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Full-Text Articles in Medicine and Health Sciences

Glial Progenitor Heterogeneity And Plasticity In The Adult Spinal Cord, Haichao Wei, Jia Qian Wu Dec 2024

Glial Progenitor Heterogeneity And Plasticity In The Adult Spinal Cord, Haichao Wei, Jia Qian Wu

Faculty, Staff and Student Publications

No abstract provided.


Etiologies Of Bloody Diarrhea In Children Presenting With Acute Gastroenteritis To Us Emergency Departments., Paola Fonseca-Romero, Ben J. Brintz, D Matthew Vierkant, Jennifer Dien Bard, Daniel M. Cohen, Ara Festekjian, Amy L. Leber, Jami T. Jackson, Neena Kanwar, Chari Larsen, Rangaraj Selvarangan, Kimberle C. Chapin, Andrew T. Pavia, Sharia M. Ahmed, Daniel T. Leung, Impact Study Investigators Dec 2024

Etiologies Of Bloody Diarrhea In Children Presenting With Acute Gastroenteritis To Us Emergency Departments., Paola Fonseca-Romero, Ben J. Brintz, D Matthew Vierkant, Jennifer Dien Bard, Daniel M. Cohen, Ara Festekjian, Amy L. Leber, Jami T. Jackson, Neena Kanwar, Chari Larsen, Rangaraj Selvarangan, Kimberle C. Chapin, Andrew T. Pavia, Sharia M. Ahmed, Daniel T. Leung, Impact Study Investigators

Manuscripts, Articles, Book Chapters and Other Papers

We used molecular testing to examine the causes of bloody diarrhea in a multicenter study of pediatric gastroenteritis. Pathogens typically associated with bloody diarrhea were detected in less than half of cases, and inappropriate antibiotic use was common, supporting the use of stool testing in patients with bloody diarrhea.


Why And When Do We Invasively Restage After Neoadjuvant Chemoimmunotherapy?, Jonathan D Spicer, Tina Cascone, Murry W Wynes, Karen L Kelly Dec 2024

Why And When Do We Invasively Restage After Neoadjuvant Chemoimmunotherapy?, Jonathan D Spicer, Tina Cascone, Murry W Wynes, Karen L Kelly

Faculty, Staff and Student Publications

No abstract provided.


Mimicking Large Spot-Scanning Radiation Fields For Proton Flash Preclinical Studies With A Robotic Motion Platform, Fada Guan, Dadi Jiang, Xiaochun Wang, Ming Yang, Kiminori Iga, Yuting Li, Lawrence Bronk, Julianna Bronk, Liang Wang, Youming Guo, Narayan Sahoo, David R Grosshans, Albert C Koong, Xiaorong R Zhu, Radhe Mohan Dec 2024

Mimicking Large Spot-Scanning Radiation Fields For Proton Flash Preclinical Studies With A Robotic Motion Platform, Fada Guan, Dadi Jiang, Xiaochun Wang, Ming Yang, Kiminori Iga, Yuting Li, Lawrence Bronk, Julianna Bronk, Liang Wang, Youming Guo, Narayan Sahoo, David R Grosshans, Albert C Koong, Xiaorong R Zhu, Radhe Mohan

Faculty, Staff and Student Publications

Previously, a synchrotron-based horizontal proton beamline (87.2 MeV) was successfully commissioned to deliver radiation doses in FLASH and conventional dose rate modes to small fields and volumes. In this study, we developed a strategy to increase the effective radiation field size using a custom robotic motion platform to automatically shift the positions of biological samples. The beam was first broadened with a thin tungsten scatterer and shaped by customized brass collimators for irradiating cell/organoid cultures in 96-well plates (a 7-mm-diameter circle) or for irradiating mice (1-cm


The Fletcher-Cox Pathway: A Unique View On Clinical Trial Education, Shalini Moningi, Shane Stecklein, Sonal Noticewala, Olsi Gjyshi, Todd Pezzi, David Boyce-Fappiano, Prajnan Das, Bruce Minsky, Emma B Holliday, Andrew J Bishop, Albert C Koong, Chelsea C Pinnix Dec 2024

The Fletcher-Cox Pathway: A Unique View On Clinical Trial Education, Shalini Moningi, Shane Stecklein, Sonal Noticewala, Olsi Gjyshi, Todd Pezzi, David Boyce-Fappiano, Prajnan Das, Bruce Minsky, Emma B Holliday, Andrew J Bishop, Albert C Koong, Chelsea C Pinnix

Faculty, Staff and Student Publications

Purpose: There currently are no established formal mentorship and training programs for radiation oncology (RO) trainees to learn trial design, creation, writing, or implementation. There only exists informal training on analyzing clinical trials in RO residency programs. The integration of a longitudinal formal training and mentorship program for clinical trialists-consisting of clinical trial education, design, mentorship, and implementation during the RO residency education-will give residents not only formal teaching in the subject but also strong tools and requisite mentorship in hopes to help them succeed as future academic physicians and leaders in the field of RO.

Methods and materials: We …


Evaluating Pre-Consult Patient Education Videos For Patients With Newly-Diagnosed Anal Squamous Cell Carcinoma: Impact On Patient Comprehension, Satisfaction And Distress, Kelsey L Corrigan, Lauren M Andring, Prajnan Das, Cheryl Pfennig, Kimberly B Porter, Ethan B Ludmir, Sonal S Noticewala, Bruce D Minsky, Grace L Smith, Eugene J Koay, Albert C Koong, Angelica Arzola, Sarah J Lee, Lashon Nelms, Emma B Holliday Dec 2024

Evaluating Pre-Consult Patient Education Videos For Patients With Newly-Diagnosed Anal Squamous Cell Carcinoma: Impact On Patient Comprehension, Satisfaction And Distress, Kelsey L Corrigan, Lauren M Andring, Prajnan Das, Cheryl Pfennig, Kimberly B Porter, Ethan B Ludmir, Sonal S Noticewala, Bruce D Minsky, Grace L Smith, Eugene J Koay, Albert C Koong, Angelica Arzola, Sarah J Lee, Lashon Nelms, Emma B Holliday

Faculty, Staff and Student Publications

We hypothesized that pre-consult patient education videos can improve patient understanding about their diagnosis, lead to high satisfaction and low distress. In this pilot study, we developed a patient education video curriculum for patients with newly-diagnosed anal cancer. Comprehension of key content was evaluated by comparing pre- and post-test scores. Patient satisfaction scores were collected. Patient distress scores (0-10) were collected at the beginning of their consult visit prior to seeing the physician. We found that patient education videos prior to consult improved patient understanding, resulted in high patient satisfaction, and low patient distress at the time of consult.


High Activity Of The New Myeloablative Regimen Of Gemcitabine/Clofarabine/Busulfan For Allogeneic Transplant For Aggressive Lymphomas, Jeremy Ramdial, Ruitao Lin, Peter F Thall, Benigno C Valdez, Chitra Hosing, Samer Srour, Uday Popat, Muzaffar Qazilbash, Amin Alousi, Melissa Barnett, Alison Gulbis, Terri Lynn Shigle, Elizabeth J Shpall, Borje S Andersson, Yago Nieto Dec 2024

High Activity Of The New Myeloablative Regimen Of Gemcitabine/Clofarabine/Busulfan For Allogeneic Transplant For Aggressive Lymphomas, Jeremy Ramdial, Ruitao Lin, Peter F Thall, Benigno C Valdez, Chitra Hosing, Samer Srour, Uday Popat, Muzaffar Qazilbash, Amin Alousi, Melissa Barnett, Alison Gulbis, Terri Lynn Shigle, Elizabeth J Shpall, Borje S Andersson, Yago Nieto

Faculty, Staff and Student Publications

Refractory aggressive lymphomas can be treated with allo-SCT, pursuing a graft-vs-lymphoma effect. While reduced intensity conditioning is safe, tumors often progress rapidly, indicating the need for more active conditioning regimens. The preclinical synergy we saw between gemcitabine (Gem), clofarabine (Clo) and busulfan (Bu) against lymphoma cell lines led us to study Gem/Clo/Bu clinically. Eligibility: age 12-65, refractory aggressive B-NHL, T-NHL or Hodgkin, with a matched donor. Infusional Gem was dose-escalated on days (d) -6 and -4 (475-975 mg/m2/day), followed by Clo (40 mg/m2/day) and Bu (target AUC, 4000 μMol min/day) (d -6 to -3). CD20+ tumors received rituximab. GVHD prophylaxis …


Cutaneous T Cell Lymphoma Atlas Reveals Malignant Th2 Cells Supported By A B Cell-Rich Tumor Microenvironment, Ruoyan Li, Johanna Strobl, Elizabeth F M Poyner, Aya Balbaa, Fereshteh Torabi, Pavel V Mazin, Nana-Jane Chipampe, Emily Stephenson, Ciro Ramírez-Suástegi, Vijaya Baskar Mahalingam Shanmugiah, Louis Gardner, Bayanne Olabi, Rowen Coulthard, Rachel A Botting, Nina Zila, Elena Prigmore, Nusayhah H Gopee, Marta A Chroscik, Efpraxia Kritikaki, Justin Engelbert, Issac Goh, Hon Man Chan, Harriet F Johnson, Jasmine Ellis, Victoria Rowe, Win Tun, Gary Reynolds, Dexin Yang, April Rose Foster, Laure Gambardella, Elena Winheim, Chloe Admane, Benjamin Rumney, Lloyd Steele, Laura Jardine, Julia Nenonen, Keir Pickard, Jennifer Lumley, Philip Hampton, Simeng Hu, Fengjie Liu, Xiangjun Liu, David Horsfall, Daniela Basurto-Lozada, Louise Grimble, Chris M Bacon, Sophie C Weatherhead, Hanna Brauner, Yang Wang, Fan Bai, Nick J Reynolds, Judith E Allen, Constanze Jonak, Patrick M Brunner, Sarah A Teichmann, Muzlifah Haniffa Dec 2024

Cutaneous T Cell Lymphoma Atlas Reveals Malignant Th2 Cells Supported By A B Cell-Rich Tumor Microenvironment, Ruoyan Li, Johanna Strobl, Elizabeth F M Poyner, Aya Balbaa, Fereshteh Torabi, Pavel V Mazin, Nana-Jane Chipampe, Emily Stephenson, Ciro Ramírez-Suástegi, Vijaya Baskar Mahalingam Shanmugiah, Louis Gardner, Bayanne Olabi, Rowen Coulthard, Rachel A Botting, Nina Zila, Elena Prigmore, Nusayhah H Gopee, Marta A Chroscik, Efpraxia Kritikaki, Justin Engelbert, Issac Goh, Hon Man Chan, Harriet F Johnson, Jasmine Ellis, Victoria Rowe, Win Tun, Gary Reynolds, Dexin Yang, April Rose Foster, Laure Gambardella, Elena Winheim, Chloe Admane, Benjamin Rumney, Lloyd Steele, Laura Jardine, Julia Nenonen, Keir Pickard, Jennifer Lumley, Philip Hampton, Simeng Hu, Fengjie Liu, Xiangjun Liu, David Horsfall, Daniela Basurto-Lozada, Louise Grimble, Chris M Bacon, Sophie C Weatherhead, Hanna Brauner, Yang Wang, Fan Bai, Nick J Reynolds, Judith E Allen, Constanze Jonak, Patrick M Brunner, Sarah A Teichmann, Muzlifah Haniffa

Faculty, Staff and Student Publications

Cutaneous T cell lymphoma (CTCL) is a potentially fatal clonal malignancy of T cells primarily affecting the skin. The most common form of CTCL, mycosis fungoides, can be difficult to diagnose, resulting in treatment delay. We performed single-cell and spatial transcriptomics analysis of skin from patients with mycosis fungoides-type CTCL and an integrated comparative analysis with human skin cell atlas datasets from healthy and inflamed skin. We revealed the co-optation of T helper 2 (TH2) cell-immune gene programs by malignant CTCL cells and modeling of the tumor microenvironment to support their survival. We identified MHC-II+ fibroblasts and dendritic cells that …


Anti-Programmed Death Ligand 1 Plus Targeted Therapy In Anaplastic Thyroid Carcinoma: A Nonrandomized Clinical Trial, Maria E Cabanillas, Ramona Dadu, Renata Ferrarotto, Maria Gule-Monroe, Suyu Liu, Bryan Fellman, Michelle D Williams, Mark Zafereo, Jennifer R Wang, Charles Lu, Matthew Ning, Brian A Mckinley, Scott E Woodman, Dzifa Duose, Gary B Gunn, Naifa L Busaidy, Rare Tumor Initiative Team Dec 2024

Anti-Programmed Death Ligand 1 Plus Targeted Therapy In Anaplastic Thyroid Carcinoma: A Nonrandomized Clinical Trial, Maria E Cabanillas, Ramona Dadu, Renata Ferrarotto, Maria Gule-Monroe, Suyu Liu, Bryan Fellman, Michelle D Williams, Mark Zafereo, Jennifer R Wang, Charles Lu, Matthew Ning, Brian A Mckinley, Scott E Woodman, Dzifa Duose, Gary B Gunn, Naifa L Busaidy, Rare Tumor Initiative Team

Faculty, Staff and Student Publications

Importance: Anaplastic thyroid carcinoma (ATC) is a rare and lethal cancer. Although progress has been made in recent years in patients with mutated BRAF tumors, those who respond initially eventually die of their disease; furthermore, there are no approved therapies for non-BRAF mutated tumors.

Objective: To determine whether treatment with matched-targeted therapy plus immune checkpoint inhibitors were associated with improved overall survival (OS).

Design, setting, and participants: A phase 2 trial at a single center, tertiary institution with parallel cohorts, assigning treatment with targeted therapy according to the tumor mutation status. Patients with mutated BRAF V600E tumors received vemurafenib/cobimetinib plus …


Ultra-Low-Dose Radiation For Extranodal Marginal Zone Lymphoma Of The Lung, Susan Y Wu, Penny Q Fang, Ahmed Fetooh, Gohar S Manzar, Kelsey L Corrigan, Benjamin R Schrank, Lewis Nasr, Dai Chihara, Luis E Malpica Castillo, Ranjit Nair, Raphael E Steiner, Preetesh Jain, Sattva S Neelapu, Paolo Strati, Loretta J Nastoupil, Bouthaina S Dabaja, Chelsea C Pinnix, Jillian R Gunther Dec 2024

Ultra-Low-Dose Radiation For Extranodal Marginal Zone Lymphoma Of The Lung, Susan Y Wu, Penny Q Fang, Ahmed Fetooh, Gohar S Manzar, Kelsey L Corrigan, Benjamin R Schrank, Lewis Nasr, Dai Chihara, Luis E Malpica Castillo, Ranjit Nair, Raphael E Steiner, Preetesh Jain, Sattva S Neelapu, Paolo Strati, Loretta J Nastoupil, Bouthaina S Dabaja, Chelsea C Pinnix, Jillian R Gunther

Faculty, Staff and Student Publications

Purpose: Definitive intent radiation therapy (RT) for early-stage mucosa-associated lymphoid tissue (MALT) lymphoma typically includes a dose of 24 to 30 Gy. While modest, these doses may have associated toxicity. For patients with indolent B-cell lymphoma, there is increasing support for the use of ultra-low-dose RT (ULDRT) using 4 Gy in 2 fractions as part of a response-adapted approach, as high rates of complete response have been documented. This paradigm has been prospectively evaluated in the management of orbital and gastric indolent B-cell lymphomas; however, there is limited data guiding the use of ULDRT for lung MALT.

Methods: We conducted …


Increasing Safety Net Antibiotic Prescriptions For Acute Otitis Media In Urgent Care Clinics., Jennifer Mckinsey, Brian R. Lee, Donna Wyly, Holly Austin, Dinah Dosdos, Emily Murdock, Aimy Patel, Rana El Feghaly, Amanda Nedved Dec 2024

Increasing Safety Net Antibiotic Prescriptions For Acute Otitis Media In Urgent Care Clinics., Jennifer Mckinsey, Brian R. Lee, Donna Wyly, Holly Austin, Dinah Dosdos, Emily Murdock, Aimy Patel, Rana El Feghaly, Amanda Nedved

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: To evaluate the effectiveness of multifaceted interventions in improving the use of safety net antibiotic prescriptions (SNAPs) for nonsevere acute otitis media (AOM).

STUDY DESIGN: We used quality improvement methodology to develop iterative Plan-Do-Study-Act cycles to increase the use of SNAP for nonsevere AOM in 3 pediatric urgent care centers from October 2021 to June 2023. Interventions included education, electronic health record changes, audits and feedback, and a time-limited financial incentive. We measured the percentage of eligible patients with AOM offered SNAP as our primary outcome. Our secondary outcome measured the percentage of SNAPs accepted. Our process measure evaluated …


The Norwood With Blalock-Taussig-Thomas Shunt—Worth A Second Look?, Manasa Gadiraju, Dhaval Chauhan, Alexandra Schray, James O'Brien, Edo Bedzra Dec 2024

The Norwood With Blalock-Taussig-Thomas Shunt—Worth A Second Look?, Manasa Gadiraju, Dhaval Chauhan, Alexandra Schray, James O'Brien, Edo Bedzra

Manuscripts, Articles, Book Chapters and Other Papers

Background: Shunt repair for the Norwood procedure with either the right ventricle to pulmonary artery shunt (RVPAS) or the modified Blalock-Taussig-Thomas Shunt (BTTS) varies by institution and surgeon preference. Shunt choice has been informed by landmark trials including the Single Ventricle Reconstruction trial and modern outcomes data may engender future complementary studies. Methods: We conducted a retrospective analysis of all patients who underwent the Norwood procedure from 2014–2022 at a single center to compare outcomes by shunt type. The primary outcome measure was freedom from death or transplant. Secondary outcome measures included hospital length of stay, complications, and unplanned interventions. …


Impact Of The Adenosine Receptor A2br Expressed On Myeloid Cells On Immune Regulation During Pregnancy, Stefanie Dietz, Janine Hebel, Jessica Rühle, Alisha Huff, Holger K Eltzschig, Trim Lajqi, Christian F Poets, Christian Gille, Natascha Köstlin-Gille Dec 2024

Impact Of The Adenosine Receptor A2br Expressed On Myeloid Cells On Immune Regulation During Pregnancy, Stefanie Dietz, Janine Hebel, Jessica Rühle, Alisha Huff, Holger K Eltzschig, Trim Lajqi, Christian F Poets, Christian Gille, Natascha Köstlin-Gille

Faculty, Staff and Student Publications

During pregnancy, the maternal immune system must carefully balance protection against pathogens with tolerance toward the semiallogeneic fetus. Dysfunctions of the immune system can lead to severe complications such as preeclampsia, fetal growth restriction, or pregnancy loss. Adenosine plays a role in physiological processes and plasma‐level increase during pregnancy. The adenosine receptor A2B (A2BR), which is expressed on both, immune and nonimmune cells, is activated by high adenosine concentrations, achieved during pregnancy. We investigated the impact of A2BR expressed on myeloid cells on immune regulation during pregnancy using a mouse model with myeloid deficiency for A2BR. We demonstrate systemic changes …


Improving The Clinical Meaning Of Surrogate Endpoints: An Empirical Assessment Of Clinical Progression In Phase Iii Oncology Trials, Alexander D Sherry, Timothy A Lin, Zachary R Mccaw, Esther J Beck, Ramez Kouzy, Joseph Abi Jaoude, Adina H Passy, Avital M Miller, Gabrielle S Kupferman, Clifton David Fuller, Charles R Thomas, Eugene J Koay, Chad Tang, Pavlos Msaouel, Ethan B Ludmir Dec 2024

Improving The Clinical Meaning Of Surrogate Endpoints: An Empirical Assessment Of Clinical Progression In Phase Iii Oncology Trials, Alexander D Sherry, Timothy A Lin, Zachary R Mccaw, Esther J Beck, Ramez Kouzy, Joseph Abi Jaoude, Adina H Passy, Avital M Miller, Gabrielle S Kupferman, Clifton David Fuller, Charles R Thomas, Eugene J Koay, Chad Tang, Pavlos Msaouel, Ethan B Ludmir

Faculty, Staff and Student Publications

Disease progression in clinical trials is commonly defined by radiologic measures. However, clinical progression may be more meaningful to patients, may occur even when radiologic criteria for progression are not met, and often requires a change in therapy in clinical practice. The objective of this study was to determine the utilization of clinical progression criteria within progression-based trial endpoints among phase III trials testing systemic therapies for metastatic solid tumors. The primary manuscripts and protocols of phase III trials were reviewed for whether clinical events, such as refractory pain, tumor bleeding, or neurologic compromise, could constitute a progression event. Univariable …


The Spectrum Of Hematologic Neoplasms In Patients With Li-Fraumeni Syndrome, Yiannis Petros Dimopoulos, Wei Wang, Sa A Wang, Sanam Loghavi, Courtney D Dinardo, Yoheved Gerstein, Shimin Hu, Zhenya Tang, Charmaine Joyce Lim Ilagan, Beenu Thakral, Siba El Hussein, Jie Xu, Shaoying Li, Pei Lin, Keyur P Patel, Chi Young Ok, L Jeffrey Medeiros, Hong Fang Dec 2024

The Spectrum Of Hematologic Neoplasms In Patients With Li-Fraumeni Syndrome, Yiannis Petros Dimopoulos, Wei Wang, Sa A Wang, Sanam Loghavi, Courtney D Dinardo, Yoheved Gerstein, Shimin Hu, Zhenya Tang, Charmaine Joyce Lim Ilagan, Beenu Thakral, Siba El Hussein, Jie Xu, Shaoying Li, Pei Lin, Keyur P Patel, Chi Young Ok, L Jeffrey Medeiros, Hong Fang

Faculty, Staff and Student Publications

No abstract provided.


Association Between Socioeconomic Disadvantage And Risks Of Early And Recurrent Admissions Among Patients With Newly Diagnosed Heart Failure, Radha Dhingra, Hanzhang Xu, Bradley G Hammill, Scott M Lynch, Jessica S West, Michael D Green, Eric D Peterson, Lesley H Curtis, Matthew E Dupre Dec 2024

Association Between Socioeconomic Disadvantage And Risks Of Early And Recurrent Admissions Among Patients With Newly Diagnosed Heart Failure, Radha Dhingra, Hanzhang Xu, Bradley G Hammill, Scott M Lynch, Jessica S West, Michael D Green, Eric D Peterson, Lesley H Curtis, Matthew E Dupre

Faculty, Staff and Student Publications

Background: Socioeconomic disadvantage is associated with greater risks of hospital readmission and mortality among patients with heart failure (HF). However, it is less clear whether socioeconomic disadvantage has an immediate and lasting impact on the risk of admissions after the diagnosis of HF.

Methods: We used electronic health record data of patients aged 65 years and older with newly diagnosed HF between January 2015 and July 2018 in the Duke University Health System, with up to 8 years of follow-up. We assessed the association between neighborhood-level disadvantage, measured by the area deprivation index (lower, moderate, or higher) and hospital admissions …


The Impact Of Early Axial Interfragmentary Motion On The Fracture Healing Environment: A Scoping Review, Griffin R Rechter, Ryan Tyler Anthony, Justin Rennard, James F Kellam, Stephen J Warner Dec 2024

The Impact Of Early Axial Interfragmentary Motion On The Fracture Healing Environment: A Scoping Review, Griffin R Rechter, Ryan Tyler Anthony, Justin Rennard, James F Kellam, Stephen J Warner

Faculty, Staff and Student Publications

Purpose: The initial interfragmentary motion (IFM) at a fracture site determines the mode of fracture healing. Understanding the impact of orthopaedic interventions on the fracture environment is essential to advancing our knowledge of fracture healing. The purpose of this scoping review is to analyze the orthopaedic literature to assess our understanding of the effects of early axial IFM on fracture healing outcomes.

Methods: PubMed, OVID, and Scopus databases were queried to identify all studies from inception until June 2023 assessing axial IFM on fracture healing outcomes in animal and human subjects. We collected information regarding the amount of IFM, osteotomy/fracture …


Nasal Virus Infection Induces Asthma Exacerbation Through B-Cell-Dependent Recruitment Of Inflammatory Monocytes, Kody A Waldstein, Arman Issimov, Maria Ganama, Valerie Jinge, Stephen Tilley, Xiaoyang Hua Dec 2024

Nasal Virus Infection Induces Asthma Exacerbation Through B-Cell-Dependent Recruitment Of Inflammatory Monocytes, Kody A Waldstein, Arman Issimov, Maria Ganama, Valerie Jinge, Stephen Tilley, Xiaoyang Hua

Faculty, Staff and Student Publications

Background: Upper respiratory viral infections (URVIs) are responsible for 80% of asthma exacerbation episodes. However, the underlying mechanisms remain poorly understood.

Methods: In this study, we used a mouse model of URVI and examined the impact of URVI on asthma phenotypes and the underlying mechanisms.

Results: Previously, we have reported that nasal-restricted infection with respiratory syncytial virus (RSV) only produces mild sino-nasal inflammation and mucus production, without causing direct lung infection. However, such nasal-restricted infection dramatically enhanced TH2 and TH17 inflammatory responses in the lungs and increased airway hyperresponsiveness (AHR) in mice with house dust mite (HDM)-induced asthma. Additionally, nasal-restricted …


Defining Breast Cryoablation Treatment Success: A Guide For The Curative And Palliative Treatment Of Breast Cancer, Monica L Huang, Deanna L Lane, Lauren Q Chang Sen, Rosalind P Candelaria, Henry M Kuerer, Kelly K Hunt, Catherine Akay, Bora Lim, Simona Shaitelman, Rosa F Hwang, Hui Chen, Rajani Katta, Lumarie Santiago Dec 2024

Defining Breast Cryoablation Treatment Success: A Guide For The Curative And Palliative Treatment Of Breast Cancer, Monica L Huang, Deanna L Lane, Lauren Q Chang Sen, Rosalind P Candelaria, Henry M Kuerer, Kelly K Hunt, Catherine Akay, Bora Lim, Simona Shaitelman, Rosa F Hwang, Hui Chen, Rajani Katta, Lumarie Santiago

Faculty, Staff and Student Publications

Rationale and objectives: Recent ICE3 trial of breast cryoablation for breast cancer demonstrated 98% success rate, similar to breast-conserving surgery. However, ICE3 and other published studies did not differentiate curative from palliative treatment nor define patient-specific treatment objectives. We sought to define treatment success of curative and palliative breast cryoablation for breast cancer in meeting procedure objectives and patient-specific treatment objectives.

Materials and methods: We conducted a retrospective analysis of breast cancer patients who underwent breast cryoablation during 2021-2024. Breast radiologists performed outpatient cryoablation using local anesthesia and argon gas cryoprobes under ultrasound or MRI guidance. Patient demographics, referral indications, …


Sleep Disturbances Based On Patient Reported Outcomes In Patients With Breast Cancer, Saadia A Faiz, Ashley S Knox, Bryan Fellman, Bibi Aneesah Jaumally, G Nancy Pacheco, Aneesa Das, Reeba Mathew, Rashmi Murthy, Jennifer K Litton, Diwakar D Balachandran, Lara Bashoura Dec 2024

Sleep Disturbances Based On Patient Reported Outcomes In Patients With Breast Cancer, Saadia A Faiz, Ashley S Knox, Bryan Fellman, Bibi Aneesah Jaumally, G Nancy Pacheco, Aneesa Das, Reeba Mathew, Rashmi Murthy, Jennifer K Litton, Diwakar D Balachandran, Lara Bashoura

Faculty, Staff and Student Publications

Purpose: Sleep disturbances are common in patients with breast cancer, but comprehensive evaluations with patient-reported outcomes (PRO) and sleep evaluation with polysomnography (PSG) are lacking. This study describes sleep disruption using PROs and PSG to identify underlying sleep disorders.

Methods: A retrospective review of patients with breast cancer undergoing formal sleep evaluation from 4/1/2009 to 7/31/2014 was performed. Clinical characteristics, PROs using Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS), and PSG data were reviewed.

Results: 404 patients were identified with 43% early, 30% locally advanced and 17% metastatic disease. PSQI revealed poor sleep in 75%, and ESS …


Surfactant Protein-C Regulates Alveolar Type 2 Epithelial Cell Lineages Via The Cd74 Receptor, Krishan G Jain, Yang Liu, Runzhen Zhao, Preeti J Muire, Nan-Miles Xi, Hong-Long Ji Dec 2024

Surfactant Protein-C Regulates Alveolar Type 2 Epithelial Cell Lineages Via The Cd74 Receptor, Krishan G Jain, Yang Liu, Runzhen Zhao, Preeti J Muire, Nan-Miles Xi, Hong-Long Ji

Faculty, Staff and Student Publications

Background: Deficiency of surfactant protein-C (SPC) increases susceptibility to lung infections and injury, and suppressed expression of SPC has been associated with the severity of acute respiratory distress syndrome (ARDS). Alveolar type 2 epithelial cells (AT2) are critical for maintenance and repair of the lung. However, the role of the SPC in the regulation of AT2 cell lineage and the underlying mechanisms are not completely understood.

Methods: This study aimed to investigate the mechanisms by which SPC regulates AT2 lineages. Sftpc-/- mice were used to model the SPC deficiency in ARDS patients. We utilized three-dimensional (3D) organoids to compare AT2 …


Cams In Command: Aging Brain Macrophages Fine-Tune Stroke Immune Responses, Rodney M Ritzel, Danye Jiang, Louise D Mccullough Dec 2024

Cams In Command: Aging Brain Macrophages Fine-Tune Stroke Immune Responses, Rodney M Ritzel, Danye Jiang, Louise D Mccullough

Faculty, Staff and Student Publications

Central nervous system-associated macrophages (CAMs) are a unique subset of immune cells located at the interface between the blood and the brain parenchyma. In a recent study in mice, Levard and colleagues found that CAMs regulate immune cell trafficking, endothelial activation, and antigen presentation following stroke exclusively in aged animals, underscoring the importance of using translationally relevant models for studying age-related diseases.


Redox Regulation Of Proteostasis, Long Duy Duong, James D West, Kevin A Morano Dec 2024

Redox Regulation Of Proteostasis, Long Duy Duong, James D West, Kevin A Morano

Faculty, Staff and Student Publications

Oxidants produced through endogenous metabolism or encountered in the environment react directly with reactive sites in biological macromolecules. Many proteins, in particular, are susceptible to oxidative damage, which can lead to their altered structure and function. Such structural and functional changes trigger a cascade of events that influence key components of the proteostasis network. Here, we highlight recent advances in our understanding of how cells respond to the challenges of protein folding and metabolic alterations that occur during oxidative stress. Immediately after an oxidative insult, cells selectively block the translation of most new proteins and shift molecular chaperones from folding …


Outcomes Of Mechanical Thrombectomy In Anticoagulated Patients With Acute Distal And Medium Vessel Stroke, Hamza Salim, Basel Musmar, Nimer Adeeb, Vivek Yedavalli, Dhairya Lakhani, Sahibjot Singh Grewal, Kareem El Naamani, Nils Henninger, Sri Hari Sundararajan, Anna Luisa Kühn, Jane Khalife, Sherief Ghozy, Luca Scarcia, Benjamin Yq Tan, Robert W Regenhardt, Jeremy J Heit, Nicole M Cancelliere, Joshua D Bernstock, Aymeric Rouchaud, Jens Fiehler, Sunil Sheth, Ajit S Puri, Christian Dyzmann, Marco Colasurdo, Xavier Barreau, Leonardo Renieri, João Pedro Filipe, Pablo Harker, Răzvan Alexandru Radu, Mohamad Abdalkader, Piers Klein, Thomas R Marotta, Julian Spears, Takahiro Ota, Ashkan Mowla, Pascal Jabbour, Arundhati Biswas, Frédéric Clarençon, James E Siegler, Thanh N Nguyen, Ricardo Varela, Amanda Baker, Muhammed Amir Essibayi, David Altschul, Nestor R Gonzalez, Markus A Möhlenbruch, Vincent Costalat, Benjamin Gory, Christian Paul Stracke, Mohammad Ali Aziz-Sultan, Constantin Hecker, Hamza Shaikh, David S Liebeskind, Alessandro Pedicelli, Andrea M Alexandre, Illario Tancredi, Tobias D Faizy, Erwah Kalsoum, Boris Lubicz, Aman B Patel, Vitor Mendes Pereira, Adrien Guenego, Adam A Dmytriw, Mad Mt Investigators Dec 2024

Outcomes Of Mechanical Thrombectomy In Anticoagulated Patients With Acute Distal And Medium Vessel Stroke, Hamza Salim, Basel Musmar, Nimer Adeeb, Vivek Yedavalli, Dhairya Lakhani, Sahibjot Singh Grewal, Kareem El Naamani, Nils Henninger, Sri Hari Sundararajan, Anna Luisa Kühn, Jane Khalife, Sherief Ghozy, Luca Scarcia, Benjamin Yq Tan, Robert W Regenhardt, Jeremy J Heit, Nicole M Cancelliere, Joshua D Bernstock, Aymeric Rouchaud, Jens Fiehler, Sunil Sheth, Ajit S Puri, Christian Dyzmann, Marco Colasurdo, Xavier Barreau, Leonardo Renieri, João Pedro Filipe, Pablo Harker, Răzvan Alexandru Radu, Mohamad Abdalkader, Piers Klein, Thomas R Marotta, Julian Spears, Takahiro Ota, Ashkan Mowla, Pascal Jabbour, Arundhati Biswas, Frédéric Clarençon, James E Siegler, Thanh N Nguyen, Ricardo Varela, Amanda Baker, Muhammed Amir Essibayi, David Altschul, Nestor R Gonzalez, Markus A Möhlenbruch, Vincent Costalat, Benjamin Gory, Christian Paul Stracke, Mohammad Ali Aziz-Sultan, Constantin Hecker, Hamza Shaikh, David S Liebeskind, Alessandro Pedicelli, Andrea M Alexandre, Illario Tancredi, Tobias D Faizy, Erwah Kalsoum, Boris Lubicz, Aman B Patel, Vitor Mendes Pereira, Adrien Guenego, Adam A Dmytriw, Mad Mt Investigators

Faculty, Staff and Student Publications

Background: Stroke remains a major health concern globally, with oral anticoagulants widely prescribed for stroke prevention. The efficacy and safety of mechanical thrombectomy (MT) in anticoagulated patients with distal medium vessel occlusions (DMVO) are not well understood.

Methods: This retrospective analysis involved 1282 acute ischemic stroke (AIS) patients who underwent MT in 37 centers across North America, Asia, and Europe from September 2017 to July 2023. Data on demographics, clinical presentation, treatment specifics, and outcomes were collected. The primary outcomes were functional outcomes at 90 days post-MT, measured by modified Rankin Scale (mRS) scores. Secondary outcomes included reperfusion rates, mortality, …


Evaluating Novel In Silico Tools For Accurate Pathogenicity Classification In Epilepsy-Associated Genetic Missense Variants, Ludovica Montanucci, Tobias Brünger, Christian M Boßelmann, Alina Ivaniuk, Eduardo Pérez-Palma, Samden Lhatoo, Costin Leu, Dennis Lal Dec 2024

Evaluating Novel In Silico Tools For Accurate Pathogenicity Classification In Epilepsy-Associated Genetic Missense Variants, Ludovica Montanucci, Tobias Brünger, Christian M Boßelmann, Alina Ivaniuk, Eduardo Pérez-Palma, Samden Lhatoo, Costin Leu, Dennis Lal

Faculty, Staff and Student Publications

Objective: Determining the pathogenicity of missense variants in clinical genetic tests for individuals with epilepsy is crucial for guiding personalized treatment. However, achieving a definitive pathogenic classification remains challenging, with most missense variants still classified as variants of uncertain significance (VUS) and with the availability of many computational tools which may provide conflicting predictions. Here, we aim to evaluate the performance of state-of-the-art computational tools in pathogenicity prediction of missense variants in epilepsy-associated genes. This will assist in selecting the most appropriate tool and critically assess their use in clinical setting.

Methods: We assessed the performance of nine in silico …


Research Prioritization In Hernia Surgery: A Modified Delphi Achqc And Vhoc Expert Consensus, Daphne Remulla, Mazen R Al-Mansour, Christopher Schneider, Sharon Phillips, William W Hope, Joel F Bradley Iii, Richard A Pierce, Luis Arias-Espinosa, Karla Bernardi, Julie L Holihan, Michelle Loor, Mike K Liang, Benjamin T Miller Dec 2024

Research Prioritization In Hernia Surgery: A Modified Delphi Achqc And Vhoc Expert Consensus, Daphne Remulla, Mazen R Al-Mansour, Christopher Schneider, Sharon Phillips, William W Hope, Joel F Bradley Iii, Richard A Pierce, Luis Arias-Espinosa, Karla Bernardi, Julie L Holihan, Michelle Loor, Mike K Liang, Benjamin T Miller

Faculty, Staff and Student Publications

Purpose: Numerous clinical practice guidelines and consensus statements have been published in hernia surgery, however, there is still a need for high-quality evidence to address remaining unanswered questions. The aim of this study was to conduct research priority setting through a modified Delphi process to identify a list of top research priorities in hernia surgery.

Methods: A structured literature review of clinical practice guidelines was performed by the steering committee. Topics considered clinically significant, practical to study and lacking strong evidence were extracted and refined into a comprehensive list, then entered into a two-round Delphi survey for prioritization at the …


Resolution Of Painful Trichodysplasia Spinulosa With Topical Cidofovir: Case Report, Kevin M Burningham, Ritu N Swali, Peter L Rady, Anisha B Patel, Stephen K Tyring Dec 2024

Resolution Of Painful Trichodysplasia Spinulosa With Topical Cidofovir: Case Report, Kevin M Burningham, Ritu N Swali, Peter L Rady, Anisha B Patel, Stephen K Tyring

Faculty, Staff and Student Publications

Purpose: Trichodysplasia spinulosa (TS) is a rare, disfiguring skin condition which presents with widespread asymptomatic or pruritic, skin-colored papules with white protruding keratin spiculations in immunocompromised individuals. Due to its rarity, there is little data to guide treatment decisions. The purpose of this article is to report a case of TS that completely resolved after treatment with topical cidofovir.

Materials and methods: A 19-year-old immunosuppressed female presented with widespread painful, itchy bumps on the nose and face. Upon examination, there were erythematous papules with hyperkeratinized spicules affecting the central face. Biopsy of the lesions was consistent with TS which was …


Guidelines On Management Of Hereditary Polyposis Syndromes In Pediatric Patients: Agreement, Disagreement And Where It Matters, Taina Hudson, Claudia Phen, Isabel Rojas, Shlomi Cohen, Warren Hyer, Thomas M. Attard Dec 2024

Guidelines On Management Of Hereditary Polyposis Syndromes In Pediatric Patients: Agreement, Disagreement And Where It Matters, Taina Hudson, Claudia Phen, Isabel Rojas, Shlomi Cohen, Warren Hyer, Thomas M. Attard

Manuscripts, Articles, Book Chapters and Other Papers

Hereditary polyposis syndromes are rare but potentially devastating conditions which require multidisciplinary care from an early age. Societal guidelines, which ideally combine expert opinions and medical evidence, serve as the framework for disease diagnosis, surveillance and treatment. However, there is a significant underrepresentation of pediatric gastroenterology input in guideline formulation, and additionally, recommendations can vary significantly between societies, which can have a moderate-to-high clinical impact on patient care. This paper aims to summarize key differences in management based on societal guidelines and identify some of the factors which may contribute to divergence in care in hereditary polyposis syndromes in pediatric …


Therapeutic Perspectives For Prion Diseases In Humans And Animals, Rebeca Benavente, Rodrigo Morales Dec 2024

Therapeutic Perspectives For Prion Diseases In Humans And Animals, Rebeca Benavente, Rodrigo Morales

Faculty, Staff and Student Publications

No abstract provided.


Implementation Of A Transition-Of-Care Model For Adult Ischemic Stroke Survivors, Megan Akacsos Dec 2024

Implementation Of A Transition-Of-Care Model For Adult Ischemic Stroke Survivors, Megan Akacsos

Electronic Theses and Dissertations

The lasting physical and cognitive deficits associated with the complexities of newly acquired

disabilities resulting from an acute ischemic stroke (AIS) may lead to hospital readmissions. The

participating healthcare facility on the U.S. West Coast reported a hospital readmission rate for

AIS survivors of 24.29% within 30 days of discharge. This doctoral nursing project aimed to

determine if implementing the Comprehensive Post-Acute Stroke Services (COMPASS) model

would reduce 30-day readmission rates compared to no standardized transition-of-care model in

adult AIS survivors over 30 days. Implementing the COMPASS model in this patient population

was expected to better educate and support stroke …