Medical Specialties Commons^™

A Thiouracil Desulfurase Protects Clostridioides Difficile Rna From 4-Thiouracil Incorporation, Providing A Competitive Advantage In The Gut, Matthew J Munneke, Yifeng Yuan, Eva C Preisner, Catherine D Shelton, Darian T Carroll, Nicole S Kirchoff, Ken P Dickson, Jose O Cantu, Martin V Douglass, M Wade Calcutt, Katherine N Gibson-Corley, Maribeth R Nicholson, Mariana X Byndloss, Robert A Britton, Valérie De Crécy-Lagard, Eric P Skaar

Faculty, Staff and Students Publications

Nucleotides are essential building blocks for major cellular macromolecules and are critical for life. Consequently, bacterial pathogens must acquire or synthesize nucleotides during infection. Clostridioides difficile is the most common hospital-acquired gastrointestinal infection, and nutrient acquisition is critical for pathogenesis. However, the impact of nucleotide metabolism on C. difficile infection remains unclear. Here, we discover that 4-thiouracil (4-TU), a pyrimidine analog present in the human gut, is toxic to commensal bacteria. 4-TU hijacks the uracil salvage pathway for incorporation into RNA through the uracil phosphoribosyltransferase activity encoded by PyrR and Upp. C. difficile can salvage 4-TU as a pyrimidine source …

An Unsupervised Map Of Excitatory Neuron Dendritic Morphology In The Mouse Visual Cortex, Timo Lüddecke, Brendan Celii, Paul G Fahey, Eric Y Wang, J Alexander Bae, Agnes L Bodor, Derrick Brittain, Joann Buchanan, Daniel J Bumbarger, Manuel A Castro, Forrest Collman, Nuno Maçarico Da Costa, Sven Dorkenwald, Leila Elabbady, Akhilesh Halageri, Zhen Jia, Chris Jordan, Dan Kapner, Nico Kemnitz, Sam Kinn, Kisuk Lee, Kai Li, Ran Lu, Thomas Macrina, Gayathri Mahalingam, Eric Mitchell, Shanka Subhra Mondal, Shang Mu, Barak Nehoran, Sergiy Popovych, R Clay Reid, Casey M Schneider-Mizell, H Sebastian Seung, William Silversmith, Marc Takeno, Russel Torres, Nicholas L Turner, William Wong, Jingpeng Wu, Wenjing Yin, Szi-Chieh Yu, Jacob Reimer, Philipp Berens, Andreas S Tolias, Alexander S Ecker

Faculty, Staff and Students Publications

Neurons in the neocortex exhibit astonishing morphological diversity, which is critical for properly wiring neural circuits and giving neurons their functional properties. However, the organizational principles underlying this morphological diversity remain an open question. Here, we took a data-driven approach using graph-based machine learning methods to obtain a low-dimensional morphological "bar code" describing more than 30,000 excitatory neurons in mouse visual areas V1, AL, and RL that were reconstructed from the millimeter scale MICrONS serial-section electron microscopy volume. Contrary to previous classifications into discrete morphological types (m-types), our data-driven approach suggests that the morphological landscape of cortical excitatory neurons is …

The Medial Olivocochlear Efferent Pathway Potentiates Cochlear Amplification In Response To Hearing Loss, Ariadna Cobo-Cuan, Marcela A Morán, Bong Jik Kim, Clayton B Walker, Michael J Serafino, Frank Macias-Escriva, Juemei Wang, James B Dewey, Brian E Applegate, Matthew J Mcginley, John S Oghalai

Faculty, Staff and Students Publications

The mammalian cochlea receives efferent feedback from the brain. Many functions for this feedback have been hypothesized, including on short timescales, such as mediating attentional states, and long timescales, such as buffering acoustic trauma. Testing these hypotheses has been impeded by an inability to make direct measurements of efferent effects in awake animals. Here, we assessed the role of the medial olivocochlear (MOC) efferent nerve fibers on cochlear amplification by measuring organ of Corti vibratory responses to sound in both sexes of awake and anesthetized mice. We studied long-term effects by genetically ablating the efferents and/or afferents. Cochlear amplification increased …

Association Of Plant-Based Dietary Patterns With Female Reproductive Cancer Incidence And Mortality: A Systematic Review, Esther L. Farley, Scott Moore, Gary A. Giovino, Darryl Somayaji

Campus Research Month

Healthy plant-based eating, a health-related behavior that nurses may promote, has been associated with a decrease in multiple types of cancer. However, the association of a healthy plant-based dietary pattern with decreased female reproductive cancers has not yet been established.

This review of the literature followed PRISMA guidelines to search for the relationship between a healthy plant-based dietary pattern and incidence of and mortality from a breast or gynecological cancer diagnosis. Databases searched for this review included PubMed, EMBASE, CINAHL, and Web of Science.

We identified 27 publications that met the qualifications for inclusion. Twelve studies covered mortality from breast, …

What Do Medical Assistants Do?, Ryan Williams

Student Research Symposium

Medical assistants interact with patients before, during, and after provider interactions. They assist providers, conduct clinical maintenance, and mediate between patients, providers, and administration personnel.

3d-Printed Organ-Realistic Phantoms To Verify Quantitative Spect/Ct Accuracy For 177lu-Psma-617 Treatment Planning, Lydia J. Wilson, Sara Belko, Eric L. Gingold, Shuying Wan, Rachel Monane, Robert S. Pugliese, Firas Mourtada

Department of Radiation Oncology Faculty Papers

Background/Objectives: Accurate patient-specific dosimetry is essential for optimizing radiopharmaceutical therapy (RPT), but current tools lack validation in clinically realistic conditions. This work aimed to develop a workflow for designing and fabricating patient-derived, organ-realistic RPT phantoms and evaluate their feasibility for commissioning patient-specific RPT radioactivity quantification. Methods: We used computed tomographic (CT) and magnetic resonance (MR) imaging of representative patients, computer-aided design, and in-house 3D printing technology to design and fabricate anthropomorphic kidney and parotid phantoms with realistic organ spacing, anatomically correct orientation, and surrounding tissue heterogeneities. We evaluated the fabrication process via geometric verification (i.e., volume comparisons) and leak testing …

A Vomiting And Dyspneic Teenager, Janet Han, Do, Shireen Khan, Md

Jefferson Health - Northeast Posters (formerly Aria Health Posters)

History of Present Illness

CHIEF COMPLAINT: Shortness of Breath

15 y/o female with no pertinent PMHx presents to the emergency department with shortness of breath onset 3 days ago. Patient is also reporting cough, congestion, sore throat, subjective fever and chills, myalgias, as well as nausea and vomiting. Today, she states she is so nauseous she has tried to force herself to throw up several times. Since then, she has been experiencing neck pain with movement. Patient is UTD with all her vaccines. Denies alcohol and drug use. Initially denies vaping/smoking; later states she has vaped daily until her symptoms’ …

Potential Benefits And Drawbacks Of Washing Stored Red Blood Cells Prior To Transfusion: A Scoping Review, Mary Mccullough

Student Works

Background: There is growing interest in washing banked blood with an intraoperative autotransfusion device (IAT) prior to transfusing to patients. The main purpose of this practice is to reduce the effects caused by storage lesion, both to the blood and the patient, and diminish the cost and of washing by using an IAT as opposed to washing in the blood bank.

Objective: The objective of this scoping review is to summarize the existing data on the use of IATs for washing stored banked blood and evaluate the potential advantages and disadvantages associated with transfusing the washed blood.

Method: This scoping …

Molecular Subtyping Of Hypertensive Disorders Of Pregnancy, Michal Elovitz, Elaine Gee, Nathaniel Delaney-Busch, Alison Moe, Mitsu Reddy, Arkady Khodursky, Johnny La, Ilma Abbas, Kay Mekaru, Hunter Collins, Farooq Siddiqui, Rory Nolan, Rupsa Boelig, Daniel Kiefer, Pamela Simmons, George Saade, Antonio Saad, Ebony Carter, Thomas Mcelrath, Stephen Quake, Mark Depristo, Carrie Haverty, Manfred Lee, Eugeni Namsaraev, Vincenzo Berghella, Ai-Ris Collier, Antonia Frolova, Esther Park-Hwang, Luis Pacheco, Elizabeth Sutton, Maneesh Jain, Kara Rood, William A Grobman, Joseph Biggio, Cynthia Gyamfi-Bannerman, Arun Jeyabalan, Morten Rasmussen

Department of Obstetrics and Gynecology Faculty Papers

Hypertensive disorders of pregnancy (HDP), including preeclampsia, affect 1 in 6 pregnancies, are major contributors to maternal morbidity and mortality, yet lack precision medicine strategies. Analyzing transcriptomic data from a prospectively-collected diverse cohort (n = 9102), this study reveals distinct RNA subtypes in maternal blood, reclassifying clinical HDP phenotypes like early/late-onset preeclampsia. The placental gene PAPPA2 strongly predicts the most severe forms of preeclampsia in individuals without pre-existing high risk factors, months before symptoms, and its overexpression correlates with earlier delivery in a dose-dependent manner. Further, molecular subtypes characterized by immune genes are upregulated in less severe forms of HDP. …

The Cardiovascular Care Of The Pediatric Athlete, Jonathan B Edelson, Susan Etheridge, Dermot M Phelan, Keri Shafer, Chris Snyder, Silvana Molossi, Alfred Danielian, Eli M Friedman, Jeff Hsu, Mustafa Husaini, Eugene H Chung, Matthew W Martinez, Aaron L Baggish, Benjamin D Levine, Jonathan H Kim, American College Of Cardiology Sports & Exercise Cardiology Council

Faculty, Staff and Students Publications

Sports cardiology broadly encompasses the cardiovascular care of individuals who place a high premium on habitual exercise, sports performance, and/or sports competition. Some of the essential aspects within sports cardiology include the preparticipation cardiac evaluation and the management of cardiac diseases in athletes. Although most sports cardiology practitioners are trained in adult cardiology, a significant number of individuals who participate in sports are pediatric-aged, < 18 years old. Up to two-thirds of children in middle and high school participate in organized sports or are involved in nonorganized recreational sports. The cardiovascular care of pediatric-aged athletes can be challenging because many of the classic tenets and principles in adult sports cardiology do not fully generalize to pediatrics, and there is a lack of the evidence base that may be present for adult athletes. The epidemiology, presentation, and progression of cardiovascular diseases can be significantly different between pediatric and adult athletes. The evaluation of potential diseases and management considerations may also differ between pediatric and adult athletes. Similar to adults, there are "gray zones" where it is difficult to differentiate between normal exercise-induced cardiac remodeling and true cardiac pathology, but the additional lack of normative standards further complicates assessments in pediatric athletes. Management decisions for pediatric athletes are generally based on limited data but carry substantial short- and long-term implications. Thus, shared decision-making as part of the determination of clinical management strategies and for sports participation is critical and requires the participation of the parents or guardian(s). In this state-of-the-art review, key differences between pediatric and adult-aged athletes are highlighted. Specifically, how to define the "pediatric athlete," consider cardiovascular adaptations observed among pediatric athletes, determine preparticipation screening options and optimal symptom-driven evaluations in children, and consider best practices for pediatric athletes with several key cardiac conditions are detailed. The purpose of this document is to represent the first primary reference available to providers who care for pediatric athletes with cardiovascular concerns.

Phase 2 Trial Of Ibrutinib And Nivolumab In Patients With Relapsed Cns Lymphomas, Dai Chihara, Raphael E Steiner, Ranjit Nair, Lei Feng, Sairah Ahmed, Luis Malpica, Shivon A Mathew, Wirt Montinez, Gita Masand, Felipe Samaniego, Maria A Rodriguez, Fredrick B Hagemeister, Luis E Fayad, Swaminathan P Iyer, Loretta J Nastoupil, Sattva S Neelapu, Christopher R Flowers, Jason R Westin

Faculty, Staff and Student Publications

Treatment options are limited for both relapsed/refractory primary and secondary central nervous system (CNS) lymphoma and the prognosis remains poor. Previous studies have shown the activity of Bruton tyrosine kinase inhibitors and programmed death-1-targeted therapies in CNS lymphoma, and studies suggested potential synergy. Therefore, we conducted a phase 2 trial that combined ibrutinib with nivolumab for patients with relapsed/refractory CNS lymphoma. Patients received 560 mg oral ibrutinib daily with 240 mg IV nivolumab every 14 days (28 days per cycle). Patients who had partial or complete response after 6 cycles of treatment could continue therapy for up to 2 years …

Identifying The Human Olfactory And Chemosignaling Neural Networks Using Event Related Fmri And Graph Theory, Saideh Ferdowsi, Tom Foulsham, Alireza Rahmani, Dimitri Ognibene, Luca Citi

Faculty, Staff and Student Publications

This study aims to characterize and compare the functional neural networks associated with different olfactory stimuli, including air, non-social odours, and human body odours. We introduce a novel processing pipeline based on event-related functional magnetic resonance imaging (fMRI) and graph theory for network identification. To ensure the stability and small worldness of the characterized networks, we conduct statistical validations, network modularity assessments, and robustness measurement against local attacks. The key hypothesis is that human body odours (so-called social odours) and non-social odours engage distinct neural networks, particularly in regions responsible for social processing. We found that the posterior medial orbitofrontal …

Challenges In Transitioning From Methadone To Buprenorphine-Naloxone For Chronic Pain Management: Two Cases, Alaa Abd-Elsayed

Faculty, Staff and Students Publications

Background: Methadone is frequently used for chronic pain management due to its long half-life and NMDA receptor activity, making it an effective option for opioid-tolerant patients. Buprenorphine-naloxone is increasingly explored as an alternative for chronic pain and opioid use disorder, offering partial opioid agonism with a ceiling effect on respiratory depression. The transition from methadone to buprenorphine-naloxone remains clinically challenging, requiring careful management to prevent withdrawal and ensure adequate pain control.

Case descriptions: Two patients with chronic pain were transitioned from methadone to buprenorphine-naloxone. The first patient, a mid-40s female, was abruptly switched from methadone 10 mg twice daily dosing …

Tumor-Derived Arachidonic Acid Reprograms Neutrophils To Promote Immune Suppression And Therapy Resistance In Triple-Negative Breast Cancer, Fengshuo Liu, Zhan Xu, Xiaoxin Hao, Ling Wu, Weijie Zhang, Hilda L Chan, Bo Wei, Philip L Lorenzi, Yang Gao, Igor Bado, Luis Becerra-Dominguez, Charlotte Helena Rivas, Sergio Aguirre, Bradley C Pingel, Yi-Hsuan Wu, Yunfeng Ding, Jun Liu, David G Edwards, Livia S Eberlin, Xiang H-F Zhang

Faculty, Staff and Students Publications

The combination of immune checkpoint blockade and chemotherapies is the standard of care for triple-negative breast cancer (TNBC). However, initially, responsive tumors can still develop recurrences, suggesting acquired resistance mechanisms that remain poorly understood. Herein, we discover that TNBC cells surviving anti-programmed cell death protein-1 (anti-PD-1) and chemotherapy treatment accumulate neutral lipids. Disrupting lipid droplet formation in cancer cells reverses resistance and mitigates the immunosuppressive microenvironment. Single-cell RNA sequencing reveals a subset of neutrophils exhibiting a lipid-laden phenotype similar to adjacent tumor cells. Mechanistically, tumor-derived extracellular vesicles carrying lipids, including arachidonic acid (AA), mediate neutrophil reprogramming. Blocking dietary intake of …

Differential Antibody Response To Ebv Proteome Following Ebvst Immunotherapy In Ebv-Associated Lymphomas, Helen E Heslop, Rayne H Rouce, Anna E Coghill, Cliona M Rooney, Carla Proietti, Denise L Doolan

Faculty, Staff and Students Publications

Epstein-Barr virus (EBV) is associated with a diverse range of lymphomas. EBV-specific T-cell (EBVST) infusions have shown promise in safety and clinical effectiveness in treating EBV-associated lymphomas; however, not all patients respond to T-cell immunotherapies. To identify EBV antigen–specific antibody responses associated with clinical outcomes, we comprehensively characterized antibody responses to the complete EBV proteome using a custom protein microarray in 56 patients with EBV-associated lymphoma who received EBVST infusions in phase 1 clinical trials. Responders (nonprogressors) and nonresponders (progressors) had distinct antibody profiles against EBV. Twenty-five immunoglobulin G (IgG) antibodies were significantly elevated in higher levels in nonresponders than …

Understanding Challenges To Breast Cancer Screening For African American Women In Detroit: A Study Of Social And Healthcare Inequities, Miranda Goodson, Whitney Bowyer, Erika Lopez, Anna Lundh

Medical Student Research Symposium

African American (AA) women have lower adherence to breast cancer screening guidelines, which may contribute to delayed diagnoses and reduced survival rates. These disparities are often influenced by limited access to quality healthcare and persistent inequities faced within Michigan. With Detroit's population being 77% AA, examining studies focused on the experiences of Black women within urban healthcare networks is essential to understanding the connections between demographic, socioeconomic factors, and breast cancer outcomes. To assess these studies, a literature search was conducted using Ovid Medline yielding 24 associated articles.

Mammogram rates among AA women in Detroit remain low, reflecting a complex …

Working Conditions Of Perfusionists In North America: A Scoping Review, James Strong

Student Works

Perfusionists face significant challenges, including long hours, high workloads, burnout, and workplace risks like sleep deprivation and discrimination, which impact both their well-being and patient outcomes. Despite these concerns, no comprehensive review has mapped workforce trends, and the lack of widespread American Society of Extracorporeal Technology (AmSECT) guideline implementation worsens the situation. This scoping review highlights these issues, emphasizing the need for standardized assessments, better enforcement of guidelines, and proactive strategies to improve perfusionist well-being and patient safety. This scoping review aims to describe the working conditions of North American Certified Clinical Perfusionists (CCPs).

Hickam’S Dictum Of The Great Vessels: Saddle Embolism And Dissection, Eric Wetzel, Do, Kyle Mohney, Do, Jessica Schumann, Do, Olubunmi Olarewaju, Do

Jefferson Health - Northeast Posters (formerly Aria Health Posters)

History of Present Illness

Chief Complaint:
Shortness of breath

History of Present:
Illness A 66-year-old female with a past medical history of hypertension presents to the emergency department concerned for shortness of breath and palpitations. She reports her symptoms started abruptly while on a morning walk. She notes she took her home blood pressure medication this morning per her usual routine and had otherwise been feeling well. She describes feeling like she is having a “high grade panic attack”, similar to past panic attacks but with increased intensity. She denies associated weakness, numbness, chest pain, nausea, vomiting, or abdominal pain. …

Structural Updates To The Implant And Refill Needle Of The Port Delivery Platform, Dante J. Pieramici, Peter A. Campochiaro, Margaret Chang, Ian Pearce, Carl D. Regillo, Shamika Gune, Nancy Holekamp, Carlos Quezada-Ruiz, Shrirang V. Ranade, Natasha Singh, Geoffrey Wise, Joshua Horvath

Wills Eye Hospital Papers

PURPOSE: The purpose of this study was to report the impact of component-level changes and manufacturing process improvements on septum durability in the ocular implant of the Port Delivery Platform (PD-P), more commonly known as the Port Delivery System with ranibizumab (PDS) with its current formulation.

METHODS: Laboratory tests were conducted to determine (1) the bond strength of the septum to the overmold, (2) the amount of force utilized for the refill needle to puncture the septum, and (3) septum durability over 50 years. To simulate multiple refill-exchanges over long-term clinical use, implants were aged at elevated temperature in saline …

Mechanistic Insights Into The Structure-Based Design Of A Cspz-Targeting Lyme Disease Vaccine, Alan Wang, Yi-Lin Chen, Jungsoon Lee, Zhuyun Liu, Xiuli Yang, Ulrich Strych, Dagnija Tupina, Inara Akopjana, Maria-Elena Bottazzi, Utpal Pal, Ching-Lin Hsieh, Wen-Hsiang Chen, Yi-Pin Lin

Faculty, Staff and Students Publications

Borrelia burgdorferi (Bb) causes Lyme disease (LD), one of the most common vector-borne diseases in the Northern Hemisphere. Here, we solve the crystal structure of a mutated Bb vaccine antigen, CspZ-YA that lacks the ability to bind to host complement factor H (FH). We generate point mutants of CspZ-YA and identify CspZ-YAI183Y and CspZ-YAC187S to trigger more robust bactericidal responses. Compared to CspZ-YA, these CspZ-YA mutants require a lower immunization frequency to protect mice from LD-associated inflammation and bacterial colonization. Antigenicity of wild-type and mutant CspZ-YA proteins are similar, as measured using sera from infected people or immunized …

Ototoxicity Monitoring: The Evolution Of A Protocol For Head And Neck Cancer Patients, Jena Patel, Jacob Beiriger, Kalena Liu, Zachary Urdang, Julia Croce, Molly Wolfson, Jacob Hulswit, Olivia Giglio, Jacob B. Hunter, Irina L. Middleton

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

OBJECTIVE: We evaluated an ototoxicity monitoring program (OMP) for improving audiologic follow-up in head and neck cancer (HNC) patients.

STUDY DESIGN: Retrospective cohort study.

SETTING: Tertiary academic center.

METHODS: Two hundred and forty patients were recommended for chemotherapy between January 2017 and June 2022. An OMP was implemented in March 2021; every patient received an audiology referral and was contacted to schedule a pretreatment audiogram. Patients were divided into pre-OMP and post-OMP cohorts. Main outcome measures included rates of pretreatment audiograms, posttreatment audiograms, posttreatment otologic symptoms, and hearing aid utilization.

RESULTS: There were 131 patients evaluated pre-OMP and 109 evaluated …

Targeted Ehr-Based Communication Of Diagnostic Uncertainty (Tecu) In The Emergency Department: Protocol For An Effectiveness Implementation Trial, Danielle M Mccarthy, Sara Malone, Dimitrios Papanagnou, Benjamin E Leiby, Amandy M B Doty, Phillip Watts, Rahul Yadav, Julia K Pugliese, Jonathan Woodworth, Tracy Esteves Camacho, Efrat Kean, Kristin L Rising

Department of Emergency Medicine Faculty Papers

BACKGROUND: At least 37 % emergency department (ED) patients are discharged without a definitive diagnosis, resulting in diagnostic uncertainty. Transitions of care are high-risk periods for patient safety, especially for patients discharged with diagnostic uncertainty. Effective communication between clinicians and patients improves these care transitions. Previous research developed tools to support high quality discharge in the setting of diagnostic uncertainty, including: a communication checklist, a physician training program, and a patient-facing information sheet.

METHODS: This study aims to enhance transitions for patients leaving the ED with diagnostic uncertainty through an electronic health record (EHR)-based strategy. The intervention, the Targeted EHR-based …

Pediatric And Congenital Cardiac Services: An Innovative And Empowering Approach To Global Training And Equitable Care, Wyman W. Lai, Dominique Vervoort, David Bradley, Antonio G. Cabrera, Casey Culbertson, Alejandro Floh, Saurabh K. Gupta, Babar S. Hasan, Adrian Holloway, Jeffrey P. Jacobs, Kathy J. Jenkins, R. K. Kumar, L.A. Larrazabal, Colin J. Mcmahon, Daniel J. Penny, Alistair Phillips, Emilio Quezada, Craig A. Sable, Shubhika Srivastava, Sandra L. Staveski, Patcharapong Suntharos, David F. Teitel, Betsy Tirado, Brian C. Tran, Bistra Zheleva, Liesl Zuhkle, Anthony C. Chang

Division of Cardiology Faculty Papers

Congenital heart disease is a leading cause of preventable death in children, with a disproportionate impact on low- and middle-income countries. Despite progress in treating congenital heart disease globally, significant challenges remain in accessing specialized cardiovascular care, particularly cardiac surgery, in low- and middle-income countries. This review examines current models of assistance and proposes a novel global training program to address these inequities. Key challenges identified include building program infrastructure, training health care providers, ensuring financial sustainability, and promoting local engagement. The proposed program, structured under a new international organization, will leverage emerging technologies to deliver accessible and rigorously assessed …

Mri-Based Digital Twins To Improve Treatment Response Of Breast Cancer By Optimizing Neoadjuvant Chemotherapy Regimens, Chengyue Wu, Ernesto A B F Lima, Casey E Stowers, Zhan Xu, Clinton Yam, Jingfei Ma, Thomas E Yankeelov

Faculty, Staff and Student Publications

We developed a practical framework to construct digital twins for predicting and optimizing triple-negative breast cancer (TNBC) response to neoadjuvant chemotherapy (NAC). This study employed 105 TNBC patients from the ARTEMIS trial (NCT02276443, registered on 10/21/2014) who received Adriamycin/Cytoxan (A/C)-Taxol (T). Digital twins were established by calibrating a biology-based mathematical model to patient-specific MRI data, which accurately predicted pathological complete response (pCR) with an AUC of 0.82. We then used each patient's twin to theoretically optimize outcome by identifying their optimal A/C-T schedule from 128 options. The patient-specifically optimized treatment yielded a significant improvement in pCR rate of 20.95-24.76%. Retrospective …

Association Of Age, Sex And Education With Access To The Intravenous Thrombolysis For Acute Ischemic Stroke, Kyusik Kang, Kyungbok Lee, Jun Lee, Keun-Sik Hong, Byung-Chul Lee, Kyung-Ho Yu, Dong-Eog Kim, Joon-Tae Kim, Jay Chol Choi, Jee Hyun Kwon, Wook-Joo Kim, Kyu Sun Yum, Sung-Il Sohn, Hyungjong Park, Sang-Hwa Lee, Kwang-Yeol Park, Chi Kyung Kim, Sung Hyuk Heo, Moon-Ku Han, Anjail Z Sharrief, Sunil A Sheth, Hee-Joon Bae

Faculty, Staff and Student Publications

Background: Barriers to treatment with intravenous thrombolysis (IVT) for patients with acute ischemic stroke (AIS) in South Korea remain incompletely characterized. We analyze a nationwide prospective cohort to determine patient-level features associated with delayed presentation and non-treatment of potential IVT-eligible patients.

Methods: We identified consecutive patients with AIS from 01/2011 to 08/2023 from a multicenter and prospective acute stroke registry in Korea. Patients were defined as IVT candidates if they presented within 4.5 hours from the last known well, had no lab evidence of coagulopathy, and had National Institute of Health Stroke Scale (NIHSS) ≥ 4. Multivariable generalized linear mixed …

Racial Disparities In Parkinson Disease Clinical Phenotype, Management, And Genetics: Protocol For A Prospective Observational Study, Deborah A Hall, Josh M Shulman, Andrew Singleton, Sara Bandres Ciga, Michelle Hyczy S Tosin, Bichun Ouyang, Lisa Shulman

Faculty, Staff and Students Publications

Background: Parkinson disease (PD) has been described and studied extensively in White populations, with little known about how the disease manifests and progresses in patients from the Black community. Studies investigating disease features in Black populations are uncommon, with some suggesting that the Black population with PD is more disabled and has greater disease severity and different clinical features compared with the White population with PD. These health disparities are likely to influence the quality of care for Black patients with PD.

Objective: This study aimed to investigate the motor and nonmotor symptoms and quality of life in Black and …

Vestibular Neurons Link Motion Sickness, Behavioural Thermoregulation And Metabolic Balance In Mice, Longlong Tu, Xing Fang, Yongjie Yang, Meng Yu, Hailan Liu, Hesong Liu, Na Yin, Jonathan C Bean, Kristine M Conde, Mengjie Wang, Yongxiang Li, Olivia Z Ginnard, Qingzhuo Liu, Yuhan Shi, Junying Han, Yi Zhu, Makoto Fukuda, Qingchun Tong, Benjamin Arenkiel, Mingshan Xue, Yang He, Chunmei Wang, Yong Xu

Children’s Nutrition Research Center Staff Publications

Motion sickness is associated with thermoregulation and metabolic control, but the underlying neural circuitry remains largely unknown. Here we show that neurons in the medial vestibular nuclei parvocellular part (MVePC) mediate the hypothermic responses induced by motion. Reactivation of motion-sensitive MVePC neurons recapitulates motion sickness in mice. We show that motion-activated neurons in the MVePC are glutamatergic (MVePCGlu), and that optogenetic stimulation of MVePCGlu neurons mimics motion-induced hypothermia by signalling to the lateral parabrachial nucleus (LPBN). Acute inhibition of MVePC-LPBN circuitry abrogates motion-induced hypothermia. Finally, we show that chronic inhibition of MVePCGlu neurons prevents diet-induced obesity and improves glucose homeostasis …

Life On The Dry Side: A Roadmap To Understanding Desiccation Tolerance And Accelerating Translational Applications, R A Marks, J T B Ekwealor, M A S Artur, L Bondi, T C Boothby, O M S Carmo, D C Centeno, K K Coe, H J W Dace, S Field, A Hutt, S Porembski, A Thalhammer, L Van Der Pas, A J Wood, P Alpert, D Bartels, S Boeynaems, M N Datar, T Giese, W I Seidou, S M Kirchner, J Köhler, U G V S S Kumara, J Kyung, R Lyall, B D Mishler, J B V T Ndongmo, M S Otegui, V Reddy, J Rexroth, S M Tebele, R Vanburen, J Verdier, U C Vothknecht, M F Wittenberg, E Zokov, M J Oliver, S Y Rhee

Duncan NRI Faculty and Staff Publications

To thrive in extreme conditions, organisms have evolved a diverse arsenal of adaptations that confer resilience. These species, their traits, and the mechanisms underlying them comprise a valuable resource that can be mined for numerous conceptual insights and applied objectives. One of the most dramatic adaptations to water limitation is desiccation tolerance. Understanding the mechanisms underlying desiccation tolerance has important potential implications for medicine, biotechnology, agriculture, and conservation. However, progress has been hindered by a lack of standardization across sub-disciplines, complicating the integration of data and slowing the translation of basic discoveries into practical applications. Here, we synthesize current knowledge …

The Effectiveness Of Gad-7 Screening In High School Students, Tamara L. Smith, Allison Darnell, Margaret Harvey, Phd, Acnp-Bc, Chfn, Jacqueline Sharp Dnp, Aprn, Pmhp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Adolescent mental health is a growing concern, with anxiety disorders being particularly prevalent among high school students. Left untreated, anxiety can significantly impact academic performance, social functioning, and long-term mental health. The COVID-19 pandemic exacerbated these challenges, highlighting the critical need for effective screening and intervention strategies. The Generalized Anxiety Disorder 7-item scale (GAD-7) is a validated tool for identifying anxiety disorders, yet its application in high school settings is limited. This scoping review explores the effectiveness of GAD-7 in increasing mental health referrals and improving anxiety outcomes in high school students.

Methods

A comprehensive search was conducted across …

Implementation & Evaluation Of A Neonatal Intensive Care Unit Transition To Early Intervention Program For High-Risk Infants: A Pilot Study, Erin Price, Otd, Otr/L, Cnt, Ntmtc, Amy Carroll Otd, Otr/L

Department of Occupational Therapy Posters and Presentations

Background

Advances in medicine have increased the survival rate of preterm infants. It is well documented that preterm infants have increased risk for developmental delays (Heiny et al., 2020; Pineda et al., 2020) . Additionally, after long stays in the NICU, families report anxiety and feeling unprepared to care for their fragile child at home (Cheong at al., 2020; Garfield et al., 2014; Aloysius et al., 2018; Lakshmanan et al., 2019) . Preterm infants have fewer developmental delays when enrolled in a program that fosters development of skills and provides caregiver education; however, there is often a 4-5 month gap …