United States

Abstract Title
Lupus Hepatitis complicated by Debilitating Muscle Weakness due to Somatoform Disorder 

Background
A 55-year-old female with a medical history significant for systemic lupus erythematosus (SLE) presented with an inability to ambulate due to profound fatigue and generalized muscle weakness. Her hospital course was complicated by acute liver injury attributed to lupus hepatitis. Medical workup for muscle weakness was inconclusive leading to a diagnosis of somatoform disorder. This case presents a unique intersection of medical and psychiatric challenges, offering valuable insights into the physical and psychological aspects of managing SLE. 

Case Presentation
Patient is a 55-year-old female with a medical history of SLE on chronic prednisone 10 mg daily and hypertension who presented to the hospital with diffuse muscle weakness. 
On presentation, vital signs revealed a temperature of 38°C, blood pressure of 130/62 mmHg, and heart rate of 126 bpm. EKG revealed sinus tachycardia. Laboratory studies were notable for leukopenia (WBC 2.91K/µL), transaminitis with an ALT of 500 IU/L and AST of 1,112 IU/L, total bilirubin of 1.5 mg/dL, mildly elevated CPK at 236 IU/L, and a profoundly elevated ferritin level at 15,900 ng/mL. 

Laboratory findings were consistent with an acute lupus flare, evidenced by an elevated anti-dsDNA level of 67 IU/mL (normal range &lt;5 IU/mL), elevated anti-ENA antibodies, and low C3 and C4 titers. Negative rheumatologic and infectious workup included autoimmune hepatitis, hepatitis B, hepatitis C, Lyme disease, and blood cultures. Imaging studies, including abdominal ultrasound, CT, and MRI, revealed only an incidental 0.7 cm hemangioma. 

Workup for muscle weakness unrevealing given no acute findings on brain and diffuse spine MRIs and minimally peaking CPK to 302IU/L. The patient deferred lumbar puncture. She was later discharged to sub-acute rehabilitation. Given minimal improvement in weakness and inconsistent physical exam findings, weakness was attributed to functional neurological disorder. 

Discussion
Autoimmune hepatitis was considered less likely due to the patient&#39;s chronic use of prednisone and mycophenolate, as well as negative serologies. Although CMV testing returned positive, it was attributed to chronic immunosuppression and was considered unlikely to contribute significantly to the clinical presentation. Hepatitis A total antibodies were positive, but hepatitis A IgM was negative one week prior to hospital presentation. 

Lupus, or lupoid hepatitis, is a rare manifestation of SLE. This diagnosis occurs in approximately 2 to 6% of cases of patients previously diagnosed with lupus who develop and an acute hepatitis1,2,3. 

Sources 

1. Arnett FC, Reichlin M. Lupus hepatitis: an under-recognized disease feature associated with autoantibodies to ribosomal P. Am J Med. 1995;99(5):465-472. doi:10.1016/s0002-9343(99)80221-6 
2. Imran S, Thabah MM, Azharudeen M, Ramesh A, Bobby Z, Negi VS. Liver Abnormalities in Systemic Lupus Erythematosus: A Prospective Observational Study. Cureus. 2021;13(6):e15691. Published 2021 Jun 16. doi:10.7759/cureus.15691 
3. Piga M, Vacca A, Porru G, Cauli A, Mathieu A. Liver involvement in systemic lupus erythematosus: incidence, clinical course and outcome of lupus hepatitis. Clin Exp Rheumatol. 2010;28(4):504-510.

AMA Research Challenge 2025 

Lupus Hepatitis complicated by Debilitating Muscle Weakness due to Somatoform Disorder

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AMA Research Challenge 2022

Welcome to the largest national, multi-specialty research event featuring research from 750 medical students, residents and fellows, and international medical graduates.


Abstract Title
Lupus Hepatitis complicated by Debilitating Muscle Weakness due to Somatoform Disorder 

Background
A 55-year-old female with a medical history significant for systemic lupus erythematosus (SLE) presented with an inability to ambulate due to profound fatigue and generalized muscle weakness. Her hospital course was complicated by acute liver injury attributed to lupus hepatitis. Medical workup for muscle weakness was inconclusive leading to a diagnosis of somatoform disorder. This case presents a unique intersection of medical and psychiatric challenges, offering valuable insights into the physical and psychological aspects of managing SLE. 

Case Presentation
Patient is a 55-year-old female with a medical history of SLE on chronic prednisone 10 mg daily and hypertension who presented to the hospital with diffuse muscle weakness. 
On presentation, vital signs revealed a temperature of 38°C, blood pressure of 130/62 mmHg, and heart rate of 126 bpm. EKG revealed sinus tachycardia. Laboratory studies were notable for leukopenia (WBC 2.91K/µL), transaminitis with an ALT of 500 IU/L and AST of 1,112 IU/L, total bilirubin of 1.5 mg/dL, mildly elevated CPK at 236 IU/L, and a profoundly elevated ferritin level at 15,900 ng/mL. 

Laboratory findings were consistent with an acute lupus flare, evidenced by an elevated anti-dsDNA level of 67 IU/mL (normal range <5 IU/mL), elevated anti-ENA antibodies, and low C3 and C4 titers. Negative rheumatologic and infectious workup included autoimmune hepatitis, hepatitis B, hepatitis C, Lyme disease, and blood cultures. Imaging studies, including abdominal ultrasound, CT, and MRI, revealed only an incidental 0.7 cm hemangioma. 

Workup for muscle weakness unrevealing given no acute findings on brain and diffuse spine MRIs and minimally peaking CPK to 302IU/L. The patient deferred lumbar puncture. She was later discharged to sub-acute rehabilitation. Given minimal improvement in weakness and inconsistent physical exam findings, weakness was attributed to functional neurological disorder. 

Discussion
Autoimmune hepatitis was considered less likely due to the patient's chronic use of prednisone and mycophenolate, as well as negative serologies. Although CMV testing returned positive, it was attributed to chronic immunosuppression and was considered unlikely to contribute significantly to the clinical presentation. Hepatitis A total antibodies were positive, but hepatitis A IgM was negative one week prior to hospital presentation. 

Lupus, or lupoid hepatitis, is a rare manifestation of SLE. This diagnosis occurs in approximately 2 to 6% of cases of patients previously diagnosed with lupus who develop and an acute hepatitis1,2,3. 

Sources 

1. Arnett FC, Reichlin M. Lupus hepatitis: an under-recognized disease feature associated with autoantibodies to ribosomal P. Am J Med. 1995;99(5):465-472. doi:10.1016/s0002-9343(99)80221-6 
2. Imran S, Thabah MM, Azharudeen M, Ramesh A, Bobby Z, Negi VS. Liver Abnormalities in Systemic Lupus Erythematosus: A Prospective Observational Study. Cureus. 2021;13(6):e15691. Published 2021 Jun 16. doi:10.7759/cureus.15691 
3. Piga M, Vacca A, Porru G, Cauli A, Mathieu A. Liver involvement in systemic lupus erythematosus: incidence, clinical course and outcome of lupus hepatitis. Clin Exp Rheumatol. 2010;28(4):504-510.

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Background
The obesity paradox refers to the unexpected observation that individuals with obesity (BMI ≥ 30) sometimes experience better clinical outcomes than those with lower BMI, despite obesity being associated with worse prognoses in breast cancer. Some subgroups, such as premenopausal women and patients with advanced HER2+ disease, have shown improved survival with higher BMI. Factors like methodological bias, reverse causation, high BMI’s association with high muscle mass, or BMI’s limitations as a measure of adiposity have been suggested as possible explanations for this paradox. Given adipose tissue’s varying metabolic effects across races, we aimed to further characterize this paradox and assess its impact on racial differences in survival outcomes.

Methods
Using anonymized electronic health records from the TriNetX network, we conducted a retrospective cohort study of metastatic (Stage IV) breast cancer patients with BMI data within one month of their diagnosis. Patients with other primary cancers were excluded. Four cohorts were created based on race and BMI: obese and non-obese African-American and Caucasian patients. Propensity score matching (1:1) controlled for age, sex, comorbidities, tumor characteristics, treatment modalities, and receptor status. The primary outcome was 10-year overall survival.

Results
After matching, each African-American subgroup included 1,219 patients; each Caucasian subgroup included 5,448 patients. Obese African-American patients had significantly longer median survival than non-obese counterparts (2,074 vs. 1,236 days; p < 0.0001). Among Caucasian patients, no significant survival difference was observed (1,908 vs. 2,067 days; p = 0.70).

Conclusion
The obesity paradox has a notable impact on survival among African-American patients with metastatic breast cancer but not among Caucasian patients. These findings suggest a need for race-specific prognostic assessments and further investigation into underlying biological mechanisms.


The Weight of Race: Understanding the Obesity Paradox in Metastatic Breast Cancer

Background: Microglial metabolic dysfunction is a key contributor to the progression of Parkinson’s Disease (PD), a neurodegenerative disorder marked by dopaminergic neuronal loss in the substantia nigra and pathological α-synuclein accumulation. As the primary immunoregulatory cells of the central nervous system (CNS), microglia play a critical role in maintaining neuronal health. In PD, they help phagocytose α-synuclein to clear misfolded protein aggregates, release neurotrophic factors such as brain-derived neurotrophic factor (BDNF) and IGF-1 to support neuronal survival, conduct immune surveillance for injury or infection, and regulate synaptic pruning, ion balance, and clearance of apoptotic cells. Microglia can adopt pro-inflammatory (M1-like) or anti-inflammatory (M2-like) phenotypes; the latter secretes cytokines such as IL-10 and TGF-β to limit inflammation and promote neuroprotection.
However, in PD, chronic microglial activation impairs their ability to clear α-synuclein and maintain their immunoregulatory functions. This dysfunctional state is associated with elevated oxidative stress and sustained neuroinflammation. Metabolically, these chronically activated microglia shift from oxidative phosphorylation (OXPHOS) to glycolysis, favoring rapid but less efficient ATP production to sustain their inflammatory activity. Interestingly, this glycolytic reprogramming mirrors the Warburg effect observed in cancer cells, in which cells preferentially undergo aerobic glycolysis despite sufficient oxygen availability, supporting increased functional output at the expense of metabolic efficiency.
Therapeutic strategies that restore mitochondrial respiration and reestablish metabolic balance may reverse this pro-inflammatory phenotype and promote neuroprotection. To address this, we screened a library of approximately 400 mitochondria-targeted small molecules for their ability to enhance OXPHOS and suppress glycolysis in α-synuclein–exposed microglia under PD-like inflammatory conditions. Overall, this study aims to identify promising therapeutic candidates that restore homeostatic microglial function, reduce neuroinflammation, and support the development of targeted treatments for PD.
Methods: A three-phase in vitro study was designed using mouse microglial cells (MV2). In Phase I, we optimized cell density and α-synuclein fibril (PFF) dose to model PD-relevant inflammation and metabolic disruption. The optimal seeding density (~20,000 cells/well) and PFF concentration (10 μM) were selected based on morphology and cytokine output. In Phase II, approximately 400 mitochondria-targeted small molecules from the TargetMol library were screened. PFF-treated cells were exposed to compounds and analyzed via Seahorse XF technology for Oxygen Consumption Rate (OCR), Extracellular Acidification Rate (ECAR), and ATP production. Phase III will validate lead compounds mechanistically, assessing cytokine suppression and mitochondrial effect in microglial cells (MV2).
Results Preliminary Phase I data confirmed that 10 μM PFF induces robust microglial activation with elevated TNF-α, IL-6, and nitric oxide. Seahorse assay setup confirmed consistent OCR and ECAR measurements. Compound screening is ongoing; several candidates show potential to enhance mitochondrial oxidative respiration and suppress glycolytic flux in α-synuclein–treated microglia.
Conclusion: This ongoing study outlines a novel screening approach to identify therapeutics that restore microglial homeostasis in PD. By combining disease modeling with real-time metabolic analysis, we aim to discover compounds that reverse glycolytic bias and mitigate neuroinflammation. These findings may inform the development of microglia-targeted therapies to protect against neurodegeneration in PD and related disorders.

Targeted Screening to Restore Microglial Bioenergetics in Parkinson’s Disease Using Seahorse XF Technology

Abstract
Hip osteoarthritis (OA) is a chronic, progressive degenerative joint disorder associated with significant morbidity and limited non-surgical treatment options. Over the past 20 years, Platelet-rich plasma (PRP) has garnered increasing interest as a conservative intervention in the setting of OA; however, its clinical efficacy in hip OA remains inconclusive due to substantial heterogeneity in preparation protocols and administration methods. This systematic review aims to examine randomized controlled trials (RCTs) published between 2019 and 2024 that evaluated the efficacy of PRP in the management of hip osteoarthritis, with specific criteria including the use of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and/or the Visual Analog Scale (VAS) for outcome measurement. Three RCTs met the eligibility criteria. While short-term improvements in pain and function were observed in patients with mild to moderate OA, long-term benefits were inconsistent. Considerable variability in PRP composition (leukocyte-rich versus leukocyte-poor), activation techniques, injection schedules, and follow-up durations was evident across studies. Particularly, one trial demonstrated no significant advantage of PRP over placebo. Methodological limitations, including lack of blinding, underreporting of PRP characteristics, and protocol heterogeneity, impeded the ability to draw definitive conclusions. Although PRP may provide short-term symptomatic relief in early-stage hip osteoarthritis, the absence of standardized protocols highlights the need for rigorous, long-term randomized controlled trials that employ consistent classification systems (e.g., PAW or MARSPILL) and stratified patient populations to inform evidence-based clinical guidelines.


A Systematic Review of Recent Developments in Platelet-Rich Plasma Therapy in Hip Osteoarthritis: Variability in Protocols and Clinical Outcomes (2019–2024)

Background 
Discount pharmacies such as Mark Cuban Cost Plus Drugs (MCCPD), GoodRx, and SingleCare have emerged to improve medication affordability in the United States (U.S.). These platforms differ in pricing strategy: MCCPD uses a cost-plus model with a 15% markup, pharmacy fee, and shipping fee, GoodRx collaborates with Pharmacy Benefit Managers to negotiate discounts, and SingleCare functions through direct-to-pharmacy partnerships. While prior research has explored pricing savings of these platforms, limited work compares these three platforms for common chronic medications. Given hypertension’s high prevalence, we evaluated how differing pricing models affect the costs of antihypertensive medication for patients.
Methods
The cross-sectional study compared out-of-pocket costs for antihypertensive drugs across the three platforms. Medications were selected based on preferred medication lists from UpToDate, restricted to low dose and 30-day supplies. MCCPD prices were nationally consistent, while GoodRx and SingleCare prices fluctuated based on ZIP Codes. Therefore, eight ZIP Codes were selected using a stratified random sampling across U.S. Census regions and urban/rural status. The prices were then collected on May 26, 2025 and analyzed descriptively to determine price differences based on platform and regionality.
Results
Among the medications analyzed, MCCPD offered the lowest price for twenty drugs (63%), GoodRx for eight drugs (25%), and SingleCare for four drugs (12%). While prices varied across platforms and savings were drug specific, the cost-plus model used by MCCPD had the lowest pricing for many medications. However, it should be noted that MCCPD was once the most expensive by a considerable margin (e.g. Amlodipine-valsartan-hydrochlorothiazide). While some geographical differences in prices were observed, there were no consistent patterns across regions.
Conclusion
All three platforms have the potential for significant cost savings with no single system being universally superior in offering the lowest price. This analysis highlights a need for price comparison across platforms for individual drugs, especially for uninsured and underinsured individuals with high co-pays. These results may shed some light on the true value of antihypertensive drugs, free from price opacity oftentimes introduced by health plans and pharmacy benefit managers. Physicians, pharmacists, and policymakers can use these findings to educate patients to better navigate healthcare costs and rally support for increased price transparency in the U.S. drug market.

Cross-platform analysis of antihypertensive drug pricing: MCCPD, GoodRx, and SingleCare

Background: Short-term medical missions (STMMs) are widely recognized for delivering healthcare to underserved communities. Tropical climates coupled with sparse dermatology resources contribute to poorer outcomes for patients in these regions especially. STMMs provide a unique experience in training medical students to treat neglected tropical diseases in addition to exposure to foreign medical systems. This study involved second-year preclinical students from Meharry Medical College, along with faculty physicians, partnering with Misión Para Cristo to participate in an STMM in Catacamas, Honduras. 
Objective: The primary objective was to evaluate the ways STMMs enhanced students’ clinical skills. An emphasis was placed on dermatologic and infectious disease cases encountered to highlight the impact of exposure to novel cases through STMMs on quality of medical education.
Methods: Thirteen medical students participated in the study. A preliminary survey was administered assessing subjective competencies before the STMM. Approximately one year post-mission, participants were invited to complete a survey assessing subjective competencies and overall satisfaction with the experience. Descriptive statistics were used for quantitative data analysis, and a Mann-Whitney U-test was conducted to compare medians. Patient diagnostic data was quantified and categorized the types of cases encountered to reflect the diversity of clinical exposure. 
Findings: Survey responses demonstrated significant improvements in clinical skill proficiency: 77% of students reported increased proficiency in vital sign measurement and history taking, 85% in physical examination skills, and 100% in treatment decision-making. Confidence in patient interactions improved in 85% of participants, with a median increase from 2 to 4 on a 5-point scale (p = 0.0008, Mann-Whitney U-test). Student satisfaction with the mission was high; six participants rated preparation for third-year clinical rotations a 5/5, and eleven rated opportunities to lead patient interactions a 5/5. Dermatologic concerns accounted for 10% of the total cases seen with significant overlap with the infectious disease cases that accounted for 21% of the total cases. Patients seen for dermatologic concerns during this STMM most frequently involved eczema, psoriasis, lichen planus, and parasitic infections including cutaneous leishmaniasis. 
Conclusions and Future Directions: Participation in this STMM significantly enhanced students’ clinical skills and confidence with patient interactions. Early clinical exposure to diverse patient populations provides an opportunity to enhance clinical approaches to disease management. These findings underscore the value of STMMs in medical education as an effective tool for building core clinical competencies and strengthening patient communication skills. Further research dedicated to the impact of STMMs on medical education stands to improve the quality of medical education and cultural competency.

The Impact of Global Health Experiences on Dermatologic Medical Education

Background
Clinical reasoning is a cornerstone of effective medical practice, but many medical students face difficulty in developing structured, evidence-based diagnostic approaches early in their training. Traditional methods of teaching diagnostic reasoning rely heavily on clinical exposure and case-based discussions, which may vary in consistency and depth. With the emergence of artificial intelligence (AI) tools such as ChatGPT, an advanced large language model capable of synthesizing clinical information, there is potential to introduce a new, interactive layer to diagnostic education. This study explores the integration of ChatGPT into internal medicine training to enhance diagnostic learning, metacognition, and confidence among medical students.

Methods
We implemented a two-week educational pilot among 22 final-year medical students during their internal medicine rotation. Each student was presented with daily standardized clinical vignettes and was instructed to independently develop a differential diagnosis and initial workup. Afterward, they submitted the same case to ChatGPT and compared the AI-generated response with their own. Students recorded insights and discrepancies in structured reflection logs. At the end of the rotation, a feedback survey was administered to evaluate the tool’s perceived educational value, usability, and influence on diagnostic confidence.

Results
Survey analysis revealed that 91 percent of participants found the AI-generated responses helpful in broadening their differential diagnoses, while 88 percent felt more confident in their diagnostic reasoning after using the tool. Students appreciated ChatGPT’s structured approach, inclusion of red flag symptoms, and reminders of rare conditions. Several noted that the AI helped identify cognitive blind spots and reinforce clinical pathways. However, concerns were expressed regarding the occasional inclusion of outdated or generalized content and lack of source citations. All students emphasized the importance of using ChatGPT under faculty supervision to avoid overreliance or misinterpretation.

Conclusion
The integration of AI tools like ChatGPT into diagnostic education shows promising potential as a supplementary resource. When combined with structured reflection and faculty oversight, AI can enhance clinical reasoning, stimulate curiosity, and bridge knowledge gaps. While not a replacement for clinical experience or traditional teaching, ChatGPT may serve as an effective adjunct in preparing students for real-world diagnostic challenges. Ongoing research is warranted to measure its long-term impact on diagnostic accuracy, knowledge retention, and clinical decision-making.



Incorporating AI Tools Like ChatGPT into Diagnostic Teaching for Medical Students

Background
A national survey revealed that only 9 medical schools met the minimum 25 hours set by the National Academy of Sciences on nutrition instruction.1 There is a gap in nutrition education within medical school curricula, impacting not only future patients but also the physicians
themselves. A qualitative survey was conducted for all graduating fourth-year medical at UTMB to assess their perception on the nutrition education received in their medical education to date. A total of 212 students (96% response rate) reported their top three concerns being lack of nutritional recommendations for obesity, lack of nutritional recommendations for dyslipidemia, and lack of knowledge for nutritional needs during the life course of pregnancy and lactation. This report underscores the lack of nutrition education in existing medical schools and to address this a new interprofessional hands-on session in the Transition to Residency course was created at UTMB.

Methods
The Nutrition 101 workshop was led by a registered and licensed dietitian with a PhD in nutrition. The interactive session was conducted in two cohorts, reaching 79 fourth-year medical students. The workshop covered sustainable eating habits, basic macronutrient and micronutrient information, meal planning, and practical applications like healthy meal preparation. Students'
perceptions were assessed through a post-session survey with a 4-point Likert scale (Not at all, Slightly, Moderately, Significantly) and a yes/no question about their preparedness for intern year.

Results
The survey, completed by 20 students (25.3% response rate), revealed that 42.86% felt the workshop would significantly improve their personal nutrition habits. Additionally, 47.62% reported increased confidence in applying the knowledge gained to future patient care, and 52.38% indicated a significant expansion in their understanding of nutrition principles. Furthermore, 57.89% agreed that the session moderately enhanced their understanding of the
relationship between nutrition and common medical conditions. All (100%) respondents felt better prepared for their intern year after the workshop.

Conclusion
The Nutrition 101 workshop addressed a critical gap in medical education by enhancing both personal and professional nutritional knowledge among future physicians. Integrating such
nutrition curriculum content into both pre-clinical and clinical years is essential for promoting healthier lifestyles among physicians and their patients. This pilot program highlights the need for national curriculum reform to include comprehensive nutrition education throughout medical training and residency programs.

Enhancing Nutritional Competence Among Medical Students: A Pilot Educational Intervention

AMA abstract category: Choose one
Public Health and Health Policy Submissions in Public Health and Health Policy must relate to the science of protecting and improving the health of people and their communities. This work is achieved by promoting healthy lifestyles, researching disease and injury prevention, and detecting, preventing, and responding to infectious diseases. This topic also includes studies on COVID-19, vaccinations, and health equity.
Clinical and Translational Research Submissions in Clinical and Translational Research must center around human subject research aimed towards prevention, diagnosis, or treatment of disease processes either fully in the clinical setting, or as a bridge between the lab and clinical practice.
Note: All abstracts must be submitted using this approved template and must not include pictures, graphs, or tables. The abstract must not exceed 400 words, excluding the abstract title, page numbering, or any ancillary entrant information. Citations or references are not a necessity with the abstract. If your abstract is accepted for consideration, you may include citations or references with your poster.

Abstract Title
Community‐Led Control of Schistosomiasis in Rural Nigeria Using the Foldscope, Environmental Mapping, and Educational Initiatives
Draft 2 (word count 400)
Background
Schistosomiasis is a neglected tropical disease transmitted through freshwater contact, disproportionately affecting children in low-resource settings. In rural Nigeria communities like those in Ogun State, dependence on natural freshwater for daily occupation increased vulnerability to Schistosoma haematobium infection, which can cause hematuria, anemia, and long-term risks including bladder and cervical cancer. Limited clinic access, stigma, and low diagnostic capacity–due to the need for electricity, skilled personnel, and costly equipment of traditional microscopy–delay timely care in these regions.
Methods
This mixed-methods study (July 22 to August 1, 2025) with three components. First, it will evaluate the feasibility and diagnostic potential of a community-led screening strategy using the Foldscope, a $1 paper microscope, paired with a reusable filtration slide. The study will be conducted in Imala and Imala Odo, high-prevalence communities near the Oyan River Dam. Community health extension workers (CHEWs) will be trained to identify Schistosoma ova in urine samples from children and adults. Diagnostic results will be compared to gold-standard microscopy, and participants will receive praziquantel treatment as needed from a local clinician. Interviews with CHEWs and NTD coordinators will assess feasibility for broader implementation. Second, environmental mapping (July 17–22) will use drones and satellite imagery to locate Bulinus snail habitats and model potential transmission zones in arcGIS. Third, to promote local engagement and youth education, we are deploying a large-format, traditionally-woven mat game based on Schisto & Ladders. This locally adapted board game teaches children about symptoms, transmission, and prevention, and will be reimagined into a group game to be played in an educational setting, embodying the principles of disease transmission for spatial understanding.
Results
Preliminary findings from Houston demonstrate that the Foldscope has 79% sensitivity and 100% specificity among untrained users compared to gold-standard microscopy. In Nigeria, we anticipate enrolling 406 participants across Imala and Imala Odo during the study period. Quantitative outcome variables for evaluating Foldscope effectiveness will include sensitivity, specificity, positive and negative predictive values, and overall diagnostic accuracy. Qualitative data will be through focus groups and interviews with CHEWs and local clinicians to assess the acceptability and feasibility of community-led screening. 
For the environmental mapping component, outcome variables will include vegetation density around water access points across 4 transmission hotspot sites, additionally ground-truthing verification of habitat images using vegetation and snail samples.
Conclusion
This project integrates ultra-low-cost diagnostics, geospatial surveillance, and culturally tailored education to support scalable, community-led schistosomiasis control aligned with SDGs 3, 4, 6, and 9.


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Community‐Led Control of Schistosomiasis in Rural Nigeria with a $1 microscope and Drone Mapping

Atrial fibrillation is a common arrhythmia that raises stroke risk, often requiring
anticoagulation. This case report discusses a 79-year-old female with Atrial fibrillation and prior stroke, who was intolerant to anticoagulation due to recurrent bleeding. Percutaneous left atrial appendage occlusion is the next step in management to reduce stroke. She had a patent foramen ovale closure with an Amplatzer septal occluder, posing challenges for the left atrial appendage occlusion procedure. In this case, the watchman device was successfully placed under transesophageal echocardiography and fluoroscopy, avoiding interference with the patent foramen ovale device.

Successful left atrial appendage closure using Watchman in a patient with an atrial septal defect

Educational Objective: At the conclusion of this presentation,
participants should be able to diagnose and treat
coccidioidomycosis in the larynx.​
Objective: To present a rare case of coccidioidomycosis
manifesting as a laryngeal mass and to explore the key clinical
features, diagnostic challenges, and treatment considerations
that can aid in the timely recognition or exclusion of the disease in
future cases. We also review the existing literature of
disseminated coccidioidomycosis to contextualize this case.​
Study Design: A single case report of a patient with
disseminated coccidioidomycosis is described. ​
Methods: A case report of a 26-year-old female with a history of
persistent cough and hoarseness. She presents with persistent
throat issues and voice changes. The patient was initially
prescribed antibiotics, but they were ineffective in resolving her
loss of voice. At presentation, a lesion on the right arytenoid was
found after laryngoscopy. ​
Results: Patient underwent a biopsy. Final pathology revealed
coccidiomycosis in the right supraglottic and right arytenoid
mass. ​
Conclusion: This case report highlights the importance of
including Disseminated Coccidiomycosis in the differential
diagnosis of patients with persistent hoarseness and cough,
especially in endemic regions. ​

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