Medical Specialties Commons^™

E-Cigarette Switching And Financial Incentives To Promote Combustible Cigarette Cessation Among Adults Accessing Shelter Services: A Pilot Study, Munjireen Sifat, Adam C. Alexander, Michael S. Businelle, Summer G. Frank-Pearce, Laili Kharazi Boozary, Theodore L. Wagener, Jasjit S. Ahluwalia, Darla E. Kendzor

Department of Medical Oncology Faculty Papers

Background: Smoking prevalence among U.S. adults experiencing homelessness is ≥70 %. Interventions are needed to address persisting tobacco disparities.

Methods: Adults who smoked combustible cigarettes (CC) daily (N=60) were recruited from an urban day shelter and randomly assigned to an e-cigarette switching intervention with or without financial incentives for carbon monoxide (CO)-verified CC abstinence (EC vs. EC+FI). All participants received an e-cigarette device and nicotine pods during the first 4 weeks post-switch; and those in the EC+FI group also received escalating weekly incentives for CC abstinence during the same period. Key follow-ups were conducted at 4- and 8-weeks …

Management Of Aorto-Right Ventricular Fistulas After Tavr, Ricardo Chia, Chamaka Kalutota, Kerry Cao, Steven Douedi, William Chang, Dominic Pinciotti, Mohammad Beizaeipour, Jennifer Joiner, Daniel Ice, Ronald Ross, Richard Kovach, Chunguang Chen, Muhammad Raza

Division of Cardiology Faculty Papers

This clinical case series reviews the diagnosis and management of aorto-right ventricular fistulas post-transcatheter aortic valve replacement, highlighting 3 cases. We emphasize early detection, individualized treatment strategies, and the role of multidisciplinary heart teams in achieving favorable outcomes. Comprehensive imaging and procedural planning are crucial for successful intervention and management of this rare complication.

Lactobacillus Rhamnosus Modulates Murine Neonatal Gut Microbiota And Inflammation Caused By Pathogenic Escherichia Coli., Hao Xuan, Shahid Umar, Cuncong Zhong, Wei Yu, Ishfaq Ahmed, Joshua Wheatley, Venkatesh Sampath, Susana Chavez-Bueno

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Pathogenic Escherichia coli strains produce neonatal septicemia after colonizing the neonatal gut. While the probiotic Lactobacillus rhamnosus GG (LGG) effectively reduces neonatal sepsis, LGG's effects on the neonatal intestinal microbiota alterations and inflammation triggered by E. coli are incompletely understood. We hypothesized that LGG significantly modulates the specific neonatal gut microbial populations changes and the inflammatory response elicited by the enteral introduction of septicemia-producing E. coli. To test this hypothesis, newborn rats were pretreated orally with LGG or placebo prior to infection with the neonatal E. coli septicemia clinical isolate SCB34. Amplicon 16S rRNA gene sequencing was performed on …

Skn-1 Activation During Infection Of Caenorhabditis Elegans Requires Cdc-48 And Endoplasmic Reticulum Proteostasis, Carolaing Gabaldón, Ozgur Karakuzu, Danielle A Garsin

Faculty, Staff and Student Publications

During challenge of Caenorhabditis elegans with human bacterial pathogens such as Pseudomonas aeruginosa and Enterococcus faecalis, the elicited host response can be damaging if not properly controlled. The activation of Nrf (nuclear factor erythroid-related factor)/CNC (Cap-n-collar) transcriptional regulators modulates the response by upregulating genes that neutralize damaging molecules and promote repair processes. Activation of the C. elegans Nrf ortholog, SKN-1, is tightly controlled by a myriad of regulatory mechanisms, but a central feature is an activating phosphorylation accomplished by the p38 mitogen-activated kinase (MAPK) cascade. In this work, loss of CDC-48, an AAA+ ATPase, was observed to severely compromise SKN-1 …

Successful Transcatheter Mitral Valve Mass Extraction With Complete Resolution Of The Severe Mitral Regurgitation, Hussam Al Hennawi, Ahmad Abulshamat, Shaurya Srivastava, Mohammed Qintar

Abington Jefferson Health Papers

Interest has arisen in exploring the off-label application of left-sided percutaneous mechanical aspiration, where conventional management strategies may not suffice. Percutaneous mechanical aspiration has been shown to be effective as a diagnostic and therapeutic intervention in select patients with infective endocarditis. This paper hereby reports the first case of a successful transeptal large bore manual aspiration device (AlphaVac; Angiodynamics) for nonbacterial thrombotic endocarditis with total resolution of associated severe mitral valve regurgitation.

What Makes An Effective Chief Of Pediatric Cardiology: Insights From Chiefs Of North American Pediatric Programs, Michael E. Kim, Wayne Franklin, Anne M. Dubin, Jeffrey J. Kim, Shubhayan Sanatani, R. Krishna Kumar, Shubhika Srivastava, Thomas R. Kimball, Mark Lewin, Joseph Rossano, Colin J. Mcmahon

Department of Medicine Faculty Papers

BACKGROUND: Although the position of a pediatric cardiology chief is often seen as the apex of one's academic career, its roles, responsibilities, and qualifications are not well defined in the literature. This study was done to gain further insight of the role and attributes of a pediatric cardiology chief by surveying those who are currently serving the position across North American centers.

METHODS AND RESULTS: This was a mixed-methods study with a survey given to North American pediatric cardiology chiefs at programs with fellowship training programs. The survey was a semistructured questionnaire that was independently reviewed by 3 cardiologists. Smaller …

Activation Of A Gpcr, Orl1 Receptor: A Novel Therapy To Prevent Heart Failure Progression, Saliha S Pathan, Aarthi Pugazenthi, Beverly R E A Dixon, Theodore G Wensel, Todd K Rosengart, Megumi Mathison

Faculty, Staff and Students Publications

The number of ischemic heart failure (HF) patients is growing dramatically worldwide. However, there are at present no preventive treatments for HF. Our previous study showed that Gata4 overexpression improved cardiac function after myocardial infarction in rat hearts. We also found that Gata4 overexpression significantly increased the expression of a Pnoc gene, an endogenous ligand for the cell membrane receptor ORL1. We hypothesized that the activation of the ORL1 receptor would suppress HF in a rat ischemic heart model. Adult Sprague Dawley rats (8 weeks old, six males and six females) underwent left anterior descending coronary artery ligation. Three weeks …

Gpr56: Gpcr As A Guardian Against Ferroptosis, Yuelong Yan, Li Zhuang, Boyi Gan

Faculty, Staff and Student Publications

Transmembrane receptor proteins are proficient in sensing external signals and initiating downstream pathways to control cell survival. Lin et al. demonstrated that GPR56, a G-protein-coupled receptor, can be activated by its agonist to suppress ferroptosis-a form of cell death-and effectively mitigate ferroptosis-associated liver damage.

Mitral Annular Disjunction In Heritable Thoracic Aortic Disease: Insights From The Montalcino Aortic Consortium, Kishan L Asokan, Jennifer R Landes, Wannes Renders, Laura Muiño Mosquera, Julie De Backer, David W Jantzen, Anji T Yetman, Gisela Teixido-Tura, Arturo Evangelista, Richmond Jeremy, Edward G Jones, Shaine Morris, Tam Doan, Maral Ouzonian, Alan Braverman, Guillaume Jondeau, Olivier Milleron, Dianna M Milewicz, Siddharth K Prakash

Faculty, Staff and Student Publications

Background: Mitral annular disjunction (MAD), posterior displacement of the mitral valve leaflet hinge point, predisposes to arrhythmias or sudden cardiac death. We evaluated the burden of MAD, mitral valve prolapse (MVP), and mitral regurgitation (MR) by heritable thoracic aortic disease gene in a cross-sectional analysis of 2014-2023 data in the Montalcino Aortic Consortium registry.

Methods and results: MAD was determined by direct measurement of echocardiographic images. MR and MVP were defined according to current clinical guidelines. Associations were evaluated using χ2 or Fisher exact tests. MR and MVP were enriched in Montalcino Aortic Consortium participants (672) with pathogenic variants (PV) …

Gene Discovery From Microbial Gene Libraries I: Protection Against Reactive Oxygen Species-Driven Dna Damage, John C Taylor, Carmen Gu Liu, James D Chang, Brianna E Thompson, Anthony W Maresso

Faculty, Staff and Students Publications

Reactive oxygen species (ROS) pose a lethal risk for all life forms by causing damage to cell processes, genome-wide DNA damage-driving mutation, replicative instability, and death. Thus, the development of mechanisms to resist or repair ROS-induced DNA damage is critical for the reliable replication of nucleic acids. DNA repair and protection mechanisms have been discovered in all forms of life. However, the vast array of microbes that may harbor novel repair or protection mechanisms, especially bacterial viruses, have not been adequately assessed. Here, we screened a microbial gene library composed primarily of phage open reading frames (ORFs) to uncover elements …

Trends In Transcatheter Versus Surgical Aortic Valve Replacement Outcomes In Patients With Low-Surgical Risk: A Systematic Review And Meta-Analysis Of Randomized Trials, Sina Kazemian, Parisa Fallahtafti, Mohammad Sharifi, Negin Sadat Hosseini Mohammadi, Hamidreza Soleimani, Arman Soltani Moghadam, Elaheh Karimi, Yaser Sattar, Yaser Jenab, Mehdi Mehrani, Alimohammad Hajizeinali, Mina Iskander, Mehrshad Fathian Sabet, Negar Salehi, Karim Al-Azizi, Diaa Hakim, Mahboob Alam, Kaveh Hosseini

Faculty, Staff and Students Publications

Background: Limited data exist on long-term outcomes after transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR). This meta-analysis aims to elucidate outcome trends following TAVR versus SAVR in patients with severe aortic stenosis and low-surgical risk.

Methods and results: A systematic search was conducted in PubMed, Embase, Scopus, and the Cochrane Library databases from inception until May 2024, to identify studies comparing TAVR versus SAVR in patients with low-surgical risk (Society of Thoracic Surgeons predicted risk of mortality score < 4%). The primary outcome was all-cause mortality. Secondary outcomes included cardiovascular mortality, stroke, disabling stroke, rehospitalization, myocardial infarction, aortic valve reintervention, permanent pacemaker implantation, and new-onset atrial fibrillation. Binary random-effects models were used to compare the risk of each outcome across various follow-up intervals and the risk of bias was assessed using the Cochrane Collaboration's Risk of Bias-2 tool. The meta-analysis included 6 randomized trials including 4682 patients. TAVR was associated with a lower risk of all-cause mortality than SAVR in the 30-day (hazard ratio [HR: 0.45] [95% CI: 0.26-0.77], I2: 0%) and 30-day to 1-year (HR: 0.55 [95% CI: 0.37-0.81], I2: 16%) follow-ups. However, the …

White Matter Hyperintensities And Mild Tbi In Post-9/11 Veterans And Service Members, David F Tate, Erin D Bigler, Gerald E York, Mary R Newsome, Brian A Taylor, Andrew R Mayer, Mary Jo Pugh, Angela P Presson, Zhining Ou, Elizabeth S Hovenden, Josephine Dimanche, Tracy J Abildskov, Rajan Agarwal, Heather G Belanger, Aaron M Betts, Timothy Duncan, Blessen C Eapen, Carlos A Jaramillo, Michael Lennon, Jennifer E Nathan, Randall S Scheibel, Matthew B Spruiell, William C Walker, Elisabeth A Wilde

Faculty, Staff and Student Publications

Introduction: The neurobehavioral significance of white matter hyperintensities (WMHs) seen on magnetic resonance imaging after traumatic brain injury (TBI) remains unclear, especially in Veterans and Service Members with a history of mild TBI (mTBI). In this study, we investigate the relation between WMH, mTBI, age, and cognitive performance in a large multisite cohort from the Long-term Impact of Military-relevant Brain Injury Consortium-Chronic Effects of Neurotrauma Consortium.

Materials and methods: The neuroimaging and neurobehavioral assessments for 1,011 combat-exposed, post-9/11 Veterans and Service Members (age range 22-69 years), including those with a history of at least 1 mTBI (n = 813; median …

How Did Dat Happen? A Coombs Negative Delayed Hemolytic Transfusion Reaction In A Patient With Myelodysplastic Syndrome: A Case Report, Aniket Vijay Rao Dr, Aditya Sanjeevi, Daniel Jose Idoate, Nagesh Jadhav, Basil Verghese, Himal Kharel

Advances in Clinical Medical Research and Healthcare Delivery

Delayed hemolytic transfusion reactions (DHTRs) present significant challenges in diagnosis and management despite advancements in pre-transfusion testing. We report a case of a 76-year-old female with myelodysplastic syndrome (MDS) who developed severe hemolytic anemia following a seemingly compatible blood transfusion and appropriate pretransfusion testing. Evaluation revealed characteristics consistent with DHTR. Diagnostic uncertainty arose due to a negative Direct Antiglobulin Test (DAT) in the setting of a concomitant Vitamin B-12 deficiency. She was supported with prednisone and B12 supplementation. We discuss challenges in diagnosis, including the limitation of DAT, and propose strategies for comprehensive antibody identification. The case underscores the importance …

Could Sigmoid Diverticulitis, Drug-Induced Liver Injury, And Drug-Induced Pancreatitis Co-Occur?, Rutwik Pradeep Sharma, Ryan Tam, Michael Labuzetta, Richard Alweis

Advances in Clinical Medical Research and Healthcare Delivery

Sigmoid diverticulitis is a leading cause of gastrointestinal pathology etiology, which causes hospital admissions in Western society. Recent studies have shown its prevalence to be 1-4%. Drug-induced liver injury (DILI) is a primary cause of acute liver failure in the West^. The incidence of DILI is between 14-19 cases per 100,000 population. The prevalence of drug-induced pancreatitis (DIP) is 2-5%, although this is hard to estimate given the lack of large-scale studies. Sulfasalazine is a disease-modifying antirheumatic drug that is indicated for the treatment of chronic inflammatory diseases such as rheumatoid arthritis and ulcerative colitis. It has been associated …

Cardiac Arrest Following Svc Intravascular Stenting: A Case Report, Afrah Ali, Shahtaj Shah, Varun Mehta, Lubna Ziauddin, Asma Khan, Sameen Khurshid, Fawaz Ali

Advances in Clinical Medical Research and Healthcare Delivery

Superior vena cava (SVC) syndrome is a known collection of symptoms caused by obstruction of blood flow through the superior vena cava. Symptoms notably seen include difficulty breathing, coughing, hoarse voice, and swelling of the head, neck, and arm. It is most commonly seen secondary to malignancy from tumor infiltration of the vessel wall and is frequently associated with lung cancer due to anatomic location.

Treatment of SVC syndrome largely depends on severity of symptoms. While treatment of underlying cause is considered first line, intravascular stenting is also commonly considered in life threatening cases and for symptomatic relief.

We report …

From Infection To Encapsulation; A Case Report On Encapsulating Peritoneal Sclerosis, Clinical Challenges And Management, Sidra Memon Md, Jacob Seth Psomiadis Md, Syed Uzair Mahmood, Jennifer Hoffman Md

Advances in Clinical Medical Research and Healthcare Delivery

Encapsulating Peritoneal Sclerosis (EPS) is a rare but deadly sequlae of peritoneal dialysis resulting in intraperitoneal inflammation and fibrosis. The disease itself can present in a variety of ways and is associated with significant morbidity and mortality. Here we present the case of a man in his 50's with a history of chronic peritoneal aspergillus as well as end-stage renal disease on peritoneal dialysis that had multiple admissions for abdominal fluid collections as well as bowel obstruction. After a multidisciplinary approach, the patient was diagnosed with encapsulating peritoneal sclerosis and then started the recommended therapy of tamoxifen and prednisone.

Acute Mitral Regurgitation Presenting As Unilateral Pulmonary Edema, Jacob Seth Psomiadis, Austin Kim Md, Whitnee Otto Md, Kavitha Vemuri Md

Advances in Clinical Medical Research and Healthcare Delivery

Acute mitral regurgitation caused by papillary muscle rupture is a rare and life-threatening complication of myocardial infarction. This devastating complication can present as unilateral cardiogenic pulmonary edema which can be easily mistaken for other cardiopulmonary pathology, resulting in delay of care. Proper evaluation and diagnosis is key for obtaining timely surgical evaluation. Here we present a case of an 87-year-old male with a past medical history of coronary artery disease status post percutaneous intervention with one stent, cerebrovascular accident status post left carotid stenting, and Alzheimer’s dementia that presented to the emergency department with a chief complaint of exertional dyspnea …

Recurrent Deep Vein Thrombosis In May Thurner Syndrome Precipitated By Heparin Induced Thrombocytopenia: A Case Report And Review Of Literature, Abhishek Bhandari, Chengu Niu

Advances in Clinical Medical Research and Healthcare Delivery

May Thurner Syndrome involves the extrinsic compression of the left common iliac vein by the right common iliac artery, which predisposes to venous thrombosis. This case report and review of literature details a complex instance of recurrent Deep Vein Thrombosis (DVT) in a 58-year-old female patient with May Thurner Syndrome (MTS), exacerbated by Heparin-Induced Thrombocytopenia (HIT). The patient, post Coronary Artery Bypass Graft surgery, developed leg symptoms leading to the discovery of an extensive DVT from the calf veins to the external iliac vein. She was initially treated with heparin, which was switched to bivalirudin following a significant drop in …

Prevalence Of Serious Diagnoses And Disposition Among Older Adults Presenting With A Chief Complaint Of Constipation, A Retrospective Repeated Cross-Sectional Study, Ari B. Friedman, Michael N. Adjei-Poku, Rachel Gonzales, Rachel Kelz, Rachel R. Wu, Anne R. Cappola

Journal of Geriatric Emergency Medicine

A chief complaint of “constipation” in the emergency department (ED) is generally considered low-risk, and potentially suitable for lower acuity care. However, it may also indicate abdominal pain perceived as lower severity by triage staff, despite being relatively high-risk. We hypothesized that ED visits for constipation in older adults would more frequently result in the diagnosis of serious, treatable conditions compared to younger adults. We analyzed data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) over an 8-year period (2013-2020). Older adults with constipation were more likely to be non-Hispanic White. Among adults with constipation, 25.6% (95% CI: 22.8-28.4) …

Integrating Geriatric House Call Practice Into Paramedic Education: A Novel Educational Approach On Attitudes And Acceptance, Phillip D. Magidson, Mariah L. Robertson, Robby May, Mattan Schuchman, Eric Garfinkel, Matthew J. Levy

Journal of Geriatric Emergency Medicine

Objective: This study aimed to assess the feasibility and acceptance of integrating geriatric house call practice clinical exposure into paramedic education and to explore the impact on attitudes towards older adults among paramedic students.

Methods: Paramedic students from a fire department training program participated in a geriatric house call practice in collaboration with an academic health system. Pre- and post-program surveys were conducted to evaluate changes in attitudes towards older adults using the Ageing Semantic Differential (ASD) scale. Patient feedback on paramedic involvement was collected through post-visit surveys.

Results: Six paramedic students completed 25 house call visits over eight weeks. …

Health Outcomes Reported By Healthcare Providers And Clients Of A Community-Based Medically Tailored Meal Program, Jessica M. Sautter, Jule Anne Henstenburg, Adrian Glass Crafford, Ian Rowe-Nicholls, Victor S. Diaz, Kaitlyn Ann Bartholomew, Julia S. Evans, Maria R. Johnson, Jeffrey Zhou, Deeksha Ajeya

Department of Family & Community Medicine Faculty Papers

BACKGROUND: Medically tailored meal (MTM) programs provide home-delivered meals to people living with serious illness and poor nutritional status. Client outcome studies have found evidence of decreased healthcare utilization and cost savings associated with MTM program participation, and inconclusive evidence of change in health measures. The purpose of this study was to use a novel observational framework to describe the client profile and change in health outcomes using routinely collected health and program data from a community-based MTM program at MANNA (Philadelphia, PA).

METHODS: Clients reported their self-rated health and experiences of food insecurity and malnutrition. Healthcare providers reported clients' …

Differences In Brain Volume In Military Service Members And Veterans After Blast-Related Mild Tbi: A Limbic-Cenc Study, Emily L Dennis, Jared A Rowland, Carrie Esopenko, Nicholas J Tustison, Mary R Newsome, Elizabeth S Hovenden, Brian B Avants, Jessica Gill, Sidney R Hinds, Kimbra Kenney, Hannah M Lindsey, Sarah L Martindale, Mary Jo Pugh, Randall S Scheibel, Pashtun-Poh Shahim, Robert Shih, James R Stone, Maya Troyanskaya, William C Walker, Kent Werner, Gerald E York, David X Cifu, David F Tate, Elisabeth A Wilde

Faculty, Staff and Students Publications

Importance: Blast-related mild traumatic brain injuries (TBIs), the "signature injury" of post-9/11 conflicts, are associated with clinically relevant, long-term cognitive, psychological, and behavioral dysfunction and disability; however, the underlying neural mechanisms remain unclear.

Objective: To investigate associations between a history of remote blast-related mild TBI and regional brain volume in a sample of US veterans and active duty service members.

Design, setting, and participants: Prospective cohort study of US veterans and active duty service members from the Long-Term Impact of Military-Relevant Brain Injury Consortium-Chronic Effects of Neurotrauma Consortium (LIMBIC-CENC), which enrolled more than 1500 participants at 5 sites used in …

The Utilization Of Echocardiography In Children With Staphylococcus Aureus Bacteremia, Richard Bui, Lauren M Sommer, Meghan Walther, Kristina G Hulten, Jesus G Vallejo, Sheldon L Kaplan, J Chase Mcneil

Faculty, Staff and Students Publications

The need for echocardiography in pediatric Staphylococcus aureus bacteremia (SAB) remains uncertain. We reviewed 331 pediatric SAB cases. Nine subjects, all with comorbidities, met the echocardiogram criteria for infective endocarditis (IE). IE was associated with congenital heart disease and prolonged bacteremia, suggesting that echocardiography is unnecessary in most children with SAB.

Post-Artesunate Delayed Hemolysis In Pediatric Malaria Patients In The United States, Sesh A Sundararaman, Karen L Hanze Villavicencio, Brianne Roper, Ziyi Wang, Amy K F Davis, Jonathan A Mayhew, Michelle L Wang, Nina L Tang, Vijaya L Soma, Gail F Shust, Margaret E Feeney, Indi Trehan, Jill E Weatherhead, Chandy C John, Jeffrey S Gerber, Audrey R Odom John

Faculty, Staff and Students Publications

Post-artesunate delayed hemolysis (PADH) occurred in 6 of 24 children treated with artesunate for severe malaria in the United States; however, severe hemolysis requiring hospitalization or transfusion was rare. In children in the United States treated with artesunate, counseling, and symptom monitoring may be preferred to weekly laboratory surveillance for PADH.

Transport Of Β-Amyloid From Brain To Eye Causes Retinal Degeneration In Alzheimer’S Disease, Qiuchen Cao, Shige Yang, Xiaowei Wang, Huaiqing Sun, Weijie Chen, Yuliang Wang, Junying Gao, Yanchi Wu, Qiuhua Yang, Xue Chen, Songtao Yuan, Ming Xiao, Maiken Nedergaard, Yuqing Huo, Qinghuai Liu

Faculty, Staff and Students Publications

The eye is closely connected to the brain, providing a unique window to detect pathological changes in the brain. In this study, we discovered β-amyloid (Aβ) deposits along the ocular glymphatic system in patients with Alzheimer's disease (AD) and 5×FAD transgenic mouse model. Interestingly, Aβ from the brain can flow into the eyes along the optic nerve through cerebrospinal fluid (CSF), causing retinal degeneration. Aβ is mainly observed in the optic nerve sheath, the neural axon, and the perivascular space, which might represent the critical steps of the Aβ transportation from the brain to the eyes. Aquaporin-4 facilitates the influx …

Characterization Of Driver Mutations Identifies Gene Signatures Predictive Of Prognosis And Treatment Sensitivity In Multiple Myeloma, Jian-Rong Li, Abinand Krishna Parthasarathy, Aravind Singaram Kannappan, Shahram Arsang-Jang, Jing Dong, Chao Cheng

Faculty, Staff and Students Publications

In multiple myeloma (MM), while frequent mutations in driver genes are crucial for disease progression, they traditionally offer limited insights into patient prognosis. This study aims to enhance prognostic understanding in MM by analyzing pathway dysregulations in key cancer driver genes, thereby identifying actionable gene signatures. We conducted a detailed quantification of mutations and pathway dysregulations in 10 frequently mutated cancer driver genes in MM to characterize their comprehensive mutational impacts on the whole transcriptome. This was followed by a systematic survival analysis to identify significant gene signatures with enhanced prognostic value. Our systematic analysis highlighted 2 significant signatures, TP53 …

Nepali Oral Microbiomes Reflect A Gradient Of Lifestyles From Traditional To Industrialized, Erica P Ryu, Yoshina Gautam, Diana M Proctor, Dinesh Bhandari, Sarmila Tandukar, Meera Gupta, Guru Prasad Gautam, David A Relman, Ahmed A Shibl, Jeevan Bahadur Sherchand, Aashish R Jha, Emily R Davenport

Faculty, Staff and Student Publications

Background: Lifestyle plays an important role in shaping the gut microbiome. However, its contributions to the oral microbiome remain less clear, due to the confounding effects of geography and methodology in investigations of populations studied to date. Furthermore, while the oral microbiome seems to differ between foraging and industrialized populations, we lack insight into whether transitions to and away from agrarian lifestyles shape the oral microbiota. Given the growing interest in so-called "vanishing microbiomes" potentially being a risk factor for increased disease prevalence in industrialized populations, it is important that we distinguish lifestyle from geography in the study of microbiomes …

Genetic Risk Factors Underlying White Matter Hyperintensities And Cortical Atrophy, Yash Patel, Jean Shin, Eeva Sliz, Ariana Tang, Aniket Mishra, Rui Xia, Edith Hofer, Hema Sekhar Reddy Rajula, Ruiqi Wang, Frauke Beyer, Katrin Horn, Max Riedl, Jing Yu, Henry Völzke, Robin Bülow, Uwe Völker, Stefan Frenzel, Katharina Wittfeld, Sandra Van Der Auwera, Thomas H Mosley, Vincent Bouteloup, Jean-Charles Lambert, Geneviève Chêne, Carole Dufouil, Christophe Tzourio, Jean-François Mangin, Rebecca F Gottesman, Myriam Fornage, Reinhold Schmidt, Qiong Yang, Veronica Witte, Markus Scholz, Markus Loeffler, Gennady V Roshchupkin, M Arfan Ikram, Hans J Grabe, Sudha Seshadri, Stephanie Debette, Tomas Paus, Zdenka Pausova

Faculty, Staff and Student Publications

White matter hyperintensities index structural abnormalities in the cerebral white matter, including axonal damage. The latter may promote atrophy of the cerebral cortex, a key feature of dementia. Here, we report a study of 51,065 individuals from 10 cohorts demonstrating that higher white matter hyperintensity volume associates with lower cortical thickness. The meta-GWAS of white matter hyperintensities-associated cortical 'atrophy' identifies 20 genome-wide significant loci, and enrichment in genes specific to vascular cell types, astrocytes, and oligodendrocytes. White matter hyperintensities-associated cortical 'atrophy' showed positive genetic correlations with vascular-risk traits and plasma biomarkers of neurodegeneration, and negative genetic correlations with cognitive functioning. …

Dosimetric Comparison Of 3d Conformal And Vmat With Dibh For Right Breast Cancer, Lundie Cervantes

Masters Projects

This study explores the use of the Deep Inspiration Breath Hold (DIBH) technique in radiotherapy for right-sided breast cancer, comparing the dosimetric outcomes of 3D conformal radiation therapy (3DCRT) and volumetric modulated arc therapy (VMAT). Using a retrospective design, ten patients with prior left breast DIBH scans were analyzed to assess right breast radiation dose distributions to critical organs at risk (OARs), including the heart, lungs, liver, and contralateral breast. Each patient’s treatment plan was developed for both VMAT and 3DCRT using Varian Eclipse software.

The results show that 3DCRT significantly lowered mean heart dose (0.56 Gy vs. 1.26 Gy, …

Racial And Sociodemographic Disparities In The Use Of Targeted Therapies In Advanced Ovarian Cancer Patients With Medicare, Anne Knisely, Chi-Fang Wu, Alexa Kanbergs, Nuria Agusti, Kirsten A Jorgensen, Alexander Melamed, Sharon H Giordano, Jose Alejandro Rauh-Hain, Roni Nitecki Wilke

Faculty, Staff and Student Publications

Objective: To describe sociodemographic and racial disparities in receipt of poly ADP-ribose polymerase inhibitors (PARPi) and bevacizumab among insured patients with ovarian cancer.

Methods: This retrospective study used the Surveillance, Epidemiology, and End Results (SEER)-Medicare database to identify patients with advanced stage, high grade serous ovarian cancer diagnosed between 2010 and 2019. The primary outcome of interest was receipt of PARPi or bevacizumab at any time after diagnosis. χ2 tests were used to compare categorical variables. Factors independently associated with the receipt of PARPi and/or bevacizumab were identified using a multivariable logistic regression.

Results: The cohort included 6242 patients; 276 …