Medicine and Health Sciences Commons^™

Medical School Watercooler Newsletter - February 13, 2025, Lindsay Hughes

Watercooler Newsletter

This is the Thursday, February 13, 2025 edition of the Frederick P. Whiddon College of Medicine's newsletter -- Watercooler.

Contents include:

• Solidarity Week highlights human connection in healthcare
• Cardiology fellows win state Jeopardy championship for second consecutive year
• Whiddon COM showcases data-driven research on physician wellness and healthcare disinformation
• USA welcomes Moreno-Walton as vice chair of emergency medicine

How Hormonal Changes And The Oral Microbiome Interact With Periodontal And Alzheimer’S Disease To Influence Chronic Inflammation And Cognitive Decline?, Vanessa Chavez-Sinks, Kamran H. Awan

Annual Research Symposium

This review aims to investigate the potential of the bidirectional relationship between Alzheimer’s disease and periodontal disease. The Key players of hormonal fluctuations and microbiome dysbiosis emphasize the shared mechanisms that interplay among both conditions to identify the potential therapeutic opportunities.

The Efficacy Of Inspiratory Muscle Training Post Covid: A Systematic Review, Robert Dekerlegand, Sydney Brannen, Olivia Bunch, Amrit Deo, Erin Dopke, Kayleigh Moreland

Department of Physical Therapy Posters

Introduction

• Fatigue and dyspnea can persist post COVID infection and negatively impact both functional capacity and quality of life (QOL).^1,2
• Residual pulmonary impairments and/or inspiratory muscle dysfunction associated with COVID infection contribute to these symptoms.^2,3
• Ventilatory demands exceeding the capacity of the inspiratory muscles can exacerbate these symptoms accentuating activity limitations that restrict participation in life roles.
• As symptom-limited exercise and QOL are related to inspiratory muscle function post COVID,^4,5 inspiratory muscle training (IMT) may improve rehabilitation outcomes.³
• The purpose of this systematic review was to determine the potential efficacy of IMT in individuals post-COVID.

Nurse Experiences Of Caring For Children With Autism Spectrum Disorder In Los Angeles Pediatric Intensive Care Units, Makenna Brown

Walden Dissertations and Doctoral Studies

One in 22 California children is diagnosed with autism spectrum disorder (ASD). In combination with sensory considerations, healthcare costs, and increased healthcare utilization, these children face a lesser quality of care and poorer health outcomes. The literature addresses healthcare needs and experiences from various viewpoints, but does not address the experiences of nurses (RN) caring for children with ASD in the pediatric intensive care unit (ICU). The purpose of this study was to gain an understanding of RN’s challenges, and the helpful strategies utilized in practice. A qualitative, grounded study approach, centered on the patient-and-family centered care conceptual framework, was …

Arrhythmogenic Right Ventricular Cardiomyopathy: A Comprehensive Review, Taha Shaikh, Darren Nguyen, Jasmine Dugal, Michael Dicaro, Brianna Yee, Nazanin Houshmand, Kachon Lei, Ali Namazi

Department of Internal Medicine Faculty Research

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is characterized by structural abnormalities, arrhythmias, and a spectrum of genetic and clinical manifestations. Clinically, ARVC is structurally distinguished by right ventricular dilation due to increased adiposity and fibrosis in the ventricular walls, and it manifests as cardiac arrhythmias ranging from non-sustained ventricular tachycardia to sudden cardiac death. Its prevalence has been estimated to range from 1 in every 1000 to 5000 people, with its large range being attributed to the variability in genetic penetrance from asymptomatic to significant burden. It is even suggested that the prevalence is underestimated, as the presence of genotypic mutations …

Executive Summary: Educating Staff On The Use Of The Columbia Suicide Severity Rating Scale, Muktar Trawalley

Walden Dissertations and Doctoral Studies

Suicidal ideation is a serious public health concern among individuals, especially in the United States. The Columbia-Suicide severity rating scale (C-SSRS) is the tool used to assess the severity and frequency of suicidal ideations. The gap in practice at this site is that mental health providers lack knowledge of using the C-SSRS. This evidence-based educational project aimed to improve nursing knowledge on using the C-SSRS in a psychiatric mental health facility. A practice-focused question was developed: Among psychiatric nurses in an outpatient mental health facility, does staff education on C-SSRS improve their knowledge of its application over 8 weeks, as …

Jarisch-Herxheimer Reaction After Benzathine Penicillin G Treatment In Adults With Early Syphilis: Secondary Analysis Of A Randomized Clinical Trial., Jodie A. Dionne, Chunming Zhu, Jorge Mejia-Galvis, Kimberly Workowski, Teresa A. Batteiger, Julia C. Dombrowski, Kenneth H. Mayer, Candice J. Mcneil, Arlene C. Seña, Stephanie Taylor, Harold C. Wiesenfeld, Matthew M. Hamill, Charlotte Perlowski, Edward W. Hook Iii

School of Medicine Faculty Publications

Key Points: Question: What proportion of patients with early syphilis have symptoms of the Jarisch-Herxheimer reaction (JHR) after treatment with benzathine penicillin G, and what are the associated characteristics? Findings: This prespecified secondary analysis of a multisite US randomized clinical trial found that, among 249 adults with early syphilis, JHR symptoms occurred after benzathine penicillin G treatment in 59 participants (23.7%). Onset of JHR was within 12 hours of treatment for 86.0% of participants, and JHR was associated with successful treatment response, secondary syphilis, and absence of HIV. Meaning: This study suggests that patients treated with benzathine penicillin G for …

Integrating Postnatal Care Into The Redesign Of Group Care Beyond Birth, Ashley Gresh, Astrid Van Damme, Deborah Lynn Billings Phd, Sharon Schindler Rising, Shaimaa Ibrahim, Abiola Ajibola, Ellen Chirwa, Jennyfer Don-Aki, Nastassia Donoho, Manodj Hindori, Nafisa Jiddawi, Emeka Kanebi, Esnath Kapito, Catherine Kay, Tara Kinra, Vlorian Milliqaj, Bolanle Oyeledun, Marlies E.B. Rijnders, Octavia Wiseman, Ghutai Sadeq Yaqubi, Crystal L. Patil

Faculty Publications

Background

Globally, alarmingly high rates of maternal and infant mortality and morbidity persist. A constellation of health system and social factors contribute to this, including poor quality and barriers to accessing health care, including preventive services. As such, there have been calls for a redesign of maternal and child health (MCH) services. Although group care has primarily been tested in antenatal settings, it offers a promising redesign that optimizes maternal and child health care, survival, and well-being. The purpose of this study was to produce a blueprint of an adapted group care model that integrates postnatal maternal care, well-child care, …

Replacement Of Monensin With A Proprietary Tannin-Blend Additive In Calf-Fed Holstein Steer Diets, Sydney M. Bowman-Schnug, Luke K. Fuerniss, Joe D. Cameron, Jonathon L. Beckett, Muhammad Ahsin, Stephan Van Vliet, Guy D. Hufstedler, Bradley J. Johnson

Nutrition, Dietetics, and Food Sciences Faculty Publications

A proprietary tannin blend was evaluated as a potential ionophore replacement considering traits of feedlot cattle growth performance, carcass traits, and health. Holstein steers (n = 1450; initial shrunk body weight (SBW) = 141.6 ± 34.2 kg.) were blocked by origin and randomly assigned to receive a finishing diet containing one of two treatments: 1) 14,500 mg per head daily of Silvafeed ByProX (SBPX; ByPro/BX blend, Silvateam S.p.A, San Michele Mondovì, Italy) or 2) 180 mg per head daily of monensin (MON; Rumensin™ 90, Elanco, Greenfield, IN). Steers were on trial for 341 ± 11 days. Pen was the …

Pharmacist Avoidance Or Reductions In Medical Costs Considering Board Of Pharmacy Specialties Certification (Pharm-Bps)., Keaton S Smetana, Edith Liang, William Adams, Payal K Gurnani, William J Peppard, Alexander H Flannery, Megan A Rech

Pharmacy Articles

No abstract provided.

Structure-Activity Relationship Studies Of Dna Methyltransferase 1 Monovalent Degraders, Chao Qian, Youngeun Lee, Yulin Han, Yue Zhong, Jujun Zhou, Joel Hrit, Ling Xie, Qin Chen, H Ümit Kaniskan, Xian Chen, Scott Rothbart, Xiaodong Cheng, Yan Xiong, Jian Jin

Faculty, Staff and Student Publications

DNA methyltransferase 1 (DNMT1), which catalyzes maintenance methylation of hemimethylated DNA during DNA replication, is overexpressed in cancer. Recently, the first-in-class DNMT1-selective noncovalent small-molecule inhibitors, GSK3484862 and GSK3685032, were discovered. These inhibitors were also reported to degrade DNMT1. However, structure–activity relationship (SAR) studies of these monovalent DNMT1 degraders are lacking. Here, we report our SAR studies of this scaffold on degrading DNMT1, which led to the discovery of multiple lead degraders, including compound 4 (MS9024). Compound 4 potently and selectively degraded DNMT1 in multiple cancer cell lines in a concentration-, time-, and proteasome-dependent manner without altering DNMT1 transcription. Further mechanism-of-action …

Inhibition Of Histone Methyltransferase Ezh2 For Immune Interception Of Colorectal Cancer In Lynch Syndrome, Charles M Bowen, Fahriye Duzagac, Abel Martel-Martel, Laura Reyes-Uribe, Mahira Zaheer, Jacklyn Thompson, Nan Deng, Ria Sinha, Soham Mazumdar, Melissa W Taggart, Abhinav K Jain, Elena Tosti, Winfried Edelmann, Krishna M Sinha, Eduardo Vilar

Faculty, Staff and Student Publications

Colorectal precancers in Lynch syndrome (LS) exhibit a distinct immune profile, presenting unique opportunities for developing immune-interception strategies to prevent carcinogenesis. Epigenetic modulation by EZH2 of immune-related genes is implicated in the carcinogenesis of different cancer types, including colorectal cancer. This study utilizes a mouse model of LS and ex vivo colonic organoids to assess the effects of the EZH2 inhibitor GSK503 on immune regulatory pathways, tumorigenesis, and epigenetic reprogramming. Our findings revealed that GSK503 significantly increased CD4+ and CD8+ T cells in both splenocytes and colonic mucosa of treated mice compared with controls. Additionally, a preventive dose of GSK503 …

Successful Posthospitalisation Oncology Workflow Implementing Lace+ Score To Stratify And Reduce Readmissions Within A Safety-Net Hospital, Cindy M Pabon, Janine Wong, Marcela Perez, Jessica Jimenez-Abarca, Lianchun Xiao, Lymesia Jackson, Anne Park, Anjali Lankford, Vinita Akula, Saumil Datar, Taylor Hopper, Yaser Alkhatib, Terri Earles, Tejal Patel

Faculty, Staff and Student Publications

Background: Patients with advanced cancers visit the emergency room and get hospitalised frequently, with potentially half of these visits being avoidable. Our institution provides comprehensive, low-cost cancer treatment to a safety-net population in Texas. We performed a retrospective review of hospital readmission patterns amongst our oncology patients and developed a posthospitalisation workflow to reduce readmissions.

Method: Following discharge, oncology patients were risk stratified based on their Length of stay, Acuity of admission, Charlson comorbidity index score and Emergency department visits+index in the past 6 months. The higher the score, the quicker the outpatient oncology follow-up. In addition to addressing acute …

Associations Between Atmospheric Ozone, Pm2.5 And Prevalence Of Diabetes In Georgia, United States, Kingsley A. Kalu, Jingjing Yin, Atin Adhikari

Journal of the Georgia Public Health Association

Objective:

This study examines the association between two air pollutants (PM_2.5 and ozone), and the prevalence of adult diabetes mellitus in relation to various confounding factors.

Methods:

We collected diabetes prevalence data from the 2015 County Health Ranking and Georgia Health Data Hub. A negative binomial regression analysis was conducted to examine the associations between the county-level dependent variable “adult diabetes” (for adults aged> 18 years diagnosed with Type 1 and Type 2 diabetes) and two independent county-level variables: percentage of days ³ NAAQS for ozone and PM_2.5 concentration levels while controlling for confounders.

Results:

At the county …

Perspectives Of African American And Hispanic/Latino Individuals On Hiv Molecular Cluster Detection, Maxwell Richardson, Brendan H. Pulsifer, Jane Yoon Scott, David Holland, Eleanor W. Garlow, Pascale Wortley, Daniel Mauck, Jenna Gettings, Valeria Cantos, Masonia Traylor, Eric Rangel, David Folkes, Carlos Saldana

Journal of the Georgia Public Health Association

Background: Responding to HIV clusters detected using molecular data has been shown to reduce transmission and improve testing, treatment, and prevention. However, there are varied opinions about the use of cluster detection activities, and some advocates have raised concerns about patient consent, data security, and the potential for HIV criminalization. Incorporating the perspectives of marginalized populations that are disproportionately affected by HIV is essential to understanding the diversity of those perspectives, yet it is often overlooked in the literature. Thus, our study seeks to highlight the perspectives of Black/African American and Hispanic/Latino individuals in the Southern United States on HIV …

Phase 3 Trial Of Cabozantinib To Treat Advanced Neuroendocrine Tumors, Jennifer A Chan, Nikolaos A Trikalinos, Et Al.

2020-Current year OA Pubs

BACKGROUND: Treatment options for patients with advanced neuroendocrine tumors are limited. The efficacy of cabozantinib in the treatment of previously treated, progressive extrapancreatic or pancreatic neuroendocrine tumors is unclear.

METHODS: We enrolled two independent cohorts of patients - those with extrapancreatic neuroendocrine tumors and those with pancreatic neuroendocrine tumors - who had received peptide receptor radionuclide therapy or targeted therapy or both. Patients were randomly assigned in a 2:1 ratio to receive cabozantinib at a dose of 60 mg daily or placebo. The primary end point was progression-free survival as assessed by blinded independent central review. Key secondary end points …

Phages Carry Orphan Antitoxin-Like Enzymes To Neutralize The Dartg1 Toxin-Antitoxin Defense System, Anna Johannesman, Leila C Awasthi, Nico Carlson, Michele Leroux

2020-Current year OA Pubs

The astounding number of anti-phage defenses encoded by bacteria is countered by an elaborate set of phage counter-defenses, though their evolutionary origins are often unknown. Here, we report the discovery of an orphan antitoxin counter-defense element in T4-like phages that can overcome the bacterial toxin-antitoxin phage defense system, DarTG1. The DarT1 toxin, an ADP-ribosyltransferase, modifies phage DNA to prevent replication while its cognate antitoxin, DarG1, is a NADAR superfamily ADP-ribosylglycohydrolase that reverses these modifications in uninfected bacteria. We show that some phages carry an orphan DarG1-like NADAR domain protein, which we term anti-DarT factor NADAR (AdfN), that removes ADP-ribose modifications …

Treatment Of Small Intracranial Aneurysms Using The Smallss Scoring System: A Novel System For Decision Making, Mira Salih, Michael Young, Thomas B. Fodor, Alexander Andreev, Samuel D. Pettersson, Joanna M. Roy, Basel Musmar, Max Shutran, Phillip Taussky, Christopher S. Ogilvy

Department of Neurosurgery Faculty Papers

BACKGROUND: Treatment of unruptured intracranial aneurysms (UIA) less than 7 mm is controversial. We created a scoring system to guide decision making and validated the system utilizing over 700 cases treated with microsurgery or endovascular procedures.

METHODS: The scoring system SMALLSS included Size, (4-7 mm: 1 point, < 3.9 mm: 0 point), Multiple aneurysms (yes: 1, no: 0), Anatomic location (posterior: 1, anterior: 0), Lineage- family history of aneurysm (yes:1, no: 0), Lifetime risk (age < 65: 1, age > 65: 0), Smoking history (yes: 1, no: 0 ), Shape (irregular:1, smooth:0 ). Validation of this system was performed through retrospective review of prospectively maintained data for UIA patients treated between 2014 and 2021. We then performed an external validation of a cohort of 200 small aneurysms < 7 mm treated at a high volume cerebrovascular center.

RESULTS: A total of 1152 cases …

Prediction Of Cognitive Conversion Within The Alzheimer’S Disease Continuum Using Deep Learning, Siyu Yang, Xintong Zhang, Xinyu Du, Peng Yan, Jing Zhang, Wei Wang, Jing Wang, Lei Zhang, Huaiqing Sun, Yin Liu, Xinran Xu, Yaxuan Di, Jin Zhong, Caiyun Wu, Jan D Reinhardt, Yu Zheng, Ting Wu

Faculty, Staff and Students Publications

Background: Early diagnosis and accurate prognosis of cognitive decline in Alzheimer's disease (AD) is important to timely assignment to optimal treatment modes. We aimed to develop a deep learning model to predict cognitive conversion to guide re-assignment decisions to more intensive therapies where needed.

Methods: Longitudinal data including five variable sets, i.e. demographics, medical history, neuropsychological outcomes, laboratory and neuroimaging results, from the Alzheimer's Disease Neuroimaging Initiative (ADNI) cohort were analyzed. We first developed a deep learning model to predicted cognitive conversion using all five variable sets. We then gradually removed variable sets to obtained parsimonious models for four different …

Navigating Epstein-Barr Virus (Ebv) And Post-Transplant Lymphoproliferative Disorder (Ptld) In Pediatric Liver Transplantation: Current Knowledge And Strategies For Treatment And Surveillance, Erin Y Chen, Natasha Dilwali, Krupa R Mysore, Sara Hassan, Sara Kathryn Smith, Wikrom Karnsakul

Faculty, Staff and Students Publications

Epstein-Barr virus (EBV) is strongly associated with the development of post-transplant lymphoproliferative disorder (PTLD) in pediatric liver transplant recipients. PTLD is one of the most common malignancies following liver transplantation and is associated with significant morbidity and mortality. Factors such as EBV-serostatus mismatch and prolonged or high levels of immunosuppression impact a patient's risk of developing PTLD. While pre-transplant EBV serological screening and post-transplant monitoring of EBV-DNA levels are strongly recommended, universal guidelines for its prevention and management are lacking. Due to a lack of robust prospective studies, current clinical practices vary widely. The treatment of PTLD typically involves reducing …

Plasma Micrornas To Select Optimal Patients For Antibody Production From Anti-Addiction Vaccines, Thomas R Kosten, Amrit Koirala, David A Nielsen, Coreen B Domingo, Ynhi T Thomas, Preethi H Gunaratne, Cristian Coarfa

Faculty, Staff and Students Publications

Background: Cocaine and illicit amphetamines (disguised as “Adderall”) are being laced with fentanyl and producing accidental and intentional fatal overdoses. Vaccines can prevent these overdoses, but 33% of humans generate insufficient anti-drug antibody (AB) levels. Plasma microRNAs (miRs) can be used to predict non-responders. We have plasma stored from 152 cocaine vaccine trial participants following three vaccinations over 9 weeks and examined miRs as potential response biomarkers. Methods: We compared 2517 miRs before anti-cocaine vaccination in participants with the highest (n = 25) to the lowest (n = 23) antibody levels. False Discovery Rates (FDRs) were applied to identify differentially …

Long-Term 3-Year Follow-Up Of Mosunetuzumab In Relapsed Or Refractory Follicular Lymphoma After ≥2 Prior Therapies, Laurie H Sehn, Nancy L Bartlett, Et Al.

2020-Current year OA Pubs

Mosunetuzumab, a CD20×CD3 T-cell engaging bispecific antibody, redirects T cells to eliminate malignant B cells. We present updated efficacy and safety data of a pivotal phase 1/2 study after a median follow-up of 37.4 months in 90 patients with relapsed/refractory (R/R) follicular lymphoma (FL) and ≥2 prior lines of therapy treated with fixed-duration mosunetuzumab. Investigator-assessed complete response (CR) rate and objective response rate were 60.0% (95% confidence interval [CI], 49.1-70.2) and 77.8% (95% CI, 67.8-85.9), respectively. Among 70 responders, median duration of response was 35.9 months (95% CI, 20.7 to not estimable [NE]). Among 54 patients who achieved CR, 49 …

Feasibility Of An Undergraduate Academic Fellowship In Global Health System Development, Haleigh Pine, Brody R Mayoras, Maxwell C Klapow, Nathanael J Smith, Peter G Delaney, Zachary J Eisner

2020-Current year OA Pubs

BACKGROUND: Despite increasing student interest in global health, undergraduate opportunities remain limited and often lack practical, multidisciplinary experiences. To address professional gaps for future healthcare professionals and global health workers, it is crucial to incorporate resource management, business practices, and leadership into undergraduate volunteer service-learning programs.

METHODS: Lay First Responders (LFR) International's Fellowship Program in Emergency Medical Care and Innovation (ECMI) trains undergraduates to develop community-based emergency medical services in low- and middle-income countries, focusing on global capacity building, service leadership, and cultural competency. The year-long program guides fellows through a three-stage process of skill-development, design, and project implementation. The …

The Impact Of Medical Training On Student Health: A Pilot Study Of Physical Wellness, Nick Hill, Matt Hill, Braxton Bingham, Sara Beaudry-Wiltse

Annual Research Symposium

No abstract provided.

A Systematic Review Of Recent Developments In Platelet-Rich Plasma Therapy In Hip Osteoarthritis: Variability In Protocols And Clinical Outcomes (2019–2024), Emily Awdish, Marlena Muszynska, Konrad Lautenschlager, Ali Hamade

Annual Research Symposium

No abstract provided.

Advancing Dental Education Through Technological Integration: Opportunities And Challenges, Jazmine Gill, Urwa Asad, Zainab Qazalbash, Shilpa Bhandi, Frank Licari, Shankargouda Patil

Annual Research Symposium

No abstract provided.

Treatment Approaches For Immediate Implant Placement In Infected Site, Urwa Asad, Zainab Qazalbash, Jazmine Gill, Shilpa Bhandi, Frank Licari, Shankargouda Patil

Annual Research Symposium

No abstract provided.

A Systematic Review Of Persisting Tissue Health Challenges Amid Insulin Delivery System Advancements: Continuous Subcutaneous Insulin Infusion (Csii) And Lipohypertrophy In Diabetic Patients, Marlena Muszynska, Emily Awdish

Annual Research Symposium

No abstract provided.

Enhancing Learning In Restorative Dentistry And Endodontics: A Systematic Review Of Blended Educational Methods Running Title: Blended Learning In Dental Education, Kendall Morrison, Shankargouda Patil Phd Frcpath Fds Rcps Ficd Fpfa, Frank Licari Dds, Mph, Mba, Shilpa Bhandi Bds, Mds, Ficd,Fpfa

Annual Research Symposium

Title: Enhancing Learning in Restorative Dentistry and Endodontics: A Systematic Review of Blended Educational Methods Running Title: Blended Learning in Dental Education

Abstract

Background: The integration of e-learning into dental education has accelerated, driven by technological advancements and the need for adaptive teaching methods post-pandemic. Blended learning, which combines traditional face-to-face instruction with online components, offers a promising approach in dental curricula.

Objective: This systematic review examines the impact of blended learning on theoretical knowledge retention and clinical skills development in restorative dentistry and endodontics among undergraduate dental students.

Methods: A comprehensive literature search was conducted across Scopus, PubMed, Web …

Effect Of Routine Third Trimester Ultrasounds On Maternal Mental Health In Low-Risk Population In Utah, Claire Z. Zai, Priyanka R. Purohit, Emily M. Snyder, Bryson M. Mcadams, Daniela A. Betancourt-Martinez, Donna O. Van Beuge, Maria N. Easler, Makayla A. Muzinic, Carlos E. Angulo

Annual Research Symposium

Purpose: One in five pregnant women in the United States experience a maternal mental health condition. Within Utah from 2018-2022, during pregnancy, 22.7% of women experienced depression and 31.6% experienced anxiety, and 15.1% experienced postpartum depression. These data represent a prevalence higher than the national average. Third trimester ultrasound (TTUS) is not a standard of care performed in the United States currently. Previous TTUS research has mainly focused on the financial burden and birth outcomes rather than maternal mental health. Literature on first trimester ultrasound has demonstrated a notable impact on maternal mental health, but these outcomes within the third …