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Full-Text Articles in Medicine and Health Sciences

Cardiotoxicity Induced By Capecitabine And Oxaliplatin In Gastric Cancer Treatment: A Rare Case Of Cardiac Arrest And Cardiogenic Shock., Muhammad Umer Riaz Gondal, Jared Segal, John Lemoine, Zainab Kiyani, Devi Parvathy Jyothi Ramachandran Nair, Brian Mccauley Apr 2024

Cardiotoxicity Induced By Capecitabine And Oxaliplatin In Gastric Cancer Treatment: A Rare Case Of Cardiac Arrest And Cardiogenic Shock., Muhammad Umer Riaz Gondal, Jared Segal, John Lemoine, Zainab Kiyani, Devi Parvathy Jyothi Ramachandran Nair, Brian Mccauley

Tower Health Research Day

No abstract provided.


The Silent Culprit: Factor V Leiden’S Covert Role In Recurrent Miscarriages And First-Time Thromboembolism, Tanner Aldous, Sarah Almarzooqi, Mingran Yu, Jeremy Ellis Apr 2024

The Silent Culprit: Factor V Leiden’S Covert Role In Recurrent Miscarriages And First-Time Thromboembolism, Tanner Aldous, Sarah Almarzooqi, Mingran Yu, Jeremy Ellis

Tower Health Research Day

No abstract provided.


Debone The Fish Carefully: A Case Of Vibrio Vulnificus Septicemia, Simranpreet Singh, Devi Parvathy Jyothi Ramachandran Nair, Zohaib Yousaf, Tahminah Kausar, Hamzah Moh'd Apr 2024

Debone The Fish Carefully: A Case Of Vibrio Vulnificus Septicemia, Simranpreet Singh, Devi Parvathy Jyothi Ramachandran Nair, Zohaib Yousaf, Tahminah Kausar, Hamzah Moh'd

Tower Health Research Day

No abstract provided.


Don’T Let The Diarrhea Fool You: A Hazy Presentation Of Cannabinoid Hyperemesis Syndrome, Matthew Kent, Leyla Wade, Micah Kaiser, Karen Avgush Apr 2024

Don’T Let The Diarrhea Fool You: A Hazy Presentation Of Cannabinoid Hyperemesis Syndrome, Matthew Kent, Leyla Wade, Micah Kaiser, Karen Avgush

Tower Health Research Day

No abstract provided.


When Potassium Cries Wolf: Pseudohyperkalemia In A Hospitalized Patient With Chronic Lymphocytic Leukemia, Leyla Wade, Matthew Kent, Karen Avgush Apr 2024

When Potassium Cries Wolf: Pseudohyperkalemia In A Hospitalized Patient With Chronic Lymphocytic Leukemia, Leyla Wade, Matthew Kent, Karen Avgush

Tower Health Research Day

No abstract provided.


Detecting The 2-Micron Plasmid In Saccharomyces Cerevisiae, Caitlin C. Allen, Eric T. Gillock Apr 2024

Detecting The 2-Micron Plasmid In Saccharomyces Cerevisiae, Caitlin C. Allen, Eric T. Gillock

SACAD: Scholarly Activities

This research is a continuation of work started by a previous student, Camryn Greving. Camryn was screening for the presence of the 2-micron plasmid using PCR primers specific for the REP2 gene, devised by Nakayashiki et al. In this research, we confirmed the presence of the plasmid by using primers specific for the RAF1 gene, which were designed by Strope et al.


Vaccine Effectiveness Against Influenza A-Associated Hospitalization, Organ Failure, And Death: United States, 2022-2023, Nathaniel M Lewis, Yuwei Zhu, Ithan D Peltan, Manjusha Gaglani, Tresa Mcneal, Shekhar Ghamande, Jay S Steingrub, Nathan I Shapiro, Abhijit Duggal, William S Bender, Leyla Taghizadeh, Samuel M Brown, David N Hager, Michelle N Gong, Amira Mohamed, Matthew C Exline, Akram Khan, Jennifer G Wilson, Nida Qadir, Steven Y Chang, Adit A Ginde, Nicholas M Mohr, Christopher Mallow, Adam S Lauring, Nicholas J Johnson, Kevin W Gibbs, Jennie H Kwon, Cristie Columbus, Robert L Gottlieb, Catherine Raver, Ivana A Vaughn, Mayur Ramesh, Cassandra Johnson, Lois Lamerato, Basmah Safdar, Jonathan D Casey, Todd W Rice, Natasha Halasa, James D Chappell, Carlos G Grijalva, H Keipp Talbot, Adrienne Baughman, Kelsey N Womack, Sydney A Swan, Elizabeth Harker, Ashley Price, Jennifer Decuir, Diya Surie, Sascha Ellington, Wesley H Self, Investigating Respiratory Viruses In The Acutely Ill (Ivy) Network Apr 2024

Vaccine Effectiveness Against Influenza A-Associated Hospitalization, Organ Failure, And Death: United States, 2022-2023, Nathaniel M Lewis, Yuwei Zhu, Ithan D Peltan, Manjusha Gaglani, Tresa Mcneal, Shekhar Ghamande, Jay S Steingrub, Nathan I Shapiro, Abhijit Duggal, William S Bender, Leyla Taghizadeh, Samuel M Brown, David N Hager, Michelle N Gong, Amira Mohamed, Matthew C Exline, Akram Khan, Jennifer G Wilson, Nida Qadir, Steven Y Chang, Adit A Ginde, Nicholas M Mohr, Christopher Mallow, Adam S Lauring, Nicholas J Johnson, Kevin W Gibbs, Jennie H Kwon, Cristie Columbus, Robert L Gottlieb, Catherine Raver, Ivana A Vaughn, Mayur Ramesh, Cassandra Johnson, Lois Lamerato, Basmah Safdar, Jonathan D Casey, Todd W Rice, Natasha Halasa, James D Chappell, Carlos G Grijalva, H Keipp Talbot, Adrienne Baughman, Kelsey N Womack, Sydney A Swan, Elizabeth Harker, Ashley Price, Jennifer Decuir, Diya Surie, Sascha Ellington, Wesley H Self, Investigating Respiratory Viruses In The Acutely Ill (Ivy) Network

Faculty, Staff and Students Publications

BACKGROUND: Influenza circulation during the 2022-2023 season in the United States largely returned to pre-coronavirus disease 2019 (COVID-19)-pandemic patterns and levels. Influenza A(H3N2) viruses were detected most frequently this season, predominately clade 3C.2a1b.2a, a close antigenic match to the vaccine strain.

METHODS: To understand effectiveness of the 2022-2023 influenza vaccine against influenza-associated hospitalization, organ failure, and death, a multicenter sentinel surveillance network in the United States prospectively enrolled adults hospitalized with acute respiratory illness between 1 October 2022, and 28 February 2023. Using the test-negative design, vaccine effectiveness (VE) estimates against influenza-associated hospitalization, organ failures, and death were measured by …


The Stress Of Measuring Plantar Tissue Stress In People With Diabetes-Related Foot Ulcers: Biomechanical And Feasibility Findings From Two Prospective Cohort Studies, Chantal M Hulshof, Madelyn Page, Sjef G Van Baal, Sicco A Bus, Malindu E Fernando, Lisette Van Gemert-Pijnen, Kilian D R Kappert, Scott Lucadou-Wells, Bijan Najafi, Jaap J Van Netten, Peter A Lazzarini Apr 2024

The Stress Of Measuring Plantar Tissue Stress In People With Diabetes-Related Foot Ulcers: Biomechanical And Feasibility Findings From Two Prospective Cohort Studies, Chantal M Hulshof, Madelyn Page, Sjef G Van Baal, Sicco A Bus, Malindu E Fernando, Lisette Van Gemert-Pijnen, Kilian D R Kappert, Scott Lucadou-Wells, Bijan Najafi, Jaap J Van Netten, Peter A Lazzarini

Center on Aging Staff Publications

Reducing high mechanical stress is imperative to heal diabetes-related foot ulcers. We explored the association of cumulative plantar tissue stress (CPTS) and plantar foot ulcer healing, and the feasibility of measuring CPTS, in two prospective cohort studies (Australia (AU) and The Netherlands (NL)). Both studies used multiple sensors to measure factors to determine CPTS: plantar pressures, weight-bearing activities, and adherence to offloading treatments, with thermal stress response also measured to estimate shear stress in the AU-study. The primary outcome was ulcer healing at 12 weeks. Twenty-five participants were recruited: 13 in the AU-study and 12 in the NL-study. CPTS data …


Apigenin Alleviates Autistic-Like Stereotyped Repetitive Behaviors And Mitigates Brain Oxidative Stress In Mice, Petrilla Jayaprakash, Dmytro Isaev, Keun-Hang Susan Yang, Rami Beiram, Murat Oz, Bassem Sadek Apr 2024

Apigenin Alleviates Autistic-Like Stereotyped Repetitive Behaviors And Mitigates Brain Oxidative Stress In Mice, Petrilla Jayaprakash, Dmytro Isaev, Keun-Hang Susan Yang, Rami Beiram, Murat Oz, Bassem Sadek

Biology, Chemistry, and Environmental Sciences Faculty Articles and Research

Studying the involvement of nicotinic acetylcholine receptors (nAChRs), specifically α7-nAChRs, in neuropsychiatric brain disorders such as autism spectrum disorder (ASD) has gained a growing interest. The flavonoid apigenin (APG) has been confirmed in its pharmacological action as a positive allosteric modulator of α7-nAChRs. However, there is no research describing the pharmacological potential of APG in ASD. The aim of this study was to evaluate the effects of the subchronic systemic treatment of APG (10–30 mg/kg) on ASD-like repetitive and compulsive-like behaviors and oxidative stress status in the hippocampus and cerebellum in BTBR mice, utilizing the reference drug aripiprazole (ARP, 1 …


Altered Platelet-Megakaryocyte Endocytosis And Trafficking Of Albumin And Fibrinogen In Runx1 Haplodeficiency, Fabiola Del Carpio-Cano, Guangfen Mao, Lawrence E. Goldfinger, Jeremy Wurtzel, Liying Guan, Mohammad Afaque Alam, Kiwon Lee, Mortimer Poncz, A. Koneti Rao Apr 2024

Altered Platelet-Megakaryocyte Endocytosis And Trafficking Of Albumin And Fibrinogen In Runx1 Haplodeficiency, Fabiola Del Carpio-Cano, Guangfen Mao, Lawrence E. Goldfinger, Jeremy Wurtzel, Liying Guan, Mohammad Afaque Alam, Kiwon Lee, Mortimer Poncz, A. Koneti Rao

Cardeza Foundation for Hematologic Research

Platelet α-granules have numerous proteins, some synthesized by megakaryocytes (MK) and others not synthesized but incorporated by endocytosis, an incompletely understood process in platelets/MK. Germ line RUNX1 haplodeficiency, referred to as familial platelet defect with predisposition to myeloid malignancies (FPDMMs), is associated with thrombocytopenia, platelet dysfunction, and granule deficiencies. In previous studies, we found that platelet albumin, fibrinogen, and immunoglobulin G (IgG) were decreased in a patient with FPDMM. We now show that platelet endocytosis of fluorescent-labeled albumin, fibrinogen, and IgG is decreased in the patient and his daughter with FPDMM. In megakaryocytic human erythroleukemia (HEL) cells, small interfering RNA …


Essential Right Heart Physiology For The Perioperative Practitioner Poqi Ix: Current Perspectives On The Right Heart In The Perioperative Period, Matthew D Mcevoy, Paul M Heerdt, Vicki Morton, Raquel R Bartz, Timothy E Miller, Poqi Ix Collaborators Apr 2024

Essential Right Heart Physiology For The Perioperative Practitioner Poqi Ix: Current Perspectives On The Right Heart In The Perioperative Period, Matthew D Mcevoy, Paul M Heerdt, Vicki Morton, Raquel R Bartz, Timothy E Miller, Poqi Ix Collaborators

Faculty, Staff and Students Publications

As patients continue to live longer from diseases that predispose them to right ventricular (RV) dysfunction or failure, many more patients will require surgery for acute or chronic health issues. Because RV dysfunction results in significant perioperative morbidity if not adequately assessed or managed, understanding appropriate assessment and treatments is important in preventing subsequent morbidity and mortality in the perioperative period. In light of the epidemiology of right heart disease, a working knowledge of right heart anatomy and physiology and an understanding of the implications of right-sided heart function for perioperative care are essential for perioperative practitioners. However, a significant …


Cardiovascular Disease Management With Sodium-Glucose Cotransporter-2 Inhibitors In Patients With Type 2 Diabetes: A Cardiology Primer, Allan Zhang, Ramsey Kalil, Alexander Marzec, Stephanie A Coulter, Salim Virani, Kershaw V Patel, Matthew W Segar Apr 2024

Cardiovascular Disease Management With Sodium-Glucose Cotransporter-2 Inhibitors In Patients With Type 2 Diabetes: A Cardiology Primer, Allan Zhang, Ramsey Kalil, Alexander Marzec, Stephanie A Coulter, Salim Virani, Kershaw V Patel, Matthew W Segar

Faculty, Staff and Students Publications

Patients with type 2 diabetes face an elevated risk of cardiovascular disease. This review centers on sodium-glucose cotransporter-2 (SGLT2) inhibitors, a class of drugs that, according to a growing body of evidence, may have major potential for managing cardiovascular disease in patients with type 2 diabetes. This review presents findings from multiple clinical trials suggesting that SGLT2 inhibitors can not only serve as preventive therapeutic agents but also play a role in the active management of heart failure. The discussion includes the mechanism of action of SGLT2 inhibitors, emphasizing that they enhance urinary glucose excretion, which could lead to improved …


Modeling An Infection Outbreak With Quarantine: The Sibkr Model, Mikenna Dew, Amanda Langosch, Theadora Baker-Wallerstein Apr 2024

Modeling An Infection Outbreak With Quarantine: The Sibkr Model, Mikenna Dew, Amanda Langosch, Theadora Baker-Wallerstein

Rose-Hulman Undergraduate Mathematics Journal

Influenza is a respiratory infection that places a substantial burden in the world population each year. In this project, we study and interpret a data set from a flu outbreak in a British boarding school in 1978 with mathematical modeling. First, we propose a generalization of the SIR model based on the quarantine measure in place and establish the long-time behavior of the model. By analyzing the model mathematically, we determine the analytic formulas of the basic reproduction number, the long-time limit of solutions, and the maximum number of infection population. Moreover, we estimate the parameters of the model based …


Association Of Psychological Quality Of Life Scores And Adverse Experiences In Stop2 Multi-Center Clinical Trial, Blessed Mbogo Apr 2024

Association Of Psychological Quality Of Life Scores And Adverse Experiences In Stop2 Multi-Center Clinical Trial, Blessed Mbogo

Undergraduate University Honors Capstones

Background: Prior research has observed the relationship between psychological stressors and onset of chronic diseases as well as increased severity. This begs the question of whether psychometric qualities in Health-Related Quality of Life instruments can preliminarily predict participant risk of pathology or adverse events (AE) in clinical trials. Specifically, in studies of cystic fibrosis (CF), a genetic disease that primarily affects the lungs, pancreas, and other organs due to mucus accumulation. Methods: The study design was an ancillary analysis of a clinical trial (STOP-2) examining duration of intravenous antimicrobial treatment for pulmonary exacerbations in CF (n=908). Demographic characteristics, genotype, clinical …


Sub-Saharan Africa’S Handling Of Covid-19 Pandemic: Rwanda Versus Tanzania, Luke D. Baumel Apr 2024

Sub-Saharan Africa’S Handling Of Covid-19 Pandemic: Rwanda Versus Tanzania, Luke D. Baumel

Honors Undergraduate Conference

How has the Covid-19 outbreak in early 2020 and the pandemic that followed been handled in Sub-Saharan Africa? What was done well and what was done poorly and why? What are the implications of the way it was handled? These questions and more are answered throughout this paper, using Rwanda as an example of a Sub-Saharan African country who handled it relatively well and neighboring Tanzania as an example of a Sub-Saharan African country that mishandled the outbreak and pandemic. In early 2021, most Sub-Saharan African countries had been afflicted by Covid-19 at a relatively lower rate than many Western …


The Evolving Role Of Monomethyl Fumarate Treatment As Pharmacotherapy For Relapsing-Remitting Multiple Sclerosis, Alan D. Kaye, John Lacey, Viet Le, Ahmed Fazal, Nicole A. Boggio, Dorothy H. Askins, Lillian Anderson, Christopher L. Robinson, Antonella Paladini, Chizoba N. Mosieri, Adam M. Kaye, Shahab Ahmadzadeh, Sahar Shekoohi, Giustino Varrassi Apr 2024

The Evolving Role Of Monomethyl Fumarate Treatment As Pharmacotherapy For Relapsing-Remitting Multiple Sclerosis, Alan D. Kaye, John Lacey, Viet Le, Ahmed Fazal, Nicole A. Boggio, Dorothy H. Askins, Lillian Anderson, Christopher L. Robinson, Antonella Paladini, Chizoba N. Mosieri, Adam M. Kaye, Shahab Ahmadzadeh, Sahar Shekoohi, Giustino Varrassi

School of Medicine Faculty Publications

Multiple sclerosis is the most common autoimmune disease affecting the central nervous system (CNS) worldwide. Multiple sclerosis involves inflammatory demyelination of nerve fibers in the CNS, often presenting with recurrent episodes of focal sensory or motor deficits associated with the region of the CNS affected. The prevalence of this disease has increased rapidly over the last decade. Despite the approval of many new pharmaceutical therapies in the past 20 years, there remains a growing need for alternative therapies to manage the course of this disease. Treatments are separated into two main categories: management of acute flare versus long-term prevention of …


Islet Autoantibodies As Precision Diagnostic Tools To Characterize Heterogeneity In Type 1 Diabetes: A Systematic Review, Jamie L Felton, Maria J Redondo, Richard A Oram, Cate Speake, S Alice Long, Suna Onengut-Gumuscu, Stephen S Rich, Gabriela S F Monaco, Arianna Harris-Kawano, Dianna Perez, Zeb Saeed, Benjamin Hoag, Rashmi Jain, Carmella Evans-Molina, Linda A Dimeglio, Heba M Ismail, Dana Dabelea, Randi K Johnson, Marzhan Urazbayeva, John M Wentworth, Kurt J Griffin, Emily K Sims, Ada/Easd Pmdi Collaborators Apr 2024

Islet Autoantibodies As Precision Diagnostic Tools To Characterize Heterogeneity In Type 1 Diabetes: A Systematic Review, Jamie L Felton, Maria J Redondo, Richard A Oram, Cate Speake, S Alice Long, Suna Onengut-Gumuscu, Stephen S Rich, Gabriela S F Monaco, Arianna Harris-Kawano, Dianna Perez, Zeb Saeed, Benjamin Hoag, Rashmi Jain, Carmella Evans-Molina, Linda A Dimeglio, Heba M Ismail, Dana Dabelea, Randi K Johnson, Marzhan Urazbayeva, John M Wentworth, Kurt J Griffin, Emily K Sims, Ada/Easd Pmdi Collaborators

Faculty, Staff and Students Publications

BACKGROUND: Islet autoantibodies form the foundation for type 1 diabetes (T1D) diagnosis and staging, but heterogeneity exists in T1D development and presentation. We hypothesized that autoantibodies can identify heterogeneity before, at, and after T1D diagnosis, and in response to disease-modifying therapies.

METHODS: We systematically reviewed PubMed and EMBASE databases (6/14/2022) assessing 10 years of original research examining relationships between autoantibodies and heterogeneity before, at, after diagnosis, and in response to disease-modifying therapies in individuals at-risk or within 1 year of T1D diagnosis. A critical appraisal checklist tool for cohort studies was modified and used for risk of bias assessment.

RESULTS: …


Cannabis Use Associated With Lower Mortality Among Hospitalized Covid-19 Patients Using The National Inpatient Sample: An Epidemiological Study, Joseph-Kevin Igwe, Ugo Alaribe Apr 2024

Cannabis Use Associated With Lower Mortality Among Hospitalized Covid-19 Patients Using The National Inpatient Sample: An Epidemiological Study, Joseph-Kevin Igwe, Ugo Alaribe

Faculty, Staff and Students Publications

BACKGROUND: Prior reports indicate that modulation of the endocannabinoid system (ECS) may have a protective benefit for Covid-19 patients. However, associations between cannabis use (CU) or CU not in remission (active cannabis use (ACU)), and Covid-19-related outcomes among hospitalized patients is unknown.

METHODS: In this multicenter retrospective observational cohort analysis of adults (≥ 18 years-old) identified from 2020 National Inpatient Sample database, we utilize multivariable regression analyses and propensity score matching analysis (PSM) to analyze trends and outcomes among Covid-19-related hospitalizations with CU and without CU (N-CU) for primary outcome of interest: Covid-19-related mortality; and secondary outcomes: Covid-19-related hospitalization, mechanical …


Covid-19 Vaccination In Patients With Inborn Errors Of Immunity Reduces Hospitalization And Critical Care Needs Related To Covid-19: A Usidnet Report, John Mcdonnell, Kimberley Cousins, M. Elizabeth M. Younger, Adam Lane, Hassan Abolhassani, Roshini S. Abraham, Salem Al-Tamemi, Juan Carlos Aldave-Becerra, Eman Hesham Al-Faris, Alberto Alfaro-Murillo, Suzan A. Alkhater, Nouf Alsaati, Alexa Michelle Altman Doss, Melissa Anderson, Ernestina Angarola, Barbara Ariue, Danielle E. Arnold, Amal H. Assa'ad, Caner Aytekin, Meaghan Bank, Jenna R.E. Bergerson, Jack Bleesing, John Boesing, Carolina Bouso, Nicholas Brodszki, Diana Cabanillas, Carol Cady, Meghan A. Callahan, Luke Wall, Et Al Apr 2024

Covid-19 Vaccination In Patients With Inborn Errors Of Immunity Reduces Hospitalization And Critical Care Needs Related To Covid-19: A Usidnet Report, John Mcdonnell, Kimberley Cousins, M. Elizabeth M. Younger, Adam Lane, Hassan Abolhassani, Roshini S. Abraham, Salem Al-Tamemi, Juan Carlos Aldave-Becerra, Eman Hesham Al-Faris, Alberto Alfaro-Murillo, Suzan A. Alkhater, Nouf Alsaati, Alexa Michelle Altman Doss, Melissa Anderson, Ernestina Angarola, Barbara Ariue, Danielle E. Arnold, Amal H. Assa'ad, Caner Aytekin, Meaghan Bank, Jenna R.E. Bergerson, Jack Bleesing, John Boesing, Carolina Bouso, Nicholas Brodszki, Diana Cabanillas, Carol Cady, Meghan A. Callahan, Luke Wall, Et Al

School of Medicine Faculty Publications

BACKGROUND: The CDC and ACIP recommend COVID-19 vaccination for patients with inborn errors of immunity (IEI). Not much is known about vaccine safety in IEI, and whether vaccination attenuates infection severity in IEI. OBJECTIVE: To estimate COVID-19 vaccination safety and examine effect on outcomes in patients with IEI. METHODS: We built a secure registry database in conjunction with the US Immunodeficiency Network to examine vaccination frequency and indicators of safety and effectiveness in IEI patients. The registry opened on January 1, 2022, and closed on August 19, 2022. RESULTS: Physicians entered data on 1245 patients from 24 countries. The most …


Idiopathic Intracranial Hypertension After Abrupt Cessation Of Medication: A Case Report Of Abrupt Glucagon-Like Peptide-1 (Glp-1) Receptor Agonist Cessation And Review Of The Literature, Brittany Heckel Apr 2024

Idiopathic Intracranial Hypertension After Abrupt Cessation Of Medication: A Case Report Of Abrupt Glucagon-Like Peptide-1 (Glp-1) Receptor Agonist Cessation And Review Of The Literature, Brittany Heckel

Department of Jefferson Headache Center Papers and Presentations

PURPOSE OF REVIEW: The purpose of this review is two-fold: (1) to discuss a case report of idiopathic intracranial hypertension (IIH) after abrupt cessation of a glucagon-like peptide-1 (GLP-1) receptor agonist with resultant rapid weight gain and (2) to review the literature regarding the potential role of GLP-1 receptor agonists in the treatment of IIH as well as potential pitfalls.

RECENT FINDINGS: GLP-1 receptor agonists have become widely used to treat obesity. Obesity is a known risk factor for the development of IIH, though the precise pathophysiology is unclear. GLP-1 receptor agonists may help treat IIH by promoting weight loss, …


Formulation, Characterization, And In Vivo Immunogenicity Evaluation Of Heat-Stabilized Dissolvable Polymeric Microneedles, Aidan Lane Leyba Apr 2024

Formulation, Characterization, And In Vivo Immunogenicity Evaluation Of Heat-Stabilized Dissolvable Polymeric Microneedles, Aidan Lane Leyba

Biomedical Engineering ETDs

Since its introduction, vaccination has improved health outcomes tremendously. However, modern vaccination efforts are still difficult to implement, particularly in developing countries with warm climates. This includes complex and expensive cold-chain management of vaccines to maintain stability, a lack of medical personnel to administer parental vaccines, and needle phobia. As an alternative, dissolvable microneedles have recently been studied for their simple and painless application. In this thesis, I present a novel manufacturing process for polymer-based dissolvable microneedles, loaded with virus-like particles vaccines conjugated to TRIO or Sialokinin peptides to target malaria and arboviruses, respectively. We have performed multiple characterization studies …


First-In-Human Phase I Study Of Tinengotinib (Tt-00420), A Multiple Kinase Inhibitor, As A Single Agent In Patients With Advanced Solid Tumors, Sarina A Piha-Paul, Binghe Xu, Ecaterina E Dumbrava, Siqing Fu, Daniel D Karp, Funda Meric-Bernstam, David S Hong, Jordi A Rodon, Apostolia M Tsimberidou, Kanwal Raghav, Jaffer A Ajani, Anthony P Conley, Frank Mott, Ying Fan, Jean Fan, Peng Peng, Hui Wang, Shumao Ni, Caixia Sun, Xiaoyan Qiang, Wendy J Levin, Brenda Ngo, Qinhua Cindy Ru, Frank Wu, Milind M Javle Apr 2024

First-In-Human Phase I Study Of Tinengotinib (Tt-00420), A Multiple Kinase Inhibitor, As A Single Agent In Patients With Advanced Solid Tumors, Sarina A Piha-Paul, Binghe Xu, Ecaterina E Dumbrava, Siqing Fu, Daniel D Karp, Funda Meric-Bernstam, David S Hong, Jordi A Rodon, Apostolia M Tsimberidou, Kanwal Raghav, Jaffer A Ajani, Anthony P Conley, Frank Mott, Ying Fan, Jean Fan, Peng Peng, Hui Wang, Shumao Ni, Caixia Sun, Xiaoyan Qiang, Wendy J Levin, Brenda Ngo, Qinhua Cindy Ru, Frank Wu, Milind M Javle

Faculty, Staff and Student Publications

PURPOSE: This first-in-human phase I dose-escalation study evaluated the safety, pharmacokinetics, and efficacy of tinengotinib (TT-00420), a multi-kinase inhibitor targeting fibroblast growth factor receptors 1-3 (FGFRs 1-3), Janus kinase 1/2, vascular endothelial growth factor receptors, and Aurora A/B, in patients with advanced solid tumors.

PATIENTS AND METHODS: Patients received tinengotinib orally daily in 28-day cycles. Dose escalation was guided by Bayesian modeling using escalation with overdose control. The primary objective was to assess dose-limiting toxicities (DLTs), maximum tolerated dose (MTD), and dose recommended for dose expansion (DRDE). Secondary objectives included pharmacokinetics and efficacy.

RESULTS: Forty-eight patients were enrolled (dose escalation, …


Dysexecutive Difficulty And Subtle Everyday Functional Disabilities: The Digital Trail Making Test, David J Libon, Rod Swenson, Sean Tobyne, Ali Jannati, Daniel Schulman, Catherine C Price, Melissa Lamar, Alvaro Pascual-Leone Apr 2024

Dysexecutive Difficulty And Subtle Everyday Functional Disabilities: The Digital Trail Making Test, David J Libon, Rod Swenson, Sean Tobyne, Ali Jannati, Daniel Schulman, Catherine C Price, Melissa Lamar, Alvaro Pascual-Leone

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Digital neuropsychological tests reliably capture real-time, process-based behavior that traditional paper/pencil tests cannot detect, enabling earlier detection of neurodegenerative illness. We assessed relations between informant-based subtle and mild functional decline and process-based features extracted from the digital Trail Making Test-Part B (dTMT-B).

METHODS: A total of 321 community-dwelling participants (56.0% female) were assessed with the Functional Activities Questionnaire (FAQ) and the dTMT-B. Three FAQ groups were constructed: FAQ = 0 (unimpaired); FAQ = 1-4 (subtle impairment); FAQ = 5-8 (mild impairment).

Results: Compared to the FAQ-unimpaired group, other groups required longer pauses inside target circles (p < 0.050) and produced more total pen strokes to complete the test (p < 0.016). FAQ-subtle participants required more time to complete the entire test (p …


The Bone Marrow Endothelial Progenitor Cell Response To Septic Infection, Xin Shi, Kevin J. Simms, Thomas J. Ewing, Yuan-Ping Lin, Yi-Ling Chen, John N. Melvan, Robert W. Siggins, Ping Zhang Apr 2024

The Bone Marrow Endothelial Progenitor Cell Response To Septic Infection, Xin Shi, Kevin J. Simms, Thomas J. Ewing, Yuan-Ping Lin, Yi-Ling Chen, John N. Melvan, Robert W. Siggins, Ping Zhang

School of Graduate Studies Faculty Publications

Early increase in the level of endothelial progenitor cells (EPCs) in the systemic circulation occurs in patients with septic infection/sepsis. The significance and underlying mechanisms of this response remain unclear. This study investigated the bone marrow EPC response in adult mice with septic infection induced by intravenous injection (i.v.) of . For experiments, sorted marrow stem/progenitor cells (SPCs) including lineage(lin)stem cell factor receptor (c-kit)stem cell antigen-1 (Sca-1), linc-kit, and lin cells were cultured with or without lipopolysaccharides (LPSs) and recombinant murine vascular endothelial growth factor (VEGF) in the absence and presence of anti-Sca-1 crosslinking antibodies. In a separate set of …


Vitamin D Deficiency In Scheuermann's Disease Is Associated With Increased Adverse Outcomes, Shivan N. Chokshi, Srikanth Mudiganty, Rutledge Carter Clement, William Accousti Apr 2024

Vitamin D Deficiency In Scheuermann's Disease Is Associated With Increased Adverse Outcomes, Shivan N. Chokshi, Srikanth Mudiganty, Rutledge Carter Clement, William Accousti

School of Medicine Faculty Publications

INTRODUCTION: Scheuermann's disease is a diagnosis of hyperkyphosis commonly encountered in pediatric patients. Studies in animal models suggest an association with vitamin D deficiency, however, extensive studies have not been performed in humans. This study analyzes the role of vitamin D deficiency on unfavorable results in patients with Scheuermann's disease. METHODS: The TriNetX database was utilized to perform a retrospective analysis. Patients in the United States aged 0-18 years with Scheuermann's disease were identified using International Classification of Diseases, Tenth Revision (ICD-10) codes and categorized into those with and without a diagnosis of vitamin D deficiency. Comparison of patient groups …


Effect Of Aspirin Versus Low-Molecular-Weight Heparin Thromboprophylaxis On Medication Satisfaction And Out-Of-Pocket Costs: A Secondary Analysis Of A Randomized Clinical Trial, Nathan N O'Hara, Katherine P Frey, Deborah M Stein, Joseph F Levy, Gerard P Slobogean, Renan Castillo, Reza Firoozabadi, Madhav A Karunakar, Joshua L Gary, William T Obremskey, Rachel B Seymour, Joseph Cuschieri, C Daniel Mullins, Robert V O'Toole, Metrc Apr 2024

Effect Of Aspirin Versus Low-Molecular-Weight Heparin Thromboprophylaxis On Medication Satisfaction And Out-Of-Pocket Costs: A Secondary Analysis Of A Randomized Clinical Trial, Nathan N O'Hara, Katherine P Frey, Deborah M Stein, Joseph F Levy, Gerard P Slobogean, Renan Castillo, Reza Firoozabadi, Madhav A Karunakar, Joshua L Gary, William T Obremskey, Rachel B Seymour, Joseph Cuschieri, C Daniel Mullins, Robert V O'Toole, Metrc

Faculty, Staff and Student Publications

BACKGROUND: Current guidelines recommend low-molecular-weight heparin for thromboprophylaxis after orthopaedic trauma. However, recent evidence suggests that aspirin is similar in efficacy and safety. To understand patients' experiences with these medications, we compared patients' satisfaction and out-of-pocket costs after thromboprophylaxis with aspirin versus low-molecular-weight heparin.

METHODS: This study was a secondary analysis of the PREVENTion of CLots in Orthopaedic Trauma (PREVENT CLOT) trial, conducted at 21 trauma centers in the U.S. and Canada. We included adult patients with an operatively treated extremity fracture or a pelvic or acetabular fracture. Patients were randomly assigned to receive 30 mg of low-molecular-weight heparin (enoxaparin) …


Does An Early, Balanced Resuscitation Strategy Reduce The Incidence Of Hypofibrinogenemia In Hemorrhagic Shock?, David T Lubkin, Krislynn M Mueck, Gabrielle E Hatton, Jason B Brill, Mariela Sandoval, Jessica C Cardenas, Charles E Wade, Bryan A Cotton Apr 2024

Does An Early, Balanced Resuscitation Strategy Reduce The Incidence Of Hypofibrinogenemia In Hemorrhagic Shock?, David T Lubkin, Krislynn M Mueck, Gabrielle E Hatton, Jason B Brill, Mariela Sandoval, Jessica C Cardenas, Charles E Wade, Bryan A Cotton

Faculty, Staff and Student Publications

OBJECTIVES: Some centers have recommended including concentrated fibrinogen replacement in massive transfusion protocols (MTPs). Given our center's policy of aggressive early balanced resuscitation (1:1:1), beginning prehospital, we hypothesized that our rates of hypofibrinogenemia may be lower than those previously reported.

METHODS: In this retrospective cohort study, patients presenting to our trauma center November 2017 to April 2021 were reviewed. Patients were defined as hypofibrinogenemic (HYPOFIB) if admission fibrinogen

RESULTS: Of 29 782 patients, 6618 level 1 activations, and 1948 patients receiving emergency release blood,

CONCLUSIONS: Low rates of hypofibrinogenemia were found in our center which treats hemorrhage with early, balanced …


Artificial Intelligence Predictive Analytics In Heart Failure: Results Of The Pilot Phase Of A Pragmatic Randomized Clinical Trial, Konstantinos Sideris, Charlene R Weir, Carsten Schmalfuss, Heather Hanson, Matt Pipke, Po-He Tseng, Neil Lewis, Karim Sallam, Biykem Bozkurt, Thomas Hanff, Richard Schofield, Karen Larimer, Christos P Kyriakopoulos, Iosif Taleb, Lina Brinker, Tempa Curry, Cheri Knecht, Jorie M Butler, Josef Stehlik Apr 2024

Artificial Intelligence Predictive Analytics In Heart Failure: Results Of The Pilot Phase Of A Pragmatic Randomized Clinical Trial, Konstantinos Sideris, Charlene R Weir, Carsten Schmalfuss, Heather Hanson, Matt Pipke, Po-He Tseng, Neil Lewis, Karim Sallam, Biykem Bozkurt, Thomas Hanff, Richard Schofield, Karen Larimer, Christos P Kyriakopoulos, Iosif Taleb, Lina Brinker, Tempa Curry, Cheri Knecht, Jorie M Butler, Josef Stehlik

Faculty, Staff and Students Publications

OBJECTIVES: We conducted an implementation planning process during the pilot phase of a pragmatic trial, which tests an intervention guided by artificial intelligence (AI) analytics sourced from noninvasive monitoring data in heart failure patients (LINK-HF2).

MATERIALS AND METHODS: A mixed-method analysis was conducted at 2 pilot sites. Interviews were conducted with 12 of 27 enrolled patients and with 13 participating clinicians. iPARIHS constructs were used for interview construction to identify workflow, communication patterns, and clinician's beliefs. Interviews were transcribed and analyzed using inductive coding protocols to identify key themes. Behavioral response data from the AI-generated notifications were collected.

RESULTS: Clinicians …


Harnessing Rna Technology To Advance Therapeutic Vaccine Antigens Against Chagas Disease, Chiara Mancino, Jeroen Pollet, Assaf Zinger, Kathryn M Jones, Maria José Villar, Ana Carolina Leao, Rakesh Adhikari, Leroy Versteeg, Rakhi Tyagi Kundu, Ulrich Strych, Federica Giordano, Peter J Hotez, Maria Elena Bottazzi, Francesca Taraballi, Cristina Poveda Apr 2024

Harnessing Rna Technology To Advance Therapeutic Vaccine Antigens Against Chagas Disease, Chiara Mancino, Jeroen Pollet, Assaf Zinger, Kathryn M Jones, Maria José Villar, Ana Carolina Leao, Rakesh Adhikari, Leroy Versteeg, Rakhi Tyagi Kundu, Ulrich Strych, Federica Giordano, Peter J Hotez, Maria Elena Bottazzi, Francesca Taraballi, Cristina Poveda

Center for Medical Ethics and Health Policy Staff Publications

Chagas disease (CD) (American trypanosomiasis caused by Trypanosoma cruzi) is a parasitic disease endemic in 21 countries in South America, with increasing global spread. When administered late in the infection, the current antiparasitic drugs do not prevent the onset of cardiac illness leading to chronic Chagasic cardiomyopathy. Therefore, new therapeutic vaccines or immunotherapies are under development using multiple platforms. In this study, we assessed the feasibility of developing an mRNA-based therapeutic CD vaccine targeting two known T. cruzi vaccine antigens (Tc24—a flagellar antigen and ASP-2—an amastigote antigen). We present the mRNA engineering steps, preparation, and stability of the lipid …


Aortic Stenosis Management In Patients With Acute Hip Fracture, Juan A. Terré, Juan Torrado, Isaac George, Rafael Harari, Pedro R. Cox-Alomar, Pedro A. Villablanca, Robert T. Faillace, Juan F. Granada, George Dangas, Mario J. Garcia, Azeem Latib, José Wiley Apr 2024

Aortic Stenosis Management In Patients With Acute Hip Fracture, Juan A. Terré, Juan Torrado, Isaac George, Rafael Harari, Pedro R. Cox-Alomar, Pedro A. Villablanca, Robert T. Faillace, Juan F. Granada, George Dangas, Mario J. Garcia, Azeem Latib, José Wiley

School of Medicine Faculty Publications

The treatment of severe aortic stenosis (SAS) has evolved rapidly with the advent of minimally invasive structural heart interventions. Transcatheter aortic valve replacement has allowed patients to undergo definitive SAS treatment achieving faster recovery rates compared to valve surgery. Not infrequently, patients are admitted/diagnosed with SAS after a fall associated with a hip fracture (HFx). While urgent orthopedic surgery is key to reduce disability and mortality, untreated SAS increases the perioperative risk and precludes physical recovery. There is no consensus on what the best strategy is either hip correction under hemodynamic monitoring followed by valve replacement or preoperative balloon aortic …