Simeng Wang, MD

All Publications

• Evaluating Financial Toxicity and Quality of Life Among Acute Care Surgery Patients: A Mixed-Methods Study. Journal of the American College of Surgeons Kennedy, C., Wang, S., Chen, J., Flojo, R., King, J., Arnow, K., Earley, M., Abreo, A., Knowlton, L. M., S-SPIRE Qualitative Study Team 2025

  Abstract

  BACKGROUND: Acute care surgery (ACS) patients face financial burdens and impact on quality-of-life (QoL), which can be significant for the uninsured. Hospital Presumptive Eligibility (HPE) aims to reduce costs and improve access. We evaluated patient-reported outcomes following hospitalization, hypothesizing that HPE improved recovery trajectory.STUDY DESIGN: A convergent mixed methods study of ACS patients 18-64 years was performed at an academic Level I trauma center from December 2024 to August 2025. HPE patients were compared with insured patients. SF-12 QoL and American Association for the Surgery of Trauma (AAST) financial hardship survey tool were completed at hospitalization and 1-3 months post-discharge. Thematic analysis of semi-structured interviews was conducted to evaluate access to care and financial toxicity.RESULTS: Ten out of the 110 patients were HPE and the rest were insured controls. HPE patients were younger (median: 39.5 vs. 43.5 years), had higher ICU admission (30% vs. 9%) and non-routine discharge (22% vs.7%) rates. At 3 months post-discharge, both groups had reduced household income (HPE vs. controls: 33% vs. 20%) and difficulty paying non-medical bills (50% vs. 25%). HPE patients additionally reported lower SF-12 measures. In qualitative analysis, HPE patients cited rapid access to insurance and expected reduction in out-of-pocket cost as program benefits.CONCLUSION: Risk for financial toxicity remains high among ACS patients. Patients enrolled in HPE faced additional financial and psychosocial strains during post-admission recovery. QoL and financial metrics are important to understand longitudinal patient outcomes and guide policies to improve patient recovery.

  View details for DOI 10.1097/XCS.0000000000001652

  View details for PubMedID 41051099

• Ultrasound-guided percutaneous cryoneurolysis of intercostal nerves in traumatic rib fractures. Injury Forrester, J. D., Wang, S., Myers, A. A., Earley, M., Guthrie-Baker, S., Abreo, A., Knight, A. W., Tung, J. 2025: 112321

  Abstract

  Multimodal pain control is the cornerstone of managing acute traumatic rib fractures. We employed surgeon-administered, ultrasound-guided percutaneous cryoneurolysis of intercostal nerves (USPCNIN) as an adjunct opioid-sparing analgesic modality at the bedside.This was a single-institution case series. Patients between 18-64 years of age who sustained traumatic rib fracture between ribs 3-9, deemed ineligible for surgical stabilization, and had pre-procedure numeric pain scores ≥5 underwent USPCNIN within 24 h of study enrollment by an attending chest wall surgeon. Primary outcomes were changes in daily narcotic use and numeric pain score from pre-intervention up to 30-day follow-up visits. Additional outcomes included hospital length of stay, procedure-related adverse events, and rib-specific readmission.Fifteen patients were identified. Median (IQR) patient age was 52 (43, 58) years and four (27 %) were female. Median (IQR) number of rib fractures was 5 (4, 8). Median (IQR) hospital length of stay was 4 (3, 7) days. Daily opioid use (measured in morphine milligram equivalents, MME) and present pain intensity (PPI) decreased significantly from pre-intervention to hospital discharge (median MME 96.5 vs. 49.5, p = 0.043; median PPI 10 vs. 7, p = 0.020). Twelve patients completed 30-day follow-up and had significantly decreased MME and PPI from hospital discharge (median MME 62.3 vs. 5, p = 0.014; median PPI 6.5 vs. 3, p = 0.001). There were no complications directly attributable to the procedure. There were no rib-specific readmissions.USPCNIN is a minimally-invasive, bedside procedure that can be safely performed by trauma surgeons and augment pain control for acute traumatic rib fractures.

  View details for DOI 10.1016/j.injury.2025.112321

  View details for PubMedID 40240230

• Medicaid Enrollment After Hospital Presumptive Eligibility in the Emergency Department. JAMA health forum Wang, S., Arnow, K., Sakamoto, M. M., Knowlton, L. M. 2025; 6 (4): e250768

  Abstract

  Hospital presumptive eligibility (HPE) is an emergency Medicaid program enabling eligible uninsured patients to temporarily access Medicaid benefits during hospital encounters. It provides a pathway to long-term Medicaid coverage, but this feature may be underutilized among patients who received HPE in the emergency department (ED) and were discharged immediately thereafter.To characterize if 6-month Medicaid enrollment rates varied by patient demographics and ED encounter characteristics and identify factors that potentially impact enrollment.A retrospective cohort study analyzing data from HPE-participating EDs in California between January 1, 2016, and December 31, 2021, was carried out from January 2024 to November 2024. Unadjusted differences in 6-month Medicaid enrollment rates among patient groups were analyzed with χ2 tests. Multivariable logistic regression was used to evaluate the adjusted odds of enrollment by different demographic and encounter characteristics. Patients aged 19 to 64 years who were uninsured, were treated and released from ED, and received HPE during the encounter were included.Receiving HPE during ED encounters.The primary outcome was Medicaid enrollment within 6 months after receiving HPE in ED.Of the 585 693 patients who received HPE during ED treat-and-release encounters, 175 495 were of Hispanic ethnicity (30.0%), 73 518 were White (12.6%), 33 829 were Black (5.8%), 12 824 were Asian or Pacific Islanders (2.2%), 1685 were Alaskan Native or American Indian (0.003%), 27 610 were of other race and ethnicity (0.05%), and 260 732 did not report race and ethnicity (44.5%). A total of 217 430 (37.1%) of 585 693 patientsof the total study population who received HPE during ED treat-and-release encounters enrolled in Medicaid by 6 months. In the regression model, male (adjusted odds ratio [aOR] 0.74; 95% CI, 0.72-0.76; P < .001), Hispanic (vs White: aOR, 0.94; 95% CI, 0.90-0.98; P = .007), and Spanish speaking (vs English speaking: aOR, 0.72; 95% CI, 0.68-0.77; P < .001) patients were less likely to enroll in Medicaid coverage. Annual enrollment rates declined notably following the onset of the COVID-19 pandemic (40.6% to 29.8%). Weekend encounters were more likely to have lower enrollment (vs weekday: aOR, 0.95; 95% CI, 0.93-0.97; P < .001). EDs in public hospitals (vs nonprofit: aOR, 1.27; 95% CI, 1.04-1.55; P = .02) or large hospitals (vs small: aOR, 1.13; 95% CI, 1.00-1.27; P = .04) were more likely to have higher enrollment. There was variable enrollment across different regions of California (27.3%-47.2%).In this cohort study, Medicaid enrollment rates after receiving HPE in ED varied across different patient, facility, and geographic characteristics, highlighting the need for additional resources to ensure Medicaid coverage among this high-risk uninsured population.

  View details for DOI 10.1001/jamahealthforum.2025.0768

  View details for PubMedID 40279116

• The role of respiratory therapy in rib fracture management. Current problems in surgery Anderson, T. N., Wang, S., Free, D., Forrester, J. D. 2024; 61 (12): 101664

  View details for DOI 10.1016/j.cpsurg.2024.101664

  View details for PubMedID 39647970

• Percutaneous cryoneurolysis: new kid on the rib fracture pain 'Block'. Trauma surgery & acute care open Wang, S., Myers, A. A., Forrester, J. D. 2024; 9 (1): e001575

  View details for DOI 10.1136/tsaco-2024-001575

  View details for PubMedID 39296595

  View details for PubMedCentralID PMC11409356

• Percutaneous Cryoneurolysis for Pain Control After Rib Fractures in Older Adults. JAMA surgery Wang, S., Earley, M., Kesselman, A., Vezeridis, A. M., Picel, A. C., Kothary, N., Forrester, J. D. 2024

  View details for DOI 10.1001/jamasurg.2024.2063

  View details for PubMedID 39110467

  View details for PubMedCentralID PMC11307162

• Small bowel obstruction due to a migrated pyloric stent. Trauma surgery & acute care open Agolia, J. P., Wang, S., Fisher, A., Bryan, J. L., Knowlton, L. M. 2024; 9 (1): e001443

  View details for DOI 10.1136/tsaco-2024-001443

  View details for PubMedID 38756695

  View details for PubMedCentralID PMC11097799

• Severe intracranial and intra-abdominal hemorrhage: timing is everything. Trauma surgery & acute care open Farooqi, N. B., Wong, S. Y., Wang, S., Knowlton, L. M. 2024; 9 (1): e001434

  View details for DOI 10.1136/tsaco-2024-001434

  View details for PubMedID 38616787

  View details for PubMedCentralID PMC11015236

• Prolonged Ischemia Increases Complications Among High- and Low-Volume Centers in Lung Transplantation ANNALS OF THORACIC SURGERY Wadowski, B. J., Wang, S., Angel, L. F., Geraci, T. C., Chan, J. C. Y., Chang, S. H. 2023; 116 (2): 374-381

  Abstract

  The effect of prolonged allograft ischemic time on lung transplant outcomes remains controversial, with most studies associating it with increased mortality, but this effect is partly mitigated by center volume. This study sought to evaluate the mechanism of these findings and clarify the impact of ischemic time on short-term outcomes in a national sample.Data on lung transplants (January 2010-Janary 2017) were extracted from the Scientific Registry of Transplant Recipients database. Ischemic time was dichotomized as prolonged ischemic time (PIT) or no PIT (N-PIT) at 6 hours. High-volume centers were defined as the top quintile. The primary outcome was 30-day, 1-year, and 3-year mortality; secondary outcomes included in-hospital complications and 72-hour oxygenation.Among 11,809 records, there were significant differences between PIT and N-PIT recipients by demographics, lung allocation score, and donor organ metrics. In a 1:1 propensity score-matched cohort (n = 6422), PIT recipients had reduced survival compared with N-PIT at 3 years (66.5% vs 68.8%, P = .031). On multivariable analysis, this effect persisted among low-volume but not high-volume centers. PIT recipients were more likely to require reintubation, prolonged (>5 days) mechanical ventilation, hemodialysis, longer stay, and acute rejection (all P < .01). Except for reintubation, these disparities were present at both high- and low-volume centers independently. Ischemic time had no effect on 72-hour oxygenation.PIT remains associated with higher rates of postoperative complications and reduced short-term survival. While center volume ameliorated the survival impact, this was not achieved by reducing postoperative complications. Further research is warranted before broadening ischemic time thresholds among low-volume centers.

  View details for DOI 10.1016/j.athoracsur.2022.10.018

  View details for Web of Science ID 001051261500001

  View details for PubMedID 37489398

• Protein arginine methyltransferase 1 is a novel regulator of MYCN in neuroblastoma ONCOTARGET Eberhardt, A., Hansen, J. N., Koster, J., Lotta, L. T., Wang, S., Livingstone, E., Qian, K., Valentijn, L. J., Zheng, Y., Schor, N. F., Li, X. 2016; 7 (39): 63629-63639

  Abstract

  Amplification or overexpression of MYCN is associated with poor prognosis of human neuroblastoma. We have recently defined a MYCN-dependent transcriptional signature, including protein arginine methyltransferase 1 (PRMT1), which identifies a subgroup of patients with high-risk disease. Here we provide several lines of evidence demonstrating PRMT1 as a novel regulator of MYCN and implicating PRMT1 as a potential therapeutic target in neuroblastoma pathogenesis. First, we observed a strong correlation between MYCN and PRMT1 protein levels in primary neuroblastoma tumors. Second, MYCN physically associates with PRMT1 by direct protein-protein interaction. Third, depletion of PRMT1 through siRNA knockdown reduced neuroblastoma cell viability and MYCN expression. Fourth, we showed that PRMT1 regulates MYCN stability and identified MYCN as a novel substrate of PRMT1. Finally, we demonstrated that mutation of putatively methylated arginine R65 to alanine decreased MYCN stability by altering phosphorylation at residues serine 62 and threonine 58. These results provide mechanistic insights into the modulation of MYCN oncoprotein by PRMT1, and suggest that targeting PRMT1 may have a therapeutic impact on MYCN-driven oncogenesis.

  View details for DOI 10.18632/oncotarget.11556

  View details for Web of Science ID 000387167800063

  View details for PubMedID 27571165

  View details for PubMedCentralID PMC5325390