Digital Commons Network^™

Seeing Surgery Differently: The Role Of Virtual Reality In Pediatric Care, Bob Underwood, Mark Ryan

Pediatrics in Practice: A CME Podcast

Virtual reality is changing how pediatric surgeons plan procedures, educate care teams and help children and families better understand what to expect. In this episode, Mark Ryan, MD, pediatric surgeon, discusses how virtual reality is being used in pediatric surgery today, its impact on patient experience and surgical planning and what pediatricians should know as this technology continues to evolve.

Click here to stream the podcast episode.

Muc13-Associated Molecular Interactome In Pancreatic Cancer, Anupam Dhasmana, Swati Dhasmana, Rajasekhar Baru, Abigail Gomez, Shafiul Haque, Sheema Khan, Murali Yallapu, Subhash Chauhan

School of Medicine Publications

Mucin-13 (MUC13) has emerged as a critical molecular player involved in tumorigenesis, cancer progression, metastasis, and evasion of immune surveillance, including in pancreatic cancer. In this report, we identified MUC13 molecular interactome using an integrated immunoprecipitation and liquid chromatography–mass spectrometry (accession no. of protein data JPST004189) approach combined with systems network biology to determine its plausible functional protein–protein interaction network and associated oncogenic mechanisms. This study reveals a total of 54 key MUC13 interactor proteins (including cyclin-dependent kinase 1, catenin delta 1, Caludin-1, ErbB3-binding protein 1, basic transcription factor 3, tight junction protein 1, etc.). Interestingly, the majority of these …

Psychological Safety In Health Care: A Prerequisite For High Reliability, Sonali Thosani

Advances in Cancer Education and Quality Improvement

This paper presents a viewpoint on how psychological safety contributes to patient safety, teamwork, and high reliability.

Clinical Medical Emergency Team Training Simulation (Cmetts): An Interprofessional Simulation For Medical Students And Nursing Residents, Allan John R. Barcena, Marvin R. Bernardino, Dominic Karl M. Bolinas, Kitz Paul D. Marco, Toni Edwards, Shelita Kimble, James Cavalier, Marites P. Melancon, Jillian R. Gunther

Advances in Cancer Education and Quality Improvement

Effective teamwork and communication are critical during medical emergencies, particularly in oncology, yet health care professionals are often trained separately, creating challenges for interprofessional collaboration. Evidence-based frameworks like Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) offer structured tools to optimize team performance. This study describes a simulation-based program, the Clinical Medical Emergency Team Training Simulation (CMETTS), designed to instill foundational teamwork skills in early-stage learners. First-year medical students and newly graduated nursing residents participated in an interprofessional simulation involving medical emergency scenarios followed by structured debriefing sessions guided by TeamSTEPPS principles. We evaluated the program’s effectiveness …

Lessons Learned For Improving Trainee Engagement And Utilization Of Education And Training Materials For Cancer Research, Katerina M. Santiago, Tania Galindo, Michaela A. Dinan

Advances in Cancer Education and Quality Improvement

Background: A core component of the National Cancer Institute Cancer (NCI) Cancer Center Support Grant requires cancer centers to coordinate research career enhancement and related activities. The Yale Cancer Center, an NCI-designated comprehensive cancer center, established the Cancer Research Training and Education Coordination (CRTEC) component in 2016. In response to the needs of trainees, CRTEC has developed several initiatives that we have identified and described here as best practices to engage and support trainees.

Methods: We had 2 aims to improve engagement: 1) increasing our visibility and trainee awareness of CRTEC and nurturing bidirectional communication and 2) offering …

Centralizing Communication Intake To Improve Workflow Visibility And Engagement: A Quality Improvement Project In A Cancer Center's Education Division, Menatalla El-Sharkawi, Mohamed Ait Aiss

Advances in Cancer Education and Quality Improvement

Background: In large or complex organizations, multiple teams may be charged with managing different components of a project, initiative, or administrative assignment. When these teams have overlapping needs for information, the absence of a structured intake and tracking process can limit transparency, reduce efficiency, and hinder coordination across communication channels.

Methods: Drawing on principles of strategic communications and project management, we created a structured and centralized information sharing process for teams within the education division of a comprehensive cancer center. The intervention included workflow redesign, development of a standardized intake system, and use of real-time dashboard analytics to support operation …

Icu Decision Tool Impact On Rebound Hyperglycemia, Daniel J. Donovan, Emily Highsmith, Sonya Khan, Michelle Horng

Advances in Cancer Education and Quality Improvement

Hyperglycemia, defined as a blood glucose level ≥180 mg/dL in the hospitalized patient, is linked to negative outcomes including longer hospital stays, increased infection risk, and higher morbidity and mortality rates. In addition to critically ill patients with diabetes, hyperglycemia can develop in individuals without diabetes due to factors such as steroid use, continuous tube feedings, and an elevated stress response. Patients who have uncontrolled hyperglycemia are often placed on continuous insulin infusions (CII), but rebound hyperglycemia frequently occurs after CII discontinuation if the maintenance insulin regimen (MIR) is insufficient. Implementation of a MIR decision support tool integrated within an …

Biomechanical Effects Of Bilateral Torsion And Skeletal Fusion: A Case Study, Linnéa Forbes

Honors Projects

As part of both a personal endeavor and an academic project, I have investigated the aetiology and treatment of seemingly idiopathic and debilitating leg pain in a patient over the past 10 years. Via collaboration with medical professionals at Cincinnati Children’s Hospital, Cincinnati Premier Physical Therapy, and Cincinnati Women’s TriHealth, I have identified sources of pain at the anatomical level. The combination of internal femoral torsion, external tibial torsion, pes planus, and bony fusions appear to be major perpetuators of the pain. An effective treatment continues to be evasive. To date, I have attempted to find answers through genetic approaches, …

Quantifying Sleep Wake Rhythms In The Hospital Environment With Digital Technologies, Carsten Skarke, Nadim El Jamal, Michael V. Genuardi, Thomas G. Brooks, Antonijo Mrčela, Nicholas F. Lahens, Makayla Cordoza, Sean Sarles, Amarachi Mbadugha, Dineth R. Karunamuni, Shikhar Gupta, Charles J. Bae, Amita Sehgal, Thomas P. Cappola, Jacob T. Gutsche, Pavan Atluri, Nimesh D. Desai, Michael A. Acker, Gregory R. Grant, Richard J. Schwab, Ilene M. Rosen, Garret A. Fitzgerald

Division of Cardiology Faculty Papers

Postoperative clinical care is prone to circadian desynchronization that may influence health outcomes. In an exploratory, feasibility-oriented and signal-exploration effort, we collected 1.8 million data points using 11 remote sensors during preoperative, in-hospital and post-discharge settings in 13 elective cardiac surgery patients (5.2% enrolled from 252 screened). We found that room traffic continued during nighttime with ≥1 visit/h. Sound levels exceeded the recommended 45 dBA threshold (51.9 ± 3.3 vs. 48.3 ± 4.2 dBA during nighttime). Brightness dropped at night (89.9 ± 87.7 to 3.7 ± 9.8 lux), but bright light exposures occurred. Ambient room temperature lacked sleep-inducing diurnal variability. …

Transforming Patient Safety And Care Practices Through Interprofessional Education, Kaleena Ramirez, Claudia C. Tamara, Jennifer Sells, Karen Clatt, Banan Abuharb, Mary Coolbaugh-Murphy, Iris Culwell, Anca Fumurescu, Mary Gust, Lori Simmons, Delores Whiteing, Annie Koenig, Sara Martinez, Wilton Muriithi, Shaun T. Caldwell, Susan Lee, Mary Sizemore, Kimberly Ann H. Krumwiede

Advances in Cancer Education and Quality Improvement

As healthcare increasingly relies on interdisciplinary teams to deliver safe and effective care, the development of interprofessional collaboration competencies among students in health care professions has become an educational priority. In response, The University of Texas MD Anderson Cancer Center School of Health Professions integrated a longitudinal interprofessional education curriculum to foster collaborative practice readiness and prepare students for team-based interdisciplinary environments that ensure safe and patient-centered care. The curriculum was guided by the Interprofessional Education Collaborative 2016 and 2023 core competencies for interprofessional collaborative practice, reinforced with the Real Colors® Personality Instrument and Team Strategies and Tools to Enhance …

Interprofessional Education Development In An Oncology-Focused Healthcare Institution, Mary Sizemore, Michael Morris, Mohamed Ait Aiss, Gregory Botz, Jolyn Taylor, Joshua Kuban, Diane C. Bodurka

Advances in Cancer Education and Quality Improvement

Background: Despite growing recognition of the value of interprofessional education (IPE), most IPE work has focused on undergraduate learners, leaving a critical gap in postgraduate and clinical environments. This report describes a phase 1, formative, pre-implementation quality improvement (QI) initiative to establish an institution-wide IPE program at an oncology center without a traditional medical school.

Methods: We used a developmental, multiphase mixed methods design integrating 3 inputs: (1) Virtual Interprofessional Teaching and Learning (VITAL) faculty-development feedback, (2) IPE Steering Committee feedback, and (3) simulation evaluation used as an applied context (not the sole focus). Surveys were administered to VITAL participants, …

A Performance And Quality Improvement Intervention Integrating Molecular Testing To Support Personalized Cancer Care In Lung And Thyroid Cancers, Suzanne Murray, Monica Augustyniak, John Vu, Elbert Y. Kuo, Manolo G. Pasia Jr., Sheri L. Rivera, Kelly M. Rodriguez, Vivek Subbiah, Patrice Lazure, Ecaterina E. Dumbrava

Advances in Cancer Education and Quality Improvement

Introduction: Molecular testing has been underutilized in the diagnosis and treatment of cancer patients, despite its potential to significantly impact clinical decision-making and resulting health outcomes.

Objectives: This project aimed to evaluate the process and impact of a performance/quality improvement (PI/QI) intervention to optimize the integration of molecular testing for patients with non-small cell lung cancer (NSCLC) or thyroid cancer (TC).

Methods: Physicians, advanced practice providers, and nurses were engaged in the PI/QI at 2 cancer centers (Site A and Site B) for up to 18 months following a pre-intervention needs assessment. Gaps identified at baseline informed …

Tom: Treatment Outcome Monitor - A Web-Based Tool Designed Specifically For Clinics With Limited Resources, Saurabh Shashikumar Nair, Alba Kihn Alarcon, Maritza Elodia Cupil Barrios, Milton Estuardo Ixquiac Cabrera, Mynor Villeda, Joseph Steyn, Anneray Richards, Ricardo Ruggeri, Loida Orozco, Angel Velarde, Indranil Mallick, Graeme Lazarus, Christoph Trauernicht, Vicky De Falla, Tim Edwards, Johnny Inthaphone, Adenike Olanrewaju, Laurence E. Court, Joshua Niedzielski

Advances in Cancer Education and Quality Improvement

Background: Although three-fourths of cancer deaths are expected to occur in low- and middle-income countries (LMICs) by 2030, most cancer research still comes from high-income countries. One barrier to cancer research in LMICs is lack of infrastructure for systematic data collection, including electronic medical record systems. We developed Treatment Outcome Monitor (TOM), a cloud-based tool for tracking cancer patient outcomes, designed specifically for resource-limited settings.

Methods: TOM was developed through iterative design cycles with continuous feedback from health care providers from across the world. We focused on creating a simple, web-based solution that addresses real-world challenges in resource-limited …

Groove ‘N’ Grow: Promoting Social Participation Through Dance And Movement, Juliana N. Ward, Karen Park

Spring 2026 OTD Capstone Symposium

Groove ‘n’ Grow is a structured pediatric occupational therapy group program designed to improve social participation, engagement, and sensory regulation in children with developmental and sensory processing differences through dance and movement-based activities. The program was developed as part of an occupational therapy doctoral capstone project and implemented within a pediatric outpatient therapy clinic. The purpose of the program is to provide children with developmental and sensory processing differences opportunities to practice peer engagement, cooperative participation, emotional regulation, and emotional awareness in a supportive small-group environment.

Chemotherapy-Induced Activation Of Caspase-1 And Il-1Α Release By Cancer Cells Remotely Skews Myelopoiesis To Drive Pro Tumorigenic Systemic Neutrophil-Dominant Inflammation, Stephen Qr Wong, Kazukuni Hayashi, Ethan J Subel, Yung Hsing Huang, Hongbo Gao, Haley E Garcia, Sophie J Porter, Mustafa Karabicici, Xen Ping Hoi, Mark D Alonzo, Armine Kasabyan, Efrosini Tsouko, Crystal S Shin, Lisa Bouchier-Hayes, Dimitrios Korentzelos, Chen Chen, Michael Brooks, Zheng Yin, Renil S Titus, Lan Zhou, Yinan Gong, Yulin Li, Stephen Tc Wong, Ziad El-Zaatari, Dharam Kaushik, Raj Satkunasivam, Fotis Nikolos, Keith S Chan

Faculty, Staff and Students Publications

While chemotherapy-induced tumor cell death is known to modulate the local immune landscape, its systemic impact on distant bone marrow—a site essential for immune cell maturation—remains underexplored. Here, we show that gemcitabine chemotherapy induces inflammatory caspase-1-dependent pyroptosis in epithelial cancer cells (epiCaspase-1). Despite its inflammatory nature, epiCaspase-1-mediated cell death is non-immunogenic. Clinically, elevated expression of an epiCaspase-1 gene signature correlates with worse patient outcomes. Mechanistically, epiCaspase-1 triggers the noncanonical release of IL-1α through NINJ1 lytic pores, remotely skewing bone marrow hematopoiesis towards granulocyte-monocyte progenitors and mature neutrophil output. This systemic reprogramming elevates the neutrophil-to-lymphocyte ratio (NLR) in both peripheral blood …

Health Professional Education Associations: What Other Professions Teach Us About Building Resources, Community, And Advocacy For Midwifery Educators, Kim Q. Dau, Ms, Cnm

Doctor of Midwifery Advances in Midwifery Projects

In response to a looming health care workforce deficit, several health professions have experienced recent rapid workforce growth. These professions are supported by specialized health professional associations designed to promote educational excellence in the face of rapid growth. In contrast, the midwifery profession does not have dedicated professional organizations to support education programs. The purpose of this study is to better understand the various strategies used by selected health professional education associations and their value to the profession. This can be adapted to promote the growth and excellence of midwifery education in the United States, responding to the need for …

Ms-Gator: Multi-Scale Graph Attention With Topological Reasoning For Segmentation And Classification Of Prostate Cancer Based On Gleason Scores Using Histopathology Images, Sujata Patil, Mahadeva Swamy, Kavitha Sooda, Rajanikanth Vadigepalli, Khalid Nazim Abdul Sattar, Md Rafeeq

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Prostate cancer is one of the prevalent and potentially fatal malignancies, affecting men globally. Accurate segmentation and classification of prostate cancer in histopathology images remain challenging due to complex tissue architecture, staining variability, and high inter-observer differences in manual diagnosis. To address these challenges, this research proposes a Multi-Scale Graph Attention with Topological Reasoning (MS-GATOR) for segmentation and classification of prostate cancer based on Gleason Scores (GS). The MS-GATOR incorporates topological reasoning with hierarchical biological structures by constructing a graph-based representation among three spatial scales such as nuclei, glands, and tissues using Delaunay triangulation to capture both geometric and photometric …

Patient's Age Impact On Stroke Risk And Intracranial Aneurysm Occlusion: Scent Flow Diverter Study-A Nonrandomized Clinical Trial On Large And Giant Aneurysms, Ajay K. Wakhloo, Paul Jenkins, Philip M. Meyers, Alexander L. Coon, Peter T. Kan, Ajit S. Puri, Joost De Vries, Giuseppe Lanzino, Mark D. Bain, Koji C. Ebersole, Babu G. Welch, Aclan Dogan, Pascal Jabbour, J. Mocco, Adnan H. Siddiqui, Aquilla S. Turk, Philipp Taussky, Ricardo A. Hanel

Department of Neurosurgery Faculty Papers

BACKGROUND AND OBJECTIVES: The prospective single-arm nonrandomized SCENT (Surpass Intracranial Aneurysm Embolization System Pivotal) trial on flow diverter treatment of large and giant intracranial aneurysms (IA) was analyzed for patients' age and IA characteristics affecting stroke and occlusion rates over 5 years (Trial registration NCT01716117).

METHODS: Impact on major ipsilateral stroke and IA occlusion was studied by stratifying age as 65 years and younger vs older than 65. Kaplan-Meier estimates of time to both endpoints, stratified by age, were created. Univariate predictors of time-to-stroke were analyzed using univariable proportional hazards regression models. Limited bivariable modeling was also attempted.

RESULTS: Of …

Developing Pediatric Educational Resources For Occupational Therapy Fieldwork Students And New Employees, Alyssa Gottheiner

Entry-Level Occupational Therapy Doctorate - Doctoral Capstone Symposium

For occupational therapy students, the fieldwork education portion of their curriculum allows them to apply theory and principles learned in their academic program into practice with actual clients (Occupational therapy fieldwork education, 2022). Research indicates the benefit of access to resources and adapting to different learning styles in occupational therapy fieldwork education (Grenier, 2015). Research also indicates that training programs for new healthcare employees can positively impact knowledge, skills, and performance (Patel et al., 2023).  However, there is a lack of research on the availability and benefit of supplemental educational resources for students to access during fieldwork education in pediatric …

Stroke Thrombectomy With A Novel Reperfusion System Including A 0.088′′ Aspiration Catheter: The Imperative Trial, William Mack, Reade Andrew De Leacy, Jonathan A. Grossberg, Shahram Majidi, Robert Dana Tomalty, Maxim Mokin, Jan Vargas, Kenneth V. Snyder, Brett L. Cucchiara, Victoria Parada

School of Medicine Publications

Background Mechanical thrombectomy is the standard of care for large vessel occlusion (LVO) stroke, yet most device trials focus on individual technologies rather than complete systems.

Objective To evaluate the safety and efficacy of the Zoom Reperfusion System compared with performance goals derived from a meta-analysis of trials using established thrombectomy technologies.

Methods Prospective, multicenter, non-randomized, investigational device exemption trial conducted across 26 United States centers from October 2021 to March 2024. Adults with anterior circulation LVO stroke within 8 hours of onset were treated using the Zoom System, which includes aspiration catheters ranging from 0.035″ to 0.071″, and a …

A Mild Case Of Pseudoachondroplasia In A Child: Lessons For Long-Term Primary Care, Alec J. Pupo D.O., Connor J. Stinson D.O., Autumn Dye D.O.

The Journal of Integrated Primary Care

Background: Pseudoachondroplasia (PSACH) is a rare autosomal dominant skeletal dysplasia caused by pathogenic variants in the cartilage oligomeric matrix protein (COMP) gene. It is classically characterized by early-onset growth failure, disproportionate short stature, progressive epiphyseal dysplasia, and premature degenerative joint disease. Although phenotypic variability has been reported, PSACH is often regarded as a uniformly severe condition with predictable orthopedic morbidity.

Case Presentation: We report an eleven-year-old female with genetically confirmed PSACH who demonstrates an unexpectedly mild clinical phenotype, despite a maternal history of severe disease requiring bilateral total hip replacement during adolescence. The patient exhibited mild hip dysplasia, evolving genu …

A Digital Diabetes Prevention Program For Hispanic Adolescents (Fit24+): Protocol For A Feasibility Randomized Controlled Trial, Erica G Soltero, Marbelly Partida, Sandra Mihail, Lizette Villanueva, Callie Lopez, Salma M Musaad, Teresia M O'Connor, Maria J Redondo, Matthew Buman, Debbe Thompson

Faculty, Staff and Students Publications

Background: Hispanic youth are disproportionately impacted by obesity and subsequent type 2 diabetes (T2D) yet remain underrepresented in diabetes prevention research. Digital health interventions hold promise for increasing the accessibility to and engagement in disease prevention programming, particularly among high-risk populations. However, there is a significant gap in the literature regarding digital T2D prevention programs for adolescents or Hispanic youth.

Objective: The objective of this article is to describe the protocol for examining the feasibility of a 12-week digital diabetes prevention program among Hispanic adolescents with obesity.

Methods: Participants (N=40; aged 12-16 years) will be randomized (1:1) to a 12-week …

Fatal Ochrobactrum Anthropi Bacteremia Following Intravenous Stem Cell Therapy In Immunocompetent Patient, Daler Kudratov, Wendy Martinez, Jonathan Barnett

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

Gastric Outlet Obstruction And Bowel Perforation Secondary To Ingestion Of Multiple Foreign Bodies: A Case Review, Kassidy Fix, Mark Jay Cheek

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

A Model For Creating Ai-Generated Simulations For Clinically Complex Scenarios, Makayla Morning, Parker Litchliter, Jennifer Dulaney, Linda Haddox

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

Views, Knowledge, And Implications Of Abortion Law In Texas Obgyn Residencies, Jessica Harper, Sharon Barazani, Kate Mowry, Melissa Mendez

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

Are You My Doctor? Impact Of Role Identification Badges In Improving Resident Experience, Rasmeet Kaur, Laura Preece

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

Acute Traumatic Aortic Injury: What The Radiologist Needs To Know, Kristina Ramirez-Garcia, Catalina Jaramillo, Emma Ferguson, Jason Au, Erika Odisio, Gustavo S Oderich, Daniel Ocazionez, Cihan Duran, Thanila Macedo

Faculty, Staff and Students Publications

Acute traumatic aortic injury (ATAI) is a rare but life-threatening consequence of blunt trauma that requires prompt diagnosis and accurate imaging assessment. This review presents an imaging-based approach to ATAI, with emphasis on computed tomography angiography (CTA) as the first-line modality for diagnosis, grading, treatment planning, and follow-up. CTA enables the detection of both direct and indirect signs while also allowing for the assessment of lesion severity, extent, and associated findings that may influence management. Familiarity with common mimics and anatomic variants improves diagnostic confidence and helps avoid false positive interpretations. Careful protocol optimization, including multiphasic acquisition, bolus timing, and …

Holding Hope: Empowering Parents Through Perinatal And Nicu Palliative Care, Huntington N. Cotten

Entry-Level Occupational Therapy Doctorate - Doctoral Capstone Symposium

Families receiving perinatal and neonatal Palliative Care (PC) services can experience significant emotional and practical challenges while caring for a child with medical complexities. The Care Companion, a family centered, educational resource, was created in response to survey findings indicating that rehabilitation therapists (OT, PT, and SLP) encountered challenges in providing PC services, followed by site‑specific insights that highlighted additional gaps in family support, education, and parent–infant bonding. This Occupational Therapy (OT) Capstone project was completed within a large academic pediatric medical center providing interdisciplinary PC services to families whose infants have been diagnosed with serious, life‑limiting conditions. The purpose …

Choice-Aya: Adapting An Evidence-Based Contraceptive Counseling Intervention For Adolescents And Young Adults Experiencing Homelessness., Mariah E. Brewe, Anna Burns, Nikolaus Schuetz, Taylor Stephens, Emma Francis, Haylie Yost, Stephani L. Stancil

Manuscripts, Articles, Book Chapters and Other Papers

INTRODUCTION: Adolescents and young adults (AYA) experiencing homelessness face an increased risk of reproductive violence, unintended pregnancy, and barriers accessing healthcare. While interventions focused on efficacy-first contraceptive counseling are successful at increasing rates of long-acting reversible contraceptive (LARC) use, little is known about how an efficacy-first approach is received by AYA experiencing homelessness given unique factors associated with their reproductive health care. We aimed to adapt the evidence-based CHOICE contraceptive counseling approach for AYA experiencing homelessness.

METHODS: Focus groups discussion with AYA experiencing homelessness were conducted to understand prior reproductive health care experiences and contraception counseling preferences, comparing efficacy first …