Digital Commons Network^™

Does Exclusive Breastfeeding Duration And Quality Affect Maternal Sensitivity: Fear Vs. Normative Situations, Camila Herrera Zamora

Electronic Theses and Dissertations

The present study examined whether exclusive breastfeeding duration and perceived breastfeeding quality predict maternal sensitivity across emotionally challenging versus normative caregiving contexts in infancy. Twenty-four mother–infant dyads participated in three laboratory visits during which maternal sensitivity was assessed across interaction conditions. It was hypothesized that (1) longer breastfeeding duration would be associated with greater sensitivity during fear-inducing contexts, (2) breastfeeding duration and quality would interact to predict sensitivity, and (3) sensitivity would be higher during fear-inducing situations. Contrary to expectations, maternal sensitivity was highest in the normative/free-play condition and increased over time, peaking at 14 to 16 months. Exclusive breastfeeding …

Psychometric Properties Of A New Acculturation Scale For Latinos/Hispanics, Alicia Goytizolo

Electronic Theses and Dissertations

The current study evaluated the psychometric properties of the newly developed Multi-Ethnic Acculturation Scale (MAS), a multidimensional instrument designed to assess behavioral and cognitive aspects of cultural adaptation among Hispanic/Latino individuals in the United States. A sample of 208 adults from diverse Hispanic backgrounds completed the MAS alongside two validated acculturation measures: the Short Acculturation Scale for Hispanics and the Vancouver Index of Acculturation. Exploratory factor analyses revealed a partially distinct but moderately correlated factor structure for both American and Latino cultural orientation subscales, supporting a bidimensional conceptualization of acculturation. Internal consistency was high across both subscales (Cronbach’s α > .90), …

Anomaly Detection Of Seasonal Vessel Activity, Travis Rybicki

Theses: Doctorates and Masters

Monitoring maritime traffic is essential for ensuring the safety of vessels, safeguarding transported goods or persons, and preventing illicit or hazardous activity at sea. Increasingly, researchers have explored data-driven approaches to model expected vessel behaviour and detect deviations or anomalies. These anomalies—such as course deviations, unauthorised area entries, or unexpected operational patterns—can indicate emergencies, regulatory breaches, or unlawful intent. Data broadcast by vessels provides a valuable resource for such analyses; however, the inherent complexity and context-dependency of maritime behaviour present persistent modelling challenges. One critical yet underutilised factor in this context is seasonality. For certain vessel types, for example, fishing …

Shaping Pakistan's Future, Sdsb 360 Magazine

Faculty Research - Newspaper and Magazine Articles

SDSB 360 is in conversation with Dr. Ishrat Husain, an influential Pakistani banker, economist, and reformer whose leadership has shaped Pakistan’s financial landscape. From steering the State Bank of Pakistan (1999–2006) to driving educational excellence as Dean of IBA Karachi (2008–2016) and championing institutional reforms as Advisor to the Prime Minister (2018–2022), Dr. Husain’s career is a testament to visionary leadership and a relentless pursuit of progress.

A Real Fish Story On Christmas, Manuel F. Medrano

History Faculty Publications

No abstract provided.

Prophylactic Use Of Lipid Emulsion Therapy After Inadvertent Administration Of 0.5% Ropivacaine For A Bier Block: A Case Report., Alexander Luong, Sirimas Lau, Elizabeth Johnson-Gray, Rayyan Bhutta, Austin Shaffer, Mitchell Hughes, Andrew Gable, Matthias Franzen

Surgery Articles

The Bier block for intravenous regional anesthesia is generally well tolerated, and few complications have been reported. It provides a bloodless surgical field and adequate analgesia when performed correctly. A diluted short-acting local anesthetic such as 0.5% lidocaine is typically used. Our case is a 41-year-old female who presented for endoscopic carpal tunnel release of her right wrist. An accidental injection of 30 mL of 0.5% ropivacaine was given instead of the normal 30 mL of 0.5% lidocaine, with a total tourniquet time of 46 min. Although the maximum safe dose of local anesthetic was not exceeded, lipid emulsion was …

Addressing The Prescribing Patterns And Environmental Impact Of Dry Powder Inhalers (Dpi) Versus Metered Dose Inhalers (Mdi), Abby Lindseth, Md, Claudia Leonard, Shelley Schoepflin Sanders

Abstracts, Posters, Presentations

No abstract provided.

The Reliability Gap: How Traditional Search Engines Outperform Artificial Intelligence (Ai) Chatbots In Rosacea Public Health Information Quality, Houston C. Nelson, Morgan T. Beauchamp, April A. Pace

Department of Medicine Faculty Publications

Background: The internet has become a primary source of health information for the public, with important implications for patient decision-making and public health outcomes. However, the quality and readability of this content vary widely. With the rise of generative artificial intelligence (AI) tools such as ChatGPT and Gemini, new challenges and opportunities have emerged in how patients access and interpret medical information.

Objective: To evaluate and compare the quality, credibility, and readability of consumer health information provided by traditional search engines (Google, Bing) and generative AI platforms (ChatGPT, Gemini) using three validated instruments: DISCERN, JAMA Benchmark Criteria, and Flesch-Kincaid Readability …

Oral Microbiome And Inflammatory Bowel Disease: New Understanding And Call To Action, Michael Saadeh, Sydney Donohue, Shaina Ailawadi, Gordon Hong, David A. Johnson

Department of Medicine Faculty Publications

The oral microbiome is the second largest microbial community in the human body after the gut microbiome. It includes an array of fungi, bacteria, amoebae, flagellates, archaea, and viruses, all of which are potential pathogens. This microbiome can act as a facilitator not only for protection but also for aggravation when dysbiosis occurs. Although conventional thought is this is primarily in terms of oral health issues, such as dental caries and gingival disease. The systemic effects of the oral microbiome however, are relevant to both gastrointestinal (GI) disease and non-GI disease. These systemic risks occur for several reasons, including upregulation …

Association Between Neighborhood-Level Social Vulnerability And Hypertension Outcomes, John E. Brush Jr., Chungsoo Kim, Yuntian Liu, Xin Xin, Chenxi Huang, Iris J. Lundy, Jordan R. Asher, Mitsuaki Sawano, Patrick Young, Jacob Mcpadden, Mark Anderson, John S. Burrows, Harlan M. Krumholz, Yuan Lu

Department of Medicine Faculty Publications

Background

Neighborhood-level social vulnerability is associated with hypertension prevalence and severity and with cardiovascular complications in conditions other than hypertension, but its association with cardiovascular complications in patients with hypertension is understudied.

Objectives

The aim of the study was to examine how the neighborhood-level social vulnerability index (SVI) influences cardiovascular outcomes in a large, diverse cohort of patients with hypertension.

Methods

We used electronic health data to examine the association between census tract-level rankings for the SVI with a composite endpoint of incident myocardial infarction, congestive heart failure, or stroke.

Results

In a longitudinal cohort of 330,972 patients with hypertension …

Percutaneous Levoatrial Cardinal Vein Closure For Stroke Prevention, Chee Spencer, Amir Hasani, Alexander Ellis, David Adler

Department of Medicine Faculty Publications

We report 2 cases of cerebral embolism related to congenital levoatrial cardinal vein anomalies. Both patients had positive echocardiographic agitated saline studies but intact interatrial septum on transesophageal echocardiography. Levoatrial cardinal vein was diagnosed using computed tomography angiography. A novel technique for percutaneous levoatrial cardinal vein closure using vascular plug devices was successful in both patients.

A Linear Presentation Of Cutaneous Rosai Dorfman Disease, Emily Sheetz, Ryan C. Saal, Molly K. Smith, Rachel Chikowski Byrd

Department of Medicine Faculty Publications

[Case description] A 53-year-old female with type II diabetes and hypertension presented to the dermatology clinic with a 3-month history of an asymptomatic linear eruption along the right knee that extended distally along the shin. Initial biopsy showed an atypical lymphohistiocytic infiltrate (Fig 1), which was found to be polyclonal. At her 3-month follow up visit, the eruption demonstrated significant clinical progression with numerous indurated papules and papulonodules, some of which were tender, along the right knee and pretibial surface (Fig 2). No improvement was noted with topical triamcinolone prescribed at her initial visit.

Psychedelic Minimalism: The Case Against Music In Psychedelic Therapy Settings, Samir A. Nader

Department of Medicine Faculty Publications

[Introduction: reframing the role of setting] In recent years, renewed attention has been given to the centrality of set and setting in psychedelic-assisted therapy. The Reporting of Setting in Psychedelic Clinical Trials (ReSPCT) guidelines reflect an evolving consensus: therapeutic outcomes are not solely pharmacologically determined but are heavily shaped by both the environment and the psychological state of the participant (2). Within this evolving paradigm, music has assumed a privileged role, framed as a therapeutic constant, typically curated to be emotionally supportive or evocative, and especially emphasized during peak psychedelic states (3). The prevailing assumption is that music facilitates safety, …

Late Diagnosis Of Klinefelter Syndrome: Overcoming Phenotypic Variability And Diagnostic Oversights, Amna Kamran, Chinelo Okigbo

Department of Medicine Faculty Publications

We report a case of Klinefelter syndrome (KS) diagnosed in adulthood, emphasizing the impact of phenotypic variability and the declining reliance on physical examination in delayed recognition. A 27-year-old male with obesity, low libido, and biochemical and clinical primary hypogonadism was found to have 47, XXY karyotype, consistent with KS. His hypogonadism was initially attributed to obesity and overlooked, despite classic signs of a micropenis and small testes. The case highlights the importance of physical examination, comprehensive history, and clinician awareness in diagnosing KS, particularly in atypical presentations. KS is associated with increased risks of osteoporosis, cardiovascular disease, and psychosocial …

Her2 Alterations Across Solid Tumors: Implications For Comprehensive Testing, Ahmed Ismail, Chimay Jani, Nusrat Jahan, Malla Midhun, Arnab Basu, Garima Gupta, Bassel El-Rayes, Sejong Bae, Tyler Mattox, Cyntanna Hawkins, Rebecca C. Arend, Mehmet Akce, Yanis Boumber, Aakash Desai

Department of Medicine Faculty Publications

Purpose

ERBB2 (HER2) alterations (e.g., overexpression, amplification, and mutations) are known to drive tumor progression. These changes, particularly in non-breast and gastric/gastroesophageal cancers, remain poorly characterized. With pan-tumor approval of HER2-targeted therapies like Trastuzumab deruxetecan (T-DXd), understanding ERBB2 alterations across diverse cancers is crucial.

Methods

HER2 analysis was conducted on 653 solid tumor specimens at the University of Alabama, using immunohistochemistry (IHC), copy number (CN) variation (CNV) assessment, and mutational profiling. The correlation between CN amplification and IHC expression was evaluated using Somers' D ordinal association.

Results

Of the 653 cases, HER2 IHC scores were distributed as 3 + (3.1%), …

Medical Students' Attitudes Towards Research Participation After The United States Medical Licensing Examination Step 1 Scoring Change, Danxun Li, Nina Li, Curt Bay, Uzoma Ikonne

Department of Medicine Faculty Publications

Background

The recent transition of scoring for the United States Medical Licensing Examination (USMLE) Step 1 exam from a numerical grading system to pass/fail system has significant implications for residency applicants. It is anticipated that research productivity will gain greater importance in the evaluation process. To understand how medical institutions can best support students, we seek to understand medical students' motivations and experience conducting research in medical school after the USMLE Step 1 scoring change.

Methods

This is a mixed-methods, cross-sectional study that examines the motivations and barriers that medical students face in conducting academic or clinical research. A survey …

A Novel D-Peptide Modulates Dclk1 Gelsolin Interactions, Reducing Pdac Tumor Growth, Landon L. Moore, Dongfeng Qu, Parthasarathy Chandrekesan, Kamille Pitts, Randal May, Byron E. Anderson, Milton L. Brown, Courtney W. Houchen

Department of Medicine Faculty Publications

What drives inflammation-associated tumorigenesis and progression in pancreatic ductal adenocarcinoma (PDAC)? Doublecortin-like kinase 1 (DCLK1) is a central driver of inflammation-associated tumorigenesis, with elevated expression linked to worse clinical outcomes. Two isoforms of DCLK1 possess a unique extracellular domain (ECD). DCLK1 isoform 2 contains two microtubule-binding domains, while isoform 4, lacks the microtubule-binding domains but, plays a pivotal role in tumor progression. We identified novel D-peptides that selectively target this ECD, significantly suppressing PDAC cell proliferation in vitro and tumor growth in xenograft models without inducing cell death. In silico modeling and binding assays revealed DCLK1 isoform 4 interacts with …

Screening And Addressing Food Insecurity At Free Clinics: A Scoping Review, Gautam Ramanathan, William Zak, Daiwik Munjwani, Robert Fisher, Esther May Sarino, Mary J. Scourboutakos

Department of Medicine Faculty Publications

Food insecurity (FI) is highly prevalent amongst patients seeking care at free, student-run health clinics. This study sought to examine the existing literature of food insecurity screenings and interventions at free clinics across the U.S. In this review, we provide the rate of FI screenings, the prevalence of FI, demographic information of patients screened, and interventions and barriers faced by clinics while implementing interventions to improve FI. Studies included in this review needed to implement a FI screening and intervention program in a free clinic within the United States. Additionally, eligible studies could address additional social determinants of health or …

Discordance Between Profound Hyperprolactinemia And Hormone Immunostaining In A Pit1-Positive Pituitary Neuroendocrine Tumor. A Rare Case Report, Aneela Arif, Radwa Osman

Department of Medicine Faculty Publications

We present a rare case of a functioning macroprolactinoma with negative hormone immunohistochemistry (IHC) but positive PIT1 transcription factor staining. This case highlights the diagnostic value of transcription factor IHC when clinical and biochemical findings are discordant with hormone staining. An 18-year-old female with unremarkable medical history presented with high prolactin levels, galactorrhea, and amenorrhea for 6 months. She was not on any medications, and was not sexually active, or trying to conceive. Prolactin levels were markedly elevated (462, 1,067, and 1,282 ng/mL). MRI showed a 13×12×14 mm T2-hyperintense, slightly cystic pituitary macroadenoma with suprasellar extension and optic chiasm compression, …

Role Of Device Therapy In Complementing Contemporary Medical Management, Yoel Benarroch, Natalie Tapaskar, Amin Yehya

Department of Medicine Faculty Publications

Heart failure (HF) is a clinical syndrome characterized by signs and symptoms resulting from any structural or functional deficiency of ventricular filling or blood ejection. The mainstay of initial treatment remains lifestyle modifications, guideline-directed medical therapy, and addressing contributing factors. However, the past two decades have come with significant advances in device therapies to improve morbidity and mortality in HF despite evidence-based management as above. Given the rapidly evolving area of HF research and therapeutic development, it is important for clinicians to be familiar with novel therapies and how they can complement medical management. In this review we discuss the …

Blood Culture Utilization: How Many Follow-Up Cultures Are Needed?, George Jones, Jennifer Hanrahan

Department of Medicine Faculty Publications

Background: Follow-up blood cultures (BCx) are ordered after an initial positive culture in many instances. The number of follow-up cultures needed is not clear. Obtaining unnecessary BCx may cause unintended consequences. The optimal balance between stewardship and patient safety warrants investigation. We sought to assess the frequency with which a third set is positive after a negative second BCx. Methods: We conducted a retrospective study of BCx submitted to the microbiology laboratory from 1/1/18-11/1/23. We included all patients ≥18 years who had at least two follow-up BCx drawn 24-72 hours after an initial positive culture. Data were collected from electronic …

A Case Displaying The Importance Of Jak1 And Jak2 Gene Transcription In Antifungal Defense Against Coccidioidomycosis, Jennifer K. Priessnitz, Taylor Colore, Nelson Nicolasora

Department of Medicine Faculty Publications

This case report explores the consequences of ruxolitinib via inhibition janus kinase 1 (JAK1) and JAK2 pathways in the context of fungal defense in a patient diagnosed with pulmonary coccidioidomycosis during ruxolitinib therapy for polycythemia vera. The patient experienced a relapse of pulmonary coccidioidomycosis after antifungal treatment was discontinued while continuing ruxolitinib use. This case illustrates the heightened risk of discontinuing antifungal therapy in endemic regions, emphasizing the critical need for continued monitoring. Furthermore, this case underscores the vital role of the JAK1 and JAK2 signaling cascade, particularly the interferon-gamma (INF-γ)-JAK1 and JAK2-signal transducer and activator of transcription 1 (STAT) …

Percutaneous Closure Of A Left Ventricular Pseudoaneurysm Using A Post-Infarct Vsd Device Guided By Intracardiac Echocardiography, Omar Jafar, Nicholas Valle, Rupinder Bahniwal, Matthew Summers

Department of Medicine Faculty Publications

Left ventricular pseudoaneurysm (LVPA) is a rare, life-threatening complication that may arise after cardiac surgery, myocardial infarctions, or infective endocarditis. We present a case of a 55-year-old woman with complex surgical history and prior infective endocarditis who developed an incidental LVPA. Due to lack of surgical repair options, a percutaneous approach was pursued using a post-infarct ventricular septal defect device (PIVSD) under guidance of fluoroscopy and intracardiac echocardiography (ICE) guidance with successful exclusion of LVPA. This case highlights the utility of multimodal imaging in the percutaneous management of complex left ventricular lesions.

Exploring The Role Of 5-Hydroxymethyl-2-Furfural And Sumiki's Acid In Beta-Cell Metabolism, Daiwik Munjwani, Demitrius Hill, David Regan, David Lee, Mike Muehlbauer, Hans-Ewald Hohmeier, Mette Jensen, Neolle E. Younge, James Bain

Department of Medicine Faculty Publications

Type 1 diabetes (T1D), a leading cause of mortality in the United States, is associated with heart disease, nephropathy, neuropathy, retinopathy, and stroke. While management of T1D with medications and healthy lifestyle choices is critical, recent research highlights the contributory role of environmental diabetogens in the pathogenesis of T1D. Here, we propose that the furan compound, 5-hydroxymethyl-2-furfural (HMF), which forms when hexoses such as glucose or fructose lose three water molecules during thermal food processing, might be an unrecognized dietary diabetogen. HMF is a suspected mutagen and carcinogen. In a previous experiment in the rat 832/13 beta-cell line, when cultures …

Sarcoidosis With Isolated Osseous Manifestations Mimicking Metastatic Malignancy, Ahmed Ismail, Ahmed Saleh, Yanis Boumber

Department of Medicine Faculty Publications

Sarcoidosis is an inflammatory disease of unknown etiology that commonly involves multiple organ systems, with the lungs and lymph nodes most frequently affected. Osseous involvement, although recognized, is considered uncommon and often overlooked due to its nonspecific clinical and radiographic features. Patients may be asymptomatic or present with pain, swelling, and functional limitations of the affected limb. Imaging can reveal findings such as bone lesions that mimic malignancy, including lytic or sclerotic changes. Diagnosis relies on histopathological confirmation of non-caseating granulomas. Treatment is directed at symptom relief and preservation of limb function. Here, we present a rare case of isolated …

Age-Group Differences In Friend Influence Over Academic Achievement And Physical Activity, Laury-Ann Bedard Leclerc

Electronic Theses and Dissertations

Speculation about the developmental shifts in the magnitude of peer influence has outstripped empirical research. Friends are assumed to be particularly influential at the onset of adolescence, as adult oversight declines and the salience of peers increases. Few studies, however, have explored age-group differences in the magnitude of friend influence over academic achievement and physical activity. The present longitudinal study compares friendship dyads in late childhood (grades 4-5) versus early adolescence (grades 6-7), describing the strength of their mutual influence across peer- and self-reports of academic achievement and physical activity. Participants included 170 adolescents (99 girls, 71 boys) in 85 …

Oral Anticoagulation Versus No Anticoagulation After Spontaneous Intracranial Hemorrhage In Patients With Atrial Fibrillation: A Systematic Review And Meta-Analysis Of Randomized Controlled Trials, Prathik Saravanan, Vaibhav Vats, Abouchita Rimane, Shrishti Agarwal, Srinidhi Kondepudi, Mathew Reji, Batoul Taqi, Naser Ashraf Tadvi, Preeti Elizabeth Jossy, Anjana Kumaram Kunnel Sabu, Asma's Munasar Ali Alsubari, Ranjit Sah, Hira Sarfraz, Muhammad Usman Khan, Abdullah Wahab Arif

Department of Medicine Faculty Publications

The decision to resume oral anticoagulation (OAC) in patients with atrial fibrillation (AF) after an intracranial hemorrhage (ICH) remains a significant clinical challenge due to competing risks of ischemic stroke and recurrent bleeding. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing long-term OAC with no OAC in patients with AF following an ICH. We searched MEDLINE, Embase, CENTRAL, and ClinicalTrials.gov through September 2025. The primary outcomes were ischemic stroke and ICH. Secondary outcomes included major adverse cardiovascular events (MACE), major bleeding, cardiovascular mortality, and all-cause mortality. Risk ratios (RRs) with 95% confidence intervals (CIs) were …

The Impact Of College And Career Student Success Curriculum And Xello On High School Students’ Self-Efficacy, Academic Motivation, And Academic Performance, Rosemyrtle J. Louis

Electronic Theses and Dissertations

The study aimed to determine whether the school counselor-led CCSS program (Brigman & Villares, 2015), a curriculum designed to foster cognitive and social-emotional skills, combined with the technological college and career exploration platform, Xello (2019), enhances participating students’ self-efficacy, academic motivation, and academic performance. The CCSS and Xello program consisted of five 45-minute lessons delivered in the classroom by school counselors once a week for five weeks. A quasi-experimental design was utilized with 115 high school students from Southeast Florida assigned to either a treatment group (n = 71) or a control group (n = 44). Pretest and …

Covid-19, Business Resilience, And Government Contracting: Did The Paycheck Protection Program (Ppp) Impact The Disaster Resilience Of Small Disadvantaged Businesses After Covid-19? The Case Of Government Contracting In The United States., Jean-Claude M. Ndongo

Electronic Theses and Dissertations

This dissertation examines the disaster resilience of disadvantaged small businesses that have engaged in contracting activities with the U.S. federal government from 2018 to 2023. Federal government agencies procure goods and services from small businesses in the private sector through contracts that allow those businesses to be competitive in the market and overcome the impact of disasters on their activities. The notion of disaster resilience has traditionally focused on natural hazards like wildfires, earthquakes, tornadoes, or hurricanes; however, lately, it has been increasingly applied to diverse contexts. Business resilience to disasters refers to businesses' ability to return to their pre-disaster …

Fibrinolysis For Apical Thrombus As A Bridge To Emergent Valve-In-Valve Transcatheter Aortic Valve Replacement, Nicholas J. Valle, Omar A. Saleh, Mani C. Akunuri, Parth K. Parikh, Joshua A. Cohen, Deepak R. Talreja, Matthew R. Summers

Department of Medicine Faculty Publications

Background

Left ventricular (LV) thrombus is traditionally a contraindication to transcatheter aortic valve replacement due to embolic risk. Consequently, management of valvular cardiogenic shock complicated by LV thrombus identifies unique challenges that require innovative strategies.

Case Summary

A 58-year-old woman with critical bioprosthetic aortic stenosis, cardiogenic shock, and large LV thrombus (2.8 × 2.6 cm) underwent successful valve-in-valve transcatheter aortic valve replacement after systemic fibrinolysis bridge therapy.

Why Beyond the Guidelines

Current guidelines contraindicate transcatheter aortic valve replacement in patients with LV thrombus. This case demonstrates the novel use of low-dose, slow infusion tissue plasminogen activator as a bridge therapy …