Medical Specialties Commons^™

Angiotensin Blockade Therapy And Survival In Pancreatic Cancer: A Population Study, Scott W Keith, Vittorio Maio, Hwyda A Arafat, Matthew Alcusky, Thomas Karagiannis, Carol Rabinowitz, Harish Lavu, Daniel Z. Louis

College of Population Health Faculty Papers

Background: Pancreatic cancer (PC) is one of the most aggressive and challenging cancer types to effectively treat, ranking as the fourth-leading cause of cancer death in the United States. We investigated if exposures to angiotensin II receptor blockers (ARBs) or angiotensin I converting enzyme (ACE) inhibitors after PC diagnosis are associated with survival.

Methods: PC patients were identified by ICD-9 diagnosis and procedure codes among the 3.7 million adults living in the Emilia-Romagna Region from their administrative health care database containing patient data on demographics, hospital discharges, all-cause mortality, and outpatient pharmacy prescriptions. Cox modeling estimated covariate-adjusted mortality hazard ratios …

P118. Colonic Stent Presenting With Stent Impaction And Erosion Through The Colonic Wall, Benjamin Randall Hart, Jon Hain

Conference Presentation Abstracts

Background: Colonic stenting has been shown to be effective as a palliative measure in colorectal cancer when

patients present with obstructing symptoms. However, its efficacy when used for complications of colonic anastomoses are less well-studied. We present a case report of an elderly gentleman with a colonic stent placed for anastomotic stricture, which led to stent migration stent impaction with erosion in the sigmoid colon.

A 92-year-old gentleman presented to the ED with several days worth of nausea and vomiting. He had recently undergone a partial colectomy with an ileocolonic anastomosis approximately one year prior and then had a covered …

Translating Research Into Practice-Implementation Recommendations For Pediatric Rheumatology; Proceedings Of The Childhood Arthritis And Rheumatology Research Alliance 2020 Implementation Science Retreat, Cagri Yildirim-Toruner, Rajdeep Pooni, Y Ingrid Goh, Emily Becker-Haimes, James W Dearing, Maria E Fernandez, Esi M Morgan, Gareth Parry, Jon M Burnham, Stacy P Ardoin, Fatima Barbar-Smiley, Joyce C Chang, Peter Chiraseveenuprapund, Vincent Del Gaizo, Guy Eakin, Lisa C Johnson, Yukiko Kimura, Andrea M Knight, Melanie Kohlheim, Erica F Lawson, Mindy S Lo, Nancy Pan, Andrea Ring, Tova Ronis, Rebecca E Sadun, Emily A Smitherman, Alysha J Taxter, Janalee Taylor, Richard K Vehe, Sheetal S Vora, Jennifer E Weiss, Emily Von Scheven, Mas For The Carra Implementation Science Workgroup

Faculty, Staff and Student Publications

The translation of research findings into clinical practice is challenging, especially fields like in pediatric rheumatology, where the evidence base is limited, there are few clinical trials, and the conditions are rare and heterogeneous. Implementation science methodologies have been shown to reduce the research- to- practice gap in other clinical settings may have similar utility in pediatric rheumatology. This paper describes the key discussion points from the inaugural Childhood Arthritis and Rheumatology Research Alliance Implementation Science retreat held in February 2020. The aim of this report is to synthesize those findings into an Implementation Science Roadmap for pediatric rheumatology research. …

Lipid-Loaded Tumor-Associated Macrophages Sustain Tumor Growth And Invasiveness In Prostate Cancer, Michela Masetti, Roberta Carriero, Federica Portale, Giulia Marelli, Nicolò Morina, Marta Pandini, Marta Iovino, Bianca Partini, Marco Erreni, Andrea Ponzetta, Elena Magrini, Piergiuseppe Colombo, Grazia Elefante, Federico Simone Colombo, Joke M M Den Haan, Clelia Peano, Javier Cibella, Alberto Termanini, Paolo Kunderfranco, Jolanda Brummelman, Matthew Wai Heng Chung, Massimo Lazzeri, Rodolfo Hurle, Paolo Casale, Enrico Lugli, Ronald A Depinho, Subhankar Mukhopadhyay, Siamon Gordon, Diletta Di Mitri

Faculty, Staff and Student Publications

Tumor-associated macrophages (TAMs) are correlated with the progression of prostatic adenocarcinoma (PCa). The mechanistic basis of this correlation and therapeutic strategies to target TAMs in PCa remain poorly defined. Here, single-cell RNA sequencing was used to profile the transcriptional landscape of TAMs in human PCa, leading to identification of a subset of macrophages characterized by dysregulation in transcriptional pathways associated with lipid metabolism. This subset of TAMs correlates positively with PCa progression and shorter disease-free survival and is characterized by an accumulation of lipids that is dependent on Marco. Mechanistically, cancer cell-derived IL-1β enhances Marco expression on macrophages, and reciprocally, …

Home-Based Spirometry Telemonitoring After Allogeneic Hematopoietic Cell Transplantation: Mixed Methods Evaluation Of Acceptability And Usability, Ajay Sheshadri, Sukh Makhnoon, Amin M Alousi, Lara Bashoura, Rene Andrade, Christopher J Miller, Karen R Stolar, Muhammad Hasan Arain, Laila Noor, Amulya Balagani, Akash Jain, David Blanco, Abel Ortiz, Michael S Taylor, Alex Stenzler, Rohtesh Mehta, Uday R Popat, Chitra Hosing, David E Ost, Richard E Champlin, Burton F Dickey, Susan K Peterson

Faculty, Staff and Student Publications

Background: Home-based spirometry (HS) allows for the early detection of lung complications in recipients of an allogeneic hematopoietic cell transplant (AHCT). Although the usability and acceptability of HS are critical for adherence, patient-reported outcomes of HS use remain poorly understood in this setting.

Objective: The aim of this study is to design a longitudinal, mixed methods study to understand the usability and acceptability of HS among recipients of AHCT.

Methods: Study participants performed HS using a Bluetooth-capable spirometer that transmitted spirometry data to the study team in real time. In addition, participants completed usability questionnaires and in-depth interviews and reported …

Srgn-Triggered Aggressive And Immunosuppressive Phenotype In A Subset Of Ttf-1-Negative Lung Adenocarcinomas, Ichidai Tanaka, Delphine Dayde, Mei Chee Tai, Haruki Mori, Luisa M Solis, Satyendra C Tripathi, Johannes F Fahrmann, Nese Unver, Gargy Parhy, Rekha Jain, Edwin R Parra, Yoshiko Murakami, Clemente Aguilar-Bonavides, Barbara Mino, Muge Celiktas, Dilsher Dhillon, Julian Phillip Casabar, Masahiro Nakatochi, Francesco Stingo, Veera Baladandayuthapani, Hong Wang, Hiroyuki Katayama, Jennifer B Dennison, Philip L Lorenzi, Kim-Anh Do, Junya Fujimoto, Carmen Behrens, Edwin J Ostrin, Jaime Rodriguez-Canales, Tetsunari Hase, Takayuki Fukui, Taisuke Kajino, Seiichi Kato, Yasushi Yatabe, Waki Hosoda, Koji Kawaguchi, Kohei Yokoi, Toyofumi F Chen-Yoshikawa, Yoshinori Hasegawa, Adi F Gazdar, Ignacio I Wistuba, Samir Hanash, Ayumu Taguchi

Faculty, Staff and Student Publications

BACKGROUND: Approximately 20% of lung adenocarcinoma (LUAD) is negative for the lineage-specific oncogene Thyroid transcription factor 1 (TTF-1) and exhibits worse clinical outcome with a low frequency of actionable genomic alterations. To identify molecular features associated with TTF-1-negative LUAD, we compared the transcriptomic and proteomic profiles of LUAD cell lines. SRGN , a chondroitin sulfate proteoglycan Serglycin, was identified as a markedly overexpressed gene in TTF-1-negative LUAD. We therefore investigated the roles and regulation of SRGN in TTF-1-negative LUAD.

METHODS: Proteomic and metabolomic analyses of 41 LUAD cell lines were done using mass spectrometry. The function of SRGN was investigated …

Retinal Horizontal Cells Use Different Synaptic Sites For Global Feedforward And Local Feedback Signaling, Christian Behrens, Shubhash Chandra Yadav, Maria M Korympidou, Yue Zhang, Silke Haverkamp, Stephan Irsen, Anna Schaedler, Xiaoyu Lu, Zhuohe Liu, Jan Lause, François St-Pierre, Katrin Franke, Anna Vlasits, Karin Dedek, Robert G Smith, Thomas Euler, Philipp Berens, Timm Schubert

Faculty, Staff and Students Publications

In the outer plexiform layer (OPL) of the mammalian retina, cone photoreceptors (cones) provide input to more than a dozen types of cone bipolar cells (CBCs). In the mouse, this transmission is modulated by a single horizontal cell (HC) type. HCs perform global signaling within their laterally coupled network but also provide local, cone-specific feedback. However, it is unknown how HCs provide local feedback to cones at the same time as global forward signaling to CBCs and where the underlying synapses are located. To assess how HCs simultaneously perform different modes of signaling, we reconstructed the dendritic trees of five …

Diabetes: Risk Factor And Translational Therapeutic Implications For Alzheimer's Disease, Jeffrey Cummings, Andrew Ortiz, Janelle Castellino, Jefferson Kinney

Integrated Health Sciences Faculty Research

Type 2 diabetes mellitus (T2DM) and Alzheimer's disease (AD) commonly co-occur. T2DM increases the risk for AD by approximately twofold. Animal models provide one means of interrogating the relationship of T2DM to AD and investigating brain insulin resistance in the pathophysiology of AD. Animal models show that persistent hyperglycaemia results in chronic low-grade inflammation that may contribute to the development of neuroinflammation and accelerate the pathobiology of AD. Epidemiological studies suggest that patients with T2DM who received treatment with specific anti-diabetic agents have a decreased risk for the occurrence of AD and all-cause dementia. Agents such as metformin ameliorate T2DM …

Multi-Center Planning Study Of Radiosurgery For Intracranial Metastases Through Automation (Mc-Prima) By Crowdsourcing Prior Web-Based Plan Challenge Study, M K H Chan, T Gevaert, N Kadoya, J Dorr, R Leung, S Alheet, A Toutaoui, R Farias, M Wong, C Skourou, M Valenti, I Farré, C Otero-Martínez, D O'Doherty, J Waldron, S Hanvey, M Grohmann, Haisong Lui

Department of Radiation Oncology Faculty Papers

Background: Planning radiosurgery to multiple intracranial metastases is complex and shows large variability in dosimetric quality among planners and treatment planning systems (TPS). This project aimed to determine whether autoplanning using the Muliple Brain Mets (AutoMBM) software can improve plan quality and reduce inter-planner variability by crowdsourcing results from prior international planning study.

Methods: Twenty-four institutions autoplanned with AutoMBM on a five metastases case from a prior international planning competition from which population statistics (means and variances) of 23 dosimetric metrics and resulting composite plan score (maximum score = 150) of other TPS (Eclipse, Monaco, RayStation, iPlan, GammaPlan, MultiPlan) were …

Performance Determinants Of Unsupervised Clustering Methods For Microbiome Data, Yushu Shi, Liangliang Zhang, Christine B Peterson, Kim-Anh Do, Robert R Jenq

Faculty, Staff and Student Publications

Background: In microbiome data analysis, unsupervised clustering is often used to identify naturally occurring clusters, which can then be assessed for associations with characteristics of interest. In this work, we systematically compared beta diversity and clustering methods commonly used in microbiome analyses. We applied these to four published datasets where highly distinct microbiome profiles could be seen between sample groups, as well a clinical dataset with less clear separation between groups.

Results: Although no single method outperformed the others consistently, we did identify the key scenarios where certain methods can underperform. Specifically, the Bray Curtis (BC) metric resulted in poor …

African-American Lay Pastoral Care Facilitators’ Perspectives On Dementia Caregiver Education And Training, Nik M. Lampe, Nidhi Desai, Tomeka Norton-Brown, Alexandra C. H. Nowakowski, Robert L. Glueckauf

The Qualitative Report

The African-American Alzheimer’s Caregiver Training and Support Project 2 (ACTS 2) is a faith-integrated, skills-training and support program for distressed African American family caregivers of persons living with dementia across Florida. Caregivers participate in a 12-week, telephone-based, skills-building and support program led by faith community workers (i.e., lay pastoral care facilitators) who provide volunteer services to their denominations. In this case study, we examined facilitators’ perspectives and recommendations for supplementary audiovisual and written training materials to optimize group process and goal-setting skills. Utilizing a qualitative approach, we explored facilitators’ needs, experiences in using current training materials, and recommendations for supplementary …

Understanding The Context Of Healthcare Utilisation For Children Under-Five With Diarrhoea In The Drc: Based On Andersen Behavioural Model, Siyu Zou, Xinran Qi, Keiko Marshall, Maria Asif Bhura, Rie Takesue, Kun Tang

Department of Paediatrics and Child Health

Background: Diarrhoea is one of the leading causes of death among children under 5 years old in the Democratic Republic of the Congo (DRC). Despite positive effects on prognosis, there is limited literature about the healthcare-seeking behaviours of children with diarrhoea, especially in the DRC. This study used the Andersen Behavioural Model, a theoretical framework, which was commonly adopted to study healthcare utilisation, to investigate and predict factors associated with the use of healthcare to treat diarrhoea in the DRC.
Methods: Data collected from 2626 under-five children with diarrhoea in the last 2 weeks from the Multiple Indicators Cluster Survey …

Cognitive Reserve And Mild Cognitive Impairment, Maryam Iraniparast, Yidan Shi, Ying Wu, Leilei Zeng, Colleen J. Maxwell, Richard J. Kryscio, Philip D. St. John, Karen S. Santacruz, Suzanne L. Tyas

Sanders-Brown Center on Aging Faculty Publications

Background and Objectives Little is known about the effect of education or other indicators of cognitive reserve on the rate of reversion from mild cognitive impairment (MCI) to normal cognition (NC) or the relative rate (RR) of reversion from MCI to NC vs progression from MCI to dementia. Our objectives were to (1) estimate transition rates from MCI to NC and dementia and (2) determine the effect of age, APOE, and indicators of cognitive reserve on the RR of reversion vs progression using multistate Markov modeling.

Methods We estimated instantaneous transition rates between NC, MCI, and dementia after accounting …

Multiple Approaches Converge On Three Biological Subtypes Of Meningioma And Extract New Insights From Published Studies, James C Bayley, Caroline C Hadley, Arif O Harmanci, Akdes S Harmanci, Tiemo J Klisch, Akash J Patel

Faculty, Staff and Student Publications

One-fifth of meningiomas classified as benign by World Health Organization (WHO) histopathological grading will behave malignantly. To better diagnose these tumors, several groups turned to DNA methylation, whereas we combined RNA-sequencing (RNA-seq) and cytogenetics. Both approaches were more accurate than histopathology in identifying aggressive tumors, but whether they revealed similar tumor types was unclear. We therefore performed unbiased DNA methylation, RNA-seq, and cytogenetic profiling on 110 primary meningiomas WHO grade I and II). Each technique distinguished the same three groups (two benign and one malignant) as our previous molecular classification; integrating these methods into one classifier further improved accuracy. Computational …

I Don't Have A Diagnosis For You: Preparing Medical Students To Communicate Diagnostic Uncertainty In The Emergency Department, Maria Poluch, Jordan Feingold-Link, Nethra S. Ankam, Jared Kilpatrick, Kenzie Cameron, Shruti Chandra, Amanda Doty, Matthew Klein, Danielle Mccarthy, Kristin L. Rising, David Salzman, Deborah Ziring, Dimitrios Papanagnou

Department of Emergency Medicine Faculty Papers

Introduction: Diagnostic uncertainty abounds in medicine, and communication of that uncertainty is critical to the delivery of high-quality patient care. While there has been training in communicating diagnostic uncertainty directed towards residents, a gap remains in preparing medical students to understand and communicate diagnostic uncertainty. We developed a session to introduce medical students to diagnostic uncertainty and to practice communicating uncertainty using a checklist during role-play patient conversations.

Methods: This virtual session was conducted for third-year medical students at the conclusion of their core clerkships. It consisted of prework, didactic lecture, peer role-play, and debriefing. The prework included reflection prompts …

Social Media-Based Intervention To Promote Hbv Screening And Liver Cancer Prevention Among Korean Americans: Results Of A Pilot Study, Y Alicia Hong, Soo Yee, Pramita Bagchi, Hee-Soon Juon, Sojung Claire Kim, Daisy Le

Department of Medical Oncology Faculty Papers

Objective: In United States, Asian Americans are 10 times more likely to have hepatitis B virus (HBV) infection than Whites. Asian immigrants with limited English proficiency face extra barriers to HBV screening and many are unaware of the infectious status. This study aimed to evaluate a social media-based intervention to promote HBV screening and liver cancer prevention among Korean Americans (KA) with limited English proficiency.

Methods: Our community-academia partnership developed the "Lets talk about liver cancer" mHealth program by adapting a CDC media campaign. The program consisted of culturally tailored short video clips and pictorial messages and was delivered over …

Interplay Between Soluble Cd74 And Macrophage-Migration Inhibitory Factor Drives Tumor Growth And Influences Patient Survival In Melanoma, Yasunari Fukuda, Matias A Bustos, Sung-Nam Cho, Jason Roszik, Suyeon Ryu, Victor M Lopez, Jared K Burks, Jeffrey E Lee, Elizabeth A Grimm, Dave S B Hoon, Suhendan Ekmekcioglu

Faculty, Staff and Student Publications

Soluble forms of receptors play distinctive roles in modulating signal-transduction pathways. Soluble CD74 (sCD74) has been identified in sera of inflammatory diseases and implicated in their pathophysiology; however, few relevant data are available in the context of cancer. Here we assessed the composition and production mechanisms, as well as the clinical significance and biological properties, of sCD74 in melanoma. Serum sCD74 levels were significantly elevated in advanced melanoma patients compared with normal healthy donors, and the high ratio of sCD74 to macrophage-migration inhibitory factor (MIF) conferred significant predictive value for prolonged survival in these patients (p = 0.0035). Secretion of …

Imaging-Based Screening Of Deubiquitinating Proteases Identifies Otubain-1 As A Stabilizer Of C-Myc, Shannon E Moree, Laure Maneix, Polina Iakova, Fabio Stossi, Ergun Sahin, Andre Catic

Faculty, Staff and Students Publications

The ubiquitin-proteasome pathway precisely controls the turnover of transcription factors in the nucleus, playing an important role in maintaining appropriate quantities of these regulatory proteins. The transcription factor c-MYC is essential for normal development and is a critical cancer driver. Despite being highly expressed in several tissues and malignancies, the c-MYC protein is also continuously targeted by the ubiquitin-proteasome pathway, which can either facilitate or inhibit c-MYC degradation. Deubiquitinating proteases can remove ubiquitin chains from target proteins and rescue them from proteasomal digestion. This study sought to determine novel elements of the ubiquitin-proteasome pathway that regulate c-MYC levels. We performed …

Conditional Drug Approval As A Path To Market For Oncology Drugs In Canada: Challenges And Recommendations For Assessing Eligibility And Regulatory Responsiveness, Melanie Mcphail, Emma Weiss, Tania M. Bubela

Office of the Provost

International drug regulators use conditional drug approval mechanisms to facilitate faster patient access to drugs based on a lower evidentiary standard typically required of drug approvals. Faster and earlier access is justified by limiting eligibility to drugs intended for serious and life-threatening diseases and by requiring post-market evidence collection to confirm clinical benefit. One such mechanism in Canada, the Notice of Compliance with Conditions (NOC/c) policy, was introduced in 1998. Today, most of the drugs approved under the NOC/c policy are for oncology indications. We analyze oncology drugs approvals under the NOC/c policy to inform discussions of two tradeoffs applied …

Abcc6 Null Mice-A Model For Mineralization Disorder Pxe Shows Vertebral Osteopenia Without Enhanced Intervertebral Disc Calcification With Aging, Paige K Boneski, Vedavathi Madhu, Ryan Tomlinson, Irving Shapiro, Koen Van De Wetering, Makarand V Risbud

Department of Orthopaedic Surgery Faculty Papers

Chronic low back pain is a highly prevalent health condition intricately linked to intervertebral disc degeneration. One of the prominent features of disc degeneration that is commonly observed with aging is dystrophic calcification. ATP-binding cassette sub-family C member 6 (ABCC6), a presumed ATP efflux transporter, is a key regulator of systemic levels of the mineralization inhibitor pyrophosphate (PPi). Mutations in ABCC6 result in pseudoxanthoma elasticum (PXE), a progressive human metabolic disorder characterized by mineralization of the skin and elastic tissues. The implications of ABCC6 loss-of-function on pathological mineralization of structures in the spine, however, are unknown. Using the Abcc6 -/- …

Risk Factors For Hospitalizations Among Older Adults With Gastrointestinal Cancers, Daneng Li, Can-Lan Sun, Rebecca Allen, Christiana J Crook, Abrahm Levi, Richard Ballena, Heidi D Klepin, Rawad Elias, Supriya G Mohile, William P Tew, Cynthia Owusu, Hyman B Muss, Stuart M Lichtman, Cary P Gross, Andrew Chapman, Ajeet Gajra, Harvey J Cohen, Vani Katheria, Arti Hurria, William Dale

Department of Medical Oncology Faculty Papers

Background: Older adults (≥65 years) with gastrointestinal (GI) cancers who receive chemotherapy are at increased risk of hospitalization caused by treatment-related toxicity. Geriatric assessment (GA) has been previously shown to predict risk of toxicity in older adults undergoing chemotherapy. However, studies incorporating the GA specifically in older adults with GI cancers have been limited. This study sought to identify GA-based risk factors for chemotherapy toxicity-related hospitalization among older adults with GI cancers.

Patients and methods: We performed a secondary post hoc subgroup analysis of two prospective studies used to develop and validate a GA-based chemotherapy toxicity score. The incidence of …

Hypophosphatemia Causing St Elevation In A Critically Ill Noncardiac Surgery Postoperative Patient., Joey Junarta, Gregary D Marhefka

Division of Cardiology Faculty Papers

The patient is a 73-year-old female with peripheral vascular disease, coronary artery disease, and systemic lupus erythematosus, who underwent mesenteric artery bypass surgery. She suffered from a pneumonia after surgery, causing acute hypoxic respiratory failure and septic shock. Due to shock, she developed acute renal failure. She was intubated, ventilated, and received continuous veno-venous hemodialysis for renal failure. ST elevation was first observed on telemetry and subsequently confirmed on electrocardiogram. Marked ST elevation is present in the anterior leads with reciprocal ST depression in the inferior leads. A prolonged QT interval is also present. What is the most likely diagnosis?

Early Postoperative Arrhythmias After Pediatric Congenital Heart Disease Surgery: A 5-Year Audit From A Lower- To Middle-Income Country, Sidra Ishaque, Saleem Akhtar, Asma Akbar Ladak, Russell Seth Martins, Muhammad Kamran Younis Memon, Alisha Raza Kazmi, Fatima Mahmood, Anwar Ul Haque

Department of Paediatrics and Child Health

Background: Postoperative arrhythmias are a known complication after surgical repair for congenital heart disease (CHD). This study aimed to identify and discuss the prevalence, diagnosis, and management of common rhythm disturbances seen in the immediate postoperative period after surgery for CHD in the pediatric population at a tertiary care hospital in Pakistan.
Methods: A retrospective study was conducted at a tertiary care hospital in Pakistan between January 2014 and December 2018. All pediatric (old) patients admitted to the intensive care unit and undergoing continuous electrocardiographic monitoring after surgery for CHD were included in this study. Data pertaining to the incidence, …

Innovations In Cervical Spine Trauma: Developing The Next Generation Upper Cervical Spine Injury Classification System, Brian A Karamian, Hannah Levy, Paul D. Minetos, Michael L. Smith, Alex R. Vaccaro

Rothman Institute Papers

The upper cervical spine not only consists of intricate bony and ligamentous anatomy affording unique flexibility but also has increased susceptibility to injuries. The upper cervical spine trauma can result in a wide spectrum of injuries that can be managed both operatively and nonoperatively. Several existing classification systems have been proposed to describe injuries of the upper cervical spine, many of which rely on anatomic descriptions of injury location. Prior fracture classifications are limited in scope, characterizing fractures restricted to a single region of the upper cervical spine, and fail to provide insight into injury management. The AO Spine Upper …

Novel Approaches To Coronary Perforations: Everything But The Kitchen Sink., Dany Jacob, Michael P Savage, David L Fischman

Division of Cardiology Faculty Papers

No abstract provided.

Similar Mortality Among United States Veterans With Invasive And Noninvasive Pneumonia Due To Group B Streptococcus, Brigid M. Wilson, Sunah Song, Robin L.P. Jump, Federico Perez

Faculty Scholarship

Background: The nosology of noninvasive pneumonia due to group B Streptococcus (GBS) is not well defined. This study compared clinical characteristics and outcomes of patients with invasive pneumonia and noninvasive pneumonia caused by GBS. Methods: We conducted a retrospective cohort study among Veterans Affairs (VA) healthcare users between 2008 and 2017. Using data from electronic health records, we identified patients who had blood or respiratory cultures that grew GBS and had invasive pneumonia or noninvasive pneumonia. We analyzed patient and infection characteristics associated with all-cause mortality, including among the subset of patients with cultures that were monomicrobial for GBS. Results: …

Compounding Inequalities: Adolescent Psychosocial Wellbeing And Resilience Among Refugee And Host Communities In Jordan During The Covid-19 Pandemic, Nicola Jones, Sarah Baird, Bassam Abu Hamad, Zulfiqar Ahmed Bhutta, Erin Oakley, Manisha Shah, Jude Sajdi, Kathryn M. Yount

Department of Paediatrics and Child Health

Purpose: The COVID-19 pandemic and associated risk-mitigation strategies have altered the social contexts in which adolescents in low- and middle-income countries live. Little is known, however, about the impacts of the pandemic on displaced populations, and how those impacts differ by gender and life stage. We investigate the extent to which the pandemic has compounded pre-existing social inequalities among adolescents in Jordan, and the role support structures play in promoting resilience.
Methods: Our analysis leverages longitudinal quantitative survey data and in-depth qualitative interviews, collected before and after the onset of COVID-19, with over 3,000 Syrian refugees, stateless Palestinians and vulnerable …

Nutritional Status And Dietary Intake Of School-Age Children And Early Adolescents: Systematic Review In A Developing Country And Lessons For The Global Perspective, Durray Shahwar Abid Khan, Jai K. Das, Shagufta Zareen, Zohra S. Lassi, Afsah Salman, Muhammad Raashid, Aftab A. Dero, Aijaz Khanzada, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: The prevalence of double burden of malnutrition (DBM) is high in low- and middle-income countries (LMICs). Data on malnutrition trends is present for children age, however the data for school-going children and adolescents aged 5-15 years is scarce.
Objective: This systematic review presents the pooled prevalence of nutritional status and dietary intake among school-going children and adolescents (5-15 years of age) in an LMIC of Pakistan and the perspective for broader global nutrition in this age group.
Methods: An electronic search of databases was run on Pubmed and Medline (via Ovid) along with gray literature and archives of local …

A Summary Of The Inaugural Who Classification Of Pediatric Tumors: Transitioning From The Optical Into The Molecular Era., Stefan M Pfister, Miguel Reyes-Múgica, John K C Chan, Henrik Hasle, Alexander J Lazar, Sabrina Rossi, Andrea Ferrari, Jason A Jarzembowski, Kathy Pritchard-Jones, D. Ashley Hill, Thomas S Jacques, Pieter Wesseling, Dolores H López Terrada, Andreas Von Deimling, Christian P Kratz, Ian A Cree, Rita Alaggio

Pathology Faculty Publications

Pediatric tumors are uncommon, yet are the leading cause of cancer-related death in childhood. Tumor types, molecular characteristics, and pathogenesis are unique, often originating from a single genetic driver event. The specific diagnostic challenges of childhood tumors led to the development of the first World Health Organization (WHO) Classification of Pediatric Tumors. The classification is rooted in a multilayered approach, incorporating morphology, IHC, and molecular characteristics. The volume is organized according to organ sites and provides a single, state-of-the-art compendium of pediatric tumor types. A special emphasis was placed on "blastomas," which variably recapitulate the morphologic maturation of organs from …

Chromosome-Level Genome Of Schistosoma Haematobium Underpins Genome-Wide Explorations Of Molecular Variation., Andreas J Stroehlein, Pasi K Korhonen, V Vern Lee, Stuart A Ralph, Margaret Mentink-Kane, Hong You, Donald P Mcmanus, Louis-Albert Tchuem Tchuenté, J Russell Stothard, Parwinder Kaur, Olga Dudchenko, Erez Lieberman Aiden, Bicheng Yang, Huanming Yang, Aidan M Emery, Bonnie L Webster, Paul J. Brindley, David Rollinson, Bill C H Chang, Robin B Gasser, Neil D Young

Microbiology, Immunology, and Tropical Medicine Faculty Publications

Urogenital schistosomiasis is caused by the blood fluke Schistosoma haematobium and is one of the most neglected tropical diseases worldwide, afflicting > 100 million people. It is characterised by granulomata, fibrosis and calcification in urogenital tissues, and can lead to increased susceptibility to HIV/AIDS and squamous cell carcinoma of the bladder. To complement available treatment programs and break the transmission of disease, sound knowledge and understanding of the biology and ecology of S. haematobium is required. Hybridisation/introgression events and molecular variation among members of the S. haematobium-group might effect important biological and/or disease traits as well as the morbidity of disease …