New Applications Of Cardiopulmonary Exercise Testing Parameters Characterize Age-Related Changes In Exercise Performance During Adolescence, Katerina Kourpas, Takeshi Tsuda

Department of Pediatrics Faculty Papers

BACKGROUND: Age-related changes in exercise performance during adolescence are complex because of progressive physical and functional changes, in which multiple factors are involved.

METHODS: Peak and submaximal cardiopulmonary exercise testing (CPET) parameters were studied in healthy children and adolescents.

RESULTS: TTotal 303 subjects were divided into six groups by ages and sex: ≤11 years old (yo) (28/22 for males/females), 12–15 yo (61/98), and ≥16 yo (52/42). Rest and peak heart rate (HR) were comparable in all groups. Absolute peak values of oxygen consumption (˙ VO2), work rate (WR), and oxygen pulse (OP) were higher in older age groups in both …

Nmda Receptor Subunit Nmr-2 Regulates Pathogen-Induced Immune Responses Via The Nervous System In C. Elegans, Benson Otarigho, Jonathan Lalsiamthara, Alejandro Aballay

Faculty, Staff and Student Publications

Neural control of innate immunity must balance restraint of basal immune activity with rapid activation upon pathogen encounter. Glutamate, the primary excitatory neurotransmitter in the nervous system, has been implicated in several neurological disorders associated with inflammation, suggesting a potential link to immune regulation. However, how glutamatergic signaling contributes to immune balance remains unknown. Here, we demonstrated that the NMDA-type ionotropic glutamate receptor subunit NMR-2, a component of the NMDA receptor complex, acts in the

A Cross-Sectional Analysis Of The Vaginal Microenvironment In Rheumatoid Arthritis, Marlyd E Mejia, Savannah Bowman, Jessica Lee, Ali El-Halwagi, Keshia Ferguson, Maryjo Maliekel, Yixuan Zhou, Camille Serchejian, Clare M Robertson, Mallory B Ballard, Lee B Lu, Sobia Khan, Olubunmi O Oladunjoye, Shixia Huang, Sandeep K Agarwal, Kathryn A Patras

Faculty, Staff and Students Publications

The human microbiota is implicated in the development and progression of rheumatoid arthritis (RA). Given the increased RA burden in women and well-known correlations between the vaginal microbiota and local inflammation, we seek to understand the vaginal microenvironment in the context of RA pathology. Self-collected vaginal swabs and questionnaires on dietary, menstrual, and health information were obtained from 36 RA and 50 demographically-matched control women, 18–63 years of age. Medication regimen, along with disease activity and severity, was captured for the RA cohort. Vaginal swabs were subjected to long-read 16S rRNA gene sequencing, multiplex cytokine analyses, and quantification of rheumatoid …

Diabetes Mellitus Exacerbates Covid-19 Severity And Prolongs Recovery: A Clinical Study From Southern Iraq, Hussein Ali Hussein Al-Hchaimi, Mohammad Ali Hassan Jassim, Mustafa Abbass, Shahab Abdulla, Ralela Makline

AUIQ Complementary Biological System

Diabetes mellitus (DM) constitutes one of the most consequential comorbidities shaping the clinical trajectory of Coronavirus Disease 2019 (COVID-19), operating through intersecting mechanisms of chronic inflammation, endothelial injury, and immunosuppression that collectively amplify viral pathogenicity. This study investigated the impact of diabetes type on COVID-19 symptom severity, hospitalization duration, and recovery time among patients in Nasiriyah City, southern Iraq — a region substantially underrepresented in the global DM–COVID-19 literature. A descriptive cross-sectional study was conducted across healthcare facilities in Nasiriyah City from 2023 to 2024. A total of 150 hospitalized adult patients carrying confirmed diagnoses of both COVID-19 and type …

Postural Rehabilitation In The Management Of Chronic Neck Pain: A Comprehensive Literature Review, Yashfa Arman

Internet Journal of Allied Health Sciences and Practice

Purpose: This systematic review synthesizes current evidence on the efficacy of major postural rehabilitation techniques for chronic neck pain. Method: A systematic literature search was conducted in PubMed, Scopus, and PEDro databases up to May 2024. Randomized controlled trials and systematic reviews investigating posture-focused interventions for adults with non-specific chronic neck pain were included. Results: Seventeen studies met the inclusion criteria. Findings indicate that all techniques are effective, but each excels in distinct domains. Neck-specific exercises provided the most significant reduction in pain intensity (up to 58%) and functional disability. Global Postural Re-education (GPR) demonstrated superiority in improving objective measures …

Operational And Implementation Evaluation Of A Short-Term Medical Service Program In Rural Guatemala, Mitchell M. Michalak, Shamecka Douglas, Oscar Gonzalez, Giovanna Sanguinetti, Ashley Sweat

Internet Journal of Allied Health Sciences and Practice

Correlation Of Oxidative Stress Markers Between Serum And Colostrum And Their Association With Production Performance In Lactating Sows From A Prrs-Unstable Herd, Supasit Sopin, Yonlayong Woonwoong, Pichai Jirawattanapong, Prapassorn Boonsoongnern, Wirod Lakkanasombat, Alongkot Boonsoongnern

The Thai Journal of Veterinary Medicine

Oxidative stress occurs when the production of reactive oxygen species exceeds the antioxidant defense capacity of living organisms. Oxidative stress is commonly assessed using serum samples; however, blood sampling in pigs is often avoided on commercial farms because of disease transmission concerns and animal welfare considerations. This study aimed to evaluate the correlation between oxidative stress markers in serum and colostrum samples and to determine their association with production performance in lactating sows. A total of 34 Landrace × Large White sows from a commercial farrow-to-finish farm were included in the study. Blood and colostrum samples were collected immediately after …

Epstein–Barr Virus Common And Rare Complications In Iraq: Review Paper, Ameer Mohammed Kadhim, M. Jafar Zainaldeen, Zainab Haider Abdulmajeed

Maaen Journal for Medical Sciences

Background: Epstein–Barr Virus (EBV) is a highly ubiquitous herpesvirus found globally, it is associated to both a wide range of condition including common, pervasive infections and severe, rare diseases. In Iraq, despite a significant increased incident of chronic illnesses and viral- related malignancies, the local overview of EBV-associated complications remains fragmented. Aim: This review synthesizes the current available Iraqi literature to delineate the dual nature of EBV’s impact, distinguishing between common epidemiological manifestations and its role in severe clinical complications in local cohorts. Key Findings: high seroprevalence (~80%) of EBV in healthy Iraqi population, with noteworthy association observed in autoimmune …

Evaluating Behavioral Intervention Strategies For Reducing Hyperactivity In Children Diagnosed With Autism Spectrum Disorder And Comorbid Adhd, Murtadha M. Abd Noor, Dunya Habeeb Shnain

Maaen Journal for Medical Sciences

One of the most difficult and complex symptoms in children with autism spectrum disorder (ASD) and comorbid attention deficit hyperactivity disorder (ADHD) is hyperactivity. This has a substantial negative impact on daily functioning, learning, and responsiveness to therapy interventions, as well as on intervention programs that aim to manage behavior in schools and clinical settings, thereby restricting children's engagement in these programs as management behaviors become more emphasized. Given marked heterogeneity in clinical presentations and a lack of consensus on the most effective behavioral strategies, there remains an imperative to systematically evaluate targeted, specific strategies for reducing hyperactivity in this …

Standardizing Tms Intensity Across Different Coils Using Individualized Electric Field Modeling, Evgenii Kim, Mohammad Daneshzand, Keren Zhu, Danyal Fareed Bhutto, Teresa Jacobson Kimberley, Dylan J. Edwards, Netri Pajankar, Parker Kotlarz, Tommi Raij, Sergey N. Makaroff, Aapo Nummenmaa

Moss-Magee Rehabilitation Papers

Quantitative measures for Transcranial Magnetic Stimulation (TMS) intensity are needed to ensure safe and consistent application in therapeutic and research settings. However, resting motor thresholds (rMTs), commonly used to determine stimulation intensity, depend on the coil used. Unless motor mapping and treatment coils are identical, re-thresholding is necessary, increasing patient discomfort and potentially introducing variability across studies. These considerations raise an unresolved fundamental question: does individual rMT reflect a consistent cortical electric field (E-field) magnitude independent of coil geometry? We tested the hypothesis that rMT corresponds to a coil-invariant cortical E-field magnitude and evaluated a computational method for predicting stimulator …

Advancing Personalized Oral–Systemic Care Through Tongue Mapping, Lani Mcbeth Bs, Rdh

Metro Denver Dental Society Articulator Magazine

This article explores the role of Systemic Tongue Mapping (STM) as a complementary tool for advancing personalized oral-systemic care. Rooted in Traditional Chinese Medicine (TCM) and examined through an integrative healthcare lens, STM encourages clinicians to assess tongue characteristics as potential indicators of systemic imbalance and inflammation. Lani McBeth, BS, RDH, discusses how tongue mapping can enhance patient education, support preventive care conversations and encourage interdisciplinary collaboration. This article highlights how dental professionals can expand their role in whole-body wellness and early detection.

Calcium Signaling And Postsynaptic Density Dynamics: The Roles Of Calmodulin In Synaptic Protein Regulation, Keyaa Dilip Shah, Yonghong Zhang

School of Integrative Biological & Chemical Sciences Faculty Publications

Calcium signaling in neuronal cells is the principal mechanism underlying learning and synaptic plasticity, whereas the postsynaptic density (PSD) is an important center where calcium-dependent processes are organized and regulated. This review explores the roles of calmodulin (CaM) in facilitating calcium-dependent modulation of the activities of synaptic proteins in the PSD. We focus on the molecular processes through which CaM interacts with calcium signals to regulate the function, localization, and interactions of central synaptic proteins, including calcium/calmodulin-dependent protein kinase II (CaMKII), membrane-associated guanylate kinases (MAGUKs), and N-methyl-D-aspartate (NMDA) receptors. We aim to summarize recent advances in structural, biochemical, and imaging …

Mitigating Disparities In Diagnosis Of Dementia, Lycia Tramujas Vasconcellos Neumann, Simin Mahinrad, Erin L. Abner, Soo Borson, Goldie S. Byrd, Maria Carrillo, Lindsay Clark, Anthony N. Correro Ii, Kacie D. Deters, Gladys E. Maestre

School of Medicine Publications

The field of Alzheimer's disease and related dementias (AD/ADRD) is undergoing a transformative shift with a better understanding of disease biology, biomarker-based diagnostics, and disease-modifying therapies. Yet, these advancements risk exacerbating existing disparities in diagnosis and care. The 2024 Alzheimer's Association International Conference (AAIC) Advancements: Exploring Equity in Diagnosis convened interdisciplinary experts to address these inequities and chart a path toward population-generalizable research and practice. This article synthesizes key insights from the conference, highlighting considerations for inclusive and representative research design, ethical approaches in diagnostic disclosure, as well as challenges and solutions at individual, community, and systemic levels to advance …

Beyond The Mortality Paradox: Redesigning Uti Care For People Living With Dementia Through Diagnostic Stewardship, Rob E. Carpenter

Human Resource Development Faculty Publications and Presentations

Managing urinary tract infections (UTI) in people living with dementia presents a mortality paradox: clinicians must balance the risks of antibiotic overuse against the dangers of delayed treatment in high-risk phenotypes. Standard diagnostic criteria often rely on classic, localizing markers like fever and dysuria. However, these gatekeeper signs are frequently absent or blunted in dementia care due to age-associated immune dysregulation and immunosenescence. Consequently, infections often manifest as nonspecific neurobehavioral changes, leading to predictable misclassification and harmful diagnostic delays. This paper reframes UTI management in dementia as a clinical pathway and measurement architecture problem. We propose a verification-first service pathway …

Response To Kodali Et Al., “Hailey-Hailey Disease: A Review And An Approach To Management”, Christina Tolete, Teresa Duong, Adam Friedman, Leonardo Tjahjono

Department of Medicine Faculty Papers

No abstract provided.

Increasing Lead (Pb) Screening Participation Rates In The Pediatric Patient Population At The Philadelphia College Of Osteopathic Medicine Lancaster Avenue Community Healthcare Center, Jacob Varrato

PCOM Biomedical Studies Student Scholarship

Elevated blood lead levels (EBLLs) are an ongoing public health crisis predominantly affecting children under six in low-income communities located in major cities across the United States (Zartarian et al. 2024). Chronic lead exposure due to outdated housing, polluted water, and contaminated soil is especially harmful in early childhood. Frequent hand to mouth contact at this age increases the risk of ingesting particulate matter containing lead (CDC). EBLLs can predispose children to neurocognitive deficits, cardiovascular disease, and epigenetic modifications to gene expression patterns (Collin et al. 2022). While precautionary measures and timely screening protocols greatly reduce the risk of developing …

Effects Of Mitoquinone On Doxorubicin-Induced Cytotoxicity In H9c2 Cardiac Myoblasts And 22rv1 Prostate Cancer Cells, Tia Patrick

PCOM Biomedical Studies Student Scholarship

Introduction:

Although Doxorubicin (DOX) is a widely prescribed chemotherapeutic agent, its clinical use is limited by cardiotoxicity (DIC) caused by oxidative stress, mitochondrial dysfunction, and cardiac apoptosis. Dexrazoxane (DEX) is the only FDA-approved cardioprotective agent to prevent DIC. However, DEX may induce secondary malignancy. Mitochondria-targeted antioxidants (MTAs), such as mitoquinone (MitoQ) and 10-(6′-plastoquinonyl) decyltriphenylphosphonium (SKQ1), selectively accumulate within mitochondria to scavenge reactive oxygen species (ROS) at their primary site of production. Our previous findings demonstrated that MitoQ and SKQ1 prevented the reduction in cell viability caused by DOX treatment in H9c2 myoblasts. However, it remains unclear whether MitoQ can selectively …

Neuroinflammation And Neuropathology In A Novel Tau, Amyloid-Beta And Alpha-Synuclein Co-Pathology Model, Jhodi Mickayla Webster

ETDs from 2020-2029

Neurodegenerative diseases including Alzheimer’s disease (AD) and Parkinson disease (PD) often present with overlapping proteinopathies rather than aggregated proteins in isolation. Amyloid-β (Aβ) and phosphorylated tau are found in a substantial proportion of idiopathic PD cases, while α-synuclein (α-syn) pathology is present in over half of AD cases. The presence of these co-pathologies is associated with accelerated cognitive decline and increase mortality in these patients. In parallel, neurodegenerative diseases are increasingly recognized as being shaped by interactions between central nervous system (CNS) pathology and the immune system. Despite this, most experimental animal models of neurodegenerative disease examine single pathologies in …

The Healthcare Transition Experiences Of Emerging Adults With Congenital Adrenal Hyperplasia, Leslie Noojin Pitts

ETDs from 2020-2029

Congenital adrenal hyperplasia (CAH) is a group of disorders characterized by enzyme deficiencies impairing adrenal hormone production and requiring lifelong management. Individuals with CAH experience increased morbidity and mortality due to the underlying condition, steroid exposure, and inadequate preventative care. Despite clinical guidelines recommending a structured healthcare transition (HCT), little is known about the HCT experiences of emerging adults with CAH. Understanding these experiences is critical for identifying practice gaps and developing interventions to improve health outcomes. This qualitative descriptive study explored the HCT experiences, challenges, and outcomes of emerging adults with CAH, as guided by the refined Social Ecological …

The Dermatologic Effects Of Climate Change On Skin Of Color Populations: A Comprehensive Review, Grace Ugwueke, Simona A. Alomary, Nicole J. Baker, Susan C. Taylor Md, Nada Elbuluk Md

Student Papers, Posters & Projects

Background: Climate change contributes to rising temperatures, worsening air pollution, increasing UV exposure, and more frequent extreme weather events with downstream consequences for dermatologic conditions. However, limited research has examined how these climate-related effects can impact skin of color (SOC) populations, who often face disproportionate environmental exposures and structural inequities. Objective: To summarize the dermatologic implications of climate and environmental stressors on SOC populations. Methods: A literature search of PubMed and Embase (2000-2025) identified studies assessing dermatologic outcomes related to climate change or environmental exposures. Of 1254 records screened, 133 duplicates were removed, leaving 1121 studies for evaluation. Twenty-three studies …

The Effects Of Bone Health And Variation On Saw Mark Signatures, Lily Ambrose

PCOM Biomedical Studies Student Scholarship

Bone health and structural variation are multifactorial. Population, environment, age, diet, and health influence the overall functional morphology of bone and its response to stressors. Reduced cortical porosity, trabecular thinning, and low bone mass are common indicators of age-related and pathological changes, affecting a significant portion of the population. Because of this, bones encountered in medicolegal investigations often differ from what is considered “normal.” The structural integrity of bone needs to be considered because density influences mechanical strength and response to external forces. In criminal dismemberment cases, forensic scientists analyze saw marks to identify tool class and reconstruct events. While …

2026 Cyber-Resilient Health Care Workshop Report, Malcolm Schongalla, Sergey Bratus

Computer Science Technical Reports

The ISTS and the Dartmouth College Cybersecurity Cluster hosted the successful, inaugural Cyber-Resilient Health Care (CRHC) Workshop, March 5th & 6th, 2026. The event theme was "Innovation and Implementation," in response to the need to shift from reactive to proactive resiliency measures in the healthcare sector. Approximately 30 experts in clinical health care, cybersecurity, medical technology, policy, and innovation met to discuss solution-focused innovations addressing hard, cyber-related problems in health care. The agenda featured keynotes, an expert panel, innovation pitches, small group discussions, and a tabletop infrastructure disaster exercise. Participants gained insights into the obstacles and solutions involved in supporting …

Decentralizing Dementia Research To The Us–Mexico Border: The Rio Grande Valley Ad-Rcmar As A Model For Translational Equity, Gladys E. Maestre, John Blangero, Eron Manusov, Gabriel A. De Erausquin, Francisco Fernandez, Silvia Mejia-Arango, Vincent P. Diego, Juan C. Lopez-Alvarenga, Claudia Alaniz, Neyra García, Rosa V. Pirela, Andrew Tsin, Michael Mahaney

School of Medicine Publications

Translational equity means ensuring that diagnostics, treatments, care models, and prevention strategies are developed and implemented so they work for populations with the greatest burden and least access to care. In Alzheimer's disease and related dementias (ADRD), where most evidence derives from highly educated, non-Hispanic White participants at large academic centers, translational equity is critical to prevent misclassification, limited access, and widening disparities and to ensure that underrepresented communities shape how new knowledge moves into practice. Hispanic and other populations in the United States are disproportionately affected by ADRD yet remain underrepresented in research, with gaps especially pronounced in high-poverty …

Exploring The Role Of Vitamin D In Familial Mediterranean Fever: Pathogenesis, Triggers, And Immune Modulation, Hagop Sassounian, Saad Aad, Hilda E. Ghadieh, Lara Khouzami, Elsa Nicolas, Sami Azar, Frederic Harb

All Works

Familial Mediterranean Fever (FMF) is among the most frequent autoinflammatory diseases in populations originating from the area of Middle Eastern and Mediterranean countries. It is caused by mutations in the MEFV gene, which causes dysregulated pyrin expression and thus an immunologic anomaly. FMF is diagnosed by recurrent episodes of fever and serosal inflammation, predominantly peritonitis and pleuritis, as well as other systemic symptoms. Recent research is dedicated to searching for factors beyond genetic code contributing to how FMF evolves, the severity of its symptoms and response to conventional therapy—colchicine. These factors include epigenetic modifications of the MEFV gene and other …

Roots And Greens: Discovering The Power Of Indigenous Produce, Abiodun T. Atoloye, Sherif O. Olasoji, Ebunoluwa G. Ibidapo

Nutrition, Dietetics, and Food Sciences Courseware

The curriculum was designed in alignment with the Cognitive Theory of Multimedia Learning (CTML), Empowerment Theory (ET), and Social Cognitive Theory (SCT) frameworks. These frameworks were used to determine the selection and sequencing of learning activities. As reflected in CTML principles, the use of texts, images, infographics, and videos enhances knowledge retention and information comprehension and helps prevent cognitive overload. Through activities, homework, and family engagement, the principles of ET were incorporated into the curriculum to facilitate participants’ perceived control over food-related decisions. Additionally, by applying the principles of SCT, the curriculum incorporates scenario-based questions, opportunities to engage with peers, …

Comparable Endogenous Immune Reconstitution, Car-T Expansion, And Cytokine Profiles With Bendamustine Versus Fludarabine/Cyclophosphamide Lymphodepletion, Matthew Schwede, Sarah Hawley, Zachary Reitz, Faith Kierney, Neil Bailey, Tenzin Tsomo, Laiken Lopez, Terry Gilbertson, Christopher A Carney, Doug Kieper, Kelly Paulson, Krish Patel

All Poster Presentations

No abstract provided.

Development And Validation Of The Lifetime Sense Of Safety Scale In Kenyan Adults, Karen Blackmon, Anne Nyambura, Anne Gitere, Levi Muyela, Catherine Onyancha, Kendi Muchungi, Catherine Ajalo, Litha Musili, Rachel Maina, Edna Bosire, Lukoye Atwoli, Zul Merali, Chinedu Momoh

Brain and Mind Institute

Background. Safety supports psychological wellbeing and potentially shapes brain aging yet existing scales overlook cumulative lifespan safety experiences.

Methods. To address this gap, we developed and validated the Lifetime Sense of Safety (LSS) scale in Kenyan adults. The LSS uses visual analog scaling with a red-to-green color gradient to retrospectively rate felt safety across life stages and settings. We evaluated scale psychometrics and associations with social determinants of health and indicators of brain health.

Results. The LSS shows adequate internal consistency and test-retest reliability, with two distinct but correlated factors representing childhood and adulthood safety. Women and …

Contextual Variability In Under-Diagnosed Cardiometabolic Disease And Cognitive Vulnerability Among Populations At High Risk For Alzheimer's Disease And Related Dementias, Nwanyieze Jiakponnah, Joseph Curran, Tamlyn Watermeyer, Jasmit Shah, Litha Musili, Stanely Onyango, Benard Aliwa, Zul Merali, Karen Blackmon, Chinedu Momoh

Brain and Mind Institute

Underdiagnosis of cardiometabolic risk factors (CMRFs) may represent an unrecognised biological pathway contributing to dementia risk; yet remains poorly characterised in African and African diaspora populations. We quantified the prevalence and determinants of underdiagnosed hypertension and abnormal glycaemia across four cohorts comprising up to 7000 adults aged ≥40 years from Nigeria, Kenya, and The United States: Indianapolis, and North Texas. Underdiagnosis was defined as absence of self-reported diagnosis despite elevated systolic blood pressure ( ≥130 mmHg) or fasting blood glucose ( ≥100 mg/dL). Cohort-stratified analyses examined demographic, socioeconomic, cognitive, Alzheimer’s genetic, and blood-based biomarker correlates. Underdiagnosis was pervasive in African …

A Decade Of Leadership And Impact: Celebrating 10 Years Of The Ors Spine Section, Makarand V. Risbud

College of Life Sciences Faculty Papers

No abstract provided.

Socio-Ecological Models As A Framework For 21st-Century Genetic Counseling, Shana L. Merrill, Rebecca Mueller

College of Life Sciences Faculty Papers

Socio-ecological models and the related concepts of micro-, meso-, and macro-level practice are commonly used in the fields of social work and public health yet have not been thoroughly conceptualized for application to genetic counseling practice, research, and training. The field of genetic counseling is currently undergoing significant expansion with more genetic counseling training programs, greater variation in genetic counselor job roles, and genetic counselors practicing in more globally dispersed regions. It is therefore a critical time to conceptualize and tailor relevant theoretical frameworks to unify and guide the evolving field of genetic counseling. In this paper, we posit that …