Medicine and Health Sciences Commons^™

Integrating Consumer-Grade Wearable Data Into Orthopedic Risk Stratification For Amateur Athletes: A Perspective On An Untapped Clinical Tool, Youssef Salama, William Gadbois, Kevin Reck, Scott Yaekle

Medical Student Research Symposium

Background:

Consumer-grade wearables have rapidly expanded beyond fitness tracking, providing continuous physiologic and biomechanical data. Metrics such as heart rate variability (HRV), sleep efficiency, and training load have been validated as markers of both recovery and overtraining. However, orthopedic care has not yet translated these data into clinical use. Given the rising burden of overuse injuries in recreational athletes, wearable-derived information may offer a practical opportunity for early detection and prevention within outpatient settings.

Methods:

A narrative perspective review of literature from 2010–2025 was performed using PubMed. Studies addressing wearable device validity, physiologic correlates of musculoskeletal injury, and training-load modeling …

Comparing Injury Incidence Between Major League Soccer And The English Premier League During The 2024/2025 Season: A Retrospective Cohort Study, William Gadbois, Youssef Salama, Kevin Reck, Scott Mohamed El-Sayed Yaekle

Medical Student Research Symposium

Background

Major League Soccer (MLS) and the English Premier League (EPL) differ substantially in geographic footprint, travel requirements, competition structure, and scheduling. These structural differences may influence player injury risk, yet no study has directly compared injury incidence between the two leagues within the same competitive season. In 2024, MLS introduced a centralized, standardized injury-reporting system that improved transparency and created a unique opportunity for direct comparison with the EPL.

Methods

This retrospective cohort study will analyze all reported time-loss injuries during the 2024 MLS and 2024–25 EPL seasons. Injury data will be collected from publicly available league reports, club …

Characterizing Stiffness Dynamics Of Normal And Malignant Breast Spheroids Using Brillouin Microscopy, Razanne Rafat Zaghloul, Karlin Hilai, Chenjun Shi, Jitao Zhang

Medical Student Research Symposium

Background: Breast cancer progression and metastasis are closely linked to alterations in the mechanical properties of tumor cells and their microenvironment. Softer, more deformable cells are often associated with higher metastatic potential. While atomic force microscopy (AFM) is the current gold standard for mechanical characterization, it is limited to surface measurements and can damage 3D cultures. It remains unclear how the mechanical properties evolve over time in normal versus malignant spheroids. This study utilizes Brillouin light-scattering microscopy, a non-contact and label-free optical technique, to assess stiffness changes in normal and malignant breast epithelial spheroids over time. Understanding these mechanical signatures …

Environmental Mercury Alters Immune Pathways Linked To Autoimmune Risk In Mice Mirroring Humans, Maurgan Lee, Paul Stemmer, Randall Gill, Allen Rosenspire, Anil Aranha, Heather Gibson

Medical Student Research Symposium

Background and Purpose: Mercury is a pervasive environmental contaminant, and human epidemiologic studies have linked chronic low-level exposure to increased autoimmune disease-risk. Dysregulated lymphocyte activation and impaired signaling tolerance are central mechanisms in human autoimmunity. Protein phosphorylation governs lymphocyte differentiation and function, alterations in phosphoproteomic networks may represent a signature of immune disruption. This study evaluates how low dose mercury exposure modifies B and T cell abundance and intracellular signaling patterns in BALB/c and Diversity Outbred (DO) mice.

Methods: BALB/c and DO mice were exposed to low dose HgCl2 in their water for two weeks or provided standard water controls. …

Age-Dependent Physiologic Differences And Predicted Survival In Pediatric Trauma Patients, Christian Hudson-Bradford Md, Laura Elizabeth Sansoterra, Elika Ridelman Phd, Samantha Carranza, Megan Zacarias, Christina Shanti Md

Medical Student Research Symposium

Background:
Pediatric trauma patients exhibit outcomes not fully captured by adult-derived prediction models. This study examined clinical measures associated with predicted survival in this population.

Methods:
A retrospective review was conducted at a level one pediatric trauma center for patients ≤12 years old admitted between July 2015 and October 2024 with major trauma (Injury Severity Score (ISS) >15). A total of 406 eligible cases were categorized by Trauma and Injury Severity Score (TRISS) survival probability as preventable (>0.50), possibly preventable (0.25–0.50), or non-preventable (< 0.25). Demographic, physiologic, and management variables were compared using Kruskal–Wallis and chi-square tests with Bonferroni correction.

Results:
Most patients were classified as preventable (83%), followed by possibly preventable (9.8%) and non-preventable …

Comparative Effectiveness Of Liposomal Bupivacaine And Regional Nerve Blocks For Analgesia After Total Knee Arthroplasty, Ahmed Makled, Amir Ghafarian, Jawad Saad, Muhammed Zahriyeh, Muaaz Wajahath, Khaled Saleh

Medical Student Research Symposium

Title: Comparative Effectiveness of Liposomal Bupivacaine and Regional Nerve Blocks for Analgesia After Total Knee Arthroplasty

Introduction: Liposomal bupivacaine (Exparel) has been adopted in total knee arthroplasty (TKA) as a long-acting local anesthetic. However, its comparative effectiveness against standard regional anesthesia techniques, such as femoral or adductor canal block, remains insufficiently defined. This study evaluates postoperative analgesic utilization following TKA among patients receiving Exparel, regional blocks, or no regional intervention, using matched cohorts from a large national dataset.

Methods: Patients who underwent primary TKA between January 1, 2005 and January 1, 2025 were retrospectively identified from a multi-institutional electronic medical …

Real-World Clinical Outcomes Of Robotic-Assisted Total Knee Arthroplasty: A Propensity-Matched Comparative Study, Hassan Yassine, Amir Ghafarian, Jawad Saad, Abdel Kareem Hilo, Muaaz Wajahath, Khaled Saleh

Medical Student Research Symposium

Background:

Robotic-assisted total knee arthroplasty (RA-TKA) is increasingly utilized to improve component alignment and soft-tissue balance, yet its impact on clinically meaningful outcomes in large real-world populations remains uncertain. Although prior studies demonstrate improved radiographic accuracy, whether robotic assistance reduces postoperative complications, opioid utilization, or midterm mechanical failure has not been established at scale.

Methods:

We conducted a retrospective, propensity-matched cohort study using the TriNetX US Collaborative Network to identify adults undergoing primary TKA from 2018–2023. Robotic-assisted procedures were defined by CPT 27447 with concurrent robotic navigation codes. Propensity score matching (1:1) was performed to balance demographics and comorbidities, yielding …

Malnutrition At The Time Of Surgery Predicts Increased Morbidity After Distal Femur Fracture Fixation: A Propensity-Matched Analysis, Jawad Saad, Amir Ghafarian, Tyler Forbes, Muaaz Wajath, Noor Saad, Khaled Saleh

Medical Student Research Symposium

Abstract

Background: Distal femur fractures (DFF) are serious injuries most often affecting older adults with multiple medical comorbidities. Malnutrition is known to worsen outcomes in elective orthopedic surgery, but its impact in urgent DFF fixation, where optimization time is limited, remains unclear. This study evaluated whether preoperative malnutrition predicts 90-day morbidity after DFF fixation and whether implant choice influences risk among malnourished patients.

Methods: Adults undergoing operative DFF fixation from 2005–2025 were identified using the TriNetX U.S. Collaborative Network. Malnutrition was defined as serum albumin ≤3.5 g/dL or leukocyte count ≤1.5×10³/µL within one year preoperatively. After 1:1 propensity matching for …

Maternal Cardiovascular Outcomes In Pregnancies Complicated By Pulmonary Hypertension: A Multicenter Cohort Study, Ali Eidy, Aiden Tang, Tarun Bomma, Prit Patel, Asa Smith-Villegas, Ali Awad Md

Medical Student Research Symposium

Title: Maternal Cardiovascular Outcomes in Pregnancies Complicated by Pulmonary Hypertension: A Multicenter Cohort Study

Authors: Ali Eidy, BS, Aiden Tang, BS, Tarun Bomma, BS, Prit Patel, BS, Asa Smith-Villegas, BS, Ali Awad, MD

Background: Routine pregnancies exhibit a considerable amount of cardiovascular strain, which is only amplified when complicated by pulmonary hypertension (PH). Despite advances in PH treatment and therapy, there is limited data that shows the outcomes of PH on maternal cardiovascular health. This study evaluated these risks across a large, diverse cohort to better understand how PH affects maternal hemodynamics and cardiac functions.

Methods: Using the TriNetX Research …

Five-Year Prescription Trends In Anti-Vegf Utilization: A Randomized Sampling Of Real-World Injection Patterns, Sarah Noonan Bs, Batoul Dabajeh Bs, Richard Tuttle Bs, Ahmad Yousef Ba, Mba, Paul Edwards Md, Katherine Jaje Md, Deedra Lapointe Mha, Robert Culmone Cpa, Charles S. Day Md, Mba

Medical Student Research Symposium

Background

Previous studies have demonstrated that bevacizumab (Avastin) achieves comparable visual outcomes to branded agents such as aflibercept (Eylea), ranibizumab (Lucentis), and faricimab (Vabysmo), while offering a substantially lower cost. This study evaluates five-year prescription trends across three cohorts to identify changing utilization patterns. Real-world prescription behaviors enable this analysis to provide insight into clinical decision-making and to highlight opportunities to enhance value-based ophthalmic care.

Methods

A retrospective, descriptive analysis was conducted using electronic medical record data between 2020-2025. Three patient cohorts were identified based on anti-VEGF injection type and sequence:

• Cohort 1: Bevacizumab (Avastin) only

• Cohort 2: Bevacizumab (Avastin) …

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Variation In Baroreceptor Sensitivity Prevents Generalized Anxiety, Alexander Weaver, Jack Summers, Judy Taha, Zachary Miklja, Warren Lockette

Medical Student Research Symposium

VARIATION IN BARORECEPTOR SENSITIVITY PREVENTS GENERALIZED ANXIETY. Alexander Weaver, Jack Summers, Judy Taha, Zak Miklja, Warren Lockette. Division of Endocrinology, Wayne State University School of Medicine, Detroit, MI.

Key words: anxiety, baroreceptors, cardiovascular disease, PIEZO 1, humans, instantaneous baroreceptor sensitivity

BACKGROUND

We reported ex vivo measurements of PIEZO 1 channel activity in erythrocytes can predict those individuals with high levels of generalized anxiety. Because PIEZO 1 channels are expressed in cardiac baroreceptors, we next tested our hypothesis that contrasts in generalized anxiety in the population could be due to individual differences in PIEZO 1-dependent instantaneous baroreceptor sensitivity.

METHODS

Thirteen …

Economic Perspectives On Medical Training: A Specialty-Level Break-Even Analysis For Wayne Trained Physicians, Michael Niculcea, Joseph Kunnappilly, Isaak Miller, Connor Genschaw, Biola Makinde-Odusola

Medical Student Research Symposium

Title:

Economic Perspectives on Medical Training: A Specialty-Level Break-Even Analysis for Wayne Trained Physicians

Michael Niculcea, Joseph Kunnappilly, Isaak Miller, Connor Genschaw, Biola Makinde-Odusola

Background:

U.S. medical students graduate with high educational debt, yet financial literacy remains overlooked in medical school curricula. Trainees enter residency with a limited understanding of how specialty and loan repayment strategies affect long-term finances. Break-even analysis, which identifies when total revenue exactly offsets total costs, can help students at Wayne State University School of Medicine (WSUSOM) better visualize the factors shaping their financial futures.

Methods:

This analysis assumes 4 years of medical school financed entirely …

Impact Of Dietician Counseling On Outcomes In Newly Diagnosed Celiac Disease, Andreas Mozny B.A., Alyusuf Elnaggar B.A., James Mo M.D., Suraj Suresh M.D.

Medical Student Research Symposium

Title: Impact of Dietician Counseling on Outcomes in Newly Diagnosed Celiac Disease

Background: Dietician counseling is routinely recommended for newly diagnosed celiac disease (CD), yet its measurable impact is not well defined. This study examined whether early dietician involvement improves clinical symptoms or serologic outcomes.

Methods: We retrospectively reviewed adults with biopsy-confirmed CD at a single center from 2020–2024. Demographics, symptoms, and laboratory data were collected by chart review with ≥6 months of follow-up. Patients who met with a dietician formed the dietician group; all others were assigned to the non-dietician group. Fisher's Exact tests evaluated abdominal …

Promising Efficacy Of Avapritinib In Pdgfra Ecdna–Amplified Glioblastoma, Sydni Rosenfeld, Artem Berezovsky, Indrani Datta, Andrea Transou, Susan Irtenkauf, Laura Hasselbach, Ana C. Decarvalho

Medical Student Research Symposium

Background: Avapritinib, a selective inhibitor of mutated class III receptor tyrosine kinases (RTKs), shows promise in PDGFRA-altered pediatric glioma. We studied its efficacy in a glioblastoma (GBM) model (HF3253) containing two PDGFRA alterations: constitutive activation via an indel mutation and extrachromosomal DNA (ecDNA) amplification. We hypothesized that Avapritinib would preferentially improve survival in PDGFRA-amplified tumors.

Methods: Orthotopic xenografts derived from HF3253 PDGFRA ecDNA(+) (n=19) and ecDNA(-) (n=10) cells were treated with 40 mg/kg Avapritinib (5 days/week). To validate the role of PDGFRA expression, wild-type PDGFRA was overexpressed in ecDNA(-) cells, generating high PDGFRA levels with minimal ligand-independent activation in vivo. …

Speed And Cosmetic Outcomes Of Skin Closure Methods In Head And Neck Surgery: A Network Meta-Analysis Of Randomized Trials, Marcel Addis Jackson, Jacob Nielsen, John Cramer

Medical Student Research Symposium

Background The optimal skin-closure technique in head and neck surgery is uncertain, with sutures, staples, and tissue adhesive (glue) all in common use.

Objective To compare time to skin closure, postoperative scar appearance, overall surgical time, and cost across sutures, staples, and glue in head and neck surgery.

Methods We systematically screened 549 records in Covidence and included prospective randomized controlled trials comparing sutures vs staples, staples vs glue, or glue vs sutures. Eight trials met eligibility; six were pooled and two summarized narratively. A random-effects network meta-analysis (MetaInsight) evaluated two primary outcomes: time to skin closure and scar score …

Enhanced Control Of Central Sleep Apnea With Adjunctive Therapy: Cpap Plus Oxygen And/Or Acetazolamide., Ali J. Mustapha, Maria Fatima, S. Shanker, A. Aldiwaikat, M. Habra, K. Jackson, S. Habra, M. Bawa, A. Moustapha, N. Pandya, S. Gosh, A. Sankari, M.S. Badr

Medical Student Research Symposium

Background: Effective Treatment of central sleep apnea (CSA) remains elusive. CPAP may be an efficacious treatment for CSA, but it rarely eliminates CSA. The purpose of this investigation was to determine the efficacy of adding acetazolamide, low-flow oxygen, or both to CPAP therapy for CSA treatment.

Methods: A controlled, double-blinded, crossover study evaluated the efficacy of acetazolamide, supplemental oxygen, and their combination in reducing sleep-disordered breathing compared with standard PAP therapy. All 82 participants completed full polysomnography under five conditions: (1) Baseline, (2) Baseline PAP, (3) Acetazolamide at 250 mg at bedtime, (4) low-flow Oxygen ( 2-4 L/min), and (5) …

Assessing The Reproductive Potential Of Late Mature Cryopreserved Oocytes, Keri Bergin, Ashna Mehra

Medical Student Research Symposium

Title: Assessing the reproductive potential of late mature cryopreserved oocytes

Authors: Keri Bergin, Ashna Mehra, Rick Slifkin, Morgan Baird, Dmitry Gounko, Carlos Hernandez-Nieto, Joseph Lee, Chelsea Canon, Alan B Copperman, Lucky Sekhon

Background:

Oocytes retrieved at the germinal vesicle (GV) or metaphase I (MI) stage may mature in vitro to MIIs for cryopreservation. Limited data exist on the reproductive potential of late mature MIIs after thaw. This study assesses the thaw, fertilization, and embryo development outcomes of late mature versus immediately mature cryopreserved oocytes.

Methods:

This retrospective cohort study analyzed autologous oocyte cryopreservation cycles with thaws from January 2016 – …

Oct Evidence Supports Oxidative Stress And Retinoid Deficiency But Not Mitochondrial Inefficiency During Healthy Human Aging, Laura Zvinys, Ehimenmen Ataman, Sukhanjit Kaur, Saleh Ahmed, Madelyn Moretti, Megan Johnson, James Soetedjo, Harman Bindra, Emmaline O'Neil, Rida Waseem, Yannick Liermann, Sarah Thiele, Bruce Berkowitz Phd

Medical Student Research Symposium

Background: To test for evidence of macula oxidative stress, impaired retinoid handling, and/or photoreceptor energy inefficiencies during healthy human aging as measured by next-generation OCT biomarkers.

Methods: OCT was used to examine light-adapted 20-30 and 70-90-year-old, male and female subjects without overt ophthalmologic disease. Two biomarkers were measured: 1) external limiting membrane (ELM) to retinal pigment epithelium (RPE) contraction, which can arise from oxidative stress-induced acidosis and is concordant with impaired spatial distribution of 11-cis retinal chaperone retinal binding protein 3, and 2) the sub-ELM hyperreflective band profile shape, or Mitochondria Configuration within Photoreceptor inner segments measured with …

Twice As Long, Half The Risk: Piccs Outperform Cvcs In Pediatric Burn Patients, Christian Hudson-Bradford Md, Megan Zacarias Bs, Samantha Carranza Bs, Elika Ridelman Phd, Christina Shanti Md

Medical Student Research Symposium

Title: Twice as Long, Half the Risk: PICCs Outperform CVCs in Burn Patient

Christian Hudson-Bradford MD, Megan Zacarias BS, Elika Ridelman PhD, Samantha Carranza BS, Christina Shanti MD

Background: Venous access is critical in burn care for fluid resuscitation, medication delivery, and nutritional support. While central venous catheters (CVCs) are traditionally used, peripherally inserted central catheters (PICCs) offer an alternative option with a potentially favorable safety profile, longer dwell time, and reduced need for re-insertion. This study compares patient characteristics, complication rates, and catheter duration between PICC and CVC lines in pediatric burn patients, advocating for early PICC …

Comparison Of Non-Invasive Methods For Measuring Intracranial Hypertension, Danielle Santoyo, B.S., Eric Mylfurry, B.S., Marilyn Li, B.S., Matthew Mellor, B.S., Mercylia Untono, B.S., Urva Mehveen, B.S., Hari Ramakrishnan, B.S., James Paxton, M.D., M.B.A.

Medical Student Research Symposium

Introduction and Purpose of Review:

Intracranial hypertension (IHTN) is a serious complication associated with neurological injuries. Once IHTN is detected, it is crucial to make swift decisions regarding medical treatments. This review focuses on the effectiveness and utility of noninvasive methods used to detect IHTN in the emergency department (ED).

Methods:

We conducted a comprehensive search for PubMed articles to find data on non-invasive intracranial pressure (ICP) evaluation methods including; optic nerve sheath diameter ultrasound (ONSS), automated infrared pupillometry (AIP), Tympanic Membrane Displacement (TMD), Transcranial Doppler Ultrasound (TDU), CT, and MRI. We compared; cost, accuracy, estimated time per method, specificity …

Indocyanine Green Focused Near-Infrared Fluorescence Lymphography Localization In Treatment Of Chyle Leak After Mastectomy With Targeted Left Axillary Sentinel Node Biopsy For Breast Cancer., Bradley C Kruithoff, Dawn Cox, Mark Cripe

Women’s Health Articles

We present a woman in her 60s who underwent bilateral mastectomy with left axillary targeted lymph node biopsy in the setting of high grade invasive ductal carcinoma of the left breast with metastasis to a left axillary lymph node. Her postoperative course was complicated by high output milky drainage from her left axillary surgical drain, consistent with a chyle leak, after confirmatory testing demonstrated drain fluid with high triglyceride content. The patient failed non-operative management consisting of low-fat diet and compressive measures. Ultimately, the patient returned to the operating room where indocyanine green near-infrared fluorescence lymphography was used to localized …

Electronic Research Notebooks And Partnership Checklists: Fostering Cultured Collaboration In Evidence Synthesis Projects Using Labarchives And Swirl-Sr, Gary Kaplan, Mslis, Ahip, Abby Adamczyk, Mlis, Ahip, Emmett Booth, Mlis, Ahip, Stephanie Roth, Mlis, Ahip

Academic Commons and Scott Memorial Library Staff Papers and Presentations

Background

Librarians providing evidence synthesis services often face project management challenges, from tracking progress on search strategy development to clarifying team roles. Librarians have a variety of tools to address these challenges.¹ We propose using electronic lab notebooks (ELNs), which standardize how scientists record research progress. Institutions have adapted ELNs to protect intellectual property and improve rigor and reproducibility.

Although many published systematic reviews report following guidelines such as PRISMA, they still lack rigor and reproducibility.² Therefore, one of the authors developed the Standards for Working with Research Librarians-on Systematic Reviews (SWiRL-SR) checklist to facilitate collaboration and improve …

Axitinib-Pembrolizumab And Adverse Event Management In Patients With Advanced Renal Cell Carcinoma, Neil Shah, Yaa Ababio, Anthony Eccleston, Dharanija Rao, Scott Kelly, Jane Chang, Sarah Lucht, Caleb Paydar, Bryce Van Doren, Emily Bland, William John, Sarah Giegerich, Jalyna Laney, Bruce Feinberg, Kevin Zarrabi

Kimmel Cancer Center Faculty Papers

IMPORTANCE: Understanding approaches to managing treatment-related adverse events (AEs) in immunotherapy and tyrosine kinase inhibitor-based treatments in a clinical setting is critical for reaching optimal patient outcomes.

OBJECTIVE: To investigate the management of AEs in community practices during first-line axitinib plus pembrolizumab therapy for advanced renal cell carcinoma (aRCC).

DESIGN, SETTING, AND PARTICIPANTS: This study comprised a cross-sectional electronic physician survey and a multisite, retrospective cohort study of the medical records of US patients with aRCC who initiated first-line axitinib-pembrolizumab between April 22, 2019, and January 31, 2024. Data were analyzed from September 18 to December 20, 2024.

EXPOSURE: First-line …

Titanium Dioxide: An Inquiry Into The Mechanisms And Implications Of Exposure In Gut Dysbiosis And Metabolic Disorders, Meghan Gardiner

Senior Honors Theses

Titanium dioxide (TiO₂) is one of the most prevalent food additives utilized in commercial products in the United States. While TiO₂ was originally hailed as a nontoxic and cost-effective additive, studies are beginning to reveal that TiO₂ is not as safe as it once seemed. TiO₂ may contribute to the development of insulin resistance and metabolic disorders through direct and indirect mechanisms. The compound induces gut dysbiosis, leading to alterations in bacterial metabolites and pro-inflammatory cytokines, which results in the selective resistance of glucocorticoid receptors. Additionally, TiO₂ itself can translocate from the gut to …

Co-Occurring Clonal Hematopoiesis Exhibits Strong Selection And High Leukemia Risk, Kara M Barnao, Aubrey K Hubbard, Irenaeus C C Chan, Weiyin Zhou, Yasminka A Jakubek, Giulio Genovese, Wendy S W Wong, Rebecca L Kelly, Corey D Young, Derek W Brown, Wen-Yi Huang, Neal D Freedman, Kristine Jones, Amy Hutchinson, Belynda Hicks, Duc Tran, Donna Arnett, Kathleen C Barnes, Joshua C Bis, Eric Boerwinkle, Jennifer A Brody, April P Carson, Daniel I Chasman, Michael H Cho, Pinkal Desai, Margaret F Doyle, Myriam Fornage, Xiuqing Guo, Nancy Heard-Costa, Marguerite Ryan Irvin, Andrew D Johnson, Sharon L R Kardia, Charles Kooperberg, Daniel Levy, Joshua P Lewis, Yun Li, Ruth J F Loos, Taralynn M Mack, Rasika A Mathias, Braxton D Mitchell, Kari E North, Nathan Pankratz, Patricia A Peyser, Michael H Preuss, Bruce M Psaty, Laura M Raffield, Susan Redline, Stephen S Rich, Jerome I Rotter, Edwin K Silverman, Albert V Smith, Jennifer A Smith, Adrienne Stilp, Yin Cao, Paul Scheet, Alexander P Reiner, Alexander G Bick, Stephen J Chanock, Paul L Auer, Kelly L Bolton, Mitchell J Machiela

Faculty, Staff and Student Publications

Clonal hematopoiesis of indeterminate potential (CHIP) and mosaic chromosomal alterations (mCAs) are two types of clonal hematopoiesis (CH) associated with hematological parameters and malignancy risk. Here we show, in genomic data from 546,090 biobank participants, that co-occurring CH (≥2 CH mutations detected) is present in 1.6% of cancer-free individuals and shows strong evidence for selection (up to 804x enrichment). Co-occurrence is more frequent in those with a prior cancer (3.6%), suggesting treatment-induced selection. Acquisition of CHIP usually precedes mCAs with co-occurrences manifesting stronger phenotypic disruptions in telomere attrition and hematologic parameters than component CH events. Individuals with co-occurring CH have …

In-Use Stability And Device Compatibility Define Clinically Actionable Handling Limits For A Gmp-Produced Attenuated Listeria Monocytogenes Vaccine Expressing Gucy2c, Jagmohan Singh, Taranjot Johar, Vannessa Scully, Scott A. Waldman, Babar Bashir, Adam E. Snook

Department of Pharmacology, Physiology, and Cancer Biology Faculty Papers

Background: Live-attenuated Listeria monocytogenes (Lm) vectors are a clinically validated cancer immunotherapy platform, but translation requires reproducible, clinically realistic workflows for dose preparation and infusion. For live bacterial products, in-use stability and device compatibility can drive dose variability through adsorption, settling, and device losses. Methods: We developed and GMP-manufactured an attenuated Lm vaccine expressing human GUCY2C (Lm-GUCY2C) and performed translational characterization, including construct verification and immunogenicity readouts, and defined the administration-focused in-use stability and device compatibility. Post-thaw stability was assessed in primary cryovials and during preparation and delivery from 250 mL saline infusion bags using standard clinical devices (syringes/needles, filter-free …

Using The Socio-Ecological Model To Explore Parents' Resilience And Perceptions Of Adverse Childhood Experiences: A Qualitative Study In The Southeastern United States, Maribel G Dominguez, Christine Markham, Andrew E Springer, Louis D Brown

Faculty, Staff and Student Publications

Background: The negative impact of adverse childhood experiences (ACEs) on child development is documented. The parent-child relationship protects against ACEs and improves healthy child development, playing a crucial role in preventing and mitigating ACEs by strengthening parental resilience. However, there is a gap in the literature on our understanding of parental resilience's impact on the parent-child relationship within the social-ecological model (SEM) (i.e., intra- and interpersonal, community, and societal levels). Objective: This study explores parents' perspectives on parental resilience as a protective factor for preventing and mitigating ACEs at every level of the SEM. Method: This study uses a thematic …

A Soft Diet Attenuates Exercise-Induced Increases In Cortical Bone Density And Formation In Long Bones In Growing Mice, Yasuhiro Shimizu, Fatma Rashed, Huan Cao, Yuki Arai, Takashi Ono, Kazuhiro Aoki

Faculty, Staff and Student Publications

Bone and muscle are closely linked through functional interdependence. Training and regular exercise can improve and maintain optimal bone mass and strength. Here, we investigated the effects of exercise combined with soft versus hard diet (pellet) on long bones in mice. Four groups of male C57BL/6J mice (n = 5 per group) were studied: hard diet (pellet) with exercise, soft diet (powdered) with exercise, hard diet (pellet) without exercise, and soft diet (powdered) without exercise. Femur and tibia were analyzed using radiographic, micro-CT, and histomorphometric techniques. Exercise combined with a hard diet significantly increased cortical bone density, mineral apposition rate, …

Childcare Challenges Among Surgical Trainees And Faculty: A Single-Institution Study, Emma G Burke, Sarah Peiffer, Melissa Koci, Lindsay Dean, Kristy L Rialon, Michele Loor, Alice King

Faculty, Staff and Students Publications

Background: Previous studies have demonstrated the challenges of parenthood in surgical training and careers. However, certain aspects of childrearing for surgeons remain understudied. We aim to leftacterize the complexity and costs of childcare amongst surgical trainees and faculty.

Methods: An anonymous, self-administered survey was conducted within the Department of Surgery at a large academic medical center. Both male and female trainees and faculty were included in the analysis. Chi-square or Fisher's Exact test was performed.

Results: Forty-six respondents provided information about childcare costs, with 37% of respondents being residents or fellows. Trainees worked longer workhours (p = 0.003) than their …

Circulating Metabolites Associated With Protection Against Mycobacterium Tuberculosis Infection And Inhibition Of Mycobacterial Growth, Todia P Setiabudiawan, Lika Apriani, Julian Avila-Pacheco, Edwin Ardiansyah, Vinod Kumar, Bachti Alisjahbana, Ayesha J Verrall, Andrew R Dinardo, Agnes R Indrati, Vera P Mourits, L Charlotte J De Bree, Simone J C F M Moorlag, Clary B Clish, Leo A B Joosten, Arjan Van Laarhoven, Krista E Van Meijgaarden, Mihai G Netea, Simone A Joosten, Valerie A C M Koeken, Philip C Hill, Reinout Van Crevel

Faculty, Staff and Students Publications

A significant proportion of individuals who are heavily exposed to infectious tuberculosis patients do not acquire Mycobacterium tuberculosis (Mtb) infection, as detected by an interferon gamma release assay (IGRA). We examined circulating metabolite profiles and metabolic genotypes in 199 heavily exposed IGRA-negative tuberculosis household contacts in Indonesia. Based on differentially abundant metabolites, activity of several pathways including arachidonic acid, arginine and proline, glutathione, and tryptophan metabolism, correlated with a negative IGRA at three months. SNPs near PRODH (involved in arginine and proline metabolism) were associated with circulating proline concentrations and persistently negative IGRA results, while SNPstudys near AFMID (involved in …