Medicine and Health Sciences Commons^™

Reducing The Use Of Erythropoiesis-Stimulating Agents In Hemodialysis Patients, Myriamme Neree

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice project was a quality improvement (QI) initiative. Nephrologists were inconsistent in ordering iron studies and sometimes delayed the initiation of erythropoiesis-stimulating agents (ESAs) on admission to the inpatient site. These delays often led to suboptimal outcomes. The practice-focused question guiding the project asked whether a nurse-driven iron protocol would improve adherence to anemia management guidelines. The project’s purpose was to evaluate the impact of the evidence-based nurse-driven protocol. I used descriptive and inferential statistics for data analysis. Findings demonstrated a statistically significant improvement in the timely completion of iron studies and in intravenous (IV) iron …

Endocrine Disrupting Chemicals And Adrenal Gland​, Gülay Şi̇mşek Bağir, Melek Eda Ertörer

Turkish Journal of Medical Sciences

Endocrine disrupting chemicals (EDCs) are exogenous compounds that have hormone-like effects inside the body. Endocrine disruptors can affect adrenal glands in humans and animals. Adrenocortical dysfunction related to chemical exposure has been reported in the literature.The human adrenal gland is crucial for the synthesis of steroid hormones (glucocorticoids, mineralocorticoids, and androgens) and amino acid-derived hormones (epinephrine and norepinephrine). All steps in the adrenocortical steroidogenesis pathway are potential targets for chemical inhibition, including the adrenocorticotropic hormone receptor, steroidogenic acute regulatory protein, mitochondrial cytochrome P450 (CYP) enzymes (CYP11A1, CYP17, CYP21, CYP11B1, and CYP11B2), and 3-hydroxysteroid dehydrogenase D4,5 isomerase. EDCs either inhibit the …

The Effects Of Endocrine Disruptors On The Female Reproductive System, Riza Gökhan Baykal, Reyhan Ersoy

Turkish Journal of Medical Sciences

Endocrine-disrupting chemicals (EDCs) are a diverse, comprehensive group of mostly synthetic chemicals that disrupt many physiological functions in humans and animals. EDCs are particularly disruptive to the female reproductive system. Reproductive function in women is a dynamic process regulated by the hypothalamic–pituitary–ovarian axis. EDCs show their effects on the reproductive system through estrogenic, antiestrogenic, androgenic, and antiandrogenic effects or by directly affecting gonadotropin-releasing hormone secretion. Disruption in the menstrual cycle, decrease in fertility, infertility, increased risk of miscarriage, polycystic ovary syndrome, endometriosis, early or delayed puberty, and hormone-sensitive cancers can be listed as the main negative effects of endocrine disruptors …

Endocrine-Disrupting Chemicals In Metabolic Bone Diseases, Including Osteoporosis, Betül Gündüz, Eli̇f Kiliç Kan, Ayşegül Atmaca

Turkish Journal of Medical Sciences

Endocrine disruptors are chemical substances widely utilized across various industrial sectors. Due to their structural similarity to natural ligands, they bind to receptors and influence the endocrine system via agonist–antagonist mechanisms. Exposure occurs through the consumption of contaminated food and water, inhalation of polluted air and dust, and dermal contact. Owing to their dynamic remodeling capacity, bones represent potential targets for endocrine-disrupting chemicals. These chemicals can disrupt bone formation, skeletal development, hormonal regulation, and calcium metabolism. Sensitivity to endocrine-disrupting chemicals is greatest during the prenatal and early postnatal periods. This review summarizes the effects of endocrine-disrupting chemicals on bone tissue.

Surgical Revision In The Presence Of An S. Aureus Infection Increases Virulence Factor Expression And Activates A Multi-Tissue Inflammatory Response, Carly J. Smith, Arianna J. Moniodes, Amanda R. Watkins, Autumn G. Melvage, Thomas P. Thompson, Eirene Choi, Abigail A. Lucas, Brendan F. Gilmore, Thomas P. Schaer, Noreen J. Hickok, Theresa A. Freeman

Department of Orthopaedic Surgery Faculty Papers

Replacing implanted medical hardware due to infection often requires one or more revision surgeries. Each surgery triggers a tissue injury response and disrupts the established bacterial biofilm. However, the complex tissue response to reinjury and biofilm disturbance is not well understood. Our results show that with an existing infection, immunological niches such as the bone marrow, lymph nodes, and circulating blood further upregulate pro-inflammatory programs in response to revision. Rather than reducing bacterial burden, this heightened inflammation provokes virulence factor expression and tissue damage, including bone osteolysis and muscle fibrosis. While muscle fibrosis appears transient and begins resolving by 14 …

Urinothorax And Empyema: Presentation Of An Unusual Complication Of A Rare Condition, Nolan Fox, Nicholas Fox, Shourjo Chakravorty, Neeraj Sinha

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

A 68-year-old male with a history of metastatic bladder cancer and urinary obstruction presented with intractable hiccups and chest pain is presented in this case. He was found to have a unilateral pleural effusion in addition to ipsilateral renal metastasis abutting the diaphragm. Imaging revealed empyema. Thoracentesis revealed positive cultures and a lack of malignant cells on cytology. Comorbid urinary obstruction and urinary tract infection suggested the rare diagnosis of an infected urinothorax. Thoracentesis also revealed pleural fluid creatinine greater than serum creatinine, meeting the most specific diagnostic criteria for urinothorax and establishing the diagnosis. Treatment aimed at evacuating the …

Hydrodynamic Contrast Recanalization-Facilitated Rotational Atherectomy To Treat A Heavily Calcified Coronary Chronic Total Occlusion, Som P Singh, Mustafa Al Qaysi, Angelo Nascimbene, Mauro Carlino, Salman A Arain

Faculty, Staff and Student Publications

BACKGROUND: Percutaneous coronary intervention (PCI) for heavily calcified chronic total occlusion (CTO) remains among the most challenging procedures in interventional cardiology. Hydrodynamic contrast recanalization (HDR) is a novel crossing technique for CTO that uses intraplaque contrast microinjections in the proximal CTO to facilitate the passage of polymer jacketed wires. The use of HDR combined with rotational atherectomy (RA) during CTO PCI in heavily calcified arteries has not been described.

CASE SUMMARY: A 72-year-old man with refractory angina was referred for revascularization of a chronically occluded ramus intermedius. The presence of heavy calcium and flush occlusion of the left main artery …

Unraveling The Drivers Of Inequality In Maternal Healthcare Utilization In Indonesia: A Decomposition Analysis, Wji Wahyuningsih, Kemal N. Siregar, Syifa Nurhakiki

Jurnal Ekonomi Kesehatan Indonesia

This study assessed socioeconomic inequalities in maternal healthcare utilization in Indonesia and identifies key factors driving these inequalities. We used data from 2013 and 2023 Indonesian Health Surveys, comprised of a total unweighted sample of 15,638 and 9,923 women aged 15-49 in the 2013 and 2023, respectively. Concentration index (CI) measured wealth-based inequality, and decomposition analysis identified primary drivers of inequalities in maternal healthcare access. Overall maternal healthcare service utilization has increased, but significant inequalities persist. Antenatal care showed minimal improvement, with the CI rising from 0.059 to 0.079, indicating a persistent higher socioeconomic distribution. Facility-based deliveries improved, with the …

Clinical Outcomes Of Patients With Unsuccessful Mechanical Thrombectomy Versus Best Medical Management Of Medium Vessel Occlusion Stroke In The Middle Cerebral Artery Territory, Tobias D Faizy, Vivek Yedavalli, Hamza Adel Salim, Dhairya A Lakhani, Basel Musmar, Nimer Adeeb, Muhammed Amir Essibayi, Motaz Daraghma, Kareem El Naamani, Nils Henninger, Sri Hari Sundararajan, Anna Luisa Kuhn, Jane Khalife, Sherief Ghozy, Luca Scarcia, Leonard Ll Yeo, Benjamin Yq Tan, Robert W Regenhardt, Jeremy Josef Heit, Nicole M Cancelliere, Aymeric Rouchaud, Jens Fiehler, Sunil A Sheth, Ajit S Puri, Christian Dyzmann, Marco Colasurdo, Leonardo Renieri, João Pedro Filipe, Pablo Harker, Răzvan Alexandru Radu, Mohamad Abdalkader, Piers Klein, Thomas R Marotta, Julian Spears, Takahiro Ota, Ashkan Mowla, Pascal Jabbour, Arundhati Biswas, Frédéric Clarençon, James E Siegler, Thanh N Nguyen, Ricardo Varela, Amanda Baker, David Altschul, Nestor Gonzalez, Markus A Möhlenbruch, Vincent Costalat, Benjamin Gory, Christian Paul Stracke, Constantin Hecker, Gaultier Marnat, Hamza Shaikh, Christoph J Griessenauer, David S Liebeskind, Alessandro Pedicelli, Andrea Maria Alexandre, Illario Tancredi, Erwah Kalsoum, Max Wintermark, Boris Lubicz, Aman B Patel, Vitor Mendes Pereira, Adam A Dmytriw, Adrien Guenego, Mad-Mt Investigators

Faculty, Staff and Student Publications

Background: Current randomized controlled trials are investigating the efficacy and safety of mechanical thrombectomy (MT) in patients with medium vessel occlusion (MeVO) stroke. Whether best medical management (MM) is more efficient than unsuccessful vessel recanalization during MT remains unknown.

Methods: This was a retrospective cohort study using data from 37 academic centers across North America, Asia, and Europe between September 2017 and July 2021. Only patients with occlusion of the distal branches (M2 and M3) of the middle cerebral artery territory were included. Unsuccessful MT was defined as a modified Thrombolysis in Cerebral Infarction score of 0-2a. Propensity score matching …

Effects Of Pamam Dendrimer Size On Antimicrobial Activity For Acne Treatment, Elise M. Inae

Honors Theses

This study investigated the antimicrobial activity of G1, G2, and G3-Hex-NH2 polyamidoamine (PAMAM) dendrimers with an emphasis on how dendrimer size influenced their efficacy against C. acnes and S. epidermidis. Dendrimers are nano-sized, radially symmetric polymers composed of highly branched units that extend out from a central core. Dendrimers are known to exhibit antimicrobial activity against Gram-negative bacteria by disrupting the lipid bilayer and causing membrane damage. This study explored their effect on a different group of microorganisms–Gram-positive skin flora. Kirby-Bauer disk diffusion tests were performed to evaluate minimum inhibitory concentrations for each dendrimer solution. All generations of PAMAM dendrimers …

Her2-Low And Her2-Ultralow Metastatic Breast Cancer And Trastuzumab Deruxtecan: Common Clinical Questions And Answers, Nusayba A Bagegni, Karthik V Giridhar, Daphne Stewart

2020-Current year OA Pubs

Approximately 80% of invasive breast cancers are classified as human epidermal growth factor receptor 2 (HER2)-negative; however, many of these tumors have detectable levels of HER2 surface expression. Trastuzumab deruxtecan (T-DXd) is a HER2-directed antibody-drug conjugate with a membrane-permeable payload that is cytotoxic to both HER2-expressing tumor cells and neighboring cells via the bystander antitumor effect. T-DXd has shown significant antitumor activity in clinical trials for patients with HER2-positive (immunohistochemistry [IHC] 3+ or IHC 2+/in situ hybridization [ISH]+) breast cancer. In addition, the results of the DESTINY-Breast04 trial demonstrated the clinical benefit of T-DXd in patients with HER2-low (IHC 1+ …

Investigating The Polygenic Relationship Between Heavy Cannabis Use And Schizophrenia In The All Of Us Research Program, Isabelle Austin-Zimmerman, Hayley H A Thorpe, John J Meredith, Jibran Y Khokhar, Tian Ge, Marta Di Forti, Arpana Agrawal, Emma C Johnson, Sandra Sanchez-Roige

2020-Current year OA Pubs

BACKGROUND: Decades of research have identified a strong association between heavy cannabis use and schizophrenia (SCZ), with evidence of correlated genetic factors. However, many studies on the genetic relationship between cannabis use and psychosis have lacked data on both phenotypes within the same individuals, creating challenges due to unmeasured confounding. We aimed to address this by using multimodal data from the All of Us Research Program, which contains genetic data as well as information on SCZ diagnosis and cannabis use.

METHODS: We tested the association between cannabis use disorder (CUD) and SCZ polygenic scores (PGSs) with SCZ and heavy cannabis …

The Influence Of Endocrine Disrupters On Gut Microbiota, Kader Ugur

Turkish Journal of Medical Sciences

Endocrine disruptors (EDs) are closely associated with the second brain, the microbiota-derived enteric nervous system, commonly referred to as the gut microbiota. The microbiota plays a crucial role in human health and the development of diseases. In today’s industrialized world, the presence of EDs in air, water, and soil leads to primary human exposure through dermal contact and ingestion. The impact of these EDs on the microbiota remains unclear. EDs that disrupt the balance of the gut microbiota may contribute to a range of disorders, including metabolic (obesity, diabetes mellitus), cardiovascular (vascular stenosis, cerebrovascular disease), reproductive (infertility, ovarian and testicular …

Ratio Quantification Of Geranium And Rose Essential Oil Mixtures Via Leep Learning Analysis Of Complex Raman Spectra, Jia Wei Tang, Yong Xuan Hong, Jie Chen, Yun Yun Xie, Zhang Wen Ma, Qing Hua Liu, Liang Wang

Research outputs 2022 to 2026

Due to their high economic value, essential oils (EOs) are increasingly subject to adulteration, posing significant challenges for quality assessment and control. Owing to its excellent molecular specificity, Raman spectroscopy has been widely employed for the analysis and evaluation of EO products. In this study, we collected a total of 2700 Raman spectra comprising rose essential oil (REO, n = 900), geranium essential oil (GEO, n = 900), and their mixtures (n = 900). We first constructed a conventional convolutional neural network to distinguish spectra corresponding to varying EO mixing ratios. Interpretability analysis revealed that spectral peaks at 800, 1000, …

Dens Evaginatus: Odontogenesis Anomaly Case Reports, Robert Warren Dds, Elizabeth Berry Dds

Virginia Dental Journal

No abstract provided.

Review On The War Against Glioblastoma Multiforme Tumors, Liv Baldasare

Best Integrated Writing

This review article discusses different treatment approaches for glioblastoma multiforme tumors. The lethal characteristics of the glioblastoma are defined in depth. Risk factors, such as career firefighting, are explored, and the effect socioeconomic status has on prognosis is evaluated. The endocannabinoid system is defined, and its role in lowering rates of proliferation for glioblastoma tumors is discussed. Immunotherapies for glioblastomas are reviewed. Specifically, the current clinical trials on an Australian physician who is battling his own glioblastoma are discussed. Importantly, this physician is using his own treatment regimen and has been having clear scans for 18 months.

Best Integrated Writing Fall 2025 - Complete Edition, Wright State University School Of Humanities And Cultural Studies, Tracy Smith, Kristie Mckiernan

Best Integrated Writing

Best Integrated Writing includes excellent student writing from Integrated Writing courses taught at Wright State University.

Physical Performance Differences Between Top And First League Female Football Players: Insights From Locomotion Metrics, Mariola Gepfert, Artur Gołaś, Miłosz Drozd, Katarzyna Strońska-Grabień, Piotr Sawicki, Ewelina Lulińska

Baltic Journal of Health and Physical Activity

Background: This study aims to compare locomotion metrics between Poland’s Top League and First League at the team level using 10 Hz GPS. Methods: Team-level match data (autumn round) were analysed. The following metrics were computed: total distance, high-speed running (HSR: 19–23 km·h⁻¹ [5.28–6.39 m·s⁻¹]), sprinting (> 23 km·h⁻¹ [> 6.39 m·s⁻¹]), accelerations and decelerations at two thresholds (> 3.0 and > 4.0 m·s⁻²), and Player Load (arbitrary units, tri-axial accelerometry). Between-league differences were tested with Mann–Whitney U; rank-biserial effect sizes were reported. Results: Top League teams covered more sprint and HSR distance and performed more ACC/DEC at both thresholds (all …

Adjudicated Cardiovascular Events In Patients With Covid-19: Association With Vaccination Status And Changes Over Time, Behnood Bikdeli, Darsiya Krishnathasan, Antoine Bejjani, Candrika D. Khairani, Nada Hamade, Umberto Campia, Julia Davies, Nicole Porio, Ali Assi, Andre Armero, Anthony Tristani, Marcos D. Ortiz-Rios, Victor Nauffal, Zaid I. Almarzooq, Eric Q. Wei, Bridget Mcgonagle, Mariana Pfeferman, Sina Rashedi, Alyssa Sato, Giovanni Scimeca, Valeria Zuluaga-Sánchez, Mehrdad Zarghami, Aditya Achanta, Sirus Jesudasen, Bruce C. Tiu, Geno J. Merli, Orly Leiva, John Fanikos, Aditya M. Sharma, Samantha M. Rizzo, Ruth B. Morrison, Alec Vishnevsky, Shiavax J. Rao, Sivan Naveh, Abdelghani El Rafei, James Welker, Marc P. Bonaca, Brett J. Carroll, Samuel Z. Goldhaber, Zhou Lan, Gregory Piazza, The Corona-Vte Network Investigators

Jefferson Hospital Staff Papers and Presentations

BACKGROUND: Patients with COVID-19 are at risk of thrombotic and cardiovascular complications. Existing risk estimates derive from early COVID-19 experiences. More recent event rates, temporal trends, and the association between vaccination status and cardiovascular outcomes remain unclear.

METHODS: The CORONA-VTE Network (COVID-19 Registry to Assess Frequency, Risk Factors, Management, and Outcomes of Arterial and Venous Thromboembolic Complications) multicenter registry included patients with COVID-19 from March 2020 to February 2024. A composite of venous and arterial thrombotic events and a composite of adjudicated cardiovascular events were assessed at 90 days after COVID-19 diagnosis. Time-to-first-event analyses were stratified by inpatients and outpatients …

Cv: Jodi Faulk (Radiography), Jodi Faulk

Rehabilitation and Health Sciences Department Faculty Curricula Vitae

No abstract provided.

Green Synthesis Of And Antimicrobial Susceptibility Testing Of (2z)-2-[(4-Fluorophenyl)Methylidene]-1-Benzofuran-3-One, Rod Albert C. Olofernes

Honors Theses

Antimicrobial resistance is a global health challenge, rendering once-effective antibiotics less potent or entirely ineffective. In response, there is increasing interest in developing antimicrobial agents through environmentally sustainable methods. In this study, a fluorinated aurone derivative, (2Z)-2-[(4-fluorophenyl)methylidene]-1-benzofuran-3-one, was synthesized using a green Knoevenagel condensation approach. Eco-friendly catalysts were employed to minimize environmental impact and avoid hazardous byproducts. Product formation was confirmed to avoid wasting resources. The compound was evaluated for antimicrobial properties using a Kirby-Bauer plate, but did not demonstrate consistent or significant antimicrobial activity, therefore lacking promise as a standalone antibiotic.

2025 December 16 - Medical Student Education Committee Minutes, Medical Student Education Committee, East Tennessee State University

Medical Student Education Committee Minutes

No abstract provided.

Molecular Effects Of Glucose On Mir503hg-Regulated Genes In Triple-Negative Breast Cancer, Victoria Reid, Barbara Yang, Kyle Russo, Melina J. Sedano, Ramesh Choudhari, Enrique I. Ramos, Shrikanth S. Gadad

School of Medicine Publications

Triple-negative breast cancer (TNBC) is the most aggressive breast cancer subtype, characterized by a lack of key hormone receptors in tumor cells. As there are limited treatment options for these patients, it is crucial to understand the underlying mechanisms by which TNBC constantly evolves and evades treatments. In this regard, the pervasive nature of transcription provides a potential reservoir of transcripts, including both coding and noncoding, that TNBC leverages to sustain a proliferative advantage and support tumor growth. TNBC is affected by energy sources such as glucose, which can have a profound impact on gene expression regulation mediated by various …

Bridging The Gap: Optimizing Outpatient Care Delivery In Rural Kenya Through A Telemedicine Workflow Training Initiative, Elizabeth K. Bennett

Doctoral Dissertations and Projects

Access to timely, high-quality outpatient care in rural Kenya is constrained by workforce shortages, geographic barriers, and inefficiencies in care delivery. This Doctor of Nursing Practice project evaluated the impact of implementing a structured telemedicine workflow and training program for a regional mission hospital in the highlands of Western Kenya and its satellite outpatient clinic. Guided by the Iowa Model of Evidence-Based Practice, Kotter's Change Theory, and the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) framework, the project employed a quasi-experimental, pre-post design, with eight medical providers participating in structured workshops, interactive telemedicine simulations, and workflow integration exercises. Impacts were …

Cv: Jodi Faulk (Radiography), Jodi Faulk

Health Sciences Department Curricula Vitae

No abstract provided.

Flawed Design And Selection Bias In Critical Care Randomized Controlled Trials (Rcts): The Patient Safety Risk Of The "Rct Mimic"., Lawrence A Lynn

Ambulatory and Primary Care Articles

Over three decades, randomized controlled trials (RCTs) for critical care syndromes such as acute respiratory distress syndrome (ARDS), sepsis, and community acquired pneumonia (CAP) have repeatedly produced non-reproducible results, at times leading to high-impact reversals of global protocols when later studies revealed harm. These trials enroll patients using expert-derived threshold sets intended to define the syndrome. This analytic review presents the first historical and formal methodological review and mathematical analysis of such RCT using causal symbolic modeling (cSM), directed acyclic graphs (DAGs), and do-calculus. The review includes landmark publications, task-force threshold sets, and case examples, including the 2025 REMAP-CAP corticosteroid …

Mitigating Risk Of Premature Ovarian Insufficiency Using Adjunct Chinese Herbal Medicines: A Nested Patient-Control Study In Female Cancer Patients With Chemotherapy, Tzu-Ning Tseng, Hou-Hsun Liao, Hanoch Livneh, Ming-Chi Lu, Szu-Chin Li, Tzung-Yi Tsai

Leadership, Learning and Counseling Faculty Publications and Presentations

Premature ovarian insufficiency (POI) is a common late effect of chemotherapy among survivors of adolescent and young-adult cancer (AYAC). Given on the widespread use of Chinese herbal medicine (CHM) in restoring individual health, we performed a cohort-based nested patient-control study with the aim of exploring the effect of blending CHM into routine care on the reduction of chemotherapy-induced POIrisk among females with AYAC.

Work-Life Conflict, Anxiety, And Depression In Collegiate Athletic Trainers With Children Under 5, Jordan Helton, Glenn R. Penny, Seth Swary

Student Dissertations

The research problem for this study was that collegiate athletic trainers with children under 5 years old experience significant work-life conflict and negative mental health outcomes. The purpose of this study was to explore how collegiate ATs with young children describe their experiences of work-life conflict and to how these experiences relate to symptoms of anxiety and depression. Guided by interrole conflict theory and work-life conflict theory the study posed two research questions: (1) How do collegiate ATs with children under 5 describe their experiences of work-life conflict? (2) What is the relationship work-life conflict experiences on the symptoms …

Is Ai Replacing Human Mental Health Professionals?, Michiko Ueda

Population Health Research Brief Series

An increasing number of people are turning to generative artificial intelligence (AI) tools and AI-assisted chatbots to manage mental health concerns. This data slice presents findings from a national survey of U.S. adults aged 18-49 (N = 1,805) conducted in October 2025. Among respondents, 35.2% reported using AI tools more than once a week for mental health support. Among those who had ever seen a human mental health professional, 28.4% reported visiting human providers less often since beginning to use AI for the same purpose. The findings suggest that a subset of users may be using AI to replace, rather …

Traumatic And Incidental Diaphragmatic Hernias In Adults: A Case Series Highlighting Diagnostic Challenges, Surgical Management, And Postoperative Outcomes, Prajwal Chandrashekhara, Chanchal Raj Chhallani, Preethi Hiremath

Manipal Journal of Medical Sciences

Background:
Diaphragmatic hernia (DH) in adults, although uncommon, presents a significant clinical challenge due to its variable symptoms and potential for life-threatening complications. The condition can be either traumatic or congenital, and in some cases, it may be found incidentally during imaging for unrelated conditions. This case series aims to highlight the diverse clinical presentations, diagnostic challenges, surgical management strategies, and postoperative outcomes associated with diaphragmatic hernias in adults.

Methods:
We present four cases of diaphragmatic hernias diagnosed in adult patients, including both traumatic and incidental findings. Case 1 involves a 26-year-old male with a traumatic diaphragmatic hernia following a …