Medicine and Health Sciences Commons^™

Empowering Resident Autonomy, Competence, And Relatedness Through Opt-Out Visits, Emily Lisco, Md, Alexandra Hughes, Lcsw, Meghan O’Meara, Phd, Lpc

Department of Psychiatry and Human Behavior Posters

Background

• House staff officers are more likely to experience burnout than their age-matched peers in the general population.³
• ACGME Common Program requirements emphasize the importance of well-being in residency programs, including the opportunity to attend healthcare appointments during working hours.¹
• Opt-out programs have been used to increase help-seeking behavior and provide low-barrier access to mental health care and other supports.^{2, 4-5}
• Self-determination theory proposes that individuals’ well-being can be enhanced if the core psychological needs of autonomy, competence, and relatedness are met.⁶
• The lack of perceived autonomy, competence, and connection felt by residents can lead to …

Medical School Watercooler Newsletter - February 20, 2025, Lindsay Hughes

Watercooler Newsletter

This is the Thursday, February 20, 2025 edition of the Frederick P. Whiddon College of Medicine's newsletter -- Watercooler.

Contents include:

• USA Health cardiology fellow selected for prestigious skills course
• Student interest groups participate in USA Walk Against Eating Disorders
• Medical students present at SMA Physicians-in-Training Leadership Conference
• Physicians and students engage in Honest Conversations
• Medical students selected for esteemed Otolaryngology Future Scholars Program

Medical School Watercooler - February 20, 2025, Lindsay Hughes

Watercooler Newsletter

This is the Thursday, February 20, 2025 edition of the Frederick P. Whiddon College of Medicine's newsletter -- Watercooler.

Contents include: 

• USA Health cardiology fellow selected for prestigious skills course
• Student interest groups participate in USA Walk Against Eating Disorders
• Medical students present at SMA Physicians-in-Training Leadership Conference
• Physicians and students engage in Honest Conversations
• Medical student selected for esteemed Otolaryngology Future Scholars Program

Legal Residency Status And Its Relationship With Health Indicators Among Syrian Refugees In Lebanon: A Nested Cross-Sectional Study, Marie-Elizabeth Ragi, Hala Ghattas Ph.D., Berthe Abi Zeid, Hazar Shamas, Noura Joseph El Salibi, Sawsan Abdulrahim, Jocelyn Dejong, Stephen J. Mccall, The Caep Study Group

Faculty Publications

Background Failure to possess or renew legal residency permits increases the burden on a vulnerable refugee population. It risks detention or deportation, and hinders access to basic services including healthcare. This study aimed to examine the association between legal residency status and health of Syrian refugees living in Lebanon.

Methods Data were from two independent nested cross-sectional studies collected in 2022 through telephone surveys. In the first study, all Syrian refugees aged 50 years or older from households that received humanitarian assistance were invited to participate. The second included all adult Syrian refugees residing in a suburb of Beirut. The …

Automated Detection Of Reduced Ejection Fraction Using An Ecg-Enabled Digital Stethoscope: A Large Cohort Validation, Ling Guo, Gregg S. Pressman, Spencer N. Kieu, Scott B. Marrus, George Mathew, John Prince, Emileigh Lastowski, Rosalie V. Mcdonough, Caroline Currie, John N. Maidens, Hussein Al-Sudani, Evan Friend, Deepak Padmanabhan, Preetham Kumar, Edward Kersh, Subramaniam Venkatraman, Salima Qamruddin

Einstein Health Papers

BACKGROUND: Asymptomatic left ventricular systolic dysfunction (ALVSD) affects 7 million globally, leading to delayed diagnosis and treatment, high mortality, and substantial downstream health care costs. Current detection methods for ALVSD are inadequate, necessitating the development of improved diagnostic tools. Recently, electrocardiogram-based algorithms have shown promise in detecting ALVSD.

OBJECTIVES: The authors developed and validated a convolutional neural network (CNN) model using single-lead electrocardiogram and phonocardiogram inputs captured by a digital stethoscope to assess its utility in detecting individuals with actionably low ejection fractions (EF) in a large cohort of patients.

METHODS: 2,960 adults undergoing echocardiography from 4 U.S. health care …

Staff Education On Advantages Of Administering Phq-9 Screening To Adolescents And Young Adults Receiving Transcranial Magnetic Stimulation (Tms) Therapy In An Outpatient Mental Health Clinic, Florence O. Gbadehan

Walden Dissertations and Doctoral Studies

page This Doctor of Nursing Practice (DNP) study filled a practice gap in an outpatient mental health clinic by increasing staff understanding of the PHQ-9 screening tool for teenagers and young adults undergoing Transcranial Magnetic Stimulation (TMS) therapy. The project sought to answer the following practice-focused question: will teaching staff about the PHQ-9 increase knowledge? A staff education program was developed and implemented to address this gap, with professional persons examining and approving the content before it was distributed. Twelve voluntary clinical staff members attended a sixty-minute in-person educational session, which was followed by a ten-question multiple-choice pre/post-test to assess …

Semaglutide And Nonarteritic Anterior Ischemic Optic Neuropathy, Cindy X Cai, Michelle Hribar, Sally Baxter, Kerry Goetz, Swarup S Swaminathan, Alexis Flowers, Eric N Brown, Brian Toy, Benjamin Xu, John Chen, Aiyin Chen, Sophia Wang, Cecilia Lee, Theodore Leng, Joshua R Ehrlich, Andrew Barkmeier, Karen R Armbrust, Michael V Boland, David Dorr, Danielle Boyce, Thamir Alshammari, Joel Swerdel, Marc A Suchard, Martijn Schuemie, Fan Bu, Anthony G Sena, George Hripcsak, Akihiko Nishimura, Paul Nagy, Thomas Falconer, Scott L Duvall, Michael Matheny, Benjamin Viernes, William O'Brien, Linying Zhang, Benjamin Martin, Erik Westlund, Nestoras Mathioudakis, Ruochong Fan, Adam Wilcox, Albert Lai, Jacqueline C Stocking, Sahar Takkouche, Lok Hin Lee, Yangyiran Xie, Izabelle Humes, David B Mccoy, Mohammad Adibuzzaman, Raymond G Areaux, William Rojas-Carabali, James Brash, David A Lee, Nicole G Weiskopf, Louise Mawn, Rupesh Agrawal, Hannah Morgan-Cooper, Priya Desai, Patrick B Ryan

Faculty, Staff and Student Publications

Importance

Semaglutide, a glucagonlike peptide-1 receptor agonist (GLP-1RA), has recently been implicated in cases of nonarteritic anterior ischemic optic neuropathy (NAION), raising safety concerns in the treatment of type 2 diabetes (T2D).

Objective

To investigate the potential association between semaglutide and NAION in the Observational Health Data Sciences and Informatics (OHDSI) network.

Design, Setting, and Participants

This was a retrospective study across 14 databases (6 administrative claims and 8 electronic health records). Included were adults with T2D taking semaglutide, other GLP-1RA (dulaglutide, exenatide), or non–GLP-1RA medications (empagliflozin, sitagliptin, glipizide) from December 1, 2017, to December 31, 2023. The incidence proportion …

Synergistic Effects Of Bacillus Coagulans And Β-Glucans: Potential Benefits Of Probiotic And Prebiotic Use On The Gastrointestinal Tract And Microbiome In Humans, Jennifer Bermudez

Annual Research Symposium

No abstract provided.

Genetic Markers Of Early Response To Lurasidone In Acute Schizophrenia, Akane Yoshikawa, Jiang Li, Ney Alliey-Rodriguez, Herbert Y. Meltzer

School of Medicine Publications

Prediction of treatment response by genetic biomarkers has potential for clinical use and contributes to the understanding of pathophysiology and drug mechanism of action. The purpose of this study is to detect genetic biomarkers possibly associated with response to lurasidone, during the first four weeks of treatment. One-hundred and seventy-one acutely psychotic patients from two placebo-controlled clinical trials of lurasidone were included. Genetic associations with changes in Positive and Negative Syndrome Scale total score at weeks one, two, and four were examined. Genotyping was done with the Affymetrix 6.0 microarray and associations were computed using PLINK regression model. Although genome-wide …

Membrane Lipids Augment Cell Envelope Stress Signaling Via The Madrs System To Defend Against Antimicrobial Peptides And Antibiotics In Enterococcus Faecalis, William R Miller, April Nguyen, Kavindra V Singh, Samie Rizvi, Ayesha Khan, Sam G Erickson, Stephanie L Egge, Melissa Cruz, An Q Dinh, Lorena Diaz, Philip C Thornton, Rutan Zhang, Libin Xu, Danielle A Garsin, Yousif Shamoo, Cesar A Arias

Faculty, Staff and Student Publications

Enterococci have evolved resistance mechanisms to protect their cell envelopes against bacteriocins and host cationic antimicrobial peptides (CAMPs) produced in the gastrointestinal environment. Activation of the membrane stress response has also been tied to resistance to the lipopeptide antibiotic daptomycin. However, the actual effectors mediating resistance have not been elucidated. Here, we show that the MadRS (formerly YxdJK) membrane antimicrobial peptide defense system controls a network of genes, including a previously uncharacterized 3-gene operon (madEFG) that protects the Enterococcus faecalis cell envelope from antimicrobial peptides. Constitutive activation of the system confers protection against CAMPs and daptomycin in the absence of …

Antibiotic-Induced Loss Of Gut Microbiome Metabolic Output Correlates With Clinical Responses To Car T-Cell Therapy, Rishika Prasad, Abdur Rehman, Lubna Rehman, Faezeh Darbaniyan, Viktoria Blumenberg, Maria-Luisa Schubert, Uria Mor, Eli Zamir, Sabine Schmidt, Tomo Hayase, Chia-Chi Chang, Lauren Mcdaniel, Ivonne Flores, Paolo Strati, Ranjit Nair, Dai Chihara, Luis E Fayad, Sairah Ahmed, Swaminathan P Iyer, Michael Wang, Preetesh Jain, Loretta J Nastoupil, Jason Westin, Reetakshi Arora, Joel Turner, Fareed Khawaja, Ranran Wu, Jennifer B Dennison, Meghan Menges, Melanie Hidalgo-Vargas, Kayla Reid, Marco L Davila, Peter Dreger, Felix Korell, Anita Schmitt, Mark R Tanner, Richard E Champlin, Christopher R Flowers, Elizabeth J Shpall, Samir Hanash, Sattva S Neelapu, Michael Schmitt, Marion Subklewe, Johannes Francois-Fahrmann, C K Stein-Thoeringer, Eran Elinav, Michael D Jain, Eiko Hayase, Robert R Jenq, Neeraj Y Saini

Faculty, Staff and Student Publications

Antibiotic (ABX)–induced microbiome dysbiosis is widespread in oncology, adversely affecting outcomes and side effects of various cancer treatments, including immune checkpoint inhibitors and chimeric antigen receptor T-cell (CAR-T) therapies. In this study, we observed that prior exposure to broad-spectrum ABXs with extended anaerobic coverage such as piperacillin-tazobactam and meropenem was associated with worse anti-CD19 CAR-T therapy survival outcomes in patients with large B-cell lymphoma (N = 422) than other ABX classes. In a discovery subset of these patients (n = 67), we found that the use of these ABXs was in turn associated with substantial dysbiosis of gut microbiome function, …

Aif3 Splicing Variant Elicits Mitochondrial Malfunction Via The Concurrent Dysregulation Of Electron Transport Chain And Glutathione-Redox Homeostasis, Mi Zhou, Shuiqiao Liu, Yanan Wang, Bo Zhang, Ming Zhu, Jennifer E Wang, Veena Rajaram, Yisheng Fang, Weibo Luo, Yingfei Wang

Faculty, Staff and Student Publications

Genetic mutations in apoptosis-inducing factor (AIF) have a strong association with mitochondrial disorders; however, little is known about the aberrant splicing variants in affected patients and how these variants contribute to mitochondrial dysfunction and brain development defects. We identified pathologic AIF3/AIF3-like splicing variants in postmortem brain tissues of pediatric individuals with mitochondrial disorders. Mutations in AIFM1 exon-2/3 increase splicing risks. AIF3-splicing disrupts mitochondrial complexes, membrane potential, and respiration, causing brain development defects. Mechanistically, AIF is a mammalian NAD(P)H dehydrogenase and possesses glutathione reductase activity controlling respiratory chain functions and glutathione regeneration. Conversely, AIF3, lacking these activities, disassembles mitochondrial complexes, increases …

A Protocol To Purify Human Mediator Complex From Freestyle 293-F Cells, Hui-Chi Tang, Kuang-Lei Tsai, Ti-Chun Chao

Faculty, Staff and Student Publications

The Mediator, a multi-subunit protein complex in all eukaryotes, comprises the core mediator (cMED) and the CDK8 kinase module (CKM). As a molecular bridge between transcription factors (TFs) and RNA polymerase II (Pol II), the Mediator plays a critical role in regulating Pol II-dependent transcription. Considering its large size and complex composition, conducting in vitro studies on the Mediator complex is challenging, especially when isolating the intact and homogeneous complex from human cells. Here, we present a method to purify the intact CKM-cMED complex from FreeStyle 293-F cells (293-F cells), which offers advantages for performing large-scale protein purification. To isolate …

Does Adiponectin Inform Cardiovascular Risk In Older Adults?: The Aric Study, Layla A Abushamat, Xiaoming Jia, Lu Xu, Chao Cheng, Chiadi E Ndumele, Caroline Sun, B Gwen Windham, Kunihiro Matsushita, Bing Yu, Vijay Nambi, Biykem Bozkurt, Jane E B Reusch, Casey M Rebholz, Elizabeth Selvin, Christie M Ballantyne, Ron C Hoogeveen

Faculty, Staff and Student Publications

BACKGROUND: Adiponectin, an atheroprotective adipokine, is associated with adverse outcomes in older age. It is unclear whether this is due to overlapping pathophysiological pathways with N-terminal pro-B-type natriuretic peptide (NT-proBNP).

OBJECTIVES: The authors investigated adiponectin's associations with cardiovascular disease (CVD) risk in older adults.

METHODS: Among Atherosclerosis Risk in Communities prospective cohort study participants without baseline CVD at visit 5 (n = 4,729, mean age 75), adiponectin and adiponectin/NT-proBNP category associations with incident CVD events (heart failure [HF], atherosclerotic cardiovascular disease, and death during median follow-up of 5.5 years) and echocardiographic parameters were assessed. Metabolomic signatures of adiponectin/NT-proBNP categories were …

Erythritol, Erythronate, And Cardiovascular Outcomes In Older Adults In The Aric Study, Layla A Abushamat, Bing Yu, Ron C Hoogeveen, Caroline Sun, Chao Cheng, Sean M Hartig, Mark A Herman, Ashok Balasubramanyam, Jane Eb Reusch, Elizabeth Selvin, Chiadi E Ndumele, Vijay Nambi, Christie M Ballantyne

Faculty, Staff and Student Publications

BACKGROUND: Circulating erythritol, an endogenously produced metabolite and an artificial sweetener, is associated with cardiovascular outcomes.

OBJECTIVES: The authors assessed associations of erythritol and its downstream metabolite, erythronate, with cardiovascular risk factors and events in older adults in the ARIC (Atherosclerosis Risk In Communities) study (visit 5, 2011-2013).

METHODS: We included 4,006 participants without prevalent cardiovascular disease and with metabolomic profiling. Erythritol and erythronate were measured by mass spectrometry. We analyzed associations of log-transformed erythritol and erythronate with cardiovascular risk factors and events using Cox proportional hazard models.

RESULTS: Participants in the highest tertiles of erythritol or erythronate were older, …

Approaches To Engaging Faith Communities In Public Health Efforts Regarding Vaccination, Genetics, And Colorectal Cancer: A Systematic Review, Ana S Iltis, Lauren L Baker, Kari Baldwin, Lucas Cruz, Lauren H Yaeger, James M Dubois

2020-Current year OA Pubs

BACKGROUND: Public health professionals regularly engage faith communities to improve public health. This systematic review characterizes approaches that public health professionals have used to engage faith communities and evaluates them using the Theory of Planned Behavior. It examines engagement regarding vaccination and genetic and genomic healthcare, which have generated significant controversy within religious groups and, for comparison, colorectal cancer screening, which has not.

METHODS: This systematic review followed PRISMA reporting guidelines. We searched 8 online databases (e.g., Medline, Embase, Scopus). Publications in English that reported engaging a faith community on genetics, vaccination, or colorectal cancer screening were included. We screened …

Zika Virus Ns1 Drives Tunneling Nanotube Formation For Mitochondrial Transfer And Stealth Transmission In Trophoblasts, Rafael T Michita, Long B Tran, Steven J Bark, Deepak Kumar, Shay A Toner, Joyce Jose, Indira U Mysorekar, Anoop Narayanan

Faculty, Staff and Students Publications

Zika virus (ZIKV) is unique among orthoflaviviruses in its vertical transmission capacity in humans, yet the underlying mechanisms remain incompletely understood. Here, we show that ZIKV induces tunneling nanotubes (TNTs) in placental trophoblasts which facilitate transfer of viral particles, proteins, mitochondria, and RNA to neighboring uninfected cells. TNT formation is driven exclusively via ZIKV non-structural protein 1 (NS1). Specifically, the N-terminal 1-50 amino acids of membrane-bound ZIKV NS1 are necessary for triggering TNT formation in host cells. Trophoblasts infected with TNT-deficient ZIKV

Oral Inflammation And Microbiome Dysbiosis Exacerbate Chronic Graft-Versus-Host Disease, Yui Kambara, Hideaki Fujiwara, Akira Yamamoto, Kazuyoshi Gotoh, Shuma Tsuji, Mari Kunihiro, Tadashi Oyama, Toshiki Terao, Ayame Sato, Takehiro Tanaka, Daniel Peltier, Keisuke Seike, Hisakazu Nishimori, Noboru Asada, Daisuke Ennishi, Keiko Fujii, Nobuharu Fujii, Ken-Ichi Matsuoka, Yoshihiko Soga, Pavan Reddy, Yoshinobu Maeda

Faculty, Staff and Students Publications

The oral microbiota, second in abundance to the gut, is implicated in chronic systemic diseases, but its specific role in graft-versus-host disease (GVHD) pathogenesis has been unclear. Our study finds that mucositis-induced oral dysbiosis in patients after hematopoietic cell transplantation (HCT) associated with increased chronic GVHD (cGVHD), even in patients receiving posttransplant cyclophosphamide. In murine HCT models, oral dysbiosis caused by bilateral molar ligatures exacerbated cGVHD and increased bacterial load in the oral cavity and gut, with Enterococcaceae significantly increasing in both organs. In this model, the migration of Enterococcaceae to cervical lymph nodes both before and after transplantation activated …

Effects Of Acute Pro-Inflammatory Stimulation And 25-Hydroxycholesterol On Hippocampal Plasticity And Learning Involve Nlrp3 Inflammasome And Cellular Stress Responses, Yukitoshi Izumi, Kazuko A O'Dell, Steven Mennerick, Charles F Zorumski

2020-Current year OA Pubs

Neuroinflammation is an increasingly important target for therapeutics in neuropsychiatry and contributes to cognitive dysfunction, disability and death across a range of illnesses. We previously found that acute effects of pro-inflammatory stimulation with lipopolysaccharide (LPS) on hippocampal long-term potentiation (LTP), a form of synaptic plasticity involved in learning and memory, requires synthesis of the oxysterol, 25-hydroxycholesterol (25HC) and exogenous 25HC mimics effects of LPS. However, downstream mechanisms engaged by LPS and 25HC remain uncertain. Here we use rat hippocampal slices and in vivo behavioral studies to provide evidence that acute modulation of synaptic plasticity by both LPS and 25HC requires …

Reneu: A Pivotal, Phase Iib Trial Of Mirdametinib In Adults And Children With Symptomatic Neurofibromatosis Type 1-Associated Plexiform Neurofibroma, Christopher L Moertel, Angela C Hirbe, Et Al.

2020-Current year OA Pubs

PURPOSE: Pharmacologic therapies for neurofibromatosis type 1-associated plexiform neurofibromas (NF1-PNs) are limited; currently, none are US Food and Drug Administration-approved for adults.

METHODS: ReNeu is an open-label, multicenter, pivotal, phase IIb trial of mirdametinib in 58 adults (≥18 years of age) and 56 children (2 to 17 years of age) with NF1-PN causing significant morbidities. Patients received mirdametinib capsules or tablets for oral suspension (2 mg/m

RESULTS: Twenty-four of 58 adults (41%) and 29 of 56 children (52%) had a BICR-confirmed objective response during the 24-cycle treatment phase; in addition, two adults and one child had confirmed responses during long-term …

Media Through The Lens Of Scientific Reductionism: The Gene-Ius Of Genetic Determinism In Gattaca, Asmita Lehther

Kentucky Undergraduate Journal for the Health Humanities

This essay examines the construct of scientific reductionism within the framework established by Andrew Niccol’s film Gattaca, illustrating how genetic determinism shapes social hierarchies and opportunities. By analyzing Vincent's struggle as an "in-valid" in a society that equates genetic superiority with worth, the essay critiques the reduction of individual potential to biological labels, revealing the oppressive nature of such systems.

Ischemia And Anatomy In The New 2024 European Guidelines For Chronic Coronary Syndromes: Update And Comparison Of Recommendations, Christian Adrián Caroli

Journal of the Saudi Heart Association

The new 2024 European guideline on chronic coronary syndromes is a pivotal document for clinical practice, updating the evidence and indications after five years, incorporating insights from the paradigm-shifting ISCHEMIA trial. This article explores the evolving role of functional and anatomical testing in assessing coronary artery disease, highlighting the introduction of a new risk probability score based on clinical and risk factors. Additionally, it provides a detailed comparison between these European recommendations and those from the most influential American guidelines, emphasizing key differences in the approach to risk stratification and diagnostic strategies. This comprehensive analysis provides valuable insights for optimizing …

Reducing Patient No-Show Rates In A Mental Health Outpatient Clinic, John K. Kamau

Walden Dissertations and Doctoral Studies

This doctoral project is a quality improvement initiative to enhance staff knowledge and confidence through expert feedback validating educational interventions at a mental health outpatient clinic. The practice problem highlighted staff preparedness gaps to effectively address patient-specific barriers, impacting patient engagement and care delivery, resulting in high appointment no-shows. Addressing this issue within nursing practice was essential, as consistent care was critical for managing psychiatric conditions effectively. The question guiding the project was as follows: How does implementing a specialized staff training program impact staff knowledge and confidence in reducing no-shows? This project aimed to equip staff with evidence-based tools …

The Correlation Between Temporomandibular Disorder (Tmd) And Vitamin D Deficiency, Iris Kim, Claudia Freitas

Annual Research Symposium

No abstract provided.

Intraocular Pressure Changes Associated With Psychological Stress Or Anxiety In Both Healthy And Glaucoma-Diagnosed Patients, Triston Crook, Porter Biggs, James Fini, Zane Kingsbury

Annual Research Symposium

No abstract provided.

Insurance And Iol Selection: A Case For Reevaluating Toric Iol Premium Designation Status In Astigmatic Cataract Patients, Conrad K. Ashby, Kayvon A. Moin, David W. Sant, Phillip C. Hoopes, Majid Moshirfar

Annual Research Symposium

Roseman Symposium 2025

Investigating Fetalgro Ex As An Alternative To Fetal Bovine Serum In Supplementing Cell Culture Growth, Porter Fife

Annual Research Symposium

No abstract provided.

Evaluation Of Various Methods For Obtaining Dna Samples From Remote Individuals, Alexander Baumann, Elden Jenkins, Jared Carter, Mark Crawford, Jonathon Alden Enlow, Marlena Muszynska, Christopher Spencer Walker, Christina Nelson, John A. Kriak, Kyle B. Bills, David W. Sant

Annual Research Symposium

Roseman Symposium 2025

Retrospective Analysis Of Angiotensin Receptor Blockers And Knee Cartilage Volume In Osteoarthritis: Evidence From The Osteoarthritis Initiative, Parv Kale, Vijay Kale

Annual Research Symposium

No abstract provided.

Exploring The Potential Of Oncolytic Viruses As A Novel Therapeutic Approach For Breast Cancer Treatment, Renad Alsayyad, Claudia M. Tellez Freitas

Annual Research Symposium

No abstract provided.