Medicine and Health Sciences Commons^™

6-Day-Old Term Infant With Fever And Lethargy, Gangaram Akangire, Archana Kulkarni, Winston M. Manimtim

Manuscripts, Articles, Book Chapters and Other Papers

Osteomyelitis in the neonatal period can be a diagnostic challenge, especially if it is mimicking brachial plexus palsy. We present a unique case of 6-day-old term infant with lethargy and fever diagnosed with Group B Streptococci (GBS) sepsis and meningitis. Few days later, infant developed right arm immobility leading to hematogenous spread of GBS to right humerus, leading to osteomyelitis and septic arthritis. Infant was treated with intravenous Ampicillin for 4 weeks with full arm mobility and full recovery from sepsis and meningitis. This case provides several clinical vignettes that may be crucial in timely diagnosis and treatment of osteomyelitis …

Practice Of Ventilation In Middle-Income Countries (Provent-Imic): Rationale And Protocol For A Prospective International Multicentre Observational Study In Intensive Care Units In Asia, Luigi Pisani, Anna Geke Algera, Ary Serpa Neto, Areef Ahsan, Abigail Beane, Kaweesak Chittawatanarat, Abul Faiz, Rashan Haniffa, Reza Hashemian, Madiha Hashmi

Department of Anaesthesia

Introduction: Current evidence on epidemiology and outcomes of invasively mechanically ventilated intensive care unit (ICU) patients is predominantly gathered in resource-rich settings. Patient casemix and patterns of critical illnesses, and probably also ventilation practices are likely to be different in resource-limited settings. We aim to investigate the epidemiological characteristics, ventilation practices and clinical outcomes of patients receiving mechanical ventilation in ICUs in Asia.
Methods and Analysis: PRoVENT-iMIC (study of PRactice of VENTilation in Middle-Income Countries) is an international multicentre observational study to be undertaken in approximately 60 ICUs in 11 Asian countries. Consecutive patients aged 18 years or older who …

Common Ribs Of Inhibitory Synaptic Dysfunction In The Umbrella Of Neurodevelopmental Disorders, Rachel Ali Rodriguez, Christina Joya, Rochelle M. Hines

Psychology Faculty Research

The term neurodevelopmental disorder (NDD) is an umbrella term used to group together a heterogeneous class of disorders characterized by disruption in cognition, emotion, and behavior, early in the developmental timescale. These disorders are heterogeneous, yet they share common behavioral symptomatology as well as overlapping genetic contributors, including proteins involved in the formation, specialization, and function of synaptic connections. Advances may arise from bridging the current knowledge on synapse related factors indicated from both human studies in NDD populations, and in animal models. Mounting evidence has shown a link to inhibitory synapse formation, specialization, and function among Autism, Angelman, Rett …

Factors Involved In Suppression Of Human Vγ9vδ2 T-Lymphocytes And Impact Of Checkpoint Blockades On The Effector Functions Of Vγ9vδ2 T-Lymphocytes, Minji Choi, Andrew Wiemer, Andrea Hubbard, Brian Aneskievich

University Scholar Projects

Chronic antigenic stimulation leads to T cell exhaustion, which drastically dampens T cell effector functions. Upon exhaustion, T cells progressively lose their proliferative capacity, cytokine production, and cytotoxic effector functions against tumors. T cell exhaustion involves programmed cell death-1 (PD-1), which is an inhibitory co-stimulation receptor. Limited scope of studies has been done regarding impact of PD-1 expression on the effector functions of γδ T cells. In this study, we investigated expression of PD-1 and its impact on effector functions of human γδ T cells. When γδ T cells were stimulated with phosphoantigens (HMBPP and POM₂-C-HMBP) and analyzed …

A Week Devoted To Wellness In The Preclinical Phase: Lessons Learned, Nethra S. Ankam, Md

Department of Rehabilitation Medicine Posters

Background

During the 2017-2018 academic year, a large private medical college underwent a complete transformation of its curriculum from a primarily lecture based, traditional format to an integrated, longitudinal format that included both time limited blocks and longitudinal threads of content. Wellness, conceptualized at both wellness of the provider and the patient, is one of the eight threads.

Goals

• Provide a structured pause in medical school for you to reflect on your own wellness
• Allow time to explore the ideas of resilience
• Provide time for rejuvenation
• Allow you to start building productive habits to last you throughout your entire medical …

Decibel Levels And Employee Perceptions Of Noise Levels In Child Care Facilities, Emily K. Pope

Honors Program Theses and Projects

This quantitative study investigated decibel levels and employee perceptions of the noise levels in four child care facilities. Using a sound level meter, the decibel levels of each facility were measured when the rooms were unoccupied and when they were unoccupied and, information about the acoustic environment was collected. Employees (n= 22) completed a survey rating noise levels during activities throughout the day and the potential implications of the noise levels on their voice and hearing. Results showed that the child care facilities adhered to OSHA standards for permissible noise in work environments (90dBA for 8 hours). The sound-level measurements …

Improving Nurse Managers Skills In The Veterans Health Administration, Charles Silveri

Doctor of Nursing Practice Scholarly Projects

The Veterans Health Administration (VHA) provides an education module for nurse mangers that prepares them for unique duties and responsibilities. This project explores the self-reported confidence in knowledge learned of nurse managers who participated in an online management and leadership training program through measurement of pre- and post- training participation. The aim of this study is to analyze an online training program for nurse managers in regards to improvement in leadership/management skills and promote better management and patient advocacy (Kvas, Seljak & Stare, 2014; American Organization of Nurse Executives (AONE) Nurse Executive Competencies, 2005).

Translesion Synthesis Inhibitors As Anti-Cancer Adjuvant Agents, Kelly Allison Chan

University Scholar Projects

The translesion synthesis (TLS) pathway is a major mechanism through which cancer cells replicate past DNA lesions and promote chemoresistance. TLS allows cancers to survive genotoxic chemotherapy and increases the rate of mutation in tumors leading to drug-resistant cells. Cancer cells use a set of specialized low-fidelity TLS DNA polymerases to copy over lesions with Rev1 serving as a key scaffolding protein. Suppressing Rev1 activity sensitizes cancers to genotoxic chemotherapy and reduces the onset of chemoresistance by decreasing tumor mutation rate. Disruption of the Rev1/polζ-dependent TLS selective inhibitors has demonstrated the ability to sensitize cancer cells to platinating agents and …

Genotype-Specific Insertion Of Cytotoxic Genetic Elements Into Cancer Cells, Ryan Englander

University Scholar Projects

The new gene editing system CRISPR/Cas9, composed of a complex composed of a guide RNA and the Cas9 endonuclease, promises to revolutionize biological research and potentially allow clinicians to directly modify patient DNA in vivo. While its applications in the treatment of genetic diseases and in modifying immune cells for immunotherapy are currently being explored, CRISPR/Cas9’s potential utility as a modular system for targeting tumor-specific mutated sequences has not as of yet been explored. While CRISPR/Cas9 is specific enough to target small insertions and deletions or gross chromosomal rearrangements, it is not specific enough to reliably restrict editing to …

A Journey Through Homelessness: A Photovoice Project With Youth Experiencing Homelessness In Minnesota, Bonnie D. Paulsen

Theses and Graduate Projects

The purpose of this project was to conduct a photovoice project with youth experiencing homelessness who frequent a drop-in center in the Midwest. Youth experiencing homelessness are a marginalized population whose numbers continue to grow. Photovoice is a method by which marginalized populations have an opportunity to express their lived experiences through photographs and what those photographs mean to them. Four youth from the drop-in center in the Midwest participated in the photovoice project. The youths were given cameras and instructions to take photographs of three broad areas: what homelessness means to them, their dreams for their futures and how …

Flow, Creativity And Autism Spectrum Disorder: Creatively Supporting Development And Pro-Social Behavior In Children With Asd, Mehdi Raoufi

Expressive Therapies Capstone Theses

This literature review is an analysis of the literature exploring the use of expressive arts modalities with children living with Autism Spectrum Disorder (ASD), with a focus on emotional regulation and behavior modification. Historically, Applied Behavior Analysis (ABA) has been the standard in terms of behavior modification for this population, but current research and qualitative inquiries suggested that members of this population need more support in emotional regulation and communication than ABA is able to provide. Using an intermodal arts-based method developmentally promotes social and communication abilities in children with ASD. Further, channeling stereotypic behaviors into creative flow can regulate, …

Nurses' Health And Professional Quality Of Life, Deborah Amason

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Nurse's Health and Professional Quality of Life

Abstract

This study investigated relationships between general health (GH), professional quality of life (PQL) and perceived stress (PS) of nurses at a 382-bed southeastern hospital.

Background: Several studies showed that GH and PQL are associated. The health, quality of life, and perceived stress of nurses was a growing concern in the hospital. Nurse leaders needed data to inform evidence-based efforts to promote nurse health and improve quality of life while reducing stress.

Design: This cross-sectional correlation study measured GH, PQL, and PS using four validated and reliable instruments: The Medical Outcomes Short Form …

Cd8+ T-Cell Responses In Vaccination: Reconsidering Targets And Function In The Context Of Chronic Antigen Stimulation, Gabriela L. Cosma, Laurence Eisenlohr

Department of Microbiology and Immunology Faculty Papers

Cytotoxic CD8 T cells play important roles in eliminating infected and transformed cells. Owing to their potential for therapeutic applications, significant efforts are dedicated toward developing CD8 T cell-based vaccines. Thus far, CD8 T-cell vaccination strategies have had limited success therapeutically in contrast to those targeting antibody-based immunity. However, if the current challenges and gaps in the understanding of T-cell biology are overcome, the full potential of rational CD8 T-cell vaccine design might be realized. Here, we review recent progress in this direction, focusing on target selection and maintenance of function in the settings of chronic infections and cancers.

Evaluating Itraconazole Analogues And Translesion Synthesis Inhibitors As Anti-Cancer Agents, Kelly Allison Chan

Honors Scholar Theses

My projects were to evaluate itraconazole (ITZ) analogues as anti-cancer hedgehog (Hh) and angiogenesis inhibitors, and translesion synthesis (TLS) inhibitors as anti-cancer agents. Itraconazole (ITZ) is a clinically effective triazole antifungal agent that has also been identified for its anti-cancer properties. As reported in the current literature, ITZ inhibits Gli1 transcription of the Hedgehog (Hh) signaling pathway and angiogenesis. However, the triazole moiety of ITZ has a detrimental side effect of inhibiting cytochrome P450 3A4 enzymes (CYP3A4). Thus, we have removed the triazole from the ITZ scaffold and develop a new series of ITZ analogues called des-triazole ITZ analogues. The …

The Impact Of Being Born With Cleft And Cleft Reparative Surgery On Overall Health And Speech Outcomes, Khatansuudal Kira Evsanaa, Sam Manning, Jeriemiah Maller

Creative Activity and Research Day - CARD

Orofacial cleft is one of the most common and treatable birth defects in the world. If left untreated, orofacial cleft can impair normal speech development, and could lead to a number of health consequences later in life. The main motivation of the study is to measure the impact of being born with cleft and the cleft reparative surgery on overall speech and health for teenagers in India using difference-in-differences approach along with household fixed effects method. Overall health outcome was measured using height, weight, grip strength and BMI, and the speech outcome was measured using “Universal Parameters of Speech Evaluation”. …

The Impact Of Cleft Lip And Palate Repair Surgery On Cognitive And Academic Outcomes For Teens In India, Jeremiah R. Maller

Creative Activity and Research Day - CARD

India has a backlog of an estimated 1,000,000 patients in need of cleft lip and palate repair. Unrepaired clefts result in social stigma and diminished psychological well-being, physical health and academic functioning. Cleft repair surgery has the potential to restore functioning in these domains. However, the magnitude of the social, educational, and economic impact of cleft repair surgery has not been evaluated using statistically rigorous methods. An estimation of the psychosocial and educational impact of cleft repair has implications for the appropriate allocation of public health resources. We use data gathered from teenagers in India. A difference-in-differences method is employed …

Ketogenic Diet Enhances Neurovascular Function With Altered Gut Microbiome In Young Healthy Mice, David Ma, Amy C. Wang, Ishita Parikh, Stefan J. Green, Jared D. Hoffman, George Chlipala, M. Paul Murphy, Brent S. Sokola, Björn Bauer, Anika M. S. Hartz, Ai-Ling Lin

Sanders-Brown Center on Aging Faculty Publications

Neurovascular integrity, including cerebral blood flow (CBF) and blood-brain barrier (BBB) function, plays a major role in determining cognitive capability. Recent studies suggest that neurovascular integrity could be regulated by the gut microbiome. The purpose of the study was to identify if ketogenic diet (KD) intervention would alter gut microbiome and enhance neurovascular functions, and thus reduce risk for neurodegeneration in young healthy mice (12–14 weeks old). Here we show that with 16 weeks of KD, mice had significant increases in CBF and P-glycoprotein transports on BBB to facilitate clearance of amyloid-beta, a hallmark of Alzheimer’s disease (AD). These neurovascular …

Performance Anxiety And The Benefits Of Proper Breathing For Singing, Kate Zecher

Undergraduate Theses

The intent of this thesis is to help those with Music Performance Anxiety, or anxiety in general, better understand their anxiety and its causes. They can then use this knowledge to reduce or control their symptoms in order to improve their performance, whether on a stage or in a classroom. One of the main symptoms of Music Performance Anxiety is constriction of the chest. It is one of the most debilitating symptoms to singers as it causes shortness of breath. Therefore, focusing on anxiety in relation to breathing will most benefit those with Music Performance Anxiety. In addition, learning about …

A Cytotoxic Evaluation Of A Chalcone Derivative Library On A549 Cells, Mary Elaine Kuo

Undergraduate Theses

Chalcones, a precursor to flavonoids, are chemical compounds found naturally in plants. The chalcones’ structure consists of a ketone bridge attached to two aromatic rings. Varying substituents on the aromatic rings allow for different affects, including anti-cancer properties. As a Michael acceptor, chalcones interact with pathways that cause inhibition of the initiation, promotion, and progression of cancer tumors. We have screened 32 compounds for growth inhibition in lung cells that vary the flexibility and confirmation of the 3 carbon bridge between the two aromatic rings as well as the effects of electronic modifications to the aromatic ring. We have found …

Do Calories Count? Examining The Impact Of Calorie Awareness On Food Selection, April V. Rose

Doctor of Psychology (PsyD)

This study examined whether purchasing behavior of patrons in a college campus café changed when calorie information was provided. It compared weekly sales on food items before and after calorie information was posted for a group of target items (n = 6) that had calorie counts posted in fall 2017 and two groups of comparison items. Archival sales data were collected using the existing point-of-sale system. Sales of target items, which had calories displayed next to them, dropped significantly when compared with sales of the same items during the previous year. Sales of target items also dropped significantly when compared …

A Novel Approach To Debriefing Medical Simulations: The Six Thinking Hats., Xiao Chi Zhang, Hyunjoo Lee, Carlos Rodriguez, Joshua Rudner, Dimitrios Papanagnou

Department of Emergency Medicine Faculty Papers

Simulation has become a standard training method in emergency medicine (EM). Specifically, post-simulation debriefings offer participants the opportunity for reflection while exposing their knowledge and practice gaps. The educational yield of these debriefings, however, is contingent on the debriefer's skills. Without professional development, faculty and educators may not be equipped with supportive debriefing strategies. We propose the Six Thinking Hats (6TH), originally developed by Edward de Bono (1970) as a debriefing framework to support effective, high-yield debriefing conversations. The six colored hats represent six unique approaches to critical thinking. The white hat represents the facts; the green hat, creativity and …

Spiritual Perspectives, Spiritual Care, And Recovery-Oriented Practice In Psychiatric Mental Health Nurses, Melissa Neathery

Nursing Theses and Dissertations

The prevalence of mental illness is well documented with 450 million people suffering with a mental illness worldwide. Nurses are integral to the delivery of mental health services and can influence the provision of individually focused, evidence-based, and culturally competent care. Spiritual care has been shown to enhance coping, improve well-being, and increase satisfaction with care for those in mental health recovery. Three manuscripts presented in this dissertation portfolio explored and addressed the concepts spirituality and spiritual care for those in mental health and substance use recovery. The Recovery Practice Model was examined and how spiritual care can be integrated …

The Effect Of My Health Companion© On Self-Management And Quality Of Life In Persons With End Stage Renal Disease: A Multiple Case Study Approach, Julie D. Leming

Nursing Theses and Dissertations

End stage renal disease (ESRD) is the fifth and final stage of chronic kidney disease. Persons with ESRD face significant challenges to quality of life when undergoing renal replacement therapy with hemodialysis. Complex medical regimens accompanied by severe physical discomforts related to both ESRD and dialysis can take a serious emotional toll. Two manuscripts presented in this dissertation portfolio explore the issues facing this population. First, a comparative concept analysis explores three potential psychosocial responses for which nurses are uniquely positioned to intervene. A second manuscript details a multiple-case study with embedded units of analysis that aimed to test the …

Analysis Of Clinical Data To Determine The Minimum Number Of Sensors Required For Adequate Skin Temperature Monitoring Of Superficial Hyperthermia Treatments., Akke Bakker, Rebecca Holman, Dario B. Rodrigues, Hana Dobšíček Trefná, Paul R. Stauffer, Geertjan Van Tienhoven, Coen R.N. Rasch, Hans Crezee

Department of Radiation Oncology Faculty Papers

PURPOSE: Tumor response and treatment toxicity are related to minimum and maximum tissue temperatures during hyperthermia, respectively. Using a large set of clinical data, we analyzed the number of sensors required to adequately monitor skin temperature during superficial hyperthermia treatment of breast cancer patients.

METHODS: Hyperthermia treatments monitored with >60 stationary temperature sensors were selected from a database of patients with recurrent breast cancer treated with re-irradiation (23 × 2 Gy) and hyperthermia using single 434 MHz applicators (effective field size 351-396 cm²). Reduced temperature monitoring schemes involved randomly selected subsets of stationary skin sensors, and another subset …

Maternal Obesity And Fetal Macrosomia: An Integrative Review Of The Literature Regarding Interventions, Charity Stalcup

Senior Honors Theses

Research suggests pre-pregnancy obesity is associated with an increased risk of macrosomia in the newborn. Since women are expected to gain weight during pregnancy, the standard recommendation of weight loss for obesity is not ideal for this population. In this systematic review of the literature regarding interventions for maternal obesity to reduce fetal macrosomia, 149 articles were screened using three different databases to identify recent randomized controlled trials related to this topic. A total of 11 full text articles were analyzed and included in the review. The articles addressed nutritional, lifestyle, and pharmacological interventions. The results indicated there is currently …

Human Breast Tumor Cells Support Productive Hcmv Infection, Kaitlin Branch

Creative Activity and Research Day - CARD

Breast cancer is the leading cause of cancer deaths among women. While many risk factors for breast cancer are known, viral infection has emerged as a potential factor in tumor development. Human Cytomegalovirus (HCMV) generally causes mild or asymptomatic infection; however, recent evidence links HCMV to breast cancer. In particular, the viral cytokine cmvIL-10 promotes proliferation, migration, and invasion of breast cancer cells in culture. Since HCMV is transmitted via human breast milk, we hypothesized that breast tumor cells could become infected and produce cmvIL-10. HCMV infection of breast cancer cells was confirmed with fluorescence microscopy. Viral gene expression was …

The Santa Clara, 2018-04-26, Santa Clara University

The Santa Clara

No abstract provided.

Cognitive Changes Following Multiple-Modality Exercise And Mind-Motor Training In Older Adults With Subjective Cognitive Complaints: The M4 Study, Narlon Cassio Boa Sorte Silva, Dawn P. Gill, Adrian M. Owen, Teresa Liu-Ambrose, Vladimir Hachinski, Ryosuke Shigematsu, Robert Petrella

Lifestyle Research Team

Background

We investigated the effects of multiple-modality exercise with additional mind-motor training on cognition in community-dwelling older adults with subjective cognitive complaints.

Methods

Participants (n = 127, mean age 67.5 [7.3] years, 71% women) were randomized to receive 45 minutes of multiple-modality exercise with additional 15 minutes of either mind-motor training (M4, n = 63) or control (balance, range of motion and breathing exercises [M2, n = 64]). In total, both groups exercised 60 minutes/day, 3 days/week, for 24 weeks. Standardized global cognitive functioning (GCF), concentration, reasoning, planning, and memory were assessed at 24 weeks and after a 28-week no-contact …

Endoscopic Ultrasound Features Of Multiple Endocrine Neoplasia Type 1-Related Versus Sporadic Pancreatic Neuroendocrine Tumors: A Single-Center Retrospective Study, Gianluca Tamagno, Vanessa Scherer, Alberto Caimo, Simona Bergmann, Peter Kann

Articles

Pancreatic neuroendocrine tumors (pNETs) can occur in patients with a familial syndrome either as multiple endocrine neoplasia type 1 (MEN-1) or as sporadic tumors. Endoscopic ultrasound (EUS) has become one of the first-line investigations for pNET characterization. The ultrasonographic features of pNETs may differ depending on the familial versus sporadic pathogenesis of the tumor. Therefore, the EUS findings could help and direct the definition of a pNET with an impact on the most appropriate diagnostic and ther- apeutic patient management. Methods: In this single-center retrospective study, we reviewed the EUS features of 94 pNETs from 37 MEN-1 patients and 15 …

A Multi-Faceted Intervention To Improve Naloxone Co-Prescription Rates Among Primary Care Providers, Jolane S. Conklin

Evidence-Based Practice Project Reports

It is estimated that 91 Americans die every day due to opioid overdoses, with at least half of those overdoses involving an opioid prescription (CDC, 2016d). To address this issue, the U.S. Department of Health and Human Services (USDHHS) has initiated an opioid initiative, and the Centers for Disease Control and Prevention (CDC) has released a clinical guideline, both of which include a focus on increasing use of naloxone. Despite these recommendations, providers often fail to co-prescribe naloxone to patients at increased risk of opioid overdose. The purpose of this evidence-based practice (EBP) project was to evaluate the effect of …