Digital Commons Network^™

Short Term Echocardiographic And Clinical Assessment Of Aortic Valve Neo-Cuspidization (Ozaki Procedure) In Comparison With Mechanical Aortic Valve Replacement, Amr Mohamed Ahmed Elshabrawy, Mohamed A. Gabr, Eid M Daoud, Mohammed Sanad, Sherif Arafa

Mansoura Medical Journal

Background: Aortic valve neo-cuspidization (AVNeo, Ozaki procedure) has emerged as an alternative to conventional aortic valve replacement, aiming to preserve native aortic root dynamics and improve postoperative hemodynamics. The replacement of the aortic valve presents challenges because both biological and mechanical prostheses have notable limitations.

Aim: To evaluate the short-term clinical and echocardiographic outcomes of aortic valve neocuspidization (Ozaki procedure) compared with mechanical aortic valve replacement (AVR) in patients with isolated aortic valve disease.

Patients and methods: This prospective comparative observational study included 42 adult patients with isolated aortic valve disease. 20 patients underwent AVNeo (Ozaki procedure) and 22 …

A Chicken Model For Non-Invasive Diagnosis Of Infant Developmental Dysplasia Of The Hip (Ddh) Using Acoustic Transmission Measurements, Aliza Shah

Honors Undergraduate Theses

Developmental dysplasia of the hip (DDH) is a condition characterized by abnormal development and stability of the hip joint. In a healthy infant, the femoral head (ball) fits securely within the acetabulum (socket of the pelvis), allowing for proper joint function. In DDH, the relationship is disrupted, ranging from mild acetabular dysplasia to partial (subluxation) or complete dislocation of the femoral head. This condition represents a range of structural abnormalities that develop during early growth. The integrity of the hip joint is essential for physical mobility, and disruption of this structure can lead to significant functional impairment. DDH may result …

Investigating The Role Of Traditional Chinese Herbal Medicine For Cancer Symptom Management In Older Adults: A Rapid Review, Isabelle C. Karshner

Honors Undergraduate Theses

Background: Patients with cancer often experience symptoms related to disease, complications, and treatment. One potential method of alleviating these symptoms is traditional Chinese herbal medications (TCHM). This rapid review explores the role of traditional Chinese herbal medications in treating cancer-related symptoms in older adults.

Purpose: The purpose of this rapid review is to gain and provide a better understanding of the effects of TCHM on cancer-symptom management in the older adult population. This review explores the association between TCHM and effects on cancer symptoms in older adults, including interactions, toxicity, and signs/symptoms of TCHM use that may be useful information …

Synthesis And Characterization Of Succinate Dehydrogenase Inhibitors H2/Z14 And C6/Z96 In Order To Combat Small Cell Lung Cancer, Lauren M. Graves

Honors Undergraduate Theses

The use of ubiquinone inhibitors to combat cancer is a recent development in medicinal science and procedures to efficiently synthesize these drugs remain limited. C6/Z96 and H2/Z14, two succinate dehydrogenase inhibitors, have been previously tested in vitro against NSCLC with positive results. Their similarity to ubiquinone is what makes them a strong candidate for a succinate dehydrogenase inhibitor at the ubiquinone binding site. The heterocyclic scaffolds and substituents are proposed to bind strongly through a combination of electronics, hydrogen-bonding, and fit, allowing them to bind well and prove to be more favorable than ubiquinone when competing for the Q-site. By …

Dupilumab For Patients With Allergic Fungal Rhinosinusitis, Amber U. Luong, Joshua M. Levy, Sarah K. Wise, Joseph K. Han, Mamoru Yoshikawa, Luo Zhang, Rodney Schlosser, Prerna Ranganathan, Paula Dakin, Jennifer Maloney, George D. Yancopoulos, Andrew P. Fontenot, Neelam A. Phadke, Lacey R. Robinson

Department of Otolaryngology (ENT) Faculty Publications

Background

Allergic fungal rhinosinusitis (AFRS) is a severe subtype of chronic rhinosinusitis characterized by fungal hypersensitivity and accentuated type 2 inflammation. Dupilumab-a fully human monoclonal antibody blocking interleukin-4/13, approved for type 2 inflammatory diseases, including chronic rhinosinusitis with nasal polyps-may benefit patients with AFRS.

Objective

We sought to understand the effect of dupilumab in AFRS

Methods

In this phase 3 trial, patients with AFRS aged ≥6 years were randomized to dupilumab or matched placebo for 52 weeks. The primary end point was Lund-Mackay computed tomography (LMK-CT) score, quantifying sinus opacification, at 52 weeks. Secondary end points were multiplicity-controlled and hierarchically …

Establishment Of An In Vitro Dss-Induced Epithelial Injury Model To Investigate Il-6 Signaling And Microbial Metabolite Mediated Barrier Recovery, Srijal Kunwar

Graduate Studies Theses and Dissertations 2026

Dextran sodium sulphate (DSS) is widely used in vivo to induce epithelial injury; however, the molecular effects of DSS on intestinal epithelial cells, that investigate inflammatory and metabolic repair mechanisms remain unclear. Here, we establish an in vitro DSS-induced epithelial damage model using differentiated Caco-2 cell monolayer. Exposure to 2.5%(w/v) DSS for 24 hours resulted in significant upregulation of pore forming protein Claudin-2(2.677-fold) and oxidative marker, NOX-1(1.866-fold), accompanied by increased ROS production confirmed via DHE staining. Increased epithelial permeability was observed by TEER analysis, without significant cytotoxicity. Surprisingly, ELISA analysis revealed significant downregulation of IL-6 (p-value …

Gz17.602, A Combination Of Three Nutraceuticals, Interacts With Carboplatin And Etoposide To Kill Neuroblastoma, Michael R. Booth

Theses and Dissertations

This study examined the efficacy of GZ17.602, a combination of Harmine, Isovanillin, and Curcumin as a therapeutic for MYCN-amplified Neuroblastoma, both alone and in combination with standard of care chemotherapeutics. This was done due to the low survival rate associated with these neuroblastomas, the large degree of morbidity associated with current treatments, previous experiments in the Dent lab having shown 602 as effective for killing cancers of other types, and the current lack of understanding of the biology of GZ17.602 in solid pediatric cancers. Due to the GZ17.602 components being present at different concentrations in tumors than those administered, the …

Comorbid Psychosis In The General Population, Mariam Sankoh

Theses and Dissertations

Psychosis is a complex psychiatric phenotype characterized by substantial heterogeneity in symptom presentation, psychosis diagnosis, comorbidity patterns, and genetic architecture across diverse populations in the general population. Despite advances in psychiatric epidemiology and genomics, important gaps remain in understanding how psychosis symptoms and psychosis-related diagnoses manifest across racial and ethnic groups and how evolutionary genomic factors may contribute to disease risk and cross-ancestry genetic prediction. This dissertation, Characterizing Comorbidity in Psychosis in the General Population, integrates epidemiological, psychometric, and evolutionary genetic approaches to examine psychosis across diverse populations.

Aim 1 examined racial and ethnic differences in psychosis comorbidity patterns …

Dietary Acculturation, Dietary Inflammatory Potential, And Metabolic Syndrome Among Immigrants In The United States: A Mixed-Methods Approach Using Nhanes And Qualitative Data, Esse G. Foka Nzaha

Theses and Dissertations

Background and Objectives: Immigrants in the United States undergo acculturation — a process of sociocultural and behavioral adaptation to the host country. Increasingly, behavioral adaptations have been associated with cardiometabolic health and chronic disease risk. Metabolic syndrome (MetS), a cluster of conditions including abdominal obesity, elevated blood pressure, impaired fasting glucose, elevated triglycerides, and reduced HDL cholesterol, is a major risk factor for type 2 diabetes mellitus, cardiovascular diseases and other chronic diseases, including cancer. Despite the growing immigrant population in the U.S., the role of diet and dietary acculturation in MetS development remains poorly understood in this population. This …

24-H Circadian Rest-Activity Rhythms And Physical Frailty In Older Adults: A Biopsychosocial Perspective On Sex Differences And Social Capital, Jisu Kim

Theses and Dissertations

Physical frailty is a prevalent geriatric syndrome characterized by age-related decline across multiple physiological systems. Physical frailty is associated with an elevated risk of adverse health outcomes, including chronic disease progression and all-cause mortality, representing a significant and growing public health concern. Disrupted circadian rest-activity rhythms (RARs) are increasingly recognized as clinically meaningful markers of physical frailty in older adults. However, the extent to which biological sex and social determinants of health (SDoH), particularly social capital, contribute to or modify the associations between RARs and physical frailty remains underexplored.

Therefore, this dissertation summarizes the existing literature on age-related changes in …

Comparison Of Artificial Intelligence Vs Human Observer For Periapical Radiolucency Detection, Adam J. Pink

Theses and Dissertations

Objective: The aim of this study was to assess the performance of an Artificial Intelligence (AI) program (OverJet AI) with that of experienced endodontic residents, endodontists, a radiologist, and dental students in detecting periapical radiolucencies using radiographic images.

Methods: One hundred and fifty periapical radiographic images were analyzed using the OverJet AI software to determine the presence/absence of a periapical radiolucency as well as the size (small 1-3mm, medium 4-6mm, and large 6+mm). The unaltered images were also evaluated by two endodontic residents, two practicing endodontists, an oral radiologist and two 4th year dental students.

Results: Agreement between the AI …

Local Lung Delivery Of Ginkgetin For Therapeutic Intervention In Lung Fibrosis, Cimone L. Richardson

Theses and Dissertations

Lung fibrosis (LF) is a progressive, irreversible pathological condition in the lungs that is ultimately fatal. Current drug treatments (nintedanib, pirfenidone, and nerandomilast) slow disease progression but cause significant systemic adverse effects due to oral administration. Transient receptor potential vanilloid 4 (TRPV4), a mechanosensitive ion channel, may play a role in LF progression and represent a novel anti-LF target. Ginkgetin (GKT), a natural biflavonoid, is a potent TRPV4 inhibitor with anti-inflammatory and antioxidative properties. Local lung delivery could achieve high local lung concentrations while minimizing systemic exposure. Accordingly, this project evaluates GKT's therapeutic intervention efficacy in LF via local lung …

Assessment Of Major Adverse Cardiovascular Event Across Diverse Racial Groups Of Psoriasis Patients On Biologic Therapy: A Retrospective Cohort Study, Chunghwan Ro, Ana Ormaza Vera, Waleed Adawi, Clinton W. Enos

Department Dermatology Faculty Publications

Psoriasis is associated with an increased risk of major adverse cardiovascular events (MACE), and biologic therapy may reduce this risk by targeting systemic inflammation. However, limited data exist on whether long term MACE risk differs by biologic class or across racial groups. We conducted a retrospective cohort study to assess the risk of primary MACE in psoriasis patients receiving biological therapies, stratified by biological class, compared with biologic-naïve psoriasis patients. Whether MACE risk among biologic-treated patients varied by race was further examined. After 1:1 propensity score matching, 36 330 biologic-treated patients were compared with 36 330 non-biologic-treated patients. Incident MACE …

Implementation Of Tg-351 Reference Dosimetry For A 6 Mv Photon Beam In An Mr-Guided Radiotherapy System, Nicholas A. Castellano Jr.

Theses and Dissertations

Magnetic resonance guided radiation therapy (MRgRT) combines magnetic resonance imaging (MRI) and radiation therapy to enable the visualization of anatomy in real time during treatment. The presence of a magnetic field in MRgRT affects charged particle radiation and detector responses, necessitating changes to traditional reference dosimetry procedures. The American Association of Physicists in Medicine (AAPM) Task Group 351 (TG-351) provides a formalism for reference dosimetry in MRgRT. In this study, the TG 351 formalism is used to perform reference dosimetry for a 6 MV flattening filter-free (FFF) photon beam from a Viewray MRIdian MR-Linac radiation therapy system. Beam quality determination, …

Evaluating Novel Targeted Combination Therapies For Gastrointestinal Cancers, Joseph A. Goode

Graduate Studies Theses and Dissertations 2026

Gastrointestinal (GI) cancers remain among the leading causes of cancer-related mortality worldwide, with therapeutic resistance continuing to limit the effectiveness of current treatments. Three complementary studies were conducted to identify therapeutic vulnerabilities and evaluate novel combination strategies in pancreatic ductal adenocarcinoma (PDAC) and colorectal cancer (CRC).  First, dual inhibition of fibroblast growth factor receptor 4 (FGFR4) and phosphoinositide 3-kinase (PI3K)/mammalian target of rapamycin (mTOR) signaling was investigated in PDAC models. A combination of targeted drug treatments reduced viability, clonogenic survival, migration, and suppressed signaling pathways involved in translational control. This supported a functional interaction between FGFR4 and PI3K-mTOR co-activation in …

Spectrum Of Neurodevelopmental Disorders In Children Attending A Developmental Clinic In Dar Es Salaam, Tanzania, Aleya Zulfikar Remtulla, Sumayyah Nasiruddin Saudin, Orujul Hassan, Mariam Noorani

Paediatrics and Child Health, East Africa

Background: Neurodevelopmental disorders (NDDs) in children present significant challenges for healthcare systems globally. In Tanzania, children with NDDs and their families face significant challenges due to late diagnosis, lack of standardized screening tools, widespread stigma and cultural beliefs that deter health-seeking behaviours. Awareness about NDDs is low, and financial constraints further complicate access to necessary medical interventions. The country suffers from a severe shortage of specialized healthcare providers, and general healthcare providers often lack adequate training. Additionally, limited specialized facilities, high treatment costs and insufficient healthcare policies dedicated to NDDs make it difficult to manage these conditions effectively. Understanding the …

Survivors Of Historical Intergenerational And Familial Trauma Scale For Black American Descendants Of Enslaved People: A Development And Initial Validation Study, Loryn Chás Kimbrough

Graduate Research Theses & Dissertations

Despite extensive research documenting cultural and racialized trauma, no validated assessment tool had previously captured the intrafamilial mechanisms of trauma transmission specific to the BADEP population, whose trauma lineage is rooted in slavery. The present study addresses this gap through the development and initial validation of the Survivors of Historical Intergenerational and Familial Trauma Scale (SHIFTS), a culturally grounded instrument designed to measure the transmission of historical trauma (HT) and ongoing intergenerational trauma (IGT) among Black American Descendants of Enslaved People (BADEPs). The SHIFTS examines how HT gives rise to the continued transmission of two interrelated legacies: survival-based and trauma-rooted …

Assessing Sustainable E-Cigarette Prevention Messaging In Public Health Communication, Addo Anim Adinkrah

Graduate Research Theses & Dissertations

This study examines the sustainability of e-cigarette or vaping prevention messaging on X (formerly Twitter) and the message-design strategies used by public health institutions to maintain message visibility over time. Using the McGuire Communication/Persuasion Model and Media Framing theoretical frameworks, the research employs a qualitative thematic analysis based on Braun and Clarke’s six-phase approach to analyze 506 tweets from official accounts affiliated with the Centers for Disease Control and Prevention (CDC) and the U.S. Food and Drug Administration (FDA). The findings reveal that prevention messages are sustained through repeated core warnings and reinforcement of institutional authority rooted in scientific and …

Sex Differences In Clinical Characteristics, Treatment, And Outcomes Of Cardiovascular Disease: Kenya Heart Registry Analysis, Lilian Mbau, Martha Gulati, Mzee Ngunga, Jasmit Shah, Felix Barasa, Jeilan Mohamed, Anders Barasa, Bernard Gitura, Harun Otieno, Etienne Amendezo

Internal Medicine, East Africa

Background Cardiovascular disease is the leading cause of death globally, with approximately 80% of these deaths occurring in low- and middle-income countries. Sex differences in cardiovascular disease are well described in high-income countries but limited in low- and middle-income countries.

Objectives This study sought to evaluate the sex differences in clinical presentation, cardiovascular risk profile, diagnosis, treatment, and outcomes among patients in the Kenya Heart Registry.

Methods Data were prospectively collected from 3 tertiary hospitals, including patients with heart failure, acute coronary syndrome, venous thromboembolism, and atrial fibrillation. Primary outcomes were in-hospital and 6-month mortality, as well as sex-specific differences …

Targeting Nuclear Receptors In Muscular Dystrophies And Regenerative Myogenesis, Eira Mann, Hoang Vu, Vihang A Narkar, Yu Liu

The Brown Foundation: Institute of Molecular Medicine

Skeletal muscle is a highly plastic tissue with a robust capacity for regeneration, largely driven by resident satellite cells. Muscular dystrophies comprise a heterogeneous group of inherited disorders characterized by progressive muscle degeneration, chronic inflammation, and impaired regenerative capacity. Despite well-defined genetic etiologies, effective disease-modifying therapies for these disorders, as well as many acquired myopathies, remain limited. Emerging evidence identifies nuclear receptors (NRs) as key regulators of skeletal muscle homeostasis, integrating hormonal, metabolic, and environmental signals to control transcriptional programs governing mitochondrial function, metabolism, inflammation, and myogenesis. In this review, we summarize the diverse roles and mechanisms of action of …

Immune Checkpoint Inhibitor-Induced Cardiotoxicity: From Immune Mechanisms To Clinical Surveillance And Targeted Therapies, Nathan K Chen, Kathryn D Hok, Narsi Chokshi, Anthony Shadid, Haydn E Rich, Lavanya Gunamalai, Marie-Francoise Doursout, Nirmal K Banda, Pooja Shivshankar

The Brown Foundation: Institute of Molecular Medicine

Immune checkpoint inhibitors (ICIs) have transformed the treatment landscape across a broad range of malignancies by restoring antitumor immunity through blockade of key inhibitory immune pathways, including programmed death receptor-1 (PD-1), programmed death ligand-1 (PD-L1), and cytotoxic T-lymphocyte-associated antigen-4 (CTLA-4). Yet the same widespread immune activation that drives their therapeutic benefit renders patients susceptible to immune-related adverse events (irAEs). Among these cardiovascular toxicities have emerged as a particularly critical concern, drawing growing attention within the evolving field of cardio-oncology. ICI-associated cardiotoxicity encompasses a broad clinical spectrum, ranging from myocarditis and pericarditis to arrhythmias, heart failure, and vascular complications. Of these, …

In Memoriam: Professor Dan J. Stein (1962-2025) — A Global Pioneer With An African Heart, Gregers Wegener, Bernard Lerer, Alan Frazer, Anthony Grace, Kazutaka Ikeda, Gabriella Gobbi, Allan Young, Joseph Zohar, Pierre Blier, Lukoye Atwoli

Internal Medicine, East Africa

With profound sadness we mark the passing of Professor Dan J. Stein—clinician, scientist, philosopher, and friend. A pioneer of International and African psychiatry, and a central figure in global neuropsychopharmacology, he devoted his life to understanding and relieving the burden of mental disorders in South Africa, across the African continent, and worldwide. In his death, we have lost a true giant.

Surgical Interventions For Treating Vesicovaginal Fistula In Women, Yoshiyuki Okada, Tomomi Matsushita, Takeshi Hasegawa, Hisashi Noma, Erika Ota, Bob Achila, Yasukuni Yoshimura

Obstetrics and Gynaecology, East Africa

Objectives This is a protocol for a Cochrane Review (intervention). The objectives are as follows:

To assess the benefits and harms of surgical interventions for treating vesicovaginal fistula in women.

Seeing Public Health In Color: Phenomenological Perspectives Of Bipoc Women In Leadership, Jasmyn Spicer

All Graduate Theses, Dissertations, and Other Capstone Projects

Public health is a complex, ever-changing industry that holds pivotal capacity to impact society on a larger scale. For the United States, disparities and inequity in public health have had significant consequences for Black, Indigenous, and People of Color (BIPOC) communities. Effective leadership in public health has the potential to impact roles, policy development, and the overall scope of oversight regarding the quality of care that communities are provided in the industry. While BIPOC women are underrepresented in public health leadership roles, they have the capacity to advance equity in the field and contribute to culturally responsive care in foundational …

Ai Privacy And Security In Healthcare: A Systematic Literature Review, Diane Dolezel, Karima Lalani, Valerie Watzlaf, Kerryn Butler-Henderson, Elise V Z Lambert, Mary Morton, Jamie Sand, David Gibbs, Susan Fenton

Faculty, Staff and Student Publications

Background: Artificial intelligence is expanding into telemedicine and telerehabilitation, yet significant privacy and security concerns persist.

Scope: To synthesize empirical evidence on privacy and security approaches in health care, particularly those relevant to distributed home care.

Methodology: A systematic review identified 80 studies (2019 to 2025), and Latent Dirichlet Allocation (LDA) topic modeling characterized the privacy and security themes.

Results: Sixty-six studies addressed privacy, only seventeen addressed security, and three studies addressed both. LDA identified four themes: patient data privacy, federated learning for medical imaging, encrypted training and secure computation, and healthcare data governance. Most studies emphasized privacy-preserving approaches, like …

Advancing Virus-Associated Lymphoma Research In Latin America: A Global Opportunity For Cancer Science, Irene Tamí-Maury, Bryan Valcarcel, Maria Alejandra Torres, Arlett Hernandez Chavez, Luis Malpica

Faculty, Staff and Student Publications

No abstract provided.

Nasal Cavity Microbial Makeup And The Influence On Psychiatric Symptoms Following Fire Exposure In Firefighters, Paul Grunsted, Chao Xu, Amanda Janitz, Jessica Reese, Janis Campbell, Tasha M Santiago-Rodriguez, Sara J Javornik Cregeen, Joseph F Petrosino, Jooyeon Hwang

Faculty, Staff and Student Publications

Background: Firefighters experience high levels of occupational stress and trauma, increasing their risk of depression, anxiety, and post-traumatic stress disorder (PTSD). Although microbial communities may influence brain function and behavior through neural pathways, the nasal microbiome remains understudied. This study examined associations between nasal microbiome characteristics and psychiatric symptoms among firefighters.

Methods: We conducted a cross-sectional study of 34 firefighters recruited from Texas fire stations. Participants completed validated questionnaires assessing depression, anxiety, and PTSD. Nasal swabs were collected before and after fire suppression and 16S rRNA sequencing was used to characterize microbial communities. Alpha and beta diversity, relative abundance, and …

Algorithmic Medicine And The Duty To Disclose: Informed Consent Through The Lens Of Radiology, Lee Rodriguez

Michigan Law Review

Informed consent is the law’s mechanism for protecting patient autonomy by requiring disclosure of facts that bear on the decision to accept or refuse care. Artificial intelligence now helps decide what is medically true for patients, yet informed consent law still assumes that diagnostic judgment is rendered by a human mind whose reasoning is at least in principle communicable. Radiology has become the leading setting for this tension. AI systems triage worklists, flag suspected abnormalities, and anchor first-pass impressions in ways that guide radiologists’ attention and, in practice, can coauthor diagnostic conclusions while remaining invisible to patients. When patients are …

An Integrated Lifestyle-, Genetic- And Metabolomics-Based Prediction Model For Mild Cognitive Aging In The Hchs/Sol, Annah B Wyss, Yana Hrytsenko, Linfeng Hu, Iris J Broce, Robert C Kaplan, Wassim Tarraf, Bing Yu, Eric Boerwinkle, Qibin Qi, Myriam Fornage, Charles Decarli, Hector M González, Tamar Sofer

Faculty, Staff and Student Publications

Prediction models for cognitive aging measures have largely evaluated demographic variables and APOE carrier status in populations of European ancestry. To comprehensively assess prediction models among Hispanic/Latinos, we considered 12 models (6 predictor sets and 2 methods) for global cognitive score change (GCSC) and mild cognitive impairment (MCI) in the Study of Latinos-Investigation of Neurocognitive Aging (SOL-INCA) (N = 5856). Based on the average mean squared error (MSE) for GCSC or average area under the curve (AUC) for MCI across 100 randomly split testing and training sets, performance was similar across models, but slightly better for the following models: …

Enhancing Data Compatibility In An Evolving Landscape: Medical Cannabis And Polysubstance Use Protocols In The Phenx Toolkit, Anne Buu, Johannes Thrul, Amanda Bunting, Tamara Haegerich, Wayne Huggins, Christian Hopfer, Denise Vidot, Cataia Ives, Ryan Mcneil, Sarah Zemore, Corrie Vilsaint, Elizabeth Fallon, Christine Hill, Carol Hamilton, John Kelly

Faculty, Staff and Student Publications

Introduction: With increasing legalization of medical cannabis and prevalence of polysubstance use in the United States comes the need for standard psychometrically validated measures to study these substances' health effects in the population. The PhenX (consensus measures for Phenotypes and eXposures) Toolkit (www.phenxtoolkit.org) is a freely accessible catalog of recommended measurement protocols to promote data compatibility across studies, but this extensive catalog did not include measures in these important areas.

Methods: In 2024, a PhenX Working Group of experts followed a well-established consensus process to identify and recommend measurement protocols suitable for inclusion in studies on medical cannabis and polysubstance …