Medicine and Health Sciences Commons^™

Virus-Specific T-Cell Therapy For The Management Of Viral Infections In The Immunocompromised, Kiriakos Koukoulias, Penelope Georgia Papayanni, Ann Marie Leen, Spyridoula Vasileiou

Faculty, Staff and Students Publications

Background: Immunocompromised individuals are at major risk for severe infectious complications. This is particularly relevant in the context of allogeneic hematopoietic stem cell transplantation (allo-HCT) - a treatment modality that has proven curative for a range of malignant and nonmalignant hematological diseases. However, transplant-associated immune suppression leaves patients susceptible to infectious complications from viruses such as cytomegalovirus (CMV), adenovirus (AdV), Epstein-Barr virus (EBV), and BK virus (BKV). While pharmacological agents are available to prevent and/or treat some of these viruses, they can be associated with significant toxicities and are often ineffective. To circumvent these issues, several groups have explored the …

Beta-Blockers After Pci For Stable Coronary Artery Disease And Preserved Left Ventricular Ejection Fraction, Safi U Khan, Usman Ali Akbar, Muhammad Shahzeb Khan, Kershaw V Patel, Amna Nadeem, Samarth Thakkar, Hassaan B Arshad, Salim S Virani, Khurram Nasir, Sachin S Goel, Alpesh R Shah, William Zoghbi, Neal S Kleiman

Faculty, Staff and Students Publications

Background: Limited data exist on the long-term impact of beta-blocker therapy after percutaneous coronary intervention (PCI) in patients with stable coronary artery disease (CAD) and preserved left ventricular ejection fraction (LVEF).

Objectives: The aim of the study was to evaluate the effects of early beta-blocker initiation vs no initiation following PCI in patients with stable CAD and preserved LVEF.

Methods: This retrospective cohort study employed target trial emulation and incident user design, utilizing the TriNetx database (2009-2024). Early beta-blocker initiation (within days 1 and 7) was compared with no initiation using 1:1 greedy propensity score matching. The outcomes included all-cause …

Testosterone Modulation Of Muscle Transcriptomic Profile During Lifestyle Therapy In Older Men With Obesity And Hypogonadism, Viola Viola, Tagari Samanta, Maria Liza Duremdes Nava, Alessandra Celli, Reina Armamento-Villareal, Ngoc Ho Lam Nguyen, Georgia Colleluori, Yoann Barnouin, Nicola Napoli, Clifford Qualls, Benny Abraham Kaipparettu, Dennis T Villareal

Faculty, Staff and Students Publications

Background: Testosterone replacement therapy (TRT) added to lifestyle therapy can mitigate weight-loss-induced reduction of muscle mass and bone mineral density (BMD) in older men with obesity and hypogonadism.

Objective: To investigate the molecular mechanisms underlying the attenuation of muscle and BMD loss in response to TRT during intensive lifestyle intervention in this high-risk older population.

Methods: Among 83 older (≥ 65 years) men with obesity (BMI ≥ 30 kg/m2) and hypogonadism (early AM testosterone persistently < 300 ng/dL) associated with frailty (Modified Physical Performance Test score ≤ 31) randomized into 26-week lifestyle therapy plus testosterone (LT+TRT) or placebo (LT+Pbo) in the LITROS trial, 38 underwent serial muscle biopsies for the muscle transcriptomics substudy.

Results: Despite similar ~10% weight loss, lean body mass and thigh muscle volume decreased less in LT+TRT than LT+Pbo (-2% vs. -4%, respectively; p = …

Sustainable Solutions To The Continuous Threat Of Antimicrobial Resistance, Brad Spellberg, David N Gilbert, Michael Baym, Gonzalo Bearman, Tom Boyles, Arturo Casadevall, Graeme N Forrest, Sarah Freling, Bassam Ghanem, Fergus Hamilton, Brian Luna, Jessica Moore, Daniel M Musher, Travis B Nielsen, Priya Nori, Matthew C Phillips, Liise-Anne Pirofski, Andrew F Shorr, Steven Y C Tong, Todd C Lee, Emily G Mcdonald

Faculty, Staff and Students Publications

To combat antimicrobial resistance (AMR), advocates have called for passage of the Pioneering Antimicrobial Subscriptions To End Upsurging Resistance (PASTEUR) Act in the United States, which would appropriate $6 billion in new taxpayer-funded subsidies for antibiotic development. However, the number of antibiotics in clinical development, and US Food and Drug Administration approvals of new antibiotics, have already markedly increased in the last 15 years. Thus, instead of focusing on more economic subsidies, we recommend reducing selective pressure driving AMR by (1) establishing pay-for-performance mechanisms that disincentivize overprescribing of antibiotics, (2) focusing existing research and development funding on strategies that decrease …

Oral Anticoagulant Initiation In Patients With Kidney Failure On Hemodialysis Newly Diagnosed With Atrial Fibrillation (2007-2020): An Observational Study Of Trends And Disparities, Wolfgang C Winkelmayer, Austin Hu, Pascale Khairallah, Medha Airy, Kevin F Erickson, Tara I Chang, Jingbo Niu

Faculty, Staff and Students Publications

Rationale & objective: Atrial fibrillation (AF) is common in patients with kidney failure on hemodialysis (HD), but few patients receive oral anticoagulant (OAC) treatment. Availability of direct-target OACs starting in 2010 may have induced greater OAC initiation, but this has not been systematically studied.

Study design: Retrospective cohort study.

Setting & participants: Using Medicare fee-for-service billing claims (2006-2020), we identified previously OAC-naïve HD patients newly-diagnosed with AF between January 1, 2007, and October 1, 2020.

Exposures: Calendar year; race/ethnicity.

Outcomes: OAC initiation within 90 days from AF diagnosis (any; specific agent).

Analytical approach: We estimated initiation risk ratios for each …

Disease Activity Of Rheumatoid Arthritis And Kidney Function Decline: A Large Prospective Registry Study, Sho Fukui, Wolfgang C Winkelmayer, Sara K Tedeschi, Javier Marrugo, Hongshu Guan, Leslie Harrold, Heather J Litman, Tomohiro Shinozaki, Daniel H Solomon

Faculty, Staff and Students Publications

Introduction: Chronic kidney disease (CKD) is a common comorbidity of rheumatoid arthritis (RA). The association of longitudinal RA disease activity with long-term kidney function has remained uncertain.

Method: We analysed a multicentre prospective RA registry in the USA from 2001 to 2022. The exposure was updated time-averaged Clinical Disease Activity Index (TA-CDAI) categories from study enrolment. The primary outcome was a longitudinal estimated glomerular filtration rate (eGFR) change. Secondary outcomes included developments of CKD stage G3a (eGFR< 60 mL/min/1.73 m2) and stage G3b (eGFR< 45 mL/min/1.73 m2). Results were adjusted for relevant time-fixed and time-varying covariates.

Results: 31 129 patients (median age: 58.0 years, female: 76.3%, median eGFR: 90.7 mL/min/1.73 m2) contributed 234 973 visits and 146 778 person-years …

Intercostal Nerve Cryoablation In Lung Transplantation: A Single-Center, Propensity Score-Matched Analysis, Marcelo Salan-Gomez, Ramiro Fernandez, Ethan D'Silva, Belia Camarena, Emma Hills, Andres Leon, Syed B Peer, Abdussalam Elsenousi, Puneet Garcha, Gabriel Loor

Faculty, Staff and Students Publications

Background: Achieving adequate pain control after lung transplantation is an essential milestone in a patient's recovery. We compared postoperative opioid use, clinical outcomes, and respiratory function in lung transplant recipients treated with intercostal nerve cryoablation (INC) compared to those receiving standard pain management.

Methods: We reviewed all adult lung transplants performed at our center between January 2016 and December 2022. We excluded cases performed through median sternotomy and patients with prior thoracotomies, multiorgan transplants, and redo transplants. We performed a propensity score-matched analysis, comparing patients who received INC versus those who received standard pain management. The primary outcome was cumulative …

Environmental Sustainability In The Outpatient Clinic Setting, Matthew M Sattler, Monica Abd El Nour, Virginia R Mckay, Jason P Burnham

2020-Current year OA Pubs

This article will highlight recent efforts published in the medical literature to promote environmental sustainability in the outpatient clinic setting, which are likely to be feasible for health professionals to implement in their own practices. These potential efforts are divided into 3 broad categories: (1) reducing travel to the clinic when feasible, (2) reducing waste production in the clinic, and (3) optimizing the use of high-value diagnostics and therapeutics. As research specifically related to interventions to promote environmental sustainability in outpatient clinics is relatively limited, health professionals are encouraged to continue sharing success stories from their own practice.

A Staged Approach To Resecting A Large Rectal Polyp Using Endoscopic Mucosal Resection And Trans-Anal Endoscopic Microsurgery: A Case Report, Bhavna A Guduguntla, Jared Yee, Paul E Wise, Ahmad Najdat Bazarbashi

2020-Current year OA Pubs

Large rectal adenomatous polyps are not uncommon. Proctectomy sparing interventions are favored when feasible. We present a case of a 62-year-old woman, who presented with diarrhea for several years. Colonoscopy revealed a very large 60 mm rectal polyp, biopsied as tubulovillous adenoma. This was successfully resected using a staged approach with endoscopic mucosal resection and trans-anal endoscopic microsurgery. Endoscopic mucosal resection removed 70% of the lesion with central scarred not amenable to resection but amenable to transanal excision. Pathology demonstrated tubulovillous adenoma with negative margins. Flexible sigmoidoscopy at 6-month follow-up revealed well healed scar without recurrence or residual disease. This …

Nuclear Egfr In Breast Cancer Suppresses Nk Cell Recruitment And Cytotoxicity, Angelica Escoto, Ryan Hecksel, Chance Parkinson, Sara Crane, Benjamin Atwell, Shyanne King, Daniela Ortiz Chavez, Alison Jannuzi, Barbara Sands, Benjamin G Bitler, Todd A Fehniger, Andrew L Paek, Megha Padi, Joyce Schroeder

2020-Current year OA Pubs

Natural Killer (NK) cells can target and destroy cancer cells, yet tumor microenvironments typically suppress NK cell recruitment and cytotoxicity. The epidermal growth factor receptor (EGFR) is a potent oncogene that can activate survival, migration, and proliferation pathways, and clinical data suggests it may also play an immunomodulating role in cancers. Recent work has demonstrated a novel role for nuclear EGFR (nEGFR) in regulating transcriptional events unique from the kinase domain. Using a novel peptide therapeutic (cSNX1.3) that inhibits retrograde trafficking of EGFR and an EGFR nuclear localization mutant, we discovered that nEGFR suppresses NK cell recruitment and cytotoxicity. RNA-Seq …

Triacylglycerol Mobilization Underpins Mitochondrial Stress Recovery, Zakery N Baker, Yunyun Zhu, Rachel M Guerra, Andrew J Smith, Aline Arra, Lia R Serrano, Katherine A Overmyer, Shankar Mukherji, Elizabeth A Craig, Joshua J Coon, David J Pagliarini

2020-Current year OA Pubs

Mitochondria are central to myriad biochemical processes, and thus even their moderate impairment could have drastic cellular consequences if not rectified. Here, to explore cellular strategies for surmounting mitochondrial stress, we conducted a series of chemical and genetic perturbations to Saccharomyces cerevisiae and analysed the cellular responses using deep multiomic mass spectrometry profiling. We discovered that mobilization of lipid droplet triacylglycerol stores was necessary for strains to mount a successful recovery response. In particular, acyl chains from these stores were liberated by triacylglycerol lipases and used to fuel biosynthesis of the quintessential mitochondrial membrane lipid cardiolipin to support new mitochondrial …

Unprecedented Female Mutation Bias In The Aye-Aye, A Highly Unusual Lemur From Madagascar, Richard J Wang, Yadira Peña-García, Muthuswamy Raveendran, R Alan Harris, Thuy-Trang Nguyen, Marie-Claude Gingras, Yifan Wu, Lesette Perez, Anne D Yoder, Joe H Simmons, Jeffrey Rogers, Matthew W Hahn

Faculty, Staff and Students Publications

Every mammal studied to date has been found to have a male mutation bias: male parents transmit more de novo mutations to offspring than female parents, contributing increasingly more mutations with age. Although male-biased mutation has been studied for more than 75 years, its causes are still debated. One obstacle to understanding this pattern is its near universality-without variation in mutation bias, it is difficult to find an underlying cause. Here, we present new data on multiple pedigrees from two primate species: aye-ayes (Daubentonia madagascariensis), a member of the strepsirrhine primates, and olive baboons (Papio anubis). In stark contrast to …

Historical Demography And Species Distribution Models Shed Light On Speciation In Primates Of Northeast India, Mihir Trivedi, Kunal Arekar, Shivakumara Manu, Lukas F K Kuderna, Jeffrey Rogers, Kyle Kai-How Farh, Tomas Marques Bonet, Govindhaswamy Umapathy

Faculty, Staff and Students Publications

Past climate change is one of the important factors influencing primate speciation. Populations of various species could have risen or declined in response to these climatic fluctuations. Northeast India harbors a rich diversity of primates, where such fluctuations can be implicated. Recent advances in climate modeling as well as genomic data analysis has paved the way for understanding how species accumulate at a particular geographic region. We utilized these methods to explore the primate diversity in this unique region in relation to past climate change. To ascertain the population level changes, we inferred the demographic history of nine species of …

Hospice Patients In The Emergency Department: Challenging High-Risk Encounters With Unanswered Questions And Unquestioned Answers, Jason K Bowman, Joan M Teno, Kei Ouchi

Faculty, Staff and Students Publications

No abstract provided.

The Efficacy Of Complementary And Alternative Medicines In Medical Dermatology: A Comprehensive Review, Promise Ufomadu, Bartley Joseph Gill, Ida Orengo, Theodore Rosen, Ikue Shimizu

Faculty, Staff and Students Publications

Background: In recent years, there has been a widespread patient use of complementary and alternative medicines (CAMs) for dermatological application, despite few RCT-level studies on these supplements. This creates a barrier for dermatologists and others in counseling patients who may be using or might be tempted to use these CAM agents. This review investigates various CAM modalities used by patients for medical dermatology, exploring their efficacy and toxicity profiles.

Methods: A comprehensive review was performed on the effectiveness of several CAMs utilized in medical dermatology by patients. A literature search was conducted using PubMed, Embase, Google Scholar, Web of Science, …

What Does Randomization Do?, Michael A. Lewis

Journal of Humanistic Mathematics

In the health and social sciences, when it comes to causal inference, randomized controlled trials (RCTs) are considered the gold standard. The justification for granting RCTs this status is the claim that random allocation to different treatment groups addresses the problem of confounding variables by ensuring that any differences in observed outcomes across treatment groups can be attributed only to differences in treatment. I contend that this is a misunderstanding of what random allocation does and that once we see where this argument goes wrong, it becomes clear that the difference, concerning causal inference, between a single observational study versus …

Juggling Diapers And Diagnoses: The Trials Of Fatherhood And Medical School, Anderson G. White

Marshall Journal of Medicine

This paper explores the intersection of sleep deprivation and academic performance from the perspective of a third-year medical student and a new father. As sleepless nights become routine due to the demands of parenting, the impact on academic responsibilities is profound. Research indicates that new parents experience significant reductions in sleep satisfaction, which in turn affects learning efficiency and overall academic performance. The challenges of balancing medical studies with the chaos of fatherhood highlight the urgent need for institutional support and flexible policies to accommodate the unique circumstances of student-parents. Ultimately, while the journey is fraught with exhaustion, the joys …

The Implementation Of Faculty Development In Providing Effective Feedback Utilizing Simulation, Mark Gustafson, Jessica Amos, Lisa Calderwood

Marshall Journal of Medicine

Background

Feedback is important in medical education, but various factors can impact its effectiveness. Feedback frameworks have been created to address these challenges, but simulation-based instruction of these frameworks has not been studied. This study aims to evaluate the effectiveness of instruction utilizing simulation to teach faculty how to deliver feedback.

Methods

Faculty development feedback workshops were held from October 2022 through May 2023 at Charleston Area Medical Center Institute for Academic Medicine. Each workshop consisted of a didactic session and 3 simulated scenarios during which the faculty learner gave feedback to a resident. Surveys were conducted before the workshop, …

Introducing A Point-Of-Care Tool To Teach Health Science Students About Social Determinants Of Health, Cassandra Simpkins, Alexandra Bowman, Kathleen Bors, Meghan Allwes, Lisa Calderwood

Marshall Journal of Medicine

Background

Social determinants of health (SDoH) are recognized as modifiable drivers of optimal health and an opportunity to achieve health equity, yet many clinicians still experience barriers to addressing their patients’ social needs. To help connect patients to supportive resources, the American Academy of Family Physicians developed the Neighborhood Navigator (NN) tool. This study examined the impact of incorporating the NN tool into SDoH education for medical and pharmacy students and examined their perceptions of the tool.

Methods

This prospective study of third- and fourth-year medical and PharmD students included assessments before and after an SDoH learning activity. The survey …

Retrospective Chart Reviews: A Practical Approach To Designing, Collecting Data, And Writing The Manuscript, Olivia Hart, Jennie L. Yoost

Marshall Journal of Medicine

No abstract provided.

Ignatzschineria Species Bacteremia: A Case Report And Review Of The Literature, Katherine Sandomirsky, Mark Sayegh, Priscila Lopez, Yone Lwin, Sharon Mannheimer

Marshall Journal of Medicine

Ignatzschineria species, a member of the Gammaproteobacteria class of bacteria, is a gram-negative, aerobic, non-spore forming rod. This emerging human pathogen has been found in the digestive tract of the parasitic Wohlfarhtia magnifica fly. Infections in humans are uncommon and are usually associated with maggot infestation (wound myiasis). Rare cases of Ignatzschineria species bacteremia have been reported in individuals with myiasis of chronic skin wounds. Current literature describes 4 known species of Ignatzschineria: I. indica, I. larvae, I. ureiclastica, and I. cameli. An additional 2 cases of Ignatzachineria bacteremia were caused by Ignatzschineria species that were “unable to …

A Rare Case Of Gallstone Ileus In A Young Female: A Surgical Case Report, Justin West, Toufeeq Suliman, Pranav Balakrishnan, Curtis W. Harrison Jr., Md, Facs, David Denning

Marshall Journal of Medicine

Gallstone ileus, a rare yet potentially life-threatening complication of cholelithiasis, poses diagnostic and therapeutic challenges. This is the case of a 36-year-old female with no significant medical history who presented with mid-abdominal pain and recurrent vomiting. Diagnostic imaging via CT scan revealed a cholecystoduodenal fistula and 2 large gallstones causing bowel obstruction. Following resuscitation, she underwent prompt exploratory laparotomy with enterotomy and gallstone removal, followed by an uneventful recovery and discharge. This case underscores the importance of early recognition and timely surgical intervention in managing gallstone ileus.

Atypical Presentation Of Non-Small Cell Lung Carcinoma With Metastasis To Breast Tissue, Tylar P. Seckman, Diane Krutzler-Berry, Mohamed Ashal, Waqas Mahmud, Krista L. Denning, Logan M. Lawrence

Marshall Journal of Medicine

Malignant neoplasms of the lung commonly metastasize to lymph nodes, bone, brain, and liver via hematogenous and lymphatic routes. Much less commonly, metastasis occurs in the breast. Secondary metastatic disease of the breast is very rare, with a reported incidence ranging from 0.4-1.3%­­—with primary lung cancer being one of the most anomalous sources. This case details non-small cell lung cancer metastasis to the breast with proven primary contralateral lung origination. This atypical finding prompts medical professionals to consider these malignant cells' immunologic, histologic, and pathologic makeup to understand further and treat the neoplasm.

A Decade Of Scientific Excellence: Celebrating The Marshall Journal Of Medicine, Darshana T. Shah

Marshall Journal of Medicine

No abstract provided.

Pass It Along: Learning About Health Inequities Through Project-Based Learning And A Student-Developed Workshop, Marcy S. Ekanayake-Weber, Deanna Cunha, Kristi L. Fung, Sydney Macgregor, Nicole Ribeiro, Nicholas Smith

International Journal of Transformative Teaching and Learning in Higher Education

People in marginalized communities experience reduced quality of healthcare due to complex interactions between implicit bias, stereotypes, and structural inequities, but future healthcare providers remain unprepared to confront these problems. To address the issue of health inequities in health sciences education, a project-based learning seminar for undergraduates called “Biology of Inequity” was developed and offered by the Department of Anthropology at [redacted] University in Spring semester 2022. Following the project-based learning (PBL) framework, the course was extremely interactive, culminating in a project where students were asked to “materially improve health inequalities out in the real world.” The students responded by …

Culture Shock: Exploring The Truths & Benefits Of Remote Work In Higher Education, Teresa M. Stephens, Kristen Poston, Sarah Miller, Catherine O. Durham, Amy Williams

International Journal of Transformative Teaching and Learning in Higher Education

In “Culture Shock,” Gallup’s 2023 publication, the authors explore the COVID-19 pandemic’s impact on work and life, urging a reevaluation of leadership strategies, especially for remote work. They highlight a significant shift, with many U.S. employees hesitant to return to traditional offices, favoring new remote work environments that integrate work and life. This shift is also evident in higher education, where faculty see benefits in productivity and well-being, despite some pressure to revert to old norms. Clifton and Harter (2023) argue that the focus should be on how organizations build and maintain relationships in this evolving landscape. Their thesis emphasizes …

Occupational Therapy Assistant Preparatory Course To Improve Mock Certification Exam Scores: An Evidenced-Based Intervention, Anderston St. Germain

Journal of Innovation in Health Sciences Education

Abstract

Introduction: The overall goal of educators of occupational therapy is to produce graduates capable of meeting entry-level employment status, which becomes evident when they pass the national certification exam. This evidence-based pilot project investigated an occupational therapy assistant certification exam preparatory course designed to improve mock certification test scores of graduates from an occupational therapy assistant program.

Methods: The project was implemented as a pilot study in the fall of 2017 with six participants. The course was delivered using a face-to-face teaching model and designed based on the most recent evidence from the literature. The course content included …

6,7-Dichloro-1h-Indole-2,3-Dione-3-Oxime Functions As A Superagonist For The Intermediate-Conductance Ca2+-Activated K+ Channel KCa3.1, Joshua A. Nasburg, Kyle C. Rouen, Connor J. Dietrich, Heesung Shim, Miao Zhang, Igor Vorobyov, Heike Wulff

Pharmacy Faculty Articles and Research

NS309 (6,7-dichloro-1H-indole-2,3-dione-3-oxime) is widely used as a pharmacological tool to increase the activity of small- and intermediate-conductance calcium-activated potassium channels. NS309 is assumed to function as a positive allosteric gating modulator. However, its binding site and the molecular details of its action remain unknown. Here, we show that NS309 has a profound effect on the calcium-dependent gating of the intermediate-conductance Ca2+-activated K+ channel KCa3.1. In inside-out experiments, 10 μM NS309 shifted the calcium EC50 from 430 to 31 nM. In whole-cell experiments, changing free intracellular calcium from 250 nM to 3 μM decreased the EC50 of …

02-06-25 Hsc Committee Meeting Agenda, Patricia Serna

HSC Committee (A subcommittee of the UNM Board of Regents)

02-06-25 HSC Committee Meeting Agenda

Does College Guarantee Economic Mobility?: Incorporating Lost In-Kind Benefits Into The Calculation, Amy S. White

Publications and Research

Average salaries of college graduates are higher than salaries of those without degrees. However, the experience of graduating and out-earning the income requirements for in-kind or entitlement benefits like Medicaid, public assistance, Supplemental Nutritional Assistance Plan, and/or Section 8 housing vouchers are not taken into consideration in any mobility calculation nor are students prepared to lose their benefits. Teaching at an urban commuter school in a financially disadvantage borough, I have identified a gap in the research literature and supportive services for these low-income students. This opinion piece further describes the problem and highlights areas for future action and research.