Medical Specialties Commons^™

Cancer Screening Uptake And Usual Source Of Care Among Hispanic Survivors Of Adolescent And Young Adult Cancer, Eunju Choi, Amy M Berkman, Clark R Andersen, John M Salsman, Andrea C Betts, Joel Milam, Kimberly A Miller, Susan K Peterson, Qian Lu, Christabel K Cheung, Lauren V Ghazal, J A Livingston, Michelle A T Hildebrandt, Susan K Parsons, David R Freyer, Michael E Roth

Faculty, Staff and Student Publications

Purpose: This study examines cancer screening rates and the usual source of care among Hispanic survivors of adolescent and young adult (AYA, aged 15-39) cancer, a group at increased risk for poor health outcomes, including secondary cancers.

Methods: National Health Interview Survey data were analyzed to identify Hispanic survivors of AYA cancer and Hispanic age- and sex-matched non-cancer controls. Breast, cervical, and colorectal screening (ever screened and up-to-date according to the U.S. Preventive Services Task Force recommendations) as well as reporting a usual source of care were compared among survivors and controls eligible for screening using multivariable logistic regressions.

Results: …

Minimal Ablative Margin Quantification Using Hepatic Arterial Versus Portal Venous Phase Ct For Colorectal Metastases Segmentation: A Dual-Center, Retrospective Analysis, Noreen S Siddiqi, Yuan-Mao Lin, Jessica Albuquerque Marques Silva, Gregor Laimer, Peter Schullian, Yannick Scharll, Alexandra M Dunker, Caleb S O'Connor, Kyle A Jones, Kristy K Brock, Reto Bale, Bruno C Odisio, Iwan Paolucci

Faculty, Staff and Student Publications

Objective: To compare the predictive value of minimal ablative margin (MAM) quantification using tumor segmentation on intraprocedural contrast-enhanced hepatic arterial (HAP) versus portal venous phase (PVP) CT on local outcomes following percutaneous thermal ablation of colorectal liver metastases (CRLM).

Methods: This dual-center retrospective study included patients undergoing thermal ablation of CRLM with intraprocedural preablation and postablation contrast-enhanced CT imaging between 2009 and 2021. Tumors were segmented in both HAP and PVP CT phases using an artificial intelligence-based auto-segmentation model and reviewed by a trained radiologist. The MAM was quantified using a biomechanical deformable image registration process. The area under the …

Survival-Inferred Fragility Of Statistical Significance In Phase Iii Oncology Trials, Alexander D Sherry, Yufei Liu, Pavlos Msaouel, Timothy A Lin, Alex Koong, Christine Lin, Joseph Abi Jaoude, Roshal R Patel, Ramez Kouzy, Molly B El-Alam, Avital M Miller, Mohannad Owiwi, Jonathan Ofer, David Bomze, Zachary R Mccaw, Tomer Meirson, Ethan B Ludmir

Faculty, Staff and Student Publications

In phase III oncology trials, superiority is defined by statistical significance using P thresholds. However, this approach has been criticized because P is continuous. Here, we reconstruct patient-level data for 230 phase III oncology trials to model the robustness of statistical significance by estimating the survival-inferred fragility index (SIFI), defined as the smallest number of patients changing arms that alters the statistical significance interpretation. The median SIFI was 8 patients (IQR 4-19), representing 1.4% of enrollments (IQR 0.7%-3%). As a continuous statistic, P-but not the significance interpretation-was correlated with SIFI. Moreover, overall survival endpoints were more fragile than surrogate endpoints. …

Feasibility Of Manufacturing And Antitumor Activity Of Til For Advanced Endometrial Cancers, Yongliang Zhang, Kathleen N Moore, Amir A Jazaeri, Judy Fang, Ilabahen Patel, Andrew Yuhas, Patrick Innamarato, Nathan Gilbert, Joseph W Dean, Behzad Damirchi, Joe Yglesias, Rongsu Qi, Michelle R Simpson-Abelson, Erwin Cammaart, Sean R R Hall, Hequn Yin

Faculty, Staff and Student Publications

Lifileucel, a tumor-infiltrating lymphocyte (TIL) cell therapy approved for advanced melanoma, demonstrates promise for treating other solid tumors, including endometrial cancer (EC). The current study evaluates the feasibility of manufacturing TILs from EC tumors using Iovance’s proprietary 22-day Gen2 manufacturing process. Key parameters, including TIL yield, viability, immune phenotype, T-cell receptor clonality, and cytotoxic activity, were assessed. Of the 11 EC tumor samples processed at research scale, 10 (91%) successfully generated >1 × 109 viable TIL cells, with a median yield of 1.1 × 1010 cells and a median viability of 82.8%. Of the four EC tumor samples processed at …

Machine-Learning Driven Strategies For Adapting Immunotherapy In Metastatic Nsclc, Maliazurina B Saad, Qasem Al-Tashi, Lingzhi Hong, Vivek Verma, Wentao Li, Daniel Boiarsky, Shenduo Li, Milena Petranovic, Carol C Wu, Brett W Carter, Girish S Shroff, Tina Cascone, Xiuning Le, Yasir Y Elamin, Mehmet Altan, Simon Heeke, Ajay Sheshadri, Joe Y Chang, Percy P Lee, Zhongxing Liao, Don L Gibbons, Ara A Vaporciyan, J Jack Lee, Ignacio I Wistuba, Cara Haymaker, Seyedali Mirjalili, David Jaffray, Justin F Gainor, Yanyan Lou, Alessandro Di Federico, Federica Pecci, Mark Awad, Biagio Ricciuti, John V Heymach, Natalie I Vokes, Jianjun Zhang, Jia Wu

Faculty, Staff and Student Publications

Immune checkpoint inhibitors (ICIs), either as monotherapy (ICI-Mono) or combined with chemotherapy (ICI-Chemo), improves survival in advanced non-small cell lung cancer (NSCLC). However, prospective guidance for choosing between these options remains limited, and single-feature biomarkers like PD-L1 prove inadequate. We develop a machine learning model using clinicogenomic data from four cohorts (MD Anderson n = 750; Mayo Clinic n = 80; Dana-Farber n = 1077; Stand Up To Cancer n = 393) to predict individual benefit from adding chemotherapy. Benefit scores are calculated using five distinct functions derived from 28 genomic and 6 clinical features. Our integrated model, A-STEP (Attention-based …

Kids Exploring The World With Chatbots, Maggie Mckay, Mark Connelly

Parent-ish Podcast

Are your kids chatting away with AI? In this episode, we provide parents with the tools they need to understand the implications of children's interactions with chatbots. Find out what signs to look for and how to set healthy boundaries to protect your child from potential pitfalls of digital companionship.

Click here to stream the podcast episode.

Supporting Children In Managing Extracurricular Activities, Maggie Mckay, Simone Moody

Parent-ish Podcast

As the school year nears, so do busy schedules and the "extras" that kiddos do outside of school. While children love their sports, clubs and other extracurriculars, it can be hard to balance them with school and other important activities. Simone Moody, PhD, Clinical Psychologist at Children's Mercy in Kansas City, discusses signs your child might be overextended, how to find balance and more in this podcast.

Click here to stream the podcast episode.

Ibrutinib In Combination With Lenalidomide Revlimid/Dexamethasone In Relapsed/Refractory Multiple Myeloma (Aft-15)., Yvonne Efebera, Vera Suman, Shira Dinner, Taylor O'Donnell, Ashley Rosko, John Mckay, Peter Barth, Patrick Hagen, Saad Usmani, Paul Richardson, Jacob Laubach

Oncology Articles

BACKGROUND: Studies have suggested a synergism between lenalidomide (LEN) and ibrutinib (IBR) in multiple myeloma (MM). Both downregulate IRF4, a key target and master transcriptional factor regulating myeloma cell survival.

METHOD: A 3 + 3 phase I trial was conducted to determine the maximum tolerated dose (MTD) of IBR in combination with LEN + dexamethasone (DEX) in patients with relapsed/refractory (RR) MM who had at least one prior line of therapy. Three dose levels (DLs) were planned. The cycle length was 28 days. IBR was administered orally daily in doses of 560 mg on DL1-2 and 840 mg on DL3, …

Effects Of Oxygen Manipulation On Myofibroblast Phenotypic Transformation In Patients With Radiation-Induced Fibrosis, Eric Mastrolonardo, Sarah Sussman, Bo Yun, Victor Jegede, Dev Amin, Joel Rosenbloom, Andrew P. South, Voichita Bar-Ad, Peter J Wermuth, Adam J. Luginbuhl

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

We tested if hyperoxic conditions can reduce the proportion of active myofibroblasts, which are assumed to be a major driver of head and neck radiation-induced fibrosis, as measured by expression levels of pro-fibrotic genes. Radiated, non-cancerous soft tissue from the head and neck and skin/soft tissue from non-radiated flap donor site were collected from each patient. Myofibroblast density was quantified using immunofluorescence staining with α-SMA and DAPI and visualisation under confocal microscopy and compared between baseline non-radiated and radiated tissue from the same patient. From each tissue specimen, fibroblast cell lines were cultured and exposed to either normoxic, hypoxic, or …

Uncharted Territory: The First Case Of Cardiac Myxoma In A Patient With Nf2, Muhammad Sabri, Zinya Talukder, Naila Ijaz, Joseph Neri

Rothman Institute Papers

BACKGROUND: Cardiac myxoma is a benign tumor, typically originating in the left atrium, and is often linked to Carney complex. In our literature review, there are no case reports of cardiac myxoma in patients with neurofibromatosis type 2 (NF2).

CASE SUMMARY: A 60-year-old man presented with dizziness and was found to have meningioma and vestibular schwannoma, consistent with NF2. Cardiac myxoma was incidentally diagnosed through echocardiography and confirmed by cardiac magnetic resonance imaging and tissue pathology. The mass was surgically resected. The patient was offered genetic testing; however, he decided to not undergo further testing.

DISCUSSION: NF2 is an inherited …

Infectious Scleritis: A Comprehensive Narrative Review Of Epidemiology, Clinical Characteristics, And Management Strategies, Hamidreza Ghanbari, Masoud Rahimi, Ali Momeni, Kiana Hassanpour, Nikoo Bayan, Karen E. Lee, Alex Hansen, Ali R. Djalilian, Christopher J. Rapuano, Mohammad Soleimani

Wills Eye Hospital Papers

This study aims to provide an update on infectious scleritis (IS). A comprehensive search was conducted using Google Scholar, Scopus, and PubMed. IS is a rare but critical condition that presents significant diagnostic challenges and often leads to poor visual outcomes. It accounts for approximately 5%-10% of scleritis cases and warrants significant attention due to its delayed diagnosis. Ocular surgery is the primary contributor to IS, accounting for a substantial proportion of cases ranging from 58% to 83%, followed by trauma contributing to approximately 10% of cases. IS can be caused by various microorganisms, including bacteria (86%-87%), fungi (11%-13%), viruses, …

Understanding The Health And Social Determinants Of Health Needs Of Resettled Afghan Refugees In Houston, Texas, Karissa Chesky, Angelica Garcia, Aaron Pathak, Imran Humza Hanif, Srijana Shrestha, Sophia Banu

Faculty, Staff and Students Publications

Purpose

Methods

Improving Door-In-Door-Out Times For Stemi Transfer Patients: Impact Of A Protocolized Autolaunch Process, Hashim Zaidi, Waleed Kayani, Eric Power, Hei Kit Chan, Sini Eapen, Benjamin Karfunkle

Faculty, Staff and Students Publications

Background: The timely transfer of patients with ST-segment elevation myocardial infarction (STEMI) to percutaneous coronary intervention-capable centers is critical for improving outcomes. Although the American Heart Association recommends a door-in-door-out (DIDO) time of ≤30 minutes, national compliance remains low.

Project rationale: At Harris Health, no patients with STEMI met this benchmark before 2022. We implemented a quality improvement (QI) initiative, including an "Autolaunch" process, to expedite STEMI transfers.

Project summary: During 2022-2023, we introduced QI initiatives, including the Autolaunch protocol, for patients with unequivocal STEMI. This process included rapid emergency medical services activation, direct catheterization laboratory transfer, and prearrival cardiologist …

Effects Of Long Covid On Healthcare Utilization, Michael Gottlieb, Erica S. Spatz, Huihui Yu, Imtiaz Ebna Mannan, Michelle Santangelo, Caitlin Malicki, Nicole L. Gentile, Rachel E. Geyer, Alex Charlton, Jonathan W. Dyal, Joann G. Elmore, Kristyn Gatling, Mandy J. Hill, Juan Carlos C. Montoy, Kelli N. O'Laughlin, Kristin L. Rising, Sharon Saydah, Kari A. Stephens, Ralph C. Wang, Lauren E. Wisk, Arjun K. Venkatesh, Robert A. Weinstein

Jefferson Center for Connected Care Faculty Papers

BACKGROUND: While most research on Long COVID (LC) has focused on symptoms and quality of life, there remains a critical need to better understand the effect of LC on resource utilization. This study sought to determine the type and amount of healthcare utilization among participants with versus without LC.

METHODS: This was a secondary analysis of a prospective, longitudinal, multicenter U.S. study of adult participants with symptomatic COVID-19, confirmed with testing, who completed 3-month post-infection surveys and had electronic health record data for at least 180 days pre- and post-index testing. We excluded participants with any COVID-19 infections within the …

Adolescents' Use Of Music For Pain Management., Rebecca J. Lepping, Lora L. Black, Kymberly A. Kline, Deanna Hanson-Abromeit, Andrea L. Chadwick, Dustin Wallace, William R. Black

Manuscripts, Articles, Book Chapters and Other Papers

To investigate the experiences of adolescents with chronic pain who participated in an intensive interdisciplinary pain treatment program, this secondary study analyzes the themes that emerged regarding the spontaneous utilization of music in coping strategies for chronic pain. During research interviews focused on coping skills and treatment engagement, participants spontaneously reported using music as an effective coping strategy for managing pain. A deductive thematic analysis revealed key themes related to their usage, including using music as a distractor, motivator and in other ways as coping strategies. Since participants indicated that music is essential to their experiences of coping with pain, …

One-Year Clinical Outcomes In Patients With Acute Coronary Syndrome Treated With Clopidogrel Versus Prasugrel Versus Ticagrelor: Results Of The Polish Registry Of Acute Coronary Syndromes (Pl-Acs), Julia M. Umińska, Michał Skrzypek, Małgorzata Ostrowska, Piotr Adamski, Aldona Kubica, Piotr Niezgoda, Robert Gajda, Marek Gierlotka, Bartosz Hudzik, Wiktor Kuliczkowski, Diana A. Gorog, Paul A. Gurbel, Jolanta Siller-Matula, Łukasz Szarpak, Michael Savage, Grzegorz Skonieczny, Udaya Tantry, Przemysław Trzeciak, Eliano P. Navarese, Jacek Kubica, Mariusz Gąsior

Division of Cardiology Faculty Papers

BACKGROUND: Efficient dual antiplatelet therapy is crucial in reducing adverse cardiovascular events in patients with acute coronary syndrome (ACS). Comparative effectiveness between clopidogrel, prasugrel, and ticagrelor remains unclear in real-world settings.

AIMS: The objective was to evaluate one-year clinical outcomes in ACS patients treated with clopidogrel, prasugrel, or ticagrelor using data from the Polish Registry of Acute Coronary Syndromes (PL-ACS).

MATERIAL AND METHODS: This retrospective cohort study analyzed 381 278 ACS patients from the PL-ACS registry from 2009 to 2022, who were treated with clopidogrel, prasugrel, or ticagrelor during hospitalization with a 12-month consistent regimen. The primary outcome was one-year …

Comparing Dosimetric Outcomes Of Static Imrt And Vmat In Accelerated Partial Breast Irradiation For Medially Located, Left-Sided Tumor Beds, Rani Jamil

Masters Projects

Abstract

Introduction: Accelerated partial breast irradiation (APBI) has emerged as a targeted alternative to whole-breast irradiation for early-stage breast cancer, particularly for patients with medially located, left-sided tumors. Static intensity-modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) offer advanced dose conformity, yet no direct comparisons between static IMRT and VMAT have been conducted specifically for medially located, left-sided APBI, a uniquely challenging anatomical subgroup. This study evaluates dosimetric differences between static IMRT and VMAT plans to determine which modality provides superior target coverage and organ-at-risk (OAR) sparing in left-sided APBI.

Methods: Ten patients with medially located left-sided breast …

Constitutive Il-7 Signaling Promotes Car-Nk Cell Survival In The Solid Tumor Microenvironment But Impairs Tumor Control, Matthew Dysthe, Ishwar Navin, Dayenne Van Leeuwen, Josue Pineda, Corrine Baumgartner, Cliona M Rooney, Robin Parihar

Faculty, Staff and Students Publications

Background: Adoptive transfer of chimeric antigen receptor (CAR)-expressing natural killer (NK) cells has demonstrated success against hematological malignancies. Efficacy against solid tumors has been limited by poor NK cell survival and function in the suppressive tumor microenvironment (TME). To enhance efficacy against solid tumors, stimulatory cytokines have been incorporated into CAR-NK cell therapeutic approaches. However, current cytokine strategies have limitations, including systemic toxicities, exogenous dependencies, and unwanted TME bystander effects. Here, we aimed to overcome these limitations by modifying CAR-NK cells to express a constitutively active interleukin (IL)-7 receptor, termed C7R, capable of providing intrinsic CAR-NK cell activation that does …

The Histone H3 Lysine 36 Demethylase Kdm2a/Fbxl11 Controls Polycomb-Mediated Gene Repression And Germ Cell Development In Male Mice, Michael T Bocker, Grigorios Fanourgakis, Kristie Wetzel, Pavel A Komarov, Hélène Royo, Alexia Rohmer, Sunwoo Chun, Ching-Yeu Liang, Hubertus Kohler, Taiping Chen, Xiaohong Mao, Mark A Labow, Reginald A Valdez, Michael B Stadler, Dirk G De Rooij, Paola Capodieci, John Tallarico, Antoine H F M Peters, Thomas B Nicholson

Faculty, Staff and Student Publications

KDM2A/FBXL11 is a Jumonji-domain containing lysine demethylase catalyzing the removal of mono- and di-methyl modifications of histone H3 lysine 36 (H3K36me1/2). While Kdm2a is required for mouse embryogenesis, its role in adult physiology has been largely unexplored. Using conditional deletion approaches, we demonstrate that Kdm2a deficiency leads to testicular atrophy and male infertility. Although spermatogonial stem cells remain unaffected, proliferating and differentiating spermatogonia exhibit delayed cell cycle progression and apoptosis. RNA-sequencing of purified spermatogonia and spermatocytes reveals Kdm2a-dependent repression of over 750 genes during spermatogonial differentiation. Chromatin immunoprecipitation followed by sequencing (ChIP-seq) demonstrates increased H3K36me2 levels at CpG-rich gene promoters …

The Microtubule-Severing Enzyme Spastin Regulates Spindle Dynamics To Promote Chromosome Segregation In Trypanosoma Brucei, Thiago Souza Onofre, Qing Zhou, Ziyin Li

Faculty, Staff and Student Publications

Microtubule-severing enzymes play essential roles in diverse cellular processes, including mitosis and cytokinesis, by modulating microtubule dynamics. In the early branching Trypanosoma brucei, microtubule-severing enzymes are involved in cytokinesis and flagellum length control, but none of them have been found to regulate mitosis. Here we report the characterization of the microtubule-severing enzyme spastin in the procyclic form of T. brucei. We demonstrate that spastin severs microtubule in vitro and overexpression of spastin disrupts spindle microtubules in vivo in trypanosomes, leading to defective chromosome segregation. Knockdown of spastin impairs spindle integrity and disrupts chromosome alignment and segregation. We further show that …

Thyrotoxicosis In Pregnancy Cured By Total Thyroidectomy, Owen G. Alvine, Daniel Thum Md

Aesculapius Journal (Health Sciences & Medicine)

Thyrotoxicosis during pregnancy is a rare but potentially life-threatening condition that requires prompt recognition and management. This case report describes a 23-year-old pregnant woman with a history of Graves’ disease who presented with symptoms of thyrotoxicosis, including tachycardia, weight loss, and dyspnea. Initial treatment with propylthiouracil and propranolol was insufficient, and her condition progressed to include pericardial effusion with early tamponade physiology and systemic inflammatory response syndrome (SIRS). Despite medical therapy, her symptoms persisted, necessitating a total thyroidectomy during the second trimester. Postoperatively, the patient experienced significant clinical improvement and delivered a healthy infant at term. This case highlights the …

Impact Of Extended Reality On Robot-Assisted Surgery Training: A Systematic Review And Meta-Analysis, Michael Bickford, Fayez Alruwaili, Sara Ragab, Hanna Rothenberg, Mohammad Abedin-Nasab

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Robot-assisted surgeries (RAS) have an extremely steep learning curve. Because of this, surgeons have created many methods to practice RAS outside the operating room. These training models usually include animal or plastic models; however, extended reality simulators have recently been introduced into surgical training programs. This systematic review and meta-analysis was conducted to determine if extended reality simulators can improve the performance of robotic novices and how their performance compares to the conventional training of surgeons on surgical robots. Using the PRISMA 2020 guidelines, a systematic review was performed searching PubMed, Embase, Web of Science, and Cochrane library for studies …

Impact Of Posttransplant Cyclophosphamide-Based Gvhd Prophylaxis In Patients 70 Years And Older: An Update From Bmt Ctn 1703., Sameem Abedin, Michael J Martens, Javier Bolaños-Meade, Monzr M Al Malki, Qinghua Lian, Lyndsey Runaas, Hany Elmariah, Mahasweta Gooptu, Karilyn T Larkin, Brian C Shaffer, Alison W Loren, Melhem Solh, Amin M Alousi, Omer H Jamy, Miguel-Angel Perales, Andrew Rezvani, Ami Bhatt, Najla El Jurdi, Janny M Yao, Kristy Applegate, Leslie S Kean, Yvonne A Efebera, Ran Reshef, William Clark, Eric Leifer, Wael Saber, Mary M Horowitz, Richard J Jones, Shernan G Holtan, Mehdi Hamadani

Oncology Articles

Allogeneic hematopoietic cell transplant (allo-HCT) is underutilized in adults aged ≥70 years. Morbidity, often driven by graft-versus-host disease (GVHD), is considered a major barrier to its use. The BMT CTN 1703 trial (ClinicalTrials.gov identifier: NCT03959241) randomly assigned adults with hematologic malignancies undergoing allo-HCT after reduced intensity conditioning to receive either posttransplant cyclophosphamide, mycophenolate mofetil, and tacrolimus (PTCy) or tacrolimus and methotrexate (Tac/MTX) for GVHD prophylaxis. Overall study results revealed superior GVHD-free, relapse-free survival (GRFS) with PTCy-based prophylaxis. This analysis explored the impact of PTCy in patients aged ≥70 years enrolled in BMT CTN 1703. We analyzed outcomes for 96 patients …

Policy Review Of The Aha Clinical Practice Guideline For Congestive Heart Failure: Evaluating Best Practices, Brenda E. Garcia

Student Scholarly Projects

Practice Problem: Congestive heart failure (CHF) is a significant public health challenge that impacts various populations and contributes to rising hospital admission rates.

PICOT: The PICOT question that guided this scholarly project was: For healthcare policymakers and interprofessional teams (P), how does a policy review of the American Heart Association’s Clinical Practice Guidelines for Heart Failure (I), guided by the CDC’s Polaris Framework (C), conducted over a 12-week period (T), evaluate alignment with evidence-based practices and potential for adoption in the care of patients with congestive heart failure (O)?

Evidence: This scholarly project focused on reviewing the current clinical guidelines …

Act With Nmosd: A Targeted, Telehealth-Delivered Mental Health Intervention For Patients & Caregivers, Darcy C. Esiason, Patrick J. Smith, Charles L. Peppers, Emily Wakschal, Leigh Andrews, Chelsi N. Nurse, Hallie M. Kushner, Christopher F. Drescher, Heather Bruschwein, Wendy Erler, Tom Hattrich, Ankita Deshpande, Michael Levy, Thomas P. Leist, C. Virginia O'Hayer

Department of Psychiatry and Human Behavior Faculty Papers

PURPOSE: The rare, unpredictable, debilitating nature of neuromyelitis optica spectrum disorder (NMOSD) constitutes a unique psychological burden. This single-arm, pilot clinical trial examined the effectiveness of Acceptance and Commitment Therapy (ACT) tailored to meet the psychological burden of NMOSD, a brief telehealth-delivered intervention, targeting this burden.

METHODS: Forty-three adults with NMOSD (76 % aquaporin-4 seropositive (AQP4+)) in USA, with elevated anxiety and/or depression completed 6-weeks of an experiential talk therapy designed to increase psychological flexibility and valued action, specifically tailored to address the psychological burden of NMOSD: Acceptance and Commitment Therapy (ACT) w NMOSD. Patients attended via Zoom, along with …

Clinicopathologic Risk Factors For Post-Operative Complications After Enucleation Of Pancreatic Neoplasms, Isheeta Madeka, Steven Yi, Julia S. Evans, David Baek, Haresh V. Naringrekar, Harish Lavu, Charles J. Yeo, Avinoam Nevler, Wilbur B. Bowne

Kimmel Cancer Center Faculty Papers

BACKGROUND: Pancreatic enucleation is a parenchymal-sparing procedure used for highly select patients with pancreatic neoplasms. We aim to utilize a multi-institutional health research network platform (TriNetX) and a single, high-volume center to assess complications and identify risk factors associated with post-operative pancreatic fistulas (POPF) after pancreatic enucleation.

METHODS: A two-tiered retrospective study was conducted. We identified 423 patients from TriNetX, and 34 patients from a single-institution IRB-approved database who underwent pancreatic enucleation between 2004-2025 and 2012-2023, respectively. Univariate and multivariate analyses were performed to determine risk factors associated with post-operative complications and occurrence of POPFs.

RESULTS: In the TriNetX cohort, …

Amaurosis Fugax Progressing To Retinal Artery Occlusion With Anterior Migration Of A Retrobulbar Embolus On Orbital Color Doppler Imaging, Ari H. August, Turner D. Wibbelsman, Erik Massenzio, Sarah E. Thornton, Danijel J. Peričić

Wills Eye Hospital Papers

PURPOSE: Orbital color Doppler imaging (CDI) is useful in the evaluation of sudden monocular vision loss, providing information on etiology which may guide management. We present two cases of amaurosis fugax progressing to retinal artery occlusion (RAO) associated with migration of a hyperechoic particle within the central retinal artery (CRA) and altered vascular dynamics found on CDI.

OBSERVATIONS: Both patients presented with amaurosis fugax, and CDI revealed a hyperechoic particle 2.8 mm from the optic nerve head in both patients. Patient 1 was found to have severe aortic stenosis and a thoracic aortic aneurysm and was managed with dual antiplatelet …

A Whole-Brain Voxel-Based Analysis Of Structural Abnormalities In Ptsd: An Enigma-Pgc Study, Cheryl R Z See, Shuqing Si, C Lexi Baird, Courtney C Haswell, Ahmed Hussain, Miranda Olff, Dick J Veltman, Jessie L Frijling, Mirjam Van Zuiden, Saskia B J Koch, Laura Nawijn, Li Wang, Ye Zhu, Gen Li, Yuval Neria, Xi Zhu, Benjamin Suarez-Jimenez, Sigal Zilcha-Mano, Amit Lazarov, Jennifer S Stevens, Kerry Ressler, Negar Fani, Tanja Jovanovic, Sanne J H Van Rooij, Milissa L Kaufman, Lauren A M Lebois, Isabelle M Rosso, Elizabeth A Olson, Justin T Baker, Scott R Sponheim, Seth G Disner, Nicholas D Davenport, Amit Etkin, Adi Maron-Katz, Murray B Stein, Martha E Shenton, Dan J Stein, Jonathan Ipser, Sheri-Michelle Koopowitz, Soraya Seedat, Stefan Du Plessis, Leigh L Van Den Heuvel, Shmuel Lissek, Hannah Berg, Thomas Straube, David Hofman, Lee A Baugh, Gina L Forster, Raluca M Simons, Jeffrey S Simons, Vincent A Magnotta, Kelene A Fercho, Xin Wang, Andrew S Cotton, Erin N O'Leary, Hong Xie, Daniel W Grupe, Jack B Nitschke, Richard J Davidson, Christine L Larson, Terri A Deroon-Cassini, Carissa W Tomas, Jacklynn M Fitzgerald, Jennifer Urbano Blackford, Bunmi O Olatunji, Evan M Gordon, Geoffrey May, Steven M Nelson, Ruth Lanius, Jean Théberge, Maria Densmore, Richard W J Neufeld, Chadi G Abdallah, Christopher L Averill, Ilan Harpaz-Rotem, Ifat Levy, John H Krystal, Elbert Geuze, Remko Van Lutterveld, Emily L Dennis, David F Tate, David X Cifu, William C Walker, Elisabeth A Wilde, Nic J A Van Der Wee, Robert R J M Vermeiren, Steven J A Van Der Werff, Katie Mclaughlin, Kelly Sambrook, Matthew Peverill, Joaquim Radua, Lauren E Salminen, Neda Jahanshad, Sophia I Thomopoulos, Anthony James, Lucia Valmaggia, Paul M Thompson, Rajendra A Morey, Matthew J Kempton

Faculty, Staff and Students Publications

Background: Patients with posttraumatic stress disorder (PTSD) exhibit smaller regional brain volumes in commonly reported regions including the amygdala and hippocampus, regions associated with fear and memory processing. In the current study, we have conducted a voxel-based morphometry (VBM) meta-analysis using whole-brain statistical maps with neuroimaging data from the ENIGMA-PGC PTSD working group.

Methods: T1-weighted structural neuroimaging scans from 36 cohorts (PTSD n = 1309; controls n = 2198) were processed using a standardized VBM pipeline (ENIGMA-VBM tool). We meta-analyzed the resulting statistical maps for voxel-wise differences in gray matter (GM) and white matter (WM) volumes between PTSD patients and …

Fractional Flow Reserve From Coronary Ct: Evidence, Applications, And Future Directions, Arta Kasaeian, Mohadese Ahmadzade, Taylor Hoffman, Mohammad Ghasemi-Rad, Anoop Padoor Ayyappan

Faculty, Staff and Students Publications

Coronary computed tomography angiography (CCTA) has emerged as the leading noninvasive imaging modality for the assessment of coronary artery disease (CAD), offering high-resolution visualization of the coronary anatomy and plaque characterization. The development of fractional flow reserve derived from CCTA (FFR-CT) has further transformed the diagnostic landscape by enabling the simultaneous evaluation of both anatomical stenosis and lesion-specific ischemia. FFR-CT has demonstrated diagnostic accuracy comparable to invasive FFR. The combined use of CCTA and FFR-CT is now pivotal in a broad range of clinical scenarios, including the evaluation of stable and acute chest pain, assessment of high-risk and complex plaque …

No Evidence Of Pitavastatin Effect On Muscle Area Or Density Among People With Hiv, Kristine M Erlandson, Triin Umbleja, Heather J Ribaudo, Michael T Lu, Jana Taron, Marissa R Diggs, Pamela S Douglas, Kathleen V Fitch, Carl J Fichtenbaum, Markella V Zanni, Judith A Aberg, Maria C Rodriguez-Barradas, Katharine Breaux, Rosalba Gomez Morones, Craig A Sponseller, Judith S Currier, Gerald S Bloomfield, Sarah M Chu, Alex B Lu, Carlos D Malvestutto, Steven K Grinspoon, Todd T Brown

Faculty, Staff and Students Publications

Background: Skeletal muscle area (MA) and muscle density (MD) are key determinants of physical function and typically decline with increasing age. Statins have well-known musculoskeletal effects but whether statins impact MA or MD is not well established, especially in the setting of randomized treatment.

Methods: REPRIEVE is a double-blind randomized trial evaluating the effect of pitavastatin for primary prevention of major adverse cardiovascular events in people with HIV (PWH). Thoracic paraspinal, pectoralis, and infraspinatus MA and MD were assessed among Mechanistic Substudy participants with CT at baseline and month 24.

Results: Of 804 substudy participants, 510 remained on study treatment …