Medicine and Health Sciences Commons^™

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 …

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 …

Postoperative Staphylococcal Toxic Shock Syndrome In A Patient Following Right Knee Fracture Repair: A Case Report, Nicole Nyamongo, James Garritano, Daniel Rosen, Theodore Rosen

Faculty, Staff and Students Publications

Toxic shock syndrome (TSS) is a rare but life-threatening multisystem disorder most commonly caused by Staphylococcus aureus. It is characterized by the acute onset of high fever, hypotension, a diffuse macular rash, and multiorgan involvement. We report the case of a male in his late 30s who sustained a patellar fracture with associated retinacular injury following trauma and subsequently underwent open reduction and internal fixation. Several days after discharge, he developed fever, chills, hypotension, and a pruritic, erythematous rash. He was readmitted and initially evaluated by the orthopedic service, which did not recommend additional imaging or surgical intervention, as …

Three Versus Six Sessions Of Problem-Solving Training With Or Without Boosters For Care Partners Of Adults With Dementia (Cades): A Randomised Controlled Optimization Trial, Shannon B. Juengst, Alexandra Holland, Kristin Wilmoth, Matthew Lee Smith, Gang Han, Charlene Supnet-Bell, Chung Lin (Novelle) Kew, Alka Khera, Gladys Maestre

School of Medicine Publications

Background: Problem-Solving Training/Descubriendo Soluciones Juntos (PST/DSJ) can improve emotional consequences of caregiving. We assessed the number of sessions and boosters needed for reducing caregiver burden and depressive symptoms among Alzheimer's disease and related dementias (ADRD) care partners.

Methods: We conducted a randomised factorial-design trial of bilingual PST/DSJ among ADRD care partners (NCT04748666). Participants were randomly assigned (blocks of 8 stratified by language) to 3 PST/DSJ sessions with (n = 19) or without (n = 21) boosters or 6 PST/DSJ sessions with (n = 28) or without (n = 29) boosters. The Zarit Burden Interview measured caregiver burden and …

Safety Of Uninterrupted Anticoagulation Use In Patients Undergoing Hemodialysis Access Creation With Regional Anesthesia: A Research Report, Melissa M. Cruz, James J. Fitzgibbon, Abena Appah-Sampong, Patrick Heindel, Lucinda R. Holden-Wingate, Dirk M. Hentschel, Charles Keith Ozaki, Felicity Billings, Kamen V. Vlassakov, Mohamad A. Hussain

School of Medicine Publications

No abstract provided.

Efficacy And Safety Of Bridging Intravenous Thrombolysis Before Mechanical Thrombectomy In Acute Ischemic Stroke: A Systematic Review And Meta-Analysis, Tallal Mushtaq Hashmi, Mushood Ahmed, Hadiah Ashraf, Muhammad Shakir, Ibrahim Ahmad Bhatti, Ahmad Alareed, Faizan Ahmed, Ali Hasan, Ameer E. Hassan

School of Medicine Publications

Background: The safety and efficacy of intravenous thrombolysis (IVT) before mechanical thrombectomy (MT) in acute ischemic stroke remain uncertain.

Methods: We comprehensively searched PubMed, Embase, and the Cochrane Library from inception to May 30, 2025. Randomized controlled trials comparing IVT before MT versus MT alone in acute ischemic stroke were included. The primary outcome was excellent functional outcome (modified Rankin Scale score 0–1 at 90 days) and good functional outcome (modif ied Rankin Scale score 0–2). Secondary outcomes included successful recanalization, all-cause death, symptomatic, and any intracranial hemorrhage. Odds ratios (ORs) with 95% confidence intervals (CIs) were pooled using …

Assessing The Impact Of Tungiasis On Children’S Quality Of Life In Kenya, Lynne Elson, Berrick Otieno, Abneel Matharu, Naomi Riithi, Esther Chongwo, Francis Mutebi, Hermann Feldmeier, Jürgen Krücken, Ulrike Fillinger, Amina Abubakar

Institute for Human Development, East Africa

Tungiasis is a neglected tropical skin disease caused by the sand flea, Tunga penetrans which penetrates the skin causing considerable pain and itching. In this cross-sectional study we aimed to assess its impact on the quality of life of school children in Kenya. School pupils (198) aged 8–14 years with tungiasis were randomly selected and interviewed using a tungiasis-specific quality of life instrument (TLQI). The caregivers of each infected pupil and 199 randomly selected caregivers of uninfected pupils were interviewed using the proxy KIDscreen52 to assess their child’s general health-related quality of life (HR-QoL). Generalized linear models were used to …

Assessing The Psychological Wellbeing And Resilience Of Frontline Health Workers In Uganda: A Cross-Sectional Study, Ahmed Sarki, Joseph Atukwatse, Gideon Mbithi, Sabina Odero, Mary Namuguzi, Bernard Mutwiri, Lestine Bitakwitse, Peninah Wachira, Kevinson Mwangi, Eunice Ndirangu, Amina Abubakar

Institute for Human Development, East Africa

Background: Health workers in the frontline are the major drivers of health systems in low- and middle-income countries. However, these health workers face both chronic and acute shocks and stressors that expose them to mental health problems which are often overlooked. We examined the prevalence of mental health problems, correlates of psychological functioning, and resilience of frontline health workers in Uganda.

Methods: We conducted a cross-sectional study comprising 1800 frontline health workers across all regions of Uganda from August through October 2023. We used tools such as the PC-PTSD-5, PHQ9, PSS, GAD-7, Oldenburg Burnout Inventory, and CD-RISC-10 to assess PTSD, …

Reliability And Spatial Consistency Of Mr Diffusion Tensor Imaging Measures Along The Cerebral Perivascular Space, Enchao Qiu, Joga Chaganti, Phillip Phan, M. Alizadeh, Devon Middleton, Kiran Talekar, Prabath Mondel, Scott H. Faro, Feroze Mohamed, Hsiangkuo Yuan

Department of Radiology Faculty Papers

BACKGROUND AND PURPOSE: Diffusion tensor imaging analysis along the perivascular space (DTI-ALPS) has emerged as a promising noninvasive method for evaluating water motion that may reflect glymphatic system function. However, the reliability of DTI-ALPS measurements across different region-of-interest (ROI) selection methods remains underinvestigated. This study aimed to assess the interrater reliability among three neuroradiologists in native space and compare DTI-ALPS indices derived from ROIs placed in subjects' native space versus standardized Montreal Neurological Institute (MNI) space.

METHODS: DTI-ALPS indices from 16 healthy subjects were calculated from both left and right hemispheres using two ROI placement approaches: (1) native space ROIs …

End User Experiences Of An Electronic Health Records Platform In A Tertiary Hospital System In Kenya, Anmol Shrestha, Jasmit Shah, Zamanali Khakhar, Armando Ruiz, Zohray Talib, Sayed Karar

Internal Medicine, East Africa

Background: Electronic Health Record (EHR) systems allow health care facilities to provide better care to patients and improve overall provider efficiency. They are vital for low-and middle-income countries in achieving the United Nations Sustainable Development Goal of ensuring healthy lives and promoting the well-being of all their citizens. This study aimed to evaluate perceptions and usage of a comprehensive EHR by end-users after its deployment into a tertiary hospital system and its outpatient centers in Kenya and also aimed to understand the effectiveness of various implementation strategies deployed by the institution during their implementation process.

Methods: We conducted …

Diagnostic Journey In The Recognition Of Oncogenic Osteomalacia, Steven B. Nagelberg, Mihaela Biscoveanu, Barbara Bix, Carrie Andrews, Srinivas Prasad

Jefferson Health - Northeast Papers (formerly Aria Health Papers)

A 73-year-old woman with a remote history of successfully treated primary hyperparathyroidism was referred to our office because of multiple skeletal fractures and proximal muscle weakness. Prior laboratory evaluation demonstrated hypocalcemia, vitamin D deficiency, elevated PTH, and elevated alkaline phosphatase. Updated evaluation in our clinic additionally showed hypophosphatemia prompting measurement of serum fibroblast growth factor 23 (FGF23). FGF23 proved to be markedly elevated prompting consideration of tumor-induced osteomalacia. Positron emission tomography with Cu-64 oxodotreotide revealed an enhancing focus in the left thoracic spine that was confirmed on magnetic resonance imaging to be a 1.5-cm extradural mass. The patient underwent surgical …

Himmelfarb Headlines - September/October 2025, The George Washington University, Himmelfarb Health Sciences Library

Himmelfarb Headlines (2009 - present)

News, information, and resources relating to Himmelfarb Library that is of interest to patrons.

Development Of A School Nurse Simulation Boot Camp, Jodi S. Bullard, Angela Preston, Jenifer Chilton

Nursing Faculty Publications and Presentations

A school nurse continuing education program was developed by School of Nursing faculty at an East Texas university, providing school nurses with documented competence in nursing skills focused on equitable health outcomes. The 8 hr School Nurse Boot Camp program consisted of a keynote address on local pediatric health topics and a series of 30-min speed simulations focused on mental and physical health issues. A total of 62 school nurses attended the three boot camp offerings during the 2023/2024 academic school year and represented a student population of 78,275. Participants indicated satisfaction with the event and interest in future continuing …