Medical Student Submissions [P – S]

Nischal Praveen
nprave3@uic.edu
Chicago Campus

Background: Extraction of unstructured and semi-structured medical data is a key prerequisite for the application of bioinformatics. Portability, scalability, and protection of health information remain key problems in data analytics in medicine that cannot easily be solved using machine learning techniques alone, highlighting the importance of multi-faceted approaches.

Research Question: Can rule-based algorithms reliably identify and extract transthoracic echocardiographic (TTE) report findings for use in a data analytics pipeline?

Methods: Deidentified adult TTE reports were obtained between 09/14/2020 to 03/30/2023 within a single urban academic healthcare system. A rule-based algorithm was developed using derivatives of regular expressions in R to capture chamber parameters, cardiac function, and valvular disease. The accuracy was evaluated in a subset of manually adjudicated reports by study cardiologists.

Results: In 1000 reports, 23079 (78.4%) data points were obtained out of 29423 maximal data points for 37 variables. Out of 803 manually verified NA data points, 743 (92.5%) were accurate. The mean net accuracy of all variables was 99.8%. Continuous data points showed 100% accuracy. 7.5% of NA data points were inaccurate with most errors in categorical variables.

Conclusions: A rule-based algorithm is effective at converting cardiologist-read TTE reports into datasets ready for use data analytics.

Michael Pudlo
mpudlo2@uic.edu
Peoria Campus

Background: Antimicrobial resistance (AMR) presents a global health crisis with significant impacts on both high- and low-income populations. This study investigates community awareness of AMR in Peoria, focusing on socioeconomic disparities and their influence on AMR risks through a knowledge, attitudes, and practices (KAP) survey.

Methods: The validation surveys were conducted in person with participants from two clinics serving different socioeconomic groups to document the time to complete the survey, participants’ impressions, and areas of confusion. Subsequent data from the validation surveys was analyzed to establish preliminary associations between income status and KAP.

Results: Preliminary descriptive analysis showed that participants in both high and low-income groups were inconsistent in correctly determining if common illnesses can be treated with antibiotics. The majority of participants (13/21) have not heard of terms used to describe AMR. Most participants (19/20) in both groups agree that doctors should only prescribe antibiotics when needed, while only the majority of high-income participants (8/10) agree that everyone should take responsibility for taking antibiotics responsibly.

Conclusion: Additional surveys will determine if the trend of low KAP surrounding AMR is prevalent in Peoria. As of now, both high- and low-income groups in Peoria could benefit from education on how common illnesses are treated, as well as the importance of being aware of AMR.

Jett Ramir
jettar2@uic.edu
Peoria Campus

Nocardia is a genus of nearly 50 species of bacteria that are characterized as gram positive, aerobic, branching-filamentous organisms that stain partially acid-fast. Cutaneous Nocardiosis is an uncommon manifestation of Nocardia infection typically seen in immunocompetent hosts.

A 69 year old woman with a history of bilateral lung transplantation consulted her primary care physician regarding a skin rash. Over the next day, the rash had gotten worse and painful which prompted the family to bring her to the emergency department. Physical exam in the ED showed painful pustules and subcutaneous nodules along the chest. Initial workup in the hospital was negative. On the third day of hospitalization, the lesion culture was positive for Nocardia cyriacigeorgica. Treatment could not include Trimethoprim-Sulfamethoxazole since the patient had a history of allergy to sulfa drugs. A multi-drug regimen was started with Imipenem and Linezolid. Subsequent workup was positive for Cryptococcus in the cerebrospinal fluid, and greater than 1 million copies of BK virus in the Urine. Whole body PET CT elicited numerous hypermetabolic foci of infection, concerning disseminated infection.
This is the first case report to describe cutaneous presentation of disseminated Nocardia cyriacigeorgica in the US, to our knowledge. This report also presents a challenging treatment plan, highlighting the use of multidrug regimens when Trimethoprim-sulfamethoxazole is not indicated.

Allison Raymundo
araymu2@uic.edu
Chicago Campus

Background
The Patient Activation Measure (PAM) and Perceived Stress Scale (PSS) are crucial for understanding patients’ abilities to manage their health and stress. PAM evaluates a patient’s knowledge, skills, and confidence in managing their health, while PSS assesses perceived stress levels.

Aims
This study aims to analyze the relationship between PAM and PSS in an older, urban, obese patient population and to identify if and how these measures and their relationship differ based on demographics such as race, education, and income.

Methods
The study utilized baseline self-reported data from 504 participants in the Project on EHR-Integrated Lifestyle Interventions for Adults Aged 50 and Older (PIVOT). Data included age, sex, race, education level, annual income, BMI, and Type 2 diabetes diagnosis.

Results
Analysis revealed a significant negative relationship between PAM and PSS. This relationship was consistent across income, education, and race. Level 4 PAM was associated with high income and education, while low stress correlated with increased age and education.

Conclusion
The study underscores a significant inverse relationship between patient activation and perceived stress, consistent across demographic factors. Understanding this relationship can help healthcare providers develop tailored interventions and empower healthcare systems to support patients in reducing stress and increasing activation, ultimately leading to improved health management and quality of life.

Allison Raymundo
araymu2@uic.edu
Chicago Campus

Introduction:
The representation of skin of color in dermatology education is crucial for preparing future physicians to recognize dermatologic conditions across diverse populations. This study surveyed the University of Illinois Class of 2027 medical students at the end of Block 3 to assess their perceptions of skin of color representation in their dermatology curriculum.

Methods:
Approximately 300 students across three campuses (Chicago, Rockford, Peoria) were invited to participate, with 35 responses collected. Using a primarily Likert-scale format, the survey evaluated the perceived adequacy of curriculum representation and preparedness to diagnose dermatologic pathology in the skin of color.

Results:
Results revealed that 40% of respondents agreed or strongly agreed that the current curriculum adequately represents all skin colors. However, only 17% felt prepared to recognize adult skin conditions across all skin types, 11% felt prepared for pediatric skin conditions, and 31% felt informed about hair disorders specific to various hair types. Furthermore, 57% reported an understanding of skin cancer risk across skin types. Notably, 94% expressed interest in using VisualDx to enhance their competency in recognizing skin conditions on skin of color.

Discussion:
In conclusion, the findings suggest that students feel inadequately prepared to care for patients of color in dermatologic contexts, though limitations such as a low response rate may introduce bias.

Allison Raymundo
araymu2@uic.edu
Chicago Campus

Student feedback is essential to medical education, providing insight into curriculum effectiveness and instructional quality. However, low response rates hinder the utility of these evaluations. To address this challenge, the University of Illinois College of Medicine implemented a QR code intervention during Blocks 5 and 6 for the Class of 2027. A QR code linked to the Evaluations platform was placed on the first and last slide of every lecture to simplify access and serve as a visual reminder to submit feedback.

The effectiveness of this intervention was assessed by comparing feedback submission rates and average comments per lecture between the Class of 2026 (control) and Class of 2027 (intervention). In Blocks 1-4, submission rates averaged 15% for the Class of 2026 and 17% for Class of 2027, with no significant difference (p = 0.10). Comments per lecture averaged 7.3 for the Class of 2026 and 10 for Class of 2027, with marginal significance (p = 0.05), establishing baseline comparability between the classes.
In Blocks 5-6, submission rates averaged 7% for the Class of 2026 and 12% for Class of 2027 (p < 0.001). Comments per lecture averaged 1.6 for the Class of 2026 and 4.3 for Class of 2027 (p < 0.001).

These results suggest the QR code intervention improved feedback participation during Blocks 5 and 6. This low-cost strategy shows promise for enhancing student engagement and generating actionable data to support curriculum improvements in medical education.

Allison Raymundo
araymu2@uic.edu
Chicago Campus

The Clinical Executive Medicine (CEMED) program is a 4-year elective curriculum designed to equip medical students with the skills necessary to address challenges in healthcare administration, policy, and clinical practice. This study evaluated the program and identified areas for improvement via a survey of students across 3 campuses that assessed students’ motivations, satisfaction with program components, and alignment of expectations with experiences.

Students reported joining CEMED to develop leadership skills, understand healthcare systems and management, engage in hands-on experiences, and receive training in health policy and public health. Quantitative analyses showed mixed satisfaction, with seminar content (3.66/5) and mentorship (3.64/5) rated highest. Students indicated a need for clearer expectations, greater structure, and more hands-on learning. Only 33.3% of students reported a sense of community, citing remote learning and low in-person attendance as barriers. Mentorship was identified as critical to satisfaction, though concerns about mentor communication and alignment with student interests were notable.
While CEMED provides valuable content and mentorship, enhancements in program structure, cohort engagement, and experiential learning are needed. Recommendations include implementing an orientation, incentivizing in-person participation, refining the mentorship match process, and clearer guidelines for capstone projects to better meet program objectives.

Meghana Reinhardt
msharm22@uic.edu
Rockford Campus

Domestic violence (DV) is a global public health crisis with severe long-term healthcare consequences. Despite frequent interactions with DV victims, healthcare providers often lack the training to address these cases effectively. This study evaluated the impact of a DV training on medical students’ knowledge and confidence in five domains: recognizing DV victims, understanding DV-related knowledge, using screening tools, referring patients to services, and teaching others. A pre-post study design was employed with n=65 first and second-year medical students who participated in a training developed in collaboration with the Family Peace Center. Participants completed pre- and post-training surveys evaluating knowledge and confidence. Quantitative data was analyzed using descriptive statistics and paired t-tests, while qualitative feedback informed future interventions. The training significantly improved scores across all domains, with an average increase of 1.63 points (Mean Pre = 2.25, Mean Post = 3.88, p < 0.001), with largest increases in Screening (Mean Difference = 1.86, Cohen's d = 2.74) and Teaching (Mean Difference = 1.74, Cohen's d = 2.05). Qualitative responses highlighted the importance of practice, such as standardized patient encounters, to reinforce skills. This study demonstrates the effectiveness of tailored training and advocates for integrating such programs into medical curricula to improve healthcare providers' readiness and future patient outcomes.

William Reiser
wkr2@uic.edu
Rockford Campus

Total hip arthroplasties (THAs) are a generally well accepted and long lasting treatment option for patients. However, in prolonged use, THAs have been shown to undergo corrosion, of which there are two types: mechanically-assisted corrosion (MAC) and cell-accelerated corrosion (CAC). These two forms of corrosion have been shown to synergistically promote corrosion at the taper junction of THAs. In this system, MAC creates metal debris particles that are phagocytosed by macrophages and osteoblasts, allowing for the creation of reactive oxygen species and further corrosion through CAC. A knowledge gap exists concerning how cells arrive at the taper junction to participate in CAC. In this study, we aim to further understand the mechanism by which cells migrate to the taper junction to engage in CAC through a novel technique. A 3D bioprinted gelatin methacrylate (GelMA) scaffold will be used to accurately replicate the in vivo dispersal of corrosion debris. We hypothesize that the presence of cobalt-chromium (CoCr) particles and ions will induce the migration of osteoblast-like (MG63) cells toward the source of particles, in a manner similar to the migration of cells in vivo during CAC. The objective of this study is to observe the migration of MG63 cells toward CoCr particles and ions as a model for unveiling the cellular migration into the THA taper junction during CAC. Results from this study explain the migration mechanism cells use to enter the taper junction of THAs.

Lauryn Remmers
lremme2@uic.edu
Peoria Campus

Background: Climate change poses significant threats to public health, yet medical student education on health impacts is limited. As future healthcare providers, it is crucial that students understand how to identify and address these issues. This study aims to evaluate the efficacy of a climate change education event in improving medical students’ understanding of the health impacts of climate change and confidence in addressing these issues in clinical practice.

Methods: 8 medical students at the University of Illinois College of Medicine Peoria participated in a 1-day event featuring clinical cases from the Climate Resources for Health Education, an open-source, peer-reviewed climate change and health curriculum, and a guest speaker. Pre- and post-event surveys measured understanding and confidence in addressing climate change’s health impacts using a Likert scale. Quantitative responses were analyzed using Wilcoxon Signed Rank Test. Qualitative assessments were collected post-event.

Results: Students demonstrated improved understanding in how healthcare contributes to climate change (p<0.05). Qualitative responses highlighted appreciation for learning about air pollution, diabetes and climate change anxiety.

Conclusion: A 1-day climate change education event improved medical students' understanding of healthcare's role in climate change and highlighted unique health connections, emphasizing the value of integrating climate change topics into medical education.

Dalton Rogers
droger20@uic.edu
Rockford Campus

Lung cancer is a leading cause of cancer mortality in the US, with 234,580 new cases and 125,070 deaths projected in 2024. SphK2, which is upregulated in NSCLC, phosphorylates Sphingosine to Sphingosine-1-Phosphate. Upregulation of SphK2 is correlated with worse patient outcomes. Therapies to inhibit Tyrosine Kinase (TKIs) have shown to be effective, however TKI resistance occurs after 6 to 19 months. This study investigates the role of SphK2 in NSCLC tumorigenesis and its potential as a therapeutic target. IF studies demonstrated increased SphK2 expression (2.5 to 2.6 fold p<0.02) in NSCLC cell lines compared to parental cell lines. 3D bioprinted spheroids treated with SphK2 inhibitors (SphK2I) and Osimertinib (OR) resulted in a reduction in spheroid formation by 87.3% and 78.2% when compared to OR alone or Sph2KI alone, respectively (p<0.001). Similar results were found with siRNA knockdown. Additionally, after siRNA knockdown EMT biomarkers Vimentin and N-cadherin were downregulated (5-3.3 fold respectively) and E-cadherin was upregulated 1.8 fold when compared to the Mock (p<0.05) indicating its role in EMT. IHC revealed elevated SphK2 expression in late-stage NSCLC tumor samples compared to early-stage samples (p<0.01). Higher expression of SphK2 in tumor samples was correlated with reduced patient survival when compared to lower expression (50.0 vs. 34.0 months respectively, p<0.05). This shows, SphK2 inhibition reduces tumor growth and overcomes OR resistance in NSCLC.

Ryan Rutherford
rruthe3@uic.edu
Chicago Campus

This study evaluates the impact of GLP-1 receptor agonists (GLP-1 RAs) on postoperative outcomes for patients undergoing total shoulder arthroplasty (TSA). GLP-1 RAs such as semaglutide and liraglutide have become increasingly popular anti-obesity medications despite initially being prescribed to treat type 2 diabetes. It is crucial to understand how these medications impact surgical outcomes as the rates of diabetes, obesity, TSA surgery, and GLP-1 RA usage all continue to increase. This retrospective cohort study analyzed 86,926 patients who underwent primary TSA between 2010 and 2022. The TSA control and TSA GLP-1 RA group were matched for age, gender, ECI, CCI, diabetes, hypertension, and obesity. Patients in the GLP-1 RA group were 38% less likely to visit the ED within 90 days, 30% less likely to experience a surgical site infection, and 62% less likely to require a postoperative blood transfusion. GLP-1 RA users were also 44% and 31% less likely to experience a pulmonary embolism or urinary tract infection, respectively. However, GLP-1 RA users were 13% more likely to experience acute kidney injury compared to the control group. The results illustrate the potential role of GLP-1 RA usage in the perioperative period to help mitigate TSA complications. Further research should investigate the optimal dosage, patient selection protocol, and timing of GLP-1 RA administration relative to surgery.

Ryan Rutherford
rruthe3@uic.edu
Chicago Campus

Sun exposure is necessary to maintain proper vitamin D levels, but excessive exposure can put individuals at risk of developing skin cancer. People who purposely avoid sun exposure due to concerns of skin cancer and those who inadvertently get less sun exposure because of where they live are both at an increased risk of vitamin D deficiency, osteoporosis, and hip fracture. This study explores the comparative risks and outcomes associated with these conditions, as hip fractures have a one-year mortality rate of over 20% in elderly populations. This retrospective cohort study used PearlDiver to access electronic health records of patients diagnosed with basal cell carcinoma, squamous cell carcinoma, and a matched cohort without skin cancer. Individuals with skin cancer were 22% less likely to have sustained any type of fragility fracture (OR 0.79, p<0.001), 50% less likely to have a hip fracture (OR 0.5, p<0.001), and 26% less likely to have a spine fracture (OR 0.74, p<0.001). Conversely, the skin cancer group was 21% more likely to experience a forearm fracture (OR 1.21, p<0.001). Our findings support the large body of literature that emphasizes the importance of vitamin D in bone health while highlighting the need for more balance in public health messaging regarding sun exposure in elderly individuals. Certain health risks, such as hip fracture, may be overshadowed by more publicly advertised conditions like skin cancer despite its extremely low mortality rate.

Justin Ryk
jryk@uic.edu
Chicago Campus

Among singers, there is a belief that certain musical styles are more harmful and increase the risk of vocal pathology. Prior studies have suggested correlations between vocal performance style and pathology but often fail to account for medical comorbidities and lifestyle factors that also influence vocal health.
We conducted a retrospective cohort chart review of patients seen at the Chicago Institute for Voice Care (2017–2020) to assess whether classical Western (e.g., opera), non-classical Western, or multiple musical styles are associated with a higher relative risk of vocal pathology. Understanding these relationships can help singers better address factors affecting vocal health.

Singers completed questionnaires documenting their vocal practices, while laryngoscopic findings, vocal pathologies, and relevant comorbidities were extracted. Many also completed the Voice Handicap Index (VHI) to evaluate the functional and quality-of-life impact of vocal issues.

Preliminary analysis (2019-2020) included 86 participants (52 females, 32 males). Classical singers had lower average VHI scores than non-classical and multiple-style singers, though differences were not statistically significant. Most singers presented in the mild-to-moderate range. Laryngopharyngeal reflux (LPR) was the most common pathology (70%, 60/86). No significant differences were found in the proportions of vocal pathologies across musical styles. A larger sample size is needed to confirm these findings.

Claire Sagartz
csagar4@uic.edu
Rockford Campus

Hereditary spastic paraplegia (HSP) is a neurodegenerative disease that affects motor neurons, causing patients to develop progressive muscle weakness. SPG11 is the most common autosomal recessive form of HSPs. The SPG11 mutation can be studied in the lab using induced pluripotent stem cells (iPSCs). Potential biomarker for SPG11 are the pTau or Tau proteins. The pTau levels and the pTau:Tau ratio demonstrated a significant increase when measured in iPSC derived neurons from patients with other neurodegenerative disease. The pTau:Tau biomarker can be further tested with the introduction of Drp inhibitors like P110, which have demonstrated therapeutic potential in past studies in SPG11. The aim of this project was to determine whether SPG11 mutation increased the pTau levels and the pTau:Tau ratio in cortical neurons. Another aim of this project was to determine the effect of P110 on pTau and Tau. SPG11 and control iPSCs were differentiated into cortical neurons using established protocol. Biological triplicate independent samples were studied. The concentrations of pTau and Tau were measured in the samples using respective ELISA kits. ANOVA test showed statistically significant increases in pTau and pTau:Tau in SPG11 neurons compared to the control neurons. Moreover, P110 treatment showed a trend in reducing the pTau expression level in SPG11 neurons. The significant increase in pTau and pTau:Tau from our study shows promise for the use of pTau as a biomarker for SPG11.

Aneil Saini
aneil2@uic.edu
Peoria Campus

Background: Surgeons struggle to determine the optimal timing for procedures, perfecting the balance between haste and caution. Severity of pathology, need for optimization, and fear of missing optimal timing are at play, as well as availability of an OR and staff. EGS is fraught with such questions and the impact on mortality and morbidity of operative timing is not unclear.

Methods: Using NSQIP data from 2021 – 2022, EGS procedures including bowel resections and cholecystectomies were identified. Elective cases were excluded. Patients were divided into early, delayed, and late surgery groups with 24-48 hours as the control. Multivariate logistic regression was used to evaluate effect of time to surgery on mortality, and postoperative morbidities while controlling for demographic variables.

Results: Among 81613 patients, odds of mortality was found to be increased in early (5 days) surgeries, but not in delayed (3-5 days). SSIs, sepsis and risk of reoperation were increased in all groups. Septic shock was increased in early and late groups. Readmission was increased in delayed and late groups.

Conclusions: Time to surgery predicts mortality and morbidity. This may be contributed to by non- modifiable factors, especially in the early surgery group. Delayed surgery does not pose a risk for mortality, but incidence of morbidities is elevated. Late surgery confers significantly higher odds of all negative outcomes.

Aneil Saini
asaini7@uic.edu
Peoria Campus

Background: The Model for End-Stage Liver Disease (MELD) score, originally designed to predict 90 day mortality in cirrhotic patients, has potential for stratifying risk in Emergency General Surgery (EGS). EGS involves high-risk procedures often performed in critically ill patients where existing calculators may not fully capture the impact of metabolic derangements. This study evaluates the utility of MELD score for predicting 30-day mortality in patients undergoing urgent/emergent procedures.

Methods: Our retrospective cross-sectional study analyzed patients with calculable MELD Scores undergoing EGS procedures from the NSQIP database (2017-2022) excluding 2020. Model performance was evaluated with c-statistic and Brier score. Logistic regression was used to determine and compare the odds ratio for mortality at each MELD Score. Analysis was controlled for age, race and case type.

Results: MELD showed excellent predictive ability with excellent accuracy (AUC: 0.824; Brier score: 0.0175) for patients undergoing EGS procedures. Absolute and predicted mortality at each MELD Score was assessed and plotted. Odds ratio table at different MELD Scores showed significantly increased mortality odds with increasing score.

Conclusion: The MELD score is a reliable tool for predicting 30-day mortality in EGS, with actionable thresholds to guide preoperative planning. Future work should focus on prospective validation and refining the model for high-risk groups.

Anthony Sanchez-Forteza
asanc@uic.edu
Chicago Campus

Treatment of refractory Grade-I Lumbar Degenerative Spondylolisthesis (LDS) with lumbar spinal stenosis (LSS) has historically involved open decompression with Lumbar interbody fusion (LIF). LIF however is associated with limited postoperative range of motion and increased risk of adjacent segment disease (ASD). Total Posterior Spine System (TOPS) facet arthroplasty was recently introduced as an alternative to LIF with proposed advantages in preserving spinal mobility and stability. Recent studies have shown superiority of TOPS in the management of LDS with improved outcomes and comparable complication rates. The purpose of this study is to report a single-center experience managing LDS with the TOPS system. Average operative time was 175.9 minutes (SD 46.9 minutes). Complications were limited, with an incidental durotomy occurring in 1 patient. Average length-of-stay was 2.8 days (SD 1.2 days). There were no re-operations following initial TOPS facet arthroplasty. Average lumbar segmental lordosis was 10.7° preoperatively and 10.1° at latest follow up. Improved ambulatory capacity and back/leg pain scores were observed in all patients with complete resolution of pain in 5/7 patients. This case series suggests TOPS facet arthroplasty is effective in relieving LDS-associated pain while maintaining close-to-normal range of motion and reducing risk of ASD. TOPS may therefore offer a promising avenue for future treatment of patients with LDS, LSS, or ASD.

Shashank Sandu
ssandu2@uic.edu
Chicago Campus

Electrophysiological manifestations of atrial fibrillation (AF) are readily seen with many electrocardiogram-based (ECG) models developed to predict AF, including genetic risk. We aimed to identify and classify distinguishing ECG features of structural genetic variants linked with AF. We also aimed to improve AF characterization by extracting fibrillatory waves (f-waves), information-rich chaotic atrial electrical activity. In 306 individuals with AF, whole-exome sequencing was done to identify deleterious variants in genes associated with cardiac structural proteins, including ACTC1, DES, MYH6, MYL2, TTNC1, TTNI3, TTNT2, TTN. Deep neural networks (DNN) differentiated between cases of genetic structural mutations and controls without deleterious variants. Atrial electrical activity was extracted from ECGs in SR and AF using adaptive Single Value Decomposition (SVD). From the f-wave signal, approximate entropy (ApEn), root mean square amplitude (RMS), and dominant frequency (DF) were calculated. The individual DNN models had a balanced accuracy between 0.85 to 0.95. Cluster analysis revealed similarity between TTN, ACTC1, MYBPC3, and MYH6 (P<0.001). Common predictive features included the initial phase of the P-wave across variants (P<0.001). We show that ECG-based models provide insight into how different ECG features differentiate between AF mechanisms. DNNs using f wave-derived parameters may improve risk stratification and targeted interventions for those with AF.

Alyson Sato
asato4@uic.edu
Chicago Campus

Despite an overall cervical cancer decline in the US, the NIH reports increased incidence and mortality in low socioeconomic communities. Our prior research showed 50% of UI Health patients’ income is below poverty level and access to fruits and vegetables was the most significant community-level predictor of high-risk human papillomavirus (HR-HPV). We aim to investigate the potential correlation between anemia and cervical precancer lesions among HR-HPV positive patients.

A retrospective electronic medical review of patients who received cervical cancer screenings from April 2016 – January 2019 with pre-screening hemoglobin levels was conducted. Pearson’s chi-squared tests were adopted to assess associations between cervical intraepithelial neoplasia (CIN) results, grouped as negative, low (CIN1, CIN2), and high (CIN2-3, CIN3 and CIS) to HPV results, MCV, and anemia (defined as hemoglobin <11 g/dL).

Of 5,071 that met the criteria, 20.3% were positive HR-HPV of which 80% were HR-HPV Other. Out of 595 patients, 145 cases of negative biopsy, 336 cases of low-grade lesions, and 114 cases of high-grade were included. Low hemoglobin levels before first HPV test were associated with CIN (p=0.049), with 32% anemia in negative CIN, 26% in low CIN, and 39% in high CIN.

Our study suggests a potential link between anemia and high-grade cervical lesions. Prospective study to further establish mechanistic association will help in understanding this link and possible interventions.

Nathan Schuler
nschul20@uic.edu
Chicago Campus

We present a 68 year old patient, seen at multiple tertiary care centers offering radical nephrectomy only. Despite adequate contralateral kidney function, the patient preferred maximal preservation of kidney function.

Using Elucis VR software, we segmented relevant renal anatomy and vasculature. From these 3D models we created hydrogel molds which were subsequently 3D printed and used to cast PVA hydrogels matching the mechanical properties of renal parenchyma, based on prior tensile testing of live tissue.

Two preoperative simulations were performed, with the surgeon identifying areas of heavier vs lighter bleeding prior to live surgery, allowing for dissection of lesser perfused regions first to reduce blood loss. Examination of the resection bed after completion assessed proximity of major arteries, veins and pelvicalyceal system. The patient was called in prior to the procedure for a digital rehearsal with the surgeon and educated broadly on procedural steps, specifics of her case, and anticipated challenges. The procedure was performed successfully, utilizing clamping of the renal artery and vein, with 22 minutes of Warm ischemia time and EBL of 75cc. Histology identified the mass as WHO/ISUP Grade 3 clear cell renal carcinoma.

With this case of highly vascularized completely endophytic complex renal mass partial nephrectomy, we combined three technologies that had been used on individual bases in order to perform a highly precise tumor enucleation.

Robert Schwartz
robbyschwartz12@gmail.com
Chicago Campus

Purpose: To determine predictive factors for Boston Type 1 Keratoprosthesis (KPro) long-term visual acuity outcomes and complication development.

Methods: This single-center, retrospective cohort study analyzed 114 eyes from 104 patients with at least 1 year of follow-up who underwent KPro implantation between September 2005 and September 2015.

Results: Mean follow-up time was 117.1 ± 52.0 months (range, 0-203 months). The mean retention time of the primary KPro was 87.9 ± 60.7 months (range, 2-185 months). Before surgery, 1% of patients had visual acuity better than 20/200, which improved to 31.4% at five years and 17.6% at ten years. Patients with burn-related injuries had the best rate of maintaining or improving visual acuity compared to non-inflammatory conditions and autoimmune conditions at 5 years (30.8% vs 24.7% vs 16.7%, respectively) and at 10 years (15.4% vs 9.1% vs 8.3% respectively). Patients aged 65 and younger at the time of surgery were more likely to maintain or improve visual acuity at 5 years (27.6% vs 18.8%) and 10 years (16.5% vs 3.1%). New-onset glaucoma was found more in burn-related cases (43.8%) or autoimmune cases (42.9%) and less in non-inflammatory diagnoses (15.5%).

Conclusion: Age below 65 years old at the time of surgery and chemical or thermal burn diagnosis show the highest chance for vision improvement and complication reduction in long-term KPro use.

Luke Sclamberg
lukess2@uic.edu
Rockford Campus

Introduction
Posterior heterotopic ossification of the spinal cord (PHO) is a rare condition leading to the compression of neural structures. We present a case of a 61-year-old male with a history of high BMI and Ankylosing Spondylitis who underwent a thoracic laminectomy for the treatment of PHO secondary to AS. He presented with a history of low back pain and neurologic symptoms.

Investigation/Intervention
CT scan confirmed central canal and neural foraminal stenosis at T9-T12 secondary to PHO. The patient underwent a thoracic laminectomy. Removal of the ossified mass was performed. The patient experienced significant improvement in neurological symptoms postoperatively.

Discussion:
PHO is a rare complication that can lead to significant morbidity in patients with AS. The development of lesions can result in compression of neural structures, causing neurologic symptoms. Heterotopic ossification (HO) is believed to be a result of aberrant bone formation due to inflammation in AS. Moreover, a higher BMI (as with our patient) may contribute to mechanical stress on the spine, exacerbating the risk of HO. Laminectomy is a surgical procedure performed to decompress the spinal cord and nerve roots.

Conclusion:
This case report demonstrates the successful management of PHO of the spinal cord in a patient with Ankylosing Spondylitis and a high BMI. Clinicians should consider PHO in patients with AS coupled with high BMI and take measures to prevent neurologic deficits.

Luke Sclamberg
lukess2@uic.edu
Rockford Campus

Introduction
Posterior heterotopic ossification of the spinal cord (PHO) is a rare condition leading to the compression of neural structures. We present a case of a 61-year-old male with a history of high BMI and Ankylosing Spondylitis who underwent a thoracic laminectomy for the treatment of PHO secondary to AS. He presented with a history of low back pain and neurologic symptoms.

Investigation/Intervention
CT scan confirmed central canal and neural foraminal stenosis at T9-T12 secondary to PHO. The patient underwent a thoracic laminectomy. Removal of the ossified mass was performed. The patient experienced significant improvement in neurological symptoms postoperatively.

Discussion:
PHO is a rare complication that can lead to significant morbidity in patients with AS. The development of lesions can result in compression of neural structures, causing neurologic symptoms. Heterotopic ossification (HO) is believed to be a result of aberrant bone formation due to inflammation in AS. Moreover, a higher BMI (as with our patient) may contribute to mechanical stress on the spine, exacerbating the risk of HO. Laminectomy is a surgical procedure performed to decompress the spinal cord and nerve roots.

Conclusion:
In conclusion, this case report demonstrates the successful management of PHO of the spinal cord in a patient with Ankylosing Spondylitis and a high BMI. Clinicians should consider PHO in patients with AS with high BMI and take measures to prevent neurologic deficits.

Darren Seaney
dseaney2@uic.edu
Chicago Campus

Introduction:
Diabetes mellitus (DM) increases the risk of atrial fibrillation (AF), the most common cardiac arrhythmia, by over 60%. Multiple mechanisms are hypothesized to contribute to this increased risk, including structural remodeling (fibrosis and cardiac dilation) and cardiac autonomic neuropathy (CAN; denervation of the parasympathetic nervous system). However, it is unknown to what extent these pathways contribute to the pathogenesis of AF.

Objectives:
To determine the structural and autonomic changes in diabetic patients due to AF using electrocardiography.

Methods:
A retrospective case-control study was designed using DM patients at the University of Illinois Hospital. Sinus ECGs were analyzed for parameters representative of diastolic dysfunction (QRS-T angle) and CAN (p-wave vector angle, heart rate variability). The diagnosis of AF was determined through clinical review. ECGs 1 year prior to diagnosis compared to those without a future diagnosis of AF.

Results:
A cohort of 772 pre-AF DM cases were analyzed. The p-wave elevation angle was lower in pre-AF cases (9.7 degrees, p = 3.8*10^-9). The QRS-T angle was increased in pre-AF cases (11.6 degrees, p = 3.0*10^-9).

Conclusion:
The change in the p-wave axis direction indicates a shift in the origin of depolarization. In addition, the QRS-T angle suggests an increase in diastolic dysfunction. These findings support the hypothesis that both autonomic and structural pathways increase AF risk among diabetics.