Medicine and Health Sciences Commons^™

Geometric Accuracy Of Low-Dose Ct Scans For Use In Shoulder Musculoskeletal Research Applications, Rebekah L Lawrence, Lydia Nicholson, Erin C S Lee, Kelby Napier, Benjamin Zmistowski, Michael J Rainbow

2020-Current year OA Pubs

Computed tomography (CT) imaging is frequently employed in a variety of musculoskeletal research applications. Although research studies often use imaging protocols developed for clinical applications, lower dose protocols are likely possible when the goal is to reconstruct 3D bone models. Our purpose was to describe the dose-accuracy trade-off between incrementally lower-dose CT scans and the geometric reconstruction accuracy of the humerus, scapula, and clavicle. Six shoulder specimens were acquired and scanned using 5 helical CT protocols: 1) 120 kVp, 450 mA (full-dose); 2) 120 kVp, 120 mA; 3) 120 kVp, 100 mA; 4) 100 kVp, 100 mA; 5) 80 kVp, …

Immune-Mediated Myositis Following Gene Therapy For Duchenne Muscular Dystrophy: A Case Report, Susan T Iannaccone, Chunyu Cai, Brittney Rhem, Kaitlin Batley, Veena Rajaram, Benjamin M Greenberg, Sachi Dharia, Craig M Zaidman

2020-Current year OA Pubs

No abstract provided.

Predicting Post-Surgical Functional Status In High-Grade Glioma With Resting State Fmri And Machine Learning, Patrick H Luckett, Michael O Olufawo, Ki Yun Park, Bidhan Lamichhane, Donna Dierker, Gabriel Trevino Verastegui, John J Lee, Peter Yang, Albert Kim, Omar H Butt, Milan G Chheda, Abraham Z Snyder, Joshua S Shimony, Eric C Leuthardt

2020-Current year OA Pubs

PURPOSE: High-grade glioma (HGG) is the most common and deadly malignant glioma of the central nervous system. The current standard of care includes surgical resection of the tumor, which can lead to functional and cognitive deficits. The aim of this study is to develop models capable of predicting functional outcomes in HGG patients before surgery, facilitating improved disease management and informed patient care.

METHODS: Adult HGG patients (N = 102) from the neurosurgery brain tumor service at Washington University Medical Center were retrospectively recruited. All patients completed structural neuroimaging and resting state functional MRI prior to surgery. Demographics, measures of …

Nlrp1 Inflammasome Promotes Senescence And Senescence-Associated Secretory Phenotype, Inés Muela-Zarzuela, Juan Miguel Suarez-Rivero, Andrea Gallardo-Orihuela, Chun Wang, Kumi Izawa, Marta De Gregorio-Procopio, Isabelle Couillin, Bernhard Ryffel, Jiro Kitaura, Alberto Sanz, Thomas Von Zglinicki, Gabriel Mbalaviele, Mario D Cordero

2020-Current year OA Pubs

BACKGROUND: Senescence is a cellular aging-related process triggered by different stresses and characterized by the secretion of various inflammatory factors referred to as senescence-associated secretory phenotype (SASP), some of which are produced by the NLRP3 inflammasome. Here, we present evidence that the NLRP1 inflammasome is a DNA damage sensor and a key mediator of senescence.

METHODS: Senescence was induced in fibroblasts in vitro and in mice. Cellular senescence was assessed by Western blot analysis of several proteins, including p16, p21, p53, and SASP factors, released in the culture media or serum. Inflammasome components, including NLRP1, NLRP3 and GSDMD were knocked …

Overall Survival In Patients With Endometrial Cancer Treated With Dostarlimab Plus Carboplatin-Paclitaxel In The Randomized Engot-En6/Gog-3031/Ruby Trial, M A Powell, C Mccourt, Et Al.

2020-Current year OA Pubs

BACKGROUND: Part 1 of the RUBY trial (NCT03981796) evaluated dostarlimab plus carboplatin-paclitaxel compared with placebo plus carboplatin-paclitaxel in patients with primary advanced or recurrent endometrial cancer (EC). At the first interim analysis, the trial met one of its dual primary endpoints with statistically significant progression-free survival benefits in the mismatch repair-deficient/microsatellite instability-high (dMMR/MSI-H) and overall populations. Overall survival (OS) results are reported from the second interim analysis.

PATIENTS AND METHODS: RUBY is a phase III, global, double-blind, randomized, placebo-controlled trial. Part 1 of RUBY enrolled eligible patients with primary advanced stage III or IV or first recurrent EC who were …

Nf1 Mutation Disrupts Activity-Dependent Oligodendroglial Plasticity And Motor Learning In Mice, Yuan Pan, Corina Anastasaki, Jit Chatterjee, Suzanne Scheaffer, David H Gutmann, Et Al.

2020-Current year OA Pubs

Neurogenetic disorders, such as neurofibromatosis type 1 (NF1), can cause cognitive and motor impairments, traditionally attributed to intrinsic neuronal defects such as disruption of synaptic function. Activity-regulated oligodendroglial plasticity also contributes to cognitive and motor functions by tuning neural circuit dynamics. However, the relevance of oligodendroglial plasticity to neurological dysfunction in NF1 is unclear. Here we explore the contribution of oligodendrocyte progenitor cells (OPCs) to pathological features of the NF1 syndrome in mice. Both male and female littermates (4-24 weeks of age) were used equally in this study. We demonstrate that mice with global or OPC-specific Nf1 heterozygosity exhibit defects …

The Space Omics And Medical Atlas (Soma) And International Astronaut Biobank, Eliah G Overbey, Kelly L Bolton, Et Al.

2020-Current year OA Pubs

Spaceflight induces molecular, cellular and physiological shifts in astronauts and poses myriad biomedical challenges to the human body, which are becoming increasingly relevant as more humans venture into space

A Maternal Brain Hormone That Builds Bone, Muriel E Babey, Xiao Zhang, Erica L Scheller, Et Al.

2020-Current year OA Pubs

In lactating mothers, the high calcium (Ca

High-Dimensional Single-Cell Analysis Of Human Natural Killer Cell Heterogeneity, Lucas Rebuffet, Marco Colonna, Et Al.

2020-Current year OA Pubs

Natural killer (NK) cells are innate lymphoid cells (ILCs) contributing to immune responses to microbes and tumors. Historically, their classification hinged on a limited array of surface protein markers. Here, we used single-cell RNA sequencing (scRNA-seq) and cellular indexing of transcriptomes and epitopes by sequencing (CITE-seq) to dissect the heterogeneity of NK cells. We identified three prominent NK cell subsets in healthy human blood: NK1, NK2 and NK3, further differentiated into six distinct subgroups. Our findings delineate the molecular characteristics, key transcription factors, biological functions, metabolic traits and cytokine responses of each subgroup. These data also suggest two separate ontogenetic …

Psilocybin Desynchronizes The Human Brain, Joshua S Siegel, Demetrius Perry, Benjamin P Kay, Evan M Gordon, Timothy O Laumann, T Rick Reneau, Nicholas V Metcalf, Samuel R Krimmel, Joshua S Shimony, Julie A Schweiger, Dean F Wong, David A Bender, Kristen M Scheidter, Forrest I Whiting, Jonah A Padawer-Curry, Eric J Lenze, Marcus E Raichle, Abraham Z Snyder, Ginger E Nicol, Nico U F Dosenbach, Et Al.

2020-Current year OA Pubs

A single dose of psilocybin, a psychedelic that acutely causes distortions of space-time perception and ego dissolution, produces rapid and persistent therapeutic effects in human clinical trials

Neoantigen-Specific Cytotoxic Tr1 Cd4 T Cells Suppress Cancer Immunotherapy, Hussein Sultan, Yoshiko Takeuchi, Jeffrey P Ward, Tian-Tian Liu, Vladimir Sukhov, Yuang Song, Samuel Ameh, Simone Brioschi, Darya Khantakova, Cora D Arthur, J Michael White, Heather Kohlmiller, Kathleen C F Sheehan, Marco Colonna, Kenneth M Murphy, Maxim N Artyomov, Robert D Schreiber, Et Al.

2020-Current year OA Pubs

CD4

Lisocabtagene Maraleucel In Follicular Lymphoma: The Phase 2 Transcend Fl Study, Franck Morschhauser, Brad Kahl, Et Al.

2020-Current year OA Pubs

An unmet need exists for patients with relapsed/refractory (R/R) follicular lymphoma (FL) and high-risk disease features, such as progression of disease within 24 months (POD24) from first-line immunochemotherapy or disease refractory to both CD20-targeting agent and alkylator (double refractory), due to no established standard of care and poor outcomes. Chimeric antigen receptor (CAR) T cell therapy is an option in R/R FL after two or more lines of prior systemic therapy, but there is no consensus on its optimal timing in the disease course of FL, and there are no data in second-line (2L) treatment of patients with high-risk features. …

Cell-Free Dna For The Detection Of Kidney Allograft Rejection, Olivier Aubert, Tarek Alhamad, Raja Dandamudi, Vikas R Dharnidharka, Et Al.

2020-Current year OA Pubs

Donor-derived cell-free DNA (dd-cfDNA) is an emerging noninvasive biomarker that has the potential to detect allograft injury. The capacity of dd-cfDNA to detect kidney allograft rejection and its added clinical value beyond standard of care patient monitoring is unclear. We enrolled 2,882 kidney allograft recipients from 14 transplantation centers in Europe and the United States in an observational population-based study. The primary analysis included 1,134 patients. Donor-derived cell-free DNA levels strongly correlated with allograft rejection, including antibody-mediated rejection (P < 0.0001), T cell-mediated rejection (P < 0.0001) and mixed rejection (P < 0.0001). In multivariable analysis, circulating dd-cfDNA was significantly associated with allograft rejection (odds ratio 2.275; 95% confidence interval (CI) 1.902-2.739; P < 0.0001) independently of standard of care patient monitoring parameters. The inclusion of dd-cfDNA to a standard of care prediction model showed improved discrimination (area under the curve 0.777 (95% CI 0.741-0.811) to 0.821 (95% CI 0.784-0.852); P = 0.0011) and calibration. These results were confirmed in the external validation cohorts (n = 1,748) including a cohort of African American patients (n = 439). Finally, dd-cfDNA showed high predictive value to detect subclinical rejection in stable patients. Our study provides insights on the potential value of assessing dd-cfDNA, in addition to standard of care monitoring, to improve the detection of allograft rejection. ClinicalTrials.gov registration: NCT05995379 .

Potential Us Health Care Savings Based On Clinician Views Of Feasible Site-Of-Care Shifts, Nikhil R Sahni, Crosbie Marine, David M Cutler, Laura N Medford-Davis, Melvin Mezue, Omar Kattan, Ed Levine, Karen E Joynt Maddox

2020-Current year OA Pubs

IMPORTANCE: Shifting care to alternative sites when clinically appropriate may be associated with reduced US health care spending, improved access, and, in some cases, improved care outcomes.

OBJECTIVE: To fill 2 main gaps in the current literature on site-of-care shifts: (1) understanding the clinician perspective on appropriateness of alternative care sites, given the central role they play in referrals and patient trust and (2) considering all potential sites where care could shift and calculating net savings potential.

DESIGN, SETTING, AND PARTICIPANTS: In this survey study, physicians (MDs and DOs), nurse practitioners, physician assistants, nurse anesthetists, radiology and imaging technicians, and …

Traumatic Brain Injury, Seizures, And Cognitive Impairment Among Older Adults, Yiqi Zhu, Jonathan Williams, Kebede Beyene, Jean-Francois Trani, Ganesh M Babulal

2020-Current year OA Pubs

IMPORTANCE: Traumatic brain injury (TBI), seizures, and dementia increase with age. There is a gap in understanding the associations of TBI, seizures, and medications such as antiseizure and antipsychotics with the progression of cognitive impairment across racial and ethnic groups.

OBJECTIVE: To investigate the association of TBI and seizures with the risk of cognitive impairment among cognitively normal older adults and the role of medications in moderating the association.

DESIGN, SETTING, AND PARTICIPANTS: This multicenter cohort study was a secondary analysis of the Uniform Data Set collected between June 1, 2005, and June 30, 2020, from the National Alzheimer's Coordination …

Accumulation Of Alkyl-Lysophosphatidylcholines In Niemann-Pick Disease Type C1, Sonali Mishra, Pamela Kell, David Scherrer, Dennis J Dietzen, Charles H Vite, Elizabeth Berry-Kravis, Cristin Davidson, Stephanie M Cologna, Forbes D Porter, Daniel S Ory, Xuntian Jiang

2020-Current year OA Pubs

Lysosomal function is impaired in Niemann-Pick disease type C1 (NPC1), a rare and inherited neurodegenerative disorder, resulting in late endosomal/lysosomal accumulation of unesterified cholesterol. The precise pathogenic mechanism of NPC1 remains incompletely understood. In this study, we employed metabolomics to uncover secondary accumulated substances in NPC1. Our findings unveiled a substantial elevation in the levels of three alkyl-lysophosphatidylcholine [alkyl-LPC, also known as lyso-platelet activating factor (PAF)] species in NPC1 compared to controls across various tissues, including brain tissue from individuals with NPC1, liver, spleen, cerebrum, cerebellum, and brain stem from NPC1 mice, as well as in both brain and liver …

Thrombotic Microangiopathy In Pregnancy: Current Understanding And Management Strategies, Manuel Urra, Shannon Lyons, Corina Gabriela Teodosiu, Richard Burwick, Anuja Java

2020-Current year OA Pubs

Thrombotic microangiopathy (TMA) represents a heterogeneous group of disorders characterized by microvascular thrombosis and end-organ damage. Pregnancy-associated thrombotic microangiopathy (p-TMA) has emerged as a distinct clinical entity with unique diagnostic challenges. Identifying the specific form of p-TMA is critical for appropriate and timely management. This review offers a comprehensive overview of the various forms of thrombotic microangiopathies associated with pregnancy, highlighting our current understanding of their pathophysiology and the evolving landscape of diagnosis and treatment for each.

Himmelfarb Library Liaison Letter - August 2024, The George Washington University, Himmelfarb Health Sciences Library

Himmelfarb Library Liaison Letters

No abstract provided.

Investigating The Role Of Insulin-Like Signaling In Paclitaxel-Induced Nociceptive Hypersensitivity Using Drosophila Melanogaster, Sreepradha Sridharan

Dissertations and Theses (Open Access)

Paclitaxel (PTX), a chemotherapeutic that alters microtubule dynamics, is known to induce nociceptive hypersensitivity and sensory neuron damage in human patients and in Drosophila larvae. We used a modified feeding protocol to establish a genetically tractable Drosophila model of PTX-induced hypersensitivity. Larvae fed PTX exhibited hypersensitivity to thermal and mechanical stimuli. Thermal hypersensitivity was observed at low concentrations of PTX (even below 1 μM per ml of food), begins within 8 hours of PTX feeding, and did not completely resolve at the larval stage. Live imaging of peripheral thermal nociceptors showed that this hypersensitivity precedes observable neuronal damage. At low …

Determining Spatiotemporal Regulation Of Actin Dynamics In Choroid Fissure Closure, Cristal Gonzalez

Master's Theses

There are several stages of development necessary for proper vision. During vertebrate eye development, early eye morphology progresses in three stages: optic cup morphogenesis, basement membrane breakdown, and tissue fusion. Eye development is an intricate collaboration between many cells and requires tissues to migrate and bridge together. The following research investigates the Danio Rerio eye development to understand the molecular regulation of choroid fissure closure (CFC). It is hypothesized that CFC requires temporal and spatial regulation of actin dynamics. We investigate this question using chemical inhibitors, cytochalasin D, an actin treadmilling inhibitor, and NSC23766, a Rac-GEF inhibitor of the actin …

Adopting A Systems-Thinking Approach To Optimise Dietary And Exercise Referral Practices For Cancer Survivors, Ria Joseph, Nicolas H. Hart, Natalie Bradford, Fiona Crawford-Williams, Matthew P. Wallen, Reegan Knowles, Chad Y. Han, Vivienne Milch, Justin J. Holland, Raymond J. Chan

Research outputs 2022 to 2026

Purpose: Service referrals are required for cancer survivors to access specialist dietary and exercise support. Many system-level factors influence referral practices within the healthcare system. Hence, the aim of this study was to identify system-level factors and their interconnectedness, as well as strategies for optimising dietary and exercise referral practices in Australia. Methods: A full-day workshop involving national multidisciplinary key stakeholders explored system-level factors impacting dietary and exercise referral practices. Facilitated group discussions using the nominal group technique identified barriers and facilitators to referral practices based on the six World Health Organisation (WHO) building blocks. The systems-thinking approach generated six …

Delirium Prevention And Management In An Adult Intensive Care Unit Through Evidence-Based Nonpharmacological Interventions: A Scoping Review, Gideon U. Johnson, Amanda Towell-Barnard, Christopher Mclean, Beverley Ewens

Research outputs 2022 to 2026

Objective: To map and review current literature to describe evidence-based nonpharmacological interventions for delirium prevention and management in adult critically ill patients. Introduction: Previous research has demonstrated the efficacy of nonpharmacological interventions for intensive care unit (ICU) delirium; however, the heterogeneity and complexity of these interventions make it challenging to disseminate and integrate into clinical practice. Design: This scoping review follows the Joanna Briggs Institute (JBI) Protocol Guidelines. Data sources: Cumulative Index of Nursing and Allied Health Literature, Medical Literature Analysis and Retrieval System Online, PsycINFO, JBI, ProQuest, and Excerpta Medica databases were searched until August 2023. Review methods: Double …

Mitochondrial Ca2+-Coupled Generation Of Reactive Oxygen Species, Peroxynitrite Formation, And Endothelial Dysfunction In Cantú Syndrome, Elsayed Metwally, Alfredo Sanchez Solano, Boris Lavanderos, Evan Yamasaki, Pratish Thakore, Conor Mcclenaghan, Natalia Rios, Rafael Radi, Yumei Feng Earley, Colin G. Nichols, Scott Earley

2020-Current year OA Pubs

Cantú syndrome is a multisystem disorder caused by gain-of-function (GOF) mutations in KCNJ8 and ABCC9, the genes encoding the pore-forming inward rectifier Kir6.1 and regulatory sulfonylurea receptor SUR2B subunits, respectively, of vascular ATP-sensitive K+ (KATP) channels. In this study, we investigated changes in the vascular endothelium in mice in which Cantú syndrome-associated Kcnj8 or Abcc9 mutations were knocked in to the endogenous loci. We found that endothelium-dependent dilation was impaired in small mesenteric arteries from Cantú mice. Loss of endothelium-dependent vasodilation led to increased vasoconstriction in response to intraluminal pressure or treatment with the adrenergic receptor agonist phenylephrine. We also …

Cone-Beam Computed Tomography (Cbct)-Guided Adaptive Boost Radiotherapy For A Patient With Locally Advanced Cervical Cancer Ineligible For Brachytherapy, Alice E. Silberstein, Joshua P. Schiff, Robbie Beckert, Xiaodong Zhao, Eric Laugeman, Stephanie Markovina, Jessika A. Contreras

2020-Current year OA Pubs

Brachytherapy is a critical component of locally advanced cervical cancer treatment, and patients ineligible for brachytherapy historically have poor outcomes. Delivery of boost with stereotactic body radiation therapy (SBRT) has been studied, though toxicity is a concern. Recent case reports have explored adaptive radiation boost, which can adjust plans for inter-fraction motion using magnetic resonance guidance. Herein, we report the first patient with locally advanced cervical cancer ineligible for brachytherapy who was treated with a cone-beam computed tomography (CBCT)-guided adaptive boost following completion of chemoradiation. A 71-year-old female with locally advanced cervical cancer was treated with chemoradiation and was deemed …

Functional Contribution Of Epithelial To Mesenchymal Transition Program On Krasg12d Targeting Efficacy In Pancreatic Cancer, Ana S. Maldonado

Dissertations and Theses (Open Access)

Functional contribution of epithelial to mesenchymal transition program on KRAS^G12D targeting efficacy in pancreatic cancer

Ana S. Maldonado, BS

Advisory Professor: Raghu Kalluri, M.D., Ph.D.

Pancreatic Ductal Adenocarcinoma (PDAC), a highly aggressive, metastatic, and therapeutically resistant form of pancreatic cancer has been projected to become the second-leading cause of cancer related mortality in the United States. This is driven by its detection difficulty, treatment efficacy, and asymptomatic nature, among other factors. PDAC is driven predominantly by KRAS^G12D mutations, which are responsible for the initial development of pancreatic intraepithelial neoplasia (Pan-IN) lesions, that are further maintained and progressed until …

Ot's Role In Community Accessibility At Public Parks And Playgrounds For Parents With Disabilities, Janae Paulo, Amy Lyons-Brown, Stacy Frauwith, Lena Gipson Showalter

Summer 2024 OTD Capstone Symposium

Public parks and playgrounds play a crucial role in fostering parent-child interaction, social inclusion, and community engagement. However, these essential recreational spaces often remain inaccessible to individuals with disabilities (Lynch et al., 2020). Research underscores the benefits of inclusive playgrounds, yet many are not designed to accommodate adults with disabilities, thus creating barriers for parents with disabilities who wish to engage with their children (Dalpra, 2022; Jacob et al., 2017). Although occupational therapy (OT) practitioners are instrumental in ensuring environmental accessibility within home settings, their involvement in the design of public spaces is limited. Young et al. (2019) advocate for …

Impacts Of Pelvic Floor Dysfunction On The Occupations Of Postpartum Women, Julia Hernandez, Amy Lyons-Brown

Summer 2024 OTD Capstone Symposium

This study investigates the impact of pelvic floor dysfunction (PFD) on the daily activities of postpartum women. Eleven women participated in an online survey, with four engaging in follow-up interviews via Microsoft Teams. The survey indicated that 91% of respondents experienced at least one symptom of PFD, including urine leakage, difficulty reaching the toilet in time, unexpected passing of wind, decreased vaginal sensation, a bulge at the vaginal opening, pelvic heaviness, and vulvar pain during sex. Despite these prevalent symptoms, 82% had not been offered pelvic floor therapy.

Participants rated their awareness of pelvic floor health topics predominantly as "Less …

Technical Considerations In Robotic Aberrant Right Subclavian Artery Resection For Dysphagia Lusoria, Luke Meredith, Emily Isch, Mohammed Ali, Michael Nooromid, Olugbenga Okusanya

Department of Surgery Faculty Papers

Dysphagia lusoria occurs due to compression of the esophagus as an aberrant right subclavian artery (ARSA) crosses the mediastinum. Surgical management includes open, hybrid, and endovascular techniques, with no consensus gold standard. There are few reports of robotic-assisted ARSA resection. We describe the innovative technique and outcomes for two patients who successfully underwent robotic-assisted transthoracic resection of an ARSA after right carotid–subclavian bypass for dysphagia lusoria. Both patients experienced improvement or resolution of their dysphagia and no major complications. In select patients with a noncalcified origin of the ARSA without aneurysmal degeneration, the robotic-assisted approach represents a viable option.

Exploring Psychology Graduate Students’ Desire And Ability To Discuss Their Personal Trauma History With Clinical Supervisors, Madeleine Lane

Dissertations

Inspired by the archetype of the “wounded healer,” described by Carl Jung as a psychologist who enters the field with psychological wounds of their own, and the prevalence of such wounded healers in the mental health field today, this study aimed to explore clinical psychology doctoral students’ experiences of self-disclosure of their personal trauma history, a specific type of psychological wound, in clinical supervision. The goal was to explore whether and how students’ trauma history is discussed in clinical supervision; the importance of such discussions for students’ professional and personal development; and the impact of having or not having …

Quality Improvement Project: Fall Prevention Among Older Adults In Snf Through Staff Education And Hourly Rounding, Reshmi Abraham

Doctor of Nursing Practice Projects

Falls among elderly individuals in Skilled Nursing Facilities (SNF) pose a widespread and significant healthcare challenge, often resulting in severe injuries, reduced quality of life, and increased healthcare expenses. Despite the current efforts to prevent falls, they still occur frequently, underscoring the importance of effective interventions for prevention. This Doctor of Nursing Practice (DNP) project focuses on quality improvement (QI) in healthcare. It aims to reduce fall rates among older adults in SNF by providing staff education and implementing scheduled hourly rounding. This approach aligns with existing research, emphasizing the importance of proactive patient monitoring and improved staff knowledge in …