Medicine and Health Sciences Commons^™

Giving Back During The Covid-19 Pandemic, Kenneth P. Serbin

At Risk for Huntington's Disease

No abstract provided.

Letter To The Student Body, Amber Stanley

Reflections, Poetry, Photos, and other Writings

This is a letter I wrote to the student body in response to the COVID pandemic. This was a class assignment.

Spiraling, Grace Meharg

Reflections, Poetry, Photos, and other Writings

This is a personal piece written late at night reflecting on feeling weariness and hopelessness in this situation.Then also considering those who are far less fortunate and those who are at the front lines.

Hepatitis B Virus Hbx Protein Mediates The Degradation Of Host Restriction Factors Through The Cullin 4 Ddb1 E3 Ubiquitin Ligase Complex, Marissa M Minor, F Blaine Hollinger, Adrienne L Mcnees, Sung Yun Jung, Antrix Jain, Joseph M Hyser, Karl-Dimiter Bissig, Betty L Slagle

Faculty, Staff and Students Publications

The hepatitis B virus (HBV) regulatory HBx protein is required for infection, and its binding to cellular damaged DNA binding protein 1 (DDB1) is critical for this function. DDB1 is an adaptor protein for the cullin 4A Really Interesting New Gene (RING) E3 ubiquitin ligase (CRL4) complex and functions by binding cellular DDB1 cullin associated factor (DCAF) receptor proteins that recruit substrates for ubiquitination and degradation. We compared the proteins found in the CRL4 complex immunoprecipitated from uninfected versus HBV-infected hepatocytes from human liver chimeric mice for insight into mechanisms by which HBV and the cell interact within the CRL4 …

On The Inadequacy Of Species Distribution Models For Modelling The Spread Of Sars-Cov-2: Response To Araújo And Naimi, Joseph D. Chipperfield, Blas M. Benito, Robert B. O'Hara, Richard J. Telford, Colin J. Carlson

United States Public Health Resources

The ongoing pandemic of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is causing significant damage to public health and economic livelihoods, and is putting significant strains on healthcare services globally. This unfolding emergency has prompted the preparation and dissemination of the article “Spread of SARS-CoV-2 Coronavirus likely to be constrained by climate” by Araújo and Naimi (2020). The authors present the results of an ensemble forecast made from a suite of species distribution models (SDMs), where they attempt to predict the suitability of the climate for the spread of SARS-CoV-2 over the coming months. They argue that climate is …

A Case Of Pacemaker Syndrome Mimicking A Heart Failure Exacerbation, Seline Haci, Som Aftabizadeh, Senthil Thambidorai, Karan Gupta, Ahsan Khan, Aman Patel, Kimberly Wilson, Anand Subramanian

Cardiology

No abstract provided.

Ten Years Risk Assessment Of Atherosclerotic Cardiovascular Disease Using Astro-Charm And Pooled Cohort Equation In A South Asian Sub-Population, Tariq Ashraf, Muhammad Naeem Mengal, Atif Sher Muhammad, Asal Khan Tareen, Nauman Khan, Khawar Abbas Kazmi, Asif Nadeem, Shakil Sarwar, Zara Bashir, Nadeem Qamar, Musa Karim

Medical College Documents

Background: Atherosclerotic cardiovascular diseases (ASCVD) are on the rise in low and middle-income countries attributed to modern sedentary lifestyle and dietary habits. This has led to the need of assessment of the burden of at-risk population so that prevention measures can be developed. The objective of this study was to assess ten years risk assessment of ASCVD using Astro-CHARM and Pooled Cohort Equation (PCE) in a South Asian sub-population.
Methods: A total of 386 residents of all six districts of Karachi with no ASCVD were enrolled in the study through an exponential non-discriminative referral snowball sampling technique. The inclusion criteria …

Ua94/6/1 My Story: Wku Women's Basketball's Sandra Skinner, Sandra Skinner

Student/Alumni Personal Papers

My Story is a series of first-person feature articles written by WKU student-athletes. The student-athletes will be telling their own stories in their own words. This article written by women’s basketball redshirt senior Sandra Skinner, whose final season was cut short because of the cancellation of the Conference USA Tournament earlier this month.

Case Series Of Anca Vasculitis As Prognostic Marker For Severity Or Relapse Of Glomerulonephritis., Jake N. Cho, Venkat Chitumalla, Izuchukwu Nwakoby

Nephrology

No abstract provided.

Community Of Immunity: A Process Improvement To Increase Influenza Vaccination Uptake, Macy Ball

DNP Projects

Background & Review of Evidence: Annual flu vaccination has been recommended for everyone over the age of six months (National Foundation for Infectious Disease [NFID], 2016). A low flu vaccination rate among college students living in a residential community poses the risk for spreading a highly-contagious respiratory illness caused by the virus. Students have the ability to spread the disease to everyone around them in their dormitories, classrooms, shared restrooms and via social gatherings (NFID, 2016). College students who contract the flu virus experience approximately eight or more days of the illness (NFID, 2016).

Purpose: The purpose of …

A Case Series Of Hyponatremia And Management In Hospitalized Patients, Jake N. Cho, Rebecca Ong, Izuchukwu Nwakoby

Nephrology

No abstract provided.

Computer Aided Detection Of Tuberculosis On Chest Radiographs: An Evaluation Of The Cad4tb V6 System, Keelin Murphy, Shifa Salman Habib, Syed Mohammad Asad Zaidi, Saira Khowaja, Aamir Khan, Jaime Melendez, Ernst T. Scholten, Farhan Amad, Steven Schalekamp, Maurits Verhagen

Community Health Sciences

There is a growing interest in the automated analysis of chest X-Ray (CXR) as a sensitive and inexpensive means of screening susceptible populations for pulmonary tuberculosis. In this work we evaluate the latest version of CAD4TB, a commercial software platform designed for this purpose. Version 6 of CAD4TB was released in 2018 and is here tested on a fully independent dataset of 5565 CXR images with GeneXpert (Xpert) sputum test results available (854 Xpert positive subjects). A subset of 500 subjects (50% Xpert positive) was reviewed and annotated by 5 expert observers independently to obtain a radiological reference standard. The …

Predictors Of Poor Quality Of Life After Primary Lower Limb Deep Venous Thrombosis: A Perspective From A Developing Nation, Nadeem Ahmed Siddiqui, Muhammad Asad Moosa, Fareed A. Shaikh, Noman Shahzad, Shahid Nazir, Ziad Sophie

Department of Surgery Docs

Objective: We aimed to determine predictors of poor long term quality of life, using the VEINES Quality of Life (QOL) questionnaire, in patients with lower limb deep venous thrombosis (DVT).
Material and Methods: This study included adult patients with primary lower limb DVT between January 2007 and December 2017. Post thrombotic syndrome (PTS) was assessed using the Villalta score and Quality of Life (QoL) by the VEINES quality of life questionnaire.
Results: Our study included 125 patients, 57 (45.6%) of whom were males. The patient population's median age was 41 years (IQR: 34-47 years). The median follow …

Thrombotic, Inflammatory, And Hif-Regulated Genes And Thrombosis Risk In Polycythemia Vera And Essential Thrombocythemia, Radhika Gangaraju, Jihyun Song, Soo Jin Kim, Tsewang Tashi, Brandi N Reeves, Krishna M Sundar, Perumal Thiagarajan, Josef T Prchal

Faculty, Staff and Students Publications

Thrombosis is a major cause of morbidity and mortality in polycythemia vera (PV) and essential thrombocythemia (ET). The pathophysiology of thrombosis in these disorders remains unclear, and we hypothesized that upregulation of thrombotic, inflammatory, and hypoxia-inducible factor (HIF)-regulated genes may play a role in it. We performed unbiased RNA sequencing in granulocytes and platelets of PV patients and found differential expression of several thrombotic, inflammatory, and HIF-regulated genes. The expression of many of these genes positively correlated with JAK2 expression and JAK2V617F allelic burden. We then validated these findings by quantitative polymerase chain reaction analyses of selected gene transcripts in …

A 12-Lead Ecg Database To Identify Origins Of Idiopathic Ventricular Arrhythmia Containing 334 Patients, Jianwei Zhang, Guohua Fu, Kyle Anderson, Huimin Chu, Cyril Rakovski

Mathematics, Physics, and Computer Science Faculty Articles and Research

Cardiac catheter ablation has shown the effectiveness of treating the idiopathic premature ventricular complex and ventricular tachycardia. As the most important prerequisite for successful therapy, criteria based on analysis of 12-lead ECGs are employed to reliably speculate the locations of idiopathic ventricular arrhythmia before a subsequent catheter ablation procedure. Among these possible locations, right ventricular outflow tract and left outflow tract are the major ones. We created a new 12-lead ECG database under the auspices of Chapman University and Ningbo First Hospital of Zhejiang University that aims to provide high quality data enabling detection of the distinctions between idiopathic ventricular …

Diabetes Debunked: What You Need To Know, Maggie Hutson

Honors Program: Senior Projects (Public)

The goal of this Honors creative project is to encourage health literacy in populations who are curious about Type 2 Diabetes or have Type 2 Diabetes. From personal experience, I have seen noncompliance in diabetics and wondered why since it is a serious, progressive disease. After researching, I found that some diabetics do not understand the scope of their disease, especially since many of the dangerous complications that arise from Type 2 Diabetes do not present until later in the disease when it is too late. For my senior project, I decided to write an educational paper as a supplement …

Neutrophil Infiltration Into The Cervical Compartment Is Suppressed By Hiv Infection, Madeline Maschka

Honors Program: Senior Projects (Public)

Human Papillomavirus (HPV), is a small circular dsDNA virus with at least 200 different genotypes; each genotype is identified by at least 10% difference at the DNA level in the L1 capsid gene. Each HPV genotype affects the body in different tissues, either mucosal or cutaneous. Mucosal HPVs type 16 and 18 are known as high-risk strains, since HPV infection is the most common cause of cervical cancer and plays a central role in formation of precancerous lesions. Human immunodeficiency virus (HIV) damages the body’s immune system by targeting CD4+ T cells. Once CD4+ T cells are infected, the body …

Suddenly, Grace Meharg

Reflections, Poetry, Photos, and other Writings

This is a piece I wrote on March 18, 2020 reflecting on the last week of Taylor and all of the rapid changes that occurred which brought all of us to scatter.

Ideology Affects Trust In Science Agencies During A Pandemic, Lawrence C. Hamilton, Thomas G. Safford

Carsey Publications

In this perspectives brief, authors Lawrence Hamilton and Thomas Safford discuss the importance of government and public respect for scientific advice in mitigating the impacts of COVID-19. Striking political divisions in attitudes toward science have recently been evident in U.S. government statements and actions regarding the pandemic, and in opinions or behavior reported by general-public surveys. Although the COVID-19 crisis is breaking news, these political divisions in respect for science during a pandemic have deeper roots. A nationwide survey conducted by Carsey School researchers in 2016, immediately after the elections, found 25-point gaps between Trump and Clinton voters, or between …

Trends In The Sources Of Endophthalmitis At Kresge Eye Institute, Anita Vaishampayan, Kresge Eye Institute

Medical Student Research Symposium

Purpose

Endophthalmitis is a defined as a purulent inflammation of the intraocular fluids, namely the vitreous and aqueous humor. Endophthalmitis most commonly develops from infection, but can also be acquired from inflammatory and neoplastic conditions. We sought to determine these sources at our institute and to look for trends in our urban population.

Methods

A retrospective chart review of patients who attended the Kresge Eye Institute in Detroit, MI between 2003 to 2018 was performed. Patient list was identified from our EMR using the diagnoses codes related endophthalmitis. Information gathered included demographics, type of tissue/fluid cultured, the presumed source of …

Management Of Childhood Migraine By Headache Specialist Versus Non-Headache Specialists, Kelly Valentini, Radhika Gutta, Gunjanpreet Kaur, Ahmad Farooqi, Lalitha Sivaswamy

Medical Student Research Symposium

This study aims to compare the management practices of a headache specialist with non-headache specialists in the treatment of pediatric migraine. The use of appropriate rescue medications and prophylactic agents, application of neuro-imaging, and short-term outcomes are compared in children treated by the two groups of physicians. A retrospective cohort study was conducted utilizing the electronic medical records of children 3-18 years of age with migraine, who were evaluated at a tertiary care children’s hospital from 2016-2018. Of the 849 patients that met the study criteria, 469 were classified as having chronic migraine or high-frequency episodic migraine and were followed …

Comparison Of Pre- And Post-Operative Shoulder Muscle Emg Profiles In Reverse Total Shoulder Arthroplasty Patients, Emily Lau, Sreten Franovic, Noah Kuhlmann, Eric C. Makhni Md, Stephanie Muh Md

Medical Student Research Symposium

Background: Deltoid muscle function is central in reverse total shoulder arthroplasty (RTSA) function; however, there is limited information available regarding changes in deltoid activity before and after surgery. Few tests exist to evaluate specific muscle metrics pre and post operatively. Surface Electromyographic (EMG) is non-invasive and allows for observation of motions with multifaceted analysis of movement with minimal patient demand. Understanding the changes in shoulder muscle activation, namely in the deltoid, in patients pre and post-RTSA can further advance understanding of the procedure and rehabilitation efforts.

Methods: Nine individuals were recruited for this study: all patients underwent RTSA by a …

Inflammatory Markers In Bicuspid Transcatheter Aortic Valve Replacement, Molly N. Pantelic, Paul Nona, Dee Dee Wang

Medical Student Research Symposium

Background

Aortic stenosis (AS) has a prevalence of 2%. Valve replacement is the definitive treatment for AS, with transcatheter aortic valve replacement (TAVR) offering a minimally invasive alternative to surgery.

Bicuspid aortic valve (BAV) is the most common congenital cardiac abnormality. BAV patients are predisposed to AS, and comprise a distinct, younger TAVR patient population. Given limited prior work on inflammatory markers for TAVR risk assessment, this study sought to investigate if white blood cell count (WBC) correlates with BAV TAVR patient severity and post-TAVR outcomes.

Methods

A single-center retrospective analysis was performed on patients with BAV who underwent TAVR …

Atrx Loss In Pediatric Glioma Results In Epigenetic Dysregulation Of G2/M Checkpoint Maintenance And Sensitivity To Atm Inhibition, Brendan Mullan, Tingting Qin, Ruby Siada, Carla Danussi, Jacqueline Brosnan-Cashman, Drew Pratt, Taylor Garcia, Viveka Nand Yadav, Xinyi Zhao, Meredith Morgan, Sriram Venneti, Alan Meeker, Alnawaz Rehemtulla, Pedro Lowenstein, Maria Castro, Carl Koschmann

Medical Student Research Symposium

ATRX is a histone chaperone protein recurrently mutated in pediatric glioma. The mechanism which mediates the proliferative advantage of ATRX loss in pediatric glioma remains unexplained. Recent data revealed a distinct pattern of DNA binding sites of the ATRX protein using ChIP-seq in mouse neuronal precursor cells (mNPCs). Using the ATRX peaks identified in p53^-/- mNPCs, we confirmed that ATRX binding sites were significantly enriched in gene promoters (p < 0.0001) and CpG islands (p < 0.0001) compared with random regions. Gene set enrichment (GSE) analysis identified that cell cycle and regulation of cell cycle were among the most significantly enriched gene sets (p=2.52e-16 and 1.61e-9, respectively). We found that ATRX loss resulted in dysfunction of G2/M checkpoint maintenance: (1) ATRX-deficient pediatric glioblastoma (GBM) cells exhibited a seven-fold increase in mitotic index at 16 hours after sub-lethal radiation, and (2) murine GBM cells with ATRX knockdown demonstrated impaired pChk1 signaling on western blot at multiple time points after radiation compared to controls (p=0.0187). Notably, the ATM signaling (pChk2) remained intact in those cells, suggesting a potential therapeutic target. ATRX-deficient mouse cells were uniquely sensitive to ATM inhibitors at 1 uM alongside 8 Gy radiation compared to controls with intact ATRX (AZD0156: p=0.0027 and AZD01390: p=0.0436). Mice intra-cranially implanted with ATRX-deficient GBM cells showed improved survival (n=10, p=0.0018) when treated with AZD0156 combined with radiation. Our findings suggest that ATRX loss in glioma results in unique sensitivity to ATM inhibition via epigenetic dysregulation of G2/M checkpoint maintenance.

Post-Surgical Pyoderma Gangrenosum After Breast Surgery: A Case Series, Jahan Tajran, Daniella Anderson, Arif Chaudhry, Dennis Hammond

Medical Student Research Symposium

Background:

Pyoderma gangrenosum (PG) is a rare inflammatory cutaneous disorder that is thought to be due to innate immune system dysfunction, specifically of neutrophils. PG has been well documented in patients with autoimmune disorders like Ulcerative Colitis and Rheumatoid Arthritis. PG can also present in surgical patients, imitating a potential wound infection and necrotizing fasciitis. Although PG is a diagnosis of exclusion, prompt recognition is essential to attaining desired aesthetic outcomes, especially with breast involvement. We present a case series of four patients who developed PG following breast surgery. We analyze each patient’s medical history, symptoms, wound progression and management …

Quality Improvement In Ibd Care: The Influence Of A Qi Specific Conference For Fellows, Olayinka Afolabi, Alexis Faber, Raya Kutaimy, Paul Naylor, Murray Ehrinpreis

Medical Student Research Symposium

Given the complexity of management of inflammatory bowel disease (IBD), medical societies such as the American Gastroenterological Association (AGA) and Crohn’s and Colitis Foundation of America (CCFA) have established measures aimed at defining quality of care. In 2011, the AGA proposed 10 quality metrics for IBD, eight of these measures relate to outpatient management and two focus on inpatient management. Our objective was to evaluate compliance with these measures in our own general GI practice and determine whether a GI conference discussing quality improvement (QI) in 2017 was effective.

Impact Of Treatment Modality On Overall Survival In Localized Ductal Prostate Adenocarcinoma: A National Cancer Database Analysis, Chandler Bronkema, Sohrab Arora, Nikola Rakic, Akshay Sood, Deepansh Dalela, Jacob Keeley, Marcus Jamil, James O. Peabody, Craig G. Rogers, Mani Menon, Firas Abdollah

Medical Student Research Symposium

INTRODUCTION AND OBJECTIVE: Ductal adenocarcinoma is considered a rare histological variant of prostate adenocarcinoma (PCa). Given the rarity of this subtype, optimal treatment strategies for men with nonmetastatic ductal PCa is largely unknown. We aimed to describe the impact of surgery, radiotherapy, and systemic therapy on overall survival (OS) in men with nonmetastatic ductal PCa.

METHODS: We retrospectively selected 2209 cases of ductal PCa, diagnosed between 2004 and 2015, within the National Cancer Database (NCDB). Exclusion of metastatic patients yielded a total sample of 1993 individuals. Cox regression analysis tested the impact of treatment (surgery, radiotherapy, systemic therapy and no …

Long-Term Outcomes Of Bleb Needling Following Primary Glaucoma Filtering Surgery In Primary Open Angle Glaucoma, Bryen Turco, Vaama Patel, Chaesik Kim, Justin Tannir, Lauren Keshishian, Anju Goyal, Mark Juzych, Bret Hughes, Faisal Ridha Al-Timimi

Medical Student Research Symposium

Purpose: To determine the long-term success rate of bleb needling in a predominantly African American population and to identify factors associated with success.

Methods: We conducted a retrospective, observational clinical study in patients with primary open angle glaucoma. Patients who underwent a primary trabeculectomy, with or without an express shunt placement, and then subsequently had a bleb needling procedure were selected for this study. Patients were followed every three months for a period of two years. Failure criteria included achieving an intraocular pressure (IOP) of greater than 20 mmHg or greater than 80% of the pre-needling value on …

Use Of Biologics In Pityriasis Rubra Pilaris: A Case Report And Review Of The Literature, Elizabeth A. Warbasse, Taryn Huizenga Md

Medical Student Research Symposium

Pityriasis rubra pilaris (PRP) is an inflammatory papulosquamous disorder of unknown etiology. It is characterized by hyperkeratotic scaling plaques with an orange-red hue, “islands of sparing,” and palmoplantar keratoderma; it may cause erythroderma. There have been no completed controlled clinical trials for the treatment of PRP, and there are no FDA approved treatments at this time; most treatment evidence is derived from case reports. This review of the literature explores the use of various biologics which have been attempted for treatment of widespread or treatment resistant PRP. Some case reports have demonstrated efficacy of anti-IL-17 and anti-IL12/23 agents for PRP …

Disease Mongering: How Sickness Sells, Vanessa C. Iroegbulem

Augustana Center for the Study of Ethics Essay Contest

“Disease mongering” is the practice of widening diagnostic boundaries of an illness and promoting their public awareness to expand the markets for treatment and to increase profits. This tactic typically used by pharmaceutical companies, medical equipment manufacturers, insurance companies, and even some doctors and patient groups, has become a great concern. Disease mongering has since increased in parallel with “medicalization,” which attempts to label normal human conditions as medical problems, thus becoming the subject of medical study, diagnosis, prevention, or treatment. This paper first seeks to examine how an increasing amount of life’s natural conditions and ailments are being seen …