Medicine and Health Sciences Commons^™

The Caroline Grace Medema Memorial Fund

West Michigan District Dental Society Bulletin

In this heartfelt letter from Brent and Lorene Medema, the family shares their story and reaction to the decision by the WMDDS Board of Directors to honor their late daughter through the Caroline Grace Medema Memorial Fund. The fund will provide financial support for pregnant women and children in need of dental care.

Wmdds Bulletin Fall 2025

West Michigan District Dental Society Bulletin

In the Fall 2025 issue, the reader will find the following feature articles:

• The Carolina Grace Medema Memorial Fund
• West Michigan Members in Missions: “Better to Give Than to Receive" and "Arctic Barnabas Ministries"
• Pearls from Local Dentists

Also included are your monthly tripartite update, news from West Michigan counties, the President's Message and Editor's Letter.

Cultivating Excellence: Academic Support For Diverse Nursing Students, Tara Flood, Dnp, Rn, Cbc

College of Nursing Posters

Introduction

Cultural experiences and the development of acumen in nursing school are deeply interconnected. Meaningful engagement with diverse cultures fosters empathy, self awareness, and nuanced communication that is essential for providing competent patientcentered care. The inclusion of an Academic Support team in nursing education is essential for nursing student success and for creating inclusive learning environments, particularly for students from diverse backgrounds.

Mosquito Classification And Explainability From Image Data Via Deep Learning Techniques, Farhat Binte Azam

USF Tampa Graduate Theses and Dissertations

According to the World Health Organization (WHO), mosquitoes are the deadliest animals on Earth, responsible for more human deaths annually than any other species. Mosquito-borne illnesses continue to pose severe risks to global health. In 2015 alone, there were an estimated 214 million malaria cases worldwide. Similarly, a 2016 report from the Centers for Disease Control and Prevention (CDC) revealed that Puerto Rico’s Department of Health received over 62,500 suspected cases of Zika, with 29,345 confirmed positive cases. In 2019, Southeast Asia experienced its worst dengue outbreak in recorded history. Of the approximately 4,500 mosquito species distributed across 34 genera, …

Sensitivity And Specificity Of The Cobas Liat Ct/Ng/Mg Nucleic Acid Test In A Clinical Laboratory Setting And Point-Of-Care Location, B Van Der Pol, R Arcenas, C Boraas, S Chavoustie, L L. Crane, N D'Empaire, A C. Ermel, G Harnett, F Hinestrosa, S House, Rebecca A. Lillis, J Miller, A Mills, R Poblete, S A. Young

School of Medicine Faculty Publications

Sexually transmitted infections, e.g., Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Mycoplasma genitalium (MG), present with similar signs/symptoms and are often treated empirically due to delays in receiving diagnostic test results. This study evaluated the clinical performance of the Cobas Liat CT/NG/MG nucleic acid amplification test (NAAT) in detecting these pathogens in a point-of-care (POC) setting. This non-interventional, multicenter study recruited symptomatic/asymptomatic participants from 13 geographically diverse POC sites across the USA. Prospective clinician- and self-collected specimens (urine/vaginal swabs) were used to determine the sensitivity and specificity of the Cobas Liat CT/NG/MG test relative to the composite reference standard (CRS), …

Why Aren’T More People Calling 988 For Mental Health Crises?, Michiko Ueda, Colleen M. Heflin, Yanhong Liu, Qingyi Yu, Seethalakshmi Ramanathan

Center for Policy Research

When someone is in a mental health crisis, calling 911 has long been the default response. However, 911 call centers are not well-equipped to handle mental health emergencies, and law enforcement dispatch can result in unnecessary arrests, hospitalizations, or crisis escalation. The 988 Suicide and Crisis Lifeline launched in 2022 is a free, confidential alternative, yet awareness remains low and misconceptions persist. Using data from a 2024 national online survey of nearly 1,900 U.S. adults ages 18-50, this brief summarizes findings about awareness of 988, willingness to use it, and concerns about the service. Results show that only 22% of …

A Literature Review Of The United States Of America’S Reliance On Imported Covid Personal Protective Equipment During The Pandemic, Pradip K. Shukla, Izzet Kosar, Hedieh Setayesh

Business Faculty Articles and Research

This paper provides a literature review of United States of America’s reliance on imported Covid Personal Protective Equipment (PPEs) during the Covid pandemic. The abstracted and cited articles show that the United States was too reliant on imported PPEs, primarily imported from Asia which led to shortages as the cases of Covid surged at various points during the waves of Covid cases. This supply and demand imbalance was not just an inconvenience such as the toilet paper shortage and other supply chain disruptions of basic commodities; this supply and demand imbalance had life and death impacts for many first responders, …

Sexual Activity And Functioning After Breast Cancer Treatment: Perspectives On The Importance Of Pleasure From A Radiotherapy Cohort, Melanie Besculides, Lauren Carney, Ksenia Gorbenko, Sheryl Green, Melissa Brito, Jezelle Lynch, Carly Feldman, Cindy Munoz, Madhu Mazumdar, Deborah C. Marshall

Student Papers, Posters & Projects

BACKGROUND: Breast cancer affects millions of women and while treatment can be lifesaving, it also has numerous side effects, including those related to sexual function, which often impact the ability to experience pleasure from sex. This study aimed to understand how breast cancer survivors define sexual activity, identify important aspects, and ascertain perceived impacts of treatment on sexual activity and function, particularly related to pleasure.

METHODS: Semi-structured interviews were conducted with women who were breast cancer survivors at least one-year post-radiation. Priority populations were oversampled (racial/ethnic/sexual/gender minorities, those aged over 65 or under 45). The sample included 23 participants: 11 …

Immediate Vs On-Demand Maternal Oral Feeding For Parturients After Caesarean Section: A Systematic Review And Meta-Analysis Of Randomised Controlled Trials, Ahmed H. Saad, Ahmed S. Badran, Ahmed S. Ashour, Mohamed A. Abdeltawab, Aalaa Elgeritly, Iman Elzahaby

Sultan Qaboos University Medical Journal

This review compared the efficacy and safety of immediate oral feeding (initiated within 2 hours post-operation) versus on-demand feeding following caesarean section (CS). A systematic search of electronic databases up to 20 February 2025 identified three randomised controlled trials (RCTs) including a total of 1,158 patients. The quality of the included studies was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool. Statistical analysis was performed using Review Manager (RevMan) software to calculate mean differences (MDs), standardised mean differences (SMDs), and risk ratios (RRs). Immediate oral feeding was associated with a shorter time to first bowel sounds (MD …

Does Motor Skill Competence Influence Physical Activity Behavior? Focusing On Sport-Specific Skills, Yubing Wang, Yaogang Han, Pan Li, Bin Zhang

International Journal of Physical Activity and Health

The purpose of this study was to investigate the widely held belief that motor skill competence positively affects physical activity behavior (PA), considering the task-specific nature of motor skill competence and the context-specific nature of PA. Specifically, we examined the effects of students’ jump rope (JR) and basketball (BB) competence on their PA in six contexts. A total of 134 sixth grade students participated in this study. All variables were assessed using appropriate tools. A series of hierarchical regression analyses were conducted to address the research questions. Students’ JR competence did not significantly influence their PA in either JR-related or …

Multinucleate Cell Angiohistiocytoma, Connor A. Sheehan, Jayci G. Rhein, Jordan Hyde, Jason B. Lee, Sylvia Hsu

Department of Dermatology and Cutaneous Biology Faculty Papers

No abstract provided.

Does Cognitive Frame Affect Clinical Reasoning Among Medical Students? A Cross-Sectional Study, Xiao C. Zhang, Sara A. Belko, Andrew J Monick

Department of Emergency Medicine Faculty Papers

Background Diagnostic errors affect patient safety and lead to high costs. Cognitive bias is a key source of diagnostic error, and the framing effect poses a particular clinical challenge. The extent to which individual factors affect susceptibility to the framing bias is unclear, and the role of expertise in particular is contested across the literature. Objectives This study investigated the effects of framing bias on diagnostic reasoning among medical students. We hypothesised that the effects attributable to framing would be mediated by the number of years of medical education completed. Methods Participants were randomly assigned on an automated basis with …

Scrotal Temperature Change During Running In Naked Humans, Yasuho Takii, Makoto Fukuda, Kazuyuki Kanosue, Tamae Yoda

Children’s Nutrition Research Center Staff Publications

Male reproductive organs are functionally affected by high body temperature. This study aimed to clarify the thermoregulation mechanisms of the human scrotum during running, and experiments were conducted to investigate temperature changes in the whole body and the scrotum. Eleven male long-distance runners performed treadmill running at 60%[Formula: see text] for 60 min in an indoor environment at 27 °C and 40% relative humidity. Immediately after the start of the run, the skin temperatures in areas other than the scrotum decreased or showed a tendency to decrease. In contrast, the scrotal temperature increased immediately after the start of the run. …

Patterns And Characteristics Of Firearm Thefts From Vehicles In San Antonio, Texas, Alexander Testa, Jennifer Thompson, Luis Mijares, Ryan Ramphul, Dylan B Jackson, Jack Tsai

Faculty, Staff and Student Publications

Background: Firearm thefts from motor vehicles are currently the leading source of stolen firearms in the United States. Yet little is known about the temporal, spatial, and contextual characteristics of these thefts. This study aims to advance understanding of firearm theft from vehicles by analyzing all reported incidents that occurred in San Antonio, Texas, in 2024.

Methods: Data are extracted from police reports from all reported incidents of firearm theft from vehicles reported to the San Antonio Police Department between January 1 and December 31, 2024. Information on the number and type of firearms stolen, vehicle make and model, date, …

Correlates Of Sexual Health Service Use Amongst Unmarried Young Adults In Kathmandu, Nepal, Joshua Jayasinghe, Connie M. Ulrich, Anju Shrestha, Mamata Sherpa Awasthi, Jesse Chittams, Bridgette M. Rice, Prakash Shrestha, Anne M. Teitelman

College of Nursing Faculty Papers & Presentations

BACKGROUND: In Nepal, sexual relationships outside of the traditional arranged marital system are increasingly common. Despite the availability of modern sexual health care, research on how to effectively deliver sexual health services to unmarried young adults in Nepal is limited.

OBJECTIVE: This study examined key theoretical correlates between Andersen's Behavioral Model of Health Service Use and actual sexual health service use among unmarried young adults (aged 18 to 25) in Kathmandu, Nepal.

METHODS: Unmarried young adults between 18 and 25 were recruited from colleges and universities in the Kathmandu area. A total of 110 women and 93 men completed the …

The Ruling Relations Of Care: An Institutional Ethnography Of High-Risk Prenatal Care Experiences, Nicole L. Harris

USF Tampa Graduate Theses and Dissertations

Disrespect during pregnancy, labor, and delivery is common in the United States. The Centers for Disease Control and Prevention has estimated that approximately one in five women overall, and over 30% of Black women, report being ignored, dismissed, or verbally mistreated during their care. Public health efforts have primarily focused on individual-level interventions to improve patient-provider communication or reduce provider bias; however, these strategies have been critiqued for their limited scope and effectiveness in shifting outcomes. Instead, researchers and advocates have called for an examination of the structures that shape clinical encounters, including policies, protocols, workflows, and organizational culture. This …

Managing Anticoagulation In A Patient With Calciphylaxis And Mechanical Valve: A Therapeutic Dilemma, Qutaiba Qafisheh, Abdalhakim Shubietah, Mohanad Qwaider, Muath A. Baniowda, Abdalrahman Assaassa, Roaa Aljunaidi, Abubakar Nazir

Division of Cardiology Faculty Papers

BACKGROUND: Calciphylaxis is a rare, life-threatening vasculopathic syndrome most commonly seen in end-stage renal disease (ESRD) and associated with high mortality. Vitamin K antagonists complicate management in patients with mechanical valves by potentially exacerbating vascular calcification while remaining essential for thromboprophylaxis.

CASE PRESENTATION: A 50-year-old woman with ESRD on hemodialysis and a mechanical mitral valve on warfarin presented with severe abdominal pain and rapidly progressive necrotic ulcers. Despite broad-spectrum antibiotics and sodium thiosulfate, lesions worsened. Biopsies were nondiagnostic; however, the clinical phenotype was consistent with calciphylaxis. A multidisciplinary team transitioned anticoagulation from warfarin to subcutaneous unfractionated heparin (UFH) (333 U/kg …

Rebound Bursting Selectively Enables Fast Dynamics In Dopamine Midbrain Neurons Projecting To The Dorsolateral Striatum, Strahinja Stojanovic, Christopher J. Knowlton, Richard Egger-Mackrodt, Johanna Mankel, Josef Shin, Stephan Lammel, Carmen C. Canavier, Jochen Roeper

School of Graduate Studies Faculty Publications

Dopamine (DA) midbrain neurons are involved in a wide array of key brain functions including movement control and reward-based learning. They are also critical for major brain disorders such as Parkinson's disease or schizophrenia. DA neurons projecting to distinct striatal territories are diverse with regard to their molecular makeup and cellular physiology, which are likely to contribute to the observed differences in temporal DA dynamics. Among these regions, the dorsolateral striatum (DLS) displays the fastest DA dynamics, which might control the moment-to-moment vigor and variability of voluntary movements. However, the underlying mechanisms for these DLS-specific fast DA fluctuations are unresolved. …

Epdevatlas: Mapping Gabaergic Cells And Microglia In The Early Postnatal Mouse Brain, Josephine K. Liwang, Fae N. Kronman, Hyun-Jae Pi, Yuan-Ting Wu, Daniel J. Vanselow, Steffy B. Manjila, Deniz Parmaksiz, Donghui Shin, Yoav Ben-Simon, Michael Taormina, Sharon W. Way, Hongkui Zeng, Bosiljka Tasic, Lydia Ng, Yongsoo Kim

School of Graduate Studies Faculty Publications

During development, brain regions follow encoded growth trajectories. Compared to classical brain growth charts, high-definition growth charts could quantify regional volumetric growth and constituent cell types, improving our understanding of typical and pathological brain development. Here, we create high-resolution 3D atlases of the early postnatal mouse brain, using Allen CCFv3 anatomical labels, at postnatal days (P) 4, 6, 8, 10, 12, and 14, and determine the volumetric growth of different brain regions. We utilize 11 different cell type-specific transgenic animals to validate and refine anatomical labels. Moreover, we reveal region-specific density changes in γ-aminobutyric acid-producing (GABAergic) neurons, cortical layer-specific cell …

Prevalence And Clinical Impact Of Pseudohypercalcemia In Paraproteinemia: A Case And Cohort Study, Usman Sunusi, Li Chen, Nianyi Li, Jason K Y Lee, Irmeen Siddiqui, Erin Goodhue, Rongrong Huang, Jieli Li

Faculty, Staff and Students Publications

Background: Hypercalcemia is a common and serious complication of malignancy, often contributing to morbidity and mortality. In patients with paraproteinemia, elevated total calcium with normal ionized calcium, termed pseudohypercalcemia, can complicate diagnosis and lead to inappropriate treatment. While this phenomenon has been described in case reports, its prevalence and clinical impact in routine practice remain poorly defined.

Methods: We report a case of pseudohypercalcemia in a patient with IgG κ multiple myeloma and conducted a retrospective review of de-identified data to assess the prevalence and biochemical associations of pseudohypercalcemia in paraproteinemia. Available data included serum protein electrophoresis (SPEP), …

Fastk Post-Transcriptional Regulators – A ‘Fast-Track’ In Mitochondrial Gene Expression, Justin Van Riper, Bridget J Corsaro, Monica C Pillon

Faculty, Staff and Students Publications

Fas-activated serine/threonine kinase (FASTK) proteins comprise one of the largest families of mitochondrial post-transcriptional regulators. Members are classified based on their conserved C-terminus, which shows homology with the PD-(D/E)XK superfamily of endoribonucleases. However, it is still uncertain which of these FASTK members are catalytic. The six human FASTK homologs rely on their RNA-binding activity to regulate distinct stages of mitochondrial gene expression, including early processing of nascent RNA, 3'-end messenger RNA (mRNA) maturation, ribosomal RNA (rRNA) modification, mRNA stability, and translation. Genetic and genomic studies have highlighted the crucial role of FASTK proteins in balancing the mitochondrial transcriptome and controlling …

Translational Framework Linking Perfluoroheptanoic Acid (Pfhpa) Exposure To Metabolic Dysfunction Associated Steatotic Liver Disease In Adolescents, Brittney O Baumert, Ana C Maretti-Mira, Douglas I Walker, Zhenjiang Li, Nikos Stratakis, Hongxu Wang, Yinqi Zhao, Fabian Christoph Fischer, Qiran Jia, Damaskini Valvi, Scott M Bartell, Jiawen Carmen Chen, Thomas Inge, Justin R Ryder, Todd Jenkins, Stephanie Sisley, Stavra Xanthakos, David E Kleiner, Rohit Kohli, Sarah Rock, Sandrah P Eckel, Michele A La Merrill, Max M Aung, Matthew P Salomon, Rob Mcconnell, Jesse Goodrich, David V Conti, Lucy Golden-Mason, Lida Chatzi

Faculty, Staff and Students Publications

Background: The rising prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD), particularly among pediatric populations, requires identification of modifiable risk factors to control disease progression. Per- and polyfluoroalkyl substances (PFAS) have emerged as potential contributors to liver damage; however, their role in MASLD remains underexplored. This study aimed to develop a translational framework integrating human and in vitro data to elucidate the effect of PFAS on MASLD development.

Methods: We measured PFAS plasma levels in the Teen-LABS cohort (n = 136), comprising adolescents with obesity (mean age = 16.8 years) undergoing bariatric surgery. Plasma samples were also analyzed using proteomic …

Microglia Sensing Of Peripheral Signals That Bridge The Brain And Body, Claire E Young, Melanie A Samuel

Faculty, Staff and Students Publications

Microglia are the resident immune cell of the brain, and alterations in microglia signaling have been implicated in many neurodegenerative disorders. While microglia responses to central cues and other brain cell types are well documented, studies are increasingly investigating the impact of peripherally derived signals on microglia function. A diverse array of peripheral cues, including dietary components, hormones, and bacteria metabolites and components from the microbiome cross the blood brain barrier and directly influence microglia state through ligand-receptor interactions. This review highlights the complexity of brain-body interactions from the perspective of microglia function and proposes the idea that microglia could …

Insights Into Spheroid Formation: Interaction Of Ovarian Cancer Cells With Macrophage Populations In The Tumor Microenvironment, Simone Pisano, Yajaira Sofia Jimenez, Paul Rees, Jing Xiao, Deyarina Gonzalez, Robert Steven Conlan, Bruna Corradetti

Faculty, Staff and Students Publications

Background: Treating advanced ovarian cancer (OC) is challenging due to the immunosuppressive tumor microenvironment. This study investigates tumor-immune cell interactions using organotypic spheroid models that simulate the in vivo microenvironment.

Methods: A dual-model spheroid system was established combining serous adenocarcinoma SKOV-3 cells with monocytes, pro-inflammatory (MΦ1) or anti-inflammatory (MΦ2) macrophages, or their derived exosomes (EXOs). In Model A, immune cells or EXOs were co-seeded with tumor cells to replicate early heterotypic aggregation. In Model B, immune cells or EXOs were introduced 24 h post-spheroid formation to simulate immune infiltration into established spheroids. Spheroid morphology was quantified by diameter and circularity, …

Nasal Microbionts Differentially Colonize And Elicit Cytokines In Human Nasal Epithelial Organoids, Andrea I Boyd, Leah A Kafer, Isabel F Escapa, Amal Kambal, Hira Tariq, Susan G Hilsenbeck, Hoa Nguyen-Phuc, Anubama Rajan, Joshua M Lensmire, Kathryn A Patras, Pedro A Piedra, Sarah E Blutt, Katherine P Lemon

Faculty, Staff and Students Publications

Nasal colonization by Staphylococcus aureus or Streptococcus pneumoniae is associated with an increased risk of infection by these pathobionts, whereas nasal colonization by Dolosigranulum species is associated with health. Human nasal epithelial organoids (HNOs) differentiated at air-liquid interface (ALI) physiologically recapitulate human nasal respiratory epithelium with a robust mucociliary blanket. Due to their natural stem-like properties, HNO lines are a long-term experimental resource that offers genetic diversity based on the different donors. To develop HNOs as a new model system for bacterial nasal colonization, we reproducibly monocolonized HNOs differentiated at ALI with S. aureus, S. pneumoniae, or Dolosigranulum …

Brca2 Deficiency And Replication Stress Drive Apobec3-Mediated Genomic Instability, Kathy Situ, Abby M Green, Et Al.

2020-Current year OA Pubs

BRCA2 plays a critical role in stabilizing stalled replication forks, yet critical gaps remain in understanding how BRCA2 deficiency triggers fork collapse and drives genomic instability. Here, we identify cytidine deaminase APOBEC3B as a key driver of this process. Using a unique uracil-in-DNA probe, we show that BRCA2 loss promotes APOBEC3B-mediated uracil accumulation in single-stranded DNA (U-ssDNA) at stalled forks. These lesions when processed by UNG2 and APE1, trigger fork collapse and release ssDNA fragments into the cytoplasm, activating NF-κB signaling. This in turn upregulates APOBEC3B expression, establishing a self-reinforcing loop that amplifies cytidine deamination at stalled forks and exacerbates …

Chromatin Profiling Identifies Putative Dual Roles For H3k27me3 In Regulating Cell Type-Specific Genes And Transposable Elements In Choanoflagellates, James M Gahan, Lily W Helfrich, Laura A Wetzel, Natarajan V Bhanu, Zuo-Fei Yuan, Benjamin A Garcia, Robert J Klose, Alex De Mendoza, David S Booth

2020-Current year OA Pubs

Chromatin-based mechanisms contribute to the exquisite regulation of gene expression during animal development. But how those mechanisms evolved remains elusive. Here we investigate chromatin regulatory features in the closest relatives of animals, choanoflagellates. In a model choanoflagellate Salpingoeca rosetta, we compare chromatin accessibility and histone modifications to gene expression. Accessible genomic regions in S. rosetta primarily correspond to gene promoters, and we find no evidence of distal gene regulatory elements that resemble enhancers deployed to regulate developmental genes in animals. Remarkably, the histone modification H3K27me3 decorates genes with cell type-specific expression, revealing a functional similarity in S. rosetta and animals. …

Enampt/Tlr4 Signaling Drives Pah Cellular Phenotypic Switching And Lung Vascular Remodeling, Mohamed Ahmed, Zhiyu Dai, Et Al.

2020-Current year OA Pubs

BACKGROUND: The attenuation of cellular phenotypic switchingdriving PAH vascular remodeling remains an unmet therapeutic need. As eNAMPT (nicotinamide phosphoribosyltransferase)/TLR4 signaling significantly contributes to PH pathobiology, an eNAMPT-neutralizing ALT-100 mAb was utilized to rescue monocrotaline (MCT) and hypoxia/Sugen (Hy/Su) preclinical PH rat models and to evaluate eNAMPT/TLR4 involvement in endothelial cell (EC), smooth muscle cell (SMC) and monocyte/macrophage phenotypic switching.

METHODS: MCT-PH or Hy/Su-PH rats received IgG or ALT-100 mAb (subQ, beginning week 4) with measurements of PH severity and lung tissue scRNAseq at day 42.

RESULTS: PH severity indices (hemodynamic, histologic, vascular remodeling) were significantly attenuated in MCT-PH and Hy/Su-PH …

Short Term Hemodynamic Effects Of Atrial Fibrillation In A Closed-Loop Human Cardiac-Baroreflex System, Oluwasanmi Adeodu, Michelle Gee, Babak Mahmoudi, Rajanikanth Vadigepalli, Mayuresh V. Kothare

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Atrial fibrillation (AF) remains the leading cardiac cause of stroke and AF-related death rate in the United States has been increasing for over twenty years. While the effect of standalone AF on heart rate is well established, there is a lack of clarity on its impact on other critical hemodynamic metrics. This is ostensibly due to interaction with other common comorbidities, especially hypertension. In addition, AF has a complex relationship with the state of the baroreflex. Evidence indicates that baroreflex sensitivity (BRS), the ability of the intrinsic cardiac control system to initiate parasympathetic response, is suppressed during AF. Therefore, a …

Long-Term Liver-Targeted Aav8 Gene Therapy For Mucopolysaccharidosis Iva, Shaukat A. Khan, Eliana Benincore-Florez, Fnu Nidhi, Jose Victor Álvarez, Dione A. Holder, Shunji Tomatsu

Department of Pediatrics Faculty Papers

Mucopolysaccharidosis IVA (MPS IVA) is a lysosomal storage disease with an autosomal recessive trait caused by the deficiency of N-acetylgalactosamine-6-sulfate sulfatase (GALNS) enzyme, which leads to the accumulation of chondroitin-6-sulfate and keratan sulfate, primarily in cartilage and its extracellular matrix, resulting in a direct impact on cartilage and bone development, as well as subsequent systemic skeletal dysplasia. ERT and HSCT are current treatment options, but they have a limited effect on bone lesions. In this article, we investigated liver-specific AAV8 vectors with a thyroxine-binding globulin promoter in the MPS IVA murine model to evaluate the long-term (24 weeks in males …