Medicine and Health Sciences Commons^™

Trps1 Expression Is Frequently Seen In A Subset Of Cutaneous Mesenchymal Neoplasms And Tumors Of Uncertain Differentiation: A Potential Diagnostic Pitfall, Moon Joo Kim, Yi A Liu, Yunyi Wang, Jing Ning, Woo Cheal Cho

Faculty, Staff and Student Publications

Although extensively studied in cutaneous epithelial neoplasms, the TRPS1 immunoreactivity in cutaneous mesenchymal neoplasms and tumors of uncertain differentiation (CMNTUDs), such as atypical fibroxanthoma (AFX), remains largely unexplored. We assessed TRPS1 immunoreactivity in 135 CMNTUDs, comprising 46 fibrohistiocytic/fibroblastic tumors, 28 vascular tumors, 24 peripheral nerve sheath tumors (PNSTs), 21 tumors of uncertain differentiation, and 16 smooth muscle tumors. Additionally, we included selected cases of melanoma with spindled cell morphology or desmoplastic features (n = 9) and sarcomatoid squamous cell carcinoma (SSCC) (n = 5) to compare TRPS1 expression patterns with those of AFX. TRPS1 expression was prevalent in dermatofibromas (24/24), …

Nrg Oncology And Particle Therapy Co-Operative Group Patterns Of Practice Survey And Consensus Recommendations On Pencil-Beam Scanning Proton Stereotactic Body Radiation Therapy And Hypofractionated Radiation Therapy For Thoracic Malignancies, Wei Liu, Hongying Feng, Paige A Taylor, Minglei Kang, Jiajian Shen, Jatinder Saini, Jun Zhou, Huan B Giap, Nathan Y Yu, Terence S Sio, Pranshu Mohindra, Joe Y Chang, Jeffrey D Bradley, Ying Xiao, Charles B Simone, Liyong Lin

Faculty, Staff and Student Publications

Stereotactic body radiation therapy (SBRT) and hypofractionation using pencil-beam scanning (PBS) proton therapy (PBSPT) is an attractive option for thoracic malignancies. Combining the advantages of target coverage conformity and critical organ sparing from both PBSPT and SBRT, this new delivery technique has great potential to improve the therapeutic ratio, particularly for tumors near critical organs. Safe and effective implementation of PBSPT SBRT/hypofractionation to treat thoracic malignancies is more challenging than the conventionally fractionated PBSPT because of concerns of amplified uncertainties at the larger dose per fraction. The NRG Oncology and Particle Therapy Cooperative Group Thoracic Subcommittee surveyed proton centers in …

Clinical And Genomic Landscape Of Ras Mutations In Gynecologic Cancers, Ji Son, Yingao Zhang, Heather Lin, Oriol Mirallas, Pablo Alvarez Ballesteros, Mirella Nardo, Natalie Clark, R Tyler Hillman, Erick Campbell, Vijaykumar Holla, Amber M Johnson, Amadeo B Biter, Ying Yuan, Lauren P Cobb, David M Gershenson, Amir A Jazaeri, Karen H Lu, Pamela T Soliman, Shannon N Westin, Elizabeth D Euscher, Barrett C Lawson, Richard K Yang, Funda Meric-Bernstam, David S Hong

Faculty, Staff and Student Publications

Purpose: We aimed to describe RAS mutations in gynecologic cancers as they relate to clinicopathologic and genomic features, survival, and therapeutic implications.

Experimental design: Gynecologic cancers with available somatic molecular profiling data at our institution between February 2010 and August 2022 were included and grouped by RAS mutation status. Overall survival was estimated by the Kaplan-Meier method, and multivariable analysis was performed using the Cox proportional hazard model.

Results: Of 3,328 gynecologic cancers, 523 (15.7%) showed any RAS mutation. Patients with RAS-mutated tumors were younger (57 vs. 60 years nonmutated), had a higher prevalence of endometriosis (27.3% vs. 16.9%), and …

Hypertensive Retinopathy As A Predictor Of Coronary Artery Disease In Elderly Hypertensive Patients With Angina Pectoris: A Comparative Study, Heba Abdulilah Ali Albayati, Firas Shanshal

Iraqi National Journal of Medicine

Background: In exploring novel avenues to assess cardiac health, this study investigates the potential of retinal vascular signs (RVS) as an effective tool for predicting coronary artery disease (CAD) in elderly hypertensive patients who present with angina pectoris. Considering the rising prevalence of cardiac disorders, there is an increasing interest in using noninvasive imaging modalities for early cardiovascular disease detection. This study conducts a comprehensive analysis to establish a direct correlation between retinal microvascular alterations and the development of heart disease in hypertensive patients. Methods: A total of 70 elderly hypertensive patients with acute angina underwent coronary angiograms and were …

Insight On Colonoscopy Findings In Southern Iraq: Retrospective Study From A Tertiary Center, Zeinab Kamil Dhahi, Loma Ahmed Al Mansory

Iraqi National Journal of Medicine

Background: Colonoscopy is the most trusted diagnostic tool in the screening and diagnosis of colorectal cancer and other colorectal diseases. Aim: This study intends to present the results of colonoscopic procedures carried out in Center for Digestive and Liver Disease and Surgery in Basrah Methods: Retrospective evaluation of 698 consecutive subjects who underwent screening or diagnostic colonoscopy at Basra Center for Liver Disease and Digestive System between 2014 and February 2020 was conducted. The primary outcome measure was the rate of adenoma detection, calculated alternately as the total number of detected neoplastic lesions divided by the number of subjects screened …

Outcome Of Endoscopic Cartilage Tympanoplasty In Anteriorly Extended Tympanic Membrane Perforation, Ahmed Fadhil Hasan, Amjed Hayder Ali Altaee, Saif Mohammed Hussein

Iraqi National Journal of Medicine

Background: The study was conducted to assess hearing improvement and graft uptake rate in patients with an anteriorly extended tympanic membrane perforation who underwent endoscopic cartilage tympanoplasty. Aim: The study aims to assess the efficacy of endoscopic cartilage tympanoplasty in repairing an anteriorly extended tympanic membrane perforation. Methods: A total of 135 patients aged between 10 and 63 years with an anteriorly extended tympanic membrane perforation were included in this study. Patients with an active middle ear disease and ossicular abnormality were excluded. Pure-tone audiometry was performed preoperatively at 500, 1000, 2000, and 4000 Hz, and the air-bone gap (ABG) …

Versatility Of Radial Artery Fascio-Cutaneous Free Flap For Head And Neck Reconstruction, Abdulrahman Miran, Rana Kamal Ibrahim

Iraqi National Journal of Medicine

Background: Reconstruction of the head and neck has made significant progress with the advent of microsurgery. The radial artery free flap is a workhorse flap in head and neck reconstruction due to its high-quality tissue that conforms to the complex and vital structures in this region. Aim: This study aims to assess the versatility and pliability of the radial artery free flap in the reconstruction of head and neck defects. Methods: A retrospective study was conducted over a six-year period (2017 to 2022) in Erbil, the capital of the Kurdistan region in Iraq, at Maryamana and PAR private hospitals. Twelve …

Comparative Analyses Of Immune Marker Levels In Seronegative And Seropositive Iraqi Rheumatoid Arthritis Patients, Ahmed Aledany, Eman Tariq Ali Altaee, Ali Nazar Mohammed, Falah Hassan Shari Alsukainy

Iraqi National Journal of Medicine

Background: Rheumatoid arthritis (RA) comprises an inflammation-based condition with a clinical phenotype that is mainly reliant on the occurrence of rheumatoid factor and anti-citrullinated protein antibodies. Literature indicates that seronegativity might be accompanied by higher severity of clinical symptoms, while higher disease activity, based on the recent classification criteria should also be associated with seronegativity. Aim: This investigation targets the identification of more efficient immune markers of RA seropositivity as well as examining the possibility that the latter is associated with lower severity. Methods: Serum samples from 128 RA patients, 106 seropositive and 22 seronegative, were analyzed using ELISA to …

Specific Patterns Of Endogenous Functional Connectivity Are Associated With Harm Avoidance In Obsessive-Compulsive Disorder, Merage Ghane, Lucas Trambaiolli, Michele A Bertocci, Freddyson J Martinez-Rivera, Henry W Chase, Tyler Brady, Alex Skeba, Simona Graur, Lisa Bonar, Satish Iyengar, Gregory J Quirk, Steven A Rasmussen, Suzanne N Haber, Mary L Phillips

Faculty, Staff and Student Publications

Background: Individuals with obsessive-compulsive disorder (OCD) show persistent avoidance behaviors, often in the absence of actual threat. Quality-of-life costs and heterogeneity support the need for novel brain-behavior intervention targets. Informed by mechanistic and anatomical studies of persistent avoidance in rodents and nonhuman primates, our goal was to test whether connections within a hypothesized persistent avoidance-related network predicted OCD-related harm avoidance (HA), a trait measure of persistent avoidance. We hypothesized that 1) HA, not an OCD diagnosis, would be associated with altered endogenous connectivity in at least one connection in the network; 2) HA-specific findings would be robust to comorbid symptoms; …

Brain-Age Prediction: Systematic Evaluation Of Site Effects, And Sample Age Range And Size, Yuetong Yu, Hao-Qi Cui, Shalaila S Haas, Faye New, Nicole Sanford, Kevin Yu, Denghuang Zhan, Guoyuan Yang, Jia-Hong Gao, Dongtao Wei, Jiang Qiu, Nerisa Banaj, Dorret I Boomsma, Alan Breier, Henry Brodaty, Randy L Buckner, Jan K Buitelaar, Dara M Cannon, Xavier Caseras, Vincent P Clark, Patricia J Conrod, Fabrice Crivello, Eveline A Crone, Udo Dannlowski, Christopher G Davey, Lieuwe De Haan, Greig I De Zubicaray, Annabella Di Giorgio, Lukas Fisch, Simon E Fisher, Barbara Franke, David C Glahn, Dominik Grotegerd, Oliver Gruber, Raquel E Gur, Ruben C Gur, Tim Hahn, Ben J Harrison, Sean Hatton, Ian B Hickie, Hilleke E Hulshoff Pol, Alec J Jamieson, Terry L Jernigan, Jiyang Jiang, Andrew J Kalnin, Sim Kang, Nicole A Kochan, Anna Kraus, Jim Lagopoulos, Luisa Lazaro, Brenna C Mcdonald, Colm Mcdonald, Katie L Mcmahon, Benson Mwangi, Fabrizio Piras, Raul Rodriguez-Cruces, Jessica Royer, Perminder S Sachdev, Theodore D Satterthwaite, Andrew J Saykin, Gunter Schumann, Pierluigi Sevaggi, Jordan W Smoller, Jair C Soares, Gianfranco Spalletta, Christian K Tamnes, Julian N Trollor, Dennis Van't Ent, Daniela Vecchio, Henrik Walter, Yang Wang, Bernd Weber, Wei Wen, Lara M Wierenga, Steven C R Williams, Mon-Ju Wu, Giovana B Zunta-Soares, Boris Bernhardt, Paul Thompson, Sophia Frangou, Ruiyang Ge, Enigma‐Lifespan Working Group

Faculty, Staff and Student Publications

Structural neuroimaging data have been used to compute an estimate of the biological age of the brain (brain‐age) which has been associated with other biologically and behaviorally meaningful measures of brain development and aging. The ongoing research interest in brain‐age has highlighted the need for robust and publicly available brain‐age models pre‐trained on data from large samples of healthy individuals. To address this need we have previously released a developmental brain‐age model. Here we expand this work to develop, empirically validate, and disseminate a pre‐trained brain‐age model to cover most of the human lifespan. To achieve this, we selected the …

Bayesian Varying-Effects Vector Autoregressive Models For Inference Of Brain Connectivity Networks And Covariate Effects In Pediatric Traumatic Brain Injury, Yangfan Ren, Nathan Osborne, Christine B Peterson, Dana M Demaster, Linda Ewing-Cobbs, Marina Vannucci

Faculty, Staff and Student Publications

In this article, we develop an analytical approach for estimating brain connectivity networks that accounts for subject heterogeneity. More specifically, we consider a novel extension of a multi-subject Bayesian vector autoregressive model that estimates group-specific directed brain connectivity networks and accounts for the effects of covariates on the network edges. We adopt a flexible approach, allowing for (possibly) nonlinear effects of the covariates on edge strength via a novel Bayesian nonparametric prior that employs a weighted mixture of Gaussian processes. For posterior inference, we achieve computational scalability by implementing a variational Bayes scheme. Our approach enables simultaneous estimation of group-specific …

The Price We Pay: An Integrative Review Exploring The Effects Of Wellness Culture On Nurse Burnout Rates, Rebekah Lillian Vance

Doctoral Dissertations and Projects

The purpose of this integrative review is to identify cultural factors contributing to nurse burnout and to explore the strategies and effectiveness of wellness culture and cultural changes on nurse burnout rates. Nurse burnout has been attributed to a myriad of factors and has been identified in nursing since the 1970s. While other professions with similar burnout issues have investigated and implemented culture-wide changes to address burnout, nursing has remained stagnant in the field of burnout research, often applying single interventions that fall short of creating significant, lasting change. An integrative review of nursing, peer-reviewed literature was conducted in an …

Provider Implementation Of Probiotics As An Adjuvant Treatment Modality For Patients With Anxiety And Or Depression In A Primary Care Setting, Sarah Dedmon

Doctoral Dissertations and Projects

The prevalence of anxiety and depression among Americans is growing rapidly. Patients are seeking out traditional treatments as offered by their primary care providers, but also frequently look toward integrative or complementary methods of managing their symptoms. The use of dietary supplements is at an all-time high, yet the U.S. Food and Drug Administration does not regulate these substances for potency and purity or evaluate them using quality standards as it does pharmaceuticals. Most providers lack education regarding the physiological interaction their patients may experience when using these substances and are naïve to their place in primary care medicine. The …

The Effects Of An Emotional Intelligence And Empathy Interactive Education Program With Prelicensure Nursing Students, Karen Browne

Doctoral Dissertations and Projects

A dissertation is presented on a teaching program for emotional intelligence (EI) and empathy with a cohort of nursing students enrolled in a traditional, undergraduate nursing college in the Northeast region of the United States (US). An interactive teaching program was used with various media to present new material and learning activities during the spring semester. The importance of teaching nursing students the aspects of EI was to prepare them for the rigors of the profession by allowing them to delve into their own self-awareness and emotional regulation, which in turn helps to connect with patients in a more robust …

Tractography-Based Modeling Explains Treatment Outcomes In Patients Undergoing Deep Brain Stimulation For Obsessive-Compulsive Disorder, Ron Gadot, Ningfei Li, Ben Shofty, Michelle Avendano-Ortega, Sarah Mckay, Kelly R Bijanki, Meghan E Robinson, Garrett Banks, Nicole Provenza, Eric A Storch, Wayne K Goodman, Andreas Horn, Sameer A Sheth

Faculty, Staff and Students Publications

BACKGROUND: Deep brain stimulation (DBS) is an established and expanding therapy for treatment-refractory obsessive-compulsive disorder. Previous work has suggested that a white matter circuit providing hyperdirect input from the dorsal cingulate and ventrolateral prefrontal regions to the subthalamic nucleus could be an effective neuromodulatory target.

METHODS: We tested this concept by attempting to retrospectively explain through predictive modeling the ranks of clinical improvement as measured by the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) in 10 patients with obsessive-compulsive disorder who underwent DBS to the ventral anterior limb of internal capsule with subsequent programming uninformed by the putative target tract.

RESULTS: Rank …

Single-Cell Total-Rna Profiling Unveils Regulatory Hubs Of Transcription Factors, Yichi Niu, Jiayi Luo, Chenghang Zong

Faculty, Staff and Students Publications

Recent development of RNA velocity uses master equations to establish the kinetics of the life cycle of RNAs from unspliced RNA to spliced RNA (i.e., mature RNA) to degradation. To feed this kinetic analysis, simultaneous measurement of unspliced RNA and spliced RNA in single cells is greatly desired. However, the majority of single-cell RNA-seq chemistry primarily captures mature RNA species to measure gene expressions. Here, we develop a one-step total-RNA chemistry-based single-cell RNA-seq method: snapTotal-seq. We benchmark this method with multiple single-cell RNA-seq assays in their performance in kinetic analysis of cell cycle by RNA velocity. Next, with LASSO regression …

Editorial: Ethical Considerations In Electronic Data In Healthcare, Dheya Mustafa, Mousa Al-Kfairy

All Works

No abstract provided.

The Role Of Pharmacy In Supporting Safe And Effective Transitions Of Care, Laressa Bethishou

Pharmacy Faculty Articles and Research

Goal To inform pharmacists and pharmacy technicians of the importance of and processes for conducting transitions of care when patients are moving among healthcare settings.
Summary A narrative review of recent events and research into transitions of care (TOCs) — the movement of patients from one healthcare setting to another. To be conducted safely and effectively, the entire patient care team must optimize patient care and communicate up-to-date information among its members. As the medication experts on the healthcare team, pharmacists are well poised to receive and share information that impacts medication use and patient safety. Pharmacy technicians can play …

Associations Of Ambulatory Blood Pressure Measurements With High-Sensitivity Troponin And Natriuretic Peptide Levels In Sprint, Nikit Venishetty, Jarett D Berry, James A De Lemos, Elaine Wu, Minjae Lee, Paul E Drawz, Vijay Nambi, Christie M Ballantyne, Anthony A Killeen, Joachim H Ix, Michael G Shlipak, Simon B Ascher

Faculty, Staff and Students Publications

Background: Nighttime blood pressure (BP) has greater prognostic importance for cardiovascular disease (CVD) than daytime BP, but less is known about nighttime and daytime BP associations with measures of subclinical CVD.

Methods: Among 897 Systolic Blood Pressure Intervention Trial Study (SPRINT) participants with 24-hour ambulatory BP monitoring obtained near the 27-month study visit, 849 (95%) had N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin T (hs-cTnT) measured at the 24-month study visit. Multivariable linear regression analyses were performed to evaluate the associations of nighttime and daytime BP with cardiac biomarker levels.

Results: The mean age was 69 ± 12 …

Electroencephalogram Alpha Oscillations In Stroke Recovery: Insights Into Neural Mechanisms From Combined Transcranial Direct Current Stimulation And Mirror Therapy In Relation To Activities Of Daily Life, Chia-Lun Liu, Ya-Wen Tu, Ming-Wei Li, Ku-Chou Chang, Chih-Hung Chang, Chih-Kuang Chen, Ching-Yi Wu

2020-Current year OA Pubs

The goal of stroke rehabilitation is to establish a robust protocol for patients to live independently in community. Firstly, we examined the impact of 3 hybridized transcranial direct current stimulation (tDCS)-mirror therapy interventions on activities of daily life (ADL) in stroke patients. Secondly, we explored the underlying therapeutic mechanisms with theory-driven electroencephalography (EEG) indexes in the alpha band. This was achieved by identifying the unique contributions of alpha power in motor production to ADL in relation to the premotor cortex (PMC), primary cortex (M1), and Sham tDCS with mirror therapy. The results showed that, although post-intervention ADL improvement was comparable …

Antitumor Activity Of A Pyrrolobenzodiazepine Antibody-Drug Conjugate Targeting Lgr5 In Preclinical Models Of Neuroblastoma, Jianghua Tu, Yukimatsu Toh, Adela M Aldana, Jake J Wen, Ling Wu, Joan Jacob, Li Li, Sheng Pan, Kendra S Carmon, Qingyun J Liu

Faculty, Staff and Student Publications

Neuroblastoma (NB) is a cancer of the peripheral nervous system found in children under 15 years of age. It is the most frequently diagnosed cancer during infancy, accounting for ~12% of all cancer-related deaths in children. Leucine-rich repeat-containing G-protein-coupled receptor 5 (LGR5) is a membrane receptor that is associated with the primary tumor formation and metastasis of cancers in the gastrointestinal system. Remarkably, high levels of LGR5 are found in NB tumor cells, and high LGR5 expression is strongly correlated with poor survival. Antibody-drug conjugates (ADCs) are monoclonal antibodies that are covalently linked to cell-killing cytotoxins to deliver the payloads …

Intratumoral Microbiome Of Adenoid Cystic Carcinomas And Comparison With Other Head And Neck Cancers, Tatiana V Karpinets, Yoshitsugu Mitani, Chia-Chi Chang, Xiaogang Wu, Xingzhi Song, Ivonne I Flores, Lauren K Mcdaniel, Yasmine M Hoballah, Fabiana J Veguilla, Renata Ferrarotto, Lauren E Colbert, Nadim J Ajami, Robert R Jenq, Jianhua Zhang, Andrew P Futreal, Adel K El-Naggar

Faculty, Staff and Student Publications

Adenoid cystic carcinoma (ACC) is a rare, usually slow-growing yet aggressive head and neck malignancy. Despite its clinical significance, our understanding of the cellular evolution and microenvironment in ACC remains limited. We investigated the intratumoral microbiomes of 50 ACC tumor tissues and 33 adjacent normal tissues using 16S rRNA gene sequencing. This allowed us to characterize the bacterial communities within the ACC and explore potential associations between the bacterial community structure, patient clinical characteristics, and tumor molecular features obtained through RNA sequencing. The bacterial composition in the ACC was significantly different from that in adjacent normal salivary tissue, and the …

Author Correction: Brafv600e-Mutant Metastatic Nsclc: Disease Overview And Treatment Landscape, David Planchard, Rachel E Sanborn, Marcelo V Negrao, Aria Vaishnavi, Egbert F Smit

Faculty, Staff and Student Publications

No abstract provided.

Transcriptomic Analysis Reveals The Anti-Cancer Effect Of Gestational Mesenchymal Stem Cell Secretome, Salvatore Vaiasicca, Gianmarco Melone, David W James, Marcos Quintela, Jing Xiao, Seydou Yao, Richard H Finnell, Robert S Conlan, Lewis W Francis, Bruna Corradetti

Faculty, Staff and Students Publications

The environment created during embryogenesis contributes to reducing aberrations that drive structural malformations and tumorigenesis. In this study, we investigate the anti-cancer effect of mesenchymal stem cells (MSCs) derived from 2 different gestational tissues, the amniotic fluid (AF) and the chorionic villi (CV), with emphasis on their secretome. Transcriptomic analysis was performed on patient-derived AF- and CV-MSCs collected during prenatal diagnosis and identified both mRNAs and lncRNAs, involved in tissue homeostasis and inhibiting biological processes associated with the etiology of aggressive cancers while regulating immune pathways shown to be important in chronic disorders. Secretome enrichment analysis also identified soluble moieties …

Langerhans Cell Histiocytosis: Nacho Update On Progress, Chaos, And Opportunity On The Path To Rational Cures, Kevin Bielamowicz, Peter Dimitrion, Oussama Abla, Simon Bomken, Patrick Campbell, Matthew Collin, Barbara Degar, Eli L Diamond, Olive S Eckstein, Nader El-Mallawany, Mark Fluchel, Gaurav Goyal, Michael M Henry, Michelle Hermiston, Michael Hogarty, Michael Jeng, Rima Jubran, Joseph Lubega, Ashish Kumar, Stephan Ladisch, Kenneth L Mcclain, Miriam Merad, Qing-Sheng Mi, D Williams Parsons, Erin Peckham-Gregory, Jennifer Picarsic, Zachary D Prudowsky, Barrett J Rollins, Peter H Shaw, Birte Wistinghausen, Carlos Rodriguez-Galindo, Carl E Allen, North American Consortium For Histiocytosis

Faculty, Staff and Students Publications

Langerhans cell histiocytosis (LCH) is a myeloid neoplastic disorder characterized by lesions with CD1a-positive/Langerin (CD207)-positive histiocytes and inflammatory infiltrate that can cause local tissue damage and systemic inflammation. Clinical presentations range from single lesions with minimal impact to life-threatening disseminated disease. Therapy for systemic LCH has been established through serial trials empirically testing different chemotherapy agents and durations of therapy. However, fewer than 50% of patients who have disseminated disease are cured with the current standard-of-care vinblastine/prednisone/(mercaptopurine), and treatment failure is associated with long-term morbidity, including the risk of LCH-associated neurodegeneration. Historically, the nature of LCH-whether a reactive condition versus …

Pure Epidural Extraosseous Cavernous Hemangioma With Thoracic Myelopathy: Case Report And Review Of Literature, Jordan Guntin, Ashley Ricciardelli, Alex Flores, Jeffrey Chen, Jeffrey Treiber, Alfonso Fuentes

Faculty, Staff and Students Publications

Introduction: Pure epidural spinal cavernous hemangiomas are rare, benign vascular tumors that account for approximately 4% of all spinal epidural tumors. Due to their dumbbell shape and propensity for foraminal invasion, they are often misdiagnosed and inadequately treated. We present a case of a 58-year-old male with extra-osseous cavernous hemangioma to better aid in diagnosis and management of these lesions.

Case presentation: A 58-year-old male presented with chronic lower back pain, progressive lower extremity weakness, T10 sensory level, absent lower extremity proprioception, hyperreflexia, and an episode of bowel incontinence. Imaging demonstrated T7-T10 homogenous dorsal epidural mass causing cord signal change. …

A Presentation Of Acute On Chronic Pancreatitis Complicated By Pancreaticopleural Fistula Leading To Bilateral Exudative Pleural Effusions And Empyema, Ashruta Patel, Do, Ms

The Journal of Integrated Primary Care

This case report highlights a rare but serious complication of acute pancreatitis, where pancreatic juice drains into the pleural space, causing bilateral exudative pleural effusions and potentially leading to empyema. The patient's history of alcohol abuse and splenic vein thrombosis likely contributed to the development of this complication. The clinical presentation, including progressive shortness of breath and pleuritic chest pain, along with findings on examination and imaging, prompted further investigation. The MRI findings of a pancreaticopleural fistula, along with a pseudocyst, were significant in diagnosing the condition. Treatment involved a multidisciplinary approach, including antibiotic therapy, chest tube placement to drain …

A Mixed Methods Acceptability And Feasibility Study Of A Patient-Initiated Approach To Increasing Weight Communication In Primary Care, Jocelyn E. Remmert, Leon Mccrea, Nicole T. Crane, Adam Gilden, Meghan L. Butryn

The Journal of Integrated Primary Care

Background: Weight discussions between patients and physicians can have a positive impact on patients’ health, yet they occur infrequently in primary care. No study to date has promoted patient-initiated weight discussions. This study aimed to test the feasibility, acceptability, and explore trends of the effect of a waiting room-based pamphlet intervention to promote patient-initiated weight discussions.

Methods: Adults (n=60) with overweight or obesity attending a primary care appointment were recruited from the waiting room and randomized to receive the intervention pamphlet or to a non-intervention control condition. All participants attended their appointment and completed post-appointment assessments.

Results: Three …

Case Report Of A Brief Modular Anxiety Intervention For Integrated Primary Care: Addressing Clinician Feasibility Concerns And Barriers To Using Manualized Treatments, Katherine Buckheit, Robyn L. Shepardson, Luke Mitzel, Risa B. Weisberg, Stephen A. Maisto, Jennifer Funderburk

The Journal of Integrated Primary Care

Individuals with anxiety symptoms commonly present in primary care settings and prefer behavioral health (versus pharmacotherapy) treatment, but behavioral health interventions are underutilized. Primary care behavioral health (PCBH) models, in which embedded behavioral health providers deliver behavioral treatment in primary care, may help address the gap in provision of anxiety treatment. However, evidence-based anxiety treatment options feasible for delivery in primary care are limited, and clinicians often report concerns about using manualized interventions. Recent recommendations by the U.S. Preventative Services Task Force to increase anxiety screening among adults in primary care may result in increased identification of individuals with anxiety …

Employing Interactive Architecture Techniques In Architectural Design Methodologies To Retrieve Ancient Egyptian Identity, Dina Elwy Aly Hamed Hussein Dr. Lobna Abd-Allah Abd-Elfattah Agha , Dr. Azza Sobhi Ragab Elsakka

Journal of Engineering Research

Architectural projects often rely on modern technologies like smart architecture and environmental treatments, neglecting the principles and philosophy that reflect civilization, ideas, culture, and traditions. This leads to short-lived buildings that depend on these technologies without any purpose of preserving them. Technicians must constantly renew technology to improve production and without benefits, as threats of superior artificial intelligence have been warned, that autonomous machines may perform tasks without programmers understanding how to reach this level. Instead of relying solely on environmental or smart technology, we should make technology serve the design idea rather than relying solely on it. Considering this, …