Medicine and Health Sciences Commons^™

Revisiting The Effect Of Udenafil On Exercise Performance In Patients With Fontan Circulation: Results Of A Post Hoc Analysis Of The Fuel Trial, David J Goldberg, William B Orr, Et Al.

2020-Current year OA Pubs

BACKGROUND: In the FUEL (Fontan Udenafil Exercise Longitudinal) trial, a positive treatment effect was identified for outcomes at the ventilatory anaerobic threshold but not for the primary outcome, oxygen consumption (Vo

METHODS: Participants were divided into subgroups by baseline predicted peak Vo

RESULTS: Of the 379 participants with paired exercise data, 302 (80%) had a baseline peak Vo

CONCLUSIONS: In this post hoc subgroup analysis, after exclusion of patients with Fontan circulation with near-normal baseline peak Vo

REGISTRATION: URL: https://clinicaltrials.gov; Unique identifier: NCT0274115.

Echocardiographic Assessment Of Pulmonary Hemodynamics And Right Ventricular Performance In Neonatal Murine Hypoxia, Kel Vin Woo, Philip T Levy, Carla J Weinheimer, Amanda L Hauck, Aaron Hamvas, David M Ornitz, Attila Kovacs, Gautam K Singh

2020-Current year OA Pubs

No abstract provided.

Promising Practices To Address Healthcare Needs Voiced By Local Native Americans, Noelle Taylor, Mykin R. Higbee, Raiden Gaul

Transforming Communities

Purpose

To examine barriers and facilitators to nursing education among Native Americans and identify evidence-based strategies to increase the number of Native American nurses working in their local communities to address health disparities.

Background

Native Americans experience significantly higher rates of chronic illnesses such as diabetes and heart disease, and lower life expectancies. Only 4% of registered nurses identify as Native American, with no growth despite increased funding for diversity in nursing education. This underrepresentation contributes to culturally insensitive care and persistent healthcare inequities stemming from historical marginalization and trauma.

Methods

A comprehensive literature review was conducted using CINAHL, PubMed, …

The Professional And Occupational Identities Of Nicu Occupational Therapists, Lindsay M. Marquardt, Karen Park

Summer 2025 OTD Capstone Symposium

Occupational therapists in the neonatal intensive care unit (NICU) provide specialized care, including infant positioning, feeding, handling techniques, and anticipatory guidance. While the American Occupational Therapy Association has outlined the role, little research has explored how therapists perceive their own occupational and professional identities in this highly specialized setting. This study explored the perspectives of NICU occupational therapists to better understand how their roles and identities are shaped within the NICU environment. A mixed-methods descriptive design was used. Data was collected through an electronic survey including Likert-scale and open-ended questions, with optional 30-minute follow-up interviews. Snowball and convenience sampling were …

Addressing Psychosocial Barriers To Participation In People Experiencing Homelessness: An Occupational Therapy Workshop, Preston E. Bender

Student Capstone Papers

This capstone project addressed the critical gap in occupational therapy education and practice regarding the psychosocial needs of people experiencing homelessness. Despite the occupational therapy profession’s emphasis on holistic, person-centered care, many occupational therapy practitioners and occupational therapy students report feeling a lack of self-efficacy and preparedness to navigate the complex psychological, social, and systemic barriers that hinder occupational participation among this population. This capstone project aimed to address the perceived unpreparedness among clinicians through the creation of an 8-hour interactive educational workshop. The workshop is grounded in the Model of Human Occupation and informed by the Bridging the Transition …

Anti-Inflammatory Diet And Probiotic Supplementation As Strategies To Modulate Immune Dysregulation In Autism Spectrum Disorder, Carlos Andrés Naranjo-Galvis, Diana María Trejos-Gallego, Cristina Correa-Salazar, Jessica Triviño-Valencia, Marysol Valencia-Buitrago, Andrés Felipe Ruiz-Pulecio, Luisa Fernanda Méndez-Ramírez, Jovanny Zabaleta, Miguel Andres Meñaca-Puentes, Carlos Alberto Ruiz-Villa, Marcela Orjuela-Rodriguez, Juan Carlos Carmona-Hernández, Luisa Matilde Salamanca-Duque

School of Medicine Faculty Publications

Background/Objectives: Autism spectrum disorder (ASD) is a neurodevelopmental condition associated with behavioral and cognitive impairments. Increasing evidence also links ASD with systemic immune dysregulation, including abnormal cytokine profiles and chronic low-grade inflammation. Emerging evidence suggests that targeted dietary strategies and probiotic supplementation may modulate immune responses and gut–brain interactions in patients with ASD. This study aimed to evaluate the immunomodulatory effects of a structured anti-inflammatory diet (NeuroGutPlus) compared to multi-strain probiotics in children with ASD. NeuroGutPlus is a nutritionally complete anti-inflammatory dietary protocol that targets gut integrity, inflammation, and mitochondrial function. It includes a diet low in gluten, FODMAPs, casein, …

Palpation Characteristics Of An Instrumented Virtual Cricothyroidotomy Simulator, Melih Turkseven, Trudi Di Qi, Ganesh Sankaranarayanan, Suvranu De

Engineering Faculty Articles and Research

Cricothyroidotomy (CCT) is a critical, life-saving procedure requiring the identification of key neck landmarks through palpation. Interactive virtual simulation offers a promising, cost-effective approach to CCT training with high visual realism. However, developing the palpation skills necessary for CCT requires a haptic interface with tactile sensitivity comparable to human fingers. Such interfaces are often represented by plastic partial mannequins, which require further adaptation to integrate into virtual environments. This study introduces an instrumented physical palpation interface for CCT, integrated into a virtual surgical simulator, and tested on 10 surgeons who practiced the procedure over a training period. Data on haptic …

School Safety And Health Policies, Bob Underwood, Erin Mccann

Pediatrics in Practice: A CME Podcast

In this episode, we sit down with Dr. Erin McCann, MD, MPH, attending physician at the Children’s Mercy Primary Care Clinic, to explore the evolving landscape of school safety and health policies. From mental health support and chronic illness management to emergency preparedness and public health mandates, Dr. McCann shares practical insights on how pediatricians can partner with schools and families to create safer, healthier learning environments. Whether you're navigating new legislation or advocating for your patients, this conversation offers timely guidance and actionable takeaways.

Click here to stream the podcast episode.

Asymmetric Fgf Receptor Dimerization: Implications For Fgf23 Biology And Drug Discovery, Mohammed S. Razzaque, Moosa Mohammadi

School of Medicine Publications

Fibroblast growth factor 23 (FGF23) requires both αKlotho and heparan sulfate proteoglycans (HSPGs) as obligatory coreceptors to bind, dimerize, and activate its FGF receptors (FGFRs) in the kidney, thereby regulating mineral ion and vitamin D homeostasis. Cryogenic electron microscopy studies reveal that FGF23 signaling proceeds through an asymmetric 1:2:1:1 FGF23–FGFR–αKlotho–HS assembly. According to this structural model, αKlotho simultaneously anchors FGF23 and one FGFR chain, referred to as the primary receptor (FGFRP), to form a 1:1:1 FGF23-FGFRP-αKlotho triplex, which boosts FGF23-FGFRP interaction. Subsequently, the HS coreceptor aids the triplex in recruiting a second FGFR chain, or secondary receptor (FGFRS), leading to …

08.18.2025 Ored Connect, Liz Williamson

ORED Newsletter

ORED on-demand training, Tableau training, Research Reception 2025

The Professional And Occupational Identities Of Nicu Occupational Therapists, Lindsay M. Marquardt, Karen Park

Summer 2025 OTD Capstone Symposium

Occupational therapists in the neonatal intensive care unit (NICU) provide specialized care, including infant positioning, feeding, handling techniques, and anticipatory guidance. While the American Occupational Therapy Association has outlined the role, little research has explored how therapists perceive their own occupational and professional identities in this highly specialized setting. This study explored the perspectives of NICU occupational therapists to better understand how their roles and identities are shaped within the NICU environment. A mixed-methods descriptive design was used. Data was collected through an electronic survey including Likert-scale and open-ended questions, with optional 30-minute follow-up interviews. Snowball and convenience sampling were …

Understanding Loss To Follow-Up: The Role Of Social Determinants Of Health In Infants Referred After A Positive Newborn Screening – A Quantitative Analysis, Betsy Graham-Moeller Graham-Moeller

Walden Dissertations and Doctoral Studies

Newborn screening (NBS) is a vital U.S. public health initiative that identifies medical conditions shortly after birth. Patients with positive screenings are referred for medical follow-up or evaluation. However, many patients do not receive the recommended long-term follow-up, posing concerns for healthcare providers and public health professionals working to ensure timely treatment and care continuity. Based on the Social Determinants of Health framework, this quantitative, retrospective cohort study aimed to examine demographic and clinical factors associated with follow-up adherence among 691 infants identified through NBS in Colorado and Wyoming. The purpose of the study was to determine whether race, ethnicity, …

Extended Survival With Pancreatic Carcinosarcoma: A Case Report And Literature Review, Tian Xiao, Claire Browne, Morgan Black, Celia Marginean, Elena Tsvetkova

Faculty, Staff and Students Publications

Pancreatic carcinosarcoma is a rare and aggressive malignancy that can mimic pancreatic adenocarcinomas in presentation but often has different disease biology and different responses to conventional treatment for pancreatic adenocarcinoma. Case reports have documented a 5-year overall survival of approximately 13% only if the disease is caught at an earlier stage and is amenable to multi-modality treatment, including surgery, chemotherapy, and radiation. In the advanced stage, treatments do not often provide benefit, and patients may decline rapidly. There are currently no studies demonstrating survival benefits with chemotherapy in patients with metastatic carcinosarcoma, owing to both the rarity and the often …

Mechano-Signal Transduction Pathways Of The Diaphragmatic Muscle And Role Of Cytoskeleton, Junaith S Mohamed, Patricia S Pardo, Aladin M Boriek

Faculty, Staff and Students Publications

Mechanotransduction, also referred to as mechano-signal transduction, is a biophysical process wherein cells perceive and respond to mechanical stimuli by converting them into biochemical signals that initiate specific cellular responses. This mechanism is fundamental to the development and growth, and proper functioning of mechanically active tissues, such as the diaphragm-a respiratory muscle vital for breathing in mammals. In vivo, the diaphragm is subjected to transdiaphragmatic pressure, and therefore, its muscle fibers are subjected to mechanical forces not only in the direction of the muscle fibers but also in the direction transverse to the fibers. Previous research conducted in our laboratory …

Improving Automated Deep Phenotyping Through Large Language Models Using Retrieval-Augmented Generation, Brandon T Garcia, Lauren Westerfield, Priya Yelemali, Nikhita Gogate, E Andres Rivera-Munoz, Haowei Du, Moez Dawood, Angad Jolly, James R Lupski, Jennifer E Posey

Faculty, Staff and Students Publications

Background: Diagnosing rare genetic disorders relies on precise phenotypic and genotypic analysis, with the Human Phenotype Ontology (HPO) providing a standardized language for capturing clinical phenotypes. Rule-based HPO extraction tools use concept recognition to automatically identify phenotypes, but they often struggle with incomplete phenotype assignment, requiring significant manual review. While large language models (LLMs) hold promise for more context-driven phenotype extraction, they are prone to errors and "hallucinations," making them less reliable without further refinement. We present RAG-HPO, a Python-based tool that leverages retrieval-augmented generation (RAG) to elevate accuracy of HPO term assignment by LLM. This approach bypasses the limitations …

High-Grade Glioma With Pleomorphic And Pseudopapillary Features: A Single-Institution Series Of Three Cases, Eric A Goethe, Rasha Alfattal, Subhiksha Srinivasan, Pushan Dasgupta, Vinay Puduvalli, Shiao-Pei Weathers, Leomar Y Ballester, Jeffrey S Weinberg, Sujit Prabhu, Sherise D Ferguson, Maria A Gubbiotti

Faculty, Staff and Students Publications

Introduction: Modern molecular diagnostic techniques such as DNA methylation profiling are leading to the reclassification of several central nervous system malignancies and discovery of novel diagnostic entities, such as high-grade glioma with pleomorphic and pseudopapillary features (HPAP).

Methods: We performed a retrospective chart review of all patients with HPAP confirmed with methylation profiling at a single institution between 2023 and 2025. Demographic, radiographic, surgical, and outcome data were collected.

Results: Three patients were identified: two females and one male with a mean age of 49.7 years (range 25-62). No patients had a prior cancer history. One patient had an incidentally …

Anti-Tumor Activity Of Camptothecin Analog Conjugate Of An Rspo4-Based Peptibody Targeting Lgr4/5/6 In Preclinical Models Of Colorectal Cancer, Yukimatsu Toh, Ling Wu, Jianghua Tu, Zhengdong Liang, Adela M Aldana, Jake J Wen, Li Li, Sheng Pan, Julie H Rowe, Martha E Hensel, Carolyn L Hodo, Rick A Finch, Kendra S Carmon, Qingyun J Liu

The Brown Foundation: Institute of Molecular Medicine

Background: Antibody-drug conjugates (ADCs) are a significant advancement in targeted cancer therapy, but none are approved for colorectal cancer (CRC). LGR4/5/6, highly expressed in most CRCs, are promising targets. While LGR5-targeting ADCs show strong anti-tumor effects, their efficacy is limited by LGR5 loss in some CRC cells. RSPO4, a natural ligand for LGR4/5/6, binds all three receptors with high affinity. This research develops RSPO4-based peptibody drug-conjugates (PDCs) to simultaneously target LGR4/5/6, offering a novel therapeutic approach for CRC.

Methods: LGR4/5/6 expression in CRCs was analysed using RNA-seq datasets and Western blot. Peptibody binding affinities were measured, conjugated to camptothecin analog, …

Using Exercise To Treat Anxiety In Adult Patients With Addiction, Emmanuella N. Nnadozie

Walden Dissertations and Doctoral Studies

Summary In this Doctor of Nursing Practice (DNP) project, I selected a staff education as the best intervention to improve staff knowledge in using exercise to treat anxiety disorders in adult patients at a recovery clinic for addiction. Anxiety disorders are highly prevalent among individuals undergoing substance abuse treatment, often exacerbating withdrawal symptoms and increasing relapse risks; thus, integrating the use of exercise in addition to existing standard care for anxiety treatment in individuals with substance use disorder (SUD) will lead to decreased anxiety, decreased alcohol use and drug cravings, improved quality of life and affect, increased abstinence, and improve …

Enhancing Social Determinants Of Health Education In Home Health Care Including Social Determinants Of Health In Assessments And Care Plans For Home Health Clinicians, Emilia Mbanwite

Walden Dissertations and Doctoral Studies

This staff education-focused doctor of nursing practice (DNP) project addressed the critical practice problem of one southern health care facility staff’s knowledge on the integration of social determinants of health (SDOH) into home health care plans. Despite SDOH screening, clinicians lacked standardized training to effectively assess and intervene on factors such as housing, transportation, and food insecurity, contributing to preventable hospitalizations, particularly in vulnerable populations. The practice-focused question addressed whether an evidence-based education module could improve home health nurses’ knowledge and application of SDOH in assessments and care plans. The project’s purpose was to develop, implement, and evaluate this training …

Simulated Emergency Room Sign-Outs: What They Tell Us About Diagnostic Accuracy And Opportunities For Improvement, Roni Matin, Brent R King, Amit M Mehta, Susan H Fenton, Nathan R Hoot, David J Robinson, Charles L Maddow, Amy Franklin

Faculty, Staff and Student Publications

Objective: Emergency department (ED) sign-outs provide continuity of care for patients at shift changes. However, these periods have been associated with communication breakdowns and medical errors. We explored information factors (stage-of-the-case and the explicitness of the sign-out narrative) to determine their impact on clinicians' diagnostic accuracy and confidence.

Methods: Clinicians from 2 academic ED sites reviewed patient vignettes sign-out narratives (N=69). Using a within-subjects experiment, the explicitness of the sign-out information (i.e., broad statement about labs versus stating each test) and the patient's stage in the diagnostic process (e.g., labs pending, treatment occurring, etc.) at the time of sign-out varied. …

Factors That Influence Female Orthopaedic Surgeons' Decision To Pursue A Career In Sports Medicine: A Mixed-Methods Study, Nichelle M Enata, Katherine M Gerull, Ahmed Hanafy, Mary K Mulcahey, Derrick M Knapik, Matthew V Smith

2020-Current year OA Pubs

BACKGROUND: Despite the increased percentage of women in medical school and in orthopaedic residency programs, the percentage of women pursuing careers in sports medicine has only increased 3% over the past decade.

PURPOSE: To investigate the experiences and perceptions of female orthopaedic surgeons about sports medicine, identifying factors influencing career interest in this surgical subspecialty.

STUDY DESIGN: Cross-sectional study.

METHODS: A mixed-methods approach, combining an online survey and qualitative interviews, was utilized to compare the clinical experiences and personal perceptions of women in orthopaedic sports medicine with women in other orthopaedic subspecialties. Surveys were distributed to members of the Ruth …

Targeted Depression Screening For At-Risk High School Students: An Integrated Review, Joseph Calub

DNP Qualifying Manuscripts

Depression in high school students is underrecognized because symptoms can present not only as mood issues but also behavioral or academic problems. This integrated review examined literature from 2010-2015 using PsycInfo, ERIC, CINAHL, and PubMed to evaluate the effectiveness of targeted depression screening for students referred for behavioral, academic, or social concerns. Studies meeting inclusion criteria assessed targeted or clinically referred screening methods, with a focus on validated tools such as the Patient Health Questionnaire modified for Adolescents (PHQ-A). Findings indicate that targeted screening effectively identifies depressive symptoms in at-risk students and is more feasible in resource-limited schools than universal …

Improving Diabetes Management Through Evidence-Based Educational Resources In A Federally Qualified Health Center, Linda F. Dunbar

Doctor of Nursing Practice Final Project Abstract

Purpose

The purpose of this scholarly project was to implement updated culturally tailored diabetes education materials, conduct staff training sessions, and promote consistent documentation of hemoglobin A1c values and adherence to evidence-based guidelines, aligned with current American Diabetes Association (ADA) standards of care. These interventions aimed to reduce the percentage of adults with HbA1c levels greater than 9%.

Background

The project was implemented at a Federally Qualified Health Center (FQHC) in a rural community of Tomball, Texas. The patient population is 73% Hispanic/Latino, who primarily speak Spanish, and are disproportionately affected by diabetes.

Methodology

The project was implemented using the …

The Silent Epidemic: Equipment Maintenance Failures And Patient Outcomes In Ghana's Healthcare System, Ramseyer Adekorang Asamoah, Celene Dzreke, Evans Dzreke, David Kanzin

Health & Biomedical Sciences Faculty Publications

Broken tools indicate a broken system. This new study reveals how medical equipment failures destroy Ghana's public hospitals, turning life-saving technologies into silent murderers that disproportionately affect rural areas. Moving beyond technical diagnostics, we study the cascading systemic failures, chronic underfunding, critical staff shortages, and fragmented supply chains that leave 40% of vital equipment, such as ventilators, MRI scanners, and dialysis machines, inoperable at any given time. We quantify the devastating human toll through rigorous mixed-methods analysis of equipment downtime records across ten regional hospitals (2018-2023) and profound narratives from 50 frontline stakeholders, doctors forced to improvise without working incubators, …

An Integrated Literature Review Examining Nurse Burnout Interventions, Wislande Joseph

DNP Qualifying Manuscripts

Nurse burnout has detrimental consequences for patients, nurses, and organizations and can negatively impact patient outcomes, nurse quality of life, and organizational costs. This integrated literature review aimed to examine interventions for nurse burnout in order to identify what characterizes effective interventions, whether evidence supports implementing such interventions, and how the most commonly-implemented intervention type (mindfulness-based) in particular impacts signs and symptoms of nurse burnout. A two-part search was conducted of CINAHL, PubMed, Google Scholar, and APA PsychInfo. Part one investigated burnout interventions broadly using the primary search terms nurse burnout and interventions; part two focused specifically on mindfulness-based interventions …

Considering Climate Contexts: Examining Promotive And Punitive School Characteristics Among Diverse High School Students, Ashley Bazin, Maryse Richards, Akila Raoul, Allison Lloyd, Elizabeth Rovegno, Yael Granot

Psychology: Faculty Publications

Schools are a critical developmental context for adolescents that can, depending on certain characteristics, do a better or worse job at promoting student resilience and well- being. In working to meet student needs and respond to student behaviors, schools can exhibit more punitive characteristics, like exclusionary discipline practices, or more promotive characteristics, including restorative practices and marshaling of mental health resources. While punitive factors have been associated with more negative outcomes, especially for marginalized students, and promotive factors have been associated with more positive outcomes for students, these factors have rarely been considered together. We conducted an online survey of …

Prior Adolescent Oxycodone Exposure Enhances Pain Sensitivity Following Chronic Intermittent Ethanol In Adult Female Mice, Lisa L. Wilson, Lucas Albrechet-Souza, Linh Ha, Nicholas W. Gilpin, Tiffany A. Wills

School of Graduate Studies Faculty Publications

The opioid crisis remains a critical public health concern, with rising rates of overdose and opioid use disorder. While opioids are effective for managing pain, both chronic use and withdrawal are associated with increased pain sensitivity. Although most prior research has focused on adults, opioid use during adolescence is common and linked to a heightened risk for developing alcohol use disorder and other forms of substance misuse. Like opioids, acute alcohol use can be analgesic, but chronic alcohol exposure and withdrawal lead to increased pain sensitivity. However, the interactive effects of adolescent opioid and adult alcohol exposure on pain remain …

Single Balloon Enteroscopy In The Elderly, Marc J Zuckerman, Majd Michael, Mohammad Bashashati, Alok K Dwivedi, Nancy A Casner, Mohamed O Othman, Sherif E Elhanafi

Faculty, Staff and Students Publications

Background: Single-balloon enteroscopy (SBE) is a minimally invasive procedure to assess and treat small bowel pathologies. The most common use is to detect suspected small bowel bleeding: Insignificant gastrointestinal (GI) bleeding or iron deficiency anaemia (IDA). The safety and feasibility of SBE in the elderly has not been adequately studied.

Aim: To assess the safety and feasibility of both antegrade and retrograde SBE in elderly patients.

Methods: We performed a retrospective cohort study of all antegrade and retrograde SBE done at our center from March 2011 through May 2020. We collected patient's data including demographics, indications, findings, therapeutic interventions, and …

Old Vs New Local Ancestry Inference In Hchs/Sol: A Comparative Study, Xueying Chen, Hao Wang, Iris Broce, Anders Dale, Bing Yu, Laura Y Zhou, Xihao Li, Maria Argos, Martha L Daviglus, Jianwen Cai, Nora Franceschini, Tamar Sofer

Faculty, Staff and Student Publications

Hispanic/Latino populations are admixed, with genetic contributions from multiple ancestral populations. To uncover genetic associations in these populations, researchers often turn to admixture mapping, which relies on inferred counts of "local" ancestry, i.e. the source ancestral population at a locus. Local ancestries are inferred using external reference panels that represent ancestral populations, making the choice of inference method and reference panel critical. This study used a dataset of Hispanic/Latino individuals from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) to evaluate how updates in local ancestry inference (LAI) affect results, specifically, the 'old' LAI performed using a popular inference method …

Newly Diagnosed Acute Myeloid Leukemia In Unfit Patients: 2026 Treatment Algorithms, Naseema Gangat, Courtney D Dinardo

Faculty, Staff and Student Publications

Management paradigms for newly-diagnosed acute myeloid leukemia (ND-AML) in patients considered unfit to receive intensive chemotherapy have evolved with improved understanding of disease biology. In this setting, management requires clear delineation of goals of therapy that should include preservation of quality-of-life (QoL). Combination of venetoclax (Ven) and a hypomethylating agent (HMA) is the current standard-of-care in most circumstances with flexible options in regard to drug dose and duration of treatment as well as the addition (triplet combinations) or alternative use of targeted therapies, such as inhibitors of FLT3, IDH1, IDH2, or menin for patients with NPM1MUT …