Digital Commons Network^™

Identification Of A Cytokine Biomarker For Prognostic Modeling Of Breast Cancer-Related Lymphedema, Alison J Wu, Neil Lin, Jie Su, Cherie Lin, Madison-Shira Hossack, Wei Shi, Farnoosh Abbas-Aghababazadeh, Wei Xu, Benjamin Haibe-Kains, Simona F Shaitelman, Melissa B Aldrich, Fei-Fei Liu, Jennifer Y Y Kwan

Faculty, Staff and Student Publications

Lymphedema is a chronic complication of breast cancer treatment, and early intervention is crucial to reduce morbidity. This study evaluated the role of blood-based cytokine biomarkers in the prognostication of breast cancer-related lymphedema (BCRL) to improve risk prediction. A secondary analysis of inflammatory biomarkers for BCRL was performed using a previously published cohort of 147 breast cancer patients who had undergone serum cytokine profiling during their treatment at the Princess Margaret Cancer Centre from 2010-2014. Prognostic cytokine variables for lymphedema were selected by regression analysis and independence from known clinical risk factors. Regression-based modeling was employed to integrate prognostic variables …

Endothelial Oncogenic Kras Mutation Drives The Dynamics Of Microglia And Macrophages In Brain Arteriovenous Malformation, Hyejin Park, Jung-Eun Park, Bridger H Freeman, Bosco Seong Kyu Yang, Shun-Ming Ting, Alexander K Suh, Jude Pj Savarraj, Shuning Huang, Jakob Körbelin, Huimahn Alex Choi, Sean P Marrelli, Jaroslaw Aronowski, Peng Roc Chen, Eunhee Kim, Eun S Park

Faculty, Staff and Student Publications

Mutation of KRAS in endothelial cells (KRAS-EC) leads to intracerebral hemorrhage (ICH) in brain arteriovenous malformations (bAVM), resulting in severe disabilities or even death. However, it is unclear what causes this hemorrhagic conversion of bAVM. Here, using a locally established, clinically-relevant sporadic bAVM mouse model, created by overexpressing mutant KRAS (KRASG12V) in the brain EC, we demonstrate that KRAS-EC act as trigger for microglia (MG) activation and infiltration of macrophages (Mϕ). Using three-dimensional immunostaining approach with cleared human and mouse bAVM tissues, we demonstrate an abundance of MG/Mϕ around the bAVM nidus. The presence of MG/Mϕ are correlated to the …

Pain Prevalence And Pain Management At The End Of Life: Regional And Urban-Rural Differences From A National-Representative Survey Of Chinese Older Adults, Yaolin Pei, Xiang Qi, Zexi Zhou, Yifan Lou, Jing Wang, Yang Li, Bei Wu

Faculty, Staff and Student Publications

Background: Effective pain management is essential for improving quality of life at the end of life. However, challenges persist globally, particularly in China, where palliative care remains underdeveloped. This study investigates pain prevalence and the associations between pain severity, place of death, and the quality of pain management among older adults in China, with a focus on regional and urban-rural disparities.

Methods: We used data from the 2014, 2016, 2018, and 2020 waves of the China Longitudinal Aging Social Survey. The final sample included 1,525 older adults who died during the study period. We conducted OLS regression analyses to examine …

Phase I Study Of Bevacizumab And Temsirolimus Combination Therapy In Advanced Malignancies: Safety, Efficacy, And Ovarian Cancer Expansion, Sarina A Piha-Paul, Chieh Tseng, Emily Thompson, R Jason Stafford, Hung Le, Lei Kang, Siqing Fu, Apostolia Tsimberidou, George Blumenschein, Jordi Rodon Ahnert, John M Slopis, David Hong, Aung Naing, Funda Meric-Bernstam, Chaan S Ng, Shannon Westin, Anil K Sood

Faculty, Staff and Student Publications

Background: Bevacizumab and temsirolimus target angiogenic and mTOR pathways in cancer progression.

Methods: This phase I study enrolled 48 heavily pretreated patients with advanced solid tumors, including an ovarian cancer expansion cohort. Patients received bevacizumab biweekly plus temsirolimus weekly in a 3 + 3 design to assess safety, maximum tolerated dose (MTD) and dose-limiting toxicities (DLTs). Exploratory analyses included tumor genomic profiling and dynamic contrast-enhanced MRI (DCE-MRI).

Results: Patients had a median age of 59 and median four prior therapies. Common tumor types were ovarian (27%) and head and neck (15%). Treatment-related adverse events occurred in 93.8%, with 31.3% ≥grade …

Transient Protein Structure Guides Surface Diffusion Pathways For Electron Transport In Membrane Supercomplexes, Chun Kit Chan, Jonathan Nguyen, Corey F Hryc, Chitrak Gupta, Kevin Redding, William Dowhan, Matthew L Baker, Alberto Perez, Eugenia Mileykovskaya, Abhishek Singharoy

Faculty, Staff and Student Publications

The exact biological role of mitochondrial supercomplexes remains debated, particularly their role in guiding redox proteins across membranes during energy conversion. We integrate multiscale modeling and single particle cryo-electron microscopy (cryo-EM) to examine electron transfer in mitochondrial supercomplexes composed of complexes III and IV (CIII and CIV). Using bioinformatic and entropy-based methods, we generated structural ensembles capturing conformations of CIII's disordered QCR6 hinge within the yeast CIII2CIV2 supercomplex. Molecular and Brownian Dynamics simulations reveal that these negatively charged hinge states electrostatically couple with redox proteins, promoting their binding and directional diffusion across the membrane on millisecond timescales. Rather than hindering …

Effects Of Bungee-Based Training On Physical Performance And Arch Jump Kinematics In Female College Rhythmic Gymnasts, Nasser Abouzeid, Mariola Gepfert, Abdulrahman I. Alaqil, Abdulmalek K. Bursais, Hussein Hashoos, Mohammed S. Alibrahim, Labeeb Z. Moseekh, Amr S. Hamza

Baltic Journal of Health and Physical Activity

Background: The purpose of this study was to examine the effects of an eight-week bungee-based training program on selected physical performance variables and arch jump kinematics in female college rhythmic gymnasts. Material and methods: Eighteen female college students (age: 18.1 ± 0.9 years) were randomly assigned to an experimental group (EG; n = 9) or a control group (CG; n = 9). The EG completed a bungee workout training program three times per week for eight weeks, while the CG followed a traditional rhythmic gymnastics training program. Physical performance variables included vertical jump, leg strength, back strength, standing long jump, …

The Heart’S Hidden Influencer: Epicardial Adipose Tissue In The Pathogenesis Of Heart Failure, Aobo Li, Avilash Mondal, Jianli Zhao, John Zhang, Xin-Liang Ma

Department of Emergency Medicine Faculty Papers

Abstract – Heart failure (HF) is a complex, multifactorial clinical syndrome with diverse etiologies and phenotypic manifestations, affecting millions of people globally. HF is broadly classified into 3 subtypes: HF with reduced ejection fraction, HF with mildly reduced ejection fraction, and HF with preserved ejection fraction. Each subtype exhibits distinct pathophysiological mechanisms, clinical trajectories, and therapeutic responses, posing significant challenges in terms of diagnosis and management. Epicardial adipose tissue (EAT), a metabolically active visceral fat depot situated in close proximity to the myocardium, plays a dual role in physiological and pathological states, offering potential utility as a biomarker and therapeutic …

Ubiquitination Of Oncogenic Mutant P53 Via Attenuation Of Ribosome Biogenesis Machinery Effectively Inhibits Pancreatic Tumor Growth, Mudassier Ahmad, Sahir Sultan Alvi, Haider Ahsan, Carlos Perez, Andrew Massey, Vivek K Kashyap, Neeraj Chauhan, Emmanuel Anning, Manish K Tripathi, Dae J Kim, Nirakar Sahoo, Tamer Oraby, Murali M Yallapu, Mohammad Moshahid Khan, Manu M Sebastian, Subhash C Chauhan, Bilal B Hafeez

Faculty, Staff and Student Publications

Dysregulated ribosome biogenesis and p53 mutations are known to play oncogenic roles in various cancers, including pancreatic cancer. In this study, we demonstrated the therapeutic potential of BMH-21, a pharmacologic inhibitor of RNA polymerase I, against pancreatic cancer by uncovering a novel molecular mechanism involving RPA194-mediated ubiquitination of mutant p53 without affecting the ubiquitination of wild-type p53. Our key findings are that (i) BMH-21 selectively induces apoptosis and cell growth inhibition of pancreatic cancer cells with no effect on normal human pancreatic ductal epithelial cells; (ii) BMH-21 degrades RPA194; (iii) BMH-21 inhibits recruitment of both RPA194 and RPA135 on rDNA …

The Next Layer: Augmenting Foundation Models With Structure-Preserving And Attention-Guided Learning For Local Patches To Global Context Awareness In Computational Pathology, Muhammad Waqas, Rukhmini Bandyopadhyay, Eman Showkatian, Amgad Muneer, Anas Zafar, Frank R Alvarez, Maricel Corredor Marin, Wentao Li, David Jaffray, Cara Haymaker, John V Heymach, Natalie Vokes, Luisa M Solis Soto, Jianjun Zhang, Jia Wu

Faculty, Staff and Student Publications

Foundation models have emerged as powerful feature extractors in computational pathology. However, they typically omit mechanisms for leveraging the global spatial structure of tissues and the local contextual relationships among diagnostically relevant regions-key elements for understanding the tumor microenvironment. Multiple instance learning (MIL) remains an essential next step following the foundation model, designing a framework to aggregate patch-level features into slide-level predictions. We present EAGLE-Net, a structure-preserving, attention-guided MIL architecture designed to augment prediction and interpretability. EAGLE-Net integrates multi-scale absolute spatial encoding to capture global tissue architecture, a top-K neighborhood-aware loss to focus attention on local microenvironments, and background suppression …

Tumor Radiosensitization With Gold Nanoparticles: Evolving Strategies To Improve Tumoral Gold Uptake And Catalyze Future Clinical Translation, Prapannajeet Biswal, Geraldine V Vijay, Gabrielle Krouse, Phuoc Minh Quan Mai, Bhoomika Muruvekere Lakshmisha, Sanaz Keshavarz Shahbaz, Mahdieh Yousefi Taba, Aria Sabbagh, Lydia Wt Cheung, Yuri Mackeyev, Khadijeh Koushki, Sunil Krishnan

Faculty, Staff and Student Publications

Radiation therapy is integral to the treatment regimens of over 50% of cancer patients. However, it is not biologically targeted to just the tumor, leading to adverse effects in peritumoral normal tissue. Selective uptake of gold nanoparticles (AuNPs) by tumors realizes tumor-specific radiosensitization via increased secondary electron release from high atomic number gold atoms. Here, we review AuNP-mediated radiosensitization and outline strategies to optimize tumor-targeted AuNP delivery. Modifying the physicochemical characteristics of AuNPs, including size, shape, charge, and surface chemistry, can increase their ability to evade the reticuloendothelial system (RES) and penetrate the dense tumor stromal architecture, thereby promoting tumor …

Nci-Designated Cancer Centers' Policies And Practices With Regard To Alcohol And Cancer: A Call To Lead, Ernest T Hawk, Stephanie L Martch, Meghan Si, Sanjay Shete

Faculty, Staff and Student Publications

Background: Alcohol, a known carcinogen since 1988, increases risk of cancers of the mouth, pharynx, larynx, esophagus, liver, breast, and colorectum. More than one half of US adults consume alcohol whereas about two thirds are unsure whether or unaware that alcohol intake is linked to cancer risk.

Methods: Our objective was to survey awareness, beliefs, intentions, policies, practices, and goals/perceived responsibilities related to establishing/promoting actions to reduce alcohol-related cancer risks from leaders of 72 NCI-Designated Cancer Centers.

Results: Sixty-one percent responded. Forty-three percent either believed in or were uncertain about alcohol's purported health benefits. Nevertheless, 86% considered it part of …

Exercise Performance In Ordinary Children And Adolescents: Baseline, Pandemic, And Post-Pandemic, Abby Skiena, Gina D'Aloisio, Ms, Takeshi Tsuda, Md

Alpha Omega Alpha Research Symposium Posters

Background: The COVID-19 pandemic might have created considerable negative impacts on the physical fitness of ordinary adolescents, which may pose a major threat to long-term cardiovascular health.

Methods: Healthy adolescents (ages 11 to 18) who underwent cardiopulmonary exercise testing (CPET) were grouped into baseline (~ 3/2020), pandemic (4/2020 ~12/2022), and post-pandemic (1/2023~ 5/2024) periods. Data are shown as mean ± standard deviation.

Results: Peak oxygen consumption (VO2/kg) and peak work rate (WR/kg) were significantly reduced during pandemic in both sexes and did not improve during post-pandemic in males (Table 1). The decline of peak oxygen pulse (OP/kg) …

Clinician Perceptions Of Barriers And Strategies To Improve Pediatric Hypertension Detection, Abbas H. Zaidi, Erica D. Sood, Sarah De Ferranti, Fabliha Khurshan, Samuel Gidding, Varsha Zadokar, Jonathan M Miller, Anne E Kazak

Department of Pediatrics Faculty Papers

IMPORTANCE: Pediatric hypertension remains underrecognized despite its high prevalence (approximately 5%) and long-term cardiovascular implications. Although guidelines for screening and diagnosis exist, less than 25% of affected children are diagnosed, and more than half do not receive timely follow-up care. Clinician-specific implementation barriers and directly informed strategies, which may alleviate this gap, are insufficiently described.

OBJECTIVE: To identify clinician-reported barriers and actionable recommendations to improve pediatric hypertension detection and follow-up in primary care using the Consolidated Framework for Implementation Research.

DESIGN, SETTING, AND PARTICIPANTS: Semistructured qualitative interviews were conducted between November 1, 2022, and March 31, 2023, with health care …

Cd8+ T Cells In The Tumor Microenvironment Modulate The Response To Endocrine Therapy In Breast Cancer, Fabiana Napolitano, Yunguan Wang, Dhivya R Sudhan, Paula I Gonzalez-Ericsson, Luigi Formisano, Nisha Unni, Shahbano Shakeel, James Z Zhu, Khushi Ahuja, Lei Guo, María Rosario Chica-Parrado, Yuki Matsunaga, Pamela Luna, Chang-Ching A Lin, Yasuaki Uemoto, Kyung-Min Lee, Hongli Ma, Nathaniel J Evans, Alberto Servetto, Saurabh Mendiratta, Spencer D Barnes, Roberto Bianco, Yisheng V Fang, Lin Xu, Jeon Lee, Tao Wang, Justin M Balko, Gordon B Mills, Marilyne Labrie, Ariella B Hanker, Carlos L Arteaga

Faculty, Staff and Student Publications

The role of the tumor immune microenvironment (TIME) in modulating responses to antiestrogen therapy in hormone receptor-positive (HR+) breast cancers remains unclear. We analyzed pre- and on-treatment biopsies from patients with HR+ breast cancer treated with letrozole to induce estrogen deprivation (ED). Stromal tumor-infiltrating lymphocytes, assessed by H&E staining, and immune-related gene sets, including IFN-γ signaling genes, measured by RNA-Seq, were increased in ED-resistant tumors. Cyclic immunofluorescence and spatial transcriptomics revealed an abundance of CD8+ T cells and enhanced antigen processing and immune gene signatures in ED-resistant tumors. In this group, the expression of CXCL9, CXCL10, and CXCL11 - chemokine …

Mom Is Developing Too: Preliminary Evidence For The Reciprocal Effects Of Infant Sensory Reactivity And Maternal Behavior, Emily C. Sweiss, Vincent Berardi, Elysia Poggi Davis, Curt A. Sandman, Laura M. Glynn

Psychology Faculty Articles and Research

Caregiver sensitivity to infant cues is well-established as a predictor of child development. Infants also actively influence their social environment, especially their caregivers, even from their earliest days. Sensory reactivity, characterized as hypo- (under) and hyper- (over) responding to environmental stimuli, is one domain of development that is likely to influence caregiver-infant interaction, due to its role in regulating emotions and responses to both physical and social stimuli. Although sensory reactivity could be an important target for improving caregiver-child interaction, the longitudinal, reciprocal relations between infant sensory reactivity and caregiver behaviors are currently unknown. In the present proof-of-concept study, we …

Lysine Demethylase 4a (Kdm4a) Maintains Basal Body Architecture And Protects Against Ciliary Destabilization, Manga Motrapu, Lindsey Hudson, Pratim Chowdhury, Xiaoli Wang, Yuya Nakatani, Sofia Vargas-Hernandez, Sung Y Jung, Menuka Karki, Cheryl Walker, Anna-Karin Gustavsson, Ruhee Dere

Faculty, Staff and Students Publications

Primary cilia are sensory organelles essential for signaling and defects in formation, maintenance or structure underlie diverse ciliopathies. Here, we identify lysine demethylase 4A (KDM4A) as a previously unrecognized mediator of ciliogenesis. Using genetic depletion and pharmacologic inhibition, we show that KDM4A is required for cilia assembly and maintenance. Super-resolution imaging reveals KDM4A localization at the basal body, where it distinctively wraps around the centrioles. We uncover a direct interaction between KDM4A and Rootletin (CROCC), a structural protein mediating centriole cohesion, and demonstrate that KDM4A loss increases inter-centriolar distances, implicating basal body architecture in ciliary failure. Together, these findings define …

Evidence Based Management Of High Ldl-C For Prevention Of Atherosclerotic Cardiovascular Disease In Adult Patients In Resident Run Clinic: A Qi Project, Astha Prasai, Sahej Manesh Singh Arora, Hafsa Jawaid, Aakriti Jain, Omofolarin Babayale, Nauman Naeem, Hina Ukrani, Nawid Latifi, Binita Neupane, Soon-Il Song, Gaurav Sharma

Advances in Clinical Medical Research and Healthcare Delivery

Background:

Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of death worldwide and in the United States, with significant healthcare and economic burden. Despite clear guideline recommendations, the implementation of ASCVD risk assessment and statin use for primary prevention remains suboptimal.

Methods:

A quality improvement project was conducted at a resident run clinic with an objective to improve ASCVD risk documentation and guideline-based lipid management. A total of 600 patients aged 40-75 years without a history of cardiovascular disease were randomly selected- 300 in the pre-intervention group and 300 in the post-intervention group. The intervention included didactic sessions and quick …

Neuroinflammation And Its Role In Depression– A Review Of Emerging Biomarkers And Therapeutic Targets, Sophia M. Valerino

Advances in Clinical Medical Research and Healthcare Delivery

Major depressive disorder (MDD) is a prevalent and debilitating mental illness that affects millions globally. Traditionally, the pathophysiology of MDD was thought to be due primarily neurotransmitter imbalances. However, emerging research highlights the role of neuroinflammation in MDD pathogenesis. Elevated levels of pro-inflammatory cytokines, microglial activation, and blood-brain barrier dysfunction have been implicated in the etiology of MDD. Additionally, biomarkers such as C-reactive protein and neuroimaging findings further support the neuroinflammatory hypothesis. This growing body of evidence has led to increased interest in novel treatment approaches, including anti-inflammatory medications and lifestyle interventions, as potential therapeutic strategies. While selective serotonin reuptake …

A Rare Case Of Gastrointestinal Stromal Tumor Outside The Gastrointestinal Tract, Ashton I. D'Souza, Jasdeep S. Bajwa, Basil George Verghese

Advances in Clinical Medical Research and Healthcare Delivery

Extra-gastrointestinal stromal tumors are rare mesenchymal tumors occurring outside the gastrointestinal tract, comprising ~5% of all gastrointestinal stromal tumors. A 65-year-old man undergoing evaluation for nephrolithiasis was incidentally found to have a 7.2 cm mesenteric mass proven to be gastrointestinal stromal tumors on biopsy. After limited response to imatinib, the patient underwent successful surgical resection. Mesenteric gastrointestinal stromal tumors often present larger and more aggressive, but in this instance, early incidental detection permitted effective intervention. This case highlights the diagnostic challenges posed by extra-gastrointestinal stromal tumors due to their atypical location and nonspecific symptoms. Extra-gastrointestinal stromal tumors should be considered …

Gabapentin Induced Seizures: A Rare Presentation Of Toxicity, Muhammad Umer Mukhtar, Akaansha Varma, Abdullah M. Firoze Ahmed

Advances in Clinical Medical Research and Healthcare Delivery

Gabapentin is a medication used for the management of neuropathic pain, focal seizures, and several other medical conditions. We report a case of a young male who experienced generalized tonic clonic seizures following the intentional ingestion of 31 grams of gabapentin. This case describes an unusual manifestation of gabapentin toxicity, namely seizures, and highlights the overdose of gabapentin for recreational purposes. Furthermore, this report emphasizes the rising misuse of gabapentin and underscores the importance of providers remaining vigilant in recognizing potential substance use disorders.

Idiosyncratic Drug Induced Liver Injury Secondary To Ciprofloxacin: A Reminder To Always Check Medication History, Xavier Zonna, Conor Banta, Erika Anson Md

Advances in Clinical Medical Research and Healthcare Delivery

A 38-year-old Caucasian male with no significant past medical history presented to the emergency department with complaints of nausea, vomiting, abdominal pain, and jaundice of 2 days duration. He noticed this in addition to pruritus, fever, and malaise. He had severe transaminitis and hyperbilirubinemia on laboratory evaluation. He was admitted for acute liver injury of an unknown etiology. He had taken a course of ciprofloxacin days prior to presentation for UTI at an outlying facility. Serologies were also concerning possible autoimmune liver disease with elevated Anti-Nuclear Antibody and equivocal Anti Smooth Muscle Antibody. Liver biopsy was negative for any autoimmune …

Literally Heartburn: A Case Report Exploring Potential Preventive Measures Of Esophageal Injury After Radiofrequency Ablation For Atrial Fibrillation, Venkat Arutla, Chengu Niu, Prajjwol Bhatta, Basil George Verghese

Advances in Clinical Medical Research and Healthcare Delivery

Esophageal injury (EI) after radiofrequency ablation (RF) for atrial fibrillation (AF) is a feared complication due to its extreme variability in presentation and very high mortality rate. The incidence of EI after RF ablation also varies widely among the literature. The diagnosis and management of EI is a combination of swift clinical recognition, confirmatory computed tomography (CT) imaging, and prompt surgical repair. This case discusses a 56-year-old male with past medical history of AF who presented to the hospital with complaints of chest pain, shortness of breath and nausea after undergoing recent RF ablation for AF. Imaging revealed an esophageal …

Bilateral Congenital Radioulnar Synostosis - Case Report, Derek A. Diangelis, Matthew J. Hudson

Advances in Clinical Medical Research and Healthcare Delivery

A 2-year-old male presented to an orthopedic outpatient office due to a supination defect in both of his upper limbs. X-rays of the affected limbs revealed fusion of the proximal radioulnar joints indicating congenital radioulnar synostosis (CRUS). CRUS is abnormal development of the upper limbs occurring during weeks 3—7 of embryological development. Causes of CRUS include genetic syndromes and spontaneous mutations. Treatment options include nonoperative and surgical treatments, however, treatment is controversial due to a lack of clinical evidence. Proposed screening methods could help improve detection rates and improve clinical management. This report aims to increase awareness of CRUS and …

Pembrolizumab-Induced Primary Adrenal Insufficiency: A Rare But Life-Threatening Endocrine Irae, Syeda Sarah Raza, Mehr A. Orakzai, Abdullah A. Orakzai

Advances in Clinical Medical Research and Healthcare Delivery

Pembrolizumab, a PD-1 checkpoint inhibitor, is widely used in the treatment of various malignancies. While it improves overall survival, it can lead to immune-related adverse events (irAEs), including rare endocrine disorders such as primary adrenal insufficiency (PAI). We present a case of PAI induced by Pembrolizumab in a 75-year-old man, emphasizing the importance of early recognition and timely management.

‘Is The Patient Clear For Surgery?’ Takotsubo Cardiomyopathy Presenting As T-Wave Inversions In A Pre-Operative Ekg: A Case Report, Muhammad Hammad Sharif, Madeeha Khaleeque, Syed Faiz Abbas, Gaurav Sharma, Aditya Sanjeevi, Muhammad Hassan Jan, Atif Ahmed

Advances in Clinical Medical Research and Healthcare Delivery

Takotsubo cardiomyopathy (TC) can cause dynamic changes in the electrocardiogram (EKG) and troponin elevation which can be misinterpreted as an acute coronary event that can cause an unnecessary delay in the surgery and affect the outcomes of a non-cardiac surgery. We present a case of a patient with pre-operative T-wave inversions diagnosed with TC. A 90-year-old female presented with a femur fracture. Pre-operative EKG showed symmetric T-wave inversions in the inferior and pre-cordial leads. Delta troponin was unremarkable and she remained chest pain-free. Transthoracic echocardiogram (TTE) showed an ejection fraction of 60% with apical ballooning and basal hyperkinesis concerning for …

A Case Of Fatal Herpes Zoster Ophthalmicus And Encephalitis In An Immunocompetent Host With A Review Of Literature, Kellyn E. Wilkes, Rutwik Pradeep Sharma, Laurie Proia

Advances in Clinical Medical Research and Healthcare Delivery

Herpes zoster is a common disease that can have several complications. Here, we present a case of herpes zoster ophthalmicus with coexisting encephalitis that unfortunately resulted in patient mortality. A 70-year-old male with a past medical history of Parkinson’s disease and schizophrenia presented to the emergency department after being found altered at home. Physical exam was notable for left-sided crusted facial rash, left conjunctival injection, and purulent drainage coming from the right eye. Given the location and appearance of his rash, he was diagnosed with herpes zoster ophthalmicus. There was suspicion for encephalitis given his altered mental status but unfortunately, …

Rectal Adenocarcinoma Presenting As Full-Thickness Prolapse With External Haemorrhoids: Case Report., Samantha Temucin, Sean Singh, Valerie Bauer, Roy Sandau

General Surgery Resident Research

We present a case of a 51-year-old male with a colonic adenocarcinoma that presented as a full-thickness rectal prolapse with external haemorrhoids. This patient had no significant medical or surgical history and presented to the emergency department with a rectal prolapse which had become incarcerated and increasingly painful over the previous 2 weeks. A computed tomography (CT) abdomen and pelvis appeared benign, demonstrating a full-thickness rectal prolapse with no definite rectal mass. A colonoscopy was performed, revealing anterior rectal mucosal edema, fibrosis, and a possible mass. This prompted the patient to be taken to the operating room for a low …

Controlled Antibiotic Release From Emulsion-Loaded Alginate And Fibrin Hydrogels Using Ultrasound, Ziba Ghareh Nazi Fam, Asia Winslow, Mario Fabiilli, Sam Varghese, Brian Oeffinger, Flemming Forsberg, Noreen Hickok, Lauren Delaney

Department of Radiology Faculty Papers

Postoperative infections remain a major complication after spinal fusion surgery, often caused by biofilm-forming bacteria that resist short-term antibiotic prophylaxis. Vancomycin (VAN) is sometimes delivered locally during surgery; however, levels diminish rapidly, leaving patients vulnerable to late-onset infections. We developed a composite hydrogel integrating perfluorohexane-based emulsions within alginate or fibrin matrices to enable both sustained and ultrasound-triggered VAN release. Water-in-oil-in-water emulsions were prepared using fluorosurfactant-stabilized perfluorohexane as the volatile oil phase, then embedded in hydrogels and exposed to ultrasound (2.5 MHz, 5.5 MPa peak negative pressure) to initiate acoustic droplet vaporization for triggered release. Drug release was quantified spectrophotometrically and …

Mapping Social Determinants Of Health Data In Sub-Saharan Africa: A Scoping Review Protocol, Felix Anyiam, Jessica Gjonaj, Ngeresa Osango, Richard Mugo, Peace Aber, Jasmit Shah, Judith Mangeni, Rajesh Vedanthan, Joseph Hogan, Ann Mwangi

Internal Medicine, East Africa

Introduction Research has increasingly underscored the impact of factors such as socioeconomic status, education, healthcare access, housing and environmental conditions in shaping population health outcomes. These factors, collectively called social determinants of health (SDOH), provide crucial context for understanding drivers of health outcomes. In sub-Saharan Africa (SSA), the study of SDOH is critical due to the region’s unique sociocultural and economic conditions. Understanding how SDOH interacts with health systems and capturing SDOH in data is crucial for informing modelling efforts and policies improving population health more effectively. This scoping review aims to map the types of data used to capture …

Evaluation Of The Intempo Path Set For Cyberknife Prostate And Lung Sbrt: A Single-Institution Experience, Yingcui Jia, Lei Fu, Shari Rudoler, Eric Gressen, Yevgeniy Vinogradskiy, Qianyi Xu

Department of Radiation Oncology Faculty Papers

PURPOSE: The InTempo adaptive imaging system is an important component of the Accuray CyberKnife System, designed to enhance the system's ability to track and correct tumor motion during treatment. However, a limitation of this feature is the reduction of available nodes for treatment planning. The impact of a reduced number of nodes on the quality of InTempo-based treatment plans has not previously been evaluated. This retrospective study aims to compare the dosimetry of CyberKnife plans with and without The InTempo path set for both prostate and lung stereotactic body radiotherapy (SBRT).

METHODS: This study included twelve consecutive prostate SBRT patients …