Medicine and Health Sciences Commons^™

Total Aortic Arch Replacement Using The Thoraflex Hybrid Device: Evolution From Investigational To Federally Approved Use In The United States, Vicente Orozco-Sevilla, Joseph S Coselli, Susan Y Green, Veronica A Glover, Ricardo De Jesus Avendaño Garnica, Anna H Xue, Lauren K Barron, Marc R Moon

Faculty, Staff and Students Publications

Background: After the US Food and Drug Administration (FDA) approved the Thoraflex Hybrid device in April 2022, hybrid devices to facilitate total arch replacement (TAR) became commercially available in the United States. However, little is known about how the Thoraflex device has been used since then. We present our experience (2016-2025) with this device.

Methods: At our practice, 62 patients [median age, 65 (54-73) years] underwent frozen elephant trunk (FET) TAR with the Thoraflex device: 14 under an investigational device exemption (IDE) (2016-2018) and 48 after FDA approval (2022-2025). Both Ante-Flo (straight) and Plexus (branched) models were used.

Results: Patients …

A Decade-Wide View Into Medical Student Professional Identity Formation Using The Career Eulogy: Are Gen Zs Different?, William J. Crump Md, Kristin L. Wickham Md, Craig Ziegler Phd, Nicholas T. Duncan Mba, Mph

Marshall Journal of Medicine

Introduction

Students born after 1996 (Gen Z) perceive themselves as distinct from millennials. Earlier surveys described Gen Z as valuing relationships, meaningful work, financial security, and happiness. Over the past decade, medical school populations have shifted from predominantly millennial to Gen Z. This study examined changes in professional identity formation across this period, using a validated career eulogy instrument.

Methods

From 2015 to 2024, 113 medical students at a rural regional medical school completed an annual career eulogy (98% participation). Students responded to the prompt: “Imagine you are retiring from medicine. In about 50 words, what would you like to …

The Glymphatic System And Sleep: Functional Relevance For Brain Homeostasis And Beyond, David Gozal

Marshall Journal of Medicine

It has been less than 15 years since the glymphatic system was identified. The discovery has revolutionized the understanding of the unique functions of cerebrospinal fluid (CSF) and the extracellular fluid within the central nervous system (CNS) and their unique connectivity to the rest of the body. The role of sleep in regulating glymphatic clearance from the brain and the potential reciprocal role of the glymphatic system in modulating regional neuronal activities, including sleep states, is rapidly emerging. It is shedding light on the role of sleep and the glymphatic system as toxic waste clearance facilitators for the brain, revealing …

Unusual Wave Morphologies In Ulnar Neuropathy With Marinacci Anastomosis: A Case Report, Micaela Owens

Marshall Journal of Medicine

Marinacci anastomosis is a normal but rare anatomic variant of the median and ulnar nerves, consisting of an interconnection from the ulnar nerve to the median nerve within the proximal forearm. This is a case of Marinacci anastomosis occurring in the presence of both median and ulnar neuropathies, producing unusual waveform characteristics. Knowledge of normal anatomic variation can improve diagnostic accuracy in nerve conduction studies.

Ruptured Internal Mammary Artery Perforator After Reduction Mammoplasty: A Case Report, Carol Wright Becker, Abigail Roop, Daniel Sutphin, Roger Tillotson

Marshall Journal of Medicine

A 60-year-old female who was 10 days post-reduction mammoplasty presented to the emergency department due to the sudden onset of swelling and pain in her left breast. A contrast-enhanced CT scan of the chest revealed active arterial bleeding. The patient was emergently taken to the operating room, where she underwent evacuation of a large hematoma as well as ligation of a left internal mammary perforator artery. This case represents a rare occurrence of life-threatening postoperative bleeding into the chest wall/breast after reduction mammoplasty, which developed 10 days postoperatively. The successful outcome and complete recovery were attributed to the timely recognition …

Use Of Naltrexone For Treating Binge Eating And Food Obsession Related To Trauma: A Case Report And Literature Review, Rebecca K. Hicks, Iram Kingson, Jordan Gaal, Suzanne Holroyd

Marshall Journal of Medicine

Impulse-control disorders, including those related to eating behaviors, are complex conditions with limited pharmacologic treatment options. While naltrexone is primarily used for opioid and alcohol dependence, emerging research suggests it may also be effective in managing a variety of impulse-driven conditions. As a pure opioid antagonist, naltrexone’s mechanism of action involves the inhibition of opioid receptors on dopaminergic neurons involved in the reward pathway of the brain, thereby reducing the reinforcing effects of substances such as alcohol and opioids. Research suggests that through this mechanism of action, naltrexone shows promise in treating impulsive behaviors also driven by the reward pathway, …

Potential Impact Of Artificial Intelligence In Cardiovascular Medicine, Katherine Konczak, Elizabeth G. Dieter, Robert S. Dieter Ii, Robert S. Dieter Md, Rvt, Alm, Aravinda Nanjundappa Md

Marshall Journal of Medicine

Artificial intelligence (AI), particularly machine learning (ML), is increasingly transforming cardiovascular medicine by enhancing diagnostic accuracy, imaging analysis, risk prediction, and treatment planning. AI applications in imaging, such as echocardiography, cardiac computed tomography (CT), and magnetic resonance imaging (MRI), improve detection, automate measurements, and reduce variability. Deep learning models interpret electrocardiograms (ECGs) with high accuracy in electrophysiology, aiding early diagnosis of arrhythmias and inherited syndromes. In cardio-oncology, AI identifies cardiovascular risk markers in cancer patients and monitors therapy-related cardiotoxicity. AI-driven tools also support real-time procedural guidance and individualized therapy using electronic health records and imaging data. Despite promising outcomes, concerns …

Will There Be A Pill For That? ‘Money Dysmorphia’ And The Medicalization Of Struggles For Subsistence, Bojan Savic

Emancipations: A Journal of Critical Social Analysis

This article questions the rationality, operation, and effects of money dysmorphia as an emerging mental health diagnosis. It critiques the medicalization of financial angst amid the capitalist “polycrisis”, showing how the individuation and somatic pathologization of class subordination, socioeconomic precarity, and struggles for subsistence obscure capitalist inequalities, depoliticize them, and shield them from critique. I identify five concurrent strategies through which struggles for subsistence are medicalized: trivialization, reversal of social import, repetition, direct depoliticization, and the substitution of inequality with poverty. Furthermore, I show how the medicalizing discourse reifies money dysmorphia by constructing its social costs. The article concludes by …

Nsu Otd Peer Mentoring Program: Improving Otd Student Knowledge And Professionalism, Mckinley Rivas

Department of Occupational Therapy Entry-Level Capstone Projects

No abstract provided.

Enhancing Education, Awareness, And Resources Related To Aging In Place For Older Adults And Stakeholders Within Community-Based Care, Nevaria M. Rumery

Department of Occupational Therapy Entry-Level Capstone Projects

No abstract provided.

Cuerpos Que Hablan. Sensibilización Sobre La Violencia Ginecológica Y Obstétrica, Yamile Vargas Hernández, Carlota Castro Quintana, Sara Milena Niño Montero, Fabián Andrés Casallas Rojas

Ciencias de la Salud

Cuerpos que hablan. Sensibilización sobre la violencia ginecológica y obstétrica surge como producto de la investigación “Adaptación de la escala de la violencia obstétrica en la ruta integral de atención en salud, para la población materno perinatal colombiana” —avalada por la Universidad de Cundinamarca—, en la que participaron docentes o gestores del conocimiento y el aprendizaje de los programas de Psicología y de Enfermería, asociados a la Facultad de Ciencias de la Salud. Asimismo, pretende ser una herramienta para visibilizar la violencia ginecológica y obstétrica y mitigarla en el contexto colombiano. Es importante señalar que la información aquí consignada fue …

Sex-Dependent Differences In Cardiac Function And Strain In Doxorubicin-Induced Cardiomyopathy, Anna J. A. Webb, Bea O. Cabot, Aasish Chowdary, Wilhelm S. Smith, Benjamin Zeidler, Cortland H. Johns, Craig J. Goergen

Discovery Undergraduate Interdisciplinary Research Internship

Doxorubicin is a chemotherapeutic agent used to treat many types of cancer. While effective, doxorubicin can cause cardiomyopathy, a disease affecting the heart muscle. Although the effects of doxorubicin on the heart are well studied, the mechanisms leading to cardiomyopathy are not well understood. Previous studies have used murine models to study the cardiotoxicity of doxorubicin. These reports showed that cardiac dysfunction is more pronounced in male compared to female mice. The goal of this study is to further evaluate sex differences in doxorubicin induced cardiomyopathy using 4-dimensional strain mapping techniques. In this study, both female and male C57Bl/6J mice …

Open Field Two-Texture Preference Testing Is Not Associated With The Neuropathic Pain-Like Phenotype That Occurs Following Mouse Cervical Contusion Spinal Cord Injury, David A. Jaffe, Megan A. Lyttle, Angelo C. Lepore

Farber Institute for Neuroscience Faculty Papers

Development of neuropathic pain (NP) is one of the major complications associated with spinal cord injury (SCI). While well-established methods such as von Frey mechanical and facial grimace testing are often used to assess SCI-induced NP-like behaviors in animal models, these assays have significant limitations, including experimenter bias and long periods of active testing and analysis. To address these challenges, we aimed to develop a novel open field 2-texture preference test (TTPT) to assess NP-like behaviors following unilateral C5 hemicontusion SCI in mice. To do so, we modified the open field apparatus by introducing both a rough and a smooth …

Ctnna3 Deficiency Promotes Heart Regeneration By Enhancing Cardiomyocyte Proliferation In Neonatal Mice, Sha Zou, Wuhou Dai, Wufan Tao, Jifen Li, Zeyi Cheng, Hongyan Wang

Department of Medicine Faculty Papers

Background: Heart regeneration requires renewal of lost cardiomyocytes. However, the mammalian heart loses its proliferative capacity soon after birth, and the molecular signaling underlying the loss of cardiac proliferation postnatally is not fully understood.

Purpose: This study aimed to investigate the role of Catenin alpha 3 (Ctnna3), coding for alpha T catenin (αT-catenin) protein in regulating cardiomyocyte proliferation and heart regeneration during the neonatal period.

Methods: Here we report that ablation of Ctnna3 and highly expressed in hearts, accelerated heart regeneration following heart apex resection in neonatal mice.

Results: Our results show that Ctnna3 deficiency enhances cardiomyocyte proliferation …

Implications Of Palliative Care Education Amongst Critical Care Nurses And Applicable Screening Criteria For Consultation, Paiten Rask

DNP Projects

Background:
Palliative care is underutilized and/or consulted too late in the patient stay to provide optimal benefits to patients and families. There is a gap in nursing knowledge and confidence surrounding the topic of palliative care and the ability to advocate for specialty involvement for patients.

Objectives:
This project's purpose is to educate registered nurses in critical care about palliative care and introduce the idea of an objective palliative care screening tool. The project involved implementation of pre and post-test analysis of knowledge and confidence following a presentation of educational content. The content also included mock patient scenarios that require …

Implementing A Standardized Education Program To Enhance Nurses' Utilization Of Virtual Nurse Support, Emma Steck

DNP Projects

The rapid expansion of telehealth and virtual nursing support necessitates the development of standardized education programs to optimize the utilization of virtual support systems. This quality improvement project aimed to address the problem of inconsistent and outdated orientation methods for hospital nurses working with virtual registered nurse (ViRN) support staff at a large Midwest hospital. The project engaged over 800 nursing staff across more than 30 inpatient care units, with a focused pilot conducted on three intervention units. The intervention involved the development of an online learning module designed to standardize training and improve utilization of ViRN support. Utilizing the …

Dosimetric Comparisons Of 6mv, 6fff, 10mv, And 10fff On Vmat Planning In Patients With Endometrial Cancer, Madisin M. Depas

Masters Projects

Purpose: This study aimed to evaluate the dosimetric and efficiency impacts of different photon beam energies—6MV, 6 flattening filter free (FFF), 10MV, and 10FFF—on volumetric modulated arc therapy (VMAT) plans for endometrial cancer, with attention to target coverage, organ at risk (OAR) sparing, and treatment efficiency.

Methods: A retrospective analysis was conducted on 25 patients with post-hysterectomy endometrial cancer. Each patient received four VMAT plans with varying energies. Planning metrics assessed included planning target volume (PTV) dose maximum (Dmax), conformity index (CI), heterogeneity index (HI), OAR doses (bladder, bowel, rectum), and total monitor units (MU). Correlations were drawn …

Precision Medicine And Beyond: Evolving Roles Of Targeted Therapy, Immunotherapy, And Artificial Intelligence In Oncology, Linwei Li, Anika Doppalapudi, Jennifer Escamilla, Annu Karithara, Christine Pham, Angel Phillip, Sriya Gullapalli, Lois Baldado, Arjun Bellamkonda, Daniela Gonzalez, Amin Ibrahim, David Sta. Maria, Kaitlyn Ybanez, Hugo Zamarron, Shizue Mito

School of Medicine Publications

Precision medicine in oncology is an evolving therapeutic approach that leverages genetic, clinical, and biomarker data to tailor treatments to individual patients. This review explores the three core pillars of modern precision oncology: targeted therapy, immunotherapy, and the integration of artificial intelligence (AI) into clinical practice. Targeted therapies, including monoclonal antibodies and antibody-drug conjugates, selectively inhibit molecular pathways involved in tumor growth. While conventional chemotherapy remains the backbone of treatment and has improved remission rates, its cytotoxic nature limits broader applicability and increases the risk of comorbidities. Immunotherapies, particularly immune checkpoint inhibitors and chimeric antigen receptor T-cell therapies, have transformed …

In Vitro Α-Glucosidase Enzyme Inhibition Activity Test Of Water Extract From Sintok (Cinnamomum Sintoc Blume) Bark, Astrella Amanda Putri Saksono, Inana Ratu Soripada Simanjuntak, Mariana Wahjudi, Marisca Evalina Gondokesumo

Pharmaceutical Sciences and Research

Diabetes mellitus is a condition characterized by elevated blood glucose levels beyond the normal limits. One therapeutic approach for managing diabetes mellitus involves inhibiting the α-glucosidase enzyme, which plays a role in glucose absorption in the body. However, the use of oral antidiabetic drugs from the α-glucosidase inhibitor class often causes gastrointestinal side effects. Therefore, exploring natural materials as alternative treatments is a promising option. In Indonesia, one plant with potential as an alternative treatment is sintok (Cinnamomum sintoc Blume), a member of the Cinnamomum genus, which is widely utilized in traditional medicine for chronic diseases such as …

Gastroprotective Potential Of Medicinal Plant From Central Kalimantan: Sungkai Leaves (Peronema Canescens Jack)-Ultrasonic Assisted Extraction In Rats Induced With Absolute Ethanol, Dilasari Savitri, Elsa Trinovita, Ratna Widayati, Septi Handayani, Sintha Nugrahini

Pharmaceutical Sciences and Research

Peptic ulcer disease is a gastrointestinal disorder associated with significant morbidity and mortality. Enhancing the quality of life of patients with peptic ulcers often involves integrating conventional treatments with complementary alternative therapies. One such alternative therapy is herbal remedies, which local communities have long recognized. Sungkai leaves (Peronema canescens Jack) contain various bioactive components, including flavonoids, alkaloids, saponins, tannins, steroids, and phenolic compounds. This study aimed to assess the gastroprotective properties of sungkai leaf extract (Peronema canescens Jack) by analyzing the average size of gastric lesions in male Wistar rats exposed to absolute ethanol. The research used a …

Método Para La Enseñanza Del Cuidado En Enfermería. Competencia En Práctica Basada En La Evidencia, Adriana Hernández Bustos, María Victoria Rojas Martínez

Ciencias de la Salud

Método para la enseñanza del cuidado en enfermería. Competencia en práctica basada en la evidencia es un libro resultado de un proyecto de investigación multicéntrico desarrollado en Colombia, cuyo objetivo fue analizar el nivel de conocimiento, actitudes y habilidades sobre la Práctica Basada en la Evidencia (PBE) en estudiantes de programas de Enfermería de diferentes regiones del país. Esta obra colectiva surge en respuesta a la necesidad de consolidar la formación en competencias PBE desde el pregrado, reconociendo que el ejercicio profesional en enfermería debe estar fundamentado en el uso sistemático y crítico de la evidencia científica, en armonía con …

Effects Of Liver Surgery On Drug Transporters In The Liver And Remote Organs, Reza Mehvar

Pharmacy Faculty Articles and Research

Alterations in drug transporters in acute liver failure and chronic liver diseases, such as cirrhosis, have been reviewed before. However, there is a lack of comprehensive reviews on how liver surgery, including transplantation and partial hepatectomy, affects drug transporters. Because ischemia–reperfusion (IR) injury is a hallmark of liver transplantation and most other surgical procedures of the liver, this review focuses on the effects of IR injury, in addition to liver resection, on the expression and function of transporters in the liver and remote organs. Most of the reported studies in this area are carried out in animal models of liver …

The Processes That Contribute To Readiness To Learn For An Accelerated Nursing Graduate: A Grounded Theory Study, Kaye A.L. Whyte

Theses & Dissertations

The worldwide nursing shortage has led to maintaining an adequate nursing workforce as a global challenge. Increased recruitment efforts have fostered changes to some educational programs, giving rise to the proliferation of Accelerated Nursing Programs (ACCEL). These accelerated nursing programs are a highly successful way of educating future registered nurses, leading to concerns by registered nurses, hospital administrators, and nursing faculty who question the transitional competence of graduates from Accelerated Nursing Programs. The purpose of this study was to understand the transition processes for accelerated nursing graduates. The intended impact of this research was important to nursing for two reasons: …

A Workplace Posture Initiative To Reduce Work-Related Musculoskeletal Disorders, Carrie Isaac

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Work-related musculoskeletal disorders (WRMSDs) are a leading cause of occupational injury and discomfort in industrial workplaces. Although an ergonomic program existed at the project site, a formalized process to detect postural misalignments early had not been established. Relying on employee self-reporting, delayed intervention, and limited opportunities to prevent injuries before they progress.

Aim of the Project: A proactive posture screening program using PostureScreen® was implemented to identify postural deviations that could contribute to WRMSDs. Emphasis was placed on supporting employees through early awareness of posture-related issues and evaluation of alignment improvements following individualized intervention.

Review of the Evidence: Evidence …

Integrating Circulating Tumor Dna Into Clinical Management Of Colorectal Cancer: Practical Implications And Therapeutic Challenges, Nikhil Vojjala, Viktoriya Gibatova, Raj N Shah, Sakshi Singal, Rishab Prabhu, Geetha Krishnamoorthy, Karen Riggins, Nagaishwarya Moka

Faculty, Staff and Students Publications

The American Cancer Society estimates that over 152,000 new cases of colorectal cancer (CRC) were diagnosed in 2024, with more than 105,000 cases affecting the colon and 46,000 involving the rectum. CRC remains the second leading cause of cancer-related deaths in the United States, with an estimated 53,010 deaths in 2024. In the era of precision medicine, which incorporates molecular and environmental information into clinical decision-making, identifying patients harboring a deficiency in Deoxyribonucleic acid (DNA) repair allowed for targeted immunotherapies and significantly reduced CRC-related mortality. A significant advancement in this domain is the application of liquid biopsy, which has emerged …

Systematic Review Of Parkinsonism In Cerebrotendinous Xanthomatosis, Jennifer Hanson, Penelope E Bonnen

Faculty, Staff and Students Publications

Background: Cerebrotendinous Xanthomatosis (CTX) is a rare, inherited metabolic disease caused by pathogenic variants in CYP27A1. The clinical presentation of this progressive disease includes cognitive deficits, ataxia, peripheral neuropathy, and pyramidal signs, as well as bilateral cataracts and tendon xanthomas. In some cases, CTX also includes parkinsonism. The goals of this study are to develop a data source that provides improved characterization and awareness of parkinsonism in CTX.

Methods: We conducted a systematic review of the literature according to PRISMA guidelines to identify all published individuals diagnosed with CTX and parkinsonism. Clinical signs, imaging findings and treatment response to …

In Pursuit Of A Better Hospital Quality Metric For Medicare, Brad Wright Ph.D.

Faculty Publications

No abstract provided.

Central Lines And Peripherally Inserted Central Line Reeducation, Monica Lyn Gallik

Walden Dissertations and Doctoral Studies

Objective: Will a central line and peripherally inserted central line reeducation program increase the nurses’ knowledge pertaining to dressing changes, cap changes, and chlorohexidine baths? Method: 26 nurses on an observation unit were sent a power point presentation. Of the 26 nurses that received the power point 18 nurses participated. The power point presentation had a pretest and posttest embedded into it. Both the pretest and posttest consist3ed of the same 10 questions. The average of the pretest and posttest were used to calculate the normalized learning gained. Results: The average pretest score was 60, the average posttest score was …

Assessment Of Total Cardiovascular Risk Using Who/Ish Risk Prediction Chart Among Adults In Rural Areas Of Mysuru: A Cross-Sectional Study, Anchu R Nath, Amogha Shree, Rashmi S, Shweta N K, Deepshika R, Sunil Kumar D

Digital Journal of Clinical Medicine

Background:

Cardiovascular diseases (CVDs) are a leading cause of morbidity and mortality in rural India, where preventive healthcare infrastructure remains underdeveloped. Myocardial infarction and stroke are among the deadly events that are caused by a combination of risk factors that are present in the majority of cardiovascular diseases (CVD). This study aimed to estimate the 10-year CVD risk among adults in rural Mysuru using the WHO/ISH risk prediction charts, a practical tool designed for low-resource settings.

Methodology:

This community-based cross-sectional study was conducted over three months (January 2025- March 2025), involving 172 study participants from the rural field practice area …

Staff Education On Culturally Tailored Hispanic Diabetes Management In A Primary Care Community Clinic, Robyn Elizabeth Reeves

Walden Dissertations and Doctoral Studies

The Hispanic population is the fastest-growing ethnic minority in the United States, and they have a 66% chance of developing Type 2 diabetes mellitus (T2DM). Less than half of Hispanic patients with diabetes achieve optimal glycemic control due to cultural barriers and dietary issues. At the project site, a primary care practice in the southeastern United States regarding cultural competency training in diabetes management for Hispanics was identified. The practice-focused question was: Does providing education to primary care staff improve their knowledge of diabetes management among Hispanic patients with diabetes, as evidenced by pre- and post-surveys? In the project, I …