Digital Commons Network^™

Nicu Team Nursing Model: Purposeful Collaborative For Positive Outcomes, Kymeyone Lanehart, Rebecca Palmer, Jerithea Tidwell, Lisa Mason, Sharica Whitten, Katie Doerge, Sushmita Yallapragada

2024

INNOVATION

Background: In 2013, an elevated CLABSI rate as high as 3.4 indicated that a specialized team approach would be necessary to improve quality care and patient outcomes. Development of a unique blood stream infection (BSI) team, that focused specifically on managing central lines, was successful and later expanded in to focus on other quality metrics. In 2015, the team was re-named safety and quality (SAQ). In 2016, the NICU utilized the team model by developing an internal transport team (ITT) to complete internal transports for procedures. The SAQ and ITT groups merged in 2019 to improve efficiency in the …

Rise Of The New Grad: Early Engagement Of New Graduate Nurses In Professional Governance, Annie Tolliver, Katie Fields

2024

INNOVATION

Background: Traditionally, new graduate nurses (GNs) are advised to gain experience before participating in Nursing Professional Governance (NPG). NPG is a structure that empowers nurses to be decision-makers regarding the nursing practice environment. We identified GNs had minimal knowledge of and engagement in NPG. An innovative process was developed to involve GNs in NPG, challenging the traditional approach.

Literature: Substantial evidence supports that nurses engaged in NPG are empowered to make decisions, leading to better patient outcomes and increased professional satisfaction. Research shows GNs’ dedication and professional satisfaction are tied to their ability to embed into the organizational culture …

Exploration Of Central Venous Catheter Protective Devices In The Pediatric Population: A Mixed Methods Study, Lindsey Flores, Quineka Smith, Maria Leal, Melissa Ruffini

2024

RESEARCH

Purpose:
/="/">In the pediatric population, about 25% of the catheters are reported to have issues such as CLABSI, line dislodgement, contamination, or catheter breaks. The primary purpose of this study is to explore caregiver and nurse satisfaction of pediatric patients with CVCs that utilize a wearable protective device with specific aims to determine parent’s perception of the feasibility while wearing the device. Wearable devices are an extra measure utilized among pediatric patients for nurses and parents to further protect the CVC dressing and catheter from complications. A single site study found that utilizing a wearable device reduced line …

New Approach To Professional Governance In Ambulatory, Brittney Saldierna, Katelyn Tinkey, Diana Sarmiento

2024

INNOVATION

Shared Governance Committees have involved frontline staff in driving change for many years. However, they often involve significant input from leaders, making frontline staff feel like their opinions don't matter as much. Professional Governance Committees emphasize that frontline staff should be the primary drivers of change without significant influence from leaders. Leaders should focus on removing barriers to the frontline staff's vision and ensuring that all changes comply with policies and regulations.

This Ambulatory System has created a unique structure in which the Ambulatory Council (AC) is the overarching structure for nine other councils. These councils meet monthly and …

Exploration Of Decedent Care Practices Among Pediatric Hospitals In The United States, Mayra Garcia, Kim Mccarthy, Kiele Samuel, Kathleen Ellis, Lisa Jones, Joe Don Cavender, Ryan Campbell, Chelsea Reynolds, Jesse Leos, Pauline Chen

2024

RESEARCH

Purpose:
Pediatric deaths in hospitals profoundly affect both staff and families, underscoring the need for clear decedent care processes and specialized training to navigate emotional and procedural challenges. Cooling rooms and reflection spaces, which provide families with more time for memory-making and help ease the emotional burden of separation, have been shown to offer significant support. However, these facilities are less common in the U.S., highlighting the necessity for further research in this area. The purpose of this study was to explore the decedent care (DC) practices in pediatric hospitals in the United States.

Methods:
Participants were recruited via …

Midline Catheter Implementation: Expanding Vascular Access Options In A Level Iv Nicu To Decrease Vascular Injury, Kymeyone Lanehart, Rebecca Palmer, Jeri Tidwell, Sushmita Yallapragada, Courtney Campbell, Lebanon David, Katie Doerge

2024

EBP

Background: PIV catheters are the most placed device in the NICU requiring frequent attempts, with a brief duration due to complications which indicate removal before completion of treatment. PIVs used for treatment have a patient safety risk of PIVIE; the severity can be mild, moderate, or severe depending on the swelling and tissue damage. PIVIE rates are one of the patient quality outcomes and are increasing in the NICU. Considering the increased risks of long-term consequences from tissue injury associated with PIVs, MCD may improve quality and patient outcomes.

Problem: PICOT question: (P)For eligible neonates in a level IV …

Administration Of Naxitamab In High-Risk Neuroblastoma Patients To Manage Adverse Reactions, Lauren Brown, Nikki Marshall, Diamond Wright

2024

INNOVATION

Neuroblastoma is the most common extracranial solid tumor in children with approximately 700 cases diagnosed yearly. Children treated with traditional therapies experience a recurrence rate over 50%, increasing the chances of poor clinical outcomes. Integrating anti-disialoganglioside-2 (GD2) monoclonal antibodies like Naxitimab have significantly improved patient outcomes. However, there is no standardized process between pediatric institutions to administer the drug while managing adverse drug reactions. Naxitimab received accelerated approval from the US Food and Drug Administration for children over age one with relapsed/refractory high-risk Neuroblastoma. Approximately half of the patients receiving Naxitimab encountered acute adverse events (AEs). Different institutions manage …

The Use Of Storybook Implementation For Patient Education Tools, Jennifer Brown

2024

EBP

Practice Problem: For children with growth delay and their parents, how can implementation of storybooks with images, compared to disease specific handouts, increase understanding and knowledge of the disease and treatment as well as decrease anxiety? It was identified that parents and patients coming to the Endocrine Clinic for growth delay, did not always fully understand the reasons for the growth evaluation or causes of growth delay.

Literature/Evidence: Literature was retrieved, appraised, and synthesized to define best practices to create storybooks. Best practices included, using storybooks that include images, co-creation with intended audience. Using storybooks for patient education …

Study Uncovers The Role Of Polygenic Risk Scores In Hypertension Management, Staff

Browse All News

No abstract provided.

Delusive Nature Of Flip-Flop Sign Secondary To Histoplasmosis, Omer Riyadh, Omron Hassan, Yashwanth Yerramalla

Student Publications

Histoplasmosis, caused by Histoplasma capsulatum, often mimics the appearance of lung cancer on fludeoxyglucose (FDG) positron emission tomography (PET) scans. The “flip-flop fungus,” due to its similar presentation on imaging modalities, can lead to false-positive results and unnecessary invasive testing. We present a 46-year-old male patient with a lung nodule and bilateral hilar lymphadenopathy on an FDG-PET scan who initially presented with chest discomfort. Histoplasma infection was confirmed through Grocott's methenamine silver (GMS) stains on bronchoscopy-guided biopsy specimens. An analysis of additional cases from the literature highlighted the diverse clinical presentations and outcomes associated with this condition that may be …

Ai-Enhanced Decision-Making For Course Modality Preferences In Higher Engineering Education During The Post-Covid-19 Era, Amirreza Mehrabi, Jason Morphew, Babak Nadjar Araabi, Negar Memarian, Hossein Memarian

School of Engineering Education Faculty Publications

The onset of the COVID-19 pandemic has compelled a swift transformation in higher-education methodologies, particularly in the domain of course modality. This study highlights the potential for artificial intelligence and machine learning to improve decision-making in advanced engineering education. We focus on the potential for large existing datasets to align institutional decisions with student and faculty preferences in the face of rapid changes in instructional approaches prompted by the COVID-19 pandemic. To ascertain the preferences of students and instructors regarding class modalities across various courses, we utilized the Cognitive Process-Embedded Systems and e-learning conceptual framework. This framework effectively delineates the …

The Association Of The Oral Microbiota With Cognitive Functioning In Adolescence, Oxana Y Naumova, Pavel V Dobrynin, Galina V Khafizova, Elena L Grigorenko

Faculty, Staff and Students Publications

Background: A growing body of research supports the role of the microbial communities residing in the digestive system in the host's cognitive functioning. Most of these studies have been focused on the gut microbiome and its association with clinical phenotypes in middle-aged and older adults. There is an insufficiency of population-based research exploring the association of normative cognitive functioning with the microbiome particularly with the oral microbiota.

Methods: In this study, using metagenomics and metabolomics, we characterized the salivary microbiome diversity in a sample of 51 males of Hispanic and African American origin aged 12-18 years and explored …

The Bg News September 27, 2024, Bowling Green State University

BG News (Student Newspaper)

The BGSU campus student newspaper. September 27, 2024. Homecoming Issue.

Length-Scale Study In Deep Learning Prediction For Non-Small Cell Lung Cancer Brain Metastasis, Haowen Zhou, Siyu Lin, Mark Watson, Cory T Bernadt, Oumeng Zhang, Ling Liao, Ramaswamy Govindan, Richard J Cote, Changhuei Yang

2020-Current year OA Pubs

Deep learning-assisted digital pathology has demonstrated the potential to profoundly impact clinical practice, even surpassing human pathologists in performance. However, as deep neural network (DNN) architectures grow in size and complexity, their explainability decreases, posing challenges in interpreting pathology features for broader clinical insights into physiological diseases. To better assess the interpretability of digital microscopic images and guide future microscopic system design, we developed a novel method to study the predictive feature length-scale that underpins a DNN's predictive power. We applied this method to analyze a DNN's capability in predicting brain metastasis from early-stage non-small-cell lung cancer biopsy slides. This …

A Basally Active Cgas-Sting Pathway Limits Sars-Cov-2 Replication In A Subset Of Ace2 Positive Airway Cell Models, Maritza Puray-Chavez, Jenna E Eschbach, Ming Xia, Kyle M Lapak, Qianzi Zhou, Ria Jasuja, Jiehong Pan, Jian Xu, Zixiang Zhou, Shawn Mohammed, Qibo Wang, Dana Q Lawson, Sanja Djokic, Gaopeng Hou, Siyuan Ding, Steven L Brody, Michael B Major, Dennis Goldfarb, Sebla B Kutluay

2020-Current year OA Pubs

Host factors that define the cellular tropism of SARS-CoV-2 beyond the cognate ACE2 receptor are poorly defined. Here we report that SARS-CoV-2 replication is restricted at a post-entry step in a number of ACE2-positive airway-derived cell lines due to tonic activation of the cGAS-STING pathway mediated by mitochondrial DNA leakage and naturally occurring cGAS and STING variants. Genetic and pharmacological inhibition of the cGAS-STING and type I/III IFN pathways as well as ACE2 overexpression overcome these blocks. SARS-CoV-2 replication in STING knockout cell lines and primary airway cultures induces ISG expression but only in uninfected bystander cells, demonstrating efficient antagonism …

Crinophagic Granules In Pancreatic Β Cells Contribute To Mouse Autoimmune Diabetes By Diversifying Pathogenic Epitope Repertoire, Hao Hu, Anthony N Vomund, Orion J Peterson, Neetu Srivastava, Tiandao Li, Lisa Kain, Wandy L Beatty, Bo Zhang, Chyi-Song Hsieh, Luc Teyton, Cheryl F Lichti, Emil R Unanue, Xiaoxiao Wan

2020-Current year OA Pubs

Autoimmune attack toward pancreatic β cells causes permanent loss of glucose homeostasis in type 1 diabetes (T1D). Insulin secretory granules store and secrete insulin but are also thought to be tissue messengers for T1D. Here, we show that the crinophagic granules (crinosome), a minor set of vesicles formed by fusing lysosomes with the conventional insulin dense-core granules (DCG), are pathogenic in T1D development in mouse models. Pharmacological inhibition of crinosome formation in β cells delays T1D progression without affecting the dominant DCGs. Mechanistically, crinophagy inhibition diminishes the epitope repertoire in pancreatic islets, including cryptic, modified and disease-relevant epitopes derived from …

Nur77 Protects The Bladder Urothelium From Intracellular Bacterial Infection, Christina A Collins, Chevaughn Waller, Ekaterina Batourina, Lokesh Kumar, Cathy L Mendelsohn, Nicole M Gilbert

2020-Current year OA Pubs

Intracellular infections by Gram-negative bacteria are a significant global health threat. The nuclear receptor Nur77 (also called TR3, NGFI-B, or NR4A1) was recently shown to sense cytosolic bacterial lipopolysaccharide (LPS). However, the potential role for Nur77 in controlling intracellular bacterial infection has not been examined. Here we show that Nur77 protects against intracellular infection in the bladder by uropathogenic Escherichia coli (UPEC), the leading cause of urinary tract infections (UTI). Nur77 deficiency in mice promotes the formation of UPEC intracellular bacterial communities (IBCs) in the cells lining the bladder lumen, leading to persistent infection in bladder tissue. Conversely, treatment with …

Massively Parallel Characterization Of Insulator Activity Across The Genome, Clarice K Y Hong, Yawei Wu, Alyssa A Erickson, Jie Li, Arnold J Federico, Barak A Cohen

2020-Current year OA Pubs

A key question in regulatory genomics is whether cis-regulatory elements (CREs) are modular elements that can function anywhere in the genome, or whether they are adapted to certain genomic locations. To distinguish between these possibilities we develop MPIRE (Massively Parallel Integrated Regulatory Elements), a technology for recurrently assaying CREs at thousands of defined locations across the genome in parallel. MPIRE allows us to separate the intrinsic activity of CREs from the effects of their genomic environments. We apply MPIRE to assay three insulator sequences at thousands of genomic locations and find that each insulator functions in locations with distinguishable properties. …

Awareness Of, Willingness To Use, And Experiences With Pre-Exposure Prophylaxis Among Youth In Nigeria, Titilola Gbaja-Biamila, Juliet Iwelunmor, Et Al.

2020-Current year OA Pubs

BACKGROUND: Youth (ages 14-24) in Nigeria have disproportionately high rates of new HIV infection. Pre-exposure prophylaxis could substantially reduce new infections among youth but has not been scaled up. This cross-sectional study aimed to assess Pre-exposure prophylaxis awareness, willingness to use, and prior use of Pre-exposure prophylaxis among youth in Nigeria.

METHODS: This is a secondary analysis of cross-sectional data from a quasi-experimental pilot study (clinical trial NCT04070287). The analysis focused on Pre-exposure prophylaxis awareness, willingness to use, and prior use among 324 youth recruited between September 2019 to March 2020. Descriptive statistics were calculated as frequencies and percentages for …

Investigating The Role Of Mental Imagery Use In The Assessment Of Anhedonia, Julie L Ji, Marcella L Woud, Angela Rölver, Lies Notebaert, Jemma Todd, Patrick J F Clarke, Frances Meeten, Jürgen Margraf, Simon E Blackwell

School of Psychology

Anhedonia, or a deficit in the liking, wanting, and seeking of rewards, is typically assessed via self-reported "in-the-moment" emotional and motivational responses to reward stimuli and activities. Given that mental imagery is known to evoke emotion and motivational responses, we conducted two studies to investigate the relationship between mental imagery use and self-reported anhedonia. Using a novel Reward Response Scale (adapted from the Dimensional Anhedonia Rating Scale, DARS; Rizvi et al., 2015) modified to assess deliberate and spontaneous mental imagery use, Study 1 ( N  = 394) compared uninstructed and instructed mental imagery use, and Study 2 ( N  = …

Disparities In Stage At Diagnosis Among Hispanic Patients With Gastric Cancer In The United States, Antoine Jeri-Yabar, Liliana Vittini-Hernandez, Renzo Aller-Rojas, Francisco Arias-Reyes, Sirish Dharmapuri

School of Medicine Publications

Simple Summary

This study investigates racial disparities in the stage of gastric cancer at diagnosis and overall survival among different racial groups using data from the SEER database (2018–2021). The retrospective cohort study of 18,984 patients found that Hispanics are 19% more likely to be diagnosed at a later stage of gastric cancer compared to non-Hispanics. Additionally, both Hispanics and Black patients showed poorer overall survival compared to Non-Hispanic Whites. The disparities are attributed to factors such as healthcare access, insurance coverage, language barriers, and preventive health service utilization. These findings highlight the need for targeted interventions to address these …

Usf2 And Tfeb Compete In Regulating Lysosomal And Autophagy Genes, Jaebeom Kim, Young Suk Yu, Yehwa Choi, Do Hui Lee, Soobin Han, Junhee Kwon, Taichi Noda, Masahito Ikawa, Dongha Kim, Hyunkyung Kim, Andrea Ballabio, Keun Il Kim, Sung Hee Baek

Duncan NRI Faculty and Staff Publications

Autophagy, a highly conserved self-digestion process crucial for cellular homeostasis, is triggered by various environmental signals, including nutrient scarcity. The regulation of lysosomal and autophagy-related processes is pivotal to maintaining cellular homeostasis and basal metabolism. The consequences of disrupting or diminishing lysosomal and autophagy systems have been investigated; however, information on the implications of hyperactivating lysosomal and autophagy genes on homeostasis is limited. Here, we present a mechanism of transcriptional repression involving upstream stimulatory factor 2 (USF2), which inhibits lysosomal and autophagy genes under nutrient-rich conditions. We find that USF2, together with HDAC1, binds to the CLEAR motif within lysosomal …

Prevalence Of Cardiometabolic Risk Factors In Women: Insights From The Houston Heartreach Study, Arjun R Raghuram, Matthew W Segar, Stephanie Coulter, Joseph G Rogers

The Texas Heart Institute Journal

BACKGROUND: Cardiovascular disease is the leading cause of death among women in the United States. Past research has highlighted the importance of the relationship between female-specific demographics and traditional risk factors. The present analysis aimed to identify the prevalence of modifiable risk factors in women attending a community cardiovascular health screening.

METHODS: Data collected between 2011 and 2019 were obtained from the Houston HeartReach Registry. Participants were classified as having or not having each of 4 traditional cardiometabolic risk factors: hypertension, diabetes, body mass index indicating overweight or obesity, and dyslipidemia. Differences in prevalence were compared using the Pearson χ2 …

The "Pros" Of Probiotics: A Review Of Probiotics Place In Therapy, Kelley Maberry, Hanh Nguyen, Connor Quinter, Justine Magalona

Transformative Medicine

As different probiotic supplements become increasingly seen in the market, questions regarding their use for gut health from patients rises as well. Because these supplements do not require FDA approval, their safety and efficacy is often unknown and limited research available poses an even greater challenge for healthcare providers when prompted with questions regarding their use. This article summarizes evidence-based recommendations provided by the American Gastroenterological Association (AGA) and the World Gastroenterology Organization (WGO). Of the conditions discussed, supportive evidence on the use of probiotics is mostly seen in the prevention of C. diff associated diarrhea, prevention of antibiotic associated …

Which Endocrine Disorder Does This Ecg Suggest?, Muhammad Mohsin Zafar, Muhammad Asad Hanif

Transformative Medicine

No abstract provided.

An Unusual Presentation Of Erythrodermic Psoriasis, Eden L. Parks, Kojo-Frimpong B. Awuah Md, Caitlin D. Couper Md

Transformative Medicine

Introduction

Erythrodermic psoriasis is a rare form of psoriasis, occurring in less than 3% of patients with psoriasis. Limited information is known regarding diagnosis and treatment for this form of psoriasis, with most studies involving small groups or single patients. This unusual case of erythrodermic psoriasis outlines the presentation, diagnosis, and treatment that occurred in a 53-year-old patient who initially presented with dyspnea and a fever.

Case Presentation

The 53-year-old patient was originally admitted for dyspnea and a fever. A maculopapular rash developed diffusely on the upper extremities, lower extremities, trunk, and face. The rash then desquamated over several days, …

Management Strategies Of Cesarean Section Ectopic Pregnancy: A Case Report, Hannah E. Daley, Ava R. Hansen, Priyanka Raju Md, Jonathan Buerger Md

Transformative Medicine

Introduction:

Cesarean scar ectopic pregnancy is a rare form of pregnancy with potential life-threatening complications such as severe hemorrhage, uterine rupture, and emergency hysterectomy Currently, there is no consensus regarding a standardized treatment algorithm for this specific variant of ectopic pregnancies.

Case Description:

This case describes a 28-year-old female with history of two prior cesarean sections who was diagnosed with cesarean section scar ectopic pregnancy. Initial management with intramuscular methotrexate was unsuccessful in the setting of inadequate decrease in β-hCG level. The patient ultimately underwent surgical management with dilation and suction evacuation under ultrasound guidance for removal of the ectopic …

The Kent-Collins Protocol For Symptom Management In Post-Radiotherapy Eustachian Tube Dysfunction: A Case Report, Matthew E. Kent, Patrick J. Collins, Ayal A. Aizer

Transformative Medicine

Introduction: Eustachian tube dysfunction is a common side effect of radiotherapy for head and neck cancers or brain tumors, although few effective treatments exist. The Kent-Collins Protocol represents a novel therapeutic option for post-radiotherapy Eustachian tube dysfunction.

Case Description: The Kent-Collins Protocol was employed in one patient with Eustachian tube dysfunction following fractionated stereotactic radiotherapy for cerebral metastases from HER-2 positive breast cancer. The Kent-Collins Protocol provided relief of symptoms (conductive hearing loss, aural fullness, and otalgia) for a range of 5 to 45 minutes. The protocol could be repeated when symptoms returned to provide additional relief. The patient also …

Catastrophic Spontaneous Uterine And Bladder Rupture In An Unscarred Uterus, Nathanael N. Hoskins Do, Kathryn Brandt Do, Tory Peterson Md

Transformative Medicine

Introduction:

Uterine rupture during pregnancy is a rare event which can be life-threatening for both the patient and the fetus. This case report describes a rare complication of uterine rupture which ultimately required a hysterectomy and extensive urologic reconstruction.

Case Description:

A 36-year-old patient presented to the hospital after term pre-labor rupture of membranes. The patient underwent induction of labor which ultimately resulted in a uterine rupture in an unscarred uterus. The rupture extended into the posterior bladder wall, right ureter, urethra, and anterior vaginal wall, resulting in a vesicovaginal fistula. The patient required a cesarean hysterectomy due to the …

Spontaneous Spinal Epidural Hematoma Presenting As A Stroke Alert: A Case Report, Christian Flores Do, Monisha Bindra Do, Mph, Adam Sigal Md, Michael Romeo Do

Transformative Medicine

Introduction

Spinal epidural hematoma (SEH) is a rare pathologic entity that accounts for less than 1% of all space-occupying spinal canal lesions [2,8]. Even more rare are spontaneous spinal epidural hematomas (SSEH), defined as a SEH without a known traumatic or inciting cause, with a reported incidence of 0.1 cases per 100,000 annually [1,2]. Currently, there is a paucity of literature regarding this topic [2,3]. SSEH can easily be missed or misdiagnosed if clinicians do not hold a high level of clinical suspicion.

Case Description

A 69-year-old female with no history of anticoagulation use or preceding trauma presented to the …