Medicine and Health Sciences Commons^™

The Role Of Serum Total Cholesterol In Coronary Heart Disease: A Prospective Cohort Analysis From The Framingham Heart Study, Sanish Maharjan

Capstone Experience: Master of Public Health

Objective: To investigate the association between serum total cholesterol and coronary heart disease (CHD), accounting for key risk factors in adults aged 32–70 years.

Methods: We analyzed data from 4,382 participants of the Framingham Heart Study, a prospective cohort study with 24 years of follow-up. Multivariable logistic regression was used to assess the relationship between serum cholesterol and CHD, adjusting for age, sex, smoking status, systolic blood pressure, BMI, diabetes, and heart rate.

Results: Individuals with high (aOR = 1.87; 95% CI = 1.52 - 2.32; p<.0001) and borderline high (aOR = 1.40; 95% CI = 1.13 - 1.75; p = 0.0024) cholesterol levels have significantly higher odds of developing CHD than those with normal cholesterol. Older (aOR=1.03; 95% CI=1.03–1.05), male (aOR=2.16; 95% CI=1.86–2.51), current smokers (aOR=1.20; 95% CI=1.03–1.39), hypertensive (aOR=1.88; 95% CI=1.55–2.26), obese (aOR=3.03; 95% CI=1.24–7.43), and diabetic individuals (aOR=2.41; 95% CI=1.63–3.56), had significantly higher CHD risk.

Conclusions: Elevated serum cholesterol significantly increases CHD risk, emphasizing …

The Informal, Non-Prescribed Use Of Antiretroviral Medications For Prep Among A National Us-Based Sample Of Gay, Bisexual, And Other Men Who Have Sex With Men: A Cross-Sectional Study, Mance E. Buttram, Matthew S. Ellis, Krishen D. Samuel, Matthew Hayhurst

Health, Human Performance and Recreation Faculty Publications and Presentations

This brief report presents findings on informal, non-prescribed PrEP use among an online sample of gay, bisexual and other men who have sex with men (n = 196). Mean age was 33.4. Participants were Hispanic (13.3%), African American (15.8%), white (63.8%), and other race/ethnicity (6.6%). Informal PrEP users (11%) more frequently reported past year sexually transmitted infections (p < 0.001), group sex (p < 0.001), sex in public (p < 0.01), transactional sex (p < 0.001), ever receiving a formal PrEP prescription (p < 0.05), and ease of finding diverted HIV medications on gay dating/sex apps (p < 0.05). Formal PrEP uptake should be encouraged to mitigate potential negative consequences of informal use.

Policies And Price Controls On The Research And Development Of Orphan Drugs In The United States And The European Union, Bena Pearl Filipczak Smith

Master's Theses

There is substantive literature surrounding the impact of price controls on the research and development (R&D) of new pharmaceutical products. The European Union (EU) and United States (US) are often studied in contrast to examine the influence of price controls as the US has fewer pharmaceutical price controls than the EU.

We find moderate evidence that the US spent more on annual domestic pharmaceutical R&D than the EU between 2004 and 2021, on average, before and after adjusting for GDP growth per capita and year. We find strong evidence that the US increased annual domestic R&D spending at a faster …

Using The Intercultural Development Inventory To Measure Intercultural Development For A High-Impact Global Community Engagement Program, Jennifer Crystle, Megan W. Moran, Diana G. Venskus

Journal of Global Education and Research

High-impact practices (HIPs) in higher education, such as global community engagement programs, enhance student learning and lead to increased levels of civic involvement among graduates. However, it is unknown if participation in a global community engagement/service-learning program affects the development of cultural competence. The purpose of this study was to determine if student and faculty participation in a two-week community engagement/service-learning program in Guatemala would result in intercultural development measured using the Intercultural Development Inventory (IDI) tool. Participants were recruited from a graduate physical therapy education program in the U.S. and completed a pre- and post-trip IDI. Data analysis revealed …

Synthesis Of Photocleavable Molecules For Neurological Applications, Nishal Madujith Egodawaththa Arachchilage Don

Theses and Dissertations

In recent biomedical research, the precise control of molecular dynamics through light activation has emerged as a powerful tool, particularly in the field of neurobiology. This approach involves the use of photocleavable cages or photoprotective groups (PPGs) that are chemically tethered to biologically active molecules such as neurotransmitters or calcium chelators. These cages remain inert until exposed to specific wavelengths of light, typically in the visible range, triggering the release of the active compound with high spatiotemporal precision.

For neurotransmitter systems, such as glutamate (Glu), which plays a critical role in synaptic transmission and memory formation, researchers have developed novel …

Cognitive Behavioral Therapy-Enhanced Through Videoconferencing For Night Eating Syndrome, Binge-Eating Disorder And Comorbid Insomnia: A Case Report, Bernou Melisse, Teresa Arora

All Works

Background: Both night-eating syndrome and binge-eating disorder are characterized by episodes of excessive food consumption, significant distress, and functional impairment related to maladaptive eating behaviors. Both types of eating disorders are associated with poorer sleep quality. Cognitive behavioral therapy has demonstrated good outcomes for binge-eating disorder; however, it is unknown if it is effective for night-eating syndrome and comorbid insomnia. Case presentation: The current paper presents a case report of a Dutch woman in her 40’s receiving cognitive behavioral therapy-enhanced for night-eating syndrome, as well as binge-eating disorder. However, to tailor the intervention to her specific needs, throughout the course …

Asthma Prevalence Among United States Population Insights From Nhanes Data Analysis, Sarya Swed, Bisher Sawaf, Feras Al-Obeidat, Wael Hafez, Amine Rakab, Hidar Alibrahim, Mohamad Nour Nasif, Baraa Alghalyini, Abdul Rehman Zia Zaidi, Lamees Alshareef, Fadel Alqatati, Fathima Zamrath Zahir, Ashraf I. Ahmed, Mulham Alom, Anas Sultan, Abdullah Almahmoud, Agyad Bakkour, Ivan Cherrez-Ojeda

All Works

Asthma is a prevalent respiratory condition that poses a substantial burden on public health in the United States. Understanding its prevalence and associated risk factors is vital for informed policymaking and public health interventions. This study aims to examine asthma prevalence and identify major risk factors in the U.S. population. Our study utilized NHANES data between 1999 and 2020 to investigate asthma prevalence and associated risk factors within the U.S. population. We analyzed a dataset of 64,222 participants, excluding those under 20 years old. We performed binary regression analysis to examine the relationship of demographic and health related covariates with …

Impact Of Prenatal Genomics On Clinical Genetics Practice, Roni Zemet, Ignatia B Van Den Veyver

Duncan NRI Faculty and Staff Publications

Genetic testing for prenatal diagnosis in the pre-genomic era primarily focused on detecting common fetal aneuploidies, using methods that combine maternal factors and imaging findings. The genomic era, ushered in by the emergence of new technologies like chromosomal microarray analysis and next-generation sequencing, has transformed prenatal diagnosis. These new tools enable screening and testing for a broad spectrum of genetic conditions, from chromosomal to monogenic disorders, and significantly enhance diagnostic precision and efficacy. This chapter reviews the transition from traditional karyotyping to comprehensive sequencing-based genomic analyses. We discuss both the clinical utility and the challenges of integrating prenatal exome and …

Whole Exome-Seq And Rna-Seq Data Reveal Unique Neoantigen Profiles In Kenyan Breast Cancer Patients, Godfrey Wagutu, John Gitau, Kennedy Mwangi, Mary Murithi, Elias Melly, Alexandra R. Harris, Shahin Sayed, Stefan Ambs, Francis Makokha

Pathology, East Africa

Background: The immune response against tumors relies on distinguishing between self and non-self, the basis of cancer immunotherapy. Neoantigens from somatic mutations are central to many immunotherapeutic strategies and understanding their landscape in breast cancer is crucial for targeted interventions. We aimed to profile neoantigens in Kenyan breast cancer patients using genomic DNA and total RNA from paired tumor and adjacent non-cancerous tissue samples of 23 patients.

Methods: We sequenced the genome-wide exome (WES) and RNA, from which somatic mutations were identified and their expression quantified, respectively. Neoantigen prediction focused on human leukocyte antigens (HLA) crucial to cancer, HLA type …

Responding To The Workforce Crisis: Consensus Recommendations From The Second Workforce Summit Of The American Society Of Pediatric Nephrology., Danielle E. Soranno, Sandra Amaral, Isa Ashoor, Meredith A. Atkinson, Gina-Marie Barletta, Michael C. Braun, Joann Carlson, Caitlin Carter, Annabelle Chua, Vikas R. Dharnidharka, Keri Drake, Elif Erkan, Dan Feig, Stuart L. Goldstein, David Hains, Lyndsay A. Harshman, Elizabeth Ingulli, Alexander J. Kula, Mary Leonard, Sudha Mannemuddhu, Shina Menon, Zubin J. Modi, Marva Moxey-Mims, Arwa Nada, Victoria Norwood, Michelle C. Starr, Priya S. Verghese, Darcy K. Weidemann, Adam Weinstein, Jodi Smith

Manuscripts, Articles, Book Chapters and Other Papers

IMPORTANCE: Pediatric patients with complex medical problems benefit from pediatric sub-specialty care; however, a significant proportion of children live greater than 80 mi. away from pediatric sub-specialty care.

OBJECTIVE: To identify current knowledge gaps and outline concrete next steps to make progress on issues that have persistently challenged the pediatric nephrology workforce.

EVIDENCE REVIEW: Workforce Summit 2.0 employed the round table format and methodology for consensus building using adapted Delphi principles. Content domains were identified via input from the ASPN Workforce Committee, the ASPN's 2023 Strategic Plan survey, the ASPN's Pediatric Nephrology Division Directors survey, and ongoing feedback from ASPN …

Development Of Novel Ionization Chambers For Reference Dosimetry In Electron Flash Radiotherapy, Kevin Liu, Shannon Holmes, Ahtesham Ullah Khan, Brian Hooten, Larry Dewerd, Emil Schüler, Sam Beddar

Faculty, Staff and Student Publications

Background: Reference dosimetry in ultra-high dose rate (UHDR) beamlines is significantly hindered by limitations in conventional ionization chamber design. In particular, conventional chambers suffer from severe charge collection efficiency (CCE) degradation in high dose per pulse (DPP) beams.

Purpose: The aim of this study was to optimize the design and performance of parallel plate ion chambers for use in UHDR dosimetry applications, and evaluate their potential as reference class chambers for calibration purposes. Three chamber designs were produced to determine the influence of the ion chamber response on electrode separation, field strength, and collection volume on the ion chamber response …

Pathway-Based Clustering Identifies Two Subtypes Of Cancer-Associated Fibroblasts Associated With Distinct Molecular And Clinical Features In Pancreatic Ductal Carcinoma, Hongjing Ai, Rongfang Nie, Xiaosheng Wang

Faculty, Staff and Student Publications

Existing single-cell clustering methods are based on gene expressions that are susceptible to dropout events in single-cell RNA sequencing (scRNA-seq) data. To overcome this limitation, we proposed a pathway-based clustering method for single cells (scPathClus). scPathClus first transforms single-cell gene expression matrix into pathway enrichment matrix and generates its latent feature matrix. Based on the latent feature matrix, scPathClus clusters single cells using the method of community detection. Applying scPathClus to PDAC scRNA-seq datasets, we identified two types of cancer-associated fibroblasts (CAFs), termed csCAFs and gapCAFs, which highly expressed complement system and gap junction-related pathways, respectively. Spatial transcriptome analysis revealed …

A Whodunnit: Anterior St-Elevation Myocardial Infarction In A Patient Found To Have Apparent Takotsubo Cardiomyopathy, Left Anterior Descending Artery Disease, And Myocardial Bridging, Justin Salman, Ariella Azimi, Shehab Al Ansari, Kevin Honan, Salman A Arain

Faculty, Staff and Student Publications

We present a case of a 52-year-old male with no known past medical history who presented to an outside hospital with acute chest pain. Initial workup revealed anteroseptal ST-elevation myocardial infarction (STEMI) for which the patient was transferred to our facility for emergent percutaneous coronary intervention (PCI). However, the patient's hospital course revealed numerous confounding pathologies that can also present as STEMI, including transthoracic echocardiogram (TTE) abnormalities consistent with takotsubo cardiomyopathy (TCM) as well as myocardial bridging presenting as post-PCI STEMI in the setting of nitroglycerin use. The purpose of this case report is to discuss non-acute coronary syndrome causes …

Endovascular Thrombectomy For Childhood Stroke (Save Childs Pro): An International, Multicentre, Prospective Registry Study, Peter B Sporns, Kartik Bhatia, Todd Abruzzo, Lisa Pabst, Stuart Fraser, Melissa G Chung, Warren Lo, Ahmed Othman, Sebastian Steinmetz, Ulf Jensen-Kondering, Stefan Schob, Daniel P O Kaiser, Wolfgang Marik, Christina Wendl, Ilka Kleffner, Hans Henkes, Hermann Kraehling, Thi Dan Linh Nguyen-Kim, René Chapot, Umut Yilmaz, Furene Wang, Muhammad Ubaid Hafeez, Flavio Requejo, Nicola Limbucci, Birgit Kauffmann, Markus Möhlenbruch, Omid Nikoubashman, Peter D Schellinger, Patricia Musolino, Ali Alawieh, Jenny Wilson, Dominik Grieb, Alexandra S Gersing, Thomas Liebig, Martin Olivieri, Jaroslava Paulasova Schwabova, Ales Tomek, Panagiotis Papanagiotou, Grégoire Boulouis, Olivier Naggara, Christine K Fox, Kirill Orlov, Alexandra Kuznetsova, Carmen Parra-Farinas, Prakash Muthusami, Robert W Regenhardt, Adam A Dmytriw, Tanja Burkard, Mesha Martinez, Daniel Brechbühl, Maja Steinlin, Lisa R Sun, Ameer E Hassan, André Kemmling, Sarah Lee, Heather J Fullerton, Jens Fiehler, Marios-Nikos Psychogios, Moritz Wildgruber

Faculty, Staff and Student Publications

Background: Emerging evidence suggests that endovascular thrombectomy is beneficial for treatment of childhood stroke, but the safety and effectiveness of endovascular thrombectomy has not been compared with best medical treatment. We aimed to prospectively analyse functional outcomes of endovascular thrombectomy versus best medical treatment in children with intracranial arterial occlusion stroke.

Methods: In this prospective registry study, 45 centres in 12 countries across Asia and Australia, Europe, North America, and South America reported functional outcomes for children aged between 28 days and 18 years presenting with arterial ischaemic stroke caused by a large-vessel or medium-vessel occlusion who received either endovascular …

Neonatal Outcomes In Term And Preterm Infants Following Adjunctive Azithromycin Antibiotic Prophylaxis For Non-Elective Cesarean Delivery, Jane K Martin, Sherri A Longo, Victoria R Jauk, Erin A S Clark, George R Saade, Kim A Boggess, Sean Esplin, Ronald J Wapner, Michelle Y Owens, Sean C Blackwell, William W Andrews, Jeff M Szychowski, Alan T Tita

Faculty, Staff and Student Publications

Objective: It is currently unknown whether adjunctive azithromycin prophylaxis at the time of non-elective cesarean has differential effects on neonatal outcomes in the context of prematurity. The objective of this study was to compare whether neonatal outcomes differ in term and preterm infants exposed to adjunctive azithromycin prophylaxis before non-elective cesarean delivery.

Study design: A planned secondary analysis of a multi-center randomized controlled trial that enrolled women with singleton pregnancies ≥24 weeks gestation undergoing non-elective cesarean delivery (during labor or ≥4 h after membrane rupture). Women received standard antibiotic prophylaxis and were randomized to either adjunctive azithromycin (500 mg) or …

Association Of Late Eating With Colorectal Adenomas: A Cross-Sectional Study, Darbaz Adnan, Edena R Khoshaba, Mostafa Abel-Reheem, Jonathan Q Trinh, Yin Cao, Faraz Bishehsari

Faculty, Staff and Student Publications

Purpose: Colorectal cancer (CRC) is linked to lifestyle exposures. However, changes in the CRC rates among younger populations remain poorly understood and suggest the existence of yet unidentified factor(s) that may contribute to colon carcinogenesis. Here, we investigated the potential role of time of eating in the risk of pre-cancerous colonic neoplasms (tubular adenoma: TA).

Methods: We enrolled 663 participants undergoing screening colonoscopies. Data on food timing, dietary intake, sleep/wake patterns, and chronotype were collected through structured questionnaires. Late eating was defined as the consumption of food or snack within a 3-hour window of sleep onset for at least four …

A Comparison Of The 2022 Versus 2011 National Institute Of Child Health And Human Development Web-Based Risk Estimator For Bronchopulmonary Dysplasia., Mitch Kinkor, Jake Schneider, Farhath Sulthana, Janelle R. Noel-Macdonnell Phd, Alain Cuna

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: To compare the predictive accuracy of the 2022 vs 2011 National Institute of Child Health and Human Development estimator for identifying infants at high risk for bronchopulmonary dysplasia (BPD).

METHODS: We conducted a single-center retrospective study of infants ≤28 weeks' gestation. Demographic and respiratory support data were used to calculate risk for BPD or death by the BPD estimators. Our outcomes of interest included (1) treatment with systemic steroids for BPD and (2) composite outcome of death or highest severity of BPD at 36 weeks' postmenstrual age. We used c-statistics and area under receiver operator characteristic curves (AUC) to …

Glial Progenitor Heterogeneity And Plasticity In The Adult Spinal Cord, Haichao Wei, Jia Qian Wu

Faculty, Staff and Student Publications

No abstract provided.

Etiologies Of Bloody Diarrhea In Children Presenting With Acute Gastroenteritis To Us Emergency Departments., Paola Fonseca-Romero, Ben J. Brintz, D Matthew Vierkant, Jennifer Dien Bard, Daniel M. Cohen, Ara Festekjian, Amy L. Leber, Jami T. Jackson, Neena Kanwar, Chari Larsen, Rangaraj Selvarangan, Kimberle C. Chapin, Andrew T. Pavia, Sharia M. Ahmed, Daniel T. Leung, Impact Study Investigators

Manuscripts, Articles, Book Chapters and Other Papers

We used molecular testing to examine the causes of bloody diarrhea in a multicenter study of pediatric gastroenteritis. Pathogens typically associated with bloody diarrhea were detected in less than half of cases, and inappropriate antibiotic use was common, supporting the use of stool testing in patients with bloody diarrhea.

Why And When Do We Invasively Restage After Neoadjuvant Chemoimmunotherapy?, Jonathan D Spicer, Tina Cascone, Murry W Wynes, Karen L Kelly

Faculty, Staff and Student Publications

No abstract provided.

Mimicking Large Spot-Scanning Radiation Fields For Proton Flash Preclinical Studies With A Robotic Motion Platform, Fada Guan, Dadi Jiang, Xiaochun Wang, Ming Yang, Kiminori Iga, Yuting Li, Lawrence Bronk, Julianna Bronk, Liang Wang, Youming Guo, Narayan Sahoo, David R Grosshans, Albert C Koong, Xiaorong R Zhu, Radhe Mohan

Faculty, Staff and Student Publications

Previously, a synchrotron-based horizontal proton beamline (87.2 MeV) was successfully commissioned to deliver radiation doses in FLASH and conventional dose rate modes to small fields and volumes. In this study, we developed a strategy to increase the effective radiation field size using a custom robotic motion platform to automatically shift the positions of biological samples. The beam was first broadened with a thin tungsten scatterer and shaped by customized brass collimators for irradiating cell/organoid cultures in 96-well plates (a 7-mm-diameter circle) or for irradiating mice (1-cm

The Fletcher-Cox Pathway: A Unique View On Clinical Trial Education, Shalini Moningi, Shane Stecklein, Sonal Noticewala, Olsi Gjyshi, Todd Pezzi, David Boyce-Fappiano, Prajnan Das, Bruce Minsky, Emma B Holliday, Andrew J Bishop, Albert C Koong, Chelsea C Pinnix

Faculty, Staff and Student Publications

Purpose: There currently are no established formal mentorship and training programs for radiation oncology (RO) trainees to learn trial design, creation, writing, or implementation. There only exists informal training on analyzing clinical trials in RO residency programs. The integration of a longitudinal formal training and mentorship program for clinical trialists-consisting of clinical trial education, design, mentorship, and implementation during the RO residency education-will give residents not only formal teaching in the subject but also strong tools and requisite mentorship in hopes to help them succeed as future academic physicians and leaders in the field of RO.

Methods and materials: We …

Evaluating Pre-Consult Patient Education Videos For Patients With Newly-Diagnosed Anal Squamous Cell Carcinoma: Impact On Patient Comprehension, Satisfaction And Distress, Kelsey L Corrigan, Lauren M Andring, Prajnan Das, Cheryl Pfennig, Kimberly B Porter, Ethan B Ludmir, Sonal S Noticewala, Bruce D Minsky, Grace L Smith, Eugene J Koay, Albert C Koong, Angelica Arzola, Sarah J Lee, Lashon Nelms, Emma B Holliday

Faculty, Staff and Student Publications

We hypothesized that pre-consult patient education videos can improve patient understanding about their diagnosis, lead to high satisfaction and low distress. In this pilot study, we developed a patient education video curriculum for patients with newly-diagnosed anal cancer. Comprehension of key content was evaluated by comparing pre- and post-test scores. Patient satisfaction scores were collected. Patient distress scores (0-10) were collected at the beginning of their consult visit prior to seeing the physician. We found that patient education videos prior to consult improved patient understanding, resulted in high patient satisfaction, and low patient distress at the time of consult.

High Activity Of The New Myeloablative Regimen Of Gemcitabine/Clofarabine/Busulfan For Allogeneic Transplant For Aggressive Lymphomas, Jeremy Ramdial, Ruitao Lin, Peter F Thall, Benigno C Valdez, Chitra Hosing, Samer Srour, Uday Popat, Muzaffar Qazilbash, Amin Alousi, Melissa Barnett, Alison Gulbis, Terri Lynn Shigle, Elizabeth J Shpall, Borje S Andersson, Yago Nieto

Faculty, Staff and Student Publications

Refractory aggressive lymphomas can be treated with allo-SCT, pursuing a graft-vs-lymphoma effect. While reduced intensity conditioning is safe, tumors often progress rapidly, indicating the need for more active conditioning regimens. The preclinical synergy we saw between gemcitabine (Gem), clofarabine (Clo) and busulfan (Bu) against lymphoma cell lines led us to study Gem/Clo/Bu clinically. Eligibility: age 12-65, refractory aggressive B-NHL, T-NHL or Hodgkin, with a matched donor. Infusional Gem was dose-escalated on days (d) -6 and -4 (475-975 mg/m2/day), followed by Clo (40 mg/m2/day) and Bu (target AUC, 4000 μMol min/day) (d -6 to -3). CD20+ tumors received rituximab. GVHD prophylaxis …

Cutaneous T Cell Lymphoma Atlas Reveals Malignant Th2 Cells Supported By A B Cell-Rich Tumor Microenvironment, Ruoyan Li, Johanna Strobl, Elizabeth F M Poyner, Aya Balbaa, Fereshteh Torabi, Pavel V Mazin, Nana-Jane Chipampe, Emily Stephenson, Ciro Ramírez-Suástegi, Vijaya Baskar Mahalingam Shanmugiah, Louis Gardner, Bayanne Olabi, Rowen Coulthard, Rachel A Botting, Nina Zila, Elena Prigmore, Nusayhah H Gopee, Marta A Chroscik, Efpraxia Kritikaki, Justin Engelbert, Issac Goh, Hon Man Chan, Harriet F Johnson, Jasmine Ellis, Victoria Rowe, Win Tun, Gary Reynolds, Dexin Yang, April Rose Foster, Laure Gambardella, Elena Winheim, Chloe Admane, Benjamin Rumney, Lloyd Steele, Laura Jardine, Julia Nenonen, Keir Pickard, Jennifer Lumley, Philip Hampton, Simeng Hu, Fengjie Liu, Xiangjun Liu, David Horsfall, Daniela Basurto-Lozada, Louise Grimble, Chris M Bacon, Sophie C Weatherhead, Hanna Brauner, Yang Wang, Fan Bai, Nick J Reynolds, Judith E Allen, Constanze Jonak, Patrick M Brunner, Sarah A Teichmann, Muzlifah Haniffa

Faculty, Staff and Student Publications

Cutaneous T cell lymphoma (CTCL) is a potentially fatal clonal malignancy of T cells primarily affecting the skin. The most common form of CTCL, mycosis fungoides, can be difficult to diagnose, resulting in treatment delay. We performed single-cell and spatial transcriptomics analysis of skin from patients with mycosis fungoides-type CTCL and an integrated comparative analysis with human skin cell atlas datasets from healthy and inflamed skin. We revealed the co-optation of T helper 2 (TH2) cell-immune gene programs by malignant CTCL cells and modeling of the tumor microenvironment to support their survival. We identified MHC-II+ fibroblasts and dendritic cells that …

Anti-Programmed Death Ligand 1 Plus Targeted Therapy In Anaplastic Thyroid Carcinoma: A Nonrandomized Clinical Trial, Maria E Cabanillas, Ramona Dadu, Renata Ferrarotto, Maria Gule-Monroe, Suyu Liu, Bryan Fellman, Michelle D Williams, Mark Zafereo, Jennifer R Wang, Charles Lu, Matthew Ning, Brian A Mckinley, Scott E Woodman, Dzifa Duose, Gary B Gunn, Naifa L Busaidy, Rare Tumor Initiative Team

Faculty, Staff and Student Publications

Importance: Anaplastic thyroid carcinoma (ATC) is a rare and lethal cancer. Although progress has been made in recent years in patients with mutated BRAF tumors, those who respond initially eventually die of their disease; furthermore, there are no approved therapies for non-BRAF mutated tumors.

Objective: To determine whether treatment with matched-targeted therapy plus immune checkpoint inhibitors were associated with improved overall survival (OS).

Design, setting, and participants: A phase 2 trial at a single center, tertiary institution with parallel cohorts, assigning treatment with targeted therapy according to the tumor mutation status. Patients with mutated BRAF V600E tumors received vemurafenib/cobimetinib plus …

Ultra-Low-Dose Radiation For Extranodal Marginal Zone Lymphoma Of The Lung, Susan Y Wu, Penny Q Fang, Ahmed Fetooh, Gohar S Manzar, Kelsey L Corrigan, Benjamin R Schrank, Lewis Nasr, Dai Chihara, Luis E Malpica Castillo, Ranjit Nair, Raphael E Steiner, Preetesh Jain, Sattva S Neelapu, Paolo Strati, Loretta J Nastoupil, Bouthaina S Dabaja, Chelsea C Pinnix, Jillian R Gunther

Faculty, Staff and Student Publications

Purpose: Definitive intent radiation therapy (RT) for early-stage mucosa-associated lymphoid tissue (MALT) lymphoma typically includes a dose of 24 to 30 Gy. While modest, these doses may have associated toxicity. For patients with indolent B-cell lymphoma, there is increasing support for the use of ultra-low-dose RT (ULDRT) using 4 Gy in 2 fractions as part of a response-adapted approach, as high rates of complete response have been documented. This paradigm has been prospectively evaluated in the management of orbital and gastric indolent B-cell lymphomas; however, there is limited data guiding the use of ULDRT for lung MALT.

Methods: We conducted …

Increasing Safety Net Antibiotic Prescriptions For Acute Otitis Media In Urgent Care Clinics., Jennifer Mckinsey, Brian R. Lee, Donna Wyly, Holly Austin, Dinah Dosdos, Emily Murdock, Aimy Patel, Rana El Feghaly, Amanda Nedved

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: To evaluate the effectiveness of multifaceted interventions in improving the use of safety net antibiotic prescriptions (SNAPs) for nonsevere acute otitis media (AOM).

STUDY DESIGN: We used quality improvement methodology to develop iterative Plan-Do-Study-Act cycles to increase the use of SNAP for nonsevere AOM in 3 pediatric urgent care centers from October 2021 to June 2023. Interventions included education, electronic health record changes, audits and feedback, and a time-limited financial incentive. We measured the percentage of eligible patients with AOM offered SNAP as our primary outcome. Our secondary outcome measured the percentage of SNAPs accepted. Our process measure evaluated …

The Norwood With Blalock-Taussig-Thomas Shunt—Worth A Second Look?, Manasa Gadiraju, Dhaval Chauhan, Alexandra Schray, James O'Brien, Edo Bedzra

Manuscripts, Articles, Book Chapters and Other Papers

Background: Shunt repair for the Norwood procedure with either the right ventricle to pulmonary artery shunt (RVPAS) or the modified Blalock-Taussig-Thomas Shunt (BTTS) varies by institution and surgeon preference. Shunt choice has been informed by landmark trials including the Single Ventricle Reconstruction trial and modern outcomes data may engender future complementary studies. Methods: We conducted a retrospective analysis of all patients who underwent the Norwood procedure from 2014–2022 at a single center to compare outcomes by shunt type. The primary outcome measure was freedom from death or transplant. Secondary outcome measures included hospital length of stay, complications, and unplanned interventions. …

Impact Of The Adenosine Receptor A2br Expressed On Myeloid Cells On Immune Regulation During Pregnancy, Stefanie Dietz, Janine Hebel, Jessica Rühle, Alisha Huff, Holger K Eltzschig, Trim Lajqi, Christian F Poets, Christian Gille, Natascha Köstlin-Gille

Faculty, Staff and Student Publications

During pregnancy, the maternal immune system must carefully balance protection against pathogens with tolerance toward the semiallogeneic fetus. Dysfunctions of the immune system can lead to severe complications such as preeclampsia, fetal growth restriction, or pregnancy loss. Adenosine plays a role in physiological processes and plasma‐level increase during pregnancy. The adenosine receptor A2B (A2BR), which is expressed on both, immune and nonimmune cells, is activated by high adenosine concentrations, achieved during pregnancy. We investigated the impact of A2BR expressed on myeloid cells on immune regulation during pregnancy using a mouse model with myeloid deficiency for A2BR. We demonstrate systemic changes …