Research
Noteworthy Publications in 2024-25
External validation and update of the pediatric asthma risk score as a passive digital marker for childhood asthma using integrated electronic health records
Publication: eClinicalMedicine
Date: June 2025
Background: In the search for practical prognostic decision support, numerous childhood asthma prediction tools (including a recent Pediatric Asthma Risk Score [PARS]) with modest prognostic accuracy have been developed, however, the prognostic utility of these tools using existing electronic health records (EHR) in clinical settings is unknown. To test the hypothesis that childhood asthma can be predicted using EHR, we sought to externally validate and update the PARS as a passive digital marker (PDM) for asthma risk.
Efruxifermin in Compensated Liver Cirrhosis Caused by MASH
Publication: New England Journal of Medicine
Date: May 2025
Background: In phase 2 trials involving patients with stage 2 or 3 fibrosis caused by metabolic dysfunction–associated steatohepatitis (MASH), efruxifermin, a bivalent fibroblast growth factor 21 (FGF21) analogue, reduced fibrosis and resolved MASH. Data are needed on the efficacy and safety of efruxifermin in patients with compensated cirrhosis (stage 4 fibrosis) caused by MASH.
Lysosomal dysfunction and inflammatory sterol metabolism in pulmonary arterial hypertension
Publication: Science
Date: January 2025
Summary: Pulmonary arterial hypertension (PAH) is a poorly understood condition that remains difficult to treat and carries a high risk of mortality. Harvey et al. identified a nuclear receptor called NCOA7 that acts as a biological brake on inflammation in the lining of blood vessels (see the Perspective by Pullamsetti and Savai). In cells and in mouse and rat models, deficiency of NCOA7 promoted lysosomal dysfunction and the generation of proinflammatory bile acids and oxysterols. This finding was consistent with data from patients, for whom the severity of PAH symptoms and mortality correlated with the gene sequence of NCOA7. The authors also identified a potential therapeutic approach by designing a compound that activated NCOA7 and improved disease manifestations in a rat model of PAH. —Yevgeniya Nusinovich
Palliative Care Program for Community-Dwelling Individuals With Dementia and Caregivers
Publication: JAMA
Date: January 2025
Findings: In this randomized clinical trial that included 201 patient-caregiver dyads, the mean Neuropsychiatric Inventory Questionnaire (NPI-Q) severity score (range, 0-36) at 24 months was 9.15 in the dementia palliative care group and 9.39 in the usual care group, and there was no significant difference in the rate of change in NPI-Q severity from baseline between groups over time.
Rapid implementation of a clinical decision-support workflow during the national blood culture bottle shortage
Publication: Infection Prevention In Practice
Date: December 2024
Conclusion: Within three weeks of the BC bottle shortage announcement, we successfully deployed evidence-based BC restrictions in the electronic medical record (EMR), reducing our BC orders by 29.5%. We encourage others to consider and potentially replicate our workflow to contribute to diagnostic stewardship.
Efficacy of life saving malaria drug may be waning in children
Publication: Nature Africa
Date: November 2024
Summary: Intravenous artesunate, a semisynthetic derivative of artemisinin, is the World Health Organization (WHO)–recommended treatment for malaria requiring parenteral treatment. Malaria caused 608 000 deaths in 2022, mostly due to Plasmodium falciparum.1 Artemisinin partial resistance due to Pfkelch13 variations has been documented in East Africa in uncomplicated malaria but not in complicated malaria. We assessed artemisinin partial resistance, Pfkelch13 variations, and malaria recrudescence in Ugandan children with complicated malaria.
Accuracy, thoroughness, and quality of outpatient primary care documentation in the U.S. Department of Veterans Affairs
Publication: BMC Primary Care
Date: July 2024
Conclusion: Among outpatient primary care electronic records examined, most issues that patients initiated in discussion were absent from notes, and nearly half of notes referred to information or observations absent from transcripts. EHRs may contribute to certain kinds of errors. Approaches to improving documentation should consider the roles of the EHR, patient, and clinician together.
Use of At-Home Medical Tests Among Older US Adults: A Nationally Representative Survey
Publication: Sage
Date: September 2024
Abstract: The availability of direct-to-consumer, at-home medical tests has grown over the last decade, but it is unknown how frequently older adults purchase at-home tests, how they perceive such tests, and how interested they are in using at-home tests in the future. We conducted a cross-sectional, nationally representative survey of non-institutionalized US adults aged 50 to 80 about their previous use of, perceptions of, and future intentions to use at-home medical tests. We found that nearly half of older adults (48.1%) have purchased an at-home medical test (95% CI 45.2%-51.0%), including 32.0% (95% CI 29.3%-34.8%) who purchased a COVID-19 test, 16.6% (95% CI 14.7%-18.7%) who purchased an at-home DNA or genetic test, 5.6% (95% CI 4.5%-7.0%) who purchased a screening test for cancer, and 4.4% (95% CI 3.4%-5.6%) who purchased a test for an infection other than COVID-19. Compared with White, non-Hispanic adults, Black, non-Hispanic adults were less likely to have purchased an at-home test (35.5% vs 49.6%, P < .01). Those with a college degree and those with an annual household income greater than $100K were more likely than others to have purchased at-home tests (55.5% vs 42.0%, P < .01; 60.6% vs 39.0%, P < .001, respectively). Most older adults had positive perceptions about at-home tests and expressed interest in using at-home tests in the future. At-home medical testing is now common among older adults. Clinicians should be familiar with different tests that patients can purchase and be prepared to discuss the potential advantages and disadvantages of at-home testing.
Spatial transcriptomic analysis of primary and metastatic pancreatic cancers highlights tumor microenvironmental heterogeneity
Publication: Nature Genetics
Date: September 2024
Abstract: Although the spatial, cellular and molecular landscapes of resected pancreatic ductal adenocarcinoma (PDAC) are well documented, the characteristics of its metastatic ecology remain elusive. By applying spatially resolved transcriptomics to matched primary and metastatic PDAC samples, we discovered a conserved continuum of fibrotic, metabolic and immunosuppressive spatial ecotypes across anatomical regions. We observed spatial tumor microenvironment heterogeneity spanning beyond that previously appreciated in PDAC. Through comparative analysis, we show that the spatial ecotypes exhibit distinct enrichment between primary and metastatic sites, implying adaptability to the local environment for survival and progression. The invasive border ecotype exhibits both pro-tumorigenic and anti-tumorigenic cell-type enrichment, suggesting a potential immunotherapy target. The ecotype heterogeneity across patients emphasizes the need to map individual patient landscapes to develop personalized treatment strategies. Collectively, our findings provide critical insights into metastatic PDAC biology and serve as a valuable resource for future therapeutic exploration and molecular investigations.
Clinical Outcomes Associated With Various Microvascular Injury Patterns Identified by CMR After STEMI
Publication: Journal of the American College of Cardiology
Date: May 2024
Conclusions: MVI is associated with future adverse outcomes only in patients with a hemorrhagic phenotype (IMH+). Patients with only MVO (MVO+/IMH−) had a prognosis similar to patients without MVI (MVO−/IMH−). This highlights the independent prognostic importance of IMH in assessing and managing risk after STEMI.
Possible roles of phytochemicals with bioactive properties in the prevention of and recovery from COVID-19
Publication: Frontiers in Nutrition
Date: July 2024
Results: The participants who did not contract COVID-19 consumed vegetables, herbs/spices, and fermented foods/beverages significantly more than the participants who contracted COVID-19. Among the six countries (India/Iran/Italy/Japan/Russia/Spain) with over 100 participants and high correspondence between the location of the participants and the language of the survey, in India and Japan the people who contracted COVID-19 showed significantly shorter recovery time, and greater daily intake of vegetables, herbs/spices, and fermented foods/beverages was associated with faster recovery.
Patents awarded
Inhibitors to treat and prevent diseases such aspulmonary arterial hypertension
Developed by Roberto Machado, Chief of the Division of Pulmonary, Critical Care, Sleep and Occupational Medicine at the IU School of Medicine, and Angelia Lockett, an Assistant Professor of Medicine, the inhibitors have been shown to prevent and reverse vascular remodeling — a structural change that can lead to damage or rupture of arterial walls that occurs due to pulmonary arterial hypertension — significantly improving treatment for this disease.
Better health care search recommendations
Developed by Titus Schleyer, a Professor of Biomedical Informatics, and Xia Ning, a former Professor of Computer Information Science at IU and currently a faculty member at Ohio State University, this model for filter searches recommends terms based on clinicians’ previous searches and individual patient visits to aid clinicians in decision-making and improve patient care.