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Antibiofilm Properties Of 4-Hydroxy-3-Methyl-2-Alkenylquinoline, A Novel Burkholderia-Derived Alkaloid, Mckinley D Williams, Taylor R Sweeney, Sabrina Trieu, Ravi Orugunty, Abdelahhad Barbour, Fereshteh Younesi, Michael Glogauer, Nopakorn Hansanant, Ronald Shin, Shi-En Lu, Kevin Cao, Abraham Tenorio, Sigmund J Haidacher, Anthony M Haag, Thomas D Horvath, Leif Smith May 2025

Antibiofilm Properties Of 4-Hydroxy-3-Methyl-2-Alkenylquinoline, A Novel Burkholderia-Derived Alkaloid, Mckinley D Williams, Taylor R Sweeney, Sabrina Trieu, Ravi Orugunty, Abdelahhad Barbour, Fereshteh Younesi, Michael Glogauer, Nopakorn Hansanant, Ronald Shin, Shi-En Lu, Kevin Cao, Abraham Tenorio, Sigmund J Haidacher, Anthony M Haag, Thomas D Horvath, Leif Smith

Faculty, Staff and Students Publications

Biofilms are an important colonization mechanism employed by several microbial species to better establish themselves and monopolize the acquisition of resources across different environs. Some bacteria have evolved specialized metabolites that, when secreted, disrupt the formation and stability of biofilms generated by competing heterospecies, providing the producing organism with an ecological advantage. Soil-derived species are probable candidates for the identification of such compounds, given the intense level of competition that occurs within the terrestrial ecosystem. The MS14 strain of Burkholderia contaminans isolated from soil in Mississippi has previously been shown to produce antimicrobial compounds like occidiofungin and ornibactin. In this …


Unpacking Violence: Examining Socioeconomic, Psychological, And Genetic Drivers Of Gun-Related Homicide And Potential Solutions, John Menezes, Kavita Batra May 2025

Unpacking Violence: Examining Socioeconomic, Psychological, And Genetic Drivers Of Gun-Related Homicide And Potential Solutions, John Menezes, Kavita Batra

Department of Plastic Surgery Faculty Research

Background: Gun-related homicide remains a persistent public health crisis in the United States, with over 48,000 firearm-related deaths reported in 2022, including 19,651 homicides and 27,032 suicides. Despite frequent calls for tighter gun control, firearm access alone does not explain the complexity of violence. Objective: This commentary aims to unpack the socioeconomic, psychological, and biological drivers of gun-related homicide and propose integrative, evidence-based solutions that extend beyond legislative reform. Methods: We synthesized data from peer-reviewed literature, national crime and health databases (e.g., Centers for Disease Control and Prevention and Federal Bureau of Investigation), and international reports. We examined patterns related …


Revisiting Traumatic Intracerebral Hemorrhage In The Context Of Enrich: Illustrative Cases, Erik Werheim, Brendan Mcshane, Zachary Sokol, Theodore Hannah, Robert Ziechmann, Phillip Villaneuva May 2025

Revisiting Traumatic Intracerebral Hemorrhage In The Context Of Enrich: Illustrative Cases, Erik Werheim, Brendan Mcshane, Zachary Sokol, Theodore Hannah, Robert Ziechmann, Phillip Villaneuva

Department of Surgery Faculty Papers

BACKGROUND: Traumatic intracerebral hemorrhage (tICH) is a common form of intracranial hemorrhage after traumatic brain injury (TBI). The role of surgical intervention in tICH remains a subject of discussion. Recent trials, such as Early Minimally Invasive Removal of Intracerebral Hemorrhage (ENRICH), have shown the efficacy of minimally invasive clot evacuation for non-tICH for hemorrhages with volumes of 30-80 mL. The generalizability of ENRICH to tICH remains unclear; however, it demonstrates the need for rigorous studies evaluating the efficacy of surgical intervention in tICH versus medical management.

OBSERVATIONS: Here the authors present 2 cases of tICH, both in the dominant temporal …


Hand Hygiene Roles, Challenges, And Intervention Feedback From School Staff: A Qualitative Analysis, Belize, 2022-2023, Anh N Ly, Christina Craig, Dian Maheia, Yolanda Gongora, Vickie Romero, Rosalva Blanco, Allison Lino, Kelsey Mcdavid, Allison Stewart, Victoria Trinies, Alexandra Medley, Francis Morey, Russell Manzanero, Matthew Lozier, Kristy O Murray May 2025

Hand Hygiene Roles, Challenges, And Intervention Feedback From School Staff: A Qualitative Analysis, Belize, 2022-2023, Anh N Ly, Christina Craig, Dian Maheia, Yolanda Gongora, Vickie Romero, Rosalva Blanco, Allison Lino, Kelsey Mcdavid, Allison Stewart, Victoria Trinies, Alexandra Medley, Francis Morey, Russell Manzanero, Matthew Lozier, Kristy O Murray

Faculty, Staff and Students Publications

Hand hygiene (HH) in school settings can reduce the spread of infectious diseases and student absenteeism due to illness. During the COVID-19 pandemic, the World Health Organization recommended HH as a public health measure to prevent disease transmission. Understanding school staff's experiences with school-based programs is important for future program development and improvement. As part of a mixed-methods study, we conducted in-depth interviews in March 2022 with school administrators and teachers at 12 primary schools in Belize, selected based on high gaps in HH resources, to understand HH responsibilities, supplies, and challenges. An intervention was implemented to increase HH knowledge …


Cone Beam Ct Dose Optimisation: A Review And Expert Consensus By The 2022 Estro Physics Workshop Igrt Working Group, Lydia J. Wilson, Andria Hadjipanteli, Daniella E. Østergaard, Evelien Bogaert, Kirstie F. Brown, Rianne Dejong, James Earley, Magali Edouard, Marina Khan, Josh Lindsay, Jessica Van Der Himst, George X. Ding, Tim Wood, Marianne C. Aznar, Nuria Jornet, Georgios Ntentas May 2025

Cone Beam Ct Dose Optimisation: A Review And Expert Consensus By The 2022 Estro Physics Workshop Igrt Working Group, Lydia J. Wilson, Andria Hadjipanteli, Daniella E. Østergaard, Evelien Bogaert, Kirstie F. Brown, Rianne Dejong, James Earley, Magali Edouard, Marina Khan, Josh Lindsay, Jessica Van Der Himst, George X. Ding, Tim Wood, Marianne C. Aznar, Nuria Jornet, Georgios Ntentas

Department of Radiation Oncology Faculty Papers

Image guided radiotherapy (IGRT) using kilovoltage cone-beam CT (CBCT) has become an indispensable tool to ensure the geometric accuracy of radiotherapy treatment delivery. Although significant technical advances have been made in reducing imaging dose, the repeated imaging procedures can still accumulate significant dose to healthy tissues. Despite the widespread use, we still lack clear guidance for optimisation and widely accepted frameworks for evaluating the quality and suitability of CBCT imaging protocols. To address this gap, the 2022 European Society for Radiotherapy and Oncology (ESTRO) Physics Workshop focused on image-quality and imaging-dose optimisation for IGRT using CBCT. This publication represents a …


Implementation Of A Health Care Transition Pathway For Children And Adults With Inborn Errors Of Metabolism: A Pilot Project, Brittany M. Murray May 2025

Implementation Of A Health Care Transition Pathway For Children And Adults With Inborn Errors Of Metabolism: A Pilot Project, Brittany M. Murray

Doctor of Nursing Practice Scholarly Projects

Background: Children with medically complex diseases require highly specialized care by a highly specialized team. Those with rare disease, including inborn errors of metabolism (IEMs), are a medically complex population and face significant challenges undergoing the health care transition from a child/family-centered model to an adult/patient-centered model of care. The project site follows patients with IEMs in the Metabolism Program, but previously did not have a coordinated process and had insufficient resources for patients/families for the health care transition.

Methods: The Plan-Do-Study-Act (PDSA) method was utilized as the model for improvement. Due to the complexity of the population and time …


Thsd1 Is A Multifaceted Regulator In Health And Disease, Mengjun Dai, Kuizhi Qu, Sophie Liu, Zhen Xu, Yan-Ning Rui May 2025

Thsd1 Is A Multifaceted Regulator In Health And Disease, Mengjun Dai, Kuizhi Qu, Sophie Liu, Zhen Xu, Yan-Ning Rui

Faculty, Staff and Student Publications

Thrombospondin Type 1 Domain-Containing Protein 1 (THSD1) is a transmembrane protein increasingly recognized for its critical roles in vascular biology and disease pathogenesis. Initially identified as a marker of hematopoietic stem and endothelial cells during embryogenesis, THSD1 has since been implicated in a wide spectrum of physiological and pathological processes. This paper consolidates current knowledge on THSD1, with a focus on its roles in vascular integrity, perinatal disorders, and tumorigenesis. In vascular systems, THSD1 promotes focal adhesion assembly and suppresses autophagy-mediated adhesion turnover, thereby stabilizing endothelial attachment and maintaining barrier function. Genetic and functional studies support its protective role against …


A Smart Pill Bottle And Text Messaging Intervention For Promoting Medication Adherence In Patients With Chronic Myeloid Leukemia: A Pilot Study Of Txt4 Tki, Kuang-Yi Wen, Neil Palmisiano, Rita Smith, Rachel Slamon, Gina Keiffer, Christian Fidler, Margaret Kasner, Lindsay Wilde, Md May 2025

A Smart Pill Bottle And Text Messaging Intervention For Promoting Medication Adherence In Patients With Chronic Myeloid Leukemia: A Pilot Study Of Txt4 Tki, Kuang-Yi Wen, Neil Palmisiano, Rita Smith, Rachel Slamon, Gina Keiffer, Christian Fidler, Margaret Kasner, Lindsay Wilde, Md

Department of Medical Oncology Faculty Papers

BACKGROUND: Patients undergoing tyrosine kinase inhibitor (TKI) therapy for chronic myeloid leukemia (CML) often face challenges with adherence, despite the efficacy of the treatment. Theory-guided and evidence-informed interventions addressing psychosocial and adherence barriers are critical for promoting adherence. Using a mixed-method approach, the pilot study developed and evaluated the feasibility and potential impact of an intervention "txt4TKI," to support medication and symptom management among CML patients undergoing TKI therapy.

METHODS: Guided by the Necessity and Concerns framework, the study comprised two phases: Phase 1 involved qualitative patient needs assessment interviews informing intervention design. Phase 2 was a single-arm pilot study …


Development And Pilot Testing Of An Addiction Clinic-Based Pre-Exposure Prophylaxis Uptake And Adherence Intervention For Women With Substance Use Disorders: Protocol For A Pilot Randomized Trial, Angela M Heads, Diane Santa Maria, Mandy J Hill, Robert Suchting, Kimberly N Evans, Zaneta Gaul, Luba Yammine, Constanza De Dios, Joy M Schmitz May 2025

Development And Pilot Testing Of An Addiction Clinic-Based Pre-Exposure Prophylaxis Uptake And Adherence Intervention For Women With Substance Use Disorders: Protocol For A Pilot Randomized Trial, Angela M Heads, Diane Santa Maria, Mandy J Hill, Robert Suchting, Kimberly N Evans, Zaneta Gaul, Luba Yammine, Constanza De Dios, Joy M Schmitz

Faculty, Staff and Student Publications

Background: Black and Hispanic women in the United States continue to bear disproportionate incidence of HIV related to sexual transmission and injection drug use. Specifically, women with substance use disorders (SUDs) are more likely to engage in vaginal or anal condomless sex associated with HIV transmission. Pre-exposure prophylaxis (PrEP) is a highly effective HIV prevention tool but is not widely used by racial or ethnic minority women. Effective interventions for engaging women with SUDs in HIV prevention interventions that are culturally appropriate and, therefore, more appealing to racial or ethnic minority women with SUDs are critically needed.

Objective: This 3-phased …


Commencement, Philadelphia (2025), Philadelphia College Of Osteopathic Medicine May 2025

Commencement, Philadelphia (2025), Philadelphia College Of Osteopathic Medicine

Commencements

Philadelphia Campus Commencement Program, 2025. Degrees include Doctor of Osteopathic Medicine, Doctor of Philosophy in Educational Psychology, Doctor of Psychology in Clinical Psychology, Doctor of Psychology in School Psychology, Educational Specialist in School Psychology, Master of Science in Applied Behavioral Analysis, Master of Science in Applied Positive Psychology, Master of Science in Mental Health Counseling, Master of Science in Biomedical Sciences, Master of Science in Forensic Medicine, Master of Science in Health Sciences - Physician Assistant Studies.

Commencement Speaker: John J. Lynch III.


Neuroanatomical And Morphometric Differences In Children Who Stutter, Mohammad A. Khan May 2025

Neuroanatomical And Morphometric Differences In Children Who Stutter, Mohammad A. Khan

Honors Scholar Theses

Childhood-Onset Fluency Disorder commonly known as stuttering is a neurodevelopmental speech disorder characterized by disruptions in speech fluency. While genetic and neurobiological factors are implicated, the structural brain differences underlying stuttering remain unclear. This study investigated neuroanatomical alterations in children who stutter (CWS) compared to typically fluent children (TFC), focusing on gray matter volume, cortical thickness, and surface area in speech-related regions; the Inferior Frontal Gyrus, Middle Temporal Gyrus, and Pre-motor Operculum. High-resolution MRI data from 100 children (48 CWS, 52 TFC) aged 3–12 years were analyzed using FreeSurfer. Group comparisons revealed no statistically significant differences in cortical thickness, surface …


Post-Recovery Viral Shedding Shapes Wastewater-Based Epidemiological Inferences, Tin Phan, Samantha Brozak, Bruce Pell, Stanca M Ciupe, Ruian Ke, Ruy M Ribeiro, Anna Gitter, Kristina D Mena, Alan S Perelson, Yang Kuang, Fuqing Wu May 2025

Post-Recovery Viral Shedding Shapes Wastewater-Based Epidemiological Inferences, Tin Phan, Samantha Brozak, Bruce Pell, Stanca M Ciupe, Ruian Ke, Ruy M Ribeiro, Anna Gitter, Kristina D Mena, Alan S Perelson, Yang Kuang, Fuqing Wu

Faculty, Staff and Student Publications

Background: The prolonged viral shedding from the gastrointestinal tract is well documented for numerous pathogens, including SARS-CoV-2. However, the impact of prolonged viral shedding on epidemiological inferences using wastewater data is not yet fully understood.

Methods: To gain a better understanding of this phenomenon at the population level, we extended a wastewater-based modeling framework that integrates viral shedding dynamics, viral load data in wastewater, case report data, and an epidemic model.

Results: Our results indicate that as an outbreak progresses, the viral load from recovered individuals gradually becomes predominant, surpassing that from the infectious population. This phenomenon leads to a …


Comprehensive Evaluation Of Phosphoproteomic-Based Kinase Activity Inference, Sophia Müller-Dott, Eric J Jaehnig, Khoi Pham Munchic, Wen Jiang, Tomer M Yaron-Barir, Sara R Savage, Martin Garrido-Rodriguez, Jared L Johnson, Alessandro Lussana, Evangelia Petsalaki, Jonathan T Lei, Aurelien Dugourd, Karsten Krug, Lewis C Cantley, D R Mani, Bing Zhang, Julio Saez-Rodriguez May 2025

Comprehensive Evaluation Of Phosphoproteomic-Based Kinase Activity Inference, Sophia Müller-Dott, Eric J Jaehnig, Khoi Pham Munchic, Wen Jiang, Tomer M Yaron-Barir, Sara R Savage, Martin Garrido-Rodriguez, Jared L Johnson, Alessandro Lussana, Evangelia Petsalaki, Jonathan T Lei, Aurelien Dugourd, Karsten Krug, Lewis C Cantley, D R Mani, Bing Zhang, Julio Saez-Rodriguez

Faculty, Staff and Students Publications

Kinases regulate cellular processes and are essential for understanding cellular function and disease. To investigate the regulatory state of a kinase, numerous methods have been developed to infer kinase activities from phosphoproteomics data using kinase-substrate libraries. However, few phosphorylation sites can be attributed to an upstream kinase in these libraries, limiting the scope of kinase activity inference. Moreover, inferred activities vary across methods, necessitating evaluation for accurate interpretation. Here, we present benchmarKIN, an R package enabling comprehensive evaluation of kinase activity inference methods. Alongside classical perturbation experiments, benchmarKIN introduces a tumor-based benchmarking approach utilizing multi-omics data to identify highly active …


Can The Location Of Angina Predict The Site Of Coronary Artery Occlusion In Acute Myocardial Infarction? – The Acolyte Study, Kamal Sharma, Ashwati Konat, Poojan Prajapati, Kavya Darji, Shalin Rawal, Vatsa Bhavsar, Prahar Darji, Yashrajsinh Gohil, Masum Patel, Shubham Patel, Parjanya Bhatt, Yashvi Pethani, Stuti Shah, Hardik Desai May 2025

Can The Location Of Angina Predict The Site Of Coronary Artery Occlusion In Acute Myocardial Infarction? – The Acolyte Study, Kamal Sharma, Ashwati Konat, Poojan Prajapati, Kavya Darji, Shalin Rawal, Vatsa Bhavsar, Prahar Darji, Yashrajsinh Gohil, Masum Patel, Shubham Patel, Parjanya Bhatt, Yashvi Pethani, Stuti Shah, Hardik Desai

Journal of the Saudi Heart Association

Aim: To evaluate the relationship between the location of chest pain (topography) and the site of coronary artery involvement in patients with acute coronary syndrome (ACS) undergoing percutaneous transluminal coronary angioplasty (PTCA).

Materials and Methods: This prospective, observational study included 411 consecutive ACS patients admitted to a tertiary care center between January 2017 and December 2019. A total of 589 angina topographic sites were analyzed. The site and characteristics of chest pain, along with electrocardiogram and coronary angiography findings, were documented and assessed for correlation with the involved coronary artery.

Results: Among the 411 patients, 337 (82.0%) were male and …


Interprofessional Collaboration Between Primary Care And Occupational Therapy, Ellen Modlin, Phd, Otr/L, Bcp, Caps, Deana Shevit Goldin, Phd, Dnp, Arnp, Fnp-Bc May 2025

Interprofessional Collaboration Between Primary Care And Occupational Therapy, Ellen Modlin, Phd, Otr/L, Bcp, Caps, Deana Shevit Goldin, Phd, Dnp, Arnp, Fnp-Bc

Journal of Interprofessional Practice and Collaboration

Purpose: This article explores the utilization of occupational therapy (OT) in interprofessional health care teams in adult populations. Primary care settings are typically the first point of contact for individuals seeking health care services; therefore, primary care practitioners (PCPs) are in a unique position to initiate collaboration with specialty clinicians to optimize the use of health care resources.

Method: Peer- reviewed literature from primary care and OT research was reviewed and summarized. The search focused on barriers and potential opportunities for collaboration between primary care and occupational therapy in adult populations.

Results: Occupational therapy (OT) is underutilized, as lack of …


Global Dna Methylation Differences Involving Germline Structural Variation Impact Gene Expression In Pediatric Brain Tumors, Fengju Chen, Yiqun Zhang, Wei Li, Fritz J Sedlazeck, Lanlan Shen, Chad J Creighton May 2025

Global Dna Methylation Differences Involving Germline Structural Variation Impact Gene Expression In Pediatric Brain Tumors, Fengju Chen, Yiqun Zhang, Wei Li, Fritz J Sedlazeck, Lanlan Shen, Chad J Creighton

Children’s Nutrition Research Center Staff Publications

The extent of genetic variation and its influence on gene expression across multiple tissue and cellular contexts is still being characterized, with germline Structural Variants (SVs) being historically understudied. DNA methylation also represents a component of normal germline variation across individuals. Here, we combine germline SVs (by short-read sequencing) with tumor DNA methylation across 1292 pediatric brain tumor patients. For thousands of methylation probes for CpG Islands (CGIs) or enhancers, rare and common SV breakpoints upstream or downstream associate with differential methylation in tumors spanning various histologic types, a significant subset involving genes with SV-associated differential expression. Cancer predisposition genes …


Turning Analysis Into Action: Opportunities And Challenges In Implementing Wastewater Science For Public Health Decision-Making, Anna Gitter, Valeria Ruvalcaba, Katelyn Clark, Theresa Tran Carapucci, Fuqing Wu, Blake M Hanson, Jennifer Deegan, John Balliew, Eric Boerwinkle, Anthony W Maresso, Kristina D Mena May 2025

Turning Analysis Into Action: Opportunities And Challenges In Implementing Wastewater Science For Public Health Decision-Making, Anna Gitter, Valeria Ruvalcaba, Katelyn Clark, Theresa Tran Carapucci, Fuqing Wu, Blake M Hanson, Jennifer Deegan, John Balliew, Eric Boerwinkle, Anthony W Maresso, Kristina D Mena

Faculty, Staff and Students Publications

In the 5 years since the emergence of the COVID-19 pandemic, the field of wastewater-based epidemiology (WBE) has dramatically expanded with programs implemented across the globe to monitor for SARS-CoV-2 and other viruses of public health concern. However, the best way to use wastewater surveillance data and inform local communities of the utility of wastewater science remains limited and sporadically discussed. Specifically, there is vague guidance regarding interpreting varying levels of viral loads in wastewater for public health significance. While collaborative efforts are key to implementing these community-specific wastewater surveillance programs, effectively using the data for public health decision-making still …


Simultaneous Targeting Of Tumor Cells And Tumor-Associated Macrophages To Reprogram Glioblastoma Using Trypsinized Extracellular Vesicles Carrying Tumor Suppressive Microrna, Grace H Nguyen, Minhye Noh, Jin Muk Kang, Alexandra A Miller, Minxin Huang, Jiyeon Kim, Jeong-Yeon Lee, Sangwoon Chung, Hongyu Wang, George A Calin, Cynthia Ju, Holger K Eltzschig, Yeshavanth Banasavadi-Siddegowda, Zhongming Zhao, Ji Young Yoo, Tae Jin Lee May 2025

Simultaneous Targeting Of Tumor Cells And Tumor-Associated Macrophages To Reprogram Glioblastoma Using Trypsinized Extracellular Vesicles Carrying Tumor Suppressive Microrna, Grace H Nguyen, Minhye Noh, Jin Muk Kang, Alexandra A Miller, Minxin Huang, Jiyeon Kim, Jeong-Yeon Lee, Sangwoon Chung, Hongyu Wang, George A Calin, Cynthia Ju, Holger K Eltzschig, Yeshavanth Banasavadi-Siddegowda, Zhongming Zhao, Ji Young Yoo, Tae Jin Lee

Faculty, Staff and Student Publications

Glioblastoma (GBM) remains difficult to treat due to poor drug delivery across the blood-brain barrier and an immunosuppressive tumor microenvironment (TME). Tumor-suppressive microRNAs (miRNAs) offer a promising strategy to reprogram both tumor cells and the TME, but inefficient delivery systems limit their clinical application. We previously reported that tumor-suppressive miR-138 regresses tumor growth in preclinical GBM models. Here, we demonstrate that trypsin digestion of extracellular vesicles (EVs) enhances labeling efficiency with folate (FA), enhancing selective targeting of folate receptor (FR)-positive GBM cells and enabling simultaneous targeting of tumor-associated macrophages (TAMs). FA-labeled trypsinized EVs (tEVs) loaded with miR-138 inhibit tumor growth, …


Towards Universal Chemosensory Testing: Needs, Barriers, And Opportunities, Steven D. Munger, Kai Zhao, Linda A. Barlow, Duncan Boak, Katie Boateng, Susan E. Coldwell, Pamela Dalton, Richard L. Doty, Jennifer E. Douglas, Valerie Duffy, Frank A. Franklin, John E. Hayes, Howard J. Hoffman, Patrice Hubert, Paule V. Joseph, Jeb M. Justice, Joshua M. Levy, Julie A. Mennella, Marianna Obrist, M. Yanina Pepino, Jayant M. Pinto, Edmund A. Pribitkin, Christopher T. Simons, Mark W. Albers, Valentina Parma May 2025

Towards Universal Chemosensory Testing: Needs, Barriers, And Opportunities, Steven D. Munger, Kai Zhao, Linda A. Barlow, Duncan Boak, Katie Boateng, Susan E. Coldwell, Pamela Dalton, Richard L. Doty, Jennifer E. Douglas, Valerie Duffy, Frank A. Franklin, John E. Hayes, Howard J. Hoffman, Patrice Hubert, Paule V. Joseph, Jeb M. Justice, Joshua M. Levy, Julie A. Mennella, Marianna Obrist, M. Yanina Pepino, Jayant M. Pinto, Edmund A. Pribitkin, Christopher T. Simons, Mark W. Albers, Valentina Parma

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Millions of people in the United States experience a reduced or distorted ability to smell or taste. Chemosensory disorders such as anosmia (the inability to smell), parosmia (distorted smell), or dysgeusia (altered taste) have major impacts on health and quality of life including difficulty sensing dangers such as fire or spoilage, a diminished palatability of food and drink that can negatively influence diet and nutrition, feelings of social isolation, and an increased incidence of frailty, anxiety, and depression. Smell or taste dysfunction can also be symptoms of other health issues, including sinonasal disease, cancer, or neurodegenerative disease. Aging adults are …


Surrogate Trust In The Intensive Care Unit: What Can We Do Better?, Abdul W. Kazi, Phoebe Chun, David Oxman, Erika J. Yoo May 2025

Surrogate Trust In The Intensive Care Unit: What Can We Do Better?, Abdul W. Kazi, Phoebe Chun, David Oxman, Erika J. Yoo

Department of Medicine Faculty Papers

BACKGROUND/OBJECTIVES: Previous investigation into patients' trust in medical providers is largely limited to the outpatient setting, where increased trust is associated with improved adherence, satisfaction, and self-reported quality of life. Contrastingly, in the intensive care unit (ICU), patients are frequently incapacitated, and it is surrogates that engage with clinicians for decision making. This pilot study aims to measure and compare surrogate trust in the healthcare system and ICU physicians.

METHODS: We measured surrogate trust in both the healthcare system and providers by administering two domain-specific trust-measuring surveys (the Healthcare System Distrust Scale and a modified Trust in Physicians Scale) to …


Perianal Infections Update, Boris Garber, Jonathan Glauser May 2025

Perianal Infections Update, Boris Garber, Jonathan Glauser

Faculty Scholarship

Purpose of Review We describe the evaluation, treatment, and disposition of patients presenting with perianal and rectal complaints, specifically focusing on identifying and treating various infectious diseases affecting this area. Risk factors and preventative strategies are also discussed where known. Recent Findings Several professional medical associations, namely the World Society of Emergency Surgery and the American Association for the Surgery of Trauma, recently promulgated new guidelines concerning the diagnosis and management of common infectious rectal disorders [1]. The American College of Radiology also published its criteria for choosing appropriate imaging modalities for anorectal disease [2]. Additionally, new meta-analyses have been …


Sociodemographic And Psychosocial Characteristics Of E-Cigarette Ever-Use: U.S. Hints 6 Survey, Lilianna Phan, Kuang-Yi Wen, Hee Jun Kim, Julie A. Barta, Hee-Soon Juon May 2025

Sociodemographic And Psychosocial Characteristics Of E-Cigarette Ever-Use: U.S. Hints 6 Survey, Lilianna Phan, Kuang-Yi Wen, Hee Jun Kim, Julie A. Barta, Hee-Soon Juon

Department of Medical Oncology Faculty Papers

Objective

With high U.S. e-cigarette use prevalence and e-cigarette health risks, we examined associated factors for ongoing public health efforts.

Methods

We used national data from the 2022 Health Information National Trends Survey to estimate the overall U.S. prevalence of e-cigarette ever- and current-use and to examine associations by sociodemographics (i.e., age, race/ethnicity, gender, marital status, employment status, education level) and depressive symptoms (i.e., PHQ-4; no, mild, moderate or severe symptoms) using weighted multivariable logistic regressions adjusted for cigarette smoking status (n = 5924).

Results

In 2022, 17.1 % of U.S. adults ever-used e-cigarettes; of which, 4.3 % currently-used …


Icanfeel: A Digital Art Activity To Support Distress Detection In Adult Oncological Patients, Marie J. Deschamps May 2025

Icanfeel: A Digital Art Activity To Support Distress Detection In Adult Oncological Patients, Marie J. Deschamps

Expressive Therapies Dissertations

Considered the 6th vital sign, distress, a combination of hopelessness, anxiety, fear, and depression, can impact patients’ quality of life, treatment adherence, and mortality. While screening is required in oncological centers, distress remains under-detected. This study examined the use of Icanfeel, a novel digital art-based tool, to complement traditional psychometric assessments such as Edmonton Symptom Assessment System (ESAS), to support patients’ expressions of symptoms and distress detection. Hospitalized adult oncological patients (N = 22) engaged twice with Icanfeel and with an active control condition. At various time points during the protocol, patients self-reported symptom burden using ESAS, self-disclosure …


Addressing Socioeconomic Disparities In The Treatment Of Antimicrobial-Resistant Infections: The Role Of Pharmacists In Mitigating Barriers, Arin Wade, Danielle Egbujor, Anna Spalvieri, Owen Fox, Marisa Petrunich, Joshua Honaker, Samantha Mccord, Kasie Landin May 2025

Addressing Socioeconomic Disparities In The Treatment Of Antimicrobial-Resistant Infections: The Role Of Pharmacists In Mitigating Barriers, Arin Wade, Danielle Egbujor, Anna Spalvieri, Owen Fox, Marisa Petrunich, Joshua Honaker, Samantha Mccord, Kasie Landin

Pharmacy and Wellness Review

Antimicrobial resistance is an escalating global threat driven by inappropriate antibiotic use and shaped by socioeconomic disparities. Social determinants of health, including limited healthcare access, poverty, low health literacy, and environmental conditions, contribute to higher rates of resistant infections and poorer treatment outcomes in underserved populations. Barriers such as pharmacy deserts, self-medication, and inadequate stewardship infrastructure amplify these risks. Pharmacists, as accessible and highly trained healthcare professionals, play a critical role in combating antimicrobial resistance by optimizing antibiotic use, delivering culturally competent education, and leading antimicrobial stewardship programs across settings. Community and clinical pharmacists are especially well positioned to bridge …


Neoadjuvant With Low-Dose Radiotherapy, Tislelizumab, Albumin-Bound Paclitaxel, And Cisplatin For Resectable Locally Advanced Head And Neck Squamous Cell Carcinoma: Phase Ii Single-Arm Trial, Zhigang Liu, Dong Wang, Guanjun Li, Muhua Yi, Zhaoyuan Zhang, Guihua Zhong, Liangfu Xu, Rong Jiang, Yannan Zheng, Linxuan Huang, Yingpeng Peng, Lizhong Liang, Jianpeng Li, Ye Liu, Jun Lai, Xianjuan Lv, Yongqiang Xu, Qiaodan Liu, Zhiqiang Wang, Zhutian Liu, Qinan Yang, Li Nie, Jiao Lei, Xiaotao Huang, Zhijie Liu, Wen Jiang May 2025

Neoadjuvant With Low-Dose Radiotherapy, Tislelizumab, Albumin-Bound Paclitaxel, And Cisplatin For Resectable Locally Advanced Head And Neck Squamous Cell Carcinoma: Phase Ii Single-Arm Trial, Zhigang Liu, Dong Wang, Guanjun Li, Muhua Yi, Zhaoyuan Zhang, Guihua Zhong, Liangfu Xu, Rong Jiang, Yannan Zheng, Linxuan Huang, Yingpeng Peng, Lizhong Liang, Jianpeng Li, Ye Liu, Jun Lai, Xianjuan Lv, Yongqiang Xu, Qiaodan Liu, Zhiqiang Wang, Zhutian Liu, Qinan Yang, Li Nie, Jiao Lei, Xiaotao Huang, Zhijie Liu, Wen Jiang

Faculty, Staff and Student Publications

Although pathological complete response (pCR) and major pathological response (MPR) rates of neoadjuvant immunotherapy combined with chemotherapy in head and neck squamous cell carcinoma (HNSCC) trials remain suboptimal, emerging evidence highlights the synergistic potential of combining low-dose radiotherapy with immunotherapy to promote the efficacy of immunotherapy. This phase II, open-label, single-arm, multicenter trial (NCT05343325) enrolled 28 patients with untreated stage III-IVB HNSCC (NeoRTPC02). Patients received neoadjuvant low-dose radiotherapy, the programmed death-1 (PD-1) inhibitor tislelizumab, albumin-bound paclitaxel, and cisplatin for two cycles, followed by radical resection ~4 weeks after treatment completion. The primary endpoint, pCR rate, was achieved in 14 of …


Decreasing Time To Antibiotics In Febrile Oncology Patients With Central Line In The Pediatric Emergency Department; A Quality Improvement Initiative, Abbigayle Carlson, Leslie Hueschen, Stephanie Clark, Christopher Kaberline, Joel Thompson May 2025

Decreasing Time To Antibiotics In Febrile Oncology Patients With Central Line In The Pediatric Emergency Department; A Quality Improvement Initiative, Abbigayle Carlson, Leslie Hueschen, Stephanie Clark, Christopher Kaberline, Joel Thompson

Research Days

Background: Oncology patients are at a high risk for sepsis, due to chemotherapy-induced immunosuppression and neutropenia as well as presence of a central venous catheter. Due to the high risk of sepsis, these patients require antibiotics within 60 minutes of Emergency Department (ED) arrival. During our baseline period, Sept 2022-May 2023, we only achieved this 38% of the time at Children’s Mercy ED.

Aim: By April 30th, 2024, we will increase the percentage of ED febrile oncology patients receiving antibiotics < 60 min of arrival from 36.6% to 80%, stratifying by race and ethnicity, to monitor for inequities.

Methods: Our outcome measures were the percentage of ED febrile oncology patients with antibiotics given < 60 min of arrival and the median time to antibiotic administration. Our process measures were the percentage of standard order-set usage and percentage of patients with critical information notes. Our balance measure was time from arrival to ED triage. We created a process map and fishbone diagram and identified several delays in antibiotics administration. We performed interventions with Plan-Do-Study-Act methodology. First, we implemented standing nursing orders to decrease the time spent waiting for a provider to order antibiotics (June 2024). Next, the outpatient oncology providers created a Critical Information Note, which directed prompt antibiotic administration prior to labs or consultation (August 2024). To engage physicians, we made this a Maintenance of Certification (MOC) project, with monthly review of run charts (Oct 2024). Next, we prioritized timely access of the patients’ central line, with a nursing script to communicate with families the importance of accessing their child’s central line as soon as possible (Oct 2024). We created a Central Line Note, identifying the type of central line and needle size required to access the line (March 2024).

Results: With the implementation of …


Emergency Medicine Residency Website Wellness Pages: A Content Analysis, Alexandra Sappington, Brian Milman May 2025

Emergency Medicine Residency Website Wellness Pages: A Content Analysis, Alexandra Sappington, Brian Milman

School of Medicine Faculty Publications

Introduction: The COVID-19 pandemic impacted the way medical students seek residency positions. In 2020, the Accreditation Council for Graduate Medical Education advocated for virtual interviews. Most emergency medicine (EM) interviews in 2023 remained virtual, and this format will persist for the foreseeable future. Since students are not evaluating programs in person in most cases, residency websites are crucial for prospective residents. Resident wellness is critical for resident training and important to prospective residents; it follows that programs must be transparent about resident wellness on websites. In this study we aimed to quantify the number of EM programs with wellness pages …


Tacrolimus Dosing In Liver Transplant Recipients Using Phenotypic Personalized Medicine: A Phase 2 Randomized Clinical Trial, Jeffrey Khong, Megan Lee, Curtis Warren, Un Kim, Sergio Duarte, Kenneth Andreoni, Sunaina Shrestha, Mark Johnson, Narendra Battula, Danielle Mckimmy, Thiago Beduschi, Ji-Hyun Lee, Derek Li, Chih-Ming Ho, Ali Zarrinpar May 2025

Tacrolimus Dosing In Liver Transplant Recipients Using Phenotypic Personalized Medicine: A Phase 2 Randomized Clinical Trial, Jeffrey Khong, Megan Lee, Curtis Warren, Un Kim, Sergio Duarte, Kenneth Andreoni, Sunaina Shrestha, Mark Johnson, Narendra Battula, Danielle Mckimmy, Thiago Beduschi, Ji-Hyun Lee, Derek Li, Chih-Ming Ho, Ali Zarrinpar

Department of Surgery Faculty Papers

Tacrolimus is the most commonly used immunosuppression drug after solid organ transplantation; however, its dosing is challenging due to substantial inter-individual variability, often resulting in blood levels that deviate from the target therapeutic range. We explored whether a dynamically customized, phenotypic-outcome-guided drug dosing method could improve maintenance of drug trough levels within pre-determined target ranges, focusing on tacrolimus immediately after liver transplantation. This single-center, partially blinded, completed clinical trial involved 62 adults undergoing liver transplantation, block randomized into parallel groups: standard-of-care (SOC) clinician-determined or Phenotypic Personalized Medicine (PPM)-guided tacrolimus dosing. The primary outcome was percentage of post-transplant days with large …


Observed And Reported Outcomes Following Experiential Cultural Capability And Clinical Yarning Training For Clinicians Treating Aboriginal And Torres Strait Islander People With Persistent Pain, Stuart Ekberg, Renata F. I Meuter, Ivan Lin, Roslyn Rowen, Angela Kinnell, Eva Malacova, Tania Waring, Kushla Houkamau, Marayah Taylor, Matthew Bryant, Jermaine Isua, Andrew Claus, Paul Gray, Joseph Kluver, Christina M. Bernardes, Greg Pratt May 2025

Observed And Reported Outcomes Following Experiential Cultural Capability And Clinical Yarning Training For Clinicians Treating Aboriginal And Torres Strait Islander People With Persistent Pain, Stuart Ekberg, Renata F. I Meuter, Ivan Lin, Roslyn Rowen, Angela Kinnell, Eva Malacova, Tania Waring, Kushla Houkamau, Marayah Taylor, Matthew Bryant, Jermaine Isua, Andrew Claus, Paul Gray, Joseph Kluver, Christina M. Bernardes, Greg Pratt

Journal of the Australian Indigenous HealthInfoNet

Communication is recognised as crucial to culturally safe healthcare, and poor communication remains a major reason that Aboriginal and Torres Strait Islander people do not access healthcare. This pragmatic, pre-post comparison study employed mixed methods to evaluate cultural capability and clinical yarning training delivered to 57 clinicians supporting Aboriginal and Torres Strait Islander people at three persistent pain management services in Queensland, Australia. Observable outcomes of the training were evaluated by video recording clinicians’ training experiences and seven consultations with patients that occurred either pre- or post-training. Reported outcomes were evaluated by using a modified Cultural Safety Survey (CSS), which …


Spontaneous Pneumothorax In A Male High School Wrestler, Laura Breese, Sara Stiltner May 2025

Spontaneous Pneumothorax In A Male High School Wrestler, Laura Breese, Sara Stiltner

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE/BACKGROUND
A pneumothorax is the presence of air in the pleural space, it is a life threatening condition and can be classified as spontaneous, acquired, or by pathophysiology. (1)(2) This specific case presents the incident of a spontaneous pneumothorax in an adolescent population.