Medicine and Health Sciences Commons^™

Observation And Reflection Of Neighborhood And Community 2026: Observation And Reflection Of Disparities In Access To Healthy Foods, Education, And Stable Healthcare, Kerolos Aziz, Uma Sriram, Sarah Yee, Hassan Saad, Jessica Delgado, Shiyuan Gong, Seyrona Mclean

Patient Education Projects

No abstract provided.

Observation And Reflection Of Neighborhood And Community 2026: Reflection On Neighborhood Environment And Economic Instability As Barriers To Health, Charity Godbold, Sarah Syeda, Zachary Houslander, Sydney Kelly, Jason Fahmy, Eliezer Ponce De Leon, Jessica Wang, Omar Tayeb

Patient Education Projects

No abstract provided.

Observation And Reflection Of Neighborhood And Community 2026: Systemic Barriers In 48203—Poverty, Food Deserts, And Inadequate Infrastructure—Directly Impact The Health And Futures Of Its Residents., Kerestin Aziz, Sanjana Aiella, Brady Bak, Maanas Sharma, Catherine Hofley, Silas Stewart, Ahmed Marabeh, Samantha Hoey

Patient Education Projects

No abstract provided.

Observation And Reflection Of Neighborhood And Community 2026: Housing, Transportation, & Education And Reflection, Seareen Maaita, Alexis Kmak, Balraj Dhanoa, Sergio Guerra, Shrikar Modukuri, Gwenyth Sirrine, Ciara Hancock, Mohamed Ramadan

Patient Education Projects

No abstract provided.

Discharge Process Improvement Initiative Using An N-By-T Strategy In A Progressive Care Unit In An Acute Care Setting, Sukhvir Walia

Doctor of Nursing Practice Projects

Background

Timely and efficient patient discharge processes are crucial for enhancing hospital throughput, reducing emergency department boarding, optimizing inpatient bed utilization, and ensuring safe transitions of care. Delayed hospital discharges contribute to prolonged hospitalizations, operational inefficiencies, increased healthcare expenditures, and decreased patient satisfaction. Progressive care units (PCU) are particularly vulnerable to discharge delays because patients frequently require multidisciplinary coordination before safe discharge can occur.

Purpose

The purpose of this quality improvement project was to evaluate the effectiveness of implementing a structured discharge readiness checklist combined with an n-by-T discharge planning strategy during multidisciplinary patient progressive rounds (PPRs) to improve discharge …

A Rare Case Of Gastric Ascariasis, Sharon Pan, Kevin Yu, Blaine A Mathison, Yan Gao, Marc Roger Couturier, Salem Muayad, Violeta Chávez, Ranya Selim

Faculty, Staff and Student Publications

Background: Ascariasis, caused by the parasitic roundworm Ascaris lumbricoides, is one of the most common helminthic infections globally. Spread by contaminated soil through the fecal-oral route, A. lumbricoides typically infects the small intestine and has rarely been reported to infect the stomach.

Case summary: We describe an unusual case of a male in his 30s with a history of neuroendocrine tumor (NET) who immigrated from Colombia and who underwent esophagogastroduodenoscopy (EGD) and colonoscopy for further evaluation of abdominal pain. He was incidentally found to have a female Ascaris worm in his stomach that was retrieved during the EGD.

Conclusion: …

Alternative Abl1 Isoform Expression In Oncogenic Translocations: Implications For Cancer Progression, Jessica Teague

Biological Sciences

Abstract (also on poster): Previous studies in our lab show that an alternate isoform of Bruton’s tyrosine kinase, BTK-C, is required for the survival of several epithelial-derived cancer cells. BTK-C is transcribed from an alternative promoter and includes a 34-amino-acid N- terminal extension with a palmitoylation sequence that alters its subcellular localization. Nine other human kinases have similar alternative N-termini (ANT), often producing palmitoylated or non-palmitoylated isoforms from different transcriptional start sites. Among these, ABL1 is a known oncogenic kinase and key drug target. Translocation mutations at the 5′ end of ABL1 are a major cause of adult leukemias. This …

Towards Dementia-Inclusive Digital Text-Based Health Information: A Multi-Method Investigation Of Cognitive And Affective Accessibility, Margi Engineer

All Dissertations

This dissertation examines the accessibility, readability, emotional tone, and trustworthiness of digital, text‑based dementia information and investigates how older adults with and without dementia cognitively and affectively engage with such content. It further explores the potential of generative AI to improve dementia information delivery through the development of a domain‑specific retrieval‑augmented generation (RAG) large language model (LLM) chatbot designed to deliver accessible, stigma‑free information. The dissertation comprises four studies using complementary quantitative and qualitative methods. Study I conducts a large‑scale content analysis of 300 medical articles, 35 websites, and 50 blogs, applying readability metrics, LIWC‑based linguistic and sentiment analysis, and …

Most-Favored-Nation Benchmarking Versus Value-Based Contracting: Institutional Fit Of Pharmaceutical Pricing Tools In The United States, Canada, And The United Kingdom, Kola Adegoke, Olajide Alfred Durojaye, Abimbola Adegoke, Adeyinka Adegoke

Health & Biomedical Sciences Faculty Publications

Background: Soaring drug prices pose a significant obstacle to affordable and equitable access to medicines in high-income healthcare systems. This study compares two leading reform tool families, Most Favored Nation (MFN)/international reference pricing (IRP) and value-based contracting (VBC), across the United States, Canada, and the United Kingdom, with attention to cost containment, value-linked incentive design, equity of access, and implementation feasibility. U.S. policy developments (CMS Innovation Center’s GENEROUS, GLOBE, and GUARD models) extend international benchmark-based design options beyond the 2020 MFN rule.

Methods: Guided by institutional and governance theories, we conducted a structured comparative policy analysis using a four-dimensional trade-off …

Surgical Timing After Acromioclavicular Joint Separation: Association With Clinical Outcomes, Mallory B Lane, Jacob Siahaan, James M Gregory

Faculty, Staff and Student Publications

Background: Treatment of acromioclavicular joint (ACJ) separations continually lacks consensus between providers, and while low-grade injuries generally respond well to conservative management, high-grade injury management is more complex. For patients requiring surgery, the effect of the timing of surgery with respect to the original injury on clinical outcomes remains unclear.

Hypothesis: Clinical outcome measures would worsen as the time between ACJ dislocation injury and surgery increased.

Study design: Cohort study; Level of evidence, 3.

Methods: A large nationwide insurance claims database was queried for patients who had an ACJ dislocation injury using International Classification of Diseases, Ninth and Tenth Revision …

Multidisciplinary Approach To Complex Lower Extremity Limb Salvage In Pyogenic Arthritis, Pyoderma Gangrenosum, And Acne (Papa) Syndrome: A Case Report, Michael M Talanker, Anthony V Basta, Tien Do, Robert Tung, Addison Allen, Morgan Martin, Bryan L Ruygrok, Patrick J Kellam, Jeffrey G Trost, Mohin A Bhadkamkar

Faculty, Staff and Student Publications

Limb salvage using free tissue transfer in patients with rare autoinflammatory syndromes is poorly described, and the safety of microvascular reconstruction in this population remains uncertain. Hereditary pyogenic arthritis, pyoderma gangrenosum, and acne (PAPA) syndrome is characterized by dysregulated inflammation, pathergy, and impaired wound healing, raising concern for flap compromise and postoperative complications. We report a rare case of lower extremity free tissue transfer in a patient with PAPA syndrome. A 66-year-old woman with rheumatoid arthritis and PAPA syndrome presented with rapid wound breakdown, violaceous ulceration, exposed hardware, and periprosthetic joint infection following left total knee arthroplasty (TKA). Examination revealed …

Severe, Non-Apneic Respiratory Dysfunction And Hypoxia Following Generalized Convulsive Seizures, Haley E Pysick, Rup K Sainju, Roshni Nair, Deidre N Dragon, Eduardo Bravo, Laura Vilella, Xiaojin Li, Samden D Lhatoo, George B Richerson, Brian K Gehlbach

Faculty, Staff and Student Publications

Objective: Sudden unexpected death in epilepsy (SUDEP) is a devastating consequence of some generalized convulsive seizures (GCS). Recent work has focused on seizure related apnea as a biomarker of SUDEP risk, frequently without characterizing the adequacy of non-apneic ventilation or identifying other dysfunctional breathing patterns. We hypothesized that GCS frequently induce immediate, severe, non-apneic respiratory dysfunction that can induce critical hypoxia and bradycardia and sought to characterize breathing patterns after GCS.

Methods: Adult patients admitted to an epilepsy monitoring unit were studied. The effects of GCS on breathing and heart rate were analyzed using nasal pressure transducers, chest and abdominal …

Assessment Of Skin In Patients With Systemic Sclerosis Using High-Frequency Ultrasound And Shear Wave Elastography: A Comparative Study With Histology, Molecular, And Clinical Parameters, Ruhani Desai, Filemon Tan, Minghua Wu, Jeffery L Browning, Samuel Theodore, Meng Zhang, Brian Skaug, Harshdeep Singh Chawla, Manmohan Singh, Salavat Aglyamov, Kirill V Larin, Maureen Mayes, Shervin Assassi

Faculty, Staff and Student Publications

Objective: Ultrasound (US) has been proposed as a potential tool for assessing skin fibrosis in systemic sclerosis (SSc). However, a large-scale comparison of US-based assessment with histologic markers of skin fibrosis has not been reported. We evaluated US-based skin assessments for their face validity (differentiation between involved SSc and healthy control [HC] skin), construct validity (comparison to modified Rodnan skin score [mRSS]), and criterion validity (comparison to histologic and gene expression fibrosis markers).

Methods: Twenty HCs and 52 patients with SSc underwent clinical and US assessment followed by a forearm skin biopsy. Predefined areas were assessed on the finger, hand, …

Brief Report: Hepatitis B Vaccination Histories In Persons With Hiv Needing Revaccination, Minhee Kang, Triin Umbleja, Anchalee Avihingsanon, Sandra W Cardoso, Josphat Kosgei, Karen J Vigil, Ta Thi Dieu Ngan, Unoda Chakalisa, Stephanie Caruso, Kenneth E Sherman, Kristen M Marks

Faculty, Staff and Student Publications

Introduction: Past studies of hepatitis B vaccines in people with HIV (PWH) have shown mixed results about improving responses with increases in dose or dose frequency, leading to inconsistent guidelines and practice. We examined vaccine series completion and revaccinations in PWH lacking a seroprotective response.

Methods: Hepatitis B vaccination histories were evaluated as a retrospective study in 561 participants of A5379 trial (NCT04193189). Individuals in 41 sites in Africa, Asia, South America, and the United States qualified for the trial with antibody titers below the seroprotective level (< 10 mIU/mL) despite past hepatitis B vaccinations. The primary measure of interest was the number of vaccines in the past vaccination records.

Results: Of the 1098 trial candidates, 561 (51%) did not …

Quantitative Muscle Magnetic Resonance Imaging Demonstrates Resolution Of Muscle Edema In Refractory Dermatomyositis: A Post Hoc Analysis Of A Proof-Of-Concept Clinical Trial Of Tofacitinib, Mona Dabiri, Anshula Nallapati, Marwin Groener, Patrick Debs, Jemima Albayda, Eleni Tiniakou, Lisa Christopher-Stine, Laura Fayad, Julie J Paik

Faculty, Staff and Student Publications

Objective: To evaluate changes in muscle edema using short-tau inversion recovery (STIR) imaging and quantitative diffusion-weighted imaging (DWI) with apparent diffusion coefficient (ADC) mapping in patients with refractory dermatomyositis (DM) treated with tofacitinib.

Methods: This post hoc imaging analysis included patients from a 12-week, open-label trial of tofacitinib 11 mg daily in refractory DM. Bilateral thigh magnetic resonance imaging was obtained at baseline and week 12 using standardized STIR, T1-weighted, and DWI sequences. Muscle edema (ME) and fascial edema were assessed qualitatively on STIR imaging. ADC values were measured in muscles demonstrating baseline STIR hyperintensity using three nonoverlapping regions of …

Race To Mitigate Aortic Dissection: Exercise, Pde5a, And The Dissecting Aorta, Siddharth K Prakash

Faculty, Staff and Student Publications

No abstract provided.

The Impact Of Rapid Infusers On The Hemostatic Potential Of Cryoprecipitate Products, Connor D Purvis, Samantha Redden, Andrew Jacobson, Yao-Wei Wang, Julie Campbell, Jessica Cardenas, Jan-Michael Van Gent, Bryan A Cotton

Faculty, Staff and Student Publications

Background: In cases of massive transfusion, intravenous access can be limited. Additionally, delivering different products through separate lines and infusion methods adds unnecessary steps. RBC, plasma, and whole blood (WB) are delivered via rapid infusers; cryoprecipitate (CRYO) is infused through separate access and is not approved with these devices.

Study design and methods: We examined the impact of different transfusion methods on hemostatic performance and factor activity using two available CRYO products. Ten bags of CRYO, ten bags pathogen-reduced CRYO (Intercept® Fibrinogen Complex, IFC), and 20 units of WB were obtained. Each CRYO bag was infused with one unit of …

Estrogen As A Therapeutic Agent: Targeting Endotheliopathy And Coagulopathy In Trauma, Niruktha Raghavan, Mira Patel, Bryan A Cotton, Julia Coleman, Donald Jenkins

Faculty, Staff and Student Publications

Background: Traumatic injury remains a leading cause of death, often due to uncontrolled hemorrhage and trauma-induced coagulopathy (TIC). TIC is critically triggered by the endotheliopathy of trauma, involving endothelial cell injury and glycocalyx degradation. Despite conventional advances, the stable casualty rate underscores the urgent need for new precision resuscitation strategies that acknowledge factors like biological sex.

Design: The central hypothesis is that estrogen confers a survival advantage in hormonally active females through a dual action: endothelial cell stabilization (halting glycocalyx shedding) and its inherent procoagulant effect. The analysis assesses the therapeutic potential of both exogenous estrogen and female-derived blood products …

Declaring Futility After Traumatic Injury And The Burden Of Failure On The Surgeon, Jan-Michael Van Gent, Bryan A Cotton

Faculty, Staff and Student Publications

In this edition of the THOR supplement in Transfusion, there are two articles that deal with resuscitation futility and transfusion. In one article, Yazer et al. delve into the details of the studies outlined in this editorial and summarize the literature on the topic of transfusion and futility. The second article by Dr. Jay Malone discusses the ethical issues surrounding massive transfusion and resuscitation. Taken together, these articles address the clinical and ethical issues surrounding this very emotive and difficult topic.

Risk-Stratified Transitional Care And Cardiovascular Hospitalizations By Sex: A Secondary Analysis Of A Randomized Clinical Trial., Douglas S Lee, Chang Nancy Wang, Peter C Austin, Sharon E Straus, Michael E Farkouh, Alice Chong, Monica Taljaard, Stephanie Poon, Stuart Smith, Robert S Mckelvie, Robert M Iwanochko, Andrea Macdougall, Esam Elbarasi, Peter M Cram, Jiming Fang, Clare L Atzema, Jacob A Udell, Paula A Rochon, Michael J Schull, Susanna Mak, Heather J Ross

Heart and Vascular Articles

IMPORTANCE: Female patients with heart failure (HF) are older and more often present with preserved left ventricular ejection fraction (LVEF), whereas male patients present with more ischemic disease. Despite these differences, an emergency department-based acute HF strategy may be equally applicable to both sexes.

OBJECTIVE: To determine whether the strategy for acute HF management in the Comparison of Outcomes and Access to Care for Heart Failure (COACH) trial differed by sex.

DESIGN, SETTING, AND PARTICIPANTS: This prespecified secondary analysis of the multicenter COACH stepped-wedge, cluster-randomized clinical trial included 10 acute care hospitals in Ontario, Canada. Data were collected from January …

Rethinking Mixed Dka-Hhs: An Extreme Presentation Of Hyperosmolar Hyperglycemic State, Sajith Silva, Umair Malik, Amin Pasha, Sujata Kambhatla

Conference Presentation Abstracts

Introduction: The American Diabetes Association (ADA) recognizes diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) as life-threatening hyperglycemic emergencies that can overlap clinically; approximately 10% of presentations are described as mixed DKA–HHS. Because current guidelines do not define a single “mixed” category, overlap is best understood as concurrent fulfillment of key elements of both syndromes: DKA-type anion-gap metabolic acidosis with ketonemia or ketonuria, together with HHS-type severe hyperglycemia, hyperosmolality, and dehydration. We report an extreme HHS presentation (glucose >2,100 mg/dL) with limited DKA overlap. Case Description: A 34-year-old woman with longstanding type 1 diabetes mellitus managed with an insulin pump, …

A Rare Price Of Pain Control: Methemoglobinemia From A Lidocaine Patch, Sushmita Mantravadi, Kesava Mankikanta Achuta, Aaron Goyal, Amin Pasha, Abed L. Dabaja

Conference Presentation Abstracts

Introduction The overall prevalence of methemoglobinemia is around 0.035%. Methemoglobinemia is a rare but potentially life-threatening complication of local anesthetic use. While all patients are at risk, those with cardiac or pulmonary compromise are more susceptible to developing clinical manifestations. We report a case of acquired methemoglobinemia following topical lidocaine patch application for post-operative pain management in an elderly patient. Case Presentation 84-year-old male with a past medical history of aortic stenosis status post Transcatheter aortic valve replacement, Coronary artery disease, gastrointestinal bleed due to colon polyps, obstructive sleep apnea, chronic kidney disease, trigeminal neuralgia, obesity, essential hypertension, chronic atrial …

Neurointerventional Advances In 2025, Amol Mehta, Sunil A Sheth, Ashutosh P Jadhav

Faculty, Staff and Student Publications

No abstract provided.

Antidepressant-Like Effects Of Extinction Learning As An Animal Model Of Behavioral Therapy, Jing Liu, Sarah E Bulin, David A Morilak

Faculty, Staff and Student Publications

Exposure-based behavioral therapy, the most effective treatment for posttraumatic stress disorder (PTSD), also reduces depressive symptoms. However, neurobiological mechanisms underlying the beneficial effects of exposure-based behavioral therapy on depression remain unknown. Our lab has established fear extinction as a rat model of exposure therapy to investigate the mechanisms underlying its therapeutic behavioral effects in chronically stressed rats. In this study, we demonstrated that extinction learning reduced immobility in the forced-swim test and reversed chronic stress-induced reduction in sucrose preference. Chemogenetic inactivation of pyramidal neurons in the ventral medial prefrontal cortex (vmPFC) prevented these antidepressant-like effects of extinction. Extinction learning enhanced …

Creating Space For New Ideas And Advancing Gender Equity In Physical Activity And Health Research: Reflections On The Nature Portfolio Physical Activity Series, Andrea Ramírez Varela, Deborah Salvo, Pedro C Hallal, Erica Hinckson

Faculty, Staff and Student Publications

No abstract provided.

Computational Modeling Meets 3d Bioprinting: Emerging Synergies In Cardiovascular Disease Modeling, Tanmay Mukherjee, Mehdi Salar Amoli, Sarah Rezapourdamanab, Lama Rita El Shammas, Martin L Tomov, Emilio A Mendiola, Vahid Serpooshan, Reza Avazmohammadi

Faculty, Staff and Student Publications

Cardiovascular diseases (CVDs) remain the leading cause of death worldwide, underscoring the need for improved strategies in diagnosis, treatment, and disease modeling. Traditional in vitro models often fall short in replicating human CV physiology, prompting efforts to advance cardiac tissue engineering and computational modeling. Among these, three-dimensional (3D) bioprinting has emerged as a transformative tool, enabling the creation of biomimetic CV constructs that more faithfully replicate native tissue structure and function. However, challenges persist in achieving appropriate mechanical properties and long-term performance of engineered CV constructs. Computational modeling offers powerful solutions to assist with these challenges, providing predictive insights into …

Are Drains After Trauma Splenectomy Associated With Organ Space Surgical Site Infections?, Stephanie Martinez Ugarte, Mokunfayo O Fajemisin, Seokhun Kim, William D Rieger, Renee W Green, Gabrielle E Hatton, Lillian S Kao

Faculty, Staff and Student Publications

Introduction: Left upper quadrant (LUQ) drain use after trauma splenectomy varies, with minimal existing data to guide practice. We aimed to investigate the association of LUQ drains with organ space surgical site infection (OS-SSI) after splenectomy. We hypothesized that LUQ drains after trauma splenectomy are associated with increased odds of OS-SSI.

Patients and methods: A retrospective study of adult blunt trauma patients who underwent splenectomy from 7/2018 to 6/2024 was performed. We excluded patients who survived < 5 days after operation, and those with an intraoperatively identified pancreatic injury. Demographics, surgical details, and drain information were abstracted from the medical record. Inverse probability of treatment weighting (IPTW) was used to balance variables between patients who did and did not receive an LUQ drain after splenectomy. Multivariable logistic regression with IPTW was performed to estimate the association of LUQ drains with OS-SSI.

Results: Of 179 patients, 68% (n = 121) were male, the median age was 38 years (interquartile range 28, 55), and 27% (n = …

An Assessment Of Green Plasma: The In Vitro Hemostatic Superiority Of A Currently Discarded Blood Product, Samantha C Redden, David J Sun, Yao-Wei W Wang, Elizabeth Hartwell, Jessica C Cardenas, Scott D Olson, Bryan A Cotton

Faculty, Staff and Student Publications

Introduction: Recent studies have linked trauma patient outcomes to the plasma donor's sex, with premenopausal females associated with improved survival and lower organ failure. Currently, green-colored plasma (due to oral contraceptive use) is removed from the donor pool. We set out to evaluate the hemostatic potential of green plasma.

Study design & methods: We obtained 90 units of plasma from our regional blood center: 30 units of visible green plasma and 60 units of standard-color plasma divided between male and female donors. We collected clinical data such as age, sex, ethnicity, and number of pregnancies. We then assessed the hemostatic …

Associations Between Source-Specific Nitrate And Nitrite Intakes And Metabolic Dysfunction-Associated Steatotic Liver Disease In Two Prospective Cohorts, Nicola P. Bondonno, Pratik Pokharel, Benjamin H. Parmenter, Liezhou Zhong, Dorit W. Erichsen, Jörg Schullehner, Kirsten Frederiksen, Cecilie Kyrø, Peter Fjeldstad Hendriksen, Jonathan M. Hodgson, Torben Sigsgaard, Christina C. Dahm, Anne Tjønneland, Alysha S. Thompson, Tilman Kühn, Aedín Cassidy, Anja Olsen, Catherine P. Bondonno

Research outputs 2022 to 2026

SummaryBackground and AimsDietary nitrate and nitrite may have source-dependent effects on liver health: plant-sourced nitrate may confer hepatoprotective benefits via its conversion to nitric oxide, whereas nitrate and nitrite from animal foods, processed meats, or contaminated drinking water may promote liver injury via their conversion to N-nitrosamines. We aimed to examine associations between source-specific nitrate and nitrite intakes and incident metabolic dysfunction-associated steatotic liver disease (MASLD) in two large cohorts. Secondary aims were to assess associations with liver MRI biomarkers and to evaluate whether nitric oxide-pathway gene variants modify associations with plant-sourced nitrate/nitrite.MethodsWe analysed 53,854 participants from the Danish Diet, …

Beyond The First Bout: Adaptations To Repeated Injuries Across Physiological And Pathological Conditions, Cory W. Baumann, Christopher P. Ingalls, Kazunori Nosaka, Jarrod A. Call

Research outputs 2022 to 2026

Skeletal muscle exhibits remarkable plasticity following injury, yet most research has focused on responses to a single bout of eccentric contractions. This review addresses adaptations to repeated eccentric contraction–induced injuries across physiological and pathological conditions, with emphasis on insights from preclinical rodent models. In healthy muscle, the repeated bout effect (RBE) reduces strength loss and accelerates recovery after subsequent bouts. However, these adaptations are highly condition dependent. Aging can attenuate the RBE, while dystrophic muscle remains vulnerable to repeated injury despite compensatory remodeling. Other factors, including but not limited to, chronic alcohol intake and malignant hyperthermia can influence these responses, …