Digital Commons Network^™

Dose-Escalated Preoperative Proton Therapy For Retroperitoneal Sarcomas: Initial Outcomes Of A New Treatment Paradigm, Sreenija Yarlagadda, Tugce Kutuk, Ramon Jimenez, Muni Rubens, Matthew Hall, Nicole Eiseler, Noah Kalman

All Publications

Purpose: Retroperitoneal sarcomas (RPS) have varied treatment practices with regard to the use of radiation therapy (RT). Preoperative RT ∼50 Gy is commonly used, but the Surgery With or Without Radiation Therapy in Untreated Nonmetastatic Retroperitoneal Sarcoma (STRASS-1) randomized trial demonstrated no improvement in abdominal recurrence-free survival with preoperative RT. Dose escalation has been proposed to improve the efficacy of preoperative RT. We analyzed RPS treated with preoperative intensity modulated proton therapy (IMPT) to an escalated dose of 63 Gy at a single institution.

Methods and materials: Patients who received preoperative RT with IMPT with RPS between January 2015 and …

On The Discontinuation Of Enteral Feeding In Head And Neck Cancer: A Case Report, Kyle Fisk, Ana Sanchez

HCA Healthcare Journal of Medicine

Introduction

The goal of palliative care is to preserve the quality of life or patient “comfort” in patients with serious diseases. Palliative care providers serve a wide range of patients: from those who seek curative treatment to those who are actively dying. Given this range, palliative care must mirror the dynamic goals of the patient at different stages of life and treatment. Throughout these stages, a goal of the palliative care provider would be to avoid hastening death; however, this often leads to clinical decisions that directly pit the patient’s comfort against the patient’s life span. This is most salient …

A Rare Case Of Candida Glabrata Cervical Spondylodiscitis, Angelina Hong, Lily Hyungjung Lim, Ali Tariq Alvi, Pallavi Aneja

HCA Healthcare Journal of Medicine

Introduction

Invasive candidiasis can lead to numerous life-threatening sequelae. Candida glabrata is the second-most common causative species of invasive candidiasis. This species possesses a high risk for persistent infection and candidemia. An uncommon complication of invasive candidiasis is spondylodiscitis and can rarely affect the cervical spine.

Case Presentation

The patient is a female in her late 50s with a complex medical history inclusive of chronic obstructive pulmonary disease, chronic pain, multiple abdominal surgeries, prolonged intensive care unit admission, and administration of total parenteral nutrition and broad-spectrum antibiotics who presented with complaints of worsening neck pain. She was last hospitalized 3 …

Significance Of Chronic Kidney Disease On Morbidity And Mortality In Hospitalized Patients With Covid-19, Varsha Suresh, Alexis Finer, Aarushi Varshney, Kay Thi Khine, Ishak Mansi, Abdo Asmar

HCA Healthcare Journal of Medicine

Background

Patients with comorbid illnesses are at risk for worse outcomes with a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; COVID-19). Our research examined patients with chronic kidney disease (CKD) to establish whether it remains an independent risk factor for mortality and morbidity in patients with COVID-19.

Methods

We conducted a retrospective cohort study using an electronic patient database in 2020. An observational dataset from 149 hospitals comprising a United States-based health system (HCA Healthcare) was analyzed. Hospitalized patients (N=11 086), aged 18 and above, with a COVID-19 polymerase chain reaction positive result between January 1, 2020, and September 1, …

Comparison Of The Effects Of The Three Methods Of Massage, Selected Yoga Exercises And Massage-Yoga Combination On The Depression In Elderly Women, Elham Piri, Behnam Ghasemi, Ali Shafizadeh

Baltic Journal of Health and Physical Activity

Introduction: The present study aims to compare the effects of massage, selected yoga exercises and massage-yoga combination methods on symptoms of depression. Materials and Methods: According to the research criteria, 60 available samples were selected and randomly divided into three experimental groups and single control one. The Beck Depression Inventory was completed by the examinees before the intervention, two months after its beginning and one month after ending. Each experimental group received one of the massage interventions, selected yoga exercises and massage-yoga combination for eight weeks, three sessions per week and for a period of 40 minutes per session. The …

Acts Of Care: Recovering Women In Late Medieval Health, Tanya Stabler Miller

Medieval Feminist Forum: A Journal of Gender and Sexuality

No abstract provided.

The Basque Seroras: Local Religion, Gender, And Power In Northern Iberia, 1550–1800, Phyllis Zagano

Medieval Feminist Forum: A Journal of Gender and Sexuality

No abstract provided.

Massive Upper Gi Bleeding From Duodenal Invasion Of Hepatocellular Carcinoma Successfully Treated With Embolization And Hemospray®, Patrick Twohig, Erin Walsh, Amy Calderon

Graduate Medical Education Research Journal

Direct invasion of hepatocellular carcinoma (HCC) into the duodenum is a unique and life-threatening complication of HCC that has been rarely reported. A 60-year-old male with known HCC and cirrhosis presented with melena. Computed tomography of the abdomen and pelvis showed a 7cm hepatic mass abutting the duodenum. Esophagogastroduodenoscopy demonstrated a large, actively oozing mass in the duodenum treated with Hemospray® followed by transarterial embolization (TAE). Active upper gastrointestinal bleeding due to duodenal invasion of HCC can be successfully treated with Hemospray® Endoscopic Hemostat and TAE.

Education For Primary Care Providers On Advance Care Planning: A Systematic Literature Review, Lindsey Ward

DNP Qualifying Manuscripts

Background: Healthcare providers in primary care treat patients at various stages of life. As patients age, it becomes necessary for providers to support their older patients throughout the aging process and address patient care even into life’s end stages. Primary care providers (PCPs) are well-positioned to provide this support and can do so through incorporating end-of-life (EOL) conversations in practice. Such discussions are called advance care planning (ACP). Though PCPs can play a crucial role in their patients’ EOL care decisions, providers report their limited knowledge of ACP as a barrier to its application.Consequently, further education for providers on utilizing …

Cabozantinib Plus Atezolizumab In Previously Untreated Advanced Hepatocellular Carcinoma And Previously Treated Gastric Cancer And Gastroesophageal Junction Adenocarcinoma: Results From Two Expansion Cohorts Of A Multicentre, Open-Label, Phase 1b Trial (Cosmic-021)., Daneng Li, Yohann Loriot, Adam Burgoyne, James Cleary, Armando Santoro, Daniel Lin, Santiago Ponce Aix, Ignacio Garrido-Laguna, Ramu Sudhagoni, Xiang Guo, Svetlana Andrianova, Scott Paulson

Kimmel Cancer Center Faculty Papers

BACKGROUND: Cabozantinib is approved for previously treated advanced hepatocellular carcinoma (aHCC) and has been investigated in gastric cancer (GC) and gastroesophageal junction adenocarcinoma (GEJ). Atezolizumab plus bevacizumab is approved for unresectable or metastatic HCC untreated with prior systemic therapy. We evaluated efficacy and safety of cabozantinib plus atezolizumab in aHCC previously untreated with systemic anticancer therapy or previously treated GC/GEJ.

METHODS: COSMIC-021 (ClinicalTrials.gov, NCT03170960) is an open-label, phase 1b study in solid tumours with a dose-escalation stage followed by tumour-specific expansion cohorts, including aHCC (cohort 14) and GC/GEJ (cohort 15). Eligible patients were aged ≥18 years with measurable locally advanced, …

Describing The Evidence Linking Interprofessional Education Interventions To Improving The Delivery Of Safe And Effective Patient Care: A Scoping Review, Tamara Cadet, Joseph Cusimano, Shelley Mckearney, Julie Honaker, Cynthia O'Neal, Reza Taheri, Virginia Uhley, Yingting Zhang, Margaret Dreker, Judith S. Cohn

Pharmacy Faculty Articles and Research

Empirical evidence indicates that collaborative interprofessional practice leads to positive health outcomes. Further, there is an abundance of evidence examining student and/or faculty perceptions of learning or satisfaction about the interprofessional education (IPE) learning experience. However, there is a dearth of research linking IPE interventions to patient outcomes. The objective of this scoping review was to describe and summarize the evidence linking IPE interventions to the delivery of effective patient care. A three-step search strategy was utilized for this review with articles that met the following criteria: publications dated 2015–2020 using qualitative, quantitative or mixed methods; the inclusion of healthcare …

Using Mindfulness In Nursing Burnout. An Integrative Review., April Day Branham

Doctoral Dissertations and Projects

The purpose of this integrative review is to evaluate if mindfulness is effective in decreasing nursing burnout. Nursing burnout has negatively affected the nursing profession for many years, and since the COVID-19 pandemic, it appears to be worse. Mindfulness is a practice that has been used for decades, however, it is gaining more attention in the nursing realm. Mindfulness consists of being present in a moment without judgment. It can consist of individual exercises that are completed using an instructor in person, in an application on a smartphone or computer, or yoga-based mindful activities. A preliminary literature review was completed …

December 16, 2023, Seattle University School Of Law

Commencement Programs

No abstract provided.

Rufus Earl Dabbs, Sr.

African American Funeral Programs

Rufus_Earl_Dabbs_Sr.pdf - Funeral program for Rufus Earl Dabbs, Sr.

Reverend Raleigh Cail Jr.

African American Funeral Programs

Reverend_Raleigh_Cail_Jr.pdf - Funeral program for Reverend Raleigh Cail Jr.

Application Of The Us Food And Drug Administration’S Sentinel Routine Querying Tools To The Taiwan Sentinel Data Model-Formatted National Health Insurance Research Database, Fang-Ju Lin, Ling-Ya Huang, Chi-Chuan Wang, Sengwee Toh

Journal of Food and Drug Analysis

The U.S. Food and Drug Administration’s Sentinel System is a leading distributed data network for drug safety surveillance in the world. The National Health Insurance Research Database (NHIRD) in Taiwan was converted into the Taiwan Sentinel Data Model (TSDM) based on the Sentinel Common Data Model (SCDM) version 6.0.2. The goal of this study was to investigate the feasibility of applying the same study designs, analytic choices, and analytic tools as used by the U.S. Sentinel System to examine the same drug-outcome associations in the TSDM-formatted NHIRD. Four known drug-outcome associations previously examined by the U.S. Sentinel System were selected …

Analysis And Identification Of Phenolic Compounds With Antiproliferative Activity From Chinese Olive (Canarium Album L.) Fruit Extract By Hplc-Dad-Spe-Tt-Nmr, Yu-Te Yeh, Chien-Kuang Chen, Yi-Chun Liao, Shoei-Sheng Lee, Shu-Chen Hsieh

Journal of Food and Drug Analysis

Chinese olives (Canarium album L.) are rich in phenolic compounds, exhibiting a broad spectrum of potential clinical applications. This study is the first report on the isolation and elucidation of bioactive compounds with high antiproliferative activity from the ethyl acetate fraction of a Chinese olive fruit methanolic extract (CO-EtOAc). We used the WST-1 assay to determine which subfractions of CO-EtOAc had significant antiproliferative activity using the murine colon cancer cell line CT26. Subsequently, the functional compounds were characterized by the hyphenated technique and high-performance liquid chromatography-diode array detector-solid phase extraction-transfer tube-nuclear magnetic resonance (HPLC-DAD-SPE-TT-NMR). Thirteen phenolic constituents were identified …

Gardner-Webb Recognized 2023 Summer And Fall Graduates On Dec. 15, Office Of University Communications

Gardner-Webb NewsCenter Archive

Gardner-Webb University celebrated the achievements of nearly 500 graduates on Dec. 15. The commencement ceremony was held at 9 a.m. in Lutz-Yelton Convocation Center. Graduates who completed their degrees in the 2023 Summer and Fall semesters were honored. Scholastic awards were presented to online and traditional undergraduate students. Doctoral candidates received their hoods, and Gardner-Webb President Dr. William M. Downs conferred undergraduate and graduate degrees on all graduates.

Implementing An African American Cultural Awareness Program For Skilled Nursing Facility Staff, Adekemi T. Adedipe

Doctor of Nursing Practice (DNP) Projects

Background: Patient care is most effective when patients and providers establish a therapeutic connection in a cultural context. Nurses’ lack of awareness of a cultural context for patient care impairs establishing a therapeutic provider/patient relationship, with care of lesser quality and poorer health outcomes as consequences.

Local Problem: Staff at a Northern Californian skilled nursing facility (SNF) caring for African American patients with mental illness lacked self-awareness of the cultural context of care. Staff did not consider cultural constructs of care in treating patients and developing care plans.

Methods: Educational intervention to increase the cultural competence of a skilled …

The Contribution Of Principlism To Foster Ethical And Clinical Reciprocity In Resolving Healthcare Dilemmas, Dominic Glorioso

Electronic Theses and Dissertations

Principlism is an ethical method that uses an analytical framework based on a set of principles that can function as guidelines for healthcare professionals. The term was made

famous by the work of two bioethicists, Tom L. Beauchamp and James F. Childress. Their book, Principles of Biomedical Ethics and its multiple editions described a set of norms that are basic

for biomedical ethics. The first edition of their book was published in 1979, and the ninth edition in 2019. Its persistence and durability speak for themselves. In addition, their writings made

famous the four bioethical principles of respect for Autonomy, …

The Normative Requirement For Shared Decision Making (Sdm) In Healthcare Ethics, Margaret Nornor-Quadjie

Electronic Theses and Dissertations

Medicine and medical technology started to advance after World War II. During that period, the practice of medicine became technical. A lot began to happen in the biomedical world during the period after WWII that attracted comments, criticisms, and analyses from scholars. Perhaps, the 1947 Doctors’ Trial at the Nuremberg Tribunal and the Nuremberg Code may be said to be the defining moment for bioethics. These events eventually led to, in the United States, the passage of the National Research Act of 1974 that established the Institutional Review Board system and the National Commission for Protection of Human Subjects of …

Citrullinated And Malondialdehyde-Acetaldehyde Modified Proteins Promote Cellular Inflammatory And Fibrotic Responses Associated With Rheumatoid Arthritis, Nozima Aripova

Theses & Dissertations

Rheumatoid arthritis (RA) is a systemic, autoimmune disease primarily characterized by perpetual synovial inflammation that results in synovial tissue proliferation and fibrosis (pannus). Although joint involvement is the predominant manifestation of RA, extra-articular features, such as interstitial lung disease (ILD), contribute significantly to the elevated mortality associated with the condition. Post-translational modifications play a significant role in RA and RA-ILD pathogenesis. Circulating anti-citrullinated protein antibodies (ACPAs) are a highly diagnostic tool implicating a potential role for citrullinated antigens in RA and RA-ILD.

Recently, antibodies to malondialdehyde acetaldehyde adducts (MAA) have been markedly elevated in patients with RA and RA-ILD. MAA …

A Case Of Filgrastim-Induced Neutrophilic Dermatosis Of The Dorsal Hands In A Patient With Felty Syndrome, Tejas P Joshi, Yelena Dokic, Gordana Verstovsek, Theodore Rosen

Faculty, Staff and Students Publications

Neutrophilic dermatosis of the dorsal hands (NDDH) is a variant of Sweet syndrome that presents with erythematous bullae, papules/plaques, or pustules on the dorsal hands. It is most commonly associated with hematologic and solid organ malignancies, though cases of NDDH associated with inflammatory bowel disease, rheumatologic disorders, and medication exposure have also been described in the literature. Felty syndrome is a rare complication of long-standing rheumatoid arthritis characterized by neuropathy, splenomegaly, and neutropenia. Granulocyte colony stimulating factors (e.g., filgrastim) can be utilized to rescue the neutropenia observed in Felty syndrome, but this treatment may subsequently cause Sweet syndrome. Herein, we …

Optimizing Sepsis Management Through Enhanced Protocol Compliance In The Emergency Department, Andrea Garcia

Master's Projects and Capstones

Problem: Compliance and timeliness with the sepsis bundle protocol are continuously increasing, resulting in poor patient outcomes. This quality improvement project aims to increase sepsis bundle compliance and earlier sepsis management in the Emergency Department (ED) to reduce sepsis mortality rates and length of hospital stay.

Context: Hospital A’s emergency department is a level II adult trauma center located in the Greater Bay Area that treats a range of patients presenting with life-threatening diagnoses such as sepsis, traumatic injuries, and electrolyte imbalances.

Interventions: The sepsis committee team was provided recommendations to implement post-data analysis. Interventions recommended included standardizing and increasing …

Campaigning Beyond: Sepsis Awareness Among Non-Clinical Staff, Cynthia Wong

Master's Projects and Capstones

Problem: Sepsis stands as the foremost cause of illness and death among hospitalized patients globally, yet a considerable number remain oblivious to this critical condition. Based on the pre-implementation survey among non-clinical staff members of an urban hospital, awareness of sepsis must be heightened to ensure swift recognition and response.

Context: The project conducted takes place in five distinct non-clinical departments at a large hospital organization in Northern California. Each department plays an essential role in the holistic and efficient functioning of the organization to provide quality patient care.

Interventions: A sepsis awareness campaign was implemented throughout the month of …

Differential Diagnostic Considerations In A Patient With New Onset Apathy: A Case Study On Frontal Lobe Glioblastoma Multiforme, Joy Zarandy, Sarah Yoon, Sharnikha Saravanan, Sanjana Das, Sarah Thomas

The Journal of Integrated Primary Care

This case study involves a 50 year-old previously healthy female presenting with a two-week history of clinically significant apathy. The patient and her family assume her symptoms are due to a potential underlying psychiatric condition; however, neurologic and systemic disorders should also be considered when evaluating a patient with sudden personality change. After a thorough history and physical exam, further evaluation with neuroimaging is performed due to suspicion of neurological etiology. A sizable ring-enhancing lesion in the frontal lobe is noted on MRI, and a diagnosis of glioblastoma multiforme (GBM) is confirmed with biopsy. GBM, or grade 4 astrocytoma, is …

The Experiences Of Black Women Direct Care Workers In Long-Term Care, Nakeshia Knight-Coyle

Dissertations and Theses

This study expands understanding about the experiences of Black women direct care workers (DCWs) experiences with racism, discrimination, and economic exploitation in the long-term care (LTC) sector. It comes at a critical time when COVID-19 has demonstrated the important and essential nature of long-term care work. COVID-19 has also elucidated the challenges of an insufficient workforce and its detrimental impact on the long-term care system’s ability to meet the care needs of those accessing long-term care services. Finally, workforce needs are projected to increase with the impending influx of baby boomers into retirement, making this study a timely effort at …

Frailty In End-Stage Liver Disease: Understanding Pathophysiology, Tools For Assessment, And Strategies For Management, Mazen Elsheikh, Ahmed El Sabagh, Islam B Mohamed, Megha Bhongade, Manal M Hassan, Prasun Kumar Jalal

Faculty, Staff and Students Publications

Frailty and sarcopenia are frequently observed in patients with end-stage liver disease. Frailty is a complex condition that arises from deteriorations across various physiological systems, including the musculoskeletal, cardiovascular, and immune systems, resulting in a reduced ability of the body to withstand stressors. This condition is associated with declined resilience and increased vulnerability to negative outcomes, including disability, hospitalization, and mortality. In cirrhotic patients, frailty is influenced by multiple factors, such as hyperammonemia, hormonal imbalance, malnutrition, ascites, hepatic encephalopathy, and alcohol intake. Assessing frailty is crucial in predicting morbidity and mortality in cirrhotic patients. It can aid in making critical …

Making The Rounds, 1996, V1 N15, April 8, Advocate Aurora Health

Historical Documents - Combined

The Park Ridge Center, Chicago, IL: Issue of "Making the Rounds in Health, Faith, & Ethics", a publication from The Park Ridge Center for the Study of Health, Faith and Ethics, associated with Lutheran General Hospital. This issue has a feature on narrative ethics, and an interview with Martha Holstein about societal responsibility and children.

Making The Rounds, 1996, V1 N17, May 5, Advocate Aurora Health

Historical Documents - Combined

The Park Ridge Center, Chicago, IL: Issue of "Making the Rounds in Health, Faith, & Ethics", a publication from The Park Ridge Center for the Study of Health, Faith and Ethics, associated with Lutheran General Hospital. This issue features a roundtable discussion on the new legal status of physician-assisted suicide in the state of Washington.