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How Does Schizophrenia Affect the Expression of Alpha 7 Nicotinic Acetylcholine Receptors in the Brain?
No full textSchizophrenia (SZ) is a psychiatric disorder with a pathophysiology that has not yet been fully understood. This mental illness is characterized by disruptions in cognition, social activity, affect, and perception, and affects approximately 0.085% of individuals worldwide. The Alpha 7 Nicotinic Acetylcholine Receptor (α7nAChR) has been connected to auditory function gating deficits. The purpose of this review is to understand the current literature in how the levels of α7nAChR expression and function are affected by SZ, information that could be used to develop therapies to modulate auditory hallucinations in patients with SZ. A literature search was conducted for peer-reviewed journal articles with adult participants and filtered for randomized controlled trials and clinical studies. From this search, several studies were selected. These studies investigated α7nAChR levels in various brain regions (hippocampus, thalamus, frontal cortex, parietal cortex, cingulate cortex, orbitofrontal cortex, and temporal cortex), sera, and overall gene expression. Analysis reveals inconsistencies in changes in receptor levels, several studies without significant results, and several studies with low numbers of initial participants. Therefore, while conclusions were drawn based on the current literature that α7nAChR expression and function are decreased in patients with SZ compared to control subjects, more research is required to confirm. This need is especially focused on the hippocampus, since previous literature has suggested a link between α7nAChR, the hippocampus, and auditory signal gating deficits in SZ. Further research is also required into the development and testing of α7nAChR agonist medications and their effects on α7nAChR expression and function in the previously listed brain regions
Impact of Acceptance Date on Medical Students\u27 Stress & Academic Success
Get PDFEach year, medical school admissions committees use various predictive factors to determine the demographics of their incoming cohorts, including undergraduate or graduate GPAs, MCAT scores, socioeconomic background, gap years, and more. Put together, these factors can paint a picture of how ready an applicant is to face the rigors of medical school. Once applicants are accepted, they face similar life stressors accompanied by the transition to medical school, but the amount of time they have to handle these life stressors is variable depending on when they are admitted. This study aimed to determine if late acceptance into medical school would significantly increase life stressors\u27 impact on academic performance due to decreased transition time. While no significant relationships were found between the chosen predictive factors, transition time, and academic performance, we found which stressors burden students most when transitioning to medical school. The most burdensome stressors reported by participants included major changes in living conditions, financial state, and personal habits. Future recommendations for this research include recruiting a larger sample size to represent incoming cohorts fully and using an inventory specific to medical school-related stressors
Investigating Patient Barriers in Receiving Mammography Screenings Following the COVID-19 Pandemic
Get PDFCurrent literature shows reduced breast cancer mortality is associated with compliance of mammographic screenings (Duffy, 2020), specifically increasing the survival rate an estimated 1-2% every year for the past thirty years (Giordano, 2004). However, during the Covid-19 pandemic, rates of basic cancer screenings, including breast cancer, all declined (Chen, 2021). Unfortunately, even in a “post-pandemic” world, years after the height of the pandemic, the Rowan-Virtua School of Osteopathic Medicine Family Medicine Office has noticed many female patients still have not kept up with their routine basic healthcare screenings. While there are many barriers in access to healthcare, this survey-based study aims to uncover the rates of mammograms and barriers affecting patients’ completion of Breast Cancer screenings since the Covid-19 pandemic. A fourteen question survey was distributed to 65 female patients between the ages of 40 and 75, in a Suburban Family Medicine Office. The survey responses were analyzed and the findings provide insight on the barriers hindering patients from conducting their annual mammograms. 58.46% of participants did not complete their annual mammogram screening in the recommended time frame. The largest variation of responses as to why women did not complete their mammogram regarded the time commitment of appointments. Even though we are technically in a “post-pandemic” time, there is still a gap in participation in routine screening exams. This data informs healthcare providers about the barriers in preventative healthcare and will help providers better understand patients’ needs to improve women’s health outcomes
Investigating the Efficacy of Myo-Inositol in Adolescents with Polycystic Ovary Syndrome: A Scoping Review
Get PDFPolycystic ovary syndrome (PCOS) affects approximately 6 to 13% of adolescent girls in the United States.6 PCOS poses difficulty with diagnosing and treatment with adolescents as its symptoms are heterogenous and are often rationalized with other diagnoses. Key diagnostic features of PCOS include irregular menstruation, infertility, obesity, hirsutism, increased risk of diabetes mellitus, hypertension, lipid abnormalities and metabolic syndrome.12 Currently, there are no pharmacological therapies approved by the FDA to treat PCOS.5 Alternatives include pharmacological management of symptoms with medications like combined oral contraceptive pills, metformin and anti-obesity agents.6 Recently, more discussion about the lack of PCOS treatment has been circulating social media sites like TikTok and Youtube, platforms that have large adolescent audiences. With this discussion, there has been a large focus on using myo-inositol (MI), a supplement that is available over the counter, to treat PCOS. MI is a manufactured derivative of the body’s inositol that is used to reduce insulin resistance, improve ovarian function and lower androgen levels in females with PCOS.4 Understanding the efficacy of MI is vital across all medical specialties, as its mechanism affects the entire body and overall health
‘Not So Atypical’: An Atypical Presentation of West Nile Virus and Guillain-Barre Syndrome
Get PDFGuillain-Barre Syndrome (GBS) is defined by acute areflexic paralysis, usually starting in the distal lower extremities, and ascending to the upper extremities. It is associated with albuminocytologic dissociation, which involves elevated protein levels and normal cell counts in the cerebrospinal fluid. One of the types of GBS, called Miller-Fischer Syndrome (MFS), is characterized by ophthalmoplegia, ataxia, and areflexia. This case report focuses on a 49-year-old male with an atypical presentation of Guillain-Barre syndrome. Guillain-Barre syndrome can be classically caused by Campylobacter jejuni. However, there can be other infectious causes as well, namely Cytomegalovirus, Epstein-Barr virus, Varicella-Zoster virus, Mycoplasma pneumonia. The aim of this case report is to highlight another infectious cause for Guillain-Barre syndrome – West Nile Virus. Little data is available with respect to West Nile Virus being the cause of GBS. However, our case suggests that West Nile Virus should be in the differential diagnoses for patients presenting with GBS symptoms
Quincke’s Phenomenon – The ACE Inhibitor Culprit
Get PDFAngioedema is defined as a non-pitting edema that involves the subcutaneous layer and additionally may include submucosal layers of tissue which pertain to the face, oral cavity, larynx, lips, extremities and gastrointestinal tract; this becomes a life-threatening situation particularly when there is involvement of the larynx. Angioedema may be classified as either histamine-mediated or bradykinin-mediated. Histamine-mediated, associated with mast-cell and basophil activation, is the most common. Bradykinin-mediated (secondary to hereditary, acquired C1-inhibitor deficiency, ACEI-associated angioedema) occur when an allergic reaction and hives will not trigger this reaction. The C1-inhibitor is a regular of the complement system and either dysfunction or lack thereof of the inhibitor itself will result in an excess of kallikrein, which results in the proteolysis of high-molecular-weight kininogen and bradykinin; this cascade leads to increased edema and vascular permeability. Associated angioedema results from the decreased degradation of bradykinin. This spiral cascade involving plasmin, XIIa and kallikrein leads to generation of bradykinin and edema. Since this process is not clearly a distinct disease, nor simply a syndrome, we refer to it as a phenomenon
DEVELOPMENT OF A XENOGRAFT FOR ANNULAR REPAIR USING PULSED ELECTRIC FIELD EXPOSURES FOR ENHANCED DECELLULARIZATION
Get PDFSevere back injuries and chronic pain necessitate surgical replacement of damaged intervertebral disc (IVD) cartilage in advanced disease stages. Bovine IVD tissue has been exposed to an upper threshold pulsed electric field (PEF) dose, causing cell death without thermal damage to the tissue. Subsequent PEF exposures at lower magnitudes have accelerated the removal of immunogenic biomolecules though electrokinetic extraction using optimized aqueous solutions. This approach yields a natural scaffold, ready for biocompatibility and mechanical strength assessment. The effects of microsecond pulsed electric fields (µsPEF) on primary bovine AF fibroblast-like cells have been characterized in vitro. PEFs of 10 and 100 µs durations, with varying numbers of pulses and electric field strengths, were applied to the cells. Furthermore, a low-intensity and minimally heating PEF-induced electrokinetic flow for molecular extraction has been established, involving the determination of the electrophoretic mobility of charged molecules within the AF cartilage tissue. Ultimately, a biocompatible AF scaffold has been generated using PEF and electrolyte solutions in a custom-designed bioreactor. Compared to chemical methods that take days, PEF application achieves decellularization of cartilage tissue within three hours, while preserving the desired biomolecules and ultrastructure of the tissue matrix
Medial Patellofemoral Ligament Augmented With a Reinforced Bioinductive Implant Is Biomechanically Similar to the Native Medial Patellofemoral Ligament at Time Zero in a Cadaveric Model
Get PDFPurpose: To biomechanically compare primary medial patellofemoral ligament (MPFL) repair (MPFLr) augmented with a reinforced bioinductive implant (RBI) to the native MPFL ligament and a semitendinosus (semi-T) MPFL reconstruction (MPFLR) at time zero. Methods: Four fresh-frozen matched pair cadavers (8 knees) were used to biomechanically compare the native MPFL to augmented MPFLr (n = 4) and semi-T MPFLR (n = 4). The native MPFL (n = 8) was isolated, preserving the femoral and patellar attachments, and pulled to failure. The semi-T was harvested from 1 of the matched pairs and whipstitched, as was a 250-mm × 5-mm RBI. A standard double-bundle docking technique was utilized. The patella was potted and mechanically pulled parallel to the transverse axis until failure in both cohorts. Cyclic creep, load and displacement at failure, failure mode, and stiffness were recorded. Results: Failure load was highest in the RBI with repair group (287 ± 130 N) compared to the native MPFL (219 ± 64 N) and the semi-T group (84 ± 29 N). No statistically significant difference in failure load between the RBI augmentation with repair group and the native ligament (P = .19) were found. The semi-T reconstruction group failed at the least amount of displacement (7.93 ± 3.4 mm) compared to the native MPFL (20.9 ± 9 mm) (P \u3c .01) and the RBI with repair group (33.2 ± 17.7 mm) (P \u3c .02). At 10 mm of displacement, the RBI group (8.3 ± 1.2 N/mm) demonstrated stiffness in the midrange compared to the native MPFL (14.1 ± 7.1 N/mm). Early anchor/tendon pullout failure on the patella side was noted in the semi-T group compared to the RBI group. One reconstruction was excluded from analysis due to poor bone quality. Conclusions: No statistically significant difference was seen between the augmented MPFL repair and the native MPFL in load-to-failure testing. The augmented MPFL repair was observed to have biomechanical properties similar to the native MPFL. MPFLr with RBI augmentation provided consistent stiffness at clinically relevant displacement. Clinical Relevance: Primary MPFL repair and reconstruction using the semi-T graft, while effective, are nevertheless imperfect procedures. MPFL repair has been shown to have higher instability recurrence rates, while the stiffness profile of MPFLR with semi-T is higher than the native MFPL and may lead to knee stiffness, loss of motion, or cartilage damage. The results of this time-zero biomechanical study indicate that the use of an RBI for augmentation of a primary MPFL repair may be a viable alternative to traditional MPFL repair or reconstruction using a semi-T graft
3D BIOACTIVE THIOL-NORBORNENE HYDROGELS FOR GUIDING STEM CELL MECHANOSENSING AND DIFFERENTIATION
No full textHydrogels are soft, highly hydrated polymeric networks commonly used as biomaterial scaffolds in tissue engineering. To mimic the extracellular matrix of tissues, hydrogels can be chemically modified to incorporate either bioactive molecules such as peptides, or physically modified with crosslinkers to alter hydrogel stiffness and degradation. Hydrogels with defined characteristics can be synthesized using chemical reaction schemes such as photo-click chemistry, which offers spatial and temporal control over biochemical and physical properties. The goal of this thesis is to leverage thiol-norbornene click chemistry, a subtype of photo-click chemistry, to develop 3D hydrogels with biochemical and biophysical cues that guide mesenchymal stem cell (MSC) mechanosensing and differentiation. Macromers from either naturally derived (hyaluronic acid, HA) or synthetic (polyethylene glycol, PEG) origin were modified with norbornene groups (Nor) and covalently crosslinked with di-thiolated molecules to form hydrogels amenable to biochemical functionalization with mono-thiolated peptides. PEG-Nor and HA-Nor hydrogels demonstrated a broad range of mechanical properties and were functionalized with adhesive and bone-inducing peptides to promote MSC adhesion and to guide 3D osteogenic differentiation. The thiol-norbornene hydrogels designed in this thesis are highly tunable and serve as a cell-culture platform with broad applications in studying 3D cellular mechanosensing and in developing bone-producing materials
Distracted Driving: Identification, Contributing Factors, and Safety Countermeasures
No full textDistracted driving is a hazardous behavior responsible for 25% of all fatal traffic crashes in New Jersey. While traditional methods such as surveys, videos, and simulations have been used to identify and evaluate distracted driving events, these approaches primarily provide cross-sectional data that fails to capture the true rate of distraction on the road. This study addresses this limitation by collecting longitudinal data on distracted driving events across selected corridors in New Jersey. A data collection team continuously drove through these corridors, manually counting and video recording driver distraction events. The collected data was then analyzed to assess the significance of various temporal features and geometric roadway features on the distraction rate. Additionally, video data from the observational study was used to detect driving behaviors using a deep learning algorithm. The study further examined drivers\u27 involvement in distraction in conjunction with other risky behaviors, such as speeding and seatbelt non-compliance. An incident-crash equivalence analysis was performed to identify distraction hotspots. The effects of vehicle type, driving lane, adverse weather conditions, and high visibility enforcement campaigns on distraction were analyzed. The findings of this study revealed that cellphone use is the most prevalent form of distraction. Distractions like receiving calls, grooming, and talking to passengers were significantly influenced by the time of day and roadway type. The results suggest that law enforcement and awareness campaigns should focus on roads with positive medians, wider shoulders, and signalized intersections. Additionally, the study recommends targeted countermeasures for specific conditions such as speeding, fast lane driving, adverse weather, and seatbelt non-compliance to effectively reduce distracted driving in New Jersey