Medicine and Health Sciences Commons^™

Suturing Education For Athletic Trainers: An Evidence-To-Practice Review, Morgan K. Webb, Brett T. Heim, Allyson E. Ritchey, Kenya Moore, Zachary K. Winkelmann

Clinical Practice in Athletic Training

Teaching suturing skills to medical students is a critical component of their education. Implementing suturing into a comprehensive framework is developed from how professors teach the skill. Suturing is a required skill by the General Medical Council that all medical students must have, and how it is being introduced to new students is changing. This review aimed to summarize different educational interventions and determine the most efficient and cost-effective way to teach future suturing skills. The original systematic review included 25 articles in the final data synthesis. Fourteen studies were randomized control trials, six were quasi-experimental, and five were observational. …

In The Realm Of The Size Of Effect: What Advantages Do Cohen's D Or Glass's D Have?, Juan C. Lopez-Alvarenga, Isabel Omaña-Guzmán, Lucia M. Perez-Navarro

School of Medicine Publications

No abstract provided.

The Role Of Fibroblast Activation Protein On Left Ventricular Growth And Extracellular Matrix Remodeling As A Function Of Age And Pressure Overload, Amelia Marie Churillo

Theses and Dissertations

Fibroblast activation protein (FAP) is abundantly expressed in cancer associated fibroblasts and contributes to extracellular matrix (ECM) remodeling. Recent studies using imaging techniques have identified increased levels of FAP in the left ventricle (LV) of patients identified as at risk for developing heart failure. However, the role of FAP in regulated LV myocardial structure and function remains unclear. This project tested two hypotheses: First, genetic ablation of FAP would modify LV structure and function and be more pronounced with aging. Second, genetic ablation of FAP would modify LV structure and function with LV pressure overload (LVPO) accompanied by ECM remodeling.

Rapid Discrimination Of Mycobacterium Tuberculosis And Non-Tuberculous Mycobacteria Disease Via Interpretive Machine Learning Analysis Of Routine Laboratory Tests, Jia Wei Tang, Xue Song Xiong, Ting Ting Huang, Yu Lu Zhang, Lin Fei Yao, Wen Wen Zhang, Yun Yun Xie, Quan Fa Liang, Zhi Xuan Tan, Kun Jiang, Xin Liu, Liang Wang

Research outputs 2022 to 2026

Objectives Rapid discrimination of infections caused by Mycobacterium tuberculosis (MTB) and non-tuberculous mycobacteria (NTM) is crucial in clinical settings. Despite overlapping clinical and radiological features, the two require markedly different therapeutic approaches and public health responses. Current laboratory methods are time-consuming and complex, underscoring the urgent need for a simple and efficient diagnostic tool to inform public health decision-making. Methods Demographic, haematological and biochemical data were collected from two hospitals in Jiangsu province, China, between December 2018 and October 2024. A total of 400 patients were included in the training cohort, with 66 patients used for external validation. Six machine …

October 2025, Swosu Bulldog Wellness Committee

SWOSU BULLDOG WELLNESS

• October is National Dental Hygiene Month!
• Reminder: YOGA class Oct. 14th for SWOSU employees
• Spooktacular Step Challenge
• Home Fire Safety
• Wellness Committee has three standing desks to loan out
• National Family Health Month
• Autumn Word Search

Reducing Aspiration Pneumonia By Implementing An Enhanced Oral Care Toolkit, Jennifer London

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Oral care is essential for reducing bacteria and preventing aspiration pneumonia. The risk of aspiration pneumonia increases when protocols are not followed. In 2024, a regional hospital in the Midwest United States spent approximately one million dollars on the preventable healthcare-associated infection known as aspiration pneumonia. A pre-project chart audit of 100 random patient charts on a medical/surgical step-down unit revealed that only 1 of the 100 charts had oral care documented as completed.

Aim of the Project: The primary aims of this project were to increase nursing documentation of oral care by 50% and to decrease …

Improving Pain Assessment After Bedside Percutaneous Endoscopic Gastrostomy (Peg) Placement, Sherman Cotton

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Baseline audits at a 44-bed critical-illness recovery hospital showed low reliability in two post-PEG practices: (1) pain reassessment within 90 minutes of an intervention and (2) complete PEG-site documentation (skin, drainage, tube position/measurement). Baseline performance averaged 55% and 62%, both of which were below the organization’s 90% benchmark.

Aim of the Project: From May to July 2025 (12 weeks), improve on-time pain reassessment and ensure PEG-site documentation reaches at least 90%, maintaining this level for three or more consecutive weeks; monitor workload to prevent increases in perceived charting time and ensure safety by avoiding a rise in PEG-related …

Implementing A Standardized Ssri Tapering Protocol In The Outpatient Setting, Chelsea Sopo-Ngwa

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Selective serotonin reuptake inhibitors (SSRIs) are one of the most prescribed antidepressant medications in the outpatient psychiatric setting. Abrupt discontinuation or improper tapering of these medications may result in SSRI withdrawal symptoms. Adverse effects may lead to poor patient outcomes and increase healthcare utilization. A baseline chart review and provider readiness survey within the outpatient psychiatric practice revealed inconsistency in provider documentation related to SSRI tapering plans, patient education, and follow-up planning. The gap in practice highlighted the lack of a standardized SSRI tapering protocol to guide evidence-based medication tapering practices and promote patient safety.

Aim: The …

Reducing Hospital-Acquired Pressure Injuries In Critical Care Using A Preventing Pressure Ulcers Data Tool, Elizabeth Appiah-Caslin

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Hospital-acquired pressure injuries (HAPIs) are preventable yet remain a significant source of patient harm, especially in high-acuity settings like the Neurocritical Care (NCC) unit. HAPIs increase morbidity, length of stay, and healthcare costs. Despite having a prevention bundle, the NCC unit exceeded national benchmarks due to inconsistent adherence, delayed consultations, and variable documentation. Addressing this issue supports the organization's goals for safety and quality, aligning with CMS and Joint Commission standards.

Aim of the Project: This 12-week quality improvement project aimed to reduce HAPI incidence in the NCC unit by implementing the AHRQ Preventing Pressure Ulcers Data Tool. The …

Enhancing Nursing Documentation Accuracy For Female External Urinary Collection Devices Through Structured Documentation Huddles, Tiffany Ealy

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Accurate documentation of female external urinary collection devices (EUCDs), such as the PureWick, is crucial for maintaining continuity of care and ensuring efficient resource utilization. However, inconsistent nursing documentation practices have led to gaps in regulatory compliance and communication among healthcare teams. Baseline data revealed frequent omissions and inaccuracies in female EUCD charting, indicating a significant practice gap that requires targeted improvement.

Aim of the Project: The purpose of the evidence-based practice (EBP) project was to improve nursing documentation accuracy for female EUCDs by implementing structured documentation huddles, thereby enhancing organizational compliance.

Review of the Evidence: A …

Eat, Sleep, Console Care For Infants With Neonatal Abstinence Syndrome: A Multisite Evaluation, Amanda Fout

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Opioid use in pregnancy continues to rise, leading to increasing cases of neonatal abstinence syndrome (NAS). Traditional management with the Finnegan Neonatal Abstinence Scoring System (FNASS) often results in pharmacologic treatment, prolonged hospitalizations, and higher costs. Inconsistent FNASS scoring at the hospital system contributed to unnecessary NICU admissions and variable outcomes. Eat, Sleep, Console (ESC) was introduced as an alternative approach, but its effectiveness had not been formally evaluated.

Aim of the Project: The aim of the quality improvement initiative was to evaluate the effectiveness of the ESC model in improving outcomes for infants with NAS across three hospitals …

Implementing A Sepsis Questionnaire To Reduce Readmissions…A Health Plan’S Experience, Vernita L. Kelley

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Sepsis is a life-threatening condition with high readmission risk, threatening patient recovery and survival. In the managed care organization (MCO) where this DNP project was implemented, sepsis ranks among the top five readmission diagnoses. The organization's 30-day readmission rate of 15.5% is substantially higher than the benchmark of 9.29%, highlighting a clinical quality issue, a strain on patient outcomes, and a strain on healthcare resources.

Aim of the Project: This quality improvement (QI) project aimed to reduce sepsis readmissions by embedding a sepsis questionnaire into case management workflows to identify clinical risks and social determinants of health, improve transitions, …

Quality Improvement Initative To Reduce Falls Among Geriatric Patients In The Inpatient Mental Health Setting, Regina Johnson

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Falls are widely recognized as a leading cause of injury and hospitalization among older adults, with geriatric psychiatric patients at particularly high risk due to polypharmacy, cognitive impairment, and mobility challenges. At the project site, baseline audits revealed inconsistent use of structured fall risk tools, limited nurse-driven medication review, and gaps in post-fall documentation. The absence of an embedded electronic health record feature for medication review highlighted a significant practice gap requiring intervention.

Aim of the Project: The aim of this quality improvement (QI) project was to reduce fall risk in a geriatric psychiatric hospital through structured post-fall medication …

Fall Reduction Utilizing Fall Tailored Intervention For Patient Safety In Acute Care, Lauren Poindexter

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Hospitalized patient falls cause physical, psychological, and financial harm and persist despite prevention bundles. A Midwest Ohio acute medical unit experienced higher-than-benchmark fall rates (1.53–7.58 falls/1,000 patient days; unit rate 113% of the national median), with a rising trend in FY25. Reliance on the Schmid tool and existing interventions lacked structured patient/family engagement, as well as comprehensive medication assessment, leading to under-recognition of risk and limited nurse-driven prevention.

Aim of the Project: The aim of the project was to reduce inpatient fall rates and fall-related injuries on a medical unit by implementing the Agency for Healthcare Research and Quality …

Implementing Pain Reassessment Workflow To Improve Timely Pain Management In Hospice Patients: A Quality Improvement Project, Oluremi Omodara

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Timely pain reassessment is a vital component of hospice care, directly influencing the quality of life for patients. Despite the high prevalence of pain, which affects 55% of hospice patients due to disease progression or adverse drug reactions, only 51% of those reporting moderate to severe pain at admission receive a documented reassessment. The gap highlights an organizational issue in pain management stemming from the absence of a clearly defined period and workflow for reassessment.

Aim of the Project: The aim of the quality improvement (QI) project was to improve compliance with pain reassessment documentation within 48 hours …

Improving Patient Portal Messaging Workflow, Tanya M. Fitzpatrick

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Inefficiencies in patient portal secure messaging between providers and patients in a large primary care practice led to delayed resolution times, averaging 5.6 days per message. Most messages were closed by physicians or advanced practice providers, resulting in imbalanced workload distribution, increased provider burden, and reduced communication efficiency. The lack of standardized guidelines for message use, character limits, or triage processes contributed to workflow disruptions, a diminished patient experience, and unreimbursed provider time.

Aim of the Project: The aim of the project was to reduce average portal message closure times by at least 38% through the implementation of standardized …

Fall Prevention In Home Care: The Introduction Of The Steadi Initiative As Evidence-Based Tool, Margarida Barbosa - Barreiro

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Falls continue to be one of the leading causes of injury and mortality among older adults and remain a significant driver of healthcare utilization and cost. Within the home health setting, inconsistent practices in fall risk assessment and intervention have contributed to care gaps and increased patient vulnerability. The absence of a standardized, evidence-based process created the need for a structured quality improvement initiative to strengthen patient safety.

Aim of the Project: The purpose of this quality improvement project was to integrate the CDC’s Stopping Elderly Accidents, Deaths, and Injuries (STEADI) toolkit into home health visits to enhance the …

Global Npd Volunteerism From Your Home Office, Leanna Ross

Publications 2026-present

No abstract provided.

Dynamic Rewiring Of Microrna Networks In The Brainstem Autonomic Control Circuits During Hypertension Development In The Female Spontaneously Hypertensive Rat, Alison Moss, Ankita Srivastava, Lakshmi Kuttippurathu, James S. Schwaber, Rajanikanth Vadigepalli

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

We describe global microRNA (miRNA) changes in the central autonomic control circuits during the development of neurogenic hypertension. Using the female spontaneously hypertensive rat (SHR) and the normotensive Wistar Kyoto (WKY), we analyzed the dynamic miRNA expression changes in three brainstem regions-the nucleus of the solitary tract, caudal ventrolateral medulla, and rostral ventrolateral medulla-as a time series beginning at 8 wk of age before hypertension onset through to extended chronic hypertension. Our analysis yielded nine miRNAs that were significantly differentially regulated in all three regions between SHR and WKY over time. We collated computationally predicted gene targets of these nine …

Lung Cancer In Patients Of African Descent: A Transcontinental Review Of Epidemiology, Disparities, Outcomes, And Opportunities For Equity In Africa, North America, South America, And The Caribbean, Elvis Obomanu, Colton Jones, Verna Vanderpuye, Nazik Hammad

Division of Internal Medicine Faculty Papers & Presentations

Lung cancer in people of African descent is characterized by transcontinental disparities driven by epidemiologic heterogeneity, systemic inequities, and unequal access to health care. Globally, lung cancer incidence and mortality rates vary; however, underdiagnosis and late-stage presentation in low- and middle-income countries obscure the true prevalence of lung cancer because of limited cancer registries and diagnostic infrastructure. In Africa, most patients with lung cancer present at an advanced stage, primarily because of health illiteracy, misdiagnosis, delayed referrals, and inadequate treatment infrastructure. Although tobacco smoking remains a dominant risk factor worldwide, African populations are disproportionately exposed to environmental and occupational hazards, …

Hiv And Lung Cancer: A Single Cancer Center Experience, Julia Palecki, Matthew Tucker, Andrew Bernstein, Garrett Melby, Tingting Zhan, Ida Micaily

Division of Internal Medicine Faculty Papers & Presentations

Lung cancer (LC) is the leading cause of cancer death in people living with HIV (PLWH) and disproportionately affects this group regardless of CD4 count. At the Sidney Kimmel Comprehensive Cancer Center (SKCCC) at Jefferson Health, we treat an underserved PLWH population with LC and aim to study their clinical course, as they are often excluded from LC trials. We retrospectively reviewed 36 PLWH diagnosed with LC at Jefferson Health from 2016 to 2023. We found that 24 patients were male, 20 patients were Black, and that the median age of LC diagnosis is 66 years (range 38-83 years). 27 …

Progress In Progressive Pulmonary Fibrosis, Jesse Roman

Rothman Institute Papers

No abstract provided.

Occupational Therapy Interventions Supporting Transition To Adulthood For Individuals With Idd: A Systematized Review, Jenna Banzhaf, Emily Cummings, Bethany Krenzer, Kamryn Pokorney, Danielle Westmark, Stacy Smallfield, Molly Whitlow

Student Systematized Reviews: Occupational Therapy

Purpose: Individuals with intellectual and developmental disabilities (IDD) transitioning to adulthood often receive minimal support, resulting in challenges with education, employment, and independent living. This systematized review aimed to identify interventions within the scope of occupational therapy to aid a smoother transition to adulthood for individuals with IDD. By analyzing existing research, this study identified evidence-based OT strategies to promote independence, self-determination, and community participation.

Design: A systematized review of synthesized results from peer-reviewed studies that examined transition-related interventions for individuals with IDD. Articles were included if they address programs, skills, or approaches within the scope of OT.

Method: A …

Peritoneal Immunosurgery: Immunotherapy Augmented Surgery For The Treatment Of Peritoneal Cancers, Ada I Ozcan, Arianexys Aquino López, Mary K Mckenna, Malcolm K Brenner, Alastair M Thompson

Faculty, Staff and Students Publications

Peritoneal malignancy often indicates disruptions in multiple physiological systems resulting from widespread cancer. The heterogenous origin and dynamic nature of peritoneal cancer make it difficult to treat with standard approaches that fit into guidelines. We describe how successful treatment should address the underlying pathology, the systemic response to surgical treatments and target the immune perturbations that facilitate the establishment and propagation of this multifaceted disease.

Hyaluronidase-1 Mediates Postprandial Suppression Of Hepatic Gluconeogenesis, Xi Chen, Sophie Dogné, Yanru Deng, Huiqiao Li, Jieyi Meng, Charlise Giang, Jan-Bernd Funcke, Leon G Straub, Michelle Dias, Sundararajah Thevananther, Qiang Tong, Abu Hena Mostafa Kamal, Chandra Shekar R Ambati, Yu'e Liu, Nagireddy Putluri, Xia Gao, Miao-Hsueh Chen, Dongyin Guan, Hari Krishna Yalamanchili, Shangang Zhao, Nathalie Caron, Yi Zhu

Faculty, Staff and Students Publications

Hepatic gluconeogenesis is a critical process that generates glucose from non-carbohydrate precursors during fasting to support vital organs like the brain and red blood cells. Postprandially, this process is rapidly suppressed to allow for glucose storage as glycogen and lipids in the liver. Failure to suppress gluconeogenesis after meals leads to elevated postprandial glucose levels, a key feature of type 2 diabetes. This dynamic switch is regulated by insulin and glucagon, but insulin resistance impairs this regulation. In this study, we identified a novel mechanism involving postprandial circulating hyaluronan (HA) and lysosomal hyaluronidase-1 (HYAL1) that suppresses hepatic gluconeogenesis by rewiring …

Pan-Uk Biobank Genome-Wide Association Analyses Enhance Discovery And Resolution Of Ancestry-Enriched Effects, Konrad J Karczewski, Rahul Gupta, Masahiro Kanai, Wenhan Lu, Kristin Tsuo, Ying Wang, Raymond K Walters, Patrick Turley, Shawneequa Callier, Nirav N Shah, Nikolas Baya, Duncan S Palmer, Jacqueline I Goldstein, Gopal Sarma, Matthew Solomonson, Nathan Cheng, Sam Bryant, Claire Churchhouse, Caroline M Cusick, Timothy Poterba, John Compitello, Daniel King, Wei Zhou, Cotton Seed, Hilary K Finucane, Mark J Daly, Benjamin M Neale, Elizabeth G Atkinson, Alicia R Martin

Faculty, Staff and Students Publications

Large biobanks, such as the UK Biobank (UKB), enable massive phenome by genome-wide association studies that elucidate genetic etiology of complex traits. However, individuals from diverse genetic ancestry groups are often excluded from association analyses due to concerns about population structure introducing false positive associations. Here, we generate mixed model associations and meta-analyses across genetic ancestry groups, inclusive of a larger fraction of the UKB than previous efforts, to produce freely-available summary statistics for 7,266 traits. We build a quality control and analysis framework informed by genetic architecture. Overall, we identify 14,676 significant loci (p < 5 × 10−8) in the meta-analysis that were not found in the EUR genetic ancestry group alone, including novel associations for example between CAMK2D and triglycerides. We also …

Adeno-Associated Virus-Mediated Silencing Of Sox4 Leads To Long-Term Amelioration Of Liver Phenotypes In Mouse Models Of Alagille Syndrome, Duncan Fox, Jun Xie, Jennifer L Burwinkel, Josh M Adams, Kashish Chetal, Marzieh Keivandarian, Yaniv Faingelernt, Sanjay Subramanian, Mario F Lopez, Anna L Peters, Nathan Salomonis, Neda Zarrin-Khameh, Guangping Gao, Stacey S Huppert, Hamed Jafar-Nejad

Faculty, Staff and Students Publications

Background & aims: In patients with Alagille syndrome (ALGS), bile duct paucity often leads to severe cholestatic phenotypes for which liver transplantation remains the only definitive treatment. No Food and Drug Administration-approved mechanism-based strategies exist to enhance biliary development in ALGS or other diseases with bile duct paucity. We aimed to identify a therapeutic target to address this unmet need.

Methods: Preclinical ALGS mouse models lacking 1 copy of Jag1 with or without conditional deletion of 1 or both copies of Sox9 were used. Sox4 levels were reduced genetically or with adeno-associated virus 8 (AAV8) vectors driving a Sox4-silencing sequence. …

Protein Kinase Rock1 Activates Mitochondrial Fission Linking To Oxidative Stress And Muscle Atrophy, Meijun Si, Jihong Chen, Rizhen Yu, Hongchun Lin, Feng Li, Sungyun Jung, Sandhya S Thomas, Farhard R Danesh, Yanlin Wang, Hui Peng, Zhaoyong Hu

Faculty, Staff and Students Publications

Introduction: Chronic kidney disease (CKD) is associated with protein-energy wasting, characterized by a reduction in muscle mass and strength. Although mitochondrial dysfunction and oxidative stress are implicated in the pathogenesis of muscle wasting, underlying mechanisms remain unclear.

Methods: Here, we used transcriptomic analysis, metabolomics analyses, and mouse gene manipulation to investigate the effects of mitochondrial plasticity and oxidative stress on muscle wasting the subtotal nephrectomy mouse models of CKD. The mice with CKD were age- and sex-matched to sham-operated controls.

Results: Through these approaches, Rho-associated kinase ROCK1 emerged as a key molecule responsible for the observed mitochondrial fission and oxidative …

High Prevalence Of Abnormal Baseline Lung Function In Pediatric And Young Adult Hematopoietic Stem Cell Transplant Recipients: A Report From The Transpire Study, Jane Koo, Richard Cooper, Stephanie L Edwards, Adam Lane, Sara Katherine Loveless, Lauren Strecker, Kelly E Lake, Kasiani C Myers, Christopher Towe, Jessica Patti, Laura L Walkup, Kathryn A Wikenheiser-Brokamp, Margaret L Macmillan, Philip Lacher, Tamara Griffin, Merve Tekman, Gabriel Salinas Cisneros, Kevin Wu, Matthew S Zinter, Fernando A Urrego, K Scott Baker, Matthew F Abts, Sheri Ballard, Jason L Freedman, Alexander Caraballo, Lisa R Young, Maureen B Josephson, Julian L Allen, Devaney M Camburn, Erin E Doherty, Mashid Sababi Azamian, Martha Arredondo, Manuel Silva-Carmona, Leslie E Lehmann, Wai Wong, Jonathan M Gaffin, William Mcalpine, Mona Li, Samuel B Goldfarb, Jason C Woods, Stella M Davies

Faculty, Staff and Students Publications

Background: Pulmonary complications are a major cause of morbidity and mortality in pediatric and young adult hematopoietic stem cell transplant (HSCT) recipients. The impact of preexisting lung dysfunction on posttransplant outcomes remains understudied.

Methods: In a multi-institutional prospective cohort of 444 patients (≤24 years) undergoing allogeneic HSCT at eight centers, baseline lung function was categorized as normal or abnormal using clinical history, imaging, pulmonary function tests (PFTs), and pulmonologist review. Spirometry and diffusion capacity were assessed at baseline, Day 100, 1 year, and 2 years post-HSCT.

Results: Baseline pulmonary dysfunction was present in 224 patients (50.4%), including impaired spirometry (46.4%), …

Transdiagnostic Correlates Of Family Accommodation In Anxious Youth, Whitney S Shepherd, Erika S Trent, Orri Smarason, Hannah N Sansone, Daphne M Ayton, Amanda Palo, Abigail E Candelari, Wayne K Goodman, Andrew G Guzick, Eric A Storch

Faculty, Staff and Students Publications

Anxiety disorders are common in children and cause significant impairment. Family accommodation, which refers to behavioral changes that family members make to temporarily alleviate a child’s anxiety, has been linked to child anxiety symptom severity. Although emotional vulnerabilities for anxiety such as emotion dysregulation, anxiety sensitivity, and distress intolerance have been associated with family accommodation, research concerning the relationship between these constructs among anxious youth is limited. We hypothesized that these variables would be uniquely and positively associated with family accommodation and would moderate the relationship between anxiety symptom severity and family accommodation. Treatment-seeking child–parent dyads (N = 90; …