Medical Specialties Commons^™

Standardizing Evaluation Of Patient-Specific 3d Printed Models In Surgical Planning: Development Of A Cross-Disciplinary Survey Tool For Physician And Trainee Feedback, Lauren Schlegel, Michelle Ho, M. Fields, Erik Backlund, Robert S. Pugliese, Kristy M. Shine

Department of Emergency Medicine Faculty Papers

Background: 3D printed models are becoming increasingly popular in healthcare as visual and tactile tools to enhance understanding of anatomy and pathology in medical trainee education, provide procedural simulation training, and guide surgical procedures. Patient-specific 3D models are currently being used preoperatively for trainee medical education in planning surgical approaches and intraoperatively to guide decision-making in several specialties. Our study group utilized a modified Delphi process to create a standardized assessment for trainees using patient-specific 3D models as a tool in medical education during pre-surgical planning.

Methods: A literature review was conducted to identify survey questions administered to clinicians in …

No One Should Have To Give Birth Alone: An Analysis Of The Efficacy Of Community-Based Doula Programs Serving Ethnic Minorities In San Francisco, Maria Margaret Nelson

Master's Projects and Capstones

Adverse birth outcomes for both the parent and the child disproportionately affect people of color. Evidence demonstrates that one of the ways to mitigate these negative consequences is through the utilization of a doula, a trained birth companion that is not a medical provider but whose role it is to physically and emotionally support the patient through pregnancy, birth, and postpartum. Community-based doula programs, where the doula is of the same cultural background as the client, are particularly effective in improving birth outcomes in communities of color by providing culturally competent care and helping to navigate a healthcare system that …

Improved Sars-Cov-2 Sequencing Surveillance Allows The Identification Of New Variants And Signatures In Infected Patients, Antonio Grimaldi, Francesco Panariello, Patrizia Annunziata, Teresa Giuliano, Michela Daniele, Biancamaria Pierri, Chiara Colantuono, Marcello Salvi, Valentina Bouché, Anna Manfredi, Maria Concetta Cuomo, Denise Di Concilio, Claudia Tiberio, Mariano Fiorenza, Giuseppe Portella, Ilaria Cimmino, Antonio Sorrentino, Giovanna Fusco, Maria Rosaria Granata, Pellegrino Cerino, Antonio Limone, Luigi Atripaldi, Andrea Ballabio, Davide Cacchiarelli

Duncan NRI Faculty and Staff Publications

Background: Genomic surveillance of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the only approach to rapidly monitor and tackle emerging variants of concern (VOC) of the COVID-19 pandemic. Such scrutiny is crucial to limit the spread of VOC that might escape the immune protection conferred by vaccination strategies or previous virus exposure. It is also becoming clear now that efficient genomic surveillance would require monitoring of the host gene expression to identify prognostic biomarkers of treatment efficacy and disease progression. Here we propose an integrative workflow to both generate thousands of SARS-CoV-2 genome sequences per week and analyze host …

Regulation Of Microglial Activation In Stroke In Aged Mice: A Translational Study, Conelius Ngwa, Abdullah Al Mamun, Shaohua Qi, Romana Sharmeen, Yan Xu, Fudong Liu

Faculty, Staff and Student Publications

Numerous neurochemical changes occur with aging and stroke mainly affects the elderly. Our previous study has found interferon regulatory factor 5 (IRF5) and 4 (IRF4) regulate neuroinflammation in young stroke mice. However, whether the IRF5-IRF4 regulatory axis has the same effect in aged brains is not known. In this study, aged (18-20-month-old), microglial IRF5 or IRF4 conditional knockout (CKO) mice were subjected to a 60-min middle cerebral artery occlusion (MCAO). Stroke outcomes were quantified at 3d after MCAO. Flow cytometry and ELISA were performed to evaluate microglial activation and immune responses. We found aged microglia express higher levels of IRF5 …

Understanding Diagnostic Pathways In Systemic Sclerosis And Systemic Sclerosis-Associated Interstitial Lung Disease: A Retrospective Cohort Study, Shervin Assassi, Nan Shao, Ziwei Yin, Elizabeth R Volkmann, Donald F Zoz, Thomas B Leonard

Faculty, Staff and Student Publications

Systemic sclerosis-associated interstitial lung disease (SSc-ILD) is usually detected in a patient known to have SSc but may be diagnosed prior to SSc. We probed an insurance database to investigate documentation of ILD prior to SSc. Using Optum's Clinformatics® Data Mart Database, we identified patients with an SSc index date between January 1, 2010, and September 30, 2015, based on International Classification of Diseases (ICD)-9-Clinical Modification (CM) codes, ≥2 medical claims associated with SSc on different dates within 1 year, and ≥3 years of continuous enrollment prior to SSc index date (ICD-9-CM cohort). We identified an ICD-10-CM cohort comprising patients …

Current Challenges In Image-Guided Magnetic Hyperthermia Therapy For Liver Cancer, Anirudh Sharma, Erik Cressman, Anilchandra Attaluri, Dara L Kraitchman, Robert Ivkov

Faculty, Staff and Student Publications

For patients diagnosed with advanced and unresectable hepatocellular carcinoma (HCC), liver transplantation remains the best option to extend life. Challenges with organ supply often preclude liver transplantation, making palliative non-surgical options the default front-line treatments for many patients. Even with imaging guidance, success following treatment remains inconsistent and below expectations, so new approaches are needed. Imaging-guided thermal therapy interventions have emerged as attractive procedures that offer individualized tumor targeting with the potential for the selective targeting of tumor nodules without impairing liver function. Furthermore, imaging-guided thermal therapy with added standard-of-care chemotherapies targeted to the liver tumor can directly reduce the …

Extracorporeal Membrane Oxygenation In The Care Of A Preterm Infant With Covid-19 Infection: Case Report, Jessica Patrick-Esteve, Christy Mumphrey, David Yu, Emily Masoumy, Jeremy Lawson, David Hebert, Brian Barkemeyer

School of Medicine Faculty Publications

Coronavirus disease 2019 (COVID-19) was first reported to the World Health Organization (WHO) in December 2019 and has since unleashed a global pandemic, with over 518 million cases as of May 10, 2022. Neonates represent a very small proportion of those patients. Among reported cases of neonates with symptomatic COVID-19 infection, the rates of hospitalization remain low. Most reported cases in infants and neonates are community acquired with mild symptoms, most commonly fever, rhinorrhea and cough. Very few require intensive care or invasive support for acute infection. We present a case of a 2-month-old former 26-week gestation infant with a …

Occupational Therapy's Role In Athletic Retirement, Diana Mellin, Karen Park, Madison Harris

Summer 2022 Virtual OTD Capstone Symposium

Athletic retirement is described as a life transition involving withdrawal from the athletic role. Throughout the process of athletic retirement, individuals experience a loss of identity, roles, routines, and social support which has shown to negatively impact their overall mental health and well-being (Marterella & Smoot, 2017). This study investigated elite athletes’ experiences throughout their transition to athletic retirement, a ten-question online survey and semi-structured interviews were administered. Themes that emerged from the data are occupational adjustment and relearning roles, experiencing a crossroads of identity, external expectations, and pressures. Participants shared experiencing a period of burnout and detachment right after …

Risk Of Transmission Of Respiratory Viruses During Aerosol-Generating Medical Procedures (Agmps) Revisited In The Covid-19 Pandemic: A Systematic Review, Jenine Leal, Brenlea Farkas, Liza Mastikhina, Jordyn Flanagan, Becky Skidmore, Charleen Salmon, Devika Dixit, Stephanie Smith, Stephen Tsekrekos, Bonita Lee, Joseph Vayalumkal, Jessica Dunn, Robyn Harrison, Melody Cordoviz, Roberta Dubois, Uma Chandran, Fiona Clement, Kathryn Bush, John Conly, Oscar Larios

Faculty, Staff and Student Publications

BACKGROUND: In many jurisdictions healthcare workers (HCWs) are using respirators for aerosol-generating medical procedures (AGMPs) performed on adult and pediatric populations with all suspect/confirmed viral respiratory infections (VRIs). This systematic review assessed the risk of VRIs to HCWs in the presence of AGMPs, the role respirators versus medical/surgical masks have on reducing that risk, and if the risk to HCWs during AGMPs differed when caring for adult or pediatric patient populations.

MAIN TEXT: We searched MEDLINE, EMBASE, Cochrane Central, Cochrane SR, CINAHL, COVID-19 specific resources, and MedRxiv for English and French articles from database inception to September 9, 2021. Independent …

Navigating Care Transitions For Older Adults In The Emergency Department When A Social Worker Is Unavailable, Rebecca Weeks, Kathy Sawasky, Adam Perry, Michael Malone

Journal of Geriatric Emergency Medicine

Some Emergency Departments do not have social worker staffing to assess high- risk older adults who have been identified. This is of particular concern in during care transitions for older patients who are at risk for poor health outcomes. We describe triggers for the emergency provider to recognize older patients at high risk and bundles of appropriate services and community supports to mitigate risk.

Supporting Rural Seniors Aging In Place Using Telehealth, Angel Alexander Gomez, Susan Macdermott

Summer 2022 Virtual OTD Capstone Symposium

Background: The United States is witnessing a demographic shift in that the number of Americans aged 65 and older is projected to nearly double from 52 million in 2018 to 95 million by 2060; the percentage of the 65 and older age group will increase from 16 % to 23 % (Administration for Community Living, 2018). In this ever-growing population, the American Association of Retired Persons (AARP) 2018 survey found that 76% of Americans over the age of 50 would prefer to remain in their current residence and 77% would like to continue living in their community as long as …

Transportation As A Barrier To Healthcare Access For Older Adults Of Low Socioeconomic Status, Yanira Barajas, Susan Macdermott, Jazminne Orozco Arteaga

Summer 2022 Virtual OTD Capstone Symposium

The older adult population of those in the age group 65+ is one of the fastest growing populations in the following years. This project sought to identify what barriers older adults of low socioeconomic status face when trying to access transportation to healthcare appointments. The project also sought to understand what barriers healthcare professionals saw when their senior clients tried using transportation as well as what opportunities occupational therapists have to address the barriers if any. There was a theme of disconnect which appeared between healthcare professionals and their senior clients across multiple healthcare disciplines. This project was able to …

A Comprehensive Search Of Non-Canonical Proteins In Non-Small Cell Lung Cancer And Their Impact On The Immune Response, Ehsan Irajizad, Johannes F Fahrmann, James P Long, Jody Vykoukal, Makoto Kobayashi, Michela Capello, Chuan-Yih Yu, Yining Cai, Fu Chung Hsiao, Nikul Patel, Soyoung Park, Qian Peng, Jennifer B Dennison, Taketo Kato, Mei Chee Tai, Ayumu Taguchi, Humam Kadara, Ignacio I Wistuba, Hiroyuki Katayama, Kim-Anh Do, Samir M Hanash, Edwin J Ostrin

Faculty, Staff and Student Publications

There is substantial interest in mining neoantigens for cancer applications. Non-canonical proteins resulting from frameshift mutations have been identified as neoantigens in cancer. We investigated the landscape of non-canonical proteins in non-small cell lung cancer (NSCLC) and their induced immune response in the form of autoantibodies. A database of cryptoproteins was computationally constructed and comprised all alternate open reading frames (altORFs) and ORFs identified in pseudogenes, noncoding RNAs, and untranslated regions of mRNAs that did not align with known canonical proteins. Proteomic profiles of seventeen lung adenocarcinoma (LUAD) cell lines were searched to evaluate the occurrence of cryptoproteins. To assess …

Saudi Heart Association Position Statement On The Use Of Biomarkers For The Management Of Heart Failure And Acute Coronary Syndrome, Waleed Alhabeeb, Adel Abdulkader Tash, Fawaz Almutari, Kamal Al Ghalayini, Maryam Alqaseer, Mostafa Alshamiri, Suleiman Kharabsheh, Wail Alkashkari

Journal of the Saudi Heart Association

Background: The burden of acute coronary syndrome (ACS) and heart failure (HF) remains high in Saudi Arabia. Biomarkers can greatly improve the management and outcomes of these conditions, but no official guidance is available on their use in Saudi Arabia. Consensus panel: An expert panel of cardiologists, interventional cardiologists and cardiac surgeon reviewed available evidence and formulated recommendations relevant to clinical practice in Saudi Arabia. Consensus findings: high-sensitivity cardiac troponins play a major role in the diagnosis of ACS and the exclusion of myocardial infarction in patients with HF. Natriuretic Peptides are recommended to determine the likelihood of a diagnosis …

Perceptions Of Using Diabetic Alert Dogs To Promote Occupations And Quality Of Life, Haley Speake, Rocio Alvarenga, Adam Gibson

Summer 2022 Virtual OTD Capstone Symposium

This capstone project consisted of a pilot phenomenological qualitative research study with the goal of assessing diabetic alert dogs' impact on their owners' occupations and quality of life from the owner's perspective. Individuals with type 1 diabetes that personally own a diabetic alert dog were interviewed virtually using a semi-structured approach. The goal of the interview questions was to gather information regarding health management, daily occupations, and quality of life. Gaps in the research were identified, and it was found that few research studies focused on the impact or benefits of a diabetic alert dog from the owner’s perspective. Therefore, …

A Genome-Wide Screen Identifies Pdpk1 As A Target To Enhance The Efficacy Of Mek1/2 Inhibitors, Weijia Cai, Nicole A. Wilski, Timothy J. Purwin, Megane Vernon, Manoela Tiago, Andrew E. Aplin

Department of Cancer Biology Faculty Papers

Melanomas frequently harbor activating NRAS mutations. However, limited advance has been made in developing targeted therapy options for NRAS mutant melanoma patients. MEK inhibitors (MEKi) show modest efficacy in the clinic and their actions need to be optimized. In this study, we performed a genome-wide CRISPR-Cas9-based screen and demonstrated that loss of Phosphoinositide-dependent kinase-1 (PDPK1) enhances the efficacy of MEKi. The synergistic effects of PDPK1 loss and MEKi was validated in NRAS mutant melanoma cell lines using pharmacological and molecular approaches. Combined PDPK1 inhibitors (PDPK1i) with MEKi suppressed NRAS mutant xenograft growth and induced gasdermin E-associated pyroptosis. In an immune-competent …

Esophageal Carcinoma And Associated Risk Factors: A Case-Control Study In Two Tertiary Care Hospitals Of Kabul, Afghanistan, Ramin Saadaat, Jamshid Abdul-Ghafar, Ahmed Maseh Haidary, Nooria Atta, Tazeen Saeed Ali

Community Health Sciences

Purpose: Esophageal cancer (EC) is the most common cancer among males in Afghanistan, thus we aimed to conduct a case-control study to determine the associated risk factors with EC in two tertiary care hospitals of Kabul, Afghanistan.
Patients and methods: We enrolled 132 EC cases and 132 controls and used conditional logistic regression to estimate the odds ratio (OR) with consideration of 95% confidence interval (CI).
Results: The results of our study revealed that esophageal squamous cell carcinoma (ESCC) was the predominant type of EC constituting 75.8% of the cases. The results of the multivariate logistic analysis showed that males …

Adults With Preexisting Diagnosis Of Heart Failure In The Environment Of Coronavirus Disease 2019, Ronald Phillips

Dissertations

Background: Heart disease continues to be the leading cause of death among adults in the United States and other industrialized countries. Heart failure (HF) is a form of heart disease and has become an epidemic with complications and medical care costs increasing at an alarming rate. HF affects more than 5.7 million adults in the United States with an incidence between 550,000 to 670,000 annually, primarily affecting females, African Americans, and adults aged 55 years and older. HF is also associated with a high rate of mortality, estimated to increase, with a risk rate of 13%, 32%, and 64% among …

A Smartwatch Step-Counting App For Older Adults: Development And Evaluation Study, George Boateng, Curtis L. Petersen, David Kotz, Karen L. Fortuna, Rebecca Masutani, John A. Batsis

Dartmouth Scholarship

Background: Older adults who engage in physical activity can reduce their risk of mobility impairment and disability. Short amounts of walking can improve quality of life, physical function, and cardiovascular health. Various programs have been implemented to encourage older adults to engage in physical activity, but sustaining their motivation continues to be a challenge. Ubiquitous devices, such as mobile phones and smartwatches, coupled with machine-learning algorithms, can potentially encourage older adults to be more physically active. Current algorithms that are deployed in consumer devices (eg, Fitbit) are proprietary, often are not tailored to the movements of older adults, and have …

A Differential Diagnosis Of Unusual Gastric Ulcer, Soo-Yoon Sung, Hyun Ho Choi, Kyung Jin Seo

Faculty, Staff and Student Publications

The endoscopic findings of diffuse large B cell lymphoma have various presentations. In our case, the patient had developed multiple elevated central ulceration lesions, and the peripheral elevated portion had a heaped-up margin. The margin had a sharp, smooth edge that was not infiltrative and could be confused with a simple gastric ulcer. Endoscopists should be aware of the possibility of multiple lymphoma ulcers with heaped-up margins. We present some unusual endoscopic features of lymphoma, which are easily misdiagnosed as gastric ulcers.

Increased Expression Of Interferon-Induced Transmembrane 3 (Ifitm3) In Stroke And Other Inflammatory Conditions In The Brain, Elisabeth Harmon, Andrea Doan, Jesus Bautista-Garrido, Joo Eun Jung, Sean P Marrelli, Gab Seok Kim

Faculty, Staff and Student Publications

Microglia, the resident innate immune cells of the brain, become more highly reactive with aging and diseased conditions. In collaboration with other cell types in brains, microglia can contribute both to worsened outcome following stroke or other neurodegenerative diseases and to the recovery process by changing their phenotype toward reparative microglia. Recently, IFITM3 (a member of the "interferon-inducible transmembrane" family) has been revealed as a molecular mediator between amyloid pathology and neuroinflammation. Expression of IFITM3 in glial cells, especially microglia following stroke, is not well described. Here, we present evidence that ischemic stroke causes an increase in IFITM3 expression along …

The Immune Response To Airway Mycosis, Wei Ruan, Xinxin Ma, In Hyuk Bang, Yafen Liang, Jochen Daniel Muehlschlegel, Kuang-Lei Tsai, Tingting W Mills, Xiaoyi Yuan, Holger K Eltzschig

Faculty, Staff and Student Publications

Despite increasing availability and more successful interventional approaches to restore coronary reperfusion, myocardial ischemia-reperfusion injury is a substantial cause of morbidity and mortality worldwide. During myocardial ischemia, the myocardium becomes profoundly hypoxic, thus causing stabilization of hypoxia-inducible transcription factors (HIF). Stabilization of HIF leads to a transcriptional program that promotes adaptation to hypoxia and cellular survival. Transcriptional consequences of HIF stabilization include increases in extracellular production and signaling effects of adenosine. Extracellular adenosine functions as a signaling molecule via the activation of adenosine receptors. Several studies implicated adenosine signaling in cardioprotection, particularly through the activation of the Adora2a and Adora2b …

A Novel Prognostic 7-Methylguanosine Signature Reflects Immune Microenvironment And Alternative Splicing In Glioma Based On Multi-Omics Analysis, Zihan Wang, Zhiwei Zhong, Zehua Jiang, Zepeng Chen, Yuequn Chen, Yimin Xu

Research outputs 2022 to 2026

Glioma is the most common type of central nervous system tumor with increasing incidence. 7-methylguanosine (m7G) is one of the diverse RNA modifications that is known to regulate RNA metabolism and its dysregulation was associated with various cancers. However, the expression pattern of m7G regulators and their roles in regulating tumor immune microenvironments (TIMEs) as well as alternative splicing events (ASEs) in glioma has not been reported. In this study, we showed that m7G regulators displayed a close correlation with each other and most of them were differentially expressed between normal and glioma tissues. Two m7G signatures were then constructed …

Extracorporeal Membrane Oxygenation Therapy In Covid-19 Patients With Acute Respiratory Distress Syndrome, Joseph B. Zwischenberger, Katherine Breetz

Journal of Shock and Hemodynamics

Patients with coronavirus disease of 2019 (COVID-19) may present with a wide range of symptoms ranging from asymptomatic to critically ill. Approximately 10-14% of patients require hospitalization. Those individuals requiring hospitalization can deteriorate rapidly with worsening hypoxemia or new-onset pneumonia, resulting in 20-30% of patients developing acute respiratory distress syndrome (ARDS).

When refractory to medical management, severe ARDS secondary to other illnesses has been successfully treated with extracorporeal membrane oxygenation (ECMO). We completed a comprehensive literature review of ECMO utilization for patients with severe COVID-19 who were unresponsive to critical care management. Of the 1419 patients with a reported diagnosis …

Covid-19 Newsletter (Vol. 131), Center For Disaster Medicine, New York Medical College

COVID-19 Newsletter

No abstract provided.

Comparative Study Between Minimally Invasive Right Anterior Mini-Thoracotomy Versus Conventional Median Sternotomy In Isolated Aortic Valve Replacement: Early Outcome, Ashraf Abdelaziz, Hazem G. Bakr, Ibrahim M. Helmi

Journal of Medicine in Scientific Research

Background In cardiac surgery, minimally invasive surgical procedures have recently been adopted. These innovative procedures have a number of benefits, including less postoperative discomfort, fewer morbidity and mortality, faster recovery, and shorter hospital stays at lower costs. Patients and methods Outcomes of 30 patients who underwent isolated aortic valve replacement, were subjected to a prospective comparative study, were compared. In group A (n = 15) minimally invasive right anterior mini-thoracotomy approach and in group B (n = 15) conventional median sternotomy approach had been used. Results The second group had much higher total morbidity than the first. In …

Environmental Metagenomic Assessment And Its Usefulness In The Present Pandemic, Pathum Sookaromdee, Viroj Wiwanitkit

Journal of Medicine in Scientific Research

No abstract provided.

Conventional Transradial Access Versus Distal Transradial Access For Coronary Angiography And Interventions, Ahmed K. A. Ghany Hassan

Journal of Medicine in Scientific Research

Introduction For so many years, femoral access has been the standard access for all interventional cardiologists performing coronary angiography and percutaneous coronary interventions. In the past 15 years, radial access gained more fame over femoral access as it has a lower risk of bleeding and it is more convenient to patients due to early mobilization and less hospital stay. Recently, the distal transradial access in the anatomical snuffbox has emerged as a new access for coronary procedures that carries some advantages over the standard proximal transradial access. These advantages include radial artery preservation in patients who may use radial artery …

Association Between Vitamin D Receptor Gene (Bsmi-Rs1544410 And Foki-Rs2228570) Polymorphisms And Type 1 Diabetes Mellitus In Egyptian Children, Abeer M. Mohyi, Dina M. El-Abd, Eman A. Rashed, Ghada A. Omar, Mona M. A. Abdullatif

Journal of Medicine in Scientific Research

Introduction Type 1 diabetes mellitus (T1DM) is an autoimmune disorder triggered by both environmental and genetic risk factors. Although some studies have reported that single-nucleotide polymorphisms of vitamin D receptor (VDR) gene play a role in T1DM susceptibility, their associations are inconclusive and remain controversial in different ethnic groups. This case–control study aimed to evaluate the association between VDR (BsmI-rs1544410 and FokI-rs2228570) single-nucleotide polymorphisms and T1DM in Egyptian children. A total of 100 participants, 50 children with T1DM (cases) and 50 nondiabetic, age-matched and sex-matched patients (controls), were enrolled in the study in which BsmI-rs1544410 and …

Cytokine Profiling For Egyptian Diabetic Patients With Nephropathy, Abdel R. B. Abdel Gaffar, Ibrahim A. Emara, Rania Hassan Mohamed, Samar M. Samir

Journal of Medicine in Scientific Research

Background Evidence suggests that poor glycemic control is significantly associated with the development of microvascular complications of diabetes such as nephropathy. Studies have indicated that interleukin 17 (IL-17), interferon gamma-inducible protein 10 (IP-10), and IL-10 are important risk factors for nephropathy. This study aimed to evaluate the cytokine profile for diabetic patients with nephropathy. Patients and methods The study included 72 diabetic patients who were divided into two groups. Group 1 included diabetic patients without complications with an albumin creatinine ratio of less than or equal to 30, while group 2 included 36 diabetic patients with an albumin creatinine ratio …