Medical Specialties Commons^™

Evaluating Glucagon-Like Peptide-1 Receptor Agonist Safety Before Upper Endoscopy: A Systematic Review And Meta-Analysis, Zohaib Ahmed, Amna Iqbal, Sami Ghazaleh, Abdallah Kobeissy, Ali Nawras, Yaseen Alastal, Hani Saad, Sarmed Mansur, Idrees Mohiuddin, Umair Iqbal, Dushyant Singh Dahiya, Syeda Faiza Arif, Connor Campbell, Wade Lee-Smith, Mohammad Asif, Faisal Kamal, Aamir Saeed, Omar Horani

Division of Gastroenterology and Hepatology Faculty Papers

BACKGROUND: The use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) has remarkably increased in the past few years as they have demonstrated significant reduction in A1c and major cardiovascular outcomes and have led to weight loss with low risk of hypoglycemia. GLP-1 RA use has raised concerns about potential associations with increased gastric retention and adverse outcomes in upper endoscopy procedures.

METHODS: We conducted a comprehensive search across multiple databases to identify comparative studies evaluating the impact of GLP-1 RA exposure versus non-exposure on upper endoscopy outcomes. Studies comparing GLP-1 RAs to other medications were excluded. The primary outcome was …

Handgrip Strength, Handgrip Endurance And Bmi: A Comprehensive Approach To Health Assessment Among The General Population Of Madikeri, Dr Asha S. Das, Dr Ravikiran Kisan, Dr Suhas Y. Shirur, Dr Narasimha Rai K, Dr Sanjay Bhagoji

Digital Journal of Clinical Medicine

Introduction: Being physically fit is essential for lowering the risk of illness and enhancing longevity. While Body Mass Index (BMI) is frequently used to evaluate body composition, Hand Grip Strength (HGS) and Hand Grip Endurance (HGE) are important indicators of general well-being. Goal: To assess BMI, HGS, and HGE and ascertain how they correlate in a selected group of subjects. Methods: Fifty participants between the ages of 20 and 40 years participated in a comparative cross-sectional study at the Department of Physiology, Kodagu Institute of Medical Sciences, Madikeri. Participants were divided into three BMI groups after anthropometric measurements were taken. …

An Evaluation Of Total Navicular Implants: A Scoping Review, James Mcclure Hughes, Nicholas Belardo Obias, Amanda Killeen

School of Podiatric Medicine - Student Research

The aim of this study is to determine the efficacy and safety profile of total navicular implants based on current literature.

Navicular insults such as high-energy trauma, osteonecrosis, and Muller-Weiss syndrome may result in avascular necrosis or a critical sized bone defect, conditions that are highly difficult to manage given current treatment modalities. Total navicular implants may offer a solution to these problems. While 3D printing of implants remains investigational, its use in highly individualized cases involving the talus has had promising results with conditions like avascular necrosis, tumors, trauma, and arthritis. The navicular is unique in its attachments to …

From Charcuterie Board To Clinical Ward: Pediococcus Pentosaceus As An Emerging Wound Pathogen - A Scoping Review, Jessica Sima, Mariana Rodriguez, Stephanie Campbell, Amanda Killeen

School of Podiatric Medicine - Student Research

Currently, there are 12 known species of Pediococcus, with P. Acidilactici and P. pentosaceus being the most well-known. P. pentosaceus is a Gram-positive, lactic acid bacterium, and is most often recognized for its wide usage as a probiotic and fermenter of wines and cheeses. It is also studied for its anti-inflammatory effects and antimicrobial properties against many common pathogens, such as Salmonella, Clostridium difficile, E.coli, etc.  However, the Pediococcus species can be an opportunistic pathogen in immunocompromised patients, and its resistance to glycopeptides and tetracycline limits treatment options.

We conducted a scoping review using Google Scholar and PubMed with the …

A Novel Guide‑Free Internal Device Fixation For Transverse Tri‑Planar Distal Metatarsal Osteotomy: A Retrospective Review​, Maya D. Kaafarani, Brittney White, Graham A. Hamilton, Shannon M. Rush

School of Podiatric Medicine - Student Research

Introduction: Minimally invasive surgery (MIS) for bunion correction has gained popularity due to favorable outcomes and reduced recovery times. However, most MIS techniques rely on commercial instrumentation for osteotomy, reduction, and fixation. This retrospective study evaluates patients treated with a novel tri-planar distal metatarsal osteotomy performed without specialized MIS guides, using only standard surgical tools and a novel device.

Methods: A retrospective review was conducted on 28 patients (31 procedures, including 3 bilateral cases) who underwent MIS bunion correction from 2021 to 2024. The technique involved a 2–3 cm medial incision, transverse osteotomy at the distal surgical neck of the …

Olanzapine-Based Vs Neurokinin-1 Receptor Antagonist Antiemetic Regimens In Highly Emetogenic Chemotherapy: Systematic Review And Meta-Analysis Of Efficacy And Safety, Advaitha Mv, Nikhilesh Anand, Biacin Babu, Ayoola Awosika, Uttam Udayan, Jacqueline Mendoza, Alissa Lopez, Brahmaiahchari Rangachari, Sabyasachi Maity, Bharathi Gadad

School of Medicine Publications

Background: Chemotherapy-induced nausea and vomiting is common in patients who receive highly emetogenic chemotherapy (HEC). Olanzapine acts on multiple neurotransmitters and effectively reduces delayed-phase nausea.

Aim: To compare the safety and efficacy of olanzapine-based vs neurokinin-1 receptor antagonist-based antiemetic regimens in adults receiving HEC.

Methods: This review followed Preferred Reporting Items for Systematic Reviews and Meta-analyses 2020 guidelines and searched various databases like PubMed, Scopus, etc., between 2020-2025. 14 studies were included in the systematic review with 11 meeting the criteria for meta-analysis. Primary outcomes were complete response (no vomiting, no rescue medication) and nausea control during acute (0-24 hours), …

An Atlas Of Human Siglecs Integrates Expression, Affinity, And Cis/Trans Sialoglycan Recognition Profiles, Claire Guetta-Oz, Fahima Mozaneh, Jaesoo Jung, Kelli A Mccord, Ronit Rosenfeld, Kan Zhong, Hongzhi Cao, Hai Yu, Xi Chen, Lori J West, Matthew S Macauley, Vered Padler-Karavani

Faculty, Staff and Students Publications

All living cells have a sugar-coat that facilitates communication. Sialic acids cap mammalian glycans and are recognized by immune cells through sialic acid-binding immunoglobulin-like lectins (Siglecs) that regulate signaling by their cytoplasmic motifs. Inconsistent reports of Siglecs expression and sialoglycan recognition limit their therapeutic potential. Here we investigate 14 functional human Siglecs for their expression, glycan interactions and affinities. SIGLEC mRNA is broad in blood-derived monocytes and dendritic cells, restricted in natural-killer/B cells and absent in T cells, with similar Siglec-proteins expression in splenocytes. Binding to 114 glycans across 274 glycan microarrays, 220 splenocytes-assays and 132 cell-based arrays, reveal Siglecs …

Disruption Of The Lrrk2 Substrate Rab12 Facilitates Neurotransmission And Causes Hyperactivity In Mice, Xingjian Li, Yuanxin Chen, Huaixing Wang, Xue Zhang, Noah Guy Lewis Guiberson, Xianting Li, Jacqueline Burré, Junmin Peng, Hui Zhang, Zhenyu Yue

Department of Neuroscience Faculty Papers

RAB12 is a small GTPase and a validated substrate of LRRK2, a kinase genetically linked to Parkinson's disease (PD). While RAB12-LRRK2 signaling has been implicated in ciliogenesis and immune regulation, the neuronal function of RAB12 remains largely unexplored. Here, we investigated the role of RAB12 in synaptic physiology using Rab12 knockout (KO) mice. Rab12 KO mice developed normally but exhibited increased locomotor activity in adulthood. Electrophysiological recordings from striatal slices revealed enhanced presynaptic release probability and increased excitatory drive onto medium spiny neurons. Consistently, live-cell imaging of cultured cortical neurons revealed that Rab12 deletion facilitated, while Rab12 overexpression inhibited, synaptic …

Speed Of Intravenous Fluid On Glycocalyx Integrity And Central Blood Volume In A Porcine Septic Shock Model, Yosef Levenbrown, Md Jobayer Hossain, Paul T. Fawcett, Marjorie Postell, Anne M. Hesek, Lynell S. Jones, James P. Keith, Thomas H. Shaffer

Department of Pediatrics Faculty Papers

BACKGROUND: It is unclear whether the rate of intravenous fluid (IVF) administration in sepsis influences glycocalyx breakdown. This study aimed to measure the effect of rapid versus slow fluid bolus in a septic pig model on the integrity of the glycocalyx by measuring the serum levels of heparan sulfate and syndecan-1, breakdown products of the glycocalyx. Because endothelial glycocalyx is composed of apical cell membrane-bound proteoglycans such as syndecan-1, covalently bound with long linear glycosaminoglycans such as heparan sulfate, shedding of these different glycocalyx components is closely related. Additionally, we measured central blood volume (blood volume in the heart and …

Multifocal Papillary Thyroid Carcinoma With Ret P.V804m, Eml4-Alk Fusion, And Braf V600e Positivity, Jacob Beiriger, Leonard Estephan, Lubna Zuberi, Stacey Gargano, Elizabeth Cottrill

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Multifocal papillary thyroid cancer (PTC) can arise from independent primaries with discordant drivers in parallel clonal evolution rather than a single-clone pattern. We present a 31-year-old female with multifocal PTC harboring 3 distinct oncogenic alterations: a germline RET p.V804M mutation, low-frequency EML4-ALK fusion, and BRAF V600E mutation. The RET and ALK alterations were identified in a midpole nodule, whereas BRAF positivity was seen in a separate lower pole tumor. Ultrasound revealed multiple right-lobe thyroid nodules; the dominant 2.1-cm lesion was hypoechoic with calcifications. Fine needle aspiration revealed Bethesda III cytology, prompting thyroid lobectomy and an ipsilateral central neck dissection was …

Inhibition Of Cyclophilin D Rescues Cardiac Function And Bioenergetic Defects Caused By Neonatal Hypoxia, Jonathan R. Burris, Gisela Beutner, Min Yee, Bartholomew V. Simon, Michael F. Swartz, Kathryn B. Boudreau, Ethan D. Cohen, Chaitanya A. Kulkarni, Prottoy Hasan, Hongyue Wang, Karen L. De Mesy Bentley, György Hajnóczky, George M. Alfieris, Eric M. Small, Paul S. Brookes, Michael A. O'Reilly, George A. Porter

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Increased oxygen levels at birth regulate myocyte bioenergetic and structural maturation controlled by mitochondrial cyclophilin D (CypD). We evaluated mechanisms of neonatal hypoxic cardiac dysfunction by exposing neonatal mice to 12% oxygen and studied cardiac bioenergetics, myocyte maturation, and function. Hypoxia decreased the activity/assembly of electron transport chain complex I, uncoupled oxidative phosphorylation, increased proliferation, decreased differentiation, increased ventricular mass, and decreased cardiac function. CypD inhibition rescued most hypoxia-mediated effects and increased cardiac function. In conclusion, neonatal hypoxia alters cardiac bioenergetics, myocyte maturation, and cardiac function through CypD-dependent pathways, providing potential therapeutic targets for neonatal cardiac dysfunction.

Glp-1 Receptor Agonists In Diabetic Foot And Ankle Care: Skeletal Liability Or A Blessing In Disguise? A Scoping Review, Daniela Lizbeth Avilez, Amanda Killeen

School of Podiatric Medicine - Student Research

Introduction: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly prescribed for glycemic control and weight reduction in patients with Type 2 Diabetes Mellitus (T2DM). Patients with T2DM exhibit elevated fracture risk despite preserved bone mineral density due to impaired bone quality and microarchitectural compromise. Whether GLP-1 RA therapy exacerbates or mitigates skeletal risk remains clinically relevant to podiatric care.

Hypothesis: We hypothesized that GLP-1 RA therapy is not associated with increased lower extremity fracture risk and may demonstrate protective trends influenced by age and duration of therapy.

Methods: A review of PubMed and Google Scholar (2010–2026) was conducted. Inclusion criteria …

Sudden Cardiac Arrest & Newly Diagnosed Arrhythmogenic Cardiomyopathy In A High School Athlete, Jacob Rolfes, Brent Holtgrewe, Mike Tzianos

2026 Student Academic Showcase

A high school soccer player experienced sudden cardiac arrest during competition and required immediate CPR and AED use. Following resuscitation, physicians ruled out commotio cordis and identified findings consistent with arrhythmogenic cardiomyopathy, supported by a prolonged T-wave on EKG while all other laboratory and catheterization results were normal. The athlete later received an ICD and pacemaker, prompting significant physical, emotional, and lifestyle adjustments. This capstone project examines the emergency response, the role of trained medical personnel at sporting events, and the implications of early cardiac screening for adolescent athletes. Through consented family interviews, structured questionnaires, and case-based data collection, the …

Longitudinal Fueling Status Of High School Female Athletes, Kaylee Turner, Abigail Rickermann

2026 Student Academic Showcase

Low energy availability (LEA) is a clinically significant concern in adolescent female athletes due to its impact on growth and development, bone health, hormonal function, performance, recovery, and cognitive outcomes. Despite established associations, a clear longitudinal understanding of how LEA relates to injury and illness rates across an academic year remains limited, representing a clinical gap in athletic training and sports medicine literature. The purpose of this capstone project was to develop a comprehensive Institutional Review Board (IRB) protocol to support a future longitudinal investigation examining LEA and its relationship to injury and illness incidence in high school female athletes. …

Effectiveness Of Rule Modification And Contact Exposure Reduction In Adolescent Contact Sports, Alex Martin

2026 Student Academic Showcase

Clinical Question: In adolescent athletes participating in contact sports, does rule modification or contact restriction reduce sport-related concussion incidence compared with standard full-contact rules? Background: Sport-related concussion remains a major concern in youth athletics. Structural prevention strategies, such as limiting contact exposure, have been proposed as effective approaches, though their comparative effectiveness remains under review. Methods: A critically appraised topic (CAT) was conducted using Google Scholar to identify peer-reviewed studies from the past 15 years examining rule modification or contact restriction as primary prevention strategies. Six high-quality studies met inclusion criteria, including one meta-analysis, one systematic review, prospective cohort studies, …

Clinical Evaluation And Rehabilitation Of A Complex Non-Contact Knee Injury In A Collegiate Athlete, Shelby Pritt

2026 Student Academic Showcase

This case follows the rehabilitation of a 22-year-old collegiate lacrosse player recovering from a complex knee injury. During the initial evaluation, the athlete presented with pain, swelling, and limited active range of motion, secondary to pain. The rehabilitation protocol used a combination of ACL, MCL, and meniscus standardized rehabilitation parameters. The primary goal of rehabilitation was to safely return the athlete play the following season. This case highlights the importance of knee health and the role of preventative exercise programs in reducing injury risks. This case covers the rehabilitation of a complex right knee injury primarily focusing on a complete …

Optimization Of Pediatric Multidetector Ct Imaging Parameters Using A Machine Learning–Based Monte Carlo Simulation Model, Ali O. Masoud, Adithya Rajnaryanan, Khamis O. Amour, Ahmed M. Jusabani, Justin E Ngaile, Manoj Kumar, Mwingereza John Kumwenda Dr

Tanzania Journal of Science

This study utilized Monte Carlo (MC) simulations to optimize radiation doses in pediatric multidetector computed tomography (MDCT) head scans by analyzing key parameters like tube current (mA), tube voltage (kV), pitch, and slice thickness. The findings indicate that reducing tube current significantly lowers the Computed Tomography Dose Index (CTDIvol) and Dose Length Product (DLP), effectively minimizing patient radiation exposure. Higher pitch values (0.7–0.9) further reduced radiation by decreasing beam overlap, while using a thinner slice thickness (0.6 mm) improved dose efficiency. A comparison highlighted the effectiveness of optimization: simulated parameters kVp 100, mAs 81, pitch 0.98 yielded a CTDIvol of …

The Heart Puts Pressure On Cancer Growth, Wyatt G Paltzer, James F Martin

Faculty, Staff and Students Publications

Mechanical forces in the heart prevent tumor expansion in mice.

Improving Pneumococcal Immunization Counseling In Children With Systemic Lupus Erythematous, Sarah Dettmann

Doctoral Dissertations & Projects

Background: Pediatric patients with systemic lupus erythematosus (SLE) face elevated risk for invasive pneumococcal disease, yet fewer than 10% are estimated to be current on pneumococcal vaccine (PCV) recommendations.

Local Problem: This quality improvement (QI) project aimed to develop and implement a standardized pneumococcal immunization screening and counseling process in a pediatric rheumatology clinic.

Method: Three consecutive PDSA cycles guided implemention across a nine-week intervention period using a pre-post quasi-experimental design.

Interventions: A multicomponent strategy was employed, including a PCV decision algorithm, EHR Smart Phrase, PCP referral template, and patient education brochure.

Results: Pre-implementation PCV counseling was documented …

Seeing Surgery Differently: The Role Of Virtual Reality In Pediatric Care, Bob Underwood, Mark Ryan

Pediatrics in Practice: A CME Podcast

Virtual reality is changing how pediatric surgeons plan procedures, educate care teams and help children and families better understand what to expect. In this episode, Mark Ryan, MD, pediatric surgeon, discusses how virtual reality is being used in pediatric surgery today, its impact on patient experience and surgical planning and what pediatricians should know as this technology continues to evolve.

Click here to stream the podcast episode.

Burden Of Cardiovascular Disease In Pakistan – Insight From Global Burden Of Disease Study 2019, Tazeen H Jafar, Sawera Hanif, Christian Razo, Mahboob Alam, Jamal S Rana, Khurram Nasir, Bashir Hanif, Salim S Virani, Abdul Mannan Khan Minhas

Faculty, Staff and Students Publications

Background: Pakistan, currently the fifth-largest country by population globally, has experienced a population increase of over 100% since 1990. It is facing an escalating challenge from cardiovascular diseases (CVD). The Global Burden of Disease (GBD) 2019 study provides an in-depth evaluation of Pakistan's health situation since 1990, offering essential insights into the nation's overall health conditions.

Methods: The data were obtained from the Global Burden of Disease Study 2019, which provides records for global, regional, and national burden of diseases. Specifically, data regarding CVD and its subtypes, morbidity, and mortality in Pakistan and globally from 1990 to 2019 were used …

Determinants Of Dna-Sequence-Based Diagnostic Yield In The Cser Consortium., James Mj Lawlor, John M Greally, Lucia Hindorff, Gail P Jarvik, Sara Kalla, Barbara A Koenig, Mark Kvale, Pui-Yan Kwok, Mary Norton, Sharon E Plon, Bradford C Powell, Anne Slavotinek, Michelle L Thompson, Alice B Popejoy, Eimear E Kenny, Neil Risch

Faculty, Staff and Students Publications

Purpose: Diagnostic yield from exome and genome sequencing varies widely across studies. It remains unclear how much of this variation reflects patient-level factors (e.g., sex, clinical features, race/ethnicity, genetic ancestry) versus site-level practices such as sequencing modality or variant interpretation workflows. We aimed to quantify the contributions of these factors to diagnostic outcomes across five U.S. clinical sequencing sites.

Methods: We performed a cross-sectional analysis of 3,008 prenatal, neonatal, and pediatric cases from the NHGRI Clinical Sequencing Evidence-Generating Research (CSER) consortium (2017-2023). Clinical indications spanned neurodevelopmental, neurological, immunological, metabolic, craniofacial, skeletal, cardiac, prenatal, and oncologic presentations. Genetic ancestry was inferred …

Lessons Learned From A Sustained Mobile Prenatal Care Delivery Program: Results From A Mixed-Methods Evaluation To Understand Appointment Attendance And Patient Satisfaction., Stacey Cunnington, Candice Mims, Rebecca Barbeau, Sonia Booker, Mary Ann Abiado, Gain Robinson, Salina Tesfay, Cintia Ulloa-Hays, Donna Beach, Nimo Farah, Eleanor Porter, Rebecca Rudel, Jacey A Greece

Women’s Health Articles

No abstract provided.

Muc13-Associated Molecular Interactome In Pancreatic Cancer, Anupam Dhasmana, Swati Dhasmana, Rajasekhar Baru, Abigail Gomez, Shafiul Haque, Sheema Khan, Murali Yallapu, Subhash Chauhan

School of Medicine Publications

Mucin-13 (MUC13) has emerged as a critical molecular player involved in tumorigenesis, cancer progression, metastasis, and evasion of immune surveillance, including in pancreatic cancer. In this report, we identified MUC13 molecular interactome using an integrated immunoprecipitation and liquid chromatography–mass spectrometry (accession no. of protein data JPST004189) approach combined with systems network biology to determine its plausible functional protein–protein interaction network and associated oncogenic mechanisms. This study reveals a total of 54 key MUC13 interactor proteins (including cyclin-dependent kinase 1, catenin delta 1, Caludin-1, ErbB3-binding protein 1, basic transcription factor 3, tight junction protein 1, etc.). Interestingly, the majority of these …

Psychological Safety In Health Care: A Prerequisite For High Reliability, Sonali Thosani

Advances in Cancer Education and Quality Improvement

This paper presents a viewpoint on how psychological safety contributes to patient safety, teamwork, and high reliability.

Kobayashi Maru, Daniel Mahoney

Advances in Cancer Education and Quality Improvement

This poem invites the reader to consider the uncertainty of facing an unwinnable situation. Kobayashi Maru is a reference to a fictional leadership test from Star Trek, designed to confront participants with a no-win scenario. While the test is famously “beaten” by the show’s hero, this piece aspires to depict the often unwinnable circumstance of caring for a child with incurable illness. The reader is provided space to consider how the balance of emotions and values may shift when read through the eyes of a parent, clinician, or observer.

The Weight Of The White Coat, Jonathan Cunningham

Advances in Cancer Education and Quality Improvement

This is a poem reflecting on the mission of the medical provider through the image of the white coat.

Beyond Boundaries: A Model For Boosting Staff Retention And Morale Through Career Mobility, Tiffany Hughes, Abigail Caudle, Robert Ghafar, Brandon Freudensprung, Paloma Vasquez

Advances in Cancer Education and Quality Improvement

Retention and morale in health care are strategic imperatives that directly influence patient care, quality outcomes and operational stability. At The University of Texas MD Anderson Cancer Center, we found a significant gap in the career advancement opportunities for our clinical and administrative staff. Employees lacked visibility into career growth pathways, leaving them disengaged and increasing the overall turnover rate. In response, our division launched a structured, transparent Career Mobility Model to provide employees with the clarity and tools needed for advancement. This model integrates career mapping, shadowing programs, and leader-led career conversations, all of which led to measurable gains …

Clinical Medical Emergency Team Training Simulation (Cmetts): An Interprofessional Simulation For Medical Students And Nursing Residents, Allan John R. Barcena, Marvin R. Bernardino, Dominic Karl M. Bolinas, Kitz Paul D. Marco, Toni Edwards, Shelita Kimble, James Cavalier, Marites P. Melancon, Jillian R. Gunther

Advances in Cancer Education and Quality Improvement

Effective teamwork and communication are critical during medical emergencies, particularly in oncology, yet health care professionals are often trained separately, creating challenges for interprofessional collaboration. Evidence-based frameworks like Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) offer structured tools to optimize team performance. This study describes a simulation-based program, the Clinical Medical Emergency Team Training Simulation (CMETTS), designed to instill foundational teamwork skills in early-stage learners. First-year medical students and newly graduated nursing residents participated in an interprofessional simulation involving medical emergency scenarios followed by structured debriefing sessions guided by TeamSTEPPS principles. We evaluated the program’s effectiveness …

Lessons Learned For Improving Trainee Engagement And Utilization Of Education And Training Materials For Cancer Research, Katerina M. Santiago, Tania Galindo, Michaela A. Dinan

Advances in Cancer Education and Quality Improvement

Background: A core component of the National Cancer Institute Cancer (NCI) Cancer Center Support Grant requires cancer centers to coordinate research career enhancement and related activities. The Yale Cancer Center, an NCI-designated comprehensive cancer center, established the Cancer Research Training and Education Coordination (CRTEC) component in 2016. In response to the needs of trainees, CRTEC has developed several initiatives that we have identified and described here as best practices to engage and support trainees.

Methods: We had 2 aims to improve engagement: 1) increasing our visibility and trainee awareness of CRTEC and nurturing bidirectional communication and 2) offering …