Medicine and Health Sciences Commons^™

Application Of Lymphedema Education Toolkit For Nurse Coordinators, Julian K. Miranda

Master's Projects and Capstones

Problem: There is approximately one in five breast cancer survivors affected by breast cancer-related lymphedema (BCRL), a potentially debilitating condition affecting the physical, emotional, social, and financial well-being of individuals. Context: This Quality Improvement (QI) project was conducted at an outpatient facility of Hospital X’s Women’s Cancer Center. Within this microsystem, there are 24 permanent clinical nurse coordinators and advanced practice providers, with 15 nurse coordinators dedicated to care for patients with breast cancer or gynecological conditions. Intervention: The intervention aims to evaluate if a standardized educational tool improves early interventions for patients with lymphedema and knowledge among healthcare providers …

Development, Validation, And Diagnostic Performance Of A Novel Radiomic Model For Predicting Prostate Cancer Recurrence, Linda M. Huynh

Theses & Dissertations

Multi-parametric magnetic resonance imaging (MP-MRI)-derived radiomics have been shown to capture sub-visual patterns for the quantitative characterization of prostate cancer (PC) phenotypes. The present dissertation seeks to develop, evaluate, and compare the performance of an MRI-derived radiomic model for the prediction of PC recurrence following definitive treatment with radical prostatectomy (RP).

MP-MRI was obtained from 339 patients who had a minimum of 2 years follow-up following RP at three institutions. The prostate was manually delineated as the region of interest and 924 radiomic features were extracted. All features were evaluated for stability via intraclass correlation coefficient (ICC) and image normalization …

Sex And Age Differences In Near-Infrared Spectroscopy Responses And The Resulting Influences On Cognition, Miranda K. Traylor

<strong> Theses and Dissertations </strong>

Vascular dysfunction is the earliest known marker of neurodegeneration. However, limited research has been conducted to determine if changes in peripheral vascular function track differences in brain health. Therefore, the purpose was to determine if previously reported sex differences in near-infrared spectroscopy (NIRS) vascular occlusion test (VOT) parameters persist across the lifespan and if these differences track age- and sex-related differences in a cognitive task. Ninety-nine healthy, cognitively intact adults (50 women, 49 men) across the adult lifespan (19-81 yrs) were used for analysis. The combination of NIRS-VOT was used to quantify microvascular function. Cognition was defined as the time …

Decoding Implant-Related Sickness: Unraveling The Complexities Of Breast Implant Illness, Madison M. Stewart

Senior Theses

This thesis investigates the phenomenon of breast implant illness (BII), examining its potential correlation with individual factors such as obesity and poor lifestyle habits. BII, characterized by nonspecific symptoms, is often self-diagnosed by patients influenced by social media and internet sources, leading to requests for implant removal. Conducting a comprehensive meta-analysis, the study scrutinizes existing literature to evaluate the association between BII, obesity, and lifestyle choices. Employing inclusion criteria, peer-reviewed publications are analyzed through systematic review methodology to offer insights into the interplay between BII and adiposity, exploring inflammatory mechanisms and patient behaviors like exercise and smoking. The research aims …

Quantitative Benefits Of Reducing The Inferior Border Of Right-Sided Free Breathing Intact Breast Treatment Plans Regarding Liver Dose, Shelby Handshue

Culminating Experience Projects

Introduction

Breast cancer is a prevalent disease in the United States, affecting approximately one in eight women during their lifetime (Leaver & Washington, 2010). Advancements in medical treatments have evolved from mastectomy to a multidisciplinary approach. Radiation therapy plays a crucial role in preventing local recurrence after breast conserving surgery. Traditionally, whole breast irradiation has been administered over 25-28 fractions to a total dose of 45-50 Gray (Gy), followed by a boost of 5-8 fractions to the tumor bed. In recent times, hypofractionation, which involves a shorter treatment schedule of 15-16 fractions to a total dose of 42.5 Gy, followed …

Functional Impact Of Ethyl-Β-D-Glucuronide On Mycobacterium Tuberculosis Stimulated Lung Macrophages, Charles Inaku

Biotechnology Theses

Chronic alcohol abuse has been shown to alter immune defense mechanisms in humans and mice which makes the host susceptible to infections, including Mycobacterium tuberculosis (Mtb) infection. However, limited information is available on the mechanisms involved in alcohol-mediated host immune system dysfunction.

In this study, we determined the effects of ethyl-β-d-glucuronide (EtG), an alcohol-derived metabolite, on immune response of mice lung macrophages. We measured cytokine and chemokine production by gamma-irradiated mtb (γ-mtb) stimulated mice lung macrophages in the presence or absence of EtG. We also determined the effect of EtG on the metabolic state of γ-mtb stimulated mice lung macrophages. …

The Benefits Of Art Therapy On Stress And Anxiety Of Oncology Patients During Treatment, Helen Shiepe

Expressive Therapies Capstone Theses

Within the last ten years research on art therapy and its positive impact on oncology patients’ stress and anxiety during treatment has been minimal. Oncology patients whether they are children or adults when diagnosed experience similar reactions due to their diagnosis, treatment, and in some cases end of life care. The current question is whether or not art therapy does have a positive impact on decreasing the stress and anxiety with oncology patients while undergoing treatment. Deane, Fitch & Carmen (2000), discussed art therapy as a healing art that is “intended to integrate physical, emotional, and spiritual care by facilitating …

Center Based Cardiac Rehabilitation Outcomes Associated With Covid-19 Pandemic: A Retrospective Comparative Cohort Study, Haley Williams, Kayla Woodworth

Doctor of Nursing Practice Projects: College of Nursing

Background: Traditional cardiac rehabilitation (CR) is a multidisciplinary, multifaceted program for cardiac patients. Throughout the Covid-19 pandemic, health care, including center-based CR (CBCR) programs, were closed to in-person sessions. Even with the return to CBCR participation, patient outcomes may have been affected by this disruption in care. The goal of this study was to determine if CR participation outcomes differed before and after CBCR program closure due to Covid-19.

Methods: A retrospective comparative cohort design was used to examine CR participant outcome data before and after the Covid-19 pandemic. Convenience sampling of CR participants at a large, urban …

A Machine Learning Approach For Predicting Clinical Trial Patient Enrollment In Drug Development Portfolio Demand Planning, Ahmed Shoieb

Masters Theses

One of the biggest challenges the clinical research industry currently faces is the accurate forecasting of patient enrollment (namely if and when a clinical trial will achieve full enrollment), as the stochastic behavior of enrollment can significantly contribute to delays in the development of new drugs, increases in duration and costs of clinical trials, and the over- or under- estimation of clinical supply. This study proposes a Machine Learning model using a Fully Convolutional Network (FCN) that is trained on a dataset of 100,000 patient enrollment data points including patient age, patient gender, patient disease, investigational product, study phase, blinded …

Exploring Novel Intradialytic Techniques To Identify & Ameliorate Of Hemodialysis-Induced Myocardial Ischemic Injury, Jarrin D. Penny

Electronic Thesis and Dissertation Repository

Patients with chronic kidney disease requiring hemodialysis to sustain life have extremely high rates of cardiovascular morbidity/mortality. This is both a consequence of the disease process and treatment. Hemodialysis induces systemic circulatory stress is largely due to the extracorporeal circuit and volume removal. The stress induced by intermitted hemodialysis is repetitive with cumulative cardiovascular effect and is the principal driver of heart failure and sudden death in this vulnerable population. The insults imposed by hemodialysis result in left ventricular regional wall motion abnormalities and lead to myocardial stunning with permanent damage to the vasculature and myocardium. Currently, the adversity caused …

Support Their Sleep: Enhancing Nurses' Knowledge And Implementation Of Non-Pharmacological Sleep Protocols To Improve Patient Rest, Recovery, And Reduce Cognitive Impairment., David C. Barry

Master's Theses and Capstones

Background: Sleep and rest play an influential role in promoting recovery and healing in humans. Hospitalized patients are at risk for altered sleep from hospitalization, illness, and stimulation from a hospital environment. Non-pharmacologic interventions preformed by nurses can help to improve sleep and sleep environment for patients.

Local problem: There was no protocol or available information regarding patient sleep promotion for nurses to references when caring for patients.

Methods: Nurses in the microsystem (n=8) were administered a pre/post questionnaire containing Likert scales and a short quiz containing knowledge-based questions. Questionnaires were distributed to nurses prior to and after …

A Descriptive And Visual Analysis Of The North Coast Fall Prevention Survey Data, Mishell Lopez

Cal Poly Humboldt theses and projects

Older adults over 65 will double from 52.4 million in 2018 to 94.7 million in 2060. Among this aging group, falls affect one out of four older adults and are a critical economic concern for our American society, with yearly costs of $50 billion. In older adults, falling can result in negative consequences such as fear of falling, injuries, mobility restrictions, and loss of independence. California has one of the highest costs per fall ($4 billion annually) and a high percentage of adults who have fallen (30.6%) compared to the nation. Moreover, two of California’s northwest rural counties, Del Norte, …

How Sleep Disturbances Affect Those With Borderline Personality Disorder And The Implications For Treatment, Molly L. Schmanke

Regis University Student Publications (comprehensive collection)

This thesis argues that there is limited research on Borderline Personality Disorder’s comorbidity with sleep disorders, and by pointing out the gaps in knowledge this will encourage researchers and doctors to consider this topic as important in the health care field. Sleep disorders can be anything from reduced total sleep time, fragmented sleep, and changes in sleep architecture, and all of these can cause and be caused by disruption of the circadian clock. There are various ways in which circadian clock disruption can cause diseases, cancer, and mental disorders through genes, sleep, and the environment. Borderline Personality Disorder comorbid with …

Development Of A Low-Dose Radiation Therapy Device For Acute Respritory Distress Syndrome, Thomas Heath Davis

Masters Theses

This research focuses on the development of a low dose radiotherapy (LD-RT) device for treatment of acute respiratory distress syndrome (ARDS), a respiratory illness that affects millions of people a year. The use of orthovoltage (200 – 500 keV) X-ray energy provides many advantages over traditional radiotherapy delivery with linear accelerators, such as low cost and greater accessibility. In addition, X-ray tubes have been shown throughout history to provide good treatment outcomes for pneumonia, and research has shown LD-RT to be just as effective with ARDS. This proposal summarizes my efforts in determining the dosimetric properties of a LD-RT system …

Methods Development In Inflammatory Bowel Disease, Andrew B. Steimke

Theses and Dissertations (ETD)

Inflammatory bowel disease (IBD) is a disease that is classified into two subtypes: ulcerative colitis (UC) and Crohn’s disease (CD). Symptoms can range from mild discomfort to requiring surgical intervention and affects approximately 1-in-200 adults in America alone, with global incidence rates increasing. While many treatments exist for IBD, perhaps the main reason for the lack of a cure is that there are many different pathogeneses that all lead to a very similar expression of symptoms. Over 240 IBD loci have been identified to date, yet the causative allele that drives the association has only been identified in ~60 of …

Induced Cytotoxicity In Crebbp/Ep300mut Head And Neck Squamous Cell Carcinoma, Thomaia Pamplin

Dissertations & Theses (Open Access)

INDUCED CYOTOXICTY IN CREBBP/EP300mut HEAD AND NECK SQUAMOUS CELL CARCINOMA

Thomaia Pamplin

Advisor: Curtis Pickering, Ph.D.

Background: Head and neck squamous cell carcinoma HNSCC is the most common malignancy in the head and neck. Most cases are found in advanced stages and depending on the location can be treated with surgical resection and/or radiation (XRT), chemotherapy, or chemoradiation. Our lab groups have identified that HNSCC with a mutation in its CREBBP/EP300 genes can be sensitized to XRT when the histone acetyltransferase activity of CREBBP/EP300 is inhibited. This radiosensitization manifests in the form of increased cell death for …

Evaluation Of A Process Change Using An Updated Sedation Protocol, Rachel Allen

Dissertations

Problem: Pediatric delirium is continuing to increase intensive care environments and for patients who require mechanical ventilation and continuous sedative medications. Delirium is harmful to the patient creating lasting neurologic and mental health issues along with prolonged hospitalization and increased healthcare cost

Method: For this quality improvement (QI) project, a descriptive observational study was used to evaluate the implementation of a sedation protocol for patients who are mechanically ventilated and on continuous sedative medications. This was completed with the use of retrospective chart reviews three months prior to implementation and three months after the new protocol was implemented. Nurses were …

Micro-Rna Analysis Of Extracellular Vesicles Secreted By Alveolar Macrophages And Epithelial Cells In Response To Cadmium, Anisha Bhakta

Biotechnology Theses

Inhalation of cadmium (Cd) has been an environmental health concern with the increase in industrial activities and smoking. Cd exposure is known to affect several organs such as lungs, kidneys, and liver. In this study, we wanted to understand if Cd inhalation exposure can affect the lungs and other organs in the body. Exosomes are extracellular vesicles secreted by all living cells and are known to carry toxicants between organs. We investigated whether Cd exposure could affect exosome biogenesis and their composition. Cd exposure did not affect the viability of A549, a lung epithelial cell line and macrophages derived from …

Multicolor Fluorescence Guided Surgery For Head And Neck Cancer, Dani Szafran-Reeder

University Honors Theses

This project aims to take a novel, NIR nerve-specific fluorophore LGW05-75⁴ and test its compatibility with a tumor-targeting affibody molecule, ABY-029⁶ that has been labeled with IRDye800CW. The overall goal is to show that these two molecules can be co-administered to show the nerves and tumor cells in real-time to better assist surgeons in a full resection while avoiding iatrogenic nerve damage.

Hepatocellular Carcinoma Image-Guided Intervention: Quantitative Characterization Of Reagents For Thermochemical Ablation, Emily A. Thompson

Dissertations & Theses (Open Access)

Thermochemical ablation (TCA) is a minimally invasive therapy under development for hepatocellular carcinoma, a leading cause of cancer death worldwide. TCA utilizes acid-base chemistry delivered simultaneously to induce local ablation when administered. When delivered via a mixing catheter placed directly into the tumor, acid (e.g., AcOH) and base (e.g., NaOH) react to completion at the catheter tip, producing the acetate salt, water, and releasing heat (Δ>50°C) in sufficient quantities to induce lethal osmotic and thermal stress in tumor cells. However, these two reagents are not distinguishable from tissues with noninvasive imaging modalities, which makes monitoring the delivery of TCA …

Safety Measures In The Epilepsy Monitoring Unit: An Organizational Assessment, Tina Yates

Doctor of Nursing Practice Scholarly Projects

Long-term video-electroencephalography (EEG) monitoring in the epilepsy monitoring unit (EMU) is an elective procedure and generally safe. Clinical experts determined the EMU protocols at a level-4 comprehensive epilepsy center were not followed correctly. The project is a retrospective chart audit incorporating Ray’s Bureaucratic Caring theoretical framework with Donabedian’s conceptual model. The project objective is to evaluate if safety measures protocols are implemented appropriately in the EMU and determine whether a need exists for quality improvements.

The project reviewed patients admitted to the EMU from September 2021 through November 2021 who developed a generalized tonic clonic (GTCs) seizure with electrographic epileptiform …

Nanoparticles For Biomedical Applications, Joseph Kim

Dissertations & Theses (Open Access)

This thesis presents development and evaluation of the potential of three new nanoparticles for biomedical applications. With the rapid growth of the field of nanoscience, researchers have explored developing nanoparticles for various biomedical applications, including imaging, therapy, and drug delivery. This thesis demonstrates the development of two C­₆₀ fullerene based nanoparticles and one boron based nanoparticle to answer key questions related to their biological potential.

In the first part of the thesis, we describe synthesis and characterization of a pure boron nanoparticle containing asolectin phospholipid-based liposome construct prepared using a water-in-oil emulsion method, as a novel alternative agent for …

Impact Of Interleukin-34 On The Promotion Of Bone Osteolysis And Neuroinflammation In Experimental Models Of Alzheimer’S Disease, Anny Ho

All HCAS Student Capstones, Theses, and Dissertations

Alzheimer’s disease (AD) is a growing health concern and is the most common type of dementia worldwide. Emerging evidence indicates that aggregated amyloid-beta (Aβ) peptides, one of the hallmark features of AD neuropathology, can increase RANKL-mediated osteoclast activity leading to the prevalence and severity of inflammatory osteolysis, e.g., osteoporosis and periodontal bone loss. Conversely, osteolytic lesions are associated with increased risk of dementia diagnosis indicating that there is a direct link between dementia and inflammatory osteolysis. It was demonstrated that the neuronal cells primarily produce interleukin-34 (IL-34) and microglia, macrophages, and osteoclast precursors express colony-stimulating factor 1 receptor (CSF-1R), a …

Evaluation Of Hippocampal Allostatic Load-Associated Factors In Animal Models Of Post-Traumatic Stress Disorder: Relevance To Human Ptsd, Dennis Parker Kelley

LSU Doctoral Dissertations

Post-traumatic stress disorder (PTSD) is associated with elevated allostatic load, nearly double the risk for metabolic syndrome, reduced hippocampal volume, and contextual memory processing deficits. Emerging evidence suggests that these stress effects may predispose individuals to the development of PTSD, and there is a known relationship between chronic stress and metabolic dysfunction. In this work, we utilized two rat models of PTSD to explore these connections. We used an acute predator odor stressor to investigate the relationship between PTSD-like behaviors and mitochondrial dysfunction in the hippocampus of rats, and we observed that conditioned place avoidance was associated with reduced mitochondrial …

Increasing Awareness Of Personal Harm Reduction Interventions In The Clinical Setting: A Quality Improvement Project, Shawn Theberge

DNP Scholarly Projects

Abstract

The ever-rising concern for safety in the healthcare setting has become increasingly prevalent and levels of hostility and violence more publicly visible. Over the last decade both patients and clinicians have been targeted in healthcare facilities at record levels. These incidents have created an environment of not only risk but increased anxiety and feelings of uncertainty for most clinical personnel. The study will initially measure clinician’s viewpoint of the clinical setting that they work in; and over the span of the project, track and evaluate the effects of the interventions on clinicians’ overall feelings and perceptions. The expected outcome …

Investigating The Role Of Nlrp3 Inflammasome In Chemotherapy-Induced Peripheral Neuropathy, Urszula O. Warncke

Theses and Dissertations

Paclitaxel and oxaliplatin are commonly used antineoplastic drugs that cause chemotherapy-induce peripheral neuropathy (CIPN) in up to 90% of patients. The sensory symptoms of CIPN include numbness, loss of proprioception, tingling, spontaneous burning, shooting or electric shock-like pain, mechanical and thermal allodynia, and cold hypersensitivity among others. Affected patients struggle with daily activities, have a low quality of life, and might stop cancer treatment. Unfortunately, there are no effective prophylactic or therapeutic treatments for these side effects. Many studies point to the involvement of inflammation as a major contributor of CIPN pathology. We investigated the effects of genetic (NLRP3 …

Effectiveness Of Stabilized Hypochlorous Acid In Acute Peritonitis Treatment: A Murine Surgical Study, Benjamin Michael Pomeroy

MSU Graduate Theses

Peritonitis is an inflammatory condition affecting the mesothelial cells that line the peritoneal cavity and is commonly induced by bowel perforations. This medical emergency is treated through antibiotic therapy and surgical intervention followed by tissue irrigation (lavage). Acute treatments aim to remove the bacterial burden, however recurring peritoneal infections occur at high rates and contribute to patient morbidity. These recurring infections are likely due to the inability of lavage solutions to remove the entire massive intra-abdominal bacterial load due to intestinal perforation. Numerous antiseptic solutions and antibiotic additives have been evaluated in their ability to improve source control by abdominal …

Auto- Ethnography With A Deep Dive Into Changes Mental Health During The Pandemic And A Look Into The Way The Pandemic Has Shaped Nursing Protocols For Recent Nursing College Graduates, Audrey Shaffer, Sarah Bereznay

Williams Honors College, Honors Research Projects

In this project we completed a deep dive into how the Covid-19 pandemic reshaped our mental health and has affected our preparation for careers as registered nurses through a series of auto- ethnographic narrative journals using scholarly articles to support this idea. By utilizing personal narratives, we analyzed and reflected upon the cognitive and mental changes we experienced throughout this pandemic. We fulfilled this by comprising two personal narratives with inquiries pertaining to each shared narrative by utilizing the common themes of being nursing students and living through a pandemic. Within these personal narratives, we discussed how the pandemic influenced …

Spontaneous Coronary Artery Dissection, Amy N. Wagner

Graduate Dissertations and Theses

Spontaneous coronary artery dissection (SCAD) causes 35% of myocardial infarctions in women under the age of 50 years old. Typically, these are healthy, active women without risk factors for atherosclerotic coronary artery syndromes. SCAD is a myocardial infarction caused by a coronary arterial dissection and not atherosclerotic plaques. Because of this, those effected do not present with the typical risk factors associated with acute atherosclerotic coronary syndromes. Therefore, clinicians must maintain a high level of suspicion for SCAD in young, healthy, women presenting with chest pain. Observation and pharmacological therapies are the preferred methods of treatment for a SCAD event. …

Advancement Of A 3d Computational Phantom And Its Age Scaling Methodologies For Retrospective Dose Reconstruction Studies, Aashish Gupta

Dissertations & Theses (Open Access)

We have used a 3D age-scalable computational phantom for over two decades for retrospective dose reconstruction studies of childhood cancer survivors (CCS) treated with 2D historic radiotherapy (RT). However, our phantom and its age scaling functions (ASF) must be updated so that it can be used in studies that include survivors treated with contemporary RT. We aimed to implement our phantom and its age scaling functions in DICOM format and determine the feasibility of applying our ASFs to accurately scale the whole-body CT-based anatomies.

In the implementation study, we developed Python scripts that model the phantom and ASFs in a …