Medicine and Health Sciences Commons^™

Brain Hubs Defined In The Group Do Not Overlap With Regions Of High Inter-Individual Variability, Derek M Smith, Brian T Kraus, Ally Dworetsky, Evan M Gordon, Caterina Gratton

2020-Current year OA Pubs

Connector 'hubs' are brain regions with links to multiple networks. These regions are hypothesized to play a critical role in brain function. While hubs are often identified based on group-average functional magnetic resonance imaging (fMRI) data, there is considerable inter-subject variation in the functional connectivity profiles of the brain, especially in association regions where hubs tend to be located. Here we investigated how group hubs are related to locations of inter-individual variability. To answer this question, we examined inter-individual variation at group-level hubs in both the Midnight Scan Club and Human Connectome Project datasets. The top group hubs defined based …

Impact Of Geroscience On Therapeutic Strategies For Older Adults With Cardiovascular Disease: Jacc Scientific Statement, Daniel E Forman, George A Kuchel, John C Newman, James L Kirkland, Elena Volpi, George E Taffet, Nir Barzilai, Ambarish Pandey, Dalane W Kitzman, Peter Libby, Luigi Ferrucci

Faculty, Staff and Students Publications

Geroscience posits that cardiovascular disease (CVD) and other chronic diseases result from progressive erosion of the effectiveness of homeostatic mechanisms that oppose age-related accumulation of molecular damage. This hypothetical common root to chronic diseases explains why patients with CVD are often affected by multimorbidity and frailty and why older age negatively affects CVD prognosis and treatment response. Gerotherapeutics enhance resilience mechanisms that counter age-related molecular damage to prevent chronic diseases, frailty, and disability, thereby extending healthspan. Here, we describe the main resilience mechanisms of mammalian aging, with a focus on how they can affect CVD pathophysiology. We next present novel …

Insight Into The Mechanism Of H+-Coupled Nucleobase Transport, Jun Weng, Xiaoming Zhou, Pattama Wiriyasermkul, Zhenning Ren, Kehan Chen, Eva Gil-Iturbe, Ming Zhou, Matthias Quick

Faculty, Staff and Students Publications

The nucleobase/ascorbic acid transporter (NAT) family comprises proteins in all kingdoms of life. Their substrates, nucleobases and their analogs, have special attention in therapeutic applications, such as the treatment of solid tumors, lymphoproliferative diseases, viral infections, and inflammatory diseases. Here, we present the crystal structure of a bacterial NAT member, PurT of Colwellia psychrerythraea (PurTCp) at 2.80 Å resolution that, together with functional data, provide insight into the transport mechanism of NAT family members.

Oleoylethanolamide Facilitates Pparα And Tfeb Signaling And Attenuates Aβ Pathology In A Mouse Model Of Alzheimer’S Disease, Michele M Comerota, Manasee Gedam, Wen Xiong, Feng Jin, Lisheng Deng, Meng C Wang, Jin Wang, Hui Zheng

Faculty, Staff and Students Publications

BACKGROUND: Age is the strongest risk factor for the development of Alzheimer's disease (AD). Besides the pathological hallmarks of β-amyloid (Aβ) plaques and neurofibrillary tangles, emerging evidence demonstrates a critical role of microglia and neuroinflammation in AD pathogenesis. Oleoylethanolamide (OEA) is an endogenous lipid amide that has been shown to promote lifespan and healthspan in C. elegans through regulation of lysosome-to-nucleus signaling and cellular metabolism. The goal of our study was to determine the role of OEA in the mediation of microglial activity and AD pathology using its stable analog, KDS-5104.

METHODS: We used primary microglial cultures and genetic and …

Spatial Organization Of The Mouse Retina At Single Cell Resolution By Merfish, Jongsu Choi, Jin Li, Salma Ferdous, Qingnan Liang, Jeffrey R Moffitt, Rui Chen

Faculty, Staff and Students Publications

The visual signal processing in the retina requires the precise organization of diverse neuronal types working in concert. While single-cell omics studies have identified more than 120 different neuronal subtypes in the mouse retina, little is known about their spatial organization. Here, we generated the single-cell spatial atlas of the mouse retina using multiplexed error-robust fluorescence in situ hybridization (MERFISH). We profiled over 390,000 cells and identified all major cell types and nearly all subtypes through the integration with reference single-cell RNA sequencing (scRNA-seq) data. Our spatial atlas allowed simultaneous examination of nearly all cell subtypes in the retina, revealing …

Infectious Profiles In Pediatric Anti-N-Methyl-D-Aspartate Receptor Encephalitis, Alexander J Sandweiss, Timothy A Erickson, Yike Jiang, Varun Kannan, Jonathan M Yarimi, Jesse M Levine, Kristen Fisher, Eyal Muscal, Gail Demmler-Harrison, Kristy O Murray, Shannon E Ronca

Faculty, Staff and Students Publications

Anti-N-methyl-d-aspartate receptor autoimmune encephalitis (NMDAR AE) is an antibody-mediated neurological disorder that may be caused by post-herpes simplex virus-1 meningoencephalitis (HSV ME) and ovarian teratomas, although most pediatric cases are idiopathic. We sought to evaluate if other infections precede NMDAR AE by conducting a single-center, retrospective, case-control study of 86 pediatric cases presenting to Texas Children's Hospital between 2006 and 2022. HSV ME (HSV-1 and HSV-2) was a significantly more common preceding infection in the experimental group compared to control patients with idiopathic intracranial hypertension, while there was no difference in remote HSV infection between the two groups. Recent Epstein-Barr …

A Multiparameter Molecular Classifier To Predict Response To Neoadjuvant Lapatinib Plus Trastuzumab Without Chemotherapy In Her2+ Breast Cancer, Jamunarani Veeraraghavan, Carolina Gutierrez, Carmine De Angelis, Robert Davis, Tao Wang, Tomas Pascual, Pier Selenica, Katherine Sanchez, Hiroaki Nitta, Monesh Kapadia, Anne C Pavlick, Patricia Galvan, Brent Rexer, Andres Forero-Torres, Rita Nanda, Anna M Storniolo, Ian E Krop, Matthew P Goetz, Julie R Nangia, Antonio C Wolff, Britta Weigelt, Jorge S Reis-Filho, Susan G Hilsenbeck, Aleix Prat, C Kent Osborne, Rachel Schiff, Mothaffar F Rimawi

Faculty, Staff and Student Publications

PURPOSE: Clinical trials reported 25% to 30% pathologic complete response (pCR) rates in HER2+ patients with breast cancer treated with anti-HER2 therapies without chemotherapy. We hypothesize that a multiparameter classifier can identify patients with HER2-"addicted" tumors who may benefit from a chemotherapy-sparing strategy.

EXPERIMENTAL DESIGN: Baseline HER2+ breast cancer specimens from the TBCRC023 and PAMELA trials, which included neoadjuvant treatment with lapatinib and trastuzumab, were used. In the case of estrogen receptor-positive (ER+) tumors, endocrine therapy was also administered. HER2 protein and gene amplification (ratio), HER2-enriched (HER2-E), and PIK3CA mutation status were assessed by dual gene protein assay (GPA), research-based …

Risk-Adapted Treatment Strategies With Pre-Irradiation Chemotherapy In Pediatric Medulloblastoma: Outcomes From The Polish Pediatric Neuro-Oncology Group, Marta Perek-Polnik, Anne Cochrane, Jinli Wang, Marzanna Chojnacka, Monika Drogosiewicz, Iwona Filipek, Ewa Swieszkowska, Magdalena Tarasinska, Wiesława Grajkowska, Joanna Trubicka, Paweł Kowalczyk, Bożenna Dembowska-Bagińskai, Mohamed S Abdelbaki

2020-Current year OA Pubs

Craniospinal irradiation (CSI) has been a major component of the standard of care treatment backbone for childhood medulloblastoma. However, chemotherapy regimens have varied based on protocol, patient age, and molecular subtyping. In one of the largest studies to date, we analyzed treatment outcomes in children with newly-diagnosed medulloblastoma treated with pre-irradiation chemotherapy followed by risk-adapted radiotherapy and maintenance chemotherapy. A total of 153 patients from the Polish Pediatric Neuro-Oncology Group were included in the analysis. The median age at diagnosis was 8.0 years, and median follow-up time was 6.4 years. Sixty-seven patients were classified as standard-risk and eighty-six as high-risk. …

Discovery And Targeting Of A Noncanonical Mechanism Of Sarcoma Resistance To Adi-Peg20 Mediated By The Microenvironment, Leonard C Rogers, Jeff C Kremer, Caitlyn B Brashears, Zongtao Lin, Alliny C S Bastos, Adriana Baker, Nicole Fettig, Dong Zhou, Kooresh I Shoghi, Carina A Dehner, John S A Chrisinger, Benjamin A Garcia, Toshinao Oyama, Brian A Van Tine, Et Al.

2020-Current year OA Pubs

PURPOSE: Many cancers lack argininosuccinate synthetase 1 (ASS1), the rate-limiting enzyme of arginine biosynthesis. This deficiency causes arginine auxotrophy, targetable by extracellular arginine-degrading enzymes such as ADI-PEG20. Long-term tumor resistance has thus far been attributed solely to ASS1 reexpression. This study examines the role of ASS1 silencing on tumor growth and initiation and identifies a noncanonical mechanism of resistance, aiming to improve clinical responses to ADI-PEG20.

EXPERIMENTAL DESIGN: Tumor initiation and growth rates were measured for a spontaneous Ass1 knockout (KO) murine sarcoma model. Tumor cell lines were generated, and resistance to arginine deprivation therapy was studied in vitro and …

Assessing Pharmacists' Knowledge Of Drugs' Dialyzability In Four Health Institutions In Al-Najaf, Iraq, Zahraa Saad Oufi, Ihsan Salah Rabeea

Maaen Journal for Medical Sciences

Background: Drugs' dialyzability is the degree to which a drug is filtered out of the blood stream during dialysis. This process is influenced by various factors, including properties of the drug and dialysis procedure. As drug experts, pharmacists must pay close attention to drugs' dialyzability when counseling patients on medications to ensure that therapeutic drug concentrations are maintained in the patient's body.
Aim: This study aimed to assess the knowledge of pharmacists working in dialysis centers or hospitals with dialysis wards regarding drugs' dialyzability.
Methodology: A descriptive cross-sectional study was conducted in November 2022. A three-section questionnaire was developed and …

Potential Benefits And Challenges Of Chatgpt In Future Nursing Education, Ahmed Lateef Alkhaqani

Maaen Journal for Medical Sciences

ChatGPT is a language model that has the potential to revolutionize nursing education and research by making it a quick and time-efficient process. This article highlights the challenges and opportunities this technology presents to nursing and health science education, including concerns around academic integrity and privacy and the need for educators to adapt quickly to ensure staff training and comprehensive policies are in place. Furthermore, educators and educational institutions firmly oppose the utilization of ChatGPT, perceiving its application as a direct menace to academic honesty, which might have an impact on academic, educational, and public well-being.

Advanced Mesoporous Silica Nanoparticles: Synthesis, Characteristics And Applications, Asmaa Abdelaziz Mohamed, Marwa Malik Kamil, Firas Aziz Rahi, Noor Zuhair Kbah

Maaen Journal for Medical Sciences

Recent breakthroughs in pharmaceutical delivery methods employing a range of carriers have radically transformed modern diagnostic and therapeutic practices. Mesoporous silica nanoparticles (MSNs) were created due to the demand for substances with superior thermal and chemical capabilities. These ordered porous substances have generated a lot of interest as carriers due to their distinct advantages over the competition. They may be made economically using a simple process. Moreover, the shape, pore size, and particle size may all be changed by modifying the synthesis's conditions. Investigations on MSNs as drug carriers have reportedly accelerated in recent years, highlighting the potential benefits of …

Court Decisions Demonstrate Need For Public Health Economy: A Position Statement Of Public Health Liberation, Christopher Williams, Public Health Liberation Board Of Directors

Advances in Clinical Medical Research and Healthcare Delivery

The recent decisions of the Supreme Court of the United States have major implications for public health. The position statement of Public Health Liberation, a membership nonprofit, underscores the importance of a disciplinary shift in public health toward study and effectuation of the Public Health Economy.

Severe Covid-19 Following Rituximab And Nirmatrelvir/Ritonavir Treatment In A Patient With Mctd, Case Report, Rohail A. Baig, Faieja Chowdhury, Omar Siddiqui, Adnaan Sheikh, Varun Mehta, Pranjali Dakwale

Advances in Clinical Medical Research and Healthcare Delivery

This is an article about how the use of medications such as nirmatrelvir/ritonavir can cause rebound COVID-19 and how the use of Rituximab, a biologic agent, can prolong the duration and increase severity of symptoms of COVID-19 in patients with pre-disposed autoimmune diseases that are on chronic pharmacotherapy.

Bi-Atrial Thrombus Via Patent Foramen Ovale With Medical Noncompliance: A Case Report, Reid Mccullough, Ayesha Cheema, Owesh Contractor, Krystal Tomsky-Jackson

Advances in Clinical Medical Research and Healthcare Delivery

Numerous diagnoses in the hospital setting require anticoagulation. With different etiologies, certain specific assessments may not have a treatment plan that is studied extensively in evidence-based medical texts. In these uncommon situations, management may not have clear medical guidelines for successful treatment. We present a case of bi-atrial thrombus via PFO with concurrent pulmonary embolism, extensive clot burden history, and the plan to move forward with Angiovac. In patients with this specific history and pathology, modern procedures like Angiovac should be considered and discussed.

Encephalopathy Tango: When Beta-Lactam Antibiotics Waltz With Gaba Receptor, Ali Mohamed, Nagesh Jadhav, Mohamed Elbathani, Abubaker Farah

Advances in Clinical Medical Research and Healthcare Delivery

Beta-lactam antibiotics are a class of drugs that are widely used to treat a variety of infections. They are generally well-tolerated, but they can cause a variety of side effects, including allergic reactions, acute interstitial nephritis (AIN) and neurotoxicity.

We present a patient who developed neurotoxicity after being treated with cephalosporin and carbapenem antibiotics. A 76-year-old female was admitted to the hospital with osteomyelitis of the right foot. She was initially treated with cefepime and daptomycin. She was discharged and then began to experience delirium with visual hallucinations and acute kidney injury. After common causes of confusion were excluded, the …

Stiff Person Syndrome: A Rare Presentation Of A Rare Disorder, Muhammad Hammad Sharif, Basil George Verghese

Advances in Clinical Medical Research and Healthcare Delivery

Stiff Person Syndrome (SPS) is a rare autoimmune disease that is caused by the lack of inhibition to excitatory neurotransmitters in the central nervous system (CNS) which then leads to inappropriate and excessive motor unit firing causing stiffness, a characteristic feature of the disease. SPS has an incidence of one case in a million and occurs in the middle-aged population with a female predominance. SPS mostly occurs in the background of autoimmune disorders like type 1 diabetes, thyroid disorders, pernicious anemia, and less often, vitiligo. The pathophysiology is not completely understood; however, there is a strong correlation between high …

Persistent Foci Of Infection: A Case Of Two Mycotic Aneurysms Separated In Time In A Patient With Infective E. Faecalis Endocarditis, Julia C. Stone, Joel Thompson, Joseph Hatem, Evan Basha

Advances in Clinical Medical Research and Healthcare Delivery

This is a case report of a patient who presented with mycotic aneurysms of two different blood vessels at separate hospital visits following a diagnosis of infective endocarditis.

Cystic Fibrosis - An Ever Evolving Challenge, Abdullah A. Orakzai, Osama Sherjeel Khan, Syeda Sarah Raza, Muhammad H. Sharif, Mehr A. Orakzai

Advances in Clinical Medical Research and Healthcare Delivery

Cystic fibrosis (CF) is a genetic disease that results from mutations in a large single gene located on chromosome 7. More than 2000 different mutations in the gene have been identified to have caused the disease. Most of these mutations are exceedingly rare and therefore not a part of CF screening or all testing panels. This case discusses an adult female with a history of asthma, bronchiectasis, pseudomonas colonization, and respiratory failure on chronic oxygen who presented to the ED with sudden onset shortness of breath, fever, chills, body aches, nonproductive cough, and headache. The patient's condition clinically improved with …

Pseudo-Wellens Syndrome: A Rare Entity Associated With Cocaine Use, Mohamed Salah Mohamed, Syed Hamza Waheed, Amir Mahmoud, Anas Hashem, Bipul Baibhav, Abdullah M. Firoze Ahmed

Advances in Clinical Medical Research and Healthcare Delivery

Wellens syndrome usually indicates critical left anterior descending artery (LAD) occlusion. Pseudo-Wellens syndrome consists of criteria of Wellens syndrome in the absence of critical LAD occlusion. We report a case of Pseudo-Wellens syndrome related to cocaine use. A 52-year-old male with a medical history of hypertension and diabetes, presented with acute retrosternal chest pain of 3 days duration. Physical examination was unremarkable. EKG on presentation showed deep T-wave inversions in leads V2 to V5. Highly sensitive troponin was elevated. The patient admitted to using cocaine daily for the past two months. Due to concerns for Wellens syndrome, the patient had …

Hydroxychloroquine Induced Cardiomyopathy, Mohamed Salah Mohamed, Katrina Wojciechowski, Scott Feitell, Muhammad Osama, Anas Hashem, Jayesh Patel, Amir Mahmoud, Ali Abdelhay, Prakash Upreti, Soidjon Khodjaev

Advances in Clinical Medical Research and Healthcare Delivery

Hydroxychloroquine (HCQ) is one of the immunomodulatory medications used in treatment of autoimmune diseases. Rarely, HCQ can cause serious complications, such as cardiotoxicity. We present a rare case of HCQ-induced cardiomyopathy. 60-year-old female patient with a medical history of SLE on chronic HCQ therapy for 28 years, preexisting non-ischemic cardiomyopathy and heart failure with reduced ejection fraction for 7 years, and complete heart block status post pacemaker insertion presented with acute chest pain and severe weight loss. Patient underwent coronary angiogram that showed normal coronaries and right-sided heart catheterization that showed acute heart failure. Echocardiogram showed LVEF of 30% with …

Non-Histaminergic Angioedema Following Infection With Covid-19, Sheza Malik, Basil George Verghese, S Shahzad Mustafa

Advances in Clinical Medical Research and Healthcare Delivery

Non-respiratory manifestations of COVID-19, including dermatological manifestations, have been reported, and although urticaria associated with COVID-19 has been reported, there have been no reports of non-histaminergic angioedema following infection with mild COVID-19. Non-histaminergic angioedema has a gradual onset and is characterized by submucosal swelling without accompanying urticaria or pruritus, and poor response to antihistamines and corticosteroids. We report a case of non-histaminergic angioedema in a 29-year-old woman with a history of mild COVID-19 infection. Our case highlights the fact that early diagnosis of non-histaminergic angioedema in mild COVID-19 patients is crucial for effective treatment and requires a high level of …

Median Arcuate Ligament Syndrome: A Rare Cause Of Abdominal Pain That Is Difficult To Identify, Mark E. Eskander, Matthew Thrall, Joel P. Thompson

Advances in Clinical Medical Research and Healthcare Delivery

Median arcuate ligament syndrome (MALS) is a rare disease that occurs when the celiac artery is compressed by the median arcuate ligament. Patients with MALS typically present with non-specific symptoms that overlap with more common diseases. As a result, patients may undergo extensive workup and unnecessary treatments before being properly diagnosed with MALS. In this case we present a 23-year-old female with chronic postprandial abdominal pain that persisted despite undergoing a cholecystectomy. This case highlights the symptoms and imaging findings needed to diagnose MALS and thus prevent unnecessary surgical interventions.

Stimulant Medication Use In Children/Adolescent Athletes With Adhd Reduce The Recovery Time Of Concussions And Traumatic Brain Injury, Matthew Lee

Master of Science in Physician Assistant Studies Capstone Presentations (Center City)

Introduction

• Concussions and TBIs are well-known injuries occurring 30-50 million times a year worldwide and are commonly seen in sports.¹ The majority of TBIs are mild yet still have the potential to cause lifelong detrimental effects.
• Short- and long-term complications include difficulty thinking, difficulty concentrating, changes in emotions and personality, decreased memory and sensation, and may lead to depression and dementia.²
• Especially in children and adolescents who are undergoing brain development.
• There are no known prophylactic medications, however, some studies have indicated that sympathomimetic drugs, MPH, may be neuroprotective in the setting of TBIs.
• The purpose of this …

Impact Of Mental Health Boarding In The Emergency Department And Recommendations On How We Can Improve, Kyra Buettner

Master of Science in Physician Assistant Studies Capstone Presentations (Center City)

Introduction

Every year in the United States there is an estimated 2 million adolescents who experience suicidal ideation or attempt suicide.¹ The shortage of behavioral and mental health professionals has led to an increase in emergency department (ED) visits. “Boarding” is defined as “the practice of holding patients in the ED or another temporary location after the decision to admit or transfer has been made.²” The purpose of this study is to evaluate the following question - in adolescent patients with suicide attempt or mental health crisis, does boarding in the ED result in poorer mental health …

Role Of Suction-Based Airway Clearance Devices In Pediatric Foreign Body Airway Obstruction, Rebecca Braver

Master of Science in Physician Assistant Studies Capstone Presentations (Center City)

Introduction

• Foreign body airway obstruction (FBAO) represents a significant cause of morbidity and mortality in the pediatric population. Factors including pediatric anatomy, chewing and swallowing difficulties, developmental stages, habits and behaviors, and children’s toys and foods increase risk of FBAO in children.^1,2
• BLS guidelines for FBAO management in responsive children ages 1-8 call for a series of subdiaphragmatic abdominal thrusts, which increase intrathoracic pressure to force air and the foreign body out of the airway.^3,4 Abdominal thrusts have higher reports of injury compared to all other FBAO interventions, with risk of thoracic, vascular, and gastro-esophageal injury.^5-7
• Novel …

Electric Field Navigated 1-Hz Rtms For Poststroke Motor Recovery: The E-Fit Randomized Controlled Trial, Dylan J. Edwards, Charle Y. Liu, Kari Dunning, Felipe Fregni, Jarmo Laine, Benjamin E. Leiby, Lynn M. Rogers, Richard L. Harvey

Moss-Magee Rehabilitation Papers

BACKGROUND: To determine if low-frequency repetitive transcranial magnetic stimulation targeting the primary motor cortex contralateral (M1_CL) to the affected corticospinal tract in patients with hemiparetic stroke augments intensive training–related clinical improvement; an extension of the NICHE trial (Navigated Inhibitory rTMS to Contralesional Hemisphere Trial) using an alternative sham coil.

METHODS: The present E-FIT trial (Electric Field Navigated 1Hz rTMS for Post-stroke Motor Recovery Trial) included 5 of 12 NICHE trial outpatient US rehabilitation centers. The stimulation protocol remained identical (1 Hz repetitive transcranial magnetic stimulation, M1_CL, preceding 60-minute therapy, 18 sessions/6 wks; parallel arm randomized clinical …

The Role Of Repetitive Transcranial Magnetic Stimulation (Rtms) V. Electroconvulsive Therapy (Ect) In Geriatric Depression Treatment: Efficacy & Tolerability, Madeleine Sarro

Master of Science in Physician Assistant Studies Capstone Presentations (Center City)

Background

• Geriatric depression, or depression in a population over the age of 60, is a highly debilitating mental health condition with a prevalence of 25% versus 10% in the general population.^{1, 2} Increasing prevalence is expected in the next 30 years with a rise in the population size for adults over 60 from 12% to 22%.³
• Limiting variables in the treatment of geriatric depression include polypharmacy, intolerable adverse effects, medical comorbidities, drug resistance and atypical symptom presentation.^2-7
• Due to uniformity in underlying pathophysiology, current treatment guidelines for geriatric depression are the same as for the general population. …

Remote Patient Monitoring: Future Directions, Anna Buchanan, Rahul Nadendla

URGENT Matters

No abstract provided.

The Impact Of Intralesional 5-Fluorouracil In The Treatment Of Keloid Scars, Madeline Derham

Master of Science in Physician Assistant Studies Capstone Presentations (Center City)

Background

- The American Academy of Dermatology (AAD) defines a keloid scar as a type of raised scar extending past the initial area of injury¹

- Approximately 10% of the general population affected - significant risk factors include +family history, darker skin tones, mechanism of injury (burn, surgical)³

- Symptom presentation: pain, pruritus, burning, increased sensitivity³

- Varying existing treatment methods with high resistance and recurrence rates leading to no agreed upon standard approach⁵

• Most widely adopted method currently : intralesional (ILS) steroid ^injection5