Digital Commons Network^™

Radiation-Induced Biliary Strictures Leading To Recurrent Pyogenic Liver Abscesses: A Case Report, Rhea Ratan, Md, Beatriz Torre, Md, Rishi Pawa, Md

The Medicine Forum

Introduction

Radiation-induced biliary damage, including strictures, stenosis, cholangitis, and posthepatic cholestasis, is a rare complication of radiation therapy reported most frequently in the context of hepatobiliary cancers and other upper abdominal mal ignancies.^1-3 This complication often occurs with a delayed presentation, with a variable latency period ranging from months to as late as decades after treatment.^1-4 Histologic examination demonstrates segmental bile duct wall thickening, cholestasis, fibrosis, and features consistent with radiation injury.^1,5 Most reported cases involve the common bile duct and major hepatic ducts, where endoscopic and percutaneous interventions remain feasible. These are identified during surveillance imaging, …

Diet And Dysphagia: Balancing Aspiration Risk With Quality Of Life, Margot Noyelle, Md, Kenna Hawes, Md, J. Marco Cipriaso, Md, Megan Cecchine, Md

The Medicine Forum

Nil per os (NPO) diets are often prescribed for patients who have dysphagia to prevent aspiration pneumonia, but recent studies have questioned the efficacy of such strict recommendations. This case report describes the care provided to a 73-year-old woman with chronic dysphagia who described her inability to eat or drink as the “single greatest agony” of a months-long hospitalization. This report highlights the ethical challenges of determining diet orders for patients with dysphagia.

Sustainable Solutions For Food Security In Djibouti: A Renewable Energy Initiative, Michaëlle Arielle Kouakep Tsoh, Tsoh Ekassi Gilbert, Thierry Césaire Kenmogne, Brice Pinga Tcheugoué, Justin Kouamo

Revue Marocaine de Droit, d'Economie et de Gestion (Moroccan Journal of Law, Economics and Management)

According to the World Bank Group, East African countries have fragile food systems and low agricultural production. Djibouti is among the most undernourished countries in Africa and is severely affected by freshwater scarcity. Households regularly face climatic shocks and high electricity costs. This literature review characterizes Djibouti’s food systems and food security situation, identifies and analyzes renewable energy technologies implemented to improve food security in the local context, and presents renewable technologies as sustainable solutions to food insecurity. The results show that rural households are more likely to be food insecure and that the Djiboutian government promotes sustainable energy solutions. …

Serum Igf-1 And Igfbp-3 In Preschool Children With Adjudicated Sepsis: A Retrospective Case–Control Study, Wei Pan, Wenwen Zhang

Journal of Pediatric Infectious Diseases

Objective: Sepsis in children is accompanied by marked inflammatory and metabolic perturbations. Conventional markers such as C-reactive protein (CRP) and procalcitonin (PCT) reflect inflammation but do not capture broader endocrine–metabolic responses. We therefore examined serum insulin-like growth factor-1 (IGF-1) and insulin-like growth factor binding protein-3 (IGFBP-3) in preschool children with retrospectively adjudicated sepsis and explored their in-sample discriminatory ability within this dataset. This study was exploratory and was not designed to validate clinically actionable biomarkers. Methods: We conducted a retrospective case–control study of 73 children aged 4–6 years with retrospectively adjudicated sepsis and 80 age- and sex-matched healthy controls. For …

Balancing Diagnostic Accuracy And Antimicrobial Stewardship In Neonatal Sepsis, Jeslyn Tengkawan, Mmdeah Hapsari, Dimas Tri Anantyo, Helmia Farida, Adhie Nur Radityo, Moh Syarofil Anam, Seda Yilmaz Semerci

Journal of Pediatric Infectious Diseases

Objective: Neonatal sepsis continues to be a major cause of morbidity and mortality globally, particularly in developing countries. The rising rate of antimicrobial resistance underscores the urgent need for reliable, practical sepsis prediction tools to optimize antibiotic use. The Sepsis Prediction Score (SPS) integrates clinical and laboratory parameters and has shown a positive impact in simplifying clinical decision-making. This study aimed to evaluate the diagnostic accuracy of the SPS in predicting late-onset sepsis (LOS) in a tertiary referral hospital in Indonesia. Methods: This diagnostic study used a cross-sectional design and was conducted at Dr. Kariadi General Hospital, using medical records …

Late-Onset Cobalamin C Deficiency Associated Atypical Hemolytic Uremic Syndrome – Diagnostic Pitfalls: A Case Report, Martha Stampfli, Sibylle Tschumi, Giacomo Simonetti, Corinne Benchimol, Gabriela Oesch, Alexander Lämmle, Matthias Baumgartner

Journal of Child Science

Introduction: Cobalamin C (cblC) deficiency represents a rare but treatable and potentially underrecognized cause of thrombotic microangiopathy (TMA) in both pediatric and adult populations. It is a multisystem disorder with heterogeneous clinical manifestations. TMA occurs in 10-25% of affected individuals. Case presentation: A ten-year-old girl presented with vomiting and abdominal pain, followed by generalized status epilepticus and hypertensive crisis. Neuroimaging was unremarkable. Laboratory evaluation demonstrated severe renal impairment (creatinine 506 µmol/L), microangiopathic hemolysis and thrombocytopenia. Atypical hemolytic uremic syndrome (aHUS) was suspected and treated with eculizumab and intermittent hemodialysis. Genetic analysis identified biallelic pathogenic variants in the MMACHC gene, confirming …

Development Of The Toileting Habit Profile Questionnaire -2nd Revision; Assessing Sensory-Based Toileting Difficulties, Isabelle Beaudry-Bellefeuille, Eduardo Ramos-Polo

Journal of Child Science

Background: Childhood functional defecation disorders (FDD), including functional constipation and non-retentive fecal incontinence, are classified as disorders of gut–brain interaction and are increasingly recognized as a public health concern. FDD are commonly associated with challenging toileting behaviors and reduced participation in age-appropriate toileting routines, which may contribute to both the onset and maintenance of symptoms. Identifying factors underlying toileting participation difficulties is essential for effective intervention planning. Occupational therapy practitioners have developed expertise in addressing participation challenges in daily activities, including toileting, and in identifying sensory integration issues that may interfere with engagement. Aim: This paper introduces the Toileting Habit …

Physical Development Of Children Born From Adolescent Mothers: A Descriptive Evaluation Compared To World Averages, Sebahat Aydos, Aysel Köksal Akyol

Journal of Child Science

Background: Adolescent motherhood is a globally prevalent phenomenon that has been the subject of scientific research for many years. However, comprehensive scientific studies focusing on the physical development of children born to adolescent mothers remain quite limited. Objective: The aim of this study was to compare the height, weight, and head circumference development of infants and children born to adolescent mothers with the World Health Organization Multicenter Growth Reference Study (WHO MGRS) data. Methods: The study sample consisted of 2,209 infants and children born to adolescent mothers in Turkey, whose records were extracted from the Infant/Child Follow-up Data Set of …

Cultivating Narratives: A Critical Discourse Analysis Of Higher Education Student-Led Farms And Gardens, Maximilan Sherard, Marc T. Sager

Publications

Despite extensive research on community agriculture, little attention has been paid to student-led farms or gardens (SFGs) in higher education contexts. SFGs represent a unique site for community agriculture due to their diverse stakeholders, academic affiliations, and the institutional policies they navigate. This study examines online promotional materials from 42 SFGs located on land-grant higher education campuses across the United States. Using critical discourse analysis, we (1) map these organizations’ practices and (2) identify competing discourses about community and agriculture within their promotional narratives. We identify and explain four core practices (membership, growing, distribution, and purpose) and connect these practices …

When Muscle Matters: Skeletal Muscle Mass And Surgical Outcomes, Lauren G. Schumacher

Summer Interdisciplinary Research Symposium

Objective: The goal of this project was to explore the relationship between skeletal muscle mass and postoperative complications in order to evaluate how muscle-based surgical risk assessment could lead to actionable preoperative plans for adult surgical patients.

Methods: A literature review was conducted using ScienceDirect and Research Rabbit to identify studies examining skeletal muscle and surgical outcomes. Full text studies involving adult surgical patients and evaluating skeletal muscle characteristics were included, while studies involving pediatric, non-surgical populations, lacking postoperative follow-up, or published before 2020 were excluded. Five total studies consisting of meta-analyses, retrospective cohort studies, a systematic review, and a …

Accélérer Le Changement Pour Les Adolescentes D’Afrique De L’Ouest Et Du Centre Grâce À L’Autonomisation Économique, Mame Soukeye Mbaye, Sarah Engebretsen, Maty Dia, Karen Austrian

Adolescents and Young People

La série « L’avenir des filles en point de mire : données probantes d’Afrique de l’Ouest et du Centre » examine les défis auxquels font face les adolescentes de la région et met en lumière des approches éclairées par les données probantes pour améliorer leurs conditions de vie. Cette note résume les données disponibles sur l’autonomisation économique des adolescentes — revenus, moyens de subsistance, épargne, inclusion financière, capacité d’action, transition vers le monde du travail, ou l’ensemble de ces éléments — en Afrique de l’Ouest et du Centre, en s’appuyant notamment sur les données issues des pays prioritaires du GIRL …

Examining Clinical Educators’ Readiness For Artificial Intelligence In Medical Education: An Exploratory Qualitative Study, Tim Murphy, Ginger Vaughn, Rob E. Carpenter, Benjamin Mckinney, Rochell Mcwhorter

Human Resource Development Faculty Publications and Presentations

Artificial intelligence (AI), treated in this study as an umbrella term for AI-enabled clinical and educational technologies rather than as a single platform, is reshaping medical education, including how diagnostic skills, treatment planning, and patient care are taught. This study examines AI integration in medical education through the perceptions and readiness of clinical educators. Guided by the Unified Theory of Acceptance and Use of Technology, the study explores factors influencing AI adoption in medical training, including performance expectancy, effort expectancy, social influence, and facilitating conditions. In this exploratory study, semi-structured interviews were conducted with 15 clinical educators in the south-central …

Working Out Loud Resilience In Cooperative Extension: Results From An Internal Pilot Program, Lyndi M. Buckingham-Schutt, Debra Sellers, Barbara Dunn Swanson, Jody Catherine Gatewood

Journal of Human Sciences and Extension

This study evaluates Working Out Loud (WOL) Resilience, a program designed to enhance resilience through peer-to-peer learning, targeting social isolation and self-determination. The WOL Resilience pilot program, delivered by Iowa State University Extension and Outreach facilitators, included 29 participants and 5 facilitators over 8 weeks. Participants engaged in weekly sessions focusing on 8 resilience attributes. Evaluation included baseline, midpoint, and post surveys; facilitator feedback forms; and interviews. Results showed improvements in resilience attributes from baseline to post-program and indicated high program acceptability and positive behavioral changes. The peer-to-peer learning model proved beneficial for participants and feasible for delivery through Extension …

Using Needs Assessments To Hear The Voices Of Extension Non-Clients, Odunayo O. Omotilewa, Omolola A. Adedokun

Journal of Human Sciences and Extension

Using data from the University of Kentucky (UK) Extension statewide community needs assessment, this study uncovers the Extension education needs of Kentuckians who are not familiar with the Extension program. Typically, the Extension program development and evaluation model begins with a needs assessment to identify and prioritize community needs, issues, and/or opportunities that can be addressed through targeted educational programming/outreach. As such, needs assessments amplify and empower the voices of community members, especially those who may not be familiar with Extension, and uncover their self-reported need for practical education and assistance. This study investigates differences in Extension education needs between …

Evaluating The Impact Of A Community-Based Prenatal Education Program On Maternal Knowledge And Intentions In Utah, Aaron T. Hunt, Jenna Dyckman, Kaylee Cox

Journal of Human Sciences and Extension

Maternal and infant health in the U.S. has worsened, with rising rates of maternal mortality, gestational diabetes, postpartum depression, and infant mortality. Prenatal education is a proven strategy to improve outcomes, yet many expecting parents rely on unvetted information or lack access to reliable resources. To address this gap, a pilot prenatal education program was implemented through Utah State University Extension to improve knowledge, attitudes, and intentions related to breastfeeding, nutrition, mental health, and other key topics. The program consisted of 3 1-hour, evidence-based workshops incorporating lectures and interactive activities. A retrospective pre-post survey was completed by 28 pregnant participants …

Geomapping With Python: An Innovative Data Visualization Technique, Tirna Purkait, Dipti Dev

Journal of Human Sciences and Extension

No abstract provided.

A Comparison Of Regional Food Systems And Food Security In Rural Mississippi And Italy, Reinhard M. Knerr, Athan M. Gregory, Anne Cafer

Journal of Human Sciences and Extension

In the Mississippi (MS) Delta, more than 40% of residents are food-insecure despite predominantly agricultural land use. We hypothesized that limited social networks and non-navigable food market systems constrain MS producers, limit market viability, and hinder regional food sovereignty. This ethnography compared rural Italian and Mississippian food systems through semi-structured interviews of food producers, processors, and marketers. We described differences in social networks between groups that led to differential capacities to share capital and to overcome producer and labor constraints. We also described key differences in governmental and Extension support of local food systems. Finally, we provided suggestions for addressing …

Reflections On Participation In Collective Impact Initiatives: Through The Lens Of Extension Practitioners, Omolola A. Adedokun, Marian Jaitto-Jeffrey, Jacqueline Corum

Journal of Human Sciences and Extension

Collective Impact (CI) continues to gain recognition as a useful model for guiding the development, implementation, and evaluation of cross-sectoral efforts addressing complex social issues, including substance use recovery and workforce development. However, application of CI in Extension is very scant, and evaluation of its implementation, process, and outcomes remains a persistent challenge. Hence, the need for rigorous process and outcome evaluations of CI initiatives to build the literature base. Using a mix of focus group and survey methods, this process evaluation study examined Extension professionals’ experiences in two CI initiatives, with a specific focus on their perceptions of the …

Culturally Responsive Evaluation In Extension Programs For Indigenous Youth, Sara M. Tomis, J.C. Bunch, Amy Harder, T. Grady Roberts

Journal of Human Sciences and Extension

Indigenous communities, deserving and in need of salient Extension services, experience disparity in programming and culturally responsive evaluation because of historic and current social and financial barriers. An exploration of culturally responsive evaluation practices in Extension programs serving Indigenous youth audiences is warranted to identify areas for improvement. A focus group of Extension professionals was conducted to investigate evaluation practice within a federally funded Extension program. Findings indicated that Extension professionals were committed to operating and evaluating in ways that respected Indigenous culture, but improvements in culturally responsive practice are needed among both university and federal partners.

Exploring Immune Priming In The Species Exaiptasia Diaphana, Torrence Campos

Biology Theses

Vibrio coralliilyticus is a pathogen that infects various coral species across several reef ecosystems and causes mortality within a span of a few days. With increasing temperatures, the pathogen becomes more virulent towards coral. Probiotics such as MCH1-7 have previously been used to treat infected corals before and after exposure to V. coralliilyticus. In this study, we will be using a species of sea anemone Exaiptasia diaphana in place of coral to evaluate the effects of two V. coralliilyticus strains ATCC BAA-450 and OFT6-21. It was determined that BAA-450 was more virulent. It led to immediate stress and higher mortality. …

The Hope College Department Of Biology: The First 50+ Years, Christopher C. Barney

Faculty Publications

The Hope College Department of Biology was founded in 1899 with the appointment of the first Professor of Biology at Hope, Samuel Mast. During the first 50+ years of the Biology Department, there were eight total faculty members in the department, including Frances Koeman, the first female faculty member in the natural sciences. Four faculty members, Mast, Frank Patterson, Oscar Thompson, and Teunis Vergeer were primarily responsible for developing the department’s curriculum and programs, with Mast and Vergeer also carrying out published research. The department was housed primarily in Van Raalte Hall and the Science Building (now Lubbers Hall) for …

Pearson Syndrome: Expanding The Clinical Spectrum Of A Mitochondrial Cytopathy-A Case Report, Alizah Faisal, Hooria Waqas, Hania Masood, Armeen Butt, Saad Rahman, Muhammad Sheraz Hameed, Syed Rafay Hussain Zaidi, Ali Iqbal, Muhammad Usama Naveed

Department of Medicine Faculty Papers

BACKGROUND: Pearson syndrome (PS) is a rare multisystem mitochondrial disorder characterized by single large-scale mitochondrial DNA deletions (SLSMDs). It typically presents in infancy with refractory sideroblastic anemia, exocrine pancreatic insufficiency, and failure to thrive. Due to its heterogeneous manifestations and resemblance to other hematological conditions, early diagnosis remains a clinical challenge.

CASE PRESENTATION: A south asian male infant presented with persistent pancytopenia, severe anemia unresponsive to intravenous and oral iron and multivitamin supplements, exocrine pancreatic insufficiency, failure to thrive, and metabolic acidosis. Born to consanguineous parents, the child had a significant family history of early infant deaths and hematological abnormalities. …

A Holistic Christian Perspective On Wellness For College Students - A Qualitative Analysis, Shari L. Jurgens, Deb Majewski, Jessica Clevering

Movement and Being: The Journal of the Christian Society for Kinesiology, Leisure and Sports Studies

Aim: This study sought to explore the impact of a Christ-centered, holistic wellness course on college-aged students’ understanding of key wellness principles. The goal was to gain insight into how students comprehend and apply these principles considering their spiritual and personal development.

Background: Wellness education for undergraduate students is both timely and essential, especially within Christian higher education, where nurturing the whole person is a core value. A common misconception is that wellness pertains only to physical and mental health. However, Scripture affirms that human flourishing involves a harmony of body, mind, and spirit. A holistic, biblically informed approach to …

The Critical Pediatric Obesity Window: Pre-Pubertal Metabolic Disease And The Fallacy Of Delayed Intervention., Matthew Lindquist, Brooke Sweeney

Manuscripts, Articles, Book Chapters and Other Papers

Despite increasing recognition of pediatric obesity as a chronic disease, many clinicians continue to rely on "watchful waiting," assuming pubertal growth will mitigate excess weight and metabolic risk. Current evidence contradicts this approach. Children under 12 years of age with obesity frequently demonstrate clinically significant metabolic disease, including insulin resistance, dyslipidemia, dysglycemia, and metabolic dysfunction-associated steatotic liver disease (MASLD), often before symptoms emerge. Puberty does not reverse these processes; rather, physiologic pubertal insulin resistance amplifies preexisting metabolic dysfunction and accelerates disease progression. Delayed intervention allows potentially irreversible injury during a critical period of metabolic plasticity. This article reviews contemporary biologic …

Insurance Type And Menopausal Hormone Therapy Use Among Us Women, Arina Chesnokova, Sunni Mumford, Allison Schachter, Rebecca Hamm, Scott Lorch, Matthew Klebanoff, Sarah Lindley, Erika Harness, Makeba Williams, Marilyn Schapira

Student Papers, Posters & Projects

IMPORTANCE: Access to menopausal hormone therapy (MHT) in the US remains low. Understanding whether insurance type is associated with MHT underuse and racial disparities in menopausal care is critical for designing interventions that increase evidence-based and equitable menopause care.

OBJECTIVE: To examine whether Medicaid compared with private insurance is associated with lower MHT use among US women. A secondary objective explored the degree that payer type is associated with observed racial differences in MHT use.

DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study used the 2013-2014, 2015-2016, and 2017-2020 cycles of the National Health and Nutrition Examination Survey (NHANES) to identify …

Esophageal Stricture Post Congenital Tracheoesophageal Fistula Repair, Zaid A. Zaid, Momtaz Al-Nima

Iraqi Postgraduate Medical Journal

Background: It’s a narrowing of > 50% of the esophagus lumen or as a narrowing detected on a contrast study , or at esophagostomy in combination with symptomsTracheoesophageal fistula (TEF) is a relatively rare congenital anomaly occurring in one in 2500-3000 live births (3)Moreover, the life expectancy of the patients without proper treatment may be measured in weeksAim of study: evaluation of the demographics, surgical details, and postoperative outcomes of pediatric patients undergoing surgery for Tracheoesophageal Fistula (TEF) repair.Methods: The study was conducted at Pediatric Teaching Hospital/Medical City from December, 2022, to November , 2023. A total of 35 cases post …

Evaluation Of Peripheral Nerves In Patients With Acromegaly By Electrodiagnostic Study, Taiseer Saad Musa, Farqad Bader Hamdan, Abbas Mahdi Rahmah

Iraqi Postgraduate Medical Journal

Background: Acromegaly is a rare multisystem disorder caused by excess growth hormone (GH) and insulin-like growth factor 1 (IGF-1), typically from a pituitary somatotroph adenoma. Neurological complications, particularly peripheral neuropathies, are common but under-investigated.Objectives: To evaluate peripheral nerve involvement in Iraqi patients with acromegaly and assess the impact of IGF-1 levels, disease duration, adenoma size, and other clinical variables on nerve function.Methods: A cross-sectional study included 41 acromegalic patients (≥25 years) who underwent detailed neurophysiological testing. Patients were classified as metabolically controlled or uncontrolled based on IGF-1 levels.Results: IGF-1 and GH levels were significantly lower in the controlled group (p<0.001), while other clinical variables showed no significant differences. Neurophysiological findings revealed significantly reduced sensory and motor amplitudes, prolonged latencies, and slower conduction velocities in the uncontrolled group. IGF-1 levels correlated positively with sensory and motor latencies and negatively with conduction velocities and CMAP amplitudes. Larger adenoma size and presence of diabetes were also associated with worse nerve parameters. Deep X-ray therapy and surgical excision showed beneficial associations with median nerve conduction velocity.Conclusion: Peripheral nerve dysfunction, including carpal tunnel syndrome and polyneuropathy, is more severe in metabolically uncontrolled acromegaly. Macroadenomas and poor biochemical control are linked with worse neurophysiological outcomes.

Alternative Methods To Improve Livestock Performance While Grazing Low-Quality Forages., Ivan Raynard Thomas Jr

Graduate Theses and Dissertations

Stocker cattle producers in the southeastern part of the U.S. heavily depend on traditional forages such as bermudagrass [Cynodon dactylon] pastures during the warm season for grazing. Summer annual forages offer stocker cattle operations a valuable alternative source of forage. These forages have high yield potential and can help extend the grazing season. This is particularly beneficial during the summer months when traditional forage sources may be limited. Warm-season annual grasses may experience a decrease in crude protein concentrations during late summer and early fall. As a result, it may be necessary to find alternative sources of crude protein or …

Soilless Substrates As A Critical Control Point For Mitigating Food Safety Risks Within Hydroponic Leaf Lettuce Production, Eric Nuertey Tetteh

Graduate Theses and Dissertations

The effect of hydroponic soilless substrates and microbial biocontrol agents on the persistence of foodborne pathogens in indoor lettuce production is variable depending on substrate type, pathogen species, and biocontrol formulation. This study addressed key gaps by first characterizing the ability of different substrates to support Salmonella and Listeria monocytogenes survival and then evaluating the ability of pine biochar and Bacillus subtilis to suppress pathogen persistence in selected substrates under controlled conditions. In the first experiment, the persistence of Salmonella and L. monocytogenes was evaluated in four soilless substrates: rockwool (RW), low density foam (LDF), peat moss (PM) and coco …

Challenges And Opportunities In Dry Aging: Producer Perspectives And Valorization Of Dry- Aged Waste Products, Peyton Scout Arnold

Graduate Theses and Dissertations

Despite the projected increase in the dry aging market, producers may be hesitant to incorporate dry aging practices. This thesis aims to identify primary concerns faced by producers in implementing a dry aging program. Semi-structured interview surveys were conducted via Qualtrics (N = 100). Results indicated that an “advanced” level of dry aging knowledge correlated with a higher importance in the use/sale of dry aged products (P = 0.02). Cost, demand, and sourcing were the top three concerns of producers practicing dry aging. Those considering implementation were concerned with cost, processing parameters, safety, demand, and sourcing. No significant differences were …