Digital Commons Network^™

Cervical Cancer Screening Coverage And Associated Factors Among Women Aged 25-59 In Eswatini: Insights From The 2021 Population-Based Hiv Impact Assessment (Phia), Abenezer Melaku Tafese, Bikiltu Dirbaba, Meseker Fentie, Charnita Zeigler-Johnson

College of Population Health Faculty Papers

BACKGROUND: Cervical cancer is the most common cancer and the leading cause of cancer mortality among women in Eswatini, which reported the highest cervical cancer incidence and mortality rates globally in 2022. However, recent nationally representative published data on cervical cancer screening coverage in Eswatini remain limited. This study aimed to estimate cervical cancer screening coverage and identify factors associated with screening uptake among women aged 25-59 years in Eswatini.

METHOD: Data were drawn from the 2021 Eswatini Population-based HIV Impact Assessment (PHIA), a nationally representative cross-sectional household survey. Survey-weighted bivariable and multivariable logistic regression analyses were conducted to identify …

Inhibiting Chikungunya Virus Protease Using Mtase-Like Domain Interactions For Novel Antiviral Therapies, Justin G. Julander

Funded Research Records

No abstract provided.

Persistent Chemotherapy-Induced Peripheral Neuropathy As A Chronic Cancer Pain Syndrome: Mechanisms, Therapeutic Limitations, And Future Directions, Reed Firestone, Jamin Morrison

Department of Medicine Faculty Papers

Background/Objectives: Chemotherapy-induced peripheral neuropathy (CIPN) is a common, dose-limiting complication of cancer therapy and a major contributor to chronic neuropathic pain among cancer survivors. Although traditionally managed as a treatment-related toxicity, persistent CIPN frequently persists long after chemotherapy completion and is increasingly recognized as a major survivorship and palliative care challenge. This review synthesizes current mechanistic, clinical, and translational evidence and reframes persistent CIPN as a chronic neuropathic cancer pain syndrome. Methods: A narrative review of peer-reviewed literature was conducted using PubMed/MEDLINE, Embase, and the Cochrane Library, supplemented by manual review of key references and clinical guidelines. Emphasis was placed …

Rare Presentation Of Sequential Mucosa-Associated Lymphoid Tissue Lymphoma, Follicular Lymphoma, And Chronic Lymphocytic Leukemia: A Case-Based Review, Khushi J. Desai, Ansy H. Patel, Patrick T. O’Dowd, Joseph A. Tworek, Preeti G. Misra, Li Ding

Journal of Community Hospital Internal Medicine Perspectives

Introduction: Occurrence of 2 (or more) Hodgkin's and non-Hodgkin's lymphoma concordantly or sequentially in a single patient is very rare.

Case: An 88-year-old Italian male with a history of mucosa-associated lymphoid tissue (MALT) lymphoma in remission and indolent follicular lymphoma under surveillance, presented with acute autoimmune hemolytic anemia (AIHA). While initially speculated to be secondary to follicular lymphoma relapse, stable mesenteric lymphadenopathy compared to prior CT abdomen/pelvis and smudge cells on peripheral smear prompted further evaluation. Peripheral blood flow cytometry indicated a mature B-cell neoplasm, which was confirmed to be chronic lymphocytic leukemia (CLL) with a bone marrow biopsy. Minimal …

Left-Ventricular Non-Compaction Cardiomyopathy Presenting With Atrial Flutter With Rapid Ventricular Response, Sahil Ghay, Baneet Kaur, J. Armando Talavera, Koushik Sanku, Viky S. Loescher, Julien A. Exposito

Journal of Community Hospital Internal Medicine Perspectives

Left ventricular non-compaction cardiomyopathy (LVNC) is a rare genetic cardiomyopathy characterized by prominent trabeculations and deep recesses that predispose to arrhythmias and heart failure. We describe a 42-year-old man with persistent tachycardia and exertional fatigue found to have CTI-dependent atrial flutter with 2:1 conduction. Transesophageal echocardiography showed severe biventricular dysfunction with an ejection fraction of 15%, and cardiac MRI confirmed LVNC with a non-compacted to compacted ratio of 3.3. After successful ablation and normal coronary angiography, he was diagnosed with LVNC. This case highlights an unusual presentation of LVNC with typical atrial flutter and underscores the value of cardiac MRI …

The Effect Of Empiric Initiation Of Treatment On Outcomes Among Patients Presenting With Extrapulmonary Mycobacterium Tuberculosis Infection In A Community Hospital Setting, Talha Awwal, Faisal Raja Kh, Hanya Awaba, Waseem Anwar, Jinma Ren, Muhammad Aamir Safdar, Saqib Walayat, John J. Farrell

Journal of Community Hospital Internal Medicine Perspectives

Background: Extrapulmonary tuberculosis (EPTB) accounts for ~20% of Mycobacterium tuberculosis infections in Pakistan. Diagnostic delays are common and may worsen outcomes. We evaluated whether empiric treatment initiation improves outcomes among patients with EPTB at a large public hospital in Islamabad, Pakistan. Methods: Retrospective cohort of consecutive EPTB cases at Pakistan Institute of Medical Sciences (January–June 2016). Patients were categorized as clinically diagnosed (symptoms/radiology) or laboratory-supported (histology, microbiology, or biochemical tests). Standard Directly Observed Therapy Short-course (DOTS) based regimens were used. Outcomes were treatment success, failure, loss to follow-up, and mortality; groups were compared using chi-square testing. Results: Of 317 EPTB …

Assessing Current Non-Pharmacologic Pain Management Practices For Sickle Cell Disease In Adults, Shreya Kolipaka, Michelle Axe, Charmaine Wright, Stephanie Guarino

Student Papers, Posters & Projects

OBJECTIVES: Both acute and chronic pain caused by sickle cell disease (SCD) is often managed with opioid therapy despite limited evidence for long-term efficacy. Adequately managing SCD pain requires a comprehensive approach, incorporating both pharmacologic and non-pharmacologic interventions. In other conditions, peer-mentored group programs are effective in managing chronic pain; however, their role in SCD is not yet described. Our objective is to understand patients' current pharmacologic and non-pharmacologic SCD management practices as well as further exploring perspectives of pain related to SCD.

METHODS: Participants were interviewed using semi-structured format. Audio-recorded interviews were transcribed. Descriptive statistics and pain management modality …

Healthcare Access And The Persistent Racial Disparities In Low Birth Weight, Zaheda A. Hussain, Yadanar Moe

DePaul Discoveries

Low birth weight (LBW), defined as less than 2,500 grams, is an influential factor contributing to infant mortality in the United States, with significant racial disparities between Black and White mothers. This study analyzed data from 3,054 Black and White mothers collected from the 2018 National Health Interview Survey to explore the association between access to medical care and LBW within different racial groups. The prevalence of LBW was 8.0%. Overall, mothers without a usual place of medical care had, on average, an 18% higher risk of LBW than those with a usual place (OR = 1.18, 95% CI: 0.80–1.74). …

Testing Elicitors Of Homologous Jadr2 Proteins To Regulate Natural Product Production, Carzon J. Williams, Emilee A. Patterson, Allison S. Walker

SPARK Symposium Presentations

The growing threat of antimicrobial resistance (AMR) has and will contribute to global economic and public health concerns in the foreseeable future leading into 2050. As mortality rates derived from AMR are projected to reach 10 million if no viable solution is found to combat it through hastened drug discovery. The use of natural products to mitigate AMRs effects is viable as more than 50% of FDA approved drugs are natural products. These natural products are synthesized by biosynthetic gene clusters (BGC), found in bacteria with a regulatory protein not allowing transcription until unbound . Current methods of eliciting the …

Biotic Therapies For Irritable Bowel Syndrome: Current Interventions, Gina Wodarczyk, Maria Winte, Diana Mastellone, Termen Singh, Joshua Desipio, Sangita Phadtare

Division of Gastroenterology and Hepatology Faculty Papers

Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder characterized by recurrent abdominal pain and changes in bowel habits without measurable disease processes. Recent research emphasizes the gut-brain-microbiome (GBM) axis and explores how microbiota influence gastrointestinal and central nervous system functions. Here, we first discuss a brief overview of various treatment approaches for IBS, focusing on interventions such as probiotics, prebiotics, or synbiotics that target the GBM axis in adults with IBS. Relevant trials discussed the use of probiotics, prebiotics, or synbiotics.

Specific Carbohydrate Diet Versus Mediterranean Diet In Adult Patients With Mild To Moderate Ulcerative Colitis: A Randomized Controlled-Feeding Trial, Albert Sheng-Yin Chen, Long Nguyen, Brianna Gray, Katherine Williams, Jenny Gurung, Lauren Canha, Jessica Mcgoldrick, Jane Hubbard, Hamed Khalili

Student Papers, Posters & Projects

Background and aims: This pilot randomized controlled-feeding trial compared the effect of Specific Carbohydrate Diet (SCD) and Mediterranean diet (MeD) in mild to moderate ulcerative colitis (UC).

Methods: Seventeen adults were randomized to a 6-week SCD (n = 8) or MeD (n = 9) intervention. Primary outcome was change in partial Mayo Clinic score (pMCS).

Results: The study was discontinued early due to significant dropout (n = 9, 52.9%). There was no significant between-group differences observed for pMCS change (SCD, -0.8; MeD, -1.3; p = 0.499) or secondary outcomes. Exploratory metagenomic analysis revealed enrichment of Parasutterella excrementihominis …

Feasibility And Acceptability Of Automated Texts To Offer, Screen, And Enroll Patients In A Cancer Clinical Trial Financial Reimbursement Program: Mixed Methods Study, Ashley E Santaniello, Hena Patel, Sarah Milinski, Mohan Balachandran, Vivian Nguyen, E. Paul Wileyto, Robert H. Vonderheide, Dana Dornsife, Robert G. Johnson, Carmen E. Guerra

Student Papers, Posters & Projects

BACKGROUND: Out-of-pocket (OOP) costs pose a significant barrier to participating in cancer clinical trials (CCTs). Financial reimbursement programs (FRPs) that reduce the burden of OOP costs can support participation in CCTs if the information is readily available to participants at the time of enrollment. Prior studies have shown the importance and impact of FRPs, but despite improvements, significant barriers still remain.

OBJECTIVE: This study was designed to explore the feasibility and acceptability of automated texts designed to offer, screen, and enroll CCT participants in an FRP for OOP travel and lodging-related clinical trial costs.

METHODS: This study used a mixed …

Spontaneous Intracranial Hypotension With Negative Brain Mri Findings: A Systematic Review Of Diagnostic Strategies And Clinical Outcomes, Marina Romozzi, Giuseppe Garignano, Valid Rastegar, Francesco Onorati, Catello Vollono, Federico Tosto, Masahito Katsuki, Yasuhiko Matsumori, Francesco Signorelli

Student Papers, Posters & Projects

BACKGROUND: Spontaneous intracranial hypotension (SIH) is a debilitating syndrome typically characterized by orthostatic headache and classic brain MRI findings. However, brain MRI abnormalities are indirect manifestations of cerebrospinal fluid (CSF) volume depletion rather than direct evidence of the leak, and some patients may present with unrevealing or absent typical brain MRI findings, posing a considerable diagnostic challenge.

METHODS: A comprehensive search of PubMed/Medline, Web of Science, and Scopus was conducted to perform a systematic review, according to PRISMA guidelines, analyzing the available evidence on MRI-negative SIH (patients without typical SIH findings on their initial brain MRI), including its clinical features, …

Hemidiaphragmatic Segmental Zoster Paresis, Terrence Sanvictores, Johnson Ukken

School of Medicine Faculty Research

The reactivation of latent varicella-zoster virus within infected neurons can lead to common clinical manifestations, including rash, acute neuritis, post-herpetic neuralgia, herpes zoster ophthalmicus, and Ramsay–Hunt syndrome. Segmental zoster paresis is an unusual neurologic complication of shingles that is defined by focal asymmetric motor weakness in the myotome corresponding to skin lesions of the dermatome. This case is a presentation of a patient who developed chronic hypoxia and severe atelectasis attributed to right-sided phrenic nerve paralysis secondary to herpes zoster infection.

Benefits Of Pet Friendly Work Environments On Physical, Mental, And Social Health Of Office Workers: A Systematic Review, Ahmed Radwan, Jenna Keeman, Tristan Hunzinger, Owen Wilson, Shayla Seymour

People and Animals: The International Journal of Research and Practice

Background: Pet-friendly workplace initiatives are increasingly common, yet the empirical evidence for benefits to office workers’ physical, mental, and social health is scattered and heterogeneous.

Objective: To synthesize evidence on health-related outcomes associated with pet-friendly work environments for office and desk-based workers, and to appraise the current level of evidence.

Methods: A PRISMA-guided systematic search (2014–2024) was conducted in PubMed, PsycINFO, MEDLINE, OVID, CINAHL, and Google Scholar. Two reviewers independently screened titles/abstracts and full texts, extracted data, and appraised study quality using the Critical Appraisal Skills Program (CASP) checklists. Outcomes were coded and synthesized narratively within three domains: physical, mental, …

Pearson Syndrome: Expanding The Clinical Spectrum Of A Mitochondrial Cytopathy-A Case Report, Alizah Faisal, Hooria Waqas, Hania Masood, Armeen Butt, Saad Rahman, Muhammad Sheraz Hameed, Syed Rafay Hussain Zaidi, Ali Iqbal, Muhammad Usama Naveed

Department of Medicine Faculty Papers

BACKGROUND: Pearson syndrome (PS) is a rare multisystem mitochondrial disorder characterized by single large-scale mitochondrial DNA deletions (SLSMDs). It typically presents in infancy with refractory sideroblastic anemia, exocrine pancreatic insufficiency, and failure to thrive. Due to its heterogeneous manifestations and resemblance to other hematological conditions, early diagnosis remains a clinical challenge.

CASE PRESENTATION: A south asian male infant presented with persistent pancytopenia, severe anemia unresponsive to intravenous and oral iron and multivitamin supplements, exocrine pancreatic insufficiency, failure to thrive, and metabolic acidosis. Born to consanguineous parents, the child had a significant family history of early infant deaths and hematological abnormalities. …

Assessing Hpv And Hpv Vaccine Awareness And Perception Amongst Undergraduate Students, Maura Hawkins

Honors Theses

Human Papillomavirus (HPV) is one of the most common sexually transmitted infections in the United States. Vaccination rates remain low among college-aged students despite an effective vaccine being available. This study investigates HPV and HPV vaccination-related knowledge, beliefs, and perceptions among undergraduate students to inform targeted intervention strategies. Participants included undergraduate students (n = 19) who attended one of three focus groups conducted in April 2025 at the University of South Alabama. Structured interview guides explored HPV knowledge, perceived risk and severity, attitudes towards vaccination, autonomy in health decision-making, trust in health information sources, and preferred educational strategies. Discussions were …

Effects Of Obstructive Sleep Apnea On Circulating Immune Cells Profiles: Evidence From Nhanes Dataset And Mendelian Randomization, Yajie Jia, Xiang Gao, Shenglong Xu, Jingli Shi, Haifeng Hou, Yanru Li, Demin Han

Research outputs 2022 to 2026

Objectives: This study aimed to investigate the impact of Obstructive Sleep Apnea (OSA) on immune cell profiles by utilizing both the National Health and Nutrition Examination Survey (NHANES) dataset and a two-sample Mendelian Randomization (MR) method. Methods: We included 20,732 participants from the NHANES to explore the relationship between symptom defined OSA and peripheral immune cells. Additionally, we conducted a two-sample MR analysis to investigate the effect of OSA on 35 summarized peripheral immune cell properties and 731 immunophenotypes. To ensure the robustness of findings in MR analysis, we conducted a sensitivity analysis. Results: The NHANES dataset and MR analysis …

Inpatient Versus Outpatient Management Of Bilateral Optic Nerve Head Elevation Presentation To A Tertiary Emergency Department, Mengchen Suo, Johnny Lo, Fred K. Chen

Research outputs 2022 to 2026

Introduction: Increased accessibility to fundus cameras has changed the referral pattern for patients with suspected bilateral optic nerve head elevation (BONHE) presenting to emergency departments (EDs). We aim to review the management of these patients to streamline the process. Methods: A retrospective review of patients with suspected BONHE referred to a tertiary centre ED between 2017 and 2022. We collected demographics, referral source, clinical assessment, neuroimaging and retinal imaging results. Final diagnosis and treatment outcomes were compared between those managed as inpatients and those managed as outpatients. Results: 100 patients were referred to the ED with a suspected BONHE. Most …

Optimizing Esophagogastric Junction Assessment And Antisecretory Medication Documentation During Egd: A Preintervention Quality Improvement Analysis, Vikram R. Ekambaram, Maneera Chopra, Wasseem Skef

Summer Research Program Abstracts

No abstract provided.

Regional Hemodynamic Characterization Of The Thoracic Aorta Using 4d Flow Mri: A Single-Center Pilot Study, John H. Major

Summer Research Program Abstracts

No abstract provided.

Ai-Segmented Upper Airway Imaging Biomarkers Across The Lifespan, David L. Holt, Vishwa S. Parekh

Summer Research Program Abstracts

No abstract provided.

Functional Characterization Of A Hepcidin Knockout Mouse Model For The Study Of Acute Pancreatitis, Andrew Schmidt, Amanda Bean, Jiajing Li, Danqing Ren, Suhair Al Salihi, Yanna Cao, Tien Ko

Summer Research Program Abstracts

No abstract provided.

Comparison Of Refractive Accuracy Of Iolmaster 700, Lenstar Ls 900, And Anterion For Iol Power Calculation, Travis Williams Md Ms, Mena Kozman Md, Siddhant Patil, Leon Toursarkissian, Ahmad Kheirkhah Md

Summer Research Program Abstracts

No abstract provided.

Pyogenic Liver Abscess Associated With Acute Hepatitis A And Burkholderia Cepacia Sepsis In A Child: A Rare Case Report, Anjali M, Poonam Wade, Snehal Sahebrao Kasbe, Neha Bhongale

Digital Journal of Clinical Medicine

Pyogenic liver abscess is an uncommon but potentially life-threatening infection in children. Although it is usually associated with underlying predisposing conditions, its occurrence in association with acute hepatitis A is infrequently reported.

We report a case of a 4-year-old male child who presented with fever, jaundice, and abdominal distension and was diagnosed with pyogenic liver abscess associated with concurrent hepatitis A infection and Burkholderia cepacia complex sepsis.

This case underscores the need to consider secondary bacterial infection in children with hepatitis A who have persistent fever or an unexpected clinical course despite appropriate supportive care. Although jaundice may initially be …

Social Phobia, Coping Strategies, And Socio-Demographic Associations Among Late Adolescents: A Cross-Sectional Study, Ezhilan B U, Jesymol Joy, Smitha Chandrashekarappa Dr.

Digital Journal of Clinical Medicine

Background: Adolescence is a transitional period from childhood to adulthood, often marked by psychological challenges such as social anxiety, also known as social phobia. It is characterized by excessive fear of social interactions and can lead to impaired functioning or depression. Globally, its prevalence ranges from 6-10% in developed countries and 10-44% in developing countries. Coping strategies play a crucial role in managing social phobia, varying by individual characteristics. This study aimed to determine the prevalence of social phobia, identify coping strategies, and evaluate their association with socio-demographic factors among late adolescents.

Methodology: A cross-sectional study was conducted …

Long-Term Quality Of Life For Patients With Merkel Cell Carcinoma Receiving Standard-Of-Care Adjuvant Radiation Therapy, Christian Paul D. Denolan, Kelsey N. Nordlund, Aya F. Salem, Devarati Mitra

Summer Research Program Abstracts

No abstract provided.

Persistent Gaps In Management And Risk Factor Control Among Patients With Atherosclerotic Cardiovascular Disease: All Of Us Research Program, Yakubu Bene-Alhasan, Soad Al Osta, Yussif Issaka, Isaac Acquah, Ahmad Alkhatib, Leen Othman, Samuel Mensah, Ato Howard, Christie Ballantyne, Salim S. Virani

Population Health, East Africa

Background

Methods

U.S. Cardiovascular Mortality Before And During Covid-19: Cdc Wonder Vs Gbd Comparison, Mirza Ali Baig, Muhammad Umar, Carol Becker, Salim S. Virani, Dmitry Abramov, Xiaoming Jia, Abdul Minhas

Population Health, East Africa

No abstract provided.

Ultrasound-Enhanced Targeted Delivery Of Atheroglitatide For Prevention Of In-Stent Restenosis, Elizabeth Jaime Nava

Summer Research Program Abstracts

No abstract provided.