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Shedding Light On Seasonal Depression: Practical Strategies For Pediatric Care, Mike Smith, Sara R. Gould Dec 2025

Shedding Light On Seasonal Depression: Practical Strategies For Pediatric Care, Mike Smith, Sara R. Gould

Pediatrics in Practice: A CME Podcast

As daylight fades and winter approaches, pediatricians often see an uptick in mood-related concerns among children and adolescents. In this episode, we explore how to recognize the signs of seasonal depression, differentiate it from other mood disorders, and apply evidence-based interventions. Our expert guest shares practical screening tools, treatment options—including light therapy and behavioral strategies—and tips for partnering with families and schools to support mental health during the darker months. Whether you’re in primary care or a specialty clinic, this conversation offers actionable insights to help you guide patients through seasonal challenges.

Click here to stream the podcast episode.


Transdiagnostic Links Of Reward Processing In Obsessive-Compulsive Disorder And Depression, Kevin M Wagner, Matti Cervin, Jessica S C Cheng, Jasmine Arriaga, Vanessa Zavala Cruz, Dayan Berrones, Josselyn S Muñoz, Renee M Frederick, Jacey L Anderberg, Belinda E Núñez Bracho, Victor R Adorno, Leonardo F Fontenelle, Andrew D Wiese, Latin American Trans-Ancestry Initiative For Ocd Genomics (Latino), Brazilian Obsessive-Compulsive Spectrum Disorder Working Group (Gttoc), James J Crowley, Eric A Storch Dec 2025

Transdiagnostic Links Of Reward Processing In Obsessive-Compulsive Disorder And Depression, Kevin M Wagner, Matti Cervin, Jessica S C Cheng, Jasmine Arriaga, Vanessa Zavala Cruz, Dayan Berrones, Josselyn S Muñoz, Renee M Frederick, Jacey L Anderberg, Belinda E Núñez Bracho, Victor R Adorno, Leonardo F Fontenelle, Andrew D Wiese, Latin American Trans-Ancestry Initiative For Ocd Genomics (Latino), Brazilian Obsessive-Compulsive Spectrum Disorder Working Group (Gttoc), James J Crowley, Eric A Storch

Faculty, Staff and Students Publications

Objectives: Transdiagnostic models aim to uncover shared mechanisms across mental disorders. Reward responsiveness (the ability to experience pleasure from rewarding stimuli) is a plausible, yet underexplored, transdiagnostic mechanism linking obsessive-compulsive disorder (OCD) and depression. This study used network analysis to (1) examine how key reward responsiveness domains are interlinked in individuals with OCD and (2) explore how each domain is uniquely associated with OCD and depression.

Methods: A total of 1345 individuals with a history of OCD symptoms (ages 18-88, 71 % women) from Latino communities in the United States (including Puerto Rico) and nine Latin American countries completed validated …


Recreating Fiber Recruitment With Fiber Recruitment Using Additive Manufacturing, Natalia D. Mciver Dec 2025

Recreating Fiber Recruitment With Fiber Recruitment Using Additive Manufacturing, Natalia D. Mciver

Biomedical Engineering ETDs

Injured ligaments are often repaired with tendon grafts which may over or under constrain the joint; there is a need for an artificial graft option with the mechanical properties of a native ligament. Crimped fibers within ligaments allow for recruitment which means the viscoelastic properties of stress relaxation and creep are not inversely related. A feasibility study using ACLs and large-scale crimp models to study viscoelasticity, led to an in-depth analysis of the scapholunate interosseous ligament. Using the Modified Kelvin spring-dashpot model, for describing viscoelasticity with a variable stiffness property (time dependent fiber recruitment), we defined the relationship between creep …


Distinguishing Acute Cardiac Events From Chronic Troponin Elevation: Integrating High-Sensitivity Troponin Trends With Objective Ischemic Evidence Under The 4th Udmi Across Diverse Renal Function Profiles, Aidan Fernandez, Amanda Green, Silvija Milanovic, Eric Han, Asia Elbooz, Michael Petrauskis, Justin Nippert, Michael Marchick, Nicholas Maldonado, Mohammed Ruzieh, Elizabeth Warren, Matthew Shaw, Lars Beattie, Brandon Allen Dec 2025

Distinguishing Acute Cardiac Events From Chronic Troponin Elevation: Integrating High-Sensitivity Troponin Trends With Objective Ischemic Evidence Under The 4th Udmi Across Diverse Renal Function Profiles, Aidan Fernandez, Amanda Green, Silvija Milanovic, Eric Han, Asia Elbooz, Michael Petrauskis, Justin Nippert, Michael Marchick, Nicholas Maldonado, Mohammed Ruzieh, Elizabeth Warren, Matthew Shaw, Lars Beattie, Brandon Allen

Florida Journal of Emergency Medicine (FJEM)

The Fourth (4th) Universal Definition of Myocardial Infarction (UDMI) provides a standardized framework to enhance diagnostic accuracy and clinical decision-making. However, challenges can arise due to the use of subjective clinical assessment in diagnostic criteria or in the presence of impaired renal clearance. This study modifies the 4th UDMI by requiring objective ischemic evidence to improve consistency in myocardial infarction (MI) classification and applies it across diverse patient populations.

In this retrospective study, patients who presented to the emergency department (ED) with 99th percentile high sensitivity cardiac troponin (hs-cTn) values were classified using the modified 4th UDMI into the categories …


Disaster Exercise: Evaluating Mci Triage Training, Michael J. Steflovich Jr, Jodie Stobierski, Alexis Davis, Natasha Pavlinetz, Nela Isic, Nicole Roberson, Earl Best Md Dec 2025

Disaster Exercise: Evaluating Mci Triage Training, Michael J. Steflovich Jr, Jodie Stobierski, Alexis Davis, Natasha Pavlinetz, Nela Isic, Nicole Roberson, Earl Best Md

Florida Journal of Emergency Medicine (FJEM)

Abstract

Study Objectives

The primary objective of this study was to evaluate the effectiveness of a didactic lecture-based training on mass casualty incident (MCI) triage performance among first- and second-year medical students. Specifically, the study aimed to measure improvements in overall triage accuracy, as well as reductions in over-triage and under-triage rates for both adult and pediatric patients.

Methods

This study employed a pre-test/post-test design involving 31 participants. Participants completed an electronic pre-test consisting of 30 patient scenarios (20 adult and 10 pediatric) before attending a 40-minute didactic lecture on MCI triage principles. The lecture covered the identification of MCI …


Stakeholder Criteria For Trust In Artificial Intelligence-Based Computer Perception Tools In Health Care: Qualitative Interview Study, Ansh Rai, Meghan E Hurley, John Herrington, Eric A Storch, Casey J Zampella, Julia Parrish-Morris, Anika Sonig, Gabriel Lázaro-Muñoz, Kristin Kostick-Quenet Dec 2025

Stakeholder Criteria For Trust In Artificial Intelligence-Based Computer Perception Tools In Health Care: Qualitative Interview Study, Ansh Rai, Meghan E Hurley, John Herrington, Eric A Storch, Casey J Zampella, Julia Parrish-Morris, Anika Sonig, Gabriel Lázaro-Muñoz, Kristin Kostick-Quenet

Faculty, Staff and Students Publications

Background: Computer perception (CP) technologies hold significant promise for advancing precision mental health care systems, given their ability to leverage algorithmic analysis of continuous, passive sensing data from wearables and smartphones (eg, behavioral activity, geolocation, vocal features, and ambient environmental data) to infer clinically meaningful behavioral and physiological states. However, successful implementation critically depends on cultivating well-founded stakeholder trust.

Objective: This study aims to investigate, across adolescents, caregivers, clinicians, and developers, the contingencies under which CP technologies are deemed trustworthy in health care.

Methods: We conducted 80 semistructured interviews with a purposive sample of adolescents (n=20) diagnosed with autism, Tourette …


Health-Related Quality Of Life In The Era Of Immune Checkpoint Blockade: What Do Patient-Reported Outcomes Reveal?, Alexandra M Dunker, Neha Malik, Kathryn J Krause, Emily Z Keung, Jason B Liu, Elise F Nassif Haddad, Neeta Somaiah, Heather G Lyu, Christina L Roland Dec 2025

Health-Related Quality Of Life In The Era Of Immune Checkpoint Blockade: What Do Patient-Reported Outcomes Reveal?, Alexandra M Dunker, Neha Malik, Kathryn J Krause, Emily Z Keung, Jason B Liu, Elise F Nassif Haddad, Neeta Somaiah, Heather G Lyu, Christina L Roland

Faculty, Staff and Student Publications

Background: Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment by providing durable survival gains, but understanding their effects on patient health-related quality of life (HRQL) is critical.

Methods: We performed a narrative review of cross-sectional surveys, early-phase trials, and large-scale phase II and III randomized controlled clinical trials assessing FDA-approved ICIs, including programmed cell death protein 1 (PD-1) inhibitors, programmed death ligand 1 (PD-L1) inhibitors, and cytotoxic T lymphocyte-associated antigen 4 (CTLA-4) inhibitors, with emphasis on patient-reported HRQL. Validated HRQL instruments were summarized, and for pivotal trials, the positioning of HRQL outcomes as primary, secondary, or exploratory endpoints was taken …


Moderators Of A Mhealth Intervention For Adolescent Physical Activity: Intervention Refinement Study., Christopher C. Cushing, Adrian Ortega, David A. Fedele, Calissa J. Leslie-Miller, Jordan A. Carlson, Ann M. Davis, Joshua M. Smyth Dec 2025

Moderators Of A Mhealth Intervention For Adolescent Physical Activity: Intervention Refinement Study., Christopher C. Cushing, Adrian Ortega, David A. Fedele, Calissa J. Leslie-Miller, Jordan A. Carlson, Ann M. Davis, Joshua M. Smyth

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: An adaptive text messaging intervention to promote adolescent physical activity has demonstrated feasibility, acceptability, and preliminary efficacy in a recent proof-of-concept study. To inform future intervention development, a secondary analysis of the data examined how physical activity is influenced by mood, environment, and physical feelings of energy and fatigue.

OBJECTIVE: This study aims to understand how both macro- and microtemporal variables (eg, psychological and environmental variables at both levels) influence the efficacy of a brief mobile health intervention (ie, NUDGE) for physical activity.

METHODS: Using a matched control design, we evaluated the effect of daily positive and negative affect, …


Inhibitory Control, Attentional Bias, And Palatable Food Consumption In Adolescents: A Laboratory Feasibility Randomized Controlled Trial., Carolina M. Bejarano, Adrian Ortega, Christopher C. Cushing Dec 2025

Inhibitory Control, Attentional Bias, And Palatable Food Consumption In Adolescents: A Laboratory Feasibility Randomized Controlled Trial., Carolina M. Bejarano, Adrian Ortega, Christopher C. Cushing

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Understanding relationships among inhibitory control, attentional bias to food cues, and food consumption in nonclinical adolescent samples can inform preventive efforts for disordered eating and associated health risks.

OBJECTIVE: This pilot study conducted preliminary testing of an inhibitory control training intervention on attentional bias toward food cues, hedonic appetite, and food consumption, as well as examined inhibitory control's relationship with hedonic appetite, food consumption, binge eating, and cognitive restraint.

METHODS: Participants (N=43; mean age 15.1, SD 1.7 years; 31/43, 72% female) were randomized to a food cue-specific go/no go inhibitory control training intervention or control group, took part in …


The Perspectives And Experiences Of Prospective Parents Declining Diagnostic Prenatal Genome Sequencing In Continuing Pregnancies With Fetal Structural Anomalies, Lisa S Weingarten, Allison Rosenbaum, Jessica De Voest, Stephanie Galloway, Jessica L Giordano, Samantha Stover, Lauren E Westerfield, Grant Bonesteele, Kelly L Gilmore, Leandra Tolusso, Beatrix Wong, A Theresa Wittman, Daniel T Swarr, Nancy Leslie, Anthony Johnson, Ignatia B Van Den Veyver, Neeta L Vora, Rebecca G Clifton, Aaron B Caughey, Ronald J Wapner, Wendy K Chung Dec 2025

The Perspectives And Experiences Of Prospective Parents Declining Diagnostic Prenatal Genome Sequencing In Continuing Pregnancies With Fetal Structural Anomalies, Lisa S Weingarten, Allison Rosenbaum, Jessica De Voest, Stephanie Galloway, Jessica L Giordano, Samantha Stover, Lauren E Westerfield, Grant Bonesteele, Kelly L Gilmore, Leandra Tolusso, Beatrix Wong, A Theresa Wittman, Daniel T Swarr, Nancy Leslie, Anthony Johnson, Ignatia B Van Den Veyver, Neeta L Vora, Rebecca G Clifton, Aaron B Caughey, Ronald J Wapner, Wendy K Chung

Duncan NRI Faculty and Staff Publications

Objective: This study evaluates an understudied perspective: the experiences of prospective parents who decline prenatal genome sequencing (pGS) for continuing pregnancies with fetal structural anomalies.

Method: We recruited a total cohort of 300 parents of 150 pregnancies who declined pGS, including 33 individuals who underwent an invasive procedure. These parents were invited to participate in a semi-structured interview between 1 and 15 months post-partum. We used Thematic Analysis to code and analyze interviews.

Results: We interviewed 22 parents of 16 pregnancies. Reasons for declining testing included risks of invasive procedures (n = 19, 86%), lack of prenatally actionable findings (n …


Investigating Dysfunctional Cognition Change As A Putative Mechanism Of Cbt For Youth Anxiety, Ocd And Ptsd: Protocol For An Individual Participant Data Meta-Analysis, Ivana Buric, Anke Klein, Ronald M Rapee, Brooke Levis, Philip C Kendall, Eric A Storch, Lynn Mobach Dec 2025

Investigating Dysfunctional Cognition Change As A Putative Mechanism Of Cbt For Youth Anxiety, Ocd And Ptsd: Protocol For An Individual Participant Data Meta-Analysis, Ivana Buric, Anke Klein, Ronald M Rapee, Brooke Levis, Philip C Kendall, Eric A Storch, Lynn Mobach

Faculty, Staff and Students Publications

Introduction: Anxiety disorders, obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD) are common in children and adolescents and can lead to significant impairment. Cognitive behavioural therapy (CBT) with exposure is the first-line treatment, yet approximately half of treated youth do not achieve full remission. Dysfunctional cognitions-negative automatic thoughts, maladaptive beliefs and distorted interpretations-are considered key targets of CBT, but evidence in youth is mixed and underpowered. This study will examine whether change in dysfunctional cognitions mediates treatment outcome in anxiety, OCD and PTSD symptoms and whether this association varies across individual characteristics.

Methods and analysis: An individual participant data meta-analysis …


A Double-Edged Sword: Ethical And Psychological Implications Of Apoe Genotype Disclosure Across The Lifespan, Diego Iacono Dec 2025

A Double-Edged Sword: Ethical And Psychological Implications Of Apoe Genotype Disclosure Across The Lifespan, Diego Iacono

Department of Neurology Faculty Papers

The apolipoprotein E (APOE) gene is the strongest genetic risk factor for sporadic Alzheimer’s disease (AD), with the ε4 allele increasing risk and decreasing the average age of onset. While APOE genotyping is primarily used in research or clinical settings for patients with memory concerns, interest in disclosing APOE status to asymptomatic individuals—particularly during early adulthood—is growing. This trend is fueled by the rise of direct-to-consumer genetic testing and emerging prevention-focused clinical trials. However, ethical debates remain unresolved about the potential harms of early disclosure, including anxiety, stigma, and misunderstanding of probabilistic risk. Conversely, some argue that knowledge of APOE …


Engaging Ukrainian Tf-Cbt Therapists In A Practice Skills Course To Support Their Wellbeing, Elisabeth Pollio, Esther Deblinger, Beth Cooper, Maike Garbade, Julie P Harrison, Elisa Pfeiffer Dec 2025

Engaging Ukrainian Tf-Cbt Therapists In A Practice Skills Course To Support Their Wellbeing, Elisabeth Pollio, Esther Deblinger, Beth Cooper, Maike Garbade, Julie P Harrison, Elisa Pfeiffer

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Background: Burnout and secondary traumatic stress (STS) are common among therapists working with trauma-exposed clients, which can negatively impact them professionally and personally. The shared trauma of war exposure may put therapists at greater risk. To help support their wellbeing, an eight-session course was offered to Ukrainian therapists following training in Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). This course involves therapists personally utilizing the PRACTICE skills taught to clients in TF-CBT for professional and personal benefit.

Objective: The objective was to gather preliminary evidence on the potential impact of implementing the course with Ukrainian therapists providing TF-CBT during a period of …


The Effectiveness Of A Chronic Care Management Program On Hospitalization Rates And Quality Of Life In Chronic Kidney Disease Patients, Sophie Burris Dec 2025

The Effectiveness Of A Chronic Care Management Program On Hospitalization Rates And Quality Of Life In Chronic Kidney Disease Patients, Sophie Burris

Doctoral Projects

Chronic Kidney Disease (CKD) is a progressive condition that distinctively affects underserved rural communities due to limited access to healthcare, provider shortages, and transportation barriers. Chronic Care Management (CCM) has emerged as a patient-centered, initiative-taking approach that emphasizes care coordination and self-management support. The purpose of this doctoral project was to evaluate the impact of implementing a CCM program in Caucasian females over the age of 40 with CKD residing in an underserved rural community post hospitalization. The Chronic Care Model (CCM) is the framework that guides the doctoral project which compared outcomes in patients enrolled in a CCM program …


Prevalence Of Sleep Disturbances And Factors Associated Among School Going Children In Uganda, A Cross-Sectional Study, Martha Sajatovic Dec 2025

Prevalence Of Sleep Disturbances And Factors Associated Among School Going Children In Uganda, A Cross-Sectional Study, Martha Sajatovic

Faculty Scholarship

Background: Sleep disturbances greatly impact children's academic performance and social well-being. This study set out to determine the prevalence of sleep disturbances and factors associated among school going children in Kawempe division, Kampala, Uganda. Methods: In a community cross-sectional study, 548 study participants using random cluster sampling were enrolled. The children start lessons at 8am and end the days classes at 5pm. Random cluster sampling method was used to select participants from the 19 parishes in Kawempe district. Data was collected using a semi-structured questionnaire and Sleep Disturbance Scale for Children (SDSC). Descriptive statistics and multivariate binary logistic regression were …


Implementation Of The Modified Severity Assessment Scale (Msas) For Alcohol Withdrawal In An Inpatient Psychiatric Unit, Grace R. Lindsey Dec 2025

Implementation Of The Modified Severity Assessment Scale (Msas) For Alcohol Withdrawal In An Inpatient Psychiatric Unit, Grace R. Lindsey

Doctor of Nursing Practice

Background: Alcohol withdrawal is a potentially life-threatening condition frequently seen in psychiatric inpatient settings, especially among individuals with co-occurring alcohol use disorder and mental illness. The Clinical Institute Withdrawal Assessment for Alcohol Scale-revised, while widely used, depends on patient self-report, making it less effective for individuals with altered mental status or psychosis.

Purpose: This quality improvement project implemented the Modified Severity Assessment Scale, an objective, observation-based alcohol withdrawal protocol, in an inpatient psychiatric setting to improve safety, treatment accuracy, and care standardization.

Objectives: The project focused on ensuring full staff adoption of the protocol, reducing intensive care unit transfers …


Quality Of Life And Mental Health: A Qualitative Exploration Of Perceived Factors That Impact Older Adults, Chasiti Herring Dec 2025

Quality Of Life And Mental Health: A Qualitative Exploration Of Perceived Factors That Impact Older Adults, Chasiti Herring

All-Inclusive List of Electronic Theses and Dissertations

Enhancing quality of life and well-being is a universal phenomenon across the lifespan. As the population ages, older adults are in great need of supportive services to enhance quality of life and their ability to manage their mental health. The purpose of this study is to examine the quality of life (QoL) of older adults. This study aimed to provide valuable research in the area of QoL through the exploration of perceived factors that impact the older adult population. This exploratory qualitative research study consisted of 10 older adult participants between the ages of 65 and 95. Research recruitment prioritized …


Sleep-Disordered Breathing Subtypes And Future Diet Quality In The Multi-Ethnic Study Of Atherosclerosis, Kaitlin S Potts, Cecilia Castro-Diehl, Tianyi Huang, Alexis C Wood, Jerome I Rotter, Stephen S Rich, Tamar Sofer, Susan Redline, Heming Wang Dec 2025

Sleep-Disordered Breathing Subtypes And Future Diet Quality In The Multi-Ethnic Study Of Atherosclerosis, Kaitlin S Potts, Cecilia Castro-Diehl, Tianyi Huang, Alexis C Wood, Jerome I Rotter, Stephen S Rich, Tamar Sofer, Susan Redline, Heming Wang

Children’s Nutrition Research Center Staff Publications

Objectives: Sleep-disordered breathing (SDB) and diet quality impact cardiometabolic disease, but few studies have examined if SDB influences diet quality. This study estimated the association between SDB subtypes (with and without sleepiness) and future diet quality in the Multi-Ethnic Study of Atherosclerosis.

Methods: Probable SDB was characterized by self-reported physician-diagnosed sleep apnea (PDSA) or habitual snoring and subtyped by presence or absence of sleepiness. A food frequency questionnaire measured diet 1.6 years before, and 7.8 years after SDB assessment. Diet quality was measured with the Alternate Healthy Eating Index-2010 (AHEI). Mean differences in AHEI at follow-up by SDB subtypes were …


Periodizing Exercise Medicine Prescription For Patients With Cancer: A Narrative Opinion, Francesco Bettariga, Robert U. Newton, Chris Bishop, Luca Maestroni, Anita Borsati, Alice Avancini, Sara Pilotto, Dennis R. Taaffe, Daniel A. Galvão, G. Gregory Haff Dec 2025

Periodizing Exercise Medicine Prescription For Patients With Cancer: A Narrative Opinion, Francesco Bettariga, Robert U. Newton, Chris Bishop, Luca Maestroni, Anita Borsati, Alice Avancini, Sara Pilotto, Dennis R. Taaffe, Daniel A. Galvão, G. Gregory Haff

Research outputs 2022 to 2026

Exercise has emerged as an effective therapeutic strategy in cancer management. Long-term supervised exercise programs, including resistance training and aerobic training, can improve body composition and physical fitness, modulate circulating factors (e.g., hormones, cytokines), enhance treatment tolerance, and reduce side effects, potentially influencing cancer progression and reducing mortality risk. Despite advancements in exercise oncology, opportunities remain to refine exercise prescription through the integration of advanced methodologies such as periodization and autoregulatory programming strategies. Periodization, a systematic approach to organizing training over time, has demonstrated benefits in general fitness and clinical populations but is underexplored in cancer care. Emerging evidence suggests …


The Frontal Assessment Battery In Older Multilingual Kenyan Adults, Anne Njoki Gitere, Anne Nyambura, Karen Blackmon, Levi Muyela, Rachel Maina, Olivera Nesic Taylor,, Jasmit Shah, Dilraj Sokhi, Sylvia Mbugua, Samuel Gitau, Sheila Waa, Juzar Hooker, Zul Merali, Chinedu Momoh, Karen Blackmon Dec 2025

The Frontal Assessment Battery In Older Multilingual Kenyan Adults, Anne Njoki Gitere, Anne Nyambura, Karen Blackmon, Levi Muyela, Rachel Maina, Olivera Nesic Taylor,, Jasmit Shah, Dilraj Sokhi, Sylvia Mbugua, Samuel Gitau, Sheila Waa, Juzar Hooker, Zul Merali, Chinedu Momoh, Karen Blackmon

Brain and Mind Institute

 

Background: The Frontal Assessment Battery (FAB) was developed as a short (6-item) bedside assessment of executive dysfunction in older adults with suspected neurodegeneration. This study describes psychometric features of the FAB in multilingual Kenyan adults with and without clinical diagnosis of dementia.

Method: The FAB consists of six items assessing verbal abstract reasoning, lexical fluency, motor learning, and inhibitory control. The score on each item ranges from 0-3, with higher scores indicating better performance. Bilingual English-Swahili study personnel translated, blind back-translated, and applied consensus-driven cultural adaptations. FAB was then administered to 95 participants [71 cognitively unimpaired (CU) controls; 24 people …


Burden Of Neurodevelopmental Disorders In Kenyan Children, Symon Kariuki, Patricia Kipkemoi, Martha Kombe, Mary Bitta, Jacqueline Phillips Owen, Amina Abubakar, Charles Newton Dec 2025

Burden Of Neurodevelopmental Disorders In Kenyan Children, Symon Kariuki, Patricia Kipkemoi, Martha Kombe, Mary Bitta, Jacqueline Phillips Owen, Amina Abubakar, Charles Newton

Institute for Human Development, East Africa

Importance: Neurodevelopmental disorders (NDDs) such as autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and intellectual disability contribute to one-tenth of the global burden of mental and neurologic disorders. The burden of NDDs is not well documented in Africa.

Objective:To assess the prevalence, risk factors, and comorbidities of NDDs in young Kenyan children.

Design, setting and participants: This cross-sectional study was conducted among children aged 6 to 9 years residing in the Kilifi Health and Demographic Surveillance System in Kenya. In stage I of the study, children were screened for NDDs from March 16, 2015, to September 14, 2016; those …


Dual-Level Pattern Tree For Visual Field Improves Glaucoma Progression And Polygenic Risk Prediction, Luo Song, Lucy Q. Shen, Louis R. Pasquale, Michael V. Boland, Sarah R. Wellik, Carlos Gustavo De Moraes, Ayellet Segre, Janey L. Wiggs, Constance Turman, Jonathan S. Myers, Tobias Elze, Nazlee Zebardast, David S. Friedman, Jae H. Kang, Mengyu Wang Dec 2025

Dual-Level Pattern Tree For Visual Field Improves Glaucoma Progression And Polygenic Risk Prediction, Luo Song, Lucy Q. Shen, Louis R. Pasquale, Michael V. Boland, Sarah R. Wellik, Carlos Gustavo De Moraes, Ayellet Segre, Janey L. Wiggs, Constance Turman, Jonathan S. Myers, Tobias Elze, Nazlee Zebardast, David S. Friedman, Jae H. Kang, Mengyu Wang

Wills Eye Hospital Papers

PURPOSE: To develop a dual-level pattern tree to characterize visual field (VF) loss subtypes that can be used to better predict glaucoma progression and glaucoma polygenic risk scores (PRSs).

METHODS: This study included 113,030 patients from three datasets, each used for a specific purpose: (1) model training, (2) progression forecasting, and (3) PRS correlations. We applied archetypal analysis to cluster 24-2 VFs into trunk patterns and their branch patterns. The Cox regression model was used to forecast VF progression using mean deviation (MD) slope, MD-fast slope, total deviation (TD) pointwise slope, and visual field index (VFI) slope. Multivariable regression analyses …


Best Practice Recommendations For Anesthesia Providers In Preventing Postoperative Delirium In The Geriatric Population Undergoing Non-Cardiac Surgery, Ana Primeaux, Ashanti Reed Dec 2025

Best Practice Recommendations For Anesthesia Providers In Preventing Postoperative Delirium In The Geriatric Population Undergoing Non-Cardiac Surgery, Ana Primeaux, Ashanti Reed

Doctoral Projects

Postoperative delirium (POD) is a significant and preventable complication in geriatric patients undergoing non-cardiac surgery. Such complication is associated with foreseeable consequences, such as prolonged hospitalization, long-term cognitive decline, increased morbidity and mortality, and increased costs. Despite the emerging awareness of evidence-based nonpharmacologic and pharmacologic interventional strategies, POD still represents a clinical challenge for anesthesia providers.

Currently, there is a lack of clinical guidelines to guide formalized education and evidence-based interventions on POD prevention across anesthesia practice settings. Consequently, there is a critical need to raise awareness that the lack of clinical guidelines and the high incidence of POD may …


Decreasing Barriers To The Utilization Of Cryopreserved Sperm In Male Cancer Survivors: An Expert Review And Guide, Megan V Alexander, Hailie Ciomperlik, Anna Claire Reynolds, Allyson Nevins, Luwam Ghidei, Jordan Kassab, Kevin Campbell, John Sullivan, Michael D Jochum, Laura Detti, Terri L Woodard, Larry I Lipshultz, Laurie J Mckenzie Dec 2025

Decreasing Barriers To The Utilization Of Cryopreserved Sperm In Male Cancer Survivors: An Expert Review And Guide, Megan V Alexander, Hailie Ciomperlik, Anna Claire Reynolds, Allyson Nevins, Luwam Ghidei, Jordan Kassab, Kevin Campbell, John Sullivan, Michael D Jochum, Laura Detti, Terri L Woodard, Larry I Lipshultz, Laurie J Mckenzie

Faculty, Staff and Students Publications

Background: Sperm cryopreservation offers male cancer patients a critical opportunity to preserve fertility prior to gonadotoxic therapy, yet utilization of banked sperm remains modest, typically under 10%. A structured understanding of barriers across the cancer survivorship continuum is needed to support patients in utilization of cryopreserved sperm in alignment with their reproductive goals.

Materials and methods: This expert review synthesizes current evidence and clinical experience to explore the multifaceted barriers to cryopreserved sperm use and propose specific solutions. Key intervention timepoints are examined, including the post-treatment fertility return visit, long-term cryopreservation while remote from family building, readiness for family building, …


Implications Of Cooccurring Adhd For The Cognitive Behavioural Treatment Of Anxiety In Autistic Children, Elise Ng-Cordell, Eric A Storch, Philip C Kendall, Jeffrey J Wood, Amori Yee Mikami, Connor M Kerns Dec 2025

Implications Of Cooccurring Adhd For The Cognitive Behavioural Treatment Of Anxiety In Autistic Children, Elise Ng-Cordell, Eric A Storch, Philip C Kendall, Jeffrey J Wood, Amori Yee Mikami, Connor M Kerns

Faculty, Staff and Students Publications

Background: Childhood mental health conditions commonly cooccur, with potential treatment implications. Autistic children frequently experience anxiety and attention deficit/hyperactivity disorder (ADHD). We investigated the implications of this cooccurrence for Cognitive Behavioural Therapy (CBT), a front-line treatment for anxiety in autistic children. We tested whether (1) ADHD predicts anxiety treatment response, (2) ADHD improves in response to anxiety treatment and (3) ADHD improvement is related to reductions in anxiety.

Method: Autistic children with elevated anxiety (N = 167) enrolled in a multisite, randomised controlled trial comparing standard CBT, autism-adapted CBT and treatment as usual. ADHD symptoms and severity were assessed via …


How Well Can Commonly Used Anxiety Scales Detect Treatment Outcomes In The Context Of Autism?, Huilin Chen, Jeffrey J Wood, Connor M Kerns, Eric A Storch, Philip C Kendall, Gaia Scerif, Cathy Creswell Dec 2025

How Well Can Commonly Used Anxiety Scales Detect Treatment Outcomes In The Context Of Autism?, Huilin Chen, Jeffrey J Wood, Connor M Kerns, Eric A Storch, Philip C Kendall, Gaia Scerif, Cathy Creswell

Faculty, Staff and Students Publications

Anxiety is one of the most prevalent mental health challenges in autistic children, yet there is limited evidence on effective tools to measure treatment outcomes. Previous research with non-autistic children has found that the Child Anxiety Impact Scale, Parent Version achieved good diagnostic accuracy when measuring treatment outcomes and performed better than a commonly used symptom measure. However, this has not been evaluated for autistic children. The present study examined the psychometric properties of the Child Anxiety Impact Scale, Parent Version in autistic children and compared its utility against other anxiety symptom measures, to detect treatment outcomes as assessed by …


Benchmarking Empirical Severity For The Yale-Brown Obsessive Compulsive Scale-Second Edition, Caitlin M Pinciotti, Juliana Avery, Chencheng Zhang, Josselyn S Muñoz, Dayan Berrones, Vanessa Zavala Cruz, Andrew D Wiese, Jacey L Anderberg, Renee M Frederick, Tomás Miño, Nuria Lanzagorta, Juan Camilo Restrepo, Marcos E Ochoa-Panaifo, Wayne K Goodman, James J Crowley, Eric A Storch, Matti Cervin Dec 2025

Benchmarking Empirical Severity For The Yale-Brown Obsessive Compulsive Scale-Second Edition, Caitlin M Pinciotti, Juliana Avery, Chencheng Zhang, Josselyn S Muñoz, Dayan Berrones, Vanessa Zavala Cruz, Andrew D Wiese, Jacey L Anderberg, Renee M Frederick, Tomás Miño, Nuria Lanzagorta, Juan Camilo Restrepo, Marcos E Ochoa-Panaifo, Wayne K Goodman, James J Crowley, Eric A Storch, Matti Cervin

Faculty, Staff and Students Publications

The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) is considered the primary instrument for assessing the presence and severity of obsessive-compulsive disorder (OCD). Conceptual and empirical critiques inspired the development of an updated version of the instrument, the Yale-Brown Obsessive Compulsive Scale-Second Edition (Y-BOCS-II), with a higher ceiling of OCD severity to better differentiate between severe and the most debilitating OCD presentations, among other revisions. The Y-BOCS-II has demonstrated sound psychometric properties across diverse samples. Empirically derived severity benchmarks have been proposed for the original Y-BOCS, yielding somewhat different ranges than what has been commonly used in clinical and research settings, yet …


Symptom Burden, Healthcare Utilization, And Risky Behaviors In Survivors Of The Childhood Cancer Survivor Study (Ccss): An Observation Cohort Study, Rachel Webster, Deo Kumar Srivastava, Lu Xie, Himani Darji, Wei Liu, Meghan E Mcgrady, Tara M Brinkman, Nicole M Alberts, Kirsten K Ness, Bernard Fuemmeler, Alicia S Kunin-Batson, I-Chan Huang, Gregory T Armstrong, Rebecca M Howell, Daniel M Green, Yutaka Yasui, Kevin R Krull Dec 2025

Symptom Burden, Healthcare Utilization, And Risky Behaviors In Survivors Of The Childhood Cancer Survivor Study (Ccss): An Observation Cohort Study, Rachel Webster, Deo Kumar Srivastava, Lu Xie, Himani Darji, Wei Liu, Meghan E Mcgrady, Tara M Brinkman, Nicole M Alberts, Kirsten K Ness, Bernard Fuemmeler, Alicia S Kunin-Batson, I-Chan Huang, Gregory T Armstrong, Rebecca M Howell, Daniel M Green, Yutaka Yasui, Kevin R Krull

Faculty, Staff and Student Publications

Background: Childhood cancer survivors face physical, psychological, and neurological symptoms that contribute to risky health behaviors and increased healthcare utilization. Traditional survivorship care models overlook risk associated with this symptom burden. The current study examined symptoms phenotypes to identify high-risk groups.

Methods: Five-year survivors (N = 17,231; Mean [standard deviation] age = 27.4 [5.98]; 80% non-Hispanic White; 48% female) from the Childhood Cancer Survivor Study (NCT01120353) self-reported symptoms and risky behavior at baseline and first follow-up (original cohort data collection: baseline 1994-1998 and follow-up 2002-2004; expansion cohort: baseline 2008-2010 and follow-up 2014-2016). Medical records were extracted through chart …


Improvement And Maintenance Of Clinical Outcome Assessments In Atopic Dermatitis With Amlitelimab, Andrew Blauvelt, Raj Chovatiya, Joseph F Merola, Stephan Weidinger, Ken Igawa, Ella Brookes, Christine Weber, Jennifer Wang, Cori Gray Dec 2025

Improvement And Maintenance Of Clinical Outcome Assessments In Atopic Dermatitis With Amlitelimab, Andrew Blauvelt, Raj Chovatiya, Joseph F Merola, Stephan Weidinger, Ken Igawa, Ella Brookes, Christine Weber, Jennifer Wang, Cori Gray

Faculty, Staff and Student Publications

Background: Amlitelimab, a fully human, nondepleting, anti-OX40 ligand monoclonal antibody, demonstrated reductions in lesional and pruritic endpoints in adults with moderate-to-severe atopic dermatitis (AD) in phase 2a and 2b trials.

Objectives: Here, we examined the effect and durability of amlitelimab on clinical outcome assessments (COAs) in the randomized STREAM-AD phase 2b trial.

Methods: Adults with moderate-to-severe AD with prior inadequate response to or inadvisability of topical medications received subcutaneous amlitelimab (250 mg with 500-mg loading dose, 250 mg, 125 mg or 62.5 mg) or placebo every 4 weeks in Part 1 (Weeks 0-24; 1:1:1:1:1 randomization). In Part 2, Week 24 …


Standardized Research Electronic Cigarette Acceptability Among Adult Men And Women Who Smoke Combustible Cigarettes, Jason D Robinson, Yong Cui, Maher Karam-Hage, Janice A Blalock, Sanjay Shete, George Kypriotakis, Peiying Yang, Paul M Cinciripini Dec 2025

Standardized Research Electronic Cigarette Acceptability Among Adult Men And Women Who Smoke Combustible Cigarettes, Jason D Robinson, Yong Cui, Maher Karam-Hage, Janice A Blalock, Sanjay Shete, George Kypriotakis, Peiying Yang, Paul M Cinciripini

Faculty, Staff and Student Publications

Objective: The U.S. electronic cigarette marketplace is diverse and has evolved rapidly. To provide a standardized research model, the U.S. National Institute on Drug Abuse developed the Standard Research E-Cigarette (SREC). This study characterized potential gender differences in product use, acceptability, reinforcement, and nicotine dependence symptoms when switching from combustible cigarettes (CCs) to nicotine and placebo SRECs.

Method: In total, 169 adults (82 women) who smoke were enrolled in this all-remote randomized double-blind crossover trial. During Weeks 1-2, participants used their usual brand cigarettes (UBCs). During Weeks 3-4 and 5-6, they were instructed to use the tobacco-flavored SREC (either nicotine …