Medicine and Health Sciences Commons^™

Do-Not-Resuscitate Orders In The Perioperative Period: A Quality Improvement Project, Brooke Popejoy, Connor Lebsack, Rena Bish

Doctor of Nursing Practice (DNP) Student Projects

Background & Significance: Management of do-not-resuscitate (DNR) orders during the perioperative period presents ongoing ethical and clinical challenges. Variability in provider knowledge and documentation can compromise patient autonomy and safety. Despite institutional policies, such as Barnes-Jewish Hospital’s “Goals of Care Directive,” inconsistent adherence remains common.

Review of Literature Findings: Evidence reveals that limited provider education contributes to uncertainty in managing perioperative DNRs. Studies by Baumann et al. (2017), Chappell et al. (2023), and Crowe and Marsh (2023) support targeted educational interventions to improve provider competence and consistency with national guidelines regarding required reconsideration.

Methods: Preintervention and postintervention surveys will be …

Riding The End-Tidal Wave: Enhancing Nurse Confidence And Clinical Competence On Capnography Waveform Interpretation, Megan Monda, Kirk Wallis, Rachel Zehner

Doctor of Nursing Practice (DNP) Student Projects

This quality improvement project addressed inconsistent use of end-tidal carbon dioxide (ETCO2) monitoring among nurses in the Cardiac Procedure Center (CPC) at Barnes-Jewish Hospital. Although capnography detects respiratory compromise earlier than pulse oximetry, limited staff education contributed to variability in waveform interpretation and clinical response. Guided by Kurt Lewin’s Change Model and the Plan-Do-Study-Act cycle, four structured one-hour educational sessions were delivered to CPC nurses and supplemented with hands-on practice and visual cognitive aids. Pre-, immediate post-, and two-week post-education surveys evaluated changes in knowledge, confidence, and clinical skill. Mean knowledge scores improved from 65% at baseline to 75% immediately …

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

Doctor of Nursing Practice (DNP) Student Projects

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

Enhancing Ot-Classroom Staff Collaboration: A Usability Study Of A Formalized Sensory Communication Process, Victoria Foo, Neil Harvison, Alyson Pasquale, George Bulger, Jessica Evans

Post Professional Occupational Therapy Doctoral (PPOTD) Student Capstone Projects

Addressing students’ sensory-based behaviors can be challenging when there are no team-based and student-centered approaches in place, making it essential to create an interdisciplinary framework where OTs and classroom staff communicate consistently to blend supports. Effective communication and collaboration involve carryover, explanation, education, and training of sensory processing and sensory-based interventions (SBI) as crucial components in a knowledge translation process.

Assessing The Feasibility Of Integrating Occupational Therapy Services Within A Pediatric Primary Care Setting For Children 0-3 Years Old., Amanda L. Wilbert, Cristina Dumitrescu, Kim Karr

Post Professional Occupational Therapy Doctoral (PPOTD) Student Capstone Projects

The objective of this capstone project was to assess the feasibility of implementing occupational therapy (OT) services within a pediatric primary care office using a manualized service delivery approach. Occupational therapy is inherently grounded in parent coaching and education, positioning the profession to play a critical role in supporting families and promoting early identification of developmental risk. This project aimed to address a documented gap in the inclusion of OT within pediatric primary care by exploring how OT services can support parenting skills and monitor children identified as at risk for developmental, behavioral, or psychosocial concerns. The project was conducted …

Outcomes Of Deep Peroneal Neurectomy: A Scoping Review Of Complications, Postoperative Recovery, And Patient-Reported Satisfaction, Krista Elizabeth Samreth, James Hughes, Amayrani Sanchez, Nicholas Obias, Madeleine Mehaffey, Stephanie Campbell Dpm, Aacfas

School of Podiatric Medicine - Student Research

Background: Deep peroneal neurectomy (DPN) evolved as a surgical treatment alternative for patients with painful midfoot arthritis who may not tolerate more invasive surgery such as arthrodesis. This scoping review aims to display current evidence of postoperative recovery complications and patient-reported outcomes specific to alternative surgical treatment of DPN.

Methods: A scoping review was completed using PRISMA-ScR reporting standards. Investigators searched PubMed, Google Scholar, Foot & Ankle Orthopedics, and Journal of Foot and Ankle Surgery for studies from 2002 to 2025 with search terms: “deep peroneal neurectomy,” OR “deep peroneal nerve excision,” OR “peroneal neurectomies” AND “midfoot arthritis”. Exclusion criteria …

High Concordance Of Physician-Attestation With Manual Data Abstraction For Sickle Cell Type: An Ash Rc Data Hub Study, Alexis Thompson, Ashima Singh, Donna Neuberg, Amanda Brandow, Allison King, Sophie Lanzkron, Emily Semmel, Sam Walters, Susan Rogers, Kathleen Torres, William Wood

Cardeza Foundation for Hematologic Research

Sickle cell disease (SCD) is the most common inherited blood disorder in the United States. The American Society of Hematology Research Collaborative (ASH RC) has built an SCD Data Hub (DH) to facilitate research and quality improvement using real-world data. To our knowledge, we report here the first analyses from the DH, focusing on cohort demographics and accurate identification of SCD diagnosis type. DH sites have data use agreements with ASH RC to extract and transfer electronic health record (EHR) data at least quarterly. Principal investigators (PI) provided additional attestation of SCD diagnosis based on existing local data sources deemed …

Cross-Sectional Associations Of Metabolically Healthy Obesity, Lifestyle Factors, And Steatotic Liver Disease In Adults From The Fels Longitudinal Study, Ariana L Garza, Audrey C Choh, John Blangero, Cici X Bauer, Stefan A Czerwinski, Miryoung Lee

Faculty, Staff and Student Publications

Objective: To examine the associations of metabolic health and obesity phenotypes with liver fat accumulation and hepatic steatosis in adults.

Methods: We analyzed 676 non-Hispanic white adults (18-95 years; 55.8% female) from the Fels Longitudinal Study using a cross-sectional design. Participants were classified into metabolically healthy normal weight (MHNW), metabolically healthy obesity (MHO), metabolically unhealthy normal weight (MUNW), and metabolically unhealthy obesity (MUO) phenotypes. Metabolically unhealthy status was defined as the presence of ≥1 metabolic dysfunction, consistent with prior epidemiological definitions; secondary analyses using ≥2 were also performed. Obesity was defined using DXA-derived body fat percentage. Liver fat (%) was …

Serum Metabolites Associated With Depression And Anxiety In The Hispanic Community Health Study/Study Of Latinos, Xinye Qiu, Yu Zhang, Yogesh Purushotham, Qibin Qi, Bing Yu, Jan Bressler, Krista M Perreira, Humberto Parada, Martha L Daviglus, Alejandra Cid Vega, Carmen R Isasi, Linda C Gallo, Tamar Sofer

Faculty, Staff and Student Publications

Omics signatures for psychiatric conditions have been under-investigated. In this study, we used data from a representative observational cohort study of Hispanic/Latino adults to identify serum metabolites associated with symptoms of depression or anxiety and to develop and assess metabolite risk scores (MRSs) of these phenotypes. We conducted a metabolome-wide association study of 768 metabolites with depression and anxiety symptoms, using two separate assay batches measured from baseline samples collected between June 2008 and July 2011 for discovery (batch 1: n = 4002 adults) and replication (batch 2: n = 2178 adults). We estimated the associations via survey-based generalized linear …

Vestibular Schwannoma Microsurgery In The Era Of Multimodal Treatment: Advances In Technique And Patient Selection, Ibrahem Albalkhi, Basel Musmar, Nimer Adeeb, Hussam Abou-Al-Shaar, Jacques J Morcos

Faculty, Staff and Student Publications

Background: The management of vestibular schwannoma (VS) has traditionally prioritized gross total resection to achieve high tumor control, often at the cost of cranial nerve injuries and quality of life impairment. However, advances in surgical approaches and intraoperative technologies, coupled with active surveillance and/or adjuvant treatment, have shifted the management paradigm towards prioritizing patient-centered outcomes, which are as critical as oncological control.

Content: The authors reviewed the technical advances driving this paradigm shift, including endoscopic assistance in the different microsurgical approaches (retrosigmoid, translabyrinthine, and middle cranial fossa approaches) of VS resection and advanced neuromonitoring (facial nerve electromyography and cochlear/auditory evoked …

Risk Of Alzheimer Dementia After High-Dose Vs Standard-Dose Influenza Vaccination, Avram Samuel Bukhbinder, Yaobin Ling, Lauren Jhin, Elizabeth He, Kristofer Harris, Mya Rodriguez, Jenna Thomas, Gabriela Cruz, Kamal Phelps, Yejin Kim, Luyao Chen, Xiaoqian Jiang, Paul E Schulz

Faculty, Staff and Student Publications

Background and objectives: Previous studies, including large cohort analyses comparing vaccinated and unvaccinated adults, suggest that routine immunizations such as inactivated influenza vaccines (IIVs) may reduce Alzheimer dementia (AD) risk. Whether AD risk differs after high-dose IIV (H-IIV) vs standard-dose IIV (S-IIV) remains unexamined. We hypothesized that AD risk would be lower among adults ≥65 years after H-IIV compared with S-IIV.

Methods: This retrospective cohort study analyzed data spanning 2014-2019 from IQVIA PharMetrics Plus for Academics, a US health care claims database. Eligible participants were ≥65 years with ≥2 years of continuous medical and pharmaceutical coverage and no previous diagnostic …

Percutaneous Coronary Intervention And Vascular Access Complications: A Contemporary Review, Tanawat Attachaipanich, Muzamil Khawaja, Edwin A Takahashi, Hafeez Ul Hassan Virk, Mahboob Alam, Ian C Gilchrist, Chayakrit Krittanawong

Faculty, Staff and Students Publications

Transradial approach (TRA) is preferred over transfemoral approach (TFA) for percutaneous coronary interventions due to lower bleeding, vascular complications, and mortality, particularly in acute coronary syndrome. Radial access complications included intraprocedural events (spasm, dissection, and perforation) and postprocedural events (radial artery occlusion, hematoma, pseudoaneurysm, arteriovenous fistula, nerve injury, and infection). TFA remains necessary in certain settings but carries higher complication risk. Optimizing patient selection and procedural planning is essential to minimize vascular complications.

Feasibility Of Nationwide Remote Chronic Neural Data Collection From Recording-Enabled Deep Brain Stimulation Systems, Kasra A Mansourian, Ajay D Gandhi, Jonathan H Bentley, Kalman A Katlowitz, Danika L Paulo, Nisha Giridharan, Mohammed A Hasen, Tommy B Liu, Zain U Naqvi, Sarah S Soubra, Thomas A Hamre, Rick R Hanish, Eric A Storch, Wayne K Goodman, Sameer A Sheth, Nicole R Provenza

Faculty, Staff and Students Publications

Introduction: Bidirectional deep brain stimulation (DBS) devices can continuously record neural activity while delivering stimulation. Due to memory limitations on the implanted device on which data are stored, frequent data downloads are required to prevent data loss. In this study, we present a novel collaborative data collection method utilizing a nationwide network of device representatives to allow frequent data transfer that reduces data loss without imposing travel burden on patients.

Methods: We collected chronic neural data from nine patients with severe obsessive-compulsive disorder who received ventral capsule/ventral striatum DBS treatment between May 2023 and August 2024. We included patients implanted …

Age-Associated Hematopoietic Variants In The Rhesus Macaque, Josephine De La Fuente, Chiraag D Kapadia, R Alan Harris, Muthuswamy Raveendran, Giovanne B Diniz, John H Morrison, Jeffrey Rogers, Margaret A Goodell

Faculty, Staff and Students Publications

No abstract provided.

Yap Induces A Prorenewal Metabolic State In Cardiomyocytes, Lin Liu, Jeffrey D Steimle, Chang-Ru Tsai, Fansen Meng, Yuka Morikawa, Yi Zhao, Sandra Carmichael, Xiao Li, James F Martin

Faculty, Staff and Students Publications

BACKGROUND: Cardiomyocytes, as highly specialized and differentiated somatic cells, possess a limited capacity for renewal. Neonatal rodents possess the ability to regenerate cardiomyocytes after injury; however, this regenerative capacity declines rapidly with cardiomyocyte maturation, suggesting an inhibitory network between cellular maturation and cardiomyocyte proliferation. Maturing cardiomyocytes undergo a metabolic shift from predominantly glycolysis in the neonatal state to increased fatty acid oxidation in the mature state, which poses a barrier to cardiomyocyte proliferation and cardiac regenerative repair. YAP, a transcriptional cofactor regulated by the Hippo signaling pathway, promotes cardiac regenerative repair. We investigated the role of YAP in mediating metabolic …

High Concordance Of Physician-Attestation With Manual Data Abstraction For Sickle Cell Type: An Ash Rc Data Hub Study, Alexis A Thompson, Ashima Singh, Donna S Neuberg, Amanda M Brandow, Allison A King, Sophie Lanzkron, Emily A Semmel, Sam Walters, Susan Rogers, Kathleen Torres, William A Wood

2020-Current year OA Pubs

Sickle cell disease (SCD) is the most common inherited blood disorder in the United States. The American Society of Hematology Research Collaborative (ASH RC) has built an SCD Data Hub (DH) to facilitate research and quality improvement using real-world data. To our knowledge, we report here the first analyses from the DH, focusing on cohort demographics and accurate identification of SCD diagnosis type. DH sites have data use agreements with ASH RC to extract and transfer electronic health record (EHR) data at least quarterly. Principal investigators (PI) provided additional attestation of SCD diagnosis based on existing local data sources deemed …

Microarray Analysis Of Human Abdominal Aortic Aneurysm With Emphasis On Cardiovascular Genes Revealed Differentially Expressed Genes, Song Lu, Li Ping Li, John V. White, Xiaoying Zhang, Ifeyinwa Nwaneshiudu, Adaobi Nwaneshiudu, Nectaria Ntaoula, John Gaughan, Dimitri S. Monos, Wan-Lu Lin, Charalambos C. Solomides, Emilia L. Oleszak, Chris D. Platsoucas

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

BACKGROUND/AIM: We examined gene expression profiles in abdominal aortic aneurysm (AAA) lesions vs. normal aortas by cDNA microarray and real-time quantitative reverse-transcriptase polymerase chain reaction (qRT-PCR).

MATERIALS AND METHODS: Phosphorus (³²P)-labeled cDNA from AAA specimens (mean AAA size 6.65 cm) and normal aortas were hybridized with a 588-gene microarray primarily of the cardiovascular system. The results were validated by qRT-PCR.

RESULTS: A total of 35 out of the 588 genes were differentially expressed, with either log₂ ratio of AAAs/controls ≥1 (upregulated; 20 genes) or ≤-1 (downregulated; 15 genes) in AAA lesions vs. normal aorta, and …

Familial Healthy Aging And Longevity: The Role Of Spouses, Søren Netra, Angéline Galvin, Matthew Keys, Katrine Lawaetz Kristensen, Jacob Krabbe Pedersen, Bharat Thyagarajan, Svetlana Ukraintseva, Mary K Wojczynski, Dorret I Boomsma, Kaare Christensen

2020-Current year OA Pubs

BACKGROUND: Families with exceptional longevity often experience delayed onset of age-related diseases and reduced mortality across generations-a pattern influenced by shared genetic and behavioral factors. While several studies have focused on the members of longevity-enriched families (LEF), little is known about the health trajectories of the spouses marrying into these families. Given prior evidence of substantially reduced mortality among spouses of LEF members, determining whether this advantage reflects selection, shared environments, or behavioral convergence is essential for understanding the mechanisms that underlie intergenerational health transmission.

METHODS: We conducted a multigenerational, retrospective matched cohort study using nationwide Danish civil and health …

Associations Between Smoking Habits And Weight-Related Behaviors Among People Who Smoke In The United Arab Emirates: A Cross-Sectional Study, Sharifa Alblooshi, Maryam Hassan Dawood, Dana N. Abdelrahim, Marika Lo Monaco, Falak Zeb

All Works

Background: Smoking is one of the leading global public health problems, and is complicated by multiple reasons for its prevalence and associated health problems. An understanding of the influence of smoking activity on weight management is essential to formulate successful health programs. Aim: The objective of the present study was the investigation of the association between smoking habits and weight management among adult people who smoke in the UAE. Methods: A cross-sectional study was conducted with 232 participants who completed a 36-item questionnaire assessing their smoking habits and weight management practices. Results: The sample consisted mostly of males (75.4%) aged …

Mitigation Of Race-Based Antihypertensive Prescribing, Victoria Scaccia Msn Rn Cnl Dnp, Bridget O'Brien Dnp, Stephanie Crane Md, Amanda Bradke Md

North American Conference to End Race-Based Medicine

No abstract provided.

Six Steps To Squats: A Training Protocol To Guide Functional Rehabilitation Following Isolated Lower Extremity Fractures, Batoul Baydoun, Abdurrahman Ehsan, Manar Chebli, Zarrar Chauhdri, Ahmed Memon, Ahmad Almaat Bs, Omar Abdalla Bs, Haytham Alqasmi Bs, Ameen Suhrawardy Md, Rahul Vaidya Md

North American Conference to End Race-Based Medicine

No abstract provided.

Reconsidering The Use Of Race & Ethnicity In Clinical Decision-Making: The Path Towards Liberation Medicine, Donna Ahmadian Ms, Mph

North American Conference to End Race-Based Medicine

No abstract provided.

Sleeve Gastrectomy Vs. Glp-1 Agonists (Semaglutide): A Cost-Effectiveness Perspective On Long-Term Obesity Management, Naushad Khan, Luv Agarwal, Ritesh Sheth Md

North American Conference to End Race-Based Medicine

No abstract provided.

Contemplating Race In Clinical Algorithms: Educating The Physicians Of Tomorrow, Adam Gaetz

North American Conference to End Race-Based Medicine

No abstract provided.

Reimagining Black Maternal Health Narratives: Embracing A Vitality Framework For Joy, Liberation, And Healing, Ijeoma Nnodim Opara, Yasmine M. Elmi

North American Conference to End Race-Based Medicine

No abstract provided.

Voices From The Field: Provider Perspectives On The Implementation And Impact Of Race-Neutral Pfts, Kumbie Madondo Phd, Zoelene Hill Phd, Kimberly Murdaugh Md Ms, Natoushka Trenard Md

North American Conference to End Race-Based Medicine

No abstract provided.

Gender Disparities In Medical Student Clinical Experiences During Obstetrics And Gynecology Rotations In The Usa, Naushad Khan, Luv Agarwal, Ritesh Sheth Md, Rehana Sheikh

North American Conference to End Race-Based Medicine

No abstract provided.

Artificial Intelligence In Dental And Orthopedic Skeletal Imaging: A Scoping Review Of Methodological Convergence And Translational Gaps, Man Hung, Isabella Strickler, Annabella Jensen, Bayler Gunnell, Alicia Parry, Samuel Dyal, Martin S. Lipsky

Institute on Aging Publications

This scoping review aimed to answer the question: to what extent do artificial intelligence applications in dental and orthopedic skeletal imaging demonstrate true cross-disciplinary methodological convergence versus parallel development with shared translational barriers? This scoping review synthesizes AI applications across both fields to characterize methodological overlap, developmental asymmetries, and translational gaps, rather than assuming convergence. Following the PRISMA-ScR reporting standards, we searched PubMed, Scopus, Web of Science, IEEE Xplore, and EMBASE for peer-reviewed, English-language human studies published between January 2015 and May 2025. Eligible studies applied AI, machine learning, or deep learning to diagnostic, segmentation, or preoperative planning tasks in …

Escaping Traditional Teaching: An Interactive Approach To Pediatric Oncology Nursing Education, Paige A. Ackerman Bsn, Rn

Patient Care Services / Nursing

No abstract provided.

Association Between The Combined Herbal Medicines And Risk Of Dental Diseases In Patients With Rheumatoid Arthritis: Insight From A Nationwide Database, Chiu-Hui Ling, Wei-Jen Chen, Ying-To Hsu, Hanoch Livneh, Ming-Chi Lu, Tzung-Yi Tsai

Leadership, Learning and Counseling Faculty Publications and Presentations

Background and Objectives:

Patients with rheumatoid arthritis (RA) are found to have a higher risk of dental diseases. Although herbal medicines (HMs) have long been used to treat various conditions, few studies focus on its impact on dental diseases. In this longitudinal cohort study, we assessed the correlation between HM use and risk of dental diseases in RA groups.

Materials and Methods:

A total of 2359 persons with RA aged 20–80 who were free of dental diseases between 2001 and 2010 were retrospectively enrolled from nationwide register-based data. They were then classified into HMs and non-HMs groups based on whether …