Digital Commons Network^™

Association Between The 2022 Aha/Acc/Hfsa Heart Failure Staging And Cardiovascular And Kidney Outcomes In Patients With Diabetes And Kidney Disease: A Post Hoc Analysis Of The Scored Randomized Controlled Trial, Ayodele Odutayo, Deepak L Bhatt, Vikas S Sridhar, Michael Szarek, Christopher P Cannon, Lawrence A Leiter, Darren K Mcguire, Julia B Lewis, Renato D Lopes, Benjamin M Scirica, Kausik K Ray, Michael J Davies, Phillip Banks, Manon Girard, Subodh Verma, Jacob A Udell, Bertram Pitt, Ph Gabriel Steg, David Z I Cherney

Faculty, Staff and Student Publications

Background: The 2022 American Heart Association/American College of Cardiology/Heart Failure Society of America heart failure (HF) classification incorporates cardiac biomarkers to identify early risk of HF. The HF stages may also guide the prognosis and management of cardiovascular and kidney-related events.

Methods: SCORED (Effect of Sotagliflozin on Cardiovascular and Renal Events in Patients With Type 2 Diabetes and Moderate Renal Impairment Who Are at Cardiovascular Risk) was a randomized trial in diabetes with kidney disease comparing sotagliflozin versus placebo on cardiovascular death, HF hospitalizations, and urgent HF visits. SCORED participants were grouped by HF stage post hoc. Stage A: no …

Maturity-Onset Diabetes Of The Young (Mody) In A Racially/Ethnically Diverse Pediatric Population, Shilpi Relan, Guido Alarcon, Danielle Guffey, Charles G Minard, Mary E Fang, Kelly Timmons, Rona Y Sonabend, Mustafa Tosur, Maria J Redondo, Jennifer E Posey

Faculty, Staff and Students Publications

Context: Current practice guidelines recommend considering a diagnosis of maturity-onset diabetes of the young (MODY) in patients with diabetes with an affected parent but without typical features of type 1 or type 2 diabetes.

Objective: To test if these criteria apply to a real-world cohort of racially/ethnically diverse children with diabetes.

Methods: We performed a retrospective case review of electronic medical records of youth diagnosed with MODY in a large academic pediatric hospital in Southwestern United States. Cases were ascertained based on the identification of a molecular diagnosis of MODY.

Results: We studied 50 genetically confirmed cases of MODY: 60% …

Spatial Strategies In Non-Territorial Societies: How Feral Horses Maintain Boundaries With Other Groups, Tamao Maeda, Sota Inoue, Monamie Ringhofer, Satoshi Hirata, Shinya Yamamoto

Faculty, Staff and Students Publications

Encounters between competitive individuals or groups are common in social animals and can involve costly aggression; thus, animals often employ strategies to minimize direct conflict. However, research on whether and how animals adjust their group spatial structure when they encounter or spatially co-occur with a different group remains limited. We investigated how non-territorial units in feral horse multilevel societies manage spatial encounters with neighbouring units. We observed 25 reproductive units in northern Portugal, using drones, and employed statistical analyses to quantify spatial dynamics. We found that horses actively adjusted their spatial formations depending on the proximity of other units. Units …

Simulated Complex Cells Contribute To Object Recognition Through Representational Untangling, Mitchell B Slapik, Harel Z Shouval

Faculty, Staff and Student Publications

The visual system performs a remarkable feat: it takes complex retinal activation patterns and decodes them for object recognition. This operation, termed "representational untangling," organizes neural representations by clustering similar objects together while separating different categories of objects. While representational untangling is usually associated with higher-order visual areas like the inferior temporal cortex, it remains unclear how the early visual system contributes to this process-whether through highly selective neurons or high-dimensional population codes. This article investigates how a computational model of early vision contributes to representational untangling. Using a computational visual hierarchy and two different data sets consisting of numerals …

Hidden Malignancy: Ileocecal Intussusception As An Atypical First Presentation Of Diffuse Large B-Cell Lymphoma In Adulthood, Komal Harisinghani, Parth Adrejiya, Mohammad Abubaker, Oluchi Idenyi, Raman Babayeuski, Noor Qureshi, Ashok Kanugula, Sara Assaf, Daniel Assaf, Srikanth Maddika

Journal of Community Hospital Internal Medicine Perspectives

Intussusception is predominantly a pediatric condition, with only about 5% of all intussusception cases occurring in adults with primary intestinal lymphomas comprising 1%–4% of gastrointestinal malignancies, 90% of which are B-cell non-Hodgkin lymphomas (NHL). Diffuse large B-cell lymphoma (DLBCL), the most common subtype of NHL, often leads to intussusception without classical B symptoms. We present the case of a 33-year-old male with ileocolonic intussusception caused by a 4.8 × 5.3 × 5.5 cm enhancing mass. Histopathology and FISH confirmed DLBCL without MYC, BCL2, or BCL6 rearrangements, ruling out double- or triple-hit lymphoma. Following a right ileo-colectomy, R-CHOP(rituximab, cyclophosphamide, doxorubicin, vincristine, …

Accuracy Of Frozen Section For Hpv-Associated Squamous Cell Carcinoma Of Unknown Primary, Sindhura Sridhar, Annie Moroco, Shravan Gowrishankar, Mitra Mehrad, Kim Ely, James Lewis, Madalina Tuluc, Stacey Gargano, Melanie Hicks, Kyle Mannion, Arielle Thal, Adam Luginbuhl, Joseph Curry, David Cognetti, Michael Topf

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

INTRODUCTION: Current guidelines for the management of metastatic squamous cell carcinoma of unknown primary (SCCUP) recommend submission of suspicious primary sites for frozen section analysis (FSA). This study aims to investigate the diagnostic accuracy of FSA for identification of HPV-associated SCCUP.

METHODS: A retrospective cohort study of patients with biopsy-proven p16-positive SCCUP who underwent diagnostic operation at two tertiary care institutions was performed. Sensitivity, specificity, PPV, and NPV of diagnostic FSA were assessed.

RESULTS: 77 patients were included in analysis. 66 patients underwent definitive TORS (diagnostic TORS operation with subsequent neck dissection after identification of the occult primary tumor), 7 …

A Review Of 3d-Printed Medical Devices For Cancer Radiation Therapy., Radiah Pinckney, Santosh Kumar Parupelli, Peter Sandwall, Sha Chang, Salil Desai

Oncology Articles

This review explores the transformative role of three-dimensional (3D) printing in radiation therapy for cancer treatment, emphasizing its potential to deliver patient-specific, cost-effective, and sustainable medical devices. The integration of 3D printing enables rapid fabrication of customized boluses, compensators, immobilization devices, and GRID collimators tailored to individual anatomical and clinical requirements. Comparative analysis reveals that additive manufacturing surpasses conventional machining in design flexibility, lead time reduction, and material efficiency, while offering significant cost savings and recyclability benefits. Case studies demonstrate that 3D-printed GRID collimators achieve comparable dosimetric performance to traditional devices, with peak-to-valley dose ratios optimized for spatially fractionated radiation …

Real-Time Hemodynamic Deterioration Following Polymorphic Ventricular Tachycardia In A Patient With Preexisting Aicd Implanted With Lvad, Dhruvil Patel, Maya Guglin, Deepa Iyer, Chonyang Albert, Jagpreet Grewal, Kenneth Dulnuan

The VAD Journal

Ventricular arrhythmias (VAs) are common in patients with a left ventricular assist device (LVAD), but the literature remains inconclusive regarding the benefits of an automatic implantable cardioverter-defibrillator (AICD) in this population, especially in those with a preexisting device before LVAD implantation. Here, we report the acute hemodynamic consequences of polymorphic ventricular tachycardia in a patient with a preexisting biventricular AICD who was implanted with an LVAD (HeartMate 3). This case underscores the importance of considering AICD placement on a case-by-case basis and highlights the need for a well-designed study to establish its benefit in this population.

Beyond The Exam Room: Pediatricians Advocating Through State Aap, Heidi Sallee, Kelly Kreisler, Thuylinh Pham

Grand Rounds

1. Evaluate the current political climate and effects on child health at a National and State level.
2. Identify key child health policy issues for the states of Missouri and Kansas.
3. Use different forms of advocacy to share personal expertise.
4. Partner with state AAP Chapters to improve child health outcomes locally.

Rab5c Increases Endothelial Release Of Vwf By Regulating Vesicle Trafficking, Paula Reventun, Pablo Toledano-Sanz, Maria Delgado-Marin, Maria Viskadourou, D Brian Foster, Paul S De Vries, Maria Sabater-Lleal, Nunzio Alcharani, Claudia Gonzalez-Cucharero, William O Osburn, Alanna C Morrison, Alisa S Wolberg, Nicholas L Smith, Marios Arvanitis, Charles J Lowenstein

Faculty, Staff and Student Publications

Background: Abnormal levels of VWF (von Willebrand Factor) are a risk factor for venous thromboembolism (VTE) and bleeding. Genome-wide association studies for VWF have identified novel candidate genes that may regulate VWF levels in humans, including RAB5C (RAS-associated protein RAB5C). We hypothesized that RAB5C regulates VWF release from endothelial cells.

Methods: We studied the effect of RAB5C on vesicle trafficking in human endothelial cells. We performed CRISPR (clustered regularly interspaced short palindromic repeats) interference targeting 2 genetic variants linked to altered VWF levels and evaluated RAB5C expression by reverse transcription-quantitative polymerase chain reaction. We silenced RAB5C or overexpressed RAB5C wild-type, …

Safety And Effectiveness Of Bolt-Mounted Versus Tunnelled External Ventricular Drains: A Systematic Review, Meta-Analysis And Trial-Sequential Analysis, Shaan Patel, Shiva A. Nischal, Ayush Sinha, Kush Kale, Pious D. Patel, Jack Jallo, Srinivas K. Prasad

Department of Neurosurgery Faculty Papers

BACKGROUND: External ventricular drains (EVDs) are fundamental to neurocritical care, yet substantial procedural heterogeneity persists, particularly regarding bolt-mounted versus tunnelled catheter fixation. The relative safety and effectiveness of these approaches remain unclear, with conflicting data from observational studies and a lack of trial-level evidence.

OBJECTIVE: To compare bolt-mounted and tunnelled EVDs across accuracy, reoperation, and key safety outcomes using systematic review, meta-analysis, and trial-sequential analysis.

METHODS: Following PRISMA guidelines, PubMed, Embase, and CENTRAL databases were searched (November 2025) for randomised or observational studies comparing bolt-mounted with tunnelled EVDs in adults. Two reviewers independently screened studies, extracted data, and assessed risk …

Genome-Wide Gene By Sleepiness Interaction Analysis For Sleep Apnea, Pavithra Nagarajan, Nuzulul Kurniansyah, Jiwon Lee, Sina A Gharib, Yushan Xu, Yiyan Zhang, Brian Spitzer, Tariq Faquih, Hufeng Zhou, Eric Boerwinkle, Han Chen, Daniel J Gottlieb, Xiuqing Guo, Nancy L Heard-Costa, Bertha A Hidalgo, Daniel Levy, Peter Y Liu, Hao Mei, Rebecca Montalvan, Sutapa Mukherjee, Kari E North, George T O'Connor, Lyle J Palmer, Sanjay R Patel, Bruce M Psaty, Shaun M Purcell, Laura M Raffield, Stephen S Rich, Jerome I Rotter, Richa Saxena, Albert V Smith, Katie L Stone, Xiaofeng Zhu, Topmed Sleep Trait Working Group, Brian E Cade, Tamar Sofer, Susan Redline, Heming Wang

Faculty, Staff and Student Publications

Study objectives: Excessive daytime sleepiness (EDS), influenced by environmental and social-behavioral factors, is reported by a subset of patients with sleep apnea-a group that may be at elevated cardiovascular risk. However, it is unclear whether sleep apnea with and without EDS have distinct genetic underpinnings. In this study, we perform gene-by-EDS interaction analyses for apnea hypopnea index, a diagnostic marker of sleep apnea severity, to understand EDS's influence on its underlying genetic risk.

Methods: Discovery interaction analyses for common variants and gene-based rare variants were conducted respectively using multi-ethnic Trans-Omics for Precision Medicine (N = 11 619) data, followed by …

The Biomedical Landscape Of Genomic Structural Variation In The Qatari Population, Elbay Aliyev, Najeeb Syed, Alessia Visconti, Taghi Aliyev, Aziz Belkadi, Mohammadmersad Ghorbani, Niccolò Rossi, Haroon Naeem, Geethanjali Devadoss Gandhi, Gaurav Thareja, Aljazi Al-Maraghi, Waleed Aamer, Amal Abdulsalam Ibrahim, Rulan Shaath, Farooq Omar Al-Ajli, Rozaimi Mohamad Razali, Fritz J Sedlazeck, Sonia Davila, Ammira Akil, Karsten Suhre, Younes Mokrab, Mario Falchi, Khalid A Fakhro

Faculty, Staff and Students Publications

We present a large-scale study of structural variation (SV) in the Qatari population, based on short-read whole-genome sequencing (WGS) of 6,141 individuals, identifying 153,946 variants across 5 classes reflecting the region's diversity and evolutionary history. Leveraging consanguinity and biobank phenotypes, we identify >180 putative gene knockouts, and use proteomics to show functional consequences in homozygotes. Conversely, 52 genes show significant depletion of homozygous deletions, eight of which cause severe pediatric disease or murine embryonic lethality. Examining phenotypic extremes uncovers several non-exonic homozygous deletions with large effect, including in SPIRE2 (creatinine), MAGI2 (leanness) and a chr19 microRNA cluster (extreme obesity). Further, …

Repeated Mild Head Injury Establishes A Senescent Cranial Bone Marrow Niche That Impairs Brain Metabolism, Patrick J Devlin, Romeesa Khan, Trang H Do, Bryce E West, Janelle M Korf, Gary U Guzman, Chunfeng Tan, John Ahn, Rene Flores, Micheal E Maniskas, Sean P Marrelli, Anna Malovannaya, Erica Underwood, Rodney M Ritzel

Faculty, Staff and Students Publications

Traumatic brain injury (TBI) of any severity is associated with long-term systemic inflammation and increased risk of peripheral comorbidities, yet the mechanisms driving immune dysregulation and accelerated aging after repeated mild head impacts remain poorly defined. Here, we investigated the acute and chronic effects of repeated mild TBI (rmTBI) on distal and proximal bone marrow compartments in the femur and calvaria, respectively. Using a modified weight-drop mouse model delivering rotational and acceleration-deceleration forces (3 hits/week for up to 16 weeks), rmTBI produced no mortality, skull fracture, hemorrhage, or brain leukocyte infiltration. One day after three consecutive impacts, rmTBI induced robust …

Interprofessional Collaboration In Inpatient Rehabilitation For Patient With Thiamine Deficiency-Related Sensorimotor And Cognitive Deficits – Case Report, Christina Thomas, Tahreem Hashmi, Joanne Delgado-Lebron, Rania Massad

Journal of Interprofessional Practice and Collaboration

Purpose: We aim to describe the clinical presentation, interprofessional management, and functional outcomes of a patient with thiamine deficiency. Problem: Thiamine deficiency can result in peripheral polyneuropathy and cognitive deficits that limit function and participation. Despite deficits that warrant interprofessional neurorehabilitation, previous reports focus narrowly on medical management. Case: A 36-year-old female was admitted to inpatient rehabilitation with a diagnosis of Guillain Barre. She underwent evaluation by the interprofessional team that revealed cognitive deficits inconsistent with Guillain Barre. Further medical workup identified a thiamine deficiency. Comprehensive treatment included supplementation managed by the physiatrist; promotion of motor learning and neuroplasticity to …

High-Sensitivity Cardiac Troponin I And Frailty: Associations With The Frailty Index And Fried Phenotype In Older Women, Jedd Pratt, Abadi K. Gebre, Carlos J. Toro-Huamanchumo, Elsa Dent, Trent Bozanich, Wai E. Lim, Elizabeth Byrnes, Julee Mcdonagh, Caleb Ferguson, Craig Sale, Kun Zhu, Carl Schultz, Richard L. Prince, Joshua R. Lewis, Marc Sim

Research outputs 2022 to 2026

Despite the nexus between cardiovascular health and frailty, the relevance of high-sensitivity cardiac troponin I (hs-cTnI), a biomarker of myocardial injury, to frailty is poorly understood. We examined whether hs-cTnI concentrations were associated with frailty in a well-characterized cohort of older women. A total of 1151 community-dwelling women from the Perth Longitudinal Study of Aging Women (mean age ± SD = 75.2 ± 2.7 years) were included. Frailty was operationalized using a validated frailty index (FI) of cumulative deficits and a modified Fried phenotype. Plasma hs-cTnI were categorized into quartiles. Cross-sectional associations between hs-cTnI quartiles and frailty were assessed using …

Alcohol And The Endocrine System: A Critical Review Of Disruptions, Potential Mechanisms, And Health Implications, Patricia E. Molina, Liz Simon

School of Graduate Studies Faculty Publications

The endocrine system coordinates and integrates cellular activity throughout the body by regulating cellular and organ function and maintaining homeostasis. Homeostasis, the dynamic maintenance of internal balance despite changing external or internal conditions, is essential for proper cellular function. The endocrine system achieves this through a complex regulatory network of hormone-mediated signaling among multiple endocrine organs, relying on precisely regulated synthesis and release of hormones and specific hormone-receptor interactions. Endocrine-mediated actions coordinate critical physiological processes, including growth, metabolism, reproduction, stress adaptation, and circadian rhythms throughout the lifespan. Endocrine glands—such as the hypothalamus, pituitary, thyroid, parathyroid glands, pancreas, adrenal glands, and …

Spatial Omics At The Forefront: Emerging Technologies, Analytical Innovations, And Clinical Applications, Yunhe Liu, Yibo Dai, Linghua Wang

Faculty, Staff and Student Publications

Spatial omics transforms our understanding of cancer by revealing how tumor cells and the microenvironment are organized, interact, and evolve within tissues. Here, we synthesize advances in spatial technologies that map tumor ecosystems with unprecedented fidelity. We highlighted analytical breakthroughs-including multimodal integration and emerging spatial foundation models-that resolve functional niches and spatial communities, converting spatial patterns into mechanistic insights. We summarize how spatially organized features, from immune hubs to microbiota and neural interfaces, shape tumor evolution and clinical outcomes. We then outline how spatial approaches illuminate precancer biology, metastatic adaptation, and therapy response. Bridging discovery and translation, we provide a …

Dynamic Fib-4 Score Changes And Hcc Risk In Patients With Masld And Elevated Liver Enzymes: A Nationwide Cohort Study, Yee Hui Yeo, Hsiu J Ho, Tsai-Wei Huang, Teng-Yu Lee, Ju Dong Yang, George Cholankeril, Chien-Jen Chen, Hawi-I Yang, Chuen-Fei Chen, Hung-Chuen Chang, Chun-Ying Wu

Faculty, Staff and Students Publications

Introduction: Hepatocellular carcinoma (HCC) can develop in individuals with metabolic dysfunction-associated steatotic liver disease (MASLD) without cirrhosis, especially in those with elevated liver enzymes. However, there is currently no low-cost, scalable screening tool for this population. To address this need, we investigated the association between serial changes in FIB-4 (fibrosis-4) scores over a 3-year period and the risk of developing HCC in a large, diverse cohort of patients with MASLD without cirrhosis.

Methods: This study utilized a nationwide cohort from the National Health Insurance Research Database (NHIRD), including 810,698 patients with MASLD who had demographic and laboratory data at baseline …

Tumor-Infiltrating Bacteria Disrupt Cancer Epithelial Cell Interactions And Induce Cell-Cycle Arrest, Jorge Luis Galeano Niño, Falk Ponath, Victor A Ajisafe, Clara R Becker, Andrew G Kempchinsky, Martha A Zepeda-Rivera, Javier A Gomez, Hanrui Wu, Jessica G Terrazas, Heather Bouzek, Elizabeth Cromwell, Pritha Chanana, Matthew Wong, Ashish Damania, Michael G White, Y Nancy You, Scott Kopetz, Nadim J Ajami, Jennifer A Wargo, Christopher D Johnston, Susan Bullman

Faculty, Staff and Student Publications

Tumor-infiltrating bacteria are increasingly recognized as modulators of cancer progression and therapy resistance. We describe a mechanism by which extracellular intratumoral bacteria, including Fusobacterium, modulate cancer epithelial cell behavior. Spatial imaging and single-cell spatial transcriptomics show that these bacteria predominantly localize extracellularly within tumor microniches of colorectal and oral cancers, characterized by reduced cell density, transcriptional activity, and proliferation. In vitro, Fusobacterium nucleatum disrupts epithelial contacts, inducing G0-G1 arrest and transcriptional quiescence. This state confers 5-fluorouracil resistance and remodels the tumor microenvironment. Findings were validated by live-cell imaging, spatial profiling, mouse models, and a 52-patient colorectal cancer cohort. Transcriptomics reveals …

A Case Of Listeria Monocytogenes Bacteremia In A Middle-Aged Woman With A History Of Primary Biliary Cholangitis, Caleb Smack, Jared T. Lausen, Aaron Mills

Eastern Virginia Medical Journal

In this report, we discuss the case of a patient with Listeria monocytogenes bacteremia likely resulting from primary biliary cholangitis (PBC) induced cirrhosis. We aim to bolster the body of literature on Listeria bacteremia and establish PBC as a risk factor for this rare complication. Our patient, who presented with sepsis, was subsequently found to have Listeria bacteremia and received intravenous antibiotic treatment of ampicillin for 3 total weeks with complete resolution of her disease. This is the first case suggesting that cirrhosis as a result of PBC may be an independent risk factor for Listeria bacteremia. In patients at …

Circulating Tumor Dna: Reducing Burden In Hpv+ Oropharyngeal Cancer Surveillance, Liza M. Joseph Pa-C

Lynchburg Journal of Medical Science

This review examines the rising prevalence of human papillomavirus-related (HPV+) oropharyngeal squamous cell carcinoma (OPSCC) and evaluates the role of circulating tumor HPV DNA (ctHPVDNA) in diagnosis and post-treatment surveillance. A comprehensive literature search of electronic databases, including PubMed, Medline, Cochrane Library, and Google Scholar, identified studies that validated ctHPVDNA as a biomarker with high sensitivity and specificity, assessed its cost-effectiveness, and explored patient and provider perceptions. Clinical evidence supports that plasma-based ctHPVDNA is the most accurate method for detecting disease recurrence and quantifying tumor burden. Patient perception studies reported high confidence in ctHPVDNA testing, while providers viewed it as …

Subcutaneous Insulin Use In Diabetic Ketoacidosis, Patrick Mcgrath

Lynchburg Journal of Medical Science

The reviewed literature focuses on the clinical application of subcutaneous (SQ) insulin, particularly rapid-acting insulin analogs (RAIAs), in treating selected patients with mild to moderate diabetic ketoacidosis (DKA). The use of SQ insulin offers a viable alternative to traditional intravenous (IV) insulin infusions, enabling DKA management outside intensive care unit (ICU) settings and reducing healthcare resource utilization. Current DKA management protocols emphasize comprehensive fluid resuscitation and correction of electrolyte imbalances, with IV regular insulin administered at 0.1 units/kg/hour. This review synthesizes findings from multicenter cohort studies, meta-analyses, and randomized controlled trials (RCTs) available via PubMed, focusing on adult patients diagnosed …

Brief Overview Of Assessment And Prognostication Tools For Palliative Care Oncology Patients, Nicole Schwensow

Lynchburg Journal of Medical Science

Patients with life-threatening illnesses can be at risk for the progression of their disease over time. Consequences of such an illness can include recurrent hospitalizations, poor symptom control, and a lack of understanding by the patient and family of the disease, its usual course, and prognosis. Palliative care is a philosophy of care intended to address these issues. While receiving palliative care, patients can continue to undergo treatments directed at a cure, whereas hospice patients no longer receive treatment for underlying diseases. Both approaches focus on symptom control. To best care for palliative patients over time, several outcome domains should …

Understanding Monoclonal Gammopathy Of Undetermined Significance, Scott Winkel Msph, Mhs, Pa-C

Lynchburg Journal of Medical Science

Monoclonal gammopathy of undetermined significance (MGUS) is a premalignant plasma cell disorder characterized by serum monoclonal protein (M-protein) levels less than 3.0 g/dL, less than 10% plasma cells in the bone marrow, and absence of end-organ damage. It mainly affects older adults and is often an incidental finding. While most cases remain indolent, a subset progresses to malignancies such as multiple myeloma, smoldering myeloma, AL amyloidosis, lymphoproliferative disorders, macroglobulinemia, and monoclonal gammopathy of renal significance. This review summarizes current insights into MGUS pathophysiology, risk factors, molecular mechanisms, clinical features, diagnostic approaches, including laboratory assessments and imaging, and emphasizes early detection …

Proton Versus Photon Radiotherapy For Patients With Oropharyngeal Cancer In The Usa: A Multicentre, Randomised, Open-Label, Non-Inferiority Phase 3 Trial, Steven J Frank, Paul M Busse, J Jack Lee, David I Rosenthal, Mike Hernandez, David M Swanson, Adam S Garden, G Brandon Gunn, Samir H Patel, James W Snider, Daniel J Ma, Jason K Molitoris, Nancy Y Lee, Upendra Parvathaneni, Mark W Mcdonald, Noah S Kalman, Alexander Lin, Nasiruddin Mohammed, Christina Henson, Christian Hyde, Gopal K Bajaj, Sanford R Katz, Roi Dagan, William H Morrison, Jay P Reddy, C David Fuller, Shalin J Shah, Jack Phan, Gregory M Chronowski, Lauren Mayo, Erich M Sturgis, Renata Ferrarotto, Xiaorong R Zhu, Xiaodong Zhang, Li Wang, Katherine A Hutcheson, Adel K El-Naggar, Amy C Moreno, Anna Lee, Michael T Spiotto, Neil D Gross, Stephen Y Lai, Jay J Liao, Jonathan Paly, Zhongxing Liao, Robert L Foote

Faculty, Staff and Student Publications

Background: Radiotherapy is an integral component of treatment for oropharyngeal cancer. Toxicity from the current state-of-the-art photon radiotherapy, intensity-modulated radiation therapy (IMRT), has prompted the search for alternative, less toxic therapies. One such alternative that might de-intensify treatment is proton therapy. In this trial, we aimed to directly compare IMRT with intensity-modulated proton therapy (IMPT), both concurrent with systemic therapy, hypothesising comparable disease control and survival and lower toxicity.

Methods: This randomised, multicentre, open-label, non-inferiority, phase 3 trial was conducted in 21 sites (cancer centres or universities) in the USA. Patients (aged ≥18 years) with stage III or stage IV …

Effectiveness Of Myoinositol Versus Metformin As Adjuvant Treatment On Infertile Pcos Women Undergoing Ovulation Induction Cycles Prospective Cohort Study, Ahmed M. Salman, Fatma M. Sayed, Hesham Mohammed Hamad

Journal of Medicine in Scientific Research

Background In anovulatory infertility Polycystic ovary syndrome (PCOS) plays a leading role, characterized by endocrine and metabolic disturbances. While metformin is usually used to decrease insulin resistance and restore ovulation, myoinositol has emerged as a promising alternative with fewer side effects. This study aimed to evaluate and compare the effectiveness of metformin and myoinositol as adjuvant treatments in infertile women with PCOS in ovulation induction cycles. Patient and methods This prospective cohort study included 192 women diagnosed with PCOS-related infertility, divided into two groups (n = 96 each) receiving either metformin or myoinositol for 3 months prior to ovulation induction. …

Breast Cancer Therapy Induced Right Ventricular Cardiomyopathy: A Single Institute Experience, Doaa M Elsayed, Safa Ahmed Balata, Mohamed Elsayed Saleh

Journal of Medicine in Scientific Research

Background It is well-known that chemotherapy medicines can cause cardiomyopathy and left ventricular dysfunction as adverse effects. There is scant evidence concerning the effects of chemotherapeutic drugs on the integrity & functionality of the right ventricle (RV). Aim To study the impact of cardiotoxic systemic therapy on right ventricular function in nonmetastatic breast cancer cases, particularly evaluating the efficacy of modern echocardiographic procedures for the early recognition of RV cardiomyopathy. Patient and Method A total of 104 women diagnosed with breast cancer participated in this prospective trial. Two therapy groups were established for the cases: 42 patients received anthracycline therapy, …

Frequency Of Autoimmune Primary Adrenal Insufficiency In Children And Adolescents With Type 1 Diabetes Mellitus, Randa Mohamed Darwish, Ayat Ibrahim Ghanem, Lamis Safwat Mubarak

Journal of Medicine in Scientific Research

Background Type 1 diabetes mellitus (T1DM) is a chronic endocrine disorder of autoimmune origin with a predisposition to the development of further autoimmune diseases, including autoimmune adrenal insufficiency (Addison’s disease). Although uncommon and frequently underdiagnosed, it can coexist with T1DM, causing life-threatening complications if undiagnosed. Aim To assess the frequency of autoimmune adrenal insufficiency in children with T1DM and its association with other autoimmune diseases. Methods A cross-sectional study was conducted on 110 children with type 1 diabetes mellitus (T1DM) and 100 age- and sex-matched healthy controls. All participants underwent a full clinical evaluation and laboratory testing, including serum cortisol, …

Effect Of Therapeutic Ultrasound Versus Anti-Inflammatory Drugs In The Treatment Of Trigger Finger. A Placebo Randomized-Controlled Trial., Eslam Elsayed Ali Shohda

Journal of Medicine in Scientific Research

Background: Trigger finger (TF) is a painful disorder that hinders the use of the entire hand. One of the most widely used modalities in the field of physiotherapy is therapeutic ultrasound (US); however, no randomized control trial has investigated the use of US in the treatment of TF. The objective of this trail is to determine the effect of therapeutic US on pain intensity and the frequency of daily finger clicking in patients with TF. Materials and Methods: A single-blind, randomized (1:1), placebo-controlled, clinical trial was conducted at a physiotherapy outpatient clinic at Alahrar Teaching Hospital in Zagazig, Egypt. Twenty …