Medical Specialties Commons^™

A Single Institution Study Of Tert Promoter Mutations Detected Upon Preoperative And Postoperative Testing Of Thyroid Nodules: Characterization And Clinicopathologic Significance Of Tert Mutations Occurring In Isolation And In Conjunction With Other Mutations Or Gene Fusions, Reem Khraishi, Pradip Manna, Ujwala Gosavi, Phillip Palmer, Andrew Neeson, Violet Quann, Elizabeth Cottrill, Stacey Gargano

Jefferson Hospital Staff Papers and Presentations

Introduction

• Telomerase reverse transcriptase (TERT) promoter mutations occur in follicular cell-derived thyroid neoplasms, often coexisting with other mutations and associated with aggressive clinicopathologic features.
• The significance of TERT mutations occurring in isolation (iTERT) is unclear.
• We examined TERT-positive thyroid specimens (preoperative FNA and postoperative FFPE) to evaluate the clinicopathologic significance of this mutation occurring in isolation vs. in conjunction with other genetic alterations.

Improving Access To Specialized Rare Cancer Care Through A Navigation-Driven Centralized Metastatic Uveal Melanoma Multidisciplinary Tumor Board, Jameson Lynch, Rn

Kimmel Cancer Center Papers, Presentations, and Grand Rounds

Background

Metastatic uveal melanoma (mUM) is a rare malignancy; up to 50% of patients with uveal melanoma develop systemic metastases, with liver involvement occurring in up to 90% of metastatic cases.1 Thomas Jefferson University Hospital has extensive experience managing liver-dominant mUM, supported by prior single-institution longitudinal data involving 730 patients with uveal melanoma liver metastasis.3 This mUM program represents a specialized referral model for complex liver-dominant disease, offering multidisciplinary review, advanced liver-directed treatment planning, and coordinated access to specialty oncology care. Oncology navigation facilitates this model by coordinating intake, acquisition of outside imaging and records, pre-travel case preparation, tumor board …

Ultrasound-Stimulated Microbubbles In Cancer Therapy: A Review Of Clinical And Translational Evidence, Seyedeh M. Khatami, Arash Rahmani, Ji-Bin Liu, John Eisenbrey

Department of Radiology Faculty Papers

Ultrasound-stimulated microbubbles (USMB) have evolved from a diagnostic contrast technology into an investigational cancer therapy. Acoustically driven microbubble cavitation generates localized mechanical effects that can permeabilize cell membranes, disrupt tumor vasculature, and transiently open biological barriers. This review synthesizes the clinical and translational evidence for USMB-based oncologic therapy across its three principal applications: radiosensitization, drug delivery, and thermal ablation. A narrative review of English-language literature was conducted using PubMed/MEDLINE through April 2026. Radiosensitization is most clinically advanced in liver malignancies, supported by phase 2 randomized data in hepatocellular carcinoma and an efficacy signal in intrahepatic cholangiocarcinoma, with early-phase trials in …

Recommendations For The Management Of Spontaneous Intracranial Hypotension With Spinal Longitudinal Epidural Csf Collection: A Delphi Study, Soyoun Choi, Ian Carroll, Deborah I. Friedman, Peter G. Kranz, Eugene Lee, Manjit Matharu, Simy Parikh, Henrik W. Schytz, Marcio N. Portes Souza, Yen-Feng Wang, Hsiangkuo Yuan, Mi Ji Lee

Department of Neurology Faculty Papers

BACKGROUND AND OBJECTIVES

Spontaneous intracranial hypotension (SIH) results from spinal CSF leakage. Epidural blood patch (EBP) is an important first-line treatment. However, pre-EBP, intra-EBP, and post-EBP practice varies widely owing to limited consensus guidance. We aimed to develop expert consensus statements to support clinical decision-making in SIH management, including peri-EBP practices, focusing on patients with spinal longitudinal epidural CSF collection (SLEC) before definitive leak type classification.

METHODS

An international multidisciplinary Delphi process was conducted between January 2024 and July 2025, involving experts in neurology, neurosurgery, radiology, and anesthesiology. Consensus was defined a priori as ≥70% agreement for strong agreement, 60%-69% …

Using Implementation Research Frameworks To Identify Facilitators And Barriers To Implementation Of Ferric Carboxymaltose Intravenous Iron Among Moderately Anemic Postpartum Women Participating In A Trial In India, Umesh Charantimath, Valerie L. Flax, Ashwini Dandappanavar, Anika Hannan, Mrityunjay C. Metgud, Avinash Kavi, Manjunath Somannavar, Shivaprasad S. Goudar, Simal Thind, Rosemary Frasso, Lauren Wiener, Sabrina Larosa, Cecilia Rasco, Elizabeth M. Mcclure, Richard Derman

College of Population Health Faculty Papers

Postpartum anemia affects approximately 75% of women in India. We conducted this implementation research (IR) related to the use of ferric carboxymaltose (FCM) intravenous (IV) iron as part of a trial in anemic postpartum women. The aim of the IR study was to understand potential facilitators and barriers to implementation of single-dose FCM IV iron. This is a mixed-methods study in three secondary-level healthcare facilities in Belagavi, India, designed to explore selected Consolidated Framework for Implementation Research constructs and Proctor’s framework elements. Quantitative data were gathered via surveys of postpartum women who received IV FCM (n = 308) and from …

Small Leucine-Rich Proteoglycans In Cancer: Three Decades Of Discovery, Gabriel J. Pascal, Sadie Kim, Christopher Xie, Maria Danial, Iris Barone, Renato V. Iozzo

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Small leucine-rich proteoglycans (SLRPs) are a well-known family of extracellular matrix (ECM) molecules. They consist of five classes with 18 different protein cores originally recognized as having a physically supportive component to the extracellular structure and tissue integrity. There has been a significant conceptual shift from the original paradigm as mere contributors to ECM structure to the current concept of bioactive signaling molecules. Over the past three decades, SLRPs have evolved into critical modulators of signaling events in cells by contributing to the regulation of receptor activity and intercellular communication. They also affect key biological processes such as tissue remodeling, …

Time-Varying Spatial Ventricular Gradient Orientation Is Associated With Anthracycline Heart Failure, Andrea N. Rosas Diaz, Hans F. Stabenau, Patricia Tung, Jason Nelson, Gabriel Pajares Hurtado, Sarah Warack, Sanam Alilou, Arunashis Sau, Daniel B. Kramer, Aarti Asnani, Jonathan W. Waks

Division of Cardiology Faculty Papers

BACKGROUND

Anthracycline use is limited by cardiotoxicity resulting in heart failure (HF). The spatial ventricular gradient(SVG) is a vectorcardiographic measurement of myocardial electrical heterogeneity associated with sudden death and incident HF. It is unclear if serial measurement of SVG after anthracycline initiation can help predict subsequent HF.

OBJECTIVES

The objective of the study was to determine if time-varying SVG measurements are associated with anthracycline HF.

METHODS

Retrospective, single-center study of adult patients with cancer treated with anthracyclines between 1992 to 2019. Standard 12-lead electrocardiograms obtained within 6 months before and up to 5 years after anthracycline initiation were analyzed. Patients …

Spriz (Ccdc127) Protein Conserved In Deuterostome Animals Is A Rigid Omm-Imm Tether That Locally Sets Mitochondrial Ims Volume, Raman Shulinski, Roman Loban, Danny Farhat, Benjamín Cartes-Saavedra, Matthew J. Magda, Pavel Kotchetkov, Victoria Caminiti, Linda David, Yuri I. Wolf, Conor O'Dwyer, Morgan Fullerton, Yan Burelle, Jyh-Yeuan E. Lee, Andrea Raimondi, Eugene V. Koonin, György Hajnóczky, Mary-Ellen Harper, Luca Pellegrini

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

The double-membrane nature of mitochondria generates an intermembrane volume through which ions, reactive oxygen species, and metabolites must flux to reach the matrix or cytosol, but whether this volume is a genetically specified structure remains unknown. We identify SPRIZ (spatial regulator of the intermembrane zone), the product of Ccdc127, a gene conserved across deuterostome animals. SPRIZ assembles into an ∼18-nanometer homodimeric tether anchored in the outer mitochondrial membrane (OMM) and inserted into the inner mitochondrial membrane (IMM) through vertebrate-specific hydrophobic loops, physically spacing the two membranes and setting local intermembrane volume. Cryo-electron tomography of native mitochondria revealed rod-like densities …

Editorial: Community Series In Unveiling The Next Generation Of Cancer Immunity & Immunotherapy In Lung Cancer, Volume Ii, Nethaji Muniraj, Mohanraj Sadasivam, Chellappagounder Thangavel

Center for Translational Medicine Faculty Papers

No abstract provided.

A Phase 2, Open-Label, Multicenter Study Of The Safety And Efficacy Of Tak-007 In Adult Patients With Relapsed/Refractory B-Cell Non-Hodgkin Lymphoma, Justin Darrah, Indumathy Varadarajan, Amitkumar Mehta, Jennifer Saultz, Matthew Mckinney, Monalisa Ghosh, Usama Gergis, Andrew Krueger, Kevin Galinsky, Girish Bende, Ajeetha Ramachandran, Varsha Sundaresan, Siddha Kasar, Bradley Hupf, Sharon Chen, Leopold Sellner, Reem Karmali

Department of Medical Oncology Faculty Papers

In relapsed/refractory large B-cell lymphoma (LBCL), chimeric antigen receptor (CAR)-natural killer (NK) cell therapies offer potential advantages over CAR-T-cell therapies, including off-the-shelf availability and scalable manufacturing. We performed a phase 2 study of single-dose TAK-007, a cryopreserved, cord blood-derived, off-the-shelf CD19 CAR-NK cell therapy, in 26 heavily pre-treated patients with relapsed/refractory B-cell non-Hodgkin lymphoma (NHL). Adverse events were manageable, with limited grade 1-2 cytokine release syndrome (11.5%). Overall response rate with TAK-007 800 x106 CD19 CAR+ viable NK cells (n=14) was 60.9% (95% CI: 38.5-80.3). Median progression-free survival was 2.0 months (95% CI: 0.99-3.58) in LBCL (n=10) and 5.6 months …

Translation And Comprehensive Validation Of The Neurological Outcome Scale For Traumatic Brain Injury (Nos-Tbi) Into Brazilian Portuguese, Karina T. Weber, Luciana B. M. Alves, Monica C. Braga, Suleimy C. Mazin, Brunna R. Pileggi, Millene R. Camilo, Viviane A. Guimaraes, Clara M. A. Barreira, Frederico Alessio-Alves, Aline S. Carvalho, Aline C. Pacheco-Castilho, João P. Leite, Dylan J. Edwards, Octavio M. Pontes-Neto, Taiza G. S. Edwards

Moss-Magee Rehabilitation Papers

Background: Traumatic brain injury (TBI) is a leading cause of disability in Brazil and worldwide. National and multinational clinical trials in TBI require global standardization of outcome measures. The original English version of the Neurological Outcome Scale for TBI (NOS-TBI) is a valid and valuable neurological assessment tool. However, NOS-TBI has not yet been validated in Brazilian Portuguese.

Objective: To perform the translation, cultural adaptation, and validation of the NOS-TBI in a Brazilian cohort of individuals with TBI.

Methods: We conducted the translation and cultural adaptation of the NOS-TBI scale to Brazilian Portuguese, followed by an analysis of psychometric properties: …

From Model To Mastery: High-Fidelity Cricothyrotomy Simulation With A 3d-Printed And Biological Tissue Model, Lauren E. Schlegel, Sruti Tekumalla, Sara Belko, Aarti Agarwal, Eva Varotsis, Julianna Rodin, Robert Pugliese, Morgan Hutchinson, Richard Goldman

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Objective

Emergency cricothyroidotomy is a rare procedure utilized in the setting of patients who cannot be oxygenated or intubated. To enhance training in this critical skill, we developed and validated an immersive, high‐fidelity task trainer that integrates a 3D‐printed airway model with a porcine soft‐tissue layer, and we assessed its impact during simulation‐based training sessions.

Study Design

Observational.

Setting

Single institution (16 otolaryngology and 30 emergency medicine trainees).

Methods

Our trainer consisted of an accurate 3D‐printed airway model and neck incorporating anatomical structures and a biological soft‐tissue layer. A survey was administered before and after the simulation. The simulations were …

Early Prediction Of The Breast Cancer Response To Neoadjuvant Chemotherapy Based On Intratumoral Interstitial Fluid Pressure Using 3-D Subharmonic-Aided Pressure Estimation, Sung In Choi, Basak Dogan, Corinne E. Wessner, Jessica H. Porembka, Priscilla Machado, B. Bersu Ozcan, Nisha Unni, Maysa Abu-Khalaf, Kenneth Hoyt, Flemming Forsberg, Kibo Nam

Department of Radiology Faculty Papers

Elevated intratumoral interstitial fluid pressure (IFP) may negatively impact the efficacy of neoadjuvant chemotherapy (NAC). This study aimed to predict the breast cancer response to NAC based on intratumoral IFP using 3D contrast-enhanced ultrasound (CEUS) with subharmonic-aided pressure estimation (SHAPE). This prospective study enrolled breast cancer patients undergoing NAC from two clinical sites. 3D CEUS was performed at 0%, 10%, and 30% of NAC completion using a GE Logiq E9 with Definity. The pressure gradients between the tumor and adjacent normal tissue were estimated by SHAPE, utilizing the inverse linear relationship between the ultrasound contrast agent’s subharmonic signal amplitude and …

Training Apart, Together: Team Dynamics In Individual Sports And Surgical Residency, W. Jack Palmer, Dylan Bertoni, Elizabeth E. Cottrill, Colin T. Huntley

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Surgeons in training share notable parallels with competitive athletes, including rigorous training, skill specialization, and functioning under pressure. Surgical educators have leveraged this comparison, incorporating techniques from sports psychology, such as mental imagery and mindfulness, to improve trainees' individual performance and well-being. Surgical trainees and athletes both rely on effective teamwork for optimal outcomes, suggesting that residency leaders can glean valuable team-level insights from sports psychology. This article examines how the structure of surgical residency influences team dynamics, using concepts from sports psychology to identify evidence-based strategies for improving program cohesion and resident well-being. The surgical literature typically conceptualizes surgery …

Early Hands-On Surgical Exposure: Outcomes Of A Student-Led Surgical Externship Program For Preclinical Students, Meryem C. Guler, Elizabeth Spitz, Jennifer E. Geller, Talar Tatarian, Renee Tholey

Department of Surgery Faculty Papers

Objective: Early surgical exposure may potentially influence medical students' decision to pursue a surgical career. At our urban, academic medical school, senior medical students developed a Surgical Externship Program (SEP) to provide first-years with hands-on OR experience. This program is a structured 1- to 2-week immersive experience in which first-year students scrubbed into operations, participated in rounds, and engaged with surgical teams under resident and attending supervision. This study evaluates the SEP's impact on surgical interest, OR confidence, and clinical exposure.

Setting: Academic tertiary care hospital.

Participants: First-year medical students.

Design: First-year students participated in a 1- or 2-week SEP …

Drug Development And Promising Therapeutic Targets For Coronary Artery Disease: Current Landscape And Future Prospects: Cvia State-Of-The-Art Review, Shan Hu, Zhen Guo, Chenze Li, Xiang Nie, Jinjie Wang, Jianmei He, Cheng Zhuang, Limin Zhang, Depeng Li, Yutong Lin, Danan Wang, Duanbin Li, Fomin Zhang, Qiongjun Zhu, Xiaoyi Bao, Ning Zhang, Xiaolu Jiao, Wenbin Zhang, Beibei Du, Hongmei Zhao, Yongjian Zhu, Bing Xiao, Yupeng Liu, Haoyu Wu, Di Fan, Peng Li, Hongshan Chen, Xin-Liang Ma, Jun Pu

Department of Emergency Medicine Faculty Papers

Coronary artery disease (CAD) remains the leading cause of death globally, despite the limited efficacy of current pharmacological therapies. The need for safer and more effective treatment strategies has never been more urgent. This review provides a contemporary overview of advances in CAD drug development. Novel lipid-lowering agents such as proprotein convertase subtilisin/kexin type 9 (PCSK9) and angiopoietin-like protein 3 (ANGPTL3) inhibitors, anti-inflammatory therapies targeting interleukin pathways, and metabolic modulators have expanded the therapeutic landscape. Concurrently, precision medicine and drug repurposing approaches, informed by genomic profiling and biomarker-based stratification, are transforming the framework of CAD therapy. The integration of artificial …

Palopegteriparatide For Adults With Chronic Hypoparathyroidism: Skeletal Dynamics Through 3 Years Of The Phase 2 Path Forward Trial, Mishaela Rubin, Bart Clarke, Lorenz Hofbauer, Aliya Khan, Peter Schwarz, Tamara Vokes, Intekhab Ahmed, Andrea Palermo, Filomena Cetani, Uberto Pagotto, Carol Zhao, Michael Ominsky, Bryant Lai, Jenny Ukena, Aimee Shu, Lars Rejnmark

Division of Endocrinology, Diabetes and Metabolic Diseases Faculty Papers

Hypoparathyroidism is an endocrine disease caused by insufficient levels of PTH, which acts directly on bone and kidney and indirectly on the intestine to regulate calcium and phosphate balance. In clinical trials, palopegteriparatide (TransCon PTH) treatment enabled independence from conventional therapy (no active vitamin D, ≤600 mg/d calcium) and maintained serum biochemistries within normal ranges. The current analyses describe patterns of change in BMD, serum bone turnover markers, and serum and urine calcium in adults with chronic hypoparathyroidism treated with palopegteriparatide through 3 years of the PaTH Forward trial. Baseline BMD Z-scores for the LS, TH, FN, and 1/3 distal …

Cost Analysis Of Venous Stent Reconstruction In The Treatment Of Chronic Lower Extremity Venous Occlusive Disease : Cost Analysis Of Venous Stent Reconstruction For Chronic Lower Extremity Venous Occlusive Disease, Samir S. Jambhekar, Jacob J. Bundy, Spencer B. Lewis, Ravi N. Srinivasa, Anthony N. Hage, Eric J. Monroe, Jeffrey Forris Beecham Chick, David S. Shin, Matthew Abad-Santos, Mina S. Makary

Department of Radiology Faculty Papers

No abstract provided.

Using An Automated Evaluation System To Improve Medical Student Evaluation Response Rate And Reduce Administrative Burden, Chaiya Laoteppitaks, Alisha Agarwal, Jason Gonzalez, Nina Mingioni, Xiao C. Zhang

Department of Emergency Medicine Faculty Papers

BACKGROUND: Email reminders facilitate timely task completion but can create substantial administrative burdens for clerkship staff. In our emergency medicine (EM) clerkship, third-year medical students initiate digital evaluation requests after each clinical shift, requiring frequent manual reminders to maintain completion rates. The time-intensive nature of this process highlights the need for a more efficient and scalable approach.

METHODS: This multi-site, pre-post study evaluated clinical performance evaluation completion rates and time to completion during the required EM clerkship over 48 weeks before and after implementation of an automated reminder system in September 2024. The system integrated existing survey functionality with Microsoft …

Management Of Non-Survivable Head Trauma: Opportunities For Improvement, Sanjana R. Salwi, Mackenzie D. Castellanos, Therese Murphy, Pious D. Patel, Sonia Ajmera, Alex P. Vaz, Connor A. Wathen, Niels D. Martin, Monisha A. Kumar, James M. Schuster, Dmitriy Petrov

Department of Neurosurgery Faculty Papers

BACKGROUND: Managing patients with non-survivable head trauma who do not meet brain death criteria presents significant ethical and clinical challenges. Decisions frequently fall to surrogates with limited guidance, particularly when organ donation status is unknown. This study assessed physician perspectives on communication, interventions, and institutional factors.

METHODS: We conducted a national survey of academic neurosurgery, trauma surgery, and neurocritical care programs. Items examined communication barriers, interventions by donor status, institutional support, and a dissonance measure for interventions viewed as inappropriate.

RESULTS: A total of 133 physicians responded. Top communication barriers were medical literacy, unclear patient values, and intrafamily conflict. Physicians …

Automated Artificial Intelligence-Enabled Measurement Of Cardiac Structures On Point-Of-Care Ultrasonography: A Prospective Multicenter Validation Study, Sarah F. Mercaldo, Bernardo C. Bizzo, Tsion Sadore, Madeleine A. Halle, Ashley L. Macdonald, Isabella Newbury-Chaet, Eric L'Italien, Alex S. Schultz, Victor Tam, Sheila M. Hegde, Judy R. Mangion, Praveen Mehrotra, Qiong Zhao, Justina Wu, James M. Hillis

Division of Cardiology Faculty Papers

Introduction: Point-of-care ultrasonography (POCUS) enables clinicians to obtain critical diagnostic information at the bedside, especially in resource-limited settings. This information may include 2D cardiac quantitative data, although measuring the data manually can be time-consuming and subject to user experience. Artificial intelligence (AI) can potentially automate this quantification. This study assessed the interpretation of key cardiac measurements on POCUS images by an AI-enabled device (AISAP Cardio V1.0).

Methods: This retrospective diagnostic accuracy study included 200 POCUS cases from four hospitals (two in Israel and two in the United States). Each case was independently interpreted by three cardiologists and the device for …

Osteoblast-Derived Nerve Growth Factor Supports Skeletal Adaptation To Mechanical Load And The Osteoanabolic Effect Of Gambogic Amide In Mice, Ibtesam Rajpar, Eri Mclaughlin, Gabriella Fioravanti, Nicholas Ruggiero, Nohael Cherian, Liliana Minichiello, Ryan E. Tomlinson

Department of Orthopaedic Surgery Faculty Papers

In adult mice, new bone accrual following mechanical load is mediated by the neurotrophin nerve growth factor (NGF) that is expressed by osteoblasts on the bone surface. NGF can bind to its high affinity receptor, neurotrophic tyrosine kinase receptor type 1 (TrkA), on peripheral sensory nerves resident in bone and support new bone formation. However, the osteoanabolic therapeutic potential of NGF-TrkA signaling to repair bone is limited due to the long-lasting thermal and mechanical hyperalgesia induced by administration of NGF in mice and humans. Here, we investigated whether 1) mature osteoblasts are the primary source of NGF required for bone …

Transportability Of An Artificial Intelligence Electrocardiography Model For Structural Heart Disease: External Validation And Recalibration Of Echonext-Mini In Mimic-Iv, Emmanuel Otabor, Abdulraheem Hassan, Ayoyimika Okunlola, Justin Lam, Laith Alomari, Michael Hamilton

Einstein Health Papers

AIMS: Structural heart disease is often underdiagnosed, and echocardiography is limited by access and referral thresholds. Artificial intelligence electrocardiography (AI-ECG) may identify echocardiographically defined structural heart disease. EchoNext-Mini is a released AI-ECG model, accompanied by a benchmark dataset, that detects a composite structural heart disease outcome and component conditions from 12-lead electrocardiogram waveforms together with age, sex, and electrocardiographic measurements. We assessed its transportability and recalibration.

METHODS AND RESULTS: We linked electrocardiograms from MIMIC-IV to subsequent transthoracic echocardiograms, including adults whose electrocardiogram preceded an eligible echocardiogram within one year, one per patient. Labels were mapped to structured echocardiographic fields using …

Interface Geometry Governs Probe Insertion Mechanics And Electrode Deviation In Layered Brain-Mimicking Phantoms For Deep Brain Stimulation, Siyu Chen, Chengyuan Wu, Ethan Anders, Rungun Nathan, Olivia M. Bailey, Qifu Wang, Curtis L. Johnson, Qianhong Wu

Department of Neurosurgery Faculty Papers

Parkinson's disease (PD) is a progressive neurological disorder often treated with Deep Brain Stimulation (DBS), a surgical procedure that involves implanting electrodes to improve motor function. Accurate electrode placement is critical for treatment efficacy but can be influenced by tissue deformation, insertion forces, and the mechanical properties of brain tissue. In this study, we investigated the role of layer interface angle as a controlled biomechanical factor affecting insertion forces and electrode deviation. A two-layer agar gel phantom was constructed to produce a prescribed stiffness transition between a lower-stiffness and a higher-stiffness gel layer, and its small-amplitude dynamic shear-stiffness contrast was …

Successful Treatment Of Recurrent Epithelioid Trophoblastic Tumor (Ett) With Pembrolizumab After Pembrolizumab: A Case Report And Review Of Literature In Treatment Of Ett, Sarah Mokma, Sarah Alnaif, Nicholas Cardillo

Abington Jefferson Health Papers

BACKGROUND: Epithelioid Trophoblastic Tumors (ETT) are rare, which makes an optimal treatment regimen difficult to determine. Since PD-L1 is expressed in placental tissue and in gestational trophoblastic neoplasia (GTN), immunotherapies such as pembrolizumab have been proposed as possible treatments.

CASE PRESENTATION: The case presented is a 50-year-old postmenopausal female who presented with postmenopausal bleeding and a large, fungating cervical mass. Cervical biopsies confirmed ETT. The patient underwent primary debulking surgery with radical abdominal hysterectomy, bilateral salpingo-oophorectomy, and sigmoid colon resection. The patient was diagnosed with a FIGO Stage IV ETT due to tumor extension to sigmoid colon with a high-risk …

Operative Vs Non-Operative Management Of Ventral Hernia: A Population Based Study Of Long-Term Benefits And Consequences, Sourav Podder, Julia A. Baran, Scott H. Koeneman, Francesco Palazzo, Nicole L. Dugan, Christopher Keating, Sami Tannouri

Department of Surgery Faculty Papers

Purpose: Ventral hernia (VH) management has progressed beyond simply physical repair of the defect. It now involves a strategy that purposefully restores abdominal core function and prevents future complications. This study investigates the association between ventral hernia repair (VHR) and functional disorders related to the abdominal core in addition to bowel obstruction, opioid misuse, and physical therapy utilization.

Methods: This retrospective cohort study used administrative codes from the TriNetX database. The outcomes of interest were spine and pelvic floor dysfunction, constipation, incontinence, genital prolapse, bowel obstruction, opioid misuse, and physical therapy utilization.

Results: A total of 587 384 patients were …

Feasibility And Acceptability Of Perioperative Application Of Biofeedback-Based Virtual Reality Vs Control For Pain And Anxiety In Children And Adolescents Undergoing Surgery: Pilot Randomized Controlled Trial, Anna Lin, Brenna Rachwal, Lindsey Asti, Zandantsetseg Orgil, Isabela Santiago, Lili Ding, Susmita Kashikar-Zuck, Christopher King, Sara Williams, William Black, Peter Minneci, Vanessa Olbrecht

Department of Anesthesiology Faculty Papers

BACKGROUND: The impact of biofeedback-based virtual reality (VR-BF) on pain and anxiety in pediatric surgical patients remains unexplored.

OBJECTIVE: The objective of this study was to evaluate the feasibility and acceptability of perioperative VR-BF use in children and adolescents.

METHODS: We performed a single-blind, 2-arm, randomized pilot trial. Children aged 12 to 18 years undergoing surgery with expected moderate-to-severe postoperative pain and more than 1 overnight admission were randomized (1:1) to the intervention or control group. Participants in the intervention group received VR-BF using ForeVR (functional outcome response to engaging virtual reality [VR]), a novel, gamified digital intervention that integrates …

Strengthening Health System-Community Partnerships To Address Pediatric Social Needs: A Qualitative Study, Joy Friedman, Melissa A. Alderfer, Kelsey Higgins, Aaron Carpenter, Jennifer Sciolla, Sarah E. Wawrzynski

Department of Pediatrics Faculty Papers

IntroductionStructural and social conditions influence pediatric health outcomes. Successful implementation of social needs screening and referral programs depends on community-based organizations (CBOs) to provide resources that address health-related social needs (HRSN). We explored current practices and perspectives of health care workers and CBO representatives on improving health system-CBO partnerships.MethodsParticipants were purposively recruited from a variety of health care settings involved in HRSN screening and CBOs delivering resources in the community. Participants completed semi-structured interviews. Qualitative thematic analysis was used to summarize data.ResultsTen key informants participated (six health care workers and four CBO representatives). Four themes were identified: 1) mismatches in …

Intravascular Immune Cell Labeling As A Critical Methodological Tool For Characterizing Cd4+ T Cells In The Lung In Eae, Gholamreza Azizi, Mohamad Rostami

Department of Neurology Faculty Papers

INTRODUCTION: Growing evidence highlights the lung -brain axis as a key contributor to CNS autoimmunity. However, accurate characterization of lung immune cells remains technically challenging because standard transcardial perfusion does not eliminate the lung's extensive marginated intravascular leukocyte pool, allowing circulating cells to contaminate analyses of the lung parenchyma.

METHODS: Experimental autoimmune encephalomyelitis (EAE) was induced in mice by immunization with MOG35-55 peptide in complete Freund's adjuvant, followed by pertussis toxin administration. Lung mononuclear cells were isolated after intravascular (IV) CD45 labeling, transcardial perfusion, and enzymatic digestion. Immune cell populations and intracellular cytokine production were analyzed by multicolor flow cytometry …

Gait Characteristics In Older Adults Using The Protokinetics Zeno Walkway: The Atherosclerosis Risk In Communities (Aric) Study, Katherine J. Hunzinger, Laura Skow, Andrea L. C. Schneider, Michael E. Griswold, Xiaoqian Zhu, Farwa Ali, Pamela L. Lutsey, Jennifer A. Schrack, Luigi Ferrucci, Eleanor M. Simonsick, B. Gwen Windham

Department of Exercise Science Faculty Papers

BACKGROUND: Gait speed is an important indicator of functional status and health outcomes in older adults. Electronic gait mats are common in research, but stopwatches are more feasible in clinical practice. This study compared agreement between single task (ST) gait speed measured by stopwatch and gait mat and described single and dual task (DT) gait performance measured by gait mat.

METHODS: A subset of Atherosclerosis Risk in Communities (ARIC) Study Visit 8 participants completed ST cognitive (serial subtractions), ST gait speed, and DT gait (gait with serial subtractions) on an electronic gait mat; ST gait speed was also assessed by …