Medicine and Health Sciences Commons^™

What Next? A Challenging Case Of Refractory Hypertension With End-Organ Dysfunction In A 33-Year-Old Male, Rezane Miftari Md, Shaun Abid, Anton Stolear, Irma Fotjhadi

Posters

We present a challenging case of a 33-year-old male with history of longstanding hypertension since high school, which progressed to RH complicated by severe left ventricular hypertrophy and hypertensive nephrosclerosis.

Toward A Unified Neuroaesthetic Framework For Art-Based Interventions In Substance Use Recovery - A Review, Piper Hutson, James Hutson

Faculty Scholarship

Art-based interventions have gained increasing recognition as complementary strategies for substance use disorder (SUD) recovery and prevention, yet the field remains fragmented across clinical art therapy, community-based programs, and expressive digital practices. This article advances a unified neuroaesthetic framework that integrates sensory regulation, narrative integration, and interpersonal synchronization as the core mechanisms of healing. Drawing on recent U.S.-based empirical studies (post-2020), the paper synthesizes evidence from multiple modalities, including visual arts, music therapy, dance/movement practices, and digital storytelling, each demonstrating measurable effects on craving reduction, stress regulation, identity reconstruction, and social connection. Neuroscientific insights are central: findings highlight how creative …

Gaming As Therapeutic Modality For Military Veterans: Evidence, Mechanisms, And Program Design, Piper Hutson, James Hutson

Faculty Scholarship

This study synthesizes interdisciplinary evidence on game-based interventions for military veterans, mapping neurological mechanisms to clinically relevant outcomes while outlining design principles for community programs that leverage interactive media. The review characterizes how structured gameplay supports emotional regulation through attentional control, predictable feedback schedules, and reward-mediated learning that elevates motivation and mood; links to dopaminergic signaling and reduced rumination suggest plausible pathways for affective stabilization. Executive functions receive targeted engagement via strategy, puzzle, and action mechanics that demand working memory, cognitive flexibility, inhibition, and rapid decision-making, providing ecologically valid practice with measurable transfer to daily functioning. Social architectures in multiplayer …

Secondhand Smoke Exposure Among United States Children With Functional Disabilities: National Health And Nutrition Examination Survey, 2021–2023, Raed A. Bahelah

Population Health Science Publications

Objective

Methods

Results

The Question Of Textbooks In Academic Libraries: To Purchase Or Not? A Scoping Review, Jeanette Aprile, Danielle Aloia, Deborah A. Crooke, Marie T. Ascher

NYMC Faculty Publications

Objectives: Textbook costs have escalated for students and the library. The objective of this scoping review is to assist libraries in developing a collection policy for course-required textbooks informed by themes and outcomes recognized in the existing body of research.

Methods: The scoping review was conducted using Arksey and O’Malley’s framework and the JBI Manual for Evidence Synthesis. The team did an environmental scan, constructed a comprehensive search strategy in six databases, and conducted hand and cited-reference searching. Included papers were quantitative or qualitative studies with outcomes described and mapped to prevailing themes.

Results: Nine hundred twenty-three records were identified …

Premenopausal Transition In Neurodivergent Women With Musculoskeletal Syndromes: Mechanisms, Risks, And Neuroinclusive Therapeutics, Piper Hutson, James Hutson

Faculty Scholarship

Neurodivergent women with chronic musculoskeletal syndromes experience disproportionate premenopausal symptom burdens that are poorly characterized in extant clinical paradigms and practice. The compounded interplay of estrogen fluctuations in premenopause with sensory–executive differences and baseline nociception from joint or connective-tissue pathology yields intensified pain, mood dysregulation, and functional decline. Evidence indicates estrogen modulates nociception, neuroinflammation, bone remodeling, and monoaminergic signaling; premenopausal variability magnifies pain, affective lability, and cognitive drift—effects accentuated in autism and ADHD. Coexisting hypermobility, fibromyalgia, or connective-tissue disorders compromise joint integrity and proprioception, increasing susceptibility to estrogen-dependent changes in bone microarchitecture and tendon homeostasis. This article advances an integrative …

Sense Of Belonging Of Bachelor Nursing Students: A Descriptive-Comparative Study, Evangeline Fangonil-Gagalang, Phoebe (Yeon) S. Kim, Justin Schneider, Renee Gregg

Nursing Faculty Publications

ackground: A sense of belonging, defined as acceptance, inclusion, and identity within a group, significantlyinfluences nursing students’ academic and social integration into college. Limited belonging causes studentattrition.Aim: This research explored factors influencing nursing students’ sense of belonging and identified elementspromoting or hindering this feeling.Methods: This is a cross-sectional, descriptive comparative study that was conducted with undergraduatenursing students (N = 201) from multiple campuses at a southwestern U.S. university. Data were collectedvia an anonymous survey using the Department Sense of Belonging and Involvement (DeSBI) tool. Descrip-tive and comparative statistics were analyzed.Results: Campus location significantly influenced students’ sense of belonging. Satellite campus …

The Effect Of Genotype On Self-Reported Dysarthria And Dysphagia In Parkinson's Disease: A Parkinson's Progression Marker Initiative Study, Matthew Dumican, Therese Reyers, Alyson Malczewski, Zoe Thijs

Communication Disorders and Occupational Therapy Faculty Publications and Presentations

Objectives The objective of this study was to examine baseline and longitudinal differences of self-reported dysarthria and dysphagia in the most common genetic subtypes of Parkinson's disease (PD) using the Parkinson's Progression Marker Initiative (PPMI) dataset. Methods This was a retrospective, longitudinal study utilizing data from the PPMI dataset. Dysarthria- and dysphagia-specific questions from the Unified Parkinson's Disease Rating Scale (UPDRS) and Scales of Outcomes in Parkinson's Disease-Autonomic questionnaire (SCOPA-AUT) were extracted for people with Parkinson's disease (PwPD) with leucine-rich repeat kinase 2 gene (LRRK2), GBA, and SNCA genotypes across up to five research visits. Relevant patient (age, sex, etc.) …

Patterns And Implications Of Missed Injuries On Computed Tomography Imaging In Older Blunt Trauma Patients, Arnav Mahajan, Vanessa P. Ho

Faculty Scholarship

Background: Older adults sustain disproportionately morbid injuries from low energy mechanisms, yet guidance around computed tomography imaging is lacking for this demographic. We hypothesize that current imaging practices may lead to potentially missed injuries, increasing morbidity and mortality. Methods: A secondary analysis of a prospective multicenter study (11/2020–12/2021) of older blunt trauma patients was performed. Suboptimal imaging was defined as a mismatch between final injury diagnosis and initial computed tomography imaging. We compared optimally vs not optimally imaged patients to determine factors associated with suboptimal imaging and examined mortality, hospital length of stay, and critical care use with a multivariable …

Transcription Factor Ybx1 Orchestrates Drug Resistance And Tumor Progression In Hcc, Dennis Kwabiah, Veerababu Nagati, Manish K. Tripathi

School of Medicine Publications

Drug resistance continues to be a significant challenge in cancer treatment, responsible for over 90% of worldwide cancer-related deaths. Transcription factors (TFs), which control vital cellular processes, also play a crucial role in cancer development and resistance. In hepatocellular carcinoma (HCC), resistance to sorafenib, a primary targeted therapy, significantly impairs treatment effectiveness and worsens patient outcomes. Among TFs, Y-box binding protein 1 (YBX1) has been recognized as a regulator of aggressive cancer traits in colorectal and breast cancers. However, its role in HCC and sorafenib resistance remains unclear. This review examines YBX1’s role in HCC progression and drug resistance, its …

Systematic Review And Evidence Gap Mapping Of Alzheimer's Disease Biomarker Studies In Those With Intellectual And Developmental Disability, Lubnaa B. Abdullah, Ney Alex Alliey, Emma Elizondo, Ney Alliey Rodriguez, Gladys Maestre, James Hall

School of Medicine Publications

There are a relatively small number of investigations into brain aging in those with intellectual and developmental disability (I/DD). This project seeks to (1) characterize the internationally available multi-omics Alzheimer's disease (AD) biomarker studies including those with I/DD, and (2) discuss future research directions. PubMed, Web of Science, and Scopus were searched under the following criteria: cross-sectional or longitudinal AD-omics studies on adults (18 +) with I/DD. 532 studies were identified, 186 studies were evaluated for full-text, 79 studies were excluded, and 117 studies were extracted. Most biological specimens were analyzed in blood, plasma, or serum. Metabolomics, hormonomics, and transcriptomics …

Mindfulness-Based Interventions For Adults With Coronary Artery Disease: An Integrative Review Of Impact On Risk Factors And Outcomes, Alexa Archer, Kristiina Hyrkas

MaineHealth Maine Medical Center

Aim: To synthesize recent evidence on the effects of MBIs on psychological and cardiovascular health.

Airway Management In Patients With Vocal Cord Paralysis: A Review Of Intubation Techniques, Intraoperative Challenges, And Outcomes., Rayyan Bhutta, Ali Osman, Tala Maya, Justin Ma, Ali Al Saeed, Sumit Sidhu, Mariya Wood, Bilal Akhtar, Sirimas Lau, Matthias Franzen

Surgery Articles

Vocal cord paralysis (VCP) presents with unique challenges when managing airways, particularly during endotracheal intubation. This literature review explores the effects of unilateral and bilateral VCP on intubation technique, first-pass success, extubation safety, and perioperative airway planning. While video laryngoscopy (VL) is becoming increasingly favored for its superior airway visualization, it does not always confirm successful placement in patients with VCP. Complications such as airway edema, aspiration risk, and cuff misplacements are increased in this patient population, and they may be more vulnerable to post-extubation complications, especially without the use of steroid prophylaxis or intensive post-operative planning. A comparison of …

Exploring Boundaries With Food, Substances, And People In Substance Use Recovery: A Qualitative Analysis, Tiffany Champagne-Langabeer, Audrey Sarah Cohen, Kriti Shrestha, Jie Zhu, Audrey Lopez, Alisha Campbell, Christine Bakos-Block

Faculty, Staff and Student Publications

Background: In the United States, over 47 million youth and adults live with a substance use disorder (SUD). These individuals are frequently malnourished and have metabolic dysregulation as a result. Nutrition interventions incorporating a mindfulness-based approach help recovery efforts that are physical and mental.

Objective: The objective of this study was to explore and analyze the perspectives and experiences of individuals with SUD regarding emotional regulation and nutrition. The study used a mixed methods approach to generate insights for improving recovery support and developing future interventions.

Design: In 2024, an exploratory mixed methods study was conducted based on a large …

Implementation Of Screening And Assessment Tools For Diagnosing Opioid Use Disorder: A Systematic Review, Audrey Lopez, Audrey Sarah Cohen, Francine Vega, Tiffany Champagne-Langabeer

Faculty, Staff and Student Publications

Introduction: As the prevalence of opioid use disorder (OUD) continues to rise, early detection by medical professionals can often be the first step in linking individuals to treatment. This systematic review was designed to identify implemented OUD screening and assessment tools with studies published from January 2019 through June 2024, uncover common themes associated with implementation, and determine if these tools were recommended in clinical practice.

Methods: A systematic literature search was conducted within PubMed, EMBASE, and Web of Science using the keywords 'opioid use disorder,' 'documentation,' and 'screening assessment tool.' Three investigators independently reviewed titles, abstracts, and full-text articles …

Exploring Boundaries With Food, Substances, And People In Substance Use Recovery: A Qualitative Analysis, Tiffany Champagne-Langabeer, Audrey Sarah Cohen, Kriti Shrestha, Jie Zhu, Audrey Lopez, Alisha Campbell, Christine Bakos-Block

Faculty, Staff and Student Publications

Background: In the United States, over 47 million youth and adults live with a substance use disorder (SUD). These individuals are frequently malnourished and have metabolic dysregulation as a result. Nutrition interventions incorporating a mindfulness-based approach help recovery efforts that are physical and mental.

Objective: The objective of this study was to explore and analyze the perspectives and experiences of individuals with SUD regarding emotional regulation and nutrition. The study used a mixed methods approach to generate insights for improving recovery support and developing future interventions.

Design: In 2024, an exploratory mixed methods study was conducted based on a large …

Auricular Point Acupressure For Older Adults With Chronic Low Back Pain: A Randomized Controlled Trial, Jennifer Kawi, Chao Hsing Yeh, Nada Lukkahatai, Hulin Wu, Natalia E Morone, Ronald Glick, Elizabeth A Schlenk, Claudia Campbell, Johannes Thrul, Xinran Huang, Hongyu Wang, Hejingzi Monica Jia, Paul Christo, Constance Johnson

Faculty, Staff and Student Publications

Objective: Efficacious modalities are limited in chronic low back pain (cLBP). We determined the efficacy of auricular point acupressure (APA) in older adults with cLBP.

Design: 3-arm randomized controlled trial.

Setting: Baltimore, Maryland.

Participants: Participants, ≥60 years with cLBP, were randomized (1:1:1) to APA with ear points targeted to cLBP (T-APA, n = 92), points nontargeted to cLBP (NT-APA, n = 91), or waitlist education control (n = 89), and followed up to 6 months (6M). Participants in the APA groups received 4 weekly APA sessions; the education control group received 4 weekly educational sessions.

Intervention: APA.

Main outcomes and …

Sex Differences In The Treatment With Pcsk9 Monoclonal Antibodies- Real World Experience From A Dedicated Preventive Cardiology Clinic, Lital Hodeda, Alon Eisen, Aviad Rotholz, Ran Kornowski, Chen Gurevitz

Faculty, Staff and Student Publications

Purpose: Proprotein convertase subtilisin/kexin type 9 monoclonal antibodies (PCSK9 mAb) lower low-density lipoprotein cholesterol (LDL-C) levels and reduce atherosclerotic cardiovascular disease (ASCVD). Data regarding sex differences in PCSK9 mAb treatment remain lacking. This study examines sex differences in patients' characteristics, indications, efficacy, and safety of PCSK9 mAb treatment.

Methods: Retrospective study based on data from the Preventive Cardiology and Lipids Clinic in Rabin Medical Center on patients prescribed with PCSK9 mAb. Collected data included medical background, medications, indications and laboratory data, analyzed by sex.

Results: 246 patients were included (mean age 67y, ASCVD 78.8 %, mean baseline LDL-C 128.2 mg/dL). …

Variational Temporal Deconfounder Network For Individualized Treatment Effect Estimation With Longitudinal Observational Data, Hao Dai, Yu Huang, Yuxi Liu, Xing He, Jingchuan Guo, Mattia Prosperi, Jiang Bian

Faculty, Staff and Student Publications

Objective: By leveraging real-world electronic health record (EHR) data, this study set out to estimate individualized treatment effects (ITE) in longitudinal observational settings to advance personalized medicine, addressing key challenges that are often observed in real-world clinical scenarios and pose statistical challenges, including hidden confounding and dynamic treatment regimens.

Methods: We propose the Variational Temporal Deconfounder Network (VTDNet), a novel framework designed to account for time-varying hidden confounding using a variational recurrent transformer-based autoencoder. Specifically, VTDNet comprises three critical components: a temporal Encoder-Decoder structure to capture hidden representation, a Treatment Block that captures interdependencies among multiple treatments, and a Potential …

Mycobacterium Genavense-Induced Spindle Cell Pseudotumor Presenting With Symptoms Of Giant Cell Arteritis., Britney Le, Guilherme Kuceki, Jamie Zussman

Ambulatory and Primary Care Articles

No abstract provided.

Clinical Uptake Of An Antigen-Based Approach To Membranous Nephropathy: A Survey Of General Nephrologists And Glomerular Disease Experts., Eibhlin Goggins, Andrew Delaat, Bryce Barr, Jonathan Taliercio, Ali Mehdi, Georges Nakhoul, Brendan Bowman, Corey Cavanaugh

Ambulatory and Primary Care Articles

BACKGROUND: In recent years, there has been an emergence of new antigens discovered in membranous nephropathy (MN). Whether these antigens have impacted the approach to, and management of, MN patients undertaken by nephrologists is still unclear.

METHODS: We conducted a cross-sectional international survey pertaining to 13 antigens recently discovered in MN. The survey was distributed by the National Kidney Foundation, direct emails, and social media.

RESULT: PLA2R, THSD7A, NELL1, and EXT1/2 testing were readily available while the most common response for other antigen testing was 'Not Performed' or 'Unknown'. All respondents had tested for or treated PLA2R-positive MN. Of 79 …

Biopsychosocial Profiles Following Acl Reconstruction: A Latent Class Analysis Of Barriers To Return-To-Activity, Erich Petushek, Matthew S. Harkey, Kim Santiago, Alexander Stamm, Shelby Baez, Jed A. Diekfuss, Gregory D. Myer, Christopher Kuenze

Michigan Tech Publications

Objective: Understanding of how biopsychosocial factors interrelate to affect recovery from ACL injuries is essential for improving patient outcomes. This research aimed to use Latent Class Analysis (LCA) to classify individuals post-ACL reconstruction into subgroups reflecting their particular biopsychosocial challenges to recovery. Design: Cross-Sectional. Methods: This multisite investigation included 134 ACLR patients approximately 6 months (5.6 months ± 1.8 SD) following surgery. The ACL Reasons scale, various Patient Reported Outcome (PRO), and performance-based measures were assessed. LCA was used to categorize patients into subgroups based on the ACL Reasons scale. Subgroups were then compared across demographic, PRO, and performance-based measures …

A Fascination With Gastrointestinal Viruses, Mary Kolb Estes

Faculty, Staff and Students Publications

My arrival into this world came quickly, according to my mother, and it feels like my life has mirrored that rapid beginning. I have enjoyed a rich, varied, and stimulating life and career that have gone through several phases. I credit genetics, my family, technological advances, and many environmental factors for shaping my career. Being a virologist allowed me to be curious and creative and to make several unexpected discoveries. This has been a fun and rewarding journey, but it wasn't always easy. I am not accustomed to talking about myself, but I am happy to share some scientific achievements …

Intracranial Rhizomucor Pusillus Mucormycosis In An Adolescent Triggering A Stroke Alert: A Case Report And A Systematic Review Of Pediatric Cases, Rima El Atrache, Melissa Mizerik, Joaquin Francisco Ruiz Lopez, Eric Engstrom, Karla Patricia Salazar, Mikael C Guzman-Karlsson, Daniel Davila-Williams, Sonali Sen, Kristen S Fisher, Jennifer C Erklauer

Faculty, Staff and Students Publications

Mucormycosis is a rare, life-threatening opportunistic infection primarily affecting immunocompromised patients. The available literature on Rhizomucor pusillus (R pusillus) infections of the central nervous system (CNS) in children is very limited. We present the case of an immunocompromised adolescent with intracranial mucormycosis due to R pusillus manifesting with stroke-like symptoms. This case highlights this rare condition's diagnostic complexity and management challenges. We include a review of the available literature on pediatric R pusillus CNS infections to increase awareness among health care providers.

Fluid Assessment Scoring Tool (Fast): Development Of A Novel Fluid Assessment Scoring Tool For Critically Ill Pediatric Patients-A Pilot Study, Mohammed Salameh, Pranali Awadhare, Jennifer Joiner, Michael Scheurer, Utpal Bhalala

Faculty, Staff and Students Publications

Introduction: Monitoring fluid balance (FB) is important yet challenging in the pediatric intensive care unit (PICU). Currently used, conventional methods of fluid assessment are either not feasible or unreliable. Also, there is a lack of composite scores or clinical algorithms that use different parameters of fluid status. We aim to develop a fluid assessment scoring tool (FAST) to clinically assess the fluid status of children in the PICU.

Methods: In this pilot study, we included critically ill patients aged 0-21 years who presented to our PICU between December 2020 and March 2021 and required invasive or non-invasive mechanical ventilation, inotropes, …

Clinical Phenotype And Outcomes In Autoimmune Encephalitis After Herpes Simplex Virus Encephalitis: A Systematic Review And Meta-Analysis, Jonathan Cleaver, Renetta Chungath, Amy Gimson, Christine Strippel, Bryan Ceronie, Babak Soleimani, Thomas Johnson, Eyal Muscal, Kristen Fisher, Yike Jiang, Timothy A Erickson, Kristy O Murray, Siv Tonje Faret Hovet, Charlotte Aaberg Poulsen, Anna Søgaard Magnussen, Pauline Dumez, Shannon Ronca, Martin Häusler, Annegret Quade, Andrew Swayne, Morten Blaabjerg, Mette Nissen, Alexander J Sandweiss, Jerome Honnorat, Russell Dale, Ming Lim, Michael Eyre, Margherita Nosadini, Lahiru Handunnetthi, Sarosh R Irani, Adam E Handel

Faculty, Staff and Students Publications

Background: Autoimmune encephalitis after herpes simplex virus encephalitis (HSVE-AE) represents the intersection of central nervous system infection and autoimmunity. Defining the phenotype and the safety and effectiveness of immunotherapy in HSVE-AE would help identify immunotherapy candidates, optimise therapeutic strategies, and improve patient outcomes.

Methods: We systematically searched Embase, Medline, PubMed, and Web of Science (2007-2024) for cases meeting consensus criteria for AE after confirmed HSVE. Demographics, phenotype, treatment and outcome data were extracted. Dimensionality reduction, network analysis, and multivariate logistic regression was used to explore age- and diagnosis-specific patterns and outcome predictors.

Results: From 2259 articles screened, 78 studies (225 …

Comparative Effectiveness Of Less Vs More Frequent Hydrocortisone Dosing In Septic Shock, Alan Hao, Tianshi David Wu, Keegan Collins, Danielle Guffey, Rebecca Kessinger, Meghna Vallabh, Ali Omranian

Faculty, Staff and Students Publications

Objectives: Guidelines recommend hydrocortisone as an adjunctive treatment in septic shock, but the optimal dosing regimen is unknown. A national shortage of hydrocortisone in 2023 prompted a change in institutional practice for hydrocortisone administration from 50 mg every 6 hours to 100 mg every 12 hours in an effort to reduce waste and conserve vials, creating an opportunity to evaluate the comparative effectiveness of these two regimens. The primary efficacy outcome was time to shock resolution, and secondary outcomes evaluated in this study were mortality, renal replacement therapy (RRT), medication costs, and maximum vasopressor dose attained.

Design: Single-center, retrospective cohort …

A Functional Perspective On Astrocyte Heterogeneity, Wookbong Kwon, Michael R Williamson, Benjamin Deneen

Faculty, Staff and Students Publications

Astrocytes are glial cells of the central nervous system (CNS) that perform an array of diverse functions that are essential for brain activity. Studies on the functional diversity of astrocytes suggest that such diversity may be derived from specialized populations. We provide an overview of the current state of research on astrocyte diversity and outline current challenges and knowledge gaps while also examining the developmental origins of these populations and how their interactions with neurons contribute to their functional heterogeneity. We highlight recent studies that provide evidence for functionally diverse astrocyte populations under homeostatic conditions and as an adaptive response …

A Multi-Institutional Multi-Methods Analysis Of Jeopardy Systems In Academic Hospital Medicine, Kirsten N Kangelaris, Angela Keniston, Andrew D Auerbach, Gregory Bowling, Marisha Burden, Shradha A Kulkarni, Luci K Leykum, Anne S Linker, Matthew Sakumoto, Jeffrey Schnipper, Gopi Astik

Faculty, Staff and Students Publications

Background: Hospital medicine programs use backup ("jeopardy") systems to cover unexpected staffing gaps, but little is known about their structures or optimal practices.

Objectives: To describe jeopardy structures, assess clinician perceptions, and identify potential approaches across a broad sample of hospital medicine groups.

Methods: This multi-methods study, conducted within a national hospitalist consortium, used virtual focus groups and an email survey to (1) describe the presence and structure of jeopardy systems and (2) explore features perceived as fair, equitable, and tolerable. Rapid qualitative analysis identified major themes, while descriptive methods analyzed survey data.

Results: Twenty-five individuals participated in focus groups, …

Critical Care Cadets: A Serious Game For Managing Mechanical Ventilation, Daniel Hassumani, Satid Thammasitboon, Fong Lam, Aarti Bavare, Moushumi Sur, Shelley Kumar, Thomas Reeves, Brian Rissmiller

Faculty, Staff and Students Publications

Background: Pediatric critical care medicine (PCCM) fellows require proficiency in mechanical respiratory support and ventilator management strategies. Traditional training methods have limitations, and there is a need to expedite the learning process. Serious games have emerged as effective supplements to traditional teaching methods, promoting knowledge acquisition through immersive and engaging experiences. However, there is a void in the context of complex decision making in mechanical ventilation management.

Objective: To develop a serious game to enhance the knowledge and practical strategies of PCCM fellows in mechanical ventilation management.

Methods: The game was designed on the basis of theory-informed design principles and …