Medicine and Health Sciences Commons^™

Chronic Illness Education 2025: Preventative Measures To Mitigate The Development Of Atherosclerotic Coronary Artery Disease, Alexander Orr, Celina Wu, Elijah Marquez, Fateh Ahmad, Kendyll Gartrelle, Logan Harrison, Mia Sooch, Zahra Chehab, Emilio Espinal

Patient Education Projects

No abstract provided.

Chronic Illness Education 2025: Local Action, Lower Pressure- Resources To Advocate For Improvement In Hypertension Within The Community, Carinne Jarvis, Elinor Harrison, George Yalamanchili, Kamakashi Sharma, Mackenzie Fitzgerald, Neel Lachhwani, Nimr Assaf, Richard Tuttle

Patient Education Projects

No abstract provided.

Chronic Illness Education 2025: Resources To Improve Risk Of Hypertension, Bruna Storch Dos Santos, Bryce Brophy, Chonling Liu, Emily Webber, Izzy Havis, Janet Brenya, Noma Imudia, Eli Jarjous

Patient Education Projects

No abstract provided.

Chronic Illness Education 2025: School-Centered Interventions To Address Childhood Obesity, Aaron Yang, Amanda York, James Mcknight, Madison Jordan, Myron Shaba, Riley Marchin, Rita Pisegna, Constantine Tangalos

Patient Education Projects

No abstract provided.

Chronic Illness Education 2025: Emotional And Behavioral Concerns With Limited Support, Ahmed Alzubaidi, Ambrielle Stoltz-Bango, Grace Doakes, Ikenna Oduocha, Isaak Miller, Kelly-Ozze Bollou, Marta Haireek, Wyatt Feldman

Patient Education Projects

No abstract provided.

Chronic Illness Education 2025: Education And Resources To Improve Pediatric Type I Diabetes Mellitus Care Within Schools And Child Care Services, Alexander Seidel, Alexandra Thomas, Christine Larrea, Daven Sarikonda, Jack Gurwin, Maria Karla Bermudez Pineiro, Matthew Mello, Sana Soman

Patient Education Projects

No abstract provided.

Chronic Illness Education 2025: Navigating Depression And Anxiety Amid Socioeconomic Strain, Afrah Ansari, Candice Miller, Elizabeth Heinz, Joshua Teso, Muhammad Idrees, Omolola Suleiman, Sospeter Machani, Celia Somers

Patient Education Projects

No abstract provided.

Chronic Illness Education 2025: Depressive Symptoms And Treatment Hesitancy In A Middle-Aged Male Living Alone, Abdulrahman Altatan, Abigail Biddix, Joseph Kunnappilly, Katherine Zhang, Kehinde Bolaji, Kyrillos Ayoub, Maya Fajardo, Michael Niculcea

Patient Education Projects

No abstract provided.

Extubation Decisions With Predictive Information For Mechanically Ventilated Patients In Icu, Guang Cheng, Jingui Xie, Zhichao Zheng, Haidong Luo, Oon Cheong Ooi

Research Collection Lee Kong Chian School Of Business

Weaning patients from mechanical ventilators is a crucial decision in intensive care units (ICUs), significantly affecting patient outcomes and the throughput of ICUs. This study aims to improve the current extubation protocols by incorporating predictive information on patient health conditions. We develop a discrete-time, finite-horizon Markov decision process with predictions of future state to support extubation decisions. We characterize the structure of the optimal policy and provide important insights into how predictive information can lead to different decision protocols. We demonstrate that adding predictive information is always beneficial, even if physicians place excessive trust in the predictions, as long as …

Heterogeneous Impacts For Malaria Control From Larviciding Across Villages And Considerations For Monitoring And Evaluation, Ellie Sherrard-Smith, Ulrike Fillinger, Jean Philippe B. Tia, Peter Winskill, Benjamin G. Koudou, Emile S.F. Tchicaya, Antoine Sanou, Fredros Okumu, Mercy Opiyo, Silas Majambere, Arran Hamlet, Giovanni Charles, Ben Lambert, Thomas S. Churcher

All Peer-Reviewed Publications

Malaria vector control tools currently focus on insecticide treated nets (ITNs) and indoor residual spraying in malaria-endemic locations, but additional preventative strategies are needed to address protection gaps. Larval source management (LSM) includes larvicide application to aquatic habitat and an array of alternative forms of environmental efforts. An individual-based transmission model for falciparum malaria is used to demonstrate the theoretical benefit of suppressing malaria adult mosquito vector densities through LSM. The model simulates results of epidemiological trials from Western Kenya (a hilly area with papyrus swamps adjacent to human settlements and moderate to high perennial malaria transmission) and Côte d’Ivoire …

Hernia Recurrence Risk Matters More Than Mesh Type To Patients Undergoing Ventral Hernia Repair, Stephanie Martinez Ugarte, Mokunfayo O Fajemisin, Chelsea J Guy-Frank, Dalya M Ferguson, Jonah J Stulberg, Lillian S Kao, Julie L Holihan

Faculty, Staff and Student Publications

Introduction: Patients' perceptions about synthetic mesh for ventral hernia repair (VHR) may stem from a lack of knowledge of risks. We assessed patients' threshold for accepting the risk of hernia recurrence to avoid synthetic mesh.

Methods: Patients ≥18 y old with prior or upcoming VHR viewed a one-time video decision aid describing recurrence risk with biologic versus synthetic mesh. Patients chose between these options using a probability trade-off (PTO) technique, varying hernia recurrence rate with biologic mesh. Based on randomized trials, the recurrence rate using synthetic mesh was 9%. The PTO score was the recurrence rate (0%-100%) at which patients …

Aortopexy With Plication Of Kommerell Diverticulum Is An Effective Alternative To Diverticulum Resection And Reimplantation Of The Aberrant Left Subclavian Artery For Surgical Management Of Vascular Rings In Children, Adegbemisola Aregbe Perkins, Ana-Lucia Tomescu, Christopher J Knott-Craig, Umar Boston, Thomas Spentzas, Karthik Vaidyanathan Ramakrishnan

Faculty, Staff and Student Publications

Background

Right aortic arch with an aberrant left subclavian artery arising from a Kommerell diverticulum is the most common form of vascular ring. We report the outcomes of plication and pexy of the diverticulum in addition to division of the left-sided ligamentum to treat this lesion in children.

Methods

Forty-four patients were included in the study; 22 patients underwent division of the ligamentum arteriosum alone, while the other half underwent plication and/or pexy of the Kommerell diverticulum in addition to division of the ligamentum. The primary outcome of interest was reintervention for persistent symptoms following the initial operation. The other …

A Mystery Caller Study On Pain Management Options For Intrauterine Device Placement, Mitali Sharma

Student Scholarship

Objectives: To understand whether clinics present pain management options for intrauterine device (IUD) placement over the phone and whether these options align with current evidence for effective pain control during placement. Study design: We used a mystery shopper approach and a standardized call script to collect information from a diverse, purposive sample of 100 clinics listed on www.bedsider.org. Results: We reached responsive personnel at 90 of the 100 selected clinics, of whom 32 (36%) would not provide information about pain control for IUD placement by phone or to non-established patients. Of the 58 clinics that provided information, four (6.9%) reported …

Aggressive, Adaptive, And Underestimated: From Allergy To Arboviruses, The Rise Of The Lone Star Tick, Emily Ellen Owens Pickle

Theses and Dissertations

Once considered a nuisance with little medical importance, the lone star tick (Amblyomma americanum, Acari:Ixodidae) has emerged as a formidable vector driving a new era of public health threats across the United States of America. This dissertation traces the rise of the lone star tick from obscurity to infamy, exploring its expanding geographic range, unique immunologic impacts on humans, and role in the transmission of emerging tickborne viruses. Through a series of integrated studies, this work characterizes the epidemiology, immunology, and ecological context of tick-borne diseases in the southeastern U.S., with a particular focus on α-Gal syndrome (AGS), …

Inorganic Nanoparticle And Nanoplastic Transformations And The Impact On Biouptake By Freshwater Algal Cells Using Single Cell And Single Particle Inductively Coupled Plasma Mass Spectrometry, Elizabeth Carey Bair

Theses and Dissertations

The ubiquitous presence of nanoparticles (NPs) and nanoplastics (NPPs) and their effects on environmental and human health is a significant concern. They are used in every aspect of our lives, and while they offer many benefits, there are concerns about their impacts on ecosystems and human health. The primary aim of this dissertation is to quantify NP and NPP transformations in the presence of algae and determine how those transformations influence bioavailability. The methodology involves two complementary analytical techniques: single particle (SP) and single cell (SC) inductively coupled plasma mass spectrometry (ICP-MS). These techniques are tested and applied to two …

Gender Differences In The Associations Between Developmental Disabilities And Anxiety And Depression Symptoms Among U.S. Children: Insights From The 2021 National Health Interview Survey, Gloria Wang, Muyiwa Ategbole, Xingguang Luo, Kesheng Wang, Chun Xu

Health & Biomedical Sciences Faculty Publications

Background: Limited research has explored the associations between developmental disabilities and symptoms of anxiety and depression among U.S. children during the COVID-19 pandemic.

Objective: This study investigates the associations between developmental disabilities and symptoms of anxiety and depression among U.S. children and examines whether these associations differ by gender.

Methods: The analysis included 6092 children aged 5-17 from the 2021 National Health Interview Survey (NHIS). Key risk factors for anxiety and depression symptoms included attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), intellectual disability (ID), learning disability (LD), and developmental delay (DD). Weighted multivariable logistic regression (MLR) was conducted to evaluate …

Examining Relationships Between Us Children's Physical Activity Levels During Recess, School Days, And Weekend Days, Christopher M. Murphy, Erin K. Howie, Matthew J. Barenie, Kari A. Weber, Michael R. Thomsen

Health, Human Performance and Recreation Faculty Publications and Presentations

Objective: Physical activity opportunities, such as recess, in educational settings are vital yet only a handful of states have policies in place to ensure daily minimum recess allotment. We aim to investigate associations between physical activity during recess and other time periods to better understand the extent to which recess physical activity is related to physical activity throughout the week. Methods: Children K-5th grade were from four schools in Little Rock, Arkansas. Children wore accelerometers on their waist to assess physical activity across the week. Chi-square and t-tests or Wilcoxon rank-sum tests and multi-level mixed effects generalized linear regression were …

The Effect Of Anterior Closing Wedge Slope-Reducing Osteotomy On Coronal Alignment-Effect Of Osteotomy Technique, Starting Point, And Degree Of Correction., James Matthew Helm, Mark Coggins, Brian Crowley, Maile Curbo, Jacob Siahaan, Alexis Aboulafia, Alfred A Mansour

Faculty, Staff and Student Publications

Background: Techniques for anterior closing wedge slope-reducing osteotomy (ACW-SRO) remain variable regarding management of the tibial tubercle and osteotomy starting point. Moreover, the potential unintended effect on coronal alignment has not yet been determined.

Purpose: To determine the effect of the ACW-SRO technique and starting point on coronal alignment in knees with an elevated posterior tibial slope (PTS).

Study design: Descriptive laboratory study.

Methods: Full-length lower extremity computed tomography scans were retrospectively reviewed in patients presenting to our level 1 trauma center to identify patients with an elevated PTS of ≥12° without secondary trauma to the lower extremity. Materialise software …

A Recipe For Disaster - Sodium Bicarbonate Overdose, Adeola A Kosoko, Amara Ogoke, Kyle Vogt

Faculty, Staff and Student Publications

Audience: Emergency medicine residents post-graduate years 1-4.

Introduction: Sodium bicarbonate is a compound found commonplace in many households and in many products. It lends itself to countless everyday uses including cooking and cleaning. Physicians prescribe sodium bicarbonate regularly both on- and off-label regularly for various ailments.1 Due to the ubiquitous way both emergency physicians and the general public use and are exposed to sodium bicarbonate, we wanted to prepare learners to identify and appropriately manage sodium bicarbonate toxicity.Obtaining a thorough history not just of medications prescribed but of significant ingestions or infusions is critical in diagnosing this toxicity. Furthermore, acute …

Efficacy And Safety Of Mechanical Thrombectomy In Distal Medium Middle Cerebral Artery Occlusion Ischemic Stroke Patients On Low-Dose Aspirin, Hamza Adel Salim, Vivek Yedavalli, Fathi Milhem, Basel Musmar, Nimer Adeeb, Motaz Daraghma, Kareem El Naamani, Nils Henninger, Sri Hari Sundararajan, Anna Luisa Kühn, Jane Khalife, Sherief Ghozy, Luca Scarcia, Benjamin Yq Tan, Robert W Regenhardt, Jeremy J Heit, Nicole M Cancelliere, Joshua D Bernstock, Aymeric Rouchaud, Jens Fiehler, Sunil 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, Muhammed Amir Essibayi, David Altschul, Nestor R Gonzalez, Markus A Möhlenbruch, Vincent Costalat, Benjamin Gory, Christian Paul Stracke, Constantin Hecker, Hamza Shaikh, Christoph J Griessenauer, David S Liebeskind, Alessandro Pedicelli, Andrea M Alexandre, Illario Tancredi, Tobias D Faizy, Erwah Kalsoum, Max Wintermark, Boris Lubicz, Aman B Patel, Vitor Mendes Pereira, Adrien Guenego, Adam A Dmytriw

Faculty, Staff and Student Publications

Background: Acute ischemic stroke (AIS) from distal medium vessel occlusion (DMVO) presents unique treatment challenges. Mechanical thrombectomy (MT) is emerging as a viable option for these patients, yet the role of pre-stroke aspirin treatment is unclear. This study evaluates the impact of pre-stroke low-dose aspirin on outcomes in DMVO patients undergoing MT.

Methods: We conducted a multinational, multicenter, propensity score-weighted analysis within the Multicenter Analysis of primary Distal medium vessel occlusions: effect of Mechanical Thrombectomy (MAD-MT) registry. Patients with AIS due to DMVO, treated with MT, were included. We compared outcomes between patients on pre-stroke low-dose aspirin (75-100 mg) and …

Interconnections Of Insulin/Igf-1 Signaling And Autophagy Abnormalities In Alzheimer’S Disease, Wang Liao, Jinfeng Xuan, Woo-In Ryu, Mariana K Bormann, Yoon Lee, Haley Dion, Elizabeth Evangelista, Ruiyi Li, Lucas Trambaiolli, Jun Liu, Arthur J Siegel, Brent P Forester, Bruce M Cohen, Kai-Christian Sonntag

Faculty, Staff and Student Publications

Introduction: Impaired insulin (INS) and insulin-like growth factor 1 (IGF-1) signaling are features of both brain aging and late-onset Alzheimer's disease (LOAD). However, their exact underlying mechanisms and cause-and-effect linkages, including the downstream regulation of endocytosis and autophagy, are still not well understood.

Methods: We investigated INS/IGF-1 signaling and its connection with endocytic and autophagic processes in fibroblasts from LOAD patients and healthy young or old control individuals.

Results: Compared to control old-age cells, protein levels in the INS/IGF-1 signaling cascade were elevated in LOAD cells, but activation of AKT was reduced. The activation of the INS/IGF-1/AKT/FOXO1 or mTOR axes …

Arterial Anastomosis To Injured Vessels: Outcomes In Lower Extremity Trauma Reconstruction, Ellen Wang, Jessica R Nye, Imran Rizvi, Kylie R Swiekatowski, Bora Kahramangil, Paul Won, Noa G Kopplin, Stephen F Parlamas, Jeffrey G Trost, Mohin A Bhadkamkar

Faculty, Staff and Student Publications

Background: Although traditional teaching advocates that microsurgical anastomoses should be performed to uninjured vessels outside the zone of injury (ZOI), there is no defined way to assess the extent of the ZOI, and uninjured vessels may not be available. To evaluate the complications ascribed to the ZOI and injured vessels, outcomes between arterial anastomoses fashioned from within the ZOI versus noninjured recipient vessels were compared.

Methods: A retrospective review was conducted of adult patients who required lower extremity free flap (FF) reconstruction from 2016 to 2024. Injury to the recipient artery (transection, avulsion, or thrombosis) was determined by intraoperative assessment …

Preventing Acute Kidney Injury And Its Longer-Term Impact In The Critically Ill, Alexander Zarbock, Lui Forni, Jay L Koyner, Hernando Gómez, Neesh Pannu, Marlies Ostermann, Rinaldo Bellomo, John A Kellum, Thilo Von Groote

Faculty, Staff and Student Publications

Acute kidney injury (AKI) is a heterogeneous syndrome that not only affects short-term morbidity and mortality but also influences long-term outcomes. AKI is part of acute kidney disease (AKD) that encompasses a range of different conditions and is characterized by a kidney dysfunction lasting 90 days or less after which time the term chronic kidney disease (CKD) applies. AKD may result in irreversible loss of nephrons and may lead to CKD. In this narrative review, an update on different aspects of AKI in critically ill patients will be provided. We discuss biomarkers for early diagnosis of AKI, sub-clinical AKI, as …

Long-Term Exposure To Multiple Air Pollutants And Multi-Level Socioeconomic Status: Joint Effects On Age-Related Macular Degeneration, Subsequent Ocular Comorbidity, And Death In Middle-Aged And Older Adults, Yang Yang, Liangkai Chen, Qichen Liu, Min Mu, Jing Huang, Guangming Zhang, Qianqian Song

Faculty, Staff and Student Publications

Background: Both air pollution and socioeconomic status (SES) are recognized as significant determinants of health outcomes. However, no study has explored the combined effects of air pollutants and SES on (1) age-related macular degeneration (AMD) incidence; (2) trajectories from baseline to AMD, subsequent ocular comorbidity (OCMD), and mortality; and (3) life expectancy in middle-aged and older adults.

Methods: Using UK Biobank data, we created two composite air pollution scores (APS) and assessed SES at individual and neighborhood levels. OCMD was defined as glaucoma or cataract occurrence after AMD diagnosis. Cox proportional hazard regression models, multistate models, and life tables were …

Switching From Adalimumab Reference Product To And Among Adalimumab Biosimilars Outside The Usa: Insights For Us Clinicians, John R P Tesser, Aline Charabaty, Adelaide A Hebert

Faculty, Staff and Student Publications

Ten adalimumab biosimilars have been introduced in the United States (USA) since 2023, while adalimumab biosimilars have been available for several years in other countries. These experiences of biosimilar uptake outside the USA can inform US-based healthcare professionals on switching in real-life practice settings. Considerations include how healthcare professionals might meaningfully address patient concerns about outcomes to improve patient satisfaction. A search of the MEDLINE database was used to identify publications on switching to and among adalimumab biosimilars in an ex-US setting, with no restriction on publication language and using a time frame of 1 January 2017 through 12 December …

Endovascular Therapy For Late-Window M2-Segment Middle Cerebral Artery Occlusion: Analysis Of The Clear Study, Simon Winzer, Daniel P O Kaiser, Muhammad M Qureshi, Alicia C Castonguay, Daniel Strbian, Raul G Nogueira, Simon Nagel, Jean Raymond, Mohamad Abdalkader, Jelle Demeestere, João Pedro Marto, Hiroshi Yamagami, Kanta Tanaka, Sunil A Sheth, Anne Dusart, Patrik Michel, Marta Olive Gadea, Marc Ribo, Osama O Zaidat, Diogo C Haussen, Hilde Henon, Mahmoud H Mohammaden, Markus A Möhlenbruch, James E Siegler, Ajit S Puri, Johannes Kaesmacher, Piers Klein, Liisa Tomppo, Francois Caparros, João Nuno Ramos, Mouhammad Jumaa, Syed Zaidi, Nicolas Martinez-Majander, Stefania Nannoni, Lieselotte Vandewalle, Flavio Bellante, Milagros Galecio-Castillo, Sergio Salazar-Marioni, Pekka Virtanen, Anke Wouters, Rita Ventura, Jessica Jesser, Adnan Mujanovic, Liqi Shu, Abiya Qureshi, Zhongming Qiu, Hesham E Masoud, Manuel Requena, Mikko Sillanpää, Wei Hu, Eugene Lin, Charlotte Cordonnier, Daniel Roy, Shadi Yaghi, Davide Strambo, Urs Fischer, Santiago Ortega-Gutierrez, Robin Lemmens, Peter A Ringleb, Thanh N Nguyen, Volker Puetz

Faculty, Staff and Student Publications

Background: There is uncertainty about whether patients with M2 occlusion benefit from endovascular therapy (EVT) in the late (6-24-hour) time window. We evaluated the clinical outcomes of patients with M2 occlusion selected for EVT compared with those who received medical management (MM) in the late window.

Methods: This multinational cohort study was conducted at 66 sites across 10 countries (January 2014 to May 2022). We included consecutive patients with late-window stroke due to M2 occlusion, baseline National Institutes of Health Stroke Scale score of ≥5, and premorbid modified Rankin Scale score of ≤2 who received EVT or MM alone. The …

A Case Of Aqp4-Igg Neuromyelitis Optica Presenting With Orbital Inflammatory Syndrome, Lucy A Bailey, Roy F Riascos, Ore-Ofe O Adesina

Faculty, Staff and Student Publications

A 45-year-old healthy African-American man experienced 2 months of right-eye soreness followed by acute onset of right painful vision loss with binocular, oblique diplopia. Visual acuity was count fingers OD and 20/20 OS. He had a partial, right, pupil-involving cranial nerve III palsy with a right relative afferent pupillary defect and optic disc edema with tortuous vessels. Magnetic resonance imaging showed increased T2 signal with tortuosity and thickening of the retrobulbar right optic nerve with associated restricted diffusion and enhancement, enhancement of orbital fat adjacent to the optic nerve sheath, and relative right proptosis. Workup was positive for aquaporin-4 antibody …

Automated Mycoplasma Genitalium Molecular Macrolide Resistance Detection And Nucleic Acid Target Semi-Quantitation: Patient Demographic Considerations, Josephine Moore, Trinity Krueger, Amanda Zapp, Stephen C Lavey, Kimber L Munson, Irene A Stafford, Michael E Newcomb, Brian Mustanski, Erik Munson

Faculty, Staff and Student Publications

Recent work has optimized parameters of a real-time reverse transcriptase PCR-based laboratory-developed test on the Panther Fusion system which detects Mycoplasma genitalium-specific macrolide resistance-associated mutations LDT (MRM-LDT) from primary swab and urine specimens. In this study, MRM-LDT was applied to a large multi-demographic study set to further characterize M. genitalium resistance in the United States. A total of 2,145 primary clinical specimens testing positive for M. genitalium 16S rRNA by transcription-mediated amplification (TMA) were initially titered by the same assay using serial 10-fold dilutions to determine relative target nucleic acid burden. Specimens were then processed for MRM-LDT. Findings were stratified …

Encephalitis In Immunocompromised Vs Immunocompetent Patients: A Comparative Study, Anna Kolchinski, Margaret Li, Ralph Habis, Paris Bean, Ashley N Heck, John C Probasco, Rodrigo Hasbun, Arun Venkatesan

Faculty, Staff and Student Publications

Background: Encephalitis is characterized by brain parenchymal inflammation caused by infection or autoimmunity. There are limited recent data on how immunocompromised patients with encephalitis differ from the general encephalitis population.

Methods: This retrospective study of 2 large medical institutions compares clinical characteristics and outcomes of immunocompromised and immunocompetent patients with all-cause encephalitis.

Results: Of the 657 patients, 151 (23%) were immunocompromised. Immunocompromised patients were more likely to have an infectious etiology, comorbidities, inflammatory cerebrospinal fluid (CSF) profile, abnormal neuroimaging, and worse clinical outcomes as assessed by discharge Glasgow Outcome Scale (GOS) and in-hospital mortality (all P < .05). The most commonly identified etiologies in immunocompromised patients were herpes simplex virus (HSV) and varicella zoster virus. HSV accounted for similar proportions in the immunocompromised (18%) and immunocompetent (14%) groups, though it was more commonly associated with a CSF neutrophilia in the immunocompromised group (P = .001). Strikingly, …

Evolving Hemodynamics In Fontan Circulation: Age-Driven Insights In Patients With Interrupted Inferior Vena Cava And Hepatoazygos Shunt, Vikas Kannojiya, Akshita Sahni, Emily Eickhoff, Neha Zacharia, Nicole St Clair, Noah Schulz, Peter E Hammer, Pedro J Del Nido, Rahul H Rathod, David M Hoganson, Vijay Govindarajan

Faculty, Staff and Student Publications

Patients with interrupted inferior vena cava (I-IVC) and azygos continuation who undergo Fontan completion via hepatoazygos shunting exhibit unique hemodynamic challenges. This study evaluates age-related shifts in systemic venous return dominance, hepatic flow distribution (HFD), power loss (PL), and flow disturbances using patient-specific computational fluid dynamics (CFD). Data analysis from 95 patients with I-IVC showed a nonlinear shift in upper-to-lower body systemic flow dominance with ratios of 2, 1, and 0.5 (correlating to ages ∼3, ∼10, and ∼20, respectively). CFD simulations for 17 selected patients revealed a trend of increasing HFD toward the right pulmonary artery, with median splits of …