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The purpose of this study was to assess sociodemographic and behavioral risk factors associated with driving after marijuana use (DAMU) among West Virginia college students. Participants were recruited from West Virginia University between September and November 2022. The study sample was restricted to students who were ≥18 years of age; reported recently driving; possessed a current, valid driver's license from any US state; and were enrolled for at least one credit hour in the Fall 2022 semester. Among respondents (N = 772), 28.9% reported DAMU. Students who had a GPA of B (adjusted odds ratio [AOR]: 2.17, 95% confidence interval [CI]: 1.06–4.42), smoked or ingested marijuana in the past year (AOR: 26.51, 95% CI: 10.27–68.39), drove after drinking (AOR: 2.38, 95% CI: 1.18–4.79), and used both marijuana and alcohol concurrently and then drove (AOR: 10.39, 95% CI: 2.32–46.54) associated with DAMU. Individuals who felt the behavior was somewhat dangerous or not dangerous or thought their peers approved of DAMU showed significant associations with DAMU. As DAMU was prevalent, future interventions that raise awareness of the danger and potential consequences of DAMU may be needed to reduce this risky behavior on college campuses. [ABSTRACT FROM AUTHOR]

Purpose: Mutations in Topoisomerase I–binding RS protein (TOPORS) have been previously documented and have been described to result in pathological autosomal dominant retinitis pigmentosa (adRP). In our study, we describe the various genotypes and clinical/phenotypic manifestations of TOPORS-related mutations of our unique patient population in Rural Appalachia. Methods: The medical records of 416 patients with inherited retinal disease at the West Virginia University Eye Institute who had undergone genetic testing between the years of 2015–2022 were reviewed. Patients found to have pathologic RP and mutations related to TOPORS were then analyzed. Results: In total, 7 patients (ages 12–70) were identified amongst three unique families. All patients were female in our study. The average follow-up period was 7.7 years. A mother (70 yr) and daughter (51 yr) had a novel heterozygous nonsense point mutation in TOPORS c.2431C > T, p.Gln811X (Exon 3) that led to premature termination of the desired protein resulting in early onset vision loss, cataract formation, and visual field restriction. The mother developed a full-thickness macular hole which was successfully repaired. Five other patients were found to have previously described TOPORS mutations. Visual field loss was progressive with age in both cohorts. Conclusions: Seven patients at our institution were identified to have mutations in TOPORS resulting in autosomal dominant retinitis pigmentosa. Two patients were found to have novel truncating mutations in the TOPORS gene resulting in profound night blindness and visual field loss, recurrent macular edema, and in one individual, epiretinal membrane formation leading to a macular hole which was able to be successfully repaired. [ABSTRACT FROM AUTHOR]

Keynote Lecture Blind Sailing Unlimited Kris Scheppe, Blind Sailing Unlimited Kris was born with a genetic eye disorder leaving him with very limited peripheral vision. Despite this, his sense of [...]

Recessive Protein O-linked-mannose beta-1,2-N-acetylglucosaminyltransferase 1 (POMGNT1) mutations can cause early onset muscle–eye–brain disease but have also more recently been associated with non-syndromic Retinitis Pigmentosa. In this case series, we describe three sisters affected by non-syndromic autosomal recessive POMGNT1 retinopathy with a report of a new variant. The three patients received care at West Virginia University Eye Institute, including full ophthalmic examination with additional fundus imaging, optical coherence tomography (OCT), electroretinogram (ERG), and visual field testing. Diagnostic panel testing of 330 genes was also obtained. The proband was seen for cataract evaluation at age 42, and her fundus examination was suggestive of retinitis pigmentosa. Her oldest sister had been treated for acute anterior uveitis with retinal vasculitis. Another sister was diagnosed with multiple sclerosis (MS) and peripheral retinal degeneration. Posterior subcapsular cataracts were diagnosed between age 42 and 55 in all three sisters, each with constricted fields with preserved central vision. We identified one pathogenic POMGNT1 variant (c.751 + 1G > A) and one likely pathogenic variant (c.1010T > C p.Ile337Thr) in all three sisters. A thorough family history and examination of the siblings with genotyping might have led to an earlier diagnosis of retinal inherited disease and avoidance of immunomodulatory treatment in the oldest sibling. [ABSTRACT FROM AUTHOR]

Introduction Service members and veterans applying to medical schools can be a challenging experience. Often, the applicants have difficulty providing descriptions of their experiences. Additionally, their pathway to medical school is significantly different compared to traditional applicants. We sought to determine if there were statistically significant factors within a cohort of U.S. military medical school applications to a U.S.-based allopathic medical school to provide recommendations on how to best advise military applicants. Methods Data about social, academic, and military factors were collected and analyzed from the American College Application Service (AMCAS) applications to the West Virginia University School of Medicine (WVU SoM) from the 2017 to 2021 cycles. Eligibility criteria included the applications that indicated that the applicant listed any type of military experience. Results In the 5-year study period, there were 25,514 applicants to the WVU SoM, and 1.6% (n  = 414) self-identified as military applicants. Of the military applicants, 28 (7%) were accepted to the WVU SoM. Statistically significant differences were found in several factors, including but not limited to academic performance, number of total experiences (14.5 vs. 12, P  = .01), and number of military experiences (4 vs. 2, P  = .003) listed on the AMCAS applications. In the accepted group, 88% of the applications included information about military experiences, which was understandable to the nonmilitary researchers compared to 79% in the nonaccepted group (P  = .24). Conclusions Premedical advisors can share statistically significant findings with military applicants, so they are informed about the academic and experiential factors associated with medical school acceptance. Applicants should also be advised to provide clear explanations of any military lexicon used in their applications. Although not statistically significant, there were a higher percentage of applications that contained descriptions of military language that was understandable to the civilian researchers in the accepted group vs. the nonaccepted group. [ABSTRACT FROM AUTHOR]

Water-in-diesel emulsion fuel has become a popular alternative fuel for diesel engines. The main limitation is related to its stability, whereby it relies heavily on surfactants to remain homogeneous, therefore causing production costs to rise. This paper highlights the application of real-time non-surfactant emulsion fuel supply system (RTES), a water/diesel emulsifying device without surfactants, to produce water-in-diesel emulsion fuel in a common rail direct injection diesel engine powered vehicle. In this study, RTES was installed near to the diesel fuel pump to ensure water-in-diesel emulsions were continuously fed to the engine. The test vehicle was set up on a roller dynamometer and operated following a modified West Virginia University (WVU) 5-Peak cycle. Fuel consumption and exhaust emissions were measured to determine the optimum water percentage of emulsion fuel and suitable timing for emulsion fuel to be introduced into the fuelling system based on the vehicle speed. The results revealed that the optimum water percentage of the emulsion fuel for the test vehicle is 10 wt%, as it was capable to reduce fuel consumption as well as nitrogen oxides and smoke emissions of a common rail direct injection diesel engine powered vehicle. [ABSTRACT FROM AUTHOR]

Background and Aim: Sars‐CoV‐19 pandemic necessitated a transition to telemedicine for many healthcare encounters. The environmental impact of this transition in gastroenterology (GI) combined with user experience has not been studied. Methods: We conducted a retrospective cohort study of patients who underwent telemedicine visits (telephone and video) at a GI clinic at West Virginia University. Distance of patients' residence from clinic × 2 was calculated, and Environmental Protection Agency calculators utilized to calculate greenhouse gas (GHG) emissions that were avoided from tele‐visits. Patients were reached by telephone and were asked questions to fill in a validated Telehealth Usability Questionnaire with Likert scales (1–7). Variables were also collected via chart review. Results: A total of 81 video and 89 telephone visits were conducted for gastroesophageal reflux disease (GERD) between March 2020 and March 2021. A total of 111 patients were enrolled, with a response rate of 65.29%. Mean age was lower in the video visit cohort compared with the telephone visit cohort (43.45 ± 14.32 years vs 52.34 ± 17.46 years). Most patients had medications prescribed during the visit (79.3%), and a majority had laboratory testing orders placed (57.7%). We calculated a total distance of 8732 miles that the patients would have traveled if they were to present for in‐person visits (including return trips). A total of 393.3 gallons of gasoline would have been required to transport these patients to and from the healthcare facility to their residence. A total of 3.5 metric tons of GHG's were saved by avoiding 393.3 gallons of gasoline for travel. In relatable terms, this is equivalent to burning more than 3500 pounds of coal. This averages to 31.5‐kg GHG emissions and 3.54 gallons of gasoline saved per patient. Conclusion: Telemedicine for GERD resulted in significant environmental savings and was rated highly for access, satisfaction, and usability by patients. Telemedicine for GERD can be an excellent alternative to in‐person visits. [ABSTRACT FROM AUTHOR]

Objective: To report the incidence of postoperative epiretinal membrane (ERM) formation after primary pars plana vitrectomy (PPV) for giant retinal tear associated retinal detachment (GRT-RD) repair as well as its clinical characteristics and visual outcomes at a level one trauma and tertiary referral academic center. Patients and Methods: Patients with primary RD repair for GRT-RD at West Virginia University from September 2010 to July 2021 were identified using the ICD-10 codes (H33.031, H33.032, H33.033 and H33.039). Imaging studies including optical coherence tomography (OCT) were manually reviewed pre- and post-operatively for ERM formation after PPV for GRT-RD repair in patients who underwent PPV or combined PPV and scleral buckle (SB). Univariate analysis was performed to analyze clinical factors for ERM formation. Results: The study included 17 eyes of 16 patients who underwent PPV for GRT-RD. Postoperative ERM was observed in 70.6% (13 of 17 eyes) of the patients. Anatomic success was achieved in all patients. The mean (range) preoperative and final best corrected visual acuity (BCVA) in logMAR units by macula status was 0.19 (0– 0.5) and 0.28 (0– 0.5) for macula-on and 1.7 (0.5– 2.3) and 0.7 (0.2– 1.9) for macular-off GRT-RDs. Clinical variables including use of medium-term tamponade with perfluorocarbon liquid (PFCL), cryopexy, endodiathermy, number of tears or total clock hours of tears did not correlate with an increased risk of ERM formation. Conclusion: Post-vitrectomized eyes for GRT-RD repair have a significantly higher incidence of ERM formation, nearing 70% in our study. Surgeons may consider prophylactic ILM peel at the time of removal of tamponade agents or weigh in ILM peel at the time of primary repair, a more challenging surgical technique in our opinion. [ABSTRACT FROM AUTHOR]