Medical Specialties Commons^™

Beyond The Cycle: How Menstruation Influences Gender Identity And Well-Being In Binary And Non-Binary Adults, Rin Nguyen

College of Education and Human Sciences: Dissertations, Theses, and Student Research

Approximately 1.8 billion people worldwide menstruate, including transgender and gender-diverse (TGD) people, yet their experiences remain underrepresented in research. Given that menstruation can affect gender alignment and psychological well-being, understanding its impact on TGD people is critical. Gender congruence, or alignment between one’s gender identity and expression, is a key factor influencing well-being, with research linking it to reduced depression and anxiety. Furthermore, emerging research on gender euphoria, the joy experienced when gender congruence is experienced, suggests it may serve as a protective factor for mental health and well-being. Gender euphoria has been associated with reduced psychological distress and increased …

Clinical Pathway For Rhogam Administration In The Emergency Department, Lauren Kyzar, Amy Bigham

Appalachian Student Healthcare Research Review

Background: Clinical pathways in emergency departments (ED) are designed to standardize patient care and reduce variability in clinical practice. In a rural hospital setting, the ED management of RhoGAM administration in pregnant patients with vaginal bleeding varied by provider with no standard of care achieved. This approach raised concerns about potential patient safety issues.

Methods: In response, the local emergency department medical director, in conjunction with local perinatal providers developed a clinical pathway to standardize care and optimize RhoGAM administration. The clinical pathway was implemented to the local ED providers over a three-month period. Retrospective chart review for Type and …

A Meta-Analysis Of Endometrial Cancer Metabolites As Potential Non-Invasive Biomarkers, Makenna K. Johnson

Honors Theses

Endometrial Cancer (EC) is the most prevalent gynecological cancer in the United States and causes tens of thousands of deaths. Despite its massive negative impact in developed countries, there currently is no reliable screening tool used to diagnose women. Due to this urgent need for minimally invasive and precise techniques to diagnose this malignancy, the metabolomics field has been at the forefront of current research. An untargeted mass-spectrometry approach is used by many researchers to form an initial hypothesis as to which metabolites are key in identifying EC cases. However, there are sometimes inconsistencies between studies. A meta-analysis approach examines …

Measuring School Anxiety In Pediatric Chronic Pain: Initial Investigation Of The Psychometric Properties Of The School Anxiety Inventory For Chronic Pain (Sai-Cp), Caitlyn Maye, Robert C. Gibler, Kristen E. Jastrowski, Dustin Wallace Phd, Cara M. Hoffart, Jenny Scheurich Phd

Posters

Introduction: School anxiety is common among adolescents with chronic pain and often impacts academic and social functioning. Existing anxiety measures lack specificity for capturing the unique sources and symptoms of school-related anxiety in this population. To address this gap, a bank of new potential measure items (the School Anxiety Inventory for Chronic Pain [SAI-CP]), was developed based on the original School Anxiety Inventory (SAI), qualitative interviews with adolescents with chronic pain, and expert clinician input. The objective of this study was to evaluate the construct validity and internal consistency of the SAI-CP and identify avenues for future measure refinement. Method: …

Recognizing What Matters Most: Using Safety-Critical Tasks To Strengthen Central Line-Associated Bloodstream Infection (Clabsi) Prevention Rounds, Lacey Bergerhofer, Christian Anthony Schneider, Emily Evans

Posters

Background: Our CLABSI improvement team developed high-risk rounding processes on the Hematology/Oncology unit. Expanding this model to additional Med/Surg units was challenging due to limited staffing and time-intensive tasks required during rounds. Concurrently, CLABSI rates across other Med/Surg units increased, necessitating a scalable approach. Objectives: Apparent Cause Analysis (ACA) review in Med/Surg units identified an opportunity to strengthen surveillance by engaging Vascular Access subject-matter experts. Our proactive high-risk rounds pilot led to CLABSI rate reduction. The objective was to expand service coverage without compromising established high-risk rounding quality standards. Our goal is to assess > 90% of central lines in Med/Surg …

Two Glands, One Problem: Navigating Fertility Treatment In Concurrent Nonclassic Congenital Adrenal Hyperplasia And Polycystic Ovary Syndrome, Paul Meram, Mary Show, Elliott Gappy, Ajaz Banka

Conference Presentation Abstracts

Background: Nonclassic congenital adrenal hyperplasia (NCCAH) caused by 21-hydroxylase deficiency is generally a milder variant of congenital adrenal hyperplasia characterized by partial enzyme activity and variable increases in adrenal androgen levels. Patients presenting with such a condition may present in adolescence or adulthood with symptoms such as acne, hirsutism, irregular menses, and infertility. These symptoms often overlap with those of Polycystic Ovary Syndrome (PCOS), creating challenges in differentiation and management. It is critical to differentiate between PCOS and NCCAH in females of reproductive age, as hyperandrogenism treatment depends on the underlying cause, such as adrenal, ovarian, or a combination of …

Preclinical Animal Modeling To Investigate Redox-Mediated Molecular Dysfunction In Traumatic Brain Injury, Brandon Z. Mcdonald

Department of Agricultural and Biological Systems Engineering: Dissertations, Theses, and Student Research

Impacts associated with traumatic brain injury (TBI) induce a multitude of neurological morbidities mediated by a spread of biochemical dysfunction. Redox stress is a significant contributor to TBI pathophysiology and several redox stress markers have substantial evidence to support their role in diagnosing preclinical and clinical TBI. However, there is a critical need to verify their translational utility through correlations with behavioral, imaging, and molecular modalities. In chapter two, we examined the therapeutic efficacy of an antioxidant treatment (NPC3) using a controlled cortical impact (CCI) mouse model of TBI. NPC3 alleviated glial expression and reactivity while influencing the expression of …

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 …

Population Pharmacokinetics And Dosing Simulations Of Pentobarbital In The Pediatric Population, Victoria Etges Helfer, Lorena Medina-Aymerich, William J. Muller, Marisa Meyer, Amira Al-Uzri, Russell Mcculloh, Chi D. Hornik, Stephen J. Balevic, Rachel G. Greenberg, Daniel K. Benjamin, Sarah G. Anderson, Daniel Gonzalez

Department of Pediatrics Faculty Papers

Pentobarbital is a barbiturate with sedative and anticonvulsant properties, occasionally used in pediatric patients for preoperative sedation, deep sedation during mechanical ventilation, and seizure control. Despite its long-standing clinical use, age-appropriate dosing remains challenging due to variability across studies and limited pediatric pharmacokinetic (PK) data. This study (NCT01431326) aimed to characterize the population pharmacokinetics of pentobarbital in pediatric patients (birth to 21 years) and evaluate dosing strategies using model-based simulations. A two-compartment population PK model, allometrically scaled to total body weight, adequately described pentobarbital plasma concentrations, with no additional covariates identified as significant. Simulations were conducted across four age groups: …

Diagnostic Ability Of Rate Of Torque Development For Patellofemoral Pain, Arun Loganathan, Neal R. Glaviano Phd, Sungwan Kim Phd

Honors Scholar Theses

Context: Patellofemoral pain (PFP) is a highly prevalent condition (22.7% in general population) that significantly impacts the quality of life of those who suffer from it. However, there is no gold standard test to diagnose it yet, leading to inconsistencies with treatment as well as delayed intervention. Rate of torque development (RTD) is a neuromuscular measure that has shown strong connections to PFP.

Objective: The purpose of this study is to determine the diagnostic ability of RTD for PFP.

Design: Cross-sectional.

Setting: Laboratory.

Participants: Thirty-five individuals with PFP (24 males and 11 females, 22.7 ± 3.7 years, 1.67 ± 0.1 …

Validation Of A Real-Time Pcr Laboratory Developed Test For The Detection Of Pneumocystis Jirovecii In Bronchoalveolar Lavage Samples, Caitlyn Moon

Honors Scholar Theses

Pneumocystis jirovecii is an opportunistic, host-obligate fungal pathogen responsible for causing P. jirovecii pneumonia (PJP) in humans. PJP is treated with trimethoprim-sulfamethoxazole (TMP-SMX), a strong broad-spectrum antibiotic that carries risk of renal and hepatotoxicity. Therefore, rapid diagnosis or exclusion of PJP is crucial to ensure PJP-positive patients receive effective treatment and PJP-negative patients avoid unnecessary antibiotics. Unlike most microorganisms, P. jirovecii cannot be cultured, presenting complications for the typical methods of diagnosing fungal pathogens. Historically, the gold standard for diagnosis was direct microscopic examination with stains such as methenamine silver and calcofluor white, but this diagnostic technique requires highly skilled …

Play To Win: A Randomized Controlled Trial To Assess The Effects Of Play-Based Training On Upper Extremity Function In Children With Hemiplegia, Vivian London

Honors Scholar Theses

Hemiplegia, or paralysis of one side of the body, is the primary symptom of unilateral cerebral palsy, a subtype of cerebral palsy, the most common movement disorder in children. Standard of care is regular physical and occupational therapy to improve performance in bimanual activities, but conventional therapy can be expensive and draining for caregivers and children, so a need exists for a novel intervention that can take place at home and that is economical for families while being engaging for children. This thesis reports data from a subset of ten children seen as part of a randomized controlled clinical trial …

The Development Of A Crispr-Based Calibrated Functional Assay For Classifying Pathogenicity Of Msh2 And Msh6 Variants In Lynch Syndrome, Olivia N. Amodeo

Honors Scholar Theses

Lynch syndrome is a hereditary disease caused by the inheritance of a mismatch repair gene variant. Individuals with this condition are predisposed to cancer development, most commonly colorectal cancer. Current guidelines for variant classification are based on numerous evidence categories, including functional evidence. However, many novel clinical variants are not well characterized, and evidence is difficult to obtain if functional assays are not calibrated.

To address this, our lab created a calibrated functional assay that calculates an odds of pathogenicity score for MSH2 and MSH6 gene variants that can be used as evidence for classifying variants of uncertain significance. This …

Persistent Wheezing In An Adolescent Patient, Matilda Dervisevic, Stephen Cliff

Posters

No abstract provided.

Participant Recruitment, Baseline Characteristics And Burden Of Cardiometabolic Risk Markers Among Adults With Prediabetes In Kenya: Insights From The Fermented Foods And Prediabetes Study, Rosebella Iseme, Alex Muia, Jacob Shabani, Samuel Mucheru, Catherine Gathu, Eliphas Gitonga, Redempta Mutisya, Peter Kioko, Jalal Safipour, Cornelia Witthöft

Population Health, East Africa

Aims

Methods

Results …

Extracorporeal Membrane Oxygenation (Ecmo) Neuromonitoring And Acute Brain Injury, Children's Mercy Kansas City

Clinical Pathways

No abstract provided.

Pertussis, Children's Mercy Kansas City

Clinical Pathways

No abstract provided.

Targeting The Dorsolateral Prefrontal Cortex With Transcranial Direct Current Stimulation To Improve Depression And Anxiety In Parkinson's Disease, Brock Renicks

Honors Theses

The aim of this study is to observe the outcomes of transcranial direct current stimulation (tDCS) as a treatment for Parkinson’s Disease (PD). This study will primarily look at changes in depression and anxiety, as these symptoms are often comorbid with Parkinson’s Disease. Transcranial direct current stimulation is a non-invasive, very low-intensity form of electrical stimulation of the brain. It is being increasingly used as a form of treatment for Parkinson’s Disease and depression and anxiety, however the literature is ambiguous, showing mixed results throughout various studies, with no standardization of tDCS administration. To determine the effect of tDCS on …

Spontaneous Coronary Artery Dissection In Postpartum: A Hidden Cause Of Maternal Myocardial Infarction, Riya Chhabra, Brian Renard

Conference Presentation Abstracts

Spontaneous coronary artery dissection (SCAD) is a tear in the coronary artery lining which decreases blood flow to the heart. SCAD is the leading cause of myocardial infarction in young to middle aged women, especially during and after pregnancy. While SCAD is often managed conservatively, patients are prone to complications like cardiomyopathy. This case underscores the importance of considering SCAD as a differential for postpartum women with chest pain. Furthermore, this case highlights the diagnosis and management of an atypical stress-induced cardiomyopathy with global hypokinesis following postpartum SCAD. A 37-year-old female postpartum for five weeks presented to our hospital with …

Pattern Dynamics And Stochasticity Of Brain Rhythms And Spike Trains In A Tauopathy Mouse Model Of Alzheimer’S Disease, Clarissa M. Hoffman

Dissertations and Theses (Open Access)

Systems neuroscience posits that every aspect of perceived physical reality, every aspect of animal and human behavior, and every cognitive phenomenon emerges from patterns of neuronal activity. While most researchers embrace this idea, there are major difficulties in describing and analyzing these complex neuronal dynamics—spike flows produced by cells ensembles, synchronized extracellular field oscillations, and other patterns—which limits our understanding of how the activity of individual neurons and the whole-animal cognition and behavior might be connected. In particular, we lack the approaches and even the semantics for connecting the individual cell outputs and the integrated results of their activity. Current …

Technical Development, Optimization, And Clinical Implementation Of Quantitative Magnetic Resonance Imaging Methods For Radiation Oncology, Lucas Mccullum

Dissertations and Theses (Open Access)

Magnetic resonance imaging (MRI) has gradually grown more important in the field of radiation oncology. This paradigm shift has grown from initial experiments with MRI of cancerous lesions in the early 1970s, to the integration of MRI images for radiation therapy treatment planning (i.e., MRI-Simulation) in the early 1980s, to the combined MRI linear accelerator (MR-Linac) becoming commercially available in 2018 which can simultaneously image a tumor and treat it with radiation. However, due to its novelty in radiation oncology, its full potential for the integration of quantitative MRI-based biomarkers has yet to be fully realized.

Therefore, this dissertation will …

Platelet Gαz Regulates Ovarian Tumor Growth And Mediates The Effects Of Chronic Stress, María G. Torres Carrizalez

Dissertations and Theses (Open Access)

Ovarian cancer is the most aggressive gynecologic cancer, with 12,450 estimated deaths in 2026. Elevated platelet counts are commonly observed in patients with ovarian cancer and are associated with enhanced tumor growth and poor prognosis. Patients with ovarian cancer are frequently exposed to elevated levels of stress, which has been correlated with accelerated disease progression and increased mortality. Interestingly, the platelet Gαz protein is activated by epinephrine through the α2A-adrenergic receptor, suggesting a potential mechanistic link between stress signaling and platelet-driven tumor progression. To investigate this, I evaluated the role of platelet Gαz in ovarian cancer using control (Gz^{fl/fl …}

A Global Prospective Harmonization Framework For Suicidality, Anhedonia, And Obsessive-Compulsive Symptoms In Psychiatric Genetic Studies: A Cross-Continental Study Within The Ancestral Population Network, Ana Diaz-Zuluaga, Jacey Anderberg, Ana Ramirez-Diaz, Andrea Marques, Catherine Rast, Daniel Bustamante, Deborah Jonker, Johanna Valencia-Echeverry, Stella Gichuru, Lukoye Atwoli

Internal Medicine, East Africa

This study aims to prospectively collect harmonized, quantitative, and dimensional psychiatric phenotypes (suicidality, anhedonia, and obsessive-compulsive symptoms) and information on discrimination, stigma, and unfair treatment in up to 27,500 individuals across diverse ancestries and clinical populations for genetic analysis within the NIMH Ancestral Population Network (APN). Five APN projects are participating in the current study (PUMAS-Paisa, PUMAS-NeuroGAP, KOMOGEN-D, LATINO, and SAX-II), spanning recruitment over 15 countries across the Americas, Africa, and Asia. Participants are being enrolled via the recruitment protocols specific to each participating project. The harmonized clinical battery includes the Columbia-Suicide Severity Scale, Snaith-Hamilton Pleasure Scale, and Florida Obsessive-Compulsive …

Seroprevalence Of Helicobacter Pylori Infection Among Asymptomatic Patients Served By A Safety-Net Healthcare System, Jourdan Brown, Daniel Avila, Jennifer Mistica Zafiro Garcia-Villanueva, Lisa C Danek, Hammad Mahmood, Thomas Porter, Ann Gotschall, Noreen F Pirzada, Jaime J Rueda, Lee B Lu, Afroze Ali, Ijeoma Anyakorah, Sanjana J Bhattarai, Anees Fatima, Jessica Garcia, Hung V Nguyen, Bharat Joshi, Malvika Juneja, Misba S Lateef, Najda Mujtaba, Preethi V Nambi, Jay S Orr, Huma Rahman, Stephanie Nguyen, Amna Waqar, Yanyan Chen, David Y Graham, Hashem B El-Serag, Mimi C Tan

Faculty, Staff and Students Publications

Background & aims: Helicobacter pylori screening and eradication is a cost-effective strategy for primary gastric cancer prevention in high-risk populations outside the United States. There is a paucity of population-based H pylori seroprevalence data available in high-risk U.S. groups, particularly data for low-income, uninsured patient populations.

Methods: We used data from a cross-sectional study of a largely underserved, immigrant, and minority patient population. Inclusion criteria included asymptomatic individuals 30-65 years of age without prior H pylori testing or treatment. Consented patients completed a study survey and a blood draw to screen for H pylori using IgG serology. We calculated seroprevalence …

A Smoking-Related Plasma Protein Score And Smoking-Related Cancer Risk And Mortality In The Atherosclerosis Risk In Communities Study, Hana Zahed, Christie M Ballantyne, Kenneth R Butler, Josef Coresh, David J Couper, Panagis Galiatsatos, Marc J Gunter, Ron C Hoogeveen, Mattias Johansson, Corinne E Joshu, P Martijn Kolijn, Christina M Lill, Jiayun Lu, Michael T Marrone, Giovanna Masala, David C Muller, Anna E Prizment, Raul Zamora-Ros, Nilanjan Chatterjee, Adrienne Tin, Elizabeth A Platz

Faculty, Staff and Students Publications

Background: Self-reported smoking may not fully capture individualized risk of smoking-related cancer, but circulating proteins may reflect biological consequences of smoking. Thus, we developed a score based on smoking-related proteins and evaluated its association with smoking-related cancer.

Methods: This prospective cohort study included 10 563 participants aged 47-70 years in the Atherosclerosis Risk in Communities study. Plasma proteins were measured using the SomaScan Platform (SomaLogic Operating Co, Inc). The score was constructed from proteins associated with current smoking, pack-years, or recent quitting identified by linear regression and elastic net regression. Cox regression was used to estimate adjusted hazard ratios and …

Fructose: Metabolic Signal And Modern Hazard, Marcus D Goncalves, Samir Softic, Kimber L Stanhope, Laura G Sánchez-Lozada, Mark A Herman, Joshua D Rabinowitz

Faculty, Staff and Students Publications

There is much interest in the role of sweeteners such as table sugar (sucrose) and high-fructose corn syrup in obesity and metabolic disease. Both sweeteners consist of glucose and fructose, two six-carbon isomeric sugars. Whereas glucose ingestion may promote obesity through its effects to stimulate insulin secretion, fructose has unique metabolic effects that promote triglyceride synthesis and fat accumulation. These effects arise from fructose's well-known role as a signal of metabolic plenty. Under modern conditions of overnutrition, chronic excess fructose drives features of metabolic syndrome. Emerging evidence further links fructose to cancer and dementia. Here we review the biochemical, molecular …

Plasma Metabolites After 10-Weeks Of Glucose Vs Fructose-Sweetened Beverages In Subjects With Overweight/Obesity, Peter J Havel, Kimber L Stanhope, Olga Ilkayeva, Christopher B Newgard, Nicola M Mckeown, Mark A Herman

Faculty, Staff and Students Publications

To identify metabolites as potential biomarkers of fructose vs glucose consumption and related metabolic changes, we conducted exploratory metabolomic profiling of fasting blood samples from participants in a double-blind, parallel-arm trial involving 31 male and female adults with overweight or obesity, both before and after supplementation with glucose- or fructose-sweetened beverages. Orthogonal Partial Least Square Discriminatory Analysis (OPLS-DA) was used to identify metabolites that could discriminate between the 2 intervention groups. Changes in 16 metabolites (5 of which are branched-chain amino acid catabolic pathway metabolites) and the branched chain keto acid (BCKA) composite score showed nominal (FDR adjusted P-value …

Risk Factors When Considering Heart Transplants With Donors Aged 45 Or Above: Development Of A Novel Mortality Risk Score Using Unos Data, Gabriel Loor, Andrew Civitello, Todd Rosengart, Kenneth Liao

Faculty, Staff and Students Publications

Background: Current International Society for Heart and Lung Transplantation guidelines support the use of donor hearts aged ≥45 if significant coronary artery disease is excluded and ischemic time remains < 4 hours. This study aimed to identify additional risk factors affecting patient survival and develop a risk score for recipients of older donor hearts.

Methods: We performed a retrospective cohort study of adult heart transplants using donors aged ≥45 from January 2000 to June 2024, using United Network for Organ Sharing data. Multivariable Cox regression identified risk factors for mortality, and the most significant variables were used to construct a risk score.

Results: Of 58,859 adult heart transplants, 9,843 (16.7%) involved donors aged ≥45. Recipient median age was 58 years (interquartile range, 51-64). One-, 5-, …

Novel Model To Predict Survival In Dcd Heart Transplants: Development Of A Mortality Risk Score Using Unos Data, Gabriel Loor, Andrew Civitello, Todd Rosengart, Kenneth Liao

Faculty, Staff and Students Publications

Background: While prior studies have compared outcomes between donation after brain death (DBD) and donation after circulatory death (DCD) heart transplants, this study focuses on donor and recipient characteristics influencing survival and develop a risk score exclusively in DCD heart transplants.

Methods: We analyzed adult DCD heart transplants in the UNOS database from January 2019 to June 2024. Mortality risk factors were assessed using multivariable Cox proportional hazards regression. The coefficients of the most significant factors were used to develop a mortality risk score.

Results: Among 18,014 adult heart transplants, 1453 (8.1%) were DCD recipients. One-, two-, and three-year survival …

Ai-Powered Insights In Pediatric Nephrology: Current Applications And Future Opportunities., Arwa Nada, Yamen Ahmed, Jieji Hu, Darcy K. Weidemann, Gregory H. Gorman, Eva Glenn Lecea, Ibrahim A. Sandokji, Stephen Cha, Stella Shin, Salar Bani-Hani, Sai Sudha Mannemuddhu, Rebecca L. Ruebner, Aadil Kakajiwala, Rupesh Raina, Roshan George, Rim Elchaki, Michael L. Moritz, The American Society Of Pediatric Nephrology Quality Improvement And Artificial Intelligence (Aspn Qi/Ai) Interest Group

Manuscripts, Articles, Book Chapters and Other Papers

Artificial intelligence (AI) is rapidly emerging as a transformative force in pediatric nephrology, enabling improvements in diagnostic accuracy, therapeutic precision, and operational workflows. By integrating diverse datasets-including patient histories, genomics, imaging, and longitudinal clinical records-AI-driven tools can detect subtle kidney anomalies, predict acute kidney injury, and forecast disease progression. Deep learning models, for instance, have demonstrated the potential to enhance ultrasound interpretations, refine kidney biopsy assessments, and streamline pathology evaluations. Coupled with robust decision support systems, these innovations also optimize medication dosing and dialysis regimens, ultimately improving patient outcomes. AI-powered chatbots hold promise for improving patient engagement and adherence, while …