Digital Commons Network^™

Perioperative Care Of A Child With Miller-Dieker Syndrome., Samantha A Currier, Lance M Relland, Joseph D Tobias

Ambulatory and Primary Care Articles

Miller-Dieker syndrome (MDS), also known as Miller-Dieker lissencephaly syndrome or chromosome 17p13.3 deletion syndrome, is a rare chromosomal disorder (microdeletion syndrome) characterized by lissencephaly, altered facial features, and neurologic disability. Classic phenotypic findings include a prominent forehead, micrognathia, and a short nose. Children with MDS are often born with associated end-organ involvement including congenital heart disease as well as motor and neurologic impairments including seizures. Progressive central nervous system involvement frequently leads to upper airway and swallowing dysfunction with recurrent bouts of aspiration, pneumonia, and respiratory failure. We present a 3-year-old child with MDS who presented for anesthetic care for …

The Omeract Core Domain Sets For Calcium Pyrophosphate Deposition Disease, Nicola Dalbeth, Yiling Zhang, Owen Hensey, David Grossberg, Ken Cai, Amy Fuller, Geraldine M Mccarthy, Tristan Pascart, Augustin Latourte, Edoardo Cipolletta, William J Taylor, Cesar Diaz-Torne, Tim L Jansen, Lih En Hong, Silvia Sirotti, Fabio Becce, Georgios Filippou, Beverley Shea, Robin Christensen, Jasvinder A Singh, Abhishek Abhishek, Sara K Tedeschi

Faculty, Staff and Students Publications

Objectives: To develop OMERACT core domain sets for chronic and recurrent calcium pyrophosphate deposition (CPPD) disease and acute calcium pyrophosphate (CPP) crystal arthritis.

Methods: Following OMERACT methodology, the CPPD Working Group (comprising of patient research partners, fellows, clinicians, and methodologists) defined the core domain sets. The development of the core sets occurred through a scoping review, qualitative study, Delphi surveys, and ranking exercises to identify the most relevant domains. A virtual e-module was developed to enable members of the OMERACT community to discuss and vote for endorsement of the OMERACT CPPD core domain sets.

Results: The core domains for chronic …

Transgenic Hookworm Secretes Anti-Tetrodotoxin Human Single Chain Antibody, Kumar Sachin Singh, Suman Bharti, Bruce A Rosa, Mahdiyeh Bigham, Samuel C Uzoechi, Young-Jun Choi, John C Martin, Danielle Kemper, Slavica Pavlovic Djuranovic, Darren A Pickering, Rachael Ryan, Bethany K Bracken, Maria Elena Bottazzi, Eric C Carnes, Wannaporn Ittiprasert, Matthew Moyle, Paul J Brindley, Alex Loukas, Sergej Djuranovic, Makedonka Mitreva

Faculty, Staff and Students Publications

Biologics, protein- and peptide-based drugs derived from living organisms or cell lines have emerged as effective therapies across a broad range of indications. However, parenteral administration and the need for frequent dosing increase costs and limit compliance, creating an urgent need for innovative platforms capable of continuously, safely, and efficiently delivering sustained biologics in situ within the host. Here, we describe a bioengineered hookworm platform to manufacture and deliver biologic therapeutics in vivo. As proof of concept, we engineer the Ancylostoma ceylanicum secretome by inserting a human single-chain variable fragment antibody (s16-HuScFv) into its genome. Transgene expression does not perturb …

Complement Activation In Maternal And Placental Pathology Of Preeclampsia, Manu T Banadakoppa, Madhulatha S Chauhan, Moises J Tacam, Allyson W Nevins, Antonio H Ruano, Simone H Ruano, Jon A Fuson, Chandra Yallampalli

Faculty, Staff and Students Publications

Background: Preeclampsia is a multifactorial, pregnancy-related disorder characterized by new-onset hypertension and proteinuria, with distinct early- and late-onset forms. Although complement dysregulation has been implicated in the pathogenesis of preeclampsia, its causal role remains unclear. In mice, Crry (complement receptor 1-related protein Y) functions as a critical complement regulator at the fetal-maternal interface. Because complete Crry deficiency is embryonically lethal, direct in vivo investigation of complement activation in pregnancy has been challenging.

Methods: We generated a placenta-specific, doxycycline-inducible short hairpin RNA mouse model in which Crry expression can be downregulated in a dose-dependent manner. This system employs Cyp19-driven Cre recombinase …

Impact (Immune Monitoring And Phenotype Assessment Of Clinical Trajectory) For Patients With Inborn Errors Of Immunity From The Primary Immune Deficiency Treatment Consortium (Pidtc), Danielle E Arnold, Hesham Eissa, Elizabeth Dunn, Geoffrey D E Cuvelier, Nicola A M Wright, Rebecca A Marsh, Suhag Parikh, Blachy Davila Saldana, Mark T Vander Lugt, Rosa Bacchetta, Lisa Forbes Satter, Shanmuganathan Chandrakasan, Erinn Kellner, Eric J Allenspach, Erica G Schmitt, Brent Logan, Lauri Burroughs, Morton J Cowan, Linda M Griffith, Luigi Notarangelo, Sung-Yun Pai, Michael A Pulsipher, Christopher C Dvorak, Elie Haddad, Jennifer M Puck, Troy R Torgerson, Jennifer W Leiding, Jennifer Heimall, Alice Y Chan

Faculty, Staff and Students Publications

Background: Evaluating natural history and outcomes of rare inborn errors of immunity (IEIs) has been challenging due to the diverse disease manifestations and lack of standardized data.

Objective: To develop a set of standardized, quantitative, generalizable data collection modules to measure organ dysfunction in IEIs, modeled on the previously validated Common Terminology Criteria for Adverse Event system for grading treatment toxicity.

Methods: Disease conditions were organized by organ system. Experts from the Primary Immune Deficiency Treatment Consortium identified essential features of severe combined immunodeficiency, chronic granulomatous disease, Wiskott-Aldrich syndrome, and primary immune regulatory disorders and compared these to Common Terminology …

The Relationship Between Psychological Stress And Sars-Cov-2 Nucleocapsid-Antibody Response Following Natural Infection: Longitudinal Findings From The Aegis Study, Erika T Beidelman, Ashley Judge, David B Allison, Stephanie Dickinson, Lilian Golzarri Arroyo, Anna L M Macagno, Michael J Ricciardi, Jon Macy, Stanley Perlman, Christina Ludema, Kevin C Maki, Molly Rosenberg

Faculty, Staff and Students Publications

Psychological stress can cause diminished immune response to infectious challenges. The extent this holds true during severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the modifying effect of vaccination status is untested. We explored these relationships in a non-random sample standardized to the US adult population. Across 2178 participants in the Aegis study (2021-2022), we identified 507 eligible laboratory-confirmed SARS-CoV-2 infections. We estimated the natural log of nucleocapsid-binding antibody absorbance (N-antibody) at study visits up to 225 days following a positive SARS-CoV-2 test. Linear mixed effects models were fit to estimate the association of baseline perceived stress and, separately, …

A Novel Qa Method For Adaptive Aperture Position Verification Of Proton Therapy System, Shuxin Fan, Tiezhi Zhang, Xiandong Zhao, Winter Green, Baozhou Sun, Tianyu Zhao, Yao Hao

Faculty, Staff and Students Publications

Accurate Adaptive Aperture (AA) leaf positioning is essential for some proton therapy systems to ensure precise dose delivery and patient safety. However, conventional quality assurance (QA) methods can be suboptimal or inefficient for routinely assessing the dynamic nature of AA in the Mevion S250i HYPERSCAN system. This study introduces a novel automated QA method to verify AA positions utilizing a scintillation detector. A specialized QA plan consisting of 7 rectangular fields was generated in the RayStation treatment planning system (TPS) and delivered using the Mevion S250i HYPERSCAN proton therapy system. Dose distributions were measured with an IBA Lynx PT scintillation …

Cytosine Base Editing Of Lpa In Transgenic Mice Averts Large Deletions, Marcel A Chuecos, So Hyun Park, Madhvi M Bhakta, Usosa Too-Chiobi, Daniel Betancourth, Mingming Cao, Marco De Giorgi, Christopher J Walkey, Anjana Tiwari, Biana Godin, Julia M Assini, Donna J Palmer, Philip Ng, Michael B Boffa, Marlys L Koschinsky, Gang Bao, William R Lagor

Faculty, Staff and Students Publications

Lipoprotein(a) (Lp(a)) is a genetically determined causal risk factor for cardiovascular disease, with approximately 20% of the population exhibiting elevated levels. While there are promising drugs in development, there are currently no approved therapies specifically designed to lower Lp(a) levels. For high-risk individuals with extreme levels of Lp(a), liver-directed genome editing could be an effective one-time solution. Genome editing approaches such as CRISPR and TALENs can reduce Lp(a) in LPA-transgenic mouse models, but they frequently induce large and potentially harmful genomic deletions. Here, we report the first application of TadA-derived cytosine base editing (CBE), delivered via helper-dependent adenovirus (HDAdV) and …

“Thrown To The Fire”: Exploring The Impact Of The Covid-19 Pandemic On The Education And Self-Efficacy In New Graduate Physical Therapists, Michael Furtado, Gregory Brusola, Dana Wild

Internet Journal of Allied Health Sciences and Practice

Purpose: The COVID-19 pandemic significantly disrupted Doctor of Physical Therapy (DPT) education and practice, leading to emergency transitions to online learning and interruptions in clinical experiences across the United States. These disruptions raised concerns about their impact on new graduate DPTs' self-efficacy and professional readiness. The current issue addressed by this study is the effect of these disruptions on new graduate self-efficacy and confidence in their professional role. This mixed-method study aimed to assess the extent of clinical education disruption, evaluate its effects on self-efficacy, and explore the lived experiences of new graduate DPTs during the pandemic. Method: A survey …

An Exploratory Study: The Presence Of Imposter Syndrome In New Graduate Allied Health Professionals And Its Relationship To Location Of Practice, Samantha J. Barber, Carol A. Flavell Dr, Moira Smith Dr

Internet Journal of Allied Health Sciences and Practice

Purpose: Imposter syndrome (IS) explores the feelings of fraudulence within personal and professional settings. Commonly IS results in impaired self-confidence, and self-perceptions of one’s own abilities, their mental health, and places them at a higher risk of burnout. Imposterism is linked to transitionary periods, such as being newly graduated, and while IS addressed amongst the medical community [doctors and nurses], there is a gap in literature relating to IS amongst allied health professionals (AHPs). Additionally, there is no known literature in which IS presence or severity is explored in relation to an individual’s geographic location. The aim of this study …

Aphasia Therapy In An Arabic-Speaking Individual After Stroke: A Case Report, Mohammed F. Alharbi Dr

Internet Journal of Allied Health Sciences and Practice

Purpose: This case report describes the clinical application and preliminary outcomes of Arabic-adapted Semantic Feature Analysis (SFA), Phonological Components Analysis (PCA), and Verb Network Strengthening Treatment (VNeST) in an Arabic-speaking adult with post-stroke aphasia and highlights language-specific factors that affect the adaptation of these interventions to Arabic. Methods: The participant was a 53-year-old right-handed native Arabic-speaking man who developed moderate to severe nonfluent transcortical motor aphasia after a left middle cerebral artery stroke. One month after stroke onset, he underwent assessment with the Short Aphasia Test for Gulf Arabic speakers, which showed relatively preserved auditory comprehension and repetition but marked …

Student Perceptions Of Artificial Intelligence: A Freelisting Study, Gary Kaplan, Mslis, Ahip, Jessica G. Hamilton, Mls, Rebecca Miller, Mlis, Rosemary Frasso, Phd, Cph

Thomas Jefferson University Faculty Days

Background

Librarians typically provide guest lectures on topics in information literacy, connecting students to the scholarly literature. Hervieux & Wheatley’s Six Frames for AI Literacy emphasize the need to engage in AI discourse. As artificial intelligence changes the way students often interact with information, librarians must adjust their approach, whether changing the framing while retaining the traditional content, or changing the content. In the 2025-26 academic year, we experimented with various approaches. Here we describe a brief freelisting exercise we conducted before the lessons to surface students’ perceptions of artificial intelligence.

Molecular And Histologic Studies Of The Amygdala And Reward Circuits In Rhesus Macaques (Macaca Mulatta) With Self-Injurious Behavior (Sib), Jackie Barua

Doctoral Dissertations

Self-injurious behavior (SIB), also known as non-suicidal self-injury (NSSI), is characterized by deliberate infliction of harming one’s own body tissues without committing suicide, and persists in a group of captive rhesus macaques despite an enhanced enrichment program and pharmacological intervention with diazepam. The aim of this dissertation was to identify the neurobiological underpinnings of SIB by combining RNA-seq guided transcriptomic discovery and targeted candidate gene validation with unbiased histological and imaging analysis. The secondary aim was to employ a complementary mouse model to investigate the endogenous opioid system in response to diazepam. The amygdala transcriptome of primates with SIB (n …

Enhancing Hiv Prevention: Implementation And Evaluation Of A Standardized Hiv Risk Assessment Screening In A Primary Care Setting, William Duckworth

Doctoral Dissertations

Background: HIV remains a persistent public health concern, with 1.3 million people affected worldwide. Although advances in treatment have improved long-term management, early prevention still relies on identifying individuals at elevated risk. In many primary care settings, routine HIV risk assessment is inconsistent or absent, resulting in missed opportunities to screen, educate and initiate prevention strategies such as pre-exposure prophylaxis (PrEP). This gap underscores the need for structured, evidence-based tools to improve early risk identification and strengthen HIV prevention efforts. Purpose: Implement and evaluate an evidence-based standardized screening process for HIV risk assessment to achieve early identification and enhance appropriate …

Enhancing Hpv Vaccination Engagement And Uptake Among Young Adults Aged 17 To 26 Through A Multilevel, Multicomponent Intervention, Sarah Dianne Girlinghouse

Doctoral Dissertations

Background: Human papillomavirus (HPV) remains one of the most common vaccine-preventable infections, with vaccination rates among young adults aged 17 to 26 remaining below Healthy People 2030 targets. University health settings represent a critical opportunity to improve vaccine uptake. Prior to this quality improvement (QI) initiative, student health services (SHS) at a public university in the southern United States did not routinely offer HPV vaccination, resulting in missed opportunities for prevention. Evidence supports provider recommendation, clinical decision support, and improved access as key drivers of HPV vaccination uptake. Purpose: The purpose of this QI project was to increase HPV vaccination …

Secondary Cutaneous Involvement In Peripheral T-Cell Lymphoma: Diagnostic Frameworks, Staging Integration, And Therapeutic Implications, Aura Calderon, Jose Loayza Pintado, Cristina Kochi, Jared Hensley, Andres Suarez Parraga, Everardo Cobos

School of Medicine Publications

The occurrence of secondary cutaneous manifestations in peripheral T-cell lymphoma (PTCL) is relatively infrequent and can resemble benign dermatoses, leading to diagnosis delays. We present the case of a 78-year-old female patient with a diagnosis of PTCL affecting the left parotid gland, who experienced a 2-day sudden and intensely pruritic skin eruption, which progressed from both forearms to the trunk, involving more than 50% of the total body surface area. Initially, the eruption was managed as a hypersensitivity reaction with antihistamines and corticosteroids, with temporary symptomatic relief; however, the rapid clinical progression in the context of an established diagnosis of …

Activated Dorsomedial Hypothalamic Astrocytes Regulate Feeding Behavior, Bella M. Lisenby

Honors Projects

The dorsomedial hypothalamus (DMH) region of the brain has been shown to be important for anticipatory feeding activity and play a role in restricting excessive food intake. In obese animals that overconsume calories, astrocytes within the DMH exhibit intracellular signaling changes indicative of cellular activation. Because astrocytes are known to influence neuronal function, we hypothesize that activated astrocytes regulate behavior. In the current study, we use chemogenetics combined with stereotaxic surgery to assess the contribution of astrocyte activity in the DMH towards metabolic behaviors.

Fentanyl Mediated Distortions Of Phasic Dopamine Release Dynamics Encoding Natural Reward And Aversive Processing In The Mammalian Mesolimbic Circuit, Oliver P. Culver Iv

MUSC Theses and Dissertations

Mu opioid receptor (MOR) agonists are recognized to disinhibit tonic dopamine (DA) in the ventral striatum (VS), contributing to opioid addiction and euphoria. However, MOR agonists can also inhibit non-drug reward-seeking, and disrupt conditioned responding to aversive stimuli, a phenomenon not readily explained by tonic DA disinhibition. We hypothesized that this effect could be due in part to disruption of phasic DA responses to conditioned stimuli (CS) which critically shape and maintain behaviors during naturalistic reward and aversive processing. Because MOR effects on CS-evoked phasic DA are largely unexamined, we conducted in vivo fiber photometric recordings in water-deprived male and …

Liver Injury From Medications Used For Treating Inflammatory Bowel Disease: The Drug-Induced Liver Injury Network Experience, Harish Gopalakrishna, Jiezhun Gu, Yi-Ju Li, Huiman Barnhart, Dina Halegoua-De Marzio, Herbert L. Bonkovsky, A. Sidney Barritt, Jean P. Molleston, Naga P. Chalasani, Marwan Ghabril

Division of Gastroenterology and Hepatology Faculty Papers

BACKGROUND: We aimed to investigate and characterise DILI due to approved therapies for inflammatory bowel disease (IBD).

METHODS: Using the Drug-Induced Liver Injury Network (DILIN) prospective study, we evaluated definite, highly likely, or probable DILI attributed to IBD therapies, including use for non-IBD indications (but excluding corticosteroids). HLA allele associations were investigated.

RESULTS: Among 1806 participants, 81 (4.5%) had IBD-agent DILI: 31 biologics (27 infliximab), 35 immunomodulators (31 azathioprine/mercaptopurine), 14 aminosalicylates (11 sulfasalazine) and 1 small molecule (tofacitinib). Median age was 45 years with 75% female and 78% White. Patients with biologic-DILI were younger, had longer latency (median 124 days), …

Evaluating Outcomes Of Alternative Pathologic Terminology In High-Grade Dysplastic Colorectal Lesions, Shaman Dalal, Aakash Desai, Nahel Tunio, Jacqueline Khalil, Devereaux Sellers, Marc Landsman

Division of Gastroenterology and Hepatology Faculty Papers

Background Pathologists occasionally classify colorectal adenomas with dysplastic mucosal invasion as intramucosal carcinoma (IMC), or carcinoma in situ (CIS), instead of high-grade dysplasia (HGD), potentially leading to earlier surveillance colonoscopies and inappropriate surgical referrals. We aimed to analyze differences in the management of patients with these diagnoses, and examined the factors that may lead to inappropriate early interval (IEI) follow-up recommendations for surveillance.

Methods We reviewed 870 colonoscopy and pathology reports from 2015-2022, excluding cases of colorectal cancer, inflammatory bowel disease, and lesions not amenable to endoscopic resection. Surveillance appropriateness was defined in accordance with the 2020 US Multi Society …

A Strategy For Standardizing Stimulant And Benzodiazepine Management For Advanced Nursing Practice And Drug Safety, Michael Iheukwu Agugo

Walden Dissertations and Doctoral Studies

No abstract provided.

Nursing Students Applying Active Teaching And Learning To Develop Clinical Judgment Skills, Charlene Lindsay Jones

Walden Dissertations and Doctoral Studies

No abstract provided.

Motivation And Leadership Development Among Federal Nurse Leaders, Sarah Davis-Arnold

Walden Dissertations and Doctoral Studies

No abstract provided.

Mdds: The Road Ahead, Shelly Fava Ms, Cmp, Cae

Metro Denver Dental Society Articulator Magazine

This article outlines the Metro Denver Dental Society’s (MDDS) vision for supporting dental professionals through education, innovation and community engagement. MDDS Executive Director, Shelly Fava, highlights the organization’s commitment to addressing emerging trends in dentistry, including oral-systemic health and workforce development. It also explores how MDDS plans to strengthen member value through expanded programming, strategic partnerships and future-focused initiatives. The article provides insight into the association’s long-term priorities and its role in shaping the future of organized dentistry in Colorado.

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 …

Garlic-Derived Metabolite Activates Lkb1, Promotes Adipose Enampt Secretion, And Improves Age-Related Muscle Function Via Hypothalamic Signaling, Jun-Ichiro Suzuki, Kiyoshi Yoshioka, Masahiro Kurita, Takumi Sugimoto, Takahiro Eguchi, Naoki Ito, Aoi Kodama, Yasutomi Kamei, Masahiro Ohtani, Toshiaki Matsutomo, Shin-Ichiro Imai

2020-Current year OA Pubs

Garlic (Allium sativum L.) and its aged extract contain many bioactive compounds that can bring health benefits to humans. Among them, S-1-propenyl-L-cysteine (S1PC) has recently drawn significant attention in the field of nutriceutical research. However, the mechanism of its molecular action has remained poorly understood. Here, we show that S1PC significantly activates liver kinase B1 (LKB1) through enhancing its tertiary complex formation with STRAD and MO25, leading to stimulating the phosphorylation of a mammalian NAD

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 …

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

Reducing Cardiovascular Disease Risk In Obesity: An Unexpected But Welcome Fourier Transformation, Layla A Abushamat, Arsalan Hamid, Vijay Nambi, Huaizhu Wu, Christie M Ballantyne

Faculty, Staff and Students Publications

No abstract provided.

A Multi-Country Community Of Practice To Strengthen Quality Improvement In Low- And Middle-Income Countries: A Quality Improvement Program Description, Samhita Bhargava, Heather A Haq, Brodus A Franklin, Elizabeth Davis, Florence Anabwani-Richter, Thobile Bhembe, Lindokuhle P Dlamini, Makhosazana Dlamini, Andy Chapola, Nomsa Kafumba, Chisomo Mzandu Zinyemba, Menard Bvumbwe, Kyakuwa Richard Jjuuko, Jacqueline Balungi Kanywa, Dithan Kiragga, Andreas Boy Isaac, Esther Makhalanyane, Lwamba Nyembo, Retselisitoe Mahlaha, John T Farirai, Eunice W Ketang'enyi, Andrea E M Imsen, Iuliana Costas, Susan B Torrey

Faculty, Staff and Students Publications

Background/objectives: Quality improvement (QI) is widely used in global health to improve patient outcomes, reduce costs, and strengthen service delivery. The Texas Children's Global Health Network (TCGHN) includes nine independent non-governmental organizations supporting healthcare in low- and middle-income countries (LMICs), with pediatric HIV clinical centers of excellence in six countries in sub-Saharan Africa (SSA), supported technically by Baylor College of Medicine. We describe the development of a virtual QI Community of Practice (QICoP) to connect geographically dispersed teams and strengthen local QI capacity.

Methods: In 2022, QI and global health experts convened to design the QICoP and assess site readiness. …