Medical Specialties Commons^™

Secondary School Activity Modifications Based On Pre-Event Wbgt Readings, Jason Meredith, Adam B. Rosen, Colleen Vogel, Ross Mathiasen

Posters and Presentations: Family Medicine

No abstract provided.

Gaza War: Too Many Citizens Being Killed, Sheraz Yaqub, Bjørn Edwin, Zane Hammoud, Gabriel Herrera-Almario, Buthaina Jabir, Kristoffer Lassen, Pål Dag Line, Miguel Angel Lopez-Gonzalez, Michael Puttick, Mohammed Ahmed Idrees Saadelnour, José Sampaio-Neto, Raghuram Sampath, Konstantin V. Sementsov, Ajith K. Siriwardena, Ernesto Sparrelid, Alberto Büge Stein, Robert Sutcliffe, Helena Taflin, Hany Takla, Silvio Valdec, Cherisse N. Vinoya, Waleed Zaid, Stephen J. Wigmore

School of Dentistry Faculty Publications

No abstract provided.

Trends And Outcomes Of Same-Day Discharge Total Ankle Arthroplasty In The United States: A National Analysis From 2012-2021, Kevin X. Farley, Robert S. Dean, Ricky Sareini, Elijah Auch, Zachary Vaupel, Paul T. Fortin

Conference Presentation Abstracts

OBJECTIVE: Same-day discharge Total Ankle Arthroplasty (TAA) is becoming more common. This study sought to report the percentage of patients within a national database that had a same-day discharge following TAA, and to compare the complication rates for patients that had same-day discharge to those that had a short hospital stay. METHODS: From 2012-2021, the National Surgical Quality Improvement Project (NSQIP) database was used to identify all patients undergoing TAA. All patients discharged to their home on the day of surgery were identified. A comparison cohort of patients with a hospital stay of 1 to 2 days who were then …

A Digital Twin Of The Infant Microbiome To Predict Neurodevelopmental Deficits., Nicholas Sizemore, Kaitlyn Oliphant, Ruolin Zheng, Camilia R Martin, Erika C Claud, Ishanu Chattopadhyay

Internal Medicine Faculty Publications

Despite the recognized gut-brain axis link, natural variations in microbial profiles between patients hinder definition of normal abundance ranges, confounding the impact of dysbiosis on infant neurodevelopment. We infer a digital twin of the infant microbiome, forecasting ecosystem trajectories from a few initial observations. Using 16S ribosomal RNA profiles from 88 preterm infants (398 fecal samples and 32,942 abundance estimates for 91 microbial classes), the model (Q-net) predicts abundance dynamics with R² = 0.69. Contrasting the fit to Q-nets of typical versus suboptimal development, we can reliably estimate individual deficit risk (M_δ) and identify infants …

Best Screening: Introducing The Neonatal Assessment Visual European Grid To Nicus In Tennessee, Gabrielle Sledge

OTD Capstone Projects

Blind Early Services Tennessee (BEST) is an early intervention agency that serves children ages 0-5 with visual impairments across Tennessee. BEST serves over 200 children and families across the state offering early intervention (BEST Start), parent empowerment (BEST Advocate), and family support (BEST Together) programming. The purpose of this project was to assist in the implementation of an early identification initiative (BEST Screening) using the Neonatal Assessment Visual European Grid (NAVEG). The NAVEG is a newborn vision screening shown to identify neurological risk for visual impairments. The long-term goal of this program is to promote the screening and early identification …

Childhood Cancer Survivorship: Navigating A New Normal In Middle Tennessee, Karli M. Beaumont

OTD Capstone Projects

Monroe Carell Jr. Children’s Hospital at Vanderbilt in partnership with Vanderbilt-Ingram Cancer Center offers REACH for Cancer Survivorship, a pediatric cancer survivorship clinic. REACH provides a full range of follow-up care designed to meet the physical, emotional, and practical needs of survivors and continuous surveillance of deleterious effects of cancer and its treatments. The purpose of this project was to meet population and agency needs through research of long- and late-term sequela while advocating for occupational therapy’s role in the oncology population through the proactive therapy and prospective surveillance models. The process of creating this project included synthesizing the literature, …

Health Professional Students Receiving Osteopathic Manipulative Treatment: An Interdisciplinary And Interprofessional Activity To Improve Attitudes Towards Osteopathic Medicine And Interprofessional Collaboration, Nicole Neiman, Justinas Joksas, Erica Sickel, Anne Marie Zeller

Research Day

No abstract provided.

Storylines Of Family Medicine Xii: Family Medicine And The Healthcare System, Kurt C. Stange

Faculty Scholarship

Storylines of Family Medicine is a 12-part series of thematically linked mini-essays with accompanying illustrations that explore the many dimensions of family medicine, as interpreted by individual family physicians and medical educators in the USA and elsewhere around the world. In 'XII: Family medicine and the future of the healthcare system', authors address the following themes: 'Leadership in family medicine', 'Becoming an academic family physician', 'Advocare-our call to act', 'The paradox of primary care and three simple rules', 'The quadruple aim-melding the patient and the health system', 'Fit-for-purpose medical workforce', 'Universal healthcare-coverage for all', 'The futures of family medicine' and …

Genome-Wide Screening Identifies Trim33 As An Essential Regulator Of Dendritic Cell Differentiation, Ioanna Tiniakou, Pei-Feng Hsu, Lorena S Lopez-Zepeda, Görkem Garipler, Eduardo Esteva, Nicholas M Adams, Geunhyo Jang, Chetna Soni, Colleen M Lau, Fan Liu, Alireza Khodadadi-Jamayran, Tori C Rodrick, Drew Jones, Aristotelis Tsirigos, Uwe Ohler, Mark T Bedford, Stephen D Nimer, Vesa Kaartinen, Esteban O Mazzoni, Boris Reizis

Faculty, Staff and Student Publications

The development of dendritic cells (DCs), including antigen-presenting conventional DCs (cDCs) and cytokine-producing plasmacytoid DCs (pDCs), is controlled by the growth factor Flt3 ligand (Flt3L) and its receptor Flt3. We genetically dissected Flt3L-driven DC differentiation using CRISPR-Cas9-based screening. Genome-wide screening identified multiple regulators of DC differentiation including subunits of TSC and GATOR1 complexes, which restricted progenitor growth but enabled DC differentiation by inhibiting mTOR signaling. An orthogonal screen identified the transcriptional repressor Trim33 (TIF-1γ) as a regulator of DC differentiation. Conditional targeting in vivo revealed an essential role of Trim33 in the development of all DCs, but not of monocytes …

Non-Traumatic Osteonecrosis Of The Femoral Head Induced By Steroid And Alcohol Exposure Is Associated With Intestinal Flora Alterations And Metabolomic Profiles, Qing-Yuan Zheng, Ye Tao, Lei Geng, Peng Ren, Ming Ni, Guo-Qiang Zhang

Faculty, Staff and Student Publications

OBJECTIVE: Osteonecrosis of the femoral head (ONFH) is a severe disease that primarily affects the middle-aged population, imposing a significant economic and social burden. Recent research has linked the progression of non-traumatic osteonecrosis of the femoral head (NONFH) to the composition of the gut microbiota. Steroids and alcohol are considered major contributing factors. However, the relationship between NONFH caused by two etiologies and the microbiota remains unclear. In this study, we examined the gut microbiota and fecal metabolic phenotypes of two groups of patients, and analyzed potential differences in the pathogenic mechanisms from both the microbial and metabolic perspectives.

METHODS: …

In Silico And In Vitro Study Of Isoquercitrin Against Kidney Cancer And Inflammation By Triggering Potential Gene Targets, Safia Iqbal, Md Rezaul Karim, Shahnawaz Mohammad, Jong Chan Ahn, Anjali Kariyarath Valappil, Ramya Mathiyalagan, Deok-Chun Yang, Dae-Hyo Jung, Hyocheol Bae, Dong Uk Yang

Faculty, Staff and Student Publications

Kidney cancer has emerged as a major medical problem in recent times. Multiple compounds are used to treat kidney cancer by triggering cancer-causing gene targets. For instance, isoquercitrin (quercetin-3-O-β-d-glucopyranoside) is frequently present in fruits, vegetables, medicinal herbs, and foods and drinks made from plants. Our previous study predicted using protein-protein interaction (PPI) and molecular docking analysis that the isoquercitrin compound can control kidney cancer and inflammation by triggering potential gene targets of IGF1R, PIK3CA, IL6, and PTGS2. So, the present study is about further in silico and in vitro validation. We performed molecular dynamic (MD) simulation, gene ontology (GO), Kyoto …

New-Onset Depression Following Total Shoulder Arthroplasty: The Impact Of Preoperative Patient Factors And Postoperative Complications, Kevin X. Farley, Robert S. Dean, Eric R. Wagner, Michael B. Gottschalk, J Michael Wiater

Conference Presentation Abstracts

OBJECTIVE: Depression has been well studied as a risk factor for postoperative complications following total shoulder arthroplasty (TSA). However, little is known about new-onset depression (NOD) following TSA. The purpose of this study is to determine the incidence of NOD following TSA and identify risk factors for its occurrence. METHODS: This was a retrospective review of patients undergoing TSA in the Truven Health MarketScan database. NOD was identified. Patients with preoperative depression were excluded from analysis. Postoperative complications were identified, including the development of a prosthetic joint infection (PJI), need for revision surgery, and postoperative dislocation. If a complication occurred …

Coronary Microvascular Dysfunction In Childhood: An Emerging Pathological Entity And Its Clinical Implications, Takeshi Tsuda, Gina Patel

Department of Pediatrics Faculty Papers

Coronary microvascular dysfunction (CMD) encompasses a spectrum of structural and functional alterations in coronary microvasculature resulting in impaired coronary blood flow and consequent myocardial ischemia without obstruction in epicardial coronary artery. The pathogenesis of CMD is complex involving both functional and structural alteration in the coronary microcirculation. In adults, CMD is predominantly discussed in context with anginal chest pain or existing ischemic heart disease and its risk factors. The presence of CMD suggests increased risk of adverse cardiovascular events independent of coronary atherosclerosis. Coronary microvascular dysfunction is also known in children but is rarely recognized due to paucity of concommitent …

Photophobia Is Associated With Lower Sleep Quality In Individuals With Migraine: Results From The American Registry For Migraine Research (Armr), Nina Sharp, Mark J Burish, Kathleen B Digre, Jessica Ailani, Mahya Fani, Sophia Lamp, Todd J Schwedt

Faculty, Staff and Student Publications

BACKGROUND: Patients with migraine often have poor sleep quality between and during migraine attacks. Furthermore, extensive research has identified photophobia as the most common and most bothersome symptom in individuals with migraine, second only to headache. Seeking the comfort of darkness is a common strategy for managing pain during an attack and preventing its recurrence between episodes. Given the well-established effects of daily light exposure on circadian activity rhythms and sleep quality, this study aimed to investigate the relationship between photophobia symptoms and sleep quality in a cohort of patients with migraine.

METHODS: A cross-sectional observational study was conducted using …

Serum Neuroactive Metabolites Of The Tryptophan Pathway In Patients With Acute Phase Of Affective Disorders, Yanli Li, Leilei Wang, Junchao Huang, Ping Zhang, Yanfang Zhou, Jinghui Tong, Wenjin Chen, Mengzhuang Gou, Baopeng Tian, Wei Li, Xingguang Luo, Li Tian, L Elliot Hong, Chiang-Shan R Li, Yunlong Tan

Faculty, Staff and Student Publications

BACKGROUND: Many studies showed disrupted tryptophan metabolism in patients with affective disorders. The aims of this study were to explore the differences in the metabolites of tryptophan pathway (TP) and the relationships between TP metabolites and clinical symptoms, therapeutic effect in patients with bipolar disorder with acute manic episode (BD-M), depressive episode (BD-D) and major depressive disorder (MDD).

METHODS: Patients with BD-M (n=52) and BD-D (n=39), MDD (n=48) and healthy controls (HCs, n=49) were enrolled. The serum neuroactive metabolites levels of the TP were measured by liquid chromatography-tandem mass spectrometry. Hamilton Depression Scale-17 item (HAMD-17) and Young Mania Rating Scale …

Phase 1b Study Of Intraperitoneal Ipilimumab And Nivolumab In Patients With Recurrent Gynecologic Malignancies With Peritoneal Carcinomatosis, Anne Knisely, Emily Hinchcliff, Bryan Fellman, Ann Mosley, Kathryn Lito, Sara Hull, Shannon N Westin, Anil K Sood, Kathleen M Schmeler, Jolyn S Taylor, Steven Y Huang, Rahul A Sheth, Karen H Lu, Amir A Jazaeri

Faculty, Staff and Student Publications

Background: Intravenous immune checkpoint blockade (ICB) has shown poor response rates in recurrent gynecologic malignancies. Intraperitoneal (i.p.) ICB may result in enhanced T cell activation and anti-tumor immunity.

Methods: In this phase 1b study, registered at Clinical.

Trials: gov (NCT03508570), initial cohorts received i.p. nivolumab monotherapy, and subsequent cohorts received combination i.p. nivolumab every 2 weeks and i.p. ipilimumab every 6 weeks, guided by a Bayesian design. The primary objective was determination of the recommended phase 2 dose (RP2D) of the combination. Secondary outcomes included toxicity, objective response rate (ORR), progression-free survival (PFS), and overall survival (OS).

Findings: …

Combined Deletion Of Men1, Atrx And Pten Triggers Development Of High-Grade Pancreatic Neuroendocrine Tumors In Mice, Mary Esmeralda Fuentes, Xiaoyin Lu, Natasha M Flores, Simone Hausmann, Pawel K Mazur

Faculty, Staff and Student Publications

Pancreatic neuroendocrine tumors (PanNETs) are a heterogeneous group of tumors that exhibit an unpredictable and broad spectrum of clinical presentations and biological aggressiveness. Surgical resection is still the only curative therapeutic option for localized PanNET, but the majority of patients are diagnosed at an advanced and metastatic stage with limited therapeutic options. Key factors limiting the development of new therapeutics are the extensive heterogeneity of PanNETs and the lack of appropriate clinically relevant models. In that context, genomic sequencing of human PanNETs revealed recurrent mutations and structural alterations in several tumor suppressors. Here, we demonstrated that combined loss of MEN1, …

Comparison Of Injuries Sustained On Grass And Artificial Turf By Usl1 Men’S Soccer Team. Part 1: Match Related Injuries, Michael Osterholt, Jason Meredith, Jenenne A. Geske

Posters and Presentations: Family Medicine

No abstract provided.

Water, Sanitation, And Hygiene Infrastructure And Resources In Schools In Belize During The Covid-19 Pandemic, 2021-2023, Anh N Ly, Kelsey Mcdavid, Christina Craig, Dian Maheia, Yolanda Gongora, Alexandra Medley, Francis Morey, Russell Manzanero, Gerhaldine Morazan, Allison Lino, Vickie Romero, Rosalva Blanco, Kanako Ishida, Matthew Lozier, Kristy O Murray

Faculty, Staff and Students Publications

Access to water, sanitation, and hygiene (WASH) resources in schools is critical for disease prevention and control, especially during public health emergencies. In Belize, systematic, national data on WASH in schools are needed to inform public health decisions and interventions. From December 2021 to January 2022, a national survey was sent electronically to government and government-aided primary and secondary schools in Belize (N = 308) to gather information on WASH services. From the survey, 12 pilot schools were selected based on the highest self-reported need for WASH resources to participate in additional evaluation and intervention, which included environmental nudges, supplemental …

Akap12 Upregulation Associates With Pde8a To Accelerate Cardiac Dysfunction, Hanan Qasim, Mehrdad Rajaei, Ying Xu, Arfaxad Reyes-Alcaraz, Hala Y Abdelnasser, M David Stewart, Satadru K Lahiri, Xander H T Wehrens, Bradley K Mcconnell

Faculty, Staff and Students Publications

BACKGROUND: In heart failure, signaling downstream the β2-adrenergic receptor is critical. Sympathetic stimulation of β2-adrenergic receptor alters cAMP (cyclic adenosine 3',5'-monophosphate) and triggers PKA (protein kinase A)-dependent phosphorylation of proteins that regulate cardiac function. cAMP levels are regulated in part by PDEs (phosphodiesterases). Several AKAPs (A kinase anchoring proteins) regulate cardiac function and are proposed as targets for precise pharmacology. AKAP12 is expressed in the heart and has been reported to directly bind β2-adrenergic receptor, PKA, and PDE4D. However, its roles in cardiac function are unclear.

METHODS: cAMP accumulation in real time downstream of the β2-adrenergic receptor was detected for …

Storylines Of Family Medicine Xii: Family Medicine And The Healthcare System, William B Ventres, Leslie A Stone, Jeannette E South-Paul, Kendall M Campbell, Aerial R Petty, Hima Ekanadham, Kurt C Stange, Rebecca S Etz, William L Miller, Robert L Ferrer, Marianna Kong, Thomas Bodenheimer, Roger Strasser, Sharon C M Reece, Joshua Freeman, John M Westfall

Faculty, Staff and Students Publications

Storylines of Family Medicine is a 12-part series of thematically linked mini-essays with accompanying illustrations that explore the many dimensions of family medicine, as interpreted by individual family physicians and medical educators in the USA and elsewhere around the world. In ‘XII: Family medicine and the future of the healthcare system’, authors address the following themes: ‘Leadership in family medicine’, ‘Becoming an academic family physician’, ‘Advocare—our call to act’, ‘The paradox of primary care and three simple rules’, ‘The quadruple aim—melding the patient and the health system’, ‘Fit-for-purpose medical workforce’, ‘Universal healthcare—coverage for all’, ‘The futures of family …

Influence Of Rna Circularity On Target Rna-Directed Microrna Degradation, Federico Fuchs Wightman, Jerónimo Lukin, Sebastián A Giusti, Michael Soutschek, Laureano Bragado, Berta Pozzi, María L Pierelli, Paula González, Juan P Fededa, Gerhard Schratt, Rina Fujiwara, Jeremy E Wilusz, Damián Refojo, Manuel De La Mata

Faculty, Staff and Students Publications

A subset of circular RNAs (circRNAs) and linear RNAs have been proposed to 'sponge' or block microRNA activity. Additionally, certain RNAs induce microRNA destruction through the process of Target RNA-Directed MicroRNA Degradation (TDMD), but whether both linear and circular transcripts are equivalent in driving TDMD is unknown. Here, we studied whether circular/linear topology of endogenous and artificial RNA targets affects TDMD. Consistent with previous knowledge that Cdr1as (ciRS-7) circular RNA protects miR-7 from Cyrano-mediated TDMD, we demonstrate that depletion of Cdr1as reduces miR-7 abundance. In contrast, overexpression of an artificial linear version of Cdr1as drives miR-7 degradation. Using plasmids that …

Structural Basis Of Dna Crossover Capture By Escherichia Coli Dna Gyrase, Marlène Vayssières, Nils Marechal, Long Yun, Brian Lopez Duran, Naveen Kumar Murugasamy, Jonathan M Fogg, Lynn Zechiedrich, Marc Nadal, Valérie Lamour

Faculty, Staff and Students Publications

DNA supercoiling must be precisely regulated by topoisomerases to prevent DNA entanglement. The interaction of type IIA DNA topoisomerases with two DNA molecules, enabling the transport of one duplex through the transient double-stranded break of the other, remains elusive owing to structures derived solely from single linear duplex DNAs lacking topological constraints. Using cryo–electron microscopy, we solved the structure of Escherichia coli DNA gyrase bound to a negatively supercoiled minicircle DNA. We show how DNA gyrase captures a DNA crossover, revealing both conserved molecular grooves that accommodate the DNA helices. Together with molecular tweezer experiments, the structure shows that the …

Miniature Battery-Free Epidural Cortical Stimulators, Joshua E Woods, Amanda L Singer, Fatima Alrashdan, Wendy Tan, Chunfeng Tan, Sunil A Sheth, Sameer A Sheth, Jacob T Robinson

Faculty, Staff and Student Publications

Miniaturized neuromodulation systems could improve the safety and reduce the invasiveness of bioelectronic neuromodulation. However, as implantable bioelectronic devices are made smaller, it becomes difficult to store enough power for long-term operation in batteries. Here, we present a battery-free epidural cortical stimulator that is only 9 millimeters in width yet can safely receive enough wireless power using magnetoelectric antennas to deliver 14.5-volt stimulation bursts, which enables it to stimulate cortical activity on-demand through the dura. The device has digitally programmable stimulation output and centimeter-scale alignment tolerances when powered by an external transmitter. We demonstrate that this device has enough power …

Restoring Effective Sleep Time In Post Cardiac Surgery Patients: A Quality Improvement Project, Brooke Watts Bsn, Rn

Epsilon Sigma at-Large Research Conference

Purpose: Restoring Effective Sleep Time in Post Cardiac Surgery Patients: A Quality Improvement Project

Brooke Watts, BSN, RN, DNP Student, Murray State University

Dr. Kristin Reid, DNP, APRN, ACNS-BC, DNP Program Director/Assistant Professor Murray State University

Aims: This quality improvement project was developed using DNP project guidelines provided through Murray State University and was designed to improve sleep in hospitalized cardiac surgery patients.

Processes: IRB approval was obtained from the healthcare institution and academic institution. This two-phase quality improvement project was designed to analyze the effects of a change in normalized hospital routines on self-reported sleep in post-cardiac surgery patients. …

Cavernous Wonders: Delving Into Cavernous Sinus Syndrome In Neuro-Ophthalmology, Anza Rizvi, Ba

inSIGHT

Cavernous sinus syndrome (CSS) is any disease process that affects the cavernous sinus. This syndrome is marked by a complex interplay of neurovascular symptoms, primarily due to the compression or dysfunction of the cranial nerves that traverse the cavernous sinus. Understanding the intricate details of this syndrome is critical to providing optimal care and improving patient outcomes.

Seeing Clearly: A Bright Future With Light Adjustable Intraocular Lenses For Presbyopia, Shady Mina, Bs

inSIGHT

Presbyopia, or the age-related decline in the ability to focus on near objects, is a common vision disorder that affects 1.8 billion people globally, with this number expected to increase to 2.1 billion by 2030.^1-4 A diminished accommodation response is the primary cause of presbyopia.¹ The eye has a very complex accommodation mechanism that permits people to distinctly see objects from various distances.^1,3 Even though the precise mechanism of accommodation is yet to be determined, the current evidence strongly supports Helmholtz’s theory, which claims that the thickness and curvature of the eye’s lens increase while its diameter …

Medical Missions, Ethical Considerations And The Future For Healthcare Delivery In Ophthalmology, Robert Medina, Ba

inSIGHT

Beginning hundreds of years ago, priests from Europe embarked on ‘medical missions’ with the goals of delivering care to the body, mind, and soul. Hundreds of years later, members of the United States healthcare system set out on humanitarian medical missions to provide medical assistance to communities in developing countries.¹ The concept of providing care internationally as a product of global social responsibility has become engrained in the United States healthcare system, and is popular among providers, trainees, and pre-medical students. In 2023, 21.8% (n = 3264) of matriculating medical students reported participating in international volunteer work, while 7.0% …

Chronic Progressive External Ophthalmoplegia, Bahram Pashaee, Mph, Bs

inSIGHT

Chronic progressive external ophthalmoplegia is an inherited or sporadic form of dystrophy that preferentially affects the extraocular muscles of the eye. While this dystrophy can manifest systemically, the extraocular muscles are commonly involved due to their constant metabolic demands and vulnerability to oxidative stress.¹ This preferential involvement of the eyelid levator muscle and extraocular muscles makes CPEO an important condition to consider in a differential diagnosis for eyelid asymmetry and double vision among other conditions such as myasthenia gravis, thyroid-associated ophthalmoplegia, and other mitochondrial myopathies.² This dystrophy tends to occur in the third or fourth decade of life. …

Macular Holes: Diagnosis, Treatment, And Complications, Ayra Khan, Bs

inSIGHT

Macular hole is a condition that affects the central visual field of the eye. Without prompt diagnosis and intervention, macular holes can progressively worsen, significantly impacting both vision and overall quality of life.