Digital Commons Network^™

The Role Of Bandemia In Clinical Outcomes Of Critically Ill Septic Patients., Yerandi Gil, Grettel Gonzalez Garcia, Ambar Sekulis, Rafael Miret, Siddarth Kathuria, Mauricio Danckers, Daniel Heller

East Florida Division GME Research Day 2025

Rationale: Bandemia, defined as the presence of immature neutrophils in circulation, is commonly used as an early marker of systemic inflammation and infection. 1 However, its prognostic significance in sepsis, severe sepsis, and septic shock remains uncertain. 1-2 This study aimed to determine whether bandemia is associated with adverse clinical outcomes and increased intensive care unit (ICU) resource utilization among critically ill septic patients admitted from the emergency department (ED).

Methods: A retrospective analysis was conducted using de-identified data from the HCA Healthcare database. Adult patients (aged 18–90 years) admitted to the ICU at HCA Florida Aventura Hospital from the …

Laproscopic Robotic-Assisted Common Bile Duct Exploration For Primary Choledochlithiasis 20 Years After Cholecystetomy In A Hostile Abdomen, Enoch Wong, Kristen Payne, James Burdick, Hassan Ahmed

North Texas Research Forum 2025

Introduction: The incidence of concomitant cholelithiasis and choledocholithiasis is 5-20%. Primary choledochlithiasis more than 3 years after cholecystectomy is an even rarer event with only a handful of case reports in the literature. Robot-assisted laparoscopic common bile duct exploration with intraoperative choledochoscopy is a relatively recent development in biliary surgery. In this report, we describe the use of this technique in a patient with rare presentation and surgically challenging anatomy. Objective: To describe a minimally invasive approach for CBD exploration with extraction of choledocholithiasis in a surgically hostile abdomen and Roux-En-Y anatomy. Methods: This report describes the case of a …

An Unexpected Source Of Gi Bleeding: Enteric Muco-Submucosal Elongated Polyp In The Proximal Jejunum With Literature Review, Galvin Dhaliwal, Dev Patel, Ashvin Singh Dhaliwal, Aakriti Soni, Bilal Ashraf, Shane Sweeney, Sushovan Guha, Ahmed Ouni

Gulf Coast Division GME Research Day 2025

No abstract provided.

Turmeric, Red Yeast Paste, And Statins: A Recipe For Dili, John V. Nahas, Sinay Ceballos, Franklin Kasmin

East Florida Division GME Research Day 2025

Introduction Drug induced liver injury (DILI) contributes to a significant portion of acute liver injuries and acute liver failure in the west. DILI accounts for approximately 11% of acute liver failure cases in the US according to ACG. Insulting agents are numerous and well documented in the NIH LiverTox database, however the rarity and complexity of individual agents is a matter of ongoing study. Case Description/Methods A 52 year old man with PMH of HTN and HLD presents for a 2 week history of abdominal swelling, bilateral lower extremity swelling, decreased appetite, and positional shortness of breath. He endorses occasionally …

An Evaluation Of The Decline In Primary Care Physician Visits, 2010 To 2021, Anuradha Jetty, Marie Ezran, Alison Huffstetler, Yalda Jabbarpour

Department of Family & Community Medicine Faculty Papers

INTRODUCTION: Primary care is the backbone of the United States healthcare system, yet it continues to be underfunded and inaccessible to many. Previous studies explored primary care visit patterns until 2016, leaving gaps in our understanding of how recent factors like state Medicaid expansions, the Coronavirus Disease 2019 (COVID-19) pandemic, and population growth have influenced these patterns. Hence, the objective of the current study was to analyze the trends in primary care visits provided by outpatient clinicians over time and by visit type and contextualize study findings within the changing healthcare landscape.

METHODS: The Medical Expenditure Panel Survey data (2010-2021) …

The Chemical Straightjacket: Institutional Over-Use Of Psychotropic Drugs On Children In Lieu Of Therapeutic Community Mental Health Services, Marisa Leib-Neri

Indiana Journal of Law and Social Equality

This Article argues that the abysmal state of children’s mental health in America is in part due to an overreliance on and over prescription of psychotropic drugs inside psychiatric residential institutions in lieu of community based mental health services. This overreliance on residential institutions and psychotropic drugs has allowed a new form of chemical restraint to flourish—the chemical straitjacket. This Article uses the medication lists of twelve children in seven different North Carolina psychiatric residential treatment facilities to demonstrate how the chemical straitjacket operates: the prescription of drugs not approved for pediatric populations, counter to evidence-based practices for particular diagnoses, …

Adenomatoid Tumor Of The Testis: A Report Of Two Cases And Literature Review, Amadadin Alhlib, Trudea Juma, Shahin Sayed

General Surgery, East Africa

Testicular adenomatoid tumor is a rare benign condition that can resemble testicular malignancies in its clinical presentation, potentially leading to overtreatment, such as radical orchidectomy. In our two case reports, we aim to better understand the behavior of this disease by examining its clinical presentation, as well as radiological, intraoperative, and pathological findings.

A Vision Transformer Based Assistive System For Dermatological Diagnosis In Systemic Lupus Erythematosus, Syeda Lamima Farhat

All Graduate Theses, Dissertations, and Other Capstone Projects

Systemic Lupus Erythematosus (SLE) is a complex and often underdiagnosed autoimmune disease that affects multiple organs and presents with a wide range of symptoms-ranging from fatigue and joint pain to life-threatening organ damage. One of its most visible and diagnostically significant indicators is the Butterfly Malar Rash (BMR), a distinctive facial rash that often resembles other common dermatological conditions like rosacea, acne, eczema, and fifth disease. This overlap can lead to misdiagnosis or delayed detection, especially in busy clinical environments. To assist dermatologists in distinguishing BMR from similar facial rashes, this study explores the development of an AI-powered image classification …

Oregon Doula Workforce Analysis, Aisha K Gilmore, Apoorva Somayazulu, Lindsay Dickey, Rosemelty Jimenez Medal

Articles, Abstracts, and Reports

No abstract provided.

Editing Approaches To Treat Alpha-1 Antitrypsin Deficiency, Derek M. Erion, Leah Y. Liu, Christopher R. Brown, Stephen I. Rennard, Humam Farah

Journal Articles: Pulmonary & Critical Care Med

TOPIC IMPORTANCE: Alpha-1 antitrypsin (AAT) deficiency is a genetic disorder most commonly due to a single G to A point mutation (E342K), leading to debilitating lung and/or liver disorders and is associated with increased mortality. The E342K point mutation causes a conformational change of the AAT protein resulting in its retention in liver hepatocytes. This reduces AAT secretion into the serum resulting in higher protease activities due to the lack of inhibition from AAT, causing damage to healthy lung tissue. The current standard of care for lung manifestations involves weekly IV augmentation therapy and is considered suboptimal for these patients. …

Medical-Grade Honey And Standard Dressings In Burn Wound Care: Evaluating Effectiveness, Cost, And Patient Outcomes, Chloe Shin, Andrew Golonka

Nursing | Student Research Posters

Background: Burn injuries burden the healthcare system globally as silver sulfadiazine (SSD) is the standard treatment even though it delays healing and is highly costly. Medical-grade honey (MGH) demonstrates superior antimicrobial and anti-inflammatory properties, however, there are still evidence gaps when comparing effectiveness, cost efficiency, and patient centered outcomes. Purpose: This study aims to compare MGH and SSD amongst these gaps to inform evidence based burn care. Methods: A randomized controlled trial will enroll 100 people between 25-50 years of age with first and second degree burns, < 20% total body surface area within two hospital burn units. Participants will be assigned to either MGH or SSD treatment. The study will be a single blind design where dermatologists evaluating the wound photographs will not know the treatment given. Primary outcomes include wound healing time, infection rates, and patient reported pain scores. Secondary outcomes will focus on cost effectiveness analyses and patient quality of life. Standardized protocols will be implemented for data collection, wound assessment, and safety monitoring. Results: We anticipate that MGH will have lower infection rates, promote faster wound healing, improved outcomes from patient reports, and better cost effectiveness through shorter hospital stays and reduced medical treatments compared to SSD. Conclusion: This study will provide evidence comparing MGH and SSD across economic, clinical, and patient centered outcomes. If our hypothesis aligns with the results, MGH could be a new evidence based standard in burn care as it offers many advantages over SSD in patient comfort, healing efficiency, and medical costs. The findings will provide areas for future research, especially long term outcome and a bigger patient population.

The Remote Supervision Road To Registrar Training In Australia - Paving The Path With Pixels And Phones (A Narrative Review)., Nicholas Coburn, Kylie Fitzgerald, Brett Vaughan

Health Professions Education

Purpose: Specialist medical training in rural or remote Australia is limited due to current requirements of specialist medical colleges to supervise and train registrars onsite. Remote supervision, where the registrar is supervised via telephone and videoconferencing technology remotely, offers a solution that allows doctors to train in rural or remote areas. This review describes the opportunities, challenges, and recommendations to pave the path for a best practice model of remote supervision for private practice focused registrar training in Australia which may offer insights for other countries with rural and remote medical workforces.

Methods: Ovid Medline and Ovid Embase were …

Comparing The Patient Shielding Practices For Healthcare Facilities In Southeast Georgia, Genesis Horton

Honors College Theses

Since the discovery of X-rays in 1895, research has consistently been conducted on their capabilities and limitations in healthcare. One primary focus of interest is patient shielding, especially regarding radiation protection and patient safety. Introduced in the mid-1900s, patient shielding has been practiced to protect the gonads, the thyroid, and other radiosensitive body parts. This research project investigated common shielding protocols implemented in healthcare facilities, specifically within Southeast Georgia. This study utilized anonymized in-person interviews with local imaging departments regarding their procedures and protocols for patient shielding. Results from these interviews have been analyzed and compared to shielding best practices …

Prognostic And Predictive Value Of Gastric Acid Suppressants In The Eortc 1325/Keynote-054 Randomized Phase Iii Trial Of Pembrolizumab Vs Placebo In Resected Stage Iii Melanoma, Emanuel Bührer, Nina Glassee, Michal Kicinski, Oliver J. Kennedy, Christian U. Blank, Georgina V. Long, Victoria G. Atkinson, Stéphane Dalle, Andrew M. Haydon, Andrey Meshcheryakov, Adnan Khattak, Matteo S. Carlino, Shahneen Sandhu, James Larkin, Susana Puig, Paolo A. Ascierto, Piotr Rutkowski, Dirk Schadendorf, Marye Boers-Sonderen, Anna Maria Di Giacomo, Alfonsus J.M. Van Den Eertwegh, Jean Jacques Grob, Ralf Gutzmer, Rahima Jamal, Alexander C.J. Van Akkooi, Sara Gandini

Research outputs 2022 to 2026

Background: The gut microbiome plays a pivotal role in regulating immunity. Gastric acid suppressants (GAS) are known to alter the gut microbiome and might therefore modify response to immunotherapy in cancer patients. We estimated associations of GAS with recurrence-free survival (RFS) and distant metastasis-free survival (DMFS) in the EORTC 1325/KEYNOTE-054 trial. Methods: Patients with resected stage III melanoma were randomized to receive 200 mg of pembrolizumab or placebo. Pembrolizumab prolonged RFS and DMFS (reported elsewhere). We used Cox models to estimate hazard ratios (HR) and 95 % confidence intervals (CI) for the association between GAS at baseline, and RFS and …

Advancing Person-Centred Care Through Palliative Care Wa’S Acp Workshops: The Longer-Term Impact, Gertrude G. Phiri, Emma Gunner, Philip Bafile, Davina Porock

Research outputs 2022 to 2026

Planning for end-of-life and associated decision-making is one of global significance as it impacts the quality of care in palliative care settings, including ensuring that personal preferences are honoured. It is a priority for the Australian health system to use Advance Care Planning (ACP) as it is an effective tool for individuals and their families to make their personal preferences known and implemented. The aim of this project was to evaluate the longer-term impact of the Palliative Care Western Australia (PCWA) ACP workshops. Semi-structured, open-ended questions were used to collect data from 21 participants. Reflexive thematic analysis was used to …

Enhancing Cardiovascular Risk Prediction In Hypertensive Adults: A 3pm-Based Evaluation Of Insulin Resistance And Arterial Stiffness, Yulong Lan, Zhaogui Wu, Dan Wu, Lingyu Xu, Hongfa Wei, Chutao Wu, Youren Chen, Xiaolan Li, Shouling Wu

Research outputs 2022 to 2026

Objective: Hypertension management remains challenging due to coexisting insulin resistance (IR) and arterial stiffness—two silent yet synergistic drivers of atherosclerotic cardiovascular disease (ASCVD). This study aimed to evaluate their joint impact on ASCVD risk and assess their utility in predictive, preventive, and personalized strategies. Methods: In this prospective cohort study of 30,094 adults with hypertension, IR was assessed using the triglyceride-glucose (TyG) index (calculated as ln [TG (mg/dL) × FBG (mg/dL)/2]) and arterial stiffness via brachial-ankle pulse wave velocity (baPWV). Time-to-event analyses examined their individual and combined associations with ASCVD incidence. Results: Over a median 5.6-year follow-up, 1655 ASCVD cases …

Intake Of Total, Classes, And Subclasses Of (Poly)Phenols And Risk Of Lymphoid Neoplasms: A Prospective Analysis In The Epic Cohort, Enrique Almanza-Aguilera, David Guananga-Álvarez, Yolanda Benavente, Alexandra Nieters, Caroline Besson, Fatemeh Saberi Hosnijeh, Cecilie Kyrø, Nicola P. Bondonno, Christina C. Dahm, Elisabete Weiderpass, Therese Truong, Mariem Louati-Hajji, Xuan Ren, Verena Katzke, Matthias B. Schulze, Fabrizio Pasanisi, Claudia Vener, Giovanna Masala, Maria Teresa Giraudo, Rosario Tumino, Amaia Aizpurua, Maria Jose Sánchez, José María Huerta, Marcela Guevara, Cristina Lasheras, Paolo Vineis

Research outputs 2022 to 2026

Background: Existing epidemiological evidence regarding the potential role of (poly)phenol intake in lymphoma development is limited. Methods: We investigated the associations between the intake of total and individual classes and subclasses of (poly)phenols and the risk of lymphoma, including main frequent subtypes in the EPIC cohort using multivariable-adjusted Cox proportional hazards models. Results: During a mean 14-year follow-up (time frame: from 1990–1994 to 2008–2013), 2394 incident lymphoma cases were diagnosed from a total of 367,463 individuals. No significant associations were observed between total intakes of (poly)phenols, flavonoids, and phenolic acids and overall lymphoma risk. Total (poly)phenols, phenolic acid and hydroxycinnamic …

Proximal Chronic Total Occlusion Of The Left Anterior Descending Coronary Artery: Conventional Vs. Minimally Invasive Revascularization, Ahmed Shafeek Ali, Mahmoud Maher Abdou Ibrahim, Haitham Alshahat Ramadan

Journal of Medicine in Scientific Research

Introduction Minimally invasive techniques have gained much popularity in recent years. Our goal is comparing the initial outcomes of the minimally invasive technique to the traditional method for managing chronic total occlusion of the left anterior descending coronary artery. Methods A total of 60 ischemic individuals with isolated chronic total occlusion (CTO) of the left anterior descending coronary artery and a history of failed PCI were prospectively studied at the National Heart Institute, Cairo, Egypt, between June 2021 to November 2023. Patients were matched using EuroSCORE II, all patients were operated on utilizing the off-pump technique. Group 1 encompassed 30 …

Effect Of Non-Complicated Cataract Extraction With Phacoemulsification On Central Macular Thickness (Cmt) And Ganglion Cell Complex (Gcc) In Non-Diabetic Patients At Sohag Teaching Hospital, Mohammed Shikhoun Ahmed, Mariam Kamal

Journal of Medicine in Scientific Research

Background: Cataracts are widely acknowledged as the primary cause of blindness on a global scale. Cataract surgery, particularly phacoemulsification, is the most effective and the only approved intervention for cataracts, regardless of etiology. Phacoemulsification, with its numerous advantages, is the most widely used method for cataract removal. It is important to note that while phacoemulsification is considered a safe and effective procedure, there are potential complications that need to be managed. Methods: This study included one hundred eyes of 93 nondiabetic patients undergoing noncomplicated cataract operation at the ophthalmology department at Sohag Teaching Hospital. A preoperative assessment of the best …

Hand Grip Strength As A Predictor Of Pulmonary Function In Children With Congenital Heart Disease: A Cross-Sectional Study, Taher S.E. Taha, Abeer El Sayed Hamed, Mohamed Ahmed Omar, Shymaa Mahmoud Maaty

Journal of Medicine in Scientific Research

Background Children with congenital heart disease (CHD) frequently present with reduced pulmonary function due to cardiopulmonary impairments and decreased physical activity levels. Peripheral muscle weakness is common and may reflect overall respiratory performance. Aim To examine the correlation between hand grip strength (HGS) and pulmonary function parameters in pediatric CHD patients. Settings and Design In this cross-sectional study, 50 children aged 6–14 years with confirmed CHD were recruited from the National Heart Institute, Egypt. Methods and Material Pulmonary function tests were conducted using a calibrated spirometer, measuring FVC, FEV1, PEF, FEV1/FVC ratio, and MMV. HGS was assessed using a hydraulic …

Effect Of Integrated Neuromuscular Inhibition Technique On Iliotibial Band Friction Syndrome, Esraa Tarek Farouk Ahmed, Amir Mohamed Saleh, Hassan Hussien Ahmed, Doaa Rafat El Azab

Journal of Medicine in Scientific Research

Background: It was reported that, 25% of adults experience limited mobility and a diminished quality of life due to knee pain. The iliotibial band friction syndrome (ITBFS) is a frequent overuse injury that causes lateral knee pain. It is marked by recurrent lateral knee pain as well as motor impairment in the lower extremities. Pain worsens with exercise and weight-bearing activities, especially at 30° of knee flexion, and patients usually have a history of overuse caused by knee flexion and extension.Objective: To determine the impact of the integrated neuromuscular inhibition technique on pain intensity, knee range of motion and knee …

Characterizing Fermentable Carbohydrate Foods In The Diets Of Children With Abdominal Pain-Related Disorders Of Gut-Brain Interaction And Healthy Children, Vishnu Narayana, Jocelyn Chang, Ann R Mcmeans, Tasha Murphy, Rona L Levy, Robert J Shulman, Bruno P Chumpitazi

Children’s Nutrition Research Center Staff Publications

Objectives: Restricting dietary fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) can alleviate symptoms in children with disorders of gut-brain interaction (DGBI). Due to the restrictions of a low FODMAP diet (LFD), a less restrictive FODMAP Gentle diet (FGD) has been suggested. However, the types and amounts of high FODMAP foods and carbohydrates commonly consumed by children have not been studied. We aimed to identify the high FODMAP foods and proportions of FODMAP carbohydrates consumed by children with DGBI and healthy children (HC) and to determine which usually ingested FODMAPs would be restricted on the FGD.

Methods: Three-day diet records from …

Robot-Assisted Surgical Treatment Of Caseoma, Nancy Wang, Abdussalam Elsenousi, Kenneth K Liao

The Texas Heart Institute Journal

This report reviews 5 cases of mitral annular caseoma. Four patients presented with fatigue, stroke, or mitral stenosis. Robot-assisted resection of caseoma with or without mitral valve replacement was successfully performed in all patients with good outcomes. These cases demonstrate the safety and efficacy of robotic surgery in treating caseoma.

Mody Calculator And Clinical Features Routinely Used To Distinguish Mody From Type 2 Diabetes In Adults Perform Poorly For Youth Clinically Diagnosed With Type 2 Diabetes, Raymond J Kreienkamp, Beverley M Shields, Toni I Pollin, Amy S Shah, Angela D Liese, Anna Bellatorre, Catherine Pihoker, Mustafa Tosur, Jose C Florez, Shylaja Srinivasan, Andrew T Hattersley, Miriam S Udler, Maria J Redondo

Children’s Nutrition Research Center Staff Publications

No abstract provided.

Maternal Lipidomics For The Accurate Prediction Of Fetal Cyanotic Congenital Heart Defects, Onur Turkoglu, Nadia Ashrafi, Ali Yilmaz, Romana Ashrafi Mimi, Abdullah Khan, Perry Friedman, Ciara Talbot, Stewart Graham, Ray Bahado-Singh

Conference Presentation Abstracts

Objective: Late diagnosis of cyanotic congenital heart defects (CCHD) significantly increases newborn morbidity and mortality. However, a significant percentage of CCHD cases remain undetected prenatally. Our objectives were therefore to evaluate the accuracy of maternal serum lipidomic markers for the prenatal detection of CCHD and also to elucidate the pathogenesis of these disorders. Study Design: This prospective case-control study included 40 cases of CHD (22 cyanotic, 18 acyanotic) and 39 unaffected controls. Maternal serum samples were profiled via a combination of Ultra-High-Performance Liquid Chromatography coupled with Mass Spectrometry and Nuclear Magnetic Resonance. The mean of each lipid specie was compared …

Surgical Repair Of An Atypical Midsubstance Distal Biceps Tendon Partial Tear: A Case Report, Michael M. Valenzuela, Genoveffa R. Morway, Christopher M. Jones

Orthopedic Surgery Resident Research

[No abstract available]

Pseudoachondroplasia, A Case Report (Preprint), Alec J. Pupo, Connor J. Stinson, Autumn Dye

Internal Medicine Resident Research

No abstract available.

Wearable-Derived Heart Rate Variability Reveals Autonomic Dysfunction In Schizophrenia (Preprint), Alec J. Pupo, Stephanie H. Felgoise

Internal Medicine Resident Research

Autonomic dysfunction has long been implicated in schizophrenia, yet objective physiological markers remain underutilized in psychiatric research. Heart rate variability (HRV), a noninvasive measure of autonomic regulation, is conventionally derived from short electrocardiographic recordings. In this study, we tested whether continuous, wearable-derived HRV can identify physiologic alterations in schizophrenia-spectrum disorders. Using the NIH All of Us database, we analyzed second-level Fitbit heart rate data from 26 individuals with schizophrenia-spectrum diagnoses and 26 matched controls. Frequency-domain analyses focused on ultra-low frequency (ULF), very low frequency (VLF), and truncated low frequency (tLF) bands, given sampling constraints. Schizophrenia participants showed significantly reduced power …

Elevated Neutrophil-To-Lymphocyte Ratios In Schizophrenia: Insights From A Precision Medicine Cohort (Preprint), Alec J. Pupo, Connor J. Stinson, Chinwendu Madukwe, Stephanie H. Felgoise

Internal Medicine Resident Research

Systemic inflammation has been increasingly implicated in the pathophysiology of schizophrenia. The neutrophil-to-lymphocyte ratio (NLR), a readily available marker of systemic inflammation, has not been thoroughly investigated in large, demographically-matched schizophrenia cohorts. Using data from the All of Us Research Program, we analyzed participants with schizophrenia (n = 396) matched to controls (n = 396) by sex, race, and age. NLR was calculated as the ratio of each participant’s median neutrophil count to median lymphocyte count across all available measurements, excluding extreme values (NLR > 7). Distribution normality was assessed using the Shapiro–Wilk test, and group differences were evaluated with the …

Summary Of: Ai Diabetic Retinopathy Screening In A Primary Care Setting In Rural Maine, Rachel Heuer Md, Emma Daybranch Mph, Anastasia Tsomides Do, Jessica F. Dibiase Mph, Neil Korsen Md, Brian Nolan Md

Northern New England Clinical & Translational Research

Diabetic retinopathy (DR) is the leading cause of blindness globally. Early diagnosis and treatment reduce the risk of vision loss by 98%.

Study found @ "AI Diabetic Retinopathy Screening in a Primary Care Setting in Rural M" by Rachel Heuer, Emma DayBranch et al.