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Pituitary Adenoma Presenting as Cranial Nerve III Palsy and Hemifacial Pain
Get PDFPituitary adenomas are common neoplasms arising from the pituitary adenohypophyseal cell. They can be classified by cell type, size and as nonfunctioning or functioning based on the secretion of pituitary hormones. Of these, approximately 48% are macroadenomas (\u3e10 mm) and approximately 53% are prolactinomas. For how common these adenomas are, only 1 of 1100 persons manifest clinical symptoms1 rendering detection and clinical management challenging.
Non-functioning adenomas are slow growing like most pituitary adenomas and are usually detected due to their mass effect on neighboring structures.2 The majority of the reported symptoms as a results of these mass effects are visual field defects and headaches.3 This is usually due to a superior expansion and thus compression to the optic chiasm. In rare instances, inferior expansion, and or cranial nerve palsies have been reported.4
We present the case of an 80-year-old patient with a pituitary macroadenoma with cavernous sinus extension who presented with CN III palsy and hemifacial pain
Social experiences, life satisfaction, and social support of immigrant families with young children in a highly urban city
Get PDFGrounding this study in Bronfenbrenner’s ecological framework, the authors used a survey that includes psychometrically sound measures, to investigate the social experiences of 54 immigrant families with young children and the factors that shape their perceptions of life satisfaction and social support in a highly urban city. Results show persistent challenges related to discrimination and access to resources. Despite these challenges, participants’ overall satisfaction with life was rated high and positively correlated with their comfort with practicing their culture and with their perceived social support. Implications involve the need to design evidence-based policies and programmes that promote immigrant families’ wellbeing
Educational chatbot development informed by clinical simulations
Get PDFThis manuscript introduces an innovative approach to developing educational chatbots informed by clinical simulations to enhance learning experiences. With the rapid interaction of generative AI in education, this work provides a structured process to creating chatbots that simulate interactions for educational purposes. The four development phases, Conceptualization, Protocol Design, Technical Design, and Trials and Revisions are grounded in the foundational practices of clinical simulations. This approach bridges gaps between theory and practical application of emerging technologies while emphasizing the role of humans at the center of AI-enhanced learning. In addition to technical guidance, pedagogical strategies for introducing chatbots to students are provided. This comprehensive framework can provide educators with tools to create and implement dynamic learning tools to create more personalized and immersive experiences
LOW-POWER SENSOR DESIGN AND FUSION TO EDGE DEVICES FOR HIGH-SPEED OBJECT DETECTION AND ENHANCED SOLDIER SITUATIONAL AWARENESS
Get PDFThreat detection and physiological monitoring of soldiers from fused sensor data collected in real time is currently limited to running deep neural networks with substantial computing needs. The lack of data acquisition from sensor readings and efficient detection of novel enemy signatures motivates the need for a low-power, low-cost, wireless multisensor fusion computing system. We propose the current trends in Internet of Things to deploy a chargeable, wireless multi-channel acquisition system that can be interfaced to a high speed, Single Board Computer (SBC) such as the NVIDIA Jetson Orin capable of running object detection models, such as YOLOv7-tiny to enable high speed target detection, and monitoring of soldier’s health and weapon states at a low-cost, and low-power. Target detection and data fusion was achieved at ∼60 FPS with a YOLOv7-tiny model trained on a custom drone dataset with a NVIDIA Jetson Orin equipped with a USB camera, and connected to a custom wireless Wearable Multi-Channel Physiological Device (WMCPD) centered around the ESP32 and interfaced to two physiological sensors: Pulse Oximeter, and GSR sensor that synchronized heart rate, Oxygen saturation (SpO2), and Galvanic Skin Response (GSR). Based on the power metrics required for the ESP32 and the interfaced sensors, a multi-channel acquisition system was designed that features a USB-C battery charging interface capable of charging a Li-Ion (500 mAh) to power the system. This Low Power, wearable multi-channel, physiological device (WMCPD) can transmit the sensitive fused, physiological data to wireless devices such as the Edge device, or the HoloLens 2, to not only keep track of the soldier’s physiological state, but to further exemplify efficient processing at the edge and capture soldier feedback from real-time sensitive data collection, and its affect on integrating to the external devices in the mixed reality setting (TGGSE) such as the Orin or Hololens. Additionally, a custom weapon sensing device was developed that monitors the real-time ammunition, and recoil of a soldier’s gun, and was designed to be serially compatible with military devices and vehicles over MilCAN
BEHAVIORAL EFFECTS OF NOVEL TREATMENTS FOR PAIN USING DIFFERENT PATHWAYS
Get PDFPain is defined as an unpleasant sensation that is mostly caused by a stimulus from our surroundings. This sensation has the potential to become a significant concern, disrupting daily activities, and diminishing overall quality of life. However, it could also hold significant importance as it serves as a protective mechanism. Pain acts as an alarm system for the human body, alerting it to potentially harmful situations where tissues may be at risk of damage1. Despite the considerable advancements in pain treatment and the extensive knowledge scientists possess regarding the pathophysiology and pathways of pain, numerous medications aimed at alleviating pain often carry significant side effects that could limit their use. This thesis aims to elucidate the diverse pain pathways and explore several potential therapeutic targets for pain management. The main goal of these investigations is to find therapeutic targets to relieve pain. This involves developing non-opioid pain-relieving medications or finding new candidate medications that can be co-administered with opioid analgesics to selectively enhance analgesia. This approach will lead to reducing overall opioid exposure and the risks of opioid-induced side effects
ANALYZING NOVEL METAL ALLOYS FOR GLUCOSE SENSING AND ELECTROCATALYSIS
Get PDFIn pharmaceutical and medicinal chemistry, metals and metal alloys often receive less attention compared to biological or organic compounds due to many factors including toxicity in the body for drug development or the cost of these metals. However, metals can play an important role in pharmaceuticals, having an impact on original cancer drugs, such as platinum used for head and neck tumors. Electrocatalysis is also another topic that receives less attention over topics such as chromatography in pharmaceuticals due to its potential toxic catalysts and voltages that could be harmful to the body. Electrocatalytic sensors can play an important role in pharmaceuticals by measuring concentrations of biomolecules. In this case, an electrocatalytic reaction was studied, catalyzing CO2 into DMC for laboratory purposes. This electrocatalytic reaction used an Au/Pd slab catalyzing CO2 to DMC while determining its mechanism computationally. With the knowledge of sensors and metal alloys, potential glucose sensors were studied with three different types of Nickel Phosphides (NiPs) to determine how effective each is in sensing applications based on the metal content, binding energies, Fermi energies, and binding of other biomolecules in blood. This work was fully computational, with a checkerboard Au/Pd slab being efficient for CO2 electrocatalysis and Ni3P being the most desirable glucose sensor out of all three. The software consists of Schrodinger, Quantum Espresso, and the Amsterdam Modeling Suite
THE ROLE OF THE CDK8 KINASE MODULE IN MAINTAINING PROTEOSTASIS
Get PDFThe underlying etiology of numerous disease states results from perturbations in the maintenance of cellular proteostasis. Carcinogenesis relies on these perturbations to foster uncontrolled cell growth and eventual metastases, while neurodegenerative diseases are a consequence of such perturbations. Control of these processes occurs at numerous molecular levels, commonly starting with transcription. A key transcriptional complex that is involved is the CDK8 Kinase Module (CKM). The CKM is conserved from yeast to man, forming a tetrameric complex consisting of MED12, MED13, CDK8, and CCNC. The CKM has not only been implicated in a variety of cancers but also in a spectrum of developmental disorders. Using RNA sequencing on murine and human cell lines, I showed that the CKM regulates the transcription of genes mediating conserved proteostasis pathways including translation, protein degradation, and differentiation. In addition, I showed that these processes are druggable targets, as chemotherapeutics aimed at translation and protein degradation, sensitized CCNC-/- cells to cell death. The use of CKM inhibitors phenocopied this sensitivity when cyclin C was present. As customized drug treatments become a reality, these data represent an approach that may be used to target cancers. These data further present a model of how mutations in the CKM can contribute to a diverse spectrum of disease states
TOWARDS A FUNDAMENTAL UNDERSTANDING OF THE POLYMER COLD SPRAY PROCESS
No full textCold spray technology lends itself as a versatile process to rapidly apply quality polymer coatings to various substrates; barring limited, although clearly demonstrated, success. The limited success of polymer sprays is a result of modern cold spray knowledge originating from studies with metals. Thus, a deeper understanding of how polymers behave in cold spray is needed to make polymer cold spray a commercially viable process. Various tools are used in this dissertation to progress the fundamental understanding of polymer cold spray as it relates to general processing parameters with a focus on characteristics that do not occur in metals. Polymer chain length is identified as a critical factor dictating the behavior of polymers impacting at cold spray-like velocities. The effects of slow heat transfer in polymer particles compared to metals is investigated using computational modeling. Unlike metals, intraparticle thermal gradients occur in polymers that are demonstrated to influence particle deformation. Particle temperature, substrate temperature, and velocity effects are demonstrated using cold spray experiments. Increased particle velocities are demonstrated to improve spray properties, contrary to suggestions made in previous literature. This improvement is attributed to polymer viscoelasticity. Viscoelasticity is elucidated using light gas gun-accelerated polymer projectiles and high-speed videography. Results indicate that viscoelastic impact behavior is a key limiting factor to polymer cold spray that is not present in metals
RESISTING INTERNALIZED STIGMA (RIS): ACCEPTABILITY AND FEASIBILITY OF A COGNITIVE BEHAVIORAL STIGMA INTERVENTION FOR EARLY PSYCHOSIS
Get PDFThe clinical high-risk state for psychosis (CHR-P) was created to help identify individuals experiencing early signs of psychosis to help forestall worsening symptoms. CHR-P individuals may experience stigma that may stem from internal or external processes, including from receiving specialized care. Research has demonstrated associations between internalized stigma and psychosocial and functional outcomes, which underscores the need for interventions to help mitigate the impact of stigma while balancing the need for treatment. To date, there is only one stigma intervention specifically designed for individuals designated as CHR-P, which is psychoeducational in nature. Based on the recent call to action that highlights the need for specialized stigma interventions for CHR-P groups, this study piloted the first manualized, cognitive-behaviorally based stigma intervention designed for early psychosis, including those at risk. The study took place at the University of Pennsylvania’s Psychosis Evaluation and Recovery Center and recruited 9 CHR-P and first episode psychosis subjects to participate in two simultaneously run groups. Psychosocial and functional outcomes were assessed at baseline and follow-up and demonstrated reductions in stigma and depression and elevations in sense of purpose, self-esteem, and social cognitive performance. Qualitative interviews showed acceptability, feasibility, and ideas for manual refinement
Expansion of Osteopathic Medicine Practitioner Education on Substance Use Disorders
Get PDFCONTEXT: Medical school graduates are generally not well prepared to treat patients with substance use disorders (SUDs), even though opioid overdose deaths in the United States have increased in recent years. When it comes to training in SUDs, osteopathic medicine lags far behind allopathic medicine. It was only in 2019 that the American Osteopathic Association approved Board Certification in Addiction Medicine to help combat the opioid epidemic. Few articles have been published in the literature pertaining to substance use education for osteopathic students and trainees.
OBJECTIVES: The goal of this study was to expand the education of osteopathic medical students and primary care residents in SUDs and measure the effect that education had on the attitudes and knowledge of student and residents about SUDs.
METHODS: This study collected anonymous data in the form of a voluntary online survey from third- and fourth-year students at an osteopathic medical school and family medicine residents. The survey was completed by 115 students and 29 family medicine residents. Participants completed a pretest survey and then participated in the Physician Undergraduate and Resident Substance Use Education (PURSUE) curriculum developed by the researchers. This consisted of three online modules covering Screening, Brief Intervention, and Referral to Treatment (SBIRT), substance use assessments, and treatment of SUDs. Upon conclusion of the training modules, medical student participants then completed a posttest survey to assess for any changes in knowledge and attitude. Participants also answered questions related to clinical case scenarios involving patients at varying risk levels who were assessed utilizing SBIRT.
RESULTS: Students and residents who participated in the training demonstrated an increase in their average scores between the pretest and posttest, indicating effectiveness in learning from the modules. The overall increase in average scores on the pretest and posttest was 6.5 %, which was determined to be statistically significant (p
CONCLUSIONS: The results of our project support the need and benefit of incorporating educational modules on this topic area within medical school curriculums and residency training. Expanding the number of healthcare workers proficient in providing this type of care in these types of settings will improve the quality of and access to medical care in some of our highest-need populations