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Cefepime Pharmacokinetics In Critically Ill Children With Multiple Organ Dysfunction Syndrome Using Volumetric Absorptive Microsampling, Victor Amajor, Amanda Bwint, Steven Shein, Janet Hume, Courtney Rowan, Leeanne Flygt, Matthew Malone, Erin Stenson, Scott Weiss, Matt Zinter, Sujatha Kannan, Mary Dahmer, Ryan Nofziger, Manjunath Pai, Athena Zuppa, Nathaniel Rhodes, Mark Hall, Marc Scheetz, Kevin Downes Jul 2026

Cefepime Pharmacokinetics In Critically Ill Children With Multiple Organ Dysfunction Syndrome Using Volumetric Absorptive Microsampling, Victor Amajor, Amanda Bwint, Steven Shein, Janet Hume, Courtney Rowan, Leeanne Flygt, Matthew Malone, Erin Stenson, Scott Weiss, Matt Zinter, Sujatha Kannan, Mary Dahmer, Ryan Nofziger, Manjunath Pai, Athena Zuppa, Nathaniel Rhodes, Mark Hall, Marc Scheetz, Kevin Downes

Department of Pediatrics Faculty Papers

Up to half of critically ill children experience multiple organ dysfunction syndrome (MODS), which worsens outcomes and increases mortality risk. Cefepime is a broad-spectrum antibiotic commonly used in pediatric sepsis, but its pharmacokinetics during MODS has not been evaluated. We performed a prospective, observational study of critically ill children with MODS who were administered cefepime and collected up to 15 whole blood samples over 3 days using volumetric absorptive microsampling (VAMS). We performed nonlinear mixed-effects modeling to develop a population PK model for cefepime in children with MODS. We then reran our final population PK model using estimated plasma concentrations …


Timing Matters: Safe And Timely Insulin Administration, Katlyn Lenox Jul 2026

Timing Matters: Safe And Timely Insulin Administration, Katlyn Lenox

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Timely insulin administration is essential for safe inpatient diabetes management and is strongly associated with improved glycemic control and fewer adverse events. Despite ADA recommendations to administer insulin within 30 minutes of point‑of‑care (POC) glucose testing, internal data showed only 44% compliance, with an average delay of 44 minutes. These delays increased the risk of hypo‑ and hyperglycemia and highlighted the need for workflow redesign and strengthened nursing processes.

Aim of the Project: To increase the percentage of insulin doses administered within 30 minutes of POC glucose testing, reduce adverse glycemic events, enhance patient safety, and align practice with …


Purposeful Rounds: A Structured Fall Prevention Plan: Final Report, Cincerlyn Lewis Jul 2026

Purposeful Rounds: A Structured Fall Prevention Plan: Final Report, Cincerlyn Lewis

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Falls are the most frequently reported preventable events in hospitalized patients.  Falls in the project unit were increasing, and a gap analysis revealed variation in how nurses assessed fall risk and implemented interventions. Evidence indicated that inconsistent rounding undermined situational awareness and delayed identification of patient needs. This gap highlighted the need for a structured, evidence‑based rounding process to improve consistency and reliability.

Aim of the project: The Purposeful Rounds (PR) project aimed to implement a structured process to improve rounding consistency and staff responsiveness, while reducing fall rates over a 12‑week period.

Review of the Evidence: Evidence-based literature …


Increasing Referrals To The Lung Cancer Screening Program, Megan Randall Jul 2026

Increasing Referrals To The Lung Cancer Screening Program, Megan Randall

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Lung cancer is the leading cause of cancer-related deaths worldwide and is frequently diagnosed at advanced stages when treatment options are limited. A Veterans Administration (VA) primary care clinic demonstrated lower referral rates to the lung cancer screening (LCS) program than a comparable VA clinic despite having a higher prevalence of tobacco users. Existing electronic health record reminders focused on smoking cessation and did not systematically assess eligibility for LCS, contributing to underutilization of the screening program.

Aim of the Project: The aim of this quality improvement project was to increase referrals to the LCS program by improving identification …


Poor Adherence To Established Clinical Guidelines In Outpatient Bladder Cancer Management, Melanie Boren Jul 2026

Poor Adherence To Established Clinical Guidelines In Outpatient Bladder Cancer Management, Melanie Boren

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: The outpatient urology practice encountered challenges with adherence to Clinical Practice Guidelines (CPGs), primarily due to unfamiliarity and lack of operational accountability. This led to a low adherence rate of only 40% among patients with bladder cancer. Key issues included inadequate training and knowledge gaps regarding CPGs.

Aim of the Project: The project aimed to improve patient care and outcomes in bladder cancer treatment by enhancing patient retention and adherence to treatment protocols. Evidence-based interventions were implemented to optimize care delivery and support adherence to prescribed treatments.

Review of Evidence: A literature review highlights the effectiveness of nurse navigator …


Skin Is In: Promoting Breastfeeding Through Immediate Cesarean Skin-To-Skin, Autumn Spencer Jul 2026

Skin Is In: Promoting Breastfeeding Through Immediate Cesarean Skin-To-Skin, Autumn Spencer

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: The Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) and the American College of Obstetricians and Gynecologists identify immediate, uninterrupted skin-to-skin contact as a standard of care that improves neonatal stability, breastfeeding outcomes, and maternal satisfaction. Despite these recommendations, timely initiation following cesarean birth remains inconsistent. At the project site, skin-to-skin initiation averaged 72 minutes after birth, exceeding the 10-minute benchmark, and exclusive breastfeeding rates were below the national standard of 70%. Contributing barriers included workflow variability, unclear role expectations, and inconsistent communication.

Aim of the Project: The aim of the project was to improve infant and maternal …


A Quality Improvement Approach To Reducing Chronic Obstructive Pulmonary Disease Readmissions, Florwisse Rubio Jul 2026

A Quality Improvement Approach To Reducing Chronic Obstructive Pulmonary Disease Readmissions, Florwisse Rubio

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem:

The problem identified at the project site is that care transitions for patients with COPD lack standardized discharge processes, leading to inconsistent education, limited follow-up, and poor coordination of care.

Aim of the Project:

The primary aim was to improve patient outcomes by reducing the 19.6% 30-day readmissions among older adults diagnosed with COPD at the selected project site by implementing a standardized discharge intervention over 12 weeks, measuring progress, and ensuring appropriate workflow. The initiative of this project sought to foster a sense of proper continuity of care through timely follow-up, interprofessional communication among patients and providers, and …


Reducing Emergency Department Boarding Using Pull-Based Throughput Intervention: Quality Improvement Project, Eunice Dundu Jul 2026

Reducing Emergency Department Boarding Using Pull-Based Throughput Intervention: Quality Improvement Project, Eunice Dundu

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Emergency department (ED) boarding increases overcrowding and delays care. A 200-bed acute care hospital in the southeastern United States has a median time from inpatient bed readiness to ED departure that exceeds its hospital benchmarks, resulting in prolonged boarding and delays. Hospital data showed a median bed-ready-to-departure time of 76 minutes, exceeding the target of less than 45 minutes. Workflow analysis identified delays in transport activation, communication, and accountability as major contributors to inefficiency.

Aim of the Project: ED throughput quality improvement project aimed to reduce the median time from when an inpatient bed is marked ready to …


Improving Medication Reconciliation Compliance In Home Health Admissions, Paula A. Petrie-Rivas Jul 2026

Improving Medication Reconciliation Compliance In Home Health Admissions, Paula A. Petrie-Rivas

All Doctor of Nursing Practice (DNP) Scholarly Projects

Background: Clinician compliance with medication reconciliation at a home health agency was below regulatory expectations, with agency performance significantly lower than state and national averages. Workflow inefficiencies, inconsistent clinician practices, and limited training contributed to noncompliance, increasing the risk of medication discrepancies, preventable rehospitalizations, and Medicare reimbursement penalties.

Aim: This quality improvement project implemented a standardized medication reconciliation workflow using the Agency for Healthcare Research and Quality’s MATCH toolkit to improve clinician compliance during admission to home health.

Evidence: Literature supports structured medication reconciliation as an effective strategy to improve safety during transitions of care. The MATCH toolkit provides a …


Enhancing Medication Timeliness Through Structured Handoff In A Mental Health Facility, Belinda Zinhu Jul 2026

Enhancing Medication Timeliness Through Structured Handoff In A Mental Health Facility, Belinda Zinhu

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Delayed medication administration in an adult inpatient mental health facility exceeded organizational benchmarks and posed risks to patient safety, treatment effectiveness, and continuity of care. Baseline electronic health record (EHR) audits showed that about 30% of scheduled medications were administered outside the organization's acceptable timeframe, and inconsistent nurse shift handoffs contributed to the delays.

Aim of the Project: The aim of the quality improvement project was to improve patient outcomes by implementing the I-PASS standardized handoff communication tool to reduce late medication administration from 30% to 15% within 12 weeks.

Review of the Evidence: Evidence supports structured handoff frameworks …


Pressure Injury Prevention Bundle Implementation In An Acute Care Unit, Hannah K. Pobi Jul 2026

Pressure Injury Prevention Bundle Implementation In An Acute Care Unit, Hannah K. Pobi

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Pressure Injuries are quality indicators that reflect the quality of care delivered to patients. With a hospital-acquired pressure injury rate above 12%, the project site exceeded the national benchmark average of 5-8% for acute inpatient settings. The cost of managing hospital acquired pressure injury ranges from $20,900 to $151,700 per patient, compounded by complications in a patient’s treatment plan.

Aim of the Project: To reduce the prevalence of HAPIs in a step-down unit to below 8% by implementing the Pressure Injury Prevention bundle. The PIP bundle, an evidence-based intervention, primarily aimed to educate the nursing team on its …


Fall Tailoring Interventions For Patient Safety: A Program Evaluation, Shirley Morrison Jul 2026

Fall Tailoring Interventions For Patient Safety: A Program Evaluation, Shirley Morrison

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Falls with injury rates had increased for over two years at the project hospital until nurse leaders implemented a new fall-prevention intervention. Patient falls are the most common preventable adverse event in acute care hospitals, with approximately 700,000 to 1 million occurring annually in the United States. Before implementing the Fall Tailoring Interventions for Patient Safety (TIPS) toolkit, the hospital’s program lacked an evidence-based approach and a fall communication board to alert staff, patients, and families about the individual fall risk status, leaving a significant gap in patient-centered care.

Aim of the Project: The aim of the project was …


Reducing Catheter-Associated Urinary Tract Infections In Progressive Care, Kelli S. Bylsma Jul 2026

Reducing Catheter-Associated Urinary Tract Infections In Progressive Care, Kelli S. Bylsma

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Catheter-associated urinary tract infections (CAUTI) harm patients and increase healthcare costs. In fiscal year 2025, the progressive care unit reported a CAUTI rate 2.5 times the National Healthcare Safety Network benchmark of 1.0 infection per 1,000 catheter days. A gap analysis revealed that the project site lacked a policy mandating chlorhexidine baths for catheterized patients, resulting in suboptimal catheter hygiene and ineffective bactericidal intervention.

Aim of the Project: The aim of the quality improvement project was to reduce CAUTI rates by 50% through daily chlorhexidine baths for catheterized patients in the progressive care unit.

Review of the Evidence: Recent …


Dnp Final Report: Implementing The 5-2-1-0 Lifestyle Framework To Address Elevated Bmi In Pediatric Primary Care, Mary K. Williams Jul 2026

Dnp Final Report: Implementing The 5-2-1-0 Lifestyle Framework To Address Elevated Bmi In Pediatric Primary Care, Mary K. Williams

DNP Final Reports

Pediatric obesity remains a significant public health concern, particularly in rural areas where access to specialty care is limited. Primary care settings provide an important opportunity for early identification and intervention through family-based lifestyle modification. The purpose of this quality improvement project was to evaluate the feasibility and preliminary impact of implementing the 5-2-1-0 healthy habits framework, developed by researchers at Penn State, in a rural pediatric primary care clinic to promote improved lifestyle behaviors among children with elevated body mass index (BMI).

This project included pediatric patients ages 5–16 years presenting for well-child visits with a BMI at or …


The Effect Of The Continuous Care Model On Self-Practices And Quality Of Life Among Preeclamptic Women, Amira Ahmed Altweel, Salma Abd-Elatty Moawed, Amr Mahmoud Riad, Shaimaa Hassan Mohamady Jul 2026

The Effect Of The Continuous Care Model On Self-Practices And Quality Of Life Among Preeclamptic Women, Amira Ahmed Altweel, Salma Abd-Elatty Moawed, Amr Mahmoud Riad, Shaimaa Hassan Mohamady

Nursing

No abstract provided.


Transforaminal Endoscopic Lumbar Decompression: Defining Its Scope And Limitations, Kai-Uwe Lewandrowski, Álvaro Dowling, Jun Ho Lee, Benedikt W Burkhardt, Óscar L. Alves, Avelino Parajón, Jorge Felippe Ramirez, Nicola Montemurro, Alex R. Vaccaro, Morgan P. Lorio Jul 2026

Transforaminal Endoscopic Lumbar Decompression: Defining Its Scope And Limitations, Kai-Uwe Lewandrowski, Álvaro Dowling, Jun Ho Lee, Benedikt W Burkhardt, Óscar L. Alves, Avelino Parajón, Jorge Felippe Ramirez, Nicola Montemurro, Alex R. Vaccaro, Morgan P. Lorio

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Transforaminal endoscopic lumbar decompression (TELD) has emerged as a minimally invasive alternative for managing lumbar stenosis and disc herniations. While the literature consistently reports favorable outcomes, real-world adoption remains variable, with discrepancies often linked to surgeon experience and case complexity.

OBJECTIVE: To evaluate surgeon perspectives on the clinical applicability of TELD across different pathologies and compare these findings with published evidence.

METHODS: An international cross-sectional survey was conducted among spine surgeons. Responses were analyzed using Rasch modeling to assess consensus levels, with agreement categorized as strong, moderate, weak, or disagreement. Differential Item Functioning (DIF) and correlation analyses were applied …


Association Between Cesarean Scar Niche Characteristics And Menstrual Irregularities: A Cross-Sectional Study, Ridab Ali Saeed, Ahmed R. Shaker Jul 2026

Association Between Cesarean Scar Niche Characteristics And Menstrual Irregularities: A Cross-Sectional Study, Ridab Ali Saeed, Ahmed R. Shaker

Iraqi Postgraduate Medical Journal

ABSTRACT:Background: Cesarean section is a prevalent obstetric procedure with potential complications, including the formation of uterine niches or isthmoceles. These defects are associated with irregular menstrual cycles and adverse gynecological outcomes.Aim of the Study: To evaluate the association between cesarean scar niches and menstrual irregularities, and examine whether niche size and myometerial thickness are linked to menstrual irregularities.Patients and Methods: This cross-sectional observational study included 200 women with a history of cesarean section. Participants were divided into regular and irregular menstrual cycle groups and further categorized by the presence or absence of uterine niches. Clinical and demographic data were collected, …


Neonatal And Maternal Outcomes In Pregnancies With Sonographically Diagnosed Nuchal Cord: A Prospective Cohort Study, Eman Muhammad Ramadan, Samar Sarsam Jul 2026

Neonatal And Maternal Outcomes In Pregnancies With Sonographically Diagnosed Nuchal Cord: A Prospective Cohort Study, Eman Muhammad Ramadan, Samar Sarsam

Iraqi Postgraduate Medical Journal

ABSTRACT:Background: Nuchal cords, where the umbilical cord encircles the fetal neck, are a common obstetric finding, potentially impacting neonatal and maternal outcomes. Their clinical significance remains debated.Aim of the Study: To evaluate the prevalence of nuchal cords in pregnancies at Al Elwiya maternity teaching hospital and to evaluate the association between nuchal cord presence and effects on neonatal and maternal outcomes.Patients and Methods: A prospective, single-center, cohort study was conducted at Al-Elwiya Maternity Teaching Hospital from first of January to first of December 2024. It included 600 pregnant women in the study 107 had an ultrasound diagnosed with nuchal cords. …


Subcutaneous Nodules On The Elbows Of A Teenager, Arman Haveric, Jayci G. Rhein, Jason B. Lee, Shayan Waseh, Sylvia Hsu, Afton R. Metkowski Jul 2026

Subcutaneous Nodules On The Elbows Of A Teenager, Arman Haveric, Jayci G. Rhein, Jason B. Lee, Shayan Waseh, Sylvia Hsu, Afton R. Metkowski

Department of Dermatology and Cutaneous Biology Faculty Papers

No abstract provided.


Spatially Dissecting Drivers Of Inter-And Intra-Tumoral Heterogeneity In Kenyan Breast Cancer, Mustapha Abubakar, Shahin Sayed, Hela Koka, Scott Lawrence, Karun Mutreja, Xing Hua, Petra Lenz, Samuel Anyaso-Samuel, Rosemary Kamau, Beryl Ooro Jul 2026

Spatially Dissecting Drivers Of Inter-And Intra-Tumoral Heterogeneity In Kenyan Breast Cancer, Mustapha Abubakar, Shahin Sayed, Hela Koka, Scott Lawrence, Karun Mutreja, Xing Hua, Petra Lenz, Samuel Anyaso-Samuel, Rosemary Kamau, Beryl Ooro

Pathology, East Africa

Despite growing evidence on the impact of intra-tumoral heterogeneity (ITH) in breast cancer (BC), its biological drivers and clinically relevant mitigation strategies remain poorly characterized, particularly in low-resource settings where spatial profiling is rarely applied. To address this gap, we conducted a comprehensive, multiplatform spatial profiling study of BC in a Kenyan population. Using the NanoString GeoMx™ Digital Spatial Profiler, we quantified 44 protein markers across 707 spatially defined, PanCK-segmented Areas of Illumination (AOIs) from 31 tumors. All tumors exhibited measurable ITH, with one-third showing marked heterogeneity. Sixteen patients exhibited two or more intrinsic subtypes within their tumors, three of …


Alumni Journal - Volume 97, Number 2, Loma Linda University School Of Medicine Jul 2026

Alumni Journal - Volume 97, Number 2, Loma Linda University School Of Medicine

Alumni Journal, School of Medicine

Editorials
2 | From the Editor
4 | From the President
6 | From the Dean

News
8 | School of Medicine News
10 | Alumni News
14 | Students: AI-HEAL
15 | Paying It Forward Scholarship
16 | This & That
18 | Department Report: Cardiothoracic Surgery
20 | AIMS Report: Gleaning Missions Blessings at Hôpital Adventiste d’Haïti
22 | AIMS News

Graduation 2026
24 | Graduation Feature: A celebration of the class of 2026

Features
42 | By the Graduates: Stories and reflections
48 | Richard H. Hart '70, DrPH: Reflections on Hart's Legacy Upon Retirement
53 | …


Unlocking The Potential Of Sub-Saharan Africa In Globalized Cancer Clinical Trials: A Perspective From The 2024 Aortic-Asco Stakeholder Meeting, Abiola Ibraheem, Adedayo Joseph, Miriam Mutebi, Mansoor Saleh, Sitna Mwanzi, Olusegun Alatise Jul 2026

Unlocking The Potential Of Sub-Saharan Africa In Globalized Cancer Clinical Trials: A Perspective From The 2024 Aortic-Asco Stakeholder Meeting, Abiola Ibraheem, Adedayo Joseph, Miriam Mutebi, Mansoor Saleh, Sitna Mwanzi, Olusegun Alatise

General Surgery, East Africa

Sub-Saharan Africa (SSA) remains significantly underrepresented in global cancer clinical trials, despite having the largest population of individuals of African descent, an essential demographic for ensuring diversity in clinical research. This study, developed from the 2024 African Organization for Research and Training in Cancer (AORTIC)-ASCO stakeholder meeting, addresses the critical need to involve SSA in cancer trials to improve global trial diversity and patient outcomes. Although globalization of trials has shifted research sites to regions like Eastern Europe and Asia, < 1% occur in Africa. This report highlights emerging solutions such as regional alliances, decentralized trial models, capacity-building initiatives, and public-private partnerships. The role of AORTIC and its Clinical Trial Special Interest Group in advancing training, infrastructure development, and international collaboration is discussed, with notable clinical trial networks, such as HypoAfrica, ARETTA, African Research Group for Oncology, and regional consortia, illustrating growing momentum and capability. This study advocates for a coordinated strategy to integrate SSA into global trials, ensuring more inclusive, effective, and equitable cancer treatment outcomes.


Pyogenic Liver Abscess Associated With Acute Hepatitis A And Burkholderia Cepacia Sepsis In A Child: A Rare Case Report, Anjali M, Poonam Wade, Snehal Sahebrao Kasbe, Neha Bhongale Jul 2026

Pyogenic Liver Abscess Associated With Acute Hepatitis A And Burkholderia Cepacia Sepsis In A Child: A Rare Case Report, Anjali M, Poonam Wade, Snehal Sahebrao Kasbe, Neha Bhongale

Digital Journal of Clinical Medicine

Pyogenic liver abscess is an uncommon but potentially life-threatening infection in children. Although it is usually associated with underlying predisposing conditions, its occurrence in association with acute hepatitis A is infrequently reported.

We report a case of a 4-year-old male child who presented with fever, jaundice, and abdominal distension and was diagnosed with pyogenic liver abscess associated with concurrent hepatitis A infection and Burkholderia cepacia complex sepsis.

This case underscores the need to consider secondary bacterial infection in children with hepatitis A who have persistent fever or an unexpected clinical course despite appropriate supportive care. Although jaundice may initially be …


Da Mosang Tarsier Series: Developing Digital Bullying Prevention Materials For Filipino Parents Of Grade School Students, Rudy M. Danganan Jr., Ann Christine V. Braga, Maria Kristina S. Alfonso, Romelito Manuel D.S. Clorina, Ma. Regina Hechanova Jul 2026

Da Mosang Tarsier Series: Developing Digital Bullying Prevention Materials For Filipino Parents Of Grade School Students, Rudy M. Danganan Jr., Ann Christine V. Braga, Maria Kristina S. Alfonso, Romelito Manuel D.S. Clorina, Ma. Regina Hechanova

Children and Families

Bullying remains a significant public health and educational concern worldwide and is particularly prevalent in Philippine public schools, with Grade 7 students identified as a vulnerable group. Although the Anti-Bullying Act of 2013 (Republic Act No. 10627) mandates school-based policies and procedures, persistent implementation gaps underscore the need to strengthen home–school partnerships and equip parents with practical, culturally grounded response strategies. This paper describes the development of the Da Mosang Tarsier Series, a set of digital psychoeducational comic strips designed for Filipino parents of Grade 7 students. Guided by a user-centered design (UCD) framework, the project began with a Generative …


Thromboelastography-Guided Laparoscopic Splenectomy In A Patient With Immune Thrombocytopenia And Recent Drug-Eluting Stent Placement: A Case Report, Josue Gaona, Janki Patel Jul 2026

Thromboelastography-Guided Laparoscopic Splenectomy In A Patient With Immune Thrombocytopenia And Recent Drug-Eluting Stent Placement: A Case Report, Josue Gaona, Janki Patel

School of Medicine Student Publications and Presentations

Background

Perioperative management of patients with immune thrombocytopenia (ITP) is particularly challenging when complicated by recent coronary stenting requiring dual antiplatelet therapy (DAPT), due to competing risks of bleeding and thrombosis.

Case Presentation

We report the case of an 80-year-old male with refractory ITP and recent drug-eluting stent placement who underwent elective laparoscopic splenectomy. Although preoperative optimization with corticosteroids and intravenous immunoglobulin increased platelet count from <  20 × 109/L to 177 × 109/L, functional hemostatic adequacy remained uncertain given concurrent ITP and ongoing antiplatelet therapy. Thromboelastography (TEG) was performed using the TEG 6s system with a Global Hemostasis Cartridge. Standard TEG parameters demonstrated preserved clot initiation, formation, and strength across multiple channels, supporting progression to surgery. Laparoscopic splenectomy was completed under general anesthesia without complications or need for transfusion. The patient recovered on the general surgical ward and was discharged on Postoperative Day 3 with a platelet count of 139 × 109/L. Platelet count 2 weeks postoperatively was 343 × 109/L.

Conclusion

This case highlights the utility of TEG as a tool to guide perioperative decision-making in patients with ITP receiving antiplatelet therapy. By providing a functional assessment of coagulation, TEG can help individualize perioperative …


Development And Implementation Of Educational Modules On Management Of Neonates With Critical Congenital Heart Disease In The Delivery Room (Learn-Chd)., Noorjahan Ali, Brenda Law, Alyssa R. Thomas, Philip T. Levy, Ruby Gupta, Summer Elshenawy, Danielle Reed, Leeann R. Pavlek, Jennifer Shepherd, Sharada H. Gowda, Molly K. Ball, Beth Ann Johnson, Chloe Joynt Jul 2026

Development And Implementation Of Educational Modules On Management Of Neonates With Critical Congenital Heart Disease In The Delivery Room (Learn-Chd)., Noorjahan Ali, Brenda Law, Alyssa R. Thomas, Philip T. Levy, Ruby Gupta, Summer Elshenawy, Danielle Reed, Leeann R. Pavlek, Jennifer Shepherd, Sharada H. Gowda, Molly K. Ball, Beth Ann Johnson, Chloe Joynt

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Neonates with congenital heart disease may require delivery room interventions beyond standard care. Because existing guidelines and educational programs rarely address these needs, we developed and evaluated targeted educational modules.

METHODS: Teams were randomized to online eLearning modules or directed readings. Individual pre-/post-knowledge scores were compared. Team performance was tested in simulated delivery scenarios including abruption, hypoplastic left heart syndrome, d-transposition of great arteries and congenital complete heart block.

RESULTS: 32 teams from 9 centers participated. The module group had improved knowledge scores (mean change 6% vs -0.3% e-Learning group, p = 0.01). Simulation performance was similar between groups …


Spatially Dissecting Drivers Of Inter- And Intra-Tumoral Heterogeneity In Kenyan Breast Cancer, Mustapha Abubakar, Shahin Sayed, Hela Koka, Scott Lawrence, Karun Mutreja, Xing Hua, Petra Lenz, Samuel Anyaso-Samuel, Rosemary Kamau, Beryl Ooro Jul 2026

Spatially Dissecting Drivers Of Inter- And Intra-Tumoral Heterogeneity In Kenyan Breast Cancer, Mustapha Abubakar, Shahin Sayed, Hela Koka, Scott Lawrence, Karun Mutreja, Xing Hua, Petra Lenz, Samuel Anyaso-Samuel, Rosemary Kamau, Beryl Ooro

Pathology, East Africa

Despite growing evidence on the impact of intra-tumoral heterogeneity (ITH) in breast cancer (BC), its biological drivers and clinically relevant mitigation strategies remain poorly characterized, particularly in low-resource settings where spatial profiling is rarely applied. To address this gap, we conducted a comprehensive, multiplatform spatial profiling study of BC in a Kenyan population. Using the NanoString GeoMx™ Digital Spatial Profiler, we quantified 44 protein markers across 707 spatially defined, PanCK-segmented Areas of Illumination (AOIs) from 31 tumors. All tumors exhibited measurable ITH, with one-third showing marked heterogeneity. Sixteen patients exhibited two or more intrinsic subtypes within their tumors, three of …


A Phase-Ii Randomized Controlled Pilot Study Of Nicotinamide Riboside Supplementation In Older Adults With Amnestic Mild Cognitive Impairment, Christopher Martens, Kevin Decker, Theodore Deconne, Faria Sanjana, Fiona Horvat, Nicholas Rizzi, Catherine Awad, Elizabeth Habash, Joshua Hobson, Mary Kramer, Michael Armstrong, Nichole Reisdorph, Ryan Pohlig, Alyssa Lanzi, Curtis Johnson, Matthew Cohen, James Ellison Jul 2026

A Phase-Ii Randomized Controlled Pilot Study Of Nicotinamide Riboside Supplementation In Older Adults With Amnestic Mild Cognitive Impairment, Christopher Martens, Kevin Decker, Theodore Deconne, Faria Sanjana, Fiona Horvat, Nicholas Rizzi, Catherine Awad, Elizabeth Habash, Joshua Hobson, Mary Kramer, Michael Armstrong, Nichole Reisdorph, Ryan Pohlig, Alyssa Lanzi, Curtis Johnson, Matthew Cohen, James Ellison

Department of Psychiatry and Human Behavior Faculty Papers

INTRODUCTION: Declining nicotinamide adenine dinucleotide (NAD+) may elevate risk of Alzheimer's disease.

METHODS: We conducted a 12-week double-blind, randomized, placebo-controlled pilot study to evaluate the safety, tolerability, and preliminary efficacy of the NAD+ precursor, nicotinamide riboside (NR), for enhancing cognitive function and cerebral blood flow (CBF) in adults with amnestic mild cognitive impairment (aMCI).

RESULTS: 42 participants completed the study (NR = 22, placebo = 20). Adherence was similar between groups with no serious adverse effects. Blood NAD+ increased twofold in the NR group. There were no improvements in cognitive function (primary outcome), total CBF, or blood pressure (secondary outcomes). …


The Effects Of Abstinence Status And Sleep Quality On Resting State Alpha Power In Cocaine Use Disorder, Heather E Webber, Danielle A Kessler, Joy M Schmitz, Scott D Lane, Robert Suchting Jul 2026

The Effects Of Abstinence Status And Sleep Quality On Resting State Alpha Power In Cocaine Use Disorder, Heather E Webber, Danielle A Kessler, Joy M Schmitz, Scott D Lane, Robert Suchting

Faculty, Staff and Student Publications

Rationale

Substance use disorders are associated with notable sleep disturbances. Electroencephalogram (EEG) alpha power occurs during wakeful rest, is associated with sleepiness, and indicates neural deactivation.

Objectives

The goal of the current study was to assess the effects of abstinence on the relationship between alpha power and subjective sleep quality in participants with cocaine use disorder (CUD).

Methods

Participants with CUD (n = 32) who were recently or non-abstinent completed a resting-state EEG paradigm (90 s eyes open/closed). Absolute alpha power was calculated using the fast Fourier transform and by averaging within the power spectra of the alpha band (8–13 …


Psychological And Neuromechanical Recovery After Concussion: Dual-Task Stability And Kinesiophobia From Return To Play To Six Months., Melissa Anderson, Daniel Le, Mallory Faherty, Carolyn Killelea, Jeffrey Bytomski, Corina Martinez, Michael Bergeron, Timothy Sell Jul 2026

Psychological And Neuromechanical Recovery After Concussion: Dual-Task Stability And Kinesiophobia From Return To Play To Six Months., Melissa Anderson, Daniel Le, Mallory Faherty, Carolyn Killelea, Jeffrey Bytomski, Corina Martinez, Michael Bergeron, Timothy Sell

OhioHealth Research Institute Articles

BACKGROUND: Sport-related concussion (SRC) increases the risk of subsequent musculoskeletal injury, yet the mechanisms underlying this vulnerability remain unclear. Fear of movement (kinesiophobia) may contribute to impaired motor control.

PURPOSE: This study examined kinesiophobia and postural stability in adolescent athletes at return-to-play (RTP) after SRC and evaluated changes six months later.

DESIGN: Observational analytical study with cross-sectional (case-control) and prospective cohort components.

METHODS: Thirty-seven concussed athletes (15.7 ± 1.3 years, 45.9% female) and 17 matched controls (16.4 ± 2.1 years, 52.9% female) completed static single-leg stance and dynamic single-leg landing tasks under single- and dual-task (Stroop) conditions. Fear of movement …