Medical Sciences Commons^™

Navigating Nonlinear Pathways: Challenges And Opportunities For Diversity, Equity, And Inclusion Leaders In Academic Emergency Medicine, Melanie F Molina, Annika Bhananker, Beatrice Torres, Dalia Owda, Edgardo Ordoñez, Anita N Chary

Faculty, Staff and Students Publications

OBJECTIVES: Diversity, equity, and inclusion (DEI) leadership roles have grown in academic emergency medicine (EM). We sought to elucidate specific pathways to DEI leadership roles among current DEI leaders in academic EM.

METHODS: From March to May 2023, we conducted semistructured, qualitative interviews with DEI leaders in academic EM across 5 US regions to investigate their pathways to leadership. Participants were recruited via email using Accreditation Council for Graduate Medical Education-accredited EM residency websites and the Academy for Diversity and Inclusion in EM. After recording and transcribing the interviews, we used an inductive approach to identify major themes.

RESULTS: Of …

Crispr/Cas9 Gene Therapy Increases The Risk Of Tumorigenesis In The Mouse Model Of Hereditary Tyrosinemia Type I, Tong Chen, Mercedes Barzi, Nika Furey, Hyunjae R Kim, Francis P Pankowicz, Xavier Legras, Sara H Elsea, Ayrea E Hurley, Diane Yang, David A Wheeler, Malgorzata Borowiak, Beatrice Bissig-Choisat, Pavel Sumazin, Karl-Dimiter Bissig

Center for Medical Ethics and Health Policy Staff Publications

Background & aims: The therapeutic potential of CRISPR gene editing has been demonstrated in various animal models; however, little is known about its long-term consequences. This study seeks to bridge this gap by investigating the lasting consequences of CRISPR gene therapy in an animal model of hereditary tyrosinemia type I (HT-I). We compared the standard of care-nitisinone, a small molecule inhibitor of hydroxyphenylpyruvate dioxygenase (HPD)-with the deletion of the Hpd gene by CRISPR gene therapy. Both treatments block flux through tyrosine catabolism and thereby prevent the accumulation of toxic catabolites in HT-I.

Methods: We assessed the efficacy and safety of …

Ethical Considerations For Sharing Aggregate Results From Pragmatic Clinical Trials, Stephanie R Morain, Abigail Brickler, Joseph Ali, Patricia Pearl O'Rourke, Kayte Spector-Bagdady, Benjamin Wilfond, Vasiliki Rahimzadeh, Caleigh Propes, Kayla Mehl, David Wendler

Center for Medical Ethics and Health Policy Staff Publications

A growing literature has explored the ethical obligations and current practices related to sharing aggregate results with research participants. However, no prior work has examined these issues in the context of pragmatic clinical trials. Several characteristics of pragmatic clinical trials may complicate both the ethics and the logistics of sharing aggregate results. Among these characteristics include that pragmatic clinical trials may affect the rights, welfare, and interests of not only patient-subjects but also clinicians, meaning that results may be owed to a broader range of groups than typically considered in other research contexts. In addition, some pragmatic clinical trials are …

Amniocentesis In Pregnancies At Or Beyond 24 Weeks: An International Multicenter Study, Roni Zemet, Mohamad Ali Maktabi, Alexandra Tinfow, Jessica L Giordano, Thomas M Heisler, Qi Yan, Roni Plaschkes, Jenny Stokes, Jennifer M Walsh, Siobhán Corcoran, Erica Schindewolf, Kendra Miller, Asha N Talati, Kristen A Miller, Karin Blakemore, Kate Swanson, Jana Ramm, Ivonne Bedei, Teresa N Sparks, Angie C Jelin, Neeta L Vora, Juliana S Gebb, David A Crosby, Michal Berkenstadt, Boaz Weisz, Ronald J Wapner, Ignatia B Van Den Veyver

Center for Medical Ethics and Health Policy Staff Publications

Background: Amniocentesis for genetic diagnosis is most commonly done between 15 and 22 weeks of gestation but can be performed at later gestational ages. The safety and genetic diagnostic accuracy of amniocentesis have been well-established through numerous large-scale multicenter studies for procedures before 24 weeks, but comprehensive data on late amniocentesis remain sparse.

Objective: To evaluate the indications, diagnostic yield, safety, and maternal and fetal outcomes associated with amniocentesis performed at or beyond 24 weeks of gestation.

Study design: We conducted an international multicenter retrospective cohort study examining pregnant individuals who underwent amniocentesis for prenatal diagnostic testing at gestational ages …

Spatial And Seasonal Dynamics Of Mosquito Species In Harris County, Texas, Highlight Risk Of Arbovirus Introduction And Transmission, Morgan Jibowu, Maximea Vigilant, Andre Luis Costa-Da-Silva, Alisa Nelson, Heather T Essigmann, Eric L Brown, Sarah M Gunter

Faculty, Staff and Student Publications

Mosquito-borne diseases pose a significant public health threat, particularly in densely populated urban areas. Climate change, urbanization, and global connectivity have fueled the expansion of mosquitoes and their associated pathogens, increasing the disease burden. Harris County, Texas, is among the most vulnerable regions in the United States for mosquito-borne disease outbreaks, underscoring the critical need for localized insights into mosquito population dynamics to inform vector surveillance and control strategies. This study provides a comprehensive analysis of the population dynamics of mosquito species in Harris County by exploring their species composition, spatial distribution, and seasonal patterns. Our findings reveal the extensive …

Neighborhood Disadvantage And Inequities In Access To Preemptive And Living Kidney Transplantation, Brandon M Fairless, Oluwatunmise A Fawole, Duc T Nguyen, Ankona Banerjee, Kenneth J Nobleza, Abiodun O Oluyomi, Omar Rosales, Jayna M Dave, Elizabeth A Onugha

Children’s Nutrition Research Center Staff Publications

Key Points:

1. Pediatric patients residing in low-resource neighborhoods experienced lower rates of preemptive and living donor kidney transplantation.

2. Household-level factors (single-parent, non-English primary language, and receiving government assistance) may also affect the type of transplant received.

3. Area Deprivation Index scores offer an objective way to quantify neighborhood-level disadvantage and can enhance pretransplant screening.

Background: Living donor kidney transplant (LDKT) generally results in better outcomes than deceased donor kidney transplant (DDKT). Preemptive kidney transplant (KT) allows patients to bypass undergoing maintenance dialysis and is associated with improved patient and graft survival. Studies in the US pediatric population have shown racial-ethnic disparities …

Association Of Messenger Rna Coronavirus Disease 2019 (Covid-19) Vaccination And Reductions In Post Covid Conditions Following Severe Acute Respiratory Syndrome Coronavirus 2 Infection In A Us Prospective Cohort Of Essential Workers, Josephine Mak, Sana Khan, Amadea Britton, Spencer Rose, Lisa Gwynn, Katherine D Ellingson, Jennifer Meece, Leora R Feldstein, Harmony Tyner, Laura J Edwards, Matthew S Thiese, Allison Naleway, Manjusha Gaglani, Natasha Solle, Jefferey L Burgess, Julie Mayo Lamberte, Meghan Shea, Taryn Hunt-Smith, Alberto Caban-Martinez, Cynthia Porter, Ryan Wiegand, Ramona Rai, Kurt T Hegmann, James Hollister, Ashley Fowlkes, Meredith Wesley, Andrew L Philips, Patrick Rivers, Robin Bloodworth, Gabriella Newes-Adeyi, Lauren E W Olsho, Sarang K Yoon, Sharon Saydah, Karen Lutrick

Center for Medical Ethics and Health Policy Staff Publications

Background: Data are limited on whether vaccination reduces post COVID conditions (PCCs) risk after less severe nonhospitalized coronavirus disease 2019 (COVID-19). This study assessed whether COVID-19 vaccination protected against PCCs in persons with mild initial infections during Delta and Omicron variant predominance.

Methods: This study utilized a case-control design, nested within the HEROES-RECOVER cohort. Participants aged ≥18 years with test-confirmed severe acute respiratory syndrome coronavirus disease 2 (SARS-CoV-2) between 28 June 2021 and 14 September 2022 were surveyed for PCCs, defined by symptoms lasting >4 weeks after initial infection. Cases self-reported PCCs and controls self-reported no PCCs. The exposure was …

Mobilizing Prevention And Early Detection Of Alzheimer's Disease And Related Dementias (Adrd) In Allegheny County Through The Area Agency On Aging (Aaa), Laiba N. Mirza

Public Health Capstone Projects

1. Objectives: In collaboration with the Department of Human Services (DHS): the Area Agency on Aging (AAA) using the Healthy Brain Initiative (HBI), my capstone project will involve the development of a comprehensive literature review examining the impacts of Alzheimer’s disease and related dementias (ADRD) on patients and their caregivers. The project aims to help the AAA focus on strategies to delay the onset of ADRD in Allegheny County. It also seeks to evaluate and enhance early detection programs for ADRD established by the AAA in communities within the county. Additionally, the project will explore how public health initiatives can …

Heart Failure In Black Populations: Epidemiology, Pathophysiology, And Treatment Disparities, Kazi N. Islam, Rahib K. Islam, Ivan Nguyen, Yasmeen Magherahabed, Humza Pirzadah, M. Bazlur Rashid

School of Medicine Faculty Publications

Heart failure (HF) remains a significant health challenge globally, placing a heavy burden on individuals, families, and healthcare systems. The prevalence of HF continues to rise, posing substantial public health concerns. This burden is particularly pronounced among the Black Population, who face higher prevalence, earlier onset, and greater severity of HF compared to other racial and ethnic groups. This review explores the multifaceted landscape of HF in Black individuals by examining epidemiological patterns, pathophysiological mechanisms, clinical presentations, treatment disparities, and clinical outcomes. Black individuals exhibit distinct pathophysiological characteristics, such as genetic variations contributing to heightened susceptibility and severity of HF. …

Contraceptive Hormone Influences On The Role Of Primary Reinforcement And Reinforcer-Enhancement In Nicotine Self-Administration, Kathleen Robin Mcnealy

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

Hormonal contraceptives contain a synthetic estrogen (e.g., ethinyl estradiol/EE) and/or a synthetic progestin (e.g., levonorgestrel/LEVO) and can exacerbate nicotine intake. However, whether altered intake reflects changes in nicotine reinforcement or enhancement by nicotine of co-occurring reinforcers is unknown. This reinforcer-enhancement effect is evidenced in rats when nicotine self-administration is increased by the presence of a visual stimulus (VS) reinforcer. This dissertation examined the effects of EE and LEVO on nicotine reinforcement and reinforcer-enhancement in ovary-intact female Sprague-Dawley rats. Rats were implanted with a jugular catheter and assigned to receive daily injections of EE (Vehicle, 0.125 [Low], or 0.18 [High] μg/day; …

Family Genetic Risk Communication And Reverse Cascade Testing In The Babyseq Project, Melissa K Uveges, Hadley Stevens Smith, Stacey Pereira, Casie Genetti, Amy L Mcguire, Alan H Beggs, Robert C Green, Ingrid A Holm

Center for Medical Ethics and Health Policy Staff Publications

Purpose: Genomic sequencing of newborns can initiate disease surveillance and therapy for children and may identify at-risk relatives through reverse cascade testing. We explored genetic risk communication and reverse cascade testing among families of newborns who underwent exome sequencing and were identified as having a risk for an autosomal dominant disease.

Methods: We conducted semistructured interviews with parents of newborns enrolled in the BabySeq Project who had a pathogenic or likely pathogenic variant associated with an autosomal dominant childhood- and/or adult-onset disease returned. We used directed content analysis to derive themes.

Results: From 11 families, all first-degree relatives (n = …

Navigating Your Us Bioscience Career Into The 2030s, Peter J Hotez

Center for Medical Ethics and Health Policy Staff Publications

The coming decade might see major cuts to the United States Government funding for biomedicine and the mainstreaming of pseudoscience. But your biosciences PhD gives you the problem-solving skills to navigate this maelstrom, especially if you maintain flexibility, optimism, and enthusiasm for uncharted paths.

Inhibition Of Il-6 Trans-Signaling Promotes Post-Stroke Functional Recovery In A Sex And Dose-Dependent Manner, Cassandra Hall, Dustin T Nguyen, Kate Mendoza, Chunfeng Tan, Anjali Chauhan

Faculty, Staff and Student Publications

Introduction: Elevated circulating IL-6 levels are associated with poorer outcomes after stroke, and increased serum IL-6 levels are linked to a higher risk of stroke. IL-6 binds to soluble IL-6 receptors (sIL-6R) and subsequently to ubiquitously expressed gp130, initiating proinflammatory trans-signaling. This study tested the hypothesis that inhibiting IL-6 trans-signaling by administering soluble (s) gp130 improves long-term functional outcomes in young mice after stroke.

Methods: Recombinant mouse gp130Fc chimera (sgp130) was administered one hour after middle cerebral artery occlusion (MCAO) followed by twice-weekly administration for 2 weeks in mice (8-15 weeks old). Behavioral assessments were done on days 7 and …

Benefits Of Equilibrium Between Microbiota- And Host-Derived Ligands Of The Aryl Hydrocarbon Receptor After Stroke In Aged Male Mice, Pedram Peesh, Maria P Blasco-Conesa, Ahmad El Hamamy, Romeesa Khan, Gary U Guzman, Parisa Honarpisheh, Eric C Mohan, Grant W Goodman, Justin N Nguyen, Anik Banerjee, Bryce E West, Kyung Ae Ko, Janelle M Korf, Chunfeng Tan, Huihui Fan, Gabriela D Colpo, Hilda Ahnstedt, Lucy Couture, Solji Roh, Julia K Kofler, Jose F Moruno-Manchon, Michael E Maniskas, Jaroslaw Aronowski, Rodney M Ritzel, Juneyoung Lee, Jun Li, Robert M Bryan, Anjali Chauhan, Venugopal Reddy Venna, Louise D Mccullough, Bhanu Priya Ganesh

Faculty, Staff and Student Publications

Recent studies have highlighted the crucial role of microglia (MG) and their interactions with the gut microbiome in post-stroke neuroinflammation. The activation of immunoregulatory pathways, including the aryl hydrocarbon receptor (AHR) pathway, is influenced by a dynamic balance of ligands derived from both the host and microbiota. This study aimed to investigate the association between stroke-induced dysbiosis and the resultant imbalance in AHR ligand sources (loss of microbiota-derived [indole-based] and increase of host-derived [kynurenine-based]) after stroke. Microbiota-derived AHR ligands decreased in human plasma and remained low for days following an ischemic stroke highlighting the translational significance. Transient-middle-cerebral-artery-occlusion was performed in …

Investigating The Relationship Between The Circadian Clock, Age, And Lifestyle, Samuel Park, Amaka Eziakonwa, Amega Nguyen, Madison Payne, Erich Stahmer, Alexis Salinas, Payson Broome, Angel Oliver, Christian Mccormick, Jasmyn Brown, Julie A. Zacharias-Simpson, Jutta Ward, Deborah Bell-Pedersen

Annual Research Symposium

This poster presentation aims to understand how circadian clock strength and phase are affected by age and lifestyle. By analyzing changes in physiological rhythms, the study seeks to develop strategies for promoting healthy aging by optimizing circadian function.

Tracking The Effects Of Time Zone Shift On An Individual’S Circadian Rhythm, Amaka Eziakonwa, Erich Stahmer, Amega Nguyen, Samuel Park, Madison Payne, Alexis Salinas, Deborah Bell-Pedersen, Julie A. Zacharias-Simpson

Annual Research Symposium

This poster presentation aims to understand how a rapid time-zone change can affect an individual’s circadian rhythms. By quantifying changes in physiological rhythms, the study seeks to develop targeted therapeutic interventions to mitigate the negative effects of jetlag.

Can We Eliminate The Negative Consequences Of Circadian Desynchronization Caused By Night Shift Work By Using A Light Therapy Lamp To Simulate A Sunset?, Amega Nguyen, Madison Payne, Amaka Eziakonwa, Erich Stahmer, Alexis Salinas, Samuel Park, Julie A. Zacharias-Simpson, Deborah Bell-Pedersen

Annual Research Symposium

This poster aims to understand the relationship between desynchronosis of circadian rhythms and night-shift work and how light therapy can mitigate some of the issues of desynchronosis. This study seeks to develop therapies for disrupted circadian rhythms from night-ship works.

Quantifying The Impact Of Circadian Rhythm On Cognitive Domains: An Objective Assessment, Christian Mccormick, Angel Oliver, Neha Doppalapudi, Austin Gibson, Micah Kwallek, Bardia Movafagh, Samuel Park, Jutta Ward, Deborah Bell-Pedersen

Annual Research Symposium

This poster presentation explores the relationship between an individuals circadian clock and its effects on cognitive performance and overall cognitive function. By assessing the rhythms of multiple physiological parameters, this study aims to draw a connection with cognitive function in order to provide potential avenues for individualized treatments for those with disorders affecting cognitive function.

Investigating The Impact Of Shift Work On Circadian Rhythms And Health In Healthcare Workers, Dominique Gillette, Grace Godfrey, Jacob Godfrey, Angela Nguyen, Hannah Gewaid, Carissa Salamatin, Sharon Sengphanith, Samuel Park, Colin Burton, Neha Doppalapudi, Daniel Oraee, Deborah Bell-Pedersen

Annual Research Symposium

This poster presentation aims to discuss how working the night shift contributes to health risks through the disruption of circadian rhythm in healthcare workers. We hope to gain insight on the relationship between these disturbances and the circadian clock in order to establish strategies that optimize healthy lifestyles for healthcare workers.

Transcranial Magnetic Stimulation As A Treatment Modality For Functional Bowel Disorder And Irritable Bowel Syndrome And Possible Correlations With The Gut-Brain Axis: A Review, Lauren Draper, Devin Pfister, Ethan Zaugg

Annual Research Symposium

Functional Bowel Disorders (FBD), including Irritable Bowel Syndrome (IBS), are highly prevalent gastrointestinal conditions classified as Disorders of Gut-Brain Interactions (DGBIs) under the Rome IV criteria. These conditions, marked by abdominal pain, altered bowel habits, and significant psychological comorbidities, present substantial challenges in both diagnosis and treatment. Conventional therapies primarily target gut-centric mechanisms but often yield limited efficacy, underscoring the need for approaches that account for the complex interplay of the gut-brain axis in DGBI pathophysiology.

Wellness Literature Review - 2024, Bidhu Sharma, Martin Huecker, Brian A. Ferguson

Journal of Wellness

Introduction: The Journal of Wellness has moved to a single calendar year editorial review of wellness literature. This annual review includes studies published in 2024.

Methods: Authors conducted a PubMed and Google Scholar keyword search, narrowing results to interventional studies / clinical trials in humans.

Literature in Review: We conducted a thematic review of a selection of relevant papers from the literature search. COVID-19 crisis has exacerbated the rate of burnout and impacted well-being of healthcare providers. Need for intervention in this area has arisen significantly since the pandemic. Post pandemic, working conditions have been normalized to some extent, however, …

Plasma Proteomic Characterization Of Motoric Cognitive Risk And Mild Cognitive Impairment, Gabriela T Gomez, Sanish Sathyan, Jingsha Chen, Myriam Fornage, Pascal Schlosser, Zhongsheng Peng, Jenifer Cordon, Priya Palta, Kevin J Sullivan, Adrienne Tin, B Gwen Windham, Rebecca F Gottesman, Nir Barzilai, Sofiya Milman, Joe Verghese, Josef Coresh, Keenan A Walker

Faculty, Staff and Student Publications

INTRODUCTION: Motoric cognitive risk (MCR) is a pre-dementia syndrome characterized by mobility and cognitive dysfunction. This study conducted a proteome-wide study of MCR and compared the proteomic signatures of MCR to that of mild cognitive impairment (MCI).

METHODS: Participants were classified as MCR using a memory questionnaire and 4-meter walk. We measured 4877 plasma proteins collected during late-life and midlife. Multivariable logistic regression related each protein to late-life MCR/MCI. MCR-associated proteins were replicated internally at midlife and in an external cohort.

RESULTS: Proteome-wide analysis (n = 4076) identified 25 MCR-associated proteins. Eight of these proteins remained associated with late-life MCR …

Figg At 5: An Update On Us Public Perspectives On Forensic Investigative Genetic Genealogy Five Years After Its Introduction To Criminal Investigations, Christi J Guerrini, Jill O Robinson, Mohamed I Elsaid, Whitney Bash Brooks, Ariel Levchenko, Stephanie M Fullerton, Sara Huston, Norah L Crossnohere, John F P Bridges, Jacklyn M Dahlquist, Louiza Kalokairinou, Diana Madden, Cece Moore, Amy L Mcguire

Center for Medical Ethics and Health Policy Staff Publications

In 2018, after law enforcement announced it had used a technique called forensic investigative genetic genealogy (FIGG) to identify the Golden State Killer, we conducted a U.S. general population survey and found most respondents supported using FIGG to solve violent crimes. Since then, FIGG has helped close hundreds of criminal cases, but it also has weathered controversies. On FIGG's fifth anniversary, we conducted an expanded, follow-up survey with U.S.-based participants to determine if public opinion had changed and found continued support for FIGG across most applications. The same proportion (91 %) of respondents in the 2018 and 2023 surveys endorsed …

Improving Individualized Rhabdomyosarcoma Prognosis Predictions Using Somatic Molecular Biomarkers, Mark Zobeck, Javed Khan, Rajkumar Venkatramani, M Fatih Okcu, Michael E Scheurer, Philip J Lupo

Center for Medical Ethics and Health Policy Staff Publications

Purpose: Molecular markers increasingly influence risk-stratified treatment selection for pediatric rhabdomyosarcoma (RMS). This study aims to integrate molecular and clinical data to produce individualized prognosis predictions that can further improve treatment selection.

Methods: Clinical variables and somatic mutation data for 20 genes from 641 patients with RMS in the United Kingdom and the United States were used to develop three Cox proportional hazard models for predicting event-free survival (EFS). The Baseline Clinical (BC) model included treatment location, age, fusion status, and risk group. The Gene Enhanced 2 (GE2) model added TP53 and MYOD1 mutations to the BC predictors. The Gene …

Longitudinal Phage-Bacteria Dynamics In The Early Life Gut Microbiome, Michael J Tisza, Richard E Lloyd, Kristi Hoffman, Daniel P Smith, Marian Rewers, Sara J Javornik Cregeen, Joseph F Petrosino

Center for Medical Ethics and Health Policy Staff Publications

Microbial colonization of the human gut occurs soon after birth, proceeds through well-studied phases and is affected by lifestyle and other factors. Less is known about phage community dynamics during infant gut colonization due to small study sizes, an inability to leverage large databases and a lack of appropriate bioinformatics tools. Here we reanalysed whole microbial community shotgun sequencing data of 12,262 longitudinal samples from 887 children from four countries across four years of life as part of the The Environmental Determinants of Diabetes in the Young (TEDDY) study. We developed an extensive metagenome-assembled genome catalogue using the Marker-MAGu pipeline, …

Revisiting What Constitutes A Neglected Tropical Disease?, Paul J Brindley, Peter J Hotez, Shaden Kamhawi

Center for Medical Ethics and Health Policy Staff Publications

PLOS Neglected Tropical Diseases (PLOS NTDs) publishes research devoted to pathogenesis and other clinical aspects, epidemiology, prevention, diagnosis, treatment, and control of the neglected tropical diseases (NTDs), as well as work relevant to public health policy. We define NTDs as poverty-promoting infectious diseases that can negatively impact the quality of life in rural areas and poor urban areas of low- and middle-income countries but which can also affect specific communities within high-income countries. The poverty-inducing effects of the NTDs operate by impairing child health and development, pregnancy outcomes for both mother and child, worker productivity, and quality of life. The …

Resilience And Coping: A Qualitative Analysis Of Cognitive And Behavioral Factors In Adults With Osteogenesis Imperfecta, Hannah E Cho, Whitney S Shepherd, Gianna M Colombo, Andrew D Wiese, W Conor Rork, Kristin M Kostick, Dianne Nguyen, Members Of The Bbdc, Chaya N Murali, Marie-Eve Robinson, Sophie C Schneider, Justin H Qian, Brendan Lee, V Reid Sutton, Eric A Storch

Center for Medical Ethics and Health Policy Staff Publications

Purpose: The aim of this qualitative study was to investigate resilience among adults with Osteogenesis Imperfecta (OI).

Materials and methods: Semi-structured interviews were conducted with 15 adults with OI. Transcripts were coded and subsequently abstracted, yielding themes specific to resilience and coping. Interview guides covered broad topics including pain challenges specific to OI, mental health issues related to OI, and priorities for future interventions for individuals with OI.

Results: Participants described resilience in the context of OI as the ability to grow from adversity, adapt to challenges resulting from OI-related injuries, and find identities apart from their condition. Psychological coping …

Ethical Governance For Genomic Data Science In The Cloud, Vasiliki Rahimzadeh, Sarah C Nelson, Adrian Thorogood, Jonathan Lawson, Stephanie M Fullerton

Center for Medical Ethics and Health Policy Staff Publications

Cloud platforms offer distinct advantages, but questions remain about how to ethically and efficiently manage human genomic data in the cloud. Data governance needs to be adapted to ensure transparency and security for research participants, as well as equitable and sustainable access for researchers.

Incidence And Survival Of Children And Adolescents With Wilms Tumor, United States, 2001-2020, Andres F Espinoza, Ekene Onwuka, David A Siegel, Shifan Dai, Sanjeev A Vasudevan, Michael E Scheurer, Philip J Lupo

Center for Medical Ethics and Health Policy Staff Publications

Background: Wilms tumor (WT) is the most common pediatric malignancy of the kidney. Past studies describing WT incidence and survival used surveillance data with < 30% of the US population. We evaluated differences in WT incidence and survival comparing demographic groups and tumor characteristics.

Methods: We analyzed new cases of WT among patients aged < 20 years at diagnosis by using incidence data from US Cancer Statistics (USCS) for 2003-2020 and 5-year relative survival (RS) data from the National Program of Cancer Registries (NPCR) for 2001-2019. To assess incidence trends, average annual percent change (AAPC) was calculated by using joinpoint regression. Relative survival (RS) and all-cause survival were calculated overall and by demographic and clinical variables.

Results: During 2003-2020, 8218 cases of WT were reported in USCS, which represented an age-adjusted incidence rate of 5.7 cases per million. Rates were the highest among females (6.3), children aged 0-4 years (17.2), and non-Hispanic Black patients (7.1). Overall, trends remained stable (AAPC = -0.4, 95% CI: -1.4 to 0.4). Among 7567 cases of WT in NPCR, 5-year RS was 92.6%. Patients with the lowest …

Hispanic Patients Undergoing Spinal Fusion For Neuromuscular Scoliosis Sustain Health Inequalities, Armando S Martinez, David Momtaz, Travis Kotzur, Alexandra Mclennan, Abdullah Ghali, Farhan Ahmad, Ebubechi Adindu, Alan C Santiago-Rodriquez, Ali Seifi, Brian Smith

Faculty, Staff and Students Publications

INTRODUCTION: Pre- and postoperative optimization remains a complex process impacted by various demographic factors. Our study aims to identify and describe those demographic factors associated with poor outcomes after spinal fusion with instrumentation in neuromuscular scoliosis to reduce health disparities and improve postoperative outcomes.

METHODS: A retrospective analysis was conducted using Healthcare Cost and Utilization Project data from 2016 to 2020, encompassing a random sample of 20% of procedures in the United States. Data included demographic and hospital variables, including days from admission to the procedure, length of stay, recovery time, total charge, discharge disposition, and mortality rates. In addition …