Medical Specialties Commons^™

Metabolic Reprogramming Following Mitochondrial Transfer Between Idh2-Mutant Chondrosarcoma Cells And A Normal B-Cell Line, Caleb Wyckoff, Christopher Osgood, Ellen Jing, Michael Stacey

Bioelectrics Publications

Background/Objectives: Chondrosarcoma, glioblastoma, acute myeloid leukemia, chronic lymphocytic leukemia, and cholangiocarcinoma cancers all contain mutations in the gene isocitrate dehydrogenase 2 (IDH2). The mutant IDH2 enzyme metabolizes alpha-ketoglutarate (αKG) into the potent oncometabolite D-2-hydroxyglutarate (D2HG) in the mitochondria of these cancers, leading to altered cellular metabolism. Emerging evidence suggests that mitochondrial transfer between cancer and recipient cells represents an important form of intercellular communication that may influence cellular metabolism. The presence of intercellular TNTs between IDH2-mutant chondrosarcoma cells motivated an investigation into mitochondria-associated physiological changes occurring during an intercellular exchange with immune cells. A mitochondrial transfer is a two-way …

Establishment And Histopathological Characterization Of A Kyse-30 Subcutaneous Xenograft Model Of Esophageal Squamous Cell Carcinoma, Pavel A. Solopov, Alayna Enos, Mantas Silkunas, Giedre Silkuniene, Eleni Zivla, Andrei G. Pakhomov, Olga N. Pakhomova

Bioelectrics Publications

Background/Objectives: Esophageal squamous cell carcinoma (ESCC) is an aggressive malignancy with poor prognosis and limited treatment options, highlighting the need for reliable preclinical models for translational research. Although xenograft models are widely used in cancer biology, systematic characterization of subcutaneous ESCC models under defined implantation conditions remains limited. The objective of this study was to systematically compare implantation conditions and define histopathological and growth-related parameters that enable reproducible tumor establishment while maintaining a practical experimental window for therapeutic studies. Methods: We established and characterized a subcutaneous ESCC xenograft model using human ESCC cell line KYSE-30 implanted into immunodeficient J:NU mice. …

Combination Therapy With Hsp90 Inhibitors And Nanopulse Stimulation Synergistically Impedes Hepatocellular Carcinoma And Breast Cancer Growth In Mice, Christiana Dimitropoulou, Gagan Thangjam, Brittany P. Lassiter, Teresa Hooker, Ruben M. L. Colunga Biancatelli, John D. Catravas, Stephen J. Beebe

Bioelectrics Publications

Nanopulse Stimulation (NPS) represents a promising and innovative therapeutic approach to cancer. Heat shock protein 90 Inhibitors (HI), on the other hand, are currently under investigation in multi-drug chemotherapy trials for various types of malignancies. Here we present results of a combination therapy employing two HSP90 inhibitors (AUY-922 or 17-AAG) and NPS to ablate cancer growth. We firstly tested the inhibitors alone or in combination with NPS in vitro in N1S1 cells, and then into two models of orthotopic Hepatocellular Carcinoma (HCC) and 4T1-Luc breast cancer. NPS + HI reduced tumor growth more than the sum of HI and NPS …

Synergistic Sensitization Of Pancreatic Cancer Cells By Nanosecond Pulsed Electric Fields And Cold Atmospheric Plasma Via Amplifying Ros And Apoptotic Signaling, Zobia Minhas, Edwin A. Oshin, Lifang Yang, Chunqi Jiang, Siqi Guo

Bioelectrics Publications

Pancreatic cancer remains a highly lethal malignancy, with standard therapies offering limited benefits in advanced stages; thus, novel strategies that exploit specific cancer cell vulnerabilities are urgently needed. Building on our previous findings that nanosecond pulsed electric fields (nsPEF) combined with cold atmospheric plasma (CAP) produce enhanced cytotoxicity, this study investigates the molecular mechanisms underlying this synergy. Pan02 pancreatic cancer cells were subjected to nsPEF, CAP, or a combination of both. We assessed cell viability, reactive oxygen species (ROS) production, and mitochondrial integrity using metabolic assays, flow cytometry, and fluorescence microscopy. Apoptotic markers were evaluated via Western blotting and caspase …

Nanosecond Electric Pulses As A Novel In Situ Vaccination Strategy For Cancer Treatment: Mechanisms, Challenges And Prospects, Siqi Guo

Bioelectrics Publications

Nanosecond electric pulses (nsEPs) are an emerging pulsed-power technology with unique bioelectric characteristics distinct from conventional long-pulse electroporation. As a tunable physical modality, nsEPs can modulate intracellular structures, membrane dynamics, and signaling pathways. Increasing evidence supports nsEPs as a promising non-thermal tumor ablation approach due to their high spatial precision, preservation of critical tissue structures, and minimal adverse effects. One of the most significant discoveries associated with nsEP tumor ablation is the induction of potent systemic antitumor immunity, particularly in situ vaccination (ISV) effects and, in some cases, abscopal effects against distant untreated tumors. Substantial evidence demonstrates that nsEPs can …

Differences Of Sex Development (Dsd), Children's Mercy Kansas City

Clinical Pathways

No abstract provided.

Autologous Peripheral Nerve Tissue Grafts Implanted Into The Nucleus Basalis Of Meynert And Substantia Nigra At The Time Of Bilateral Deep Brain Stimulation In Parkinson Disease: A Report Of 2 Cases, Samuel R. Daly, Jorge E. Quintero, Lisa M. Koehl, Elizabeth Roslyn Wallace, Zain Guduru, Julie A. Gurwell, Tripp Hines, Jaimie Hixson, Saad Hulou, John T. Slevin, Frederick A. Schmitt, Greg A. Gerhardt, Craig G. Van Horne

Neurosurgery Faculty Publications

Background and Objectives: Cholinergic degeneration in the nucleus basalis of Meynert (NBM) is implicated in the cognitive impairment seen in Parkinson disease (PD) and is being examined as a potential therapeutic target. We have previously shown the safety of delivering investigational autologous cell-based therapy, ie, peripheral nerve tissue (PNT), to the substantia nigra (SN) at the time of deep brain stimulation (DBS) surgery in PD (DBS-Plus). In this study, we assessed the safety and feasibility of simultaneously delivering that PNT to both the NBM and SN at the time of DBS.

Methods: Two patients with idiopathic PD and mild cognitive …

Seasonal And Geographic Trends In Photodynamic Therapy And Cryosurgery Use In The United States: A Cross-Sectional Study From 2015-2022., Dawn Merritt, Jon Lyons, Mouna Mikati, Christian Geils, Todd Schlesinger

Ambulatory and Primary Care Articles

BACKGROUND: Photodynamic therapy (PDT) is an effective field treatment for actinic keratoses (AKs). It is an ideal option for patients who prefer a minimally invasive procedure conveniently administered in their physician's office. Anecdotal clinician insights suggest that it may not be used at the same rate year-round.

OBJECTIVE: This study investigates whether PDT and cryosurgery usage is affected by season and geographic location in the United States.

METHODS: The data source is an aggregate of closed and open United States medical procedural claims (

RESULTS: PDT utilization is affected by season and geographic location. Procedural claims peak during cooler months …

Mechanical-Medical Convergence In Heart Failure: Artificial Intelligence, Finite-Element Modeling, And 3d Printing For Diagnosis And Prognosis, Quazi Noor E. Sabrina, Quazi Md Zobaer Shah, Quazi Noor E. Sohela, Md Mahabub Hasan Mousum, Md. Moyeen Uddin Chisty, Quazi Md. Akbar Shah

Mechanical & Aerospace Engineering Faculty Publications

Heart failure remains a leading cause of global morbidity and mortality, yet routine clinical indices often miss the regional biomechanical disturbances that drive progression and shape treatment response. This State-of-the-Art review examines how finite-element (FE) modeling, additive manufacturing, and artificial intelligence (AI) are converging to improve the diagnosis, phenotyping, procedural planning, and prognostic assessment of heart failure (HF). Although these technologies have matured in structural heart disease and transcatheter intervention research, their greatest translational potential may lie in HF, where patient-specific ventricular remodeling, myocardial stress–strain heterogeneity, valve-ventricular coupling, and device-tissue interaction are incompletely captured by conventional clinical indices. We synthesize …

The Treatment Of Obesity In The Context Of The Obesity Paradox In Patients With Heart Failure: A Narrative Review, Pamela L. Alebna, Sarah Martey, Anurag Mehta, Carl J. Lavie, Salvatore Carbone

EVMS School of Health Professions Faculty Publications

Purpose of review

While excess adiposity is a known risk factor for incident heart failure ( HF), once the condition is established, observational data suggest that increased body mass index (BMI) may confer a survival advantage. This paradox has emphasized the underlying roles of cardiorespiratory fitness (CRF), and body composition, particularly lean mass (LM), in influencing clinical outcomes.

Recent findings

In this review, we explore the multifaceted nature of the obesity paradox in HF, with a focus on emerging anti-obesity incretin-mimetic therapies, such as glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and dual GLP-1/glucose-dependent insulinotropic polypeptide (GIP) receptor agonists. These agents …

Early Pressure Injury Identification And Intervention In Emergency Department Older Adults Who Are Admitted Into A Community Hospital Intensive Care Unit, Lisa M. Britt

Doctor of Nursing Practice (DNP) Scholarly Projects

A clinical gap was identified when reviewing a hospital acquired pressure injury (HAPI) dashboard from a 369- bed, acute care community hospital located in North Texas. Fifty percent of HAPIs acquired occurred in older adults, aged 60 or higher, who were admitted into the intensive care unit (ICU) from the emergency department (ED). A retrospective review of the electronic health records (EHR) demonstrated that none of the patients had received HAPI prevention interventions while they were in the ED and the inconsistent document of skin assessments resulted in identification of few HAPIs present on admission (POA). The purpose of this …

A Chronic Pain Self-Management Quality Improvement Bundle For Veterans, Srijana D. Baniya

Doctor of Nursing Practice (DNP) Scholarly Projects

Introduction: Veterans often face challenges accessing care services due to limited awareness of available resources for support, Self-care, and mental health (Harding et al., 2019; Patel et al., 2024). Given the high prevalence of Chronic pain and opioid use in this population, Self-management (SM) education and non-pharmacologic interventions are required to address the biological, psychological, and social effects of pain (Bair et al., 2015; Mumba et al., 2024; Nahin, 2017; Higgins et al., 2020). This Quality improvement project aims to determine whether implementing an evidence-based SM bundle for chronic pain improved Pain severity scores and increased understanding of SM strategies. …

Editor's Choice - International Expert Consensus On The Management Of Acute Aortic Type B Intramural Haematoma And Penetrating Ulcer, Francesco Squizzato, Mario D'Oria, Michele Antonello, Santi Trimarchi, Kevin Mani, Andrew Holden, Tilo Kölbel, Stephan Haulon, Eric Verhoeven, Dittmar Böckler, Tim Resch, Ali Azizzadeh, Joseph Lombardi, Michele Piazza, Aaron Thomas Fargion, Alexander Zimmerman, Ali Azizzadeh, Anders Wanhainen, Andrew Holden, Antonio Freyrie, Adam W. Beck, Adi Bachar, Barend M. E. Mees, Blandine Maurel, Cristoph A. Nienaber, Christos Karkos, Daniela Branzan, Darren Schneider, Randall Demartino, Dittmar Boeckler, Domenico Angiletta, Emanuel J. R. Tenorio, Enrico Gallitto, Eric Verhoeven, Fabio Verzini, Felice Pecoraro, Filippo Benedetto, Firas F. Mussa, Francesco Squizzato, Franco Grego, Gabriele Piffaretti, Emanuele Gatta, Giovanni Pratesi, Giovanni Tinelli, Giuseppe Asciutto, Glenn Wei Leong Tan, Hence Verhagen, Giacomo Isernia, Jean-Paul P. M. De Vries, Jacob Budtz-Lilly, Jorge Fernández-Noya, Jonathan Sobocinski, Joseph Hockley, Kak Khee Yeung, Andrea Kahlberg, Kevin Mani, Joseph V. Lombardi, Luca Bertoglio, Luca Mezzetto, Ludovic Canaud, Manar Khashram, Marcelo Ferreira, Marco Virgilio Usai, Mark G. Davies, Mark Farber, Martin Czerny, Matthew R. Smeds, Mauro Gargiulo, Germano Melissano, Michel Bosiers, Michele Antonello, Michele Piazza, Miranda Witheford, Michel M.P.J. Reijnen, Marc Schermerhorn, Nikolaos Tsilimparis, Nun Dias, Jean Panneton, Kosmas Paraskevas, Gianbattista Parlani, Patrick W.H.E. Vriens, Rafael Malgor, Raffaele Pulli, Ross Milner, Salvatore T. Scali, Sani J. Laukontaus, Santi Trimarchi, Sandro Lepidi, Konstantinos Spanos, Stefano Fazzini, Theodosios Bisdas, Thomas Maldonado, Tilo Koelbel, Tim Resch, Tomasz Jakimowicz, Nicola Troisi, Isabelle Van Herzeele, Vicente Riambau, Wassim Mansour, Wouter Van Den Eynde, Yamume Tshomba

Department Surgery Faculty Publications

Objective

The aim of this study was to achieve an international expert consensus on managing acute type B penetrating aortic ulcers (PAUs) and intramural haematomas (IMHs).

Methods

A modified Delphi consensus process was employed to develop recommendations for the management of acute type B PAU and IMH. Surveys were sent to international experts practicing in high volume aortic centres worldwide. Statements were voted on using a four point Likert scale in a three round Delphi process. Statements achieving grade A (full agreement 75%) or B (overall agreement 80%, full disagreement <  5%) were included as expert recommendations. Consistency of responses was measured using Cohen's κ and the intraclass correlation coefficient.

Results

Eighty three experts were included in the final analysis: …

An Analysis Of Pediatric Retinoblastoma Medical Malpractice Litigation, Victoria Miller, Alyssa D. Reese, Katherine Foote, Alejandro Navarro, Andrew Galfano, Christian Hietanen

Department Surgery Faculty Publications

BACKGROUND: Retinoblastoma is a cancer of the retina that is most commonly diagnosed in the pediatric population. Unfortunately, this cancer can spread, leading to poor outcomes such as enucleation. The purpose of this study was to determine the characteristics of medical malpractice litigation associated with a diagnosis of retinoblastoma in the pediatric population.

METHODS: A search for all available cases associated with "retinoblastoma" in the Westlaw Campus Research Legal Database was conducted. This spanned from database inception to August 2023. Cases were included if there was a complaint of medical malpractice related to retinoblastoma present in a pediatric patient. Demographic …

Endovascular Arch Repair Using A Novel Single Branch Arch Stent Graft: 30-Day Results From The Chronic Dissection Arm Of The Nexus Aortic Arch Clinical Study To Evaluate Safety And Effectiveness Investigational Device Exemption Study, Bradley G. Leshnower, Jean Panneton, Himanshu J. Patel, Adam W. Beck, Mathew Wooster, Kyle W. Eudailey, Shinichi Fukuhara, Jae Cho, Sanford Zeigler, Westley Ohman, Puja Kachroo, Derek Brinster, Shahab Toursavadkohi, Mehrdad Ghoreishi, Brandley Taylor, Frank Arko, Paul Hayes, Ross Milner

Department Surgery Faculty Publications

Objective

Moderate levels of frailty or a previous sternotomy make open repair of aortic arch pathology high risk or even preclude any treatment. This study examined 30-day outcomes from the NEXUS Aortic Arch Clinical Study to Evaluate Safety and Effectiveness investigational device exemption (TRIOMPHE IDE) study of an off-the-shelf stent-graft system for Zone 0 endovascular aortic arch repair in patients with high-risk chronic dissection.

Methods

TRIOMPHE IDE is a prospective, multicenter study evaluating the NEXUS system (Endospan) in chronic aortic dissection (n = 54). Following cervical debranching, NEXUS was delivered into the arch first, followed by an ascending aortic stent-graft. …

Digital Speech Biomarkers Of Cognitive Functioning In Multilingual Kenyan Adults, Adolfo M. Garcia, Levi Muyela, Alejandro Sosa Welford, Matías Caccia, Anne Njoki Gitere, Anne Nyambura, Erick Muhando, Zul Merali, Chinedu Momoh, Karen Blackmon

Brain and Mind Institute

Background: Digital speech biomarkers show promise as cost-effective and scalable diagnostic tools for cognitive decline and dementia in African research and healthcare settings. However, significant gaps remain in language-specific normative data, cross-linguistic validation, and standardized protocols for multilingual populations. Targeting cognitively unimpaired multilingual Kenyan adults, here we aim to validate speech timing features from natural language, against performance on standardized culture-sensitive neuropsychological measures.

Method: This study was funded by Davos Alzheimer's Collaborative and took place in an outpatient clinic at the Aga Khan University in Nairobi, Kenya. Participants completed culturally adapted tests tapping on word list learning, visual memory, …

Predictors Of Increased Length Of Stay And Cost In Readmissions For Spinal Surgical Site Infections, Matthew Giammanco, Alex Zhang, Phillip Alexeev, Ryan Snowden

SPARK Symposium Presentations

Abstract:

Background

Surgical site infection (SSI) following spinal surgery remains a costly and morbid complication, frequently necessitating hospital readmission and operative management. While prior studies have characterized the overall economic burden of spinal SSI, the specific drivers of cost during SSI-related readmissions are poorly defined. The primary research question of this study was to identify clinical, operative, and microbiologic factors associated with increased hospital cost, length of stay, and financial margins during readmission for operative management of spinal SSI.

Methods

We performed a retrospective cohort study of adult patients readmitted for surgical management of spinal SSI at a single tertiary …

Use Of Preference Signals In Family Medicine Residency Recruitment, John E. Snellings, Hanwen Miao, Daniel L. Meyer, Miranda A. Moore

Department of Family and Community Medicine Faculty Publications

Background and Objectives: Increases in graduate medical education application volume led to the introduction of preference signaling—a tool within the Electronic Residency Application Service that allows applicants to signal their sincere interest to a limited number of programs. This study aims to evaluate how family medicine program directors used preference signals during the 2023–2024 recruitment season, the first year this tool was available to family medicine programs. Understanding program director perspectives on preference signal utility is crucial for determining the tool’s impact on the residency selection process.

Methods: Data were collected through the Council of Academic Family Medicine Educational Research …

Infantile Epileptic Spasms Syndrome: Clinical Profile And Outcomes At A Tertiary Hospital In Kenya, Peninah Mwangi, Katherine Oyieke, Sam Gwer, Pauline Samia

Paediatrics and Child Health, East Africa

Background: Infantile epileptic spasms syndrome (IESS) is characterised by onset of epileptic spasms between 3 and 12 months, with or without typical hypsarrhythmia, and developmental stagnation or regression. There are limited data on the clinical profile and treatment outcomes of IESS in sub-Saharan Africa.

Objective: To describe the clinical profile and treatment outcomes of infants diagnosed with and managed for IESS at Aga Khan University Hospital, Nairobi.

Methods: Records of children aged 3–24 months diagnosed with IESS between January 2012 and December 2021 were identified from the hospital information system using the terms “infantile spasm”, “epileptic spasms”, …

Exploring Biopsychosocial Influences On Hookup Culture And Disrupting Compulsory Behaviors In Emerging Adults: A Multidisciplinary Analysis Of A Contemporary Public Health Concern, Catherine Benjamin

Honors Theses and Capstones

Multidisciplinary analysis, including biology, psychology, and sociology, to better understand the compulsory Hookup Culture that exists as a contemporary public health concern among the age group defined as emerging adults. Sexually Transmitted Infections (STIs) diagnoses are steadily rising in the United States and disproportionately affecting college students. Early socialization and current educational resources that contribute to shame and stigma are discussed to explain how lifestyle and social conditions can act as risk factors for individual health outcomes.

Improving Low Fresh Gas Flow Adherence To Lower Co2e Emissions, Luke Charles Ricci

Honors Theses and Capstones

Volatile anesthetic gases contribute significantly to healthcare-related greenhouse gas emissions. These greenhouse gas emissions can be increased due to higher fresh gas flows. At Dartmouth-Hitchcock Medical Center (DHMC), open and semi-open systems with fresh gas flow (FGF) rates above two liters per minute result in anesthetic gas waste. Literature suggests multifaceted quality improvement interventions are effective in improving low fresh gas flow adherence in anesthesia provider practices. The purpose of this study was to evaluate the potential reduction in anesthetic gas waste and carbon dioxide equivalent (CO₂e) emissions at Dartmouth-Hitchcock Medical Center through improved adherence to low fresh gas flow …

Hypokalemic Periodic Paralysis In A Young Woman With Mast Cell Activation Syndrome: An Atypical Presentation Associated With An Ultra-Rare Cacna1s Variant, Yasmin Aboutaleb, Ali Moradi, Saba Noreen, Abdullah Sahyouni, Hasin Sharma, Olu Oyesanmi, Ian M. Kahane, Yizhi Lin, Hakan R. Toka

West Florida Division GME Research Day 2026

No abstract provided.

Allergic Contact Dermatitis To Medihoney Gel After Mastectomy: Role Of Alkyl Glucoside Sensitization In Chronic Wounds, Madison M. Taylor, Jordan L. Jafarnia, Austin Black, Kelly C. Nelson, Megan N. Rogge

Gulf Coast Division GME Research Day 2026

No abstract provided.

Oral N-Acetylcysteine In Hepatitis C - Induced Acute Liver Injury: A Case Report, Mohammed Irfan Khan, Shuchita Jhaveri, Renu Thomas, Kevin Garnepudi, Galvin Dhaliwal, Ahmed Ouni, Shane P. Sweeney, Julian Nguyen

Gulf Coast Division GME Research Day 2026

No abstract provided.

Unexpected Culprit Revealed After Mechanical Aspiration Thrombectomy: High Thrombus Burden Presenting With Junctional Rhythm Due To Occlusion Of Sinoatrial Node Artery, Originating From Left Circumflex Artery, Anush Agrawal, Dilesha D. Kumanayaka, Anusha Putta

Gulf Coast Division GME Research Day 2026

No abstract provided.

A South Texas Mousetrap: A Case Report Of Murine Typhus And Diagnostic Dilemmas, Arjun Kamath, Jose Garza, Matthew Wagner, Deekshita Valiveti, Percy Thomas, Christopher Ganson, Abhay Vakil, Zuhair Ali

Gulf Coast Division GME Research Day 2026

No abstract provided.

Not Just Cholecystitis: Cancer With Cholecystitis, Saira Ahmed, Joseph Daodu, Anila Punjwani, Shane Sweeney, Pierre Khoury, John Hardaway, Mike K. Liang

Gulf Coast Division GME Research Day 2026

No abstract provided.

A Case Report Of Anaphylactic Shock To Tirzepatide, Elinor Barsh, Mohamed Ahmed, Dmitriy Scherbak

Continental and Mountain Divisions GME Resarch Day 2026

No abstract provided.

When Ckd Isn't What It Seems: A Case Of Lect2 Amyloidosis, Ankita Ojha, Banshi M. Rathi

Gulf Coast Division GME Research Day 2026

No abstract provided.

Unloading The Left Ventricle On Va Ecmo: Comparative Effectiveness Of Ecpella, Iabp, And Venting, Yves Najm Mrad, Snehalkumar Patel

Gulf Coast Division GME Research Day 2026

No abstract provided.