Digital Commons Network^™

Improvements In Eeg Tracing Following Initiation Of Cannabidiol: A Case Report, Katherine Horman, Ara Hall, Kailash Pawar

Posters

No abstract provided.

Perceptions Of Family Medicine Among First-Year Medical Students At Aga Khan University, Nairobi, Kenya, Catherine Gathu, Lucy Mwangi, Peter Kioko, Tatiana Elwes

Family Medicine, East Africa

Background: Family Medicine (FM) is vital in delivering comprehensive and continuous care essential for robust primary healthcare systems. However, it remains underappreciated in many settings, particularly in sub-Saharan Africa.

Aim: This study aimed to assess the perceptions of FM among first-year medical students at Aga Khan University (AKU), Kenya.

Setting: A cross-sectional survey was conducted between August 2024 and September 2024 among the first-year medical students at AKU. All were invited to participate via email.

Methods: An 18-item questionnaire focused on three areas: perception and choice of medicine as a career, perception of FM and choice of FM as a …

The Scope And Impact Of Walking The Talk For Dementia 2024, Sherril B. Gelmon, Kate Irving, Walter Dawson, Jonathan Adrián Zegarra-Valdivia, Lingani Mbakile-Mahlanza, Fernando Aguzzoli-Peres

Institute on Aging Publications

Walking the Talk for Dementia (WTD) is a global educational initiative integrating a walk along the Camino de Santiago with a symposium to combat dementia stigma, raise awareness, and foster inclusion.

Patient, Family And Clinician Priorities For Critical Care Research In Asia And Africa: A James Lind Alliance Priority Setting Partnership Using Modified Delphi And Nominal Group Techniques, Ccaa Priority Setting Partnership Steering Group, Teddy Abonyo, Sumaiya Arfin, Diptesh Aryal, Abi Beane, Martina Borellini, Arjen Dondorp, Emma Donley, Punam Gautam, Tiffany Gooden

Anaesthesiology, East Africa

Background This James Lind Alliance (JLA) Priority Setting Partnership aimed to identify and prioritise unanswered questions important to adult patients, their families and health professionals with lived experience of critical care across Asia and Africa.

Methods Modified Delphi techniques were used to generate suggestions using an online survey. Following verification, literature review and content analysis, these suggestions were iteratively codified into emergent topics. Topics were presented in a second online survey for ranking, prior to an online workshop where nominal group technique was used to identify top priority questions across stakeholder groups. Surveys were disseminated using snowballing techniques.

Findings The …

Pregnancy Outcomes Among Women With And Without Hiv Infections Who Underwent Excisional Treatment For High-Grade Cervical Intraepithelial Neoplasia: A Retrospective Cohort Study In Low-Resource Settings, Poli Amubuomombe, Peter Itsura, Philiph Tonui, Elkanah Orang'o, Benjamin Odongo, Patrick Loehrer, Susan Cu-Uvin

Obstetrics and Gynaecology, East Africa

Objective The standard treatment for high-grade squamous intraepithelial lesions is excisional involving the uterine cervix, while surveillance is an acceptable approach for low-grade squamous intraepithelial lesions. There is controversy about excisional treatment on pregnancy outcomes. The objective of this study was to determine pregnancy outcomes in women living with and without HIV who underwent excisional treatment for high-grade cervical intraepithelial lesions.

Design This retrospective cohort study compared the pregnancy outcomes of women with and without HIV who were or were not treated for cervical intraepithelial lesions. A cohort of 488 women with and without HIV infection who did or did …

Use Of Hybrid Versus Video-Only Teledermatology Varies By Condition: A Cross-Sectional Study Of 2064 Encounters, Jacqueline Penn, Kathryn Achuck, Christine Deng, Richard W. Hass, Elizabeth Jones

Department of Medicine Faculty Papers

No abstract provided.

Management Of Displaced Supracondylar Fractures Of The Humerus Using Lateral Versus Crossed Kirschner Wires: A Prospective Randomized Controlled Clinical Trial, Ashlee Dobbe, Emily K. Schaeffer, Njalalle Baraza, Firoz Miyanji, Christine Alvarez, Anthony P. Cooper, Chris W. Reilly, Kishore Mulpuri

General Surgery, East Africa

Aims: We sought to evaluate whether loss of reduction in lateral Kirschner (K)-wiring is noninferior to crossed K-wiring in closed reduction and percutaneous pinning of Type III supracondylar humerus fractures.

Methods: A prospective, randomized, non-inferiority trial was conducted. Emergency department patients aged three to seven years with Type III supracondylar humerus fractures were invited to participate with informed consent. Block randomization allocated patients into one of two pin configuration groups (lateral or crossed). Surgical technique and postoperative management were standardized between groups. All patients were treated with above-elbow casts, but no strict standardized protocol was applied. The primary outcome was …

Adult Out Of Hospital Cardiac Arrest Criteria For Extracorporeal Cardiopulmonary Resuscitation Activation May Not Be The Same For Pediatric Out Of Hospital Cardiac Arrest, Lindsay Fick, Sherouk A. Abdelmoity, Jennifer Flint, Ashley Sherman, Jenna Miller

Presentations

Pediatric out-of-hospital cardiac arrest (OHCA) remains a high-mortality event, with survival to discharge consistently below 10%. Although extracorporeal cardiopulmonary resuscitation (E-CPR) improves outcomes for in-hospital cardiac arrest, its application in the pre-hospital environment is not well defined for pediatrics. Identifying which pediatric patients might benefit from OHCA ECPR activation is essential for developing feasible pre hospital pediatric E-CPR systems. Preliminary analysis of applying  criteria for adult OHCA ECPR activation can provide a crucial next step in establishing feasibility and applicability for the pediatric patient population.

Methods

A single center retrospective review was conducted of pediatric OHCA cases presenting from 2018–2025. …

Longitudinal Peripheral Blood Transcriptomics Reveal Novel Signatures During Cardiac Allograft Rejection., Rachad Ghazal, Min Wang, Akshatha N. Srinivas, Jenny J. Cao, Hridyanshu Vyas, Duan Liu, Asha Nair, Byron H. Smith, Li Wang, Daniel S. Yip, Parag C. Patel, David E. Steidley, Brian W. Hardaway, Alfredo L. Clavell, Sudhir S. Kushwaha, Walter D. Park, Mark D. Stegall, Howard Eisen, Naveen L. Pereira

Division of Cardiology Faculty Papers

Background: Acute cellularrejection (ACR) remains a major cause of morbidity afterhearttransplantation despite advances in immunosuppression. Whole genometranscriptomicprofiling offers a systems-based, unbiased approach to elucidate the molecular mechanisms underlying ACR. However, noninvasive,longitudinal biomarker assessments capable of capturing the temporal dynamics ofrejection biology remain scarce.

Methods: RNA sequencing ofperipheralblood fromheart transplant recipients before, during, and after ACR was compared with nonrejection controls. Pathway analysis was conducted using differentially expressed genes (DEGs), and a machine learning approach was applied to assessgene-based prediction of ACR.

Results: A total of 235 rejection-specific significant DEGs and 863 postrejection DEGs (false discovery rate < 0.05) were identified. During ACR, DEGs were enriched for T-cell activation/differentiation, apoptosis, and B-cell receptor signaling pathways. By combining the 2 sets of DEGs, a panel of 71 common genes was identified that reflected the significant, longitudinal transcriptomic dynamics of ACR. In an elastic net machine learning-based classifier, DYNLL1 and SERF2 were …

Quantitative Echocardiography Markers To Denote Severity Of Tricuspid Regurgitation Compared To Cardiac Mri In Single Right Ventricle Variants, Tony Zunica, Daniel Forsha, Janelle Noel-Macdonnell, Anmol Goyal

Posters

Background: Single right ventricle and Hypoplastic Left Heart Syndrome (HLHS) are congenital heart diseases that require multiple palliative surgeries to create a single right ventricular system. 25-30% of these patients develop significant tricuspid regurgitation (TR), which is associated with worse outcomes among all stages of palliation. Echocardiography remains the cornerstone imaging modality for serial evaluation in these patients. However, estimating tricuspid regurgitation is highly subjective in the pediatric population, necessitating need for reliable and reproducible quantitative echocardiography markers. Currently, cardiac magnetic resonance (CMR) is considered the gold standard for quantification of tricuspid regurgitation with good accuracy and reproducibility. Objectives/Goal: Our …

Intraoperative Care And Complications Of Symptomatic Adolescent And Young Adult Patients Undergoing Laparoscopy To Diagnose And/Or To Treat Endometrioses: A Multi-Institutional Review., Jacquelyn R. Evans, Katherine Bergus, Lindsey Asti, Lesley L. Breech, Ruiqi Cen, Yuan Yuan Gong, S Paige Hertweck, Holly R. Hoefgen, Anne H. Horne, Ashli A. Lawson, Seema Menon, Kathleen E. O'Brien, Shashwati Pradhan, Brenna Rachwal, Yolanda R. Smith, Priya Suvarna, Sarah Van Son, Geri Hewitt

Manuscripts, Articles, Book Chapters and Other Papers

STUDY OBJECTIVE: This multi-institutional, retrospective study explores the risks of laparoscopy for diagnosis and treatment of endometriosis to facilitate shared medical decision-making in patients age < 22 years old with chronic pain considering surgery.

METHODS: A retrospective review of patients less than 22 years old who had surgically proven endometriosis at eight pediatric hospitals was completed. Patient demographics, operative interventions, concurrent procedures, and complications were evaluated.

RESULTS: There were 284 patients with pathologically confirmed endometriosis with a median age of 16.86 years (15.51, 18.06). During the index procedure, diagnostic biopsy alone was performed (35.92%), followed by ablation (29.93%), excision (20.07%), excision and ablation (12.68%), and cryoablation (1.41%). Most common …

Diagnostic Challenges Of Anomalous Left Coronary Artery From The Right Pulmonary Artery., Lavina Desai, Sanket Shah, Edo Bedzra, Christopher Mathis

Manuscripts, Articles, Book Chapters and Other Papers

• ALCAPA is a rare congenital heart defect seen in about one in 300,000 live births. • ALCARPA is an even rarer subset of ALCAPA with the LCA originating from the RPA. • Few cases report ALCARPA associated with coarctation of the aorta. • Coarctation and VSD may cause PH with antegrade LCA flow. • These defects are hard to diagnose and require coronary imaging before surgery.

The Influence Of Preoperative Bowel Preparation On Surgical Site Infection In Pediatric Colorectal Surgery., Katlyn G. Mckay, Naomi-Liza Denning, Rebecca M. Rentea, Eunice Y. Huang

Manuscripts, Articles, Book Chapters and Other Papers

Surgical site infection (SSI) is one of the most common nosocomial infections that occur in pediatric patients in the United States, with colorectal procedures consistently demonstrating the highest rates of SSI. Strategies to reduce SSI in colorectal surgery include standardized perioperative colorectal care bundles, which commonly incorporate preoperative bowel preparation. Robust adult literature exists supporting the use of mechanical bowel preparation in combination with oral antibiotics to mitigate SSI; however, pediatric evidence remains less definitive. Current pediatric literature shows heterogeneity of bowel preparation use amongst surgeons, with existing literature consisting primarily of small retrospective studies. A well-designed pediatric randomized controlled …

Flare Guns And Trauma: Patterns, Severity, And Clinical Implications From Case And National Surveillance Data, Ramsay Hafer, Andrew Huff, Lara Phillips

Department of Emergency Medicine Faculty Papers

Flare guns are pyrotechnic devices capable of causing serious injury due to high-temperature combustion and projectile discharge. Though intended for signaling in maritime or wilderness settings, improper use can result in trauma patterns distinct from those seen with typical burns or fireworks. Despite their severity, flare gun injuries remain underreported and poorly characterized. We conducted a scoping review of PubMed, Scopus, and Ovid to identify 12 case reports involving 13 patients, and reviewed US National Electronic Injury Surveillance System records from 2015 to 2024, identifying 18 flare gun-specific injuries for a combined total of 31 injuries. Demographic, injury mechanism, body …

Recurrent Miller Fisher Syndrome: A Case Report, Larry Vernier, Griffin B. Gilmore, Kelsey Van Housen, Xiao C. Zhang

Department of Emergency Medicine Faculty Papers

INTRODUCTION: Guillain-Barré syndrome can manifest with progressive paralysis, requiring careful monitoring and treatment with steroids or intravenous (IV) immunoglobin. While this disease can be devastating and require intensive care unit level of care, there are few incidences of relapses.

CASE REPORT: A 67-year-old man with a past medical history of Miller Fisher syndrome variant of Guillain-Barré syndrome, with complete recovery, presented to the emergency department (ED) with ataxia, ophthalmoplegia, dysphonia, and ambulatory dysfunction. The patient noticed his neurologic symptoms after waking up, and he presented to the ED with physical examination positive for difficulty with upward gaze, mild right lower …

Prevalence And Risk Factors For Laparoscopic Managed Ectopic Pregnancies At A Tertiary Referral Hospital - A 10-Year Synopsis: A Cross Sectional Study, Steve Mutiso, Eric Mugambi

Obstetrics and Gynaecology, East Africa

Background Ectopic pregnancies (EP) are a common pregnancy associated complication. They are associated with significant morbidity, and rarely mortality, if not managed properly. EP have a myriad of predisposing factors that help identify patients at risk and facilitate early diagnosis and intervention. We set out to conduct an audit of EP managed surgically at our hospital for a 10-year period and discern the incidence, prevalence and risk factors of their occurrence.

Methods This study was designed as a Retrospective Clinical Audit based at the Aga Khan University Hospital (AKUH). Study population was all women admitted to AKUH with a diagnosis …

Design And Implementation Of An Aapm Volunteer Database For Advancing Global Medical Physics Initiatives., Teh Lin, Minsun Kim, Courtney Morrison, Jiahan Zhang, Kevin Little, Yan-Hong Xin, Michael Woodward, Peter Sandwall, Eun Young Han

Oncology Articles

PURPOSE: The purpose of this study is to assess American Association of Physicists in Medicine (AAPM) members' availability to volunteer, share their expertise, and promote global collaboration in medical physics by partnering with international colleagues who seek support in strengthening their medical physics practice.

METHODS: The questionnaire was administered to AAPM members to assess their willingness to volunteer, preferred engagement modalities, and availability for different types of volunteer activities. The questionnaire was integrated into the AAPM member profile and covered therapy, diagnostic, and nuclear medicine disciplines, capturing participants' visiting preferences and expertise in teaching and training. Respondents were categorized based …

Age And Sex Impact The Role Of Thrombospondin-2 And Thrombospondin-5 In Response To Hindlimb Ischemia, Irene Helenowski, Ashley Peters, Melissa Rangel, Corinne Bunn Md, Xuerong Wang, Kristopher Maier, Vivian Gahtan

Biostatistics Collaborative Core: Faculty Publications and Other Works

Peripheral arterial disease progression to critical limb ischemia remains a significant burden in the aged, necessitating revascularization. Therapies to enhance neovascularization, such as angiogenesis or arteriogenesis, may provide an option for patients not suitable for surgery. The thrombospondins (TSPs) are secreted matricellular glycoproteins, with TSP-1, TSP-2, and TSP-5 implicated in neovascularization. Currently, there is little data regarding the effects of TSP-2, TSP-5, sex, and aging on angiogenesis and arteriogenesis. In vitro, the effect of TSP-2 or TSP-5 on early or late passage endothelial cell (EC) tubule formation or disruption was assessed. In vivo, angiogenesis, and arteriogenesis in male and female, …

Does Hormone Replacement Therapy Reduce Bone Resorption In Postmenopausal Women With An Intact Uterus?, Ashley Harding

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not hormone replacement therapy reduces bone resorption in postmenopausal women with an intact uterus.

STUDY DESIGN: A systematic review of three double blind randomized control trials (RCTs) published from 2016 to 2022.

DATA SOURCES: All RCTs were published in peer reviewed journals in English and were found on PubMed and Google Scholar. Articles were chosen based on relevance to the clinical question.

OUTCOME MEASURED: Level of bone resorption was measured via assessment of bone turnover markers at baseline and after use of hormone replacement therapy in all …

An Examination Of Racial Bias In Scoring The Autism Diagnostic Observation Schedule (Ados) Module 3: An Item Response Theory Analysis, Yuen Yvonne Yu, Austin Wyman, Calliana J Faulk, Lizzy J Fulop, Rebecca L Greenberg, Rachel M Benecke, Lauren K Steinbeck, Jessica Foy, Caitlyn Kim, George O Emory, Eric A Storch, Casey J Zampella, Benjamin E Yerys, Robert T Schultz, Julia Parish-Morris, John D Herrington, Caitlin C Clements

Faculty, Staff and Students Publications

Given the rising prevalence of autism among racial minority children in the United States, but persistent service use disparities, this study examines potential bias in specific items from the autism diagnostic observation schedule (ADOS), a highly regarded autism evaluation. We leveraged unidimensional item response theory graded response models and a sample of 735 children to analyze the differential item functioning (DIF) of items within ADOS Module 3. Three items showed significant signs of racial bias: A1 (overall language level), A5 (offers information), and D5 (compulsions and rituals). On these items, Black/African American and Asian children were usually more likely to …

Maternal Myo-Inositol Intake And Congenital Heart Defects In Offspring: A Population-Based Case-Control Study, Ruiqi Cen, L Joseph Su, Jun Ying, Mohammed S Orloff, Elijah H Bolin, Xiangyang Lou, Lynn M Almli, Lorenzo D Botto, Marilyn L Browne, Richard H Finnell, Mary M Jenkins, Eirini Nestoridi, Andrew F Olshan, Paul A Romitti, Gary M Shaw, Wendy N Nembhard

Faculty, Staff and Students Publications

Objective: To investigate associations between maternal periconceptional (three months prior through the third pregnancy month) myo-inositol intake and the odds of selected congenital heart defects in offspring.

Design: A population-based case-control study using the National Birth Defects Prevention Study (NBDPS) database.

Setting: United States.

Population or sample: Women with singleton live births without major birth defects (controls) and women with singleton live births, stillbirths, or terminations with selected nonsyndromic congenital heart defects (CHD; cases).

Methods: Descriptive analyses, logistic regression models, ascertainment of myo-inositol intake from supplements and food using a shortened food frequency questionnaire and survey.

Main outcome measures: Odds …

Participant Retention In A Prospective Multicenter Cohort Of Participants With Pancreatitis And Factors Associated With Attrition, Radmila Choate, Jun Xu, Jeffrey J Easler, Samuel Han, Anna E Phillips, Melena D Bellin, William E Fisher, Evan L Fogel, Chris Forsmark, Phil A Hart, Stephen J Pandol, Walter G Park, Jose Serrano, Stephen K Van Den Eeden, Santhi Swaroop Vege, Liang Li, Darwin L Conwell, Dhiraj Yadav

Faculty, Staff and Students Publications

Objectives: Participant retention is essential in prospective studies to minimize bias and maintain validity. This study aimed to estimate retention rates and identify factors influencing attrition in a multicenter cohort (PROCEED) of US adults with acute/recurrent acute pancreatitis (AP/RAP) and chronic pancreatitis (CP).

Methods: Participants from the PROCEED study with AP/RAP or CP eligible for follow-up within the designated visit window were included. Retention was defined as completing at least one follow-up visit during the observation period. Retention was analyzed by follow-up mode (in-person and/or medical record review) and disease type (AP/RAP and CP). Retention factors were assessed using univariate …

Trans-Broad-Ligament Abdominal Cerclage Versus Blind Needle-Piercing Abdominal Cerclage During Pregnancy: A Comparison Of Surgical Outcomes, Qiannan Yang, Daniel Y Lovell, Joseph Nassif, Lubna Chohan, Jugnu Biba Nijjar, Nurul Farhanah Binte Abdul Latif, Zhenkun Guan, Xiaoming Guan

Faculty, Staff and Students Publications

No abstract provided.

Induction Of Yin Yang 1 (Yy1) Overexpression In Mature Adipocytes Promotes Dysfunctional Adipose Tissue And Systemic Insulin Resistance In Mice, Line Pedersen, Christy M Gliniak, Thomas Myhre Dale, Qingzhang Zhu, Chao Li, Jan-Bernd Funcke, Clair Crewe, Jiahui Luo, Lauren Palluth, Yi Zhu, Philipp E Scherer

Faculty, Staff and Students Publications

The ubiquitous transcription factor Ying Yang 1 (YY1) plays a fundamental role in multiple biological processes and is believed to regulate up to 10 % of all human genes. In thermogenic brown adipose tissue, YY1 has been linked to controlling mitochondrial gene expression and regulating cellular oxidative respiration, protecting against diet-induced obesity and alterations in energy balance. The role of YY1 in non-thermogenic, white adipose tissue, on the other hand, remains largely unknown. Here, we show that adipocyte-specific induction of YY1 promotes dysfunctional adipose tissue and systemic insulin resistance in mice. Long-term YY1 induction in mature adipocytes leads to reduced …

Perioperative Anaphylaxis In A Healthy Adolescent After First Lifetime Surgery, Shayan Sazdar, Salman Aljubran

Posters

Introduction: Perioperative anaphylaxis is a rare life-threatening event. Its evaluation poses complex considerations inherent to the use of multiple medications. Patient presentation: A healthy 11-year-old boy developed anaphylaxis shortly after discharge home from first lifetime surgery for orchiopexy. Perioperative medications included rocuronium, propofol, fentanyl, bupivacaine, sugammadex, ondansetron, dexamethasone, dexmedetomidine, and ketorolac. No antibiotics. After surgery, he consumed fast food dinner and ice cream. Within 2 hours after discharge home, he returned to our Emergency Department (ED) with facial and tongue angioedema, hives, and respiratory distress. He received multiple doses of intramuscular epinephrine and briefly required epinephrine drip in the ED. …

Asthma Phenotypes And Control In 22q11.2 Deletion Syndrome: A Single-Center Retrospective Study, Cody Shopper, Katey Campbell, Nikita S. Raje

Posters

Background: Patients with 22q11.2 deletion syndrome have increased rates of atopy and immune dysregulation and may experience a higher burden of asthma; however, real-world data describing asthma control, severity, and treatment patterns in this population are limited. We hypothesized that asthma control and severity patterns in patients with 22q11.2 deletion syndrome differ from those observed in the general asthma population. Objectives/Goal: To characterize asthma control, severity, and treatment patterns among patients with 22q11.2 deletion syndrome and to compare observed patterns with those typically reported in the general asthma population. Methods/Design: We conducted a retrospective observational cohort study of patients with …

A Case Report Of Milk-Alkali Syndrome Secondary To Excessive Antacid Use, Samir Beso, Layla Abubshait

Einstein Health Papers

INTRODUCTION: Milk-alkali syndrome is characterized by the triad of hypercalcemia, metabolic alkalosis, and acute kidney injury resulting from excessive intake of calcium and absorbable alkali. Despite falling out of prominence with the advent of modern ulcer treatments, milk-alkali syndrome has experienced a resurgence with the widespread availability of over-the-counter calcium preparations, which now account for up to 10% of hypercalcemia cases.

CASE REPORT: A 60-year-old man with multiple comorbidities presented to the emergency department with altered mental status after his scheduled kyphoplasty was canceled due to concerning neurological findings. Laboratory evaluation revealed severe hypercalcemia, marked metabolic alkalosis, and acute kidney …

Pericardial Effusion, Children's Mercy Kansas City

Clinical Pathways

No abstract provided.

Total Hip Replacement Eras, Children's Mercy Kansas City

Clinical Pathways

No abstract provided.

Early And Late Outcomes Of Patient-Specific Endografts With Retrograde Outer Branches For Complex Aortic Aneurysms Involving Cranially Oriented Target Vessels, Bruno Pagnin Schmid, Lucas Ruiter Kanamori, Mohamed Ahmed Abdelhalim, Alexander Vanmaele, Guilherme B Lima, Dora Babocs, Harishankar Ramachandran Nair, Ying Huang, Bijan Modarai, Gustavo S Oderich

Faculty, Staff and Students Publications

Objective: To evaluate the early and late outcomes of patient-specific endografts with retrograde outer branches for the treatment of complex aortic aneurysms involving cranially oriented target vessels (TVs).

Methods: This multicenter retrospective study incorporated both prospectively and retrospectively collected data from consecutive patients who underwent fenestrated-branched endovascular aortic repair using patient-specific endografts with retrograde branches for complex aortic aneurysms with cranially oriented TVs from August 1, 2015, to October 31, 2024. Cranial orientation was defined as an aorta-to-vessel origin angle greater than 30°. The primary outcome was retrograde branch-related target artery instability (TAI). Secondary outcomes included retrograde branch-related mortality, major …