Translational Medical Research Commons^™

Planning And Dissemination Of Quality Improvement Activities: A Qualitative Study Evaluating Barriers And Enablers To Implementation Of The Squire 2.0 Guidelines, Jessica Rose Phillips

Doctor of Philosophy in Translational Health Sciences Dissertations

Background: Quality improvement (QI) initiatives aim to systematically improve the efficiency and safety of healthcare provided to patients. These data-driven projects also seek to improve processes within the healthcare industry. Potential goals for quality improvement projects (QIPs) can include improving patient outcomes, improving healthcare access, increasing efficiency, and enhancing patient safety. While essential to improve care at the local level, QIPs are not without challenges. Currently, healthcare organizations plan and report the findings of these QIPs in non-standardized ways. This can lead to missing key details and the sharing of inaccurate results, among other things. The Standards for Quality Improvement …

Implementation Of The Masac Recommendations For The Practical Application Of The Cdc Opioid Prescription Guidelines For Chronic Pain Management In Persons With Bleeding Disorders (Pwbd): A Mixed-Methods Study, Lena M. Volland

Doctor of Philosophy in Translational Health Sciences Dissertations

Background: Chronic pain affects the majority of individuals with bleeding disorders (PWBD), diminishing functional abilities, community participation, mental health, and autonomy while increasing opioid usage and healthcare expenses. Despite calls for integrated care models, evidence-based guidelines tailored to PWBD have historically been insufficient. In early 2020, the Medical and Scientific Advisory Council (MASAC) of the National Bleeding Disorders Foundation (NBDF) published the first evidence-based recommendations for chronic pain management, incorporating the 2016 Centers for Disease Control and Prevention (CDC) prescribing guidelines along with additional suggestions for healthcare providers (HCP). The extent of their implementation at U.S. Hemophilia Treatment Centers (HTC) …

Tobacco Smoke Exposure Is A Driver Of Altered Oxidative Stress Response And Immunity In Head And Neck Cancer, Yang Li, Pedram Yadollahi, Fonma N Essien, Vasanta Putluri, Chandra Shekar R Ambati, Karthik Reddy Kami Reddy, Abu Hena Mostafa Kamal, Nagireddy Putluri, Lama M Abdurrahman, Maria E Ruiz Echartea, Keenan J Ernste, Akshar J Trivedi, Jonathan Vazquez-Perez, William H Hudson, William K Decker, Rutulkumar Patel, Abdullah A Osman, Farrah Kheradmand, Stephen Y Lai, Jeffrey N Myers, Heath D Skinner, Cristian Coarfa, Kwangwon Lee, Antrix Jain, Anna Malovannaya, Mitchell J Frederick, Vlad C Sandulache

Faculty, Staff and Student Publications

Background: Exposomes are critical drivers of carcinogenesis. However, how they modulate tumor behavior remains unclear. Extensive clinical data show cigarette smoke to be a key exposome that promotes aggressive tumors, higher rates of metastasis, reduced response to chemoradiotherapy, and suppressed anti-tumor immunity. We sought to determine whether smoke itself can modulate aggressive tumor behavior in head and neck squamous cell carcinoma (HNSCC) through reprogramming of the cellular reductive state.

Methods: Using established human and murine HNSCC cell lines and syngeneic mouse models, we utilized conventional western blotting, steady state and flux metabolomics, RNA sequencing, quantitative proteomics and flow cytometry to …

Socioeconomic And Demographic Factors In Genetic Testing Utilization Among Advanced Prostate Cancer Patients: A Retrospective Single-Institution Study, Alexandra T. Skowron Ms, Karen Childers, Courtney M. Rose Ms, Kyle C. Mcelyea Md, Avery K. Supernois Bs, Yousuf Hussain, Mohammed Baseer Ms, Sunita Ghosh Phd, Clara Hwang Md

Medical Student Research Symposium

Introduction

Germline genetic testing in patients with advanced prostate cancer (PCa) is underutilized. Socioeconomic and demographic factors are hypothesized to affect low rates of testing, but causality has not been established. This single institution, retrospective study aimed to understand what barriers may affect germline genetic testing for PCa patients.

Methods

The Henry Ford Health (HFH) tumor registry was queried for new diagnoses of stage 3, 4A and 4B PCa from 2017-2022. Census tract levels were assigned using patient addresses and neighborhood-based geocoding was completed for Median household income (gMHI) and Social vulnerability index (SVI). gMHI and SVI were divided into …

Unveiling The Dynamics Of Intersectional Aging: A Qualitative Exploration Of Aging And Social Participation Among Transgender Older Adults, Tiff Cunin

Doctor of Philosophy in Translational Health Sciences Dissertations

For more than thirty years, extensive research has focused on understanding and supporting healthy aging among older adults in the United States. This research has emphasized the importance of community engagement, access to resources, and interpersonal relationships among the broader older adult population, However, it has largely overlooked how transgender older adults experience aging and how those experiences shape their social participation. Additionally, understanding how intersecting marginalized identities—such as race and transgender identity—affect social participation is essential.

This study employed a qualitative multiple case study design to explore the experiences transgender older adults have while aging and how those experiences …

Longitudinal Changes In Aerodigestive Responses To Varying Nipple Properties In Infant Pigs, François D H Gould, Christopher Mayerl, Khaled Adjerid, Jessica Reibel, Nichole Charles, Chloe Edmonds, Rebecca Z German

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Coordination of respiration and swallowing is critical for survival in infant mammals and changes throughout infant maturation. Infants show sensorimotor feeding responses to changes in physical properties of nipples. Commercial nipples are promoted as improving aerodigestive coordination. However, it is unknown how nipple properties influence coordination of respiration and swallowing. Furthermore, how infant-nipple interactions change throughout maturation is not well understood. We designed and manufactured four silicone nipples of the same shape that varied in two parameters: nipple opening diameter and nipple stiffness. We used our validated infant pig model to test the impact of nipple parameters on aerodigestive coordination …

Strategies To Improve Antibody-Mediated Protection Against Herpes Simplex Virus Infections, Matthew D. Slein

Dartmouth College Ph.D Dissertations

No efficacious vaccine exists for herpes simplex virus and the global burden of disease remains high. Antibodies can serve as potent therapeutics to protect high risk populations such as neonates. Although rare, neonatal HSV (nHSV) infections can result in significant mortality and lifelong neurological morbidity even with antiviral therapy. While HSV-specific maternally derived antibodies significantly reduce the risk of neonatal disease in humans, the mechanisms by which they mediate protection have yet to be described. Using a mouse model of neonatal HSV (nHSV) infections we aimed to determine the mechanisms of antibody-mediated protection using monoclonal antibodies (mAbs) targeting two of …

Leveraging Large Language Models For Knowledge-Free Weak Supervision In Clinical Natural Language Processing, Enshuo Hsu, Kirk Roberts

Faculty, Staff and Student Publications

The performance of deep learning-based natural language processing systems is based on large amounts of labeled training data which, in the clinical domain, are not easily available or affordable. Weak supervision and in-context learning offer partial solutions to this issue, particularly using large language models (LLMs), but their performance still trails traditional supervised methods with moderate amounts of gold-standard data. In particular, inferencing with LLMs is computationally heavy. We propose an approach leveraging fine-tuning LLMs and weak supervision with virtually no domain knowledge that still achieves consistently dominant performance. Using a prompt-based approach, the LLM is used to generate weakly-labeled …

Serum Metal Ion Levels In Patients Undergoing Revision Should Arthroplasty, Rishi Chatterji, Brandon Fisher, Avianna Elizabeth Arapovic, Yuying Xing, J Michael Wiater

Conference Presentation Abstracts

INTRODUCTION: Shoulder arthroplasty systems are transitioning towards more modular prosthesis options with the goal of reducing complication profiles and increasing range of motion. Modularity may increase the potential for fretting, corrosion, and subsequent release of metal ions. These events have been associated with adverse reactions in hip and knee arthroplasty, but not in the setting of revision shoulder arthroplasty. The purpose of this study was to identify associations between implant designs, metallurgy, patient characteristics, and serum metal ion levels in patients undergoing revision shoulder arthroplasty. METHODS: 51 patients that underwent revision shoulder arthroplasty were retrospectively reviewed based on prospectively collected …

Gatad2b O-Glcnacylation Regulates Breast Cancer Stem-Like Potential And Drug Resistance, Giang Le Minh, Jessica Merzy, Emily Esquea, Nusaiba Ahmed, Riley Young, Ryan Sharp, Tejsi Dhameliya, Bernice Agana, Mi-Hye Lee, Jennifer Bethard, Susana Comte-Walters, Lauren Ball, Mauricio Reginato

Kimmel Cancer Center Faculty Papers

The growth of breast tumors is driven and controlled by a subpopulation of cancer cells resembling adult stem cells, which are called cancer stem-like cells (CSCs). In breast cancer, the function and maintenance of CSCs are influenced by protein O-GlcNAcylation and the enzyme responsible for this post-translational modification, O-GlcNAc transferase (OGT). However, the mechanism of CSCs regulation by OGT and O-GlcNAc cycling in breast cancer is still unclear. Analysis of the proteome and O-GlcNAcome, revealed GATAD2B, a component of the Nucleosome Remodeling and Deacetylase (NuRD) complex, as a substrate regulated by OGT. Reducing GATAD2B genetically impairs mammosphere formation, decreases expression …

Reconstitution Of Mirna-205 In Docetaxel Resistant Prostate Cancer Cells: A Nanotherapeutic Approach, Neeraj Chauhan, Eswara Naga Hanuma Kumar Ghali, Rahul Tiwari, Iris Enriquez, Rajasekhar Baru, Subhash C. Chauhan, Murali M. Yallapu

Research Symposium

Background: Prostate cancer (PrCa) is the second most diagnosed cancer and cause of death in men globally. Docetaxel (Dtxl) based first line chemotherapy is the main available therapeutic choice for PrCa patients. However, most (almost all) patients develop resistance to Dtxl treatment, making it difficult to treat such patients with no effective adjuvant therapy. Although cabazitaxel may be used to treat these patients, it is associated with many severe side effects including low white blood cells and allergic reactions. Therefore, finding an alternative strategy to reduce Dtxl resistance is of high importance for treating PrCa. miR-205 is a widely studied …

Developing Ship On-Chip Strategy Of Transporting Theranostic Radionuclides For Rapid And Efficient Radiopharmaceutical Production, Mai Lin, Robert Ta, Mark Mc Veigh, Joseph Lapka, Don Nolting, Leon Marcel Bellan, William Charlton, H. Charles Manning

Research Symposium

Introduction: Radiopharmaceuticals play a critical role in cancer diagnosis, staging, and therapy. Recent successes in radiotheranostics (which utilize targeted radiopharmaceutical pairs for both diagnosis and therapy) have led to improved outcomes in challenging clinical settings, such as neuroendocrine tumors and prostate cancer. Despite the tremendous potential, development of new radiopharmaceutical agents and widespread distribution is hampered by the extreme costs associated with production and delivery. Most hospitals require a substantial investment in facility and operational equipment for radiosynthesis that in turn limits the development of radiopharmaceuticals and their impact on precision medicine. Herein, we describe a simple and inexpensive microfluidic …

Roles Of Mir-223 In Platelet Function And High On-Treatment Platelet Reactivity: A Brief Report And Review, Shayan Askari, Lawrence E. Goldfinger

Cardeza Foundation for Hematologic Research

BACKGROUND: Platelets are highly enriched in microRNAs (miRNAs), which are genomically encoded 19-25 nucleotide non-coding RNAs that target complementary mRNAs through total or near-total base pairing. MiR-223 is among the most abundant miRNAs in human and murine platelets, but despite ongoing investigations in recent years, miR-223 roles in platelet physiology and its putative roles in high on-treatment platelet reactivity (HTPR) remain controversial, as studies showed varying findings.

OBJECTIVES: In the current hybrid review/report, we aim to compare studies that investigated miR-223 in platelet function and HTPR. Additionally, we briefly report our own findings on murine miR-223-deficient platelets.

METHODS: We have …

The Role Of The Female Reproductive Cycle In Social Communication And Relevance To Mental Health, Julissa Amaro Castillo, Fernando Dominguez, Ariana Hinojosa, Giselle Padilla, Mario Gil

Research Symposium

The female reproductive cycle is characterized by fluctuating hormones, including estrogens and progesterone, that are involved in reproductive health; however, they have also been linked to disorders like Premenstrual syndrome (PMS), Premenstrual Dysphoric Disorder (PMDD), mood swings, depression and others. The goal of this study is to use the Syrian hamster (Mesocricetus auratus) as an animal model to examine the influence of the reproductive cycle and hormones on behavior. Scent-marking activity known as flank marking is exhibited by territorial or sociable animals. In essence, animals mark their territory or convey information such as reproductive status by rubbing their flanks or …

Effects Of Arginine-Vasopressin In The Brain On Cardiovascular Function In A Psychosocial Stress Animal Model, Esmeralda Lopez-Garcia, Ariana V. Hinojosa, Esperanza I. Alaniz, Fernando Dominguez, Giselle Padilla, Mario Gil

Research Symposium

Background: Psychosocial stress impacts cardiovascular health, increasing the risk of events like myocardial infarction (MI), stress cardiomyopathy, and neuropsychiatric disorders, including Major Depressive Disorder (MDD) and Anxiety. However, our understanding of the biological mechanisms that connect psychosocial stress with negative cardiovascular and psychological outcomes remains incomplete. Arginine-vasopressin (AVP) is linked to both mental and physical health by regulating social behavior, blood pressure, and anxiety-related behaviors. This study investigates the potential cardioprotective effects of the neuropeptide AVP, in an effort to generate evidence that it may strengthen heart function and lessen the severity of adverse cardiovascular events caused by stress, brain …

Exploring The Effects Of Serotonin And Ssris On The Neurological, Behavioral, And Cardiovascular Systems Under Induced Stress –Using The Animal Model Of The Syrian Hamster, Ariana V. Hinojosa, Esperanza I. Alaniz, Esmeralda Lopez-Garcia, Giselle Padilla, Fernando Dominquez, Mario Gil

Research Symposium

Background: Serotonin is a neurotransmitter that has been found to have a wide range of effects on not just the neuropsychological processes but has also been found to exert effects outside the central nervous system (CNS); regulating numerous biological processes, such as metabolism, gastrointestinal system, reproductive function, and even the cardiovascular system. However, there is still a limited understanding of how serotonin affects all these systems due to its complexity and ability to regulate homeostasis. This project aims to create a stronger foundation of knowledge about serotonin and its influence on the interaction between the CNS, behavior, and cardiac function …

Detection Of Alteration In Carotid Artery Volumetry Using Standard-Of-Care Computed Tomography Surveillance Scans Following Unilateral Radiation Therapy For Early-Stage Tonsillar Squamous Cell Carcinoma Survivors: A Cross-Sectional Internally-Matched Carotid Isodose Analysis, Efstratios Koutroumpakis, Mohamed A Naser, Abdallah Sherif Radwan Mohamed, Salman A Eraj, Andrea Jarre, Jay C Shiao, Mona Kamal, Subha Perni, Jack P Phan, William H Morrison, Steven J Frank, G Brandon Gunn, Adam S Garden, Anita Deswal, Jun-Ichi Abe, David I Rosenthal, Elie Mouhayar, Clifton D Fuller

Faculty, Staff and Student Publications

Aim: This study leveraged standard-of-care CT scans of patients receiving unilateral radiotherapy (RT) for early tonsillar cancer to detect volumetric changes in the carotid arteries, and determine whether there is a dose-response relationship.

Methods: Disease-free cancer survivors (>3 months since therapy and age > 18 years) treated with intensity modulated RT for early (T1-2, N0-2b) tonsillar cancer with pre- and post-therapy contrast-enhanced CT scans available were included. Patients treated with definitive surgery, bilateral RT, or additional RT before the post-RT CT scan were excluded. Isodose lines from treatment plans were projected onto both scans, facilitating the delineation of carotid artery …

Investigating The Relationship Between The Circadian Clock, Age, And Lifestyle, Samuel Park, Amaka Eziakonwa, Amega Nguyen, Madison Payne, Erich Stahmer, Alexis Salinas, Payson Broome, Angel Oliver, Christian Mccormick, Jasmyn Brown, Julie A. Zacharias-Simpson, Jutta Ward, Deborah Bell-Pedersen

Annual Research Symposium

This poster presentation aims to understand how circadian clock strength and phase are affected by age and lifestyle. By analyzing changes in physiological rhythms, the study seeks to develop strategies for promoting healthy aging by optimizing circadian function.

Tracking The Effects Of Time Zone Shift On An Individual’S Circadian Rhythm, Amaka Eziakonwa, Erich Stahmer, Amega Nguyen, Samuel Park, Madison Payne, Alexis Salinas, Deborah Bell-Pedersen, Julie A. Zacharias-Simpson

Annual Research Symposium

This poster presentation aims to understand how a rapid time-zone change can affect an individual’s circadian rhythms. By quantifying changes in physiological rhythms, the study seeks to develop targeted therapeutic interventions to mitigate the negative effects of jetlag.

Can We Eliminate The Negative Consequences Of Circadian Desynchronization Caused By Night Shift Work By Using A Light Therapy Lamp To Simulate A Sunset?, Amega Nguyen, Madison Payne, Amaka Eziakonwa, Erich Stahmer, Alexis Salinas, Samuel Park, Julie A. Zacharias-Simpson, Deborah Bell-Pedersen

Annual Research Symposium

This poster aims to understand the relationship between desynchronosis of circadian rhythms and night-shift work and how light therapy can mitigate some of the issues of desynchronosis. This study seeks to develop therapies for disrupted circadian rhythms from night-ship works.

Transcranial Magnetic Stimulation As A Treatment Modality For Functional Bowel Disorder And Irritable Bowel Syndrome And Possible Correlations With The Gut-Brain Axis: A Review, Lauren Draper, Devin Pfister, Ethan Zaugg

Annual Research Symposium

Functional Bowel Disorders (FBD), including Irritable Bowel Syndrome (IBS), are highly prevalent gastrointestinal conditions classified as Disorders of Gut-Brain Interactions (DGBIs) under the Rome IV criteria. These conditions, marked by abdominal pain, altered bowel habits, and significant psychological comorbidities, present substantial challenges in both diagnosis and treatment. Conventional therapies primarily target gut-centric mechanisms but often yield limited efficacy, underscoring the need for approaches that account for the complex interplay of the gut-brain axis in DGBI pathophysiology.

Characteristics And Outcomes Of Adults Hospitalized With Respiratory Syncytial Virus, Brian S. Shaw, Cara Slaton, Ian P. Murphy, Michael Mcalister, Daniel Egan, Kwabena Ayesu

The University of Louisville Journal of Respiratory Infections

Background: Respiratory syncytial virus (RSV) is a negative sense single-stranded RNA virus (ssRNA) that primarily causes respiratory infections in both children and older adults. We examined clinical characteristics and outcomes of hospitalized adult patients who tested positive for RSV.

Methods: This was a multicenter, retrospective, descriptive study that examined adult patients admitted with a positive RSV test over two years across eight hospitals in Orlando, Florida.

Results: A total of 120 patients were included, of which 88 (73%) were 60 years old and older. Overall, patients with RSV infection were caucasian (62%) with a median age of 70 years and …

Notch3 Deletion Regulates Hiv-1 Gene Expression And Systemic Inflammation To Ameliorate Chronic Kidney Disease, Mackenzie Thornton, Nicole Sommer, Mercedes Mcgonigle, Anil Kumar Ram, Sireesha Yerrathota, Henrietta Ehirim, Aakriti Chaturvedi, Johnny Dinh Phan, Anubhav Chakraborty, V. Praveen Chakravarthi, Sumedha Gunewardena, Mudit Tyagi, Jaya Talreja, Tao Wang, Pravin Singhal, Pamela V. Tran, Timothy A. Fields, Patricio E. Ray, Navneet K. Dhillon, Madhulika Sharma

Center for Translational Medicine Faculty Papers

Anti-retroviral therapy (ART) has decreased human immunodeficiency virus (HIV)-1-associated morbidity. However, despite ART, immune cells remain latently infected, leading to chronic inflammation and HIV-1-associated comorbidities. New strategies are needed to target viral proteins and inflammation. We found activation of Notch3 in renal cells of the HIV-1 transgenic mouse model (HIV-Tg26) and in patients with HIV-associated nephropathy. We hypothesized that targeting NOTCH3 activation constitutes an effective therapy for HIV-related chronic kidney disease. We generated HIV-Tg26 mice with Notch3 knocked out (Tg-N3KO). Compared to HIV-Tg26 mice at 3 months, Tg-N3KO mice showed a marked reduction in renal injury, skin lesions and mortality …

Pull Or Play? The Interpretation Of A Novel, Ai-Powered On-Field Decision Support Tool., Lynne Becker, Dafne Badilla, Osho Yonzon, Xiaoyu Wu, Roland Rocafort, Erik Viogan Phd, Devansh Manocha

Journal for Sports Neuroscience

The document titled "Pull or Play? The interpretation of a novel, AI-powered on-field decision support tool" explores the development and application of the Injury Impact Severity Score (IISS)™ for assessing traumatic brain injuries (TBIs), particularly in sports settings. It addresses the limitations of current assessment tools like the Glasgow Coma Scale (GCS) and proposes a more objective approach using patient-reported data and machine learning algorithms.

Key points include:

• Background: TBIs are a significant health concern with under-reported cases and a lack of effective research. Current assessment tools like the GCS have limitations in accuracy and speed, especially in dynamic …

Application Of The Theory Of Planned Behavior In Concussion Disclosure: A Systematic Review, Michelle L. Weber Rawlins, R. Curtis Bay, Tamara Valovich Mcleod

Internet Journal of Allied Health Sciences and Practice

Purpose: Many athletes do not seek care for a suspected concussion for a number of reasons. Failing to do so can lead to persisting symptoms, longer recovery, or secondary injury. The Theory of Planned Behavior (TPB), along with knowledge of concussion, has been used to examine concussion care seeking. It is theorized that TPB components including attitudes, subjective norms, and self-efficacy are associated with one’s intention to perform a health-related behavior, and their actual behavior. Many studies have used the TPB in an attempt to predict concussion disclosure, with mixed results. The purpose of this systematic review was to determine …

Perinuclear Organelle Trauma At The Nexus Of Cardiomyopathy Pathogenesis Arising From Loss Of Function Lmna Mutation, Jason C. Choi

Center for Translational Medicine Faculty Papers

Over the past 25 years, nuclear envelope (NE) perturbations have been reported in various experimental models with mutations in the LMNA gene. Although the hypothesis that NE perturbations from LMNA mutations are a fundamental feature of striated muscle damage has garnered wide acceptance, the molecular sequalae provoked by the NE damage and how they underlie disease pathogenesis such as cardiomyopathy (LMNA cardiomyopathy) remain poorly understood. We recently shed light on one such consequence, by employing a cardiomyocyte-specific Lmna deletion in vivo in the adult heart. We observed extensive NE perturbations prior to cardiac function deterioration with collateral damage in the …

Editorial: Unveiling The Next Generation Of Cancer Immunity & Immunotherapy, Mohanraj Sadasivam, Nethaji Muniraj, Chellappagounder Thangavel

Center for Translational Medicine Faculty Papers

No abstract provided.

Poner En Práctica Las Regulaciones Federales: Habilitando A Los Pacientes Dominio Limitado Del Inglés, Caitlyn Gailey

World Languages and Cultures Senior Capstones

This paper examines the gaps in the U.S. healthcare system that affect the Hispanic community, focusing on language barriers and cultural competence. It highlights the challenges faced by Limited English Proficiency (LEP) patients, who may struggle with medical terminology, leading to misdiagnosis and improper treatment. The paper advocates for culturally sensitive language services, including qualified interpreters, translated documents and signage in order to improve communication, patient satisfaction, and reduce medical errors. It calls for systemic changes to ensure equitable care for all patients, regardless of language or cultural background.

El Uso De Las Prácticas Curativas No Occidentales En Lugar De Y Dentro De La Cultura Biomédica, Lynda Gulledge

World Languages and Cultures Senior Capstones

This paper explores the difficulties that the Hispanic community faces when accessing healthcare in the United States, which emphasizes the use of biomedical culture. Topics such as cultural and linguistic barriers, past and present healthcare policies, and the use of non-Western medical practices are examined. Furthermore, this paper explores the history and use of curanderismo as an accessible and culturally appropriate form of healthcare. Lastly, the integration and acknowledgement of curanderismo in biomedical culture is explored and encouraged in order to create a more holistic healthcare experience for the Hispanic community.

Research Annual Report Fy2025, Children's Mercy Kansas City

Research Annual Reports

Annual report of the research at Children's Mercy Kansas City in Kansas City MO, a pediatric medical center.