Medical Pathology Commons^™

Headache And Vision Loss As Initial Symptoms For An Acute Invasive Rhino-Orbital-Cerebral Mucormycosis, Thanh Le Od, Gregg Wentworth Od

Optometric Clinical Practice

Background: Acute invasive rhino-orbital-cerebral mucormycosis (ROCM) is a rare fungal infection commonly caused by Rhizopus species. It occurs in immune- compromised individuals who have acquired immune deficiency syndrome (AIDS), leukemia, uncontrolled diabetes mellitus, or organ transplant patients who are on immunosuppressive therapy. Diagnosing invasive ROCM is challenging because its clinical presentation can be nonspecific, and it is not frequently observed in ophthalmic practices. Case Report: A 66-year-old Hispanic male with poorly controlled diabetes mellitus presented with the complaint of severe headache and retrobulbar pain in the right eye. An ophthalmic examination revealed normal ocular health in both eyes. Computerized tomography …

Typhlitis In A Neutropenic Patient, Alice He Bs, Wern Lynn Ng Md, Lay She Ng Md, Si Yuan Khor Md, Chandi Garg Md

Tower Health Research Day

No abstract provided.

Li-Fraumeni Syndrome And The Benefits Of Annual Comprehensive Screening: A Pancreatic Adenocarcinoma Case, Alice He Bs, Wern Lynn Ng Md, Faith Seltun Do, Lay She Ng Md, Si Yuan Khor Md, Elham Nasrollahi Md, Chandi Garg Md, Rong Rong Ge Md

Tower Health Research Day

No abstract provided.

Swine Influenza A Virus: Challenges And Novel Vaccine Strategies, Erika M. Petro-Turnquist, Matthew J. Pekarek, Eric A. Weaver

Nebraska Center for Virology: Faculty Publications

Swine Influenza A Virus (IAV-S) imposes a significant impact on the pork industry and has been deemed a significant threat to global public health due to its zoonotic potential. The most effective method of preventing IAV-S is vaccination. While there are tremendous efforts to control and prevent IAV-S in vulnerable swine populations, there are considerable challenges in developing a broadly protective vaccine against IAV-S. These challenges include the consistent diversification of IAV-S, increasing the strength and breadth of adaptive immune responses elicited by vaccination, interfering maternal antibody responses, and the induction of vaccine-associated enhanced respiratory disease after vaccination. Current vaccination …

Diffuse Alveolar Haemorrhage Due To Atypical Hemolytic Uremic Syndrome (Ahus) Associated With Covid-19, Atif Siddiqui, Amanda Tchakarov

Faculty, Staff and Student Publications

Delayed presentation of atypical HUS after COVID‐19 with diffuse alveolar haemorrhage is uncommon and can be life threatening.

Spontaneous Tumor Lysis Syndrome In A Patient With Recent Diagnosis Of Multiple Myeloma — An Unusual Presentation, Taha Al Hassan, Olga G. Cantu-Rodriguez, Eunbee Cho, Edgar G. Dorsey Trevino

Research Symposium

Background: Tumor lysis syndrome (TLS) is an oncologic emergency that surfaces as a constellation of metabolic imbalances due to the rapid destruction of cancer cells and subsequent dissemination of their contents. However, a markedly rare subtype of TLS, known as spontaneous TLS (STLS), occurs without an evident trigger, such as cytotoxic therapy, and carries a similar mortality risk. It is paramount to recognize high-risk cases early and implement therapeutic measures to prevent complications of STLS.

Case Presentation: We present the case of a 74-year-old gentleman with a recent diagnosis of Kappa-restricted multiple myeloma who presented with worsening weakness, tremors, ataxia, …

Pilot Study For Use Of An Arthrometer To Assess Joint Laxity In People With Ehlers-Danlos Syndrome, Dawn T. Gulick, Valerie Iovine, Kerstin Palombaro

Internet Journal of Allied Health Sciences and Practice

Purpose: Joint hypermobility is a condition in which synovial joints move beyond normal limits. Approximately 10-25% of children and 5-25% of adults experience hypermobility syndrome. One such hypermobility syndrome is an inherited connective tissue disorder known as Ehlers-Danlos Syndrome (EDS). Typically, a score of 4-5 out of 9 on the Beighton scale is indicative of hypermobility in adults. Whereas 6 out of 9 is the criteria for children. No significant correlations were found between the systemic features of EDS and the Beighton score. The purpose of this pilot study was to see if an arthrometer could be used …

Deep Learning Approaches For Cancer Prognosis Prediction Using Histopathological, Omics, And Clinical Data, Shuai Jiang

Dartmouth College Ph.D Dissertations

Accurate prediction of patient outcomes is crucial for shared clinical decision-making, treatment planning, and patients' psychological adjustment. Histopathological features of cancer, including tumor size, lymph node involvement, and metastasis, are commonly incorporated into survival prediction models, underscoring the prognostic value of whole slide images (WSIs). Concurrently, studies have highlighted the significance of omics data, such as transcriptomics, in providing valuable insights into cancer prognosis.

The emerging deep learning methods have brought new opportunities in biomedical informatics. Despite a growing body of studies on the application of deep learning methods for predicting prognosis using WSIs, the results are varied, primarily due …

Ensuring Successful Biomarker Studies In Bladder Preservation Clinical Trials For Non-Muscle Invasive Bladder Cancer, David J. Mcconkey, Brian C. Baumann, Stephanie Cooper Greenberg, David J. Degraff, Scott E. Delacroix, Jason A. Efstathiou, Jared Foster, Susan Groshen, Edward E. Kadel, Francesca Khani, William Y. Kim, Seth P. Lerner, Trevor Levin, Joseph C. Liao, Matthew I. Milowsky, Joshua J. Meeks, David T. Miyamoto, Kent W. Mouw, Eugene J. Pietzak, David B. Solit, Debasish Sundi, Abdul Tawab-Amiri, Pamela J. West, Sara E. Wobker, Alexander W. Wyatt, Andrea B. Apolo, Peter C. Black

School of Medicine Faculty Publications

Recent technological advances have created new opportunities for performing biomarker studies within the National Cancer Institute’s (NCI’s) National Clinical Trials Network (NCTN) clinical trials. These new platforms yield more robust measurements when tissue and blood handling is optimized. At the same time, there is a strong interest in banking tissue and derivatives, such as DNA and RNA, for future biomarker studies using novel platforms that may emerge during the intervening time to trial completion. The NCI recently hosted a Clinical Trials Planning Meeting focused on two trial concepts for bladder preservation in patients with high-risk non-muscle invasive bladder cancer (NMIBC) …

Hif Expression In Clear-Cell Renal Cell Carcinoma (Ccrcc) Tumors Of Adults With And Without Obstructive Sleep Apnea (Osa), Olivia Heppell, Carlos Guerra Londono, Nilesh Gupta

Medical Student Research Symposium

Introduction: Upregulation of hypoxia-inducible factors (HIF) is an important pathological feature shared by clear cell renal cell carcinoma (ccRCC) and obstructive sleep apnea (OSA). However, it is unclear whether OSA alters the pathogenesis of ccRCC via HIF expression.

Methods: A retrospective cohort of adults undergoing nephrectomy for ccRCC was identified electronically (IRB#16040-1). The diagnosis of OSA was established with preoperative STOP-BANG scores or polysomnography. A consecutive sample of 20 individuals with and 20 without OSA was selected. Clinical characteristics and pathology results were reviewed. Resected tumor sections were immunohistochemically stained for HIF-1& HIF-2 at antibody dilutions of 1:150. Intensity and …

Trps1 Expression In Non-Melanocytic Cutaneous Neoplasms: An Immunohistochemical Analysis Of 200 Cases, Yi A Liu, Phyu P Aung, Yunyi Wang, Jing Ning, Priyadharsini Nagarajan, Jonathan L Curry, Carlos A Torres-Cabala, Doina Ivan, Victor G Prieto, Qingqing Ding, Woo Cheal Cho

Faculty, Staff and Student Publications

BACKGROUND: Although trichorhinophalangeal syndrome type 1 (TRPS1) was initially thought to be highly sensitive and specific for carcinomas and mesenchymal tumors of mammary origin, more recent data suggest its expression is not limited to breast neoplasms but also can be seen in other cutaneous neoplasms, such as extramammary Paget disease and squamous cell carcinoma (SCC) in situ.

METHODS: Two-hundred cases of non-melanocytic cutaneous neoplasm, including basal cell carcinomas (BCCs) (n = 41), SCCs (n = 35), Merkel cell carcinomas (MCCs) (n = 25), and adnexal neoplasms (n = 99), were tested for TRPS1 expression using a monoclonal anti- TRPS1 rabbit …

Tailoring T Fh Profiles Enhances Antibody Persistence To A Clade C Hiv-1 Vaccine In Rhesus Macaques, Anil Verma, Chase E. Hawes, Sonny R. Elizaldi, Justin C. Smith, Dhivyaa Rajasundaram, Gabriel Kristian Pedersen, Xiaoying Shen, La Tonya D. Williams, Georgia D. Tomaras, Pamela A. Kozlowski, Rama R. Amara, Smita S. Iyer

School of Medicine Faculty Publications

CD4 T follicular helper cells (Tfh) are essential for establishing serological memory and have distinct helper attributes that impact both the quantity and quality of the antibody response. Insights into Tfh subsets that promote antibody persistence and functional capacity can critically inform vaccine design. Based on the Tfh profiles evoked by the live attenuated measles virus vaccine, renowned for its ability to establish durable humoral immunity, we investigated the potential of a Tfh1/17 recall response during the boost phase to enhance persistence of HIV-1 Envelope (Env) antibodies in rhesus macaques. Using a DNA-prime encoding gp160 antigen and Tfh polarizing cytokines …

Collagen Type Xii Is Undetectable In Keratoconus Bowman’S Layer, Mohammed Rigi, Hyeck-Soo Son, Loren Moon, Mario Matthaei, Divya Srikumaran, Albert S Jun, Charles G Eberhart, Uri S Soiberman

Faculty, Staff and Student Publications

PURPOSE: Corneal biomechanical failure is the hallmark of keratoconus (KC); however, the cause of this failure remains elusive. Collagen type XII (

METHODS: TaqMan quantitative PCR was performed on 31 corneal epithelium samples of progressive KC and myopic control eyes. Tissue microarrays were constructed using full-thickness corneas from 61 KC cases during keratoplasty and 18 non-KC autopsy eyes and stained with an antibody specific to COL12A1. Additionally,

RESULTS: COL12A1 expression was reduced at transcript levels in KC epithelium compared to controls (ratio: 0.58, p<0.03). Immunohistochemical studies demonstrated that COL12A1 protein expression in BL was undetectable, with reduced expression in KC epithelium, basement membrane, and stroma.

CONCLUSIONS: The apparent absence of COL12A1 in KC BL, together with the functional importance that

Data Encoding For Healthcare Data Democratization And Information Leakage Prevention, Anshul Thakur, Tingting Zhu, Vinayak Abrol, Jacob Armstrong, Yujiang Wang, David A Clifton

Faculty, Staff and Student Publications

The lack of data democratization and information leakage from trained models hinder the development and acceptance of robust deep learning-based healthcare solutions. This paper argues that irreversible data encoding can provide an effective solution to achieve data democratization without violating the privacy constraints imposed on healthcare data and clinical models. An ideal encoding framework transforms the data into a new space where it is imperceptible to a manual or computational inspection. However, encoded data should preserve the semantics of the original data such that deep learning models can be trained effectively. This paper hypothesizes the characteristics of the desired encoding …

Covid-19-Associated Myocarditis: Screening For Early Diagnosis, Yousuf Khan, Salmman Ahmed, Samuel John Wlasowicz, Ronald G. Lott Iii, Xavier C. Zonna

Advances in Clinical Medical Research and Healthcare Delivery

The SARS-CoV-2 virus (causing COVID-19), has infected about 770 million people, and caused the death of about 6.9 million people worldwide in the span of three years (John Hopkins Resource Center). Common symptoms of a patient infected with the virus include shortness of breath, fever, chills, fatigue, loss of taste or smell, and muscle aches. However, recent studies have also shown a prevalence of patients presenting with cardiac inflammation (endocarditis, myocarditis or pericarditis) as a potential comorbidity, both during the infectious stage as well as after the infection has subsided. A pattern of specific clinical markers may be indicative of …

Piriformis Syndrome With A Variant Presentation, Roberto Chuapoco, Ryan E. Linford

Annual Research Symposium

Piriformis syndrome has long been a diagnostic quandary due to its tendency to present as other nerve-related conditions. Piriformis syndrome is commonly caused by entrapment of the sciatic nerve as it travels through the greater sciatic foramen due to hypertrophy of the piriformis muscle. However, its constellation of symptoms, including radiating pain down the thigh, can easily be mistaken for lumbosacral radiculopathy. This case report aims to address the misdiagnosis of piriformis syndrome which has prolonged pain for many patients and increased the cost of medical care. It demonstrates a 76-year-old female with a confounding presentation of piriformis syndrome: buttock …

Acute Neutrophilic Vasculitis (Leukocytoclasia) In 36 Covid-19 Autopsy Brains, Roy H. Rhodes, Gordon L. Love, Fernanda Da Silva Lameira, Maryam Sadough Shahmirzadi, Sharon E. Fox, Richard S. Vander Heide

School of Medicine Faculty Publications

Background: Hypercytokinemia, the renin-angiotensin system, hypoxia, immune dysregulation, and vasculopathy with evidence of immune-related damage are implicated in brain morbidity in COVID-19 along with a wide variety of genomic and environmental influences. There is relatively little evidence of direct SARS-CoV-2 brain infection in COVID-19 patients. Methods: Brain histopathology of 36 consecutive autopsies of patients who were RT-PCR positive for SARS-CoV-2 was studied along with findings from contemporary and pre-pandemic historical control groups. Immunostaining for serum and blood cell proteins and for complement components was employed. Microcirculatory wall complement deposition in the COVID-19 cohort was compared to historical control cases. Comparisons …

Probiotic Limosilactobacillus Reuteri Dsm 17938 Changes Foxp3 Deficiency-Induced Dyslipidemia And Chronic Hepatitis In Mice, Erini Nessim Kostandy, Ji Ho Suh, Xiangjun Tian, Beanna Okeugo, Erin Rubin, Sara Shirai, Meng Luo, Christopher M Taylor, Kang Ho Kim, J Marc Rhoads, Yuying Liu

Faculty, Staff and Student Publications

The probiotic Limosilactobacillus reuteri DSM 17938 produces anti-inflammatory effects in scurfy (SF) mice, a model characterized by immune dysregulation, polyendocrinopathy, enteropathy, and X-linked inheritance (called IPEX syndrome in humans), caused by regulatory T cell (Treg) deficiency and is due to a Foxp3 gene mutation. Considering the pivotal role of lipids in autoimmune inflammatory processes, we investigated alterations in the relative abundance of lipid profiles in SF mice (± treatment with DSM 17938) compared to normal WT mice. We also examined the correlation between plasma lipids and gut microbiota and circulating inflammatory markers. We noted a significant upregulation of plasma lipids …

Chronic Wasting Disease: State Of The Science, Jason C Bartz, Rebeca Benavente, Byron Caughey, Sonja Christensen, Allen Herbst, Edward A Hoover, Candace K Mathiason, Debbie Mckenzie, Rodrigo Morales, Marc D Schwabenlander, Daniel P Walsh, The Nc North American Interdisciplinary Chronic Wasting Disease Research Consortium Members

Faculty, Staff and Student Publications

Chronic wasting disease (CWD) is a prion disease affecting cervid species, both free-ranging and captive populations. As the geographic range continues to expand and disease prevalence continues to increase, CWD will have an impact on cervid populations, local economies, and ecosystem health. Mitigation of this "wicked" disease will require input from many different stakeholders including hunters, landowners, research biologists, wildlife managers, and others, working together. The NC1209 (North American interdisciplinary chronic wasting disease research consortium) is composed of scientists from different disciplines involved with investigating and managing CWD. Leveraging this broad breadth of expertise, the Consortium has created a state-of-the-science …

Child Deaths Caused By Klebsiella Pneumoniae In Sub-Saharan Africa And South Asia: A Secondary Analysis Of Child Health And Mortality Prevention Surveillance (Champs) Data., Jennifer Verani, Dianna Blau, Emily Gurley, Victor Akelo, Nega Assefa, Vicky Baillie, Quique Bassat, Mussie Berhane, James Bunn, R Gunturu

Pathology, East Africa

Background; Klebsiella pneumoniae is an important cause of nosocomial and community-acquired pneumonia and sepsis in children, and antibiotic-resistant K pneumoniae is a growing public health threat. We aimed to characterize child mortality associated with this pathogen in seven high-mortality settings.

Methods; We analysed Child Health and Mortality Prevention Surveillance (CHAMPS) data on the causes of deaths in children younger than 5 years and stillbirths in sites located in seven countries across sub-Saharan Africa (Ethiopia, Kenya, Mali, Mozambique, Sierra Leone, and South Africa) and south Asia (Bangladesh) from Dec 9, 2016, to Dec 31, 2021. CHAMPS sites conduct active surveillance for …

Non‐V600e Braf Mutation In Hairy Cell Leukemia Variant, Anjanaa Vijayanarayanan, Sa A Wang, Sofia Garces, Karan Saluja, L Jeffrey Medeiros, Beenu Thakral

Faculty, Staff and Student Publications

No abstract provided.

Bacterial Contamination Of Platelet Products, Michael R. Jacobs `, Bowen Zhou, Robert W. Maitta

Faculty Scholarship

Transfusion of bacterially contaminated platelets, although rare, is still a major cause of mortality and morbidity despite the introduction of many methods to limit this over the past 20 years. The methods used include improved donor skin disinfection, diversion of the first part of donations, use of apheresis platelet units rather than whole-blood derived pools, primary and secondary testing by culture or rapid test, and use of pathogen reduction. Primary culture has been in use the US since 2004, using culture 24 h after collection of volumes of 4–8 mL from apheresis collections and whole-blood derived pools inoculated into aerobic …

Cd133-Dependent Activation Of Phosphoinositide 3-Kinase /Akt/Mammalian Target Of Rapamycin Signaling In Melanoma Progression And Drug Resistance, Naji Kharouf, Thomas W. Flanagan, Abdulhadi A. Alamodi, Youssef Al Hmada, Sofie Yasmin Hassan, Hosam Shalaby, Simeon Santourlidis, Sarah Lilly Hassan, Youssef Haikel, Mossad Megahed, Robert T. Brodell, Mohamed Hassan

School of Medicine Faculty Publications

Melanoma frequently harbors genetic alterations in key molecules leading to the aberrant activation of PI3K and its downstream pathways. Although the role of PI3K/AKT/mTOR in melanoma progression and drug resistance is well documented, targeting the PI3K/AKT/mTOR pathway showed less efficiency in clinical trials than might have been expected, since the suppression of the PI3K/mTOR signaling pathway-induced feedback loops is mostly associated with the activation of compensatory pathways such as MAPK/MEK/ERK. Consequently, the development of intrinsic and acquired resistance can occur. As a solid tumor, melanoma is notorious for its heterogeneity. This can be expressed in the form of genetically divergent …

Multivalent Epigraph Hemagglutinin Vaccine Protects Against Influenza B Virus In Mice, Erika M. Petro-Turnquist, Brigette Corder Kampfe, Amber Gadeken, Matthew J. Pekarek, Eric A. Weaver

Nebraska Center for Virology: Faculty Publications

Influenza B virus is a respiratory pathogen that contributes to seasonal epidemics, accounts for approximately 25% of global influenza infections, and can induce severe disease in young children. While vaccination is the most commonly used method of preventing influenza infections, current vaccines only induce strain-specific responses and have suboptimal efficacy when mismatched from circulating strains. Further, two influenza B virus lineages have been described, B/Yamagatalike and B/Victoria-like, and the limited cross-reactivity between the two lineages provides an additional barrier in developing a universal influenza B virus vaccine. Here, we report a novel multivalent vaccine using computationally designed Epigraph hemagglutinin proteins …

Mechanisms Of Melanoma Progression And Treatment Resistance: Role Of Cancer Stem-Like Cells, Youssef Al Hmada, Robert T. Brodell, Naji Kharouf, Thomas W. Flanagan, Abdulhadi A. Alamodi, Sofie Yasmin Hassan, Hosam Shalaby, Sarah Lilly Hassan, Youssef Haikel, Mosaad Megahed, Simeon Santourlidis, Mohamed Hassan

School of Medicine Faculty Publications

Melanoma is the third most common type of skin cancer, characterized by its heterogeneity and propensity to metastasize to distant organs. Melanoma is a heterogeneous tumor, composed of genetically divergent subpopulations, including a small fraction of melanoma-initiating cancer stem-like cells (CSCs) and many non-cancer stem cells (non-CSCs). CSCs are characterized by their unique surface proteins associated with aberrant signaling pathways with a causal or consequential relationship with tumor progression, drug resistance, and recurrence. Melanomas also harbor significant alterations in functional genes (BRAF, CDKN2A, NRAS, TP53, and NF1). Of these, the most common are the BRAF and NRAS oncogenes, with 50% …

Enhancing Mitosis Quantification And Detection In Meningiomas With Computational Digital Pathology, Hongyan Gu, Chunxu Yang, Issa Al-Kharouf, Shino Magaki, Nelli Lakis, Christopher Kazu Williams, Sallam Mohammad Alrosan, Ellie Kate Onstott, Wenzhong Yan, Negar Khanlou, Inma Cobos, Xinhai Robert Zhang, Neda Zarrin-Khameh, Harry V Vinters, Xiang Anthony Chen, Mohammad Haeri

Faculty, Staff and Student Publications

Mitosis is a critical criterion for meningioma grading. However, pathologists' assessment of mitoses is subject to significant inter-observer variation due to challenges in locating mitosis hotspots and accurately detecting mitotic figures. To address this issue, we leverage digital pathology and propose a computational strategy to enhance pathologists' mitosis assessment. The strategy has two components: (1) A depth-first search algorithm that quantifies the mathematically maximum mitotic count in 10 consecutive high-power fields, which can enhance the preciseness, especially in cases with borderline mitotic count. (2) Implementing a collaborative sphere to group a set of pathologists to detect mitoses under each high-power …

Preclinical Repurposing Of Sitagliptin As A Drug Candidate For Colorectal Cancer By Targeting Cd24/Ctnnb1/Sox4-Centered Signaling Hub, Jing-Wen Shih, Alexander T H Wu, Ntlotlang Mokgautsi, Po-Li Wei, Yan-Jiun Huang

Faculty, Staff and Student Publications

Despite significant advances in treatment modalities, colorectal cancer (CRC) remains a poorly understood and highly lethal malignancy worldwide. Cancer stem cells (CSCs) and the tumor microenvironment (TME) have been shown to play critical roles in initiating and promoting CRC progression, metastasis, and treatment resistance. Therefore, a better understanding of the underlying mechanisms contributing to the generation and maintenance of CSCs is crucial to developing CSC-specific therapeutics and improving the current standard of care for CRC patients. To this end, we used a bioinformatics approach to identify increased CD24/SOX4 expression in CRC samples associated with poor prognosis. We also …

A Rare Case Of A Giant Cell Tumor Of The Peroneal Tendon Sheath, Francois M. Lokenye Dpm, Breana Marine Dpm, Orlexia Thomas Dpm, Mariam Kamil Bs

Posters

This case report discusses a 31-year-old male with TGCT in the peroneal tendon sheath, detailing clinical and radiological features.

his study explores the surgical interventions, diagnostic challenges, treatment options, and outcomes of TGCT, emphasizing its consideration in the differential diagnoses of painful foot and ankle masses.

Socioeconomic Status And Health Disparities Drive Differences In Accelerometer-Derived Physical Activity In Fatty Liver Disease And Significant Fibrosis, Lucia Tabacu, Sajag Swami, Mark Ledbetter, Mohamad S. Siddiqui, Ekaterina Smirnova

Mathematics & Statistics Faculty Publications

Background and aims

The cornerstone of clinical management of patients with nonalcoholic fatty liver disease (NAFLD) are lifestyle changes such as increasing physical activity (PA) aimed at improving cardiometabolic risk. To inform NAFLD prevention and treatment guidelines we aimed to: (i) quantify the role of PA on lowering the risk for NAFLD and fibrosis; (ii) characterize NAFLD and fibrosis association with PA in the context of socioeconomic environment.

Methods

A sample of 2648 participants from the NHANES 2003–2006 was selected to develop survey weighted multivariable logistic regression models for predicting NAFLD and significant fibrosis, diagnosed non-invasively via fatty liver index …

Disease Footprints: Understanding Basic Pathophysiology, Jeff Vasiloff, Md, Mph

OHIO Open Faculty Textbooks

Basic pathophysiology explained by Jeffrey Vasiloff, MD, MPH, Associate Clinical Professor, PA Program; Adjunct Professor, PT Program, College of Health Sciences and Professions, Ohio University Dublin Medical Campus; Physician Consultant: Ohio Association of Physician Assistants; Physician Volunteer: Franklin County & Columbus Medical Reserve Corps; Board Certification: Internal Medicine & Diabetes and Endocrinology.