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Full-Text Articles in Medicine and Health Sciences

Targeting The Cerebrovasculature In Sepsis: A Focus On The Brain Microvascular Endothelium, Divine C. Nwafor Jan 2023

Targeting The Cerebrovasculature In Sepsis: A Focus On The Brain Microvascular Endothelium, Divine C. Nwafor

Graduate Theses, Dissertations, and Problem Reports

The blood-brain barrier (BBB) is a critical interface between the systemic circulation and the brain. It is a specialized multicellular unit composed of brain microvascular endothelial cells (BMECs), pericytes, a basement membrane, and astrocytic end foot processes. BMECs are a principal component of the BBB that provide the structural framework needed for the stringent transport of molecules into the brain. BMEC dysfunction permits the trafficking of neurotoxins from systemic circulation into the brain, which ultimately exacerbates BBB dysfunction and neuroinflammation. Studies have shown that BBB dysfunction is a key determinant of cognitive decline in sepsis. However, there are critical knowledge ...


Childhood And Adolescent Obesity: Related Comorbidities And Interventions, Jasmine Wong Dec 2022

Childhood And Adolescent Obesity: Related Comorbidities And Interventions, Jasmine Wong

Nursing | Senior Theses

Background

The prevalence of childhood and adolescent obesity in the United States has steadily risen over the years and has become a public health concern. Obesity is defined as a BMI at or above the 95th percentile for children and teens of the same age and sex. Obese children and adolescents are at risk for poor health and poor quality of life. Furthermore, there are numerous comorbidities associated with childhood and adolescent obesity. While some of the associated diseases are acute, others can become chronic and result in lifelong conditions.

Objective

The purpose of the present thesis is to explore ...


Association Of Visceral Adiposity Index With Incident Nephropathy And Retinopathy: A Cohort Study In The Diabetic Population, Zhiyuan Wu, Siqi Yu, Xiaoping Kang, Yue Liu, Zongkai Xu, Zhiwei Li, Jinqi Wang, Xinlei Miao, Xiangtong Liu, Xia Li, Jingbo Zhang, Wei Wang, Lixin Tao, Xiuhua Guo Dec 2022

Association Of Visceral Adiposity Index With Incident Nephropathy And Retinopathy: A Cohort Study In The Diabetic Population, Zhiyuan Wu, Siqi Yu, Xiaoping Kang, Yue Liu, Zongkai Xu, Zhiwei Li, Jinqi Wang, Xinlei Miao, Xiangtong Liu, Xia Li, Jingbo Zhang, Wei Wang, Lixin Tao, Xiuhua Guo

Research outputs 2022 to 2026

Background: The association between visceral adiposity index (VAI) and diabetic complications has been reported in cross-sectional studies, while the effect of VAI on complication development remains unclear. This study aims to evaluate the longitudinal association of VAI and Chinese VAI (CVAI) with the incidence of diabetic nephropathy and retinopathy using a Chinese cohort. Methods: A total of 8 948 participants with type 2 diabetes from Beijing Health Management Cohort were enrolled during 2013–2014, and followed until December 31, 2019. Nephropathy was confirmed by urine albumin/creatinine ratio and estimated glomerular filtration rate; retinopathy was diagnosed using fundus photograph. Results ...


Utility Of The Motivation To Change Lifestyle And Health Behaviors For Dementia Risk Reduction Scale (Mclhb-Drr) Based On A North American Sample, Angelina E. Witbeck Jun 2022

Utility Of The Motivation To Change Lifestyle And Health Behaviors For Dementia Risk Reduction Scale (Mclhb-Drr) Based On A North American Sample, Angelina E. Witbeck

Dissertations

As the population ages, the prevalence rates of dementia continue to increase. Without a cure or promising treatment for dementia, the best course of lowering the prevalence rates of dementia is through preventative measures. Through an electronic survey, the study utilized the MCLHB-DRR scale to determine whether (1) gender, age, educational background, and socioeconomic status will impact the motivational factors to change lifestyle and health behaviors to reduce the risk of developing dementia and (2) direct experiences with individuals that have a dementia diagnosis are likely to impact one's motivational factors to change lifestyle and health behaviors to reduce ...


The Life Story Analysis Of Those Suffering From Autoimmune Thyroiditis, Azalea Di Nardi Jun 2022

The Life Story Analysis Of Those Suffering From Autoimmune Thyroiditis, Azalea Di Nardi

Dissertations

The purpose of this study was to understand the pervasive impacts of autoimmune thyroiditis, specifically Hashimoto’s and Graves’ disease. To accomplish this, the life story methodology was utilized to gather individual experiences from 11 participants diagnosed with Hashimoto’s or Graves’ disease. The participants completed a background and general health questionnaire and 45- to-100-minute virtual interview disclosing their journey from the onset of symptoms, through diagnosis, to their most recent state. Themes were compiled from the interviews, which allowed identification of the largest areas of impact, needs, and future implications for practitioners and providers. Major themes identified were decreased ...


Enriching The Perioperative Enhanced Recovery After Surgery (Eras) Program For Patients Undergoing Whipple Procedure For Pancreatic Cancer, Natalie E. Fisher May 2022

Enriching The Perioperative Enhanced Recovery After Surgery (Eras) Program For Patients Undergoing Whipple Procedure For Pancreatic Cancer, Natalie E. Fisher

Doctor of Nursing Practice Final Manuscripts

Pancreatic cancer remains one of the most complex and lethal diseases worldwide with surgical resection as a major treatment choice. Although surgery may be one of the only options for advanced pancreatic cancer, it is not without a lengthy hospital stay, a long list of possible postoperative complications, and an increased risk for readmission after discharge. Enhanced recovery after surgery (ERAS) programs have been implemented for years in other surgical services for cancer care. These programs have now been extended and researched to include patients undergoing surgery for pancreatic cancer. These programs are designed to assist patients and their families ...


Epistemic Injustice, Endometriosis And Dance/ Movement Therapy: An Autoethnographic Investigation, Kevana West May 2022

Epistemic Injustice, Endometriosis And Dance/ Movement Therapy: An Autoethnographic Investigation, Kevana West

Expressive Therapies Capstone Theses

As the field of dance/ movement therapy evolves to meet the demands of a rapidly changing social landscape, it is imperative that clinicians think critically about the degree to which our work is steeped in oppressive frameworks and ideologies. This investigation uses testimony to explore epistemic injustice as it relates to the author’s experience of living with endometriosis and the pursuit of professional licensure. Considering the limited amount of research on the condition, along with the perceived absence of literature within the field of dance/ movement therapy, further study is warranted. The experimentation phase of this research incorporated the ...


Multi-Strain Epidemic Model With Infected Vaccinated And Re-Infected Recovered Population: Application To Covid-19 Pandemic, Olusegun Michael Otunuga May 2022

Multi-Strain Epidemic Model With Infected Vaccinated And Re-Infected Recovered Population: Application To Covid-19 Pandemic, Olusegun Michael Otunuga

Biology and Medicine Through Mathematics Conference

No abstract provided.


A Within-Host Modeling Framework For Sars-Cov-2 Infection To Support Vaccine Strategies, Morgan Rose, Rachel Jennings, Jeffry Schroeter May 2022

A Within-Host Modeling Framework For Sars-Cov-2 Infection To Support Vaccine Strategies, Morgan Rose, Rachel Jennings, Jeffry Schroeter

Biology and Medicine Through Mathematics Conference

No abstract provided.


Dynamics Of The Climax And Attack Communities In Cystic Fibrosis, Peter Uhl May 2022

Dynamics Of The Climax And Attack Communities In Cystic Fibrosis, Peter Uhl

Biology and Medicine Through Mathematics Conference

No abstract provided.


The Effect Of Prep Uptake And Adherence On The Spread Of Hiv In The Presence Of Casual And Long-Term Partnerships, Sylvia J. Gutowska, Katharine Gurski, Kathleen Hoffman May 2022

The Effect Of Prep Uptake And Adherence On The Spread Of Hiv In The Presence Of Casual And Long-Term Partnerships, Sylvia J. Gutowska, Katharine Gurski, Kathleen Hoffman

Biology and Medicine Through Mathematics Conference

No abstract provided.


A Sailor’S Disease Presenting In Urban America With Red Spots On The Legs, John A. Buchan, Bruce H. Gray May 2022

A Sailor’S Disease Presenting In Urban America With Red Spots On The Legs, John A. Buchan, Bruce H. Gray

Cooper Rowan Medical Journal

Sailors were often affected by nutritional deficiencies due to the absence of fresh foods on long voyages. One example is the development of scurvy from a lack of vitamin C ingestion. In modern society in which fresh food are available this disease is infrequently recognized. The following case describes a 62-year-old male who presented with “red spots” on his legs and a large area of ecchymosis on his thigh. After initial testing failed to elicit a cause, a dietary history revealed that the patient had a peculiar diet of only ice cream with a total avoidance of fruits and vegetables ...


Covid-19 Newsletter (Vol. 119), Center For Disaster Medicine, New York Medical College May 2022

Covid-19 Newsletter (Vol. 119), Center For Disaster Medicine, New York Medical College

COVID-19 Newsletter

No abstract provided.


Isolation And Characterization Of Α-Hcd7 Scfv Expressing Exosomes And Synthesis Of Hybrid Exosome-Liposome For Analyses, Sahil Patel May 2022

Isolation And Characterization Of Α-Hcd7 Scfv Expressing Exosomes And Synthesis Of Hybrid Exosome-Liposome For Analyses, Sahil Patel

Biotechnology Theses

The goal of this thesis project is to isolate and characterize exosomes that express anti-human CD7 (α-hCD7) single chain variable fragment (scFv), which will be further utilized for T celltargeted gene editing. To reach this goal, exosomes from HEK 293 cells and Jurkat cells were isolated and characterized with different methodologies. To obtain α-hCD7 scFv-expressing exosomes, the HEK 293 cells were subjected to transfection of custom-plasmid pDisplay-αhCD7 scFv, and the expression of α-hCD7 scFv on the HEK 293-derived exosomes were then confirmed by immunogold staining, western blotting, and flow cytometry. To transfect 293 cells, calcium phosphate transfection was utilized, and ...


Implementing A Self-Management Glucose Monitoring Pathway To Improve Glycemic Control, Brian Kozaczka May 2022

Implementing A Self-Management Glucose Monitoring Pathway To Improve Glycemic Control, Brian Kozaczka

Doctor of Nursing Practice Scholarly Projects

Introduction: Nationwide and locally in Los Angeles, CA, uncontrolled diabetes remains a complex chronic condition within the primary care setting. Chronically uncontrolled diabetes is costly for patients and health care systems due to high morbidity and mortality rates. As payor sources move in the direction of providing payment based on core measures and value-based care, chronic illness programs designed to improve these outcomes must be developed, implemented, and sustained. The Federally Qualified Health Center (FQHC) in which this quality improvement project was conducted represents the largest of 11 comprehensive care, family practice FQHCs in the South-Central Los Angeles area.

Background ...


A Preliminary Investigation Of Neuroantibody Levels, Prevalence, And Environmental Factors In Patients With Neurological Dysfunction, Jihan Azar May 2022

A Preliminary Investigation Of Neuroantibody Levels, Prevalence, And Environmental Factors In Patients With Neurological Dysfunction, Jihan Azar

Theses and Dissertations

Nervous system damage comprises a large proportion of diseases worldwide. It is also the most difficult to diagnose. Biomarkers for nervous system damage are needed in order to diagnose these diseases early enough to allow for intervention. In this study, we recruited patients from two Egyptian hospitals with MCI, ET and NMS and health references. Serum autoantibody levels against neural proteins and heavy metals were analyzed and compared. Immunoglobulin G (IgG) antibodies against neurofilament H (NFH), Glial Fibrillary Acidic Protein (GFAP), Myelin Basic Protein (MBP) and alpha synuclein (a-SYN) and Immunoglobulin M (IgM) antibody against neurofilament light (NFL) were among ...


Coronavirus Update 5-11-22, The Coronavirus Planning Team May 2022

Coronavirus Update 5-11-22, The Coronavirus Planning Team

University Briefings & Virtual Events

With the end of the semester, we have shut down the COVID dashboard. We will evaluate the need for it in the future based on the status of the virus.


A Small Peptide Increases Drug Delivery In Human Melanoma Cells, Shirley Tong, Shaban Darwish, Hanieh Hossein Nejad Ariani, Kate Alison Lozada, David Salehi, Maris A. Cinelli, Richard B. Silverman, Kamaljit Kaur, Sun Yang May 2022

A Small Peptide Increases Drug Delivery In Human Melanoma Cells, Shirley Tong, Shaban Darwish, Hanieh Hossein Nejad Ariani, Kate Alison Lozada, David Salehi, Maris A. Cinelli, Richard B. Silverman, Kamaljit Kaur, Sun Yang

Pharmacy Faculty Articles and Research

Melanoma is the most fatal type of skin cancer and is notoriously resistant to chemotherapies. The response of melanoma to current treatments is difficult to predict. To combat these challenges, in this study, we utilize a small peptide to increase drug delivery to melanoma cells. A peptide library array was designed and screened using a peptide array-whole cell binding assay, which identified KK-11 as a novel human melanoma-targeting peptide. The peptide and its D-amino acid substituted analogue (VPWxEPAYQrFL or D-aa KK-11) were synthesized via a solid-phase strategy. Further studies using FITC-labeled KK-11 demonstrated dose-dependent uptake in human melanoma cells. D-aa ...


Health Equity & Obesity Management: An Improvement Project In A Federally Qualified Healthcare Center In Central Harlem, Brianna Bouchez May 2022

Health Equity & Obesity Management: An Improvement Project In A Federally Qualified Healthcare Center In Central Harlem, Brianna Bouchez

Doctor of Nursing Practice Scholarly Projects

Description of the problem: Obesity is a growing healthcare problem worldwide with extraordinary costs to the individual's health and the healthcare system. Individuals most affected by obesity include socioeconomically disadvantaged individuals, often with limited resources to seek specialized care.

Available knowledge: Various weight-loss interventions exist but access and success rates vary. Weight loss is often modest and additional factors such as social determinants of health, health literacy, and patient motivation are all factors important to the success of an intervention.

Specific Aims: The purpose of this quality improvement project was to improve self-regulatory weight loss behaviors and increase weight ...


National Early Warning Score (News) For Covid-19 Infected Patients: A Clinical Guidance Tool, Robert Villegas May 2022

National Early Warning Score (News) For Covid-19 Infected Patients: A Clinical Guidance Tool, Robert Villegas

Doctor of Nursing Practice Final Manuscripts

Background: Coronavirus 2019 (COVID-19) presents with variable clinical manifestations from asymptomatic to life-threatening organ dysfunction. The National Early Warning Score, also known as NEWS, was initially developed to detect adult inpatient deterioration using existing physiological data and adverse clinical outcomes from 35,585 medical admissions. The NEWS guideline consists of six parameters: respiratory rate, pulse, oxygen saturation, temperature, systolic blood pressure, and level of consciousness.

Purpose: This project implemented NEWS guidelines to identify patients at high risk for deterioration with COVID-19.

Evidence-Based Interventions: The project included retrospective-prospective chart reviews for 100 patients diagnosed with COVID-19 from October 2020 to December ...


Hepatitis B And D: A Forecast On Actions Needed To Reduce Incidence And Achieve Elimination, Scott Greenhalgh, Andrew Klug May 2022

Hepatitis B And D: A Forecast On Actions Needed To Reduce Incidence And Achieve Elimination, Scott Greenhalgh, Andrew Klug

Spora: A Journal of Biomathematics

Viral hepatitis negatively affects the health of millions, with the worst health outcomes associated with the hepatitis D virus (HDV). Fortunately, HDV is rare and requires prior infection with the hepatitis B virus (HBV) before it can establish infection and transmit. Here, we develop a mathematical model of HBV and HDV transmission in Sub-Saharan Africa to investigate the effects of hepatitis B vaccination on both HBV and HDV. Our findings illustrate a hepatitis B vaccination rate above 0.006 year-1 reduces hepatitis D by over 90%, and a vaccination rate above 0.0221 year-1 reduces hepatitis B by ...


Covid-19 Newsletter (Vol. 118), Center For Disaster Medicine, New York Medical College May 2022

Covid-19 Newsletter (Vol. 118), Center For Disaster Medicine, New York Medical College

COVID-19 Newsletter

No abstract provided.


Quantifying Intra- And Interlimb Use During Unimanual And Bimanual Tasks In Persons With Hemiparesis Post-Stroke, Susan V. Duff, Aaron Miller, Lori Quinn, Gregory Youdan Jr., Lauri Bishop, Heather Ruthrauff, Eric Wade May 2022

Quantifying Intra- And Interlimb Use During Unimanual And Bimanual Tasks In Persons With Hemiparesis Post-Stroke, Susan V. Duff, Aaron Miller, Lori Quinn, Gregory Youdan Jr., Lauri Bishop, Heather Ruthrauff, Eric Wade

Physical Therapy Faculty Articles and Research

Background

Individuals with hemiparesis post-stroke often have difficulty with tasks requiring upper extremity (UE) intra- and interlimb use, yet methods to quantify both are limited.

Objective

To develop a quantitative yet sensitive method to identify distinct features of UE intra- and interlimb use during task performance.

Methods

Twenty adults post-stroke and 20 controls wore five inertial sensors (wrists, upper arms, sternum) during 12 seated UE tasks. Three sensor modalities (acceleration, angular rate of change, orientation) were examined for three metrics (peak to peak amplitude, time, and frequency). To allow for comparison between sensor data, the resultant values were combined into ...


Memory T Cell Populations In Human Leukemia, Sara Mcelroy May 2022

Memory T Cell Populations In Human Leukemia, Sara Mcelroy

Research Days

Background: Incorporating the immune system into cancer management is an area of robust research. Treatment modalities aimed at activating cytotoxic T cells against malignancies include immune checkpoint inhibitors, bispecific T-cell engagers, and chimeric antigen receptor (CAR) tumor-specific T cells. Most anti-cancer T cell research is narrowly focused, but knowledge about the nature of diverse sub-populations of T cells in cancer, particularly memory T cells, is vital prior to potential incorporation into therapies. T memory stem cells (Tscm) are of interest due to their longevity and powerful abilities of self-renewal and creating the full spectrum of memory CD8+ T cells, including ...


Creating A Guideline For Sti Testing In The Pediatric Population, Alexandria Molaro, Alexandra Evans, Alex Niebrugge May 2022

Creating A Guideline For Sti Testing In The Pediatric Population, Alexandria Molaro, Alexandra Evans, Alex Niebrugge

Doctor of Nursing Practice Projects

Sexually transmitted infection (STI) prevention, education, screening, and management in pediatric primary care settings are of importance due to the increasing number of cases yearly. Almost half of the 26 million new STIs that occurred in 2018 were among young people 15-24. An opportunity existed in a rural pediatric primary clinic, for improved adherence to Centers for Disease Control and Prevention (CDC) or American Academy of Pediatrics (AAP) recommendations to screen/test patients. An evidence-based project (EBP) was developed to address this concern. Project objectives included: developing STI screening guidelines for pre-teen to young adults, developing a screening algorithm, providing ...


Variation In Laboratory & Radiographic Workup And Outcome In Children Hospitalized With Common Musculoskeletal Infections, Emily Bonanni May 2022

Variation In Laboratory & Radiographic Workup And Outcome In Children Hospitalized With Common Musculoskeletal Infections, Emily Bonanni

Research Days

Watch recording of live presentation.

Background: Common pediatric musculoskeletal infections (MSKIs) require prompt recognition & treatment to prevent significant morbidity and mortality. Variation in initial workup of these infections & associations with clinical outcomes is not well studied and could aid development of evidence-based guidelines to provide high-value care for all MSKIs.

Objectives/Goal: Examine variation in initial lab testing & imaging obtained in patients hospitalized for common MSKIs and explore association with clinical outcomes (length of stay (LOS), cost, 30-day readmission).

Methods/Design: We performed a retrospective, multicenter cohort study of hospitalized children aged 6 months to 18 years with a diagnosis of acute osteomyelitis, septic arthritis or pyomyositis from 1/1/16 to 6/30/20 using the Pediatric Health Information System (PHIS) database. We collected rates of common lab testing (complete blood count [CBC], inflammatory marker [IM], blood culture) & radiographic studies (ultrasound [US], xray [XR], magnetic resonance imaging [MRI], computed tomography [CT] scan) obtained on hospital days 0 & 1. K-means clustering grouped hospitals based on frequency of which lab and imaging studies were obtained. Logistic regression was used to determine associations between overall cluster utilization & risk-adjusted patient outcomes.

Results: We identified 6597 children admitted from 44 hospitals with an included MSKI diagnosis. More than 50% were 2-10 years of age, with a majority being male (Table 1). Most children ( > 84%) had CBC or IM, with some variation across diagnoses. MRI and XR imaging were used most frequently (56 and 59%, respectively), also with variation across diagnoses (Table 1). Cluster 1 (n=15) showed slightly higher lab utilization and lower US use (Figure 1) with significantly shorter hospital LOS for patients with acute osteomyelitis (3.7 vs. 4.0 days, p-value 0.043; Table 2) but no significant difference in cost or readmission rates. There were no outcome differences for patients with septic arthritis or pyomyositis.

Conclusions: Despite a lack of universal practice guidelines in the work up & management of pediatric MSKIs, little variation existed in workup or outcomes across hospitals. This may be due to similar initial presentation of many MSKIs. Future investigation of differences in detailed patient-level clinical factors (e.g., lab results, vitals) on initial presentation or downstream hospital management could elucidate if associations with outcomes ...


A Fatal Case Of Covid-19 Pneumonia In A Fully Vaccinated Heart Transplant Recipient, Agastya D. Belur, Diana Otero, Christina Dunbar Matos May 2022

A Fatal Case Of Covid-19 Pneumonia In A Fully Vaccinated Heart Transplant Recipient, Agastya D. Belur, Diana Otero, Christina Dunbar Matos

The University of Louisville Journal of Respiratory Infections

The development and administration of mRNA vaccines against SARS-CoV-2 are seeing lower numbers of COVID-19 cases and fatalities among fully vaccinated, immunocompetent adults. We present a case of fatal COVID-19 pneumonia in a heart transplant recipient who had received two doses of mRNA COVID-19 vaccine before the Centers for Disease Control and Prevention had recommended additional doses.


Orthodox Jewish Women And Ritual Purity During The Pandemic, Stephen Covell, Diane Riggs, Cameron Borg May 2022

Orthodox Jewish Women And Ritual Purity During The Pandemic, Stephen Covell, Diane Riggs, Cameron Borg

Modules for Teaching Pandemic Response and Religion in the USA

The following teaching module is designed for high school and college level instructors who seek to teach a lesson on the impact the COVID-19 pandemic has had on Jewish women and their ritual purity. The teaching module features a lesson plan, case studies, and assignments that can be incorporated as the instructor sees fit. This teaching module was created by Wester Michigan University's Department of Comparative Religion.


Covid-19 Vaccine Mandate, Mikhail Kun, Tatiana Ryzhakova May 2022

Covid-19 Vaccine Mandate, Mikhail Kun, Tatiana Ryzhakova

Publications and Research

The COVID-19 pandemic has wreaked havoc on the planet and killed millions of people. Health care workers and radiology technicians who come into direct contact with COVID-19 patients have indeed been the most affected by the virus. Since the pandemic began, the COVID-19 cases among health care workers have surged and quadrupled. COVID-19 vaccine mandate is the need of the time. Mandates have a history and are in effect for other diseases such as smallpox, measles, or mumps. But since the vaccines have come out for COVID-19, there is a public impetus to condemn these vaccines, based on the false ...


Covid-19, Vaccination, And Heart Transplantation, Forest W. Arnold May 2022

Covid-19, Vaccination, And Heart Transplantation, Forest W. Arnold

The University of Louisville Journal of Respiratory Infections

No abstract provided.