Digital Commons Network^™

Sonographer Clinical Skills Training: What Can We Learn From International Education And Clinical Training Models To Address The Workforce Shortage?, Jennifer Alphonse, Gill Harrison, Christopher Edwards, Rebecca Perry, Afrooz Najafzadeh Abriz, Ignatius Pereira, Tara Chegwin, Pauline A. Mitchell, Adrienne J. Young, Shelley A. Park, Kate Russo, Michelle Fenech, Ann Quinton

Research outputs 2022 to 2026

Introduction: The sonographer workforce shortage is worldwide, with limited access to clinical training positions a major contributing factor to qualified sonographers entering the workforce. Our aim is to examine sonographer training models in English-speaking countries where sonographers are the primary providers of diagnostic ultrasound services and clinical training (work integrated learning/WIL) is embedded within accredited course curricula to troubleshoot the sonographer workforce shortage.

Methodology: An extensive search of Australian and international sonography course providers was performed. Accredited courses where WIL is a curriculum component and is assessable were included. Courses from Australia were compared to international courses and course elements …

Neurochemical Impact Of Psychostimulants: Longitudinal Mri Analysis Of Brain Iron Content In Children With Adhd, Hugo A.E. Morandini, Sjoerd B. Vos, Paola Chivers, Tim J. Silk, Pradeep Rao

Research outputs 2022 to 2026

Background: Attention Deficit/Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder in school-aged children and has been associated with impaired brain iron homeostasis. Evidence has shown that psychostimulant treatment may affect brain iron content in children with ADHD, however, longitudinal evidence remains limited. The present longitudinal study investigated the effect of psychostimulant treatment duration and age at treatment onset on brain iron content in children with ADHD. Methods: Neuroimaging and phenotypical data were collected from the publicly available Oregon ADHD-1000 dataset. After screening, data from 29 psychostimulant-medicated children with ADHD and 38 neurotypical children were included. Individual General Estimating Equation (GEE) …

Trx Suspension Vs Swiss-Ball Core Training For Core-Muscle Endurance And Static/Dynamic Balance In Overweight Inactive Women: A Randomized Trial, Siavash Naddafha, Mona Sarhadi, Maryam Taherkhani, Abbas Biniaz

Research outputs 2022 to 2026

Purpose: Prolonged sitting and physical inactivity are key risk factors for trunk-muscle weakness, impaired balance, and low-back pain in overweight women. Although unstable-surface training is widely prescribed, head-to-head comparisons between TRX suspension and Swiss-ball exercise are limited. We compared these modalities for effects on core-muscle endurance and balance.

Methods: Thirty overweight, inactive women (30 ± 5 years; BMI 27.3 ± 1.6 kg·m⁻2) were block-randomized (1:1) to 8 weeks (3 sessions/week) of TRX or Swiss-ball training using five matched exercises at Borg RPE 13–15 on the 6–20 scale. Outcomes were trunk-extensor (Biering-Sørensen), trunk-flexor (60° curl-up), and trunk-lateral (side-bridge) endurance; static balance …

Reply, Jacqueline L. Chen, Amanda J. Lu, Rohan Verma, Li Wang, Douglas D. Koch, Allison J. Chen

Department of Medicine Faculty Papers

No abstract provided.

Towards Human-Centered Digital Health Interventions, Kristin M Kostick-Quenet, Eric A Storch

Center for Medical Ethics and Health Policy Staff Publications

This article discusses the potential of digital health interventions (DHIs) in mental health care, emphasizing the importance of designing them to foster genuine humanistic care. It highlights current challenges in measuring engagement and outcomes, advocating for integrating human-centered endpoints such as dignity, autonomy, and therapeutic alliance into evaluation frameworks. The authors call for mechanistic research to identify effective engagement strategies and context-specific implementation approaches. Ultimately, successful DHIs should demonstrate both clinical efficacy and the preservation of humane, person-centered care, ensuring ethical and meaningful mental health support through technology.

Nf1 Loss In Estrogen Receptor-Positive Breast Cancer Induces Osteoclast Formation And Immunosuppression To Promote Bone Metastasis, Zifan Zhao, Ze-Yi Zheng, Jonathan T Lei, Matthew J Baik, Yi-Hsuan Wu, Lauren K Somes, Andres F Mosquera Paternina, Omar A Harb, Owen A Chang, Fengshuo Liu, Matthew V Holt, Junkai Wang, Igor Bado, Hai Wang, George Miles, Zbigniew Gugala, Meenakshi Anurag, Ahmed Elkhanany, Yi Li, Valentina Hoyos, Xiang H-F Zhang, Eric C Chang

Faculty, Staff and Students Publications

Estrogen receptor-positive (ER+) breast cancer exhibits a marked propensity for skeletal metastasis; however, the molecular drivers of bone colonization remain incompletely defined. We investigated the tumor suppressor neurofibromin (NF1), a dual repressor for RAS and ER signaling, whose inactivation promotes endocrine therapy (ET) resistance and is associated with inferior relapse-free survival. NF1 copy number loss was detected in 62% of ER+ patients who subsequently developed metastases and was associated with an increased likelihood of bone metastases at initial diagnosis. In mouse xenograft models, NF1-depleted ER+ breast cancer cells demonstrated enhanced dissemination to skeletal sites following surgical resection of primary tumors. …

Cracking The Code: Genotype-Phenotype Correlation Models In Sarcoglycanopathies, Leonela Luce, Conrad C Weihl, Et Al.

2020-Current year OA Pubs

OBJECTIVE: Sarcoglycanopathies are among the most severe limb-girdle muscular dystrophies (LGMD), though milder presentations have been described. These diseases are primarily caused by missense variants, but the limited predictability of their effect on protein maturation, complex formation, and transport has hindered reliable genotype-phenotype correlations. This study aimed to establish accurate genotype-phenotype correlations for LGMDR3, LGMDR4, and LGMDR5.

METHODS: We analyzed the largest sarcoglycanopathy cohort to date (n = 541). Clinical data, including age at symptom onset and loss of ambulation, were collected and used to define phenotype severity. Predictive models were developed considering the impact of non-truncating variants on secondary …

Spinal Cord Imaging For Multiple Sclerosis: Advances, Priorities, And Opportunities, Cornelia Laule, Matthew R Brier, Et Al.

2020-Current year OA Pubs

The spinal cord plays a central role in the pathophysiology and clinical manifestations of multiple sclerosis (MS), yet remains under-studied compared with the brain. This review summarizes key insights from the 2025 North American Imaging in MS Spinal Cord Imaging Workshop, highlighting recent advances, ongoing challenges, and future opportunities in MS spinal cord imaging. We review pathological studies and outline the clinical relevance of spinal cord lesions and atrophy for diagnosis, prognosis, and disease monitoring, highlighting emerging biomarkers of progression independent of relapse activity. Correlations between magnetic resonance imaging, histopathology, and clinical outcomes support the validation and translational potential of …

Irs: Iterative Reference Selection Improves Normalization Of Microbiome Sequencing Data, Yiming Shi, Lili Liu, Jun Chen, Kristine M Wylie, Todd N Wylie, Sung Hee Park, Ruiwen Zhou, Yin Cao, Stephanie A Fritz, Molly J Stout, Maria Cristina Vazquez Guillamet, Lei Liu

2020-Current year OA Pubs

Microbiome studies often seek to determine how the absolute abundances of individual taxa change across biological conditions, yet sequencing read counts are sample-specific scaled representations of those abundances. Because sampling depth can differ across samples, fold changes calculated directly from sequencing read counts do not generally represent absolute-abundance fold changes. Normalization methods attempt to account for these between-sample differences in sampling depth, but their accuracy depends on the reference used. In particular, total-sum scaling uses all taxa as the reference and can introduce compositional bias. Reference-based methods instead rely on taxa that are stable across conditions, but contamination of the …

Myxedema Coma With Cardiogenic Shock: Diagnostic Challenges And Risks Of Amiodarone In Acute Thyroid Failure, Jean Carlos Ramos Cardona, Gunjan Mundhra, Munachiso Egbo, Veniamin Melnychuk, Suzanne Quinn Martinez

HCA Healthcare Journal of Medicine

Background

Myxedema coma is a rare but life-threatening manifestation of severe hypothyroidism characterized by altered mental status, hypothermia, bradycardia, and multiorgan dysfunction. Delayed diagnosis is common, particularly in elderly patients with multiple comorbidities. Cardiac complications, including malignant arrhythmias, are underrecognized contributors to morbidity and mortality. Profound hypothyroidism compromises cardiac myocyte function through reduced activity of enzymes involved in calcium uptake, leading to impaired myocardial contraction and relaxation. This results in decreased heart rate, reduced cardiac output, and altered left ventricular function, which may be further exacerbated in patients with heart failure with reduced ejection fraction. Prolongation of the ventricular action …

Blaschko-Linear Lupus Erythematosus In A Pediatric Patient, Marshall Hall, Olivia Mayer, Henry Lim, Dustin V. Wilkes, Michael Carletti, Stephen E. Weis

HCA Healthcare Journal of Medicine

The lines of Blaschko represent epithelial cell migration during embryonic development. Rare forms of cutaneous lupus erythematosus may manifest along these lines, and lesions are termed Blaschko-linear lupus erythematosus (BLE). The purpose of this case study is to present a rare manifestation of linear cutaneous lupus erythematosus following the lines of Blaschko in a pediatric patient. To date, there are very few reports of BLE. We present a 17-year-old female with a 2-month history of a mildly tender growing lesion along the right nasofacial sulcus. The patient denied lesions elsewhere and any systemic, joint, or mucosal symptoms. A biopsy of …

Opioid Free Anesthesia In Arthroscopic Knee Surgery: A Feasible Approach To Patient Care, Carson Gifford, Denise Vidal, Dail Kim, Austin Goff, Paul Reynolds

HCA Healthcare Journal of Medicine

Background

The opioid epidemic has prompted exploration of opioid-free anesthesia (OFA) techniques, but the optimal approach is still debated. While some OFA protocols substitute opioids with other agents, these alternatives can introduce their own risks. The objective of this study was to investigate whether eliminating intraoperative opioids without analgesic substitution in arthroscopic knee procedures affects postoperative pain control and opioid requirements.

Methods

We conducted a retrospective analysis of 205 patients who underwent arthroscopic knee procedures between August and November 2023. Patients were divided into 2 groups: those who received intraoperative fentanyl (25-200 mcg, n = 144) and those who received …

Erratum: Presentation Of Cutaneous Large B-Cell Lymphoma, Leg Type

HCA Healthcare Journal of Medicine

This corrects the article “Presentation of Cutaneous Large B-Cell Lymphoma, Leg Type” in volume 6, issue 6 on page 527.

Identifying Pyle's Metaphyseal Dysplasia – An Incidental Finding Of Skeletal Pathology On A Dental Checkup, Shruthi Parthasarathy, Amudhan Azhagan, Arthisri Anandhi Sekar, Poongodi V, Ram Shankar

Chulalongkorn Medical Journal

Introduction:

Pyle's disease, also known as familial metaphyseal dysplasia, is a rare autosomal recessive genetic disorder that primarily affects the skeletal system, particularly in children and adolescents. Characterized by distinctive radiographic features such as Erlenmeyer flask deformity and metaphyseal widening, Pyle's disease often goes underdiagnosed due to its mild clinical manifestations.

Case report:

This case report details a 15-year-old female patient presenting with retained milk teeth and unerupted permanent teeth, alongside notable skeletal abnormalities including genu valgum and kyphosis. Clinical and radiographic evaluations revealed significant dental anomalies, including multiple impacted permanent teeth and mild dysmorphic facial features. Although genetic testing …

Evaluation Of Mdm2 Mrna Expression According To Clinicopathological Characteristics In Oral Squamous Cell Carcinoma (Oscc) Patients, Tirta Wardana

Chulalongkorn Medical Journal

Background: The murine double minute 2 (MDM2) gene encodes an E3 ubiquitin ligase that targets p53 for degradation, thereby influencing the pathogenesis of oral squamous cell carcinoma (OSCC).

Objective. The present study investigates MDM2 mRNA expression and its association with clinical and pathological characteristics in OSCC patients.

Methods: We conducted an observational-analytical study using a cross-sectional design. The study involved 39 OSCC patients. RNA extraction, cDNA synthesis, and quantitative PCR (qPCR) were performed. We quantified relative MDM2 mRNA expression using the Livak method (2-ΔΔCT) and GenEX MultiD software version 6.0. Statistical significance was assessed using independent t-tests.

Results: Although no …

Machine Learning-Based Gene Signature Detection Highlights Cxcl12 As A Key Marker For Aml Prediction, Selahattin Alperen Uysal, Burçin Kaymaz

Chulalongkorn Medical Journal

Background: Acute myeloid leukemia (AML) is a severe hematologic malignancy marked by uncontrolled proliferation and impaired differentiation of myeloid cells, disrupting normal hematopoiesis and resulting in poor clinical outcomes. Conventional diagnostic approaches often lack the precision to accurately classify AML subtypes, necessitating the integration of advanced computational methods to improve diagnostic and therapeutic strategies.

Objectives: This study aimed to apply machine learning (ML) techniques to transcriptomic data in order to identify a concise and informative gene signature capable of distinguishing AML cases from normal samples. Additionally, the study sought to evaluate the performance of predictive models in supporting AML prediction …

Assessing The Reliability Of Machine Learning Models In Classifying Depression Severity Using Facebook Text, Keito Yoneyama

Chulalongkorn Medical Journal

Depression is a growing global issue that requires urgent attention, particularly in Thailand. Without timely intervention, it can lead to serious consequences such as health complications, reduced social participation, and even suicide. Consequently, there has been increased research focused on developing algorithms to identify and classify social media data according to depression severity. This study aimed to evaluate the extent to which such algorithms are a suitable tool for the preliminary classification of Thai Facebook text into different levels of depression severity. The methodology involved data collection through surveys and Facebook scraping, followed by data preprocessing, feature engineering, and model …

Erratum: Genetic Variations In Extracellular Matrix Degradation Pathways Linking To Major Depressive Disorder: Evidence From A Large-Scale Genetic Association Study, Halliru Zailani, Daniel Tzu-Li Chen, Sheng-Che Lin, Jia-Hau Lee, Mei-Ling Li, Bing-Fang Huang, Jane Pei-Chen Chang, Kuan-Pin Su

BioMedicine

No abstract provided.

Design And Development Of Novel Peptidomimetic Compounds For Cancer Therapeutics: Focus On Hsp90–Cdc37 Interaction, Sarath Perumal, Ramanathan Karuppasamy

BioMedicine

Background: The HSP90 and CDC37 molecular chaperone complex governs the

stability and function of numerous client protein kinases, making it a crucial cancer target. Given their central role, disrupting this interaction induces proteotoxic stress and inhibits tumor progression. Therapeutic peptides are the mainstay of treatment for disruption of key interactions, yet they face limitations such as toxicity, resistance, and poor stability. Aim: This study aims to leverage peptidomimetics as novel disruptors of the HSP90–CDC37 interaction. Methods: Two peptides, a 9-mer and a 7-mer, were rationally designed by analyzing key regions facilitating HSP90–CDC37 complex formation. In silico mutational analysis identified …

Traditional Chinese Medicine And Healthcare Utilization In Bipolar Disorder: A Population-Based Study With Propensity-Matched And Mirror-Image Analyses, Shu-Ping Chen, Su-Tso Yang, Kai-Chieh Hu, Hui-Chih Chang, Jane Pei-Chen Chang, Kuan-Pin Su

BioMedicine

Background: Bipolar disorder (BD) is a chronic relapsing illness associated with high rates of acute psychiatric hospitalizations (APH) and emergency services (ES) use, placing burdens on healthcare systems. Many patients seek complementary modalities, including traditional Chinese medicine (TCM), alongside standard pharmacotherapy. However, population-based evidence regarding TCM’s effect on acute healthcare utilization in BD is lacking.

Methods: Using data from Taiwan’s Longitudinal Health Insurance Database 2000 (LHID 2000), this population-based study employed propensity score matching (PSM) based on age, gender, the index year (defined as the calendar year of the index date for TCM users and their matched nonTCM counterparts), and …

Responding To Medetomidine In Philadelphia: Narrative Summary Of The Public Health Response To A New Psychoactive Substance, Tareva Warrick-Stone, Serge-Emile Simpson, Phil Durney, Dennis Goodstein, Catherine Abrams, Raymond Bobb, Kory London, Daniel Teixeira Da Silva

Division of Internal Medicine Faculty Papers & Presentations

BACKGROUND: Despite the emergence of medetomidine as the dominant adulterant in Philadelphia's illicit opioid supply, coordinated public health responses are limited or non-existent in the literature. Thus, we summarize a recent Summit in Philadelphia of outpatient and inpatient service providers who specialize in the care of persons who use drugs to discuss medetomidine response readiness and building ongoing community readiness for potential destabilizing drug supply changes.

PURPOSE: Describe a public health intervention that distributed information about practices across health care settings and mobilized key informants to identify and address barriers to treatment.

METHODS: Descriptive summary of the in-person Summit organized …

Understanding Oral Habits And Malocclusion In School-Aged Children: Insights From Parental And Child Knowledge, Attitudes, And Practices, Maria Laurentia Sanjaya, Evan Raditya Pratomo, Markus Santoso, Agrippine Putricia Asaeli, Eveline Yulia Darmadi, Joy Janny Thenarianto, Jennifer Regina Putri Purwono, Eunike Jacquelyn Widarto

Kesmas

Malocclusion is a prevalent oral health problem in children associated with oral bad habits, yet the extent to which parental and child knowledge, attitudes, and practices (KAP) influence orthodontic status remains insufficiently understood. This cross-sectional study investigated relationships between parental and child KAP, oral habits, and malocclusion in school-aged children, involving 67 child–parent pairs from an elementary school in Surabaya, Indonesia. Parental and child KAP as well as child-reported oral habits were assessed using a validated questionnaire. Children subsequently underwent standardized clinical orthodontic examinations, including alginate jaw impressions to produce dental study models, which were evaluated using the Index of …

The Association Between Rapid Growth In Children Under The Age Of Five And Adolescent Obesity, Ratu Ayu Dewi Sartika, Fadila Wirawan, Iche Andriyani Liberty, Nurul Husna Mohd Shukri, Siti Arifah Pujonarti, Edy Purwanto, Munaya Fauziah

Kesmas

Early-life nutrition is a critical predictor of long-term health, yet the association between rapid early-childhood growth and adolescent obesity, particularly in relation to the “double burden of malnutrition,” remains under-researched in Indonesia. This study aimed to analyze the association between rapid growth and adolescent obesity. Data were obtained from the 1997, 2000, and 2014 waves of the Indonesian Family Life Survey (IFLS). This study included 641 children (aged 0–23 months at baseline) with complete anthropometric measurements across all three waves. Rapid growth was defined as an increase in z-scores of >0.67 in weight-for-age (WAZ), height-for-age (HAZ), or weight-for-height (WHZ) between …

Effect Of Partial Ablation Of Skeletal Dynamin Related Protein 1 On Mitochondrial Health, Inflammation, And Fibrosis In A Mouse Model Of Duchenne Muscular Dystrophy, Tessa L. Duzz

Graduate Masters Theses

Duchenne muscular dystrophy (DMD) is a progressive neuromuscular disorder characterized by muscle weakness, degeneration, fibrosis, and impaired muscle regeneration. Mitochondrial dysfunction is an early pathological feature of DMD and has been linked to excessive mitochondrial fission. Dynamin-related protein 1 (Drp1) is a central regulator of mitochondrial fission, a key process in regulating mitochondrial quality and function. Inhibition of Drp1-mediated mitochondrial fission has shown promise as a potential therapeutic target for alleviating pathology and dysfunction in dystrophic muscle. The objective of this study was to determine whether partial skeletal muscle-specific ablation of Drp1 could improve muscle pathology and mitochondrial health in …

Staff Education On Standardized Suicide Risk Assessment In An Outpatient Clinic For Behavioral Health, Fanta Haja Cabah

Walden Dissertations and Doctoral Studies

Suicide risk assessment is a high-priority nursing safety responsibility in outpatient behavioral health. The practice gap was a variation in nurses’ knowledge of validated suicide screening, direct inquiry, risk escalation, referral, and related documentation expectations working in an outpatient behavioral health clinic located on the Eastern Atlantic Coast. To address this problem, I developed, implemented, and evaluated a staff education program on a standardized suicide risk assessment. The practice question focused on whether staff knowledge increased following participation in the education program. Ten nursing staff members participated in a 60-minute education program. Pretest and posttest questionnaires included 20 multiple-choice questions. …

Adverse Drug Reaction Reporting In Dental Practice And The Importance Of Pharmacovigilance In Dental Education, Radhakrishna Lagishetty, Lakshmi Ramya T, Kvr Barath Raju, Mohan Kumar Pasupuleti

Journal of Dentistry Indonesia

Background: Adverse drug reactions (ADRs) are a critical component of patient safety; however, ADR monitoring remains underutilized in dentistry. This study aimed to assess knowledge, attitudes, and practices regarding ADR reporting among undergraduate and postgraduate students and practicing dentists.

Methods: A cross-sectional observational study was conducted using a structured, validated 19-item questionnaire covering socio-demographics, knowledge (6 items), attitude (4 items), and practice (5 items), which was distributed both in person and online. A total of 258 complete responses were analyzed out of 300 individuals contacted (response rate: 86%). Descriptive statistics and Chi-square tests were applied, with p < 0.05 considered statistically significant.

Results …

Investigation Of Patients' Use Of Non-Pharmacological Substances In Dental Pain Management, Neslihan Yılmaz Çırakoğlu, Özgenur Kaya

Journal of Dentistry Indonesia

Background: Dental pain is a complex condition influenced by biological, biochemical, environmental, and psychological factors. Before seeking professional care, many patients attempt to relieve dental pain using self-administered, non-medical agents. This study aimed to investigate patients’ use of non-pharmacological substances in dental pain management and to identify factors influencing these practices.

Methods: The questionnaire consisted of four sections addressing demographic characteristics, oral hygiene habits, pain characteristics, and pain-relief agents. Categorical variables were analyzed using Pearson’s chi-square test. Categorical data are presented as frequencies and percentages, while continuous data are expressed as mean ± standard deviation and median values. …

Orthodontic Camouflage Treatment Of A Severe Class Iii Skeletal Pattern With Anterior Open Bite: A Case Report, Dikeledi Maureen Letsholo, Mandla Dominic Nyakale, Mosimane Peter Silas Sethusa

Journal of Dentistry Indonesia

Background: Class III malocclusion combined with anterior open bite (AOB) is one of the most challenging occlusal problems to treat. The objective of this article was to report a case of an adult female patient diagnosed with Class III malocclusion combined with an anterior open bite and a hyperdivergent facial pattern.

Case Report: Camouflage orthodontic treatment with the extraction of maxillary and mandibular first premolars was used to treat the patient. Anterior teeth were retracted maximally against the Nance holding arch and fixed lingual arch appliances, and box elastics were used to close AOB. At the end of …

Evaluation Of Antibiotic Use Using The Gyssens Method On Clinical Outcomes In Ischemic Stroke Patients, Juniarto Mende, Graciano A. Maturbongs, Yohana K. A. Mbulang

Pharmacology and Clinical Pharmacy Research

Ischemic stroke is a health problem that causes death and neurovascular disability worldwide. The inflammatory response due to infection can increase ischemic stroke and increase brain damage through changes in blood pressure, coagulation, immune response, and endothelial function. This study aims to evaluate the rationality of antibiotic use on clinical outcomes in ischemic stroke patients. This study used a cross-sectional design. Retrospective data were taken from the medical records of Jayapura Regional Hospital for the period January 1, 2023, to May 31, 2025. The study subjects were all patients who suffered ischemic stroke and received antibiotics. Evaluation of the rationality …

Staff Education To Increase Knowledge And Awareness Of Sexually Transmitted Diseases, Alie Sholola Sahid

Walden Dissertations and Doctoral Studies

Background STIs or sexually transmitted diseases (STDs) are consequential public health emergencies that affect millions of people globally and have long-term health implications (Garcia et al., 2024). STIs are infections that are passed from one person to another through sexual contact with the most common types of STIs include chlamydia, trichomoniasis, general herpes, and human papillomavirus (HPV). It is estimated that each year, more than 20% of the U.S. population has had an STI, with around 26.2 million cases per year (Centers for Disease Control and Prevention [CDC], 2024a). The common types of STIs include chlamydia, trichomoniasis, general herpes, and …