Medicine and Health Sciences Commons^™

Associations Of Blood Pressure Level And Variability With Cortical Thickness: A Cross-Sectional Analysis From The Maracaibo Aging Study, Romeo De Leon, Shana Garza, Silvia Mejia-Arango, Kristina Vatcheva, Sokratis Charisis, Claudia L. Satizabal, Luis J. Mena, Joseph H. Lee, Joseph D. Terwilliger, Eron Manusov

School of Medicine Publications

Background: Although high blood pressure (BP) level and variability are associated with Alzheimer's Disease (AD), their relationship with cortical thickness in brain regions that are associated with AD is unclear. Furthermore, the role of 24-hour BP has not been examined. We investigated the associations of office and ambulatory BP measures with cortical thickness in brain regions implicated in AD.

Methods: We performed a cross sectional analysis of 304 participants without dementia from a population-based study with office and 24-hour BP and magnetic resonance imaging (MRI) data. We considered cortical thickness values derived from 10 regions throughout the frontal, parietal, and …

Reduced Threat-Related Neural Efficiency: A Possible Biomarker For Pediatric Anxiety Disorders, Julia O. Linke, Reut Naim, Simona P. Haller, Parmis Khosravi, Beck Scheinberg, Meghan E. Byrne, Anita Harrewijn, Ellen Leibenluft, Melissa A. Brotman, Anderson M. Winkler, Daniel Samuel Pine

School of Medicine Publications

Objective: Pediatric anxiety disorders are common and predict adult psychopathology, yet current treatments, such as cognitive-behavioral therapy (CBT), produce lasting remission in less than 50% of affected youths. To support the search for improved, mechanistically grounded interventions, this study evaluated neural efficiency, defined as similarity in functional connectivity between a threat task and rest, as a potential biomarker. The study evaluated neural efficiency in relation to anxiety diagnosis and treatment response.

Methods: The authors compared 103 youths with an anxiety disorder diagnosis (mean age, 12.5 years [SD=2.91], 62% female) to 103 youths with no psychiatric diagnosis (mean age, 13.4 years …

Spinning-Induced Exertional Rhabdomyolysis Without Acute Kidney Injury, Yolanda V. Gutierrez, Ronald Shaju, Alyssa L. Sepulveda, Joaquin Rivera, Aamir Ahmad

School of Medicine Publications

Rhabdomyolysis is a condition with a myriad of causes, including both traumatic and non-traumatic. Traumatic conditions are observed in crush injuries, compartment syndrome, and fractures, while non-traumatic rhabdomyolysis is commonly seen due to exertional heat stroke, extreme physical exercise, and dehydration. This case report explores two cases of extreme non-traumatic rhabdomyolysis caused by indoor cycling, also known as spinning. A common complication of severe rhabdomyolysis is acute kidney injury (AKI), which increases the risk of renal failure. Rapid interventions such as aggressive intravenous fluids are necessary to prevent kidney function loss. In this case report, two sisters, on two separate …

Breaking The Resistance: A Narrative Review Of The Evolution From Traditional Drugs To Precision Therapies In Epilepsy, Tirath Patel, Fathimathul Henna, Ashfaq Ahmed, Ayesha Ahmad, Noor Ul Huda, Syed Aaraiz Ul Hassan, Aiman Muhammad, Amna Javed, Maryem Filal, Nikhilesh Anand

School of Medicine Publications

Background: Epilepsy is a chronic neurological disorder characterized by recurrent seizures, affecting approximately 50 million individuals globally. While conventional antiseizure medications (ASMs) control seizures in 70-80% of patients, about 30% experience drug resistance or intolerable side effects, necessitating alternative approaches.

Objective: To critically compare the efficacy, safety, and accessibility of conventional and emerging therapies for epilepsy, particularly in the context of treatment-resistant cases and global disparities in care.

Methods: This narrative review synthesized evidence from 120 peer-reviewed articles published between 2015 and 2025. Literature was retrieved from PubMed, Embase, Cochrane Library, and Scopus using predefined search terms related to epilepsy …

Early Detection In Oral Cancer: Are We Prepared For Artificial Intelligence-Driven Precision Medicine?, Nikil Kumar, Sinnha Kumari, Sadia Sultana, Muhammad Saad Khan, Tirath Patel, Nikhilesh Anand

School of Medicine Publications

Oral cancer, particularly oral squamous cell carcinoma, remains a serious health concern, with a poor prognosis and a late diagnosis. Leukoplakia, erythroplakia, lichen planus, and submucous fibrosis are examples of oral potentially malignant disorders that must be detected early but are not always so by traditional, laborious, and subjective diagnostic techniques. In oral cancer, artificial intelligence (AI) and precision medicine are becoming game-changing technologies that enhance individualized care, treatment planning, and diagnostic precision. Complex imaging and histopathology data may be analyzed using machine learning and deep learning algorithms, particularly convolutional neural networks, which can identify patterns that are invisible to …

Application Of Current Enteral Nutrition Support Recommendations To Infants Born Less Than 750 Grams Or Less Than 25 Weeks' Gestation: A Critical Review, Mar Romero-Lopez, Mamta Naik, Teresa Hartman, Ann Anderson-Berry, Melissa Thoene

Journal Articles: Pediatrics

Clinicians face a paucity of evidence-based recommendations for provision of enteral nutrition in infants born < 750 g or < 25 weeks' gestation, termed "nano-preterm." Current enteral nutrition recommendations for extremely low birth weight infants may not be broadly applicable to nano-preterm infants due to physiological and developmental differences, while others may be appropriate. Key enteral nutrition-related considerations include: the unique anatomy and physiology of the gastrointestinal tract, altered metabolic capacity, availability of maternal milk and use of alternative substrates, detailed methods of initiation and advancement of enteral feeding, methods of human milk fortification, targeted requirements for macronutrient and micronutrients, and the safety and efficacy of enteral nutrition support management to optimize the growth and development of the nano-preterm infant. This comprehensive review focused on enteral nutrition provision in nano-preterm infants, thoroughly evaluating available literature and identifying knowledge gaps about the unique physiology and metabolism of the nano-preterm infant as it pertains to enteral nutrition. Ultimately, prospective multicenter research is needed to establish evidence-based guidelines to promote optimal growth and development while minimizing complications of extreme prematurity.

Robust Lc–Ms/Ms Method For Quantification Of Ascorbic Acid In Infant Formula And Heat-Processed Donor Human Milk: A Stabilization And Matrix Effects Mitigation Approach, Omar M. Al Kilani, Lee C. Winchester, Melissa Thoene, Colman Freel, Christopher Lee Shaffer, Anthony T. Podany

Journal Articles: Pediatrics

Ascorbic acid is an essential antioxidant for infant health; however, its quantification in infant formula and human milk is challenging due to matrix complexity, analyte instability, and lack of blank matrix equivalents. This study presents a simple and robust LC-MS/MS method that bypasses the need for standard addition using only 20 µL sample. The method showed excellent linearity (R² > 0.99), precision (CV < 15%), accuracy (±10%), and sensitivity (LOD < 0.0375 µg/mL). Stock and working solutions remained stable for months at −20 and −80 °C, respectively, avoiding daily preparation. Optimized extraction substantially reduced matrix effects. The method was externally validated using certified infant formula reference material and successfully applied to commercial samples, with incurred sample reanalysis showing <  20% variation. This validated method offers a practical tool for the routine quantification of ascorbic acid in heat-processed donor human milk and infant formula, with the potential for application to other matrices.

Nutritional Management At 22-23 Weeks Gestational Age: Evidence And Knowledge Gaps, Mar Romero-Lopez, Mamta Naik, Melissa Thoene, Ann Anderson-Berry

Journal Articles: Pediatrics

With advancing medical capabilities, survival of infants born at 22-23 weeks' gestation is increasing. However, specific recommendations for nutrition support for these infants are lacking. This review examines the unique characteristics of infants born at 22-23 weeks' gestation that impact parenteral and enteral nutrition support, highlighting the lack of evidence and knowledge gaps for optimal practices. Current recommendations developed for extremely or very low birth weight infants may be unsuitable for infants born at 22-23 weeks' gestation due to important differences in anatomy, physiology, body composition, and metabolic capabilities. Key challenges include severely limited intraluminal digestion, profound immune and microbiome …

Efficacy And Safety Of Anticoagulation For Pediatric Cerebral Sinovenous Thrombosis: Systematic Review And Meta-Analysis, Muayad Azzam, Hassan Kawtharany, Marisol Betensky, Aseel Alkhader, Qais Hamarsha, Hadi Khaled Abou Zeid, Razan Mansour, Carine Tabak, Payal Patel, Sarah Lamat Baghdadi, Rachel S. Bercovitz, Rukhmi Bhat, Tina Bliss, Brian R. Branchford, Leonard R. Brandão, Anthony K. C. Chan, E. Vincent S. Faustino, Julie Jaffray, Sophie Jones, Bryce A. Kerlin, Nicole Kucine, Riten Kumar, Christoph Male, Marie-Claude Pelland-Marcotte, Leslie Raffini, Chittalsinh M. Raulji, Sarah E. Sartain, Clifford M. Takemoto, Cristina Tarango, C. Heleen Van Ommen, Maria C. Velez, Sara K. Vesely, John Wiernikowski, Suzan Williams, Hope P. Wilson, Gary Woods, Ayesha Zia, Paul Monagle, Reem A. Mustafa

Journal Articles: Pediatrics

We performed this systematic review and meta-analysis to assess the efficacy and safety of anticoagulation therapy versus no anticoagulation in pediatric patients with cerebral sinovenous thrombosis (CSVT). Eligible studies included pediatric patients with CSVT that compared anticoagulation to no anticoagulation and reported on at least one relevant outcome (mortality, neurological deficit, thrombus resolution, recurrence, and bleeding). Meta-analysis reported risk ratios (RR) or differences (RD) (95% CIs) and absolute effects per 1000 patients. Risk of bias was assessed using ROBINS-I, and the certainty of evidence was evaluated with GRADE. After removing duplicates, we screened 8925 records independently and in duplicate, from …

Intermittent Phrenic Afferent Activation Induces Phrenic Motor Plasticity, Nicole M. Popp, Taylor C. Holmes, Elizabeth A. Rozycki, Kristi A. Streeter

Physical Therapy Faculty Research and Publications

Approaches such as electrical stimulation of the phrenic neuromuscular system are currently used in humans to manage breathing impairments. We recently showed that electrical stimulation of the diaphragm muscle induces phrenic afferent-dependent plasticity. These findings highlight the need to better understand the mechanisms of afferent-mediated plasticity to guide and improve the development of novel therapies using electrical stimulation. Here, we tested the hypothesis that intermittent activation of large-diameter phrenic afferents induces phrenic motor plasticity, which, like other forms of plasticity, is pattern sensitive. We delivered inspiratory-triggered electrical stimulation using a narrow pulse width (0.1 ms) to preferentially activate large-diameter afferents, …

Transitioning To Life After Sport: Empowering Former College Varsity Athletes To Live More Healthfully, Linda Piacentine, Taylor L. Wolf, Jacob J. Capin

Physical Therapy Faculty Research and Publications

Introduction: 

The transition out of competitive sport comes with a range of psychosocial challenges for athletes, particularly when retirement is involuntary (e.g., due to injury). Little is known about the health of former athletes who often manage prior injuries and changing biopsychosocial factors.

Purpose: 

Identify the unique experiences of varsity athletes during college and as they transition to life after college sports and determine the facilitators, barriers, and needs of college varsity athletes to engage in a physically active and healthy lifestyle after competitive sport retirement.

Methods: 

Thirty former college varsity athletes (15F, 15M; mean age 23 ± 1 yrs; …

The Effects Of Stress-Related Hormones On Excitatory Synapse Formation, Autumn C. Garvey

Honors Undergraduate Theses

Stress profoundly influences brain function through neuromodulatory hormones that regulate synaptic plasticity, yet how temporal patterns of hormone exposure shape excitatory synapse formation remains poorly understood. This study investigates how exposure to stress hormones, norepinephrine and cortisol, affects excitatory synapse development. While existing research primarily compares concentration models, real-world stress occurs in variable patterns that may produce distinct neural outcomes. To address this gap, differentiated Neuro2A neuronal cells are exposed to norepinephrine or cortisol under a continuous treatment paradigm designed to model chronic stress conditions. Following treatment, immunofluorescence imaging is utilized to quantify excitatory synapse formation through analysis of presynaptic …

Neighborhood Deprivation Associated With Impaired Sit-To-Stand Performance In Middle-Aged And Older Adults: A Cross-Sectional Analysis With Clinical Implications, Kenneth Harrison, Silvia Campos-Vargas, Brandon M. Peoples, Keven G. Santamaria-Guzman, David T. Redden, Michael A. Samaan, Jaimie A. Roper

Kinesiology and Health Promotion Faculty Publications

Background: Socioeconomic factors significantly influence health outcomes in older adults, yet their impact on specific aspects of mobility remains unclear. This study investigates the relationship between area-level socioeconomic disadvantage and mobility health in older adults.

Methods: We conducted a cross-sectional study of 110 community-dwelling older adults recruited and collected using voluntary response sampling at eight health fairs across rural Southeast Alabama in 2022–2024 (60 ± 16 years, 80% female). Area-level socioeconomic status was measured using the Area Deprivation Index (ADI), a validated composite measure of neighborhood disadvantage. Mobility was assessed using the Instrumented Timed Up and Go (iTUG) test and …

Comparative Analysis Of Serum-Free Culture Conditions On Cell Proliferation And Extracellular Vesicle Production By Adipose-Derived Stem Cells, Ayna Ghulldu

Honors Undergraduate Theses

Adipose-derived stem cells (ADSCs) are promising candidates in regenerative medicine due to their proliferative capacity, self-renewal, and secretion of extracellular vesicles (EVs) that mediate intercellular communication. Serum-free media has been increasingly explored for MSC culture as it eliminates xenogeneic components, improving human therapeutic suitability. However, comparative evaluation of distinct serum-free formulations on ADSC proliferation and EV output simultaneously remains limited. This study compares a serum-containing medium to three proprietary serum-free media prototypes differing in composition, including the presence or absence of extracellular matrix proteins, to inform the optimization of culture conditions for clinical use. Proliferation, EV characteristics, and gene expression …

The Impact Of Gastric Sleeve And Roux-En-Y Gastric Bypass On Chief Cell Function And Protein Digestion In Obese Patients, Garikoitz Mikel Gainza

Honors Undergraduate Theses

Obesity has become one of the largest global health concerns of the 21^st century, correlating with numerous associated diseases. To help address the growing prevalence and burden of obesity, sleeve gastrectomy and Roux-en-Y gastric bypass have become two commonly performed surgical procedures done to promote weight loss by altering the anatomical structure of the stomach and surrounding organs of the gastrointestinal system. Although the benefits of improved metabolism linked to these surgical procedures are well studied, their impact on the physiology of gastric cells, and more specifically chief cells as they relate to protein digestion post-surgery, is yet to …

Guideline For A Burnout Bundle For Nurses In Psychiatric Mental Health Units, Festus Irabor

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Abstract

Problem: Burnout among nurses, especially in psychiatric mental health units, significantly impacts both their well-being and the quality of patient care. Despite its severity, with approximately 30% of nurses worldwide affected and contributing to a 31.5% nurse turnover rate (Ge et al., 2023), there are limited formal guidelines specifically targeting nurse burnout prevention in the mental health setting. The issue is particularly acute in the United States, where 91.1% of psychiatric nurses report experiencing burnout, compared to 79.9% of other healthcare professionals (Anger et al., 2024). In the local unit 38.05% have experienced burnout.

Purpose: The PICOTS for this …

Iron Deficiency And Iron Deficiency Anemia: Inconsistent Screening Practices And Delayed Result Processing In Children 12-18 Months, Madonna J. Mahoney Marshall

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Introduction:

Iron deficiency and iron deficiency anemia in children aged 12 to 18 months are prevalent conditions that, if not identified and treated early, are associated with adverse neurodevelopmental outcomes.

Purpose:

This quality improvement project evaluated the impact of a standardized screening and follow-up protocol on laboratory result retrieval, provider review, and caregiver follow-through in a military pediatric clinic.

Method:

A pre-post intervention design guided by the Plan-Do-Study-Act framework was implemented over 11 weeks and included staff education, standardized workflows, and caregiver outreach.

Results:

The intervention improved laboratory completion and caregiver follow-up rates; however, sustainability was limited by staffing constraints …

Barriers To Immunity: Understanding Covid-19 Vaccine Uptake In Africa, Emilia Blechschmidt

Honors Theses

This thesis examines the factors influencing COVID-19 vaccine uptake across African countries, with a focus on structural, informational, and behavioral barriers to immunization. Drawing on cross-country data, the study analyzes how access to transportation, reliable information, and healthcare resources shape vaccination rates, alongside the effect of demographics and institutional factors in shaping individual perceptions of risk and vaccine safety.

The findings emphasize that the broader strength and preparedness of national health systems strongly influence vaccine uptake. Countries that demonstrated higher coverage of routine childhood immunizations, such as polio and hepatitis B, also tended to perform better in COVID-19 uptake efficiency …

Imagined Afterlives: Anti-Black Medical Violences In Contemporary Black Arts, Katie Schadler

Honors Theses

“Imagined Afterlives: Anti-Black Medical Violences in Contemporary Black Arts” is a multi-genre exploration that studies the following works: Venus (1996) by Suzan Lori Parks, Get Out (2017) by Jordan Peele, and Dawn (1987) by Octavia Butler. I respectively study an experimental play, a psychological horror film, and a speculative novel to understand how Black creatives are depicting and responding to anti-Black violences, particularly medical violences. This work brings together Black art spanning from the late 1980s to 2017 as well as historical events and figures from the eighteenth century all the way to a not-so-distant future. While these works defamiliarize …

Long-Term Incidence Trends And Stage Distribution Of Cutaneous Melanoma In The United States (1975–2022): A Seer Population-Based Analysis, Thea Danielle Amadasun, Shahzaib Maqbool

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.

Smarca4-Deficient Carcinoma Of The Gastroesophageal Junction, Hanna Riga, Austin Lehr

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.

A Rare Case Of New Onset Lisinopril-Induced Angioedema Improved With Tranexamic Acid: A Case Report, Hafiz Numan Ijaz, Shahzaib Maqbool, Yugandhar Kandimalla

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.

2026 Midamerica Gme Research Symposium, Hca Healthcare

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.

Atypical Del(5q) Mutation In Myelodysplastic Syndrome Presenting With Thrombocytopenia: A Case Report Of Tp53-Mutated High-Risk Biology, Shahzaib Maqbool, Munaf Siyamwala, Amelia Goslin, Shivani R. Scharf, Katsiaryna Laziuk

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.

Intestinal Tuberculosis Masquerading As Crohn’S Disease: A High-Risk Diagnostic Mimic, Maikel Tawadrous, Tejaswi Vadde, Subuhee Ahmed, Lawrence San Jose, Chelsea Curry, Aradhana Pandey

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.

High-Flow Ectatic Anomalous Right Coronary Artery From The Pulmonary Artery With Stimulant-Induced Cardiomyopathy: A Case Report, Prithvi Basu Roy, Danish Bawa, Louis Orlando

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.

From Focal Peroneal Neuropathy To Complex Regional Pain Syndrome: A Case Of Progressive Unilateral Lower Extremity Pain, Ali Haider, Yu-Shiuan Hsu

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.

Alpha 1 Antitrypsin Deficiency In Primary Care: A Case Presentation, John Sweetman, Gazala Parvin

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.

Intermittent Hypoxia In A Middle-Aged Woman With A Probable Bethlem Myopathy Carrier State And Suspected Complex Sleep-Related Hypoventilation, Jonathan Paul Ladera, Louis Orlando

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.

"Qt Okay, Bowel Not Okay"- Dofetilide Masking An Evolving Small-Bowel Obstruction, Tejaswini Yeshala, Pankti Shah, Syed Ali Abidi, Archana Machavarapu

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.