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2024

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Articles 8341 - 8370 of 9443

Full-Text Articles in Medical Specialties

Cbct Perceptions Of Radiology Leaders In The Midwest Dental Schools: A Qualitative Study, Tenzin Dadul Jan 2024

Cbct Perceptions Of Radiology Leaders In The Midwest Dental Schools: A Qualitative Study, Tenzin Dadul

Dissertations

Problem

The integration of Cone Beam Computed Tomography (CBCT) in dental education is hindered by a lack of formal training among radiology leaders, insufficient institutional support, and financial constraints. Despite the proven efficacy of CBCT in enhancing diagnostic accuracy and treatment planning, its adoption in pre-doctoral curricula remains limited. This gap in education poses significant challenges for dental graduates, who are increasingly expected to utilize advanced imaging technologies in clinical practice.

Purpose of Study

This qualitative study aimed to explore the perceptions of radiology leaders in Midwest dental schools regarding the integration of CBCT education into pre-doctoral curricula. The objectives …


Impact Of Personal Continuous Glucose Monitor Use During Hospitalization On Rates Of Hypoglycemia And Provider Confidence, Rebecca Longo Jan 2024

Impact Of Personal Continuous Glucose Monitor Use During Hospitalization On Rates Of Hypoglycemia And Provider Confidence, Rebecca Longo

DNP Scholarly Projects

Continuous Glucose Monitors (CGMs) are an essential tool for managing diabetes in the outpatient setting, helping individuals achieve glucose goals. However, CGMs are not currently FDA-approved for use in the hospital setting. Despite this limitation, many individuals continue using their personal CGM during hospitalization or begin using them prior to discharge if the care team believes the technology will support glucose management during and after leaving the hospital.

This project aimed to evaluate whether individuals using personal CGMs during hospitalization experienced less hypoglycemia and whether reviewing CGM data could improve provider confidence in insulin dosing. While initiating CGM use during …


Enhanced Neuroprotection And Neuropromotion In Extremely Premature Infants Through Mindful Hands-On Care And Increased Family Involvement, Kristen Sergott Jan 2024

Enhanced Neuroprotection And Neuropromotion In Extremely Premature Infants Through Mindful Hands-On Care And Increased Family Involvement, Kristen Sergott

DNP Scholarly Projects

Background: Medical breakthroughs including antenatal corticosteroids and exogenous surfactants have improved survival in extremely premature and extremely low birth weight (EP-ELBW) infants. Currently, babies as young as 22 weeks’ gestation are being actively resuscitated and provided with intensive care in neonatal intensive care units (NICUs) around the world. As a consequence of premature delivery, fragile and immature newborns are at risk for significant morbidities affecting their multiple organ systems. Additionally, such infants encounter neurodevelopmental trauma induced by recurrent stressful experiences ubiquitous to the NICU. Postnatal stress contributes to alterations in the hypothalamic-pituitary-adrenal (HPA) axis and is associated with alterations in …


Say No To Drugs: Nonpharmacologic Interventions For Preventing Delirium In Critically Ill Patients Intubated & Sedated In A Pediatric Icu, Jessica C. Ellzey Jan 2024

Say No To Drugs: Nonpharmacologic Interventions For Preventing Delirium In Critically Ill Patients Intubated & Sedated In A Pediatric Icu, Jessica C. Ellzey

DNP Projects

Background. Delirium is an acute clinical syndrome that is characterized by features of disrupted arousal, attention, cognition, sleep, and perception. Delirium is a well-documented phenomenon in critical care settings in both adult and pediatric populations, particularly among patients with length of stay greater than or equal to 48 hours. Delirium has multiple adverse effects, including increased mortality rate, prolonged duration of mechanical ventilation, higher reintubation rates, prolonged intensive care unit (ICU) admission, prolonged hospital admission, short- and long-term cognitive impairment, and posttraumatic stress disorder. There are currently no accepted guidelines or FDA approved medications to treat ICU delirium in the …


Home Blood Pressure Monitoring Bundle For Hypertension Outcomes In Adult Patients Receiving Care In Public Health Clinics, Christine Jennifer Victorian Jan 2024

Home Blood Pressure Monitoring Bundle For Hypertension Outcomes In Adult Patients Receiving Care In Public Health Clinics, Christine Jennifer Victorian

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Hypertension (HTN) that is not adequately controlled leads to cardiovascular disease, stroke, and heart disease. It affects 116 million adults (47%) in the United States (U.S.). The HTN compliance rate in a South Texas public health clinic was 64%, below the national benchmark of 76%. Home blood pressure monitoring (HBPM) was recommended in a joint statement by the American Heart Association (AHA) and the American Medical Association (AMA). Literature evidence revealed that the HBPM bundle increased BP control (< 140/90 mmHg) compliance.

Methods: A quality improvement (QI) bundle was initiated to address the low HTN compliance rate from a quality management perspective. …


Using The Electronic Medical Record To Improve Nurse Workload, Sharon C. Le Roux Jan 2024

Using The Electronic Medical Record To Improve Nurse Workload, Sharon C. Le Roux

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background

Equitable nurse-patient assignments have been associated with improved nurse well-being, patient satisfaction and outcomes. Despite this, in an academic medical center in the southwestern United States, there is no standardized process to create equitable nurse-patient assignments.

Objectives

The aim of this project was to improve inpatient oncology nurse well-being and satisfaction through the implementation of an EMR based nurse-patient assignment tool.

Methods

The IOWA Model-Revised for evidence-based practice was used as the basis for this project. Data collected included demographics, the Well-Being Index Survey, perception of satisfaction with manual workload tool, along with knowledge and use of the …


Intravenous Contrast Extravasations Of Ct Contrast Media Prevention Bundle, Shakerra T. Brown Jan 2024

Intravenous Contrast Extravasations Of Ct Contrast Media Prevention Bundle, Shakerra T. Brown

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Contrast extravasations pose significant risks during intravenous contrast media imaging procedures, with potential adverse outcomes ranging from minor skin irritation to severe tissue necrosis. Despite technological advancements and procedural safeguards, contrast extravasations remain a concern in healthcare settings. A comprehensive needs assessment at our institution revealed a notable incidence of contrast extravasations, highlighting the need for targeted interventions to mitigate risk and enhance patient safety. This project aims to explore the complexities of contrast extravasations, examining contributing factors, associated complications, and current prevention and management strategies to inform evidence-based practices and improve patient outcomes. This Doctor of Nursing Practice (DNP) …


Guideline For Screening Of Trichomonas Vaginalis Infections In The Correctional Setting, Nahirobi J. Madrid Antunez Jan 2024

Guideline For Screening Of Trichomonas Vaginalis Infections In The Correctional Setting, Nahirobi J. Madrid Antunez

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Objective: This guideline project focused on creating a screening guideline for T. vaginalis that would benefit healthcare providers in a correctional healthcare setting for incarcerated females entering the facility.

Methods: A literature review was conducted. The PubMed and MEDLINE search engines, were used to obtain medical, biomedical and life sciences literature, and CINAHL for nursing and allied health resources, Governmental agency sites, such as the Centers for Disease Control and Prevention (CDC), were also explored. Guideline recommendations were extrapolated from the literature review, and then rated by, stakeholders.

Results: Several overarching themes were identified. Screening of asymptomatic women for T. …


Obesity Management Guideline For The Correctional Setting, Rumi Y. Sato Jan 2024

Obesity Management Guideline For The Correctional Setting, Rumi Y. Sato

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Obesity can cause multiple chronic conditions, including cancer and death. Los Angeles jail primary care clinics do not address obesity management despite health hazards, rising costs, and high obesity rates in correctional facilities. The Centers for Medicare and Medical Services (CMS) obesity-management guidelines are over ten years old and outdated. The aim of this Doctor of Nursing Practice (DNP) project was to update the CMS obesity-management guideline with the newest intense behavioral therapy (IBT) evidence to assist the correctional multidisciplinary healthcare team. This project took place in a Los Angeles correctional facility's primary care clinic. A detailed literature review gathered …


Developing Toolkit For Adults With Autism Spectrum Disorder In An Oncology Outpatient Clinic, Brittany J. Johnson Dnp, Fnp-C Jan 2024

Developing Toolkit For Adults With Autism Spectrum Disorder In An Oncology Outpatient Clinic, Brittany J. Johnson Dnp, Fnp-C

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Autistic adults are at higher risk of being diagnosed with co-occurring health conditions, and yet they are a vulnerable group for disparities in access and outcomes. One of the key barriers to better outcomes is poor patient-provider communication. This study the use of AASPIRE’s AHAT communication toolkit as a channel between healthcare workers and autistic adults to facilitate their appointments within the outpatient oncology department, as well as assessing healthcare providers’ knowledge and self-efficacy in caring for the patients. Sixteen healthcare providers (12 registered nurses and four patient care assistants) completed pre and post intervention surveys and utilized the AHAT …


Glutamate Optimization As A Treatment For Depression: A Clinical Guideline, Luisa Angeles Collins Villares Jan 2024

Glutamate Optimization As A Treatment For Depression: A Clinical Guideline, Luisa Angeles Collins Villares

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Based on the use of drugs to treat hypertension and tuberculosis for depression, the monoamine hypothesis led to the development of antidepressants in 1952. Serotonin was recognized as a deficiency associated with depression in 1967. As a fine-tuning orchestration of neurotransmitters and neuromodulators, the glutamate system became known using Spravato in 2019 and Auvelity in 2022. In this pilot study, mental health experts rated the importance of 24 science-based recommendations to optimize glutamatergic therapy in depression for a proposed guideline on a Likert scale from zero to four. The results were analyzed using a non-parametric predictive modeling method called Chi-Square …


Biomechanics, Strength, And Physical Function After Surgical Repair Of Rotational Ankle Fractures, Benjamin Brightwell Jan 2024

Biomechanics, Strength, And Physical Function After Surgical Repair Of Rotational Ankle Fractures, Benjamin Brightwell

Theses and Dissertations--Kinesiology and Health Promotion

Ankle Fractures account for approximately 9% of all lower extremity fractures and incidence continues to rise. Up to 53% of ankle fractures require surgical intervention. Impaired physical function is one of the most reported and observed lasting effects of surgically repaired ankle fractures. Additionally, limited physical capacity and function have been identified as the primary threats to health-related quality of life after surgical repair of ankle fractures. These impairments to physical capacity and functionality can last longer than 5 years after surgery. Since surgery typically successfully restores stability and congruency of the talocrural joint, these poor long-term outcomes are an …


Enlarged Perivascular Spaces Are A Clinically Relevant Neuroimaging Biomarker Of Cerebral Small Vessel Disease, Timothy Justin Libecap Jan 2024

Enlarged Perivascular Spaces Are A Clinically Relevant Neuroimaging Biomarker Of Cerebral Small Vessel Disease, Timothy Justin Libecap

Theses and Dissertations--Neuroscience

Vascular contributions to cognitive impairment and dementia (VCID) represents the intersection between cerebrovascular disease and cognitive decline. Cerebral small vessel disease (cSVD) is an important risk factor that may precede the onset of VCID by years. cSVD is characterized by in-vivo neuroimaging biomarkers including enlarged perivascular spaces (ePVS). PVS are the site of interchange between interstitial fluid (ISF) and cerebrospinal fluid (CSF) which is believed to play a role in the removal of brain waste. Reduced clearance may lead to enlargement of the PVS and subsequent accumulation of toxic solutes characteristic of neurodegeneration. Given the presence of ePVS in brain …


The Role Of Dystrophic Microglia In Aging And Disease, Ryan K. Shahidehpour Jan 2024

The Role Of Dystrophic Microglia In Aging And Disease, Ryan K. Shahidehpour

Theses and Dissertations--Neuroscience

Microglia are the primary immune cells of the central nervous system and are crucial in maintaining homeostasis and defense from disease and injury in the brain. Recent genome-wide association studies (GWAS) have also highlighted microglia as a central player in Alzheimer’s disease (AD). However, the mechanisms of microglia’s influence are poorly understood. Traditionally, microglial subtypes characterized physiologically as “reactive” or “activated” have been linked with disease and injury in the brain. However, morphologically, a recently described microglia category known as “dystrophic,” characterized structurally by fragmented processes and cytoplasmic decay is believed to be more strongly associated with aging and neurodegeneration. …


Repolarizing Tumor-Associated Macrophages In Ovarian Cancer: A Novel Immunotherapeutic Approach, David Schweer Jan 2024

Repolarizing Tumor-Associated Macrophages In Ovarian Cancer: A Novel Immunotherapeutic Approach, David Schweer

Theses and Dissertations--Clinical and Translational Science

Ovarian cancer, recognized for its high lethality and resistance to conventional immunotherapies, mandates innovative strategies to confront its intricate challenges. The tumor microenvironment (TME), orchestrated by tumor-associated macrophages (TAMs), assumes a pivotal role in disease progression, rendering TAMs an appealing therapeutic target. This study endeavors to explore the prospect of repolarizing TAMs from a protumor M2 phenotype to an antitumor M1 state, employing M1 macrophage-derived vesicles (MEVs) as a groundbreaking immunotherapeutic approach.

The primary objective is to investigate the capacity of M1 MEVs to repolarize M2 macrophages in vitro towards an anti-tumor M1-like phenotype. By inducing human macrophages to adopt …


Developing Radiosensitizers To Enhance Radiotherapy In Treating Gastroenteropancreatic Neuroendocrine Tumor, Zeta Chow Jan 2024

Developing Radiosensitizers To Enhance Radiotherapy In Treating Gastroenteropancreatic Neuroendocrine Tumor, Zeta Chow

Theses and Dissertations--Clinical and Translational Science

Gastroenteropancreatic Neuroendocrine Tumor (GEP-NET) is a heterogeneous group of malignancies arising from multipotent neuroendocrine stem cells in the gastrointestinal tract. The incidence of GEP-NET continues to rise, possibly due to the advancement of imaging and biomarkers available for diagnosis. However, even though the majority of patients are diagnosed with low-grade and localized disease, a significant percentage of patients present with advanced-stage metastatic disease with poor prognosis in months to a few years. These advanced-stage GEP-NET patients can also present with a variety of debilitating symptoms that significantly impact their quality of life. The role of palliative-intent surgery is limited, and …


Evaluation Of The Cellular And Physiologic Impact Of Mitomycin C On Colon Cancer, Hannah Mcdonald Jan 2024

Evaluation Of The Cellular And Physiologic Impact Of Mitomycin C On Colon Cancer, Hannah Mcdonald

Theses and Dissertations--Clinical and Translational Science

Cytoreductive surgery (CRS) and heated intraperitoneal chemotherapy (HIPEC) with Mitomycin C (MMC) has more than doubled the overall and disease-free survival in patients with peritoneal metastases (PM) due to colorectal cancer (CRC) over the past two decades. Although MMC is the most used HIPEC drug for PM due to CRC, dosing protocols vary dramatically between and within institutions across the world. Additionally, little is known about the impact of hyperthermia and MMC on intracellular pathways for CRC. The aim of this work is to determine the optimal dosing strategy in the clinical application of MMC and hyperthermia for treatment of …


A Quality Improvement Initiative To Reduce Preanalytical Blood Gas Errors, Layla Haver Newbrough Jan 2024

A Quality Improvement Initiative To Reduce Preanalytical Blood Gas Errors, Layla Haver Newbrough

Graduate Theses, Dissertations, and Problem Reports (ETD)

Abstract

Introduction: Laboratory testing is one of the most commonly performed procedures in healthcare and resulting data are paramount to clinical decision making. Background: Preanalytical blood gas laboratory errors often stem from the incorrect recording of a patient’s fraction of inspired oxygen (FiO2) within the laboratory collection application. Incorrect FiO2 may cause erroneous results or delays in reporting results that have the potential to negatively impact patient safety and medical management.

Purpose: The purpose of this quality improvement initiative was to reduce the occurrence of preanalytical blood gas laboratory errors. Methods/Interventions: This initiative combined modification of the laboratory collection application …


Efficient Classification Of Very High Resolution Images, Mohammad I. Nouyed Jan 2024

Efficient Classification Of Very High Resolution Images, Mohammad I. Nouyed

Graduate Theses, Dissertations, and Problem Reports (ETD)

In recent decades, deep learning approaches have shown significant improvement in various image understanding tasks. However, analysis of high-resolution images remains a major challenge. In this work, we address the challenge of very high-resolution histopathological image (VHRHI) classification using a new information-theoretic discriminative patch selection approach. We show results on a high-resolution image dataset, namely, gigapixel whole slide tissue images for cancer tumors. Then we address how to efficiently classify challenging histopathology images, such as gigapixel whole-slide images for cancer diagnostics with image-level annotation. These ``weak labels'' are applied throughout the image but describe tumor regions of variable sizes and …


Point Of Care Ultrasound (Pocus) For Advanced Practice Providers (Apps), Crystal S. Rogers Jan 2024

Point Of Care Ultrasound (Pocus) For Advanced Practice Providers (Apps), Crystal S. Rogers

DNP Projects

Background: Advanced practice providers (APPs) routinely lack the skillset to perform Point of Care Ultrasound (POCUS) because currently, there is not a standardized curriculum within scholarly programs (Santos et al., 2018) and/or inadequate hospital training to perform these competencies (Huang et al., 2021). The absence of a standard curriculum has limited the ability of APPs to practice with full scope, provide care that is comparable to physician partners in the acute care setting, and deliver highest quality of patient care. Implementing standard education to train APPs for POCUS addresses this identified gap.

Purpose: The purpose of this project was to …


Far Posterior Approach For Rib Fracture Fixation: Surgical Technique And Tips., Taylor J Manes, Daniel T Degenova, Benjamin C Taylor, Jignesh N Patel Jan 2024

Far Posterior Approach For Rib Fracture Fixation: Surgical Technique And Tips., Taylor J Manes, Daniel T Degenova, Benjamin C Taylor, Jignesh N Patel

Surgery Articles

BACKGROUND: The present video article describes the far posterior or paraspinal approach to posterior rib fractures. This approach is utilized to optimize visualization intraoperatively in cases of far-posterior rib fractures. This technique is also muscle-sparing, and muscle-sparing posterolateral, axillary, and anterior approaches have been shown to return up to 95% of periscapular strength by 6 months postoperatively

DESCRIPTION: Like most fractures, the skin incision depends on the fracture position. The vertical incision is made either just medial to a line equidistant between the palpable spinous processes and medial scapular border or directly centered over the fracture line in this region. …


Predicting Endothelium-Dependent Diastolic Function (Fmd)And Its Correlation With The Degree Of Coronary Artery Disease (Cad) And Plaque Vulnerability For Cardiovascular Events, Guangming Zhang, Jing Yang, Hanghang Xing, Hongning Yin, Guoqing Gu Jan 2024

Predicting Endothelium-Dependent Diastolic Function (Fmd)And Its Correlation With The Degree Of Coronary Artery Disease (Cad) And Plaque Vulnerability For Cardiovascular Events, Guangming Zhang, Jing Yang, Hanghang Xing, Hongning Yin, Guoqing Gu

Faculty, Staff and Student Publications

OBJECTIVE: This study aims to investigate the correlation between vascular endothelium-dependent diastolic function (FMD) and the degree of coronary artery disease (CAD), plaque vulnerability, and its predictive value for cardiovascular events.

METHODS: Initially, patients (n=100) who were admitted from January 2020 to January 2021 and intended to undergo percutaneous coronary intervention (PCI) were selected. Further, FMD in all patients was determined before the procedure and divided into a high-FMD group (≥4.2%) and a low-FMD group (

RESULTS: No significant differences were observed concerning general information, number of coronary arteries-associated branches, lesion type, involvement of the left main stem (LM), the …


Us Hospices’ Approach To Racial/ Ethnic Minority Inclusion: A Qualitative Study, M. Courtney Hughes, Erin Vernon, Monica Kowalczyk, Marlon Basco-Rodillas Jan 2024

Us Hospices’ Approach To Racial/ Ethnic Minority Inclusion: A Qualitative Study, M. Courtney Hughes, Erin Vernon, Monica Kowalczyk, Marlon Basco-Rodillas

Faculty Articles, Papers, and Other Scholarship

Objective: To examine hospices’ approaches to improving the current racial/ethnic hospice utilisation disparity.

Methods: During June and July 2020, we conducted in-depth, semistructured interviews with 22 hospice leaders from across the USA. The interviews focused on inclusive strategy approaches. We analysed the data using qualitative methods.

Results: Multiple themes emerged about racial/ ethnic minority inclusion strategies: (1) hospices tailor strategies to the local communities they serve; (2) improvement involves addressing social determinants of health that extend beyond end-of-life care; (3) costs of strategies are not a primary concern and the benefits are worth the costs; and (4) hospices want to …


Measuring Decision Aid Effectiveness For End-Of-Life Care: A Systematic Review, M. Courtney Hughes, Erin Vernon, Chinenye Egwuonwu, Oluwatoyosi Afolabi Jan 2024

Measuring Decision Aid Effectiveness For End-Of-Life Care: A Systematic Review, M. Courtney Hughes, Erin Vernon, Chinenye Egwuonwu, Oluwatoyosi Afolabi

Faculty Articles, Papers, and Other Scholarship

Objective

To systematically review research analyzing the effectiveness of decision aids for end-of-life care, including how researchers specifically measure decision aid success.

Methods

We conducted a systematic review synthesizing quantitative, qualitative, and mixed-methods study results using Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Four databases were searched through February 18, 2023. Inclusion criteria required articles to evaluate end-of-life care decision aids. The review is registered under PROSPERO (#CRD42023408449).

Results

A total of 715 articles were initially identified, with 43 meeting the inclusion criteria. Outcome measures identified included decisional conflict, less aggressive care desired, knowledge improvements, communication improvements, tool …


Comparison Between Acute Leukaemia Screening Tube And Lineage Specific Panels For The Diagnosis Of Acute Leukaemia At The Aga Khan University Hospital, Nairobi, Douglas Irimu Munga Jan 2024

Comparison Between Acute Leukaemia Screening Tube And Lineage Specific Panels For The Diagnosis Of Acute Leukaemia At The Aga Khan University Hospital, Nairobi, Douglas Irimu Munga

Master of Medicine in Clinical Pathology

Introduction; Acute leukaemia is a heterogeneous group of haematological malignancies. It is categorized depending on the immature cells that proliferate and replace the normal tissue in the bone marrow. The broad categories are acute myeloid leukaemia if the immature cells are myeloblasts and acute lymphoid leukaemia if lymphoblasts. Other rare categories are blastic plasmacytoid dendritic cell neoplasm (BPDCN) and acute leukaemias of ambiguous lineage which include acute undifferentiated leukaemia and mixed phenotype acute leukaemias (MPALs). The classification is important as the treatment and management differ hence a timely and accurate diagnosis is paramount. Multiparameter comparison of the immunophenotype is possible …


Novel Spirocyclic Dimer, Spid3, Targets Chronic Lymphocytic Leukemia Survival Pathways With Potent Preclinical Effects, Alexandria Eiken, Audrey L. Smith, Sydney A. Skupa, Elizabeth Schmitz, Sandeep Rana, Sarbjit Singh, Siddhartha Kumar, Jayapal Reddy Mallareddy, Aguirre A. De Cubas, Akshay Krishna, Achyuth Kalluchi, M. Jordan Rowley, Christopher R. D'Angelo, Matthew A. Lunning, Gregory Bociek, Julie M. Vose, Amarnath Natarajan, Dalia El-Gamal Jan 2024

Novel Spirocyclic Dimer, Spid3, Targets Chronic Lymphocytic Leukemia Survival Pathways With Potent Preclinical Effects, Alexandria Eiken, Audrey L. Smith, Sydney A. Skupa, Elizabeth Schmitz, Sandeep Rana, Sarbjit Singh, Siddhartha Kumar, Jayapal Reddy Mallareddy, Aguirre A. De Cubas, Akshay Krishna, Achyuth Kalluchi, M. Jordan Rowley, Christopher R. D'Angelo, Matthew A. Lunning, Gregory Bociek, Julie M. Vose, Amarnath Natarajan, Dalia El-Gamal

Journal Articles: Oncology and Hematology

Chronic lymphocytic leukemia (CLL) cell survival and growth is fueled by the induction of B-cell receptor (BCR) signaling within the tumor microenvironment (TME) driving activation of NFκB signaling and the unfolded protein response (UPR). Malignant cells have higher basal levels of UPR posing a unique therapeutic window to combat CLL cell growth using pharmacologic agents that induce accumulation of misfolded proteins. Frontline CLL therapeutics that directly target BCR signaling such as Bruton tyrosine kinase (BTK) inhibitors (e.g., ibrutinib) have enhanced patient survival. However, resistance mechanisms wherein tumor cells bypass BTK inhibition through acquired BTK mutations, and/or activation of alternative survival …


Myc Overexpression In Natural Killer Cell Lymphoma: Prognostic And Therapeutic Implications, Chengfeng Bi, Yuhua Huang, Roshia Ali, Fang Wang, Xia Yang, Alyssa Bouska, Lu Xu, Xinbao Hao, Matthew A. Lunning, Wing C. Chan, Javeed Iqbal, Dennis D. Weisenburger, Julie M. Vose, Kai Fu Jan 2024

Myc Overexpression In Natural Killer Cell Lymphoma: Prognostic And Therapeutic Implications, Chengfeng Bi, Yuhua Huang, Roshia Ali, Fang Wang, Xia Yang, Alyssa Bouska, Lu Xu, Xinbao Hao, Matthew A. Lunning, Wing C. Chan, Javeed Iqbal, Dennis D. Weisenburger, Julie M. Vose, Kai Fu

Journal Articles: Oncology and Hematology

The current clinical management of extranodal natural killer (NK)/T-cell lymphoma (ENKTL) primarily depends on conventional chemotherapy and radiotherapy, underscoring the need for innovative therapeutic strategies. This study explores the clinical significance and therapeutic implication of c-MYC (MYC) in ENKTL. Initially, we identified MYC protein overexpression in approximately 75% of cases within a large cohort of 111 patients. MYC overexpression was strongly correlated with lymphoma cell proliferation and poor clinical outcomes. Intriguingly, integrating MYC expression into the prognostic index of NK cells lymphoma with Epstein-Barr virus (PINK-E) prognostic model significantly enhanced its predictive power. Subsequently, we implemented MYC knockdown in NK …


High-Grade B-Cell Lymphoma, Not Otherwise Specified: Cns Involvement And Outcomes In A Multi-Institutional Series, Narendranath Epperla, Adam S. Zayac, Daniel J. Landsburg, Allison M. Bock, Grzegorz S. Nowakowski, Emily C. Ayers, Mark Girton, Marie Hu, Amy Beckman, Shaoying Li, L Jeffrey Medeiros, Julie E. Chang, Habibe Kurt, Jose Sandoval-Sus, Mohammad Ali Ansari-Lari, Shalin K. Kothari, Anna Kress, Mina L. Xu, Pallawi Torka, Suchitra Sundaram, Stephen D. Smith, Kikkeri N. Naresh, Yasmin Karimi, David A. Bond, Andrew M. Evens, Seema G. Naik, Manali Kamdar, Bradley M. Haverkos, Reem Karmali, Umar Farooq, Julie M. Vose, Paul Rubinstein, Amina Chaudhry, Adam J. Olszewski Jan 2024

High-Grade B-Cell Lymphoma, Not Otherwise Specified: Cns Involvement And Outcomes In A Multi-Institutional Series, Narendranath Epperla, Adam S. Zayac, Daniel J. Landsburg, Allison M. Bock, Grzegorz S. Nowakowski, Emily C. Ayers, Mark Girton, Marie Hu, Amy Beckman, Shaoying Li, L Jeffrey Medeiros, Julie E. Chang, Habibe Kurt, Jose Sandoval-Sus, Mohammad Ali Ansari-Lari, Shalin K. Kothari, Anna Kress, Mina L. Xu, Pallawi Torka, Suchitra Sundaram, Stephen D. Smith, Kikkeri N. Naresh, Yasmin Karimi, David A. Bond, Andrew M. Evens, Seema G. Naik, Manali Kamdar, Bradley M. Haverkos, Reem Karmali, Umar Farooq, Julie M. Vose, Paul Rubinstein, Amina Chaudhry, Adam J. Olszewski

Journal Articles: Oncology and Hematology

Little is known about the central nervous system (CNS) risk in high-grade B-cell lymphoma, not otherwise specified (HGBL NOS). Hence, we sought to describe the rates of baseline CNS involvement, risk of CNS recurrence after primary therapy, and management strategies in HGBL NOS. In this multicenter retrospective study, we included 160 adults with newly diagnosed HGBL NOS treated between 2016 and 2021 at 20 US institutions. Eleven patients (7%) had baseline CNS involvement at diagnosis (leptomeningeal = 6, parenchymal = 4, and both = 1). Baseline CNS involvement was significantly associated only with MYC rearrangement (OR = 3.5) and testicular …


Bet Inhibition Reforms The Immune Microenvironment And Alleviates T Cell Dysfunction In Chronic Lymphocytic Leukemia, Audrey L. Smith, Sydney A. Skupa, Alexandria P. Eiken, Timothy E. Reznicek, Elizabeth Schmitz, Nolan Williams, Dalia Y. Moore, Christopher R. D'Angelo, Avyakta Kallam, Matthew A. Lunning, Gregory Bociek, Julie M. Vose, Eslam Mohamed, Anna R. Mahr, Paul W. Denton, Ben Powell, Gideon Bollag, M. Jordan Rowley, Dalia El-Gamal Jan 2024

Bet Inhibition Reforms The Immune Microenvironment And Alleviates T Cell Dysfunction In Chronic Lymphocytic Leukemia, Audrey L. Smith, Sydney A. Skupa, Alexandria P. Eiken, Timothy E. Reznicek, Elizabeth Schmitz, Nolan Williams, Dalia Y. Moore, Christopher R. D'Angelo, Avyakta Kallam, Matthew A. Lunning, Gregory Bociek, Julie M. Vose, Eslam Mohamed, Anna R. Mahr, Paul W. Denton, Ben Powell, Gideon Bollag, M. Jordan Rowley, Dalia El-Gamal

Journal Articles: Oncology and Hematology

Redundant tumor microenvironment (TME) immunosuppressive mechanisms and epigenetic maintenance of terminal T cell exhaustion greatly hinder functional antitumor immune responses in chronic lymphocytic leukemia (CLL). Bromodomain and extraterminal (BET) proteins regulate key pathways contributing to CLL pathogenesis and TME interactions, including T cell function and differentiation. Herein, we report that blocking BET protein function alleviates immunosuppressive networks in the CLL TME and repairs inherent CLL T cell defects. The pan-BET inhibitor OPN-51107 reduced exhaustion-associated cell signatures resulting in improved T cell proliferation and effector function in the Eμ-TCL1 splenic TME. Following BET inhibition (BET-i), TME T cells coexpressed significantly fewer …


High-Grade B-Cell Lymphoma Not Otherwise Specified, With Diffuse Large B-Cell Lymphoma Gene Expression Signatures: Genomic Analysis And Potential Therapeutics, Waseem G. Lone, Alyssa Bouska, Tyler A. Herek, Catalina Amador, Joo Song, Alexander M. Xu, Dylan T. Jochum, Issa Ismail Issa, Dennis D. Weisenburger, Xuan Zhang, Sharath Kumar Bhagavathi, Tayla B. Heavican-Foral, Sunandini Sharma, Ab Rauf Shah, Abdul Rouf Mir, Aisha Ahmad Alkhinji, Dalia El-Gamal, Bhavana J. Dave, Keenan Hartert, Jiayu Yu, Mallick Saumyaranjan, Timothy C. Greiner, Julie M. Vose, Timothy W. Mckeithan, Kai Fu, Michael Green, Chengfeng Bi, Akil Merchant, Wing C. Chan, Javeed Iqbal Jan 2024

High-Grade B-Cell Lymphoma Not Otherwise Specified, With Diffuse Large B-Cell Lymphoma Gene Expression Signatures: Genomic Analysis And Potential Therapeutics, Waseem G. Lone, Alyssa Bouska, Tyler A. Herek, Catalina Amador, Joo Song, Alexander M. Xu, Dylan T. Jochum, Issa Ismail Issa, Dennis D. Weisenburger, Xuan Zhang, Sharath Kumar Bhagavathi, Tayla B. Heavican-Foral, Sunandini Sharma, Ab Rauf Shah, Abdul Rouf Mir, Aisha Ahmad Alkhinji, Dalia El-Gamal, Bhavana J. Dave, Keenan Hartert, Jiayu Yu, Mallick Saumyaranjan, Timothy C. Greiner, Julie M. Vose, Timothy W. Mckeithan, Kai Fu, Michael Green, Chengfeng Bi, Akil Merchant, Wing C. Chan, Javeed Iqbal

Journal Articles: Oncology and Hematology

High-grade B-cell lymphoma not otherwise specified (HGBCL, NOS) has overlapping morphological and genetic features with diffuse large B-cell lymphoma (DLBCL) and Burkitt lymphoma (BL), leading to uncertainty in its diagnosis and clinical management. Using functional genomic approaches, we previously characterized HGBCL and NOS, that demonstrate gene expression profiling (GEP), and genetic signatures similar to BL. Herein, we characterize distinct HGBCL, NOS, cohort (n = 55) in adults (n = 45) and in children (n = 10), and compared the GEP, genomic DNA copy number (CN), and mutational spectrum with de novo DLBCL (n = 85) and BL (n = 52). …