Digital Commons Network^™

Hydroxocobalamin In Septic Shock Management – Should It Be Introduced Sooner?, Linh Tang Taylor, Md, Cameron Miles Long, Md, Omar Pandhair

Books, Presentations, Posters, Etc.

Introduction: Treating sepsis involves timely antibiotics, adequate fluid resuscitation, and vasopressor support if shock develops. Plasma concentrations of nitric oxide and hydrogen sulfides are elevated in early sepsis, contributing to vasoplegia,1 a pathology that isn’t addressed by vasopressors. High-dose hydroxocobalamin (vitamin B12) does, and therefore, has long been explored as a potential adjunct to vasopressors, though no consensus or official guidelines for its use have been published. Case Report: A 26-year-old man who was diagnosed with acute myeloid leukemia a few months prior presented to the emergency room for fever, weakness, and emesis. He was found to be profoundly hypotensive …

A Fatal ‘Sepsis’: Intravascular Large B-Cell Lymphoma In Disguise, Jennifer L. Wong, Do1, Jared A. Shipley, Md2, Christine Johnson, Md3

Books, Presentations, Posters, Etc.

Introduction: Intravascular large B-cell lymphoma (IVLBCL) is a rare, aggressive subtype of non-Hodgkin lymphoma characterized by selective proliferation of neoplastic cells within small vessel lumina. Cases in Western countries more commonly involve the central nervous system or skin, whereas patients in Eastern regions often present with hemophagocytic syndrome or medullary disease. The absence of lymphadenopathy, low circulating tumor burden, and subtlety of morphologic clues contribute to delays in diagnosis. By presentation, most have advanced disease, and a substantial proportion are diagnosed only at autopsy. We report a unique case with mixed features who manifested respiratory involvement and ultimately suffered cardiovascular …

Puzzling Papules: Uncovering The Etiology Of A Rash In A Returning Traveler, Lisa Stampke, Md, Shahana Baig-Lewis, Md

Books, Presentations, Posters, Etc.

Introduction: There are an estimated 1.8 billion people that travel internationally every year [1]. Approximately 22-64% of those acquire an infectious disease during or after returning home that is not endemic to their home country [1]. This is especially concerning in our current political climate and declining vaccination rates in the United States which places more patients at risk for preventable diseases [2]. These factors present a unique challenge in diagnosing and treating a symptomatic returning traveler. Case Description: A 25-year-old incompletely vaccinated male returned from Kenya after volunteering for 5-weeks in a rural hospital. He was in his usual …

Hepatic Schistosomiasis: An Unexpected Culprit Behind The Hepatic Mass, Jin Yun Do, Udip Dahal Md, Kenneth Flora, Md

Books, Presentations, Posters, Etc.

Introduction: Schistosomiasis is the second most common parasitic infection worldwide and is associated with significant morbidity and mortality. We present an unusual case of hepatic schistosomiasis presenting as a hepatic mass. Case Description: A 78-year-old male with no prior hepatobiliary disease with an incidental finding of a hepatic lesion on postoperative abdominal CT imaging after an endovascular aneurysm repair. He lived in China until immigrating to the United States over 50 years ago. Previously hospitalized for abdominal pain and diarrhea, at which time he was told he had an infection in his liver. Details of treatment are unknown. He has …

Closing The Gap: Standardizing Sepsis Management To Address Racial Disparities Across Oregon Providence Hospitals, Jennifer Wong, Do, Shelley Schoepflin Sanders, Md, Facp

Books, Presentations, Posters, Etc.

Introduction: Sepsis is a time-sensitive, life-threatening medical emergency affecting approximately 1.7 million adults annually in the United States, contributing to nearly 270,000 deaths and over $24 billion in healthcare expenditures. Delays in recognition and initiation of treatment can significantly increase mortality. Previous studies have identified persistent racial disparities in sepsis care, including lower rates of recognition as the principal diagnosis and delayed antibiotic initiation for Black patients compared with White patients. In alignment with Providence’s mission to provide compassionate, equitable care, Oregon Providence hospitals implemented a standardized “Sepsis Order Set” in all Emergency Departments (ED) to reduce treatment delays and …

Idiopathic Systemic Capillary Leak Syndrome With Shock And Compartment Syndrome Due To Influenza A, Jobe Ashby, Md, Katelyn Bobrowski, Do, Ryan Best, Md

Books, Presentations, Posters, Etc.

INTRODUCTION: Idiopathic systemic capillary leak syndrome (ISCLS) is a rare, poorly understood condition that leads to extreme pathology with severe but predictable complications. First described in 1960, ISCLS has been identified in about 260 case reports and is marked by a triad of hypotension, hypoalbuminemia, and hemoconcentration often preceded by upper respiratory tract infection. It is divided into distinct phases of prodrome, extravasation, and recovery. We present a case of a middle-aged woman who presented with influenza A infection and developed ISCLS needing ICU level care for shock and bilateral upper extremity compartment syndrome. DESCRIPTION: Our patient is a 49-year-old …

Sepsis Transitional Care Management: A Phone Call To Reduce Readmission Health Inequity, Linh Tang Taylor, Md, Erica Leser, Ms, Alyssa Nelson, Michelle Schoepflin Sanders, Md

Books, Presentations, Posters, Etc.

Introduction: Sepsis accounts for 52% of hospital admissions in the United States and is the leading cause of death among hospitalized patients1 . However, disparity exists among sepsis survivors with race being reported as a determinant of recovery2 . Such disparity exists in Providence Oregon 8 hospitals: Providence Black patients have higher sepsis readmission rates than White (12.93% vs 11.65%). Using modified community-based participatory research, data analysis, and stakeholder interviews, we identified one potential root cause of the disparity: Black patients being readmitted are not receiving our system's Transitional Care Management (TCM) services. We aim to eliminate the Black/White sepsis …

Ofatumumab Associated Legionella Pneumonia In A Young Multiple Sclerosis Patient, Jobe Ashby, Omar Panhair

Books, Presentations, Posters, Etc.

Ofatumumab is the only anti-CD20 IgG1κ human monoclonal antibody therapy for relapsing forms of multiple sclerosis (MS) that patients can self-administer subcutaneously. Anti-CD20 agents are biologic therapies that carry an increased risk of serious infections, but rarely Legionellosis. We present the case of a young man taking ofatumumab for his MS who developed Legionella pneumoniae pneumonia. A 30-year-old man with MS diagnosed two years prior, stable on ofatumumab, presented with fevers, cough, and hemoptysis. A week earlier, he developed fevers and myalgias after administering ofatumumab, but these symptoms persisted longer than usual. Though initial vital signs were normal, he appeared …

Gent-Le Dosing: Evaluating The Safety Of Gentamicin At Higher Doses For Late Preterm And Term Neonates, Jason Hector, D. Erin Wilson, Aiyana Ooki-Knutson, Jennifer Conley

Books, Presentations, Posters, Etc.

Abstract: In June 2024, Providence St Joseph Health updated the standard gentamicin dose in the Pediatric and Neonatal Aminoglycoside protocol from 4 mg/kg to 5 mg/kg every 24 hours for late preterm and term neonates. This project aims to evaluate late preterm and term neonatal patients who received gentamicin for empiric sepsis coverage within the first seven days of life, at 4 mg/kg/dose or 5 mg/kg/dose, to assess the safety of the standardized 5 mg/kg dosing for late preterm and term neonates after the protocol change. This study is a multicenter retrospective pre-/post-intervention analysis at a multistate health system spanning …

The Impact Of Covid-19 On Playwork: Five Years On, Pete King

International Journal of Playwork Practice

In 2020, at the start of the March 2020 COVID-19 lockdown in the United Kingdom, a study was undertaken with 23 participants exploring the impact this may have on playwork and playwork practice.  That project started an 18-month longitudinal study between March 2020 and September 2022.  COVID-19 was five years ago, and this final study aimed to explore the current impact on playwork and playwork practice.  In total, 8 interviews were undertaken, and the results constructed 4 main themes regarding the continuing effects of COVID-19: 1) Community Engagement, 2) Emotional Regulation, 3) Outdoors, and 4) Health and Safety.  The findings …

Perceptions Of Rural Large Animal Owners On Cost And Distance As Barriers To Veterinary Medicine, Alyssa Dalleske

Honors College Theses

Access to veterinary care remains a significant issue in rural communities due to financial, geographic, and access barriers. Limited access to veterinary care can have an impact on animal welfare and an economic impact for producers. This study aimed to assess factors influencing access to veterinary services, including cost, distance to clinics, perceived value of care, and availability of mobile veterinary professionals. The survey was distributed to rural large animal owners using social media, and gained 20 participants. It collected data on perceived barriers within their communities. The survey results indicated that cost of care and distance to veterinary clinics …

Global Research On Palm Oil Diseases And Infections: A Bibliometric Analysis, Fahmi Achmad Saputra, Indria Puti Mustika, Anna Safarida, Catur Sriherwanto, Nicky Rahmana Putra

Makara Journal of Technology

The sustainability of global palm oil production faces significant threats from a range of diseases and infections affecting palm oil crops. This study presents a comprehensive bibliometric analysis to map the scientific landscape and evolution of research related to palm oil diseases over the past decade. Using data from the Scopus database, 366 relevant documents were analyzed using R and VOSviewer to uncover trends in publication volume, citation impact, prolific authors, country contributions, and keyword co-occurrence networks. The findings reveal a strong research concentration on G. boninense, highlighting its critical role as a persistent pathogen in oil palm plantations. Emerging …

Care Among Crisis: Trauma And Building Resiliency With Wildfire Respondents, Zurisadai A. Inzunza, Monika Scherer, Maximus Balliet, Zoe Hollingsworth, Adrienne Martinez-Hollingsworth

Creating Healthy Work Environments (CHWE)

In January 2025, over 230 employees were rapidly deployed from a Federally Qualified Health Center (FQHC) system to support the medical and social needs of Eaton wildfire evacuees at the Pasadena Convention Center (PCC). Of the thousands of Pasadena and Altadena residents displaced, many of the employees were directly impacted. As environmental disasters are becoming more frequent, organizations can implement measures to reduce the psychological impact by promoting coping strategies to improve mental wellbeing for nursing professionals.^1,2

Research has shown that volunteer responders who are highly motivated report lower levels of burnout.³ There is a gap in research …

An Exploration Of Drivers Of Sepsis Outcomes In Racial And Ethnic Minority Populations, Matthew Moritz, Omar Pandhair, Shelley Schoepflin Sanders

Books, Presentations, Posters, Etc.

RATIONALE: Race and ethnicity affect sepsis outcomes in unclear ways. Existing data is conflicting, with some studies suggesting minority patients do worse, while others did not show a difference in outcomes between these groups. We sought to investigate whether inequalities exist in sepsis outcomes for different racial and ethnic groups in our large hospital system and to characterize how they may manifest. METHODS: We performed a retrospective cohort study of adults diagnosed with sepsis and discharged from any of Providence’s 52 hospitals between January 1 and December 31, 2023. We grouped patients into ten different race/ethnicity groups including White, Black, …

Capitalizing On Crisis: A Statistical Analysis Of Federal Funding And The Surge In White-Collar Criminal Activity During The Covid-19 Pandemic, Lee R. Gibson

Doctoral Dissertations and Projects

The COVID-19 pandemic ushered in a new era that has forever changed how people work, communicate, and socialize. The pandemic also brought one of the most significant influxes of financial assistance to individuals, businesses, educational institutions, and state and local governments that has ever been seen. This massive infusion of cash, which was orchestrated and managed by the federal government, was instituted in a manner that provided quick relief with little ability for oversight, resulting in every assistance program experiencing high rates of fraudulent activity. This project aims to understand if the levels of white-collar crime increase during a disaster, …

Examining The Relationship Of Telehealth Use Between Zoom Fatigue And Psychological Well-Being, And The Moderating Role Of Social Support Seeking And Work-Life Boundaries Among Remote Therapists, Angelia M. Worley

Doctoral Dissertations and Projects

During the COVID-19 pandemic, mental health therapists rapidly transitioned to telehealth services. In addition, therapists experienced a significant increase in client demand, leading to larger caseloads and longer waitlists. In the post-pandemic context, many therapists have continued to deliver services via telehealth, either fully remote or in a hybrid format. However, there is limited research on the relationship between telehealth intensity and therapist wellness. The purpose of this correlational study was to examine the relationship between telehealth intensity (duration, frequency, and burstiness) and wellness outcomes, specifically, synchronous telehealth fatigue (STF; therapist-related Zoom fatigue) and psychological well-being (PWB). Furthermore, this study …

Unmasking The Murmur: Native Pulmonic Valve Endocarditis By Streptococcus Mitis In A Patient Without Classic Risk Factors, Nathan Fletcher, Ruben Martinez, Daniel Graber, Mitali Roy

Advocate GME

Introduction: Infective endocarditis (IE) of the native pulmonic valve is exceedingly rare. Reported cases most commonly involve Staphylococcus aureus and occur in patients with intravenous (IV) drug use or congenital valvular disease.

Case Description: A 50-year-old woman with coronary artery disease and a secundum atrial septal defect (ASD) presented after one week of rigors, dyspnea, chest pain, and vomiting. Initial evaluation showed leukocytosis (14.3 K/mcL) and unremarkable vital signs. A previously undocumented high-pitched murmur was noted at the left upper sternal border. Blood cultures drawn in the emergency department grew Streptococcus species at 19 hours, and empiric IV ceftriaxone was …

Salmonella Seeding: Cavitary Pneumonia In The Setting Of Bronchopleural Fistula, Hannah Runnoe, Megan Elmes, Zachary Sedor-Schiffhauer, Essam Mekhaiel, Frances Boly, Saira Ajmal

Advocate GME

No abstract provided.

Metastatic Masquerade: A Tragic Case Of Tuberculosis Meningitis Masquerading As A Metastatic Brain Lesion Complicated By Cardiac Arrest, Hannah Runnoe, Rusheek Rawal, Rachel Morris, Radhika Huliyar, Dana Mueller

Advocate GME

No abstract provided.

Expanding The Mutation Spectrum Of Non-Syndromic Retinitis Pigmentosa In Consanguineous Pakistani Families: Unraveling Novel Pathogenic Variants In Rp1, Pde6b, And Prcd Genes For Precision Diagnosis, Tayyaba Shan, Nimra Mukhtar, Sayyed Hammad Ullah, Asad Ullah, Asfandyar Ahmad Khan, Yumei Li, Meng Wang, Raeesa Tehreem, Amtul Aziz, Kiran Afshan, Rui Chen, Sabika Firasat

Faculty, Staff and Students Publications

No abstract provided.

Drug Risk Knowledge Discovery For Western Medicines Based On Knowledge Graph Link Prediction, Jianxiang Wei, Ma Hengyuan Ma, Yuehong Sun, Wenwen Du, Letian Hu

Journal of Scientific Information Research

[Purpose/significance] The risk information contained in drug instructions is usually incomplete, and some new adverse reactions can only be discovered in actual clinical use. This paper proposes an information organization and knowledge discovery method for pharmacovigilance, in order to timely and accurately identify missing risk knowledge in drug instructions. [Method/process] Drug instructions of 8 152 Western medicines are collected as the research data; On the basis of ontology construction, data annotation, and model training, the UIE model is used to jointly extract entity and relationship triplets from the research data; A new knowledge graph link prediction method CompGCN-RotatE, is proposed, …

Progress And Perfection, Vanessa Sturz Dds

Virginia Dental Journal

No abstract provided.

Va Dent J October, November And December 2020.Pdf

Virginia Dental Journal

No abstract provided.

The Role Of The Delta Neutrophil Index In Determining The Severity Of Intrahepatic Cholestasis Of Pregnancy, Selçuk Atalay, Melike Çaltekin, Nihal Çallıoğlu, Fırat Ersan, Verda Alpay, Yasin Anasız, Ipek Geyikoğlu

Saudi Medical Journal

Objective: This study aimed to investigate the clinical utility of the delta neutrophil index (DNI) in distinguishing patients with intrahepatic cholestasis of pregnancy (ICP) from healthy pregnant women, and to assess its potential role in evaluating disease severity. Methods: This retrospective analysis included data from 249 pregnant women. Among them, 131 were identified with ICP, based on clinical symptoms and total bile acid levels ≥ 10 μ mol/L. The remaining 118 participants served as healthy controls. The ICP cases were categorized into mild (TBA 10–39 μ mol/L; n = 90) and severe (TBA ≥ 40 μ mol/L; n = 41) …

Mental Health In Relation To Parental Absence: A Systematic Review, Mohammed Barry, Abdulaziz Alyahyawi, Heba Jafar Sabbagh

Saudi Medical Journal

Objective: To evaluate the literature based on the relationship between orphaned children and mental health, compared to non-orphaned children. Mental well-being of orphaned children is a profound intricate topic that connects with broader concerns of childcare. This systematic review aims to evaluate the literature regarding the relationship between mental health and parental absence. Methods: We conducted a systematic search of PubMed, MEDLINE, and Science Direct in October 2025, with 1017 screened studies. Six studies met the inclusion criteria. Independent reviewers performed quality assessments using the Newcastle-Ottawa scale (NOS). Subsequently, a meta-analysis was performed when possible. Results: Findings indicate that orphaned …

Enhancing Anesthesia Clinicians’ Knowledge And Confidence In Prophylactic Antibiotic Selection For Patients Receiving Concomitant Therapeutic Antimicrobials, Nicholas Rangel, Michela Williams, Amber Theisen

Doctor of Nursing Practice (DNP) Student Projects

: Background and Review of Literature: Antibiotics are essential for preventing surgical site infections (SSIs), but improper selection can contribute to antimicrobial resistance, increased costs, and patient harm. Studies show that clinical decision support (CDS) tools can improve antibiotic prescribing practices using evidence-based guidelines.  Purpose: This project aimed to integrate a revised CDS tool into the workflow of a anesthesia clinicians at a midwestern academic medical center, incorporating allergy-specific guidelines and antimicrobial substitution recommendations for patients on concomitant therapeutic antimicrobials (CTA) to improve decision-making. Methods: This project used pre- and post-surveys to assess clinicians’ knowledge, confidence, and satisfaction in selecting …

Molecular Characterization And Virulence Factors Of Streptococcus Mutans Isolated From Dental Caries In Type 2 Diabetic Patients, Tiba Abed Maarij Al-Ogaidi, Shaymaa Ismael Kadhim Al-Juboori

Baghdad Science Journal

Individuals with type 2 diabetes are particularly susceptible to frequent and uncontrolled dental caries. Streptococcus mutans, a main cause of dental caries, impacts millions each year and presents significant oral health challenges. Although extensively studied, the bacterium's pathogenesis remains incompletely understood, underscoring the need for further research. This study aimed to isolate and analyze the molecular characteristics of Streptococcus mutans in patients with type 2 diabetes. It explored the bacterium's capacity to infect, survive, and endure acidic oral environments. Samples were taken from 50 individuals with both type 2 diabetes and dental caries, 50 with dental plaque, and 20 …

Isolation And Identification Of Airborne Bacteria Within The University Of Baghdad Campus, Iraq By Using 16s Rrna Gene Technique, Shahad Emad Muheisen, Israa Mohsin Jasim, Fouad K. Mashee Al-Ramahi

Baghdad Science Journal

This study aimed to identify and classify airborne bacteria in outdoor air within the campus of the University of Baghdad, Iraq, using the passive sampling technique. Air samples were collected from ten sites and analyzed by the 16S rRNA gene sequencing technique. The results revealed significant seasonal differences in both microbial and particulate matter concentrations. Bacterial concentrations were considerably higher during the wet season, with 3238.6 CFU/m³ compared to the dry season, with 1872.6 CFU/m³. PM2.5 levels averaged 47.58 μg/m³ in the wet season and declined to 11.33 μg/m³ in the dry season, while PM10 …

Achieving Healthy Upbringing Through School Design: A Case Study Of Iraqi School Buildings, Tuqa Abbas Alqari, Ibrahim Jawad Kadhim Al-Yousif, Enas Salim

Iraqi Journal of Architecture and Planning

Children worldwide face critical health challenges, including obesity, physical inactivity, poor awareness of healthy lifestyles, and the spread of infectious diseases during the school year, affecting their future well-being. Given the vital role of school buildings in children's development—by providing supportive environments that enhance physical, mental, and social well-being—the concept of "health-promoting schools" has gained research attention. This study reviews global literature to identify key design considerations and indicators for such schools, analyzing successful international models. It also examines the current state of local schools, both existing and newly constructed, along with proposed designs from the Engineering Affairs Unit of …

Incentivizing Bidirectional Ev Charging Stations, Luke Warkall

Health Matrix: The Journal of Law-Medicine

California recently enacted a law that gives the California Energy Commission authority to require that Electric Vehicles (“EVs”) sold in California be capable of bidirectional charging. A bidirectional EV is capable of sending energy stored in the EV battery to a person’s home and to the grid. Bidirectional EVs are a novel step in the right direction in the global fight against climate change. They offer a substantial and mobile power source to communities recovering from natural disasters and can offset the demand for nonrenewable energy consumption by storing solar, wind and other renewable energy, then sending that energy back …