Medicine and Health Sciences Commons^™

Missed Opportunities For Stroke Prevention In Patients With Hypertension: A Retrospective Case-Control Study, Huanhuan Yang, Yuntian Liu, Chungsoo Kim, Chenxi Huang, Mitsuaki Sawano, Patrick Young, Jacob Mcfadden, Mark Anderson, John S. Burrows, Harlan M. Krumholz, John E. Brush Jr., Yuan Lu

Department of Medicine Faculty Publications

Background

Hypertension is the leading modifiable risk factor for ischemic stroke, yet the adequacy of preventative hypertension care in routine clinical practice remains suboptimal, potentially representing missed opportunities for stroke prevention. We evaluated the association between hypertension care delivery and incident ischemic stroke.

Methods

 We conducted a retrospective, matched, nested case-control study among adults with hypertension using data from a large regional health system (2010-2024). Patients with a first-ever ischemic stroke were matched 1:2 to controls on age, sex, race and ethnicity, and calendar time. Three care metrics were assessed: (1) outpatient visits with blood pressure measurement per year; (2) …

Performance And Safety Of A Multi-Cancer Early Detection Test: The Pathfinder 2 Study, Nima Nabavizadeh, Charles Mcdonnell, Dax Kurbegov, Marc Matrana, Shirish Gadgeel, Raymond H. Kim, Gretchen Stipec, Kevin C. Oeffinger, Michael J. Demeure, James W. Lillard Jr., Rebecca Kaltman, Jennifer Tran, Alan Roth, Samia Tahhan, Andrews Poklepovic, Donald Richards, Margarita Lopatin, Celine Marquez, Margaret Mccusker, Karthik V. Giridhar

Department of Medicine Faculty Publications

Early cancer detection improves survival; however, most cancer types do not have guideline-recommended screening. We previously reported the first PATHFINDER study that established feasibility of cancer screening with a blood-based multi-cancer early detection (MCED) test that predicts cancer signal origin (CSO) to guide diagnostic workup. The prospective, interventional PATHFINDER 2 study expands clinical evidence for the MCED test by evaluating co-primary endpoints of MCED performance metrics and safety in participants aged 50 years or older without clinical suspicion of cancer. Performance measures included cancer detection rate, positive and negative predictive values, episode sensitivity, specificity and CSO prediction accuracy. Safety was …

Donor-Derived Cell-Free Dna In Antibody-Mediated Rejection: An Analysis Of The Surveillance Heartcare Outcomes Registry, Paul J. Kim, Amit H. Alam, Jeffrey J. Teuteberg, Kiran K. Khush, Sean P. Pinney, Richard K. Cheng, Amin Yehya, Jeremy Kobulnik, Kevin M. Pinney, Kris A. Oreschak, Christopher R. Ensor Pharmd, Steven Fan, Marcus A. Urey, Palak Shah, Shelley A. Hall

Department of Medicine Faculty Publications

Background

Donor-derived cell-free DNA (dd-cfDNA) has emerged as a biomarker for antibody-mediated rejection (AMR), but its performance characteristics have not been evaluated in a large contemporary heart transplant population.

Objectives

The study aimed to characterize the incidence and timing of biopsy-proven AMR and evaluate the performance characteristics of dd-cfDNA for AMR.

Methods

The authors included 2,240 subjects from the SHORE (Surveillance HeartCare Outcomes Registry) registry transplanted between 2017 and 2022 with verified biopsy, dd-cfDNA, echocardiographic, and donor-specific antibody (DSA) data. They evaluated the performance characteristics of dd-cfDNA for AMR and the incidence of AMR in different clinical contexts.

Results

AMR …

Transvascular Endobronchial Ultrasound-Guided Transbronchial Needle Aspirations (Ebus-Tbna) To Confirm Urothelial Carcinoma Metastasis To The Pulmonary Artery, Kyle Admire, Stephen Gegick

Department of Medicine Faculty Publications

Tumours within the pulmonary arteries provide a diagnostic challenge due to their similar appearance to pulmonary emboli. Often, the decision to sample is multidisciplinary and the best approach to take is often unknown. Here we describe a case of urothelial carcinoma which metastasised to the mediastinum with evidence of tumour burden within the pulmonary artery. Sampling of this by endovascular and thoracoscopic means was unsuccessful; however, we were able to provide a diagnosis using direct visualization with endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). This report is the first of a central pulmonary artery tumour caused by urothelial carcinoma biopsied by …

A Fishy Situation: Hand Infection Due To Mycobacterium Marinum Mistaken For Giant Cell Tumor, Alynna Knaub, Dylan Baker, Jennifer Hanrahan

Department of Medicine Faculty Publications

Mycobacterium marinum is an acid-fast bacterium (AFB) associated with exposure to water and aquatic species. When inoculated, infection can result in nodular cutaneous lesions. In the absence of detailed history or culture data, these nodular skin lesions can be mistaken for noninfectious orthopedic conditions. We present a case of M. marinum mistaken for a giant cell tumor. This case illustrates the overlap in these conditions, as well as the utility of QuantiFERON Gold testing to provide supportive evidence for the diagnosis of Mycobacterium marinum.

The Psychiatric Burden Of Hidradenitis Suppurativa: A Trinetx Analysis Of Sex-Specific Disparities In Mental Health And Medication Use, Emily Sheetz, Julia Feord, Collette Sholi, Parker Adams, Tamas Gal, Susan G. Kornstein, Arturo Saavedra

Department of Medicine Faculty Publications

Background:

Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition associated with physical and psychological burden. Prior research has shown increased rates of depression and anxiety among individuals with HS; however, sex-based disparities in the prevalence of these mental health conditions in patients with HS remain underexplored.

Objective:

To evaluate sex-based differences in the prevalence of major depressive disorder (MDD), generalized anxiety disorder (GAD), and the prescribing of antidepressants and anxiolytics among patients with HS.

Methods:

Using the TriNetX database, we identified patients over the age of 18 who had a recorded diagnosis of HS. Propensity score matching based on …

Upadacitinib For Recalcitrant Extraintestinal Crohn Disease, Avery H. Seward, Jeffrey P. Callen

Department of Medicine Faculty Publications

[Introduction] Crohn disease is a chronic inflammatory bowel disease that affects the gastrointestinal tract from the mouth to the anus. Extra-intestinal manifestations of Crohn disease are common, with the skin being the most commonly involved site.¹ Cutaneous manifestations of Crohn include lesions that directly extend from the bowel to the skin, whereas extraintestinal Crohn disease involves sites that do not directly extend from the bowel.¹ Extraintestinal Crohn disease is often resistant to treatments and often does not parallel the activity of the bowel disease.¹ There have only been 3 documented cases of extraintestinal Crohn disease responding to upadacitinib.²,³ We describe …

Concomitant Transcatheter Edge-To-Edge Repair For Mitral And Tricuspid Regurgitation For Polyvalvular Disease, Omar Khan, Matthew Summers

Department of Medicine Faculty Publications

This patient is a 77-year-old male with non-ischemic cardiomyopathy, severe tricuspid regurgitation, and moderate mitral regurgitation who underwent simultaneous transcatheter edge-to-edge repair of both mitral and tricuspid valves. Post-procedure, the patient exhibited significant symptomatic improvement and reduced regurgitation severity, highlighting the feasibility of dual-valve TEER in high-risk patients.

Successful Use Of Chimeric Antigen Receptor T-Cell (Car-T) Therapy With Lisocabtagene Maraleucel In A Renal Transplant Recipient With Refractory/Relapsed Diffuse Large B-Cell Lymphoma (Dlbcl), Waqqas Tai, Fatima Chaudhry, Nesreen Shahrour, Jessica Thomas, Afoma Anyadibe, Anuoluwa Oyetoran, Swathi Gopishetty, Precious Idogun, Dilip Samarapungavan, Jassim H. Sarmad, Ishmael Jaiyesimi

Department of Medicine Faculty Publications

This case describes a 53-year-old male with end-stage renal disease who developed monomorphic post-transplant lymphoproliferative disorder (PTLD) in the form of diffuse large B-cell lymphoma (DLBCL) after kidney transplantation. Despite initial treatment with rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone (R-CHOP), the patient's disease progressed, and he was referred for chimeric antigen receptor (CAR) T-cell therapy with lisocabtagene maraleucel (liso-cel). Given his post-transplant status, his immunosuppressive agents (tacrolimus and mycophenolate) were held, and prednisone was tapered to 5 mg daily to maintain minimal baseline immunosuppression. After lymphodepleting chemotherapy and liso-cel infusion, the patient experienced no significant toxicities, including cytokine release syndrome (CRS) …

Combined Snare And Buddy-Balloon Strategy For Failed Valve Crossing In Valve-In-Valve Transcatheter Aortic Valve Replacement, Hira Sarfraz, Muhammad U. Javed, Parth K. Parikh, Joshua A. Cohen, Raymond L. Benza, Matthew R. Summers, Deepak R. Talreja

Department of Medicine Faculty Publications

Background Retrograde valve crossing during valve-in-valve transcatheter aortic valve replacement (ViV TAVR) may fail despite modern delivery systems. Case Summary A 67-year-old man with a degenerated 27-mm Magna Ease bioprosthesis and unfavorable aortic geometry (kinked ascending aorta at a prior surgical graft site) underwent ViV TAVR, where retrograde valve crossing failed despite multiple stiff guidewires and snare traction alone. Successful delivery of a 29-mm Evolut FX+ was ultimately achieved by combining gooseneck-snare traction for coaxial realignment with a partially inflated Tyshak buddy balloon acting as a mechanical ramp across the surgical valve frame. Discussion This case demonstrates a structured, stepwise …

Insurance Disparities In Hidradenitis Suppurativa: A Comprehensive Review Of Demographics, Outcomes, And Access To Care, Alim Osman, Alexandra R. Nigro, Michael C. Povelaitis, Marc Z. Handler

Department of Medicine Faculty Publications

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition that disproportionately affects women, African Americans, and individuals of biracial descent. It is associated with substantial physical and psychiatric morbidity, reducing quality of life.

Objective: This review analyzed disparities in treatment outcomes, disease progression, and healthcare access among HS patients based on insurance type.

Methods: Using PRISMA guidelines, a comprehensive literature search identified 7 studies meeting inclusion criteria. Owing to data heterogeneity, studies were qualitatively analyzed.

Results: Findings consistently demonstrated that Medicaid patients experienced worse outcomes than those with private insurance or Medicare. Medicaid patients had higher rates of comorbid …

Combined Snare And Buddy-Balloon Strategy For Failed Valve Crossing In Valve-In-Valve Transcatheter Aortic Valve Replacement, Hira Sarfraz, Muhammad U. Javed, Parth K. Parikh, Joshua A. Cohen, Raymond L. Benza, Matthew R. Summers, Deepak R. Talreja

Department of Medicine Faculty Publications

Background

Retrograde valve crossing during valve-in-valve transcatheter aortic valve replacement (ViV TAVR) may fail despite modern delivery systems.

Case Summary

A 67-year-old man with a degenerated 27-mm Magna Ease bioprosthesis and unfavorable aortic geometry (kinked ascending aorta at a prior surgical graft site) underwent ViV TAVR, where retrograde valve crossing failed despite multiple stiff guidewires and snare traction alone. Successful delivery of a 29-mm Evolut FX+ was ultimately achieved by combining gooseneck-snare traction for coaxial realignment with a partially inflated Tyshak buddy balloon acting as a mechanical ramp across the surgical valve frame.

Discussion

This case demonstrates a structured, stepwise …

Complicated Third Sternotomy For Left Ventricular Outflow Tract Obstruction Secondary To Mitral Valve Prosthesis Strut, Rishab Agarwal, Alleabelle Bradshaw, Michelle Carvajal, Jennifer S. Lawton

Department of Medicine Faculty Publications

Introduction: LVOT obstruction after surgical bioprosthetic MVP placement is uncommon and the influence of the MVP strut width has seldom been examined.

Case presentation: A 74-year-old female presented with palpitations, chest pain, and shortness of breath. She had MVR with 31-mm bioprosthetic valve 2 years prior. TEE confirmed LVOT obstruction secondary to a MVP strut, causing a peak gradient of 55 mmHg. The redo operation was complicated by iatrogenic Type A aortic dissection. The patient was immediately cooled for DHCA with RCP and ascending aortic replacement was performed. MVR was then performed with a prosthesis with narrower strut width. Recovery …

Percutaneous Closure Of Ventricular Septal Rupture After Myocardial Infarction:, Thomas A. Cook, Simone K. Schumaecker, Anjani Patibandla, Nicholas J. Valle, Matthew R. Summers

Department of Medicine Faculty Publications

BACKGROUND: Ventricular septal rupture (VSR) following acute myocardial infarction is a rare but deadly complication with mortality rates exceeding 90% when left untreated. Coronary ischaemia leads to myocardial necrosis and friability resulting in septal rupture, most commonly 3-5 days post-infarction. The sudden development of a left-to-right shunt causes volume overload in the right ventricle, pulmonary vasculature, and left atrium, precipitating biventricular failure, and cardiogenic shock. Management requires careful consideration of timing and modality of closure along with stabilization with mechanical circulatory support in severe cases.

CASE SUMMARY: A 65-year-old female presented with anterior ST-segment elevation myocardial infarction complicated by VSR …

Understanding Risk And Protective Factors Of Intimate Partner Violence: A Public Health And Social Advocacy Approach, Mangai Natarajan, Yasemin Irvin-Erickson, Brittany Suh, Susan Nembhard, Lindsay Smith, Yi-Fang Lu

Sociology & Criminal Justice Faculty Publications

Intimate partner violence (IPV) is a recurring social problem that has individual, interpersonal, community, and societal level consequences necessitating interdisciplinary knowledge and a holistic, systemic approach for prevention. Recent research on IPV indicates the need to identify the implications of the COVID-19 pandemic for IPV risk and subsequent consequences to inform mitigation solutions. Using a mixed-methods design, this rapid assessment research aims to address an existing gap by gathering primary data on the perceived risk and protective factors in addressing IPV through interviews, focus group discussions (n = 102), and surveys (n = 324) from a purposive sample of victim …

[Review Of The Book The Prescription-To-Prison Pipeline: The Medicalization And Criminalization Of Pain, By M. Smirnova], Hayley Jackey

Sociology & Criminal Justice Faculty Publications

[Introduction] Smirnova’s The Prescription-to-Prison Pipeline offers a critical examination of the impacts of prescription drugs as well as the over-policing and policies created to push individuals into the carceral system rather than providing other options for assistance. Smirnova further captures the social inequalities of race and class of those encased in this pipeline. Within this understanding of the detriment that the system, medical providers, and society place on those who use substances, Smirnova’s use of interviews allows for a clear understanding of how these systems work in conjunction to uphold the pipeline.

Effects Of Differential Stress And Mental Health On Substance Use Among College Students, Avdi S. Avdija, Arif Akgul

Sociology & Criminal Justice Faculty Publications

Substance use among college students is often seen as a coping mechanism for some students who are prone to extreme stress, depression, or anxiety. Multiple forms of stress become the leading factors that push students toward substance use. This study tests the effects of college stressors, depression, and anxiety on substance use among college students. The results are based on the data that were collected using a 101-item questionnaire administered to 302 college students at a public university in the Midwest U.S.A. Using Logistic Regression as the primary data analysis technique, the findings of this study show that social stressors …

Comparing Us Medicare Coverage Options As A Contributing Mechanism To Sticking Or Switching To An Insurance Plan, Lisa M. Grabert, Brian J. Miller, Kathryn L. Wagner

College of Nursing Faculty Research and Publications

Background

In 2025, the US Medicare program is expected to spend over $1.1 trillion taxpayer dollars. A growing trend in the US Medicare program is more beneficiaries electing a private insurer, referred to as Medicare Advantage (MA), to manage their care. Since 2023, a slight majority of Medicare beneficiaries have elected to enroll in MA, yet little is understood about the mechanisms that drive beneficiaries toward their choices.

Methods

Our objective was to examine the association between comparing coverage options and ‘switching’ or ‘sticking’ with Fee-for-Service (FFS) Medicare or Medicare Advantage (MA). We conducted a panel study, using data from …

From The Goodness Of Our Hearts: A Scoping Review Of Qualitative Literature On Altruism As A Reward Mechanism For Nursing, Jacqueline Christianson, Madaline Mccarthy, Bonnie Sommers-Olson, Emily Horner, Norah L. Johnson

College of Nursing Faculty Research and Publications

Introduction

Altruism, the desire to help others, is a common motivation for choosing a career in nursing. Improved understanding of the role of altruism as a reward or motivation for currently-practicing nurses may inform future interventions to improve effort-reward balance among practicing nurses. Therefore, the purpose of this study was to collect, examine, and present literature on how altruism has been described as a reward mechanism or motivation for engaging in professional nursing.

Methods

This scoping review of literature used the Arksey & O’Malley method, PRISMA-ScR reporting checklist, and Rayyan review management platform. PubMed, Web of Science, and CINAHL were …

An Educational Intervention On Mutual Goal Setting For Hospital Nurses: A Mixed-Methods Study, Teresa Jerofke-Owen, Kristi Opper, Joseph Beiler, Maharaj Singh

College of Nursing Faculty Research and Publications

Background:

Including patients in mutual goal setting is one mechanism to personalize care delivery and improve patient outcomes.

Objective:

The purpose of this study was to examine the impact of a nurse educational intervention about mutual goal setting on nurse engagement and self-efficacy for goal setting and the nurse/patient experience of goal setting.

Methods:

During this explanatory, sequential mixed-methods study, nurse engagement in goal setting and goal quality was assessed through chart audits 1-month pre-intervention (n = 173) and 1 and 3-months (n = 144, n = 137) post-intervention. Nurse self-efficacy was measured with the Appraisal Inventory Tool. Patient experience …

Beyond Numbers: Bridging Statistical Significance And Clinical Relevance In Healthcare Research, Maharaj Singh, Waheeda Khan, Mehreen Fatima

College of Nursing Faculty Research and Publications

Objective: This study aims to bridge the gap between statistical significance and clinical relevance using rigorous statistical methodologies applied to simulated healthcare data, thereby enhancing the translational value of research outcomes for patient‑centered care. Methods: A synthetic dataset representing 10,000 patients was generated, and descriptive statistics were applied to compare two treatment groups. Binary outcomes were predicted using both a logistic regression model and a neural network. Two‑tailed tests with a significant level of 0.05 were employed, utilizing SAS version 9.4 and IBM SPSS Statistics, Version 29.0 (IBM Corp., Armonk, New York, United States of America). Results: The simulated dataset …

Artificial Intelligence And Mental Health: Promise, Pitfalls And Ethical Priorities, Maharaj Singh

College of Nursing Faculty Research and Publications

Mental health conditions are prevalent across the lifespan, yet workforce shortages, long waiting times, and fragmented systems mean many people never receive timely, evidence‑based care. Artificial intelligence (AI), including machine‑learning classifiers and large language models (LLMs), is being explored to support earlier detection, closer symptom monitoring and scalable psychoeducation. Early studies suggest AI can surface risk signals from language, sleep/activity traces and clinical notes; summarise complex records for clinicians; and deliver structured self‑help at scale. At the same time, safety, bias, privacy and accountability concerns remain salient.

Cytocompatibility, Osteogenic Potential, Antibacterial And Antibiofilm Efficacy Of A Calcium-Silicate-Based Intracanal Medication, Shehabeldin Mohamed Saber Prof.Dr.

Dentistry

This study assessed the biological and antimicrobial properties of a calcium silicate-based material and calcium hydroxide (CH) when used as intracanal medications. MTT assay, osteogenic differentiation of human periodontal stem cells (hPDLSCs), cell mineralization-assay, and determination of ALP activity were assessed to investigate the biological properties. While the agar well diffusion, crystal violet (CRV) assay and LIVE/DEAD staining of dentin slices infected with a mature E. faecalis biofilm were used to assess the antimicrobial properties. Normally distributed data were analyzed using one and two-way ANOVA and post hoc Tukey test, while for non-normally distributed data Kruskal Wallis and Dunn's tests …

Enhancing Severely Compromised Premolar Strength: Role Of Cusp Reduction Design In Cad/Cam Composite Restorations, Shehabeldin Mohamed Saber Prof.Dr.

Dentistry

The objective of this study was to assess the effect of different designs and depths of cusp reduction on fracture resistance of maxillary permanent premolars restored with CAD/CAM composite restorations. A total of 42 sound maxillary premolars were used. Standardized MOD cavities were prepared in all specimens. Teeth were randomly divided according to form of cusp reduction into three main groups (n = 14); G1:MOD cavities restored with inlays with no cusp reduction, G2:MOD cavities restored with overlays with buccal and palatal anatomical cusps reduction, G3; MOD cavities restored with overlays with buccal and palatal flat cusps reduction. Groups 2 …

Automatic Teeth Segmentation In Panoramic Radiographs Using Attention U-Net, Shehabeldin Mohamed Saber Prof.Dr.

Dentistry

Aim: The aim of this study is to investigate the effectiveness of the Attention U-Net architecture for teeth segmentation in panoramic dental images. By exploring the potential of Attention U-Net, the study aims to contribute to the development of more precise and automated dental imaging analysis, which could enhance diagnosis, treatment planning, and computer-aided dental systems. Subjects and methods: The TUFTS University dataset consisting of 1000 de-identified panoramic radiographs was used for training and testing an Attention U-Net architecture with 10-fold cross-validation. These scores surpass those of all other networks implemented on the same dataset. using a newly available benchmark …

Dual Regulation Of Osteogenesis And Inflammation By Pomegranate (Punica Granatum L.) Extract In Periodontal Ligament-Derived Stem Cells: Implications For Regenerative Medicine, Mai Hafez

Dentistry

Objectives

This article aims to compare the osteogenic along with anti-inflammatory activity of different concentrations of pomegranate extract (PG) on human periodontal ligament-derived stem cells (hPDLSCs) in vitro.

Materials and Methods

hPDLSCs were acquired from the root surface of removed molars, cultured, and then distinguished by flow cytometry analysis and several lineage differentiation potentials. To identify the effect of PG on hPDLSCs' viability, an MTT assay was performed. hPDLSCs were maintained in osteogenic induction medium with varying concentrations of PG. At the end of the induction period, osteogenesis was assessed using Alizarin Red staining, ALP assay, and qRT-PCR to determine …

Effect Of Different Finishing And Polishing Systems On Surface Roughness And Color Stability Of Composite Cad/Cam Blocks (In-Vitro Study), Hend Sayed Ahmed, Mohamed Fouad Haridy, Noura Alzayyat, Reem Mohamed Gadao

Dentistry

No abstract provided.

Effect Of Caries Removal Techniques On Micro-Tensile Bond Strength Of Cad/Cam Composite Blocks To Dentine (In-Vitro Study), Hend Sayed Ahmed, Mohamed Fouad Haridy, Hoda Fouda, Basma Khalifa, Youssef M. Haridy

Dentistry

No abstract provided.

Laser Versus Fluoride Varnish In Management Of Dentine Hypersensitivity In Non-Carious Lesions: A Randomized Clinical Trial, Hend Sayed Ahmed, Mohamed Fouad Haridy, Hoda Fouda, Amr Adham Shalaby, Youssef M. Haridy

Dentistry

No abstract provided.

The Effects Of Cigarette Smoke And Heated-Tobacco Aerosol On Streptococcus Mutans Adhesion And Surface Topography Of Dental Hard Tissues In Vitro, Mohamed Shamel, Mahmoud Al Ankily, Nourhan Taha

Dentistry

No abstract provided.