Medicine and Health Sciences Commons^™

Timing And Mode Of Death Following Treatment Of Neonatal Symptomatic Tetralogy Of Fallot, Sara M Trucco, Yun Zhang, Andrew C Glatz, Michael L O'Byrne, Christopher J Petit, Athar M Qureshi, Jeffrey D Zampi, Shabana Shahanavaz, George T Nicholson, Allen Ligon, Jennifer C Romano, Shiraz A Maskatia, Jeffery J Meadows, Christopher Mascio, Jay Patel, Kathryn Stack, Asaad G Beshish, Mark Law, Sarosh P Batlivala, Jeannette Wong-Siegel, Kristal Hock, Sarah Speed, Hala Khan, Disha Goel, Courtney Mccracken, Bryan H Goldstein

Faculty, Staff and Students Publications

Background: Neonates with tetralogy of Fallot and symptomatic cyanosis (sTOF) require early intervention, using a staged or primary repair strategy. Postprocedural mortality risk within this group is considerable. The mode of death and associated factors have been inadequately defined in early childhood mortality following treatment of sTOF. This study aims to describe the timing, cause, and associated risk factors of postprocedural death in infants with sTOF.

Methods: Neonates with sTOF who had an initial intervention from 2005 to 2017 at 9 centers of the Congenital Cardiac Research Collaborative were reviewed. Among nonsurvivors, details regarding timing, cause of death, and last …

Optimising Drowning Prevention Counselling Through A Physician Maintenance Of Certification (Moc) Quality Improvement (Qi) Initiative, Tracy E Mccallin, Anthony R Arredondo, Elizabeth A Camp, Shabana Yusuf

Faculty, Staff and Students Publications

Drowning is the leading cause of death in children 1–4 years old in the USA. Paediatricians play an important role in giving anticipatory guidance on drowning prevention. This quality improvement initiative aimed to increase the rate of drowning prevention counselling with provision of educational materials to caregivers of children aged 0–10 years during clinical encounters in an outpatient setting.

We refined a previously published Texas state educational programme that included evidence-based counselling strategies across three Plan Do Study Act (PDSA) cycles, with the addition of preintervention baseline counselling phase during expansion of the programme nationally to 17 and 21 states …

Serum Response Factor Is Essential For Endometrial Function And Prevention Of Inflammatory Fibrosis, Ryan M Marquardt, Sara A Grimm, San-Pin Wu, Peter F Lais, Shu-Yun Li, Xin Xu, Erin Smithberger, David Cunefare, Charan Ganta, David Olson, Eunhee M Jeong, Jae-Wook Jeong, Bruce A Lessey, John P Lydon, Francesco J Demayo

Faculty, Staff and Students Publications

Pregnancy requires a supportive uterine environment facilitated by steroid hormone–regulated differentiation of endometrial stromal fibroblasts into decidual cells and tight control of inflammation. Serum response factor (SRF) is a widely expressed transcription factor essential for mesenchymal cell growth and differentiation with noted roles in hormonal regulation of muscle tissues but little characterization in reproductive organs. Here, we reveal that endometrial SRF is dysregulated in human endometriosis and is critical for female reproductive success in mice through regulation of endometrial stromal and epithelial cells. Immunohistochemical analysis identified decreased endometrial SRF expression in infertile endometriosis patient tissues. RNAi-based SRF knockdown in human …

Mitomycin-C For Hpv-Positive And Hpv-Negative Platinum-Refractory, Recurrent Or Metastatic Head And Neck Squamous Cell Carcinoma: A Phase 2 Trial, Peter Oppelt, Jessica Ley, Christine Auberle, Brendan Knapp, Jesse Zaretsky, Fei Wan, Douglas Adkins

2020-Current year OA Pubs

BACKGROUND/OBJECTIVES: Functional p53 is critical for anti-tumor activity of mitomycin-C. In wild-type

METHODS: Patients with platinum-refractory RM-HNSCC received mitomycin-C (10 mg/m

RESULTS: Forty-seven patients were treated with mitomycin-C: 34 in cohort A and 13 in cohort B. Tumor response occurred in 3 of 33 evaluable patients in cohort A (ORR 9.1%, 95%CI: 0-19.4) and in 0 of 12 evaluable patients in cohort B. The duration of tumor responses in cohort A was 2.3, 2.5, and 4.5 months. The most common treatment-related AEs of any grade were anemia (96%), fatigue (62%), and thrombocytopenia (40%). No treatment-related deaths occurred.

CONCLUSIONS: Mitomycin-C had …

Nsrm (All0345) And Nsrx (Alr1976), Two Furc (Perr)-Targeted Transcriptional Regulators, Modulate Nitrogen Metabolism And Heterocyst Differentiation Genes In The Cyanobacterium Anabaena Sp. Strain Pcc 7120, Jorge Guío, Marta Acero, Anindita Bandyopadhyay, Deng Liu, Himadri B Pakrasi, Isabelle Michaud-Soret, M Teresa Bes, Emma Sevilla, María F Fillat

2020-Current year OA Pubs

UNLABELLED: The control of nitrogen metabolism in the model cyanobacterium

IMPORTANCE: Filamentous, nitrogen-fixing cyanobacteria are valuable organisms for biotechnology applications and as models for the study of multicellularity in prokaryotes. Understanding the regulation of nitrogen fixation and heterocyst development is essential for optimizing their use in synthetic biology and as biofertilizers. This study identifies two novel nitrogen secondary regulators, Alr1976 (NsrX) and All0345 (NsrM), as part of the intricate regulatory circuit governing nitrogen metabolism in the model cyanobacterium

Disparate Leukemia Mutations Converge On Nuclear Phase-Separated Condensates, Gandhar K Datar, Elmira Khabusheva, Archish Anand, Joshua Beale, Marwa Sadek, Chun-Wei Chen, Evdokiia Potolitsyna, Nayara Alcantara-Contessoto, Guangyuan Liu, Josephine De La Fuente, Christina Dollinger, Anna Guzman, Alejandra Martell, Katharina Wohlan, Abhishek Maiti, Nicholas J Short, S Stephen Yi, Vibeke Andresen, Bjørn Tore Gjertsen, Brunangelo Falini, Rachel E Rau, Lorenzo Brunetti, Nidhi Sahni, Margaret A Goodell, Joshua A Riback

Faculty, Staff and Students Publications

During cancer development, mutations promote changes in gene expression that cause transformation. Leukemia associated with aberrant HOXA expression is driven by translocations of nucleoporin genes or KMT2A as well as mutations in NPM1. The mechanistic convergence of these disparate mutations remains elusive. Here, we demonstrate that mutant nucleophosmin 1 (NPM1c) forms nuclear condensates in human cell lines, mouse models, and primary patient samples. We show NPM1c phase separation is necessary and sufficient to recruit NUP98 and KMT2A to condensates. Through extensive mutagenesis and pharmacological destabilization of phase separation, we find that NPM1c condensates are necessary for regulating gene expression, promoting …

Timing And Mode Of Death Following Treatment Of Neonatal Symptomatic Tetralogy Of Fallot, Sara M Trucco, Andrew C Glatz, Et Al.

2020-Current year OA Pubs

BACKGROUND: Neonates with tetralogy of Fallot and symptomatic cyanosis (sTOF) require early intervention, using a staged or primary repair strategy. Postprocedural mortality risk within this group is considerable. The mode of death and associated factors have been inadequately defined in early childhood mortality following treatment of sTOF. This study aims to describe the timing, cause, and associated risk factors of postprocedural death in infants with sTOF.

METHODS: Neonates with sTOF who had an initial intervention from 2005 to 2017 at 9 centers of the Congenital Cardiac Research Collaborative were reviewed. Among nonsurvivors, details regarding timing, cause of death, and last …

Lrp8 Is An Entry Receptor For Tick-Borne Encephalitis Viruses, Pengfei Li, Sean Hui, Zhenlu Chong, Michael N Nguyen, Stefanie P Muraro, Hana Janova, Hongming Ma, Shiqi Cao, Tomasz Kaszuba, Brian Imbiakha, Sathvik Palakurty, David A Price, Gaya K Amarasinghe, Daisy W Leung, Daved H Fremont, Michael S Diamond, Et Al.

2020-Current year OA Pubs

Orthoflaviviruses are a genus of arthropod-transmitted RNA viruses that infect humans and other vertebrate animals on a global scale, resulting in extensive morbidity and mortality. Among the orthoflaviviruses, tick-borne encephalitis viruses (TBEV) are an antigenic group that causes severe neurological disease in humans. However, the entry receptors for TBEV, which contribute to cell and tissue tropism, remain largely unknown. Because recent studies identified members of the low-density lipoprotein receptor (LDLR) family as possible receptors for some orthoflaviviruses and distantly related alphaviruses, we performed a targeted screen in transgenic cells expressing different LDLR members and identified LRP8 (also called ApoER2) as …

A Functional Clock In Only Two Dorsal Clock Neurons Is Sufficient To Restore The Basal Circadian Activity Pattern Of Drosophila Melanogaster, Nils Reinhard, Enrico Bertolini, Takuya Kuwahara, Manabu Sekiguchi, Dirk Rieger, Weihua Li, Paul H Taghert, Taishi Yoshii, Charlotte Helfrich-Förster

2020-Current year OA Pubs

Circadian clocks form complex networks to orchestrate the behavior and physiology of animals. Elucidating the organization of these clock networks is critical to understanding how circadian clocks achieve robust timing. Clock neurons have been best characterized in the model organism

Semaglutide And Diabetic Retinopathy: An Ohdsi Network Study, Cindy Xinji Cai, Linying Zhang, Ruochong Fan, Adam Wilcox, Albert Lai, Et Al.

2020-Current year OA Pubs

INTRODUCTION: Semaglutide, a glucagon-like peptide-1 receptor agonist (GLP-1RA) used to treat type 2 diabetes mellitus (T2D), has potential associations with higher rates of diabetic retinopathy (DR) complications including proliferative DR (PDR) and diabetic macular edema (DME). The purpose of this study was to determine whether an association exists between semaglutide and PDR and treatment-requiring DR/DME.

RESEARCH DESIGN AND METHODS: This was a retrospective cohort study of 14 databases (six administrative claims and eight electronic health records) in the Observational Health Data Sciences and Informatics Evidence Network. Adults with T2D on semaglutide, other GLP-1RA (dulaglutide, exenatide), or non-GLP-1RA medications (empagliflozin, sitagliptin, …

Telehealth Education Leveraging Electronic Transitions Of Care For Copd Patients (Tele-Toc): A Study Protocol For A Type Ii Hybrid Effectiveness-Implementation Randomised, Pragmatic Clinical Trial Of A Pharmacist-Led Intervention, Deepa Ramadurai, Cathryn T Lee, Leah Traeger, Geoff Pucci, Andrea Jackson-Sagredo, Sachin Shah, Joanna Abraham, Vineet M Arora, Valerie G Press

2020-Current year OA Pubs

INTRODUCTION: Transitions of care (TOC) between hospital, ambulatory and home settings for high-risk adults with chronic diseases are complex, costly and often result in poor health outcomes. Suboptimal care transitions lead to medication errors, non-adherence, decreased self-management skills and inadequate follow-up, all of which contribute to readmissions or emergency department visits. The Transitional Care Model aims to address these challenges through patient-centred, in-home interventions. We propose to implement and evaluate TELE-TOC: Telehealth Education Leveraging Electronic Transitions Of Care for Chronic Obstructive Pulmonary Disease (COPD) patients. This study will evaluate the added value of a virtual, pharmacy-based intervention integrated into an …

An Interview With Dr. Chris Richardson, Elizabeth Reynolds Dds

Virginia Dental Journal

No abstract provided.

Elucidating The Relationship Between Water Quality And Antibiotic Resistance Of Rainwater Microbes Across Western Humboldt County, Theo P. Murphy, Eve Wendley, Justice Laskowski, Tyler Paredes

Humboldt Journal of Microbiology

Limited studies have been conducted regarding the fecal contamination and microbial dispersal through rainwater, with no known studies investigating the potential connection between antibiotic resistant microbes and water quality in rainwater. This study seeks to identify the presence of a correlation between water quality and incidence of antibiotic resistance in rainwater microbes. We hypothesize that there will be a correlation between these two variables. We additionally anticipate a high incidence of fecal contamination across rural and urban collection sites alike, with fecal contamination being more prevalent in rural areas than urban locals. To determine water quality, we measured the concentration …

Antimicrobial Resistance In Ukraine—What Healthcare Providers Need To Know When Treating Ukrainian Refugees, Olga Vasylyeva

Advances in Clinical Medical Research and Healthcare Delivery

The scoping review assesses the trends in clinical infectious diseases reporting antimicrobial resistance (AMR) in Ukraine following a year of full-scale Russo-Ukrainian war (2022) to offer recommendations for healthcare providers caring for patients traveling from Ukraine.

Background: Until 2019, antibiotics were available to Ukrainians over the counter, and there was no systematic program to monitor bacterial resistance. Only in 2023 did a document standardizing the rational use of antibacterial and antifungal drugs become available for Ukrainian healthcare providers. By 2020, high levels of carbapenem-resistant bacteria were reported in military hospitals, 29.5%–64.2%, with Acinetobacter baumannii particularly problematic. Nosocomial infections were significantly …

Accidental Daily Dosing: Severe Methotrexate Toxicity In A Patient With Rheumatoid Arthritis, Sidra Memon, Kavitha Vemuri, Syed Uzair Mahmood, Darshit Patel

Advances in Clinical Medical Research and Healthcare Delivery

This case highlights a crucial complication of oral methotrexate therapy: toxicity due to dosing errors. A patient’s daily dosing regimen, instead of the intended weekly schedule, led to a significantly excessive cumulative dose of methotrexate over a short period, resulting in severe hematologic and mucosal toxicity. This underscores the importance of clear patient education and vigilant prescription practices to prevent such errors.

Compassion Fatigue And Burnout In Community-Based Psychiatric Staff, Faith Carini-Graves

Advances in Clinical Medical Research and Healthcare Delivery

Community-based psychiatric staff, such as the Youth ACT teams that are being initiated across New York State, are at risk for compassion fatigue due to their proximity to the trauma of their patients. This literature review explores current evidence that is available on the topic and grapples with what can be done to support psychiatric staff who work in the community with patients who experience trauma.

Plasmacytoma As The Initial Presentation Of Multiple Myeloma: A Case Report, Chantelle Martin, Sidra Memon, Austin Kim, Saleha Asghar

Advances in Clinical Medical Research and Healthcare Delivery

We report an unusual case of a woman who presented with nonspecific symptoms of unilateral facial mass and bleeding from her lower lip over several weeks. The mass was found to be relatively fixed and irregular with destruction of facial bone as evidenced by imaging. Initial investigations indicated the possibility of multiple myeloma, which was later confirmed with serum protein electrophoresis and bone marrow biopsy. Cervical lymph node biopsy confirmed presence of plasmacytoid cells positive for CD 20.

Inadvertent Transhepatic Placement Of Percutaneous Endoscopic Gastrostomy (Peg) Tube, Stephanie Yu, Brian Wight, Elizabeth Mamo, Alexander Kurchin

Advances in Clinical Medical Research and Healthcare Delivery

Of 294 patients who had a PEG tube placed and subsequently underwent CT scan of the abdomen, in 20 patients the tube traverses the left lobe of the liver. Only one of these 20 patients had a major complication, indicating the transhepatic PEG is usually well tolerated, and, if detected can be left in place.

Cardioembolic Versus Cryptogenic Stroke: A Case Report And Discussion, Lily Sitisa, Shabir Ferdows, Jonathan Brach

Advances in Clinical Medical Research and Healthcare Delivery

Ischemic strokes account for about 85% of cerebrovascular accidents. About 30–40% of ischemic strokes are classified as cryptogenic, which is defined as an ischemic stroke of the brain without a clear etiology. This case report presents a 56-year-old male with a history of uncontrolled hypertension who was admitted to a community hospital for cardioembolic versus cryptogenic stroke. It is essential for clinicians to be familiar with cryptogenic stroke and its implications for patient care.

Two Interesting Cases Of Left Ventricular Free Wall Rupture In Myocardial Infarction, Astha Prasai, Nada Hafez, Mallory A. Balmer-Swain, Rawa Sarji

Advances in Clinical Medical Research and Healthcare Delivery

We present two interesting cases of left ventricular free wall rupture following ST elevation myocardial infarction. First case was not identified on echocardiography and angiography despite high suspicion and later underwent emergent lifesaving mediastinal exploration and repair. Second case had a delayed presentation of inferior STEMI and cardiac tamponade. These cases highlight the diagnostic challenges and variable presentations of left ventricular free wall rupture (LVFWR).

Rare Case Of Visual Hallucinations In A 60-Year-Old Female With A Recurring Pituitary Macroadenoma, Angelica Alday, Farah Qureshi, Kayvan Mirhadi

Advances in Clinical Medical Research and Healthcare Delivery

Pituitary adenomas are the third most frequently occurring primary intracranial tumor and are benign neoplasms that can have profound clinical implications. While most of these masses cause hormone hypersecretion, they may also be clinically silent until they elicit symptoms of mass effect, including severe headaches and visual field defects such as bitemporal hemianopia. This report highlights an atypical presentation of a pituitary adenoma that could be valuable for internists to consider when forming a differential diagnosis for patients with hallucinations. We discuss a case of a 60-year-old woman with a recent history of multiple emergency department visits for ongoing urinary …

Aortic Valvular Papillary Fibroelastoma Presenting As Transient Ischemic Attacks, Mahrukh Tariq, Zauraiz Anjum, Joel Shapiro

Advances in Clinical Medical Research and Healthcare Delivery

We present an aortic valve Papillary Fibroelastoma diagnosed on a transesophageal echo (TEE) in 2020 in a patient who had been presenting with recurrent CNS symptoms since 2013 without any known cause. She had clean imaging including transthoracic echo (TTE) and the Fibroelastoma was discovered only on a TEE in 2020. We hope to highlight the elusive nature of the lesion as an obscure cause of CNS symptomatology.

Impact Of Frailty On Inpatient Outcomes Of Covid-19 Patients: Evidence From A Us National Inpatient Sample, Ali Jaan, Priyanshi Shah, Ashish Dhawan, Saria Qaiser, Azka Ali, Hla Myo Thwe, Oluwatosin Abimbolu, Clara Chimuanya Okpara, Michael Rajnik

Advances in Clinical Medical Research and Healthcare Delivery

Introduction: The global impact of Coronavirus Disease 2019 (COVID-19), caused by severe-acute-respiratory-syndrome coronavirus 2 (SARS-CoV-2), has been profound, claiming the lives of more than 3 million individuals within a year and a half. Among the affected population, heightened vulnerability is observed among older and frailer individuals, leading to more severe symptoms and adverse outcomes compared to their younger, non-frail counterparts. This study to analyze the impact of frailty on the outcomes of adult patients admitted with COVID-19.

Methods: Using the National Inpatient Sample (NIS) database 2020, we identified adult patients admitted with a principal diagnosis of COVID-19. The …

A Rare Case Of Systolic Heart Failure In A 32-Year-Old Man, Neha Narayanan, Paulina N. Goodermote, Mohammad Jawish

Advances in Clinical Medical Research and Healthcare Delivery

There is limited data about heart failure in individuals below 65 years of age, despite the increasing incidence and rapidly progressive nature of heart failure in this patient population. This case of a 32-year-old African American male highlights the importance of early diagnosis and rapid transfer to higher level care given the quick progression of his systolic heart failure. This case also aims to discuss the common etiologies behind heart failure in young adults, highlighting how crucial it is to consider this diagnosis in an individual with polysubstance use. We hope this case report sheds light on the rising incidence …

Giant Cell Arteritis After Mrna Covid Vaccines: Concerning Or A False Alarm?-A Retrospective Cohort Study, Syed M. F. Zabiullah, Rutwik Pradeep Sharma, Roshan Subedi, Viqarunnisa Faaiza Zahid, Yasir Loai, Sarathlal Mannumbethlal, Aatifa Aatifa

Advances in Clinical Medical Research and Healthcare Delivery

Background: The coronavirus disease (COVID-19) pandemic led to the first large-scale rapid deployment of novel messenger RNA (mRNA) vaccines. Although the effectiveness and safety of these vaccines were rigorously studied, post-vaccination adverse events such as giant cell arteritis (GCA) continue to be reported. More than two hundred and sixty three cases of new-onset GCA occurring after mRNA vaccine administration are listed in the Vaccine Adverse Events Reporting System as of October 2024. We aimed to explore the incidence of GCA after mRNA vaccines among patients in our health system and study their characteristics and outcomes.

Methods: We conducted a …

Postoperative Pain Management In Older Patients, Stephanie Guercio, Andrea M. Bodine

Advances in Clinical Medical Research and Healthcare Delivery

Background: Postoperative pain management in the older population has been described as a complex topic with providers trying to balance pain control while minimizing adverse effects of decreased physiologic reserve such as delirium and decreased cognitive function. The goal of this study was to compare pain scores and pain medications prescribed at discharge between an older age group and a middle age group after an elective cholecystectomy.

Methods: We conducted a retrospective study at a community hospital in western Massachusetts collecting data from March 1, 2022, to February 28, 2023 using laparoscopic cholecystectomy CPT code. Included were patients between 50 …

Hepatocellular Carcinoma Surveillance In Patients With Cirrhosis, Identifying Gaps In Clinical Practice, Abdullah Orakzai, Muhammad Hammad Sharif, Basil George Verghese, Shiamak Cooper, Venkat Arutla, Purva Shah, Himal Kharel, Aditya Sanjeevi, Aniket-Vijay Rao

Advances in Clinical Medical Research and Healthcare Delivery

Background:Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related death worldwide, with rising mortality rates in the United States. Early detection of HCC through routine screening significantly improves survival rates in patients with cirrhosis. Current guidelines recommend bi-annual screening using abdominal ultrasound with or without serum AFP levels; however, adherence to these guidelines is suboptimal in clinical practice.

Methods:We conducted a retrospective study of 320 adult patients diagnosed with HCC at our institution between January 1, 2023, and July 31, 2023. Patients aged >22 years were included, and their medical records were reviewed to evaluate routine surveillance …

Ada News - 11/3/2025, American Dental Association, Publishing Division

ADA News

Established in 1970 as the official newspaper of the American Dental Association, the ADA News serves practicing dentists and others allied to the dental profession in the U.S. and internationally. It is the No. 1 source of news and information about the many benefits and services the ADA delivers to members daily as well as timely information on scientific, social, political and economic developments affecting dentistry and health care.

Increasing Pediatric Hpv Vaccination Rates, Brooke A. Nicholas

Dissertations

Increasing Pediatric HPV Vaccination Rates

Abstract

Problem: The human papillomavirus (HPV) is a sexually transmitted infection that affects more than 80% of the population within the United States (Eisenhauer et al., 2020). HPV can develop into cervical, anogenital, and oropharyngeal cancers (Eisenhauer et al., 2020). About 4,000 individuals die from cervical cancer alone each year (O’Leary, 2022). The HPV vaccine, though recommended by the ACIP and AAP, is below national vaccination rates in comparison to other vaccines (O’Leary, 2022).

Methods: This quality improvement project is a non-randomized controlled trial that observed HPV vaccine dose completion rates for patients aged 9-14 …

Intranasal Delivery Of Extracellular Vesicles Derived From Human Bone Marrow Mesenchymal Stem Cells Dampens Neuroinflammation And Ameliorates Motor Deficits In A Mouse Model Of Cortical Stroke, Saviana Antonella Barbati, Chiara D'Amelio, Chiara Feroleto, Marta Morotti, Ida Nifo Sarrapochiello, Francesca Natale, Domenica Donatella Li Puma, Yolanda Gomez-Galvez, Elena Blanco-Suarez, Lorraine Iacovitti, Lucia Leone, Salvatore Fusco, Maria Vittoria Podda, Claudio Grassi

Department of Neuroscience Faculty Papers

Early treatment of ischemic stroke can significantly reduce disability and mortality rates. Stem cell-derived extracellular vesicles (EVs) have shown potential as therapeutics for neurological disorders. This study explored whether intranasal administration of EVs from human bone marrow mesenchymal stem cells (BM-MSCs) enhances forelimb motor function recovery in a mouse model of motor cortex stroke and investigated their mechanism of action, focusing on neuroinflammation. C57BL/6JRj mice received EV treatment of 0.1 × 10⁹ EVs per dose per day, 48 h post-stroke and twice weekly for four weeks. EV-treated mice showed significant improvement in forelimb deficits, as evaluated using a series …