Investigative Techniques Commons^™

Validation Of Next‑Generation Sequencing‑Derived Circulating Mrna Variants As Potential Diagnostic Tools In Hepatocellular Carcinoma And Cholangiocarcinoma, Daniel Zezulinski, Maarouf A. Hoteit, David E. Kaplan, Tingting Zhan, Cataldo Doria, Timothy M. Block, Aejaz Sayeed

Department of Pharmacology, Physiology, and Cancer Biology Faculty Papers

Liquid biopsy can transform oncology practice through early detection and real‑time monitoring of cancer progression and response to treatment. Circulating cell‑free tumor RNA offers promise as a novel and emerging alternative to circulating cell‑free tumor DNA for detecting the presence and understanding the biology of liver tumors. Both circulating DNA and RNA, which predominantly reside in extracellular vesicles, carry evidence of vital germline and somatic mutations. High impact single nucleotide changes, insertions and deletions in circulating RNA (ctRNA) serve a key role in cancer development and progression. Tumor cells exploit the RNA splicing machinery to induce structural and functional changes …

Mitochondrial Trna-Derived Fragments As Candidate Metastasis-Modifying Rna, Katy L. Swancutt, R. Mckinnon Walsh, Sydney Quijano, Emily Schueddig, Devin C. Koestler, Adam D. Scheid, Tony Vanden Bush, Yi Jing, Isidore Rigoutsos, Danny R. Welch

Computational Medicine Center Faculty Papers

UNLABELLED: How mitochondrial DNA (mtDNA) polymorphisms influence complex phenotypes remains poorly understood. Using mitochondrial-nuclear exchange mice, we previously showed that mtDNA single-nucleotide polymorphisms (SNP) modify metastasis, cardiovascular disease, and epigenetic marks independently of metabolic differences. The only mtDNA SNP correlating with these phenotypes resides in the gene encoding mitochondrial transfer RNA (tRNA)-arginine [mt-tRNAArg (UCG), mt-TR], suggesting a role for non-protein-coding loci. In this study, we identify and preliminarily characterize previously undescribed tRNA-derived fragments (tRF) generated from mt-TRs. Northern blotting revealed distinct tRF that are differentially expressed among mtDNA SNPs, between lung and liver, and between sexes. Surprisingly, small RNA sequencing …

Crispr/Cas9-Based Genome Editing: Understanding Differences In Dna Repair Pathways, Profiles, And Outcomes, Samuel Effah, Shirley Barrera, Nahia Urturi Ortiz, Will Dampier, Michael Nonnemacher, Brian Wigdahl

Kimmel Cancer Center Faculty Papers

Over a decade of advances in Clustered Regularly Interspersed Short Palindromic Repeats (CRISPR) and CRISPR-associated protein 9 (Cas9)-based technologies have culminated in the first-ever FDA-approved CRISPR/Cas-based therapy. Aside from this approved therapy for sickle cell anemia, several CRISPR/Cas-based therapies are currently under development or testing for a range of chronic diseases, including viral diseases like human immunodeficiency virus type 1 (HIV-1) infection, genetic diseases like familial hypercholesterolemia, and cancer. The success of these therapies hinges on the effective delivery of CRISPR/Cas9 components to target regions, efficient Cas endonuclease editing, repair profiles generated, and their resulting outcomes. Here, we discuss the …

Expanding Access To Noninvasive Spinal Neuromodulation For Pediatric Spinal Cord Injury Rehabilitation: A Comparative Device Study, Alice E C Palmer

College of Arts & Sciences Senior Theses

Paralysis following spinal cord injury (SCI) has traditionally been considered permanent due to the disruption of supraspinal input to spinal motor circuits. However, growing evidence suggests that spinal networks below the level of injury retain intrinsic motor-generating capabilities through central pattern generators. Transcutaneous spinal cord stimulation (scTS) is a noninvasive neuromodulation technique that delivers electrical stimulation through the skin to reactivate these spinal networks. Although prior studies demonstrate that scTS delivered through research-grade devices is safe and effective in adults and children with chronic SCI, clinical translation remains limited by lack of FDA-approved systems, high costs, and restricted access to …

Spectral Characterization Of Colorectal Cancer Using Excitation-Scanning Hyperspectral Imaging, Natalie Hadad

Honors Theses

Colorectal cancer is one of the most common and deadly cancers worldwide, with a lifetime risk of approximately one in twenty-three for men and one in twenty-five for women. Although early detection significantly improves survival, current diagnostic approaches such as tissue biopsy are invasive, reliant on subjective interpretation, have extended turnaround times, and risk missing flat or depressed lesions that are more difficult to detect than raised polyps. These limitations highlight the need for objective, minimally invasive technologies capable of detecting early tissue changes. This study investigates excitation-scanning hyperspectral imaging (Ex-HSI) as a label-free optical approach for identifying colorectal cancer–associated …

Novel Biomarker Discovery In Multiple Sclerosis, Manisha Gangasani

Honors Theses

Multiple Sclerosis (MS) is a chronic neuroinflammatory disorder affecting the brain, spinal cord, and optic nerve. Patients experience cognitive, motor, autonomic, and emotional symptoms that often overlap with other neurological conditions, making early diagnosis challenging. Current diagnostic criteria require evidence of lesions with dissemination in time and space. Racial disparities in MS outcomes are well documented, with Black individuals often exhibiting greater disease severity, higher relapse rates, and increased disability compared to White individuals. These differences likely reflect a combination of genetic, biological, environmental, and healthcare access factors, underscoring the need to improve early diagnosis and reduce inequities in care. …

Developing A Protocol For Non-Cellular Transplantation Of Donor Mitochondria Into Recipient Cells, Andrew Parton

Honors Theses

Tumor innervation has emerged as a critical feature of cancer progression, with increased nerve density correlating with enhanced aggressiveness, metastatic dissemination, and poor clinical outcome. However, the functional contribution of neurons to tumor biology remains incompletely defined. We recently identified the intercellular transfer of mitochondria from neurons to cancer cells as a mechanism that promotes tumor progression. We therefore hypothesized that disruption of this transfer could attenuate tumor aggressivity. To directly investigate this process, we developed an approach to isolate mitochondria from donor cells and transplant them into recipient cancer cells independently of canonical cell-cell interactions. Transferred mitochondria were tracked …

Microarray Analysis Of Human Abdominal Aortic Aneurysm With Emphasis On Cardiovascular Genes Revealed Differentially Expressed Genes, Song Lu, Li Ping Li, John V. White, Xiaoying Zhang, Ifeyinwa Nwaneshiudu, Adaobi Nwaneshiudu, Nectaria Ntaoula, John Gaughan, Dimitri S. Monos, Wan-Lu Lin, Charalambos C. Solomides, Emilia L. Oleszak, Chris D. Platsoucas

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

BACKGROUND/AIM: We examined gene expression profiles in abdominal aortic aneurysm (AAA) lesions vs. normal aortas by cDNA microarray and real-time quantitative reverse-transcriptase polymerase chain reaction (qRT-PCR).

MATERIALS AND METHODS: Phosphorus (³²P)-labeled cDNA from AAA specimens (mean AAA size 6.65 cm) and normal aortas were hybridized with a 588-gene microarray primarily of the cardiovascular system. The results were validated by qRT-PCR.

RESULTS: A total of 35 out of the 588 genes were differentially expressed, with either log₂ ratio of AAAs/controls ≥1 (upregulated; 20 genes) or ≤-1 (downregulated; 15 genes) in AAA lesions vs. normal aorta, and …

Suture Augmentation With Ucl Repairs In Baseball Pitchers As An Alternate To Reconstructions: An Evidence-To-Practice Review, Kayleigh A. De Koker, Kenneth E. Games

Clinical Practice in Athletic Training

An injury to the ulnar collateral ligament (UCL) is sustained through repetitive valgus motions, increasing in prevalence across all levels of baseball due to the increasing workload demands placed on the medial elbow in pitching. Traditionally, UCL tears have been managed through reconstructions followed by a lengthy rehabilitation process. In recent years, the UCL repair with suture augmentation has gained favor given the enhanced patient and clinician outcomes in return-to-play timelines, decreased medial gapping, improved Kerlan Jobe Orthopedic Clinic (KJOC) scores, and long-term functionality. Utilizing 4 databases (MEDLINE, Embase Cochrane library, Science Direct, and Scopus), literature was obtained addressing the …

Prescribed Aerobic Exercise And Sport-Related Concussion Recovery: A Validation Case Series, Lacy L. Chapel, Tamara C. Valovich Mcleod

Clinical Practice in Athletic Training

Active rehabilitation, including prescribed sub-symptom threshold aerobic exercise implemented during the acute phase of recovery after sport-related concussion, has been shown to facilitate recovery and reduce the risk of persisting postconcussion symptoms. The purpose of this validation case series was to evaluate currently available external evidence regarding the effects of prescribed aerobic exercise interventions on recovery after sport-related concussion. For this study, the patient population included college athletes diagnosed with a sport-related concussion who participated in at least 5 days per week of supervised, prescribed aerobic exercise, based on graded aerobic exercise testing and heart rate threshold. Our study findings …

A Review Of Mentorship And Recruitment Strategies For Minority Athletic Training Students, Dariana M. Brown

Clinical Practice in Athletic Training

The underrepresentation of minority athletic trainers remains a critical issue, affecting both the profession and the quality of patient care. While patient demographics continue to diversify, the athletic training workforce has not kept pace, leading to potential communication barriers, mistrust, and inadequate culturally competent care. This review examines whether culturally tailored mentorship programs and targeted recruitment initiatives improve retention, career satisfaction, and diversity in athletic training compared to standard methods. By analyzing studies on underrepresented minority students in athletic training, the review highlights key institutional barriers and systemic factors impacting recruitment and retention. Findings suggest that tailored mentorship and supportive …

Acute Management Of A Hamate Fracture In A Collegiate Baseball Player: A Disablement Model Case Study, Kayleigh A. De Koker, Cory E. Barton, Lindsey E. Eberman

Clinical Practice in Athletic Training

The purpose of this disablement model case study was to outline a collegiate baseball player with an isolated hamate fracture including the injury evaluation, diagnosis, and acute management. During a tournament game, the collegiate career of the patient ended abruptly following an injury sustained while at bat. The patient attempted to bat again but encountered significant difficulty due to the increasing pain in his hand. Consequently, the athletic trainer was called out for an on-field examination. The patient presented with no edema or ecchymosis but severe pain in the hypothenar eminence. This patient also presented with decreased grip strength with …

Evaluating Forearm Strength Variability In Collegiate Tennis Players Over The Course Of A Competitive Season, Jeffrey Williams, Payton Jensen, Kevin Laudner

Clinical Practice in Athletic Training

The muscles of the forearm undergo routine, forceful, and repetitive contractions while playing tennis and may experience adaptive changes that can precede injury. An understanding of forearm strength profiles of tennis players following a competitive season would assist clinicians’ evidence-based management of the forearm’s readiness for training, competition, and return-to-sport participation. Therefore, the purpose of this study was to explore the effects of a competitive tennis season on forearm strength among collegiate tennis athletes. A prospective, case-series design was used to examine a convenience sample of 15 asymptomatic NCAA Division I tennis players (males = 10, height = 182.88 [SD …

Quality Of Athletic Training Services For Lower Extremity Injuries, Katie Sniffen, Michael Rozier, Katherine Stamatakis, Paula Buchanan, Janet E. Simon, Leslie Hinyard

Clinical Practice in Athletic Training

The use of patient-reported outcomes in athletic training is inconsistent, limiting the ability to communicate service quality and value to key stakeholders. The objective of this study is to calculate meaningful quality outcome measures for athletic training services for lower extremity injuries in high school student-athletes. Data were collected from a subset of the National Athletic Treatment, Injury and Outcomes Network Surveillance Program and a convenience sample of high school student-athletes with patient-reported outcome measures for lower extremity time-loss injuries. Failure-toprogress proportions (FTPPs) were calculated using the Knee Injury and Osteoarthritis Outcome Score (KOOS) for knee/thigh injuries and the Foot …

Recurrent Urinary Tract Infections In An Elite Level Diver: A Disablement Model Case Study, Matt O'Sullivan, Dominique M. Stevens, Lindsey E. Eberman

Clinical Practice in Athletic Training

This article presents a case of complicated and recurrent pyelonephritis, an infection of 1 or both kidneys, in an elitelevel diver. Urinary tract infections (UTIs) are among the most common outpatient infections in the United States; most are uncomplicated and resolve without significant mortality or morbidity. However, UTIs have the potential to present significant clinical challenges if the UTI becomes complicated or recurrent. Additionally, recurrent UTIs can carry a significant burden to both the individual patients and the larger healthcare system. The current paper reviews the epidemiological literature surrounding UTIs, the significant impact they have on a patient’s health-related quality …

Comfort Level Of Collegiate Student-Athletes In Opposite And Same-Gender Patient/Provider Relationships In Athletic Training, Samantha Dickie, Yashu Tang, Sydney Nelson, Emily Madrak

Clinical Practice in Athletic Training

Gender-based comfort in patient-provider relationships is a vital aspect of athletic training care. As the profession continues to evolve—particularly with a growing number of women athletic trainers (ATs) and progression of athletic training curriculum—it is essential to understand how gender dynamics influence the comfort of collegiate athletes when receiving care. This cross-sectional survey study examined how athlete comfort varies when treated by same- versus opposite-gender ATs in general patient care and in pathology-based scenarios. Ninety-six collegiate student-athletes (62.5% female) with the mean age of 20.26 (SD 1.7) years from NCAA and NAIA institutions completed the Gender Comfort with Athletic Trainer …

Comparison Of Vibrating And Non-Vibrating Foam Roller On Hamstring Range Of Motion, Rakhoon Sung, Portia B. Resnick, Karen G. Roos, Mimi Nakajima

Clinical Practice in Athletic Training

Tightness in the distal hamstring is a common complaint among active individuals. While a foam roller is used to release muscle tension, there are limited studies about the effect using a vibrating foam roller (VFR) on hamstring flexibility and knee range of motion (ROM). For this reason, the purpose of the research was to compare the effect of a VFR and nonvibrating foam roller (NVFR) on hamstring flexibility and knee ROM in active college students. It was hypothesized that there would be more improvement in hamstring flexibility and knee ROM with a VFR than an NVFR. A randomized controlled trial …

Breaking Into Hiv-1'S Epigenetic Vault: Cure Strategies To Eliminate The Viral Reservoir, Joanna Jones, Chelsea Gunderson, Brian Wigdahl, Michael Nonnemacher

Kimmel Cancer Center Faculty Papers

Human immunodeficiency virus type 1 (HIV-1) is a retrovirus that integrates into the host cell's DNA as a provirus. Transcription from the provirus is regulated in large part by cellular proteins and epigenetic factors. These may be repressive or permissive to productive infection. The host factors that regulate this balance are therefore attractive targets for HIV-1 therapeutics. Indeed, proviral chromatin is the focus of two of the current HIV-1 cure strategies. "Shock and Kill" uses latency reversal agents to open the provirus's chromatin, promoting high levels of gene expression that induce the killing of infected cells. "Block and Lock" uses …

Differences Between Sexual Orientations Regarding Perceived Knowledge Of And Attitudes Toward Lgbtia+ Persons Among Athletic Trainers, Julianne Goza, S. Andrew Cage, Meredith Decker, Brandon J. Warner

Clinical Practice in Athletic Training

Context: LGBTQIA+ athletic trainers and patients encounter difficulties in their workplaces and sport communities. Several medical professional associations have produced statements claiming their commitment to fostering an patient-centered environment for healthcare for LGBTQIA+ patients. To date, there has been little research on the factors that impact perceived knowledge of and attitudes toward the LGBTQIA+ community among healthcare providers. With more information on what factors impact perceived knowledge of and attitudes toward the LGBTQIA+ community, better interventions for improving perceived knowledge and attitudes toward the LGBTQIA+ community could be created. The purpose of this study was to determine differences between sexual …

Awareness Of Native American Living Conditions Among Athletic Trainers, Laurel Trail, Brandon Warner, Rebecca Peebles, Robert French, Lynzi Warner, S. Andrew Cage

Clinical Practice in Athletic Training

Context: Native Americans and First Nations People have dealt with healthcare disparities that have been documented in previous studies. One factor that appears to have played a role in these disparities was the Indian Removal Act of 1851 which established the first Native American reservations. The foundation of these reservations led to many Native Americans being displaced from areas where the United States was establishing new population centers. This has led many individuals not understanding the conditions that Native Americans live in. Lack of knowledge of the conditions patients live in may negatively affect clinicians’ ability to provide optimal healthcare. …

Ulnar Collateral Ligament Reconstruction Compared To Common Flexor Tendon Repair With Ulnar Collateral Ligament Reconstruction: A Case Series, Amanda Dubois, Melissa Long

Clinical Practice in Athletic Training

Introduction: The ulnar collateral ligament (UCL) is found in the medial aspect of the elbow joint capsule and is commonly injured in baseball pitchers. The common flexor tendon (CFT) is also found in the medial elbow and is less commonly injured. Both structures are key in overhead throwing, repaired via surgery, and injured due to valgus stress placed on the elbow. There is research on UCL injuries but very little on CFT injuries. There is not substantial research on the return to play protocol or rehabilitation process for either of these two structures after surgery. Patient Information: The patients for …

Impressions And Gastrointestinal Tolerance Of An Electrolyte Hydration Beverage Among Individuals Participating In Collegiate Baseball, S. Andrew Cage, Alexander Jacobsen, Brandon Warner, Jessie Gibson, Derek Lege, Robert French

Clinical Practice in Athletic Training

Context: Performing physical activity in numerous environmental conditions often results in mild to moderate dehydration. Dehydration can be problematic for the physically active population, as it can lead to decreases in physical and cognitive performance. This places emphasis on making sure individuals are properly hydrated during exercise. One of the barriers to appropriate hydration behaviors that has been identified in physically active individuals is a dislike of available hydration options. This highlights the need for sports medicine professionals to provide physically active individuals with appealing hydration options. Currently there is a lack of research exploring the flavor appeal of hydration …

Differences Between Genders Related To Perceived Knowledge Of And Attitudes Toward Lgbtia+ Persons Among Athletic Trainers, Brandon J. Warner, Julianne Goza, Meredith Decker, S. Andrew Cage

Clinical Practice in Athletic Training

Context: Previous literature reports that healthcare providers and student-athletes identifying as LGBTQIA+ encounter difficulties in their respective communities. A number medical professional associations have published statements affirming their commitment to providing access to patient-centered healthcare for LGBTQIA+ patients. Unfortunately, there is a lack of research related to the factors that influence perceived knowledge of and attitudes toward the LGBTQIA+ community among healthcare providers. More information on what factors impact perceived knowledge of and attitudes toward the LGBTQIA+ community would assist with creating interventions that improve perceived knowledge and attitudes toward the LGBTQIA+ community. The purpose of this study was to …

Hyoid Bone Fracture In A Division 1 Football Player: A Conservative Management Case Study, Kynnedy Louis, Andrew Crane, Mark Knoblauch, Layci Harrison

Clinical Practice in Athletic Training

Introduction: The hyoid bone plays an important role in speaking, swallowing, and supporting the tongue. Hyoid bone fractures account for 0.002% of all fractures and are typically seen in cases dealing with strangulations or a blunt force trauma such as occurs from vehicle accidents or martial arts injuries. Signs and symptoms of hyoid fractures can include dyspnea, pharyngeal tear, or subcutaneous emphysema, and if not recognized early can significantly damage the airway. Patient Information: A 23-year-old male collegiate football player sustained blunt trauma to the anterior part of his neck due to a tackle forcing the helmet chin strap against …

Sleep And Stress Experienced By Collegiate Baseball Players During A Fall Season, Andrew R. Gallucci, Katie M. Lee, Eric Rash, Jeremy A. Bigalke, Jason R. Carter

Clinical Practice in Athletic Training

Introduction: College students are notoriously poor sleepers due to academic and social demands. Collegiate athletes have additional athletic responsibilities that can also affect sleep. During a season, baseball players experience prolonged bouts of high intensity activity that increase the need for recovery and sleep. Athletes can also experience higher perceived stress levels, a factor also known to impact sleep. Reduced sleep quality and quantity during a competitive season can impede recovery and decrease performance. The present study sought to determine the relationships between sleep [Total Sleep Time (TST), Sleep Efficiency (SE), Sleep Onset Latency (SOL), Awakenings] and stress over a …

Extensor Hallucis Longus Focal Dystonia In A Patient With Parkinson’S Disease: A Case Study, Jessika Truax, Linda Bobo, Keilea Sumrall

Clinical Practice in Athletic Training

Introduction: Parkinson’s Disease (PD) is a common neurodegenerative disorder that affects a person’s ability to produce dopamine and control motion of the body. PD affects 1% of people over the age of 65, but the disease can occur earlier and later in life. The uncontrollable movement of any body part involved with PD is referred to as a tremor. Pathophysiology of PD causes the thalamus to have a decreased activation of the frontal cortex, thus decreased motor activity. Patients commonly have dystonia mostly in the foot resulting in striatal toe. Optional pain relief is a tenotomy of the extensor hallicus …

Sacroiliac Dysfunction In A Middle-Aged Female Runner: A Case Study, Blair Bradshaw

Clinical Practice in Athletic Training

Introduction: Research has indicated an increased prevalence of low back pain (LBP) due to SIJ dysfunction, with some reports suggesting it is the main source of pain in 15- 30% of cases. Women are more prone to incidence of SIJ pain due to a wider, more uneven, less curved, and posteriorly rotated sacrum. Additionally, women have increased mobility at the SIJ which increases stress and shear loading. Repetitive loading such as running can further contribute to SIJ dysfunction. Research suggests that female runners with SIJ pain had common biomechanical patterns putting them at more risk for injury including decreased knee …

Breaking Barriers: Disparities Among Minority Collegiate Athletes In Concussion Reporting, Josette Villanueva, Melissa Long

Clinical Practice in Athletic Training

Introduction: Concussions are a serious concern in sports medicine because of their potential long-term effects on cognitive and neurological health. However, many athletes, especially those from minority groups, hesitate to report symptoms due to fears of being sidelined, pressure to keep playing, and challenges like limited access to education, language barriers, and distrust in healthcare systems. The objective of this study was to investigate the barriers to concussion reporting among Division I collegiate athletes, with a particular focus on demographic differences, particularly racial and ethnic disparities. The goal was to identify key factors that hinder self-reporting and to propose strategies …

Overcoming Thoracic Outlet Syndrome In A Young Athlete: A Case Study, Cormia Lewis, Christina Fry, Mark Knoblauch, Layci Harrison

Clinical Practice in Athletic Training

Introduction: Thoracic Outlet Syndrome (TOS) is a rare and complex condition caused by the compression of neurovascular structures in the thoracic outlet. TOS is estimated to affect 3 to 80 individuals per 1,000,000 annually, with neurogenic TOS accounting for approximately 95% of cases. Athletes who perform repetitive overhead motions are at higher risk due to increased stress on the brachial plexus. Diagnosis can be challenging as symptoms such as pain, numbness, and weakness, often mimic other conditions such as nerve entrapment or tendon pathologies. Treatment for TOS typically begins with a conservative approach, including postural correction and strengthening, activity modification, …

Athletic Trainers’ Motivations For And Satisfaction With Transition To The Physician Practice Setting, Abigail G. Overstreet, Nicolette A. Harris, Cailee E. Welch Bacon

Clinical Practice in Athletic Training

An increasing number of athletic trainers are transitioning from traditional settings, such as secondary schools, colleges, universities, and professional sports, to physician practice. Although research suggests athletic trainers may be changing settings in search of better working conditions, little is known about their motivations for and satisfaction with the setting transition. The objective of this research was to explore athletic trainers’ motivations for and satisfaction with transition to the physician practice setting. A qualitative design was used to collect and interpret data. Eleven certified athletic trainers (6 women, 5 men; age 1⁄4 38.5 6 10.0 years) who transitioned from a …