Medical Scholar Explorers Class of 2023

Lena Ayari, M2 student at the College of Medicine, is co-authoring a review article over super-refractory status epilepticus under the guidance of Batool Kirmani, MD, FAAN, FAES, Affiliated Clinical Professor at Texas A&M University College of Medicine and Director of the CHI St. Joseph Health Epilepsy and Functional Neurosurgery Program. Super-refractory status epilepticus (SRSE) is defined as status epilepticus that persists despite general anesthesia treatment for 24 hours. SRSE is a serious condition due to the high potential for morbidity and mortality, with a mortality rate between 30 and 50%. These patients are at risk for neuronal injury and death as a result of failure to terminate seizure activity. Their review concentrates on current therapeutic approaches for SRSE, the challenges and prognosis of this condition, as well as future directions for therapy.

Sonali Batta, M1 student at the College of Medicine, is conducting a research study investigating the changes in bowel morphology after spinal cord injury (SCI) in the laboratory of Cédric Geoffroy, PhD and Assistant Professor in the Department of Neuroscience and Experimental Therapeutics at the Texas A&M College of Medicine. The general term for clinicians, for decreased bowel functioning caused by neurological disease or injury is neurogenic bowel dysfunction (NBD). Remarkably, NBD is observed in up to ~60% of SCI individuals. SCI has been shown to induce NBD because the thoracolumbar region of the spinal cord and sacral nerves coordinate colonic reflexes through sympathetic, parasympathetic, and enteric neural circuits. The most debilitating symptoms observed in NBD patients include severely decreased fecal transit through the colon, fecal incontinence, and chronic constipation. Various factors are thought to influence the regulation and motility of the colon wall, such as collagen accumulation, muscle thickness, quantity of myenteric neurons, and colonic mucosal crypt depth. Thus, a thorough histological analysis is needed to understand the specific changes in bowel morphology in distinct SCI animal models. We predict that NBD changes may have consequences on nutrient absorption, amount of stool, hormone secretion, and other body functions controlled by the spinal cord nerves. We anticipate that our results may be used to guide the customization of more effective and direct therapies in patients that will promote overall peristalsis post-SCI.

Lokeshwar S. Bhenderu, M1 student in the College of Medicine, is conducting a research project investigating the teratogenic effects of concurrent exposure of alcohol and cannabinoids (CBs) on the developing fetus under the guidance of Rajesh Miranda, PhD, a Professor at Texas A&M College of Medicine. Prenatal exposure of alcohol and CBs can lead to abnormalities ranging from craniofacial dysmorphologies to brain malformations and intellectual disabilities. Therefore, the teratogenic effects of prenatal exposure to alcohol and CBs has been heavily investigated, but the vast majority of studies considered the consumption of alcohol and CBs independently. More recent epidemiological studies have shown that concurrent use of alcohol and CBs, colloquially termed ‘cross-fading’, during pregnancy is significantly high and continues to rise as more states legalize recreational marijuana. Their project aims to investigate the mechanism by which the co-abuse of CBs and alcohol during pregnancy effect fetal development.

Jared Eichner, M1 student in the College of Medicine, is conducting a research project investigating illustrated storytelling in medicine, under the guidance of Barbara Gastel, MD, MPH, Professor of Veterinary Integrative Biosciences and of Humanities in Medicine, and Coordinator, MS Program in Science and Technology Journalism. This project includes seeking medical examples in the work of Theodor Seuss Geisel (1904-1991). Findings to date include the following: Geisel worked as a political cartoonist, animator, and screenwriter, as well as being the author and illustrator of dozens of children’s books under the pen name Dr. Seuss. Additional books, some under other pseudonyms, were collaborations with other writers and/or illustrators. At least four examples of Geisel’s work related specifically to medicine. These include three items, all to train soldiers in malaria prevention, from Geisel’s work as a World War II Army captain. They also include You’re Only Old Once! A Book for Obsolete Children, which was released on Geisel’s 82nd birthday. In this book, a senior patient, perhaps a fictionalized Geisel, endures endless waits, an Eyesight and Solvency Test, and inspections by the doctors on Stethoscope Row. Regardless of whether his work falls within the strict definition of graphic medicine, Geisel has masterfully combined multiple comic images and text to tell medically relevant stories.

Uyioghosa Evbayiro, M2 student in the College of Medicine, is conducting a research project under the guidance of Rahul Srinivasan, PhD Assistant Professor in the Department of Neuroscience & Experimental Therapeutics at Texas A&M College of Medicine. Parkinson’s disease is a common progressive neurodegenerative disorder characterized by the loss of dopaminergic neurons in the substantia nigra pars compacta. Interestingly, S100 calcium-binding protein B (S100B), an astrocytic protein is significantly increased in the serum, CSF, and brain tissue of Parkinson’s patients compared to healthy control subjects. In addition, postmortem human midbrain tissue from Parkinson’s patients display elevated levels of S100B when compared to control subjects.1 Together, these data suggest that the secretion of S100B may be pathognomonic for Parkinson’s disease. Recent work in the lab has also shown that extracellularly secreted S100B alters the frequency of spontaneous calcium fluxes in dopaminergic neurons via voltage-gated calcium channels. This further suggests that S100B can induce dopaminergic neuron death by pathologically altering the pacemaking activity of dopaminergic neurons. Thus, understanding the mechanisms by which astrocytes secrete abnormal levels of S100B is critical for developing translatable neuroprotective drugs to treat early-stage Parkinson’s. The goal of this project is to determine the signal sequences in S100B that are responsible for its secretion. We will delete a putative secretion sequence from S100B and compare the extent to which the sequence governs extracellular S100B secretion using the transfection of plasmids, tissue culture, and western blot analysis. Identification of these signal sequences will be a critical step for understanding the molecular mechanisms regulating S100B secretion and is anticipated to give insight for the development of future therapeutics that potentially impede or significantly delay the progression of Parkinson’s disease.

1. Sathe K, Maetzler W, Lang JD, et al. S100B is increased in Parkinson's disease and ablation protects against MPTP-induced toxicity through the RAGE and TNF-α pathway. Brain (London, England: 1878). 2012;135(11):3336-3347. DOI: 10.1093/brain/aws250.

Clyde Fomunung, MBA a M2 student in the College of Medicine, is conducting a research project under the guidance of Jiang Chang, MD, PhD, FAPS, a Professor and Chancellor EDGES Fellow in the Center for Genomic and Precision Medicine, Institute of Biosciences and Technology (IBT). Their research focuses on investigating the use of a cutting-edge technology, 3-D dynamic Imaging (Vevo3100), in assessing cardiac function in both normal and heart failure mouse models. Over the years, the prevalence of heart failure with preserved ejection fraction (HFpEF) has continued to increase to approximately 50% of all heart failure diagnoses in the U.S. Despite numerous efforts, little progress has been made towards improving the prognosis of patients with this diagnosis. Treatment options for HFpEF are limited but mainly include reducing systolic blood pressure below 120 mmHg through the use of diuretics. Early detection is critical towards prognosis and their research aims to assess whether certain cardiac diseases, especially HFpEF, can be detected at an earlier onset using a sensitive 3-D Imaging System

Jordan Han, M1 student at the College of Medicine, is conducting a retrospective study in the lab of Farida Sohrabji, PhD, Regents Professor and Interim Head of the Department of Neuroscience and Experimental Therapeutics at the Texas A&M College of Medicine. This study will investigate the risk of stroke in breast cancer patients treated with Tamoxifen and Letrozole adjuvant therapies, which are widely used adjuvants in breast cancer therapy. In recent studies, it has been shown that breast cancer patients are at increased risk for cardiovascular accidents before and after cancer treatment, but it is not clear whether it is due to the cancer itself, or the cancer treatments. Estrogen is believed to be a cardio- and neuroprotective factor in young women and Tamoxifen and Letrozole disrupt estrogen synthesis and estrogen signaling, suggesting a possible mechanism by which these therapies may increase cerebrovascular accidents. This study will examine their incidence of cerebrovascular accidents specifically within the breast cancer victim population and is expected to shed light on the impact of standard chemotherapies on stroke risk.

Jeremiah Ling, M1 student in the College of Medicine, is conducting a research project under the guidance of Mark Faries, PhD, an Associate Professor at the Texas A&M AgriLife Extension Service. Their research focuses on the important role that lifestyle plays in patient health, and the physician-patient relationship. They hypothesize that what we eat, how we live, and the factors that influence lifestyle are critical for patient health outcomes. Their project focuses on the opinions that patients and healthcare providers hold in regards to what constitutes a “healthy” diet, and the availability and likelihood of healthy eating habits. With chronic disease on the rise, constituting the greatest health burden to most industrialized nations, the importance of analyzing diet habits is a first step in generating population changes in lifestyle. We will survey study participants about their opinions on healthy eating, the financial cost of eating healthy diets, and other barriers. This survey will be administered prior to a training that will aim to equip and debunk stereotypes that impede healthy eating. Following this training, a second survey will be administered to measure the efficacy of training exposure. Our project is anticipated to help change the eating habits paradigms, and thereby reduce the burden of preventable chronic diseases such as Type II diabetes, morbid obesity and others.

Peter Park, M1 student in the College of Medicine, is co-writing a scholarly manuscript for peer-review under the guidance of Pooneh Bagher, PhD, Assistant Professor in the Department of Medical Physiology at Texas A&M College of Medicine. Their study focuses on how the sympathetic nervous system modulate arteriolar tone through release of neurotransmitters such as norepinephrine and ATP, which act on adrenergic and purinergic receptors, respectively. Recognition of subtle differences in the adrenergic and purinergic signaling pathways of two common wild-type rodent strains reveals a knowledge gap on the signaling pathways involved in the normal physiology of isolated human mesenteric arteries. Detailed comparison of the mice and rat animal models studied here will inform the best model to use in future studies for human mesenteric pathology and other cardiovascular diseases.

Caren Stuebe, M1 student in the College of Medicine, is designing a clinical research project investigating adverse outcomes in cauda equina syndrome under the guidance of Gerard Toussaint, MD, an Assistant Professor at Texas A&M College of Medicine and Licensed Neurosurgeon at The Texas Brain and Spine Institute. Cauda equina syndrome is a surgical emergency caused by a compression of the cauda equina in the lumbosacral spinal canal. Untreated, cauda equina syndrome can result in muscle paralysis in the lower extremities and fecal and urinary incontinence. Emergency surgical treatment for cauda equina syndrome involves a full laminectomy and discectomy, both common treatment surgeries for lumbar stenosis and radiculopathy, respectively. Their research project aims to investigate complications from these surgeries in application to cauda equina syndrome.

Sara Yasrebi, M2 student in the College of Mecicine, participated in a research project in Lifestyle Medicine to query a physician’s role to improve patient health by referring to community-based nutrition education, under the guidance of Mark D. Faries, PhD, Associate Professor at the Texas A&M AgriLife Extension Service, and Adjunct Faculty within the Health Science Center. Dietary risks are the leading risk factor for premature death in the United States, with greater disparities in low-income and rural families without adequate access to quality healthcare and quality, nutritional education. Lifestyle Medicine is the evidence-based, lifestyle therapeutic approach to prevent, treat and reverse lifestyle-related disease. While physicians might feel that nutritional counseling is within the realm of their care, many have barriers to implement nutrition-based education in practice, and depend on community-based, nutrition education programs designed for at-risk populations. The objectives of this study were to (1) identify a physician's ability to locate community nutrition education programs, and (2) identify which programs could positively impact the health care outcome of their patients. Our findings showed that while certain key words yielded a higher proportion of relevant results, the proportion of pertinent nutrition programs found within the first 10 results were low. The phrases with the largest proportion of results within the first 2 pages (> 75%) were “community education nutrition programs low-income” and “diet nutrition education programs low-income Texas”. The addition of “low-income” to the search phrase produce a more data, while the addition of “rural” or “programs” were not helpful. These findings reinforce the idea that a strategically-phrased Google-search and proper evaluation of such results poses a short-term fix to the high-demand and low-supply of formally-educated nutrition advising by physicians.