Medical Specialties Commons^™

A Umls-Based Investigation Of Laterality In Biomedical Terminologies, Rashmie Abeysinghe, Xubing Hao, Licong Cui, Guo-Qiang Zhang

Faculty, Staff and Student Publications

Laterality is an important anatomic directional property indicating the sidedness of body structures, diseases, and procedures. Errors in laterality could have catastrophic consequences in patient care. In this paper, we investigate how different biomedical terminologies organize terms indicating laterality. We leverage the Unified Medical Language System (UMLS) to identify lateral terms in different terminologies. For each lateral term, we attempt to obtain other matched lateral terms and further analyze how they are interrelated. Our results indicated that only 1.68% of the matched lateral term-pairs are hierarchically related. It was also seen that 44.24% of matched-pairs were siblings. We found that …

Extracting Temporal Expressions Of First Seizure Onset From Epilepsy Patient Discharge Summaries, Shiqiang Tao, Rashmie Abeysinghe, Blanca Talavera De La Esperanza, Samden Lhatoo, Guo-Qiang Zhang, Licong Cui

Faculty, Staff and Student Publications

Early onset of seizure is a potential risk factor for Sudden Unexpected Death in Epilepsy (SUDEP). However, the first seizure onset information is often documented as clinical narratives in epilepsy monitoring unit (EMU) discharge summaries. Manually extracting first seizure onset time from discharge summaries is time consuming and labor-intensive. In this work, we developed a rule-based natural language processing pipeline for automatically extracting the temporal information of patients’ first seizure onset from EMU discharge summaries. We use the Epilepsy and Seizure Ontology (EpSO) as the core knowledge resource and construct 4 extraction rules based on 300 randomly selected EMU discharge …

Literature Review: Pericranial Nerve Blocks For Chronic Migraines, Stephanie Wahab, Saurabh Kataria, Parker Woolley, Naanama O'Hene, Chima Odinkemere, Rosa Kim, Ivan Urits, Alan D Kaye, Jamal Hasoon, Cyrus Yazdi, Christopher L Robinson

Faculty, Staff and Student Publications

Purpose of review: Headaches, especially migraines, are one of the most pervasive neurological disorders affecting up to 15.9% of the population. Current methods of migraine treatment include lifestyle changes, pharmacologic, and minimally invasive techniques such as peripheral nerve stimulation (PNS) and pericranial nerve blocks (PNB).

Recent findings: PNBs are used to treat and prevent migraines and involves injection of local anesthetics with or without corticosteroids. PNBs include the greater occipital, supraorbital, supratrochlear, lesser occipital, auriculotemporal, sphenopalantine ganglion, and cervical root nerve blocks. Of the PNBs, the most extensively studied is the greater occipital nerve block (GONB) which has been shown …

Multi-Model Order Spatially Constrained Ica Reveals Highly Replicable Group Differences And Consistent Predictive Results From Resting Data: A Large N Fmri Schizophrenia Study, Xing Meng, Armin Iraji, Zening Fu, Peter Kochunov, Aysenil Belger, Judy M Ford, Sara Mcewen, Daniel H Mathalon, Bryon A Mueller, Godfrey Pearlson, Steven G Potkin, Adrian Preda, Jessica Turner, Theo G M Van Erp, Jing Sui, Vince D Calhoun

Faculty, Staff and Student Publications

Brain functional networks identified from resting functional magnetic resonance imaging (fMRI) data have the potential to reveal biomarkers for brain disorders, but studies of complex mental illnesses such as schizophrenia (SZ) often yield mixed results across replication studies. This is likely due in part to the complexity of the disorder, the short data acquisition time, and the limited ability of the approaches for brain imaging data mining. Therefore, the use of analytic approaches which can both capture individual variability while offering comparability across analyses is highly preferred. Fully blind data-driven approaches such as independent component analysis (ICA) are hard to …

Lipids And Lipoproteins May Play A Role In The Neuropathology Of Alzheimer’S Disease, Omer Akyol, Sumeyya Akyol, Mei-Chuan Chou, Shioulan Chen, Ching-Kuan Liu, Salih Selek, Jair C Soares, Chu-Huang Chen

Faculty, Staff and Student Publications

Alzheimer's disease (AD) and other classes of dementia are important public health problems with overwhelming social, physical, and financial effects for patients, society, and their families and caregivers. The pathophysiology of AD is poorly understood despite the extensive number of clinical and experimental studies. The brain's lipid-rich composition is linked to disturbances in lipid homeostasis, often associated with glucose and lipid abnormalities in various neurodegenerative diseases, including AD. Moreover, elevated low-density lipoprotein (LDL) cholesterol levels may be related to a higher probability of AD. Here, we hypothesize that lipids, and electronegative LDL (L5) in particular, may be involved in the …

Serum Neurofilament Light-Chain Levels And Long-Term Treatment Outcomes In Relapsing-Remitting Multiple Sclerosis Patients: A Post Hoc Analysis Of The Randomized Combirx Trial, Gary Cutter, Richard A Rudick, Carl De Moor, Carol M Singh, Elizabeth Fisher, Thijs Koster, Fred D Lublin, Jerry S Wolinsky, Henry Mcfarland, Steven Jacobson, Maria L Naylor

Faculty, Staff and Student Publications

BACKGROUND: CombiRx was a randomized, double-blind, placebo-controlled phase 3 trial in treatment-naive relapsing-remitting multiple sclerosis (RRMS) patients randomized to intramuscular interferon beta-1a (IM IFN beta-1a), glatiramer acetate (GA), or both therapies.

OBJECTIVE: This analysis investigated changes in serum neurofilament light-chain (sNfL) levels in response to treatment and assessed baseline sNfL as a predictor of relapse.

METHODS: RRMS patients treated with IM IFN beta-1a 30 µg weekly + placebo (n = 159), GA 20 mg/mL daily + placebo (n = 172), or IM IFN beta-1a + GA (n = 344) were included. A linear mixed model compared sNfL values over time. …

Pharmacokinetics And Pharmacodynamics Of Intranasal And Intramuscular Administration Of Naloxone In Working Dogs Administered Fentanyl, Ciara A Barr, Joanne Haughan, Giacomo Gianotti, Kelley Varner, Kenneth J Drobatz, Darko Stefanovski, Mary Robinson, Mark Pennington, Amanda Mcguire, Cynthia M Otto

Faculty, Staff and Student Publications

BACKGROUND: Working dogs exposed to narcotics might require reversal in the field.

OBJECTIVE: To explore the pharmacokinetic and pharmacodynamic effects of naloxone administered intramuscularly (IM) or intranasally (IN) to reverse fentanyl sedation in working dogs.

ANIMALS: Ten healthy, working dogs aged 1.7 ± 1 year and weighing 26 ± 3 kg.

METHODS: In this randomized, controlled cross-over study dogs received either 4 mg of naloxone IN or IM 10 minutes after fentanyl (0.3 mg IV) administration. Sedation was assessed at baseline and 5 minutes after fentanyl administration, then at 5, 10, 15, 20, 25, 30, 60 and 120 minutes after …

Community Socioeconomic And Urban-Rural Differences In Emergency Medical Services Times For Suspected Stroke In North Carolina, Srihari V Chari, Eric R Cui, Haylie E Fehl, Antonio R Fernandez, Jane H Brice, Mehul D Patel

Faculty, Staff and Student Publications

OBJECTIVE: Our objectives were to describe time intervals of EMS encounters for suspected stroke patients in North Carolina (NC) and evaluate differences in EMS time intervals by community socioeconomic status (SES) and rurality.

METHODS: This cross-sectional study used statewide data on EMS encounters of suspected stroke in NC in 2019. Eligible patients were adults requiring EMS transport to a hospital following a 9-1-1 call for stroke-like symptoms. Incident street addresses were geocoded to census tracts and linked to American Community Survey SES data and to rural-urban commuting area (RUCA) codes. Community SES was defined as high, medium, or low based …

Volatile Anesthetic And Outcome In Acute Trauma Care: Planned Secondary Analysis Of The Proppr Study, Colleen E Livingston, Dominique T Levy, Sepideh Saroukhani, Erin E Fox, Charles E Wade, John B Holcomb, Sam D Gumbert, Samuel M Galvagno, Olga Y Kaslow, Jean-Francois Pittet, Evan P Pivalizza

Faculty, Staff and Student Publications

BACKGROUND: This retrospective analysis of prospectively collected data from the PROPPR study describes volatile anesthetic use in severely injured trauma patients undergoing anesthesia.

METHODS: After exclusions, 402 subjects were reviewed of the original 680, and 292 had complete data available for analysis. Anesthesia was not protocolized, so analysis was of contemporary practice.

RESULTS: The small group who received no volatile anesthetic (n = 25) had greater injury burden (Glasgow Coma Scale

CONCLUSION: In this acutely injured trauma population, choice of volatile anesthetic did not appear to influence short-term mortality and morbidity. Subjects who received no volatile were more severely injured …

Il-33 Mediates Pseudomonas Induced Airway Fibrogenesis And Is Associated With Clad, Mudassir M Banday, Sangeetha B Rao, Shruthi Shankar, Mudasir A Khanday, Jon Finan, Edward O'Neill, Antonio Coppolino, Andreas Seyfang, Archit Kumar, Daniel E Rinewalt, Hilary J Goldberg, Ann Woolley, Hari Reddy Mallidi, Gary Visner, Amit Gaggar, Kapil N Patel, Nirmal S Sharma

Faculty, Staff and Student Publications

BACKGROUND: Long term outcomes of lung transplantation are impacted by the occurrence of chronic lung allograft dysfunction (CLAD). Recent evidence suggests a role for the lung microbiome in the occurrence of CLAD, but the exact mechanisms are not well defined. We hypothesize that the lung microbiome inhibits epithelial autophagic clearance of pro-fibrotic proteins in an IL-33 dependent manner, thereby augmenting fibrogenesis and risk for CLAD.

METHODS: Autopsy derived CLAD and non-CLAD lungs were collected. IL-33, P62 and LC3 immunofluorescence was performed and assessed using confocal microscopy. Pseudomonas aeruginosa (PsA), Streptococcus Pneumoniae (SP), Prevotella Melaninogenica (PM), recombinant IL-33 or PsA-lipopolysaccharide was …

Researching Covid To Enhance Recovery (Recover) Pregnancy Study: Rationale, Objectives And Design, Torri D Metz, Rebecca G Clifton, Richard Gallagher, Rachel S Gross, Leora I Horwitz, Vanessa L Jacoby, Susanne P Martin-Herz, Myriam Peralta-Carcelen, Harrison T Reeder, Carmen J Beamon, James Chan, A Ann Chang, Maged M Costantine, Megan L Fitzgerald, Andrea S Foulkes, Kelly S Gibson, Nick Güthe, Mounira Habli, David N Hackney, Matthew K Hoffman, M Camille Hoffman, Brenna L Hughes, Stuart D Katz, Victoria Laleau, Gail Mallett, Hector Mendez-Figueroa, Vanessa Monzon, Anna Palatnik, Kristy T S Palomares, Samuel Parry, Christian M Pettker, Beth A Plunkett, Athena Poppas, Uma M Reddy, Dwight J Rouse, George R Saade, Grecio J Sandoval, Shannon M Schlater, Frank C Sciurba, Hyagriv N Simhan, Daniel W Skupski, Amber Sowles, Tanayott Thaweethai, Gelise L Thomas, John M Thorp, Alan T Tita, Steven J Weiner, Samantha Weigand, Lynn M Yee, Valerie J Flaherman

Faculty, Staff and Student Publications

IMPORTANCE: Pregnancy induces unique physiologic changes to the immune response and hormonal changes leading to plausible differences in the risk of developing post-acute sequelae of SARS-CoV-2 (PASC), or Long COVID. Exposure to SARS-CoV-2 during pregnancy may also have long-term ramifications for exposed offspring, and it is critical to evaluate the health outcomes of exposed children. The National Institutes of Health (NIH) Researching COVID to Enhance Recovery (RECOVER) Multi-site Observational Study of PASC aims to evaluate the long-term sequelae of SARS-CoV-2 infection in various populations. RECOVER-Pregnancy was designed specifically to address long-term outcomes in maternal-child dyads.

METHODS: RECOVER-Pregnancy cohort is a …

Public Health Interventions Guided By Houston’S Wastewater Surveillance Program During The Covid-19 Pandemic, Loren Hopkins, Katherine B Ensor, Lauren Stadler, Catherine D Johnson, Rebecca Schneider, Kaavya Domakonda, James J Mccarthy, Edward J Septimus, David Persse, Stephen L Williams

Faculty, Staff and Student Publications

Since the start of the COVID-19 pandemic, wastewater surveillance has emerged as a powerful tool used by public health authorities to track SARS-CoV-2 infections in communities. In May 2020, the Houston Health Department began working with a coalition of municipal and academic partners to develop a wastewater monitoring and reporting system for the city of Houston, Texas. Data collected from the system are integrated with other COVID-19 surveillance data and communicated through different channels to local authorities and the general public. This information is used to shape policies and inform actions to mitigate and prevent the spread of COVID-19 at …

A Scoping Review Of Workplace Health Promotion Interventions For Chronic Diseases In Australia, Leonie Arnold, Katherine Harris, Victoria Weale

Faculty, Staff and Student Publications

OBJECTIVE: The aim of this study is to systematically chart and summarize the literature pertaining to workplace health promotion (WHP) interventions targeting the five main modifiable lifestyle risk factors for chronic disease, including smoking, nutrition, alcohol, physical activity, overweight/obesity (SNAPO) in Australian workers.

METHODS: A scoping review was performed using the framework of Arksey and O'Malley. MEDLINE, EMBASE, CINAHL, and SCOPUS were searched to identify peer-reviewed publications that evaluated primary or secondary WHP interventions which targeted one or more modifiable risk factor (SNAPO).

RESULTS: A total of fifty-six articles were included in the review. The findings revealed a heterogeneous nature …

The Kynurenine Pathway In Alzheimer’S Disease: A Meta-Analysis Of Central And Peripheral Levels, Brisa S Fernandes, Mehmet Enes Inam, Nitesh Enduru, Joao Quevedo, Zhongming Zhao

Faculty, Staff and Student Publications

OBJECTIVE: Changes in the kynurenine pathway are recognized in psychiatric disorders, but their role in Alzheimer's disease (AD) is less clear. We aimed to conduct a systematic review and meta-analysis to determine whether tryptophan and kynurenine pathway metabolites are altered in AD.

METHODS: We performed a systematic review and random-effects meta-analyses. Inclusion criteria were studies that compared AD and cognitively normal (CN) groups and assessed tryptophan or kynurenine pathway metabolites in cerebrospinal fluid or peripheral blood.

RESULTS: Twenty-two studies with a total of 1,356 participants (664 with AD and 692 CN individuals) were included. Tryptophan was decreased only in peripheral …

Lessons Learned From Interdisciplinary Efforts To Combat Covid-19 Misinformation: Development Of Agile Integrative Methods From Behavioral Science, Data Science, And Implementation Science, Sahiti Myneni, Paula Cuccaro, Sarah Montgomery, Vivek Pakanati, Jinni Tang, Tavleen Singh, Olivia Dominguez, Trevor Cohen, Belinda Reininger, Lara S Savas, Maria E Fernandez

Faculty, Staff and Student Publications

BACKGROUND: Despite increasing awareness about and advances in addressing social media misinformation, the free flow of false COVID-19 information has continued, affecting individuals' preventive behaviors, including masking, testing, and vaccine uptake.

OBJECTIVE: In this paper, we describe our multidisciplinary efforts with a specific focus on methods to (1) gather community needs, (2) develop interventions, and (3) conduct large-scale agile and rapid community assessments to examine and combat COVID-19 misinformation.

METHODS: We used the Intervention Mapping framework to perform community needs assessment and develop theory-informed interventions. To supplement these rapid and responsive efforts through large-scale online social listening, we developed a …

Multi-Task Learning For Post-Transplant Cause Of Death Analysis: A Case Study On Liver Transplant, Sirui Ding, Qiaoyu Tan, Chia-Yuan Chang, Na Zou, Kai Zhang, Nathan R Hoot, Xiaoqian Jiang, Xia Hu

Faculty, Staff and Student Publications

Organ transplant is the essential treatment method for some end-stage diseases, such as liver failure. Analyzing the post-transplant cause of death (CoD) after organ transplant provides a powerful tool for clinical decision making, including personalized treatment and organ allocation. However, traditional methods like Model for End-stage Liver Disease (MELD) score and conventional machine learning (ML) methods are limited in CoD analysis due to two major data and model-related challenges. To address this, we propose a novel framework called CoD-MTL leveraging multi-task learning to model the semantic relationships between various CoD prediction tasks jointly. Specifically, we develop a novel tree distillation …

Machine Learning-Driven Exploration Of Drug Therapies For Triple-Negative Breast Cancer Treatment, Aman Chandra Kaushik, Zhongming Zhao

Faculty, Staff and Student Publications

Breast cancer is the second leading cause of cancer death in women among all cancer types. It is highly heterogeneous in nature, which means that the tumors have different morphologies and there is heterogeneity even among people who have the same type of tumor. Several staging and classifying systems have been developed due to the variability of different types of breast cancer. Due to high heterogeneity, personalized treatment has become a new strategy. Out of all breast cancer subtypes, triple-negative breast cancer (TNBC) comprises ∼10%-15%. TNBC refers to the subtype of breast cancer where cells do not express estrogen receptors, …

Predictive Digital Twin For Optimizing Patient-Specific Radiotherapy Regimens Under Uncertainty In High-Grade Gliomas, Anirban Chaudhuri, Graham Pash, David A Hormuth, Guillermo Lorenzo, Michael Kapteyn, Chengyue Wu, Ernesto A B F Lima, Thomas E Yankeelov, Karen Willcox

Faculty, Staff and Student Publications

We develop a methodology to create data-driven predictive digital twins for optimal risk-aware clinical decision-making. We illustrate the methodology as an enabler for an anticipatory personalized treatment that accounts for uncertainties in the underlying tumor biology in high-grade gliomas, where heterogeneity in the response to standard-of-care (SOC) radiotherapy contributes to sub-optimal patient outcomes. The digital twin is initialized through prior distributions derived from population-level clinical data in the literature for a mechanistic model's parameters. Then the digital twin is personalized using Bayesian model calibration for assimilating patient-specific magnetic resonance imaging data. The calibrated digital twin is used to propose optimal …

The Short- And Long-Term Readmission Of Four Major Categories Of Digestive System Cancers: Does Obesity Or Metabolic Disorder Matter?, Yan Li, Xiaoqin Wu, Yongfeng Song, Peipei Wang, Bofei Zhang, Bingzhou Guo, Ziwei Liu, Yafei Wu, Shanshan Shao, Yiping Cheng, Honglin Guo, Xiude Fan, Jiajun Zhao

Faculty, Staff and Student Publications

Purpose: Patients with digestive system cancers (DSCs) are at a high risk for hospitalizations; however, the risk factors for readmission remain unknown. Here, we established a retrospective cohort study to assess the association between metabolic obesity phenotypes and readmission risks of DSC.

Experimental design: A total of 142,753 and 74,566 patients at index hospitalization were ultimately selected from the Nationwide Readmissions Database (NRD) 2018 to establish the 30-day and 180-day readmission cohorts, respectively. The study population was classified into four groups: metabolically healthy non-obese (MHNO), metabolically healthy obese (MHO), metabolically unhealthy non-obese (MUNO), and metabolically unhealthy obese (MUO). Multivariate Cox …

Receptor-Interacting Protein 1 And 3 Kinase Activity Are Required For High-Fat Diet Induced Liver Injury In Mice, Xiaoqin Wu, Rakesh K Arya, Emily Huang, Megan R Mcmullen, Laura E Nagy

Faculty, Staff and Student Publications

BACKGROUND: The RIP1-RIP3-MLKL-mediated cell death pathway is associated with progression of non-alcohol-associated fatty liver/steatohepatitis (NAFL/NASH). Previous work identified a critical role for MLKL, the key effector regulating necroptosis, but not RIP3, in mediating high fat diet-induced liver injury in mice. RIP1 and RIP3 have active N-terminus kinase domains essential for activation of MLKL and subsequent necroptosis. However, little is known regarding domain-specific roles of RIP1/RIP3 kinase in liver diseases. Here, we hypothesized that RIP1/RIP3 kinase activity are required for the development of high fat diet-induced liver injury.

METHODS:Rip1K45A/K45A and Rip3K51A/K51A kinase-dead mice on a C57BL/6J background and their littermate …

Acute Myeloid Leukemia With Concurrent Npm1 And Runx1 Mutations, Zhuang Zuo, L Jeffrey Medeiros, C Cameron Yin

Faculty, Staff and Student Publications

NPM1 mutation, as a founding genetic event, cooperates with other gene mutations, such as DNMT3A and FLT3, to promote the development of acute myeloid leukemia. NPM1 mutation, however, has been reported to be mutually exclusive with RUNX1 mutation in acute myeloid leukemia cases. In this study, we analyzed mutation panel testing data from a relatively large cohort of rare AML cases with both NPM1 and RUNX1 mutations. We describe the dynamic process of the emergence of these mutations, as well as molecular genetic features and clinical outcome of these patients. We show that concurrence of both mutations in acute …

Integrated Clinical Genotype-Phenotype Characteristics Of Early T-Cell Precursor Acute Lymphoblastic Leukemia, Matthew T Ye, Yi Wang, Zhuang Zuo, Steliana Calin, Hua He, Zhenya Tang, Elias J Jabbour, Gautam Borthakur, Yizhuo Zhang, Yaling Yang, M James You

Faculty, Staff and Student Publications

Background: Early T-cell precursor acute lymphoblastic leukemia (ETP-ALL) is a distinct subtype of T-ALL with a unique immunophenotype and high treatment failure rate. The molecular genetic abnormalities and their prognostic impact in ETP-ALL patients are poorly understood.

Methods: The authors performed systematic analyses of the clinicopathologic features with an emphasis on molecular genetic aspects of 32 patients with ETP-ALL.

Results: The median age was 43 years (range, 16-71). The blasts were positive for cytoplasmic CD3 and CD7 and negative for CD1a and CD8. Other markers expressed included CD34 (88%), CD33 (72%), CD117 (68%), CD13 (58%), CD5 (partial, 56%), CD2 (38%), …

Revolutionizing Bone Regeneration: Advanced Biomaterials For Healing Compromised Bone Defects, Kamal Awad, Neelam Ahuja, Ahmed S Yacoub, Leticia Brotto, Simon Young, Antonios Mikos, Pranesh Aswath, Venu Varanasi

Faculty, Staff and Student Publications

In this review, we explore the application of novel biomaterial-based therapies specifically targeted towards craniofacial bone defects. The repair and regeneration of critical sized bone defects in the craniofacial region requires the use of bioactive materials to stabilize and expedite the healing process. However, the existing clinical approaches face challenges in effectively treating complex craniofacial bone defects, including issues such as oxidative stress, inflammation, and soft tissue loss. Given that a significant portion of individuals affected by traumatic bone defects in the craniofacial area belong to the aging population, there is an urgent need for innovative biomaterials to address the …

Ribonuclease 1 Enhances Antitumor Immunity Against Breast Cancer By Boosting T Cell Activation, Ying-Nai Wang, Heng-Huan Lee, Zhou Jiang, Li-Chuan Chan, Gabriel N Hortobagyi, Dihua Yu, Mien-Chie Hung

Faculty, Staff and Student Publications

The secretory enzyme human ribonuclease 1 (RNase1) is involved in innate immunity and anti-inflammation, achieving host defense and anti-cancer effects; however, whether RNase1 contributes to adaptive immune response in the tumor microenvironment (TME) remains unclear. Here, we established a syngeneic immunocompetent mouse model in breast cancer and demonstrated that ectopic RNase1 expression significantly inhibited tumor progression. Overall changes in immunological profiles in the mouse tumors were analyzed by mass cytometry and showed that the RNase1-expressing tumor cells significantly induced CD4+ Th1 and Th17 cells and natural killer cells and reduced granulocytic myeloid-derived suppressor cells, supporting that RNase1 favors an antitumor …

Sound Speed Estimation For Distributed Aberration Correction In Laterally Varying Media, Rehman Ali, Trevor M Mitcham, Melanie Singh, Marvin M Doyley, Richard R Bouchard, Jeremy J Dahl, Nebojsa Duric

Faculty, Staff and Student Publications

Spatial variation in sound speed causes aberration in medical ultrasound imaging. Although our previous work has examined aberration correction in the presence of a spatially varying sound speed, practical implementations were limited to layered media due to the sound speed estimation process involved. Unfortunately, most models of layered media do not capture the lateral variations in sound speed that have the greatest aberrative effect on the image. Building upon a Fourier split-step migration technique from geophysics, this work introduces an iterative sound speed estimation and distributed aberration correction technique that can model and correct for aberrations resulting from laterally varying …

Naproxen Chemoprevention Induces Proliferation Of Cytotoxic Lymphocytes In Lynch Syndrome Colorectal Mucosa, Charles M Bowen, Nan Deng, Laura Reyes-Uribe, Edwin Roger Parra, Pedro Rocha, Luisa M Solis, Ignacio I Wistuba, Valerie O Sepeda, Lana Vornik, Marjorie Perloff, Eva Szabo, Asad Umar, Krishna M Sinha, Powel H Brown, Eduardo Vilar

Faculty, Staff and Student Publications

BACKGROUND: Recent clinical trial data from Lynch Syndrome (LS) carriers demonstrated that naproxen administered for 6-months is a safe primary chemoprevention that promotes activation of different resident immune cell types without increasing lymphoid cellularity. While intriguing, the precise immune cell types enriched by naproxen remained unanswered. Here, we have utilized cutting-edge technology to elucidate the immune cell types activated by naproxen in mucosal tissue of LS patients.

METHODS: Normal colorectal mucosa samples (pre- and post-treatment) from a subset of patients enrolled in the randomized and placebo-controlled 'Naproxen Study' were obtained and subjected to a tissue microarray for image mass cytometry …

Membranous Nephropathy In Chronic Lymphocytic Leukemia Responsive To Ibrutinib: A Case Report, Anna-Eve Turcotte, William F Glass, Jamie S Lin, Jan A Burger

Faculty, Staff and Student Publications

Membranous nephropathy (MN) is an uncommon renal presentation in patients with chronic lymphocytic leukemia (CLL), and as such, there is no standard therapy for these patients. A few cases of MN in CLL have been described with varying success in MN treatment involving alkylating agents and fludarabine. Here we report the first case of MN in a patient with CLL treated with ibrutinib with complete renal response. This presentation underlines the importance of recognizing rare glomerular diseases that may occur with CLL and offers a new therapeutic avenue to the treatment of CLL-associated MN.

Machine Learning-Based Prediction Of Acute Mortality In Emergency Department Patients Using Twelve-Lead Electrocardiogram, Po-Cheng Chang, Zhi-Yong Liu, Yu-Chang Huang, Yu-Chun Hsu, Jung-Sheng Chen, Ching-Heng Lin, Richard Tsai, Chung-Chuan Chou, Ming-Shien Wen, Hung-Ta Wo, Wen-Chen Lee, Hao-Tien Liu, Chun-Chieh Wang, Chang-Fu Kuo

Faculty, Staff and Student Publications

BACKGROUND: The risk of mortality is relatively high among patients who visit the emergency department (ED), and stratifying patients at high risk can help improve medical care. This study aimed to create a machine-learning model that utilizes the standard 12-lead ECG to forecast acute mortality risk in ED patients.

METHODS: The database included patients who visited the EDs and underwent standard 12-lead ECG between October 2007 and December 2017. A convolutional neural network (CNN) ECG model was developed to classify survival and mortality using 12-lead ECG tracings acquired from 345,593 ED patients. For machine learning model development, the patients were …

Artificial Intelligence-Enabled Electrocardiographic Screening For Left Ventricular Systolic Dysfunction And Mortality Risk Prediction, Yu-Chang Huang, Yu-Chun Hsu, Zhi-Yong Liu, Ching-Heng Lin, Richard Tsai, Jung-Sheng Chen, Po-Cheng Chang, Hao-Tien Liu, Wen-Chen Lee, Hung-Ta Wo, Chung-Chuan Chou, Chun-Chieh Wang, Ming-Shien Wen, Chang-Fu Kuo

Faculty, Staff and Student Publications

BACKGROUND: Left ventricular systolic dysfunction (LVSD) characterized by a reduced left ventricular ejection fraction (LVEF) is associated with adverse patient outcomes. We aimed to build a deep neural network (DNN)-based model using standard 12-lead electrocardiogram (ECG) to screen for LVSD and stratify patient prognosis.

METHODS: This retrospective chart review study was conducted using data from consecutive adults who underwent ECG examinations at Chang Gung Memorial Hospital in Taiwan between October 2007 and December 2019. DNN models were developed to recognize LVSD, defined as LVEF

RESULTS: The mean age of patients in the testing dataset was 63.7 ± 16.3 years (46.3% …

Distinct Patterns Of Auto-Reactive Antibodies Associated With Organ-Specific Immune-Related Adverse Events, Mehmet Altan, Quan-Zhen Li, Qi Wang, Natalie I Vokes, Ajay Sheshadri, Jianjun Gao, Chengsong Zhu, Hai T Tran, Saumil Gandhi, Mara B Antonoff, Stephen Swisher, Jing Wang, Lauren A Byers, Noha Abdel-Wahab, Maria C Franco-Vega, Yinghong Wang, J Jack Lee, Jianjun Zhang, John V Heymach

Faculty, Staff and Student Publications

UNLABELLED: The roles of preexisting auto-reactive antibodies in immune-related adverse events (irAEs) associated with immune checkpoint inhibitor therapy are not well defined. Here, we analyzed plasma samples longitudinally collected at predefined time points and at the time of irAEs from 58 patients with immunotherapy naïve metastatic non-small cell lung cancer treated on clinical protocol with ipilimumab and nivolumab. We used a proteomic microarray system capable of assaying antibody reactivity for IgG and IgM fractions against 120 antigens for systemically evaluating the correlations between auto-reactive antibodies and certain organ-specific irAEs. We found that distinct patterns of auto-reactive antibodies at baseline were …