Medicine and Health Sciences Commons^™

Leadership Role In Improving Patient Care At Mount Carmel East, Mrudula Maddipatla

Masters Theses/Capstone Projects

My journey to pursue career in healthcare leadership helped me realize how crucial it is to understand the role of a leader in delivering a better care for the patients. To gain that experience, I reached out to the president of Mount Carmel East (MCE) hospital for a practicum opportunity under her staff. I worked with the executive team and other senior leadership team at MCE during my practicum. I participated in Senior Leadership Team strategic meetings, Gemba walks and various colleague engagement activities.

During my time at MCE, I had many valuable learning opportunities from understanding policies and procedures, …

Effects Of Trans-Acting Factors On The Translational Machinery In Yeast, Brandon M. Trainor

Graduate School of Biomedical Sciences Theses and Dissertations

Synthesis of proteins, or translation, is a complex biological process requiring the coordinated effort of numerous protein and RNA factors. Central to translation is the ribosome, a complex macromolecular complex consisting of both ribosomal RNA (rRNA) and ribosomal protein (r-protein). Ribosomes are essential and are one of the oldest and most abundant biomolecules across all forms of life. In addition to the ribosome, translation requires messenger RNA (mRNA), transfer-RNA conjugated to an amino acid (aa-tRNA), translation factors, and energy in the form of ATP and GTP. Translation universally occurs in four major stages, initiation, elongation, termination, and recycling, with initiation …

Biopsychosocial Factors During The Perinatal Period: Risks, Preventative Factors, And Implications For Healthcare Professionals, Ashley J. Blount, Charmayne R. Adams, Ann L. Anderson-Berry, Corrine Hanson, Kara M. Schneider, Gurudutt Pendyala

Office of Health Promotion Scholarship

Women face risks to their wellbeing during the perinatal period of pregnancy. However, there is a dearth of information on perinatal risk factors within the biopsychosocial paradigm. Emphasis is often placed on biological components associated with pregnancy and women’s health. However, psychological and social determinants of health are integral during the perinatal period, and mental wellness is often a determinant for positive maternal and neonatal health outcomes. This article reviews risk factors of perinatal wellness (e.g., physical and nutritional concerns, trauma, discrimination, adverse childhood events) and highlights protective factors for women in their perinatal period. Healthcare professionals can support perinatal …

Design, Synthesis, And Evaluation Of A Novel Cytotoxic Peptide-Doxorubicin Conjugate Targeting Triple-Negative Breast Cancer, Elmira Ziaei

Pharmaceutical Sciences (PhD) Dissertations

The aim of this thesis was to design, synthesize, and characterize a novel peptide-doxorubicin conjugate, evaluate in vitro stability and cytotoxicity properties of the conjugate and study its mechanism for uptake into the triple-negative breast cancer (TNBC) cells. For the synthesis of the conjugate, first, doxorubicin (Dox) was conjugated to a highly efficient established cross-linker, MCC, to give an intermediate product, MCC-Dox. MCC-Dox was characterized using NMR spectroscopy, mass spectrometry, and RP-HPLC and purified for subsequent reaction. Second, the 11-mer peptide 18-4 (NH₂-CWxEAAYQrFL-CONH₂) with high proteolytic stability and specificity for breast cancer cells was reacted with …

Ua12/2/1 Fresh Start, Vol. 97, No. 1, Wku Student Affairs

WKU Administration Documents

College Heights Herald magazine regarding returning to WKU in person after COVID-19 lockdown.

• Stone, Damon. Fresh Faces, Familiar Traditions Come to Campus with Incoming Class – Class of 2025
• Jones, Jake. WKU Commons Sees Delays, Expected to be Completed In the Fall – University Libraries
• Murray, Debra. Living Learning Communities Bring a New Sense of Home to WKU
• Murray, Debra. What You Missed on the Hill This Summer – Garrett Conference Center, First Year Village, Munday Hall, COVID-19, Retirement
• Fisher, Brittany. Reclaiming the Hill – MASTER Plan
• Burris, Lily. Dear Readers
• Stryker, Shane. The Usual Take on My Unusual College …

Primary Care Informatics Response To Covid-19 Pandemic: Adaptation, Progress, And Lessons From Four Countries With High Ict Development, Siaw Teng Liaw, Craig Kuziemsky, Richard Schreiber, Jitendra Jonnagaddala, Harshana Liyanage, Aliasgar Chittalia, Ravninder Bahniwal, Jennifer W. He, Bridget L. Ryan, Daniel J. Lizotte, Jacqueline K. Kueper, Amanda L. Terry, Simon De Lusignan

Family Medicine Publications

OBJECTIVE: Internationally, primary care practice had to transform in response to the COVID pandemic. Informatics issues included access, privacy, and security, as well as patient concerns of equity, safety, quality, and trust. This paper describes progress and lessons learned. METHODS: IMIA Primary Care Informatics Working Group members from Australia, Canada, United Kingdom and United States developed a standardised template for collection of information. The template guided a rapid literature review. We also included experiential learning from primary care and public health perspectives. RESULTS: All countries responded rapidly. Common themes included rapid reductions then transformation to virtual visits, pausing of non-COVID …

Neighborhood Contexts And Oral Health Outcomes In A Pediatric Population: An Exploratory Study, Vladyslav A. Podskalniy, Sharat Chandra Pani, Jinhyung Lee, Liliani Aires Candido Vieira, Hiran Perinpanayagam

Dentistry Publications

Aims: This study aimed to explore the impacts of neighborhood-level socioeconomic contexts on the therapeutic and preventative dental quality outcome of children under 16 years. Materials and Methods: Anonymized billing data of 842 patients reporting to a university children’s dental over three years (March 2017–2020) met the inclusion criteria. Their access to care (OEVCH-A), topical fluoride application (TFL-CH-A) and dental treatment burden (TRT-CH-A) were determined by dental quality alliance (DQA) criteria. The three oral health variables were aggregated at the neighborhood level and analyzed with Canadian census data. Their partial postal code (FSA) was chosen as a neighborhood spatial unit …

Non-Thermal Atmospheric Pressure Plasma-Conditioned Root Dentin Promotes Attraction And Attachment Of Primary Human Dental Pulp Stem Cells In Real-Time Ex Vivo, Yeon Jee Yoo, Min Ji Kang, Hiran Perinpanayagam, Joo Cheol Park, Seung Ho Baek, Kee Yeon Kum

Dentistry Publications

This study investigated if non-thermal atmospheric pressure plasma (NTAPP) treatment of root dentin surfaces promotes human dental pulp stem cell (hDPSCs) adhesion. Freshly extracted human single-rooted teeth (n = 36) were decoronated and cut (first vertically, then horizontally) into root dentin slices (3 mm thick). Primary hDPSCs cultures were seeded onto slices randomly assigned to pretreatment groups (n = 9/group): NaOCl (1.5%), EDTA (17%) then NTAPP (Group I); NaOCl then NTAPP (Group II); NaOCl then EDTA (Group III); and NaOCl alone (Group IV). Cell viability and proliferation were measured using MTT assay with log-linear statistical analysis. Cell attachment and spreading …

Genetic Deletion Of Interleukin-15 Is Not Associated With Major Structural Changes Following Experimental Post-Traumatic Knee Osteoarthritis In Rats, Ermina Hadzic, Garth Blackler, Holly Dupuis, Stephen James Renaud, Christopher Thomas Appleton, Frank Beier

Bone and Joint Institute

Post-traumatic osteoarthritis (PTOA) is a degenerative joint disease, leading to articular cartilage breakdown, osteophyte formation, and synovitis, caused by an initial joint trauma. Pro-inflammatory cytokines increase catabolic activity and may perpetuate inflammation following joint trauma. Interleukin-15 (IL-15), a pro-inflammatory cytokine, is increased in OA patients, although its roles in PTOA pathophysiology are not well characterized. Here, we utilized Il15 deficient rats to examine the role of IL-15 in PTOA pathogenesis in an injury-induced model. OA was surgically induced in Il15 deficient Holtzman Sprague-Dawley rats and control wild-type rats to compare PTOA progression. Semi-quantitative scoring of the articular cartilage, subchondral bone, …

Anna Justina Magee: A Woman Of Determination And Vision, John F. Ditunno Jr., Chris S. Formal

Department of Rehabilitation Medicine Faculty Papers

This article tells the story of Anna J. Magee (AJM), the founder of the Magee Rehabilitation Hospital in Philadelphia, one of the country’s premier medical rehabilitation institutions. AJM’s life was shaped by her family, her times, and her city. The daughter of one of the founders of the Pennsylvania Railroad, she emerged in the late 19th century as an independent woman of elite Philadelphian society, demonstrating a special devotion to St. Stephen’s Episcopal Church at 10^th and Market Streets and, inspired by her personal physician, a determination to serve the rehabilitative needs of physically disabled patients, regardless of their …

The Age Presents Introduction To Geroscience Video Lecture Series., Alessandro Bitto, Mitchell B Lee, Cristal M Hill, Ron Korstanje, Matt Kaeberlein

Faculty Research 2021

The AGE Presents Introduction to Geroscience video lecture series is a collection of high-quality didactic video lectures and associated teaching materials focused on foundational topics in aging biology. The videos are made freely available on YouTube and are targeted toward an audience familiar with concepts learned in the first year of a college undergraduate biology/biomedical major. Members of the American Aging Association also receive the original lecture slides and lecture notes, with additional course materials to be developed in the future. We expect that these lectures will enhance understanding of geroscience among the general public while also providing tools that …

Enhanced Tyrosine Hydroxylase Activity Induces Oxidative Stress, Causes Accumulation Of Autotoxic Catecholamine Metabolites, And Augments Amphetamine Effects In Vivo., Laura M Vecchio, Patricia Sullivan, Amy R Dunn, Marie Kristel Bermejo, Rong Fu, Shababa T Masoud, Emil Gregersen, Nikhil M Urs, Reza Nazari, Poul Henning Jensen, Amy Ramsey, David S Goldstein, Gary W Miller, Ali Salahpour

Faculty Research 2021

In Parkinson's disease, dopamine-containing nigrostriatal neurons undergo profound degeneration. Tyrosine hydroxylase (TH) is the rate-limiting enzyme in dopamine biosynthesis. TH increases in vitro formation of reactive oxygen species, and previous animal studies have reported links between cytosolic dopamine build-up and oxidative stress. To examine effects of increased TH activity in catecholaminergic neurons in vivo, we generated TH-over-expressing mice (TH-HI) using a BAC-transgenic approach that results in over-expression of TH with endogenous patterns of expression. The transgenic mice were characterized by western blot, qPCR, and immunohistochemistry. Tissue contents of dopamine, its metabolites, and markers of oxidative stress were evaluated. TH-HI mice …

A Comparative Analysis Of Covid-19 Vaccine Distribution Efforts In India And Mongolia Through Data Visualization, Paridh Latawa, Sadhana Kumar, Udeshna Srimal, Rachana Tanksali, Edward Ning '23, Ajay Macherla, Haily Nguyen, Kristina Lian, Joy Jiang, Daniel Stewart

External Student Research Opportunities

COVID-19 vaccine allocation efforts have posed challenges and offered opportunities to alleviate the ongoing pandemic. Nations have employed varying approaches for COVID-19 vaccine distribution; in particular, Mongolia and India have differed in approaches to vaccine allocation efforts. As of June 2021, Mongolia has vaccinated more than 60% of its population, whereas India has only vaccinated about 7.5%. This disparity highlights the need for the present study, which utilizes a mixed-method approach to examine the two countries' vaccine distribution strategies and COVID-19 containment policies from January to July 2021. The study has three major components: 1) policy analysis to highlight core …

Treatment Of Thoracolumbar Type A3 Fractures Using A Percutaneous Intravertebral Expandable Titanium Implant: Long-Term Follow-Up Results Of A Pilot Single Center Study., David C Noriega, Jesus Crespo-Sanjuan, Wayne J. Olan, Ruben Hernandez-Ramajo, Douglas P Bell, J Javier Castrodeza Sanz, Gregorio De Jesus Labrador Hernandez, Israel Sanchez-Lite, Francisco Ardura

Neurological Surgery Faculty Publications

BACKGROUND: There are controversies about the optimal management of AO subtype A3 burst fractures. The most common surgical treatment consists of posterior fixation with pedicle screw and rod augmentation. Nevertheless, a loss of correction in height restoration and kyphotic reduction has been observed.

OBJECTIVES: The aim of this study was to assess long-term outcomes of a minimally invasive technique using a percutaneous intravertebral expandable titanium implant (PIETI).

STUDY DESIGN: This prospective, single center, pilot study was carried out on a consecutive case series of 44 patients with acute (< 2 weeks) traumatic thoracolumbar fractures AO type A3. The average follow-up was 5.6 years.

SETTING: A single center in Castilla y Leon, SpainMETHODS: Clinical outcomes …

Himmelfarb Library Liaison Letter - August 2021, George Washington University, Himmelfarb Health Sciences Library

Himmelfarb Library Liaison Letters

No abstract provided.

Cytokines: From Clinical Significance To Quantification, Chao Liu, Dewei Chu, Kourosh Kalantar-Zadeh, Jacob George, Howard A. Young, Guozhen Liu

United States Public Health Resources

Cytokines are critical mediators that oversee and regulate immune and inflammatory responses via complex networks and serve as biomarkers for many diseases. Quantification of cytokines has significant value in both clinical medicine and biology as the levels provide insights into physiological and pathological processes and can be used to aid diagnosis and treatment. Cytokines and their clinical significance are introduced from the perspective of their pro- and anti-inflammatory effects. Factors affecting cytokines quantification in biological fluids, native levels in different body fluids, sample processing and storage conditions, sensitivity to freeze-thaw, and soluble cytokine receptors are discussed. In addition, recent advances …

Mental Healthcare In Costa Rica: A Critical Perspective, Claire Elise Decelles

Theses and Graduate Projects

The country of Costa Rica often ranks high on happiness metrics and healthcare quality metrics. Mental healthcare in Costa Rica is often not discussed when reviewing those metrics. This paper attempts to explore mental healthcare in Costa Rica through a critical lens. Specifically, what factors affect the mental health of Costa Rican’s, if they experience mental health issues at the same rates as other areas of the world, what access is like, the prevalence of stigma surrounding mental illness, and how the COVID-19 pandemic has affected mental health. Through literature review and conversing with locals, it was found that mental …

Outcomes Of Elective Abdominal Aortic Aneurysm Management: Open Surgical Versus Endovascular Repair, Chelsea Armbruster

Theses and Graduate Projects

Introduction: Abdominal aortic aneurysm (AAA) is a disease with high mortality and morbidity. Evidence-based screening guidelines and elective repair options are crucial to mitigate the risk of rupture. Two primary techniques exist in the treatment of AAA. The open surgical repair method was standard of care until introduction of endovascular aneurysm repair in the 1990s. Endovascular aneurysm repair has become the mainstay of treatment of abdominal aortic aneurysms due to its minimally invasive approach and improved perioperative outcomes. Long-term overall survival outcomes are similar between the two approaches.

Methods: A systematic search of PubMed was conducted to review relevant articles …

A Literature Review: What Mental Health Challenges Are Experienced By First-Generation Latino Immigrant And Refugee Families Entering The U.S.?, Hunnaan M. Khan

Theses and Graduate Projects

It is believed that people leave their homeland and come to America for better opportunities, freedom, safety, or second chances at life. As of 2021, Latino’s account for Americas largest minority population however measures to support their communities medically and socially have fallen short. The downfalls of misunderstanding the traumas experienced in their homelands, accounting for premigration, during migration, and postmigration stressors, and systemic issues that fall short in providing culturally sensitive care creates room for mental health challenges to accumulate. Cases of traumas experienced in homelands, cultural implications, the controversies, and difficulties of being held in detention centers, challenges …

Umbilical Cord Clamping: How Timing Affects Infant Health Outcomes, Lauren Snell

Theses and Graduate Projects

The timing of umbilical cord clamping is commonly seen as an innocuous act. Many providers simply cut the cord as soon as they see fit without consideration as to what the impacts of this may be. Early umbilical cord clamping was initially considered a preventative measure for postpartum hemorrhage, but this myth has since been debunked. Now, the practice is still commonly implemented, but for reasons unknown. Delaying the clamping of the umbilical cord is thought to not only provide no risk to the mother but provide benefit to the newborn in relation to their fetal to adult physiologic transition. …

In Adults Suffering Acute Large Cerebral Vessel Occlusion, Is Direct Mechanical Thrombectomy More Effective Than Treatment With Tpa For Reducing Long-Term Morbidity?, Collin Barry

Theses and Graduate Projects

Background: Discussion whether intravenous tPA or mechanical thrombectomy is the ideal choice for treatment of acute ischemic strokes has been debated around the medical community for last three decades. However still, after several clinical trials, it is still unclear if one is superior to the other.

Methods: This meta-analysis pooled several different results from studies revolving around treatment of acute ischemic stroke. The goal of this paper was to evaluate whether previous clinical trials favoring mechanical thrombectomy had sufficient research to prove it is superior to treatment with tPA in reducing long-term morbidity. Primary outcomes measured were the modified Rankin …

What Is The Effect Of Physical Activity On The Reduction Of Macrovascular Complications In Patients Diagnosed With Type 2 Diabetes Mellitus?, Rachael M. Gordon

Theses and Graduate Projects

The increasing prevalence and healthcare burden of type 2 diabetes is a worldwide concern. It is the seventh leading cause of mortality and a significant cause of morbidity. While both the macrovascular and microvascular complications of diabetes can have a profound impact on overall health and quality of life, cardiovascular events are the leading cause of mortality in patients with type 2 diabetes. Adults with diabetes have a two to four-fold increased risk of cerebrovascular events and myocardial infarctions. Oral medications combat insulin resistance and aid in the control of hemoglobin A1c, blood pressure, and cholesterol, therefore, contributing to a …

In Patients With A Ruptured Anterior Cruciate Ligament, Does An Autograft Versus Allograft Reconstruction Provide Superior Post- Operative Outcomes?, Aaron Karo

Theses and Graduate Projects

Background: The literature surrounding anterior cruciate ligament (ACL) reconstruction (ACLR) exhibits the most commonly used grafts for a ruptured ACL are bone-patellar tendon-bone (BPTB) autografts, quadriceps tendon (QT) autografts, hamstring tendon (HT) autografts, and allografts. This paper was designed to compare the postoperative outcomes between autografts and allografts to determine which graft is superior.

Methods: A literature review of studies were searched and selected based on inclusion and exclusion criteria using Augsburg University Interlibrary loan system, PubMed, and Elsivier.

Results: The research demonstrates superior outcomes for autografts compared to allografts. Additionally, the research delineates outcomes based on the type of …

Functional Outcomes And Complications Of Total Hip Arthroplasty With Dual Mobility Cup : An Audit, Muhammad Younus Khan Durrani, Javeria Saeed, Masood Umer, Pervaiz Hashmi

Section of Orthopaedic Surgery

Objective: To determine the functional outcomes in total hip arthroplasty with a dual mobility cup, performed in our hospital.
Methods: After receiving an exemption from the Ethics review committee of the hospital, data collection for audit was started in January 2019. Records from July 2016 to June 2018 were included. All patients who underwent total hip arthroplasty with dual mobility prosthesis without any age limit were included. A proforma was prepared to collect the required information. Data was entered and analyzed on SPSS v. 21.
Results: Two hundred and ten patients were included, 114 females and 96 males. Of the …

Frequency Of Angular Malalignment After Intramedullary Nailing For Femur Shaft Fractures - A Cross-Sectional Study, Hammad Naqi Khan, Moiz Ali, Rizwan Haroon Rashid, Yasir Mohib, Pervaiz Hashmi

Section of Orthopaedic Surgery

Objective: To determine the frequency of angular malalignment of femur in patients undergoing Intra Medullary nailing for femur shaft fracture by measuring axis on immediate postoperative plain radiographs.
Methods: A cross-sectional study was conducted at the Section of Orthopaedics, Department of Surgery, Aga Khan University Hospital, Karachi from 1st January 2019 till 30th June 2019. All patients between the ages of 15 to 80 years who underwent IM nailing for femur shaft fractures were included. Angulation was measured on immediate post-operative X-ray films and an angle of ≥5° on AP and/or lateral views was defined as malalignment.
Results: A total …

Aging Gracefully - Orthocon 2021, Masood Umer, Haroon Ur Rashid, Rizwan Haroon Rashid

Section of Orthopaedic Surgery

No abstract provided.

Outcome Of Percutaneous Screw Fixation Of Posterior Pelvic Ring Injuries, Hussain Wahab, Pervaiz Hashmi, Haroon Kasi, Naveed Baloch, Tashfeen Ahmad, Haroon Rashid, Masood Umer

Section of Orthopaedic Surgery

Objective: To evaluate the clinical outcome of percutaneous fixation for unstable pelvic ring injury.
Methods: This retrospective study was conducted at orthopaedics section of Aga Khan University Hospital Karachi, Pakistan from July 2015 to December 2018. Data was retrieved from trauma registry from July 2015 till December 2018, including all patients who underwent percutaneous fixation for pelvic ring injury. Majeed pelvic score was used to determine the functional outcome.
Results: A total number of 30 patients were included, 27(90.0%) adults, and 3(10.0%) paediatrics patients. There were 21(70.0%) males and 9(30.0%)females. . Mean age of patients was 37.1±16.1 years. Post op …

Our Experience Of Treating Adult Bone Lymphoma, A Retrospective Cross-Sectional Study In A Tertiary Care Center, Aga Khan University Hospital, Karachi, Masood Umer, Muhammad Younus Khan Durrani, Javeria Saeed, Nasir Ud Din

Section of Orthopaedic Surgery

Objective: To determine the experience at the Aga Khan University Hospital in diagnosing and treating adult patients with primary lymphoma of bone.
Methodology: All patients with Primary lymphoma of bone (PLB) that were diagnosed and/or treated at Aga Khan University Hospital, Karachi from 2005 to 2019 were included as part of this study.
Results: There were 17 patients with PLB including 13 (76.5%) males and 4 (23.5%) females with a mean age of 44 ± 16.5 years. Nine patients were between 30-59 years of age at diagnosis. The mean follow-up time of patients was 80±46.7 months. Six patients had tumours …

Our Experience Of Mega-Prosthesis In Bone Tumours: A Retrospective Cross-Sectional Study In A Tertiary Care Hospital, Masood Umer, Eraj Khurshid Khan, Javeria Saeed

Section of Orthopaedic Surgery

Objective: To evaluate the oncological and functional outcomes of bone tumour patients who underwent reconstruction with mega prosthesis.
Methodology: A retrospective study was conducted in the department of Orthopaedics Aga Khan University Hospital, Karachi. All the paediatric and adult age group patients diagnosed with malignant, benign and metastatic bone tumours and meeting the inclusion criteria were selected and analysed. Retrospective data was collected from January 2008-January 2018.
Results: Sixty-two patients, 30 (48.4%) females and 32 (51.6%) males. were included in the study. Of these 57 (92%) cases had involvement of the lower limb. The mean age was 36.95±19.1 years with …

Solitary Langerhans Cell Histiocytosis Of Skull: Case Report With One-Year Follow-Up, Muhammad Junaid, Syed Sarmad Bukhari, Ali Afzal

Section of Neurosurgery

Langerhans cell histiocytosis (LCH) is a rare disorder characterised by increased production of Langerhans-type histiocytes. It is more common in the pediatric age group with a predilection for osseous involvement, though any organ may be involved. A 10-year male child was brought to the neurosurgical clinic with a slow growing painful tender mass on the head. Initial attempt to biopsy the lesion failed due to excessive bleeding. It was later imaged and removed with a frontal craniotomy. Histopathological evaluation along with immunohistochemistry revealed the true nature of the lesion. Follow-up revealed complete excision of the lesion and no recurrence at …