Medicine and Health Sciences Commons^™

Impact Of Fall Education To Oncology Staff On Oncology Patient Fall Rates, Danni Sloane

Articles, Abstracts, and Reports

Significance & Background

Falls and fall-related injuries impact patients' health outcomes and are the most commonly reported adverse event in hospitals. Patient falls also affect reimbursement rates and can increase length of stay by about 6.3 days and increase undue patient harm. An increase of patients falls on the medical and surgical oncology acute care units have caused undue physical harm, increased moral distress, mental fatigue, and burnout in nurses; as well as placing financial burdens on the healthcare system. Implementing fall education and interventions aligns with national patient safety goals, is a top-priority project, is in alignment with the …

Improving Time To Defibrillation​, Jonathan Eyestone, Dana Gilbreth, Amanda Maloney, Tina Pham

Articles, Abstracts, and Reports

"ABSTRACT TITLE: Improving Time to Defibrillation

Background: Providence St. Vincent Medical Center (PSVMC) Medical Surgical units are not meeting the American Heart Association requirement of less than 3 minutes to defibrillation. Time to defibrillation in codes with shockable rhythms averages 4.2 minutes. In Mock Codes, only one met the time less than 3 minutes; four Mock Codes had times over 5 minutes. Resuscitation Quality Improvement CPR (RQI) training is required quarterly. Defibrillator practice with overall Code Blue competency is annual.

Purpose: Combine the hands-on practice of the defibrillator with the hands-on training for RQI.

Methods: The Medical Surgical unit 6 …

Interdisciplinary Involvement In Htn Management, Kirsten Curcio, Maurice N. Tran, Estera Ianciuc

Articles, Abstracts, and Reports

No abstract provided.

Improving Patient Outcomes Through An Evidence-Based Practice Nursing Boot Camp (Program Evaluation), Kevin Brandini

Articles, Abstracts, and Reports

No abstract provided.

Addressing Maternal Health Disparities With Hospital Library Services: Information-Seeking Behavior Of Maternal Health Care Providers In Resolving Clinical Questions Related To Diverse Populations, Seema Bhakta

Articles, Abstracts, and Reports

No abstract provided.

Novel Tool Used For Measuring Team Resilience Among Caregivers In A Hospital Setting: Resilient Team Traits Identified, Tiara Benson, Ma Fe Chase, Amanda Miles

Articles, Abstracts, and Reports

No abstract provided.

Axillary Transvalvular Microaxial Pump As Bridge To Transcatheter Aortic Valve Replacement In Cardiogenic Shock, Jacob Abraham, Lian Wang, V Kumar, Eric B Kirker, Kateri Spinelli

Articles, Abstracts, and Reports

No abstract provided.

Successful Pivot Of A Community Exercise Program To Virtual During The Covid-19 Pandemic, Letracia Rose, James G Beckerman

Articles, Abstracts, and Reports

No abstract provided.

Temporal Trends And Predictors Of Surgical Ablation For Atrial Fibrillation In A Large Western Us Healthcare System, Scott Brancato, Mansen Wang, Kateri Spinelli, Alison Leiataua, James Brevig, Zachary M Deboard, Torin P. Fitton, Maheer Gandhavadi, Jonathan P. Piccini, Neil Worrall, Tyler J Gluckman

Articles, Abstracts, and Reports

No abstract provided.

Sars-Cov-2 Antibodies Detected In Human Breast Milk Postvaccination, Jill K. Baird, Shawn M. Jensen, Walter Urba, Bernard A Fox, Jason R Baird

Articles, Abstracts, and Reports

Importance The SARS-CoV-2 pandemic has infected over a hundred million people worldwide, with almost 2.5 million deaths at the date of this publication. In the United States, Pfizer-BioNTech and Moderna vaccines were first administered to the public starting in December 2020, and no lactating women were included in the initial trials of safety/efficacy. Research on SARS-CoV-2 vaccination in lactating women and the potential transmission of passive immunity to the infant through breast milk is needed to guide patients, clinicians and policy makers during the worldwide effort to curb the spread of this virus.

Objective To determine whether SARS-CoV-2 specific immunoglobins …

Neoadjuvant Anti-Ox40 (Medi6469) Therapy In Patients With Head And Neck Squamous Cell Carcinoma Activates And Expands Antigen-Specific Tumor-Infiltrating T Cells., Rebekka Duhen, Carmen Ballesteros-Merino, Alexandra K Frye, Eric Tran, Venkatesh Rajamanickam, Shu-Ching Chang, Yoshinobu Koguchi, Carlo Bifulco, Brady Bernard, Rom Leidner, Brendan Curti, Bernard A Fox, Walter Urba, Richard Bryan Bell, Andrew D Weinberg

Articles, Abstracts, and Reports

Despite the success of checkpoint blockade in some cancer patients, there is an unmet need to improve outcomes. Targeting alternative pathways, such as costimulatory molecules (e.g. OX40, GITR, and 4-1BB), can enhance T cell immunity in tumor-bearing hosts. Here we describe the results from a phase Ib clinical trial (NCT02274155) in which 17 patients with locally advanced head and neck squamous cell carcinoma (HNSCC) received a murine anti-human OX40 agonist antibody (MEDI6469) prior to definitive surgical resection. The primary endpoint was to determine safety and feasibility of the anti-OX40 neoadjuvant treatment. The secondary objective was to assess the effect of …

Rapid, Successful Adoption Of Virtual Outpatient Cardiology Care During The Covid-19 Pandemic, Lesley Jones Larson, D Christensen, S Long, Lian Wang, Kateri Spinelli, Xiaoyan Huang

Articles, Abstracts, and Reports

No abstract provided.

Immune-Based Mutation Classification Enables Neoantigen Prioritization And Immune Feature Discovery In Cancer Immunotherapy., Peng Bai, Yongzheng Li, Qiuping Zhou, Jiaqi Xia, Peng-Cheng Wei, Hexiang Deng, Min Wu, Sanny K Chan, John W Kappler, Yu Zhou, Eric Tran, Philippa Marrack, Lei Yin

Articles, Abstracts, and Reports

Genetic mutations lead to the production of mutated proteins from which peptides are presented to T cells as cancer neoantigens. Evidence suggests that T cells that target neoantigens are the main mediators of effective cancer immunotherapies. Although algorithms have been used to predict neoantigens, only a minority are immunogenic. The factors that influence neoantigen immunogenicity are not completely understood. Here, we classified human neoantigen/neopeptide data into three categories based on their TCR-pMHC binding events. We observed a conservative mutant orientation of the anchor residue from immunogenic neoantigens which we termed the "NP" rule. By integrating this rule with an existing …

Multiplex Immunofluorescence To Measure Dynamic Changes In Tumor-Infiltrating Lymphocytes And Pd-L1 In Early-Stage Breast Cancer., Katherine Sanchez, Isaac Kim, Brie Chun, Joanna Pucilowska, William L. Redmond, Walter Urba, Maritza Martel, Yaping Wu, Mary Campbell, Zhaoyu Sun, Gary Grunkemeier, Shu-Ching Chang, Brady Bernard, David B Page

Articles, Abstracts, and Reports

BACKGROUND: The H&E stromal tumor-infiltrating lymphocyte (sTIL) score and programmed death ligand 1 (PD-L1) SP142 immunohistochemistry assay are prognostic and predictive in early-stage breast cancer, but are operator-dependent and may have insufficient precision to characterize dynamic changes in sTILs/PD-L1 in the context of clinical research. We illustrate how multiplex immunofluorescence (mIF) combined with statistical modeling can be used to precisely estimate dynamic changes in sTIL score, PD-L1 expression, and other immune variables from a single paraffin-embedded slide, thus enabling comprehensive characterization of activity of novel immunotherapy agents.

METHODS: Serial tissue was obtained from a recent clinical trial evaluating loco-regional cytokine …

Developing An Enhanced 7-Color Multiplex Ihc Protocol To Dissect Immune Infiltration In Human Cancers., Zhaoyu Sun, Richard Nyberg, Yaping Wu, Brady Bernard, William L. Redmond

Articles, Abstracts, and Reports

The TSA Opal multiplex immunohistochemistry (mIHC) protocol (PerkinElmer) has been used to characterize immune infiltration in human cancers. This technique allows multiple biomarkers to be simultaneously stained in a single tissue section, which helps to elucidate the spatial relationship among individual cell types. We developed and optimized two improved mIHC protocols for a 7-color panel containing 6 biomarkers (CD3, CD8, CD163, PD-L1, FoxP3, and cytokeratin (CK)) and DAPI. The only difference between these two protocols was the staining sequence of those 6 biomarkers as the first sequence is PD-L1/CD163/CD8/CK/CD3/FoxP3/DAPI and the second sequence is FoxP3/CD163/CD8/CK/CD3/PD-L1/DAPI. By comparing PD-L1/FoxP3 staining in …

Development And Preliminary Clinical Activity Of Pd-1-Guided Ctla-4 Blocking Bispecific Dart Molecule., Alexey Berezhnoy, Bradley J Sumrow, Kurt Stahl, Kalpana Shah, Daorong Liu, Jonathan Li, Su-Shin Hao, Anushka De Costa, Sanjeev Kaul, Johanna Bendell, Gregory M Cote, Jason J Luke, Rachel E Sanborn, Manish R Sharma, Francine Chen, Hua Li, Gundo Diedrich, Ezio Bonvini, Paul A Moore

Articles, Abstracts, and Reports

Combination immunotherapy with antibodies directed against PD-1 and CTLA-4 shows improved clinical benefit across cancer indications compared to single agents, albeit with increased toxicity. Leveraging the observation that PD-1 and CTLA-4 are co-expressed by tumor-infiltrating lymphocytes, an investigational PD-1 x CTLA-4 bispecific DART molecule, MGD019, is engineered to maximize checkpoint blockade in the tumor microenvironment via enhanced CTLA-4 blockade in a PD-1-binding-dependent manner.

Nivolumab In Advanced Hepatocellular Carcinoma: Safety Profile And Select Treatment-Related Adverse Events From The Checkmate 040 Study., Karen Julien, Hiu Tung Leung, Carmen Fuertes, Megumi Mori, Miao-Jen Wang, Jocelyn Teo, Lisa Weiss, Sara Hamilton, Holly Difebo, Yoon Jin Noh, Aralee Galway, Jane Koh, Edith Brutcher, Huanyu Zhao, Yun Shen, Marina Tschaika, Yue-Yun To

Articles, Abstracts, and Reports

BACKGROUND: CheckMate 040 assessed the efficacy and safety of nivolumab in patients with advanced hepatocellular carcinoma (HCC). Understanding the safety profile of nivolumab is needed to support the management of treatment-related adverse events (TRAEs). This analysis assessed the safety of nivolumab monotherapy in the phase I/II, open-label CheckMate 040 study.

MATERIALS AND METHODS: Select TRAEs (sTRAEs; TRAEs with potential immunologic etiology requiring more frequent monitoring) occurring between first dose and 30 days after last dose were analyzed in patients in the dose-escalation and -expansion phases. Time to onset (TTO), time to resolution (TTR), and recurrence of sTRAEs were assessed, and …

Patient And Physician Predictors Of Ffr/Ifr Utilization In Acs And Sihd, Payal Kohli, Peiqi Wang, Andrew Wang, Lucy Liu, Ali Weinstein, Jeptha P. Curtis, John A. Spertus, Jonathan P. Piccini, Marty Makary, Tyler J Gluckman

Articles, Abstracts, and Reports

Background

Despite guidelines supporting FFR/iFR to guide PCI, these modalities remain underutilized. We sought to characterize factors associated with FFR/iFR use in patients undergoing index PCI for an acute coronary syndrome (ACS) or stable ischemic heart disease (SIHD).

Methods

ICD-9/10 codes were used to identify patients undergoing PCI and receiving FFR/iFR for an ACS (n=1,042,896) or SIHD (n=255,213) in a Medicare claims database from Jan. 1, 2013-June 30, 2018. Patients with functional/anatomical testing were excluded (5d prior in ACS; 60d prior in SIHD). Individuals with FFR/iFR performed 1-60 days prior to PCI were also excluded to limit analysis to non-staged …

The Impacts Of Medicaid Expansion On Rural Low-Income Adults: Lessons From The Oregon Health Insurance Experiment., Heidi Allen, Bill J. Wright, Lauren Broffman

Articles, Abstracts, and Reports

Medicaid expansions through the Affordable Care Act began in January 2014, but we have little information about what is happening in rural areas where provider access and patient resources might be more limited. In 2008, Oregon held a lottery for restricted access to its Medicaid program for uninsured low-income adults not otherwise eligible for public coverage. The Oregon Health Insurance Experiment used this opportunity to conduct the first randomized controlled study of a public insurance expansion. This analysis builds off of previous work by comparing rural and urban survey outcomes and adds qualitative interviews with 86 rural study participants for …

The Effect Of Medicaid On Medication Use Among Poor Adults: Evidence From Oregon., Katherine Baicker, Heidi L Allen, Bill J. Wright, Amy N Finkelstein

Articles, Abstracts, and Reports

Oregon's 2008 Medicaid expansion significantly increased the use of prescription medications in 2009-10.

The Quest For Sustained Multiple Morbidity Reduction In Very Low-Birth-Weight Infants: The Antifragility Project., Joseph Kaempf, N M Schmidt, S Rogers, C Novack, M Friant, L Wang, N Tipping

Articles, Abstracts, and Reports

OBJECTIVE: Can a comprehensive, explicitly directive evidence-based guideline for all therapies that might affect the major morbidities of very low-birth-weight (VLBW) infants help a neonatal intensive care unit (NICU) further improve generally favorable morbidity rates? Can Antifragility principles of provider adaptive growth from stressors, enhanced infant risk assessment and adherence to effective therapies minimize unproven treatments and reduce all morbidities?

STUDY DESIGN: Prospectively planned observational trial in VLBW infants: control group born October 2011 to September 2013 and study group October 2013 to September 2015. Multi-disciplinary evidence-based review assigned all NICU treatments into one of four distinct categories: (1) always …