Digital Commons Network^™

Outcomes Of Young Adults (Aged ≤ 40 Years) With Newly Diagnosed Multiple Myeloma After Up-Front Autologous Stem Cell Transplant, Oren Pasvolsky, Curtis Marcoux, Denái R Milton, Mark R Tanner, Qaiser Bashir, Samer Srour, Neeraj Saini, Paul Lin, Jeremy Ramdial, Yago Nieto, Hans C Lee, Krina K Patel, Partow Kebriaei, Priti Tewari, Lindsay Crawford-Suber, Sheeba K Thomas, Donna M Weber, Robert Z Orlowski, Elizabeth J Shpall, Richard E Champlin, Muzaffar H Qazilbash

Faculty, Staff and Student Publications

Multiple myeloma (MM) primarily affects older patients. There are scarce data on the outcomes of young adults undergoing autologous transplantation (auto-HCT). In this single-centre analysis, we included 117 younger patients, with a median age of 37 years (range 22-40) at transplant. Seventeen (15%) patients had high-risk cytogenetics. Before transplant, 10% of patients achieved ≥CR and 44% achieved ≥VGPR. At best post-transplant response, 56% and 77% of patients achieved ≥CR and ≥VGPR respectively. With a median follow-up for survivors of 72.6 months (range 0.9-238.0), median PFS and OS were 43.1 months (95% CI 31.2-65.0) and 146.6 months (95% CI 100.0-208.1) respectively. …

A Review Of A Strategic Roadmapping Exercise To Advance Clinical Translation Of Photoacoustic Imaging: From Current Barriers To Future Adoption, Hisham Assi, Rui Cao, Madhura Castelino, Ben Cox, Fiona J Gilbert, Janek Gröhl, Kurinchi Gurusamy, Lina Hacker, Aoife M Ivory, James Joseph, Ferdinand Knieling, Martin J Leahy, Ledia Lilaj, Srirang Manohar, Igor Meglinski, Carmel Moran, Andrea Murray, Alexander A Oraevsky, Mark D Pagel, Manojit Pramanik, Jason Raymond, Mithun Kuniyil Ajith Singh, William C Vogt, Lihong Wang, Shufan Yang, Members Of Ipasc, Sarah E Bohndiek

Faculty, Staff and Student Publications

Photoacoustic imaging (PAI), also referred to as optoacoustic imaging, has shown promise in early-stage clinical trials in a range of applications from inflammatory diseases to cancer. While the first PAI systems have recently received regulatory approvals, successful adoption of PAI technology into healthcare systems for clinical decision making must still overcome a range of barriers, from education and training to data acquisition and interpretation. The International Photoacoustic Standardisation Consortium (IPASC) undertook an community exercise in 2022 to identify and understand these barriers, then develop a roadmap of strategic plans to address them. Here, we outline the nature and scope of …

Prame And Lef1 In Combined Deep Penetrating Nevus And Combined Blue Nevus: Utility And Pitfall, Kaitlin Vanderbeck, Aimi T Rothrock, Woo Cheal Cho, Priyadharsini Nagarajan, Phyu P Aung, Courtney Hudgens, Roland L Bassett, Doina Ivan, Victor G Prieto, Jonathan L Curry, Carlos A Torres-Cabala

Faculty, Staff and Student Publications

Deep penetrating nevi (DPN), particularly those showing combined features, or combined deep penetrating nevi (CDPN), may show histopathological resemblance to blue nevus (BN) and melanoma. Preferentially Expressed Antigen in MElanoma (PRAME) is a marker that helps distinguish melanoma from benign melanocytic lesions. Lymphoid enhancer-binding factor 1 (LEF1) has been proposed to be used in conjunction with β-catenin for diagnosis of DPN. The immunohistochemical expression of PRAME and LEF1 was evaluated in 10 DPN (including 6 CDPN and 2 DPN-like proliferations with atypical features), 16 BN (including combined and cellular BN), and 2 melanomas with features of DPN or BN. PRAME …

The Initial Age-Associated Decline In Early T-Cell Progenitors Reflects Fewer Pre-Thymic Progenitors And Altered Signals In The Bone Marrow And Thymus Microenvironments, Jayashree Srinivasan, Anusha Vasudev, Carolyn Shasha, Hilary J Selden, Encarnacion Perez, Bonnie Lafleur, Shripad A Sinari, Andreas Krueger, Ellen R Richie, Lauren I R Ehrlich

Faculty, Staff and Student Publications

Age-related thymus involution results in decreased T-cell production, contributing to increased susceptibility to pathogens and reduced vaccine responsiveness. Elucidating mechanisms underlying thymus involution will inform strategies to restore thymopoiesis with age. The thymus is colonized by circulating bone marrow (BM)-derived thymus seeding progenitors (TSPs) that differentiate into early T-cell progenitors (ETPs). We find that ETP cellularity declines as early as 3 months (3MO) of age in mice. This initial ETP reduction could reflect changes in thymic stromal niches and/or pre-thymic progenitors. Using a multicongenic progenitor transfer approach, we demonstrate that the number of functional TSP/ETP niches does not diminish with …

Probiotic-Derived Ecto-5'-Nucleotidase Produces Anti-Inflammatory Adenosine Metabolites In Treg-Deficient Scurfy Mice, Yuying Liu, Shabba A Armbrister, Beanna Okeugo, Tingting W Mills, Rhea C Daniel, Jee-Hwan Oh, Jan-Peter Van Pijkeren, Evelyn S Park, Zeina M Saleh, Sharmistha Lahiri, Stefan Roos, Jmarc Rhoads

Faculty, Staff and Student Publications

Probiotic Limosilactobacillus reuteri DSM 17938 (DSM 17938) prolongs the survival of Treg-deficient scurfy (SF) mice and reduces multiorgan inflammation by a process requiring adenosine receptor 2A (A2A) on T cells. We hypothesized that L. reuteri-derived ecto-5'-nucleotidase (ecto-5'NT) activity acts to generate adenosine, which may be a central mediator for L. reuteri protection in SF mice. We evaluated DSM 17938-5'NT activity and the associated adenosine and inosine levels in plasma, gut, and liver of SF mice. We examined orally fed DSM 17938, DSM 17938Δ5NT (with a deleted 5'NT gene), and DSM 32846 (BG-R46) (a naturally selected strain derived from DSM 17938). …

Low-Grade Intestinal Inflammation Two Decades After Pelvic Radiotherapy, Sravani Devarakonda, Annika Thorsell, Per Hedenström, Azar Rezapour, Lisen Heden, Sanghita Banerjee, Malin E V Johansson, George Birchenough, Amelie Toft Morén, Karin Gustavsson, Viktor Skokic, Victor L Pettersson, Fei Sjöberg, Marie Kalm, Mohammad Al Masri, Michaela Ekh, Henrik Fagman, Mats Wolving, Rosie Perkins, Rodrigo A Morales, Francisca Castillo, Eduardo J Villablanca, Ulf Yrlid, Karin Bergmark, Gunnar Steineck, Cecilia Bull

Faculty, Staff and Student Publications

BACKGROUND: Radiotherapy is effective in the treatment of cancer but also causes damage to non-cancerous tissue. Pelvic radiotherapy may produce chronic and debilitating bowel symptoms, yet the underlying pathophysiology is still undefined. Most notably, although pelvic radiotherapy causes an acute intestinal inflammation there is no consensus on whether the late-phase pathophysiology contains an inflammatory component or not. To address this knowledge gap, we examined the potential presence of a chronic inflammation in mucosal biopsies from irradiated pelvic cancer survivors.

METHODS: We biopsied 24 cancer survivors two to 20 years after pelvic radiotherapy, and four non-irradiated controls. Using tandem mass tag …

Role Of Circulating Mitochondria In Venous Thrombosis In Glioblastoma, Ricardo Gonzalez-Delgado, Nina M Muñoz, Wendolyn Carlos-Alcalde, Min Soon Cho, Hani Lee, Jeff Jin, Victoria Serpas, Olga Gorlova, Rahul A Sheth, Vahid Afshar-Kharghan

Faculty, Staff and Student Publications

Background: Many patients with glioblastoma multiforme (GBM) develop deep venous thrombosis or pulmonary emboli. Cell-free circulating mitochondria increase after brain injury and are associated with coagulopathy.

Objectives: This study evaluated whether mitochondria play a role in the GBM-induced hypercoagulable state.

Methods: We examined the correlation between cell-free circulating mitochondria and venous thrombosis in patients with GBM and the impact of mitochondria on venous thrombosis in mice with inferior vena cava stenosis.

Results: Using plasma samples of 82 patients with GBM, we found that patients with GBM had a higher number of mitochondria in their plasma (GBM with venous thromboembolism [VTE],: …

Effect Of Exogenous L-Carnitine On Aortic Stiffness In Dyslipidemic Adolescents: Design Of A Quadruple-Blind, Randomized, Controlled Interventional Trial, Justin P Zachariah, Sandra Pena, Philip J Lupo, Nagireddy Putluri, Daniel J Penny, Melissa A Richard

Faculty, Staff and Students Publications

BACKGROUND: Atherosclerotic cardiovascular disease (ASCVD) risk factors including vascular remodeling leading to hypertension and dyslipidemia are prevalent among children and adolescents. Conflicting observational and Mendelian randomization data suggest endogenous carnitine may affect arterial stiffness and lipid traits. Because of this, we developed a study to evaluate the causal role for carnitine in arterial stiffness at a point when the lifecourse trajectory to hypertension can be modified.

METHODS: This study is a mechanistic, double-blinded, randomized control trial (RCT) in 166 adolescents with dyslipidemia for the effect of 6 months of maximum dose 3 g daily oral l-carnitine supplementation (CS+) versus placebo …

Androgen-Regulated Stromal Complement Component 7 (C7) Suppresses Prostate Cancer Growth, Zhicheng Zhou, Deyong Jia, Ohjoon Kwon, Shan Li, Huiyun Sun, Martine P Roudier, Daniel W Lin, Lawrence True, Colm Morrissey, Chad J Creighton, John K Lee, Li Xin

Faculty, Staff and Students Publications

The complement system is a major component of the innate immune system that works through the cytolytic effect of the membrane attack complex (MAC). Complement component 7 (C7) is essential for MAC assembly and its precisely regulated expression level is crucial for the cytolytic activity of MAC. We show that C7 is specifically expressed by the stromal cells in both mouse and human prostates. The expression level of C7 inversely correlates with clinical outcomes in prostate cancer. C7 is positively regulated by androgen signaling in the mouse prostate stromal cells. The androgen receptor directly transcriptionally regulates the mouse and human …

Multiscale Analysis Of Pangenomes Enables Improved Representation Of Genomic Diversity For Repetitive And Clinically Relevant Genes, Chen-Shan Chin, Sairam Behera, Asif Khalak, Fritz J Sedlazeck, Peter H Sudmant, Justin Wagner, Justin M Zook

Faculty, Staff and Students Publications

Advancements in sequencing technologies and assembly methods enable the regular production of high-quality genome assemblies characterizing complex regions. However, challenges remain in efficiently interpreting variation at various scales, from smaller tandem repeats to megabase rearrangements, across many human genomes. We present a PanGenome Research Tool Kit (PGR-TK) enabling analyses of complex pangenome structural and haplotype variation at multiple scales. We apply the graph decomposition methods in PGR-TK to the class II major histocompatibility complex demonstrating the importance of the human pangenome for analyzing complicated regions. Moreover, we investigate the Y-chromosome genes, DAZ1/DAZ2/DAZ3/DAZ4, of which structural variants have been linked to …

Cation Leak Through The Atp1a3 Pump Causes Spasticity And Intellectual Disability, Daniel G Calame, Cristina Moreno Vadillo, Seth Berger, Timothy Lotze, Marwan Shinawi, Javaher Poupak, Corina Heller, Julie Cohen, Richard Person, Aida Telegrafi, Chalongchai Phitsanuwong, Kaylene Fiala, Isabelle Thiffault, Florencia Del Viso, Dihong Zhou, Emily A Fleming, Tomi Pastinen, Ali Fatemi, Sruthi Thomas, Samuel I Pascual, Rosa J Torres, Carmen Prior, Clara Gómez-González, Saskia Biskup, James R Lupski, Dragan Maric, Miguel Holmgren, Debra Regier, Sho T Yano

Faculty, Staff and Students Publications

ATP1A3 encodes the α3 subunit of the sodium-potassium ATPase, one of two isoforms responsible for powering electrochemical gradients in neurons. Heterozygous pathogenic ATP1A3 variants produce several distinct neurological syndromes, yet the molecular basis for phenotypic variability is unclear.

We report a novel recurrent variant, ATP1A3(NM_152296.5):c.2324C>T; p.(Pro775Leu), in nine individuals associated with the primary clinical features of progressive or non-progressive spasticity and developmental delay/intellectual disability. No patients fulfil diagnostic criteria for ATP1A3-associated syndromes, including alternating hemiplegia of childhood, rapid-onset dystonia-parkinsonism or cerebellar ataxia-areflexia-pes cavus-optic atrophy-sensorineural hearing loss (CAPOS), and none were suspected of having an ATP1A3 …

Toward Nonparametric Propensity Score Estimation With Guaranteed Covariate Balance, Yan Li

Dissertations and Theses (Open Access)

Establishing clear causality between exposures and outcomes is often complicated by confounders in observational studies, which leads to imbalance in covariate distributions between treatments and biased treatment effect inference. The propensity score (PS) has been widely used to adjust this covariate imbalance in observational data. However, the propensity score analysis methods rely on a correctly specified parametric PS model. When the model is misspecified, the covariate imbalance may occur, which leads to biased estimation of the treatment effect. Therefore, it is necessary to study how to improve the model misspecification in propensity score analysis.

My Ph.D. dissertation consists of three …

Leveraging Omics To Predict Chronic Obstructive Pulmonary Disease Exacerbations: The "Immunome", Francesca Polverino, Ravi Kalhan

Faculty, Staff and Students Publications

No abstract provided.

A Myofiber-Derived Secreted Factor For Muscle Regeneration, Fang Xiao, Zheng Sun

Faculty, Staff and Students Publications

No abstract provided.

Monocytic And Blastic Plasmacytoid Dendritic Cell Differentiation In Acute Leukemia With Kmt2a Rearrangement, Owen Xue, Choladda V Curry, Hong Fang, Carlos E Bueso-Ramos, L Jeffrey Medeiros, Wei Wang

Faculty, Staff and Students Publications

Acute leukemia with KMT2A rearrangement shows a spectrum of immunophenotypic presentation, but blastic plasmacytoid dendritic cell differentiation is extremely rare. Here we present a case of KMT2A rearranged acute leukemia with a hybrid immunophenotype in which a single blast population showed both blastic plasmacytoid dendritic cell and monocytic differentiation. This unusual case contributes to the diversity of the immunophenotypic spectrum in KMT2A rearranged acute leukemia and also sheds light on the cell of origin of plasmacytoid dendritic cells.

Factors Associated With Choice Of Behavioural Weight Loss Program By Adults With Obesity, Yasaman Jamshidi-Naeini, Susan B Roberts, Stephanie Dickinson, Arthur Owora, Jon Agley, Roger S Zoh, Xiwei Chen, David B Allison

Children’s Nutrition Research Center Staff Publications

We assessed the preference for two behavioural weight loss programs, Diabetes Prevention Program (DPP) and Healthy Weight for Living (HWL) in adults with obesity. A cross-sectional survey was fielded on the Amazon Mechanical Turk. Eligibility criteria included reporting BMI ≥30 and at least two chronic health conditions. Participants read about the programs, selected their preferred program, and answered follow-up questions. The estimated probability of choosing either program was not significantly different from .5 (N = 1005, 50.8% DPP and 49.2% HWL, p = .61). Participants' expectations about adherence, weight loss magnitude, and dropout likelihood were associated with their choice (p <  .0001). Non-White participants (p = .040) and those with monthly income greater than $4999 (p = .002) were less likely to choose DPP. Participants who had postgraduate education (p = .007), did not report high serum cholesterol (p = .028), and reported not having tried losing weight before (p = .025) were more likely to choose DPP. Those who chose HWL were marginally more likely to report that being offered two different programs rather than one would likely affect their decision to enrol in one of the two (p = .052). The enrolment into DPP and HWL was balanced, but race, educational attainment, income, previous attempt to lose weight, and serum cholesterol levels had significant associations with the choice of weight loss program.

T-Cell Receptor Beta Variable Gene Polymorphism Predicts Immune-Related Adverse Events During Checkpoint Blockade Immunotherapy, Bettzy Stephen, Joud Hajjar, Shrutii Sarda, Dzifa Yawa Duose, Jeffrey M Conroy, Carl Morrison, Anas Alshawa, Mingxuan Xu, Abdulrazzak Zarifa, Sapna P Patel, Ying Yuan, Evan Kwiatkowski, Linghua Wang, Jordi Rodon Ahnert, Siqing Fu, Funda Meric-Bernstam, Geoffrey M Lowman, Timothy Looney, Aung Naing

Faculty, Staff and Student Publications

BACKGROUND: Immune checkpoint inhibitors have revolutionized cancer treatment. However, they are associated with a unique spectrum of side effects, called immune-related adverse events (irAEs), which can cause significant morbidity and quickly progress to severe or life-threatening events if not treated promptly. Identifying predictive biomarkers for irAEs before immunotherapy initiation is therefore a critical area of research. Polymorphisms within the T-cell receptor beta (TCRB) variable (TRBV) gene have been implicated in autoimmune disease and may be mechanistically linked to irAEs. However, the repetitive nature of the TCRB locus and incomplete genome assembly has hampered the evaluation of TRBV polymorphisms in the …

Interrogations Of The Tumor Microenvironment Using Magnetic Resonance Imaging, Tianzhe Li

Dissertations and Theses (Open Access)

Both tumor acidosis and tumor hypoxia are characteristics commonly found in the microenvironment of solid malignant tumors. Accurate characterization of the two phenomena could provide important information to clinicians for devising suitable treatment plans. Tumor acidosis and hypoxia are closely linked to each other. Tumor acidosis is caused by the inclination of cancer cells towards anaerobic respiration, and one of the main contributing factors for the avoidance of aerobic respiration is tumor hypoxia. Both phenomena can indicate the high metastatic potential of cancers and can also cause resistance of the cancer systems against anti-cancer therapies. Therefore, developing novel molecular imaging …

Role Of Phosphorylated Dicer1 In Tumor Progression, Raisa Reyes-Castro

Dissertations and Theses (Open Access)

DICER1 is a multidomain enzyme discovered and widely recognized for its function in small non-coding microRNA (miRNA) synthesis. In cancer development, DICER1 functions as a haploinsufficient tumor suppressor which regulates miRNAs and Epithelial-to-Mesenchymal Transition (EMT). The Arur laboratory discovered that DICER1 is phosphorylated by active ERK and that ERK-mediated phosphorylation triggers DICER1 to translocate from the cytoplasm to the nucleus of cells in worms, mice and humans. Further, a heterozygous allele of a genetically engineered mouse model of phosphomimetic Dicer1 when combined with heterozygous Kras oncogenic background contributes to lung tumor progression in vivo. Mechanisms through which phosphomimetic Dicer1 …

Genetic Analysis Of Crossover Defective Mouse Spermatocytes Reveals Discrete Crossover Precursor Intermediates, Tolkappiyan Prem Kumar

Dissertations and Theses (Open Access)

In healthy, non-replicating somatic cells of diploid organisms, like humans and mice, there are two copies of each chromosome, one from each parent. However, the germ cells of these organisms, the oocytes, and the sperm, have only one copy of each chromosome, thus ensuring that when haploid oocytes and sperm fuse to form a zygote, a diploid number of chromosomes is restored. The reduction of a diploid number of chromosomes to a haploid number of chromosomes takes place during meiosis. The meiotic cell cycle consists of two rounds of cell division, Meiosis I and Meiosis II. Meiosis I create haploid …

Statistical Modeling Approaches For The Inference Of Cancer Mechanisms, Licai Huang

Dissertations and Theses (Open Access)

The aim of this study was to explore the potential of integrating multi-platform genomic datasets to improve our understanding of the biological mechanisms behind cancer. By merging clinical outcomes with the data obtained from multi-platform genomic studies, we can gain insight into the biological mechanisms behind a patient’s response to treatment. Additionally, the evaluation of the correlations between genetic variations and gene expression provides a better understanding of the functional significance of these variations. Such knowledge has the potential to revolutionize cancer diagnosis and treatment. This thesis describes methods developed to address two related aims. Aim 1: We have developed …

Statistical Approaches To Estimate Bidirectional And Time-Varying Causal Effects Using Mendelian Randomization, Jinhao Zou

Dissertations and Theses (Open Access)

Mendelian Randomization (MR) is an epidemiological framework using genetic variants as instrumental variables (IVs) to examine the causal effect of an exposure on an outcome. It is widely used to detect causal factors of diseases and provide insight into the biological pathway of diseases. Current methods under the MR framework are built to estimate the unidirectional causal effects of exposures on outcomes and neglect the potential bidirectional causal effects. However, a bidirectional causal effect creates a feedback loop that biases the casual inference in MR studies. Furthermore, current MR methods estimate the causal effect as a single value using cross-sectional …

Landscape Of Ecdna-Borne Non-Coding Rnas In Glioblastoma, Dexin Yang

Dissertations and Theses (Open Access)

Recent advances in cancer genetics found that strong oncogene transcription can occur on a form of non-chromosome DNAs that is often amplified to tens or hundreds of copies, and that can exist in more than half of cancer types. This type of genetic material was termed extrachromosomal DNA (ecDNA). ecDNA appears to be epigenetically highly accessible and transcriptionally active compared with chromosomal DNA, which may partially underlie their critical roles in driving oncogene overexpression and cancer evolution. However, the full molecular mechanisms and regulators that confer the exceptional transcriptional activity of ecDNA-associated genes are incompletely understood.

Enhancers are key genetic …

Therapeutic Potential Of Prmt5 And Mat2a As Synthetic Lethal Targets In Mtap-Deficient Gbm Tumors, Yasaman Barekatain

Dissertations and Theses (Open Access)

Homozygous deletion of methylthioadenosine phosphorylase (MTAP) is a frequent genetic alteration found in approximately 15% of all human cancers, including glioblastoma, pancreatic cancer, mesothelioma, urothelial bladder carcinoma, and lung squamous cell carcinoma. MTAP is a critical metabolic enzyme in the methionine salvage pathway responsible for the breakdown of methylthioadenosine (MTA). As a result, MTAP-deleted cells cannot metabolize MTA, leading to the accumulation of MTA. High levels of MTA in MTAP-deleted cells partially inhibit the activity of protein arginine methyltransferase 5 (PRMT5), making these cells sensitive to PRMT5 and MAT2A inhibition. Although elevated levels of MTA in …

Acute Manipulation Of Erna Level For Dissecting Its Roles In Transcriptional Regulation, Lanxin Bei

Dissertations and Theses (Open Access)

Enhancers are the central genetic elements controlling cell-type and state specific transcription programs to dictate cell fates during development. Mechanistic understanding of enhancer action is important for both biology and disease research. In the human genome, more than 60k human enhancers were found to produce non-coding transcripts named enhancer RNAs (eRNAs). These created a new challenge to understand enhancer functions, which now are not only DNA elements that promote transcription but also RNA-producing transcription units themselves. Importantly, deregulation of eRNAs was associated with various diseases such as cancer, immune disorders, and neurodegeneration. However, the direct role of eRNAs in transcriptional …

Isolation Of Therapeutic Antibodies Against Microseminoprotien To Potentially Overcome Resistance To Anti-Angiogenic Therapy, Mason Ruiz

Dissertations and Theses (Open Access)

High-grade serous ovarian carcinoma (HGSC) is an aggressive subtype of epithelial ovarian carcinoma (EOC) and remains the most lethal gynecologic cancer. Angiogenesis is a vital function for both wound healing and oxygen homeostasis and is one of the hallmarks of cancer in solid tumors. To combat the formation of tumors, an anti-VEGF drug, bevacizumab, is used to starve tumors of blood that provide essential nutrients. While platinum-taxane doublet therapy in addition to cytoreductive surgery has been the gold standard treatment for patients with ovarian cancer, greater than 70% of patients will develop relapsed disease and be burdened with a terminal …

Molecular Mechanisms Behind Sars-Cov-2 Induced Host Genome Restructuring, Erin Simpson

Dissertations and Theses (Open Access)

Severe Acute Respiratory Syndrome Coronavirus -2 (SARS-CoV-2) has caused unprecedented morbidity and mortality worldwide. There are two pathophysiological hallmarks associated with severe patient outcomes after SARS-CoV-2 acute infection, namely delayed/weakened interferon production and overactive inflammatory responses. Our previous work has shown that these altered immune responses are due, at least in part, to significant alterations in 3D genome organization and epigenetic landscape following SARS-CoV-2 infection that are distinct from and more severe than changes caused by other viral infections or immune stimulants. While these changes at the chromatin level are important for understanding the immune dysregulation seen in some cases …

Spanish-Speaking Limited English-Proficient Patient Satisfaction And Comfort When Comparing Spanish-Speaking Provider To An Interpreter, Cindy Hernandez

Dissertations and Theses (Open Access)

A large population of Americans have limited or no English proficiency (LEP) with about 64% of those being Spanish-speaking. This creates challenges in navigating the American healthcare system, where the majority of providers are solely English-speaking. Studies have demonstrated that when patients have language discordant appointments without interpreters, they are more likely to feel less understood, have questions and comments ignored, and are less likely to receive patient-centered care in communication. It is expected that interpreters improve access to healthcare, especially for Spanish-speaking patients. However, the patient comfort and satisfaction in language discordant genetic counseling appointments has not yet been …

Unveiling Immune Checkpoint Therapy Resistance Mechanisms In The Tumor Microenvironment Using High-Dimensional Analyses, Swetha Anandhan

Dissertations and Theses (Open Access)

The advent of immune checkpoint therapy (ICT) has transformed cancer treatment, but its effectiveness is limited in certain cancers like pancreatic ductal adenocarcinoma (PDAC), which exhibit resistance to this therapy. To overcome this challenge, it is crucial to understand the underlying mechanisms that determine tumor response to ICT and develop rational therapeutic combinations. The tumor microenvironment (TME), including suppressive myeloid cells, regulatory T cells (Tregs), and cancer-associated fibroblasts (CAFs), plays a pivotal role in ICT responses. Leveraging single-cell technologies, this study explores the role and function of immune subsets in the TME that induce therapy resistance.

Using single-cell RNA sequencing …

Protein L Functionalized Microparticles For Early Detection Of Surface Markers In Heterogeneous Colorectal Lesions, Saleh Ramezani

Dissertations and Theses (Open Access)

Colorectal cancer (CRC) is the third leading cause of cancer-related deaths among both men and women worldwide, a statistic that can be improved with early detection. Increased understanding of the tumor landscape has identified surface antigens that can be utilized to distinguish normal and cancerous tissue lining the colonic lumen. Use of antibodies conjugated to nano/micromaterials offers a means to detect these antigens, however, the heterogeneous nature of tumors makes it unlikely that antibodies against a single antigen will have sufficient sensitivity and specificity to detect all tumors. A versatile micromaterial able to be functionalized with more than one targeting …