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Clinical Subtypes Of Co-Morbid Insomnia And Obstructive Sleep Apnea (Comisa): Results Of A Cluster Analysis, Yuan Shi, Xujun Feng, Fengyi Hao, Yuru Nie, Yihui Zhang, Zhaohua Chen, Siqi Guan, Larry D. Sanford, Michael V. Vitiello, Xiangdong Tang 2026 Sichuan University

Clinical Subtypes Of Co-Morbid Insomnia And Obstructive Sleep Apnea (Comisa): Results Of A Cluster Analysis, Yuan Shi, Xujun Feng, Fengyi Hao, Yuru Nie, Yihui Zhang, Zhaohua Chen, Siqi Guan, Larry D. Sanford, Michael V. Vitiello, Xiangdong Tang

Department of Pathology & Anatomy Faculty Publications

Background

Variations in the bidirectional relationship between obstructive sleep apnea (OSA) and insomnia in co-morbid insomnia and OSA (COMISA) may form distinct subtypes of COMISA, which have not been previously characterized. This study aims to identify and characterize subtypes of COMISA.

Methods

From a community-recruited COMISA cohort 256 individuals who met diagnosis for COMISA were used to identify subtypes using a two-step clustering methodology. Demographics and multidimension clinical characteristics were collected and compared among obtained subtypes. Logistic models were used to evaluate whether these subtypes were associated with cardiometabolic and mental disorders. A clinical cohort of 1816 COMISA patients was …


Spiritual And Religious Lay Community Support For Informal Caregivers Of Adults At The End Of Life: A Literature Review, Rachel Lenko 2026 Calvin University

Spiritual And Religious Lay Community Support For Informal Caregivers Of Adults At The End Of Life: A Literature Review, Rachel Lenko

University Faculty Publications and Creative Works

  • Informal caregivers of adults at the end of life often experience significant physical, psychological, and economic burden because of their caregiving and bereavement (Schulz et al., 2003; Skantharajah et al., 2022) 
  • Prior evidence suggests that spirituality and/or religiosity contribute to positive religious coping and improved adjustment to bereavement (Damianakis et al., 2012; Stelzer et al., 2020) 
  • Spiritual and religious communities often provide practical and social, in additional to spiritual/religious, support to their members 
  • There is limited evidence describing practical and social support from spiritual/religious lay communities for informal caregivers of patients in the terminal phase of a disease


Exploring The Synergy Between Very Large Transformer And Lstm Models For Effective Medical Captioning From Videos To Text: The Impact Of Captioning In Healthcare, R. V. Aswiga, Moin Ahmed Zahir 2026 Vellore Institute of Technology

Exploring The Synergy Between Very Large Transformer And Lstm Models For Effective Medical Captioning From Videos To Text: The Impact Of Captioning In Healthcare, R. V. Aswiga, Moin Ahmed Zahir

Data Science Faculty Publications

In today’s rapidly evolving digital landscape, the demand for accurate and contextually relevant subtitles for image and video content, particularly in the medical domain, is increasingly critical. Despite the proliferation of visual data across various platforms, existing captioning systems often struggle due to variations in visual settings, complex temporal relationships, and nuanced semantics. Additionally, challenges such as limited datasets, privacy issues, and specialized annotation requirements make medical image captioning particularly difficult. To tackle these challenges, we investigate cutting-edge deep learning methodologies, specifically Transfer Learning and Transformer models, through a comparative analysis. Specifically, we focus on Transfer Learning through the MedVisionCapturer …


Improving Antibiotic Prescribing For Urinary Tract Infections In Urgent Care Centers, Alexis Alastanos 2026 West Virginia University

Improving Antibiotic Prescribing For Urinary Tract Infections In Urgent Care Centers, Alexis Alastanos

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction: Urinary tract infections (UTIs) are one of the most common infections that require antibiotic therapy. Providers working in three urgent care clinics located in Eastern West Virginia diagnosis and treat UTIs based on their clinical judgement. Variability in clinical judgement results in inappropriate antibiotic use which has implications on antibiotic resistance and the financial burden of the patients as well as the entire organization.

Evidence Review: A total of 10 articles were evaluated to support the implementation of antibiotic stewardship initiatives that provide guidance in caring for this population. Interventions include electronic health record enhancements, provider education, and tracking …


Hyperglycemia Detection From Single-Lead Ecg Using A Hybrid Cnn & Transformer Model, Adam Ayomikun Ogunjembola 2026 West Virginia University

Hyperglycemia Detection From Single-Lead Ecg Using A Hybrid Cnn & Transformer Model, Adam Ayomikun Ogunjembola

Graduate Theses, Dissertations, and Problem Reports (ETD)

Diabetes Mellitus is known as high blood glucose. This high blood glucose level happens when the body has a problem with producing or using insulin. Insulin is a very important hormone that the pancreas makes to control how much glucose gets into the bloodstream and cells. Diabetes Mellitus has an effect on the body if it is not treated, such as damaging the blood vessels and nerves which can lead to stroke, kidney failure, heart attack and permanent loss of vision. Since people with diabetes need to measure their glucose levels in order to determine how much insulin or medicine …


C. Difficile Detection Method For First Responder Glove Application, Alli N. Senedak 2026 The University of Akron

C. Difficile Detection Method For First Responder Glove Application, Alli N. Senedak

Williams Honors College, Honors Research Projects

Clostridioides Difficile (C. diff) is a Anaerobic Gram-positive bacillus that is capable of spore formation, making it difficult to control its spread and duration in clinical environments. This phenomenon can provide danger to first responders, healthcare workers, and patients. The goal of this project is to create a biosensor capable of detecting C. diff in a clinical setting that can be applied to a glove apparatus. The project will involve the use of C. diff aptamers activated on the surface of an electrode. Once surface activation has been verified via surface analysis, the electrodes will be exposed to C. diff …


35 Individuals With Huwe1-Related Neurodevelopmental Disorder And Suggested Clinical Evaluations, Mindy H. Li, Deziree L. Coleman, Kelsey Hogan, Danielle Luz, Lindsay Bhandari, Newell Belnap, Tiffany Busa, Charles Coutton, Klaus Dieterich, Svetlana Gorokhova, Clara Hildebrandt, Rachel Logan, Milena Mariani, Manuela Morleo, Vincenzo Nigro, John Pappas, Rachel Rabin, Kelly Schoch, Angelo Selicorni, Vandana Shashi, Rebecca Spillman, Jennifer Sullivan, Charlotte Tardy, Samantha A. Schrier Vergano, Brock Grill, Kristin Baranano 2026 Rush University Medical Center

35 Individuals With Huwe1-Related Neurodevelopmental Disorder And Suggested Clinical Evaluations, Mindy H. Li, Deziree L. Coleman, Kelsey Hogan, Danielle Luz, Lindsay Bhandari, Newell Belnap, Tiffany Busa, Charles Coutton, Klaus Dieterich, Svetlana Gorokhova, Clara Hildebrandt, Rachel Logan, Milena Mariani, Manuela Morleo, Vincenzo Nigro, John Pappas, Rachel Rabin, Kelly Schoch, Angelo Selicorni, Vandana Shashi, Rebecca Spillman, Jennifer Sullivan, Charlotte Tardy, Samantha A. Schrier Vergano, Brock Grill, Kristin Baranano

Department of Pediatrics Faculty Publications

HUWE1 (HECT, UBA, and WWE Domain Containing E3 Ubiquitin Protein Ligase1, OMIM 300697), located at Xp11.22, encodes a ubiquitin ligase that is highly conserved across species. Genetic variants in HUWE1 described in multiple independent studies cause X-linked intellectual disability, including in the patients identified by Juberg, Marsidi, and Brooks. This report describes 35 additional cases of individuals with variants in HUWE1 and suggested guidelines for clinical management. Our study includes several female cases, which have not been widely reported previously. Our findings confirm earlier reported clinical features including developmental delay, autism, hypotonia, short stature, and dysmorphic facial features as well …


Brief Pulses Of High-Level Fluid Shear Stress Enhance Metastatic Potential And Rapidly Alter The Metabolism Of Cancer Cells, Amanda N. Pope, Devon L. Moose, Guy O. Hudson, Hank R. Weresh, Marion R. Dykstra, Aabha Y. Joshi, Patrick Breheny, Eric B. Taylor, Michael D. Henry 2026 University of Iowa

Brief Pulses Of High-Level Fluid Shear Stress Enhance Metastatic Potential And Rapidly Alter The Metabolism Of Cancer Cells, Amanda N. Pope, Devon L. Moose, Guy O. Hudson, Hank R. Weresh, Marion R. Dykstra, Aabha Y. Joshi, Patrick Breheny, Eric B. Taylor, Michael D. Henry

Department of Biomedical and Translational Sciences Faculty Publications

Circulating tumor cells (CTCs) face challenges to their survival, including mechanical and oxidative stresses that are different from cancer cells in solid primary and metastatic tumors. The impact of adaptations to the fluid microenvironment of the circulation on the outcome of the metastatic cascade is not well understood. Here, we find that cancer cells exposed to brief pulses of high-level fluid shear stress (FSS) exhibit enhanced invasiveness and anchorage-independent proliferation in vitro and enhanced metastatic colonization/tumor formation in vivo. Cancer cells exposed to FSS rapidly alter their metabolism in a manner that promotes survival by providing energy for cytoskeletal remodeling …


Localization And Functional Exploration Of Leiomodin-2'S C-Terminal Binding Sites, Mason D. Summers, Madison Little, Robert P. Young, Brayan Osegueda, Alan Palma Guillen, Garry E. Smith Jr., John R. Cart, Vitold E. Galkin, Alla S. Kostyukova 2026 Washington State University

Localization And Functional Exploration Of Leiomodin-2'S C-Terminal Binding Sites, Mason D. Summers, Madison Little, Robert P. Young, Brayan Osegueda, Alan Palma Guillen, Garry E. Smith Jr., John R. Cart, Vitold E. Galkin, Alla S. Kostyukova

Department of Biomedical and Translational Sciences Faculty Publications

Striated muscle contraction occurs through interactions between overlapping myosin-based thick and actin-based thin filaments within the sarcomere. For effective contraction to occur, the length of the thin filament must be maintained to ensure sufficient overlap with the thick filament. The proteins leiomodin and tropomodulin compete for binding at the pointed ends of thin filaments to regulate their length, using their homologous N-terminal actin and tropomyosin binding sites. Leiomodin also contains a region called the C-terminal extension, absent in tropomodulin. In this region, the cardiac isoform (leiomodin-2) contains additional actin-binding sites that enable it to bind along the sides of thin …


Educational Case: Atypical Presentation Of Primary Hyperparathyroidism With Brown Tumor, Ariel Flotte, Jonathan Light, Harrison Klause, Richard M. Conran 2026 Macon & Joan Brock Virginia Health Sciences at Old Dominion University

Educational Case: Atypical Presentation Of Primary Hyperparathyroidism With Brown Tumor, Ariel Flotte, Jonathan Light, Harrison Klause, Richard M. Conran

Department of Biomedical and Translational Sciences Faculty Publications

The following fictional case is intended as a learning tool within the Pathology Competencies for Medical Education (PCME), a set of national standards for teaching pathology. These are divided into three basic competencies: Disease Mechanisms and Processes, Organ System Pathology, and Diagnostic Medicine and Therapeutic Pathology.


Comparative Mass Spectrometry Analysis Of High And Low Centrifugation Extracellular Vesicle (Ev) Pellets From Healthy Urine Following Tamm-Horsfall Protein Removal, Dana Bielopolski, Luca Musante, Henrik Molina, Douglas Barrows, Samantha Upson, Lifang Yang, Thomas Carrol, Jonathan N. Tobin, Rhonda G. Kost, U. Erdbrügger 2026 The Rockefeller University Center for Clinical and Translational Science

Comparative Mass Spectrometry Analysis Of High And Low Centrifugation Extracellular Vesicle (Ev) Pellets From Healthy Urine Following Tamm-Horsfall Protein Removal, Dana Bielopolski, Luca Musante, Henrik Molina, Douglas Barrows, Samantha Upson, Lifang Yang, Thomas Carrol, Jonathan N. Tobin, Rhonda G. Kost, U. Erdbrügger

Department of Biomedical and Translational Sciences Faculty Publications

Objectives

Urinary extracellular vesicles (uEVs) are potential biomarkers for renal physiology and disease. Their isolation is challenged by Tamm-Horsfall protein (THP) contamination, particularly in high-speed ultracentrifugation (P100) fractions. Low-speed (P20) fractions contain biologically relevant uEVs, yet their proteomic composition is underexplored. This study evaluates strategies for THP removal to optimize mass spectrometry analysis and characterizes P20 and P100 uEV proteomes and its combination in healthy urine.

Methods

Urine from a healthy volunteer was processed via sequential centrifugation at 21,200 g (P20) and 164,244 g (P100). THP removal was performed using low ionic strength buffer (P20) and size-exclusion chromatography (P100). Western …


Oxytocin Dosing During Trial Of Labor After Cesarean To Minimize The Risk Of Uterine Rupture: A Systematic Review And Meta-Analysis, Pierpaolo Nicolì, Moti Gulersen, Jordan Beacham, Hila Hochler, Alessandra Familiari, Anna Locatelli, Cynthia Abraham, Ettore Cicinelli, Amerigo Vitagliano, Vincenzo Berghella 2026 Thomas Jefferson University

Oxytocin Dosing During Trial Of Labor After Cesarean To Minimize The Risk Of Uterine Rupture: A Systematic Review And Meta-Analysis, Pierpaolo Nicolì, Moti Gulersen, Jordan Beacham, Hila Hochler, Alessandra Familiari, Anna Locatelli, Cynthia Abraham, Ettore Cicinelli, Amerigo Vitagliano, Vincenzo Berghella

Department of Obstetrics and Gynecology Faculty Papers

OBJECTIVE: Oxytocin remains the mainstay for induction and for the management of labor arrest during trial of labor after cesarean (TOLAC). Therefore, the clinical question should be not whether to use oxytocin, but how to optimize its administration. This meta-analysis aimed to assess which oxytocin protocol, in terms of initial dose, amount of increase, timing to next increase, and maximum dose, may minimize the risk of uterine rupture (UR) during TOLAC.

DATA SOURCES: PubMed, Embase and Clinicaltrials.gov were searched up to September 21, 2024.

STUDY ELIGIBILITY CRITERIA: Randomized and nonrandomized studies evaluating the association between induction and/or augmentation with oxytocin …


Revisiting Nasal Polyp Scoring In Clinical Trials: Interpretive Variability And The Need For Standardization, Leigh J. Sowerby, Babak Pourmomenarabi, Antonino Maniaci, Olivia Ginty, Joseph Khristian Han 2026 Western University

Revisiting Nasal Polyp Scoring In Clinical Trials: Interpretive Variability And The Need For Standardization, Leigh J. Sowerby, Babak Pourmomenarabi, Antonino Maniaci, Olivia Ginty, Joseph Khristian Han

Department of Otolaryngology (ENT) Faculty Publications

[Introduction] Borish et al. provided an excellent review highlighting methodological variability among the six pivotal Phase III trials [1]. One critical yet overlooked issue is the inconsistent application of the endoscopic nasal polyp score (NPS), a primary outcome measure in all trials.


Oropharyngeal Syphilis Presenting As Tongue Based Ulcer With Lymphadenopathy, Serena F. Pu, Kevin J. Carlson, Jonathan R. Mark, Benjamin J. Rubinstein 2026 Macon & Joan Brock Virginia Health Sciences at Old Dominion University

Oropharyngeal Syphilis Presenting As Tongue Based Ulcer With Lymphadenopathy, Serena F. Pu, Kevin J. Carlson, Jonathan R. Mark, Benjamin J. Rubinstein

Department of Otolaryngology (ENT) Faculty Publications

Within the aerodigestive tract, syphilis presents with varied signs and symptoms, some of which may mimic malignancy or other disease processes. We present the case of a 29-year-old man with otalgia and odynophagia who was found on physical examination and office laryngoscopy to have a 4-cm ulcerative mass of the tongue base and cervical lymphadenopathy. While planning for tissue diagnosis, the patient’s serologies revealed positive treponemal antibody testing and elevated rapid plasma reagin (RPR) titers, confirming syphilitic infection, likely representing secondary syphilis. While awaiting operative biopsy, the patient received intramuscular penicillin with complete resolution of the mass and symptoms, and …


Post-Metabolites Of Two Commensal Bacteria Suppress Dna Damage In An Experimental Model Of Acid Reflux Disease, Maanya Pradeep 2026 University of Central Florida

Post-Metabolites Of Two Commensal Bacteria Suppress Dna Damage In An Experimental Model Of Acid Reflux Disease, Maanya Pradeep

Honors Undergraduate Theses

Chronic heartburn or gastroesophageal reflux disease (GERD) affects approximately 25% of the US population [1]. Repeated bile acid exposure from the regurgitation of stomach contents leads to the production of reactive oxygen species (ROS), which can cause oxidative DNA damage and promote genomic instability [2]. Barrett’s esophagus (BE), which can develop as a response to chronic bile acid exposure, increases the risk of esophageal adenocarcinoma (EAC) by 30% to 125% [1].

There are more than 18,000 new cases of esophageal cancer in the United States each year, and while its incidence is relatively low compared to other cancers, its mortality …


Magnesium-Based Metal Matrix Nanocomposite Implants And Nanobubble-Based Delivery Systems: Integrated Strategies For Bone Loss Treatment With Cytocompatibility Evaluation, Lucas José Martinho Bizuti 2026 University of Central Florida

Magnesium-Based Metal Matrix Nanocomposite Implants And Nanobubble-Based Delivery Systems: Integrated Strategies For Bone Loss Treatment With Cytocompatibility Evaluation, Lucas José Martinho Bizuti

Honors Undergraduate Theses

This thesis intends to investigate the development of different multimodal therapeutic strategies for combating bone loss. Most specifically, this paper will emphasize the utilization of Magnesium-Based Metal Matrix Nanocomposite Implants (MMNC) and Nanobubble-Based Delivery Systems as options for future treatment focus. The effects of biodegradable magnesium implants were evaluated for cytotoxicity and cytocompatibility via Hematoxylin and Eosin, and Masson’s Trichrome staining, as well as radiological images. The Nanobubble-Based Delivery System is being developed and optimized as a delivery system to target osteoclast activity. This paper focused on optimizing experimental parameters, which include Rotational speeds for nanobubble stimulation under microgravity conditions …


Excision Followed By Standing Cone Deformity Repair Is Tissue Conservative, Henry Lim, Christian Scheufele, Marshall Hall, Stephen Weis, Dustin Wilkes 2026 HCA Healthcare

Excision Followed By Standing Cone Deformity Repair Is Tissue Conservative, Henry Lim, Christian Scheufele, Marshall Hall, Stephen Weis, Dustin Wilkes

North Texas GME Research Forum 2026

Introduction Elliptical excisions are the most common method to treat benign and malignant tumors in dermatologic surgery. This standardized design is traditionally 3 to 4.5 times longer than the excisional width to prevent unsightly protrusions of skin after primary closure, known as “standing cone,” “Burow’s triangles” or “dog ear” deformities. This results in a scar significantly longer than the original tumor that may be less easily concealed.

Objective To compare the final repair length of a tissue conservative method to remove skin tumors and close resultant defects against predicted repair length of traditional elliptical excision.

Methods Eighteen cases are presented …


Microarray Analysis Of Human Abdominal Aortic Aneurysm With Emphasis On Cardiovascular Genes Revealed Differentially Expressed Genes, Song Lu, Li Ping Li, John V. White, Xiaoying Zhang, Ifeyinwa Nwaneshiudu, Adaobi Nwaneshiudu, Nectaria Ntaoula, John Gaughan, Dimitri S. Monos, Wan-Lu Lin, Charalambos C. Solomides, Emilia L. Oleszak, Chris D. Platsoucas 2026 Temple University

Microarray Analysis Of Human Abdominal Aortic Aneurysm With Emphasis On Cardiovascular Genes Revealed Differentially Expressed Genes, Song Lu, Li Ping Li, John V. White, Xiaoying Zhang, Ifeyinwa Nwaneshiudu, Adaobi Nwaneshiudu, Nectaria Ntaoula, John Gaughan, Dimitri S. Monos, Wan-Lu Lin, Charalambos C. Solomides, Emilia L. Oleszak, Chris D. Platsoucas

Biological Sciences Faculty Publications

Background/Aim: We examined gene expression profiles in abdominal aortic aneurysm (AAA) lesions vs. normal aortas by cDNA microarray and real-time quantitative reverse-transcriptase polymerase chain reaction (qRT-PCR).

Materials and Methods: Phosphorus (32P)-labeled cDNA from AAA specimens (mean AAA size 6.65 cm) and normal aortas were hybridized with a 588-gene microarray primarily of the cardiovascular system. The results were validated by qRT-PCR.

Results: A total of 35 out of the 588 genes were differentially expressed, with either log2 ratio of AAAs/controls ≥1 (upregulated; 20 genes) or ≤−1 (downregulated; 15 genes) in AAA lesions vs. normal aorta, and 25 of these were significantly …


Leveraging Cross-Reactivity For Dual Serological Detection Of Closely Related Schistosoma Species, Oyetunde T. Oyeyemi, Lisa M. Shollenberger 2026 Old Dominion University

Leveraging Cross-Reactivity For Dual Serological Detection Of Closely Related Schistosoma Species, Oyetunde T. Oyeyemi, Lisa M. Shollenberger

Biological Sciences Faculty Publications

Schistosomiasis is a disease of poverty that is highly prevalent in Sub-Saharan African countries. Cross-reacting proteins in Schistosoma mansoni (Sm) and S. haematobium (Sh) have been reported to pose diagnostic challenges. Proteins from these two parasites may help overcome diagnostic limitations caused by cross-reactivity and poor species discrimination in serological assays. The study aims to identify cross-reacting protein markers from S. mansoni and S. haematobium for possible concurrent diagnosis of the two parasites. High-quality protein extracts were prepared from the eggs (soluble egg antigen, SEA) and adult worms (Schistosoma worm antigens preparation, SWAP) of S. haematobium and S. mansoni …


Magnetic Resonance Only Planning Validation Using Synthetic Ct By Mvision, Eric D. Brass Sr 2026 Virginia Commonwealth University

Magnetic Resonance Only Planning Validation Using Synthetic Ct By Mvision, Eric D. Brass Sr

Theses and Dissertations

Problems: Adaptive radiotherapy requires clinically practical methods for responding to patient-anatomy changes that occur between the original planning images and the day of treatment delivery. Registering a previously acquired computed tomography scan to a newly acquired magnetic resonance image can introduce cross-modality uncertainty and may delay replanning. This thesis evaluates whether synthetic computed tomography generated from same-day magnetic resonance imaging can reduce registration-related uncertainty while supporting rapid dose recalculation for fraction-level adaptation.

Procedure: Magnetic resonance imaging DICOM data were exported from the ViewRay MRIdian treatment planning system and uploaded to MVision for synthetic computed tomography generation. The synthetic computed tomography …


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