Digital Commons Network^™

Mcs Assisted High Risk Multi-Vessel Percutaneous Intervention In Cardiogenic Shock Patient With Lv Thrombus, Amanpreet Kaur, Akhil Gade, Srinivasan Rajaganapathy, Ruben Abreu, Victor Delprincipe

North Texas GME Research Forum 2024

Background: Acute coronary syndrome patients presenting with Cardiogenic shock carry a very high mortality risk >70% without appropriate intervention in a timely fashion. Here we present a patient requiring an axial pump mechanical circulatory support despite having an apical thrombus. Case report: 55-year-old male with past medical history of type 2 diabetes mellitus and medication noncompliance was transferred from outside facility for high risk ACS with EKG showing ST segment elevation in inferior and anterolateral leads. Lab showed hsTroponin more than 125K, BG 556, HCO3 17, and Beta hydroxybutyrate of 41.87 indicating DKA. Emergent coronary angiography showed mid LAD artery …

A Retrospective Study On The Effect Of Raas Pathway Inhibitors At Decreasing The Risk Of Acute Coronary Syndrome In Hypertensive Patients With Rheumatoid Arthritis As Compared To Other Antihypertensives, Yousuf Sherwani, Asad Risvi, Senthil Thambidorai

North Texas GME Research Forum 2024

Rheumatoid arthritis (RA) is a chronic multi-system inflammatory disease of which is characterized by articular and extra-articular involvement. Patients with RA have a higher risk of mortality when compared with the general population, which is due predominantly to increased cardiovascular disease. Due to the higher incidence of CVD and MI in RA patients it has been postulated that enhanced systemic inflammation plays an important role in the pathogenesis of CVD in RA patients. Previous studies have shown that ant inflammatory medication such as systemic steroids and immune blockers have been shown to decrease the risk of MI in patients with …

Surgical Margin Analysis In Early-Stage Cervical Cancer: An Hca Retrospective Study, Chrystal Stallworth, Abel Moron, Nicole Tenzel, Timothy Kremer, Michele Mccarroll

North Texas GME Research Forum 2024

Objective: This study aimed to compare surgical margin analysis on final pathology in robotic assisted approach hysterectomy vs. all other approaches in early-stage cervical cancer.

Methods: Patients with clinical early-stage disease who underwent total and radical hysterectomy from the years 2018-2023 were categorized into robotic assisted approach group (RAH) vs all other approaches including laparoscopic hysterectomy (LAH), laparoscopic assisted vaginal hysterectomy (LAVH), and open hysterectomy (TAH). Fisher’s exact test was used for analysis of the primary outcome measure.

Results: A total of 92 patients met inclusion criteria. Mode of surgery included: 83 RAH (90.2%), 6 LAH (6.5%), 2 TAH (2.17%), …

Anchoring Sepsis Management: A Retrospective Cohort Study On Fluid Resuscitation In Advanced And End-Stage Renal Disease With Sepsis, Hunter Reed, Abraheim Al-Nasseri, Adam Robarge, Uzman Kazi

West Florida Division GME Research Day 2024

No abstract provided.

Differences In Clinical Interventions And Outcomes In Septic Patients With Heart Failure A Prospective Single Center Experience From The Sepsisquad Investigators, Jose Rodriguez Castro, Manjot Malhi, Rafael Miret, Kristen Santana, Anna Feliszek, Kevin Gopala Rao, Lyanne Rolon, Garrett Wagner, Siddarth Kathuria, Raiko Diaz, Daniel Heller, Mauricio Danckers

East Florida Division GME Research Day 2024

No abstract provided.

Recurrent Intussusception In Child Despite Repeated Surgical Correction, Carlos Cordova, Alexandra Lawlor, Tillie Schumann, Sydney Solomon, Lily Wiedrich

East Florida Division GME Research Day 2024

No abstract provided.

Ai-Supported Diagnosis Of Hypertrophic Cardiomyopathy In A Patient With Adrenal Pheochromocytoma, Muhannad Akel, Ammer Haffar, Christian Zellner

West Florida Division GME Research Day 2024

No abstract provided.

A Dramatic Case Of Acute Biventricular Failure Secondary To Acute Myocardial Infraction, Heriberto Cantu, Ahmed Mahmood, Luay Alalawi, Thomas Alexander

Gulf Coast Division GME Research Symposium 2024

No abstract provided.

A Case Of Mediastinitis From Esophageal Perforation Presenting As Gastric Volvulus/Para-Esophageal Hernia, Anam Zara, Bushra Bangash, Renu Thomas, Asad Rehman, Karthik Vadamalai, Zuhair Ali, Mishal Mazhar

Gulf Coast Division GME Research Symposium 2024

No abstract provided.

Anomalous Anomaly: A Rare Case Of The Rca Arising From The Mild Lad, Heriberto Cantu, Luay Alalawi, Ahmed Mahmood, Thomas Alexander

Gulf Coast Division GME Research Symposium 2024

No abstract provided.

The Utility Of Cologuard In A Real-World Community Setting, Abhinav K. Rao, Shivam Kalra, Danny Tran, Angeli Patel, Ibrahim Al-Saadi, Levi C. Diggins, Ian Whitaker, Shannon Kang, Kunaal Patel, Eyad Gharaibeh, Ali Khalifa, Don C. Rockey, Brett Van Leer-Greensberg

South Atlantic Division GME Research Day 2024

No abstract provided.

A Challenging Diagnosis Of Intestinal Tuberculosis Mimicking Crohn's Disease, Justin Sanchez, Gabriel Gonzales, Monte Troutman

North Texas GME Research Forum 2024

Intestinal tuberculosis (ITB) is an underrecognized disease that shares many clinical, radiologic, endoscopic, and pathologic features with Crohn's disease, making differentiation difficult. This poses a significant problem as initiation of immunosuppressives for an assumed diagnosis of CD in a patient with ITB can lead to exacerbation of infection and life-threatening consequences. A 30-year-old Nepali man with a medical history only significant for Raynaud disease presented with a febrile illness, right lower quadrant abdominal pain, and productive cough over the course of a month. He immigrated from Nepal 3 years prior to presentation, denying other risk factors or specific symptoms of …

Phase 1 Trial Of Tpi 287, A Microtubule Stabilizing Agent, In Combination With Bevacizumab In Adults With Recurrent Glioblastoma, Samuel A Goldlust, Louis B Nabors, Sigmund Hsu, Nimish Mohile, Paul J Duic, Tara Benkers, Samuel Singer, Mayank Rao, Lori Cappello, Sandra L Silberman, George Farmer

Faculty, Staff and Student Publications

BACKGROUND: Recurrent glioblastoma (rGBM) has limited treatment options. This phase 1 protocol was designed to study the safety and preliminary efficacy of TPI 287, a central nervous system penetrant microtubule stabilizer, in combination with bevacizumab (BEV) for the treatment of rGBM.

METHODS: GBM patients with up to 2 prior relapses without prior exposure to anti-angiogenic therapy were eligible. A standard 3 + 3 design was utilized to determine the maximum tolerated dose (MTD) of TPI 287. Cohorts received TPI 287 at 140-220 mg/m

RESULTS: Twenty-four patients were enrolled at 6 centers. Treatment was generally well tolerated. Fatigue, myelosuppression, and peripheral …

Cardiometabolic Genomics And Pharmacogenomics In Filipino Americans: A Cross-Sectional Study, Khalifa Y. Alrajeh

Theses and Dissertations

Background: Heart disease remains a leading cause of death in the country, with significant ethnic disparities. Filipino Americans (FAs), the third-largest Asian subgroup in U.S., face an elevated burden of dyslipidemia, a primary modifiable risk factor for heart disease. Objectives: This community-based study addresses critical knowledge gaps by characterizing the cardiometabolic and genetic factors contributing to dyslipidemia among FAs and implications for personalized cardiovascular drug therapies, particularly statin pharmacogenomics (PGx). Methods: We characterized dyslipidemia prevalence in FAs and major ethnic subgroups using nationally representative NHANES data. We examined associations between uric acid (UA) levels and lipid profiles, …

Addressing Disparity: A Waiting Room Intervention For Preeclampsia Prevention In African Americans, Morgan Semana

Nursing | Senior Theses

Maternal mortality is a pressing, global concern that particularly affects African American women in the United States. African American women face disproportionately a high maternal mortality rate (MMR), with rates more than double that of white women. Preeclampsia emerges as the leading cause of maternal mortality in African American women, driving the need for targeted interventions. To address this issue, a proposed research study aims to investigate the impact of a nurse-led, waiting room, preeclampsia and aspirin effectiveness educational intervention on the knowledge and preeclampsia rates among African American women. The study draws upon existing evidence that supports the use …

Optimizing Ventilator-Associated Pneumonia Prevention And Education: In Adult Icu Settings, Danielle Gonzalez

Nursing | Senior Theses

Background: Ventilator associated pneumonia (VAP) in adult intensive care patient units (ICU) is one of the most common and deadly nosocomial infections today. Studies have identified a gap in intensive care nurse ventilator education and compliance with hospital protocols. Overall increasing the rates of VAP and morbidity. Hospitals worldwide have shown a decrease in VAP rates after inheriting "VAP-bundles''. This includes nurse specific interventions and assessments as a preventative measure. However, studies failed to demonstrate which bundle interventions directly correspond to the prevention of VAP. Purpose: Address all components of education, a nurse’s ability to properly identify and understand the …

Advancing School Nursing Practice: A Novel Approach To Screening For Gastrointestinal Disorders In Children, Ashley Bunting, Isabella Cavlan

Nursing | Senior Theses

Background: Currently, mandated health screenings in California schools are limited to vision, hearing, and scoliosis; this leaves several other body systems unmonitored during the crucial years of childhood development. One such system is the gastrointestinal (GI) system, which plays a vital role in the normal growth, nutrition status, development, and overall health of children. Objective: By developing and implementing a GI-specific screening tool in the outpatient school setting, this research aims to increase the detection of GI disorders in children. Not only that, but school nurses can use this novel screening tool to promote early diagnosis, intervention, and …

Concepts In Animal Parasitology, Chapter 39: Haplosplanchnata Olson Et Al., 2003 (Suborder): Two Hosts With Half The Guts [Platyhelminthes, Trematoda, Digenea, Plagiorchiida], Daniel C. Huston

Concepts in Animal Parasitology

An overview of the suborder Haplosplanchnata Olson et al., 2003, a small, but distinct lineage within the Plagiorchiida. Includes a discussion of the methods of identification, general morphological characteristics, taxonomy, and life cycles.

Chapter 39 in Concepts in Animal Parasitology, by Daniel C. Huston. 2024. S. L. Gardner and S. A. Gardner, editors. Zea Books, Lincoln, Nebraska, United States. doi: 10.32873/unl.dc.ciap039

Concepts In Animal Parasitology, Chapter 47: Summary Of The Digenea (Subclass): Insights And Lessons From A Prominent Parasitologist [Platyhelminthes, Trematoda, Digenea], Robin M. Overstreet

Concepts in Animal Parasitology

An overview of the digenean trematodes (subclass Digenea) including insights and lessons from a prominent parasitologist, Robin M. Overstreet. Includes discussion of general morphology, biology, preparation methods, phylogeny, classification, life cycles, host-digenean relationships, effects on host behavior, hyperparasitism, ecology, digeneans as indicators, and literature on the digeneans.

Chapter 47 in Concepts in Animal Parasitology, by Robin M. Overstreet. 2024. S. L. Gardner and S. A. Gardner, editors. Zea Books, Lincoln, Nebraska, United States. doi: 10.32873/unl.dc.ciap047

Concepts In Animal Parasitology, Chapter 60: Monogenea Van Beneden, 1858 (Class) [Platyhelminthes], Griselda Pulido-Flores

Concepts in Animal Parasitology

An overview of the class Monogenea van Beneden, 1858, mainly ectoparasites of the skin, fins, gills, and urinary bladder of fishes, amphibians, and some reptiles. Includes discussion of their classification (both historical and current), general morphology, life cycles, and taxonomy.

Chapter 60 in Concepts in Animal Parasitology, by Griselda Pulido-Flores. 2024. S. L. Gardner and S. A. Gardner, editors. Zea Books, Lincoln, Nebraska, United States. doi: 10.32873/unl.dc.ciap060

Concepts In Animal Parasitology, Chapter 64: Phthiraptera (Order): Lice [Arthropoda], Lajos Rózsa, Haylee J. Weaver

Concepts in Animal Parasitology

An overview of lice, order Phthiraptera, including discussion of their general morphology, feeding, host range, host distribution, life cycle, macroecology, transmission, effects on hosts and role as vectors, host defenses, conservation, evolutionary origins, phylogeny, lice nuclear genome, taxonomy, and medical implications including their control.

Chapter 64 in Concepts in Animal Parasitology, by Lajos Rózsa and Haylee J. Weaver. 2024. S. L. Gardner and S. A. Gardner, editors. Zea Books, Lincoln, Nebraska, United States. doi: 10.32873/unl.dc.ciap064

Distribution Of Tick Species On Free-Ranging Ungulates In Northern New England, Karisa Graham

Honors Theses and Capstones

In Northern New England, ungulates are often parasitized by ticks, which is one of the leading causes for the decline in population. Ungulates are a good host for ticks, specifically deer ticks and winter ticks, and these ticks cause many tick-borne diseases in humans as well. The purpose of this study was to assess passive sampling from harvested animals as a means of tick surveillance in Vermont and New Hampshire. Ticks were collected from deer and moose and mapped throughout the two states by ArcGIS to visualize the trends in distribution. Relative abundance was greater in southeastern Vermont, with no …

Dual Suppression Of Glossina Pallidipes Using Entomopathogenic Fungal-Based Biopesticides And Sterile Insect Technique, Fidelis L.O. Ombura, Adly M.M. Abd-Alla, Komivi S. Akutse, Steven Runo, Paul O. Mireji, Rosemary Bateta, Joseck E. Otiwi, Inusa J. Ajene, Fathiya M. Khamis

All Peer-Reviewed Publications

Tsetse flies and trypanosomosis significantly impact bovine production and human health in sub-Saharan Africa, exacerbating underdevelopment, malnutrition, and poverty. Despite various control strategies, long-term success has been limited. This study evaluates the combined use of entomopathogenic fungi (EPF) and the sterile insect technique (SIT) to combat tsetse flies. Eleven EPF isolates were tested against teneral males of Glossina pallidipes, focusing on mortality rates, radial growth, and impacts on fly fitness. Temperature effects on conidial growth, sporulation, and spore yield of SIT-compatible/tolerant strains were also assessed. The fungal isolates significantly influenced mortality rates in both unirradiated and irradiated (SIT-treated) males (p <  0.0001). Metarhizium anisopliae strains ICIPE 20, ICIPE 32, ICIPE 41, ICIPE 62, ICIPE 78, and Beauveria bassiana ICIPE 603 showed higher SIT compatibility/tolerance with LT50 values of 11–30 days, compared to other more virulent isolates with LT50 values of 4–9 days. Temperature significantly affected the radial growth of SIT-compatible EPF strains (p <  0.0001), with M. anisopliae ICIPE 78 exhibiting the fastest conidia growth at 25°C. Spore yield varied significantly across temperatures (15–40°C), and the thermal range for conidia germination of SIT-compatible strains was 8.1–45.4°C, with an optimal range of 26.7–31.1°C. Moreover, infected unirradiated females and irradiated males (donors) successfully transmitted conidia to untreated flies (receivers) without significant differences in survival rates (p = 0.6438) and no observed sex dimorphism. Our findings highlight the potential of combining EPF and SIT as a novel dual approach that could effectively and synergistically suppress tsetse fly populations.

Tissue-Specific Localization Of Tick-Borne Pathogens In Ticks Collected From Camels In Kenya: Insights Into Vector Competence, Rua Khogali, Armanda Bastos, Joel L. Bargul, Dennis Getange, James Kabii, Daniel Masiga, Jandouwe Villinger

All Peer-Reviewed Publications

Background: Tick-borne pathogen (TBP) surveillance studies often use whole-tick homogenates when inferring tick-pathogen associations. However, localized TBP infections within tick tissues (saliva, hemolymph, salivary glands, and midgut) can inform pathogen transmission mechanisms and are key to disentangling pathogen detection from vector competence. Methods: We screened 278 camel blood samples and 504 tick tissue samples derived from 126 camel ticks sampled in two Kenyan counties (Laikipia and Marsabit) for Anaplasma, Ehrlichia, Coxiella, Rickettsia, Theileria, and Babesia by PCR-HRM analysis. Results: Candidatus Anaplasma camelii infections were common in camels (91%), but absent in all samples from Rhipicephalus pulchellus, Amblyomma gemma, Hyalomma dromedarii, …

Harnessing Antagonistic Pleiotropy: Tolc-Dependent Coliphages Can Drive Reduced Antibiotic Resistance In E. Coli, Cooper Mckenna

CMC Senior Theses

The rise of multidrug-resistant (MDR) bacterial pathogens has been a growing concern in healthcare around the world, and bacteriophage (phage) therapy is a promising method to combat MDR infections. One defense mechanism of E. coli against antibiotics is the TolC-AcrAB efflux pump. At the same time, some phages use TolC as a surface receptor to infect the cell. This puts TolC at a crossroads in which it is beneficial to the bacteria to protect against antibiotics but harmful by allowing phage infection, creating the potential for evolutionary trade-offs. Previous research has identified only three TolC-dependent phages and shown phage-resistant E. …

Gut Dysbiosis Correlates With Covid-19 Severity, Ednita Escobar

CMC Senior Theses

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) impacts not only respiratory but also gut and oral microbiomes, influencing the manifestations of COVID-19. Each person’s unique microbiome consists of microorganisms such as bacteria, fungi, and viruses, some of which are symbiotic and others potentially harmful. Alterations in the gut microbiome, specifically, can affect the severity and symptoms of COVID-19. A review of studies indicate a pattern of gut dysbiosis in COVID-19 patients characterized by a decrease in beneficial microbiota and/or an increase in opportunistic pathogens. This gut imbalance correlates with disease severity, suggesting that the gut microbiome plays a significant role …

Driven By Change: The Impact Of Macroeconomic Shifts And Covid-19 On New Vehicle Sales, Jackson Aldrich

CMC Senior Theses

This paper examines the impact of macroeconomic factors and the COVID-19 pandemic on new vehicle sales. In order to address these two topics, a two-pronged approach was used with separate regression models. The macroeconomic variables include monthly supply of new homes, CPI for urban public transportation, unemployment rate, disposable personal income, inflation expectation, consumer sentiment, average gas prices, and total vehicle miles traveled which were regressed on total vehicle sales from 1978-2022. The regression results confirmed and supported current literature and highlighted the importance of the housing market and unemployment rate on new vehicle sales. The COVID-19 pandemic model variables …

Exploring The Impact Of Caffeine, Alcohol, And Opioids On Intraocular Pressure: A Comprehensive Analysis Of Short-Term And Long-Term Effects On Vision, Jake Prieto

CMC Senior Theses

Coffee, alcohol, and opioids are addictive drugs commonly used in modern society, yet their impact on ocular health remains ambiguous. This systematic review aims to elucidate this ambiguity by examining their effects on intraocular pressure (IOP). Utilizing IOP as a metric, both short-term and long-term effects are evaluated across individuals with irregular IOP levels and healthy subjects. Furthermore, the study analyzes choroidal thickness as an additional measure to reinforce or challenge the findings regarding IOP, leveraging the inverse relationship between the two metrics concerning elevated IOP-related illnesses, such as open-angle glaucoma (OAG).

A comprehensive literature search was performed through Google …

Employing A Machine Learning Approach In Precision Oncology To Predict Pik3ca Functional Status And Identify Phenocopying Variants Of Deleterious Pik3ca Mutations, Javier Castillo

CMC Senior Theses

The following proposal describes a modular machine learning approach that detects malfunctioning genes and pathways in cancer using the transcriptome of cancer patients. The transcriptome is underused in precision oncology and, combined with machine learning, can aid in the identification of hidden responders. Applied to the PI3K/AKT/mTOR pathway, this method can be used to predict PIK3CA functional status and identify phenocopying variants of deleterious PIK3CA mutations. The classifier will do this by integrating RNA-seq, copy number, and mutation data from tumors to determine the functional status of PIK3CA using a set of learned gene-specific weights. The classifier will then be …

Human Papilloma Virus Type 16 Seroprevalence Among Men Living With Hiv, Ashley Duff

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Objectives: Individuals living with HIV are at a higher risk for developing human papillomavirus-driven oropharyngeal cancer (HPV-OPC). There are no methods for early detection; however, HPV16 E6 antibodies have been identified as a promising early marker. The objective of this study was to evaluate seroprevalence and predictors of HPV16 E6 seropositivity among men living with HIV.

Methods:2,334 men aged 40+ living with HIV with blood specimens banked within the Tennessee Center for AIDS Research (TN-CFAR) biorepository were evaluated using HPV multiplex serology. Seroprevalence of HPV16 antibodies was calculated for all HPV16 proteins analyzed (L1, E1, E2, E4, E6, E7). …