United States

Abstract Title 

Guillain-Barré Syndrome Following Anti-CD19 CAR-T Therapy in a Patient with Relapsed DLBCL 

Background 

Immune Effector Cell-Associated Neurotoxicity Syndrome (ICANS) is a well-recognized complication of chimeric antigen receptor T-cell (CAR-T) therapy related to cytokine-mediated blood-brain barrier disruption presenting as encephalopathy. In contrast, Guillain-Barré syndrome (GBS), an acute, immune-mediated peripheral demyelinating process is characterized by symmetric ascending weakness and hyporeflexia, and is rarely reported following CAR-T therapy. ICANS is managed with corticosteroids, while GBS requires intravenous immunoglobulins (IVIG) or plasmapheresis. Concurrent presentations pose diagnostic and therapeutic challenges. 



Case Presentation 

A 64-year-old male with relapsed diffuse large B-cell lymphoma received CAR T-cell therapy. On day 10, he experienced sudden lower extremity weakness and collapsed while walking. Exam revealed proximal upper extremity and hip flexor weakness (4/5) with intact reflexes and sensation. By day 12, he was encephalopathic (Immune Effector Cell-Associated Encephalopathy score [ICE] 8/10), hypotensive (BP 77/62 mmHg), hypoxic (SpO₂ 83%), and febrile. He received IV dexamethasone 10mg and tocilizumab for grade 2 CRS. Brain MRI was normal. By day 15, his mentation worsened (ICE 2/10), with intermittent apnea, diminished gag reflex, and impaired secretion clearance, prompting intubation. High-dose methylprednisolone (250 mg IV q6h) and anakinra were initiated for ICANS management. On day 18, he was minimally responsive (ICE 0–1/10). He also developed progressive symmetric weakness, flaccid tone, diminished reflexes and positive Babinski sign. Imaging remained unchanged. An electroencephalogram showed no seizures. Cerebrospinal fluid analysis revealed protein 110 mg/dL, WBC 7, negative for infection, malignancy, and autoimmune encephalopathy. Electrodiagnostic studies demonstrated reduced CMAP and SNAP amplitude. The evolving weakness, preserved sensation, albuminocytologic dissociation, and electrophysiologic findings supported a diagnosis of GBS. Due to lack of response to ICANS therapy, IVIG (0.4 g/kg/day for 5 days) was initiated on day 29 along with seven sessions of plasmapheresis. He remained encephalopathic, although with gradual neurological recovery – eye tracking, tongue movement, and light motor responses. He was discharged to a long-term acute care and was eventually weaned off ventilator support. 

Discussion: 

This case highlights the rare presentation of GBS following CAR T-cell therapy which is a distinct entity from the more commonly occurring ICANS. The patient’s early proximal weakness was atypical for ICANS and suggested peripheral involvement. Though ICANS co-occurred and progressed, concurrent GBS manifested as progressive flaccid paralysis with reduced CMAP/SNAP amplitudes and albuminocytologic dissociation. Early distinction between ICANS and GBS is crucial, as treatments differ significantly. Overlapping features delayed diagnosis and increased morbidity. Further research is needed to understand mechanisms and improve diagnostic strategies for atypical neurotoxicity following CAR-T.

AMA Research Challenge 2025 

Guillain-Barré Syndrome Following Anti-CD19 CAR-T Therapy in a Patient with Relapsed DLBCL

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poster

Background: Triple-negative breast cancer (TNBC) is an aggressive and heterogeneous form of cancer that accounts for 10-15% of all breast cancers. TNBC is associated with poor health outcomes and high rates of relapse. Notch signaling is up-regulated in TNBC and plays a pivotal role in mediating therapy resistance and cancer-stem cell (CSC) survival and proliferation. Limantrafin [(CB-103, Cellestia Biotech), Selleckchem], a first-in-class oral transcriptional Notch inhibitor, selectively blocks the interaction between the CSL-NICD complex and leads to transcriptional downregulation of the Notch oncogenic pathway. Phase 1 clinical trials conducted by Cellestia Biotech on the effect of CB-103 on adenoid cystic carcinoma and T-cell acute lymphoblastic leukemia have shown promising safety profiles and efficacy. In preclinical models, CB-103 was also shown to synergistically act with several anti neoplastic agents to inhibit tumor progression and delay relapse. Here, our objective is to investigate further and characterize the effect of CB-103 on TNBC in vitro and in vivo using a syngeneic mouse model to understand tumor-immune interactions.

Methods: Two different human TNBC cell lines, MDA-MB-231 and MDA-MB-468, were used for our experiments. MTT and colony forming assays were performed to assess cell viability and proliferation after treatment with increasing concentration of CB-103. Flow cytometry analysis was performed to quantify whether CB-103 induces apoptosis. Mammosphere formation assay was performed to interrogate CSC activity using CB-103 alone and in combination with paclitaxel (FDA-approved chemotherapy). T cell proliferation assay was performed to assess the effect of CB-103 on T cell functions. FVB mice (female) bearing the syngeneic TNBC (C0321) tumors were treated with CB-103 (50 mg/kg body weight, PO, daily) over 14 days to analyze the effect on tumor growth.

Results: CB-103 was shown to significantly decrease TNBC cell proliferation and colony formation in a dose-dependent manner. Flow cytometry analysis revealed that CB-103 induces TNBC apoptosis. CB-103 alone and in combination with paclitaxel significantly reduced mammosphere formation in a dose-dependent manner. CB-103 does not decrease T cell proliferation. CB-103 significantly reduced syngeneic mouse TNBC tumor growth without a change in body weight.

Conclusion: Our results indicate that CB-103 has potent anti-tumor activity without adverse effects on the immune system. Further investigation is warranted to completely understand the interaction between the tumor and the immune microenvironment in the presence of CB-103. Overall, this study will significantly increase our knowledge to design a clinical trial for TNBC with a novel therapeutic agent, CB-103.

Investigating a Transcriptional Notch Inhibitor as a Potential Therapeutic Agent for Triple-Negative Breast Cancer

The brain’s remarkable capacity for learning and memory relies on adaptive mechanisms that regulate synaptic efficacy across spatial and temporal scales. While synaptic plasticity is largely orchestrated through various biochemical changes within neurons, the contribution of the lipid membrane—an essential scaffold for neuronal ion channels—and the extent to which its composition influences adaptive ion conduction, remains underexplored. This study investigates whether electromechanical remodeling of lipid membranes alone in response to neurologically inspired stimulation can induce conductance changes analogous to short-term synaptic plasticity (STP), long-term potentiation (LTP), and long-term depression (LTD), phenomena essential to learning and memory formation. We utilized droplet interface bilayers (DIBs), tunable model systems that emulate neuronal membranes, composed of 1,2-diphytanoyl-sn-glycero-3-phosphocholine (DPhPC) lipids and gramicidin A (gA), an ion channel analogous to voltage-gated sodium channels. Membranes were subjected to electrical stimulation protocols of varying intensity and frequency to mimic paired-pulse facilitation (PPF) and depression (PPD) for evaluating STSP, as well as extended stimulation over 30-minutes to assess persistence as LTP and LTD. Membrane fluidity was varied via alkane oil composition to mimic biologically relevant membrane inclusions. Ionic currents, membrane area, and single-channel activity were quantified to assess adaptive membrane conduction at both ensemble and molecular levels. Membrane fluidity modulated adaptive conduction response to stimulation. Fluid membranes exhibited dynamic and elevated ion conductance consistent with STP and LTP, while stiffer membranes displayed a restricted dynamic range and reduced conductance characteristic of LTD. These divergent behaviors emerged under identical stimulation conditions, independent of protein synthesis or changes in channel number. Single-channel analysis quantified individual ion channel behavior and revealed significant increases in single-channel conductance only in fluid membranes (p<0.01*). Notably, fluid membranes maintained LTP-like conductance over 30-minutes using ~99% fewer stimulus pulses than rigid membranes. These findings demonstrate that membrane composition shapes the electromechanical response of ion channel–embedded lipid bilayers to repeated stimulation, enabling emergent conduction behaviors critical to learning and memory. Enhanced conductance in fluid membranes arises from electrocompression-driven remodeling, modulating membrane conduction efficiency without added protein synthesis. The emergence of potentiation and depression across fluidity gradients positions membrane physical properties as tunable determinants of conduction dynamics. Critically, the ability of fluid membranes to sustain LTP-like states with minimal input highlights a potential mechanism for energy-efficient synaptic modulation. Together, these results reframe the lipid membrane as an active, composition-dependent regulator of plasticity, offering a new paradigm for understanding the molecular basis of learning and memory.


Electromechanically induced membrane restructuring enables learning and memory

Introduction: Escherichia coli (E. coli) is a significant contributor to chronic wound infections, such as post-surgical wounds and diabetic ulcers, complicating recovery and straining healthcare resources. Furthermore, the rise of antibiotic resistance has intensified the search for alternative treatments. Silver-graphene oxide (AgGO) nanocomposites emerge as a promising solution, offering antimicrobial benefits while limiting systemic side effects. This study focuses on the potential of AgGO nanoparticles to eradicate E. coli infections, presenting an innovative approach to wound healing. 

Methods: We synthesized Ag-doped GO via solution synthesis using GO, AgNO3, and NaBH4 precursor. The synthesized Ag-doped GO nanocomposites were washed and dried at 90°C. Transmission electron microscopy (TEM) combined energy dispersive x-ray spectroscopy (EDS) was used to characterize the size and chemical composition of nanocomposites. To determine the Minimum Inhibitory Concentration (MIC) and Minimum Bactericidal Concentration (MBC) of AgGO, we treated E coli suspension at 1,000 CFU/mL in LB broth with increasing concentrations of AgGO ranging from 0.02 to 3 mg/mL. Our negative control was LB broth alone and our positive control was 1 µL of Kanamycin at 100 ng/µL. The treated E. coli was incubated at 37°C for 16 hours and optical density (600 nm) was measured hourly via UV-visible spectrophotometer to identify the MIC. For MBC, we subcultured E.coli from MIC wells onto agar plates for another 21 hours and determined the MBC as the lowest AgGO concentration with no colony growth, indicating 99.9% bacterial death. 

Results: TEM/EDS analysis showed the successful nucleation of AgNPs on the GO nanosheets. The MIC and MBC of AgGO against E. coli during a 3 hour incubation were 0.02375 and 0.0475 mg/mL, respectively. At 16 hours incubation, the MIC and MBC were 0.75 and 2 mg/mL, respectively, indicating that AgGO has stronger antimicrobial activity at shorter culture times.

Conclusion/Clinical significance: This study demonstrates the ability of AgGO nanocomposites to effectively inhibit E. coli growth, supporting their potential use in the treatment of wound infections. 

Acknowledgments: This work was supported by the Surgical Infection Society, and WMed Pilot grant program.

Synthesis and Antibacterial Activity of Silver Graphene Oxide Nanocomposites

Background
A massive brain abscess caused by otogenic Klebsiella pneumoniae is a neurological emergency in the United States and worldwide. We present a rare case of an otogenic massive brain abscess caused by Klebsiella pneumoniae to guide clinicians in establishing a prompt diagnosis and preventing significant morbidity and mortality.
Case Presentation
A 23-year-old male with a past medical history of uncontrolled type 1 diabetes and a recent presentation for otitis media was brought to the emergency department unresponsive. On initial examination, he was non-verbal, showed abnormal posturing to painful stimuli, and had a purulent, pinkish discharge from his left ear. He was found to be in Diabetic ketoacidosis. CT Head without contrast revealed a 5.8 cm x 4.9 cm left temporoparietal lobe abscess with significant edema, a 1.4 cm midline shift and extensive left-sided mastoiditis. Blood culture revealed Rhodotorula mucilaginosa and Aureobasidium. An emergent craniotomy evacuated 120 mL of purulent material, which grew otogenic Klebsiella pneumonia. Due to rapid pathogen identification, patient's condition stabilized with drainage of abscess, antibiotics, and comprehensive management.
Discussion
Otogenic Klebsiella pneumoniae is rarely considered as a cause of brain abscesses. A report from the Centers for Disease Control and Prevention identified only one case of Klebsiella pneumoniae as a cause of pediatric brain abscess between January 2016 and August 2022. Due to its rarity, the CDC's Active Bacterial Core surveillance system, which tracks invasive bacterial diseases, does not currently include Klebsiella pneumoniae. However, a massive brain abscess can be caused by otogenic Klebsiella pneumoniae in patients with diabetic ketoacidosis or any immunocompromised states, leading to high morbidity and mortality. 
Conclusion
This case report underscores the importance of including Klebsiella pneumoniae in the differential diagnosis of otogenic brain abscess, especially in the setting of DKA or other immunocompromised states. Early neuroimaging, prompt surgical intervention, and targeted antimicrobial therapy are critical for improving outcomes in these life-threatening infections. Clinicians should maintain a high index of suspicion for atypical pathogens to reduce diagnostic delays and prevent severe neurological sequelae.



Massive Brain Abscess Caused by Otogenic Klebsiella pneumoniae in a Young Adult with Diabetic Ketoacidosis

Background:
Tumefactive multiple sclerosis (TMS) is a rare and diagnostically challenging variant of multiple sclerosis characterized by large demyelinating brain lesions that mimic neoplasm, abscess, or ischemic stroke. Representing less than 3 per 1,000 MS cases, TMS often presents with focal neurological deficits and mass-like imaging findings that can delay diagnosis and treatment.
Case Presentation:
A 24-year-old woman with anemia presented with two weeks of left facial droop, bilateral hand paresthesias, blurry vision, and mild dysphagia. Without prior neurological history, her initial non-contrast head CT revealed subcortical hypodensities in the right frontal and left temporal lobes, prompting a stroke workup. Her recent prolonged travel and echocardiogram-confirmed patent foramen ovale raised suspicion for paradoxical embolic stroke. However, MRA/MRV, hypercoagulable labs, and extensive malignancy screening including CT chest/abdomen/pelvis were all unremarkable.
MRI brain demonstrated T2 hyperintense, incomplete ring-enhancing lesions with vasogenic edema, concerning for tumefactive demyelination versus neoplasm. MR spectroscopy was nonspecific. Lumbar puncture showed 10 isolated CSF oligoclonal bands (OCBs), confirming a diagnosis of multiple sclerosis. Remarkably, the patient’s facial droop resolved spontaneously without corticosteroid treatment, and she was discharged neurologically intact with outpatient neurology follow-up.
Discussion:
This case highlights the profound diagnostic complexity of TMS, a condition that challenges even experienced clinicians due to its ability to mimic stroke, malignancy, or abscess, both clinically and radiographically. The patient’s initial imaging findings were highly suggestive of ischemic stroke and as in many TMS cases, the early workup prioritized life-threatening differentials, delaying the eventual diagnosis.
Pathophysiologically, tumefactive demyelination involves mass-like inflammatory demyelination with associated edema, blood-brain barrier disruption, and axonal injury, leading to imaging findings that overlap significantly with high-grade gliomas and abscesses. The hallmark incomplete/open-ring enhancement on MRI, alongside vasogenic edema and CSF oligoclonal bands, is critical to distinguishing TMS. However, OCBs are detected in 30-80% of tumefactive demyelination cases, and this variability frequently prompts unnecessary biopsies amid diagnostic uncertainty.
This case is particularly notable because the patient’s neurological deficits resolved spontaneously without corticosteroid therapy, which is highly atypical in MS where deficits typically worsen or persist without treatment. This unusual self-limited course underscores the heterogeneity of TMS presentations and the diagnostic confusion it creates.
While TMS is not a newly recognized condition, its broad clinical and radiographic variability continues to challenge timely diagnosis. Case reports such as this are essential, not for novelty, but to build a clearer and more complete picture of this rare MS subtype and improve diagnostic accuracy across disciplines.

The Great Neurologic Imposter: Tumefactive Multiple Sclerosis Mimicking Stroke, Neoplasm And Everything In Between

Background
Synovial sarcoma is a rare malignant mesenchymal tumor typically arising in the
extremities of young adults. Primary pulmonary synovial sarcoma is exceedingly rare, and recurrence within the female reproductive tract has not been previously described in the literature.

Case Presentation
A 53-year-old woman with a history of primary pulmonary synovial sarcoma presented with abnormal uterine bleeding. Pelvic ultrasound demonstrated a vascular endometrial mass protruding through the external cervical os. Histopathologic analysis following dilation and curettage identified a spindle cell neoplasm consistent with synovial sarcoma, confirmed by molecular studies and reviewed at both Brigham and Women’s Hospital and Cleveland
Clinic. There was no radiographic evidence of disease elsewhere. The patient has
undergone dilation and curettage, and further surgical management including
hysterectomy is under consideration.

Histopathologic Comparison:
The patient's original pulmonary tumor measured 7.1 cm, was poorly differentiated, and showed strong immunohistochemical positivity for SS18::SSX and SSX C terminal antibodies. Cytogenetic testing confirmed a chromosomal translocation (BS-22 E06488). It was negative for Cam5.2, MYF-4, NKX2.2, LCA, STAT6, and BCOR. The gynecologic recurrence demonstrated strong nuclear SS18::SSX positivity, as well as CD99, ER, PR, WT1, vimentin, and β-catenin. Focal positivity was also seen for desmin, CD10, and p53. Notably, PAX8, p16, pancytokeratin, and SMA were negative. The molecular and histologic profiles mirrored the original pulmonary tumor, confirming recurrence. 

Discussion
This case represents a unique gynecologic recurrence of a previously pulmonary
synovial sarcoma, a presentation not previously documented. The unusual metastatic pattern raises important considerations about the natural history and surveillance strategies of rare sarcomas in women. The endometrial location, protrusion through the cervical os, and lack of disease elsewhere suggest hematogenous spread, challenging assumptions about recurrence sites and routes. Although rare, this case emphasizes the role of tissue confirmation in patients with abnormal uterine bleeding and oncologic history—even when imaging findings suggest a benign etiology. This report underscores the importance of maintaining a broad differential diagnosis in patients with prior rare malignancies and highlights the need for individualized surveillance strategies. Awareness of atypical recurrence patterns may facilitate earlier diagnosis and improve outcomes in similar future cases. The findings further support cross-disciplinary collaboration in complex oncologic presentations, particularly when involving rare tumor biology and metastatic behavior.


Rare Gynecologic Recurrence of Pulmonary Synovial Sarcoma: A Case Report and Literature Review

Abstract Title: More Than Skin Deep: Mental Health and Skin Disease Among People Experiencing Homelessness

Background: People experiencing homelessness (PEH) face a wide range of health disparities, with skin conditions among the most visible and commonly reported concerns. Chronic or untreated dermatologic conditions (eczema, psoriasis, acne, infections, scarring, etc.) can be painful, stigmatizing, and challenging to manage without stable housing, hygiene access, or continuity of medical care. Emerging research highlights the strong link between dermatologic disease and mental health conditions such as depression, anxiety, and social withdrawal. Yet, these psychosocial impacts are often underrecognized among PEH, who face additional barriers to care. At Haven for Hope, a student-run dermatology clinic, we serve PEH with skin conditions. This project aimed to assess the perceived mental health effects of skin disease among PEH to inform integrated care approaches.

Methods: An anonymous paper survey was distributed to Haven for Hope Skin Clinic patients, with a Spanish and English version available. The survey included questions on embarrassment, stigma, and social avoidance, along with validated mental health screening items from the PHQ-2 assessing anhedonia and anxiety symptoms. Patients were also asked whether they desired mental health support. Data collection is ongoing. This study was deemed IRB-exempt.

Results: 22 patients have responded thus far. Nearly one-third (29.4%) reported feeling “a lot” of embarrassment about their skin condition, and 55% reported anxiety related to their skin at least several days in the past two weeks. Over half (52.9%) reported decreased interest or pleasure in activities, a core PHQ-2 symptom, at least several days during the same period. While 35.3% reported avoiding others because of their skin, most (70.6%) did not perceive external stigma.

Conclusion: 
Preliminary findings show a significant psychosocial burden of skin disease among PEH, with high rates of anxiety and anhedonia. These results emphasize the need for brief mental health screening in dermatology clinics serving PEH. Continued data collection will guide integration of mental health assessments into dermatologic care, supporting a more holistic approach for PEH.

More Than Skin Deep: Mental Health and Skin Disease Among People Experiencing Homelessness

 Burn care varies widely in complexity, yet physicians lack standardized tools to identify which patients will require prolonged, high-resource hospitalizations at the time of admission. Most cost analyses rely on billed charges adjusted by cost-to-charge ratios, which poorly reflect actual institutional spending. In this study, we used internal hospital-incurred cost data, capturing real expenditures, to group burn patients into clinically distinct subtypes using only routinely collected admission variables. The goal was to develop a practical, interpretable framework to support earlier triage, resource planning, and multidisciplinary coordination.

We retrospectively analyzed 465 adult burn patients admitted to a regional academic burn center between 2022 and 2023. Input variables included age, total body surface area (TBSA), length of stay, ventilator days, procedure count, inhalation injury, complications, comorbidities, and burn etiology. Patients were grouped using k-means clustering based on clinical similarity. The optimal number of clusters was selected using the elbow method, and structure was validated with hierarchical clustering and t-distributed stochastic neighbor embedding. Additionally, a decision tree was trained on the cluster assignments to identify simple clinical cutoffs that distinguished the groups.

Three reproducible clusters were identified, each differing significantly in clinical trajectory and hospital-incurred cost. Cluster 1 included 204 patients, typically younger with small burns (median TBSA 3.5), short stays (median 4 days), no ventilator use, and few comorbidities or complications. Most had scald or contact injuries, and the median cost was $25,000. Cluster 2 included 164 generally older patients with moderate burns, longer stays (median 6 days), higher comorbidity burden, and multiple procedures. Flame injury was more common in this group, with a median cost of $62,000. Cluster 3 included 8 patients with extensive burns (median TBSA 34), multiple procedures, prolonged ventilation, inhalation injury, complications, and hospital stays averaging 71 days. The median cost exceeded $500,000. The decision tree identified flame injury and length of stay as the strongest predictors. Patients without flame burns and under age 47 were typically low-cost, while those with flame burns and stays of 45 days or more were assigned to the high-cost group. Additional splits involving age and burn mechanism further differentiated moderate-cost patients.

Machine learning clustering combined with decision tree analysis identified clinically distinct burn subtypes using only admission data. This framework offers interpretable thresholds to guide early triage, anticipate cost trajectories, and support value-based resource planning in burn care.



From Admission to Allocation: Using Machine Learning to Predict Burn Patient Resource Needs

Background 

In 2022 the USMLE Step 1 licensing exam transitioned from a scored exam to Pass/Fail. This change was intended to emphasize a more holistic approach towards residency applications and reduce medical student stress. Without a scored exam, however, many students struggle to distinguish themselves for their residency applications. The National Resident Matching Program released 2024 data showing that the mean abstract/presentation/publication count for U.S seniors is as high as 38 in some specialties, suggesting that research is becoming a large focus for students. This project aimed to gain vital perspectives of medical students and faculty research mentors to determine how the Step 1 transition has affected medical students’ research engagement. 



Methods 

University of Louisville medical students were invited to complete a twenty-item survey about how medical students engage in research. Students were asked to categorize their personal perceptions regarding medical student research involvement, and these responses were analyzed using descriptive statistics. Students and faculty research mentors were also invited to participate in a 30-minute, semi-structured interview to more deeply explore these findings. Interview transcripts were analyzed by two coders using a grounded theory approach in the software platform Dedoose. 



Results 

Of the survey responses (n=70), most students (87%) had participated in research. However, of those research participants, a vast majority (83%) felt pressured to do so to match into residency, despite most students having little to no personal interest in research (60%). About half of students (54%) felt that the scoring change in Step 1 had some or a great deal of influence on their overall decision to participate in research. Interview data (n=17) supported these trends. Students felt pressure to prioritize quantity of research experiences over quality, even to the extent of prioritizing research time over school and blurring research ethics like authorship best practices. Faculty agreed with this phenomenon and echoed trends of shifted student priorities, increased research interest, evidence of student burnout due to extracurricular burden, and concern over low-quality research in their fields. Students also expressed confusion regarding how residency directors view student research and even questioned whether directors prioritized quality over quantity. 



Conclusion 

This study suggests the Step 1 pass/fail shift has led many students to re-direct pressure from Step 1 studying to research endeavors. Changes on a local and national level around how research is implemented and reported for residency applications may help address these unintended consequences.

Pressure Shift: Student and Faculty Perspectives on Medical Student Research and the Step 1 Transition to Pass/Fail

Background: Middle Eastern North African Americans (MENAA) are classified as White in U.S. data, obscuring health disparities and complicating MENAA health research. Health literacy (HL) is a key social determinant that medical students can address to promote equitable care. 
Methods: A retrospective analysis using NIH All of Us data (n= 179,170) assessed HL using the BRIEF-3 scale ( ≤ 9 = inadequate HL), stratified by race, education, and income. One-way ANOVA was used to examine differences across education, income, and age groups (p <0.05 significant).
Results: Across all education levels, MENAA had lower HL than white participants (p<0.001). Despite a higher proportion with college or advanced degrees compared to their counterparts (74.0% vs 61.1%), MENAA had lower HL scores (13.8 vs 14.3, p<0.01). Across all income brackets, MENAA had lower HL scores (p<0.05 ) and a higher proportion in low-income groups (23.5% vs 17.4%). When stratified by age, MENAA also had lower HL scores (p<0.01). 
Conclusion: MENAA exhibit lower health literacy across education, income, and age groups. These findings highlight the need to train medical students to recognize and address the social needs of minoritized groups, including MENAA. Integrating HL concepts and MENAA-focused disparities into curricula can foster cultural competence and promote health equity. 


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Investigating a Transcriptional Notch Inhibitor as a Potential Therapeutic Agent for Triple-Negative Breast Cancer

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A unique case of spinal-predominant ICANS with long-term motor deficits after CAR-T therapy