Medicine and Health Sciences Commons^™

Von Willebrand Disease, Hannah Smith

Nursing Student Class Projects (Formerly MSN)

von Willebrand disease is a complex disease requiring a complex diagnoses and treatment. The family nurse practitioner must be familiar in the care of this population. The most common signs and symptoms are heavy menses and epistaxis (Abshire et al., 2015, p. 1585). The pathophysiology differs based on what type of von Willebrand disease (VWD) the patient has. VWD has many different inheritance patterns. Type 3 (the most severe) usually happens when the gene is passed from the mother as well as the father. If the inheritance pattern is recessive, and neither parent phenotypically has the disease, then the child …

Combining Magnetic Resonance Spectroscopy And Magnetic Resonance Imaging In Diagnosing Focal Brain Lesions In Children, Farah Naz Farid, Waseem Mirza, Nauman Hashmani

Section of Ophthalmology

Introduction: We attempted to find the sensitivity and specificity of various pediatric brain masses in the Pakistani population while keeping histopathology or clinical diagnosis as the gold standard.
Methods: This was a retrospective study that was conducted from January 2007 to January 2016. We reviewed the records of 204 patients that presented to the radiology department of Aga Khan University Hospital (AKUH). Out of the 204, 135 pediatric patients in the 0–18 age group with focal brain lesions who underwent magnetic resonance spectroscopy (MRS) and a biopsy or clinical diagnosis were included. If histopathology was available, it was taken as …

Creating A Taxonomy Of Local Boards Of Health Based On Local Health Departments’ Perspectives, Gulzar H. Shah, Sergey Sotnikov, Carolyn J. Leep, Jiali Ye, Timothy W. Van-Wave

Health Policy & Community Health: Faculty Presentations (1993-2023)

Objectives: To develop an LBoH classification scheme and empirical definitions to provide a coherent framework for describing variation in the LBoHs.

Data and Methods: This study is based on data from the 2015 Local Board of Health Survey, conducted among a nationally representative sample of LHD administrators, with 394 responses. The classification development consisted of the following steps: (a) theoretically guided initial domain development, (b) mapping of the survey variables to the proposed domains, (c) data reduction using principal component analysis and group consensus, and (d) scale development and testing for internal consistency.

Results: The final classification scheme included 60 …

Stromal Cyclin D1 Promotes Heterotypic Immune Signaling And Breast Cancer Growth, Timothy G. Pestell, Xuanmao Jiao, Mukesh Kumar, Amy R. Peck, Marco Prisco, Shengqiong Deng, Zhiping Li, Adam Ertel, Matthew C. Casimiro, Xiaoming Ju, Agnese Di Rocco, Gabriele Di Sante, Sanjay Katiyar, Alison Shupp, Michael P. Lisanti, Pooja Jain, Kongming Wu, Hallgeir Rui, Douglas Craig Hooper, Zuoren Yu, Aaron R. Goldman, David W. Speicher, Lisa Laury-Kleintop, Richard G. Pestell

Department of Cancer Biology Faculty Papers

The cyclin D1 gene encodes the regulatory subunit of a holoenzyme that drives cell autonomous cell cycle progression and proliferation. Herein we show cyclin D1 abundance is increased > 30-fold in the stromal fibroblasts of patients with invasive breast cancer, associated with poor outcome. Cyclin D1 transformed hTERT human fibroblast to a cancer-associated fibroblast phenotype. Stromal fibroblast expression of cyclin D1 (cyclin D1^Stroma) in vivo, enhanced breast epithelial cancer tumor growth, restrained apoptosis, and increased autophagy. Cyclin D1^Stroma had profound effects on the breast tumor microenvironment increasing the recruitment of F4/80⁺ and CD11b⁺ macrophages and increasing …

Reducing Equifinality Using Isotopes In A Process-Based Stream Nitrogen Model Highlights The Flux Of Algal Nitrogen From Agricultural Streams, William I. Ford, James F. Fox, Erik Pollock

Biosystems and Agricultural Engineering Faculty Publications

The fate of bioavailable nitrogen species transported through agricultural landscapes remains highly uncertain given complexities of measuring fluxes impacting the fluvial N cycle. We present and test a new numerical model named Technology for Removable Annual Nitrogen in Streams For Ecosystem Restoration (TRANSFER), which aims to reduce model uncertainty due to erroneous parameterization, i.e., equifinality, in stream nitrogen cycle assessment and quantify the significance of transient and permanent removal pathways. TRANSFER couples nitrogen elemental and stable isotope mass‐balance equations with existing hydrologic, hydraulic, sediment transport, algal biomass, and sediment organic …

Traceable Peo-Poly(Ester) Micelles For Breast Cancer Targeting: The Effect Of Core Structure And Targeting Peptide On Micellar Tumor Accumulation, Shyam M. Garg, Igor M. Paiva, Mohammad R. Vakili, Rania Soudy, Kate Agopsowicz, Amir H. Soleimani, Mary Hitt, Kamaljit Kaur, Afsaneh Lavasanifar

Pharmacy Faculty Articles and Research

Traceable poly(ethylene oxide)-poly(ester) micelles were developed through chemical conjugation of a near-infrared (NIR) dye to the poly(ester) end by click chemistry. This strategy was tried for micelles with poly(ε-caprolactone) (PCL) or poly(α-benzyl carboxylate-ε-caprolactone) (PBCL) cores. The surface of both micelles was also modified with the breast cancer targeting peptide, P18-4. The results showed the positive contribution of PBCL over PCL core on micellar thermodynamic and kinetic stability as well as accumulation in primary orthotopic MDA-MB-231 tumors within 4–96 h following intravenous administration in mice. This was in contrast to in vitro studies where better uptake of PEO-PCL versus PEO-PBCL micelles …

Evaluation Of The Dyad Bonding Dance Model For Mothers And Infants Exposed To Stressful Life Situations, Hadas Vered Weissberg

Expressive Therapies Dissertations

This study examines the Dyad Bonding Dance (DBD), a dance movement group therapy model developed to improve nonverbal communication between mothers exposed to stressful life situations and their children. The research emphasizes the importance of mother-child attachment relationships and transmission of stress from parents to children via nonverbal communication, which may affect bonding and child health. This qualitative study assessed the experience of dance movement therapists using this novel model. Broad research questions addressed were: (1) What are dance therapists’ experiences with the DBD model, focusing on its impact or lack of impact in improving the dyadic relationship between mother …

Evaluation Of A Pilot Multidisciplinary Debriefing Program: Promoting Pediatric Provider Emotional, Social, And Spiritual Wellbeing, Allison E. Reynolds

Doctoral Projects

Regular exposure to trauma, such as the act of bearing witness to intense suffering and pain of pediatric patients and families, has a significant effect on healthcare professionals. Despite the fact that traumatic situations in pediatrics are a reality, there is little education and few interventions focused on how to prepare and support healthcare providers to care for dying children and families or for other clinically challenging situations. Pediatric residency program directors within a large, freestanding children’s hospital identified a subjective need for support for their pediatric residents in dealing with clinically challenging situations faced during residency, motivating residency program …

Evidence-Based Protocol: Standardizing Handoffs To Improve Outcomes, Melissa L. Rykse

Master's Projects

Nurse to nurse handoffs were identified as an area for improvement in an acuity-adaptable, progressive care (AAPC) unit in a Midwestern hospital. By using the Plan, Do, Study, and Act (PDSA) quality improvement framework, the content of handoffs was standardized by the creation and use of a handoff tool, organized in a Situation, Background, Assessment, Recommendation (SBAR) manner. Outcomes of nursing satisfaction and incidental overtime were improved after the implementation of the handoff tool. This cost neutral project has a cost savings potential of $2000/year with the reduction of incidental overtime.

If Gandhi Was Your Marriage Therapist, Jason B. Whiting

Faculty Publications

Mohandas Gandhi was born in India in 1869. As a young man he left to study law in Great Britain, and later he moved with his wife and children to South Africa, where he began a legal practice. There he experienced painful discrimination and abuse, and once was beaten by a stagecoach driver for refusing to give up his seat for a European. This galvanized Gandhi’s resolve to fight injustice through principles of satyagraha (“truth and firmness”) he had learned from his mother.

Disparity In Maternal Health Services Among The Different Geopolitical Zones In Nigeria, Abubakar Sadiq Umar, Chinaro Kennedy, Hebatullah Tawfik, Daniel M. N. Okenu

Journal of Social, Behavioral, and Health Sciences

Although the use of antenatal and other skilled maternal health delivery services in Nigeria was reported to be on the increase, this research explored whether geopolitical zone of residence and place of domicile are associated with the number of antenatal visits and place of delivery. A quantitative cross-sectional study based on secondary data from the Demographic and Health Survey was used to examine the relationship between women’s geopolitical zone of residence, place of domicile (rural/urban), and the number of antenatal visits (categorized as fewer than four or four or more) and delivery (home or health facility). A total of 33,385 …

The Relationship Of Plasma Trans Fatty Acids With Dietary Inflammatory Index Among Us Adults, Mohsen Mazidi, Hong-Kai Gao, Nitin Shivappa, Michael David Wirth, James R. Hébert, Andre Pascal Kengne

Faculty Publications

Background: It has been suggested that trans fatty acids (TFAs) play an important role in cardiovascular diseases. We investigated the association between plasma TFAs and the dietary inflammatory index (DII) ™ in US adults.

Methods: National Health and Nutrition Examination Survey (NHANES) participants with data on plasma TFAs measured from 1999 to 2010 were included. Energy-adjusted-DII ™ (E-DII ™) expressed per 1000 kcal was calculated from 24-h dietary recalls. All statistical analyses accounted for the survey design and sample weights.

Results: Of the 5446 eligible participants, 46.8% (n = 2550) were men. The mean age of the population was 47.1 …

Diverticulitis, Amanda Fantino

Nursing Student Class Projects (Formerly MSN)

Diverticular disease affects approximately 2.5 million people in the United states and it accounts for more than 280,000 hospitalizations per year (Mulligan, 2015). In 2004, the treatment cost for diverticular diseases was approximately 3.6 billion dollars, this is a huge expense for health care in this country (Schneider et al., 2015). “Diverticulosis is the presence of diverticula in the absence of inflammation” (Wilkins, Embry, & George, 2013). In the United States one study found that those with diverticulosis have a twenty-five percent chance of developing diverticulitis in their lifetime (Wilkins, Embry, & George, 2013). The number of patient in the …

Essential Hypertension, Melinda Rodriguez- Tercius

Nursing Student Class Projects (Formerly MSN)

Hypertension effects 30% of the total population with incidences higher in socioeconomically deprived areas. This nurse will research the pathophysiology of essential hypertension to gain a thorough understanding of the disease and provide evidence based guidelines to assist the patient population in care and maintenance of hypertension. Control of this disease will decrease the incidence of complications that increase morbidity and mortality including cerebrovascular accidents and myocardial infarctions.

Hypertension is known to be the most common modifiable risk factor for cardiovascular related deaths in the United States (Fontil, Bibbins- Domingo, Nguyen, Guzman, & Goldman, 2017). Although hypertension is a largely …

Von Wlillebrand Disease, Deanna Miller

Nursing Student Class Projects (Formerly MSN)

VWD is one of the most prevalent inherited bleeding disorder (James, 2017). This disorder is the result of a low levels of von Willebrand factor (VWF). VWF is a protein that binds to factor VIII; an essential clotting protein and platelets in the blood vessel walls that aids in production of a platelet plug during the clotting process (National Hemophilia Foundation, n.d.). This disorder was first described in 1926 by Erik von Willebrand. He distinguished that it differed from hemophilia and named it “pseudo hemophilia” (Leebeek, Eikenboom, 2016, p. 2067).

There are three main types of VWD, which is based …

Polycystic Kidney Disease, Christy Mcguire

Nursing Student Class Projects (Formerly MSN)

This nurse is currently employed at an outpatient ambulatory hemodialysis (HD) clinic. National statistics revealed more than 660,000 Americans being treated for end stage renal disease (ESRD) and at the state level, Ohio has 16,182 individuals which are on routine HD with the primary causes attributed to diabetes and hypertension (HTN) (National Kidney Foundation [NKF], 2017). This nurse discovered a small patient population ascertained ESRD from an inherited familial disorder, particularly polycystic kidney disease (PKD). PKD is the fourth leading cause kidney failure and approximately 600,000 individuals have been diagnosed with PKD in the United States (U.S.) (NKF, 2017). PKD …

Ischemic Cardiomyopathy, Sarah Crawmer

Nursing Student Class Projects (Formerly MSN)

A summary of ischemic cardiomyopathy with topics of signs and symptoms, treatment, significance of pathophysiology, underlying pathophysiology, and implications for nursing care.

Heterozygous De Novo Ubtf Gain-Of-Function Variant Is Associated With Neurodegeneration In Childhood., Simon Edvardson, Claudia M Nicolae, Pankaj B Agrawal, Cyril Mignot, Katelyn Payne, Asuri Narayan Prasad, Chitra Prasad, Laurie Sadler, Caroline Nava, Thomas E Mullen, Amber Begtrup, Berivan Baskin, Zöe Powis, Avraham Shaag, Boris Keren, George-Lucian Moldovan, Orly Elpeleg

Paediatrics Publications

Ribosomal RNA (rRNA) is transcribed from rDNA by RNA polymerase I (Pol I) to produce the 45S precursor of the 28S, 5.8S, and 18S rRNA components of the ribosome. Two transcription factors have been defined for Pol I in mammals, the selectivity factor SL1, and the upstream binding transcription factor (UBF), which interacts with the upstream control element to facilitate the assembly of the transcription initiation complex including SL1 and Pol I. In seven unrelated affected individuals, all suffering from developmental regression starting at 2.5-7 years, we identified a heterozygous variant, c.628G>A in UBTF, encoding p.Glu210Lys in UBF, which …

Aligning Theory And Evidence-Based Practices To Enhance Human Flourishing In Nurse Executives, Jim D'Alfonso

Doctor of Nursing Practice (DNP) Projects

Today’s nurse executives lead highly complex and bureaucratic organizations undergoing sweeping reform at an unprecedented rate of change. Change and high levels of stress are the norm in health care, and ineffective stress management can hinder organizational performance and adversely impact personal wellbeing. The risks of nurse executive burnout and unprecedented turnover led to the development of a 4-hour program to teach theory-guided and evidence-based stress management techniques. The program was intended to increase awareness, enhance effective stress management skills, and improve the nurse executive’s ability to flourish in high stress environments. A pre-intervention and 6-month post-intervention assessment (n …

Implementation Of An Innovative Early Warning System: Evidenced-Based Strategies For Ensuring System-Wide Nursing Adoption, Shirley S. Paulson

Doctor of Nursing Practice (DNP) Projects

Early deterioration in adult medical-surgical patients is associated with increased intensive care unit and hospital mortality (Goldhill, 2001). Failure to recognize deterioration is a preventable patient safety and quality issue. To address this problem, since 2013, Kaiser Permanente Northern California (KP NCAL) has piloted Advance Alert Monitor (AAM) at two hospitals. This early warning system employs a set of predictive models developed by the KP NCAL Division of Research, which automatically predicts patient deterioration within the next 12 hours based on a complex algorithm of laboratory and clinical data points. Improvements in mortality and length of stay have been realized …

Readiness For Improving Safe Care Delivery Through Web-Based Hospital Nurse Scheduling & Staffing Technology: A Multi-Hospital Approach, Lisa Massarweh

Doctor of Nursing Practice (DNP) Projects

Hospital scheduling and staffing practices are linked to patient safety, nurse satisfaction, and cost outcomes (Steege & Rainbow, 2017). Staffing, while complex, is ultimately central to the overall success of the hospital. Demands to eliminate events that cause death or serious harm, produce high patient satisfaction scores while maximizing workforce productivity, test any administrator’s skillset. Providing qualified staff in the right place at the right time can be challenged by restrictive union contracts, variable patient acuities, staff attendance, and mandated staffing ratios. These demands may lead to overtime utilization. There is a growing understanding of the negative effects of healthcare …

Extrafollicular Activities: Perspectives On Hiv Infection, Germinal Centerindependent Maturation Pathways, And Kshv-Mediated Lymphoproliferation, Jennifer Totonchy

Pharmacy Faculty Articles and Research

Early events in the pathogenesis of KSHV-associated lymphoproliferations in the context of HIV disease remain poorly understood. Recent research indicates that latent HIV infection causes persistent immune dysfunction in B cell follicles. Simultaneously, lack of T cell immune surveillance in the lymph nodes dysregulates the biology of EBV. In sum, these defects bias B lymphocyte maturation away from traditional T cell-dependent germinal center-mediated pathways and towards extrafollicular pathways. Recent advances in B lymphocyte immunology suggest that extrafollicular maturation pathways for antibody secreting cells are more flexible and robust than previously believed. These responses are now understood to be both durable …

Synthesis Of Hydroxybenzylidene-Indolinones, Schiff Bases And N-Substituted Analogs And Their Effects On Bacterial Physiology., Catherine Eliana Cabrera, Neetu Dayal, Moloud Aflaki, Herman Sintim

The Summer Undergraduate Research Fellowship (SURF) Symposium

c-di-AMP is a global stress response regulator involved in some processes of biofilm formation and antibiotic resistance. It has become a candidate target for the development of new antibacterial treatments. Previous studies have shown that hydroxybenzylidene-indolinones can act as c-di-AMP synthase inhibitors. They also act as antibacterial and anti-biofilm inhibitors and re-sensitize resistant bacteria to methicillin and vancomycin. In this project, potent analogs of these compounds, including Schiff bases and N-substituted compounds, have been synthetized. The objective of this work is to explore the effect of these modifications on their biological activity. Base-catalyzed condensation and acid-catalyzed reactions were performed in …

Temporal Resolution Of Cell Death Signaling Events Induced By Cold Atmospheric Plasma And Electroporation In Human Cancer Cells, Danielle M. Krug, Prasoon K. Diwakar, Ahmed Hassanein

The Summer Undergraduate Research Fellowship (SURF) Symposium

Cancer treatment resistance and their invasive and expensive nature is propelling research towards developing alternate approaches to eradicate cancer in patients. Non-thermal, i.e., cold atmospheric plasma (CAP) and electroporation (EP) applied to the surface of cancerous tissue are new methods that are minimally invasive, safe, and selective. These approaches, both independently and synergistically, have been shown to deplete cancer cell populations, but the signaling mechanisms of death and their timelines of action are still widely unknown. To better understand the timeframe of signaling events occurring upon treatment, human cancer cell lines were treated with CAP, EP, and combined CAP with …

Effects Of Stroma On Er+ Breast Cancer Cell Metastasis, Shipeng Xu, Luis Solorio, Sarah Calve

The Summer Undergraduate Research Fellowship (SURF) Symposium

Breast cancer is one of the most wide-spread diseases among women in America. If the cancer is local, it is easily controlled by surgical resection. However, if the cancer cells metastasize, patient survival is significantly reduced. 70% of breast cancers can be targeted through estrogen receptors (ER) on the membrane, with compounds such as tamoxifen. However, tamoxifen shows unreliable outcomes on different patients and it is believed that the ineffectiveness of tamoxifen is related to the epithetical-mesenchymal transition (EMT) of cancer cells. To address this problem, we are designing a system that stimulates metastasis activation with the aim of incorporating …

Three-Dimensional Microfluidic Tumor Vascular Model For Investigating Breast Cancer Metastasis, Anastasiia Vasiukhina, Brian H. Jun, Luis Solorio, Pavlos P. Vlachos

The Summer Undergraduate Research Fellowship (SURF) Symposium

Metastasis is one of the primary reasons for the high mortality rates in female patients diagnosed with breast cancer. It involves the migration of cancer cells into the circulatory system allowing for the dissemination of cancer cells in distal tissues. Understanding the major processes that occur in cells and tissues during metastasis can help improve currently existing therapeutic methods. In order to understand such mechanisms, developing physiologically relevant tissue models is crucial. Advancements in microfluidics have led to the fabrication of 3D culture models with shear stress gradients and flow control that can recapitulate aspects of the tumor microenvironment in …

Finding Human Proteins That Bind To A Lassa Virus Protein, Maria Alejandra Pardo Ruge, Veronica J. Heintz, Douglas J. Lacount

The Summer Undergraduate Research Fellowship (SURF) Symposium

Viral hemorrhagic fevers are severe illnesses caused by many different viruses. Lassa Virus is one of these important pathogens in Western Africa, causing hemorrhagic fever and eventually death without early medical treatment. There is no vaccine and there is little information on host-pathogen interactions. Therefore, the interaction between viral proteins and host targets is useful to understand Lassa virus’s lifecycle and pathology, and to develop ways to prevent infection. In this project, we study the nucleoprotein of Lassa virus (NP), which has been reported to have anti-interferon (IFN) activity through elimination of double stranded RNA (dsRNA). These features could be …

Development Of Self-Assembling Nanoparticles For Drug Delivery Applications, Young Chan Kim, Craig Sweet, Helen Margaret Flynn, David H. Thompson

The Summer Undergraduate Research Fellowship (SURF) Symposium

Bladder cancer is the ninth most common cancer in the world, and occurs in nearly four percent of all men. Although many cases are diagnosed as early stage cancer and the tumor can be removed by surgery, reoccurrence rates are high making treatment difficult and thus one of the most expensive cancers. To address this problem, drugs are injected intravesically after tumor removal to kill any residual cancer that may cause reoccurrence. While this was a significant improvement over surgery alone, high toxicity along with short residence times in the bladder limited its effectiveness. To combat these shortcomings, we will …

Fret Biosensors: Engineering Fluorescent Proteins As Biological Tools For Studying Parkinson’S Disease, Nathan J. Leroy, Jacob R. Norley, Saranya Radhakrishnan, Mathew Tantama

The Summer Undergraduate Research Fellowship (SURF) Symposium

Parkinson’s Disease (PD) is a common neurodegenerative disease with over 200,000 new cases each year. In general, the cause of the disease is unknown, but oxidative stress inside of neurons has been associated with the disease’s pathology for some time. Currently, techniques to study the onset of PD inside of neurons are limited. This makes treatments and causes difficult to discover. One solution to this has been fluorescent protein biosensors. In short, these proteins can be engineered to glow when a certain state is achieved inside a cell. The present research discusses the engineering of a genetically-encoded fluorescent protein (FP) …

Determining The Structure Of Phospholipase C Epsilon, Hannah O'Neill, Monita Sieng, Elisabeth Garland-Kuntz, Angeline Lyon

The Summer Undergraduate Research Fellowship (SURF) Symposium

The phospholipase C (PLC) epsilon subfamily of PLC enzymes are found at highest concentration within the cardiovascular system. Improper functioning of the enzyme, whether due to overstimulation or changes in expression, has far-reaching effects within the human body Stunted heart valve development and cardiac hypertrophy and are two such examples. The mechanisms by which PLC epsilon activity is regulated in these processes remain unknown, as does the physical structure of the enzyme. In this study, we seek to determine the structure of a PLC epsilon fragment that retains enzymatic activity and is amenable to crystallization. Mutagenesis of PLC epsilon cDNA …