Medical Specialties Commons^™

Training Fm Residents In Prep Is "Hiv Possible", M Ellis Jaruzel, Carlie Nikel

Conference Presentation Abstracts

Pre-Exposure Prophylaxis (PrEP) offers the promise of dramatically reducing the risk of HIV transmission. Institutions in public health believe that PrEP is key to ending the HIV epidemic and improving access is central to this program. Prior literature has suggested that discomfort discussing sexual behaviors and STIs inhibit prescribing PrEP in primary care settings. Given the anticipated need for competent prescription of PrEP in primary care settings as a future routine part of clinical practice, a large (10/10/10) midwestern family medicine residency program designed and implemented a sexual health and PrEP OSCE in consultation with experts from the state (Michigan) …

Understanding Delays In Emergency Department Care: A National Analysis Of Wait Times, Gregory Forsberg

Mathematics, Statistics, and Computer Science Honors Projects

Emergency department (ED) wait times remain a persistent bottleneck in the United States healthcare system, impacting patient outcomes, hospital efficiency, and equitable access to care. This study analyzes nationally representative data from the National Hospital Ambulatory Medical Care Survey (NHAMCS), a complex, multi-stage probability sample. Using survey-weighted analyses and predictive modeling, we examine the effects of patient characteristics, triage acuity, and visit timing. Results indicate that operational and system-level factors, including hospital capacity, geographic region, and temporal variation, are among the most influential predictors of ED wait times

Rare Diseases In Children—Knowledge, Experiences And Challenges Faced By Pediatricians In Tanzania, Mariam Noorani, Mohamedraza Ebrahim, Francis Furia

Paediatrics and Child Health, East Africa

Diagnosing and treating rare diseases in children is a major challenge for pediatricians globally. There is a lack of adequate knowledge of these conditions and diagnostic testing is not easily accessible, which frequently results in delays in care. The knowledge, experiences and challenges faced by pediatricians in Tanzania are not known. This study used a nationwide cross-sectional online survey to describe the knowledge of pediatricians in Tanzania on rare diseases, their experiences, and the challenges they face in treating these children. The survey tool was shared on the Pediatric Association of Tanzania WhatsApp group where most pediatricians are registered. 168 …

Substance Use And Childhood Environment In Adolescent Head Injury: Examining The Effects Of Race, Jessica A. Phelps

Department of Sociology: Dissertations, Theses, and Student Research

Adolescents participating in sports are at an increased risk of concussion, which is particularly important given the difficulties with cognitive function, emotion regulation, and impulsivity that may occur as a result of this brain injury. These symptoms can predispose adolescents to subsequent concussions, leading to further damage during a critical time in neurodevelopment which can result in mental health disorder development in adulthood. It is crucial to understand what factors may predispose youth to increased rates of concussion for these reasons. As such, this paper explored whether race/ethnicity, gender, grade in school, childhood environment, and risk-taking behaviors were associated with …

Evaluating Spect Neuroimaging In Psychiatric Diagnosis: A Critical Review And Proposed Randomized Controlled Study, Kiley Carter

Senior Honors Theses

Mental illness affects a substantial proportion of adults in the United States, yet psychiatric diagnosis remains subject to diagnostic variability. Single-photon emission computed tomography (SPECT) is a neuroimaging technique that measures cerebral blood flow and has been proposed as an adjunctive tool for psychiatric evaluation. Existing literature reports group-level perfusion patterns associated with certain psychiatric conditions, suggesting potential utility in diagnosing complex or treatment-resistant cases. However, critics of SPECT emphasize the absence of randomized controlled data demonstrating improved patient outcomes. To address this gap, a prospective randomized controlled trial comparing standard psychiatric care with SPECT-guided evaluation is proposed. The proposed …

Evaluation Of The Effectiveness Of Antihypertensive Therapy Chosen Through Maternal Hemodynamic Profile Analysis, Margaret Weimer

Poster Presentations

In treatment of emergent hypertension, the American College of Obstetricians and Gynecologists (ACOG) recommends both oral labetalol and nifedipine, with no preference shown between the two. These medications have different mechanisms of action. Studies have suggested that consideration of hemodynamic profile may be an effective way to determine medication, but have not considered the Rule of 55, a simple calculation to predict hemodynamic profile.

Goals: 1. Determine if tailoring the antihypertensive to patient’s hemodynamic profile is associated with better control of blood pressure. 2. Determine if the Rule of 55 is an accurate method to determine hemodynamic profile.

Navigating The Nicu Without Words: A Case Study Of A Spanish-Speaking Mother’S Healthcare Experience, Emma Norris

Poster Presentations

Research on NICU experiences largely focuses on majority-language families; non-English-speaking families are understudied (Cleveland, 2008). The Family Integrated Care model promotes parent-infant connection and shared decision-making to improve outcomes (Wreesmann et al., 2020). Language barriers impede parent-provider communication, increasing miscommunication and parental anxiety (Kynoe et al., 2020; Ardal et al., 2011). The purpose of this research is to explore communication experiences and barriers between English-speaking and bilingual NICU nurses and a Spanish-speaking NICU mother.

Adhesion Of Antibiotic-Resistant Bacteria To Thermoplastic Materials Used In Fabricating Medical Devices: Patient Consequences, Dev V. Mehta

Poster Presentations

Burn injury patients wear supportive orthoses made by heat-forming sheets of thermoplastic material (Figs. 1 & 2). Bacteria cause severe soft tissue infections in patients wearing contaminated orthoses. Thermoplastic medical devices can develop biofilms that include antibiotic-resistant (AR) bacteria, which significantly reduces the number of available treatment options. A biofilm is a community of microorganisms that share resources allowing them to exist in a nutrient-limited environment. Biofilm microbes secrete extracellular polymeric substance (EPS) that attaches them firmly to a substrate surface while protecting them from harmful substances, including antibiotics. Bacteria living within biofilms on inanimate surfaces can survive for extended …

Modeling Structural Support To Facilitate Novel Treatments Of Degenerative Disc Disease, Jose Luis Calderon

Poster Presentations

Over 600 million people worldwide suffered from low back pain in 2020, with projections for 2050 being over 800 million [1]. Annual costs associated with low back pain total over 450 billion dollars in the US alone [2]. This research serves as a proof-of-concept for the use of structural supports to facilitate intervertebral disc healing. This treatment would involve the implementation of these supports along with existing injection treatments to promote regeneration. In both models, along with the combined model, the ability for these supports to alleviate intervertebral disc height loss is shown. This indicates that these supports would serve …

Determinants Of Hypertension Awareness And Control In Kenya: A Secondary Analysis Of National Survey Data, Alexander K. Davis

Poster Presentations

No abstract provided.

Midwives' Self-Efficacy In Perimenopause Care: An Educational Intervention, Yinka Sokunbi

Doctor of Midwifery Advances in Midwifery Projects

Study Purpose: This project evaluated the effectiveness of an asynchronous continuing education (CE) webinar in improving midwives’ self-efficacy to provide comprehensive perimenopause care.

Research Questions

1. What is the impact of a targeted CE webinar on midwives’ self-efficacy in providing comprehensive perimenopause care?

2. How do participants perceive the impact and acceptability of a pilot CE webinar?

Significance/Background: Despite midwifery’s defined role in lifespan care, engagement in perimenopause management remains limited. Gaps in formal education and continuing professional development contribute to low confidence in this area. Guided by Social Cognitive Theory, this project targeted self-efficacy as a modifiable factor influencing …

Assessment Of Correctness, Content Omission, And Risk Of Harm In Large Language Model Responses To Ophthalmology Continuing Medical Education Questions, Jacqueline L. Chen, Amanda J. Lu, Rohan Verma, Li Wang, Douglas D. Koch, Allison J. Chen

SKMC Student Presentations and Publications

PURPOSE: To evaluate the accuracy and prose responses of 2 large language models (LLMs) to ophthalmology continuing medical education questions.

DESIGN: Question prompts and multiple choice (MC) answer options were input into the 2 LLMs, and responses were analyzed for accuracy and assessed for evidence of correctness, completeness, bias, and potential harm using a previously reported standardized rubric.

SUBJECTS: Basic and Clinical Science Course questions and MC answer options from the American Academy of Ophthalmology question bank were used as inputs into the 2 LLMs (ChatGPT-4 and Google Vertex's Gemini Pro 1.5).

METHODS: The MC responses were assessed for accuracy …

Combined Middle Meningeal Artery Embolisation And Subdural Evacuation Port System Drainage For Chronic Subdural Haematoma: A Systematic Review, Single-Arm Meta-Analysis, Meta-Regression, And Cost-Benefit Analysis, Shiva A. Nischal, Santosh Guru, Shaan Patel, Ashviniy Thamilmaran, Mary Murphy

Department of Neurosurgery Faculty Papers

BACKGROUND: Chronic subdural haematoma (cSDH) is an increasingly prevalent condition in older, anticoagulated, and medically frail patients, in whom recurrence and perioperative risk remain substantial despite standard surgical evacuation. Growing recognition of cSDH as an angiogenic, inflammatory disorder has prompted interest in minimally invasive strategies that combine mechanical decompression with targeted modulation of the underlying vascular pathology. This study aimed to evaluate the safety, effectiveness, and health-economic profile of combined middle meningeal artery embolisation and subdural evacuation port system (MMAE-SEPS) drainage for cSDH, compared with conventional burr-hole evacuation.

METHODS: MEDLINE, Embase, and CENTRAL were searched from inception to 24th August …

Seeing Skin, Seeking Evidence: Lessons From A Dermatology Internship, Isabella Floyd

Health, Human Performance and Recreation Undergraduate Honors Theses

Background: Indoor tanning exposes individuals to artificial ultraviolet (UV) radiation through devices such as tanning beds and sunlamps, increasing the risk of skin damage and malignancy. Prior research suggests associations between indoor tanning and melanoma, basal cell carcinoma (BCC), and squamous cell carcinoma (SCC), with potential variation based on age of initiation and cumulative exposure.

Purpose: The purpose of this literature review was to examine the association between indoor tanning and skin cancer risk, with a focus on age at first exposure, frequency, and duration of tanning bed use across melanoma, BCC, and SCC outcomes.

Methodology: A structured literature review …

Agnikarma Therapy In Management Of Plantar Fasciitis (Vatakantaka): A Systematic Review Of Ayurvedic Case Reports, Karishma Sebastian, Nidhin John, Amanda Killeen

School of Podiatric Medicine - Student Research

Plantar fasciitis is a leading cause of heel pain, commonly affecting adults aged 40–60, characterized by microtears and inflammation of the plantar fascia.

Conventional treatments (NSAIDs, corticosteroids, orthotics, surgery) often provide incomplete relief or cause adverse effects.

In Ayurveda, plantar fasciitis corresponds to Vatakantaka, a Vata-dominant condition of the heel region (Khudukapradesha).

Agnikarma, a para-surgical Ayurvedic technique involving therapeutic thermal cauterization using heated metallic rods (Shalaka), is described for disorders involving ligaments, bones, and joints with chronic pain and stiffness.

This review synthesizes clinical case reports evaluating Agnikarma as a treatment for plantar fasciitis to determine its efficacy, safety, and …

Device And Patient-Related Complications Of Renal Denervation For Resistant Hypertension: A Post-Marketing Analysis Of The Fda Maude Database, Sai Tharun Reddy Gopannagari, Kesava Manikanta Achuta, Divya Ganisetti, Towfiqul Chowdhury, Chadi Saad

Conference Presentation Abstracts

Background: Renal denervation (RDN) has re-emerged as an adjunctive therapy for resistant hypertension following recent FDA approvals of ultrasound- and radiofrequency-based systems. While contemporary randomized trials report a favorable safety profile, real-world post-marketing data may capture a broader spectrum of complications. Methods: We queried the FDA Manufacturer and User Facility Device Experience (MAUDE) database from inception through December 22, 2025, using product code ‘QYI’ and brand names ‘Paradise’ (Recor Medical) and ‘Symplicity Spyral’ (Medtronic). Reports describing RDN procedures for resistant hypertension were included. Events were manually reviewed and categorized as vascular, device-related, hemodynamic/arrhythmic, neurologic, or other. When multiple events occurred …

Convergence And Divergence Of Opinion About Treatment Of Binocular Vision Disorders Among Vision Care Professionals, Sonia Young

Dissertations

There are three distinct professions prominent in the field of pediatric vision care. They are ophthalmology, optometry and orthoptics. All professions are integral to the detection and treatment of pediatric binocular vision disorders. However, distinct schools of thought exist to describe the best approach to pediatric binocular vision disorders and their treatments. Literature often highlights two opposing schools of thought represented by the “medical” and “behavioral” approaches. While there is academic debate about the merits and pitfalls of either approach, there is a paucity of nuanced perspectives which more closely resemble the ways in which pediatric ocular clinicians approach diagnosis …

Opioid-Free Hernia Repair Protocol Reduces Pediatric Opioid Exposure Without Compromising Pain Control, Abigail Teitelbaum, Kristin E. Lemarbe, Diane Studzinski, Corey Shafer, Antonela Muca, Emanuela Peshel, Randall Hilleary, Anthony Stallion, Nathan M. Novotny, Pavan Brahmamdam, Begum Akay

Conference Presentation Abstracts

Abstract: Purpose: Protocolizing perioperative pain management may reduce opioid exposure in children. We designed a multimodal pain management protocol for pediatric ambulatory hernia surgery with the goal of reducing opioid use. This study evaluates the impact of this protocol on opioid use, pain control, and patient/proxy satisfaction. Methods: Our protocol utilized child life services, regional anesthesia, and non-opioid analgesic adjuncts in the perioperative period. We reviewed all pediatric ambulatory hernia cases two years before and after protocol implementation. Protocol adherence was stratified by level of opioid use: high (no opioid use), medium (opioids used intraoperatively or postoperatively), and low adherence …

When Optimal Therapy Becomes High Risk: A Risk-Benefit Framework For Beta-Lactam Desensitization In Life-Threatening Mssa Infection, Rana Amoush, Aaron Kobernick

Conference Presentation Abstracts

Background Beta-lactam antibiotics are preferred for invasive methicillin-sensitive Staphylococcus aureus (MSSA) infections, especially those involving prosthetic material. Management is challenging in patients with severe beta-lactam hypersensitivity, as alternative agents may be less effective or poorly tolerated. Limited guidance exists on reassessing desensitization risk when second-line therapies become untenable. Purpose To present a case-based risk-benefit framework for evaluating beta-lactam desensitization in medically complex patients with life-threatening MSSA infections. Methods We retrospectively reviewed a patient with recurrent MSSA prosthetic graft infection and severe beta-lactam hypersensitivity. Clinical decision-making was analyzed using a structured risk–benefit framework incorporating infection severity, therapeutic superiority of beta-lactams, tolerance …

The Dietary Management Of Sodium In Children With Kidney Diseases-Clinical Practice Recommendations From The Pediatric Renal Nutrition Taskforce., José Renken-Terhaerdt, An Desloovere, Michiel Js Oosterveld, Nonnie Polderman, Evelien Snauwaert, Stella Stabouli, Johan Vande Walle, Caroline Anderson, Sheridan Collins, Larry A. Greenbaum, Matthew Harmer, Lyndsay Harshman, Christina L. Nelms, Pearl Pugh, Vanessa Shaw, Jetta Tuokkola, Molly R Wong Vega, Bradley A. Warady, Rukshana Shroff, Fabio Paglialonga

Manuscripts, Articles, Book Chapters and Other Papers

Sodium imbalance is a common concern in children with kidney diseases, presenting as either sodium excess or sodium deficit, each with significant clinical implications. Sodium excess contributes to fluid overload and hypertension, while increased sodium losses, particularly via urine or peritoneal fluid, can predispose patients to hypotension and growth failure. Effective sodium management is thus a critical component of care in pediatric kidney diseases, with dietary sodium intake playing a pivotal role in maintaining homeostasis. The Pediatric Renal Nutrition Taskforce (PRNT) has developed clinical practice recommendations (CPRs) for dietary sodium management in children with kidney diseases, addressing key aspects of …

Regional Variation Of Underlying Kidney Diseases In Children Undergoing Chronic Kidney Replacement Therapy Around The Globe., Dagmara Borzych-Dużałka, Marjolein Bonthuis, Uma Ali, Yok-Chin Yap, Michael Manno, Yihui Zhai, Reyner Loza, Seema Hashmi, Naye Choi, Kenza Soulami, Judith Exantus, Mohamed S. Al Riyami, Sameh Mabrouk, Marbella Ma Angeles, Cristina Zelaya-Camacho, Henny Adriani Puspitasari, Syed Saimul Huque, Francisco Cano, Kar Hui Ng, Sevcan A. Bakkaloğlu, Jerome Harambat, Kitty J. Jager, Bradley A. Warady, Franz Schaefer

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: There is a scarcity of information regarding the distribution of the diseases leading to kidney failure (KF) in children living in the emerging world. We used registry data to provide a global overview of the underlying disease spectrum in children commencing kidney replacement therapy (KRT).

METHODS: We analyzed KF causes among 23,620 children and adolescents commencing maintenance KRT in 80 countries, using data from the IPNA Global KRT Registry (including ESPN/ERA Registry), the International Pediatric Dialysis Network (IPDN), the United States Renal Data System (USRDS), and the Australia and New Zealand Dialysis and Transplant Registry (ANZDATA). The analysis considered …

Promises, Pitfalls, And Paths Forward For The Pediatric Research Equity Act., Alexa L. Pagano, Danielle J. Green, Jennifer Goldman, Anjali Deshmukh

Manuscripts, Articles, Book Chapters and Other Papers

IMPORTANCE: Since its enactment in 2003, the Pediatric Research Equity Act (PREA) has significantly increased the number of pediatric drug studies performed and expanded pediatric drug labeling. Despite these advancements, many drugs used in children still lack pediatric-specific US Food and Drug Administration (FDA) labeling, even when pediatric studies are required by law. Recent legislative changes strengthened the FDA's enforcement authority over PREA. As these changes are implemented, persistent gaps in pediatric drug development warrant examination. Addressing these gaps may help ensure that children are systematically included in clinical research and that medications used in children are supported by rigorous …

Piloting A Pediatric Screener For Assessing Emergent Literacy With Preschool Children, Nafia Sarhadi

Poster Presentations

From infancy, children develop literacy knowledge, which provides them with the needed skills for reading in primary school (Castillo-Rabanal &Heitmayer, 2025). Before children start to read, they develop skills that involve increasing their rhyming, alphabet, and vocabulary knowledge. Literacy is considered a social determinant of health as it plays a role in one's physical, social, and emotional maturity (Lesauxet. al, 2007). The Bay Area Women Coalition, (BAWC) Inc. has partnered with the Autism, Pediatric Language & Literacy (APLL) Lab to implement PEEL, following modifications identified by the community. The current pre-to-posttest assessment is unsuitable for community participation. An efficient method …

Evaluation Of The Effectiveness Of Antihypertensive Therapy Chosen Through Maternal Hemodynamic Profile Analysis, Margaret Weimer

Honors Theses

Medication choice is tightly regulated in most situations, but in the field of obstetric medicine, the American College of Obstetricians and Gynecologists (ACOG) recommends both labetalol and nifedipine as oral treatments for emergent hypertension, with no preference shown between the two. Studies have suggested that consideration of hemodynamic profile may be an effective way to determine medication, but have not considered the Rule of 55, a simple calculation to predict hemodynamic profile. The goals of this study were to determine whether tailoring the oral hypertensive medication to a patient’s hemodynamic profile is associated with better blood pressure control within 72 …

Choosing Death: The Moral Legitimacy Of Voluntary Active Euthanasia, Emma Rougeou

Honors Theses

During the last three decades, the issue of physician assisted suicide has captivated the interest of private citizens and state legislatures. Thinking about the matter of end-of-life concerns, particularly surrounding euthanasian (practices that hasten the deaths of suffering terminally ill people) have shifted. Views of private citizens and state-level legislation reflects a “slow shift to more permissive attitudes” (Cohen et al., 2012). Meanwhile, as recently as March 2026, state legislators in conjunction with the NY State Governor, passed a bill legalizing medical aid in dying for terminally ill patients. This thesis is intended to thoughtfully contribute to meaningful discourse on …

Spectral Characterization Of Colorectal Cancer Using Excitation-Scanning Hyperspectral Imaging, Natalie Hadad

Honors Theses

Colorectal cancer is one of the most common and deadly cancers worldwide, with a lifetime risk of approximately one in twenty-three for men and one in twenty-five for women. Although early detection significantly improves survival, current diagnostic approaches such as tissue biopsy are invasive, reliant on subjective interpretation, have extended turnaround times, and risk missing flat or depressed lesions that are more difficult to detect than raised polyps. These limitations highlight the need for objective, minimally invasive technologies capable of detecting early tissue changes. This study investigates excitation-scanning hyperspectral imaging (Ex-HSI) as a label-free optical approach for identifying colorectal cancer–associated …

Novel Biomarker Discovery In Multiple Sclerosis, Manisha Gangasani

Honors Theses

Multiple Sclerosis (MS) is a chronic neuroinflammatory disorder affecting the brain, spinal cord, and optic nerve. Patients experience cognitive, motor, autonomic, and emotional symptoms that often overlap with other neurological conditions, making early diagnosis challenging. Current diagnostic criteria require evidence of lesions with dissemination in time and space. Racial disparities in MS outcomes are well documented, with Black individuals often exhibiting greater disease severity, higher relapse rates, and increased disability compared to White individuals. These differences likely reflect a combination of genetic, biological, environmental, and healthcare access factors, underscoring the need to improve early diagnosis and reduce inequities in care. …

Characterization Of Circulating Extracellular Proteome In Plasma Samples Of Triple-Negative Breast Cancer Patients, Brionna Wilson

Honors Theses

Extracellular vesicles (EVs) are membrane-bound vesicles secreted by cells in the body that play an important role in intercellular signaling, immune modulation, and transfer of biomolecules between cells. EV s reflect the physiological state of their cells of origin, so they are being explored as potential noninvasive biomarkers for cancer detection and monitoring. Triple-negative breast cancer (TNBC), an aggressive subtype lacking targeted therapies, is difficult to detect early and currently has no reliable prognostic biomarkers. This study aimed to quantify EV concentrations in the blood serum of TNBC patients (n=40) compared with cancer-free healthy controls (n=35) as well as determine …

Developing A Protocol For Non-Cellular Transplantation Of Donor Mitochondria Into Recipient Cells, Andrew Parton

Honors Theses

Tumor innervation has emerged as a critical feature of cancer progression, with increased nerve density correlating with enhanced aggressiveness, metastatic dissemination, and poor clinical outcome. However, the functional contribution of neurons to tumor biology remains incompletely defined. We recently identified the intercellular transfer of mitochondria from neurons to cancer cells as a mechanism that promotes tumor progression. We therefore hypothesized that disruption of this transfer could attenuate tumor aggressivity. To directly investigate this process, we developed an approach to isolate mitochondria from donor cells and transplant them into recipient cancer cells independently of canonical cell-cell interactions. Transferred mitochondria were tracked …

Global Perspectives On Cns Drug Innovation: Achievements, Barriers, And Priorities For The Next Decade, Hiroyuk Uchida, Gabriella Gobbi, Joseph Zohar, Allan Young, Dan Rujescu, Ming-Chyi Huang, Suresh Sundram, Lukoye Atwoli, Jana Vukovic, Kazutaka Ikeda

Internal Medicine, East Africa

Background Over the past decade, neuropsychopharmacology has shifted from stagnation to momentum, with first-in-class mechanisms and biomarker-enabled trials spanning psychiatry and neurology.

Methods We narratively synthesized advances from 2013 to 2026 across central nervous system (CNS) discovery and development, including pivotal trials, regulatory actions, digital/real-world evidence, genetics, artificial intelligence (AI), and implementation/global-access themes that are endorsed by international societies.

Results Therapeutic gains include rapid-acting drugs for treatment-resistant depression (intranasal esketamine); psychedelic-assisted therapy for posttraumatic stress disorder and depression; neuroactive steroid γ-aminobutyric acid-A receptor positive allosteric modulators (brexanolone, zuranolone) for postpartum depression; non-dopaminergic muscarinic agonists (xanomeline–trospium) for schizophrenia; orexin receptor antagonists …