Medicine and Health Sciences Commons^™

Patterns And Implications Of Electronic Messaging Use In Clinical Communication: Insights From A Single-Center Survey., Basil George Verghese, Rupinder Buttar, Prakash Upreti, Kaiwen Zhu, Tamer Salhab Altamimi

Advances in Clinical Medical Research and Healthcare Delivery

Background: Efficient communication in healthcare is critical, significantly impacting patient outcomes. Electronic messaging tools, like Epic Secure Chat, are increasingly integrated into healthcare settings to enhance interactions among professionals. However, the practical implications of these tools on workflow and care quality are underexplored.

Methods: We conducted a comprehensive cross-sectional survey involving 309 healthcare professionals, including hospitalist physicians, advanced practice providers (APPs), and internal medicine residents, to evaluate Epic Secure Chat's usage patterns, satisfaction levels, and communication preferences.

Results: The survey yielded insightful data from 156 complete responses, revealing a notable issue with misdirected messages: 64.1% of hospitalists, 52.6% of residents, …

A Comparative Analysis Of The Accuracy Of Retrieval Augmented Generation Versus Large Language Models For Gout-Related Queries, Samikchhya Keshary Bhandari, Himal Kharel, Zeni Kharel, Prajjwol Bhatta, Mouna Reghis, Ali Mohamed, Eduardo Avalos Sugastti, Chengu Niu

Advances in Clinical Medical Research and Healthcare Delivery

Importance: To better understand ways to improve the answers from large language models by feeding them disease specific guidelines which can potentially act as a clinical decision support tool in the future Objective: To demonstrate the effect of retrieval augmentation on answers related to gout in terms of accuracy, conciseness and unambiguity. Design: Observational. Setting: Virtual experimental setting. Participants: ChatGPT 3.5 and Retrieval augmented generation powered ChatGPT. Exposure: Nine questions derived from the 2020 American College of Rheumatology guidelines on gout. Main outcomes: A zero to two subjective scale to measure the accuracy, conciseness, …

May Thurner Syndrome: Can We Stent It And Forget It ?, Sahej Arora, Asmaa Ahmed, Hafsa Jawaid, Aakriti Jain, Stephen Silver

Advances in Clinical Medical Research and Healthcare Delivery

Background: May-Thurner Syndrome (MTS) is a cause of venous obstruction and acute Deep Vein Thrombosis (DVT) in young females, due to extrinsic venous compression of left ilio-caval venous territory. It generally presents with unilateral lower limb swelling and DVT and long-term management requires endovascular stenting with anticoagulation. Little data is available on long term post-interventional outcomes. Case: A 73-year-old female with MTS, who underwent endovascular stenting of left external and common iliac vein 11 months ago, presented with recurrent symptoms. She had completed almost a year of oral anticoagulation with Eliquis approximately 45 days before presentation. She was found to …

Radiologic Findings Of A Mediastinal Mass With Pleural Fluid Cytologic Analysis: A Case Report Of Recurrent Mantle-Cell Lymphoma, Mark Cwajna, Zaain Ahmad, Evan Basha, Emily Maggioncalda, Shehbaz Ahmad, Joel Thompson

Advances in Clinical Medical Research and Healthcare Delivery

This case report details a 69-year-old male who presented with a right-sided pleural effusion and a mediastinal mass that was ultimately identified as recurrent mantle-cell lymphoma, occurring over 20 years after his initial diagnosis. Imaging findings discussed include chest radiograph and chest, abdomen and pelvis computed tomography depicting the mass compressing on various neighboring structures.

Multivalvular Native Valve E. Coli Endocarditis, Madison Baker, Jose Reyes, Natasha Singh, Samir Shah, Rohail A. Baig, Justin Nistico

Advances in Clinical Medical Research and Healthcare Delivery

E. coli is a rare cause of infective endocarditis. This report describes an 81-year-old-woman with a history of aortic stenosis and recurrent urinary tract infections who presented in sepsis secondary to E. coli urinary tract infection which was complicated by multivalvular infective endocarditis of the aortic and tricuspid native valves identified on transesophageal echocardiogram (TEE). The patient was managed medically with ceftriaxone, and resolution of both vegetations was seen on TEE without the need for cardiothoracic surgery. Literature review did not yield prior cases of multivalvular E. coli endocarditis.

Ketamine As A Novel Treatment For Bipolar Disorder: Efficacy, Safety, And Future Directions, Sophia M. Valerino

Advances in Clinical Medical Research and Healthcare Delivery

Bipolar disorder is a complex mood disorder characterized by alternating episodes of depression and mania/hypomania, affecting approximately seven million people in the United States. Current pharmacological treatments include lithium, anticonvulsants, and second-generation antipsychotics, but these medications are often associated with significant side effects and poor adherence. Ketamine, a noncompetitive NMDA antagonist, has recently gained attention as a potential treatment for bipolar disorder due to its rapid antidepressant effects, particularly in treatment-resistant mood disorders. This article examines the therapeutic potential of ketamine for bipolar disorder, focusing on its mechanism of action and efficacy. Clinical studies have shown promising results, with ketamine …

Appropriate Application Of Cardiac Telemetry Monitoring: A Quality Improvement Initiative, Muhammad H. Sharif, Abdullah A. Orakzai, Nauman Naeem, Omofolarin Babayale, Basil George Verghese

Advances in Clinical Medical Research and Healthcare Delivery

Background: Telemetry is an important clinical tool but it can be overutilized and leads to a higher cost of patient care and negative patient experience. We conducted this study to assess the effectiveness of our educational intervention in reducing inappropriate use of telemetry and to determine if there is any difference between the two types of educational interventions.

Methods: We conducted a retrospective in-patient study that included all non-ICU patients admitted on a randomly selected mid-week day at our hospital. A 2-step educational intervention was used separated by a 5-week period. The first, a PowerPoint presentation regarding the updated 2017 …

Integrating Clinical History, Imaging, And Serologic Testing For The Accurate Diagnosis Of Neurocysticercosis: A Case Report, Jedediah Bondy, Paul Dobria, Dillon Woody, Bryan Scott

Advances in Clinical Medical Research and Healthcare Delivery

Neurocysticercosis is a parasitic infection caused by the cestode Taenia solium, in which pigs serve as the definitive hosts. Humans can become accidental intermediate hosts through the ingestion of food contaminated with Taenia solium eggs via fecal-oral transmission. Once ingested, the eggs of Taenia solium hatch into larvae, which then migrate through the bloodstream and disseminate across various organs, including the central nervous system (CNS). In this case, a 40-year-old male from Mexico with a known history of seizure disorder presented to the emergency department with altered mental status. He had been told by a physician in his native …

Assessing The Risk Of Venous Thromboembolism In Patients With Hereditary Hemorrhagic Telangiectasia: A National Inpatient Sample Study, Himal Kharel, Samikchhya Keshary Bhandari, Zeni Kharel, Chengu Niu, Aditya Sanjeevi, Devam Maity, Zauraiz Anjum

Advances in Clinical Medical Research and Healthcare Delivery

Background: Hereditary hemorrhagic telangiectasia is an underrecognized entity which increases the risk of mucosal as well as visceral bleeding. The thromboembolic risk of this condition is unknown.

Methods: We used the national inpatient sample database from 2016 to 2020 and performed a retrospective cohort study using multivariate logistic regression.

Results: In this retrospective cohort study of the national inpatient sample database from 2016 to 2020 using multivariate logistic regression, we found that hereditary hemorrhagic telangiectasia did not significantly increase the risk of deep vein thrombosis and pulmonary embolism.

Successful Multimodal Interventional Management Of Extensive Portal Venous System Thrombosis In A Patient With A Hypercoagulable State, Dillon Woody, Jedediah Bondy, Donnette Dabydeen, Korinne Diss, Amanda Neider Neider

Advances in Clinical Medical Research and Healthcare Delivery

We present a case of extensive mesenteric and portal vein thrombosis in a 59-year-old male with a history of multiple thrombotic events and hypercoagulable conditions. The patient presented with abdominal pain, nausea, vomiting, and black stools, leading to the discovery of thrombosis in the portal vein, splenic vein, and superior mesenteric vein (SMV) with associated bowel ischemia. The goal of treatment was to prevent mesenteric ischemia, maintain portal vein patency, and preserve options for potential liver transplantation. The case was managed through a combination of ultrasound-guided paracentesis, portal and SMV venography, mechanical thrombectomy using the AngioJet device, and continuous thrombolytic …

Can Implementation Strategies Diminish Infection Prevention Barriers And Reduce Cardiac Surgical Site Infections, Jennifer West, Jennifer Gutowski, Jarvis Mcgrath, Kristen Paliani, Emil P. Lesho

Advances in Clinical Medical Research and Healthcare Delivery

Background:

Surgical site infections (SSI) can affect up to 26.8% of patients undergoing coronary artery bypass grafting (CABG). In New York State (NYS), hospitals are evaluated by comparing their risk-adjusted CABG SSI rates to the NYS average rate. In 2021, our facility’s rate was significantly higher than the NYS average at 3.40 and 1.51, respectively. We sought to reduce infection rates using a multidisciplinary Implementation Science (IS) approach across the continuum of care.

Methods:

Standardized definitions from the National Healthcare Safety Network were utilized in a 24-month before and after study at a 528-bed hospital that averages 468 CABG/year. In …

Cns And Retinal Radiologic Findings Of A Young Patient With Heterozygous Prothrombin G20210a Gene Mutation, Justina Kasteri, Timothy Ehmann, Bryan Scott

Advances in Clinical Medical Research and Healthcare Delivery

Stroke is one of the leading causes of death and acquired long-term disability in the world.¹ In United States stroke is the 5^th leading cause of death with a mortality rate of 49.1 deaths per 100,000 people.² Strokes can be ischemic or hemorrhagic in origin, of which 85% are ischemic strokes. Approximately 10--15% of ischemic strokes occur in patients 18-50 years of age, and inherited thrombophilia may be a contributing factor through induction of a hypercoagulable state. Prothrombin G20210A mutation has an overall prevalence of approximately 2% of the general population, with an association between young patients …

Radiologic Evaluation And Management Of Metastatic Renal Cell Carcinoma With Tumor Thrombus Extension Into Right Atrium, Zaain Ahmad, Mark Cwajna, Evan Basha, Adithya Bala, Joel Thompson

Advances in Clinical Medical Research and Healthcare Delivery

This case report discusses the radiologic evaluation, histopathology, and management of a 67-year-old female with metastatic renal cell carcinoma (RCC) extending as a tumor thrombus into the right atrium. The patient had newly developed hematuria that was not followed up with the recommended imaging modality. Months later, the patient presented to the emergency department with progressive hematuria in addition to symptoms of dyspnea and significant weight loss. Initial CT imaging revealed a large renal mass with metastasis to the liver and lungs, along with tumor thrombus invading the inferior vena cava and right atrium. Histopathologic evaluation confirmed metastatic RCC and …

Harmony In Motion: An Adaptive Dance Program For Enhancing Motor Skills And Social Engagement In Children With Down Syndrome, Diamond D. Sampson, Mary Jan Greer, Jennifer Johnson

Summer 2025 OTD Capstone Symposium

Harmony in Motion is an occupational therapy–inspired adaptive dance program designed to create inclusive, sensory-friendly ballet experiences for children with disabilities, including those with Down syndrome. Through tailored movement activities, environmental modifications, and the use of adaptive props, the program promotes participation, social connection, and self-expression.

Nike™ Hypervenom-X Footwear With And Without Localized Ankle Compression Impact Static And Dynamic Postural Stability Differently, Harish Chander, Hunter Derby, Michael Brown, Emma Conley, Jordan Doherty, Leyton Riley, Adam C. Knight

Research and Innovation Publications

Purpose

The purpose of the study was to assess the impact of athletic footwear with and without an in-built ankle compression on static and dynamic postural stability.

Methods

Twenty participants completed the modified clinical test of sensory integration of balance (mCTSIB) [eyes open (EO), eyes closed (EC), eyes open foam surface (EOF), and eyes closed foam surface (ECF)], and the limits of stability (LOS) tests with volitional leaning in all directions [front left (FL), back left (BL), back right (BR), front right (FR)] on the BTrackS™. Both tests were completed in each footwear condition [barefoot (BF), Nike™ Hypervenom-X footwear with …

Clinical And Demographic Predictors Of The Need For Pharmacotherapy In Neonatal Abstinence Syndrome, Shawana Bibi, Rachana Singh, Janis L. Breeze, Jason Nelson, Walter K. Kraft, Jonathan M. Davis

Department of Pharmacology and Experimental Therapeutics Faculty Papers

OBJECTIVE: Development and validation of a clinical prediction model for receipt of pharmacotherapy for Neonatal Abstinence Syndrome (NAS).

STUDY DESIGN: Data from three cohorts included

RESULTS: Of 698 infants included, 430 received pharmacotherapy. The final model included seven predictors of receipt of pharmacotherapy: gestational age, exposure to maternal breast milk, type of maternal opioid medication, and exposure to heroin, cocaine, benzodiazepines, and/or antipsychotic medications. The model had an AUROC of 0.68 (95% CI: 0.64-0.72; optimism corrected 0.65).

CONCLUSION: Our prediction model was parsimonious and identified seven predictors associated with the need for PT. Larger cohort studies are needed to more …

Changes In Mental Health Care Utilisation Before And During The Covid-19 Pandemic Among People Living With Hiv In The Usa: A Retrospective Cohort Study Using The All Of Us Dataset, Atena Pasha, Shan Qiao, Jiajia Zhang Ph.D., Ruilie Cai, Buwei He, Xueying Yang, Chen Liang Ph.D., Sharon Weissman, Xiaoming Li Ph.D.

Faculty Publications

Introduction Despite the profound impact of the COVID-19 pandemic on people living with HIV (PLWH) mental health, large-scale, real-world data on mental healthcare utilisation and associated factors among PLWH remain limited. This study explores mental healthcare utilisation and associated factors among PLWH during the COVID-19 pandemic.

Methods Using a retrospective cohort design, we identified and included 4575 PLWH through computational phenotyping based on relevant Observational Medical Outcomes Partnership Common Data Model concept sets from the All of Us programme between March 2018 and March 2022. Mental healthcare utilisation was measured using the yearly count of mental healthcare visits and compared …

Impacting Atherosclerotic Cardiovascular Disease Risk Screening In The Primary Care Setting, Rosalyn Primus

Doctor of Nursing Practice Projects

Cardiovascular disease continues to be the leading cause of death worldwide. Despite the availability of evidence-based guidelines recommending routine cardiovascular risk screening, tools such as the atherosclerotic cardiovascular disease (ASCVD) Risk Estimator are underutilized in primary care settings. This quality improvement project implemented an evidence-based educational intervention to enhance healthcare providers' knowledge, self-efficacy, and consistent utilization of the ASCVD Risk Estimator within a primary care setting. The project employed a quasi-experimental design involving four primary care providers. Data was collected through various methods, including a knowledge questionnaire, the Evidence-Based Nursing Practice Self-Efficacy (EBPSE) Scale, a retrospective chart review, and a …

Evaluating The Impact Of Auscultation Task Trainer On Faculty Teaching Health Assessment Course In A Bsn Program, Marie Leonie Tampus

Doctor of Nursing Practice Projects

Simulation-based education continues to transform nursing pedagogy by enhancing instructional effectiveness and clinical competency through experiential learning. In undergraduate Bachelor of Science in Nursing (BSN) programs, faculty often face challenges when teaching complex skills such as respiratory system assessment due to variability in lung sound exposure and reliance on peer-based instruction. The project aimed to evaluate whether the implementation of a high-fidelity auscultation task trainer could improve faculty knowledge and self-confidence in teaching respiratory assessment in a BSN Health Assessment course. Using a pre- and post-intervention quality improvement design, five faculty members teaching the course participated in a six-week intervention. …

The Interplay Of Oxidative Stress, Mitochondrial Dysfunction, And Neuroinflammation In Autism Spectrum Disorder: Behavioral Implications And Therapeutic Strategies, Ansab Akhtar, S K. Rahaman

School of Medicine Faculty Publications

Autism spectrum disorder (ASD) deals with several symptoms, including language and speech impairment and developmental delays. The main brain regions affected could be the prefrontal cortex (PFC) or the temporal lobe. The detrimental features could include oxidative stress, mitochondrial dysfunction, and neuroinflammation. Most often, these phenomena are interrelated and can lead to one another, creating a vicious cycle. They also influence the regulation of certain genes involved in the pathogenesis of ASD or related behavior. In the brain regions prone to these detrimental features, a cascade of free radicals, inflammatory cytokines, and mitochondrial energy disruptions is initiated. These actions during …

08.11.2025 Ored Connect, Liz Williamson

ORED Newsletter

F and A rates

ORED Research Reception

NSF Audit Final Resolution and Compliance Updates

Caregiver Training Program For Optimal Recovery Of Neuro Accidents: An Occupational Therapy Approach, Bennie L. Huitt Jr., Jennifer Featheringham, Cassandra Nelson

Summer 2025 OTD Capstone Symposium

Caregivers of individuals recovering from stroke, traumatic brain injury (TBI), or experiencing onset of dementia often are provided limited education and support after discharge, negatively impacting confidence and recovery outcomes. The Caremaster program was designed to bridge the educational gap between occupational therapists in the clinical setting and caregivers in the home settings through accessible online modules, support groups, and in-person demonstrations. Module topics included understanding neuro accidents and role of the caregiver, returning home (transition and adaptation), ADLs and Mobility, returning to roles, and social reintegration. This program aims to guide future development of scalable, community-based caregiver education that …

Perceptions Of Secondary School Faculty About Vaping Behaviour In Secondary School Students: A Qualitative Analysis In Muscat, Oman, Thamra Al Ghafri, Riyadh Al Siyabi, Rawnaq Al Said, Nihal Afifi, Mohamed Al Harthi, Ahmed Al Harthi

Sultan Qaboos University Medical Journal

Objectives: The World Health Organization has reported concerns around the increase in vaping behaviour in adolescents. This study aimed to explore the perceptions of the faculty of secondary public schools in Muscat regarding: (a) reasons for vaping among students, (b) impact of this behaviour on school/class dynamics and families and (c) effective interventions within and beyond schools. Methods: This qualitative study held 4 focus groups among secondary school faculty at 4 secondary public schools in the areas of A'Seeb, Al Amarat, Bausher and Muscat in Oman from February to March 2023. Discussions were transcribed verbatim, anonymised and thematically …

Impact Of Urban Fine Particulate Matter Exposure On Cardiovascular Health, Shelby P. Briggs

Honors Theses

Air pollution, particularly exposure to fine particulate matter (PM2.5), poses a growing threat to cardiopulmonary health. PM2.5 consists of microscopic particles smaller than 2.5 microns in diameter and originates from industrial combustion, transportation, and urban dust. These particles are classified as xenobiotics and are capable of bypassing respiratory defenses to enter systemic circulation, where they cause oxidative stress, inflammation, and cardiovascular dysfunction. This study examines the effects of PM2.5 on cardiovascular function using a murine model. Male C57BL/6 mice were divided into control (saline), subchronic (10 µg), and chronic (100 µg) groups and were exposed weekly for 11 weeks via …

Quality Improvement Project Structured Faculty Mentorship Program: A Quality Improvement Project, Nikki R. Pearson

Doctor of Nursing Practice Projects

The increasing issue of untrained faculty stepping into teaching roles poses a challenge in nursing education. This shift often causes stress and a period of disorientation. One evidence-based solution to enhance role clarity involves mentorship, which is defined as a professional relationship whereby a more experienced faculty member aids in the growth of a novice. The purpose of this project was to help novice nursing faculty by offering them structured, consistent mentorship as they moved into academia. The goal was to increase job satisfaction by clarifying roles, building a sense of support, and ultimately helping to retain faculty. The intervention …

Tutorial: A Guide To Getting Started With The Clinical Fellowship Experience, Christi Masters, Mariel L. Schroeder

Department of Speech, Language, and Hearing Sciences Faculty Publications

Purpose:

Differential Mirna Expressions Linking Environmental Risk Factors To Triple-Negative Breast Cancer Stages At Diagnosis, Amjila Bam, Yawen Hu, Xiaocheng Wu, Meng Luo, Nubaira Rizvi, Luis Del Valle, Arnold H. Zea, Fokhrul Hossain, Denise Moore Danos, Jovanny Zabaleta, Augusto Ochoa, Lucio Miele, Edward Trapido, Qingzhao Yu

School of Public Health Faculty Publications

Background/Objectives: Triple negative breast cancer (TNBC) is an aggressive, molecularly heterogeneous subtype of breast cancer, accounting for approximately 10–15% of all cases. While reproductive and metabolic factors contribute to breast cancer development, growing concerns about environmental exposures, alongside biological and socio-cultural influences, underscore the need for targeted prevention strategies across diverse populations. Despite increasing evidence linking biological, socioeconomic, and environmental factors to TNBC outcomes, the molecular mechanisms underlying these relationships remain poorly understood. Micro-RNAs (miRNAs), which regulate gene expression and play critical roles in cancer development, have emerged as potential mediators between environmental exposures and TNBC progression. The goal of …

Mental Distress And Resource Insecurity In The Kingdom Of Tonga After The 2022 Volcanic Eruption: Associations Of Water And Food Insecurity With Mental Distress, Hilary J. Bethanancourt, Indira Bose, Lupe Moala Tupou, Melissa Meinhart, Edward A. Frongillo Jr. Ph.D., Amelia Greaves, Sera L. Young

Faculty Publications

Background Water and food insecurity can harm mental health; all 3 may, in turn, be exacerbated by humanitarian crises. The linkages between food insecurity, water insecurity, and mental health are gaining attention but have not been investigated after a natural disaster.

Objective To investigate the associations between food insecurity, water insecurity, and mental distress, and how these relationships may differ between women and men, in the aftermath of the January 15, 2022, volcanic eruption in the Kingdom of Tonga.

Design Secondary analysis of nationally representative cross-sectional data from the Equality Insights Rapid survey collected 4 to 5 months after the …

Neighborhood Socioeconomic Status And Overall Survival Among Children With Acute Lymphoblastic Leukemia, Anna Hoppmann, Debroah M. Hurley, Stuart Cramer, Monique J. Brown Ph.D., Mph

Faculty Publications

A disadvantaged neighborhood, as represented by area-level socioeconomic status (SES) has been associated with adverse outcomes among children with acute lymphoblastic leukemia (ALL) in the US, but the duration of impact after ALL diagnosis is not well understood. This retrospective cohort study utilized the National Cancer Database (NCDB) to examine the impact of area-level SES on overall survival among children with ALL. Median income and education quartiles based on residential zip code were used to create a composite area-level SES variable. Individual-level variables included age, sex, race, year of diagnosis, primary payer, distance to care, rurality, time to treatment, and …

Protecting Sleep To Reduce Delirium In Patients 65 Years And Older In The Icu, Jessica L. Thomas

Doctor of Nursing Practice Final Project Abstract

Protecting Sleep to Reduce Delirium in Patients 65 Years and Older in the ICU

PURPOSE

This quality improvement (QI) project aimed to reduce the incidence of delirium by 30% through a nurse-initiated, non-pharmacological sleep improvement protocol in the ICU.

BACKGROUND

This project was implemented in a large healthcare organization in Houston, Texas, in a 16-bed Intensive Care Unit.

METHODOLOGY

A pre- and post-intervention study was conducted in the ICU over a period using Plan-Do-Study-Act (PDSA) cycles. Baseline delirium (CAM-ICU) and sleep quality (RCSQ) assessments were obtained during Phase 1. Environmental adaptations, such as low lighting, noise reduction, staff education, and …