Medicine and Health Sciences Commons^™

Managing Refractory Status Epilepticus With Early Ketamine Administration, Ashlyn Shavers

Yale School of Medicine Physician Associate Program Theses

Status epilepticus is a time-sensitive neurological emergency that can be associated with severe disability and mortality. Approximately 20% of patients with status epilepticus will fail to respond to existing first and second-line therapies that act on similar receptors. There is a need for additional therapeutic options. One candidate drug, ketamine, has a novel mechanism of action and may work synergistically to terminate seizures. This study seeks to examine whether ketamine administration along with other second-line medications can reduce seizure burden in patients with status epilepticus. Using an open-label randomized clinical trial of 436 patients, we will examine the proportion of …

Providing Trauma Informed Care For Individuals On Opioid Agonist To Increase Contraception, Devon Knight

Yale School of Medicine Physician Associate Program Theses

Individuals with opioid use disorder report having less reproductive and sexual health knowledge and are at greater risk of unintended pregnancy than their peers. This has led to increased neonatal opioid withdrawal syndrome and an increased healthcare burden, yet providing contraception and trauma informed care at treatment centers for individuals engaging in medication treatment has not been emphasized. Co-locating trauma informed reproductive and sexual health education and contraception access at substance use treatment centers provides a unique opportunity to improve knowledge and access to care for this population. We propose a randomized control trial to determine whether trauma informed care …

Spinal Fusion For Adult Degenerative Scoliosis: Rct Of Robot-Assisted Versus Navigation Guidance, Kyle Hanks

Yale School of Medicine Physician Associate Program Theses

Adult degenerative scoliosis is characterized by the side-to-side curvature of the spine due to the degeneration of facet joints and intervertebral discs. Life-limiting cases of adult degenerative scoliosis are corrected by spinal fusion, the success of which is determined by pedicle screw accuracy. Robot-assisted guidance has become more commonly used in spinal surgery to ensure pedicle screw placement. However, there is limited evidence for the role of robot-assisted guidance in the correction of adult degenerative scoliosis. Here, in this randomized controlled trial, we aim to investigate whether robot-assisted guidance can more consistently produce accurate pedicle screw placement than neuronavigation …

The Effect Of Neurologic Music Therapy On Speech Intelligibility In Children With Cerebral Palsy, Paulina Perez-Curiel

Yale School of Medicine Physician Associate Program Theses

Cerebral palsy is the most common motor disability in children and is caused by abnormal development of or damage to the brain. Children with cerebral palsy often have speech disorders, most commonly dysarthria, due to deficits in speech-motor control. The inability to communicate effectively can lead to needs not being met, self-isolation, and an overall decrease in self-perception and quality of life. In this randomized control trial, we will evaluate whether Neurologic Music Therapy improves word-level speech intelligibility in children with Cerebral Palsy. Fifty children will be exposed to Neurologic Music Therapy and fifty children will receive standard speech therapy. …

Voluntary Wheel Running Promotes Resilience To The Behavioral Effects Of Unpredictable Chronic Mild Stress In Male And Female Mice., Elias Elias, Ariel Y Zhang, Abigail G White, Matthew J Pyle, Melissa T Manners

College of Science & Mathematics Departmental Research

Besides significant benefits to physical health, exercise promotes mental health, reduces symptoms of mental illness, and enhances psychological development. Exercise can offset the impact of chronic stress, which is a major precursor to the development of mental disorders. The effects of exercise on chronic stress-induced behaviors are contradictory in preclinical studies, primarily due to the lack of data and sex-specific investigations. We sought to evaluate the effects of exercise on chronic stress-induced behavioral changes in both male and female mice. Mice were subjected to an Unpredictable Chronic Mild Stress (UCMS) paradigm with accessibility to running wheels for 2 h daily. …

Self-Modulation Of Rectus Femoris Reflex Excitability In Humans, Kyoungsoon Kim, Tunc Akbas, Robert Lee, Kathleen Manella, James Sulzer

HPD Articles

Hyperreflexia is common after neurological injury such as stroke, yet clinical interventions have had mixed success. Our previous research has shown that hyperreflexia of the rectus femoris (RF) during pre-swing is closely associated with reduced swing phase knee flexion in those with post-stroke Stiff-Knee gait (SKG). Thus, reduction of RF hyperreflexia may improve walking function in those with post-stroke SKG. A non-pharmacological procedure for reducing hyperreflexia has emerged based on operant conditioning of H-reflex, an electrical analog of the spinal stretch reflex. It is currently unknown whether operant conditioning can be applied to the RF. This feasibility study trained 7 …

Dextromethorphan/Quinidine For The Treatment Of Bulbar Impairment In Amyotrophic Lateral Sclerosis., Lauren Tabor Gray, Eduardo Locatelli, Terrie Vasilopoulos, James Wymer, Emily K. Plowman

HPD Articles

OBJECTIVE: No efficacious treatments exist to improve or prolong bulbar functions of speech and swallowing in persons with amyotrophic lateral sclerosis (pALS). This study evaluated the short-term impact of dextromethorphan/quinidine (DMQ) treatment on speech and swallowing function in pALS.

METHODS: This was a cohort trial conducted between August 2019 to August 2021 in pALS with a confirmed diagnosis of probable-definite ALS (El-Escorial Criteria-revisited) and bulbar impairment (ALS Functional Rating Scale score ≤ 10 and speaking rate ≤ 140 words per minute) who were DMQ naïve. Efficacy of DMQ was assessed via pre-post change in the ALS Functional Rating Scale-Revised bulbar …

Changes In Nascent Chromatin Structure Regulate Activation Of The Pro-Fibrotic Transcriptome And Myofibroblast Emergence In Organ Fibrosis, Morgan D. Basta, Svetlana Petruk, Ross Summer, Joel Rosenbloom, Peter J. Wermuth, Edward J. Macarak, Alex V. Levin, Alexander Mazo, Janice L. Walker

Department of Biochemistry and Molecular Biology Faculty Papers

Cell reprogramming to a myofibroblast responsible for the pathological accumulation of extracellular matrix is fundamental to the onset of fibrosis. Here, we explored how condensed chromatin structure marked by H3K72me3 becomes modified to allow for activation of repressed genes to drive emergence of myofibroblasts. In the early stages of myofibroblast precursor cell differentiation, we discovered that H3K27me3 demethylase enzymes UTX/KDM6B creates a delay in the accumulation of H3K27me3 on nascent DNA revealing a period of decondensed chromatin structure. This period of decondensed nascent chromatin structure allows for binding of pro-fibrotic transcription factor, Myocardin-related transcription factor A (MRTF-A) to nascent DNA. …

Guidebook For Occupational Therapy For End-Of-Life Care, Shannon Sudrla, Mary Smith, Alexandria Cannata, Anna Norene Carlson

Spring 2023 Virtual OTD Capstone Symposium

Patients at the end-of-life (EoL) experience functional decline in response to terminal illness and the active dying process, inhibiting participation and engagement in meaningful daily activities. Occupational therapy practitioners (OTP) are equipped to address patients’ occupational needs and desires despite their declining capacities; however, the absence of occupational therapy (OT) services in EoL care leaves patients’ occupational needs unmet, directly affecting their quality of life. The literature demonstrates the need for enhanced education and training among occupational therapy students (OTS) and practitioners to better prepare them to work with terminally ill patients who face progressive functional decline and imminent death. …

Novel Allosteric Effectors Targeting Human Transcription Factor Tead, Mayar Terek Ibrahim, Gennady M. Verkhivker, Jyoti Misra, Peng Tao

Mathematics, Physics, and Computer Science Faculty Articles and Research

The Hippo pathway is an evolutionary conserved signaling network involved in several cellular regulatory processes. Dephosphorylation and overexpression of Yes-associated proteins (YAPs) in the Hippo-off state are common in several types of solid tumors. YAP overexpression results in its nuclear translocation and interaction with transcriptional enhanced associate domain 1-4 (TEAD1-4) transcription factors. Covalent and non-covalent inhibitors have been developed to target several interaction sites between TEAD and YAP. The most targeted and effective site for these developed inhibitors is the palmitate-binding pocket in the TEAD1-4 proteins. Screening of a DNA-encoded library against the TEAD central pocket was performed experimentally to …

Monodelphis Domestica As A Fetal Intra-Cerebral Inoculation Model For Zika Virus Pathogenesis, John Thomas, Juan Garcia, Matthew Terry, Susan M. Mahaney, Oscar Quintanilla, Dionn Carlo Silva, Marisol Morales, John Vandeberg Phd

School of Medicine Publications

Monodelphis domestica (the laboratory opossum) is a marsupial native to South America. At birth, these animals are developmentally equivalent to human embryos at approximately 5 weeks of gestation, which, when coupled with other characteristics including the size of the animals, the development of a robust immune system during juvenile development, and the relative ease of experimental manipulation, have made M. domestica a valuable model in many areas of biomedical research. However, their suitability as models for infectious diseases, especially neurotropic viruses such as Zika virus (ZIKV), is currently unknown. Here, we describe the replicative effects of ZIKV using a fetal …

Glucose-Dependent Insulinotropic Polypeptide Monoclonal Antibodies Prevent And Treat Obesity In Wild-Type And Hyperphagic Mice, M Michael Wolfe, Michael O. Boylan

Faculty Scholarship

Objective: This study aimed to investigate whether a glucose-dependent insulinotropic polypeptide (GIP) monoclonal antibody (mAb) will promote weight loss in wild-type mice and to determine effects of this mAb in preventing weight gain in ob/ob mice. Methods: Phosphate-buffered saline (PBS) or GIP mAb was injected intraperitoneally to wild-type mice fed a 60% high-fat diet (HFD). After 12 weeks, mice that received PBS were divided into two groups and were fed a 37% HFD for 5 weeks; one group received PBS, and one group received GIP mAb. In a separate study, PBS or GIP mAb was injected intraperitoneally to ob/ob mice …

Extracellular-Vesicle-Based Therapeutics In Neuro-Ophthalmic Disorders, Hamed Massoumi, Sohil Amin, Mohammad Soleimani, Bita Momenaei, Mohammad Javad Ashraf, Victor H Guaiquil, Peiman Hematti, Mark I Rosenblatt, Ali R Djalilian, Elmira Jalilian

Wills Eye Hospital Papers

Extracellular vesicles (EVs) have been recognized as promising candidates for developing novel therapeutics for a wide range of pathologies, including ocular disorders, due to their ability to deliver a diverse array of bioactive molecules, including proteins, lipids, and nucleic acids, to recipient cells. Recent studies have shown that EVs derived from various cell types, including mesenchymal stromal cells (MSCs), retinal pigment epithelium cells, and endothelial cells, have therapeutic potential in ocular disorders, such as corneal injury and diabetic retinopathy. EVs exert their effects through various mechanisms, including promoting cell survival, reducing inflammation, and inducing tissue regeneration. Furthermore, EVs have shown …

Quehry: A Question Answering System To Query Electronic Health Records, Sarvesh Soni, Surabhi Datta, Kirk Roberts

Faculty, Staff and Student Publications

OBJECTIVE: We propose a system, quEHRy, to retrieve precise, interpretable answers to natural language questions from structured data in electronic health records (EHRs).

MATERIALS AND METHODS: We develop/synthesize the main components of quEHRy: concept normalization (MetaMap), time frame classification (new), semantic parsing (existing), visualization with question understanding (new), and query module for FHIR mapping/processing (new). We evaluate quEHRy on 2 clinical question answering (QA) datasets. We evaluate each component separately as well as holistically to gain deeper insights. We also conduct a thorough error analysis for a crucial subcomponent, medical concept normalization.

RESULTS: Using gold concepts, the precision of quEHRy …

Shared Decision Making In Acute Pain Management In Patients With Opioid Use Disorder: A Scoping Review, Peter D Vu, Aila Malik, A Sarah Cohen, Vishal Bansal, Morgan R Cowan, Gregory M Blazek, Tiffany Champagne-Langabeer

Faculty, Staff and Student Publications

The treatment of acute pain over the years has changed with increasing alternative therapies and increased scrutiny of opioid prescriptions. Shared Decision Making (SDM) has become a vital tool in increasing patient engagement and satisfaction in treatment decisions. SDM has been successfully implemented in the management of pain in a variety of settings; however, information regarding the use of SDM for treating acute pain in patients with a history of opioid use disorder (OUD) remains scarce. Following the Preferred Reporting Items for Systematic Reviews and Meta-analysis Extension for Scoping Reviews (PRISMA-ScR), we conducted a review to understand how SDM is …

Deepmicetl: A Deep Transfer Learning Based Prediction Of Mice Cardiac Conduction Diseases Using Early Electrocardiograms, Ying Liao, Yisha Xiang, Mingjie Zheng, Jun Wang

Faculty, Staff and Student Publications

Cardiac conduction disease is a major cause of morbidity and mortality worldwide. There is considerable clinical significance and an emerging need of early detection of these diseases for preventive treatment success before more severe arrhythmias occur. However, developing such early screening tools is challenging due to the lack of early electrocardiograms (ECGs) before symptoms occur in patients. Mouse models are widely used in cardiac arrhythmia research. The goal of this paper is to develop deep learning models to predict cardiac conduction diseases in mice using their early ECGs. We hypothesize that mutant mice present subtle abnormalities in their early ECGs …

Development Of A Nurse Anesthesia Program Point-Of-Care Ultrasound Airway Examination Curriculum, Sarah Elyse Sandheinrich Butler, Colton Phillip Butler

Doctor of Nursing Practice Projects

Airway management is a critical and fundamental skill for anesthesia providers. Point-of-care ultrasound (POCUS) is an up-and-coming assessment technique that can provide critical information about a patient’s airway anatomy and may increase patient safety during anesthesia care. As a result, understanding the appropriate POCUS equipment, techniques, findings, and clinical implications for airway examination can become essential for safe and effective anesthesia practice. This project aimed to develop a clinical airway POCUS examination curriculum with detailed instructions on all aspects of appropriate examination equipment, set-up, technique, and implications for findings. The team designed the curriculum to incorporate it into the host …

Protocol Of A Multicentre Randomised Controlled Trial Assessing Transperineal Prostate Biopsy To Reduce Infectiouscomplications, Jim Hu, Alec Zhu, Andrew Vickers, Mohamad Ezzeddine Allaf, Behfar Ehdaie, Anthony Schaeffer, Christian Pavlovich, Ashley E. Ross, David A. Green, Gerald Wang, Serge Ginzburg, Jeffrey S. Montgomery, Arvin George, John N. Graham, Benjamin T. Ristau, Andres Correa, Jonathan E. Shoag, Keith J. Kowalczyk, Tenny R. Zhang, E.M. Schaeffer

Einstein Health Papers

Introduction Approximately one million prostate biopsies are performed annually in the USA, and most are performed using a transrectal approach under local anaesthesia. The risk of postbiopsy infection is increasing due to increasing antibiotic resistance of rectal flora. Single-centre studies suggest that a clean, percutaneous transperineal approach to prostate biopsy may have a lower risk of infection. To date, there is no high-level evidence comparing transperineal versus transrectal prostate biopsy. We hypothesise that transperineal versus transrectal prostate biopsy under local anaesthesia has a significantly lower risk of infection, similar pain/discomfort levels and comparable detection of non-low-grade prostate cancer.

Methods and …

Trends And Determinants Of Modern Contraceptive Utilisation Among Adolescent Girls Aged 15-19 Years In Sierra Leone: An Analysis Of Demographic And Health Surveys, 2008-2019, Emmanuel Olal, Fassou Mathias Grovogui, Ritah Nantale, Quraish Sserwanja, Chola Nakazwe, Lilian Nuwabaine, David Mukunya, Eric Nzirakaindi Ikoona, Lenka Benova

School of Nursing & Midwifery, East Africa

Background

Modern contraceptives are effective interventions for preventing unwanted pregnancies, but their use remain low among adolescent girls in sub-Saharan Africa. First, we aimed to assess the trends of modern contraceptive use among adolescent girls aged 15-19 years in Sierra Leone in the period 2008-2019. Second, we explored how individual and contextual determinants of their use changed during this period.

Methods

We used a combined sample of 8,774 adolescent girls aged 15-19 years from the 2008, 2013, and 2019 Sierra Leone Demographic and Health Surveys (SLDHS), respectively, to estimate the modern contraceptive prevalence rate (MCPR) and unmet need for family …

Explaining Adult Obesity, Severe Obesity, And Bmi: Five Decades Of Change, Ashley W. Kranjac, Dinko Kranjac

Sociology Faculty Articles and Research

Obesity rates have increased across all segments of society since the late 1970s, but the reason behind population-level increases in body weight remains unclear. We used the 1971–2020 NHANES data to examine whether the observed trend in obesity prevalence is attributable to changing public health behaviors (i.e., intracohort change) or changing publics (i.e., cohort replacement). We partitioned total change in mean BMI, and rates of obesity and severe obesity, into its IC and CR components using linear and algebraic decomposition methods. We found that the IC mechanism (i.e., broad sectors of individuals changing) plays a dominant role in the overall …

Commencement, Philadelphia (2023), Philadelphia College Of Osteopathic Medicine

Commencements

Philadelphia Campus Commencement Program, 2023. Degrees include Doctor of Osteopathic Medicine, Doctor of Philosophy in Educational Psychology, Doctor of Psychology in Clinical Psychology, Doctor of Psychology in School Psychology, Educational Specialist in School Psychology, Master of Science in Applied Behavioral Analysis, Master of Science in Applied Positive Psychology, Master of Science in Biomedical Sciences, Master of Science in Forensic Medicine, Master of Science in Mental Health Counseling, Master of Science in Organizational Development and Leadership, Master of Science in Health Sciences - Physician Assistant Studies, Master of Science in Public Health Management and Administration, and Master of Science in School …

Co-Delivery Of Therapeutics And Bioactive Gas Using A Novel Liposomal Platform For Enhanced Treatment Of Acute Arterial Injury, Shao-Ling Huang, Melanie R Moody, Xing Yin, David D Mcpherson, Hyunggun Kim

Faculty, Staff and Student Publications

Atherosclerosis is a complex, multi-stage disease characterized by pathological changes across the vascular wall. Endothelial dysfunction, inflammation, hypoxia, and vascular smooth muscle cell proliferation contribute to its progression. An effective strategy capable of delivering pleiotropic treatment to the vascular wall is essential to limit neointimal formation. Echogenic liposomes (ELIP), which can encapsulate bioactive gases and therapeutic agents, have the potential to deliver enhanced penetration and treatment efficacy for atherosclerosis. In this study, liposomes loaded with nitric oxide (NO) and rosiglitazone, a peroxisome proliferator-activated receptor agonist, were prepared using hydration, sonication, freeze-thawing, and pressurization. The efficacy of this delivery system was …

Blockchain-Enabled Immutable, Distributed, And Highly Available Clinical Research Activity Logging System For Federated Covid-19 Data Analysis From Multiple Institutions, Tsung-Ting Kuo, Anh Pham, Maxim E Edelson, Jihoon Kim, Jason Chan, Yash Gupta, Lucila Ohno-Machado

Faculty, Staff and Student Publications

OBJECTIVE: We aimed to develop a distributed, immutable, and highly available cross-cloud blockchain system to facilitate federated data analysis activities among multiple institutions.

MATERIALS AND METHODS: We preprocessed 9166 COVID-19 Structured Query Language (SQL) code, summary statistics, and user activity logs, from the GitHub repository of the Reliable Response Data Discovery for COVID-19 (R2D2) Consortium. The repository collected local summary statistics from participating institutions and aggregated the global result to a COVID-19-related clinical query, previously posted by clinicians on a website. We developed both on-chain and off-chain components to store/query these activity logs and their associated queries/results on a blockchain …

Tempers Rising: The Effect Of Heat On Spite, Jake C. Cosgrove

Master's Theses

The relationship between heat and harmful outcomes is well documented, with research connecting various adverse economic outcomes to the climate. In the presence of increasing global warming and climate change, understanding why the climate leads to negative economic outcomes is essential for forming peaceful institutions of the future. We study how behavioral economic outcomes change in the presence of heat through a lab experiment involving 1,110 observations conducted in five different countries. This paper specifically focuses on the social preference outcome of spite. We find that increased time exposure to the treatment effect of heat is required to elicit an …

Immunometabolic Reprogramming, Another Cancer Hallmark, Vijay Kumar, John H. Stewart

School of Medicine Faculty Publications

Molecular carcinogenesis is a multistep process that involves acquired abnormalities in key biological processes. The complexity of cancer pathogenesis is best illustrated in the six hallmarks of the cancer: (1) the development of self-sufficient growth signals, (2) the emergence of clones that are resistant to apoptosis, (3) resistance to the antigrowth signals, (4) neo-angiogenesis, (5) the invasion of normal tissue or spread to the distant organs, and (6) limitless replicative potential. It also appears that non-resolving inflammation leads to the dysregulation of immune cell metabolism and subsequent cancer progression. The present article delineates immunometabolic reprogramming as a critical hallmark of …

Multi-Stakeholder Perspectives Regarding Preferred Modalities For Mental Health Intervention Delivered In The Orthopedic Clinic: A Qualitative Analysis, Abby L Cheng, Ashwin J Leo, Ryan P Calfee, Christopher J Dy, Melissa A Armbrecht, Joanna Abraham

2020-Current year OA Pubs

BACKGROUND: Although depressive and anxious symptoms negatively impact musculoskeletal health and orthopedic outcomes, a gap remains in identifying modalities through which mental health intervention can realistically be delivered during orthopedic care. The purpose of this study was to understand orthopedic stakeholders' perceptions regarding the feasibility, acceptability, and usability of digital, printed, and in-person intervention modalities to address mental health as part of orthopedic care.

METHODS: This single-center, qualitative study was conducted within a tertiary care orthopedic department. Semi-structured interviews were conducted between January and May 2022. Two stakeholder groups were interviewed using a purposive sampling approach until thematic saturation was …

Whole-Exome Sequencing Study Of Hypospadias, Zhongzhong Chen, Yunping Lei, Richard H Finnell, Yu Ding, Zhixi Su, Yaping Wang, Hua Xie, Fang Chen

Faculty, Staff and Students Publications

Hypospadias results from the impaired urethral development, which is influenced by androgens, but its genetic etiology is still unknown. Through whole exome sequencing analysis, we identified NR5A1, SRD5A2, and AR as mutational hotspots in the etiology of severe hypospadias, as these genes are related to androgen signaling. Additionally, rare damaging variants in cilia-related outer dynein arm heavy chain (ODNAH) genes (DNAH5, DNAH8, DNAH9, DNAH11, and DNAH17) (p = 8.5 × 10−47) were significantly enriched in hypospadias cases. The Dnah8 KO mice exhibited significantly decreased testosterone levels, which had an impact on …

Mass Spectrometry Imaging Reveals Abnormalities In Cardiolipin Composition And Distribution In Astrocytoma Tumor Tissues, Anna C Krieger, Luis A Macias, J Clay Goodman, Jennifer S Brodbelt, Livia S Eberlin

Faculty, Staff and Students Publications

Cardiolipin (CL) is a mitochondrial lipid with diverse roles in cellular respiration, signaling, and organelle membrane structure. CL content and composition are essential for proper mitochondrial function. Deranged mitochondrial energy production and signaling are key components of glial cell cancers and altered CL molecular species have been observed in mouse brain glial cell xenograft tumors. The objective of this study was to describe CL structural diversity trends in human astrocytoma tumors of varying grades and correlate these trends with histological regions within the heterogeneous astrocytoma microenvironment. To this aim, we applied desorption electrospray ionization coupled with high field asymmetric ion …

Neonatal Abstinence Syndrome (Nas): What You Need To Know, Maren Wright Wright Voss, Amelia Van Komen, Emily Hamilton, Aarica Cleveland, Jaclyn Miller

All Current Publications

National overdose deaths continue to rise, with 2021 marking the first time U.S. overdose deaths topped 100,000 in a 12-month timeframe. Substance use, such as alcohol, cocaine, opioids, and marijuana, during pregnancy is also increasing. As the U.S. struggles with harmful substance use, a growing number of infants are born with neonatal abstinence syndrome (NAS), a harmful outcome of fetal exposure to substances. This fact sheet will talk about why and what to do, with recommendations for safe treatment and support during pregnancy.

Joint Effect Of Human Papillomavirus Exposure, Smoking And Alcohol On Risk Of Oral Squamous Cell Carcinoma, Zheng Yang, Peng Sun, Kristina R Dahlstrom, Neil Gross, Guojun Li

Faculty, Staff and Students Publications

BACKGROUND: Smoking, alcohol consumption, and human papillomavirus (HPV) infection are known risk factors for oral squamous cell carcinoma (OSCC) including SCC of oropharynx (SCCOP) and SCC of oral cavity (SCCOC). Researchers have examined each of these risk factors independently, but few have observed the potential risk of their interaction. This study investigated the interactions among these risk factors and risk of OSCC.

METHODS: Totally 377 patients with newly diagnosed SCCOP and SCCOC and 433 frequency-matched cancer-free controls by age and sex were included. Multivariable logistic regression was performed to calculate ORs and 95% CIs.

RESULTS: We found that overall OSCC …