Medicine and Health Sciences Commons^™

A Semiparametric Modeling Approach For Analyzing Clinical Biomarkers Restricted To Limits Of Detection, Sandipan Dutta, Susan Halabi

Mathematics & Statistics Faculty Publications

Before biomarkers can be used in clinical trials or patients' management, the laboratory assays that measure their levels have to go through development and analytical validation. One of the most critical performance metrics for validation of any assay is related to the minimum amount of values that can be detected and any value below this limit is referred to as below the limit of detection (LOD). Most of the existing approaches that model such biomarkers, restricted by LOD, are parametric in nature. These parametric models, however, heavily depend on the distributional assumptions, and can result in loss of precision under …

First Impressions Of The Bedside Nurse From The Patient Perspective, Sharon Imes

Electronic Theses and Dissertations, 2020-2023

Relationships begin with first impressions. Since nurses are the cornerstone to hospital experiences, the nurse-patient relationship is of vital importance, beginning with the first impression. The nurse-patient relationship has the potential to impact the patient's trust, comfort, fear, and ultimately satisfaction with the entire hospital experience. Evidence is found in other disciplines emphasizing the importance of the first impression, however there is minimal research in nursing about first impressions of the bedside nurse. The purpose of this dissertation is to explore the first step in understanding the first impression of the bedside nurse from the patient perspective. Additionally, this research …

Survivors Of Human Trafficking: Reintegration Into The Community And Society, Charrita Ernewein

Electronic Theses and Dissertations, 2020-2023

Human trafficking is a highly profitable human rights violation and is labeled as one of the fastest growing industries worldwide. Few studies provided a detailed analysis of the survivors' accounts of their experiences and how these experiences influenced their reintegration into society. The purpose of this study was to explore and describe the experience of female survivors of sex trafficking as they reintegrated into the community and society using the survivors' voice. This study also aimed to describe the survivors experience with healthcare providers. This study obtained data from hard to detect populations (female survivors aged 18 and older) through …

Remembering To Resume: Using Simulation-Based Education To Teach Nursing Students To Manage Interruptions, Peggy Hill

Electronic Theses and Dissertations, 2020-2023

Introduction: Since nurses are expected to be constantly available and responsive, their workflow is interrupted about 85 times each shift. As nursing students socialize to the profession, they need to learn how to adapt to an interruption fraught practice environment. Background: While some interruptions are important to patient care, dealing with conflicting demands can lead to mental fatigue, increased task time, and enhanced propensity for errors. Some experienced nurses learn to create strategies that facilitate remembering to resume an interrupted task, but they are often adopted through trial and error. When simulation-based education (SBE) is used according to industry standards, …

Foresight Leadership Theory: A Grounded Theory Study Of The Conflict Management Experiences Of Healthcare Managers With Remote Employees, Desiree Nichole Van Campen

Department of Conflict Resolution Studies Theses and Dissertations

Healthcare managers of remote employees are faced with unique challenges as they relate toconflict prevention and management. The Covid-19 pandemic further complicated this issue when, because of social distancing mandates and employee health concerns, a large volume of healthcare managers and their employees were forced to transition to a remote working environment. Managers had to then develop personal strategies to successfully lead their now- remote workforce. This qualitative Grounded Theory study revealed that intentional communication, engagement, and planning are ways in which managers have been able to minimize the effects that conflict has on their employees. From the research, the …

Qualitative Comparative Case Study Exploring The Interpersonal And Intrapersonal Conflicts Experienced By Nurses While Utilizing Ehr-Electronic Health Record Technology, Patricia Alejandra Casas

Department of Conflict Resolution Studies Theses and Dissertations

Nurses are the largest group of health information technology system users. As the nurses are the focal point of patient care because they interact with multiple areas under the healthcare realm and manage multiple components of patient care, the use of EHR technology is likely to have an impact on their careers and healthcare delivery outcomes. Conflicts experienced during EHR use or adoption have been researched; however, despite these studies, understanding nurses’ experiences of conflicts remain underexplored; in particular, there have been no research studies that have differentiated between interpersonal and intrapersonal conflicts experienced. The general problem addressed in this …

Device-Related Adverse Events From Watchman Flx Implants As Reported By The Food And Drug Administration, Dongjin Suh Bs, Paul Eugene Kim Bs, Emmanuel Magsino Bs, Tae Shik Park

Graduate Research Posters

No abstract provided.

Influence Of Telephone Preoperative Evaluations On Patient Medication Compliance On Day Of Surgery, Emmanuel Magsino, Michael Jung, Olga Suarez Md

Graduate Research Posters

Patient compliance with medication instructions on day of surgery (DOS) is an important part of the preoperative assessment, as failure to comply with these may lead to serious perioperative consequences. Prior studies have shown that compliance increases with multimodal interventions. However due to the recent COVID-19 pandemic, many in-person visits transitioned to telephone visits and providers had to rely on patients to follow solely verbal instructions.

To determine medication compliance, this study compared the medication instructions provided by the VCU Preoperative Assessment Communication and Education Clinic, per chart review, with each patient’s own report of which medications they took on …

Development Of An Online Warfarin Dosing Platform Using R Programming Language To Facilitate Healthcare Professional Duties And Limit Medication Related Errors., Monther Alsultan

Graduate Research Posters

Development of an online warfarin dosing platform using R programming language to facilitate healthcare professional duties and limit medication related errors.

Monther Alsultan, Joshua M. Morriss, Daniel Contaifer Jr, Suad Alshammari; Silas Contaifer, Rachel W Flurie, Dayanjan S. Wijesinghe^#

Department of Pharmacotherapy and Outcome Sciences

Objective: 1) Gain experience in developing platform agnostic, fully operational and clinically relevant web applications for effective pharmacist led patient care. 2) Create a decision- support tool using open source software to facilitate evidence-based management therapy of warfarin in clinical settings where it is available for everyone to use at anytime and anywhere.

Introduction: …

Selective Gsk3b Deletion In Camk2a+ Forebrain Neurons Or Inhibition Via Tideglusib, Decreases Ethanol Consumption In C57bl/6j Mice, Sam Gottlieb, Andrew D. Van Der Vaart, Brennen O'Rourke, Michael F. Miles

Graduate Research Posters

Purpose: We previously identified glycogen synthase kinase-3 beta (Gsk3b) as a central member of a gene network highly regulated by acute ethanol in medial prefrontal cortex (mPFC) and associated with risk for alcohol dependence in humans. Further, we have demonstrated modulation of Gsk3b alters ethanol consumption in rodent models. GSK3B could thus represent a potential new therapeutic target for the treatment of alcohol use disorder (AUD). Here, we investigate the mechanisms of Gsk3b action in ethanol consumption and report preclinical evidence for the selective GSK3B inhibitor, tideglusib, as a therapeutic agent for AUD.

Methods: (1) Selective Cre-induced Gsk3b …

Validity Of The Actigraph Gt9x Accelerometer Step-Count Function In Adults With Heart Failure With Preserved Ejection Fraction, Jonathan D. Kenyon, Hayley Billingsley, Natalie J. Bohmke, Danielle Kirkman, Salvatore Carbone, Youngdeok Kim

Graduate Research Posters

Low physical activity is associated with heart failure with preserved ejection fraction (HFpEF). Step-counts, a measure of physical activity, can be measured via accelerometry. To date, few studies have examined validity of accelerometer-derived step-counts in the adults with HFpEF.

PURPOSE To assess criterion validity of the Actigraph GT9X accelerometer step-count function in adults with HFpEF via ankle, waist, and wrist placement, compared with manually counted, directly observed steps.

METHODS Six adults with HFpEF (age: 57.2 ± 9.4 y; African American: 50%; females: 100%) completed a cardiopulmonary exercise test (CPET) on a treadmill while wearing synchronized GT9X accelerometers on the ankle, …

Radiation Induces Metabolic Dysregulation In Pulmonary Fibroblasts, Josly Pierre-Louis, Margaret A. T. Freeberg, Jane K. Rebman, Thomas H. Thatcher, Patricia J. Sime

Graduate Research Posters

Rationale: Exposure of the lung to ionizing radiation, such as during radiotherapy, can result in pulmonary fibrosis (PF), which has few treatment options. PF is characterized by an accumulation of extracellular matrix proteins that form scar tissue, resulting in dyspnea, disruption of gas exchange, and even death. We and others have shown that metabolic reprogramming is a hallmark of idiopathic pulmonary fibrosis (IPF). IPF lung tissue, and lung fibroblasts treated with TGF-β, exhibit increased aerobic glycolysis with increased expression of lactate dehydrogenase A (LDHA) and excess production of lactate, leading to reduced extracellular pH that activates latent TGF-β. Here, we …

Frequency Of Genetic Polymorphisms Of Cyp2c19 In Native Hawaiian, And Asian And Pacific Islander Subgroups: Implications For Personalized Medicine, Khalifa Y. Alrajeh, Youssef Roman Dr

Graduate Research Posters

Pharmacogenetic testing, where prescriptions are tailored to the individual patient based on his/her genetic makeup, increases the ability to predict individual drug response. However, little is known about the prevalence of clinically actionable pharmacogenes in diverse populations. This study seeks to assess the prevalence of select drug-gene alleles that are implicated in the metabolism of commonly prescribed drugs, so-called Very Important Pharmacogenes (VIPs). The results of this study will fill in the gaps of knowledge of VIPs in underrepresented populations and characterize their potential risk for drug adverse events or due to their underlying genetic polymorphisms, especially in patients of …

Transcriptional Repressor Protein Based Macrolide Biosensor Development With Improved Sensitivity, Jayani A. Christopher

Graduate Research Posters

Macrolide antibiotics are in high demand for clinical applications. Macrolides are biosynthesized via giant assembly line polyketide synthases (PKS) which are arranged in a modular fashion. Combinatorial biosynthetic methods have been used to produce diversified macrolides by reprograming these modules and modifying tailoring enzymes required for post synthetic modifications. However it is challenging due to the size and complexity of PKSs. To overcome this challenge, new enzymes for macrolide diversification could be obtained by directed evolution where a large number of enzyme variants need to be screened. Therefore it is important to develop high throughput screening methods to identify the …

Carotid Artery Dissections From Tcar As Reported By The Food And Drug Administration, Dongjin Suh Bs, Yuchi Ma Bs, Daniel H. Newton Md, Michael F. Amendola Md, Kedar S. Lavingia Md

Graduate Research Posters

BACKGROUND: Transcarotid artery revascularization (TCAR) is hybrid procedure that allows carotid stenting using direct surgical access of the carotid artery to restore blood flow through the carotid artery. It has shown the lowest perioperative stroke rate when compared with any prospective trial of transfemoral carotid artery stenting. However, intraoperative injuries related to the procedure and its management are not well characterized. We anticipate that this analysis will add qualitative insight in further characterizing adverse outcomes of this novel technology.

METHODS: The FDA maintains a database called the MAUDE (Manufacturer and User Facility Device Experience) for surveillance of all medical devices …

Cost-Effectiveness Of Alternative Hiv Testing Strategies Among Hard-To-Reach Populations In East And Southern Africa., Deo Mujwara, Deo Mujwara

Graduate Research Posters

No abstract provided.

Covid-10, Healthcare Interior Design + Provider Experience - How Does Your Space Work For You?, Ruth E.P. Deibler

Graduate Research Posters

The lack of research on healthcare staff experience and interior design of the spaces they work in is evident. A focus on staff perspective is needed, particularly staff who navigated the COVID-19 pandemic. This research seeks to capture those stories to develop further research in order to improve staff experience. The initial phase of this mixed-methods approach is a survey. Hypothetically, by placing providers at the center of qualitative research related to healthcare interior design, we can better understand existing healthcare spaces. Ideally, we can develop additional evidence-based, human-centered solutions to transform interior environments in healthcare.

The 20-year Women’s Health …

Modeling Longitudinal Change In Cervical Length Across Pregnancy, Hope M. Wolf, Shawn J. Latendresse, Jerome F. Strauss Iii, Timothy P. York

Graduate Research Posters

Introduction: A short cervix (cervical length < 25 mm) in the mid-trimester (18 to 24 weeks) of pregnancy is a powerful predictor of spontaneous preterm delivery (gestational age at delivery < 37 weeks). Although the biological mechanisms of cervical remodeling have been the subject of extensive investigation, very little is known about the rate of change in cervical length over the course of a pregnancy, or the extent to which rapid cervical shortening increases maternal risk for spontaneous preterm delivery.

Methods: A cohort of 5,160 unique women carrying 5,971 singleton pregnancies provided two or more measurements of cervical length during pregnancy. Cervical length was measured in millimeters using a transvaginal 12-3 MHz ultrasound endocavity probe (SuperSonic Imagine). Maternal characteristics, including relevant medical history and birth outcome data, were collected for each participant. Gestational age at delivery was measured from the first day of each woman’s last menstrual period and confirmed by ultrasound. Repeated measurements of cervical length during pregnancy were modeled as a longitudinal, multilevel growth curve in MPlus. A three-level variance structure was …

Evaluating Racial And Ethnic Disparities In Access To Primary Care Among Gay And Bisexual Men In The Us, A Population At High-Risk Of Hiv Infection, Jessica S. Kiernan, April D. Kimmel

Graduate Research Posters

BACKGROUND: 69% of new HIV diagnoses in the US are among gay and bisexual men, with disparities by race and ethnicity. Primary care providers increasingly provide HIV prevention. Racial and ethnic disparities in primary care access are well-documented, but their persistence among gay and bisexual men is unknown. We examined racial and ethnic disparities in access to primary care among this population.

METHODS: We used nationally representative person-level sociodemographic, health status and utilization data, and data on organizational- and socially determinant barriers to care, from the National Health Interview Survey, 2013-2018. Outcomes were: 1) general physician visit

RESULTS: The sample …

The Association Of Menthol Cigarette Use With Any Mental Illness (Ami) And Serious Mental Illness (Smi) Among Us Smoekrs, Augustus White

Graduate Research Posters

ABSTRACT

Background: Mental illness affects 1-in-5 adults in the United States (US). Previously, those with mental illness have been shown to be 70% more likely to smoke cigarettes than the general population. However, little is known regarding whether the use of menthol cigarettes (one of only two available “characterizing flavors” of cigarettes) might impact the association between tobacco use and mental illness. Such information is critical in light of the disproportionately high rate of use of menthol cigarettes observed among African American smokers, as well as to inform recent legislative proposals that seek to ban the sale of menthol cigarettes. …

Ethnic Comparisons In Perceptions Of Health, Happiness, Hope, And Related Social Determinants Of Health In A Majority-Minority Midwestern Town, Virginia Chaidez, Yumou Qiu, Angela L. Palmer-Wackerly, Julie A. Tippens, Gilbert R. Parra, Patrick Habecker, Kimberly Gocchi Carrasco, Jordan Soliz, Lisa M. Pytlikzillig, Kirk Dombrowski

The Journal of Sociology & Social Welfare

In a rural Midwestern community sample (n=273), large proportions of Somalis and Whites ranked overall health as "Very good" (57% and 50%, respectively), while Hispanics (42%) considered it "Good". Across all groups, most are either "Happy" or "Very happy" with their jobs—64%, 91%, 83%—or their families—85%, 93%, 91.6%— with reference to Hispanics, Somalis, and Whites, respectively. When asked “In the past 30 days, how often did you feel hopeless?”, 83% of Somalis and two-thirds (67%) of Whites responded, "None of the time", while half (50%) of Hispanics indicated the same. Overall, Hispanics appeared to be less …

Pharmacogenomics And Ssris Appropriateness In Older Community Dwelling African Americans, Wint War Phyo, Lana Sargent, Elvin T. Price

Graduate Research Posters

Background: Depressive and anxiety disorders are among the most common illnesses experienced by older adults (age > 60). The selective serotonin reuptake inhibitors (SSRIs) are preferred class of antidepressants for these disorders due to their high efficacy and safety profiles among older adults. However, SSRIs are metabolized by highly polymorphic cytochrome P450 enzymes, specifically CYP2D6 and CYP2C19. This can lead to variable dose-response outcomes, especially among older African American population.

Objective: Analyze the frequency of CYP2D6 and CYP2C19 polymorphisms in African American older adults who are taking SSRIs and identify potential inappropriate use of SSRIs in these older adults using the …

Peptidomimetic And Non- Peptidomimetic Derivatives As Possible Sars-Cov-2 Main Protease (Mpro) Inhibitors, Mohammed A. Al Awadh, Mohini S. Ghatge Ph.D, Mona A. Al Khairi, Faik N. Musayev, Akua K. Donkor, Mohammed H. Al Mughram, Abdelsattar M. Omar Ph.D, Moustafa M. El-Araby Ph.D, Martin K. Safo Ph.D

Graduate Research Posters

To design novel inhibitors of the SARS-CoV-2 main protease (Mpro), we investigated the binding mode of the recently reported α-ketoamide inhibitors of this enzyme. Following, we utilized in-silico screening to identify 168 peptidomimetic and non-peptidomimetic compounds that are high probability Mpro binding candidates. The compounds were synthesized in 5 to 10 mg for initial screening for their potential inhibition of Mpro using Fluorescence Resonance Energy Transfer (FRET) assay. The study was conducted using the main protease, MBP-tagged (SARS-CoV-2) Assay Kit (BPS Bioscience, #79955-2), and the fluorescence due to enzymatic cleavage of substrate measured using BMG LABTECH CLARIOstar™, a fluorescent microplate …

Epigenetic States Regulate Tumor Aggressiveness And Response To Targeted Therapies In Lung Adenocarcinoma, Fan Chen

Theses and Dissertations--Toxicology and Cancer Biology

Non-small cell lung cancer (NSCLC) is the leading cause of cancer-related death worldwide, 85% of which are lung adenocarcinomas (LUAD). Although molecular studies of NSCLC identified targetable mutations of some oncogenes including BRAF, EGFR and ALK, no targeted therapies exist for most cases. Cancer epigenetics is the study of epigenetic modifications, including histone modifications, that control gene expression in cancer. Recent advances have revealed numerous epigenetic abnormalities in human cancers, and targeting epigenetic regulators could be effective at reversing dysregulated epigenetic programs or driving sensitivity to other targeted therapies.

Inhibitors of the histone methyltransferase EZH2 have recently been approved as …

Science-Based Regulation Of Pharmacological Substances In Competition Horses, Jacob Machin

Theses and Dissertations--Toxicology and Cancer Biology

Current testing methodologies within equine forensic toxicology focus on arbitrary thresholds and zero-tolerance policy. Modern analytical chemistry’s limits of detection are low enough that oftentimes femtogram-per-milliliter amounts of a substance can readily be identified in both blood and urine of a horse. For most pharmacologically relevant compounds, these concentrations have no relevance to pharmacological effect. It is therefore crucial that testing methodologies to determine appropriate thresholds and cut-offs be developed that are driven by biological activity rather than arbitrary limits of detection. This dissertation looks to address this by suggesting a system of calculated Effective Plasma Concentrations by which a …

Development Of An Online Warfarin Dosing Platform Using R Programming Language To Facilitate Healthcare Professional Duties And Limit Medication Related Errors., Monther Alsultan

Graduate Research Posters

Development of an online warfarin dosing platform using R programming language to facilitate healthcare professional duties and limit medication related errors.

Monther Alsultan, Joshua M. Morriss, Daniel Contaifer Jr, Suad Alshammari; Silas Contaifer, Rachel W Flurie, Dayanjan S. Wijesinghe

Department of Pharmacotherapy and Outcome Sciences

Objective: 1) Gain experience in developing platform agnostic, fully operational and clinically relevant web applications for effective pharmacist led patient care. 2) Create a decision- support tool using open source software to facilitate evidence-based management therapy of warfarin in clinical settings where it is available for everyone to use at anytime and anywhere.

Introduction: Healthcare …

Alpelisib-Induced Diabetic Ketoacidosis, Maria G. Negron Marte, Angeliki M. Stamatouli

Graduate Research Posters

INTRODUCTION

Alpelisib is a phosphoinositide 3-kinase kinase (PI3K) inhibitor indicated for the treatment of postmenopausal women and men with hormone receptor (HR)- positive, human epidermal growth factor receptor 2 (HER2)-negative, PIK3CA-mutated, advanced, or metastatic breast cancer. In combination with Fulvestrant, it has shown to significantly improved progression-free survival since its approval in May 2019. Frequent, yet reversible, side effects including hyperglycemia, cutaneous reactions, diarrhea, and pneumonitis have been described.

METHODS

Literature on the topic is reviewed.

CASE PRESENTATION

64-year-old female with past medical history of Sjögren syndrome and metastatic breast cancer that presented with progressively worsening fatigue. Admission laboratory results …

The Effect Of The Interaction Of Exercise Training And Isolation On The Serotonergic System Of App/Ps1 Mice, Bailey J. Dansby

Graduate Theses/Dissertations

Alzheimer’s disease (AD) is a complex neurodegenerative disease that is characterized by the deposition of amyloid beta (Ab) peptides and, consecutively, by a loss of memory and cognitive functions. The amyloid cascade hypothesis suggests that Ab deposition is the main pathogenic of AD. There is evidence that both changes in production and clearance of Ab may be involved in AD pathology. Past studies have shown that exercise training leads to an upregulation in proteins directly involved with Ab clearance. Chronic stress is thought to exacerbate AD pathology by increasing production of Ab. Studies have also demonstrated a link between serotonin …

Divine Narcissism: Raising A Secure Middle-Aged Adult, Rachel Sachs Riverwood

Antioch University Dissertations & Theses

Utilizing an arts-based feminist autoethnographic stance and method, this dissertation is an evocative exploration of the process and experience of attempting to develop a cohesive identity and build a secure attachment to the self. The author uses countercultural methods—prioritizing and centralizing her experience and uncovering and acting in defiance of oppressive norms—to identify and experience their impact on her identity and intra- and inter- personal relationships. Various tensions are explored, including the suppression of self and desire, self-objectification, fearful-avoidant attachment, and shame; and their influence on engaging in emotional and sexual intimacy is examined. Critique on the role of female …

Toward An Interactive, Patient-Specific, Vr-Based Obstetrics Simulator, Michel A. Audette, Marco Parente, Dulce Oliveira, Sreekanth Arikatla, Alfred Abuhamad, Rumit Singh Kakar, Mark Scerbo, Lucia Tabacu, John Conery, Christopher Macgowan, Renato Natal Jorge

Electrical & Computer Engineering Faculty Publications

This paper presents a nascent collaborative effort to achieve a Virtual Reality (VR)-based, real-time, haptics-driven patient-specific obstetrics simulator. The high-level architecture and preliminary results are presented here; the latter are based on offline birthing simulation developed by team in conjunction with open-source visualization tools. The cornerstones of this simulator will be high-fidelity generic offline birthing simulation, an anatomy-to-image nonrigid registration pipeline exploiting fetal MRI, the open-source interactive medical simulation toolkit IMSTK augmented by high-throughput deep learning-based soft tissue deformation, open-source musculoskeletal dynamics simulation platform SimTk for representing fetal motion. The initial emphasis will be on shoulder dystocia. The two main …