Medicine and Health Sciences Commons^™

Sickle Cell Disease: Stroke, Children's Mercy Kansas City

Clinical Pathways

No abstract provided.

Management Of A Splenic Artery Pseudoaneurysm Secondary To Pancreatitis, Anika Pruthi, Abigail Clark, Katherine Mcmackin, Laurel Hastings, Michael Hsu

Cooper Medical School of Rowan University Departmental Research

Introduction: Splenic artery pseudoaneurysm (SAP) is a rare and fatal complication of pancreatitis which, in the presence of a pseudocyst, requires prompt intervention to prevent rupture and hemorrhagic shock.

Case Description: A 43-year-old female with a history of chronic alcohol use, hypertension, and acute on chronic pancreatitis complicated by a pseudocyst requiring cystogastrostomy, presented as a direct transfer with abdominal pain, nausea, and poor intake by mouth. Computed tomography of the abdomen and pelvis with intravenous contrast revealed an enlarged pancreas with multiple calcifications and mild peripancreatic fat stranding. The pancreatic duct was dilated up to 9 mm, with a …

Retrospective Cohort Study Of Pure Tone Audiometry Hearing Changes Associated With Ototoxic Metals And Solvents, Continuous Noise And Impulse Noise Exposures At Robins Air Force Base From 2001-2019, Ronald Diaz Cataldo Ramos

Theses and Dissertations

Utilizing DOEHRS-IH and DOEHRS-HC, a retrospective epidemiological study was performed on Robins AFB personnel to investigate relative risks of hearing loss associated with exposures to continuous noise, impulse noise, and ototoxic metals and solvents. An analysis of variance identified age, frequency octave, era and exposure type as influencers of hearing threshold shifts. Risk ratios showed higher risk of hearing loss for exposures to continuous noise + impulse noise + ototoxic metals as well as continuous noise + impulse noise at low frequencies (500Hz and 1,000Hz), and lesser risk for exposures to continuous noise + impulse noise and continuous noise + …

Air-Based Chemical Patient Decontamination Methodologies For Arctic Regions Using Methly Salicylate As A Chemical Agent Surrogate On A Litter-Bound Manikin, Marcus D. Shadd

Theses and Dissertations

This study evaluated a mobile air shower for patient decontamination without disrobing or rinsing, an alternative for Arctic conditions where water is scarce. A manikin in extreme cold weather gear was exposed to 10 µL of methyl salicylate (MeS), a sulfur mustard surrogate, and placed in a horizontal chamber on a military litter. Airborne MeS was measured using a ppbRAE 3000 detector to assess inhalation risk for the patient and decontamination team. Three methods were tested: an air-knife system, paper towels, and no decontamination, with 10 trials each (30 total). ANOVA analysis showed significant reductions in airborne MeS with air-knife …

Analysis Of Nuclear Security And Safety Integration Using Survey Responses And Pairwise Comparison Methods, Sheila V. Gbormittah, Theodore A. Thomas, Jason Timothy Harris

International Journal of Nuclear Security

Integrating nuclear security and safety is important for implementing and sustaining nuclear technology because it promises improved and effective management. This integration is an ongoing effort to ensure that both work together with minimal conflicts. This research aimed to determine the preferred level at which nuclear security and nuclear safety integrate by using the pairwise comparison methods of decision-making. This methodology used survey responses from women nuclear professionals to identify the most-desired criteria at three levels: strategic, operational, and cultural. The strategic level includes actions that government officials and regulators can take. The operational level encompasses actions that deliver the …

Expediting Toxicological Evidence Collection In Patients Presenting To The Emergency Department With Report Of Drug Facilitated Sexual Assault (Dfsa): A Quality Improvement Project, Adelene Egan

DNP Projects

Title: Expediting Toxicological Evidence Collection in Drug-Facilitated Sexual Assault: A Quality Improvement Project

Background/Significance: Drug-facilitated sexual assault (DFSA) involves substance use to incapacitate victims, with rapid drug metabolism necessitating prompt evidence collection. Delays in blood collection reduce toxicology detection rates, compromising legal outcomes. In one New York ED, DFSA kits (Part B) were routinely collected after biological evidence (Part A), creating a critical gap.

Purpose: To improve compliance with evidence-based prioritization of blood collection (Part B before Part A) for DFSA cases through a structured QI initiative.

Methods: The project synthesized evidence from a systematic review of …

The Swahili Version Of The Cd-Risc 10 Resilience Scale: Psychometric Properties And Factors Associated With Resilience Among Healthcare Workers In Tanzania, Kevinson Mwangi, Sabina Odero, Gideon Mbithi, Rachel Odhiambo, Rosemary Stephen, Tumbwene Mwansisya, Eunice Pallangyo, Eunice Ndirangu, Amina Abubakar

Institute for Human Development, East Africa

Background: Despite the central role of resilience in promoting mental well-being, little is known about the resilience process among healthcare workers in East Africa, partly due to the lack of adequately standardised and psychometrically sound assessment tools for our context. This study provides the first psychometric evaluation of the Swahili version of the Connor-Davidson Resilience Scale 10 (CD-RISC 10) among nurses/midwives and community health volunteers (CHVs) in Tanzania, potentially informing the accuracy of measuring resilience in this setting. Additionally, we examine factors associated with self-reported resilience as measured by the CD-RISC 10 scale.

Methods We used cross-sectional data on nurses/midwives …

The Feasibility Of Pharmacokinetic-Based Dosing Of Hydroxyurea For Children With Sickle Cell Anaemia In Uganda : Baseline Results Of The Alternative Dosing And Prevention Of Transfusions Trial, Alexandra Power Hays, Ruth Namazzi, Min Dong, Caroline Kazinga, Charles Kato, Sadat Aliwuya, Kathryn Mcelhinney, Andrea L. Conroy, Adam Lane, Robert Opoka

Paediatrics and Child Health, East Africa

Pharmacokinetic (PK)-guided dosing of hydroxyurea for children with sickle cell anaemia (SCA) could optimize dosing and improve outcomes, but its feasibility has not been demonstrated in low-resource settings where the majority of affected children live. Alternative Dosing And Prevention of Transfusions (ADAPT) is a prospective trial evaluating blood transfusions and the feasibility of determining PK-guided, hydroxyurea maximum tolerated doses (MTD) for children with SCA in Uganda, using portable high-performance liquid chromatography (HPLC) and a novel PK software programme (HdxSim). ADAPT enrolled 106 participants, and 100% completed PK testing. PK-guided doses were generated for 78%, of which 38% were within the …

Self-Inflicted Chronic Laparoscopic Wounds In Endometriosis - Unveiling Major Depressive Disorder- A Case Report., Mwangi Maryanne, Charles Muteshi

Obstetrics and Gynaecology, East Africa

Background: There is no case in literature reporting an adolescent with endometriosis with major depressive disorder manifesting as chronic laparoscopic wounds. Major depressive disorder in patients with endometriosis is a common occurrence, but self-directed violence is rare.

Case presentation: We present the case of an adolescent female with chronic pelvic pain and who was treated with medical management that proved ineffective. She then underwent laparoscopic excision of endometriosis. Post-surgery she continued to experience oozing of a brown colored discharge from the primary umbilical port site, and it became a chronic non-healing wound with associated pelvic pain. Four months later she …

Church Leaders’ Health Behaviors And Program Implementation In The Faith, Activity, And Nutrition Program In The United States, Kelsey R. Day, Sara Wilcox Phd, Lindsay Decker, John Bernhart Ph.D., Mph, Ches, Meghan Baruth, Andrew T. Kaczynski Ph.D., Christine A. Pellegrini Ph.D.

Faculty Publications

Objectives: Church leaders are important to the success of faith-based health promotion interventions through the role modeling of health behaviors. However, clergy may be at a higher risk of chronic disease than their congregants and their health is understudied. This study examined church leaders’ health-related behaviors, differences in health behaviors by socio-demographic characteristics, and associations between health behaviors and church-level implementation of an ecological intervention. Methods: Pastors (n = 93) and church coordinators (n = 92) reported body mass index (BMI), self-rated health, fruit and vegetable consumption (F&V), and physical activity (PA) at baseline and 12 months post-training in the …

Diagnostic Performance Of Confocal Laser Endomicroscopy (Cle) Compared To Endoscopic Ultrasound Guided Fine Needle Biopsy (Eus-Fnb) For Identifying Pancreatic Cystic Lesions (Pcls), Ghazal Hashemipour, Jennifer Permuth, Aamir Dam, Anjuli K. Luthra, Luis Pena, Mark Friedman, Jason Fleming, Barbara Centeno, Shaffer R.S. Mok

USF-LVHN SELECT

No abstract provided.

Putting The Substance In Substantial Evidence: An Evidence-Based Approach To Flexible Drug Regulation, Emanuel Krebs, Tania M. Bubela, Melanie Mcphail, Christopher Mccabe, Dean A. Regier

Office of the Provost

For new drugs or indications, substantial evidence of clinical effectiveness is required for market authorization. In most jurisdictions, substantial evidence is not explicitly defined. Health regulators exercise discretion and are increasingly tolerant of earlier or less mature evidence. To align with flexible evidentiary standards, we argue for the adoption of a principle and, context-based approach to the evidence threshold. Our approach aims to balance the potential benefits and harms of accelerated authorization, low therapeutic value, and safety, based on a value of information (VoI) framework. In our VoI framework, substantial evidence exists when the expected net health value of further …

Unmonitored Online Exams: Valid Assessment Or Score Inflation?, Daniel G. Lannin, Taylor Flinn, Alexandra Ilie, Dan Ispas

Faculty Publications – Psychology

Background: The validity of unmonitored online exams has raised concerns about academic integrity and grade inflation, especially given the rise of artificial intelligence–powered tools.

Objective: This study evaluates the validity of unmonitored online exams by comparing student performance between two sections of an undergraduate personality psychology course: one section completed an unmonitored online multiple-choice final exam while the other completed an in-person multiple-choice final exam.

Method: A quasi-experimental design was used with two undergraduate personality psychology course sections. Section 1 (Spring 2022, n=153) took an in-person final exam, while Section 2 (Spring 2023, n=160) took an unmonitored online final exam. …

Maximizing Benefits For Our Local Authors, Joanne Romano

Library Staff Publications

Our library's publishing benefits include TA's, instructional LibGuides, predatory publisher data and other resources to share with six academic stakeholders. Keeping our authors informed of these benefits requires creative thinking. In this presentation, our resource management team shares ideas for maximizing benefits for local authors at reasonable and sustainable costs.

Engineering A Novel Treg Population To Control Autoimmune Diabetes, Sofia Colon Guzman, Elly Puckett, Ryan T. Fischer, Mary Markiewicz

Posters

Purpose Type 1 diabetes (T1D) in an autoimmune disorder where T cells attack  islet cells, which are the pancreatic cells responsible for insulin production. T1D affects about 1 in 500 children in the United States and is one of the most common chronic diseases in pediatrics. Currently, insulin is the most effective treatment for T1D However, it does not change the underlying disease, and patients still experience many complications throughout their lifetimes. With a significant increase in the prevalence of T1D in children and adolescence in the past two decades, it’s important to explore therapies that alter the immune …

Summary Of: Improving Vte Risk Assessment: Education And Prophylaxis In Rural Cancer Clinics, Heather M. Feldman, Eswar Tipirneni, Shamima Khan, Steven Ades, Allison Holm, Chris E. Holmes

Northern New England Clinical & Translational Research

•Cancer-associated thrombosis (CAT) is the second leading cause of death in patients with cancer and is preventable •Venous thromboembolism (VTE) risk assessment and preventative treatment in high-risk patients who are at low risk of bleeding are recommended for outpatients with cancer initiating therapy

Just As Expected? Older Adults’ Aging Expectations Are Associated With Subjective Cognition, Nikki Hill, Sakshi Bhargava, Justin Do, Emily Bratlee-Whitaker, Monique Brown, Renata Komalasari, Rachel Wu, Jacqueline Mogle

SKMC Student Presentations and Publications

OBJECTIVES: This study investigated the relationship between older adults' expectations regarding aging and subjective cognition. Specifically, we examined whether the three domains of aging expectations (physical health, mental health, and cognitive function) were associated with two aspects of subjective cognition: current subjective cognition and subjective cognitive decline (SCD).

METHOD: An online survey was conducted among U.S. adults aged 65-90 (N = 581; M_age=71.4, SD ± 4.81; 51% female). Measures included the 12-item Expectations Regarding Aging scale, the 8-item PROMIS Cognitive Abilities scale (current subjective cognition), and the 12-item Everyday Cognition scale (SCD). We used generalized linear models …

Rural–Urban Differences In Substance Use During Pregnancy, Emma Kathryn Boswell, Olivia M. Hinds, Cassie Odahowski Phd, Mph, Elizabeth L. Crouch, Peiyin Hung Ph.D, Christina M. Andrews Ph.D.

Faculty Publications

Purpose: Drug overdoses are now a leading cause of pregnancy-related deaths in the United States. Despite evidence of rural–urban disparities in substance use, there has not yet been a nationally representative examination of rural–urban differences in perinatal substance use. This study provides a comprehensive examination of rural–urban disparities in perinatal substance use. Methods: This study uses cross-sectional data to examine 3499 pregnant women from the 2015–2019 National Survey on Drug Use and Health (NSDUH). Rural (nonmetro)–urban (metro) differences in past-month tobacco use, alcohol use, binge drinking, illicit drug use, and marijuana use were examined using Rao–Scott chi-square tests and multivariable …

The Effect Of Furosemide On Extremely Premature Infants Treated With Nonsteroidal Anti-Inflammatory Drugs For Persistent Patent Ductus Arteriosus, Mar Romero-Lopez, Samantha Su, Rafael Bravo, Danielle R Rios, Tina Oak Findley, Covi Anne Tibe, Patrick J Mcnamara

Faculty, Staff and Student Publications

No abstract provided.

Going Green In Dermatology, Rahib K. Islam, Victoria T. Tong, Shari R. Lipner

School of Medicine Faculty Publications

No abstract provided.

Train Foot: History Of The Migrant Worker, Stephanie N. Campbell, Heather V. Tran, Nikita V. Gambhir, Luis Caporusso

School of Podiatric Medicine Publications

Immigrant labor has a long history in the United States, comprised of millions of workers from various ethnic and cultural backgrounds supporting multiple industries from farm work to steel. As of 2019, 25.6% of total migrant workers employed in the Americas [1,2]. Crush injuries or “pinch points” are events when a body part is entangled within machinery or under or between an object [3]. After a series of crush related injuries of young (20s), male Latino patients across Texas to a level 1 trauma center, case review was performed for 2 patients for which follow up could be evaluated. The …

Mental Health Screening And Its Effects On Obese And Overweight Patients: Quality Improvement Project, Amanda Ivos

DNP Projects

Obesity is a growing, multifactorial epidemic. The CDC recommends a 5% weight reduction in order to prevent potential complications associated with overweight or obese status. Mental health, particularly depression, contributes to weight issues with obese individuals having an 18% greater risk of depression, and those with depression having a 37% greater risk of obesity. Both conditions may increase the risk of cardiovascular disease and mortality. Evidence suggests screening and managing depression in overweight/obese patient may lead weight loss and better health outcomes in this patient population.

Project Goals

1. To improve weight loss outcomes in obese or overweight patients with a …

Representation And Outcomes Of Catheter Ablation For Treatment Of Atrial Fibrillation Among Patients With Obesity: A Systematic Review Of Randomized Control Trials, Danielle Dircks, Eh M. Khaing, James Aguto, Jmaylia Mimms, William Schleifer, Jason Payne, Arthur Easley, Faris Khan Md, John Windle, Shane Tsai, Daniel Anderson Md, Gleb Haynatzki, Niyada Naksuk

EMET Projects

Background: The prevalence and impact of obesity on outcomes of atrial fibrillation (AF) ablation randomized controlled trials (RCTs) have not been well studied.

Objective: To examine the proportion of participants with obesity enrolled in RCTs of AF ablation and outcomes of ablation when subgroup analysis of participants with obesity were available.

Methods: We systematically searched PubMed and EMBASE for AF ablation RCTs published between January 1, 2015 to May 31, 2022. When body mass index (BMI) data were available, normal distribution was assumed and a z score was used to estimate the proportion of obesity. Results categorized by BMI or …

Profiles And Well-Being Of Older Adult Caregivers In Singapore, Yi Wen Tan, Rachel Wen Yi Ngu, Kenneth Choo, Lydia Ng, Wensi Lim

ROSA Research Briefs

In Singapore, the government espouses a “many helping hands” philosophy towards caregiving, where care for older adults is borne by three pillars: the family, the community, and the state (Mehta & Vasoo, 2000). Of these, the family is regarded as the “first line of support”, rendering family caregivers essential to the care of older adults (Ng et al., 2016). Many of these caregivers are themselves older adults, where the average age of caregivers was found to be 62 years (Tan, 2023). As Singapore’s population continues to age, alongside demographic trends of extended longevity and a shrinking population, many more will …

Knowledge Of Human Papillomavirus Vaccine As A Determinant Of Uptake Among Guardians Of Adolescent Girls: A Single Hospital Experience In Nairobi, Kenya, Irene Nzisa, Rose Kamenwa, James Orwa, Pauline Samia

Paediatrics and Child Health, East Africa

Abstract : Cervical cancer is one of the most common preventable cancers, causing significant morbidity and mortality in women, especially in Sub-Saharan Africa. Despite the availability of free HPV vaccination, the proportion of adolescent girls vaccinated against HPV remains low.

Methods: Our aim was to identify knowledge and factors influencing HPV vaccine uptake among parents of adolescent girls and to determine the proportion of adolescent girls vaccinated within three months after the provision of additional information on cervical cancer and HPV vaccine. We undertook a mixed methods study design, with an initial cross-sectional part followed by a prospective cohort study …

Articulator Q1 2025

Metro Denver Dental Society Articulator Magazine

This issue features speakers from the 2025 Rocky Mountain Dental Convention (RMDC) and additional content including:

• A feature from Prof. Dr. Anne O'Connell on traumatic dental injuries in pediatric patients.
• A recap from Dr. Jack Nguyen of cutting-edge dental products and technologies presented at Innovation 360 during the 2025 RMDC.
• A feature from Drs. Karen Tindall and Laura Schwindt exploring science-backed strategies for stress management, mindfulness and fostering a positive workplace culture.
• An article from Mr. David Bashford detailing the ins and outs of Colorado's regulations on paid leave.
• An exploration of AI in dentistry from Ms. Laura Ramsey from …

Evaluating Performance Of The Pre-Eclampsia Integrated Estimate Of Risk-Machine Learning (Piers-Ml) Model In A Kenya Cohort Of Women With Pre-Eclampsia, Felix Mogire Nyagaka

Master of Medicine in Obstetrics and Gynecology

Introduction 

Pre-eclampsia is a leading cause of significant maternal morbidity and mortality and complicates approximately 2%-4% of all pregnancies. Delivery is the only known definitive treatment. Pre-eclampsia can have unpredictable progression with sudden deterioration leading to severe adverse outcomes.

Currently, no adverse maternal risk prediction model is validated for use in sub-Saharan Africa. The new Pre-Eclampsia Integrated Estimate of Risk Machine Learning (PIERS-ML) model identifies women with pre-eclampsia who are at the lowest and greatest risk of severe adverse maternal outcomes within 48 hours of initial assessment and informs their care. Whereas, it has been validated for use in high …

Correlation Between Fetal Abdominal Wall Adiposity And Neonatal Outcomes, Elaine Murugi Nyaga

Master of Medicine in Obstetrics and Gynecology

BACKGROUND 

Fetal growth is a result of complex interactions between genetic, nutritional, environmental, uteroplacental, and fetal factors which impact on delivery and subsequent neonatal outcomes. Fetal abdominal adiposity serves as an important indicator of fetal growth and body composition. While gestational diabetes mellitus (GDM) can influence fetal fat deposition, understanding how adiposity correlates with birth weight and neonatal outcomes in both GDM and non-GDM pregnancies provides insight into the broader significance of fetal adiposity as a marker of fetal health.

Methodology 

A cross-sectional study was conducted on 269 pregnant women to examine fetal abdominal adiposity, measured as fetal abdominal subcutaneous …

The Role Of The Apheresis Tandem Safety Timeout In Ecmo And Apheresis Therapy, Johanna I. Orrick, Debra E. Newton, Kari L. Davidson, Karen Murray

Posters

The Apheresis Tandem Safety Timeout was implemented in 2017 at Children’s Mercy Hospital (CMH) to ensure safe, coordinated care when performing therapeutic plasma exchange (TPE) alongside Extracorporeal Membrane Oxygenation (ECMO). The first tandem procedure at CMH was performed in 2013, introducing a valuable tool for treating the sickest patients in the region. However, when patients are placed on two extracorporeal circuits simultaneously, the risk of complications increases significantly. These include electrolyte imbalances, anticoagulation challenges, hemodynamic instability, and the potential for either circuit to be compromised. The ECMO and Apheresis team recognized that even minor miscommunication could lead to life-threatening complications …

A Word From The Writing Team (March 2025), Pam Walter, Mfa, Hemma Murali, Ms

A Word From the Writing Team (Newsletter)

This issue includes:

• Publication Spotlight
• Jefferson is on Newsweek’s List of Top 250 Hospitals Worldwide!
• Sign up for the March 7th Writing Retreat (Online)
• Write that Baby in 9 Weeks Workshop Series – March 6th Online
• Generative AI Acknowledgement in Publishing
• Check out the OPWPC’s Streamlined Webpage
• The OPWPC Canvas Page Offers Helpful Tools
• Looking for Your Next Fun Podcast?