Medicine and Health Sciences Commons^™

A Novel Polymer-Encapsulated Multi-Imaging Modality Fiducial Marker With Positive Signal Contrast For Image-Guided Radiation Therapy, Li Wang, Jeremiah Sanders, John F Ward, Stephen R Lee, Falk Poenisch, David Michael Swanson, Narayan Sahoo, Xiaorong Ronald Zhu, Jingfei Ma, Rajat J Kudchadker, Seungtaek L Choi, Quynh-Nhu Nguyen, Lauren L Mayo, Shalin J Shah, Steven J Frank

Faculty, Staff and Student Publications

BACKGROUND: Current fiducial markers (FMs) in external-beam radiotherapy (EBRT) for prostate cancer (PCa) cannot be positively visualized on magnetic resonance imaging (MRI) and create dose perturbation and significant imaging artifacts on computed tomography (CT) and MRI. We report our initial experience with clinical imaging of a novel multimodality FM, NOVA.

METHODS: We tested Gold Anchor [G-FM], BiomarC [carbon, C-FM], and NOVA FMs in phantoms imaged with kilovoltage (kV) X-rays, transrectal ultrasound (TRUS), CT, and MRI. Artifacts of the FMs on CT were quantified by the relative streak artifacts level (rSAL) metric. Proton dose perturbations (PDPs) were measured with Gafchromic EBT3 …

Management Of Infliximab Refractory Immune Checkpoint Inhibitor Gastrointestinal Toxicity: A Multicenter Case Series, Catriona Harvey, Kazi J Nahar, Janet Mckeown, Serigne N Lo, Sheima Farag, Nadia Yousaf, Kate Young, Liselotte Tas, Aafke Meerveld-Eggink, Christian Blank, Austin Thomas, Jennifer Mcquade, Bastian Schilling, Douglas B Johnson, Roberto Martín Huertas, Ana Arance, Joanna Lee, Lisa Zimmer, Georgina V Long, Matteo S Carlino, Yinghong Wang, Alexander Maxwell Menzies

Faculty, Staff and Student Publications

Background: Immune checkpoint inhibitor (ICI) gastrointestinal toxicity (gastritis, enteritis, colitis) is a major cause of morbidity and treatment-related death. Guidelines agree steroid-refractory cases warrant infliximab, however best management of infliximab-refractory ICI gastrointestinal toxicity (IRIGItox) is unknown.

Methods: We conducted an international multicenter retrospective case series. IRIGItox was defined as failure of symptom resolution ≤grade 1 (Common Terminology Criteria for Adverse Events V.5.0) following ≥2 infliximab doses or failure of symptom resolution ≤grade 2 after one dose. Data were extracted regarding demographics, steroid use, response to treatment, and survival outcomes. Toxicity was graded at symptom onset and time of infliximab failure. …

Cytoskeleton Remodeling Induced By Smyd2 Methyltransferase Drives Breast Cancer Metastasis, Alexandre G Casanova, Gael S Roth, Simone Hausmann, Xiaoyin Lu, Ludivine J M Bischoff, Emilie M Froeliger, Lucid Belmudes, Ekaterina Bourova-Flin, Natasha M Flores, Ana Morales Benitez, Tourkian Chasan, Marcello Caporicci, Jessica Vayr, Sandrine Blanchet, Francesco Ielasi, Sophie Rousseaux, Pierre Hainaut, Or Gozani, Muriel Le Romancer, Yohann Couté, Andres Palencia, Pawel K Mazur, Nicolas Reynoird

Faculty, Staff and Student Publications

Malignant forms of breast cancer refractory to existing therapies remain a major unmet health issue, primarily due to metastatic spread. A better understanding of the mechanisms at play will provide better insights for alternative treatments to prevent breast cancer cell dispersion. Here, we identify the lysine methyltransferase SMYD2 as a clinically actionable master regulator of breast cancer metastasis. While SMYD2 is overexpressed in aggressive breast cancers, we notice that it is not required for primary tumor growth. However, mammary-epithelium specific SMYD2 ablation increases mouse overall survival by blocking the primary tumor cell ability to metastasize. Mechanistically, we identify BCAR3 as …

Measures Of Resting-State Brain Network Segregation And Integration Vary In Relation To Data Quantity: Implications For Within And Between Subject Comparisons Of Functional Brain Network Organization, Liang Han, Micaela Y Chan, Phillip F Agres, Ezra Winter-Nelson, Ziwei Zhang, Gagan S Wig

Faculty, Staff and Student Publications

Measures of functional brain network segregation and integration vary with an individual's age, cognitive ability, and health status. Based on these relationships, these measures are frequently examined to study and quantify large-scale patterns of network organization in both basic and applied research settings. However, there is limited information on the stability and reliability of the network measures as applied to functional time-series; these measurement properties are critical to understand if the measures are to be used for individualized characterization of brain networks. We examine measurement reliability using several human datasets (Midnight Scan Club and Human Connectome Project [both Young Adult …

Dynamic Prognosis Prediction For Patients On Dapt After Drug-Eluting Stent Implantation: Model Development And Validation, Fang Li, Laila Rasmy, Yang Xiang, Jingna Feng, Ahmed Abdelhameed, Xinyue Hu, Zenan Sun, David Aguilar, Abhijeet Dhoble, Jingcheng Du, Qing Wang, Shuteng Niu, Yifang Dang, Xinyuan Zhang, Ziqian Xie, Yi Nian, Jianping He, Yujia Zhou, Jianfu Li, Mattia Prosperi, Jiang Bian, Degui Zhi, Cui Tao

School of Medicine Faculty Publications

BACKGROUND: The rapid evolution of artificial intelligence (AI) in conjunction with recent updates in dual antiplatelet therapy (DAPT) management guidelines emphasizes the necessity for innovative models to predict ischemic or bleeding events after drug-eluting stent implantation. Leveraging AI for dynamic prediction has the potential to revolutionize risk stratification and provide personalized decision support for DAPT management. METHODS AND RESULTS: We developed and validated a new AI-based pipeline using retrospective data of drug-eluting stent-treated patients, sourced from the Cerner Health Facts data set (n=98 236) and Optum’s de-identified Clinformatics Data Mart Database (n=9978). The 36 months following drug-eluting stent implantation were …

A Healthful Plant-Based Diet Is Associated With Lower Type 2 Diabetes Risk Via Improved Metabolic State And Organ Function: A Prospective Cohort Study, Alysha S. Thompson, Catharina J. Candussi, Anna Tresserra-Rimbau, Amy Jennings, Nicola P. Bondonno, Claire Hill, Solomon A. Sowah, Aedín Cassidy, Tilman Kühn

Research outputs 2022 to 2026

Background: Plant-based diets are becoming increasingly popular due to favourable environmental footprints and have been associated with lower risk of type 2 diabetes mellitus (T2DM). Here, we investigated the potential mechanisms to explain the lower T2DM risk observed among individuals following plant-based diets. Methods: Prospective data from the UK Biobank, a cohort study of participants aged 40 to 69 years at baseline, was evaluated. Associations between healthful and unhealthful plant-based indices (hPDI and uPDI) and T2DM risk were analysed by multivariable Cox regression models, followed by causal mediation analyses to investigate which cardiometabolic risk factors explained the observed associations. Results: …

Basis Of Executive Functions In Fine-Grained Architecture Of Cortical And Subcortical Human Brain Networks, Moataz Assem, Sneha Shashidhara, Matthew F Glasser, John Duncan

2020-Current year OA Pubs

Theoretical models suggest that executive functions rely on both domain-general and domain-specific processes. Supporting this view, prior brain imaging studies have revealed that executive activations converge and diverge within broadly characterized brain networks. However, the lack of precise anatomical mappings has impeded our understanding of the interplay between domain-general and domain-specific processes. To address this challenge, we used the high-resolution multimodal magnetic resonance imaging approach of the Human Connectome Project to scan participants performing 3 canonical executive tasks: n-back, rule switching, and stop signal. The results reveal that, at the individual level, different executive activations converge within 9 domain-general territories …

Investigating The Association Between Gut Bacteria And Childhood Neuropsychiatric Disorders, Maha Abdo

Theses and Dissertations

Background: The etiology of autism spectrum disorder (ASD) remains unclear. However, it’s believed to be a multifactorial condition. Several studies suggest the involvement of gut and oral microbiome in the predisposition of ASD symptoms. Understanding the pathophysiology could aid in developing better treatment strategies that improve the quality of life of ASD individuals and their caregivers.

Aim: The current study aims at characterizing the gut and oral microbiome composition of ASD children compared to their healthy siblings and mothers as control groups.

Methods: Stool and saliva samples were collected from fourteen families at Ain Shams University Hospital, Outpatient Clinic. The …

The Brain Drain Of The Egyptian Physicians: A Look From Both Sides, Hebatalla Ahmed Mohamed Ismail

Theses and Dissertations

The brain drain of well-educated and trained workers is a problem that faces many nations. The pandemic revealed the importance of being ready with all resources, especially the healthcare workers. In Egypt, according to records of the Egyptian medical syndicate, half of the registered physicians in the syndicate are working abroad. In this study, we aimed to understand the relationship between individual satisfaction regarding work or family, his capability factors, and his intention to leave the country to work in another one. A quantitative approach was used by a self-administered online questionnaire. The results showed that 66.4% of physicians who …

Cardiovascular Health Assessment In Routine Cancer Follow-Up In Community Settings: Survivor Risk Awareness And Perspectives, Kathryn E Weaver, Emily V Dressler, Sydney Smith, Chandylen L Nightingale, Heidi D Klepin, Simon Craddock Lee, Brian J Wells, W Gregory Hundley, Joseph A Demari, Sarah N Price, Randi E Foraker

2020-Current year OA Pubs

BACKGROUND: Guidelines recommend cardiovascular risk assessment and counseling for cancer survivors. For effective implementation, it is critical to understand survivor cardiovascular health (CVH) profiles and perspectives in community settings. We aimed to (1) Assess survivor CVH profiles, (2) compare self-reported and EHR-based categorization of CVH factors, and (3) describe perceptions regarding addressing CVH during oncology encounters.

METHODS: This cross-sectional analysis utilized data from an ongoing NCI Community Oncology Research Program trial of an EHR heart health tool for cancer survivors (WF-1804CD). Survivors presenting for routine care after potentially curative treatment recruited from 8 oncology practices completed a pre-visit survey, including …

Reaction Hijacking Inhibition Of Plasmodium Falciparum Asparagine Trna Synthetase, Stanley C Xie, Eva S Istvan, Daniel E Goldberg, Et Al.

2020-Current year OA Pubs

Malaria poses an enormous threat to human health. With ever increasing resistance to currently deployed drugs, breakthrough compounds with novel mechanisms of action are urgently needed. Here, we explore pyrimidine-based sulfonamides as a new low molecular weight inhibitor class with drug-like physical parameters and a synthetically accessible scaffold. We show that the exemplar, OSM-S-106, has potent activity against parasite cultures, low mammalian cell toxicity and low propensity for resistance development. In vitro evolution of resistance using a slow ramp-up approach pointed to the Plasmodium falciparum cytoplasmic asparaginyl-tRNA synthetase (PfAsnRS) as the target, consistent with our finding that OSM-S-106 inhibits protein …

Harnessing Physical Activity Monitoring And Digital Biomarkers Of Frailty From Pendant Based Wearables To Predict Chemotherapy Resilience In Veterans With Cancer, Gozde Cay, Yvonne H Sada, Mohammad Dehghan Rouzi, Md Moin Uddin Atique, Naima Rodriguez, Mehrnaz Azarian, M G Finco, Sarvari Yellapragada, Bijan Najafi

Center on Aging Staff Publications

This study evaluated the use of pendant-based wearables for monitoring digital biomarkers of frailty in predicting chemotherapy resilience among 27 veteran cancer patients (average age: 64.6 ± 13.4 years), undergoing bi-weekly chemotherapy. Immediately following their first day of chemotherapy cycle, participants wore a water-resistant pendant sensor for 14 days. This device tracked frailty markers like cadence (slowness), daily steps (inactivity), postural transitions (weakness), and metrics such as longest walk duration and energy expenditure (exhaustion). Participants were divided into resilient and non-resilient groups based on adverse events within 6 months post-chemotherapy, including dose reduction, treatment discontinuation, unplanned hospitalization, or death. A …

Comparison Of Perioperative And Postoperative Outcomes Among 3 Left Atrial Incisions: Conventional Direct, Transseptal, And Superior Septal Left Atriotomy, Estelle Démoulin, Dionysios Adamopoulos, Tornike Sologashvili, Mathieu Van Steenberghe, Jalal Jolou, Haran Burri, Christoph Huber, Mustafa Cikirikcioglu

The Texas Heart Institute Journal

BACKGROUND: Achieving optimal exposure of the mitral valve during surgical intervention poses a significant challenge. This study aimed to compare perioperative and postoperative outcomes associated with 3 left atriotomy techniques in mitral valve surgery-the conventional direct, transseptal, and superior septal approaches-and assess differences during the surgical procedure and the postoperative period.

METHODS: Inclusion criteria were patients undergoing mitral valve surgery from January 2010 to December 2020, categorized into 3 cohorts: group 1 (conventional direct; n = 115), group 2 (transseptal; n = 33), and group 3 (superior septal; n = 59). To bolster sample size, the study included patients undergoing …

The Differences In Code Status Conversation Approaches Reported By Emergency Medicine And Palliative Care Clinicians: A Mixed-Method Study, Kei Ouchi, Thidathit Prachanukool, Emily L Aaronson, Joshua R Lakin, Masaya Higuchi, Shan W Liu, Maura Kennedy, Anna C Revette, Anita N Chary, Jenson Kaithamattam, Brandon Lee, Thanh H Neville, Mohammad A Hasdianda, Rebecca Sudore, Mara A Schonberg, James A Tulsky, Susan D Block

Faculty, Staff and Students Publications

BACKGROUND: During acute health deterioration, emergency medicine and palliative care clinicians routinely discuss code status (e.g., shared decision making about mechanical ventilation) with seriously ill patients. Little is known about their approaches. We sought to elucidate how code status conversations are conducted by emergency medicine and palliative care clinicians and why their approaches are different.

METHODS: We conducted a sequential-explanatory, mixed-method study in three large academic medical centers in the Northeastern United States. Attending physicians and advanced practice providers working in emergency medicine and palliative care were eligible. Among the survey respondents, we purposefully sampled the participants for follow-up interviews. …

Exploring The Relationships Between Health Literacy And Hba1c In A Rural Border Region, Stephen Jaime

Dissertations

Aims/Objectives: The purpose of this study was to describe the relationships between select sociodemographic and clinical characteristics, individual health literacy levels, and hemoglobin A1c (HbA1c) levels among Hispanic patients with diabetes living in a rural border region.

Background: The frequency of complications from diabetes can increase as HbA1c levels rise, causing the person with diabetes to be at greater risk for blindness, amputation, or renal failure. Unfortunately, people of Hispanic background are at higher risk of developing diabetes compared to non-Hispanic Whites. Many people living in rural towns that border Mexico are of Hispanic background, increasing their risk of developing …

Verbal Abuse, Violence Prevention Climate, And Psychological Safety Among Pediatric Nurses, Donna Bigani

Dissertations

Purpose: The purpose of this study was to describe the relationships among demographic characteristics, verbal abuse, violence prevention climate, and team psychological safety.

Specific Aims: Specific aims were to describe: (1) demographic characteristics, verbal abuse, violence prevention climate, and the perception of team psychological safety by pediatric nurses; (2) relationships among select demographic characteristics, verbal abuse, violence prevention climate, and team psychological safety; and (3) the variance in team psychological safety accounted for by select demographic characteristics, verbal abuse, and violence prevention climate.

Background: Psychological safety is a key element for nursing practice and healthcare teams. Patient and employee safety …

Ogilvie's Syndrome: Acute Colonic Pseudoobstruction. A Review For Residents., Tyler Bayliss, Caleb Clark, Errington C. Thompson

Marshall Journal of Medicine

Ogilvie's syndrome (acute colonic pseudoobstruction) was first described in 1948. Acute colonic pseudoobstruction can occur in a variety of clinical settings, including postsurgical, obstetrics, pelvic surgery, critical care and sepsis. Clinicians need to recognize the syndrome early. Colonic distention without evidence of obstruction can be seen on plain films of the abdomen or CT scan. Successful therapies, including bowel rest, neostigmine and colonoscopic decompression, have been used. Avoiding respiratory compromise from abdominal distention and colonic perforation of the primary goals of treatment. Surgical intervention should be reserved for patients who are refractory to medical treatment or develops signs and symptoms …

Overcoming Communication Challenges: Training Family Medicine Interns Amidst Covid-19, Ny'nika T. Mcfadden, Connie C. Leeper, Catanya G. Stager, Amanda H. Wilkerson

Marshall Journal of Medicine

Introduction

Assessing and addressing possible deficiencies in medical school training is important for residency programs. Due to virtual rotations and low patient volumes, the COVID-19 pandemic disrupted medical students’ opportunities to practice patient communication. Communication skills are essential for medical students and residents. Continuous participation in communication training can increase the self-efficacy of healthcare professionals. Due to the likely impact of COVID-19, we designed and implemented a tailored workshop that focused on increasing 16 incoming family medicine interns’ level of comfort communicating with patients and their families.

Methods

Sixteen incoming family medicine interns participated in the workshop during orientation in …

A Case Of Occlusive Myocardial Infarction Caused By Nephrotic Syndrome In A 26-Year-Old Type 1 Diabetic, Kyle Admire, Charlotta Jornlid, Chelsea Ryan, Rebecca Pauly

Marshall Journal of Medicine

Nephrotic syndrome is a rare condition distinguished by proteinuria exceeding 3g per day. Other associated characteristics include hematuria, hypoalbuminemia, edema, and hyperlipidemia. There is an array of complications of this syndrome, which are primarily due to the profound losses of protein in the urine. One such complication is thromboembolism, with most documented cases in the form of venous thromboembolism of the extremities which is in part due to urinary loss of antithrombin III and increased synthesis of prothrombotic factors. There are limited available data regarding arterial thrombi and especially few reports about coronary thromboses, which can be life-threatening. In this …

Management Of Cryptogenic Stroke Secondary To Large Asd With Percutaneous Occluder Device And Antiplatelet Drugs, Riya Gupta, Naveed Iqbal

Marshall Journal of Medicine

Atrial septal defects (ASD) represent the most common congenital heart disease diagnosed in adult population and can present with variable clinical findings. Recent literature emphasizes the importance of management of ASD especially if it is associated with structural right heart changes such as RV dysfunction, right ventricular enlargement, arrythmias or paradoxical embolism.

The decision between medical therapy versus surgical closure of ASD is a common clinical conundrum especially in the setting of cryptogenic stroke.

More Physicians Alone Won’T Solve Rural America’S Health Care Problems, Atul Grover

Marshall Journal of Medicine

Policymakers have voiced their hope that locating family doctors and other primary care physicians within rural communities would, by itself, improve the health status of rural residents. However, access does not necessarily translate to better health. Rural populations face disproportionately worse health outcomes and inequities compared to urban populations. To improve the health care of rural America, it is critical to define—and periodically reassess—the problem and identify varying targeted policies.

Ultrasound – An Underutilized Diagnostic Tool For Ventricular Assist Device Driveline Infections, Kristina Krzelj, Tomislav Tokic, Tomislav Kopjar, Maja Cikes, Davor Milicic, Hrvoje Gasparovic

The VAD Journal

Patients with ventricular assist device (VAD) driveline infections (DLI) have reduced quality of life and increased risk of severe complications, such as sepsis, hemorrhagic or ischemic stroke, and wound infections. The management of VAD patients imposes a significant financial burden due to prolonged in-hospital stays, frequent re-admissions, expensive diagnostics, and the need for antibiotic therapy and/or surgical intervention. There is considerable room for improvement in DLI management, particularly in the early detection and treatment stages. Ultrasound, an easily applicable device available in almost every hospital, offers an unrecognized potential for the early detection of DLI. By increasing awareness about the …

La Incidencia Y El Tratamiento De Las Hernias En Ecuador En Comparación Con Los Estados Unidos Y Otros Países Del Mundo, Caleb Smith

NEXUS: The Liberty Journal of Interdisciplinary Studies

No abstract provided.

Bioethics Of Human Cloning: Are We Playing God?, Caleb Smith, Mary Katherine Flage

NEXUS: The Liberty Journal of Interdisciplinary Studies

No abstract provided.

Women’S Comfort With Mobile Applications For Menstrual Cycle Self-Monitoring Following The Overturning Of Roe V. Wade, Gabrielle M. Salvatore, Iris Bercovitz, Danielle Arigo

College of Science & Mathematics Departmental Research

Background: The overturning of Roe v. Wade in June 2022 has many implications for American women of reproductive age, as well as for researchers focused on women’s health in the United States (U.S.). Personal reproductive health data, such as information collected by menstrual cycle (MC) tracking applications (apps), can now be bought, sold, or accessed by law enforcement to enforce limits on abortion. American women have grown concerned about data privacy and have even deleted MC tracking apps following the overturning of Roe v. Wade. This concern is problematic as these apps may advance our understanding of women’s MC experiences …

An Investigation Of The Relationship Between Adverse Childhood Experiences And Women’S Mental Health, Dr. Mercedes Zubieta Richmond

Walden Dissertations and Doctoral Studies

No abstract provided.

Harnessing The Power Of Psychological Hardiness Among Adolescents: A Concept Paper, Preejana Sharma Ms, Linu Sara George Dr, Shweta Rai Dr, Tessy Treesa Jose Dr

Manipal Journal of Nursing and Health Sciences

During adolescence, developing psychological hardiness is crucial because it influences individuals’ response to pressure and helps them become more adaptable and resilient in dealing with challenging and uncertain situations. It is essential for adolescents to learn how to regulate their emotions, particularly intense emotions such as stress, anger, and anxiety, as it significantly impacts their overall well-being. In this paper, we delve into the multifaceted nature of psychological hardiness and explore its implications for personal growth and well-being. Psychological hardiness is an indispensable part of adolescent life because it helps regulate emotions and general health, enabling adolescents to cope with …

Prognostic Properties Of Kras Gene Mutation Subtypes In Resected Pancreatic Cancer, Faria Nusrat, Eliyahu Gorgov, Md, Wilbur Bowne, Md, Obehioye Isesele, Akshay Khanna, Harish Lavu, Md, Aditi Jain, Phd, Charles J. Yeo, Md, Avinoam Nevler, Md

Alpha Omega Alpha Research Symposium Posters

Introduction

• Pancreatic ductal adenocarcinoma (PDAC) is an aggressive and therapy-resistant cancer with an overall 5-year survival rate of almost 12%, making it among the most lethal of all major cancers.¹
• PDAC has a distinct genomic profile, with somatic KRAS protooncogene mutations in ~90% of cases.^2,3
• Current literature has not reached a consensus on disease prognosis based on KRAS mutation subtype.^2-5

Cardiometabolic Health: Actionable Prevention Strategies And New Care Models, Omar Leonards, David Aguilar

School of Medicine Faculty Publications

No abstract provided.

Clinical Practice Guideline-Inconsistent Management Of Fever And Neutropenia In Pediatric Oncology: A Children's Oncology Group Study, L. Lee Dupuis, Brian T. Fisher, A. J. Sugalski, Allison Caren Grimes, Michelle Nuño, S. Ramakrishnan, M. P. Beauchemin, Paula D. Robinson, Nancy Santesso, Alexandra Walsh, A. R. Wrightson, Lolie Yu, Susan K. Parsons, Lillian Sung

School of Medicine Faculty Publications

Background: The primary objective was to measure the proportion of episodes where care delivery was inconsistent with selected recommendations of a clinical practice guideline (CPG) on fever and neutropenia (FN) management. The influence of site size on CPG-inconsistent care delivery, and association between patient outcomes and CPG-inconsistent care were described. Methods: This retrospective, multicenter study included patients less than 21 years old with cancer who were at high risk of poor FN outcomes and were previously enrolled to a Children's Oncology Group (COG) study at participating National Cancer Institute Community Oncology Research Program (NCORP) institutions from January 2014 through December …