Translational Medical Research Commons^™

Design Of The Strive-Ipf Trial-Study Of Therapeutic Plasma Exchange, Rituximab, And Intravenous Immunoglobulin For Acute Exacerbations Of Idiopathic Pulmonary Fibrosis, Tejaswini Kulkarni, Gerard Criner, Daniel Kass, Ivan Rosas, Mary Beth Scholand, Daniel Dilling, Ross Summer, Steven Duncan

Division of Pulmonary and Critical Care Medicine Faculty Papers

BACKGROUND: Acute exacerbations of idiopathic pulmonary fibrosis (AE-IPF) affect a significant proportion of patients with IPF. There are limited data to inform therapeutic strategies for AE-IPF, despite its high mortality. We discuss the rationale and design of STRIVE-IPF, a randomized, multi-center, open-label Phase IIb clinical trial to determine the efficacy of combined therapeutic plasma exchange (TPE), rituximab, and intravenous immunoglobulin (IVIG), in comparison to treatment as usual (TAU), among patients with acute IPF exacerbations.

METHODS: The STRIVE-IPF trial will randomize 51 patients among five sites in the United States. The inclusion criteria have been designed to select a study population …

Operative Versus Nonoperative Management For Diverticulitis Complicated By Abscess, Alix Bernholtz, Abbie R. Bauer

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

You K, Bendl R, Taut C, et al. Randomized clinical trial of elective resection versus observation in diverticulitis with extraluminal air or abscess initially managed conservatively. Br J Surg. 2018;105(8):971-979. https://doi.org/10.1002/bjs.10868

for a patient with a recurrent diverticulitis complicated by abscess formation.

Buprenorphine For Pain Management Vs. Chronic Hydrocodone-Acetaminophen Therapy When Comorbidities Increase The Risk Of Opioid-Related Side Effects, Jessica Zhao, Doo Hee Kim

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Gordon A, Callaghan D, Spink D, et al. Buprenorphine transdermal system in adults with chronic low back pain: a randomized, double-blind, placebo-controlled crossover study, followed by an open-label extension phase. Clin Ther. 2010;32(5):844-860. https://doi.org/10.1016/j.clinthera.2010.04.018

for a patient on long-term opioid therapy with high risk factors for adverse effects.

Simplifying Treatment From Double-Inhaler To Single-Inhaler Triple Therapy In Patients With Chronic Obstructive Pulmonary Disease, Kelly Yang, Leah Warren

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using

Ferguson GT, Brown N, Compton C, et al. Once-daily single-inhaler versus twice-daily multiple-inhaler triple therapy in patients with COPD: lung function and health status results from two replicate randomized controlled trials. Respir Res. 2020;21(1):131. https://doi.org/10.1186/s12931-020-01360-w

for a patient requesting a simplified therapeutic regimen with equal efficacy for chronic obstructive pulmonary disease (COPD) management.

Effects Of Chaplain Care On Coping With Cancer, Sarah Battiston, Scott L. Baughan

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical case decision report using:

Piderman KM, Radecki CR, Jenkins SM, et al. Hearing and heeding the voices of those with advanced illnesses. Journal of Palliative Care. 2020;35(4):248-255. https://doi.org/10.1177/0825859720928623

for a patient having difficulty coping with cancer

Efficacy Of Observational Care Versus Antibiotic Therapy For Treatment Of Acute Uncomplicated Diverticulitis, Morgan Mooty, Abbie R. Bauer

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

van Dijk ST, Daniels L, Ünlü Ç, et al. Long-Term Effects of Omitting Antibiotics in Uncomplicated Acute Diverticulitis. Am J Gastroenterol. 2018;113(7):1045-1052. https://doi.org/10.1038/s41395-018-0030-y

for a patient with acute uncomplicated diverticulitis.

Radiofreqency Device As An Alternative Therapy For Refractory Nasal Valve Collapse, Sara Farooqui, Doo Hee Kim

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using

Silvers SL, Rosenthal JN, McDuffie CM, Yen DM, Han JK. Temperature-controlled radiofrequency device treatment of the nasal valve for nasal airway obstruction: A randomized controlled trial. Int Forum Allergy Rhinol. 2021 Dec;11(12):1676-1684. http://doi.org/10.1002/alr.22861

for a patient with nasal valve collapse.

Safety And Cost Effectiveness Of Immediate Sequential Bilateral Cataracts Surgery, Miles Bowman, Abbie R. Bauer

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Rush SW, Gerald AE, Smith JC, Rush AJ, Rush RB. Prospective analysis of outcomes and economic factors of same-day bilateral cataract surgery in the United States. Journal of Cataract and Refractive Surgery. 2015;41(4):732-739. https://doi.org/10.1016/j.jcrs.2014.07.034

for a patient with bilateral cataracts.

Exploring The Neural Correlates Of Mindfulness-Based Interventions In Youth, Jovan Jande, Clara Zundel, Samantha Ely, Sneha Bhargava, Carmen Carpenter, Reem Tamimi, Leah Gowatch, Mackenna Shampine, Emilie-Clare O'Mara, Shravya Chanamolu, Hilary Marusak

Medical Student Research Symposium

Mindfulness based interventions (MBI) reduce the severity of anxiety and depression among a variety of populations. While the psychological benefits of MBIs are increasingly recognized, less is known about the underlying neural correlates—particularly during childhood and adolescence, a time when many psychopathologies begin to emerge. Here, we provide the first systematic review on the neural correlates of MBI in youth. We reviewed the PubMed database for original articles examining the neural correlates of MBI in youth (0-18 years) leveraging neuroimaging. The search yielded 331 studies, of which 13 were included in the review. These studies comprised 451 participants and were …

Lack Of Alternatives To Colonoscopy Limits Care Of Patients Unable To Complete Bowel Preparation, Tala Al-Saghir

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Benech N, Vinet O, Gaudin JL, et al.: The ONECC Study Group. Colon capsule endoscopy in clinical practice: lessons from a national 5-year observational prospective cohort. Endosc Int Open. 2021;9(10):E1542-E1548. https://doi.org/10.1055/a-1526-09231

for a patient with incomplete bowel preparation and colonoscopy.

Multiple Daily Injection Insulin Regimen Is An Effective, And More Economical, Alternative To Continuous Insulin Infusion For Type 1 Diabetics, Julia Yee

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Heller S, White D, Lee E, et al. A cluster randomised trial, cost-effectiveness analysis and psychosocial evaluation of insulin pump therapy compared with multiple injections during flexible intensive insulin therapy for type 1 diabetes: the REPOSE Trial. Health Technol Assess. 2017 Apr;21(20):1-278. https://doi.org/10.3310/hta21200

for a patient with type 1 diabetes.

Nur77 Mitigates Endothelial Dysfunction Through Activation Of Both Nitric Oxide Production And Anti-Oxidant Pathways, Lin Lu, Soohwa Jang, Jiaqi Zhu, Qing Qin, Lijun Sun, Jianxin Sun

Center for Translational Medicine Faculty Papers

BACKGROUND: Nur77 belongs to the member of orphan nuclear receptor 4A family that plays critical roles in maintaining vascular homeostasis. This study aims to determine whether Nur77 plays a role in attenuating vascular dysfunction, and if so, to determine the molecular mechanisms involved.

METHODS: Both Nur77 knockout (Nur77 KO) and Nur77 endothelial specific transgenic mice (Nur77-Tg) were employed to examine the functional significance of Nur77 in vascular endothelium in vivo. Endothelium-dependent vasodilatation to acetylcholine (Ach) and reactive oxygen species (ROS) production was determined under inflammatory and high glucose conditions. Expression of genes was determined by real-time PCR and western blot …

No Difference In Pullout Strength Between A Bio-Inductive Implant And A Semitendinosus Tendon Graft In A Biomechanical Study Of Medial Patellofemoral Ligament Repair Augmentation, Austin Wetzler, Sean Mcmillan, Erik Brewer, Aakash Patel, Samuel Handy, Merrick Wetzler

Faculty Scholarship for the Rowan-Virtua School of Translational Biomedical Engineering & Sciences

Purpose: To compare the pullout strength of a bio-inductive implant (BI) used to augment a medial patellofemoral ligament (MPFL) repair with the pullout strength of semitendinosus graft in a biomechanical cadaveric model. Methods: Six matched pairs of cadavers (12 knees) were used in the biomechanical testing comparing semitendinosus tendon (Semi-T) versus a BI. The Semi-T was harvested from 1 of the matched pairs. A standard double-bundle technique using 2 sockets in the upper two-thirds of the patella 15 mm apart was performed. After docking of the graft into the patella, the patella was dissected free of soft tissues and potted …

Avaren-Fc, A Novel Immunotherapeutic, Recruits Nk Cells In B16f10 Melanoma Tumor Tissue, Sreevatsa Vemuri, Katarina Mayer, Nobuyuki Matoba

Posters-at-the-Capitol

Melanoma is the fifth most common cancer in the US, with limited effective immunotherapeutic options available for patients. Avaren-Fc (AvFc) is a novel experimental immunotherapeutic agent with a unique “lectibody” property. It is capable of targeting cancer cells through the selective recognition of high mannose glycans, which are aberrantly overrepresented on the surface of malignant cells. AvFc can interact with circulating effector immune cells equipped with Fc receptors, such as natural killer (NK) cells to induce antibody-dependent cell-mediated cytotoxicity (ADCC) and kill cancer cells. Previous work has shown that AvFc effectively induces ADCC activity against B16F10 cancer cells in vitro …

Craftivism As Inquiry: Holding Life’S Threads, Chloe Watfern, Gaynor Macdonald, Michele Elliot, Lynne Stone, Imelda Gilmore, Manuel Tecson, Najla Turk, Penny Bingham, Jane Mears, Ann Dadich, Barbara Doran, Katherine Boydell, Sarah Wallace

The Qualitative Report

In this article, we share insights regarding an arts-based research project where carers of people with dementia conveyed their experiences in cloth. Carers face high rates of mental ill health and burnout, while forming a largely undervalued and unrecognised workforce. Through this project, carers’ knowledge was valued and amplified using an innovative methodology – craftivism. During a series of five workshops in 2021, a small group of carers, researchers and artists gathered online to develop an exhibition of craftivist textile works. They evoked the complexity of their makers’ journeys supporting loved ones at the end of life, finding joy and …

Pkcε Activator Protects Hippocampal Microvascular Disruption And Memory Defect In 3×Tg-Alzheimer's Disease Mice With Cerebral Microinfarcts, Huaixing Wang, Zongxiu Zhang, Jarin Hongpaisan

Center for Translational Medicine Faculty Papers

BACKGROUND: Current evidence suggests that microvessel disease is involved in Alzheimer's disease (AD). Cerebrovascular disease correlates with cardiovascular disease and is complicated in ≈40% of AD patients. The protein kinase C (PKC) ε activator DCPLA can stimulate human antigen (Hu) R that prevents degradation and promotes the translation of mitochondrial Mn-superoxide dismutase (MnSOD) and vascular endothelial growth factor-A (VEGF) mRNAs.

METHODS: To induce brain microinfarcts, we injected triple transgenic (3×Tg) and wild-type (WT) control mice with microbeads (20 μm caliber) into common carotid arteries, with or without the DCPLA-ME (methyl-ester) for 2 weeks. After water maze training, mice at 16 …

Interleukin 31 Receptor Α Promotes Smooth Muscle Cell Contraction And Airway Hyperresponsiveness In Asthma, Santhoshi Akkenepally, Dan Yombo, Sanjana Yerubandi, Geereddy Bhanuprakash Reddy, Deepak Deshpande, Francis Mccormack, Satish Madala

Center for Translational Medicine Faculty Papers

Asthma is a chronic inflammatory airway disease characterized by airway hyperresponsiveness (AHR), inflammation, and goblet cell hyperplasia. Multiple cytokines, including IFNγ, IL-4, and IL-13 are associated with asthma; however, the mechanisms underlying the effects of these cytokines remain unclear. Here, we report a significant increase in the expression of IL-31RA, but not its cognate ligand IL-31, in mouse models of allergic asthma. In support of this, IFNγ, IL-4, and IL-13 upregulated IL-31RA but not IL-31 in both human and mice primary airway smooth muscle cells (ASMC) isolated from the airways of murine and human lungs. Importantly, the loss of IL-31RA …

Reactive Oxygen Species Behaving Badly: Oxidized Phosphatidylcholines Corrupt Ca2+ Signaling In Airway Smooth Muscle, Deepak A. Deshpande, Raymond B. Penn

Center for Translational Medicine Faculty Papers

No abstract provided.

Standardized Total Fitness Scores And Phase Angle In Cancer Survivors, Paulette Yamada, Trevor Short

Topics in Exercise Science and Kinesiology

Topics in Exercise Science and Kinesiology Volume 4: Issue 1, Article 20, 2023. Cancer treatment can lead to decrement in all components of fitness. Exercise can attenuate these effects and build fitness. Exercise program design for this population continues to evolve with high-intensity interval training at the forefront. Phase angle (PhA) is an indirect measure of cellular health and function and is associated with fitness, health, and reduced disease severity. Continued exploration spurs an emerging question: What type of training should be used to maximize improvements in PhA? We provide a visualization of a cancer rehabilitation fitness profile and present …

Sex And Gender Differences In Arthritis Health Information, Tania Al-Jilawi

Electronic Thesis and Dissertation Repository

Arthritis is a common disorder that may result in pain and inflammation, making it challenging to move or continue being active. Arthritis comes in a variety of forms. The two studies of this thesis aimed to identify the influence of intersectionality, especially sex and gender, in arthritis. The first study, a structured review, evaluated the inclusion of sex/gender and intersectional identities in patient resources of three arthritis societies: the Canadian Arthritis Society, the American Arthritis Foundation, and the National Rheumatoid Arthritis Society. The appraisal tool, the Sex/Gender and Intersectional Considerations in Patient/Consumer Health Information Appraisal Tool was used to evaluate …

Promoting Mammography Screenings In African American Women: Media, Church, And Health Providers, Lasonya Little, Debra C. Wallace, K.Jay Poole

Journal of Health Disparities Research and Practice

Due to the underutilization of screening mammography, African American women (AAW) are more likely to experience negative health outcomes after receiving a late-stage breast cancer diagnosis than White Women (WW). The purpose of this article is to examine the roles of the media, health community and the African American church and pastor and their potential impact in AAW screening decisions. Fifteen AAW, ages 45 and older, were invited to participate in a semi-structured interview. Most women agreed the African American pastor and church as well as the health community, and media are an integral part of their lives. Therefore, specific …

An American Medical Economics Phenomenon, Richard Guthmann Md, Mph

Clinical Research in Practice: The Journal of Team Hippocrates

The author reflects on his own experience with medical economics-driven phenomena in healthcare.

Increase In Hnrnpa1 Expression Suffices To Kill Motor Neurons In Transgenic Rats, Xionghao Liu, Tingting Zhang, Qinxue Wu, Cao Huang, Xu-Gang Xia, Hongxia Zhou, Bo Huang

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

A dominant mutation in hnRNPA1 causes amyotrophic lateral sclerosis (ALS), but it is not known whether this mutation leads to motor neuron death through increased or decreased function. To elucidate the relationship between pathogenic hnRNPA1 mutation and its native function, we created novel transgenic rats that overexpressed wildtype rat hnRNPA1 exclusively in motor neurons. This targeted expression of wildtype hnRNPA1 caused severe motor neuron loss and subsequent denervation muscle atrophy in transgenic rats that recapitulated the characteristics of ALS. These findings demonstrate that the augmentation of hnRNPA1 expression suffices to trigger motor neuron degeneration and the manifestation of ALS-like phenotypes. …

Immune Responses Induced At One Hour Post Cataract Surgery Wounding Of The Chick Lens, Jodirae Dedreu, Morgan Basta, Janice Walker, Sue Menko

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

While the lens is an avascular tissue with an immune-privileged status, studies have now revealed that there are immune responses specifically linked to the lens. The response to lens injury, such as following cataract surgery, has been shown to involve the activation of the resident immune cell population of the lens and the induction of immunomodulatory factors by the wounded epithelium. However, there has been limited investigation into the immediate response of the lens to wounding, particularly those induced factors that are intrinsic to the lens and its associated resident immune cells. Using an established chick embryo ex vivo cataract …

Social Determinants May Limit The Success Of Pcsk9 Inhibitors, An Effective Treatment For Hyperlipidemia In Statin-Intolerant Patients, Abigail C. Kuplicki

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Moriarty PM, Thompson PD, Cannon CP, et al. Efficacy and safety of alirocumab vs ezetimibe in statin-intolerant patients, with a statin rechallenge arm: The ODYSSEY ALTERNATIVE randomized trial. J. Clin. Lipidol. 2015;9(6):758-769. https://doi.org/10.1016/j.jacl.2015.08.006

for a statin-intolerant patient with hyperlipidemia.

Renal Disease Rehabilitation And Delaying Dialysis, Spencer Brown, Natalie Sterner

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Greenwood SA, Koufaki P, Mercer TH, et al. Effect of exercise training on estimated GFR, vascular health, and cardiorespiratory fitness in patients with CKD: a pilot randomized controlled trial. Am J Kidney Dis. 2015;65(3):425-434. https://doi.org/10.1053/j.ajkd.2014.07.015

for a patient with non-dialysis CKD interested in slowing the progression toward necessary dialysis.

Slow Surgical Correction Affects More Than Just The Bowels, Emilia M. Clementi

Clinical Research in Practice: The Journal of Team Hippocrates

Reflection on how delayed colostomy reversal affects a patient's mental and physical well-being.

Whole Genome-Based Dna Methylation Profiling In Covid-19 Patients Reveals Alterations In Pathways Linked To Neurological Dysfunctions, Syed Zami, Juozas Gordevicius, Eman Anis, Qiong Sha, Martha L. Escobar Galvis, Michael Henderson, Andrew Pospisilik, Patrik Brundin, Stewart Graham

Conference Presentation Abstracts

The sever acute respiratory syndrome corona virus 2 (SARS-CoV-2) is a highly transmissible viruswhich causes a life-threatening illness called coronavirus (COVID-19). It has cost millions ofdeath worldwide. This novel RNA betacorona virus is manifested by varying clinical symptomsranging from asymptomatic to mild to severe systemic illness with deadly outcomes. Muchevidence revealed the differences in the severity of COVID-19 infection varied widely accordingto host factors and comorbidities. It is critical to understand the interplay of genetic and epigeneticfactors and host response to this fatal virus. A substantial number of epigenome-wide associationstudies acknowledged that SARS-CoV-2 manipulate the host epigenome via DNA methylation …

Uptitrating Mycophenolate Mofetil Therapy In A Patient With Lupus Cerebritis Doesn’T Increase Risk Of Infection Compared To Cyclophosphamide, Gautham Pavar

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising

Appel GB, Contreras G, Dooley MA, et al. Mycophenolate mofetil versus cyclophosphamide for induction treatment of lupus nephritis. J Am Soc Nephrol. 2009;20(5):1103-1112. https://doi.org/10.1681/ASN.2008101028

for a patient with neuropsychiatric lupus.

Stigma And Patient-Controlled Analgesia: Trust Is The Essential Ingredient Of Successful Patient Education In The Patient-Doctor Relationship, Trey D. Vanaken

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Van Beers EJ, Van Tuijn CFJ, Nieuwkerk PT, et al. Patient-controlled analgesia versus continuous infusion of morphine during vaso-occlusive crisis in sickle cell disease, a randomized controlled trial. Am J Hematol. 2007;82(11):955-960. https://doi.org/10.1002/ajh.20944.

for a patient with recurrent vaso-occlusive crisis secondary to Sickle Cell Disease.