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Full-Text Articles in Medicine and Health Sciences

Challenges And Opportunities Of Artificial Intelligence In Cdss And Patient Safety, Yang Gong, Hua Min, Xia Jing, Ping Yu Aug 2024

Challenges And Opportunities Of Artificial Intelligence In Cdss And Patient Safety, Yang Gong, Hua Min, Xia Jing, Ping Yu

Faculty, Staff and Student Publications

Ensuring patient safety in healthcare involves training professionals and implementing clinical decision support systems (CDSS) and health IT solutions to reduce errors and adverse events. The integration of artificial intelligence (AI) into health IT has revolutionized clinical settings by enabling real-time insights and personalized recommendations. However, the use of health IT can lead to unintended consequences that are not adequately addressed during training and implementation. These consequences can hinder the maximization of benefits and limit equitable access to healthcare. In this paper, we explore the impact of AI on CDSS and health IT, discuss the challenges in educating clinical informaticians, …


Pancreaticoduodenectomy After Endoscopic Ultrasound-Guided Lumen Apposing Metal Stent (Lams): A Case Series Evaluating Feasibility And Short-Term Outcomes: Whipple After Lumen Apposing Metal Stent, Luke Meredith, David Baek, Alisha Agarwal, Faisal Kamal, Anand R. Kumar, Alexander Schlachterman, Thomas E. Kowalski, Charles J. Yeo, Harish Lavu, Avinoam Nevler, Wilbur B. Bowne Aug 2024

Pancreaticoduodenectomy After Endoscopic Ultrasound-Guided Lumen Apposing Metal Stent (Lams): A Case Series Evaluating Feasibility And Short-Term Outcomes: Whipple After Lumen Apposing Metal Stent, Luke Meredith, David Baek, Alisha Agarwal, Faisal Kamal, Anand R. Kumar, Alexander Schlachterman, Thomas E. Kowalski, Charles J. Yeo, Harish Lavu, Avinoam Nevler, Wilbur B. Bowne

Department of Surgery Faculty Papers

Introduction

Endoscopic ultrasound (EUS)-guided lumen-apposing metal stents (LAMS) represent a novel tool in therapeutic endoscopy. However, the presence of LAMS may dissuade surgeons from operations with curative-intent. We report three clinical scenarios with deployment of LAMS in patients that subsequently underwent pancreaticoduodenectomy (PD).

Methods

Six patients identified from our IRB-approved pancreas cancer database had EUS-LAMS placement prior to PD. Patient, tumor, treatment-related variables, and outcomes are herein reported.

Results

Two patients underwent a LAMS gastrojejunostomy (GJ) for duodenal obstruction. Another patient underwent LAMS choledochoduodenostomy (CDS) for malignant biliary obstruction. In three patients, a LAMS gastrogastrostomy or jejunogastrostomy was deployed post …


Loss Of Symmetric Cell Division Of Apical Neural Progenitors Drives Dennd5a-Related Developmental And Epileptic Encephalopathy, Emily Banks, Vincent Francis, Sheng-Jia Lin, Fares Kharfallah, Vladimir Fonov, Maxime Lévesque, Chanshuai Han, Gopinath Kulasekaran, Marius Tuznik, Armin Bayati, Reem Al-Khater, Fowzan S Alkuraya, Loukas Argyriou, Meisam Babaei, Melanie Bahlo, Behnoosh Bakhshoodeh, Eileen Barr, Lauren Bartik, Mahmoud Bassiony, Miriam Bertrand, Dominique Braun, Rebecca Buchert, Mauro Budetta, Maxime Cadieux-Dion, Daniel G Calame, Heidi Cope, Donna Cushing, Stephanie Efthymiou, Marwa Abd Elmaksoud, Huda G El Said, Tawfiq Froukh, Harinder K Gill, Joseph G Gleeson, Laura Gogoll, Elaine S-Y Goh, Vykuntaraju K Gowda, Tobias B Haack, Mais O Hashem, Stefan Hauser, Trevor L Hoffman, Jacob S Hogue, Akimoto Hosokawa, Henry Houlden, Kevin Huang, Stephanie Huynh, Ehsan G Karimiani, Silke Kaulfuß, G Christoph Korenke, Amy Kritzer, Hane Lee, James R Lupski, Elysa J Marco, Kirsty Mcwalter, Arakel Minassian, Berge A Minassian, David Murphy, Juanita Neira-Fresneda, Hope Northrup, Denis M Nyaga, Barbara Oehl-Jaschkowitz, Matthew Osmond, Richard Person, Davut Pehlivan, Cassidy Petree, Lynette G Sadleir, Carol Saunders, Ludger Schoels, Vandana Shashi, Rebecca C Spillmann, Varunvenkat M Srinivasan, Paria N Torbati, Tulay Tos, Maha S Zaki, Dihong Zhou, Christiane Zweier, Jean-François Trempe, Thomas M Durcan, Ziv Gan-Or, Massimo Avoli, Cesar Alves, Gaurav K Varshney, Reza Maroofian, David A Rudko, Peter S Mcpherson Aug 2024

Loss Of Symmetric Cell Division Of Apical Neural Progenitors Drives Dennd5a-Related Developmental And Epileptic Encephalopathy, Emily Banks, Vincent Francis, Sheng-Jia Lin, Fares Kharfallah, Vladimir Fonov, Maxime Lévesque, Chanshuai Han, Gopinath Kulasekaran, Marius Tuznik, Armin Bayati, Reem Al-Khater, Fowzan S Alkuraya, Loukas Argyriou, Meisam Babaei, Melanie Bahlo, Behnoosh Bakhshoodeh, Eileen Barr, Lauren Bartik, Mahmoud Bassiony, Miriam Bertrand, Dominique Braun, Rebecca Buchert, Mauro Budetta, Maxime Cadieux-Dion, Daniel G Calame, Heidi Cope, Donna Cushing, Stephanie Efthymiou, Marwa Abd Elmaksoud, Huda G El Said, Tawfiq Froukh, Harinder K Gill, Joseph G Gleeson, Laura Gogoll, Elaine S-Y Goh, Vykuntaraju K Gowda, Tobias B Haack, Mais O Hashem, Stefan Hauser, Trevor L Hoffman, Jacob S Hogue, Akimoto Hosokawa, Henry Houlden, Kevin Huang, Stephanie Huynh, Ehsan G Karimiani, Silke Kaulfuß, G Christoph Korenke, Amy Kritzer, Hane Lee, James R Lupski, Elysa J Marco, Kirsty Mcwalter, Arakel Minassian, Berge A Minassian, David Murphy, Juanita Neira-Fresneda, Hope Northrup, Denis M Nyaga, Barbara Oehl-Jaschkowitz, Matthew Osmond, Richard Person, Davut Pehlivan, Cassidy Petree, Lynette G Sadleir, Carol Saunders, Ludger Schoels, Vandana Shashi, Rebecca C Spillmann, Varunvenkat M Srinivasan, Paria N Torbati, Tulay Tos, Maha S Zaki, Dihong Zhou, Christiane Zweier, Jean-François Trempe, Thomas M Durcan, Ziv Gan-Or, Massimo Avoli, Cesar Alves, Gaurav K Varshney, Reza Maroofian, David A Rudko, Peter S Mcpherson

Faculty, Staff and Student Publications

Developmental and epileptic encephalopathies (DEEs) feature altered brain development, developmental delay and seizures, with seizures exacerbating developmental delay. Here we identify a cohort with biallelic variants in DENND5A, encoding a membrane trafficking protein, and develop animal models with phenotypes like the human syndrome. We demonstrate that DENND5A interacts with Pals1/MUPP1, components of the Crumbs apical polarity complex required for symmetrical division of neural progenitor cells. Human induced pluripotent stem cells lacking DENND5A fail to undergo symmetric cell division with an inherent propensity to differentiate into neurons. These phenotypes result from misalignment of the mitotic spindle in apical neural progenitors. Cells …


Clinical Features And Disease Progression In Older Individuals With Rett Syndrome, Jeffrey L Neul, Timothy A Benke, Eric D Marsh, Bernhard Suter, Cary Fu, Robin C Ryther, Steven A Skinner, David N Lieberman, Timothy Feyma, Arthur Beisang, Peter Heydemann, Sarika U Peters, Amitha Ananth, Alan K Percy Aug 2024

Clinical Features And Disease Progression In Older Individuals With Rett Syndrome, Jeffrey L Neul, Timothy A Benke, Eric D Marsh, Bernhard Suter, Cary Fu, Robin C Ryther, Steven A Skinner, David N Lieberman, Timothy Feyma, Arthur Beisang, Peter Heydemann, Sarika U Peters, Amitha Ananth, Alan K Percy

Faculty, Staff and Students Publications

Although long-term survival in Rett syndrome (RTT) has been observed, limited information on older people with RTT exists. We hypothesized that increased longevity in RTT would be associated with genetic variants in MECP2 associated with milder severity, and that clinical features would not be static in older individuals. To address these hypotheses, we compared the distribution of MECP2 variants and clinical severity between younger individuals with Classic RTT (under 30 years old) and older individuals (over 30 years old). Contrary to expectation, enrichment of a severe MECP2 variant (R106W) was observed in the older cohort. Overall severity was not different …


Early Rhombic Lip Protogenin+Ve Stem Cells In A Human-Specific Neurovascular Niche Initiate And Maintain Group 3 Medulloblastoma, Abhirami Visvanathan, Olivier Saulnier, Chuan Chen, Parthiv Haldipur, Wilda Orisme, Alberto Delaidelli, Seungmin Shin, Jake Millman, Andrew Bryant, Namal Abeysundara, Xujia Wu, Liam D Hendrikse, Vikas Patil, Zahedeh Bashardanesh, Joseph Golser, Bryn G Livingston, Takuma Nakashima, Yusuke Funakoshi, Winnie Ong, Alexandra Rasnitsyn, Kimberly A Aldinger, Cory M Richman, Randy Van Ommeren, John J Y Lee, Michelle Ly, Maria C Vladoiu, Kaitlin Kharas, Polina Balin, Anders W Erickson, Vernon Fong, Jiao Zhang, Raúl A Suárez, Hao Wang, Ning Huang, Jonelle G Pallota, Tajana Douglas, Joonas Haapasalo, Ferechte Razavi, Evelina Silvestri, Olga Sirbu, Samantha Worme, Michelle M Kameda-Smith, Xiaochong Wu, Craig Daniels, Antony K Michaelraj, Aparna Bhaduri, Daniel Schramek, Hiromichi Suzuki, Livia Garzia, Nabil Ahmed, Claudia L Kleinman, Lincoln D Stein, Peter Dirks, Christopher Dunham, Nada Jabado, Jeremy N Rich, Wei Li, Poul H Sorensen, Robert J Wechsler-Reya, William A Weiss, Kathleen J Millen, David W Ellison, Dimiter S Dimitrov, Michael D Taylor Aug 2024

Early Rhombic Lip Protogenin+Ve Stem Cells In A Human-Specific Neurovascular Niche Initiate And Maintain Group 3 Medulloblastoma, Abhirami Visvanathan, Olivier Saulnier, Chuan Chen, Parthiv Haldipur, Wilda Orisme, Alberto Delaidelli, Seungmin Shin, Jake Millman, Andrew Bryant, Namal Abeysundara, Xujia Wu, Liam D Hendrikse, Vikas Patil, Zahedeh Bashardanesh, Joseph Golser, Bryn G Livingston, Takuma Nakashima, Yusuke Funakoshi, Winnie Ong, Alexandra Rasnitsyn, Kimberly A Aldinger, Cory M Richman, Randy Van Ommeren, John J Y Lee, Michelle Ly, Maria C Vladoiu, Kaitlin Kharas, Polina Balin, Anders W Erickson, Vernon Fong, Jiao Zhang, Raúl A Suárez, Hao Wang, Ning Huang, Jonelle G Pallota, Tajana Douglas, Joonas Haapasalo, Ferechte Razavi, Evelina Silvestri, Olga Sirbu, Samantha Worme, Michelle M Kameda-Smith, Xiaochong Wu, Craig Daniels, Antony K Michaelraj, Aparna Bhaduri, Daniel Schramek, Hiromichi Suzuki, Livia Garzia, Nabil Ahmed, Claudia L Kleinman, Lincoln D Stein, Peter Dirks, Christopher Dunham, Nada Jabado, Jeremy N Rich, Wei Li, Poul H Sorensen, Robert J Wechsler-Reya, William A Weiss, Kathleen J Millen, David W Ellison, Dimiter S Dimitrov, Michael D Taylor

Faculty, Staff and Students Publications

We identify a population of PRTG+ve MYChigh NESTINlow stem cells in the four-week-old human embryonic hindbrain that subsequently localizes to the ventricular zone of the rhombic lip (RLVZ). Oncogenic transformation of early Prtg+ve rhombic lip stem cells initiate Group 3 Medulloblastoma (Gr3-MB)-like tumors. PRTG+ve stem-cells grow adjacent to a human specific interposed vascular plexus in the RLVZ, a phenotype which is recapitulated in Gr3-MB, but not other types of medulloblastoma. Co-culture of Gr3-MB with endothelial cells promotes tumor stem-cell growth, with the endothelial cells adopting an immature phenotype. Targeting the PRTGhigh compartment of Gr3-MB in vivo using either the diphtheria …


Saudi Heart Association / National Heart Center / Saudi Arabian Cardiac Interventional Society / Saudi Society For Cardiac Surgeons / Saudi Cardiac Imaging Group 2023 Tavi Guidelines, Turki Albacker, Adel Tash, Hussein Alamri, Mirvat Alasnag, Wail Alkashkari, Fawaz Almutairi, Faisal Alqoofi, Ahmed Alsaileek, Uthman Aluthman, Ghormallah Alzahrani, Mohammed Balghith, Fahd Makhdom Aug 2024

Saudi Heart Association / National Heart Center / Saudi Arabian Cardiac Interventional Society / Saudi Society For Cardiac Surgeons / Saudi Cardiac Imaging Group 2023 Tavi Guidelines, Turki Albacker, Adel Tash, Hussein Alamri, Mirvat Alasnag, Wail Alkashkari, Fawaz Almutairi, Faisal Alqoofi, Ahmed Alsaileek, Uthman Aluthman, Ghormallah Alzahrani, Mohammed Balghith, Fahd Makhdom

Journal of the Saudi Heart Association

Saudi Arabia has seen a significant improvement in its healthcare system over the past four decades resulting in an increase in life-expectancy. Transcatheter aortic valve implantation (TAVI) has spread widely in Saudi Arabia and has become a routine procedure in many centers. The expanding clinical indications and the availability of the technology have made it possible for many large and intermediate centers all over the country to commence their own TAVI programs. So, the aim of this document is to standardize TAVI practices in different Saudi Arabian centers through reasonable guidelines based on the evaluation and summarization of the best …


Disaster Planning For People With Spinal Cord Injury: An Educational Video Series, Kayla Webre, Steven M. Gerardi Phd, Otd, Mss, Otr, Eric Hicks Phd, Ms, Otr Aug 2024

Disaster Planning For People With Spinal Cord Injury: An Educational Video Series, Kayla Webre, Steven M. Gerardi Phd, Otd, Mss, Otr, Eric Hicks Phd, Ms, Otr

Summer 2024 OTD Capstone Symposium

A spinal cord injury is classified as an impairment of the nerves that compose the spinal cord. A spinal cord injury can affect the motor and sensory pathways below the level of the injury. As a result, people with spinal cord injury experience physical, emotional, and environmental barriers. Furthermore, they experience an increase in health-related issues such as autonomic dysreflexia, changes in the bowel and bladder system, pressure wounds, and difficulty regulating body temperature. However, these comorbidities are often exacerbated during a natural disaster. Additionally, the physical and environmental barriers continue to influence this population in times of disaster. The …


From Brazil To Canada: Translation And Cross-Cultural Adaptation Of An App For Breastfeeding Premature Babies, Gabriela Ramos Ferreira Curan, Cindy-Lee Dennis, Flavia Casasanta Marini, Rosangela Aparecida Pimenta, Thaila Correa Castral, Gracielle Schwenk, Kimberley T. Jackson, Edilaine Giovanini Rossetto Aug 2024

From Brazil To Canada: Translation And Cross-Cultural Adaptation Of An App For Breastfeeding Premature Babies, Gabriela Ramos Ferreira Curan, Cindy-Lee Dennis, Flavia Casasanta Marini, Rosangela Aparecida Pimenta, Thaila Correa Castral, Gracielle Schwenk, Kimberley T. Jackson, Edilaine Giovanini Rossetto

Nursing Publications

Objective: Translating and culturally adapting the AmamentaCoach app, originally developed in Brazil, for use by mothers of premature babies in Canada, through international research collaboration. Method: This is applied research in the form of technological development, in which the World Health Organization’s recommendations for the translation and cultural adaptation of instruments were taken into account. Five Canadian researchers who are experts in breastfeeding promotion evaluated the appearance, language, and content of the new version of the app. An 18-item instrument was used with Likert scale response options indicating the degree of agreement for each statement, where 1=Strongly Disagree, 2=Disagree, 3=Neutral, …


Delphi Analysis: Optimizing Anatomy Teaching And Ultrasound Training For Botulinum Neurotoxin Type A Injection In Spasticity And Dystonia, Kimberly Heckert, Bo Biering-Sørensen, Tobias Bäumer, Omar Khan, Fernando Pagan, Mitchell Paulin, Todd Stitik, Monica Verduzco-Gutierrez, Rajiv Reebye Aug 2024

Delphi Analysis: Optimizing Anatomy Teaching And Ultrasound Training For Botulinum Neurotoxin Type A Injection In Spasticity And Dystonia, Kimberly Heckert, Bo Biering-Sørensen, Tobias Bäumer, Omar Khan, Fernando Pagan, Mitchell Paulin, Todd Stitik, Monica Verduzco-Gutierrez, Rajiv Reebye

Department of Rehabilitation Medicine Faculty Papers

Our objective was to provide expert consensus on best practices for anatomy teaching and training on ultrasound-guided botulinum neurotoxin type A (BoNT-A) injection for specialists involved in treating spasticity and dystonia. Nine experts (three neurologists; six physical medicine and rehabilitation physicians) participated in a three-round modified Delphi process. Over three rounds, experts reached consensus on 15 of 16 statements describing best practices for anatomy and BoNT-A injection training. They unanimously agreed that knowledge of the target audience, including their needs and current competency, is crucial when designing training programs. Experts also agreed that alignment between instructors is essential to ensure …


Using Deepsignalingflow To Mine Signaling Flows Interpreting Mechanism Of Synergy Of Cocktails, Heming Zhang, Yixin Chen, Philip Payne, Fuhai Li Aug 2024

Using Deepsignalingflow To Mine Signaling Flows Interpreting Mechanism Of Synergy Of Cocktails, Heming Zhang, Yixin Chen, Philip Payne, Fuhai Li

2020-Current year OA Pubs

Complex signaling pathways are believed to be responsible for drug resistance. Drug combinations perturbing multiple signaling targets have the potential to reduce drug resistance. The large-scale multi-omic datasets and experimental drug combination synergistic score data are valuable resources to study mechanisms of synergy (MoS) to guide the development of precision drug combinations. However, signaling patterns of MoS are complex and remain unclear, and thus it is challenging to identify synergistic drug combinations in clinical. Herein, we proposed a novel integrative and interpretable graph AI model, DeepSignalingFlow, to uncover the MoS by integrating and mining multi-omic data. The major innovation is …


Short-Term Hiit Impacts Hdl Function Differently In Lean, Obese, And Diabetic Subjects, Lin Zhu, Julia An, Thao Luu, Sara M. Reyna, Puntip Tantiwong, Apiradee Sriwijitkamol, Nicolas Musi, John M. Stafford Aug 2024

Short-Term Hiit Impacts Hdl Function Differently In Lean, Obese, And Diabetic Subjects, Lin Zhu, Julia An, Thao Luu, Sara M. Reyna, Puntip Tantiwong, Apiradee Sriwijitkamol, Nicolas Musi, John M. Stafford

School of Medicine Publications

Introduction: High density lipoproteins (HDL) exert cardiovascular protection in part through their antioxidant capacity and cholesterol efflux function. Effects of exercise training on HDL function are yet to be well established, while impact on triacylglycerol (TG)-lowering has been often reported. We previously showed that a short-term high-intensity interval training (HIIT) program improves insulin sensitivity but does not inhibit inflammatory pathways in immune cells in insulin-resistant subjects. The purpose of this study is to evaluate HDL function along with changes of lipoproteins after the short-term HIIT program in lean, obese nondiabetic, and obese type 2 diabetic (T2DM) subjects.

Methods: All individuals …


Unique Genetic And Risk-Factor Profiles In Clusters Of Major Depressive Disorder-Related Multimorbidity Trajectories, Andras Gezsi, Sandra Van Der Auwera, Hannu Mäkinen, Nora Eszlari, Gabor Hullam, Tamas Nagy, Sarah Bonk, Rubèn González-Colom, Xenia Gonda, Mikko Kuokkanen Aug 2024

Unique Genetic And Risk-Factor Profiles In Clusters Of Major Depressive Disorder-Related Multimorbidity Trajectories, Andras Gezsi, Sandra Van Der Auwera, Hannu Mäkinen, Nora Eszlari, Gabor Hullam, Tamas Nagy, Sarah Bonk, Rubèn González-Colom, Xenia Gonda, Mikko Kuokkanen

School of Medicine Publications

The heterogeneity and complexity of symptom presentation, comorbidities and genetic factors pose challenges to the identification of biological mechanisms underlying complex diseases. Current approaches used to identify biological subtypes of major depressive disorder (MDD) mainly focus on clinical characteristics that cannot be linked to specific biological models. Here, we examined multimorbidities to identify MDD subtypes with distinct genetic and non-genetic factors. We leveraged dynamic Bayesian network approaches to determine a minimal set of multimorbidities relevant to MDD and identified seven clusters of disease-burden trajectories throughout the lifespan among 1.2 million participants from cohorts in the UK, Finland, and Spain. The …


Association Between Tumor-Infiltrating Lymphocytes And Survival In Patients With Metastatic Breast Cancer Receiving First-Line Chemotherapy: Analysis Of Calgb 40502, Daniel G Stover, Mark Watson, Et Al. Aug 2024

Association Between Tumor-Infiltrating Lymphocytes And Survival In Patients With Metastatic Breast Cancer Receiving First-Line Chemotherapy: Analysis Of Calgb 40502, Daniel G Stover, Mark Watson, Et Al.

2020-Current year OA Pubs

Association of stromal tumor-infiltrating lymphocytes (sTILs) with survival outcomes among patients with metastatic breast cancer (MBC) remains unclear. The primary objective was to evaluate the association of sTILs with progression-free survival in randomized phase III trial CALGB 40502. sTILs were associated with progression-free and overall survival in chemotherapy-treated MBC when controlling for treatment arm; however, this effect did not remain significant after additional adjustment for hormone receptor status. CALGB is now part of the Alliance for Clinical Trials in Oncology. Trial Registration: ClinicalTrials.gov: NCT00785291.


A Brief Alcohol Intervention (Bai) To Reduce Alcohol Use And Improve Prep Outcomes Among Men Who Have Sex With Men In Vietnam: Study Protocol For A Randomized Controlled Trial, Hao T M Bui, Byron J Powell, Et Al. Aug 2024

A Brief Alcohol Intervention (Bai) To Reduce Alcohol Use And Improve Prep Outcomes Among Men Who Have Sex With Men In Vietnam: Study Protocol For A Randomized Controlled Trial, Hao T M Bui, Byron J Powell, Et Al.

2020-Current year OA Pubs

BACKGROUND: In Vietnam and other global settings, men who have sex with men (MSM) have become the population at greatest risk of HIV infection. Although HIV pre-exposure prophylaxis (PrEP) has been implemented as a prevention strategy, PrEP outcomes may be affected by low persistence and adherence among MSM with unhealthy alcohol use. MSM have a high prevalence of unhealthy alcohol use in Vietnam, which may affect PrEP outcomes.

METHODS: Design: We will conduct a two-arm hybrid type 1 effectiveness-implementation randomized controlled trial of a brief alcohol intervention (BAI) compared to the standard of care (SOC) at the Sexual Health Promotion …


Obese African American Women’S Perceptions Of Transition From College To Workforce, Alea Lycorish Aug 2024

Obese African American Women’S Perceptions Of Transition From College To Workforce, Alea Lycorish

Walden Dissertations and Doctoral Studies

The rate of obesity continues to rise among adults in the United States, and African American (AA) women are at greater risk in comparison with any other group. This matter has become an alarming public health crisis. Obese AA women also face a higher risk of discrimination in the workforce. The purpose of this qualitative, multiple case study was to increase the understanding of the perceptions and experiences of bachelor degree educated, overweight AA women during the postgraduate phase, who entered the workforce within the past 10 years. The theoretical framework used in this study was Crenshaw’s intersectionality theory. The …


Team-Centered Care After Trauma Patient Death: Promoting Healers’ Healing By Humanizing Our Roles, Sydni Au Hoy, Carlie J. Arbaugh, Caitlin P. Bungo, Amanda J. Deutsch, Bonnie E. Chow, Kristen Gallegos, Nerissa Alansalon, Emmanuel Jisrawi, Al’Ai Alvarez, Brooke Gurland, Joseph Forrester Aug 2024

Team-Centered Care After Trauma Patient Death: Promoting Healers’ Healing By Humanizing Our Roles, Sydni Au Hoy, Carlie J. Arbaugh, Caitlin P. Bungo, Amanda J. Deutsch, Bonnie E. Chow, Kristen Gallegos, Nerissa Alansalon, Emmanuel Jisrawi, Al’Ai Alvarez, Brooke Gurland, Joseph Forrester

Journal of Wellness

Introduction: Recurrent exposures to adverse patient events, including death, affect all members of the care team and can have long-term effects on clinician performance, personal well-being, and patient safety. Recognizing the impact of patient deaths on care teams is essential to mitigating potential risks of increased clinician burnout. We share the outcomes of a three-month pilot wellness intervention implemented at a busy academic hospital, directed explicitly toward resuscitation care teams managing patients who die from traumatic injuries.

Approach: A collaborative group from Stanford’s Trauma Surgery, Emergency Department (ED), and well-being leadership developed an integrated workflow to connect with …


The Dna Repair Pathway As A Therapeutic Target To Synergize With Trastuzumab Deruxtecan In Her2-Targeted Antibody-Drug Conjugate-Resistant Her2-Overexpressing Breast Cancer, Jangsoon Lee, Kumiko Kida, Jiwon Koh, Huey Liu, Ganiraju C Manyam, Young Jin Gi, Dileep R Rampa, Asha S Multani, Jing Wang, Gitanjali Jayachandran, Dae-Won Lee, James M Reuben, Aysegul Sahin, Lei Huo, Debu Tripathy, Seock-Ah Im, Naoto T Ueno Aug 2024

The Dna Repair Pathway As A Therapeutic Target To Synergize With Trastuzumab Deruxtecan In Her2-Targeted Antibody-Drug Conjugate-Resistant Her2-Overexpressing Breast Cancer, Jangsoon Lee, Kumiko Kida, Jiwon Koh, Huey Liu, Ganiraju C Manyam, Young Jin Gi, Dileep R Rampa, Asha S Multani, Jing Wang, Gitanjali Jayachandran, Dae-Won Lee, James M Reuben, Aysegul Sahin, Lei Huo, Debu Tripathy, Seock-Ah Im, Naoto T Ueno

Faculty, Staff and Student Publications

Background: Anti-HER2 therapies, including the HER2 antibody-drug conjugates (ADCs) trastuzumab emtansine (T-DM1) and trastuzumab deruxtecan (T-DXd), have led to improved survival outcomes in patients with HER2-overexpressing (HER2+) metastatic breast cancer. However, intrinsic or acquired resistance to anti-HER2-based therapies remains a clinical challenge in these patients, as there is no standard of care following disease progression. The purpose of this study was to elucidate the mechanisms of resistance to T-DM1 and T-DXd in HER2+ BC patients and preclinical models and identify targets whose inhibition enhances the antitumor activity of T-DXd in HER2-directed ADC-resistant HER2+ breast cancer in vitro and in vivo. …


Transcriptome Profiling Of Pediatric Extracranial Solid Tumors And Lymphomas Enables Rapid Low-Cost Diagnostic Classification, Kofi B Opoku, Teresa Santiago, Priya Kumar, Sophia M Roush, Yuri Fedoriw, Tamiwe Tomoka, Vasiliki Leventaki, Larissa V Furtado, Nickhill Bhakta, Thomas B Alexander, Jeremy R Wang Aug 2024

Transcriptome Profiling Of Pediatric Extracranial Solid Tumors And Lymphomas Enables Rapid Low-Cost Diagnostic Classification, Kofi B Opoku, Teresa Santiago, Priya Kumar, Sophia M Roush, Yuri Fedoriw, Tamiwe Tomoka, Vasiliki Leventaki, Larissa V Furtado, Nickhill Bhakta, Thomas B Alexander, Jeremy R Wang

Faculty, Staff and Student Publications

Approximately 80% of pediatric tumors occur in low- and middle-income countries (LMIC), where diagnostic tools essential for treatment decisions are often unavailable or incomplete. Development of cost-effective molecular diagnostics will help bridge the cancer diagnostic gap and ultimately improve pediatric cancer outcomes in LMIC settings. We investigated the feasibility of using nanopore whole transcriptome sequencing on formalin-fixed paraffin embedded (FFPE)-derived RNA and a composite machine learning model for pediatric solid tumor diagnosis. Transcriptome cDNA sequencing was performed on a heterogenous set of 221 FFPE and 32 fresh frozen pediatric solid tumor and lymphoma specimens on Oxford Nanopore Technologies' sequencing platforms. …


Economic Behavior And Hiv Risk Behavior Among Vulnerable Women: A Prospective Randomized Control Study In Southern Uganda, Joshua Kiyingi Aug 2024

Economic Behavior And Hiv Risk Behavior Among Vulnerable Women: A Prospective Randomized Control Study In Southern Uganda, Joshua Kiyingi

Brown School Graduate Student Theses and Dissertations

In sub-Saharan Africa (SSA), the estimated population of women engaged in sex work (WESW) is 2.5 million, aged 15 to 49 years (Laga et al., 2023). WESW face numerous challenges, including high-risk behaviors that expose them to HIV, sexually transmitted infections (STIs), drug and alcohol abuse, criminalization, discrimination, mental health problems, and limited healthcare access. Globally, WESW are significantly affected by HIV, with new infections continuing to rise. Recent estimates show that although 8% of all new HIV infections are among WESW, 32.8% of them are unaware of their HIV status (UNAIDS, 2021a). The risk of acquiring HIV is 30 …


Navigating The Nuances: Overcoming Challenges In Valve-In-Valve Tavr For Sutureless And Stentless Valves, Syed Zaid, Miho Fukui, Vinayak N Bapat Aug 2024

Navigating The Nuances: Overcoming Challenges In Valve-In-Valve Tavr For Sutureless And Stentless Valves, Syed Zaid, Miho Fukui, Vinayak N Bapat

Faculty, Staff and Students Publications

No abstract provided.


Needs Of Family Caregivers Of Hospitalised Adults With Dementia During Care Transitions: A Qualitative Study In A Us Department Of Veterans Affairs Hospital, Molly J Horstman, Tracy L Evans, Crystal Guo, Mandi Sonnenfeld, Aanand D Naik, Alan Stevens, Mark E Kunik Aug 2024

Needs Of Family Caregivers Of Hospitalised Adults With Dementia During Care Transitions: A Qualitative Study In A Us Department Of Veterans Affairs Hospital, Molly J Horstman, Tracy L Evans, Crystal Guo, Mandi Sonnenfeld, Aanand D Naik, Alan Stevens, Mark E Kunik

Faculty, Staff and Student Publications

OBJECTIVE: To identify the needs of caregivers of hospitalised adults with dementia in the hospital and during care transitions.

DESIGN: Pragmatic qualitative inquiry with semi-structured interviews.

SETTING: Michael E. DeBakey Veterans Affairs Medical Center in Houston, Texas, USA.

PARTICIPANTS: 12 family caregivers (family member (n=11); friend (n=1)) and 15 health professionals (hospital medicine physicians (n=4), inpatient nurse case managers (n=2), social workers (n=4), outpatient geriatrics providers (n=2), a primary care provider (n=1), geriatric psychiatrists (n=2)) were interviewed. Caregivers were recruited while their care recipient was hospitalised and were interviewed at least 2 weeks after the care recipient was discharged from …


Comparing Visualization Performance Of Liquid Embolic Agents Using A Novel Injectable Phantom, J Ryan Mason, Cristina Dodge, Adam Beardsley, Susan Hilsenbeck, Goetz Benndorf Aug 2024

Comparing Visualization Performance Of Liquid Embolic Agents Using A Novel Injectable Phantom, J Ryan Mason, Cristina Dodge, Adam Beardsley, Susan Hilsenbeck, Goetz Benndorf

Center for Medical Ethics and Health Policy Staff Publications

Background: Radiographic visualization of liquid embolic agents (LEAs) during embolization procedures in neurovascular territory represents a crucial feature to ensure efficacy and safety for the patients during endovascular treatment of arteriovenous shunting lesions. Radiopacity of available LEAs varies significantly and limited methods are currently available for comparison. The purpose of this study was to compare the contrast resolution (CR) during injection under blank roadmap of various LEAs, as well as standard contrast material.

Methods: An injectable angiographic phantom was designed consisting of parallel tubings between 313 and 1000 micron. Under roadmap, eight radiopaque liquid agents were injected and analyzed: Onyx18®, …


The Role Of Gdf5 In Regulating Enthesopathy Development In The Hyp Mouse Model Of Xlh, Melissa Sorsby, Shaza Almardini, Ahmad Alayyat, Ashleigh Hughes, Shreya Venkat, Mansoor Rahman, Jiana Baker, Rakshya Rana, Vicki Rosen, Eva S Liu Aug 2024

The Role Of Gdf5 In Regulating Enthesopathy Development In The Hyp Mouse Model Of Xlh, Melissa Sorsby, Shaza Almardini, Ahmad Alayyat, Ashleigh Hughes, Shreya Venkat, Mansoor Rahman, Jiana Baker, Rakshya Rana, Vicki Rosen, Eva S Liu

Staff and Researcher Publications

X-linked hypophosphatemia (XLH) is caused by mutations in PHEX, leading to rickets and osteomalacia. Adults affected with XLH develop a mineralization of the bone-tendon attachment site (enthesis), called enthesopathy, which causes significant pain and impaired movement. Entheses in mice with XLH (Hyp) have enhanced bone morphogenetic protein (BMP) and Indian hedgehog (IHH) signaling. Treatment of Hyp mice with the BMP signaling blocker palovarotene attenuated BMP/IHH signaling in Hyp entheses, thus indicating that BMP signaling plays a pathogenic role in enthesopathy development and that IHH signaling is activated by BMP signaling in entheses. It was previously shown that mRNA expression of …


Right Ventricle-Pulmonary Artery Conduit Replacement Resolves Anomalous Single Coronary Stenosis In Repaired Tetralogy Of Fallot, Karl Kristian Lundin, Edward Hickey, Prakash Masand, Vivian Dimas, Katherine Bohard Salciccioli Aug 2024

Right Ventricle-Pulmonary Artery Conduit Replacement Resolves Anomalous Single Coronary Stenosis In Repaired Tetralogy Of Fallot, Karl Kristian Lundin, Edward Hickey, Prakash Masand, Vivian Dimas, Katherine Bohard Salciccioli

Faculty, Staff and Students Publications

A 41-year-old man with repaired tetralogy of Fallot and a single coronary artery (CA) arising anteriorly presented with dyspnea in the setting of moderate right ventricle-pulmonary artery conduit (RV-PAC) stenosis and moderate-to-severe extrinsic left main CA compression between the aorta and RV-PAC. His CA stenosis resolved after successful RV-PAC replacement.


Safety Of Treating Acute Pulmonary Embolism At Home: An Individual Patient Data Meta-Analysis, Dieuwke Luijten, Delphine Douillet, Kim Luijken, Cecile Tromeur, Andrea Penaloza, Olivier Hugli, Drahomir Aujesky, Stefano Barco, Joseph R Bledsoe, Kyle E Chang, Francis Couturaud, Paul L Den Exter, Carme Font, Menno V Huisman, David Jimenez, Christopher Kabrhel, Jeffrey A Kline, Stavros Konstantinides, Thijs Van Mens, Remedios Otero, W Frank Peacock, Olivier Sanchez, William B Stubblefield, Luca Valerio, David R Vinson, Philip Wells, Maarten Van Smeden, Pierre-Marie Roy, Frederikus A Klok Aug 2024

Safety Of Treating Acute Pulmonary Embolism At Home: An Individual Patient Data Meta-Analysis, Dieuwke Luijten, Delphine Douillet, Kim Luijken, Cecile Tromeur, Andrea Penaloza, Olivier Hugli, Drahomir Aujesky, Stefano Barco, Joseph R Bledsoe, Kyle E Chang, Francis Couturaud, Paul L Den Exter, Carme Font, Menno V Huisman, David Jimenez, Christopher Kabrhel, Jeffrey A Kline, Stavros Konstantinides, Thijs Van Mens, Remedios Otero, W Frank Peacock, Olivier Sanchez, William B Stubblefield, Luca Valerio, David R Vinson, Philip Wells, Maarten Van Smeden, Pierre-Marie Roy, Frederikus A Klok

Faculty, Staff and Students Publications

BACKGROUND AND AIMS: Home treatment is considered safe in acute pulmonary embolism (PE) patients selected by a validated triage tool (e.g. simplified PE severity index score or Hestia rule), but there is uncertainty regarding the applicability in underrepresented subgroups. The aim was to evaluate the safety of home treatment by performing an individual patient-level data meta-analysis.

METHODS: Ten prospective cohort studies or randomized controlled trials were identified in a systematic search, totalling 2694 PE patients treated at home (discharged within 24 h) and identified by a predefined triage tool. The 14- and 30-day incidences of all-cause mortality and adverse events …


Mitral Annular Disjunction And "Pseudo" Mitral Annular Disjunction In Mitral Valve Prolapse, Tam T Doan, Shaine A Morris Aug 2024

Mitral Annular Disjunction And "Pseudo" Mitral Annular Disjunction In Mitral Valve Prolapse, Tam T Doan, Shaine A Morris

Faculty, Staff and Students Publications

No abstract provided.


Preventing And Managing Equine Gastric Ulcer Syndrome, Kylie Bell, Karl Hoopes Aug 2024

Preventing And Managing Equine Gastric Ulcer Syndrome, Kylie Bell, Karl Hoopes

All Current Publications

Current industry trends regarding equine management practices largely contribute to the development of equine gastric ulcer syndrome (EGUS). Research on effective medical management exists; however, we lack studies on the efficacy of equine-welfare-minded solutions. This fact sheet reviews current literature, including diagnosing, treating, and preventing EGUS. It also provides a general overview of the natural equine, promoting a greater understanding of the connection between strategies to prevent and manage EGUS.


Adverse Childhood Experiences And Effects On Delinquency, Katherine Lank Aug 2024

Adverse Childhood Experiences And Effects On Delinquency, Katherine Lank

Master of Arts in Human Services

Youth involved in delinquent acts are seen interacting with the juvenile justice system at an alarming rate. Adverse childhood experiences influence the development of behavior and chances of taking risks. Children who grow up in a household with an unfit parent, substance abuse, or mental health disorders are seen turning to delinquent acts for gratification. This can have a higher chance of poor educational performance, unemployment, increased law enforcement interactions, and long-term mental and physical disabilities. Searching literature consisted of finding external factors and their control on brain development and future adult behaviors. Research was conducted on the school-to-prison pipeline, …


Work-Related Musculoskeletal Problems: A Look At How Employers View Causes, Roger C. Jensen Aug 2024

Work-Related Musculoskeletal Problems: A Look At How Employers View Causes, Roger C. Jensen

Safety Health & Industrial Hygiene

Causation concepts for work-related musculoskeletal disorders vary among authors and academic disciplines. The major causation concepts are single-event and repetitive motion. The aim of this short communication is to share findings from a recent survey of United States employers conducted by the U.S. Bureau of Labor Statistics about work-related musculoskeletal cases, and, more specifically, about whether the employers regard the causes of their employees’ musculoskeletal problems as being from a single exposure or from multiple exposures. Recommendations are offered for using terminology consistent with employer understandings.


2024 August 20 - Medical Student Education Committee Minutes, Medical Student Education Committee, East Tennessee State University Aug 2024

2024 August 20 - Medical Student Education Committee Minutes, Medical Student Education Committee, East Tennessee State University

Medical Student Education Committee Minutes

No abstract provided.