Undergraduate Medical Education Works
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Item Finding a Parallel to Eisenstein's Criteria over Finite Fields(Butler University, 2019) Heumann, Ryan; Sharma, PremFactoring polynomials over the integers is something that we all learn in high school algebra. Homework assignments are made up of countless polynomials and it is our job to find the factors. Eventually, the polynomials get longer and more difficult and we learn other methods to factor them. The problem becomes harder when you come across a polynomial which you are unable to factor. With certain polynomials like x^2+1, you can easily tell that it cannot be factored over Z. However, other times we are left wondering whether a given polynomial p(x) is factorable over Z at all. Lucky for us, Gotthold Eisenstein, a mathematician, found a sufficient condition for irreducibility over Z.Item Gaps in Rural Healthcare and Technology’s Evolving Role in Addressing Them(Purdue University, 2025-04-17) Heumann, RyanThe gap in mortality rate due to disease between rural and urban communities is substantial and continues to grow. There is no one root cause to this disparity, so there is no simple solution either. In order to even begin to reverse the trend, it is vital to understand the factors that contribute to health outcomes in rural communities. Part of this analysis includes studying where individuals are getting information about their health and healthcare. With the growth of the internet over the last three decades, this landscape has been dynamic. It becomes important to dissect its impact on health behaviors to avoid the same pitfalls as the new era of technology, marked by artificial intelligence, continues to grow exponentially.Item Effects of Functional Movement-Based Myofascial Release Therapy on Shoulder Range of Motion in a Collegiate Pitcher: A Case Report(Indiana University School of Medicine, 2025-01-26) Heumann, Ryan; Waltz, Matt; Garcia-Hosokawa, Marcel; Chlebowski, ArthurStrong, repetitive forces sustained by the shoulder joint during overhead throwing sports can cause alterations in range of motion (ROM) of the joint itself. This change can lead to risk of injury. Currently, there are a number of established therapies to increase ROM and decrease injury risk. This case report covers the use of a form of myofascial release therapy (MRT), and its effect on throwing shoulder ROM and pain in a collegiate baseball player. After twelve sessions of therapy, external rotation increased by 20.64°(16.97%) and internal rotation increased by 19.60°(65.88%). This total increase in ROM provides evidence for a less commonly used therapeutic technique and its possible effect on decreasing risk of injury in overhead throwing athletes.Item AI Tool to Bridge Rural Disparities(4th Annual Health Equity Summit, 2025-02-20) Heumann, Ryan; Dave, Darpit; Wadekar, Shakti; Steinhubl, Steven; Culurciello, Eugenio; Anand, Mohini; Shripal, Aakanksha; Wanzellar, GoncaloDisparities exist between rural and urban communities when it comes to disease, disability, and death. The reasons for this are many, interrelated, and complex and the best efforts of the limited healthcare providers in these areas largely cannot overcome them. The increased complexity of care in addition to lower access in these communities creates a set of circumstances with many hurdles to close the gap. Here, we introduce the development of an application, referred to as MAIA, with both administrative and educational functionalities that may assist providers and rural patients alike in order to decrease the disparity that exists in these communities.Item Identifying Sickle Cell Disease Beyond the Neonatal Period: A Case Series(2025-03-28) Gupta, Soumya; Slaughter, Mary; Li, Katherine; Harter, Michaela; Goubeaux, Derrick L.; Drayton Jackson, MeghanBackground: Sickle Cell Disease (SCD) is an autosomal recessive chronic condition that causes hemolytic anemia and vaso-occlusive episodes that can present as dactylitis, pain, acute chest syndrome (ACS), and other complications. For early detection and intervention, newborn screening (NBS) for SCD is mandated in all 50 states. However, this screening is not readily available in many other areas of the world. Case Description : Three children who immigrated from countries outside the United States were diagnosed with SCD beyond the neonatal period. A 17-year-old female adopted from Kenya presented to the ER with dyspnea after starting oral contraceptives and was found to have a pulmonary embolism. Hemoglobin (Hgb) was 8.1 g/dl. She rapidly deteriorated and required intubation. Bronchoalveolar lavage revealed straw-colored fluid, a rare finding consistent with ACS. Electrophoresis confirmed HbSS. A 7-year-old male from the Dominican Republic presented with pneumonia and pain. Hgb was 8.4 g/dl. There was familial anemia, but he had not received work-up due to insufficient insurance coverage. Electrophoresis showed HbSS. A 7-year-old male from Nigeria presented to the ED after an episode of gross hematuria. His baseline Hgb was 10 g/dl, and his mother had SCD. Electrophoresis showed HbSS. Clinical Significance: Sickle cell disease is a multisystem disorder with complications that can lead to severe illness. Physicians must maintain high clinical suspicion for SCD in patients who did not receive NBS presenting with recurrent pain, severe infection, end organ damage, or anemia. Diagnosis is confirmed with hemoglobin electrophoresis. Conclusion: This case series highlights the need for heightened SCD awareness, particularly in those from areas without universal NBS. Providers must obtain relevant family history, recognize SCD’s diverse presentations, and work to reduce healthcare access barriers to ensure that patients receive timely diagnosis and care.Item Impacts of Estrogen Receptor Alpha (ERα) Deficiency on Dynamics of the Ovarian Immune Microenvironment(2024-07-31) Salter, Lucy; Sessions, Katherine; Krementsov, Dimitry; Brodeur, TiaItem The effect of maternal blood transfusion history on alloimmunized pregnancies(2025-01-27) Arkerson, Brittany; Fazeh, Aghajani; McGuire, Evelyn; Modrall, Katherine; Salter, Lucy; Shanks, Anthony; Mustafa, HibaItem Resolving Discrepancies in Mayo Clinic’s CKD Patient Registry & Aiding in Novel CKD Program Implementation for Clinical Use(2022-08-05) Salter, Lucy; Moran-Melendez, Andrea; Vaughan, Lisa; Albright, Robert; MAnohar, Sandhya; Zoghby, Ziad; Kattah, Andrea; Boehmer, KaseyItem Gender-Affirming OB/GYN Care: A Case Study of IUD Placement in a Non-Binary Individual(2024-03-27) Vogel, Katherine; McGuire, Evelyn; Karki, Savin; Salter, Lucy; Henderson, RicItem Comparative Analysis of Postoperative Outcomes at 6 Weeks and 6 Months: Basilar Thumb Reconstruction with Trapezium Excision and FiberLock InternalBrace Reconstruction with Tenodesis versus Thumb Trapeziectomy with Ligament Reconstruction and Tendon Interposition(2024-06-21) Malik, Hanna; Ratigan, Connor; Yocum, Derek; Mencias, Adelbert; Fuller, SamBackground: Basilar Thumb Reconstruction (BTR) is a surgical procedure for the treatment of basilar thumb arthritis at the first carpometacarpal (CMC) joint of the thumb. There are a variety of surgical techniques that can be used in this procedure; however, they vary in post-operative outcomes of pain, function, recovery time, and strength. Optimizing surgical techniques in BTR is important for long-term patient outcomes, as the thumb is central for many activities of daily living. Research regarding the post-operative outcomes of BTR surgery with newer techniques, such as those with medical device implants, is crucial in determining the trajectory of this growing field. Hypothesis: FiberLock suture suspenionplasty will yield superior post-operative outcomes 6 weeks following BTR in terms of patient-reported outcome measures (PROMIS), functional disability (QuickDASH), and pain levels (painVAS) compared to trapexiectomy with ligament reconstruction and tendon interposition (LTRI) in patients with thumb CMC joint osteoarthritis. Methods: Retrospective data was collected on 77 patients with thumb carpometacarpal (CMC) arthritis who underwent trapeziectomy with LRTI or Arthrex FiberLockTM Suspension Implants (Arthrex, Naples, FL, USA) InternalBrace suspensionplasty with trapezium excision and side-to-side flexor carpi radialis tendon transfer. There were 39 LRTI and 39 FiberLock Internal Brace suspensionplasty procedures. Outcomes were measured using the Visual Analogue Scale (VAS) for pain, Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) questionnaire, and Patient-Reported Outcomes Measurement Information System (PROMIS) v1.2 Upper Extremity (UE) item bank. Patient demographic data was also recorded. Results: The PERMANOVA test revealed a significant difference in multivariate centroids between the groups (p < 0.01). Approximately 31.29% of the variation in the dataset was explained by the grouping variable. However, post-hoc pairwise tests demonstrated no significant (All p > 0.05) differences between groups for (VAS Pain 24 Hours, VAS Pain When Resting, VAS Pain When Active, PROMIS Upper Extremity, and Quick DASH). Summary Points: Our analysis demonstrated LRTI patient may have more consistent outcomes 6-weeks after surgery compared to the newer FiberLock procedure. However, it is promising that no significant differences were seen between the patient outcome surveys of the two groups. Future research on long-term outcomes will be beneficial in comparing the effects of this new surgical technique.