Medicine and Health Sciences Commons^™

Subcutaneous Insulin Use In Diabetic Ketoacidosis, Patrick Mcgrath

Lynchburg Journal of Medical Science

The reviewed literature focuses on the clinical application of subcutaneous (SQ) insulin, particularly rapid-acting insulin analogs (RAIAs), in treating selected patients with mild to moderate diabetic ketoacidosis (DKA). The use of SQ insulin offers a viable alternative to traditional intravenous (IV) insulin infusions, enabling DKA management outside intensive care unit (ICU) settings and reducing healthcare resource utilization. Current DKA management protocols emphasize comprehensive fluid resuscitation and correction of electrolyte imbalances, with IV regular insulin administered at 0.1 units/kg/hour. This review synthesizes findings from multicenter cohort studies, meta-analyses, and randomized controlled trials (RCTs) available via PubMed, focusing on adult patients diagnosed …

Genetic Adaptations And Malaria Prophylaxis In Sickle Cell Disease: Reducing Morbidity And Mortality, Fuseina Gimballa

Lynchburg Journal of Medical Science

This study examines the relationship between sickle cell disease (SCD) and malaria, focusing on the benefits and risks of the sickle cell trait, complications associated with SCD, and the impact of malaria infection in endemic regions. The paper emphasizes the importance of antimalarial prophylaxis for patients with SCD living in these areas. Evidence suggests a genetic adaptation in populations exposed to malaria, where a β-globin mutation provides partial protection against infection in individuals with the sickle cell trait. Studies consistently show that heterozygous carriers are largely protected from severe malaria, whereas individuals with homozygous SCD remain highly susceptible, resulting in …

Brief Overview Of Assessment And Prognostication Tools For Palliative Care Oncology Patients, Nicole Schwensow

Lynchburg Journal of Medical Science

Patients with life-threatening illnesses can be at risk for the progression of their disease over time. Consequences of such an illness can include recurrent hospitalizations, poor symptom control, and a lack of understanding by the patient and family of the disease, its usual course, and prognosis. Palliative care is a philosophy of care intended to address these issues. While receiving palliative care, patients can continue to undergo treatments directed at a cure, whereas hospice patients no longer receive treatment for underlying diseases. Both approaches focus on symptom control. To best care for palliative patients over time, several outcome domains should …

Management Of Difficult Patient Situations, Sangeetha Larsen Mpas, Pa-C

Lynchburg Journal of Medical Science

The purpose of this paper is to provide strategies for clinicians to manage difficult patient interactions. A comprehensive search of PubMed was conducted, identifying articles that identified the root cause of difficult patient interactions and assessed methods for successfully navigating these situations. The term “difficult patient” reflects the interaction of patient behavior, clinician perception, and systemic constraints rather than an inherent patient flaw. Effective management involves reframing difficult behavior as an expression of unmet needs and responding with empathy, active listening, clear boundaries, and collaborative decision-making. System-level strategies reduce patient distress and clinician burnout. Ultimately, the difficult patient represents strained …

Physician Assistants And The Medical Science Liaison Role: Expanding Career Pathways Beyond Clinical Practice, Michael Filsinger

Lynchburg Journal of Medical Science

ABSTRACT

The purpose of this article is to examine how physician assistants can transition into Medical Science Liaison roles within the pharmaceutical and biotechnology industries. Growing interest in nonclinical career pathways has prompted more physician assistants to explore opportunities in medical affairs, yet many remain uncertain about the qualifications, expectations, and academic preparation associated with these positions. A focused literature review was conducted to evaluate the competencies required for Medical Science Liaison roles, the barriers clinician applicants often encounter, and the strategies that may support successful transition into industry-based careers. Findings show that physician assistants possess relevant strengths such as …

Understanding Monoclonal Gammopathy Of Undetermined Significance, Scott Winkel Msph, Mhs, Pa-C

Lynchburg Journal of Medical Science

Monoclonal gammopathy of undetermined significance (MGUS) is a premalignant plasma cell disorder characterized by serum monoclonal protein (M-protein) levels less than 3.0 g/dL, less than 10% plasma cells in the bone marrow, and absence of end-organ damage. It mainly affects older adults and is often an incidental finding. While most cases remain indolent, a subset progresses to malignancies such as multiple myeloma, smoldering myeloma, AL amyloidosis, lymphoproliferative disorders, macroglobulinemia, and monoclonal gammopathy of renal significance. This review summarizes current insights into MGUS pathophysiology, risk factors, molecular mechanisms, clinical features, diagnostic approaches, including laboratory assessments and imaging, and emphasizes early detection …

Effect Of Remineralization And Resin Infiltration On Microhardness, Mineral Content And Cervical Microleakage Of Restored Demineralized Enamel, Sara Adel Botros, Caroline Maged Massieh

Dentistry

No abstract provided.

Real-World Data Investigating The Frequency Of Flash Glucose Monitoring And Glycaemic Metrics In Omani Diabetes Patients: A Preliminary Retrospective Cross-Sectional Study, Ammar Al-Mamari, Sumaia Al Gharabi, Merah Al Busaidy, Abdulla Al Futaisi

Sultan Qaboos University Medical Journal

Objectives: This study aimed to evaluate real-world glycaemic outcomes associated with flash glucose monitoring (FGM) use in patients with diabetes at Sultan Qaboos University Hospital, Muscat, Oman. Methods: This retrospective cross-sectional study was conducted among diabetic patients using flash glucose monitoring between January 2022 and August 2023. Patients were grouped by scanning frequency, time-in-range (TIR) and estimated A1c (eA1c). Associations between scanning frequency and glycaemic metrics were analysed. Results: A total of 436 patients were included in this study. Patients with higher scanning frequency (≥12 scans/day, median = 17) achieved greater TIR (52.4% versus 34.8%), lower time-above-range (41.8% versus 57.0%), …

Large-Scale Blood Pressure Gwas Accounting For Gene-Depression Interactions In 564,680 Individuals From Diverse Populations, Songmi Lee, Clint L Miller, Amy R Bentley, Michael R Brown, Pavithra Nagarajan, Raymond Noordam, John L Morrison, Karen Schwander, Kenneth Westerman, Minjung Kho, Aldi T Kraja, Paul S De Vries, Farah Ammous, Hughes Aschard, Traci M Bartz, Anh Do, Charles T Dupont, Mary F Feitosa, Valborg Gudmundsdottir, Xiuqing Guo, Sarah E Harris, Keiko Hikino, Zhijie Huang, Christophe Lefevre, Leo-Pekka Lyytikäinen, Yuri Milaneschi, Giuseppe Giovanni Nardone, Aurora Santin, Helena Schmidt, Botong Shen, Tamar Sofer, Quan Sun, Ye An Tan, Jingxian Tang, Sébastien Thériault, Peter J Van Der Most, Erin B Ware, Stefan Weiss, Wang Ya Xing, Chenglong Yu, Wei Zhao, Md Abu Yusuf Ansari, Pramod Anugu, John R Attia, Lydia A Bazzano, Joshua C Bis, Max Breyer, Brian Cade, Guanjie Chen, Stacey Collins, Janie Corley, Gail Davies, Marcus Dörr, Jiawen Du, Todd L Edwards, Tariq Faquih, Jessica D Faul, Alison E Fohner, Amanda M Fretts, Srushti Gangireddy, Adam Gepner, Mariaelisa Graff, Edith Hofer, Georg Homuth, Michelle M Hood, Xu Jie, Mika Kähönen, Sharon L R Kardia, Carrie A Karvonen-Gutierrez, Lenore J Launer, Daniel Levy, Maitreiyi Maheshwari, Lisa W Martin, Koichi Matsuda, John J Mcneil, Ilja M Nolte, Tomo Okochi, Laura M Raffield, Olli T Raitakari, Lorenz Risch, Martin Risch, Ana Diez Roux, Edward A Ruiz-Narvaez, Tom C Russ, Takeo Saito, Pamela J Schreiner, Rodney J Scott, James Shikany, Jennifer A Smith, Harold Snieder, Beatrice Spedicati, E Shyong Tai, Adele M Taylor, Kent D Taylor, Paola Tesolin, Rob M Van Dam, Rujia Wang, Wei Wenbin, Tian Xie, Jie Yao, Kristin L Young, Ruiyuan Zhang, Alan B Zonderman, Biobank Japan Project, Lifelines Cohort Study, Maria Pina Concas, David Conen, Simon R Cox, Michele K Evans, Ervin R Fox, Lisa De Las Fuentes, Ayush Giri, Giorgia Girotto, Hans J Grabe, Charles Gu, Vilmundur Gudnason, Sioban D Harlow, Elizabeth Holliday, Jonas B Jost, Paul Lacaze, Seunggeun Lee, Terho Lehtimäki, Changwei Li, Ching-Ti Liu, Alanna C Morrison, Kari E North, Brenda W J H Penninx, Patricia A Peyser, Michael M Province, Bruce M Psaty, Susan Redline, Frits R Rosendaal, Charles N Rotimi, Jerome I Rotter, Reinhold Schmidt, Xueling Sim, Chikashi Terao, David R Weir, Xiaofeng Zhu, Nora Franceschini, Jeffrey R O'Connell, Cashell E Jaquish, Heming Wang, Alisa Manning, Patricia B Munroe, Dabeeru C Rao, Han Chen, W James Gauderman, Laura J Bierut, Thomas W Winkler, Myriam Fornage

Faculty, Staff and Student Publications

Gene-environment interactions may enhance our understanding of blood pressure (BP) biology. We conducted a meta-analysis of multi-population genome-wide association studies (GWASs) of BP traits accounting for gene-depressive symptomatology (DEPR) interactions. Our study included 564,680 adults from 67 cohorts and four population backgrounds: African (5%), Asian (7%), European (85%), and Hispanic (3%). We discovered seven previously unreported BP loci showing gene-DEPR interaction. These loci mapped to genes implicated in neurogenesis (TGFA and CASP3), lipid metabolism (ACSL1), neuronal apoptosis (CASP3), and synaptic activity (CNTN6 and DBI). We also showed evidence for gene-DEPR interaction at nine known BP loci, further suggesting links between …

Secure Distributed Multiple Imputation Enables Missing Data Inference For Private Data Proprietors, Haris Smajlović, Yi Lian, Qi Long, Ibrahim Numanagić, Xiaoqian Jiang

Faculty, Staff and Student Publications

Scattered between many healthcare providers across the US, Electronic Health Records (EHR) are extensively used for research purposes. Collaboration and sharing of EHRs between multiple institutions often provide access to more diverse datasets and a chance to conduct comprehensive studies. However, these collaboration efforts are usually hindered by privacy issues that render the pooling of such data at a centralized database impossible. Furthermore, EHRs are often incomplete and require statistical imputation prior to the study. To enable collaborative studies on top of incomplete, private EHRs, here we provide a provably secure solution built with secure multiparty computation (SMC) that provides …

Association Of Neighborhood Economic Trajectories And Risk Of Mortality Among Older Adults, Erika Figueroa-Solis, Qian Xiao

Faculty, Staff and Student Publications

Background

Lower neighborhood socioeconomic status (SES) and decline in neighborhood SES have been linked to detrimental health outcomes, such as cardiovascular disease (CVD), cancer, and mortality. However, few studies have investigated distinct types of neighborhood economic trajectories in relation to mortality. We examined the association between the recently developed multidimensional measure of neighborhood trajectories and mortality in older adults enrolled in the National Institutes of Health-AARP Diet and Health Study (NIH-AARP).

Methods

Neighborhoods were classified into five groups based on economic change patterns from 2000 to 2016 using American Community Survey data: Stability, Growth, Displacement, Abandonment, and Poverty Concentration. Mortality …

Characteristics And Effectiveness Of Maternal Health Interventions To Prevent Mother-To-Child Transmission (Pmtct) Of Syphilis In A Global Setting: A Scoping Review Using Intervention Mapping As A Framework, Jinni Tang, Anusha Sajja, Christine Markham, Emily T Hebert, Irene Stafford, Sheryl Dacso, Melissa F Peskin

Faculty, Staff and Student Publications

Background: Despite the availability of cost-effective treatments, maternal syphilis continues to contribute significantly to preventable stillbirths and congenital syphilis cases worldwide. This scoping review aimed to identify and characterize maternal health interventions designed to prevent mother-to-child transmission (PMTCT) of syphilis globally, using a modified Intervention Mapping (IM) framework.

Methods: We conducted a scoping review of maternal health interventions targeting PMTCT of syphilis published between January 2010 and August 2023. Searches were performed in PubMed, Medline Ovid, and Embase, supplemented by manual reference screening. Eligible studies described at least one maternal health intervention addressing syphilis PMTCT and were analyzed using a …

Flipi24: A Modern Prognostic Model And Clinical Trial Enrichment Tool For Newly Diagnosed Follicular Lymphoma, Matthew J Maurer, Vit K Prochazka, Tarec Christoffer El-Galaly, Christopher R Flowers, Diego Villa, Emmanuel Bachy, Elliot J Cahn, Marguerite Fournier, Melissa C Larson, Caroline E Dietrich, Lasse Hjort Jakobsen, Hervé Ghesquières, Robert Kridel, Maher K Gandhi, Chan Y Cheah, Eliza A Hawkes, John F Seymour, Ciara L Freeman, Michael R Clausen, Björn E Wahlin, Jonathan W Friedberg, Carla Casulo, Thomas M Habermann, Yucai Wang, Loretta J Nastoupil, Peter De Nully Brown, David Belada, Andrea Janíková, Heidi Mocikova, Tomáš Fürst, Pierre Feugier, Hervé Tilly, Corinne Haioun, Andrew J Davies, Guillaume Cartron, Richard Burack, Dai Chihara, Peter Martin, Jonathon B Cohen, Izidore S Lossos, Brad S Kahl, Laurie H Sehn, Karin E Smedby, Gilles Salles, Marek Trneny, Brian K Link, Franck Morschhauser, James R Cerhan

Faculty, Staff and Student Publications

Purpose: Although most patients with follicular lymphoma (FL) can expect an indolent course, progressive lymphoma remains the primary cause of death during the first decade after diagnosis. Progression of disease within 24 months (POD24) of starting first-line (1L) immunochemotherapy defines a high-risk population with poor survival, but better risk stratification at diagnosis is needed.

Methods: The FLIPI24 model was developed and internally validated to predict 24-month event rates using individual data from 4,485 patients treated with 1L immunochemotherapy from 10 observational cohorts of FL. Overall and cause-specific survival was further evaluated in FLIPI24 risk groups. External validation in the 1L …

Identification Of Cadm1 As An Immunotherapeutic Target And Evaluation Of A Novel Cadm1-Targeting Antibody-Drug Conjugate In Preclinical Osteosarcoma Models, Yifei Wang, Zhongting Zhang, Caterina Longo, Wendong Zhang, Qi Wang, Amer Najjar, Xiangjun Tian, Rossana N Lazcano Segura, Michael E Roth, Jonathan Gill, Douglas J Harrison, Zhaohui Xu, Yanhua Yi, Xin Zhou, Sylvester Jusu, Timothy M Stearns, Steven B Neuhauser, Carol J Bult, Jing Wang, Alexander J Lazar, Richard Gorlick

Faculty, Staff and Student Publications

Due to the paucity of validated cell surface osteosarcoma-specific targets, patients with this condition have long been excluded from the benefits of antibody-drug conjugate (ADC) therapy observed in patients with several solid and hematologic malignancies. Our comprehensive surfaceome profiling approach previously identified osteosarcoma-specific cell-surface antigens that are highly expressed in osteosarcomas but minimally expressed in normal tissues. As a result, one such antigen, CADM1, was selected for the generation of an ADC. We tested a CADM1-targeting ADC with a tesirine payload (SG3249) in vitro in osteosarcoma, rhabdomyosarcoma, and neuroblastoma patient-derived xenograft cell lines. In vivo, we tested six CADM1-expressing osteosarcoma …

Proton Versus Photon Radiotherapy For Patients With Oropharyngeal Cancer In The Usa: A Multicentre, Randomised, Open-Label, Non-Inferiority Phase 3 Trial, Steven J Frank, Paul M Busse, J Jack Lee, David I Rosenthal, Mike Hernandez, David M Swanson, Adam S Garden, G Brandon Gunn, Samir H Patel, James W Snider, Daniel J Ma, Jason K Molitoris, Nancy Y Lee, Upendra Parvathaneni, Mark W Mcdonald, Noah S Kalman, Alexander Lin, Nasiruddin Mohammed, Christina Henson, Christian Hyde, Gopal K Bajaj, Sanford R Katz, Roi Dagan, William H Morrison, Jay P Reddy, C David Fuller, Shalin J Shah, Jack Phan, Gregory M Chronowski, Lauren Mayo, Erich M Sturgis, Renata Ferrarotto, Xiaorong R Zhu, Xiaodong Zhang, Li Wang, Katherine A Hutcheson, Adel K El-Naggar, Amy C Moreno, Anna Lee, Michael T Spiotto, Neil D Gross, Stephen Y Lai, Jay J Liao, Jonathan Paly, Zhongxing Liao, Robert L Foote

Faculty, Staff and Student Publications

Background: Radiotherapy is an integral component of treatment for oropharyngeal cancer. Toxicity from the current state-of-the-art photon radiotherapy, intensity-modulated radiation therapy (IMRT), has prompted the search for alternative, less toxic therapies. One such alternative that might de-intensify treatment is proton therapy. In this trial, we aimed to directly compare IMRT with intensity-modulated proton therapy (IMPT), both concurrent with systemic therapy, hypothesising comparable disease control and survival and lower toxicity.

Methods: This randomised, multicentre, open-label, non-inferiority, phase 3 trial was conducted in 21 sites (cancer centres or universities) in the USA. Patients (aged ≥18 years) with stage III or stage IV …

Broad Laboratory Testing Does Not Show Utility For Telogen Effluvium: A Retrospective Analysis Of 22-Million Laboratory Results Using Trinetx, Zachary J.K. Neubauer, Shari R. Lipner

Student Papers, Posters & Projects

No abstract provided.

Il-18 Metabolically Reprograms Car-Expressing Natural Killer T Cells And Enhances Their Antitumor Activity, Gabriel A Barragán Bravo, David A De La Cerda, Elisa Landoni, Kshiti Dholakia, Piotr Humeniuk, Leidy D Caraballo Galva, Ying Wang, Gengwen Tian, Boning Yang, Linjie Guo, Michael S Wood, Xavier Rios, Xin Xu, Amy N Courtney, Erica J Di Pierro, Joan Jacob, Yi-Han Li, Akshaya Adaikkalavan, Norihiro Watanabe, Sufeng Mao, George Miles, Gianpietro Dotti, Leonid S Metelitsa

Faculty, Staff and Students Publications

Invariant natural killer T cells (NKTs) have intrinsic anti-tumor properties that make them promising candidates for chimeric antigen receptor (CAR) immunotherapies. Transgenic cytokine expression can enhance cellular therapy potency, and we hypothesized that co-expressing IL-18 alone or with IL-15 would boost CAR-NKT therapeutic potential. To test this, we generated retroviral constructs expressing IL-15 and/or IL-18 with an inducible caspase 9 safety switch and co-transduced them with a GD2-specific CAR into human NKTs. Co-expression of IL-18 or IL-15/IL-18 increased CAR-NKT cytotoxicity, proliferation, and cytokine secretion in vitro compared to IL-15 alone. IL-18 also enhanced GPC3.CAR and CD19.CAR NKT activity against hepatocellular …

Plasma Proteomics And Incident Coronary Heart Disease, Matthew P Huber, Jennifer A Brody, Colleen M Sitlani, Thomas R Austin, Usman A Tahir, Shuliang Deng, Devendra Meena, Jingsha Chen, Kunihiro Matsushita, Christie M Ballantyne, Josef Coresh, Robert E Gerszten, Russell P Tracy, Ting Ye, Bruce M Psaty, Joshua C Bis, James S Floyd

Faculty, Staff and Students Publications

Background: Systematic profiling of plasma proteins in population studies offers a complementary approach to discovery of novel risk factors and may provide new insights into the causes of coronary heart disease.

Methods: To explore relationships between the circulating proteome and coronary heart disease (CHD), we evaluated associations of 4780 plasma proteins with incident CHD in the Cardiovascular Health Study (CHS, N=2856, 575 CHD events) and replicated significant associations in the Atherosclerosis Risk in Communities Study (ARIC, N = 10456; 1375 events).

Results: We find that 11 proteins significantly associate with incident CHD after adjusting for risk factors; and eight significantly …

Transcriptomic Signature-Guided Depletion Of Intermediate Alveolar Epithelial Cells Ameliorates Pulmonary Fibrosis In Mice, Fei Peng, Chun-Sun Jiang, Zhen Zheng, Shahram Aliyari, Dan Shan, Aaryan Sabharwal, Qinyan Yin, Shigeki Saito, Chao He, Ivan O Rosas, Joseph A Lasky, Victor J Thannickal, Yong Zhou

Faculty, Staff and Students Publications

Single-cell RNA sequencing (scRNA-seq) has identified intermediate epithelial states in pulmonary fibrosis, including KRT5-/KRT17+ aberrant basaloid cells in humans and Krt8+ alveolar differentiation intermediates (ADIs) in mice. Their functional contributions to fibrogenesis, however, remain unclear. Here, we introduce an RNA-sensing-dependent protein translation technology that enables selective targeting of Krt8+ ADI cells in vitro and in vivo. Transcriptomic analysis revealed Small Proline-Rich Protein 1 A (SPRR1A) mRNA as a shared marker of murine Krt8+ ADIs and human KRT5-/KRT17+ basaloid cells, distinguishing them from other lung cell populations. Using programmable RNA sensors, we demonstrated selective EGFP-labeling of Krt8+ ADI cells in vivo, …

The Computationally Designed Tri2-2 Miniprotein Inhibitor Protects Against Multiple Sars-Cov-2 Omicron Variants, Jimin Lee, James Brett Case, Young-Jun Park, Rashmi Ravichandran, Daniel Asarnow, M Alejandra Tortorici, Jack T Brown, Shilpa Sanapala, Lauren Carter, David Baker, Michael S Diamond, David Veesler

2020-Current year OA Pubs

The continued evolution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has compromised neutralizing antibody responses elicited by prior infection or vaccination and abolished the utility of most monoclonal antibody therapeutics. We previously described a computationally-designed, homotrimeric miniprotein inhibitor, designated TRI2-2, that protects mice against pre-Omicron SARS-CoV-2 variants. Here, we show that TRI2-2 exhibits broadly neutralizing activity of SARS-CoV-2 variants and protects mice against BQ.1.1, XBB.1.5 and BA.2.86 challenge when administered intranasally post-exposure. The resistance of TRI2-2 to viral escape by most variants and the ability to deliver it directly to the upper airways highlight the potential of the multivalent …

Long-Term Follow-Up Of Midface Hypoplasia In A Patient With Cleft Lip And Palate, Jui-Jen Fang, Hui-Ching Yu, Li-Ling Cheng, Yu-Jen Chang

Taiwanese Journal of Orthodontics

Introduction: Severe midface hypoplasia is a common craniofacial deformity in patients with cleft lip and palate (CLP), often linked to functional impairment and esthetic concerns. Although surgical and orthodontic advances have improved outcomes, long-term stability remains challenging. This report presents the management of a bilateral CLP patient and evaluates stability after more than 12 years of follow-up. Diagnosis: A 31-year-old male with bilateral CLP showed a concave facial profile, widened lip scars, reverse overjet of –30 mm, complete crossbite, and missing teeth (12, 22, 36). Palatally displaced premolars (15, 25) produced an hourglass-shaped arch. The diagnosis was skeletal Class III …

Treatment Of Skeletal Class Iii Malocclusion With Spaced Arch And Anterior Crossbite Using Low-Hysteresis Improved Super-Elastic Ti-Ni Alloy Wire (Isw), Szu-Ying Yu, Yuag-Hou Chen, Ching-Yu Yang, Jian-Hong Yu

Taiwanese Journal of Orthodontics

This article presents the orthodontic treatment of a non-surgical, non-growing skeletal Class III malocclusion using an Improved Super-elastic Ti-Ni Alloy Wire (ISW), developed by the Institute of Science Tokyo (formerly Tokyo Medical and Dental University). Teeth 28 and 48 were extracted, and ISW with long Class III intermaxillary elastics (L3–U6) was applied to eliminate anterior occlusal interference, retract the mandible, and induce a clockwise rotation of the mandibular plane. In addition to mandibular space closure, the deviated dental midline and chin asymmetry were corrected using elastic chains and intermaxillary elastics. Proper arch coordination, space management, and midline alignment were achieved, …

Orthodontic Space Closure And Third Molar Uprighting For Simultaneous Maxillary And Mandibular Molar Loss On The Same Side, Chun-Yi Huang, Yuan-Hou Chen, Ching-Yu Yang, Jian-Hong Yu

Taiwanese Journal of Orthodontics

This case report describes the successful non-surgical orthodontic management of a complex Class I malocclusion characterized by unilateral posterior tooth loss and functionally induced facial asymmetry. A 28-year-old male patient presented with a non-restorable maxillary first molar (#26) and a missing mandibular second molar (#37). The resulting occlusal discrepancy contributed to a mandibular functional shift and facial asymmetry. The patient declined prosthetic and surgical options, prompting a conservative orthodontic approach.

The treatment plan incorporated third molar protraction and upright to substitute for the missing second molar, combined with occlusal rehabilitation to correct the asymmetry. Space closure was achieved using elastic …

Nonsurgical Orthodontic Management Of A Severe Skeletal Class Ii Malocclusion Using A Modified Intrusive Arch, Ting-Wei Liu, Chun-Liang Kuo, Chun-Hsiu Yang

Taiwanese Journal of Orthodontics

Treating skeletal Class II malocclusion in non-growing patients remains a significant challenge in contemporary orthodontics. Treatment options range from dental camouflage, often involving extractions, to combined orthodontic–surgical approaches. In this case, orthodontic camouflage with extractions was selected to manage a severe skeletal Class II discrepancy in a 28-year-old female patient. A modified intrusive arch was employed to achieve simultaneous retraction and intrusion of the maxillary anterior teeth, effectively reducing excessive overjet. The biomechanical system of the modified intrusive arch generates an anterior intrusive force, a posterior extrusive force, and a posterior tip-back moment. The combined use of Tip-Edge Plus brackets …

Sociodemographic And Hiv-Related Characteristics Associated With Mental Health Diagnoses Among People Living With Hiv, Monique J. Brown Ph.D., Mph, Jiayang Xiao, Xueying Yang Ph.D., Bankole Olatosi Ph.D., Sharon Weissman, Xiaoming Li Ph.D., Jiajia Zhang Ph.D.

Faculty Publications

Mental health diagnoses have been linked to poor HIV treatment outcomes and poorer quality of life among people living with HIV (PLWH). Therefore, this study aimed to investigate the association between sociodemographic and HIV-related characteristics, and common and serious mental health disorders among PLWH in South Carolina (SC). Data were obtained from the integrated system of statewide electronic health record (EHR) data in SC (2006–2019; N = 8,124). Multivariable logistic regression models were used to determine the associations between sociodemographic and HIV-related characteristics, and common mental health disorders and serious mental health disorders. Among the study population, 4% were 60 …

Repair Techniques For Acute Rupture Of The Patellar Tendon: A Systematic Review, Gaston Davis, Harrison S. Fellheimer, Christian Mccormick, Kevin B. Freedman

Rothman Institute Papers

BACKGROUND: Multiple techniques exist to repair acute tears of the patellar tendon. Surgical repair is required to reestablish full function of the extensor mechanism of the knee, and optimal results typically occur when the tear is repaired acutely.

PURPOSE: To systematically review the literature to evaluate treatment outcomes and complication rates after acute surgical repair of patellar tendon ruptures using suture anchor repair, transosseous repair, and end-to-end repair.

STUDY DESIGN: Scoping review; Level of evidence, 4.

METHODS: A systematic review was performed to analyze outcomes after patellar tendon repair in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews …

The Role Of Brain Magnetic Resonance Spectroscopy In Assessment Of Patients With Minimal Hepatic Encephalopathy, Zeinab Moustafa Moustafa Metwalli, Mohammed Emadeldeen, Waseem Mohamad Mahmoud El Gendy, Rania Mostafa Mahmoud, Heba Abdelaziz

Journal of Medicine in Scientific Research

Background: It appears that mild and hidden Hepatic Encephalopathy (HE) is present in up to 50% of patients with chronic liver disease. Tools that can predict when HE episodes would occur may enable early detection and clinically relevant preventative treatment. The brain's magnetic resonance spectroscopy (MRS) is considered a useful technique for providing a range of structural and functional assessments. Objective: To evaluate the role of brain magnetic resonance spectroscopy in assessment of metabolic changes in patients with chronic liver disease and minimal hepatic encephalopathy for better diagnosis and thus prevention of decline in cognitive functions and health related quality …

Effect Of Therapeutic Ultrasound Versus Anti-Inflammatory Drugs In The Treatment Of Trigger Finger. A Placebo Randomized-Controlled Trial., Eslam Elsayed Ali Shohda

Journal of Medicine in Scientific Research

Background: Trigger finger (TF) is a painful disorder that hinders the use of the entire hand. One of the most widely used modalities in the field of physiotherapy is therapeutic ultrasound (US); however, no randomized control trial has investigated the use of US in the treatment of TF. The objective of this trail is to determine the effect of therapeutic US on pain intensity and the frequency of daily finger clicking in patients with TF. Materials and Methods: A single-blind, randomized (1:1), placebo-controlled, clinical trial was conducted at a physiotherapy outpatient clinic at Alahrar Teaching Hospital in Zagazig, Egypt. Twenty …

Predictors Of Mortality Among Under-Five Children Hospitalized With Severe Community-Acquired Pneumonia. A Retrospective Observational Study, Marwa Taha

Journal of Medicine in Scientific Research

Background Severe community-acquired pneumonia (SCAP) remains a critical public health issue and a leading cause of childhood mortality and morbidity, especially in developing countries. Identifying predictors of death in children with SCAP and early recognition of high-risk patients could significantly improve survival rates. Objective This study aims to identify possible predictors of mortality in pediatric SCAP, facilitating the early recognition of high-risk children. Patients and Methods This retrospective observational study included 120 children under the age of five who were admitted with SCAP, based on World Health Organization (WHO) guidelines. Demographic data, clinical characteristics, laboratory findings, and hospital outcomes were …

Knowledge And Practice Of Breast Self-Examination Among Young Women Comes To General Surgery Clinic In Shebin El Kom Teaching Hospital, Shimaa M W Kalama

Journal of Medicine in Scientific Research

Background Breast cancer, which makes up 30.4% of newly diagnosed tumors, is one of the most common cancers among young girls. Every woman who is 20 years of age or older is thought to be at risk of getting breast cancer. This research is crosssectional. The Shebin-Elkom Teaching Hospital served as the study's site. Randomized sampling was used to enroll five hundred women for this study. To collect information, a self-administration questionnaire was employed. Objective:. to evaluate the women who visited the surgery clinic at Shebin El Kom Teaching Hospital's knowledge of breast cancer, BSE, and its function in early …