Medicine and Health Sciences Commons^™

Plasma Insulin-Like Growth Factor-Binding Protein-7 Is Positively Associated With Age, Obesity, Mortality, And Cancer In Postmenopausal Women, Melissa C Orenduff, Carl F Pieper, Emma H Allott, Michael F Coleman, Su Yon Jung, Mara Z Vitolins, Jenifer I Fenton, Chu Chen, Candyce H Kroenke, Fred K Tabung, Ana Barac, Electra D Paskett, Michael N Pollak, Jennifer Hays-Grudo, Shine Chang, Stephen D Hursting

Faculty, Staff and Student Publications

Background: Predictors of premature death and cancer development are needed to more precisely identify individuals who may warrant preventive intervention. Circulating insulin-like growth factor (IGF)-binding protein-7 (IGFBP7) and, to a lesser extent, the IGFBP7/IGF-1 ratio are emerging biomarkers of renal and cardiovascular morbidity. However, their relationships with aging, obesity, mortality, and cancer risk remain unclear.

Methods: This hypothesis-generating study investigated plasma IGFBP7, IGF-1, and their ratio as predictors of all-cause mortality and the incidence of any cancer (excluding nonmelanoma skin cancer), obesity-related cancer (composite of 13 cancer types), and breast cancer in a large longitudinal cohort of postmenopausal women. We …

Restoration Of The Tumor Suppressor Function Of Y220c-Mutant P53 By Rezatapopt, A Small-Molecule Reactivator, Anna M Puzio-Kuter, Lizhong Xu, Mary Kate Mcbrayer, Romyr Dominique, Hongju H Li, Bruce J Fahr, Alyssa M Brown, Amy E Wiebesiek, Brandon M Russo, Chris L Mulligan, Hong Yang, Josh Battaglia, Kimberly A Robell, Dafydd H Thomas, Kuo-Sen Huang, Alexander Solovyov, Benjamin D Greenbaum, Jonathan D Oliner, Thomas W Davis, Melissa L Dumble, Melissa L Johnson, Shunbin Xiong, Peirong Yang, Guillermina Lozano, Marc M Fellous, Binh T Vu, Alison M Schram, Arnold J Levine, Masha V Poyurovsky

Faculty, Staff and Student Publications

Restoration of the tumor suppressor function of tumor-associated p53 mutants, including the Y220C substitution, has posed a significant challenge for therapeutic discovery. In this study, we describe rezatapopt (PC14586), part of a series of compounds designed to reactivate the p53 Y220C mutant. These compounds restore p53 tumor suppressor function by correcting its conformation and enabling it to bind DNA and activate downstream target genes, thus inducing antiproliferative changes in tumor cells. Our findings are supported by biochemical and structural analysis, in vitro and in vivo transcriptomics, and functional data, revealing the recovery of multiple aspects of the wild-type p53 program. …

Verifiable Summarization Of Electronic Health Records Using Large Language Models To Support Chart Review, Ritchie Verma, Emily Alsentzer, Zachary Strasser, Leslie Chang, Kirollos Roman, Esteban Gershanik, Camellia Hernandez, Miguel Linares, Jorge Rodriguez, Durga Thakral, Ozan Unlu, Jacqueline You, Li Zhou, David Bates

Faculty, Staff and Students Publications

Information overload in electronic health records (EHRs) hampers clinicians' ability to efficiently extract and synthesize critical information from a patient's longitudinal health record, leading to increased cognitive burden and delays in care. This study explores the potential of large language models (LLMs) to address this challenge by generating problem-based admission summaries for patients admitted with heart failure, a leading cause of hospitalization worldwide. We developed an extract-then-abstract approach guided by disease-specific "summary bundles" to generate summaries of longitudinal clinical notes that prioritize clinically relevant information. Through a mixed-methods evaluation using real-world clinical notes, we compared physicians' ability to answer patient-specific …

A Meta-Analysis And Systematic Review Of Cardiac Troponin I Vs T In Community Dwelling Adults: Is Specificity At Risk?, Yashika Parashar, Aya Awwad, Soahum Bagchi, Brian Claggett, Saman Asad Siddiqui, Ajari Winifred Ogheneochuko, Christie M Ballantyne, Christopher Defilippi

Faculty, Staff and Students Publications

Background: Cardiac troponin I and T measured by high-sensitivity assays (hs-cTn) are detectable in most ambulatory adults. Hs-cTnI and T may perform differently for prediction of cardiovascular (CV) events. In adults with myopathies and advanced age, hs-cTnT can lose CV specificity. We undertook a meta-analysis of ambulatory studies measuring hs-cTn to determine whether hs-cTnI is a superior predictor of CV outcomes.

Methods: Articles evaluating hs-cTnI or T for incident heart failure (HF), myocardial infarction (MI), CV, and all-cause death in ambulatory adults were screened. Adjusted HRs were extracted standardized as hs-cTn tertile 3 vs 1. Pooled effects were calculated, and …

Lipoprotein(A) And Heart Failure Among Black And White Participants In Atherosclerosis Risk In Communities Study, Framingham Offspring Study, And Multi-Ethnic Study Of Atherosclerosis: The Pooling Project, Sarah Nomura, Weihua Guan, Yixin Zhang, Geoffrey H Tison, Hiroaki Ikezaki, Margaret R Diffenderfer, Ching-Ti Liu, Ron C Hoogeveen, Christie M Ballantyne, Ernst J Schaefer, Michael Y Tsai

Faculty, Staff and Students Publications

Background: This study investigated Lp(a) (lipoprotein(a)) levels with heart failure (HF) incidence overall and ejection fraction (EF) subtypes among Black and White participants in a pooled analysis of MESA (Multi-Ethnic Study of Atherosclerosis), FOS (Framingham Offspring Study), and ARIC (Atherosclerosis Risk in Communities Study).

Methods: This study was conducted among 16 771 White and Black participants in ARIC (N=10 347), MESA (N=4150), and FOS (N=2274). Baseline was time of Lp(a) measurement (ARIC Visit 4: 1996-1998; MESA Visit 1: 2000-2002; FOS Cycle 6: 1995-1998). HF with reduced EF (HFrEF) was defined as EF < 50% and ≥50% as HF with preserved EF (HFpEF). Cox proportional hazards regression was used to evaluate associations between Lp(a) (log-transformed continuous, dichotomized at ≥30 mg/dL and ≥50 mg/dL, and quartiles) and HF (overall, HFpEF, HFrEF) in the overall population and stratified by race. Analyses were replicated excluding prior history of myocardial infarction.

Results: There were 2759 HF cases (HFpEF N=859; …

Mitral Valve Surgery After Failed Transcatheter Intervention For Mitral Regurgitation: Surgical Techniques, Challenges And Outcomes, Mateo Marin-Cuartas, Syed Zaid, Jörg Kempfert, Michael A Borger, Serdar Akansel, Thilo Noack, David Holzhey, Tsuyoshi Kaneko, Isaac George, Gorav Ailawadi, Robert L Smith, Arnar Geirrson, Ahmed El-Eshmawi, Dimosthenis Pandis, Suzanne De Waha, Nikolaos Bonaros, Fabien Praz, Maurizio Taramasso, Michele De Bonis, Lenard Conradi, Christian Hagl, Nicolas Doll, Mahmoud Wehbe, Alexey Dashkevich, Manuela De La Cuesta, Jagdip Kang, Zara Dietze, Philipp Kiefer, Gilbert H L Tang

Faculty, Staff and Students Publications

Objectives: This review article aims to examine the surgical approach to patients with failed mitral transcatheter edge-to-edge repair (M-TEER), focusing on operative challenges, decision-making and contemporary outcome data. Technical considerations, including device removal and the management of complex mitral valve (MV) anatomy, are discussed.

Methods: We performed a comprehensive literature review and gathered the experience from high-volume centres in the surgical management of failed M-TEER.

Results: MV surgery after failed M-TEER is a complex but increasingly necessary procedure as the use of M-TEER grows. It occurs in up to 6% of patients, with a median age of 70-76 years at …

In Situ Structure And Assembly Of The Abc-Type Tripartite Pump Macab-Tolc, Tong Huo, Wenfang Zhang, Zhili Yu, Wei Zheng, Yaoming Wu, Qiuyu Ren, Zekai Wan, Junli Cao, Zhao Wang, Xiaodong Shi

Faculty, Staff and Students Publications

The MacAB-TolC tripartite efflux pump is widely distributed in Gram-negative bacteria, extruding antibiotics and virulence factors that lead to multidrug resistance and pathogenicity. However, the in situ structure and assembly mechanism of MacAB-TolC remain unclear. Here, we resolve the in situ structures of the MacAB-TolC efflux pump in Escherichia coli by electron cryo-tomography and subtomogram averaging. In the cells without antibiotic treatment, we observe a fully assembled MacAB-TolC pump. When Escherichia coli cells are treated with erythromycin, in addition to the tripartite pumps, we also discover the emergence of MacA-TolC subcomplexes without MacB, indicating flexible binding of MacB in the …

Xbp1s-Edem2 Prevents The Onset And Development Of Hfpef By Ameliorating Cardiac Lipotoxicity, Oveena Fonseka, Rida Raja, Claire Ross, Sanskruti R Gare, Jiayan Zhang, Susanne S Hille, Katharine King, Andrea Ruiz-Velasco, Namrita Kaur, Xinyi Chen, Jessica M Miller, Riham R E Abouleisa, Qinghui Ou, Zhiyong Zou, Xiangjun Zhao, Cristian Sotomayor-Flores, Derk Frank, Eileithyia Swanton, Martin R Pool, Sara Missaglia, Daniela Tavian, Gabriele G Schiattarella, Tao Wang, Luigi Venetucci, Christian Pinali, Martin K Rutter, Bernard D Keavney, Elizabeth J Cartwright, Tamer M A Mohamed, Oliver J Müller, Wei Liu

Center for Medical Ethics and Health Policy Staff Publications

Background: Morbidity and mortality of heart failure with preserved ejection fraction (HFpEF) is increased in metabolic disorders. However, options for preventing and treating these prevalent outcomes are limited. Intramyocardial lipotoxicity contributes to cardiac dysfunction. Here, we investigate the mechanisms underlying EDEM2 (endoplasmic reticulum degradation-enhancing alpha-mannosidase-like protein 2) regulation of cardiac lipid homeostasis and assess strategies that inhibit the incidence and progression of HFpEF.

Methods: Metabolic stress was induced in C57BL/6 male mice using a high-fat diet and Nω-nitro-L-arginine methyl ester. The recombinant adeno-associated virus 9 delivery system was used for loss- and gain-of-function studies. Palmitic acid and oleic acid …

Maternal Loss Of Mouse Nlrp2 Alters The Transcriptome And Dna Methylome In Gv Oocytes And Impairs Zygotic Genome Activation In Embryos, Zahra Anvar, Michael D Jochum, Imen Chakchouk, Momal Sharif, Hannah Demond, Alvin K To, Daniel C Kraushaar, Ying-Wooi Wan, Michael C Mari, Simon Andrews, Gavin Kelsey, Ignatia B Van Den Veyver

Center for Medical Ethics and Health Policy Staff Publications

Background: NLRP2 is a subcortical maternal complex (SCMC) protein of mammalian oocytes and preimplantation embryos. SCMC proteins are encoded by maternal effect genes and play a pivotal role in the maternal-to-zygotic transition (MZT), early embryogenesis, and epigenetic (re)programming. Maternal inactivation of genes encoding SCMC proteins has been linked to infertility and subfertility in mice and humans, but the underlying molecular mechanisms for the diverse functions of SCMC proteins, and specifically the role of NLRP2, are incompletely understood.

Results: We profiled the DNA methylome of pre-ovulatory germinal-vesicle (GV) oocytes from Nlrp2-null, heterozygous (Het), and wild-type (WT) female mice and assessed the …

Mutant P53 Gain Of Function: Why Many See It, Why Some Do Not, Guillermina Lozano, Carol Prives, Kanaga Sabapathy

Faculty, Staff and Student Publications

Mutations in the TP53 tumor-suppressor gene in human cancer are unique in that 60% to 70% are of the missense variety, resulting in a full-length protein that is often highly expressed in patients' tumors. These missense mutant proteins often exhibit pro-oncogenic activities (referred to as gain of function) in mouse models and human cell lines and correlate with poor cancer prognosis in some cases.

Education In Advance Care Planning: A Novel Equity-Based, Interprofessional Service-Learning Approach, Dorothy Yam, Sriya Kudaravalli, Elizabeth A. Mulvaney, Leslie Scheunemann, Grace W. Orsatti

Journal of Innovation in Health Sciences Education

Introduction: Despite health sciences graduate schools emphasizing service-learning and interprofessionalism, they often struggle to integrate these values into the curricula effectively. Advance care planning is inherently interdisciplinary and presents an opportunity to address equity gaps through service-learning. This report describes a novel interdisciplinary service-learning initiative for graduate student trainees, focused on advance care planning in underserved communities.

Methods: After targeted training, teams of medical, law, and social work students, and professionals from their respective fields, took part in two Life Planning Fairs in historically underserved neighborhoods in Pittsburgh, Pennsylvania. Using a form developed by the Allegheny County Bar Association …

Problem-Based Learning In Speech-Language Pathology Programs: A Scoping Review, Michelle P. Phoenix, Roohit Grewal, Kayla Brissette, Maya Albin, Minseo Kim

Teaching and Learning in Communication Sciences & Disorders

Purpose: Problem-based learning (PBL) promotes student-centered, active learning and has been applied in many health disciplines, including speech-language pathology (SLP). There is some SLP literature outlining how PBL has been applied and its components, however, how PBL is applied across SLP programs worldwide is yet to be explored. We therefore sought to answer the question, how do SLP programs apply PBL and what are the associated student outcomes?

Methods: Five databases were searched, as well as searching the grey literature for relevant articles. Covidence was used to de-duplicate, collate, and review articles. SLP program, study, PBL application, and student outcome …

Quality, Suitability, Understandability, Actionability, And Readability Of Patient Education Materials: Baseline Findings From Slp Graduate Students, Bonnie K. Slavych, Greg Williams, Lauren Siemers, Lauren E. Jones, Alana Mantie-Kozlowski

Teaching and Learning in Communication Sciences & Disorders

This study evaluated graduate SLP students’ ability to communicate complex health information, highlighting strengths and areas for improvement. A cross-sectional analysis of 28 first-semester graduate students enrolled in a voice disorders course examined the quality of patient education materials they created based on fictional scenarios. Quality and credibility were assessed using the DISCERN instrument, suitability with the Suitability Assessment of Materials, and understandability/actionability with the Patient Education Materials Assessment Tool for Printable materials. Readability was analyzed using five formulas: Flesch-Kincaid Grade Level, Gunning Fog Index, FORCAST, New Dale-Chall, and Simple Measure of Gobbledygook. DISCERN scores ranged from 17 to 31 …

Foundations Of Interprofessional Practice: The Development Of A Keystone Course For An Interprofessional Collaborative Slp, Pt, And Ot Curricular Sequence, Kathleen M. Youse, Jill D. Black, Wendy L. Wachter-Schutz

Teaching and Learning in Communication Sciences & Disorders

The purpose of this paper is to describe one university’s experience in designing a foundational course that introduces the Interprofessional Education Collaborative (IPEC) Core Competencies (IPEC, 2016) and applies those competencies to interprofessional education and interprofessional practice experiences specific to the accreditation needs of three related graduate health science programs in Speech-Language Pathology, Physical Therapy, and Occupational Therapy. Four years of student evaluation data demonstrate that the foundational course effectively meets course objectives from the student perspective and provides valued opportunities to get to know student colleagues, begin to focus on effective collaboration, and gain insights into professions other than …

Case-Based Learning For Dysphagia Continuing Education: Participant Perceptions On Facilitators And Barriers, Kalea Jones, Sarah Szynkiewicz, Grayson Hill, Courtney Broadfoot, Kendrea L. Garand, Memorie M. Gosa

Teaching and Learning in Communication Sciences & Disorders

Case-based learning (CBL) is a valuable approach to healthcare education, fostering deeper learning, clinical reasoning, and decision-making skills, especially in complex medical conditions such as dysphagia. For speech-language pathologists who manage dysphagia, a CBL approach provides interactive hands-on learning opportunities. We examined the benefits and challenges of a CBL approach to dysphagia continuing education using participant feedback. Twenty participants who attended the Alabama Dysphagia Collective Conference in September 2023 in Tuscaloosa, AL completed a Likert-style survey evaluating attitudes and opinions toward a CBL conference design. Participants also provided open-ended feedback on the facilitators, barriers, clinical practice implementation, new skills learned, …

The Effect Of Blended Training On Aac Strategy Use By Pre-Service Educational Professionals, Cheri Dodge Chin, Stephanie M. Schaaf, Jennifer Gaylord, Melissa Pebly

Teaching and Learning in Communication Sciences & Disorders

This study explored the feasibility of a blended training program model on the use of Augmentative and Alternative Communication (AAC) strategies by pre-service education speech pathology students. The training incorporated Read-Ask-Answer (RAA) and naturalistic Show-Wait-Respond (SWR) techniques, aiming to increase participants’ competence in AAC strategy application. Four graduate students participated in a single-case A-B research design. Following five baseline sessions, participants completed a one-hour asynchronous online training based on a modified ImPAACT model (Kent-Walsh & Binger, 2013; Kent-Walsh & McNaughton, 2005). The training focused on RAA and SWR strategies and included video demonstrations, written practice opportunities, and reflection activities. Following …

An Escape Room To Cultivate Interprofessional Skills: A Mixed Methods Study, Rita Lenhardt, Blair Carsone, Dianna Lunsford, Melissa Goodman, Andrew Caswell

Teaching and Learning in Communication Sciences & Disorders

Interprofessional education is essential to developing future healthcare practitioners who can effectively collaborate with other professionals in practice settings. The current study examined the effectiveness of an escape room as an educational tool for interprofessional practice for occupational therapy, physical therapy, and speech-language pathology graduate students. This study employed a mixed-methods design. Eighteen healthcare graduate students agreed to participate in the educational escape room. The Students’ Perceptions of Interprofessional Clinical Education Revised instrument was used as a pre-and post-test to determine whether there were differences in the student perceptions before and after the educational escape room. In addition to the …

The Effects Of In-Depth Exposure To The Lived Experience Of Aphasia On Student Learning, Brianne Roos, Gretchen Szabo, Tami Brancamp, Elizabeth Hoover, Chaleece Sandberg, Tom W. Sather

Teaching and Learning in Communication Sciences & Disorders

Although individuals with aphasia are commonly treated by speech-language pathologists, many clinicians entering the field feel under-prepared to work with this population. Undergraduate and graduate students need appropriate training that emphasizes person-centered care mapped onto evidence-based practice, combining high-quality research evidence, clinical expertise, and client preferences. Incorporating lived experience into curricula helps shape students’ knowledge and understanding of aphasia from the perspective of patients and carepartners. Using both quantitative and qualitative methods, this study examined the impact of in-depth exposure to the lived experience of aphasia on students across six US universities. Students read the book Identity Theft: Rediscovering Ourselves …

Interdisciplinary Digital Health And Learning Survey Across Speech-Language Pathology, Technology, And Interior Design: Implications For Training In Rehabilitation And Aging-In-Place Practices, Jennine M. Harvey-Northrop, Isaac Chang, Gabriela Fonseca Pereira, Megan Cuellar

Teaching and Learning in Communication Sciences & Disorders

While the growing demand for technology integration in healthcare education and practice, technology training in speech-language pathology education is limited. Further research is warranted to investigate digital health and literacy training across interprofessional experiences. This study investigated interdisciplinary digital health and learning across speech-language pathology, technology, and interior design, as well as collaborators for virtual reality environments in rehabilitation and aging-in-place practices. Participants included 53 adult students studying speech-language pathology (N=35), technology (N=10), or interior design (N=7). The Interdisciplinary Digital Health and Learning survey was adapted from the Lin et al. (2021) for implementation across speech-language pathology, technology, and interior …

An Interdisciplinary Early Intervention Learning Community For Undergraduate Students, Ciera M. Lorio, Hannah Rudkin, Christina Rauwolf, Luminita Hartle

Teaching and Learning in Communication Sciences & Disorders

There is currently a nationwide shortage of early intervention (EI) providers in the United States, and the number of families in need of EI services is much greater than the available service providers (CEC, 2019; Barton et al., 2012). One way to increase the number of qualified service providers is to offer better and earlier preservice training in EI at the university level. To meet this need, we designed and implemented the Early Intervention Learning Community (EILC), an extracurricular experience that focused on introducing students to EI and interprofessional practice. The primary components of the EILC included self-guided learning modules, …

Assessment Of Real Time Pharmacist Intervention Using Bcid2 Within A Large Multicenter Hospital System, Andrew Staten

2025 Swedish FISH (Fostering Interdisciplinary Solutions in Healthcare) Conference

No abstract provided.

Factors Associated With Naloxone Distribution, K Elliott, Cara Gallegos, E Stewart, A Miller, J Delfeld, J Fehme

2025 Swedish FISH (Fostering Interdisciplinary Solutions in Healthcare) Conference

No abstract provided.

Advancing Science Through Connecting And Mentoring, Elaine Walsh

2025 Swedish FISH (Fostering Interdisciplinary Solutions in Healthcare) Conference

No abstract provided.

Ebp Competency, Beliefs, And Organizational Readiness: A Quantitative Descriptive Study, Everliza Nesland, Cara Gallegos, Frances Chu, Kate Freely-Lynch, Mary Jo Kelly, Sarah Culbert

2025 Swedish FISH (Fostering Interdisciplinary Solutions in Healthcare) Conference

No abstract provided.

Effect Of Nitric Oxide Scavengers On Vasopressor Requirements, Danielle Wojcik

2025 Swedish FISH (Fostering Interdisciplinary Solutions in Healthcare) Conference

No abstract provided.

Early Versus Late Vasopressor Initiation In Septic Shock – Elviss Study, Nathan Crawford, Brittanii Prahl, Jordan Amaro, Barbara Branneman, Jack Huber

2025 Swedish FISH (Fostering Interdisciplinary Solutions in Healthcare) Conference

No abstract provided.

Once-Daily Versus Twice-Daily Oral Vancomycin For Secondary Prevention Of Clostridioides Difficile Infection In Patients Treated With Systemic Antibiotics, Catherine Palmer

2025 Swedish FISH (Fostering Interdisciplinary Solutions in Healthcare) Conference

No abstract provided.

Impact Of A Multidisciplinary Pulmonary Embolism Response Team (Pert) At A Quaternary Referral Center, Sabrina Mangal, Kristina Pratt, Jennifer Nagel, Juan N Pulido, Jun Vic L. Obaob, Tabitha Weinbrenner, George P Pappas, Paul P Huang, Eric J Lehr

2025 Swedish FISH (Fostering Interdisciplinary Solutions in Healthcare) Conference

No abstract provided.

Cefdinir Use For Adults With Urinary Tract Infections In The Emergency Department, Emily Vo, Brittanii Prahl, William Barany, Barbara Branneman, Jack Huber

2025 Swedish FISH (Fostering Interdisciplinary Solutions in Healthcare) Conference

No abstract provided.

Impact Of Gum Chewing On Postoperative Ileus Following Open Heart Surgery, Jacinta Smith, Mary Jo Kelly

2025 Swedish FISH (Fostering Interdisciplinary Solutions in Healthcare) Conference

No abstract provided.