Medicine and Health Sciences Commons^™

The Tortoise, Alexa Gail Colinco

Quill & Scope

For my grandfather, Dr. Joel R. Colinco (1928-2017). The first physician in his family. A man who provided free medical care to all and who continues to do so through the Colinco Medical Mission Outreach. The 2009 Senior Poet Laureate of South Carolina. A deacon and choir director in the Philippines. A painter, tennis player, fisherman, crossword addict, gardener, and so much more. Eternally honored to be guided by his legacy and ethics. (Pang, we'll play Scrabble again in heaven, and I promise I'll spell neighbor correctly this time.)

Bearing, Christopher Liz

Quill & Scope

“Bearing” reflects on a moment of moral conflict in a combat environment, where training, survival and duty to care collide. In high-risk settings, medical service members are taught repeatedly that even in chaos, they must remain grounded; the instinct to run toward danger is tempered by the responsibility to preserve life, including their own, as a vital part of the team’s ability to continue care. The poem explores the tension between action and restraint, and the enduring weight carried when outcomes are uncertain and choices are final. In medicine, these moments become part of the cross we carry—quiet, often unseen, …

Compass, P M. Curtin

Quill & Scope

Looking ahead, it can be difficult to enjoy the review of less-than-enjoyable subjects (thinking of you, biochemistry) for STEP. Being without family and friends for what feels like long periods of time, but can really just be 12 hours, in a literal or metaphorical dark basement, is necessary to learn but sometimes dreary. All of this “points to” the final joy (and future trials) of being in-person in the clinic.

Global Genome, Patricia Weinstein

Quill & Scope

No abstract provided.

Quantifying Patient Positioning Errors And Radiation Dose Variation In Cardiac Computed Tomography Angiography, Yasser H. Hadi, Hassan B. Hawsawi, Niamh Moore, Helle Precht, Andrew England, Mark Mcentee

Journal of the Saudi Heart Association

Objectives: Accurate patient centring at the computed tomography (CT) scanner isocentre is essential for optimising radiation dose. This study aimed to quantify positioning errors, assess their relationship with radiation dose, and estimate the potential dose reduction achievable with optimal centring. Methods: This retrospective observational study included adult patients (≥18 years) who underwent electrocardiography (ECG)-gated cardiac CT angiography between January 2023 and July 2025 at a tertiary hospital. Scans were performed using Siemens SOMATOM Force dual-source CT systems. Vertical and lateral deviations from the scanner isocentre were calculated from scout images using integrated analytics within the institutional dose monitoring platform (Qaelum …

The Influence Of Fermentation Duration And Secondary Fermentation Conditions On The Bioactive Compound Profile Of Kombucha, Jordan Vereen

Honors Theses

Kombucha is a fermented sweet tea produced using a symbiotic culture of bacteria and yeast (SCOBY) and has gained widespread popularity due to its proposed health benefits. Kombucha has been studied to understand these advantages in cardiovascular support, improved metabolism, increased antioxidant effects, enhanced antimicrobial properties, and even potentially slowing the progression of certain diseases. Despite its increasing popularity, the way in which the specific bioactive compounds responsible for these effects and the fermentation conditions that influence their production remain unclear. The present study, conducted in collaboration with Dr. Budner, focuses on quantifying bioactive compounds in kombucha to better understand …

Improving Esi Triage Accuracy In The Emergency Department, Taibat Mursal Verdi

Walden Dissertations and Doctoral Studies

No abstract provided.

Staff Education On The Use Of Music To Alleviate Anxiety In Patients With Dementia Within Long-Term Care Facilities, Anyinkeng Lydia Tazi

Walden Dissertations and Doctoral Studies

No abstract provided.

The Legacy Of Lead: Lead Exposure's Harmful Effects And Its Concentration In Poc Communities, Layla Sophronia Barber

Student Theses 2015-Present

This thesis examines the disproportionate burden of lead exposure carried by low income, POC communities. The systemic nature of this problem is a symptom of a longstanding legacy of environmental injustice in the United States. Decades of federal neglect are reflected in the higher statistics of lead exposure and poisoning in predominantly black communities. While it is understood that lead exposure poses a serious threat to physical health and early cognitive development, there is a discouraging lack of urgency to remove the toxin from non-wealthy communities. The material covered by this thesis aims to identify and correct the discriminatory social …

Vision Remediation And Functional Participation For Individuals With Acquired Brain Injuries, Alina Randall

OTD Capstone Projects

This doctoral capstone project was completed in partnership with Neuro Therapy Nashville (NTN), a privately owned, outpatient neurologic rehabilitation clinic in Brentwood, TN. NTN offers occupational therapy, physical therapy, speech therapy, and counseling services to individuals with acquired brain injuries, with an emphasis on stroke, concussion, and vision remediation. The goal of the project was to increase access and availability of evidence informed resources for vision remediation and occupational therapy for individuals with acquired brain injuries. The outcomes of the project include a pilot research study which will be used to inform future analysis of vision remediation in occupational therapy, …

True North: Full Issue Download

Quill & Scope

Silence is embedded into the life of medical students. Silence pierces the air when you are standing in the back of a patient room observing the conversation, feet aching, wondering if your presence is unnecessary and overwhelming for the patient. We are transient members of the healthcare team. We contribute to patient medical records with out notes and bedside conversations, yet we lack power in the system---the authority to sign orders, be responsible to true coordination of care, the autonomy that residents wield to make healthcare decisions.

It is easy to lose your sense of self in this silence. We …

Bio 340 Final Project: Rural Population Structure And Food Production Interact To Shape Global Undernourishment, Ava Ripanti

Biology Student Scholarship

Ava Ripanti - Environmental Biology '27

Undernourishment remains a major global public health challenge, reflecting the proportion of a population lacking sufficient dietary energy intake. While food availability is central to food security, undernourishment is also shaped by structural and socioeconomic factors such as population distribution and access to resources. Although rural populations are closely tied to agriculture, they often experience higher food insecurity due to limited infrastructure, market access, and healthcare. Prior research emphasizes that broader determinants, particularly inequality and development, are stronger predictors of undernourishment than agricultural output alone, that food insecurity exists in both rural and urban …

Mental Health Screening For The Military Spouse: Prevention In Practice, Lura Allison Mcgrath

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Abstract

In recent years, a focus on mental health has moved to the forefront of healthcare. This is especially true when caring for United States military service members. The military spouses of these service members also struggle and suffer from mental health disorders. However, the mental health needs of military spouses often receive insufficient attention. Research shows military spouses are at an increased risk of developing mental health disorders and/or suffering from mental illness. A large contributor is the impact of the military lifestyle and its challenges for these spouses. However, research also reveals there has been minimal effort put …

Bacteriophage Therapy For Klebsiella Pneumoniae: Phage Screening And Efficacy Assessment In Macrophages/Neutrophils And Mouse Model, Mounika Duggineni

Biotechnology Theses

Klebsiella pneumoniae causes infections such as pneumonia and urinary tract infections, necessitating alternative therapies. As an emerging MDR pathogen, evaluating newer therapeutic strategies is essential. This study utilized bacteriophages and Klebsiella pneumoniae strains kindly provided by Dr. John, who previously isolated and characterized broad-host-range bacteriophages from hospital wastewater targeting diverse clinical K. pneumoniae isolates. Among fifteen lytic bacteriophages identified across multiple genera, bacteriophage #418 was selected and purified using ultrafiltration, yielding higher functional titers than PEG-based methods. In vitro assays showed Bacteriophage #418 nearly killed bacteria after 2 hours of co-incubation. Ex vivo studies using healthy donors human macrophages …

Hyposense: Multimodal Physiologic And Voc Wearable For Early Hypoglycemia Detection, Nidhi R. Patel

Honors Theses

Hypoglycemia remains a significant safety concern for insulin-dependent individuals, especially when blood glucose declines rapidly during exercise, sleep, or periods of impaired hypoglycemia awareness. Current continuous glucose monitors and automated insulin delivery systems have helped to improve diabetes management, but these technologies primarily respond to glucose trends after they have already started and may not actually provide sufficient warning before symptoms occur. This thesis describes the development of HypoSense, a noninvasive wrist worn wearable concept that is designed to support earlier hypoglycemia risk detection through multimodal physiologic and volatile organic compound emission sensing. HypoSense combines volatile organic compounds/gas sensing with …

The Effect Of A Superficial Biochar Layer On Soil Radon Exhalation: A Preliminary Investigation Into A Passive Residential Radon Mitigation Strategy, Nicholas Richmond Nelson

Honors Theses

Residential radon exposure is a leading cause of lung cancer worldwide, yet home testing and mitigation remain infrequent. Active mitigation systems can be costly, and existing passive radon-resistant construction techniques, while cost-effective, are not always sufficient to reduce indoor radon to below the recommended EPA threshold of 4.0 pCi/L (148 Bq/m3). This initial work examines the potential for a superficial biochar layer placed beneath a house foundation during construction to reduce soil radon exhalation and subsequent indoor radon concentration. Biochar is also being explored as an admixture to concrete, and this study investigates radon transmission through concrete with varying biochar …

Implementation Of A Planned Extubation Nurse-Led Safety Bundle In A Pediatric Cardiac Intensive Care Unit, Broderick Sutton

Doctor of Nursing Practice Final Project Abstract

Purpose: To implement and evaluate a nurse-led planned extubation safety bundle designed to improve nurse preparedness, interdisciplinary communication, workflow consistency, and confidence during planned extubation events in a pediatric Cardiac Intensive Care Unit (CICU).

Background: Planned extubation in critically ill pediatric cardiac patients requires effective interdisciplinary coordination. Variability in nurse preparation, communication, and knowledge of sedation pharmacokinetics contributed to workflow inefficiencies and patient safety concerns. Evidence supports standardized nurse-led protocols to improve extubation readiness and reduce practice variability.

Methodology: A prospective pre-post quality improvement project was conducted over eight weeks in a pediatric CICU. The intervention included a nurse-led planned …

A Quality Improvement Initiative Evaluating Factors Influencing Patient Experience With Virtual Reality During Awake​ Interventional Radiology Procedures, Quynh Dao-Payne

Doctoral Projects

Procedural anxiety and pain are common among pediatric patients undergoing awake interventional radiology (IR) procedures and may negatively affect patient comfort, cooperation, and overall patient experience. Virtual reality (VR) has emerged as a promising nonpharmacologic intervention to reduce anxiety and improve patient-centered outcomes. The purpose of this quality improvement project was to evaluate patient-reported experiences and perceived outcomes associated with VR use during awake pediatric IR procedures at Children’s Hospital Los Angeles.​ A qualitative descriptive quality improvement design was utilized. Twenty pediatric​ patients ages 10–21 years undergoing awake IR procedures with VR as part of standard clinical​ care completed structured …

The Impact Of Patient Navigation On The Hepatitis C Care Continuum In Underserved Populations: A Scoping Review, Deauntaye Jones

Honors Theses

Hepatitis C virus (HCV) remains a significant public health concern and is a leading cause of cirrhosis, hepatocellular carcinoma, and liver transplantation when left untreated. Although direct-acting antiviral therapies have made HCV curable for most patients, many underserved populations continue to experience barriers to diagnosis, linkage-to-care, treatment completion, and sustained virologic response (SVR). This study evaluated how patient navigation programs influence progression through the HCV care continuum among underserved populations. Relevant studies published between 2014 and 2025 were identified through searches of PubMed and Embase using terms related to HCV, patient navigation, linkage-to-care, underserved populations, and treatment outcomes. Following title, …

Development Of An Evidence Based Pressure Ulcer Prevention Bundle For The Medical Surgical Unit, Fanhelea Morency

Walden Dissertations and Doctoral Studies

No abstract provided.

Comparative Effectiveness Of Low Versus High Dose Upadacitinib As Maintenance Treatment In Patients With Ulcerative Colitis: A Real-World Cohort Study From The United States, Priya Sehgal, Gursimran S. Kochhar, Harpreet Kaur, Himsikhar Khataniar, Raina Shivashankar, James D. Lewis, Aakash Desai

Division of Gastroenterology and Hepatology Faculty Papers

BACKGROUND: There is limited real-word data comparing efficacy of low dose upadacitinib (UPA) to high dose UPA as maintenance therapy for ulcerative colitis (UC).

METHODS: This was a retrospective cohort study utilizing the U.S. Collaborative Network in adults ≥18 years old with UC who initiated UPA 15 mg compared to 30 mg for maintenance therapy between April 2022 and December 2023. The primary outcome was a composite of intravenous steroid use, oral steroid use, or colectomy from 12 to 60 weeks from the index UPA prescription. Propensity score matching (PSM) was performed for demographics, co-morbid conditions, laboratory, and IBD medication …

Expanding Expanded Access: A Case Of Onc201 And The Ethical Limitations Of Compassionate Use, Ava C. Hutchings

Honors Theses

This study examines the ethical and structural limitations of the Expanded Access program in the United States, with particular focus on its application to terminal pediatric illness. Although the program is intended to provide patients with life-threatening conditions access to investigational therapies outside of clinical trials, its effectiveness in serving critically ill children remains uncertain. This program is analyzed through careful consideration of regulatory review and ethical theory. Key policies governing Expanded Access are examined alongside scholarly discussions of pediatric autonomy and parental authority.

A case study of ONC201, a now-approved investigational drug, is used to illustrate how Expanded Access …

Dna Methylation Signatures Associated With Bipolar Disorder In Peripheral Blood Improve Prediction Models, Markos Tesfaye, Anne-Kristin Stavrum, Kira D Höffler, Kevin S O'Connell, Friederike S David, Melanie E Garrett, Sonia Hesam-Shariati, Bronwyn J Overs, Claudia Pisanu, Luana Spano, Oliver J Watkeys, Antoine Weihs, Rafaella Ardau, Allison E Ashley-Koch, Lavinia Athanasiu, Jean C Beckham, Kyle J Bourassa, Caterina Chillotti, Srdjan Djurovic, Ole K Drange, Josef Frank, Anouar Khayachi, Nathan A Kimbrel, Lourdes Martorell, Susanne Meinert, Ingrid Melle, Gunnar Morken, Pasquale Paribello, Marco Pinna, Gloria Roberts, Guy Rouleau, Peter R Schofield, Esteban Sepúlveda, Giovanni Severino, Vidar M Steen, Frederike Stein, Fabian Streit, Va Mid-Atlantic Mirecc Workgroup, Trine Vik Lagerberg, Martin Alda, Udo Dannlowski, Andreas J Forstner, Janice M Fullerton, Hans J Grabe, Melissa J Green, Tilo Kircher, Javier Labad, Mirko Manchia, Philip B Mitchell, Jair C Soares, Alessio Squassina, Alexander Teumer, Leonardo Tondo, Elisabet Vilella, Ole A Andreassen, Boris Chaumette, Gabriel R Fries, Stephanie Le Hellard

Faculty, Staff and Student Publications

Background: Bipolar disorder (BD) is a major mood disorder influenced by both genetic and environmental factors. While DNA methylation from peripheral tissues can reflect both genetic and environmental influences and reveal insights into disease biology, it remains understudied in BD. DNA methylation signatures may complement polygenic scores (PGS) and hold potential as biomarkers. Here, we conducted the largest epigenome-wide association study (EWAS) of BD to date and evaluated the predictive value of polymethylation scores (PMS) in classifying case-control status.

Methods: DNA methylation from peripheral blood of 1729 cases and 1747 controls, comprising twelve cohorts, was obtained. We performed meta-analyses for …

Identifying Novel Gene Dysregulation Associated With Opioid Overdose Death: A Meta-Analysis Of Differential Gene Expression In Human Prefrontal Cortex, Javan K Carter, Bryan C Quach, Caryn Willis, Melyssa S Minto, Dana B Hancock, Janitza Montalvo-Ortiz, Olivia Corradin, Ryan W Logan, Consuelo Walss-Bass, Brion S Maher, Eric Otto Johnson

Faculty, Staff and Student Publications

Only recently have human postmortem brain studies of differential gene expression (DGE) associated with opioid overdose death (OOD) been published; sample sizes from these studies have been modest (N = 40-153). To increase statistical power to identify OOD-associated genes, we leveraged human prefrontal cortex RNA-seq data from four independent OOD studies and conducted a transcriptome-wide DGE meta-analysis (N = 272). Using a unified gene expression data processing and analysis framework across studies, we meta-analyzed 20, 098 genes and found 335 significant differentially expressed genes (DEGs) by OOD status (false discovery rate <  0.05). Of these, 66 DEGs were among the list of 303 genes reported as OOD-associated in prior prefrontal cortex molecular studies (e.g., genes/gene families OPRK1, NPAS4, DUSP, EGR). The remaining 269 DEGs were not previously reported (e.g., NR4A2, SYT1, HCRTR2, BDNF). There was little evidence of genetic drivers for the observed differences in gene expression between opioid addiction cases and controls. Enrichment analyses for the DEGs across molecular pathway and biological process databases highlight an interconnected set of genes and pathways linked to orexin and tyrosine kinase receptors through MEK/ERK/MAPK signaling to affect neuronal plasticity.

Development Of Novel Plasma Proteomic Biomarkers For Cancer-Associated Thrombosis In An Advanced Cancer Cohort, Preeti, Mrinal Ranjan, Dang Pham, Juan L Bueno, Micheline M Resende, Michael E Scheurer, Christopher I Amos, Chao Cheng, Ang Li

Faculty, Staff and Students Publications

Background: Existing risk models for cancer-associated thrombosis (CAT) show suboptimal performance in selective high-risk populations with cancer. Affinity-based plasma proteomics offers a novel approach for detecting CAT risk.

Objectives: To identify plasma biomarkers for CAT using proximity extension assays in an advanced cancer cohort.

Methods: We performed a nested case-control study using the Olink Explore HT panel. The final cohort included 57 patients with CAT and 113 matched control patients from 5 selected cancer types who had samples collected between cancer diagnosis and chemotherapy initiation. Random survival forest model was used to assess nonlinear associations with CAT in 5416 normalized …

Practicing Professional Intake Consultations With Ai: An Experiential Assignment For An Exercise Prescription Course, Mark E. Hartman

Educational Practices in Kinesiology

The purpose of this article is to describe an assignment that integrates artificial intelligence (AI) with simulation-based learning in an upper-level undergraduate exercise prescription course. A large body of evidence supports the use of simulation-based education, though due to cost and feasibility limitations, it has largely been limited to medical education. This assignment leverages AI as a scalable, low-cost simulation tool, offering exercise science students a highly realistic practice simulation that reinforces both professional reasoning and interpersonal communication skills. In this assignment, titled Simulated Exercise Consultation Using ChatGPT, students practice conducting an intake session as a personal trainer while …

Progressive Cardiac Phenotypes And Reduced Reversibility From Long-Term Cugexp Rna Expression In A Dm1 Mouse Model, Rong-Chi Hu, Mohammadreza Tabary, Xander Ht Wehrens, Thomas A Cooper

Faculty, Staff and Students Publications

Myotonic dystrophy type 1 (DM1) is caused by an expanded CTG repeat in the DMPK gene, resulting in mutant transcripts that form expanded CUG (CUGexp) RNA foci and sequester muscleblind-like (MBNL) RNA-binding proteins. DM1 is multisystemic, with progressive worsening of disease manifestations in affected tissues. Disease progression is attributed to somatic expansion of the CTG repeats with age, resulting in production of CUGexp RNA with enhanced intrinsic toxicity due to increased MBNL sequestration. To determine the degree to which cardiac disease progression can occur independently of repeat expansion, we used a transgenic DM1 mouse model with inducible heart-specific expression of …

Improving Postoperative Handoff For Placenta Accreta: Implementing A Structured Handoff Communication Tool, Isabelle L. Gerrard

Doctor of Nursing Practice Final Project Abstract

Purpose Implement a standardized postoperative handoff tool to improve interdisciplinary communication during transfer of placenta accreta spectrum (PAS) patients from the operating room to an obstetric intensive care unit at an academic women's hospital.

Background Placenta accreta spectrum (PAS) is a high-risk obstetric condition requiring coordinated multidisciplinary care. At the project site, operating room (OR)-to-obstetric intensive care unit (OB ICU) handoffs lacked a standardized process. This resulted in inconsistent communication and omission of critical information. Nurses reported reduced confidence. Standardized handoff tools can improve communication and promote safer transitions of care.

Methodology This 10-week quality improvement project used Plan-Do-Study-Act methodology …

Staff Education To Improve Interpretation And Documentation Of Category Ii Fetal Heart Rate Patterns In Labor And Delivery Nurses, Lizette Girado

Walden Dissertations and Doctoral Studies

No abstract provided.

Staff Education To Improve Clinical Task Prioritization Among Outpatient Clinical Staff, Adebayo Arowolo

Walden Dissertations and Doctoral Studies

No abstract provided.