Digital Commons Network^™

Idiopathic Systemic Capillary Leak Syndrome With Shock And Compartment Syndrome Due To Influenza A, Jobe Ashby, Md, Katelyn Bobrowski, Do, Ryan Best, Md

Books, Presentations, Posters, Etc.

INTRODUCTION: Idiopathic systemic capillary leak syndrome (ISCLS) is a rare, poorly understood condition that leads to extreme pathology with severe but predictable complications. First described in 1960, ISCLS has been identified in about 260 case reports and is marked by a triad of hypotension, hypoalbuminemia, and hemoconcentration often preceded by upper respiratory tract infection. It is divided into distinct phases of prodrome, extravasation, and recovery. We present a case of a middle-aged woman who presented with influenza A infection and developed ISCLS needing ICU level care for shock and bilateral upper extremity compartment syndrome. DESCRIPTION: Our patient is a 49-year-old …

Sepsis Transitional Care Management: A Phone Call To Reduce Readmission Health Inequity, Linh Tang Taylor, Md, Erica Leser, Ms, Alyssa Nelson, Michelle Schoepflin Sanders, Md

Books, Presentations, Posters, Etc.

Introduction: Sepsis accounts for 52% of hospital admissions in the United States and is the leading cause of death among hospitalized patients1 . However, disparity exists among sepsis survivors with race being reported as a determinant of recovery2 . Such disparity exists in Providence Oregon 8 hospitals: Providence Black patients have higher sepsis readmission rates than White (12.93% vs 11.65%). Using modified community-based participatory research, data analysis, and stakeholder interviews, we identified one potential root cause of the disparity: Black patients being readmitted are not receiving our system's Transitional Care Management (TCM) services. We aim to eliminate the Black/White sepsis …

Ofatumumab Associated Legionella Pneumonia In A Young Multiple Sclerosis Patient, Jobe Ashby, Omar Panhair

Books, Presentations, Posters, Etc.

Ofatumumab is the only anti-CD20 IgG1κ human monoclonal antibody therapy for relapsing forms of multiple sclerosis (MS) that patients can self-administer subcutaneously. Anti-CD20 agents are biologic therapies that carry an increased risk of serious infections, but rarely Legionellosis. We present the case of a young man taking ofatumumab for his MS who developed Legionella pneumoniae pneumonia. A 30-year-old man with MS diagnosed two years prior, stable on ofatumumab, presented with fevers, cough, and hemoptysis. A week earlier, he developed fevers and myalgias after administering ofatumumab, but these symptoms persisted longer than usual. Though initial vital signs were normal, he appeared …

Gent-Le Dosing: Evaluating The Safety Of Gentamicin At Higher Doses For Late Preterm And Term Neonates, Jason Hector, D. Erin Wilson, Aiyana Ooki-Knutson, Jennifer Conley

Books, Presentations, Posters, Etc.

Abstract: In June 2024, Providence St Joseph Health updated the standard gentamicin dose in the Pediatric and Neonatal Aminoglycoside protocol from 4 mg/kg to 5 mg/kg every 24 hours for late preterm and term neonates. This project aims to evaluate late preterm and term neonatal patients who received gentamicin for empiric sepsis coverage within the first seven days of life, at 4 mg/kg/dose or 5 mg/kg/dose, to assess the safety of the standardized 5 mg/kg dosing for late preterm and term neonates after the protocol change. This study is a multicenter retrospective pre-/post-intervention analysis at a multistate health system spanning …

Perceptions Of Rural Large Animal Owners On Cost And Distance As Barriers To Veterinary Medicine, Alyssa Dalleske

Honors College Theses

Access to veterinary care remains a significant issue in rural communities due to financial, geographic, and access barriers. Limited access to veterinary care can have an impact on animal welfare and an economic impact for producers. This study aimed to assess factors influencing access to veterinary services, including cost, distance to clinics, perceived value of care, and availability of mobile veterinary professionals. The survey was distributed to rural large animal owners using social media, and gained 20 participants. It collected data on perceived barriers within their communities. The survey results indicated that cost of care and distance to veterinary clinics …

Expanding The Mutation Spectrum Of Non-Syndromic Retinitis Pigmentosa In Consanguineous Pakistani Families: Unraveling Novel Pathogenic Variants In Rp1, Pde6b, And Prcd Genes For Precision Diagnosis, Tayyaba Shan, Nimra Mukhtar, Sayyed Hammad Ullah, Asad Ullah, Asfandyar Ahmad Khan, Yumei Li, Meng Wang, Raeesa Tehreem, Amtul Aziz, Kiran Afshan, Rui Chen, Sabika Firasat

Faculty, Staff and Students Publications

No abstract provided.

An Exploration Of Drivers Of Sepsis Outcomes In Racial And Ethnic Minority Populations, Matthew Moritz, Omar Pandhair, Shelley Schoepflin Sanders

Books, Presentations, Posters, Etc.

RATIONALE: Race and ethnicity affect sepsis outcomes in unclear ways. Existing data is conflicting, with some studies suggesting minority patients do worse, while others did not show a difference in outcomes between these groups. We sought to investigate whether inequalities exist in sepsis outcomes for different racial and ethnic groups in our large hospital system and to characterize how they may manifest. METHODS: We performed a retrospective cohort study of adults diagnosed with sepsis and discharged from any of Providence’s 52 hospitals between January 1 and December 31, 2023. We grouped patients into ten different race/ethnicity groups including White, Black, …

Drug Risk Knowledge Discovery For Western Medicines Based On Knowledge Graph Link Prediction, Jianxiang Wei, Ma Hengyuan Ma, Yuehong Sun, Wenwen Du, Letian Hu

Journal of Scientific Information Research

[Purpose/significance] The risk information contained in drug instructions is usually incomplete, and some new adverse reactions can only be discovered in actual clinical use. This paper proposes an information organization and knowledge discovery method for pharmacovigilance, in order to timely and accurately identify missing risk knowledge in drug instructions. [Method/process] Drug instructions of 8 152 Western medicines are collected as the research data; On the basis of ontology construction, data annotation, and model training, the UIE model is used to jointly extract entity and relationship triplets from the research data; A new knowledge graph link prediction method CompGCN-RotatE, is proposed, …

The Role Of The Delta Neutrophil Index In Determining The Severity Of Intrahepatic Cholestasis Of Pregnancy, Selçuk Atalay, Melike Çaltekin, Nihal Çallıoğlu, Fırat Ersan, Verda Alpay, Yasin Anasız, Ipek Geyikoğlu

Saudi Medical Journal

Objective: This study aimed to investigate the clinical utility of the delta neutrophil index (DNI) in distinguishing patients with intrahepatic cholestasis of pregnancy (ICP) from healthy pregnant women, and to assess its potential role in evaluating disease severity. Methods: This retrospective analysis included data from 249 pregnant women. Among them, 131 were identified with ICP, based on clinical symptoms and total bile acid levels ≥ 10 μ mol/L. The remaining 118 participants served as healthy controls. The ICP cases were categorized into mild (TBA 10–39 μ mol/L; n = 90) and severe (TBA ≥ 40 μ mol/L; n = 41) …

Mental Health In Relation To Parental Absence: A Systematic Review, Mohammed Barry, Abdulaziz Alyahyawi, Heba Jafar Sabbagh

Saudi Medical Journal

Objective: To evaluate the literature based on the relationship between orphaned children and mental health, compared to non-orphaned children. Mental well-being of orphaned children is a profound intricate topic that connects with broader concerns of childcare. This systematic review aims to evaluate the literature regarding the relationship between mental health and parental absence. Methods: We conducted a systematic search of PubMed, MEDLINE, and Science Direct in October 2025, with 1017 screened studies. Six studies met the inclusion criteria. Independent reviewers performed quality assessments using the Newcastle-Ottawa scale (NOS). Subsequently, a meta-analysis was performed when possible. Results: Findings indicate that orphaned …

Enhancing Anesthesia Clinicians’ Knowledge And Confidence In Prophylactic Antibiotic Selection For Patients Receiving Concomitant Therapeutic Antimicrobials, Nicholas Rangel, Michela Williams, Amber Theisen

Doctor of Nursing Practice (DNP) Student Projects

: Background and Review of Literature: Antibiotics are essential for preventing surgical site infections (SSIs), but improper selection can contribute to antimicrobial resistance, increased costs, and patient harm. Studies show that clinical decision support (CDS) tools can improve antibiotic prescribing practices using evidence-based guidelines.  Purpose: This project aimed to integrate a revised CDS tool into the workflow of a anesthesia clinicians at a midwestern academic medical center, incorporating allergy-specific guidelines and antimicrobial substitution recommendations for patients on concomitant therapeutic antimicrobials (CTA) to improve decision-making. Methods: This project used pre- and post-surveys to assess clinicians’ knowledge, confidence, and satisfaction in selecting …

Assessment Of Health And Medical Students' Awareness, Attitude, And Preventive Practices Toward Monkeypox Outbreak, Haneen Qahtan, Taher M. Al-Fahham, Sameerah Mohammed Saeed

Preventia: The Indonesian Journal of Public Health

Monkeypox is an infectious disease caused by the monkeypox virus, which is a primarily endemic disease in Western and Central Africa. Monkeypox infections among humans have been on the rise in certain areas of Africa in recent times, leading to its identification as a major health hazard. It is important for medical college students, who will become future healthcare professionals, to actively participate in educating the general population about this illness. Their readiness and capacity to properly handle such health emergencies are strongly influenced by their knowledge, attitudes, and preventive measures regarding newly emerging infectious diseases such as monkeypox. This …

Barriers Asian Adoptees Face In Screening For Inheritable Conditions Due To A Lack Of Family Medical History, Anna Shea

Honors Projects

Adoption has been increasingly common in the United States, with more than 7.8 million people in the United States adopted (Wexler et al., 2025) and over 280,000 children in the United States adopted internationally (Orr et al., 2024). Despite this, those who are adopted, especially internationally, often face medical disadvantages compared to those biologically related to their family. The differences in treatment between adoptees and those who are biologically related are largely due to the knowledge, or lack of knowledge, of the individual’s family medical history and genetic information. Genetic or inherited disease screening is often only completed or covered …

From Charcuterie Board To Clinical Ward: Pediococcus Pentosaceus As An Emerging Wound Pathogen - A Scoping Review, Jessica Sima, Mariana Rodriguez, Stephanie Campbell, Amanda Killeen

School of Podiatric Medicine - Student Research

Currently, there are 12 known species of Pediococcus, with P. Acidilactici and P. pentosaceus being the most well-known. P. pentosaceus is a Gram-positive, lactic acid bacterium, and is most often recognized for its wide usage as a probiotic and fermenter of wines and cheeses. It is also studied for its anti-inflammatory effects and antimicrobial properties against many common pathogens, such as Salmonella, Clostridium difficile, E.coli, etc.  However, the Pediococcus species can be an opportunistic pathogen in immunocompromised patients, and its resistance to glycopeptides and tetracycline limits treatment options.

We conducted a scoping review using Google Scholar and PubMed with the …

Program And Proceedings, The Nebraska Academy Of Sciences 1880–2026: 146th Anniversary Year, One Hundred-Thirty-Sixth Annual Meeting

Nebraska Academy of Sciences: Programs and Proceedings

Program and abstracts of the proceedings for the Nebraska Academy of Sciences 136th annual meeting, 2025

Sessions

Aeronautics and Space Science

Anthropology

Biological and Medical Sciences

Earth Sciences

Ecology, Sustainability, and Environmental Science

Physics and Engineering

General Poster Session

2026 Maiben Lecture: Shifting Extremes: Understanding Nebraska’s Changing Climate and Preparing for What Lies Ahead, Deborah Bathke

2026 Friends of Science Awards: Julie Shaffer and Irina Filina

2026 C. Bertrand and Marian Othmer Schultz Colleaguate Schoalrship Award: Piper Ryschon and Bryce Reeson

In Memoriam: Paul Royster

Public Perception Of Equine Rabies And Its Implications For Future Education And Preventative Strategies, Kya Walton

Honors College Theses

This study examined the rabies knowledge, vaccination, and risks of exposures of horse owners/overseers across the state of Kentucky. Research was conducted to determine the need for public health educators and veterinarians to inform the public on rabies. Survey results concluded that respondents' general knowledge of rabies transmission and mortality rate was respectable, but knowledge relating to equine vaccination was comparatively lower. A weak inverse relationship was observed between general rabies knowledge and concern over an individual’s horses contracting rabies. A weak positive correlation was determined when looking into general rabies knowledge and the likelihood of vaccinating an individual’s horses. …

Historical Development Of Vaccines And The Public's Response, Kristen Montgomery, Samantha Prince Bsn, Rn, Melissa Ealey Bsn, Rn, Jarrad Morelock Bsn, Rn, Shelby Johnson Bsn, Rn, Kokeshia Crosby Bsn, Rn, Stephanies Himes Bsn, Rn, Theresia Hinton Bsn, Rn

Epsilon Sigma at-Large Research Conference

Purpose: Vaccines, which have become one of the most important medical accomplishments in the prevention of communicable diseases, have a history that dates to the use of variolation as early as the 11th century. The purpose of this study is to explore the historical development of vaccines and to determine the characteristics that emerged when new vaccines were developed.

Aims: The specific aim of this study is to understand if all vaccines have been received about the same by the general public or if there are certain different or diverse characteristics associated with the introduction of different vaccines.

Methods: A …

The Impact Of Covid-19 On Quality Of Care In Hospital Settings, Sophia Callahan

Health Sciences Student Scholarship

No abstract provided.

Improving Pneumococcal Immunization Counseling In Children With Systemic Lupus Erythematous, Sarah Dettmann

Doctoral Dissertations & Projects

Background: Pediatric patients with systemic lupus erythematosus (SLE) face elevated risk for invasive pneumococcal disease, yet fewer than 10% are estimated to be current on pneumococcal vaccine (PCV) recommendations.

Local Problem: This quality improvement (QI) project aimed to develop and implement a standardized pneumococcal immunization screening and counseling process in a pediatric rheumatology clinic.

Method: Three consecutive PDSA cycles guided implemention across a nine-week intervention period using a pre-post quasi-experimental design.

Interventions: A multicomponent strategy was employed, including a PCV decision algorithm, EHR Smart Phrase, PCP referral template, and patient education brochure.

Results: Pre-implementation PCV counseling was documented …

Ginsenoside-Based Theranostic Agents For Alzheimer's Disease: Implications For Brain Penetration, Cellular Uptake, And Anti-Aging Effects, Hak Soo Choi

Oxford ICSB

Red ginseng and its bioactive constituents, ginsenosides, have long been associated with neuroprotection and anti-aging effects, yet their limited ability to cross the blood-brain barrier (BBB) and poorly characterized biodistribution have hindered therapeutic translation. To address this, we developed a library of “ginsenoprobes” by conjugating major red ginseng components (Rg1, Rg3, Rb1, Rh2, Rk1, Rg5) and red ginseng extract (RGE) to a zwitterionic near-infrared (NIR) fluorophore (ZW800-1C), enabling real-time tracking of their fate in vitro and in vivo. All ginsenoprobes were purified to >95% homogeneity via preparative HPLC and rigorously characterized for optical properties, including molar extinction coefficients and dye-to-ginsenoside …

Relationships Between Adolescents With Substance Use Disorders, Their Guardians, And Expressive Arts Therapy: A Literature Review, Sarah K. Unkefer

Expressive Therapies Theses

This literature review collects the comprehensive, current research around effective treatment of adolescents with substance use disorder (SUD) and explores ways to provide psychoeducation for the adolescent and their guardians to foster healthy relationships and open communication. This author explores the ways that expressive arts therapy influences treatment and long-term recovery of adolescents with substance use disorders (SUDs) by addressing familial communication and internalized stigma. Previous studies have shown that the current primary reaction from guardians is forcing abstinence, which often damages the adolescent-guardian relationship. Since this is one of the most important relationships in an adolescent’s projected recovery journey, …

Using Geospatial Environmental And Income Variables As Predictors Of Diabetes In Appalachia, John Kunicki Huth

Walden Dissertations and Doctoral Studies

Diabetes remains disproportionately prevalent in Appalachia, and macroenvironmental contributors remain poorly understood. Guided by spatial epidemiology, this quantitative, cross-sectional ecological study examined whether county-level environmental factors including distance to mine, distance to landfill, distance to water, mean annual precipitation, mean annual temperature, forest classification, distance to impervious surface, and median income were independently and collectively associated with diabetes cases per capita in West Virginia, used as a surrogate for Appalachia. Research questions addressed environmental predictors of diabetes cases per capita with and without controlling for median income. Publicly available county-level data from 53 West Virginia counties representing adults aged 20 …

Construction And Characterization Of Novel Mycobacterium Tuberculosis-Derived Triple And Quadruple Knockout Vaccines Against Tuberculosis, Omar Garnica, Raja Veerapandian, Kishore Das, Abhishek Mishra, Varsha Rawat, Areanna Carmona, Vivek Chauhan, Rakesh Kumar, Jessica Chacon, Shrikanth S. Gadad, Subramanian Dhandayuthapani

School of Medicine Publications

Tuberculosis (TB) is a deadly disease that claims the lives of over a million people each year worldwide. The Bacille Calmette-Guérin vaccine has long been used to protect against TB, but it produces variable effects across different populations and fails to protect against adult pulmonary TB. Therefore, there is an urgent need for alternative vaccines that can offer better protection. We have developed a strategy for the rational deletion of virulence-related genes in Mycobacterium tuberculosis (Mtb) to create hyperattenuation that also enhances immunogenicity. Previously, we generated both single (∆fbpA) and double knockout (DKO) (∆fbpA-∆sapM) mutants of …

Quality Improvement Project: Enhancing Efficacy And Reducing Urine Contamination Through Simulation In The Ed, Kimberley Strong

Doctor of Nursing Practice Projects

Urine specimen contamination in emergency department settings contributes to diagnostic inaccuracies, unnecessary antibiotic use, increased healthcare costs, and decreased patient satisfaction. This quality improvement project evaluated the impact of a simulation-based educational intervention on staff knowledge, self-efficacy, and urine specimen contamination rates among emergency department nurses and patient care technicians with less than six years of clinical experience in a rural Texas hospital. The aim of this project was to enhance knowledge and self-efficacy while reducing contamination rates over a six-week period. The project was guided by Knowles’ Adult Learning Theory as the theoretical framework, supported by Lewin’s Change Theory, …

Hydatid Cyst In The Right Ventricle Leading To Tricuspid Stenosis And Heart Failure: A Case Report, Muhammad Sheraz Hameed, Syed Rafay Hussain Zaidi, Shafaq Saleem, Muhammad Ahsan, Sarah Rahman, Azeen Razzaq, Ali Iqbal, Muhammad Sohaib Alvi, Muhammad Usama Naveed

Department of Medicine Faculty Papers

BACKGROUND: Cystic hydatid infection is a parasitic disease caused by the larval stages of Echinococcus granulosus, most commonly involving the liver and lungs. Cardiac involvement is rare, accounting for less than 2% of cases, with the left ventricle being the most commonly affected site. Involvement of the right ventricle is extremely uncommon and may lead to life-threatening complications such as tricuspid valve obstruction and hemodynamic compromise.

CASE PRESENTATION: We report a rare case of a 42-year-old patient who presented to the emergency department with exertional dyspnea, hemoptysis, chest pain, syncope, peripheral edema, and signs of right-sided heart failure. The patient …

First Covid-19 Vaccination Rates Among Pregnant Tennessee Women By Month Of Conception And Urbanization Level: March 2021 – November 2021, Claudia Valenzuela, Anne K. Driscoll, Elizabeth Harvey, Heather Wingate

Journal of Appalachian Health

Introduction: Throughout the pandemic, COVID-19 vaccination coverage was lower for the general population living in rural counties than in urban counties. In Tennessee (TN), COVID-19 vaccinations became available to pregnant women in March 2021. Little is known about rates of COVID-19 vaccination in pregnancy during the pandemic, or whether these rates changed or differed by urbanization level.

Purpose: The purpose of this study is to describe COVID-19 vaccination rates among pregnant women in TN by month of conception and urbanization level.

Methods: COVID-19 vaccination data from the TN Immunization Information System and the TN Surveillance for Emerging Threats to Mothers …

Infective Endocarditis Hospitalizations In Kentucky, 2008-2018: Spatial And Temporal Trends, Meera Marji, Steve Browning, W. Jay Christian, Richard Charnigo, Steve W. Leung, Anna Kucharska-Newton

Journal of Appalachian Health

Introduction: Infective endocarditis (IE) hospitalization rates have increased significantly in the last decade, primarily due to the opioid epidemic. In 2016, Kentucky (KY) ranked among the top ten states for opioid-related overdose deaths, but limited data exist on IE trends in KY.

Purpose: This study seeks to examine county-level spatial and temporal trends in IE hospitalization rates in KY.

Methods: Hospital inpatient discharge data from 2008–2018 for KY residents aged 18 and older were analyzed. IE admissions and drug use status were identified using ICD-9 & 10 diagnosis codes. U.S. Census data calculated yearly IE hospitalization rates per 100,000 residents. …

Off-Label Clinical Applications Of Lefamulin For Multidrug-Resistant Tuberculosis And Sexually Transmitted Infections, Kerel Morris, Sukaina Momin, Vicky Mody, Shashidharamurthy Taval

Research Day

Lefamulin is a newer pleuromutilin antibiotic approved by the FDA (2019) for the treatment of community-acquired bacterial pneumonia (CAP). In addition, recent studies have shown the off-label use of Lefamulin to treat multidrug-resistant tuberculosis (MDR-TB) and sexually transmitted infections (STIs) caused by Mycoplasma genitalium. Therefore, this study aimed to conduct a literature review evaluating the potential off-label applications of lefamulin. Treatment of MDR-TB is typically complex because of the increased resistance to the standard first-line therapy. In addition, the entry of antibiotics into macrophages is limited by hypoxia, granulomas, and necrosis caused by MDR-TB. Studies have shown that Lefamulin exhibits …

Understanding Doxycycline-Induced Phototoxicity, Setareh Khani, Sydnee Jackson, Darya Khani, Rekha Yesudas

Research Day

Introduction: Doxycycline is a tetracycline-class antibiotic that inhibits bacterial protein synthesis by binding to the 30s ribosomal subunit, thereby preventing bacterial growth. It has a broad spectrum of clinical indications including treatment of Chlamydia infections, Lyme disease, Anthrax, Rickettsia, Atypical pneumonia, Staph aureus, Cholera, Acne vulgaris, and Traveler’s diarrhea, as well as malarial prophylaxis. Although generally well tolerated, effective and affordable, doxycycline is associated with several mild adverse effects like gastrointestinal distress and photosensitivity. One clinically significant adverse reaction is phototoxicity which occurs following exposure to ultraviolet radiation. In doxycycline-induced phototoxicity, the drug absorbs UV light and generates reactive oxygen …

Targeting Dysbiosis: Rebyota As A Novel Strategy For Recurrent Cdi Prevention, Christina Cologer, Mishel Alvarez, Sia Christine, Brooklyn Myers, Kaytlin Pal, Katrina Strand, Vicky Mody, Shashidharamurthy Taval

Research Day

Clostridioides difficile is a bacterium that colonizes a patient's gastrointestinal tract after the use of systemic antibiotics. This infection, also called CDI, causes severe diarrhea and can be life-threatening. In some patients, CDI recurs, creating a dangerous cycle. Recurrent CDI (rCDI) persists because systemic antibiotics induce dysbiosis, disrupting the gut microbiota’s metabolic functions and compromising the intestinal epithelial barrier. This study was conducted as a literature review evaluating the safety, efficacy, mechanism of action, and clinical use of Rebyota in preventing rCDI. Rebyota is the first FDA-approved (2023) live biotherapeutic designed to restore eubiosis in adult patients after antibiotic treatment. …