Medicine and Health Sciences Commons^™

Quality Improvement Project: Improving Emergency Medication Administration Safety In An Inpatient Psychiatric Unit, Sandra Anusiem

Doctor of Nursing Practice Projects

Psychiatric emergencies contribute to medication safety issues due to increased stress, inconsistent practices, and communication breakdowns. The problem was high rates of medication errors in psychiatric emergencies due to the lack of a structured, standardized medication management protocol. This Doctor of Nursing Practice (DNP) quality improvement project aimed to reduce medication errors in administering emergency medications in an inpatient psychiatric unit by using the Medication Administration Cross-Check (MACC) checklist. The project was completed using a quasi-experimental research design guided by the Donabedian Model of Healthcare Quality and Lewin’s Change Model. Pretest and posttest knowledge, confidence, attitude, and perceptions were obtained …

More Girls In The Classroom Improves Adolescent Mental Health, Monica Deza, Maria Zhu

Population Health Research Brief Series

Mental health challenges are common among adolescents in the United States. This brief summarizes findings from a study using data from the National Longitudinal Study of Adolescent Health (Add Health), a nationally representative survey of middle and high school students conducted in 1994-1995. The analysis included over 17,000 students from 133 schools across the United States. The authors find that the mix of boys and girls in a classroom affects adolescent mental health and school satisfaction. When classes have more girls, both boys and girls experience better mental health outcomes. Boys in classes with more female peers are 10% less …

Reducing Falls In The Acute Care Setting: A Quality Improvement Project, Elorm M. Adzokpa

Doctor of Nursing Practice Final Project Abstract

Falls remain one of the most common adverse events in acute care settings and are associated with increased morbidity, extended hospital stays, and higher healthcare costs. Orthopedic and trauma patients are particularly vulnerable due to mobility limitations, postoperative recovery, and complex medical conditions. The purpose of this quality improvement project was to reduce inpatient falls on an adult orthopedic and trauma unit by implementing a visual aid to reinforce the 5P fall-prevention framework. A pre–post quality improvement design was used during an eight-week implementation period. The intervention included a standardized fall prevention bundle that reinforced existing Fall TIPS board use …

Per Se Driving Under The Influence Of Cannabis Statutes And Blood Delta-9-Tetrahydrocannabinol Concentrations Following Short-Term Cannabis Abstinence, Robert L. Fitzgerald, Anya Umlauf, Raymond T. Suhandynata, David J. Grelotti, Marilyn A. Huestis, Kyle F. Mastropietro, Igor Grant, Thomas D. Marcotte

Institute of Emerging Health Professions Faculty Papers

BACKGROUND: Several US states have per se laws using 2 or 5 ng/mL of delta-9-tetrahydrocannabinol (THC) as cutpoints for driving under the influence of cannabis, while some have zero-tolerance statutes. These cutpoints are considered prima facia evidence of driving impairment.

METHODS: In a cohort of people who regularly use cannabis (N = 190) we measured baseline concentrations of THC after instructing participants to abstain from cannabis for at least 48 hours. Baseline driving performance was evaluated using a driving simulator. We also measured blood THC concentrations serially following a smoking session (placebo or active cannabis).

RESULTS: Forty-three percent of the …

Quality Improvement Project: Educating Nursing Faculty On Medication Administration Labs To Improve Student Competency, Chelsea Pacheco

Doctor of Nursing Practice Projects

Medication administration errors are a leading cause of preventable harm in healthcare. Faculty play a critical role in ensuring nursing students develop the knowledge and confidence to give medications safely. A needs assessment at the project site revealed that only course coordinators were teaching medication administration and dosage calculation, leaving other faculty uncertain about how to teach these skills. This quality improvement project aimed to strengthen faculty confidence and create consistency in first-year instruction through a recorded educational video. Constructivist Learning Theory provided the foundation for active, experience-based learning. Lewin’s Change Theory guided the structured implementation process to support adoption …

Quality Improvement Project: Enhancing Diabetes Management Through Continuous Glucose Monitoring Device Education Among Providers Of Underserved Groups, Shaibu Rashid

Doctor of Nursing Practice Projects

This quality improvement project aimed to enhance diabetes management among underserved populations by increasing provider confidence and utilization of continuous glucose monitoring (CGM) devices in a Federally Qualified Health Center (FQHC). Despite CGM being recognized as a standard of care for patients requiring intensive insulin therapy, its adoption in FQHCs remains limited due to provider knowledge gaps, financial barriers, and workflow challenges. Based on Kurt Lewin’s change theory, the project employed a quasi-experimental one-group pretest–posttest design to evaluate the impact of an evidence-based educational intervention among six family practice providers. The intervention included interactive sessions on CGM device use, data …

Establishing Nursing Excellence: A Quality Improvement Approach To Nursing Administration Evaluation Using Frontline Feedback, Meredith Sykora

Doctor of Nursing Practice Projects

In the increasingly complex environment of nursing education, leadership quality and responsiveness significantly influence workplace culture, faculty satisfaction, professional development, and student outcomes. Despite these realities, many academic nursing programs, including the Division of Nursing at a community college in Arkansas, lack formal structures for bidirectional leadership evaluation. This gap limits frontline faculty’s ability to provide formative feedback to program leaders, weakening shared governance and transparency. The purpose of this quality improvement project was to evaluate leadership effectiveness following the implementation of a structured bidirectional feedback process between nursing faculty and program leaders. Guided by Kouzes and Posner’s Leadership Practices …

The Right Kind Of Rarefaction: Coronary Microvascular Remodeling In Right Ventricle Failure, Cyrus Vahdatpour, Katharine Clapham, Steven M. Kawut, Kirk Jones, John J. Ryan, Danielle Petty, Shannon Talbot, Kimberly Dumoff, Ellen C. Keeley, Priti Lal, Andrew J. Bryant, Alex M. Parker, Jeremy A. Mazurek, Leonid Mirson, Andrew Murphy, Andrew Baird, Megan Schwietert, Alissa F. Schurr, Andrew Stein, Scott M. Hansen, Zhining Ou, Angela P. Presson, Dylan Miller

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

BACKGROUND: Right ventricular failure (RVF) is the primary determinant of outcomes in pulmonary hypertension (PH). Coronary microvascular dysfunction (CMD), defined by capillary rarefaction and endothelial dysfunction, may contribute to RVF but remains poorly characterized. CMD, defined by capillary rarefaction and endothelial dysfunction, may contribute to RVF through impaired myocardial oxygen delivery and fibrotic remodeling.

OBJECTIVES: To characterize right ventricle (RV) CMD and myocardial fibrosis in explanted human hearts and examine associations with echocardiographic and hemodynamic indices of RVF across PH subtypes.

METHODS: We retrospectively analyzed 57 adult patients who underwent orthotopic heart transplantation at 3 institutions (2023-2024). Explanted hearts were …

Examining The Association Between User Fee Exemptions And Maternal Healthcare Utilization In Northern Ghana, Martina Hilton-Ansah

Walden Dissertations and Doctoral Studies

Abstract In Ghana, the user fee exemption policy, implemented in 2008, provides free maternal health services, which are a key component of the National Health Insurance Scheme (NHIS). Grounded in the Health Access Livelihood Framework, the purpose of this study was to determine the association between the user fee exemption policy and the utilization of antenatal care, facility-based delivery, and postnatal care in Northern Ghana, while controlling for sociodemographic factors. A quantitative approach was employed using secondary data from the Ghana Demographic and Health Surveys, encompassing women of reproductive age (15–49 years; N = 6,948). Logistic regression was used to …

A Double-Edged Sword: Ethical And Psychological Implications Of Apoe Genotype Disclosure Across The Lifespan, Diego Iacono

Department of Neurology Faculty Papers

The apolipoprotein E (APOE) gene is the strongest genetic risk factor for sporadic Alzheimer’s disease (AD), with the ε4 allele increasing risk and decreasing the average age of onset. While APOE genotyping is primarily used in research or clinical settings for patients with memory concerns, interest in disclosing APOE status to asymptomatic individuals—particularly during early adulthood—is growing. This trend is fueled by the rise of direct-to-consumer genetic testing and emerging prevention-focused clinical trials. However, ethical debates remain unresolved about the potential harms of early disclosure, including anxiety, stigma, and misunderstanding of probabilistic risk. Conversely, some argue that knowledge of APOE …

The Triangular Interaction Between Dietary Polyphenols, Gut Microbiota, And Metabolic Syndrome, Emily Bayliss

Senior Honors Theses

Type 2 diabetes mellitus (T2DM) is a growing global health concern characterized by peripheral insulin resistance as well as impaired insulin secretion from pancreatic β-cells. Emerging evidence suggests that the gut microbiome, specifically gut dysbiosis, an imbalance in the gut microbiome, is a critical modulator of the pathophysiology of T2DM. Dietary polyphenols, a diverse group of bioactive compounds that are abundant in plant-based foods, have recently gained attention for their potential to attenuate metabolic disorders through their antioxidant and anti-inflammatory properties as well as through modulating the composition and activity of gut microbes, thereby attenuating dysbiosis. However, the diabetic state …

T Cell Senescence And Nociplastic Pain: A Proposed Etiological Mechanism, Kayla S. Riggleman

Senior Honors Theses

Nociplastic pain is a newly identified chronic pain phenotype characterized by widespread hyperalgesia and allodynia. Its etiological mechanisms are currently unknown, making medical intervention elusive. The proposed pathophysiological model connects immunosenescence with a degradation of the blood-brain barrier as a result of peripheral inflammation. Neuronal hyperexcitability and glial cell activation result, leading to nociplastic pain. It is currently thought that central sensitization is the key mechanistic driver of nociplastic pain, so this literature review seeks to expound on that. Based on this framework, chimeric antigen receptor (CAR)-T cell therapy and stem cell treatments are proposed therapeutic methodologies to be explored. …

Investigating The Mechanisms By Which Gut Microbiome Dysbiosis Contributes To The Autoimmune Response In Multiple Sclerosis, Abigail Houtrouw

Honors Theses

This literature review explores the multifaceted relationship between gut microbiome (GM) dysbiosis and multiple sclerosis (MS), highlighting key themes that advance understanding of disease pathogenesis and therapeutic potential for treatments targeting the gut. The review underscores the immune system dysregulation in MS, emphasizing the roles of T cells, B cells, and microglia in neuroinflammation and demyelination. Historically, MS pathogenesis was thought to be driven mainly by T-cell dysregulation, but current research highlights the additional roles of B-cells and microglia, the resident immune cells of the central nervous system (CNS). Additionally, this literature review identifies GM alterations and dysbiosis as critical …

Epigenome-Wide Association Study Of Nuclear Dna Methylation In Relation To Mitochondrial Heteroplasmy, Meng Lai, Kyeezu Kim, Yinan Zheng, Christina A Castellani, Scott M Ratliff, Mengyao Wang, Xue Liu, Jeffrey Haessler, Tianxiao Huan, Kwadwo Bonsu, Charles Newcomb, Kyler Mckessy, Lawrence F Bielak, Wei Zhao, Roby Joehanes, Jiantao Ma, Xiuqing Guo, Joann E Manson, Megan L Grove, Jan Bressler, Kent D Taylor, Tuuli Lappalainen, Silva Kasela, Thomas W Blackwell, Nicole J Lake, Jessica D Faul, Kendra R Ferrier, Stephen C Ekker, Lifang Hou, Charles Kooperberg, Alexander P Reiner, Kai Zhang, Patricia A Peyser, Myriam Fornage, Eric Boerwinkle, Laura M Raffield, April P Carson, Stephen S Rich, Yongmei Liu, Daniel Levy, Jerome I Rotter, Jennifer A Smith, Dan E Arking, Chunyu Liu

Faculty, Staff and Student Publications

We analyze 10,986 participants (mean age 77; 63% women; 54% non-White) across seven U.S. cohorts to study the relationship between mitochondrial DNA (mtDNA) heteroplasmy and nuclear DNA methylation. We identify 597 CpGs associated with heteroplasmy burden, generally showing lower methylation. These CpGs are enriched in dynamically regulated island shores and depleted in CpG islands, indicating involvement in context-specific rather than constitutive gene regulation. In HEK293T cells, we introduce a truncating mtDNA mutation (MT-COX3, mt.9979) and observe a positive correlation between variant allele fraction and methylation at cg04569152, supporting a direct mtDNA-nDNA epigenetic link. Many heteroplasmy-associated CpGs overlap with known methylation-trait …

Optimizing Perioperative Antibiotic Prophylaxis: A Prospective Cohort Study On Cefazolin Utilization In Surgical Patients With Penicillin Allergy Labels, Cassius Mensah, Anvinh Nguyen, Jenny Pennycuff, Israa Shwaiki, Belle Parizot, Gary Zhang, Xiaofan Huang, Suman Rajagopalan

Faculty, Staff and Students Publications

Background: Penicillin allergy labels frequently lead to second-line antibiotics for surgical prophylaxis, due to concerns for cross-reactivity. This has led to increased patient morbidity, prolonged hospitalization, and increased healthcare costs. The most common perioperative cephalosporin, cefazolin, has unique R groups, the main antigenic portion of penicillin, which makes it safe to use in type 1 hypersensitivity penicillin allergy. We evaluated the effect of education on the incidence of the following: cefazolin usage in penicillin allergy labelled patients, allergic reactions, and surgical site infections.

Methods: As a prospective study with historical controls, perioperative clinicians were educated on the natural history of …

Targeting Tet3 Suppresses Group 3 Medulloblastoma Stemness And Progression Via Impairing Hypomethylation Of Otx2 Super-Enhancer, Xuan Chen, Ziwei Wang, Yan Song, Yu Su, Yahui Zhao, Jiankang Li, Wei Wang, Jiao Zhang, Craig Daniels, Xiaochong Wu, Olivier Saulnier, Yanan Wang, Fei Liu, Kaiwen Deng, Dongming Han, Zijia Liu, Meiyu Li, Liam D Hendrikse, Alexandra Rasnitsyn, Evan Y Wang, Dongyang Wang, Zhaoyang Feng, Yanong Li, Zitong Zhao, Hongyu Yuan, Youliang Sun, Yifei Jiang, Yanfeng Shi, Tao Yang, Xueling Qi, Yong Hou, Chunde Li, Yong-Qiang Liu, Yu Tian, Shuaicheng Li, Xiaoguang Qiu, Michael D Taylor, Guo Liang Li, Tao Jiang, Hailong Liu

Faculty, Staff and Students Publications

Medulloblastoma (MB), particularly Group_3 (G3-MB), remains the most aggressive subgroup due to strong stemness and therapeutic resistance. Through genome-wide DNA methylation and transcriptomic analysis of human MB samples, we identify enhancer hypomethylation as a key feature sustaining G3-MB stemness and tumor progression. Notably, hypomethylation of the Otx2 super-enhancer (SE) is a prognostic marker and potential therapeutic target for G3-MB patients. We demonstrate that disrupting Otx2 SE activity effectively reduces tumor growth in vivo, highlighting its critical role in G3-MB maintenance. TET3, recruited by OTX2, demethylates the Otx2 SE, promoting chromatin opening and sustaining tumor proliferation and stemness. To translate these …

Multi-Omic Profiling Provides Insights Into The Heterogeneity, Microenvironmental Features, And Biomarker Landscape Of Small-Cell Lung Cancer, Mingchao Xie, Miljenka Vuko, Shashank Saran, Siyu Liu, Andrew G Chambers, Hana Baakza, Helen K Angell, Felicia Ng, Carl M Gay, Robert J Cardnell, Felix J Segerer, Alma Andoni, Jaime Rodriguez-Canales, Paul M Waring, Markus Schick, J Carl Barrett, Lauren A Byers, Giulia Fabbri

Faculty, Staff and Student Publications

Background: Greater understanding of differential therapeutic sensitivity, specifically to immunotherapy, in small-cell lung cancer (SCLC) is required.

Methods: We explored SCLC heterogeneity through integrated molecular characterization of tumor tissue samples from 159 treatment-naive patients, utilizing genetic, epigenetic, transcriptional, and proteomic profiling, immunohistochemistry staining for multiple biologically relevant markers including transcriptional subtype-defining proteins, and spatial immune profiling using multiplex immunofluorescence.

Results: Multi-omics analysis confirmed high heterogeneity across/within neuroendocrine and non-neuroendocrine subtypes. Methylomics analysis identified four methylome clusters that may enhance subtype prediction, prognosis, and longitudinal monitoring of subtype evolution. Immunohistochemistry analysis showed high MHC-I expression in non-neuroendocrine subtypes, which have greatest …

Inhibition Of Clostridioides Difficile-Specific Dna Adenine Methyltransferase Cama By Analogs Of S‑Adenosyl‑L‑Methionine, Jujun Zhou, Youchao Deng, Dan Yu, Taraneh Hajian, Masoud Vedadi, Xing Zhang, Robert M Blumenthal, Rong Huang, Xiaodong Cheng

Faculty, Staff and Student Publications

Epigenetically targeted therapies, especially those inhibiting S-adenosyl-l-methionine (SAM)-dependent methylations of DNA, mRNA, and histones, have advanced rapidly in cancer treatment. However, these therapies remain underexplored for antibiotic development, despite the growing threat of antimicrobial resistance. Here, we screened a focused library of SAM analogs against the DNA adenine methyltransferase CamA specific to the enteric pathogen Clostridioides difficile. At the same time, we examined six other adenine methyltransferases, including two bacterial DNA methyltransferases and four human RNA methyltransferases having distinct RNA substrates. Compound 113 selectively inhibited CamA (IC50 = 0.15 μM). In addition, compound 67 inhibited Caulobacter crescentus CcrM …

Individualized Perioperative Blood Pressure Management In Patients Undergoing Major Abdominal Surgery: The Improve-Multi Randomized Clinical Trial, Bernd Saugel, Agnes S Meidert, Frank M Brunkhorst, Robert Bischoff, Joseph Esser, Minca Mattis, Pauline Naue, Katharina Vogel, Alina Bergholz, Moritz Flick, Alina Kröker, Dominik X Müller, Kristen K Thomsen, Christina Vokuhl, Mirja Wegge, Sebastian Bratke, Martin Graeßner, Bettina Jungwirth, Sebastian Schmid, Carla D Grundmann, Jan M Wischermann, Patrick Kellner, Moritz Steinhaus, Linda Grüßer, Sina M Coldewey, Kai Zacharowski, Patrick Meybohm, Marit Habicher, Alexander Zarbock, Amelie Zitzmann, Svenja Letz, Claudia Neumann, Jan Larmann, Thomas Renné, Linda Krause, Eik Vettorazzi, Antonia Zapf, Annemarie Carlstedt, Daniel I Sessler, Karim Kouz

Faculty, Staff and Student Publications

Importance: Intraoperative hypotension is associated with organ injury. However, it remains unknown if targeted blood pressure management during surgery can improve clinical outcomes.

Objective: To evaluate whether individualized vs routine perioperative blood pressure management during major abdominal surgery improves clinical outcomes in patients considered at high risk of postoperative complications.

Design, setting, and participants: This randomized single-blind clinical trial enrolled patients 45 years or older undergoing elective major abdominal surgery with general anesthesia expected to last 90 minutes or longer who had at least 1 additional high-risk criterion between February 26, 2023, and April 25, 2024, at 15 German university …

Characterizing Circulating Rare Cells In Peripheral Blood For Detecting And Monitoring Multiple Myeloma And Precursor States, Stephanie N Shishido, Jeremy Mason, Mohamed Kamal, Sonia Maryam Setayesh, Amishi U Vora, David Berrios, Luz Yurany Moreno Rueda, Krina Patel, Elisabet E Manasanch, Robert Z Orlowski, Peter Kuhn

Faculty, Staff and Student Publications

Multiple myeloma (MM) arises from abnormal plasma cells (PCs) progressing from precursor states, including monoclonal gammopathy of undetermined significance (MGUS) and smoldering multiple myeloma (SMM). Understanding this transition and progression to overt MM requires improved non-invasive strategies. We employed a liquid biopsy approach to detect and characterize circulating PCs across disease states in 68 patients (MGUS = 11, SMM = 21, NDMM = 19, RRMM = 17) using multi-channel immunofluorescence staining and machine learning-assisted rare event detection. PCs were identified by CD138 and B-cell maturation antigen (BCMA) expressions, with distinct phenotypic subpopulations stratifying disease states. The D | CD138 | …

Activation Of Pro-Regenerative Gene Programs In The Mature Central Nervous System, Elizabeth Carlisle Batsel

Dissertations (1934 -)

Spinal cord injury (SCI) affects millions of people worldwide. Damage to the spinal cord disrupts the long-distance axon tracts of central nervous system (CNS) neurons. These axons fail to regenerate, leading to permanent dysfunction. Past work has shown that CNS neurons lose the capacity to elongate their axons as they mature. Conversely, after injury, embryonic and peripheral nervous system (PNS) neurons can elongate axons towards target cells, driven by the growth cone at the growing tip of the axon. Previous research has identified transcription factor (TF) families, such as the SoxC family, that contribute to embryonic and peripheral neurons’ high …

Factors Influencing Immediate Post-Angiographic Occlusion Outcomes In Intracranial Aneurysms Treated With The Woven Endobridge Device: A Multi-Center Analysis And Predictive Model From The Worldwideweb Consortium, Muhammed Amir Essibayi, Mohamed Sobhi Jabal, Hasan Jamil, Hamza Adel Salim, Basel Musmar, Nimer Adeeb, Mahmoud Dibas, Nicole M Cancelliere, Jose Danilo Bengzon Diestro, Oktay Algin, Sherief Ghozy, Sovann V Lay, Adrien Guenego, Leonardo Renieri, Joseph Carnevale, Guillaume Saliou, Panagiotis Mastorakos, Kareem El Naamani, Arbaz A Momin, Eimad Shotar, Markus Möhlenbruch, Michael Kral, Charlotte Chung, Mohamed M Salem, Ivan Lylyk, Paul M Foreman, Hamza Shaikh, Vedran Župančić, Muhammad U Hafeez, Joshua Catapano, Muhammad Waqas, Muhammed Said Besler, Yasin Celal Gunes, James D Rabinov, Julian Maingard, Clemens M Schirmer, Mariangela Piano, Anna L Kühn, Caterina Michelozzi, Robert M Starke, Ameer Hassan, Mark Ogilvie, Anh Nguyen, Jesse Jones, Waleed Brinjikji, Marie T Nawka, Marios Psychogios, Christian Ulfert, Bryan Pukenas, Jan-Karl Burkhardt, Thien Huynh, Juan Carlos Martinez-Gutierrez, Sunil A Sheth, Diana Slawski, Rabih Tawk, Benjamin Pulli, Boris Lubicz, Pietro Panni, Ajit S Puri, Guglielmo Pero, Eytan Raz, Christoph J Griessenauer, Hamed Asadi, Adnan Siddiqui, Elad I Levy, Deepak Khatri, Neil Haranhalli, Andrew F Ducruet, Felipe C Albuquerque, Robert W Regenhardt, Christopher J Stapleton, Peter Kan, Vladimir Kalousek, Pedro Lylyk, Srikanth Boddu, Jared Knopman, Stavropoula I Tjoumakaris, Hugo H Cuellar-Saenz, Pascal M Jabbour, Frédéric Clarençon, Nicola Limbucci, Vitor Mendes Pereira, Aman B Patel, David J Altschul, Adam A Dmytriw, Worldwideweb Consortium Collaborators

Faculty, Staff and Student Publications

The Woven EndoBridge (WEB) device treats wide-necked bifurcation aneurysms, but occlusion rates vary. This study aims to identify factors associated with immediate WEB device occlusion. Data from patients treated with WEB devices across 36 sites were analyzed. Machine learning algorithms and ordinal regression models were developed to predict immediate incomplete occlusion for ruptured and unruptured aneurysms. The study included 1565 patients, with 436 ruptured and 1129 unruptured aneurysms. Immediate complete occlusion was achieved in 38.3% of ruptured and 32.8% of unruptured aneurysms. For ruptured aneurysms, the CatBoost classifier achieved an AUROC of 0.69. Key predictors of incomplete occlusion included pretreatment …

Hif-2-Dependent Regulation Of Pthrp And Paraneoplastic Hypercalcemia In Aggressive Clear-Cell Renal Cell Carcinoma, Arijit Mal, Bingqing Xie, Zane Gray, Charlotte Small, Susmita G Ramanand, Yunpeng Gao, Vanina Toffessi Tcheuyap, Sashi Debnath, Alana Christie, Jeffrey Miyata, Brooklyn Jackson, Hua Zhong, Boning Gao, Jay Lohrey, Naim M Maalouf, Sangeetha M Reddy, John D Minna, Ivan Pedrosa, Xiankai Sun, Ram S Mani, Payal Kapur, James Brugarolas

Faculty, Staff and Student Publications

Renal cell carcinoma (RCC) patients with hypercalcemia (HC) have worse outcomes. HC often involves PTHrP, and the role of HIF-2 is incompletely understood. Leveraging RCC tumorgraft (TG) models of HC, which were characterized by tumor cell autonomous inflamatory/immune signatures, we show that HIF-2 inhibition with PT2399 frequently normalized calcium, downregulated circulating PTHrP and reduced HIF-2 binding to the PTHLH (PTHrP) promoter. Likely contributing to the selective induction of PTHrP in a subset of HIF-2-dependent tumors, the PTHLH locus was generally more accessible in TG(HC). However, PTHLH chromatin accessibility was grossly unaffected by PT2399, unlike elsewhere (including EPO locus in a …

Using Gnotobiotic Mice To Decipher Effects Of Gut Microbiome Repair In Undernourished Children On Tuft And Goblet Cell Function, Yi Wang, Hao-Wei Chang, Jiye Cheng, Daniel M Webber, Hannah M Lynn, Matthew C Hibberd, Clara Kao, Ishita Mostafa, Tahmeed Ahmed, Michael J Barratt, Jeffrey I Gordon

2020-Current year OA Pubs

Studies have implicated perturbations in the postnatal development of the gut microbiome as a contributing factor to childhood undernutrition. Compared to a standard ready-to-use supplementary food, a microbiome-directed complementary food (MDCF-2) designed to repair these perturbations produced superior improvements in ponderal and linear growth in clinical trials of Bangladeshi children with moderate acute malnutrition. Here, "reverse translation" experiments are performed where intact fecal microbiomes collected from trial participants before and at the end of treatment are introduced into female gnotobiotic mice just after delivery of their pups. Pups received diets designed to resemble those consumed by children in the trials …

Statistically Significant Association Does Not Imply Improvement In Prediction Of Clinical Outcomes, Shu Jiang, Bernard A Rosner, Graham A Colditz

2020-Current year OA Pubs

UNLABELLED: In the current landscape of clinical studies, the concept of statistically significant association is often mixed up with the expectation of improved prediction performance. We discuss the two concepts, association and prediction, and present the epidemiologic principles and statistical constructs that underlie the discrepancy between statistically significant associations and the rationale for their lack of impact on improving prediction in terms of discrimination. This issue is illustrated using an existing breast cancer dataset. The concept of statistically significant association should not be mixed up with the expectation of improved discrimination performance. Although some markers may not markedly improve discrimination, …

Fucosylated N-Glycan Landscape Of Triple-Negative Breast Cancer, Danielle A Scott, Souvik Seal, Laura Spruill, Jaclyn Dunne, Graham Colditz, Anand S Mehta, Richard R Drake, Marvella E Ford, Peggi M Angel

2020-Current year OA Pubs

UNLABELLED: Triple-negative breast cancer (TNBC) is an aggressive subtype of breast cancer lacking targeted therapies. Although aberrant N-glycosylation is a hallmark of malignancy, the specific roles of core-fucosylated (CF) and outer arm-fucosylated (OAF) N-glycans in TNBC progression and patient survival remain underexplored. This study utilized multiplexed glycomics by matrix-assisted laser desorption/ionization imaging mass spectrometry to spatially profile 348 N-glycans in 59 TNBC tumors with clinical characteristics including survival data. Spatial analysis revealed distinct localization patterns of CF and OAF isomers within tumor microenvironments. Strikingly, OAF glycans, but not CF, were strongly associated with tumor stage, with expression increasing from stage …

Proposed Medical School Curricula For 3d Printing, Danielle Heiser, David H Ballard, Et Al.

2020-Current year OA Pubs

BACKGROUND: 3D printing is increasingly utilized in medical education, providing a hands-on approach to anatomical learning, surgical planning, and interdisciplinary collaboration. Despite growing interest, standardized curricula incorporating 3D printing into medical education are lacking.

METHODS: A multidisciplinary team of medical educators, engineers, and students developed three distinct curricular models to integrate 3D printing into undergraduate medical education. These models include (1) integration into anatomy coursework, (2) a fourth-year clerkship elective, and (3) a pre-clerkship elective. The outline for each curriculum was designed to be adaptable across institutions, emphasizing hands-on learning, imaging segmentation, basic elements of computer-aided design (CAD), and 3D …

Upper-Body Post-Activation Performance Enhancement In Mma Athletes: Load-Dependent Effects Across Multiple Explosive Tasks, Jan Strawiński, Dariusz T. Skalski, Magdalena Prończuk, Kinga Łosińska, Ewelina Lulińska, Miłosz Drozd, Maciej Kostrzewa, Adam Maszczyk, Robert K. Roczniok

Baltic Journal of Health and Physical Activity

Background: Post-activation performance enhancement (PAPE) has become a recognized method for acutely improving explosive output, particularly relevant to upper-body performance in combat sports. Objective: This study aimed to evaluate the effects of bench press conditioning activities (CAs) at different intensities (50 %, 65 %, and 80 % 1RM) on upper-body explosive performance in mixed martial arts (MMA) athletes, with emphasis on training status. Methods: Twenty-nine male MMA athletes were divided into intermediate (n = 14) and advanced (n = 15) groups. Each participant completed three CA sessions followed by a 4-minute recovery and then performed a plyometric push-up …

Saudi Heart Association Position Statement On Adult Vaccinations For Patients With Cardiovascular Diseases, Waleed Alhabeeb, Fayssal M Farahat, Majid Alshamrani, Raed Aldahash, Mohamed S. Al-Moamary, Mohammed Balghith, Yassmin Hanfi

Journal of the Saudi Heart Association

Background: Cardiovascular diseases (CVDs) remain the leading cause of mortality worldwide. Individuals with CVD are particularly vulnerable to severe complications from vaccine-preventable infections; however, adult vaccination continues to be underutilized. Methods: A multidisciplinary expert panel from the Saudi Heart Association (SHA) conducted a comprehensive literature review and a series of consensus meetings to develop evidence-based recommendations for adult immunization in patients with CVD. Results and conclusions: Evidence from randomized trials, observational studies, and real-world data supports the role of vaccines in reducing the risk of major adverse cardiovascular events in individuals with CVD. The SHA recommends the implementation of age-appropriate …

Engaging Ukrainian Tf-Cbt Therapists In A Practice Skills Course To Support Their Wellbeing, Elisabeth Pollio, Esther Deblinger, Beth Cooper, Maike Garbade, Julie P Harrison, Elisa Pfeiffer

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Background: Burnout and secondary traumatic stress (STS) are common among therapists working with trauma-exposed clients, which can negatively impact them professionally and personally. The shared trauma of war exposure may put therapists at greater risk. To help support their wellbeing, an eight-session course was offered to Ukrainian therapists following training in Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). This course involves therapists personally utilizing the PRACTICE skills taught to clients in TF-CBT for professional and personal benefit.

Objective: The objective was to gather preliminary evidence on the potential impact of implementing the course with Ukrainian therapists providing TF-CBT during a period of …