Research Spotlight

Baylor Health Sciences Library brings to you each month the latest published research from the Baylor Scott & White and Texas A&M College of Dentistry communities. Each newly published article features the researcher, the abstract, and link to the full text. For information on including your own research, please contact Sudha Ramakrishnan at Sudha.Ramakrishnan@BSWHealth.org for BSWH or at sudharamakrishnan@tamu.edu for COD.


Posted January 15th 2022

Effects of the Configuration of Hearing Loss on Consonant Perception between Simulated Bimodal and Electric Acoustic Stimulation Hearing.

George S. Whitaker, AUD

George S. Whitaker, AUD

Yoon, Y.S., Whitaker, G. and Lee, Y.S. (2021). “Effects of the Configuration of Hearing Loss on Consonant Perception between Simulated Bimodal and Electric Acoustic Stimulation Hearing.” J Am Acad Audiol 32(8): 521-527.

Full text of this article.

BACKGROUND:  Cochlear implant technology allows for acoustic and electric stimulations to be combined across ears (bimodal) and within the same ear (electric acoustic stimulation [EAS]). Mechanisms used to integrate speech acoustics may be different between the bimodal and EAS hearing, and the configurations of hearing loss might be an important factor for the integration. Thus, differentiating the effects of different configurations of hearing loss on bimodal or EAS benefit in speech perception (differences in performance with combined acoustic and electric stimulations from a better stimulation alone) is important. PURPOSE:  Using acoustic simulation, we determined how consonant recognition was affected by different configurations of hearing loss in bimodal and EAS hearing. RESEARCH DESIGN:  A mixed design was used with one between-subject variable (simulated bimodal group vs. simulated EAS group) and one within-subject variable (acoustic stimulation alone, electric stimulation alone, and combined acoustic and electric stimulations). STUDY SAMPLE:  Twenty adult subjects (10 for each group) with normal hearing were recruited. DATA COLLECTION AND ANALYSIS:  Consonant perception was unilaterally or bilaterally measured in quiet. For the acoustic stimulation, four different simulations of hearing loss were created by band-pass filtering consonants with a fixed lower cutoff frequency of 100 Hz and each of the four upper cutoff frequencies of 250, 500, 750, and 1,000 Hz. For the electric stimulation, an eight-channel noise vocoder was used to generate a typical spectral mismatch by using fixed input (200-7,000 Hz) and output (1,000-7,000 Hz) frequency ranges. The effects of simulated hearing loss on consonant recognition were compared between the two groups. RESULTS:  Significant bimodal and EAS benefits occurred regardless of the configurations of hearing loss and hearing technology (bimodal vs. EAS). Place information was better transmitted in EAS hearing than in bimodal hearing. CONCLUSION:  These results suggest that configurations of hearing loss are not a significant factor for integrating consonant information between acoustic and electric stimulations. The results also suggest that mechanisms used to integrate consonant information may be similar between bimodal and EAS hearing.


Posted January 15th 2022

The journey from infertility to uterus transplantation: A qualitative study of the perspectives of participants in the Dallas Uterus Transplant Study.

Anji Wall, M.D.

Anji Wall, M.D.

Wall, A.E., Johannesson, L., Sok, M., Warren, A.M., Gordon, E.J. and Testa, G. (2021). “The journey from infertility to uterus transplantation: A qualitative study of the perspectives of participants in the Dallas Uterus Transplant Study.” Bjog Dec 9. [Epub ahead of print].

Full text of this article.

OBJECTIVE: To assess how absolute uterine factor infertility affects women who undergo uterus transplantation, how uterus transplantation impacts women with absolute uterine factor infertility and how uterus transplant recipients view uterus transplantation in terms of their reproductive autonomy. DESIGN: Qualitative semi-structured interview study. SETTING: Uterus transplant programme in a large academic medical centre in the USA. POPULATION/SAMPLE: Twenty one uterus transplant recipients. METHODS: A medical chart review was conducted to collect patient demographic information and clinical outcomes. Semi-structured interviews collected information regarding participants’ experience. MAIN OUTCOME MEASURE(S): The outcomes of interest were participants’ experience of infertility, experience with uterus transplantation and general perceptions of uterus transplantation. RESULTS: Six participants were pregnant (one with a second child), six had experienced early graft failure and removal, five had delivered a healthy baby, and four had a viable graft and were awaiting embryo transfer. The primary themes identified were: the negative impact of absolute uterine factor infertility diagnosis on psychological wellbeing, relationships and female identity; the positive impact of uterus transplantation on healing the emotional scars of absolute uterine factor infertility, female identity and value of research trial participation and the perception of uterus transplantation as an expansion of reproductive autonomy. All participants reported that uterus transplantation was worthwhile, regardless of individual outcome. CONCLUSION: Absolute uterine factor infertility has a negative impact on women from a young age, affects multiple relationships and challenges female identity. Uterus transplantation helps to reverse this impact, transforming women’s life narrative of infertility and enhancing female identity. TWEETABLE ABSTRACT: Absolute uterine factor infertility (AUFI) adversely affects women. Uterus transplantation helps mitigate the negative impact of AUFI, by transforming women’s life narratives of infertility and enhancing female identity.


Posted January 15th 2022

Recent advances in immune-based approaches for the treatment of esophagogastric cancer.

Ronan J. Kelly, M.D.

Ronan J. Kelly, M.D.

Weadick, C.S., Duffy, A.G. and Kelly, R.J. (2022). “Recent advances in immune-based approaches for the treatment of esophagogastric cancer.” Expert Opin Emerg Drugs: 1-13.

Full text of this article.

INTRODUCTION: The year 2021 will be remembered as a transformational year in the management of both esophageal and gastric cancers. Decades of failed clinical trials had seen limited therapeutic advances beyond refinement of the traditional combined modality approach. Targeted strategies against specific molecular alterations did not – with the exception of Her2 – yield the desired breakthroughs, and it was unclear what immune-based approaches would bring to this group of cancers. The presence of tumor-infiltrating lymphocytes in esophagogastric cancer demonstrates that an endogenous immune response is already occurring and potentially amplifiable by immune checkpoint inhibition. Recent data have validated this with FDA approvals in both the locoregional (CheckMate 577) and metastatic disease (CheckMate 649, KeyNote 590 and KeyNote 811) setting which have altered the therapeutic landscape. AREAS COVERED: Here we discuss recent data and ongoing research efforts to better define the role of immune-based approaches and select the patient cohorts who might gain the most benefit from them. EXPERT OPINION: Immunotherapy, and specifically the incorporation of the immune checkpoint inhibitors (ICI) drug class, has altered the therapeutic paradigm of many cancers in recent years. Anti-PD-1 therapies are now the new standard of care for patients with local and advanced disease.


Posted January 15th 2022

Utilization of a SARS-CoV-2-positive donor for liver transplantation.

Anji Wall, M.D.

Anji Wall, M.D.

Wall, A.E., McKenna, G.J., Onaca, N., Ruiz, R., Bayer, J., Fernandez, H., Martinez, E., Gupta, A., Askar, M., Spak, C.W. and Testa, G. (2022). “Utilization of a SARS-CoV-2-positive donor for liver transplantation.” Proc (Bayl Univ Med Cent) 35(1): 62-63.

Full text of this article.

Liver transplantation rates have been negatively affected by the pandemic caused by coronavirus disease 2019 (COVID-19), the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Current practice in the liver transplant community is to avoid utilizing SARS-CoV-2-positive donors for liver transplantation unless there is a compelling reason such as recipient illness severity. In this case, we report the use of a donor who had a positive exposure to and symptom history for COVID-19 and tested positive for SARS-CoV-2 on admission for a liver transplant recipient with primary sclerosing cholangitis and a Model of End-Stage Liver Disease score of 23 with no known COVID-19 exposures. We focus on the decision to accept this particular organ, as well as the discussion with the recipient about the unknowns of disease transmission and risk associated with this donor. The current case argues that transplant programs should begin to consider low-risk donors with positive SARS-CoV-2 testing for recipients who have the potential to benefit from liver transplantation, which may not only be those with the most severe illness.


Posted January 15th 2022

Trilaciclib prior to chemotherapy in patients with metastatic triple-negative breast cancer: final efficacy and subgroup analysis from a randomized phase II study.

Joyce O'Shaughnessy M.D.

Joyce O’Shaughnessy M.D.

Tan, A.R., Wright, G.S., Thummala, A.R., Danso, M.A., Popovic, L., Pluard, T.J., Han, H.S., Vojnović, Ž., Vasev, N., Ma, L., Richards, D.A., Wilks, S.T., Milenković, D., Xiao, J., Sorrentino, J., Horton, J. and O’Shaughnessy, J. (2021). “Trilaciclib prior to chemotherapy in patients with metastatic triple-negative breast cancer: final efficacy and subgroup analysis from a randomized phase II study.” Clin Cancer Res Dec 9;clincanres.2272.2021. [Epub ahead of print].

Full text of this article.

PURPOSE: We report final antitumor efficacy results from a phase II study of trilaciclib, an intravenous cyclin-dependent kinase 4/6 inhibitor, administered prior to gemcitabine plus carboplatin (GCb) in patients with metastatic triple-negative breast cancer (NCT02978716). EXPERIMENTAL DESIGN: Patients were randomized (1:1:1) to group 1 (GCb [days 1, 8]; n = 34), group 2 (trilaciclib prior to GCb [days 1, 8]; n = 33), or group 3 (trilaciclib [days 1, 8] and trilaciclib prior to GCb [days 2, 9]; n = 35). Subgroup analyses were performed according to CDK4/6 dependence, level of PD-L1 expression, and RNA-based immune signatures using proportional hazards regression. T-cell receptor (TCR) β CDR3 regions were amplified and sequenced to identify, quantify, and compare the abundance of each unique TCR β CDR3 at baseline and on treatment. RESULTS: Median overall survival (OS) was 12.6 months in group 1, not reached in group 2 (hazard ratio [HR] 0.31; P = 0.0016), 17.8 months in group 3 (HR 0.40; P = 0.0004), and 19.8 months in groups 2 and 3 combined (HR 0.37; P < 0.0001). Efficacy outcomes were comparable regardless of cancer CDK4/6 dependence status and immune signatures. Administering trilaciclib prior to GCb prolonged OS irrespective of PD-L1 status but had greater benefit in the PD-L1-positive population. T-cell activation was enhanced in patients receiving trilaciclib. CONCLUSIONS: Administering trilaciclib prior to GCb enhanced antitumor efficacy, with significant improvements in OS. Efficacy outcomes in immunologic subgroups and enhancements in T-cell activation suggest these improvements may be mediated via immunologic mechanisms.