Medicine and Health Sciences Commons^™

A Retrospective Quantitative Comparison Of Auto-Planning Vs. Manual-Planning For Large Breast Patients, Olivia R. Smiley

Masters Projects

Breast cancer is the most prevalent cancer among women in the United States, with many patients undergoing whole breast irradiation (WBI) following lumpectomy. Dosimetrists face challenges in planning WBI for patients with large breasts due to issues related to hotspots, dose uniformity, and extended planning times. Auto-planning tools like EZFluence, which use artificial intelligence, offer potential improvements in planning efficiency and dose distribution. This retrospective quantitative study compares auto-planning using EZFluence with manual planning for 10 large breast patients, aiming to reduce hotspots, achieve a more homogeneous dose, minimize doses to organs at risk (OARs), reduce monitor units (MUs), and …

Risk Factors Associated With Pyogenic Spinal Infections Among Intravenous Drug Users And Nonusers, Vivek Biololikar, Brendan Gleason, Lee Kripke, Robert Merrill, Colin Whitaker, Jon Handal

Einstein Health Papers

PURPOSE: To identify the differences in patient factors, presentation, treatment course, and outcomes of intravenous drug users (IVDA) vs. nonusers (non-IVDA) presenting with pyogenic spinal infections.

METHODS: We identified all cases involving spinal infections at our institution between May 2017 and January 2023. Postsurgical infections were excluded, and patients were separated into IVDA and non-IVDA groups. The patient charts were reviewed and analyzed for statistical or clinically significant differences using RStudio (2019 version 3.6.2). Our institutional review board approved this study, IRB# 2020-277, iRISID-2023-1384.

RESULTS: Fifty patients (29 males and 21 females) with primary pyogenic spinal infections were included in …

Impact Of Tumor Pigmentation In 6934 Patients With Uveal Melanoma At A Single Center, Samuel Goldstein, Ferris Bayasi, George Thomas, Matthew Barke, Michael Nguyen, Samantha Pastore, Carol Shields

Wills Eye Hospital Papers

Purpose: To evaluate clinical features and outcomes associated with degree of tumor pigmentation in patients with uveal melanoma (UM) of the choroid and ciliary body. Design: Retrospective observational study. Subjects: Six thousand nine hundred thirty-four consecutive patients with choroidal or ciliary body melanoma between 1971 and 2007 from a single ocular oncology center. Methods: Data on patient demographics, tumor characteristics, treatment approach, and clinical outcomes were collected. Comparisons between pigmented (>80% pigmentation by surface area), partially pigmented (20%–80%), and nonpigmented tumors (<20%) were performed using relevant hypothesis testing. Survival analyses for metastasis and melanoma-related death were conducted using the Kaplan–Meier method with log-rank tests for univariate comparisons. A multivariate Cox regression analysis was performed to assess the independent effects of multiple covariates on time-to-metastasis. Main Outcome Measures: Extraocular extension, ocular melanocytosis, time to tumor recurrence, tumor location, and melanoma-related metastasis and death. Results: There were 6934 eyes with UM and the degree of tumor pigmentation was classified as pigmented (n = 3762; 54%), partially pigmented (n = 2115; 31%), or nonpigmented (n = 1057; 15%). Pigmented UM was associated with extraocular extension (P < 0.001), ocular melanocytosis (P = 0.003), earlier tumor recurrence (P < 0.001), and more anterior tumor epicenter location (ciliary body, and equator to ora serrata) (P < 0.001). Pigmented UMs also exhibited the highest 10-year metastasis rate at 26%, compared with 19% for partially pigmented UMs and 16% for nonpigmented UMs (P < 0.001). Kaplan–Meier survival curves demonstrated differences among the tumor pigmentation groups for melanoma-related metastasis (P < 0.001) and melanoma-related death (P < 0.001). Multivariate Cox regression analysis for melanoma-related metastasis showed that pigmented UMs had a 29% higher relative risk of developing metastasis compared with partially pigmented UMs (P = 0.002) and a 54% higher relative risk of developing metastasis compared with nonpigmented UMs (P < 0.001). Conclusions: Pigmented choroidal and ciliary body melanoma is more often associated with ocular melanocytosis, extraocular extension, anterior tumor epicenter, and earlier tumor recurrence. We also revealed that patients with pigmented UMs demonstrate a higher 10-year rate of metastatic disease and have decreased metastatic survival relative to partially pigmented and nonpigmented UMs. Financial Disclosures: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Selection For Robust Metabolism In Domesticated Yeasts Is Driven By Adaptation To Hsp90 Stress, Natalia Condic, Hatim Amiji, Dipak Patel, William Charles Shropshire, Nejla Ozirmak Lermi, Youssef Sabha, Beryl John, Blake Hanson, Georgios Ioannis Karras

Faculty, Staff and Student Publications

Protein folding both promotes and constrains adaptive evolution. We uncover this surprising duality in the role of the protein-folding chaperone heat shock protein 90 (Hsp90) in maintaining the integrity of yeast metabolism amid proteotoxic stressors within industrial domestication niches. Ethanol disrupts critical Hsp90-dependent metabolic pathways and exerts strong selective pressure for redundant duplications of key genes within these pathways, yielding the classical genomic signatures of beer and bread domestication. This work demonstrates a mechanism of adaptive canalization in an ecology of major economic importance and highlights Hsp90-dependent variation as an important source of phantom heritability in complex traits.

Evaluation Of Patients Admitted To The Hospital With Sepsis, Febrile Neutropenia, Or Pneumonia Following Administration Of Chemotherapy, Abigail Kennedy, Savitri Skandan Md, Dennis Sopka Md, Melissa Kratz Rn, Msn, Aocn

Research Scholars

No abstract provided.

Adherence To Guideline-Based Treatment Of Recurrent C. Difficile Within Lvhn Hospitals, Zoe Tarun, Kathryn Zaffiri Mph, Eric Young Md, Jarrod W. Kile Rphd

Research Scholars

No abstract provided.

Performance Of A Biodegradable Temporary Matrix In Clinical Practice, Kurt Glaeser, Laetitia Roegner, Sigrid A. Blome-Eberwein Md

Research Scholars

No abstract provided.

Retrospective Assessment Of Donor Site Scarring Following Split-Thickness Skin Graft Procedure, Lauren Thomas, Sakura Helm, Sigrid A. Blome-Eberwein Md

Research Scholars

No abstract provided.

Getting Narcan To Post-Partum Patients With Opioid Use Disorder (Oud) At Time Of Discharge, Joshua Raggi, Courtney Boyle Do, Katelin Kimler Pharmd, Kay Young Msn, Rnc-Ob

Research Scholars

No abstract provided.

Satisfaction Survey Of Living Kidney Donors Patients With Enhanced Recovery Protocol, Aiden Tobin, Jill Knolle Lmsw, Mph, George Rofaiel Md

Research Scholars

No abstract provided.

The Fate Of Post Open-Heart Surgery Patients With Newly Developed Renal Failure, Chris Wickenheiser, Bryan D. Nelson Mba, Nr-P, James K. Wu Md

Research Scholars

No abstract provided.

Evaluating The Use Of A Single Question Derivative To Determine Post-Acute Needs Following Total Joint Replacement, Kiya Humphries, Brittany N. Shockency Bs, Carissa Hrichak Mba, Bsn, Rn

Research Scholars

No abstract provided.

Using Tqip Data To Determine The Effect Of Adding Emergency General Surgery Services To Trauma Outcomes, William Kane, Bree A. Harrison Bsn, Rn, Tcrn, Jaclyn Sharkazy Pa-C, Mspas, Kathryn L Wheel Md, Joseph J. Stirparo Md

Research Scholars

No abstract provided.

Developing A Quick Reference Guide For Staff On Ct Policies And Protocols, Rose Morgan, Jason Morgan Md, Kathleen E. Kane Md

Research Scholars

No abstract provided.

Assessing The Efficacy Of A Therapeutic Thermoregulation Protocol (Ttp) For The Burn Surgical Patient, Gwendolyn Minogue, Morgan Strecker, Jill Krystofinski Mantell Dnapc, Crna

Research Scholars

No abstract provided.

An Occupational Perspective On Collegiate Athlete Mental Health, Katelyn D. Cardwell

Graduate Student Scholarship

College can impact mental health for all students, especially those involved in a college sport. Sports require significant time dedication that decreases time available for students to be involved in other activities such as academics or leisure which can lead to increased stress. This study focuses on investigating the impact level of competition and location of school may have on student athletes’ mental health in the state of West Virginia. A mixed methods self-report survey with a total of 75 questions was administered online via Qualtrics software. Quantitative data was analyzed using Stats IQ feature on Qualtrics and qualitative data …

Macrophage Depletion Protects Against Cisplatin-Induced Ototoxicity And Nephrotoxicity, Cathy Yea Won Sung, Naoki Hayase, Peter S T Yuen, John Lee, Katharine Fernandez, Xuzhen Hu, Hui Cheng, Robert A Star, Mark E Warchol, Lisa L Cunningham

2020-Current year OA Pubs

Cisplatin is a widely used anticancer drug with notable side effects including ototoxicity and nephrotoxicity. Macrophages, the major resident immune cells in the cochlea and kidney, are important drivers of both inflammatory and tissue repair responses. To investigate the roles of macrophages in cisplatin-induced toxicities, we used PLX3397, a U.S. Food and Drug Administration-approved inhibitor of the colony-stimulating factor 1 receptor, to eliminate tissue-resident macrophages. Mice treated with cisplatin alone had considerable hearing loss (ototoxicity) and kidney injury (nephrotoxicity). Macrophage ablation resulted in significantly reduced hearing loss and had greater outer hair cell survival. Macrophage ablation also protected against cisplatin-induced …

A Randomized Controlled Trial Of The Happy, Healthy, Loved Personalized Text-Message Program For New Parent Couples: Impact On Breastfeeding Self-Efficacy And Mood., Erin Henshaw, Marie Cooper, Teresa Wood, Sanchita Krishna, Marie Lockhart, Stacey Doan

Women’s Health Articles

BACKGROUND: Breastfeeding self-efficacy has been identified as an important influence on breastfeeding outcomes. Among new parent couples, partners are uniquely positioned to be sources of support for developing breastfeeding self-efficacy, yet few breastfeeding programs have attempted to involve partners directly. The purpose of this study was to test the impact of a novel program, Happy, Healthy, Loved, on breastfeeding self-efficacy and maternal mood through emphasizing partner support and actively addressing postpartum-specific stress management in a tailored text message delivery program.

METHODS: A randomized trial was conducted in which primiparous mother-partner dyads intending to exclusively breastfeed were recruited at midwestern hospitals …

Characterizing A Complex Ct-Rich Haplotype In Intron 4 Of Snca Using Large-Scale Targeted Amplicon Long-Read Sequencing, Pilar Alvarez Jerez, Kensuke Daida, Francis P Grenn, Laksh Malik, Abigail Miano-Burkhardt, Mary B Makarious, Jinhui Ding, J Raphael Gibbs, Anni Moore, Xylena Reed, Mike A Nalls, Syed Shah, Medhat Mahmoud, Fritz J Sedlazeck, Egor Dolzhenko, Morgan Park, Hirotaka Iwaki, Bradford Casey, Mina Ryten, Cornelis Blauwendraat, Andrew B Singleton, Kimberley J Billingsley

Faculty, Staff and Students Publications

Parkinson's disease (PD) is a common neurodegenerative disorder with a significant risk proportion driven by genetics. While much progress has been made, most of the heritability remains unknown. This is in-part because previous genetic studies have focused on the contribution of single nucleotide variants. More complex forms of variation, such as structural variants and tandem repeats, are already associated with several synucleinopathies. However, because more sophisticated sequencing methods are usually required to detect these regions, little is understood regarding their contribution to PD. One example is a polymorphic CT-rich region in intron 4 of the SNCA gene. This haplotype has …

Martian Atmospheric Hydrogen And Deuterium: Seasonal Changes And Paradigm For Escape To Space, John T Clarke, Majd Mayyasi, Dolon Bhattacharyya, Jean-Yves Chaufray, Nicolas Schneider, Bruce Jakosky, Roger Yelle, Franck Montmessin, Michael Chaffin, Shannon Curry, Justin Deighan, Sonal Jain, Jean-Loup Bertaux, Eryn Cangi, Matteo Crismani, Scott Evans, Sumedha Gupta, Franck Lefevre, Greg Holsclaw, Daniel Lo, William Mcclintock, Michael Stevens, Ian Stewart, Shane Stone, Paul Mahaffy, Mehdi Benna, Meredith Elrod

Faculty, Staff and Student Publications

Mars' water history is fundamental to understanding Earth-like planet evolution. Water escapes to space as atoms, and hydrogen atoms escape faster than deuterium giving an increase in the residual D/H ratio. The present ratio reflects the total water Mars has lost. Observations with the Mars Atmosphere and Volatile Evolution (MAVEN) and Hubble Space Telescope (HST) spacecraft provide atomic densities and escape rates for H and D. Large increases near perihelion observed each martian year are consistent with a strong upwelling of water vapor. Short-term changes require processes in addition to thermal escape, likely from atmospheric dynamics and superthermal atoms. Including …

Targeting Astrogliosis In The Retrotrapezoid Nucleus: A Novel Approach To Ameliorate Respiratory Dysfunction And Alzheimer's Pathology In Mice, Zahid Iqbal, Ahmad El Hamamy, Ngoc Mai Le, Arya Ranjan, Yuxing Zhang, Li Qi, Bharti Manwani, Chunfeng Tan, Louise D Mccullough, Jun Li

Faculty, Staff and Student Publications

Alzheimer's disease (AD), a leading cause of dementia, is associated with significant respiratory dysfunctions. Our study explores the role of astrogliosis in the brainstem retrotrapezoid nucleus (RTN), a key breathing regulatory center, and its impact on breathing control and AD pathology in mice. Using Tg-2576 AD and wild-type mice, we investigated the effect of silencing the transforming growth factor-beta receptor II (TGFβR II) in the RTN. We performed behavioral tests, including the Barnes maze and novel object recognition test, along with whole-body plethysmography to assess breathing disorders. Our results showed that AD mice exhibited increased apneas and cognitive impairment, which …

Detection Of Diffusely Abnormal White Matter In Multiple Sclerosis On Multiparametric Brain Mri Using Semi-Supervised Deep Learning, Benjamin C Musall, Refaat E Gabr, Yanyu Yang, Arash Kamali, John A Lincoln, Michael A Jacobs, Vi Ly, Xi Luo, Jerry S Wolinsky, Ponnada A Narayana, Khader M Hasan

Faculty, Staff and Student Publications

In addition to focal lesions, diffusely abnormal white matter (DAWM) is seen on brain MRI of multiple sclerosis (MS) patients and may represent early or distinct disease processes. The role of MRI-observed DAWM is understudied due to a lack of automated assessment methods. Supervised deep learning (DL) methods are highly capable in this domain, but require large sets of labeled data. To overcome this challenge, a DL-based network (DAWM-Net) was trained using semi-supervised learning on a limited set of labeled data for segmentation of DAWM, focal lesions, and normal-appearing brain tissues on multiparametric MRI. DAWM-Net segmentation performance was compared to …

In Silico Analysis Of The Rop29 Protein As A Vaccine Candidate Against Toxoplasma Gondii, Amir Karimipour-Saryazdi, Fatemeh Ghaffarifar, Abdolhossein Dalimi, Masoud Foroutan, John Horton, Javid Sadraei

Faculty, Staff and Student Publications

The progression of Toxoplasma gondii (T. gondii) invasion is aided by rhoptry proteins (ROPs), which are also crucial for the parasite's survival in host cells. In this study, in silico analysis was performed to examine the various aspects of the ROP29 protein, such as physicochemical properties, potential T- and B-cell epitopes, and other significant features. The research revealed that there were 55 possible sites for posttranslational modification in the ROP29 protein. The secondary structure of the ROP29 protein consists of a random coil, an alpha-helix, and an extended strand, which account for 49.69%, 36.81%, and 13.50%, respectively. Moreover, …

Co-Localization Of Osteoclasts Differentiation Markers In An Implant Model In Diabetic Mice, Diego Adobbati, Deborah Rocha Seixas, Danieli Rodrigues, Claudia C. Biguetti

School of Podiatric Medicine - Student Research

Introduction and Hypothesis: Diabetes can impair implant osseointegration and impact implant functionality. While significant research has focused on osteogenesis during the osseointegration, little attention has been given to pre-osteoclast differentiation. We hypothesize that diabetes increases pre-osteoclast activity potentially leading to implant failure. This study aims to identify and localize osteoclast markers, specifically DC-STAMP (Dendritic Cell-Specific Transmembrane Protein) and NFATc2 (Nuclear Factor of Activated T-cells, cytoplasmic 2), in diabetic (D) and non-diabetic (ND) mice.

Methodology: Twenty-four 16-week-old male 129 Sv mice (12 diabetic and 12 non-diabetic) underwent implantation with a 0.5x1.5 mm commercially pure titanium screw in the right maxillary bone. …

Exposure To Light At Night And Risk Of Cancer: A Systematic Review, Meta-Analysis, And Data Synthesis, Samuel Ma, Yossef Alsabawi, Hashem B El-Serag, Aaron P Thrift

Faculty, Staff and Students Publications

BACKGROUND: Emerging interest surrounds the role of environmental factors, notably exposure to light at night (LAN), as a potential cause of cancer. The aim of this study was to conduct a systematic review and, if possible, meta-analysis of observational studies on LAN and cancer risk of multiple types.

METHODS: A systematic literature search in PubMed, Web of Science, and Embase, spanning from inception to May 2023, was conducted. Studies focusing on the association between LAN exposure and cancer risk in adult populations were included. We used random effects models to calculate pooled risk estimates (RR) and 95% confidence intervals (CI). …

Penetrating Posterior Urethral Injuries: Case Report And Management Strategies, Seyed Sajjad Tabei, Brandon Lippold, Wesley Baas, Gregory Murphy

2020-Current year OA Pubs

Penetrating posterior urethral trauma from gunshot wounds (GSW) is rare and requires prompt treatment to minimize complications. Data regarding the management of such cases is scarce in the literature and poorly addressed in the guidelines. Different management approaches exist, including urinary diversion with immediate versus delayed urethroplasty/fistula repair. We present our case series to add to our experience to the literature. Three patients aged 18-44 presented with ballistic posterior urethra injuries from GSW. Initial management involved urethral catheter placement, with one patient requiring operative placement of urethral and suprapubic catheters (SPTs). Complications included recurrent membranous stricture, urinary retention, rectourethral fistula, …

Porokeratosis Ptychotropica With Scalp Involvement: A Case Report, Kobpat Phadungsaksawasdi, Pravit Asawanonda

Chulalongkorn Medical Journal

Porokeratosis, a spectrum of disorders characterized by abnormal keratinization, includes the rare variant, porokeratosis ptychotropica, typically manifests with hyperkeratotic plaques on the buttocks and genital area. Its clinical mimicry to various skin diseases, coupled with under-recognition of the disorder, results in frequent misdiagnosis. This challenge is compounded by the resistance of porokeratosis ptychotropica to treatment.

We report a 62-year-old Thai male with persistent pruritic hypertrophic plaques affecting the genitogluteal area, extremities, and scalp over five years, unresponsive to diverse topical agents. Histopathological findings revealed acanthotic epidermis with a cornoid lamella, consistent with porokeratosis ptychotropica. He was given oral acitretin at …

A Rare Presentation Of Giant Hepatic Hemangioma Mimicking Fibrolamellar Hepatocellular Carcinoma, Bikash Parida, Sherry Garg, Somadatta Das

Chulalongkorn Medical Journal

Hepatic hemangioma is a frequently occurring benign liver lesion detected on Imaging. It might be challenging to make a definite diagnosis of Hepatic hemangioma since its radiological characteristics can mimic those of hepatic malignancies such as metastatic liver cancer. A 65-year-old female patient complained of a month-long reduction in appetite and distension of abdominal discomfort in the right hypochondriac area. A B-mode ultrasound was suggested for the patient. On USG, there was a large, poorly defined heterogeneous lesion that entirely occupied the right lobe of the liver. It had a hyperechoic periphery, an irregular hypoechoic patch in the center, necrosis, …

Identification And Characterization Of Malaria Box Compounds Possessing Inhibition Effect On The Sars-Cov2 Spike Protein, Chotiyapat Sangvansindhu

Chulalongkorn Medical Journal

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused millions of infections and deaths worldwide since 2019. The repurposing existing drugs is a practical and promising alternative.

Objectives: To evaluate the binding interactions and inhibitory effect of malaria box compounds on the B-cell epitope regions of SARS-CoV-2 spike protein.

Methods: Molecular docking of 400 malaria box compounds against the predicted B-cell epitopes of the spike was performed. The inhibitory effect of the malaria box compounds on the spike RBD were determined using competitive ELISA. The binding affinity between malaria box compounds and non-RBD epitopes were examined by surface …

The Impact Of Covid-19 Booster Vaccination On Reducing Mortality In Patients Hospitalized With Covid-19 At Sisaket Hospital, Nidhikul Tem-Eiam

Chulalongkorn Medical Journal

The COVID-19 vaccine has the potential to decrease hospitalizations and fatalities, even when different vaccine types are administered. Towards the end of 2021, during the ongoing COVID-19 pandemic, there were guidelines suggesting the administration of booster shots following the completion of the primary vaccine series. Consequently, this study aims to investigate the efficacy of COVID-19 booster vaccinations and the timing between booster shots in terms of preventing fatalities among COVID-19-infected patients receiving care at Si Sa Ket Hospital

A retrospective cohort study was conducted on individuals aged 18 and above who were hospitalized with COVID-19 infection at Si Sa Ket …