Medicine and Health Sciences Commons^™

Self-Reported Audiological And Vestibular Symptoms Associated With Lyme Disease, Daniella A. Bryan

Dissertations, Theses, and Capstone Projects

Background:

Lyme disease, an infectious vector-borne illness, is carried by the deer tick, Ixodes scapularis, which harbor the spirochete, Borrelia burgdorferi, affecting hundreds of thousands of people in the United States annually. Lyme disease has a multitude of clinical presentations and overlaps with other complex illnesses, making diagnosis and treatment a medical challenge. This distinct bacterium can migrate into any organ system through the mediums of soft tissue, the lymphatic system, and the circulatory system. Despite its prevalence and range in symptomatology, minimal research has been conducted to identify distinct audiological and vestibular symptoms associated with a Lyme …

Audiologic Management Of Individuals With Advanced Cochlear Otosclerosis: A Systematic Review, Sophie Silvermintz

Dissertations, Theses, and Capstone Projects

This systematic review evaluates the efficacy and outcomes of cochlear implantation (CI) in adults diagnosed with far-advanced cochlear otosclerosis. This synthesis of audiological outcomes, surgical complexities, and patient-reported quality-of-life (QoL) measures is the first systematic analysis of peer-reviewed studies on this topic. By completing a comprehensive analysis of CI's viability in managing severe-to-profound mixed or sensorineural hearing loss attributed to CO, it is anticipated that CI will be considered an option for persons experiencing the significant communication challenges presented by CO when traditional approaches to management have been ineffective.

Eleven peer-reviewed articles met the inclusion criteria, examining key outcomes including …

Localization Of Music In Perceived Motion In Cochlear Implant Users, Madeleine Beyer

Dissertations, Theses, and Capstone Projects

Spatial perception contributes to music perception and enjoyment, yet it remains understudied in cochlear implant (CI) users. Spatial effects in music are often achieved through panning, a tool which redistributes an audio signal level between or among several outputs, creating a perceived sound localization. CI users typically perform worse than normal hearing (NH) listeners on tasks of horizontal localization and music perception when manipulating the actual location of the sound. However, despite the common use of panning in daily use and consumption of music, no previous studies were conducted to examine how panning impacts the listening experience for CI users. …

Path Dependency And The Politics Of U.S. Health Reform, Sophia Spadafore

Dissertations, Theses, and Capstone Projects

This study examines the impact of path dependency on health reform efforts in the United States, specifically analyzing how past policy decisions constrain subsequent reform possibilities. Utilizing the theoretical framework of historical institutionalism, the study investigates two significant cases—the passage of Medicare and Medicaid in 1965 and the The Patient Protection and Affordable Care Act (ACA) in 2010—to illustrate how successful healthcare reforms embed institutional arrangements that limit future policy innovation. Through a comparative case study approach grounded in legislative records, historical texts, and scholarly analyses, the research highlights that major healthcare reforms in the U.S. have consistently been structured …

Development Of An Evidence-Based Mentorship Program To Support Historically Underrepresented Communication Sciences And Disorders Undergraduate Students Applying For Graduate Programs In Speech Language Pathology And/Or Audiology, Leannmarie Senat

Dissertations, Theses, and Capstone Projects

Introduction and Background

The professions of Speech-Language Pathology (SLP) and Audiology have had a long-standing history of racial, ethnic, and linguistic disparities among practitioners. In recent years, despite the increase in diversity of the United States population, and research that shows the benefits of increased diversity in healthcare, this lack of representation persists.

Purpose

The current pilot study describes the design, implementation, and evaluation of an evidence-based mentorship program aimed at supporting historically underrepresented undergraduate students in Communication Sciences and Disorders (CSD) at Brooklyn College (BC) to prepare participants who plan to apply for graduate programs in SLP and Audiology. …

Bimodal Hearing Vs. Bilateral Hearing: Presenting A Review Of Existing Literature To Assist Audiologists With Determining The Optimal Hearing Modality, Eliana Dachman

Dissertations, Theses, and Capstone Projects

While guidelines exist for cochlear implant candidates, there are no specific established guidelines for bimodal users who are considering a 2nd cochlear implant. The objective of this paper is to critically review the literature addressing the question of comparative performance outcomes for bimodal hearing (one hearing aid in combination with a cochlear implant) and bilateral cochlear implants (two cochlear implants). The inclusion criteria were publications comparing bimodal and bilateral cochlear implant performance on speech perception, localization, and subjective quality. Fifteen qualifying papers were identified and analyzed. The results indicate that there are possible advantages to bilateral cochlear implants when assessing …

Irnet: Immunotherapy Response Prediction Using Pathway Knowledge-Informed Graph Neural Network, Yuexu Jiang, Manish Sridhar Immadia, Duolin Wang, Shuai Zeng, Yen On Chan, Jing Zhou, Dong Xu, Trupti Joshi

Biomedical Sciences

Introduction: Immune checkpoint inhibitors (ICIs) are potent and precise therapies for various cancer types, significantly improving survival rates in patients who respond positively to them. However, only a minority of patients benefit from ICI treatments.

Objectives: Identifying ICI responders before treatment could greatly conserve medical resources, minimize potential drug side effects, and expedite the search for alternative therapies. Our goal is to introduce a novel deep-learning method to predict ICI treatment responses in cancer patients.

Methods: The proposed deep-learning framework leverages graph neural network and biological pathway knowledge. We trained and tested our method using ICI-treated patients’ data from several …

When Macroglossia Is Not Beckwith-Wiedemann: A Case Of An Infant With Congenital Central Hypoventilation Syndrome, Shauna Michelle Vandoren, Samira Naime

Posters

Introduction Congenital central hypoventilation syndrome (CCHS) is a rare genetic disorder caused by the mutation of the paired-like homeobox 2B (PHOX2B) gene that leads to alveolar hypoventilation during sleep and at times while awake. The majority of patients with CCHS have polyalanine repeat mutations (PARM) whereas 10% have non-PARM (NPARM). Of those with NPARM, less than 1% are caused by whole gene deletion. NPARM is associated with more severe phenotypes; however, some may have variable penetrance causing variable presentation within families. Report of case(s) Our patient is a 4-month-old infant born at 32 weeks in an outside hospital and transferred …

Whole-Exome Sequencing Identified Molecular Variants Linked To The Progression Of Gastric Precancerous Lesions In Patients From Southwestern Colombia—An Exploratory Approach., Lizeth Mejia-Ortiz, Jovanny Zabaleta, Jone Garai, Luis Eduardo Bravo, Andres Castillo

School of Graduate Studies Faculty Publications

No abstract provided.

Quality Of Life And Patient Experience In Black Women With Alopecia, Annyella Douglas, Jayson Suriano, Neda Nikbakht

Department of Dermatology and Cutaneous Biology Faculty Papers

No abstract provided.

Developmental Lead Exposure And Aggression In Male Rats: Influences Of Maternal Care And Environmental Enrichment, Shamaila Zafar, Courtney K. Williams, Jaehyun Joo, Blanca E. Himes, Jay S. Schneider

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Developmental lead (Pb) exposure results in a variety of cognitive deficits and behavioral issues including increased antisocial behavior and aggression. This study investigated the effect of developmental Pb exposure on aggression and violent behavior in male rats and the potential modulatory influences of quality of maternal care and enriched/non-enriched housing conditions. Long-Evans male rats with or without Pb exposure (perinatal or early postnatal) from low or high maternal care mothers (based on amounts of licking/grooming and arched- back nursing) were randomly assigned to live in enriched or non-enriched environments at weaning. At post- natal day 120–190, offensive aggression was assessed …

Implementing A Pre-Matriculation Program Targeting Self-Efficacy, Institutional Belongingness, And Metacognition, Steve Caloudas, Nital Appelbaum, Jesus Vallejo, Nadia Ismail, Andrea Stolar

Faculty and Staff Publications

Students come to medical school with diverse backgrounds and experiences. Accordingly, many schools have developed pre-matriculation programs to support students' transition into medical education, especially for those whose educational path may not have offered the same breath of opportunities as their incoming counterparts. Baylor College of Medicine established a pre-matriculation program for students from early assurance programs and non-traditional pathways to address gaps in student support and normalize help-seeking behavior. This program took place over 2 weeks and was developed with leadership and student partners. Participants included 21 students who completed baseline and post-program surveys. Results indicated that a focus …

Exploring Teacher Behaviors That Support Student Self-Regulated Learning In The Clinical Environment, Stephanie B Corliss, Emily K Vinas, Andrew D Bergemann, Jonathan A Macclements, Elizabeth A Nelson

Faculty and Staff Publications

Introduction: With rapidly evolving clinical practice and medical knowledge, future doctors must be independent lifelong learners. Self-regulated learning (SRL) represents a formalized approach to lifelong learning, involving cycles of planning, learning, assessment, and adjustment. Medical schools can create clinical environments where learners are instructed in SRL and encouraged to routinely practice using it. Clinical educators can provide guidance in SRL by co-regulating learning with students. The purpose of this study is to explore how clinical teachers co-regulate the learning process with students during clinical clerkships.

Methods: Data was analyzed from student evaluations of clinical teaching faculty and residents during clinical …

Is Less More? Maximizing Outcomes By Tailoring Treatments To Patients: Oncofertility And Oncomenopause, Janice S Kwon, Marie Plante, Martha Hickey, Annabelle Huguenin, Sarah Hmaidan, Terri Lynn Woodard

Faculty, Staff and Students Publications

Notable advances have been made in improving survival outcomes in various cancers, but some have incurred undesirable costs and effects to patients with respect to fertility and menopause. Patients are living longer with cancer, and patient reported outcomes are influencing decision-making by individuals and their health care providers. It is essential to evaluate existing standards of care on an ongoing basis and prioritize quality of life and long-term survivorship, particularly for interventions in early-stage cancers and risk-reducing strategies that often yield long-term life expectancy.

The Need To Integrate Mental Health Treatment Into The Care Of Mayer-Rokitansky-Küster-Hauser, Teni Davoudian, Emily Hills

Faculty, Staff and Students Publications

This mini review examines the psychological burdens of Mayer-Rokitansky-Küster-Hauser (MRKH) and encourages collaborations between medical and mental health providers who treat this condition. The psychological comorbidities of MRKH emerge in adolescence and persist into adulthood. For several years, The American College of Obstetricians and Gynecologists and researchers in this field have called for the provision of psychological counseling for individuals with MRKH. However, referrals to qualified mental health professionals remain sparse leaving many to confront the emotional complexities of MRKH with little to no support.

Twenty-Five Years Of Palivizumab: A Global Historic Review Of Its Impact On The Burden Of Respiratory Syncytial Virus Disease In Children, Xavier Carbonell-Estrany, Eric A F Simões, Louis Bont, Paolo Manzoni, Heather J Zar, Anne Greenough, Octavio Ramilo, Renato Stein, Barbara Law, Asuncion Mejias, Manuel Sanchez Luna, Paul A Checchia, Leonard Krilov, Marcello Lanari, Ron Dagan, Brigitte Fauroux, Bernhard Resch, Terho Heikkinen, Joseph B Domachowske, Joanne G Wildenbeest, Federico Martinon-Torres, Richard Thwaites, Merih Cetinkaya, Adel S Alharbi, Carlos E Rodriguez-Martinez, Daniel E Noyola, Asiah Kassim, Satoshi Kusuda, Ji-Man Kang, Barry Rodgers-Gray, Anna Platonova, Fungwe Jah, Bosco Paes

Faculty, Staff and Students Publications

Introduction: Respiratory syncytial virus (RSV) causes significant morbidity and mortality in young children. For 25 years, palivizumab has been the only effective pharmaceutical RSV preventive.

Areas covered: We summarize the development and a quarter-century of real-world evidence with palivizumab. We highlight its positive impact on the burden of RSV in high-risk children. Based on lessons learnt from its implementation, we suggest strategies for effective and equitable deployment of newer RSV preventives.

Expert opinion: Following failure of the formalin-inactivated RSV vaccine in 1967, RSV intravenous immunoglobulin was approved in 1996 after three decades' research. Subsequently, palivizumab emerged as the most effective …

Point-Of-Care Ultrasound For Guiding Pulmonary Artery Catheter Placement, Erik Su, Saul Flores

Faculty, Staff and Students Publications

No abstract provided.

Severe Gastrointestinal Manifestations In Childhood-Onset Lupus: A Single-Center Cohort And Review Of The Literature, James Orozco, Jessica Nguyen, Sara Mm Yasrebi, Marnie Blalock, Sara L Grisales, Craig L Jensen, Marietta M Deguzman

Faculty, Staff and Students Publications

Objective

Systemic lupus erythematosus (SLE) is a complex autoimmune condition with diverse manifestations. Childhood-onset SLE (cSLE) presents more severely than adult-onset disease with a higher incidence of severe neurologic or renal manifestations and lower estimated survival rates. There is limited literature on the range of severe gastrointestinal manifestations at presentation in cSLE, and this lack of information results in underappreciation of these potentially life-threatening complications and little guidance regarding management of these patients.

Methods

We reviewed cases of patients with cSLE and severe GI manifestations at presentation diagnosed at our institution and additionally provide a comprehensive review of existing cases …

Are Education, Socioeconomic Status, And Household Size Dependent Variables Influencing The Developmental Origins Of Inflammatory Bowel Disease?, Richard Kellermayer

Faculty, Staff and Students Publications

No abstract provided.

Design Of The Type 1 Diabetes And Life (T1dal) Pilot And Feasibility Study: A Brief Telehealth Intervention Targeting Health-Related Quality Of Life Across Clinical Settings, Marisa E Hilliard, Wendy Levy, Ruth S Weinstock, Korey K Hood, Paula M Trief, Daniel J Desalvo, Yuliana Rojas, Kyrah Holland, Aika K Schneider-Utaka, Selma A Alamarie, Lynn Agostini, Se-Kang Kim, Maartje De Wit, Meghan E Mcgrady, Laurel H Messer, Barbara J Anderson

Faculty, Staff and Students Publications

Background: Type 1 diabetes (T1D) management is demanding and can impact quality of life among persons with diabetes (PWDs) and their family members. Behavioral intervention research has largely focused on adolescents, and previous interventions that have benefitted quality of life have limited potential for implementation in routine care. This trial is piloting a brief behavioral intervention that targets health-related quality of life (HRQOL), which can be implemented with PWDs of all ages in a range of clinical care settings. The aims are to (1) evaluate intervention feasibility and acceptability, (2) explore pre-post change in psychosocial and clinical outcomes, and (3) …

Sci – U: Validation Of An Updated Self-Care Inventory For Contemporary Diabetes Management In Adolescents With Type 1 Diabetes, Sarah S Jaser, Tamim A Hamdan, Marisa E Hilliard, Joyce P Yi-Frazier, Randi Streisand, Faisal S Malik, Daniel J Desalvo, Maeve B O'Donnell, Annette M La Greca

Faculty, Staff and Students Publications

Aims: The Self-Care Inventory is a widely used measure to assess diabetes self-management behaviors. We sought to adapt and streamline the measure to reflect advances in diabetes management, including increased use of continuous glucose monitor and automated insulin delivery systems.

Methods: Through an expert-driven, iterative process, the updated Self-Care Inventory (SCI-U) was created by modifying items to reflect modern diabetes management and reducing the measure to 8 items. The measure was administered to 369 adolescents with type 1 diabetes in 4 regions of the United States, at baseline of two separate intervention trials (mean age = 15.5 ± 1.5, 56 …

40 Years After The Discovery Of Helicobacter Pylori: Performing Optimized “Subtraction” For Clinical Eradication, Yi Hu, Ren-Chun Du, Yong-Kang Lai, Yu-Xin Hu, Yu-Chen Zhu, Yan-An Zhou, Chun-Xi Shu, Bo Zhou, Li-Xiang Ling, Xu Shu, Yong Xie, James Y W Lau, Yin Zhu, David Y Graham, Nong-Hua Lu

Faculty, Staff and Students Publications

It has been 40 years since the first discovery of the important human pathogen, Helicobacter pylori (H. pylori). Eradication of the infection continues to pose significant challenges in part because of the global increase in antibiotic resistance. Generally, the “addition” strategy has failed to deliver the desired results for more than a short period and often contributed to the increase in the prevalence of resistant strains. As such, optimization of each component of the treatment strategy has become an increasingly critical focus of research. In this study, we summarized the evolution of H. pylori eradication regimens and the …

A Phenotypic Screen Identifies Xanthohumol And Other Flavonoids As Killers Of Bladder Cancer, Michael J Bolt, Jessica Oceguera, Alejandra Rivera Tostado, Christopher D Candler, Elina Mosa, Kazem Safari, Maureen G Mancini, Michael A Mancini

Faculty, Staff and Students Publications

Bladder cancer accounts for 4 % of cancer diagnoses in the US. Current treatments primarily involve trans-urethral resection of bladder tumors (TURBT) and immunotherapy with Bacille Calmette-Guerin (BCG). Despite the efficacy of TURBT, issues with residual tumors persist. We chose to utilize Cell Painting to screen a set of 244 flavonoid compounds for bladder cancer cell toxicity. Using multiparametric high content analysis termed SPACe, we discover promising candidates underscoring the potential of flavonoids in targeting bladder cancer cells and elucidating their mechanisms of action. Notably, compounds such as xanthohumol show promise in reducing cancer cell viability by altering lipid metabolism. …

G-Protein Coupled Receptors In Metabolic Reprogramming And Cancer, Songyeon Ahn, Benny Abraham Kaipparettu

Faculty, Staff and Students Publications

G-protein coupled receptors (GPCR) are one of the frequently investigated drug targets. GPCRs are involved in many human pathophysiologies that lead to various disease conditions, such as cancer, diabetes, and obesity. GPCR receptor activates multiple signaling pathways depending on the ligand and tissue type. However, this review will be limited to the GPCR-mediated metabolic modulations and the activation of relevant signaling pathways in cancer therapy. Cancer cells often have reprogrammed cell metabolism to support tumor growth and metastatic plasticity. Many aggressive cancer cells maintain a hybrid metabolic status, using both glycolysis and mitochondrial metabolism for better metabolic plasticity. In addition …

Speech Delay And Hearing Rehabilitation Disparities In Children With Hearing Loss, Lacey C Magee, Malek Bouzaher, Mihika Thapliyal, Yi-Chun Liu, Samantha Anne

Faculty, Staff and Students Publications

Objectives: To investigate the influence of race and insurance type on speech delay rates and hearing rehabilitation access in children with bilateral hearing loss (HL).

Study design: Retrospective cross-sectional study of pediatric patients with bilateral HL who received cochlear implants (CIs) or hearing aids (HAs).

Setting: This study used the national Pediatric Health Information System (PHIS) database to identify patients with HL across 52 tertiary care pediatric hospitals in the United States.

Methods: Data collected included demographics, CI/HA use, speech delay/disorders, and type of insurance coverage.

Results: This study identified 18,422 patients with bilateral HL (40.1% female, 66.3% white, 66.3% …

Mitral Annular Disjunction Is Associated With Ventricular Arrhythmias In Children With Marfan Syndrome, Carlos A Sanchez Parra, Ruthie M Vaughan, Alejandra Iturralde Chavez, Christina Y Miyake, Santiago O Valdes, Ricardo H Pignatelli, Anitha Parthiban, Shaine A Morris, Tam T Doan

Faculty, Staff and Students Publications

No abstract provided.

Plasma Microbial Cell-Free Dna Sequencing For The Detection Of Kingella Kingae Pediatric Spinal Infections, Asim A Ahmed, Sarah Y Park, Matthew J Smollin, Martin S Lindner, Adriana Sarmiento Clemente, Ana Del Valle Penella, P Marcelo Laufer, Carolina Sanchez-Vegas, Manuel R Cotilla, Marian E Melish, Connie Trieu, Nazia A Kabani, Joshua Cooper, Audrey R Lloyd, David W Kimberlin, John C Arnold, Alejandro Jordan-Villegas, Lori E Patterson, Catherine E Foster, Pablo Yagupsky

Faculty, Staff and Students Publications

Background: Diagnosis of Kingella kingae skeletal system infections is made challenging by the microbe's fastidious nature. Detection and quantification of circulating microbial cell-free DNA (mcfDNA) in plasma by the Karius Test, a commercial metagenomic sequencing test, may offer promise in diagnosing pediatric spinal infections caused by difficult-to-culture organisms such as K. kingae .

Methods: Plasma mcfDNA sequencing detections of K. kingae from April 2018 to December 2020 were reviewed to identify pediatric (age < 18 years) patients. Medical charts of those with spinal infections were reviewed, and mcfDNA sequencing diagnostic performance was compared with usual care tests (ie, cultures, polymerase chain reaction).

Results: Ten children with K. kingae spinal infections were identified across 7 institutions. The median age was 16.5 months (range 11-23 months). All case-patients had vertebral osteomyelitis …

Ophthalmology Examinations In Children With Skull Fractures And Underlying Focal Hemorrhage, Karli Breeden, Cindy W Christian, Joanne N Wood, Gil Binenbaum, Daniel M Lindberg, Angela Bachim, Colleen J Bressler, Lori Frasier, Terra Frazier, Nicole R Johnson, Natalie Laub, Megan M Letson, Tagrid Ruiz-Maldonado, Matthew Valente, Jenna Kiely, Jan Leonard, M Katherine Henry

Faculty, Staff and Students Publications

Objectives: To assess the frequency and yield of retinal examination in children below 2 years old undergoing abuse evaluations in the setting of skull fracture(s) and small underlying intracranial hemorrhage.

Methods: This cross-sectional study used CAPNET, a multicenter child physical abuse network, to identify children below 2 years with a skull fracture(s) and intracranial injury limited to an underlying small focal intracranial hemorrhage undergoing subspeciality child abuse evaluations. Our outcomes of interest were (1) the performance of a retinal examination, (2) the identification of retinal hemorrhages, and (3) associations of clinical factors and CAPNET site with the performance of retinal …

Linking Symptom Inventories Using Semantic Textual Similarity, Eamonn Kennedy, Shashank Vadlamani, Hannah M Lindsey, Kelly S Peterson, Kristen Dams O'Connor, Ronak Agarwal, Houshang H Amiri, Raeda K Andersen, Talin Babikian, David A Baron, Erin D Bigler, Karen Caeyenberghs, Lisa Delano-Wood, Seth G Disner, Ekaterina Dobryakova, Blessen C Eapen, Rachel M Edelstein, Carrie Esopenko, Helen M Genova, Elbert Geuze, Naomi J Goodrich-Hunsaker, Jordan Grafman, Asta K Håberg, Cooper B Hodges, Kristen R Hoskinson, Elizabeth S Hovenden, Andrei Irimia, Neda Jahanshad, Ruchira M Jha, Finian Keleher, Kimbra Kenney, Inga K Koerte, Spencer W Liebel, Abigail Livny, Marianne Løvstad, Sarah L Martindale, Jeffrey E Max, Andrew R Mayer, Timothy B Meier, Deleene S Menefee, Abdalla Z Mohamed, Stefania Mondello, Martin M Monti, Rajendra A Morey, Virginia Newcombe, Mary R Newsome, Alexander Olsen, Nicholas J Pastorek, Mary Jo Pugh, Adeel Razi, Jacob E Resch, Jared A Rowland, Kelly Russell, Nicholas P Ryan, Randall S Scheibel, Adam T Schmidt, Gershon Spitz, Jaclyn A Stephens, Assaf Tal, Leah D Talbert, Maria Carmela Tartaglia, Brian A Taylor, Sophia I Thomopoulos, Maya Troyanskaya, Eve M Valera, Harm Jan Van Der Horn, John D Van Horn, Ragini Verma, Benjamin S C Wade, Willian C Walker, Ashley L Ware, J Kent Werner, Keith Owen Yeates, Ross D Zafonte, Michael M Zeineh, Brandon Zielinski, Paul M Thompson, Frank G Hillary, David F Tate, Elisabeth A Wilde, Emily L Dennis

Faculty, Staff and Students Publications

An extensive library of symptom inventories has been developed over time to measure clinical symptoms of traumatic brain injury (TBI), but this variety has led to several long-standing issues. Most notably, results drawn from different settings and studies are not comparable. This creates a fundamental problem in TBI diagnostics and outcome prediction, namely that it is not possible to equate results drawn from distinct tools and symptom inventories. Here, we present an approach using semantic textual similarity (STS) to link symptoms and scores across previously incongruous symptom inventories by ranking item text similarities according to their conceptual likeness. We tested …

Histologic- And Genomic-Directed Adjuvant Therapy For Ampullary Adenocarcinoma: A Hidden Genome-Derived Analysis, Brett L Ecker, Kenneth Seier, Ankur Choubey, Austin M Eckhoff, Gabriella N Tortorello, Vinod P Balachandran, Nicola Blackburn, Michael I D'Angelica, Ronald P Dematteo, Daniel G Blazer, Jeffrey A Drebin, William E Fisher, Anthony J Gill, Marie-Claude Gingras, T Peter Kingham, Major K Lee, Michael E Lidsky, Daniel P Nussbaum, Michael J Overman, Jaswinder S Samra, Ronglai Shen, Carlie S Sigel, Charles M Vollmer, Alice C Wei, Sabino Zani, Australian Pancreatic Genome Initiative, Robert E Roses, Mithat Gonen, William R Jarnagin

Faculty, Staff and Students Publications

Background: The benefit of adjuvant chemotherapy (AC) for ampullary adenocarcinoma is unclear. The Hidden Genome model classifies prognostic subtypes with greater accuracy than standard histologic classification (intestinal [INT] vs pancreatobiliary [PB]), but its predictive capacity to guide the use of AC remains unstudied.

Methods: We applied the Hidden Genome model to an international cohort of 183 patients with resected ampullary adenocarcinoma who underwent genomic sequencing. The model quantified the predicted cell of origin (colorectal vs pancreas/distal bile duct) in all specimens. Overall survival (OS) was compared using Kaplan-Meier estimates, stratified by AC use versus surgery alone (SA).

Results: Most patients …