Medical Specialties Commons^™

Prevalence, Diagnostic Features, And Medical Outcomes Of Females With Turner Syndrome With A Trisomy X Cell Line (45, X/47, Xxx): Results From The Insights Registry, Natalia Klamut, Samantha Bothwell, Alexandra E Carl, Vaneeta Bamba, Jennifer R Law, Wendy J Brickman, Karen O Klein, Roopa Kanakatti Shankar, Catherina T Pinnaro, Patricia Y Fechner, Siddharth K Prakash, Iris Gutmark-Little, Susan Howell, Nicole Tartaglia, Marybel Good, Kelly C Ranallo, Shanlee M Davis

Faculty, Staff and Student Publications

Turner syndrome (TS) is defined by partial or complete absence of a sex chromosome. Little is known about the phenotype of individuals with TS mosaic with trisomy X (45,X/47,XXX or 45,X/46,XX/47,XXX) (~3% of TS). We compared the diagnostic, perinatal, medical, and neurodevelopmental comorbidities of mosaic 45,X/47,XXX (n = 35, 9.4%) with nonmosaic 45,X (n = 142) and mosaic 45,X/46,XX (n = 66). Females with 45,X/47,XXX had fewer neonatal concerns and lower prevalence of several TS-related diagnoses compared with 45,X; however the prevalence of neurodevelopmental and psychiatric diagnoses were not different. Compared to females with 45,X/46,XX, the 45,X/47,XXX group was significantly …

Characteristics Of High-Risk Bipolar Bone Loss Lesions Using 3-Dimensional Imaging, Petar Golijanin, Justin Arner, Claire Ryan, Qais Zai, Liam Peebles, Annalise Peebles, Phob Ganokroj, Ryan Whalen, Stephanie Eble, Danielle Rider, Srdjan Ninković, Matthew Provencher

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: The concept of on-track versus off-track bone lesions in glenohumeral instability continues to evolve. Although much has been ascertained from an original biomechanical model, bony pathological changes, especially on 3-dimensional (3D) imaging, have not been fully evaluated.

PURPOSE: To compare the differences in on-track versus off-track lesions to characterize glenoid and humeral head bone defects using 3D modeling software.

STUDY DESIGN: Cross-sectional study; Level of evidence, 3.

METHODS:A consecutive cohort of 75 patients with recurrent anterior instability, with evidence of Hill-Sachs lesions (HSLs) and
glenoid bone loss (GBL) and a mean age of 27.1 years (range, 18-48 years), were …

Association Of Common And Rare Variants With Alzheimer’S Disease In More Than 13,000 Diverse Individuals With Whole-Genome Sequencing From The Alzheimer’S Disease Sequencing Project, Wan-Ping Lee, Seung Hoan Choi, Margaret G Shea, Po-Liang Cheng, Beth A Dombroski, Achilleas N Pitsillides, Nancy L Heard-Costa, Hui Wang, Katia Bulekova, Amanda B Kuzma, Yuk Yee Leung, John J Farrell, Honghuang Lin, Brian W Kunkle, Adam Naj, Elizabeth E Blue, Frederick Nusetor, Dongyu Wang, Eric Boerwinkle, William S Bush, Xiaoling Zhang, Philip L De Jager, Josée Dupuis, Lindsay A Farrer, Myriam Fornage, Eden Martin, Margaret Pericak-Vance, Sudha Seshadri, Ellen M Wijsman, Li-San Wang, Alzheimer's Disease Sequencing Project;, Gerard D Schellenberg, Anita L Destefano, Jonathan L Haines, Gina M Peloso

Faculty, Staff and Student Publications

INTRODUCTION: Alzheimer's disease (AD) is a common disorder of the elderly that is both highly heritable and genetically heterogeneous.

METHODS: We investigated the association of AD with both common variants and aggregates of rare coding and non-coding variants in 13,371 individuals of diverse ancestry with whole genome sequencing (WGS) data.

RESULTS: Pooled-population analyses of all individuals identified genetic variants at apolipoprotein E (APOE) and BIN1 associated with AD (p < 5 × 10

DISCUSSION: We observed that complementary pooled-population and subgroup-specific analyses offered unique insights into the genetic architecture of AD.

HIGHLIGHTS: We determine the association of genetic variants with Alzheimer's disease (AD) using …

A Clinician’S Guide To Pediatric And Adolescent Alopecia Areata Treatments, Heli A. Patel, Rishab R. Revankar, Jenna E. Koblinski, Benjamin Ungar, Emma Guttman-Yassky, Jamie B. Mackelfresh, Dirk Elston, Peter Lio

Student Papers, Posters & Projects

Background: Available treatment options for pediatric alopecia areata are limited and may even exacerbate the physical and psychosocial burden. Objective: This article aimed to provide a treatment classification system and counseling recommendations. Recommendations: Topical corticosteroids are appropriate for initial treatment due to their ease of use and safety. Topical minoxidil and dithranol are often used as adjunctive treatments based on mixed data. Intralesional corticosteroids are effective for localized disease, but injections may be challenging in children. Contact immunotherapy, systemic corticosteroids, and immunosuppressive agents such as topical and oral Janus kinase (JAK) inhibitors, dupilumab, and low-dose methotrexate demonstrate varying effectiveness, adverse …

Obstructive Sleep Apnea And Obesity: How Weight Loss Improves Sleep Apnea Severity And Quality Of Life - An Integrative Review, Hannah Wilson, Neda Akbarshahi

Master's Projects

Introduction: With the growing prevalence of OSA due to the obesity epidemic, there is an urgent need to update treatment regimens. While CPAP continues to be the gold standard of OSA care, challenges with adherence and limited access to effective weight management strategies often impede care. The complex bidirectional relationship between obesity and OSA highlights the importance of addressing weight management in this patient population to help mitigate cardiometabolic risks. Personalized weight loss therapies should be integrated into standard OSA treatment regimens to reduce OSA severity, reduce comorbid conditions, and improve quality of life.

Aim: The objective of this integrative …

Hypoalbuminemia In Children With Acute Lymphoblastic Leukemia: Relation To Asparaginase Therapy And Impact On High Dose Methotrexate Elimination., Sophie Rex Christensen, Christina Friis Jensen, Jesper Heldrup, Zachary Taylor, Laura Ramsey, Steen Rosthøj

Manuscripts, Articles, Book Chapters and Other Papers

PURPOSE: High-dose methotrexate (HDMTX) therapy is an important component in treatment regimens for acute lymphoblastic leukemia (ALL). Courses are associated with a risk of renal injury, delayed elimination, and increased systemic toxicity. Recently hypoalbuminemia has been recognized as yet another risk factor.

METHODS: To examine the impact of serum albumin we reviewed 325 HDMTX 5 g/m2 courses in a cohort of 51 children treated on the NOPHO ALL 2008 protocol, dividing the courses into four groups with different levels of baseline albumin (A < 25 g/L, B 25-29 g/L, C 30-34 g/L and D ≥ 35 g/L).

RESULTS: Hypoalbuminemia was present in 51% of the courses, mostly in the early phases of chemotherapy while …

Azacitidine As Epigenetic Priming For Chemotherapy Is Safe And Well-Tolerated In Infants With Newly Diagnosed Kmt2a-Rearranged Acute Lymphoblastic Leukemia: Children's Oncology Group Trial Aall15p1, Erin M. Guest, John A Kairalla, Meenakshi Devidas, Emily Hibbitts, Andrew J. Carroll, Nyla A. Heerema, Holly R. Kubaney, Margaret A. August, Sidharth Ramesh, Byunggil Yoo, Midhat S. Farooqi, Melinda G. Pauly, Daniel S. Wechsler, Rodney R. Miles, Joel M. Reid, Cynthia D. Kihei, Lia Gore, Elizabeth A. Raetz, Stephen P. Hunger, Mignon L. Loh, Patrick A. Brown

Manuscripts, Articles, Book Chapters and Other Papers

Infants less than 1 year old diagnosed with KMT2A-rearranged (KMT2A-r) acute lymphoblastic leukemia (ALL) are at high risk of failure to achieve remission, relapse, and death due to leukemia, despite intensive therapies. Infant KMT2A-r ALL blasts are characterized by DNA hypermethylation. Epigenetic priming with DNA methyltransferase inhibitors increases the cytotoxicity of chemotherapy in preclinical studies. The Children's Oncology Group trial AALL15P1 tested the safety and tolerability of 5 days of azacitidine treatment immediately prior to the start of chemotherapy on day 6, in four post-induction chemotherapy courses for infants with newly diagnosed KMT2A-r ALL. The treatment was well-tolerated, with only …

What Is The Evidence? Updates In The Use Of Antenatal Corticosteroids For Patients At Risk Of Preterm Birth, Moti Gulersen, Cynthia Gyamfi-Bannerman

Department of Obstetrics and Gynecology Faculty Papers

Antenatal corticosteroids have long been considered one of the most important antenatal therapies available for pregnant patients at risk of preterm birth based on the associated reduction of neonatal morbidity and mortality following their administration. However, despite decades of research since their incorporation into routine clinical practice, a number of key questions related to antenatal corticosteroid use remain. These include evaluating the impact of antenatal corticosteroids at gestational ages outside of the previously recommended window of 24 0/7–33 6/7 weeks of gestation, determining factors associated with optimal steroid timing in order to reduce unnecessary exposure, alterations in its dosing regimen, …

Synthesis Of Photocleavable Molecules For Neurological Applications, Nishal Madujith Egodawaththa Arachchilage Don

Theses and Dissertations

In recent biomedical research, the precise control of molecular dynamics through light activation has emerged as a powerful tool, particularly in the field of neurobiology. This approach involves the use of photocleavable cages or photoprotective groups (PPGs) that are chemically tethered to biologically active molecules such as neurotransmitters or calcium chelators. These cages remain inert until exposed to specific wavelengths of light, typically in the visible range, triggering the release of the active compound with high spatiotemporal precision.

For neurotransmitter systems, such as glutamate (Glu), which plays a critical role in synaptic transmission and memory formation, researchers have developed novel …

Impact Of Prenatal Genomics On Clinical Genetics Practice, Roni Zemet, Ignatia B Van Den Veyver

Duncan NRI Faculty and Staff Publications

Genetic testing for prenatal diagnosis in the pre-genomic era primarily focused on detecting common fetal aneuploidies, using methods that combine maternal factors and imaging findings. The genomic era, ushered in by the emergence of new technologies like chromosomal microarray analysis and next-generation sequencing, has transformed prenatal diagnosis. These new tools enable screening and testing for a broad spectrum of genetic conditions, from chromosomal to monogenic disorders, and significantly enhance diagnostic precision and efficacy. This chapter reviews the transition from traditional karyotyping to comprehensive sequencing-based genomic analyses. We discuss both the clinical utility and the challenges of integrating prenatal exome and …

Whole Exome-Seq And Rna-Seq Data Reveal Unique Neoantigen Profiles In Kenyan Breast Cancer Patients, Godfrey Wagutu, John Gitau, Kennedy Mwangi, Mary Murithi, Elias Melly, Alexandra R. Harris, Shahin Sayed, Stefan Ambs, Francis Makokha

Pathology, East Africa

Background: The immune response against tumors relies on distinguishing between self and non-self, the basis of cancer immunotherapy. Neoantigens from somatic mutations are central to many immunotherapeutic strategies and understanding their landscape in breast cancer is crucial for targeted interventions. We aimed to profile neoantigens in Kenyan breast cancer patients using genomic DNA and total RNA from paired tumor and adjacent non-cancerous tissue samples of 23 patients.

Methods: We sequenced the genome-wide exome (WES) and RNA, from which somatic mutations were identified and their expression quantified, respectively. Neoantigen prediction focused on human leukocyte antigens (HLA) crucial to cancer, HLA type …

Responding To The Workforce Crisis: Consensus Recommendations From The Second Workforce Summit Of The American Society Of Pediatric Nephrology., Danielle E. Soranno, Sandra Amaral, Isa Ashoor, Meredith A. Atkinson, Gina-Marie Barletta, Michael C. Braun, Joann Carlson, Caitlin Carter, Annabelle Chua, Vikas R. Dharnidharka, Keri Drake, Elif Erkan, Dan Feig, Stuart L. Goldstein, David Hains, Lyndsay A. Harshman, Elizabeth Ingulli, Alexander J. Kula, Mary Leonard, Sudha Mannemuddhu, Shina Menon, Zubin J. Modi, Marva Moxey-Mims, Arwa Nada, Victoria Norwood, Michelle C. Starr, Priya S. Verghese, Darcy K. Weidemann, Adam Weinstein, Jodi Smith

Manuscripts, Articles, Book Chapters and Other Papers

IMPORTANCE: Pediatric patients with complex medical problems benefit from pediatric sub-specialty care; however, a significant proportion of children live greater than 80 mi. away from pediatric sub-specialty care.

OBJECTIVE: To identify current knowledge gaps and outline concrete next steps to make progress on issues that have persistently challenged the pediatric nephrology workforce.

EVIDENCE REVIEW: Workforce Summit 2.0 employed the round table format and methodology for consensus building using adapted Delphi principles. Content domains were identified via input from the ASPN Workforce Committee, the ASPN's 2023 Strategic Plan survey, the ASPN's Pediatric Nephrology Division Directors survey, and ongoing feedback from ASPN …

Development Of Novel Ionization Chambers For Reference Dosimetry In Electron Flash Radiotherapy, Kevin Liu, Shannon Holmes, Ahtesham Ullah Khan, Brian Hooten, Larry Dewerd, Emil Schüler, Sam Beddar

Faculty, Staff and Student Publications

Background: Reference dosimetry in ultra-high dose rate (UHDR) beamlines is significantly hindered by limitations in conventional ionization chamber design. In particular, conventional chambers suffer from severe charge collection efficiency (CCE) degradation in high dose per pulse (DPP) beams.

Purpose: The aim of this study was to optimize the design and performance of parallel plate ion chambers for use in UHDR dosimetry applications, and evaluate their potential as reference class chambers for calibration purposes. Three chamber designs were produced to determine the influence of the ion chamber response on electrode separation, field strength, and collection volume on the ion chamber response …

Association Of Late Eating With Colorectal Adenomas: A Cross-Sectional Study, Darbaz Adnan, Edena R Khoshaba, Mostafa Abel-Reheem, Jonathan Q Trinh, Yin Cao, Faraz Bishehsari

Faculty, Staff and Student Publications

Purpose: Colorectal cancer (CRC) is linked to lifestyle exposures. However, changes in the CRC rates among younger populations remain poorly understood and suggest the existence of yet unidentified factor(s) that may contribute to colon carcinogenesis. Here, we investigated the potential role of time of eating in the risk of pre-cancerous colonic neoplasms (tubular adenoma: TA).

Methods: We enrolled 663 participants undergoing screening colonoscopies. Data on food timing, dietary intake, sleep/wake patterns, and chronotype were collected through structured questionnaires. Late eating was defined as the consumption of food or snack within a 3-hour window of sleep onset for at least four …

A Comparison Of The 2022 Versus 2011 National Institute Of Child Health And Human Development Web-Based Risk Estimator For Bronchopulmonary Dysplasia., Mitch Kinkor, Jake Schneider, Farhath Sulthana, Janelle R. Noel-Macdonnell Phd, Alain Cuna

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: To compare the predictive accuracy of the 2022 vs 2011 National Institute of Child Health and Human Development estimator for identifying infants at high risk for bronchopulmonary dysplasia (BPD).

METHODS: We conducted a single-center retrospective study of infants ≤28 weeks' gestation. Demographic and respiratory support data were used to calculate risk for BPD or death by the BPD estimators. Our outcomes of interest included (1) treatment with systemic steroids for BPD and (2) composite outcome of death or highest severity of BPD at 36 weeks' postmenstrual age. We used c-statistics and area under receiver operator characteristic curves (AUC) to …

Glial Progenitor Heterogeneity And Plasticity In The Adult Spinal Cord, Haichao Wei, Jia Qian Wu

Faculty, Staff and Student Publications

No abstract provided.

Etiologies Of Bloody Diarrhea In Children Presenting With Acute Gastroenteritis To Us Emergency Departments., Paola Fonseca-Romero, Ben J. Brintz, D Matthew Vierkant, Jennifer Dien Bard, Daniel M. Cohen, Ara Festekjian, Amy L. Leber, Jami T. Jackson, Neena Kanwar, Chari Larsen, Rangaraj Selvarangan, Kimberle C. Chapin, Andrew T. Pavia, Sharia M. Ahmed, Daniel T. Leung, Impact Study Investigators

Manuscripts, Articles, Book Chapters and Other Papers

We used molecular testing to examine the causes of bloody diarrhea in a multicenter study of pediatric gastroenteritis. Pathogens typically associated with bloody diarrhea were detected in less than half of cases, and inappropriate antibiotic use was common, supporting the use of stool testing in patients with bloody diarrhea.

Why And When Do We Invasively Restage After Neoadjuvant Chemoimmunotherapy?, Jonathan D Spicer, Tina Cascone, Murry W Wynes, Karen L Kelly

Faculty, Staff and Student Publications

No abstract provided.

Mimicking Large Spot-Scanning Radiation Fields For Proton Flash Preclinical Studies With A Robotic Motion Platform, Fada Guan, Dadi Jiang, Xiaochun Wang, Ming Yang, Kiminori Iga, Yuting Li, Lawrence Bronk, Julianna Bronk, Liang Wang, Youming Guo, Narayan Sahoo, David R Grosshans, Albert C Koong, Xiaorong R Zhu, Radhe Mohan

Faculty, Staff and Student Publications

Previously, a synchrotron-based horizontal proton beamline (87.2 MeV) was successfully commissioned to deliver radiation doses in FLASH and conventional dose rate modes to small fields and volumes. In this study, we developed a strategy to increase the effective radiation field size using a custom robotic motion platform to automatically shift the positions of biological samples. The beam was first broadened with a thin tungsten scatterer and shaped by customized brass collimators for irradiating cell/organoid cultures in 96-well plates (a 7-mm-diameter circle) or for irradiating mice (1-cm

The Fletcher-Cox Pathway: A Unique View On Clinical Trial Education, Shalini Moningi, Shane Stecklein, Sonal Noticewala, Olsi Gjyshi, Todd Pezzi, David Boyce-Fappiano, Prajnan Das, Bruce Minsky, Emma B Holliday, Andrew J Bishop, Albert C Koong, Chelsea C Pinnix

Faculty, Staff and Student Publications

Purpose: There currently are no established formal mentorship and training programs for radiation oncology (RO) trainees to learn trial design, creation, writing, or implementation. There only exists informal training on analyzing clinical trials in RO residency programs. The integration of a longitudinal formal training and mentorship program for clinical trialists-consisting of clinical trial education, design, mentorship, and implementation during the RO residency education-will give residents not only formal teaching in the subject but also strong tools and requisite mentorship in hopes to help them succeed as future academic physicians and leaders in the field of RO.

Methods and materials: We …

Evaluating Pre-Consult Patient Education Videos For Patients With Newly-Diagnosed Anal Squamous Cell Carcinoma: Impact On Patient Comprehension, Satisfaction And Distress, Kelsey L Corrigan, Lauren M Andring, Prajnan Das, Cheryl Pfennig, Kimberly B Porter, Ethan B Ludmir, Sonal S Noticewala, Bruce D Minsky, Grace L Smith, Eugene J Koay, Albert C Koong, Angelica Arzola, Sarah J Lee, Lashon Nelms, Emma B Holliday

Faculty, Staff and Student Publications

We hypothesized that pre-consult patient education videos can improve patient understanding about their diagnosis, lead to high satisfaction and low distress. In this pilot study, we developed a patient education video curriculum for patients with newly-diagnosed anal cancer. Comprehension of key content was evaluated by comparing pre- and post-test scores. Patient satisfaction scores were collected. Patient distress scores (0-10) were collected at the beginning of their consult visit prior to seeing the physician. We found that patient education videos prior to consult improved patient understanding, resulted in high patient satisfaction, and low patient distress at the time of consult.

High Activity Of The New Myeloablative Regimen Of Gemcitabine/Clofarabine/Busulfan For Allogeneic Transplant For Aggressive Lymphomas, Jeremy Ramdial, Ruitao Lin, Peter F Thall, Benigno C Valdez, Chitra Hosing, Samer Srour, Uday Popat, Muzaffar Qazilbash, Amin Alousi, Melissa Barnett, Alison Gulbis, Terri Lynn Shigle, Elizabeth J Shpall, Borje S Andersson, Yago Nieto

Faculty, Staff and Student Publications

Refractory aggressive lymphomas can be treated with allo-SCT, pursuing a graft-vs-lymphoma effect. While reduced intensity conditioning is safe, tumors often progress rapidly, indicating the need for more active conditioning regimens. The preclinical synergy we saw between gemcitabine (Gem), clofarabine (Clo) and busulfan (Bu) against lymphoma cell lines led us to study Gem/Clo/Bu clinically. Eligibility: age 12-65, refractory aggressive B-NHL, T-NHL or Hodgkin, with a matched donor. Infusional Gem was dose-escalated on days (d) -6 and -4 (475-975 mg/m2/day), followed by Clo (40 mg/m2/day) and Bu (target AUC, 4000 μMol min/day) (d -6 to -3). CD20+ tumors received rituximab. GVHD prophylaxis …

Cutaneous T Cell Lymphoma Atlas Reveals Malignant Th2 Cells Supported By A B Cell-Rich Tumor Microenvironment, Ruoyan Li, Johanna Strobl, Elizabeth F M Poyner, Aya Balbaa, Fereshteh Torabi, Pavel V Mazin, Nana-Jane Chipampe, Emily Stephenson, Ciro Ramírez-Suástegi, Vijaya Baskar Mahalingam Shanmugiah, Louis Gardner, Bayanne Olabi, Rowen Coulthard, Rachel A Botting, Nina Zila, Elena Prigmore, Nusayhah H Gopee, Marta A Chroscik, Efpraxia Kritikaki, Justin Engelbert, Issac Goh, Hon Man Chan, Harriet F Johnson, Jasmine Ellis, Victoria Rowe, Win Tun, Gary Reynolds, Dexin Yang, April Rose Foster, Laure Gambardella, Elena Winheim, Chloe Admane, Benjamin Rumney, Lloyd Steele, Laura Jardine, Julia Nenonen, Keir Pickard, Jennifer Lumley, Philip Hampton, Simeng Hu, Fengjie Liu, Xiangjun Liu, David Horsfall, Daniela Basurto-Lozada, Louise Grimble, Chris M Bacon, Sophie C Weatherhead, Hanna Brauner, Yang Wang, Fan Bai, Nick J Reynolds, Judith E Allen, Constanze Jonak, Patrick M Brunner, Sarah A Teichmann, Muzlifah Haniffa

Faculty, Staff and Student Publications

Cutaneous T cell lymphoma (CTCL) is a potentially fatal clonal malignancy of T cells primarily affecting the skin. The most common form of CTCL, mycosis fungoides, can be difficult to diagnose, resulting in treatment delay. We performed single-cell and spatial transcriptomics analysis of skin from patients with mycosis fungoides-type CTCL and an integrated comparative analysis with human skin cell atlas datasets from healthy and inflamed skin. We revealed the co-optation of T helper 2 (TH2) cell-immune gene programs by malignant CTCL cells and modeling of the tumor microenvironment to support their survival. We identified MHC-II+ fibroblasts and dendritic cells that …

Anti-Programmed Death Ligand 1 Plus Targeted Therapy In Anaplastic Thyroid Carcinoma: A Nonrandomized Clinical Trial, Maria E Cabanillas, Ramona Dadu, Renata Ferrarotto, Maria Gule-Monroe, Suyu Liu, Bryan Fellman, Michelle D Williams, Mark Zafereo, Jennifer R Wang, Charles Lu, Matthew Ning, Brian A Mckinley, Scott E Woodman, Dzifa Duose, Gary B Gunn, Naifa L Busaidy, Rare Tumor Initiative Team

Faculty, Staff and Student Publications

Importance: Anaplastic thyroid carcinoma (ATC) is a rare and lethal cancer. Although progress has been made in recent years in patients with mutated BRAF tumors, those who respond initially eventually die of their disease; furthermore, there are no approved therapies for non-BRAF mutated tumors.

Objective: To determine whether treatment with matched-targeted therapy plus immune checkpoint inhibitors were associated with improved overall survival (OS).

Design, setting, and participants: A phase 2 trial at a single center, tertiary institution with parallel cohorts, assigning treatment with targeted therapy according to the tumor mutation status. Patients with mutated BRAF V600E tumors received vemurafenib/cobimetinib plus …

Ultra-Low-Dose Radiation For Extranodal Marginal Zone Lymphoma Of The Lung, Susan Y Wu, Penny Q Fang, Ahmed Fetooh, Gohar S Manzar, Kelsey L Corrigan, Benjamin R Schrank, Lewis Nasr, Dai Chihara, Luis E Malpica Castillo, Ranjit Nair, Raphael E Steiner, Preetesh Jain, Sattva S Neelapu, Paolo Strati, Loretta J Nastoupil, Bouthaina S Dabaja, Chelsea C Pinnix, Jillian R Gunther

Faculty, Staff and Student Publications

Purpose: Definitive intent radiation therapy (RT) for early-stage mucosa-associated lymphoid tissue (MALT) lymphoma typically includes a dose of 24 to 30 Gy. While modest, these doses may have associated toxicity. For patients with indolent B-cell lymphoma, there is increasing support for the use of ultra-low-dose RT (ULDRT) using 4 Gy in 2 fractions as part of a response-adapted approach, as high rates of complete response have been documented. This paradigm has been prospectively evaluated in the management of orbital and gastric indolent B-cell lymphomas; however, there is limited data guiding the use of ULDRT for lung MALT.

Methods: We conducted …

Increasing Safety Net Antibiotic Prescriptions For Acute Otitis Media In Urgent Care Clinics., Jennifer Mckinsey, Brian R. Lee, Donna Wyly, Holly Austin, Dinah Dosdos, Emily Murdock, Aimy Patel, Rana El Feghaly, Amanda Nedved

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: To evaluate the effectiveness of multifaceted interventions in improving the use of safety net antibiotic prescriptions (SNAPs) for nonsevere acute otitis media (AOM).

STUDY DESIGN: We used quality improvement methodology to develop iterative Plan-Do-Study-Act cycles to increase the use of SNAP for nonsevere AOM in 3 pediatric urgent care centers from October 2021 to June 2023. Interventions included education, electronic health record changes, audits and feedback, and a time-limited financial incentive. We measured the percentage of eligible patients with AOM offered SNAP as our primary outcome. Our secondary outcome measured the percentage of SNAPs accepted. Our process measure evaluated …

The Norwood With Blalock-Taussig-Thomas Shunt—Worth A Second Look?, Manasa Gadiraju, Dhaval Chauhan, Alexandra Schray, James O'Brien, Edo Bedzra

Manuscripts, Articles, Book Chapters and Other Papers

Background: Shunt repair for the Norwood procedure with either the right ventricle to pulmonary artery shunt (RVPAS) or the modified Blalock-Taussig-Thomas Shunt (BTTS) varies by institution and surgeon preference. Shunt choice has been informed by landmark trials including the Single Ventricle Reconstruction trial and modern outcomes data may engender future complementary studies. Methods: We conducted a retrospective analysis of all patients who underwent the Norwood procedure from 2014–2022 at a single center to compare outcomes by shunt type. The primary outcome measure was freedom from death or transplant. Secondary outcome measures included hospital length of stay, complications, and unplanned interventions. …

Impact Of The Adenosine Receptor A2br Expressed On Myeloid Cells On Immune Regulation During Pregnancy, Stefanie Dietz, Janine Hebel, Jessica Rühle, Alisha Huff, Holger K Eltzschig, Trim Lajqi, Christian F Poets, Christian Gille, Natascha Köstlin-Gille

Faculty, Staff and Student Publications

During pregnancy, the maternal immune system must carefully balance protection against pathogens with tolerance toward the semiallogeneic fetus. Dysfunctions of the immune system can lead to severe complications such as preeclampsia, fetal growth restriction, or pregnancy loss. Adenosine plays a role in physiological processes and plasma‐level increase during pregnancy. The adenosine receptor A2B (A2BR), which is expressed on both, immune and nonimmune cells, is activated by high adenosine concentrations, achieved during pregnancy. We investigated the impact of A2BR expressed on myeloid cells on immune regulation during pregnancy using a mouse model with myeloid deficiency for A2BR. We demonstrate systemic changes …

Improving The Clinical Meaning Of Surrogate Endpoints: An Empirical Assessment Of Clinical Progression In Phase Iii Oncology Trials, Alexander D Sherry, Timothy A Lin, Zachary R Mccaw, Esther J Beck, Ramez Kouzy, Joseph Abi Jaoude, Adina H Passy, Avital M Miller, Gabrielle S Kupferman, Clifton David Fuller, Charles R Thomas, Eugene J Koay, Chad Tang, Pavlos Msaouel, Ethan B Ludmir

Faculty, Staff and Student Publications

Disease progression in clinical trials is commonly defined by radiologic measures. However, clinical progression may be more meaningful to patients, may occur even when radiologic criteria for progression are not met, and often requires a change in therapy in clinical practice. The objective of this study was to determine the utilization of clinical progression criteria within progression-based trial endpoints among phase III trials testing systemic therapies for metastatic solid tumors. The primary manuscripts and protocols of phase III trials were reviewed for whether clinical events, such as refractory pain, tumor bleeding, or neurologic compromise, could constitute a progression event. Univariable …

The Spectrum Of Hematologic Neoplasms In Patients With Li-Fraumeni Syndrome, Yiannis Petros Dimopoulos, Wei Wang, Sa A Wang, Sanam Loghavi, Courtney D Dinardo, Yoheved Gerstein, Shimin Hu, Zhenya Tang, Charmaine Joyce Lim Ilagan, Beenu Thakral, Siba El Hussein, Jie Xu, Shaoying Li, Pei Lin, Keyur P Patel, Chi Young Ok, L Jeffrey Medeiros, Hong Fang

Faculty, Staff and Student Publications

No abstract provided.