Medical Specialties Commons^™

Perspective: Restoring Rest-The Critical Role Of Sleep In Foster Care Well-Being, Jill Mcleigh, Anna Wani, Likhita Shaik

Health Status, Outcomes, and Literacy and Healthcare Utilization

In 2023, approximately 400,000 children were in foster care in the United States, a population disproportionately affected by trauma, instability, and systemic inequities.1 These children face chronic disruptions in sleep—an essential physiological process that underpins physical development, learning, emotional regulation, and overall health.²⁻⁴ Adverse Childhood Experiences (ACEs), including abuse, neglect, and household dysfunction, are prevalent in this group and contribute to significant sleep disturbances through pathways of hyperarousal, stress dysregulation, and recurrent nightmares. 3,4 Understanding the interplay between foster care, social determinants of health (SDOH), and sleep health disparities highlights opportunities for targeted interventions to improve outcomes.

For questions about …

Combined Multichannel Intraluminal Impedance And Ph Testing In Infants And Young Children-A Narrative Review, Rochelle Sequeira Gomes, Sheeja Abraham, Michael Favara, Amy J. Sloane, Zubair H. Aghai

Department of Medicine Faculty Papers

Gastroesophageal reflux disease (GERD) is common in infants and young children, and thediagnosis and characterization of the disease continues to evolve in recent times. The typicalsymptoms thought to be related to GERD in young children are often nonspecific andubiquitous, underscoring the need for diagnostic testing in patients who have severe symptomsor complications related to GERD. Combined multichannel intraluminal impedance and pHtesting (MII-pH) is a diagnostic tool that can be used to study the frequency andseverity of gastroesophageal reflux. Compared to other diagnostic devices, MII-pH hasthe advantage of detecting both acidic and alkaline reflux events, as well as allows the study …

Disparities In Health Insurance And Delayed Care Among Hispanic Immigrants In The United States., Temitope Ayodele, Connor Fletcher, Kirk B Beredjiklian, Michael Valenzuela, Zane Mazur

Orthopedic Surgery Resident Research

BACKGROUND: Hispanic immigrants in the United States face persistent barriers to healthcare, including lower rates of insurance coverage and a greater likelihood of delaying care due to cost. Clarifying the independent effects of ethnicity and nativity on these disparities is essential to inform effective policy.

METHODS: We analyzed pooled data from the 2019-2023 National Health Interview Survey (NHIS), accessed through the Integrated Public Use Microdata Series (IPUMS). Primary outcomes were being uninsured and delayed medical care due to cost in the past 12 months. Key independent variables were Hispanic ethnicity and nativity (US-born vs. foreign-born). Covariates included survey year, age, …

Bladder Prolapse (Cystocele) Among African, Asian, And Middle Eastern Women: A Clinical And Socio-Cultural Perspective.Intraoperative Frozen Section Analysis (Ifsa): One Plastic Surgeon’S Experience With 1598 Consecutive Skin Cancer Removals, Lawrence Chiang, Michael Chang, Steven Chang, Matthew Delancy, James Monihan, Ray Armand

SKMC Student Presentations and Publications

BACKGROUND: Skin cancer continues to be the most frequently diagnosed cancer in the United States. Since 1990, the prevalence of melanoma and non-melanoma skin cancer (NMSC) has been steadily increasing.¹ NCCN guidelines recommend complete excision of NMSC to preserve function and optimize aesthetic outcomes.² The gold standard surgical treatment is Mohs Micrographic Surgery (MMS) with a reported cure rate of 99-100%.³ However, MMS requires specialized training and thus is more geographically and financially limited. The traditional technique utilized for skin cancer removal is intraoperative frozen section assessment (IFSA). IFSA is a common histopathological technique that facilitates microscopic …

Implementing A Pap Smear Tracking Tool For Increased Compliance, Meghan Marie Madea Msn, Cnm, Whnp-Bc, Katherine Ferrell Fouquier Phd, Cnm, Facnm, Bobby Bellflower Dnsc, Nnp-Bc, Faan, Faanp, Fnap

Doctor of Nursing Practice Projects

Purpose/Background

The Papanicolaou “pap” smear screens for cervical cancer in women ages 21-65 with a cervix. Inconsistent locations for lab results lead to a decrease in provider efficiency, and patients are unaware of results or recommended follow-up. This quality improvement project implemented a tracking tool within the electronic medical record (EMR) in a busy midwifery clinic. The outcomes are the identification of patients overdue for pap smears, scheduling the procedure, recording of results, and patient notification with recommended follow-up.

Methods

A one-month chart review was performed of fifty gynecology patients within a midwifery clinic. Results of pap smears were located …

Leading Change: Clinical Coaching In The Icu, Megan Jones, Kristen Mayberry

Articles, Abstracts, and Reports

Purpose (What): This project aims to describe how transformational leadership by an ICU nurse leader led to the creation of the clinical coach program. This program supports and retains newly graduated nurses and experienced nurses transitioning into the ICU through collaboration with experienced preceptors.

Relevance/Significance (Why): In 2022, hospital leadership charged the ICU nurse manager with stabilizing the ICU workforce by reducing the reliance on costly temporary travel staff, a priority due to turnover during the COVID pandemic. The nurse manager, concerned about the impact of hiring many novice ICU nurses on patient safety, collaborated with experienced preceptors to develop …

Growth Measurements In Ugandan Children With Sickle Cell Anaemia From A Hydroxyurea (Hydroxycarbamide) Treatment Trial Relative To Unaffected Sibling Controls, Dennis Kalibbala, Vincent Mboizi, Grace Nambatya, Susan Murungi, Joan Ashaba, Catherine Nabaggala, Lynnth Turyagyenda, Deogratias Munube, Phillip Kasirye, Robert Opoka

Paediatrics and Child Health, East Africa

No abstract provided.

Progress In Progressive Pulmonary Fibrosis, Jesse Roman

Rothman Institute Papers

No abstract provided.

Scalable Long-Read Nanopore Hpv16 Amplicon-Based Whole-Genome Sequencing, Maina Titus, David Giesbrecht, Cliff Oduor, Kapten Muthoka, Karamoko Niaré, Rebecca Crudale, Abebe Fola, Sin Hui, Isaac Kim Jr., Elkanah Orang'o

Obstetrics and Gynaecology, East Africa

Human papillomavirus 16 (HPV16) drives precursor cervical lesions that often progress to cervical cancer (CC). Variation within the HPV16 genome has been associated with CC risk. Here, we developed an affordable and portable amplicon-based long-read whole genome sequencing (WGS) approach using Oxford Nanopore Technologies to investigate HPV16 genetic diversity among women in sub-Saharan African countries. Applied to a control CaSki cell line and clinical samples (n = 12), our method generated complete HPV16 genomes at high coverage (median read coverage: 5,899–15,279 ×). Benchmarking our HPV16 controls showed high accuracy for two variant calling pipelines (Clair3 and PEPPER-Margin DeepVariant). Phylogenetic analysis …

Epidemiology Of Lower Extremity Amputations In The United States: An Analysis Of The Global Burden Of Disease Database From 1990 To 2019., Peter B Spencer, Cameron J Sabet, Gabrielle Dykhouse, Taylor J Manes, Phillip C Mckegg, Ambrose Loc T Ngo, Ayah Ibrahim, Jack Weick

Surgery Articles

BACKGROUND: Lower extremity amputations (LEAs) are medically, psychologically, and functionally devastating. The objective of our study was to evaluate region- and sex-specific differences of unilateral and bilateral LEAs across the United States (US) from 1990 to 2019.

METHODS: The Global Burden of Disease database was used to analyze years lived with disability (YLDs), prevalence, and incidence rates per 100,000 people for LEAs in the US from 1990 to 2019. Data were stratified into four US Census Bureau-defined regions: Northeast, Midwest, South, and West. Differences between regions and sexes were assessed, with statistical significance defined as p < 0.05.

RESULTS: From 1990 to …

Spinal Cord Injury, Children's Mercy Kansas City

Clinical Pathways

No abstract provided.

Refining The Utility Of Late Amniocentesis In High-Risk Pregnancies, Roni Zemet, Ronald J Wapner, Ignatia B Van Den Veyver

Duncan NRI Faculty and Staff Publications

No abstract provided.

Positive Depression Screen Among Pregnant Women Attending Antenatal Clinic At Aga Khan University Hospital, Michael Maina Muriithi

Master of Medicine in Obstetrics and Gynecology

Introduction: One in seven women experience peripartum depression, a common disorder that can occur during pregnancy or in the postpartum phase. Women are particularly vulnerable to depressive symptoms during pregnancy and the immediate postpartum period due to physiological changes during pregnancy as well as other sociocultural stressors. Peripartum depression is associated with significant maternal and perinatal adverse outcomes, including self-neglect, substance use, preterm birth, low birth weight and poor neurocognitive development, in offspring. There is a need to understand the prevalence and factors associated with depressive symptoms during pregnancy to improve maternal and neonatal outcomes. To our knowledge, this …

Perioperative Antibiotic Administration Review: An Analysis Of Outpatient Surgeries At Ohiohealth Doctors Hospital., Rayyan Bhutta, Thomas Shneker, Samantha Currier, Alexander Caskey, Vincent Relli-Dempsey, Matthias Franzen, Samir Patel

Surgery Articles

INTRODUCTION: A vital part of preventing surgical site infections (SSIs) is perioperative antibiotic prophylaxis. Antibiotics must be administered within a certain window of time, usually 15 to 60 minutes prior to the surgical incision, for them to be effective. The most frequently utilized medication, cefazolin, can be administered quickly by intravenous push (IVP), but other medications, such as vancomycin and clindamycin, need longer infusion times. Antibiotic efficacy declines, and the risk of SSIs is increased when scheduling requirements are not followed. With special focus on time, dosage, and variation by surgery type, this study evaluates adherence to perioperative antibiotic administration …

Global Transfusion Practices In Septic Patients In The Intensive Care Unit: Insights From The Input-Study Sub-Analysis, Vincent Kurucz, Andrew Flint, Alexis Poole, Merijn Reuland, Claudia Oord, Caroline Schaap, Jan Bakker, Maurizio Cecconi, Aarne Feldheiser, Marcus Lance

Anaesthesiology, East Africa

Background Transfusion practices among intensive care unit (ICU) patients with sepsis vary widely. While restrictive hemoglobin thresholds for red blood cell (RBC) transfusion are well studied, the indications and thresholds for platelet and plasma transfusions remain uncertain.

Methods We performed a sepsis-specific sub-analysis of the International Point Prevalence Study of Intensive Care Unit Transfusion Practices, a prospective, multicenter, observational study capturing all adult ICU admissions during four pre-scheduled weeks between March 2019 and October 2022. Patients admitted with sepsis or septic shock, or who developed sepsis during their ICU stay, were included. We recorded demographics, daily laboratory values, and transfusion …

Assessing The Accuracy And Readability Of Chatgpt 4.0'S Original And Simplified Responses To Common Patient Questions Regarding Periacetabular Osteotomy, John M. Gaddis, Elias Arellano, Blake Martin, Yossef Alsabawi, Martin Salgado-Flores, Charles South, Pablo Castaneda, Joel Wells

School of Medicine Publications

Purpose: The study aimed to evaluate the accuracy, comprehensiveness, and readability of responses generated by ChatGPT 4.0 to 30 common patient questions about the Bernese periacetabular osteotomy (PAO).

Methods: Two fellowship-trained orthopaedic surgeons specializing in hip preservation selected thirty questions from a prior study identifying common PAO questions on social media. Each question was entered into ChatGPT 4.0, and the surgeons independently graded responses. Responses were evaluated using an established grading system. Accuracy and comprehensiveness were assessed based on the concordance of response content with current literature. Readability was analysed by calculating the Flesch-Kincaid Grade Level and Flesch-Kincaid Reading Ease. …

Fascia Iliaca Compartment Block And Pericapsular Nerve Group Block Effect On Opioid Consumption In Hip Fracture Patients, David A. Brueggeman, Garrhett G. Via, Prachi Lele, Andrew W. Froehle, Michael J. Prayson, Scott J. Hadaway

Orthopaedic Surgery Faculty Publications

Background Effective pain control and reduced opioid consumption improve hip fracture outcomes. Fascia iliaca compartment blocks (FICB) effectively and safely manage acute hip fracture pain while reducing opioid consumption. Alternatively, pericapsular nerve group (PENG) blocks may provide similar analgesia while better-preserving motor function by targeting the highly innervated anterior hip capsule and sensory branches of the femoral, obturator, and accessory obturator nerves. Evidence for PENG's effectiveness is limited. The present retrospective study compared pain and MME in hip fracture patients receiving FICB (n = 1596) or PENG (n = 254), vs. a no-block (NB; n = 287) reference group. Methods …

What Time Is It? It Is 8 And 1/2 Time: A Rare Case Of Ischemic Stroke Consistent With Eight-And-A-Half Syndrome, Jessica Daza, Marcelo Bedoya-Sommerkamp, Eunbee Cho, Celia Patricia Daza, Francisco Gomez, Fatimah Bello, Jia Lin

School of Medicine Publications

Eight-and-a-half syndrome is a rare neuro-ophthalmic syndrome characterized by conjugate horizontal gaze palsy, ipsilateral internuclear ophthalmoplegia, and ipsilateral facial nerve palsy. It results from a lesion affecting the paramedian pontine reticular formation, the medial longitudinal fasciculus, and the abducens nucleus of the same side, at the level of the lower pons. We present a case of a 49-year-old man with 2-week diplopia and 3-day right-sided facial droop, drooling, and dysarthria. CT angiography of the head and neck revealed atherosclerotic disease, with decreased caliber of the basilar artery at the level of the pons. Brain MRI showed a subacute ischemic lesion …

Concurrent Local Therapy Extends Clinical Benefit Of Tebentafusp In Metastatic Uveal Melanoma Patients, Tristan L. Lim, Kamaneh Montazeri, Eric Wehrenberg-Klee, Antoine Desilets, Rino S. Seedor, Marlana Orloff, Takami Sato, Michael Caplan, Mariam El-Ashmawy, Benjamin Izar, Shaheer Khan, Inderjit Mehmi, Aleigha Lawless, Theodore S. Hong, Omid Hamid, Richard D. Carvajal, Alexander Shoushtari, Ryan J. Sullivan

Kimmel Cancer Center Faculty Papers

BACKGROUND: Tebentafusp has significantly improved overall survival in HLA-A*02:01+ metastatic uveal melanoma (mUM) patients even in those with a best objective response of progressive disease. Thus, strategies to maintain tebentafusp therapy are critical. Here, we examine the efficacy and safety of adding concurrent local therapy (CLT) to tebentafusp upon radiological progression with tebentafusp alone.

PATIENTS AND METHODS: This multicenter retrospective study included mUM patients treated with tebentafusp and CLT, consisting of extrahepatic soft tissue irradiation and liver-directed therapies (LDTs). Efficacy of target and nontarget sites were assessed per RECIST version 1.1. PFS with tebentafusp alone (PFS1) was compared to that …

Escape Of Kdm6a From X Chromosome Is Detrimental To Ischemic Brains Via Irf5 Signaling, Conelius Ngwa, Afzal Misrani, Kanaka Valli Manyam, Yan Xu, Shaohua Qi, Romana Sharmeen, Juneyoung Lee, Long-Jun Wu, Louise Mccullough, Fudong Liu

The Brown Foundation: Institute of Molecular Medicine

The role of chromatin biology and epigenetics in disease progression is gaining increasing recognition. Genes that escape X chromosome inactivation (XCI) can impact neuroinflammation through epigenetic mechanisms. Our previous study has suggested that the X escapee genes Kdm6a and Kdm5c are involved in microglial activation after stroke in aged mice. However, the underlying mechanisms remain unclear. We hypothesized that Kdm6a/5c demethylate H3K27Me3/H3K4Me3 in microglia, respectively, and mediate the transcription of interferon regulatory factor 5 (IRF5) and IRF4, leading to microglial pro-inflammatory responses and exacerbated stroke injury. Aged (17–20 months) Kdm6a/5c microglial conditional knockout (CKO) female mice (one allele of the …

Diabetes-Related Foot Complications And Socioeconomic Influences Among Hispanic Males In South Texas: A Scoping Review, Mariana J. Rodriguez, Demian Rodriguez, Amanda Killeen

School of Podiatric Medicine Publications

Introduction: Diabetes mellitus is the 7th leading cause of death in the U.S. and 6th in Texas. South Texas counties have higher diabetes rates than state and national averages. This complex, progressive disease affects multiple body systems and can lead to serious complications, especially in the lower extremities. Uncontrolled diabetes is often associated with diabetic foot ulcers (DFU), foot infections, and lower extremity amputations (LEA). South Texas, predominantly Hispanic American, is disproportionately affected. This demographic faces clinical barriers due to a lack of cultural understanding, highlighting the need for culturally sensitive healthcare workers such as promotoras. This study aimed to …

The Home Visiting Referral Quality Improvement Initiative (Thrive) Change Package, Elizabeth Yakes Jimenez, Theresa Cruz, Rebecca Craig, Ivan De La Rosa

Population Health Research and Scholarship

Early childhood home visiting programs improve maternal and child health outcomes but remain underutilized. Healthcare providers are well-positioned to connect families to home visiting services; however, structural barriers in clinical settings limit consistent and effective referral practices. The Home Visiting Referral Quality Improvement Initiative (THRIVE) change package was developed to provide a starting point for addressing these challenges. The THRIVE change package outlines actionable improvement strategies to test, such as standardizing referral workflows, training clinical teams, and establishing relationships and feedback loops with home visiting programs. It offers a scalable approach to strengthening clinical–community linkages and improving family engagement with …

Circulation Of Respiratory Viruses From Air And Human Specimens In A Pre-Kindergarten-12th Grade School District In Kansas City, Mo, Nicole Neeley, Brian Lee, Brittney Fritschmann, Luke Gard, Nibha Sagar, Dithi Banerjee, Anjana Sasidharan, Rangaraj Selvarangan, Olivia Almendares, Hannah L. Kirking, Jennifer Goldman, Jennifer E. Schuster

Posters

Background: Air sampling with respiratory virus testing in community settings may be a potential non-invasive, scalable method to monitor respiratory viruses. We performed an ecological analysis to describe the correlation between respiratory virus detections in air and human samples across all schools to evaluate the potential for air sampling as a tool for community-level surveillance. Methods: Knowledge of Infectious Diseases in Schools (School KIDS) is a voluntary respiratory virus surveillance program in a pre-kindergarten-12th grade public school district in Kansas City, MO. In 10 schools, students and staff collected anterior nasal swabs while at school, with optional on-demand swabbing when …

Une Com Research And Scholarship Fall Forum October 2025, Une Com Research & Scholarship

Osteopathic Student Research Symposia

Program including abstracts from the University of New England College of Osteopathic Medicine’s 2025 Research and Scholarship Fall Forum.

Supplemental content: List of award winners.

Soft Tissue Envelope Compromise Following Low-Side Motorcycle Accident: A Case Study And Literature Review, Steven A. Bolton, Ali Ahmad, Jonathan Rodriguez, Hooman Mir

School of Podiatric Medicine - Student Research

Purpose: This case report details a staged approach in managing a patient who presented to the ER with a displaced proximal second phalanx fracture, extensive soft tissue damage, and diffuse fracture blistering following a motorcycle crash. This case highlights that soft tissue damage may not always correlate with severe osseous injury.

Methodology: This case is a concurrent chart review of a 40-year-old who sustained a low side motorcycle injury resulting in a minimally displaced avulsion fracture of the medial 2nd toe proximal phalanx base with extensive soft tissue damage, fracture blisters, and lower extremity edema.

Procedures: Radiographic evaluation demonstrated no …

Implementing A Sepsis Questionnaire To Reduce Readmissions…A Health Plan’S Experience, Vernita L. Kelley

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Sepsis is a life-threatening condition with high readmission risk, threatening patient recovery and survival. In the managed care organization (MCO) where this DNP project was implemented, sepsis ranks among the top five readmission diagnoses. The organization's 30-day readmission rate of 15.5% is substantially higher than the benchmark of 9.29%, highlighting a clinical quality issue, a strain on patient outcomes, and a strain on healthcare resources.

Aim of the Project: This quality improvement (QI) project aimed to reduce sepsis readmissions by embedding a sepsis questionnaire into case management workflows to identify clinical risks and social determinants of health, improve transitions, …

Lung Cancer In Patients Of African Descent: A Transcontinental Review Of Epidemiology, Disparities, Outcomes, And Opportunities For Equity In Africa, North America, South America, And The Caribbean, Elvis Obomanu, Colton Jones, Verna Vanderpuye, Nazik Hammad

Division of Internal Medicine Faculty Papers & Presentations

Lung cancer in people of African descent is characterized by transcontinental disparities driven by epidemiologic heterogeneity, systemic inequities, and unequal access to health care. Globally, lung cancer incidence and mortality rates vary; however, underdiagnosis and late-stage presentation in low- and middle-income countries obscure the true prevalence of lung cancer because of limited cancer registries and diagnostic infrastructure. In Africa, most patients with lung cancer present at an advanced stage, primarily because of health illiteracy, misdiagnosis, delayed referrals, and inadequate treatment infrastructure. Although tobacco smoking remains a dominant risk factor worldwide, African populations are disproportionately exposed to environmental and occupational hazards, …

Neonatal Early-Onset Sepsis: It’S Not Always What You Think, Gabriela M. Henriquez, Kedar Tilak, Douglas Swanson, Susana Chavez-Bueno

Posters

No abstract provided.

Diabetes-Related Foot Complications And Socioeconomic Influences Among Hispanic Males In South Texas: A Scoping Review, Mariana J. Rodriguez, Demian Rodriguez, Amanda L. Killeen

School of Podiatric Medicine - Student Research

Introduction: Diabetes mellitus is the 7^th leading cause of death in the United States and is 6^th in the state of Texas. Counties from South Texas are primarily affected with higher rates of diabetes than both the state and national average. Diabetes mellitus is a complex and progressive disease which can affect multiple systems of the body, leading to serious complications if untreated, especially in the lower extremities. Uncontrolled diabetes is often associated with diabetic foot ulcers (DFU), foot infections, and lower extremity amputations (LEA). South Texas is a region predominantly populated by Hispanic Americans who are disproportionally …

Decorin Evokes A Pro-Lysosomal Pathway In Lymphatic Endothelial Cells, Gabriel J. Pascal, Dipon K. Mondal, Sadie Kim, Christopher Xie, Devanarayanan Siva Sankar, Jörn Dengjel, Renato V. Iozzo

Kimmel Cancer Center Faculty Papers

The lymphatic system is critical to the body's immune and circulatory system, and lymphangiogenesis, the development of new lymphatic vessels from pre-existing ones is a significant process capitalized upon by cancer during tumorigenesis. Decorin is a small leucine-rich proteoglycan which we have previously shown to be anti-tumorigenic and a suppressor of lymphangiogenesis. We have also shown that decorin exercises its anticancer properties through its ability to evoke autophagy. Through a comprehensive and unbiased proteomic analysis, we explored the implications of decorin exposure on protein expression within mouse lymphatic endothelial cells. We discovered that decorin enriches several protein pathways, notably proteasomal …