Digital Commons Network^™

Sweet Signs: The Impact Of Cgm Signage On Freestyle Libre Prescription Rates In A Resident Clinic, Dustin Landgrave Do, Allison Venus Md, Alex Robertson Md, Kristy Paul Md, Bhindhyaa Kaur Md, Alejandro Castaneda Md, Madeline Cozad Md

Quality Improvement & Patient Safety Forum

No abstract provided.

Increasing Procedural Training Opportunities Among Internal Medicine Residents, Calvin P. Rome Md, Cade W. Bourgeois Md, Catherine A. Loehr Md, Facp, Gurtaj S. Mahil Do, Sepehr Sadeghi Do

Quality Improvement & Patient Safety Forum

No abstract provided.

Avoiding Last-Minute Inpatient Colonoscopy Delays, Stephany Nguyen Md

Quality Improvement & Patient Safety Forum

No abstract provided.

Closing The Gap: Improving Documentation For Fluid Balance Management, Sepehr Sadeghi Do, Asad Mussarat Md, Gurtaj S. Mahil Do

Quality Improvement & Patient Safety Forum

No abstract provided.

Critical Care Billing Interventions In A Level 1 Trauma Center Ed, Archit Shukla Md, Michelle Huber Md, Stephen Lim Md, David Rayburn Md

Quality Improvement & Patient Safety Forum

No abstract provided.

Make Them Hear You: Improving Handoffs For Critically Ill Patients In The Emergency Department, Allen J. Turechek Md, Usman S. Chaudhry Md, Jasmine S. Homes Md, Kara C. Plasko Md, David A. Rayburn Md

Quality Improvement & Patient Safety Forum

No abstract provided.

Improving Patient Engagement Through Mychart Access, Catherine A. Loehr Md, Alex Anderson Md, Luke Sharrock Do, Nikki Arceneaux Md, Asad Mussarat Md, Thomas Deiss Do

Quality Improvement & Patient Safety Forum

No abstract provided.

Quality Assessment: Timeliness In Laboratory Collection, Victoria L. Mccray Md, Blane Edwards Md

Quality Improvement & Patient Safety Forum

No abstract provided.

Midline Catheters And Vtes: Should We Be Using Them In Trauma Patients?, Roslyn M. Alexander Do, Alison A. Smith Md, Phd, Patrick Greiffenstein Md, Lillian Bellfi Pharm D

Quality Improvement & Patient Safety Forum

No abstract provided.

Transforming Spaces: Interventions In Furniture Layouts To Reduce Patient Violence On A Psychiatry Unit Using A Quality Improvement Approach At University Medical Center, Thien-Huong Pham Md, Hoang Nguyen Md, Mph, Xing Zhu Md, Kelly Lauland Lopez Rn, Mshcm, Erich Conrad Md

Quality Improvement & Patient Safety Forum

No abstract provided.

From Knowledge To Action: Assessing The Influence Of Provider Education On Vaccine Importance, Tat W. Yau Md, Mph, Lauren E. Richey Md, Mph

Quality Improvement & Patient Safety Forum

No abstract provided.

Standardizing Naloxone Co-Prescription To Promote Harm Reduction In Pediatric Sickle Cell Pain Management, Nali Gillepsie Md, Morgan Viviano Md, Alexis Brantley Md, Leah Smith Do, Ushma Bhandary Md, Dana Leblanc Md, Molly Sonenklar Md

Quality Improvement & Patient Safety Forum

No abstract provided.

Optimizing Efficiency: Enhancing Early Morning Patient Discharges For Improved Healthcare Delivery, Humza Malik Md, Chantal Wicjman Md, Allison Derise Md

Quality Improvement & Patient Safety Forum

No abstract provided.

Longitudinal Outcomes Assessment: 8 Years Of A Facial Nerve Disorders Multidisciplinary Clinic, Carley Boyce Md, Aimee Galatas Bs, Sara Macdowell Pt, Dpt, Laura T. Hetzler Md, Mba, Facs

Quality Improvement & Patient Safety Forum

No abstract provided.

Artificial Intelligence Use In Medical Education: Best Practices And Future Directions, Rasheed A. M. Thompson, Yash B. Shah, Francisco Aguirre, Courtney Stewart, Costas D. Lallas, Mihir S. Shah

Department of Urology Faculty Papers

PURPOSEOF REVIEW: This review examines the various ways artificial intelligence (AI) has been utilized in medical education (MedEd)and presents ideas that will ethically and effectively leverage AI in enhancing the learning experience of medical trainees.

RECENT FINDINGS: AI has improved accessibility to learning material in a manner that engages the wider population. It has utility as a reference tool and can assist academic writing by generating outlines, summaries and identifying relevant reference articles. As AI is increasingly integrated into MedEd and practice, its regulation should become a priority to prevent drawbacks to the education of trainees. By involving physicians in …

Integrating Radiogenomics And Machine Learning In Musculoskeletal Oncology Care, Rahul Kumar, Kyle Sporn, Akshay Khanna, Phani Paladugu, Chirag Gowda, Alex Ngo, Ram Jagadeesan, Nasif Zaman, Alireza Tavakkoli

Department of Medicine Faculty Papers

Musculoskeletal tumors present a diagnostic challenge due to their rarity, histological diversity, and overlapping imaging features. Accurate characterization is essential for effective treatment planning and prognosis, yet current diagnostic workflows rely heavily on invasive biopsy and subjective radiologic interpretation. This review explores the evolving role of radiogenomics and machine learning in improving diagnostic accuracy for bone and soft tissue tumors. We examine integrating quantitative imaging features from MRI, CT, and PET with genomic and transcriptomic data to enable non-invasive tumor profiling. AI-powered platforms employing convolutional neural networks (CNNs) and radiomic texture analysis show promising results in tumor grading, subtype differentiation …

Biallelic Loss-Of-Function Variant In Minpp1 Causes Pontocerebellar Hypoplasia With Characteristic Severe Neurodevelopmental Disorder, Aljazi Al-Maraghi, Rulan Shaath, Katherine Ford, Waleed Aamer, Jehan Alrayahi, Sura Hussein, Elbay Aliyev, Nourhen Agrebi, Muhammad Kohailan, Satanay Z Hubrack, Sasirekha Palaniswamy, Adam D Kennedy, Karen L Debalsi, Sarah H Elsea, Ruba Benini, Tawfeg Ben-Omran, Bernice Lo, Ammira S A Akil, Khalid A Fakhro

Faculty, Staff and Students Publications

Pontocerebellar hypoplasia (PCH) encompasses a group of autosomal recessive neurodegenerative disorders marked by cerebellar and pontine atrophy. Multiple subtypes of PCH have been identified, among which the rare subtype PCH type 16 is caused by MINPP1 genetic variants. MINPPI encodes an enzyme essential for inositol polyphosphate dephosphorylation, regulating calcium and iron homeostasis. We conducted genome sequencing on a proband from the consanguineous family, who presented with a severe neurodegenerative disorder, to identify the underlying cause of disease. A comprehensive clinical assessment in addition to neuroradiological findings are described. We performed the functional validation of the identified variant and conducted untargeted …

Development Of An Age-Appropriate Household Dysfunction Measure And Its Concurrent Validity With Multiple Outcomes Among Middle School Adolescents In Southeast Texas, Sumaita Choudhury, Timothy J Walker, Emily T Hébert, Christine M Markham, Ross Shegog, Robert C Addy, Melissa F Peskin

Faculty, Staff and Student Publications

Existing adverse childhood experience (ACE) measures include a limited number of household dysfunction (HD) items and the use of adult-oriented language that is not always appropriate for middle schoolers. We developed an age-appropriate 10-item HD measure informed by previously validated ACE measures and tested its concurrent validity with dating violence (DV) perpetration, lifetime substance use, and mental health outcomes among middle schoolers in Southeast Texas. This cross-sectional study used the baseline data from a DV prevention intervention program for sixth graders (N = 126), Me & You Tech. Baseline data were collected from March 2023 to April 2023. To …

Decompression With Intradural Dissection For The Chiari Malformation Type I: Toward Eliminating Wound Complications, Anna Lin, Lindsey Asti, Marissa Carroll, Jeffrey Campbell, Jospeh Piatt

Department of Neuroscience Faculty Papers

BACKGROUND: There is continuing conversation about surgical technique in the management of the Chiari malformation. Popular options include osseous decompression alone, decompression with dural splitting, and decompression with intradural dissection (DID) and duraplasty. Wound complications after intradural dissection are a persistent problem. The current study of an institutional series examines wound complication rates after intradural dissection without dural closure.

METHODS: A retrospective single-institution chart review was performed for patients < 21 years with Chari malformation type I who underwent DID without dural closure and had at least 6 months of follow-up. Bone removal corresponded to the area of attachment of the rectus capitis posterior minor muscles together with laminectomy of the atlas. The trapezius and semispinalis capitis muscles were retracted but were not separated from the occiput.

RESULTS: A total of 76 patients were treated from May 2010 through May 2024. Thirty-eight (50.0%) patients had syringomyelia. The median age at surgery was 9 years (interquartile range [IQR] 4-13), …

Port Site Metastasis After Robotic Assisted Laparoscopic Radical Prostatectomy: Diagnosis Via Prostate-Specific Membrane Antigen (Psma)-Targeted 18f-Dcfpyl Pet/Ct, Joon Yau Leong, Maria D'Amico, Courtney Capella, Leonard Gomella, Joseph Izes

Department of Urology Faculty Papers

We present a case of port site metastasis (PSM) that was identified in an 82-year-old man with an elevated prostate-specific antigen (PSA) to 3.9 ng/mL, concerning for biochemical recurrence after robotic-assisted radical prostatectomy, adjuvant radiation, and six months of androgen deprivation therapy with an undetectable PSA post-treatment over 10 years ago. A 2.1 cm solitary tracer avid nodule on the right lateral abdominal wall with no other evidence of recurrence or metastatic disease was found on prostate-specific membrane antigen (PSMA)–targeted ¹⁸F-DCFPyL PET/CT scan. The patient underwent local excision of this metastatic lesion, and final pathology revealed metastatic prostatic adenocarcinoma.

Cardiac Amyloid, The Great Imitator, Nolan R. Fox, Nicholas J. Fox, Emily Newman, Brian Osler, Eugene Storozynsky

Division of Cardiology Faculty Papers

BACKGROUND: Although endomyocardial biopsy (EMB) is the criterion standard for diagnosis of infiltrative cardiac disease, cardiac sarcoidosis (CS) or cardiac amyloid can be diagnosed noninvasively through both clinical suspicion and advanced imaging techniques of cardiac magnetic resonance imaging (CMR) or cardiac positron emission tomography (PET).

CASE SUMMARY: A 79-year-old man with mediastinal sarcoidosis presented with new chest pain and a right bundle branch block, raising concern for CS. CMR and cardiac PET also supported the diagnosis of CS, but EMB ultimately revealed transthyretin amyloid cardiomyopathy. The patient was started on tafamidis and showed improvement at 1-year follow-up.

DISCUSSION: This case …

Impact Of A Sepsis Quality Improvement Initiative On Clinical And Operational Outcomes, Christopher B. Thomas, Benjamin Wyler, Claude M. D’Antonio, Mark Laperouse, Shannon Alwood, Kristen Richard, Alyse Grantham, Roya Sheybani, Matt G. Sorrells, Wei Jien Tan, James W. Teague, Hollis O’Neal, Tonya Jagneaux

School of Medicine Faculty Publications

Background/Objectives: Sepsis is a costly and life-threatening condition caused by a dysregulated host response to infection. Lack of a reliable, timely diagnostic for sepsis leads to under- and overdiagnosis, suboptimal outcomes, and strained hospital resources. Our Lady of the Lake Regional Medical Center (OLOLRMC) implemented a sepsis learning health program to evaluate and improve outcomes through standardized ED workflows and the incorporation of a novel sepsis diagnostic test. Methods: We report the results of the first year of experience following the implementation of the learning health initiative and sepsis testing. Data from the Epic EHR were analyzed across two groups: …

Socioeconomic Disparities In Breast Cancer Survival: Examining Potential Mediator Role Of Oncotype Dx(Odx) Test And Stage At Diagnosis Among Hr+/Her2- Breast Cancer Women, Pratibha Shrestha, Qingzhao Yu, Edward S. Peters, Edward Trapido, Mei Chin Hsieh, Tekeda Ferguson, Quyen D. Chu, Xiao Cheng Wu

School of Public Health Faculty Publications

Background: Women with a lower socioeconomic status (SES) have an increased risk of dying from breast cancer (BC) than those with a higher SES. The association of SES with BC survival may be partially mediated by factors such as Oncotype DX (ODX) testing and stage at diagnosis. This study aims to examine SES disparities in survival among HR+/HER2- BC women and to quantify the mediating effects of the ODX test and stage. Methods: We used data from the Louisiana Tumor Registry to identify women aged 20–90 years diagnosed with stage I–II in 2011–2014 and stage I–III in 2015–2017 HR+/HER2- BC …

Physical Activity And Body Image In Early Onset Cancer Patients, Madeleine Z. Pollard

Graduate Masters Theses

Abstract: Cancer is the leading cause of death among Americans under the age of 85 (Brown et al., 2012). There are increasing rates of cancer diagnoses in adults aged 18-49, which is described as an early onset (EO) diagnosis. Despite high survival rates (Lewis et al., 2021), EO cancer patients are at increased risk for long-term physical and psychological challenges associated with both the disease and its treatment (Haque et al., 2023). Cancer diagnosed during these critical periods of life can significantly impact self-perception and body image, which are critical to identity formation and quality of life (Castonguay, et al., …

3- And 4-Dimensional Flow Cmr In D-Transposition Of The Great Arteries After Atrial Switch Operation., Sara Santiaguel, Laura Schoeneberg, Ugonna Nwankwo, Jorge Rosado Gonzalez, Wilson King

Manuscripts, Articles, Book Chapters and Other Papers

A 19-year-old man with D-transposition of the great arteries and pulmonary stenosis underwent atrial switch operation and pulmonary valvotomy in infancy. He was lost to follow-up and presented with multiple respiratory infections. An echocardiogram was inconclusive due to poor windows. Cardiac magnetic resonance (CMR) was performed using ferumoxytol 3-dimensional whole heart and 4-dimensional flow pulse sequences, which demonstrated this patient's complex anatomy and physiology. CMR revealed severe pulmonary venous baffle obstruction. A 3-dimensional printed model was created from the CMR and provided key information for planning the complex catheterization approach required to stent the pulmonary venous baffle.

Circulating Tumor Dna Monitoring And Blood Tumor Mutational Burden In Patients With Metastatic Solid Tumors Treated With Atezolizumab, Charles Swanton, Russell W Madison, Candice Francheska B Tambaoan, Funda Meric-Bernstam, Christopher J Sweeney, Razelle Kurzrock, Howard A Burris, David R Spigel, Hanna Tukachinsky, Jason Hughes, Julia Malato, Bongin Yoo, Tania Szado, Cheryl Schwab, Lincoln W Pasquina, Amaya Gasco, Katja Schulze, Claire F Friedman

Faculty, Staff and Student Publications

Immune checkpoint inhibitors are important for treatment across tumor types but are not universally effective in controlling disease. Early understanding of tumor response, or lack thereof, can inform treatment decisions. This study evaluates changes in circulating tumor DNA (ctDNA) and blood tumor mutational burden (bTMB) for associations with response to programmed cell death 1 ligand 1 (PD-L1) blockade. We sequenced cell-free DNA collected at the start of therapy, on treatment, and at the end of therapy for 153 patients treated with atezolizumab as part of the pan-tumor MyPathway study (NCT02091141). ctDNA tumor fraction (TF) and bTMB were assessed …

Comparison Of Thrombectomy Alone Versus Bridging Thrombolysis In A Us Population Using Regression Discontinuity Analysis, Youngran Kim, Sergio Salazar-Marioni, Rania Abdelkhaleq, Ananya Iyyangar, Diogo Haussen, Jonathan Grossberg, Jaydevsinh Dolia, Aqueel Pabaney, Mahmoud Mohammaden, Ameer Hassan, Wondwossen Tekle, Hamzah Saei, Mohamad Abdalkader, Piers Klein, Taha Nisar, Adeel Saleemi, Shahram Majidi, Johanna Fifi, Gabrielle Valestin, Guillermo Linares, Kara Christopher, David S Liebeskind, Mouhammad Jumaa, Syed Zaidi, Raul Nogueira, Brijesh Mehta, Joy Sessa, Juan Vivanco-Suarez, Aaron Rodriguez-Calienes, Milagros Galecio-Castillo, Santiago Ortega-Gutierrez, James Siegler, Mary Penckofer, Italo Linfante, Sunil A Sheth, Svin Registry Consortium

Faculty, Staff and Student Publications

The role of intravenous thrombolysis (IVT) in combination with endovascular thrombectomy (EVT) for the treatment of large vessel occlusion acute ischemic stroke has been evaluated exclusively outside the US, in randomized clinical trials which failed to demonstrate non-inferiority of skipping IVT. Because practice patterns and IVT dosing differ within the US, and prior observational US-based cohorts suggested improved clinical outcomes in patients who received IVT before EVT, a US-based evaluation is needed. This is a quasi-experimental study of a large US cohort using a regression discontinuity design (RDD) that enables the estimation of causal effects when randomization is not feasible. …

Advanced Age Worsens Phenotypes Of Ocular Hypertension In Mice, Priyamvada M Pitale, Solomon E Gibson, Caroline C Keehn, Arman T Yazdian, Guofu Shen, Benjamin J Frankfort

Faculty, Staff and Students Publications

Glaucoma is a neurodegenerative disorder of the optic nerve and retinal ganglion cells (RGCs) and a major cause of blindness. The two most important risk factors for glaucoma are ocular hypertension (OHT) and advanced age. In this study, we explored the combined impact of aging and OHT on retinal neuronal and microvasculature health. We induced OHT using the bead-injection model in 12 week old (young) and 1.5 year old (old) mice and monitored intraocular pressure (IOP) for 2 weeks. We then explored vascular phenotypes, blood retinal barrier components, RGC counts, and electroretinogram (ERG) changes. Aged mice displayed reduced retinal microvasculature …

How Far Does It Go? An Analysis On The Extent Of Spinal Cord Injury In Post-Traumatic Patients, Sravani Mannuru, Sarvani Uppati, Kelsey Baker

Research Colloquium

Background: Spinal cord injury causes debilitating functional loss in post-trauma patients. Previous studies have showed that an area of edema (tissue damage and swelling) occurs at the level of spinal damage and may be related to the amount of functional loss in the patient and their associated recovery potential. We hypothesized that the extent of the injury is greater than previously studied and may better explain functional loss and recovery potential.

Methods: We retrospectively analyzed five T2-weighted MRI spinal cord images from post-trauma patients ages 32-67. Patients had a clinically diagnosed spinal cord injury that affected the cervical …

Genetic Factors Associated With Myocardial Infarction In Saudi Arabia, Abdullah Saeed, Abdullah Alshafea, Hussain Aldaghaies, Abdullatif Saeed, Abdulrahman Alshehri

Journal of the Saudi Heart Association

Introduction:

Myocardial infarction (MI) is one of the leading causes of mortality in Saudi Arabia, with individuals sharing genetic, lifestyle, and environmental risk factors. The present investigation aimed to review the literature on genetic susceptibility to MI among Saudi individuals, with a specific emphasis on genome-wide association studies (GWAS) for coronary artery disease (CAD) and MI. Studies have revealed the relationship between polymorphisms in genes such as proprotein convertase subtilisin/kexin type 9 (PCSK9), cholesteryl ester transfer protein (CETP), and cyclin-dependent kinase inhibitor 2B antisense RNA 1 (CDKN2B-AS1), which are involved in lipid metabolism, inflammation, and endothelial function.

Methods:

This PROSPERO-registered …