Digital Commons Network^™

Strategies For High-Quality Community-Based Participatory Research Partnerships In Public Health Research., Emily M. D'Agostino, Rumour Piepenbrink, Lori Brand Bateman, Dana Keener Mast, Liliane Windsor, Debra Oto-Kent, Alan Wells, Jennifer Goldman, Jennifer E. Schuster, Rachel Kaufmann, Rachel Gurarie, Miriam Nuño

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: Community-Based Participatory Research (CBPR) is grounded in trusting, reciprocal, and authentic relationships. We aimed to identify key strategies and actionable next steps to establish and sustain high-quality community-academic partnerships that foster community-based health equity.

STUDY DESIGN: Qualitative thematic analysis.

METHODS: We analyzed three recorded discussions from a roundtable session with community and academic partners from the Rapid Acceleration of Diagnostics-Underserved Populations (RADx-UP) program (2020-2025), which supported 142 community-engaged public health research projects aimed at reducing COVID-19-related health inequities.

RESULTS: Key themes identified as most fundamental to support CBPR included establishing a long-term commitment, mutual co-learning among partners, flexible and …

Incidental Colorectal Adenomas In Adolescents: Clinical Management, Genetic Evaluation, And Surveillance., Brett J. Hoskins, Shlomi Cohen, Colleen B. Flahive, Isabel Rojas, Aparajita Singh, Thomas M. Attard

Manuscripts, Articles, Book Chapters and Other Papers

The rising incidence of early-onset colorectal cancer has renewed attention to colorectal adenomas in adolescents and young adults (AYA), although these lesions remain rare and poorly characterized in adolescents. Lack of age-specific guidance creates uncertainty regarding genetic evaluation, surveillance intervals, and long-term management when these lesions are identified in adolescents. This narrative review synthesizes current evidence and expert perspective on epidemiology, evaluation, endoscopic management, surveillance, genetic considerations, and psychosocial implications of incidentally identified colorectal adenomas across the AYA spectrum, with emphasis on adolescents as a distinct clinical population. Available data largely derive from adults aged 20-49 years but suggest that …

A 2-Year Randomized Trial Of Pitavastatin Calcium Vs Placebo To Treat Combined Dyslipidemia In Adolescents With Overweight And Obesity., Brian W. Mccrindle, Silva Arslanian, Michele Mietus-Snyder, Elaine M. Urbina, Adam L. Ware, Jessica E. Teng, Felicia Trachtenberg, Mark W. Russell, Amy S. Shah, Mark Cartoski, Julie A. Brothers, Christine San Giovanni, Justin P. Zachariah, Sandra Pena, William T. Mahle, Amy L. Peterson, Sheela N. Magge, Geetha Raghuveer, Binu Sharma, Valiantsina Kazlova, Craig A. Sponseller, D'Andrea Freemon, Mario Stylianou, Sarah D. De Ferranti, Pediatric Heart Network Investigators

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Combined dyslipidemia of overweight/obesity (CDO) is prevalent in youth and is associated with an increased risk of early cardiovascular disease.

OBJECTIVE: We sought to determine the impact and safety of statin therapy for CDO in adolescents.

METHODS: A double-blind, randomized trial was performed across 18 North American sites. Participants aged 10 to 19 years with body mass index ≥85th percentile and CDO defined as non-high-density lipoprotein cholesterol (non-HDL-C) ≥120 mg/dL (3.10 mmol/L) and either low HDL-C or high triglyceride:HDL-C ratio were randomized centrally to receive either pitavastatin calcium 4 mg/d or placebo for 2 years. The primary outcome was …

Early Neurodevelopmental Outcomes In Children With Congenital Heart Disease., Mike Seed, Dawn Ilardi, Valerie Rofeberg, Cynthia Ortinau, Caren Goldberg, Garrett Reichle, Lauren Bush, Justin Elhoff, Amy Jo Lisanti, Jennifer Butcher, Caitlin Rollins, Andrew Van Bergen, Shabnam Peyvandi, Emily Bucholz, Stephanie Cox, Lyla Hampton, Jacqueline Sanz, Sonia Monteiro, Shruti Tewar, Kiona Allen, Caroline Lee, Kristi Glotzbach, Nneka Alexander, Laurel Bear, Corinne Anton, Renee Sananes, Linh Ly, Gina Boucher, Kelly Wolfe, Lindsay Edwards, Elizabeth J. Willen, Alexander Tan, Christina Ortega, Erica Sood, Anjali Sadhwani, Kari Crawford Plant, Lauren Quigley, Jessica Pliego, Elizabeth Valles, Abbey Hines, David Wypij, Thomas Miller

Manuscripts, Articles, Book Chapters and Other Papers

IMPORTANCE: Neurodevelopmental impairments are common in children with congenital heart disease.

OBJECTIVES: To compare neurodevelopmental outcomes by cardiac diagnosis and identify associations between medical and social factors and early neurodevelopmental outcomes among children with congenital heart disease.

DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional analysis used neurodevelopmental follow-up data obtained between May 1, 2019, and June 30, 2022, and entered into the Cardiac Neurodevelopmental Outcome Collaborative (CNOC) registry, with linkage to the Pediatric Cardiac Critical Care Consortium registry. Children younger than 30 months from 25 CNOC sites were studied. Data analysis was performed between January 2023 and December 2024.

EXPOSURES: Patients …

Malignant Transformation Of Sacrococcygeal Teratoma Versus Presacral Teratoma In Currarino Syndrome: Results Of 'The Sct-Study'., Lieke J. Van Heurn, Joep P M Derikx, Nigel J. Hall, Amr Abdelhamid Abouzeid, Simone De Campos Vieira Abib, Lohfa B. Chirdan, Shigehisa Fumino, Seong C. Kim, Oliver Muensterer, Maricarmen Olivos, Shawn D. St Peter, Jos Twisk, Nicolas Vinit, Tianyou Yang, Augusto Zani, L W Ernst Van Heurn, Sct-Study Consortium

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: The risk of malignant transformation and recurrence of Sacrococcygeal Teratoma (SCT) is relatively high, while it is possibly lower in cases associated with Currarino Syndrome (CS). However, the existing literature gives contradictory results. We aimed to examine the risk of malignant transformation in a large cohort of SCT and CS patients.

METHODS: In a global retrospective cohort study, data of consecutive SCT patients and CS patients with presacral teratoma was obtained from 132 institutes in 62 countries. Malignant transformation, defined as malignancy at initial resection, malignant recurrence, or death due to malignancy was analysed for SCT and CS patients. …

Prevalence And Aetiology Of Cerebral Palsy Among Nigerian Children: A Systematic Review And Meta-Analysis., Udochukwu Michael Diala, Aderonke O. Uhunmwangho-Courage, Fatima Abdullahi, Paul Ikhurionan, Caitlin Bakker, Duke Appiah, David Danjuma Shwe, Rose N. Gelineau-Morel, Kabiru Gurama, Olugbenga Akinyemi Ofakunrin, Angela Mcgillivray, Gabriel E. Ofovwe, Tina Slusher

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Nigeria is among the leading countries contributing to the burden of cerebral palsy. Cerebral palsy (CP) is the commonest physical disability in childhood, accounting for 16.2% of child neurology referrals. Many cases of CP are preventable with simple interventions such as neonatal resuscitation and effective phototherapy. Lack of reliable data on the burden of disease limits comprehensive national policy directed to the prevention, holistic care and rehabilitation of patients with cerebral palsy in Nigeria. Therefore, to effectively address this problem, this study aimed to describe the pooled prevalence of CP in Nigeria, its potential causes and types.

METHODS: This …

Infection Prevention And Control Of Candida Auris In Pediatric Settings, Thomas S. Murray, Hana Hakim, Christelle Ilboudo, Lynn Ramírez-Ávila, Jana Shaw, Terri Stillwell, Patricia Budo, Bernard Ebruke, Noa Fleiss, Amanda Green, Matthew Linam, Roshni Mathew, April Mcdougal, Natalie Neu, Zoi Dorothea Pana, Karen Ravin, Ayelet Rosenthal, Jane D. Siegel, Katlyn Steimel, Amy Valencia, Carol Vance, Lars F. Westblade, Lisa Saiman

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Candida auris (also referred to as Candidozyma auris) is an emerging multidrug-resistant fungal pathogen associated with high morbidity and mortality. Existing infection prevention and control (IPC) guidance has largely focused on adult populations, with limited recommendations for pediatric healthcare and non-healthcare settings.

METHODS: The Society for Healthcare Epidemiology of America (SHEA) convened a multidisciplinary expert panel to develop IPC recommendations for C. auris. The panel developed recommendations using a structured, iterative Delphi consensus process with rounds of discussion, refinement, and anonymous electronic voting with predefined consensus thresholds. Panelists reviewed relevant peer-reviewed and gray literature integrated with expert …

Assessing Aflatoxin Knowledge, Perceptions, And Related Practices, In A Rural Coastal Community: A Population-Based Cross-Sectional Survey, Rosebella Iseme, Joseph Abuodha, Anthony Ngugi, Innocent Abayo, Mansoor Saleh

Population Health, East Africa

Background

Aflatoxin contamination is a significant yet under-addressed food safety challenge in low-resource settings, driven by a complex interplay of environmental, agricultural, and socio-economic factors. Limited access to agricultural inputs, inadequate post-harvest handling and storage, and weak regulatory enforcement alongside food scarcity and climate change heighten the risk of contamination and exposure. Human exposure is associated with serious health consequences, including hepatocellular carcinoma, immune suppression, and childhood stunting. Although aflatoxin is increasingly recognized as a global food safety concern, little is known about community-level knowledge, risk perceptions, and preventive practices. This study examined household heads’ awareness, perceptions, and behaviours related …

Satellite-Derived Longitudinal Evidence Of Flood Effects On Community Water And Sanitation Resilience In Coastal Kenya, Felix Oluoch, Rosebella Iseme, Fredrick Gudda, Alfred Keter, Rachel Odhiambo, Jai Das, Zulfiqar Bhutta, Anthony Ngugi

Population Health, East Africa

Background Flooding can disrupt water, sanitation and hygiene services in low-income rural and peri-urban settings, yet there is limited quantitative evidence on how repeated flood exposure affects safe water and sanitation over time at the level of Community Health Units (CHUs), which are the operational units for primary health care in Kenya.

Methods We analysed repeated CHU-level data from ten Community Health Units in Kilifi County, Kenya, across eleven surveillance rounds from 2017 to 2024. For each round, we calculated the percentage of households with safe drinking water and with access to a functional latrine, and linked these outcomes to …

Exploring Csf Microrna Signatures As Diagnostic Biomarkers In Adult-Type Diffuse Gliomas, Maryam Pirhoushiaran, Kamilah Walker-Charles, Tsung-Hung Yao, Satwikreddy Putluri, Nehal Patel, Daniel H Wang, Isabel Wang, Srividya Arjuna, Antonio Dono, Angel Bueno, Sophia Nguyen, Ashish P Balar, Jason T Huse, Suprateek Kundu, Yoshua Esquenazi, Chirag B Patel, Sujit S Prabhu, Frederick F Lang, Leomar Y Ballester

Faculty, Staff and Student Publications

Mutations in isocitrate dehydrogenase (IDH) genes, specifically IDH1 and IDH2, are frequently observed in diffuse gliomas (DG) and define distinct molecular subtypes, namely IDH-wildtype and IDH-mutant. Abnormal expression of extracellular vesicle-derived microRNAs (EV-miRNAs) in the cerebrospinal fluid (CSF) of DG patients may serve as minimally invasive diagnostic and prognostic biomarkers. To investigate this potential, we employed miRNA-sequencing (miRNA-seq), quantitative real-time PCR (qRT-PCR), and multivariable logistic regression (MLR) to identify differentially expressed microRNAs (DE-miRNAs) in CSF samples from DG patients. qRT-PCR analysis demonstrated that EV-miR-21-5p effectively differentiated CSF from glioblastoma (GBM) patients versus controls (p = 0.012, AUC = 0.84) and …

Nlrp3 Inflammasome: A Link Between Systemic Infection And Alzheimer’S Disease, Tatiana Barichello, Felipe Dal-Pizzol

Faculty, Staff and Student Publications

No abstract provided.

Exploring Csf Microrna Signatures As Diagnostic Biomarkers In Adult-Type Diffuse Gliomas, Maryam Pirhoushiaran, Kamilah Walker-Charles, Tsung-Hung Yao, Satwikreddy Putluri, Nehal Patel, Daniel H Wang, Isabel Wang, Srividya Arjuna, Antonio Dono, Angel Bueno, Sophia Nguyen, Ashish P Balar, Jason T Huse, Suprateek Kundu, Yoshua Esquenazi, Chirag B Patel, Sujit S Prabhu, Frederick F Lang, Leomar Y Ballester

Faculty, Staff and Student Publications

Mutations in isocitrate dehydrogenase (IDH) genes, specifically IDH1 and IDH2, are frequently observed in diffuse gliomas (DG) and define distinct molecular subtypes, namely IDH-wildtype and IDH-mutant. Abnormal expression of extracellular vesicle-derived microRNAs (EV-miRNAs) in the cerebrospinal fluid (CSF) of DG patients may serve as minimally invasive diagnostic and prognostic biomarkers. To investigate this potential, we employed miRNA-sequencing (miRNA-seq), quantitative real-time PCR (qRT-PCR), and multivariable logistic regression (MLR) to identify differentially expressed microRNAs (DE-miRNAs) in CSF samples from DG patients. qRT-PCR analysis demonstrated that EV-miR-21-5p effectively differentiated CSF from glioblastoma (GBM) patients versus controls (p = 0.012, AUC = 0.84) and …

Scaling The Production Of Bromine-76 And Bromine-77 Labeled Poly-Adp-Ribose-Polymerase-Targeted Theranostics For Preclinical Use., Taylor R Johnson, Hong Beom Lee, Yngve Guttormsen, Jason C Mixdorf, Todd E Barnhart, Jonathan W Engle, Paul A Ellison

Faculty, Staff and Student Publications

Background: Bromine-76, a positron emitting radionuclide for positron emission tomography (PET) imaging, and bromine-77, an Auger electron (Ae) emitting radionuclide, make a unique halogen theranostic pair. These isotopes have previously been used to synthesize a rucaparib-derived, poly-ADP-ribose polymerase inhibitor ([76/77Br]RD1). As [77Br]bromide activity in [76/77Br]RD1 radiosyntheses increased, coincident with solid target hardware changes in our facility, radiopharmaceutical yield became less reproducible. This work describes the modifications to this hardware, distillation procedures, and [76/77Br]bromide solution chemistry to enable reproducible production of preclinical quantities of [76/77Br]RD1.

Results: Isotopically enriched cobalt selenide targets had production yields of 50.7 ± 8.7 MBq/µAh for bromine-76 …

Full-Body Ai Agent: A Perspective On Multi-Scale Collaborative Ai For Systemic Biology And Precision Medicine., Aoqi Wang, Jiajia Liu, Jianguo Wen, Yangyang Luo, Zhiwei Fan, Liren Yang, Xi Hu, Ruihan Luo, Yankai Yu, Sophia Li, Weiling Zhao, Xiaobo Zhou

Faculty, Staff and Student Publications

Artificial intelligence (AI) is increasingly applied to biomedical research, but most current systems remain limited to specific tasks, data types, or biological scales. This makes it difficult to connect molecular alterations, organelle dysfunction, cellular behavior, tissue remodeling, organ physiology, systemic regulation, and whole-body phenotypes into coherent biological reasoning. In this Perspective, we propose the Full-Body AI Agent as a hypothetical multi-agent framework and conceptual blueprint for future systemic biology and precision medicine, rather than a fully implemented software platform. This framework envisions a supervisory Full-Body AI Agent coordinating seven biological-level agents, namely Molecule, Organelle, Cell, Tissue, Organ, Organ System, and …

Content Matters, Context Matters: Unraveling Behavior Dynamics In An Online Health Community For Tobacco Cessation, Tavleen Singh, Runzhi Zhou, Kayo Fujimoto, Sahiti Myneni

Faculty, Staff and Student Publications

Objectives: The objective of this research was to examine the content and context-specific information diffusion patterns underlying communication pertaining to tobacco use from online health communities (OHCs).

Materials and methods: We utilized a mixed-methods approach comprising multidimensional qualitative coding to identify themes and communication attributes, automated text analysis leveraging advances in large language models (LLMs) to classify message content and context, and social network analysis to examine the dynamics of peer interactions in this study. Using QuitNet, an online tobacco cessation forum (n = 64 632 members, n = 2.39 million forum messages spanning 2000-2015), we extracted message-level features …

Anti-Egfr Liposomal Drug Delivery System Loaded With Agy2 Potentiates The Anti-Cancer Effect Of Agy2 Against Egfr Expressed Pancreatic Cancer, Raviteja Bulusu, Esther Frimpong, Joy Okoro, Sunil Krishnan, Saunjoo Yoon, Bo Han, Xue Zhu, Edward Agyare

Faculty, Staff and Student Publications

Pancreatic ductal adenocarcinoma (PDAC) remains one of the most lethal malignancies worldwide due to late diagnosis, dense stromal barriers, and resistance to existing chemotherapeutics. To address these limitations, we developed a targeted liposomal delivery system that encapsulates AGY2, a newly synthesized, more potent fluoro pyrimidine nucleoside analog. In this study, epidermal growth factor receptor (EGFR) functionalized liposomal nanoparticles (EGFR-AGY2 LNPs) were optimized using Box–Behnken Design to achieve superior physicochemical stability. The optimized formulation demonstrated nanoscale dimensions (∼121 nm), high entrapment efficiency (∼75%), and strong colloidal stability. Surface antibody conjugation was confirmed by Fourier Transform Infrared Analysis (FTIR) and immunofluorescence analysis, …

Practice Patterns In Pediatric Cardiothoracic Presurgical Conferences: A Multicenter Survey Study, Britney Reed, Poonam Puranik, Andrew Rodenbarger, Mira Trivedi, Dilachew A Adebo, Gary Beasley, Louis Bezold, M Jay Campbell, Michael R Carr, Joshua Daily, Mark Debrunner, Erica Del Grippo, Carlen G Fifer, Timothy M Hoffman, Susan R Hupp, Joshua D Kurtz, Gira Morchi, Carl Owada, Renuka Peterson, Michael D Puchalski, Ryan A Romans, Arwa Saidi, Rajesh U Shenoy, Anoop K Singh, Robert D Tunks, Thomas M Yohannan, Carolyn M Wilhelm, Jyoti K Patel

Faculty, Staff and Student Publications

Pediatric cardiothoracic surgeries are high-stakes, complex procedures, typically undergoing prior review at multidisciplinary conferences. This study evaluates practice patterns of conferences throughout the United States (US). Surveys were distributed to fellowship program directors or division directors in 124 US pediatric cardiology centers seeking information on conference logistics, fellow roles, quality improvement (QI), and satisfaction. All 47 responding centers (response rate 38%) conduct presurgical conferences, mostly on a weekly basis (92%) lasting 60-120 min (79%). The conferences are solely virtual (19%) or hybrid (81%). High-volume centers (> 300 surgical cases/year) are more likely to hold multiple conferences (13/20 vs 7/27, p <  0.01) and less likely to designate a moderator (11/20 vs 22/26, p = 0.027). Categorical pediatric cardiology fellows at 33 centers present clinical data (97%), echocardiograms (85%), catheterizations (82%), and cross-sectional imaging (39%), typically beginning in their first year. Most centers report that minor (98%) or major changes (51%) are made to patient management at least "sometimes." Responders rate conferences as very important (median 10/10 on a 10-point Likert scale, IQR 9-10), but satisfaction is more modest (median 7/10, IQR 7-9). Only 17% of centers have a formal QI process. Comments from 42 centers reveal positive themes of collaboration (68%) but also concerns about lengthy (30%) or inefficient (36%) discussion. Conclusions: This survey highlights common practices for pediatric cardiothoracic presurgical conferences. Conferences are collaborative and seen as highly impactful. However, satisfaction varies, and QI efforts are infrequent. These findings highlight opportunities for process improvement and standardization.

Ldm-Morph: Latent Diffusion Model Guided Deformable Image Registration, Jiong Wu, Tinsu Pan, Kuang Gong

Faculty, Staff and Student Publications

Deformable image registration plays an essential role in various medical image tasks. Existing deep learning-based deformable registration frameworks primarily utilize convolutional neural networks (CNNs) or Transformers to learn features to predict the deformations. However, the lack of semantic information in the learned features limits the registration performance. Furthermore, the similarity metric of the loss function is often evaluated only in the pixel space, which ignores the matching of high-level anatomical features and can lead to deformation folding. To address these issues, in this work, we proposed LDM-Morph, an unsupervised deformable registration algorithm for medical image registration. LDM-Morph integrated features extracted …

Polygenic Risk Scores And Hla Class Ii Variants Are Biomarkers Of Corticosteroid Response In Childhood Nephrotic Syndrome., Tiffany Tu, Alejandro Ochoa, Amika Sood, Ashley Dabrik, Megan Chryst-Stangl, Brandon Lane, Guanghong Wu, Frank Donovan, Ursula Harper, Settara Chandrasekharappa, Christopher Esezobor, Adaobi Solarin, David Hooper, Christine Sethna, Sandra Amaral, Mahmoud Kallash, Michelle Rheault, Priya Verghese, Vikas Dharnidharka, Eloise Salmon, Patricia Weng, Tarak Srivastava, Michael E Seifert, Cozumel Pruette, David Selewski, Keisha Gibson, Tracy Hunley, Asiri Abeyagunawardena, Shenal Thalgahagoda, Arvind Bagga, Aditi Sinha, Nicholas Webb, Larry Greenbaum, Ali Gharavi, Krzysztof Kiryluk, Matthias Kretzler, Lisa Guay-Woodford, Simone Sanna-Cherchi, Agnieszka Bierzynska, Ania Koziell, Gavin Welsh, Moin Saleem, Charles Rotimi, Eileen Chambers, Cliburn Chan, Curegn Consortium, Pnrc Glomerular Disease Group, Cibmtr/Nmdp Consortium, Annette Jackson, Adebowale Adeyemo, Rasheed Gbadegesin

Manuscripts, Articles, Book Chapters and Other Papers

INTRODUCTION: Nephrotic syndrome (NS), a common glomerular disease in children, is classified based on response to corticosteroid therapy as either steroid-sensitive nephrotic syndrome (SSNS), or steroid-resistant nephrotic syndrome (SRNS). However, there are no current reliable predictors of therapy response at initial clinical presentation.

METHODS: To evaluate predictors, we conducted genome-wide association studies, developed polygenic risk scores (PRS) for therapy response and analyzed classical HLA alleles in 1,997 children (994 discovery and 1,003 replication/validation cohorts) previously unstudied children with NS and 3,558 ancestry-matched control individuals.

RESULTS: A significant association with HLA loci defined by variants in HLA-DQB1, HLA-DRB1, and HLA-DQA1 were …

Retrospective Chart Review Of Immobilized Lipase Cartridge Use In Children With Short Bowel Syndrome., Elizaveta Khenner, Jennifer Morton, Laura Green, Ashlee Yoder, Kayla Paul, Ann E. Remmers, William San Pablo

Manuscripts, Articles, Book Chapters and Other Papers

This retrospective, single-center chart review studied the use of an in-line, immobilized lipase cartridge (ILC) in children with short bowel syndrome (SBS) at Children's Mercy Hospital. For parenteral nutrition (PN)-dependent patients, the primary endpoint was enteral feeding progression, evaluated by comparing monthly change from baseline in PN and enteral nutrition (EN) after the start of ILC use. For patients with enteral autonomy, changes from baseline in growth measure z-scores were evaluated. In 9 PN-dependent patients (with Type II or III SBS), mean PN use decreased 10.6 kcal/kg/day (15.5%) and mean EN use increased by 6.0 kcal/kg/day (39.9%) after 3.8 to …

Birth-Size Reference Charts For Newborns Admitted To The Neonatal Intensive Care Units., Fu-Sheng Chou, Hung-Wen Yeh, Crystal Hsueh, Irene E. Olsen, Veeral N. Tolia, Reese H. Clark

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Our original birth-size reference charts (the Olsen charts), published in 2010 (weight, length, head circumference) and 2015 (body mass index), had limitations, including manually defined exclusion criteria and the use of completed gestational weeks. This project aimed to update the charts and address those limitations.

METHODS: We analyzed de-identified data from infants admitted to Pediatrix NICUs between 2010 and 2022. In contrast to prior work, newborns with mortality before discharge, multiple births, and congenital anomalies were included; only statistical outliers (defined as two times the interquartile range below the first quartile or above the third quartile) were excluded. Gestational …

Parent Perspectives On Neonatal Research Without Prior Consent: A Mixed-Methods Interview Study., Stephanie A. Kraft, Abigail Brickler, Abril Beretta, Rishabh Jain, Andrea Kelsh, Kaashif A. Ahmad, Justin T. Clapp, Neal W. Dickert, Rebecca A. Dorner, Katherine F. Guttmann, Anup C. Katheria, Stephanie Kukora, Benjamin A. Mooso, Elliott Mark Weiss, Fam-Connect Collaborative

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Recruitment for clinical research in the neonatal intensive care unit (NICU) is difficult, which may lead to low enrollment rates, systematically skewed samples, and nongeneralizable results. Research without prior consent (RWPC), defined as obtaining consent only after infants have been randomized to a treatment arm, may improve enrollment but raises ethical challenges. There is a need to better understand how parents with lived experience of having an infant in the NICU consider RWPC’s impact on critical ethical values related to informed consent, including decision-making, respect, and trust. This mixed-methods study aimed to describe parental perceptions of the acceptability and …

Triple Tracer Heterogeneity In Dual Neoplasia: The "Three Musketeers" In Discerning Squamous Cell Carcinoma And Paraganglioma In The Same Patient, Shyam Kumar Ravada, Gaurav Malhotra, Aaditya Daga, Anurag R Lila, Saba Memon, Tushar Bandgar

Faculty, Staff and Student Publications

Head and neck squamous cell carcinoma of unknown primary (HNSCCUP) comprises 2%-5% of head and neck squamous cell cancers (HNSCC). Its coexistence with abdominal paraganglioma is exceedingly rare. We report a unique case of a 48-year-old male with HNSCCUP presenting as cervical lymphadenopathy and a coexisting abdominal paraganglioma. 18 F-FDG showed uptake in both lesions, while 68 Ga-DOTATATE was avid only in paraganglioma, and 68 Ga-DOTA-FAPI-04 was avid only in cervical nodes. These differential uptake patterns reflect distinct tumor biology and underscore the potential for tailoring theranostic treatment strategies with 177 Lu/ 90 Y isotopes for FAPI-avid squamous cell cancers …

Oxytocin Dynamics And Synchrony In Mother-Child Dyads: Long-Term Neuroendocrine Effects Of Maternal Institutionalization, Olga V Burenkova, Ekaterina M Shurdova, Victoria Manasevich, Marina Norkina, Polina E Pashkina, Aleksei A Podturkin, Alena Vodneva, Marina A Zhukova, Elena L Grigorenko

Faculty, Staff and Student Publications

Early institutional care (IC; orphanage) is a severe form of early psychosocial deprivation with documented long-term effects on social and caregiving functioning. Despite longstanding interest in oxytocin (OT) as a key neuroendocrine modulator of affiliative behavior and stress, OT dynamics and synchrony during mother-child interaction among mothers with IC history remain poorly understood. To our knowledge, this is the first study to characterize maternal and child OT responses and dyadic OT covariation in this population. We measured salivary OT in mothers with IC history and mothers raised in biological family care (BFC), and in their children, at baseline and after …

Cerebral Palsy Detection In Neonatal Intensive Care Unit Infants, Anais Jeday, Shane Tryon, Bryanna Leary, Oleana Jacobson

Biomedical Engineering

The project is conducted in collaboration with Dr. Eric Espinoza-Wade to develop a secure, accurate wearable sensing system for infants in the Neonatal Intensive Care Unit (NICU) who have experienced asymmetric perinatal brain injury (APBI). Infants with APBI are at increased risk for developing unilateral cerebral palsy; however, clinical diagnosis is often delayed until 12–24 months of age, limiting opportunities for early intervention.

The goal of the project is to design a wearable system that securely attaches small, lightweight accelerometers to an infant’s limbs to quantify bilateral limb movement. Triaxial acceleration data will be used to detect movement asymmetries, which …

Lymph Node Dissection And Postoperative Complications After Lung Cancer Resection, Isheeta Madeka, Khaled Noueihed, Jacob Woodroof, Shale Mack, Hamza Rshaidat, Gregory L Whitehorn, Sneha Alaparthi, Scott H. Koeneman, Tyler R. Grenda, Nathaniel R. Evans, Iii, Olugbenga T. Okusanya

Department of Surgery Faculty Papers

Importance: Current lung cancer guidelines recommend lymph node sampling (LNS) with the 3 + 1 rule, which recommends station-based sampling with at least 3 N2 (mediastinal) and 1 N1 (hilar) nodal stations. Although there is oncologic benefit to rigorous LNS, potential negative impacts on surgical outcomes have not been well investigated. As adoption of the 3 + 1 rule increases given its formalization as guideline-concordant care, associations with adverse outcomes are crucial to characterize.

Objective: To evaluate whether satisfying the 3 + 1 rule is associated with increased postoperative complications.

Design, setting, and participants: This retrospective cohort study used the …

Feasibility And Acceptability Of A Mobile App And Wearable Device For Collecting Mental Health Survey And Passively Sensed Data Among Health Care Workers In Kenya: Mixed Methods Pilot Study, Linda Khakali, Andrew Aballa, Dorcas G. Mwigereri, Willie Njoroge, Rachel Maina, Amos Bunde, Peris Musitia, Moses Nyongesa, James Orwa, Jasmit Shah, Anthony Ngugi, Lukoye Atwoli, Amina Abubakar, Zul Merali

Brain and Mind Institute

Background: Mobile apps and wearable devices may help to facilitate early detection of mental health conditions by providing objective, real-time data to supplement other forms of feedback and diagnoses. Few studies have investigated the acceptability and feasibility of using a mobile app to track survey- and wearable-based data in mental health research in Sub-Saharan Africa.

Objective: This pilot study evaluated the feasibility and acceptability of using a mobile app and wearables to capture mental health–based survey data and passively sensed data among Kenyan health care workers.

Methods: A mixed methods study was conducted among health care workers …

Recurrent Upper Gastrointestinal Bleeding Due To Gastric Arteriovenous Malformation, Lavender Otom, Priyanka Panwar, Gerald Odong, Christopher Opio, Saleem Abdulkarim

Internal Medicine, East Africa

We present the case of a 45-year-old male with repeated episodes of upper gastrointestinal bleeding due to a gastric arteriovenous malformation (AVM). The case underscores the diagnostic challenges, multidisciplinary decision-making, and management considerations associated with gastrointestinal vascular malformations. Given the rarity of gastric AVMs and their potential for serious complications, this report highlights the importance of an integrated approach to diagnosis and treatment, including advanced imaging and endovascular interventions.

Increasing Efficiency And Flow In Primary Care Clinics Using Triage Protocols Based On The Donabedian Model, Verneita Mun

Doctor of Nursing Practice Projects

Purpose

This project evaluated the effectiveness of triage protocols based on the Donabedian model in increasing efficiency and flow in primary care clinics. Patients experienced extended wait times in primary care clinics, resulting in aggravated outcomes and dissatisfaction with care delivery. Healthcare providers also experienced stress and burnout due to workload and operational inadequacies. These inefficiencies mandated a quality improvement approach that addressed patient satisfaction, workflow optimization, and resource management.

Methods

This project used structured triage protocol based on the Donabedian model, which addressed the dimensions of structure, process, and outcomes. The proposed solution was disseminated through a quality improvement …

The Wake Of Addiction: Pharmacological Strategies For Sleep Disturbances In Stimulant Use Disorders, A Systematic Review, Isabella G Bourtin, Douglas J Calvillo, Jessica C Badawi, Joy M Schmitz, Scott D Lane, Jin Ho Yoon, Heather E Webber

Faculty, Staff and Student Publications

Background: A systematic review was conducted following PRISMA guidelines to identify human studies investigating pharmacological interventions and reported sleep outcomes among individuals with CUD or MUD.

Methods: PubMed and APA PsycInfo were searched from inception to January 2025 and risk of bias was assessed. Articles were included if they included human participants with either cocaine or methamphetamine dependence, administered a pharmacological treatment, and reported night-time sleep as an outcome using at least one rigorous measurement tool. Articles were excluded if they included animals, did not include pharmacological intervention (e.g., supplements or behavioral treatments), or only assessed baseline sleep or if …