Oklahoma Health Sciences Center Research Articles

Tract-specific magnetization transfer ratio provides insights into the severity of degenerative cervical myelopathy.

Cross-sectional study. This study's goal is to report whether Magnetization Transfer Ratio (MTR) can evaluate the severity of white matter (WM) injury in degenerative cervical myelopathy (DCM). Laureate Institute of Brain Research, USA; Department of Neurosurgery, University of Oklahoma Health Sciences Center, USA. 27 DCM patients were aged-matched with 20 healthy controls (HC) and categorized into treatment groups based on modified Japanese Orthopedic Association (mJOA) severity (11 mild and 16 moderate/severe). Regional and tract MTRs were extracted from the two vertebral levels containing maximum compression within magnetization transfer images. MTR differences between groups were assessed using a one-way ANOVA or Kruskal-Wallis test. The association between MTR and mJOA measures was evaluated using Spearman's correlation. Significant decreases in MTR were found between HC and moderate/severe groups in the overall (p = 0.0065) and ventral (p = 0.0009) WM regions; and ventral corticospinal (p = 0.0101), ventral reticulospinal (p = 0.0084), spinal lemniscus (p = 0.0079), and fasciculus cuneatus (p = 0.0219) tracts. The spinal lemniscus MTR also significantly decreased between HC and mild groups (p = 0.038). Ventral reticulospinal tract MTR correlated with upper (r = 0.439; p = 0.022) and lower (r = 0.386; p = 0.047) limb motor mJOA scores. Significant tract-based MTR changes and correlations align with known DCM symptoms, are demonstrated to be lost at the regional level, and display the inhomogeneous compressive damage occurring within DCM spinal cords.

Abstract B124: Driving equity: Enhancing scientific workforce diversity through mentorship and grant writing workshops

Abstract A diverse scientific workforce fosters innovation, enhances global competitiveness, contributes to robust learning environments, improves the quality of research, advances the likelihood that historically underserved, or health disparity populations participate and benefit from health research, and enhances public trust. It isn’t merely their protected status that makes underrepresented minority scholars essential to a scientific workforce, but their culture, varying perspectives, creativity, and individual enterprise to address complex scientific problems. The Stephenson Cancer Center at the University of Oklahoma Health Sciences Center, in collaboration with the Oklahoma Center for Mentoring Excellence, has implemented a grant- writing-focused mentorship program, D.R.I.V.E. (Developing Research Initiatives through Versatile Oncology Exploration). This program is tailored to underrepresented scholars who are predoctoral, postdoctoral fellows, or early-stage investigators. Developed in response to the growing need for underrepresented minorities in cancer research, the program aims to provide participants with both theoretical knowledge and practical experience in the grant writing process. The primary objectives of the D.R.I.V.E. program is to 1) discover and promote talented underrepresented scholars and researchers in the fields of cancer and cancer health disparities research, 2) establish an early career investigator mentorship program with a strong emphasis on grant writing, and 3) utilize Training Navigators (TNs) to oversee and monitor the advancement and productivity of recently identified prospective pipeline scholars. The program serves ten mentees by providing a workshop series of interactive sessions, including discussions and lectures led by a professional with extensive experience in securing research funding, practical exercises, and collaborative activities. Each participant will have a grant application ready for submission by the end of the program. Participants also receive support through pairing with one of five faculty mentors (grant-funded oncology researchers) while utilizing Training Navigators to oversee and monitor the advancement and productivity of the pipeline scholars. A post-program survey was sent to all D.R.I.V.E participants (n = 10) as an effort to evaluate the program’s effectiveness. Initial results indicate significant improvements in participants' confidence and skills in the grant writing process. Of those who completed the post-program survey (n = 7), everyone (100%) indicated that the DRIVE program exceeded their expectations, and everyone (100%) found the DRIVE mentors to be highly helpful in providing guidance and support. While only 71% of participants deemed the Training Navigator to be beneficial, 85% recognized clear opportunities for future collaboration. In conclusion, the D.R.I.V.E. program offers a comprehensive and engaging approach to professional development in the field of cancer research. Future iterations of the program will explore expanded content to further enhance learning outcomes. Citation Format: J'Lecia G. Jones, Natasha Mickel. Driving equity: Enhancing scientific workforce diversity through mentorship and grant writing workshops [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B124.

Novel Eyelid Supraorbital Pretemporal Approach to the Anterior Communicating Artery Complex: A Quantitative Cadaveric Comparative Study

Abstract Objectives Access to the anterior communicating artery (ACom) complex may be achieved via the modified orbito-zygomatic (mOZ) or eyelid supraorbital (ES) approaches. Further, the ES approach may improve cosmesis at the cost of decreased exposure and maneuverability. Thus, a novel eyelid supraorbital pretemporal (ESP) approach, a combination of the ES approach with a pretemporal dissection, may optimize the shortcomings of the ES approach. Design This is a cadaveric study. Setting Five ES, ESP, and mOZ approaches were performed on cadaveric heads and compared. Participants Cadaveric specimens were provided under the University of Oklahoma Health Science Center's Willed Body Program. Main Outcome Measures Quantitative measures of exposure, maneuverability, and angles of attack in horizontal and vertical planes were compared between approaches. Results The ESP approach was superior in terms of exposure and deep maneuverability when compared with the ES approach (p < 0.01). In addition, this approach demonstrated superior angles of attack in vertical (p < 0.01) and horizontal (p = 0.045) planes. When compared with the mOZ approach, the ESP approach provided significantly greater exposure to the contralateral A2 (p < 0.01) with a less favorable horizontal angle of attack (p < 0.01). The ESP provides exact exposure to complete the pretemporal osteotomy, offering a unique perspective on the ACom complex. Conclusion When accessing the ACom complex, the ESP approach yields superior exposure and maneuverability compared with the ES approach and is comparable to the mOZ approach, with unique advantages provided by the addition of pretemporal osteotomy and dissection.

Safety and feasibility of outpatient CAR-T therapy: A single center analysis.

e19005 Background: Chimeric Antigen Receptor modified R Cell Immunotherapy (CAR-T) cell products have revolutionized the landscape of treatment of relapsed and refractory (R/R) B-cell malignancies and multiple myeloma. Yet, these therapies emerged with their own challenges, Cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) are the most common and serious adverse events. The model of CAR-T cell therapy in the University of Oklahoma is unique as it is designated as an outpatient therapy. Little is known regarding risk factors for hospitalization after CAR-T therapy. Methods: This is a retrospective analysis of all consecutive adult patients who had CAR-T therapy from 9/1/2019 through 9/30/2023 at the University of Oklahoma Health Sciences Center (OUHSC). Inclusion criteria were adult patients with hematologic malignancies who received an FDA approved CAR-T therapy. Exclusion criteria included patients who were younger than 18 at the time of infusion, those who received cellular therapy for solid tumors and those who received investigational CAR-T cell products. Descriptive statistics were created for continuous and categorical variables. Chi-Square analysis and independent samples t-tests were used to measure association with hospital admission and treatment response. Logistic regression was used to explore associations for all covariates with each outcome. SAS 9.4 was used to perform all analysis. An alpha of 0.05 was used to determine significance. Results: A total of 118 patients received outpatient CAR-T/Cellular therapy at OUHSC during the study period with 78 patients meeting the inclusion criteria. The mean age at time of infusion was 58.6 (range=18-85) with most being male (n=46, 59.0%), White (n=63, 80.8%), and overweight/obese (n=50, 64.1%). The majority of patients received anti CD19 CAR-T (n=64, 82.1%) while 18.0% received anti BCMA products. CRS grade 0,1 occurred in 79.5% of patients (n=62) and 79.2% of patients were hospitalized within 30 days after CAR-T therapy (Median day of admission post CAR-T=5.5). Of patients who were hospitalized 26% had grades 2-4 CRS. Complete remission was achieved in 54.7% of patients. We compared the hospitalized and non-hospitalized patients across multiple characteristics, there was no association or predictors of hospitalization found. Albumin was the only predictor for CR. Conclusions: Our study provides data for safety and feasibility of outpatient CAR-T therapy despite potential risks for hospitalization. There are no clear predictors for hospitalizations after CAR-T therapy except for the development of CRS and ICAN. Higher baseline (pre-CAR-T) serum Albumin level was associated with higher odds of achieving CR.

Identifying associations of human surfactant protein A SNPs and allelic variants with retinopathy of prematurity

Retinopathy of prematurity (ROP) is the primary cause of childhood blindness worldwide. Previous studies showed that allelic single nucleotide polymorphic (SNP) variants of the human surfactant protein A genes (SP-A1, SP-A2) are associated with the development of respiratory distress syndrome and bronchopulmonary dysplasia (BPD). In this work, we hypothesized that SP-A SNPs and allelic variants are associated with altered risk of ROP in prematurely born infants. To test this hypothesis, we used a modified PCR-based method to detect variants of the SP-A1 and SP-A2 genes in a cohort of preterm infants. Infants born at <32 weeks’ gestation and/or<1500 grams were enrolled. Scavenged blood samples or cheek swabs were collected and DNA was extracted using the QIAamp DNA Mini Kit. We measured SNPs in SP-A1 and SP-A2 using Taqman probes for allelic discrimination by PCR or PCR/RFLP/sequencing method. Associations of SP-A1 and SP-A2 SNP allele frequencies with ROP and BPD were determined using chi-square and logistic regression analyses. Our results show that, of the total patient cohort (n=59), 42 patients had a BPD diagnosis (23 with ROP and 36 without ROP). DNA analysis of these samples identified associations of SP-A1 and SP-A2 SNPs and variants with ROP. For SP-A1, the following SNP associations were found for ROP using chi-square: rs1059047 (p=0.44), rs1136450 (p=0.63), rs1136451 (p=0.21), rs1059057 (p=0.52). For SP-A2, the following SNPs associations were identified with ROP: rs1059046 (p=0.51), rs17886395 (p=0.050), rs1965707 (p=0.031), rs1965708 (p=0.46). Logistic regression analysis indicated an association of ROP with the SP-A1 6A2 variant (p-value = 0.47, OR (6A2/*)=0.8036, 95%CI [0.2299 - 2.8082], OR (6A2/6A2) = 0.4327, 95%CI [0.1063 - 1.7615]), which conferred protection, as well as an association of ROP with SP-A2 6A2 (p-value = 0.0055) with decreased risk when 1A2 variant is present. We conclude that SP-A1/SP-A2 polymorphisms are associated with the presence of ROP in infants with BPD. The 6A4 SP-A1 and SP-A2 1A2 appear to confer protection in babies against ROP. Further studies will determine the mechanisms of this protective effect. Indiana University, University of Chicago Metcalf Internship Program Grant, The University of Oklahoma Health Sciences Center. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Automated identification of atrial fibrillation from single-lead ECGs using multi-branching ResNet.

Introduction: Atrial fibrillation (AF) is the most common cardiac arrhythmia, which is clinically identified with irregular and rapid heartbeat rhythm. AF puts a patient at risk of forming blood clots, which can eventually lead to heart failure, stroke, or even sudden death. Electrocardiography (ECG), which involves acquiring bioelectrical signals from the body surface to reflect heart activity, is a standard procedure for detecting AF. However, the occurrence of AF is often intermittent, costing a significant amount of time and effort from medical doctors to identify AF episodes. Moreover, human error is inevitable, as even experienced medical professionals can overlook or misinterpret subtle signs of AF. As such, it is of critical importance to develop an advanced analytical model that can automatically interpret ECG signals and provide decision support for AF diagnostics. Methods: In this paper, we propose an innovative deep-learning method for automated AF identification using single-lead ECGs. We first extract time-frequency features from ECG signals using continuous wavelet transform (CWT). Second, the convolutional neural networks enhanced with residual learning (ReNet) are employed as the functional approximator to interpret the time-frequency features extracted by CWT. Third, we propose to incorporate a multi-branching structure into the ResNet to address the issue of class imbalance, where normal ECGs significantly outnumber instances of AF in ECG datasets. Results and Discussion: We evaluate the proposed Multi-branching Resnet with CWT (CWT-MB-Resnet) with two ECG datasets, i.e., PhysioNet/CinC challenge 2017 and ECGs obtained from the University of Oklahoma Health Sciences Center (OUHSC). The proposed CWT-MB-Resnet demonstrates robust prediction performance, achieving an F1 score of 0.8865 for the PhysioNet dataset and 0.7369 for the OUHSC dataset. The experimental results signify the model's superior capability in balancing precision and recall, which is a desired attribute for ensuring reliable medical diagnoses.

Correction: Sirpal et al. Association between Opioid Dependence and Scale Free Fractal Brain Activity: An EEG Study. Fractal Fract. 2023, 7, 659

Desiree R. Azizoddin PsyD from the TSET Health Promotion Research Center, Stephenson Cancer Center at the University of Oklahoma Health Sciences Center, USA, was not included as an author in the original publication [...]

Vascular mechanisms leading to progression of mild cognitive impairment to dementia after COVID-19: Protocol and methodology of a prospective longitudinal observational study.

Mild cognitive impairment (MCI) is a prodromal stage to dementia, affecting up to 20% of the aging population worldwide. Patients with MCI have an annual conversion rate to dementia of 15-20%. Thus, conditions that increase the conversion from MCI to dementia are of the utmost public health concern. The COVID-19 pandemic poses a significant impact on our aging population with cognitive decline as one of the leading complications following recovery from acute infection. Recent findings suggest that COVID-19 increases the conversion rate from MCI to dementia in older adults. Hence, we aim to uncover a mechanism for COVID-19 induced cognitive impairment and progression to dementia to pave the way for future therapeutic targets that may mitigate COVID-19 induced cognitive decline. A prospective longitudinal study is conducted at the University of Oklahoma Health Sciences Center. Patients are screened in the Department of Neurology and must have a formal diagnosis of MCI, and MRI imaging prior to study enrollment. Patients who meet the inclusion criteria are enrolled and followed-up at 18-months after their first visit. Visit one and 18-month follow-up will include an integrated and cohesive battery of vascular and cognitive measurements, including peripheral endothelial function (flow-mediated dilation, laser speckle contrast imaging), retinal and cerebrovascular hemodynamics (dynamic vessel retinal analysis, functional near-infrared spectroscopy), and fluid and crystalized intelligence (NIH-Toolbox, n-back). Multiple logistic regression will be used for primary longitudinal data analysis to determine whether COVID-19 related impairment in neurovascular coupling and increases in white matter hyperintensity burden contribute to progression to dementia.

Validation and Feasibility of the Postnatal Growth and Retinopathy of Prematurity Retinal Screening Criteria at a Level IV Tertiary Care Neonatal Intensive Care Unit.

Retinopathy of prematurity (ROP) is detected in preterm infants by standardized screening programs, but in general, they have poor sensitivity. The Postnatal Growth and Retinopathy of Prematurity (G-ROP) algorithm uses weight gain to predict ROP superior reported sensitivity. Our objectives are to (1) independently validate the sensitivity of G-ROP criteria for the detection of ROP in infants born at >28 weeks' gestation in a tertiary care unit in the United States and (2) to calculate the cost savings associated with a potential reduction in examinations. This is a retrospective analysis of retinal screening examination data, with post-hoc application of G-ROP criteria to determine whether G-ROP criteria had acceptable sensitivity and specificity in diagnosing Type 1 and Type 2 ROP. All infants born at >28 weeks who were screened by current American Academy of Pediatric Ophthalmologists/American Academy of Pediatrics guidelines at Oklahoma Children's Hospital at the University of Oklahoma Health Sciences Center, between 2014 and 2019, were included. Subset analysis of infants screened by second tier criteria was also performed. Potential cost savings were estimated by analyzing frequency of billing codes. And by calculating the number of infants who could have potentially been spared examination. The G-ROP criteria had 100% sensitivity in detecting type 1 and 87.6% sensitivity in detecting type 2 ROP, which would have reduced infants screened by 50%. All infants in the second tier who would require treatment were detected. A cost saving of 49% was projected. The G-ROP criteria are easy to apply in real-world setting, thus establishing feasibility. The algorithm identified all cases of type 1 ROP; however, some cases of type 2 ROP were not detected. The annual savings in hospital examination cost by using these criteria would be 50%. Therefore, G-ROP criteria can safely be used to screen for ROP and may reduce the number of unnecessary examinations. · The G-ROP screening criteria are safe and predict 100% of treatment warranted ROP.. · Adoption of G-ROP criteria is feasible for level IV NICUs.. · Adoption of G-ROP screening guidelines will result in significant cost savings..

Introducing Graduate Students in Biomedical Sciences to an Institutional Animal Research Program.

At the University of Oklahoma Health Sciences Center, graduate students enrolled in biomedical science programs comprise a significant portion of personnel working with research animals. Although the University requires that all personnel receive appropriate training before working with animals, veterinarians and research mentors agreed students would benefit from additional training. As a result, a course entitled "Laboratory Animal Use and Concepts" was added to the curriculum of the University's largest graduate program in biomedical sciences starting in 2017. The course introduces students to a number of topics relevant to the use of animals in biomedical research, with an emphasis on mice. Here we present a summary of the course and an assessment of its impact during the initial 5 y, from 2017-2021. Enrollment, student outcomes, and student evaluation surveys were included in this assessment. The course was offered to 6 classes totaling more than 120 students during this period. After completing the course, nearly 80% of students used animals as part of their graduate training. Among those, at least 21% sought additional training through formal workshops that offered supplemental opportunities to practice animal handling techniques. Student feedback suggested strong satisfaction with the course content and an appreciation for wet lab sessions. Providing enhanced training for incoming graduate students through this structured course appears to help students improve knowledge, skills, and attitudes that facilitate the responsible and ethical use of animals in biomedical research.

Hyper-Beveled Composite Skin Graft for Nasal Reconstruction.

Facial Plastic Surgery & Aesthetic MedicineAhead of Print Hyper-Beveled Composite Skin Graft for Nasal ReconstructionAniruddha C. Parikh, Robert Rhodes, Lacy S. Brame, and Ivan WayneAniruddha C. Parikh*Address correspondence to: Aniruddha C. Parikh, MD, Department of Otolaryngology—Head and Neck Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA. E-mail Address: aniruddhaparikh1@gmail.comhttps://orcid.org/0000-0002-1212-978XDepartment of Otolaryngology—Head and Neck Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.Search for more papers by this author, Robert Rhodeshttps://orcid.org/0000-0003-0646-567XW Facial Aesthetics, and Oklahoma State University Center for Health Sciences, Oklahoma City, Oklahoma, USA.Search for more papers by this author, Lacy S. BrameDepartment of Otolaryngology—Head and Neck Surgery, Oklahoma State University Center for Health Sciences, Oklahoma City, Oklahoma, USA.Search for more papers by this author, and Ivan WayneW Facial Aesthetics, and Oklahoma State University Center for Health Sciences, Oklahoma City, Oklahoma, USA.Search for more papers by this authorPublished Online:24 May 2023https://doi.org/10.1089/fpsam.2023.0021AboutSectionsView articleView Full TextSupplemental MaterialPDF/EPUBView Supplemental Data Permissions & CitationsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail View article"Hyper-Beveled Composite Skin Graft for Nasal Reconstruction." Facial Plastic Surgery & Aesthetic Medicine, , pp. FiguresReferencesRelatedDetails Volume 0Issue 0 InformationCopyright 2023, American Academy of Facial Plastic and Reconstructive Surgery, Inc.To cite this article:Aniruddha C. Parikh, Robert Rhodes, Lacy S. Brame, and Ivan Wayne.Hyper-Beveled Composite Skin Graft for Nasal Reconstruction.Facial Plastic Surgery & Aesthetic Medicine.ahead of printhttp://doi.org/10.1089/fpsam.2023.0021Online Ahead of Print:May 24, 2023PDF download

Expression of Concern. Shuangxi Wang, Jian Xu, Ping Song, Benoit Viollet, and Ming-Hui Zou. InVivo Activation of AMP-Activated Protein Kinase Attenuates Diabetes-Enhanced Degradation of GTP Cyclohydrolase I. Diabetes 2009;58:1893-1901. DOI: 10.2337/db09-0267. PMID: 19528375. PMCID: PMC2712774.

On the basis of the recommendation of the American Diabetes Association's (ADA's) Panel on Ethical Scientific Programs (ESP), the ADA, the publisher of Diabetes, is issuing this expression of concern to alert readers to the possible republication of images presented in the above-cited article. In particular, the GTPCH I panel in Fig. 2A, the β-actin panel in Fig. 2A, and the GTPCH I panel in Fig. 3A of this article are unexpectedly similar to the p67, β-actin, and Nox2 panels, respectively, of Fig. 6C of the now-retracted 2016 article cited below: Hu M, Lui B. Resveratrol via activation of LKB1-AMPK signaling suppresses oxidative stress to prevent endothelial dysfunction in diabetic mice. Clin Exp Hypertens 2016;38:381-387. DOI: 10.3109/10641963.2015.1131288. PMID: 27149559. Retraction in: Clin Exp Hypertens 2021;43:801. DOI: 10.1080/10641963.2018.1475654 In addition, the ESP has noted that within the article, the AMPK panel in Fig. 1A, the eNOS panel in Fig. 2A, and the β-actin panel in Fig. 5A, with adjustments to aspect ratios, also appear to be unexpectedly similar. In light of these concerns, the ADA has asked the University of Oklahoma Health Sciences Center, the corresponding author's institutional affiliation at the time the study was conducted, to investigate this matter. Diabetes is a member journal of the Committee on Publication Ethics (COPE) (publicationethics.org). As such, the editors of the journal and the ESP refer to COPE's guidelines and recommendations when reviewing such matters.

Statement of Retraction. Wencheng Zhang, Qilong Wang, Ping Song, and Ming-Hui Zou. Liver Kinase B1 Is Required for White Adipose Tissue Growth and Differentiation. Diabetes 2013;62:2347-2358. DOI: 10.2337/db12-1229. PMID: 23396401. PMCID: PMC3712073.

At the request of the University of Oklahoma Health Sciences Center (OUHSC), the above-cited article has been retracted. An OUHSC investigation into the integrity of the data presented in the article concluded that multiple Western blot images were falsified. The falsifications are described below.Lanes 2-5 of the Fig. 6A GAPDH Western blot were horizontally flipped and duplicated in the Fig. 6C GAPDH blot.Lanes 1 and 2 of the Fig. 6C IRS1 Western blot were horizontally flipped and duplicated in lanes 1 and 2 of the Fig. 6D IRS1 blot. The American Diabetes Association's (ADA's) Panel on Ethical Scientific Programs has also identified the following additional area of concern in the article cited above:The GAPDH panel in Fig. 4B and lanes 1-4 of the GAPDH panel in Fig. 5D appear to be duplicates, with minor size adjustments. More information about ADA's retraction policies and procedures can be found at https://diabetesjournals.org/content/journal-policies.

Long-term effects of COVID-19 on cerebrovascular function in patients with mild cognitive impairment

Background: Dementia is the sixth leading cause of death in United States and causes significant disability in the aging population. Therefore, conversion of mild cognitive impairment (MCI) to dementia, and conditions affecting conversion (e.g., hypertension), is of the utmost public health concerns. COVID-19 has had a profound effect on the aging population with increased risk of cognitive dysfunction and cerebrovascular complications following recovery of infection. We have strong preliminary data that suggest COVID-19 increases progression rate from MCI to dementia compared to MCI patients with no COVID-19 history (56% vs 23%, respectively, p=0.011). However, mechanisms contributing to these findings have yet to be elucidated. Normal brain function is reliant on endothelium dependent cerebromicrovascular dilation to provide sufficient oxygen and nutrients to active neurons (neurovascular coupling [NVC]). Thus, due to COVID-19’s deleterious effects on the cerebrovasculature and association with cognitive impairment, it is necessary to investigate vascular mechanisms that may contribute to COVID-19 induced cognitive dysfunction. Our central hypothesis is that COVID-19 induces systemic endothelial dysfunction, impairing NVC responses and contributing to increased progression of MCI to dementia. Methods: We are addressing the central hypothesis through prospective follow-up design, assessing systemic and cerebrovascular function at baseline and 18-month follow-up in MCI patients with and without history of COVID-19 infection. We will collect 200 participants over the course of 3 years and progression to dementia data will be measured by semiannual evaluation in the Department of Neurology at the University of Oklahoma Health Sciences Center. Assessment of endothelial function was measured by laser speckle contrast imaging and flow mediated dilation studies. NVC responses were measured with functional near-infrared spectroscopy during cognitive stimulation with n-back test.Preliminary results: Our preliminary results were collected at baseline from 3 MCI patients with no history of cerebrovascular complications (1 COVID + patient [77 years old, male]; 2 COVID - patients [55 and 65 years old, female]). COVID + patient showed significant attenuation of NVC responses and peripheral macro- and microvascular endothelial function compared to COVID - patients. Conclusion: Preliminary data suggest that NVC and peripheral macro- and microvascular endothelium may be impaired in MCI patients with history of COVID-19 diagnosis. Further investigation into the role that COVID-19 has on cerebrovascular function and conversion to dementia will enhance the understanding of predisposing factors that influence progression to dementia. These findings may uncover a mechanism for how COVID-19 affects cognitive function, paving the way for future therapeutic interventions targeting neurovascular uncoupling as a prominent feature in the conversion to dementia. American Heart Association (AHA834339), the National Institute on Aging of National Institutes of Health (R01AG075834), and the NIA-supported Geroscience Training Program in Oklahoma (T32AG052363) This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Assessing Biases in the Diagnosis of Psychogenic Non-Epileptic Spells (PNES) (P14-1.009)

<h3>Objective:</h3> Assessing types of biases in diagnosing psychogenic non-epileptic spells (PNES). <h3>Background:</h3> There is an established female predominance among patients diagnosed with PNES. While there have been neurobiological differences identified for this predominance, there lies the possibility of a misdiagnosis based on gender, increasing morbidity in these patients. Another survey found that African-Americans presenting with seizures are less likely to be admitted to the hospital or to undergo urgent neuroimaging compared to Caucasians, independent of insurance status. <h3>Design/Methods:</h3> A retrospective chart review was conducted at University of Oklahoma Health Sciences Center between January 2011 and December 2020 from electronic medical records (EMR). Patients greater than 5 years of age who were admitted to Epilepsy Monitoring Unit (EMU) were included and data regarding gender, race and education level was recorded using the REDCAP database system. <h3>Results:</h3> Of the 384 patients admitted to EMU, 62%(n=239) and 38 %(n=145) were women and men, respectively. 52%(n=122) of women were suspected to have PNES on initial visit out of which 50%(n=61) were concordant with both initial and EMU diagnosis of PNES. 36% (n=51) of men were suspected to have PNES in office out of which 43%(n=22) fell into the concordant group (agreement in initially suspected and final EMU diagnosis of PNES). 49%(n=66) Caucasians, 36%(n=5) African-Americans, 38%(n=8) patients with college level education and 27%(n=3) with elementary level education were in the concordant group. These differences were statistically significant in all of the aforementioned categories (McNemar’s Exact test, all p-values &lt;0.002). <h3>Conclusions:</h3> There appears to be a small but significant difference in diagnosis of PNES depending on gender, age and race. Further large multi-center studies are needed to evaluate the differences. Once such biases and health disparities are uncovered, we can identify and address them ensuring accurate diagnosis leading to treatment and management in a timely manner reducing morbidity for our patients. <b>Disclosure:</b> Dr. Bhutta has nothing to disclose. Dr. Bailey has nothing to disclose. Mr. Wolmarans has nothing to disclose. Dr. Mallum has nothing to disclose. Mr. Grunsted has nothing to disclose. Dr. Durica has nothing to disclose. Dr. Sebasigari has nothing to disclose.

Retraction of: Retraction of: Ablation of Adenosine Monophosphate-Activated Protein Kinase α1 in Vascular Smooth Muscle Cells Promotes Diet-Induced Atherosclerotic Calcification In Vivo.

HomeCirculation ResearchAhead of PrintRetraction of: Retraction of: Ablation of Adenosine Monophosphate-Activated Protein Kinase α1 in Vascular Smooth Muscle Cells Promotes Diet-Induced Atherosclerotic Calcification In Vivo Free AccessRetractionPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessRetractionPDF/EPUBRetraction of: Retraction of: Ablation of Adenosine Monophosphate-Activated Protein Kinase α1 in Vascular Smooth Muscle Cells Promotes Diet-Induced Atherosclerotic Calcification In Vivo Originally published22 Mar 2023https://doi.org/10.1161/RES.0000000000000606Circulation Research. 2023;0This article is retracted byRetraction of: Ablation of Adenosine Monophosphate-Activated Protein Kinase α1 in Vascular Smooth Muscle Cells Promotes Diet-Induced Atherosclerotic Calcification In VivoThe following Retraction Notice of a Circulation Research article is being retracted:Retraction of: Ablation of Adenosine Monophosphate-Activated Protein Kinase α1 in Vascular Smooth Muscle Cells Promotes Diet-Induced Atherosclerotic Calcification In Vivo. Circ Res. 2022;131:e151. doi: 10.1161/RES.0000000000000578In October 2022, the following Circulation Research article was retracted based on a request by the University of Oklahoma Health Sciences Center due to data irregularities and image reuse in Figure 3:Cai Z, Ding Y, Zhang M, Lu Q, Wu S, Zhu H, Song P, Zou MH. Ablation of Adenosine Monophosphate-Activated Protein Kinase α1 in Vascular Smooth Muscle Cells Promotes Diet-Induced Atherosclerotic Calcification In Vivo. Circ Res. 2016;119:422-33. doi: 10.1161/CIRCRESAHA.116.308301.Based on new information brought forward by Dr. Zhejun Cai, the University of Oklahoma Health Sciences Center revised its recommendation for the above article to correction instead of retraction.The editors are retracting this Retraction Notice in agreement with the University of Oklahoma. A separate Correction Notice has been published to update and correct Figure 3 in the original article. Previous Back to top Next FiguresReferencesRelatedDetailsRelated articlesRetraction of: Ablation of Adenosine Monophosphate-Activated Protein Kinase α1 in Vascular Smooth Muscle Cells Promotes Diet-Induced Atherosclerotic Calcification In VivoCirculation Research. 2022;131:e151-e151 Advertisement Article InformationMetrics © 2023 American Heart Association, Inc.https://doi.org/10.1161/RES.0000000000000606PMID: 36946882 Originally publishedMarch 22, 2023 PDF download Advertisement

Ferumoxytol: Another Exciting Addition to the Growing Field of Bone Marrow Imaging.

Ferumoxytol: Another Exciting Addition to the Growing Field of Bone Marrow Imaging.

Use of Aerosolized Prostacyclins in Critically Ill Patients and Association With Clinical Outcomes.

To compare the effects of inhaled epoprostenol and inhaled iloprost in critically ill patients with refractory hypoxia. We performed a retrospective cohort analysis of patients admitted to the ICUs at the University of Oklahoma Health Sciences Center between 2015 and 2018. Adult patients who received aerosolized epoprostenol or iloprost for more than 4 hours were included in the analysis. The primary endpoint measured was to compare the change in Pao2/Fio2 ratio between patients treated with iloprost compared with epoprostenol. Secondary outcomes measured were 90-day in-hospital mortality and improvement in vasopressor requirements. A total of 126 patients were included in the study, 95 of whom received iloprost (75%) and 31 patients (25%) received epoprostenol. There were significant improvements in Pao2/Fio2 ratio in both the iloprost and epoprostenol group. Patients in the epoprostenol group appeared to have a higher 90-day mortality compared with the iloprost group. However, our study was not powered to detect a mortality difference and this finding likely represents a sicker population in the epoprostenol group and prescription bias. The use of iloprost was associated with higher vasopressor requirements in the first 12 hours of administration, an association was not observed in the epoprostenol group. In this retrospective cohort analysis, use of both pulmonary vasodilators was associated with similar improvement in gas exchange. The mortality difference observed likely represents difference in severity of illness. Further studies are needed to corroborate these findings.

Abstract A101: Exploring facilitators and barriers to low-dose CT screening for lung cancer among Native American patients: The TEALS study

Abstract Purpose: Lung cancer screening (LCS) with low dose CT scanning reduces mortality but uptake of LCS is poor. Lung cancer mortality in Oklahoma’s Native American population is 45% higher than for the non-Hispanic White population. The Tribally Engaged Approaches to Lung Screening (TEALS) study is a collaboration between the University of Oklahoma Health Sciences Center and the Choctaw Nation of Oklahoma Health Services Authority (CNHSA). The goals of TEALS are to implement a systematic LCS program within Choctaw Nation and to understand LCS decision-making processes, barriers and facilitators. Procedures: Using purposive sampling from 2 of 8 CNHSA clinics in Oklahoma in 2021, we conducted a pilot study using phone interviews with patients who had completed LCS and those who had not. Using a semi-structured interview guide, we asked patients about their experience with the LCS program, factors that influenced their decision, and suggestions for improving the program. Conventional inductive content analysis was used to identify major themes. Multiple coders and peer debriefing enhanced scientific rigor. Results: Completers (4 men and 5 women) and non-completers (3 men and 3 women) were included. Major themes included: (1) Contextual factors influencing the decision-making process; (2) Individual characteristics influencing the decision-making process; and (3) Barriers to screening. Contextual factors included the provider raising the discussion of LCS, which was most frequently cited by completers but not the non-completers. Other contextual factors included the use of handouts and pamphlets during clinic visits. Patient suggestions included brochures/posters in waiting rooms and creating an information video to run on TVs in waiting areas. Individual characteristics included motivation to ‘be there’ for family/children, previous cancer in family/friends, and ease of arranging appointments. Non-completers preferred not to know or were scared to know the results of screening. Barriers included long distance travel to LCS sites, missing work, access to transportation or assistance, confusion about the appointment leading to missed appointments. Interviews highlighted the need to clarify eligibility criteria. Notably, some patients who were classified as ‘non-completers’ had already had a diagnostic CT for respiratory symptoms or as follow-up for prior cancer, indicating a gap in correctly identifying LCS eligibility. Conclusions: Findings from this pilot have guided implementation of the TEALS clinical trial. Large banners are now available in participating clinics. Academic detailing ensures the decision aid pamphlet is available and used in waiting rooms. Providers are reminded of the critical role they play in informing patients about LCS. Appointment reminders and assistance with transportation (e.g., tribal transportation) are in place. Eligibility criteria for the clinical trial have been clarified. Gathering this information from pilot study participants has enabled the team to refine the LCS intervention as it expands to other sites. Citation Format: Kathleen Dwyer, Dorothy A. Rhoades, Mark Doescher, Brook McCann, Michele Gibson, Zsolt Nagykaldi. Exploring facilitators and barriers to low-dose CT screening for lung cancer among Native American patients: The TEALS study [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr A101.

Impact of Short Term Focal Vibration Intervention On Upper Extremities In Chronic Stroke

<h3>Research Objectives</h3> To investigate the feasibility of a novel wearable focal vibration device in patients with stroke. <h3>Design</h3> Pre-post intervention trial. <h3>Setting</h3> College of Allied Health at the University of Oklahoma Health Sciences Center. <h3>Participants</h3> Convenience sample of five chronic stroke participants. <h3>Interventions</h3> Focal vibration for 10 minutes at the biceps, triceps, wrist flexors and proximal and distal wrist extensors. <h3>Main Outcome Measures</h3> Fugl-Meyer upper extremity (FMA-UE), Chedoke Arm-Hand Activity Inventory (CAHAI-7), grip strength, and qualitative survey. <h3>Results</h3> FMA-UE scores either increased or remained constant with a mean increase of 0.67. CAHAI-7 scores increased by a mean of 3.33. Grip strength decreased by an insignificant amount. Participants noted the device was comfortable and led to more normal tone in the upper extremity. <h3>Conclusions</h3> Based on initial results, short-term focal vibration intervention demonstrates promise for lowering spasticity and increasing function. Grip strength may have decreased due to lower levels of abnormal tone. Future studies will include a measure of spasticity since this device appears to assist with tone. Long-term home use of the device where the patient receives focal vibration a few days a week for several weeks may assist with tone, pain, and function. <h3>Author(s) Disclosures</h3> The authors have no disclosures.