Medicine and Health Sciences Commons^™

Older Adult's Fall Prevention Program, Myles Butler, Rebecca King

Fall 2024 OTD Capstone Symposium

The decline in bodily functions with aging increases older adults' vulnerability to falls, which is a leading cause of death within this population. The poster presents an educational based fall prevention program focused on safety awareness and risk management for older adults. In conclusion, implementing a fall prevention program leads to increased awareness regarding risk factors that are detrimental to the safety and well-being of the older adult community

Ergonomics & Environmental Changes Within The Beauty Industry To Decrease Musculoskeletal Conditions, Jessika Eiland, Rebecca King

Fall 2024 OTD Capstone Symposium

Ergonomics, adaptation, and environmental changes within the beauty industry to decrease musculoskeletal conditions in the upper extremities. Musculoskeletal disorders and their effects may limit a hairdressers ability to complete their job duties. For individuals within the beauty industry, health management can become an important factor.

Making An Easy Return To School After An Extended Illness Diagnosis, Ashlyn Eads, Mary Jan Greer, Julie Boykin

Fall 2024 OTD Capstone Symposium

This poster provides information on the capstone program created at a pediatric site. This program addresses how play-based therapy can help children with an extended illness transition back into the school setting. Both the children and their caregivers need support before, during, and after the return to school. The goals of this program were to educate caregivers on how to advocate for their child for positive outcomes, provide caregivers with resources to promote successful transition to school, provide play-based strategies for children addressing handwriting, social Skills, upper body strength, education, fine Motor Skills, and provide the site and caregivers with …

Development Of A Virtual Reality Program To Promote Occupational Participation And Decreased Psychosocial Deficits In Persons With A Brain Injury, Nicole Arneson, Rebecca King

Fall 2024 OTD Capstone Symposium

Stroke is one of the leading causes of disabilities including problems with balance, muscle weakness, abnormal muscle tone, mental health, as well as deficits in visual function and sensory function The purpose of this capstone is to develop a virtual reality program that will be used with the stroke population to address ADLs, IADLs, and quality of life.

Occupational Therapy Role In Aiding Health Management For Caregivers Of Children With Neurological Conditions, Peyton Mcgee, Mary Jan Greer, Caitlin Boyd

Fall 2024 OTD Capstone Symposium

Neurological disorders are identified as a dysfunction on any part of the nervous system that cause disability (Kumar et al., 2022). In order to enhance the outcome of children with neurological conditions, there should be an emphasis on the role and well-being of their caregivers. Common symptoms of neurological disorders among children include delayed developmental milestones, seizures and epilepsy, regression of skills, abnormal movements and behaviors, headaches, sensory processing issues, and communication difficulties. Adjusting to a new normal can be overwhelming for caregivers, especially when children transition out of rehab. The aim of the proposed capstone project is to aid …

Improving Adls, Iadls, And Qol In Breast Cancer Survivors, Tincy Samuel, Rebecca King

Fall 2024 OTD Capstone Symposium

Breast cancer and its treatment can significantly impact breast cancer survivor’s ability to perform Activities of Daily Living (ADLs), Instrumental Activities of Daily Living (IADLs), and Quality of Life (QoL). Physical activity programs have been found to positively impact various aspects of quality of life in breast cancer patients, including physical condition, state of mind, and selfesteem. However, there is a gap in the OT practice and the literature regarding how to improve independence in ADLs, IADLs, and overall quality of life in breast cancer survivors. A program was created to improve Activities of Daily Living (ADLs), Instrumental Activities of …

Type 2 Diabetes Mellitus Health Management Within The Adult Population: A Road Toward Occupational Engagement, Valeria Martinez, Cassandra Nelson, Otd, Otr/L, Mba, Cns, Ceas I

Fall 2024 OTD Capstone Symposium

Approximately 37 million Americans have been diagnosed with Type 2 Diabetes Mellitus (T2DM) (CDC, 2023). As a result, DM is ranked as the eighth leading cause of mortality in the United States, yet the management of symptoms and overall condition is frequently neglected by a significant portion of the American population (CDC, 2023). A contributing factor to this issue is the insufficient access to resources for underserved communities, particularly among the Hispanic population with low health literacy. This capstone project focuses on health management and educating the adult population with a goal of enhancing activities of daily living (ADL) and …

Unraveling The Relationship Between Sleep Behaviors And Physical Activity In The United States: Insights From 2015 To 2020 Nhanes Data, Deepali K Ernest, Bipin Singh, Fathimath Shamna, Elizabeth A Onugha, Shreela V Sharma

Faculty, Staff and Student Publications

Background: Physical activity is an important component of metabolic health. However, little is known about the impact of specific types/intensities of physical activity on sleep health, especially among ethnically diverse populations. We examined the association of various sleep behaviors with moderate to vigorous work/recreational activity.

Methods: Self-reported data from the National Health and Nutrition Examination Survey 2015-2020 were cross-sectionally analyzed for a sample of 11,039 participants in the United States (U.S.). Weighted univariate logistic regressions determined unadjusted associations, while weighted multivariable regression models adjusting for age, sex, ethnicity, BMI categories, and socio-economic status assessed the multivariable associations with moderate and …

Oculomotor Nerve Palsy Recovery Following Microsurgery Vs. Endovascular Treatment Of Posterior Communicating Artery Aneurysms: A Comparative Meta-Analysis Of Short- And Long-Term Outcomes, Rahim Abo Kasem, Conor Cunningham, Sameh Samir Elawady, Mohammad Mahdi Sowlat, Sofia Babool, Saad Hulou, Zachary Hubbard, Atakan Orscelik, Basel Musmar, Alejandro Spiotta

Department of Neurosurgery Faculty Papers

Recent advancements in endovascular treatment (EVT) and different views on optimal management for posterior communicating artery (PComA) aneurysms with oculomotor nerve palsy (ONP) highlight a need to compare recovery timelines between microsurgery and EVT; heterogeneous outcomes and influencing factors may also affect results. A comprehensive systematic review and meta-analysis were conducted by searching PubMed, Embase, Scopus, and Web of Science databases. The extracted data encompassed patient demographics, details on treatment modalities and timing, and characteristics of PComA aneurysms ONP caused by either unruptured or ruptured aneurysms. The primary outcome was ONP favorable recovery, defined as the resolution of admission symptoms, …

Aspiration Of Left Atrial Masses Using The Large-Bore Manual Aspiration System: The Aspirate La Procedure, Shaurya Srivastava, Hussam Al Hennawi, Ahmad Abulshamat, Appa Bandi, Mohammed Qintar

Abington Jefferson Health Papers

Transcatheter mass extraction of left-sided cardiac masses has gained popularity in recent years, with scarce data on effectiveness, safety, and types of devices used. Mostly, left-sided aspirations use mechanical and continuous-flow–mediated devices (the AngioVac [AngioDynamics] and Penumbra systems [Penumbra]). To our knowledge, the use of manual aspiration devices has not been reported yet. Here, we report the first case series on the use of the AlphaVac (AngioDynamics) (a large-bore manual aspiration device) system for left-sided intracardiac masses.

Influenza Knowledge And Barriers To Vaccination In Immunosuppressed Patients In The Pediatric Rheumatology Clinic., Julia G. Harris, Leslie Favier, Jordan T. Jones, Maria Ibarra, Michael J. Holland, Emily Fox, Kelly Jensen, Ashley K. Sherman, Ashley M. Cooper

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Most patients with a pediatric rheumatic disease are at increased risk of influenza due to immunosuppressive medication use. Despite initial quality improvement efforts, our influenza vaccination rate plateaued at 72%, which prompted a survey of patients and families to assess provider vaccine recommendations, influenza knowledge, and barriers to influenza vaccination.

METHODS: Patients on immunosuppressive medication or their parent were eligible to complete a survey between July 2019 and January 2020. Survey questions assessed demographics, rheumatology diagnosis, immunosuppressive medication(s), influenza vaccination recommendation, patient/parent influenza knowledge, and barriers to influenza vaccination. Influenza vaccination rates for immunosuppressed patients were acquired each influenza …

Embolic Stroke In A Patient With Left Atrial Myxoma, Muhammad Sabri, Sheraz Qamar, Naila Ijaz, Mark Decaro

Division of Cardiology Faculty Papers

We present a case of a patient with a left atrial myxoma who presented with an ischemic stroke. Her cardiac myxoma had an irregular contour and was highly mobile, both features that have been associated with a greater risk of thrombo- embolism. She was treated with prompt surgical resection

Functional Properties Of Corticothalamic Circuits Targeting Paraventricular Thalamic Neurons, Guillermo Aquino-Miranda, Dounya Jalloul, Xu O Zhang, Sa Li, Gilbert J Kirouac, Michael Beierlein, Fabricio H Do Monte

Faculty, Staff and Student Publications

Corticothalamic projections to sensorimotor thalamic nuclei show modest firing rates and serve to modulate the activity of thalamic relay neurons. By contrast, here we find that high-order corticothalamic projections from the prelimbic (PL) cortex to the anterior paraventricular thalamic nucleus (aPVT) maintain high-frequency activity and evoke strong synaptic excitation of aPVT neurons in rats. In a significant fraction of aPVT cells, such high-frequency excitation of PL-aPVT projections leads to a rapid decay of action potential amplitudes, followed by a depolarization block (DB) that strongly limits aPVT maximum firing rates, thereby regulating both defensive and appetitive behaviors in a frequency-dependent manner. …

Centering Autonomy And Choice To Support Oral Prep Utilization Among People Who Inject Drugs: Qualitative Lessons From Hptn 094 Integra, Amaya Perez-Brumer, Rose Schmidt, Rebecca Kennedy, Jordan E Lake, Yolanda R Villarreal, Sydney Bornstein, Irene Kuo, Omar Nieto, Julie Franks, Cecile Denis, Nabila El-Bassel, Steve Shoptaw, Peter Davidson, Laramie R Smith

Faculty, Staff and Student Publications

Background: Oral Pre-exposure prophylaxis (PrEP) is effective in preventing HIV transmission. However, despite high rates of HIV risk behaviors among people who inject drugs (PWID), this population remains underserved by current HIV prevention efforts in the United States. To address this challenge, we conducted an in-depth exploration of perspectives on using oral PrEP among PWID engaged in the HIV Prevention Trials Network (HPTN) 094 INTEGRA Study.

Methods: Guided by the Practical, Robust, Implementation, and Sustainability Model (PRISM), our qualitative study drew on semi-structured interviews conducted as part of the embedded implementation science evaluation of HPTN 094 INTEGRA. Seventy-seven PWID participants …

Targeting Corticotropin-Releasing Hormone Receptor Type 1 (Crhr1) Neurons: Validating The Specificity Of A Novel Transgenic Crhr1-Flpo Mouse, Mason Hardy, Yuncai Chen, Tallie Z Baram, Nicholas J Justice

Faculty, Staff and Student Publications

Corticotropin-releasing hormone (CRH) signaling through its cognate receptors, CRHR1 and CRHR2, contributes to diverse stress-related functions in the mammalian brain. Whereas CRHR2 is predominantly expressed in choroid plexus and blood vessels, CRHR1 is abundantly expressed in neurons in discrete brain regions, including the neocortex, hippocampus and nucleus accumbens. Activation of CRHR1 influences motivated behaviors, emotional states, and learning and memory. However, it is unknown whether alterations in CRHR1 signaling contribute to aberrant motivated behaviors observed, for example, in stressful contexts. These questions require tools to manipulate CRHR1 selectively. Here we describe and validate a novel Crhr1-FlpO mouse. Using bacterial artificial …

Transcriptomic Clustering Of Chronic Lymphocytic Leukemia: Molecular Subtypes Based On Bruton’S Tyrosine Kinase Expression Levels, Gorkem Kismali, Ganiraju Manyam, Nitin Jain, Cristina Ivan, Betty Lamothe, Mary L Ayres, Lakesla R Iles, William G Wierda, Varsha Gandhi

Faculty, Staff and Student Publications

Historically, CLL prognostication relied on disease burden, reflected in clinical stage. Later, chromosome abnormalities and genomics suggested several CLL subtypes which were aligned with response to therapy. Gene expression profiling data identified pathways associated with CLL progression. We hypothesized that transcriptome and proteome may identify functional omics associated with CLL nosology. As a test cohort, we utilized publicly available treatment-naïve CLL transcriptomics data (n = 130) and did consensus clustering that identified BTK-expression-based clusters. The BTK-High and BTK-Low clusters were validated in public and our in-house databases (n = >550 CLL patients). To associate with functional relevance, we took samples …

Comparison Of Vendor-Pretrained And Custom-Trained Deep Learning Segmentation Models For Head-And-Neck, Breast, And Prostate Cancers, Xinru Chen, Yao Zhao, Hana Baroudi, Mohammad D El Basha, Aji Daniel, Skylar S Gay, Cenji Yu, He Wang, Jack Phan, Seungtaek L Choi, Chelain R Goodman, Xiaodong Zhang, Joshua S Niedzielski, Sanjay S Shete, Laurence E Court, Zhongxing Liao, Fredrik Löfman, Peter A Balter, Jinzhong Yang

Faculty, Staff and Student Publications

Background/objectives: We assessed the influence of local patients and clinical characteristics on the performance of commercial deep learning (DL) segmentation models for head-and-neck (HN), breast, and prostate cancers.

Methods: Clinical computed tomography (CT) scans and clinically approved contours of 210 patients (53 HN, 49 left breast, 55 right breast, and 53 prostate cancer) were used to train and validate segmentation models integrated within a vendor-supplied DL training toolkit and to assess the performance of both vendor-pretrained and custom-trained models. Four custom models (HN, left breast, right breast, and prostate) were trained and validated with 30 (training)/5 (validation) HN, 34/5 left …

Characterization Of An Inorganic Powder-Based Scintillation Detector Under A Uhdr Electron Beam, Daline Tho, Sam Beddar

Faculty, Staff and Student Publications

(1) Background: Ultra-high dose rate (UHDR) radiation therapy needs a reliable dosimetry solution and scintillation detectors are promising candidates. In this study, we characterized an inorganic powder-based scintillation detector under a 9 MeV UHDR electron beam. (2) Methods: A mixture of ZnS:Ag powder and optic glue was coupled to an 8 m Eska GH-4001-P polymethyl methacrylate (PMMA) optical fiber. We evaluated the dependence of the detector on dose per pulse (DPP), pulse repetition frequency (PRF), and pulse width (PW). Additionally, we determined the stability and the reproducibility of the detector. (3) Results: The signal ratio between the PMMA clear optical …

Deceased Donor Renal Allograft Utility In Adult Single And Multi-Organ Transplantation In The United States, Peter J. Altshuler, Adam S. Bodzin, Kenneth A. Andreoni, Pooja Singh, Anju Yadav, Jaime M. Glorioso, Ashesh P. Shah, Carlo B. Ramirez, Warren R. Maley, Adam M. Frank

Department of Surgery Faculty Papers

BACKGROUND: Deceased donor multiorgan transplants utilizing kidneys (MOTs) can improve outcomes for multiorgan recipients but reduces kidneys for chronic renal failure patients.

METHODS: We reviewed the Organ Procurement and Transplantation Network database from 2015 through 2019, for adult deceased donor kidney transplants. Recipients were classified as kidney transplant alone (KTA) (n = 62,252) or MOTs pancreas-kidney, simultaneous pancreas-kidney (n = 3,976), liver-kidney, simultaneous liver-kidney (n = 3,212), heart-kidney, simultaneous heart-kidney (n = 808), and "other"-kidney, simultaneous "other" kidney (n = 73).

RESULTS: Liver, heart, and lung-alone transplants were at least 7 times more frequent than their MOT correlate, whereas the …

Characterization Of An Inorganic Powder-Based Scintillation Detector Under A Uhdr Electron Beam, Daline Tho, Sam Beddar

Faculty, Staff and Student Publications

Background: Ultra-high dose rate (UHDR) radiation therapy needs a reliable dosimetry solution and scintillation detectors are promising candidates. In this study, we characterized an inorganic powder-based scintillation detector under a 9 MeV UHDR electron beam.

Methods: A mixture of ZnS:Ag powder and optic glue was coupled to an 8 m Eska GH-4001-P polymethyl methacrylate (PMMA) optical fiber. We evaluated the dependence of the detector on dose per pulse (DPP), pulse repetition frequency (PRF), and pulse width (PW). Additionally, we determined the stability and the reproducibility of the detector.

Results: The signal ratio between the PMMA clear optical fiber and the …

Utility Of Colposcopy For The Screening And Management Of Cervical Cancer In Africa: A Cross-Sectional Analysis Of Providers’ Training And Practices, Joël Fokom Domgue, Issimouha Dille, Freddy Gnangnon, Sharon Kapambwe, Celine Bouchard, Nomonde Mbatani, Elodie Gauroy, Nathalie Ledaga Ambounda, Robert Yu, Fatoumata Sidibe, Joseph Kamgno, Bangaly Traore, Pierre-Marie Tebeu, Gregory Halle-Ekane, Mohenou Isidore Diomande, Jean-Marie Dangou, Fabrice Lecuru, Isaac Adewole, Marie Plante, Partha Basu, Sanjay Shete

Faculty, Staff and Student Publications

Introduction: Cervical cancer is a public health issue in Africa with devastating socioeconomic consequences due to the lack of organized screening programs. The success of screening programs depends on the appropriate investigation and management of women who test positive for screening. Colposcopic assessment following positive screening results is a noteworthy issue in Africa. This study aimed to assess the utilization of colposcopy by providers in the region.

Methods: A cross-sectional study was conducted in 2021-2022 among healthcare providers involved in cervical cancer prevention activities in Africa. They were invited to report prior colposcopy training, whether they performed colposcopy and the …

Feasibility Of Large Language Models For Ceus Li-Rads Categorization Of Small Liver Nodules In Patients At Risk For Hepatocellular Carcinoma, Jiayan Huang, Rui Yang, Xiaotong Huang, Keyu Zeng, Yan Liu, Jun Luo, Andrej Lyshchik, Qiang Lu

Department of Radiology Faculty Papers

BACKGROUND: Large language models (LLMs) offer opportunities to enhance radiological applications, but their performance in handling complex tasks remains insufficiently investigated.

PURPOSE: To evaluate the performance of LLMs integrated with Contrast-enhanced Ultrasound Liver Imaging Reporting and Data System (CEUS LI-RADS) in diagnosing small (≤20mm) hepatocellular carcinoma (sHCC) in high-risk patients.

MATERIALS AND METHODS: From November 2014 to December 2023, high-risk HCC patients with untreated small (≤20mm) focal liver lesions (sFLLs), were included in this retrospective study. ChatGPT-4.0, ChatGPT-4o, ChatGPT-4o mini, and Google Gemini were integrated with imaging features from structured CEUS LI-RADS reports to assess their diagnostic performance for sHCC. …

Comparative Analysis Of Outcomes In Adult Spinal Deformity Patients With Proximal Junctional Kyphosis Or Failure Initially Fused To Upper Versus Lower Thoracic Spine, Oluwatobi O Onafowokan, Munish Chandra Gupta, Et Al.

2020-Current year OA Pubs

No abstract provided.

M1 Recruitment During Interleaved Practice Is Important For Encoding, Not Just Consolidation, Of Skill Memory, Taewon Kim, Hakjoo Kim, Benjamin A Philip, David L Wright

2020-Current year OA Pubs

The primary motor cortex (M1) is crucial for motor skill learning. We examined its role in interleaved practice, which enhances retention (vs. repetitive practice) through M1-dependent consolidation. We hypothesized that cathodal transcranial direct current stimulation (ctDCS) to M1 would disrupt retention. We found that ctDCS reduced retention due to weakened encoding during acquisition, not disrupted consolidation. These results highlight M1's broad role in encoding and retention of novel motor skills.

Number Of Prescription Medications And Overall Survival In Metastatic Castrate-Resistant Prostate Cancer, Carley R Pickett, Daniel B Eaton, Krishny Karunanandaa, Emily Cybulla, Brendan T Heiden, Su-Hsin Chang, Yan Yan, Melanie P Subramanian, Varun Puri, Martin W Schoen

2020-Current year OA Pubs

No abstract provided.

Microglial Cd2ap Deficiency Exerts Protection In An Alzheimer's Disease Model Of Amyloidosis, Lingliang Zhang, David M. Holtzman, Et Al.

2020-Current year OA Pubs

BACKGROUND: The CD2-associated protein (CD2AP) was initially identified in peripheral immune cells and regulates cytoskeleton and protein trafficking. Single nucleotide polymorphisms (SNPs) in the CD2AP gene have been associated with Alzheimer's disease (AD). However, the functional role of CD2AP, especially its role in microglia during AD onset, remains elusive.

METHODS: CD2AP protein levels in cultured primary cells and in 5xFAD mice was studied. Microglial CD2AP-deficient mice were crossed with 5xFAD mice and the offspring were subjected to neuropathological assessment, behavioral tests, electrophysiology, RNA-seq, Golgi staining, and biochemistry analysis. Primary microglia were also isolated for assessing their uptake and morphology changes. …

Momordicine-I Suppresses Head And Neck Cancer Growth By Modulating Key Metabolic Pathways, Debojyoty Bandyopadhyay, Ellen T Tran, Ruchi A Patel, Matthew A Luetzen, Kevin Cho, Leah P Shriver, Gary J Patti, Mark A Varvares, David A Ford, Kyle S Mccommis, Ratna B Ray

2020-Current year OA Pubs

One of the hallmarks of cancer is metabolic reprogramming which controls cellular homeostasis and therapy resistance. Here, we investigated the effect of momordicine-I (M-I), a key bioactive compound from Momordica charantia (bitter melon), on metabolic pathways in human head and neck cancer (HNC) cells and a mouse HNC tumorigenicity model. We found that M-I treatment on HNC cells significantly reduced the expression of key glycolytic molecules, SLC2A1 (GLUT-1), HK1, PFKP, PDK3, PKM, and LDHA at the mRNA and protein levels. We further observed reduced lactate accumulation, suggesting glycolysis was perturbed in M-I treated HNC cells. Metabolomic analyses confirmed a marked …

Primary Anorectal Mammary-Like Adenocarcinoma: A Potential Diagnostic Pitfall With Conventional Colorectal Adenocarcinoma, Margaret L Axelrod, Xiuli Liu, Pooja Navale

2020-Current year OA Pubs

Anogenital mammary-like glands (AGMLGs) are present in the anogenital region that bear striking morphologic and protein-expression similarities to mammary glands in the breast. AGMLGs can give rise to both benign and malignant lesions which mimic primary breast lesions. Herein, we report two mammary-type adenocarcinomas arising from AGMLGs, including one in the previously unreported site of the rectum. Recognition of mammary-type adenocarcinoma in the rectal and anogenital regions is crucial as clinical management options may differ compared to conventional colorectal adenocarcinomas.

The Improving Treatment Decisions For Patients With Aortic Stenosis Through Shared Decision Making (Impact Sdm) Study: Study Protocol For A Cluster Randomized Stepped Wedge Trial, Karen Sepucha, Nishath Quader, Alexander A Brescia, Et Al.

2020-Current year OA Pubs

BACKGROUND: The American College of Cardiology, American Heart Association, and Centers for Medicare and Medicaid Services recommend shared decision-making (SDM) for patients with severe aortic stenosis choosing between transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR). Although tools such as patient decision aids (DAs) and training in SDM have been shown to improve SDM, implementation of SDM and DAs is limited. The IMproving treatment decisions for Patients with AortiC stenosis Through Shared Decision Making (IMPACT SDM) study aims to (1) determine the effectiveness of the interventions (a DA and clinician SDM training) in achieving SDM (primary outcome) …

The Biomechanics Of Fibrillin Microfibrils: Lessons From The Ciliary Zonule, Pooja Rathaur, Juan Rodriguez, John Kuchtey, Samuel Insignares, Wendell B Jones, Rachel W Kuchtey, Steven Bassnett

2020-Current year OA Pubs

Marfan syndrome is an inherited connective tissue disorder that affects the cardiovascular, musculoskeletal, and ocular systems. It is caused by pathogenic variants in the fibrillin-1 gene (