Medicine and Health Sciences Commons^™

Adapting And Delivering An Extension Diabetes Self-Management Support Program To Serve The Hispanic Community, Camden Bryan, Samantha Kanny, Christina Dietz, Danielle Mcfall, Michelle Parisi, Michelle Stancil, Johanna Bruen, Rhonda Matthews, Windsor W Sherrill

Journal of Extension

Expanding Extension education programs to serve the Hispanic community will be important as this population continues to grow. The rate of diabetes is higher among the Hispanic population than the non-Hispanic population; however, the barriers to implementing a health education program and recruiting participants are plentiful. This paper highlights the work conducted by the Clemson Cooperative Extension Service, in partnership with organizations across South Carolina, to adapt and deliver the Health Extension for Diabetes program to the Hispanic community. It offers insights into effective strategies for program adaptation, recruitment, and delivery that agents can use to overcome barriers and increase …

Rapid Recovery Of Peripheral Oxygen Saturation In Hypoxic Covid-19 Patients With Ivermectin/Doxycycline/Zinc Multidrug Therapy, Sabine Hazan, Adriana C. Vidal, Eleftherios Gkioulekas, Anoja W. Gunaratne, Sibaish Dolai, Robert L. Clancy, Peter A. Mccullough, Thomas J. Borody

School of Mathematical & Statistical Sciences Faculty Publications

Several combination therapies for the early outpatient treatment of COVID-19 were proposed by independent research groups at the onset of the pandemic during 2020 and 2021. In this observational study, we report on the outcomes of an off-label triple combination therapy, consisting of ivermectin, doxycycline, and zinc, with adjunct vitamin C and D3 supplementation, which was used on high-risk COVID-19 patients. These patients refused an initial recommendation to seek inpatient care, despite a high-risk presentation compounded with one or more comorbidities and/or severe hypoxia. Telemedicine was used to administer personalized treatment to patients at home, who did not have access …

Building Academic-Community Partnerships To Reduce Rural Health Disparities, Latoya J. O'Neal, Marcia Brown, Biswadeep Dhar, Noemi Reyes, Brittany Blake, John Diaz, Karla Shelnutt

Journal of Extension

Rural health disparities are increasing in the United States. Academic–community partnerships between Extension and faith-based organizations present a unique opportunity to improve health outcomes in rural areas. The main objective of this study was to identify the perceived barriers, needs, and strategies for implementing effective and sustainable health promotion programs through Extension and faith community partnerships. We conducted semi-structured interviews with Extension professionals and faith community leaders (N = 15). Our results suggest that academic–community partnerships could leverage shared needs, resources, and strategies to serve as a model for reducing health disparities among low-income, minoritized adults residing in rural …

Collaboration Is Key: Improving And Increasing Inclusive Programming Through Partnership, Brandy D James, Elizabeth Sparks, Fiona S Davey, Burris Duncan, Nadine Chau

Journal of Extension

Collaborative partnerships between Cooperative Extension offices and the University Centers for Excellence in Developmental Disabilities are a key opportunity to assess and improve accessible, inclusive programming for the communities they serve. This article outlines such a partnership between local Extension, the local UCEDD, and the local Network for Down Syndrome. It reviews their collaborative process and the resulting pilot program—-an inclusive cooking class. Evaluations of the program and collaborative process demonstrate that the partners' collaboration enabled organizational capacity building and improved service provision for persons with Down Syndrome.

A Conserved Mechanism For Dimerization And Activation Of Superfamily 1a Uvrd-Family Helicases, Binh Nguyen, Kacey N Mersch, Ankita Chadda, Eric A Galburt, Timothy M Lohman

2020-Current year OA Pubs

DNA helicases are ATP-dependent motor proteins that catalyze duplex DNA unwinding and are involved in DNA repair, recombination, and replication restart. Prominent members of the non-hexameric SF1A UvrD-family helicases are Escherichia coli UvrD, Rep, Bacillus stearothermophilus PcrA, and Mycobacterium tuberculosis (Mtb) UvrD1. SF1A monomers are processive 3'-to-5' single-stranded DNA translocases but need to be activated to become DNA helicases. One mechanism of activation is dimerization. Whereas Rep, UvrD, and PcrA form non-covalent dimers, the Mtb UvrD1 helicase forms a redox-dependent covalent dimer. Dimerization of Mtb UvrD1 occurs between the same regulatory domain (2B) within each subunit stabilized by a disulfide …

Multiplexed Plasmon-Enhanced Lateral Flow Assay For Early Diagnosis Of Acute Kidney Injury, Heng Guo, Yuxiong Liu, Ravi Jada, Ying Liu, Carissa Ng, Aquiles Payte, Jiaying Xu, Connor Malone, Jie Zhao, Kedhareswara Sairam Pasupuleti, Arda Aidan Arikan, Sameer Thadani, Srikanth Singamaneni, Ayse Akcan Arikan, Limei Tian

Faculty, Staff and Students Publications

Early diagnosis of acute kidney injury (AKI) remains a major clinical challenge due to the delayed and insensitive nature of conventional markers such as serum creatinine. Urinary protein biomarkers, including neutrophil gelatinase-associated lipocalin (NGAL) and cystatin C (CysC), provide earlier and complementary information on kidney injury, but their clinical translation is limited by the lack of rapid, quantitative, and multiplexed point-of-care (POC) diagnostic tests. Here, we report a multiplexed plasmonic-fluor-based lateral flow assay (p-LFA) that enables sensitive, quantitative, and simultaneous detection of NGAL and CysC. By harnessing ultrabright plasmonic-fluor nanolabels and ratiometric fluorescence analysis, the p-LFA achieves picogram-per-milliliter analytical sensitivity …

Hypoglossal Nerve Stimulation For Obstructive Sleep Apnea: A Systematic Review And Meta-Analysis On Responder-Based Outcomes And Between-Study Heterogeneity, Clemens Heiser, Marcel Braun, Colin Huntley, Michael Hutz, Thomas Michael Kaffenberger, Maurits Boon

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Background: Hypoglossal nerve stimulation (HNS) is an established surgical therapy for adults with moderate-to-severe obstructive sleep apnea (OSA) who are intolerant to positive airway pressure. Although aggregate response rates of ~70–80% have been reported, substantial variability across clinical settings remains poorly understood. Prior meta-analyses have largely emphasized pooled continuous outcomes, limiting interpretation of responder-based endpoints and drivers of between-study heterogeneity. Methods: A PRISMA-compliant systematic review and meta-analysis was performed. MEDLINE, Embase, and Cochrane CENTRAL were searched from inception through 31 December 2025. Eligible studies enrolled adults with OSA treated with implantable HNS, reported Sher-defined response (≥50% AHI reduction and residual …

Peer-Peer Mentoring In Undergraduate Medical Education (Ume): Scoping Review Of Us-Based Medical Schools, Sakshi Sehgal, Jordon Brinkley, Andrea Kadima, Sydney Wright, Nicole Winston Ms, Pharmd, Edd

Journal of the Georgia Public Health Association

Background: Mentorship plays a formative role in undergraduate medical education (UME) From shaping professional outcomes to developing longitudinal personal relationships, various forms of mentorship can influence student progress meaningfully, particularly for students from underrepresented or marginalized backgrounds. Though faculty-student mentorship has been readily investigated, limited knowledge exists regarding peer-peer mentorship structures, particularly within UME in the American medical education model. This scoping review sought to investigate existing peer-peer mentorship models, as well as report on the need for further mentorship within this realm in UME.

Methods: This scoping review employed Arksey and O’Malley’s framework. We conducted a systematic and comprehensive …

The Role Of Social Determinants Of Health In Hydroxyurea Adherence Among Persons With Sickle Cell Disease: A Systematic Review, Doreen O. Ugwu, Lori L. Vick, Terika Williams, Aurela Nikaj, Seyi Omeh, Benjamin Becerra Dr., Tilicia Mayo-Gamble

Journal of the Georgia Public Health Association

Objective: Georgia has one of the highest prevalences of sickle cell disease (SCD). For Georgians living with SCD, inadequate medication adherence is associated with important clinical outcomes. One important area that is understudied in SCD is the impact of social determinants of health (SDoH) on medication adherence. A foundational understanding of SDoH is needed to introduce, inform and carry out programs and interventions designed to facilitate hydroxyurea adherence through the state of Georgia.

Method: We conducted a systematic literature review to synthesize the literature on SDoH addressed in studies to improve hydroxyurea adherence in persons with SCD. SDoH were based …

Perspective On Lessons Not Learned: From Coley’S Toxins To Microbial Drug Delivery, Guidance For Institutional Review Boards (Irbs), Brian P. Hanley, Alejandro J. Betancourt, Gustavo Gross, Wilbur (Bo) Bowne

School of Medicine Publications

The bacterial and toxin methods of cancer treatment date back 130 years. This paradigm rests on nonspecific bacterial-toxin-generated immunotherapy. This high-risk oncology research is experiencing a renaissance of methods that are among the most effective yet. Glioblastomas and other resistant cancers are the modern touchpoint, because of remission history following sepsis. Spurred by recent research deaths, we discuss protocols IRBs should consider in live bacterial or synthetic immuno-stimulatory trials. Human systemic inflammatory response syndrome immunology is unique due to non-functioning SIGLEC-13 and 17, which control excessive Toll-like receptor 4 (TLR-4) signaling. This is not a technicality like human CD8+/CD4+ T …

Ai-Driven Detection Of Neurodevelopmental Disorder From Emotional Speech Using A Hybrid Cnn–Bilstm–Attention Framework, Nayarah Shabir, Parveen Lehana, Sheema Khan

School of Medicine Publications

Neurodevelopmental disorders (NDDs) are associated with impairments in communication, behavior, and social interaction, making accurate diagnosis clinically challenging. Autism Spectrum Disorder (ASD), a major NDD, often exhibits atypical speech patterns characterized by altered prosody and reduced emotional expressiveness. The study proposes a hybrid dual-path framework for ASD detection from emotional speech using two strategies: PCA–GMM-based acoustic modeling and a CNN–BiLSTM–Attention architecture for spectral–temporal feature learning. The proposed framework captures probabilistic, spectral, and temporal speech characteristics for robust ASD classification. Acoustic analysis demonstrated clear separability between ASD and non-ASD speech, while the deep learning framework achieved stable and reliable performance across …

Caregiving And Mental Health Among Mothers During The Covid-19 Pandemic, Makayla Elise Techentine

Walden Dissertations and Doctoral Studies

The 2019 coronavirus (COVID-19) pandemic led to reliance on family members or friends to care for the sick, resulting in a burden of informal caregiving stressors and relationship to mental health. Guided by the stress process model, this quantitative, cross-sectional study aimed to assess the relationship between caregiving stressors and the mental health of mothers of children aged 18 years or younger who were serving as informal caregivers. Secondary data from the 2020-2021 Behavioral Risk Factor Surveillance System (N = 1,772) considered the independent variables related to caregiving stressors, including hours spent caregiving, time since becoming a caregiver, personal care …

Behavioral Intentions And Use Of Telehealth Among Afro-Caribbean Immigrants In Florida, Patsy Patricia Lindo-Wood

Walden Dissertations and Doctoral Studies

Many researchers have documented the benefits of telehealth in managing cardiovascular disease and its risk factors. However, acceptance and use of telehealth among immigrants in the United States were low compared to other users, and little is known about Afro-Caribbean immigrants and their telehealth acceptance and use. Guided by the unified theory of acceptance and use of technology, this study explored how performance expectancy, effort expectancy, social influence, and facilitating conditions shape behavioral intentions and telehealth use among Afro-Caribbean immigrants in Port St. Lucie, Florida. A generic qualitative design with a purposive sampling strategy was used to interview 17 Afro-Caribbean …

Leadership-Mediated Retention Strategies To Sustain Workforce Capacity And Performance In Public Health, Meredith Winslow Wilkins

Walden Dissertations and Doctoral Studies

Workforce retention challenges continue to affect public health leaders by contributing to staffing shortages, reduced organizational capacity, and disruptions in service delivery. Public health leaders are concerned with employee turnover because it affects workforce stability, organizational performance, and the ability to meet community health needs. Grounded in Herzberg’s motivation-hygiene theory, the purpose of this qualitative pragmatic inquiry was to explore effective workforce retention strategies used by public health leaders to retain skilled staff and strengthen organizational capacity and revenue. The participants were eight public health leaders in the Northeast region of the United States with responsibility for workforce management and …

Extracellular Vesicle-Mediated Transfer Of Gsdme-Nt Pores As A Mechanism Of Inflammation Propagation, Bifeng Xiao

Master's Theses

Inflammasomes are multiprotein complexes that initiate inflammatory signaling through activation of caspase-1, cytokine maturation, and cleavage of Gasdermin D (GSDMD). Cleaved GSDMD forms membrane pores that contribute to cytokine release and pyroptotic cell death. Recent evidence suggests that extracellular vesicles (EVs) may facilitate the intercellular transfer of inflammatory mediators. This study investigated whether GSDMD N-terminal fragment (GSDMD-NT) associates with EV-enriched fractions and contributes to inflammation propagation. Doxycycline-inducible HeLa cells expressing FLAG-tagged GSDMD-NT were used to generate EV-enriched fractions. Western blot analysis detected GSDMD-NT-associated material within EV fractions, while EV marker analysis supported successful enrichment of EV-associated material. Exposure of recipient …

Bi-Allelic Loss-Of-Function Variants In Tmem63b Cause Syndromic Surfactant Dysfunction Disorder, Sock Hoai Chan, Audra N Iness, Jill A Rosenfeld, Mir Reza Bekheirnia, Lindsay C Burrage, Matthew Hoi Kin Chau, Chaerish Eint Myet Chae Htoo, Eric C Kao, Shamika Ketkar, Wan Wan Lim, Xi Luo, Rifhan Mazlan, Elizabeth Mizerik, Kein Seong Mun, Kalyani R Patel, Lorraine Potocki, Christina K Rapp, Xavier Roca, Ana Saianda, Ignacio Iglesias-Serrano, Everlyn C Siew, Donald Yuhui Sim, David R Spielberg, Sok-Kun Tae, Jing Xian Teo, Julian Warfsmann, Fan Xia, Child-Eu Registry, Saumya S Jamuar, Ee Shien Tan, Matthias Griese, Weng Khong Lim, Meow-Keong Thong, Keren Machol

Faculty, Staff and Students Publications

Transmembrane protein 63B gene (TMEM63B) encodes a mechanosensitive ion channel expressed in alveolar type II epithelial cells, where it mediates stretch-induced surfactant secretion. While heterozygous gain-of-function variants in TMEM63B have been associated with developmental and epileptic encephalopathy, no human disorder has previously been linked to bi-allelic loss-of-function variants. Here, we report five individuals from four unrelated families with childhood interstitial lung disease and bi-allelic predicted loss-of-function variants in TMEM63B. Affected individuals presented with early-onset respiratory distress, chronic hypoxemia, and diffuse parenchymal lung abnormalities on chest imaging. One individual died in infancy, two underwent bilateral lung transplantation, and two require oxygen …

Benefits Of Pet Friendly Work Environments On Physical, Mental, And Social Health Of Office Workers: A Systematic Review, Ahmed Radwan, Jenna Keeman, Tristan Hunzinger, Owen Wilson, Shayla Seymour

People and Animals: The International Journal of Research and Practice

Background: Pet-friendly workplace initiatives are increasingly common, yet the empirical evidence for benefits to office workers’ physical, mental, and social health is scattered and heterogeneous.

Objective: To synthesize evidence on health-related outcomes associated with pet-friendly work environments for office and desk-based workers, and to appraise the current level of evidence.

Methods: A PRISMA-guided systematic search (2014–2024) was conducted in PubMed, PsycINFO, MEDLINE, OVID, CINAHL, and Google Scholar. Two reviewers independently screened titles/abstracts and full texts, extracted data, and appraised study quality using the Critical Appraisal Skills Program (CASP) checklists. Outcomes were coded and synthesized narratively within three domains: physical, mental, …

The Medicine Forum Crossword, Youssef Elfatatry, Md

The Medicine Forum

ACROSS
1 One leading cause of ACS in young women

DOWN
1 A.O.A. alternative

The Parts They Don’T See, Alexis Notarianni, Md

The Medicine Forum

People think they know what resident doctors do.

They know the obvious parts: we examine patients, prescribe medications, and write notes. We diagnose infections, perform procedures, and coordinate care with nurses. We work long hours and rarely have days off. From the outside, it looks familiar enough to understand.

But there is a large portion of this job that is invisible, even to the people closest to us. It is difficult to explain, and harder still to feel understood unless you are living it.

More Than Medicine: How Advocacy, Education, And Loss Shape The Physician Within, Sheraz Qamar, Md

The Medicine Forum

Illness rarely unfolds in a linear or predictable way. Instead, it emerges through uncertainty – shaped by fragmented symptoms, gaps in access, and the limits of medical knowledge. Reflecting on three deeply personal experiences within my family, I have come to understand my role as a resident physician not only through clinical training, but through lived experience: as an advocate, an educator, and, at times, as someone profoundly affected by loss.

Holding Hands, Alexis Notarianni, Md

The Medicine Forum

My patient had already received the medications we reach for when patients are in pain and afraid — antiemetics, analgesics, and anxiolytics. The nasogastric tube was in place. What remained was not another intervention, but the simple act of being there.

My patient had been healthy until just months earlier, when his life changed abruptly. In the two hundred days since, illness had altered nearly every part of his body. Now he lay in bed in pain, breathing through a tracheostomy, receiving nutrition from a feeding tube. Tears streamed down his cheeks as he reached out and took my hand. …

Good Enough, Anne Leone, Md

The Medicine Forum

(Verse 1)
Coming out the gate a little too fast
This is not sustainable, it won’t last
Can’t turn around, I can’t backtrack
Where do I go from here
How can I maneuver this current

Ripping through and pulling me with it
Going under, air’s running out quick
but the shoreline is near

(Chorus)
Never knew that I could get through a patch so rough,
Never knew before that I was good enough,
The only thing holding me back was my own self doubt,
But I’ll let go now

(Verse 2)
hard to plan what steps to take next now …

An Examination Of Generative Ai In Medicine, J. Marco Cipriaso, Md, Trishya Srinivasan, Md

The Medicine Forum

The age of artificial intelligence (AI) is upon us. Specifically, generative AI has been transforming how we interface with the world by directly generating its own novel output.¹ Medicine is not immune to this change. AI search tools such as OpenEvidence have shown promise by providing evidence-based recommendations, already proven to perform well in primary care settings, with additional promise for future applications.² AI tools have taken over the note-writing process through ambient software, allowing physicians to dedicate more time to face-to-face interaction with their patients.³ These and other developments show clear reason to be excited about …

The Emotional Labor Of Clinicians And The Need For Reflective Support, Benedicta Olonilua, Bs, Evan Nardone, Md

The Medicine Forum

Physicians who work in Palliative Care or adjacent fields like Oncology often bear a unique emotional weight in addition to the typical responsibilities that come with the job. The nature of their work puts them in frequent contact with serious illness, dying, and grief. Additionally, they are often required to engage in conversations that are not only medically complex but also deeply personal and, at times, emotionally charged. While this emotional labor is an inherent part of the job, it can become especially heavy when there is no space to process it. Over time, this can build up and eventually …

Coping As A Team, J. Marco Cipriaso, Md

The Medicine Forum

“Medicine is the only job where someone can die, and you’re expected to go back to work, business as usual.” - Rachael Grosso MD

Methylene Blue As An Adjunctive Therapy In Refractory Septic Shock: A Case-Based Review Of Emerging Evidence, Warda Naqvi, Md, Paulina Lowery, Do, Enad Haddad, Md, Muneeba Ali, Md, Prerana Sevella, Md, Sudeep Nugooru, Md, Richard Friedenheim, Md

The Medicine Forum

Septic shock is associated with high mortality, particularly in patients who develop refractory vasoplegia despite guideline-directed therapy. Excess nitric oxide mediated vasodilation contributes to catecholamine resistance and persistent hypotension. Methylene blue (MB), an inhibitor of nitric oxide synthase and soluble guanylate cyclase, has emerged as a potential adjunctive therapy targeting this pathway. We report a case of a 36-year-old female presenting with severe septic shock secondary to aspiration pneumonia, complicated by profound hypoxemia requiring mechanical ventilation and veno-venous extracorporeal membrane oxygenation. Despite aggressive fluid resuscitation, broad-spectrum antibiotics, corticosteroids, and maximal vasopressor support, she remained hemodynamically unstable. Administration of intravenous MB …

The Intersection Of Ventilator Support And Hospice In Late Als Diagnosis, J. Marco Cipriaso, Md, Kenna Hawes, Md, Margot Noyelle, Md, Megan Cecchine, Md

The Medicine Forum

Amyotrophic lateral sclerosis (ALS) often leads to respiratory failure that can be treated with respiratory support in the form of tracheostomy plus invasive mechanical ventilation. It typically occurs late in the disease course, often allowing patients to adequately prepare by discussing their goals of care. We describe a case of a patient whose ALS was diagnosed after he had TMV initiated. As a result, the patient and family faced a daily decision on when to withdraw ventilator support, and he was unable to achieve his ultimate wish to die at home. We highlight this to recognize that serious illnesses with …

The Back Burn: A Case Report Of Mollaret’S Meningitis In A Young Male, Muneeba Ali, Md, Lubaba Mukhtar, Md, Warda Naqvi, Md, Joseph Hassey, Md, Muhammad Ayub, Md

The Medicine Forum

Mollaret’s syndrome, or benign recurrent aseptic meningitis, is a rare condition characterized by recurrent, self-limited episodes of aseptic meningitis. We present the case of a 49-year-old male with a past medical history of herpes meningitis as a teenager, who presented to the emergency department (ED) with a headache, and whose initial lumbar puncture results were consistent with viral meningitis. HSV-2 was detectable in cerebrospinal fluid (CSF) DNA by PCR but not detected on quantitative PCR. He was diagnosed with Mollaret’s meningitis, and all intravenous antiviral therapy was discontinued, with the patient making a full recovery. This case highlights the important …

Refractory Autoimmune Encephalitis In Metastatic Thymoma, Michael Predi, Do, Anna Bondonese, Md, Anish Vora, Md, Sarah W. Gordon, Do

The Medicine Forum

Thymoma-associated autoimmune encephalitis (TAAE) is a rare paraneoplastic neurological syndrome occurring in approximately 8% of thymoma patients. The condition results from thymic dysfunction leading to impaired T-cell selection and production of autoantibodies against neuronal antigens. Autoimmune encephalitis represents a severe but underrecognized complication with heterogeneous clinical presentations. Thymectomy has been shown to be the most effective treatment for TAAE.

Fever, Cytopenias, And Splenomegaly: A Hematologic Approach To Suspected Hlh In Autoimmune Liver Disease, Reed Firestone, Md, Ms

The Medicine Forum

Fever with cytopenias and splenomegaly raises concern for hematologic malignancy and hyperinflammatory syndromes such as hemophagocytic lymphohistiocytosis (HLH). Distinguishing these entities is critical, as management strategies differ significantly. In this report, we describe a 19-year-old male with autoimmune hepatitis–primary sclerosing cholangitis overlap who presented with one year of recurrent fevers, cytopenias, and splenomegaly. Extensive infectious and malignant workup, including PET imaging and bone marrow biopsy, were negative. HLH was considered; however, laboratory findings were inconsistent, including ferritin of 191 ng/mL and fibrinogen of 683 mg/dL. His course remained chronic and stable. The presentation was attributed to autoimmune liver disease with …