Medicine and Health Sciences Commons^™

Survival Impact Of Intraoperative Co2 Dysregulation In Patients Undergoing Pancreaticoduodenectomy For Pancreatic Ductal Adenocarcinoma, Ashley Wetzel, Andrea Feci, Joseph Gorman, Isabel Lavine, Edoardo Manca, Richard Zheng, Md, Nader Hanna, Md, Harish Lavu, Md, Charles J. Yeo, Md, Avinoam Nevler, Md

Alpha Omega Alpha Research Symposium Posters

Purpose: Pancreatic ductal adenocarcinomas (PDAC) are aggressive malignancies with poor prognoses. Emerging evidence suggests tissue hypercapnia (elevated CO₂) promotes aggressive, treatment resistant tumor biology. End-tidal CO₂ (ETCO₂) offers a composite measure of ventilation, systemic perfusion, and tissue CO₂ production. During curative-intent pancreaticoduodenectomy, we hypothesized that intraoperative ETCO₂ could serve as a marker of tissue CO₂ dyscapnia; both low levels indicating decreased circulatory reserves and high levels indicating tissue hypercapnia may result in worse outcomes.

Methods: We conducted a retrospective review (2017-2023) of 343 patients undergoing pancreaticoduodenectomy for PDAC. Intraoperative ETCO₂ data …

Evaluating The Impact Of Bard1 Isoform Targeting On Pdac Growth And Response To Olaparib, Lily Zekavat, Samuel Zion, Boxuan Wei, Avinoam Nevler, Aditi Jain

Alpha Omega Alpha Research Symposium Posters

Background

• BRCA-Associated Ring Domain 1 (BARD1), a heterodimeric binding partner of the tumor suppressor BRCA1, plays an essential role in homologous recombination-mediated DNA repair. Mutations in BARD1 increase cancer susceptibility and result in a molecular phenotype that predicts sensitivity to poly (ADP-ribose) polymerase inhibition (PARPi), including Olaparib.
• Several alternatively spliced isoforms of BARD1, including BARD1δ and BARD1φ, have also been implicated in tumor progression. These isoforms, characterized by deletion of exons 2-6 and 3-6, respectively, lack the RING domain required for BRCA1 interaction (Figure 1). 
• Upregulation of BARD1 isoforms is associated with poor prognosis in several tumor types. However, the …

Primary Care Use And Clinical Outcomes In A Prevalent Cohort Of Patients Receiving Hemodialysis, Dustin Le, Hatem Najar, Zoheb Backer, Rohanit Singh, Byoungjun Kim, Morgan E. Grams, Laura Plantinga, Bernard G. Jaar

Division of Nephrology Faculty Papers

Rationale & Objective - Primary care is associated with improved health outcomes, but whether this is true for patients receiving dialysis is unclear. We evaluated the association of primary care use in the previous year and clinical outcomes using a prevalent cohort of patients receiving hemodialysis.

Study Design - Retrospective cohort study.

Setting & Participants - United States Renal Data System registry of prevalent patients requiring maintenance in-center on January 1, 2019, linked with Medicare claims data.

Exposure - Primary care use was defined as ≥ 1 outpatient visit to a provider with the specialty of Family, General, Geriatric, or …

Jackson-Pratt Drain-Related Challenges And A Potential Explanation For Associated Surgical Site Pain Variability Following Breast Mastectomy And Reconstruction, Spencer Haber, Bs, Krishna Koka, Bs, Elizabeth Simon, Bs, Devin Williams, Bs, Andrew Newman, Md

Alpha Omega Alpha Research Symposium Posters

Background: The Jackson-Pratt (JP) drain is a closed suction drain used in surgeries throughout the body. This prevents seroma formation through continual negative pressure drainage while resisting collapse and obstruction. JP drains are mainstays in breast reconstruction and mastectomy.

Methods: Through a literature review using keywords such as “Surgical Site Infection” (SSI), “Quality of Life” (QOL), and “Surgical Site Pain” (SSP), we summarized JP drain-related complications in breast reconstruction and mastectomy. Although the drain effectively reduces seroma formation, there has been a lack of innovation in addressing these issues. There is no standardized approach to JP drain post-operative care or …

Hangout Hour: A Safe Space Fostering Community Within The Adolescent Young Adult (Aya) Community, Brooke Ashmore, Makena Krier

2025

National Landscape Of Pediatric And Adult Inpatient Sickle Cell Disease Care, Ashley M. Jenkins, Spoorthy Vangala, Matthew Mcintosh, Robert Legros, Sophie Lanzkron, Kevin Fiscella

Department of Medicine Faculty Papers

No abstract provided.

Clinical Features Of Infantile Epileptic Spasms Syndrome: A Systematic Review, Xiao Meng, Danielle S Takacs, Yashaswini Kelagere, Zihan Zhang, Sanjanaa Seshadri, Jiyeon Cha, Ming Li, Lei-Shih Chen

Faculty, Staff and Students Publications

Introduction

Infantile Epileptic Spasms Syndrome (IESS) is a severe epilepsy in children between one month and two years of age. Urgent referral of possible IESS cases from pediatricians and family physicians who care for children to neurologists for diagnosis and treatment has been shown to significantly improve patient health outcomes. Yet, a comprehensive list of IESS clinical features is lacking. We conducted a systematic review of studies to report IESS clinical features.

Methods

Articles from the MEDLINE Complete and Embase databases were searched from the earliest years of databases availability (1979) to July 31, 2024. We followed the Preferred Reporting …

Anxiety Or Depression Trends By Disability Status And Demographic Intersections In Us Adults, 2019-2023, David Adzrago, Kayo Fujimoto, J Michael Wilkerson, Typhanye V Dyer, Faustine Williams

Faculty, Staff and Student Publications

Importance: Mental health problems, particularly anxiety and depression, remain among the leading causes of disease burden in the US. However, trends in anxiety and depression across disability status and demographics remain understudied.

Objective: To examine trends in anxiety and depression prevalence among US adults from 2019 to 2023 by disability status and demographic characteristics.

Design, setting, and participants: This cross-sectional study used national population-based data from the National Health Interview Surveys from 2019 to 2023. Data were collected from household probability samples of noninstitutionalized US civilian adults aged at least 18 years. Data analyses were performed from December 6, 2024, …

Fedda-Tsformer: Federated Domain Adaptation With Vision Timesformer For Left Ventricle Segmentation On Gated Myocardial Perfusion Spect Image, Yehong Huang, Chen Zhao, Rochak Dhakal, Min Zhao, Guang-Uei Hung, Zhixin Jiang, Weihua Zhou

Michigan Tech Publications

BACKGROUND: Accurate assessment of left ventricular function is essential for diagnosing and managing cardiovascular disease. Gated myocardial perfusion SPECT (MPS) enables simultaneous evaluation of perfusion and function, but reliable contour extraction is challenged by image noise, resolution limits, and anatomical variability. Multi-center validation is further restricted by data privacy concerns, underscoring the need for robust and privacy-preserving contouring methods. METHODS: In this study, we propose a novel approach, FedDA-TSformer, which integrates Federated Domain Adaptation with the TimeSformer model for the task of left ventricle segmentation using MPS images. The proposed model captures spatial and temporal features through a Divide-Space-Time-Attention mechanism, …

Mom Is Developing Too: Preliminary Evidence For The Reciprocal Effects Of Infant Sensory Reactivity And Maternal Behavior, Emily C. Sweiss, Vincent Berardi, Elysia Poggi Davis, Curt A. Sandman, Laura M. Glynn

Psychology Faculty Articles and Research

Caregiver sensitivity to infant cues is well-established as a predictor of child development. Infants also actively influence their social environment, especially their caregivers, even from their earliest days. Sensory reactivity, characterized as hypo- (under) and hyper- (over) responding to environmental stimuli, is one domain of development that is likely to influence caregiver-infant interaction, due to its role in regulating emotions and responses to both physical and social stimuli. Although sensory reactivity could be an important target for improving caregiver-child interaction, the longitudinal, reciprocal relations between infant sensory reactivity and caregiver behaviors are currently unknown. In the present proof-of-concept study, we …

Clinician Perceptions Of Barriers And Strategies To Improve Pediatric Hypertension Detection, Abbas H. Zaidi, Erica D. Sood, Sarah De Ferranti, Fabliha Khurshan, Samuel Gidding, Varsha Zadokar, Jonathan M Miller, Anne E Kazak

Department of Pediatrics Faculty Papers

IMPORTANCE: Pediatric hypertension remains underrecognized despite its high prevalence (approximately 5%) and long-term cardiovascular implications. Although guidelines for screening and diagnosis exist, less than 25% of affected children are diagnosed, and more than half do not receive timely follow-up care. Clinician-specific implementation barriers and directly informed strategies, which may alleviate this gap, are insufficiently described.

OBJECTIVE: To identify clinician-reported barriers and actionable recommendations to improve pediatric hypertension detection and follow-up in primary care using the Consolidated Framework for Implementation Research.

DESIGN, SETTING, AND PARTICIPANTS: Semistructured qualitative interviews were conducted between November 1, 2022, and March 31, 2023, with health care …

Biologically-Inspired Multiscale Neuromorphic Architecture, Christian O'Reilly, Ramtin Zand

Publications

This white paper proposes a biologically-inspired multiscale neuromorphic architecture that bridges key gaps between artificial neural networks (ANNs), spiking neural networks (SNNs), and biological neural networks (BNNs). While SNNs offer promising energy efficiency, their broader adoption remains limited by suboptimal performance and the need for novel learning paradigms. To address these challenges, the proposed framework integrates structural and functional principles observed in the brain, including hierarchical organization, sparse and modular connectivity, predictive coding, and diverse neuronal dynamics.

The architecture operates across micro-, meso-, and macro-scales, incorporating neuron-level diversity (e.g., excitatory/inhibitory and principal/support cells), canonical microcircuits (CMCs), and large-scale hierarchical organization. …

Detecting Stigmatizing Language In Clinical Notes With Large Language Models For Addiction Care, Rohan Sethi, John Caskey, Yanjun Gao, Matthew M. Churpek, Timothy A. Miller, Anoop Mayampurath, Elizabeth Salisbury-Afshar, Majid Afshar, Dmitriy Dligach

Computer Science: Faculty Publications and Other Works

Intensive care units (ICU) produce numerous progress notes that may contain stigmatizing language that perpetuate negative biases and punitive approaches against patients. Patients with substance use disorders are particularly vulnerable to stigma. This study examined the performance of Large Language Models (LLMs) in the identification of stigmatizing language. We annotated a dataset with over 77,000 stigmatizing and non-stigmatizing notes from the MIMIC-III database. We utilized Meta's Llama-3 8B Instruct LLM to run the following experiments for stigma detection: zero-shot; in-context learning; in-context learning with a selective retrieval; supervised fine-tuning (SFT); and keyword search. All approaches were evaluated on a held-out …

Cd8+ T Cells In The Tumor Microenvironment Modulate The Response To Endocrine Therapy In Breast Cancer, Fabiana Napolitano, Yunguan Wang, Dhivya R Sudhan, Paula I Gonzalez-Ericsson, Luigi Formisano, Nisha Unni, Shahbano Shakeel, James Z Zhu, Khushi Ahuja, Lei Guo, María Rosario Chica-Parrado, Yuki Matsunaga, Pamela Luna, Chang-Ching A Lin, Yasuaki Uemoto, Kyung-Min Lee, Hongli Ma, Nathaniel J Evans, Alberto Servetto, Saurabh Mendiratta, Spencer D Barnes, Roberto Bianco, Yisheng V Fang, Lin Xu, Jeon Lee, Tao Wang, Justin M Balko, Gordon B Mills, Marilyne Labrie, Ariella B Hanker, Carlos L Arteaga

Faculty, Staff and Student Publications

The role of the tumor immune microenvironment (TIME) in modulating responses to antiestrogen therapy in hormone receptor-positive (HR+) breast cancers remains unclear. We analyzed pre- and on-treatment biopsies from patients with HR+ breast cancer treated with letrozole to induce estrogen deprivation (ED). Stromal tumor-infiltrating lymphocytes, assessed by H&E staining, and immune-related gene sets, including IFN-γ signaling genes, measured by RNA-Seq, were increased in ED-resistant tumors. Cyclic immunofluorescence and spatial transcriptomics revealed an abundance of CD8+ T cells and enhanced antigen processing and immune gene signatures in ED-resistant tumors. In this group, the expression of CXCL9, CXCL10, and CXCL11 - chemokine …

Women's Preferences For Home-Based Self-Sampling Or Clinic-Based Testing For Cervical Cancer Screening, Joël Fokom Domgue, Monalisa Chandra, Olajumoke Oladoyin, Manali Desai, Robert Yu, Sanjay Shete

Faculty, Staff and Student Publications

Importance: While home-based self-sampling for cervical cancer screening is an evidence-based strategy proven to increase screening access and uptake, it is not currently recommended in the US despite recent Food and Drug Administration approval of the first at-home self-sampling device. Little nationally representative research has examined preference for and drivers of home-based self-sampling over clinic-based testing (the standard of care).

Objective: To assess women's perspectives about, reasons for considering, and factors associated with preferring at-home self-sampling for cervical cancer screening.

Design, setting, and participants: This population-based cross-sectional study used data from the 2024 Health Interview National Trends Survey (HINTS 7), …

Osimertinib Activates A Tgf-Β2-Dependent Secretory Program That Drives Lung Adenocarcinoma Progression, Madhurima Ghosh, Chao Wu, Abhishek Kumar, Monique Nilsson, John V Heymach, Weina Zhao, Jiang Yu, Xin Liu, Na Ding, Shike Wang, Guan-Yu Xiao, Angelo Chen, Kate Grimley, William K Russell, Chad J Creighton, Xiaochao Tan, Jonathan M Kurie

Faculty, Staff and Student Publications

EGFR-mutant lung adenocarcinomas (LUADs) that are vulnerable to the EGFR antagonist osimertinib (Osi) eventually relapse, owing in part to the emergence of drug-tolerant persister (DTP) cells that arise through epigenetic mechanisms. Intratumoral DTP cells can herald a worse clinical outcome, but the way in which DTP cells influence LUAD progression remains unclear. Osi-resistant (OR) cells exhibit typical DTP cell features, including a propensity to undergo senescence and epithelial-mesenchymal transition (EMT), which can activate heightened secretory states. Therefore, we postulated that OR cells influence LUAD progression through paracrine mechanisms. To test this hypothesis, we utilized congenic pairs of EGFR-mutant LUAD cell …

Dispersion-Enhanced Nitrogen-Centered Photocatalysis Of The Direct Hydrogen Atom Transfer, Jiasong Zhang, Kaitong Zhuang, Ramon Trevino, Babu Raj Dhungana, Huiying Sun, Shuyu Yin, Yuting Li, Jacob A Sanchez, Xiaoyu Xia, Ramy Elerian, Yao Sun, Seth O Fremin, Chao Huang, Min He, Maosheng Cheng, Oleg V Larionov, Shengfei Jin

Faculty, Staff and Student Publications

The development of structurally distinct and modular photocatalysts for direct hydrogen atom transfer (HAT) has emerged as a key frontier in radical-mediated C-H functionalization of strong carbon-hydrogen bonds. Despite the largely untapped potential across the fields of organic synthesis, medicinal chemistry, and materials science, few classes of direct HAT photocatalysts are currently known, and the approaches to enhancing their photocatalytic activity remain underdeveloped. We report herein the development of nitrogen-centered direct HAT photocatalysts based on the acridine framework, which leverage a C9-ortho-biaryl substituent for enhancing the photocatalytic activity through stabilizing dispersion interactions with the substrate as the key steering effect. …

The Impact Of Vascular Management On Postoperative Complications In Patients Undergoing Surgery For Retroperitoneal Leiomyosarcoma, Neha Malik, Seokhun Kim, Christopher P Scally, Emily Z Keung, Heather Lillemoe, Keila E Torres, Kelly K Hunt, Sophia Khan, Christina L Roland, Heather G Lyu

Faculty, Staff and Student Publications

Background: Retroperitoneal leiomyosarcomas are aggressive malignancies. Complete surgical resection with negative margins is crucial to decrease the risk of recurrence but can be risky due to vascular involvement. The aim of our study was to evaluate the different approaches to IVC and renal vein management and their impact on postoperative complications.

Methods: We performed a retrospective review of patients who underwent surgery for retroperitoneal leiomyosarcoma with IVC and/or renal vein involvement at our institution from 2016 to 2024. Patients were stratified by intraoperative vascular management, including ligation only versus varying forms of vascular reconstruction. Postoperative complications, including bleeding, transfusions, the …

Midlife Wellness: Building Healthy Lifestyle Habits To Ensure Quality Of Life, Naomi Brower, Elizabeth Davis

All Current Publications

Life expectancy has increased significantly, but women often spend their later years in poor health unless they take proactive steps to build healthy habits early. This fact sheet provides information on healthy habits women can develop to help manage hormonal changes during perimenopause and menopause and reduce long-term health risks.

Estimated Effectiveness Of 2024-2025 Covid-19 Vaccination Against Severe Covid-19, Kevin C Ma, Jennie H Kwon, Et Al.

2020-Current year OA Pubs

IMPORTANCE: As SARS-CoV-2 JN.1 lineage descendants continue to evolve, evaluating COVID-19 vaccine effectiveness (VE) against severe COVID-19 remains important to guide vaccination strategies.

OBJECTIVE: To estimate the VE of the 2024-2025 COVID-19 vaccines against COVID-19-associated hospitalization and severe in-hospital outcomes overall and by time since dose (7-89, 90-179, and ≥180 days), JN.1 descendant lineage (KP.3.1.1, XEC, LP.8.1), and spike protein mutations associated with immune evasion.

DESIGN, SETTING, AND PARTICIPANTS: This multicenter, test-negative, case-control study conducted by the Investigating Respiratory Viruses in the Acutely Ill Network included adult patients (aged ≥18 years) hospitalized between September 1, 2024, and April 30, 2025, …

Costs Of Single Maintenance And Reliever Therapy Vs Traditional Therapy For Asthma, Tri Pham, Abigail R Barker, Sarah A Eisenstein, Eliot Jost, Anna Volerman, Krutika Chauhan, Ross C Brownson, Timothy Mcbride, Mark D Huffman, Kaharu Sumino, Lynn B Gerald, Mario Castro, Anne E Dixon, James G Krings

2020-Current year OA Pubs

IMPORTANCE: Despite strong guideline support, single maintenance and reliever therapy (SMART) for asthma is underused in the US. Limited insurance coverage of SMART-compatible inhalers remains a major barrier to its adoption.

OBJECTIVE: To compare the annual asthma management costs of SMART vs traditional therapy from a US health care payer perspective.

DESIGN, SETTING, AND PARTICIPANTS: This economic evaluation used a probabilistic decision-tree model with Monte Carlo simulations to compare the total asthma management costs for patients prescribed SMART vs traditional therapy, conducting analyses from September 1, 2024, to March 13, 2025. Input data were extracted through a systematic review of …

Slc7a8 Is Essential For Metabolic Fitness And Function Of Th2 Cells, Santosh K Panda, Do-Hyun Kim, Pritesh Desai, Shitong Wu, Patrick Fernandes Rodrigues, Raki Sudan, Yizhou Liu, Haerin Jung, Intelly Lee, Susan Gilfillan, Marina Cella, Steven J Van Dyken, Marco Colonna

2020-Current year OA Pubs

Amino acids are essential for the activation and function of CD4 T helper (Th) cells, which differentiate into Th1, Th2, Th17, and Treg subsets to coordinate immune responses. While specific amino acid transporters have been identified for Th1, Th17, and Tregs, a transporter regulating Th2 cells remains unknown. This study identifies SLC7A8 as a Th2-specific amino acid transporter in the Th compartment. We found that Slc7a8 expression is upregulated in Th2 cells compared with other T helper subsets, and Slc7a8 deficiency impairs Th2 cell proliferation and cytokine production. Furthermore, SLC7A8 was found to be crucial for an effective type 2 …

Amyloidosis Of Bridging Veins Is A Pathologic Feature Of Alzheimer's Disease, Leon C D Smyth, Daan Verhaege, Elio Standen-Bloom, Yue Wu, Steffen E Storck, Pavle Boskovic, Benjamin A Plog, Tornike Mamuladze, Jose A Mazzitelli, Zhuoying Wang, Daniel D Lee, Gwendalyn J Randolph, Katherine E Schwetye, Song Hu, Jonathan Kipnis, Et Al.

2020-Current year OA Pubs

Alzheimer's disease (AD) is characterized by the accumulation of extracellular aggregated amyloid beta, resulting from impaired waste clearance. We recently identified new cerebrospinal fluid (CSF) efflux structures termed arachnoid cuff exit (ACE) points and speculated that these may be impacted in AD, leading to impaired waste clearance function. Using 5XFAD mice, we found progressive amyloidosis of bridging veins at ACE points. Indeed, in 5XFAD mice, there is impaired CSF efflux to the dura mater, impaired CSF flow along bridging veins, and impaired blood flow through bridging veins. These observations suggest that ACE point amyloidosis plays a role in waste clearance …

Demographic And Clinicopathologic Factors Associated With Colorectal Adenoma Recurrence, Usman Ayub Awan, Qingyuan Song, Kristen K Ciombor, Adetunji T Toriola, Jungyoon Choi, Timothy Su, Xiao-Ou Shu, Kamran Idrees, Kay M Washington, Wei Zheng, Wanqing Wen, Zhijun Yin, Xingyi Guo

2020-Current year OA Pubs

IMPORTANCE: Current colorectal surveillance guidelines emphasize adenoma characteristics but overlook temporal, racial, and sex-based heterogeneity in recurrence risk, a gap that limits equitable and personalized care.

OBJECTIVE: To evaluate the associations of demographic factors, obesity, and adenoma features with recurrence risk over time in a large longitudinal surveillance cohort.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study included adults who underwent their first colonoscopic polypectomy between January 1990 and July 2024 at a tertiary medical center.

EXPOSURES: Demographic variables included race and ethnicity, sex, obesity (body mass index >30), family history of colorectal cancer (CRC) or polyps, and age at …

A Multicomponent Strategy To Increase Human Papillomavirus Vaccination Rates In Primary Care: A Cluster Randomized Clinical Trial, Ruoyun Wang, Lei Liu, Sherry Dodd, Sharon Graham, Shannon Rook, Lauren Ericson, Katie Plax, Abigail Barker, Virginia Mckay, Michelle I Silver, Jason G Newland, Allison A King

2020-Current year OA Pubs

IMPORTANCE: Human papillomavirus (HPV) vaccination prevents multiple cancers, yet vaccination rates by the recommended age remain well below national goals.

OBJECTIVE: To evaluate the effectiveness of a multicomponent strategy in increasing HPV vaccination rates in primary care settings by 13 years of age.

DESIGN, SETTING, AND PARTICIPANTS: This cluster randomized clinical trial with a parallel-group design and 1:1 allocation was conducted at 20 pediatrics primary care practices from a practice-based research network in the St Louis, Missouri, metropolitan area by clinicians delivering routine well-child visits within participating practices. The intervention was implemented over 24 months (July 1, 2020, to September …

Longitudinal Multiomic Signatures Of Ards And Sepsis Inflammatory Phenotypes Identify Pathways Associated With Mortality, Narges Alipanah-Lechner, Pratik Sinha, Et Al.

2020-Current year OA Pubs

BACKGROUNDCritically ill patients with acute respiratory distress syndrome (ARDS) and sepsis exhibit distinct inflammatory phenotypes with divergent clinical outcomes, but the underlying molecular mechanisms remain poorly understood. These phenotypes, derived from clinical data and protein biomarkers, were associated with metabolic differences in a pilot study.METHODSWe performed integrative multiomics analysis of blood samples from 160 patients with ARDS in the ROSE trial, randomly selecting 80 patients from each latent class analysis-defined inflammatory phenotype (hyperinflammatory and hypoinflammatory) with phenotype probability greater than 0.9. Untargeted plasma metabolomics and whole-blood transcriptomics at day 0 and day 2 were analyzed using multimodal factor analysis (MEFISTO). …

The Use Of Acupuncture To Address Health Disparities In The Treatment Of Low Back Pain, Vivian Li, Alexander Reals, Deepa Manda, Elizabeth Loomis

Advances in Clinical Medical Research and Healthcare Delivery

Low back pain (LBP) is a leading cause of disability, and treatment often involves a combination of pharmacological and non-pharmacological therapies. Acupuncture is a medical treatment and ideology rooted in traditional Chinese medicine that utilizes applying small needles or pressure to specific points in the body. Utilized as an adjunct to supplement standard medical care, acupuncture is a procedure that can be done in a primary care setting. Multiple studies have shown efficacy in treating acute or chronic back pain, with up to 1.5% of the US population having used acupuncture at one point.

In the pursuit of holistic health, …

Evidence Based Management Of High Ldl-C For Prevention Of Atherosclerotic Cardiovascular Disease In Adult Patients In Resident Run Clinic: A Qi Project, Astha Prasai, Sahej Manesh Singh Arora, Hafsa Jawaid, Aakriti Jain, Omofolarin Babayale, Nauman Naeem, Hina Ukrani, Nawid Latifi, Binita Neupane, Soon-Il Song, Gaurav Sharma

Advances in Clinical Medical Research and Healthcare Delivery

Background:

Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of death worldwide and in the United States, with significant healthcare and economic burden. Despite clear guideline recommendations, the implementation of ASCVD risk assessment and statin use for primary prevention remains suboptimal.

Methods:

A quality improvement project was conducted at a resident run clinic with an objective to improve ASCVD risk documentation and guideline-based lipid management. A total of 600 patients aged 40-75 years without a history of cardiovascular disease were randomly selected- 300 in the pre-intervention group and 300 in the post-intervention group. The intervention included didactic sessions and quick …

Rare Event: Neonatal Anaphylaxis Following Hepatitis B Vaccination – A Case Series From A Tertiary Care Center In India, Aarthi Ma, Revanth R

Advances in Clinical Medical Research and Healthcare Delivery

We report two cases of anaphylaxis following Hepatitis B vaccination in one-day-old neonates at a tertiary care hospital in India. Both cases presented with similar patterns of cutaneous reactions and respiratory symptoms shortly after intramuscular administration of the Hepatitis B vaccine. To our knowledge, this is among the few documented case series of neonatal anaphylaxis post–Hepatitis B vaccination, underscoring its rarity yet clinical importance. The cases highlight the critical importance of vigilant post-vaccination monitoring and prompt recognition of vaccine-associated adverse events in neonates. This report reviews current literature on anaphylaxis following vaccination and discusses optimal management strategies.

An Exploratory Study Of Social Determinants And Pediatric Lead Exposure In Chemung County, Ny, Jenna Mccracken, Anika Stundtner, Megan Kerbag, Madison Desantis, Jennifer Coseo, Richard Terry

Advances in Clinical Medical Research and Healthcare Delivery

Background: Lead exposure in children is a persistent public health concern due to its irreversible neurological and developmental effects. Children under 6 years old are particularly vulnerable due to frequent hand-to-mouth activity and increased environmental exposure. Existing literature suggests a relationship between adverse social determinants of health (SDOH), such as low parental education and residence in high-poverty areas, and elevated pediatric blood lead levels (BLLs). This study, subsidized through a community service grant from Excellus Blue Cross Blue Shield, aimed to examine the association between BLLs and SDOH among children screened at the ACCEL Community Health Clinic in Chemung County, …