Medicine and Health Sciences Commons^™

Breast Cancer: Her2-Mutant P53 Cooperation And The Cell-Of-Origin Dependent Dynamics, Abie Williams-Villalobo

Dissertations (2016-Present)

Subtype. Specifically, NCP172 and NCP245 tumors grew faster and were predominantly triple- negative than NCP245. RNA sequencing identified many differentially expressed genes (DEGs) between tumor and mammary gland controls. Ingenuity Pathway Analysis (IPA) of the DEGs revealed that pathways like Deubiquitination, Cell Cycle Checkpoints, RHO GTPase cycle, and HIF1α Signaling were associated with aggressive tumor characteristics, with heightened pathway activity in NCP172 likely contributing to greater growth and invasiveness.

This study further examined how different cells-of-origin contribute to breast cancer heterogeneity by inducing mutant p53 in either mammary myoepithelial or luminal cells. Tumors originating from myoepithelial cells (Tk5) exhibited …

Polarimetry Terahertz Imaging Of Human Breast Cancer Surgical Specimens, Nikita Gurjar, Keith Bailey, Magda O. El-Shenawee

Electrical Engineering and Computer Science Faculty Publications and Presentations

Purpose

We investigate terahertz (THz) polarimetry imaging of seven human breast cancer surgical specimens. The goal is to enhance image contrast between adjacent tissue types of cancer, healthy collagen, and fat in excised breast tumors. Based on the biological perception of random growth of cancer and invasion of surrounding healthy tissues in the breast, we hypothesize that cancerous cells interact with the THz electric field in a different manner compared with healthy cells. This difference can be best captured using multiple polarizations instead of single polarization.

Approach

Time domain pulsed signals are experimentally collected from each pixel of the specimen …

Assessing The Impact Of An Individual Diabetic Education Program And Big Data App On Three Generations Of Patient Populations, Avery C. Carpenter, Rechendia C. Carpenter, Ester M. Felipe

Doctoral Projects

Diabetes is a chronic condition that affects numerous people worldwide. Diabetic education assists people with understanding the nature of diabetes, its side effects and how to successfully deal with the condition. The doctoral project incorporates finding out how glucose monitoring, prescription administration, dieting propensities, and the significance of customary activities. With proper education the impact on one’s health with this chronic condition can improve for the better.

The nature of this doctoral project is to assess the impact that a diabetic education program and big data app have on three generations. Members of the group partnered with Hutton Healthcare in …

Psychometric Properties And Use Of The Indonesian Florida Obsessive-Compulsive Inventory, Christiana L. Ticoalu, Samsunuwijati Mar'at, P. Tommy Y. S. Suyasa, Eric A. Storch, Wayne K. Goodman, Steffi Hartanto, Riangga Novrianto, Edo S. Jaya

Makara Human Behavior Studies in Asia

Presently, in Indonesia, the lack of a validated measure for obsessive–compulsive disorder (OCD) hinders diagnosis and treatment of the disease. The current study evaluated the reliability, validity, and optimal cut-off score of the Indonesian Florida Obsessive-Compulsive Inventory (FOCI) in predicting OCD presence. The participants included 384 adults: 157 with OCD, 80 case controls with anxiety or mood disorders, and 147 healthy controls. Assessments were conducted using FOCI, Obsessive-Compulsive Inventory-Revised, Patient Health Questionnaire-9, and Generalized Anxiety Disorder-7. Test–retest reliability of the FOCI was evaluated for over 2 weeks in 30 OCD patients. The internal consistency within OCD samples for the FOCI …

Apoa2 Increases Cholesterol Efflux Capacity To Plasma Hdl By Displacing The C-Terminus Of Resident Apoa1, Snigdha Sarkar, Jamie Morris, Youngki You, Hannah Sexmith, Scott E. Street, Stephanie M. Thibert, Isaac K. Attah, Chelsea M. Hutchinson Bunch, Irina V. Novikova, James E. Evans, Amy S. Shah, Scott M. Gordon, Jere P. Segrest, Karin E. Bornfeldt, Tomas Vaisar, Jay W. Heinecke, W. Sean Davidson, John T. Melchior

Saha Cardiovascular Research Center Faculty Publications

Abstract The ability of high-density lipoprotein (HDL) to promote cellular cholesterol efflux is a more robust predictor of cardiovascular disease protection than HDL-cholesterol levels in plasma. Previously, we found that lipidated HDL containing both apolipoprotein A-I (APOA1) and A-II (APOA2) promotes cholesterol efflux via the ATP-binding cassette transporter (ABCA1). In the current study, we directly added purified, lipid-free APOA2 to human plasma and found a dose-dependent increase in whole plasma cholesterol efflux capacity. APOA2 likewise increased the cholesterol efflux capacity of isolated HDL with the maximum effect occurring when equal masses of APOA1 and APOA2 coexisted on the particles. Follow-up …

Untargeted Lipidomics Reveals Novel Hdl Metabotypes And Lipid-Clinical Correlates, Peer W. F. Karmaus, Scott M. Gordon, Marcus Y. Chen, Alison A. Motsinger-Reif, Rodney W. Snyder, Timothy R. Fennell, Suramya Waidyanatha, Reshan A. Fernando, Alan T. Remaley, Michael B. Fessler

Saha Cardiovascular Research Center Faculty Publications

Plasma high-density lipoprotein (HDL), originally studied for its role in lipid transport, is now appreciated to have wide-ranging biological functions that become defective during disease. While >200 lipids have collectively been detected in HDL, published HDL lipidomic analyses in different diseases have commonly been targeted to prespecified subsets of lipids. Here, we report the results of untargeted lipidomic analysis of HDL isolated from 101 subjects referred for computed tomographic coronary imaging for whom multiple additional clinical and lipoprotein metadata were measured. Unsupervised clustering of the total HDL lipidome revealed that the subjects fell into one of two discrete groups, herein …

Tissue Plasminogen Activator Associated Pulmonary Hemorrhage In Patient With Acta2-Associated Arteriopathy, Travis G. Hughes, Mark A. Wurth, Mary Burchett Sheppard

Saha Cardiovascular Research Center Faculty Publications

Pulmonary hemorrhage after administration of tissue plasminogen activator (tPA) is a rare complication. We present a 15- year-old boy with a heterozygous pathogenic variant in ACTA2 who presented with right brachial artery aneurysm thrombosis treated initially with tPA, resulting in pulmonary hemorrhage. We hypothesize that the underlying pulmonary abnormalities caused by the pathogenic ACTA2 variant may be a risk factor for pulmonary hemorrhage after tPA administration. (J Vasc Surg Cases Innov Tech 2024;10:101558.)

Advocacy Spotlight: Understanding The Mda's Role With Dental Insurance Reimbursement Rates, Daniel Miller D.D.S.

The Journal of the Michigan Dental Association

The Michigan Dental Association (MDA) is dedicated to advocating for members and advancing the dental profession. While federal laws prohibit the MDA from negotiating reimbursement rates with dental insurers, it provides significant support through education, advocacy, and resources.

Key initiatives include enhancing transparency in network leasing, endorsing PPO Negotiation Solutions to help practices optimize contracts, and offering educational programs on billing and coding. The MDA also facilitates peer networking and equips dentists with tools to navigate insurance challenges effectively.

Looking ahead, the MDA remains committed to empowering members through advocacy, guiding future dentists on contract literacy, and fostering a resilient …

Water Fluoridation: The Evidence Behind The Risk Of Fluoride Use, Margherita Fontana D.D.S., Ph.D., Carlos González-Cabezas D.D.S., M.S.D., Ph.D., Livia Tenuta D.D.S., M.Sc., Ph.D.

The Journal of the Michigan Dental Association

The debate surrounding fluoride use for caries control has intensified due to recent events, including a National Toxicology Program (NTP) report and a court ruling mandating EPA action on fluoride levels in tap water.

Despite concerns about fluoride's potential neurodevelopmental impact at high concentrations, current evidence shows no adverse effects at the recommended levels of 0.7 ppm in U.S. community water fluoridation programs. While studies in regions with endemic fluorosis suggest an association between high fluoride exposure and lower IQ, methodological limitations undermine causal conclusions.

Global and U.S. health authorities, including the WHO and ADA, reaffirm the safety and efficacy …

Flipping The Script: Active Learning In Drug Information, Albert Bach, Ivan Portillo

Pharmacy Faculty Articles and Research

This presentation will highlight successful strategies that incorporate drug information skills into pharmacy laboratory courses across the curriculum. Attendees will gain insights on collaboration between clinical faculty and library services, active learning techniques, and drug information assignments to utilize within a laboratory based course.

Objectives:

Plan an active learning session that introduces first-year students to drug information sources.

Describe how clinical faculty and library services can collaborate to introduce drug information to students.

Explain the implementation of a DI Question during an Order Verification module in the hospital laboratory setting.

Provide students a tool for self-reflection prior to conducting …

Prevalence Of Autism Spectrum Characteristics In Students Taking Undergraduate Computing Courses, Rachel Michaela Mettenbrink

School of Computing: Dissertations, Theses, and Student Research

The incidence rate of autism spectrum condition (ASC) has increased significantly in recent decades, as awareness of the condition and its impacts increases amongst clinicians, parents, and the general population. Medical literature has proposed that there may be a relationship between ASC and participation in the computing field. This study tests for the prevalence of autism spectrum condition traits measured by delivering the Autism Spectrum Quotient (AQ) to a population of undergraduate computer science students. We examine the relationships between AQ scores and students taking undergraduate computer science classes, sex, socioeconomic status, and parents in the computing industry. Additionally, we …

Quality Of Life After Myocardial Infarction In The Pakistani Population – Insights From A Single-Center Cohort Study, Javerya Hassan, Manzar Abbas, Hajra Arshad, Angelina Jessani, Izza Tahir, Shiza Qazi, Jasmit Shah, Zul Merali, Zainab Samad

Brain and Mind Institute

Background Health-related Quality of life (HRQoL) assessment is essential for optimizing patient care, treatment adjustments, and medical decision-making, particularly in post-Myocardial Infarction (MI) patients, but limited data exists on HRQOL post-MI from Pakistan. This study aimed to assess HRQoL and its determinants in the Pakistani population.

Methods A single-center cross-sectional study was conducted at a tertiary care hospital in Karachi, Pakistan. Patients≥18 years old with a primary diagnosis of acute MI (ICD-9 codes: 410.0-410.9 and ICD-10 codes: 121.0- 121.9) discharged from the Cardiology Service from January 2019 to December 2020 who could be contacted and consented to participate were included. …

Guidelines For The Standardization Of Pre-Analytical Variables For Salivary Biomarker Studies In Alzheimer's Disease Research: An Updated Review And Consensus Of The Salivary Biomarkers For Dementia Research Working Group, Ted K. S. Ng, Chinedu Momoh, Mei-Ann Lim, Helena Sophia Gleerup, Wayne Leifert, Catherine Ajalo, Nicholas Ashton, Henrik Zetterberg, Robert A. Rissman, Charisse N. Winston

Brain and Mind Institute

There is a pressing need for accessible biomarkers with high diagnostic accuracy for Alzheimer's disease (AD) diagnosis to facilitate widespread screening, particularly in underserved groups. Saliva is an emerging specimen for measuring AD biomarkers, with distinct contexts of use that could complement blood and cerebrospinal fluid and detect various analytes. An interdisciplinary, international group of AD and related dementias (ADRD) researchers convened and performed a narrative review of published studies on salivary AD biomarkers. We critically appraised the current state of the literature, examining both consistencies and discrepancies in existing pre-analytical variables and methodologies. We discussed how various pre-analytical variables …

Factors Associated With Tuberculosis Drug Resistance Among Presumptive Multidrug Resistance Tuberculosis Patients Identified In A Drtb Surveillance Study In Western Kenya, Albert Okumu, James Orwa, Ruth Sitati, Isaiah Omondi, Ben Odhiambo, Jeremiah Ogoro, George Oballa, Benjamin Ochieng, Steve Wandiga, Collins Ouma

Population Health, East Africa

Multidrug-resistant tuberculosis (MDR-TB) is caused by M. tuberculosis (Mtb) with resistance to the first-line anti-TB medicines isoniazid (INH) and rifampicin (RIF). In Western Kenya, there is reported low prevalence of drug resistant strains among HIV tuberculosis patients, creating a need to determine factors associated with drug resistance patterns among presumptive MDR-TB patients. To determine factors associated with drug resistance patterns among presumptive MDR-TB patients in western Kenya. Three hundred and ninety (3 9 0) sputum sample isolates from among presumptive multidrug TB patients, were analyzed for TB drug resistance as per Ministry of Health (MoH) TB program diagnostic …

Assessing The Short-Term Outcomes Of Erase And Replace: A Series Of Health & Wellness Activities, Gabriela Murza, Christina Pay, Eva Timothy, Melanie Dabb, Cris Meier

Outcomes and Impact Quarterly

Utah State University Extension faculty addressed Utah's high rate of poor mental health with activities that improved participants’ connections, confidence, and abilities. These efforts positively impacted adults' mental health and quality of life and offered an additional resource to address self-care needs while encouraging connection and skill-building.

Evaluation Of Cardiometabolic Monitoring In Patients Taking Antipsychotic Agents Within A Community Health System., Kendra Yarian Pharmd, Jenna Gilbert Pharmd, Bcpp, Libby Stabler Pharmd, Bcacp, Quyen Nguyen Pharmd, Bcacp, Leia Gaddis Pharmd, Bcps, Dpla

Pharmacy Residency

Presented at the ASHP Midyear Clinical Meeting. New Orleans, LA

This evaluation found that the majority of patients on antipsychotic agents do not have all baseline monitoring completed, and that there are significant gaps especially in lipid panel and hemoglobin A1c. Other parameters (e.g., blood pressure, weight) were more likely to be gathered, likely as part of routine visit procedure.

Medication Use Evaluation Of Fecal Microbiota Spores (Live-Brpk) For The Prevention Of Recurrent Clostridioides Difficile Infection., Haley Michaud Pharmd, Trent Towne Pharmd, Bcps, Sarah Ferrell Pharmd, Bcpps, Bhavika Patel Pharmd, Noah Budi Pharmd

Pharmacy Residency

Presented at the ASHP Midyear Clinical Meeting. New Orleans, LA

This medication use evaluation found that infectious diseases providers were more likely to prescribe advanced treatments such as fidaxomicin or fecal microbiota compared to other specialties. Of the 93.1% of patients seen by Infectious Disease, 62.9% (n=17) of those patients were prescribed fecal microbiota spores (live-brpk) (VOWST). Of the 29 eligible patients, 41.4% (n=12) were identified as missed opportunities.

Optimization Of Beta-Lactam Dosing In Critically Ill Patients With Continuous Veno-Venous Hemofiltration Or Augmented Renal Clearance., Kristin Lytal Pharmd, Mspgx, Robert D. Beckett Pharmd, Bcps, Luke Keller Pharmd, Bcps, Bcccp, Michael Todt Pharmd, Bcccp

Pharmacy Residency

Presented at the ASHP Midyear Clinical Meeting. New Orleans, LA

This evaluation found that traditional dosing of beta-lactams found in practice is often (20 to 90%) suboptimal when compared to ideal evidence-based dosing, that optimizes efficacy while limiting adverse effects from drug toxicity.

Dofetilide Initiation In A Tertiary Medical Center: A Medication Use Evaluation., Zhixi Lui Pharmd, Kris Howard Pharm, Aacc, Megan Straub Pharmd, Bcps, Elizabeth Meisberger Pharmd, Bcps, Bccp, Sarah Ferrell Pharmd, Bcpps

Pharmacy Residency

Presented at the ASHP Midyear Clinical Meeting. New Orleans, LA

This evaluation found that adherence to a pharmacist-managed protocol significantly increased dofetilide continuation rates at discharge and six months. Future implementation includes refining the current dofetilide order set, expanding the pharmacist’s role in dose selection, and standardizing documentation and intervention notes to improve protocol adherence.

Drop-It Like It’S Hot: A Droperidol Medication Use And Efficacy Evaluation In A Community Health System., Caleb Hoppe Pharmd, Sarah Meeks Pharmd, Allison Clemens Pharmd, Robert D. Beckett Pharm D

Pharmacy Residency

Presented at the ASHP Midyear Clinical Meeting. New Orleans, LA

This study found that higher doses of droperidol for abdominal pain could provide more analgesic benefit without compromising patient safety. While droperidol appears effective at relieving nausea, other more cost-effective anti-emetics may be trialed first (without diphenhydramine). Droperidol appeared to provide light sedation, although most doses were low and used on patients without severe agitation (e.g. RASS ≥ 3).

Optimizing Serum Magnesium Monitoring And Replacement In A Community Hospital., Gabrielle O. Carreon Pharmd, Ms, Jesse Christman Pharmd, Bcop, Joshua Winebaugh Pharmd, Bcps, Robert D. Beckett Pharmd, Bcps

Pharmacy Residency

Presented at the ASHP Midyear Clinical Meeting. New Orleans, LA

Findings highlight the need to revise our healthcare system’s standard hematology/oncology treatment plans to better align with appropriate magnesium monitoring, with up to 93% of magnesium lab draws potentially being unnecessary, and replacement, including better utilization of oral magnesium formulations instead of IV which can lower costs.

Discharge Antibiotic Use In Patients Hospitalized With Chronic Obstructive Pulmonary Disease (Copd) Exacerbations., Jennifer Mccarthy Pharmd, Ms, Sarah Pfaehler Pharmd, Mba, Bcps, Pacs, Ross Witte Pharmd, Bcps

Pharmacy Residency

Presented at the ASHP Midyear Clinical Meeting. New Orleans, LA

This medication use evaluation identified opportunities for improved prescribing in this population. The majority of patients receiving antibiotics had increased dyspnea only. Because of this, 90% of patients did not receive antibiotics appropriately; 94% received an excessive duration. The majority of patients had no prior to admission COPD maintenance therapy, potentially related to lack of baseline FEV1 data required for initiating therapy classification.

Optimizing Laboratory Appointment Adherence Among Patients Prescribed Psychoactive Medications, Tamara N. Blake

Doctor of Nursing Practice Final Project Abstract

PURPOSE

The purpose of this scholarly project was to implement a standardized nurse-driven phone call reminder protocol to improve adherence to scheduled laboratory appointments among patients prescribed psychoactive medications requiring bloodwork. This protocol is aimed to increase appointment adherence and reduce no-show rates within the clinic.

BACKGROUND

The project was implemented within a small outpatient community-based clinic in Round Rock, Texas which provides mental health services. The clinic experienced high no-show rates for scheduled laboratory appointments among patients prescribed psychoactive medications. Monitoring these patients is essential to ensure medication safety and prevent potential adverse effects.

METHODOLOGY

The six-week quality improvement …

The Lived Experience Of Nurses Caring For People Experiencing Homelessness: A Descriptive Phenomenological Study, Debra Guerrini

Theses & Dissertations

Background:

Marginalized patient populations, such as people experiencing homelessness, receive a lower quality of care linked to stereotyping and biases (Alspach, 2018). Populations receiving substandard healthcare are often subconsciously identified by attributes such as age, race, mental health, housing, and social status (Padilla-Moledo et al., 2016). These stigmatized attributes can be the underpinning of bias. The health status of people experiencing homelessness is generally poorer than housed populations, with evidence demonstrating the difficulties they encounter when attempting access to healthcare (Klop et al., 2018).

Purpose:

The purpose of this phenomenological study was to explore and gain a more in-depth understanding …

The Lived Experience Of Older Adults Using Telemedicine Services, Cathy Anne Cahill

Theses & Dissertations

The coronavirus 2 (SARS-CoV-2) and the subsequent pandemic transformed the healthcare delivery system in the U.S. Telemedicine became an essential mode of healthcare, and its usage increased significantly during the public health emergency. Telemedicine improved access to care, especially for vulnerable patient populations and those with chronic medical conditions. There were many other benefits, including convenience, cost savings, and reduced coronavirus transmission. It also reduced the strain on healthcare facilities and overburdened healthcare providers. A qualitative, Heideggerian phenomenological method of inquiry was conducted to understand the experience of the older adult population utilizing telemedicine services. These methods included a description …

Leaders’ Perspectives On Approaches And Challenges In Enacting Faculty Vitality In The Contemporary Landscape Of Academic Medicine: A Deductive Thematic Analysis, Jennifer L. Allie, Robert Tillman, Beatriz Tapia, Elza Mylona, Koko Aung, Janet F. Williams

School of Medicine Publications

Continual changes in organizational structures within medical schools have contributed to the expanded scope and the centralization of faculty affairs offices, which support faculty administration and supportive functions. Using qualitative interviews, we investigated the perspectives of academic medicine faculty affairs leaders regarding their offices’ priorities in sustaining faculty vitality in the face of current and anticipated challenges. A semi-structured interview protocol based on the researchers' practical knowledge, informed by the study's research inquiries, and pertinent academic literature guided the interviews. Deductive thematic analysis approach was used to identify the patterns and themes across the interviews. Our analysis revealed a central …

Mexican Clinical Practice Guidelines For Adult Overweight And Obesity Management, Emma A. Chávez-Manzanera, Juan M. Vera-Zertuche, Martha Kaufer-Horwitz, Verónica Vázquez-Velázquez, José R. Flores-Lázaro, Leonor Mireles-Zavala, Raúl Calzada-León, Juan C. Garnica-Cuellar, Verónica Sánchez-Muñoz, Juan Carlos Lopez Alvarenga

School of Medicine Publications

Purpose

To develop Mexico’s first methodologically rigorous clinical practice guideline for the management of adult overweight and obesity. The target audiences are interdisciplinary healthcare professionals across healthcare systems who are the first point of contact for patients with obesity in Mexico, patients, and health system decision makers.

Recent Findings

A review of recent international obesity clinical practice guidelines and an expert consensus process identified: i) common recommendations appropriate for implementation in Mexico and ii) knowledge gaps requiring the formulation of new recommendations. In all, 20 new recommendations and 20 good practice statements were developed using the GRADE Evidence-to-Decision Framework and …

Endovascular Thrombectomy For Childhood Stroke (Save Childs Pro): An International, Multicentre, Prospective Registry Study, Peter B. Sporn, Kartik Bhatia, Todd Abruzzo, Lisa Pabst, Stuart Fraser, Melissa G. Chun, Warren Lo, Ahmed Othman, Sebastian Steinmetz, Ameer E. Hassan

School of Medicine Publications

Background

Emerging evidence suggests that endovascular thrombectomy is beneficial for treatment of childhood stroke, but the safety and effectiveness of endovascular thrombectomy has not been compared with best medical treatment. We aimed to prospectively analyse functional outcomes of endovascular thrombectomy versus best medical treatment in children with intracranial arterial occlusion stroke.

Methods

In this prospective registry study, 45 centres in 12 countries across Asia and Australia, Europe, North America, and South America reported functional outcomes for children aged between 28 days and 18 years presenting with arterial ischaemic stroke caused by a large-vessel or medium-vessel occlusion who received either endovascular …

Cryoablation Of Primary Breast Cancer Tumors Induces A Systemic Abscopal Effect Altering Time (Tumor Immune Microenvironment) In Distant Tumors, Flávia Sardela De Miranda, Dalia Martinez-Marin, Rachel L. Babcock, Maribel Castro, Geetha P. Boligala, Sonia Y. Khan, Kathryn L. Furr, Isabel Castro-Piedras, Nicholas Wagner, Dakota E. Robison

School of Medicine Publications

Introduction: Despite recent advances, triple-negative breast cancer (TNBC) patients remain at high risk for recurrence and metastasis, which creates the need for innovative therapeutic approaches to improve patient outcomes. Cryoablation is a promising, less invasive alternative to surgical resection, capable of inducing tumor necrosis via freeze/thaw cycles. Necrotic cell death results in increased inflammatory signals and release of preserved tumor antigens, which have the potential to boost the local and systemic anti-tumor immune response. Thus, compared to surgery, cryoablation enhances the activation of T cells leading to an improved abscopal effect, defined as the occurrence of a systemic response after …

Accelerating Heritability, Genetic Correlation, And Genome-Wide Association Imaging Genetic Analyses In Complex Pedigrees, Brian Donohue, Si Gao, Thomas E. Nichols, Bhim M. Adhikari, Yizhou Ma, Neda Jahanshad, Francis J. Mcmahon, Elizabeth M. Humphries, William Burroughs, John Blangero

School of Medicine Publications

National and international biobanking efforts led to the collection of large and inclusive imaging genetics datasets that enable examination of the contribution of genetic and environmental factors to human brains in illness and health. High-resolution neuroimaging (~104–6 voxels) and genetic (106–8 single nucleotide polymorphic [SNP] variants) data are available in statistically powerful (N = 103–5) epidemiological and disorder-focused samples. Performing imaging genetics analyses at full resolution afforded in these datasets is a formidable computational task even under the assumption of unrelatedness among the subjects. The computational complexity rises as ~N2–3 (where N is the sample size), when …