Washington University School Of Medicine Research Articles

16.4 Genetic Factors Associated With Antipsychotic-Induced Weight Gain and Cardiometabolic Risk

Antipsychotic-induced weight gain (AIWG) contributes to the 20-year mortality gap between treated individuals and the general population. The Obesity Related to Antipsychotic Liability and Exposure (ORAcLE) genetics consortium is a partnership between Geisinger Health (MyCode, N > 1.8M), Icahn School of Medicine (BioMe, N = ∼30K), Regeneron Genetics Center, and Washington University School of Medicine. This presentation will review the methods and results to date.

Relationship between phenotypic features in Loeys-Dietz syndrome and the presence of intracranial aneurysms.

Loeys-Dietz syndrome (LDS) is a rare autosomal dominant condition characterized by aneurysms of the aorta, aortic branches, and intracranial arteries; skeletal and cutaneous abnormalities; and craniofacial malformations. Previous authors have reported that higher craniofacial severity index (CFI) scores, which indicate more severe craniofacial abnormalities, correlate with the severity of aortic aneurysm pathology. However, the association between syndromic features and the formation of intracranial aneurysms in LDS patients has yet to be determined. In this study, the authors evaluate the incidence of phenotypic abnormalities, craniofacial features, and Chiari malformation type I (CM-I) in a large LDS cohort and explore possible risk factors for the development of intracranial aneurysms. This was a retrospective cohort study of all patients with LDS who had been seen at the Marfan Syndrome and Aortopathy Center at Washington University School of Medicine in St. Louis in 2010-2022. Medical records were reviewed to obtain demographic, clinical, and radiographic data. The prevalence of craniofacial, skeletal, and cutaneous pathologies was determined. Bivariate logistic regression was performed to identify possible risk factors for the formation of an intracranial aneurysm. Eighty-one patients with complete medical records and intracranial vascular imaging were included in the analysis, and 18 patients (22.2%) had at least 1 intracranial aneurysm. Patients frequently demonstrated the thin or translucent skin, doughy skin texture, hypertelorism, uvular abnormalities, and joint hypermobility typical of LDS. CM-I was common, occurring in 7.4% of the patients. Importantly, the patients with intracranial aneurysms were more likely to have CM-I (22.2%) than those without intracranial aneurysms (3.2%). The mean CFI score in the cohort with available data was 1.81, with higher means in the patients with the TGFBR1 or TGFBR2 disease-causing variants (2.05 and 3.30, respectively) and lower in the patients with the SMAD3, TGFB2, or TGFB3 pathogenic variants (CFI < 1). No significant CFI difference was observed in patients with or without intracranial aneurysms (2.06 vs 1.74, p = 0.61). CM-I, and not the CFI, is significantly associated with the presence of intracranial aneurysms in patients with LDS. Surveillance for intracranial aneurysms is essential in all patients with LDS and should not be limited to those with severe phenotypes. Long-term monitoring studies will be necessary to determine whether a correlation between craniofacial abnormalities and adverse outcomes from intracranial aneurysms (growth, intervention, or rupture) exists.

Journal-related Activities and Other Special Activities at the 2022 American Society of Anesthesiologists Meeting

Journal-related Activities and Other Special Activities at the 2022 American Society of Anesthesiologists Meeting

Naltrexone: New Dosages and Uses for Pain and Inflammation

Dr. Swidan is Director, Professional Programming and Development, American Academy of Anti-Aging Medicine (A4M), Chicago, Illinois; Adjunct Associate Professor of Clinical Research and Leadership, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia; and Adjunct Clinical Associate Professor of Pharmacy, Wayne State University, Detroit, Michigan; 5204 Jackson Road, Suite C, Ann Arbor, MI 48103 E-mail [email protected]; and Dr. Frost is Clinical Professor of Anesthesiology, Icahn School of Medicine at Mount Sinai, New York, New York. Dr. Swiden is a speaker for Amgen and BioHaven. Lippincott CME Institute has identified and mitigated all relevant financial relationships. All other authors, planners, and staff have no relevant financial relationship with any ineligible organizations regarding this educational activity. This activity discusses the off-label use of low-dose naltrexone. CME Accreditation Lippincott Continuing Medical Education Institute, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Lippincott Continuing Medical Education Institute, Inc., designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. To earn CME credit, you must read the CME article and complete the quiz and evaluation assessment survey on the enclosed form, answering at least 70% of the quiz questions correctly. This CME activity expires on August 31, 2024. NCPD Accreditation Lippincott Professional Development is accredited as a provider of nursing continuing professional development (NCPD) by the American Nurses Credentialing Center's Commission on Accreditation. Lippincott Professional Development will award 2.0 contact hours for this NCPD activity. This activity has been assigned 2.0 pharmacology credits. This activity is also provider approved by the California Board of Registered Nursing, Provider Number CEP 11749 for 2.0 contact hours. Lippincott Professional Development is also an approved provider of continuing nursing education by the District of Columbia, Georgia, West Virginia, New Mexico, South Carolina, and Florida, CE Broker #50-1223. Your certificate is valid in all states. Instructions for earning ANCC contact hours are included on page 11 of the newsletter. This NCPD activity expires on September 5, 2025.

22nd Annual FAER-Helrich Research Lecture

Article| September 2022 22nd Annual FAER-Helrich Research Lecture George A. Mashour, MD, PhD George A. Mashour, MD, PhD Search for other works by this author on: This Site PubMed Google Scholar ASA Monitor September 2022, Vol. 86, 35. https://doi.org/10.1097/01.ASM.0000874280.79496.f1 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Cite Icon Cite Get Permissions Search Site Citation George A. Mashour; 22nd Annual FAER-Helrich Research Lecture. ASA Monitor 2022; 86:35 doi: https://doi.org/10.1097/01.ASM.0000874280.79496.f1 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentAll PublicationsASA Monitor Search Advanced Search Topics: michigan, professors, schools, medical, anesthesia, general, anesthetics, general, adult, care of intensive care unit patient, consultants, decision making, disclosure It is my great pleasure to announce that the 22nd Annual FAER-Helrich Research Lecture will be presented by Michael Avidan, MBBCh, FCA (SA), at ANESTHESIOLOGY 2022 in New Orleans, Louisiana. The FAER-Helrich Research Lecture recognizes outstanding scholarship by a scientist and is part of FAER's ongoing effort to encourage early-career anesthesiologists and trainees to consider careers in research and teaching. Dr. Avidan is currently the Dr. Seymour and Rose T. Brown Professor of Anesthesiology and Head of the Department of Anesthesiology at Washington University School of Medicine, as well as Anesthesiologist-in-Chief at Barnes-Jewish Hospital. Dr. Avidan was born in South Africa, earned his medical doctorate in 1991 from the University of Witwatersrand in Johannesburg, then completed his residency in anesthesiology and intensive care at the South African College of Medicine in 1996. Dr. Avidan thereafter served as a clinical lecturer from 1997 to 2000 in cardiothoracic anesthesiology and adult critical... You do not currently have access to this content.

Editorial introduction.

Current Opinion in Anesthesiology was launched in 1988. It is one of a successful series of review journals whose unique format is designed to provide a systematic and critical assessment of the literature as presented in the many primary journals. The field of anesthesiology is divided into 16 sections that are reviewed once a year. Each section is assigned a Section Editor, a leading authority in the area, who identifies the most important topics at that time. Here we are pleased to introduce the Section Editors for this issue. SECTION EDITORS Vesna Jevtovic-TodorovicVesna Jevtovic-TodorovicVesna Todorovic is the inaugural CU Medicine Endowed Chair and Chair of the Department of Anesthesiology at the University of Colorado School of Medicine, USA. Dr Todorovic received her graduate education at the University of Belgrade, Serbia (MD) and the University of Illinois, Chicago (PhD), USA and completed residency training in anesthesia at the Washington University School of Medicine in St. Louis, USA. She earned an MBA from the University of Virginia, Charlottesville, Virginia, USA and received the Harold Carron Professor of Anesthesiology Endowment from the University of Virginia Health System during her time on the faculty there. Dr Todorovic is a practicing anesthesiologist and has been working simultaneously as a clinician scientist for over 25 years. Dr Todorovic has developed three major lines of research: anesthetics as neurotoxins, the management of chronic pain and the mechanisms of anesthesia-induced developmental neurodegeneration. Dr Todorovic's research is federally funded and has resulted in over 140 peer-reviewed publications and 11 patents. She has received numerous grants from organizations such as the National Institute of Health, March of Dimes, the American Heart Association and the American Diabetes Association. Dr Todorovic served as the Chair of the National Institute of Health's Surgery, Anesthesiology and Trauma study section. She also serves on the Editorial Board for the Journal of Neurosurgical Anesthesiology and the Associate Editorial Board for British Journal of Anaesthesia. In addition, she serves as an Associate Editor for Anesthesiology. Dr Todorovic was a member of the Board of Directors for the International Society for Anaesthetic Pharmacology from 2007 and served as the Chairman in 2015. In her role as a PI, Dr Todorovic has mentored and trained over 60 graduate students, medical students and post-docs. As Chair of the Department of Anesthesiology, her focus extends to the mentorship and growth of junior faculty, expanding clinical programs, increasing collaboration with the School of Medicine and surrounding community. Richard D. UrmanRichard D. UrmanRichard D. Urman, MD, MBA, FASA is a staff anesthesiologist at the Brigham and Women's Hospital Department of Anesthesiology, Perioperative and Pain medicine in Boston, Massachusetts, USA and Associate Professor of Anesthesia at Harvard Medical School, USA, where he also received his MD and MBA degrees. He serves as Associate Chair for Dana-Farber Cancer Institute, Boston, Massachusetts, USA, and as a Medical Director for Procedural Sedation Services at the Brigham and Women's Hospital. In addition, he is the founding co-Director of the Center for Perioperative Research and the Director of the Perioperative Medicine Fellowship. He has edited a dozen textbooks, including the one on non-operating room anesthesia (NORA) entitled Anesthesia Outside the Operating Room (Cambridge Press, 2018) and has published papers on NORA safety, efficiency and outcomes. He is currently funded by the NIH, NSF, AHRQ and the industry. His research interests include pharmacology, acute pain management, patient safety and efficiency in the perioperative and periprocedural setting. He also serves as the scientific reviewer for the Department of Defense and sits on the FDA Analgesics panel. He is on the editorial boards of the Journal of Clinical Anesthesia and Anesthesia & Analgesia. Dr Urman is active in the Society for Ambulatory Anesthesia, where he serves as Assistant Treasurer and member of the executive committee. He is also Treasurer of the Society for Perioperative Assessment and Quality Improvement (SPAQI) and Treasurer of the Association of Anesthesia Clinical Directors (AACD).

Editorial introductions

Editorial introductions

FDA Clears First In Vitro Assay to Improve Alzheimer’s Diagnosis

Back to table of contents Previous article Next article Clinical & ResearchFull AccessFDA Clears First In Vitro Assay to Improve Alzheimer’s DiagnosisNick ZagorskiNick ZagorskiSearch for more papers by this authorPublished Online:22 Jul 2022https://doi.org/10.1176/appi.pn.2022.08.7.15AbstractThe assay, which measures the ratio of two forms of amyloid protein, was cleared through the FDA’s De Novo premarket review, a regulatory pathway for low- to moderate-risk devices of a new type.The Food and Drug Administration (FDA) has cleared for marketing the first diagnostic laboratory test to aid in the diagnosis of Alzheimer’s disease. The Lumipulse G β-Amyloid Ratio (1-42/1-40) test, manufactured by Fujirebio Inc., is intended for use in adults aged 55 years and older who present with cognitive impairment.The test measures two variants of the amyloid beta protein in cerebrospinal fluid (CSF). A positive result suggests that a patient likely has amyloid plaques in the brain—a hallmark feature of Alzheimer’s disease.Amyloid plaques can be identified definitively only with positron emission tomography (PET) brain scans—a process that is time consuming, expensive, and exposes people to radiation. A lumbar puncture to acquire CSF, though potentially uncomfortable, is cheaper than a PET scan and can usually be performed on an outpatient basis.“A lot of people are looking ahead to blood-based Alzheimer’s biomarkers, but the CSF will always be a better source than plasma, because it has a direct connection with the brain,” said Anne Fagan, Ph.D., a professor of neurology at Washington University School of Medicine and the Fluid Biomarker Core Leader of Washington University’s Knight Alzheimer Disease Research Center. Fagan, who has received research support from Fujirebio and other diagnostic companies, says she has used Lumipulse assays in her Alzheimer’s research studies and found them to be easy to work with and reliable.“With this test now available, I think that more patients will get an early confirmation of an Alzheimer’s diagnosis,” said Henrik Zetterberg, M.D., Ph.D., a professor of neurochemistry at the University of Gothenburg in Sweden. Zetterberg, who also studies Alzheimer’s biomarkers, noted that an early diagnosis can give patients more time to try treatments that may slow cognitive decline and prepare for the future.There are, however, limits to what the Lumipulse test can tell patients and their physicians, Fagan said.“This is not giving you a diagnosis of Alzheimer’s; it’s giving a diagnosis of amyloidosis.” She noted that amyloid buildup is associated with other neurodegenerative disorders, such as Lewy body dementia. In addition, many people can develop amyloid plaques and not yet have the associated neurodegeneration that would lead to dementia, she said.The FDA noted that the results of the Lumipulse test should be interpreted in conjunction with other clinical information before any diagnoses are made.The FDA cleared the Lumipulse test following a study of CSF samples from 292 older adults participating in the Alzheimer’s Disease Neuroimaging Initiative. In this clinical study, 97% of adults with a positive Lumipulse test had amyloid plaques in their brains as confirmed by PET scan, while only 16% of adults with a negative Lumipulse test had confirmed amyloid plaques. The low rate of false positive results in the study suggests that those scanned with the test are unlikely to be incorrectly diagnosed with amyloid plaques, which could result in unnecessary treatments and psychological distress. False negative test results could lead to potential delays in diagnosis.Zetterberg said that as other CSF assays come to market, the testing process will become even more comprehensive, which may enhance accuracy and/or uncover the specific underlying disorder. “That’s another advantage of CSF testing; it is very versatile. One can screen for numerous different biomarkers in the same sample,” he said. “With a PET scan, you can see amyloid and only amyloid.”Both Zetterberg and Fagan believe PET scans still have use in clinical settings. “Scans have drawbacks, but they do give a spatial representation of the amyloid buildup, which may impact clinical decision-making,” Fagan said. ■ResourcesThe FDA Statement on the Clearance of the Lumipulse G β-Amyloid Ratio (1-42/1-40) test ISSUES NewArchived

Adapting and Developing an Academic and Community Practice Collaborative Care Model for Metastatic Breast Cancer Care (Project ADAPT): Protocol for an Implementation Science-Based Study.

BackgroundMetastatic breast cancer (MBC) remains incurable despite significant treatment advances. Coordinating care for patients with MBC can be challenging given the various treatment options, available clinical trials, and frequent need for ancillary services. To optimize MBC care, we designed a project for adapting and developing an academic and community practice collaborative care model for MBC care (Project ADAPT), based on the Ending Metastatic Breast Cancer for Everyone (EMBRACE) program developed at Dana Farber Cancer Institute.ObjectiveWe aim to describe the implementation science–based study design and innovative components of Project ADAPT.MethodsProject ADAPT uses the Dynamic Adaptation Process informed by the Exploration, Preparation, Implementation, Sustainment framework. Washington University School of Medicine (WUSM) partnered with 3 community hospitals in the St. Louis region covering rural and urban settings. The exploration and preparation phases provide patient and provider feedback on current referral practices to finalize the approach for the implementation phase. At the implementation phase, we will enroll patients with MBC at these 3 community sites to evaluate potential collaborative care at WUSM and assess the impact of this collaborative care model on referral satisfaction and acceptability for patients with MBC and their providers. Patients may then return to their community site for care or continue to receive part of their care at WUSM. We are incorporating virtual and digital health strategies to improve MBC care coordination in order to minimize patient burden.ResultsThe exploration phase is ongoing. As of August 2021, we have recruited 21 patient and provider participants to complete surveys of the current collaborative care process at WUSM. Using a 2-tailed paired t test, 44 patients (including 10 patients from the exploration phase) and 32 oncologists are required to detect an effect size of 0.5 with 80% power at a level of significance of .05. Throughout this phase and in preparation for the implementation phase, we have iteratively updated and refined our surveys for the implementation phase based on testing of our data collection instruments. Our partner sites are in various stages of the single institutional review board (IRB) approval process. We have ongoing engagement with all partner sites, which has helped solidify our participant recruitment strategies and design patient-friendly recruitment materials. In addition, we have included a patient advocate on the research team. Members of the research team have launched a single IRB Support Network at WUSM to create a repository of the single IRB procedures in order to streamline the partner site onboarding process and facilitate enhanced collaboration across institutions.ConclusionsWith this robust model, we expect that patients with MBC will receive optimal care regardless of geographical location and the model will improve patient and provider experiences when navigating the health system.International Registered Report Identifier (IRRID)DERR1-10.2196/35736

Shattering Glass Ceilings: Three Black Women Surgeons Ascend to Chairs of Departments of Surgery.

Shattering Glass Ceilings: Three Black Women Surgeons Ascend to Chairs of Departments of Surgery.

James C. Harris, MD (1940-2021).

Sadly, Dr.James C. Harris passed away at his home in April 2021, peacefully and in the presence of his loving wife Catherine DeAngelis, MD, shortly after he was diagnosed with pancreatic cancer. He was born in Birmingham, Alabama, and received his medical degree in 1966 from the George Washington University School of Medicine in Washington, DC. This followed a year of internship at the Children's Hospital of Los Angeles in California and a residency in Pediatrics at Strong Memorial Hospital University of Rochester in New York State. He came to Johns Hopkins as a Senior Assistant Resident in Pediatrics in 1972, and it is then that Hopkins became his professional home, which he never left. He proceeded to complete his general psychiatry residency and child and adolescent psychiatry fellowship at Johns Hopkins as well. Dr.Harris was Professor of Psychiatry and Behavioral Sciences, and of Pediatrics, former Director of Child and Adolescent Psychiatry, founding director of the Developmental Neuropsychiatry Program at Hopkins and the Kennedy Krieger Institute, and a beloved mentor to so many of today's leaders in child and adolescent psychiatry. Jim was indeed a distinguished clinician, educator, scholar, investigator, and advocate; he was also my training director, mentor, and friend.

Abstract 2206: Pilot phase I clinical trial of RANKL inhibition and breast tissue gene expression in high-risk premenopausal women with dense breasts

Abstract Background: Identifying pathways that can be targeted to reduce breast density and breast cancer incidence is an unmet need, especially in premenopausal women. Receptor activator of nuclear factor-κB ligand (RANKL) signaling mediates the major proliferative response of mammary epithelium to progesterone and is positively associated with breast density but there are no clinical trial data on the impact of RANKL inhibition on breast tissue markers in women with dense breasts. We, therefore, determined the impact of RANKL inhibition on breast tissue gene expression in high-risk premenopausal women with dense breasts. Study design: Pilot phase I clinical trial of 9 healthy high-risk pre-menopausal women (≥35 years of age) with dense breasts performed at Washington University School of Medicine, St. Louis, MO from July 2018-December 2018. Fifty-five percent of participants had a positive family history of breast cancer in a first degree relative. Intervention: Participants were given a single dose of subcutaneous RANKL antibody, denosumab (60mg), at baseline (Day 1). On the same day, prior to the denosumab injection, participants had an ultrasound guided core needle biopsy and a blood draw. All study participants returned for repeat core needle biopsy and blood draw after 60 days (Day 60). Outcome Measures: Changes in breast tissue gene expression between Day 1 and Day 60 with a focus on immune/inflammatory and hormone markers. Gene expression was profiled using NanoString nCounter platform. We performed pathway enrichment analysis and used Cell Maker Enrichment library from EnrichR to identify differentially expressed genes. Genes with a p-value&amp;lt;0.05 on differential expression analysis were considered statistically significant for utilization in pathway enrichment analysis. Libraries utilized for pathway enrichment using the EnrichR platform included the ChEA transcription factor library, GO Biological Process library, and Cellular Components library. Results: Macrophage markers, including CCR5, CD86, CD300A, and CD84 and targets downstream of IRF8: (p-value =4.73e-7), neutrophil degranulation/neutrophil activation in the immune response (p-value=6.0e-21), and the secretory granule membrane pathways (p-value=2.4e-14) were downregulated in breast tissues on Day 60. Pathways involved in progesterone metabolism (p-value=0.0003), estrogen response (p-value=0.0014) and fatty acid metabolism, (p-value=0.0001) were significantly upregulated on Day 60. Specifically, genes involved in steroid hormone metabolism such as DHRS2 (p-value=3.13e-05), and AKR1B15: p-value=4.12e-05) were upregulated on Day 60. Conclusions: A single 60 mg dose of subcutaneous denosumab injection was associated with alterations in pathways involved in hormone, immune and inflammatory signaling in the breast tissues of healthy premenopausal women with dense breasts. Citation Format: Michael Waters, Kay Jayachandran, Debbie Bennet, Jin Zhang, Katherine Weilbaecher, Ian S. Hagemann, Graham A. Colditz, Catherine M. Appleton, Adetunji T. Toriola. Pilot phase I clinical trial of RANKL inhibition and breast tissue gene expression in high-risk premenopausal women with dense breasts [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 2206.

A Medical Student Living in an Empty Hospital.

1A.B. Sandler was a medical student, George Washington University School of Medicine and Health Sciences, Washington, DC, at the time of writing and is now an orthopaedic surgery resident, William Beaumont Army Medical Center, Fort Bliss, Texas; e-mail: [email protected]; Twitter: @alexisbsandler.

LINC-08. Neuro-Oncology tumor board – one-year experience of international collaboration

BACKGROUND: The management of childhood central nervous system (CNS) tumors is complex and often faces numerous challenges in low- and middle- income countries (LMICs), including delayed diagnosis and limited treatment resources. Twinning initiatives between LMICs with high- income countries are feasible and proven to be highly effective at exchanging skills and expertise to improve diagnosis, treatment and care for children with brain tumors. METHODS: A monthly multidisciplinary international pediatric neuro-oncology tumor board via zoom videoconferencing was established in January 2021. This effort is a collaboration between Washington University School of Medicine, in St. Louis, Missouri, USA and nine international sites. Given the significant contributions of this international effort, it has since grown to include 20 institutions and cancer centers from 12 countries in the Middle East, Europe, Australia and South America. RESULTS: As of January 2022, we have held 11 tumor boards, 35 cases were reviewed, and have had 320 experts attend from several specialties – neuro-oncology, neurology, neurosurgery, neuroradiology and neuropathology. A multidisciplinary team of physicians reviewed each case and recommendations were given accordingly. We also started a quarterly neurofibromatosis (NF) meeting focused to leverage the expertise of dedicated specialists in the NF center. Two NF-focused meetings took place since establishing the program, and total of five cases were discussed. CONCLUSION: Virtual videoconferencing promotes a multi-disciplinary approach for the management of pediatric CNS tumors, and it allows access for medical expertise. We anticipate the current initiative will also provide a platform for future international research collaborations and deliver the optimal medical care for neuro-oncology patients globally. Multiple potential collaborative projects are currently underway.

Age-friendly learning health systems: Opportunities for model synergy and care improvement.

Journal of the American Geriatrics SocietyEarly View Commentary Age-friendly learning health systems: Opportunities for model synergy and care improvement Beth Prusaczyk PhD, MSW, Corresponding Author Beth Prusaczyk PhD, MSW beth.prusaczyk@wustl.edu @bethp_DI orcid.org/0000-0001-8495-0836 @@bethp_DI Department of Medicine, Division of General Medical Sciences, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA Institute for Informatics, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA Correspondence Beth Prusaczyk, Instructor of Medicine, Washington University School of Medicine in St. Louis, 600 S. Taylor Avenue, Suite 102, St. Louis, MO 63110, USA. Email: beth.prusaczyk@wustl.eduSearch for more papers by this authorRobert E. Burke MD, MS, Robert E. Burke MD, MS orcid.org/0000-0002-9521-8699 Center for Health Equity Research and Promotion (CHERP), Corporal Michael Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA Division of General Internal Medicine, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USASearch for more papers by this author Beth Prusaczyk PhD, MSW, Corresponding Author Beth Prusaczyk PhD, MSW beth.prusaczyk@wustl.edu @bethp_DI orcid.org/0000-0001-8495-0836 @@bethp_DI Department of Medicine, Division of General Medical Sciences, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA Institute for Informatics, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA Correspondence Beth Prusaczyk, Instructor of Medicine, Washington University School of Medicine in St. Louis, 600 S. Taylor Avenue, Suite 102, St. Louis, MO 63110, USA. Email: beth.prusaczyk@wustl.eduSearch for more papers by this authorRobert E. Burke MD, MS, Robert E. Burke MD, MS orcid.org/0000-0002-9521-8699 Center for Health Equity Research and Promotion (CHERP), Corporal Michael Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA Division of General Internal Medicine, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USASearch for more papers by this author First published: 02 June 2022 https://doi.org/10.1111/jgs.17901 Research reported in this publication was supported by the National Institute on Aging of the National Institutes of Health under award number K01AG071749 and the VA Safer Aging through Geriatrics-Informed Evidence-Based Practices (SAGE) Quality Enhancement Research Initiative (QUERI) program (QUE 20-014). The content and views are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health or the Department of Veterans Affairs. Funding information: National Institute on Aging, Grant/Award Number: K01AG071749; U.S. Department of Veterans Affairs, Grant/Award Number: QUE 20-014 Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Early ViewOnline Version of Record before inclusion in an issue RelatedInformation

New Multi-Center Clinical Trial to Address Cochlear Implantation of Children with Asymmetric Hearing Loss or Single-Sided Deafness

New Multi-Center Clinical Trial to Address Cochlear Implantation of Children with Asymmetric Hearing Loss or Single-Sided Deafness

A Novel Innovation and Entrepreneurship (I&E) Training Program for Biomedical Research Trainees.

Contemporary science emphasizes efficient translation of scientific discoveries into tangible, innovative products and services to improve human health. Therefore, researchers need skills in innovation and entrepreneurship (I&E) to select which problems to address and bring to market the most promising solutions. Training in this skillset is not currently available to most biomedical research trainees. The Entrepreneurship for Biomedicine (E4B) training program was created to develop biomedical researchers' I&E skills. The program comprises 2 semester-length courses: E4B1 teaches core skills; E4B2 focuses on advanced skills for those interested in pursuing funding for a new venture. In addition to traditional entrepreneurship training, E4B teaches ethics and personal skills such as resilience, communication, and team-building. Each course is delivered online and requires about 4 hours weekly. Program elements include short videos for didactic content; a team-based capstone project; mentorship from experienced entrepreneurs; and a live, virtual pitch presentation. The program is housed at Washington University School of Medicine in St. Louis and is open to pre- and postdoctoral biomedical research trainees and faculty nationwide. In 2020, 77 trainees completed E4B1 and 13 went on to complete E4B2. Trainees in both courses were satisfied with learning content and mentorship and would recommend the program to a friend. Pre- and postanalyses demonstrated that trainees' confidence in their knowledge about and ability to perform I&E tasks taught throughout the program increased. Since completion, 4 graduates have received external funding for an innovation and 3 have started a company. E4B is well accepted, and this preliminary evaluation suggests the program is effective. It could serve to support medical school curricula, business competitions, and technology transfer efforts, which are opportunities for future exploration. A more robust evaluation is planned and recruitment will be expanded to increase participation from women and underrepresented populations.

MP44-13 STONE CULTURES FOR URETEROSCOPY: ARE THEY NECESSARY AND WHO NEEDS THEM? RESULTS FROM A SINGLE INSTITUTION SERIES

You have accessJournal of UrologyCME1 May 2022MP44-13 STONE CULTURES FOR URETEROSCOPY: ARE THEY NECESSARY AND WHO NEEDS THEM? RESULTS FROM A SINGLE INSTITUTION SERIES Daniel Wong, Kenneth Sands, and Alana Desai Daniel WongDaniel Wong More articles by this author , Kenneth SandsKenneth Sands More articles by this author , and Alana DesaiAlana Desai More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002610.13AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Stone cultures are recommended for high risk PCNL however their utility during ureteroscopy is less understood. We evaluate stone culture as a factor for post ureteroscopy infectious complications and determine which characteristics are associated with positive stone culture to better guide management. METHODS: Using an institutional database of stone extraction cases from 2016-2020, we evaluate all ureteroscopy cases in which stone culture was sent. We perform univariate analysis to identify factors associated with postop infection as defined by T>38°C, WBC >12K or <4K, HR >90, or UTI within 30 days of procedure. Logistic regression was performed on variables historically associated with postop infection. Univariate analysis was performed to determine factors associated with positive stone culture, followed by logistic regression using statistically significant variables. RESULTS: Of 274 ureteroscopy cases where stone culture was obtained, 71(25%) had a positive stone culture and 33(12%) had a postop infection.(Figure 1) Female sex and positive stone culture were associated with post-op infection. Positive stone culture remained the only significant predictor of postop infection on logistic regression. Predictors of positive stone culture were higher Charleston Comorbidity Index(CCI), operative time, history of UTI, and neurogenic bladder. (Figure 2) In the 33 cases of postop infection, 21 had organisms identified on post-op urine or blood cultures. Preop urine culture and stone culture were congruent with postop culture in 5(23%) and 8(38%) cases respectively. Of 12 cases with no postop organism identified, stone culture was positive in 4(33%) and preop culture was positive in 0. CONCLUSIONS: Stone culture is predictive of postop infection after ureteroscopy. Urologists should prioritize sending stone cultures for high risk patients such as those with neurogenic bladder. Stone culture may provide the only chance at culture directed antibiotic therapy in a portion of cases. Source of Funding: Washington University School of Medicine © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e757 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Daniel Wong More articles by this author Kenneth Sands More articles by this author Alana Desai More articles by this author Expand All Advertisement PDF DownloadLoading ...

Campaign Urges Users to Post Pictures of Psychiatric Medications

Campaign Urges Users to Post Pictures of Psychiatric Medications

Genomic and transcriptomic somatic alterations of hepatocellular carcinoma in non-cirrhotic livers

Genomic and transcriptomic somatic alterations of hepatocellular carcinoma in non-cirrhotic livers