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Conserved Chromatin Programs Orchestrate Cardiac Cell States In Health And Disease And Drive Cardiomyocyte Proliferation After Injury, Xiaoxiao Geng

ETDs from 2020-2029

Chromatin structure is a central regulator of gene expression and cellular identity, yet the chromatin structural factors driving cardiac disease and regeneration remain incompletely defined. This dissertation investigates how modulation of chromatin architecture shapes pathological and regenerative cardiac phenotypes through integrated single-cell transcriptomic, epigenomic, and functional analyses. To determine whether chromatin structural regulators distinguish healthy from diseased cardiac states, we curated a comprehensive list of chromatin structural genes and applied it to single-nuclei RNA sequencing datasets from human hearts with and without dilated cardiomyopathy (DCM). Chromatin structural gene expression effectively stratified cardiomyocyte and fibroblast populations by disease status. Diseased cardiomyocytes …

Enhancing Rn Confidence In Early Recognition And Treatment Of Sepsis, Tiffany Lee Gossai

Walden Dissertations and Doctoral Studies

Background: Sepsis is a leading cause of mortality in U.S. hospitals, with delays in recognition and treatment significantly contributing to poor patient outcomes. Nurses are essential to early identification and timely intervention; however, gaps in confidence and preparedness persist, particularly among newly hired staff. Traditional educational approaches may be insufficient to support rapid clinical recognition and evidence-based management. Purpose: This staff education project evaluated whether participation in a virtual sepsis escape room during general nursing orientation improved newly hired nurses’ confidence in early identification and treatment of sepsis. Methods: A virtual escape room was integrated into an existing general nursing …

Clinical Practice Guidelines For Suicide Risk Assessment, Jelitta Cleatus

Walden Dissertations and Doctoral Studies

In this doctoral project, I developed a clinical practice guideline (CPG) to address the lack of a standardized suicide risk assessment protocol at a Texas mental health clinic. At project initiation, suicide risk assessment at the facility was inconsistent due to the absence of a CPG. The guideline incorporated the Columbia-Suicide Severity Rating Scale (C-SSRS), a validated instrument that improved early detection of suicidal ideation and behaviors, which were often under recognized in older adults. This inconsistency led to the following clinical question, Does the evidence support the development of a CPG for assessing suicide risk among high-risk patients using …

Staff Education To Improve Nurse Use Of Teach-Back In Outpatient Diabetes Care, Latoya Hodge-Curtis

Walden Dissertations and Doctoral Studies

Type 2 diabetes mellitus is a prevalent chronic condition in the United States, with ineffective patient education and low health literacy linked to poor glycemic control, preventable complications, and increased health care utilization. At the project site, a practice gap was identified related to a lack of knowledge among nurses regarding the use of teach-back strategy for use with Type 2 diabetes education. The practice-focused question was: Does educating nurses on the teach back strategy for Type 2 diabetes improve knowledge as evidenced by pre- to post-survey? This project was implemented using the ADDIE (analysis, design, development, implementation, and evaluation) …

Enhancing Medication Adherence In Home-Based Hypertension Care Through Targeted Staff Education, Marie Lunie Bazile

Walden Dissertations and Doctoral Studies

Summary In this practice-based, quality improvement project, I incorporated a one-group, pre-/posttest design with the aim to evaluate a staff education intervention, reflecting on key principles in improving practice, including continuous evaluation and informing locally based change. This Doctor of Nursing Practice (DNP) project addressed the issue of inconsistent adherence to medication and the lack of staff skills in home-based hypertension management. Notably, the nurse plays an important role in medication adherence to care and in the consistent, evidence-based care with chronic diseases. The practice-focused question was: For home health staff, how does participation in an evidence-based medication adherence education …

Leveraging Informatics To Manage Lifelong Monitoring In Childhood Cancer Survivors, Kimberly Davidow, Renee Gresh, E. Anders Kolb, Ellen Guarnieri, Mary R. Cooper

College of Population Health Faculty Papers

Background: Electronic health records (EHR) have long held promise for sharing information efficiently, but this remains challenging. This quality improvement initiative sought to improve the accurate documentation of anthracycline and radiation therapy exposures in pediatric oncology patients who were treated at different institutions through a quality improvement methodology and EHR tools. Methods: A custom-built EHR smartform was previously created. Modifications were made to the smartform, and quality improvement methods were utilized to improve receipt of radiation summaries from other institutions and documentation of chemotherapeutic doses. Results: Three months after interventions, including clinician education and smartform updates, accurate anthracycline documentation improved …

Establishing T1 And Ecv Mapping Based Nomogram Differentiate Acute Ischemic And Nonischemic Myocardial Injury: A Proof-Of-Concept Study, Yanping Su, Kan Liu, Et Al.

2020-Current year OA Pubs

OBJECTIVES: To develop and validate a nomogram based on T1 and extracellular volume fraction (ECV) mapping derived from cardiovascular magnetic resonance (CMR) for differentiating ischemic from nonischemic cardiomyopathies during the acute phase.

METHODS: This retrospective study included patients who underwent CMR at the Fifth Affiliated Hospital of Wenzhou Medical University (internal dataset) and the Fifth Affiliated Hospital of Sun Yat-sen University (external dataset). Patients were assigned to a training set (n = 73), a test set (n = 30), an internal validation set (n = 28), and an external validation set (n = 16). Six multivariable logistic regression models were …

Retrospective Comparison Of Outcomes Of Osteochondral Allograft Transplantation Of The Knee Using Extended Storage Modality Missouri Osteochondral Preservation System Versus Standard Preservation, Henson Destine, Gaston Davis, Harrison S. Fellheimer, Azra Dees, Nathaniel Kern, Bradford Tucker, Kevin Freedman

Rothman Institute Papers

BACKGROUND: Osteochondral allograft (OCA) transplantation is an established surgical intervention for full-thickness chondral defects. Standard preservation (SP) protocols currently allow for OCAs to be stored for a maximum of 28 days after procurement before significant chondrocyte death. An alternative protocol, the Missouri Osteochondral Allograft Preservation System (MOPS), has been shown to allow for grafts to be stored for twice the maximum time allotment as SP.

PURPOSE: To compare clinical outcomes in patients who have undergone OCA transplantation utilizing the extended storage capabilities of the MOPS versus SP protocols.

STUDY DESIGN: Cohort study; Level of evidence, 3.

METHODS: Patients who underwent …

Partial Versus Full Revision In Cementless Single-Stage Exchange For Hip Periprosthetic Joint Infection: A Multicenter Comparative Study With 10-Year Survivorship Analysis, Wenbo Mu, Atthakorn Jarusriwanna, Boyong Xu, Scot A. Brown, Xiaogang Zhang, Alexander Dawes, Javad Parvizi Md, Li Cao

Rothman Institute Papers

BACKGROUND: Periprosthetic joint infection (PJI) is one of the most challenging complications following total hip arthroplasty (THA). Traditional management typically involves full revision to ensure comprehensive infection eradication. However, for patients with well-fixed implants, partial revision in a single-stage cementless approach may provide a viable alternative, potentially preserving bone stock and reducing operative time. The relative efficacy of this approach compared with full revision remains to be fully explored. This multicenter study aims to determine whether partial revision in cementless single-stage exchange surgery offers comparable infection control outcomes to full revision for select patients with well-fixed implants.

METHODS: We conducted …

Structural Empowerment And The Work Environment Of Nursing Home Care Workers In China, Yawen Ou

Lingnan Theses (MPhil & PhD)

China is experiencing a profound demographic transformation as its population ages rapidly, driven by declining fertility, increased longevity, and long-term effects of the One- Child policy. Traditional family-based elderly care has become increasingly unsustainable due to the pressures of the “4-2-1” family structure and the rising prevalence of empty-nest households. In this context, there is an increasing trend in institutionalized elderly care, accompanied by a growing demand for Nursing Home Care Workers (NHCWs). In spite of their vital importance, NHCWs often face heavy workloads, poor compensation, low recognition, and limited professional autonomy. This study explores the work environment and structural …

Oncofetal Reprogramming: A New Frontier In Cancer Therapy Resistance, Anh Nguyen, Molly Lausten, Bruce M. Boman

Department of Pharmacology, Physiology, and Cancer Biology Faculty Papers

Oncofetal reprogramming has recently emerged as a critical concept in translational cancer research, particularly for its role in driving therapeutic resistance across a variety of malignancies. This biological process refers to a pattern of gene expression that is restricted to embryogenesis, but becomes expressed again in a subpopulation of cancer cells. These genes are typically suppressed after embryogenesis, and their aberrant re-expression in tumors endows cancer cells with stem-like properties and enhanced adaptability. The goal of this review is the following: (i) comprehensively examine the multifaceted nature of oncofetal reprogramming; (ii) elucidate its underlying molecular mechanisms, including its regulators and …

Olutasidenib In Recurrent/Relapsed Locally Advanced Or Metastatic Idh1-Mutated Chondrosarcoma: Phase 1b/2 Trial, Robin L Jones, Roman Groisberg, Jean-Yves Blay, Howard Colman, Macarena De La Fuente, Patricia Roxburgh, Mwe Mwe Chao, Hua Tian, Florence Duffaud, Rastislav Bahleda, Brian A Van Tine

2020-Current year OA Pubs

Chondrosarcomas are rare cartilaginous neoplasms with limited treatment options. Isocitrate dehydrogenase 1/2 (mIDH1/2) mutations occur in 65% of chondrosarcomas. Here we report safety and efficacy of olutasidenib, an mIDH1 inhibitor, evaluated in patients with locally advanced or metastatic mIDH1 chondrosarcoma (Clinicaltrials.gov identifier: NCT03684811). The primary endpoint was objective response rate by tumor evaluation; secondary endpoints included adverse events, progression-free and overall survival. Patients received olutasidenib 150 mg twice daily. Twenty-three patients were enrolled; 16 were diagnosed with conventional chondrosarcoma (cCS). Median age was 57 (range, 30-71) years. In 21 response-evaluable patients, 11 (52%) had stable disease, 8 (38%) had progressive …

Staff Education On Medication Adherence, Jerome Obiagba

Walden Dissertations and Doctoral Studies

Summary The Doctor of Nursing Practice (DNP) project focuses on improving medication adherence in mental health settings, where many patients do not take medications as prescribed, leading to worsening symptoms, relapse, frequent hospitalizations, higher healthcare costs, and reduced quality of life. This problem mainly affects individuals with anxiety, bipolar disorder, major depressive disorder, and schizophrenia, and is often related to poor understanding of treatment, cultural beliefs, or limited access to care. Because nurses play a key role in medication monitoring, education, and patient support, the project examined whether staff education improves nurses’ knowledge, confidence, and effectiveness compared to standard practice …

Staff Education To Streamline Congestive Heart Failure Education, Shannon Hunter

Walden Dissertations and Doctoral Studies

Congestive heart failure (CHF) is a progressive disease that affects a diverse population. Patient-centered education is key to lowering rehospitalizations and mortality rates. Although nurses are essential providers of patient-centered education, those in acute care settings often have unclear directions for implementing and documenting CHF education. Multiple educational materials within electronic health record (EHR) systems further complicate the process and highlight the practice gap. The aim of this Doctor of Nursing Practice (DNP) project was to streamline CHF education by clarifying the role of nurses in education delivery and documentation, potentially enhancing nurse confidence and improving patient health outcomes, with …

Connecting Through Creativity: Enhancing Pediatric Care With Playful Ppe, Betty Abraha, Lauren Burns, Alayna Smith

2025

No abstract provided.

Use Of Electrocardiograms To Identify Coronary Artery Disease: Cross-Validation Of An Artificial Intelligence Model, Michael Leasure, Indu Poornima, Adam Butchy, Utkars Jain, Devin Vasoya, Michael Warnick, Brent Williams, John Rehder, Prahlad Menon, Veronica A. Covalesky, Gary S. Mintz

Department of Medicine Faculty Papers

BACKGROUND: The current gold standard for the diagnosis of coronary artery disease (CAD) is invasive angiography; however, it is an invasive procedure. Therefore, we developed an artificial intelligence model designed to predict significant CAD from a resting digital 12-lead electrocardiogram (ECG).

OBJECTIVES: This retrospective study assessed the model's ability to predict clinically significant CAD in a patient population presenting for coronary angiography.

METHODS: From 2019 to 2021, 16,476 patients had a resting 12-lead digital ECG recorded within 90 days prior to coronary angiography. The artificial intelligence model was developed using 10-fold cross-validation methodology. Clinically significant disease was defined as angiographic …

Dhodh Links Mitochondrial Bioenergetics, One-Carbon Metabolism, And Dna Repair To Sustain Aggressive Prostate Adenocarcinoma, Venugopalareddy Mekala, Jun Hyoung Park, Uttam Rasaily, Vani Venkatappa, Karthik Reddy Kami Reddy, Vasanta Putluri, Kaveri Goel, Sandra L Grimm, Sai Manohar Thota, Taylor Morrison, Cristian Coarfa, Benny Abraham Kaipparettu, Chao Cheng, Nagireddy Putluri, Jeffrey A Jones, Mukesh K Nyati, Michael Ittmann, Natalie R Gassman, Arun Sreekumar

Faculty, Staff and Students Publications

Background

Dihydroorotate dehydrogenase (DHODH) is a mitochondrial enzyme that connects de novo pyrimidine biosynthesis with the electron transport chain (ETC) function. However, its broader role in prostate cancer (PCa) signaling and response to therapy remains unclear.

Methods

We combined transcriptomic, metabolomic, epigenomic, and functional analyses with clinical outcome data to explore the effects of DHODH depletion in ancestry-annotated European American (EA) and African American (AA) prostate cancer cell line models.

Results

DHODH was markedly overexpressed in malignant prostate epithelial cells and was abundant in tumors. Its knockdown hindered cell proliferation by causing pyrimidine depletion, while unexpectedly increasing oxidative phosphorylation, ETC …

An Application-Based Ontological Knowledge Base Of Medications To Support Health Literacy And Adherence For The Consumer Population: An Aging Population Use Case, Renata Komalasari, Cui Tao

Faculty, Staff and Student Publications

No abstract provided.

Efficacy And Safety Of Letrozole, Misoprostol And Their Combination In First Trimester Missed Miscarriage: A Randomised Clinical Trial, Mohamed Fikry Yousef, Mamdouh Abdelfatah Sheeba, Hany Saad Amin Mohamed, Abdelrahman Adel Abdelmonem Salama, Ahmed Hassan, Marwan Taghian, Mahmoud Mostafa Hassan Ali, Ahmed Ragab Ebrahim Ragab, Ahmed Hassan, Amira Alasmer, Mohamed Ramadan Mohamed

Sultan Qaboos University Medical Journal

Objectives: This study evaluated the efficacy and safety of misoprostol, letrozole and their combination in first trimester missed miscarriage. Methods: This single-blind, randomised controlled trial was conducted between March 2023 and August 2024 among women diagnosed with first trimester missed miscarriage at Kasr Al-Aini Hospital, Cairo, Egypt. Participants were randomly assigned to three groups: misoprostol-only (Group A), letrozole plus misoprostol (Group B) and letrozole-only (Group C). The primary outcome was the rate of complete miscarriage. Secondary outcomes included abortion timing, adverse effects, need for surgical evacuation and the effect of age, body mass index (BMI) and gestational age on success. …

Downregulation Of Slc40a1 Leads To Iron Accumulation In Fibrotic Lung Fibroblasts, Quanjin Dang, Chaoqun Huang, Yurong Liang, Akshaya Surendran, Dharanya Muthiah, Sankha Hewawasam, Lin Liu

Faculty, Staff and Student Publications

Iron is an essential nutrient for almost all organisms. However, excess iron generates reactive oxygen species and causes tissue injuries. Iron is implicated in idiopathic pulmonary fibrosis (IPF). In this study, we examined iron accumulation in fibrotic lung fibroblasts and the underlying mechanisms. We hypothesize that the downregulation of Solute Carrier Family 40 Member 1 (SLC40A1) results in iron accumulation in lung fibroblasts of IPF patients. Using a Prussian Blue iron staining, we found that iron accumulated in the fibrotic region of the lungs from IPF patients and bleomycin- and asbestos-induced lung fibrosis mice. Iron was partially co-localized with the …

The Origin Of Hepatocellular Carcinoma Depends On Metabolic Zonation, Jason Guo, Roger Liang, Andrew Chung, Zhijie Li, Boyuan Li, Lin Li, Meng-Hsiung Hsieh, Ivy Xiangyi Fang, Benjamin Kroger, Yunguan Wang, Min Zhu, Xiongzhao Ren, Greg Mannino, Yuemeng Jia, Yonglong Wei, Stephen Moore, Daniel J Siegwart, Stephen S Chung, Zixi Wang, Tripti Sharma, Suman Komjeti, Yi Han, Purva Gopal, Guanghua Xiao, Tao Wang, Hao Zhu

Faculty, Staff and Student Publications

The origin of cancer is poorly understood because premalignant cells are rarely followed in their native environments. Although the spatial compartmentalization of metabolic functions is critical for proper liver function, it is unknown whether cancers arise from some zones but not others and whether there are metabolic determinants of cancer risk. Zone-specific, mosaic introduction of Ctnnb1 (catenin beta 1) and Arid2 (AT-rich interaction domain 2) mutations, commonly co-mutated genes in hepatocellular carcinoma (HCC), in mouse models showed that position and metabolic context determine clone fates. Ctnnb1/Arid2-driven cancers were much more likely to arise in zone 3. The …

Seipin Expression In Hepatocytes Impairs The Assembly Of Vldls And Exacerbates Steatohepatitis, Qianqian Dong, Yidan Ma, Xin Chen, Xiaowei Wang, Ziwei Liu, Liwen Qiu, Jin Wu, Yang Liu, Xiaoqin Wu, Yaru Zhou, Mingming Gao, Hongyuan Yang

Faculty, Staff and Student Publications

VLDLs are crucial for maintaining liver and whole-body lipid homeostasis. Limited knowledge exists regarding the lipidation process of VLDL. Endoplasmic reticulum (ER) luminal lipid droplets (LLDs) have been suggested to provide lipids for VLDL lipidation and maturation. Seipin, an integral membrane protein of the ER, plays key roles in the formation of cytoplasmic LDs (CLDs) and adipocyte differentiation. Surprisingly, seipin is hardly detectable in hepatocytes. Given the critical contribution of seipin in forming CLDs, we hypothesize that the absence of seipin in hepatocytes might ensure the proper formation of LLDs and the lipidation and assembly of VLDLs. To explore the …

Comparative Outcomes Of Abdominal, Laparoscopic, And Vaginal Sacral Colpopexy: A National Analysis Of Apical Suspension Procedures (2014–2022), Smit Bharat Solanki, Apurva B Pancholy, Vishal Pancholy

Faculty, Staff and Student Publications

Objective: Sacral colpopexy is a well-established procedure for apical suspension, but the relative outcomes of abdominal, laparoscopic, and vaginal approaches remain debated. This study compared perioperative outcomes across these surgical routes using a national database and evaluated trends in robotic assistance.

Materials and methods: We analyzed sacral colpopexy cases from the American College of Surgeons National Surgical Quality Improvement Program between 2014 and 2022. Patient demographics, complication rates, and surgical outcomes were compared among abdominal, laparoscopic, and vaginal procedures. Relative risks (RR) were adjusted for confounders. The utilization of robotic systems in laparoscopic procedures was examined.

Results: Among 61,524 cases, …

Shingles: A Case Report, Michele White Dds, Ryan Vahdani Dds, Mha, Gary Frey Dds, Ben Warner Ms, Dds, Md

The Journal of the Michigan Dental Association

This case report details a 58-year-old male who presented at a dental urgent care clinic with oral pain and a facial rash. The report identifies the condition as shingles (herpes zoster), caused by the reactivation of the varicella-zoster virus. It explores the clinical presentation, differential diagnosis—distinguishing it from Ramsay Hunt Syndrome and Bell’s palsy—and emphasizes the importance of early antiviral treatment. Furthermore, the source highlights the role of dental practitioners in identifying infectious diseases and promoting vaccination. It serves as an educational tool for medical and dental clinicians to enhance collaborative care and expedite treatment through better recognition of shingles …

Comparative Analysis Of Mmpi-2-Rf Scale Differences Based On History Of Mild Traumatic Brain Injury, Arielle Mousseau, Linda Baum, Nikolaus Greven, Anna S. Ord

Archives of Assessment Psychology

The present study investigated differences in MMPI-2-RF scale scores between individuals with and without a history of mild traumatic brain injury (mTBI). The goal was to identify distinct psychosocial functioning patterns in individuals with mTBI. Archival outpatient sample of 147 adults aged 18 to 70 (M = 43.28, SD = 11.13) was utilized, comprising 65 participants with mTBI and 82 without TBI. Significant differences were observed across multiple MMPI-2-RF scales. The group with mTBI history exhibited higher levels of symptom overreporting, symptom validity concerns, emotional and internalizing dysfunction, somatic and cognitive complaints, and negative emotionality, as compared to the …

Mental Health First Aid Training In K-12 Schools, Jenna L. Workman, Brianna L. Schierberg, Grace H. Sullivan, Erin Robinson

Posters-at-the-Capitol

The increasing prevalence of mental health challenges among school-aged children has become a rising public health concern. Recent data indicates that nearly 70% of schools report heightened mental health problems among students, with anxiety and depression being most common (National Center for Education Statistics, 2024). The purpose of this capstone project is to raise awareness of mental health issues in K–12 public schools and to increase faculty and staff confidence in recognizing and assisting students experiencing mental health difficulties through nurse-led Mental Health First Aid (MHFA) training. Using Peplau’s Interpersonal Relations Theory as a guiding framework, this project emphasizes the …

The 24 Hour Rule: Science Over Subds Improving Newborn Physiological Stability, Paige Orth, Grace Brown, Jena Rhoads, Erin Robinson

Posters-at-the-Capitol

The first few hours after birth are the most crucial period in a newborn’s life. Adapting to a world outside of the womb can be both challenging and stressful, leaving the neonate susceptible to many health complications. The purpose of this project is to explore if delaying the first bath for 24 hours improves the physiological stability of the newborn. Bathing time policies vary among hospitals, and there is no clear set time to follow. The importance of this project is to address the inconsistencies throughout hospital bathing policies and implement a specific 24-hour policy. Multiple databases were used to …

The Effects Of Antihistamines On Drowsiness, Symptom Relief, And Restless Leg Syndrome, Suki Kaur

Posters-at-the-Capitol

“Antihistamine” categorizes a large selection of drugs, all with different side effects and user experiences. This study explores the relationships between allergy medicine usage, side effects, symptom relief, and Restless Leg Syndrome (RLS) using data collected from 113 participants of an anonymous online survey. Five hypotheses were tested using chi-square analyses of independence at a significance level of 0.05. The data revealed a strong statistical association between first-generation antihistamine (Benadryl) use and drowsiness, misuse of allergy medicine and RLS, drowsiness and RLS, and duration of use and routine disruption. The data did not find a statistically significant relationship between relief …

Digital Morality And National Values: Pancasila As An Ethical Compass For Technology-Enhanced Counseling In Indonesia, Dominikus David Biondi Situmorang, Hendrik Tuaputimain, Muqaffi Muqaffi, M. Solehuddin

Buletin Konseling Inovatif

The very fast development of Artificial Intelligence (AI), Virtual Reality (VR), Augmented Reality (AR), and Mixed Reality (MR) in the last decade have changed the way of mental health practice internationally, including Indonesia. Although these technologies extend reach, deepen therapeutic engagement, and facilitate clinical analysis, they also present serious ethical challenges with respect to privacy, algorithmic bias, depersonalization, and disparity. This integrative review draws on literature from counseling, digital ethics, immersive technologies, and Indonesian philosophical studies to consider how Pancasila can serve as a culturally situated ethical guide for technology-mediated counseling. The results disclose four overarching themes: shifting role of …

Interpretable Linear Models For Heart Disease Prediction: A Comparative Study, Dipok Deb, Emran Hossain

Data Science and Data Mining

Heart disease remains a leading cause of mortality worldwide, underscoring the importance of accurate and transparent methods for early diagnosis. While many machine learning and artificial intelligence models have demonstrated strong predictive performance, their limited interpretability poses challenges for clinical adoption. In this study, we evaluate three interpretable linear classification models—Generalized Linear Model (GLM) logistic regression, L1-regularized (Lasso) logistic regression, and Linear Discriminant Analysis (LDA)—for heart disease prediction using the Cleveland Heart Disease dataset. Following comprehensive data preprocessing, the models are assessed on a held-out test set using standard evaluation metrics, including accuracy, precision, recall, F1-score, and the area under …