Medicine and Health Sciences Commons^™

Importance Of Persistent Right-To-Left Shunt After Patent Foramen Ovale Closure In Cryptogenic Stroke Patients, Lu He, Gesheng Cheng, Yajuan Du, Yushun Zhang

The Texas Heart Institute Journal

Percutaneous closure of patent foramen ovale (PFO) is widely performed to prevent recurrent stroke or transient ischemic attack in patients with cryptogenic stroke. However, the influence of different degrees of right-to-left shunting (RLS) has rarely been reported.

We retrospectively evaluated the cases of 268 patients with cryptogenic stroke who underwent PFO closure at our hospital from April 2012 through April 2015. In accordance with RLS severity, we divided the patients into 2 groups: persistent RLS during normal breathing and the Valsalva maneuver (n=112) and RLS only during the Valsalva maneuver (n=156). Baseline characteristics, morphologic features, and procedural and follow-up data …

Atrial Pacing In Wide-Complex Rhythm, Yang Yang, John Allison, Mark Pollet, Yochai Birnbaum

The Texas Heart Institute Journal

No abstract provided.

Interventricular Septal Rupture In A 62-Year-Old Man With Familial Amyloid Polyneuropathy, Stefano Pidello, Erika Simonato, Fulvio Orzan, Simone Frea, Antonella Barreca, Mauro Rinaldi, Massimo Boffini

The Texas Heart Institute Journal

Cardiac involvement in familial amyloid polyneuropathy consists of arrhythmias, conduction disturbances, and heart failure. To our knowledge, heart rupture has never been described in association with this condition. We report the case of a 62-year-old man with a 6-year history of refractory familial amyloid polyneuropathy who underwent liver transplantation. The operation was complicated by severe hypotension because the neuropathy involved the autonomic system. Perioperatively, the patient had a myocardial infarction, and during the next 10 days, a complete interventricular septal rupture developed, resulting in a systemic-to-pulmonary shunt. Coronary angiographic findings were normal. However, the shunt caused unstable hemodynamics, resulting in …

A Core Reference Hierarchical Primitive Ontology For Electronic Medical Records Semantics Interoperability, Ziniya Zahedi

Engineering Management & Systems Engineering Theses & Dissertations

Currently, electronic medical records (EMR) cannot be exchanged among hospitals, clinics, laboratories, pharmacies, and insurance providers or made available to patients outside of local networks. Hospital, laboratory, pharmacy, and insurance provider legacy databases can share medical data within a respective network and limited data with patients. The lack of interoperability has its roots in the historical development of electronic medical records. Two issues contribute to interoperability failure. The first is that legacy medical record databases and expert systems were designed with semantics that support only internal information exchange. The second is ontological commitment to the semantics of a particular knowledge …

A Three Article Study Examining Sexual And Gender Minority Competency Of Health Service Providers, Corrine N. Wilsey

Health Services Research Dissertations

Sexual and gender minority (SGM) individuals endure a number of health disparities, such as higher rates of violence, mental health conditions, and more medical conditions. These disparities are exacerbated by the fact that SGM individuals face issues such as accessing health insurance, social support programs, and health service providers who are knowledgeable about SGM health issues. Certain health service provider governing organizations (i.e., the American Psychological Association, the Association of American Medical Colleges, and the Gay and Lesbian Medical Association) have recognized the need for guidelines regarding SGM care in recent years and published guidelines for health service providers regarding …

Investigating A Multimodal Approach To Clinical Diagnosis Of Mild Cognitive Impairment And Alzheimer’S Disease, Sean M. Flannery

Psychology Theses & Dissertations

An estimated 5.8 million Americans suffer from dementia due to Alzheimer’s disease (AD), with that number projected to grow to 13.8 million by mid-century (Alzheimer’s Association, 2019). Mild cognitive impairment (MCI) describes the stage between normal cognitive decline that comes with aging and a dementia diagnosis (Peterson, 1999). Due to a lack of a cure or particularly effective treatment, a major goal of treatment is to focus on improving quality of life (Budson & Solomon, 2016). An early and accurate diagnosis can address this goal in a variety of ways. Despite the high prevalence and immense amount of research in …

The Determinants Of Physical Activity, Self-Monitoring Of Blood Glucose, And Poor Glycemic Control Among Individuals Diagnosed With Type 2 Diabetes In Saudi Arabia: A Cross-Sectional Study Based On The Saudi Health Interview Survey (Shis), Mohammed Abdulrahman S. Alsuliman

Health Services Research Dissertations

The prevalence of diabetes and poor glycemic control in Saudi Arabia has increased that contributed to the growing number of deaths in Saudi Arabia. It is known that type 2 diabetes (T2DM) can be prevented but there is a lack information about the magnitude of the of diabetes at national level as well as the risk factors for physical activity (PA), self-monitoring of blood glucose (SMBG), and poor glycemic. Thus, through utilizing Health promotion model (HPM), the aims are to examine the personal factors, cognitive-perceptual, and behavioral determinants of three outcomes; physical activity, SMBG, and poor glycemic control. A secondary …

Predictors Of Dental Students’ Behavioral Intention Use Of Teledentistry: An Application Of The Unified Theory Of Acceptance And Use Of Technology (Utaut) Model, Jafar Hassan Alabdullah

Health Services Research Dissertations

Shortages of dental professionals and access barriers to dental care are challenges to improving oral health and decreasing the burden of dental diseases. There are more than 57 million individuals in the U.S. who live in dental health professional shortage areas (DHPSA). The U.S. DHPSA areas need 9,951 dental practitioners to overcome the obstacles to oral care access. Due to dental care needs for these populations, it is imperative to find a new method to reach these underserved populations. Teledentistry is an innovative technology that can be used to improve access to care and oral health outcomes. Unfortunately, there is …

Social Vulnerability And Hurricane Evacuation Behavior In Hampton Roads, Va: Emergency Management Stakeholders’ Perceptions Of Low-To-Moderate Income Households In A Social Construction Paradigm, Mechelle Bonit Smith

School of Public Service Theses & Dissertations

The purpose of this research is to examine current emergency management (EM) evacuation policies and practices with respect to vulnerable populations’ hurricane evacuation behaviors. The response of vulnerable households and local and state governments’ implementation of emergency evacuation policies and practices provide possible linkages to continual problems faced by local governments in addressing its most vulnerable residents. Using social construction as a theoretical foundation provides context for the consideration of vulnerable populations in emergency management policy and hurricane evacuation.

This research is a qualitative case study of emergency management policies, practices, and perceived household evacuation behaviors in several cities of …

Mindfulness And Its Impact On Adaptive Coping And Psychological Well-Being: An Intervention For Undergraduate Students, Charles Bradley Freligh

Psychology Theses & Dissertations

The concept of mindfulness has been shown to positively impact psychological well-being, and one application of mindfulness-based interventions has been the development and implementation of courses specifically for college students, a population that has been shown to be particularly vulnerable to the negative impacts of stress. While these interventions have displayed beneficial outcomes, the mechanisms of how mindfulness exerts its impact remain unclear. One potential mechanism of mindfulness’ enhancement of well-being may be through its cultivation of an adaptive coping style in which an individual becomes more likely to approach and investigate stressors rather than avoid them. In this study, …

Group Treatment Effectiveness For Substance Use Disorders: Abstinence Vs. Harm Reduction, Jill D. Parramore

Counseling & Human Services Theses & Dissertations

The purpose of this systematic review and meta-analysis was to compare group treatment effectiveness for substance use disorders within the U.S. across treatment philosophies as it relates to the primary research question, Is there a significant difference of group treatment effectiveness between Abstinence and Harm Reduction treatment philosophies? It was hypothesized that group treatment will remain an effective intervention to treat substance use disorders between treatment philosophies and that no significant differences exist between-group comparisons. The aim of this study is to provide evidence of treatment effectiveness that will ultimately improve treatment outcomes for substance use disorders, provide guidance for …

Investigating The Impact Of The Fava Well-Being Protocol On Perceived Stress And Psychological Well-Being With At-Promise High School Students, Renee L. Fensom

Counseling & Human Services Theses & Dissertations

An elevation in stress levels can be caused by many contributing factors, which can ultimately interfere with the learning of young people. Fortunately, an increase in well being can help promote resilience, creating a buffer to stress. Therefore, the current study investigated the influence of a positive psychology intervention aimed at lowering perceived stress and increasing well-being among at-promise students. The theoretical framework for this study was based on Ryff’s Model of Psychological Well-Being (PWB). The specific intervention used was the Well-being Therapy School Protocol developed by Fava and associates, based off of Carol Ryff’s Model of PWB (Fava, 2016). …

Correlates Of Access To Hand Hygiene Resources In Ghanaian Households: An Exploratory Analysis Of The 2014 Demographic And Health Survey, Paul Lawer Kenney, Herman Nuake Kofi Agboh, Florence Akosua Agyemang, Seth Sylvester Dadzie, Henry Ofori Duah, Pascal Agbadi

College of Nursing Faculty Research and Publications

Objectives

Handwashing with soap and water remains the most effective public health measure to reduce the risk of infectious diseases, which kill over 2.5 million people annually, mostly children in developing countries. The absence of hand hygiene resources in homes put many at risk of these infectious diseases. In the wake of the outbreak of the COVID-19 pandemic, the World Health Organization (WHO) and governments around the world have stressed the importance of regular handwashing to prevent the spread of the virus. This suggests that research on water, sanitation, and hygiene issues deserve continuous scholarly attention. In Ghana, studies on …

Atrial Pacing In Wide-Complex Rhythm, Yang Yang, John Allison, Mark Pollet, Yochai Birnbaum

The Texas Heart Institute Journal

No abstract provided.

Post-Registration Experience Of Nivolumab In Advanced Hepatocellular Carcinoma: An International Study, Petros Fessas, Ahmed Kaseb, Yinghong Wang, Anwaar Saeed, David Szafron, Tomi Jun, Sirish Dharmapuri, Abdul Rafeh Naqash, Mahvish Muzaffar, Musharraf Navaid, Uqba Khan, Chiehju Lee, Anushi Bulumulle, Bo Yu, Sonal Paul, Neil Nimkar, Dominik Bettinger, Francesca Benevento, Hannah Hildebrand, Tiziana Pressiani, Yehia I Abugabal, Nicola Personeni, Yi-Hsiang Huang, Lorenza Rimassa, Celina Ang, Thomas Marron, David J Pinato

Faculty, Staff and Students Publications

BACKGROUND: Nivolumab is Food and Drug Administration approved in sorafenib-experienced, advanced hepatocellular carcinoma (HCC). Post-registration data of treatment in a real-world setting is lacking.

PATIENTS AND METHODS: We performed an international, multicenter observational study to confirm safety and efficacy of nivolumab in 233 patients treated outside clinical trials from eight centers in North America, Europe and Asia.

RESULTS: Patients received nivolumab for Barcelona Clinic Liver Cancer stage C (n=191, 92.0%) and Child-Pugh (CP) A (n=158, 67.8%) or B (n=75, 32.2%) HCC as first (n=85, 36.5%) or second to fourth systemic therapy line …

Qtc Cutoff, Gender, Race And Age On Reporting Of Prolonged Qtc, Supraja Thunuguntla, Michael Machiorlatti

School of Medicine Publications

Background
The aim of the study is to evaluate the association of QTc cutoff, gender, race, and age on reporting of QTc interval prolongation.

Methods
Retrospective study of 147 patients admitted to our hospital or ER visit from January 2016 to May 2020. Simple descriptive statistics and longitudinal linear mixed model was performed on the 213 total observations from 147 patients.

Results
The average age of the patients was 65 (±17.8, 18-98) years. Females were 32% (n=47) and Hispanics 78.4% of sample. QTc prolongation was reported in 65% (n=138) of the 213 EKG’s. Calculated 90th and 99th percentile for QTC …

“Tomorrow Never Dies”: Recent Advances In Diagnosis, Treatment, And Prevention Modalities Against Coronavirus (Covid-19) Amid Controversies, Partha Laskar, Murali M. Yallapu, Subhash C. Chauhan

School of Medicine Publications

The outbreak of novel coronavirus disease (2019-nCoV or COVID-19) is responsible for severe health emergency throughout the world. The attack of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is found to be responsible for COVID-19. The World Health Organization has declared the ongoing global public health emergency as a pandemic. The whole world fights against this invincible enemy in various capacities to restore economy, lifestyle, and safe life. Enormous amount of scientific research work(s), administrative strategies, and economic measurements are in place to create a successful step against COVID-19. Furthermore, differences in opinion, facts, and implementation methods laid additional layers …

Combinatorial Pharmacogenomic Algorithm Is Predictive Of Citalopram And Escitalopram Metabolism In Patients With Major Depressive Disorder, Richard C. Shelton, Charles R. Conway, Et Al.

2020-Current year OA Pubs

Pharmacogenomic tests used to guide clinical treatment for major depressive disorder (MDD) must be thoroughly validated. One important assessment of validity is the ability to predict medication blood levels, which reflect altered metabolism. Historically, the metabolic impact of individual genes has been evaluated; however, we now know that multiple genes are often involved in medication metabolism. Here, we evaluated the ability of individual pharmacokinetic genes (CYP2C19, CYP2D6, CYP3A4) and a combinatorial pharmacogenomic test (GeneSight Psychotropic®; weighted assessment of all three genes) to predict citalopram/escitalopram blood levels in patients with MDD. Patients from the Genomics Used to Improve DEpression Decisions (GUIDED) …

De Novo Variants Of Nr4a2 Are Associated With Neurodevelopmental Disorder And Epilepsy, Sakshi Singh, Rachel Slaugh, Jorge Granadillo, Et Al.

2020-Current year OA Pubs

PURPOSE: This study characterizes the clinical and genetic features of nine unrelated patients with de novo variants in the NR4A2 gene.

METHODS: Variants were identified and de novo origins were confirmed through trio exome sequencing in all but one patient. Targeted RNA sequencing was performed for one variant to confirm its splicing effect. Independent discoveries were shared through GeneMatcher.

RESULTS: Missense and loss-of-function variants in NR4A2 were identified in patients from eight unrelated families. One patient carried a larger deletion including adjacent genes. The cases presented with developmental delay, hypotonia (six cases), and epilepsy (six cases). De novo status was …

Tumor Organoids To Study Gastroesophageal Cancer: A Primer, Ramon U Jin, Jason C Mills

2020-Current year OA Pubs

Gastroesophageal cancers are leading causes of cancer death. Our attempts at adopting molecularly based treatment approaches have been slow and ineffective even though we begin to identify specific targetable gene mutations and pathways. It is clear that we should no longer treat all gastroesophageal cancers as a homogeneous disease, which is what we do when we use non-specific chemotherapy. However, we currently cannot monitor successful gene/pathway targeting, nor understand how/when tumors develop resistance, nor predict which patients will derive maximal benefit. To improve outcomes, we must precisely detail the heterogeneity of these tumors to then individualize cancer therapy as well …

The Efficacy Of Lenvatinib Plus Everolimus In Patients With Metastatic Renal Cell Carcinoma Exhibiting Primary Resistance To Front-Line Targeted Therapy Or Immunotherapy, Lana Hamieh, Rachel L Beck, Valerie H Le, James J Hsieh

2020-Current year OA Pubs

BACKGROUND: Patients with primary refractory metastatic renal cell carcinoma (mRCC) have a dismal prognosis and poor response to subsequent treatments. While there are several approved second-line therapies, it remains critical to choose the most effective treatment regimen.

PATIENTS AND METHODS: We identified 7 patients with clear cell mRCC who had primary resistance to vascular endothelial growth factor (VEGF)-targeted tyrosine kinase inhibitors (TKIs) or immune checkpoint inhibitor (ICI) combination therapy. The patients were treated with lenvatinib (a multitargeted TKI) plus everolimus (a mammalian target of rapamycin inhibitor). Among these 7 patients, 2 had prior TKI therapy, 3 had prior ICI therapy, …

Boarding Of Critically Ill Patients In The Emergency Department, Nicholas M Mohr, Brian T Wessman, Benjamin Bassin, Marie-Carmelle Elie-Turenne, Timothy Ellender, Lillian L Emlet, Zachary Ginsberg, Kyle Gunnerson, Kevin M Jones, Bridgette Kram, Evie Marcolini, Susanna Rudy

2020-Current year OA Pubs

OBJECTIVES: Emergency department boarding is the practice of caring for admitted patients in the emergency department after hospital admission, and boarding has been a growing problem in the United States. Boarding of the critically ill has achieved specific attention because of its association with poor clinical outcomes. Accordingly, the Society of Critical Care Medicine and the American College of Emergency Physicians convened a Task Force to understand the implications of emergency department boarding of the critically ill. The objective of this article is to review the U.S. literature on (1) the frequency of emergency department boarding among the critically ill, …

New World Mammarenaviral Hemorrhagic Fever Virus Determinants Of Infection And Disease, Brady T. Hickerson

All Graduate Theses and Dissertations, Spring 1920 to Summer 2023

Several New World mammarenaviruses (NWM) are able to cause life-threatening hemorrhagic disease in humans. These agents use human transferrin receptor 1 (hTfR1), the main protein involved in cellular uptake of iron, to infect cells. Furthermore, use of hTfR1 correlates with the ability of these viruses to cause severe disease in humans. The most prevalent pathogenic NWM is Jun√≠n virus (JUNV), which is the etiological agent of Argentine hemorrhagic fever (AHF).The pathogenesis of AHF is poorly understood. A cardinal feature of severe cases of AHF is a prolonged increase of serum interferon-a (IFN-a) concentration. This increase is hypothesized to play a …

Evaluation Of Enrichment And Identification Media For Isolation Of Common Bovine Salmonella Serotypes, Katie Irene Swanson

All Graduate Theses and Dissertations, Spring 1920 to Summer 2023

Salmonellosis is an important cause of diarrhea in humans and animals, which can lead to death in severe cases. Rapid and efficient detection of Salmonella spp. is essential to limit the spread of disease. Many enrichment procedures have been described for the isolation of Salmonella, and often include variations on Rappaport-Vassiliadis medium, which is recommended by the Food and Drug Administration (FDA). The current procedures vary in incubation temperature, incubation time, and type of media used for identification of Salmonella. This project compared four procedures for enrichment and identification of common bovine Salmonella serotypes. We determined the best …

A Compilation Of Research Experiences, Samantha C. Gotcher

All Graduate Theses and Dissertations, Spring 1920 to Summer 2023

Multiple projects comprised this thesis requirement. The projects ranged in breadth and depth and included 1) literature reviews across a variety of deaf education topics, including spreadsheets summarizing each literature review, 2) development of over 100 article summaries for the Hear to Learn website, 3) authorship on a manuscript submitted to a peer-reviewed journal, and 4) a peer-reviewed poster presentation at a national conference. My experiences in engaging in these activities immersed me into a greater understanding of the research in the field, resources for services, position papers of various entities, and recommended practices in Listening and Spoken Language (LSL) …

Are Effort And Helpfulness Ratings Of Session Activities Associated With Improved Outcomes In Web-Based Acceptance And Commitment Therapy (Act) For Caregivers?, Hannah R. Cragun

All Graduate Theses and Dissertations, Spring 1920 to Summer 2023

Family caregivers for people with dementia are providing care for up to ten years because people with dementia are living longer. This role can be demanding because the person with dementia can have behavioral and psychological symptoms that can be stressful for the caregiver to witness and manage. Acceptance and Commitment Therapy (ACT) in its traditional face-to-face format has strong scientific support in helping caregivers to be less depressed and better cope with the stress associated with taking care of their loved one. However, because caregiving is a time-demanding role, caregivers can struggle with accessing face-to-face therapy, making online ACT …

The Multigenerational Transmission Process Of Healing Social Cultural Wounds Within The Black Community: A Comprehensive Analysis, Adeola Quintero

Counseling and Family Therapy Scholarship Review

This article examines the multigenerational transmission process of healing social cultural wounds within the black community. A comprehensive research analysis of slavery, racial trauma and racism along with the events surrounding their existence in our contemporary society are explored. Revealed throughout this framework are the theories literature has posited as solutions to racial wounds such as the ‘black self-concept’, ‘Post Traumatic Slave Syndrome,’ ‘Bowen’s Multigenerational Transmission Process,’ ‘racialized disease narrative’ and the introduction of the “social cultural wounds’ concept. 15 recommendations are suggested for addressing the racial healing work within individual, institutional, and systemic healing. Current theory, models, scales assessment …

Blood Pressure Awareness Among University Of Northern Iowa Students, Abigail Weekley, Theresa Spradling, Robert Good

Summer Undergraduate Research Program (SURP) Symposium

No abstract provided.

Gateways For Transformation, Amitice L. Saremi

Counseling and Family Therapy Scholarship Review

Big life transitions, typically resulting from loss, can cause physical, emotional, and behavioral problems. Using a heuristic methodology, this article answers the question: Given polyvagal theory, how can yoga and depth psychology combine to support clients to make transitions more easily? Polyvagal theory hypothesizes that the vagus nerve, the longest cranial nerve, impacts impact many parts of the body related to physical and mental health. Breathing helps the vagus nerve function properly along with self-regulation, homeostasis, and the social engagement system. Yoga and depth psychology recognize the continuous cycles of life that exist in nature, the constancy of change, the …

Changing The Narrative For Lgbtq Adolescents: A Literature Review And Call For Research Into Narrative Therapy To Improve Family Acceptance Of Lgbtq Teens, Felicia Jordan

Counseling and Family Therapy Scholarship Review

A large body of existing research has demonstrated the importance of family acceptance as a protective factor for LGBTQ youth facing increased risks of low self-esteem, depression, suicidal ideation, and other mental-health problems. However, little research has been done on therapeutic interventions for families specifically to address stigma and discrimination against LGBTQ adolescents. In particular, narrative therapy, with its focus on deconstructing and re-storying oppressive cultural narratives, seems a natural fit, but little to no quantitative research has been done on family-based narrative therapy for LGBTQ adolescents, and only a handful of qualitative studies have been published. Therefore, the paper …