Digital Commons Network^™

Prodromal Lewy Body Disorder Features In Rem Sleep Behavior Disorder With Biomarker-Defined Synucleinopathy, Daniel Weintraub, Michele K York, Roseanne Dobkin, Anuprita R Nair, Ryan Kurth, David-Erick Lafontant, Chelsea Caspell-Garcia, Roy N Alcalay, Ethan G Brown, Lana M Chahine, Christopher Coffey, Tatiana Foroud, Douglas Galasko, Karl Kieburtz, Kenneth Marek, Kalpana Merchant, Brit Mollenhauer, Kathleen L Poston, Andrew Siderowf, Cristina Simonet, Tanya Simuni, Caroline M Tanner, Thomas F Tropea, Aleksandar Videnovic, Parkinson's Progression Markers Initiative

Faculty, Staff and Students Publications

Objective: Isolated rapid eye movement sleep behavior disorder (iRBD) is a prodromal state for Lewy body disorders and exhibits biological heterogeneity that may influence clinical expression and progression. We examined clinical features in individuals with iRBD and biomarker-defined synucleinopathy.

Methods: Parkinson's Progression Markers Initiative (PPMI) is a longitudinal, multi-center observational study. Participants included polysomnogram (PSG)-confirmed iRBD individuals who were cerebrospinal fluid (CSF) α-synuclein seed amplification assay positive with no clinical diagnosis of Parkinson's disease or dementia with Lewy bodies, along with robust healthy controls (HCs). Clinical and biological features of prodromal PD and DLB, including mild cognitive impairment (MCI), subthreshold …

Intensive Versus Standard Blood Pressure Control After Endovascular Thrombectomy In Acute Ischemic Stroke: A Meta‐Analysis Of Randomized Controlled Trials, Tallal Mushtaq Hashmi, Mushood Ahmed, Hadiah Ashraf, Muhammad Shakir, Ibrahim Ahmad Bhatti, Faizan Ahmed, Ahmad Alareed, Ali Hasan, Gregg C. Fonarow, Ameer E. Hassan

School of Medicine Publications

Background: The optimal strategy for blood pressure management following mechanical thrombectomy for acute ischemic stroke due to large vessel occlusion remains a subject of ongoing research.

Methods: We comprehensively searched PubMed, Embase, and the Cochrane Library from inception to June 20, 2025. Randomized controlled trials comparing intensive versus standard blood pressure control following mechanical thrombectomy for acute ischemic stroke were included. The primary outcomes were excellent functional outcome (modified Rankin Scale score 0-1 at 90 days) and good functional outcome (modified Rankin Scale score 0-2 at 90 days). Pooled odds ratios (ORs) with 95% CIs were calculated using a random-effects …

Be Trauma Informed: A Pilot Evaluation Of A Podcast Intervention To Improve Trauma-Informed Care Knowledge, Attitudes, And Practices Among Pediatric Critical Care Nurses, Elizabeth Devries

Dissertations (1934 -)

Trauma-informed care (TIC) is integral to pediatric critical care (PCC) but accessible, scalable education is limited. This mixed-methods pilot study developed and evaluated Be Trauma Informed, a two-episode podcast educational series designed to increase PCC nurses’ TIC knowledge, attitudes, and trauma-informed practices while also assessing implementation outcomes of feasibility, necessity, acceptability, fidelity, safety, and beginning effectiveness. The curriculum for the podcast series was developed by the primary investigator with stakeholder input from PCC and TIC experts. The podcast was professionally produced, and episodes were distributed on major podcast platforms. Using purposive convenience sampling, PCC nurses within the United States completed …

Using Chatgpt Ai To Analyze Clinical Judgment In Immersive Virtual Reality Simulation From Prelicensure Nursing Students, Shari Ann Fehrenbach

Dissertations (1934 -)

This retrospective, descriptive study examined how clinical judgment was demonstrated across two immersive virtual reality simulation (IVRS) experiences in a cohort of Direct Entry Master of Science in Nursing (DEMSN) students using a generative large language model artificial intelligence, ChatGPT, for categorization of clinical judgment cognitive processes. The National Council of State Boards of Nursing (NCSBN) Clinical Judgment Measurement Model (CJMM) guided the study (NCSBN, 2022). Nurse expert-derived CJMM-aligned scoring rubrics were applied to deidentified, developer-generated IVRS performance reports, and ChatGPT categorized whether rubric actions were demonstrated and generated case-level, scored excel files. Total CJMM and cognitive component scores were …

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

School of Medicine Publications

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

Enhancing Inference Of Differential Gene Expression In Metatranscriptomes From Human Microbial Communities, Evan M Lee, Nathan P Mcnulty, Matthew C Hibberd, Jiye Cheng, Kazi Ahsan, Hao-Wei Chang, Barak A Cohen, Jeffrey I Gordon

2020-Current year OA Pubs

Metatranscriptomic (MTX) sequencing quantifies gene expression from the collective genomes of microbial communities (microbiomes), enabling assessment of functional activity rather than functional potential. While differential expression testing is essential for RNA-sequencing analysis, current metatranscriptomic approaches have only been benchmarked on simulated data, resulting in a lack of standard practices for analysis of real datasets. Here, we use mock communities (defined mixtures of microbial cells with known properties) to quantitatively assess robustness and susceptibility of current approaches to various confounders including organisms' low relative abundance, differential abundance, low prevalence, global transcriptional output changes, and compositional effects. We show that no current …

Using Natural Products In Patients With Cancer: More Than Chemotherapy, Gailen D. Marshall

Oxford ICSB

The fundamental goal of cancer therapy is to cure the cancer. However, the approach to that goal is complicated and varies depending upon the type and stage of the tumor as well as the clinical characteristics of the patient. Cancer treatment focused on killing the tumor has considerable comorbidities associated with each therapy. Common side effects such as systemic immunosuppression, bleeding, anemia and specific organ-based pathologies each have their own significant morbidity/mortality risk. The use of natural products, both as direct antitumor agents and as moderators/mitigators of side effects of antitumor agents has a long history. Recent studies seek to …

Application Of Aqbd Principles To Build A Robust Compendial Analytical Method For The Quantification Of Phytochemicals In Mate And Guayusa Leaf Dietary Ingredients, Maria Monagas, Salika Jeelani, Greg Winter, Natalia Kouznetsova

Oxford ICSB

Mate (Ilex paraguariensis) and Guayusa (Ilex guayusa), both members of the Aquifoliaceae family, have traditionally been consumed as herbal teas in South America. Their leaves are rich in methylxanthines and hydroxycinnamoylquinic acids—quinic acid derivatives of caffeic and gregrferulic acids—which provide stimulant and antioxidant properties. These compounds make them valuable for use in health and energy beverages as well as dietary supplements. We applied the Analytical Quality-by-Design (AQbD) approach to develop a robust UHPLC method for simultaneous quantification of methylxanthines and hydroxycinnamoylquinic acids. The method and sample preparation were designed in alignment with USP General Chapter < 1220> Analytical Procedure Life Cycle and …

Examining Racial And Ethnic Differences In Quality Of Care Between Home And In-Center Hemodialysis, Sukhman Bains

2026 Symposium

Home hemodialysis (HHD) offers improved flexibility and clinical outcomes compared to in-center hemodialysis. However, its use remains limited, particularly among racial and ethnic minority populations disproportionately affected by end-stage renal disease (ESRD). This systematic review analyzed seven retrospective cohort studies (2004–2025) to assess disparities in HHD utilization and outcomes. Minority patients were significantly less likely to initiate HHD, with adjusted odds ratios ranging from 0.45 to 0.70, while no disparities were observed within Canada’s universal healthcare system. Although HHD was associated with lower mortality, this finding is likely influenced by selection bias, as HHD patients tended to be younger and …

Optimizing Itpa R178c Assays Via Hplc, Jared J. Reisnouer, Wally D. Pines

2026 Symposium

Two of the major nucleotide bases in DNA and RNA (Adenine and Guanine) are derived from the purine Inosine Monophosphate (IMP). IMP may occasionally form the noncanonical nucleotide Inosine Triphosphate (ITP) within the cell and become incorporated into DNA during replication, leading to potentially lethal errors. To combat this, human cells produce the “housekeeping” enzyme Inosine Triphosphatase (ITPA) to revert ITP to IMP. A mutation of this protein that replaces the 178th amino acid Arginine with Cysteine (R178C) is associated with a fatal infantile encephalopathy. Previous assessments of enzyme-substrate binding and catalysis for ITPA variants have been run at a …

The Burden Of Neglect: Examining Environmental And Health Risks At Kiteezi Landfill, Uganda, Rebecca Martha Nantale, Nfn Dangpa Wandji Nana, Bright Agbotui, Maame Yaa Okrah, Emmanuel N. Clottey

Montview Journal of Research & Scholarship

The Kiteezi Landfill, located near Kampala, Uganda, exemplifies the severe environmental and health challenges arising from inadequate urban waste management. Established in 1996, the landfill was designed to handle the city's waste but has been operating beyond its capacity for years. By 2024, it had received between 1,500 and 2,000 tons of solid waste daily, far exceeding its intended limits by more than 200%. This study investigates the environmental and public health impacts of the Kiteezi Landfill in Uganda. The primary research question is: How has inadequate waste management at Kiteezi Landfill contributed to environmental degradation and public health crises? …

Transforming Patient Safety And Care Practices Through Interprofessional Education, Kaleena Ramirez, Claudia C. Tamara, Jennifer Sells, Karen Clatt, Banan Abuharb, Mary Coolbaugh-Murphy, Iris Culwell, Anca Fumurescu, Mary Gust, Lori Simmons, Delores Whiteing, Annie Koenig, Sara Martinez, Wilton Muriithi, Shaun T. Caldwell, Susan Lee, Mary Sizemore, Kimberly Ann H. Krumwiede

Advances in Cancer Education and Quality Improvement

As healthcare increasingly relies on interdisciplinary teams to deliver safe and effective care, the development of interprofessional collaboration competencies among students in health care professions has become an educational priority. In response, The University of Texas MD Anderson Cancer Center School of Health Professions integrated a longitudinal interprofessional education curriculum to foster collaborative practice readiness and prepare students for team-based interdisciplinary environments that ensure safe and patient-centered care. The curriculum was guided by the Interprofessional Education Collaborative 2016 and 2023 core competencies for interprofessional collaborative practice, reinforced with the Real Colors® Personality Instrument and Team Strategies and Tools to Enhance …

Windshield Not The Rearview Mirror, Dan Fabricant

Oxford ICSB

We talk a great deal about the past at ICSB and while the history is important, we still need to skate to where the puck is going. We’ll tee up where we are and where we are going when it comes to: drug preclusion; federal preemption; state regulatory efforts; hemp/cannabis; electronic commerce platforms; claims; essentiality; and much more, like what you can do to affect real change for the future of the industry.

Functional Genomics Of Streptococcus Mutans: Identifying Critical Genes For Oral Biofilm Formation, Cara E. Pirani

Create@State

Streptococcus mutans (S. mutans) is a pathogen found in the human oral cavity that plays a central role in the development of dental caries, or tooth decay. This pathogen thrives on the sugars consumed in the diet, contributing to the breakdown of tooth enamel, especially in the presence of poor oral hygiene. S. mutans produces a glycosyltransferase enzyme that converts sucrose into the polysaccharide glucan. Glucan allows the pathogen to attach to the enamel of the tooth and begin metabolizing the sugar on the teeth, resulting in lactic acid. The acid under the biofilm layer lowers the pH of the …

Investigating Sertraline‑Mediated Modulation Of Succinate Dehydrogenase To Sensitize Tmz‑Resistant Glioblastoma Cells, Supraja Mallapuram

Create@State

Glioblastoma (GBM) is one of the deadliest and most common brain tumor which remains highly resistant to temozolomide (TMZ), contributing to poor patient outcomes. Literature suggests that sertraline, a widely used SSRI, disrupts mitochondrial metabolism in cancer cells. Because GBM depends heavily on succinate dehydrogenase (SDH) for oxidative phosphorylation, sertraline‑mediated SDH inhibition may increase metabolic stress and reduce functional TMZ resistance. This poster presents a literature‑based rationale and proposed experimental design to evaluate sertraline‑induced SDH modulation and its potential to sensitize TMZ‑resistant T98G glioblastoma cells. These findings will guide future experimental work.

Inhibitory Effects Of Novel Compounds On Biofilm Formation In Streptococcus Mutans, Graysen S. Jones

Create@State

Inhibitory Effects of Novel Compounds on Biofilm Formation in Streptococcus mutans

Synthesizing Fluorescent 3,4-Dihydropyrimidin-2(1h)-Ones Using A One-Pot Synthesis Reaction, John R. Griggs

Create@State

In medical and pharmaceutical practices, Biginelli (3,4-dihydropyrimidin-2(1H)-ones) products have a number of potential uses due to their anticancer and anti-inflammatory properties.  In addition, they are a possible treatment for acquired immunodeficiency syndrome (AIDS). These compounds can be further modified to exhibit fluorescent properties. However, before using them in medicinal studies, it is useful to establish a procedure that can easily be modified and is synthetically accessible to allow for further optimization. The experiment was performed using the Biginelli compounds as a substrate, along with a variety of aromatic aldehydes and acids. After obtaining the products and purifying them with vacuum …

Mental Health In Healthcare Workers: Is It Just A Myth Or A Fact, Considering The Abundant Access To Healthcare, Shiwani Ranjitkar

Create@State

Healthcare workers have direct access to healthcare resources, yet many continue to experience significant mental health challenges. This study investigates the factors contributing to this issue and its implications for healthcare systems. Using data analysis and a review of recent literature, national surveys, and public health reports, key factors identified include heavy workloads, emotional strain from patient care, staffing shortages, workplace harassment, and stigma associated with seeking mental health support. Research indicates that healthcare professionals frequently experience burnout, anxiety, depression, and compassion fatigue even when support resources are available. For instance, data from the Centers for Disease Control and Prevention …

Transgenic Plant Cells For The Cost-Effective Production Of Pharmaceutical Proteins, Maria Gambaro

Create@State

Plant-based systems are becoming an important method for producing pharmaceutical proteins because they can be more cost-effective, and safer compared to traditional production methods which commonly use mammalian cells. This project aims to develop a transgenic plant cell system that can produce a pharmaceutical protein using molecular cloning techniques. A transgenic plant cell has the DNA of another plant integrated into its genome, altering its gene expression to produce different proteins. To begin, a plasmid carrying the gene of interest and the DNA components needed for expression will be designed. The plasmid will then be used to introduce the gene …

Viral Hepatitis Screening In Early Breast Cancer Patients Receiving Cancer Therapy: A Quality Improvement Initiative, Katherine Klein, Jessica Hwang, Vicente Valero, David Ramirez, Jaime Kaushik

Advances in Cancer Education and Quality Improvement

American Society of Clinical Oncology guidelines recommend screening all patients for hepatitis B virus (HBV) and hepatitis C virus (HCV) before initiation of cancer therapy. Cancer patients receiving cancer therapy represent a vulnerable population, and reactivation of undetected hepatitis virus can lead to devastating consequences. At MD Anderson Cancer Center, rates of hepatitis screening for all cancer patients have been historically low. The overall aim of this quality improvement (QI) study was to increase rates of HBV and HCV screening to at least 50% in early-stage breast cancer patients before cancer therapy in the Breast Medical Oncology clinic at MD …

Interprofessional Education Development In An Oncology-Focused Healthcare Institution, Mary Sizemore, Michael Morris, Mohamed Ait Aiss, Gregory Botz, Jolyn Taylor, Joshua Kuban, Diane C. Bodurka

Advances in Cancer Education and Quality Improvement

Background: Despite growing recognition of the value of interprofessional education (IPE), most IPE work has focused on undergraduate learners, leaving a critical gap in postgraduate and clinical environments. This report describes a phase 1, formative, pre-implementation quality improvement (QI) initiative to establish an institution-wide IPE program at an oncology center without a traditional medical school.

Methods: We used a developmental, multiphase mixed methods design integrating 3 inputs: (1) Virtual Interprofessional Teaching and Learning (VITAL) faculty-development feedback, (2) IPE Steering Committee feedback, and (3) simulation evaluation used as an applied context (not the sole focus). Surveys were administered to VITAL participants, …

Spatial Computing With The Apple Vision Pro In Minimally Invasive Procedure Simulation: A Randomized Crossover Feasibility Study, Sydney Cooper, Aaron Kyle Jones, Rahul Anil Sheth, Koustav Pal, Bruno Odisio, Mark Blaylock, Shelita Kimble, Justin Bird, David Rice, Daniel Shoenthal, Emil Patel, Vipin Kamath, Sanjay Gupta, Jeffrey Siewerdsen, Joshua Kuban

Advances in Cancer Education and Quality Improvement

Purpose: This study aimed to evaluate the feasibility of wearing the Apple Vision Pro (AVP), a mixed-reality headset that integrates augmented and virtual reality, while performing minimally invasive procedures. While studies have demonstrated that spatial computing technology can improve surgical precision and reduce the risks of surgical complications, to our knowledge, no studies have specifically addressed the impact of the AVP on task performance during simulated image-guided procedures.

Materials and Methods: Thirteen diagnostic and interventional radiology residents performed image-guided central venous catheter placement, thoracentesis, and paracentesis on simulation models. Each participant completed a non-timed practice followed by the procedures once …

Utilization Of Hybrid Angiography-Ct Suites In An Interventional Oncology Practice, David Irwin, Kiyoyuki Minamiguchi, Ryosuke Taiji, Aaron Kyle Jones, Gouthami Chintalapani, Roland Bassett, Steven Y. Huang, Sanjay Gupta

Advances in Cancer Education and Quality Improvement

Purpose: To evaluate operational trends in an interventional oncology practice at a tertiary academic center before and after the addition of hybrid angiography–computed tomography (Angio-CT) rooms.

Materials and Methods: The procedure volumes and types performed in the hybrid Angio-CT rooms were retrospectively collected from 2016 to 2020. Procedures were divided into categories, including arteriography, endovascular interventional oncology, ablation, venous intervention, non-vascular catheter placement (biliary, nephrostomy, gastrostomy, etc.), and osseous interventions. Procedural trends in the Angio-CT rooms and the frequencies of combination procedures that used both CT and angiography were assessed.

Results: A major shift of catheter-based tumor-directed cases to Angio-CT …

A Performance And Quality Improvement Intervention Integrating Molecular Testing To Support Personalized Cancer Care In Lung And Thyroid Cancers, Suzanne Murray, Monica Augustyniak, John Vu, Elbert Y. Kuo, Manolo G. Pasia Jr., Sheri L. Rivera, Kelly M. Rodriguez, Vivek Subbiah, Patrice Lazure, Ecaterina E. Dumbrava

Advances in Cancer Education and Quality Improvement

Introduction: Molecular testing has been underutilized in the diagnosis and treatment of cancer patients, despite its potential to significantly impact clinical decision-making and resulting health outcomes.

Objectives: This project aimed to evaluate the process and impact of a performance/quality improvement (PI/QI) intervention to optimize the integration of molecular testing for patients with non-small cell lung cancer (NSCLC) or thyroid cancer (TC).

Methods: Physicians, advanced practice providers, and nurses were engaged in the PI/QI at 2 cancer centers (Site A and Site B) for up to 18 months following a pre-intervention needs assessment. Gaps identified at baseline informed …

Tom: Treatment Outcome Monitor - A Web-Based Tool Designed Specifically For Clinics With Limited Resources, Saurabh Shashikumar Nair, Alba Kihn Alarcon, Maritza Elodia Cupil Barrios, Milton Estuardo Ixquiac Cabrera, Mynor Villeda, Joseph Steyn, Anneray Richards, Ricardo Ruggeri, Loida Orozco, Angel Velarde, Indranil Mallick, Graeme Lazarus, Christoph Trauernicht, Vicky De Falla, Tim Edwards, Johnny Inthaphone, Adenike Olanrewaju, Laurence E. Court, Joshua Niedzielski

Advances in Cancer Education and Quality Improvement

Background: Although three-fourths of cancer deaths are expected to occur in low- and middle-income countries (LMICs) by 2030, most cancer research still comes from high-income countries. One barrier to cancer research in LMICs is lack of infrastructure for systematic data collection, including electronic medical record systems. We developed Treatment Outcome Monitor (TOM), a cloud-based tool for tracking cancer patient outcomes, designed specifically for resource-limited settings.

Methods: TOM was developed through iterative design cycles with continuous feedback from health care providers from across the world. We focused on creating a simple, web-based solution that addresses real-world challenges in resource-limited …

A Joint Effort: Accomplishments Of The Resource Center For Cannabis And Cannabinoids Research, Patrick Still, Don Stanford, Mary Paine, Nandakumara Sarma

Oxford ICSB

No abstract provided.

Cervical Cancer Screening Among Women Across The United States, Srivathsan Vijaya Raghavan

Walden Dissertations and Doctoral Studies

While cervical cancer is not among the most frequently diagnosed cancers in the United States, it remains a significant concern due to its preventability through regular Pap smears and Human Papillomavirus (HPV) vaccination. However, incidence rates are rising as screening participation among U.S. women declines. This quantitative study (N = 15714) explored cervical cancer screening behaviors by analyzing levels of community involvement and social functioning, guided by the socioecological model (SEM). The dependent variable was cervical cancer screening, while the independent variables were community involvement and social functioning. The study controlled for health insurance status, age, race, ethnicity, employment, education, …

Enhancing Post‑Discharge Outcomes: A Quality Improvement Project To Reduce 30‑Day Readmission Rates For Patients With Schizoaffective Disorder, Samson Laryea Norteye

Walden Dissertations and Doctoral Studies

This DNP quality improvement project aimed to reduce 30-day readmission rates for patients with schizoaffective disorder (SAD) by enhancing discharge planning interventions. Using pre- and post-intervention methods, the project compared readmission rates before and after implementing interventions and gathered feedback from patients and staff to identify barriers and facilitators. The intervention bundle included patient education, participation in psychotherapy or support groups, medication reconciliation, and the use of long-acting injectables (LAIs) during hospitalization and prior to discharge. Evaluation of postintervention data revealed that none of the 10 patients in the intervention group were readmitted within 30 days, indicating a significant reduction …

From Classroom To Career: Developing A Vocational Training And Job Coaching Program For Individuals With Down Syndrome At Gigi's Playhouse, Mason Freiburger

OTD Capstone Projects

This doctoral capstone project was completed through partnership with GiGi’s Playhouse Nashville. GiGi’s Playhouse is a non-profit with 61+ locations across the United States and Mexico, that offers free educational and therapeutic programming for individuals of all ages with Down Syndrome. The primary goal of this project was to develop and implement an evidence-based vocational training program for adults with Down Syndrome to promote work readiness, independence, and community participation. A secondary focus of this project was to support skill generalization through real-world application and individualized job coaching within a community-based internship. Program development included classroom-based instruction targeting communication, executive …

Creating Engaging Activities To Improve Overall Group Participation Within Centennial Adultcare Center, Ava Woessner

OTD Capstone Projects

This doctoral capstone project was conducted in collaboration with Centennial Adultcare Center, an adult day program that is dedicated to providing a stimulating and supportive environment for personal growth and independence through professional care within a reasonable fee. The center serves a variety of diagnosis including but not limited to: dementia, cerebral palsy, intellectual and developmental disabilities (IDD), stroke, and autism. The primary objectives of this project were to develop engaging, member-focused activities through the use of graded interventions and adaptive equipment, provide staff members with effective resources, and enhance the visibility and promotion of adult day services through social …