Medicine and Health Sciences Commons^™

Evaluating Differences In Nonsyndromic Orofacial Clefts By Infant Sex: National Birth Defects Prevention Study, 1997-2011, Victoria A Salinas, Natalie P Archer, Layla R Lustri, Katherine L Ludorf, Timothy Ihongbe, Wei Yang, Eva M Williford, Marilyn L Browne, Adrian M Michalski, Lindsay A Williams, Wendy Nembhard, Eirini Nestoridi, Gary M Shaw, Andrew F Olshan, A J Agopian, National Birth Defects Prevention Study

Faculty, Staff and Student Publications

Objective: To investigate nongenetic factors that may contribute to observed differences in nonsyndromic orofacial clefts by infant sex.

Study design: Using data for 1997-2011 deliveries from the National Birth Defects Prevention Study, a case-control study, we separately examined associations between 23 maternal factors and cleft lip with or without cleft palate (CL/P) and cleft palate alone (CP) using multivariable logistic regression stratified by infant sex.

Results: We compared 2986 infants with CL/P and 1557 with CP to 11 271 control infants without birth defects. After adjusting for maternal age at conception and education, lower odds of nonsyndromic orofacial clefts were …

Enhancing Data Compatibility In An Evolving Landscape: Medical Cannabis And Polysubstance Use Protocols In The Phenx Toolkit, Anne Buu, Johannes Thrul, Amanda Bunting, Tamara Haegerich, Wayne Huggins, Christian Hopfer, Denise Vidot, Cataia Ives, Ryan Mcneil, Sarah Zemore, Corrie Vilsaint, Elizabeth Fallon, Christine Hill, Carol Hamilton, John Kelly

Faculty, Staff and Student Publications

Introduction: With increasing legalization of medical cannabis and prevalence of polysubstance use in the United States comes the need for standard psychometrically validated measures to study these substances' health effects in the population. The PhenX (consensus measures for Phenotypes and eXposures) Toolkit (www.phenxtoolkit.org) is a freely accessible catalog of recommended measurement protocols to promote data compatibility across studies, but this extensive catalog did not include measures in these important areas.

Methods: In 2024, a PhenX Working Group of experts followed a well-established consensus process to identify and recommend measurement protocols suitable for inclusion in studies on medical cannabis and polysubstance …

Population-Based Analysis Of Synergistic Effects Of Functional Disability And Comorbidities On Retention In Hiv Care Among People With Hiv, Modupe Olajumoke Onigbogi, Osaro Mgbere, Paul Rowan, Ruosha Li, Charles Darkoh

Faculty, Staff and Student Publications

Objective: This cross-sectional study examined how types of disability and comorbidities influence retention in care (RIC) among people with HIV (PWH) in Houston/Harris County, Texas, USA.

Methods: Data from 1142 participants in the Houston Medical Monitoring Project (2015–2021) were analyzed. Descriptive statistics, bivariate analyses, and multivariable logistic regression were used to evaluate factors associated with RIC.

Results: Approximately 74.9% of participants were retained in care. Compared to PWH without specific comorbidities, those with dyslipidemia and kidney disease had higher odds of RIC (AOR: 2.66; 95% CI: 1.40–5.03 and AOR: 14.08; 95% CI: 1.44–138.12, respectively). PWH reporting only mobility disability had …

A Complete Diploid Human Genome Benchmark For Personalized Genomics, Nancy F. Hansen, Nathan Dwarshuis, Hyun Joo Ji, Arang Rhie, Hailey Loucks, Glennis A. Logsdon, Mitchell R. Vallger, Jessica M. Storer, Juhyun Kim, Eleni Adam, Nicolas Alternose, Dmitry Antipov, Mobin Asri, Sofia Barreira, Stephanie C. Bohaczuk, Andrey V. Bzikadze, Sara A. Carioscia, Andrew Carroll, Kuan-Hao Chao, Yanan Chu, Arun Das, Peter Ebert, Adam English, Mark Fleharty, Laura E. Fleming, Giulio Formenti, Andrea Guarracino, Gabrielle A. Hartley, Katharine Jenike, Jenna Kalleberg, Yu Kang, Robert King, Josipa Lipovac, Mira Mastoras, Matthew W. Mitchell, Shloka Negi, Nathan D. Olson, Keisuke K. Oshima, Luis F. Paulin, Brandon D. Pickett, David Porubsky, Jane Ranchalis, Desh Ranjan, Mikko Rautiainen, Harold Riethman, Robert D. Schnabel, Fritz J. Sedlazeck, Kishwar Shafin, Mile Sikic, Steven J. Solar, Alexander P. Sweeten, Winston Timp, Justin Wagner, Dongahn Yoo, Ying Zhou, Erik Garrison, Evan E. Eichler, Michaeel C. Schatz, Andrew B. Stergachis, Rachel J. O'Neill, Karen H. Miga, Steven L. Salzberg, Sergey Koren, Justin M. Zook, Adam M. Phillippy

School of Medical Diagnostics & Translational Sciences Publications

Human genome sequencing typically relies on mapping reads to a reference genome to call variants, but this approach introduces technical biases, excluding duplicated and structurally polymorphic regions of the genome. To overcome this, we present a telomere-to-telomere genome benchmark with near-perfect accuracy across 99.4% of the diploid HG002 genome. This benchmark adds 701.4 Mb of autosomal sequence and both sex chromosomes (216.8 Mb), which were absent from prior benchmarks. We annotated genes and repeats on both haplotypes, including 19,956 protein-coding genes on the maternal haplotype and 19,190 on the paternal haplotype, and developed new methods to measure the accuracy of …

Prenatal Exposure To Nicotine And Postpartum Depression: A Systematic Review And Meta-Analysis, Reem Sharaf-Alddin, May Salama, Denise Mckinney, George Saade, Qi Zhang

Health Behavior, Policy & Management Faculty Publications

Purpose: Postpartum Depression (PPD) is the most common mental health complication of childbirth, and has short-term and long-term consequences for mother, child, and the entire family. PPD is a function of several factors. Prenatal exposure to nicotine (PEN) by Active Tobacco Smoking (ATS), Secondhand Smoking (SHS), or Electronic Nicotine Products (ENPs) is a major potential risk factor. This systematic review and meta-analysis aim to summarize and evaluate all evidence regarding the association between PEN and PPD.

Methods: We searched the following databases, PubMed, Medline, Cochrane, EMBASE, and CINHAL, for studies published between Jan.1st ,2000&Sep.19th ,2024, with the outcome PPD. Studies …

Simulation Training In Radiation Oncology, Michael C. Schell, Andrew W. Beavis, Derek W. Brown, Michael Milano, Michael O'Neill, Yan Yu, Daniel C. Pavord, Peter Dunscombe

Department of Radiation Oncology Faculty Papers

Simulation training can be used in the design of new processes or, more commonly, to train and re-train healthcare personnel in standard processes. Simulation training is one avenue to making radiation oncology a high reliability health care intervention. In this paper, we explore the relevance of simulation training to the provision of high-quality and safe radiation oncology practice against the background of simulation training conducted in high reliability industries. The use of simulation training in healthcare, as well as specific examples in radiation oncology, is reviewed. An outline of the steps for developing a simulation training program is provided. Simulation …

Advancing Models Of Ptsd-Aud Comorbidity: Protocol For A Multimethod Framework Using Genetics And Ecological Momentary Assessment, Elizabeth A. Stinson, Samhita Lellapalli, Sage E. Hawn, Natalie Merrill, Lance M. Rappaport, Christina M. Sheerin, Vasiliki Michopoulos, Silviu-Alin Bacanu, Roseann E. Peterson, Abigail Powers, Ananda B. Amstadter

Psychology Faculty Publications

Background: Posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD), which are moderately heritable, frequently co-occur and contribute to significant public health burdens, particularly among economically disadvantaged urban communities. There are noted sex differences in PTSD and AUD outcomes, with evidence suggesting women have heightened susceptibility to stress-related alcohol use. Preliminary PTSD-AUD ecological momentary assessment (EMA) findings support bidirectional associations across clinical outcomes. However, no studies to date have used PTSD-AUD comorbidity models as organizing frameworks to examine the temporal ordering and stability of within-person symptom dynamics underlying the maintenance or exacerbation of PTSD and AUD symptoms, including bidirectional and …

Investigation Of A Global Mouse Methylome Atlas Reveals Subtype-Specific Copy Number Alterations In Pediatric Cancer Models., Melanie Schoof, Tuyu Zheng, Martin Sill, Roland Imle, Alessia Cais, Lea Altendorf, Alicia Fürst, Nina Hofmann, Kati Ernst, Dominik Vonficht, Kenneth Chun-Ho Chan, Tim Holland-Letz, Andreas Postlmayr, Ryo Shiraishi, Wanchen Wang, Alaide Morcavallo, Michael Spohn, Carolin Göbel, Judith Niesen, Levke-Sophie Peter, Franck Bourdeaut, Zhi-Yan Han, Yanxin Pei, Najiba Murad, Fredrik J. Swartling, Jessica Taylor, Monika Yadav, Garrett R. Gibson, Richard J. Gilbertson, Matthias Dottermusch, Rajanya Roy, Kornelius Kerl, Rainer Glass, Jiying Cheng, Martin A. Horstmann, Gerrit Wolters-Eisfeld, Haotian Zhao, Dominik Sturm, Viveka Nand Yadav, Louis Chesler, Simon Haas, William A. Weiss, Paul A. Northcott, Lena M. Kutscher, Ana Guerreiro Stucklin, Olivier Ayrault, Julia E. Neumann, Daisuke Kawauchi, David T W Jones, Kristian Pajtler, Ana Banito, Stefan M. Pfister, Ulrich Schüller, Marc Zuckermann

Manuscripts, Articles, Book Chapters and Other Papers

Copy number alterations (CNAs) are hallmarks of cancer, yet investigation of their oncogenic role has been hindered by technical limitations and missing model systems. Here we generated a genome-wide DNA methylation and CNA atlas of 106 genetic mouse models across 31 pediatric tumor types, including 18 new models for pediatric glioma. We demonstrated their epigenetic resemblance to human disease counterparts and identified entity-specific patterns of immune infiltration. We discovered that mouse tumors harbor highly recurrent CNA signatures that occur distinctly based on the tumor subgroup and driving oncogene and showed that these CNAs share syntenic regions with the matching human …

Nanofibrous Materials And Nanoparticles For Combating Antimicrobial Resistance: Synthesis, Integration, And Translational Perspectives, Rewati Raman Ujjwal, Ashish Dilip Sutar, Rahul Shukla, Gymama Slaughter

Center for Bioelectronics Publications

Antimicrobial resistance (AMR) is a major global health challenge driven by mechanisms such as biofilm formation, efflux pumps, and genetic mutations. Nanoparticulate and fibrous materials have emerged as promising strategies to overcome these limitations through multimodal antimicrobial action and controlled drug delivery. This review highlights recent advances in electrospun nanofibrous systems, including natural and synthetic polymer-based scaffolds, stimuli-responsive nanofibers, and functionalized patches. Nanoparticle-loaded nanofiber systems demonstrate enhanced performance, including bacterial eradication, sustained drug release, and significant biofilm disruption. Multifunctional systems combining antimicrobial, antioxidant, and immunomodulatory properties further show synergism. Emerging innovations, such as piezoelectric and smart sensing systems, enable self-powered …

Osmotic Dilators Vs. Foley Balloons: Bayesian Secondary Analyses Of The Dilafol Trial, Antonio F. Saad, Elenir B. C. Avritscher, Claudia Pedroza, Xiao Han, George R. Saade

Department of Obstetrics & Gynecology Faculty Publications

Background: Dilapan-S, a synthetic osmotic dilator used for pre-induction cervical ripening, has proven to be as effective as the Foley balloon in terms of vaginal versus cesarean delivery and has been associated with increased patient satisfaction. Nevertheless, its ability to lower cesarean rates and its cost-effectiveness remain poorly studied.

Objectives: To estimate the likelihood that synthetic osmotic dilators reduce cesarean deliveries and to evaluate their health system costs (2026 US$) and incremental cost-effectiveness compared to the Foley balloon during cervical ripening.

Study Design: Secondary Bayesian analyses were conducted using data from the single-center DILAFOL randomized controlled trial, which enrolled 419 …

Gastrointestinal Symptoms Associated With Sodium Bicarbonate Supplementation Protocols: A Systematic Review, Ian P. Winter, Paul Sarac, Patrick B. Wilson

Exercise Science Faculty Publications

Sodium bicarbonate positively impacts performance, but its associated gastrointestinal symptoms (GIS) may limit use. This systematic review synthesized literature that has evaluated GIS with sodium bicarbonate supplementation. Literature searches were performed from February 2024-March 2026. Eligible studies provided ≥ 5 g of sodium bicarbonate within a 24-h period or, if a multi-day protocol, at least one day involving ≥ 5 g. Included studies had a placebo group/condition or a comparison group/condition that created a contrast related to delivery method, form, or dose. In total, 101 investigations were summarized in six categories: acute single dosing (n = 35); acute spread dosing …

Biological Dental Hygiene: Principles, Educational Pathways, And Clinical Practice Considerations, Tara Newcomb

Dental Hygiene Faculty Publications

Dental hygiene practice is rapidly evolving in response to emerging evidence on the oral–systemic health connection, advances in preventive technologies, and increased emphasis on individualized, minimally invasive care. A commitment to lifelong learning and continuing professional development is essential for maintaining clinical competence and integrating new scientific knowledge into practice. Biological dental hygiene has emerged as a complementary framework that emphasizes whole-body health, biocompatibility, reduction of toxic exposures, and prevention-centered care. This approach expands traditional dental hygiene practice by incorporating enhanced risk assessment, salivary diagnostics, targeted preventive strategies, as well as patient education focused on nutrition, inflammation reduction, and systemic …

Stability Of Salivary Microrna Measures Across An Ncaa Division I Football Season: Implications For Microrna As A Biomarker Of Concussion, Thomas R. Campbell, Martina Zamponi, Delaney Leathers, Julie Cavallario, Jessica C. Martinez, Peter A. Mollica

Rehabilitation Sciences Faculty Publications

Background

Clinicians often face challenges in concussion care due to a heavy reliance on subjective patient input. Recently, research has sought objective biomarkers, like salivary microRNAs, to improve concussion management. However, significant limitations hinder the use of microRNAs as a diagnostic tool, including the cumulative effects of a contact sport season. A better understanding of the response to a contact sport season would help researchers and clinicians interpret expression changes at the time of injury in the context of seasonal variation. in Therefore, this study investigated the reliability of previously identified salivary microRNA targets across one contact sport season.

Methods …

Comparison Of Mental Illness Comorbidity Pre-Pandemic Vs. Pandemic-Era And Associations With Clinical And Demographic Characteristics For Virginia Public Hospital Inpatient Discharges With A Substance Use Disorder, Marilyn Bartholmae, Tharidu Gunawardena

Department of Medicine Faculty Publications

The rise in mental illnesses after the COVID-19 pandemic is well documented. However, it is not known whether the rates of mental illness comorbidity increased. The objectives of this study were to compare mental illness comorbidity rates before and after the pandemic among inpatients with SUD and to test associations between mental illness comorbidity, physical illness, and demographics. We used a retrospective cross-sectional design in a sample of inpatient discharges (N = 233,017) at Virginia public hospitals from January 2018 to December 2022. We used Z tests to compare rates of mental illness comorbidity pre- and post-pandemic and Chi-square tests …

Trends In Hypertension Prevalance And Control In The United States Over 25 Years, Omar Saleh, Neda Rehan, Saleh Mostafa, Rehan Qayyum

Department of Medicine Faculty Publications

Despite sustained public health efforts, hypertension remains highly prevalent in the United States, with persistent disparities across demographic and socioeconomic groups. We examined 25-year trends in hypertension prevalence, undiagnosed hypertension, and on-treatment uncontrolled hypertension in the United States using nationally representative National Health and Nutrition Examination Survey (NHANES) data from adults aged ≥18 years. Hypertension was defined as systolic BP ≥130 mmHg, diastolic BP ≥80 mmHg, or current antihypertensive use. Undiagnosed hypertension was defined as elevated BP without prior diagnosis or treatment, while on-treatment uncontrolled hypertension was defined as diagnosed hypertension with BP ≥130/80 mmHg despite treatment. Survey-weighted generalized linear …

Ultra-Processed Foods And The Cardiovascular-Kidney-Metabolic Continuum: Integrating Epidemiological, Multi-Omics, And Translational Evidence, Saiful Singar, Amirhossein Ataei Kachouei, Leandro Lantigua-Somoano, David Manley, Anthony Cardinale, Muhammad Zulfiqah Sadikan, Saurabh Kadyan, Donya Shahamati, Lorena Dias, Amber Wood, Cinthia Chavarria, Sara K. Rosenkranz, Neda S. Akhavan

Department of Medicine Faculty Publications

Cardiovascular-kidney-metabolic (CKM) syndrome integrates excess adiposity, metabolic dysfunction, kidney impairment, subclinical cardiovascular diseases, and clinical events along a staged continuum that invites unified prevention and treatment. Ultra-processed foods (UPFs) are a complex, high-prevalence exposure that may influence risk across CKM stages through nutrient profiles, additives, processing-induced compounds, and packaging-related contaminants. This review synthesizes epidemiologic, mechanistic, and translational evidence with attention to exposure definition and analytic rigor. We summarize NOVA-based UPF operationalization across dietary assessment tools, highlighting misclassification of mixed dishes, brand heterogeneity, and energy under-reporting, and we propose further examination of energy-adjusted models, calibration, and harmonized metrics. Observational studies consistently …

Frequent Emergency Department Utilization And Syphilis Case Profiles In The Sentara Healthcare System: A Retrospective Cross-Sectional Analysis In Hampton Roads, Martina Zamponi, Grace M. Tillotson, Chandler F. Knox, Mackenzie Tardif-Kunk, Thomas R. Campbell, Peter A. Mollica

Department of Medicine Faculty Publications

Background

Syphilis rates have increased substantially nationwide, disproportionately affecting marginalized populations and individuals with differing patterns of healthcare utilization. The Hampton Roads region of Virginia and North Carolina includes multiple jurisdictions with syphilis rates above the CDC screening threshold, with 7 of its 9 independent cities meeting this criterion. However, no prior study has examined the relationship between emergency department (ED) utilization patterns and documented syphilis diagnoses in this region.

Methods

A retrospective cross-sectional analysis of the Sentara Healthcare network was conducted using aggregate data from the TriNetX platform. Patients diagnosed with syphilis between 2023 and 2024 were stratified by …

Glucagon-Like Peptide Receptor Agonists (Glp-1ras) As Cardiovascular Risk Modifiers In Obstructive Sleep Apnea And Obesity: A Real-World Study, Jaeun Ahn, Junmin Song, Kyle Admire, Yu Chang, Kuan-Yu Chi, Nathaniel T. Gordon, Joshua M. Sill

Department of Medicine Faculty Publications

Introduction

Obstructive sleep apnea (OSA) is a well-established risk factor for cardiovascular disease. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have demonstrated potential in reducing cardiovascular risk and improving OSA severity. However, a significant knowledge gap remains regarding the impact of GLP-1RAs on cardiovascular events in OSA patients.

Methods

We examined patients with a BMI over 30 diagnosed with OSA between January 2010 and November 2021 without a previous diagnosis of heart failure, pulmonary hypertension, or myocardial infarction. Two cohorts were created: those prescribed GLP-1RAs within 1 year of their OSA diagnosis and patients who were never prescribed GLP-1RAs. Propensity score matching …

Factors Associated With Opioid And Antibiotic Prescribing At Us Academic Dental Institutions: 2011 To 2020, S Tungare, A-I Yansane, S Gantela, K K Kookal, S Mccurdy, T M Krause, S Sharma, M Walji

Faculty, Staff and Student Publications

Introduction: In the United States, dentists are one of the leading prescribers of opioids and antibiotics. Because dental schools are the training grounds for future dentists, it is crucial to understand how prescribing has changed and why these medications are being prescribed in academic settings.

Objectives: The objective of this research was to describe the prescribing trends and factors associated with opioid and antibiotic medication prescribing at US academic dental institutions between 2011 and 2020.

Methods: Data from electronic dental records collected through the BigMouth data repository from 9 anonymized dental institutions between 2011 and 2020 were used. Prescribing rates …

Rewiring The Immune Response In Lung Cancer: Current Progress In Bispecific Antibodies, Car-T Therapy, And The Rise Of In Vivo Car-T Platforms, Lei He, Yi Sun, Bowen Ma, Guojun Lang, Jianguo Wen, George R Blumenschein, Hong Ma

Faculty, Staff and Student Publications

Lung cancer remains the leading cause of cancer mortality worldwide and continues to impose a major clinical burden, particularly in advanced non-small cell lung cancer (NSCLC) and small-cell lung cancer (SCLC). Although targeted therapies, antiangiogenic agents, immune checkpoint inhibitors, and antibody-drug conjugates have improved outcomes in selected patients, durable responses remain limited by primary and acquired resistance. Here, we comprehensively review recent progress in immunologically oriented therapeutic strategies for lung cancer, focusing on bispecific antibodies, chimeric antigen receptor (CAR) T-cell therapy, and emerging in vivo CAR-engineering modalities. We further elaborate on the clinical rationale, latest translational and early clinical evidence, …

A Hybrid Vit-L/32-Maxvit-L Architecture With Adaptive Gated Fusion For Multiclass Gastrointestinal Disease Detection And Multi-Method Post-Hoc Explainability, Shahid Mohammad Ganie, Pijush Kanti Dutta Pramanik, Zhongming Zhao

Faculty, Staff and Student Publications

Introduction: Accurate detection of gastrointestinal diseases from endoscopic images remains challenging due to substantial inter-class similarity, intra-class variability, and heterogeneous lesion presentation. While convolutional neural networks (CNNs) effectively capture fine mucosal textures, their limited receptive field restricts global contextual reasoning. Conversely, transformer architectures model long-range dependencies but may underrepresent localized structural detail.

Methods: This study proposes a dual-branch hybrid transformer framework that integrates global token-level reasoning from ViT-L/32 with hierarchical spatial modeling from MaxViT-L. An adaptive gated fusion mechanism is introduced to dynamically regulate the relative contribution of local and global representations on a per-sample basis, enabling content-aware cross-scale integration. …

Genetic Variants Associated With Sjögren’S Disease Subtypes Stratified By Clinical Feature, Nitesh Enduru, Chihiro Iwaya, Akiko Suzuki, Zhongming Zhao, Junichi Iwata

Faculty, Staff and Student Publications

Introduction: Sjögren's disease (SjD) is a chronic autoimmune disorder characterized by dry mouth (xerostomia) and dry eyes (xerophthalmia) due to inflammation in exocrine glands, particularly the salivary and lacrimal glands. The condition presents a wide variety of clinical features, suggesting that it may involve heterogeneous conditions without a clear boundary. Although genome-wide association studies (GWAS) have identified several genetic variants associated with SjD, their roles in SjD pathogenesis remain unclear.

Methods: In this study, we aimed to identify single-nucleotide polymorphisms (SNPs) associated with SjD by categorizing patients based on four diagnostic markers: anti-Ro/SSA and anti-La/SSB antibodies, IgG levels, and lymphocyte …

Overcoming Stigma In Women's Hiv And Syphilis Care: The Role Of Faith In Healing, Irene A Stafford, Phillip C Johnson, Robin L Beach

Faculty, Staff and Student Publications

Point-of-care (POC) testing for syphilis and HIV is an effective way to provide same-day testing, results management, counseling, and treatment. Although commonly used in antenatal or sexual health clinics, our field study aimed to offer POC testing to women attending a standard care clinic in Guatemala. Nearly all women accepted testing, highlighting the patient-centered benefits and acceptability of screening in non-stigmatizing settings. Upon disclosure of results, especially positive diagnoses, patients drew comfort and resilience from their faith, an often-underprioritized resource not typically considered when addressing sexual health. These results underscore the value of integrating POC testing into routine care and …

Association Between Three-Dimensional Margin Assessment And Local Tumor Control In Percutaneous Lung Cryoablation Of Colorectal Metastases, Frank Mohn, Koustav Pal, Caleb O'Connor, Iwan Paolucci, Austin Castelo, Kamran Ahrar, Steven Yevich, Joshua D Kuban, Bruno C Odisio, Alda Lui Tam, Rahul A Sheth, Kristy K Brock

Faculty, Staff and Student Publications

Purpose

To evaluate the association of two minimum ablation margin (MAM) estimation methods: manual three-dimensional segmentation and biomechanical deformable image registration (DIR) with local tumor progression-free survival (LTPFS) after percutaneous lung cryoablation of colorectal pulmonary metastases.

Materials and Methods

This retrospective single-institution study included patients who underwent percutaneous lung cryoablation between May 2012 and March 2023 (median follow-up, 3.6 years; range, 0.8–9.6 years). Manual three-dimensional MAM was calculated for all tumors, and DIR-based MAM was estimated in a subset with intraprocedural full-thorax imaging. Cox proportional hazards regression assessed associations between MAM and LTPFS. The primary outcome was 2-year LTPFS, with …

Perspective: Radiotherapy And Body Composition: Unmet Needs In Low- And Middle-Income Countries, Alexia J Murphy-Alford, Aaron J Grossberg, Vickie E Baracos, Maha Barbar, Judy Bauer, Jonathan P Bennett, Elena Fidarova, Clifton D Fuller, Anastassia Löser, Amy C Moreno, Anurima Patra, Deepa Puttaswamy, David I Rosenthal, Judy Schoeman, Yavuz Anacak

Faculty, Staff and Student Publications

Radiotherapy plays a vital role in cancer treatment, yet its effects on patients' nutritional status can precipitate muscle loss, with significant implications for treatment tolerance and outcomes. Evidence from high-income countries increasingly links radiation-induced muscle loss to adverse clinical outcomes. In contrast, low- and middle-income countries face a stark evidence gap, despite the heightened vulnerability of cancer patients in these settings due to delayed diagnosis, limited access to care, and high rates of co-morbidities. This paper highlights the critical gaps in nutritional care for radiotherapy patients in low- and middle-income countries.

Cesarean Section Rates In Lucas Do Rio Verde, Brazil: Assessing The Impact Of Socioeconomic Status And Maternal And Neonatal Outcomes, Ramya Vemulapalli, Roni Arienti, Linder Wendt, Jay Brooks Jackson, Mary B Rysavy, Kimberly A Kenne

Faculty, Staff and Student Publications

Background

Brazil is globally known for its high rate of cesarean section despite endorsing the WHO’s current recommendation of 15%.

Objectives

Determine if socioeconomic status correlated with the rate of cesarean section (CS) at a mixed private and public hospital in the west-central region of Brazil. Describe the maternal and neonatal outcomes by mode of delivery (MOD) in the same population.

Design

Cohort study

Methods

Data from all delivering patients at São Lucas Hospital were collected during an 18-month period and analyzed. Demographics, baseline maternal health status, pregnancy and delivery information, maternal outcomes, and neonatal outcomes were entered into a …

Congenital Syphilis: From Near-Elimination To Crisis, Chad J Abresch, Irene A Stafford, Regan M Johnson, Kayode Olabanji, Ashleigh M Sutphen, Helen E Cejtin, Ashley Hoover

Faculty, Staff and Student Publications

This analytic essay examines the transformation of congenital syphilis (CS) in the United States from near-elimination to crisis. Drawing from the January 2025 Congenital Syphilis Summit in Atlanta, Georgia-convening public health leaders, Tribal health departments, the National Coalition of STD Directors, and Centers for Disease Control and Prevention experts-we contrast prevention systems during near-elimination (1998-2005) with the current crisis (2018-2025). Evidence revealed how dismantling public health infrastructure produced dramatically different outcomes, with CS cases increasing 937% over the past decade and racial/ethnic disparities worsening. American Indian/Alaska Native communities face rates up to 100 times higher than White populations in some …

Biomechanical And Computational Modeling Of Metastatic Acetabular Defects: Influence Of Tumor Location On The Risk Of Fracture, Jacob Doddridge, Hongjia He, Rui Yang, E U Conrad, Nicholas Dunbar

Faculty, Staff and Student Publications

Background: Metastatic bone disease can lead to pathologic fracture of the pelvis which affects quality of life. There are limited validated approaches for biomechanical modeling, classification, or surgical treatment of metastatic acetabular defects.

Methods: An artificial hemipelvis bone was used to calibrate a computed tomography-based computational model of the pelvis with varying locations and sizes of acetabular defects. Metastatic defects affecting the anterior and posterior column, medial wall, and their combinations were created. Mechanical testing was performed on each defect, and images of the lateral surface of the acetabulum were analyzed by digital image correlation to measure peak surface strains. …

Functional, Pharmacogenomic, And Immune Landscapes Of Long Non-Coding Rnas In Cancer, Runhao Wang, Mei Luo, Yuan Liu, Jingwen Yang, Yamei Chen, Chengxuan Chen, Lifei Ma, Stephanie Ding, James Wengler, Yong Zang, Bora Lim, Wenbo Li, Liuqing Yang, Chunru Lin, Lixia Diao, Leng Han

Faculty, Staff and Student Publications

Long non-coding RNAs (lncRNAs) are emerging as key regulators in cancer, with significant potential as diagnostic, prognostic, and therapeutic targets. Here, this work systematically analyzes lncRNA associations with targeted therapies and immunotherapies across 33 cancer types using The Cancer Genome Atlas (TCGA) and real-world datasets. This work identifies 53,173 lncRNA-pathway associations, millions of lncRNA-drug response associations (via CancerRxTissue and VAEN), and extensive correlations with immune checkpoints and infiltration. This work further identifies 69 lncRNAs associated with immunotherapy response and 2,611 differentially expressed lncRNAs between low and high objective response rate (ORR) groups. Additionally, two lncRNAs are correlated with immune-related adverse …

Bop2-Comb: Bayesian Optimal Phase Ii Design For Optimizing Doses And Assessing Contribution Of Components In Drug Combinations, Xiaohan Chi, Ying Yuan, Ruitao Lin

Faculty, Staff and Student Publications

Background: Personalized cancer treatment using combination therapies offers substantial therapeutic benefits over single-agent treatments in most cancers. However, unmet clinical needs and increasing market competition pressure drug developers to quickly optimize combination doses and clearly demonstrate the contribution of each component when developing and evaluating new combination treatments.

Methods: We propose a Bayesian optimal phase II drug-combination (BOP2-Comb) design that optimizes the combination dose and evaluates the proof-of-concept as well as the contribution of each component in two seamless stages. Our optimal calibration scheme minimizes the total trial sample size while controlling incorrect decision rates at nominal levels. This calibration …