Medicine and Health Sciences Commons^™

Insight, Volume 4, Issue 1, 2024

inSIGHT

Contents

8 - The Myopia Epidemic: Exploring the Pathology and Management of the World’s Most Common Eye Disorder
By Gabriella Baldassare

15 - Evolution of Lamellar Keratoplasty
By Ishan Kasat

19 - Bridging the Global Gap of Blindness Through Artificial Intelligence
By Nathan Delacth

24 - CMV Retinitis: An Expert’s Perspective
By Caitlyn Kwun

29 - Macular Holes: Diagnosis, Treatment, and Complications
By Ayra Khan

36 - Chronic Progressive External Ophthalmoplegia
By Bahram Pashaee

39 - Medical Missions, Ethical Considerations, and the Future for Healthcare Delivery in Ophthalmology
By Robert Medina

43 - Shaping the Future of Vision: The Rise …

Tension Activation Of Mechanosensitive Two-Pore Domain K+ Channels Traak, Trek-1, And Trek-2., Ben Sorum, Trevor Docter, Vincent Panico, Robert A Rietmeijer, Stephen G Brohawn

Cooper Medical School of Rowan University Departmental Research

TRAAK, TREK-1, and TREK-2 are mechanosensitive two-pore domain K+ (K2P) channels that contribute to action potential propagation, sensory transduction, and muscle contraction. While structural and functional studies have led to models that explain their mechanosensitivity, we lack a quantitative understanding of channel activation by membrane tension. Here, we define the tension response of mechanosensitive K2Ps using patch-clamp recording and imaging. All are low-threshold mechanosensitive channels (T10%/50% 0.6-2.7 / 4.4-6.4 mN/m) with distinct response profiles. TRAAK is most sensitive, TREK-1 intermediate, and TREK-2 least sensitive. TRAAK and TREK-1 are activated broadly over a range encompassing nearly all physiologically relevant …

Medical School Watercooler Newsletter - April 11, 2024, Lindsey Lyle

Watercooler Newsletter

This is the April 11, 2024 edition of the Frederick P. Whiddon College of Medicine’s newsletter - Watercooler.

Contents Include

• Fleck inaugurated as first female president of AUA's Southeastern Section
• Faculty and staff pilot pre-course meeting to improve student learning
• Menger named to Becker’s National Emerging Leaders in Healthcare list
• Obiaka appointed director of Pediatric Echocardiography Lab
• USA to raise sickle cell disease awareness at ArtWalk
• Participants complete Medical Education Research Certificate Program
• Pathology faculty and residents present at USCAP annual meeting
• OB/GYN Interest Group hosts annual feminine hygiene products donation drive

Poster Abstracts For 14th Annual University Of Dayton And Miami Valley Hospital Healthcare Symposium, Udayton

Pre-Health Resource Center Campus Communications

No abstract provided.

Enhancing Srna Confidence: Simulation-Based Crm Training For The Management Of Intraoperative Cardiac Arrest, Melissa Lee

Doctor of Nursing Practice Scholarly Projects

Intraoperative emergencies in the operating room (OR) are rare but necessitate early recognition and intervention.

Individual Differences In Cannabis Use Disorder With Implications For Endocannabinoid Modulation In Therapeutics Development, Erin L. Martin

MUSC Theses and Dissertations

Cannabis use disorder (CUD) is increasingly prevalent in the United States, but there is no effective pharmacological means to treat it. The endocannabinoid (eCB) system has emerged as a candidate therapeutic target demonstrating some evidence of efficacy in treating CUD. However, clinical trials evaluating eCB-modulating therapeutics have historically undervalued individual differences that could contribute to variation in treatment outcome (e.g. sex, comorbid psychiatric illness). To address this gap in the literature, the present set of studies (a) compared plasma eCB tone in groups underrepresented in treatment trials for CUD (females, individuals with comorbid major depressive disorder; MDD/CUD) with males or …

Occupation-Based Fine Motor Activities For Individuals With Parkinson's Disease At Rock Steady Boxing, Caylin N. Dean

OTD Capstone Projects

This doctoral capstone project represents a collaborative effort with Rock Steady Boxing (RSB), an organization dedicated to supporting individuals with Parkinson’s Disease (PD). Many individuals with PD experience fine motor deficits which highlights the importance of addressing these challenges. The primary objective of this project is to identify and address such deficits among participants at RSB Music City and Franklin through the development of occupation-based fine motor activities. Qualitative surveys were utilized to understand participants' satisfaction with their fine motor abilities and the impact on quality of life. The outcome of this project is a set of occupation-based fine motor …

Bridging The Gap: Equipping Caregivers With Skills To Promote Development, Victoria Long

OTD Capstone Projects

This doctoral capstone project was completed through a partnership with Alverson Pediatric Therapy, a private, community-based pediatric practice. Alverson Pediatric Therapy aims not only to meet the child’s needs, but also to equip all parents with the skills and confidence to help their child reach the next stage of development. The primary focus of this project was to develop accessible caregiver education on various occupation-based and developmentally appropriate topics. These topics included developmental milestones, emotional regulation, sensory processing, dressing, and so forth. Outcomes of the project included fourteen weeks of social media programming and four, in-depth video module scripts with …

Bridging The Gap Between The Occupational Therapy Department And The Education Department At An Inclusive Preschool, Brenna C. Hunt

OTD Capstone Projects

This doctoral capstone project was completed through a partnership with First Steps Inc. in Nashville, TN. First Steps Inc. is both an outpatient therapy clinic and an inclusive childcare facility that provides education for children with special needs alongside their typically developing peers. This project sought to bridge the gap between the occupational therapy department and the education department at First Steps to promote participation, inclusion, and developmental growth in the classrooms. The focus of the project was the development and implementation of various OT tools and resources to be used in the classrooms. Deliverables included choice boards, visual schedules, …

Increasing Staffs’ Awareness Of Adaptive Swim Lesson Methodology And Enhancing Agency’S Infant Lesson Programming, Chloe E. Volpi

OTD Capstone Projects

This doctoral capstone project was conducted in partnership with Sunshine Swim Center, located in Elk Grove, CA. Sunshine is a small-scale swim lesson company that is proud to offer their community small class sizes and personalized swim instruction. The focus of this project was to educate agency staff on the importance of adaptive swim lessons for children with disabilities and enhance the current infant lesson programming. The staff education material included information on instruction modification, informal behavior modification, alternate forms of communication, cueing, skill grading, and the sensory properties of water. Enhancements to the infant programming included adding fifteen new …

A Parent's Guide To Pediatric Wheelchair Equipment, Gianna M. Sarli

OTD Capstone Projects

This capstone project was completed through a partnership with Permobil. Permobil is an assistive technology company that makes assistive technology solutions that enrich the lives of individuals with disabilities. They create a wide range of assistive technology products including power wheelchairs, manual wheelchairs, cushions, extremity supports, positioning equipment, and so much more. The focus of this project was to create the Content Brief for a pediatric landing page on their website. This webpage is focused on how Permobil products can support a child’s occupational participation and help them achieve their daily goals. The goal of this content was to have …

The Implementation Of Animal Assisted Therapy In Adult Neurological Rehabilitation, Rachel Camilleri

OTD Capstone Projects

This doctoral capstone project was completed through a partnership with Pi Beta Phi Rehabilitation Institute at Vanderbilt University Medical Center. The focus of this project was to develop animal assisted therapy interventions that could be utilized amongst occupational therapy practitioners with the clinic’s facility dog in an effort to increase utilization of animal assisted therapy. The process for this project required a thorough review of the literature on animal assisted therapy and neurological rehabilitation, conversations with current and past facility dog teams to learn about their work, and trialing animal assisted therapy activities in patient sessions. The outcome of this …

Latent Classification Of Multi-Model Non-Homogeneous Continuous-Time Markov Chains, Joonha Chang

Dissertations and Theses (Open Access)

The continuous-time Markov chain (CTMC) model and latent clustering models are commonly used to study longitudinal measures of categorical outcomes. Because of its simple but powerful Markovian property, CTMC models have been widely used in medical and public health researches. Due to limitations in the standard CTMC model, there have been some studies on non-homogeneous continuous-time Markov chain (NH-CTMC) that utilized time-dependent rates, but the progresses have been limited. NH-CTMC can be more powerful than CTMC by its default nature of time-dependent rate that can be fitted to a wider range of applications in medical studies. In this study, we …

Education And Advocacy For Universal Design And Accessibility In Housing, Apisara Vairojanakich, Amy Lyons-Brown, Molly Wuebker

Spring 2024 Virtual OTD Capstone Symposium

In the United States, there is a lack of adequate numbers of universally designed and accessible houses in the housing market for the older population and people with disabilities. Many barriers, such as financial support and lack of knowledge for housing-related professionals, can prevent this population from participating in home occupations. The project developed educational products, including the universal design housing experience booklet, universal design housing checklist, and universal design blueprints. These products were delivered through the blog post on Uncurbed LinkedIn website. The needs assessment was conducted to provide the guidelines for the chapters in the booklet and checklist. …

Enhancing Primary Care With Progressive Muscle Relaxation For Anxiety, Depression, And Acute Stress: A Quality Improvement Project, Andrew Dudley

DNP Projects

Introduction

Depression affects 1 in 5 individuals during their lifetime (Hidalgo et al., 2021), with 23 million Americans seeking mental health treatment annually (Parish et al., 2023). While guidelines from the AAFP and APA advocate comprehensive care approaches, medication prescriptions for anxiety and depression remain prevalent, particularly among children aged 6-18 (Lester et al., 2022). Direct observation identified a need to bridge gaps in adjunctive therapies between the primary care setting and counseling services for patients who presented with mild or mild to moderate anxiety or depression. Feedback analysis by staff in the setting identified a gap in knowledge and …

Enhancing Srna Confidence: Integrating Simulation-Based Crm Training With Didactic Education To Improve Intraoperative Recognition, Communication, And Management Of Intraoperative Cardiac Arrest, Melissa Lee

Doctor of Nursing Practice Scholarly Projects

Within the operating room (OR), the ability to identify deteriorating patient conditions and effectively communicate, is essential to delivering safe and efficient care. Although rare, the critical nature of emergent events necessitates early recognition and prompt intervention by an experienced anesthesia provider. The complexity of emergency management is often related to diagnostic ambiguity, individual provider experience, and disruptions of the fast-paced OR environment, requiring appropriate training methods for proficient execution. However, student registered nurse anesthetists (SRNAs) often lack sufficient exposure to emergent clinical scenarios, leading to delayed intervention and diminished confidence during crisis management. An evidence-based simulation education guideline for …

Promoting Participation In Individuals With Parkinson’S Disease Through The Development Of Accessible Occupation-Based Resources, Kelly Struthers

OTD Capstone Projects

This doctoral capstone project was completed through partnership with Rock Steady Boxing Music City, a non-profit organization that provides boxing classes for individuals diagnosed with Parkinson’s disease and other motor-related disorders. The purpose of this project was to understand the participatory barriers that are common within the Parkinson’s disease community and develop solution-oriented resources in response to these barriers. All developed resources were intentionally created to maximize accessibility and explored areas such as driving, fatigue, caregiving, and memory. These resources were compiled and distributed to the “fighters” of Rock Steady Boxing via an in-person “OT Corner” bulletin board, the weekly …

Supporting Adolescent Parents Involved In Younglives, Rachel Fister

OTD Capstone Projects

This doctoral capstone project focused on creating educational tools and resources for adolescent caregivers, volunteer mentors, and staff associates involved in YoungLives. YoungLives is a branch of the non-profit outreach organization YoungLife, that supports adolescent/teen parents and expecting mothers worldwide. The goal of this project was to supply accessible and user-friendly resources for the population to gain knowledge on pediatric topics such as child development, age appropriate milestones, sensory processing, as well as activities to promote occupational skills. The project outcomes resulted in a guidebook and deliverables for education and training purposes, a social media platform for nationwide connection and …

Providing Sensory Integration Education And Transition Tools For The Tennessee Baptist Children’S Homes, Thuy-Duong D. Huynh

OTD Capstone Projects

This doctoral capstone project was completed through a partnership with the residential department of the Tennessee Baptist Children’s Homes, a state-wide ministry that cares for children whose families are in crisis. There were two primary focuses for this project: (1) providing sensory integration education to house parents and (2) creating tools to ease transitions. Outcomes included a presentation and training on sensory integration, a booklet with easily accessible sensory integration information, a local activity guide for day visits with families, and a routine schedule of home visits to ease transitions.

Engineering Mesenchymal Stromal Cells To Suppress Inflammation And Increase Beta-Cell Mass For Treating Type 1 Diabetes, Dhruva Patel

MUSC Theses and Dissertations

Type 1 diabetes (T1D) is a life-threatening autoimmune disease where the immune system destroys the insulin producing beta-cells in the pancreas. There is no cure for the disease, and the current treatment involves life-long, daily injection of insulin. An ideal therapy for T1D will be the suppression of autoimmunity and increased functional beta-cell mass. The immune regulatory cytokine IL10 can suppress inflammation in various autoimmune diseases. On the other hand, several growth factors and peptide hormones are known to promote an increase in beta-cell mass, through neogenesis and beta-cell proliferation. However, efficient induction of increased beta-cell mass requires preferential and …

Iowa Conference On Communicative Disorders [Program, 2024], Iowa Conference On Communicative Disorders

Iowa Conference on Communicative Disorders Programs

The Iowa Conference on Communicative Disorders provides continuing education activities in speech- language pathology that are acceptable to the State of Iowa and the American Speech-Language and Hearing Association. Areas of emphasis include adults and pediatrics.

Chemotherapy Activates Inflammasomes To Cause Inflammation-Associated Bone Loss, Chun Wang, Khushpreet Kaur, Canxin Xu, Yousef Abu-Amer, Gabriel Mbalaviele

2020-Current year OA Pubs

Chemotherapy is a widely used treatment for a variety of solid and hematological malignancies. Despite its success in improving the survival rate of cancer patients, chemotherapy causes significant toxicity to multiple organs, including the skeleton, but the underlying mechanisms have yet to be elucidated. Using tumor-free mouse models, which are commonly used to assess direct off-target effects of anti-neoplastic therapies, we found that doxorubicin caused massive bone loss in wild-type mice, a phenotype associated with increased number of osteoclasts, leukopenia, elevated serum levels of danger-associated molecular patterns (DAMPs; e.g. cell-free DNA and ATP) and cytokines (e.g. IL-1β and IL-18). Accordingly, …

Enhancing Nsclc Recurrence Prediction With Pet/Ct Habitat Imaging, Ctdna, And Integrative Radiogenomics-Blood Insights, Sheeba J Sujit, Muhammad Aminu, Tatiana V Karpinets, Pingjun Chen, Maliazurina B Saad, Morteza Salehjahromi, John D Boom, Mohamed Qayati, James M George, Haley Allen, Mara B Antonoff, Lingzhi Hong, Xin Hu, Simon Heeke, Hai T Tran, Xiuning Le, Yasir Y Elamin, Mehmet Altan, Natalie I Vokes, Ajay Sheshadri, Julie Lin, Jianhua Zhang, Yang Lu, Carmen Behrens, Myrna C B Godoy, Carol C Wu, Joe Y Chang, Caroline Chung, David A Jaffray, Ignacio I Wistuba, J Jack Lee, Ara A Vaporciyan, Don L Gibbons, John Heymach, Jianjun Zhang, Tina Cascone, Jia Wu

Faculty, Staff and Student Publications

While we recognize the prognostic importance of clinicopathological measures and circulating tumor DNA (ctDNA), the independent contribution of quantitative image markers to prognosis in non-small cell lung cancer (NSCLC) remains underexplored. In our multi-institutional study of 394 NSCLC patients, we utilize pre-treatment computed tomography (CT) and 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) to establish a habitat imaging framework for assessing regional heterogeneity within individual tumors. This framework identifies three PET/CT subtypes, which maintain prognostic value after adjusting for clinicopathologic risk factors including tumor volume. Additionally, these subtypes complement ctDNA in predicting disease recurrence. Radiogenomics analysis unveil the molecular underpinnings of these …

Shared Genomic Segments Analysis Identifies Mhc Class I And Class Iii Molecules As Genetic Risk Factors For Juvenile Idiopathic Arthritis, Cecile N. Avery, Nicole D. Russell, Cody J. Steely, Aimee O. Hersh, John F. Bohnsack, Sampath Prahalad, Lynn B. Jorde

Markey Cancer Center Faculty Publications

Juvenile idiopathic arthritis (JIA) is a complex rheumatic disease encompassing several clinically defined subtypes of varying severity. The etiology of JIA remains largely unknown, but genome-wide association studies (GWASs) have identified up to 22 genes associated with JIA susceptibility, including a well-established association with HLA-DRB1. Continued investigation of heritable risk factors has been hindered by disease heterogeneity and low disease prevalence. In this study, we utilized shared genomic segments (SGS) analysis on whole-genome sequencing of 40 cases from 12 multi-generational pedigrees significantly enriched for JIA. Subsets of cases are connected by a common ancestor in large extended pedigrees, increasing the …

Risk Factors For Failure Of Same-Day Discharge Total Knee Arthroplasty, Kevin X. Farley, Robert S. Dean, Eli Auch, Mark Karadsheh, Drew Moore

Conference Presentation Abstracts

OBJECTIVE: Cemented total knee arthroplasty (TKA) is the gold standard treatment for osteoarthritis, but uncemented TKA offers benefits like improved osseointegration and reduced complications from cement debris. This study aimed to investigate (1) if there has been a rise in uncemented TKA and (2) if there are differences in early complications between cemented and uncemented TKA. METHODS: We retrospectively reviewed data from the Michigan Arthroplasty Registry Collaborative Quality Initiative (MARCQI) database of primary TKA patients from 2017 to 2021 at a single health system (six hospitals). Uncemented TKA (uncemented fixation for femur and tibia) patients were analyzed for demographics and …

Targeted Deletion Of Nr2f2 And Vcam1 In Theca Cells Impacts Ovarian Follicular Development: Insights Into Polycystic Ovary Syndrome?†, Nicholes R Candelaria, Joanne S Richards

Faculty, Staff and Students Publications

Defining features of polycystic ovary syndrome (PCOS) include elevated expression of steroidogenic genes, theca cell androgen biosynthesis, and peripheral levels of androgens. In previous studies, we identified vascular cell adhesion molecule 1 (VCAM1) as a selective androgen target gene in specific NR2F2/SF1 (+/+) theca cells. By deleting NR2F2 and VCAM1 selectively in CYP17A1 theca cells in mice, we documented that NR2F2 and VCAM1 impact distinct and sometimes opposing theca cell functions that alter ovarian follicular development in vivo: including major changes in ovarian morphology, steroidogenesis, gene expression profiles, immunolocalization images (NR5A1, CYP11A1, NOTCH1, CYP17A1, INSL3, VCAM1, NR2F2) as well as …

Identifying A Group Of Factors Predicting Cognitive Impairment Among Older Adults, Longgang Zhao, Yuan Wang, Eric Mishio Bawa, Zichun Meng, Jingkai Wei, Sarah Newman-Norlund, Tushar Trivedi, Hatice Hasturk, Roger Newman-Norlund, Julius Fridriksson Ph.D., Anwar T. Nerchant

Faculty Publications

Background

Cognitive impairment has multiple risk factors spanning several domains, but few studies have evaluated risk factor clusters. We aimed to identify naturally occurring clusters of risk factors of poor cognition among middle-aged and older adults and evaluate associations between measures of cognition and these risk factor clusters.

Methods

We used data from the National Health and Nutrition Examination Survey (NHANES) III (training dataset, n = 4074) and the NHANES 2011–2014 (validation dataset, n = 2510). Risk factors were selected based on the literature. We used both traditional logistic models and support vector machine methods to construct a composite score …

National Incidence And Economic Burden Of Revision Shoulder Arthroplasty In The United States: Projections Through 2030, Kevin X. Farley, Robert S. Dean, Eric R. Wagner, Michael B. Gottschalk, J Michael Wiater

Conference Presentation Abstracts

PURPOSE: This study sought to use an all-payor inpatient claims database to investigate the incidence and national cumulative costs of revision shoulder arthroplasty in the United States, including those being performed for PJI. In addition, we also aimed to project the incidence and national economic impact of revision shoulder arthroplasty in the US through 2030. METHODS: The National Inpatient Sample (NIS) was used to estimate the annual number of revision shoulder arthroplasties performed between 2008 and 2019 using ICD procedure codes. Cumulative national costs were estimated. Septic revision shoulder arthroplasties were identified (i.e., cases being done for a prosthetic joint …

Charting The Cellular Biogeography In Colitis Reveals Fibroblast Trajectories And Coordinated Spatial Remodeling, Paolo Cadinu, Kisha N Sivanathan, Aditya Misra, Rosalind J Xu, Davide Mangani, Evan Yang, Joseph M Rone, Katherine Tooley, Yoon-Chul Kye, Lloyd Bod, Ludwig Geistlinger, Tyrone Lee, Randall T Mertens, Noriaki Ono, Gang Wang, Liliana Sanmarco, Francisco J Quintana, Ana C Anderson, Vijay K Kuchroo, Jeffrey R Moffitt, Roni Nowarski

Faculty, Staff and Student Publications

Gut inflammation involves contributions from immune and non-immune cells, whose interactions are shaped by the spatial organization of the healthy gut and its remodeling during inflammation. The crosstalk between fibroblasts and immune cells is an important axis in this process, but our understanding has been challenged by incomplete cell-type definition and biogeography. To address this challenge, we used multiplexed error-robust fluorescence in situ hybridization (MERFISH) to profile the expression of 940 genes in 1.35 million cells imaged across the onset and recovery from a mouse colitis model. We identified diverse cell populations, charted their spatial organization, and revealed their polarization …

‘Joining The Dots: Linking Prenatal Drug Exposure To Childhood And Adolescence’ – Research Protocol Of A Population Cohort Study, Kate Lawler, Mithilesh Dronavalli, Andrew Page, Evelyn Lee, Hannah Uebel, Barbara Bajuk, Lucinda Burns, Michelle Dickson, Charles Green, Lauren Dicair, John Eastwood, Ju Lee Oei

Faculty, Staff and Student Publications

INTRODUCTION: Prenatal drug exposure (PDE) is one of the most important causes of child harm, but comprehensive information about the long-term outcomes of the families is difficult to ascertain. The

METHODS AND ANALYSIS: Information from routinely collected administrative databases was linked for all births registered in New South Wales (NSW), Australia between 1 July 2001 and 31 December 2020 (n=1 834 550). Outcomes for seven mutually exclusive groups of children with varying prenatal exposure to maternal substances of addiction, including smoking, alcohol, prescription/illicit drugs and neonatal abstinence syndrome will be assessed. Key exposure measures include maternal drug use type, maternal …