Medicine and Health Sciences Commons^™

Irnet: Immunotherapy Response Prediction Using Pathway Knowledge-Informed Graph Neural Network, Yuexu Jiang, Manish Sridhar Immadia, Duolin Wang, Shuai Zeng, Yen On Chan, Jing Zhou, Dong Xu, Trupti Joshi

Biomedical Sciences

Introduction: Immune checkpoint inhibitors (ICIs) are potent and precise therapies for various cancer types, significantly improving survival rates in patients who respond positively to them. However, only a minority of patients benefit from ICI treatments.

Objectives: Identifying ICI responders before treatment could greatly conserve medical resources, minimize potential drug side effects, and expedite the search for alternative therapies. Our goal is to introduce a novel deep-learning method to predict ICI treatment responses in cancer patients.

Methods: The proposed deep-learning framework leverages graph neural network and biological pathway knowledge. We trained and tested our method using ICI-treated patients’ data from several …

Statewide Universal School Meal Policies And Food Insecurity In Households With Children, Dania Orta-Aleman, Marlene B. Schwartz, Anisha I. Patel, Michele Polacsek, Christina A. Hecht, Kenneth Hecht, Monica D. Zuercher, Lorrene D. Ritchie, Juliana F W Cohen, Wendi Gosliner

Health Sciences Faculty Publications

No abstract provided.

Scoring Large Muscle Movements In Pediatric Sleep Studies: An Educational Module For Sleep Technologists, Shauna Michelle Vandoren, David G. Ingram

Posters

Introduction Restless Sleep Disorder (RSD) has recently been recognized as a distinct sleep disorder, with Large Muscle Movement (LMM) scoring being a crucial component of its diagnostic criteria. This project aimed to develop and implement an online educational module to enhance the knowledge and skills of sleep technologists to accurately score LMMs. Methods We constructed an online learning module that included training on the identification and scoring of LMMs in pediatric sleep studies. The module consisted of a 10-question pre-assessment, the educational content (which explained the background of RSD diagnosis, the role of LMMs in diagnostic criteria, and current scoring …

Sunlight Exposure And The Risk Of Mortality And Breast Cancer Incidence, Noor Nadhim

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Prolonged sun exposure increases the risk of skin cancer. However, multiple sunlight-related health benefits have been identified. The overall impact of sun exposure on mortality is not clear. Sunlight could be associated with breast cancer risk via stimulating vitamin D photosynthesis; however, evidence has been mixed. Objectives: To investigate the association of time spent outdoors in daylight (in warmer and cooler months, and the total [annual]) and UV irradiance using the residential locations of participants with the risks of mortality (all-cause and cause-specific: cancer, cardiovascular [CVD], and non-cancer non-CVD) and primary invasive breast cancer.

Methods: This research …

Best Practices For A Competency-Based Curriculum In Critical Care Ultrasonography For Fellows, Paru Patrawalla, Frances West, Navitha Ramesh, Paul Mayo, Amik Sodhi

Division of Pulmonary, Allergy, and Critical Care Medicine Faculty Papers

New guidelines from the Accreditation Council on Graduate Medical Education for critical care ultrasound (CCUS) training went into effect on July 1, 2024, for critical care medicine and combined pulmonary and critical care medicine fellows. Fellowship programs will need to ensure that their fellows demonstrate competence in skills that are essential to CCUS, which currently encompasses applications in basic cardiac, lung/pleural, abdominal, and vascular ultrasonography (US). This may be a challenge for fellowship programs that have nascent CCUS curricula and limited faculty expertise. In this Perspective, we share expert and evidence-based recommendations on how to implement a competency-based curriculum in …

Perioperative Fluid Therapy Impairs Lymphatic Pump Function In Male Rats, Rebecca C Harlow-Adamek, Reetu Singh, Randolph H Stewart, Cristine L Heaps, Glen A Laine, Charles S Cox, Ranjeet M Dongaonkar

The Brown Foundation: Institute of Molecular Medicine

Because of its life-saving benefits, perioperative IV fluid therapy remains a cornerstone of medical treatment. However, it also induces sustained edemagenic stress. The resulting persistent interstitial edema-excessive fluid accumulation in the interstitium-significantly delays recovery and worsens patient outcomes. Therefore, to gain a detailed understanding of the lymphatic functional consequences of perioperative fluid therapy, this study aimed to test the hypothesis that perioperative IV fluid therapy compromises lymphatic pump function within 3 days after major surgery. Following a midline laparotomy, animals received IV fluid therapy over 48 h during recovery (FLTP). Three days post-surgery, mesenteric lymphatic vessels from FLTP and sham …

Assessment Of Emergency Medicine Residents' Situational Awareness And Perception Of Patient Safety Culture In The Emergency Department, Adriana Olson, Nathan Olson, Nicholas Hartman, Casey Morrone, Morgan Battaglia, Kamna Balhara

Department of Emergency Medicine Faculty Papers

BACKGROUND: Situational awareness (SA) and positive safety climate are crucial to patient safety. Little is known about emergency medicine (EM) trainees' SA and perception of emergency department (ED) safety climate, and the interactions of those factors with safety-related behaviors.

OBJECTIVES: Our objective was to evaluate EM residents' perceptions of ED safety climate, self-reported SA, and comfort with identifying, rectifying, and reporting safety hazards.

METHODS: In this cross-sectional study at two EM residencies, residents completed the Situational Awareness Rating Technique (SART) after ED-based or simulated resuscitations as well as a survey regarding safety climate and comfort with identifying, rectifying, and reporting …

Association Of Sars-Cov-2 With Health-Related Quality Of Life 1 Year After Illness Using Latent Transition Analysis, Lauren Wisk, Michael Gottlieb, Peizheng Chen, Huihui Yu, Kelli O'Laughlin, Kari Stephens, Graham Nichol, Juan Carlos Montoy, Robert Rodriguez, Michelle Santangelo, Kristyn Gatling, Erica Spatz, Arjun Venkatesh, Kristin Rising, Mandy Hill, Ryan Huebinger, Ahamed Idris, Michael Willis, Efrat Kean, Samuel Mcdonald, Joann Elmore, Robert Weinstein

Department of Emergency Medicine Faculty Papers

BACKGROUND: Long-term sequelae after SARS-CoV-2 infection may impact health-related quality-of-life (HRQoL), yet it is unknown how HRQoL changes during recovery. We compared patient-reported HRQoL among adults with COVID-19-like illness who tested SARS-CoV-2 positive (COVID+) with those who tested negative (COVID-).

METHODS: Participants in this prospective, multicenter, longitudinal registry study were enrolled from December 2020 through August 2022 and completed 3-month follow-up assessments until 12 months after enrollment. Participants were adults (≥18 years) with acute symptoms suggestive of COVID-19 who received a Food and Drug Administration-approved SARS-CoV-2 test. Participants received questions from PROMIS-29 (subscales: physical function, anxiety, depression, fatigue, social participation, …

Penicillin: The Burdensome Physiology Of Β-Lactamase, Lena Uyen-Thi Ngo

University Honors Theses

This thesis is a literature review investigating the effects of overusing penicillin and the nonadherence to proper treatment on the evolutionary changes in a bacterium's resistance. Drawing upon the history, present, and future of penicillin research, the examination analyzes how penicillin came to be, how bacteria developed their resistance, and how scientists are combating this issue. In doing so, the study investigates the historical timeline regarding the discovery of penicillin as an antibiotic. Furthermore, the review will examine the scientific changes within a bacterium's physiology to develop its antibiotic resistance. Finally, the review will delve into what scientists are currently …

The Impact Of Nicu Death On Bereaved Mothers, Jennie Terranova

University Honors Theses

Infant loss in the United States occurs 5.6 per 1,000 live births. This paper examines risk factors that contribute to neonatal death. Prematurity is a risk factor for NICU admission. A portion of premature babies receiving care in the NICU will die. The stressful nature of the NICU has been studied widely in journals. The impact of NICU death on hospital staff and bereaved parents has been studied less. Mortality studies suggest that bereaved mothers are at a high risk of dying within the first 5 years after their child has died. Despite the frequency of maternal death post-child loss, …

Surveying Management Strategies For Pediatric Autoimmune Hepatitis, Lillie Baca

University Honors Theses

Pediatric autoimmune hepatitis (PAIH) is a long-term condition that requires ongoing treatment and regular monitoring. It is characterized by its elevation of liver enzymes, interface hepatitis, and the specific presence of circulating autoantibodies. There is a general lack of consensus on appropriate measures of diagnostic criteria, treatment medication, and beneficial practices for monitoring the disease. The existing literature contains several subtle discrepancies that challenge a practitioner's judgement for care management of children with autoimmune hepatitis. This study is a retrospective chart review aimed at understanding the current diagnostics, treatment, and long-term management strategies of PAIH at a single center. Also, …

Assessing The Challenges Latin Immigrant Populations Face In Accessing Healthcare And Proposing Solutions To Improve Accessibility, Melina Khiabani

University Honors Theses

Access to healthcare is considered a basic human right, yet many Hispanic and Latin immigrant populations in the United States, especially those living in rural areas, face significant barriers that prevent them from receiving the care they need. These barriers include language differences, cultural misunderstandings, financial hardship, fear of legal consequences, and geographic isolation. This literature review explores the challenges that Hispanic/Latin immigrants aged 19-25 in rural areas encounter when trying to access healthcare, particularly preventative services.

Drawing from a wide range of existing research, this thesis identifies how policy restrictions, social determinants of health, and systemic discrimination contribute to …

Overcoming Vaccine-Associated Enhanced Respiratory Disease In Swine Flu With Lipid Nanoparticle-Dna Technology, The Nguyen

School of Veterinary and Biomedical Sciences: Dissertations, Theses, and Student Research

The two primary challenges in developing vaccines against swine influenza A virus (IAV-S) are the continuous viral evolution and vaccine-associated enhanced respiratory disease (VAERD). Current vaccine strategies share a common limitation: the significant time required for licensing updated vaccines. Moreover, the strain selection for vaccine updates depends entirely on predictions, raising the risk that chosen strains may not match circulating viruses. Such mismatches not only reduce vaccine efficacy but also risk exacerbating disease severity through VAERD. Here, in this thesis, we developed and evaluated a novel DNA-based vaccine platform designed to address the need for rapid updates in response to …

Cervical, Breast, And Colorectal Cancer Screening Outcomes Among Refugees In Philadelphia, Pennsylvania, Colleen Payton, Nina Kvaratskhelia, Melanie Chalfin, Jessica Deffler, Marc Altshuler

Department of Family & Community Medicine Faculty Papers

Cancer screening can detect cancer at an early stage and decrease cancer morbidity and mortality. Refugee populations may have had limited access to cancer screening before arrival in the United States. A cross-sectional analysis of cervical, breast, and colorectal cancer screening was conducted among refugees with primary care visits between 2018 and 2022 at a refugee health clinic in Philadelphia, Pennsylvania. Cancer screening outcomes included the number and type of screenings; the number of normal, inconclusive, and abnormal screening results; completion of follow-up tests for inconclusive and abnormal results; and the number of cancer diagnoses. Among 149 refugee women aged …

Pacific Rxtracts - June 2025, Pacific Rxtracts

Pacific RxTracts

Articles:

• Atzumi Receives FDA Approval as First Nasal Powder DHE for Migraine Treatment
• IMAAVY: First and Only FDA-approved Neonatal Fc Receptor Inhibitor for gMG
• New Prophylactic Treatment Approved for Hemophilia A or B, With or Without Factor Inhibitors
• Cytisinicline: The Next Smoking Cessation Aid
• FDA Approves Dupilumab for the Management of Chronic Spontaneous Urticaria
• Study Shows Promise in Combining Behavioral Treatment with Phentermine
• Metformin for Osteoarthritis
• A New Direction in Atopic Dermatitis Treatment
• Orforglipron: A Potential Oral Alternative to Injectable GLP-1 Agonists
• Beyond GLP-1s: MariTide’s Dual Mechanism in Weight Loss Therapy
• Atrasentan Gains FDA Approval to Combat Proteinuria in Primary …

Examining Long-Term Care For Ncaa Student-Athletes: Improving Concussion Protocols And Healthcare, Sydney Watson

University Honors Theses

Sports-related concussions (SRC) are a significant issue in collegiate athletics, particularly in high-impact sports. While the National Collegiate Athletic Association (NCAA) has protocols for immediate injury management, they don't fully address the long-term effects retired athletes experience. This paper examines whether former NCAA athletes who suffered from SRC should receive more comprehensive concussion-related healthcare. Findings reveal that current NCAA measures, such as baseline assessments and return-to-play protocols, fall short in addressing the lasting physical, cognitive, and emotional challenges of student-athletes who suffered multiple SRC. Protocols and procedures set by professional leagues like the NFL and NHL highlight the NCAA's gaps …

A Comprehensive Literature Review Of Gender Differences In Perception And Response To Stress, Zoe M. Shankland

University Honors Theses

It is well established that psychological stress, whether acute, chronic, or recurring, creates an imbalance in the body’s ability to regulate itself, leading to the potential for long-term disease. This paper looks at the possibility that women (anyone who identifies as a woman) experience more general mental stress than men (anyone who identifies as a man) due to women experiencing unique stressors under a patriarchal society. Men and women live different lives in modern society due to differing societal expectations and biological processes for women (menstruation, pregnancy, menopause). These extra feelings of stress may be tied to traditional gender roles …

Quantitative Analysis Using Mri Of Patients That Are High Risk For Pancreatic Cancer, Aqsa Tarik

University Honors Theses

Pancreatic ductal adenocarcinoma (PDAC) is a cancer that is detected in its later stages, causing its five-year survival rate of 2-9% (3). The majority of patients who develop PDAC unfortunately deal with a low survival rate due to the progression of the tumor in the body. Magnetic resonance imaging (MRI) can assess the structure of the tissue within organs in the body. These scans can also be used in order to detect and diagnose tumors, allowing them to be a generator of cancer biomarkers. PDAC isn’t distinguishable on conventional images, as the pancreas will appear normal, allowing the tumor progress …

Access To Healthcare For Rural Transgender Adults In The United States, Devon Smith

University Honors Theses

Urban and rural healthcare differ significantly in the amount of facilities, providers and kinds of specialty care that are offered in each environment. The United States is split into urban and rural counties in any given region, and based on those population sizes, are the allocation of healthcare resources for residents. In rural areas in the U.S., transgender adults lack access to gender-affirming care and encounter a lack of gender-affirming care providers due to workforce shortages, discrimination, and a lack of cultural competency. To determine if these residents lacked access to care compared with their urban counterparts, I performed a …

Transforming The Future Of Health: Building Learning Health Systems Across The Globe, Sandra Yankah, Robert Saunders, Mark L. Tykocinski, Claudia Salzberg, Jonathan Gonzalez-Smith, Rachel Bonesteel, Cameron Joyce, Charles Kahn, Mark Mcclellan, Eyal Zimlichman

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Health care has faced disruptions over the past 5 years, including a global pandemic, supply chain interruptions, workforce shifts, and the introduction of new artificial intelligence (AI) tools. Health care organizations continue to leverage the learning health system (LHS) concept to adapt to these challenges through iterative feedback loops. The Future of Health (FOH), an international community of over 50 senior health leaders that focuses on shared challenges across international health systems, collaborated with the Duke-Margolis Institute for Health Policy in a consensus-building process with FOH members to identify opportunities for action in an LHS. Key areas for action identified …

The Games Kids Play: Determining Concussion Risk Of Playground Sports, Brynlee Morgan

Health, Human Performance and Recreation Undergraduate Honors Theses

Playground games play a very vital role in child development, but they have been shown to present significant risks of injury, particularly concussion injuries. Supervisors of playground games or recreational sports may lack comprehensive knowledge of concussion protocols, potentially resulting in undiagnosed pediatric concussion, which can be critical to the child’s long-term health. This study aims to identify which playground games or recreational sports pose the highest risk for injury, specifically concussions, and highlights the importance of concussion prevention training for all school personnel to minimize potential health risks for children. The methodology involved the identification of injuries from playground …

June 2025: Region 10 Emerging Special Pathogen Treatment Center (Resptc) At Providence Sacred Heart Medical Center & Children’S Hospital, Providence - Special Pathogens Program

Special Pathogens Newsletters

REGION 10 SPECIAL PATHOGENS NEWSLETTER

High Immunoproteasome And Low Constitutive Proteasome Subunit Levels Correlate With Sensitivity To Bortezomib-Containing Chemotherapy: Update From The Children’S Oncology Group Aall1231 Trial, Margot S F Roeten, Johan Van Meerloo, Suzanne N Van Dijk, Zinia Kwidama, Gaye Jenkins, David T Teachey, Meenakshi Devidas, Mignon L Loh, Gertjan J L Kaspers, Sonja Zweegman, Gerrit Jansen, Terzah M Horton, Jacqueline Cloos

Faculty, Staff and Students Publications

No abstract provided.

Glucagon-Like Peptide-1 Receptor Agonists In Neurodegenerative Diseases: Promises And Challenges, Zhi Dong Zhou, Lingxiao Yi, Karolina Popławska-Domaszewicz, Kallol Ray Chaudhuri, Joseph Jankovic, Eng King Tan

Faculty, Staff and Students Publications

Glucagon-like peptide-1 (GLP-1) receptor agonists (GRA) belong to a class of compounds that reduce blood glucose and energy intake by simulating actions of endogenous incretin hormone GLP-1 after it is released by the gut following food consumption. They are used to treat type 2 diabetes mellitus (T2DM) and obesity and have systemic effects on various organs, including the brain, liver, pancreas, heart, and the gut. Patients with T2DM have a higher risk of developing neurodegenerative diseases (NDs), including Alzheimer's disease (AD), Parkinson's disease (PD), amyotrophic lateral sclerosis (ALS) and Huntington's disease (HD), accompanied by more severe motor deficits and faster …

Twenty-Five Years Of Palivizumab: A Global Historic Review Of Its Impact On The Burden Of Respiratory Syncytial Virus Disease In Children, Xavier Carbonell-Estrany, Eric A F Simões, Louis Bont, Paolo Manzoni, Heather J Zar, Anne Greenough, Octavio Ramilo, Renato Stein, Barbara Law, Asuncion Mejias, Manuel Sanchez Luna, Paul A Checchia, Leonard Krilov, Marcello Lanari, Ron Dagan, Brigitte Fauroux, Bernhard Resch, Terho Heikkinen, Joseph B Domachowske, Joanne G Wildenbeest, Federico Martinon-Torres, Richard Thwaites, Merih Cetinkaya, Adel S Alharbi, Carlos E Rodriguez-Martinez, Daniel E Noyola, Asiah Kassim, Satoshi Kusuda, Ji-Man Kang, Barry Rodgers-Gray, Anna Platonova, Fungwe Jah, Bosco Paes

Faculty, Staff and Students Publications

Introduction: Respiratory syncytial virus (RSV) causes significant morbidity and mortality in young children. For 25 years, palivizumab has been the only effective pharmaceutical RSV preventive.

Areas covered: We summarize the development and a quarter-century of real-world evidence with palivizumab. We highlight its positive impact on the burden of RSV in high-risk children. Based on lessons learnt from its implementation, we suggest strategies for effective and equitable deployment of newer RSV preventives.

Expert opinion: Following failure of the formalin-inactivated RSV vaccine in 1967, RSV intravenous immunoglobulin was approved in 1996 after three decades' research. Subsequently, palivizumab emerged as the most effective …

Eye Catching, Alec B Rezigh, Anand D Jagannath, Austin C Rezigh, Ann Marie Kumfer, Stephanie V Sherman

Faculty, Staff and Students Publications

A 55 year-old man with type 2 diabetes mellitus presented to the emergency department with subacute nausea, vomiting, and abdominal pain. He was found to have epididymitis and hyperglycemia that improved with antibiotics and supportive care. However, he was also discovered to have significant acute kidney injury and chronic, relapsing-remitting bouts of eye pain and redness, confirmed to be uveitis on ophthalmologic evaluation. Despite completing an appropriate course of antibiotics, his pyuria and kidney injury persisted. An extensive infectious, autoimmune, and malignancy work-up was negative. As such, renal biopsy was pursued and revealed findings consistent with tubulointerstitial nephritis. With a …

Weight Recidivism Post-Bariatric Surgery: A Lifestyle Modifications Educational Intervention, Kimeshia N. Johnson

Electronic Theses and Dissertations

Weight recidivism after bariatric surgery is a frustrating phenomenon for bariatric surgery patients and healthcare professionals. A 90-day lifestyle modification intervention for patients at least 18 months postsurgery was performed in the primary care setting to determine if a structured program could promote or maintain weight loss. The intervention aimed to investigate if participation in a structured lifestyle modification program would impact the body mass index of bariatric patients at least 18 months postsurgical intervention. In coordination with a nutritionist specializing in addiction and obesity education, a booklet detailing the guidelines for a 12-week program was provided to 41 bariatric …

Leadership And Peer Support Of Surgeons Post-Adverse Event: A Phenomenological Study, Maxine E. Trent

Electronic Theses and Dissertations

Abstract Surgeons are leaving the active practice of surgery and fewer physicians are pursuing surgical training, as a result the United States is predicted to have a shortage of surgeons until 2050. Surgery hosts a multitude of occupational stressors, one of which is interoperative adverse events and the subsequent experience of second victims. The literature indicates surgeons prefer psychological/emotional support from peers after interoperative adverse events. However, best practices for how to deliver peer and leadership support responses when surgeons experience second victims have not been established. This was a phenomenological qualitative study targeting practicing surgeons across the United States. …

When Macroglossia Is Not Beckwith-Wiedemann: A Case Of An Infant With Congenital Central Hypoventilation Syndrome, Shauna Michelle Vandoren, Samira Naime

Posters

Introduction Congenital central hypoventilation syndrome (CCHS) is a rare genetic disorder caused by the mutation of the paired-like homeobox 2B (PHOX2B) gene that leads to alveolar hypoventilation during sleep and at times while awake. The majority of patients with CCHS have polyalanine repeat mutations (PARM) whereas 10% have non-PARM (NPARM). Of those with NPARM, less than 1% are caused by whole gene deletion. NPARM is associated with more severe phenotypes; however, some may have variable penetrance causing variable presentation within families. Report of case(s) Our patient is a 4-month-old infant born at 32 weeks in an outside hospital and transferred …

22q11.2 Enhanced Recovery After Surgery Pathway (Eras), Children's Mercy Kansas City

Clinical Pathways

No abstract provided.