Medical Specialties Commons^™

Translating Advocacy Into Action: Exploring Oncology Healthcare Professionals’ Awareness And Use Of The Clinical Oncology Society Of Australia Position Statement On Exercise In Cancer Care, Jack Dalla Via, Francesca Cehic, Carolyn J. Peddle-Mcintyre, Christopher R. Andrew, David Mizrahi, Yvonne Zissiadis, Nigel A. Spry, Robert U. Newton, Mary A. Kennedy

Research outputs 2022 to 2026

Purpose: The Clinical Oncology Society of Australia (COSA) position statement on exercise in cancer care encourages all healthcare professionals to discuss, recommend, and refer people with cancer to exercise; however, use of these recommendations in practice is unknown. Methods: Oncology healthcare professionals working in Australia were invited to complete a cross-sectional online survey that assessed contextual factors that influence implementation of COSA exercise guidance in cancer care, based on the Consolidated Framework for Implementation Research. Results: We received 133 survey responses. Most were women (74%), nurses (35%), or oncologists (26%), involved in cancer care for > 10 years (63%), and in …

Exercise Effects On Symptoms Of Depression And Anxiety Vary By Patient, Clinical, And Intervention Characteristics In Cancer Survivors: Results From Pooled Analyses Of Individual Participant Data Of 26 Rcts, Marlou Floor Kenkhuis, Meike Doorenbos, Isa H. Mast, Neil K. Aaronson, Marc Van Beurden, Martin Bohus, Kerry S. Courneya, Amanda J. Daley, Daniel A. Galvão, Martine M. Goedendorp, Wim H. Van Harten, Sandi C. Hayes, Anouk E. Hiensch, Melinda L. Irwin, Marie José Kersten, Hans Knoop, Anne M. May, Alex Mcconnachie, Willem Van Mechelen, Nanette Mutrie, Robert U. Newton, Frans Nollet, Hester S. Oldenburg, Martina E. Schmidt, Kathryn H. Schmitz, Karl Heinz Schulz, Dennis R. Taaffe

Research outputs 2022 to 2026

Purpose: This study aimed to investigate whether socio-demographic, clinical, and intervention-related variables moderate the effects of exercise on depression and anxiety symptoms in cancer survivors. Methods: Data from 26 RCTs in the POLARIS database were analyzed using a one-step individual participant data (IPD) meta-analytic approach with linear mixed models to assess exercise effects on depression and anxiety symptoms (z-scores). Interaction terms were added to these models to explore moderators. Results are presented as betas (corresponding to Cohen’s d effect size). Results: Albeit statistically significant, exercise demonstrated negligible effects on symptoms of depression (β = − 0.11; 95% CI = − …

Rural Cancer Survivors' Perceived Delays In Seeking Medical Attention, Diagnosis And Treatment: Findings From A Large Qualitative Study, Alyssa Taglieri-Sclocchi, Ingrid Bindicsova, Susannah K. Ayre, Michael Ireland, Sonja March, Fiona Crawford-Williams, Suzanne Chambers, Jeff Dunn, Belinda C. Goodwin, Elizabeth A. Johnston

Research outputs 2022 to 2026

Aims: To investigate rural cancer survivors' self-reported reasons for perceived delays in initial cancer detection and treatment. Methods: Within a cohort study, adult cancer survivors who had travelled > 50 km for cancer care, staying at subsidised accommodation lodges in city centres in Queensland, Australia, were invited to complete a structured interview on perceived delays in: (i) seeking medical attention, (ii) receiving their diagnosis and (iii) commencing treatment. Content analysis was used to map self-reported reasons for perceived delays at each step, which were then categorised based on the perceived source: (i) personal, (ii) healthcare professional, (iii) healthcare system or (iv) …

A Child With Severe Pneumonia Cannot Feed, Causing Malnutrition: Exploring Health Worker And Caregiver Perspectives And Practices For Mitigating Malnutrition Among Children With Severe Pneumonia, A Case Of Uganda, Damalie Nalwanga, Robert Opoka, Andrew Sentoogo Ssemata, Lawrence Kakooza, Andrew Kiggwe, Victor Musiime, Sarah Kiguli

Paediatrics and Child Health, East Africa

Background: Severe pneumonia remains the leading cause of morbidity and mortality among children worldwide. Severe pneumonia causes death during hospitalization, and survivors are prone to malnutrition after discharge from the hospital. The World Health Organization and United Nations International Children’s Fund recommend ‘continued’ feeding following a severe pneumonia illness without specific recommendations on nutritional support. This recommendation could influence health workers’ and caregivers’ nutritional practices. This study aimed to explore the perspectives and practices of health workers and caregivers for mitigating malnutrition among children with severe pneumonia.

Methods: We conducted a cross-sectional qualitative study between June and November 2021 among …

Investment In Family Medicine To Improve Health Outcomes In Sub-Saharan Africa, Sunanda C. Ray, Mpundu Makasa, Innocent Besigye, Jacob Shabani, Martha Makwero

Family Medicine, East Africa

Family physicians (FPs), as educators, capacity builders and clinical governance leaders of primary care (PC) teams, work to make them more effective and responsive to the needs of their patients. Various strategies are required to raise the profile of Family Medicine (FM) to ensure stronger representation in health sector planning and policy development for advocacy on behalf of the communities they serve. An illustration is given of the need for FP leaders to become equal partners in the National Surgical, Obstetric and Anaesthesia Planning process to ensure safer surgery at district hospitals and to address unmet surgical needs. Integrating FM …

Sociodemographic Influences On Substance Use In Psychosis In An African Cohort, Megan L. Campbell, Raymond Odokonyero, Dickens Akena, Melkam Alemayehu, Lukoye Atwoli, Lori B. Chibnik, Bizu Gelaye, Stella Gichuru, Symon M. Kariuki, Karestan C. Koenen

Internal Medicine, East Africa

Background: Substance use is common among individuals with psychotic disorders, but limited research exists on the variations in substance use across countries in Africa. This study aims to investigate the frequency of alcohol, tobacco, cannabis, and khat consumption in individuals with bipolar disorder (BD) and schizophrenia (SCZ) across four African countries: South Africa, Ethiopia, Kenya, and Uganda.

Methods: We utilized data from the Neuropsychiatric Genetics of African Populations-Psychosis project, a large case-control study which will soon have genetic data on over 42,000 participants, half with psychosis. Information on substance use was collected using the Alcohol, Smoking and Substance Involvement Screening …

Exploring The Clinical Utility Of Neurofilament Light Chain Assays In Multiple Sclerosis Management., Amit Bar-Or, Jacqueline Nicholas, Jenny Feng, Francesca Sorrell, Mark Cascione

Neuroscience Articles

Multiple sclerosis (MS) is a chronic neuroinflammatory and neurodegenerative disease that affects nearly 1 million adults in the United States. Owing to its unpredictable disease course, diverse phenotypes, and an array of currently available disease-modifying therapies, a personalized approach to MS management is required. There is an unmet need to identify, validate, and incorporate prognostic, monitoring, and predictive biomarkers into routine clinical practice for MS. A mounting body of evidence supports the use of blood biomarkers, such as neurofilament light chain (NfL), in predicting disease activity and monitoring treatment response. Previous hurdles for the widespread use of NfL in the …

Corrigendum To 'Scai Expert Consensus Statement On Alternative Access For Transcatheter Aortic Valve Replacement' [Journal Of The Society For Cardiovascular Angiography & Interventions 4 (2025) 102514]., Matthew Sherwood, Keith B Allen, Thom G Dahle, Chandan M Devireddy, Jeffrey Gaca, Santiago Garcia, Kendra J Grubb, Tsuyoshi Kaneko, Chad A Kliger, Robert J Lederman, John C Messenger, Puja B Parikh, Marie-France Poulin, Carlos Sanchez, Anene Ukaigwe, James J Yun, Paul D Mahoney

Heart and Vascular Articles

[This corrects the article DOI: 10.1016/j.jscai.2024.102514.].

Telogen Effluvium And Anesthesia Considerations: A Case Report., Elizabeth Johnson-Gray, Samantha A Currier, Hanen Fernandez, Matt Brown, Matthias Franzen

Ambulatory and Primary Care Articles

Telogen effluvium is a form of non-scarring hair loss characterized by premature shedding of hair. Pathophysiologically, telogen effluvium occurs when a significant number of hair follicles prematurely enter the telogen phase, resulting in excessive shedding. The exact mechanism is unclear, but it is believed to involve alterations in the hair follicle's growth cycle, possibly mediated by illness, infection, major surgery, low protein intake, or hormonal changes. Some medications can also be linked to this disease, such as beta blockers, carbamazepine, and vitamin A. When affected hairs are in the resting phase, noticeable hair shedding occurs. Our patient was a 61-year-old …

Cardiovascular Manifestations Of Pseudoxanthoma Elasticum., Aimee Willett, Vivek V Jasti, Sean M Muir, Jay Anderson

Ambulatory and Primary Care Articles

Pseudoxanthoma elasticum (PXE) is a rare systemic disorder of elastic fibers. The most common manifestations include characteristic papules and ocular angioid streaks. Cardiovascular complications include peripheral arterial disease, hypertension, premature coronary artery disease, and cerebrovascular disease. These associations are secondary to dystrophic elastic fibers, resulting in the calcification of small- to medium-sized arteries. We present the case of a 22-year-old otherwise healthy female patient diagnosed with PXE following a biopsy of a neck lesion. Ophthalmologic evaluation revealed characteristic angioid streaks. The patient also reported early satiety and leg cramping, which prompted referral to gastroenterology and cardiology. Further investigation raised concern …

A Descriptive Bibliometric Study Of Cera Publication Dissemination, Authorship, And Citation Rates., Bryce A Ringwald, Jennifer L Middleton

Medical Education Articles

BACKGROUND AND OBJECTIVES: Barriers to performing family medicine research include funding, infrastructure, and mentorship shortages. The Council of Academic Family Medicine Educational Research Alliance (CERA) was created in 2011 to address these issues. This study explores the scope and impact of CERA-related publications in family medicine.

METHODS: We performed a descriptive bibliometric study of CERA-related publications from 2011 to 2023. Articles were sourced from Medline (PubMed), SCOPUS, and the CERA website. Data analysis focused on publication type, authors, CERA survey type, and citation rates.

RESULTS: From a total of 231 articles retrieved via initial searches and 166 from the CERA …

Utility Of Ebus-Tbna In Evaluating Mediastinal And Hilar Lymphadenopathy In Patients With Silica Exposure: A Retrospective Single-Center Study, Tarake M. Aljarod, Atul C. Mehta, Saroj Sigdel, Mark Jason Akers, John L. Saylor, Caleb S. Clark, Yousef Shweihat

Pulmonology

Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is used effectively in staging lung cancer and in the evaluation of benign causes of mediastinal and/or hilar lymphadenopathy (MHL), such as sarcoidosis. However, evidence for its utility in the diagnostic workup of silicosis is limited.

Methods: This single-center retrospective study included patients with occupational silica exposure who underwent EBUS-TBNA to evaluate MHL on computed tomography (CT). Cytology specimens were re-examined by an independent pathologist under polarized microscopy, and cytologic criteria for the diagnosis of LN silicosis were formulated from the findings. Primary outcomes were the determination of the diagnostic yield (DY) of …

Assessing The Risk Of Adverse Obstetric Outcomes And Determinants Among Mothers With Gestational Diabetes Mellitus At Aga Khan University Hospital, Nairobi, Justus Wambugu

Master of Medicine in Obstetrics and Gynecology

Background: Gestational diabetes (GDM) is recognized as a major concern in obstetric care. It is associated with adverse obstetric outcomes including the risk of cesarean delivery, pregnancy-induced hypertension, obstetric hemorrhage, induction of labour, large for gestational age fetus, preterm delivery, and admission to neonatal critical care units. However, there is limited evidence on the magnitude of risk conferred by GDM for various adverse pregnancy outcomes

Objectives: The primary objective of our study was to assess the relative risk for adverse obstetric outcomes associated with GDM in women diagnosed using the WHO-recommended 75g 2-hour oral glucose tolerance test (OGTT), compared to …

Airway Management During Emergent Laparotomy In A Patient With Subglottic Stenosis And Unilateral True Vocal Cord Paralysis: A Case Report., Rayyan Bhutta, Ali Osman, Connor Henn, Hameed H Salah, Samir Patel

Surgery Articles

This case report describes the airway course of a 52-year-old male who required emergent exploratory laparotomy for suspected gastrointestinal perforation. The patient had underlying subglottic stenosis and unilateral vocal cord paralysis, as well as a history of significant cardiopulmonary disease. Attempts at intubation using standard tube sizes were unsuccessful. A 6.0 endotracheal tube was eventually passed beyond a point of resistance, allowing the operation to proceed. He remained intubated after surgery and was successfully extubated several days later. The report emphasizes the need for adaptable airway plans and highlights the constraints that may arise during urgent operative care.

The Evaluation Of Anti-Factor Xa Levels In Hospitalised Patients Receiving Low Molecular Weight Heparin (Lmwh): A Prospective Study, Tandzile Thandwayinkosi Simelane

Master of Medicine in Clinical Pathology

Background 

Patients admitted to the hospital have been reported to have coagulation abnormalities due to various factors including immobilisation, preexisting disease, and current illness. The overall incidence of venous thromboembolism (VTE) in critically ill patients varies from 15% to well over 50%, even with the use of prophylactic measures in most patients. Low molecular weight heparin (LMWH) and unfractionated heparin (UFH) are the recommended drugs for VTE prophylaxis in inpatient care. Although not standardly recommended, the laboratory can offer monitoring of anti-Factor Xa using the gold standard method of chromogenic anti-Factor X assay. The anti-Factor Xa levels are notably affected …

A Risk Score To Predict Recurrent High Intensity Inpatient Resource Utilization For Children With Medical Complexity., Charles Maloy, Jessica L. Bettenhausen, Y Raymond Chan, Leah Jones, Kathryn Kyler, Laura Plencner, Jessica Markham, Jacqueline Walker, Smit Shah, Sian Best, Jonathan Ermer, Shelby Chesbro, Maria Newmaster M.D., Henry T. Puls

Posters

Background Children with medical complexity (CMC) use a greater amount of inpatient resources and stand to benefit from unique care models and coordination. However, hospital resources can be limited, and a better understanding of which CMC are high resource users could improve hospital and staff planning. Objective: To develop a risk score predictive of recurrent high intensity inpatient utilization among CMC. Methods: We conducted a retrospective cohort study of children < 18 years old with ≥3 complex chronic conditions (CCC) discharged from one of 48 children’s hospitals in the Pediatric Health Information System during 2021 and 2022. To reflect CMC typically cared for by a general medical service, children with cardiac procedures, dialysis, oncology, or transplant CCCs, and index hospitalization mortality were excluded. We used multivariable logistic regression to determine factors present on the index hospitalization associated with ≥5 hospitalizations or ≥3 hospitalizations with one lasting ≥25 days within any 365-day period (high inpatient utilization) in 2021-2023. We developed risk scoring system using model coefficients and defined the optimal risk score cutoff to maximize sensitivity and specificity. We then applied the risk score cutoff to children discharged to determine (a) ratio of predicted:actual CMC with recurrent high resource use and (b) the total predicted daily volume on 50th, 75th, and 90th percentile days for each hospital. Results: Of 44,432 included children , 9,596 (21.6%) had high inpatient utilization (Table). Children under 1 year of age had the highest odds of high inpatient utilization (OR 2.26 [95% CI: 2.16, 2.37]) and all CCC and technology groups (except metabolic) met statistical significance (Figure 1). The optimal risk score cutoff was 29 and predicted 17,411 (39.2%) CMC as high inpatient resource utilizers; the predicted:actual ratio of CMC with high inpatient utilization was 1.81. The mean daily census of the 50th, 75th, and 90th percentiles across hospitals was 28 CMC with recurrent high utilization (± 17), 34 (±18), and 39 (±19; Figure2). Conclusions: It is feasible to develop a risk score predictive of recurrent high inpatient utilization among CMC. There is substantial variability in volume of CMC with high utilization between pediatric hospitals. The risk score cutoff values can be modified to suit different applications and institution-specific objectives. These applications could include a dedicated service line or staffing. Alternatively, this could identify patients who would benefit from more formal handoff from inpatient to outpatient providers.

Implementing A Team-Based Approach To Reduce Blood Culture Contamination Rates In The Emergency Department: A Quality Improvement Initiative, Melissa Lockhart

Doctor of Nursing Practice Projects

Background: Blood culture contaminations (BCC) present significant risks to patients, including adverse drug reactions and the exacerbation of antibiotic resistance. BCC can also result in millions of dollars in financial burdens for hospitals due to the need for follow-up testing, treatment complications, and antibiotic stewardship efforts. At this facility, the contamination rate in the emergency department (ED) consistently exceeds the national benchmark of 3%. Contributing factors include high patient turnover and increased nursing workloads, which can lead to shortcuts in essential practices such as hand hygiene and skin disinfection before collection.

Purpose: This project aimed to evaluate whether implementing a …

Increasing Colorectal Cancer Screening Rates For Patients Without Insurance, Andrea F. Day

Doctor of Nursing Practice Projects

Background: Colorectal cancer is a leading cause of cancer-related death in the United States (U.S.), ranking as second most prevalent overall. Despite many initiatives, screening rates remain low, especially among clinic patients without insurance. The lack of an evidence-based screening protocol exacerbates these issues and increases the risk of advanced cancer and death. Initial data showed that 0% of patients were screened according to recommended guidelines.

Purpose: The project implemented a standard screening protocol to increase colorectal cancer screening rates in a rural Alabama free clinic for patients ages 45-64 lacking insurance.

Project Design: This quality improvement …

Persistent Imbalance: Women’S Representation In North American Pediatric Cardiology Leadership Roles.Persistent Imbalance: Women’S Representation In North American Pediatric Cardiology Leadership Roles, Alaina K. Kipps, Audrey C. Marshall, Neha Bansal, Holly Bauser-Heaton, Nadine Choueiter, Devyani Chowdhury, Aarti Dalal, Molly Ehrlich, Lindsay R. Freud, Supriya S. Jain, Pei-Ni Jone, Kristin Laraja, Dalia Lopez-Colon, Sonal T. Owens, Christina Ronai, Ritu Sachdeva, Corey Stiver, Nicole Sutton, Terrie Vasilopoulos, Jennifer Co-Vu

Department of Pediatrics Faculty Papers

BACKGROUND: Despite recent gender parity of physicians entering pediatric cardiology, representation of women leaders lags their male colleagues.

OBJECTIVES: We sought to better understand the variation in women in leadership roles in pediatric cardiology.

METHODS: The gender of physicians in 16 prespecified leadership positions was collected by survey between July 2022 and January 2023 from pediatric cardiology programs with >5 cardiologists in North America. We analyzed the association of women leaders with center size (based on surgical volume), geographic region, presence of categorical fellowship program, and gender of division chief and department chair.

RESULTS: Across 99 centers, a median of …

Using The Observational Medical Outcomes Partnership Common Data Model For A Multi-Registry Intensive Care Unit Benchmarking Federated Analysis: Lessons Learned, Aasiyah Rashan, Daniel P Püttmann, Nicolette F De Keizer, Dave A Dongelmans, Ronald Cornet, Otavio Ranzani, Wangari Siika, Matthew Smith, Steve Harris, Abi Beane

Anaesthesiology, East Africa

Objective: Federated analysis is a method that allows data analysis to be performed on similar datasets without exchanging any data, thus facilitating international research collaboration while adhering to strict privacy laws. This study aimed to evaluate the feasibility of using federated analysis to benchmark mortality in 2 critical care quality registry databases converted to the Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM), describing challenges to and recommendations for performing federated analysis on data transformed to OMOP CDM.

Materials and Methods: To identify as many challenges as possible and to be able to complete the benchmarking phase, …

Exploring The Efficacy Of Various Minimally Invasive Surgery (Mis) Techniques In Spinal Fusion For Degenerative Spondylolisthesis: A Systematic Review, Yolanda V. Gutierrez, Blake Martin, Joshua Nwose, Alyssa A. Sepulveda, Ronald Shaju, Aamir Ahmad, Robert H. Ablove

School of Medicine Publications

Degenerative spondylolisthesis is a common etiology of low back pain characterized by the anterior displacement of one vertebral body relative to the one below it. A key contributing factor is intervertebral disc degeneration, which compromises spinal stability. In patients with a lack of neurological issues, conservative treatment is recommended. If conservative treatment is ineffective, surgery is deemed the next step, involving decompression and fusion of the vertebrae. Over the past several decades, minimally invasive surgical (MIS) techniques have been developed and refined. This systematic review aims to compare different types of MIS techniques for the treatment of degenerative spondylolisthesis to …

Inflammatory Bowel Disease: Patient Journey And Cancer Pathology, Katie Contino, Ms

Student Papers, Posters & Projects

Inflammatory Bowel Disease is a relapsing-remitting autoimmune disease that affects the gastrointestinal tract. It consists of Crohn’s disease, which can affect the entire gastrointestinal system, and ulcerative colitis, which is limited to the colon. Inflammatory Bowel Disease has various different levels of severity that have different treatment and medication options once the diagnosis is confirmed with an endoscopic procedure. The treatment options range from daily medication to invasive surgical procedures. Specific diets are also used as a preventative measure to remain in remission. The intestinal damage inflicted to the epithelium increases the risk of developing colon cancer, specifically those with …

Systemic Exogenous Progestins With Or Without Estrogens Are Associated With Decreased Rates Of Venous Procedures For Varicose Veins, Paarth Jain, Adam M. Ostrovsky, Paul J Dimuzio, Luis H. Eraso, Michael Nooromid, Dawn Salvatore, Babak Abai

Department of Surgery Faculty Papers

OBJECTIVES: Risk factors for varicose veins (VVs) such as female sex, pregnancy, and obesity are high estrogen states, yet the role of systemic progestins with or without estrogens (SPEs) in VV management is not well characterized. This study investigates how SPE use affects rates of venous procedures for patients with VV.

METHODS: The TriNetX database was queried for subjects with International Classification of Diseases, 10th edition, diagnoses of asymptomatic VV, chronic venous insufficiency, and complicated VV (inflammation or ulceration). Patients were divided into a control cohort with no subsequent SPE use, a progestin-only cohort, and a combined estrogen-progestin (CEP) cohort. …

Beyond The Bone: A Misdiagnosis Of Paget’S Disease Reveals Polyostotic Mazabraud Syndrome, Michael Higham, Stephanie Campbell, Amanda Killeen

School of Podiatric Medicine Publications

Introduction: Mazabraud Syndrome is a rare benign condition characterized by polyostotic fibrous dysplasia and intramuscular myxomas. Due to its overlapping radiographic features, it is frequently misdiagnosed. We present a case where Mazabraud Syndrome was misdiagnosed as Paget’s disease for nearly 6 decades.

Case Presentation: A 59-year-old woman presented to the podiatry clinic with complaints of numbness and sharp pain of the left foot while in stance. Her surgical history is positive for numerous lower extremity myxomas excised over her lifetime, beginning in adolescence, and now with non-mobile soft tissue mass at the porta pedis of the left foot for 1 …

Who Reconstitutes The Chemotherapy? The Educational And Practice Needs Of Oncology Pharmacists In West Africa: A Call For Multidisciplinary Team Approach In Oncology Care., Runcie C.W. Chidebe, Ramatu M. Alabelewe, Krishna Prasad Sapkota, Darlingtina K. Esiaka, Candidus C. Nwakasi, Gloria C. Okwu, Jacinta Emejulu, Adamu A. Umar, Ndifreke Okwuegbunam, Funsho David, Toyosi Adepoju, Agha A. Agha, Ejike S. Ugwu, Simeon C. Aruah, Richard Mshelia, Rob Duncombe, Noel N. Wannang, Peace C. Babalola, R. Donald Harvey, Cindy O'Bryant, Folakemi T. Odedina

Behavioral Science Faculty Publications

PURPOSE: Oncology pharmacists (OPs) play a crucial role in cancer care, treatment, survivorship, and multidisciplinary teams (MDTs). OPs have specialized training in designing, administering, monitoring, and modifying oncology chemotherapy; managing adverse events; and evaluating clinical trials and investigational drugs. Yet, the state of OP has remained largely unknown in the clinical oncology workforce of the West African region. Therefore, this study aimed to understand who reconstitutes chemotherapy and to explain the OP educational and practice needs, challenges, and solutions in Nigeria.

MATERIALS AND METHODS: Using a concurrent embedded mixed method design, 35 OPs completed a questionnaire, and 12 others responded …

The Landscape Of Malignant Transition: Unraveling Cancer Cell-Of-Origin And Heterogeneous Tissue Microenvironment, Ruihan Luo, Jiajia Liu, Tiangang Wang, Weiling Zhao, Yanfei Wang, Jianguo Wen, Hongyu Wang, Shanli Ding, Xiaobo Zhou

Faculty, Staff and Student Publications

Understanding disease progression and sophisticated tumor ecosystems is imperative for investigating tumorigenesis mechanisms and developing novel prevention strategies. Here, we dissected heterogeneous microenvironments during malignant transitions by leveraging data from 1396 samples spanning 13 major tissues. Within transitional stem-like subpopulations highly enriched in precancers and cancers, we identified 30 recurring cellular states strongly linked to malignancy, including hypoxia and epithelial senescence, revealing a high degree of plasticity in epithelial stem cells. By characterizing dynamics in stem-cell crosstalk with the microenvironment along the pseudotime axis, we found differential roles of ANXA1 at different stages of tumor development. In precancerous stages, reduced …

The Effect Of Individual Variation On Epidemiological Dynamics: From Super-Spreaders To Landscapes Of Risk, Alexis Shannon Beagle

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

Individuals that make up a population always display some level of variation between members. At the smallest scale, individuals always maintain genetic variation, but variation continues to arise at other scales of biological organization from physiological or immunological variation within individuals to variation in behavior between individuals that can be both genetically and environmentally mediated. The role of individual variation is particularly important in the context of infectious diseases because there is strong evidence that infections are highly heterogenous, indicating that patterns of individual variation drive a significant portion of the epidemiological patterns we observe. Individual variation leads to heterogeneity …

Subclinical Hyperthyroidism Presenting As Urinary Frequency And Polyuria: A Case Report., Hameed H Salah, Elizabeth M Pines

Ambulatory and Primary Care Articles

Hyperthyroidism may present with a variety of symptoms including urinary frequency. This report discusses a case of subclinical hyperthyroidism presenting as generalized weakness, urinary frequency, polyuria, and intermittent diarrhea. However, this elderly patient had a complex past medical history including multinodular nontoxic thyroid goiter with tracheal deviation and multiple recent admissions for aspiration pneumonia, making the diagnosis of subclinical hyperthyroidism less obvious. The patient was managed with intravenous fluids and discharged on propranolol with recommendations to follow-up with endocrinology. This case demonstrates the importance of keeping hyperthyroidism on the differential for urinary frequency and polyuria without other clear etiologies.

Breast Reconstruction In Becker Nevus Syndrome, Alexis K. Schlosser, Mohammed S. Rais, Ruston J. Sanchez

School of Medicine Faculty Publications

Becker nevus syndrome is a rare cutaneous disorder characterized by the presence of a hyperpigmented patch of skin typically occurring on the upper trunk, often associated with hypertrichosis, and sometimes associated with musculoskeletal abnormalities ipsilateral to the nevus. Becker nevus syndrome can lead to breast hypoplasia. Unlike other forms of breast hypoplasia, treatment should begin before the completion of breast development. Due to the rarity of the disease, breast reconstruction in these patients has no gold-standard approach, and treatment is often delayed. Therefore, our case report highlighted the need for early treatment and provided options for reconstruction in this population. …

Individualized Functional And Structural Language Lateralities In Temporal Lobe Epilepsy And Their Impact On Memory, Ankeeta Ankeeta, Qirui Zhang, Sam Sharifzadeh Javidi, Shilpi Modi, Michael R. Sperling, Joseph I. Tracy

Department of Neurology Faculty Papers

The basis and impact of functional asymmetries in the brain, particularly language lateralization, are not fully understood, and the relationship between functional and structural asymmetries remains largely untested. This study investigated the degree to which asymmetries in hemispheric language laterality are concordant with asymmetries in gray matter (GM) structure and whether the hemispheric organization of memory is influenced by functional language asymmetries. Structural and functional MR data was acquired from 261 individuals, including those with unilateral temporal lobe epilepsy (LTLE = 96, RTLE = 69) and matched with healthy participants (HPs = 96). Functional language laterality indices (LIs) were calculated …