Medicine and Health Sciences Commons^™

Colon Cancer In Appalachian Kentucky: Unique Genetic, Microbiome And Obesity Findings In A Cohort Comparison, Zeta Chow, Jinpeng Liu, Daheng He, Chi Wang, Tong Gan, Akila Mansour, Nuha Shaker, Caroline Dravillas, Rebecca Hoyd, Eric B. Durbin, Dana L. Napier, Tianyan Gao, Kurt Schaberg, Lyen Huang, Neli Ulrich, Erin Siegel, Stephen Edge, Linda Cook, Bodour Salhia, Michelle L. Churchman, Jill Kolesar, Daniel Spakowicz, B. Mark Evers, Therese J. Bocklage

Markey Cancer Center Faculty Publications

We investigated colon cancer genomics and microenvironmental features in the Appalachian Kentucky population, a group with the highest incidence of colon cancer in the United States. We assessed two inter-related risk factors for colon cancer (obesity and abnormal gut bacterial microbiome) and their genetic associations within this population. To evaluate potential unique characteristics of the high-incidence cohort, we compared 99 propensity-matched colon cancer tumors from Appalachian Kentucky patients to 95 non-Appalachian patient tumors to evaluate driver mutations, differentially expressed genes (DEGs), Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways, Catalogue of Somatic Mutations in Cancer (COSMIC) mutational signatures, immune cell …

Hexavalent Chromium Promotes Malignant Transformation Via Enhanced Translation Of Suv39h1, Yiwei Gu, Yanan Cao, Qing Ye, Yujing Zhang, Zhishan Wang, Chengfeng Yang, Side Liu, Qing-Bai She

Markey Cancer Center Faculty Publications

Hexavalent chromium [Cr(VI)] is a widespread environmental carcinogen linked to lung cancer and other malignancies. Although genetic and epigenetic mechanisms of Cr(VI)-induced carcinogenesis have been extensively investigated, the role of translational control has remained largely unexplored. Here, we show that chronic low-dose Cr(VI) exposure in BEAS-2BR human bronchial epithelial cells activates eIF4E-driven cap-dependent translation through mTORC1-mediated phosphorylation and inactivation of the translational repressor 4E-BP1. Pharmacological inhibition of this pathway markedly suppresses Cr(VI)-induced cell transformation, cancer stem cell (CSC)-like properties, and DNA damage. Comparable inhibitory effects are observed following raptor knockdown, which disrupts mTORC1, or expression of a constitutively active non-phosphorylatable …

Rna-Micelles As Self-Assembling Structures For Efficient Co-Delivery Of Synergistic Sirna And Nucleoside Analogues To Treat Crc Lung Metastasis, Kai Jin, Piotr G. Rychahou, Daniel W. Binzel, B. Mark Evers, Peixuan Guo

Markey Cancer Center Faculty Publications

SiRNA has been widely studied in cancer gene silencing over the last 25 years. However, few siRNA-based therapeutics have been approved by the FDA. An RNA-micelle platform provides a powerful therapeutic tool through simple one-step, high-yield production that is capable of efficient colorectal cancer lung metastasis treatment, a current lethal condition with a short survival rate post-diagnosis. Here, it is reported that the use of RNA-micelles co-carrying siRNA and nucleoside analogues to completely inhibit lung metastasis of colorectal cancer (CRC). The major advantage of the RNA-micelle is the successful co-delivery of siRNA and chemotherapeutic agent in a single delivery vehicle …

Geographic Clusters Of Human Papillomavirus-Associated Cancer Incidence In The Us, 2008–2022, Todd Burus, Krystle A. Lang Kuhs, Ashish A. Deshmukh, Haluk Damgacioglu

Markey Cancer Center Faculty Publications

Objective: Despite known state and regional differences, United States (US) county-level patterns of human papillomavirus (HPV)-associated cancer incidence remain unexplored. Methods: In this cross-sectional study, we analyzed US county-level HPV-associated cancer incidence rates from 2008 to 2022 using the US Cancer Statistics Incidence Analytic Database to identify geographic clusters of high and low incidence. Clusters were identified using the Getis-Ord Gi* statistic and assessed for differences in cluster-level sociodemographic characteristics and sex-and-site-specific incidence. Results: We found 373 hot spot and 409 cold spot counties, with median incidence rates of 16.14 and 10.62 per 100,000, respectively. Hot spot counties were particularly …

Case Report: Prolonged Response To Cabozantinib And Pembrolizumab In Treatment-Refractory Metastatic Pancreatic Ductal Adenocarcinoma, Anna M. Reagan, Hannah G. Mcdonald, Jaewon Kang, Hoda Saghaeiannejad Esfahani, Caroline G. Wright, Charles J. Bailey, Carleton S. Ellis, Kaylyn R. Collette, Reema A. Patel, Mayte Murillo, Samantha F. Stokley, Michael J. Cavnar, Prakash Pandalai, Mautin T. Barry-Hundeyin, Jessica Moss, Joseph Kim

Markey Cancer Center Faculty Publications

Immunotherapy has yet to demonstrate durable efficacy in pancreatic ductal adenocarcinoma (PDAC) despite the fact that pancreatic cancer cells have higher levels of immune checkpoint expression than other cancer cell types in which immunotherapy efficacy has been well established. We observed effective cytotoxicity with the combination therapy of pembrolizumab (an anti-PD-1 monoclonal antibody, mAb) and cabozantinib (an anti-MET small molecule) in vivo. This served as the basis for an investigator-initiated phase II clinical trial (NCT05052723). The trial was open to patients with treatment-refractory metastatic PDAC with a single-arm treatment protocol of pembrolizumab and cabozantinib. Here, we report the case of …

Survival Of Patients Diagnosed With Cancer During The Covid-19 Pandemic, Todd Burus, Haluk Damgacioglu, Bin Huang, Thomas C. Tucker, Ashish A. Deshmukh, Krystle A. Lang Kuhs

Markey Cancer Center Faculty Publications

Importance  The effects of COVID-19 pandemic–related disruptions on cancer diagnosis in the US have been widely observed, but their impact on short-term survival has not been assessed.

Objective  To examine 1-year cause-specific survival (CSS) rates among patients diagnosed with cancer during 2020 and 2021 using high-quality cancer registry data.

Design, Setting, and Participants  This population-based cohort study of cancer survival between 2015 and 2021 used the Surveillance, Epidemiology, and End Results 21 Registries (SEER-21) database. The population included individuals with an invasive cancer diagnosis and complete follow-up reported to registries included in SEER-21 between January 1, 2015, and December 31, …

A Phase 1 Dose Escalation Of Lapatinib And Paclitaxel In Recurrent Ovarian Cancer, Connie D. Cao, Joseph Robert Mccorkle, Donglin Yan, Hoda Saghaeiannejad Esfahani, Rani Jayswal, Dava W. Piecoro, Ning Li, Lauren Baldwin, Rachel W. Miller, Christopher P. Desimone, Charles S. Dietrich, Frederick R. Ueland, Jill M. Kolesar

Markey Cancer Center Faculty Publications

Objective: The development of ABCB1-mediated resistance limits the clinical efficacy of paclitaxel. Lapatinib is a small-molecule reversible tyrosine kinase and ABCB1 inhibitor that could prevent resistance. Our objective was to determine a recommended phase 2 dose (RP2D) of the combination of paclitaxel and lapatinib.

Methods: A phase 1 dose-escalation study utilizing a Bayesian optimal interval (BOIN) design in recurrent ovarian cancer patients was conducted. Patients were pretreated with pulsed lapatinib in the 48 h preceding weekly paclitaxel (80 mg/m²) in 28-day cycles for up to three cycles. We evaluated three lapatinib doses, escalating from 750 to 2000 mg …

Dna-Pkcs Promotes Therapy Resistance And Metastatic Recurrence In Neuroblastoma, Mahnaz Norouzi, Subin Kim, Beibei Zhu, Chi Wang, Natalie Wu, Katherine Somers, Eddy Shih-Hsin Yang, B. Mark Evers, Eric J. Rellinger, Piotr G. Rychahou

Markey Cancer Center Faculty Publications

Purpose: High-risk neuroblastoma presents a serious clinical challenge with survival rates below 50%. Disease relapse most commonly occurs at distant metastatic sites and remains the primary driver of poor outcomes, emphasizing the need for therapies to target drivers of relapse.

Experimental design: This study identified DNA-PKcs as a critical determinant of poor survival and metastatic relapse in neuroblastoma patients. We evaluated which therapeutic modality—chemotherapy or radiotherapy—when combined with DNA-PKcs inhibition, more effectively reduces metastatic burden and prevents recurrence.

Results: Colony-forming assays revealed that established neuroblastoma colonies resist doxorubicin alone and require high-dose doxorubicin paired with DNA-PKcs inhibition to suppress progression. …

A Unique Protein Adjuvant For Precision Immunotherapy To Prevent Recurrence Of Surgically Resected Colorectal Cancer, Yasuhiro Suzuki, Rajesh Mani, B. Mark Evers

Markey Cancer Center Faculty Publications

Effectively activating protective CD8⁺ T cell immunity specifically against cancer antigens is an important pathway to prevent the growth of various types of cancers. A major obstacle in this approach is variations in cancer antigens among patients. A valuable material to overcome the antigen variation among cancer patients is the use of each individual’s own cancer cells for immunization. In colorectal cancer (CRC), approximately one-third of the patients who receive curative surgical resection have a recurrence of cancer. Therefore, the use of surgically resected CRC for immunotherapy to specifically activate the protective CD8⁺ T cells against their own …

Mental Health Needs Of Families Of Patients In Intensive Care Units And The Role Of Mobile Health: Survey Study, Anthony Faiola, Saira Soroya, Zhonglin Hao, Reinhold Munker

Markey Cancer Center Faculty Publications

Background: The experiences of patients with COVID-19 and their families manifested the most devastating effects of family separation since the 1918 Spanish influenza pandemic and, with it, a call for solutions to patient isolation and its effect on family mental health.

Objective: This study examined the recent experiences of families of critical care (intensive care unit; ICU) patients related to anxiety and depression (AD), satisfaction with clinician-family communication, and counseling from mental health and social services. This study explored correlations between these factors and family interest in mobile health (mHealth) designed to improve information flow and communication from patient bedside …

Survival Outcomes Of First-Line Therapy In De Novo Metastatic Urothelial Carcinoma With Histologic Subtypes: A National Cancer Database Analysis, Zin W. Myint, Feitong Lei, Bin Huang

Markey Cancer Center Faculty Publications

Background: Urothelial carcinoma with histologic subtypes represent an aggressive and understudied population frequently excluded from prospective clinical trials. Evidence guiding optimal first-line systemic therapy in de novo metastatic disease with histologic subtypes remains limited.

Method: Patients with de novo stage IV urothelial carcinoma with histologic subtypes diagnosed between 2016 and 2021 were identified from the National Cancer Database (NCDB). Eligible patients received first-line chemotherapy, immunotherapy, or concurrent chemoimmunotherapy (both modalities initiated within 30 days). Overall survival (OS) was compared across groups using Kaplan–Meier methods and compared using log-rank tests and multivariable Cox regression. Result: Among 800 patients, 596 (74.5%) received …

Person‑Level Health Factors Partially Mediate The Association Between Lesbian, Gay, Or Bisexual (Lgb) Identity, Allostatic Load, And Cancer Mortality In Nhanes, Justin Xavier Moore, Alisha Patel, Missy Spears, Tracy Casanova, Heidi L. Weiss, Marvin E. Langston, Keith J. Watts, Donte Boyd, Prajakta Adsul, Meredith S. Duncan, Sydney Howard

Markey Cancer Center Faculty Publications

Purpose: Individuals identifying as Lesbian, Gay, or Bisexual (LGB) with high allostatic load have more than double the cancer mortality risk of heterosexual individuals with high allostatic load. This study explored how person-level health factors mediate the relationship between individuals identifying as LGB with high allostatic load and subsequent risk of cancer mortality.

Methods: We conducted a retrospective analysis of 12,470 participants in the National Health and Nutrition Examination Survey (2001–2010) linked to the National Death Index through 31 December 2019. Survey-weighted Cox regression assessed associations of individuals identifying as LGB and allostatic load with cancer mortality. Person-level health factors …

Oncology Clinicians’ Attitudes On Hormonal Therapy After Chemoradiotherapy For Cervical Cancer, Morgan S. Levy, Marilyn Huang, Charles S. Dietrich, Denise Fabian

Markey Cancer Center Faculty Publications

No abstract provided.

Assessing The Value Of Sequential Next-Generation Sequencing And Multiple Molecular Tumor Board Reviews For Patients With Solid-Tumor Malignancies, Allison L. Swiecki-Sikora, Lydia Williams, Ning Li, Donglin Yan, Evan Bryon, Derek B. Allison, Rachel W. Miller, Charles S. Dietrich, Jill M. Kolesar

Markey Cancer Center Faculty Publications

Purpose: Multidisciplinary molecular tumor boards (MTBs) have demonstrated improved clinical outcomes in various malignancies. Sequential next-generation sequencing (NGS) is widely performed at the time of recurrence, which may lead to multiple MTB reviews. This study assessed the clinical benefit of multiple MTB reviews for sequential NGS.   Methods: A retrospective cohort review was performed to compare patients reviewed once at a single-institution MTB and those reviewed multiple times for the same diagnosis with sequential NGS between January 2016 and December 2023. Demographics were compared, and regression and survival analysis was performed.   Results: In all, 3,702 patients were included, 3,446 (91.6%) were …

Case Report: Prostate Adenocarcinoma With Peritoneal Carcinomatosis And Elevated Cea Mimicking Colorectal Cancer: A Diagnostic Dilemma, Hala Majeed, Nathan R. Shelman, Jitesh A. Patel, Janeesh S. Veedu, Insija I. Selene, Ashlyn Whitesell, Zin W. Myint

Markey Cancer Center Faculty Publications

This case report describes an exceptionally rare manifestation of prostate adenocarcinoma presenting with peritoneal carcinomatosis, rectal obstruction, and markedly elevated carcinoembryonic antigen (CEA), closely mimicking colorectal cancer. A 65-year-old man with localized high-grade prostate adenocarcinoma (Gleason 4 + 4) underwent robotic prostatectomy in November 2020, followed by salvage radiation and stereotactic body radiation therapy for early biochemical recurrence. He achieved an excellent response to androgen deprivation therapy (ADT) combined with abiraterone and prednisone, maintaining an undetectable prostate-specific antigen (PSA) level for over 2 years. In late 2024, the patient developed hematochezia, narrow stools, and abdominal pain. Imaging revealed a rectal …

Eef2k Promotes Immune Evasion In Melanoma Via Cyclin D1–Mediated Stabilization Of Pd-L1, Yijie Ren, Darby J. Ballard, Anil Kumar, Andy F. Song, Mitiksha Gupta, Xiaofang Xiong, Xingcong Ren, Jugal Kishore Das, Jin-Ming Yang, Jianxun Song

Markey Cancer Center Faculty Publications

Eukaryotic elongation factor 2 kinase (eEF2K) is a stress-responsive regulator of protein synthesis implicated in melanoma progression, but its role in tumor immune evasion remains poorly defined. We investigated how eEF2K influences programmed death ligand 1 (PD-L1) expression through modulation of Cyclin D1. We analyzed gene expression and dependency datasets from The Cancer Genome Atlas and the Cancer Dependency Map. Protein–protein interactions were assessed by co-immunoprecipitation. Cyclin D1 was inhibited pharmacologically with palbociclib. Immune responses were evaluated in murine B16-OVA and human A2058 melanoma models using flow cytometry and immunohistochemistry after genetic or pharmacologic modulation of eEF2K and Cyclin D1. …

Improving Blood Pressure Control Through Lifestyle Modification In African Americans Adults With Uncontrolled Hypertension, Tasha Leonard

Doctor of Nursing Practice (DNP) Scholarly Projects

African American adults have the highest incidence of uncontrolled hypertension (HTN), leading to premature cardiovascular death in Texas and worldwide. In a South Texas cardiac clinic, over 90% of African American adults with HTN also have obesity, compared with 55% of their Caucasian counterparts. The most prevalent factor affecting this group is poor understanding of blood pressure management, which leads to nonadherence to dietary and exercise recommendations, medication regimens, and blood pressure monitoring. The objective was to determine whether lifestyle modification using a hypertensive bundle would improve blood pressure management among African American adults in the clinical setting. The initiative …

A Guideline To Address Barriers To Mental Health Treatment Experienced By Law Enforcement Officers, Jacqueline Estrella

Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Law enforcement officers are exposed to repeated trauma on the job that may negatively affect their mental health. Officers may avoid seeking mental health treatment due to police culture, stigma, and other barriers which may increase risks for suicide, absenteeism, and maladaptive coping.

Objectives: Develop an evidenced-based guideline to address barriers law enforcement officers face in seeking mental health treatment.

Methods: The National Quality Measures Clearinghouse (NQMC) Domain Framework was used to guide a literature review to identify best practices suitable for a guideline. Articles were graded for strength based on the John Hopkins Nursing Evidence Based Practice (JHNEBP) …

Multisite, Multiancestry Genome-Wide Association Study Meta-Analysis Of Functional Seizure Disorder In A Hospital Sample Of 675,680 Patients, Slavina B Goleva, Costin Leu, Yen-Chen Anne Feng, David Burstein, Sanan Venkatesh, Rebecca Birnbaum, Veera M Rajagopal, Peter Straub, Jakob Christensen, Jocelyn F Bautista, Robyn M Busch, Imad M Najm, Jakob Grove, Anders D Børglum, Georgios Voloudakis, Panos Roussos, Jordan Smoller, Dennis Lal, Lea K Davis

Faculty, Staff and Student Publications

Background: Functional seizures (FS) are paroxysmal episodes that phenotypically resemble epileptic seizures but are not associated with brain epileptiform discharges; they are also known as psychogenic nonepileptic seizures. The exact etiology and pathophysiology of FS is unknown; however, trauma and stress-related disorders are known risk factors.

Methods: We used a validated algorithm applied to electronic health records to identify individuals with FS in 6 international biobanks and hospital sites. We conducted a multisite FS genome-wide association study (GWAS) meta-analysis, including 10,910 FS cases (9040 predicted European ancestry [EA] and 1870 predicted African ancestry [AA]) and 664,500 (561,150 EA and 103,350 …

Optimisation Of Sampling For A New Skin Microbiome Assay Pilot Study, Anita Smith

Theses

Recent interest in the diverse ecosystem of bacteria, fungi and viruses that make up the skin microbiome has led to numerous studies investigating the microbiome in healthy skin and in dermatological diseases. An imbalance of the normal skin microbial flora can cause some skin diseases, and current culture techniques are often unable to detect a microorganism to further our understanding of the clinical–microbiological correlates of disease and dysbiosis. Atopic dermatitis and rosacea are presentations that General practitioners (GPs) often manage that may have an infective or microbiological component and can be challenging to treat. Further research using culture-independent techniques is …

Breast Milk Versus Formula Feeding In The Development Of Necrotizing Enterocolitis Among Nicu Infants: An Integrative Review, Mackenzie Jameson, Faye Li, Liudmila Ryzhova, Mia Smith

Master's Projects

Introduction/Question: NEC is a serious condition characterized by the death of intestinal tissue, primarily affecting premature infants or those with low birth weight. The incidence of NEC poses a significant concern in neonatal healthcare due to its substantial mortality risk, particularly among vulnerable populations. This condition can lead to various complications, including sepsis, nutritional deficiencies, delays in growth and development, and, in severe cases, death. NEC not only impacts the health of the infant but also affects the emotional well-being and bonding experiences of parents. Despite advancements in neonatal care, the rate of NEC has increased, highlighting the need …

Asthma Integrative Review: Effects Of Aerobic Exercise On Asthma Exacerbation, Abigail Williams, Dazya Crayton, Nicole Stasiak, Sabrina Stich

Master's Projects

Asthma is a chronic respiratory illness defined by airway inflammation and episodes of exacerbation. Pharmacological intervention remains the treatment of choice; however, there is growing evidence to support moderate intensity aerobic exercise as adjunct therapy to promote asthma control. The integrative review evaluates current evidence supporting the PICO question: In adults with mild to moderate asthma, what is the effect of prescribed aerobic exercise on reducing exacerbations? A systematic search of CINAHL, Health Source: Nursing, MEDLINE, and PubMed identified eligible studies. The inclusion criteria required peer-reviewed quantitative articles written in English and published within the past five years. In addition, …

Dual Language Learner Status In Relation To Cortisol For Children In Head Start Preschool, Keala Bratsch

West Chester University Graduate Theses, Dissertations, and Final Projects

Early childhood education (ECE) has well documented school readiness benefits, especially for children facing economic hardship. Yet preschool context poses challenges that are associated with elevated stress levels and potential long-term tax on physiological systems that respond to stress. The present study examined dual language learner (DLL) status in relation to levels of the stress hormone cortisol among low-income children attending Head Start Preschool programs. Participants included 207 children ages 3- 5 years who attended preschool in 2021-22 (60.9% attending a dual-language learning school, 39.1% attending an English-instruction-only preschool; all participants meeting the criteria for low-income), and their parents or …

Extradigital Glomus Tumor Mimicking Incisional Neuroma After Total Knee Arthroplasty: A Case Report, James W. Li, Michael J. Sayegh, Heng Hong, Zhongyu Li

Stony Brook Orthopaedic and Musculoskeletal Journal

This case report describes a patient who was presented with severe incisional pain following an uncomplicated total knee arthroplasty. There was suspicion for an incisional neuroma; however, excisional biopsy revealed an extradigital glomus tumor. The patient had immediate symptom resolution post-operatively. Clinicians should maintain a suspicion for the possibility of extra-digital glomus tumors at sites of prior extremity surgery, causing exquisite tenderness and pain.

The Silent Epidemic: Deadly Outcomes Of Undiagnosed Hiv/Aids In Young People, Raksha Ramdas

UAB Huntsville Research Day - All Presentations

2026 clinical vignette poster

When Therapy Becomes The Trigger: An Antibiotic With A Twist, Hinal Rathi, Roshini Raghu, Parekha Yedla

UAB Huntsville Research Day - All Presentations

2026 clinical vignette poster

Uncovering Recurrent Oral And Genital Lipschütz Ulcers As An Initial Manifestation Of Immunodeficiency In A Sexually Inactive Adolescent, Raksha Ramdas

UAB Huntsville Research Day - All Presentations

2026 clinical vignette poster

Misleading Edema: When Pancreas Was To Blame; A Case Of Ectopic Cushing Syndrome, Soumit Sharma, Vasudha Reddy, Jesse Faulk, Madan Gowda

UAB Huntsville Research Day - All Presentations

2026 clinical vignette poster

A Rare Case Of Paraneoplastic Neuromyelitis Optica Secondary To Colonic Adenocarcinoma Responding To Folfiri Chemotherapy, Soumit Sharma, Ahmed Qaedi, Kelsey Ivey

UAB Huntsville Research Day - All Presentations

2026 clinical vignette poster

Hypopituitarism Secondary To Hiv-Associated Pituitary Toxicity Despite Viral Suppression: A Rare Presentation Of Adrenal Crisis, Soumit Sharma, Allison C. Estep, Pierce Elliot, Farrah Ibrahim

UAB Huntsville Research Day - All Presentations

2026 clinical vignette poster