Medicine and Health Sciences Commons^™

Right Ventricular Involvement In Stress Cardiomyopathy: A Case Of Biventricular Takotsubo With Cardiogenic Shock, Ahmad Muhammad, Yazan Alkehef, Theodore Schreiber

Conference Presentation Abstracts

Introduction Takotsubo cardiomyopathy (TC) is characterized by transient left ventricular (LV) dysfunction following a stressor in the absence of obstructive coronary artery disease. We present a case of a less common variant with right ventricular involvement. Hospital course A 45-year-old woman with sickle cell disease and asthma presented with nausea, vomiting, abdominal pain, and fevers, one week after the death of her father. Examination revealed an irregular tachycardia. Labs demonstrated leukocytosis, elevated lactate, and markedly increased troponin. Chest imaging showed bilateral basilar opacities. ECG demonstrated atrial flutter with rapid ventricular response. She developed progressive respiratory failure requiring intubation. Repeat ECG …

Residency As A Rite Of Passage: Assessing Liminality In Night Float And Improving Competency Evaluations, Lily Anderson-Chavarria, James Meza, Frank Mueller, Jianming Lau

Conference Presentation Abstracts

Purpose/Background: ACGME emphasizes competency-based evaluation of post-graduate education. However, written evaluations using averaged Likert Scales with minimal anchoring to real experiences is a sub-optimal method of evaluating resident competence. Through qualitative research, we explored resident’s own reflections on their transition into competent physicians and attempted to identify an alternative model for resident assessment. Based on informal observations, we predicted that night float rotations in the second-year curriculum are determinative for residents to achieve competence in clinical care. We further hypothesized that residents’ experiences mirror a Rite of Passage marked by rituals of separation, transition and reintegration, with night float serving …

Health Disparities In El Paso's Low-Income Hispanic Communities: A Mixed-Methods Analysis Of Acculturation, Obesity Metrics, And Socio-Cultural Determinants, Karen Del Rio

Open Access Theses & Dissertations

Health disparities among low-income Hispanic immigrants in the United States are shaped by complex interactions between acculturation, structural inequality, and socio-cultural determinants that behavioral and epidemiological models have not fully explained. This dissertation examines the relationship between acculturation and obesity-related outcomes among uninsured and low-income Hispanic adults of Mexican descent in El Paso, Texas, using a three-article, sequential, explanatory, mixed-methods design grounded in Latina/o Critical Race Theory (LatCrit).Article 1 presents a systematic review of 20 peer-reviewed studies examining acculturation and obesity among Mexican Americans, finding consistent evidence that longer U.S. residence is associated with increased BMI and obesity prevalence, mediated …

Human Papillomavirus (Hpv) Vaccine Acceptance: A Mixed-Methods Study And Randomized Controlled Trial Examining Messengers Of Hpv Vaccine Information Among Hispanic Parents, Alyssa Andrea Martinez

Open Access Theses & Dissertations

Hispanics make up 19.5% of the U.S. population, making them the nation's largest ethnic minority. Hispanics are disproportionately impacted by health outcomes, including many different types of cancers that are caused by the Human Papillomavirus (HPV). An HPV vaccine is available that can prevent 90% of HPV associated cancers. The purpose of this mixed-methods study and randomized experiment is to develop and test data-driven digital health messages to promote the HPV vaccine in Hispanic parents. Four specific aims were conducted among three major studies. Aim 1 (Study 1): A cross-sectional survey was conducted to obtain preliminary evidence on trusted messengers …

Adverse Childhood Experiences, Resilience, And Adaptive Functioning Among Student Veterans With Disabilities. A Resilience Portfolio Model Perspective, Donyeill Mozer

Open Access Theses & Dissertations

Adverse Childhood Experiences (ACEs) are associated with long-term psychological, physical, and behavioral outcomes; however, limited research has examined their relationship with multidimensional college adjustment among student veterans with disabilities, particularly those attending Hispanic-Serving Institutions (HSIs). Guided by the Resilience Portfolio Model, this study examined associations among ACEs, perceived resilience, and multidimensional college adjustment within an understudied population of student veterans with disabilities enrolled at an HSI. Using a cross-sectional secondary analysis of survey data, the analytic sample consisted of 129 student veterans. ACEs were measured using the Adverse Childhood Experiences Questionnaire, perceived resilience was measured using the Brief Resilience Scale, …

Implementing Mtss In Hispanic Serving Middle Schools From The Concept Of Rurality: A Qualitative Case Study On School Mental Health And The Role Of Social Work, Rosario Elena Olivera

Open Access Theses & Dissertations

Purpose: The purpose of this study was to examine the implementation of Multi-Tiered Systems of Support (MTSS) and the integration of mental health services within two middle schools in a suburban-rural mix, predominantly Hispanic school district in Southwest Texas, referred to as Desert View Independent School District. The study explored how educators and school-based mental health professionals perceive, interpret, and operationalize MTSS within their school contexts. Methods: The study employed a qualitative case study design grounded in implementation science and ecological systems theory. Data were collected through purposive sampling and included semi-structured interviews with teachers, counselors, and a district-level school …

Detecting Early Physiological Signs Of Work-Related Muscle Strain And Fatigue Using Quantitative Sensory Testing, Omar Alberto Cano

Open Access Theses & Dissertations

Background: Work-related musculoskeletal disorders (WRMSDs) are a major source of occupational disability and economic burden worldwide. Early detection of physiological strain remains challenging since traditional methods often rely on self-reported pain or diagnosis after symptom development. Quantitative Sensory Testing (QST) may provide an objective, non-invasive method for identifying early sensory changes associated with repetitive upper-extremity loading. Purpose: This pilot study examined the responsiveness of Pressure Pain Threshold (PPT) and Thermal Threshold Testing (TTT) for detecting Acute muscular strain and fatigue following repetitive manual task performance. Methods: A within-subject counterbalanced design was conducted with sixteen healthy participants. Each participant completed both …

The Intersection Of Occupational Therapy And Optometry In The Treatment Of Visual Impairments: Addressing An Unmet Need, Grace Bannon

Capstone Projects

The prevalence of visual impairments in the United States is substantial and anticipated to increase in severity over the coming decades. These impairments have wide-reaching consequences on an individual’s occupational performance in daily living. While both occupational therapists and optometrists focus on the relationship between visual function and engagement in meaningful and purposeful occupations across the lifespan, only a limited number of optometrists offer specialized vision therapy services. This gap emphasizes a growing demand for vision services to manage the needs of individuals with visual deficits. Therefore, this Doctoral Capstone Experience (DCE) sought to bridge this gap by exploring the …

Identifying The Role Of Occupational Therapy In Suicide Prevention, Grey Buchheit

Capstone Projects

Occupational therapists are uniquely positioned to identify and support individuals experiencing suicidal ideation; however, suicide prevention education remains limited within occupational therapy curricula despite its relevance across diverse practice settings. This doctoral capstone experience sought to address this educational gap by developing evidence-based suicide prevention resources for Western Michigan University's Doctor of Occupational Therapy Program while promoting student wellness and burnout prevention as complementary components of suicide prevention. Guided by a literature review, SWOT analysis, faculty interviews, and a needs assessment that included a survey of Level I fieldwork educators, this project identified opportunities to strengthen occupational therapy education related …

Supporting Neurodiversity-Affirming Practice For Young Adults: Resource Development For A Level I Occupational Therapy Fieldwork Clinic, Grace Campbell

Capstone Projects

Neurodiversity-affirming and strengths-based practices are a growing area of focus within occupational therapy, viewing neurological differences as natural variations of human diversity rather than deficits to be corrected. This Doctoral Capstone Experience (DCE) focused on applying these perspectives within the Work-to-Work Clinic, a Level I occupational therapy fieldwork clinic that serves young adults with neurodevelopmental conditions such as Autism, ADHD, and intellectual disability. Commonly-used assessments and treatment materials at the clinic were outdated, deficit-focused, and poorly suited to this population’s developmental stage, leaving many clients with unmet needs. Additionally, Level I fieldwork students are still developing clinical reasoning skills and …

Editorial: Grateful And Thankful, Michelle C. Dziurgot

The Journal of the Michigan Dental Association

Dr. Michelle Dziurgot reflects on her concluding three-year term as the Editor-in-Chief of the Michigan Dental Association Journal. She describes her personal growth through volunteerism, starting as a local component editor and advancing to the MDA Board of Trustees. The author emphasizes that the most value from membership comes through immersion and service, encouraging others to volunteer their time and talent to the association. She credits the MDA’s mentorship with shaping her professional career and practice.

The Back Page: Thanks, Mda, For 35 Years, David Foe

The Journal of the Michigan Dental Association

Retiring managing editor Dave Foe reflects on his 35-year tenure with the Michigan Dental Association. He traces the technological evolution of the Journal and the association's member communications from paper-based systems and typewriters to the digital era. Foe underscores the vital role of dental journalism as a pillar of the profession and expresses gratitude for the opportunity to have served Michigan dentists and documented their history for over three decades.

The 2026 Mda Award Winners: Recognizing Outstanding Service, David Foe

The Journal of the Michigan Dental Association

This article lists the recipients of the 2026 MDA awards, highlighting their contributions to the dental profession and public health. Notable winners include Dr. Christopher Smiley, recipient of the Meritorious Award for a lifetime of achievement in dental journalism and leadership, and Dr. Charles Burling, honored as Dentist Citizen of the Year for his community service. The feature also recognizes educators, legislative advocates, and volunteers in the Donated Dental Services (DDS) program who provide care to vulnerable populations.

Ce Spotlight:, David Foe

The Journal of the Michigan Dental Association

This source highlights on-demand continuing education courses provided by the MDA to help dental professionals meet state relicensure requirements. Featured topics include diagnosing trigeminal neuropathy, identifying human trafficking warning signs, ethics and dental jurisprudence, and 2026 updates for infection control. The courses are designed to be convenient and are counted toward specific Michigan Board of Dentistry requirements, such as pain management and delegation of duties.

Novel Applications Of Coronary Cta In Patients With Intermediate Risk Of Cad, Ashley Armstrong, Luai Madanat, Robert D. Safian

Conference Presentation Abstracts

Background: ACC/AHA guidelines provide class 1 and 2A recommendations respectively for coronary CTA and FFRCT in patients with chest pain and intermediate risk of CAD. We present a case in which novel applications of CTA excluded obstructive CAD, identified the correct diagnosis, and allowed optimization of medical therapy. Case: In a 72-year-old male with stable angina and HEART score 6, stress ECG was positive for angina and frequent PVCs (Fig 1A). Coronary CTA (Fig 1B) and FFRCCT (Fig 1C) showed non-obstructive CAD and intramyocardial bridging/severe systolic compression in the mid-LAD (Fig 1D). AI plaque analysis demonstrated a mixed plaque burden …

Leveraging State Of The Art Simulation-Based Education To Enhance Medical Student Interest In Internal Medicine And Cardiology, Mohamed Abdalaziz, Nicholas Mitchell, Ryan Madder

Conference Presentation Abstracts

Abstract Background: Early clinical exposure plays a critical role in shaping medical student interest, and therefore choice in medical specialty. Traditional curricula offer limited opportunities for hands-on engagement with cardiovascular decision-making and procedures. Simulation-based education may address this gap by providing immersive, low-risk learning experiences. Methods: An internal medicine resident and Cardiology fellow led, faculty-supported simulation curriculum was developed for third- and fourth-year medical students using a state-of-the-art simulation laboratory. Two 75-minute sessions were conducted over a two-month period, with a total of 27 students participating. The first session included a focused electrocardiography didactic emphasizing ST-elevation myocardial infarction (STEMI) recognition, …

Esophageal Diverticulum Presenting As Chest Pain In A Patient With Significant Cardiac History: A Diagnostic Challenge, Sujan Shrestha, Alnimer Khabbab, Kamal Khalil, Malitha Hettiarachchi

Conference Presentation Abstracts

Introduction: Esophageal diverticula are uncommon structural abnormalities that may present with nonspecific symptoms such as dysphagia, regurgitation, and chest discomfort. It accounts for < 5% of all cases of dysphagia. In elderly patients with significant cardiac comorbidities, chest pain and dysphagia may be initially attributed to cardiovascular pathology, potentially delaying the correct diagnosis. This case highlights the importance of comprehensive history taking in identifying esophageal diverticulum as an alternative etiology of chronic symptoms. Case presentation: A 77-year-old female with a history of atrial fibrillation, unstable angina, chronic obstructive pulmonary disease, hypertension, and diastolic heart failure presented with chest pain. Given her significant cardiac history, she underwent extensive cardiac evaluation, including serial troponins, electrocardiography, echocardiography, and stress testing, all of which showed no evidence of acute ischemia. Further history revealed intermittent dysphagia to both solids and liquids for over three years, occurring approximately twice weekly. The patient described a sensation of food getting stuck in her throat, occasionally requiring expectoration. Gastroenterology was consulted, and esophagogastroduodenoscopy revealed minimal esophagitis with a distal esophageal diverticulum. The patient was managed conservatively with pantoprazole 40 mg daily, resulting in symptomatic improvement. Discussion: Esophageal diverticula are often associated with underlying esophageal motility disorders and can present with dysphagia to both solids and liquids. Symptoms may mimic or coexist with cardiopulmonary complaints, particularly in elderly patients with multiple comorbidities. While barium esophagography remains the diagnostic modality of choice, endoscopy can identify associated mucosal pathology and confirm the diagnosis. Management is individualized based on symptom severity and diverticulum size, with conservative therapy appropriate for mildly symptomatic patients. Conclusion: This case underscores the importance of considering esophageal diverticulum in the differential diagnosis of chronic dysphagia and chest discomfort, even in patients with significant cardiac disease. Careful history taking and multidisciplinary evaluation are essential to avoid misattribution of symptoms and to ensure timely diagnosis and appropriate management.

Croup, Children's Mercy Kansas City

Clinical Pathways (Formally Known As Clinical Practice Guidelines)

No abstract provided.

Developmental Assets And Risk-Related Restraint And Resistance Orientations Among Emerging Adult College Students: Examining Protective Associations, Summer N. Beck

Graduate Theses and Dissertations

Abstract Background: Although developmental assets are well established as protective factors during childhood and adolescence, less is known about their role during emerging adulthood, a period when the prevalence of several types of risk behaviors peak. For the U.S. college student, campus can provide ideal conditions for supporting the extended transition to adulthood. However, that same environment may increase exposure to health risk behaviors. This study examined associations between developmental assets and the risk-related restraint and resistance orientations involving sexual activity, alcohol, and illicit drugs among emerging adult college students. Methods: A cross-sectional correlational design was employed with a sample …

Investigating The Influence Of Dietary Phytogenics And Postbiotics On Horizontal Transmission Of Histomonas Meleagridis In Commercial Turkey Poult Hens, Diego Fernando Cortes Velez

Graduate Theses and Dissertations

Histomonas meleagridis is a parabasalid protozoan and the causative agent of histomonosis, or blackhead disease, in turkeys. Withdrawal of the last remaining in-feed arsenical from the market in 2015 led to the re-emergence of the disease. As a result, there is a need to investigate alternatives, such as dietary inclusion of postbiotic and phytogenic compounds, to reduce H. meleagridis transmission and disease severity in commercial turkey flocks. The purpose of this project was to evaluate the influence of dietary inclusion of three different combinations of postbiotic and phytogenic compounds on H. meleagridis transmission in turkey poult hens. A thesis introduction …

In-Vitro Testing Of Light Wavelength To Detect Clots In Neonatal Extracorporeal Membrane Oxygenation Circuitry, Amanda Holmes

Dissertations and Theses (Open Access)

Background: Neonates requiring extracorporeal membrane oxygenation (ECMO) are at high risk for thrombotic complications, which contribute substantially to morbidity and mortality. Current circuit surveillance methods rely on intermittent visual inspection and indirect laboratory markers, both of which often detect thrombosis only after clinically significant progression. Optical approaches offer a non-invasive alternative for earlier clot visualization, yet the influence of illumination wavelength on detection performance under realistic ECMO conditions remains incompletely characterized.

Methods: This study evaluated wavelength-dependent clot detection performance in a controlled in-vitro neonatal ECMO circuit model using a portable imaging prototype designed to emulate bedside workflow. Twelve independent ECMO …

Low-Abundance And Fragmentary Helicobacter Pylori Dna Detected In Phenotypically Negative Gastric Biopsies Using Targeted Sequencing, Fabien Mbaya-Tshibangu, Alain Cimuanga-Mukanya, Evariste Tshibangu-Kabamba, Nadine Kayiba-Kalenda, Tressy Kalenga-Ngomba, Patrick Ngoma-Kisoko, Gunturu Revathi, Junko Akada, Benoît Mbiya-Mukinayi, Augustin Tshibaka Kabongo

Pathology, East Africa

Accurate detection and monitoring of antimicrobial resistance (AMR) in Helicobacter pylori mainly rely on phenotypic methods and culture, which can sometimes fail when bacterial load is low or after recent treatment. We investigated whether gastric biopsies classified as H. pylori-negative by standard diagnostic techniques still contain detectable bacterial DNA, including regions linked to AMR, and assessed whether selected DNA fragments can mediate allelic exchange in vitro. Gastric biopsies from 46 dyspeptic patients in the Democratic Republic of the Congo (including 23 phenotypically positive and 23 phenotypically negative individuals) were analyzed using long-read amplicon sequencing of seven resistance-associated loci, selective whole-genome …

Effect Of 50 Mg Sugammadex Syringes On Drug Utilization And Cost Savings: A Quality Improvement Study, Josue Gaona, Calandra Jones, Alisha Valdez, Lan Cao, Evan G. Pivalizza

School of Medicine Student Publications and Presentations

Background: Reversal of neuromuscular blockade by popular non-depolarizing muscle relaxants is a critical component of routine, safe anesthetic practice. Sugammadex, a modified gamma-cyclodextrin, has largely replaced acetylcholinesterase inhibitors and is recommended as the primary reversal agent by the American Society of Anesthesiologists. However, sugammadex is commonly supplied in 200 mg single-use vials, which may result in drug waste when smaller doses are required. This quality improvement project evaluated whether the introduction of 50 mg prefilled syringes at our facility could reduce drug waste and overall cost.

Methods: Following implementation of 50 mg syringes, a retrospective chart review was conducted over …

Segmental Trans-Endplate Pedicle Screws Do Not Induce Spinal Deformity In A Porcine Model, Taylor R Johnson, Talissa O Generoso, Christine Farnsworth, Amishi Jobanputra, Jonathan H Wen, Austin J Stoner, Arianne Salunga, Vivian Ho, Miranda Guzman, David Berry, Vidyadhar Upasani, John S Vorhies

Faculty, Staff and Student Publications

Purpose: Growth modulation is an established technique for limb deformity correction and is increasingly applied to spinal deformities. While distraction-based posterior and anterior compressive methods have been explored, spinal growth modulation through fixation across vertebral growth centers remains unstudied. We hypothesized that unilateral trans-endplate screws-spinal epiphysiodesis trajectory (SET) screws-could induce partial anterior growth arrest and promote scoliotic deformity in a porcine model.

Methods: Four male piglets (two experimental, two control) underwent unilateral posterior spinal instrumentation at four lower thoracic levels at eight weeks of age. Experimental animals received trans-endplate SET screws; controls received pedicle screws. Radiographs obtained three months postoperatively …

Optimized Ultrasound Imaging Of Phase-Change Nanodroplets, Charles R Dyall, Dmitry Nevozhay, Andy Liu, Trevor M Mitcham, George J Lu, Konstantin V Sokolov, Richard R Bouchard

Faculty, Staff and Student Publications

Phase-change nanodroplets (PCNDs) continue to generate significant research interest due to their potential to extravasate into tissue, to be targeted for molecular imaging and drug delivery, and to undergo an induced phase-change to "activated" microbubbles (MBs) for ultrasound (US) imaging. To accurately quantify molecular markers, however, one assumes a consistent proportion of PCNDs in a region of interest (ROI) are stably activated and imaged. Herein we present a framework for developing a diagnostic sequence that is optimized for PCND activation uniformity, contrast, and acquisition time. To develop this framework, activation was examined at three scales of increasing complexity: single, adjacent, …

Corrigendum To 'Risk Factors For Bronchiolitis Obliterans Syndrome After Initial Detection Of Pulmonary Impairment After Hematopoietic Cell Transplantation' [Transplantation And Cellular Therapy 29/3 (2023) 204-204], Mansour Alkhunaizi, Badar Patel, Luis Bueno, Neel Bhan, Tahreem Ahmed, Muhammad H Arain, Rima Saliba, Gabriela Rondon, Burton F Dickey, Lara Bashoura, David E Ost, Liang Li, Shikun Wang, Elizabeth Shpall, Richard E Champlin, Rohtesh Mehta, Uday R Popat, Chitra Hosing, Amin M Alousi, Ajay Sheshadri

Faculty, Staff and Student Publications

No abstract provided.

Potential Impact Of Parasites In The Transmission Of Chronic Wasting Disease, Paulina Soto, Rodrigo Morales

Faculty, Staff and Student Publications

No abstract provided.

Long Covid Persistence And Surveillance Gaps Across 58 Us Hospitals, Jiazi Tian, Alaleh Azhir, Matthew Decaro, Ngan Chau, Jonas Hügel, Michele Morris, Jingya Cheng, Pedram Fard, Ingrid V Bassett, Douglas S Bell, Elmer V Bernstam, Shyam Visweswaran, Jeffrey G Klann, Shawn N Murphy, Hossein Estiri

Faculty, Staff and Student Publications

Importance: Surveillance of postacute sequelae of SARS-CoV-2 infection (PASC) depends on diagnostic coding systems that capture fewer than one-half of affected individuals, rendering millions invisible to health systems and policymakers.

Objective: To quantify the gap between true PASC burden and diagnostic code-based estimates, determine the proportion representing chronic disease, and characterize organ system heterogeneity and temporal trends across diverse populations.

Design, setting, and participants: This retrospective cohort study used electronic health record data from 58 hospitals and affiliated clinics in 4 US regions, from 2017 to 2025. Adults (aged ≥18 years) with laboratory-confirmed SARS-CoV-2 infection or a COVID-19 diagnosis code …

Ucva Ontology: Standardizing Local Context Factors To Support The Analysis Of Unwarranted Clinical Variation, Apollo Mcowiti, Xubing Hao, Rebecca Z Lin, Laila Rasmy-Bekhet, Cui Tao, Susan Fenton

Faculty, Staff and Student Publications

Objectives: Unwarranted clinical variation (UCV), defined as care provided to a patient that is not proportional to the patient's needs, clinical characteristics, or preferences, results in negative patient outcomes. UCV detection is performed to compare healthcare outcomes across regions or organizations and reduce UCV incidences. However, the lack of standardized UCV concepts and the local context factors hinder the interoperability of UCV analyses between organizations. Currently, UCV analysis relies on centralized analysis, posing challenges due to the proprietary nature of an organization's healthcare and operational data. Standardizing analysis factors enables interoperable analyses by establishing a common context between organizations. This …

The Mysteries Of Postpartum Ocd: A Systematic Review, Taryn Shaffer

Honors Program: Senior Projects (Public)

Background: The research on postpartum mental health is growing, with most focusing on physical and sexual wellness, or well-known mental health symptoms such as psychosis, depression, and stress. However, as the research grows, so does the interest in lesser-known or under-considered postpartum mental health symptoms, including Obsessive-Compulsive Disorder (OCD). The focus of this research can be the exacerbation of already-present OCD symptoms, or the onset of them during pregnancy and the postpartum period. The purpose of this systematic review was to analyze research on OCD in pregnant and postpartum women. Specifically, the review included an analysis of measures used to …