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Magnetic resonance imaging features differentiate histologic and molecular subtypes of glioblastoma IDH-Wild type CNS WHO grade 4
No full textPurpose: Glioblastoma IDH-wild type, CNS WHO grade 4 (GBM) can be diagnosed on the basis of histologic features (histological-GBM) or molecular features (molecular-GBM). Only few studies report neuroimaging features of GBM in its modern classification, and none have controlled for surgical status or used multiple logistic regression analysis to determine unique predictors. Our study aimed to validate MRI features that distinguish histological-GBM and molecular-GBM.
Methods: We analyzed a training cohort (n = 255) and validation cohort (n = 44) of GBM cases, classified according to the 2021 WHO Classification of Tumors of the CNS. For the training cohort, univariate and multiple logistic regression analyses determined if MRI metrics (contrast enhancement, ring-enhancement, vasogenic edema, multifocal tumor, lesion diameter, hemorrhage, number of lobes, and normalized ADC) and surgery type (biopsy vs. resection) predicted GBM-type (histological vs. molecular). A reduced multiple logistic regression model was constructed and applied to the validation dataset.
Results: There were 231 histological-GBMs and 24 molecular-GBMs in the training cohort. Multiple logistic regression analysis including both MRI metrics and surgery type showed that contrast enhancement (OR 7.83 [95%CI: 1.23–49.68], p = 0.029), ring enhancement (OR 5.98 [95%CI: 1.09–32.93, p = 0.040), and normalized ADC (OR 0.78 [95%CI: 0.62–0.99], p = 0.039) differed between histological and molecular-GBM. Analysis of the validation dataset using the unique training dataset-derived predictor variables (contrast-enhancement, ring-enhancement, and normalized ADC) found correct classification of each histological and molecular-GBM.
Conclusion: Molecular and histological-GBM exhibit distinct MRI phenotypes independent of surgical status.
Supplementary Information: The online version contains supplementary material available at 10.1007/s11060-026-05431-8
Publications by Muslim Philanthropy Initiative
No full textA report detailing recent publications authored by members of the Muslim Philanthropy Initiative
The Role of Cardiovascular Risk Factors in White Matter Tract Microstructure: A Multi‐Cohort Study in Older Adults
No full textBackground:
Vascular risk factors (VRF) exert deleterious effects on the vasculature throughout the body, including cerebrovasculature. These effects are characterized by structural and functional alterations in the cerebrovasculature, which in turn, may impact white matter (WM) microstructure. We sought to determine the relative contributions of VRF to alterations in WM tract microstructure in a large, multi‐study cohort using diffusion tensor imaging (DTI).
Method:
We collated datasets from the Vanderbilt Memory and Aging Project (VMAP) and several Alzheimer's Disease (AD) Sequencing Project‐Phenotype Harmonization Consortium (ADSP‐PHC) cohorts, including diffusion magnetic resonance imaging and VRF (n = 1,304, 72.3±9.5 years, 53% female). ADSP‐PHC cohorts included in this study were the AD Neuroimaging Initiative (ADNI), the National Alzheimer's Coordinating Center (NACC), the Religious Orders Study/Rush Memory and Aging Project/Minority Aging Research Study (ROS/MAP/MARS), and the Wisconsin Registry of Alzheimer's Prevention (WRAP). To assess the contributions of VRF to WM microstructure, we quantified the cross‐sectional association between VRF and white matter microstructure. Specifically, VRF were used to predict differences in free‐water (FW) and fractional anisotropy (FAFWcorr) across 10 AD‐relevant WM tracts. VRF variables studied included hypertension, diabetes, heart disease, body mass index (BMI), and Atherosclerotic Cardiovascular Disease Framingham Risk Score (FRS). Covariates included age, sex, education, race, apolipoprotein E‐ɛ4 status, and cognitive status. Models were corrected for multiple comparisons using the FDR approach.
Result:
Hypertension and heart disease were significantly associated with FAFWcorr in all tracts, while FRS was a significant predictor for FAFWcorr in 9/10 tracts (top associations shown in Figure 1). Diabetes and BMI were not significant predictors for FAFWcor in any of the tracts. Hypertension was a significant predictor for FW in all tracts, and FRS was a significant predictor only in the cingulum. Diabetes, BMI, and heart disease were not significant predictors for FW in any of the tracts.
Conclusion:
This study demonstrates that VRF, especially hypertension, heart disease, and FRS, differentially impact WM tract microstructure, providing insight into their unique contributions to WM microstructure in a large multi‐cohort of older adults. These findings underscore the critical importance of managing vascular risk factors to preserve white matter integrity to potentially prevent cognitive decline
Safety and Efficacy of Vadadustat Versus Darbepoetin Alfa for Chronic Kidney Disease–Related Anemia in Patients Receiving Dialysis by Baseline Erythropoiesis‐Stimulating Agent Dose
No full textIntroduction: Erythropoiesis-stimulating agents (ESAs) and iron supplementation are standard treatments for chronic kidney disease (CKD)-related anemia. Targeting higher hemoglobin values in CKD increases cardiovascular risk. Whether the increased risk is from higher ESA doses or higher hemoglobin levels is uncertain, but alternative therapies are sought for patients requiring high ESA doses. Phase 3 INNO2VATE trials in patients with dialysis-dependent CKD (DD-CKD) demonstrated vadadustat's noninferiority compared with darbepoetin alfa. To determine vadadustat's potential to treat anemia, including in patients requiring high ESA doses, its safety and efficacy were compared with those of darbepoetin alfa across prespecified baseline ESA dose subgroups in the prevalent DD-CKD INNO2VATE trial.
Methods: We compared the safety and efficacy of vadadustat versus darbepoetin alfa across prespecified baseline ESA dose subgroups (low [≤ 90 U/kg/week], intermediate [> 90 and < 300 U/kg/week], or high [≥ 300 U/kg/week]) in the INNO2VATE prevalent trial. The primary safety endpoint was time to first adjudicated major adverse cardiovascular event (MACE). Primary and secondary efficacy endpoints were mean hemoglobin level change from baseline at weeks 24-36 and weeks 40-52, respectively.
Findings: Compared with darbepoetin alfa, first MACE hazard ratios for vadadustat were 0.99 (95% CI, 0.81-1.23), 0.93 (95% CI, 0.74-1.18), and 0.62 (95% CI, 0.34-1.14) for low, intermediate, and high baseline ESA dose subgroups, respectively (interaction p = 0.92). Vadadustat was noninferior to darbepoetin alfa in hemoglobin change from baseline to primary evaluation period, with mean differences (vadadustat-darbepoetin alfa) of -0.10 g/dL (95% CI, -0.19 to -0.02), -0.20 g/dL (95% CI, -0.30 to -0.09), and -0.39 g/dL (95% CI, -0.67 to -0.11) for low, intermediate, and high ESA dose subgroups, respectively.
Discussion: Comparing safety and efficacy by baseline ESA dose among patients with CKD on maintenance dialysis, vadadustat was noninferior to darbepoetin alfa for all ESA dose subgroups, including patients with high baseline ESA requirements
P-1517. Adult Respiratory Syncytial Virus Vaccination Receipt among Adults Testing Negative for RSV – VISION Network, October 1, 2024—March 31, 2025
No full textBackground:
On June 26, 2024, the CDC updated respiratory syncytial virus (RSV) vaccine recommendations to a single dose of RSV vaccine for all adults aged ≥ 75 years and adults aged 60-74 years with increased risk of severe RSV disease. Using electronic health record (EHR) data from the VISION platform, we described characteristics of patients testing negative for RSV who did and did not receive an RSV vaccine and assessed factors associated with RSV vaccine receipt.
Methods:
Patients with ≥ 1 emergency department (ED) or inpatient encounter at any of 6 participating health systems in 8 states with RSV-like illness (RLI) during October 1, 2024-March 31, 2025 were included. Vaccination status was ascertained from EHR, state and city immunization information systems, and medical claims. Patients who tested positive for SARS-CoV-2 or influenza viruses at the same RLI encounter were excluded. Patient age, sex, race and ethnicity, Medicaid status, number of underlying medical conditions, month of medical encounter, and documented receipt of COVID-19 or influenza vaccines were evaluated as covariates when assessing the odds of vaccination. The best fitting multivariable logistic regression models using Bayesian Information Criterion were chosen.
Results:
Among 48423 included patients, 2113 (4.4%) had documented RSV vaccine receipt. The odds of RSV vaccination differed by site and increased with calendar time and age. Compared to patients aged 60-64 years, those aged ≥ 75 years were more likely to have received an RSV vaccine (ED: aOR: 3.6, 95%CI: 2.7-4.8, Figure 1; inpatient: aOR: 2.3, 95%CI: 1.7-3.0, Figure 2). Receipt of both influenza and COVID-19 vaccine within the same season had the strongest association with RSV vaccination in both the ED (aOR: 14.88, 95%CI: 11.87-18.89, Figure 1) and hospital setting (aOR: 20.04, 95%CI: 16.20-25.03, Figure 2).
Conclusion:
Receipt of other respiratory viral vaccines was the strongest indicator of RSV vaccination in the 2024-2025 RSV season in patients testing negative for RSV among all demographic and clinical characteristics considered. RSV vaccination was lower among those aged 60-64 years than older patients. These findings inform future methods to estimate vaccine effectiveness and inform policy implementation
Understanding Alternate Work Schedules and Their Potential to Improve Work-Life Well-Being for Veterans Affairs Nurses
No full textBackground: The employee experience of clinical personnel, especially nurses, is increasingly vital for health care organizations and is now part of health care's quintuple aim, which includes improving patient experience, population health, cost, and health equity. Nurse burnout and turnover intentions have heightened since the COVID-19 pandemic, with high workload and inadequate staffing as key organizational drivers. Flexible work schedules, such as 72/80 (where one works three 12-h shifts per week but receives the pay equivalent of 80 h), have been a longstanding countermeasure, but postpandemic data on their impact are limited.
Objective: This national evaluation investigates the impact of the 72/80 work schedule on Veterans Health Administration (VHA) nurses. We hypothesized that nurses on a 72/80 schedule experience less burnout, higher job satisfaction, greater work engagement, and lower turnover intentions.
Design: We conducted a web-based survey including self-reported 72/80 work status and employee experience measures, alongside existing administrative data on employee outcomes. We analyzed the data using Mann-Whitney U tests, mixed effects, and linear regression models.
Sample: Eight thousand five hundred forty-five VHA nurses from 170 Veterans Affairs Medical Centers nationwide working in 24/7 bedded units completed the survey.
Results: The 72/80 schedule was significantly associated with lower emotional exhaustion and depersonalization, and greater personal accomplishment. In addition, 72/80 status correlated with higher workplace engagement, job satisfaction, organizational satisfaction, and lower turnover intention.
Conclusions: The 72/80 work schedule shows significant potential as a transformative workforce strategy, providing substantial benefits in recruitment, retention, and employee satisfaction
Ultra processed foods, microbiota and blood pressure
No full textUltra-processed foods (UPFs) have been accepted by the general public, especially by adults. These types of food may alter the gut microbiota and affect the human body in a negative way. This narrative study aimed to investigate the relationship between consumption of ultra-processed foods and gut microbiota and their role in hypertension among adults. Studies have found a relation between high consumption of UPF and changes in the microbiota, which leads to raised blood pressure. These studies may provide help in the use of providing more effective dietary guidelines by studying how ultra-processing changes the properties of whole foods and how they affect the gut microbiome. This research highlights the association between UPF and microbiota and how it could potentially cause hypertension in adults
Late‐life physical activity and increased default mode network connectivity
No full textBackground:
Higher levels of physical activity (PA) have been linked to a reduced risk of Alzheimer's disease (AD) dementia among older adults. However, the mechanisms underlying the association between increased PA and a lower risk of AD‐related cognitive decline remain unclear. This study aimed to investigate the relationship between late‐life PA (PAlate) and functional connectivity (FC) within major functional resting state brain networks in cognitively healthy older adults.
Method:
This study was part of the Korean Brain Aging Study for Early Diagnosis and Prediction of Alzheimer's Disease (KBASE). It included 157 cognitively normal (CN) participants who underwent comprehensive clinical assessments at baseline. The participants also received multimodal brain imaging including resting‐state functional MRI, structural MRI, [11C] Pittsburgh Compound B (PiB) positron emission tomography (PET), [18F] fluorodeoxyglucose (FDG) PET, as well as an evaluation for PAlate. For major functional resting state networks (RSN) including the frontotemporal, default mode, dorsal attention, limbic, and salience (ventral attention) networks, within‐system FC was calculated as the median value of Fisher z‐transformed node‐to‐node functional connectivity within each network.
Result:
PAlate demonstrated a significant positive association with FC of the default mode network (beta = 0.216, p = 0.010). No significant associations were found in other networks. The association between PAlate and the default mode network FC remained significant even after controlling for AD imaging biomarkers, including global amyloid retention, AD signature region cerebral glucose metabolism, and AD signature region cortical thickness.
Conclusion:
These findings indicate that PAlate is associated with increased functional connectivity within the default mode network, independent of AD‐related brain pathologies. While further research is needed, these findings suggest a potential role in reducing the risk of AD and related cognitive decline
Development of an eco‐friendly RNAi yeast attractive targeted sugar bait that silences the shaker gene in spotted‐wing drosophila, Drosophila suzukii
No full textBackground: Drosophila suzukii, or spotted-wing drosophila (SWD), (Diptera: Drosophilidae), are invasive vinegar flies of East Asian origin that have wreaked havoc on the small fruit and berry industry. In locations where SWD are well established, weekly chemical insecticide applications are necessary, resulting in increased economic costs, unwanted environmental impacts ensuing from loss of non-targeted organisms, and the eventual emergence of populations that are resistant to these insecticides. It is therefore critical that new classes of biorational pesticides and cost-effective technologies for controlling SWD are identified.
Results: Here, we used the attractive properties of Saccharomyces cerevisiae, baker's yeast, which was designed to express an RNA interference (RNAi) pesticide that specifically targets the SWD Shaker (Sh) gene, to lure and kill flies that feed on the yeast, which was delivered in a feeder as a component of an attractive targeted sugar bait (ATSB). The yeast, which was heat killed prior to preparation of the ATSB, silenced the Sh gene, resulting in severe neural defects and 96 ± 9% fly mortality in laboratory trials. The RNAi yeast was successfully fed to the flies in an easily assembled soda bottle feeder that continuously rewetted the yeast with soda, which lured and killed the flies in simulated field trials. Despite this toxicity observed in SWD, consumption of the yeast had no impact on the survival of other dipteran insects.
Conclusion: This promising ATSB technology, which was prepared with a new class of RNAi yeast insecticides, could one day be an effective component in integrated SWD control programs
Protocol of a randomized trial of acceptance and commitment therapy for patient fatigue interference and caregiver burden in advanced gastrointestinal cancer
No full textFatigue's interference with activities, mood, and cognition is one of the most prevalent and distressing problems of patients with advanced gastrointestinal cancer. As fatigue interferes with patient functioning, family caregivers often report feeling burdened by increasing demands. Evidence-based interventions for patient fatigue interference and caregiver burden are lacking in advanced gastrointestinal cancer. In a pilot trial, telephone-based Acceptance and Commitment Therapy (ACT) showed potential for reducing patient fatigue interference and caregiver burden in this population. The current Phase II trial seeks to determine the efficacy of this intervention for patients with advanced gastrointestinal cancer and moderate-to-severe fatigue interference and their family caregivers with significant caregiving burden. In this trial, 244 dyads are randomly assigned to either the ACT intervention or an education/support control. Participants in both conditions attend six weekly 50-min telephone sessions, four of which involve both dyad members, and a 30-min booster session. The primary aim is to test the effects of telephone-delivered ACT on patient fatigue interference and caregiver burden. Secondary outcomes include patient sleep interference and patient and caregiver engagement in daily activities and quality of life. Outcomes are assessed at baseline, 2 weeks post-intervention, and 3 months post-intervention. This trial also examines whether increased psychological flexibility, defined as mindful acceptance of present experiences, including challenges, while pursuing actions aligned with personal values, mediates ACT's effects on primary outcomes. Our ability to demonstrate ACT's efficacy will support its adoption in cancer care. Findings will also inform future ACT trials for dyads coping with other serious illnesses