Medical Specialties Commons^™

Cardiovascular Health In Cardiac Rehabilitation: Applying The American Heart Association Life's Simple 7 Framework In A Center-Based Cohort, Audry Chacin-Suarez, Tomoaki Hama, Matthew P. Johnson, Helayna Abraham, Thomas P. Olson, Laprincess C. Brewer

Einstein Health Papers

BACKGROUND: Cardiac rehabilitation (CR) is a comprehensive secondary cardiovascular disease program with structured lifestyle interventions to reduce morbidity and mortality. The American Heart Association cardiovascular health (CVH) framework measures health-promoting behaviors and clinical factors, but it has not been rigorously evaluated in the CR setting.

METHODS: This retrospective cohort study analyzed patients attending CR from January 2018 to September 2020. Patients were evaluated at baseline (pre-CR) and completion (post-CR) using 3 clinical factors (blood pressure, cholesterol, and hemoglobin A1c) and 4 health behaviors (smoking, body mass index, physical activity, and diet). CVH score was computed as a composite of each …

Btp2 Restricts Tulane Virus And Human Norovirus Replication Independent Of Store-Operated Calcium Entry, Francesca J Scribano, J Thomas Gebert, Kristen A Engevik, Nicole M Hayes, Jorge Villanueva, Son Pham, Soni Kaundal, Janam J Dave, B V Venkataram Prasad, Mary K Estes, Sasirekha Ramani, Joseph M Hyser

Faculty, Staff and Students Publications

Human norovirus is the leading cause of viral gastroenteritis across all age groups. While there is a need for human norovirus antivirals, therapeutic development has been hindered by a lack of cell culture systems and animal models of infection. Surrogate viruses, such as Tulane virus (TV), have provided tractable systems to screen potential antiviral compounds. Our previous work demonstrated that TV encodes a viral ion channel, which dysregulates cytosolic calcium signaling. We set out to investigate whether host pathways triggered by viral ion channel activity, including store-operated calcium entry (SOCE), play a role in virus replication. Using pharmacologic inhibitors and …

Proteogenomic Analysis Of The Calgb 40601 (Alliance) Her2+ Breast Cancer Neoadjuvant Trial Reveals Resistance Biomarkers, Eric J Jaehnig, Aranzazu Fernandez-Martinez, Tanmayi D Vashist, Matthew V Holt, Laterrica Williams, Jonathan T Lei, Chang In Moon, Beom-Jun Kim, Yongchao Dou, Haoquan Zhao, Viktoriya Korchina, Richard A Gibbs, Donna Marie Muzny, Harshavardhan Doddapaneni, Charles M Perou, Lisa A Carey, Ana I Robles, Terry Hyslop, Yujia Wen, Linda Mccart, Azra Krek, Francesca Petralia, George Miles, Shyam M Kavuri, Michael A Gillette, D R Mani, Steven A Carr, Bing Zhang, Matthew J Ellis, Shankha Satpathy, Meenakshi Anurag

Faculty, Staff and Students Publications

Proteogenomic analysis is applied to samples from the CALGB 40601 (Alliance) randomized neoadjuvant trial of trastuzumab, lapatinib, or the combination to identify biomarkers associated with pathological response status. Absence of ERBB2 gene amplification and human epidermal growth factor receptor 2 (HER2) protein overexpression by proteogenomics is associated with non-pathological compete response (pCR) (p < 0.05), highlighting potential false positives from standard diagnostics. Pathway analysis in proteogenomics-confirmed HER2+ samples identifies elevated epithelial-mesenchymal transition (EMT) and WNT-β-catenin signaling in non-pCR cases before treatment. Twenty-four pCR-associated proteins reproduce in a second proteomic dataset, and four (GPRC5A, TPBG, SP140L, and NEU1) are significant in a third. A meta-analysis of ten diverse neoadjuvant anti-HER2 treatment regimens from four independent studies confirms that non-pCR cases express higher levels of mRNA for G protein-coupled receptor class C group 5 member A (GPRC5A, p = 0.0002) and trophoblast glycoprotein (TPBG, p = 0.00008). Thus, proteogenomic analysis identifies negative biomarkers for pCR and alternative plasma membrane targets for treatment-resistant HER2+ breast cancer.

The Maturity-Onset Diabetes Of The Young (Mody) Calculator Overestimates Mody Probability In Hispanic Youth, Guido Alarcon, Anh Nguyen, Angus Jones, Beverley Shields, Maria J Redondo, Mustafa Tosur

Children’s Nutrition Research Center Staff Publications

Context: The applicability of the maturity-onset diabetes of the young (MODY) risk calculator to non-White European populations remains unknown.

Objective: We aimed to test its real-world application in Hispanic youth.

Methods: We conducted a retrospective chart review of Hispanic youth (< 23 years) with diabetes (n = 2033) in a large pediatric tertiary care center in the United States. We calculated MODY probability for all subjects, splitting them into 2 cohorts based on the original model: individuals who were started on insulin within 6 months of diabetes diagnosis (Cohort 1) and those who were not (Cohort 2).

Results: Cohort 1 consisted of 1566 individuals (median age [25p, 75p]: 16 [13, 19] years, 49% female), while Cohort 2 comprised 467 youth (median age [25p, 75p]: 17 [15, 20] years, 62% female). The mean MODY probability was 5.9% and 61.9% in Cohort 1 and Cohort 2, respectively. The mean probability for both cohorts combined was 18.8%, suggesting an …

Slow-Growing Lung Mass In A Patient With Multiple Endocrine Neoplasia Type I: Consider Carcinoid Tumor, Ramin Talebi, Charalambos C. Solomides, Nathaniel R. Evans Iii, Gregory C. Kane

Division of Pulmonary, Allergy, and Critical Care Medicine Faculty Papers

A 23-year-old man with multiple endocrine neoplasia type 1 (MEN 1) with pancreatic tail masses and Cushing syndrome (status after transsphenoidal adenomectomy) presented with a slow-growing, asymptomatic right lower lung lobe mass confirmed to be an atypical carcinoid tumor by pathologic staging following successful basilar segmentectomy with mediastinal lymphadenectomy. Pulmonary carcinoid tumor (PCT) is a rare neoplasm in patients with MEN 1, but there is limited data on trends in atypical versus typical carcinoid tumors in these patients. This case emphasizes the need to characterize these trends given the implications for metastatic potential and 5-year survival, which can help guide …

X-Linked Hypophosphatemia Management In Children: An International Working Group Clinical Practice Guideline., Dalal S. Ali, Thomas O. Carpenter, Erik A. Imel, Leanne M. Ward, Natasha M. Appelman-Dijkstra, Catherine Chaussain, Suzanne M. Jan De Beur, Pablo Florenzano, Hajar Abu Alrob, Rana Aldabagh, R Todd Alexander, Farah Alsarraf, Signe Sparre Beck-Nielsen, Martin Biosse-Duplan, Rachel K. Crowley, Karel Dandurand, Guido Filler, Lisa Friedlander, Seiji Fukumoto, Claudia Gagnon, Paul Goodyer, Corinna Grasemann, Chelsey Grimbly, Salma Hussein, Muhammad K. Javaid, Sarah Khan, Aneal Khan, Anna Lehman, Willem F. Lems, E Michael Lewiecki, Ciara Mcdonnell, Reza D. Mirza, Emmett Morgante, Archibald Morrison, Anthony A. Portale, Christina Rao, Yumie Rhee, Eric T. Rush, Heide Siggelkow, Sotirios Tetradis, Laura Tosi, Gordon Guyatt, Maria Luisa Brandi, Aliya A. Khan

Manuscripts, Articles, Book Chapters and Other Papers

CONTEXT: An International Working Group (IWG) developed new guidelines on the diagnosis, evaluation, management, and monitoring of X-linked hypophosphatemia (XLH) in children. Over the past 5 years, important advances have occurred in our understanding of the presentation, complications, and treatment of XLH.

METHODS: A group of 50 international experts in XLH from Canada, the United States, Europe, Asia, and South America, along with methodology experts and a patient partner, held 18 teleconference meetings in 2023-2024. These meetings addressed key issues regarding diagnosing, evaluating, managing, and monitoring XLH in children. Two systematic reviews were conducted to examine the impact of burosumab …

Dosimetric Advantage Of Scanning Beam Proton Therapy In Gynecologic Patients Receiving Adjuvant Radiotherapy, Rachel B Ger, Jarrod M Lentz, Joshua S Niedzielski, Sujay A Vora, Martin Bues, Danairis Hernandez Morales, Justin D Anderson, Christopher J Kutyreff, Christie A Schulz, Pedro R Lara, Ana K Ridgway, Pamela R Lemish, Justin D Gagneur, Aman Anand

Faculty, Staff and Student Publications

Background/Objectives: Adjuvant radiation for gynecologic malignancies often exposes organs at risk (OARs), such as the bone marrow, bowel, rectum, and bladder, to radiation, leading to toxicities that impact treatment tolerance and patient quality of life. Scanning proton beam therapy, particularly with Individual Field Simultaneous Optimization (IFSO), may offer dosimetric and biological advantages over volumetric modulated arc therapy (VMAT). This study evaluates the clinical impact of IFSO-based proton planning in post-operative gynecologic cancer patients.

Materials and Methods: Fourteen patients receiving adjuvant proton therapy to 45 Gy in 25 fractions were retrospectively analyzed. Comparison VMAT plans were generated on the same datasets. …

Aso Visual Abstract: Characterization Of The Germline Pathogenic Mutational Landscape And Oncologic Outcomes Among 877 Patients With Invasive Lobular Carcinoma, Victoria D Huynh, Jason Mouabbi, Henry M Kuerer, Kerollos Nashat Wanis, Hiam M Abdel-Salam, Angelica M Gutierrez, Helen M Johnson, Anthony Lucci, Kelly K Hunt, Banu K Arun

Faculty, Staff and Student Publications

No abstract provided.

Sports And Physical Activity Of Poles In The Context Of Good Health And Well-Being As A Sustainable Development Goal, Elżbieta Biernat, Monika Piątkowska, Robert Podstawski

Baltic Journal of Health and Physical Activity

Investing in physical activity (PA) is vital for achieving sustainable development goals. We examine PA trends in Poland using data from Eurobarometer surveys conducted in 2013, 2017, and 2022. In 2022, 64.6% of Poles did not participate in sports, and 41.8% did not engage in non-sport PA. There is a concerning trend of increasing inactivity in sports (Chi²_2022/2017 = 34.64; p < 0.001; Chi²_2017/2013 = 56.98; p < 0.001) and non-sports PA (Chi²_2022/2017 = 18.3, p < 0.01 and Chi²_2017/2013 = 16.95, p < 0.01). Participation in sport and PA is influenced by individual, inter-personal, environmental, political, and global factors. Notably, there is an upward trend in interpersonal (e.g., club membership, volunteering), environmental (e.g., PA in parks/nature, at home), and political (e.g., dissatisfaction with local government actions) factors. Government intervention is crucial and requires: (1) establishment of an institution for leadership and advocacy of PA, (2) adoption of a cross-sectoral approach for a coordinated change, and (3) increased in-vestment in monitoring systems to track the impact of interventions. These actions are essential for fostering a more active and healthier population in Poland.

In Vivo Direct Lentiviral Gene Therapy Improves Disease Pathology In A Mucopolysaccharidosis Iva Murine Model, Betul Celik, Estera Rintz, Shaukat Khan, Andrés F. Leal, Fnu Nidhi, Shunji Tomatsu

Department of Pediatrics Faculty Papers

Mucopolysaccharidosis IVA (MPS IVA) is an autosomal recessive disorder that causes the accumulation of keratan sulfate (KS) and chondroitin-6-sulfate in bone and cartilage. This results in progressive skeletal dysplasia, with no effective treatment available. Our study hypothesized that direct lentiviral vector (LV) gene therapy could produce active enzymes from transduced cells, impacting bone and cartilage lesions in MPS IVA. We developed LVs carrying the GALNS gene under three promoters: ubiquitous (CBh), collagen type II (COL2A1), and Mac-1 integrin subunit (CD11b). At the newborn stage and 4 weeks, Galns-knockout mice received intravenous injections at different doses (5 × 10^{9 …}

Prognosis After Switching To E-Cigarettes: Methods Raise Doubt About Conclusion, Harold J Farber

Faculty, Staff and Students Publications

No abstract provided.

Performance Of A Novel Stool Quantitative Polymerase Chain Reaction Assay For Pediatric Tuberculosis Detection In Sub-Saharan Africa, Anca Vasiliu, Lucia Carratala-Castro, Abigail Seeger, Joanna Ehrlich, Babongile Nkala, Tara Ness, Miguel Mario Cumbe, Durbbin Mulengwa, Shilzia Munguambe, Bariki Mtafya, Edson Mambuque, Nosisa Shiba, Sozinho Acacio, Lilian Komba, Clement Gascua Adu-Gyamfi, H Lester Kirchner, Christoph Lange, Andrew R Dinardo, Alberto L Garcia-Basteiro, Anna Maria Mandalakas, Alexander Kay

Faculty, Staff and Students Publications

Background: Children have paucibacillary tuberculosis and cannot provide expectorated sputum. Invasive specimen collection, by gastric aspiration or sputum induction, has a low diagnostic yield. In this study, we aimed to evaluate the diagnostic performance and additive yield of a novel stool-based assay in children diagnosed with tuberculosis in sub-Saharan Africa.

Methods: We conducted a prospective case-control study from October 2020 to June 2023 in Eswatini, Mozambique, and Tanzania. Children under 15 years newly diagnosed with tuberculosis completed clinical examination, chest radiography, culture, sputum Xpert Ultra, stool Xpert Ultra, and stool-based quantitative polymerase chain reaction (stool qPCR) assessment. Stool qPCR sensitivity …

Early Results With Embotrap Iii Stent Retriever: A Multicenter Us Experience, Georgios S Sioutas, Alex N Hoang, Fadi Al Saiegh, Oz Haim, Sanjana Salwi, Avi A Gajjar, Mohamed M Salem, Peter Kan, Omar Tanweer, Justin R Mascitelli, Brian T Jankowitz, Jan-Karl Burkhardt, Visish M Srinivasan

Faculty, Staff and Students Publications

Background

Mechanical thrombectomy with stent retrievers has become a standard treatment for acute ischemic stroke due to large vessel occlusion. Here we present a multicenter US experience using the EmboTrap III stent retriever, the latest iteration within its class.

Methods

We retrospectively reviewed patients with acute ischemic stroke treated with the EmboTrap III device at 4 US centers. We recorded baseline demographics, clinical characteristics, and procedural details. Outcomes included first-pass effect (FPE), modified FPE (mFPE), final mTICI scores, 90-day functional outcomes, and complications.

Results

A total of 92 patients were included, median age of 72 years, and 56.5% were women. …

“Are You Worried About Going Into Withdrawal Today?” Retrospective Analysis Of Single-Question, Patient-Centered Screen For Substance Use And Care Linkage, Kory S. London, Beth Hurwitz, Jennifer Davis, Tareva Warrick-Stone, Alan Cherney, Frederick Randolph, Bernice Bradley-O'Toole, Kate Deis, Karen Alexander

Department of Emergency Medicine Faculty Papers

BACKGROUND: Emergency Department (ED) screening for substance use disorder (SUD) is limited by a lack of standardization and challenging clinical environments. Existing tools may be focused on informing clinicians rather than supporting patients. This study assessed a novel single-question screening tool to identify patients at risk of withdrawal and link those with opioid use disorder (OUD) to standardized treatment.

METHODS: A cross-sectional, retrospective study was conducted at two urban EDs in Philadelphia, PA, using electronic health record data between November 8, 2022, and February 28, 2025. Patients were included in the study if they arrived ambulatory to the emergency department, …

Technical And Clinical Validity Of Assessing Measurable Residual Disease By Multicolor Flow Cytometry In An Unselected Acute Myeloid Leukemia Patient Cohort, Sa A Wang, Shaoying Li, Wei Wang, Jie Xu, Beenu Thakral, Shimin Hu, Chi Young Ok, Fuli Jia, Jeffrey L Jorgensen, L Jeffrey Medeiros, Farhad Ravandi, Nicholas J Short, Sanam Loghavi

Faculty, Staff and Student Publications

Context.—: Following the validation of a multicolor flow cytometry (MFC) assay for measurable residual disease (MRD) in acute myeloid leukemia (AML), this study examines its clinical applicability.

Objective.—: To evaluate the practicality and performance of MFC-based MRD detection in AML.

Design.—: Prospectively assessed AML MRD MFC in unselected AML patients achieving morphologic remission with follow-up studies, molecular genetics, and survival data.

Results.—: Among 379 patient bone marrow samples in this cohort, an interpretable result was obtained in 359 (95%). A total of 57 of the 359 cases (16%) were positive for MRD, and the most frequently observed immunophenotype was CD34+CD117+ …

Surgical Management Of A Pulmonary Neuroendocrine Tumor Causing Epidural Spinal Cord Compression And Transdural Intramedullary Invasion: Illustrative Case, Wesley Shoap, Kion Gregory, Jack A. Leoni, Gabriel C. Tender

School of Medicine Faculty Publications

BACKGROUND Intramedullary spinal cord metastasis from local transdural invasion is an exceedingly rare event. Therefore, specific guidance on the timing, type, and extent of surgical intervention is lacking. OBSERVATIONS A 60-year-old male with a known pulmonary neuroendocrine tumor presented with 2 days of progressive lower extremity paraplegia rendering him nonambulatory. MRI demonstrated transpleural and paravertebral invasion by the mass with extension through the left T1–2 and T2–3 neural foramina causing significant epidural compression. There was also transdural invasion at T2 extending intramedullary to the C4 spinal level, with associated cord edema. He underwent posterior cervicothoracic laminectomy and fusion with transpedicular …

Applying The Nonadoption, Abandonment, Scale-Up, Spread, And Sustainability (Nasss) Framework To Adapt The Champ App For Pediatric Feeding Tube Weaning: Application And Case Report., Dana Bakula, Alexandra Zax, Sarah T. Edwards, Kristina Nash, April Escobar, Rachel Graham, Amy Ricketts, Ryan Thompson, Sarah Bullard, Julianne Brogren, Leah Shimmens, Lori A. Erickson

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Evidence-based tube feeding (TF) weaning involves reducing the volume of tube feeds to induce hunger, with interdisciplinary monitoring to allow for proactive medical, nutritional, and behavioral intervention as needed. This can be done outpatient; however, the current standard of care requires a high degree of medical monitoring and care coordination, which can be challenging to implement. The CHAMP App is a mobile app designed for remote patient monitoring of children born with congenital heart conditions who are at high risk for medical morbidity and mortality. The CHAMP App remote patient monitoring program would be ideally suited to improve medical …

The Tumor Suppressor Hnrnpk Induces P53-Dependent Nucleolar Stress To Drive Ribosomopathies, Pedro Aguilar-Garrido, María Velasco-Estévez, Miguel Ángel Navarro-Aguadero, Álvaro Otero-Sobrino, Marta Ibáñez-Navarro, Miguel Ángel Marugal, María Hernández-Sánchez, Prerna Malaney, Ashley Rodriguez, Oscar Benitez, Xiaroui Zhang, Marisa Jl Aitken, Alejandra Ortiz-Ruiz, Diego Megías, Manuel Pérez, Gadea Mata, Jesús Gomez, Miguel Lafarga, Orlando Domínguez, Osvaldo Graña-Castro, Eduardo Caleiras, Pilar Ximénez-Embun, Marta Isasa, Paloma Jimena De Andres, Sandra Rodríguez-Perales, Raúl Torres-Ruiz, Enrique Revilla, Rosa María García-Martín, Daniel Azorín, Josune Zubicaray, Julián Sevilla, Oleksandra Sirozh, Vanesa Lafarga, Joaquín Martínez-López, Sean M Post, Miguel Gallardo

Faculty, Staff and Student Publications

The nucleolus is a membraneless organelle and an excellent stress sensor. Any changes in its architecture or composition lead to nucleolar stress, resulting in cell cycle arrest and interruption of ribosomal activity, critical factors in aging and cancer. In this study, we identified and described the pivotal role of the RNA-binding protein HNRNPK in ribosome and nucleolar dynamics. We developed an in vitro model of endogenous HNRNPK overexpression and an in vivo mouse model of ubiquitous HNRNPK overexpression. These models showed disruptions in translation as the HNRNPK overexpression caused alterations in the nucleolar structure, resulting in p53-dependent nucleolar stress, cell …

Blastemia Portrays A Poor Prognosis In Acute Leukemia Patients With Invasive Pulmonary Aspergillosis, Sung-Yeon Cho, Sebastian Wurster, Ying Jiang, Alexandre Bazinet, Yang Hui, Russel E Lewis, Takahiro Matsuo, Nathaniel Albert, Guillermo Garcia-Manero, Dimitrios P Kontoyiannis

Faculty, Staff and Student Publications

Objectives: Severe and prolonged neutropenia is associated with poor outcomes of invasive pulmonary aspergillosis (IPA) in leukemia patients. Given the high frequency of IPA in patients with relapsed/refractory leukemia, we studied the association of peripheral blood blast burden (blastemia), IPA outcomes, and antifungal immune failure, even without neutropenia.

Methods: We retrospectively reviewed adult patients with acute leukemia (AL) or myelodysplastic syndrome and culture-positive proven/probable IPA (2011-2022). Blast and neutropenia indices were calculated and incorporated into multi-variable prognostic models. The impact of blasts on immune cell-mediated fungal clearance was studied in vitro.

Results: Among 74 patients, 69% had neutropenia and 57% …

A Tubo-Ovarian Abscess In Aplastic Anemia Presenting As Fever Of Unknown Origin, Rashi Mittal, Saurabh Kumar Gautam, Prasan Kumar Panda, Latika Chawla

Chulalongkorn Medical Journal

This report describes a complex case of a tubo-ovarian abscess (TOA) presenting atypically as fever of unknown origin (FUO) in a young woman initially diagnosed with severe aplastic anemia. The case involved protracted febrile illness, heavy menstrual bleeding, and pancytopenia. Identification of an Escherichia coli tubo-ovarian abscess, rather than tuberculosis, emphasized the need for a thorough evaluation in atypical presentations of TOA. Negative tuberculosis tests highlighted the variety of possible microbial etiologies. The resolution of fever following drainage and tailored antibiotic therapy, along with timely surgical intervention, demonstrated the importance of specific management strategies in such cases. Awareness of the …

Combined Anterior Palatoplasty With Barbed Suspension Pharyngoplasty In The Treatment Of Obstructive Sleep Apnea, Patheemon Thanachaikun, Natamon Charakorn

Chulalongkorn Medical Journal

Background: Surgery is a treatment option for obstructive sleep apnea (OSA) patients for whom positive airway pressure therapy is not chosen. Various palatal surgical techniques have been developed. However, the medical literature has limited accounts concerning the use of combination of these techniques to improved outcomes.

Objective: The aim of this study is to assess the efficacy of a combined anterior palatoplasty (AP) and barbed suspension pharyngoplasty (BSP) in treating adult OSA.

Methods: Data of OSA patients who underwent the combined AP with BSP between July 2020 to May 2024 were retrospectively reviewed. The surgical outcomes, including apnea-hypopnea index (AHI), …

Analysis Of Personality Traits, Intelligence Level And Ability To Cope With Stressful Situations And Their Impact On The Evaluation Of Judo Fights, Maciej Kostrzewa, Jan Supinski, Slawomir Kownacki, Miłosz Drozd, Anna Ścisłowska-Czarnecka, Jarosław Markowski, Jan Pilch, Alicja Markiel, Marcin Żak, Adam Maszczyk

Baltic Journal of Health and Physical Activity

Background: The aim of the study presented in this article was to conduct an analysis that would answer the research question: do personality traits such as extraversion, neuroticism, openness to experience, agreeableness, conscientiousness, intelligence level, and ability to cope with stressful situations correlate with the assessment of judo fights? Materials and Methods: Ninety individuals participated in the study, including international-class referees, national-class referees, coaches, and active judo athletes. The study used a correlational analysis approach to examine the relationships between personality traits and fight assessment criteria in judo. Results: The results indicate that in the referees' group, there is a …

Advancing Novel Contrast Agents For Applications In Fluorescence-Guided Neurosurgery Using Fluorescence Cryotomography, Augustino Vittorio Scorzo

Dartmouth College Ph.D Dissertations

Fluorescence guided surgery (FGS) is an emerging surgical technique that aims to help surgeons identify tissue types to assist in surgical decision making - ideally providing “cut-by-color” guidance. A primary application for this approach is the identification of tumor tissue to achieve more accurate and complete tumor removal while simultaneously minimizing damage to surrounding normal tissue. The cornerstone of tumor visualization for FGS is the administration of fluorescent contrast agents, or in some cases metabolic precursors, designed to accumulate specifically in tumor tissue, and a wide range of agents that use different targeting mechanisms are currently under investigation. Although these …

Mechanistic Insights Into The Flash Effect: The Role Of Oxygen And Radiation Chemistry In Ultra-High Dose Rate Radiation Therapy, Jacob Pierce Sunnerberg

Dartmouth College Ph.D Dissertations

The development of new cancer therapies focuses on widening the therapeutic ratio between tumor control and normal tissue toxicity. Over the last decade, ultra-high dose rate (UHDR) radiation therapy, commonly known as FLASH radiotherapy (FLASH-RT), has shown promising potential to reduce normal tissue toxicity while maintaining tumor control. However, the underlying mechanisms of the FLASH effect remain poorly understood. This thesis explores the radiation-chemical basis of FLASH-RT, focusing on the role of oxygen and reactive oxygen species in modulating biological outcomes.

A comprehensive set of in vitro studies demonstrated that UHDR delivery significantly alters radiation chemistry compared to conventional dose …

Management And Optimization Of Chronic Renal Insufficiency In The Setting Of Kidney Cancer A Systematic Review, Jessica K. Cobb, Hiroko Miyagi, Jad Chahoud, Claude Bassil, Philippe E. Spiess

Division of Internal Medicine Faculty Papers & Presentations

PURPOSE: There is a bidirectional relationship between chronic kidney disease and the incidence of renal cell carcinoma. Despite the frequency of patients with both chronic kidney disease and renal cell carcinoma, there are limited systematic reviews detailing the nuanced treatment. This review provides comprehensive insights for clinicians for managing chronic kidney disease, and renal cell carcinoma. Methods and Methods: We reviewed published literature that examined either chronic kidney disease and renal cell carcinoma or an indirect contributor of both.

RESULTS: We compare and contrast renal cell carcinoma treatment with partial and radical nephrectomies, ablative techniques, and radiation and their impact …

Development Of Preventive Dental Guidelines In The Primary Healthcare Setting In Egypt: A Delphi Method, Basant Mehriz

Theses and Dissertations

This study addresses the critical need for standardized preventive dental care guidelines within Egypt's primary healthcare system amid the rising burden of oral diseases. Through a systematic two-phase methodology combining a comprehensive literature review and a Delphi consensus-building process engaging 35 dental professionals, the research established priorities for contextually appropriate preventive measures. The consensus framework revealed strong support for clinical interventions (mean of 83% agreement), particularly fluoride-based prevention; community initiatives (mean of 83%), especially school-based programs; policy measures (mean of 77%) such as workforce and educational development, though with variable support for taxation and social determinants approaches. Statistical analysis demonstrated …

Asymmetric Cingulum Bundle Connectivity Is Modulated By Paracingulate Sulcus Morphology, Isabel A Danstrom, Joshua A Adkinson, Meghan E Robinson, Lu Lin, Atul Maheshwari, Ben Shofty, Garrett Banks, Mohammed Hasen, Sameer A Sheth, Alica M Goldman, Eleonora Bartoli, Sarah R Heilbronner, Kelly R Bijanki

Faculty, Staff and Students Publications

The cingulum bundle (CB) is a group of axons supporting connectivity among several functional brain networks relevant in healthy and diseased states. The paracingulate sulcus (PCS) is present in at least one cerebral hemisphere across 70% of the population. PCS presence versus absence is linked to differences in structure and function of the anterior cingulate cortex, though the influence of PCS on the white matter of the CB remains unknown. The objective of this work was to define the CB electrographic connectivity profile and determine the impact of PCS morphology on CB engagement. Single-pulse electrical stimulation in combination with stereo-electroencephalography …

Hydropneumopericardium Due To Esophageal-Pericardial Fistula: A Rare Complication Of Esophageal Stenting, Svenja Schneider, Margaret Doyle, Suzanna Talento, Waqas Ullah, Gregary D. Marhefka

Division of Cardiology Faculty Papers

We present a case of a 53-year-old woman with a history of ulcerative esophagitis and esophageal stricture status post esophageal stenting that was complicated by stent migration. She presented with fatigue, melena, and dark output from her percutaneous endoscopic gastrostomy tube. An echocardiogram showed hydropneumopericardium with cardiac tamponade physiology requiring emergent pericardiocentesis. The aspirated fluid was brown and cloudy; pathology of the fluid showed meat and vegetable matter consistent with food. She ultimately required esophagectomy with esophagostomy. This case highlights the importance of early recognition of esophageal-pericardial fistulas, as delay in the management carries a high risk for morbidity and …

Type I Interferon Protects Against Bone Loss In Periodontitis By Mitigating An Interleukin (Il)-17-Neutrophil Axis, Jinmei Zhang, Qiong Ding, Angela X Wang, Maoxuan Lin, Ning Yu, Kevin Moss, Megumi A Williamson, Di Miao, Julie T Marchesan, Erliang Zeng, Wei Shi, Hongli Sun, Yu Leo Lei, Shaoping Zhang

Faculty, Staff and Student Publications

Type I interferons (IFNs-I), a group of pleiotropic cytokines, critically modulate host response in various inflammatory diseases. However, the role of the IFN-I pathway in periodontitis remains largely unknown. In this report, we describe that the IFN-β levels in the gingival crevicular fluid of human subjects were negatively associated with periodontitis and clinical gingival inflammation. Disruption of IFN-I signaling worsened alveolar bone resorption in a ligature-induced periodontitis murine model. Deficiency of the IFN-I pathway resulted in an exaggerated inflammatory response in myeloid cells and drastically increased the interleukin-17 (IL-17)-mediated neutrophil recruitment in the gingiva. We further identified that the myeloid …

Multidrug Resistance: Are We Still Afraid Of The Big Bad Wolf, Abdulelah Alhazza, Adenike Oyegbesan, Emira Bousoik, Hamidreza Montazeri Aliabadi

Pharmacy Faculty Articles and Research

After the era of multidrug resistance (MDR) against cytotoxic chemotherapy, the development of resistance against newly developed molecularly targeted drugs also seems inevitable. While the mechanisms involved in resistance against these two categories of anticancer drugs are different, the principles are similar: inherent resistance (also known as primary resistance) is a result of heterogeneity in cancer cells where a subpopulation of the cells do not show a favorable initial response to the drug, while acquired resistance (or secondary resistance), as the name suggests, is developed after repeated treatments due to the plasticity of cancer cells. Despite the introduction of a …