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I NTERNAL M EDICINE R ESEARCH S YMPOSIUM 26 th ANNUAL MAY 10 & 11, 2018

I26 annual M nternal edIcIne research syMposIuM

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Page 1: I26 annual M nternal edIcIne research syMposIuM

Internal MedIcIneresearch syMposIuM

26th annual

May 10 & 11, 2018

Page 2: I26 annual M nternal edIcIne research syMposIuM

KEYNOTE SPEAKER

David J. Salant, MD Norman G. Levinsky Professor in Nephrology Chief, Renal Section Vice Chair for Research, Department of Medicine Professor of Pathology and Laboratory Medicine Boston University Medical Center

Professor David Salant is Chief of Nephrology and Vice-Chair for Research in the Department of Medicine at Boston University Medical Center. He graduated from the Witwatersrand University

Medical School in 1969 and completed clinical training at the Johannesburg General Hospital. He received research training at Boston University with Dr. William Couser and joined the faculty in 1979. He was appointed Chief of Nephrology and Director of the Nephrology Training Program in 1987.

Supported by grants from the National Institutes of Health he has conducted extensive research on immune disorders of the kidneys, and he has authored over 180 scientific publications, reviews and book chapters. His work has focused on mechanisms of immune deposition and the role of complement in glomerular diseases, and on the structural biology of the podocyte. He was one of the earliest proponents of the notion that podocyte injury forms the basis of most, if not all, proteinuric kidney diseases. In a landmark New England Journal of Medicine paper in 2009, he and his colleagues described their discovery that a high proportion of patients with idiopathic membranous nephropathy have circulating autoantibodies to the M-type phospholipase A2 receptor on human podocytes.

Dr. Salant has received several awards and honors, including an Established Investigator Award from the American Heart Association, the Jean Hamburger Award from the International Society of Nephrology, the John P. Peters Award from the American Society of Nephrology, the Donald W. Seldin Award from the National Kidney Foundation, the Marilyn Farquhar Award at the 11th Annual Podocyte Conference and he was elected as a Fellow of the American Association for the Advancement of Science. He has served on several NIH advisory panels and on the editorial boards of several major journals. He has also played a prominent educational role nationally as member and chair of the American Board of Internal Medicine in Nephrology.

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DEPARTMENT OF INTERNAL MEDICINE

2 6 t h A n n u A l R e s e A R c h s y m p o s i u m

Poster # Abstract Title Presenter

1 Variability in Surveillance Imaging Patterns in Patients with Thoracic Aortic Aneurysm and Bicuspid Aortic Valves Neli Augustson

2 Trends in Peripartum Cardiomyopathy Outcomes and Management Nivedita Basu

3 Cost-Effectiveness and Decision Analysis of Polygenic Risk Scores in Statin Use for Primary Prevention Suzanne Butler

4 Chronic Kidney Disease is Associated with Changes in Echocardiographic Measurements Independent of Cardiomyopathy Yaser Carcora

5 Correcting Inappropriate Prescribing of Direct Oral Anticoagulants: A Population Health Approach Taylor Dawson

6 Micronutrient Intake Before and After the Low FODMAP and mNICE Diet Jeremy Farida

7Wake Up and Extubate: A Case Control Investigation of the Association Between the Spontaneous Awakening Trial and Unplanned Extubations

Michael Ferrera

8 Characterization of Mortality in Myelofibrosis Benjamin Garmezy

9 Understanding the Role of Strain Imaging in the Early Detection of Chagas Cardiomyopathy Patrick Green

10Does Additional Post-Transplant Consolidation and Prolonged Maintenance Therapy Change Outcomes in Patients with High-Risk Multiple Myeloma?

Stephanie Hoffman

11 Improving Patient Care Delivery Through Direct Admission Process Review and Enhancement Elizabeth Jahns

12 Rate of Fractional Flow Reserve Use During Elective Coronary Angiography Among Elderly Patients in the US Bradley Kay

13 Willingness to Stop PPIs in Patients with Gastroesophageal Reflux Disease: Results of a Patient Survey Jennifer Kennedy

THURSDAY, MAY 10, 2018

Towsley Dining Room 1:00-5:00 pm Electronic Poster Presentations

Resident Research Symposium POSTER PRESENTATIONS

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Poster # Abstract Title Presenter

14 Relationship of F-18 Fluorodeoxyglucose Uptake in Myocardium and Blood Pool to Biomarkers Sophia Larson

15 Hospice Care Quality in U.S. Nursing Homes Reported By Patients and Caregivers in Yelp Reviews

Jayme Laurencelle

16 IFN-Gene Expression is Elevated in SCLE and DLE and Decreases with Treatment in DLE Stephanie Lazar

17 Comorbidity Management in Patients Referred to a Heart Failure with Preserved Ejection Fraction Clinic Alexandria Miller

18 Perceptions of Resuscitation Care Among In-Hospital Cardiac Arrest Responders: A Qualitative Analysis Samyukta Mullangi

19 Effectiveness of Screening for Type 2 Diabetes Mellitus in Patients with History of Gestational Diabetes Mellitus in Primary Care Elizabeth Paluga

20 Intra-Abdominal Abscess Size and the Use of Percutaneous Drainage Are Not Associated with Avoidance of Surgery in Crohn's Disease Daniel Perl

21 Predictors of Mortality in End-Stage Renal Disease Patients with Infective Endocarditis Rachel Powell

22Comparing Provider Perspectives Across Specialties on the Primary and Transitional Care of Children and Youth with Special Health Care Needs and Adults with Chronic Childhood Conditions

Angelico Razon

23 What Do Resident Physicians Know About Menopausal Hormone Therapy in 2018? Nastassia Sylvestre

24 Transitional Care Management for COPD: The University of Michigan Experience Jennifer Taylor

25 Her2 Testing: Noncompliance and the Costs Involved James Uebel

DEPARTMENT OF INTERNAL MEDICINE

2 6 t h A n n u A l R e s e A R c h s y m p o s i u m

THURSDAY, MAY 10, 2018

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DEPARTMENT OF INTERNAL MEDICINE

2 6 t h A n n u A l R e s e A R c h s y m p o s i u m

Ford Lobby9:00 am CONTINENTAL BREAKFAST / PLENARY POSTER SESSION

Ford Auditorium10:00 WELCOME AND OPENING REMARKS John Carethers, MD, MACP Benjamin Margolis, MD

10:05 PLENARY SPEAKER SESSION

12:00 pm KEYNOTE ADDRESS - GRAND ROUNDS

Towsley Lobby1:00 LUNCH / POSTER SESSION

FRIDAY, MAY 11, 2018

Antiphospholipid Syndrome Neutrophils Demonstrate Increased Adhesive Potential Due to Surface Expression of Activated Mac-1 Gautam Sule, PhD, Rheumatology Synovial Fibroblast CD318 Expression Mediates T Cell Adhesion and Migration in Rheumatoid Arthritis Stephanie Rasmussen, BS, Rheumatology Administration of Vesicle-Encapsulated Suppressor of Cytokine Signaling 3 Inhibits Lung Epithelial Cell Transformation and Tumor Cell Function Jennifer Speth, PhD, Pulmonary & Critical Care Medicine Critical Role of Paracrine and Endocrine Signals in Maintenance of Adrenocortical Stem/Progenitor Cell Pool Yewei Xing, PhD, MEND The Impact of Adding Aspirin to Warfarin Without an Apparent Indication: An Exploration of Patients Anticoagulated for Atrial Fibrillation or Venous Thromboembolic Disease Jordan Schaefer, MD, Hematology/Oncology An Analysis of the Survival Benefits of Beta-Blockers & Calcium Channel Blockers in the Treatment of Aortic Dissection Rohan Bhandari, MD, Residency Program Impact of Duffy Antigen Phenotype on Hydroxyurea Dosing Amongst Individuals with Sickle Cell Disease Samuel Wilson, MD, Residency Program Evidence of Gut Translocation in Sepsis: Burden and Diversity of Bacterial DNA in Blood Predicts Organ Failure in Septic Patients Matthew Thau, MD, Residency ProgramGenomic Epidemiology of Carbapebem-Resistant Klebsiella pneumoniae in a High-Transmission Hospital Shawn Hawken, MPH, Infectious Diseases

Discovering a Major Autoantigen in Nephrotic Syndrome and its Clinical Implications David J. Salant, MD Norman G. Levinsky Professor in Nephrology Chief, Renal Section, Boston University Medical Center Vice Chair for Research, Department of Medicine Professor of Pathology and Laboratory Medicine Boston University Medical Center

Page 6: I26 annual M nternal edIcIne research syMposIuM

DEPARTMENT OF INTERNAL MEDICINE

2 6 t h A n n u A l R e s e A R c h s y m p o s i u m

DEPARTMENT OF INTERNAL MEDICINE

2 6 t h A n n u A l R e s e A R c h s y m p o s i u m

Towsley Dining Room / Sheldon Auditorium2:30 RESIDENT ORAL COMMUNICATIONS Towsley Dining Room Hospital Level Variation in Inpatient and Long-Term Outpatient Survival After In-Hospital Cardiac Arrest in the Veterans Health Administration Apurba Chakrabarti, MD

Time Out for Type and Screen? Matthew Ettleson, MD

Deterioration Without A Diagnosis? The Surprising Lack of Physician Documentation of Significant Events in Hospitalized Patients: A Multi- Institutional Retrospective Chart Review Amanda Huey, MD

Anti-Fibrotic Therapy and Patient Reported Outcomes in Idiopathic Pulmonary Fibrosis Shannon Kay, MD

Statin Discontinuation Between Physicians and Their Patients with Advanced Cancer: Discourse Analysis in a Standardized Patient Study Aditi Ramakrishnan, MD

Use of Mioncoseq Analysis in PTCL and CTCL Biopsies to Inform Targeted Therapeutics Anthony Scott, MD

Disease-Specific Quality of Life Improvements Do Not Predict Overall Quality of Life in Older Adults Following Discharge from Heart Failure Hospitalization Jeremy Slivnick, MD

Sheldon Auditorium A Phase II Clinical Trial of Metformin as a Cancer Stem Cell Targeting Agent in Ovarian, Fallopian Tube, and Primary Peritoneal Cancer Jason Brown, MD

Can We Do Better? A 1 Year Retrospective Review of the Management of Infectious Endocarditis at a Tertiary Care Referral Center Sami El-Dalati, MD

RaTs on the Pediatric Ward: In Pursuit of a Validated Case-Based Learning Repository Nicholas Helmstetter, MD

Active Smoking is Associated with Decreased Cd4+ T Cells in Bronchoalveolar Lavage: Spiromics Immunophenotyping Sub-Study Huram Mok, MD Healthcare Transitions and Complex Medical Conditions Arising Out of Childhood: A New Resident-Led Lecture Series for Pediatric and Internal Medicine Trainees Marie Pfarr, MD

A Comparison of Outcomes, Presentation and Treatment in Pediatric (Ped) Vs. Adult Patients (Pts) with Ewing Sarcoma Eric Schwartz, MD

Rapid Identification of Pathogens in Cystic Fibrosis Sputum Using Real-Time Metagenomics Jennifer Taylor, MD

Survival Following Salvage Therapy for Primary Refractory Peripheral T-Cell Lymphomas Janie Zhang, MD

FRIDAY, MAY 11, 2018

5:00 RESEARCH SYMPOSIUM ADJOURNS

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Poster # Plenary Poster Session Presenter

P1 Heme Oxygenase-1: Protective in Acute Venous Thrombogenesis

Alison Banka, MSE Cardiovascular Medicine

P2 Fibro-adipogenic Remodeling of the Diaphragm in Obesity-associated Respiratory Dysfunction

Eric Buras, MD, PhD MEND

P3 GLP-1 Signaling Controls Pancreatic Endocrine Development

Corentin Cras-Meneur, PhD MEND

P4 RNA Binding Protein HuR is Required for Efficient Function but not Generation of Foxp3+ Treg

Jason Ellis, PhD Allergy & Clinical Immunology

P5 Hepatocellular Carcinoma Surveillance Practice and Perceptions Among Primary Care Physicians

Yuan "Tony" Feng, MD Residency Program

P6 An Electronic Medical Record Intervention Reduces Inappropriate Transthoracic Echocardiogram Orders

Michael Henry, MD Residency Program

P7 Staphylococcus Aureus Colonization is Influenced by Cutaneous Interferon Production.

Sirisha Sirobhushanam, PhD Rheumatology

P8 Nephrin is Necessary for Podocyte Recovery Following Injury in an adult mature Glomerulus.

Rakesh Verma, PhD Nephrology

P9 Discovery of a Potent Androgen Receptor Degrader for Castration Resistant Prostate Cancer

Chao Wang, PhD Hematology/Oncology

P10Artificial Sweetener (Saccharin) Modulates Visceral Nociception by Lipopolysaccharide-Mediated Gut Barrier Dysfunction and Intestinal Inflammation

Dabo Xu, MD Gastroenterology & Hepatology

P11 The Role of Homeobox Transcription Factor Cdx2 in Hematopoiesis and Leukemogenesis

Meiling Zhao, Master Hematology/Oncology

P12 Belief, Knowledge, and Practice on Electronic Cigarettes Among Allergists, Pulmonologists and General Practitioners

Sherry Zhou, MD Residency Program

DEPARTMENT OF INTERNAL MEDICINE

2 6 t h A n n u A l R e s e A R c h s y m p o s i u m

Plenary Poster Session - Ford Lobby, 9:00 -10:00 am

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Poster # Poster Title Presenter

1Medicaid Expansion and Illness Severity among Hospitalized Patients with Asthma, Chronic Obstructive Pulmonary Disease, and Congestive Heart Failure

Andrew Admon, MD, MPH Pulmonary & Critical Care Medicine

2Adenosine 2A Receptor Agonism Protects Against Antiphospholipid Antibody-Mediated NETosis and Venous Thrombosis

Ramadan Ali, PhD Rheumatology

3 Proinsulin Misfolding in Pancreatic Beta-Cells Anoop Arunagiri, PhD MEND

4Predictors and Outcomes Associated with Post-Operative Pericardial Tamponade in Type A Acute Aortic Dissection Patients

Swechya Banskota, BS Cardiovascular Medicine

5 Structure and Function of Anticoagulation Clinics in the United States: An AC Forum Membership Survey

Geoffrey Barnes, MD, MSc Cardiovascular Medicine

6 Glucocorticoid-Augmented Efferocytosis Reduces Pneumococcal Killing by Human Alveolar Macrophages

Melissa Bates Pulmonary & Critical Care Medicine

7 Cardiovascular Risk Factors Associated with Adolescent Hypertension

Sabrina Bernardo Cardiovascular Medicine

8Update about PEARL: Pathway Exploration and Analysis in Renal Lupus in the Accelerating Medicine Partnership (AMP) Phase 1 lupus network

Celine Berthier, PhD Nephrology

9 Hepatic ER-Associated Degradation Manages FGF21 Level and Metabolism via CREBH Turnover

Asmita Bhattacharya, BS MEND

10 Patients with Likely Eosinophilic Esophagitis are at High Risk for Loss to Follow-Up After Food Impaction.

Joy Chang, MD Gastroenterology & Hepatology

11 Metastasis-specific, NK Cell-Mediated, Immune Surveillance of Lung Cancer

Peter Chockley, BS Pulmonary & Critical Care Medicine

12 Centromere Instability in Down SyndromeRafael Contreras-Galindo, PhD Infectious Diseases

13 Particulate Matter Exposure Promotes a Profibrotic Phenotype in Pulmonary Fibroblasts

Nathan Craig, BS Pulmonary & Critical Care Medicine

DEPARTMENT OF INTERNAL MEDICINE

2 6 t h A n n u A l R e s e A R c h s y m p o s i u m

Poster Session - Towsley Lobby, 1:00-2:00 pm

Poster # Plenary Poster Session Presenter

P1 Heme Oxygenase-1: Protective in Acute Venous Thrombogenesis

Alison Banka, MSE Cardiovascular Medicine

P2 Fibro-adipogenic Remodeling of the Diaphragm in Obesity-associated Respiratory Dysfunction

Eric Buras, MD, PhDMEND

P3 GLP-1 Signaling Controls Pancreatic Endocrine Development

Corentin Cras-Meneur, PhD MEND

P4 RNA Binding Protein HuR is Required for Efficient Function but not Generation of Foxp3+ Treg

Jason Ellis, PhDAllergy & Clinical Immunology

P5 Hepatocellular Carcinoma Surveillance Practice and Perceptions Among Primary Care Physicians

Yuan "Tony" Feng, MD Residency Program

P6 An Electronic Medical Record Intervention Reduces Inappropriate Transthoracic Echocardiogram Orders

Michael Henry, MD Residency Program

P7 Staphylococcus Aureus Colonization is Influenced by Cutaneous Interferon Production.

Sirisha Sirobhushanam, PhD Rheumatology

P8 Nephrin is Necessary for Podocyte Recovery Following Injury in an adult mature Glomerulus.

Rakesh Verma, PhD Nephrology

P9 Discovery of a Potent Androgen Receptor Degrader for Castration Resistant Prostate Cancer

Chao Wang, PhD Hematology/Oncology

P10Artificial Sweetener (Saccharin) Modulates Visceral Nociception by Lipopolysaccharide-Mediated Gut Barrier Dysfunction and Intestinal Inflammation

Dabo Xu, MD Gastroenterology & Hepatology

P11 The Role of Homeobox Transcription Factor Cdx2 in Hematopoiesis and Leukemogenesis

Meiling Zhao, Master Hematology/Oncology

P12 Belief, Knowledge, and Practice on Electronic Cigarettes Among Allergists, Pulmonologists and General Practitioners

Sherry Zhou, MDResidency Program

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DEPARTMENT OF INTERNAL MEDICINE

2 6 t h A n n u A l R e s e A R c h s y m p o s i u m

Poster # Poster Title Presenter

14 Long-term Priming of Innate Immune Responses in Survivors of Murine Sepsis.

Scott Denstaedt, MD Pulmonary & Critical Care Medicine

15Distinctive actions of colony-stimulating factors on proliferation and activation of two main pulmonary macrophage populations

Christina Draijer, PhD Pulmonary & Critical Care Medicine

16Presence of Mental Health Disorders, Low Socioeconomic Status, More Closely Associated with Adverse Cardiovascular Outcomes after a Recent Hospitalization

Delaney Feldeisen Cardiovascular Medicine

17 WNT Signaling Promotes Adrenal Gland Regeneration Isabella Finco, PhD MEND

18Circulating Fibrocytes Predict Biomarkers Of Immune Dysregulation And Fibrogenesis In A Genetic Interstitial Lung Disease

Sean Fortier, MD Pulmonary & Critical Care Medicine

19 Determinants of pH Profile and Acyl Chain Selectivity in Lysosomal Phospholipase A2

Vania Hinkovska-Galcheva, PhD Nephrology

20 Intestinal Oxygen Homeostasis by the Collective Action of Fermentative and Respiratory Bacteria

Matt Hoostal, Doctorate Infectious Diseases

21 ECG and Echo Characteristics in Familial Partial Lipodystrophy: The Impact of Lamin A Variants

Abdelwahab Jalal Eldin, MBBS MEND

22Managing Resistance: Impact of Antimicrobial Stewardship on Daptomycin Resistance in Vancomycin-Resistant Enterococcus (VRE)

Clare Kinnear, MPH, PhD Infectious Diseases

23Medical Student-Generated NBME-Style Cardiology Multiple Choice Questions: Student Perceptions and the Impact on Standardized Exam Performance

Josh Kurtz, BS Cardiovascular Medicine

24Metabolic Parameters, Weight Loss, and Comorbidities Four Years after Roux-en-Y Gastric Bypass and Sleeve Gastrectomy

Corey Lager, MD MEND

25 Regional transmission and Antibiotic Resistance Evolution of the Hospital Pathogen Klebsiella Pneumoniae

Zena Lapp, BA Infectious Diseases

26Emergency Department (ED) Utilization Among Cases and Controls in the Population-Based Michigan Lupus Epidemiology & Surveillance (MILES) Cohort

Jiha Lee, MD, MHS Rheumatology

DEPARTMENT OF INTERNAL MEDICINE

2 6 t h A n n u A l R e s e A R c h s y m p o s i u m

General Poster Session - Towsley Lobby, 1:00-2:00 pm

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Poster # Poster Title Presenter

27 Predicting Cell-line Specific Protein and Phospho-protein Abundances in Cancers

Hongyang Li, BS Molecular Medicine & Genetics

28 Diagnosis of Familial Partial Lipodystrophy Using Machine Learning on Dual Energy X-Ray Absorptiometry Scans

Rasimcan Meral, MD MEND

29 Therapeutic Strategies for Ataxia-Telangiectasia Lung DiseaseThomas Michniacki, MD Hematology/Oncology

30Rapamycin Suppresses T Cell Responses in Recoverin-Induced Autoimmune Retinopathy and Prevents Disease Progression in the Eyes

Enayat Nikoopour, PhD Rheumatology

31Anxiety and Depression in Patients with Fibromuscular Dysplasia: A Report from the US Registry for Fibromuscular Dysplasia

Cameron Pawlik Cardiovascular Medicine

32 Plantar Fasciitis in Patients with Type 1 and Type 2 Diabetes Mellitus: A Period Prevalence Study

Sari Priesand, DPM MEND

33 Circulating Inflammatory Mediators in the Setting of Severe Clostridium difficile Infection

Rosemary Putler, MS Infectious Diseases

34Global Cooling Reveals Stabilized Rotors That Correspond to Regions of Maximal Dominant Frequency During Cholinergic Atrial Fibrillation

Rafael Ramirez, PhD Cardiovascular Medicine

35Importance of the Large Conductance Potassium Ion Channel Subunit KCNMB1 in the Differentiation of Fibroblasts to Myofibroblasts

Anne Scruggs, MS Pulmonary & Critical Care Medicine

36 Limited Impact of Comorbidity Burden on Vascular Access Type in Maintenance Hemodialysis Patients

Jonathan Segal, MD Nephrology

37 Nitric Oxide Emitting Inflation Fluid for Dilation Balloon Catheter Assem Sherieh, MD Nephrology

38 Unique Role for miR429 in RA and Acute Model of Arthritis Matthew Siesel Rheumatology

39A 10-year Single Center Retrospective Analysis of Factors Affecting Rapid On-Site Sensitivity of Pancreatic Endoscopic Ultrasound with Fine Needle Aspiration Since 2007

Arjun Sondhi, MD Gastroenterology & Hepatology

40Magnitude and Determinants of Variation in Percutaneous Coronary Intervention Payments: Insights from Michigan Hospitals

Devraj Sukul, MD, MSc Cardiovascular Medicine

DEPARTMENT OF INTERNAL MEDICINE

2 6 t h A n n u A l R e s e A R c h s y m p o s i u m

General Poster Session - Towsley Lobby, 1:00-2:00 pm

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DEPARTMENT OF INTERNAL MEDICINE

2 6 t h A n n u A l R e s e A R c h s y m p o s i u m

General Poster Session - Towsley Lobby, 1:00-2:00 pm

Poster # Poster Title Presenter

41Patient-Reported Advantages and Disadvantages of Peritoneal Dialysis: Results from the Peritoneal Dialysis Outcomes and Practice Patterns Study

Nidhi Sukul, MD Nephrology

42Multiple Myeloma Progression Prediction with Gene Expression Profile and Clinical Features Based on Complete Ranking of Right-Censored Data

Chen Sun, MS Hematology/Oncology

43 Quantifying the Limit of Detection of Clostridium difficile Spores from Stool Using Anaerobic Culture.

Amber Thomas, MPH Infectious Diseases

44 Utility and Safety of Cardiopulmonary Exercise Testing in Hypertrophic Cardiomyopathy Patients

June Tome, BS Cardiovascular Medicine

45 Role of LPLA2 in Drug Induced Phospholipidosis Taylour Treadwell, BS Nephrology

46Proprotein Convertase Subtilisin/Kexin Type 9 Deficiency Leads to More Severe Anemia in a Murine Model of Sickle Cell Disease

Jessica Venugopal, PhD Cardiovascular Medicine

47 Respiratory Failure Patterns in Persistently Critically Ill Patients

Elizabeth Viglianti, MD MPH Pulmonary & Critical Care Medicine

48 Overuse of Glucocorticoids in Rheumatoid Arthritis: A National Survey of Primary Care Physicians

Beth Wallace, MD, MSc Rheumatology

49Insights on the Transmission of Multiple Drug-Resistant Bacterial Lineages from the Analysis of Regional Nursing Homes in Michigan

Joyce Wang, PhD Infectious Diseases

50 UVB Induces Early Increases in B Cells in Lupus-Prone Mice in a Type I Interferon Dependent Manner

Sonya Wolf, BS Rheumatology

51 Targeted MDM2 Degradation as a Novel and Efficacious Cancer Therapy

Jiuling Yang, MD Hematology/Oncology

52 Understanding the Role of the Gut Microbiome in Colorectal Tumorigenesis

Amy Yu Hematology/Oncology

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