Digital Commons Network^™

Contribution Of Matrix Metalloproteinase-2 And Matrix Metalloproteinase-9 To Upper Tract Urothelial Cancer Risk In Taiwan, Bo-Ren Wang, Hung-Huan Ma, Chao-Hsiang Chang, Cheng-Hsi Liao, Wen-Shin Chang, Mei-Chin Mong, Ya-Chen Yang, Jian Gu, Da-Tian Bau, Chia-Wen Tsai

Faculty, Staff and Student Publications

Matrix metalloproteinase (MMP)-2 and -9, which degrade type IV collagen, are linked to cancer invasion and metastasis. Gene polymorphisms in MMP-2 and MMP-9 can influence their function, impacting cancer development and progression. This study analyzed the association between polymorphisms MMP-2 rs243865 (C-1306T), rs2285053 (C-735T), and MMP-9 rs3918242 (C-1562T) with serum concentrations of these enzymes in upper tract urothelial cancer (UTUC) patients. We conducted a case-control study with 218 UTUC patients and 580 healthy individuals in Taiwan. Genotyping was performed using PCR/RFLP on DNA from blood samples, and MMP-2 and MMP-9 serum levels and mRNA expressions in 30 UTUC patients were …

Soaked In Alcohol: Beyond The Female Archetype As Reflected In Djuna Barnes, Dorothy Parker, And Zelda Fitzgerald, Chondell C. Villines

USF Tampa Graduate Theses and Dissertations

This study surveys the use and abuse of alcohol within the literature of Modernist female authors of the Jazz Age, 1920 – 1930. An examination of the works of Djuna Barnes, Dorothy Parker, and Zelda Fitzgerald is conducted to understand their treatment of alcohol consumption by women and how this treatment is more complex than their male counterparts. This dissertation focuses on each author’s use of alcohol in developing their fictional female characters and how, when, and why they drink. These questions directly relate to the use and abuse of alcohol to assuage trauma, or as a reaction to trauma. …

One Size Does Not Fit All: A Multifaceted Approach To Educate Families About Newborn Screening, Marianna H. Raia, Molly M. Lynch, Alyson C. Ward, Jill A. Brown, Natasha F. Bonhomme, Vicki L. Hunting

Psychology Faculty Publications

All families deserve access to readily available, accurate, and relevant information to help them navigate the newborn screening system. Current practices, limited resources, and a siloed newborn screening system create numerous challenges for both providers and families to implement educational opportunities to engage families in ways that meet their needs with relevant and meaningful approaches. Engaging families in newborn screening, especially those from historically underserved communities, is necessary to increase knowledge and confidence which leads to overall improved outcomes for families. This article describes three strategies that the Navigate Newborn Screening Program developed, tested, and implemented in the United States, …

Nursing Student Perceptions Of Presence In A Virtual Learning Environment: A Qualitative Description Study, Jason R. Thrift

Dissertations

Multifaceted approaches to learning are used for educating student nurses. One common teaching modality in nursing education, simulation, provides hands-on experiences in a safe environment to prepare student nurses for professional roles. High quality simulation standards recommend an engaging immersive experience, with physical, emotional, and conceptual fidelity to clinical practice. Presence is the perception of being there in a simulation as if it were real. Studies have reported improved learning outcomes with increased sense of presence. A simulation modality seldom used in nursing education is virtual reality simulation (VRSim) a three dimensional, immersive experience. VR-Sim with head mounted visual and …

Patientslikeme And Online Patient Support Communities In Dermatology, Mindy D. Szeto, Michelle Hook Sobotka, Emily Woolhiser, Pritika Parmar, Jieying Wu, Lina Alhanshali, Robert P. Dellavalle

Student Publications

Online patient-oriented platforms such as PatientsLikeMe (PLM) offer a venue for individuals with various diagnoses to share experiences and build community, though they may not be representative of the larger patient population. This potentially limits generalizability and raises concerns about the spread of misinformation, emphasizing the need for informed use and health care provider engagement.

Aerobic And Anaerobic Exercise's Impact On Cognitive Functions In Eighth Grade Students., Heather Erwin, Sarah Schreiber

Kinesiology and Health Promotion Faculty Publications

The present study examined the impact of aerobic and anaerobic exercise on cognitive abilities in eighth grade students at one middle school in southeastern US. It is known that youth do not meet recommended physical activity levels, yet there is research demonstrating a clear connection between aerobic exercise and academic performance. There is a gap in evidence regarding anaerobic exercise and cognitive capabilities. If professionals know which type of exercise is most beneficial for enhancing cognition in youth, it will behoove them to incorporate these practices in physical education and other areas throughout the school day for students. Thus, this …

Neuroendocrine Gene Subsets Are Uniquely Dysregulated In Prostate Adenocarcinoma, Nicole M. Naranjo, Anne Kennedy, Anna Testa, Cecilia E. Verrillo, Adrian D. Altieri, Rhonda Kean, D. Craig Hooper, Jindan Yu, Jonathan Zhao, Oliver Abinader, Maxwell W. Pickles, Adam Hawkins, William Kevin Kelly, Ramkrishna Mitra, Lucia R. Languino

Department of Pharmacology, Physiology, and Cancer Biology Faculty Papers

Prostate cancer has heterogeneous growth patterns, and its prognosis is the poorest when it progresses to a neuroendocrine phenotype. Using bioinformatic analysis, we evaluated RNA expression of neuroendocrine genes in a panel of five different cancer types: prostate adenocarcinoma, breast cancer, kidney chromophobe, kidney renal clear cell carcinoma and kidney renal papillary cell carcinoma. Our results show that specific neuroendocrine genes are significantly dysregulated in these tumors, suggesting that they play an active role in cancer progression. Among others, synaptophysin (SYP), a conventional neuroendocrine marker, is upregulated in prostate adenocarcinoma (PRAD) and breast cancer (BRCA). Our analysis shows that SYP …

Emotional Reactivity And Recognition Deficits In Individuals With Callous-Unemotional (Cu) Traits: A Multilevel Meta-Analysis, Emily C. Kemp

LSU Doctoral Dissertations

Youth and adults with antisocial behavior present a significant mental health concern. Elevated callous-unemotional (CU) traits, characterized by deficient empathy and remorse, distinguish clinically important subgroups of antisocial individuals who present with more severe behavior and distinct cognitive-affective characteristics that may help to explain the underlying causes of their antisocial behavior and inform more effective treatments. Specifically, two mechanisms theorized to underlie the development of elevated CU traits by way of atypical empathy development are deficient reactivity to and recognition of others’ emotions. Though a substantive literature base reports associations between CU traits and emotional processing deficits, significant inconsistencies remain. …

An Examination Of The Impact Of Court-Appointed Fines And Fees: How Governmental Reliance On These Expenses Is Harming Vulnerable Communities, Rachel Elizabeth Couche

Dissertations and Theses

Fines and fees are commonplace in the United States criminal justice system as a form of punishment for both minor and severe offenses. While substantial research has demonstrated that these financial consequences disproportionately affect certain communities, studies that depict a narrative of these impacts are vastly underrepresented in the field. This project expands upon past literature by delving into the effects of these practices on individuals and their families. The current study outlines the findings from a content analysis of twelve semi-structured interviews on the impacts of fines and fees in Oregon. The findings create a deeper understanding of how …

“I Was Determined To Fulfill This Image Of Myself That I Wanted Of A ‘Good Asian Student’”: A Photovoice Study Of Asian American College Student Mental Health, Lalaine Sevillano, Joanna C. La Torre, Taylor A. Geyton

School of Social Work Faculty Publications and Presentations

Asian American (AsA) youth and emerging adults are growing at a faster rate than all other racial and ethnic populations in the United States. Burgeoning empirical evidence shows that they are experiencing increased adverse mental health outcomes since the start of the COVID-19 pandemic. Additionally, trends in AsA youth and emerging adults’ utilization and help-seeking behaviors remain low. Health equity scholars posit that the model minority stereotype continues to obscure and minimize these mental health disparities. The current study aims to contribute to this vital research through a Photovoice study with AsA emerging adults. Fourteen AsA undergraduate students (M age …

Decreased Risk Of Osteoporosis Incident In Subjects Receiving Chinese Herbal Medicine For Sjögren Syndrome Treatment: A Retrospective Cohort Study With A Nested Case-Control Analysis, Chieh-Tsung Yen, Hanoch Livneh, Hua-Lung Huang, Ming-Chi Lu, Wei-Jen Chen, Tzung-Yi Tsai

Counselor Education Faculty Publications and Presentations

Sjögren syndrome (SS) is a long-lasting inflammatory autoimmune disease that may cause diverse manifestations, particularly osteoporosis. Though usage of Chinese herbal medicine (CHM) can safely manage autoimmune disease and treatment-related symptoms, the relation between CHM use and osteoporosis risk in SS persons is not yet recognized. With that in mind, this population-level nested case-control study aimed to compare the risk of osteoporosis with and without CHM use. Potential subjects aged 20–70 years, diagnosed with SS between 2001 and 2010, were retrieved from a national health claims database. Those diagnosed with osteoporosis after SS were identified and randomly matched to those …

Examining Associations Between Smartphone Use And Clinical Severity In Frontotemporal Dementia: Proof-Of-Concept Study, Emily W Paolillo, Nupur Ghoshal, Et Al.

2020-Current year OA Pubs

BACKGROUND: Frontotemporal lobar degeneration (FTLD) is a leading cause of dementia in individuals aged <65 years. Several challenges to conducting in-person evaluations in FTLD illustrate an urgent need to develop remote, accessible, and low-burden assessment techniques. Studies of unobtrusive monitoring of at-home computer use in older adults with mild cognitive impairment show that declining function is reflected in reduced computer use; however, associations with smartphone use are unknown.

OBJECTIVE: This study aims to characterize daily trajectories in smartphone battery use, a proxy for smartphone use, and examine relationships with clinical indicators of severity in FTLD.

METHODS: Participants were 231 adults (mean age 52.5, SD 14.9 years; n=94, 40.7% men; n=223, 96.5% non-Hispanic White) enrolled in the Advancing Research and Treatment of Frontotemporal Lobar Degeneration (ARTFL study) and Longitudinal Evaluation of Familial Frontotemporal Dementia Subjects (LEFFTDS study) Longitudinal Frontotemporal Lobar Degeneration (ALLFTD) Mobile App study, including 49 (21.2%) with mild neurobehavioral changes and no functional …

Why Medicine Needs The Humanities: An Argument For Arguments, Suraj R. Nyalakonda, Md

The Medicine Forum

As medicine plunges deeper into the 21st century, there appear to be three forces coming together that hold both promise and peril as technology’s march of progress continues unabated through the healing profession.

Musings Of A House Staff Officer On The Wards, Suraj R. Nyalakonda, Md

The Medicine Forum

I am told I am part of the house staff. I am told I am a resident. I am told my predecessors, who are now my teachers, earned the title of resident by residing at their place of work, which was also their place of passion, which was the hospital, that institution that, with the advent of the industrial revolution, came to be a producer of health, a fixer of bodies. I am also now told that we residents are increasingly the sort of thing that can burn out. The other thing I know that can burn out - when …

Shadows And Echoes Of Understanding: A Physician's Reflection On Plato's Allegory Of The Cave And Medicine, Michael Dong, Md, Tamar Wolinsky Md, Benjamin Claxton, Md, Mph, Chantel Venkataraman, Md

The Medicine Forum

Plato's Allegory of the Cave offers a lens through which one can contemplate the complexities of medicine, where the shadows and echoes of illness obscure the true forms of disease. As physicians, we seek to illuminate the shadows that shroud our patients’ understanding of their illnesses and provide clarity to help patients navigate the labyrinth of diagnoses and treatments.

Unmasked, Rehana Persaud, Ms

The Medicine Forum

The world was quiet

A virtual reality

I existed

you lived

in it

We lived

In

a

world,

that was h u s h e d …

A quiet one

The silence was DeafeninG

But

I HEARD what consumed

me

Quantum Of Solace, Jeffrey White, Md

The Medicine Forum

Dr. R was back on 3 West and looking the worse for wear. Colon cancer, partial resection, bowel obstruction, ischemia, second surgery, bleeding, third surgery, infectious colitis, four days in the ICU—this 90-year-old man, who his wife assured us was bright and vibrant before his admission, was not long for this world. His baseline dementia had begotten daily delirium. He had had heart failure and COPD before his admission, and his fluid retention had swelled his already substantial body habitus to uncomfortable proportions.

Cadaver Dissection — A Reminder Of Humanity, Samuel De Matte, Ms

The Medicine Forum

I wash my hands, pick up a pair of purple forearm gloves, and gown up in an apron. The large overhead lights flood the room with sterile illumination, reflecting off the metal cabinets onto the white walls. I approach one of the thirty-four body bags with a group of classmates. The slow growl of the zipper fills the otherwise silent room. We pull back the formaldehyde-soaked sheet to reveal our cadaver. We all notice the rose tattoo on her chest.

A Curious Case Of Ards, Normonique Dyer, Do

The Medicine Forum

Acute respiratory distress syndrome (ARDS) is a well-known description of progressive respiratory decline. ARDS can be suspected in patients that meet the following criteria: (1) progressive dyspnea with onset within 1 week of a suspected clinical insult, (2) reduction in arterial oxygen saturation, and (3) bilateral alveolar infiltrates not due to a primary cardiogenic process.¹ The management of ARDS is largely unchanged regardless of the etiology and thus will not be within the scope of discussion for this report. However, the etiology of ARDS is of significance given that the cause of a patient’s respiratory failure has prognostic implications. …

A Case Of Reactivation Tuberculosis, Edwin Perez, Md, Avish Patel, Md, Taha Awan, Md, Amman Bhasin, Md, Gautam George, Md

The Medicine Forum

Approximately 22 percent of the world population is estimated to be infected with Mycobacterium tuberculosis. The largest number of cases are seen in Sub-Saharan Africa, India, and the islands of Southeast Asia, while North America and Western Europe are “low incidence” regions.¹ In the US, most cases are seen in foreign-born individuals who emigrate from high-incidence countries. Despite the low incidence in the US, prevention and control of Tuberculosis (TB) remain an important component of Public Health.² Here we present a case of a patient of Vietnamese origin with reactivation TB and rare manifestations of TB.

Nodular Al Amyloidosis — An Unusual Etiology Of A Solitary Pulmonary Nodule, Benjamin B. Claxton, Md, Mph, Shruti Nanivadekar, Md, Stacey Gargano, Md, Prarthna C. Kulandaisamy, Md

The Medicine Forum

Solitary pulmonary nodules (SPN) are defined as single intraparenchymal opacities less than 3 centimeters. The differential diagnosis of the SPN is broad. AL amyloidosis is a protein conformational disease which occurs when certain monoclonal light chains develop an unstable tertiary structure with resultant polymerization of insoluble amyloid fibrils that deposit in the extracellular space of sundry tissues. In the lung, diffuse interstitial amyloid deposition is the most common form of the disease.

When Obstruction Meets Infection: A Case Of Multi- Drug Resistant (Mdr) E. Coli Community Acquired Pneumonia In A Patient With Metastatic Melanoma, Victor Diaz, Ms, David Saeed, Ms

The Medicine Forum

Multidrug resistant Escherichia Coli (MDR E. Coli) is a less common cause of bacterial community-acquired pneumonia as compared to Streptococcus pneumoniae and Staphylococcus aureus. We present a case of MDR E. Coli community-acquired pneumonia diagnosed on culture of bronchoalveolar lavage specimens (BAL) after bronchoscopic debulking of a metastatic melanoma mass completely obstructing the left main stem bronchus (LMSB).

Renal Cell Carcinoma Manifesting As A Tumor Thrombus Identified On Transthoracic Echocardiography & Ct Scan, Kashka Mallari, Md

The Medicine Forum

This is a 60 year old male who presented with increased lower extremity edema for a month and right upper quadrant abdominal pain for a week. A CT of his abdomen showed a right renal mass consistent with renal cell carcinoma (Figure 1, red arrow), along with a tumor thrombus extending into the inferior vena cava (IVC) to the level of the junction with the right atrium (Figure 1, blue arrow, and Figure 2). An echocardiogram revealed an enlarged IVC with an increased echogenicity likely representative of an extensive tumor (Figure 3). Subsequently, he underwent a right radical nephrectomy, vena …

Case Study: Diagnosis Of Acute Myeloid Leukemia In A Middle-Aged Patient With A History Of Aplastic Anemia, Umma Fatemam Md, Marc Yorker, Md

The Medicine Forum

The clinical and diagnostic landscape of hematologic disorders such as Myelodysplastic Syndromes (MDS) and Acute Myeloid Leukemia (AML) is complex and multifaceted, with particular challenges arising in the identification and differentiation of related conditions like aplastic anemia and hypoplastic MDS.¹ MDS, a heterogeneous group of clonal marrow disorders, is typified by dysplasia and ineffective hematopoiesis, which often culminate in cytopenias. A subset of MDS patients may experience leukemic transformation, marked by the proliferation of undifferentiated blasts, ultimately progressing to AML, a malignancy characterized by rapid growth and accumulation of these cells.² Aplastic anemia shares the clinical hallmark of …

Primary Care Provider Awareness And Attitudes Regarding Updated Brca1/2 Screening Recommendations And Genetic Testing, Emily Foecke Munden, Ms, Maria Poluch, Ms, Jennifer S. Zeiger, Ms, Maya Rosenberg, Md, Swati Shroff, Md

The Medicine Forum

Detection of BRCA1/2 gene mutations opens the door for breast cancer prevention; however, many high-risk individuals are not screened until after their first cancer diagnosis. The United States Preventive Services Task Force (USPSTF) updated its BRCA1/2 screening recommendations in 2019. This study explores provider awareness of this update and attitudes towards BRCA1/2 genetic testing. A survey was sent to Obstetrics/ Gynecology (Ob/Gyn), Internal Medicine (IM), and Family Medicine (FM) providers at Thomas Jefferson University Hospitals (TJUH). 66% of responders felt familiar with BRCA1/2 screening guidelines, and 38% were aware of the 2019 USPSTF update. Ob/Gyn providers were more familiar with …

Looking For The Unseen: Application Of Wood’S Lamp In The Ambulatory Clinic, Alexandros Grivas, Md, John Caruso, Md

The Medicine Forum

A 56-year-old female patient with a personal medical history of class III obesity and uncontrolled DM presented to the ambulatory clinic with a pruritic rash behind her knees. The rash was of 4 weeks duration and did not improve with topical application of nystatin powder. Examination revealed an erythematous patch in the intertriginous area behind the knees bilaterally, associated with mild desquamation and clear demarcation from the normal skin. No satellite lesions were noticed. (figure 1A) The patient was evaluated for an intertriginous skin rash. The differential diagnosis included intertrigo, fungal infection, psoriasis, and lichen planus. Wood’s lamp examination was …

Minocycline-Induced Hyperpigmentation In A Patient With Multiple Causes Of Skin Discoloration, Jeffrey White, Md, Amman Bhasin, Md, Gregary Marhefka, Md

The Medicine Forum

Minocycline-induced hyperpigmentation is a well-documented but poorly understood adverse effect of the popular tetracycline antibiotic minocycline, mainly affecting patients who use it for a prolonged duration. When patients develop dark skin lesions, the etiology may be clouded if a patient on minocycline has other risk factors. We describe a patient on suppressive minocycline therapy as well as anticoagulation and a history of chronic venous stasis who developed ecchymosis after an invasive procedure.

Statin-Induced Necrotizing Autoimmune Myopathy: A Case Report, Eric M. Teichner, Ms, Arjun B. Ashok, Ms

The Medicine Forum

In the landscape of contemporary medicine, statins stand out as a cornerstone in the prevention and management of atherosclerotic cardiovascular diseases. By inhibiting the 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase enzyme, statins effectively lower cholesterol levels, thus mitigating the risk of heart attacks and strokes.¹ Despite their widespread adoption and generally well-tolerated nature, the clinical panorama of statin therapy is occasionally marred by side effects, including muscle-related adverse events. These range from relatively common and benign myalgias to the rare and severe statin-induced necrotizing autoimmune myopathy (SINAM), a condition marked by muscle weakness and profoundly elevated levels of creatine kinase (CK) …

Book Review, Robert L. Powers

Journal of Mississippi History

Review of:

Medicine and Healing in the Age of Slavery Edited by Sean Morey Smith and Christopher D.E. Willoughby (Baton Rouge: Louisiana State University Press, 2021. Foreword, acknowledgements, notes, contributors, index. Pp. vii, 224. $45 hardcover. ISBN: 0807171219.)

Cover And Forewords, Casey D. Allen

The Geographical Bulletin

Cover and Forewords