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Arranging Hope
Get PDFThe author submitted this entry in the Open Verse Poetry category (Amateur division) for the 2025 On My Own Time™ (OMOT) Art Show.This poem is inspired by my experience volunteering at the hospital front desk during high school. Each day, a florist would arrive with bouquets, and I would deliver them to the patients. These flowers were not only beautiful, brightening up the rooms, but they also brought joy to the patients themselves. I wanted to explore how something as simple as flowers could provide comfort and a deeper sense of hope to those in need
How will I find you
No full textThe author submitted this entry in the Creative Non-Fiction category (Amateur division) for the 2025 On My Own Time™ (OMOT) Art Show.something I wrote while thinking of my older brother who passed away before I was bor
The End
Get PDFThe author submitted this entry in the 10-Word Story category (Amateur division) for the 2025 On My Own Time™ (OMOT) Art Show.This story draws its inspiration from the profound and often silent moments that completely alter a life's trajectory. It explores the devastating power of brevity--how a few chosen words, or even unspoken implications, can carry the weight of an entire world collapsing. It's about the sudden, shocking realization that a chapter has abruptly closed, leaving behind only the echo of what was
Whorls of You
No full textThe author submitted this entry in the Open Verse Poetry category (Amateur division) for the 2025 On My Own Time™ (OMOT) Art Show.Whorls of You was inspired by the idea that presence isn't always loud or visible,sometimes, it lingers quietly, like a fingerprint. I wanted to capture the subtle impact people leave behind, even when they think no one notices. This poem is a reminder that even in silence, absence, or soft moments, something of you remains. It's about honoring the unseen and the undeniable marks we leave on the world and each other
Space
Get PDFThe author submitted this entry in the Open Verse Poetry category (Amateur division) for the 2025 On My Own Time™ (OMOT) Art Show.This poem is a reflection on the experience of performing chest compressions and life-saving CPR. The effort demands so much attention and focus from physicians performing the measures. In turn, it is not until afterwards that one can step back and consider the impact that the experience has on others who watch the events unfold. In this case, it wasn't until after we'd tried to do what we could for nearly half an hour, after blood had filled the space (the bedsheets, our masks and eye protection), that I recognized the patient's mother watching from the corner of the room. She and I were witnessing the same thing in the same room. For that half hour, were inhabited the same space. But we also held the space in such different ways. As a parent, I could only imagine what was going through her mind as she watched us -- without the medical or technical knowledge -- rushing to save her son. I will never forget that image
Victory
Get PDFThe author submitted this entry in the Open Verse Poetry category (Amateur division) for the 2025 On My Own Time™ (OMOT) Art Show.Inspired by a situation that a friend was going through
Cacophony to Symphony
Get PDFThe author submitted this entry in the Open Verse Poetry category (Amateur division) for the 2025 On My Own Time™ (OMOT) Art Show.This chaotic year reminded me that, despite everything, I returned to what brought me to medicine: being a strong advocate for patients. That's inspired me to tell their stories to make a positive change
Machine Learning Techniques for Augmenting Hematological Malignancy Diagnosis
Get PDFThis dissertation examines the use of modern machine learning (ML) methods to enhance the diagnostic workflow of hematological malignancies, particularly in cytogenetics and clinical flow cytometry. The recent advancements in the field of ML provide a unique opportunity to develop, adapt, and evaluate algorithms for augmenting the hematopathology diagnostic workflow. The field of hematology oncology involves a complex range of diseases, and the final diagnosis is reliant on the rapid analysis of several streams of biological data, including morphologic images, cytogenetic micrographs, molecular sequencing data, and high-dimensional multicolor flow cytometry (MFC).
This dissertation explores the various strategies and advantages of using ML to augment this workflow, with a focus on automated screening for clinically informative recurring structural chromosomal abnormalities and serving as a clinical decision support system for clinical MFC data analysis. Most of the data used for this work are from patients with acute myeloid leukemia, but these ML algorithms can easily be extended to other indications. The ML models and techniques applied to cytogenetic micrographs and MFC data are predominantly of the deep learning variety, including convolutional neural networks (CNNs) and graph neural networks (GNNs), along with some other techniques like unsupervised ML, e.g., statistical representation learning and clustering, and graph partitioning.
This research provides two key developments for the field. First, that CNNs can accurately detect over a dozen recurrent structural chromosome abnormalities common in several types of acute and chronic leukemia and simultaneously ignore non-recurrent structural abnormalities, laying the groundwork for an autonomous karyotyping system. Second, the first known application a GNN to MFC data is incredibly robust predicting various subtypes of acute promyelocytic leukemia and could be used as part of a clinical decision support system. Importantly, both these studies emphasize generalizability and explainabiliy. These approaches hold promise for facilitating automated analysis in a prospective randomized study and contribute to the digitization and ML revolution taking place in hematopathology clinics worldwide
Evaluating Visual Cues to Improve Central Line Checklist Adherence: Challenges and Lessons Learned
Get PDFBACKGROUND: Standardizing central line procedures with checklists has been shown to reduce central line-associated bloodstream infections (CLABSIs), which contribute to increased morbidity, mortality, healthcare costs, and prolonged hospital stays. A prior Plan-Do-Study-Act (PDSA) study at our institution resulted in the creation of a central line checklist to standardize bedside central line insertions. While initial adherence rates reached 92% with a paper-based checklist in one ICU, adherence declined following its integration into EPIC and expansion to four additional ICUs. Post-integration survey results indicated adherence had fallen to 57%.
LOCAL PROBLEM: Checklist adherence rates of 57% highlighted a gap in consistent use, raising concerns about the checklist's ability to positively impact on infection prevention efforts. Behavioral and operational barriers, including procedural staff turnover, lack of automation in EPIC, and cognitive overload among nursing staff, were identified as significant contributors to reduced adherence.
METHODS: This study was conducted across five adult ICUs in a teaching hospital using a PDSA framework. Participants included proceduralists (resident physicians, APPs, and faculty), registered nurses, and Unit-Based Educators (UBEs). Baseline adherence data was collected through surveys, which identified barriers such as difficulty accessing the checklist and lack of awareness. Literature reviews and UBE interviews informed the intervention design.
INTERVENTION: To promote checklist use, visual cues in the form of three unique posters were created and reviewed by stakeholders for relevance. Posters were strategically placed in high-visibility areas across the ICUs to maximize exposure and encourage checklist utilization.
RESULTS: Checklist adherence across five ICUs from October 2022 to mid-March 2023 was 47% (138/293), with variability between units. The multispecialty ICU had the highest adherence (56%), while the cardiovascular ICU had the lowest (32%). Adherence rates fluctuated over time, with the highest monthly adherence observed in February (53%) and the lowest in March (44%), though March data were incomplete.
Two outcome measures were evaluated. CLABSI rates varied across units and months, increasing from 0.016 in October to 0.125 in March. Additionally, no statistically significant association was found between checklist completion and first-attempt success rates (p = 0.46).
Survey responses showed that 15 of 21 respondents (71%) were aware of at least one poster, and 10 of 21 (48%) agreed or strongly agreed that the posters were effective reminders of the checklist process. Three respondents (14%) disagreed or strongly disagreed regarding poster effectiveness, while eight (38%) were neutral.
The perception of psychological safety remained stable before and after the intervention. Nurse engagement in checklist completion varied by unit. Although usage of the recommended communication tool was reported, no direct conclusions could be drawn regarding its impact.
CONCLUSION: Although the study did not achieve the 75% adherence target across all units, it provided valuable insights into barriers and opportunities for improvement. Future efforts should prioritize implementing a forced function within EPIC to ensure checklist completion during central line procedures, thereby reducing reliance on voluntary adherence and susceptibility to human error. Tailored education to address specific ICU needs and fostering a culture of safety and collaboration among multidisciplinary teams remain critical priorities. Additionally, retrospective chart reviews could be leveraged to provide more objective pre-intervention data to guide subsequent interventions and refine future strategies
Renal acidosis: more than pH
Get PDFDetailed formal protocol with illustrations and extensive bibliography.A recording of the protocol presentation is available on UT Southwestern’s Mediasite. Note: Access to the video is restricted to authorized UT Southwestern users only.UT Southwestern--Internal Medicin