Medical Specialties Commons^™

A Prospective Study In The Treatment Of Androgenic Alopecia Using Combination Of Procapil, Capixyl, Redensyl, Garima Bansal, Rishi Bansal

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Androgenic alopecia is characterized by its diffuse loss and the miniaturization of the hair. The study aimed to assess the safety and efficacy of procapil, redensyl, capixyl, bicapil, and anagain in topical hair growth serum in androgenic alopecia.

Methods: A prospective study was conducted on 110 healthy subjects aged 18-60 with androgenic alopecia in the Department of Dermatology, Tundla, Etmadhpur. Each subject applied 1 ml of serum on a dry scalp and was followed up on the 4^th, 8^th, 12^th, and 16^th week. Mean, median, and standard deviation were calculated. A repeated measure …

Virtual Primary Care In A Large Delaware-Based Independent Academic Medical Center: Impact And Opportunity, Darrell C. Dow, Sarah E. Schenck, Tracy L. Bell, Stephanie C. Roth, Omar Khan

Department of Family & Community Medicine Faculty Papers

COVID-19 and related challenges to patient access necessitated the development of new models of care to ensure a healthy patient population. This paper describes the outcomes of a pilot virtual primary care program at a large independent academic health center in Delaware. The preliminary results are encouraging from the perspective of provider and patient satisfaction, as well as the utility of the operational model. A complete cost-benefit analysis was beyond the scope of the paper; thus, future operational research should focus on the metrics of cost and quality as key indicators of model sustainability.

30- And 90-Day Readmission Rates Following Traumatic Spinal Cord Injury: A Systematic Review And Meta-Analyses, Marjan Hesari, Seyed Danial Alizadeh, Hamid Malekzadeh, Reza Tabrizi, Mohammad-Rasoul Jalalifar, Alireza Shahmohammadi, Zahra Eskandari, Zahra Ghodsi, James Harrop, Vafa Rahimi-Movaghar

Department of Neurosurgery Faculty Papers

Study Design

Systematic Review and Meta-Analyses.

Objective

To assess the 30- and 90-day readmission rates after a traumatic spinal cord injury (SCI).

Methods

A systematic search of MEDLINE and Embase was performed. The period was from inception to June 2022, with no language restrictions. All studies investigating the 30- and/or 90-day readmission rate following traumatic SCI were included. A random-effects model to combine effect sizes in our meta-analysis was applied.

Results

Seven out of 2959 reports met eligibility. The mean age of the patients was 50.2 ± 19.9, with a male-to-female ratio of 2.4:1. The most common traumatic SCI was …

Trajectory, Interactions, And Predictors Of Higher Symptom Burden During Induction Therapy For Multiple Myeloma, Mona Kamal, Qiuling Shi, Shu-En Shen, Charles Cleeland, Xin Shelley Wang

Faculty, Staff and Student Publications

Background: Patients with multiple myeloma (MM) experience disabling symptoms that are difficult to manage and may persist after induction therapy. Monitoring disease-related and induction therapy-induced symptoms and identifying patients at greater risk for high symptom burden are unmet clinical needs. The objective of this study was to examine the trajectories of symptom severity over time and identify predictors of high symptom burden during MM induction therapy.

Methodology: Eligible patients with MM rated their symptoms by completing the MD Anderson Symptom Inventory MM module repeatedly during 16 weeks of induction therapy. Group-based trajectory modeling identified patient groups with persistently high-severity (versus …

Diet And Immune Effects Trial (Diet)- A Randomized, Double-Blinded Dietary Intervention Study In Patients With Melanoma Receiving Immunotherapy, Rachel M Farias, Yan Jiang, Erma J Levy, Cindy Hwang, Jian Wang, Elizabeth M Burton, Lorenzo Cohen, Nadim Ajami, Jennifer A Wargo, Carrie R Daniel, Jennifer L Mcquade

Faculty, Staff and Student Publications

Background: Gut microbiome modulation is a promising strategy for enhancing the response to immune checkpoint blockade (ICB). Fecal microbiota transplant studies have shown positive signals of improved outcomes in both ICB-naïve and refractory melanoma patients; however, this strategy is challenging to scale. Diet is a key determinant of the gut microbiota, and we have previously shown that (a) habitual high dietary fiber intake is associated with an improved response to ICB and (b) fiber manipulation in mice impacts antitumor immunity. We recently demonstrated the feasibility of a controlled high-fiber dietary intervention (HFDI) conducted in melanoma survivors with excellent compliance and …

Review Of The Diagnosis, Pathophysiology, And Treatment Of Naegleria Fowleri-Induced Primary Amoebic Meningoencephalitis, Terrance Zhang

MCB Articles

Naegleria fowleri is a thermophilic, ubiquitous, free-living amoeba, but is also known as the “brain-eating” amoeba. This is the etiological agent of a rare and fulminant waterborne disease known as Primary Amoebic Meningoencephalitis (PAM) that is acutely fatal in 90-99% of reported cases. Those who come into contact with infested waters are at risk of introducing the amoeba into their upper nasal canal, whence the trophozoite form is known to migrate along the olfactory nerve, through the cribriform plate, and enter the central nervous system. Although the exact pathogenesis of N. fowleri is not known, studies have demonstrated contact-dependent and …

Caffeine And Arrhythmias: A Critical Analysis Of Cardiovascular Responses And Arrhythmia Susceptibility, Adel Khalifa Sultan Hamad

Journal of the Saudi Heart Association

Caffeine is a frequently consumed stimulant in different foods and beverages: coffee, tea, chocolate, sodas, and energy drinks. While its effects on the cardiovascular system have been extensively studied, there remains controversy surrounding its potential risks, particularly in patients with heart disease. This review provides a complete overview of caffeine's pharmacological properties, sources, and cardiovascular effects, particularly emphasizing its arrhythmogenic potential. The proarrhythmic potential of caffeine, particularly on atrial fibrillation and ventricular arrhythmias, is conducted. It explains the mechanism of action, including adenosine receptor antagonism, phosphodiesterase inhibition, calcium mobilization, and catecholamine release of caffeine. Epidemiological evidence and mechanistic insights are …

Differential Infiltration Of Key Immune T-Cell Populations Across Malignancies Varying By Immunogenic Potential And The Likelihood Of Response To Immunotherapy., Islam Eljilany, Sam Coleman, Aik Choon Tan, Martin D. Mccarter, John Carpten, Howard Colman, Abdul Rafeh Naqash, Igor Puzanov, Susanne Arnold, Michelle L. Churchman, Daniel Spakowicz, Bodour Salhia, Julian Marin, Shridar Ganesan, Aakrosh Ratan, Craig Shriver, Patrick Hwu, William S. Dalton, George J. Weiner, Jose R. Conejo-Garcia, Paulo Rodriguez, Ahmad A. Tarhini

Markey Cancer Center Faculty Publications

Background: Solid tumors vary by the immunogenic potential of the tumor microenvironment (TME) and the likelihood of response to immunotherapy. The emerging literature has identified key immune cell populations that significantly impact immune activation or suppression within the TME. This study investigated candidate T-cell populations and their differential infiltration within different tumor types as estimated from mRNA co-expression levels of the corresponding cellular markers.

Methods: We analyzed the mRNA co-expression levels of cellular biomarkers that define stem-like tumor-infiltrating lymphocytes (TILs), tissue-resident memory T-cells (TRM), early dysfunctional T-cells, late dysfunctional T-cells, activated-potentially anti-tumor (APA) T-cells and Butyrophilin 3A (BTN3A) isoforms, utilizing …

The Use Of Cloud Based Machine Learning To Predict Outcome In Intracerebral Haemorrhage Without Explicit Programming Expertise, Ajay Hegde, Deepu Vijaysenan, Pitchaiah Mandava, Girish Menon

Faculty, Staff and Students Publications

Machine Learning (ML) techniques require novel computer programming skills along with clinical domain knowledge to produce a useful model. We demonstrate the use of a cloud-based ML tool that does not require any programming expertise to develop, validate and deploy a prognostic model for Intracerebral Haemorrhage (ICH). The data of patients admitted with Spontaneous Intracerebral haemorrhage from January 2015 to December 2019 was accessed from our prospectively maintained hospital stroke registry. 80% of the dataset was used for training, 10% for validation, and 10% for testing. Seventeen input variables were used to predict the dichotomized outcomes (Good outcome mRS 0-3/ …

Using Multiplexed Functional Data To Reduce Variant Classification Inequities In Underrepresented Populations, Moez Dawood, Shawn Fayer, Sriram Pendyala, Mason Post, Divya Kalra, Karynne Patterson, Eric Venner, Lara A Muffley, Douglas M Fowler, Alan F Rubin, Jennifer E Posey, Sharon E Plon, James R Lupski, Richard A Gibbs, Lea M Starita, Carla Daniela Robles-Espinoza, Willow Coyote-Maestas, Irene Gallego Romero

Faculty, Staff and Students Publications

BACKGROUND: Multiplexed Assays of Variant Effects (MAVEs) can test all possible single variants in a gene of interest. The resulting saturation-style functional data may help resolve variant classification disparities between populations, especially for Variants of Uncertain Significance (VUS).

METHODS: We analyzed clinical significance classifications in 213,663 individuals of European-like genetic ancestry versus 206,975 individuals of non-European-like genetic ancestry from All of Us and the Genome Aggregation Database. Then, we incorporated clinically calibrated MAVE data into the Clinical Genome Resource's Variant Curation Expert Panel rules to automate VUS reclassification for BRCA1, TP53, and PTEN.

RESULTS: Using two orthogonal statistical approaches, we …

Reflections From The Pandemic: Is Connectivism The Panacea For Clinicians?, Jennifer Benjamin, Tyson Pillow, Heather Macneill, Ken Masters, Anoop Agrawal, Neil Mehta

Faculty, Staff and Students Publications

The COVID-19 pandemic and the recent increased interest in generative artificial intelligence (GenAI) highlight the need for interprofessional communities' collaboration to find solutions to complex problems. A personal narrative experience of one of the authors compels us to reflect on current approaches to learning and knowledge acquisition and use solutions to the challenges posed by GenAI through social learning contexts using connectivism. We recognize the need for constructivism and experiential learning for knowledge acquisition to establish foundational understanding. We explore how connectivist approaches can enhance traditional constructivist paradigms amid rapidly changing learning environments and online communities. Learning in connectivism includes …

Advancements And Emerging Insights In Thoracolumbar Spine Trauma, Jonathan Neuhoff, Alex R. Vaccaro, Cumhur Oner, Klaus Schnake, Frank Kandziora

Department of Orthopaedic Surgery Faculty Papers

Thoracolumbar spine trauma represents a complex and evolving field within spinal surgery, with a continuous shift in treatment paradigms as research refines optimal approaches for specific patient populations. This special issue, with contributions from 20 peer-reviewed articles, brings together recent advancements in thoracolumbar trauma care, offering insight into improved diagnostic protocols, emerging surgical techniques, patient-centred outcomes, and the integration of new technologies.

Prenatal Assessment Of Brain Malformations On Neuroimaging: An Expert Panel Review, Ivana Pogledic, Kshitij Mankad, Mariasavina Severino, Tally Lerman-Sagie, Andras Jakab, Efrat Hadi, Anna C Jansen, Nadia Bahi-Buisson, Natalya Di Donato, Renske Oegema, Christian Mitter, Ivan Capo, Matthew T Whitehead, Parthiv Haldipur, Grazia Mancini, Thierry A G M Huisman, Andrea Righini, Bill Dobyns, James A Barkovich, Natasa Jovanov Milosevic, Gregor Kasprian, Maarten Lequin

Faculty, Staff and Students Publications

Brain malformations represent a heterogeneous group of abnormalities of neural morphogenesis, often associated with aberrations of neuronal connectivity and brain volume. Prenatal detection of brain malformations requires a clear understanding of embryology and developmental morphology through the various stages of gestation. This expert panel review is written with the central aim of providing an easy-to-understand road map to improve prenatal detection and characterization of structural malformations based on the current understanding of normal and aberrant brain development. For every developmental stage, the utility of each available neuroimaging modality, including prenatal multiplanar neuro sonography, anatomical MRI and advanced MRI techniques, as …

Correction: Nepali Oral Microbiomes Reflect A Gradient Of Lifestyles From Traditional To Industrialized, Erica P Ryu, Yoshina Gautam, Diana M Proctor, Dinesh Bhandari, Sarmila Tandukar, Meera Gupta, Guru Prasad Gautam, David A Relman, Ahmed A Shibl, Jeevan Bahadur Sherchand, Aashish R Jha, Emily R Davenport

Faculty, Staff and Student Publications

No abstract provided.

Epigenetic Modifiers: Exploring The Roles Of Histone Methyltransferases And Demethylases In Cancer And Neurodegeneration, Lauren Reed, Janak Abraham, Shay Patel, Shilpa S Dhar

Faculty, Staff and Student Publications

Histone methyltransferases (HMTs) and histone demethylases (HDMs) are critical enzymes that regulate chromatin dynamics and gene expression through the addition and removal of methyl groups on histone proteins. HMTs, such as PRC2 and SETD2, are involved in the trimethylation of histone H3 at lysine 27 and lysine 36, influencing gene silencing and activation. Dysregulation of these enzymes often leads to abnormal gene expression and contributes to tumorigenesis. In contrast, HDMs including KDM7A and KDM2A reverse these methylation marks, and their dysfunction can drive disease progression. In cancer, the aberrant activity of specific HMTs and HDMs can lead to the silencing …

Targeted Maternal Chagas Disease Screening Among Individuals Born In A Chagas-Endemic Country., Alvaro Proaño, Neil C Shah, Sneider A Gutierrez Guarnizo, Monica Miranda-Schaeubinger, Michael Z Levy, Robert H Gilman, Dustin D Flannery

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Chagas disease is a neglected tropical disease caused by the parasite Trypanosoma cruzi that affects 6 million people worldwide. In the United States, Chagas is estimated to affect 43 000 women of reproductive age. Pregnant persons with Chagas are at risk for congenital transmission to the newborn, which accounts for nearly a quarter of all new cases. In 2022, a US multidisciplinary expert working group4 developed recommendations for increased clinician-directed screening for Chagas. They concluded that women of reproductive age who were born in endemic countries should be tested due to vertical transmission risk. In 2024, Clark and Bern outlined …

Antibiotics For Culture-Negative Neonatal Early-Onset Sepsis: Measuring The Unmeasurable, Dustin D Flannery, Matthew B Green

Rowan-Virtua School of Osteopathic Medicine Departmental Research

No abstract provided.

Neurofeedback: New Territories And Neurocognitive Mechanisms Of Endogenous Neuromodulation, James Sulzer, T Dorina Papageorgiou, Rainer Goebel, Talma Hendler

Faculty, Staff and Students Publications

Neurofeedback (NF) is endogenous neuromodulation of circumscribed brain circuitry. While its use of real-time brain activity in a closed-loop system is similar to brain-computer interfaces, instead of controlling an external device like the latter, the goal of NF is to change a targeted brain function. In this special issue on NF, we present current and future methods for extracting and manipulating neural function, how these methods may reveal new insights about brain function, applications, and rarely discussed ethical considerations of guiding and interpreting the brain activity of others. Together, the articles in this issue outline the possibilities of NF use …

Individualized Functional Magnetic Resonance Imaging Neuromodulation Enhances Visuospatial Perception: A Proof-Of-Concept Study, Anthony Allam, Vincent Allam, Sandy Reddy, Eric M Rohren, Sameer A Sheth, Emmanouil Froudarakis, T Dorina Papageorgiou

Duncan NRI Faculty and Staff Publications

This proof-of-concept study uses individualized functional magnetic resonance imaging neuromodulation (iNM) to explore the mechanisms that enhance BOLD signals in visuospatial perception (VP) networks that are crucial for navigation. Healthy participants (n = 8) performed a VP up- and down-direction discrimination task at full and subthreshold coherence through peripheral vision, and superimposed direction through visual imagery (VI) at central space under iNM and control conditions. iNM targets individualized anatomical and functional middle- and medial-superior temporal (MST) networks that control VP. We found that iNM engaged selective exteroceptive and interoceptive attention (SEIA) and motor planning (MP) networks. Specifically, iNM increased …

Concomitant Epidural And Longitudinal Anterior Spinal Artery Contrast Spread In A Lumbar Transforaminal Epidural Steroid Injection (Tfesi), Philip J. Koehler Iii, Paul M. Kitei, David S. Stolzenberg, Elaine H. Hatch

Rothman Institute Papers

A 78-year-old female with a remote history of L3-4 decompression and fusion presented with several months of low back and radicular leg pain. MRI revealed moderate L2-L3 spinal canal stenosis, ligamentum flavum infolding, moderate bilateral foraminal stenosis, and a grade I retrolisthesis. A right sided L2-L3 TFESI was performed using multiplanar fluoroscopic imaging with a subpedicular supraneural approach. During live iodinated contrast injection, imaging revealed concomitant epidural and central arterial contrast spread. The needle was retracted and repeat live fluoroscopic imaging demonstrated no vascular uptake. Desired epidural and nerve root contrast spread remained in place with repeat still imaging. Dexamethasone …

Teaching Matters In Formula Preparation-A Measure Of Equity And Nutritional Safety, Matthew D. Di Guglielmo

Department of Pediatrics Faculty Papers

No abstract provided.

A Comparison Of Vestibular Function In Young Adult Musicians And Non-Musician Peers, Alexandria W. Greene, Ashley G. Flagge, Nicholas S. Stanley

Ashley Flagge Publications

Purpose: The majority of college-level musicians exceed the daily recommended noise dose level during instrumental practices and performances, although less than one-third report wearing hearing protection while playing their instruments. Although the hazardous effects of music on the auditory system have been established, even in young adult musicians still early in their musical careers, the effects of music on the vestibular system are still unclear. The purpose of the present study was to examine vestibular/balance differences between young adult musicians and non-musicians to determine the effects of music exposure on the vestibular system.

Method: Young adult participants aged 18-27 years …

Improving Prognostication In Hypoxic-Ischemic Encephalopathy, Daniel G Calame, Kristen S Fisher

Faculty, Staff and Students Publications

No abstract provided.

Extreme Wrinkling Of The Nuclear Lamina Is A Morphological Marker Of Cancer, Ting-Ching Wang, Christina R Dollahon, Sneha Mishra, Hailee Patel, Samere Abolghasemzade, Ishita Singh, Vilmos Thomazy, Daniel G Rosen, Vlad C Sandulache, Saptarshi Chakraborty, Tanmay P Lele

Faculty, Staff and Students Publications

Nuclear atypia is a hallmark of cancer. A recent model posits that excess surface area, visible as folds/wrinkles in the lamina of a rounded nucleus, allows the nucleus to take on diverse shapes with little mechanical resistance. Whether this model is applicable to normal and cancer nuclei in human tissues is unclear. We image nuclear lamins in patient tissues and find: (a) nuclear laminar wrinkles are present in control and cancer tissue but are obscured in hematoxylin and eosin (H&E) images, (b) nuclei rarely have a smooth lamina, and (c) wrinkled nuclei assume diverse shapes. Deep learning reveals the presence …

Onset And Progression Of Disease In Nonhuman Primates With Pde6c Cone Disorder, Monica Ardon, Lily Nguyen, Rui Chen, Jeffrey Rogers, Tim Stout, Sara Thomasy, Ala Moshiri

Faculty, Staff and Students Publications

PURPOSE: The California National Primate Research Center contains a colony of rhesus macaques with a homozygous missense mutation in PDE6C (R565Q) which causes a cone disorder similar to PDE6C achromatopsia in humans. The purposes of this study are to characterize the phenotype in PDE6C macaques in detail to determine the onset of the cone phenotype, the degree to which the phenotype progresses, if heterozygote animals have an intermediate phenotype, and if rod photoreceptor function declines over time.

METHODS: We analyzed spectral-domain optical coherence tomography (SD-OCT), fundus autofluorescence (FAF), and electroretinography (ERG) data from 102 eyes of 51 macaques (aged 0.25 …

Estimated Vaccine Effectiveness For Pediatric Patients With Severe Influenza, 2015-2020., Kelsey M. Sumner, Leila C. Sahni, Julie A. Boom, Natasha B. Halasa, Laura S. Stewart, Janet A. Englund, Eileen J. Klein, Mary A. Staat, Elizabeth P. Schlaudecker, Rangaraj Selvarangan, Christopher J. Harrison, Geoffrey A. Weinberg, Peter G. Szilagyi, Monica N. Singer, Parvin H. Azimi, Benjamin R. Clopper, Heidi L. Moline, Emma K. Noble, John V. Williams, Marian G. Michaels, Samantha M. Olson, New Vaccine Surveillance Network Collaborators

Manuscripts, Articles, Book Chapters and Other Papers

IMPORTANCE: Increasing the understanding of vaccine effectiveness (VE) against levels of severe influenza in children could help increase uptake of influenza vaccination and strengthen vaccine policies globally.

OBJECTIVE: To investigate VE in children by severity of influenza illness.

DESIGN, SETTING, AND PARTICIPANTS: This case-control study with a test-negative design used data from 8 participating medical centers located in geographically different US states in the New Vaccine Surveillance Network from November 6, 2015, through April 8, 2020. Participants included children 6 months through 17 years of age who were hospitalized or presented to an emergency department (ED) with acute respiratory illness. …

Biodata Drives Treatment Success, Steve Carstensen Dds

Metro Denver Dental Society Articulator Magazine

This article explores the growing role of biosignals and digital health technologies in dentistry, emphasizing how devices like wearable rings and sensors are enhancing the diagnosis and management of conditions such as obstructive sleep apnea, periodontal disease and chronic pain. By integrating biosignal data into patient care, dentists can provide more precise, personalized treatments, improving outcomes and supporting collaboration with primary care providers in managing chronic diseases.

The Power Of Prevention: Integrating Dental And Cardiovascular Care With The Baledoneen Method™, Amy Doneen Dnp

Metro Denver Dental Society Articulator Magazine

This article details the BaleDoneen Method™ which offers a collaborative, science-based approach to preventing and managing cardiovascular disease (CVD) by targeting the root causes of arterial plaque formation. This method integrates dental care by addressing high-risk periodontal pathogens, recognizing the critical connection between oral health and vascular health, and emphasizes the importance of personalized care to reduce systemic inflammation and cardiovascular risk.

Inherited Retinal Degenerations And Non-Neovascular Age-Related Macular Degeneration: Progress And Unmet Needs, Jacque L Duncan, Angela Bowman, Amy Laster, Claire Gelfman, David G Birch, Shannon E Boye, Stephen P Daiger, Lucian Del Priore, Donald J Zack, James T Handa

Faculty, Staff and Student Publications

Inherited retinal degeneration (IRD) disease and age-related macular degeneration (AMD) are leading causes of irreversible vision loss and blindness. Although significant progress has advanced the field in the past 5 years, significant challenges remain. The current article reviews the accomplishments and research advances that have fueled the development of treatments for patients with IRD and AMD, including the first approved gene-augmentation treatment for RPE65-related retinal degeneration and complement inhibition therapies to slow progression of geographic atrophy (GA) in AMD. The article outlines opportunities to address gaps and unmet needs that should lead to additional progress toward the development of treatments …

Systemic Administration Of A Site-Targeted Complement Inhibitor Attenuates Chronic Stress-Induced Social Behavior Deficits And Neuroinflammation In Mice, Amit Kumar Madeshiya, Brandi Quintanilla, Carl Whitehead, Stephen Tomlinson, Anilkumar Pillai

Faculty, Staff and Student Publications

Chronic stress, a risk factor for many neuropsychiatric conditions, causes dysregulation in the immune system in both humans and animal models. Additionally, inflammation and synapse loss have been associated with deficits in social behavior. The complement system, a key player of innate immunity, has been linked to social behavior impairments caused by chronic stress. However, it is not known whether complement inhibition can help prevent neuroinflammation and behavioral deficits caused by chronic stress. In this study, we investigated the potential of a site-targeted complement inhibitor to ameliorate chronic stress-induced changes in social behavior and inflammatory markers in the prefrontal cortex …