its subtypes were assessed using Cox models, and the risk …

Influenza Incidence, Lineages, And Vaccine Effectiveness Estimates In Lima, Peru, 2023, Pablo Tsukayama, Carmen Stefany Neciosup-Vera, Carlos Medina, Elsa Gonzalez-Lagos, Laura Castro, Ashley Fowlkes, Eduardo Azziz-Baumgartner, Eduardo Gotuzzo

Faculty, Staff and Student Publications

No abstract provided.

Adsorbents From Rice Husk And Shrimp Shell For Effective Removal Of Heavy Metals And Reactive Dyes In Water, Firoz Ahmed, Masoumeh Zargar

Faculty, Staff and Student Publications

Widespread contamination by heavy metals (HMs) and dyes poses a major health risk to people and ecosystems requiring effective treatment. In this work, rice husk (RH) and shrimp shells were extracted to obtain amorphous silica and chitosan, respectively, which were utilized to produce nano-chitosan-coated silica (NCCS). To ensure the stability of the nanoparticles, silica was freeze-dried after being coated with nano-chitosan. Functional groups (-NH