Medicine and Health Sciences Commons^™

Quality Improvement Project The Impact Of Targeted Education And Training On The Use Of Rapid Mood Screener Tool On The Rate Of Mood Disorders Detection Among Psychiatric Providers, Oluwatobi Adeleke

Doctor of Nursing Practice Projects

Optimal mood disorder (MD) management outcomes are associated with accurate and timely diagnosis. Yet, MD misdiagnosis, particularly Bipolar I, is an unfortunately common problem. Rapid assessment or screening tools offer effective diagnostic assessment interventions for faster diagnosis without compromising effectiveness. Still, their administration is constrained by providers’ knowledge and competence limitations. The Rapid Mood Screener (RMS) is a rapid screener for MDs, including Bipolar I, with well-established specificity, accuracy, and reliability. Provider training and education on RMS implementation can be effective in addressing the challenges providers encounter in the tool’s administration. Here, through a pre-post quasi-experimental design, this quality improvement …

Quality Improvement Project Implementing Test Anxiety-Reducing Methods In Senior-Level Nursing Students, Ashley Brooke Gray

Doctor of Nursing Practice Projects

Test anxiety is a common occurrence among university students, particularly nursing students. The purpose of this Doctor of Nursing Practice (DNP) quality improvement project was to address the problem of test anxiety among senior-level nursing students and the lack of faculty intervention in a Bachelor of Science in Nursing (BSN) program. This DNP project aimed to increase awareness of test anxiety among nursing students and provide faculty development training on identifying symptoms, utilizing the Westside Test Anxiety Scale (WTAS), and implementing test anxiety-reducing measures in the classroom. The DNP student provided training to senior-level nursing faculty in integrating relaxation methods, …

Quality Improvement Project Evidence-Based Practice For The Use Of Lower Fio2 Concentration Amongst Pediatric Anesthesia Providers, Brittany Raines

Doctor of Nursing Practice Projects

Hyperoxia during pediatric anesthesia is linked to postoperative pulmonary complications such as atelectasis and oxidative lung injury. Despite strong evidence supporting the use of lower inspired oxygen concentrations (FiO2), many providers habitually administer 100% oxygen during induction and emergence due to tradition and lack of formal guidelines. This quality improvement project aimed to reduce unnecessary hyperoxia by educating pediatric anesthesia providers on evidence-based FiO2 titration strategies. Guided by Kolb’s Experiential Learning Theory and Lewin’s Change Theory, a quasi-experimental one-group pretest/posttest design was employed. Sixteen certified registered nurse anesthetists (CRNAs) and physician anesthesiologists completed baseline surveys, participated in a targeted educational …

Pride-Ftg Advances Academic Careers Of Underrepresented Early-Stage Investigators Performing Blood Disorders Research, Betty S Pace, Oluwatoyosi A Onwuemene, Athena Starlard-Davenport, Rhea-Beth Markowitz, Vahé Heboyan, Petar Datsov, Treva Rice

2020-Current year OA Pubs

Despite improvements in the diversity of the US biomedical research workforce, individuals from different racial/ethnic groups remain underrepresented. Even though mentoring is critical for career advancement, underrepresented faculty have limited opportunities. Therefore, we evaluated a multipronged mentoring approach for early-stage underrepresented faculty trained in the Programs to Increase Diversity Among Individuals Engaged in Health-Related Research-Functional and Translational Genomics of Blood Disorders (PRIDE-FTG). The selection process involved a rigorous review of applications, considering factors such as academic potential, research interests, and commitment to diversity in biomedical research. This yearlong training experience includes 2 summer institutes consisting of lectures, grant-writing workshops, and …

Structural Basis For Membrane Microdomain Formation By A Human Stomatin Complex, Jack Stoner, Shufang Li, Ziao Fu

2020-Current year OA Pubs

Biological membranes are not just passive barriers-they actively sense and respond to mechanical forces, in part through specialized proteins embedded within them. Among these are Stomatin-family proteins, which are known to influence membrane stiffness and regulate ion channels, yet how they achieve these functions at the molecular level has remained elusive. Here, we report the 2.2 Å cryo-electron microscopy structure of the human Stomatin complex in a native membrane environment. We find that Stomatin assembles into a 16-subunit ring-shaped homo-oligomer, forming a ~12 nm-wide cage that defines a mechanically distinct, curvature-resistant membrane microdomain. While the majority of the complex exhibits …

Bclaf1 Restrains Stress Responses In Hematopoietic Stem Cells To Support Expansion And Repopulation, Stephanie J Crowley, Wei Yang, Lynn S White, Jun Wu, Yanan Li, Haley Schmidt, Kyunghee Choi, Jeffrey A Magee, Jeffrey J Bednarski

2020-Current year OA Pubs

Hematopoietic stem cells (HSCs) rapidly expand during fetal development and after stress. Here, we identify B-cell lymphoma-2-associated factor 1 (BCLAF1) as a regulator of HSC repopulation activity, with roles in the expansion of fetal HSCs and hematopoietic reconstitution after stem cell transplantation. Using mice with hematopoietic-specific and inducible deletion of Bclaf1, we find that BCLAF1 promotes fetal HSC development but is dispensable for the maintenance of adult HSCs at steady state. Loss of BCLAF1 in either fetal or adult HSCs significantly impairs their self-renewal and multilineage reconstitution activity after stem cell transplantation. Single-cell RNA sequencing of fetal hematopoietic progenitors reveals …

Brentuximab Vedotin And Nivolumab For Untreated Patients With Hodgkin Lymphoma: Long-Term Results, Bruce D Cheson, Nancy L Bartlett, Betsy Knopf, Hun J Lee, Ranjana H Advani, Beth Christian, Catherine S Diefenbach, Tatyana A Feldman, Stephen M Ansell

2020-Current year OA Pubs

No abstract provided.

[[68ga] Labelled Exendin For Radioguided Surgery Of Intrapancreatic Insulin Producing Lesions In Patients With Congenital Hyperinsulinism, Peter Kühnen, Vikas Prasad, Et Al.

2020-Current year OA Pubs

BACKGROUND: Congenital hyperinsulinism (CHI) is a life threatening disease. Localization of affected intrapancreatic beta cells responsible for focal forms during surgery can be challenging. In this study we investigated a new radioguided surgical (RGS) approach using [68Ga]Exendin to facilitate intraoperative focus detection. All patients were scanned initially with [18F]-DOPA-PET followed by [68Ga]Exendin PET to differentiate between focal and non-focal forms. Focal CHI patients were then operated. At the beginning of standard surgical dissection of the pancreas in CHI patients (n = 12), 46 MBq of [68Ga]Exendin were injected intravenously. Intrapancreatic localization of the foci was determined by using a hand-held …

The Swib Domain-Containing Dna Topoisomerase I Of Chlamydia Trachomatis Mediates Dna Relaxation, Li Shen, Abigail R. Swoboda, Caitlynn Diggs, Shomita Ferdous, Andrew Terrebonne, Amanda Santos, Noel Wolf, Luis Lorenzo Carvajal, Guangming Zhong, Scot P. Ouellette, Yuk Ching Tse-Dinh

School of Graduate Studies Faculty Publications

Chlamydia trachomatis has a DNA topoisomerase I with a unique C-terminal domain (CTD) homologous to eukaryotic SWIB domains. This study focused on determining the function of the SWIB domain-containing TopA from C. trachomatis (CtTopA). We demonstrated that, despite the lack of sequence similarity at the CTDs between CtTopA and TopA from Escherichia coli (EcTopA), full-length CtTopA removed negative DNA supercoils in vitro and complemented the growth defect of a topA mutant of E. coli. CtTopA is less processive in DNA relaxation than EcTopA in dose-response and time course studies. An antibody generated against the SWIB domain of CtTopA specifically recognized …

Association Between Weather Variables And Fascial Space Infections Of The Head And Neck: A Retrospective Chart Review, Teresa E. Fowler, Ryan F. Bloomquist, Jeffrey N. James

School of Dentistry Faculty Publications

BACKGROUND: The incidence of fascial space infections of the head and neck has long been suggested to correlate with weather patterns, though objective evidence is inconsistent, and a causative effect is difficult to prove. One issue in the existing literature is that correlations between space infections and weather patterns have been assessed in only a few climates, so data from additional regions is needed. The purpose of this study is to understand whether head and neck infection rates correlate with weather patterns in a humid subtropical climate, adding to the current literature derived largely from temperate environments. METHODS: In this …

Pd-1 Inhibition For Relapse After Allogeneic Transplantation In Acute Myeloid Leukemia And Myelodysplastic Syndrome, John M Magenau, David G Frame, Mary Riwes, John Maciejewski, Sarah Anand, Attaphol Pawarode, Anamarija M Perry, Marcus Geer, Thomas Braun, Monalisa Ghosh, Pavan Reddy

Faculty, Staff and Students Publications

Relapse of acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS) remains the primary source of mortality after allogeneic hematopoietic stem cell transplantation (HCT). Targeting programmed death-1 (PD-1) for reversing T-cell exhaustion and restoring the graft-versus-leukemia (GVL) effect may have logistical advantages over donor lymphocyte infusion. In a prospective phase 1B clinical trial, pembrolizumab was administered every 3 weeks to 16 patients with AML (n = 12) and MDS (n = 4) in relapse after HCT to assess graft-versus-host disease (GVHD), clinical response, and survival. The median time to relapse after HCT was 5.5 months and the median pretreatment bone marrow …

Non-Isolated Tetralogy Of Fallot (Tof+): Exome Sequencing Efficacy And Phenotypic Expansions, Julia Volpi, Xiaonan Zhao, Nichole Owen, Tia Evans, Muriel Holder-Espinasse, Nayana Lahiri, Eleanor Sherlock, Gemma Poke, Jeroen Breckpot, Koen Devriendt, Bjorn Cools, Alfredo Brusco, Giovanni Battista Ferrero, Enrico Grosso, Pradeep Vasudevan, Sara Loddo, Antonio Novelli, Maria Cristina Digilio, Aafke Engwerda, Marrit Hitzert, Alison Male, Lucy Bownass, Ruth Newbury-Ecob, Zosia Miedzybrodzka, Ruth Armstrong, Sally Ann Lynch, Gunnar Houge, Shiyi Xiong, Seema R Lalani, Jill A Rosenfeld, Pamela N Luna, Chad A Shaw, Daryl A Scott

Faculty, Staff and Students Publications

Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart defect (CHD). TOF may present in isolation or in conjunction with one or more non-cardiac congenital anomalies or neurodevelopmental disorders (TOF+). Uncertainty regarding the efficacy of various genetic testing strategies, and an incomplete understanding of the genetic causes of TOF+, may lead to hesitancy in recommending genetic testing, particularly, clinical exome sequencing (cES). Here, we analyzed cES data from 131 individuals with TOF+. A definitive or probable diagnosis was made for 31 individuals, yielding a diagnostic rate of 23.6% (31/131). One individual received three diagnoses. Commercially available CHD panels …

Video-Based Intervention To Reduce Treatment And Outcome Disparities In Adults Living With Stroke Or Transient Ischemic Attack (Virtual): Protocol For A Randomized Controlled Trial, Munachi Okpala, Chigozirim Izeogu, Mengxi Wang, Charles Green, Gabretta Cooksey, Thuy Nguyen, Sarah Cohen, Latonya Bryant, Daphne C Hernandez, Elmer V Bernstam, Michael Gonzales, Rhonda Conyers, Olasimbo Chiadika, Kristin Varacalli, Sean I Savitz, Jose-Miguel Yamal, Anjail Z Sharrief

Faculty, Staff and Student Publications

Background: Racial and ethnic disparities in post-stroke blood pressure (BP) control persist, and effective interventions to address post-stroke care inequities are needed. We designed a randomized comparative effectiveness trial to evaluate the Video-based Intervention to Reduce Treatment and Outcome Disparities in Adults Living with Stroke or Transient Ischemic Attack (VIRTUAL) model of care for post-stroke BP reduction.

Methods: The study will enroll 534 stroke survivors in a randomized trial to receive either the VIRTUAL intervention or enhanced standard care. Individuals with ischemic stroke, hemorrhagic stroke, or transient ischemic attack (TIA) are enrolled before hospital discharge and randomized (1:1) to VIRTUAL …

Cognitive Impairment In Adult Attention Deficit Hyperactivity Disorder: Clinical Implications And Novel Treatment Strategies, Alexis J. Vega, Gabriel V. Hernandez, Ahmed I. Anwar, Bahareh Sharafi, Rahib K. Islam, Sahar Shekoohi, Alan D. Kaye

School of Medicine Faculty Publications

Attention Deficit Hyperactivity Disorder (ADHD) is a lifelong condition; however, traditional treatment focuses on hyperactivity and inattention, which is largely a manifestation of pediatric ADHD. Studies are limited regarding cognitive difficulties, as seen in adult ADHD, as well as treatment strategies for this population. This review of the literature examines multiple recent studies that discuss various novel treatment strategies for cognitive impairment in adults with ADHD. A targeted literature review was conducted using PubMed to identify recent studies on cognitive dysfunction in adults with ADHD, with an emphasis on emerging treatment strategies. Data collected included sample size, intervention strategies, cognitive …

Shared And Distinct Alterations In Brain Structure Of Youth With Internalizing Or Externalizing Disorders: Findings From The Enigma Antisocial Behavior, Adhd, Mdd, And Anxiety Working Groups, Sophie Townend, Marlene Staginnus, Yidian Gao, Nina Alexander, Volker Arolt, Tobias Banaschewski, Mark A Bellgrove, Vivek Benegal, Robert J Blair, Laura Blanco-Hinojo, Ole Jonas Boeken, Joscha Böhnlein, Sven Bölte, Linda M Bonnekoh, Daniel Brandeis, Rodrigo A Bressan, Fabian Breuer, Willem B Bruin, Jan K Buitelaar, Katie L Burkhouse, Monica E Calkins, Marta Cano, Narcis Cardoner, Hui Chen, Xianliang Chen, David R Coghill, Olivier F Colins, Colm G Connolly, Michael C Craig, Kathryn R Cullen, Udo Dannlowski, Christopher G Davey, Andrea Dietrich, Daifeng Dong, Christine M Freitag, Thomas Frodl, Liesbet Goossens, Dominik Grotegerd, Raquel E Gur, Ruben C Gur, Jan Haavik, Cindy C Hagan, Tim Hahn, Alfons O Hamm, Ben J Harrison, Catharina A Hartman, Martin J Herrmann, Tiffany C Ho, Pieter J Hoekstra, Bharath Holla, Karim Ibrahim, Andrea Jackowski, Hamidreza Jamalabadi, Yali Jiang, Tilo Kircher, Kerstin Konrad, Anna Kraus, Jonna Kuntsi, Till Langhammer, Luisa Lazaro, Elisabeth J Leehr, Ulrike Lueken, Ren Ma, Frank P Macmaster, Gisele G Manfro, Anne Martinelli, Hannah Meinert, Susanne Meinert, Jarosław M Michałowski, Qingsen Ming, Robert Moeck, Lilianne R Mujica-Parodi, Benson Mwangi, Janina Neufeld, Joel T Nigg, Ruth L O'Gorman Tuura, Hyuntaek Oh, Jaap Oosterlaan, Yannis Paloyelis, Pedro M Pan, Luca Passamonti, Wenceslao Peñate, K Luan Phan, Kerstin J Plessen, Jesus Pujol, Karl Lundin Remnélius, Francisco Rivero, Katya Rubia, Ramiro Salas, Giovanni A Salum, Theodore D Satterthwaite, Anne Schienle, Elisabeth Schrammen, Koen R J Schruers, Gunter Schumann, Arjun Sethi, Tim Silk, Norbert Skokauskas, Jordan Smoller, Jair C Soares, Lin Sørensen, Christina Stadler, Michael C Stevens, Benjamin Straube, Thomas Straube, Andreas Ströhle, Gustavo Sudre, Denis G Sukhodolsky, Kate Sully, Xiaoqiang Sun, Chad M Sylvester, Nicola Toschi, Steven J A Van Der Werff, Alasdair Vance, Robert Vermeiren, Albert Wabnegger, Xiaoping Wang, Julia Wendt, Sarah Whittle, Julian Wiemer, Anderson M Winkler, Hans U Wittchen, Mon-Ju Wu, Qiong Wu, Tony T Yang, Yunbo Yang, Shuqiao Yao, Jibiao Zhang, Jiansong Zhou, Andre Zugman, Giovana B Zunta-Soares, Peter M Zwanzger, Sophia I Thomopoulos, Neda Jahanshad, Paul M Thompson, Kevin Hilbert, Arielle Baskin-Sommers, Charlotte A M Cecil, Moji Aghajani, Daniel S Pine, Nic J A Van Der Wee, Dan J Stein, Nynke A Groenewold, Janna Marie Bas-Hoogendam, Laura K M Han, Elena Pozzi, Lianne Schmaal, Barbara Franke, Martine Hoogman, Esther Walton, Stephane A De Brito, Graeme Fairchild, Enigma Antisocial Behavior, Anxiety, Adhd, And Mdd Working Groups

Staff and Researcher Publications

BACKGROUND: Externalizing and internalizing disorders are common in youth but are often studied separately, preventing researchers from identifying shared (i.e., transdiagnostic) alterations in brain structure. Using data from the ENIGMA Consortium, we conducted a mega-analysis to identify shared and distinct cortical and subcortical brain alterations across internalizing (anxiety disorders and depression) and externalizing disorders (attention-deficit/hyperactivity disorder [ADHD] and conduct disorder [CD]) in youth.

METHODS: 3D T1-weighted MRI data from youth (aged 4-21 years) with anxiety disorders (n=1,044), depression (n=504), ADHD (n=1,317), and CD (n=1,172), along with healthy controls (n=4,743) were analyzed. We assessed group differences in regional cortical thickness, surface …

Tracing Sars-Cov-2 Clusters Across Local Scales Using Genomic Data, Leke Lyu, Mandev Gill, Guppy Stott, Sachin Subedi, Cody Dailey, Gabriella Veytsel, Magdy Alabady, Kayo Fujimoto, Ryker Penn, Pamela Brown, Roger Sealy, Justin Bahl

Faculty, Staff and Student Publications

A quantitative understanding of local transmission dynamics is essential for designing effective prevention strategies. In this study, we developed a computational workflow to identify viral introductions and trace locally circulating clusters. We analyzed over 26,000 SARS-CoV-2 genomes and their associated metadata, collected between January and October 2021, to explore introduction and local dispersal patterns in Greater Houston, a major metropolitan area known for its demographic diversity. Our analysis identified more than 1,000 independent introduction events, resulting in clusters of varying sizes. The majority of introductions originated from domestic sources, while international introductions occurred earlier and were associated with larger cluster …

Molecular Inflammatory Expression Profiles Associated With The Frequency Of Pain In Individuals With Sickle Cell Disease, Lana Mucalo Katunaric, Shuang Jia, Ashima Singh, Mark F. Roethle, Julie A. Panepinto, David C. Brousseau, Martin J. Hessner, Amanda M. Brandow

Department of Pediatrics Faculty Papers

Pain is the most common complication of sickle cell disease (SCD). The underlying biology of SCD pain is not well understood, which is a barrier to novel, effective analgesic and preventive therapies. A wide variability in the phenotypic expression of pain exists among individuals with SCD, despite the inheritance of a similar defective hemoglobin gene. This interindividual pain variability further complicates the ability to understand the biology and effectively treat pain. We sought to discover a biological signature comprising differentially expressed genes unique to SCD that could differentiate between individuals with varied pain frequency. We conducted plasma-induced transcription analysis from …

Evidence-Based Intervention Proposal For Reducing Intimate Partner Violence Against Jamaican Women, Kimisha K. Campbell

Walden Dissertations and Doctoral Studies

Domestic violence (DV) is a significant public health concern that negatively impacts women’s health, yet gaps in trauma-informed screening and referral processes persist within nursing practice. In Jamaica, DV remains underreported, highlighting the need for enhanced provider competency in identifying and supporting survivors. The doctoral project was used to examine how implementing the trauma-informed care (TIC) model and the Identification and Referral to Improve Safety (IRIS) program could improve healthcare staff’s ability to recognize, assess, and support DV survivors. Guided by the TIC framework and the IRIS program, a mixed-methods approach was used, incorporating pre- and posttraining assessments, staff surveys, …

Extracellular Vesicles For Clinical Diagnostics: From Bulk Measurements To Single-Vesicle Analysis, Hai Linh Tran, Wenshu Zheng, David A Issadore, Hyungsoon Im, Yoon-Kyoung Cho, Yuanqing Zhang, Dingbin Liu, Yang Liu, Bo Li, Fei Liu, David Tai Wai Wong, Jiashu Sun, Kun Qian, Mei He, Meihua Wan, Yong Zeng, Ke Cheng, Tony Jun Huang, Daniel T Chiu, Luke P Lee, Lei Zheng, Andrew K Godwin, Raghu Kalluri, Steven A Soper, Tony Y Hu

Faculty, Staff and Student Publications

Extracellular vesicles (EVs) play a crucial role in intercellular communication, signaling pathways, and disease pathogenesis by transporting biomolecules such as DNA, RNA, proteins, and lipids derived from their cells of origin, and they have demonstrated substantial potential in clinical applications. Their clinical significance underscores the need for sensitive methods to fully harness their diagnostic potential. In this comprehensive review, we explore EV heterogeneity related to biogenesis, structure, content, origin, sample type, and function roles; the use of EVs as disease biomarkers; and the evolving landscape of EV measurement for clinical diagnostics, highlighting the progression from bulk measurement to single vesicle …

Assessing The Muc5b Promoter Variant In A Large Cohort Of Systemic Sclerosis-Associated Interstitial Lung Disease, Carlos Rosa-Baez, Carlos Rangel-Pelaez, Inmaculada Rodriguez-Martin, Martin Kerick, Alfredo Guillen-Del-Castillo, Carmen P Simeon-Aznar, José Luis Callejas, Alexandre E Voskuyl, Alexander Kreuter, Oliver Distler, Susanna M Proudman, Mandana Nikpour, Nicolas Hunzelmann, Jeska K De Vries-Bouwstra, Ariane L Herrick, Yannick Allanore, Lorenzo Beretta, Maureen D Mayes, Christopher P Denton, Shervin Assassi, Javier Martin, Marialbert Acosta-Herrera

Faculty, Staff and Student Publications

Objective: The common gain-of-function variant rs35705950, located in the promoter of MUC5B gene, has been strongly associated with interstitial lung diseases (ILDs) of different aetiology, such as idiopathic pulmonary fibrosis (IPF) and rheumatoid arthritis-associated ILD (RA-ILD). In this study, we aimed to investigate the association of this variant and its nearby single nucleotide polymorphisms (SNPs) in the largest cohort of systemic sclerosis-associated ILD (SSc-ILD) to date.

Methods: Samples were collected from blood/saliva, followed by DNA extraction and genotyping using SNP arrays. Data for rs35705950 and additional 903 variants within 100 Kb were obtained using genomic imputation. Subsequently, we tested their …

Charting New Territory: Ai Applications In Dental Caries Detection From Panoramic Imaging., Man Hung, Daniel Yevseyevich, Milan Khazana, Connor Schwartz, Martin S. Lipsky

Institute on Aging Publications

Dental caries remains a public health concern, and early detection prevents its progression and complications. Panoramic radiographs are essential diagnostic tools, yet the interpretation of panoramic X-rays varies among practitioners. Artificial intelligence (AI) presents a promising approach to enhance diagnostic accuracy in detecting dental caries. This scoping review examines the current literature on the use of AI programs to analyze panoramic radiographs for the diagnosis of dental caries. This scoping review searched PubMed, Scopus, Web of Science, and Dentistry and Oral Sciences Source, adhering to PRISMA guidelines. The review included peer-reviewed, original research published in English that investigated the use …

Advancing Advances, Richard Alweis, Christina Goodermote, Elizabeth Mamo

Advances in Clinical Medical Research and Healthcare Delivery

The editors report on changes coming to the journal, as well as updating the journal DEI metrics for the readership.

Patterns And Implications Of Electronic Messaging Use In Clinical Communication: Insights From A Single-Center Survey., Basil George Verghese, Rupinder Buttar, Prakash Upreti, Kaiwen Zhu, Tamer Salhab Altamimi

Advances in Clinical Medical Research and Healthcare Delivery

Background: Efficient communication in healthcare is critical, significantly impacting patient outcomes. Electronic messaging tools, like Epic Secure Chat, are increasingly integrated into healthcare settings to enhance interactions among professionals. However, the practical implications of these tools on workflow and care quality are underexplored.

Methods: We conducted a comprehensive cross-sectional survey involving 309 healthcare professionals, including hospitalist physicians, advanced practice providers (APPs), and internal medicine residents, to evaluate Epic Secure Chat's usage patterns, satisfaction levels, and communication preferences.

Results: The survey yielded insightful data from 156 complete responses, revealing a notable issue with misdirected messages: 64.1% of hospitalists, 52.6% of residents, …

A Comparative Analysis Of The Accuracy Of Retrieval Augmented Generation Versus Large Language Models For Gout-Related Queries, Samikchhya Keshary Bhandari, Himal Kharel, Zeni Kharel, Prajjwol Bhatta, Mouna Reghis, Ali Mohamed, Eduardo Avalos Sugastti, Chengu Niu

Advances in Clinical Medical Research and Healthcare Delivery

Importance: To better understand ways to improve the answers from large language models by feeding them disease specific guidelines which can potentially act as a clinical decision support tool in the future Objective: To demonstrate the effect of retrieval augmentation on answers related to gout in terms of accuracy, conciseness and unambiguity. Design: Observational. Setting: Virtual experimental setting. Participants: ChatGPT 3.5 and Retrieval augmented generation powered ChatGPT. Exposure: Nine questions derived from the 2020 American College of Rheumatology guidelines on gout. Main outcomes: A zero to two subjective scale to measure the accuracy, conciseness, …

May Thurner Syndrome: Can We Stent It And Forget It ?, Sahej Arora, Asmaa Ahmed, Hafsa Jawaid, Aakriti Jain, Stephen Silver

Advances in Clinical Medical Research and Healthcare Delivery

Background: May-Thurner Syndrome (MTS) is a cause of venous obstruction and acute Deep Vein Thrombosis (DVT) in young females, due to extrinsic venous compression of left ilio-caval venous territory. It generally presents with unilateral lower limb swelling and DVT and long-term management requires endovascular stenting with anticoagulation. Little data is available on long term post-interventional outcomes. Case: A 73-year-old female with MTS, who underwent endovascular stenting of left external and common iliac vein 11 months ago, presented with recurrent symptoms. She had completed almost a year of oral anticoagulation with Eliquis approximately 45 days before presentation. She was found to …

Radiologic Findings Of A Mediastinal Mass With Pleural Fluid Cytologic Analysis: A Case Report Of Recurrent Mantle-Cell Lymphoma, Mark Cwajna, Zaain Ahmad, Evan Basha, Emily Maggioncalda, Shehbaz Ahmad, Joel Thompson

Advances in Clinical Medical Research and Healthcare Delivery

This case report details a 69-year-old male who presented with a right-sided pleural effusion and a mediastinal mass that was ultimately identified as recurrent mantle-cell lymphoma, occurring over 20 years after his initial diagnosis. Imaging findings discussed include chest radiograph and chest, abdomen and pelvis computed tomography depicting the mass compressing on various neighboring structures.

Multivalvular Native Valve E. Coli Endocarditis, Madison Baker, Jose Reyes, Natasha Singh, Samir Shah, Rohail A. Baig, Justin Nistico

Advances in Clinical Medical Research and Healthcare Delivery

E. coli is a rare cause of infective endocarditis. This report describes an 81-year-old-woman with a history of aortic stenosis and recurrent urinary tract infections who presented in sepsis secondary to E. coli urinary tract infection which was complicated by multivalvular infective endocarditis of the aortic and tricuspid native valves identified on transesophageal echocardiogram (TEE). The patient was managed medically with ceftriaxone, and resolution of both vegetations was seen on TEE without the need for cardiothoracic surgery. Literature review did not yield prior cases of multivalvular E. coli endocarditis.

Ketamine As A Novel Treatment For Bipolar Disorder: Efficacy, Safety, And Future Directions, Sophia M. Valerino

Advances in Clinical Medical Research and Healthcare Delivery

Bipolar disorder is a complex mood disorder characterized by alternating episodes of depression and mania/hypomania, affecting approximately seven million people in the United States. Current pharmacological treatments include lithium, anticonvulsants, and second-generation antipsychotics, but these medications are often associated with significant side effects and poor adherence. Ketamine, a noncompetitive NMDA antagonist, has recently gained attention as a potential treatment for bipolar disorder due to its rapid antidepressant effects, particularly in treatment-resistant mood disorders. This article examines the therapeutic potential of ketamine for bipolar disorder, focusing on its mechanism of action and efficacy. Clinical studies have shown promising results, with ketamine …

Appropriate Application Of Cardiac Telemetry Monitoring: A Quality Improvement Initiative, Muhammad H. Sharif, Abdullah A. Orakzai, Nauman Naeem, Omofolarin Babayale, Basil George Verghese

Advances in Clinical Medical Research and Healthcare Delivery

Background: Telemetry is an important clinical tool but it can be overutilized and leads to a higher cost of patient care and negative patient experience. We conducted this study to assess the effectiveness of our educational intervention in reducing inappropriate use of telemetry and to determine if there is any difference between the two types of educational interventions.

Methods: We conducted a retrospective in-patient study that included all non-ICU patients admitted on a randomly selected mid-week day at our hospital. A 2-step educational intervention was used separated by a 5-week period. The first, a PowerPoint presentation regarding the updated 2017 …

Integrating Clinical History, Imaging, And Serologic Testing For The Accurate Diagnosis Of Neurocysticercosis: A Case Report, Jedediah Bondy, Paul Dobria, Dillon Woody, Bryan Scott

Advances in Clinical Medical Research and Healthcare Delivery

Neurocysticercosis is a parasitic infection caused by the cestode Taenia solium, in which pigs serve as the definitive hosts. Humans can become accidental intermediate hosts through the ingestion of food contaminated with Taenia solium eggs via fecal-oral transmission. Once ingested, the eggs of Taenia solium hatch into larvae, which then migrate through the bloodstream and disseminate across various organs, including the central nervous system (CNS). In this case, a 40-year-old male from Mexico with a known history of seizure disorder presented to the emergency department with altered mental status. He had been told by a physician in his native …