Medicine and Health Sciences Commons^™

Mechanistic Study Of Diatrizoic Acid Induced Proximal Tubule Cytotoxicity, Dakota Blake Ward

Theses, Dissertations and Capstones

Radiocontrast media (RCM) are necessary for many diagnostic procedures such as arteriography, percutaneous coronary intervention (PCI), and computed tomography. Contrast-induced acute kidney injury (CI-AKI) is the third most common cause of hospital-associated kidney damage accounting for 10-25% of cases worldwide. The mechanisms of contrast-induced renal impairment are not entirely known, but diminished renal hemodynamics, inflammatory responses, and direct cytotoxicity have been hypothesized. The purpose of this study was to investigate the mechanisms of direct cytotoxicity observed in HK-2 cells following treatment with diatrizoic acid (DA) and to determine the source of this damage. Mitochondrial function, endoplasmic reticulum (ER) stress, oxidative …

Regulation Of Na-K-Atpase By Arachidonic Acid Metabolites In Intestinal Epithelial Cells, Niraj Nepa

Theses, Dissertations and Capstones

The integral membrane protein sodium potassium adenosine triphosphate (Na-K-ATPase), has been extensively studied in various animal cell models. Na-K-ATPase is a multifunctional enzyme which plays a significant role in cellular physiology by regulating electrochemical potential, cell volume, pH, cytosolic calcium, and many nutrient and electrolyte transport processes. As such, it has been implicated in the pathogenesis of inflammatory bowel diseases (IBD) and has been shown to play a vital role in the malabsorption of nutrients and electrolytes. In this context, a significant amount of research has been done over the last two decades to understand the mechanisms of alteration of …

Interplay Between Genetic Predisposition And Diet In Advancing Obesity And Type 2 Diabetes In The Tallyho Mouse, Jacaline Parkman

Theses, Dissertations and Capstones

Obesity is a global epidemic, affecting all ages. It is one of the leading causes of preventable death, as it increases the risk of type 2 diabetes (T2D), hypertension, cardiovascular disease, nonalcoholic fatty liver disease, and some cancers. Obesity is a complex disease that is caused by a combination of genetic and environmental factors such as diets high in fat and sedentary life style. Despite our increased knowledge of obesity development and progression, current obesity treatments have not stopped the rise in obesity rates. There are still many unknowns related to the underlying mechanisms of obesity that need to be …

Role Of Cytochrome P450 2b6 Polymorphisms In Unexpected Methadone Death, Taha Ahmad

Theses, Dissertations and Capstones

Methadone is a synthetic, long-acting opioid prescribed as an analgesic for chronic pain. It has a single chiral center forming two enantiomers, (R)-methadone and (S)-methadone, each having specific pharmacological actions. Concentrations of (R)- and (S)-methadone above therapeutic levels have the ability to cause serious, life-threatening, and fatal side effects. Cardiotoxicity is caused by elevated (S)-methadone levels by prolonging the QT interval of the heart’s electrical cycle. In 2014, methadone accounted for only 1% of all opioids prescribed for pain, but was responsible for 3,400 of the 14,838 individuals (~23%) who died in the United States from overdoses due to prescription …

The Effectiveness Of Nutrition Education: Comparing Registered Dietitian Educators With Dietetic Interns, Amy Gannon

Theses, Dissertations and Capstones

The Department of Dietetics at Marshall University is a subcontracting agency with the West Virginia University Extension Service for the purposes of delivering nutrition education to children in low-income schools in a six-county radius in southwestern West Virginia through the Marshall University Nutrition Education Program (NEP). The method of lesson delivery includes an educational model that utilizes both registered dietitians (RD) and dietetic interns. The NEP is evaluated through several methods, including pre-/post-tests, teacher focus groups, and parental feedback surveys. To date, no evaluation has been completed to determine the effectiveness of dietetic interns’ delivery of nutrition education lessons compared …

Potential Applications Of Capsaicinoids In Small Cell Lung Cancer Therapy, Jamie Rae Friedman

Theses, Dissertations and Capstones

Lung cancer continues to be the leading cause of cancer related mortality worldwide. Lung cancer is not a single disease but an umbrella that encompasses two major classifications, nonsmall cell lung cancer (NSCLC) and small cell lung cancer (SCLC). SCLC represents about 15- 20% of all lung cancer cases and is almost exclusively diagnosed in smokers. Typically, patients will respond very well to first line treatment, but face inevitable relapse. The fact that SCLC still carries a grim 5-year survival rate of less than 5% highlights the lack of advancement in treatment options to effectively improve patient response and survival. …

Experiential Learning In Dietetics: Can Diabetes Camp Make A Difference?, Mallory Jean Mount

Theses, Dissertations and Capstones

This longitudinal qualitative case study explored the knowledge, perceptions, confidence, and empathy gained by dietetics students during experiential learning at a residential diabetes camp. Qualitative research methods were used to explore and understand participants’ experience of hands-on involvement with type one diabetes, and what they learned at camp that cannot be learned in a classroom. Data were collected over two years at Camp Kno-Koma, the diabetes camp of West Virginia. This study suggests that experiential learning at diabetes camp can make an important contribution to the overall education of dietetics students. One year of experiential learning was beneficial to participating …

From Darkness To Light: An Exploration Of Self-Discovery And Healing Through Collaborative Recovery Expressive Writing, Leighann Justice Davidson

Theses, Dissertations and Capstones

This participatory action research project was developed to explore the participants’ experiences during a collaborative recovery expressive writing (CREW) workshop while in long-term treatment from substance use disorders (SUDs). This workshop featured the primary components of the James W. Pennebaker model, but adapted the technique to create a safe environment for the participants to share their writings. This qualitative study conducted at Recovery Point West Virginia began by exploring how ten women sharing their emotions within a supportive environment used collaborative writing to continue their recovery journey through self-discovery and healing. Following the CREW workshop, the project continued with focus …

Charge Master And The Effects On Hospitals, Whitney Layton, Katie Lemmon

Theses, Dissertations and Capstones

Introduction: The hospital charge master, has been the heart of the healthcare revenue cycle, as it has served as the hospitals’ starting point for billing patients and payers. The CDM was made as an extensive breakdown of the cost of the care provided and in order for a hospital to correctly bill a patient for care received as every chargeable item in the hospital must be included in the master.

Methodology: The methodology for this study utilized a literature review. It consisted of academic sources, five electronic databases, academic journals, and government websites. Thirty- six sources were referenced for this …

Endogenous Antioxidant Overexpression As An Adjuvant To Diet Or Exercise Intervention As Therapy To Counteract Obesity And Beneficially Shift The Gut Microbiome, Deborah Lynn Amos

Theses, Dissertations and Capstones

Oxidative stress plays a key role in metabolic syndrome which includes obesity and cardiometabolic diseases. It is implicated that oxygen-derived free radicals generated during the mitochondrial electron transport chain alter the function of specific biological components, thus activating obesogenic pathways such as glucose and lipid signaling. Research on this topic is of vital importance as obesity is a high-risk factor in the development and progression of severe, debilitating, life-threatening maladies such as cardiometabolic diseases, chronic inflammatory pathologies, and cancer. Furthermore, there is no universal effective therapy to combat the rising rates of obesity with over 1.9 billion (39%) adults classified …

Rural Hospital Health In The United States, Stephanie Cole, Kathleen Lanham

Theses, Dissertations and Capstones

Introduction: Rural hospitals experienced both challenges and opportunities in providing healthcare to the community. As these facilities were one of the largest employers in the area, their impact was significant. Additionally, accessibility to necessary medical services was essential. Thus, sustainability of rural hospitals was vital. In order to assess sustainability, exploration into financial and quality outcomes could help support their ability to thrive.

Purpose of the Study: The purpose of this study was to determine the sustainability of rural hospitals in the U.S. by examining variables that affect these institutions such as accessibility, availability of services, quality outcomes, and …

The Utilization Of Telehealth/ Telemedicine In Cardiology In Rural Areas, Sophia Noplis, Jocelyn Stout

Theses, Dissertations and Capstones

Introduction: Telecardiology has been defined as a way of practicing cardiology through the utilization of telecommunications and a more cost-effective way to deliver cardiac care. As a subset of telemedicine, telecardiology has functioned to bring providers to underserved communities through technological mechanisms. Rural regions have turned to telemedicine and tapped into a network of clinical institutions exchanging practitioners and patients to emphasize value-based instead of volume-based care.

Methodology: The methodology of this qualitative study was a literature review having used mixed methodologies. Five electronic databases and government websites were utilized, and one semi-structured interview with an expert in …

The Implementation And Effects Of Computerized Physician Order Entry In Healthcare Settings, Bojing Wang, Xiaoying Liu

Theses, Dissertations and Capstones

Introduction: In the United States, medication errors has been a big problem and was the number three cause of death in 2016. Computerize Physician Order Entry (CPOE), also known as Computerized Provider Order Entry, is the process of physicians or providers entering treatment instructions or radiology, laboratory, and medication orders via computer rather than paper, and has led to a decrease in medication errors. The purpose of this study was to examine whether CPOE system could help hospitals to reduce medical errors and costs, as well as examine the new problems resulted by the use of CPOE in the …

Perceived Exertion And The Increase In Risk Of Injury In Rotc Cadets, Courtney D. Chiaramonte

Theses, Dissertations and Capstones

Context: Musculoskeletal injury in military personnel creates problems due to economic losses, and decreased training. The repetitive motions associated with military training and the daily physical training sessions can lead to the development of fatigue. Fatigue has been shown to contribute to 18% - 26% of musculoskeletal injuries. [7] Several studies have explored fatigue as a risk of injury during occupation. Fatigue has been shown to increase the perceived effort during physical exercise. The purpose of this study was to characterize the perception of effort during physical training sessions and injury rates in ROTC cadets throughout an academic year.

Methods …

Unplanned Hospitalization Among Individuals With Cancer In The Year After Diagnosis, Robin Whitney, Janice Bell, Daniel Tancredi, Patrick Romano, Richard Bold, Ted Wun, Jill Joseph

Faculty Publications

PURPOSE: Reducing acute care use is an important strategy for improving value in cancer care. However, little information is available to describe and compare population-level hospital use across cancer types. Our aim was to estimate unplanned hospitalization rates and to describe the reasons for hospitalization in a population-based cohort recently diagnosed with cancer. MATERIALS AND METHODS: California Cancer Registry data linked with administrative inpatient data were used to examine unplanned hospitalization among individuals diagnosed with cancer between 2009 and 2012 (n = 412,850). Hospitalizations for maintenance chemotherapy, radiotherapy, or planned surgery were excluded. Multistate models were used to estimate age-adjusted …

Case Managers’ Perceptions Of Effective Interventions, Julia Williamson

Nursing Theses and Capstone Projects

Case managers (CM) identify patients with high emergency department (ED) utilization and barriers to healthcare services. CM interventions need to be evaluated related to high ED utilization, identification of effective interventions, and improving patients’ self-management skills. Current literature supports the review and implementation of identified CM interventions to reduce non-emergent ED utilization, and improved patients’ health literacy, and self-management abilities. There is a lack in research related to CM perceptions’ of effective interventions to reduce ED utilization. The purpose of this study was to examine CM perceptions’ of patients’ low health literacy and self-management skills, identify barriers to self-care, and …

The Effect Of Patient Education On Oral Contraceptive Adherence Rates, Brook M. Anderson, Anmol G. Clairmont, Lydia Lutz

All Electronic Theses and Dissertations

We would like to acknowledge our project chair, Jeanne Szarzynski, PA-C, for dedicating her time, expertise, leadership and patience to truly guide the success of our research project. We appreciate her incredible insight, knowledge and skill in literature as well as clinical research to support our research project. Recognition to Barbara Leafblad, CNM, is also appropriate for her time and effort as a reader throughout the project. A very special thank you is appropriated to Lisa Naser, PA-C, and Wallace Boeve, PA-C, for lending their time and professional skills to editing this paper and providing invaluable feedback, with their help, …

Development Of Targeted Alpha Particle Therapy For Solid Tumors, Narges K. Tafreshi, Michael L. Doligalski, Christopher J. Tichacek, Darpan N. Pandya, Mikalai M. Budzevich, Ghassan El-Haddad, Nikhil I. Khushalani, Eduardo G. Moros, Mark L. Mclaughlin, Thaddeus J. Wadas, David L. Morse

Faculty & Staff Scholarship

Abstract: Targeted alpha-particle therapy (TAT) aims to selectively deliver radionuclides emitting α-particles (cytotoxic payload) to tumors by chelation to monoclonal antibodies, peptides or small molecules that recognize tumor-associated antigens or cell-surface receptors. Because of the high linear energy transfer (LET) and short range of alpha (α) particles in tissue, cancer cells can be significantly damaged while causing minimal toxicity to surrounding healthy cells. Recent clinical studies have demonstrated the remarkable efficacy of TAT in the treatment of metastatic, castration-resistant prostate cancer. In this comprehensive review, we discuss the current consensus regarding the properties of the α-particle-emitting radionuclides that are potentially …

Retrospective Review Of The Patient Cases At A Major Trauma Center In Nairobi, Kenya And Implications For Emergency Care Development, Julie Saleeby, Justin G. Myers, Karen Ekernas, Katherine Hunold, Ali Wangara, Alice Maingi, Peyton Wilson, Vincent Mutiso, Sarah Zamamiri, Daniel Bacon, Wes Davis, John Suder, Yash Agrawal, Ogar Ogar, Ian B.K. Martin, Stephen Dunlop

Faculty & Staff Scholarship

Introduction

Low- and middle-income countries (LMICs) are continuing to experience a “triple burden” of disease - traumatic injury, non-communicable diseases (NCDs), and communicable disease with maternal and neonatal conditions (CD&Ms). The epidemiology of this triad is not well characterised and poses significant challenges to resource allocations, administration, and education of emergency care providers. The data collected in this study provide a comprehensive description of the emergency centre at Kenya's largest public tertiary care hospital.

Methods

This study is a retrospective chart review conducted at Kenyatta National Hospital of all patient encounters over a four-month period. Data were collected from financial …

Mutations In Arl2bp, A Protein Required For Ciliary Microtubule Structure, Cause Syndromic Male Infertility In Humans And Mice, Abigal R. Moye, Nicola Bedoni, Jessica G. Cunningham, Urikhan Sanzhaeva, Eric S. Tucker, Peter Mathers, Virginie G. Peter, Mathieu Quinodoz, Liliana P. Paris, Luisa Coutinho-Santos, Pedro Camacho, Madeleine G. Purcell, Abbie C. Winkelmann, James A. Foster, Elena N. Pugacheva, Carlo Rivolta, Visvanathan Ramamurthy

Faculty & Staff Scholarship

Cilia are evolutionarily conserved hair-like structures with a wide spectrum of key biological roles, and their dysfunction has been linked to a growing class of genetic disorders, known collectively as ciliopathies. Many strides have been made towards deciphering the molecular causes for these diseases, which have in turn expanded the understanding of cilia and their functional roles. One recently-identified ciliary gene is ARL2BP, encoding the ADP-Ribosylation Factor Like 2 Binding Protein. In this study, we have identified multiple ciliopathy phenotypes associated with mutations in ARL2BP in human patients and in a mouse knockout model. Our research demonstrates that spermiogenesis …

Investigational Monoclonal Antibodies In The Treatment Of Multiple Myeloma: A Systematic Review Of Agents Under Clinical Development, Ahmad Iftikhar, Hamza Hassan, Nimra Iftikhar, Adeela Mushtaq, Atif Sohail, Nathaniel Rosko, Rajshekhar Chakraborty, Faryal Razzaq, Sonia Sandeep, Jason Neil Valent, Abraham Sebastian Kanate, Faiz Anwer

Faculty & Staff Scholarship

Background: Immunotherapy for multiple myeloma (MM) has been the focus in recent years due to its myeloma-specific immune responses. We reviewed the literature on non-Food and Drug Administration (FDA) approved monoclonal antibodies (mAbs) to highlight future perspectives. We searched PubMed, EMBASE, Web of Science, Cochrane Library and ClinicalTrials.gov to include phase I/II clinical trials. Data from 39 studies (1906 patients) were included. Of all the agents, Isatuximab (Isa, anti-CD38) and F50067 (anti-CXCR4) were the only mAbs to produce encouraging results as monotherapy with overall response rates (ORRs) of 66.7% and 32% respectively. Isa showed activity when used in combination with …

Baystate Medical Practices Annual Report - 2019, Andrew Artenstein Md

Baystate Medical Practices Annual Report

No abstract provided.

Fusion, 2019, George Washington University, William H. Beaumont Medical Research Honor Society

Fusion

No abstract provided.

Cuentos - 2019, George Washington University, Medical Faculty Associates

Cuentos

Cuentos is the humanities magazine of the George Washington University Medical Faculty Associates Department of Internal Medicine.

Improving Nurse-To-Nurse Handoff Communication At The Bedside Through Simulation-Based, Lisa Thornsberry Mrs.

Doctor of Nursing Practice Projects

Communication among nursing staff is crucial to the outcome of patient care. Poor handoff and communication among professionals can have a negative impact on the safety of patients. The systemic nature of the problem with miscommunication among healthcare clinicians supports the necessity of standardization of communication among nursing as a handoff of care.

Change of shift report, or nurse-to-nurse report ensures the transfer of critical information to promote patient safety and best practices. Transferring and communicating pertinent information from one shift to the next is one factor in providing continuity of care. Bedside Shift Report (BSR) is an opportunity to …

Increasing Medication Error Reporting To Improve Patient Safety, Dianna Madden

Doctor of Nursing Practice Projects

In 2006, the Institute of Medicine estimated that 1.5 million preventable adverse drug events occur in healthcare facilities annually (Institute of Medicine, 2006). Each ADE adds approximately $8,750 per hospital stay (Institute of Medicine, 2006). In 2017, the Food and Drug Administration (FDA) estimated that 1.3 million people are injured annually from medication errors (Agency for Healthcare Research and Quality, 2017). For the purposes of this project, all Registered Nurse staff on the Medical-Surgical unit were mandated to participate in an education targeted at medication error reporting, the importance of reporting, and a demonstration of inputting an error into the …

Streamlining The Nursing Approach To Newborns With Neonatal Abstinence Syndrome, Gail A. Reichert

Doctor of Nursing Practice Projects

Newborns may suffer from withdrawal symptoms after exposure to maternal substance abuse while in-utero, resulting in negative outcomes for the patient, family, and healthcare system. Neonatal Abstinence Syndrome (NAS) has increased by 300% in the United States. Non-pharmacological interventions such as rooming in, breastfeeding, and parent education are nursing activities which can improve the outcomes for NAS patients. However, a formal protocol to identify, assess, and treat the patients with non-pharmacologic evidence-based interventions is lacking. The purpose of this project was to develop, implement, and evaluate a sustainable policy to incorporate evidence-based strategies into nursing care at a rural community …

Acute Respiratory Distress Syndrome, Amelia Morgan

Nursing Student Class Projects (Formerly MSN)

Acute respiratory distress syndrome (ARDS) is a devastating form of hypoxemic respiratory failure with the potential for significant morbidity and mortality (Dalmedico, et al., 2017). Though the exact cause or trigger for ARDS is not always identified, great strides have been made in its identification and treatment since the 1990’s. Strategies include screening in the emergency department, prone positioning, and lung protective ventilator settings. Knowledge of the pathophysiological processes and familiarity with treatment strategies will aid the practitioner in the decision-making process for these critically ill patients.

Acute Respiratory Distress Syndrome, Allison Bruce

Nursing Student Class Projects (Formerly MSN)

Acute Respiratory Distress Syndrome (ARDS) burdens intensive care units (ICU) and their patients across the world. This presentation discusses the presentation, pathophysiology, current treatment and nursing implications for ARDS. This pathophysiological process requires exceptional interprofessional teamwork by the healthcare team. It is important for nurses to have an in-depth comprehension of this disease and its manifestations so that it can be detected and treated as quickly as possible. Further research and education are needed to improve the mortality rates of patients with ARDS.

An Examination Of Step Frequency And The Running Readiness Scale As Predictors Of Running-Related Injury In Collegiate Cross-Country Athletes, Shelley Payne Dr., Jenna D'Errico

Health and Sport Sciences Faculty Scholarship

Purpose: The purpose of this study was to determine the relationship between step frequency and the Running Readiness Scale and the occurrence of a Running-Related Injury (RRI) in a Division III cross-country team. Methods: Each athlete was screened prior to the season for their step frequency at a preferred and pre-determined pace. Additionally, each athlete performed 6 musculoskeletal tests known as the “Running Readiness Scale” to assess body alignment, weight distribution, and muscular endurance. Each subject logged their training and competition schedule and injury history throughout the season using the Otterbein Run Tracker app. Results: Sixteen subjects completed data collection …