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Physics-Guided Strategies For Enhancing Neural Networks Trained With Limited Data, Jose Guadalupe Perez Zamora Dec 2025

Physics-Guided Strategies For Enhancing Neural Networks Trained With Limited Data, Jose Guadalupe Perez Zamora

Open Access Theses & Dissertations

Deep neural networks excel at a wide range of processing tasks across various disciplines. However, the quantity and quality of data significantly impact network performance. In specialized domains, high-quality datasets are often difficult to gather, interpret, and curate for effective learning. Few-shot learning techniques, including transfer learning, data augmentation, and meta-learning, have emerged to address these constraints.

We propose three physics-guided strategies for enhancing neural networks trained with limited data: (1) combining existing models like LSTMs with Physics-Informed Neural Networks through two-branch architectures that merge their outputs, (2) deriving custom physics-informed data augmentation algorithms to expand limited datasets, and (3) …


Does Reducing Videofluoroscopy Frame Rate Affect Dige/St Grades In Modified Barium Swallow Studies?, Shitong Mao, Carla L Warneke, Sheila N Buoy, Ariana J Sahli, Brinda Rao Korivi, Carly E A Barbon, Kristy K Brock, Katherine A Hutcheson Dec 2025

Does Reducing Videofluoroscopy Frame Rate Affect Dige/St Grades In Modified Barium Swallow Studies?, Shitong Mao, Carla L Warneke, Sheila N Buoy, Ariana J Sahli, Brinda Rao Korivi, Carly E A Barbon, Kristy K Brock, Katherine A Hutcheson

Faculty, Staff and Student Publications

Understanding the effects of reduced frame rates on the reliability of Modified Barium Swallow (MBS) ratings for swallowing safety and efficiency is essential for clinical practice. While previous research has examined frame rate (simulated pulse rates) implications concerning penetration, aspiration, and residue ratings, the impact on summary grading systems like the Dynamic Imaging Grade of Swallowing Toxicity (DIGEST) remains unclear. This study analyzed a total of 315 full MBS videos collected from 278 patients, and 76.25% of patients were diagnosed with head and neck cancer (mean age 62.51 years, SD 8.53; 12.23% female). We performed pairwise comparisons of DIGEST grades …


Smags-Lasso: A Novel Feature Selection Method For Sensitivity Maximization In Early Cancer Detection, Hamid Khoshfekr Rudsari, Sara Khorami-Sarvestani, Johannes F Fahrmann, James P Long, Samir Hanash, Kim-Anh Do, Ehsan Irajizad Dec 2025

Smags-Lasso: A Novel Feature Selection Method For Sensitivity Maximization In Early Cancer Detection, Hamid Khoshfekr Rudsari, Sara Khorami-Sarvestani, Johannes F Fahrmann, James P Long, Samir Hanash, Kim-Anh Do, Ehsan Irajizad

Faculty, Staff and Student Publications

Background: Sensitivity and specificity are foundational metrics for cancer detection tools. However, most machine learning algorithms prioritize overall accuracy during optimization, which fails to align with clinical priorities of early detection. We aim to develop a feature selection machine learning algorithm while maximizing sensitivity at a given specificity.

Methods: We developed SMAGS-LASSO, a machine learning algorithm that combines our developed Sensitivity Maximization at a Given Specificity (SMAGS) framework with L1 regularization for feature selection. This approach simultaneously optimizes sensitivity at user-defined specificity thresholds while performing feature selection. SMAGS-LASSO utilizes a custom loss function with L1 regularization and multiple parallel optimization …


Periostin Promotes Sarcoma Growth By Promoting Tumor-Associated Macrophage Migration And Differentiation, Jin-Fen Xiao, Kristin Ishaya, Emily Y Ko, Annaliese Fowler, Marina T Broz, Jlenia Guarnerio Dec 2025

Periostin Promotes Sarcoma Growth By Promoting Tumor-Associated Macrophage Migration And Differentiation, Jin-Fen Xiao, Kristin Ishaya, Emily Y Ko, Annaliese Fowler, Marina T Broz, Jlenia Guarnerio

Faculty, Staff and Student Publications

Soft-tissue sarcomas (STS) are characterized by abundant extracellular matrix (ECM) deposition, yet the functional contribution of specific ECM components remains poorly understood. In this study, we identify periostin (POSTN), a matricellular protein, as a regulator of sarcoma progression and the tumor immune microenvironment. Analysis of human sarcoma datasets revealed that high POSTN expression correlates with poor prognosis and elevated expression of ECM-related and myeloid cell–associated genes. In murine genetic models of sarcoma, tumors expressing high levels of Postn displayed enhanced expression of ECM genes and monocyte-recruiting cytokines. Functional silencing of Postnin vivo reduced tumor growth without altering tumor cell …


Experimental Design And Control Methods For Dose Rate Optimization In A Synchrotron-Based Proton Therapy Beamline, Jason Tang, Daniel Liu, Jacob Mathew, Sabrina Campelo, Lawrence Bronk, Paige Taylor, Yuting Li, Fada Guan Dec 2025

Experimental Design And Control Methods For Dose Rate Optimization In A Synchrotron-Based Proton Therapy Beamline, Jason Tang, Daniel Liu, Jacob Mathew, Sabrina Campelo, Lawrence Bronk, Paige Taylor, Yuting Li, Fada Guan

Faculty, Staff and Student Publications

Background: Ultra-high dose rate radiotherapy (typically defined >40 Gy/s) has shown promise for enhanced normal tissue sparing while maintaining tumor control, termed the FLASH effect when this biological response is observed. However, precise dose rate control remains a technical challenge in proton therapy systems, particularly for research applications investigating dose rate effects.

Purpose: To develop and validate a passive beam modulation technique using tungsten scatterers for controllable dose rate adjustment in a synchrotron-based proton therapy beamline without modifying accelerator parameters.

Methods: We investigated dose rate modulation using tungsten foils of varying thicknesses (0.1-3.5 mm) positioned upstream in an 87.2 MeV …


Activity-Dependent Transit Dose Assessment In 192ir High-Dose-Rate Brachytherapy Surface Applicator Using Gafchromictm Ebt4 Film, Daniel Liu, Emily Draeger, Christopher J Tien, Fada Guan Dec 2025

Activity-Dependent Transit Dose Assessment In 192ir High-Dose-Rate Brachytherapy Surface Applicator Using Gafchromictm Ebt4 Film, Daniel Liu, Emily Draeger, Christopher J Tien, Fada Guan

Faculty, Staff and Student Publications

Purpose: To characterize the newly released GafChromicTM EBT4 film for transit dose measurement in high-dose rate brachytherapy (HDR-BT) surface applicators and to systematically investigate the relationship between transit dose and 192Ir source activity.

Methods: EBT4 film was used to measure dose at 3 mm depth from a horizontally oriented Leipzig-style surface applicator connected to a 192Ir HDR-BT remote afterloading unit. Transit dose was systematically characterized across eight different source activities ranging from 3.372 to 9.716 Ci (13,724 U to 39,544 U) using measurements with seven nominal dwell times (5-100 seconds, scaled to 10 Ci (40,700 U)). Transit dose was derived …


Lymphodepletion, Tumor-Infiltrating Lymphocytes, And High Versus Low Dose Il-2 Followed By Pembrolizumab In Patients With Metastatic Melanoma, Merve Hasanov, Simin Kiany, Marie-Andrée Forget, Roland Bassett, Michael A Davies, Adi Diab, Jeffrey E Gershenwald, Isabella C Glitza, Jeffrey E Lee, Anthony Lucci, Jennifer L Mcquade, Sapna P Patel, Merrick I Ross, Hussein A Tawbi, Jennifer A Wargo, Michael K Wong, Chantale Bernatchez, Patrick Hwu, Cara Haymaker, Rodabe N Amaria Dec 2025

Lymphodepletion, Tumor-Infiltrating Lymphocytes, And High Versus Low Dose Il-2 Followed By Pembrolizumab In Patients With Metastatic Melanoma, Merve Hasanov, Simin Kiany, Marie-Andrée Forget, Roland Bassett, Michael A Davies, Adi Diab, Jeffrey E Gershenwald, Isabella C Glitza, Jeffrey E Lee, Anthony Lucci, Jennifer L Mcquade, Sapna P Patel, Merrick I Ross, Hussein A Tawbi, Jennifer A Wargo, Michael K Wong, Chantale Bernatchez, Patrick Hwu, Cara Haymaker, Rodabe N Amaria

Faculty, Staff and Student Publications

This study evaluated the efficacy and safety of unengineered tumor-infiltrating lymphocytes (TILs) combined with pembrolizumab and either high (HD, Arm-1) or low (LD, Arm-2) doses of IL-2 in patients with metastatic melanoma (MM). Patients were lymphodepleted with cyclophosphamide and fludarabine, followed by TIL infusion and IL-2 (Arm-1: 720,000 IU/kg IV q 8 hrs up to 15 doses; Arm-2: 2 million IU SC for 14 days). Patients received pembrolizumab 200 mg IV starting 21 days post-TIL infusion, and every 3 weeks for up to 2 years. The primary endpoint was overall response rate (ORR) per RECIST 1.1. Blood samples were collected …


Normalization Of Temperature Effects For Quality Assurance Of Quantitative Prostate Apparent Diffusion Coefficient Imaging Across Multiple Sites, Ken-Pin Hwang, Joshua Yung, R Jason Stafford, Caroline Chung, Aradhana M Venkatesan Dec 2025

Normalization Of Temperature Effects For Quality Assurance Of Quantitative Prostate Apparent Diffusion Coefficient Imaging Across Multiple Sites, Ken-Pin Hwang, Joshua Yung, R Jason Stafford, Caroline Chung, Aradhana M Venkatesan

Faculty, Staff and Student Publications

Background: Apparent Diffusion Coefficient (ADC) as measured by diffusion weighted imaging is known to negatively correlate with prostate tumor aggressiveness. Heterogeneity in system and protocol performance causes potential variability in ADC acquired across a large scanner network, prompting a need to evaluate quantitative ADC from a prostate-specific MR diffusion protocol as part of quality assurance (QA). Due to the temperature dependence of ADC, repeatability and reproducibility assessments typically require phantoms to maintain a temperature of 0°C, imposing a considerable burden when assessing large numbers of scanners.

Purpose: To develop a QA procedure at room temperature for assessing the reproducibility of …


Addressing Controversy In Fusobacterium Nomenclature: What Exactly Does “F Nucleatum” Refer To?, Martha A Zepeda-Rivera, Floyd E Dewhirst, Susan Bullman, Christopher D Johnston Dec 2025

Addressing Controversy In Fusobacterium Nomenclature: What Exactly Does “F Nucleatum” Refer To?, Martha A Zepeda-Rivera, Floyd E Dewhirst, Susan Bullman, Christopher D Johnston

Faculty, Staff and Student Publications

The F. nucleatum group (sensu lato) is historically composed of four subspecies (F. nucleatum subsp. animalis, F. nucleatum subsp. nucleatum, F. nucleatum subsp. polymorphum, F. nucleatum subsp. vincentii). Although F. nucleatum sensu lato members are typically associated with oral disease, they have recently been shown to disseminate to the gastrointestinal tract and are associated with adverse health conditions such as inflammatory bowel disease and colorectal cancer (CRC). A growing debate over the nomenclature applied to Fusobacterium taxonomy has resulted in different names for these lineages, shifting them from their historic subspecies designations to …


Where Is Gender In The Historiography Of Lgbtq+ College Students?, Michael S. Hevel, Timothy Reese Cain Dec 2025

Where Is Gender In The Historiography Of Lgbtq+ College Students?, Michael S. Hevel, Timothy Reese Cain

Counseling, Leadership, and Research Methods Faculty Publications and Presentations

This forum contribution considers the complexities and importance of gender in the historiography of LGBTQ+ college students. After a brief introduction, we focus on four key areas in the existing historiography: women's romantic relationships in the late nineteenth and early twentieth centuries, higher education leaders' enforcement of gender norms and purges of LGBTQ+ students through the mid-twentieth century, the gender dynamics within LGBTQ+ student organizations from the 1970s onward, and trans and other LGBTQ+ students' expansion of gender possibilities, including through the use of drag. In so doing, we argue that gender analysis is important to the historiography of LGBTQ+ …


The Influence Of Task Type And Learner Language Background On Writing Production And Anxiety: A Bayesian Linear Mixed-Effects Analysis, Mahmoud Abdi Tabari, Xinya Liang, Agnes Albert Dec 2025

The Influence Of Task Type And Learner Language Background On Writing Production And Anxiety: A Bayesian Linear Mixed-Effects Analysis, Mahmoud Abdi Tabari, Xinya Liang, Agnes Albert

Counseling, Leadership, and Research Methods Faculty Publications and Presentations

Despite growing interest in task-based language teaching (TBLT), limited empirical work has examined how different rhetorical task types influence second language (L2) writing development, especially in relation to affective variables, such as writing anxiety. Existing research in TBLT has largely focused on cognitive dimensions, often neglecting individual differences in learners' emotional responses. Moreover, Long's (2014) call to use first language (L1) data as a benchmark in TBLT remains underexplored, complicating the interpretation of L2 performance patterns. To address these gaps, we examined the impact of task type and writing anxiety on the written performance of 140 university students (70 L1 …


Real-Time Estimated Sequential Organ Failure Assessment (Sofa) Score With Intervals: Improved Risk Monitoring With Estimated Uncertainty In Health Condition For Patients In Intensive Care Units, Yan He, Qian Luo, Hai Wang, Zhichao Zheng, Haidong Luo, Oon Cheong Ooi Dec 2025

Real-Time Estimated Sequential Organ Failure Assessment (Sofa) Score With Intervals: Improved Risk Monitoring With Estimated Uncertainty In Health Condition For Patients In Intensive Care Units, Yan He, Qian Luo, Hai Wang, Zhichao Zheng, Haidong Luo, Oon Cheong Ooi

Research Collection Lee Kong Chian School Of Business

Purpose: Real-time risk monitoring is critical but challenging in intensive care units (ICUs) due to the lack of real-time updates for most clinical variables. Although real-time predictions have been integrated into various risk-scoring systems to aid monitoring, existing systems do not address uncertainties in risk assessments. We developed an enhanced risk monitoring framework based on commonly used systems like the Sequential Organ Failure Assessment (SOFA) score by incorporating uncertainties to improve the effectiveness of real-time risk monitoring in ICUs.Methods: This study included 5,351 patients admitted to the Cardiothoracic ICU in the National University Hospital in Singapore. We developed machine learning …


Differential Microrna Profiling Of Blood L1cam And Bulk Extracellular Vesicles In Bipolar Disorder, Gabriel R Fries, Salahudeen Mirza, Jun Wang, Camila N C Lima, Wei Zhang, Marcela Carbajal Tamez, Giselli Scaini, Jair C Soares, Joao Quevedo Dec 2025

Differential Microrna Profiling Of Blood L1cam And Bulk Extracellular Vesicles In Bipolar Disorder, Gabriel R Fries, Salahudeen Mirza, Jun Wang, Camila N C Lima, Wei Zhang, Marcela Carbajal Tamez, Giselli Scaini, Jair C Soares, Joao Quevedo

Faculty, Staff and Students Publications

Objective: This preliminary study aimed to identify microRNA (miRNA) signatures associated with bipolar disorder (BD) by profiling blood-derived extracellular vesicles (EVs) of both putative neuronal origin and from all sources.

Method: In two parallel studies of individuals with BD and controls (CON), we characterized miRNA expression profiles of blood EVs selected for L1CAM, a putative marker of neuronal origin (n = 20 BD/20 CON), as well as bulk EVs (n = 21 BD/20 CON). For each study, analyses identified miRNAs differentially expressed between groups, followed by functional interrogation and testing for associations with clinical features.

Results: Results of …


Decreasing Barriers To The Utilization Of Cryopreserved Sperm In Male Cancer Survivors: An Expert Review And Guide, Megan V Alexander, Hailie Ciomperlik, Anna Claire Reynolds, Allyson Nevins, Luwam Ghidei, Jordan Kassab, Kevin Campbell, John Sullivan, Michael D Jochum, Laura Detti, Terri L Woodard, Larry I Lipshultz, Laurie J Mckenzie Dec 2025

Decreasing Barriers To The Utilization Of Cryopreserved Sperm In Male Cancer Survivors: An Expert Review And Guide, Megan V Alexander, Hailie Ciomperlik, Anna Claire Reynolds, Allyson Nevins, Luwam Ghidei, Jordan Kassab, Kevin Campbell, John Sullivan, Michael D Jochum, Laura Detti, Terri L Woodard, Larry I Lipshultz, Laurie J Mckenzie

Faculty, Staff and Students Publications

Background: Sperm cryopreservation offers male cancer patients a critical opportunity to preserve fertility prior to gonadotoxic therapy, yet utilization of banked sperm remains modest, typically under 10%. A structured understanding of barriers across the cancer survivorship continuum is needed to support patients in utilization of cryopreserved sperm in alignment with their reproductive goals.

Materials and methods: This expert review synthesizes current evidence and clinical experience to explore the multifaceted barriers to cryopreserved sperm use and propose specific solutions. Key intervention timepoints are examined, including the post-treatment fertility return visit, long-term cryopreservation while remote from family building, readiness for family building, …


Managing Conflict Case: The Difficult Consultant, Amrita Vempati, Suzanne Bentley, Anita Rohra, Daniela Ortiz, David Fernandez, Shagun Berry, Colleen Donovan, Nicole Novotny, Stephanie Cohen, Stephanie Stapleton, Tiffany Moadel Dec 2025

Managing Conflict Case: The Difficult Consultant, Amrita Vempati, Suzanne Bentley, Anita Rohra, Daniela Ortiz, David Fernandez, Shagun Berry, Colleen Donovan, Nicole Novotny, Stephanie Cohen, Stephanie Stapleton, Tiffany Moadel

Faculty, Staff and Students Publications

Audience: This communication case is intended for emergency medicine (EM) resident physicians and junior faculty preparing for the ABEM Certifying Exam.

Introduction: Conflict management is a common and significant challenge in the emergency department (ED), with potential negative impact on both physicians and patients. At the individual level, hospital-based conflicts can lead to emotional stress, impaired concentration, decreased trust among providers, and feelings of dehumanization.1 For patients, conflicts between physicians can compromise the quality of care and contribute to delays in treatment.1 In the ED, conflict often arises between emergency physicians (EPs) and various stakeholders, including patients, family members, nursing …


Patient-Centered Communication Case: Threatened Miscarriage, Anita Rohra, Daniela Ortiz, Shagun Berry, Colleen Donovan, Nicole Novotny, Stephanie Cohen, Charles Lei, Alaa Aldalati, Stephanie Stapleton, David Fernandez Dec 2025

Patient-Centered Communication Case: Threatened Miscarriage, Anita Rohra, Daniela Ortiz, Shagun Berry, Colleen Donovan, Nicole Novotny, Stephanie Cohen, Charles Lei, Alaa Aldalati, Stephanie Stapleton, David Fernandez

Faculty, Staff and Students Publications

Audience: This communication case is intended for EM residents of all levels.

Introduction: Patient-centered communication is a necessary skill in the practice of emergency medicine. This style of communication is crucial for promoting high-quality healthcare by prioritizing patient needs, perspectives, and values. This patient-centered communication case centers on miscarriage, a diagnosis where patient-centered communication is requisite. Approximately one in six or 17.1% of patients with a final diagnosis of miscarriage, also known as early pregnancy loss, present initially to the emergency department.1 Advising a patient of the diagnosis of miscarriage requires excellent communication skills including facile rapport building, empathy, nonverbal …


Insights From A Survey Of School Nurses: Assessing The Challenges Of Constipation In Schools, Andrew S Chu, Eric H Chiou Dec 2025

Insights From A Survey Of School Nurses: Assessing The Challenges Of Constipation In Schools, Andrew S Chu, Eric H Chiou

Faculty, Staff and Students Publications

Objectives: School nurses are key responders to students with constipation, yet their experiences are underreported. This study surveyed their observations regarding constipation, identified barriers to student restroom access, and assessed educational needs.

Methods: In this descriptive, cross-sectional survey study, an anonymous online survey was distributed to school nurses participating in a virtual education series. The survey assessed nurse demographics, frequency of encounters with constipation and encopresis, school restroom policies, barriers to restroom use, accommodation requests, and training in constipation management.

Findings: Of 125 respondents, 95% encountered students with constipation at least monthly and 55% reported ≥ 6 encounters monthly. Commonly …


Fast And Accurate Measurement Of Small Field Dosimetry Using A Novel Scintillation Detector, Yiding Han, Jingzhu Xu, Yao Hao, Baozhou Sun Dec 2025

Fast And Accurate Measurement Of Small Field Dosimetry Using A Novel Scintillation Detector, Yiding Han, Jingzhu Xu, Yao Hao, Baozhou Sun

Faculty, Staff and Students Publications

Background: The most used instruments for small-field dosimetry have notable limitations, including the need for correction of output factors, limited scanning speeds, and challenges in alignment for percentage depth dose (PDD) measurements, particularly for extremely small fields. However, plastic scintillation detectors (PSDs) are an attractive alternative for small-field dosimetry due to their correction-free nature, linear dose response, and fast response time.

Purpose: This study evaluates the robustness and accuracy of the dosimetric measurements using a new water-equivalent PSD in small-field dosimetry. The study also aims to report accurate measurements of output factors, profiles, and an indirect method for measuring PDD …


Functional Head Tremor: Contrasting Features With Other Tremor Etiologies, José Fidel Baizabal-Carvallo, Joseph Jankovic Dec 2025

Functional Head Tremor: Contrasting Features With Other Tremor Etiologies, José Fidel Baizabal-Carvallo, Joseph Jankovic

Faculty, Staff and Students Publications

Background: Functional tremor (FT) is considered the most common phenomenology among patients with functional movement disorders (FMDs). Most patients have limb tremor, but they can also present with tremor involving the head and trunk.

Objectives and methods: We aimed to assess the clinical phenomenology of functional head tremor (FHT) and contrast it with features of HT observed in 125 patients with other tremor etiologies (OTE), including 71 patients with essential tremor (ET).

Results: There were 101 consecutive patients (68.3% females) with FT from which n = 36 (35.6%) had FHT. Yes-yes tremor was the most common directionality (47.2%). Functional trunk …


Feasibility Of Expiratory Muscle Strength Training In Individuals With Progressive Supranuclear Palsy, Katya Villarreal-Cavazos, James C Borders, James A Curtis, Jordanna S Sevitz, Nora Vanegas-Arroyave, Michelle S Troche Dec 2025

Feasibility Of Expiratory Muscle Strength Training In Individuals With Progressive Supranuclear Palsy, Katya Villarreal-Cavazos, James C Borders, James A Curtis, Jordanna S Sevitz, Nora Vanegas-Arroyave, Michelle S Troche

Faculty, Staff and Students Publications

Introduction: Dysphagia is common among individuals with Progressive Supranuclear Palsy (PSP). Expiratory muscle strength training (EMST) is a treatment used to increase expiratory muscle force production for airway protection deficits. To our knowledge, no studies have tested EMST in this population. The objective of this study was to determine the feasibility of EMST in individuals with PSP.

Methods: Twenty-nine participants completed baseline measures of maximum expiratory pressure and underwent a trial session of EMST. EMST was considered feasible if participants were able to complete at least 10 repetitions at 30% of their maximum expiratory pressure. Qualitative analyses were also completed …


A Multimodal Non-Invasive Approach For Intracranial Pressure Assessment: A Single-Center Study, Dana Klavansky, Helaina Lehrer, Aris Desai, Gabriela Keeton, Neha Dangayach, Alexandra Reynolds, Spyridoula Tsetsou Dec 2025

A Multimodal Non-Invasive Approach For Intracranial Pressure Assessment: A Single-Center Study, Dana Klavansky, Helaina Lehrer, Aris Desai, Gabriela Keeton, Neha Dangayach, Alexandra Reynolds, Spyridoula Tsetsou

Faculty, Staff and Students Publications

Background: Intracranial pressure (ICP) monitoring is an integral part of acute brain injury management. While invasive ICP monitoring is the gold standard, there are several medical conditions that preclude its placement. The aim of the present study is to validate a multimodal approach for increasing ICP detection.

Material and methods: In this retrospective study, patients with acute brain injury who had an external ventricular drain (EVD) placement were included. We measured bilateral optic nerve sheath diameter (ONSD) and assessed for optic nerve disk elevation (ONDE) by using ocular ultrasound, bilateral middle cerebral artery pulsatility index (PI) by using transcranial Doppler, …


Cerebellar Purkinje Cell Stripe Patterns Reveal A Differential Vulnerability And Resistance To Cell Loss During Normal Aging In Mice, Sarah G Donofrio, Cheryl Brandenburg, Amanda M Brown, Tao Lin, Hsiang-Chih Lu, Roy V Sillitoe Dec 2025

Cerebellar Purkinje Cell Stripe Patterns Reveal A Differential Vulnerability And Resistance To Cell Loss During Normal Aging In Mice, Sarah G Donofrio, Cheryl Brandenburg, Amanda M Brown, Tao Lin, Hsiang-Chih Lu, Roy V Sillitoe

Faculty, Staff and Students Publications

Age-related neurodegenerative diseases involve reduced cell numbers and impaired behavioral capacity. Neurodegeneration and behavioral deficits also occur during aging, and notably in the absence of disease. The cerebellum, which modulates movement and cognition, is susceptible to cell loss in both aging and disease. Here, we demonstrate that cerebellar Purkinje cell loss in aged mice is not spatially random but rather occurs in a pattern of parasagittal stripes. We also find that aged mice exhibit impaired motor coordination and more severe tremor compared to younger mice. However, the relationship between patterned Purkinje cell loss and motor dysfunction is not straightforward. Examination …


How Well Can Commonly Used Anxiety Scales Detect Treatment Outcomes In The Context Of Autism?, Huilin Chen, Jeffrey J Wood, Connor M Kerns, Eric A Storch, Philip C Kendall, Gaia Scerif, Cathy Creswell Dec 2025

How Well Can Commonly Used Anxiety Scales Detect Treatment Outcomes In The Context Of Autism?, Huilin Chen, Jeffrey J Wood, Connor M Kerns, Eric A Storch, Philip C Kendall, Gaia Scerif, Cathy Creswell

Faculty, Staff and Students Publications

Anxiety is one of the most prevalent mental health challenges in autistic children, yet there is limited evidence on effective tools to measure treatment outcomes. Previous research with non-autistic children has found that the Child Anxiety Impact Scale, Parent Version achieved good diagnostic accuracy when measuring treatment outcomes and performed better than a commonly used symptom measure. However, this has not been evaluated for autistic children. The present study examined the psychometric properties of the Child Anxiety Impact Scale, Parent Version in autistic children and compared its utility against other anxiety symptom measures, to detect treatment outcomes as assessed by …


Nortriptyline Inhibits Lysosomal Exocytosis-Mediated Sasp During Gastric Cancer Progression Via Targeting Hoxa1-Pitx2 Phase Separation, Yi Zhou, Chunhui Yang, Xinyue Li, Xiaojing Wang, Wanju Jiao, Xiaolin Wang, Jiaying Qu, Bosen Zhao, Shunchen Zhou, Qiangsong Tong, Liduan Zheng Dec 2025

Nortriptyline Inhibits Lysosomal Exocytosis-Mediated Sasp During Gastric Cancer Progression Via Targeting Hoxa1-Pitx2 Phase Separation, Yi Zhou, Chunhui Yang, Xinyue Li, Xiaojing Wang, Wanju Jiao, Xiaolin Wang, Jiaying Qu, Bosen Zhao, Shunchen Zhou, Qiangsong Tong, Liduan Zheng

Faculty, Staff and Students Publications

Lysosomal exocytosis, a calcium-dependent secretory process, facilitates extracellular release of cargos that promote cancer progression, though its regulatory pathways and therapeutic strategies are poorly understood. Herein, using combined transcriptomic and proteomic approaches, we identify homeobox A1 (HOXA1) as a functional partner of paired like homeodomain 2 (PITX2) within biomolecular condensates forming via liquid-liquid phase separation. Mechanistically, HOXA1-PITX2 complex facilitates the expression of mucolipin 1 (MCOLN1) and RAS-related protein Rab-3A (RAB3A), which drive lysosomal exocytosis of galectin-1 (LGALS1) and insulin like growth factor binding protein 7 (IGFBP7) from senescent gastric cancer cells. This process potentiates AKT activation and epithelial-mesenchymal transition, accelerating …


Racial And Ethnic Disparities In Pediatric Autoimmune Encephalitis: A Systematic Review, Jennifer H Yang, Kristen S Fisher, Julia Dumcum, Sophie Zacharek, Alexandra B Kornbluh, Kelsey Poisson, Mary C Karalius, Leigh Sepeta Dec 2025

Racial And Ethnic Disparities In Pediatric Autoimmune Encephalitis: A Systematic Review, Jennifer H Yang, Kristen S Fisher, Julia Dumcum, Sophie Zacharek, Alexandra B Kornbluh, Kelsey Poisson, Mary C Karalius, Leigh Sepeta

Faculty, Staff and Students Publications

Objectives: Health disparities and social determinants of health are increasingly recognized as important predictors for clinical outcomes in autoimmune disease. However, this is poorly studied in pediatric autoimmune encephalitis (AE).

Methods: We conducted a systematic literature review in accordance with PRISMA guidelines. Searches included Medline (Pubmed), EMBASE, and Web of Science databases from inception years to October 4, 2024. Inclusion criteria were: 1) Patients diagnosed with AE ≤ 18 years old; 2) any report of race and/or ethnicity, 3) report of specific diagnostics and disease outcomes, 4) observational cohort studies, epidemiological studies or case series/ cohort studies of n ≥ …


Presenteeism Among Health Care Personnel With Covid-19, James C. Crosby, Eliezer Santos Leon, Brian Chinnock, Karisa K. Harland, Anusha Krishnadasan, Nicholas M. Mohr, Ian D. Plumb, Melissa Briggs Hagen, Kelli Wallace, David A. Talan, Anne Zepeski, Tracy Young, Howard A. Smithline, Lilly C. Lee, Stephen C. Lim, Gregory J. Moran, Mark T. Steele, David G. Beiser, John P. Haran, Peter C. Hou, Brett Faine, Utsav Nandi, Walter A. Schrading, Anne Chipman, Frank Lovecchio, Alysia Powers, Lisandra Uribe, Kavitha Pathmarajah, Dean M. Hashimoto, Chloe Namias, Efrat Kean, Elizabeth Krebs, Amy Stubbs, Sara Roy, Lucia Solis, Mary Mulrow, Nathan Graff, Jillian M Tozloski, William Mower, Jacqueline Caldera, Michelle Huber, Jacob Hampton, Abigail Lopes, Katherine Elkort, Stephanie A. Eucker, Carla Kingsbury, Jonathan Femling, Silas Bussmann, Jane Yee, Joseph Stuppy, Richard E. Rothman, Gaby Dashler, Marcel E. Curlin, Mastura Wahedi, Laurie Kemble Dec 2025

Presenteeism Among Health Care Personnel With Covid-19, James C. Crosby, Eliezer Santos Leon, Brian Chinnock, Karisa K. Harland, Anusha Krishnadasan, Nicholas M. Mohr, Ian D. Plumb, Melissa Briggs Hagen, Kelli Wallace, David A. Talan, Anne Zepeski, Tracy Young, Howard A. Smithline, Lilly C. Lee, Stephen C. Lim, Gregory J. Moran, Mark T. Steele, David G. Beiser, John P. Haran, Peter C. Hou, Brett Faine, Utsav Nandi, Walter A. Schrading, Anne Chipman, Frank Lovecchio, Alysia Powers, Lisandra Uribe, Kavitha Pathmarajah, Dean M. Hashimoto, Chloe Namias, Efrat Kean, Elizabeth Krebs, Amy Stubbs, Sara Roy, Lucia Solis, Mary Mulrow, Nathan Graff, Jillian M Tozloski, William Mower, Jacqueline Caldera, Michelle Huber, Jacob Hampton, Abigail Lopes, Katherine Elkort, Stephanie A. Eucker, Carla Kingsbury, Jonathan Femling, Silas Bussmann, Jane Yee, Joseph Stuppy, Richard E. Rothman, Gaby Dashler, Marcel E. Curlin, Mastura Wahedi, Laurie Kemble

Department of Medicine Faculty Papers

IMPORTANCE: Presenteeism-defined as continuing to work during an illness-poses a public health risk in the workplace and is especially hazardous within health care institutions where vulnerable patients may be exposed to nosocomial infections. Understanding the frequency and characteristics of health care personnel (HCP) who report presenteeism while ill with COVID-19 may help mitigate SARS-CoV-2 spread in hospitals and other health care institutions.

OBJECTIVES: To determine the frequency of presenteeism among HCP with symptomatic COVID-19, and to evaluate the demographic, occupational, and clinical factors associated with it.

DESIGN, SETTING, AND PARTICIPANTS: This is an observational cohort study that uses data from …


Plasma Metabolomic And Proteomic Signatures Of Blood Pressure Management After Bariatric Surgery Among Adolescents, Shudi Pan, Zhenjiang Li, Juan Pablo Lewinger, Jesse A Goodrich, Hongxu Wang, Sarah Rock, Carmen Chen, Todd M Jenkins, Stephanie Sisley, Stephen R Daniels, Douglas I Walker, Max T Aung, Erika Garcia, Rob Mcconnell, Sandrah P Eckel, Michele A La Merrill, Tanya L Alderete, Zhuanghua Chen, Frank D Gilliland, Thomas H Inge, David V Conti, Justin R Ryder, Lida Chatzi Dec 2025

Plasma Metabolomic And Proteomic Signatures Of Blood Pressure Management After Bariatric Surgery Among Adolescents, Shudi Pan, Zhenjiang Li, Juan Pablo Lewinger, Jesse A Goodrich, Hongxu Wang, Sarah Rock, Carmen Chen, Todd M Jenkins, Stephanie Sisley, Stephen R Daniels, Douglas I Walker, Max T Aung, Erika Garcia, Rob Mcconnell, Sandrah P Eckel, Michele A La Merrill, Tanya L Alderete, Zhuanghua Chen, Frank D Gilliland, Thomas H Inge, David V Conti, Justin R Ryder, Lida Chatzi

Faculty, Staff and Students Publications

Background: Emerging omics approaches, including metabolomics and proteomics, can be integrated into obesity treatment for better blood pressure management. We tested whether preoperative metabolomic and proteomic profiles predict long-term elevated blood pressure (EBP) changes better than known risk factors in adolescents undergoing bariatric surgery.

Methods: We included 108 participants from the Teen-LABS (Teen-Longitudinal Assessment of Bariatric Surgery). Plasma untargeted metabolomics (via liquid chromatography with high-resolution mass spectrometry) and Olink proteomics were assessed pre surgery. An elastic net model with stability selection was used to identify features predictive of EBP reductions 5 years post surgery. Models including identified metabolites, proteins, and …


Synthesis Of Phenyl-Substituted Zinc Dipyrrin Photosensitizer For Carbon Dioxide Reduction, Stephen Ankomah Dec 2025

Synthesis Of Phenyl-Substituted Zinc Dipyrrin Photosensitizer For Carbon Dioxide Reduction, Stephen Ankomah

Electronic Theses and Dissertations

The release of CO₂ from fossil fuel combustion drives the need for its conversion into more sustainable options like CO and CH₄ via photocatalytic reduction. This process requires a catalyst, sensitizer, and electron donor. Zinc dipyrrin-based complexes are promising photosensitizers, offering an alternative to expensive, rare-metal-based systems. Most first-row transition metal dipyrrin compounds have short excited-state lifetimes due to rapid nonradiative decay, but Zn(II) dipyrrin complexes stand out. With a d¹⁰ configuration, they lack deactivating ligand field states and can access long-lived triplet states through a charge-separated intermediate. A phenyl-substituted Zn(II) dipyrrin complex was synthesized and studied using NMR to …


The People’S Medicine: Modern Perspectives On Folk Medicine In South Central Appalachia, Stacey M. Horton Dec 2025

The People’S Medicine: Modern Perspectives On Folk Medicine In South Central Appalachia, Stacey M. Horton

Electronic Theses and Dissertations

The study addresses the critical need to document Appalachian folk medicine conventions and cultural practices from a modern perspective. In so doing, it addresses folk medicine research gaps in understudied places in South Central Appalachia, particularly in Southwestern Virginia and Northeast Tennessee. This research utilizes participant observation and oral history interviews to research modern Appalachian folk medicine practices among a select group of practitioners. Interviews focused on individuals who center their professional careers and subsequent lifestyles around herbalism, foraging, folk medicine, ethnobotany, and botanicals. By utilizing a critical praxis framework, the study seeks to move beyond lists of symptoms and …


Strategic Enhancement Of Biofuel Production Using Bacillus Subtilis As A Model Organism: A Dual Approach Of Gene Essentiality Mapping And Optimization, Angela A. Zebede Dec 2025

Strategic Enhancement Of Biofuel Production Using Bacillus Subtilis As A Model Organism: A Dual Approach Of Gene Essentiality Mapping And Optimization, Angela A. Zebede

Electronic Theses and Dissertations

With rising global demand for renewable energy, enhancing microbial platforms for biofuel production is vital. This study engineered Bacillus subtilis to improve resilience to solvent stress by targeting membrane lipid biosynthesis pathways essential for integrity. Growth curve analysis (OD₆₀₀) showed that phosphatidylserine (PS) and phosphatidylethanolamine (PE) knockout strains grew significantly slower than wild type (168), indicating the importance of these lipids under stress. Laurdan fluorescence spectroscopy was used to assess membrane properties. Generalized polarization (GP) analysis revealed a concentration-dependent reduction in membrane order upon 1%–2% 1-butanol exposure. GP values declined progressively from control to 2% treatment, reflecting increased membrane fluidity …