Digital Commons Network^™

Pentosan Polysulfate Sodium (Pps, Elmiron) Maculopathy Demonstrates The Importance Of Coordinated Care From A Low Vision Perspective, Charlotte I. Spada Od, Stephanie Schmiedecke Barbieri Od, Patricia Sanchez Diaz Dvm, Phd, Jeffrey Rabin Od, Phd

Optometric Clinical Practice

Background: Pentosan polysulfate sodium (PPS, Elmiron®) is a widely used medication to reduce pain caused by interstitial cystitis, a bladder disorder most often affecting females. PPS maculopathy is a novel form of toxic retinal disease often not recognized or mistaken for other retinal conditions such as macular degeneration due to the initial similarities on fundus exam. However, when visualized using fundus autofluorescence, affected eyes show characteristic hyper/hypo-autofluorescent patterns.

Case report: A patient taking PPS for 10 years presented with macular changes and complaints of blurry vision and nyctalopia. Clinical, electrodiagnostic, and genetic testing were performed including fundus autofluorescence and …

Outer Macular Holes: A Case Series, Kaitlyn J. Moore Od, Katherine Dunatov Od, Wendy Mcgonigal Od, Karen Reeves Od

Optometric Clinical Practice

Background: Outer foveal microdefects (OFMDs) are small focal photoreceptor interruptions that often present with minimal symptoms and are best identified using optical coherence tomography (OCT).

Case Series: This report describes three cases of outer foveal microdefects discovered incidentally during routine eye examinations.

Conclusion: These cases highlight the importance of OCT in detecting subtle macular abnormalities that may be missed on clinical examination.

Outcomes Of A Vision Care Program That Provides Comprehensive Eye Exams To Children Who Have Failed School Screenings In The San Antonio Northside Independent School District, Raelyn Ottenbreit Od, Timothy Wingert Od, Chantelle Ribisi Od, Elizabeth Marunde Od

Optometric Clinical Practice

Purpose: To determine the impact of a program that provides a comprehensive eye exam to children who failed a vision screening.

Method: Seven hundred seventeen students from the San Antonio Northside Independent School District (NISD) received a comprehensive eye examination. The records of these students were retrospectively analyzed to determine the impact of the exam on this population.

Results: The mean improvement in visual acuity after receiving a comprehensive eye exam at the Rosenberg School of Optometry was approximately five- and one-half lines of acuity. In addition to refractive error, other conditions related to eye coordination and ocular …

Global Burden Of Enteric Infectious Diseases, Diarrhoeal Diseases, And Corresponding Aetiologies, 1990–2023: A Systematic Analysis For The Global Burden Of Disease Study 2023, Gbd 2023 Diarrhoeal Disease And Enteric Infectious Diseases Collaborators, Kathryn H. Jacobsen

Health Studies Faculty Publications

Summary

Background

The Epidemiology Of Kidney And Urinary Tract Infections In Pediatric Chronic Kidney Disease: Prevalence, Risk Factors And Association With Gfr Decline In The Chronic Kidney Disease In Children Study., Derek K. Ng, Andrea R. Molino, Siyao Zhang, Emily J. Stonebrook, Craig S. Wong, Pratyush Gyawali, Kimberly J. Reidy, Susan L. Furth, Bradley A. Warady, Jeffrey J. Fadrowski, Ckid Study Investigators

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Urinary tract and kidney infections are potential complications in pediatric chronic kidney disease (CKD), especially among patients with congenital anomalies of the kidney and urinary tract (CAKUT). We characterized the prevalence of self-reported infections from childhood through young adulthood; evaluated risk factors; and quantified the association with CKD progression.

METHODS: Infections in the past year were self-reported at annual Chronic Kidney Disease in Children (CKiD) study visits. Age-specific infection prevalences were stratified by sex and CKD diagnoses (glomerular, non-glomerular non-CAKUT, CAKUT low-risk for infections, and three CAKUT high-risk categories: reflux nephropathy, obstructive uropathy, and other high-risk). Repeated measures logistic …

Tumor Cell-Derived Gremlin1 Correlates With Tumor Progression In Gastrointestinal Cancers, Amanda C. Bean

Summer Research Program Abstracts

No abstract provided.

Early Prediction Of The Breast Cancer Response To Neoadjuvant Chemotherapy Based On Intratumoral Interstitial Fluid Pressure Using 3-D Subharmonic-Aided Pressure Estimation, Sung In Choi, Basak Dogan, Corinne E. Wessner, Jessica H. Porembka, Priscilla Machado, B. Bersu Ozcan, Nisha Unni, Maysa Abu-Khalaf, Kenneth Hoyt, Flemming Forsberg, Kibo Nam

Department of Radiology Faculty Papers

Elevated intratumoral interstitial fluid pressure (IFP) may negatively impact the efficacy of neoadjuvant chemotherapy (NAC). This study aimed to predict the breast cancer response to NAC based on intratumoral IFP using 3D contrast-enhanced ultrasound (CEUS) with subharmonic-aided pressure estimation (SHAPE). This prospective study enrolled breast cancer patients undergoing NAC from two clinical sites. 3D CEUS was performed at 0%, 10%, and 30% of NAC completion using a GE Logiq E9 with Definity. The pressure gradients between the tumor and adjacent normal tissue were estimated by SHAPE, utilizing the inverse linear relationship between the ultrasound contrast agent’s subharmonic signal amplitude and …

Allergic And Adverse Reactions To Hearing Aid Materials: Clinical Cases And A Proposed Preventive Screening Questionnaire, Margaret Hanger

AuD Capstone Projects - Communication Sciences and Disorders

Abstract (Case 1)

An adverse reaction of the external auditory canal for an adult hearing aid user

Introduction: Contact dermatitis, an allergic skin reaction triggered by exposure to irritants or allergens, has become more common with the widespread use of in-ear devices such as hearing aids. Prolonged contact may lead to redness, itching, pain, and skin breakdown, potentially impacting device use and user satisfaction.

Case Presentation: An adult male who wears a turban was fitted with binaural in-the-ear hearing aids. Shortly after initial use, he experienced bilateral ear discomfort. His hearing aids were remade to address presumed physical fit issues. …

Early Hands-On Surgical Exposure: Outcomes Of A Student-Led Surgical Externship Program For Preclinical Students, Meryem C. Guler, Elizabeth Spitz, Jennifer E. Geller, Talar Tatarian, Renee Tholey

Department of Surgery Faculty Papers

Objective: Early surgical exposure may potentially influence medical students' decision to pursue a surgical career. At our urban, academic medical school, senior medical students developed a Surgical Externship Program (SEP) to provide first-years with hands-on OR experience. This program is a structured 1- to 2-week immersive experience in which first-year students scrubbed into operations, participated in rounds, and engaged with surgical teams under resident and attending supervision. This study evaluates the SEP's impact on surgical interest, OR confidence, and clinical exposure.

Setting: Academic tertiary care hospital.

Participants: First-year medical students.

Design: First-year students participated in a 1- or 2-week SEP …

A Profile Of Assisted Living Direct Care Workforce Training Requirements Across The United States, Erh-Chi Hsu, Paula Carder, Lindsey Smith, Zhiqing E. Zhou, Olga Yakusheva, Anna S. Beeber, Eric Jutkowitz, Kali Thomas

Institute on Aging Publications

Objectives

To characterize assisted living (AL) direct care worker (DCW) training requirements across the United States and how these regulations have changed over time. Specifically, we examine state-level profiles of training regulations, including duration, frequency, content, source of materials, evaluation, and changes in regulatory coverage.

Design

Cross-sectional and longitudinal descriptive study using state policy data and AL directories from 2019, 2021, and 2023.

Setting and Participants

All US states' AL training–related regulations; all ALs and AL beds governed by those regulations.

Methods

We used a mixed-methods approach with an explanatory sequential design (QUAN → qual), first conducting health services regulatory …

Spatial Bias In Quality Of Estimated Delivery Date Records In The Electronic Health Record, Abigail Lewis, Randi Foraker, Min Lian, Min Zhao, Inez Oh, Aditi Gupta, Antonina Frolova, Philip R O Payne

2020-Current year OA Pubs

OBJECTIVES: This study evaluates the quality of estimated delivery dates (EDD) captured in electronic health record (EHR) systems, focusing on identifying and quantifying bias in these estimates for patients seeking prenatal care.

MATERIALS AND METHODS: We measured spatial and racial biases in the completeness and concordance of EDDs recorded in the EHR for patients seeking prenatal care. Element presence and agreement were compared across the catchment area to identify spatial patterns of bias in EDD records.

RESULTS: We obtained 38 477 unique pregnancy episodes in the EHR representing 33 081 unique patients between 2018 and 2022. Clear spatial and racial …

Using Electronic Health Record Audit Logs To Identify Pediatric Intensive Care Unit Teams, Liem M Nguyen, Stefanie S Sebok-Syer, Dane Jacobson, Karley Mariano, John Grunyk, Shelby Burk, Yasaman Nourkhalaj, Kimberley Kirk, Jochen Profit, Christian Rose, A Jay Holmgren, Thomas Kannampallil, Daniel Tawfik

2020-Current year OA Pubs

BACKGROUND: Teamwork influences patient outcomes, but electronic health records (EHRs) do not reliably capture patient care team members, limiting its study. EHR audit logs provide insights into healthcare workers' workflows and may help identify patients' care team members.

OBJECTIVE: To develop, validate, and compare algorithms utilizing EHR audit logs to identify patient-centric primary teams (bedside nurse, frontline clinician, and attending physician) in pediatric intensive care units (ICUs).

METHODS: We observed rounds for 1931 patient days (development = 678; validation = 1253) across pediatric (PICU), neonatal (NICU) and cardiovascular (CVICU) ICUs at a quaternary children's hospital and documented each patient's daytime …

Sex-Related Differences In Fingerprint Minutiae Counts Among Secondary School Students In Sagamu, Ogun State, Nigeria, Olukayode Olushola Odubela, Osonuga Ifabunmi Oduyemi, Dr Kazeem Adeyinka Adeboyejo, Opeyemi Abel Bamgbose

AUIQ Complementary Biological System

Background: Dermatoglyphic minutiae are permanent epidermal ridge characteristics widely utilized in forensic identification and biometric science. Previous studies have demonstrated sex-related differences in fingerprint ridge morphology and ridge count, with females generally exhibiting higher ridge count than males. However, quantitative minutiae-based studies among Nigerian adolescents remain limited. This study evaluated sex-related and bilateral variations in fingerprint minutiae among secondary school students in Sagamu, Ogun State, Nigeria. Methods: This cross-sectional analytical study involved 300 apparently healthy students aged 14–18 years, recruited from an initial pool of 318 students assessed for eligibility across Batoro Community Grammar School, Remo Secondary School, and Remo …

Effectiveness Of An Integrated Activity-Based And Tele-Monitoring Intervention On Mental Health Literacy And Resilience Among Urban Older Adults In Thailand: A Quasi-Experimental Study, Khunatpakorn Makkabphalanon, Pramote Thangkratok, Jutamast Wongjan, Natchaya Palacheewa

Journal of Health Research

Background: Mental health problems among older adults are a growing public health concern, particularly in urban areas. Mental health literacy can enhance problem recognition, self-help, and help-seeking. This study examined changes in mental health literacy and resilience among urban older adults following an integrated activity-based and tele-monitoring intervention.

Methods: A one-group quasi-experimental repeated-measures study was conducted among 30 adults aged 60 years and older in urban communities in Thailand. Participants received a structured 3-hour activity-based mental health literacy intervention followed by 1 month of tele-monitoring support. Data were collected at baseline, immediately after the intervention, and at 1-month follow-up. Changes …

Burden And Prioritization Of Airborne Diseases In Bogor City, 2024: A Situational Analysis, Tuti Alawiyah, Helda Helda, Menikha Maulida

Jurnal Epidemiologi Kesehatan Indonesia

Indonesia, particularly urban agglomeration areas such as Bogor, continues to face major challenges related to air quality, resulting in an increased risk of airborne disease transmission. This study aimed to assess the burden of airborne diseases and determine health problem priorities in Bogor City using surveillance data from 2022 to October 2024. A descriptive epidemiological study was conducted in Bogor City using surveillance data from 2022 to 2024. Health problem prioritization was performed using the Pan American Health Organization (PAHO)-adapted Hanlon method through structured questionnaires administered to an expert panel consisting of health office officials and heads of primary healthcare …

An Evaluation Of Southern Nevada’S Pediatric Care Ecosystem, David Damore, Tina Quigley, Nick Fiore

Policy Briefs and Reports

In 2024, The Lincy Institute and the Nevada Health and Bioscience Corporation released a report prepared by the consulting firm Tripp Umbach detailing the case for a stand-alone children’s hospital in Southern Nevada. Shortly thereafter, Intermountain Health announced it would build Nevada’s first such facility in Las Vegas, expected to open in 2030. To complement the hospital’s development, The Lincy Institute undertook an independent evaluation of the regional pediatric care landscape. The analysis draws on secondary data and discussions with advocates, health system administrators, practitioners, and providers. The report examines:

• Fiscal, resource, and workforce challenges underlying Nevada’s poor population-level pediatric …

Determinants Of Antiretroviral Therapy Status Among Men Who Have Sex With Men (Msm) Living With Hiv In Greater Jakarta, Leonita Agustine, Mondastri Korib Sudaryo, Helwiah Umniyati

Jurnal Epidemiologi Kesehatan Indonesia

Men who have sex with men (MSM) are a key population contributing to the largest proportion of new HIV infections among the adult population in Indonesia, accounting for 44% of new infections in 2024. However, antiretroviral therapy (ART), as a key intervention in HIV control, remains suboptimal among this group, with previous studies showing that only around 57% of MSM living with HIV in Indonesia were receiving ART. In urban settings such as Greater Jakarta, these gaps may be more pronounced due to complex social and structural barriers to care. This study used a cross-sectional design based on data from …

Improving Provider Confidence In Suicide-Risk Screening Through Training On A Safe-T-Guided Pathway At Intake, Shukairo Mack Baker

Doctor of Nursing Practice Projects

Evidence supports structured suicide-prevention education, but inconsistent pathway use at outpatient intake prompted this quality improvement project to evaluate provider confidence. The aim was increased confidence after training on a Suicide Assessment Five-Step Evaluation and Triage (SAFE-T) guided pathway. Donabedian's structure, process, and outcome model and the Awareness, Desire, Knowledge, Ability, and Reinforcement change model guided implementation through one Plan, Do, Study, Act cycle. A single-group pre-test and post-test design involved seven clinicians at one hybrid outpatient behavioral health clinic. All available eligible staff (100%) completed a 2.5-hour training and both surveys. The Suicide Risk Assessment Confidence Scale was administered …

Plasmodium Falciparum Parasite Density And Its Association With Malaria Rapid Diagnostic Test Positivity Among School-Aged Children Across Diverse Malaria Transmission Settings In Mainland Tanzania, Felista Mwingira

Tanzania Journal of Science

Malaria rapid diagnostic tests (mRDTs) are widely used for malaria diagnosis and surveillance; however, their performance is influenced by parasite density. This study assessed the relationship between parasite density and mRDT positivity among school-aged children (SAC) across diverse malaria transmission settings in mainland Tanzania. Data were obtained from 17,131 school-aged children participating in a nationwide malaria survey. Malaria infection was assessed using mRDT and quantitative polymerase chain reaction (qPCR) targeting the Plasmodium falciparum lactate dehydrogenase (PfLDH) gene. Parasite density distributions were examined across demographic, environmental, and epidemiological characteristics. Malaria prevalence was 19.5% by malaria rapid diagnostic test (mRDT) and 19.2% …

When Should You Repeat A Child's Cbc?, Mike Smith, Sara Mcelroy

Pediatrics in Practice: A CME Podcast

"I found an unexpected abnormal CBC — should I repeat it or refer?" This episode focuses on repeat testing and early steps for abnormal CBCs. Sara McElroy, MD, pediatric hematologist at Children's Mercy explains when mild changes can be safely rechecked versus urgent referral. She covers transient marrow suppression with infection, lab artifact and repeat timing (about 4–6 weeks), the role of return precautions, and when to escalate to hematology or the ER.

Click here to stream the podcast episode.

The Effects Of C-Arm Positioning On The Accuracy Of Acetabular Reorientation In A Periacetabular Osteotomy Surgical Model, Cameron S. Baller

Summer Research Program Abstracts

No abstract provided.

Quality Improvement Project: Improving Nurse Confidence In Managing Patient Aggression Using The Brøset Violence Checklist And Team-Based Strategies, Grace Amakulor

Doctor of Nursing Practice Projects

Workplace violence remains a concern in psychiatric nursing, particularly when changes in patient behavior are not recognized early or communicated consistently. This quality improvement (QI) project was conducted at a psychiatric recovery center in Central Ohio after identifying a practice gap in aggression risk assessment and response. The purpose was to implement and evaluate a multicomponent aggression-management approach using the Brøset Violence Checklist (BVC), structured team huddles, and individualized aggression care plans. The aim was to improve nurse confidence (primary outcome) and reduce aggressive behavioral incidents (secondary outcome) over four weeks. Bandura’s Social Cognitive Theory and Lewin’s Change Theory guided …

Quality Improvement Project: Improving Psychiatric Provider Confidence In Prescribing Long-Acting Injectable (Lai) Antipsychotics Through A Structured Education Program, Emile Bihnyuy

Doctor of Nursing Practice Projects

Schizophrenia is a disorder that affects about 24 million people globally and needs regular antipsychotic drug management to prevent relapse. Although long-acting injectable (LAI) antipsychotics are associated with better adherence to and fewer relapses than oral antipsychotics, their use is underutilized in outpatient psychiatric care. This quality improvement project aimed to increase psychiatric providers' confidence in the prescribing of LAIs by implementing a structured 12-week education program in an outpatient psychiatric clinic in Texas. The implementation was guided by the Iowa Model of Evidence-Based Practice and the change process informed by Lewin's Change Model. Four psychiatric providers completed the modified …

Quality Improvement Project: The Impact Of Proper Utilization Of Suicidal Ideation Screening Tools, Anuoluwapo Bode-Oloye

Doctor of Nursing Practice Projects

Suicide remains a significant public health concern, emphasizing the importance of consistent and evidence-based suicide risk assessment in outpatient mental health settings. The purpose of this Doctor of Nursing Practice quality improvement project was to determine how the provider’s implementation of the Columbia Suicide Severity Rating Scales (CSSRS) according to the recommendations of the Substance Abuse and Mental Health Services Administration would impact the confidence and the rate of completion of suicidal screening tools (Columbia Suicide Severity Rating Scales) compared to current clinic policy in an outpatient mental health clinic for over twelve weeks. This project used Lewin’s change model …

Quality Improvement Project: Assessing Healthcare Providers’ Confidence, Familiarity, And Implementation Of The Audit-C Screening Tool For Alcohol Use Disorder In Adults With Depression In Primary Care, Babatunde Thanni Shittu

Doctor of Nursing Practice Projects

In depressed adults, alcohol use disorder (AUD) is a clinically meaningful comorbidity whose existence may go unnoticed unless a systematically introduced practice of conducting standardized alcohol-use screening is implemented. The current quality improvement (QI) project evaluated the use of the Alcohol Use Disorders Identification Test-Consumption (AUDI-C) in order to improve the capacity of healthcare providers to diagnose co-occurring AUD and integrate standardized screening into healthcare. Guided by the Knowledge-to-Action (KTA) framework and Kotter’s Change Model, the project aimed to improve provider familiarity, confidence, self-efficacy, screening, documentation, and referral practices. A pretest–posttest design was implemented with 13 licensed healthcare providers in …

Individual Host Variation In Single-Cell Responses To Enteroaggregative Escherichia Coli Infection Modeled With Human Colon Organoids, Ling Qiu, Tajhal D Patel, Hannah E Jones, Cristian Coarfa, Anthony W Maresso

Faculty, Staff and Students Publications

Enteroaggregative Escherichia coli (EAEC) is a leading cause of diarrhea worldwide. Interestingly, EAEC disease outcomes vary dramatically among infected individuals, ranging from asymptomatic colonization to acute and chronic diarrhea. While previous research has focused on EAEC virulence factors, emerging evidence suggests that host genetic and cellular background may be equally important in determining disease susceptibility. To understand host-driven disease heterogeneity, we performed single-cell RNA sequencing on human colon organoids (HCOs) derived from three healthy adult donors following EAEC 042 infection. Surprisingly, despite comparable EAEC adherence across donors, we observed striking donor-specific responses to infection at multiple levels. A total of …

Eeg-Emg Coupling And Functional Neuroplasticity In Elite Combat Athletes: Effects Of Neurofeedback Training On Corticomuscular Coherence And Performance, Alicja Markiel, Kinga Łosińska, Marcin Żak, Adam Maszczyk

Baltic Journal of Health and Physical Activity

Background: Neurofeedback training has gained attention as a neuroplasticity based intervention for athletic performance, yet pathways linking cortical oscillatory modulation to neuromuscular adaptation and strength remain poorly characterized in elite combat athletes. Objective: This study examines whether EEG neurofeedback targeting sensorimotor alpha upregulation and frontal theta/delta modulation enhances cortico-muscular coherence, neuromuscular function, and maximal strength in elite MMA athletes. Methods: Thirty elite male MMA athletes (n = 10/arm) were randomized to intensive neurofeedback (E20G, 20 sessions), abbreviated neurofeedback (E15G, 15 sessions), or sham control. EEG spectral indices, EMG parameters (RMS, MF, iEMG, onset latency), beta band CMC, and maximal strength …

Sociodemographic Predictors Of Patient Adherence To Timely Follow-Up Colposcopy/Leep After Abnormal Pap Screening, Gigi Baer

Summer Research Program Abstracts

No abstract provided.

Nuclear Neuroimaging Approaches To Traumatic Brain Injury: Current Insights And Future Directions, Shivani Daksh, Anupriya Adhikari, Nikhil Kumar, Garima Mann, Anupama Datta

Makara Journal of Science

The aftermath of a traumatic brain injury is characterized by a state of disruption, progressing into secondary injury and culminating in a complex network of interconnected pathophysiological disturbances.  The potential risk of developing neurological disorders after TBI highlights the pressing need to enhance our understanding and develop therapeutic in-terventions to alleviate its devastating consequences. Traumatic brain injury can lead to a range of problems, including pain, swelling, axonal degeneration, and chronic amnestic and non-amnestic cognitive impairments. The first and essential step in the management of TBI is to identify and characterize the clinical symptoms. This systematic review outlines the established …

Quality Improvement Project: Early Screening For Kidney Disease In Primary Care Clinics, Binsy Easow

Doctor of Nursing Practice Projects

Chronic kidney disease (CKD) is a common complication of diabetes. Evidence-based guidelines recommend urine albumin-to-creatinine ratio (UACR) screening for early identification of albuminuria in patients with diabetes; however, screening was inconsistently completed in an outpatient primary care clinic. This quality improvement project evaluated the impact of a standardized, provider-focused intervention on UACR screening completion and therapy intensification in patients with microalbuminuria. The Iowa Model served as the evidence-based practice framework, Lewin’s Change Theory provided the theoretical framework for practice change, and the Plan-Do-Study-Act cycle guided implementation and evaluation. A quasi-experimental pre- and post-intervention design was used. The intervention was delivered …