Medicine and Health Sciences Commons^™

Re: Physician And Advanced Practice Clinician Burnout In Rural And Urban Settings., Cody J Klinker

Ambulatory and Primary Care Articles

No abstract provided.

Optimal Diagnostic Strategies For Concussion-Related Vision Disorders: A Review, Iniya K. Adhan, Kammi B. Gunton

Wills Eye Hospital Papers

Concussions are a mild form of traumatic brain injury (TBI) that is typically self-limited and transient with a high prevalence within our communities. Due to the vast visual network interconnectivity, visual symptoms secondary to a concussion occur about 90% of the time. A gold standard to confirm concussion acutely has not been well established. Visual function testing based on symptoms remains the standard of care in off-site evaluation for diagnosis of oculomotor dysfunction. This review covers the current diagnostic strategies for vision based disorders post-concussion for sideline testing, off-site testing, and research driven testing.

Treatment Outcomes Following Tme For Biologically Unfavorable Locally Advanced Rectal Cancer, Maryam Aleissa, Amr Aref, Hussein Gharib, Ernesto R. Drelichman, Amer Zeni, Amer Alame, Jasneet S. Bhullar

Conference Presentation Abstracts

Purpose/Background: Many centers now offer organ preservation for selected patients with locally advanced rectal cancer. Our group initiated three Phase II trials to assess the safety of this approach in various clinical scenarios. Nonoperative management was recommended only for patients achieving complete clinical response CCR)after total neoadjuvant therapy TNT. Total mesorectal excision TME was advised when CCR was not achieved (primary TME), following residual cancer after Limited Local Excision LLE (completion TME), or after tumor recurrence/regrowth post-LLE or watchful waiting WW (salvage TME). This study examines treatment outcomes following primary or salvage TME in these biologically unfavorable cases.

Methods/Interventions: Each …

Comparison Of Magnetic Resonance Imaging (Mri) And Endoluminal Endoscopic Ultrasound (Eus) For Restaging Rectal Cancer After Neoadjuvant Chemotherapy, Judy Sheffeh, Amr Aref, Mohammed Barawi, Amer Alame, Amer Zeni, Ernesto R. Drelichman, Jasneet S. Bhullar

Conference Presentation Abstracts

Purpose/Background: Given the high incidence and mortality of rectal cancer, accurate staging and restaging are crucial for guiding optimal interventions. However, no consensus exists on the best imaging modality for restaging after neoadjuvant chemoradiotherapy. This study aims to compare MRI and EUS in the restaging of rectal cancer following neoadjuvant chemoradiotherapy.

Methods/Interventions: We conducted a prospective observational study and enrolled patients with rectal cancer. EUS and MRI were performed at diagnosis for initial staging and repeated after neoadjuvant chemotherapy and chemoradiotherapy for restaging. A total of 43 patients were enrolled, with 25 patients (10 males, 15 females) with rectal cancer …

Development Of A Light-Based Platform To Assess Cervical Mucus Barrier Function And Physical Mucus Properties, Elizabeth J. Buzbee

McKelvey School of Engineering Graduate Student Theses & Dissertations

Preterm birth is the leading cause of neonatal morbidity and mortality worldwide, yet current clinical tools for predicting its risk lack specificity and reliability. Cervical mucus plays a crucial role in maintaining pregnancy by forming a barrier that protects the uterus against infection. This study investigates the use of laser speckle rheology as a noninvasive technique to assess cervical mucus biomechanics. Synthetic cervical mucus was fabricated at varying hydration levels and tested using a conventional rheometer that confirmed that the mechanical properties of the synthetic mucus samples were representative of physiological cervical mucus. These results were compared to the complex …

Explaining Patient Data Towards Improving Patient Understanding And Medical Efficiency, Lupe K. Hernandez Jr.

Masters Theses

Patients frequently access medical test results through electronic health record (EHR) portals, often before receiving input from healthcare providers. These results typically lack interpretation or are presented with complex clinical terminology, leading to confusion, anxiety, and misinformed decision-making. This thesis examines using large language models (LLMs), such as ChatGPT, to generate test result summaries in detailed and simplified formats automatically. A Python-based middleware was developed to interface between OpenEMR and OpenAI’s API, enabling automated summary generation. Summaries included a clinically detailed version and a simplified version written at a third-grade reading level. Two surveys were conducted: one with undergraduate and …

Should Physicians Take The Rap? Normative Analysis Of Clinician Perspectives On Responsible Use Of 'Black Box' Ai Tools, Ben H Lang, Kristin Kostick-Quenet, Jared N Smith, Meghan Hurley, Rita Dexter, Jennifer Blumenthal-Barby

Center for Medical Ethics and Health Policy Staff Publications

Background: Increasing interest in deploying artificial intelligence tools in clinical contexts has raised several ethical questions of both normative and empirical interest. One such question in the literature is whether "responsibility gaps" (r-gaps) are created when clinicians utilize or rely on such tools for providing care, and if so, what to do about them. These gaps are particularly likely to arise when using opaque, "black box" AI tools. Compared to normative and legal analysis of AI-generated responsibility gaps in health care, little is known, empirically, about health care providers views on this issue. The present study examines clinician perspectives on …

Narratives Or Not? Examining The Roles Of Message Format And Individuals' Stages Of Change In The Context Of Hpv Vaccination Promotion, Mengfei Guan, Shawn C. Chiang, Regan M. Murray, Wen-Juo Lo, Larry T. Hill, Ann C. Klassen, Jennifer A. Manganello, Amy E. Leader, Philip M. Massey

Department of Medical Oncology Faculty Papers

Narrative persuasion has been widely used in health communication campaigns and persuasive message design. However, several meta-analyses showed that the relative effectiveness of narratives in promoting behavior change was not consistently observed in the existing literature. With the goal of exploring boundary conditions of narrative effects, this study investigates the interaction effects of narrative persuasion and stages of change on promoting behavior change in the context of encouraging parents to vaccinate their children against human papillomavirus (HPV). Findings from an online experiment (N = 593) showed that non-narrative messages were more effective in bolstering behavioral intention than narrative messages among …

Clinical Value Of Chatgpt For Epilepsy Presurgical Decision-Making: Systematic Evaluation Of Seizure Semiology Interpretation, Yaxi Luo, Meng Jiao, Neel Fotedar, Jun-En Ding, Ioannis Karakis, Vikram R. Rao, Melissa Asmar, Xiaochen Xian, Orwa Aboud, Yuxin Wen, Jack J. Lin, Fang-Ming Hung, Hai Sun, Felix Rosenow, Feng Liu

Engineering Faculty Articles and Research

Background: For patients with drug-resistant focal epilepsy, surgical resection of the epileptogenic zone (EZ) is an effective treatment to control seizures. Accurate localization of the EZ is crucial and is typically achieved through comprehensive presurgical approaches such as seizure semiology interpretation, electroencephalography (EEG), magnetic resonance imaging (MRI), and intracranial EEG (iEEG). However, interpreting seizure semiology is challenging because it heavily relies on expert knowledge. The semiologies are often inconsistent and incoherent, leading to variability and potential limitations in presurgical evaluation. To overcome these challenges, advanced technologies like large language models (LLMs)—with ChatGPT being a notable example—offer valuable tools for …

Staff Education To Improve Gestational Diabetes Knowledge In Family Practice Staff, Lawretta Udogadi Aghomon

Walden Dissertations and Doctoral Studies

The project was a staff education program on gestational diabetes mellitus (GDM) that was carried out in an outpatient primary health facility to help improve staff knowledge of GDM. GDM is a pregnancy complication where women with no history of diabetes become hyperglycemic during their gestational period. According to the Centers for Disease Control and Prevention, the percentage of mothers giving birth who received a diagnosis of diabetes during pregnancy has increased in the last 10 years. Limited healthcare staff knowledge is a constraint in preventing the increase of GDM incidence. The practice-focused question was: Among healthcare staff at a …

The Experience Of Non-English Speaking Hispanic Patients During Kidney Transplant Evaluation, Ana Ivette Merced-Castro

Walden Dissertations and Doctoral Studies

There has been an increase in the incidence of Hispanics being diagnosed with end stage renal disease (ESRD), which has evolved from the rise in type 2 diabetes and hypertension. However, Hispanics and African American people are less likely to receive kidney transplants than non-Hispanic White individuals, and many Hispanics referred for transplants often do not complete the evaluation process due to its complexities. The purpose of this qualitative narrative descriptive study, guided by the socioeconomic model, was to explore the lived experiences of non-English-speaking Hispanic patients during the kidney transplant evaluation process. Six participants were recruited for the individual …

Distinguishing Chronic Sigmoid Volvulus From Ogilvie Syndrome: A Case Report, Amanda Paulus, Arpit Aggarwal, Sara Glendinning

Conference Presentation Abstracts

Purpose/Background: Benign etiologies of large bowel obstructions are categorized by mechanical or functional. Mechanical obstructions include volvulus, hernia, adhesions, and stricture. Sigmoid volvulus is the most common benign cause of large bowel obstruction. Functional disorders include colonic pseudo obstruction, paralytic ileus, and chronic constipation. Colonic pseudo obstruction (also known as Ogilvie’s Syndrome) is a functional disorder that causes a large bowel obstruction that can be acute or chronic in nature.

Methods/Interventions: A 62-year-old male with chronic constipation and multiple comorbidities presented with abdominal distention and dyspnea. He was previously treated for Ogilvie's pseudo obstruction through conservative measures. On exam, his …

Impact Of Prior Exposures On Biomarkers Of Blast During Military Tactical Training, Zhaoyu Wang, Shengnan Sun, Alis Aksar Kranfli, Jeffrey Nemes, Molly J. Sullan, Andrew J. Hoisington, Lisa A. Brenner, Miciej Skotak, Christina R. Lavalle, Yongchao Ge, Walter Carr, Fatemah Haghighi

Faculty Publications

Blast injuries and subclinical effects are of significant concern among those Service Members (SMs) participating in military operations and tactical trainings. Studies of SMs repeatedly exposed during training find concussion-like symptomology with transient decrements in neurocognitive performance, and alterations in blood biomarkers. How prior mild TBI (mTBI) history interacts with low-level blast (LLB) exposure, however, remains unexplored, which we investigate in the present study, to identify interindividual biomarker changes from LLB exposures influenced by prior history of mTBI.

Risk Of Coronary Obstruction In Redo-Transcatheter Aortic Valve Replacement Between Bicuspid And Tricuspid Aortic Valves, Atsushi Okada, Syed Zaid, Miho Fukui, Evan Walser-Kuntz, Larissa I Stanberry, Marcus R Burns, John R Lesser, João L Cavalcante, Paul Sorajja, Vinayak N Bapat

Faculty, Staff and Students Publications

Background: Transcatheter aortic valve replacement (TAVR) is approved across all risk profiles, including patients with bicuspid aortic valves. These patients are generally younger, with a higher chance of reintervention.

Objectives: The aim of this study was to compare the feasibility of redo transcatheter aortic valve (TAV) between bicuspid and tricuspid aortic valves.

Methods: A computed tomographic (CT) simulation of redo-TAV was conducted using 913 post-TAVR CT studies from patients who underwent TAVR with SAPIEN 3 or SAPIEN 3 Ultra (S3; n = 623) or Evolut R, Evolut PRO, or Evolut PRO+ (Evolut; n = 290) valves. Fifty-nine cases were for …

Defining Three Principles For Credible Evidence Synthesis And Reviews In Health Professions Education, Michelle Daniel, Morris Gordon, Hussein Uraiby, Peter Boedeker, Janice Hanson, Diana Dolmans, Satid Thammasitboon

Faculty, Staff and Students Publications

As reviews become increasingly central to informing educational practice and guiding research in health professions education, the need for methodological clarity and quality has grown. This Commentary highlights three foundational principles - alignment, rigor, and transparency - that underpin high-quality reviews, regardless of type. We illustrate how these principles apply across commonly used review types, including systematic, scoping, realist, and narrative reviews. By aligning the research question with the appropriate review methodology, employing rigorous processes for evidence collection and synthesis, and maintaining transparency in methodological reporting, review teams can produce credible, transferable, and dependable findings. Embracing these principles not only …

Augmented Reality Microscopy To Bridge Trust Between Ai And Pathologists, Sunil Badve, Xiuli Liu, Et Al.

2020-Current year OA Pubs

Diagnostic certainty is the cornerstone of modern medicine and critical for maximal treatment benefit. When evaluating biomarker expression by immunohistochemistry (IHC), however, pathologists are hindered by complex scoring methodologies, unique positivity cut-offs and subjective staining interpretation. Artificial intelligence (AI) can potentially eliminate diagnostic uncertainty, especially when AI "trustworthiness" is proven by expert pathologists in the context of real-world clinical practice. Building on an IHC foundation model, we employed pathologists-in-the-loop finetuning to produce a programmed cell death ligand 1 (PD-L1) CPS AI Model. We devised a multi-head augmented reality microscope (ARM) system overlayed with the PD-L1 CPS AI Model to assess …

Phase Ii Study Of Venetoclax Added To Bendamustine And Obinutuzumab In Patients With High-Risk Follicular Lymphoma As Front-Line Therapy: Pre0403, Craig A Portell, Opeyemi A Jegede, Nina Wagner-Johnston, Grzegorz S Nowakowski, Christopher Fletcher, Jonathon B Cohen, Andrew M Evens, Lori J Rosenstein, Jeffrey W Craig, Nishitha Reddy, Brad S Kahl

2020-Current year OA Pubs

Over-expression of BCL-2 defines follicular lymphoma (FL). Venetoclax (VEN), a selective BCL-2 inhibitor, has previously been evaluated with bendamustine-based chemoimmunotherapy. VEN was given continuously, resulting in promising efficacy but unacceptable toxicity. The Phase II PrE0403 study was designed to evaluate intermittent dosing of VEN (10 days per cycle) combined with obinutuzumab and bendamustine (VEN-OB) in untreated FL subjects with high-risk features defined as a FLIPI-1 score of ≥3 and/or high tumor burden by GELF criteria. A total of 56 subjects were planned to be accrued with a goal of having 51 subjects eligible to improve the historical 50% CR rate …

Structural Proteomics Defines A Sequential Priming Mechanism For The Progesterone Receptor, Matthew D Mann, Min Wang, Josephine C Ferreon, Phoebe S Tsoi, Michael P Suess, Antrix Jain, Anna Malovannaya, Roberto Vera Alvarez, Bruce D Pascal, Raj Kumar, Dean P Edwards, Patrick R Griffin

Faculty, Staff and Students Publications

The progesterone receptor (PR) is a steroid-responsive nuclear receptor with two isoforms: PR-A and PR-B. Disruption of PR-A:PR-B signaling is associated with breast cancer through interactions with oncogenic co-regulatory proteins (CoRs). However, molecular details of isoform-specific PR-CoR interactions remain poorly understood. Using structural mass spectrometry, we investigate the sequential binding mechanism of purified full-length PR and intact CoRs, steroid receptor coactivator 3 (SRC3) and p300, as complexes on target DNA. Our findings reveal selective CoR NR-box binding by PR and unique interaction surfaces between PR and CoRs during complex assembly, providing a structural basis for CoR sequential binding on PR. …

Mentorship Across A Decade: From Early Career To Mid-Career, Jessica Immonen

The Journal of Integrative Physiology

As a member of the editorial board of the Journal of Integrative Physiology, I was asked to share my reflections on mentoring. The way I functioned as a mentor when I was a junior faculty member was strongly shaped by the mentorship I received through my training years. The way I function as a mentor in my mid-career era has brought pearls from my training mentors but it has become unique to me as a person and a professional.

Machine Learning Course: A 15-Week Interactive Curriculum With Code And Case Studies, Pegah Khosravi

Open Educational Resources

This open-access machine learning course is a comprehensive 15-week curriculum developed and published on GitHub with full Google Colab compatibility. It combines theoretical concepts with hands-on Python coding, real-world datasets, and structured projects covering regression, classification, clustering, deep learning, transformers, and multimodal AI. The course is designed for students, educators, and researchers interested in applied machine learning, including biomedical applications. It includes explainable AI components and ethical discussions to align with modern AI standards. The course is maintained by BioMind AI Lab at CUNY.

Improved Survival With Improved Naprc Compliance: Our Single Institution Experience, Jacob Applegarth, Claire Bova, Scarlett B. Hao, Harry Wasvary

Conference Presentation Abstracts

The National Accreditation Program for Rectal Cancer (NAPRC) was developed in 2017 in an effort to better standardize rectal cancer care in the United States. This study investigates short-term outcomes of rectal cancer patients relative to compliance with NAPRC standards at an NAPRC accredited institution.

Effect Of Clean Closing Trays In Enhanced Recovery After Surgery Protocol On Surgical Site Infection Rates In Colorectal Surgeries, Elizabeth Carlson, Shelli Bergeron, Scarlett B. Hao, Kristin Lemarbe, Nora Laban, Diana Lee, Bradley Krasnick, Harry Wasvary

Conference Presentation Abstracts

Reducing surgical site infections (SSIs) after colorectal surgeries remains a key quality improvement target. The summative effect of multiple pre-, intra-, and post-operative interventions bundled as part of Enhanced Recovery After Surgery (ERAS) programs have been shown to effectively reduce SSIs, however the individual impact of each intervention has not been well-studied. This study evaluates the impact of clean closing tray use on the rate of SSIs in colorectal surgeries.

When Patients Say No – Outcomes Of Opting Against Recommended Treatment After Total Neoadjuvant Therapy For Stage Ii/Iii Rectal Cancer, Scarlett B. Hao, Jacob Applegarth, Erin Mueller, Harry Wasvary, Matthew Ziegler, Bradley Krasnick

Conference Presentation Abstracts

Patients with stage II/III rectal cancer, upon completion of total neoadjuvant therapy (TNT), may be recommended total mesorectal excision (TME) or a watch-and-wait (WW) approach depending on their clinical tumor response. However, in shared decision-making, patients may ultimately decide for surgery when it is not recommended or against surgery when it is recommended. This study aimed to describe the tumor response outcomes of patients with LARC who pursue and do not pursue the recommended approach following TNT.

What Is The Impact Of An Education Program Designed To Remove The Healthcare Professional As A Barrier To Care For The Transgender And Gender Diverse Community?, Richard D. Dansereau

Doctoral Projects

Healthcare disparities disproportionately affect transgender and gender-diverse (TGD) individuals, often due to implicit biases among healthcare providers. This study examines the impact of an educational intervention designed to address these biases and improve care for TGD patients. Using the Biased Care Model as a guiding framework, the intervention targeted three critical phases of bias: pre-visit assumptions, in-visit interactions, and post-visit decisions. Conducted in the intensive care unit of a mid-sized hospital in Northern California, the study employed a pretest-posttest quasi-experimental design involving multidisciplinary healthcare workers. Participants completed a modified Jefferson Scale of Empathy survey to assess changes in cognitive and …

Metastatic Colon Cancer And Single Agent Neoadjuvant Immunotherapy: A Single Institution Experience, Jacob Applegarth, Scarlett B. Hao, Claire Bova, Harry Wasvary

Conference Presentation Abstracts

Pembrolizumab was granted accelerated FDA approval for the treatment of patients with metastatic MMR deficient solid tumors and has shown significant benefit in the treatment of metastatic colorectal cancer. Recently, the NICHE-2 trial demonstrated that neoadjuvant nivolumab plus ipilimumab led to a significant response in locally advanced MMR deficient colon cancer. This report is a single institution's experience regarding the treatment of metastatic colon cancer with neoadjuvant immunotherapy. Since 2022, our institution has treated two patients with neoadjuvant pembrolizumab for metastatic colon cancer and achieved complete clinical and pathologic responses with no residual evidence of malignancy.

The Relationship Between A Supportive Community And The Self-Efficacy Of Adolescents, Shalom Sulungaine

Science Symposium

Studies have proven that communities and relationships play a part in the development of adolescents. However, different communities and relationships impact adolescents differently, and not all influence their self-efficacy in the way that we may assume. It is known that teachers and parents play a role in building self-efficacy in adolescents and teaching them how to manage their own choices that influence their self-efficacy. A big factor that is not yet known is if and how community violence affects the self-efficacy of adolescents. In this study, I will be exploring the relationship between the self-efficacy of adolescents, and how this …

Autoimmune Diseases And Antibodies, Chloe A. Harvick

Science Symposium

This is a research presentation asking the question, "Is there a relationship between autoimmune diseases and the likelihood of higher antibody levels?" Using a dataset of participants with and without autoimmune diseases, it covers whether antibody levels (of Immunoglobulin M and Complement 4) average differently between a healthy control group and four autoimmune disease groups: Sjogren's Disease (SD or SS), Systemic Lupus Erythematosus (SLE), ANCA-associated vasculitis (SV), and Rheumatoid Arthritis (RA). Finding differences such as these will give a better understanding of the biomarkers of autoimmune diseases and help further the scientific research within the health field.

This is a …

Ultrasound-Guided Sciatic And Femoral Nerve Block For Perioperative Pain Management In A Thai Crossbreed Dog Undergoing Tibial Plateau Leveling Osteotomy (Tplo): A Case Report, Wutti Bunjerdsuwan, Sirirat Niyom

The Thai Journal of Veterinary Medicine

This case report presents the use of ultrasound-guided sciatic and femoral nerve blocks as an alternative analgesic technique for perioperative pain control in a Thai crossbreed dog undergoing left tibial plateau leveling osteotomy (TPLO). The orthopedic examination revealed a 4/5 left hindlimb lameness score, with positive results on both the tibial compression test (TCT) and cranial drawer test (CDT). Radiographic evaluation showed the absence of a fat pad sign and osteophyte formation around the left stifle joint. A definitive diagnosis of left cranial cruciate ligament rupture (CCLR) was made. The dog underwent CCLR correction via TPLO, with perioperative pain managed …

Online Multimedia Education Effect On Breast Health Knowledge And Self-Efficacy, Brooke D. Hancock, Elizabeth Frankle, Jennifer Cera, Leeza Struwe, Mackenzie Koch

Doctor of Nursing Practice Projects: College of Nursing

Objective: To evaluate comprehension and retention of breast health and BSE by providing evidence-based education via a website. The researchers aimed to measure knowledge of breast health, self-efficacy of performing breast health promotion, and usability of the interventional website.

Design: A single group efficacy trial was used.

Setting: The study was conducted in two outpatient clinics in Nebraska that provided well women health care.

Participants: A convenience sample of 100 women were enrolled

Methods: Breast health knowledge was assessed with the Breast Health Assessment (BHA) and consisted of 3 subscales. The Champions Health Belief Model Scale (CHBM) assessed BSE self-efficacy …

Implementation Of An Adolescent Women’S Health And Wellness Education Program, Lauren Acker, Laynee Conner, Jennifer Cera

Doctor of Nursing Practice Projects: College of Nursing

Objectives: The goal of this research study was to provide scientific evidence supporting the importance and effectiveness of implementing a women’s health and wellness education course and its effect on (1) adolescent knowledge of sexual health and hygiene, (2) self-efficacy in menstrual management, and (3) self-empowerment in managing their own reproductive health.

Design: This was a mixed methods pilot study utilizing a pre/post-test single intervention efficacy trial. Quantitative and qualitative data were obtained.

Setting: The setting included two different sites including one outpatient ambulatory obstetrics/gynecology clinic and one community outreach center. Both sites were located within a midwestern metropolitan …