Medicine and Health Sciences Commons^™

Role Of Psychiatric Factors Hindering Physical Rehabilitation After Acl Reconstructive Surgery, Malak Rafik, Davian Caraballo, James Fini Jr., Nathan Barnhurst

Annual Research Symposium

No abstract provided.

Periodontitis Linked With Urinary Tract Infections- Coincidence Or Causality?, Ali Shariff, Shankargouda Patil, Shilpa Bhandi, Frank Licari

Annual Research Symposium

Urinary tract infection is a cumulative term used to describe an infection of any part of the urinary system. Periodontitis is a chronic inflammatory condition of the tooth-supporting structures. The literature points towards an inter-relationship between periodontitis and other systemic diseases such as metabolic syndrome, diabetes mellitus, coronary heart diseases, etc. Several studies indicate a pathophysiologic inter-relationship between periodontitis and urinary tract infections. Considering the inflammatory nature of periodontitis and urinary tract infections, a common link of causality may be present between the two diseases. P. gingivalis, a key periodontal pathogen, is a significant agent in disseminating infection …

How To Avoid Arterial Access During Transcatheter Closure Of Patent Ductus Arteriosus Using Anatomo-Haemodynamic Landmark, Mohit Sachan, Kumar Himanshu, Mukesh Jitendra Jha, Santhosh Kumar Sinha, Mahmodullah Razi, Awadhesh Kumar Sharma, Puneet Aggarwal, Praveen Shukla, Rakesh Verma

Journal of the Saudi Heart Association

Objective- To evaluate the feasibility, safety, and efficacy of transcatheter closure (TCC) of patent ductus arteriosus (PDA) using anatomical-physiological landmark without any arteriography.Method- In this prospective, non-randomized study, all consecutive patients with PDA undergoing transcatheter closure at LPS Institute of Cardiology, Kanpur, India between January 2019 and June 2024 were evaluated. TCC was performed using anatomical and physiological landmark without aortogram, and device was deployed through antegrade route only. Transthoracic echocardiography with colour-Doppler imaging was used to confirm position of the device before final deployment. Primary outcome was procedural and fluoroscopy time, and major complications (access site …

Structure-Activity Relationship Studies Of Dna Methyltransferase 1 Monovalent Degraders, Chao Qian, Youngeun Lee, Yulin Han, Yue Zhong, Jujun Zhou, Joel Hrit, Ling Xie, Qin Chen, H Ümit Kaniskan, Xian Chen, Scott Rothbart, Xiaodong Cheng, Yan Xiong, Jian Jin

Faculty, Staff and Student Publications

DNA methyltransferase 1 (DNMT1), which catalyzes maintenance methylation of hemimethylated DNA during DNA replication, is overexpressed in cancer. Recently, the first-in-class DNMT1-selective noncovalent small-molecule inhibitors, GSK3484862 and GSK3685032, were discovered. These inhibitors were also reported to degrade DNMT1. However, structure–activity relationship (SAR) studies of these monovalent DNMT1 degraders are lacking. Here, we report our SAR studies of this scaffold on degrading DNMT1, which led to the discovery of multiple lead degraders, including compound 4 (MS9024). Compound 4 potently and selectively degraded DNMT1 in multiple cancer cell lines in a concentration-, time-, and proteasome-dependent manner without altering DNMT1 transcription. Further mechanism-of-action …

Inhibition Of Histone Methyltransferase Ezh2 For Immune Interception Of Colorectal Cancer In Lynch Syndrome, Charles M Bowen, Fahriye Duzagac, Abel Martel-Martel, Laura Reyes-Uribe, Mahira Zaheer, Jacklyn Thompson, Nan Deng, Ria Sinha, Soham Mazumdar, Melissa W Taggart, Abhinav K Jain, Elena Tosti, Winfried Edelmann, Krishna M Sinha, Eduardo Vilar

Faculty, Staff and Student Publications

Colorectal precancers in Lynch syndrome (LS) exhibit a distinct immune profile, presenting unique opportunities for developing immune-interception strategies to prevent carcinogenesis. Epigenetic modulation by EZH2 of immune-related genes is implicated in the carcinogenesis of different cancer types, including colorectal cancer. This study utilizes a mouse model of LS and ex vivo colonic organoids to assess the effects of the EZH2 inhibitor GSK503 on immune regulatory pathways, tumorigenesis, and epigenetic reprogramming. Our findings revealed that GSK503 significantly increased CD4+ and CD8+ T cells in both splenocytes and colonic mucosa of treated mice compared with controls. Additionally, a preventive dose of GSK503 …

Prediction Of Cognitive Conversion Within The Alzheimer’S Disease Continuum Using Deep Learning, Siyu Yang, Xintong Zhang, Xinyu Du, Peng Yan, Jing Zhang, Wei Wang, Jing Wang, Lei Zhang, Huaiqing Sun, Yin Liu, Xinran Xu, Yaxuan Di, Jin Zhong, Caiyun Wu, Jan D Reinhardt, Yu Zheng, Ting Wu

Faculty, Staff and Students Publications

Background: Early diagnosis and accurate prognosis of cognitive decline in Alzheimer's disease (AD) is important to timely assignment to optimal treatment modes. We aimed to develop a deep learning model to predict cognitive conversion to guide re-assignment decisions to more intensive therapies where needed.

Methods: Longitudinal data including five variable sets, i.e. demographics, medical history, neuropsychological outcomes, laboratory and neuroimaging results, from the Alzheimer's Disease Neuroimaging Initiative (ADNI) cohort were analyzed. We first developed a deep learning model to predicted cognitive conversion using all five variable sets. We then gradually removed variable sets to obtained parsimonious models for four different …

Plasma Micrornas To Select Optimal Patients For Antibody Production From Anti-Addiction Vaccines, Thomas R Kosten, Amrit Koirala, David A Nielsen, Coreen B Domingo, Ynhi T Thomas, Preethi H Gunaratne, Cristian Coarfa

Faculty, Staff and Students Publications

Background: Cocaine and illicit amphetamines (disguised as “Adderall”) are being laced with fentanyl and producing accidental and intentional fatal overdoses. Vaccines can prevent these overdoses, but 33% of humans generate insufficient anti-drug antibody (AB) levels. Plasma microRNAs (miRs) can be used to predict non-responders. We have plasma stored from 152 cocaine vaccine trial participants following three vaccinations over 9 weeks and examined miRs as potential response biomarkers. Methods: We compared 2517 miRs before anti-cocaine vaccination in participants with the highest (n = 25) to the lowest (n = 23) antibody levels. False Discovery Rates (FDRs) were applied to identify differentially …

Treatment Of Small Intracranial Aneurysms Using The Smallss Scoring System: A Novel System For Decision Making, Mira Salih, Michael Young, Thomas B. Fodor, Alexander Andreev, Samuel D. Pettersson, Joanna M. Roy, Basel Musmar, Max Shutran, Phillip Taussky, Christopher S. Ogilvy

Department of Neurosurgery Faculty Papers

BACKGROUND: Treatment of unruptured intracranial aneurysms (UIA) less than 7 mm is controversial. We created a scoring system to guide decision making and validated the system utilizing over 700 cases treated with microsurgery or endovascular procedures.

METHODS: The scoring system SMALLSS included Size, (4-7 mm: 1 point, < 3.9 mm: 0 point), Multiple aneurysms (yes: 1, no: 0), Anatomic location (posterior: 1, anterior: 0), Lineage- family history of aneurysm (yes:1, no: 0), Lifetime risk (age < 65: 1, age > 65: 0), Smoking history (yes: 1, no: 0 ), Shape (irregular:1, smooth:0 ). Validation of this system was performed through retrospective review of prospectively maintained data for UIA patients treated between 2014 and 2021. We then performed an external validation of a cohort of 200 small aneurysms < 7 mm treated at a high volume cerebrovascular center.

RESULTS: A total of 1152 cases …

Navigating Epstein-Barr Virus (Ebv) And Post-Transplant Lymphoproliferative Disorder (Ptld) In Pediatric Liver Transplantation: Current Knowledge And Strategies For Treatment And Surveillance, Erin Y Chen, Natasha Dilwali, Krupa R Mysore, Sara Hassan, Sara Kathryn Smith, Wikrom Karnsakul

Faculty, Staff and Students Publications

Epstein-Barr virus (EBV) is strongly associated with the development of post-transplant lymphoproliferative disorder (PTLD) in pediatric liver transplant recipients. PTLD is one of the most common malignancies following liver transplantation and is associated with significant morbidity and mortality. Factors such as EBV-serostatus mismatch and prolonged or high levels of immunosuppression impact a patient's risk of developing PTLD. While pre-transplant EBV serological screening and post-transplant monitoring of EBV-DNA levels are strongly recommended, universal guidelines for its prevention and management are lacking. Due to a lack of robust prospective studies, current clinical practices vary widely. The treatment of PTLD typically involves reducing …

A Systematic Review Of Recent Developments In Platelet-Rich Plasma Therapy In Hip Osteoarthritis: Variability In Protocols And Clinical Outcomes (2019–2024), Emily Awdish, Marlena Muszynska, Konrad Lautenschlager, Ali Hamade

Annual Research Symposium

No abstract provided.

A Systematic Review Of Persisting Tissue Health Challenges Amid Insulin Delivery System Advancements: Continuous Subcutaneous Insulin Infusion (Csii) And Lipohypertrophy In Diabetic Patients, Marlena Muszynska, Emily Awdish

Annual Research Symposium

No abstract provided.

Effect Of Routine Third Trimester Ultrasounds On Maternal Mental Health In Low-Risk Population In Utah, Claire Z. Zai, Priyanka R. Purohit, Emily M. Snyder, Bryson M. Mcadams, Daniela A. Betancourt-Martinez, Donna O. Van Beuge, Maria N. Easler, Makayla A. Muzinic, Carlos E. Angulo

Annual Research Symposium

Purpose: One in five pregnant women in the United States experience a maternal mental health condition. Within Utah from 2018-2022, during pregnancy, 22.7% of women experienced depression and 31.6% experienced anxiety, and 15.1% experienced postpartum depression. These data represent a prevalence higher than the national average. Third trimester ultrasound (TTUS) is not a standard of care performed in the United States currently. Previous TTUS research has mainly focused on the financial burden and birth outcomes rather than maternal mental health. Literature on first trimester ultrasound has demonstrated a notable impact on maternal mental health, but these outcomes within the third …

Task-Shifting And Task-Sharing In Low And Middle-Income Countries (Lmic’S): Impact On Surgical Outcomes And Global Healthcare Delivery, Nate Nyberg, Matthew Hill, Anna Liles, Elizabeth Amera, Sarah Ngo, Triston Crook

Annual Research Symposium

No abstract provided.

Innovations And Adaptations Of Laparoscopic Surgery To Resource-Limited Settings In Low And Middle-Income Countries (Lmic’S), Nate Nyberg, Kennedy Scheele, Chelsea Chang, Erica Tutuwan, Sarah Siddiqui

Annual Research Symposium

No abstract provided.

Challenges In Diagnosing And Treating Fungal Endocarditis: A Case Report Of Recurrent Candida Endocarditis In A Hemodialysis Patient, Ghaidaa Almuhammadi, Rawia Alzughaibi, Lamar Amer, Talal Alzahrani

Journal of the Saudi Heart Association

Fungal endocarditis (FE) is a rare yet life-threatening condition, especially in hemodialysis (HD) patients with indwelling long-term catheters. Symptoms often overlap with non-fungal infective endocarditis, making diagnosis difficult. As FE incidence increases, healthcare providers face challenges in diagnosing and managing this severe condition. Early suspicion of FE is crucial for patients with long-term catheters. We reported a 23-year-old male with end-stage renal disease (ESRD) on HD that developed FE affecting the tricuspid valve, requiring valve replacement and anti-fungal medication. Despite these interventions, he had recurrent Candida prosthetic endocarditis(CPE). Currently, he is receiving anti-fungal medication, with plans for a third surgery.

The Safety Of Ramadan Fasting In Chronic Heart Failure Patients With Reduced Ejection Fraction, Ahmed Farouk Alaarag, Mahmoud Abd Elkhalek Abou-Omar, Osama Ahmed Amin

Journal of the Saudi Heart Association

Objectives: Even though Islam excludes the sick from Ramadan Fasting (RF), countless Muslims choose to fast throughout this holy month. So, it is of paramount importance to review how RF influences patients with chronic Heart Failure with reduced Ejection Fraction (HFrEF). Our study intended to check the safety of RF in these patients.

Methods: We selected patients under 75 years old with compensated chronic HFrEF. After applying all the exclusion conditions, those who insisted on fasting during the coming Ramadan were enrolled in fasting Group I (90 patients). Those who decided not to fast were listed as control Group …

Pediatric Diabetes Education, Trisha Williams, Tobie O'Brien, Amanda Williams

Advanced Practice Perspectives Podcast: For Nursing Contact Hours

Join us as we delve into the groundbreaking changes in the diagnosis and treatment of type 1 diabetes in children. Amanda Williams shares insights on new staging processes and the FDA-approved drug teplizumab, which adds years of quality life to young patients.

Click here to stream the podcast episode.

Describing The Intersection Of Ethnicity And Gender In Early-Stage Non-Small Cell Lung Cancer, Hamza Rshaidat, Isheeta Madeka, Gregory L. Whitehorn, Jonathan Martin, Shale J. Mack, Sneha Alaparthi, Tyler R. Grenda, Nathaniel R. Evans Iii, Olugbenga T. Okusanya

Jefferson Hospital Staff Papers and Presentations

Objective

Methods

Novel Biomarkers Of Fetal And Neonatal Environmental Exposure, Effect And Susceptibility, Cynthia F. Bearer

Faculty Scholarship

Abstract: Rapid advancements in science and technology have allowed medical providers to treat wider ranges of diseases with safer and more effective therapies than ever before. One of the areas of health that has been consistently understudied, however, is one that affects us all: environmental health or the effects that the chemicals we are exposed to every day have on our acute and chronic health. This effect can be exacerbated during and shortly after pregnancy, as an individual exposure is often shared by both the mother and the fetus/neonate. The diagnosis and monitoring of chemical exposure can be quite challenging, …

Contribution Of Rare Chromosome 22q112 Copy Number Variants To Non-Syndromic Bicuspid Aortic Valve, Helene Digregorio, Sara Mansoorshahi, Steven G Carlisle, Catherina Tovar Pensa, Abi Watts, Courtney Mcneely, Anna Sabate-Rotes, Anji Yetman, Hector I Michelena, Julie F A De Backer, Laura Muiño Mosquera, Malenka M Bissell, Maria Grazia Andreassi, Ilenia Foffa, Dawn S Hui, Anthony Caffarelli, Yuli Y Kim, Rodolfo Citro, Margot De Marco, Justin T Tretter, Kim L Mcbride, Simon C Body, Dianna M Milewicz, Siddharth K Prakash, Ebav Investigators

Faculty, Staff and Student Publications

Background: Bicuspid aortic valve (BAV) is the most common congenital heart defect in adults, often leading to complications such as thoracic aortic aneurysms and aortic stenosis. While BAV is frequently associated with 22q11.2 deletion syndrome (22q11.2DS), the contribution of rare copy number variants (CNVs) in this region to non-syndromic BAV is less clear. This study is aimed to assess the role of rare 22q11.2 CNVs in patients with early-onset BAV (EBAV) and to determine whether these variants are linked to an increased risk of complications.

Methods: Whole genome microarray genotyping was conducted on 272 patients with BAV with early onset …

Efficacy And Safety Of Nivolumab Plus Ipilimumab In Patients With Metastatic Variant Histology (Non-Clear Cell) Renal Cell Carcinoma, Mohammad Jad Moussa, Jaanki Khandelwal, Nathaniel R Wilson, Kiran L Malikayil, Devaki Shilpa Surasi, Tharakeswara K Bathala, Yiyun Lin, Priya Rao, Pheroze Tamboli, Kanishka Sircar, Helen Ajufo, Khaled M Elsayes, Amishi Shah, Andrew C Johns, Sangeeta Goswami, Elshad Hasanov, Eric Jonasch, Pavlos Msaouel, Matthew T Campbell, Omar Alhalabi, Nizar M Tannir

Faculty, Staff and Student Publications

Background: Nivolumab plus ipilimumab (nivo/ipi) is a standard of care first-line (1 L) therapy for patients with metastatic clear-cell renal cell carcinoma (ccRCC), but its role in patients with metastatic, non-ccRCC has not been fully defined. We report a single-institution experience with nivo/ipi in non-ccRCC.

Methods: Between November 2017 and February 2024, 55 patients with metastatic non-ccRCC received nivo/ipi at MD Anderson Cancer Center. The tumor response was assessed by blinded radiologists using RECIST v1.1. The overall response rate (ORR), progression-free survival (PFS), PFS milestone, duration of response (DoR), and overall survival (OS) were determined. Next-generation sequencing (NGS) was performed …

Designing Patient-Centered Interventions For Emergency Care: Participatory Design Study, Woosuk Seo, Shruti Jain, Vivian Le, Jiaqi Li, Zhan Zhang, Hardeep Singh, Kalyan Pasupathy, Prashant Mahajan, Sun Young Park

Faculty, Staff and Students Publications

Background: Emergency departments (EDs) are high-pressure environments where clinicians diagnose patients under significant constraints, including limited medical histories, severe time pressures, and frequent interruptions. Current ED care practices often inadequately support meaningful patient participation. Most interventions prioritize clinical workflow and health care provider communication, inadvertently overlooking patients' needs. Additionally, patient-facing technologies in EDs are typically developed without meaningful patient input, leading to solutions that may not effectively address patients' specific challenges. To enhance both patient-centered care practices and the diagnosis process in EDs, patient involvement in technology design is essential to ensure their needs during emergency care are understood and …

Effect On Cardiovascular Outcome Of Sodium-Glucose Co-Transporter-2 (Sglt2) Inhibitors Among Cancer Patients Treated With Anthracycline: A Systematic Review And Meta-Analysis, Chalothorn Wannaphut, Phuuwadith Wattanachayakul, Sakditad Saowapa, Ben Ponvilawan, Manasawee Tanariyakul, Jakrin Kewcharoen, Pitchaporn Yingchoncharoen, Thanathip Suenghataiphorn, Noppawit Aiumtrakul, Jared Acoba

Department of Medicine Faculty Papers

Background/objectives: Sodium-glucose-co-transporter-2 (SGLT2) inhibitors have shown benefit in reducing cardiovascular disease outcomes in diabetes patients. Anthracycline therapy is associated with a risk of cardiomyopathy. However, the impact of SGLT2 inhibitors in the prevention of cardiomyopathy and heart failure in cancer patients undergoing anthracycline treatment remains unclear. Thus, we conducted a systematic review and meta-analysis to explore the effect of the prevention of cardiovascular outcomes in patients with cancer and diabetes who had received anthracycline therapy.

Methods: We systematically reviewed Medline and EMBASE databases from inception to January 2024 for studies focusing on cancer patients with a history of anthracycline therapy. …

A Literary Review Of Physician Approach To Patient Care: Implications In Cancer Care, Daniel Ramirez, Kinsley Batson

Annual Research Symposium

No abstract provided.

Mhealth App To Promote Healthy Lifestyles For Diverse Families Living In Rural Areas: Usability Study, Alejandra Perez Ramirez, Adrian Ortega, Natalie Stephenson, Angel Muñoz Osorio, Anne E Kazak, Thao-Ly Phan

Department of Pediatrics Faculty Papers

BACKGROUND: Mobile Integrated Care for Childhood Obesity is a multicomponent intervention for caregivers of young children with obesity from rural communities that was developed in collaboration with community, parent, and health care partners. It includes community programming to promote healthy lifestyles and address social needs and health care visits with an interdisciplinary team. A digital mobile health platform-the Healthy Lifestyle (Nemours Children's Health) dashboard-was designed as a self-management tool for caregivers to use as part of Mobile Integrated Care for Childhood Obesity.

OBJECTIVE: This study aimed to improve the usability of the English and Spanish language versions of the Healthy …

Early Childhood Caries And Associated Risk Factors Among Preschool Children In Southeast Iran, Homa Kamyabi, Parisa Kalantari, Azadeh Horri, Fereshteh Abbasi, Mahsa Kalantari

School of Public Health Faculty Publications

Objective: To determine the prevalence of ECC and evaluate its association with possible risk factors in a group of preschool children in Kerman, Iran. Material and Methods: This cross-sectional study was conducted in Kerman on healthy preschool children (up to 6 years old) in June and October 2021. The children were randomly selected from kindergartens using a clustered sampling method, and their height, weight, dental caries, and occlusion were evaluated. Parents completed a questionnaire assessing feeding habits (breast/bottle feeding) and oral habits during the first two years of life. Data were analyzed by logistic regression and chi-squared test using SPSS …

Surgical Repair Of An Atypical Midsubstance Distal Biceps Tendon Partial Tear: A Case Report, Michael M. Valenzuela, Genoveffa R. Morway, Christopher M. Jones

Department of Orthopaedic Surgery Faculty Papers

No abstract provided.

Regression Modeling Of Cumulative Incidence Function For Left-Truncated Right-Censored Competing Risks Data: A Modified Pseudo-Observation Approach, Rong Rong, Jing Ning, Hong Zhu

Faculty, Staff and Student Publications

Statistical methods have been developed for regression modeling of the cumulative incidence function (CIF) given left-truncated right-censored competing risks data. Nevertheless, existing methods typically involve complicated weighted estimating equations or nonparametric conditional likelihood function and often require a restrictive assumption that censoring and/or truncation times are independent of failure time. The pseudo-observation (PO) approach has been used in regression modeling of CIF for right-censored competing risks data under covariate-independent censoring or covariate-dependent censoring. We extend this approach to left-truncated right-censored competing risks data and propose to directly model the CIF based on POs, under general truncation and censoring mechanisms. We …

Nprl2 Gene Therapy Induces Effective Antitumor Immunity In Kras/Stk11 Mutant Anti-Pd1 Resistant Metastatic Non-Small Cell Lung Cancer (Nsclc) In A Humanized Mouse Model, Ismail M Meraz, Mourad Majidi, Renduo Song, Feng Meng, Lihui Gao, Qi Wang, Jing Wang, Elizabeth J Shpall, Jack A Roth

Faculty, Staff and Student Publications

Expression of NPRL2/TUSC4, a tumor-suppressor gene, is reduced in many cancers including NSCLC. Restoration of NPRL2 induces DNA damage, apoptosis, and cell-cycle arrest. We investigated NPRL2 antitumor immune responses in aPD1R/KRAS/STK11^mt NSCLC in humanized-mice. Humanized-mice were generated by transplanting fresh human cord blood-derived CD34 stem cells into sub-lethally irradiated NSG mice. Lung-metastases were developed from KRAS/STK11^mt/aPD1R A549 cells and treated with NPRL2 w/wo pembrolizumab. NPRL2-treatment reduced lung metastases significantly, whereas pembrolizumab was ineffective. Antitumor effect was greater in humanized than non-humanized-mice. NPRL2 + pembrolizumab was not synergistic in KRAS/STK11^mt/aPD1R tumors but was …

Bbox1 Restrains Tbk1-Mtorc1 Oncogenic Signaling In Clear Cell Renal Cell Carcinoma, Chengheng Liao, Lianxin Hu, Liwei Jia, Jin Zhou, Tao Wang, Kangsan Kim, Hua Zhong, Hongwei Yao, Lei Dong, Lei Guo, Qian Liang, Cheng Zhang, Fangzhou Zhao, Jun Fang, Hongyi Liu, Shina Li, Lin Xu, Jeremy M Simon, Srinivas Malladi, Payal Kapur, James Brugarolas, Ralph J Deberardinis, Qing Zhang

Faculty, Staff and Student Publications

Clear cell renal cell carcinoma (ccRCC), a metabolic disease originating from renal proximal convoluted tubule (PCT) epithelial cells, remains incompletely understood in terms of its initiating signaling events. Here, we identify γ-butyrobetaine hydroxylase 1 (BBOX1), a key enzyme in carnitine synthesis predominantly expressed in PCT cells, as a tumor suppressor in ccRCC. BBOX1 expression is lost during ccRCC malignant transformation, and its restoration reduces cell viability in physiological medium and inhibits xenograft tumor growth. Transcriptomic analyses reveal that BBOX1 suppresses critical metabolic pathways including mTORC1 signaling and glycolysis in ccRCC. Further, we identify TANK-binding kinase 1 (TBK1) as an essential …