Digital Commons Network^™

Preschool Classroom Behavior In Context: Development And Validation Of The Spanish Form Of The Adjustment Scales For Preschool Intervention (Aspi), Rebecca Jane Bulotsky-Shearer, Paul A. Mcdermott, Jenna Futterer, Michael Lopez, Mileidis Gort

Archives of Assessment Psychology

The purpose of the study was to validate the context scale scores for the Spanish language form of the Adjustment Scales for Preschool Intervention (ASPI) for use by early childhood teachers from Spanish-speaking backgrounds. Exploratory and confirmatory factor analyses in a diverse sample of preschool children from low-income families (N = 4,077) revealed two dimensions of context scales of behavioral adjustment: Problems in Preschool Classroom Contexts Requiring Disciplined Behavior and Problems in Contexts Requiring Engaged Behavior. ASPI dimension scores across Spanish and English language forms were horizontally equated through item response theory (IRT). Criterion-related validity using multilevel models was established …

Editorial: Symmetry As A Guiding Principle In Artificial And Brain Neural Networks, Volume Ii, Fabio Anselmi, Ankit B Patel

Faculty, Staff and Students Publications

No abstract provided.

The Co-Expression Of The Depolarizing And Hyperpolarizing Mechanosensitive Ion Channels In Mammalian Retinal Neurons, Vivian Y Pang, Zhuo Yang, Samuel M Wu, Ji-Jie Pang

Faculty, Staff and Students Publications

Introduction

The elevation of the intraocular and extraocular pressures is associated with various visual conditions, including glaucoma and traumatic retinal injury. The retina expresses mechanosensitive channels (MSCs), but the role of MSCs in retinal physiology and pathologies has been unclear.

Methods

Using immunocytochemistry, confocal microscopy, and patch-clamp recording techniques, we studied the co-expression of K⁺-permeable (K-MSCs) TRAAK and big potassium channel BK with the epithelial sodium channel ENaC and transient receptor potential channel vanilloid TPRV4 and TRPV2 favorably permeable to Ca²⁺ than Na⁺ (together named N-MSCs), and TRPV4 activity in the mouse retina.

Results

TRAAK immunoreactivity …

Evaluating One-Week Post-Casting Alignment Checks And Surgical Intervention Rates In Pediatric Type Iia Supracondylar Humeral Fractures, Jason Z Amaral, Rebecca J Schultz, Benjamin M Martin, Jacob P Scioscia, Basel Touban, Barkha N Chhabra, Kelly Cline, Scott D Mckay

Faculty, Staff and Students Publications

BACKGROUND: This study aims to determine the rate of surgical intervention in children with type IIA supracondylar humerus fractures (SCHF) following routine post-casting radiographic assessment. We hypothesized that no cases would convert to operative management following one-week post-casting alignment assessments.

METHODS: This single-center retrospective study focused on pediatric patients diagnosed with type IIA SCHF from 2019 to 2022. Patients were treated with initial long arm cast immobilization, followed by a one-week post-casting radiographic alignment check in cast. Fractures were graded in consensus using the Wilkins-Modified Gartland classification system by three fellowship-trained pediatric orthopaedic surgeons. Demographics, casting details, follow-up dates, and …

Childhood And Adolescent Relapsed/Refractory Aggressive B-Cell Lymphomas With T(8;14) And Bcl2 Expression, Burkitt Lymphoma Versus Diffuse Large B-Cell Lymphoma: A Diagnostic Challenge, Fouad El Dana, Sofia Alexandra Garces Narvaez, Nader K El-Mallawany, Jennifer E Agrusa, Zoann E Dreyer, Andrea N Marcogliese, Mohamed Tarek Elghetany, Jyotinder N Punia, Chi Young Ok, Keyur P Patel, Dolores H Lopez-Terrada, Kevin E Fisher, Choladda V Curry

Faculty, Staff and Students Publications

We present 2 diagnostically challenging cases of pediatric/adolescent relapsed/refractory aggressive mature B-cell non-Hodgkin lymphoma (B-NHL) within the spectrum of Burkitt lymphoma and diffuse large B-cell lymphoma and illustrate the different therapeutic regimens that are employed for pediatric and adult cancer centers. Both cases displayed varying-sized lymphoma cells with occasional single prominent nucleoli and heterogeneous BCL2 expression. Cytogenetics revealed complex karyotypes with t(8:14)(q24.2;q32) and IGH::MYC rearrangement by FISH. Next generation sequencing revealed deleterious TP53 and MYC mutations. We concluded that both could be diagnosed as “DLBCL-NOS with MYC rearrangement” using the current pathologic classifications, 2022 International Consensus Classification (ICC) and World …

Predictive Analytics In Bronchopulmonary Dysplasia: Past, Present, And Future, Bryan G Mcomber, Alvaro G Moreira, Kelsey Kirkman, Sebastian Acosta, Craig Rusin, Binoy Shivanna

Faculty, Staff and Students Publications

Bronchopulmonary dysplasia (BPD) remains a significant complication of prematurity, impacting approximately 18,000 infants annually in the United States. Advances in neonatal care have not reduced BPD, and its management is challenged by the rising survival of extremely premature infants and the variability in clinical practices. Leveraging statistical and machine learning techniques, predictive analytics can enhance BPD management by utilizing large clinical datasets to predict individual patient outcomes. This review explores the foundations and applications of predictive analytics in the context of BPD, examining commonly used data sources, modeling techniques, and metrics for model evaluation. We also highlight bioinformatics' potential role …

Outcomes For Patients With Head And Neck Sarcoma Treated Curatively With Radiation Therapy And Surgery, Alison K Yoder, Ahsan Farooqi, Devarati Mitra, J Andrew Livingston, Dejka M Araujo, Erich M Sturgis, Ryan Goepfert, Andrew J Bishop, B Ashleigh Guadagnolo

Faculty, Staff and Students Publications

Purpose: Soft tissue sarcomas (STSs) of the head and neck (H&N) are rare malignancies that are challenging to manage. We sought to describe the outcomes of patients treated with curative intent using combined surgery and radiation therapy (RT) for H&N STS.

Methods and materials: We performed a single-institution retrospective review of patients with nonmetastatic STS of the H&N who were treated from 1968 to 2020. The Kaplan-Meier method was used to estimate disease-specific survival (DSS) and local control (LC). Multivariable analyses (MVAs) were conducted using Cox proportional hazards model.

Results: One hundred ninety-two patients had a median follow-up of 82 …

Fluoxetine And Sertraline Inhibit Height Growth And Growth Hormone Signaling During Puberty, Chadi Calarge, Chima Amushie, Stephanie Dinh, James A Mills, Sridevi Devaraj, Griselda Barba-Villalobos, Jacqueline Nguyen, Jose M Garcia, Stephanie Sisley, Fida Bacha, Babette Zemel

Faculty, Staff and Students Publications

Purpose: The aim of this study was to examine the effect of fluoxetine and sertraline on height growth and insulin-like growth factor-1 (IGF-1) during puberty.

Methods: In this 6-month cohort study, electronic medical records were used to identify 8- to 15-year-old participants, within 1 month of starting fluoxetine (n = 39) or sertraline (n = 27), and sexual maturation stages 2 to 4 were confirmed. Conditions that interfere with height growth led to exclusion. Participants underwent anthropometric assessments and phlebotomy. Healthy, unmedicated children (n = 36) also provided anthropometric data.

Results: After the baseline height Z-score, sex, Tanner stage, daily …

Molecular Profiling Of A Hepatocellular Neoplasm Not Otherwise Specified (Hcn-Nos) Demonstrates Distinct Molecular Features In Hepatoblastoma And Hcc-Like Components, Yan Chen Wongworawat, Stephen F Sarabia, Martin Urbicain, Paola Francalanci, Pavel Sumazin, Rita Alaggio, Dolores H López-Terrada

Faculty, Staff and Students Publications

Hepatoblastomas (HB) are embryonal tumors with quiet genomes diagnosed mostly in children under 3 years of age and often cured by surgical resection and chemotherapy. However, a subset of HBs behave aggressively, displaying characteristic histologic features and higher genomic instability. Hepatocellular neoplasm-not otherwise specified (HCN-NOS) is a provisional diagnostic category for tumors exhibiting either intermediate or a combination of both HB and hepatocellular carcinoma (HCC) histological features. In this study, we characterized an HCN-NOS diagnosed in a 3-year-old patient presenting with a liver mass, in which both HB and HCC histological components were amendable to macro-dissection and molecular profiling. The …

High-Fat Diets Promote Peritoneal Inflammation And Augment Endometriosis-Associated Abdominal Hyperalgesia, Tristin Herup-Wheeler, Mingxin Shi, Madeleine E Harvey, Chandni Talwar, Ramakrishna Kommagani, James A Maclean, Kanako Hayashi

Faculty, Staff and Students Publications

Immune dysfunction is one of the central components in the development and progression of endometriosis by establishing a chronic inflammatory environment. Western-style high-fat diets (HFD) have been linked to greater systemic inflammation to cause metabolic and chronic inflammatory diseases, and are also considered an environmental risk factor for gynecologic diseases. Here, we aimed to examine how HFD cause an inflammatory environment in endometriosis and discern their contribution to endometriotic-associated hyperalgesia. Our results showed that HFD-induced obesity enhanced abdominal hyperalgesia that was induced by endometriotic lesions. Peritoneal inflammatory macrophages and cytokine levels increased by lesion induction were elevated by chronic exposure …

Rapid Gene Fusion Testing Using The Nanostring Ncounter Platform To Improve Pediatric Leukemia Diagnoses In Sub-Saharan Africa, Julie M Gastier-Foster, Fredrick Lutwama, Olive Mbabazi, Steven Mlenga, Kennedy Ulaya, Ruth Namazzi, E Faith Hollingsworth, Dolores Lopez-Terrada, Kevin E Fisher, Angshumoy Roy, Carl E Allen, David G Poplack, Rizine Mzikamanda, Nmazuo Ozuah, Peter Wasswa

Faculty, Staff and Students Publications

Risk stratification and molecular targeting have been key to increasing cure rates for pediatric cancers in high-income countries. In contrast, precise diagnosis in low-resource settings is hindered by insufficient pathology infrastructure. The Global HOPE program aims to improve outcomes for pediatric cancer in Sub-Saharan Africa (SSA) by building local clinical care and diagnostic capacity. This study aimed to assess the feasibility of implementing molecular assays to improve leukemia diagnoses in SSA. Custom NanoString nCounter gene fusion assays, previously validated in the US, were used to test samples from suspected leukemia patients. The NanoString platform was chosen due to relatively low …

Genetic Variation Between Small Bowel And Colon-Predominant Crohn's Disease, Halee Patel, R Alan Harris, Justin H Qian, Numan Oezguen, Ashleigh Watson, Reka G Szigeti, Stanley Cho, Wenly Ruan, Savini Britto, Antone Opekun, Geoffrey Preidis, Richard Kellermayer

Faculty, Staff and Students Publications

No abstract provided.

Improving Outpatient Medication Reconciliation And Reducing Adverse Drug Events: Development Of A New Process, Marisa Kristine Blake-Raut

Yale School of Nursing Digital Theses

AbstractImportance: Prescribed medications can pose risks to patient safety. In the United States, persons aged over 65 account for nearly 450,000 annual emergency department (ED) visits, and they are seven times more likely to require hospital admission than younger persons (Centers for Disease Control and Prevention, 2022). Medication reconciliation (MR) errors are more likely to affect those older than 65, but can be prevented by using standardized MR criteria that identify medications with higher risks for adverse drug events (ADEs) (O’Mahoney, 2020). Objective: The DNP project goal was to create and implement a risk stratified medication reconciliation (RSMR) intervention process …

My Identi T: Improving Mental Health Outcomes Through Group Support In Pre-Treatment Transgender Teens, Jill Day

Yale School of Nursing Digital Theses

Transgender youth (TGY) are at an increased risk for depression, anxiety, and suicidality; delaying transition can worsen this. Nationally, gender programs have waitlists beyond a year. In conservative states, providers are fewer in number, and legislation may prohibit services. Thus, gender programs rely on mental health and primary care providers to assist youth who express a strong desire to be a gender other than that assigned at birth, and who endure protracted wait times to start treatment. This DNP project developed and implemented an evidence-based, gender-affirming peer support group to improve patient experience and mental health outcomes by providing information …

Relationship-Centered Communication In Breast Cancer Screening: An Interdisciplinary Training Model, Patricia Aideen Ducharme

Yale School of Nursing Digital Theses

Breast cancer screening is essential for early detection and reducing disease progression. However, its underuse contributes to late-stage diagnoses, adverse health consequences, and reduced survival rates. Research has shown that high-quality communication significantly influences women's adherence to breast cancer screening, leading to earlier detection and better health outcomes. However, many healthcare providers receive no formal communication skills training. Healthcare providers who undergo relationship-centered communication (RCC) training demonstrate stronger interpersonal relationships, which result in increased provider-patient satisfaction, more efficient healthcare teams, and improved quality of patient care. To date, most RCC studies have focused predominantly on the physician-patient relationship rather than …

Establishing An Infrastructure For Nursing Innovation In A Large Urban Magnet®Hospital, Gregory Parsons Eichelzer

Yale School of Nursing Digital Theses

Problem and Context: Despite nursing's potential to contribute valuable solutions to healthcare challenges, dedicated nursing innovation development programs are scarce. This scarcity, compounded by a lack of nursing leadership competencies in fostering innovation, inhibits nurses' ability to translate innovative ideas into clinical practice effectively.

Intervention: This Doctor of Nursing Practice (DNP) project addressed this gap by establishing a structure, process, and technology access based on industry-standard for nursing innovation in the inpatient setting.

Aims and Methods: The project aimed to establish a structure, process, and technology access based on industry-standard for nursing innovation in the inpatient setting, to implement and …

Implementation Of A Transition Shock Prevention Workshop To Promote Satisfaction And Confidence Among New To Practice Nurse Practitioners, Denis L. Hawkins

Yale School of Nursing Digital Theses

For decades nurse researchers such as Patricia Benner and Margaret Flinter have focused on the challenges of role transition in nursing (Benner, 2004; Flinter, 2010). Role transition from RN to NP can be a daunting experience. Many new-to-practice nurse practitioners experience a phenomenon known as Transition Shock which is described as disproportionate feelings of anxiety and doubt that can consume personal energy during the initial period of role adjustment (Duchscher, 2009). Literature demonstrates that feelings of transition shock can be influenced by factors such as readiness for learning, unwelcoming environments, and the learning curriculum (Barnes, 2015; Duchscher, 2008; MacClellan, et. …

Implementation And Evaluation Of Perinatal Educational Video Series – Postpartum Hemorrhage, Daileann Lamara Hemmings

Yale School of Nursing Digital Theses

Abstract

Implementation and Evaluation of Perinatal Educational Video Series –Postpartum Hemorrhage Per the Centers for Disease Control and Prevention (2021), 700 women die each year due to pregnancy related complications in the United States. Black women (Erickson, 2020) have a 26.6% higher risk for morbidity resulting from postpartum hemorrhage (PPH) and a five times higher risk of mortality. Education can serve as a tool to increase knowledge, promote a mother’s ability to identify the onset of a risk and report signs and symptoms of PPH that could otherwise lead to complications or death. ​ This DNP pilot project developed and …

Nonfatal Strangulation And Intimate Partner Violence Decision Tree Protocol, Joy Martin

Yale School of Nursing Digital Theses

AbstractNonfatal Strangulation and Intimate Partner Violence Decision Tree Protocol Problem and Context Nonfatal strangulation (NFS) is the ultimate form of power and control in intimate partner violence (IPV). Native American women are at an increased risk of intimate partner violence. Symptoms of strangulation are frequently missed by first responders. Victims often decline medical examination. Victims of nonfatal strangulation can have significant long term complications and increased morbidity throughout their lives. Intervention or Innovation This project provided educational training sessions to first responders within a Native American community in the Southwestern United States to increase knowledge and comfort when responding to …

Retaining New Graduate Nurses: Creating A Model Inpatient Transition To Practice Program In A Large Healthcare System, Amanda Jane Richards

Yale School of Nursing Digital Theses

Abstract

Retaining New Graduate Nurses: Creating a Model Inpatient Education to Practice Program in a Large Healthcare SystemPurpose: The purpose of this study is to address the persistent challenge of high turnover rates among New Graduate Nurses (NGNs) by implementing and evaluating a Dedicated Education Unit (DEU) model in a large hospital. The DEU aims to provide intensive support and training to NGNs during their transition to clinical practice, with a focus on improving retention rates and enhancing patient care quality. Background: New Graduate Nurse turnover rates have reached alarming levels, impacting healthcare organizations' stability and patient outcomes. Traditional postgraduate …

Moral Distress: The Importance Of Support For Black And Brown Nurses After Encountering Racism From Patients And Peers In The Acute Care Setting, Marsha Sinanan

Yale School of Nursing Digital Theses

Purpose: This DNP project developed and implemented an online training program to support Black and Brown nurses’ post-racism encounters in the acute care inpatient setting. Background: Nationally, it is estimated that 25% of nurses experience mistreatment by patients each year, but many fail to report these episodes (Campbell, 2016). The retention of Black and Brown nurses is essential, as cultural congruence or shared experiences among patients and members of their healthcare team can, be an important bridge for promoting safety and the best clinical outcomes (Moceri, 2014). Methods: Approximately 400 RNs were invited to participate in a 15-minute online training …

The California Bridge Model For Emergency Department-Initiated Medication-Assisted Treatment For Opioid Use Disorder: Adaptations For Perinatal Hospital Services, Devin C. Thomas

Yale School of Nursing Digital Theses

Background: Poor access to gender-specific, pregnancy-focused medication-assisted treatment for perinatal opioid use disorder greatly contributes to adverse outcomes for pregnant patients, infants, and society, at large. It is well established that Emergency Department-initiated pharmacotherapy for opioid use disorder is safe, effective, and can be rapidly adopted by hospital systems to improve access to care for people who misuse opioids. Like the Emergency Department, perinatal hospital services are well positioned to serve as critical access points in the treatment of perinatal opioid use disorder. However, concerns such as lack of training, workflow inefficiencies, and bias act as barriers to co-located, integrated …

Copd C.A.R.E. Connect: A Systems Trajectory To Reducing Copd Readmissions In A Large National Healthcare Institution, Jennifer Mariano

Yale School of Nursing Digital Theses

COPD is the third principal diagnosis accounting for 30-day all-cause readmission,14.4% of rehospitalization are due to acute exacerbation and occur within 3 days after discharge. Readmission exposes the patient to risks of medical errors and hospital-acquired infection. An interprofessional care program for COPD patients called “COPD C.A.R.E. (Control Avoidable REadmissions) Connect” was established within the medical surgical unit at this large national healthcare institution. The program utilized frontline expert collaboration to provide inpatient COPD-specific healthcare teachings, promote self-care, and ensure the timeliness of post-discharge care. The project aimed to adapt an interprofessional care service for hospitalized COPD inpatients to reduce …

Lack Of Association Of A1c With Postoperative Complications In Children With Type 1 Or Type 2 Diabetes, Grace Kim, Mckenna C Richards, Abigail B Smith, Kathleen M Strybos, Xiaofan Huang, Kristen Staggers, Stephen A Stayer, Rahul G Baijal

Faculty, Staff and Students Publications

Not meeting recommended A1C targets may be associated with postoperative complications in adults, but there are no studies reporting on the relationship between preoperative A1C and postoperative complications in children with type 1 or type 2 diabetes. The objective of this study was to determine whether elevated A1C levels were associated with an increased incidence of postoperative complications in children with diabetes presenting for elective noncardiac surgery or diagnostic procedures. It found no such association, suggesting no need to delay elective surgery in children with diabetes until A1C is optimized.

Planning For Children In Disasters: Education And Strategies For The Best Outcomes, Mark X Cicero, Nichole R Davis, Allison Marie Henning, Steven Krug

Faculty, Staff and Students Publications

No abstract provided.

Choice Of Adjuvant And Antigen Composition Alters The Immunogenic Profile Of A Sars-Cov-2 Subunit Vaccine, William R Lykins, Jeroen Pollet, Jessica A White, Brian Keegan, Leroy Versteeg, Ulrich Strych, Wen-Hsiang Chen, Raodoh Mohamath, Gabi Ramer-Denisoff, Sierra Reed, Samuel Beaver, Alana Gerhardt, Emily A Voigt, Mark A Tomai, Robert Sitrin, Robert K M Choy, Frederick J Cassels, Peter J Hotez, Maria Elena Bottazzi, Christopher B Fox

Faculty, Staff and Students Publications

Introduction: Since their introduction, adjuvanted recombinant subunit vaccines against COVID-19 have played a pivotal role in protecting global populations. Optimizing the immune response's quality, amplitude, and durability to these vaccines depends on the appropriate adjuvant choice and dose in combination with the selected antigen.

Methods: Here, we employed a preclinical mouse model to study the adaptive humoral and cellular immune responses to a SARS-CoV-2 receptor binding domain (RBD) antigen formulated with one of four different immune agonists [GLA, 3M-052, CpG-1826 (CpG), and dmLT], in combination with one of two different immune-stimulating formulations, a stabilized squalene emulsion (SE) or aluminum hydroxide …

Continuing Education And Professional Development: Unifying Opportunities For Genetic Counselors Globally, Kathleen D Valverde, Tiffiney R Hartman, Sara L Reichert, Robin L Bennett, Martha Dudek, Debra Duquette, Daniel Riconda, Nancy J Cox, Gail P Jarvik, Sarah H Elsea, Elizabeth M Mcnally, Kim C Worley, Daniel J Rader

Faculty, Staff and Students Publications

No abstract provided.

Research Considerations For Prospective Studies Of Patients With Coma And Disorders Of Consciousness, Lorenzo Tinti, Thomas Lawson, Erika Molteni, Daniel Kondziella, Verena Rass, Tarek Sharshar, Yelena G Bodien, Joseph T Giacino, Stephan A Mayer, Moshgan Amiri, Susanne Muehlschlegel, Chethan P Venkatasubba Rao, Paul M Vespa, David K Menon, Giuseppe Citerio, Raimund Helbok, Molly Mcnett

Faculty, Staff and Students Publications

Disorders of consciousness are neurological conditions characterized by impaired arousal and awareness of self and environment. Behavioural responses are absent or are present but fluctuate. Disorders of consciousness are commonly encountered as a consequence of both acute and chronic brain injuries, yet reliable epidemiological estimates would require inclusive, operational definitions of the concept, as well as wider knowledge dissemination among involved professionals. Whereas several manifestations have been described, including coma, vegetative state/unresponsive wakefulness syndrome and minimally conscious state, a comprehensive neurobiological definition for disorders of consciousness is still lacking. The scientific literature is primarily observational, and studies-specific aetiologies lead to …

Editorial: Epilepsy And Alzheimer’S Disease: Shared Pathology, Clinical Presentations, And Targets For Treatment, Beth Leeman-Markowski, Jeannie Chin, Dominique Leitner, Keith Vossel

Faculty, Staff and Students Publications

No abstract provided.

Laminar Multi-Contrast Fmri At 7t Allows Differentiation Of Neuronal Excitation And Inhibition Underlying Positive And Negative Bold Responses, Xingfeng Shao, Fanhua Guo, Junghwan Kim, David Ress, Chenyang Zhao, Qinyang Shou, Kay Jann, Danny Jj Wang

Faculty, Staff and Students Publications

A major challenge for human neuroimaging using functional MRI is the differentiation of neuronal excitation and inhibition which may induce positive and negative BOLD responses. Here, we present an innovative multi-contrast laminar functional MRI technique that offers comprehensive and quantitative imaging of neurovascular (CBF, CBV, BOLD) and metabolic (CMRO2) responses across cortical layers at 7T. This technique was first validated through a finger-tapping experiment, revealing ‘double-peak’ laminar activation patterns within the primary motor cortex. By employing a ring-shaped visual stimulus that elicited positive and negative BOLD responses, we further observed distinct neurovascular and metabolic responses across cortical layers and eccentricities …