Medicine and Health Sciences Commons^™

Experiences Of Lgbtqia+ Medical Students: Gaps And Challenges During Preclinical Education., Samantha Temucin, Natalie Florescu, Paige Varin, Leeann Tanaka, Robert Bettiker, Erin N Harrop, Kendrin Sonneville

PCOM Scholarly Works

Background

While attempts to diversify the physician workforce are ongoing, limited research exists exploring the experiences LGBTQIA+ medical students during their preclinical training. The purpose of this study is to examine how interpersonal interactions, campus climate, and the availability of campus support influence the well-being of LGBTQIA+ medical students across U.S. medical schools during their preclinical education.

Method

Medical students self-identifying as LGBTQIA + and enrolled in either Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) institutions in the U.S. in 2024 completed an online, 136-item survey. Participants were asked about preclinical medical school experiences, perceptions of their …

Comparative Evaluation Of Orthodontic Measurements Using Two Intraoral Scanners Versus Conventional Plaster Models: An In Vivo Study, Pranoy Nair, Achint Juneja, Monis Raza, Prashant Shahi, Ridhi Kothari, Deepthi Raj

International Arab Journal of Dentistry

Introduction: This study evaluated and compared the accuracy and reliability of two intraoral scanners, iTero Element 1 and Panda P2, with conventional plaster models for essential orthodontic measurements.

Methods: Thirty subjects were evaluated using three methods: plaster casts, iTero Element 1, and Panda P2. Inter-canine distance, inter-molar distance, overjet, overbite, and Bolton’s ratios were measured. Data was analysed using one-way ANOVA and Tukey’s post-hoc test after confirming normality (Shapiro–Wilk). Intra-operator reliability was assessed using Dahlberg’s formula and ICC.

Results: No statistically significant differences were observed among the three methods (p > 0.05). Both scanners demonstrated high repeatability and minimal measurement error, …

Virtual Reality For The Management Of Postoperative Pain And Anxiety In Children And Adolescents Undergoing Nuss Repair Of Pectus Excavatum: Randomized Controlled Trial, Charlotte M. Walter, Dillon Froass, Nora Bell, Lauren Haack, Chloe Boehmer, Claudia Bruguera Torres, Rachel Spivak, Max Chou, Kristie Geisler, Keith O'Conor, Sara E. Williams, Lili Ding, Christopher D. King, Vanessa A. Olbrecht

Department of Medicine Faculty Papers

BACKGROUND: Virtual reality (VR) is a novel technology with implications for pain and sensory processing. VR may serve as a novel, scalable method to deliver clinically validated therapy for pain management as an alternative or adjunct to opioids for acute pain. Given that psychological factors and pain perception are both components of postoperative pain, it may also be beneficial to incorporate modalities that decrease anxiety, such as active relaxation and guided meditation with VR. Unfortunately, these therapies are not widely available due to multiple barriers. VR has the potential to deliver pain-reducing, psychologically based therapy to children, thereby enhancing multimodal …

Molecular Risk Markers Define Risk Of Relapse In Myeloid Leukemia Of Down Syndrome Beyond Measurable Residual Disease., Jason N. Berman, Anupam Verma, Shelton Viola, Todd A. Alonzo, Yi-Cheng Wang, Lisa Eidenschink Brodersen, Michael Loken, Amy Beckman, Betsy Hirsch, Susana Raimondi, Karen M. Chisholm, Xiaotu Ma, Rhonda Ries, Soheil Meshinchi, Alan S. Gamis, Reuven Schore, Jeffrey W. Taub, E Anders Kolb, Todd Cooper, Johann Hitzler

Manuscripts, Articles, Book Chapters and Other Papers

Myeloid leukemia of Down syndrome (ML-DS) is a distinct form of pediatric acute myeloid leukemia (AML) that responds to reduced-intensity chemotherapy, as compared with non-DS AML that requires intensive chemotherapy and often stem cell transplant. While most patients with ML-DS have a favorable prognosis, outcomes for those with refractory or relapsed disease are dismal. Children's Oncology Group study AAML1531 introduced the use of measurable residual disease by multiparameter flow cytometry at the end of the first course of induction therapy (EOI-1 MRD) for risk stratification of treatment intensity. Of 280 patients with ML-DS who were enrolled, 41 were classified as …

A Multi-State Look Into Early Intervention Speech-Language Pathologists’ Confidence Identifying And Diagnosing Autism, Allison Gladfelter, Adelaide Parr, Anna Cannone, Sarah O'Connor

CISLL Publications

Purpose: Although autism can be reliably diagnosed by 18 months of age, long wait times and limited access to qualified providers prevent families from obtaining timely diagnostic services. Trained speech-language pathologists (SLPs) are qualified to diagnose autism, ideally as part of a multidisciplinary team. SLPs working on early intervention (EI) teams are well-situated to help close this diagnostic wait time gap. The purpose of this survey study was to explore EI SLPs’ experiences serving autistic children, confidence in identifying and diagnosing autism, and their perceptions of barriers or facilitators to diagnostic confidence and wait times.

Method: 287 EI SLPs from …

Potency-Related Effects Of Smoked Cannabis On Simulated Driving Performance: A Randomized, Controlled Crossover Trial, Bruna Brands, Adam Zaweel, Madison Wright, Patricia Di Ciano, Christine M. Wickens, Justin Matheson, Andrew Fares, Omer S. M. Hasan, Marcos Sanches, Beth Sproule, Marilyn A. Huestis, Timothy L. Brown, Bernard Le Foll

Institute of Emerging Health Professions Faculty Papers

Given the increasing availability of high-potency Δ9-tetrahydrocannabinol (Δ9-THC) products, understanding potency-related effects of Δ9-THC on driving performance is an important public safety issue. This randomized, double-blind, placebo-controlled, within-subjects trial examined the effects of smoked cannabis with varying Δ9-THC concentrations on simulated driving. Adults aged 19–45 who regularly used cannabis and held valid driver’s licenses completed simulated driving tasks after smoking placebo, or cannabis containing low (6.25%/47 mg Δ9-THC), medium (12.5%/94 mg Δ9-THC), or high (22%/165 mg Δ9-THC) Δ9-THC levels. The primary outcome was mean speed (km/h); secondary measures included maximum speed, standard deviation of lateral position (SDLP), reaction time (RT), …

Incidence And Risk Factors Of Recoarctation Following Surgical Repair Of Aortic Coarctation In Infants: A Retrospective Single-Centre Study, Hamid Atiyaq Al Badi, Hamood Al Kindi, Khalid Al Alawi, Abdullah Al Furqani, Laith Al Kindi, Madan Mohan Maddali

Sultan Qaboos University Medical Journal

Objectives: The reported incidence and risk factors for aortic recoarctation (reCoA) after surgical repair in infants vary widely. This study aimed to determine the incidence of reCoA and to identify associated risk factors in a cohort of infants. Secondary objectives included assessing parameters associated with reintervention. Methods: This retrospective cohort study was conducted at the National Heart Center, Muscat, Oman, and included all infants who underwent surgical repair of coarctation of the aorta (CoA) from January 2016 to December 2022. Preoperative, intraoperative and postoperative data were collected, including demographics, prostaglandin E2 use, surgical technique and echocardiographic measurements. Recoarctation was defined …

Paternal Alienation, Paternal Strain, Generativity, Adjustment, And Resilience (P-Apgar): A Conceptual Framework For Fathers’ Perinatal Psychosocial Adjustment, Rachael Elizabeth Schmitz

Nursing and Health Sciences

Paternal perinatal depression is underrecognized, and existing tools often fail to capture male-specific symptomatic expressions. Fathers experience significant psychosocial changes during the transitional period, yet clinical assessment of paternal mental health remains largely absent from routine clinical practice. This paper introduces a multi-dimensional tool called the P-APGAR. The theory-informed conceptual tool is meant to guide the assessment of fathers’ perinatal adjustment, operationalizing core elements of role-based, relational, and emotional adaptation. The model adapts the logic of the traditional newborn APGAR score to a father-centered context based on Paternal Identity, Alienation, Paternal Strain, Generativity, Adjustment, and Resilience. A theoretical synthesis approach …

The Association Of P27 With Prostate Cancer Outcomes: A Secondary Analysis Of Nrg/Rtog 8610 And 9202, Krishnan Patel, Stephanie Pugh, Jeffry Simko, Anthony Zietman, Michelangelo Fiorentino, David Paul D'Souza, Seth Rosenthal, Adam Currey, Adam Dicker, Bradley Stish, Eric Horwitz, Tyler Robin, Michael Dominello, Christopher Peters, Kwang Choi, Jason Efstathiou, Samir Narayan, George Daniel Grass, Zaker Rana, Phuoc Tran, Massimo Loda, Paul Nguyen

Kimmel Cancer Center Faculty Papers

PURPOSE: The cyclin-dependent kinase inhibitor p27 is a well-profiled modulator of cell cycle progression. Low nuclear p27 levels have been demonstrated to have a negative prognostic impact on outcomes in patients undergoing prostatectomy. The prognostic value of p27 after radiation therapy (RT) for prostate cancer is unknown.

METHODS AND MATERIALS: Levels of p27 were evaluated in pre-RT prostate biopsy samples from 2 randomized, phase 3 trials, NRG/RTOG 8610 and 9202, which treated patients with RT with or without androgen deprivation therapy (ADT). Nuclear p27 was analyzed using immunohistochemistry and quantified using automated imaging analysis. The association of p27 as both …

Clinical Trial Success Rate In Lymphoma: Fate Of Trials And Agents From 2000 To 2019, Zhiping Luo, Meng Li, Brian C Primeaux, Rahul Shah, Ruitao Lin, Swaminathan P Iyer, Loretta J Nastoupil, Michael R Green, Jason R Westin, Christopher R Flowers, Dai Chihara

Faculty, Staff and Student Publications

Although previous studies have examined the drug development and clinical trial success rates in oncology, a comprehensive analysis of development success rate in lymphoma has not been performed. Therefore, we analyzed lymphoma trials initiated between 1 January 2000 and 31 December 2019, using the Trialtrove database and ClinicalTrials.gov. We identified phase 1, 2, and 3 trials that included patients with lymphoma and analyzed the transition rate of investigational agents across phases and their US Food and Drug Administration (FDA) approval rates to assess the efficiency and success of the clinical development process. A total of 1032 phase 1 trials and …

Endometriosis Knowledge Among Emergency Medicine Providers: Diagnostic Skills And Symptom Recognition, Caidon Iwuagwu, Laurel X. Chen, Ellen Slattery, Pranjal Srivastava, Hamsitha Karra, Sheyenne Tung, Adrienne Burton, Camila Bomtempo, Jamie Aranda

Department of Surgery Faculty Papers

Objective: Endometriosis is associated with significant diagnostic delays, averaging 6.7 years, largely due to nonspecific symptoms and inadequate diagnostic approaches. Over 15,000 emergency department (ED) visits in the United States annually involve patients with endometriosis, highlighting the need for knowledge of endometriosis. This study surveys emergency medicine (EM) attendings, residents, nurse practitioners, physician assistants, and fellows to assess knowledge and practice in managing endometriosis-related ED complaints. Methods: A questionnaire from a prior endometriosis survey was modified for EM providers and administered anonymously via email (Qualtrics, Provo, UT) in monthly newsletters to providers at an academic and six associated community EDs. …

International Consensus-Driven Recommendations For Patient-Reported Outcome Research Objectives In Early Phase Dose-Finding Oncology Trials: Optimise-Ror, Emily Alger, Olalekan Lee Aiyegbusi, Amylou C Dueck, Anna Minchom, Madeline Pe, John D Peipert, Claire Snyder, Stefan N Symeonides, Roger Wilson, Ethan Basch, Yu Qiao, Susan E Bates, Helen Bulbeck, Lizzie Dean, Massimo Di Maio, Aaron R Hansen, Olga Kholmanskikh, Ken Kobayashi, Dónal Landers, Christophe Le Tourneau, J Jack Lee, Brigette B Y Ma, Lynley V Marshall, Sheetal Patel, Joan Petrie, Gregory R Pond, Kieran Prior, Khadija R Rantell, John F Reeve, Olga Solovyeva, Nolan A Wages, Harald A Weber, Melanie J Calvert, Christina Yap

Faculty, Staff and Student Publications

Purpose: There is growing scientific interest in incorporating patient-reported outcomes (PROs) in early phase dose-finding oncology trials (DFOTs) to assess tolerability, inform dose selection, and guide later stage trial design. However, research indicates that PRO objectives in DFOTs are often unclear. The Incorporating Patient-Reported Outcomes in Dose-Finding Trials-Research Objectives Recommendations (OPTIMISE-ROR) project was established to support trialists to effectively incorporate PROs into DFOTs.

Methods: Using the Enhancing Quality and Transparency of Health Research (EQUATOR) Network's methodological framework, guideline development included the following: (1) a methodological review of published DFOTs incorporating PROs; (2) candidate item generation, refined through expert consultation; (3) …

Hematopoietic Cell Transplantation For Wiskott-Aldrich Syndrome: A Pidtc Report, Jessie L Alexander, Blachy J Dávila Saldaña, Ruta Brazauskas, Sravya Gethika Dammalapati, Linda M Griffith, Ami J Shah, Kristin A Shimano, Hans D Ochs, Jack J Bleesing, Christen L Ebens, Malika Kapadia, Andrea Bauchat, Neena Kapoor, Joseph H Oved, Hesham Eissa, Hannah Lust, Michael D Keller, Hilary Haines, Shanmuganathan Chandrakasan, Julie-An Talano, Ahmad Rayes, Lisa Madden, Evan Shereck, Holly K Miller, Lisa Forbes Satter, Caridad Martinez, Jacob Rozmus, Jeffrey J Bednarski, Lolie C Yu, Deepakbabu Chellapandian, Victor M Aquino, Alan Knutsen, Hey Chong, Ashley Chopek, Alfred P Gillio, Avni Joshi, Hemalatha Rangarajan, Theodore B Moore, Jeffrey R Andolina, Kenneth B Desantes, Mark Vander Lugt, Susan E Prockop, David C Shyr, Kathleen E Sullivan, Suhag Parikh, Katja G Weinacht, Troy R Torgerson, Rebecca Marsh, Christopher C Dvorak, Alice Y Chan, Elie Haddad, Jennifer R Heimall, Michael A Pulsipher, Jennifer W Leiding, Donald B Kohn, Jennifer M Puck, Luigi D Notarangelo, David J Rawlings, Morton J Cowan, Aleksandra Petrovic, Sung-Yun Pai, Lauri M Burroughs

Faculty, Staff and Students Publications

Wiskott-Aldrich syndrome (WAS), an X-linked disorder characterized by immunodeficiency, thrombocytopenia, autoimmunity, and malignancy, can be effectively treated with allogeneic hematopoietic cell transplantation (HCT). Older age at HCT and mismatched donors are known to affect overall survival (OS). However, the influence of specific clinical manifestations or WAS variant class on OS and factors associated with event-free survival (EFS) remain incompletely defined. We analyzed outcomes of 308 patients with WAS who underwent HCT at 37 institutions of the Primary Immune Deficiency Treatment Consortium from 1990 to 2018. With a median follow-up of 5.3 years, the 5-year OS and EFS were 87.2% and …

Bacterial Fecal Microbiome Composition Associated With Hiv Stage Among Rural And Peri-Urban Adults Living With Hiv In Uganda, Bożena M Morawski, Elise R Morton, Miya Yunus, Claudia Muñoz-Zanzi, Rojelio Mejia, Ran Blekhman, David R Boulware, Sarah M Lofgren

Faculty, Staff and Students Publications

Background

Gut microbiome composition in HIV-infection provides insight into HIV pathogenesis and potentially offers avenues to adjunctive HIV therapies. Although two-thirds of people living with HIV (PLHIV) are in Africa, studies of the gut microbiome PLHIV have focused on non-African populations. Additionally, social, cultural, and environmental factors influence the gut microbiome and differ substantially between African and Western and urban and rural communities. Here, we quantify the relationships between immune status and fecal microbiome composition in 175 rural Ugandan PLHIV.

Methods

In 2013, 175 Ugandan PLHIV contributed a single fecal sample as part of a cohort study of 202 participants. …

Underexplored Maternal Microbiomes: Immune, Metabolic, And Microbial Pathways Shaping Pregnancy Outcomes, Rafael Tomoya Michita, Nicole Jimenez, Melissa M Herbst-Kralovetz, Indira U Mysorekar

Faculty, Staff and Students Publications

Maternal microbial ecosystems play critical roles in shaping reproductive physiology and pregnancy outcomes. During the pre-conception and prenatal periods, these communities modulate maternal physiology by regulating immune tolerance, nutrient metabolism, and susceptibility to pregnancy complications such as preterm birth, hypertensive disorders, and gestational diabetes. While the gut microbiota has been extensively studied, the roles of cervicovaginal, urinary, respiratory, oral, and upper reproductive tract microbiomes remain less clear. In this minireview, we synthesize current knowledge on these underexplored maternal microbiomes, with an emphasis on the cervicovaginal and urinary microbiota and their interactions with the placenta and fetus. We discuss cross-niche microbial …

Evaluating Strategies For Reducing Rates Of Adult Obesity In The United States Through Childhood Education And Exercise, Ameer M. Abdelkrim

Doctoral Dissertations and Projects

Obesity is a growing national public health crisis, impacting millions of adults and children in the U.S. Untreated obesity causes or aggravates diseases across multiple body systems. The societal impacts of obesity include an avoidable strain on the national healthcare system, with obesity and its comorbid conditions raising healthcare costs. Proactive policy and practices, with strict oversight, are essential for achieving a reduction in obesity rates. One proactive strategy that may be effective is early-age intervention, including enhanced physical activity and nutrition education for U.S. children. This study evaluates adolescent-intervention strategies for reducing rates of adult obesity. The employed methods …

The Role Of Personality In Collegiate Athletes’ Indicators Of Performance And Injury Experiences – A Mixed Methods Study, Allison Traub

Doctoral Dissertations and Projects

This mixed methods study explores the impact of collegiate athletes' indicators of personality traits as attributed to athletic performance, injury experiences, and sport identity. Sports often emphasize physical abilities, yet the role of personality is equally significant—though it has received comparatively little attention in psychological research. This research addresses such a gap through examining how personality traits shape athletes’ competitive behavior along with coping strategies. The traits are defined within the 16 Personalities framework using Myers-Briggs Type Indicator (MBTI) and how it influences just how athletes recover. This research will explore research questions such as how personality affects college athletes' …

Investigating Nursing Instructors’ Perceptions Of Students’ Critical Thinking And Clinical Judgment After Attending A Flipped Pathophysiology Course, Ashley L. Harmon

Doctoral Dissertations and Projects

The purpose of this phenomenological study was to understand an instructor’s ability to develop critical thinking and clinical judgment for pathophysiology nursing students at a state university in the southeastern United States while using the flipped pedagogical approach. The theory guiding this study was Piaget’s constructivist theory, which aligned with the active role of learners in constructing knowledge, and supported the exploration of how flipped classrooms influenced the development of critical thinking and clinical judgment. The central research question for this study was: What are nursing instructors’ perceptions of students' development of critical thinking and clinical judgment when applying pathophysiology …

The Schizophrenia Effect: Families Facing Schizophrenia-Spectrum Disorders, Ginger A. Christmas

Doctoral Dissertations and Projects

Schizophrenia is primarily known for its bizarre psychosis, as the brain struggles to distinguish between what is real and what is not. This qualitative study employed constructive, interpretative phenomenological analysis (IPA) to explore the idea that families with a family member diagnosed with a schizophrenia-spectrum disorder (SSD) in the United States have specific needs, which may include social and spiritual support and integration into treatment. While the needs of families facing SSD have been studied in non-Western countries, the schizophrenia effect on families in the U.S. remains less understood. A purposive sample of 11 individuals, representing 15 family members with …

A Phenomenological Study Of Complex Post-Traumatic Stress Disorder In Combat Deployed Women Combat Veterans, Caren Valencia Chen

Doctoral Dissertations and Projects

The purpose of this phenomenological study was to delineate factors that impact women combat veterans with Complex Post-Traumatic Stress Disorder (C-PTSD) after deployment and completion of military service. The theory guiding this was Strauss and Corbin’s grounded theory. The conceptual framework guiding the study was Crenshaw's intersectionality theory. C-PTSD is often diagnosed with service members throughout their time in the military, and after their time in the military is complete. The central research question, “What are the lived experiences of women combat veterans diagnosed with C-PTSD?” was addressed through interviews with focus groups. The sub-questions to analyze direct correlation issues …

Health Disparities Resulted From The Relationships Between Vulnerable Patients And Providers, Matthew Maurice Bradley

Doctoral Dissertations and Projects

The study's purpose was to understand patterns of mistrust between providers and patients in vulnerable and underserved populations. The theories guiding this study were the critical theory and the critical race theory created by Max Horkheimer as it explains how people can collaborate and actively participate in rebuilding trust. The intention is to rebuild trust and reduce health disparities in the United States. The general problem is the lack of provisional resources for underserved and vulnerable communities, resulting in the population lacking trust in healthcare administration. Speicher and Francis (2022) examined how increasing physician turnover, burnout, depression, and dissatisfaction affect …

Emapalumab Use In Malignancy-Associated Hemophagocytic Lymphohistiocytosis In The United States: The Real-Hlh Study, Adi Zoref-Lorenz, Carl E Allen, Edward M Behrens, Shanmuganathan Chandrakasan, May Chien, Michelle L Hermiston, Ashley P Hinson, Stefanos Intzes, Michael S Isakoff, Jennifer W Leiding, Abiola Oladapo, Arun Panigrahi, Sachit A Patel, Priti Pednekar, Anish K Ray, Jennifer A Rothman, Blachy Dávila Saldaña, Kelly J Walkovich, Joanna Weinstein, John D Yee, Michael B Jordan, Joanna Weinstein, Ashley P Hinson, Carl E Allen, Olive S Eckstein, Nitya Gulati, Shanmuganathan Chandrakasan, Hilary Haines, Taizo A Nakano, Sachit A Patel, Edward M Behrens, Stefanos Intzes, Allyson Hays, Blachy Dávila Saldaña, Michael B Jordan, Adi Zoref-Lorenz, Rabi Hanna, Michael Isakoff, Anish K Ray, Jennifer A Rothman, Anand Tandra, Robert Cooper, Jennifer W Leiding, May Chien, Susmita Sarangi, Vinod K Gidvani-Diaz, Prakash Satwani, John Carter, Michael Henry, Nicholas Gloude, Sima Bhatt, Deepika Bhatla, Lauren Draper, Arun Panigrahi, Michelle L Hermiston, Renee Modica, Mona Riskalla, Ashley Baker, Brant Ward

Faculty, Staff and Students Publications

Malignancy-associated hemophagocytic lymphohistiocytosis (mHLH), a hyperinflammatory syndrome, has poor prognosis and no standard therapy. Emapalumab, a fully human monoclonal antibody that neutralizes the proinflammatory cytokine interferon gamma, is approved for treating primary hemophagocytic lymphohistiocytosis (pHLH). REAL-HLH, a retrospective chart review conducted across 33 US hospitals, evaluated real-world treatment patterns and outcomes in patients treated with ≥1 dose of emapalumab between 20 November 2018 and 31 October 2021. Data are presented for the subset of patients with mHLH. Overall, 51 of 105 (48.6%) patients were categorized as having secondary HLH, of which 17 of 51 patients had HLH associated with an …

Incarcerated Geriatric Patients’ Experiences Of Aging And Healthcare, Michelle I Suh, Stephen Chen, Megan Benavides, Sumin Yoon, Nia Lucas, Josiah D Rich, Marc David Robinson, Anita N Chary

Faculty, Staff and Students Publications

Older adults comprise the fastest growing demographic in correctional facilities in the United States. Studies have shown older adults in prison report difficulty accessing healthcare and navigating the prison environment. Little is known about how older adults navigate aging and access healthcare in the jail setting. We sought to explore experiences of older adults incarcerated in a county jail. We conducted semi-structured qualitative interviews with 20 older adults (> 50 years old) who were incarcerated at a local county jail and were referred to the emergency department for acute care needs. Interviews focused on experiences of aging while incarcerated and …

An Interpretable Machine Learning Model For Predicting Prognosis Of Medulloblastoma Integrating Genetic And Clinical Features, Yu Su, Kaiwen Deng, Xuan Chen, Zhaoyang Feng, Dongyang Wang, Craig Daniels, Hyun Yong Koh, Ricardo Daniel Gonzalez, Hiromichi Suzuki, Tsubasa Miyauchi, Fei Liu, Wei Wang, Jiankang Li, Shuaicheng Li, Rui Chen, Xiaoguang Qiu, Chunde Li, Tao Jiang, Michael D Taylor, Jiao Zhang, Hailong Liu, Yu Tian

Faculty, Staff and Students Publications

Background: Medulloblastoma (MB), the most common malignant pediatric brain tumor, lacks prognostic tools integrating clinical, molecular, and treatment-related characteristics for individualized management.

Methods: We developed machine learning models using multicenter data from 729 Chinese patients (2001-2023), of whom 509 were assigned to the training set and 220 to the testing set, and further validated the models on 201 patients from international MB consortia. To accommodate patients and researchers with varying datatypes, four application scenarios were established, including clinical-molecular-radiotherapy (CMR), clinical-molecular (CM), clinical-radiotherapy (CR), and clinical-only (CO).

Results: We construct four model scenarios and assess their predictive performance in the testing …

Hematopoietic Cell Transplantation For Wiskott-Aldrich Syndrome: A Pidtc Report, Jessie L Alexander, Jeffrey J Bednarski, Et Al.

2020-Current year OA Pubs

Wiskott-Aldrich syndrome (WAS), an X-linked disorder characterized by immunodeficiency, thrombocytopenia, autoimmunity, and malignancy, can be effectively treated with allogeneic hematopoietic cell transplantation (HCT). Older age at HCT and mismatched donors are known to affect overall survival (OS). However, the influence of specific clinical manifestations or WAS variant class on OS and factors associated with event-free survival (EFS) remain incompletely defined. We analyzed outcomes of 308 patients with WAS who underwent HCT at 37 institutions of the Primary Immune Deficiency Treatment Consortium from 1990 to 2018. With a median follow-up of 5.3 years, the 5-year OS and EFS were 87.2% and …

Differential Contributions Of Clpx And Clpp To Pulmonary Virulence In Classical And Hypervirulent Klebsiella Pneumoniae, Nathan M Lin, Emily C Marino, Jordan M Schlotmann, David A Rosen

2020-Current year OA Pubs

No abstract provided.

Adaptations To An Implementation Study For Integrating Hypertension Management Into Hiv Care In Lagos, Nigeria: Application Of The Frame, Chioma Hope Nwankwo, Juliet Iwelunmor, Et Al.

2020-Current year OA Pubs

BACKGROUND: Implementation strategies are dynamic and multi-faceted, and may require adaptations to fit implementation contexts, especially in lower-and-middle income countries. We report the adaptations for an ongoing late-stage implementation science trial (R01HL147811) that integrates hypertension management into HIV care in Lagos, Nigeria - a country with a high dual-disease burden - through the Task Strengthening Strategy for Hypertension (TASSH) intervention and Practice Facilitation implementation strategy.

METHODS: FRAME (Framework for Reporting Adaptations and Modifications-Enhanced) modules were used to record adaptations to the intervention (i.e., TASSH) respectively, enhance participant recruitment and retention rates, and increase frequency of trainings. Data collection sources included …

Recommendations For The Diagnosis And Management Of Cln3 Disease (Batten Disease) Using The Delphi Consensus Methodology, Jonathan W Mink, Jonathan D Cooper, Et Al.

2020-Current year OA Pubs

BACKGROUND: CLN3 disease, also called Juvenile Neuronal Ceroid Lipofuscinosis (JNCL), or Batten disease, is an ultra‑rare, neurodegenerative lysosomal storage disorder generally affecting individuals during the first decade of life. There can be a delay in diagnosis or misdiagnosis due to a lack of awareness, and when the most common presenting symptom of visual loss is attributed to more common conditions affecting vision. METHODS: We used a previously published Expert Mapping Tool (EMT) to identify multidisciplinary professionals with diagnostic or clinical management expertise, as well as patient advocates with experience of CLN3 disease. A systematic literature review of published evidence using …

A Practice-Based Implementation Strategy Bundle For Integrating Behavioral Health In Primary Care: A Matrixed Multiple Case Study, Gretchen Buchanan, Kelley Mccall, Lorella Palazzo, Michelle Bagwell, Shivani Patel, Shravya Allena, Byron J Powell

2020-Current year OA Pubs

BACKGROUND: Integrated behavioral health (IBH) is an evidence-based approach to addressing mental health in primary care settings. It typically involves augmenting a primary care team with a behavioral health professional (e.g., psychologist, licensed clinical social worker) who sees patients for brief, focused concerns; can function as a bridge to specialty care; and provides medical providers with support and education about patient behavioral health concerns. IBH has slowly begun to disseminate across the United States, but practices encounter significant implementation barriers. How IBH is implemented has not been systematically studied outside of trials, yet this study could provide a rich foundation …

Ultrasound-Guided Skeletal Muscle Biopsy Technique Permits Measurement Of Structural, Functional, Cellular And Biochemical Properties, Addison Barber, Amber Willbanks, Guadalupe Meza, Jeremie L A Ferey, Gretchen A Meyer, Sudarshan Dayanidhi, W David Arnold, Richard L Lieber, Ishan Roy

2020-Current year OA Pubs

Human muscle biopsies are often required to study or diagnose diseases. However, traditional approaches are challenging due to limited sample size, quality, or participant discomfort. Fine-gauge needle biopsies (≥ 14-gauge), present an alternative but may yield insufficient tissue for comprehensive analysis. Ultrasound guidance, coupled with vacuum-assisted, single needle-insertion multiple sampling addresses these challenges. In 19 healthy participants (mean age: 30.1 ± 10 years, 42% male), 2-3 samples were collected from a single needle insertion into the vastus lateralis (VL) and tibialis anterior (TA). Summed VL and TA sample masses averaged 148 ± 38 mg and 166 ± 64 mg, with …