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Fgf19 As A Colorectal Cancer Serum Biomarker And Fgfr4 As A Mediator Of Anti-Her2 Resistance In Breast Cancer, Jordan Beardsley

Graduate Studies Theses and Dissertations 2026

The fibroblast growth factor 19 (FGF19)-fibroblast growth factor receptor 4 (FGFR4) signaling pathway regulates hepatic metabolism, bile acid (BA) synthesis, and hepatocyte proliferation. This signaling axis also is implicated in promoting tumor progression, therapeutic resistance, and metastasis in certain cancers.

In colorectal cancer (CRC) there is a critical need for non-invasive biomarkers for disease detection and monitoring. We identified FGF19 as a candidate CRC serum marker through meta-transcriptomics and found FGF19 to be expressed and secreted by CRC cell lines. Tumor-derived FGF19 was detectable in mouse serum at levels correlating with tumor volume in a subcutaneous xenograft model. RNA sequencing …

Wilson’S Disease Psychosis In A Young Man With Autism Spectrum Disorder: A Case Report And Focus On Management, Landon C. Sowell, Barbara L. Gracious

HCA Healthcare Journal of Medicine

Introduction

Wilson's disease is a rare autosomal recessive disorder, affecting approximately 1 in 30 000 individuals and is characterized by abnormal copper accumulation in the body, primarily affecting the liver and brain. Psychiatric manifestations as a first presentation, particularly psychosis, are less commonly recognized resulting in failure to begin treatment early in the course of the disease. This case report highlights a patient that presented to the hospital with psychosis, who was later diagnosed with Wilson’s disease. This case underscores the importance of considering organic causes in first-episode psychosis.

Case Presentation

An 18-year-old man with a history of autism spectrum …

Disruption Of Protein-Protein Interaction Hotspots In The C-Terminal Domain Of Mlh1 Confers Mismatch Repair Deficiency, Keri M. Fishwick, Diego Gomez Vieito, Giada Greco, Giulio Collotta, Marco Gatti, Anastasija A. Kulik, Raphaël Guérois, Ivan Corbeski, Ashutosh S. Phadte, Issam Senoussi, Petr Cejka, Anna Pluciennik, Antonio Porro, Alessandro A. Sartori

Department of Biochemistry and Molecular Biology Faculty Papers

MutLα, a heterodimer of MLH1 and PMS2, plays a key role in DNA mismatch repair (MMR), which maintains genomic stability by correcting replication errors. Loss of MLH1 function causes MMR deficiency (MMRd), leading to elevated mutation rates and increased cancer susceptibility. However, MMRd can offer a therapeutic advantage, as high tumour mutational burden enhances the efficacy of immune checkpoint inhibition. MMR also drives somatic expansion of CAG repeats linked to Huntington’s disease (HD) pathogenesis. The C-terminal domain (CTD) of MLH1 contains at least two distinct protein–protein interaction (PPI) sites. The S1 site supports heterodimerization with the PMS2 endonuclease, whereas the …

Speeding Up Interval Estimation For R2-Based Mediation Effect Of High-Dimensional Mediators Via Cross-Fitting, Zhichao Xu, Chunlin Li, Sunyi Chi, Tianzhong Yang, Peng Wei

Faculty, Staff and Student Publications

Mediation analysis is a useful tool in investigating how molecular phenotypes such as gene expression mediate the effect of exposure on health outcomes. However, commonly used mean-based total mediation effect measures may suffer from cancellation of component-wise mediation effects in opposite directions in the presence of high-dimensional omics mediators. To overcome this limitation, we recently proposed a variance-based R-squared total mediation effect measure that relies on the computationally intensive nonparametric bootstrap for confidence interval estimation. In the work described herein, we formulated a more efficient two-stage, cross-fitted estimation procedure for the R2 measure. To avoid potential bias, we performed …

Gut Microbiome Metagenomics In Clinical Practice: Bridging The Gap Between Research And Precision Medicine, Henok Ayalew Tegegne, Tor C Savidge

Faculty, Staff and Students Publications

Gut microbiome metagenomics is emerging as a cornerstone of precision medicine, offering exceptional opportunities for improved diagnostics, risk stratification, and therapeutic development. Advances in high-throughput sequencing have uncovered robust microbial signatures linked to infectious, inflammatory, metabolic, and neoplastic diseases. Clinical applications now include pathogen detection, antimicrobial resistance profiling, microbiota-based therapies, and enterotype-guided patient stratification. However, translation into routine care is hindered by significant barriers including methodological variability, limited functional annotation, lack of bioinformatics standardization, and underrepresentation of global populations. This review synthesizes current translational strategies, emphasizing the need for hypothesis-driven designs, multi-omic integration, longitudinal and multi-center cohorts, and mechanistic validation. …

An Integrated Platform For Concurrent Structural And Single-Nucleotide Variants Improves Copy-Number Detection And Reveals Pathogenic Alleles In Undiagnosed Mendelian Families, Haowei Du, Ming Yin Lun, Lidiia Gagarina, Jesse D Bengtsson, Christopher M Grochowski, Michele G Mehaffey, James Paul Hwang, Shalini N Jhangiani, Sravya V Bhamidipati, Donna M Muzny, M Cecilia Poli, Sebastian Ochoa, Ivan K Chinn, Anna Lindstrand, Jennifer E Posey, Richard A Gibbs, Pengfei Liu, James R Lupski, Claudia M B Carvalho

Faculty, Staff and Students Publications

Background: Copy number variation (CNV) is a class of genomic structural variation (SV) that contributes to genomic disorders and can significantly impact health. Short-read genome sequencing (sr-GS) enables genome-wide SV calling which has been shown to increase diagnosis in unsolved rare disease families. The growing number of large sequencing cohort projects with sr-GS data available requires open free analytical tools that provide visualization of CNV and SV integrated calls associated with gene annotation, proband-parent trio analysis to enable prioritization of de novo variants, B-allele frequency (BAF) plots to support CNV calls, parent of origin assessment and mosaicism detection.

Methods: To …

Novel Physical And Biological Applications Of Carbon Ion Radiotherapy, Danushka Seneviratne, Prapannajeet Biswal, Sunil Krishnan

The Brown Foundation: Institute of Molecular Medicine

Carbon ion radiation therapy (CIRT) is a high-LET radiotherapy, which distinguishes itself from traditional low-LET radiation, such as photons and protons, through its unique physical aspects, biological attributes, and the dramatically increased damage it causes within cellular DNA. Given its distinctive characteristics, it is expected to improve the therapeutic ratio of radiation treatments and enhance treatment outcomes in traditionally radiation-resistant tumor histologies. Despite these unique properties, much remains to be understood regarding the clinical use of CIRT before its full potential can be realized. In this review, we summarize the distinct advantages of CIRT with regard to its physical and …

Isg15 Dysregulates Endoplasmic Reticulum-Mitochondrial Contacts And Calcium Homeostasis In Ataxia Telangiectasia, Oygul Mirzalieva, Ryan E. Reed, Arthur L. Haas, Meredith A. Juncker, Patrick Logarbo, Jennifer M. Klein, David Worthylake, Shyamal D. Desai

School of Graduate Studies Faculty Publications

Dysregulation of endoplasmic reticulum and mitochondrial (ER:Mit) contacts and mitochondrial calcium (mitCa2+) homeostasis are found in several neurodegenerative disorders, including Ataxia Telangiectasia (A-T). However, the cellular basis of these defects remains unclear. Previously, we demonstrated that the aberrantly elevated Interferon-Stimulated Gene 15 (ISG15) pathway inhibits protein polyubiquitylation, its dependent protein turnover, and mitophagy pathways in A-T. Literature indicates that silencing of mitochondrial ubiquitin ligase 1 (MUL1) stabilizes mitofusin2 (MFN2) and attenuates mitCa2+ uptake from ER to Mit (mitCa2+influx) in primary neurons. We have replicated these findings in apparently healthy fibroblasts. We hypothesized that elevated ISG15 may inhibit ubiquitin-dependent MUL1-mediated degradation …

Black Bone Mri Morphometry For Mandibular Cortical Bone Measurement In Head And Neck Cancer Patients: Prospective Method Comparison With Ct, Lisanne V Van Dijk, Juan Ventura, Kareem A Wahid, Lin L Zhu, Brigid A Mcdonald, Sara Ahmed, Keith L Sanders, Sonja M Stieb, Lance Mccoy, Christina S Sharafi, Kathryn E Preston, Natalie A West, Sarah Mirbahaeddin, Dina M El-Habashy, Travis Salzillo, Samuel Mulder, Joly Fahim, Aubryane Dearmas, Mona Arbab, Yao Ding, Jihong Wang, Bastien Rigaud, Anando Sen, Mark Chambers, Katherine A Hutcheson, Kristy K Brock, Abdallah S R Mohamed, Stephen Y Lai, Clifton D Fuller

Faculty, Staff and Student Publications

Objectives: Determine the utility of low-flip angle "black bone" magnetic resonance imaging (MRI) for cortical mandibular bone assessment compared to computed tomography (CT).

Methods: Quantification of cortical mandibular bone width was performed per Hamada et al. at 15 cross-sectional interdentium locations on pretreatment black bone MRI and CT for 15 oropharyngeal cancer patients, with interobserver analyses on a subset of three patients by 11 observers. CT and MRI measurements were compared using Bland-Altman analysis, Lin's concordance, and Deming regression; interobserver variability was assessed with absolute variance and intraclass correlation coefficient (ICC).

Results: Bland Altman and Deming regression analyses showed CT …

Retinal Vasculature In Schizophrenia Spectrum Disorder, Caroline Simon Sherman, Erik Gunnarsson, Nycole Hidalgo, Victoria Chen, Kevin Zhang, Shuo Chen, Hwiyoung Lee, Hugh O'Neill, L Elliot Hong, Osamah Saeedi

Faculty, Staff and Student Publications

The purpose of this research is to determine whether retinal vasculatures differ between participants with schizophrenia spectrum disorder (SSD) and controls. Ninety participants (51 SSD, mean age 35.8 ± 13.5, and 39 controls, mean age 35.5 ± 11.4) underwent 3 × 3 mm2 macular and 6 × 6 mm2 optic nerve head (ONH) optical coherence tomography angiography (OCTA) scans. En face macula and ONH region images were divided into quadrants, binarized, and then skeletonized. Skeletonized vessel densities were compared between our two groups. Additionally, the foveal avascular zone (FAZ) size and acircularity index were compared between the two groups. There …

Detection Of The Linac Jaw Face Angle Misalignment Using High Energy Electron Beam Symmetry, Song Gao, Andres Cibrian, Jared Ohrt, Peter Balter

Faculty, Staff and Student Publications

Purpose: To demonstrate the usage of a high energy electron beam symmetry measured at different collimator angles to detect jaws face angle misalignments on Varian TrueBeam linear accelerators (linac) during acceptance and commissioning processes.

Methods: During the linac acceptance, all beams were steered to a symmetric shape with the gantry and collimator at 0°. We noted that the symmetries of higher energies electrons (e.g., 16 MeV, 20 MeV) changed over 2% when measured with the collimator at 90° and/or 270° for two linacs commissioned within 5-months of each other. Misaligned applicators were ruled out as the cause of this issue. …

Anti-Saccade Error Rates Are Associated With Somatic Depressive Symptoms In Cocaine Use Disorder, Constanza De Dios, Heather E Webber, Margaret C Wardle, Jin H Yoon, Michelle A Patriquin, Jessica N Vincent, Joy M Schmitz, Scott D Lane

Faculty, Staff and Student Publications

Background: Inhibitory control deficits are associated with cocaine use disorder (CUD) development and maintenance. Additionally, drug use and inhibitory control can be negatively affected by depressive symptoms, including somatic factors like sleep disturbance and fatigue.

Aim: The current study assessed the relationship between inhibitory control and depressive symptoms among individuals initiating CUD treatment. We examined associations among anti-saccade response inhibition performance, total scores on the Beck Depression Inventory-II (BDI-II), and individual BDI-II items.

Methods: N = 101 patients enrolled in a clinical trial for CUD completed drug-specific anti-saccade and depression (BDI-II) measures prior to treatment. Generalized linear models tested the …

Exploring The Role Of Astrocyte System Xc– In Excitatory/Inhibitory Balance, Samantha Olivia Sutton

Theses - ALL

Astrocytes play a central role in maintaining excitatory/inhibitory (E/I) balance in the central nervous system by supporting intracellular glutathione (GSH) synthesis and regulating extracellular glutamate. System xc– (Sxc–), an obligate cystine/glutamate antiporter encoded by SLC7a11, couples the import of L-cystine with the export of L-glutamate. It is highly expressed throughout the cortex, hippocampus, striatum, and cerebellum, where its activity provides cystine—the rate-limiting substrate for cysteine-dependent GSH production—and contributes to ambient glutamatergic tone. Although global loss of Sxc– alters seizure threshold and redox homeostasis, whether these effects arise specifically from the loss of astrocytic Sxc– has remained unresolved. This thesis examined …

Investigating Chronic Toxicity, Diet, Patient-Reported Outcomes And The Microbiome In Immunotherapy-Treated Metastatic Melanoma Survivors: A New Frontier, Margaux Robert, Satabdi Saha, Nazli Dizman, Michelle Rohlfs, Elizabeth Sirmans, Julie Simon, Rodabe N Amaria, Isabella C Glitza Oliva, Hussein A Tawbi, Michael A Davies, Alexandra Ikeguchi, Karen Basen-Engquist, Keri Schadler, Michael E Roth, Wenye Song, Xiaotao Zhang, Nadim J Ajami, Lorenzo Cohen, Jennifer A Wargo, Christine B Peterson, Jennifer L Mcquade, Carrie R Daniel

Faculty, Staff and Student Publications

Background/Objectives: Immune checkpoint blockade (ICB) therapies have significantly improved outcomes in metastatic melanoma. However, immune-related adverse events (irAEs) and persistent chronic toxicities (CTs) among this emerging survivor population likely influence different facets of quality of life. This study characterized CT, patient-reported outcomes (PROs), diet, physical activity and gut microbiome features in a cohort of long-term survivors with a history of ICB-treated metastatic melanoma.

Methods: Forty-eight patients with a history of metastatic melanoma who initiated ICB treatment at least 3 years earlier and were not currently on treatment were prospectively enrolled from a melanoma survivorship clinic. Participants completed screening …

Society For Immunotherapy Of Cancer: Standards For Reporting Of Multiplex Immunohistochemistry/Immunofluorescence Assays (Stormi), Sam Sater, Carlo B Bifulco, Jaime Rodriguez-Canales, Joe Yeong, Guray Akturk, Michael Angelo, Carmen Ballesteros-Merino, Peter Bankhead, Subham Basu, Jorge M Blando, Saska Brajkovic, Marco Cassano, Benjamin J Chen, Ahmet F Coskun, Tricia R Cottrell, Carlos E De Andrea, Robin H Edwards, Colt Egelston, Logan L Engle, Marc S Ernstoff, Rong Fan, Michael Feldman, Bernard A Fox, Jerome Galon, Robyn Gartrell, Sacha Gnjatic, Benjamin F Green, James L Gulley, Anne Hellebust, Stephen Hewitt, Travis J Hollmann, Lucas A Horn, William J Howat, Clifford C Hoyt, Shawn M Jensen, Arutha Kulasinghe, Wiem Lassoued, Steven Lott, James Mansfield, Sebastian Marwitz, George Netto, David B Page, Edwin Parra, David L Rimm, Scott J Rodig, Roberto Salgado, Denis Schapiro, Kurt A Schalper, Joel C Sunshine, Michael J Surace, Alexander S Szalay, Magdalena Thurin, Jose C Villasboas, Keith Wharton, Ignacio I Wistuba, Jennifer H Yearley, Yinyin Yuan, Geroge Zaki, James Ziai, Janis M Taube

Faculty, Staff and Student Publications

Multiplex immunofluorescence and immunohistochemistry (mIF/IHC) are increasingly employed antibody-based technologies that use tissue sparingly and facilitate the detection of co-localized or neighboring biomarkers. Specifically, these platforms enable spatial analyses of the tumor microenvironment as well as extended applications, for example, describing normal tissue anatomy, autoimmunity, infectious diseases, etc. mIF/IHC has greatly enhanced biomarker discovery efforts, and a growing number of studies suggest superiority to traditional IHC. Standardization of staining approaches, reporting of image analysis strategies and resultant data is critical for facilitating cross-study comparisons, validation, deployment, and generalization of findings. To address this challenge, The Society for Immunotherapy of Cancer …

Development Of A Procedure For Prion Surveillance In The Laboratory Setting, Damian Gorski, Isaac Schauer, Kane Spicker, Ananya Tupaki-Sreepurna, Fei Wang, Claudio Soto, Sandra Pritzkow

Faculty, Staff and Student Publications

Infectious prions readily adhere to common surfaces, retain infectivity, and are highly resistant to conventional decontamination, posing significant biosafety challenges in the medical and research environments. Recent occupational exposures underscore the urgency of improving safety measures. Here, we describe an approach combining foam-swab surface sampling and protein misfolding cyclic amplification to enhance prion surveillance. Our results demonstrate the ability to detect prions most relevant to human health directly from contaminated surfaces, even at 100 million-fold dilutions of the brain. We applied our method to assess the completeness of prion decontamination and show that high prion quantities can resist even approved …

Long Covid Incidence Across Sars-Cov-2 Lineages And Identification Of Conserved Spike Targets For Multivalent Vaccines, Grace J. Kim, Md Ashad Alam, Judy S. Crabtree, Rebecca Rose, Susanna L. Lamers, San Chu, Ronald Horswell, Daniel Fort, Lucio Miele

School of Graduate Studies Faculty Publications

Background: Long COVID remains poorly characterized at the genomic level. The primary aim of this study was to examine the relationship between viral sequences and the incidence of Long COVID at a tertiary care center in Louisiana between April 2020 and December 2022. A secondary aim was analysis of the Spike protein to identify conserved regions for multivalent vaccine targets. Method: To estimate Long COVID incidence across variants, we linked 4,789 SARS-CoV-2 sequences to 3,090 de-identified patient electronic health record information. The base population was defined as any patient with an International Classification of Diseases-10-Clinical Modification COVID-19 diagnosis code (U07.1) …

Abnormalities In Sensorimotor Brain Function Are Related To Chronicity Of Low Back Pain, Jo Armour Smith, Rongwen Tain, Kelli G. Sharp, Laura M. Glynn, Linda R. Van Dillen, Jesse V. Jacobs, Steven C. Cramer

Physical Therapy Faculty Articles and Research

Maladaptive plasticity in the brain may contribute to chronic low back pain (LBP) and underlie the altered postural control of the lumbopelvic musculature that is evident in some individuals with LBP. We recently described an MRI-compatible leg-raise paradigm to measure brain activity associated with lumbopelvic postural control. The objective of this study was to compare brain function in young adults with and without a history of LBP and to determine relationships between brain function, pain, and postural control characteristics. We recruited 55 participants with a history of LBP, who were asymptomatic when studied, and 30 healthy controls. Postural control during …

Metabolomic Profiling Reveals Brain Lipid Alterations In Pex7-Deficient Models Of Rhizomelic Chondrodysplasia Punctata, Riya Sankhe, Meredith I Williams, Wedad Fallatah, Laura Mackay, Mary Layne Brown, Pranjali Bhagwat, Sarah H Elsea, Nancy Braverman, Michael F Wangler

Duncan NRI Faculty and Staff Publications

Rhizomelic chondrodysplasia punctata type 1 (RCDP1) is a peroxisomal disorder characterized by skeletal shortening, intellectual disability, seizures, cataracts, and reduced lifespans. RCDP1 is caused by biallelic loss-of-function variants in PEX7, which encodes a protein required for importing select enzymes into the peroxisome matrix, including those essential for ether lipid synthesis (e.g., plasmalogens) and the branched-chain fatty acid catabolism. Plasmalogen deficiency is a hallmark of RCDP1 and other peroxisomal disorders, including RCDP types 2-5 (RCDP2-5) and Zellweger spectrum disorders (ZSD). Here, we performed comprehensive metabolomic profiling of clinical samples from RCDP patients and Pex7-deficient mouse models. We identified profound …

Endocrine Disruptors And Pregnancy, Betül Yi̇ği̇t Yalçin, Gamze Bi̇li̇k Oyman, Ayşe Kubat Üzüm

Turkish Journal of Medical Sciences

Sensitivity to endocrine disruptors is higher in early life. In pregnant women, endocrine disruptor chemicals can be passed to the baby through the placenta or through breast milk during lactation, leading to long-term and permanent adverse effects. These endocrine disruptors may cause adverse effects in women such as infertility, implantation defects, premature birth, spontaneous abortions, gestational hypertension, gestational diabetes. Exposure to endocrine disruptors in the intrauterine period may result in adverse effects on the reproductive system, metabolic changes, low birth weight, retardation in mental and physical development and also may be associated with congenital malformations. It is of great importance …

The Effects Of Endocrine Disruptors On The Female Reproductive System, Riza Gökhan Baykal, Reyhan Ersoy

Turkish Journal of Medical Sciences

Endocrine-disrupting chemicals (EDCs) are a diverse, comprehensive group of mostly synthetic chemicals that disrupt many physiological functions in humans and animals. EDCs are particularly disruptive to the female reproductive system. Reproductive function in women is a dynamic process regulated by the hypothalamic–pituitary–ovarian axis. EDCs show their effects on the reproductive system through estrogenic, antiestrogenic, androgenic, and antiandrogenic effects or by directly affecting gonadotropin-releasing hormone secretion. Disruption in the menstrual cycle, decrease in fertility, infertility, increased risk of miscarriage, polycystic ovary syndrome, endometriosis, early or delayed puberty, and hormone-sensitive cancers can be listed as the main negative effects of endocrine disruptors …

Genomic Ascertainment Of Chek2 -Related Cancer Predisposition, Sunyoung Kim, Jung Kim, Mark Ramos, Jeremy Haley, Diane Smelser, H. Shanker Rao, Uyenlinh L. Mirshahi, Katherine L. Nathanson, Barry I. Graubard, Hormuzd A. Katki, David Carey, Douglas R. Stewart

School of Graduate Studies Faculty Publications

Importance: There is clear evidence that deleterious germline variants in CHEK2 increase risk for breast and prostate cancers; there is limited or conflicting evidence for other cancers. Objective: To quantify the prevalence of as well as cancer risk and survival associated with CHEK2 germline pathogenic and likely pathogenic variants using genomic ascertainment. Design, Setting, and Participants: This case-control study used 2 electronic health record-linked and exome-sequenced biobanks: UK Biobank (n = 469765) and Geisinger MyCode (adults only; n = 167050). Variants were classified according to American College of Medical Genetics and Genomics and the Association for Molecular Pathology criteria. Cases …

Impact Of Postoperative Intraocular Pressure Spikes On Outcomes Following Goniotomy: A Comparative Study Of Surgical Techniques, Wesam S. Shalaby, Steven L. Chang, Julia Yu, Teresa Horan, Sagar Shah, Shahin Hallaj, Marlene Moster, Reza Razeghinejad, Daniel Lee, Michael Pro, Aakriti Shukla, Ping Huang, Jonathan S. Myers, Tina Xia, Dilru Amarasekera

Wills Eye Hospital Papers

AIM AND BACKGROUND:To compare postoperative intraocular pressure (IOP) spikes and 1-year surgical success among goniotomy procedures: Kahook Dual Blade (KDB), OMNI, bent ab interno needle goniotomy (BANG), and gonioscopy-assisted transluminal trabeculotomy (GATT).

MATERIALS AND METHODS: This single-center, retrospective chart review included glaucoma patients ≥18 years, who underwent goniotomy from January 2021 to December 2022 with ≥3 months of follow-up. Primary outcomes were IOP spikes (≥10 mm Hg increase within 3 months) and 12-month surgical success (≥20% IOP and/or ≥1 medication reduction without further surgery). Secondary outcomes included IOP and medication changes.

RESULTS: Among 247 eyes (107 KDB, 63 OMNI, 77 …

Spinach (Spinacia Oleracea L) Flavonoids Are Hydrolyzed During Digestion And Their Bioaccessibility Is Under Stronger Genetic Control Than Raw Material Content, Michael P Dzakovich, Alvin L Tak, Elaine A Le, Rachel P Dang, Benjamin W Redan, Geoffrey A Dubrow

Children’s Nutrition Research Center Staff Publications

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Protein-Nucleic Acid Language Model-Assisted Design Of Precise And Compact Adenine Base Editor, Jingxuan Ren, Jiawei Yao, Qiuyu Cao, Yinuo Li, Yang Li, Ziyi Zhang, Xiyu Ge, Shengfang Wang, Yang Zhang, Xiaogang Wang, Xiaohui Zhang

Faculty, Staff and Students Publications

Adenine base editors (ABEs) are powerful tools for gene therapy. However, efficient version of ABEs (e.g. ABE8e) always induce excessive bystander and off-target editing events and are large in size, hindering their potential in clinical disease treatment. Here, we develop a pre-trained Protein-Nucleic Acid Constrained Language Model to design ABE8e with high activity, reduced editing window and decreased size. By further engineering, the smallest ABE8e- PNLM-pcABE- with a 27% size reduction, exhibits high activity, precise 3-nt editing window, and reduced off-target events near background level in HEK293T cells. Compared to ABE8e, PNLM-pcABE has up to 133.5-fold precision improvement in pathogenic …

Telemedicine Versus Conventional Care For Nonspecific Neck Pain: A Randomized Controlled Study, Selki̇n Yilmaz Muluk, Sevtap Badil Güloğlu, Begüm Ünlütaşkiran

Turkish Journal of Medical Sciences

Background/aim: Telemedicine (TM) can overcome travel barriers in nonspecific neck pain (NNP), yet a comprehensive, physiatrist-supervised TM model has not been directly compared to standard in-clinic care. The aim of this study was to determine whether a video-based exercise and remote follow-up program is as effective as conventional follow-up in reducing pain and disability in NNP.

Materials and methods: This parallel-group randomized controlled trial (registered in ClinicalTrials.gov) included 68 adults (mean age = 40.52 years) with NNP who were randomly allocated 1:1 to the TM group (TG, n = 34) or control group (CG, n = 34). Both received identical …

The Impact Of Hypophosphatemia On Biochemical Profile And Renal Outcomes In Primary Hyperparathyroidism: A Nationwide Retrospective Study, Nai̇m Ata, Beki̇r Uçan, Hali̇l Durantaş, Oğulcan Boz, Mustafa Şahi̇n, Mustafa Mahi̇r Ülgü, Şuayi̇p Bi̇ri̇nci̇, Muhammed Kizilgül

Turkish Journal of Medical Sciences

Background/aim: Although low phosphorus (P) concentrations are a recognized feature of primary hyperparathyroidism (PHPT), they are not among the diagnostic or surgical criteria. The present study evaluates the association between serum phosphorus levels and clinical outcomes in PHPT patients.

Materials and methods: A search of the Turkish Ministry of Health’s National Electronic Database was conducted using ICD-10 diagnostic codes and laboratory data to identify PHPT cases within the Turkish population from 2017 to 2022.

Results: The records of a total of 113,330 PHPT patients (77.5% female; mean age 58.9 ± 15.6 years) were analyzed, revealing a mean serum phosphorus level …

Preoperative Awareness Of Nasal And Facial Aesthetic Deformities Among Rhinoplasty Candidates, Ağah Yeni̇çeri̇, Nagi̇han Gülhan Yaşar, Burak Hazir, Meli̇h Çayönü

Turkish Journal of Medical Sciences

Background/aim: This study primarily aimed to evaluate the preoperative awareness of nasal and facial anatomical deformities among patients scheduled for primary rhinoplasty. The secondary objective was to assess changes in patients’ self-perception and aesthetic expectations regarding surgical outcomes following preoperative consultation with the surgeon.

Materials and methods: In this prospective cross-sectional study, 56 adult patients seeking primary aesthetic rhinoplasty at a tertiary care center were included. Each participant completed a 10-item anatomical evaluation form. An experienced rhinoplasty surgeon independently evaluated the same parameters. Additionally, participants completed a two-item visual analogue scale (VAS) questionnaire both before and after the preoperative consultation. …

Serial D-Dimer Measurements Dynamically Predict Severity In Acute Biliary Pancreatitis: A Prospective Observational Study, Kemal Tekeşi̇n, Tolga Canbak, Ayli̇n Acar, Fati̇h Başak, Hasan Kumru, Olgun Erdem

Turkish Journal of Medical Sciences

Background/aim: Early risk stratification is required in cases of acute biliary pancreatitis (ABP). Traditional scoring systems such as Ranson’s criteria are complex and often delay treatment. D-dimer, a basic marker of systemic inflammation and coagulation, has shown promise as a prognostic tool. The present study investigates whether the predictive accuracy of serial serum D-dimer measurements is superior to that of the Ranson and BISAP scoring systems for moderate-to-severe ABP.

Materials and methods: Included in this single-center prospective observational study were 264 patients diagnosed with ABP between July 2022 and July 2025 whose collected data were analyzed. The participants were categorized …

Impact Of Patient Education Meetings On Disease Knowledge In Chronic Urticaria Patients, Nazan Beyhan, Hati̇ce Eylül Bozkurt Yilmaz, Asli Çi̇ftci̇, Ömür Aydin, Di̇lşad Mungan, Betül Ayşe Si̇n, Gülfem Eli̇f Çeli̇k, Murat Türk, İnsu Yilmaz, Sevi̇m Bavbek

Turkish Journal of Medical Sciences

Background/aim: Chronic urticaria (CU) is a manageable disease with symptoms of itching and visible lesions that can disrupt daily life and reduce quality of life. The severity of symptoms can vary, and the cause is often unknown. Concerns among patients as regards to treatment and prognosis highlight the need for disease education to enhance self-management and reduce anxiety. The present study examines the effect of disease education on the knowledge level of CU patients.

Materials and methods: Patients with CU who presented to the allergy clinics of two tertiary university hospitals were invited to inperson education sessions including slide presentations …