Translational Medical Research Commons^™

Chief Complaint And Geriatric Depression: Assessing Risk For 30- And 90-Day Readmission, Eric James, Michelle Moccia, Victoria Lucia

Posters

Readmission to the hospital has significant monetary costs and represents a care gap for older adults. This investigation examines how a positive geriatric depression screen and chief complaint contribute to 30- and 90-day readmission risk. Depression recognition with follow-up care is a critical first step to prevent adverse outcomes such as readmission.

Beyond Covid-19: The Impact Of Recent Pandemics On Medical Students And Their Education: A Scoping Review, Moneb Bughrara, Stephanie Swanberg, Victoria Lucia, Keaton Schmitz, Dawn Jung, Tracy Wunderlich-Barillas

Posters

Over the past two years, COVID-19 has greatly altered undergraduate medical education (UME) as well as daily life. Medical schools across the world were disrupted and had to immediately adapt the educational experience to the online environment in order to continue the delivery of quality UME. However, COVID-19 was not the only recent pandemic. This posed the question, were similar disruptions and adaptations also seen in recent past pandemics such as Severe Acute Respiratory Syndrome (SARS) or Middle East Respiratory Syndrome (MERS) that could have prepared UME for COVID-19? This scoping review investigated the educational and personal impact of recent …

Identification Of Molecular Markers Associated With Copd In Non-Smokers And Smokers: A Bioinformatics Analysis, Agede O. Ayodele, Isa M. Wasagu, Ademola E. Fawibe, Alakija K. Salami

The University of Louisville Journal of Respiratory Infections

Background

Even though the proportional burden of COPD among never-smokers is significant in both developing and developed nations, accounting for around 30% of all COPD in the community, there is little awareness of the prevalence of COPD in this population. Understanding the molecular processes that underlie COPD in nonsmokers is essential.

Methods

Dataset (GSE146560) was acquired from the Gene Expression Omnibus (GEO). The limma and clusterProfiler software tools were used to identify differentially expressed genes (DEGs) and conduct a functional enrichment analysis respectively.

Results

In all, 10,583 DEGs were found, of which 1,065 were up-regulated and 9,518 were down-regulated. The …

Kir-Based Inhibitory Cars Overcome Car-Nk Cell Trogocytosis-Mediated Fratricide And Tumor Escape, Ye Nmn Li

Dissertations and Theses (Open Access)

Trogocytosis is an active process that transfers surface material from targeted to effector cells. Using multiple in vivo tumor models and clinical data, we report that chimeric antigen receptor (CAR) activation in natural killer (NK) cells promoted the transfer of the CAR-cognate-antigen from tumor to NK cells, resulting in (1) lower tumor antigen density, thus impairing the ability of CAR-NK cells to engage with their targets, (2) induced self-recognition and continuous CAR-mediated engagement, resulting in fratricide of trogocytic antigen expressing NK cells (NK^TROG+) and NK cell hyporesponsiveness. This phenomenon could be offset by a dual-CAR system incorporating both …

Targeting Metabolic Alterations Associated With Smooth Muscle Α-Actin Pathogenic Variant Attenuates Moyamoya-Like Cerebrovascular Disease, Anita Kaw

Dissertations and Theses (Open Access)

Heterozygous pathogenic variants in ACTA2, encoding smooth muscle α-actin (α-SMA), predispose to thoracic aortic aneurysms and dissections. De novo missense variants disrupting ACTA2 arginine 179 (p.Arg179) cause a multisystemic disease termed smooth muscle dysfunction syndrome (SMDS), which is characterized by early onset thoracic aortic disease and moyamoya disease-like (MMD) cerebrovascular disease. The MMD-like cerebrovascular disease in SMDS patients is marked by bilateral steno-occlusive lesions in the distal internal carotid arteries (ICAs) and their branches. To study the molecular mechanisms that underlie the ACTA2 p.Arg179 variants, a smooth muscle-specific Cre-lox knock-in mouse model of the heterozygous Acta2 R179C variant, termed …

Modeling Antihypertensive Therapeutic Inertia And Intensification To Support Clinical Action Toward Hypertension Control, Benjamin Martin

All Dissertations

Background

Hypertension is the leading modifiable risk factor for cardiovascular disease and consequent mortality worldwide. In the U.S., more than half of hypertension cases remain uncontrolled, despite availability of effective pharmaceutical treatment options. Evidence suggests that therapeutic inertia, defined as clinician failure to initiate or increase therapy when treatment goals are unmet, is the most influential barrier to improving hypertension control. Substantial rates of therapeutic inertia have been reported in ambulatory primary care settings where hypertension is typically treated and managed. Understanding and overcoming the forces driving therapeutic inertia in hypertension management is a critical strategy to reach population health …

A Retrospective Study On The Incidence Of Ckd Diagnosis Post Covid-19 Infection With Variations In Glycemic Control, Eduardo Leon, Jithin John, Nick Ludka, Ramin Homayouni

Posters

The COVID-19 pandemic has emphasized that the virus can cause multi-organ complications, especially in patients with pre-existing conditions such as type-2 diabetes mellitus (T2DM), who are at higher risk for poor outcomes. Some patients may also develop T2DM post-infection due to the virus's effects on insulin secretion and blood glucose regulation. Glycated hemoglobin (HbA1c) is a useful tool for assessing blood glucose levels over time, diagnosing diabetes and monitoring disease management. Elevated levels of HbA1c have been linked to diabetic nephropathy (DN) and chronic kidney disease (CKD), both of which are potential complications of COVID-19 infection. This study aims to …

Iatrogenic Nerve Injuries During Surgeries Of The Neck: A Systematic Review, Tajuldeen Al-Hasani, Jickssa Gemechu, Varna Taranikanti

Posters

Iatrogenic nerve injuries in the neck can present with a wide spectrum of symptoms ranging from mild pain, numbness, or weakness, to devastating consequences for patients such as permanent irreversible damage, disability, or even death. Surgical interventions in the neck region, especially those requiring radical dissections in the neck carry a significant risk of iatrogenic injury to several vital nerves passing through the neck such as vagus, phrenic, brachial plexus, cervical plexus, and ansa cervicalis.

Telemedicine Success - A Rapid Review, Anna Carman, Victoria Lucia

Posters

Telemedicine involves utilizing telecommunications and technology to deliver healthcare - including diagnosis, consultation, education, care management, and patient self-management - to populations with otherwise limited access to care. It offers a broad-range of benefits, including increased care accessibility, improved continuity of care, and decreased costs, without sacrificing patient satisfaction. However, telemedicine requires unique skills and approaches, unfamiliar to many physicians. We conducted a rapid review of research-validated techniques, across multiple subspecialties, to identify research-validated techniques for maximizing telemedicine appointments, synthesized in a comprehensive list, in order to support clinicians in modern healthcare settings.

Analysis Of The Efficacy Of The Modified Finnegan Scoring System, Benjamin Collaer, Victoria Lucia

Posters

Neonatal Abstinence Syndrome (NAS) is a constellation of opiate withdrawal symptoms including irritability, inadequate feeding/ growth, and seizures in neonates This condition occurs shortly after birth if the fetus had significant exposure to opiates in-utero. Since 2014, each NAS case at Beaumont Royal Oak and Troy Hospitals has had their treatment dictated by their score on the Modified Finnegan Scoring System (MFSS). This scoring system was created to minimize unnecessary opiate-based treatments for neonates with NAS. The main objective of this study is to analyze the efficacy of the MFSS and observe the change in patient outcomes since its implementation …

Incidence Of Myopathy In Post Covid-19 Patients Undergoing Statin Therapy, Jithin John, Eduardo Leon, Ramin Homayouni

Posters

Statin-associated myositis has been documented since its first use, causing an increase in Creatinine Kinase levels. While some suggest avoiding statins in individuals with COVID-19, recent literature suggests that statin use is protective against SARS-CoV-2 infection due to its antioxidant and anti-inflammatory properties. The role of statin therapy in COVID-19 cases, especially regarding myopathy, remains scarce. We hypothesize that different statin therapies prior to SARS-CoV-2 infection are associated with an increased risk of myopathy and an increase in blood CK levels.

Regenerative Medicine For Tendon/Ligament Injuries: De Novo Equine Tendon/Ligament Neotissue Generation And Application, Takashi Taguchi

LSU Doctoral Dissertations

Tendon and ligament injuries are debilitating conditions across species. Poor regenerative capacities of these tissues limit restoration of original functions. The first study evaluated the effect of cellular administration on tendon/ligament injuries in horses using meta-analysis. The cellular administration was effective in restoring ultrasonographic echogenicity and increasing vascularity during early phase of healing. Additionally, it improved microstructural organization of healed tissue in terms of cellularity and fiber alignment. However, the study did not support its use for increasing rate of return to performance, expression/deposition of tendon-specific genes/proteins, or mechanical properties.

The findings led to the second study that engineered implantable …

Persistently Elevated Hbv Viral-Host Junction Dna In Urine As A Biomarker For Hepatocellular Carcinoma Minimum Residual Disease And Recurrence: A Pilot Study, Selena Y Lin, Dina Halegoua-De Marzio, Peter Block, Yu-Lan Kao, Jesse M. Civan, Fwu-Shan Shieh, Wei Song, Hie-Won Hann, Ying-Hsiu Su

Department of Medicine Faculty Papers

Hepatitis B virus (HBV)-host junction sequences (HBV-JSs) has been detected in the urine of patients with HBV infection. This study evaluated HBV-JSs as a marker of minimum residual disease (MRD) and tumor recurrence after treatment in HBV-hepatocellular carcinoma (HCC) patients. Archived serial urine DNA from two HBV–HCC with recurrence as confirmed by MRI and four HBV-related cirrhosis (LC) patients were used. Urinary HBV-JSs were identified by an HBV-targeted NGS assay. Quantitative junction-specific PCR assays were developed to investigate dynamic changes of the most abundant urinary HBV-JS. Abundant urinary HBV-JSs were identified in two cases of tumor recurrence. In case 1, …

Pimt Is A Novel And Potent Suppressor Of Endothelial Activation, Chen Zhang, Zhifu Guo, Wennan Liu, Kyosuke Kazama, Louis Hu, Xiaobo Sun, Lu Wang, Hyoungjoo Lee, Lin Lu, Xiao-Feng Yang, Ross Summer, Jianxin Sun

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

Proinflammatory agonists provoke the expression of cell surface adhesion molecules on endothelium in order to facilitate leukocyte infiltration into tissues. Rigorous control over this process is important to prevent unwanted inflammation and organ damage. Protein L-isoaspartyl O-methyltransferase (PIMT) converts isoaspartyl residues to conventional methylated forms in cells undergoing stress-induced protein damage. The purpose of this study was to determine the role of PIMT in vascular homeostasis. PIMT is abundantly expressed in mouse lung endothelium and PIMT deficiency in mice exacerbated pulmonary inflammation and vascular leakage to LPS(lipopolysaccharide). Furthermore, we found that PIMT inhibited LPS-induced toll-like receptor signaling through its interaction …

Job Satisfaction And Burnout In Nursing, Tasha M. Tovar

MSN Capstone Projects

Job satisfaction, or lack thereof, can directly lead to burnout. Nursing is known globally as a high-stress career, thus leading to an increased level of burnout. Job burnout is among the most important occupational disorders and phenomena which have received great attention in the recent century (Nabizadeh et al., 2020). Multiple studies have proven that subtle, low-cost interventions can decrease the burnout experienced by nurses, leading to reduced turnover rates and an increase in the quality of patient care. Higher quality of care leads to improvement in patient satisfaction scores and also to increased reimbursement rates (Jun et al., 2021). …

I Finally Understand How Applying The Fagan Nomogram Can Change Medical Decision-Making, David Salvatori, Do

Clinical Research in Practice: The Journal of Team Hippocrates

The author reflects on the case that changed his opinion on the efficacy of the Fagan nomogram.

Understanding Coordinated Specialty Care Best Practice Through Fidelity Practices: A Qualitative Exploration, Halley Read

Doctor of Philosophy in Translational Health Sciences Dissertations

Background: Coordinated Specialty Care (CSC) is a multidisciplinary care model for providing care to youth and young adults having their first episode of psychosis. While outcomes of CSC effectiveness are overwhelmingly positive, and widespread implementation has occurred in all US states and territories, what is CSC best practice regarding components and fidelity to the model is not clear. CSC implementation is well documented from a fidelity to the model standpoint, but the highly variable fidelity practices and versions of the model are not well understood. Nor are the experiences of those who deliver or receive care. Adding to the complexity …

A Mixed Methods Sequential Explanatory Design Study Exploring How Demographic Factors Contribute Individuals Presenting To The Emergency Department For Seizure Management, Radwa Aly Msc

Doctor of Philosophy in Translational Health Sciences Dissertations

Psychogenic nonepileptic seizures (PNES) mimic epileptic seizures in their clinical manifestations, but are not associated with an abnormal electrical discharge on electroencephalogram. PNES attacks are often treated and managed as likely epileptic seizures, subjecting the patient to unnecessary anti-seizure medications (ASM). Both epileptic seizures and PNES are common reasons for visiting the emergency department (ED), especially for patients without access to ambulatory care. There is growing evidence highlighting disparities in seizure care in the ED related to race, ethnicity, and socioeconomic status (SES). PNES is a significant burden to the patient and society because of the annual costs spent on …

Mir125a As Molecular Target Of Vitamin D Mediated Inhibition Of Cd4+ T Cell Differentiation Into Th17 Cells In Mrl/Lpr Lupus-Prone Mice, Miranda Hilt

Undergraduate Distinction Papers

The dynamic function of vitamin D in an array of immunomodulatory and anti-inflammatory mechanisms and its implication in the pathogenesis of autoimmune diseases has been the topic of much recent scholarship. Here I attempt to elucidate the molecular mechanism of vitamin D-mediated inhibition of the differentiation of CD4+ T cells into pro-inflammatory Th17 cells in MRL/lpr lupus prone mice by investigating how miR-125a expression is affected by dietary modulation of cholecalciferol (vitamin D₃). MRL/MpJ and MRL/lpr mice were split into three experimental groups and fed specially formulated diets that varied in their concentrations of vitamin D. …

Effectiveness Of Vacuotherapy And Dry Needling As Adjunct Treatment For Musculoskeletal Cases: A Cohort In A Pt Clinic., Adnan N. Balisi, Vince Paul Lobaton, Dane Debulgado, Jhonas Jegira, Mae Adrinne Tumonong, Christian James Brillas, Ritchie Belle Gelito, Mychelle Rae Marasigan

Philippine Journal of Physical Therapy

Introduction: Usage of vacuum therapy and dry needling in physical therapy management of musculoskeletal cases have gained increasing usage but the literature regarding their effects is limited. This study determines the effect size of the interventions, which are vacuotherapy and dry needling as adjunct treatments to exercises, performed in a local PT clinic to musculoskeletal cases in three different treatment sessions with a week gap in between.

Methods: The study is a retrospective cohort where sampling was purposive in gathering historical patient charts. The numerical pain rating scales and relevant range of motion (ROM) in the musculoskeletal cases …

Effect Of Dual Tasking And Levodopa-Induced Dyskinesia On Postural Sway In People With Parkinson's Disease, Joseph Ayotunde Aderonmu, Carolin Curtze

UNO Student Research and Creative Activity Fair

Parkinson's disease (PD) is a neurodegenerative disorder that results in motor impairments such as gait and balance deficits. Levodopa is one of the most effective drugs in treating the slowness of movement in individuals with PD. However, the long-term use of levodopa in treating PD often causes undesirable involuntary and uncontrollable movements, known as levodopa-induced dyskinesia (LID). LID is a known cause of increased postural sway. Yet, the relative contribution of the body segments often affected by dyskinesia to postural sway is unknown. We aimed to investigate the contribution of different body segments to postural sway in PD for individuals …

Thymic Stromal Lymphopoietin Participates In The Host Response To Intra-Amniotic Inflammation Leading To Preterm Labor And Birth, Tomi Kanninen, Li Tao, Roberto Romero, Yi Xu, Marcia Arenas-Hernandez, Jose Galaz, Zhenjie Liu, Derek Miller, Dustyn Levenson, Jonathan M. Greenberg, Jonathan Panzer, Justin Padron, Kevin Theis, Nardhy Gomez-Lopez Phd

Medical Student Research Symposium

Objective: To determine if bacteria (Ureaplasma parvum and Sneathia spp.) associated with intra-amniotic infection can trigger the induction of cytokine Thymic stromal lymphopoietin (TSLP) in human amnion epithelial cells (hAECs) in vitro.

Material or subjects: Amniotic fluid and chorioamniotic membrane (CAM) were collected from women with sPTL who delivered at term (n=30) or preterm without intra-amniotic inflammation (n=34), with sterile intra-amniotic inflammation (SIAI, n=27), or with intra-amniotic infection (IAI, n=17). Amnion epithelial cells (AECs), Ureaplasma parvum, and Sneathia spp. were also utilized.

Methods: The expression of TSLP, TSLPR, and IL-7Rα was evaluated in amniotic fluid or CAM by …

Implicit Bias And Stigma Theory In Clinical Practice: Developing “Habits Of Mind” For Clinical Inquiry, James Peter Meza

Clinical Research in Practice: The Journal of Team Hippocrates

The editor introduces a new article type in this issue, Translational Social Science, and reflects on the social theory required to perceive and counteract implicit bias.

Stigma Is A Very Real Part Of Clinical Practice, Aaron Rivkin

Clinical Research in Practice: The Journal of Team Hippocrates

The author reflects on avoiding stigmatizing language in clinical practice.

Glut1 Is Redundant In Hypoxic And Glycolytic Nucleus Pulposus Cells Of The Intervertebral Disc, Shira N. Johnston, Elizabeth S. Silagi, Vedavathi Madhu, Duc H. Nguyen, Irving M. Shapiro, Makarand V. Risbud

Department of Orthopaedic Surgery Faculty Papers

Glycolysis is central to homeostasis of nucleus pulposus (NP) cells in the avascular intervertebral disc. Since the glucose transporter, GLUT1, is a highly enriched phenotypic marker of NP cells, we hypothesized that it is vital for the development and postnatal maintenance of the disc. Surprisingly, primary NP cells treated with 2 well-characterized GLUT1 inhibitors maintained normal rates of glycolysis and ATP production, indicating intrinsic compensatory mechanisms. We showed in vitro that NP cells mitigated GLUT1 loss by rewiring glucose import through GLUT3. Of note, we demonstrated that substrates, such as glutamine and palmitate, did not compensate for glucose restriction resulting …

Advancing Health Equity In The Us Military, James D. Mancuso, John Young, Jennifer Rusiecki, Shauna Stahlman, Natasha Schvey, Toya Randolph, Candy Wilson, Catherine Witkop, Patrick Hyde, Althea Green, Patcho Santiago, Donald Shell, Tracy Sbrocco

Journal of Health Disparities Research and Practice

Eliminating health disparities and achieving health equity are central to US national health objectives and the Military Health System’s “quadruple aim,” which has readiness as its core aim. Because military service members enjoy universal eligibility for health care, it is sometimes assumed that health disparities do not exist in the Department of Defense (DoD). However, while some studies have shown that disparities have been attenuated or eliminated in the DoD, others suggest that significant disparities remain. Reasons these disparities may remain include that universal eligibility for care does not necessarily result in equal to access to care, and that equal …

Umbilical Cord Blood Transplantation: Connecting Its Origin To Its Future, Gabriela Sanchez-Petitto, Katayoun Rezvani, May Daher, Hind Rafei, Partow Kebriaei, Elizabeth J Shpall, Amanda Olson

Faculty, Staff and Student Publications

Transplantation of umbilical cord blood (UCB) is an attractive alternative source of hematopoietic stem cells (HSCs). The unique properties of cord blood and its distinct immune tolerance and engraftment kinetics compared to bone marrow (BM) and peripheral blood progenitor cells, permit a wider disparity in human leukocyte antigen levels between a cord blood donor and recipient after an unrelated umbilical cord blood transplant (UCBT). In addition, it is readily available and has a lowered risk of graft-versus-host disease (GvHD), with similar long-term clinical outcomes, compared to BM transplants. However, the relatively low number of cells administered by UCB units, as …

Narrative Review Of Single Ventricle: Where Are We After 40 Years?, Antonio F Corno, Tina O Findley, Jorge D Salazar

Faculty, Staff and Student Publications

Background and objective: Key medical and surgical advances have been made in the longitudinal management of patients with "functionally" single ventricle physiology, with the principles of Fontan circulation applied to other complex congenital heart defects. The purpose of this article is to review all of the innovations, starting from fetal life, that led to a change of strategy for single ventricle.

Methods: Our literature review included all full articles published in English language on the Cochrane, MedLine, and Embase with references to "single ventricle" and "univentricular hearts", including the initial history of the treatments for this congenital heart defects as …

Performance Of A Sars-Cov-2 Rt-Pcr Assay With Non-Traditional Specimen Types, Subathra Marimuthu, Holly Aliesky, Heather Ness, Daniya Sheikh, Sathya Rashmit, Dawn Balcom, Leslie A. Wolf

The University of Louisville Journal of Respiratory Infections

During the first two years of the coronavirus disease 2019 (COVID-19) pandemic, nasopharyngeal (NP) specimens were the gold standard for clinical diagnostic testing. As information about the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing the pandemic continued to be shared, it was clear that the virus could be detected in other specimen types during an active infection. The University of Louisville Infectious Diseases Laboratory accepted non-traditional specimen types, most without a paired, positive NP result, for research purposes only to support local epidemiology efforts. A real-time reverse transcription-polymerase chain reaction (RT-PCR) assay originally validated for NP specimens was used …

What? Now A Respiratory Syncytial Virus Epidemic, Aya Allam, Steven B Lippmann

The University of Louisville Journal of Respiratory Infections

No abstract provided.