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Targeting Nstemi Readmissions: Education To Protect The Hearts Of Our Patients, Gisha Gireesan

Master's Projects and Capstones

Section I: Abstract

Problem: January and February 2021 data showed a rise in readmissions for the NSTEMI population. This is significant as 2020 had a readmission rate of 5.6% and 7.3% in 2019. This sudden increase in readmissions within the first two months of the year is a cause for concern and immediate action is needed.

Context: 2020 had a reduction in cardiac catheterizations due to the multiple canceled cases during the COVID 19 pandemic. As the cases were being rescheduled along with new cases in 2021, the institution experienced an uptake in readmissions.

Interventions: The staff of department 220 …

Clabsi Prevention In The Icu-A New Approach, Shannon M. Hicks

Master's Projects and Capstones

Abstract

The Center for Disease Control and Prevention (CDC) emphasizes that the primary cause of preventable deaths and disabilities among hospitalized patients in the United States are hospital-acquired infections (HAIs). Based on the CDC surgical site infection monitoring, common infections include central line-associated bloodstream infection (CLABSI), ventilator-associated pneumonia, and catheter-associated urinary tract infections. This paper primarily focuses on the problem of CLABSI, with an aim to reduce the net occurrences of CLABSIs in the intensive care unit (ICU) through the interventional use of SecurePortIV skin adhesive during the insertion of central lines. Although few researchers have examined the implication of …

Utility Of S100a12 As An Early Biomarker In Patients With St-Segment Elevation Myocardial Infarction, Xiaolin Zhang, Minghui Cheng, Naijing Gao, Yi Li, Chenghui Yan, Xiaoxiang Tian, Dan Liu, Miaohan Qiu, Xiaozeng Wang, Bo Luan, Jie Deng, Shouli Wang, Hongyan Tian, Geng Wang, Xin-Liang Ma, Gregg W Stone, Yaling Han

Department of Emergency Medicine Faculty Papers

Importance: S100A12 is a calcium binding protein which is involved in inflammation and progression of atherosclerosis.

Objective: We sought to investigate the utility of S100A12 as a biomarker for the early diagnosis and prognostication of patients presenting with ST-segment elevation myocardial infarction (STEMI).

Design, Setting, and Participants: S100A12 was measured in 1023 patients presenting to the emergency department with acute chest pain between June 2012 and November 2015. An independent cohort of 398 patients enrolled at 3 different hospitals served as a validation cohort.

Main Outcomes and Measures: The primary clinical endpoint of interest was major adverse cardiac and cerebral …

Creating Cautionary Tales: Institutional, Judicial, And Societal Indifference To The Lives Of Incarcerated Individuals, Nicole B. Godfrey

Arkansas Law Review

It has long been said that a society’s worth can be judged by taking stock of its prisons. That is all the truer in this pandemic, where inmates everywhere have been rendered vulnerable and often powerless to protect themselves from harm. May we hope that our country’s facilities serve as models rather than cautionary tales. Justice Sonia Sotomayor, joined by Justice Ruth Bader Ginsburg, issued the above-quoted clarion call to protect the lives of incarcerated people on May 14, 2020. At that point, the COVID-19 pandemic had brought American society to a standstill for a little more than two months, …

Arkansas Law Review - Volume 74 Number 3, Review Editors

Arkansas Law Review

No abstract provided.

The Minutes Of The Marshall University Staff Council Meeting, December 2021, Marshall University Staff Council

Staff Council Minutes

No abstract provided.

Intrinsically Disordered Protein Regions In Human Evolution And As Therapeutic Targets, Karen Paco Mendivil

KGI Theses and Dissertations

Intrinsically disordered proteins (IDPs) and IDP regions (IDPRs) fail to form stable structures but have important biological functions via interacting with various molecular partners (proteins, DNA, RNA, glycosaminoglycans). We hypothesized that IDPRs are potential targets for therapeutics development because they are reservoirs of evolutionary innovation, and they play crucial roles in adaptation to pathogens.

We first studied the evolution of IDPRs in the human proteome and compared it with the proteome of non-human primates. We have found that evolutionary young protein-coding genes have included low conserved regions in the N-terminal part of proteins, and such regions are linked to high …

Skin Bacterial Metacommunities Of San Francisco Bay Area Salamanders Are Structured By Host Genus And Habitat Quality., Shannon Buttimer, Obed Hernandez-Gomez, Erica Bree Rosenblum

Natural Sciences and Mathematics | Faculty Scholarship

Host-associated microbial communities can influence physiological processes of macroorganisms, including contributing to infectious disease resistance. For instance, some bacteria that live on amphibian skin produce antifungal compounds that inhibit two lethal fungal pathogens, Batrachochytrium dendrobatidis (Bd) and Batrachochytrium salamandrivorans (Bsal). Therefore, differences in microbiome composition among host species or populations within a species can contribute to variation in susceptibility to Bd/Bsal. This study applies 16S rRNA sequencing to characterize the skin bacterial microbiomes of three widespread terrestrial salamander genera native to the western United States. Using a metacommunity structure analysis, we identified dispersal barriers for these influential bacteria between salamander …

Nurse Plays Pivotal Role In Combating Overdose Deaths Through New Naloxone Initiative, Adam Pope

Browse All News

No abstract provided.

Footprint For New Genomic Medicine Building Takes Shape, Uab Heersink School Of Medicine News

Browse All News

No abstract provided.

Recovery Network Awareness: A Training Guide To Help Clients Choose An Aftercare Program For Sobriety, Thomas Bosek

Dissertations, Theses, and Projects

Abstract

Recovery environments are a crucial role in any individual’s journey to achieve sobriety. A safe environment will allow people who have a history of substance use to work their program effectively and decrease their relapse potential. The purpose of this paper is to identify multiple recovery-based programs for new professionals and providers entering the field of substance abuse treatment that allow their clients to have the best opportunity to succeed with their personal goals. The main programs discussed in this paper include 12 step programs, SMART Recovery, Harm reduction, and Medication Assisted Therapy. Choosing the right program for clients …

In-Situ Monitoring Of Additive Manufacturing Using Digital Image Correlation, Martina Jani

Doctoral Dissertations and Master's Theses

Advances in additive manufacturing over the past decade have led to applications in multiple fields. In particular, additive manufacturing answers the need for high flexibility in designing complex structures, however, the rapid thermal fluctuations during processing lead to numerous defects and processing-induced residual stresses. In this research, an in-situ approach using Digital Image Correlation (DIC) is developed to monitor the deformation during the processing, and thereby analyze the formation of defects and residual stresses. DIC is a visual technique that compares the changes in speckle pattern in consecutive images of a specimen to determine the displacements and strains. This research …

A Step-By-Step Guide To Implementing A Multidisciplinary Endocarditis Team, Sami El-Dalati, Daniel Cronin, James Riddell, Michael Shea, Richard L. Weinberg, Emily Stoneman, Twisha Patel, Kirra Ressler, George Michael Deeb

Internal Medicine Faculty Publications

Over the last several years multiple studies, primarily from European centers have demonstrated the clinical and outcomes benefits of multidisciplinary endocarditis teams. Despite this literature, adoption of this approach to patient care has been slower in the United States. While there is literature outlining the optimal composition of an endocarditis team, there is little information to guide providers as they attempt to transform practice from a fragmented, disjointed process to an efficient, collaborative care model. In this review, the authors will outline the steps they took to create and implement a successful multidisciplinary endocarditis team at the University of Michigan. …

Energetic Tradeoffs, Infection, And Immunity In Wild Chimpanzees Of Uganda And Tanzania, Sarah Renee Phillips

Anthropology ETDs

Infectious disease is a primary source of mortality for most mammal species, but scientists have little understanding of factors driving variation in infection and immunity between individuals, populations, and species in the wild. Life history theory provides an evolutionary framework for delineating distribution of available energy to competing physiological demands, including growth, reproduction, and maintenance. Early life reproduction should be favored over late life survival, but, in long-lived species, reproductive success is strongly tied to survival to old age. Slower pace of reproduction could allow investment in immunity, reducing risk of morbidity and mortality to infectious disease. Additionally, several host …

A New Criterion For Fluoroquinolone-Associated Disability Diagnosis: Functional Gastrointestinal Disorders, Deanna N. Cannizzaro, Lydia F. Naughton, Maya Z. Freeman, Linda Martin, Charles L. Bennett M.D., Ph.D., Cecilia Bove

Faculty Publications

Background and Objectives: Fluoroquinolones (FQs) are a broad-spectrum class of antibiotics routinely prescribed for common bacterial infections despite recent recommendations to use them only for life-threatening cases. In addition to their antimicrobial properties, FQs act in the central nervous system as GABAA receptor inhibitors, which could potentially affect functionality of the vagus nerve at the forefront of gastrointestinal (GI) tract function. Alterations in neural control of digestion have been shown to be linked to Functional Gastrointestinal Disorders (FGIDs), which are usually diagnosed based on self-reported symptoms. The aim of this study was to assess the incidence of FGIDs following FQ …

Phase 3 Safety And Efficacy Of Azd1222 (Chadox1 Ncov-19) Covid-19 Vaccine, Ann R Falsey, Magdalena E Sobieszczyk, Ian Hirsch, Stephanie Sproule, Merlin L Robb, Lawrence Corey, Kathleen M Neuzil, William Hahn, Julie Hunt, Mark J Mulligan, Charlene Mcevoy, Edwin Dejesus, Michael Hassman, Susan J Little, Barbara A Pahud, Anna Durbin, Paul Pickrell, Eric S Daar, Larry Bush, Joel Solis, Quito Osuna Carr, Temitope Oyedele, Susan Buchbinder, Jessica Cowden, Sergio L Vargas, Alfredo Guerreros Benavides, Robert Call, Michael C Keefer, Beth D Kirkpatrick, John Pullman, Tina Tong, Margaret Brewinski Isaacs, David Benkeser, Holly E Janes, Martha C Nason, Justin A Green, Elizabeth J Kelly, Jill Maaske, Nancy Mueller, Kathryn Shoemaker, Therese Takas, Richard P Marshall, Menelas N Pangalos, Tonya Villafana, Antonio Gonzalez-Lopez

Faculty, Staff and Student Publications

BACKGROUND: The safety and efficacy of the AZD1222 (ChAdOx1 nCoV-19) vaccine in a large, diverse population at increased risk for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the United States, Chile, and Peru has not been known.

METHODS: In this ongoing, double-blind, randomized, placebo-controlled, phase 3 clinical trial, we investigated the safety, vaccine efficacy, and immunogenicity of two doses of AZD1222 as compared with placebo in preventing the onset of symptomatic and severe coronavirus disease 2019 (Covid-19) 15 days or more after the second dose in adults, including older adults, in the United States, Chile, and Peru.

RESULTS: …

Birth Rights And Birth Wrongs Through A Common Law Lens: Why The No Liability Regime Is Likely To Endure, Richard A. Epstein

The Journal of Contemporary Legal Issues

Dov Fox’s recent book, the aptly named Birth Rights and Wrongs, is, as its title suggests, a study of the stark conflicts that arise in the highly contested area of reproductive rights. Fox makes the powerful case that the legal protection of reproductive rights, in all their protean forms, is systematically under-protected relative to two key benchmarks: the standards of ordinary decency, and social expectations. In my view, he has an acute awareness of these failures. But his greatest strength is also his greatest weakness, as he systematically ignores the great successes wrought through the current system, as disjointed …

Estimation Of Perceived Occupational Stress Among Library Professionals Of Central University Libraries Of Delhi And Utter Pradesh: A Comparative Study, Kasam Ali Research Scholar, Nishat Fatima Professor And Head

Library Philosophy and Practice (e-journal)

Abstracts: Occupational Stress is a growing problem today that affects the well-being and health of employees and their work organizations around the globe. A university library plays pivotal role in higher studies globally; builds the academic character of the university and acts as an active tool for research and development activities for the university in particular; and nation and society in general. The present study was investigated to ascertain the occupational stress among library professionals of central university libraries in Delhi and Uttar Pradesh in a comparative way. Census sample was used to collect data from the working library professionals …

Risk Factors For Poor Outcomes Among Patients With Extensively Drug-Resistant Tuberculosis (Xdr-Tb): A Scoping Review, Karan Varshney, Beverly Anaele, Matthew Molaei, Rosemary Frasso, Vittorio Maio

College of Population Health Faculty Papers

In recent years, there has been an upsurge in cases of drug-resistant TB, and strains of TB resistant to all forms of treatment have begun to emerge; the highest level of resistance is classified as extensively drug-resistant tuberculosis (XDR-TB). There is an urgent need to prevent poor outcomes (death/default/failed treatment) of XDR-TB, and knowing the risk factors can inform such efforts. The objective of this scoping review was to therefore identify risk factors for poor outcomes among XDR-TB patients. We searched three scientific databases, PubMed, Scopus, and ProQuest, and identified 25 articles that examined relevant risk factors. Across the included …

Mhealth: A Mediating Tool For Community Health Workers’ Transformation In Armed Conflict Zones, Nakama David, Samuel C. Avemaria Utulu, Jennifer Tyndall

The African Journal of Information Systems

Communities affected by armed conflict are striving to provide access to effective healthcare services in countries like Nigeria, where there exists a fragile healthcare system with an acute deficit of manpower and resources. This fragility has a negative impact on child health service delivery. mHealth is considered an excellent platform for enhancing/transforming the activities of community health workers (CHWs) in the delivery of effective health services. This paper aims to explore how mHealth implementation mediates and transforms the activities of CHWs in an armed conflict setting using activity theory as a lens. An interpretive research methodology was used, and the …

We Are ... Marshall, December 15, 2021, Office Of Marshall University Communications

We Are ... Marshall: the Newsletter for Marshall University 1999-2023

No abstract provided.

Il-4i1 Regulation Of Immune Protection During Mycobacterium Tuberculosis Infection., Lerato Hlaka, Mumin Ozturk, Julius E Chia, Shelby-Sara Jones, Shandre Pillay, Sibongiseni K L Poswayo, Thabo Mpotje, Justin K Nono, Simphiwe R N Simelane, Suraj P Parihar, Sugata Roy, Harukazu Suzuki, Frank Brombacher, Reto Guler

Faculty Research 2021

BACKGROUND: Interleukin 4 (IL-4i1)-induced gene 1 encodes L-phenylalanine oxidase that catabolizes phenylalanine into phenylpyruvate. IL-4i1 is mainly expressed by antigen-presenting cells (APCs), inhibits T-cell proliferation, regulates B-cell activation, modulates T cell responses, and drives macrophage polarization, but its role in bacterial infections is understudied.

METHODS: We evaluated IL-4i1 deletion in macrophages and mice on infection with virulent H37Rv and W-Beijing lineage hypervirulent HN878 Mycobacterium tuberculosis (Mtb) strains. The bacterial growth and proinflammatory responses were measured in vitro and in vivo. Histopathological analysis, lung immune cell recruitment, and macrophage activation were assessed at the early and chronic stages of Mtb infection. …

Plasmonically-Enhanced Dna-Rna Hybrid-Based Bioassay For Amplification-Free Quantification Of Sars-Cov-2, Yuxiong Liu

McKelvey School of Engineering Graduate Student Theses & Dissertations

Corona Virus Disease 2019 (COIVD-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a highly infectious respiratory illness. Within just a few months, it spread around the whole world and became a global pandemic. Real-time reverse-transcription polymerase chain reaction (RT-PCR) works as a gold standard method diagnosing COVID-19 with high sensitivity and specificity. But due to the programs of RT-PCR, it usually takes more than 24 hours to get the results while specialized devices are also required. False-negative results can happen as well using RT-PCR which increase the risk of spreading coronavirus. To promote quicker detection of COVID-19, …

Quantitative Characterization Of Microbial Ecologies In Dysbiosis And Infection, Eric Keen

Arts & Sciences Graduate Student Theses and Dissertations

In 1973, Theodosius Dobzhansky famously wrote that nothing in biology makes sense except in the light of evolution. Today, nearly 50 years later, little in microbiology – or in biology, for that matter – makes sense except in the light of genomics. Microbial genomics populates the field with innumerable testable hypotheses for evaluation in vitro and in vivo, allows us to monitor microbial populations in real time and at a massive scale, and underpins our approach to entire domains of microbiology, including microbial evolution. In this Thesis, I present three studies from my graduate research united by their common theme …

Surveillance And Dynamics Of Bacteria And Resistance Genes In Humans And Hospitals, Alaric Wences D'Souza

Arts & Sciences Graduate Student Theses and Dissertations

Bacteria live in, on, and around us. These bacteria affect human health through beneficial commensal interactions that promote normal development and through harmful infections or perturbations leading to disease. Understanding the prevalence, spread, and resilience of these bacteria in humans and human environments is critical to clinical medicine and epidemiology. I investigated environmental and human resident bacteria to understand dynamics in bacterial communities and how these dynamics may impact human health.Hospitals are one critical location of human-bacterial interactions. Bacteria can contaminate hospital surfaces from patients or environmental sources and subsequently transmit from surfaces to vulnerable patients. I analyzed bacteria from …

Getting It Right! Improving Kenya’S Human Capital By Reducing Stunting—A Household Account, Timothy Abuya, Wangari Ng'ang'a

Reproductive Health

In the last two decades, Kenya has attained middle-income status and established a diverse and private-sector-driven economy. On several socio-economic indicators, such as education, gender equality, and democracy, Kenya scores much higher than its peers. More than two-thirds of Kenyans are under 35 years of age, thus the country’s development hinges on the quality of its youth—their levels of education and skills, their values and attitudes, and the quality of their health and productivity. While Kenya’s investments in the development of its human capital positions the country well to sustain accelerated growth, the trajectory is threatened by high rates of …

Utility Of Facebook's Social Connectedness Index In Modeling Covid-19 Spread: Exponential Random Graph Modeling Study, Beth Prusaczyk, Kathryn Pietka, Joshua M Landman, Douglas A Luke

Open Access Publications

BACKGROUND: The COVID-19 (the disease caused by the SARS-CoV-2 virus) pandemic has underscored the need for additional data, tools, and methods that can be used to combat emerging and existing public health concerns. Since March 2020, there has been substantial interest in using social media data to both understand and intervene in the pandemic. Researchers from many disciplines have recently found a relationship between COVID-19 and a new data set from Facebook called the Social Connectedness Index (SCI).

OBJECTIVE: Building off this work, we seek to use the SCI to examine how social similarity of Missouri counties could explain similarities …

Identification Of Candidate Microbial Biomarkers Of Disease And Design Of Engineered Microbial Therapeutics For The Gut Microbiome, Aura Lucia Ferreiro

McKelvey School of Engineering Graduate Student Theses & Dissertations

The human gut microbiome is a compositionally and functionally diverse community of microorganisms that profoundly influences the health of the host. Deep characterization of gut microbiomes via high-throughput sequencing has identified associations between the gut microbiome and disease states, and spurred development of engineered microbial therapeutics. Successful translation of these research efforts to the clinic will involve i) consideration of how engineered microbes behave and adapt in the gut, towards the implementation of biosafety mechanisms, and ii) identification and validation of microbial biomarkers of disease. This dissertation describes both investigative (Chapter 2) and engineering (Chapters 3 and 4) approaches to …

A Rare Presentation Of Miller Fisher Syndrome, A Rare Variant Of Guillain Barre Syndrome, Saumya Mittal

Manipal Journal of Medical Sciences

Guillain Barre syndrome presents as acute onset of gradually progressive ascending flaccid paralysis with hyporeflexia or areflexia. The variants are acute inflammatory demyelinating polyneuropathy, acute motor axonal neuropathy, acute motor sensory axonal neuropathy, and Miller Fisher syndrome. Miller Fisher syndrome includes symptoms that form a classical triad of ophthalmoplegia, ataxia, and hyporeflexia or areflexia. This case presents a case of Miller Fisher syndrome with atypical features wherein the patient had normal reflexes and his reflexes remained normal in follow-up.

The Five Ds Of Outpatient Antibiotic Stewardship For Urinary Tract Infections, Melanie C Goebel, Barbara W Trautner, Larissa Grigoryan

Faculty, Staff and Students Publications

Urinary tract infections (UTI) are one of the most common indications for antibiotic prescriptions in the outpatient setting. Given rising rates of antibiotic resistance among uropathogens, antibiotic stewardship is critically needed to improve outpatient antibiotic use, including in outpatient clinics (primary care and specialty clinics) and emergency departments. Outpatient clinics are in general a neglected practice area in antibiotic stewardship programs, yet most antibiotic use in the United States is in the outpatient setting. This article provides a comprehensive review of antibiotic stewardship strategies for outpatient UTI in the adult population, with a focus on the "five Ds" of stewardship …