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Impact of Machine Learning/AI Models in Cancer Treatment
No full textAI/ML's foray into healthcare, especially oncology, heralds a paradigm shift in patient diagnosis, treatment, and monitoring. Historical applications have showcased AI's proficiency in interpreting complex diagnostic images, predicting treatment responses, and personalizing therapy regimens based on genetic data. However, the full integration of these technologies in cancer care remains nascent, with significant untapped potential. Through a meticulous examination of existing literature and recent case studies, this study positions itself at the forefront of efforts to harness AI/ML's full capabilities, aiming to catalyze a comprehensive adoption in cancer treatment protocols.
The use of AI/ML in healthcare, particularly in oncology, has been growing, driven by advances in technology and data analytics. Studies have shown promising results in using AI/ML for diagnostic imaging, genetic profiling, and treatment efficacy prediction. Despite these advances, there remains a significant gap in the comprehensive application of these technologies across all stages of cancer care. This study situates itself within the ongoing efforts to bridge this gap, drawing on extensive literature to underscore the potential and current limitations of AI/ML in improving cancer treatment
UNDERSTANDING AND ADDRESSING HEALTH DISPARITIES AMONGST EASTERN FIREFIGHTERS USING CARDIOMETABOLIC RISK SCORES
No full textCardiac events have remained the leading cause of on-duty deaths among US firefighters for the past five decades. PURPOSE: The purpose of this study was to assess the prevalence of cardiometabolic risk (CMR) and examine racial differences between White non-Hispanic and minority firefighters in Eastern North Carolina, specifically the Pitt County area. An adaptation of a predictive CMR model equation was developed to form a composite risk score using data accessible from local firefighters’ annual fitness assessment conducted through East Carolina University’s Cardiovascular Health Assessment Program. By utilizing comprehensive annual fitness assessments, this study aims to address the existing gap in regional data. While research on firefighter health is growing, there is a clear need for more studies focused on the specific population of firefighters in Eastern North Carolina, considering the unique environmental challenges they face. Understanding the impact of cardiometabolic health is crucial for developing effective interventions and improving their overall wellbeing. Eastern North Carolina minority firefighters are expected to have a higher relative risk for cardiovascular disease compared to their White non-Hispanic counterparts. To understand the relationship between cardiometabolic risk (CMR) and sudden cardiac death (SCD), this study examines health disparities faced by firefighters in Eastern North Carolina, with a focus on addressing CMR to better understand the predispositions of SCD. METHODS: 183 career firefighters (38 ± 9 yrs) participated in this study. Group comparisons were made between White non-Hispanic firefighters (n = 150) and minority firefighters (n = 33). CMR composite scores were calculated for firefighters using established cardiometabolic indicators: diagnosed cardiovascular diseases, hypertension medication use, dyslipidemia medication use, diabetes status, tobacco abuse, android gynoid ratio, and metabolic equivalence. An independent samples t-test was conducted to evaluate group differences. RESULTS: The independent samples t-test showed no statistically significant difference in CMR scores between Minority and White non-Hispanic firefighters, t (1.423), p = 0.138, with a negligible effect size (Cohen’s d = 2.21). White non-Hispanic firefighters had a slightly higher mean CMR score (M = 4.21, SD = 2.24) compared to Minority firefighters (M = 3.63 SD = 2.07). Levene’s test confirmed equal variances across groups. CONCLUSION: Contrary to initial predictions, no significant racial differences in CMR were observed among firefighters for the sample population in Eastern North Carolina. Rather, individual health indicators—particularly lipid profiles—emerged as primary contributors to CMR. These findings challenge prior assumptions regarding elevated CMR among minorities, which is a trend often seen in the general population. Future research should investigate protective and occupational factors that may contribute to this pattern and consider intersectional influences such as rank or years of service. These findings challenge prior assumptions regarding elevated CMR among minorities, which is often seen within the general population. Future research should explore protective and occupational factors contributing to this pattern, and consider intersectional influences such as rank, years of service, localized, occupational, and/or behavioral contributions to firefighters’ health risk. Delimitations: This study is delimited to career firefighters employed from Greenville, NC, and the surrounding areas encompassing a small portion of eastern North Carolina. The scope is confined to those who participate in the Cardiovascular Health Assessment Program conducted by East Carolina University’s Human Performance Lab. The risk assessment will encompass specific metrics such as lipid profiles, anthropometric measures, and stress test results. The findings were interpreted under the NFPA Standard 1952 Category B criteria and the guidelines set forth by the American College of Sports Medicine. It is important to note that this study will not assess long-term clinical outcomes beyond the initial assessment, nor will it include data from departments outside the designated geographical region
Characterization of Ethanol-Induced Enhancement of Human Epidermal Growth Factor Receptor 2 Mediated Cardiotoxic Interactions
No full textTrastuzumab (TZB), a targeted therapy for HER2-positive breast cancer, is associated with cardiotoxicity driven by oxidative stress and disrupted autophagy. Ethanol, widely consumed among cancer patients, also induces cardiomyocyte damage through increased reactive oxygen species (ROS) and calcium dysregulation. This study investigates whether ethanol amplifies TZB-induced cardiotoxicity in HER2-overexpressing rat cardiomyocytes. We hypothesized that ethanol exposure exacerbates ROS generation, suppresses antioxidant enzymes such as heme oxygenase-1 (HO-1), Catalase, and Glutathione, and inhibits autophagy marker LC3B. H9c2 cardiomyoblasts were treated with ethanol (1%) for 24 hours and analyzed via immunofluorescence and western blotting. Ethanol significantly increased HER2 expression and decreased HO-1 levels, suggesting a potential mechanism for exacerbated cardiotoxicity. These findings provide novel insight into how ethanol may worsen the cardiac side effects of TZB and highlight the need for monitoring alcohol consumption in cancer patients undergoing HER2-targeted therapy
Superpatching for Image Analysis Using Transformers and Superpixels
No full textTransformers have revolutionized Computer Vision, offering robust performance across diverse tasks. However, their reliance on uniform pixel patching presents limitations, including
computational inefficiency for larger images, suboptimal handling of local features, and an
inability to process non-uniform patches. Addressing these constraints allows for new opportunities to expand their utility in demanding fields, such as medical imaging.
This work proposes a novel architecture combining Convolutional Neural Networks (CNNs)
and Transformers to leverage superpixels, clusters of pixels with shared characteristics that
capture local feature boundaries effectively. We propose an architecture that segments images
into a collection of superpixels, vectorizes these superpixels using a CNN, and passes the
resulting tokenized vector representations to a standard Transformer. By removing the
uniformity constraint in patching, our approach aims to enhance Transformer performance
on tasks requiring large-scale image analysis and fine-grained local feature understanding,
potentially opening a way for broader Transformer applications in Computer Vision
More green, less red in diet can cut cancer risk
No full textMedical residents, medical students, and dietetic students often co-author a column for the Daily Reflector under Dr. Kolasa's byline. The authors research the topic a reader or patient has asked. Dr. Kolasa reviews their draft for technical accuracy, patient friendly language, people first language. She fact checks the study or other evidence-based reference the author provides. If a physician review is appropriate, Dr. Kolasa requests a colleague from ECU physicians to review the article. The final draft is submitted to the Reflector with the editor having the final say. The headline is written by the Reflector headline writer. The food and nutrition column has run weekly since 1987. Starting in 2020, in addition to the Daily Reflector, the article is published in daily and weekly papers owned by the Adams Publishing Group East (https://adamspg.com)This is a weekly Q and A newspaper column under the byline of Dr. Kathy Kolasa. This column is a guidance on dietary interventions to reduce long-term risk of cancer.non
Grace Campbell Thesis Document
No full textIs Offloading the Knee During Functional Tasks Predictive of Quadriceps Weakness in Healthy and ACLR Individuals.
By
Grace Campbell
July, 2025
Director of Thesis (or Dissertation): Anthony Kulas
Major Department: Kinesiology
ABSTRACT
INTRODUCTION: Anterior Cruciate Ligament tears (ACL) are common injuries that often occur in young individuals who participate in cutting and jumping sports. Individuals who suffer from an ACL injury are faced with short and long term-effects in their lives. These individuals typically have a decreased active lifestyle, an increase in medical bills, and run the risk of developing osteoarthritis (OA) at an earlier age. Even after surgery and recovery, individuals who have a reconstructed ACL (ACLR) are 15 times more likely to suffer a second knee injury compared to the risk of a healthy population of athletes sustaining their first ACL injury. Because of the high rates or second injury focus has been put onto the components of the return to sport (RTS) criteria. The RTS is composed of 4 main components: patient reported outcomes, testing of functional movements, quadriceps strength, leg strength symmetry (LSI) within 90%, and time. From those 4 components only time and quadriceps LSI has been shown to be a risk factor of a second ACL injury. Unfortunately, not everyone has the resources, such as a dynamometer, to properly test quadriceps LSI so they rely on a person’s functional ability. As of now functional tests are not predictive but assessing a single leg vertical jump and the way they move during each test may help functional tests be more predictive risk factor. PURPOSE: Determine the effect of knee extensor torque and mechanical work during a single leg vertical jump on quadriceps strength weakness in ACLR individuals. METHODS: 35 total subjects, 16 healthy 19 ACLR were taken through a similar process to an individual testing out of ACL rehab by completing multiple components of the return to sport (RTS) criteria. Each participant completed the Marx’s activity rating scale, Knee osteoarthritis outcome score (KOOS), and the Tampa scale of kinesiophobia (TSK) surveys. To get a strength profile on each participant a series of 3 different strength tests were collected bilaterally on the HUMAC dynamometer. Followed by testing functional performance during a single leg vertical jump (SLVJ) and single leg horizontal jump (SLHJ) completed bilaterally. RESULTS: Significant differences were seen within the ACLR group when comparing the injured limb to the non-injured limb during isokinetic strength testing (p =.048), joint moments at the knee during SLVJ (p =.002) and SLHJ (p =.001) and overall jump height during the SLVJ (p =.003). These differences are not seen within the healthy controls. CONCLUSION: The underperformance in strength and function seen in the ACLR group is more than likely related to a quadriceps weakness and was shown from the performance metrics but also by the way the ACLR group adapted to move by offloading their knee when completing the functional tasks. Clinically the single leg vertical jump may prove to be a better assessment of function compared to the single leg horizontal jump due to the quadriceps effort needed to and the uniform movement pattern used to complete the jump
Complete search strategies for “ACE-ing Healthcare: Healthcare Utilization from Emerging to Older Adulthood in Individuals with Adverse Childhood Experiences (ACEs): A Systematized Literature Review” Wilson, L.
No full textThe concept domains for this search included: emerging adults and adults in the age range of (20-63); adverse childhood experiences or ACEs; healthcare utilization. Searches were performed in June 2025. Databases included: PsycINFO via ProQuest, MEDLINE via PubMed, CINAHL via EBSCOhost, Education Database via ProQuest, and SOCIndex via EBSCOhost. There were no limiters used in this search
VISUALLY TRANSLATING CULINARY MEDICINE: THE INNOVATION BEHIND CREATING A HEALTHY/WHOLESOME COOKBOOK RAISING FOOD LITERACY AND COMBATTING CARDIOMETABOLIC RISK FACTORS
No full textSignificance
Using my creative photography/videography skills, I have created an interactive cookbook to increase culinary and health literacy for low-income Fresh Start patients from rural eastern North Carolina. This cookbook will empower patients of the Fresh Start program to have an increased quality of life by equipping enhanced culinary skills to support improved diet quality, nutrition, and health.
We “eat with our eyes”. Creating food that is beautiful, flavorful, and healthy- combines art and science to meet sensory and nutritional needs. To address barriers and promote healthy eating I have created an interactive cookbook that uniquely has both step-by-step recipes with pictures and QR codes leading to brief videos visualizing cooking techniques as well as introductory material supporting food literacy (e.g., you don’t have this use that, things to keep in your pantry) that are visually appealing and simple to promote healthier eating and tailored for individuals with less financial resources (e.g., inexpensive, common ingredients, limited equipment) and literacy/numeracy (reading and following recipe) while promoting healthy eating with a variety of colors, textures, flavors.
My Final Product
The finished product consists of a hardcopy cookbook with sections that include Breakfast, Soups, Salads and Snacks, Vegetables, Main dishes, and Desserts. Each section contains modified recipes to accompany the needs of the patient population, prioritizing fruits and nonstarchy vegetables as well as low sugar, lean proteins, and fiber. Every recipe has been handmade and photographed in a visually appealing manner. Not only were the recipes photographed but the culinary process has been brought to life through the utilization of step-by-step cooking videos accessed through QR codes. Patients can now visualize the cooking process increasing their culinary skills and self-efficacy. Recipe videos will also be utilized on the Fresh Start social media page to increase participant engagement. This cookbook has been made available both in paper copies as well as digitally to increase access for every patient the Fresh Start Program serves
Use of Quality by Design in Clinical Trial Implementation Planning
No full textInternational Council on Harmonisation (ICH) E8(R1) guidance recommends proactive clinical trial planning to ensure participant safety and study integrity (ICH, 2021). By applying these concepts during trial implementation planning, investigative sites can have a more robust approach to detecting, remediating, and preventing errors. Following a literature review, FOCUS-PDSA was utilized by a quality improvement team (QIT) in developing a tool to introduce Quality by Design (QbD) concepts for study plan development. A narrated slide presentation was provided to orient staff. The project was implemented from January 13, 2025, through April 25, 2025, over four clinical trial studies. An anonymous survey was conducted among the eight research coordinators participating in the pilot, assessing the use of the tool in terms of clarity, ease of use, impact on time management, and knowledge gained in QbD concepts. Four surveys were returned, with respondents indicating an increased knowledge of QbD post-pilot, openness to further QbD education, general satisfaction with the tool, and content relevant to their role. However, responses indicated some were open to future use of QbD in study planning, while others were unsure. Comments suggested more guidance on identifying critical factors and developing comprehensive study plans. Clinical trial research is essential to advancing medical knowledge as a critical arm of translational science. Safeguarding participant safety and trial integrity through protocol development and study implementation planning is paramount. Although demonstrated through a small sample of survey returns, utilizing QbD methodologies shows potential benefits during trial implementation planning at the investigative site level.D.N.P
Allosteric Regulation of Human 15-Lipoxygenase-2 by Substrate and Calcium-Mediated Protein-Membrane Interactions
No full textAbstract:
Lipoxygenases (LOXs) are a family of iron enzymes that catalyze the peroxidation of polyunsaturated fatty acids to generate oxylipins, which in both plants and animals play essential roles in signaling. In humans, LOX function presents a double-edged sword as they have known involvement in resolving and promoting chronic inflammation. Of the six LOX genes, human 15-lipoxygenase-2 (15-LOX-2) enzyme oxidizes arachidonic acid (AA) to produce 15-hydroperoxyeicosatetraenoic acid (15-HPETE) a precursor of lipoxins and correlated with plaque formation in arteries, increasing risk of cardiovascular disease. Despite related health impacts of 15-LOX-2, there are few selective inhibitors and no drugs prescribed in the United States that target and inhibit LOXs function. Additionally, the structural regulation of LOX function remains to be understood. Allosteric regulation provides a new outlook on the functional mechanism of proteins. Proteins bind a regulatory molecule or metal at a site other than the active site causing a conformational change that alters the protein’s activity. X-ray structures of 15-LOX-2 and other animal LOXs provide evidence of binding sites for divalent calcium ions (Ca2+) that are predicted to serve as allosteric effectors promoting full activity of animal LOXs in the presence of membrane causing the helix-α2 – the gatekeeper for substrate binding – to promote substrate
acquisition to the active site. In this thesis, biochemical and biophysical methods such as isothermal titration calorimetry, differential scanning calorimetry, limited proteolysis, and surface plasmon resonance are used to understand the thermodynamic profiles that drive Ca2+ binding to promote protein-membrane interactions of 15-LOX-2 and thereby influence LOX catalysis