Medicine and Health Sciences Commons^™

Barbell Trajectory And Kinematics During Two International Weightlifting Championships, Aaron J. Cunanan

Electronic Theses and Dissertations

Several methods have been used in the scientific literature to study the weightlifting pull. Broadly, these methods are used to measure kinematic or kinetic variables exhibited by the lifter, the barbell, or the lifter-barbell system. However, there is an apparent disconnect between weightlifting research and coaching practice that may reduce the perceived benefits of technique analysis among coaches and present some challenges for coaches who seek to incorporate technique analysis into their coaching practice. Differences and trends in the technique of competitive weightlifting performances are apparent from the available literature. However, there are also gaps in the literature due to …

Impact Of Adverse Childhood Experiences On Mental Health Outcomes And Related Prescription Practices In A Psychiatric Inpatient Sample, Carrie Lemay

Electronic Theses and Dissertations

A definitive association between adverse childhood experiences (ACEs) and negative physical and mental health outcomes has been established. There is evidence that individuals in forensic psychiatric facilities are disproportionately exposed to ACEs, which may impact severity, prognosis, and age of onset of psychiatric symptoms, including behavioral concerns of institutional aggression, self-harm behaviors, and suicide attempts. Such psychiatric and behavioral concerns are often managed through multiple psychotropic prescriptions, leading to psychotropic polypharmacy. This study evaluated the relationship between ACEs, mental health and behavioral concerns, and psychotropic polypharmacy through analysis of archival data from a forensic inpatient psychiatric facility. A total of …

Neonatal Intensive Care Unit Speech-Language Pathologists’ Perceptions Of Infants With Neonatal Abstinence Syndrome, Lauren Fabrize

Electronic Theses and Dissertations

Objective: The purpose of this study was to determine the characteristics, assessment, and treatment of infants with Neonatal Abstinence Syndrome (NAS) as perceived by Speech-Language Pathologists (SLP) and whether it differed from those of other Neonatal Intensive Care Unit populations.

Methods: A secure web-based questionnaire with 62 questions collected information on NAS, caseloads, treatment environment, and demographics. Twenty-six respondents initiated the survey; 42% completed most or all questions. Response analyses included descriptive and nonparametric inferential statistics.

Results: Infants with NAS were on the caseloads of 73% of respondents. The majority (79%) only saw infants with NAS and feeding problems. Primary …

Sugammadex Versus Neostigmine: Operating Room Time And Cost, Annie Benscheidt, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background The choice of neuromuscular blockade reversal agents impacts cost and operating room time. Currently, the two medications used to reverse neuromuscular blockade are Neostigmine and Sugammadex. These medications differ in both cost and pharmacologic profiles which effect the time and predictability of reversal (Carron, Zarantonello, Tellaroli, & Ori, 2016). Evaluating cost and time differences in reversal using Sugammadex and Neostigmine helps anesthesia providers select the appropriate medication. This evidence based practice project examined the difference in case length and operating room and reversal agent costs in cases using Sugammadex and Neostigmine at Providence Sacred Heart Medical Center.

Methods • …

Assisted Dying For Prison Populations - Lessons From And For Abroad, Jocelyn Downie, Adelina Iftene, Megan Steeves

Articles, Book Chapters, & Popular Press

No abstract provided.

Plasmid Mediated Colistin Resistance In Enterobacteriaceae Isolated From Feces Of Broiler Chicken In The United Arab Emirates, Sara Abdelkafi Mahmoud Ali

Theses

Although human infections with colistin-resistant Mcr-producing Enterobacteriaceae have been reported from the Arabian Peninsula, the presence of mcr gene in strains of animal origin has not been studied.

Ten composite faecal samples were collected in each of four geographically distant poultry farms in Abu Dhabi Emirate. Ten colonies from McConkey agar containing 1 mg/L colistin from each sample were PCR-screened for mcr-1, mcr-2, MCR-3, mcr-4, mcr-5. Of the positive ones, one isolate representing each distinct plasmid profile was selected for susceptibility testing and for whole-genome sequencing (WGS). Transfer of the MCR-1 gene into Escherichia coli …

Data-Driven Decision-Support For Process Improvement Through Predictions Of Bed Occupancy Rates, Kar Way Tan, Qi You Ng, Francis Ngoc Hoang Long Nguyen, Sean Shao Wei Lam

Research Collection School Of Computing and Information Systems

Managing bed utilization and ensuring the supply keeps up with the demand is not an easy task in a large public hospital with many medical disciplines. The bed managers who makes decisions on reserving and allocating beds centrally require high-dimensional data from several hospital information systems supporting emergency room, specialized clinics and bed management processes. In this work, we put together an automated process for cleaning, consolidating and integrating data from several hospital information systems to several reports required by the bed managers to analyse the bed occupancy situations across more than thirty medical disciplines. To prevent bed crunch situations …

Data-Driven Surgical Duration Prediction Model For Surgery Scheduling: A Case-Study For A Practice-Feasible Model In A Public Hospital, Kar Way Tan, Francis Ngoc Hoang Long Nguyen, Boon Yew Ang, Jerald Gan, Sean Shao Wei Lam

Research Collection School Of Computing and Information Systems

Hospitals have been trying to improve the utilization of operating rooms as it affects patient satisfaction, surgery throughput, revenues and costs. Surgical prediction model which uses post-surgery data often requires high-dimensional data and contains key predictors such as surgical team factors which may not be available during the surgical listing process. Our study considers a two-step data-mining model which provides a practical, feasible and parsimonious surgical duration prediction. Our model first leverages on domain knowledge to provide estimate of the first surgeon rank (a key predicting attribute) which is unavailable during the listing process, then uses this predicted attribute and …

Lehigh Valley Hospital–Hazleton Trauma Pi Process, Alexandra K. Evans

Department of Medicine

No abstract provided.

A Cross Sectional Study Of Medical Students’ Perception Of Their Educational Environment In Ghana, Temitope Ade-Oshifogun, Jean Amost Cadet, Jochebed B. Ade-Oshifogun

Faculty Publications

Background: The quality of medical education is affected by many factors, one of which is the educational environment of medical education. However, there is paucity of studies addressing the educational environment from African medical schools. The aim of this study was to determine the clinical year students’ perceptions of their educational environment at a medical school in Ghana. This was done with the goal of identifying factors that may impact positive changes in the school. Methods: A cross-sectional study was undertaken using the DREEM questionnaire. The questionnaire was administered to students in clinical years 1, 2, & 3 at the …

Por Ahí Dicen: Sexual Health Promotion Campaign In A Puerto Rican Community, Isabella M. Antenucci, Yessica Guzman, Phillip Granberry, Maria Idali Torres

Gastón Institute Publications

The purpose of this study was to assess Puerto Rican mother’s levels of exposure to the Spanish media campaign launched by Por Ahi Dicen, and to assess the identification mothers had with these stories. The methodology consisted of in-person survey interviews of 210 Puerto Rican mothers residing in the city of Springfield, Massachusetts. The study used a sub-set of data taken from these interviews and analyzed using Microsoft Excel and Stata15. The major finding of this study showed that the mothers who regularly watched television in the 90-day campaign time frame were more exposed to the campaign than they were …

Exploring Neighborhood Level Variation In Incidence And Secondary Transmission Of Seasonal Influenza, Melissa Freeland

Masters Theses

Influenza epidemics in the United States, are major causes of morbidity and mortality, and cause serious economic disruption on an annual basis. Evidence has begun to accumulate linking neighborhood-level socioeconomic disadvantage to higher rates of hospitalization and mortality related to influenza (Cordoba & Aiello, 2016; Jung, Lin, & Viswanath, 2013). Some studies suggest that this may be due to lower rates of vaccination, higher rates of comorbidities in socioeconomically disadvantaged communities (Cordoba & Aiello, 2016; Jung, Lin, & Viswanath, 2013; Ross & Mirowsky, 2001). However, few studies have evaluated the effects of neighborhood level socioeconomic disadvantage and structural features on …

Influence Of Child Feeding Practices And Selected Basic Conditioning Factors On Stunting In Children Between 6 And 24 Months Of Age In Myanmar, Khine-Wai-Wai Phu, Jariya Wittayasooporn, Chuanruedee Kongsaktrakul

Makara Journal of Health Research

Background: A cross-sectional predictive study was carried out to examine the influence of child feeding practices on stunting status of children between 6–24 months in Yangon Children Hospital, Myanmar. This study aimed to assess if dependent-care can influence stunting. Methods: Data were collected by anthropometric measurement from a total of 216 children between 6 and 24 months of age. For mothers, structured interview, demographic form, and infant child feeding index were used. Descriptive statistics, chi-square, and logistic regression were carried out. Results: One-fourth of participants exhibited a low score of infant child-feeding practices, whereas median and high score practice accounted …

Effect Of Coral Goniopora Sp Scaffold Application On Human Osteoblast-Like Mg-63 Cell Activity In Vitro, Vera Julia, Basril Abbas, Endang W. Bachtiar, Benny S. Latief, Anne M. Kuijpers-Jagtman

Makara Journal of Health Research

Background: Coral is an osteo-conductive biomaterial that can act as an alternative scaffold for osteogenesis. In this in vitro study we analyzed the activity of osteoblast-like cells after treatment with the coral Goniopora. Methods: Human osteoblast-like MG-63 cells were incubated in α-minimal essential medium supplemented with 10% fetal bovine serum and 300 ng/mL amphotericin B plus 1% penicillin-streptomycin and stored in a 5% CO2 incubator at 37°C. The Goniopora were smashed into size A (20 mesh), B (1–2 mm), and C (200 mesh) particles, sterilized using gamma radiation and applied to cells. Protein and alkaline phosphatase (ALP) concentrations were evaluated …

Gene Expression Of Selected Apoptotic Markers In Human Oral Squamous Carcinoma Hsc-3 Cell Line Treated With Myrmecodia Pendans Plant Extract, Widya Lestari, Wan N A W Yusry, Siti H. Iskandar, Solachuddin J A Ichwan, Nining I. Irfan, Wastuti H. Suriyah

Makara Journal of Health Research

Background: Myrmecodia pendans (M. pendans), or Sarang Semut, is an epiphyte with anticancer potential. It was recently reported that it induces apoptotic activity in the human oral squamous carcinoma (HSC-3) cell line. This study aimed to investigate the effect of M. pendans treated samples on the expression of apoptotic markers, Bax and Bcl-2. Methods: M. pendans was purchased from West Papua, Indonesia. The hypocotyl was dried thoroughly and then extracted aqueously. The apoptotic activity was detected via flow cytometry. Bax and Bcl-2 expression was analyzed by quantitative real-time polymerase chain reaction. Results: Results of our cell cycle analysis reveal that …

Contemporary Nursing In Rural Appalachia: A Hermeneutic Study, Evelyn Brewer

Electronic Theses and Dissertations

Nurses make up a significant source of direct care for individuals, families, and communities. The problematic distribution of nurses and the potential to lose practicing nurses emphasizes the importance of retention and support of nursing professionals, especially in rural locations. One of the best ways to discover what is important to nurses is to ask and listen to the replies.

The focus for this dissertation is the lived experience of registered nurses in a six-county area in three adjoining states in rural South Central Appalachia. The purpose of this study is to interpret and understand the lived experience of contemporary …

Sociodemographic Factors Associated With Mothers’ Experiences Of Psychosocial Care And Communication By Midwives During Childbirth In Nairobi, Kenya, Jane Kabo, Eleanor Holroyd, Grace Edwards, Ahmed Sarki

School of Nursing & Midwifery, East Africa

Purpose: To clarify sociodemographic and socioeconomic factors associated with mothers’ experiences of psychosocial care and communication by midwives during childbirth in Nairobi, Kenya.

Design: A descriptive cross-sectional study conducted in a government national referral hospital. Respondents were 109 systematically sampled mothers who delivered in the study hospital. Mothers’ experiences of intrapartum care were assessed using three subscales from the Experience of Psychosocial Care and Communication during Childbirth Questionnaire (effective communication; emotional support; and respect, care and dignity). Simple and multivariable logistic regression analyses were used to assess associations between sociodemographic factors, socioeconomic factors and mothers’ experiences of intrapartum care.

Findings: …

Case-Based Insights: Arab Muslim Mothers’ Experiences Of Managing A Child Newly Diagnosed With Type 1 Diabetes Mellitus, Rachel Cathrine Rossiter, Jennifer Louise Cooper, Suhad Issa Marjei, Sharon Brownie

School of Nursing & Midwifery, East Africa

Mothers frequently fulfill the role of primary caregiver for children diagnosed with type 1 diabetes mellitus (T1DM). A T1DM diagnosis has a significant impact on the child and the wider family unit. The objective is to develop understanding of mothers’ experiences caring for children diagnosed with T1DM in the cultural context of the Middle East to facilitate enhanced health service provision and support. This study used a qualitative design. Data were collected in individual semistructured interviews. Participants were mothers of Arabic descent and Muslim belief who had a child diagnosed with T1DM within the last 12 months. All mothers were …

Biological Pathway Involvement In Melanoma Heterogeneity And Drug-Induced Resistance, Sarah V. Pack

STAR Program Research Presentations

Tumors develop resistance to numerous drug therapies, and this remains a major obstacle in treating many types of non-surgical cancers. Melanoma provides a good model system for studying drug resistance in cancer due to its high propensity to incur resistance after a significant initial response to a drug. Genes that are highly expressed in melanoma cancer cells have been studied, but in order to further understand the collective function of these highly expressed genes we must analyze gene sets, or pathways. A single gene’s function is rarely independent of other genes, and pathway analysis takes this into account.

Our objective …

Culturally Appropriate Education In Managing Hypertension In African Americans, Kristina Jones

Doctoral Dissertations and Projects

Abstract The historical treatment of African Americans with events such as the Tuskegee experiment and Jim Crow laws combined with distrust of the healthcare system may be affecting health outcomes in African Americans with hypertension. Cultural appropriate education by a provider of the same race is a method that can be utilized to bridge the trust gap between African Americans and providers and assist African Americans in managing their hypertension. A community based culturally appropriate educational intervention by a provider of the same race was implemented over the course of eight weeks to assist African Americans with hypertension to improve …

Mobile-Based Technology App Used To Improve Self-Care Management Of Patients With Type 2 Diabetes Mellitus, Fred Allen Smith Jr

Doctoral Dissertations and Projects

Billions of dollars are spent on diabetes in healthcare each year. Patients with lower socio-economic-status tend to have poor glycemic control, higher associated diabetic complications, and higher associated mortality rates. In underserved patients with type 2 diabetes, does utilization of a Diabetes app, compared to previous self-care management and clinic education, lower the Hemoglobin A1c over a 3-month period? A 3-month scholarly project was conducted in a small rural town in Virginia with an average median income around $17,000. N=21 were selected for the scholarly project. Inclusive criteria consisted of adults aged 19-70 years with a diagnosis of type 2 …

Reducing Central Line-Associated Bloodstream Infections In The Intensive Care Unit By Improving Compliance With Dressing Changes And Curos Caps Use, Jennifer Khaziga Kilel

Doctoral Dissertations and Projects

Background: Reducing central line-associated bloodstream Infections (CLABSI) is a topic of global importance due to associated risk of sepsis, increased length of hospital stay, high healthcare cost, and increased morbidity and mortality among critically ill patients in the intensive care unit (ICU). The mortality rate of patients who acquire CLABSI 15-25% The cost of CLABSI treatment per event is greater than US $16,500. Central cine-associated Bloodstream Infections affect the organization’s national ranking in patient quality and safety as well as reimbursement from the Centers for Medicare and Medicaid (CMS). The aim of the quality improvement project was to improve the …

An Information Theory Model For Optimizing Quantitative Magnetic Resonance Imaging Acquisitions, Drew Mitchell

Dissertations and Theses (Open Access)

Quantitative magnetic resonance imaging (qMRI) is a powerful group of imaging techniques with a growing number of clinical applications, including synthetic image generation in post-processing, automatic segmentation, and diagnosis of disease from quantitative parameter values. Currently, acquisition parameter selection is performed empirically for quantitative MRI. Tuning parameters for different scan times, tissues, and resolutions requires some measure of trial and error. There is an opportunity to quantitatively optimize these acquisition parameters in order to maximize image quality and the reliability of the previously mentioned methods which follow image acquisition.

The objective of this work is to introduce and evaluate a …

Modeling Proton Relative Biological Effectiveness Using Monte Carlo Simulations Of Microdosimetry, Mark A. Newpower

Dissertations and Theses (Open Access)

Proton therapy is a radiotherapy modality that can offer a better physical dose distribution when compared to photon radiotherapy by taking advantage of the Bragg peak, a narrow region of rapid energy loss. Proton therapy is also known to offer an enhanced relative biological effectiveness (RBE) compared to photons. In the current clinical standard, RBE is fixed at 1.1 at all points along the proton beam, meaning protons are assumed to require 10% less dose than photons to achieve target coverage and organ at risk (OAR) sparing. However, there is mounting clinical evidence, and a significant number of in vitro …

Role Of C-Met And Egfr In Acquired Resistance To Parp Inhibitors In Triple-Negative Breast Cancer, Clinton Yam

Dissertations and Theses (Open Access)

Triple-negative breast cancer is associated with a poor prognosis and treatment options are limited. The Poly (ADP-ribose) polymerase (PARP) inhibitors, olaparib and talazoparib, were recently approved for metastatic breast cancer (including triple-negative breast cancer) in patients with a germline BRCA1/2 mutation. Despite impressive response rates of ~60%, the prolongation in median progression-free survival with PARP inhibitors is modest, suggesting the emergence of resistance. We previously demonstrated that c-MET contributes to intrinsic resistance to PARP inhibitors in triple-negative breast cancer. However, whether c-MET plays a role in acquired resistance to PARP inhibitors in triple-negative breast cancer remains unclear. Here, we show …

Oxidative Phosphorylation: A Critical Feature And Novel Therapeutic Target In Melanoma Brain Metastases, Grant Fischer

Dissertations and Theses (Open Access)

We recently showed via RNA-sequencing (RNA-seq) analysis of clinical samples that melanoma brain metastases (MBMs) have higher expression of oxidative phosphorylation (OXPHOS) genes (including PPARGC1A or PGC1α) than patient-matched extracranial metastases (ECMs). Thus, the central hypothesis of this dissertation is that OXPHOS plays a critical role in the pathogenesis of MBMs.

RNA-seq analysis identified increased expression of OXPHOS genes in intracranial (ICr) vs. subcutaneous (SQ) xenografts of 4 different human melanoma cell lines. Increased OXPHOS in the ICr xenografts was confirmed by direct metabolite analysis and [U-¹³C]-glucose tracing analysis. Together, these studies indicate that the brain TME …

The Influence Of The Pep-Pts And Other Metabolic Systems On The Master Virulence Regulator Atxa And To Xin Gene Expression In Bacillus Anthracis, Naomi Bier-Reizes

Dissertations and Theses (Open Access)

AtxA, the master virulence gene regulator in Bacillus anthracis, is a PRD-containing virulence regulator (PCVR) as indicated by the crystal structure, post-translational modifications, and activity of the protein. PCVRs are transcriptional regulators, named for the regulatory domains subject to phosphorylation by the phosphoenolpyruvate phosphotransferase system (PEP-PTS), termed PTS Regulatory Domains (PRD), and for their impact on virulence gene expression. Generally, the phosphorylation of a PCVR regulates protein activity and multimerization. AtxA is phosphorylated at two histidine residues - one in each of its two PRDs. Phosphorylation at position 199 allows for AtxA to positively affect expression of virulence genes, whereas …

Dhhc5 Regulates Beta-Adrenergic Signaling In The Heart Through Palmitoylation Of G Alpha Proteins, Jie Chen

Dissertations and Theses (Open Access)

S-palmitoylation is a reversible posttranslational modification that plays an important role in regulating protein localization, trafficking, and stability. Recent studies have shown that some proteins undergo extremely rapid palmitoylation/depalmitoylation cycles after cellular stimulation supporting a direct signaling role for this posttranslational modification. The work in this dissertation investigated whether β-adrenergic stimulation led to stimulus-dependent palmitoylation of downstream signaling proteins in immortalized and primary cell models. I found that β-adrenergic stimulation led to rapidly increased Gαs and Gαi palmitoylation only in primary cardiomyocytes. The kinetics of palmitoylation was temporally consistent with the downstream production of cAMP and contractile responses. I identified …

Tracking Treatment Response And Resistance To Parp Inhibition (Talazoparib) In Hereditary Pancreatic Cancer., Jennifer Goldstein

Dissertations and Theses (Open Access)

polyADP ribose polymerase (PARP) inhibitors are a class of drugs that block the PARP enzymes, involved in the repair of singe-stranded DNA breaks through the base excision repair pathway. PARP inhibition leads to replication-associated double stranded DNA breaks, which are repaired by homologous recombination (HR). In tumors with HR defects (i.e. BRCA mutants), there is a shift to error-prone DNA repair and subsequent genomic instability and cell death.

In 2014, Olaparib became the first FDA-approved PARP inhibitor for the treatment of BRCA-mutant ovarian cancer. In the phase III POLO (Pancreas cancer OLaparib Ongoing) trial presented at the American Society …

Bilirubin Nanoparticle As An Anti-Inflammatory Therapy For Graft Versus Host Disease, Sumedha Pareek

Dissertations and Theses (Open Access)

Graft versus host disease (GvHD) caused by alloreactive donor lymphocytes is a fatal complication of hematopoietic stem cell transplant (HSCT). Myeloablative conditioning regimen, consisting of chemotherapy and/or radiation, given prior to HSCT can cause tissue damage. This non-specific tissue damage triggers cross-presentation of alloantigens to the donor immune cells, causing recruitment of leukocytes and production of inflammatory cytokines. Targeting this inflammation without affecting the anti-leukemia effects of HSCT, continues to be one of the biggest challenge in finding a therapy for GvHD. Bilirubin is a tetrapyrrole pigment, found in the blood, with natural anti-oxidative and anti-inflammatory properties. Using mouse models …