Digital Commons Network^™

Implementation Of A Standardized Handoff Reference Tool From The Intensive Care Unit To The Operating Room, Sophia Agbomah, Stacie Summers

Doctor of Nursing Practice (DNP) Student Projects

Background and Review of Literature: This quality improvement (QI) intervention evaluated the effectiveness of a standardized handoff reference tool for patients transferring from the Surgical Intensive Care Unit (SICU) to the operating room (OR) in a large metropolitan level I trauma center. There was minimal data to assess the quality of this sequence of patient transfer as no systematic ICU-OR handoff content practices were currently employed at the hospital. This project aimed to help fill the practice-knowledge gap that could impact some of the most vulnerable patients during ICU-OR transfer. Methods: Pre- and post-implementation staff surveys, live observations, and chart …

Assessing Workflow In The Postanesthesia Care Unit, Laura Mcgrath, Emma Vierod

Doctor of Nursing Practice (DNP) Student Projects

The postanesthesia care unit (PACU) environment must function smoothly as a critical recovery area for monitoring of immediate postoperative patients. Timely responsiveness to complications is imperative to ensure patient safety. Following postanesthesia observation, a patient is discharged from the PACU to home or is admitted to the hospital. If this transition is delayed by excessive discharge times or poorly managed patient adverse events, it can cause major bottlenecks and issues with throughput for the perioperative setting. This project aims to study the present workflow in the PACU, identify gaps in the workflow and provide recommendations to perioperative leadership. Current PACU …

Reducing Unsecured Medications In Anesthetizing Area, Christine Bergesch, Kate Manuel

Doctor of Nursing Practice (DNP) Student Projects

Background and Review of Literature: Anesthetic medications should be secured consistently to prevent adverse outcomes such as medication errors, drug diversion, and financial loss. Standardized practice for medication stewardship is not established by Washington University Department of Anesthesiology (WUDA). Anesthesia providers’ imprudent medication stewardship practices are a continuous challenge due to the controlled and time-sensitive drugs they provide. Purpose: The purpose of this quality improvement (QI) project was to decrease the number of medications left behind unsecured in anesthetizing areas, describe the most frequently encountered barriers and category of medications left behind unsecured, and improve knowledge and utilization of the …

Improving Anesthesia Clinicians’ Knowledge And Confidence When Selecting Prophylactic Antimicrobials For Patients On Concomitant Antimicrobial Therapy, Garry Gregson, Emily Shands

Doctor of Nursing Practice (DNP) Student Projects

Anesthesia clinicians at Barnes-Jewish Hospital (BJH) in Saint Louis, Missouri experienced uncertainty and discomfort when they selected preoperative antibiotics for patients who were already receiving concomitant therapeutic antimicrobials (CTA) unrelated to surgical prophylaxis. Various evidence-based interventions were proposed to address this issue. The first intervention was the addition of pathogens of concern to the surgical antimicrobial prophylaxis (SAP) protocol at BJH. The second intervention was the creation of a reference table that supplemented the revised protocol and allowed clinicians to efficiently determine the pathogens of concern for each surgery. This also included the CTAs efficacy for preventing surgical site infections …

Propofol Disposal In The Operating Room: Addressing The Practice Knowledge Gap, Samantha Trulove, Audreau Conley

Doctor of Nursing Practice (DNP) Student Projects

Background: There is an increasing incidence of propofol diversion and abuse amongst healthcare workers. Barnes-Jewish Hospital (BJH) has implemented the Stericycle controlled substance disposal system (CsRx) in the operating rooms (ORs) to address this issue; however, propofol continued to be left unsecured.

Purpose: The QI initiative aimed to raise anesthesia clinician awareness of propofol’s abuse potential and of the Stericycle CsRx container, ultimately to reduce unsecured propofol.

Methods: An educational intervention was utilized to address the identified problem. Data on unsecured propofol was collected via an auditing process of pharmaceutical waste bin contents at the BJH North campus endoscopy suite. …

What Factors Increase Risk Of Alzheimer's Disease And Related Dementia?, Elizabeth Vásquez, Kai Zhang

Population Health Research Brief Series

Alzheimer’s disease is the most common form of dementia and ranks 7th in the leading causes of death in the United States (U.S.). This data slice uses nationwide data from 3,155 counties in the U.S. to identify the factors that best predict county-level rates of Alzheimer’s Disease and Related Dementias (ADRDs) in 2018. The results indicate that insufficient sleep, consuming less than one serving of fruits and vegetables per day, having no high school diploma, Black population percentage, and social vulnerability were among the leading factors predicting county-level ADRD prevalence.

Evaluation Of Outcomes Between The Top-Down Versus The Bottom-Up Approach For Retropubic Midurethral Sling, Vidushri Mehrotra, John Pearl, David Sheyn, Susan D. Wherley

Student Scholarship

Introduction and hypothesis: Retropubic midurethral sling (MUS) placement is the gold standard for the treatment of stress urinary incontinence in the USA. The procedure can be approached from either a top-down or a bottom-up direction, but there is a paucity of contemporary data regarding outcomes between these approaches. The aim of this study was to provide updated clinical outcomes data. Methods: This was a retrospective cohort study of women undergoing the retropubic MUS procedure alone or at the time of pelvic organ prolapse repair between 2010 and 2020 at a single academic medical center. The electronic medical record was used …

Soil Health Class-2: Soil Ph, Jiyul Chang, Becki Ritter, Dean Feller, Madhav P. Nepal

iLEARN Teaching Resources

This lesson on soil pH explores the crucial role of soil acidity or alkalinity in plant health and productivity. Soil pH, or potential of Hydrogen ions in soil, is a measure of how acidic or basic soil is. Appropriate soil pH condition is important to grow plants. If soil pH is not appropriate, plants cannot absorb nutrients from soil well, then plants cannot grow well and cannot produce vegetables. This class will show what an appropriate soil pH condition is and how to measure soil pH of garden using simple test kit. Covering the pH scale from acidic to alkaline, …

The Eu's Regulation Of Speech: A Critical View, Vincenzo Zeno-Zencovich

University of the Pacific Law Review

No abstract provided.

Remedies For "Disinformation", Russell L. Weaver

University of the Pacific Law Review

No abstract provided.

Judicial Process, Free Speech, And Ordered Liberty, Luke M. Milligan, Robert E. Ranney

University of the Pacific Law Review

No abstract provided.

Regulation Of Online Speech In The Uk, Mariette W. Jones

University of the Pacific Law Review

No abstract provided.

Misinformation, Social Media, And Opportunities For Content-Based Regulation Within The Constraints Of The United States Constitution's Free Speech Guarantee, Leslie Gielow Jacobs

University of the Pacific Law Review

No abstract provided.

The Pathogenicity Of Vancomycin-Resistant Enterococcus Faecalis To Colon Cancer Cells, Li Zhang, Mingxia Deng, Jing Liu, Jiajie Zhang, Fangyu Wang, Wei Yu

Faculty, Staff and Student Publications

BACKGROUND: The aim of this study was to investigate the pathogenicity of vancomycin-resistant Enterococcus faecalis (VREs) to human colon cells in vitro.

METHODS: Three E. faecalis isolates (2 VREs and E. faecalis ATCC 29212) were cocultured with NCM460, HT-29 and HCT116 cells. Changes in cell morphology and bacterial adhesion were assessed at different time points. Interleukin-8 (IL-8) and vascular endothelial growth factor A (VEGFA) expression were measured via RT-qPCR and enzyme-linked immunosorbent assay (ELISA), respectively. Cell migration and human umbilical vein endothelial cells (HUVECs) tube formation assays were used for angiogenesis studies. The activity of PI3K/AKT/mTOR signaling pathway was measured …

Novel Ancestry-Specific Primary Open-Angle Glaucoma Loci And Shared Biology With Vascular Mechanisms And Cell Proliferation, Valeria Lo Faro, Arjun Bhattacharya, Wei Zhou, Dan Zhou, Ying Wang, Kristi Läll, Masahiro Kanai, Esteban Lopera-Maya, Peter Straub, Priyanka Pawar, Ran Tao, Xue Zhong, Shinichi Namba, Global Biobank Meta-Analysis Initiative, Serena Sanna, Ilja M Nolte, Yukinori Okada, Nathan Ingold, Stuart Macgregor, Harold Snieder, Ida Surakka, Jonathan Shortt, Chris Gignoux, Nicholas Rafaels, Kristy Crooks, Anurag Verma, Shefali S Verma, Lindsay Guare, Daniel J Rader, Cristen Willer, Alicia R Martin, Milam A Brantley, Eric R Gamazon, Nomdo M Jansonius, Karen Joos, Nancy J Cox, Jibril Hirbo

Faculty, Staff and Student Publications

Primary open-angle glaucoma (POAG), a leading cause of irreversible blindness globally, shows disparity in prevalence and manifestations across ancestries. We perform meta-analysis across 15 biobanks (of the Global Biobank Meta-analysis Initiative) (n = 1,487,441: cases = 26,848) and merge with previous multi-ancestry studies, with the combined dataset representing the largest and most diverse POAG study to date (n = 1,478,037: cases = 46,325) and identify 17 novel significant loci, 5 of which were ancestry specific. Gene-enrichment and transcriptome-wide association analyses implicate vascular and cancer genes, a fifth of which are primary ciliary related. We perform an extensive statistical analysis of …

Dieta De La Milpa: A Culturally-Concordant Plant-Based Dietary Pattern For Hispanic/Latine People With Chronic Kidney Disease, Annabel Biruete, Gabriela Leal-Escobar, Angeles Espinosa-Cuevas, Luis Mojica, Brandon M. Kistler

Purdue University Libraries Open Access Publishing Fund

Chronic kidney disease (CKD) disproportionately affects minorities in the United States, including the Hispanic/Latine population, and is a public health concern in Latin American countries. An emphasis on healthy dietary patterns, including the Mediterranean and the Dietary Approaches to Stop Hypertension (DASH) diets, has been suggested as they are associated with a lower incidence of CKD, slower CKD progression, and lower mortality in kidney failure. However, their applicability may be limited in people from Latin America. The Dieta de la Milpa (Diet of the Cornfield) was recently described as the dietary pattern of choice for people from Mesoamerica (Central Mexico …

Impact Of Palliative Care Utilization Among Kidney Cancer Patients In Us Hospitals: A National-Scale Analysis, Rushin Patel, Mrunal Patel, Darshil Patel, Chieh Yang, Afoma Onyechi, Jessica Ohemeng-Dapaah, Zalak Patel, Safia Shaikh

2020-Current year OA Pubs

No abstract provided.

Recombinant Rod Domain Of Vimentin Reduces Sars-Cov-2 Viral Replication By Blocking Spike Protein-Ace2 Interactions, Fong Wilson Lam, Cameron August Brown, Shannon Elizabeth Ronca

Faculty, Staff and Students Publications

Although the SARS-CoV-2 vaccination is the primary preventive intervention, there are still few antiviral therapies available, with current drugs decreasing viral replication once the virus is intracellular. Adding novel drugs to target additional points in the viral life cycle is paramount in preventing future pandemics. The purpose of this study was to create and test a novel protein to decrease SARS-CoV-2 replication. We created the recombinant rod domain of vimentin (rhRod) in E. coli and used biolayer interferometry to measure its affinity to the SARS-CoV-2 S1S2 spike protein and the ability to block the SARS-CoV-2–ACE2 interaction. We performed plaque assays …

Current Strategies For Increasing Knock-In Efficiency In Crispr/Cas9-Based Approaches, Andrés Felipe Leal, Angelica María Herreno-Pachón, Eliana Benincore-Flórez, Amali Karunathilaka, Shunji Tomatsu

Department of Pediatrics Faculty Papers

Since its discovery in 2012, the clustered regularly interspaced short palindromic repeats (CRISPR) and CRISPR-associated protein 9 (Cas9) system has supposed a promising panorama for developing novel and highly precise genome editing-based gene therapy (GT) alternatives, leading to overcoming the challenges associated with classical GT. Classical GT aims to deliver transgenes to the cells via their random integration in the genome or episomal persistence into the nucleus through lentivirus (LV) or adeno-associated virus (AAV), respectively. Although high transgene expression efficiency is achieved by using either LV or AAV, their nature can result in severe side effects in humans. For instance, …

Burial And Subsequent Growth Of Rigid Ryegrass (Lolium Rigidum) And Ripgut Brome (Bromus Diandrus) Following Strategic Deep Tillage, Catherine Borger, George Mwenda, Sarah Collins, Stephen Davies, Arslan Peerzada Dr, Andrew Van Burgel

Biosecurity Research Articles

Soil amelioration via strategic deep tillage is occasionally utilised within the conservation tillage systems to alleviate soil constraints, but its impact on weed seed burial and subsequent growth within the agronomic system is poorly understood. This study assessed the effects of different strategic deep tillage practices, including soil loosening (deep ripping), soil mixing (rotary spading), or soil inversion (mouldboard plough), on weed seed burial and subsequent weed growth, compared to a no-till control. The tillage practices were applied in 2019 at Yerecoin and Darkan, Western Australia, and data on weed seed burial and growth was collected during the following three-year …

A Comprehensive Patient-Specific Prediction Model For Temporomandibular Joint Osteoarthritis Progression, Najla Al Turkestani, Tengfei Li, Jonas Bianchi, Marcela Gurgel, Juan Prieto, Hina Shah, Erika Benavides, Fabiana Soki, Yuji Mishina, Margherita Fontana, Arvind Rao, Hongtu Zhu, Lucia Cevidanes

Pacific Faculty Work

Temporomandibular joint osteoarthritis (TMJ OA) is a prevalent degenerative disease characterized by chronic pain and impaired jaw function. The complexity of TMJ OA has hindered the development of prognostic tools, posing a significant challenge in timely, patient-specific management. Addressing this gap, our research employs a comprehensive, multidimensional approach to advance TMJ OA prognostication. We conducted a prospective study with 106 subjects, 74 of whom were followed up after 2 to 3 y of conservative treatment. Central to our methodology is the development of an innovative, open-source predictive modeling framework, the Ensemble via Hierarchical Predictions through Nested cross-validation tool (EHPN). This …

Susceptible Windows Of Prenatal And Postnatal Fine Particulate Matter Exposures And Attention-Deficit Hyperactivity Disorder Symptoms In Early Childhood, Wei-Jen Chen, Alison M Rector-Houze, Mònica Guxens, Carmen Iñiguez, Michael D Swartz, Elaine Symanski, Jesús Ibarluzea, Antonia Valentin, Aitana Lertxundi, Llúcia González-Safont, Jordi Sunyer, Kristina W Whitworth

Faculty, Staff and Student Publications

Few prior studies have explored windows of susceptibility to fine particulate matter (PM_2.5) in both the prenatal and postnatal periods and children’s attention-deficit/hyperactivity disorder (ADHD) symptoms.

We analyzed data from 1,416 mother-child pairs from the Spanish INMA (INfancia y Medio Ambiente) Study (2003–2008). Around 5 years of age, teachers reported the number of ADHD symptoms (i.e., inattention, hyperactivity/impulsivity) using the ADHD Diagnostic and Statistical Manual of Mental Disorders. Around 7 years of age, parents completed the Conner’s Parent Rating Scales, from which we evaluated the ADHD index, cognitive problems/inattention, hyperactivity, and oppositional subscales, reported as age- and sex-standardized …

The Influence Of Mentoring On Goal Attainment And Role Satisfaction For Registered Nurses In Acute Care Facilities, Christine B. Smith

Dissertations

Mentoring has been suggested as a means to assist with role transition, career planning, and retention in the profession by providing opportunities for personal and professional growth lead to satisfaction. Satisfaction is especially crucial for the retention of Registered Nurses in a time when the profession has been experiencing a critical shortage. This quantitative study examined the influence of mentoring for RNs who have been employed in acute care facilities for the first time for less than 2 years. Using Bouquillon's mentoring instrument and based in the frameworks of King and Kram, the study suggests mentoring is occurring among new …

Global Nursing Leadership Competency Framework: Transforming The Future Of Healthcare, Barbara Stilwell

Biennial Convention (CONV)

While nursing leadership courses proliferate, there is no globally agreed competency framework. A team led by Sigma with funding support from J&J Foundation has created an evidence based global nursing leadership competency framework. Attend this session and learn about this innovative framework and ways to move health care forward.

General Cognitive Ability In High School, Attained Education, Occupational Complexity, And Dementia Risk, Jimi Huh, Thalida Em Arpawong, Tara L. Gruenewald, Gwenith G. Fisher, Carol A. Prescott, Jennifer J. Manly, Dominika Seblova, Ellen E. Walters, Margaret Gatz

Psychology Faculty Articles and Research

INTRODUCTION

We address the extent to which adolescent cognition predicts dementia risk in later life, mediated by educational attainment and occupational complexity.

METHODS

Using data from Project Talent Aging Study (PTAS), we fitted two structural equation models to test whether adolescent cognition predicts cognitive impairment (CI) and Ascertain Dementia 8 (AD8) status simultaneously (N_{Cognitive Assessment} = 2477) and AD8 alone (N_{Questionnaire} = 6491) 60 years later, mediated by education and occupational complexity. Co-twin control analysis examined 82 discordant pairs for CI/AD8.

RESULTS

Education partially mediated the effect of adolescent cognition on CI in the cognitive assessment aample and …

Annual Research Review: The Power Of Predictability – Patterns Of Signals In Early Life Shape Neurodevelopment And Mental Health Trajectories, Elysia Poggi Davis, Laura M. Glynn

Psychology Faculty Articles and Research

The global burden of early life adversity (ELA) is profound. The World Health Organization has estimated that ELA accounts for almost 30% of all psychiatric cases. Yet, our ability to identify which individuals exposed to ELA will develop mental illness remains poor and there is a critical need to identify underlying pathways and mechanisms. This review proposes unpredictability as an understudied aspect of ELA that is tractable and presents a conceptual model that includes biologically plausible mechanistic pathways by which unpredictability impacts the developing brain. The model is supported by a synthesis of published and new data illustrating the significant …

Executive Functioning Of Kindergarteners As Predicted By Parenting Style, Parental Warmth, And Parents’ Socioeconomic Status, Kimberly D. Barrow

Walden Dissertations and Doctoral Studies

An academic achievement disparity exists between children from low-income and high-income households, and this gap progressively expands over time. A child’s executive functioning skills and interactions with their parents can contribute to this deficit. This static group comparison and quantitative correlational research study was conducted to examine the effects of parental warmth, parenting style, and parents’ socioeconomic status (SES) and the impact on kindergarten students’ working memory and inhibition executive functioning skills. The research was guided by Bandura’s social learning theory and Baumrind parenting style theory. The data sources were online self-reported surveys completed by parents with children in kindergarten. …

Practice And Reflection On Cultivating Top-Notch Innovative Talents In Life Sciences And Medicine, Shuhan You, Jianzhong Zhou, Juan Li, Minghui Kong, Weihong Tan

Bulletin of Chinese Academy of Sciences (Chinese Version)

At present, China is moving towards the grand goal of building a world power in science and technology and a modernized socialist country. The shortage of top-notch innovative talents is one of the key factors restricting China’s efforts to build a world power in science and technology and a modernized socialist country. The report of the 20th CPC National Congress, for the first time, has deployed education, science and technology, and talent in a “trinity” special chapter, coordinated and planned as a whole, providing a fundamental guideline for the cultivation of top-notch innovative talents. This study takes the practice of …

Rapid Soil Detection Technology Aids In Assessing Soil Nutrients In China, Wei Wu, Xiaoyong Liao, Xiaopeng Li, Yuntao Wu, Huixian Lu, Yucheng Zhang, Jiabao Zhang

Bulletin of Chinese Academy of Sciences (Chinese Version)

Soil quality is the core issue for ensuring China’s food security, and soil health is the top priority of soil quality. Comprehensive, rapid and accurate acquisition of soil background data is the prerequisite for achieving homogeneous soil management and formulating balanced fertilization strategies, which will play a key role in improving non-point source pollution caused by unreasonable fertilization and achieving balanced grain yield increase. This study reviews rapid soil testing methods both domestically and internationally. Based on previous research, it proposes a technical approach to rapidly detect soil nutrient concentrations by calculating the gamma quanta released during the decay of …

Experience And Enlightenment Of Eu Natura 2000 Protected Area Network, Ling Tang, Baorong Huang, Tong Jin, Xuetian Hu

Bulletin of Chinese Academy of Sciences (Chinese Version)

The EU Natura 2000 protected area network, covering nearly 19% of the land and 10% of the sea in the EU, has played an important role in protecting biodiversity and enhancing regional socio-economic well-being, and is regarded as the most successful protected area network in the world. Its successful experience is mainly reflected in five aspects. (1) The adoption of regional biodiversity conservation legislation and the promotion of compliance with the law by member countries to promote the construction of the protected area network. (2) The establishment of a decision-making and implementation mechanism that combines the EU resolution process and …