Medicine and Health Sciences Commons^™

Emergency Department Utilization For Educational Prioritization For Children By Levels Of Community Advantage, Katherine Randolph, Chris Kennedy, Jennifer Watts, Matt Hall

Research Days

Background: Children with higher social deprivation have higher emergency department (ED) utilization. The Childhood Opportunity Index (COI) is a validated multidimensional measure of community advantage which includes access to resources and healthy neighborhood factors. Educational priorities are frequently not tied to risk data.

Objective: This study aimed to identify zip codes with higher-than-expected ED utilization by diagnoses to prioritize the development of educational initiatives for hospitals, emergency medical services, pediatrician offices, and the community.

Methods: We performed a population-based study of children aged 0-17 years who presented to an ED in Kansas or Missouri in 2023 using census data via …

Variables Affecting Neurodevelopmental Outcome In Infants With Critical Congenital Heart Disease, Elizabeth Loughman, Julie Weiner Do, Marcie Files Md

Research Days

Background: The mortality of cardiac conditions in infancy is improving with advances in surgical planning and medical management. Neurologic morbidity remains significant. Clinically correlating an infant with their neurologic exam, MRI/EEG, and subsequent developmental testing remains a challenge. Counseling regarding neurologic outcomes after cardiac intervention is difficult due to the wide range of findings that can sometimes be clinically irrelevant.

Purpose: The goal of this study is to identify factors associated with poor neurodevelopmental outcomes in infants with critical congenital heart defects (CCHD) as assessed by the Bayley Scales of Infant and Toddler Development Edition IV (Bayley).

Methods: This is …

Implementation Of A Weaning Protocol For Inhaled Nitric Oxide In A Level Iv Neonatal Intensive Care Unit, Elizabeth Loughman, Julie Weiner Do, Maryam El Tawil, Chris Nitkin Md

Research Days

Background: Decrease time to begin iNO weaning from 13 hours to 9.75 hours by 31 December 2024 in patients with persistent pulmonary hypertension of the newborn (PPHN).

Methods: Countermeasures include (1) provider education at each disciplinary level, (2) badge reminder cards and laminated copies of the protocol available at the bedside, (3) order set modifications, (4) abnormality tracking at huddles. Data collection will be automated through weekly Business Objects report. The main outcome measure will be time to first wean of iNO after meeting protocol criteria. Feedback regarding the ease of weaning will be generated via Gemba Rounds.

Results: These …

Preferred And Actual Place Of Death To Assess Goal Concordant End Of Life Care For Children With Cancer, Amy Johnson Md, Mba, Lisa Tarbell Msn, Rn, Fnp-C, Brooke Fridley Phd, Terrie Flatt Do

Research Days

This study examines disparities in pediatric end-of-life (EOL) cancer care, highlighting socioeconomic and racial inequities in concordance between preferred and actual death locations, ICU deaths, and intensive interventions, with findings emphasizing the need for earlier palliative care integration, proactive preference documentation, and tailored approaches to improve equity and family-centered care.

Effect Of Social Determinants Of Health On Clinic Visit Attendance In Patients With Hemophilia, Shailly Gaur Md, Brian Lee Phd, Mph, James Anderst Md, Msci, Katie Foote Lscsw, Lcsw, Osw-C, Andrea Bradley-Ewing Mpa, Ma, Shannon Carpenter Md

Research Days

Background

Social determinants of health (SDOH) create barriers to seeking care regularly, especially for patients with chronic disease. Patients with moderate-severe hemophilia A and B (factor 8 and 9 deficiencies respectively) have a life-long higher risk of bleeding and require chronic therapies. Specialized care is offered through hemophilia treatment centers (HTCs); however, these can be difficult to access for some individuals. Previous SDOH research in this patient population has been limited; therefore, it can be difficult to identify the barriers to care that exist. There is a need to examine SDOH more thoroughly to create patient-directed interventions to improve access …

Intraspinal Anomalies In Presumed Ais Does Not Increase The Risk Of Intraoperative Neuromonitoring Changes During Posterior Spinal Fusion, Connor Mathes, Bill Woodhams, Aaron Shaw, John Anderson, Michael Benvenuti, Richard Schwend

Research Days

This study aims to identify the association between intraoperative neuromonitoring changes during posterior spinal fusion surgery among patients with adolescent idiopathic scoliosis and those found to have intraspinal anomalies on standard preoperative imaging.

Teen And Young Adult Experiences With Intrauterine Device Placement Under Procedural Sedation: A Pilot Study, Ellen Bryant, Stephani L. Stancil, Anne-Marie Priebe, Andrea Nos, Ashli A. Lawson

Research Days

Intrauterine devices (IUDs) are a reliable method of contraception and menstrual management, but uptake of them, especially in the adolescent population, can be limited by concerns for pain and anxiety during the placement procedure. Pain management plans for IUD insertion are recommended prior to placement, but data regarding multiple modes of analgesia and anxiolysis have shown mixed results. This study is designed as a pilot study to analyze adolescent experiences with IUD placement with sedation, as well as to identify patient characteristics that may be associated with a favorable or unfavorable experience.

Implementation Of An Enhanced Recovery After Surgery Pathway In Adolescent Patients Undergoing Laparoscopic Evaluation Of Endometriosis, Lauren Roth Md, Madeline Ross Md, Todd Glenski Md, Emily Weisberg Md, Ashli Lawson

Research Days

This study evaluates the implementation of an Enhanced Recovery After Surgery (ERAS) pathway for adolescent patients undergoing diagnostic laparoscopy for endometriosis at a tertiary children's hospital. The retrospective reviewed included 53 patients (20 pre-ERAS, 33 post-ERAS) aged 12-20 years old, comparing preoperative compliance, intraoperative adherence, and postoperative outcomes. Findings showed 81% compliance with preoperative medication, 76% received appropriate preoperative medications, and 39% had recommended carbohydrate loading. Intraoperative compliance was 87%, with 61% adherence to postoperative medications. Post-anesthesia care unit (PACU) stay time increased (44 vs 53 minutes, p=0.21), but pain scores, postoperative prescriptions, and hospital readmissions remained unchanged. This study …

Impact Of A Multidisciplinary Clinic On Hormone Replacement Therapy In Adolescents With Turner Syndrome, Madeline Ross, Trisha Patel, Ashli A. Lawson, Joseph Cernich, Tazim Dowlut-Mcelroy

Research Days

Background

Turner Syndrome (TS) is associated with primary ovarian insufficiency (POI). Most adolescents with TS require hormone replacement therapy (HRT).1 International guidelines recommend transdermal estradiol (TDE) as first-line estrogen replacement therapy.1 Care within a multidisciplinary clinic (MDC) has been associated with higher adherence to screening guidelines for metabolic and auditory disorders in TS.2 It is unknown if adherence to guidelines for postpubertal HRT differ for adolescents with TS managed in a MDC compared to those managed outside of a MDC. Our study aimed to compare 1) postpubertal HRT regimen prescribed, and 2) compliance to HRT and menstrual bleeding patterns for …

Analytical Verification Of The Fda Cleared Xpert® Xpress Cov-2 Plus Test For Sars-Cov-2 Detection In Respiratory Specimens, Gabriela M. Henriquez, Neena Kanwar, Rangaraj Selvarangan

Research Days

Introduction

The COVID-19 pandemic, caused by SARS-CoV-2, highlighted severe gaps in broad testing and prompt diagnosis. Rapid real-time RT-PCR assay Xpert® Xpress CoV-2 Plus was developed to enhance SARSCoV-2 detection in respiratory specimens. Using ZeptoMetrix's inactivated organisms, this study seeks to assess its analytical performance and compare its accuracy with current standard of care diagnostic assay.

Methods

The accuracy of the Xpert® Xpress CoV-2 Plus test was evaluated using ZeptoMetrix NATtrol inactivated SARS-CoV-2 organisms diluted with pooled negative nasopharyngeal (NP) swabs. Ten positive and ten negative NP swabs were tested over five days at two sites, with >90% agreement required. …

A Novel Approach To The Management Of Extreme Hypernatremia Using Continuous Kidney Replacement Therapy And Hypertonic Saline, Bahar Barani, Xuexin Lu, Darcy Weidemann, Jenna Miller, Nathan Beins, Judith Vansickle, Vimal Chadha

Research Days

Case series about two patients with severe hypernatremia and kidney failure who were treated with a novel mechanism using continuous dialysis and customized fluids with good outcomes.

Bivalirudin Versus Heparin In Patients With Congenital Diaphragmatic Hernias Requiring Extracorporeal Life Support, Cory Nonnemacher, Seth Saylors, Vatche Melkonian, Richard Hendrickson, Inna Lobeck

Research Days

Introduction

Congenital Diaphragmatic Hernia (CDH) is a rare congenital anomaly. The pulmonary hypoplasia, pulmonary hypertension and altered cardiac function associated with CDH may result in early cardiorespiratory failure requiring life-saving extracorporeal life support (ECLS). Early repair of CDH on ECLS has shown to improve survival, but poses an increased bleeding risk due to anticoagulation. Heparin has traditionally been the anticoagulant of choice for ECLS. Recent data has suggested that the use of bivalirudin may result in lower bleeding rates and transfusion requirements. This study aims to stratify complications for patients with CDH repaired on heparin versus bivalirudin, hypothesizing that complications …

Spinal Deformity Characteristics Associated With Intraspinal Anomalies In A Population Of Presumed Ais, Connor Mathes, Aaron Shaw, Bill Woodhams, John Anderson, Michael Benvenuti, Richard Schwend

Research Days

This study aims to identify an association between pre-operative radiographic criterion and the presence of an underlying intraspinal anomaly in patients presenting with presumed adolescent idiopathic scoliosis undergoing posterior spinal fusion.

Adherence To Oral Iron In Adolescent Females With Iron Deficiency Secondary To Heavy Menstrual Bleeding, Kennedy Sheedy, Lauren Amos Md, Ms

Research Days

Iron deficiency is an important, but often minimized issue among adolescent females. While treat with oral iron is generally first-line treatment, IV iron has been shown to be safe and effective. Our study looks at adherence and barriers to oral iron treatment and assesses current use of IV iron for iron deficiency at Children's Mercy, in hopes of helping move towards utilizing the most beneficial treatment for each individual patient.

Teaming Up For Better Health: An Interprofessional Collaborative Approach To Older Adult Oral Care, Deborah Dowd, Jodie Lopez, Jennifer Goodman

Utah Conference on Community Engagement

Oral health is a critical component of overall health, significantly influencing systemic diseases and the quality of life in older adults. Conditions such as xerostomia, swallowing difficulties, and poor oral self-care are associated with aspiration pneumonia. Integrating oral health into healthcare in long-term care facilities (LTCFs) is essential for preventing various conditions and improving quality of life. Effective oral hygiene is crucial in avoiding non-ventilator hospital-associated pneumonia by reducing oral biofilm and lowering the risk of pneumonia. Nurses' knowledge and care in oral health across healthcare settings are vital for positive health outcomes. Revising nursing curricula to incorporate oral health …

A Comparative Evaluation Of Local And Imported Ciprofloxacin Tablets Marketed In Yemen, Tareq Maqlam, Abdullah H Maad

Al-Ameed Journal for Medical Research and Health Sciences

Ciprofloxacin is one of the most common antibacterial drugs used mainly for gastrointestinal and urinary tract infections. This study aimed to compare the quality specifications of two Yemeni ciprofloxacin hydrochloride tablet products with two non-Yemeni brands. Samples were randomly selected from different batch numbers and subjected to physicochemical testing in accordance with pharmacopeial monographs. Additionally, microbiological susceptibility testing was performed against Staphylococcus aureus and Escherichia coli. All tested products complied with pharmacopoeial standards for weight uniformity (Escherichia coli and Staphylococcus aureus, with brand D demonstrating the highest activity. These findings suggest that Yemeni ciprofloxacin tablets meet quality standards …

Sedentary Behavior And Light-Intensity Physical Activity During Pregnancy And Cardiovascular Health: A Science Advisory From The American Heart Association, Kara H. Whitaker, Bethany Barone Gibbs, Marie-France Hivert, Nour Makarem, Elizabeth Moxley, Jason Vaught, Kelly R. Evenson

Faculty Scholarship-Nursing

The Physical Activity Guidelines for Americans supports sitting less and moving more. Growing evidence suggests that a waking behavior profile with less sedentary behavior and more light-intensity physical activity is associated with more favorable cardiovascular health. Remarkably, little is known about how these behaviors relate to cardiovascular health during pregnancy. The purpose of this American Heart Association science advisory is to describe the existing evidence on devicemeasured sedentary behavior and light-intensity physical activity in relation to cardiovascular health during pregnancy and to make specific calls to action for future research to improve health outcomes and to promote health equity. Outcomes …

Can Flywheel Training Serve As A Viable Intervention For Dynamic Strength Index Based Programs?, Jeffrey Ruiz

Doctorate in Kinesiology

The purpose of this case series was to examine the effects that flywheel training had on a person’s dynamic strength index in comparison to concurrent training (DSI). It has been shown that with strength training alone there can be an overall decrease in the DSI, due to an increase the IMTP peak force and no significant change in the CMJ performance (Comfort et al., 2018). Flywheel training’s effect on the DSI specifically have not been previously examined. It was hypothesized that a regimented flywheel training intervention will demonstrate an

improvement in the peak force for the countermovement jumps as well …

Integrating Artificial Intelligence In Orthopedic Care: Advancements In Bone Care And Future Directions, Rahul Kumar, Kyle Sporn, Joshua Ong, Ethan Waisberg, Phani Paladugu, Swapna Vaja, Tamer Hage, Tejas C. Sekhar, Amar S. Vadhera, Alex Ngo, Nasif Zaman, Alireza Tavakkoli, Mouayad Masalkhi

SKMC Student Presentations and Publications

Artificial intelligence (AI) is revolutionizing the field of orthopedic bioengineering by increasing diagnostic accuracy and surgical precision and improving patient outcomes. This review highlights using AI for orthopedics in preoperative planning, intraoperative robotics, smart implants, and bone regeneration. AI-powered imaging, automated 3D anatomical modeling, and robotic-assisted surgery have dramatically changed orthopedic practices. AI has improved surgical planning by enhancing complex image interpretation and providing augmented reality guidance to create highly accurate surgical strategies. Intraoperatively, robotic-assisted surgeries enhance accuracy and reduce human error while minimizing invasiveness. AI-powered smart implant sensors allow for in vivo monitoring, early complication detection, and individualized rehabilitation. …

The Nicu Nurse’S Aptitude In Teaching Neuroprotective Care To Caregivers Of Neonates, Lucy Bradley

Honors College Theses

Preterm neonates are at risk of developmental delays, behavioral problems, and mental health challenges. Neuroprotective care is essential to mitigate these risks, and nurses play a crucial role in educating caregivers on these practices. This study aims to investigate neonatal nurses' knowledge and confidence in teaching caregivers about neuroprotective care and to determine the extent to which caregivers implement these practices. A mixed-methods research design will be employed, using a survey to collect data from neonatal nurses who have at least one year of experience working in a NICU. The survey will assess nurses' understanding of neuroprotective care, their confidence …

Assessment Of The Risk Factors Affecting Diabetes Outcome In Kumasi Metropolis Of Ghana, Audrey Jacobs

Honors College Theses

This paper examines Kumasi Metropolis, Ghana risk factors for diabetes outcomes, considering the prominent determinants such as geographic location, income, and educational level. Such determinants play a role when it comes to shaping health outcomes, with research indicating positive correlation between per capita expenditure on healthcare and life expectancy. In spite of that, inequalities do occur, even in developing nations such as Ghana, where minimal health care investment impacts poor health outcomes. Socioeconomic factors, including low living conditions, poor access to healthcare, and illiteracy, reinforce health disparities, especially in rural areas. Informed by a review of past research, we hypothesized …

Physiologically Based And Population Pharmacokinetic Modeling Of Midazolam In Children With Obesity Using Real-World Data, Sean Mccann, Victória E. Helfer, Stephen J. Balevic, William J. Muller, John N. Van Den Anker, Amira Al-Uzri, Marisa L. Meyer, Sarah G. Anderson, Sitora Turdalieva, Andrea N. Edginton, Daniel Gonzalez, Best Pharmaceuticals For Children Act Pediatric Trials Network Steering Committee

Department of Pediatrics Faculty Papers

Children represent a highly complex and variable population for treatment, including interindividual differences in drug dose-exposure. Midazolam has been used as a sedative for hospitalized children on- and off-label; however, factors affecting interindividual variability (IIV) in observed clearance for this population are not fully understood and can result in extreme under- or overexposure. Obesity has been described as a significant influence on midazolam in adolescents, which could potentially alter drug exposure. The goal of this study was to use two modeling strategies to evaluate dose-exposure of midazolam in children with and without obesity. Population pharmacokinetic modeling assessed whether measures of …

Use Of Margins Around Small Brain Metastasis Improves Specificity Of Evaluation Methods For Stereotactic Radiosurgery Treatment Plans, Purity Kemunto Bundi

LSU Master's Theses

Purpose: To reduce the high false positive rates (FPRs ≥ 46%) from the evaluation of Gamma Knife stereotactic radiosurgery (SRS) treatment plans for small brain metastases. Specifically, we modified two evaluation indices, Treated Volume Ratio (TVR) and Gradient Index (GI), which exhibited FPRs exceeding 84%. A false positive result incorrectly indicates that an acceptable plan, as determined by a medical physicist and a radiation oncologist, is inacceptable.

Methods: This study utilized training and validation datasets from Gamma Knife treatment plans from The University of Texas MD Anderson Cancer Center (MDACC) and Mary Bird Perkins Cancer Center (MBPCC). Data included doses, …

Harnessing Machine Learning For Predictive Healthcare: A Path To Efficient Health Systems In Africa, Kabiru Gulma, Zainab Saidu, Kingsley Godfrey, Abubakar Wada, Zayyanu Shitu, Auwal A. Bala, Safiya Bala Borodo, Sa’Adatu M. Julde, Mustapha Mohammed

School of Medicine Publications

Machine learning (ML) presents a transformative opportunity to strengthen African health systems through predictive healthcare. This paper explores the applications, benefits, and implementation challenges of ML in African health contexts, where resource limitations and infrastructure gaps often impede efficient healthcare delivery. By leveraging supervised and unsupervised ML models-such as decision trees, neural networks, and support vector machines-predictive healthcare can aid in early disease detection, improve patient outcomes, and optimize resource allocation. Real-world case studies across the continent, including malaria forecasting and telemedicine applications, illustrate the potential of ML to mitigate the burdens of delayed diagnosis, an underutilized workforce, and a …

Chronic Inflammation: The Link Between A High Added Sugar Diet And Disease, Anna Collins

Senior Honors Theses

The modern diet includes many processed foods that contain added sugars, resulting in a significant increase in daily glucose and fructose consumption. Considering this, there is an increased effort to uncover the effects of excess sugar intake on the body’s health and metabolism. Strong evidence supports the connection between a high added sugar diet and the presence of chronic, low-grade inflammation due to cellular distress and metabolic dysfunction. Prolonged inflammatory responses are linked to tissue damage and the development of various metabolic diseases that are prevalent in modern society, such as obesity, fatty liver disease, cardiovascular disease, and type 2 …

05-20-25 Board Of Regents Notice Of Meeting, Patricia Serna

HSC Committee (A subcommittee of the UNM Board of Regents)

Publish 05-20-25 Board of Regents Notice of Meeting

Ovarian Cancer G Protein-Coupled Receptor-1 Signaling Bias Dictates Anti-Contractile Effect Of Benzodiazepines On Airway Smooth Muscle, Dominic R. Villalba, Arun K. Jannu, Elham Javed, Isha Dandekar, Ruping Wang, Deepak A. Deshpande, Steven S. An, Reynold A. Panettieri, Dale D. Tang, Raymond B. Penn, Ajay P. Nayak

Center for Translational Medicine Faculty Papers

BACKGROUND: We recently reported that the ovarian cancer G protein-coupled receptor-1 (OGR1) can be pharmacologically biased with specific benzodiazepines to couple with distinct heterotrimeric G proteins in human airway smooth muscle (ASM) cells. Lorazepam stimulated both G

METHODS: Models of histamine (His) -stimulated contraction included imaging of ex vivo human precision cut lung slices (hPCLS) and Magnetic Twisting Cytometry (MTC) analysis of human ASM cell stiffness. To explore mechanisms of regulation, we examined effects on myosin light chain (pMLC) phosphorylation and PKA activity in primary human ASM cultures, as well as actin cytoskeleton integrity as defined by changes in the …

Normobaric And Hyperbaric Oxygen Therapy In Pediatric Dog Bite Nasal Tip Avulsion/Replantation, Paul G. Harch, Adam Shalek, Jen Karen Erbil, Brett J. King, Abigail E. Chaffin

School of Medicine Faculty Publications

A 4-year-old healthy girl sustained a composite dog bite avulsion of the tip of her nose that was intraoperatively replanted without vascular reanastomosis 2 hours and 45 minutes after the avulsion. The replanted tip initially appeared viable, but became dusky at 16 hours and cyanotic at 32 hours postreplantation. Hyperbaric oxygen therapy commenced at 40 hours postreplantation, and intermittent normobaric oxygen was added at night after the fourth hyperbaric oxygen treatment. Hyperbaric oxygen therapy was dosed according to tissue response/appearance and signs of patient oxidative stress with progressive improvement in viability. The patient received 30 hyperbaric oxygen treatments in 26 …

Investigating Undergraduate Conditioned Place Preference Utilizing Virtual Alcohol Stimuli, Nikole A. Rodriguez Torres, Robert Astur, Jeffrey Divino

Honors Scholar Theses

Alcohol use remains a major concern among college students, with binge drinking linked to serious physical and mental health problems. But how much does the environment influence these addictive behaviors? The relationship between environmental cues and alcohol related behaviors is a critical area of study, particularly understanding reward and motivation mechanisms. Binge drinking, common among college students, is associated with a range of negative outcomes such as physical harm, legal issues, poorer overall health, sleep problems, depression, anxiety, and severe thoughts of suicide. In our study, college undergraduates were exposed to two VR rooms: one with alcohol-related stimuli and one …

Exploring The Relationship Between Diet And Mental Health, Emory Layne

Honors Theses

Dietary patterns in Western societies have shifted over the past century due to the rise of food manufacturing and technological advancements. Ultra-processed foods now account for approximately half of the daily energy intake in high-income countries. Similarly, the national mental health crisis emerged in the 21st century and worsened after the COVID-19 pandemic. The changes in diet have impacted the gut microbiome, which interacts with the brain through the bidirectional gut-brain axis. Research suggests the concept of the gut-brain axis is a principal indicator of diet’s impact on mental health. However, this area of research is still emerging and requires …