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Laproscopic Robotic-Assisted Common Bile Duct Exploration For Primary Choledochlithiasis 20 Years After Cholecystetomy In A Hostile Abdomen, Enoch Wong, Kristen Payne, James Burdick, Hassan Ahmed 2025 HCA Healthcare

Laproscopic Robotic-Assisted Common Bile Duct Exploration For Primary Choledochlithiasis 20 Years After Cholecystetomy In A Hostile Abdomen, Enoch Wong, Kristen Payne, James Burdick, Hassan Ahmed

North Texas Research Forum 2025

Introduction: The incidence of concomitant cholelithiasis and choledocholithiasis is 5-20%. Primary choledochlithiasis more than 3 years after cholecystectomy is an even rarer event with only a handful of case reports in the literature. Robot-assisted laparoscopic common bile duct exploration with intraoperative choledochoscopy is a relatively recent development in biliary surgery. In this report, we describe the use of this technique in a patient with rare presentation and surgically challenging anatomy. Objective: To describe a minimally invasive approach for CBD exploration with extraction of choledocholithiasis in a surgically hostile abdomen and Roux-En-Y anatomy. Methods: This report describes the case of a …


An Evaluation Of The Decline In Primary Care Physician Visits, 2010 To 2021, Anuradha Jetty, Marie Ezran, Alison Huffstetler, Yalda Jabbarpour 2025 Thomas Jefferson University

An Evaluation Of The Decline In Primary Care Physician Visits, 2010 To 2021, Anuradha Jetty, Marie Ezran, Alison Huffstetler, Yalda Jabbarpour

Department of Family & Community Medicine Faculty Papers

INTRODUCTION: Primary care is the backbone of the United States healthcare system, yet it continues to be underfunded and inaccessible to many. Previous studies explored primary care visit patterns until 2016, leaving gaps in our understanding of how recent factors like state Medicaid expansions, the Coronavirus Disease 2019 (COVID-19) pandemic, and population growth have influenced these patterns. Hence, the objective of the current study was to analyze the trends in primary care visits provided by outpatient clinicians over time and by visit type and contextualize study findings within the changing healthcare landscape.

METHODS: The Medical Expenditure Panel Survey data (2010-2021) …


Formulation Development Of Dual-Compartment Topical Inserts Combining Tenofovir Alafenamide And Elvitegravir For Flexible On-Demand Hiv Prevention, Vivek Agrahari, M. Melissa Peet, Neelima Chandra, Prakash Ramalingam, Pardeep K. Gupta, Sriramakamal Jonnalagadda, Onkar N. Singh, Timothy J. McCormick, Gustavo F. Doncel, Meredith R. Clark 2025 Macon & Joan Brock Virginia Health Sciences at Old Dominion University

Formulation Development Of Dual-Compartment Topical Inserts Combining Tenofovir Alafenamide And Elvitegravir For Flexible On-Demand Hiv Prevention, Vivek Agrahari, M. Melissa Peet, Neelima Chandra, Prakash Ramalingam, Pardeep K. Gupta, Sriramakamal Jonnalagadda, Onkar N. Singh, Timothy J. Mccormick, Gustavo F. Doncel, Meredith R. Clark

Department of Obstetrics & Gynecology Faculty Publications

Pre-exposure prophylaxis (PrEP) has emerged as a prominent approach for the prevention of HIV infections. While the latest advances have resulted in effective oral and injectable product options, there are still gaps in on-demand, event-driven, topical products for HIV prevention that are safe and effective. Here we describe the formulation development of a dual-compartment topical insert containing tenofovir alafenamide fumarate (TAF) and elvitegravir (EVG) that may be administered when needed, vaginally or rectally, pre- or post-coitus, for flexible HIV prophylaxis. Specifically, we describe the lab-scale formulation development, preclinical mucosal safety and pharmacokinetics (PK) testing in rabbits, long-term stability, and scale-up …


Exploring The Impact Of Pain Management Agreements On Physician-Patient Relationship: A Qualitative Analysis From The Patient’S Perspective In Opioid Analgesic Treatment, Shriya Doranala 2025 University of Central Florida

Exploring The Impact Of Pain Management Agreements On Physician-Patient Relationship: A Qualitative Analysis From The Patient’S Perspective In Opioid Analgesic Treatment, Shriya Doranala

Honors Undergraduate Theses

Pain management agreements are increasingly used in the treatment of chronic pain with opioid analgesics. These agreements aim to reduce misuse of opioids by providing patients clear regulations and requirements to follow during treatment. This study seeks to assess the effect of pain management agreement for opioid treatment on the patient-physician relationship from the perspective of patients with a pain management agreement in the past two years. We recruited participants for the semi-structured interview through online media groups dedicated to patients with chronic pain that is treated with opioids. A cohort of eight individuals recruited from September 2023 to January …


Postpartum Depression In Adolescent Mothers: Evaluating The Effectiveness Of Screening Tools, Social And Cultural Interventions, Ysabella M. Co 2025 Dominican University of California

Postpartum Depression In Adolescent Mothers: Evaluating The Effectiveness Of Screening Tools, Social And Cultural Interventions, Ysabella M. Co

Nursing | Senior Theses

Background: Pregnancies among adolescents is often an outcome of improper sex education and understanding. It is vital to provide mothers with the proper medical care and resources throughout their pregnancy and postpartum period to prevent any risks or harm from occurring. With the complexities and stressors of pregnancy at such a young age, it is important for healthcare to provide resources regarding postnatal depression diagnoses and interventions, especially to a population that is at risk for mental health issues. Objective: To provide adolescent mothers thorough medical care and lessen the risk of experiencing postpartum depression. By providing frequent …


The Effectiveness Of Botulinum Toxin Injections In The Management Of Chronic Neck And Shoulder Myofascial Pain: A Nursing Perspective, Jia Zhou 2025 Dominican University of California

The Effectiveness Of Botulinum Toxin Injections In The Management Of Chronic Neck And Shoulder Myofascial Pain: A Nursing Perspective, Jia Zhou

Nursing | Senior Theses

Abstract

Background

Chronic neck and shoulder myofascial pain has long been challenging patients and medical professionals due to its limited response to traditional therapies on top of high recurrence. Physical therapy, oral analgesics, and trigger point injections have only provided partial or short-term relief. As a result, botulinum toxin type A injections have been explored as an alternative treatment. Previous studies have shown promising short-term outcomes, but concerns regarding long-term safety, cost-effectiveness, and potential adverse effects, particularly in older adults, have remained unresolved. These gaps have highlighted the need for comprehensive evaluation from both clinical and nursing perspectives.

Objective

The …


Implementation Of Robotics And Artificial Intelligence To Oncological Surgery, Ian Ngo 2025 Dominican University of California

Implementation Of Robotics And Artificial Intelligence To Oncological Surgery, Ian Ngo

Nursing | Senior Theses

Background/ significance: Introduced in the late 20th century, robotic systems have enhanced surgeons’ capabilities by providing accurate and precise control of instruments. These systems helped minimize invasiveness in surgical procedures, providing greater precision, and gave flexibility to difficult-to-access areas of the body. Tools powered by AI help surgeons accurately identify and remove cancerous tissues, which can lead to better surgical outcomes and fewer complications. Purpose: The purpose of this study is to focus on evaluating how Robotic-Assisted Systems (RAS) and Artificial Intelligence (AI) impact surgical precision, patient recovery, and to address economic efficiencies. associated with integrating said systems into the …


Motion Artifacts (Ma) At-Rest In Measured Arterial Pulse Signals: Time-Varying Amplitude In Each Harmonic And Non-Flat Harmonic-Ma Coupled Baseline, MD Mahfuzur Rahman, Mamun Hasan, Zhili Hao 2025 Old Dominion University

Motion Artifacts (Ma) At-Rest In Measured Arterial Pulse Signals: Time-Varying Amplitude In Each Harmonic And Non-Flat Harmonic-Ma Coupled Baseline, Md Mahfuzur Rahman, Mamun Hasan, Zhili Hao

Mechanical & Aerospace Engineering Faculty Publications

Motion artifacts (MA) cause great variability in a measured arterial pulse signal, and treatment of MA solely as a baseline drift (BD) fails to eliminate its effect on the measured signal. This paper presents a study on the effect of MA at rest (< 0.7 Hz) on measured arterial pulse signals using a microfluidic-based tactile sensor. By taking full account of the dynamic behavior of the transmission path from the true pulse signal in an artery to a measured pulse signal at the sensor, the tissue-contact-sensor (TCS) stack, an analytical model of MA in a measured pulse signal is developed. In this model, the TCS stack is treated as a 1DOF system for its dynamic behavior; MA is quantified as the displacement (i.e., BD) and time-varying system parameters (TVSP) of the TCS stack. The mathematical expression of MA in a measured pulse signal reveals that while BD remains as low-frequency additive noise, TVSP causes time-varying harmonics in a measured pulse signal. Further time-frequency analysis (TFA) of measured pulse signals validates the existence of TVSP and, for the first time, reveals its effect on a measured pulse signal: time-varying amplitude in each harmonic and non-flat harmonic-MA-coupled baseline.


The Effectiveness Of Botulinum Toxin Injections In The Management Of Chronic Neck And Shoulder Myofascial Pain: A Nursing Perspective, Jia Zhou 2025 Dominican University of California

The Effectiveness Of Botulinum Toxin Injections In The Management Of Chronic Neck And Shoulder Myofascial Pain: A Nursing Perspective, Jia Zhou

Nursing | Student Research Posters

No abstract provided.


Developing A Nursing Early-Intervention Bundle To Decrease The Prevalence Of Post-Intensive Care Syndrome, Aneesha Biju 2025 Dominican University of California

Developing A Nursing Early-Intervention Bundle To Decrease The Prevalence Of Post-Intensive Care Syndrome, Aneesha Biju

Nursing | Student Research Posters

Post-intensive care syndrome (PICS) has become an increasingly recognized challenge in critical care as more patients survive prolonged mechanical ventilation and lengthy ICU stays. Although lifesaving interventions support recovery from the primary illness, many patients develop new or worsened physical, cognitive, or psychological impairments after discharge. These complications often limit independence, slow recovery, and create long-term burdens for both patients and families. Research shows that early, consistent nursing interventions, such as delirium prevention, early mobility, mental health support, and family communication, can reduce the risk of PICS. The absence of a unified and standardized approach results in inconsistent practices and …


Fabricating Silver-Ceria Polymer Nanocomposite Scaffolds For Biomedical Therapeutic Applications, Shreya S. Pawar 2025 University of Central Florida

Fabricating Silver-Ceria Polymer Nanocomposite Scaffolds For Biomedical Therapeutic Applications, Shreya S. Pawar

Honors Undergraduate Theses

Improper healing of bone fractures and limited regeneration of bone following bone tumor resection remain a prevalent complication worldwide. Long-term effects of this include joint instability, limited movement, and arthritis. Bone infections (osteomyelitis), reactive oxygen species (ROS) generation via excessive inflammation, and underlying conditions such as osteoporosis can contribute to suboptimal bone tissue regeneration. ROS accumulation stimulates osteoblast apoptosis, while promoting osteoclast differentiation. These processes inhibit mineralization and osteogenesis. Conventional therapeutics involve the utilization of drugs and bone grafts. However, these approaches pose limitations and can result in subsequent complications. Microbial infections, ROS accumulation, and excessive inflammations are factors that …


Allograft Reconstruction For Fluoroquinolone-Induced Achilles Rupture: A Case Study, Val Haddon, Brandon Mojica, Joel Santana, Marjory Jones 2025 HCA Healthcare

Allograft Reconstruction For Fluoroquinolone-Induced Achilles Rupture: A Case Study, Val Haddon, Brandon Mojica, Joel Santana, Marjory Jones

West Florida Division GME Research Day 2025

No abstract provided.


Saline Sonography Vs Hysteroscopy For Evaluation Of The Uterine Cavity, Sonam Parag, Mark Sanchez, Yissa Fonticiella, James Baron 2025 HCA Healthcare

Saline Sonography Vs Hysteroscopy For Evaluation Of The Uterine Cavity, Sonam Parag, Mark Sanchez, Yissa Fonticiella, James Baron

West Florida Division GME Research Day 2025

No abstract provided.


Breaking The Iv Habit: Oral Antibiotics For Gram-Negative Bacteremia In The Modern Era, Adam Albadawi, Maria Milko 2025 HCA Healthcare

Breaking The Iv Habit: Oral Antibiotics For Gram-Negative Bacteremia In The Modern Era, Adam Albadawi, Maria Milko

West Florida Division GME Research Day 2025

No abstract provided.


The Hidden Risk Of Bupropion Overdose: Pulseless Electrical Activity Without Seizures And A Deceptively Normal Ekg, Yasmin Aboutaleb, Helen Diaz-Garcia, Nicole Santiago-Gonzalez, Omar Perez Feliciano 2025 HCA Healthcare

The Hidden Risk Of Bupropion Overdose: Pulseless Electrical Activity Without Seizures And A Deceptively Normal Ekg, Yasmin Aboutaleb, Helen Diaz-Garcia, Nicole Santiago-Gonzalez, Omar Perez Feliciano

West Florida Division GME Research Day 2025

No abstract provided.


Closed Small Bowel Obstruction With Mesenteric Strangulation, Michael Calderon, Parth Patel, Patricia Abbitt, Chase Croft 2025 HCA Healthcare

Closed Small Bowel Obstruction With Mesenteric Strangulation, Michael Calderon, Parth Patel, Patricia Abbitt, Chase Croft

West Florida Division GME Research Day 2025

No abstract provided.


Implementation Of Formalized Education Of Ultrasound-Guided Intravenous Peripheral Line Placement In A Family Medicine Residency, Lucas Zadan, Gloria Travieso-Zadan, Sean Quinonez 2025 HCA Healthcare

Implementation Of Formalized Education Of Ultrasound-Guided Intravenous Peripheral Line Placement In A Family Medicine Residency, Lucas Zadan, Gloria Travieso-Zadan, Sean Quinonez

West Florida Division GME Research Day 2025

No abstract provided.


American Heart Association Blood Pressure Classification And Subsequent Risk Of Preeclampsia, Rebecca Horgan, Erkan Kalafat, Elena Sinkovskaya, Alfred Abuhamad, George Saade 2025 Macon & Joan Brock Virginia Health Sciences at Old Dominion University

American Heart Association Blood Pressure Classification And Subsequent Risk Of Preeclampsia, Rebecca Horgan, Erkan Kalafat, Elena Sinkovskaya, Alfred Abuhamad, George Saade

Department of Obstetrics & Gynecology Faculty Publications

Background: In 2017, the American Heart Association (AHA) and American College of Cardiology updated their hypertension guidelines for the nonpregnant population, lowering the diagnostic thresholds to systolic blood pressure ≥130 mmHg or diastolic blood pressure ≥80 mmHg. This reclassification has raised important questions regarding whether blood pressure (BP) values previously considered within the normal range in pregnancy may, in fact, confer an increased risk for hypertensive disorders of pregnancy (HDPs).

Objective: To evaluate the association between first-trimester BP classified by AHA thresholds and the subsequent development of HDPs.

Study design: This was a secondary analysis of a prospective, multicenter cohort …


A Rare Complication Of Dilation And Evacuation: Unrecognized Extrauterine Retained Products Of Conception, Aviana Terschueren, Lauren Siewertsz van Reesema, Joseph Hudgens 2025 Macon & Joan Brock Virginia Health Sciences at Old Dominion University

A Rare Complication Of Dilation And Evacuation: Unrecognized Extrauterine Retained Products Of Conception, Aviana Terschueren, Lauren Siewertsz Van Reesema, Joseph Hudgens

Department of Obstetrics & Gynecology Faculty Publications

Introduction: Surgical abortions, including dilation and evacuation, are among the safest gynecological procedures, with complication rates ranging from 0.5–4.0%. Uterine perforation, though rare (0.2–0.8%), can result in serious sequela, including translocation of retained products of conception into the abdominal cavity. We present a rare case of abdominal retained products of conception following a second-trimester dilation and evacuation.

Case Report: A 29-year-old G3P1112 underwent an elective surgical abortion at 17 weeks’ gestation, complicated by hemorrhage necessitating transfer to an outside hospital. She was treated with uterotonics and a blood transfusion and was discharged after a 6-day hospitalization. Initial transvaginal ultrasound showed …


Training Set Augmentation And Harmonization Enables Radiomic Models To Detect Early Onset Of Lung Cancer, Claire Huchthausen, Menglin Shi, Gabriel L.A. Sousa, James Larner, Einsley Janowski, Jonathan Colen, Krishni Wijesooriya 2025 University of Virginia

Training Set Augmentation And Harmonization Enables Radiomic Models To Detect Early Onset Of Lung Cancer, Claire Huchthausen, Menglin Shi, Gabriel L.A. Sousa, James Larner, Einsley Janowski, Jonathan Colen, Krishni Wijesooriya

Data Science Faculty Publications

Radiomics-based machine learning models have the potential to detect lung cancer at inception from CT scans and transform patient outcomes. Low malignancy rates in early-development pulmonary nodules (PNs) and variable image acquisition hinder development of clinically applicable radiomics-based early detection models. To address these challenges, we augmented training using later-development PNs and harmonized for acquisition effects. We first trained machine learning models to predict PN malignancy using radiomic features from scans of early-development benign and malignant PNs (n = 187) harmonized using ComBat. Observing near-chance performance, we augmented training with later-development benign and malignant PNs (n = 225). We evaluated …


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