Diseases Commons^™

Validation Of A Real-Time Pcr Laboratory Developed Test For The Detection Of Pneumocystis Jirovecii In Bronchoalveolar Lavage Samples, Caitlyn Moon

Honors Scholar Theses

Pneumocystis jirovecii is an opportunistic, host-obligate fungal pathogen responsible for causing P. jirovecii pneumonia (PJP) in humans. PJP is treated with trimethoprim-sulfamethoxazole (TMP-SMX), a strong broad-spectrum antibiotic that carries risk of renal and hepatotoxicity. Therefore, rapid diagnosis or exclusion of PJP is crucial to ensure PJP-positive patients receive effective treatment and PJP-negative patients avoid unnecessary antibiotics. Unlike most microorganisms, P. jirovecii cannot be cultured, presenting complications for the typical methods of diagnosing fungal pathogens. Historically, the gold standard for diagnosis was direct microscopic examination with stains such as methenamine silver and calcofluor white, but this diagnostic technique requires highly skilled …

Play To Win: A Randomized Controlled Trial To Assess The Effects Of Play-Based Training On Upper Extremity Function In Children With Hemiplegia, Vivian London

Honors Scholar Theses

Hemiplegia, or paralysis of one side of the body, is the primary symptom of unilateral cerebral palsy, a subtype of cerebral palsy, the most common movement disorder in children. Standard of care is regular physical and occupational therapy to improve performance in bimanual activities, but conventional therapy can be expensive and draining for caregivers and children, so a need exists for a novel intervention that can take place at home and that is economical for families while being engaging for children. This thesis reports data from a subset of ten children seen as part of a randomized controlled clinical trial …

Safety And Efficacy Of Individualised Exercise And Nad+ Precursor Supplementation In Patients With Friedreich’S Ataxia In The Usa: A Single-Centre, 2 × 2 Factorial, Randomised Controlled Trial, Kimberly Lin, Anna Bucha, Kara Mcsweeney, Kristin Wade, Antoneta Karaj, Jaclyn Tamaroff, Shannon O'Malley, Nicole Chung, Nicolette Cilenti, Julianne Wanner, Gabriel Adzika, Clementina Mesaros, Ian Blair, Teerapat Rojsajjakul, Suraj Serai, Jennifer Farmer, Kyle Bryant, Yingying Lu, Michael Harhay, David Weber, Stephen Paridon, Erin Seifert, Mary Putt, Payman Zamani, Joseph Baur, David Lynch, Shana Mccormack

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

BACKGROUND:Friedreich's ataxia is a rare, chronic, progressive, neurodegenerative condition affecting multiple organ systems, including neurological, musculoskeletal, cardiac, and endocrine systems, and is marked by low cardiopulmonary fitness. We tested the effect of exercise and NAD⁺ precursor supplementation with nicotinamide riboside, which have each shown benefits in animal and early clinical studies, on cardiopulmonary fitness in individuals with Friedreich's ataxia.

METHODS: This 12-week, outpatient, phase 2, single-site (Children's Hospital of Philadelphia, Philadelphia, PA, USA), randomised, 2 × 2 factorial clinical trial recruited individuals aged 10–40 years with an ejection fraction of 45% or greater who were able to exercise. A …

Sepsis As An Immune Continuum: Cytokine Storm To Lymphopenia And Pics, Chelsey King

Senior Honors Theses

Sepsis is a leading cause of morbidity and mortality worldwide, driven by a dynamic immune continuum that progresses from early hyperinflammation to profound immunosuppression. This review examines the three overlapping phases of sepsis: the inflammation-mediated cytokine storm driven by dysregulated PRR activation, NF-κB signaling, and NETosis; apoptosis-driven lymphopenia involving caspase-mediated lymphocyte death, dendritic cell dysfunction, and metabolic exhaustion; and prolonged immunoparalysis culminating in persistent inflammation, immunosuppression, and catabolism syndrome (PICS). Key mechanisms linking these phases, including the co-existence of hyper- and hypo-inflammatory states, are synthesized alongside relevant clinical biomarkers such as IL-6, HLA-DR, and single-cell immune profiles. This review highlights …

Mechanisms Of Binding And Immune Escape Resistance For Broadly Neutralizing Antibodies Targeting Distinct Conserved Sars-Cov-2 Spike Epitopes: A Hierarchical Approach Integrating Mutational Profiling And Energy Landscape Analysis, Mohammed Alshahrani, Will Gatlin, Max Ludwick, Lucas Turano, Brandon Foley, Gennady M. Verkhivker

Mathematics, Physics, and Computer Science Faculty Articles and Research

The continued evolution of SARS-CoV-2 has enabled an escape from most monoclonal antibodies, yet a subset of broadly neutralizing antibodies targeting three newly identified super-conserved RBD epitopes—SCORE-A, SCORE-B, and SCORE-C—retains remarkable activity against even the most recent JN.1-derived sublineages. Here, we employed an integrated computational framework combining conformational dynamics, mutational scanning, MM-GBSA binding energetics, and frustration profiling to dissect the molecular mechanisms by which XGI antibodies achieve broad neutralization and resistance to immune escape. Structural analysis revealed that all three SCORE epitopes share a common architecture: a highly conserved, minimally frustrated core that provides stable anchoring, flanked by peripheral regions …

Improving Glp-1 Ra Initiation In Primary Care Through A Paper-Based Clinical Decision Support Tool, Carissa R. Bowery, Karen Carver

Epsilon Sigma at-Large Research Conference

Title: Improving GLP-1 RA Initiation in Primary Care Through a Paper-Based Clinical Decision Support Tool

Authors: Carissa R. Bowery, MSN, FNP-C; East Tennessee State University College of Nursing. Karen M. Carver, PhD, APRN, FNP-C; East Tennessee State University College of Nursing

This quality improvement project focuses on improving evidence-based pharmacologic management of adults with type 2 diabetes mellitus (T2DM) and obesity through implementation of a paper-based clinical decision support (CDS) tool in primary care. The aim is to increase initiation of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) among eligible patients and improve provider adherence to current clinical guidelines.

Processes: This …

The Impact Of Normothermic Regional Perfusion Compared With Cold Storage On Warm Ischemia Time In Donation After Circulatory Death Organ Transplantation: A Scoping Review, Chris Turner

Student Works

ABSTRACT

2.Structured summary:

Background: Donation after circulatory death (DCD) has expanded the donor pool but introduces an inevitable period of warm ischemia that threatens graft viability. Preservation techniques such as normothermic regional perfusion (NRP) and static cold storage (SCS) aim to minimize this injury and improve transplant outcomes.

Objective: This scoping review identifies and synthesizes published evidence comparing NRP with SCS in DCD organ transplantation, focusing on their respective effects on warm ischemia time, graft function, and early post‑transplant outcomes.

Methods: Following the PRISMA‑ScR framework [23], searches were conducted in MEDLINE, PubMed, Embase, and Scopus for English‑language studies involving DCD …

Ms-Gator: Multi-Scale Graph Attention With Topological Reasoning For Segmentation And Classification Of Prostate Cancer Based On Gleason Scores Using Histopathology Images, Sujata Patil, Mahadeva Swamy, Kavitha Sooda, Rajanikanth Vadigepalli, Khalid Nazim Abdul Sattar, Md Rafeeq

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Prostate cancer is one of the prevalent and potentially fatal malignancies, affecting men globally. Accurate segmentation and classification of prostate cancer in histopathology images remain challenging due to complex tissue architecture, staining variability, and high inter-observer differences in manual diagnosis. To address these challenges, this research proposes a Multi-Scale Graph Attention with Topological Reasoning (MS-GATOR) for segmentation and classification of prostate cancer based on Gleason Scores (GS). The MS-GATOR incorporates topological reasoning with hierarchical biological structures by constructing a graph-based representation among three spatial scales such as nuclei, glands, and tissues using Delaunay triangulation to capture both geometric and photometric …

Brain Delivery Of Antibody-Derived Biologicals For Alzheimer’S Disease: An Updated Narrative Review, Rachita K. Sumbria, Ruben J. Boado

Pharmacy Faculty Articles and Research

Antibodies directed against β-amyloid (Aβ) have been developed for the treatment of Alzheimer’s disease (AD). However, the in vivo central efficacy is reduced by the poor penetration of antibodies across the blood–brain barrier (BBB). In addition, these antibodies have been associated with adverse effects like amyloid-related imaging abnormalities. Thus, the development of new antibody-based therapies for AD with improved transport across the BBB may improve efficacy and reduce adverse effects. Antibodies targeting the BBB transferrin receptor (TfR) are able to cross the BBB through receptor-mediated transcytosis, producing a global distribution throughout the brain. Along the same line, bispecific antibodies directed …

A “Found-Down” Non-Traumatic Compartment Syndrome Of Upper Extremity Requiring Amputation, Nicholas Ray, Aileen Ebadat

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

Bilateral Intracranial Subdural Hematoma Following Epidural Anesthesia, Eric B. Cox, Adaeza Onuoha

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

Selfwrap-Assisted Arteriovenous (Save) Fistulas Study: Updates And Preliminary Safety Data, Sydney Parker, Ahmad Lambert, Shir Yelovitch, Mike Barakat, Tim Boire, Ryan Turley

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

Dual Antiplatelet Therapy And Bleeding Risk In Carotid Endarterectomy, Sara Khan, Sydney Parker, Ryan Turley

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

When A Copper Iud Crosses Boundaries: Colo-Uterine Fistula With Sepsis, Melissa Cullum, Victoria Roberts, Linda Haddox

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

Reducing Surgical Site Infection After Colorectal Surgery: A Multidisciplinary Review Of Process Improvement, Robin Daemmrich, Quentin Dipasquale, Deborah Klepac, Nick Mathers, Travis Holloway

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

Diagnostic Challenges And Surgical Management Of A Cervical Ectopic Pregnancy Mimicking Cesarean Scar Implantation, Xena Morataya, Laura Reguero, Uti Essien, Stacy Sassaman, Jorge Venegas

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

The Role Of Intravascular Ultrasound Imaging In 30-Day Readmissions Among Acute St-Elevation Myocardial Infarction Patients, Britta Watson

MUSC Theses and Dissertations

Cardiovascular disease (CVD) remains one of the leading causes of death in the United States. Coronary artery disease (CAD) is the largest contributor to deaths that result from cardiovascular disease. When CAD is left untreated, it can result in an acute ST elevation myocardial infarction (STEMI). To treat coronary blockages caused by CAD, a percutaneous coronary intervention (PCI) is performed. A PCI is a non-invasive procedure that uses coronary balloons and stents to open a narrowed or blocked coronary artery and restore blood flow.

An acute ST elevation myocardial infarction (STEMI) is a major cause of early hospital readmissions. Technological …

Improving Anesthesia Provider Confidence In The Identification, Management, And Treatment Of Postoperative Delirium, Brittany M. Whistle, Charles Dustin Phelps

Scholars Week

Purpose: Postoperative Delirium (POD) is a potentially devastating complication of anesthesia that is poorly understood by clinical staff leading to poor outcomes for surgical patients. This study is meant to determine if a focused knowledge presentation accompanied by visual aids could increase anesthesia providers confidence in identifying, diagnosing, and treating Postoperative Delirium.

Methodology: Utilizing a statistical model to analyze respondents results on a standardized test administered before and after an informational presentation with visual aids on the topic of Postoperative Delirium.

Results: Results indicated a statistically significant difference between pretest and posttest scores, with a p-value of .002, t(11) = …

Effect Of Pre-Training Patients Using A Self-Directed Slideshow Presentation On Visual Field Reliability In First-Time Test Takers, Lillian M. Centlivre B.S., Derek Zahnleuter B.S., Rahul Babu B.S., Chaesik Kim, Kaitlin Ziadeh Md, Hanna Simmons Md, Vivian Rajeswaren Md, Aleskey Parker Williams Do, Jacob Im Md, Aleksey Mishulin Md, Faisal Ridha Al-Timimi Md, Hassan Tokko

Medical Student Research Symposium

Title: Effect of Pre-Training Patients Using a Self-Directed Slideshow Presentation on Visual Field Reliability in First-Time Test Takers

Authors: Lillian Centlivre BS, Derek Zahnleuter BS, Rahul Babu BS, Chaesik Kim BSEE, Kaitlin Ziadeh MD, Hanna Simmons MD, Vivian Rajeswaren MD, Aleksey Parker Williams DO, Jacob Im MD, Aleksey Mishulin MD, Faisal Ridha Al-Timimi MD, Hassan Tokko MD

Background: Visual field (VF) testing is essential for detecting glaucoma, but reliability is limited by patient inexperience and poor fixation. Prior studies report VF test reliability around 59%, primarily attributed to increased fixation loss (FL). Other studies note 75.9% reliability using training videos …

Selective Retention Of Birdshot Pellets In The Rearfoot: A Case Demonstrating Tissue Preservation And Functional Recovery, Yasim Zafar, Steven Bolton, Alexandria Armstrong, Hooman Mir

School of Podiatric Medicine - Student Research

Level of Evidence: III (Case Study)

Statement of Purpose: Gunshot wounds to the foot pose a unique surgical dilemma—whether to pursue aggressive foreign body removal or to preserve soft tissue integrity. This case highlights the management of a birdshot injury to the rearfoot where selective non-removal of pellets near the neurovascular bundle led to complete healing and full functional recovery. The purpose is to emphasize tissue preservation over aggressive exploration in complex ballistic foot injuries.

Case Study: A 26-year-old female sustained a birdshot gunshot wound to the right rearfoot. Multiple small entry wounds were noted on the posterior and plantar …

Pre-Operative Antiplatelet Therapy Is Associated With Increased Risk Of Periprosthetic Joint Infection Following Total Shoulder Arthroplasty, Muhammad Hamza Ilyas, Mohammad Daher, Viraj Deshpande, Adam Lindsay, Joseph A. Abboud, Hafiz F. Kassam

Rothman Institute Papers

Background Antiplatelet therapy is widely prescribed for the prevention and management of cardiovascular disease and for mitigation of thromboembolic risk. However, its impact on post-operative periprosthetic joint infection (PJI) following total shoulder arthroplasty (TSA) remains poorly defined.MethodsA retrospective cohort study was conducted using the TriNetX US Research Network. Propensity score matching was performed to balance demographics, body mass index, and Charlson Comorbidity Index variables. The primary outcome was the incidence of PJI at 90 days, 6 months, and 1 year. Secondary outcomes included post-operative medical and surgical complications. Comparative risk was quantified using risk ratios with 95% confidence intervals. Subgroup …

Gene-Agnostic Therapeutic Strategies For Inherited Retinal Diseases: Neuroprotection And Immunomodulation, Lucas W. Rowe, S. Patricia Becerra, Robert E. Maclaren, Robert L. Avery, Charles C. Wykoff, Allen C. Ho, Carl D. Regillo, Dean Eliott, Andrew Osborne, Katie M. Binley, Thomas A. Ciulla

Wills Eye Hospital Papers

Background/Objectives: Inherited retinal diseases (IRDs) represent a genetically heterogeneous group of disorders caused by mutations in over 280 genes with more than 3100 identified variants. While gene-specific replacement therapies have achieved landmark success with voretigene neparvovec (Luxturna) for biallelic RPE65-associated retinal dystrophy, developing individual therapies for each genetic subtype remains impractical. This review examines gene-agnostic therapeutic approaches utilizing neuroprotection and immunomodulation that target common pathophysiological mechanisms shared across multiple IRD genotypes. Methods: We reviewed the literature on neuroprotective and immunomodulatory gene therapy strategies for IRDs, focusing on neurotrophic factors and complement system modulation. Results: Neuroprotective approaches delivering neurotrophic factors—including pigment …

Transcranial Alternating Current Stimulation As An Adjuvant For Nonfluent Aphasia: A Proof-Of-Concept Study, Lynsey M. Keator, Lisa Johnson, Roger Newman-Norlund, Kyler Spell, Samaneh Nemati, Leigh Ann Spell, Dirk B. Den Ouden, Christopher Rorden, Julius Fridriksson

Department of Speech-Language Pathology Faculty Papers

Effective rehabilitation tools are essential for improving language outcomes in chronic aphasia. Speech entrainment is a behavioral treatment that has shown promise in enhancing speech output in nonfluent aphasia, potentially by acting as an external mechanism to synchronize anterior and posterior language regions in the left hemisphere. Transcranial alternating current stimulation has been hypothesized to enhance functional connectivity between brain regions by amplifying endogenous oscillations. This proof-of-concept study explored whether high-definition tACS (HD-tACS) could improve speech fluency in nonfluent aphasia when paired with speech entrainment. In a double-blind, pseudorandomized study, 1 mA of HD-tACS at 7 Hz was applied to …

Defining A Multi-Omic, Ai-Enabled Stool Screening Paradigm For Colorectal Cancer: A Consensus Framework For Clinical Translation, Arturo Loaiza-Bonilla, Yan Leyfman, Viviana Cortiana, Rhys Crawford, Shivani Modi

Einstein Health Papers

Colorectal cancer (CRC) develops through both conventional adenoma-carcinoma and serrated neoplasia pathways, yet noninvasive screening still under-detects the advanced precursor lesions that enable true cancer prevention. Stool-based screening reduces CRC mortality, but its preventive impact remains constrained by limited detection of advanced precancerous lesions (APLs), including advanced adenomas and sessile serrated lesions. Next-generation multitarget stool DNA assays (mt-sDNA; e.g., Cologuard Plus) have established high sensitivity for CRC and specificity approaching 94%, leaving improved APL detection as the principal opportunity for innovation. This review presents a consensus framework for a multi-omic stool screening paradigm that integrates host epigenetic markers (DNA methylation) …

Editorial: Clinical Imaging, Neurophysiological, Neuropathology And Neuroethics Studies On Disorders Of Consciousness, Coma Mechanisms, And Theories Of Consciousness: A Unifying Attempt, Diego Iacono, Manuel Trachsel, Thanh Phan, Charlène Aubinet

Department of Neurology Faculty Papers

No abstract provided.

Metabolic Responses To Freund’S Adjuvants And Oncolytic Viruses: Implications On Vaccines And Tumor Immunity, Kiruthiga Mone

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

Freund’s adjuvants have been extensively used in experimental research, and they modulate immune responses through various mechanisms. While both complete Freund’s adjuvant (CFA) and incomplete Freund’s adjuvant (IFA) contain the same mineral oil base, CFA contains the killed extract of Mycobacterium tuberculosis (M. tb) as an additional ingredient. Because the CFA contains mycobacterial content similar to that of Bacillus Calmette-Guérin (BCG), which induces trained immunity (TI), we tested the hypothesis that CFA may elicit TI-like features. To test this hypothesis, we investigated the metabolic and epigenetic reprogramming induced by CFA, with IFA and BCG as controls, in inbred …

Selectivity Modulation Of Small Cationic Membrane-Active Cyclic Peptides With Broad-Spectrum Activity Against Bacteria And Fungi, Sandeep Lohan, Rakesh Kumar Tiwari, Innokentiy Maslennikov, Kaustav Das Gupta, Shakti Singh, Keykavous Parang

Pharmacy Faculty Articles and Research

To investigate how ring size and backbone flexibility influence antimicrobial potency and cytotoxicity, we synthesized a series of macrocyclic peptides of lead peptide p1 (c[Arg-Arg-arg-arg-dip-Trp-dip]) by incorporating Gly, 2-aminoethoxyacetic acid (EAA), or 2,4-diaminobutyric acid (Dab). Two optimized peptides, 6b and 10b, retained broad-spectrum activity against drug-resistant Gram-positive (MIC, 1.5–6.2 μg/mL) and Gram-negative bacteria (MIC, 4–25 μg/mL), as well as pathogenic fungi, while exhibiting enhanced selectivity for microbial cells. Their therapeutic indices (TI ∼407 and ∼394, respectively) were ∼2-fold higher than p1, indicating improved safety. Both peptides remained effective against Gram-negative pathogens beyond the reach of daptomycin, were rapidly bactericidal, and …

Comparison Of Ventilation Support During Laser Treatment Of Retinopathy Of Prematurity, Jason Peng, Raghav Taneja, Barry N. Wasserman, Krystal Hunter, Vineet Bhandari, Alla Kushnir

Wills Eye Hospital Papers

Highlights: What are the main findings? Preterm infants undergoing ROP laser surgery with routine elective intubation had significantly longer durations of post-operative mechanical ventilation. Routine intubation during this procedure did not improve short-term clinical outcomes, such as overall hospital length of stay or timing of laser intervention in the infant’s life. What are the implications of the main findings? Routine intubation strategies may unnecessarily increase exposure to mechanical ventilation without improving clinical outcomes. Standardization of perioperative intubation practices across hospitals may be needed to optimize respiratory support in this vulnerable population. Objective: To compare respiratory outcomes between infants undergoing retinopathy …

Evidentiary Standards For Newly Approved Antibiotics For Uncomplicated Urinary Tract Infections, Rosa Rodriguez-Monguio, Enrique Seoane-Vazquez, John H. Powers Iii

Pharmacy Faculty Articles and Research

Importance: Uncomplicated urinary tract infections (uUTIs) are among the most common bacterial infections and are typically treated with existing oral antibiotics. In 2024–2025, the FDA approved two new oral agents, sulopenem etzadroxil/probenecid and gepotidacin, via expedited review pathways, for the treatment of uUTIs. Objective: To assess the clinical significance and regulatory evidence supporting FDA approval of sulopenem/probenecid and gepotidacin for uUTI, and to analyze the adherence of pivotal phase III trials to regulatory standards for approval and FDA guidelines. Design, Setting, and Participants: Comparative descriptive analysis of publicly available data from phase 3 randomized, double-blind, active-controlled clinical …

Musculoskeletal Infection Reporting And Data System (Mski-Rads): Reviewed And Explained, Angela He, Flavio Duarte Silva, Mina Guirguis, Erin F. Alaia, William B Morrison, Avneesh Chhabra

Department of Radiology Faculty Papers

A standardized guideline and scoring system are recommended for the imaging evaluation of musculoskeletal infections on MR imaging. The Musculoskeletal Infection Reporting and Data System (MSKI-RADS) is a recently developed and validated classification system using MR imaging that can be used to classify the severity and extent of musculoskeletal infections, improve radiology-pathology concordance, and outline the corresponding management recommendations. This review article explains MSKI-RADS and discusses the different elements of this system in detail with a review of pertinent literature so that the readers can apply it in their practices. The work outlines the technical considerations for optimal MR imaging …