Medicine and Health Sciences Commons^™

Kendra's Paradox: Redefining The Statutory Approach To Assisted Outpatient Psychiatric Treatment In New York, Matt Donelian

Cardozo Journal of Equal Rights & Social Justice

The note critically examines the limitations of Kendra's Law in New York, which provides Assisted Outpatient Treatment (AOT) for individuals with severe mental illnesses. While the law aims to balance public safety and individual rights, its strict eligibility criteria often prevent timely intervention, leading to worse outcomes for those in need. The note proposes reforming the law to prioritize clinical assessments over past actions, enabling earlier intervention while respecting individual rights. This reform would address the law's retroactive nature and promote a more proactive, compassionate approach to mental health care.

Brain Candy: Wayne State University School Of Medicine Journal Of Arts And Culture, 12th Edition, Wayne State University School Of Medicine Gold Humanism Honor Society

Gold Humanism Honor Society

Brain Candy incorporates paintings, written pieces, and poetry from all the medical classes at Wayne State University School of Medicine to shed light on the creative process in medicine, the city of Detroit, and the experiences of health care providers. This year, the journal is organized into four sections, each of which denotes a particular time period within medical school. The first edition of Brain Candy was published online and in print in 2009, produced by a generous grant by the Gold Humanism Honor Society (GHHS). The edition featured poetry, nonfiction, short fiction, and different types of artwork. With generous …

Traumatic Brain Injury And Substance Use Disorder: A Clinic Based Exploratory Study, Steven Daniel Wheeler, Amanda Acord-Vira, Cecelia Simons, Kaleigh Papez, Jeremy Dixon, Cortland Nesley

Graduate Student Scholarship

Background: Traumatic brain injury (TBI) and substance use disorders (SUD) are common co-occurring conditions that have been investigated in isolation over the past several decades. Research regarding the conditions in unison have yielded conflicting results; however, there is a clear correlation linking negative implications of one condition on the other.

Objectives: To explore factors contributing to SUD among persons screening positive for a history of TBI and to validate the importance of screening for TBI as part of the SUD treatment program intake process.

Setting: Outpatient SUD treatment programs across West Virginia.

Design: Exploratory Study.

Methods: Those who screened positive …

Comparison Of Six Handheld Ultrasound Devices By Pediatric Point Of Care Ultrasound (Pocus) Experts, Stephanie K Leung, Ria Dancel, Riya N Soni, Ariadna Perez-Sanchez, Michael J Mader, Haitham Al-Wahab, Thomas W Conlon, Maria V Fraga, Javier J Lasa, Andrea Matho, Hannah Smith, Nilam J Soni

Faculty, Staff and Student Publications

BACKGROUND: Point of care ultrasound (POCUS) use is increasing among pediatric clinicians, but lack of access to ultrasound devices is a major barrier. The availability of pocket-sized handheld ultrasound devices ("handhelds") has improved access. However, no head-to-head comparative studies of handhelds in children have been performed to guide purchasing decisions.

METHODS: This cross-sectional study compared six handhelds: Butterfly iQ+™ (Butterfly Network Inc.), Clarius® (Clarius Mobile Health™), Kosmos™(EchoNous), TE Air™ (Mindray®), Vscan Air™ SL (General Electric), and Lumify™ (Philips Healthcare). Eight pediatric POCUS experts acquired views showing the abdominal right upper quadrant (RUQ), cardiac apical 4-chamber, and superficial neck and lung …

Evaluating The Human Abuse Potential Of Concurrent Use Of Electronic Cigarettes And Low Nicotine Cigarettes Among Adults Who Smoke, Jason D Robinson, Yong Cui, George Kypriotakis, Jeffrey M Engelmann, Maher Karam-Hage, Jennifer A Minnix, Charles E Green, Sanjay Shete, Dorothy K Hatsukami, Eric C Donny, Sharon E Murphy, Stephen S Hecht, Thomas Eissenberg, David W Wetter, Paul M Cinciripini

Faculty, Staff and Student Publications

The U.S. Food and Drug Administration has stated its intention to reduce the nicotine content of combustible cigarettes to render them less addictive. This study evaluated the impact of providing adults who smoke with both very low nicotine content cigarettes (VLNCCs) and electronic cigarettes (ECs) of varying nicotine content on measures of human abuse potential. Participants (

Harnessing Knowledge And Data For Clinical Information Extraction In The Era Of Large Language Models, Yan Hu

Dissertations and Theses (Open Access)

The rapid digitization of healthcare records has led to the widespread adoption of Electronic Health Records (EHRs), which contain rich, unstructured clinical notes. These notes hold valuable information for patient care and clinical research, but their complexity and unstructured nature pose significant challenges for effective utilization. Clinical Information Extraction (IE) aims to bridge this gap by transforming unstructured text into structured data, enabling automated analysis. Traditional Natural Language Processing (NLP) techniques, such as Named Entity Recognition (NER), have been widely used for clinical IE, but recent advancements in Large Language Models (LLMs) like GPT-3.5, GPT-4, and LLaMA have opened new …

Leveraging And Advancing The Foundation Models For Clinical Trajectory Analysis Based On Electronic Health Record Data, Jianping He

Dissertations and Theses (Open Access)

Enhancements in foundation models have provided significant potentials for clinical applications. This dissertation leverages and advances foundation models for a range of clinical tasks using electronic health record (EHR) data, demonstrating their applicability in Clinical Temporal Relation Extraction (CTRE), disease prediction, and patients trajectory analysis.

Aim 1 is to efficiently adapt large language models (LLMs) for CTRE in both full data and few-shot settings. This study leveraged four LLMs: GatorTron-Base, GatorTron-Large, LLaMA3.1, and MeLLaMA. The proposed fine-tuning strategies include: (a) standard fine-tuning; (b) hard-prompting; (c) soft-prompting; (d) Low-Rank Adaptation (LoRA). We found that nearly all proposed fine-tuning strategies outperformed existing …

Genetic Counseling As An Emerging Global Profession: Exploring Commonalities And Collaborations Among 15 Countries, Evelyn J. Leary

Senior Theses

Since 1969, the genetic counseling profession has expanded to almost 50 countries and is now considered a global profession. This paper’s goal was to explore the evolution of genetic counseling over time and among varied countries and to identify common themes in the establishment of the profession internationally. Each country known to have practicing genetic counselors was sorted into one of five categories: the first four were by the first training program’s establishment year, and the fifth included countries with genetic counselors but no domestic training program. Three countries from each category were selected to be highlighted based on factors …

Shifting Healthcare In Rural South Carolina: A Study Of Media Coverage Of The Effects Of Hospital Closures, Morgan Harper

Senior Theses

Rural hospital closures have become an increasingly urgent issue in healthcare across the United States. These closures have impacted access to healthcare, the job market, and general community health. Most hospitals have been forced to close due to low patient volumes, financial struggles, and corporate ownership. Immediate implications of closures include the displacement of healthcare workers, community concern about lacking a central healthcare facility, and increased travel times to access care.

This thesis examines South Carolina’s healthcare landscape in areas with hospital closures since 2012 and explores the effects of and responses to these closures as discussed in newspapers and …

The Impact Of Discretion On Human Service Workers Supporting The Health Of Unaccompanied Minors In Foster Care, Diana M. Clark

Senior Theses

Unaccompanied children (UCs) are a vulnerable population that enters government custody and accesses healthcare via the Office of Refugee Resettlement (ORR)'s system of care. While prior research has focused on generating policy recommendations to improve healthcare services available to UCs both in ORR custody and following release from custody, this thesis will instead expand upon the experiences of staff members working at ORR-contracted agencies. These workers make decisions that have short- and long-term implications on the health and wellbeing of UCs. Drawing from 65 in-depth interviews with human service workers in ORR-contracted voluntary agencies, this thesis uses street-level bureaucracy framework …

Psychedelic Psychotherapy And The Mental Health Crisis: A Historical And Scientific Review, Dylan Kunkel, Neil Levens, Charles Schumpert

Senior Theses

The global mental health crisis continues to expose the limitations of traditional psychiatric treatments for major depressive disorder (MDD) and post-traumatic stress disorder (PTSD). As conventional antidepressants offer modest remission rates and delayed efficacy, interest has grown in the therapeutic potential of psychedelic compounds. This thesis explores psychedelic psychotherapy through both a historical and scientific lens, tracing its roots from ancient ceremonial practices to modern clinical trials. It also provides context behind the neurobiological mechanisms by which psychedelics like psilocybin, LSD, ketamine, MDMA, and DMT affect mood and cognition. These compounds appear to reduce default mode network (DMN) connectivity, increase …

Impacts On College-Aged Asian American Mental Health, Zahra Soherwardy

Senior Theses

This study explores the relationship between different forms of racial harassment and mental health issues in Asian American college students. Asian American mental health is a growing concern in the field of public health. Asian Americans have the lowest treatment rates and some of the highest stigma levels of any demographic. They are also impacted by the model minority myth and discrimination, further alienating them from getting help. The topics of subtle racism, blatant racism, and current racial discrimination were compared to depressive symptoms, anxiety, self-esteem, and four domains of aggression using survey data. Subtle racism was found to be …

A Visual Journey Of Indigenous Health Doctoral Research Students - Photovoice Research, Shawnda Schroeder, Brynn Luger, Gem Wilson, Julie Smith-Yliniemi, Grace Karikari

Indigenous Health Faculty Publications

We conducted a qualitative photovoice research project in which students attending summer seminar in 2024 captured images during their week on campus, then submitted the images along with title and narrative. Two virtual focus groups were then held to present and discuss these images. Focus group discussions were transcribed, coded, and were validated through code confirmation and member checking. A crucial component of photovoice research is presentation of the images and associated narratives. This is a transformative research method, intended to generate community awareness about an important topic, and to empower participants through presentation of their experience. This photo book …

Infographic: Students Who Are American Indian: Seal!Nd 2021-2022 School Year, Shawnda Schroeder, Tonya Connor

Indigenous Health Faculty Publications

Evaluation data from the North Dakota’s school-based sealant program demonstrate oral health concerns for children who are American Indian and Alaksa Native. Three out of every five students who are American Indian (60%) had untreated decay or rampant decay compared to only 36% of their non-Indigenous peers during the 2021-2022 school year.

Infographic: Covid-19 Pandemic Impact On Student Oral Health: Seal!Nd 2021-2022 School Year., Shawnda Schroeder, Tonya Connor

Indigenous Health Faculty Publications

North Dakota’s school-based sealant program identifies increased need for dental treatment and prevention following the COVI-19 pandemic. During the 2020-2021 school year, roughly one out in every two students presented with untreated decay among the 36 North Dakota schools participating in the sealant program.

Infographic: Reach Of Seal!Nd: Impact For Students In North Dakota, 2021-2022 School Year, Shawnda Schroeder, Tonya Connor

Indigenous Health Faculty Publications

Fifty schools in North Dakota participated in a school-based sealant program during the 2021-2022 scho9ol year, making a difference in the oral health and well-being of nearly 1,200 students.

Report: Evaluation Of Seal!Nd: School Year 2021-2022, Shawnda Schroeder, Tonya Connor

Indigenous Health Faculty Publications

This comprehensive report provides evaluation data on the reach and impact of the North Dakota Oral Health Program’s school-based sealant program through the 2021-2022 school year. Data are presented longitudinally and identify inequities in care provision by race, grade level, and self-reported gender.

Report: North Dakota Department Of Health Oral Health Program: Full Evaluation Of The Oral Health Program’S Activities Under Centers For Disease Control And Prevention (Cdc) Grant, State Actions To Improve Oral Health Outcomes (Year Four), Shawnda Schroeder

Indigenous Health Faculty Publications

The North Dakota Oral Health Program is situated within the Healthy and Safe Communities Section of the ND Department of Health and Human Services. Funding from the Centers for Disease Control and Prevention’s (CDC’s) State Actions to Improve Oral Health Outcomes enables the Oral Health Program to strengthen (1) a school-based dental sealant program (SEAL!ND); (2) efforts to promote and sustain optimal levels of CWF; (3) oral health surveillance; and (4) a pilot program to facilitate medical dental integration though blood pressure screening at dental offices. This report highlights programmatic work and presents the results of the formative evaluation for …

Report: Evaluation Of Seal!Nd: School Year 2023-2024, Shawnda Schroeder, Rashid Ahmad

Indigenous Health Faculty Publications

The North Dakota school-based sealant program (SEAL!ND) prioritizes providing preventive oral health care to underserved students by targeting schools with 45% or greater of their students enrolled in the free and reduced fee school lunch program (these are considered qualifying schools). Although schools with a larger proportion of youth who are from lower-income households are prioritized by federal funding, additional schools participate and receive care from local dental providers (these are referred to as non-qualifying). This report highlights the reach of the program and the students served during the 2023-2024 school year.

Semi-Parametric Testing For Ordinal Treatment Effects In Time-To-Event Data Via Dynamic Dirichlet Process Mixtures Of The Inverse-Gaussian Distribution., Jonathan A Race, Amy S Ruppert, Yvonne Efebera, Michael L Pennell

Ambulatory and Primary Care Articles

Time-to-event data often violate the proportional hazards assumption under which the log-rank test is optimal. Such violations are especially common in the sphere of biological and medical data where heterogeneity due to unmeasured covariates or time varying effects are common. A variety of parametric survival models have been proposed in the literature which make more appropriate assumptions on the hazard function, at least for certain applications. One such model is derived from the first hitting time paradigm which assumes that a subject's event time is determined by a latent stochastic process reaching a threshold value. Several random effects specifications of …

April 2025, Swosu Bulldog Wellness Committee

SWOSU BULLDOG WELLNESS

Practice mindfulness!

Here are some strategies for a healthier Spring

April word search

Postnatal Zika And Dengue Infection And Their Effects On Neurodevelopment Among Children Living In Rural Guatemala, Edwin J Asturias, Amy K Connery, Daniel Olson, Molly M Lamb, Alejandra Paniagua-Avila, Evan J Anderson, Chris Focht, Alison M Colbert, Muktha Natrajan, Jesse J Waggoner, Erin Scherer, D Mirella Calvimontes, Guillermo A Bolaños, Desirée Bauer, Paola Arroyave, Sara Hernández, Maria A Martinez, Aida V Ralda, Neudy Rojop, Edgar E Barrios, Andrea Chacon, Walla Dempsey, Kay M Tomashek, Wendy A Keitel, Hana M El Sahly, Flor M Muñoz

Faculty, Staff and Students Publications

Background: Prenatal Zika virus (ZIKV) infection leads to microcephaly and adverse neurodevelopment. The effects of postnatal ZIKV infection on the developing brain are unknown. We assessed the neurodevelopmental outcomes of children exposed postnatally during the ZIKV epidemic.

Methods: A prospective study enrolled infants 0-3 months of age and their mothers, and children 1.5-3.5 years of age in rural Guatemala from 2017 and were followed for 12 months until 2019. Neurodevelopment was evaluated using the Mullen Scales of Early Learning (MSEL). ZIKV and dengue virus (DENV) infections were identified by polymerase chain reaction (PCR) using active surveillance. Serological analyses, stratified by …

Targeting Malaria Using Rts,S/As01 Liposome Based Therapy In Combination With Cryptolepis Sanguinolenta, Michelle Villacorta Del Castillo

Selected Honors Theses

Malaria has shown to be a threatening disease to half of the population of the world, with currently 241 million cases reported. Malaria treatments have yet to be completely effective due to their ability and resistance to antimalarial drugs Plasmodium falciparum has developed, making it challenging to help treat this disease. RTS, S/AS01 has been shown to act on the pre-erythrocytic stage of malaria, targeting the circumsporozoite protein of Plasmodium falciparum expressed by the malaria parasite during this stage. At the same time, Cryptolepsis Sanguinolenta has been shown to have 90% inhibition of Plasmodium falciparum K1 growth. They have both …

Supporting College Students’ Mental Health Through Occupational Therapy, Mallory R. Watts

Selected Honors Theses

The mental health of college students has emerged as a significant concern, particularly because of the pressures of academic, social, and personal demands intensify. This study investigates the role of Occupational Therapy (OT) in supporting the mental health of college students, exploring the potential need for integrating OT services into campus programs. By assessing the current mental health resources available to students and evaluating their effectiveness, this research aims to identify gaps in support and determine whether OT could serve as a valuable addition to existing services. Through a combination of surveys, interviews, and literature reviews, the study examines students' …

Importance Of Postreduction Ct Scans In Posterior And Transverse Posterior Wall Acetabular Fracture-Dislocations, Samantha R Gardner, Douglas R Haase, Nikhil Gattu, Stephen J Warner, Milton L Chip Routt, Patrick Kellam, Jonathan G Eastman

Faculty, Staff and Student Publications

Objectives: To report the frequency of patients with pre-reduction and postreduction computed tomography (CT) scans associated with acetabular fracture-dislocations and the change in position of associated intra-articular fragments occurring with joint reduction.

Design: Retrospective case series.

Setting: Regional Level 1 trauma center.

Patient selection criteria: Patients who sustained Arbeitsgemeinschaft fur Osteosynthesefragen/Orthopedic Trauma Association 62A1 and 62B1 posterior wall or transverse posterior wall acetabular fracture-dislocations with pre-reduction and postreduction CT imaging from February 2020 to July 2023.

Outcome measures and comparisons: Intra-articular fragments were identified, and change in position (fossa to cranial, intra-articular to extra-articular, etc.) was noted from pre-reduction to …

Uric Acid Stroke Cerebroprotection Transcended Sex, Age, And Comorbidities In A Multicenter Preclinical Trial, Rakesh B Patel, Mariia Kumskova, Hanish Kodali, Ivan Budnik, Vitalii Kuznetsov, Aditi Jain, Abhishek Jha, Daniel Thedens, Nirav Dhanesha, Brijesh Sutariya, Karisma A Nagarkatti, Jessica Lamb, Pradip Kamat, Yanrong Shi, Brooklyn Avery, Takahiko Imai, Xuyan Jin, Anjali Chauhan, Ligia S B Boisserand, Mohammad B Khan, Krishnan Dhandapani, Basavaraju G Sanganahalli, Lauren H Sansing, David C Hess, Raymond C Koehler, Louise D Mccullough, Jaroslaw Aronowski, Cenk Ayata, Márcio A Diniz, Patrick D Lyden, Anna M Planas, Angel Chamorro, Anil K Chauhan, Enrique C Leira, Span Investigators

Faculty, Staff and Student Publications

Background: Past failures in translating stroke cerebroprotection provoked calls for a more rigorous methodological approach, leading to the stroke preclinical assessment network SPAN (Stroke Preclinical Assessment Network), where uric acid (UA) treatment exceeded a prespecified efficacy boundary for the primary functional outcome. Still, successful translation to humans requires confirmation of the effect of UA across key biological variables relevant to patients with stroke.

Methods: We measured the effects of intravenous UA treatment (16 mg/kg) versus intravenous saline in groups of animals enrolled in the SPAN network with diverse comorbidities, sex, and age. The masked study drug or placebo was administered …

Opportunities In Stroke Care At Safety Net Hospitals: A Socioecological Perspective, Anjail Sharrief, Joshua Wollen, Maha Almohamad, M Carter Denny, Erica Jones, Aardhra M Venkatachalam, Digvijaya Navalkele, Shivika Chandra, Mariam Ahmed, Robert Pratt, Bradley D Shy, John Mcmenamy, Chigozirim Izeogu, Lesli E Skolarus, Nneka L Ifejika, Nicole R Gonzales

Faculty, Staff and Student Publications

Safety net hospitals (SNHs) provide care to patients regardless of their insurance status or ability to pay, serving populations at the highest risk for poor stroke outcomes. These include historically marginalized racial and ethnic groups, and individuals disproportionately affected by adverse social drivers of health, including lower socioeconomic status, housing instability, and limited access to preventive care. Improving stroke care at SNHs presents a critical opportunity to strengthen care delivery for individuals with the greatest need. However, such efforts require a clear understanding of the barriers across all levels of the healthcare system. In this Perspective, the authors adopt a …

Fungal Infections In People Who Use Drugs, Jose Portugal Gonzales, Luis Ostrosky-Zeichner

Faculty, Staff and Student Publications

Illicit drug use in the United States continues to rise, alongside an increasing number of severe infections associated with drug use. Surveillance studies report that 28%–34% of candidemia cases are linked to intravenous drug use, with Candida albicans being the most commonly isolated species, followed by Candida parapsilosis and Candida glabrata. Marijuana use is associated with lung infections caused by Aspergillus and the Mucorales, showing a 3.5-fold increased risk of mold infections and a 2.2-fold increased risk for other fungal infections. Intravenous drug use also presents a recognized risk factor for Aspergillus and Mucorales infections. Additionally, substances like …

Acute Pain Trajectories In Elderly Patients With Fragility Hip Fractures, Paul Potnuru, Christina Goehl, Katherine S Becker, Alejandro Juul, Madison Aycock, Johanna Blair De Haan, Sudipta Sen, Michelle Ge, Stephen J Warner, Nadia Hernandez

Faculty, Staff and Student Publications

Background: Pain management for hospitalized elderly patients with fragility hip fractures (FHF) remains challenging. This study aims to distinguish acute pain trajectories in FHF patients that can inform personalized analgesia management.

Methods: We conducted a prospective observational study of patients aged 65 and older with FHF at a Level I trauma center. The primary outcome was daily average pain assessed for five days post-injury using the Brief Pain Inventory (BPI). We used group-based trajectory modeling (GBTM) to distinguish acute pain trajectories. Then, factors and secondary outcomes (opioid use and hospital length of stay [LOS]) associated with more severe pain trajectories …

The Interaction Between Antithrombin And Endothelial Heparan Sulfate Mitigates Pulmonary Thromboinflammation After Trauma And Hemorrhagic Shock, Maria Del Pilar Huby Vidaurre, Ava K Mokhtari, Baron K Osborn, Bryan A Cotton, Yao-Wei Wang, Yongmei Xu, Katelyn Arnold, Jian Liu, Jillian R Richter, Jessica C Cardenas

Faculty, Staff and Student Publications

Introduction:

Trauma and hemorrhagic shock (T/HS) are associated with multiple organ injury. Antithrombin (AT) has anti-inflammatory and organ protective activity through its interaction with endothelial heparan sulfate containing a 3-O-sulfate modification. Our objective was to examine the effects of T/HS on 3-O-sulfated (3-OS) heparan sulfate expression and determine whether AT-heparan sulfate interactions are necessary for its anti-inflammatory properties.

Methods:

Male Sprague Dawley rats underwent laparotomy, gut distension and fixed-pressure hemorrhagic shock (HS) and resuscitation. Liquid chromatography-coupled mass spectrometry analyses were performed to measure pulmonary and plasma heparan sulfate di/tetrasaccharides. Pulmonary mRNA levels were assessed by nCounter …