Diagnosis Commons^™

A Painful Diffuse Rash, Bruce M. Lo, Melanie Shoemaker, Kiersten Potter, Katherine Schaffer

Department of Emergency Medicine Faculty Publications

[Patient presentation]

A 41-year-old male with no past medical history presented with 1 week of ulcers to the left side of his face, followed by several days of a painful rash to the trunk and back after a sexual encounter. The patient denies any fever or previous rash and any illicit drug use. Initial vital signs included a temperature of 97 °F, a heart rate of 89 beats per minute, and blood pressure of 135/79 mm Hg. Physical examination revealed a macular papular rash across his trunk and back (Fig 1) and facial ulcerations with eschar (Fig 2) at the …

Central Centrifugal Cicatricial Alopecia In Pediatric Patients: A Retrospective Analysis, Radhika Gupta, Nikhita Perry, Noelle Desir, Iain Encarnacion, Jonathan Miles, Susan Taylor, Michelle Oboite, Temitaya Ogunleye

Department Dermatology Faculty Publications

[Introduction] Central centrifugal cicatricial alopecia (CCCA) is a scarring alopecia that predominantly affects middle-aged women of African descent.¹ It begins at the vertex scalp and expands centrifugally, and given that symptoms may be absent, many patients have scarring at presentation. CCCA is primarily described in adult populations, with limited reports of CCCA in children.²^-⁴ We aimed to characterize demographics, clinical findings, and histological features among pediatric patients with CCCA to facilitate earlier diagnoses, prior to irreversible alopecia.

Understanding The Impact Of Psychosocial Barriers On Colorectal Cancer Knowledge In Emerging Black Men, Chelsey Mcgill, Maria D. Thomson, Caroline Kuno, Emmanuel Taylor, Kimberly Lawrence, Alison J. Patev, Arnethea L. Sutton, Ruth Nyagaka, Oxana Palesh, Larry D. Keen Ii

Research and Infrastructure Service Enterprise (RISE) Faculty Publications

In the United States, Colorectal Cancer (CRC) is one of the most commonly diagnosed cancers and the third leading cause of death among non-Hispanic African American/Black (henceforth Black) men. Inadequate CRC knowledge leads to missing early warning signs, delaying prevention and increasing risk. Emerging adulthood (18-25) is a key period for building healthy behaviors and addressing barriers to CRC knowledge in addition to understanding attitudes and practices to CRC screening. Psychosocial barriers - including social support, medical mistrust, and perceived racial discrimination - contribute to the lack of CRC knowledge among older Black men, yet emerging adult Black men remain …

Non-Invasive Detection Of Intracranial Pressure, Andrei V. Nesterenko

Honors Undergraduate Theses

Intracranial pressure is a critical metric used when managing tumors, strokes, TBIs, hydrocephalus, and other operative conditions. Traditional methods for continuous ICP monitoring, intraparenchymal catheters, epidural transducers etc., are invasive and carry a high risk of infection. Previous attempts to create accurate, easy to use, and non-invasive ICP monitoring techniques have been unsuccessful. In this study, we investigated the utility of supraorbital and posterior auricular photoplethysmography to monitor changes in ICP during orthostatic tilt and hyperventilation, which increase and decrease ICP respectively.

Through a continuous 5-minute recording on a tilt-table we characterized SOA and PAA waveforms in 12 participants (ages …

Devising A Protocol For Mri Clearance In Patients With Cardiac Implantable Electronic Devices (Cied), Sienna Luk, Alvin Mathew, Darshan Bhatty, Kamran Rizvi

North Texas GME Research Forum 2026

Background: Magnetic Resonance Imaging (MRI) in patients with Cardiac Implantable Electronic Devices (CIEDs) remains a logistical challenge in many clinical settings. At Medical City Denton, the absence of a standardized institutional policy has led to significant inefficiencies, including prolonged hospital stays and increased healthcare costs. The primary objective of this project was to address these barriers by developing a streamlined, evidence-based protocol to improve care coordination and resource utilization for patients with CIEDs requiring diagnostic imaging.

Methods: Launched in 2026, this pilot initiative utilized a multi-stakeholder approach involving hospitalists, EPs, radiology staff, and device representatives. A core component of the …

Esophageal Squamous Cell Carcinoma Incidentally Detected On Barium Swallow: A Case Report, Muhammad Rubeel Akram, Aditya Rao, Muhammad T. Siddique

North Texas GME Research Forum 2026

Background: Esophageal cancer is an aggressive malignancy with a poor prognosis, and has high rates of recurrence despite curative-intent therapy. While endoscopy with biopsy remains the gold standard for diagnosis, non-diagnostic imaging studies are performed when evaluating for dysphagia, and may bring to light underlying pathology, warranting further workup. Surgical resection following neoadjuvant chemoradiation is often performed, but postoperative complications and disease recurrence are important concerns. This case highlights the crucial role of early detection via imaging and the clinical burden associated with esophageal squamous cell carcinoma.

Case Presentation: A 76-year-old female presented with dysphagia and underwent a barium esophagogram, …

Prognostic Value Of Systemic Inflammatory Indices For Predicting Mace In Nstemi Patients Undergoing Pci, Boney Lapsiwala, Aditya Sharma, Usman Khan, Jorim Parmar, Justin Soloman, Veeranna Vibhuti, Mehdi Khalafi

North Texas GME Research Forum 2026

Background: Cardiovascular diseases (CVD) account for nearly one-third of global mortality, with ischemic heart disease caused by a mismatch between myocardial oxygen supply and demand. Despite advances in percutaneous coronary intervention (PCI) and contemporary pharmacotherapy, patients with non–ST-segment elevation myocardial infarction (NSTEMI) continue to experience substantial residual risk for major adverse cardiovascular events (MACE). As traditional risk stratification tools have limited ability to identify high-risk individuals, interest has shifted toward biomarkers reflecting inflammatory pathways central to atherosclerosis and plaque instability. Hematologic inflammatory markers including pan inflammatory value (PIV), systemic immune inflammation index (SII), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) initially …

Handheld Magnet Screening Of External Fixator Components: A Laboratory Assessment Of Gross Ferromagnetism Relevant To Mri Safety, Troy B. Puga, Mckenna W. Box, Lyn D. Ward, John T. Riehl

North Texas GME Research Forum 2026

Introduction Much controversy remains regarding the ability of patients with an external fixator in place to undergo Magnetic Resonance Imaging (MRI). The main concern for radiology departments is that the external fixator system components can lead to adverse events due to interactions of the external fixator and the magnet of the MRI. However, there is no clear evidence to support these claims or theories in the current literature. Yet, MRI’s are denied daily across the country for patients having an external fixator in place. Numerous patients with an external fixator would likely benefit from an MRI to prevent delayed care, …

Positive Efast—Not So Fast, Barry J. Knapp, Mitchell Vallone, Megan Duggins, Matt Jones, Jacob Knapp, Lily Kauffman, Alexander Dornstauder

Department of Emergency Medicine Faculty Publications

[Patient presentation] A 68-year-old man presented via emergency medical services (EMS) with right hip pain following a traumatic fall from his bicycle. On arrival at the emergency department, he was alert and oriented. Physical examination revealed only tenderness over the greater trochanter of the left femur, with no significant pain on passive range of motion of the left hip. Plain radiography demonstrated a left acetabular fracture (Fig 1).

Standardization Of Neuromuscular Reflex Analysis—Role Of Fine-Tuned Vision-Language Model Consortium And Openai Gpt-Oss Reasoning Llm-Enabled Decision Support System, Eranga Bandara, Ross Gore, Sachin Shetty, Ravi Mukkamala, Christopher K. Rhea, Brittany S. Samulski, Amin Hass, Atmaram Yarlagadda, Shaifali Kaushik, Malith De Silva, Andriy Maznychenko, Inna Sokolowska, Kasun De Zoysa

VMASC Publications

Background/Objectives: Accurate assessment of neuromuscular reflexes, such as the Hoffmann reflex (H-reflex), plays a critical role in sports science, rehabilitation, and clinical neurology. Conventional interpretation of H-reflex electromyography (EMG) waveforms is subject to inter-rater variability and interpretive bias, limiting reliability and standardization. This study aims to develop an automated, interpretable, and robust agentic AI–driven framework for H-reflex waveform analysis. Methods: We propose a fine-tuned Vision–Language Model (VLM) consortium combined with a reasoning Large Language Model (LLM)–enabled decision support system for automated H-reflex interpretation. Multiple VLMs were fine-tuned on curated datasets of H-reflex EMG waveform images annotated with expert clinical observations, …

Recent Advances In Triboelectric Nanogenerators For Biomedical And Cardiovascular Monitoring, Amit Sarode, Jegan Rajendran, Gymama Slaughter

Center for Bioelectronics Publications

Triboelectric nanogenerators (TENGs) have emerged as versatile self-powered platforms for wearable and implantable biomedical sensing, offering an alternative to battery-dependent electronic devices. By converting biomechanical energy from physiological motion into electrical signals, TENGs enable simultaneous energy harvesting and active sensing within flexible, lightweight, and biocompatible architectures. This review summarizes recent advances from 2020 to 2025 in triboelectric nanogenerator (TENG)-based cardiovascular monitoring. The discussion focuses on material systems, device configurations, sensing mechanisms, and applications including pulse detection and cuffless blood pressure estimation. Representative studies are compared to highlight emerging trends in wearable and self-powered sensing technologies. However, differences in experimental conditions, …

A Portable Potentiostat Integrated With A Pt/Zno/Lig Electrode For Non-Enzymatic Glucose Detection, Reagan Aviha, Gymama Slaughter

Center for Bioelectronics Publications

Continuous glucose monitoring is critical for effective diabetes management; however, conventional benchtop potentiostats are bulky, costly, and unsuitable for decentralized point-of-care (PoC) applications. To address these limitations, this work presents a miniaturized, low-cost electrochemical sensing platform integrating a non-enzymatic glucose sensor with a portable potentiostat. The sensing electrode is based on laser-induced graphene modified with zinc oxide and platinum nanostructures via electrodeposition to enable sensitive glucose detection under physiological conditions. A custom-designed portable potentiostat was developed to control electrode potentials and perform electrochemical measurements, and its performance was experimentally validated against a commercial Metrohm system. Glucose detection was evaluated using …

Modern Potentiostat Architectures For Electrochemical Sensing: Design, Integration, And Future Directions, Reagan Aviha, Gymama Slaughter

Center for Bioelectronics Publications

Potentiostats are essential to electrochemical sensing, enabling precise control of electrode potentials and measurement of current responses. As demand grows for portable, wearable, and point-of-care systems, potentiostat design has evolved from benchtop instruments to compact, low-power, and wirelessly connected platforms. This review provides a comprehensive, system-level perspective on modern potentiostat architectures, covering operational principles, analog front-end design, signal generation and acquisition, communication protocols, and software integration. Unlike prior reviews that treat these aspects independently, this work integrates electrochemical theory with electronic design and data communication frameworks. Key components, including operational amplifiers, transimpedance amplifiers, DAC/ADC subsystems, and microcontroller-based control, are examined …

Electrochemical Hemoglobin Biosensors For Point-Of-Care Diagnostics, Ashwini Dantanarayana, Gymama Slaughter

Center for Bioelectronics Publications

Hemoglobin (Hb) and its glycated variant (HbA1c) are essential clinical biomarkers for diagnosing anemia, acute hemorrhage, and long-term glycemic control. The growing demand for decentralized point-of-care (POC) testing has accelerated the development of rapid, inexpensive, and portable electrochemical sensing platforms. These technologies exploit the intrinsic redox activity of the heme prosthetic group, yet achieving efficient direct electron transfer (DET) remains a fundamental challenge because the electroactive iron center is deeply embedded within the globin structure. This review critically examines recent advances in electrochemical Hb sensing, tracing the evolution of electrode architectures from conventional carbon substrates to nanostructured materials, including graphene, …

Clinical Subtypes Of Co-Morbid Insomnia And Obstructive Sleep Apnea (Comisa): Results Of A Cluster Analysis, Yuan Shi, Xujun Feng, Fengyi Hao, Yuru Nie, Yihui Zhang, Zhaohua Chen, Siqi Guan, Larry D. Sanford, Michael V. Vitiello, Xiangdong Tang

Department of Pathology & Anatomy Faculty Publications

Background

Variations in the bidirectional relationship between obstructive sleep apnea (OSA) and insomnia in co-morbid insomnia and OSA (COMISA) may form distinct subtypes of COMISA, which have not been previously characterized. This study aims to identify and characterize subtypes of COMISA.

Methods

From a community-recruited COMISA cohort 256 individuals who met diagnosis for COMISA were used to identify subtypes using a two-step clustering methodology. Demographics and multidimension clinical characteristics were collected and compared among obtained subtypes. Logistic models were used to evaluate whether these subtypes were associated with cardiometabolic and mental disorders. A clinical cohort of 1816 COMISA patients was …

Exploring The Synergy Between Very Large Transformer And Lstm Models For Effective Medical Captioning From Videos To Text: The Impact Of Captioning In Healthcare, R. V. Aswiga, Moin Ahmed Zahir

Data Science Faculty Publications

In today’s rapidly evolving digital landscape, the demand for accurate and contextually relevant subtitles for image and video content, particularly in the medical domain, is increasingly critical. Despite the proliferation of visual data across various platforms, existing captioning systems often struggle due to variations in visual settings, complex temporal relationships, and nuanced semantics. Additionally, challenges such as limited datasets, privacy issues, and specialized annotation requirements make medical image captioning particularly difficult. To tackle these challenges, we investigate cutting-edge deep learning methodologies, specifically Transfer Learning and Transformer models, through a comparative analysis. Specifically, we focus on Transfer Learning through the MedVisionCapturer …

35 Individuals With Huwe1-Related Neurodevelopmental Disorder And Suggested Clinical Evaluations, Mindy H. Li, Deziree L. Coleman, Kelsey Hogan, Danielle Luz, Lindsay Bhandari, Newell Belnap, Tiffany Busa, Charles Coutton, Klaus Dieterich, Svetlana Gorokhova, Clara Hildebrandt, Rachel Logan, Milena Mariani, Manuela Morleo, Vincenzo Nigro, John Pappas, Rachel Rabin, Kelly Schoch, Angelo Selicorni, Vandana Shashi, Rebecca Spillman, Jennifer Sullivan, Charlotte Tardy, Samantha A. Schrier Vergano, Brock Grill, Kristin Baranano

Department of Pediatrics Faculty Publications

HUWE1 (HECT, UBA, and WWE Domain Containing E3 Ubiquitin Protein Ligase1, OMIM 300697), located at Xp11.22, encodes a ubiquitin ligase that is highly conserved across species. Genetic variants in HUWE1 described in multiple independent studies cause X-linked intellectual disability, including in the patients identified by Juberg, Marsidi, and Brooks. This report describes 35 additional cases of individuals with variants in HUWE1 and suggested guidelines for clinical management. Our study includes several female cases, which have not been widely reported previously. Our findings confirm earlier reported clinical features including developmental delay, autism, hypotonia, short stature, and dysmorphic facial features as well …

Educational Case: Atypical Presentation Of Primary Hyperparathyroidism With Brown Tumor, Ariel Flotte, Jonathan Light, Harrison Klause, Richard M. Conran

Department of Biomedical and Translational Sciences Faculty Publications

The following fictional case is intended as a learning tool within the Pathology Competencies for Medical Education (PCME), a set of national standards for teaching pathology. These are divided into three basic competencies: Disease Mechanisms and Processes, Organ System Pathology, and Diagnostic Medicine and Therapeutic Pathology.

Revisiting Nasal Polyp Scoring In Clinical Trials: Interpretive Variability And The Need For Standardization, Leigh J. Sowerby, Babak Pourmomenarabi, Antonino Maniaci, Olivia Ginty, Joseph Khristian Han

Department of Otolaryngology (ENT) Faculty Publications

[Introduction] Borish et al. provided an excellent review highlighting methodological variability among the six pivotal Phase III trials [1]. One critical yet overlooked issue is the inconsistent application of the endoscopic nasal polyp score (NPS), a primary outcome measure in all trials.

Leveraging Cross-Reactivity For Dual Serological Detection Of Closely Related Schistosoma Species, Oyetunde T. Oyeyemi, Lisa M. Shollenberger

Biological Sciences Faculty Publications

Schistosomiasis is a disease of poverty that is highly prevalent in Sub-Saharan African countries. Cross-reacting proteins in Schistosoma mansoni (Sm) and S. haematobium (Sh) have been reported to pose diagnostic challenges. Proteins from these two parasites may help overcome diagnostic limitations caused by cross-reactivity and poor species discrimination in serological assays. The study aims to identify cross-reacting protein markers from S. mansoni and S. haematobium for possible concurrent diagnosis of the two parasites. High-quality protein extracts were prepared from the eggs (soluble egg antigen, SEA) and adult worms (Schistosoma worm antigens preparation, SWAP) of S. haematobium and S. mansoni …