Medicine and Health Sciences Commons^™

Real-World Outcomes Of Dedicated Leaflet Modification For Bioprosthetic Valve-In-Valve Tavr: A 150-Patient Commercial Experience., Raj R Makkar, Aakriti Gupta, Ignacio Inglessis, Curtiss T Stinis, Pradeep K Yadav, Vinod H Thourani, Stanley J Chetcuti, Matthew Summers, Vivek Patel, Bassem M Chehab, Apurva Patel, Gilbert H L Tang, Sahil Khera, Michael Rinaldi, Trevor Simard, Jeffrey Southard, Benjamin R Stripe, Brian Whisenant, Keith Allen, Yoseph Rozenman, Danny Dvir, Carlos E Sanchez, Jeffrey Popma, Martin B Leon, Philippe Généreux

Heart and Vascular Articles

BACKGROUND: Coronary obstruction during valve-in-valve (ViV) transcatheter aortic valve replacement (TAVR) is infrequent but catastrophic. Mechanical splitting of bioprosthetic leaflets may mitigate this risk, but real-world experience remains limited.

OBJECTIVES: The aim of this is to evaluate procedural performance and in-hospital outcomes of a dedicated mechanical leaflet-splitting device in ViV TAVR.

METHODS: Consecutive postapproval cases were performed at 28 centers from February to November 2025. Patients were selected for elevated risk based on preprocedural computed tomography criteria, including virtual valve-to-coronary distance ≤4 mm and/or virtual valve-to-sinotubular junction distance ≤3 mm. Procedural outcomes were assessed among patients in whom splitting was …

Effectiveness Of Lay Workers Delivering Behavioural Activation For People With Depression: Systematic Review And Meta-Analysis, Shwikar Othman, Lauren Blekkenhorst, Asangaedem Akpan, Irene Ngune, Nilufeur Mckay, Alison Kennedy, Elizabeth Armstrong, Michael Hunter, Kevin Murray, Mathew Coleman, Richard Gray, Emma Jones, Christopher Lee, Martin Jones

Research outputs 2022 to 2026

Background Behavioural activation is effective for depression, but its effectiveness in treating adults with depression when delivered by lay workers remains unclear. Aims To examine the effectiveness of behavioural activation delivered by lay workers, compared with any control group, in reducing depressive symptoms in adults. Method This systematic review searched six databases from inception to January 2025, for randomised controlled trials (RCTs) comparing behavioural activation and any control conditions for individuals with depression when delivered by lay workers. Additional searches were conducted in the international trial registries and reference lists (PROSPERO registration CRD42024625620). Risk of bias was assessed using the …

Does Set Configuration Influence Long-Term Adaptations To Complex Training In National-Level Wrestlers? A Volumematched Randomized Trial, Yueqiang Ma, Pengpeng Gou, Yuxiong Huang, Jialiang Yu, Lijia Zhou, Kai Xu, Binbin Jia, Danyang Li

Research outputs 2022 to 2026

Objectives: Complex training is commonly used to enhance strength and explosive performance in athletes; however, the long-term influence of set configuration within complex training remains unclear in highly trained wrestlers. This randomized, volumematched trial investigated whether set configuration influences long-term adaptations to complex training (CT) in national-level male Chinese-style wrestlers. Specifically, the study compared the effects of cluster-set complex training (CS-CT) and traditional-set complex training (TS-CT) on maximal strength, lower-limb explosive performance, anaerobic power, and sport-specific performance.

Methods: Sixteen highly trained wrestlers (Tier 3; n=16) completed an 8-week lowerbody CT program performed twice weekly. Participants were randomly allocated to either …

In Silico Screening And Molecular Analyses Identify Apigenin From Scutellaria Barbata As A Potent Akt1 Inhibitor In Breast Cancer, Md. Maruf Khan, Md. Arju Hossain, Fatematuz Zohora, Md. Sohel, Md. Faisal Amin, Fatematuz Zuhura Evamoni, M. Nazmul Hoque

School of Integrative Biological & Chemical Sciences Faculty Publications

Breast cancer (BC) remains a leading cause of cancer-related mortality in women worldwide. Scutellaria barbata, a traditional Chinese medicinal herb, possesses recognized anticancer properties, but its mechanistic role in BC is not fully elucidated. This study employed an integrated in silico approach to identify the key flavonoids, targets, and pathways through which S. barbata exerts its anti-BC effects. A multi-step computational methodology incorporating network pharmacology, molecular docking, and dynamics simulations was utilized to profile bioactive compounds from S. barbata. From an initial set of 34 phytocompounds, three flavonoids namely apigenin, 4’-hydroxywogonin, and hispidulin demonstrated favorable drug-likeness, high bioavailability, …

Scholarship, Discovery, And The Formation Of Physicians, Anderson Spickard

Cumberland Medica

The launch of Cumberland Medica marks an important milestone for the Thomas F. Frist, Jr. College of Medicine. More than a journal, it reflects something we hope will be deeply woven into our culture: a community of learners committed to discovery, scholarship, and the formation of physicians. This issue showcases the work of our students while also reflecting the scholarship, mentorship, and educational leadership of faculty and staff. More importantly, it reflects our belief that scholarship is not simply about producing knowledge. It is one of the ways physicians learn how to see.

Refining Of An Online Rotator Cuff Related Pain Screening Tool (Orcs): A Mixed Methods Refinement Study, Andrew J. Smythe, Rhiannon Whale, Melanie Farlie, Peter Malliaras

Internet Journal of Allied Health Sciences and Practice

Purpose: The purpose of this study is to refine an online rotator cuff related shoulder pain screening tool. Method: A mixed methods item-refinement study was used. The original tool was designed through expert opinion and informal literature review. In this study the original tool was refined over three rounds of cognitive interviews totalling 39 participants. The screening tool consisted of two sections, red flag screening followed by rotator cuff related shoulder pain differential diagnostic items. Results from each round of interviews were summarised and informed a nominal group research panel review process to modify items and develop a finalised version …

Objectively And Subjectively Measured Physical Activity Levels Among Children And Adolescents In Poland (2012–2022): A Systematic Review, Jarosław Herbert, Vasylyna Petrovets

Baltic Journal of Health and Physical Activity

This article aims to provide a comprehensive review of research on physical activity levels among children and adolescents in Poland from 2012 to 2022, considering both objective and subjective assessment methods. A systematic review of the literature was conducted in accordance with the PRISMA reporting recommendations. PubMed, Scopus, Web of Science, Google Scholar databases, as well as Polish scientific databases were searched. The review included studies published from 2012 to 2022, on children and adolescents aged 3–18 living in Poland, assessing physical activity levels using objective and/or subjective methods. This analysis of the selected studies showed that physical activity levels …

Influence Of Peak Height Velocity On The Level Of Motor Skills And Anthropometric Features In Young Male Footballers, Dariusz Tadeusz Skalski, Magdalena Prończuk, Artur Terbalyan, Kinga Łosińska, Adam Maszczyk, Robert Krzysztof Roczniok

Baltic Journal of Health and Physical Activity

Background: This study examines the influence of Peak Height Velocity (PHV) on motor abilities and anthropometric characteristics of young male football players aged 12–16. The research aimed to determine whether PHV significantly affects motor performance beyond the chronological age, providing insights for talent identification and training optimization. Materials and methods: A total of 248 male football players from four professional academies were assessed and categorized into three maturation groups: Pre-PHV (n = 95, 38.3%), Mid-PHV (n = 98, 39.5%), and Post-PHV (n = 55, 22.2%) Anthropometric measurements included height, body mass, BMI, and leg length, while motor tests …

Quality Improvement Project Improving Provider Confidence For Medication Adherence Screening Through Use Of The Medication Adherence Rating Scale (Mars), Tamara Cheek

Doctor of Nursing Practice Projects

Medication nonadherence affects 50% to 70% of individuals with serious mental illness. This contributes to symptom relapses, hospitalization, poor treatment outcomes, and higher healthcare costs. The purpose of this quality improvement project was to evaluate the impact of a competency-based Medication Adherence Rating Scale (MARS) training program on provider confidence and standardized adherence screening in a psychiatric clinic, to improve confidence and increase use of a standardized assessment. Guided by Bandura's Self-Efficacy Theory and Lewin's Change Management Model and implemented using the Plan-Do-Study-Act framework, the project used a quantitative quasi-experimental pre-post design with eight psychiatric mental health nurse practitioners. Data …

Quality Improvement Project: Addressing Appointment Non-Adherence Through Social Needs Screening, Dorathy Anderson

Doctor of Nursing Practice Projects

Mental health care access in the US faces systemic barriers that delay treatment and disrupt care, often worsening patient outcomes. Unmet social needs of health, such as transportation, financial, and housing issues, lead to missed appointments and fragmented care, thereby increasing health disparities. This quality improvement project evaluated whether targeted staff education improved the identification and response to social needs that affect appointment adherence. Adult Learning Theory guided the training, while Lewin’s Theory of Change and the Plan-Do-Study-Act framework informed implementation and evaluation. The intervention population consisted of five clinic staff members. A quasi-experimental pretest-posttest design was used to evaluate …

The Impact Of Telephonic Versus Video Platforms On Nurses’ Intrinsic Motivation: An Evidence-Based Practice Project, Brittney Saldierna

Doctor of Nursing Practice Projects

Ambulatory pediatric nurses frequently rely on telephone-only encounters for telehealth triage and patient education despite the availability of video-enabled technology. Literature demonstrates that the inability to visually assess patients limits clinical assessment accuracy, communication effectiveness, and nurse confidence. The purpose of this evidence-based practice project was to evaluate whether educating ambulatory pediatric nurses on the integration of video-enhanced telehealth encounters impacts intrinsic motivation and perceived competence compared with telephone-only encounters. Guided by the Iowa Model of Evidence-Based Practice and the ADKAR Change Management Model, this quantitative, quasi-experimental project was applied utilizing the PDSA cycle implementation framework in ambulatory pediatric specialty …

Quality Improvement Project: The Impact Of Standardized Handoff Communication In A Home Acute Care Setting, Antonius Devon Speed

Doctor of Nursing Practice Projects

Effective nurse-to-nurse handoff communication is essential in hospital-at-home telehealth care, where remote nurses depend on accurate electronic health record documentation and structured shift-to-shift communication. This quality improvement project evaluated whether education and implementation of a standardized Situation, Background, Assessment, Recommendation (SBAR) workflow improved staff-reported handoff quality and reduced communication-related near-miss events over 8 weeks. Lewin's Change Theory, Rogers's Diffusion of Innovations, and the Plan-Do-Study-Act framework guided implementation and sustainability. A quantitative, quasi-experimental one-group pretest-posttest design was used. The intervention included SBAR education, a workflow checklist, and a handoff template. Outcomes were selected Handover Evaluation Scale (HES) responses and aggregate near-miss …

Assessing Renal Dysfunction Incidence Related To Intravenous Acyclovir Usage, Marwa Said Aljahwari, Mohammad Abobakr Alghazali, Aya Said Alsaidi

Sultan Qaboos University Medical Journal

Objectives: This study aimed to assess the incidence and contributing factors of renal dysfunction among patients receiving intravenous (IV) acyclovir at Khoula Hospital, Muscat, Oman. Specifically, this study aimed to evaluate the incidence of acute kidney injury (AKI) following IV acyclovir administration, associated risk factors and potential preventive strategies to reduce nephrotoxicity. Methods: This retrospective cohort study was conducted at Khoula Hospital and included patients aged 12–80 years who received IV acyclovir between January 2019 and December 2023. Patients with pre-existing renal disease or increased baseline serum creatinine were excluded. The sample size was computed using Daniel's formula, resulting …

Quality Improvement Project: Implementation Of Trauma-Informed Care Education In An Outpatient Psychiatric Clinic, Ornela Claude Ika

Doctor of Nursing Practice Projects

Trauma-informed care (TIC) is an evidence-based approach that promotes safe, patient-centered care for individuals with a history of trauma. Many patients receiving services in psychiatric settings have experienced trauma, placing them at risk for retraumatization during healthcare encounters. Despite the recognized benefits of TIC, the outpatient psychiatric clinic involved in this project lacked a formal trauma-informed care education program for staff. The purpose of this quality improvement project was to determine whether implementation of a structured trauma-informed care educational intervention improved staff attitudes toward trauma-informed care. Lewin’s Change Theory and the Plan-Do-Study-Act framework guided project implementation. A quantitative pre-intervention and …

Quality Improvement Project: Impact Of Adjunct Clinical Faculty Mentorship On Self-Confidence: A Quality Improvement Project, Fairah Solomon

Doctor of Nursing Practice Projects

Novice adjunct clinical faculty transitioning from expert clinicians to nurse educators face many challenges, particularly in understanding their roles, responsibilities, and educational frameworks. Despite an established orientation at the project site, a structured mentorship program to support the role transition is lacking. This quality improvement (QI) project aimed to improve novice adjunct clinical faculty’s self-confidence through the implementation of a structured mentorship intervention. Guided by Lewin's Change Theory and Constructivist Learning Theory, the project utilized a quasi-experimental pre- and post-test design. Implementation was guided by the Plan-Do-Study-Act framework. A purposive sample of seven novice adjunct clinical faculty with less than …

Adaptation Of The Transition Readiness Assessment Questionnaire For Pediatric-Onset Multiple Sclerosis: Protocol For A User-Centered Design Approach, Claudia Gambrah-Lyles, Aaron W Abrams, Sara Loud, Hollie Schmidt, Emily Blosberg, Melissa Wright, Kelsey E Poisson, Kristen S Fisher, Kimberly A O'Neill, Akash Virupakshaiah, John W Rose

Faculty, Staff and Students Publications

Background: Pediatric-onset multiple sclerosis (POMS) is a chronic, progressive neurologic condition requiring lifelong management and coordinated transition from pediatric to adult care. Evidence-based guidelines identify transition readiness assessment as a core component of successful transition; however, most POMS clinics do not formally assess readiness, and existing tools do not address POMS-specific challenges, such as fluctuating disability, complex treatment regimens, and cognitive impairment. This gap underscores the need for a transition readiness measure tailored to POMS.

Objective: This paper aims to describe a stakeholder-engaged, implementation science-guided protocol for adapting the Transition Readiness Assessment Questionnaire (TRAQ) version 6.0 to reflect the unique …

Closing The Gaps: Reforming Maryland Controls On Veterinary Antimicrobial Distribution, Samantha Capaldo, Kerry Mcclaughry

Journal of Food Law & Policy

Antimicrobials have been used in livestock and other food animals in the United States (“U.S.”) since the late 1940s. An antimicrobial is “[a]ny natural, synthetic, or semisynthetic substance that can eradicate or prevent the growth of microbes,” including “[a]ntibacterial, antifungal, antiparasitic, and antiviral medications.” Antimicrobial use in food animals is subject to a complex statutory and regulatory framework at both the state and federal levels. Antimicrobial use in food animals has been widely criticized for contributing to antimicrobial-resistant bacterial infections in humans. In response to this criticism, the U.S. Food and Drug Administration (“FDA”) and several states, including Maryland, have …

Proceedings Of The 25th International Symposium On Adapted Physical Activity: Easy Read Edition Of The Symposium Proceedings, Catherine Carty, Niamh Cronin, Ian Coleman Horgan, Stuart Dodd, Jack Dowling, Lydia Murphy, Alex Nicholls, Yann O'Carroll, Robbie O'Neill, Meabh Rohan, Brandon Rumian, Diarmuid O'Connor, Eamonn Carroll, Gerard O'Carroll, Jasmin Richter, Mary Shanahan, Aaron Doherty, Sasha Fitzgerald, Katie Lyons, Katie Mahoney, Afeefah Memon, Conor Moriarty, Adrian O'Sullivan, Dylan Shine, Michelle Enright, Phil Mcsweeney, Sophie Casey

Publications

This book is the Easy Read Proceedings of the 25th International Symposium of Adapted Physical Activity (ISAPA 2025), hosted by Munster Technological University under the Patronage of UNESCO. A small number of printed books are available in MTU libraries, and there is a digital version available online on the South West Open Research Deposit.

I Cry At Night Before You: Theologies Of Depression In The Psalms, Travis Spillum Osb

Obsculta

This work looks to the Psalms to discover theologies that resonate with experiences of depression. If one struggling with depression feels as if God is angry with them, that their condition is oppressing them, that loved ones have abandoned them, or that God's love for them is wavering, they can utilize the psalmist's words to voice their feelings and express their anguish in prayer to a God who is seemingly deaf to their groaning.

Bridging Gaps In Childhood Systemic Lupus Erythematosus Treated At An Outpatient Clinic, Allen M. Savedra

Walden Dissertations and Doctoral Studies

No abstract provided.

Staff Education Project To Improve Nursing Knowledge And Patient Safety, Njideka Maureen Okeke

Walden Dissertations and Doctoral Studies

No abstract provided.

Continuing Medical Education As A Workforce Learning System For Artificial Intelligence In Clinical Practice, Tim Murphy, Rob E. Carpenter

Human Resource Development Faculty Publications and Presentations

Artificial intelligence (AI) is increasingly embedded in clinical decision support, documentation, imaging, predictive analytics, and workflow management. However, the educational systems responsible for preparing practicing physicians to use AI have not fully addressed the interpretive, ethical, and organizational demands of AI-supported care. This qualitative case study examined how continuing medical education (CME) shapes physicians’ readiness to integrate AI into clinical practice. Guided by the Unified Theory of Acceptance and Use of Technology (UTAUT) and human resource development (HRD), the study analyzed semi-structured interviews with 14 physicians from diverse specialties within a large academic health system. Organizational artifacts, including CME announcements, …

Reflections On Inclusive Qualitative Research With Autistic Emerging Adults: Lessons Learned And Practical Recommendations, Acadia W. Buro, Heidi Rishel Brakey, Monica F. Asencio Pimentel, Elizabeth Yakes Jimenez

Population Health Research and Scholarship

We explored inclusive qualitative data collection strategies for autistic emerging adults (ages 18–25) to identify nutrition-related resource needs and inform intervention development. We conducted Zoom interviews with autistic emerging adults, their caregivers, and service providers. We co-developed recruitment materials with a community advisory board of autistic advocates and offered and adapted interview accommodations in real time to align with participants’ preferences. Common accommodations included receiving questions in advance and in the chat, having a caregiver present, and simplifying questions. Some techniques used with neurotypical participants translated well to our participants, such as reflective listening, a conversational tone, and allowing pauses; …

Critical Care Nurses’ Self-Efficacy In Responding To Emergency Code Situations, Nesheemah Sabree

Walden Dissertations and Doctoral Studies

No abstract provided.

Improving Procedural Confidence: Outcomes Of A Surgical Skills Workshop For Medical Students, Mary Arden G Guillory, Jennifer Escamilla, Anika Doppalapudi, Ashlyn Holubar, Kaitlyn Ybanez, Mark Manickath, Maci Oestreich, Mckenna Stallworth, Kelsey Baker

School of Medicine Publications

Introduction Introducing surgical skills early in medical training may enhance students' confidence and readiness for clinical training. Simulation-based skill workshops provide students with a comfortable learning environment, resulting in effective learning. The goal of the Surgical Skills Workshop was to provide first- and second-year medical students with hands-on exposure to essential surgical skills. The educational impact on medical students' confidence in performing the respective surgical skills and changes in surgical career interest was assessed.

Methods: First- and second-year medical students at the University of Texas Rio Grande Valley School of Medicine participated in a hands-on surgical skills workshop comprising eight …

Meeting Report From The 2025 Cure Ocular Melanoma (Cure Om) Global Science Meeting, Amsterdam, The Netherlands, October 2025, Andrew E. Aplin, Katherina Alsina, Allison S. Betof, Joseph Birkett, Marcus O. Butler, George Cole, Rizwan Haq, Florian A. Karreth, Vinit B. Mahajan, Rahul Marpadga, Prithvi Mruthyunjaya, Paul Nathan, Jonas A. Nilsson, Gary Palmer, Joseph J. Sacco, Takami Sato, Sarah Stanhope, Pang-Ning Teng, Kyleigh Lipira

Department of Pharmacology, Physiology, and Cancer Biology Faculty Papers

The 2025 Cure Ocular Melanoma (CURE OM) Global Science Meeting took place in Amsterdam, The Netherlands on October 25th, 2025. Several promising drug candidates are in development; however, there is still an urgent need for better prevention, detection, and treatment of uveal melanoma. The purpose of this meeting was to promote international collaboration and idea exchange between scientists, industry, and patient advocates.

Qualitative Evaluation Of The Seated Physical Activity Intervention (Spin) Randomized Controlled Trial For Wheelchair Users With Multiple Sclerosis (Ms): Formative Feedback And Future Directions, Angela J Piasecki, Robert W Motl, Katherine Froehlich-Grobe, Stephanie L Silveira

Faculty, Staff and Student Publications

Background/objectives: Wheelchair users with multiple sclerosis (MS) often face barriers that restrict participation in physical activity and exercise training. This manuscript reports on participant feedback to guide evaluating and refining a novel exercise training program, Seated Physical activity INtervention (SPIN). SPIN was adapted from the Guidelines for Exercise in MS (GEMS) approach using a three-step community-engaged research framework based on meeting the needs of wheelchair users with MS.

Methods: Semi-structured interviews were conducted with 9 participants who completed the 16-week SPIN intervention. The key SPIN intervention components were the exercise prescription, exercise equipment, and behavioral coaching grounded in Social Cognitive …

Staff Education On Stress Management And Coping Strategies For Psychiatric Nurses, Chidinma Uwakwe

Walden Dissertations and Doctoral Studies

No abstract provided.

Knowledge, Attitudes And Dispensing Practices Regarding Antimicrobial Resistance And Stewardship: A Comparative National Assessment Among Primary Healthcare Pharmacists In Oman, Mohammed Al Ghafari, Meher Rizvi, Hana Al Ghusaini, Zaima Al Rawahi, Wafa Al Balushi, Manal Al Ghafri, Hamed Al-Qanubi, Zuhair Al Salti, Idris Al Jumaa, Muhammed Rafiq

Sultan Qaboos University Medical Journal

Objectives: Antimicrobial resistance (AMR) is driven by inappropriate antibiotic use. This study aimed to assess the knowledge, attitudes and dispensing practices (KAP) regarding AMR and antimicrobial stewardship (AMS) among primary healthcare (PHC) pharmacists and assistant pharmacists in Oman. Furthermore, the study sought to compare these parameters across facilities with historically high versus standard antibiotic consumption to identify structural determinants of AMS.

Methods: This national cross-sectional study was conducted among PHC pharmacy staff in February 2025. KAP were assessed via a structured electronic questionnaire. Data were analysed using generalized estimating equation models to identify KAP predictors while accounting for facility-level …

The Roots Of Sexual Violence In Utah: A Framework For Understanding Harm, Susan R. Madsen

Marketing and Strategy Faculty Publications

Sexual violence in Utah is not an anomaly, a private tragedy, or the result of individual deviance. It is a patterned, predictable outcome of cultural norms, social systems, and power structures that shape how people understand gender, authority, and worth. Despite Utah’s reputation for strong families, close‑knit communities, and deep religious commitment, the state continues to report higher‑than‑national‑average rates of rape, child sexual abuse, and other forms of gender‑based harm. These realities demand a deeper understanding of why violence persists—and what can be done to prevent it.

This white paper synthesizes decades of national and international research, Utah‑specific data, and …