Medicine and Health Sciences Commons^™

An Expanded Toolkit For Gene Tagging Based On Mimic And Scarless Crispr Tagging In, David Li-Kroeger, Oguz Kanca, Pei-Tseng Lee, Sierra Cowan, Michael T Lee, Manish Jaiswal, Jose Luis Salazar, Yuchun He, Zhongyuan Zuo, Hugo J Bellen

Faculty, Staff and Students Publications

We generated two new genetic tools to efficiently tag genes in Drosophila. The first, Double Header (DH) utilizes intronic MiMIC/CRIMIC insertions to generate artificial exons for GFP mediated protein trapping or T2A-GAL4 gene trapping in vivo based on Cre recombinase to avoid embryo injections. DH significantly increases integration efficiency compared to previous strategies and faithfully reports the expression pattern of genes and proteins. The second technique targets genes lacking coding introns using a two-step cassette exchange. First, we replace the endogenous gene with an excisable compact dominant marker using CRISPR making a null allele. Second, the insertion is replaced …

The High-Level Mobility Assessment Tool (Himat) In Myotonic Dystrophy Type 2: A Case Report, Kim B. Smith, Evan M. Pucillo

Physical Therapy Collection

Myotonic dystrophy type 2 (DM2) is a progressive muscular dystrophy with multi-system manifestations and can affect functional mobility, gait, and balance. Currently, there are few reports of functional outcome measures in this population. This case describes the change in function detected by the High-level Mobility Assessment Tool (HiMAT) and 30-second Chair Stand Test (CST) in a high-functioning adult female with DM2 after physical therapy treatment. The patient’s chief complaint was muscular pain and fatigue that affected activities of daily living (ADLs). Multimodal physical therapy focused on neuromuscular re-education, balance and strength training, patient education, and moderate cardiorespiratory training. Improvements were …

Assessing A Novel Point-Of-Care Ultrasound Training Program For Rural Healthcare Providers In Kenya, Grace W. Wanjiku, Gregory Bell, Benjamin Wachira

Emergency Medicine, East Africa

Background: A novel point-of-care ultrasound (PoCUS) training program was developed to train rural healthcare providers in Kenya on the Focused Assessment with Sonography for Trauma (FAST), thoracic ultrasound, basic echocardiography, and focused obstetric ultrasonography. The program includes a multimedia manual, pre-course testing, 1-day hands-on training, post-testing, 3-month post-course evaluation, and scheduled refresher training. This study evaluates the impact of the course on PoCUS knowledge and skills. Competency results were compared based on number of previous training/refresher sessions and time elapsed since prior training.

Methods: Trainees were evaluated using a computer-based, 30 question, multiple-choice test, a standardized observed structured clinical exam …

Experiences Of African American Mothers Following Infant Death, Katina W. Jones

Nursing Theses and Dissertations

African American women have been disproportionately affected by unfavorable birth outcomes for decades. Infant mortality rates for non-Hispanic African American women have been almost twice as high as that of Caucasian women for years. The goal of this study was to: (1) understand African American mothers’ experiences with infant death and (2) discover how African American mothers manage their grief following the loss of an infant. A review of the literature revealed African American women experience infant loss at a rate of 13.31 deaths per 1,000 live births compared to 5.63 for Caucasian women and 4.75-9.22 for other racial and …

The Effect Of E-Book Vocabulary Instruction On Spanish-English Speaking Children, Carla Wood, Lisa Fitton, Yaacov Petscher, Estrella Rodriguez, Gretchen Sunderman, Taehyeong Lim

Faculty Publications

Purpose: This study aimed to examine the effect of an intensive vocabulary intervention embedded in e-books on the vocabulary skills of young Spanish-English speaking English learners (ELs) from low-socioeconomic status backgrounds. Method: Children (N = 288) in kindergarten and 1st grade were randomly assigned to treatment and read-only conditions. All children received e-book readings approximately 3 times a week for 10-20 weeks using the same books. Children in the treatment condition received e-books supplemented with vocabulary instruction that included scaffolding through explanations in Spanish, repetition in English, checks for understanding, and highlighted morphology. Results: There was a main effect of …

Pubh 4798: Internship In Health Education And Promotion, Jamie S. Cromley

College of Public Health: Faculty Syllabi (2014-2021)

This course provides the senior level Public Health majors with a practical experience in an appropriate practice setting. Students must complete all course work in the Public Health major prior to enrolling in this course.

Orthographic Fast-Mapping Across Time In 5- And 6-Year-Old Children, Victoria Henbest

Victoria S. Henbest Publications

The purpose of this study was to examine the orthographic fast-mapping abilities of 5- and 6-year-old children across time to determine (a) growth in the ability to quickly acquire mental images of written words, (b) the effect of words' statistical regularities on the learning of written word images across time, (c) whether the statistical regularities of words impact children's eye movements during an orthographic fast-mapping task, and (d) the relation among written word learning and future literacy skills.Twenty-eight 5- and 6-year-old children viewed and listened to 12 short stories while their eye movements were recorded across 2 time points (approximately …

Dietary Inflammatory Index And Biomarkers Of Lipoprotein Metabolism, Inflammation And Glucose Homeostasis In Adults, Catherine Phillips, Nitin Shivappa, James R. Hébert, Ivan Perry

Faculty Publications

Accumulating evidence identifies diet and inflammation as potential mechanisms contributing to cardiometabolic risk. However, inconsistent reports regarding dietary inflammatory potential, biomarkers of cardiometabolic health and metabolic syndrome (MetS) risk exist. Our objective was to examine the relationships between a food frequency questionnaire (FFQ)-derived dietary inflammatory index (DII®), biomarkers of lipoprotein metabolism, inflammation and glucose homeostasis and MetS risk in a cross-sectional sample of 1992 adults. Energy-adjusted DII (E-DII) scores derived from an FFQ were calculated. Lipoprotein particle size and subclass concentrations were measured using nuclear magnetic resonance (NMR) spectroscopy. Serum acute-phase reactants, adipocytokines, pro-inflammatory cytokines and white blood cell (WBC) …

Disparities In Pulmonary Fibrosis Care In The United States: An Analysis From The Nationwide Inpatient Sample, Adam W. Gaffney, Steffie Woolhander, David Himmelstein, Danny Mccormick

Publications and Research

Background: Idiopathic pulmonary fibrosis is a disease with high morbidity and mortality. Care for these patients, including lung transplantation, may provide significant benefits, but is resource-intensive and expensive. Disadvantaged patients with IPF may hence be at risk for receiving inferior care.

Methods: We analyzed data from the Nationwide Inpatient Sample, a database consisting of all hospitalizations from a 20% sample of US hospitals. We identified adults hospitalized with IPF between 1998 and 2011 using ICD-9 codes. We assessed the effect of insurance coverage and socioeconomic status (SES) on lung transplantation, a treatment that may improve survival. We also examined the …

Personal Oral Infection Control, Low Birthweight, And Preterm Births In Appalachia West Virginia: A Cross-Sectional Study, R. Constance Wiener, Christopher Waters

Clinical and Translational Science Institute

Introduction. Appalachia West Virginia has a higher prevalence of preterm and low birthweight babies than the US national prevalence. Many factors have been studied which are known to infuence preterm births and low birthweight babies. Tere are limited interventions that are available to decrease the likelihood of preterm and low birthweight babies; however oral health and personal oral infection control may be helpful. Te purpose of this study was to evaluate the association of limited personal oral infection control among pregnant West Virginia Appalachian women and poor birth outcomes (preterm and low birthweight babies). Methods. A secondary data analysis of …

Studying Cancer Immunotherapy Using Patient-Derived Xenografts (Pdxs) In Humanized Mice., Yunsik Choi, Sanghyuk Lee, Kapyoul Kim, Soo-Hyun Kim, Yeun-Jun Chung, Charles Lee

Faculty Research 2018

Cancer immunotherapy is a promising way to eliminate tumor cells by using the patient's own immune system. Selecting the appropriate animal models to develop or validate preclinical immunotherapeutic trials is now an important aspect of many cancer research programs. Here we discuss the advantages and limitations of using genetically engineered immunodeficient mouse models, patient-derived xenografts (PDXs), and humanized mouse models for developing and testing immunotherapeutic strategies.

Additional Attachment Of The Semitendinosus And Gracilis Muscles To The Crural Fascia: A Review And Case Illustration., Asad Rizvi, Joe Iwanaga, Rod J Oskouian, Marios Loukas, R Shane Tubbs

Articles, Abstracts, and Reports

The semitendinosus and gracilis muscles insert primarily onto the superior medial aspect of the tibia. These tendons can be harvested for anterior cruciate ligament reconstruction, and knowledge of their accessory attachments is important for the success of such harvesting procedures. Here, we present a case illustration and review of the attachment of these muscles into the crural fascia (deep fascia of the leg), which is often an underappreciated insertion site.

Cannabis Shenanigans: Advocating For The Restoration Of An Effective Treatment Of Pain Following Spinal Cord Injury., Daniel E. Graves, Phd

Department of Rehabilitation Medicine Faculty Papers

Cannabis is an effective treatment for pain following spinal cord injury that should be available to patients and researchers. The major argument against the rescheduling of cannabis is that the published research is not convincing. This argument is disingenuous at best, given that the evidence has been presented and rejected at many points during the political dialog. Moreover, the original decision to criminalize cannabis did not utilize scientific or medical data. There is tension between the needs of a society to protect the vulnerable by restricting the rights of others to live well and with less pain. It is clear …

Wormian Bone Of The Orbit: A Case Report., Asad Rizvi, Joe Iwanaga, Rod J Oskouian, Marios Loukas, R Shane Tubbs

Articles, Abstracts, and Reports

Wormian bones are formed due to abnormal ossification centers in various locations in the skull. Genetic and/or environmental factors have been proposed to explain their formation. These bones can be normal anatomical variants or associated with a number of pathological conditions. The literature reports the most common locations of these bones as the cranial sutures, and reports of the presence of these bones in the orbit are rare. Clinically, these bones in the orbit can simulate fractures on imaging or can dislodge during surgery causing injury to the surrounding structures. Herein, we report a case of wormian bones of the …

Progression Of Gastric Acid Production In Preterm Neonates: Utilization Of In-Vitro Method, Murali R. Palla, Shashidhar Harohalli, Tim N. Crawford, Nirmala Desai

Pediatrics Faculty Publications

Background: Limited studies are done regarding ability to produce gastric acid in preterm infants and most studies used in vivo method of assessing gastric pH.

Objectives: To assess the feasibility of using an in vitro method of measuring gastric pH in babies ≤ 28 weeks gestational age (GA) and determine whether changes in gastric pH differ with gestational age, mode of delivery, and use of antenatal steroids.

Design/Methods: Prospective study that enrolled extremely low birth weight (ELBW) babies. Gastric aspirate collected before feeding. In vitro testing of gastric aspirates for pH were done on days of life 1, 3, 5, …

Postpartum Hemorrhage: A Change Strategy, Alison Landis

Master's Projects and Capstones

Problem: Postpartum hemorrhage (PPH) is one of the leading causes of severe maternal morbidity and mortality. It is unpredictable and can occur with or without identified risk factors. A postpartum hemorrhage can happen rapidly, therefore it is important for the team to be trained and prepared to recognize and respond quickly to the situation, by quantifying blood loss at deliveries.

Context:The California Maternal Quality Care Collaborative (CMQCC) has created a toolkit to better prepare maternal child health teams for readiness, recognition, response, and reporting when a hemorrhage occurs. This program was rolled out on the unit in 2015 resulting …

Advance Alert Monitor, Liesel Buchner

Master's Projects and Capstones

Problem: The acute deterioration of patients outside the Intensive Care Unit (ICU) are safety and quality concerns. Studies have shown that these deteriorations are associated with increased morbidity and mortality. This study aims to standardize the Rapid Response Team (RRT) nurse documentation in response to an Advanced Alert Monitor (AAM) alert, as at baseline no such alert nor standardized response and documentation exist.

Context: Hospitals are continually challenged to innovate and create systems that can track multiple parameters and identify at-risk patients earlier on. An Early Warning System (EWS) in combination with a RRT significantly reduces patients’ potential for clinical …

Amiodarone-Induced Peripheral Phlebitis:Implementation Of Practice Guideline To Decrease Incidence, Elaine Mindo

Master's Projects and Capstones

Abstract

Amiodarone is used in the management of ventricular and atrial arrhythmias, and the drug of choice among many cardiothoracic surgeons to manage post-operative arrhythmias. Atrial fibrillation with rapid ventricular response, is the most common arrhythmia treated with amiodarone in a telemetry unit in one medical center located in northern California. Nurses have noted a high incidence rate of phlebitis related to amiodarone infusion even when the current hospital guidelines are being followed. Data were collected over six months and included 35 patients, each infusion via a different intravenous site was considered another occurrence, for a total of 40 infusions. …

Reducing Patient Harm From Catheter Associated Urinary Tract Infections: A Quality Improvement Project, Grace Cooper

Master's Projects and Capstones

Abstract

Problem: The Institute of Medicine’s seminal report on patient safety, To Err Is Human led to widespread effort to improve the safety of patients. Healthcare-associated safety problems, which include healthcare-associated infection (HAI), account for far more considerable morbidity and mortality than “never events”. The first harm to be addressed as part of the “No Preventable Harms” campaign was catheter-associated urinary tract infection (CAUTI).

Context: The microsystem is a 20-bed mixed medical surgical intensive care unit. Unit assessment at the beginning of the quality project indicated that there were 2 CAUTIs attributed to the unit in a span of 6 …

Improving The Care For Acute Ischemic Stroke Patients, Hermelinda Gonzalez Rivero

Master's Projects and Capstones

Abstract

Problem: Decreasing the time to assess acute ischemic stroke patients impacts the patients’ well-being. The clinical benefit of intravenous Alteplase for ischemic stroke patients results in better outcomes. Intravenous thrombolysis success is dependent on narrowing time to treat (Fonarow et al., 2014). Decreasing the time to intravenous thrombolysis for acute ischemic stroke patients augments the ability of patients to improve the quality of life by minimizing disability and improving health outcomes (Speirs & Mitchell, 2015).

Context: The microsystem chosen for this evidence-based change of practice project change takes place in the Northern California emergency department (ED). The ED provides …

Improving The Timing Of Antibiotic Administration In High-Risk Neonates, Jed Comuelo

Master's Projects and Capstones

Improving the Timing of Antibiotic Administration in High-Risk Neonates

Abstract

Problem: The rapid nurse turnover and improper use of the golden hour flowsheet are some of the factors that affect the timing of antibiotic administration. A review of 38 patient charts was done and only shows 20% received antibiotics within 1 hour.

Context: This microsystem is a 22-bed neonatal intensive care unit with an average of 900 admissions per year. The team is composed of doctors, nurses, respiratory therapist, and pharmacists. The budget needed for this project consists of the overtime pay needed to compensate nurses for attending additional staff …

Improve Effectiveness In Trauma Teamwork, Ginger Miramontes

Master's Projects and Capstones

On average, each Ventilator-Associated Event (VAE) is anticipated to increase the length of stay in the Intensive Care Unit (ICU), resulting in potential adverse events and cost to the organization. The Center for Disease Control (CDC) defines VAE as the increase of daily minimum positive end-expiratory pressure (PEEP) and fraction of inspired oxygen (FiO2) values, after a baseline period of patient stability or improvement on the ventilator (CDC, 2018). Standard endotracheal tube designs have led to the incidence of VAE because of the accumulation of subglottic secretions in the trachea. Untreated VAE can later result in Ventilator Associated Pneumonia (VAP). …

Clinical Nurse Leader As Educator: Creating Standardized Orientation Materials For Patient Care Coordinators, Sylvia Su

Master's Projects and Capstones

The purpose of this quality improvement project is to create standardized orientation materials for patient care coordinators (PCC) in a medium-sized community hospital. The problem of not providing standardized orientation materials to newly-hired PCCs presents a risk of PCCs being unable to render the same level of quality of care to patients. Standardized orientation materials can help the newly-hired PCCs to access needed resources in a timely manner and provide patients with consistent quality of care. In order to create the orientation materials, a pre-intervention qualitative interview was conducted to determine the need for developing such tools. Through several PDSA …

Prompts To Increase Physical Activity At Points-Of-Choice Between Stairs And Escalators: What About Escalator Climbers?, John Belletierre, Ben Nguyen, Sandy Liles, Vincent Berardi, Marc A. Adams, Paddy Dempsey, Yael Benporat, Jacqueline Kerr, Andrea Z. Lacroix, Melbourne Hovell

Psychology Faculty Articles and Research

Since 1980, many studies have evaluated whether stair-use prompts increased physical activity by quantifying changes in stair use. To more completely evaluate changes in physical activity, this study addressed the often-overlooked assessment of climbing up escalators by evaluating the degree to which stair-use sign prompts increased active ascent—defined as stair use or escalator climbing. Over 5 months, at an airport stairs/escalator point of choice, we video-recorded passersby (N = 13,544) who ascended either stairs or escalators, on 10 days with signs and 10 days without signs. Ascenders using the stairs, standing on the escalator, and climbing the escalator were …

Quantifying Spatial Potential Access Equity In An Agent Based Simulation Model Of Buprenorphine Treatment Policy In The United States, Alexandra Elizabeth Nielsen

Dissertations and Theses

Opioid dependence and opioid related deaths are a public health problem which the United States Centers of Disease Control have declared an epidemic. While opioid agonist therapy for opioid addiction has been accepted as the most effective treatment for opioid dependence among academics, and office based buprenorphine treatment has been available in the Unites States for over 10 years, OB buprenorphine faces many barriers to widespread adoption. Empirical data on the geographic distribution of physicians able to prescribe buprenorphine and the prescribing patterns of those physicians show considerable unevenness in access and utilization of treatment services.

Federal-level policies have recently …

Education, Not Restriction, Is Key To Reducing Harm From Offshore Gambling, Sally Gainsbury, Alex Blaszczynski, Brett Abarbanel

Hospitality Faculty Research

Australian internet gambling policies have been refined and prohibitions on illegal gambling sites clarified in recent years. These offshore sites not only pose potential harm to consumers in the form of fraudulent and deceptive dealings, but also have long-term consequences through reducing the tax dollars generated by the licensed market. Our research takes a closer look at why gamblers use offshore sites, and the implications of this for policymaking.

Promoting Adherence To Best Practice Related To Urine Reflex To Culture Testing, Maykel Verdecia Alonso Ba,Rn-Cphn

Nursing and Health Professions Faculty Research and Publications

Over a two week period, the infection control nurse, from a trauma designated facility located in norther California, planned a practice improvement project in collaboration with the laboratory microsystem to educate referring physicians and increase adherence to the Centers for Disease Control (CDC) protocol, which delineates recommended best practices related to urine reflex to culture testing. Urinalysis (UA) is a test that triggers a reflex urine culture when pyuria is present. Frequent urine culturing without the presence of pyuria can cause unnecessary treatment with antimicrobials. From January 2017 to December 2017, 10% of UAs from 200 urine samples from asymptomatic …

Medication Exposure Patterns In Primary Care Patients Prescribed Pharmacogenetically Actionable Opioids, Mitchell R. Knisely, Janet S. Carpenter, Marion E. Broome, Ann M. Holmes, Diane Von Ah, Todd Skaar, Claire Burke Draucker

The Qualitative Report

Current approaches to assessing medication exposure fail to capture the complexity of the phenomenon and the context in which it occurs. This study’s purpose was to develop a typology of subgroups of patients who share common patterns of medication exposure. To create the typology, we used an exemplar sample of 30 patients in a large public healthcare system who had been prescribed the pharmacogenetically actionable opioids codeine or tramadol. Data related to medication exposure were drawn from large data repositories. Using a person-oriented qualitative approach, eight subgroups of patients who shared common patterns of medication exposure were identified. The subgroups …

From Contemplation To Action: Mechanisms Of Change In The Mentoring Academy, Linda S. Behar-Horenstein, Huibin Zhang

The Qualitative Report

Mentoring is fundamental to the professional development of research scientists in academic health centers (AHC). Qualified mentors can support the development of competencies considered most significant in training research scientists. Yet AHC faculty may have little preparation in and knowledge of how to mentor. Emerging AHC mentor academies provide educational environments whereby faculty can learn the art and practice of mentoring. However, little is known about their effectiveness. Using the Transtheoretical Change Model (TTM), this study explored how 23 mentors used newly learned information to change their communication styles and develop shared expectations with mentees. Based on an inductive analysis …

Improving Intermediate Lactate Sepsis Bundle Performance, Jocelyn Alimboyoguen

Master's Projects and Capstones

Problem: The aim of this project is to improve intermediate sepsis bundle performance with a primary focus on repeat lactate within 6 hours of arrival in the ED. One of the most significant problems we are facing today in healthcare, with an incidence of 300 to more than 1,000 cases per 100,000 persons annually in the United States, is severe sepsis (Gaieski, Edwards, Kalian, & Carr, 2013).

Context: Multiple studies have shown a strong correlation in reducing hospital and 30-day mortality by implementing process-oriented bundle for patients with sepsis and intermediate lactate values in accordance with the Surviving Sepsis Campaign …