Digital Commons Network^™

Axitinib-Pembrolizumab And Adverse Event Management In Patients With Advanced Renal Cell Carcinoma, Neil Shah, Yaa Ababio, Anthony Eccleston, Dharanija Rao, Scott Kelly, Jane Chang, Sarah Lucht, Caleb Paydar, Bryce Van Doren, Emily Bland, William John, Sarah Giegerich, Jalyna Laney, Bruce Feinberg, Kevin Zarrabi

Kimmel Cancer Center Faculty Papers

IMPORTANCE: Understanding approaches to managing treatment-related adverse events (AEs) in immunotherapy and tyrosine kinase inhibitor-based treatments in a clinical setting is critical for reaching optimal patient outcomes.

OBJECTIVE: To investigate the management of AEs in community practices during first-line axitinib plus pembrolizumab therapy for advanced renal cell carcinoma (aRCC).

DESIGN, SETTING, AND PARTICIPANTS: This study comprised a cross-sectional electronic physician survey and a multisite, retrospective cohort study of the medical records of US patients with aRCC who initiated first-line axitinib-pembrolizumab between April 22, 2019, and January 31, 2024. Data were analyzed from September 18 to December 20, 2024.

EXPOSURE: First-line …

Titanium Dioxide: An Inquiry Into The Mechanisms And Implications Of Exposure In Gut Dysbiosis And Metabolic Disorders, Meghan Gardiner

Senior Honors Theses

Titanium dioxide (TiO₂) is one of the most prevalent food additives utilized in commercial products in the United States. While TiO₂ was originally hailed as a nontoxic and cost-effective additive, studies are beginning to reveal that TiO₂ is not as safe as it once seemed. TiO₂ may contribute to the development of insulin resistance and metabolic disorders through direct and indirect mechanisms. The compound induces gut dysbiosis, leading to alterations in bacterial metabolites and pro-inflammatory cytokines, which results in the selective resistance of glucocorticoid receptors. Additionally, TiO₂ itself can translocate from the gut to …

Co-Occurring Clonal Hematopoiesis Exhibits Strong Selection And High Leukemia Risk, Kara M Barnao, Aubrey K Hubbard, Irenaeus C C Chan, Weiyin Zhou, Yasminka A Jakubek, Giulio Genovese, Wendy S W Wong, Rebecca L Kelly, Corey D Young, Derek W Brown, Wen-Yi Huang, Neal D Freedman, Kristine Jones, Amy Hutchinson, Belynda Hicks, Duc Tran, Donna Arnett, Kathleen C Barnes, Joshua C Bis, Eric Boerwinkle, Jennifer A Brody, April P Carson, Daniel I Chasman, Michael H Cho, Pinkal Desai, Margaret F Doyle, Myriam Fornage, Xiuqing Guo, Nancy Heard-Costa, Marguerite Ryan Irvin, Andrew D Johnson, Sharon L R Kardia, Charles Kooperberg, Daniel Levy, Joshua P Lewis, Yun Li, Ruth J F Loos, Taralynn M Mack, Rasika A Mathias, Braxton D Mitchell, Kari E North, Nathan Pankratz, Patricia A Peyser, Michael H Preuss, Bruce M Psaty, Laura M Raffield, Susan Redline, Stephen S Rich, Jerome I Rotter, Edwin K Silverman, Albert V Smith, Jennifer A Smith, Adrienne Stilp, Yin Cao, Paul Scheet, Alexander P Reiner, Alexander G Bick, Stephen J Chanock, Paul L Auer, Kelly L Bolton, Mitchell J Machiela

Faculty, Staff and Student Publications

Clonal hematopoiesis of indeterminate potential (CHIP) and mosaic chromosomal alterations (mCAs) are two types of clonal hematopoiesis (CH) associated with hematological parameters and malignancy risk. Here we show, in genomic data from 546,090 biobank participants, that co-occurring CH (≥2 CH mutations detected) is present in 1.6% of cancer-free individuals and shows strong evidence for selection (up to 804x enrichment). Co-occurrence is more frequent in those with a prior cancer (3.6%), suggesting treatment-induced selection. Acquisition of CHIP usually precedes mCAs with co-occurrences manifesting stronger phenotypic disruptions in telomere attrition and hematologic parameters than component CH events. Individuals with co-occurring CH have …

Using The Socio-Ecological Model To Explore Parents' Resilience And Perceptions Of Adverse Childhood Experiences: A Qualitative Study In The Southeastern United States, Maribel G Dominguez, Christine Markham, Andrew E Springer, Louis D Brown

Faculty, Staff and Student Publications

Background: The negative impact of adverse childhood experiences (ACEs) on child development is documented. The parent-child relationship protects against ACEs and improves healthy child development, playing a crucial role in preventing and mitigating ACEs by strengthening parental resilience. However, there is a gap in the literature on our understanding of parental resilience's impact on the parent-child relationship within the social-ecological model (SEM) (i.e., intra- and interpersonal, community, and societal levels). Objective: This study explores parents' perspectives on parental resilience as a protective factor for preventing and mitigating ACEs at every level of the SEM. Method: This study uses a thematic …

Evaluating The Association Between Chronic Health Conditions And Caregiver Burden For Male Dementia Caregivers, Dareion D. Hill-Smith

Walden Dissertations and Doctoral Studies

No abstract provided.

Teaching Motivational Interviewing Techniques To Nursing Staff To Improve Glycemic Control In Patients With Diabetes, Augustine Ngouondjyou Fotsing

Walden Dissertations and Doctoral Studies

No abstract provided.

Circulating Metabolites Associated With Protection Against Mycobacterium Tuberculosis Infection And Inhibition Of Mycobacterial Growth, Todia P Setiabudiawan, Lika Apriani, Julian Avila-Pacheco, Edwin Ardiansyah, Vinod Kumar, Bachti Alisjahbana, Ayesha J Verrall, Andrew R Dinardo, Agnes R Indrati, Vera P Mourits, L Charlotte J De Bree, Simone J C F M Moorlag, Clary B Clish, Leo A B Joosten, Arjan Van Laarhoven, Krista E Van Meijgaarden, Mihai G Netea, Simone A Joosten, Valerie A C M Koeken, Philip C Hill, Reinout Van Crevel

Faculty, Staff and Students Publications

A significant proportion of individuals who are heavily exposed to infectious tuberculosis patients do not acquire Mycobacterium tuberculosis (Mtb) infection, as detected by an interferon gamma release assay (IGRA). We examined circulating metabolite profiles and metabolic genotypes in 199 heavily exposed IGRA-negative tuberculosis household contacts in Indonesia. Based on differentially abundant metabolites, activity of several pathways including arachidonic acid, arginine and proline, glutathione, and tryptophan metabolism, correlated with a negative IGRA at three months. SNPs near PRODH (involved in arginine and proline metabolism) were associated with circulating proline concentrations and persistently negative IGRA results, while SNPstudys near AFMID (involved in …

Hiv/Aids-Related Awareness And Misconceptions Among Grade 10 Students In Muttrah Wilayat, Muscat, Oman: A Descriptive, Cross-Sectional Study, Rahma Abdullah Al Riyami, Balqees Ahmed Al -Maawali, Nabila Hamood Al Wahaibi, Mariam Rashid Al Rashdi, Fatma Ahmed Al Hinai

Sultan Qaboos University Medical Journal

Objectives: Despite Oman having a low HIV prevalence, stigma and lack of knowledge among young people may hinder prevention efforts. This study aimed to assess HIV/AIDS-related knowledge and misconceptions among Grade 10 students in Muttrah wilayat in Oman. Methods: This cross-sectional study was conducted in February 2025 and included Grade 10 students from 4 governmental schools in Muttrah selected via proportional stratified sampling. The sample size was calculated depending on the number of students in Grade 10. Data collection was performed during face-to-face interviews using a validated Arabic-language questionnaire. Results: A total of 271 Grade 10 students were included in …

Vol 6. May '26 Full Issue, Donna L. Williams

Journal of the Louisiana Public Health Association

No abstract provided.

Implementation Of Vanderbilt Acuity Tool In The Emergency Department, Ogemdi Millicent Asaa

Walden Dissertations and Doctoral Studies

No abstract provided.

The Perijunctional Zone Is A Molecularly Distinct Muscle Subdomain Altered In Duchenne Muscular Dystrophy, Seth G Haddix, Chuansheng Zhang, Yanhong Liu, Juan Oses-Prieto, Alma L Burlingame, Matthew N Rasband

Faculty, Staff and Students Publications

The neuromuscular junction (NMJ) is a well-established model for synapse development, structure, and function. Surrounding the NMJ is a narrow perijunctional zone (PJZ), enriched in muscle-specific voltage-gated sodium channels that prevent synaptic fatigue. Despite this role, the PJZ remains poorly characterized. To determine its molecular composition, we engineered mice to express the biotin ligase TurboID fused to the cell adhesion molecule neurofascin (Nfasc), and that localizes to the PJZ through ankyrin scaffolding proteins. Using proximity proteomics, we identify numerous PJZ-associated proteins, including Perilipin 4 (Plin4), that are highly enriched and clustered at the PJZ. We also perform proximity proteomics on …

Improving A1c Levels Through An Individualized Diabetes Education Among Patients Living With Type 2 Diabetes, David W. Cardona Jr.

Doctor of Nursing Practice Final Manuscripts

Type 2 diabetes mellitus (T2DM) represents an increasing global health, social, and financial burdens. Nutrition, among other diabetes self-management topics, is a foundational aspect in managing T2DM. Significant knowledge gaps persist among patients regarding the impact of mindful eating habits in relation to euglycemia. Individualized diabetes education focused on healthy eating habits offers a promising strategy to address this gap. The quality improvement (QI) project aimed to evaluate the impact of diabetes education, focused on nutritional awareness, and mindful eating habits on hemoglobin (A1c) levels, weight, and diabetes self-management questionnaire scores (DSMQ-R) were assessed among adults living with T2DM. The …

The Impact Of Translated Phq-9 And Gad-7 Scales On Treatment Recommendations In An Adult Vietnamese Population: A 3-Month Primary Care Evaluation, Vivienne Bui

Doctor of Nursing Practice Final Manuscripts

Depression and anxiety are prevalent yet underdiagnosed in limited-English-proficient (LEP) populations due to language barriers, cultural stigma, and provider bias. Vietnamese-speaking patients are particularly vulnerable to under-recognition in primary care. This quality improvement project evaluated whether implementing Vietnamese-translated Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) tools would improve mental health diagnosis and referral rates. Guided by the Johns Hopkins Evidence-Based Practice Model, a pre–post design was conducted at a San Diego clinic from March 26 to June 26, 2025. Vietnamese-speaking adults (≥18 years) completed translated PHQ-9 and GAD-7 forms during intake. Providers used scores in conjunction with clinical …

Predicting The Risk Of Diabetes Using Machine Learning Algorithms, Noor Ismail Ibrahim, Jamal Kamil Alrudaini, Hytham Falih Hassan, Sahar Faeq Jaafar

Al-Nisour Journal for Medical Sciences

Diabetes is a chronic disorder that many people suffer from. This disease develops when the blood glucose level is high. Serious side effects, such as harm to the heart, kidneys, eyes, and other organs may result from diabetes neglected treatment. Diabetes has numerous causes, including aging, obesity, inactivity, genetics, poor food and lifestyle choices. Early identification of this illness helps lessen its negative consequences. There are many traditional methods for predicting this disease, but they are expensive. Early prediction of diabetes benefits all those at risk by providing early treatment. With the advancement of healthcare technology, machine learning algorithms can …

Advantages Of Treatment Pollution By Nanomaterial: Review, Riyam Lateef Khalaf, Ola Abdulkareem Nori

Al-Nisour Journal for Medical Sciences

Pollution remains one of the most pressing global environmental challenges and is increasing day by day, with serious implications for public health and the environment. Among the various approaches to address this issue, nanotechnology has emerged as a promising solution due to its unique properties, such as high surface area, reactivity, and catalytic efficiency. There are four types of pollution that can be treated by nanotechnology, air pollution, soil pollution, water pollution and light pollution. This review studies recent research on the use of nanoparticles for pollution treatment, focusing on the mechanisms through which they degrade pollutants, the diverse applications …

Allopurinol Beyond Hyperuricemia: A Multifaceted Therapeutic Agent With Expanding Clinical, Safa Khaldoon, Emad Yousif, Khawla A. Kasar, Hazim F. Abbas

Al-Nisour Journal for Medical Sciences

Allopurinol is a well-established xanthine oxidase inhibitor widely used in the management of hyperuricemia, gout, tumor lysis syndrome, and uric acid nephrolithiasis. This review provides a comprehensive overview of its pharmacology, mechanism of action, pharmacokinetics, clinical efficacy, safety profile, and emerging insights from recent clinical and translational studies. Despite being in clinical use for over five decades, allopurinol remains the first-line urate-lowering therapy worldwide due to its proven efficacy, favorable safety profile, and cost-effectiveness. Beyond its classical role in inhibiting xanthine oxidoreductase, increasing evidence highlights additional therapeutic effects, including antioxidant and anti-inflammatory activities. The structural similarity of allopurinol to purine …

Effect Of Different Methods Of Smoking On Serum Level Of Vitamin D Among University Students In Baghdad, Sabiha Aljubory, Usama Salman Altimari

Al-Nisour Journal for Medical Sciences

Vitamin D has different biological actions in the body. Vitamin D has pleiotropic effects in multiple organ systems. Vitamin D deficiency has been found to have an inverse relationship with tobacco smoking. The objective of this study was to identify the prevalence of Vitamin D level and its correlates with tobacco smoking among University student male and female. Volunteer was conducted on a sample of university student, both males and females Iraq, during the period from January to December 2020. A pretested questionnaire was used for data collection adopted from previous standard national surveys and studies, and the questionnaire included …

Barriers To Physical Activity Among Community College Students, Erica Keels

Doctoral Dissertations and Projects

The purpose of this qualitative study was to explore the perceived barriers, motivators, and student-identified strategies related to physical activity among students enrolled at a community college located in Northwest Florida. Guided by the Social Ecological Model (SEM), Self-Determination Theory (SDT), Health Belief Model (HBM), and Theory of Planned Behavior (TPB), this study employed a qualitative descriptive design to examine students’ lived experiences and perceptions that influence their physical activity behaviors. Data were collected through an online open-ended survey administered to students aged 18 years and older. A total of 134 students initially accessed the survey, and 126 eligible participants …

The Relationship Between Mentorship And Career Longevity For New Clinicians In Emergency Medical Services, Katherine Elizabeth Contreras

Doctoral Dissertations and Projects

The purpose of this qualitative descriptive phenomenological study was to understand how mentorship assisted a new Emergency Medical Services (EMS) clinician in navigating the challenges of the first year at an EMS agency in Central Texas. Guiding the study was Lev Vygotsky’s theory of social constructivism, which focuses on knowledge gained through human activities, social interactions, and behavior modeling. Twelve study participants completed one-on-one interviews, two participants completed a single focus group interview, and the researcher conducted naturalistic observations, during which the participants shared personal, firsthand experiences that answered the study’s central research question: How does mentorship help new EMS …

Improving Staff Competence In Phq-9 Administration, Obinna C. Okonkwo

Walden Dissertations and Doctoral Studies

No abstract provided.

An Evidence-Based Practice Trauma-Informed Care And Pediatric Crisis Management Training Initiative, Annette Renea Porter

Walden Dissertations and Doctoral Studies

No abstract provided.

Staff Education To Improve Early-Stage Chronic Kidney Disease Patient Education, Yoel Madruga Reyes

Walden Dissertations and Doctoral Studies

No abstract provided.

Inadequate Access To Healthcare In Low-Income Hispanic Communities In Brooklyn, Joanna Marie Garcia

Doctoral Dissertations and Projects

The purpose of this qualitative research was to understand healthcare disparities using the Solar and Irwin conceptual framework and to shed light on healthcare disparities as the reason low-income Hispanic patients, male and female, from the ages of 20-90 in Brooklyn, New York, received inadequate access to healthcare. Healthcare disparities represented a critical issue in providing adequate patient care for adult Hispanic patients within the United States healthcare system. Research into healthcare disparities has been conducted; however, detailed information about the causes of the disparities was lacking, especially concerning inadequate access to healthcare in low-income Hispanic communities. This qualitative research …

Mitochondrial Ca2+ Uniporter (Mcu) Variants Form Plasma-Membrane Channels, Iuliia Polina, Jyotsna Mishra, Michael Cypress, Maria Landherr, Nedyalka Valkov, Isabel Chaput, Bridget Nieto, Brian Rhee, Ameneh Ahrari, Nathan Demichaelis, Kye-Im Jeon, Ulrike Mende, Peng Zhang, Bong Sook Jhun, Jin O-Uchi

Center for Translational Medicine Faculty Papers

MCU, originally known as CCDC109A, is widely recognized as the gene responsible for encoding a pore-forming subunit of a Ca2+-selective channel, mitochondrial Ca2+ uniporter complex (mtCUC). While MCU expression is typically highly mitochondrial-specific, we report here a protein variant derived from the MCU gene, termed MCU-S, which lacks the mitochondria-targeting sequence (MTS) and forms a Ca2+-permeable channel outside of mitochondria. The mRNA of MCU-S was ubiquitously expressed in all cell types/tissues tested, with particularly high expression in human platelets. MCU-S protein formed Ca2+ channels at the plasma membrane, which exhibited similar channel properties to those observed in mtCUC. MCU-S channels …

Staff Education On Nonpharmacological Sleep Hygiene Strategies, Miranda Akateh Morfaw

Walden Dissertations and Doctoral Studies

No abstract provided.

Clinical Practice Guideline Emergency Department Discharge Acuity Scale To Improve Care Transitions, Charlisa Hedrick

Walden Dissertations and Doctoral Studies

No abstract provided.

Determinants Of Pre-Exposure Prophylaxis Medication Use Among People Aged 18–29 Years Living In Florida, Jeremiah Magraubin Mchaka Wandabwa

Walden Dissertations and Doctoral Studies

No abstract provided.

Staff Education To Improve Early Identification And Management Of Clinical Deterioration In Pediatric Patients Using A Standardized Assessment Protocol, Sarabjit Chahal

Walden Dissertations and Doctoral Studies

No abstract provided.

Movement-Stabilized Three-Dimensional Optical Recordings Of Membrane Potential Changes And Calcium Dynamics In Hippocampal Ca1 Dendrites, Kevin C Gonzalez, Satoshi Terada, Asako Noguchi, George N Zakka, Cliodhna O'Toole, Giuliana Bilbao, Luke Reynolds, Anna Jász, Borbála Kertész, Zoltán Szadai, Alissa Shen, François St-Pierre, Franck Polleux, Attila Losonczy, Balázs Rózsa

Faculty, Staff and Students Publications

Local dendritic computations are thought to critically influence neuronal signaling and plasticity yet remain largely unexplored in vivo due to challenges in stably imaging small structures at ultrafast timescales. We developed a 3D real-time motion correction platform for movement-stabilized, ultrafast two-photon voltage imaging. By co-labeling CA1 pyramidal neurons with voltage and calcium indicators, we simultaneously measured somato-dendritic and electro-calcium coupling at multiple dendritic sites. We characterized isolated dendritic spikes and distance-dependent backpropagation of naturally occurring and photostimulation-evoked bursts and single spikes. We found that bursts backpropagated more reliably than single spikes, validated that somato-dendritic coupling decreases with distance from soma, …

Factors Associated With Vaping Frequency Among University Students, Oluwatosin Marylyn Oduneye

Masters Theses

Electronic cigarette use among university students is a growing public health concern, with approximately 20-25% reporting current use. Despite extensive research on vaping initiation, factors associated with vaping frequency among established users remain understudied. This study examined stress-coping mechanisms, peer influence, and health risk perceptions as predictors of vaping frequency, guided by Bandura's Social Cognitive Theory (SCT). A quantitative cross-sectional survey was administered via Microsoft Forms to 399 university students aged 21-25 with recent vaping experience, recruited nationally through campus flyers and online platforms. Multiple linear regression was conducted in SAS OnDemand for Academics, with stress-coping, peer influence, and health …