Medicine and Health Sciences Commons^™

A Guideline-Based Approach To Increase Early Mobilization In The Pediatric Patient Following Cardiothoracic Surgery, Kayla Keeven

Dissertations

A Guideline-Based Approach to Increase Early Mobilization in the Pediatric Patient Following Cardiothoracic Surgery

Problem: Prolonged bedrest during the post-operative period contributes to complications that lengthen hospital stay and increase mortality and medical costs. Early mobilization is recognized as safe and feasible in critically ill children. However, there is no standardized procedure nor method of identifying patients who are safe to mobilize in a pediatric cardiac intensive care unit (ICU).

Method: The quality improvement (QI) project employed a descriptive observational design utilizing a retrospective-prospective method to assess the effects of implementing an early mobilization guideline in a pediatric cardiac ICU. …

Management Of Post-Extubation Dysphagia Using The Yale Swallow Protocol, Nicole West

Dissertations

Abstract

Problem: Post extubation dysphagia (PED) increases the patient’s risk for long term complications contributing to increased healthcare cost. Intensive care settings rarely use standardized swallow screening assessments for patients post extubation leading to variation in the evaluation of PED. Variation in the assessment of swallowing post extubation can lead to the missed diagnosis of patients with dysphagia.

Methods: This quality improvement (QI) project was a prospective cohort study implementing an evidence-based swallow screening protocol, the Yale Swallow Protocol (YSP), in an intensive care unit. This study was conducted over four months, which included a pre survey, education, implementation, and …

Hearing At The Mall: Multibeam Processing Technology Improves Hearing Group Conversations In A Real-World Food Court Environment, Paula Folkeard, Niels S. Jensen, Homayoun K. Parsi, Sascha Bilert, Susan Scollie

Communication Sciences and Disorders Publications

How can hearing aids make group conversations easier in noisy public spaces?

Hearing aids often struggle to help users follow conversations in noisy, real-world environments like busy food courts. This study found that a new hearing aid technology using multiple adaptive beams to track different speakers improved users' ability to understand and focus on group conversations in a mall food court setting. These results suggest that advancements in hearing aid algorithms that account for the natural head movements and multiple conversation partners could significantly enhance the listening experience for people with hearing loss in challenging everyday situations.

Neonatal Hyperbilirubinemia And Phototherapy: The Implementation Of Seminal Clinical Practice Guidelines, Christina Coleman

Dissertations

Problem: On a postpartum care and pediatric unit from February 2022 to December 2023, the average monthly percentage of neonatal patients greater than 35 weeks gestation with hyperbilirubinemia who were treated with phototherapy before it was medically supported by the current guidelines was 42.855% (N=668). The department’s goal was to decrease this number to 10%. Initiation of phototherapy with a subthreshold bilirubin level exposes many infants to an unnecessary treatment modality which can prolong the infant’s length of stay in the hospital and can be associated with adverse effects, such as maternal-infant bonding and breastfeeding rates.

Methods: The …

Implementing A Brief Intervention For Smoking Cessation In An Inpatient Psychiatric Facility, Erika Gotway

Dissertations

Abstract

Problem: Smoking is a leading cause of various preventable diseases, and those who experience mental illness smoke cigarettes at a higher rate than the general population. Brief intervention is a type counseling that has proven successful in encouraging smokers to quit. The “5 A’s” is a type of brief intervention which stands for: Ask, Advise, Assess, Assist, Arrange. Addressing the smoking epidemic among individuals with mental illness is not only essential for improving their overall well-being, but also for reducing health disparities and enhancing the effectiveness of existing mental health interventions.

Methods: The approach to this project was a …

360 Degree Clinical Competence Evaluation For Pediatric Hospitalist Advance Practice Provders, Elizabeth A. Schickler

Dissertations

Problem: Advanced practice provider (APP) peer reviewed clinical competencies is an expected part of professional, organizational, and The Joint Commission (Joint Commission) requirements, however, is not well defined and subject to organizational application and interpretation. Providers favor peer review as a means to improve professional practice. There is a lack of data to support frequency of feedback and method of feedback to support readiness to change practice and comfort giving and receiving feedback.

Methods: The quality improvement project utilized an analytical experimental design.

The Cardin Hospitalist Advanced Practice Provider - Readiness Assessment (CHAPP-RA) tool was implemented to a convenience sample …

Evidence-Based Prostate Cancer Screening Interventions For Black Men: A Systematic Review, Abigail Lopez, Jared T. Bailey, Dorothy Galloway, Leanne Woods-Burnham, Susanne B. Montgomery, Rick Kittles, Dede K. Teteh-Brooks

Health Sciences and Kinesiology Faculty Articles

Abstract

Prostate cancer is the second leading cause of death for men in the U.S. and Black men are twice as likely to die from the disease. However, prostate cancer, if diagnosed at an earlier stage, is curable. The purpose of this review is to identify prostate cancer screening clinical trials that evaluate screening decision-making processes of Black men.

Methods

The databases PubMed, Ovid MEDLINE, CINAHL Plus, and PsychInfo were utilized to examine peer-reviewed publications between 2017 and 2023. Data extracted included implementation plans, outcome measures, intervention details, and results of the study. The Critical Appraisal Skills Programme was used …

Longitudinal Program Evaluation Of An Inter-Institutional Mentorship Network For Pediatric Rheumatology Using A Quality Improvement Framework, Kristen Hayward, Alexi Grom, Eyal Muscal, Peter A Nigrovic, Kelly A Rouster-Stevens, Kaveh Ardalan, Linda Hiraki, L Nandini Moorthy

Faculty, Staff and Students Publications

BACKGROUND: The American College of Rheumatology (ACR)/Childhood Arthritis and Rheumatology Research Alliance (CARRA) Mentoring Interest Group (AMIGO) is an inter-institutional mentorship program launched to target mentorship gaps within pediatric rheumatology. Initial program evaluation indicated increased mentorship access. Given the small size of the pediatric rheumatology workforce, maintaining a consistent supply of mentors was a potential threat to the longevity of the network. Our aims were to: (i) describe the sustainability of AMIGO over the period 2011-2018, (ii) highlight ongoing benefits to participants, and (iii) describe challenges in the maintenance of a mentorship network.

METHODS: A mixed-methods approach centered on a …

An Orientation Towards Care In Occupational Therapy: A Theoretical Framework, Myah G. Beylotte

Movement and Being: The Journal of the Christian Society for Kinesiology, Leisure and Sports Studies

The purpose of this paper is to explore Ethic of Care (Gilligan, 1936; Noddings, 1984) in an occupational therapy (OT) setting and to determine if empathetic and relational care can provide greater patient outcomes. Ethic of Care (EoC), originally established by Gilligan (1936), is a moral orientation towards care that has been applied in the areas of education, nursing, sports coaching, and other popular professions (Fisher et al., 2017; Gano-Overway et al., 2009; Knust & Fisher, 2015; Lachman, 2012; Newton et al., 2007; Noddings, 2005; Schools, et al., 2020), but has not been widely researched in the field of OT. …

Nourish: Promoting Body Acceptance Through Christ-Centered Identity In Female Collegiate Cross Country Runners, Kirsten E. Howland, Melinda B. Smith

Movement and Being: The Journal of the Christian Society for Kinesiology, Leisure and Sports Studies

Competitive runners are at increased risk for developing eating disorders (EDs), which can have serious effects on both sport and life. Clinical and psychological treatments for EDs are largely ineffective; therefore, to reduce the incidence of disordered eating in young runners, there is a need for preventative programs focused on shifting cultural attitudes and mindset. The purpose of this study was to implement and evaluate Nourish, a Biblically-based pilot program designed to promote body appreciation and a holistic view of the self through rooting identity in Christ. Seven members of the women’s cross country team at a private Division …

Comprehensive Considerations For Dermatologists: The Application Of Fdg-Pet In Evaluating Cutaneous Lesions In Pediatric Langerhans Cell Histiocytosis, Sahithi Talasila, Eric M. Teichner, Robert C. Subtirelu, Naga Chaitanya P. Talasila, Sricharvi Mannam, Thomas Werner, Abass Alavi, Mona-Elisabeth Revheim

Student Papers, Posters & Projects

Langerhans cell histiocytosis (LCH) is a complex disorder characterized by the clonal proliferation of Langerhans cells, primarily affecting children and adolescents. This condition exhibits a wide spectrum of clinical presentations, necessitating a multidisciplinary approach for diagnosis, treatment, and follow-up. Cutaneous manifestations of LCH are significant, mimicking common dermatoses and posing diagnostic challenges. [18F]Fluorodeoxyglucose-Positron Emission Tomography (FDG-PET) has emerged as an important tool in the evaluation of pediatric LCH, offering insights into disease activity, extent, and therapeutic response. Moreover, FDG-PET provides a non-invasive means to distinguish between active LCH skin lesions and other dermatological conditions with similar clinical appearances, enhancing diagnostic …

Free Flap Reconstruction Following Head And Neck Trauma, Larissa Sweeny, Anne C. Kane, Carissa M. Thomas, Neal Futran, Joseph M. Curry, Andrés M. Bur, G. Nina Lu, Aishwarya Shukla, Hunter Skoog, Jaime A. Pena Garcia, Angela E. Alnemri, Rahul Alapati, Michael Dileo, Andrew Fuson, Kenneth Tan, Farshid Taghizadeh, Gina D. Jefferson, Daniel Petrisor, Mark K. Wax

School of Medicine Faculty Publications

Background: Free flap (FF) reconstruction of traumatic injuries to the head and neck is uncommon. Methods: Multi-institutional retrospective case series of patients undergoing FF reconstruction for a traumatic injury (n = 103). Results: Majority were gunshot wounds (GSW; 85%, n = 88) and motor vehicle accidents (11%, n = 11). Majority underwent osseous reconstruction (82%, n = 84). FF failures (9%, n = 9/103) occurred in GSW patients (100%, n = 9/9) and when multiple subsites were injured (89%, n = 8/9). Preoperative antibiotics correlated with lower rates of a neck washouts (4% vs. 19%) (p = 0.01) and 30-day …

Inverted Triplications Formed By Iterative Template Switches Generate Structural Variant Diversity At Genomic Disorder Loci, Christopher M Grochowski, Jesse D Bengtsson, Haowei Du, Mira Gandhi, Ming Yin Lun, Michele G Mehaffey, Kyunghee Park, Wolfram Höps, Eva Benito, Patrick Hasenfeld, Jan O Korbel, Medhat Mahmoud, Luis F Paulin, Shalini N Jhangiani, James Paul Hwang, Sravya V Bhamidipati, Donna M Muzny, Jawid M Fatih, Richard A Gibbs, Matthew Pendleton, Eoghan Harrington, Sissel Juul, Anna Lindstrand, Fritz J Sedlazeck, Davut Pehlivan, James R Lupski, Claudia M B Carvalho

Faculty, Staff and Students Publications

The duplication-triplication/inverted-duplication (DUP-TRP/INV-DUP) structure is a complex genomic rearrangement (CGR). Although it has been identified as an important pathogenic DNA mutation signature in genomic disorders and cancer genomes, its architecture remains unresolved. Here, we studied the genomic architecture of DUP-TRP/INV-DUP by investigating the DNA of 24 patients identified by array comparative genomic hybridization (aCGH) on whom we found evidence for the existence of 4 out of 4 predicted structural variant (SV) haplotypes. Using a combination of short-read genome sequencing (GS), long-read GS, optical genome mapping, and single-cell DNA template strand sequencing (strand-seq), the haplotype structure was resolved in 18 samples. …

Silmitasertib (Cx-4945) Disrupts Erî±/Hsp90 Interaction And Drives Proteolysis Through The Disruption Of Ck2β Function In Breast Cancer Cells, Hogyoung Kim, Emma Elkins, Rahib Islam, Bo Cao, Nour Abbes, Kaela Battles, Sihyoung Kim, Sichan Kim, Christopher Williams

School of Graduate Studies Faculty Publications

Aberrant estrogen receptor (ERα) signaling mediates detrimental effects of tamoxifen including drug resistance and endometrial hyperplasia. ERα36, an alternative isoform of ERα, contributes to these effects. We have demonstrated that CK2 modulates ERα expression and function in breast cancer (BCa). Here, we assess if CX-4945 (CX), a clinical stage CK2 inhibitor, can disrupt ERα66 and ERα36 signaling in BCa. Using live cell imaging, we assessed the antiproliferative effects of CX in tamoxifen-sensitive and tamoxifen-resistant BCa cells in monolayer and/or spheroid cultures. CX-induced alterations in ERα66 and ERα36 mRNA and protein expression were assessed by RT-PCR and immunoblot. Co-immunoprecipitation was performed …

Phase Ib Study Of Unesbulin (Ptc596) Plus Dacarbazine For The Treatment Of Locally Recurrent, Unresectable Or Metastatic, Relapsed Or Refractory Leiomyosarcoma, Brian A Van Tine, Matthew A Ingham, Steven Attia, Christian F Meyer, John D Baird, Esther Brooks-Asplund, Dhiren D'Silva, Ronald Kong, Anthony Mwatha, Kylie O'Keefe, Marla Weetall, Robert Spiegel, Gary K Schwartz

2020-Current year OA Pubs

PURPOSE: This multicenter, single-arm, open-label, phase Ib study was designed to determine the recommended phase II dose (RP2D) and to evaluate the safety and preliminary efficacy of unesbulin plus dacarbazine (DTIC) in patients with advanced leiomyosarcoma (LMS).

PATIENTS AND METHODS: Adult subjects with locally advanced, unresectable or metastatic, relapsed or refractory LMS were treated with escalating doses of unesbulin orally twice per week in combination with DTIC 1,000 mg/m

RESULTS: Unesbulin 300 mg administered orally twice per week in combination with DTIC 1,000 mg/m

CONCLUSION: Unesbulin 300 mg twice per week plus DTIC 1,000 mg/m

Hemodynamics Regulate Spatiotemporal Artery Muscularization In The Developing Circle Of Willis, Siyuan Cheng, Ivan Fan Xia, Renate Wanner, Javier Abello, Amber N Stratman, Stefania Nicoli

2020-Current year OA Pubs

Vascular smooth muscle cells (VSMCs) envelop vertebrate brain arteries and play a crucial role in regulating cerebral blood flow and neurovascular coupling. The dedifferentiation of VSMCs is implicated in cerebrovascular disease and neurodegeneration. Despite its importance, the process of VSMC differentiation on brain arteries during development remains inadequately characterized. Understanding this process could aid in reprogramming and regenerating dedifferentiated VSMCs in cerebrovascular diseases. In this study, we investigated VSMC differentiation on zebrafish circle of Willis (CoW), comprising major arteries that supply blood to the vertebrate brain. We observed that arterial specification of CoW endothelial cells (ECs) occurs after their migration …

Combating Disparities In A Pandemic: Increasing Dissemination Of Coronavirus Disease 2019 Resources In Spanish., Romina Barral, Nicholas Clark, Fernando Zapata, Lines Vargas Collado, July Jean Cuevas, Cristina Fernandez Md

Manuscripts, Articles, Book Chapters and Other Papers

INTRODUCTION: Disparities exist in access to coronavirus disease 2019 (COVID-19)-related health information. We aimed to close a gap in online traffic between English and Spanish COVID-19-related health information on our institution's publicly-facing website by 50% within ten months.

METHODS: We used A3 improvement methodology. Outcome measures were the mean monthly difference between English and Spanish COVID-19 online traffic vis-a-vis (1) total webpage views and (2) unique webpage visits. Process measures were stratification of outcome measures by language. Plan-Do-Study-Act cycles included: Recurring advertisements on a local Spanish television station disseminating up-to-date COVID-19 information, including our institution's Spanish COVID-19 online resources, incorporation …

Ragopathies And The Rising Influence Of Raggtpases On Human Diseases, Irene Sambri, Marco Ferniani, Andrea Ballabio

Duncan NRI Faculty and Staff Publications

RagGTPases (Rags) play an essential role in the regulation of cell metabolism by controlling the activities of both mechanistic target of rapamycin complex 1 (mTORC1) and Transcription factor EB (TFEB). Several diseases, herein named ragopathies, are associated to Rags dysfunction. These diseases may be caused by mutations either in genes encoding the Rags, or in their upstream regulators. The resulting phenotypes may encompass a variety of clinical features such as cataract, kidney tubulopathy, dilated cardiomyopathy and several types of cancer. In this review, we focus on the key clinical, molecular and physio-pathological features of ragopathies, aiming to shed light on …

Community-Based Participatory Obesity Prevention Interventions In Rural Communities: A Scoping Review, Saagar Dhanjani, Haley Allen, Beatriz Varman, Chishinga Callender, Jayna M Dave, Debbe Thompson

Library Staff Publications

Child obesity is a worldwide public health concern. In America, children from rural areas have greater odds of obesity in comparison to those from urban areas. Community-engaged research is important for all communities, particularly under-represented communities. This paper reports the results of a scoping review investigating community-engaged research in obesity prevention programs tested with school-aged children in rural America. A literature search of Medline Ovid was conducted to identify interventions reporting the results of obesity prevention interventions that promoted a healthy diet or physical activity (PA) behaviors to school-age children in rural communities of the United States (US). After title …

Predictive Value Of Has-Bled And Hemorr2hages Bleeding Risk Scores After Percutaneous Coronary Intervention, Ianis Doomun, Daphné Doomun, Sara Schukraft, Diego Arroyo, Selma T Cook, Tibor Huwyler, Jean-Jacques Goy, Jean-Christophe Stauffer, Mario Togni, Serban Puricel, Stéphane Cook

The Texas Heart Institute Journal

BACKGROUND: Various scoring systems have been developed to assess the risk of bleeding in medical settings. HAS-BLED and HEMORR2HAGES risk scores are commonly used to estimate bleeding risk in patients receiving anticoagulation for atrial fibrillation, but data on their predictive value in patients undergoing percutaneous coronary intervention (PCI) are limited.

METHODS: This study evaluated and compared the predictive abilities of the HAS-BLED and HEMORR2HAGES bleeding risk scores in all-comer patients undergoing PCI. The PARIS score, specifically designed for patients undergoing PCI, was used as a comparator. The scores were calculated at baseline and compared with the occurrence of events during …

Conserved Mechanisms Of Drug Induced Lifespan Extension In S. Cerevisiae And C. Elegans, Christine E. Robbins

Biomedical Sciences ETDs

Aging is a phenomenon that brings aches, pains and a risk of developing diseases. Many researchers have discovered pathways that regulate aging by altering gene expression. Understanding genetic regulation of aging is key but identifying drugs that target aging will result in translatable treatments. Additionally, understanding how drugs are interacting with our cells allows us to create targeted therapies. I study two types of drugs. First, tRNA synthetase inhibitors are a class of drugs that inhibit charging of tRNAs. I identified a mechanism of lifespan extension by upregulation of the conserved transcription factor, Gcn4 / Atf-4. Second, I found that …

Toward The Development Of A Pan-Lyssavirus Vaccine, Sabrine Ben Hamed, Jacob Myers, Anisha Chandwani, Christoph Wirblich, Drishya Kurup, Nir Paran, Matthias Schnell

Department of Microbiology and Immunology Faculty Papers

In addition to the rabies virus (RABV), 16 more lyssavirus species have been identified worldwide, causing a disease similar to RABV. Non-rabies-related human deaths have been described, but the number of cases is unknown, and the potential of such lyssaviruses causing human disease is unpredictable. The current rabies vaccine does not protect against divergent lyssaviruses such as Mokola virus (MOKV) or Lagos bat virus (LBV). Thus, a more broad pan-lyssavirus vaccine is needed. Here, we evaluate a novel lyssavirus vaccine with an attenuated RABV vector harboring a chimeric RABV glycoprotein (G) in which the antigenic site I of MOKV replaces …

Barriers To And Facilitators Of Implementing Colorectal Cancer Screening Evidence-Based Interventions In Federally Qualified Health Centers: A Qualitative Study, Emanuelle M Dias, Joe R Padilla, Paula M Cuccaro, Timothy J Walker, Bijal A Balasubramanian, Lara S Savas, Melissa A Valerio-Shewmaker, Roshanda S Chenier, Maria E Fernandez

Faculty, Staff and Student Publications

Background: There is an urgent need to increase colorectal cancer screening (CRCS) uptake in Texas federally qualified health centers (FQHCs), which serve a predominantly vulnerable population with high demands. Empirical support exists for evidence-based interventions (EBIs) that are proven to increase CRCS; however, as with screening, their use remains low in FQHCs. This study aimed to identify barriers to and facilitators of implementing colorectal cancer screening (CRCS) evidence-based interventions (EBIs) in federally qualified health centers (FQHCs), guided by the Consolidated Framework for Implementation Research (CFIR).

Methods: We recruited employees involved in implementing CRCS EBIs (e.g., physicians) using data from a …

Costs And Impact Of Disease In Adults With Sickle Cell Disease: A Pilot Study, Sophie Lanzkron, Nicole Crook, Joanne Wu, Sarah Hussain, Randall G. Curtis, Derek Robertson, Judith R. Baker, Diane Nugent, Amit Soni, Jonathan C. Roberts, Megan M. Ullman, Julie Kanter, Michael B. Nichol

Cardeza Foundation for Hematologic Research

We assessed the feasibility to estimate illness burden in adults with SCD, investigated factors associated with health-related quality of life (HRQoL), and estimated societal burden. We recruited 32 participants and collected data on fatigue, HRQoL, and work productivity and activity impairment via patient survey. Health care utilization was abstracted for the 12 months before enrollment using medical chart review. Mean age was 36.7 years; 84.4% of participants had hemoglobin SS or Sβthal0 disease, and 81.3% reported chronic pain (experiencing pain on ≥3 days per week in the past 6 months). Mean EQ-5D-3L visual analogue scale score was 63.4 and the …

Discordant Prenatal Cell-Free Dna Screening Vs. Diagnostic Results Of Sex Chromosome Aneuploidies: Implications For Newborn Screening And Genetic Counseling, Susan Howell, Shanlee M. Davis, Billie Carstens, Mary Haag, Judith L. Ross, Nicole R. Tartaglia

Department of Pediatrics Faculty Papers

Sex chromosome aneuploidies (SCAs) collectively occur in 1 in 500 livebirths, and diagnoses in the neonatal period are increasing with advancements in prenatal and early genetic testing. Inevitably, SCA will be identified on either routine prenatal or newborn screening in the near future. Tetrasomy SCAs are rare, manifesting more significant phenotypes compared to trisomies. Prenatal cell-free DNA (cfDNA) screening has been demonstrated to have relatively poor positive predictive values (PPV) in SCAs, directing genetic counseling discussions towards false-positive likelihood rather than thoroughly addressing all possible outcomes and phenotypes, respectively. The eXtraordinarY Babies study is a natural history study of children …

Prothrombin Time (Pt), Activated Partial Thromboplastin Time (Aptt), Fibrinogen, And D-Dimer In Coronavirus Disease 2019 Outcome, Fredy Wirya Atmaja, Sri Suryo Adiyanti, Diyah Kristanty, Surya Dwira, Kusmardi Kusmardi

Indonesian Journal of Medical Chemistry and Bioinformatics

COVID-19, caused by SARS-CoV-2 has been reported to be associated with coagulopathy and DIC. This study aimed to investigate the profiles and differences of PT, APTT, fibrinogen, and D-dimer in COVID- 19 outcome. This retrospective cohort was conducted at Central Laboratory Clinical Pathology Department of dr. Cipto Mangunkusumo Hospital from July – December 2020. Demographic, clinical, and laboratory data were extracted from EHR and compared between poor and good outcome. Ninety-seven subjects were confirmed positive COVID-19, 45 of whom (46.4%) were in poor outcome group, while 52 subjects (53.6%) were in good outcome group. Median of PT 11.0” (9.7-28.3), APTT …

Perceived Stress, Social Media Usage, And Sleep Quality In United States Adults, Justine P. Scott

Walden Dissertations and Doctoral Studies

The purpose of this quantitative study was to explore the intricate connections among perceived stress, sleep quality, and social media usage metrics, challenging prior assumptions by highlighting social media as a noteworthy stress coping mechanism. The research aimed to understand the relationship between sleep quality, perceived stress, and the frequency and quality of social media use, guided by the biopsychosocial model as the theoretical framework.The study involved adults aged 20-65. A questionnaire incorporated four validated instruments to assess these variables: the Epworth Sleepiness Scale (ESS), Internet Addiction Diagnostic Questionnaire (IADQ), Perceived Stress Scale (PSS), and Social Media Quality Measure (SMQM). …

Tsg-6+ Cancer-Associated Fibroblasts Modulate Myeloid Cell Responses And Impair Anti-Tumor Response To Immune Checkpoint Therapy In Pancreatic Cancer, Swetha Anandhan, Shelley Herbrich, Sangeeta Goswami, Baoxiang Guan, Yulong Chen, Marc Daniel Macaluso, Sonali Jindal, Seanu Meena Natarajan, Samuel W Andrewes, Liangwen Xiong, Ashwat Nagarajan, Sreyashi Basu, Derek Ng Tang, Jielin Liu, Jimin Min, Anirban Maitra, Padmanee Sharma

Faculty, Staff and Student Publications

Resistance to immune checkpoint therapy (ICT) presents a growing clinical challenge. The tumor microenvironment (TME) and its components, namely tumor-associated macrophages (TAMs) and cancer-associated fibroblasts (CAFs), play a pivotal role in ICT resistance; however, the underlying mechanisms remain under investigation. In this study, we identify expression of TNF-Stimulated Factor 6 (TSG-6) in ICT-resistant pancreatic tumors, compared to ICT-sensitive melanoma tumors, both in mouse and human. TSG-6 is expressed by CAFs within the TME, where suppressive macrophages expressing Arg1, Mafb, and Mrc1, along with TSG-6 ligand Cd44, predominate. Furthermore, TSG-6 expressing CAFs co-localize with the CD44 expressing macrophages in the TME. …

Correction: A Microcosting Approach For Planning And Implementing Community-Based Mental Health Prevention Programs: What Does It Cost?, Sharmily Roy, Henry Shelton Brown, Lisa Sanger Blinn, Sarah Carter Narendorf, Jane E Hamilton

Faculty, Staff and Student Publications

No abstract provided.

Radiation Therapy With Or Without Cisplatin For Local Recurrences Of Endometrial Cancer: Results From An Nrg Oncology/Gog Prospective Randomized Multicenter Clinical Trial, Ann H Klopp, Danielle Enserro, Matthew Powell, Marcus Randall, Julian C Schink, Robert S Mannel, Laura Holman, David Bender, Christina L Kushnir, Floor Backes, Susan L Zweizig, Steven Waggoner, Kristin A Bradley, Lana Desouza Lawrence, Parviz Hanjani, Christopher J Darus, William Small, Higinia R Cardenes, Jonathan M Feddock, David S Miller

Faculty, Staff and Student Publications

Purpose: Pelvic recurrence is a frequent pattern of relapse for women with endometrial cancer. A randomized trial compared progression-free survival (PFS) after treatment with radiation therapy alone as compared with concurrent chemotherapy.

Materials and methods: Between February 2008 and August 2020, 165 patients were randomly assigned 1:1 to receive either radiation treatment alone or a combination of chemotherapy and radiation treatment. The primary objective of this study was to determine whether chemoradiation therapy was more effective than radiation therapy alone at improving PFS.

Results: The majority of patients had low-grade (1 or 2) endometrioid histology (82%) and recurrences confined to …