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Development Of A Mediation Model Of Pain Cognition In Adult Patients With Sickle Cell Disease, Daniel M. Sop

Theses and Dissertations

Pain is a hallmark of Sickle Cell Disease (SCD), a genetic hemoglobinopathy characterized by chronic hemolytic anemia, vaso-occlusion, and organ damage. While acute vaso-occlusive crises (VOC) have been extensively studied, the mechanisms underlying chronic pain and its interplay with brain function remain unclear. This dissertation investigates the relationships between cerebral blood flow (CBF), fluid cognition, and pain sensitivity in adults with SCD, utilizing advanced imaging techniques and validated assessment tools.

Arterial spin labeling (ASL) and functional magnetic resonance imaging (fMRI) were employed to measure CBF and brain activity, respectively. Pain sensitivity was assessed using the Pain Sensitivity Questionnaire (PSQ), and …

Extension For Community Healthcare Outcomes-Palliative Care In Africa And Quality Of Life, Symptoms, Patient Experience, And Caregiver Distress Among Patients With Cancer, Sriram Yennurajalingam, Olaitan Soyannwo, John Weru, Edwina Beryl, Henriette Burger, Esther Nafulah, Oladayo Aikomo, Adeniyi Adenipekun, Irene Botchway, Mary Ocansey

Haematology and Oncology, East Africa

Purpose: In this study, we aimed to evaluate the association between the Extension for Community Healthcare Outcomes-Palliative Care (ECHO-PC; ECHO Model–Based comprehensive educational and telementoring intervention) for health care professionals (HCPs) and change in patient-reported quality-of-life (QOL; Functional Assessment of Cancer Therapy-General [FACT-G]) among patients with advanced cancer. We also examined the association between ECHO-PC and changes in symptom distress (Edmonton Symptom Assessment Scale [ESAS]), patient experience and satisfaction, and caregiver distress scores.

Methods: ECHO-PC Clinic sessions were conducted twice a month for 1 year by an interdisciplinary team of PC clinicians at the MD Anderson Cancer Center, with participation …

Juvenile Arthritis, Body Image, And Disordered Eating: An Exploration Of Experiences, Katelyn Ann Melcher

Graduate Student Theses, Dissertations, & Professional Papers

This qualitative study examined eating and body experiences among youth with juvenile arthritis (JA). JA, an autoimmune condition affecting nearly 300,000 youth in the United States, poses significant challenges including chronic pain, disability, and psychological concerns such as anxiety and depression. Adolescence is a critical developmental time for body image and disordered eating concerns to emerge. However, no qualitative research has explored the interactions of JA, body image, and eating behaviors among youth. Twelve youth with a JA diagnosis participated in a semistructured qualitative interview examining their experiences with JA and their feelings about their bodies and food as they …

Phenotypic Variation In Disease Severity Among Hospitalized Pediatric Patients With Covid-19: Assessing The Impact Of Covid-19 In The Epico Study, María Camila Sossa-Alarcón, Mónica Paola Gutiérrez, Natalia Becerra, Luz Yessenia Ortegon, María Camila David, Melisa Naranjo Vanegas, Gabriela Friedrich, Pablo Vásquez-Hoyos, María Lucía Mesa-Rubio, Luis Miguel Navarro-Ramirez, Sergio Moreno-Lopez, Olga Lucía Baquero, Luz Marina Mejía, Juan Gabriel Piñeros, Sonia Restrepo-Gualteros, Carlos Álvarez-Moreno, Alejandro Díaz-Díaz, Iván Gutierrez-Tobar, Andrés Camilo Mesa, William Ricardo Bachiller Tuta, Clara Esperanza Galvis Diaz, Martha Africano, José Manuel Nieto, Paola Marsela Pérez Camacho, Claudia Beltrán-Arroyave, Rosalba Vivas Trochez, Irati Gastesi, Cinta Moraleda, Alfredo Tagarro García, Blanca Herrero, Lourdes Calleja, Carlos Grasa, Paula Rodriguez, Susana Melendo, Antoni Soriano-Arandes, Irene Gómez Pastrana, Sonsoles García García, Victoria Fumado, Andrea Ramírez Varela

Faculty, Staff and Student Publications

Objective: To characterize the clinical phenotypes of SARS-CoV-2 infection in hospitalized children as part of the EPICO multicenter cohort study.

Methods: We included hospitalized children with confirmed SARS-CoV-2 infection from Colombian and Spanish institutions to assess disease evolution and outcomes. Cluster analysis was performed to identify clinical phenotypes.

Results: A total of 2318 patients were included (55% male, 36% infants). Five phenotype clusters emerged: Cluster 1 (26.5%): infants without comorbidities, low PICU admissions and mortality; Cluster 2 (18.5%): respiratory comorbidities, high microorganism co-detection and mortality; Cluster 3 (11.5%): fever, gastrointestinal symptoms, high PICU admissions; Cluster 4 (32%): mild unspecific symptoms, …

Faculty Of Radiation Oncology 2022 Workforce Census, Hon Trinh, Nathan Stevens, Gerard Adams, Raphael Chee, Tuan Ha, Marcel Knesl, Jack Mitchell, Sakshi Nagpal, Edward Sia, Daniel Xing

Research outputs 2022 to 2026

Introduction: This paper reports the key findings of the Faculty of Radiation Oncology 2022 workforce census. This is the first census since the COVID-19 pandemic and questions have been updated to assess the impact on RANZCR trainees and fellows. This report focuses on the analysis of respondents from Australia, New Zealand and overseas members, with a separate paper to follow focusing exclusively on New Zealand respondents. Method: The census was conducted in mid-late 2022 with many questions repeated from previous censuses. New questions were asked about theranostics, working remotely, hypofractionation and the impact of COVID-19 on work practices. Results: The …

Exercise In Cancer Care For People With Lung Cancer: A Narrative Synthesis, Kellie Toohey, David Mizrahi, Nicolas H. Hart, Ben Singh, Pedro Lopez, Maddison Hunter, Robert U. Newton, Kathryn H. Schmitz, Diana Adams, Lara Edbrooke, Sandi Hayes

Research outputs 2022 to 2026

Objectives: Lung cancer is the second most common cancer diagnosed worldwide, resulting in significant physical and psychological consequences. In this narrative review, we explore the role of exercise as an adjunct therapy to counteract health issues experienced by people before, during and after treatment for lung cancer, and offer recommendations for exercise prescription and future research. Design: Narrative cornerstone review. Methods: A narrative review was conducted to explore the role of exercise in cancer care for people diagnosed with lung cancer. Results: Improvements in fitness, strength and quality of life have been demonstrated in people with lung cancer following participation …

Inclusion Of Patient-Centered, Non-Microbiological Endpoints And Biomarkers In Tuberculosis Drug Trials, Andrew R Dinardo, Wilbert Sabiiti, Stephen H Gillespie, Sophia B Georghiou, Norbert Heinrich, Norbert Hittel, Sami Taghlabi, Danna Carrero Longlax, Mikashmi Kohli, Ursula Panzner, Collins Musia, Christoph Lange, Anca Vasiliu, Rob J W Arts, Anna M Mandalakas, Morten Ruhwald, Lieven J Stuyver, Reinout Van Crevel

Faculty, Staff and Students Publications

Tuberculosis drug trials are primarily designed to identify antibiotic regimens with the strongest potency to kill Mycobacterium tuberculosis. However, microbiologic cure is not synonymous with improved health and recovery. Beyond antimicrobial efficacy, parameters such as morbidity and mortality related to lung function, cardiovascular health, and cancer should be prioritized. This narrative review emphasizes the critical need to emphasize clinical outcomes as much, if not more, than microbiological endpoints. We examine the underlying pathophysiological mechanisms and determinants of non-microbiological outcomes in tuberculosis, providing a synthesis of current knowledge. While there is growing evidence for some biomarkers to risk stratify TB …

Advancing Narcolepsy Advocacy: Bridging Patient Narratives And Systemic Change, Ahmed Salem Bahammam, Lindsay Jesteadt, Hamza Dhafar, Amir Sharafkhaneh

Faculty, Staff and Students Publications

We introduce the Stigma-to-Structure Advocacy Framework, a novel, evidence-based model designed to transform narcolepsy advocacy by systematically bridging patient narratives with structural change. Narcolepsy remains a profoundly underdiagnosed and misunderstood neurological disorder, with persistent diagnostic delays and pervasive cultural stigma undermining patient well-being and access to care. Despite recent progress in awareness and support, advocacy efforts remain fragmented and insufficiently integrated with health policy, particularly in low- and middle-income countries. This perspective advances a strategic evolution of narcolepsy advocacy through the Stigma-to-Structure Advocacy Framework, which is anchored in three pillars: narrative-driven awareness, clinical system integration, and policy activation. Drawing on …

Treatment Fidelity And Outcome In Cbt For Youth With Autism: The Meya Fidelity Scale, Bryce D Mcleod, Jeffrey J Wood, Jennifer Cecilione Herbst, Danielle Dunn, Philip C Kendall, Eric A Storch, An Chuen Cho, Kashia A Rosenau

Faculty, Staff and Students Publications

Objective: Assessing treatment fidelity in effectiveness research is critical to interpreting study findings. This paper details the development and initial psychometric evaluation of the Modular Evidence-Based Practices for Youth with Autism Fidelity Scale (MEYA-FS) designed to support the assessment of cognitive-behavioral treatments for youth with autism in effectiveness research.

Method: Recorded treatment sessions (N = 338) were randomly selected from 77 youth (M age = 9.65 years, SD = 1.87; 50.67% White; 85.33% male) who received the Schema, Emotion, and Behavior-Focused Therapy for Children (SEBASTIEN) (n = 51) or Coping Cat (n = 24) program.

Results: …

My Body My Choice: A Qualitative Study Of Volitional Female Sterilization In The U. S. Latina And Hispanic Female Population, Heather Morris Tuip

Antioch University Dissertations & Theses

This qualitative study, utilizing an interpretative phenomenological analysis methodology, elucidates the experience of Latina and Hispanic women living in the United States who have volitionally undergone sterilization or have sought the procedure out for birth control. Understanding the rich, contextual, lived experience of Latina and Hispanic women through an intersectional framework highlights how cultural influences and contemporary policies on reproductive rights informed their personal choice to undergo a female sterilization procedure. The participants of this study shared how they made meaning of their experiences. Within a homogenous sampling of study participants who share ethnicities and genders, six group experiential themes …

Weighted Family History Density Of Substance Use: Influence On Participant Substance Use Onset, Escalation, And Duration, Carleigh A. Litteral

Theses and Dissertations--Psychology

Substance use disorders impose a staggering toll on the United States (U.S.), straining healthcare systems, destabilizing communities, and profoundly impacting both individuals and families. Approximately one in six Americans aged 12 and older had a past-year substance use disorder in 2022 (Key Substance Use, 2022), and nearly one-third of adults experience a substance use disorder in their lifetime (Wu, 2010), contributing to an economic burden exceeding $400 billion annually (National Drug Threat Assessment, 2011). Family history of substance use disorders is a key predictor of vulnerability, with individuals who have affected relatives being 2–8 times more …

Phenobarbital And Ciwa Protocol: A Retrospective Analysis Of Alcohol Withdrawal Optimization, Cooper Alden Josephs, Trey Austin Doss, Maulikkumar Patel, Taylor Templeton-Jager

South Atlantic Division GME Research Day 2025

No abstract provided.

Maternal Postpartum Depression, The Family Unit, And Childhood Development, Sara Kate Wiggins, Alexandria Bailey, Peyton Dekle, Joshua Ferrell

South Atlantic Division GME Research Day 2025

No abstract provided.

Use Of Indocyanine Green Angiography To Reduce Postoperative Complications In Post-Mastectomy Breast Reconstruction: An Umbrella Review, William R. Clifton, Phil Moon, Emily V. Clifton, Julia C. Stager, Spencer R. Anderson

South Atlantic Division GME Research Day 2025

No abstract provided.

Nitrous Oxide Induced Psychosis: A Case Report, Brianne Kimmet, Barbara Gracious

South Atlantic Division GME Research Day 2025

No abstract provided.

The Hatchet Man Of Baghdad: A Serial Killer Under The Ba’Ath Regime, Amy Mackenzie, Muniza Shah

South Atlantic Division GME Research Day 2025

No abstract provided.

Seizure In The Setting Of Metoprolol Overdose, Shilpa Amin, Justin H. Le, Hannah Sodergren

South Atlantic Division GME Research Day 2025

No abstract provided.

Salicylate Overdose Protocols For Family Medicine Physicians, Christine Tamayo, Denae Kappers, Patricia Gilford

South Atlantic Division GME Research Day 2025

No abstract provided.

Case Report Of Tricyclic Antidepressant Toxicity With Prolonged Qt/Qtc And Widened Qrs On Ekg, Alexandra Doan, Joshua Wilkes, Jonathan Leggett, Jarratt Lark

South Atlantic Division GME Research Day 2025

No abstract provided.

Retrospective Comparison Of Emergency Department (Ed) Length Of Stay (Los) Between Marijuana And Alcohol Users, Paul Bomar, Jonathan Leggett, Lisa Persaud, Franklin Schaefer, Vanessa Knapp, Lauren Eisenberg, Austin Johnson

South Atlantic Division GME Research Day 2025

No abstract provided.

Havana Syndrome: A Scientific Review Of An Unresolved Medical Mystery, Aishik Dutta

Digital Journal of Clinical Medicine

Background

Since 2016, U.S. and Canadian officials have reported Anomalous Health Incidents (AHIs), or "Havana Syndrome," characterised by a strange sensory experience followed by chronic neurological, cognitive, and vestibular issues. The cause is intensely debated, with primary hypotheses pointing to either psychosocial factors or a directed-energy weapon, creating a significant medical and geopolitical puzzle.

Methods

This review critically assesses the current evidence by analysing peer-reviewed clinical studies and major institutional reports.

Results

The findings are deeply contradictory. A 2020 NASEM report identified directed, pulsed radiofrequency energy as the most plausible mechanism for a core set of symptoms. Conversely, comprehensive 2024 …

Self-Inflicted, Non-Sexual, Non-Masturbatory Penile Fracture Case Report - An Atypical Presentation, Sajan Sehgal, Vijayakumar R, Sachin Dharwadkar, Amruthraj G. Gowda

Digital Journal of Clinical Medicine

Background: Traumatic injuries to the genitalia are uncommon due to the mobility of the penis and scrotum. Penile fracture is a relatively rare condition arising from disruption of tunica albuginea with rupture of the corpus cavernosum. In order to ensure that such an injury is not missed, it is necessary to have a high index of suspicion to diagnose this condition.

Result: Patient underwent an emergency repair of penile fracture.

Conclusion: We hereby, report a rare case of accidental, non-masturbatory, self-inflicted penile fracture which was diagnosed promptly based on clinical assessment, confirmed radiologically and managed surgically, resulting …

Case Series On Consultation-Liaison Psychiatry In Pain Abdomen With School Refusal Among Children, Jatin Kumar, Aditya Takiar, Kishor M, Sudhamshu K.C, Anil Kumar M.G., Prashanth S.N

Digital Journal of Clinical Medicine

Chronic abdominal pain is one of the most common causes of school refusal in children often leading to multiple hospital visits and expenses. This study was done to assess the psychiatric morbidity underlying functional gastrointestinal complaints in children presenting to paediatric surgery unit. We conducted a prospective case series (N=11; ages 8–13) of children referred from Paediatric Surgery between June and December 2025. All these children presented with idiopathic abdominal pain and a significant period of absence from school. These children were evaluated for any organic causes through the use of various investigations including imaging studies and were referred to …

Evaluating The Efficacy Of Vertical Integration In Training Undergraduate Medical Students Under Competency Based Medical Education Curriculum, Pratham Mehta, Yashika Sharma, Kishor M, Arun M

Digital Journal of Clinical Medicine

Background: The National Medical Council in the Indian Medical Graduate guidelines to enhance learning, recommends Vertical and Horizontal Integration. Vertical integration may be defined as a curricular strategy that aligns para-clinical and clinical teaching across time with a view to enhancing relevance and application of knowledge. The present study is an attempt to test whether vertical integration of Forensic Medicine and Psychiatry is associated with greater short-term learning gains and improved student perceptions compared with conventional didactic lectures.

Methods: With Institutional and Ethics Committee clearance, a two-phase quasi-experimental study was performed across two consecutive academic cohorts (Phase 1, …

Comparison Of Primary Care Experiences And Outpatient Health Service Utilization Among Black And Latino Homeless-Experienced Veterans: An Analysis Of Patient-Centered Medical Homes, Melissa Chinchilla, Audrey L Jones, Aerin Derussy, Michael F Green, Lillian Gelberg, Alexander S Young, Jack Tsai, Sonya E Gabrielian, Stefan G Kertesz

Faculty, Staff and Student Publications

Objectives: To examine whether, among persons with recent homeless experience, minoritized clients rate primary care differently from non-minoritized clients in Veterans Affairs (VA) mainstream and homeless tailored clinics, through the largest survey of homeless-experienced Black, White, and Latino Veterans to date.

Methods: Surveys were collected from HEVs in Homeless-tailored Patient-Aligned Care Teams (HPACTs) and mainstream Patient Aligned Care Teams (PACTs; n = 4894). We tested multivariable associations between race/ethnicity, clinic (HPACT vs mainstream-PACT), and their interaction, on care experience ratings and service utilization.

Results: There were no major differences in care ratings by race/ethnicity; medical and social vulnerability factors were …

Individualized Frequency And Montage Tacs To Engage Theta-Gamma Coupling And Enhance Working Memory In Mild Cognitive Impairment, Mina Mirjalili, Iryna S Palamarchuk, Heather Brooks, Reza Zomorrodi, Ashley Melichercik, Wei Wang, Sean M Nestor, Daniel M Blumberger, Abhishek Datta, Christopher Bowie, Bernadette Mdawar, Kullervo Hynynen, Sanjeev Kumar, Tarek K Rajji

Faculty, Staff and Student Publications

Mild Cognitive Impairment (MCI) is a clinical prodromal stage of Alzheimer's disease. Enhancing executive functions in patients with MCI could optimize cognitive compensatory mechanisms and slow cognitive decline. The prefrontal cortex (PFC) and its connections to the hippocampus support executive functions, including working memory. Transcranial alternating current stimulation (tACS) can modulate these connections by engaging theta-gamma coupling (TGC) and may thereby strengthen working memory. This study, "tACS to engage theta-gamma coupling and enhance working memory in MCI" (tACS-MCI), will assess the feasibility and cognitive effects of EEG and MRI-guided individualized tACS. The stimulation will target the prefrontal and temporal cortices …

Recovery Of Verbal Working Memory Depends On Left Hemisphere White Matter Tracts, Randi C Martin, Junhua Ding, Ali I Alwani, Steve H Fung, Tatiana T Schnur

Faculty, Staff and Student Publications

Researchers propose that the recovery of language function following stroke depends on the recruitment of perilesional regions in the left hemisphere and/or homologous regions in the right hemisphere. Many investigations of recovery focus on changes in gray matter regions, whereas relatively few examine white matter tracts and none address the role of these tracts in the recovery of verbal working memory. The present study addressed these gaps, examining the role of left versus right hemisphere tracts in the longitudinal recovery of phonological and semantic working memory. For 24 individuals with left hemisphere stroke, we assessed working memory performance within 1 …

Exploring The Role Of Reward Functioning In The Overlap Of Post-Traumatic Stress And Cocaine Use Disorder, Kate Hull, Hanaan Bing-Canar, Krista Miloslavich, Christopher Holden, Aneet Ahluwalia, Scott D Lane, Joy M Schmitz, Margaret C Wardle

Faculty, Staff and Student Publications

Background: Posttraumatic stress disorder (PTSD) symptoms are common in people with cocaine use disorder (CUD), and even sub-threshold PSTD symptoms result in worse treatment outcomes. Difficulties with reward functioning may drive this comorbidity. Impairments in reward functioning are prominent in both PTSD and CUD and contribute to development of substance use problems after trauma. There are three distinct reward processes that may be involved in the PTSD/CUD overlap: consummatory reward (ability to experience pleasure), motivational reward (willingness to exert effort for rewards), and reward learning (adapting behavior based on reward history). Here we test whether impairments in these reward functions …

Exposure Therapy Consortium: Outcomes Of The Proof-Of-Principle Study, Jasper A J Smits, Jonathan S Abramowitz, Rebecca A Anderson, Joanna J Arch, Daniel Badeja, Snir Barzilay, Amanda N Belanger, Thomas Borchert, Emma Bryant, Alane S Burger, Laura J Dixon, Christina D Dutcher, Hayley E Fitzgerald, Bronwyn M Graham, Anke Haberkamp, Stefan G Hofmann, Jürgen Hoyer, Jonathan D Huppert, David Johnson, Baraa Q Kabha, Alex Kirk, Jürgen Margraf, Peter M Mcevoy, Bryan Mcspadden, Jill Newby, Michael W Otto, Santiago Papini, E Marie Parsons, Andre Pittig, Roxana Pittig, Winfried Rief, Svenja Schaumburg, Kiara R Timpano, Lena Waltemate, Andre Wannemüller, Cornelia Weise, Exposure Therapy Consortium

Faculty, Staff and Student Publications

Background: This paper reports on the outcomes of a proof-of-principle study for the Exposure Therapy Consortium, a global network of researchers and clinicians who work to improve the effectiveness and uptake of exposure therapy. The study aimed to test the feasibility of the consortium's big-team science approach and test the hypothesis that adding post-exposure processing focused on enhancing threat reappraisal would enhance the efficacy of a one-session large-group interoceptive exposure therapy protocol for reducing anxiety sensitivity.

Methods: The study involved a multi-site cluster-randomized controlled trial comparing exposure with post-processing (ENHANCED), exposure without post-processing (STANDARD), and a stress management intervention (CONTROL) …

New Insights Into The Mechanisms Of Electroconvulsive Therapy In Treatment-Resistant Depression, Ana C Ruiz, Abdul Haseeb, William Baumgartner, Edison Leung, Giselli Scaini, Joao Quevedo

Faculty, Staff and Student Publications

Electroconvulsive therapy (ECT) remains one of the most effective interventions for treatment-resistant depression (TRD), particularly in cases involving severe symptomatology, suicidality, or psychotic features. Despite advancements aimed at enhancing the safety and cognitive tolerability of ECT, concerns about cognitive side effects continue to limit its broader acceptance. A deeper understanding of the mechanisms underlying ECT is therefore critical for refining its use and maximizing clinical outcomes. Through a narrative review of recent literature, this paper synthesizes current evidence comparing the efficacy of ECT, ketamine, and repetitive transcranial magnetic stimulation (rTMS) in the treatment of TRD. Then, the review delves into …