Digital Commons Network^™

A Longitudinal Observational Study Of Medical Cannabis Use And Polypharmacy Among Patients Presenting To Dispensaries In Pennsylvania, Emily R. Hajjar, Allison Herens, Erin L. Kelly, Kayla Madden, Jessica M. Lungen, Brooke K. Worster

College of Pharmacy Faculty Papers

Background: Cannabis use is increasing among adults to treat a variety of health conditions. Given the potential for interactions and adverse events, it is important to assess the use of medical cannabis along with other concomitant medications when assessing for polypharmacy. Methods: The objective of this observational, longitudinal study was to examine medical cannabis (MC) use along with concomitant medications over 12 months in patients with serious medical conditions enrolled in the Pennsylvania (PA) Department of Health’s (DOH) Medical Marijuana Program and to collect and catalog which forms of MC patients are taking along with their concomitant medications. Results: There …

Disruption Of The Interaction Between Mutationally Activated Gαq And Gβγ Attenuates Aberrant Signaling, Jenna L Aumiller, Philip B Wedegaertner

Department of Biochemistry and Molecular Biology Faculty Papers

Heterotrimeric G protein stimulation via G protein-coupled receptors promotes downstream proliferative signaling. Mutations can occur in Gα proteins which prevent GTP hydrolysis; this allows the G proteins to signal independently of G protein-coupled receptors and can result in various cancers, such as uveal melanoma (UM). Most UM cases harbor Q209L, Q209P, or R183C mutations in Gαq/11 proteins, rendering the proteins constitutively active (CA). Although it is generally thought that active, GTP-bound Gα subunits are dissociated from and signal independently of Gβγ, accumulating evidence indicates that some CA Gα mutants, such as Gαq/11, retain binding to Gβγ, and this interaction is …

Mst1-Mediated Phosphorylation Of Nur77 Improves The Endometrial Receptivity In Human And Mice, Xinyu Cai, Yue Jiang, Zhiwen Cao, Mei Zhang, Na Kong, Lina Yu, Yedong Tang, Shuangbo Kong, Wenbo Deng, Haibin Wang, Jianxin Sun, Lijun Ding, Ruiwei Jiang, Haixiang Sun, Guijun Yan

Center for Translational Medicine Faculty Papers

Background: Successful embryo implantation requires the attachment of a blastocyst to the receptive endometrial epithelium, which was disturbed in the women with recurrent implantation failure (RIF). Endometrial β3-integrin was the most important adhesion molecule contributing to endometrial receptivity in both humans and mice. Nur77 has been proven indispensable for fertility in mice, here we explore the role of Nur77 on embryo-epithelial adhesion and potential treatment to embryo implantation failure.

Methods: The expression and location of Mst1 and Nur77 in endometrium from fertile women and RIF patients were examined by IHC, qRT-PCR and Western blotting. In vitro kinase assay following with …

Use Of Serial Smartphone-Based Assessments To Characterize Diverse Neuropsychiatric Symptom Trajectories In A Large Trauma Survivor Cohort, Francesca L Beaudoin, Xinming An, Archana Basu, Yinyao Ji, Mochuan Liu, Ronald C Kessler, Robert F Doughtery, Donglin Zeng, Kenneth A Bollen, Stacey L House, Jennifer S Stevens, Thomas C Neylan, Gari D Clifford, Tanja Jovanovic, Sarah D Linnstaedt, Laura T Germine, Scott L Rauch, John P Haran, Alan B Storrow, Christopher Lewandowski, Paul I Musey, Phyllis L Hendry, Sophia Sheikh, Christopher W Jones, Brittany E Punches, Michael C Kurz, Robert A Swor, Vishnu P Murty, Meghan E Mcgrath, Lauren A Hudak, Jose L Pascual, Elizabeth M Datner, Anna Marie Chang, Claire Pearson, David A Peak, Roland C Merchant, Robert M Domeier, Niels K Rathlev, Brian J O' Neil, Paulina Sergot, Leon D Sanchez, Steven E Bruce, Justin T Baker, Jutta Joormann, Mark W Miller, Robert H Pietrzak, Deanna M Barch, Diego A Pizzagalli, John F Sheridan, Jordan W Smoller, Steven E Harte, James M Elliott, Karestan C Koenen, Kerry J Ressler, Samuel A Mclean

Department of Emergency Medicine Faculty Papers

The authors sought to characterize adverse posttraumatic neuropsychiatric sequelae (APNS) symptom trajectories across ten symptom domains (pain, depression, sleep, nightmares, avoidance, re-experiencing, anxiety, hyperarousal, somatic, and mental/fatigue symptoms) in a large, diverse, understudied sample of motor vehicle collision (MVC) survivors. More than two thousand MVC survivors were enrolled in the emergency department (ED) and completed a rotating battery of brief smartphone-based surveys over a 2-month period. Measurement models developed from survey item responses were used in latent growth curve/mixture modeling to characterize homogeneous symptom trajectories. Associations between individual trajectories and pre-trauma and peritraumatic characteristics and traditional outcomes were compared, along …

Graph Theoretical Measures Of Fast Ripple Networks Improve The Accuracy Of Post-Operative Seizure Outcome Prediction, Shennan A Weiss, Itzhak Fried, Chengyuan Wu, Ashwini Sharan, Daniel Y. Rubinstein, Jerome Engel, Michael R Sperling, Richard J Staba

Department of Neurosurgery Faculty Papers

Fast ripples (FR) are a biomarker of epileptogenic brain, but when larger portions of FR generating regions are resected seizure freedom is not always achieved. To evaluate and improve the diagnostic accuracy of FR resection for predicting seizure freedom we compared the FR resection ratio (RR) with FR network graph theoretical measures. In 23 patients FR were semi-automatically detected and quantified in stereo EEG recordings during sleep. MRI normalization and co-registration localized contacts and relation to resection margins. The number of FR, and graph theoretical measures, which were spatial (i.e., FR rate-distance radius) or temporal correlational (i.e., FR mutual information), …

Implementation And Outcomes Of The Trauma Ambassadors Program: A Case Study Of Trauma-Informed Youth Leadership Development, Jeanne Felter, Phd, Lpc, He Len Chung, Amanda Guth, Stephen Didonato, Phd, Lpc, Ncc

Counseling and Behavioral Health Faculty Papers

Community-based programs serve a critical need for vulnerable youth and families. In recent years, researchers and practitioners have urged programs to adopt a trauma-informed care (TIC) approach to address adversity in young people's lives. The purpose of this article is to describe the implementation and outcomes of the Trauma Ambassador (TA) Program, a pilot youth leadership program guided by a community-university partnership that utilized a TIC approach in an underserved East North Philadelphia neighborhood. Fourteen youth engaged in interactive trainings to build their understanding of trauma and develop practical tools to support encounters with individuals with trauma histories. Focus groups …

An Entosis-Like Process Induces Mitotic Disruption In Pals1 Microcephaly Pathogenesis, Noelle A Sterling, Jun Young Park, Raehee Park, Seo-Hee Cho, Seonhee Kim

Center for Translational Medicine Faculty Papers

Entosis is cell cannibalism utilized by tumor cells to engulf live neighboring cells for pro- or anti-tumorigenic purposes. It is unknown whether this extraordinary cellular event can be pathogenic in other diseases such as microcephaly, a condition characterized by a smaller than normal brain at birth. We find that mice mutant for the human microcephaly-causing gene Pals1, which exhibit diminished cortices due to massive cell death, also exhibit nuclei enveloped by plasma membranes inside of dividing cells. These cell-in-cell (CIC) structures represent a dynamic process accompanied by lengthened mitosis and cytokinesis abnormalities. As shown in tumor cells, ROCK inhibition completely …

Differentiating Pc12 Cells To Evaluate Neurite Densities Through Live-Cell Imaging, Jordyn Karliner, Diane E Merry

Department of Biochemistry and Molecular Biology Faculty Papers

Although PC12 cells are a valuable tool in neuroscience research, previously published PC12 cell differentiation techniques fail to consider the variability in differentiation rates between different PC12 cell strains and clonal variants. Here, we present a comprehensive protocol to differentiate PC12 cells into equivalent neurite densities through live-cell imaging for morphological, immunocytochemical, and biochemical analyses. We detail steps on optimized substrate coating, plating techniques, culture media, validation steps, and quantification techniques.

Point And Counterpoint: Polatuzumab Vedotin In The Front-Line Therapy For Diffuse Large B- Cell Lymphoma, Colin Thomas, Sameep Thapa, Connor Mclaughlin, Molly Halloran, Porcu Pierluigi

Department of Medical Oncology Faculty Papers

No abstract provided.

Jefferson Digital Commons Quarterly Report: October-December 2022, Anita Lai, Mlis

Jefferson Digital Commons Reports

This quarterly report includes:

• Articles
• Conferences and Symposiums
• Dissertations
• Faculty Books
• Grand Rounds and Lectures
• Interprofessional Story Slam
• JCRS Capstone Presentation
• Journals and Newsletters
• Miscellaneous
• Posters
• Scholarly Inquiry
• What People are Saying About the Jefferson Digital Commons

Functional Assessment Data: Current Status Of Federal Initiatives To Support Interoperability Among Post Acute Care Settings, Edgar Chou

Division of Internal Medicine Faculty Papers & Presentations

Health information needed along the transitions in care includes functional status such as self-care abilities assessments. Despite current federal efforts to support interoperability of functional status data, gaps still exist. Functional status assessments are included in data collection instruments widely used in four post acute care (PAC) settings, with each type of setting using a different standard instrument. These various instruments lack a shared standard for the content (meaning) of functional assessment items, necessitating mapping to a standard data terminology. Analysis indicates complete LOINC representation and incomplete SNOMED representation among functional status items and instruments. The new U.S. Core Data …

Robotically Assisted Mitral Valve Repair—Port-Only Totally Endoscopic Approach, Kellen J. Round, Colin C. Yost, Jake L. Rosen, Jenna L. Mandel, Meagan Wu, Luke C. Olson, Jordan E. Goldhammer, T. Sloane Guy

Department of Surgery Faculty Papers

Robotic mitral valve repair (MVR) is an emerging option to treat degenerative valve disease. Compared to open thoracotomy, robotic mitral valve surgery has been shown to afford decreased postoperative length of stay with comparable rates of mortality and morbidity. Among the variety of techniques for robotic MVR, the totally endoscopic approach remains the least invasive method to date. In this report, we describe our technique for totally endoscopic robotically-assisted MVR. In particular, we seek to highlight the use of several unique techniques in MVR. Percutaneous cannulation with use of the endoballoon is employed for cardiopulmonary bypass (CPB), thus avoiding traditional …

Effect Of A Muc5ac Antibody (Npc-1c) Administered With Second-Line Gemcitabine And Nab-Paclitaxel On The Survival Of Patients With Advanced Pancreatic Ductal Adenocarcinoma: A Randomized Clinical Trial, Brandon M Huffman, Atrayee Basu Mallick, Nora K Horick, Andrea Wang-Gillam, Peter Joel Hosein, Michael A Morse, Muhammad Shaalan Beg, Janet E Murphy, Sharon Mavroukakis, Anjum Zaki, Benjamin L Schlechter, Hanna Sanoff, Christopher Manz, Brian M Wolpin, Philip Arlen, Jill Lacy, James M Cleary

Department of Medical Oncology Faculty Papers

Importance: Treatment options are limited for patients with advanced pancreatic ductal adenocarcinoma (PDAC) beyond first-line 5-fluorouracil, leucovorin, irinotecan, and oxaliplatin (FOLFIRINOX), with such individuals commonly being treated with gemcitabine and nab-paclitaxel.

Objective: To determine whether NPC-1C, an antibody directed against MUC5AC, might increase the efficacy of second-line gemcitabine and nab-paclitaxel in patients with advanced PDAC.

Design, setting, and participants: This multicenter, randomized phase II clinical trial enrolled patients with advanced PDAC between April 2014 and March 2017 whose disease had progressed on first-line FOLFIRINOX. Eligible patients had tumors with at least 20 MUC5AC staining by centralized immunohistochemistry review. Statistical analysis …

Inherited Human Itk Deficiency Impairs Ifn-Γ Immunity And Underlies Tuberculosis, Masato Ogishi, Rui Yang, Rémy Rodriguez, Dominic P Golec, Emmanuel Martin, Quentin Philippot, Jonathan Bohlen, Simon J Pelham, Andrés Augusto Arias, Taushif Khan, Manar Ata, Fatima Al Ali, Flore Rozenberg, Xiao-Fei Kong, Maya Chrabieh, Candice Laine, Wei-Te Lei, Ji Eun Han, Yoann Seeleuthner, Zenia Kaul, Emmanuelle Jouanguy, Vivien Béziat, Leila Youssefian, Hassan Vahidnezhad, V Koneti Rao, Bénédicte Neven, Claire Fieschi, Davood Mansouri, Mohammad Shahrooei, Sevgi Pekcan, Gulsum Alkan, Melike Emiroğlu, Hüseyin Tokgöz, Jouni Uitto, Fabian Hauck, Jacinta Bustamante, Laurent Abel, Sevgi Keles, Nima Parvaneh, Nico Marr, Pamela L Schwartzberg, Sylvain Latour, Jean-Laurent Casanova, Stéphanie Boisson-Dupuis

Department of Dermatology and Cutaneous Biology Faculty Papers

Inborn errors of IFN-γ immunity can underlie tuberculosis (TB). We report three patients from two kindreds without EBV viremia or disease but with severe TB and inherited complete ITK deficiency, a condition associated with severe EBV disease that renders immunological studies challenging. They have CD4+ αβ T lymphocytopenia with a concomitant expansion of CD4-CD8- double-negative (DN) αβ and Vδ2- γδ T lymphocytes, both displaying a unique CD38+CD45RA+T-bet+EOMES- phenotype. Itk-deficient mice recapitulated an expansion of the γδ T and DN αβ T lymphocyte populations in the thymus and spleen, respectively. Moreover, the patients' T lymphocytes secrete small amounts of IFN-γ in …

Repurposing Ms Immunotherapies For Cidp And Other Autoimmune Neuropathies: Unfulfilled Promise Or Efficient Strategy?, Felix Kohle, Marinos Dalakas, Helmar C Lehmann

Department of Neurology Faculty Papers

Despite advances in the treatment of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and other common autoimmune neuropathies (AN), still-many patients with these diseases do not respond satisfactorily to the available treatments. Repurposing of disease-modifying therapies (DMTs) from other autoimmune conditions, particularly multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD), is a promising strategy that may accelerate the establishment of novel treatment choices for AN. This approach appears attractive due to homologies in the pathogenesis of these diseases and the extensive post-marketing experience that has been gathered from treating MS and NMOSD patients. The idea is also strengthened by a number …

Ticagrelor Plus Aspirin Vs Clopidogrel Plus Aspirin In Mild Non-Cardioembolic Ischemic Stroke: A Protocol Of A Randomized, Controlled, Active Comparator Arm, Outcome Assessor Blind, Feasibility Study, Athena Sharifi-Razavi, Amir Moghadam Ahmadi, Nasim Tabrizi, Razieh Daz

Farber Institute for Neuroscience Staff Papers and Presentations

Background & Objectives: The risk of recurrence after a transient ischemic attack (TIA) or minor stroke is high especially within three months after first event. The aim of study is assessing the efficacy of ticagrelor plus aspirin in reduction of mild non-cardioembolic ischemic stroke or high risk TIA recurrence during first 3 months.

Methods: This is a randomized, controlled, active comparator arm, outcome assessor blind, parallel group, feasibility study design on 90 patients with diagnosis of non-cardioembolic minor ischemic stroke or high risk TIA admitted in Bou-Ali Sina Hospital, Sari, Iran. After meeting all inclusion and exclusion criteria, patients will …

Trial In Progress: Sonoporation For Disrupting The Pancreatic Cancer Microenvironment To Enhance Chemotherapy Delivery And Improve Outcomes, James Posey, John R. Eisenbrey, Babar Bashir, Patrick Mille, Atrayee Basu Mallick, Rajan Singla, Spiros Kotopoulis, Ingrid Nordaas, Audun Magerøy Trelsgård, Tæraneh Jouleh, Georg Dimcevski, Odd Helge Gilja, Flemming Forsberg

Department of Medical Oncology Posters

Background

• Pancreatic ductal adenocarcinoma (PDAC) is 3% of cancers diagnosed in the United States with 62,210 new cases expected in 2022, but it is the fourth leading cause of cancer-related deaths.
• Hence, there is a considerable clinical need to develop innovative strategies for effective drug delivery and treatment monitoring, resulting in improved outcomes for patients with PDAC.
• Sonoporation is a novel method that can enhance the therapeutic efficacy of co-administered chemotherapy by localized contrastenhanced ultrasound imaging (CEUS) of gas-filled microbubbles (ultrasound contrast agent UCA), which temporarily changes the tumor vascular microenvironment by increasing leakage from angiogenic vessels through microstreaming, shockwaves …

An Analytic And Systemic View Of The Digital Transformation Of Healthcare, Xuejuan J. Zhang

Full-Text Theses & Dissertations

Industry 4.0 represents a digital revolution that is driven by technologies that blur the lines between the physical and digital worlds. Industry 4.0, the latest industrial revolution, is poised to have a profound impact on all aspects of society. In order to understand how the healthcare industry is being transformed by the convergence of the physical and digital realms, a systems perspective is taken in this study. Two research questions are addressed regarding the opportunities and interventions that can be provided by both analytical and systems conceptions of digital transformation. I use a systemic literature review approach to address the …

Soft System Methodology Applied To Stakeholder Engagement In Social Services Nonprofit Organizations, Robyn Chin

Full-Text Theses & Dissertations

This dissertation explored the challenges of a Community Development Financial Institution (CDFI), a non-profit social service organization, and the value of employing a systems thinking approach to problem formulation and problem-solving to address its challenges. Soft Systems Methodology (SSM), a systems-informed framework, encourages collective learning and fosters an appreciation for differing perspectives about problem formulation amongst stakeholders instead of rushing to solve predefined issues. One common challenge from current research is that due to reliance on sparse profits and grants earmarked for programmatic endeavors, there is insufficient funding for organizational development. The literature also identified a deficit in stakeholder engagement …

Food Insecurity In The Working Poor, Carol L. Haines

Full-Text Theses & Dissertations

Food insecurity in the working poor impacts many stakeholders other than the individuals unable to obtain enough healthy food. These stakeholders include employers, care providers, insurance companies and the government. Although there are some programs available to improve food insecurity conditions, more can be done by bringing together these varied stakeholders. This dissertation examines the opinions of many stakeholders to understand if novel ideas would improve food insecurity in the working poor.

Because the causes for individuals suffering from food insecurity are dissimilar, food insecurity is a complicated problem which can only be improved by applying many different solutions. A …

The New Jersey Fee-For-Service Model: Evidence Of Social Entrepreneurship In A New Public/ Private Business Relationship, Christine Wiltsee

Full-Text Theses & Dissertations

This dissertation focuses on a shift in the case management function in New Jersey’s Division of Developmental Disabilities. The shift, predicated on the state operating within the Medicaid Home and Community Based Model, resulted in a restructuring from exclusively state operated services to a new public/private relationship. The focus of this study was the unique market opportunity that resulted and the engagement of social entrepreneurs. Using the framework developed by Dees (1998), the characteristics of a social entrepreneur were explored. Through semi-structured interviews with individuals who initiated new for-profit businesses in social services, data were collected that evaluated and compared …

Anxiety And Uterine Artery Doppler Flow In A Population Of Pregnant Women Of High Risk Down Syndrome Fetus: A Prospective Cohort Study, Mahboobeh Shirazi, Mehnoosh Torkzaban, Margan Ghaemi, Maryam Moshfeghi, Mahmood Shirazi, Maryam Emadzadeh, Lida Ahmadi, Zahra Khazaeipoor, Sara Mirzaeian

Department of Radiology Faculty Papers

Background: Fetal exposure to maternal anxiety is associated with low birth weight and maternal stress may be led to constriction of uterine arteries. This study compared the relation of anxiety and uterine artery doppler flow indices in pregnant women with the high and low-risk of Down syndrome.

Materials and methods: This prospective cohort study was conducted among pregnant women in the second trimester that were classified as having a high or low risk according to their prenatal aneuploidy screening outcome. The high risk group underwent amniocentesis. Anxiety was initially assessed using the Spielberger State-Anxiety Inventory (STAI) and uterine artery blood …

Contrast-Enhanced Ultrasound Li-Rads: A Pictorial Review, Osama Mahmoud, Ajay Makkena, Corinne E. Wessner, Ji-Bin Liu, John Eisenbrey, Andrej Lyshchik

Department of Radiology Faculty Papers

The American College of Radiology has implemented the Liver Imaging Reporting and Data System (LI-RADS) to help detect, interpret, and guide the management of suspected lesions on surveillance imaging for hepatocellular carcinoma (HCC) in patients with cirrhosis. The classification of indeterminate nodules with a grading algorithm can be used for multiple imaging modalities (US, CT, and MRI) and incorporates multiple imaging features to appropriately classify observations with different likelihood of being HCC. Contrast-enhanced ultrasound (CEUS) LI-RADS has been fully implemented since 2017. The aim of this pictorial article is to provide a comprehensive review of CEUS LI-RADS utilization, discuss its …

Designing A Digital Employee Experience For Research Administration Using A Sequential Mixed-Methods Approach, Michael A. Jones

Full-Text Theses & Dissertations

This dissertation examines the concept of digital employee experience in the research administration industry. Using a digital employee experience framework, the study examined how the pandemic impacted the research administration work environment. This dissertation presents perceptions and draws insights from research administration leaders, management, and staff on digital work and digital employee experiences through the pandemic. The dissertation was motivated by three research questions: (1) What challenges did research administrators encounter during the Pandemic? (2) What were the research administrators’ perceptions of digital transformation during their employee journey? and (3) What is the future of research administration as the industry …

Assessing The Patient Experience Evaluation Methodology: A Review Of The Hcahps Survey And Related Processes, Michael Molta

Full-Text Theses & Dissertations

The healthcare industry has undergone substantial changes that influence how hospitals evaluate success. Legislation from the Centers for Medicare and Medicaid Services (CMS.gov, 2023) that informs reimbursement levels of patient populations in all U.S. hospitals require organizations to focus on patient experiences, more specifically on scores from the Hospital Consumer Assessment of Healthcare Providers and Systems Survey, referred to as HCAHPS (pronounced H-caps). The Consumer Assessment of Healthcare Providers and Systems Survey or CAHPS® Hospital Survey or Hospital CAHPS® (CAHPS ® is a registered trademark of the Agency for Healthcare Research and Quality). This standardized survey instrument and data collection …

Transitioning Residents Out Of Public Housing, William Franklin Myles

Full-Text Theses & Dissertations

This dissertation examined the transition low-income residents out of federally subsidized housing. Housing programs are important because they provide decent, safe, and sanitary housing to millions of individuals who are economically disadvantaged. In some research, it has been determined that people from public housing experience difficulties in gaining access to resources that would enable them to transition out of public housing successfully. This becomes an added hurdle faced by those who desires to transition out of public housing. Understanding their experiences, their feelings, and their belief system provides a level of education into why it becomes difficult for individuals to …

Redesigning Athlete Leadership, Derek Hunsberger

Full-Text Theses & Dissertations

This dissertation explores the critical role of team captains in fostering effective leadership within athletic teams, utilizing a novel approach that integrates systems thinking and design thinking principles. It challenges the prevailing practice of coaches selecting team captains based solely on athletic prowess or popularity, highlighting the need for a more comprehensive and strategic approach to leadership identification and development.

The research employed an Idealized Design session as a unique methodology to gather insights and perspectives from key stakeholders, including coaches, athletes, and support staff. This approach seeks to uncover latent needs and systemic factors influencing team dynamics, leadership effectiveness, …

Understanding And Application Of Systems Thinking To Diversity Challenges At Higher Education Institutions, Odell Jones

Full-Text Theses & Dissertations

This research argues that establishing and sustaining leadership diversity within Higher Education Institutions (HEIs) is a complex-systems challenge and that those responsible for leading efforts to establish and sustain diversity, referred to as DEI leaders, should adopt a mindset of systems thinking and apply problem-solving methods and tools informed by systems thinking. Semi-structured interviews with DEI Leaders at HEIs were conducted regarding background and perceptions of their work, and how they thought about and made choices concerning diversity challenges. Interview questions were designed to gain an understanding of the degree to which these leaders think about DEI and if they …

Respiratory Therapy Staff Retention: A Systems Thinking Approach, Jerin G. Juby

Full-Text Theses & Dissertations

Respiratory therapists are an integral part of the healthcare workforce in the United States. The healthcare workforce shortage accelerated by the COVID global pandemic has impacted respiratory therapy departments across the nation, with organizations struggling to hire and retain staff. The prevailing approaches in combating this is linear in nature and does not consider the complexity of the system. The purpose of this dissertation is to address retention issues in respiratory therapy departments from a systems thinking approach and to develop a prototype utilizing systems thinking methodologies and tools.

Nasal Accumulation And Metabolism Of Δ9-Tetrahydrocannabinol Following Aerosol (‘Vaping’) Administration In An Adolescent Rat Model, Alexa Torrens, Christina M Ruiz, Maricela X Martinez, Alex Mabou Tagne, Pritam Roy, Dakota Grimes, Faizy Ahmed, Valeria Lallai, Victoria Inshishian, Malia Bautista, Yen-Chu Chen, Marilyn A. Huestis, Aditi Das, Christie D Fowler, Stephen V Mahler, Daniele Piomelli

Institute of Emerging Health Professions Faculty Papers

Passive aerosol exposure to Δ9-tetrahydrocannabinol (THC) in laboratory animals results in faster onset of action and less extensive liver metabolism compared to most other administration routes and might thus provide an ecologically relevant model of human cannabis inhalation. Previous studies have, however, overlooked the possibility that rodents, as obligate nose breathers, may accumulate aerosolized THC in the nasal cavity, from where the drug might directly diffuse to the brain. To test this, we administered THC (ten 5-s puffs of 100 mg/mL of THC) to adolescent (31-day-old) Sprague-Dawley rats of both sexes. We used liquid chromatography/tandem mass spectrometry to quantify the …