Digital Commons Network^™

Virtual Adaptation Of An International Exchange Program In Medical Education, Celia Fung, Nicholas Maxwell, Stephen Powell, Michelle Benassai, Natalia Chunga, Jennifer Corcoran, William Barbosa, Marisabel Lopez, Betsy Hanampa, Melissa Llaiqui-Condori, Victor Delgado-Lazo, Karina Mendoza, Yanet Astete, Martin Flor, Sheyla Palacios, Blanca Valdovinos, Jorge Risco, Isabel Camargo, Ralph Jozefowicz, Karlo J Lizárraga

2020-Current year OA Pubs

Medical education has drastically transformed during the COVID-19 pandemic. Measures such as adopting telemedicine visits, minimizing the number of trainees on service, discontinuing external rotations, and converting in-person to online didactics have been broadly and swiftly implemented. While these innovations have promoted greater interconnectivity amongst institutions and made continuing medical education possible, international exchange programs in medical education are still largely disrupted. In response to the changing guidelines and restrictions necessitated by the COVID-19 pandemic, the authors used Kern's six-step approach to design and implement a virtual curriculum to replace the in-person activities of the 2020-2021 Neurology Peru-Rochester exchange program …

Cdc20 Regulates Sensitivity To Chemotherapy And Radiation In Glioblastoma Stem Cells, Diane D. Mao, Ryan T. Cleary, Amit Gujar, Tatenda Mahlokozera, Albert H. Kim

2020-Current year OA Pubs

Glioblastoma stem cells (GSCs) are an important subpopulation in glioblastoma, implicated in tumor growth, tumor recurrence, and radiation resistance. Understanding the cellular mechanisms for chemo- and radiation resistance could lead to the development of new therapeutic strategies. Here, we demonstrate that CDC20 promotes resistance to chemotherapy and radiation therapy. CDC20 knockdown does not increase TMZ- and radiation-induced DNA damage, or alter DNA damage repair, but rather promotes cell death through accumulation of the pro-apoptotic protein, Bim. Our results identify a CDC20 signaling pathway that regulates chemo- and radiosensitivity in GSCs, with the potential for CDC20-targeted therapeutic strategies in the treatment …

Unique Molecular Identifier-Based High-Resolution Hla Typing And Transcript Quantitation Using Long-Read Sequencing, Caleb Cornaby, Maureen C Montgomery, Chang Liu, Eric T Weimer

2020-Current year OA Pubs

HLA typing provides essential results for stem cell and solid organ transplants, as well as providing diagnostic benefits for various rheumatology, gastroenterology, neurology, and infectious diseases. It is becoming increasingly clear that understanding the expression of patient HLA transcripts can provide additional benefits for many of these same patient groups. Our study cohort was evaluated using a long-read RNA sequencing methodology to provide rapid HLA genotyping results and normalized HLA transcript expression. Our assay used NGSEngine to determine the HLA genotyping result and normalized mRNA transcript expression using Athlon2. The assay demonstrated an excellent concordance rate of 99.7%. Similar to …

Experiences Using A Multidisciplinary Model For Treating Injection Drug Use Associated Infections: A Qualitative Study, Nathanial S Nolan, Emily Gleason, Laura R Marks, Tracey Habrock-Bach, Stephen Y Liang, Michael J Durkin

2020-Current year OA Pubs

Background: Over the past two decades, the United States has experienced a dramatic increase in the rate of injection drug use, injection associated infections, and overdose mortality. A hospital-based program for treating opioid use disorder in people who inject drugs presenting with invasive infections was initiated at an academic tertiary care center in 2020. The goal of this program was to improve care outcomes, enhance patient experiences, and facilitate transition from the hospital to longer term addiction care. The purpose of this study was to interview two cohorts of patients, those admitted before vs. after initiation of this program, to …

Molecular Heterogeneity In Pediatric Malignant Rhabdoid Tumors In Patients With Multi-Organ Involvement, Katherine E Miller, Margaret Shatara, Et Al

2020-Current year OA Pubs

Rhabdoid tumors (RTs) of the brain (atypical teratoid/rhabdoid tumor; AT/RT) and extracranial sites (most often the kidney; RTK) are malignant tumors predominantly occurring in children, frequently those with

Efficient T Cell Migration And Activation Require L-Plastin, Hemant Joshi, Sharon Celeste Morley

2020-Current year OA Pubs

Rapid re-organization of the actin cytoskeleton supports T-cell trafficking towards immune sites and interaction with antigen presenting cells (APCs). F-actin rearrangement enables T-cell trafficking by stabilizing adhesion to vascular endothelial cells and promoting transendothelial migration. T-cell/APC immune synapse (IS) maturation also relies upon f-actin-anchored LFA-1:ICAM-1 ligation. Therefore, efficient T-cell responses require tight regulation of f-actin dynamics. In this review, we summarize how the actin-bundling protein L-plastin (LPL) regulates T-cell activation and migration. LPL enhances f-actin polymerization and also directly binds to the β2 chain of the integrin LFA-1 to support intercellular adhesion and IS formation in human and murine T …

"Second-Class" Rhetoric, Ideology, And Doctrinal Change, Eric M. Ruben, Joseph Blocher

Faculty Journal Articles and Book Chapters

A common refrain in current constitutional discourse is that lawmakers and judges are systematically disfavoring certain rights. This allegation has been made about the rights to free speech and free exercise of religion, but it is most prominent in debates about the right to keep and bear arms. Such “second-class” treatment, the argument goes, signals that the Supreme Court must intervene aggressively to police the disrespected rights. Past empirical work casts doubt on the descriptive claim that judges and policymakers are disrespecting the Second Amendment, but that simply highlights how little we know about how the second-class argument functions as …

Justice Breyer And Patent Eligibility, David O. Taylor

Faculty Journal Articles and Book Chapters

Justice Breyer leaves the Supreme Court having left a significant mark on patent eligibility law. In Mayo Collaborative Services v. Prometheus Laboratories, he eliminated the ability to obtain patents on many useful applications of new (and even breakthrough) discoveries. The author discusses how Justice Breyer’s test for patent eligibility both contradicts the historical approach and has had pernicious impact on the patent system and investment in development of technology, including, and in particular, medical technologies.

New Approaches To Disarming Domestic Abusers, Natalie Nanasi

Faculty Journal Articles and Book Chapters

Laws prohibiting perpetrators of intimate partner violence from possessing firearms have long been on the books. But the failure to enforce them, thus allowing abusers to keep their weapons, has led to deadly consequences. While the criminal justice system has in recent years increased efforts to disarm domestic abusers, they have yielded minimal success.

It should be unsurprising that threatening criminal consequences for illegally possessing firearms has not been an effective strategy. Perpetrators knew they were breaking the law when they assaulted their partners, but did so anyway. And the calculated risk they take by not relinquishing guns often pays …

Can Blockchain Revolutionize Tax Administration?, Orly Sulami Mazur

Faculty Journal Articles and Book Chapters

Experts predict that the use of smart contracts and other applications of blockchain technology could revolutionize the manner in which we do business. Blockchain technology promises the elimination of middlemen, increased trust and transparency, and improved access to shared information and records. Thus, it is no surprise that companies and entrepreneurs are developing blockchain solutions for an array of markets, ranging from real estate to health care. But can this new technology revolutionize tax administration?

This Article is the first to consider blockchain technology’s role in addressing the shortcomings of our current administration system— namely, a large tax gap, high …

Systematic Review With Meta-Analysis: Safety And Effectiveness Of Combining Biologics And Small Molecules In Inflammatory Bowel Disease, Quazim A Alayo, Osama Altayar, Matthew A Ciorba, Deborah Thomas, Parakkal Deepak, Et Al.

2020-Current year OA Pubs

BACKGROUND: Combining biologics and small molecules could potentially overcome the plateau of drug efficacy in inflammatory bowel disease (IBD). We conducted a systematic review and meta-analysis to assess the safety and effectiveness of dual biologic therapy (DBT), or small molecule combined with a biologic therapy (SBT) in IBD patients.

METHODS: We searched MEDLINE, EMBASE, Scopus, Web of Science, Cochrane Database of Systematic Reviews, and Clinical trials.gov until November 3, 2020, including studies with 2 or more IBD patients on DBT or SBT. Main outcome was safety assessed as pooled rates of adverse events (AEs) and serious AEs (SAEs) for each …

Analyte-Sensing Particles And Impact Of Plastics On Environmentally Abundant Bacteria, Tania Thalyta Silva De Oliveira

Open Access Dissertations

Nano and microscale materials exhibit exciting chemical, physical and biological properties that dictate how they function. Furthermore, their surface chemistry influences how they respond to a specific application and interact with their surroundings. In this dissertation, a technique used to synthesize tunable hybrid gold nanoparticles for environmental sensing applications by Raman is presented, as well as the fate of nano and microplastics when in the presence of an abundant bacteria in the aquatic environment.Gold nanoparticles are widely used in many applications due to their various properties, such as facile synthesis, biocompatibility, surface conjugation with various ligand types, and tunability. The …

Dyadic Experience Of Emotion Regulation For Families With Autism Spectrum Disorder, Coral L. Shuster

Open Access Dissertations

This dissertation was constructed to better understand the role that emotion regulation(ER) difficulties have in the lives of children diagnosed with autism spectrum disorder (ASD). Three research methods were utilized and are presented in this order: secondary data analysis, systematic literature review, and a cross-sectional observational study. The secondary data analysis (chapter one) aimed to understand the association between family conflict, child ER, parent perceived stress, and ASD-related social responsiveness in a sample of 2,229 children included in a nationwide longitudinal study. Findings suggest that higher social responsiveness scores predict more ER difficulties as reported by a parent. Parent perceived …

Co-Constructing Self-Compassion, Amanda Ashley Roy

Open Access Dissertations

The present study sought to explore the process by which thirty graduate or undergraduate students, university or college staff, community members, and employed or interning peer recovery specialists aged 19-64 utilize and define self-compassion through the use of virtual interviews and online surveys. Constructivist Grounded Theory and Convergent Mixed Methodology techniques revealed that participants utilize and define self-compassion in holistic and mindful ways with a large focus on self-care. Data also indicate that numerous factors can impact a person’s decision to respond compassionately, including the type of situation, if others are involved, and age. No gender differences were observed, though …

Performance-Based Multiscale Tuning Of Inclusion-Modified And 3d Printed Composites For Improved Performance Under Static And Dynamic Loading Conditions, Sami Doner

Open Access Dissertations

Over the past decades, composite materials have become an essential part of real-life structures because of their exceptional mechanical performance and significantly low weight to load-carrying capacity ratio compared to metals. However, many composite structures suffer from early failures under various loading conditions. These failures may vary depending on the type of material used and its corresponding material properties such as concrete (brittleness), sandwich composites (delamination and core failure) and polymer composites (lower strength and energy absorption). Over the years, the demand for stronger materials has increased dramatically as the new designs are getting more complex that require better materials …

Hypertension, Rheumatoid Arthritis, And Hypothyroidism In Women Born Preterm Of The Women's Health Initiative, Pamela L. Brewer

Open Access Dissertations

Advances in perinatal and neonatal management, along with improved healthcare technologies, have increased the long-term survival of individuals who were born preterm. Millions of preterm birth survivors now reach adulthood. Premature birth, defined as birth before 37 weeks gestation, predisposes individuals to adverse health risks later in life. The Developmental Origins of Health and Disease (DOHaD) theory was used as a framework for this dissertation. The main tenets of the DOHaD theory are that early birth infers immature organ development and when coupled with maternal, neonatal, and environmental stressors, long-term health consequences and/or chronic disease may result. International studies report …

Drivers’ Response To Scenarios When Driving Connected And Automated Vehicles Compared To Vehicles With And Without Driver Assist Technology, Srinivas S. Pulugurtha, Raghuveer Gouribhatla

Mineta Transportation Institute

Traffic related crashes cause more than 38,000 fatalities every year in the United States. They are the leading cause of death among drivers up to 54 years in age and incur $871 million in losses each year. Driver errors contribute to about 94% of these crashes. In response, automotive companies have been developing vehicles with advanced driver assistance systems (ADAS) that aid in various driving tasks. These features are aimed at enhancing safety by either warning drivers of a potential hazard or picking up certain driving maneuvers like maintaining the lane. These features are already part of vehicles with Driver …

Bruton's Tyrosine Kinase Supports Gut Mucosal Immunity And Commensal Microbiome Recognition In Autoimmune Arthritis, Rachel H Bonami, Christina E Thurman, Sonam Verma, Camille S Westlake, Lindsay E Nyhoff, Bridgette B Barron, Andrea Reboldi, Peggy L Kendall

2020-Current year OA Pubs

Bruton's tyrosine kinase (

Relief Of Chronic Pain Associated With Increase In Midline Frontal Theta Power, Nabi Rustamov, Elizabeth A. Wilson, Alexandra E. Fogarty, Lara W. Crock, Eric C. Leuthardt, Simon Haroutounian

2020-Current year OA Pubs

INTRODUCTION: There is a need to identify objective cortical electrophysiological correlates for pain relief that could potentially contribute to a better pain management. However, the field of developing brain biomarkers for pain relief is still largely underexplored.

OBJECTIVES: The objective of this study was to investigate cortical electrophysiological correlates associated with relief from chronic pain. Those features of pain relief could serve as potential targets for novel therapeutic interventions to treat pain.

METHODS: In 12 patients with chronic pain in the upper or lower extremity undergoing a clinically indicated nerve block procedure, brain activity was recorded by means of electroencephalogram …

Epithelial Abnormalities In The Small Intestine Of Zambian Children With Stunting, Chola Mulenga, Sanja Sviben, Kanta Chandwe, Beatrice Amadi, Violet Kayamba, James A J Fitzpatrick, Victor Mudenda, Paul Kelly

2020-Current year OA Pubs

BACKGROUND: Environmental enteropathy (EE) contributes to impaired linear growth (stunting), in millions of children worldwide. We have previously reported that confocal laser endomicroscopy (CLE) shows fluorescein leaking from blood to gut lumen

METHODS: We performed confocal laser endomicroscopy (CLE) in 75 children and collected intestinal biopsies for histology in 91 children. CLE videos were evaluated, employing the Watson score to determine severity of leakiness. Morphometry was carried out on well-orientated mucosa and 3 biopsies were examined by electron microscopy.

RESULTS: Confocal laser endomicroscopy demonstrated substantial leakage from circulation to gut lumen in 73 (97%) children. Histology consistently showed characteristic changes …

Loss Of Function Of Wfs1 Causes Er Stress-Mediated Inflammation In Pancreatic Β-Cells, Shuntaro Morikawa, Lindsey Blacher, Chinyere Onwumere, Fumihiko Urano

2020-Current year OA Pubs

Wolfram syndrome is a rare genetic disorder characterized by juvenile-onset diabetes mellitus, optic nerve atrophy, hearing loss, diabetes insipidus, and progressive neurodegeneration. Pathogenic variants in the

Semi-Quantitative Assay To Measure Urease Activity By Urinary Catheter-Associated Uropathogens, Jesus M Duran Ramirez, Jana Gomez, Chloe L P Obernuefemann, Nathaniel C Gualberto, Jennifer N Walker

2020-Current year OA Pubs

Catheter-associated urinary tract infections (CAUTIs) are one of the most common healthcare-associated infections in the US, accounting for over 1 million cases annually and totaling 450 million USD. CAUTIs have high morbidity and mortality rates and can be caused by a wide range of pathogens, making empiric treatment difficult. Furthermore, when urease-producing uropathogens cause symptomatic CAUTI or asymptomatic catheter colonization, the risk of catheter failure due to blockage increases. The enzyme urease promotes catheter blockage by hydrolyzing urea in urine into ammonia and carbon dioxide, which results in the formation of crystals that coat the catheter surface. If CAUTI is …

Driving Performance In Older Adults: Current Measures, Findings, And Implications For Roadway Safety, Robert Toups, Theresa J Chirles, Johnathon P Ehsani, Jeffrey P Michael, John P K Bernstein, Matthew Calamia, Thomas D Parsons, David B Carr, Jeffrey N Keller

2020-Current year OA Pubs

BACKGROUND AND OBJECTIVES: Over 10,000 people a day turn 65 in the United States. For many older adults, driving represents an essential component of independence and is one of the most important factors in overall mobility. Recent survey studies in older adults suggest that up to 60% of older adult drivers with mild cognitive impairment, and up to 30% with dementia, continue to drive. The purpose of this review is to provide a comprehensive and detailed resource on the topics of cognition and driving for clinicians, researchers, and policymakers working on efforts related to older adult drivers.

RESEARCH DESIGN AND …

Role Of Tau Deposition In Early Cognitive Decline In Down Syndrome, Sigan L Hartley, Benjamin L Handen, Dana Tudorascu, Laise Lee, Annie Cohen, Brianna Piro-Gambetti, Matthew Zammit, William Klunk, Charles Laymon, Shahid Zaman, Beau M Ances, Marwan Sabbagh, Bradley T Christian

2020-Current year OA Pubs

INTRODUCTION: Drawing on the amyloid/tau/neurodegeneration (AT[N]) model, the study examined whether the tau positron emission tomography (PET) biomarker [

METHODS: Data from 123 non-demented adults with DS (

RESULTS: In models adjusting for controls, tau SUVR was negatively associated with episodic memory performance in the Aβ+ but not Aβ- group. The Aβ+/T

DISCUSSION: Similar to late-onset and autosomal dominant Alzheimer's disease (AD), high tau was an indicator of early prodromal AD in DS.

Skeletal Muscle Contractile Function In Heart Failure With Reduced Ejection Fraction - A Focus On Nitric Oxide, Lauren K Park, Andrew R Coggan, Linda R Peterson

2020-Current year OA Pubs

Despite advances over the past few decades, heart failure with reduced ejection fraction (HFrEF) remains not only a mortal but a disabling disease. Indeed, the New York Heart Association classification of HFrEF severity is based on how much exercise a patient can perform. Moreover, exercise capacity-both aerobic exercise performance and muscle power-are intimately linked with survival in patients with HFrEF. This review will highlight the pathologic changes in skeletal muscle in HFrEF that are related to impaired exercise performance. Next, it will discuss the key role that impaired nitric oxide (NO) bioavailability plays in HFrEF skeletal muscle pathology. Lastly, it …

Distinguishing Tumor Admixed In A Radiation Necrosis (Rn) Background: 1h And 2h Mr With A Novel Mouse Brain-Tumor/Rn Model, Xia Ge, Kyu-Ho Song, John A Engelbach, Liya Yuan, Feng Gao, Sonika Dahiya, Keith M Rich, Joseph J H Ackerman, Joel R Garbow

2020-Current year OA Pubs

PURPOSE: Distinguishing radiation necrosis (RN) from recurrent tumor remains a vexing clinical problem with important health-care consequences for neuro-oncology patients. Here, mouse models of pure tumor, pure RN, and admixed RN/tumor are employed to evaluate hydrogen (

MATERIALS AND METHODS: A pipeline of common quantitative

RESULTS: Differences in quantitative

CONCLUSIONS: These findings, employing a pipeline of quantitative

Avoid Or Embrace? Practice Effects In Alzheimer's Disease Prevention Trials, Andrew J Aschenbrenner, Jason Hassenstab, Guoqiao Wang, Yan Li, Chengjie Xiong, Eric Mcdade, David B Clifford, Randall J Bateman, Et Al.

2020-Current year OA Pubs

Demonstrating a slowing in the rate of cognitive decline is a common outcome measure in clinical trials in Alzheimer's disease (AD). Selection of cognitive endpoints typically includes modeling candidate outcome measures in the many, richly phenotyped observational cohort studies available. An important part of choosing cognitive endpoints is a consideration of improvements in performance due to repeated cognitive testing (termed "practice effects"). As primary and secondary AD prevention trials are comprised predominantly of cognitively unimpaired participants, practice effects may be substantial and may have considerable impact on detecting cognitive change. The extent to which practice effects in AD prevention trials …

Elevated Axonal Protein Markers Following Repetitive Blast Exposure In Military Personnel, Rany Vorn, Rosanne Naunheim, Chen Lai, Chelsea Wagner, Jessica M Gill

2020-Current year OA Pubs

Blast exposures that occur during training are common in military personnel; however, the biomarkers that relate to these subtle injuries is not well understood. Therefore, the purpose of this study is to identify the acute biomarkers related to blast injury in a cohort of military personnel exposure to blast-related training. Thirty-four military personnel who participated in the training program were included in this study. Blood samples were collected before and after repetitive blast-related training on days 2 (

The Temporal Relationship Between Local School Closure And Increased Incidence Of Pediatric Diabetic Ketoacidosis, Casey K Mccluskey, Janine E Zee-Cheng, Margaret J Klein, Matthew C Scanlon, Alexandre T Rotta, Kenneth E Remy, Christopher L Carroll, Steven L Shein

2020-Current year OA Pubs

IMPORTANCE: The incidence of pediatric diabetic ketoacidosis (DKA) increased early in the COVID-19 pandemic, but the relative contribution of behavioral changes and viral-related pathophysiology are unknown.

OBJECTIVE: To evaluate the relationship between school closure date and onset of increased DKA to help clarify the etiology of the increased incidence.

DESIGN: A multi-center, quality-controlled Pediatric Intensive Care Unit (PICU) database was used to identify the number of admissions to a participating PICU with DKA on each calendar day from 60 days before local school closure to 90 days after, and compared to baseline data from the same periods in 2018-2019. Interrupted …

Low Cancer Incidence In Naked Mole-Rats May Be Related To Their Inability To Express The Warburg Effect, Pedro Freire Jorge, Matthew L Goodwin, Maurits H Renes, Maarten W Nijsten, Matthew Pamenter

2020-Current year OA Pubs

Metabolic flexibility in mammals enables stressed tissues to generate additional ATP by converting large amounts of glucose into lactic acid; however, this process can cause transient local or systemic acidosis. Certain mammals are adapted to extreme environments and are capable of enhanced metabolic flexibility as a specialized adaptation to challenging habitat niches. For example, naked mole-rats (NMRs) are a fossorial and hypoxia-tolerant mammal whose metabolic responses to environmental stressors markedly differ from most other mammals. When exposed to hypoxia, NMRs exhibit robust hypometabolism but develop minimal acidosis. Furthermore, and despite a very long lifespan relative to other rodents, NMRs have …