Medical Specialties Commons^™

Vaginal Pra1 Identifies Clinically Relevant Candida Albicans Vaginitis And Excludes Asymptomatic Colonization: An Exploratory Study, Elena Roselletti, Barbara Kozma, David Ratonyi, Alexandra Kunkli, Bence Kozma, Peter Takacs, Duncan Wilson

Department of Obstetrics & Gynecology Faculty Publications

Background

Accurate interpretation of Candida detection in women with vulvovaginal symptoms remains difficult, because organism recovery may reflect either clinically relevant infection or nonpathogenic colonization. We have recently demonstrated that the secreted fungal zinc-binding protein, Pra1 is responsible for driving the inflammatory immunopathology of VVC. We therefore reasoned that PRA1 expression by Candida albicans in the vagina may act as a diagnostic tool to discriminate between commensal colonisation and active disease.

Methods

We conducted a 12-week prospective, single-center exploratory biomarker analysis nested within a registered parent clinical trial. Nine women with vulvovaginal symptoms provided cervicovaginal lavage samples and clinical data …

Training Set Augmentation And Biology-Aware Harmonization Improve Radiomic Models For Lung Cancer Prediction In Indeterminate Nodules, Claire Huchthausen, Menglin Shi, Gabriel De Sousa, James Larner, Einsley Janowski, Jonathan Colen, Krishni Wijesooriya

Data Science Faculty Publications

CT radiomics-based machine learning has potential to predict lung cancer in pulmonary nodules (PNs) earlier than standard-of-care methods. Low malignancy rates in early-development PNs and variable image acquisition hinder development of radiomic models for diagnosing these PNs. To address these challenges, we augmented training using later-development PNs and harmonized for acquisition effects. We examine early-development benign and malignant PNs (n = 106) below the sensitivity of standard-of-care diagnosis. Classifiers predicting malignancy performed near chance when trained on ComBat-harmonized radiomic features from only early-development PNs. We then augmented training with later-development benign and malignant PNs (n = 225). We evaluated whether …

An Environmentally Relevant Phthalate Mixture Impairs Ovulatory Prostaglandin And Progesterone Receptor Pathways In Human Granulosa Cells In Vitro, Katie L. Land, Hong Xu, James W. Akin, Patrick R. Hannon

Obstetrics and Gynecology Faculty Publications

Ovulatory defects are the leading cause of female infertility. Widespread exposure to endocrine-disrupting chemicals, such as phthalates, may contribute to the high prevalence of failed ovulation among infertile women. Using primary ovarian granulosa cells obtained from women, we tested the hypothesis that exposure to an environmentally relevant mixture of phthalate metabolites (MPTmix) impairs essential mediators of the ovulatory process, including progesterone (P4), progesterone receptor (PGR), and prostaglandins (PGs). The composition of the MPTmix was derived from urinary phthalate levels in women. Ovarian granulosa cells, obtained from in vitro fertilization patients, were acclimated in culture to regain responsiveness to hCG (human …

Animal Models Of Aortic Aneurysm And Dissection: A Comparative Guide For Mechanism, Therapeutic Testing, And Translational Readouts, Shayan Mohammadmoradi, Sidney W. Whiteheart

Saha Cardiovascular Research Center Faculty Publications

Aortic aneurysms and dissections are devastating vascular diseases with high mortality, yet no pharmacological therapy has proven effective in halting growth or preventing rupture. Surgical and endovascular repair remain the only treatment options for advanced disease. Animal models have been indispensable in defining mechanisms and testing candidate therapies, but the diversity of protocols, strain-dependent variability, and heterogeneous endpoints complicate interpretation and translation. This review provides an update focused on how to match models to specific research questions. We critically compare commonly used abdominal aortic aneurysm (AAA) models (angiotensin II ± hyperlipidemia, elastase, calcium chloride, β-aminopropionitrile BAPN hybrids, and mineralocorticoid agonist/fludrocortisone …

Affordability And Serving Accuracy Of A Publicly Available Dash Meal Plan For Women Using Snap Benefits, Kendra Oonorasak, Mansura Shahad Bawa, Nadia Ayesha Sesay, Emma Smith, Taylor Emerson, Jayden Brewer, Brandi M. White

Health and Clinical Sciences Faculty Publications

Background/Objectives: This regional case study evaluated the affordability and serving accuracy of a publicly available one-week DASH meal plan for single-woman households using Supplemental Nutrition Assistance Program (SNAP) benefits in central Kentucky.

Methods: For each food item in the one-week plan, total grocery costs and per-serving costs were calculated using January 2025 prices from two national grocery chains commonly patronized in an urban area in central Kentucky. Calculated costs were compared to the average weekly food cost for women aged 20–50 years in a single household based on the Thrifty Food Plan (TFP). Servings for food groups and categories were …

Procedural-Based Contemporary Management Of Bell's Palsy Long-Term Sequelae: A Narrative Review, Robert M. Frederick, Rhorie Kerr, Eric Dobratz, William Dougherty

Department of Otolaryngology (ENT) Faculty Publications

Objective

To describe the long-term sequelae of Bell's palsy and summarize available treatment options, including recent advances, so that general otolaryngologists and other practitioners are aware of the clinical findings and available interventions.

Data Sources

PubMed.

Review Methods

A literature search was performed on December 18, 2024, via PubMed using keywords such as "synkinesis," "selective myectomy," "selective neurectomy," "botulinum toxin," "intervention" in the context of "Bell's palsy" with preference for articles published within the last 5 to 10 years but inclusion of select older articles that provided necessary context for the current topic. Articles included in the review were written …

Differences In Biologic Clinical Trials For Chronic Rhinosinusitis With Nasal Polyps—Are We Comparing Apples With Oranges?, Marjolein Cornet, Peter W. Hellings, Martin Desrosiers, Martin Wagenmann, Richard Follows, Laura Walrave, Luz Adriana Jimenez, Lee Tombs, Dawn Edwards, Peter Howarth, Joseph K. Han

Department of Otolaryngology (ENT) Faculty Publications

In recent years, several biologics targeting Type 2 inflammation have been developed for treating chronic rhinosinusitis with nasal polyps (CRSwNP). These have been studied in registrational randomized controlled trials (RCTs), which vary in their patient populations, trial design, endpoints, geography, timing, or data-handling processes. While (in)direct treatment comparisons and meta-analyses have been carried out to compare efficacy results from RCTs, often these fail to properly account for these between-study differences. Here, we summarize the key between-study differences that can influence trial outcomes and highlight the resulting challenges faced when comparing outcomes from different Phase III RCTs of biologics in CRSwNP.

Neuron-Enriched Extracellular Vesicle Micrornas Reflect Hormonal Suppression Associated With Oral Contraceptive Use In Young Women, Amulya Chowdhory, Rebekah Frye, Roxann Roberson-Nay

Undergraduate Research Posters

Hormonal contraceptives alter hypothalamic–pituitary–ovarian (HPO) feedback, but their impact on brain-associated molecular communication remains poorly understood. Neuron- enriched extracellular vesicle (nEV) microRNAs (miRNAs), isolated from plasma, provide a minimally invasive window into brain molecular activity. This pilot study examined nEV miRNA expression in young women (ages 18–22) who were either naturally cycling or using a combined monophasic oral contraceptive (OC) pill. To identify hormonally responsive miRNAs, we calculated effect sizes (Cohen’s d) between the two groups and selected those showing large between-group differences (|d| ≥ 0.8). These miRNAs were entered into a principal component analysis (PCA) to reduce dimensionality, and …

The Use Of Human Milk Versus Formula Feeding To Decrease The Incidence Of Nec For Preterm Infants In The Nicu: An Integrative Research Review (Irr), Shelby Everard Larkins-Hutchins

Covenant Nurses Week 2026

No abstract provided.

The Effects Of Non-Pharmacologic Interventions On Preventing Secondary Stroke: An Integrated Research Review, Ahnnabeth Everard Millis

Covenant Nurses Week 2026

No abstract provided.

Initiation, Timing, And Duration Of Prone Positioning In Icu Ards Patients: An Integrative Research Review (Irr), Amanda Everard Thomas

Covenant Nurses Week 2026

No abstract provided.

Nurses' Perspectives On Caring For Critically Ill Children During A Measles Outbreak: A Case Report, Cara Everard Gallegos, Melissa Gale Robinson, Brittny Ayola, Lacey Kovar, Nicole Roehrig

Covenant Nurses Week 2026

No abstract provided.

Improving Timely Asthma Treatment In A Pediatric Emergency Department Through A Standardized Evidence-Based Pathway, Olivia Everard Harris

Covenant Nurses Week 2026

No abstract provided.

Improving Patient Outcomes Through Structured Nursing Surveillance In Acute Stroke And Transient Ischemic Attack (Tia): An Integrative Research Review (Irr), Sheeba Everard Matthew

Covenant Nurses Week 2026

No abstract provided.

Improving Glycemic Outcomes In T2dm, Alejandra Everard Ydrogo-Borrego

Covenant Nurses Week 2026

No abstract provided.

Impact Of Rapid Response Team On In-Hospital Cardiac Arrest Events, Sara Everard Tucker, Julie Gale Bell, Stephanie Pigg, Shelby Austin, Kelsey Sawyer, Stephan Smith, Michelle Bradberry, Jonathan Ortegon, Matt Mitchell

Covenant Nurses Week 2026

No abstract provided.

Erythropoiesis-Stimulating Agent (Esa) Therapy In Dialysis Patients With Cancer: Yes Or No?, Jesette Baliad, Ferlie Joy Dela Cruz, Essie Galvan, Ma.Dulce Palting

Covenant Nurses Week 2026

No abstract provided.

Enhancing Early Seizure Detection In Cricial Care Through Nurse-Driven Rapid Eeg, Dylan Delaney, Brenna Gale Jackson, Ruben Sanchez, Amanda Garza, Rebecca Kilgore

Covenant Nurses Week 2026

No abstract provided.

Empowering Nurses In Cardioversion Management, Joel Hutcherson, Abby Gale Perez

Covenant Nurses Week 2026

No abstract provided.

Association Between Perioperative Patient-Reported Outcomes And Upper Extremity Functional Performance In Degenerative Cervical Myelopathy, Harshit Arora, Hassan Darabi, Vishwajeet Singh, Aysha Alsahlawi, Jared T. Wilcox, Francis Farhadi

Neurosurgery Faculty Publications

Background: Degenerative cervical myelopathy (DCM) is caused by chronic compression of the cervical spinal cord. Individuals usually present with a combination of upper extremity dysfunction, imbalance, and bladder dysfunction, which impact overall quality of life. Various questionnaires like mJOA, Nurick, NDI, and DCM-72 have been used for disease stratification. Our study aims to evaluate the clinical correlation between self-reported measures and objective upper extremity assessments and to derive the minimal clinically important difference (MCID) for individuals with DCM.

Methods: A prospective two-center study of consecutive patients diagnosed with DCM was undertaken. A comprehensive assessment of upper extremity functioning including dexterity, …

Revisiting The Faith Trial: A Secondary Analysis Yielding Novel Insights With The Win Ratio, Sofia Bzovsky, Nathan N. O'Hara, Gerard P. Slobogean, Sheila Sprague, Daniel E. Axelrod, Graeme Hoit, Kiara Pannozzo, Mohit Bhandari, Marc Swiontkowski, Emil Schemitsch, Rudolf W. Poolman, The Faith Investigators

Orthopaedic Surgery Faculty Publications

Background: Many orthopaedic trials use any unplanned reoperation as the primary outcome, but this overlooks how patients experience those outcomes. Using a high-quality hip fracture trial, we demonstrate how the relative importance of multiple patient-important outcomes can be effectively incorporated into data analysis, providing a more comprehensive understanding of treatment impact. Methods: This secondary analysis of the Fixation using Alternative Implants for the Treatment of Hip Fracture (FAITH) trial included 1,079 patients aged 50 years or older with a low-energy femoral neck fracture who were randomly assigned to treatment with a sliding hip screw or cancellous screws. The original trial …

Leveraging Virtual Reality And Haptics To Teach Surgical Skills: A Usability Study On Retropubic Midurethral Slings, Lauren Siff, Ginger S. Watson, Jerome Dixon, Moshe Feldman, Franklin Bost, Philippe J. Giabbanelli

VMASC Publications

Traditional methods to learn soft-tissue surgical procedures rely on cadaver labs or patient-based learning, which are costly and geographically limited, and raise ethical questions. Virtual reality (VR) with haptic feedback offers a scalable alternative, but most current platforms emphasize bone-based rather than soft-tissue procedures learned by feel. We developed a VR+haptic simulation for preoperative training of retropubic midurethral sling (MUS) surgery. This study examines the usability of this platform with thirteen expert urogynecologic surgeons and subsequently makes improvements (e.g., in haptics) to evaluate the platform with twelve trainees based on the NASA Task Load Index for workload and a UTAUT-informed …

Severity And Duration-Dependent Aortic Stiffening In A Rabbit Coarctation Model Identifies Constitutive Material Parameters As Promising Regional Biomarkers For Hypertension Progression, Arash Ghorbannia, Jamasp Azarnoosh, John F. Ladisa Jr.

VMASC Publications

Coarctation of the aorta (CoA) alters hemodynamics and drives regional remodeling, yet the influence of severity and duration on constitutive properties is undefined. We quantified mechanical responses from CoA to identify constitutive parameters capturing stiffening across clinical severities and durations. Mild (≤ 12 mmHg), intermediate (13–20 mmHg), and severe (> 20 mmHg) CoA was created in rabbits for short, long, and prolonged durations (~ 1, 3, or 22 weeks, respectively). Stress–stretch curves from proximal and distal regions were fit with multiple constitutive models (Linear Elastic, Neo-Hookean, Yeoh, Ogden, Mooney–Rivlin, Holzapfel). Model performance was evaluated by normalized RMSE and R², with …

Machine Learning Classification Of Prostate Cancer Genomic Sequences Using K-Mer And Sequence-Derived Features, Kuldeep Rawat, Hirendra Nath Banerjee, Jamie Noble, Saa Naudia Deloatch, Satyendra Banerjee, Sachin Shetty, Soumya Banerjee

VMASC Publications

Prostate cancer disproportionately impacts African American men, who experience significantly higher mortality rates and earlier disease onset than other populations. Current diagnostic approaches, including prostate-specific antigen testing and biopsy, lack sufficient specificity and sensitivity, underscoring the need for accurate, molecular-level classification tools. This paper presents a machine learning framework for binary classification of genomic DNA sequences as cancerous or healthy. A dataset of 1684 FASTA-formatted sequences obtained from the National Library of Medicine - GenBank was analyzed, with 1662 sequences retained after quality control filtering. Feature engineering yielded 67 attributes, including GC content, Shannon entropy, sequence length, and trinucleotide k-mer …

Longitudinal Changes In Plasma Biomarkers Of Immune Activation, Neuronal Inflammation And Injury In Persons With Hiv Initiating Art, Merle Henderson, Peter Dutey-Magni, Carolina Herrera, Wolfgang Stöhr, Alejandro Arenas-Pinto, Owen Swann, Amanda Heslegrave, Henrik Zetterberg, John Tregoning, Sarah Fidler, François Raffi, Andrea Calcagno, Ab Babiker, Alan Winston

CONRAD Publications

Background

Data on changes in biomarkers of brain health, and their associations with cognitive function in adults commencing either dual- or triple-antiretroviral therapy (ART) are sparse.

Methods

Plasma biomarkers (neurofilament light [NfL], glial fibrillary acidic protein [GFAP], sCD14, CXCL10, neopterin and IL-6) were measured at baseline and after 96 weeks on ART in individuals randomized to darunavir/ritonavir and either tenofovir-DF/emtricitabine (triple-ART, n = 119) or raltegravir (dual-ART, n = 119) in NEAT-001/ANRS143. Regression models examined associations of baseline and week-96 biomarker concentrations with HIV clinical parameters, composite cognitive test scores (Standardized neuropsychological test [NPZ], 7-domains) and treatment arm.

Results

In …

Early Detection In Oral Cancer: Are We Prepared For Artificial Intelligence-Driven Precision Medicine?, Nikil Kumar, Sinnha Kumari, Sadia Sultana, Muhammad Saad Khan, Tirath Patel, Nikhilesh Anand

School of Medicine Publications

Oral cancer, particularly oral squamous cell carcinoma, remains a serious health concern, with a poor prognosis and a late diagnosis. Leukoplakia, erythroplakia, lichen planus, and submucous fibrosis are examples of oral potentially malignant disorders that must be detected early but are not always so by traditional, laborious, and subjective diagnostic techniques. In oral cancer, artificial intelligence (AI) and precision medicine are becoming game-changing technologies that enhance individualized care, treatment planning, and diagnostic precision. Complex imaging and histopathology data may be analyzed using machine learning and deep learning algorithms, particularly convolutional neural networks, which can identify patterns that are invisible to …

Application Of Current Enteral Nutrition Support Recommendations To Infants Born Less Than 750 Grams Or Less Than 25 Weeks' Gestation: A Critical Review, Mar Romero-Lopez, Mamta Naik, Teresa Hartman, Ann Anderson-Berry, Melissa Thoene

Journal Articles: Pediatrics

Clinicians face a paucity of evidence-based recommendations for provision of enteral nutrition in infants born < 750 g or < 25 weeks' gestation, termed "nano-preterm." Current enteral nutrition recommendations for extremely low birth weight infants may not be broadly applicable to nano-preterm infants due to physiological and developmental differences, while others may be appropriate. Key enteral nutrition-related considerations include: the unique anatomy and physiology of the gastrointestinal tract, altered metabolic capacity, availability of maternal milk and use of alternative substrates, detailed methods of initiation and advancement of enteral feeding, methods of human milk fortification, targeted requirements for macronutrient and micronutrients, and the safety and efficacy of enteral nutrition support management to optimize the growth and development of the nano-preterm infant. This comprehensive review focused on enteral nutrition provision in nano-preterm infants, thoroughly evaluating available literature and identifying knowledge gaps about the unique physiology and metabolism of the nano-preterm infant as it pertains to enteral nutrition. Ultimately, prospective multicenter research is needed to establish evidence-based guidelines to promote optimal growth and development while minimizing complications of extreme prematurity.

Robust Lc–Ms/Ms Method For Quantification Of Ascorbic Acid In Infant Formula And Heat-Processed Donor Human Milk: A Stabilization And Matrix Effects Mitigation Approach, Omar M. Al Kilani, Lee C. Winchester, Melissa Thoene, Colman Freel, Christopher Lee Shaffer, Anthony T. Podany

Journal Articles: Pediatrics

Ascorbic acid is an essential antioxidant for infant health; however, its quantification in infant formula and human milk is challenging due to matrix complexity, analyte instability, and lack of blank matrix equivalents. This study presents a simple and robust LC-MS/MS method that bypasses the need for standard addition using only 20 µL sample. The method showed excellent linearity (R² > 0.99), precision (CV < 15%), accuracy (±10%), and sensitivity (LOD < 0.0375 µg/mL). Stock and working solutions remained stable for months at −20 and −80 °C, respectively, avoiding daily preparation. Optimized extraction substantially reduced matrix effects. The method was externally validated using certified infant formula reference material and successfully applied to commercial samples, with incurred sample reanalysis showing <  20% variation. This validated method offers a practical tool for the routine quantification of ascorbic acid in heat-processed donor human milk and infant formula, with the potential for application to other matrices.

Nutritional Management At 22-23 Weeks Gestational Age: Evidence And Knowledge Gaps, Mar Romero-Lopez, Mamta Naik, Melissa Thoene, Ann Anderson-Berry

Journal Articles: Pediatrics

With advancing medical capabilities, survival of infants born at 22-23 weeks' gestation is increasing. However, specific recommendations for nutrition support for these infants are lacking. This review examines the unique characteristics of infants born at 22-23 weeks' gestation that impact parenteral and enteral nutrition support, highlighting the lack of evidence and knowledge gaps for optimal practices. Current recommendations developed for extremely or very low birth weight infants may be unsuitable for infants born at 22-23 weeks' gestation due to important differences in anatomy, physiology, body composition, and metabolic capabilities. Key challenges include severely limited intraluminal digestion, profound immune and microbiome …

Efficacy And Safety Of Anticoagulation For Pediatric Cerebral Sinovenous Thrombosis: Systematic Review And Meta-Analysis, Muayad Azzam, Hassan Kawtharany, Marisol Betensky, Aseel Alkhader, Qais Hamarsha, Hadi Khaled Abou Zeid, Razan Mansour, Carine Tabak, Payal Patel, Sarah Lamat Baghdadi, Rachel S. Bercovitz, Rukhmi Bhat, Tina Bliss, Brian R. Branchford, Leonard R. Brandão, Anthony K. C. Chan, E. Vincent S. Faustino, Julie Jaffray, Sophie Jones, Bryce A. Kerlin, Nicole Kucine, Riten Kumar, Christoph Male, Marie-Claude Pelland-Marcotte, Leslie Raffini, Chittalsinh M. Raulji, Sarah E. Sartain, Clifford M. Takemoto, Cristina Tarango, C. Heleen Van Ommen, Maria C. Velez, Sara K. Vesely, John Wiernikowski, Suzan Williams, Hope P. Wilson, Gary Woods, Ayesha Zia, Paul Monagle, Reem A. Mustafa

Journal Articles: Pediatrics

We performed this systematic review and meta-analysis to assess the efficacy and safety of anticoagulation therapy versus no anticoagulation in pediatric patients with cerebral sinovenous thrombosis (CSVT). Eligible studies included pediatric patients with CSVT that compared anticoagulation to no anticoagulation and reported on at least one relevant outcome (mortality, neurological deficit, thrombus resolution, recurrence, and bleeding). Meta-analysis reported risk ratios (RR) or differences (RD) (95% CIs) and absolute effects per 1000 patients. Risk of bias was assessed using ROBINS-I, and the certainty of evidence was evaluated with GRADE. After removing duplicates, we screened 8925 records independently and in duplicate, from …