Digital Commons Network^™

An Update On The Role Of Multimodal Analgesia In Perioperative Pain Management, Whitney N. Kuwamoto, Grace C. Eddy, Edward R. Mariano, Eric S. Schwenk

Department of Anesthesiology Faculty Papers

Multimodal analgesia has become a foundational principle of acute perioperative pain management and enhanced recovery and involves the application of nonpharmacologic, pharmacologic, and/or interventional techniques. The overall goal of this approach is to apply a combination of different modalities that target discrete points along the pain pathway and thereby avoid the overreliance on opioids and associated side effects. Since our review in 2018, there have been significant developments that have prompted an updated review of multimodal analgesia. In this article, we identify and summarize important trends that influence the current approach to acute perioperative pain management as well as provide …

Lessons Learned From The Validation Of A Machine Learning-Based Colorectal Carcinoma Screening Pipeline In Sub-Saharan Africa, Alfred Githuka, Ulysses Balis, Ye Chan Kim, Eileen Weinheimer-Haus, Christopher Williams, Jerome Cheng, Kelou Yao, John Blau, Shahin Sayed, Mansoor Saleh

Haematology and Oncology, East Africa

Background Artificial intelligence for digital pathology may improve cancer detection and workflow efficiency in low- and middle-income countries, but most models are trained and validated in high-income settings, creating uncertainty about generalizability and real-world deployability under differing pre-analytic and infrastructure conditions.

Objective To validate a locally optimized colorectal carcinoma screening pipeline, retrained on data from a local Kenyan cohort, and to assess its feasibility as a sensitivity-forward assistive pre-screening workflow.

Methods Formalin-fixed, paraffin-embedded hematoxylin and eosin-stained slides from 136 biopsy-proven colonic adenocarcinoma cases and 20 normal controls from 2 Kenyan institutions were digitized at 40× using a Grundium Ocus scanner. …

In Reply To The Letter To The Editor Regarding "The Effect Of Glp-1 Receptor Agonists On Reoperation Following Anterior Cervical Discectomy And Fusion", Nicholas C. Bank, Daniel Whittingslow, Sam Duggan, Joshua L. Morningstar, Douglas S. Weinberg

Student Papers, Posters & Projects

No abstract available

Emergency Medical Services Mental Health: Causes Of Providers Leaving The Industry, Brian C. Selke

Graduate Theses and Dissertations (2019 - present)

Employee resilience and mental health have become critical concerns in Emergency Medical Services (EMS) as workforce shortages increasingly threaten staffing stability and patient care. National Registry of Emergency Medical Technicians (NREMT) data indicates that more than 30% of eligible EMS providers did not recertify between 2020 and 2023, raising concerns about workforce sustainability. This study examines EMS providers’ intentions to leave the profession and identifies workplace factors associated with turnover. A statewide survey of more than 1,200 licensed EMS providers in Alabama was analyzed using regression techniques to evaluate the relationship between workplace conditions and turnover intentions. Results demonstrate that …

Small But Mighty: How Can Pediatric Psychologists Harness The Power Of Digital Single-Session Interventions?, Christina Amaro, Alexandra Monzon, Melissa Alderfer, Kimberly Canter, Michael Amylon, Stephanie Fooks-Parker, Jessica Schleider, Susana Patton, Katie Devine

Department of Pediatrics Faculty Papers

OBJECTIVE: Single-session interventions (SSIs) are an innovative, scalable approach for addressing the unmet behavioral and mental health needs of pediatric patients and their families. Specifically, digital SSIs, which are self-guided and delivered online, offer a low-cost and accessible approach but are currently underutilized in pediatric psychology.

METHODS: This topical review aims to describe SSIs broadly and the specific need for digital SSIs, explore potential applications within pediatric psychology, outline future directions and considerations, and present two examples of community-engaged digital SSI design.

RESULTS: SSIs evidence small to medium effects across a range of mental health concerns, including distress, anxiety, and …

"I Can See Where This Is Taking Me": Medical Students' Perceptions Of Humanities Courses At Aga Khan University, Kenya, Catherine Gathu, Marthaclaire Zammit, Urvi Saboo, Robert Opoka

Family Medicine, East Africa

Background Humanities courses in medical training are increasingly recognized as essential for developing empathetic, reflective and socially responsive physicians. Although well-established globally, their integration into medical education in African contexts remains limited. In Kenya, humanities are often peripheral within curricula dominated by biomedical sciences and clinical medicine. Aga Khan University (AKU), Nairobi, has introduced a novel medical curriculum that embeds seven core humanities courses as central components of the initial phase of its MBChB program. This study explored students’ perceptions and lived experiences of these humanities courses.

Methods A retrospective descriptive study using an embedded mixed-methods design was conducted among …

A Misplaced Pocket Of Air: Intramural Gastric Air Most Consistent With Gastric Emphysema, Priyanka Panwar, Lavender Otom, Subo Marsa, Gerald Odong, Steven Idet, Irene Muchiri, Hussein Abdulsamad, John Odhiambo, Christopher Opio, Amos Mwasamwaja, Saleem Abdulkarim

Internal Medicine, East Africa

Background Gastric emphysema (GE), or gastric pneumatosis, is a rare, noninfectious cause of intramural gastric air that must be distinguished from emphysematous gastritis (EG), a highly lethal infectious entity. Despite similar radiographic appearances, these conditions differ substantially in etiology, clinical course, management, and prognosis.

Cases We report three hemodynamically stable patients with CT-confirmed intramural gastric air most consistent with GE. Two had associated portal venous gas. The cases occurred in distinct clinical contexts: infectious gastroenteritis with retching, transient midgut volvulus with obstructive gastric overdistension, and alcohol-related upper gastrointestinal bleeding with forceful vomiting and a Mallory–Weiss tear. Although early EG could …

Leveraging Administrative Health Data To Capture Rare Adverse Drug Reactions: Identifying Pediatric Patients With Trimethoprim-Sulfamethoxazole Acute Respiratory Distress Syndrome., Keith Feldman, Jenna Miller, Katherine Doane, Laura Loftis, James W. Antoon, Kevin J. Downes, Jennifer Goldman

Manuscripts, Articles, Book Chapters and Other Papers

Rare adverse drug reactions (ADRs) are underrecognized and underreported in the electronic medical record (EMR). These events often require clinical review, making systematic identification challenging. The study aim was to develop an approach to prioritize identification and validation of a rare ADR to trimethoprim-sulfamethoxazole causing acute respiratory distress syndrome (TMP-SMX ARDS) across medical institutions. We developed a clinical phenotype based on 2 local TMP-SMX ARDS cases mapped to standardized elements of a national comparative healthcare database (PHIS). We validated identification of TMP-SMX ARDS at scale across medical institutions. A set of scoring criteria was created to prioritize cases and generate …

Hyperadhesive Von Willebrand Factor Contributes To Pathogenesis Of Preeclampsia, Yajuan Wang, Chenyu Wang, Katie L Houck, Xiaoli Gao, Yuanyuan Chen, Xin Xu, Xue Zhao, Miguel A Cruz, Shu Zhang, Chester Q Li, Fengxia Xue, Min Li, Swati Shree, Jing-Fei Dong, Cha Han

Children’s Nutrition Research Center Staff Publications

Background: Preeclampsia is the most common complication of pregnancy, significantly affecting maternal and fetal health, and is characterized by placental and systemic endotheliopathy. Patients with preeclampsia have elevated levels of VWF (von Willebrand Factor), which is associated with poor clinical outcomes. However, whether VWF serves as a marker for endotheliopathy or contributes to the pathogenesis of preeclampsia remains poorly understood.

Methods: We investigated the role of hyperadhesive VWF in the development of preeclampsia by studying patients, evaluating mouse models, and performing in vitro experiments.

Results: We show that patients develop VWF- and fibrin-rich thrombosis in the placenta and have significantly …

Source-Specific Nitrate And Nitrite Intake And Bladder Cancer: Findings From The Danish Diet, Cancer And Health Cohort, Dorit W. Erichsen, Cecilie Kyrø, Jörg Schullehner, Susanne Rosthøj, Catherine P. Bondonno, Liezhou Zhong, Ole Raaschou-Nielsen, Pratik Pokharel, Torben Sigsgaard, Peter Fjeldstad Hendriksen, Frederik Dalgaard, Christina Dahl, Jonathan M. Hodgson, Christina C. Dahm, Anja Olsen, Anne Tjønneland, Nicola P. Bondonno

Research outputs 2022 to 2026

Introduction Nitrate and nitrite, present in ground and drinking water, as well as foods, may contribute to bladder cancer through the formation of carcinogenic N -nitrosamines. However, risk likely depends on both the source and endogenous nitrosating factors. Methods Among participants of the Danish Diet, Cancer, and Health Cohort (N = 54,610) with no history of cancer, source-specific nitrate and nitrite intakes (drinking water, plant sources, naturally occurring animal sources, and additive-permitted meat sources) were estimated from national water monitoring data and food frequency questionnaires using food databases. Bladder cancer cases were ascertained through the Danish Cancer Registry. Multivariable-adjusted Cox …

Ecmo Use In Infants With Bronchopulmonary Dysplasia: A Literature Review., John Ibrahim, Nicholas Carr, Franscesca Miquel Verges, Natalie Rintoul, Robert Digeronimo, John M. Daniel Iv, Sarah Keene, Burhan Mahmood

Manuscripts, Articles, Book Chapters and Other Papers

Bronchopulmonary dysplasia (BPD) is a leading cause of chronic respiratory failure in infants. Severe BPD is associated with prolonged mechanical ventilation, pulmonary hypertension, and high morbidity and mortality. As disease severity increases, extracorporeal membrane oxygenation (ECMO) is being reconsidered as a potential rescue therapy. Historically, ECMO has been reserved for neonates with reversible respiratory failure and those who required mechanical ventilation for less than 14 days, while infants with BPD were excluded. However, advancements in ECMO technology, anticoagulation strategies, and ventilatory management have led to a reassessment of its role in this population. Emerging reports suggest ECMO may serve as …

Impact Of Trisomy 21 On Post Pull-Through Enterocolitis And Bowel Function In Children With Hirschsprung Disease: A Pcplc Analysis., Marshall W. Wallace, Scott S. Short, Rachel C. Crady, Ron W. Reeder, Hira Ahmad, Kelly Austin, Andrea Badillo, Casey M. Calkins, Megan M. Durham, Julie R. Fuchs, Christopher Gayer, Julia E. Grabowski, Jamie C. Harris, Charles R. Hong, Ankur Rana, Rebecca M. Rentea, Nelson Rosen, Payam Saadai, Caitlin A. Smith, K Elizabeth Speck, Cristine S. Velazco, Richard J. Wood, Michael D. Rollins

Manuscripts, Articles, Book Chapters and Other Papers

INTRODUCTION: We evaluated whether Trisomy 21 (T21) affected bowel management use, ability to toilet train for stool, and rates of Hirschsprung-Associated Enterocolitis (HAEC) in children with Hirschsprung disease (HD). We hypothesized that T21 would be associated with increased rates of HAEC, bowel management program (BMP) use, and delayed toilet training for stool.

METHODS: Children with HD in the Pediatric Colorectal and Pelvic Learning Consortium (PCPLC) database who underwent primary pull-through were included and stratified by T21 status: HD only versus HD + T21. Children requiring a redo pull-through, initially managed with a stoma, or those who had inadequate follow-up were …

All-Cause And Cause-Specific Mortality In Gambling Disorder: Evidence From A Nation-Wide Matched And Sibling Cohort Study In Taiwan, Yang-Chieh Brian Chen, Chih-Wei Hsu, Liang-Jen Wang, Mu-Hong Chen, Yao-Hsu Yang, Chih-Sung Liang, Edward Chia-Cheng Lai

Children’s Nutrition Research Center Staff Publications

Background and aims: Gambling disorder (GD) has been linked to suicidal ideation and suicide deaths; however, evidence on all-cause and cause-specific mortality-particularly in Asian populations-remains limited. Using a retrospective cohort study based on nationwide matched and sibling cohort, we investigated all-cause and cause-specific mortality risk in patients with GD.

Design, setting and participants: A retrospective cohort study was conducted using 2000-2022 data from Taiwan's National Health Insurance Research Database. A cohort of 961 individuals diagnosed with GD was identified. An age- and sex-matched control cohort (n = 3,844) and an unaffected sibling cohort (n = 675) were constructed. Cumulative survival …

Concerns With The Statistical Analysis In “Effect Of Combined Glp-1 Analogue And Bupropion/Naltrexone On Weight Loss: A Retrospective Cohort Study”, Thirupathi Reddy Mokalla, Henry T Robertson, Sherri Pals, David B Allison

Children’s Nutrition Research Center Staff Publications

No abstract provided.

Are We Winning At Twinning? Persistent Cni Use In Identical Kidney Transplants., Nicholas S. Herrera, Shivani Wadnerkar, Diane M. Cibrik

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Calcineurin inhibitors (CNIs) revolutionized kidney transplantation by reducing acute rejection rates. Identical twin kidney transplantation is the only setting in which the allograft is immunologically indistinguishable from self, yet CNI use persists. We characterized CNI utilization across end-stage kidney disease etiologies and examined whether CNI exposure was associated with reduced rejection or improved death-censored graft survival (DCGS).

METHODS: We performed a retrospective cohort study using scientific registry of transplant recipients data (January 2000-August 2025). Among 255 adult identical twin kidney transplant recipients, discharge regimens were categorized by CNI use; Firth penalized Cox regression was the primary method for 10-year …

Extending Genome-Wide Association Studies To Admixed Cohorts With High Degrees Of Relatedness, Taotao Tan, Alejandra Vergara-Lope, José Jaime Martínez-Magaña, Nirav N Shah, Yi-Sian Lin, Kai Yuan, Jaime Berumen, Jesus Alegre-Díaz, Pablo Kuri-Morales, Roberto Tapia-Conyer, Joel Gelenter, Janitza L Montalvo-Ortiz, Wei Zhou, Jason M Torres, Elizabeth G Atkinson

Duncan NRI Faculty and Staff Publications

Admixed populations comprise a large portion of the human population worldwide, but are often excluded from genome-wide association studies (GWASs) due to analytic challenges. Our group developed Tractor, a local-ancestry-informed GWAS tool designed for admixed samples that produces accurate ancestry-specific effect sizes and boosts the discovery power to identify ancestry-enriched loci. However, Tractor operates under an assumption of unrelated samples. Here, to address this gap, we propose Tractor-Mix, which allows for well-calibrated association studies in datasets containing admixed samples with relatedness. Extensive simulations show that this method is competitive with other state-of-the-art approaches that do not produce ancestry-specific results. Empirical …

A Blended Genome And Exome Sequencing Method Captures Genetic Variation In An Unbiased And Cost-Effective Manner, Toni A Boltz, Benjamin B Chu, Matthew Defelice, Calwing Liao, Julia M Sealock, Robert Ye, Jacqueline I Goldstein, Lerato Majara, Jack M Fu, Susan K Service, Lingyu Zhan, Sarah E Medland, Sinéad B Chapman, Simone Rubinacci, Jonna L Grimsby, Tamrat Abebe, Melkam Alemayehu, Fred K Ashaba, Elizabeth G Atkinson, Tim B Bigdeli, Amanda B Bradway, Harrison Brand, Lori B Chibnik, Samuel Deluca, Ana M Diaz-Zuluaga, Abebaw Fekadu, Michael Gatzen, Bizu Gelaye, Stella Gichuru, Marissa L Gildea, Toni C Hill, Hailiang Huang, Kalyn M Hubbard, Wilfred E Injera, Roxanne James, Moses Joloba, Christopher Kachulis, Phillip R Kalmbach, Rogers Kamulegeya, Gabriel Kigen, Soyeon Kim, Nastassja Koen, Edith K Kwobah, Joseph Kyebuzibwa, Seungmo Lee, Niall J Lennon, Penelope A Lind, Esteban A Lopera-Maya, Johnstone Makale, Serghei Mangul, Justin Mcmahon, Pierre Mowlem, Henry Musinguzi, Rehema M Mwema, Noeline Nakasujja, Carter P Newman, Lethukuthula L Nkambule, Conor R O'Neil, Ana Maria Olivares, Catherine M Olsen, Linnet Ongeri, Sophie J Parsa, Adele Pretorius, Shengying Qin, Raj Ramesar, Faye L Reagan, Chiara Sabatti, Jacquelyn A Schneider, Welelta Shiferaw, Christine Stevens, Anne Stevenson, Erik Stricker, Rocky E Stroud, Jessie Tang, Megan Townsend, David Whiteman, Mary T Yohannes, Mingrui Yu, Kai Yuan, Dickens Akena, Lukoye Atwoli, Symon M Kariuki, Karestan C Koenen, Charles R J C Newton, Dan J Stein, Solomon Teferra, Zukiswa Zingela, Carlos N Pato, Michele T Pato, Carlos Lopez-Jaramillo, Nelson B Freimer, Roel A Ophoff, Loes M Olde Loohuis, Michael E Talkowski, Benjamin M Neale, Daniel P Howrigan, Alicia R Martin

Duncan NRI Faculty and Staff Publications

Here we developed and deployed the blended genome exome (BGE) method, a DNA library approach that generates low-pass whole-genome (1–4× mean depth) and deep whole-exome (30–40× mean depth) data in a single sequencing run. BGE is cost-effective, empowers most genomic discoveries possible with deep whole-genome sequencing and captures global common single-nucleotide polymorphism diversity. We applied BGE to sequence >53,000 samples from the PUMAS Project (Populations Underrepresented in Mental Illness Associations Studies), including African, African American and Latin American populations. Imputed genotypes showed high concordance with Illumina Global Screening Array calls (R2 ≥ 95% for minor allele frequency ≥1%; …

Maternal, Perinatal, Neonatal, And Postpartum Outcomes Following Severe Acute Respiratory Syndrome - Coronavirus-2 Infection In Pregnancy: A World Health Organization Multi-Country Prospective Cohort Study, Edna Kara, Sami Gottlieb, Nathalie Broutet, Anna Thorson, Marie Delnord, Ibukun-Oluwa Abejirinde, Ronaldo Silva, Marleen Temmerman, Rodney Adam, Ingrid Gichere

Pathology, East Africa

Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has raised global concerns regarding its impact on pregnant women and their infants, particularly across evolving variants. This study aimed to determine if infection during pregnancy increased the risk of adverse maternal, perinatal, neonatal, or postpartum outcomes during pre-Omicron and Omicron periods.

Methods We conducted a prospective cohort study in 10 primarily low- and middle-income countries, comprising public and private maternity hospitals in rural and urban areas. Maternal age and comorbidity adjusted mixed-effects models with country-specific random intercepts were used to estimate relative risks (RRs) comparing participants with and without infection …

Demographic And Clinical Characteristics Of Participants In The Neuropsychiatric Genetics Of African Populations-Psychosis (Neurogap-Psychosis) Study: A Descriptive Analysis, Rocky Stroud, Kimberly Hook, Melkam Alemayehu, Lukoye Atwoli, Mark Baker, Lori Chibnik, Bizu Gelaye, Stella Gichuru, Symon Kariuki, Rehema Mwema

Internal Medicine, East Africa

Background Approximately 1.3 million individuals in sub-Saharan Africa, as well as millions of others worldwide, live with psychotic disorders. However, there is limited mental health research based on these populations and even less of a focus on neuropsychiatric genetics research within these settings.

Methods To address this gap, the Neuropsychiatric Genetics of African Populations-Psychosis (NeuroGAP-Psychosis), a case-control study, collected data identifying genetic and environmental risk factors associated with psychotic disorders in Ethiopia, Kenya, South Africa, and Uganda. This paper describes baseline demographic and clinical characteristics of the 42,953 participants recruited between 2018–2023 and compares these characteristics by country and case …

Hippo Signaling Regulates Cuticle Pigmentation And Dopamine Metabolism In Drosophila, Shelley B Gibson, Samantha L Deal, Ye-Jin Park, Bo Sun, Yanyan Qi, Jung-Wan Mok, Hyung-Lok Chung, Hongjie Li, Shinya Yamamoto

Duncan NRI Faculty and Staff Publications

Pigmentation plays multiple important roles in development, physiology and evolution. Melanization of the insect cuticle requires dopamine as a precursor of melanin and involves key enzymes in dopamine biosynthesis including Tyrosine hydroxylase (TH) and Dopa decarboxylase (Ddc). Some studies have hinted that disruption of the evolutionarily conserved Hippo signaling pathway, which has been primarily studied in the context of tissue growth, may lead to changes in cuticle pigmentation in the fruit fly Drosophila melanogaster. However, to our knowledge, there have not been any systematic investigations into their potential mechanistic links. In this study, we identified that all genes that comprise …

Advancing Health Equity In Global Oncology: A Collaborative Academic-Cancer Society-Industry Program To Address Health Disparities In Sub-Saharan Africa, Kenneth Merrell, Ben Kamdem-Talom, Hannah Anie, Christine Wekesa, Nomsa Tsikai, Miriam Mutebi, Rakiya Saidu, Nwamaka Lasebikan, Adamu Bojude, Randiak Alaro

General Surgery, East Africa

Purpose Cancer care capacity in sub-Saharan Africa (SSA) is constrained by late diagnosis and limited treatment access. Few funding mechanisms support innovative, locally led programs to address these challenges. A collaborative initiative was developed to strengthen oncology care through quality improvement (QI) projects.

Materials and Methods The program was developed by Global Bridges Oncology (GBO) at Mayo Clinic, Pfizer Global Medical Grants, and the African Organisation for Research and Training in Cancer. A committee composed primarily of African oncology experts guided the process. An RFP was disseminated across SSA in English, French, and Portuguese, inviting applications to improve diagnostic and …

Expanding Cleft Surgical Workforce Capacity In Low- And Middle-Income Countries Through Competency-Based Training, Daniel Bradley, Jonathan Diaz, Emily Jones, Kealani Unkel, Atenas Bustamante, Zenebe Gebremariyam, Daniel Abate, Mamy Andriamanarivo, Mekonen Abebe, Armando Siu

General Surgery, East Africa

Objective To evaluate a competency-based cleft surgery training pathway designed to expand local surgical capacity in low- and middle-income countries (LMICs).

Design Prospective observational study of cleft surgery training outcomes between July 2022 and September 2024.

Setting Operation Smile cleft surgery programs and partner hospitals in LMICs, with integrated virtual education.

Patients/Participants Twenty trainee cleft surgeons from 11 countries.

Interventions A competency-based training pathway combining virtual education and mentored operative experience, with assessment using a validated surgical competency tool.

Main Outcome Measures Changes in self-reported surgical confidence and educator-rated surgical competency

Results Trainee cleft surgeons participated in 1168 cleft lip …

Association Between Stress Mindset, Psychological Symptoms, And Psychosocial Risk In Liver Transplant Patients, Sarah Kay Brill

Dissertations

Psychosocial functioning is a central component of liver transplant evaluation, yet less is known about how cognitive factors, such as stress mindset, relate to transplant readiness. The present study examined the association between stress mindset and psychosocial risk, as well as its relationship with depressive symptoms, anxiety, and perceived stress among patients undergoing liver transplant evaluation. Patients included 62 adults completing standard pre-transplant assessment measures, including the Stress Mindset Measure–Specific (SMM-S), Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Perceived Stress Scale (PSS). Hierarchical logistic regression analyses indicated that stress mindset was …

Defining The Value Of Elective Lumbar Fusion: A Systematic Review Of Existing Methodologies And Framework For The Operative Value Index, Advith Sarikonda, Anthony Chen, Theo S. Biddle, Danyal A. Quraishi, Preston Carey, Arbaz A. Momin, Matthews Lan, Dwight Mitchell Self, Ashmal S. Kabani, Ahilan Sivaganesan

Department of Neurosurgery Faculty Papers

BACKGROUND: Despite wide variation in the outcomes and costs of lumbar fusion, few studies have integrated these domains together within a single metric to assess "value" (outcomes achieved per dollar spent). In this review, we sought to 1) characterize existing metrics of cost-effectiveness for lumbar fusion, 2) evaluate all applications of time-driven activity-based costing (TDABC) in spine surgery, and 3) outline the conceptual foundation for a standardized Operative Value Index (OVI).

METHODS: Two PRISMA-concordant systematic reviews were performed on PubMed and Scopus databases. The first review examined all studies which reported a cost-effectiveness metric for lumbar fusion. The second review …

A Cooking Skills Intervention For Long-Term Weight Loss In Young Adults With Intellectual Disabilities: Rationale And Design For A Randomized Trial., Lauren T. Ptomey, Jessica C. Danon, Delwyn Catley, Richard A. Washburn, Amy Bodde, Francisco J. Diaz, Brian C. Helsel, Anna M. Rice, Joseph R. Sherman, Madison Koester, Walker S. Mckinney Ph.D., Joseph E. Donnelly

Manuscripts, Articles, Book Chapters and Other Papers

Young adults with intellectual disability (ID) are an underserved population with a high prevalence of obesity, obesity-related health conditions, and reduced ability to complete instrumental and basic activities of daily living (I/ADLs). After leaving the structured environment of public school, many young adults with ID spend more time at home or in day programs, begin living more independently, or enter the workforce. These transitions may increase reliance on fast or processed foods and reduce opportunities for physical activity, contributing to accelerated weight gain. Previous research has demonstrated clinically meaningful short- and long-term weight loss (18-24 months) in adults with mild-to-moderate …

Current Practices Of Index Hospitalization Anticoagulant Use In Pediatric Patients With Acute Myeloid Leukemia., Abbey Elsbernd, Natalie Grills, James W. Antoon, Kathyrn Kyler, Lucas E. Orth, Timothy J. Savage, Matt Hall, Jennifer Goldman, Shannon L. Carpenter

Manuscripts, Articles, Book Chapters and Other Papers

Management and prevention of thromboembolism (TE) in pediatric acute myeloid leukemia (AML) are challenging because of prolonged periods of thrombocytopenia and associated bleeding. There are no guidelines for prophylactic or therapeutic anticoagulation for children with AML. This study aimed to understand the use of anticoagulation and its association with bleeding events (BEs) during index hospitalization in children with AML, both with and without thromboses. A retrospective cohort study was performed using the Pediatric Health Information System administrative database of index hospitalizations for patients aged 1 to 21 years from 2016 to 2024 with the diagnosis of AML across 49 children's …

The Effect Of Elevated Blood Pressure And Stage One Hypertension On Perinatal Outcomes In Appalachian Gravidas: A Retrospective Cohort Study, Caroline Briggs, Austin L. Loop, Grace E. Montgomery, David G. Chaffin, Jesse Cottrell

Marshall Journal of Medicine

Introduction:  There is literature in the obstetric population that suggests any degree of hypertension (blood pressures greater than or equal to 120 systolic or 80 diastolic) can lead to adverse maternal and fetal outcomes.  We sought to determine if pregnant patients in our Appalachian population with elevated blood pressure or stage 1 hypertension have an increased risk of gestational hypertension and preeclampsia.

Methods:  A retrospective chart review was performed on patients who received obstetric care with the Marshall University OB/GYN department and delivered at Cabell Huntington Hospital.  Delivery outcomes were obtained for 233 deliveries from March 30, 2020 to September …

A Prospective Study Of Hyperspectral Imaging For Lower Extremity Tissue Assessment In Normative And At-Risk Populations, Jessica Sima, Mariana Rodriguez, Stephanie Campbell, Amanda Killeen

School of Podiatric Medicine - Student Research

Introduction:  Diabetic foot ulceration and peripheral vascular disease remain major causes of morbidity and limb loss, yet early identification of tissue compromise can be challenging, particularly across diverse skin tones. Hyperspectral imaging (HSI) is a non-invasive technology that quantifies tissue oxygenation by measuring the absorption and reflection of near-infrared light.

The objective of this study is to evaluate the relationship between oxygenation, skin tone, skin temperature, and ambient skin temperature in adults with and without risks of foot ulcers.

Method: This ongoing prospective observational study recruits English- and Spanish-speaking adults aged 18 and over from campus, clinics, and community outreach …

Comparative Effectiveness Of Antiseptic And Antibiotic Irrigation Versus Normal Saline In Infected Total Ankle Arthroplasty: A Systematic Review, Madelaine Adkins, Yahan Wei, Amanda Killeen

School of Podiatric Medicine - Student Research

Introduction: Periprosthetic joint infection (PJI) is a rare but devastating complication following total ankle arthroplasty (TAA). Acute infections are commonly managed with debridement, antibiotics, and implant retention (DAIR), in which irrigation plays a critical role in reducing bacterial burden. Although irrigation protocols have been investigated in total hip and total knee arthroplasty, evidence specific to infected TAA remains unclear. This systematic review evaluated the available literature regarding irrigation practices in the surgical management of infected TAA.

Methods: A systematic review was conducted in accordance with PRISMA guidelines. PubMed and Scopus were search for English-language studies published between December 2005 and …

The Role Of Mitochondria In The Pathogenesis Of Parkinson’S Disease, Oyinkansola Mudasiru, Vivian Etugbo, Bhuvana Lakkasetter, Claudia Biguetti, Reginald Adiele

School of Podiatric Medicine - Student Research

Introduction: Parkinson’s disease (PD) is a progressive neurodegenerative disorder characterized by the degeneration of the dopaminergic neurons of the substantia nigra that leads to motor and non-motor dysfunctions. Emerging evidence highlights mitochondrial dysfunction as a key factor in PD pathogenesis. This project aims to investigate the pathophysiology of PD, highlighting the involvement of oxidative stress, and examining current and emerging therapeutic approaches aimed at restoring mitochondrial function.

Methodology: A systematic literature review was conducted using PubMed and Google Scholar within the 2004-2024 date range. Keywords included “Parkinson’s disease”, “mitochondrial dysfunction", “oxidative stress”, and neurodegeneration”. Data was extracted regarding …