Medicine and Health Sciences Commons^™

Novel Applications Of Coronary Cta In Patients With Intermediate Risk Of Cad, Ashley Armstrong, Luai Madanat, Robert D. Safian

Conference Presentation Abstracts

Background: ACC/AHA guidelines provide class 1 and 2A recommendations respectively for coronary CTA and FFRCT in patients with chest pain and intermediate risk of CAD. We present a case in which novel applications of CTA excluded obstructive CAD, identified the correct diagnosis, and allowed optimization of medical therapy. Case: In a 72-year-old male with stable angina and HEART score 6, stress ECG was positive for angina and frequent PVCs (Fig 1A). Coronary CTA (Fig 1B) and FFRCCT (Fig 1C) showed non-obstructive CAD and intramyocardial bridging/severe systolic compression in the mid-LAD (Fig 1D). AI plaque analysis demonstrated a mixed plaque burden …

Leveraging State Of The Art Simulation-Based Education To Enhance Medical Student Interest In Internal Medicine And Cardiology, Mohamed Abdalaziz, Nicholas Mitchell, Ryan Madder

Conference Presentation Abstracts

Abstract Background: Early clinical exposure plays a critical role in shaping medical student interest, and therefore choice in medical specialty. Traditional curricula offer limited opportunities for hands-on engagement with cardiovascular decision-making and procedures. Simulation-based education may address this gap by providing immersive, low-risk learning experiences. Methods: An internal medicine resident and Cardiology fellow led, faculty-supported simulation curriculum was developed for third- and fourth-year medical students using a state-of-the-art simulation laboratory. Two 75-minute sessions were conducted over a two-month period, with a total of 27 students participating. The first session included a focused electrocardiography didactic emphasizing ST-elevation myocardial infarction (STEMI) recognition, …

Right Atrial Thrombosis In Behcet's Disease Presenting With Tricuspid Inflow Obstruction, Famta Basher Bisher, Thekrayat M. Asad, Sireen Shehadah

Conference Presentation Abstracts

Introduction Behçet’s disease (BD) is a chronic multisystem vasculitis characterized by recurrent mucocutaneous, ocular, vascular, and neurologic manifestations. Cardiac involvement is rare but can be severe, with intracardiac thrombosis representing an uncommon and potentially life-threatening complication. Management is challenging, as first-line medical therapy may be limited by bleeding risk or hemodynamic compromise. Case Presentation A 26-year-old woman with a 9-year history of Behçet’s disease presented with two weeks of progressive dyspnea, palpitations, fever, fatigue, and cough. She denied chest pain, or syncope, or lower extremity swelling. One year prior, she had been hospitalized for pulmonary embolism and was found to …

Recommendations For Sharing Cardiovascular Implantable Electronic Device Data With Patients Based On Clinician Interviews, Carly Daley, Jonathan Shirazi, Tina Allmandinger, Mindy Flanagan, Stephanie Pruitt, Hung-Yeh Lin, Victor P. Cornet, Jeanne Carroll, Yi Rong Tan, Tammy Toscos, Michael Mirro

Health Services and Informatics Research

BACKGROUND Cardiovascular implantable electronic devices (CIEDs) capture an abundance of data that requires specific medical knowledge to interpret. Currently, there are no clear recommenda tions for sharing clinically meaningful CIED data with patients from the abundance of data in CIED remote monitoring reports.

OBJECTIVE The objectives of this study were to explore clinicians’ perceptions of clinical care gaps related to CIED data that could be improved through patient access to data and to generate recom mendations for sharing CIED data with patients.

METHODS In this institutional review board-exempt, 2-phase sequential qualitative study, 42 semi-structured phone interviews were conducted with 32 …

Hematopoietic Cell Transplant Access And Patient Diversity, Rachel Cusatis, Ramzi Abboud, Et Al.

2020-Current year OA Pubs

IMPORTANCE: Allogeneic hematopoietic cell transplant (HCT) is curative for hematologic cancers, yet access remains inequitable for racially and ethnically underrepresented and socioeconomically disadvantaged populations, making the goal of having a suitable donor for every patient who needs a transplant challenging. The ACCESS trial broadened access by enrolling patients without matched donors, who instead received an HCT from a mismatched unrelated donor.

OBJECTIVE: To compare baseline characteristics of ACCESS trial participants with participants enrolled in a similar clinical trial and a patient-reported outcome (PRO) protocol cohort.

DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study included adult participants (aged ≥18 years) from 3 …

The Camus Initiative: A Multiphase, Multicentre International Collaboration To Redefine Risk Stratification, Reporting, And Grading Of Surgical Complications In Urology., Christopher Soliman, Niranjan J. Sathianathen, Niall M. Corcoran, Nathan Lawrentschuk, Patrick Y. Wuethrich, Marc A. Furrer, Paul Chung, Camus Study Group Collaborators

Department of Neurology Faculty Papers

Surgical complications remain a major source of preventable morbidity, mortality, and health care expenditure, but existing frameworks such as the Clavien-Dindo classification and Comprehensive Complication Index are clinician-centred and intervention-focused and fail to capture cumulative patient-centred outcomes. This protocol outlines the Complications After Major and Minor Urological Surgery (CAMUS) initiative, a global, multiphase effort to redefine complication reporting, risk stratification, and outcome measurement in urological surgery. CAMUS aims to address these limitations via an integrated, seven-arm programme combining retrospective and prospective data analysis, consensus development, and digital infrastructure design. Arm 1 has assembled a retrospective data set of 130 034 …

Eptinezumab In Treatment-Resistant Chronic Migraine: Four-Year Real-World Effectiveness And Treatment Persistence, Wan-Jen Hsieh, Kelly Nicol, Chai Ching Ng, Tsung-Wei Hou, Phillip Phan, Scott W. Keith, Brittany Heckel, Michael J. Marmura, Hsiangkuo Yuan

Department of Neurology Faculty Papers

AimTo evaluate 48-month real-world outcomes of eptinezumab users in chronic migraine (CM), including longitudinal effectiveness, treatment persistence, reasons for discontinuation, and post-discontinuation anti-calcitonin gene-related peptide (CGRP) treatment patterns.MethodsWe conducted a retrospective cohort study of 112 CM subjects initiating eptinezumab at a tertiary headache center between 2019 and 2021. Monthly headache days (MHD), migraine disability assessment (MIDAS), and average pain intensity (API) were extracted at baseline and every 6 months for up to 48 months using a predefined outcome form at each visit. Longitudinal changes were analyzed using generalized estimating equations (GEE) with an unstructured correlation matrix, adjusting for age, sex, …

Sustainment Of Hydroxyurea Adherence In Patients With Sickle Cell Disease, Andrew M Heitzer, Zachary Wooten, Guangjin Luo, Marsha Treadwell, Allison A King, Victor R Gordeuk, Nirmish Shah, Christina M Abrams, Sarah Mccuskee, Siera Gollan, Jennifer Longoria, Jane S Hankins, Sickle Cell Disease Implementation Consortium

2020-Current year OA Pubs

IMPORTANCE: Despite established treatment guidelines and strong therapeutic benefit, hydroxyurea remains underused among patients with sickle cell disease.

OBJECTIVE: To assess the change in self-reported hydroxyurea use (ie, taking the medication at all) and adherence (ie, the number of days taken per week) over time and to examine factors associated with the trajectory of hydroxyurea use and adherence.

DESIGN, SETTING, AND PARTICIPANTS: Data were collected through the Sickle Cell Disease Implementation Consortium, a longitudinal, multicenter, observational cohort study that recruited patients from 8 centers across the US. Data collection occurred from 2017 to 2022, and analyses were performed from January …

Adventitial Macrophage Accumulation Impairs Perivascular Nerve Function In Mesenteric Arteries With Inflammatory Bowel Disease, Elizabeth A. Grunz, Benjamin W. Jones, Olubodun Michael Lateef, Sidharth Sen, Katie Wilkinson, Trupti Joshi, Erika M. Boerman

Biomedical Sciences

Introduction: Inflammatory bowel disease involves aberrant immune responses and is associated with both cardiovascular disease risk and altered intestinal blood flow. However, little is known about how inflammatory bowel disease affects regulation of perivascular nerves that mediate blood flow. Previous work found perivascular nerve function is impaired in mesenteric arteries with Inflammatory bowel disease. The purpose of this study was to determine the mechanism of impaired perivascular nerve function.

Methods: RNA sequencing was performed on mesenteric arteries from IL10−/− mice treated with H. hepaticus to induce disease (inflammatory bowel disease) or left non-gavaged (Control). For all other studies, Control and …

Improving Follow-Up After School-Based Dental Screenings Using Koha Data In Monterey County, Andre N. Edmond

Capstone Projects and Master's Theses

Limited follow-up after school-based oral health screenings is a major issue for young children in Monterey County, especially for those who do not have a regular source of dental care. This project focused on improving how screening data is used to connect students to needed services. The internship was completed with the Monterey County Oral Health Program and aimed to develop a better system for tracking KOHA (Kindergarten Oral Health Assessment) data and improving follow-up care for students identified with dental needs. Key activities included analyzing screening data, entering into a tracking system, and comparing results from different schools. The …

Impact Of Inhibiting Mitochondrial Calcium Uptake On Calcium Homeostasis And Postmortem Metabolism In Porcine Muscle, Fatema Rahaman Mishu

All Graduate Theses and Dissertations, Fall 2023 to Present

After harvesting the animal, pork muscle continues to undergo changes as it turns from muscle into meat. During this early period, the muscle uses up energy and produces acid, which lowers pH and can affect important quality traits such as color and how well the meat holds water. A key driver of these early changes is calcium, a natural mineral inside muscle cells that helps control contraction and energy use. In this study, we tested whether mitochondria (the cell’s “powerhouse”) help control calcium after harvest and, in turn, influence early postmortem changes in pork. We used a research compound (DS16570511) …

Evaluating The Impact Of Myplate-Based Expanded Food And Nutrition Education Program (Efnep) On Healthy Dietary Choices Among Low-Income Families, Theresa N. Agbonome

Electronic Theses, Projects, and Dissertations

Dietary behaviors towards healthy food choices remain a major public health issue in the United States, with prevalence among low-income families. The University of California Agriculture and Natural Resources (UCANR) with Expanded Food and Nutrition Education Program (EFNEP) trains both health educators and volunteers to provide community-based nutrition education, which prioritizes low-income families. The initiative employs the MyPlate guidelines that are composed of 5 different food groups which include fruits, vegetables, protein, grains, and dairy products. This project focuses on evaluating nutritional habits of disadvantaged families within San Bernardino County (SBC) by using an evidence-based evaluation tool known as the …

Development Of An Employee Leave Guide Handbook At The California University Of Science And Medicine, Leyal Nidal Fakhreddine

Electronic Theses, Projects, and Dissertations

Employee leave policies play an important role in supporting workforce well-being, organizational compliance, and retention of skilled labor, especially in medical and educational health institutions. However, employees still experience confusion when trying to make sense of complicated leave options such as the Family and Medical Leave Act (FMLA), maternity and paternity leave, and military leave. The lack of clear, centralized guidance can result in delays, miscommunication, and increased workplace stress.

This project was carried out as a part of the Master of Public Health (MPH) program integrative learning experience requirements at California State University, San Bernardino, and was conducted during …

Reducing Hospital Readmissions Through Post-Discharge Follow-Up Programs, Gurjeet Singh

Electronic Theses, Projects, and Dissertations

Within 30 days of the discharge, hospital readmissions continue to be one of the significant problems in healthcare organizations and are commonly seen as the measure of care quality, coordination, and efficiency. The high readmission rates indicate the disconnect between inpatient and outpatient settings, patient education, medication reconciliation, and discharge planning. They also have high financial implications in value-based reimbursement settings. The proposed project will be a descriptive and analytical literature review studying the effects of structured post discharge follow up interventions such as scheduled telephone calls, telehealth visits, and home based outreach on preventing unnecessary hospital readmission and enhancing …

Certified Health Education Specialist Exam Toolkit For Undergraduate Public Health Students, Briana C. Villari

Electronic Theses, Projects, and Dissertations

The Certified Health Education Specialists (CHES) is a credentialing exam that is offered by the National Commission for Health Education Credentialing, Inc (NCHEC) for public health professionals and students. With the completion of this exam, individuals can demonstrate their mastery of core health education skills and concepts. With the 2025 testing cycle, roughly 63 to 73 percent of test takers passed. The purpose of this project is to create a CHES exam toolkit for undergraduate public health students in preparation for their exam. The development of this toolkit was guided by the Health Education Specialists Practical Analysis (HESPA II 2020), …

Assessing The Needs Of Public Health Professionals In The Inland Empire, Esteban Silva-Garcia

Electronic Theses, Projects, and Dissertations

An effective public health system relies on the need for highly trained professionals with degrees or certifications within the field of public health. As public health continues to evolve, professionals are required to improve and evolve with the pace of technology and knowledge advancements. This project focuses on reviewing literature on the current ongoing needs of public health professionals and providing them with resources that are available at low to no cost. It surveys the needs of public health professionals in the Inland Empire and the solutions created by organizations and federal agencies to support professional development for current and …

The Quantification Of Fluoride Water Quality And Its Significance On Oral Health, Harleen Kaur Maroak

Electronic Theses, Projects, and Dissertations

Fluoride is a naturally occurring mineral and studies have shown that when added to community water supplies, it effectively reduces dental caries. According to the U.S. Public Health Services (PHS), 0.7mg/L is the optimal fluoride level in drinking water to prevent tooth decay. This study focuses on examining the fluoride levels in water in San Bernardino County (SBC) and Riverside County (RC). Data is collected from recently published articles, databases along with assessing the laboratory water sample (n=45) analysis to determine if the fluoride levels are meeting the optimal standards. In SBC, there are total of 154 water systems with …

How Are Women Dealing With Polycystic Ovary Syndrome?, Adrianna A. Brown

Electronic Theses, Projects, and Dissertations

Background and Aims: PCOS is one of the leading multisystem conditions among women of reproductive age. Dietary changes may help improve outcomes associated with PCOS and its comorbidities. While a lower carbohydrate, moderate protein diet is often recommended, those with PCOS often use temporary diets or dietary supplements instead of or in addition to prescription medications due to dissatisfaction with their treatment options. Additionally, studies examining the usefulness of supplements and their effects on PCOS symptoms are lacking. This study explored the prevalence of use of temporary diets, prescription medications, and dietary supplements among women with PCOS.

Methods: An anonymous …

Tips For Health Care Practitioners: A Guide For Adolescent Obesity, Regina Santana

Electronic Theses, Projects, and Dissertations

Adolescent obesity continues to be a significant public health concern that is associated with long term physical consequences. The purpose of this project was to develop an evidence based, user friendly guidebook that supports healthcare professionals in the education of adolescents with obesity and their families. A structured literature review development process was used to inform the current development of the guidebook. The guidebook includes components of obesity management such as nutrition and physical activity recommendations. The validity of the content was established through the evaluation of five healthcare professionals that include registered dietitians and licensed therapists. The guidebook was …

The Effects Of Administration Policies On Patient Care Quality And Healthcare Service Costs, Rajveer Kaur

Electronic Theses, Projects, and Dissertations

This study examines how administrative policies in U.S. healthcare systems affect patient care quality and service costs. It addresses a gap by analyzing the combined effects of policy, leadership, and technology on both clinical outcomes and financial performance. Using a qualitative descriptive approach guided by the PRISMA protocol, the study systematically identified and analyzed eighteen peer-reviewed articles. The findings show that value-based purchasing policies relate to improved patient safety indicators. Standardized clinical protocols and workforce competency initiatives strengthen care consistency and reduce hospital readmissions. The use of digital health technologies, such as telehealth and predictive analytics, helps optimize resources and …

Associations Between Water Intake, Dietary Quality, And Beverage Consumption Among University Students, Mohammad A. Qazi

Electronic Theses, Projects, and Dissertations

Title: Associations Between Water Intake, Dietary Quality, and Beverage Consumption Among University Students

Background and Aims: Sugar-sweetened beverage (SSB) and ultra-processed food (UPF) consumption significantly contribute to chronic disease risk and is often more common in underserved and racially/ethnically diverse communities. Drinking water is a low-cost, calorie-free behavior that may support healthier beverage and dietary patterns. Previous studies show that increased daily water consumption positively correlates with better diet quality and is inversely correlated with SSB and UPF consumption. This study aims to examine whether (1) increased daily water intake is associated with self-reported diet quality and (2) self-reported hydration …

Easy Travel-Friendly Snack Recipes For College Students To Support Mental Well-Being, Lidia Vides

Electronic Theses, Projects, and Dissertations

College is a pivotal period in life of a young adult, marked by newfound independence, increased responsibilities, heightened academic pressure, and significant changes in daily routine. While this transition can often be exciting for a young adult, it also presents many different challenges. As a result, many students experience increased levels of stress, anxiety, and depression. Nutrition plays a powerful yet often overlooked role in supporting mental and physical health. Current research studies show that a balanced diet rich in whole food ingredients can help regulate mood and promote emotional well-being through multiple biological pathways. However, despite this knowledge, convenient, …

Examining Physical Activity Behaviors And Associated Health Indicators In College Students, Elizabeth A. Reyes

Electronic Theses, Projects, and Dissertations

Background: Physical activity (PA) is a critical determinant of both physical and mental health, yet many individuals fail to meet recommended guidelines. College students face increasing challenges related to physical inactivity, elevated stress levels, and poor sleep quality, all of which negatively impact their overall health and academic success. College students who fail to meet recommended PA guidelines are at an increased risk of chronic diseases. This study aimed to examine patterns of PA among college students and explore associations with sleep quality and perceived stress.

Methods: A cross-sectional design was employed using a self-administered questionnaire that included items on …

A Mixed-Methods Investigation Of Physician Compassion In Consultations For Chronic Primary Pain, Sarah Daehler

All Graduate Theses and Dissertations, Fall 2023 to Present

Chronic primary pain refers to physical pain that has no apparent organic cause, cannot be explained by another condition, and has associated psychological distress or functional impairment. Chronic primary pain is common and can significantly interfere with functioning, including occupational or social functioning. Research has shown that physicians struggle to treat this population, with many physicians reporting feeling unequipped and many patients feeling that their physicians are unhelpful and dismissive. Compassion may play a key role in improving these difficult interactions. The present study analyzed a sample of 99 participants with chronic pain and 100 healthy controls to learn more …

Glucagon-Like Peptide-1ra As A Public Health Interventions, Briana Sepeda

Electronic Theses, Projects, and Dissertations

Glucagon-like peptide receptor agonist (GLP-1RA) medications have become a prominent topic of interest both in clinical medicine and broader societal discussions. Although the medication are relatively new and expensive, ongoing research continues to explore pharmacologic modifications aimed at improving therapeutic effectiveness and prolonged drug half-life. GLP-1RAs have gained significant traction due to their ability to lower glycosylated hemoglobin (A1c) and blood glucose levels in individuals who have been diagnosed with type 2 diabetes (T2D). In addition to glycemic control, evidence suggests its associations with appetite suppression, weight loss, reducing cardiovascular disease, improved renal dysfunction, neuroprotective effects related to neurodegenerative disease …

What Is Transitional Care And Its Role In Reducing Readmissions, Decia Rodriguez

Electronic Theses, Projects, and Dissertations

Thirty-day readmissions to hospitals creates significant clinical and financial burdens in healthcare systems and worsens patient outcomes. This project reviews transitional care programs as strategic interventions to minimize preventable readmission with a specific focus on pharmacist-led medication reconciliation. Due to the extensive literature review, this work proves that structured transitional care is effective in closing the gaps between acute hospital care and home-based recovery because it coordinates medication management, patient education, and follow-up care. As it has been shown, pharmacists are in a central position to minimize medication errors and enhance compliance, especially in chronic patients such as those with …

When The Eagle Strikes The Vein: A Case Of Styloid-Induced Venous Sinus Thrombosis, Neud Kiros, Ahmad Chehab, Abeer Abukamil, Ali Luqman, Kamil Abu-Shaban, Mehdy Haidar, Ay-Ming Wang

Conference Presentation Abstracts

Clinical History 41-year-old male with no prior relevant medical history presented to the emergency department with severe neck pain and occipital headaches radiating bilaterally to the temporal regions. He also reported diplopia and “tunnel vision.” He had presented two weeks earlier with similar symptoms and was advised outpatient follow-up. Initial CT head and cervical spine were unremarkable. Imaging Findings Brain MRI/MRV demonstrated heterogeneous signal and enhancement in the left transverse and sigmoid sinuses and jugular bulb, initially thought to reflect possible motion artifact. However, CT venography was recommended for further assessment. The MRI also showed subtle left posterior occipital subdural …

Diffuse Marrow And Orbital Fat Signal Abnormality Mimicking Infiltrative Disease: A Case Of "Flip-Flop" On Mri, Mehdy Haidar, Alexander Pietroski, Kamil Abu-Shaban, Anant Krishnan

Conference Presentation Abstracts

Clinical History A 68-year-old male with a history of left tonsillar squamous cell carcinoma treated 5 months ago and reportedly negative recent PET and CT scans of the neck and body with eye pain with possible but uncertain remote history of trauma was sent in for imaging of the orbits. The patient has a feeding tube and was recently hospitalized and discharged for tube obstruction. Imaging Findings Orbital imaging revealed diffuse signal alterations involving the orbital and scalp fat, and marrow, characterized by low signal intensity on T1WI and high signal intensity on T2WI. In particular on the STIR sequence, …

Postoperative Ileus After Lumbar Spine Surgery: Modifiable Risk Factors And Impact On Outcomes, Ali Mehaidli, Richard Easton, Alqasim Elnaggar, Gary George, Ahmad Almaat, Victor Chang, Jad Khalil, Kevin Taliaferro

Conference Presentation Abstracts

Introduction: Postoperative ileus (POI) is an infrequent but impactful complication following lumbar spine procedures. While well-characterized in abdominal surgery, spine-specific data remain limited, particularly regarding modifiable risk factors. Materials and Methods: We analyzed 41,164 patients who underwent elective lumbar spine surgery between 2018 and 2023 using the Michigan Spine Surgery Improvement Collaborative (MSSIC) registry. Multivariable generalized estimating equation models were used to identify independent risk factors for POI. We also evaluated the association between POI and postoperative outcomes, including patient-reported outcome measures (PROMs). Results: POI occurred in 1.1% of patients (n = 447). Independent risk factors included older age (RR …

Halo Effect Of Prescribing Guidelines For Opioid Naive Patients Translates To Opioid Non-Naive Patients Undergoing Lumbar Decompression: A Michigan Spine Surgery Improvement Collaborative (Mssic) Study, Anisse Chaker, Geoff Kahn, Michael Melhem, Jian-Hui Hu, Kari Jarabek, Heegook Yeo, Jawad Saad, Abdullah Al-Tekreeti, Kenneth Easton, Jad Khalil, Richard Easton, Doirs Tong, Miguelangelo Perez-Cruet, Noojan Kazemi, Ilyas Aleem, Muwaffak Abulhak, David Nerenz, Victor Chang

Conference Presentation Abstracts

Introduction: Chronic opioid dependency in spine surgery is an ongoing concern given the ongoing opioid epidemic. We have previously reported on our cohort of opioid-naıve patients, however the literature has shown that patients with opioid use at baseline are at higher risk of less favorable outcomes. Starting in 2022, MSSIC instituted state-wide prescribing guidelines for opioid naıve patients undergoing one- or two-level lumbar decompression surgery (laminectomy, laminotomy, foraminotomy, microdiscectomy) with performance goals of 80% compliance. The goal of this study was to evaluate whether there would be a form of a “halo” effect on prescribing patterns for patients with baseline …