Medicine and Health Sciences Commons^™

Covid-19: A Gray Swan’S Impact On The Adoption Of Novel Medical Technologies, Denise R. Dunlap, Roberto S. Santos, Craig M. Lilly, Sean Teebagy, Nathaniel S. Hafer, Bryan O. Buchholz, David D. Mcmanus

Management Faculty Publications

The COVID-19 pandemic offers a unique context and opportunity to investigate changes in healthcare professional perceptions towards the adoption of novel medical technologies, such as point-of-care technologies (POCTs). POCTs are a nascent technology that has experienced rapid growth as a result of COVID-19 due to their ability to increase healthcare accessibility via near-patient delivery, including at-home. We surveyed healthcare professionals before and during COVID-19 to explore whether the pandemic altered their perceptions about the usefulness of POCTs. Our network analysis method provided a structure for understanding this changing phenomenon. We uncovered that POCTs are not only useful for diagnosing COVID-19, …

Seasonal Climatic Niche And Migration Movements Of Double-Crested Cormorants, D. Tommy King, Guiming Wang, Fred L. Cunningham

United States Department of Agriculture Wildlife Services: Staff Publications

Avian migrants are challenged by seasonal adverse climatic conditions and energetic costs of long-distance flying. Migratory birds may track or switch seasonal climatic niche between the breeding and non-breeding grounds. Satellite tracking enables avian ecologists to investigate seasonal climatic niche and circannual movement patterns of migratory birds. The Double-crested Cormorant (Nannopterum auritum, hereafter cormorant) wintering in the Gulf of Mexico (GOM) migrates to the Northern Great Plains and Great Lakes and is of economic importance because of its impacts on aquaculture. We tested the climatic niche switching hypothesis that cormorants would switch climatic niche between summer and winter …

Case Report On Peri-Operative Surgical And Anaesthetic Management Of Ruptured Humongous Lung Abscess, Khalid Maudood Siddiqui, Akbar Azizullah, Muhammad Saad Yousuf

Department of Anaesthesia

Introduction: Early thoracic empyema is usually treated through video-assisted thoracoscopic (VATS) decortication. Patient selection is important for decortication if an effective surgical outcome is required. Lung isolation techniques are required to provide anesthesia for these patients to facilitate the surgeon while operating on the affected lung. The ultimate target is to protect the non-diseased contra-lateral lung from contamination.
Presentation of case: We are presenting a unique case of 20-year-old female, resident of Karachi, who was brought to the emergency room (ER) with signs of sepsis, hypotension, and multi-organ failure. She was brought to the operating room to undergo video-assisted thoracoscopy …

Antiaging Mechanism Of Natural Compounds: Effects On Autophagy And Oxidative Stress., Elizabeth Taylor, Yujin Kim, Kaleb Zhang, Lenne Chau, Bao Chieu Nguyen, Srujana Rayalam, Xinyu Wang

PCOM Scholarly Works

Aging is a natural biological process that manifests as the progressive loss of function in cells, tissues, and organs. Because mechanisms that are meant to promote cellular longevity tend to decrease in effectiveness with age, it is no surprise that aging presents as a major risk factor for many diseases such as cardiovascular disease, neurodegenerative disorders, cancer, and diabetes. Oxidative stress, an imbalance between the intracellular antioxidant and overproduction of reactive oxygen species, is known to promote the aging process. Autophagy, a major pathway for protein turnover, is considered as one of the hallmarks of aging. Given the progressive physiologic …

Prmt5 Activates Akt Via Methylation To Promote Tumor Metastasis., Lei Huang, Xiao-Ou Zhang, Esteban J Rozen, Xiaomei Sun, Benjamin Sallis, Odette Verdejo-Torres, Kim Wigglesworth, Daniel Moon, Tingting Huang, John P Cavaretta, Gang Wang, Lei Zhang, Jason M Shohet, Mary M. Lee, Qiong Wu

Department of Pediatrics Faculty Papers

Protein arginine methyltransferase 5 (PRMT5) is the primary methyltransferase generating symmetric-dimethyl-arginine marks on histone and non-histone proteins. PRMT5 dysregulation is implicated in multiple oncogenic processes. Here, we report that PRMT5-mediated methylation of protein kinase B (AKT) is required for its subsequent phosphorylation at Thr308 and Ser473. Moreover, pharmacologic or genetic inhibition of PRMT5 abolishes AKT1 arginine 15 methylation, thereby preventing AKT1 translocation to the plasma membrane and subsequent recruitment of its upstream activating kinases PDK1 and mTOR2. We show that PRMT5/AKT signaling controls the expression of the epithelial-mesenchymal-transition transcription factors ZEB1, SNAIL, and TWIST1. PRMT5 inhibition significantly attenuates primary tumor …

In Vivo Determination Of The Human Corneal Elastic Modulus Using Vibrational Optical Coherence Tomography, Marcos A. Crespo, Hiram J. Jimenez, Tanmay Deshmukh, Jose S. Pulido, Ahmed Saeed Saad, Frederick H Silver, Dominick A Benedetto, Christopher J Rapuano, Zeba Syed

Wills Eye Hospital Papers

Purpose: To determine the in vivo elastic modulus of the human cornea using vibrational optical coherence tomography (VOCT).

Methods: Vibrational analysis coupled with optical coherence tomography (OCT) was used to obtain the resonant frequency (RF) and elastic modulus of corneal structural components. VOCT corneal thickness values were measured using OCT images and correlated with corneal thickness determined with Pentacam (Oculus, Wetzlar, Germany). Moduli were obtained at two locations: central cornea (CC) and inferior cornea (IC). Measurements were obtained with and without anesthetic eye drops to assess their effect on the modulus measurements.

Results: VOCT thickness values correlated positively (R2 = …

Interleukin-8 Produced From Cancer-Associated Fibroblasts Suppresses Proliferation Of The Ocuch-Lm1 Cancer Cell Line, Ryota Tanaka, Kenjiro Kimura, Shimpei Eguchi, Go Ohira, Shogo Tanaka, Ryosuke Amano, Hiroaki Tanaka, Masakazu Yashiro, Masaichi Ohira, Shoji Kubo

Department of Medical Oncology Faculty Papers

Background: Cancer-associated fibroblasts (CAFs) play an important role in cancer growth by interacting with cancer cells, but their effects differ depending on the type of cancer. This study investigated the role of CAFs in biliary tract cancers (BTCs), compared with pancreatic ductal adenocarcinoma (PDAC) as a comparison cohort.

Methods: We retrospectively evaluated alpha-smooth muscle actin (αSMA) expression in CAFs from 114 cases of PDAC and 154 cases of BTCs who underwent surgical treatment at our institution from 1996 to 2017. CAFs were isolated from resected specimens of BTC and PDAC, and tested for the effects of their supernatants and cytokines …

Optical Control Of Protein Delivery And Partitioning In The Nucleolus, Peng Tan, Tingting Hong, Xiaoli Cai, Wenbo Li, Yun Huang, Lian He, Yubin Zhou

Faculty, Staff and Student Publications

The nucleolus is a subnuclear membraneless compartment intimately involved in ribosomal RNA synthesis, ribosome biogenesis and stress response. Multiple optogenetic devices have been developed to manipulate nuclear protein import and export, but molecular tools tailored for remote control over selective targeting or partitioning of cargo proteins into subnuclear compartments capable of phase separation are still limited. Here, we report a set of single-component photoinducible nucleolus-targeting tools, designated pNUTs, to enable rapid and reversible nucleoplasm-to-nucleolus shuttling, with the half-lives ranging from milliseconds to minutes. pNUTs allow both global protein infiltration into nucleoli and local delivery of cargoes into the outermost layer …

Selected Transesophageal Echocardiographic Parameters Of Left Ventricular Diastolic Function Predict Length Of Stay Following Coronary Artery Bypass Graft-A Prospective Observational Study, Samhati Mondal, Nauder Faraday, Wei Dong Gao, Sarabdeep Singh, Sachidanand Hebbar, Kimberly N Hollander, Thomas S Metkus, Lee A Goeddel, Maria Bauer, Brian Bush, Brian Cho, Stephanie Cha, Stephanie O Ibekwe, Domagoj Mladinov, Noah S Rolleri, Laeben Lester, Jochen Steppan, Rosanne Sheinberg, Nadia B Hensley, Anubhav Kapoor, Jeffrey M Dodd-O

Faculty, Staff and Students Publications

(1) Importance: Abnormal left ventricular (LV) diastolic function, with or without a diagnosis of heart failure, is a common finding that can be easily diagnosed by intra-operative transesophageal echocardiography (TEE). The association of diastolic function with duration of hospital stay after coronary artery bypass (CAB) is unknown. (2) Objective: To determine if selected TEE parameters of diastolic dysfunction are associated with length of hospital stay after coronary artery bypass surgery (CAB). (3) Design: Prospective observational study. (4) Setting: A single tertiary academic medical center. (5) Participants: Patients with normal systolic function undergoing isolated CAB from September 2017 through June 2018. …

The Power Of Partnerships: State Public Health Department Multisector Collaborations In Major Chronic Disease Programme Areas In The United States, Edward Tsai, Peg Allen, Louise Farah Saliba, Ross C Brownson

2020-Current year OA Pubs

BACKGROUND: Multisector collaboration between state public health departments (SHDs) and diverse community partners is increasingly recognized as important for promoting positive public health outcomes, addressing social determinants of health, and reducing health inequalities. This study investigates collaborations between SHDs in the United States and different types of organizations addressing chronic disease in and outside of the health sector.

METHODS: SHD employees were randomly selected from the National Association of Chronic Disease Directors membership list for participation in an online survey. Participants were asked about their primary chronic disease work unit (cancer, obesity, tobacco, diabetes, cardiovascular disease, and others), as well …

Genetic Diversity Of Cladosporium Species Isolated From Air Of Cairo, Egypt Using Microsatellite Primed Pcr (Mp-Pcr) And Universally Primed Pcr (Up-Pcr) Techniques, Mohammed Salah Abdulrahman, Hamido M. Hefny, Moselhy S. Mansy, Amal A. I. Mekawey

Bulletin of Faculty of Pharmacy Cairo University

The samples were then identified by macroscopic and microscopical methods, Molecular fingerprinting, of Cladosporium strains populations depending on MP-PCR using Primers (AGG) 5 , (CAG) 5 , (GACA) 4 , and (AG) 8 C. In addition, we have applied the UP-PCR technique using L21 and Fok1 Genotyping patterns extracted by MP-PCR showed good discrimination with amplification of (AGG) 5 , (AG) 8 C and (CAG) 5 over (GACA) 4. In addition, L21 primer revealed variability over FOK1 primer. current work indicate that MP-PCR and UP-PCR fingerprinting method are appropriate for characterization of large groups of Cladosporium due to its simplicity

Phytochemicals, Acute Toxicity And Genotoxicity Of Chewing Sticks From Zanthoxylum Zanthoxyloides Root And Distemonanthus Benthamianus Stem, Chinwe S. Alaribe, Akolade R. Oladipupo, Anjola T. Adebesin, Omolayomi Kaska, Emuejevoke T. Toye

Bulletin of Faculty of Pharmacy Cairo University

Dental caries has been reported to touch almost half of the world’s population, making it one of the most prevalent disease conditions in the world. Studies have shown that chewing sticks could be useful in cleaning of teeth and could offer protection against dental conditions, including caries. Given the increasing usage of chewing sticks and their unstandardized nature, in this study we investigated the acute toxicity, genotoxic effects on liver and kidney, and phytochemical constituents of chewing sticks from Zanthoxylum zanthoxyloides root and Distemonanthus benthamianus stem, widely used in West Africa. Chemical tests showed the presence of saponins, alkaloids, flavonoids, …

The Effect Of Energy Drink Consumption On Brake Reaction Time, Jenna Howden, Hailey Remme

Scholarly Horizons: University of Minnesota, Morris Undergraduate Journal

Objective: To investigate if brake reaction times improve for college aged students after consuming an energy drink (ED).

Design: Cross-sectional.

Setting: College Setting Participants: 103 college aged participants (1=35, 2=34, 3=34). Brake reaction time tested 30 minutes post consumption of ED drink containing either 150 mg of caffeine, 34 mg of caffeine, or 0 mg of caffeine (placebo). Completion of Rand SF-36 general health and the General Knowledge Questionnaire for Adults surveys.

Results: All groups improved brake reaction time from pre-to post-test. When comparing brake reaction time between groups, no statistical differences occurred.

Conclusions: The majority of college students consumed …

External Load In Male Professional Volleyball: A Systematic Review, Marcel Frezza Pisa, Arthur Marques Zecchin, Leonardo Gaspar Gomes, Enrico Fuini Puggina

Baltic Journal of Health and Physical Activity

Introduction. The objectives of this systematic review were to identify the volleyball external loads values in the literature and to verify the applicability of different means of quantification and monitoring of these variables during training sessions and matches. Material and methods: This systematic review was produced following the PRISMA statement recommendations, and the search for publications was carried out in the databases PubMed/NCBI, SportDiscus via EBSCOhost, SciELO. 12 studies meet the criteria and were included in this review. Results: The most used tool for quantification, monitoring and evaluation of external loads are video recording and manual or semi-automatic counting of …

No Mental Illness Impact On Post-Aortic Valve Replacement Patients’ New-Onset Atrial Fibrillation, Natalie Kolba, Julia Dokko, Samantha Novotny, Sohaib Agha, Ashutosh Yaligar, Puja Parikh, Aurora Pryor, Henry Tannous, Laurie Shroyer, Thomas Bilfinger

Department of Surgery Faculty Publications

No abstract provided.

Implementation Of A Critical Event Debriefing Tool In The Pediatric Intensive Care Unit, Tara Fiala

Dissertations

Problem: Working in the Pediatric Intensive Care Unit (PICU), staff encounter critical patient events without warning. Debriefing after adverse patient events has been shown to give staff the opportunity to process these events in an open, honest, and judgement-free environment. Debriefing has been recognized as a tool for detecting medical errors, improving team communication, providing emotional support, and analyzing team performance.

Methods: A descriptive, observational pilot study was used to implement the DISCERN tool into a large, midwestern, urban PICU. The aim of the quality improvement project was to achieve a debriefing tool completion rate of 20% over a one-month …

Life Matters, Marina Fischer

Dissertations

Problem: One of the challenges facing many primary care providers is managing hypertension. Hypertension contributes to cardiovascular disease events. Consequently, the high occurrence of hypertension related visits signifies a clinical practice gap in hypertension management resulting in substandard blood pressure outcomes. The purpose of this clinical scholarship project was to assess the difference of pre and post Quality of Life Scale (QOLS) scores in a hypertensive population.

Methods: This quality improvement project used a longitudinal, observational design with prospective data collection. The sample included newly diagnosed hypertensive adults ages 21 to 64 years old. The sample was administered the World …

Implicit Bias Training For Perinatal Nursing, Racheal Lakine-Harden

Dissertations

Problem: Maternal and fetal morbidity and mortality is a rising health care crisis in the United States. Black women are disproportionately affected. Clinician implicit bias and medical racism have been named as factors in this crisis. Recommendations to address this public health peril include; educating and raising awareness among front-line perinatal nursing staff on implicit bias and its consequences for Black women. The purpose of this project is to evaluate the impact of implicit bias training on nurses’ awareness of implicit bias, attitudes, and beliefs about disparities, and the likelihood to engage in behaviors to reduce or address racial bias …

Healthcare-Associated Pressure Injury Prevention In The Intensive Care Unit, Ross Quinton

Dissertations

Problem: Healthcare-associated pressure injuries (HAPIs) occur when prolonged pressure is on the sacrum, coccyx, elbows, and heels, during a hospital stay. HAPIs can result in increased morbidity and mortality, and prolonged hospital stays, which consequently requires excess expenditure on treatment. Early specialty mattress placement can prevent HAPI acquirement.

Methods: This quality improvement (QI) pilot project aimed to increase specialty prevention mattress usage in the intensive care unit (ICU). A sleep surface decision tree was implemented into the admission process in a 30-bed ICU. A retrospective record review was used to examine demographics, comorbidities, HAPI risk, length of stay, and when …

Effect Of A Turn Clock On Hospital-Acquired Pressure Injury Incidence, Sydney Warren

Dissertations

Problem: Hospital-Acquired Pressure Injuries (HAPIs) are the only quality metric increasing in incidence and are preventable. HAPIs are wounds to bony prominences during a hospitalization and can increase hospital costs, morbidity, and mortality. HAPIs could be prevented through interventions, including repositioning patients every 2 hours and using a turn clock method. The aim of this quality improvement (QI) pilot project was to decrease HAPI incidence.

Methods: A turn clock method was implemented on a general medicine floor at a mid-sized, suburban medical center utilizing a descriptive retrospective observational design. Data was collected for the pre-intervention timeframe from June through August …

Implementing Patient Acuity Scale On A Medical-Surgical Unit, Coreen Ladd

Dissertations

Problem: Nurses commonly report dissatisfaction with their workload levels due to inequity of shift assignments. Imbalanced workload distribution has been shown to lead to missing or delayed care. Increased nursing workload has been linked to increased fall rates, healthcare associated infections, and avoidable deaths. Research has shown that patient classification is more accurate when an instrument is used. The purpose of this quality improvement project was to implement a patient acuity tool to aid nurse-patient shift assignments on a medical-surgical unit. The project aimed to provide a standardized and objective method of measuring patient acuity.

Methods: The project took place …

Effect Of A Trauma Informed Care Tool In A Pediatric Cardiac Intensive Care Unit, Taylor Park

Dissertations

Problem: Parents of infants less than one-year-old with complex congenital heart disease (CCHD) experience significant stress while their child is admitted to the pediatric cardiac intensive care unit (PCICU), often resulting in trauma to parents and their families. Trauma informed care (TIC) seeks to minimize the impact of emotional trauma and it acknowledges previous trauma an individual may have experienced.

Methods: The purpose of this quality improvement (QI) project was to assess the thrive guide’s ability to decrease parental stress in the pediatric cardiac intensive care unit (PCICU). The aim was to decrease parental Perceived Stress Scale (PSS) scores by …

Doubling Down On Sepsis: A Quality Improvement Project To Improve Sepsis Bundle Compliance On An Inpatient Oncology Unit, Kayla Slay

Dissertations

Problem: Sepsis is a leading cause of death worldwide, and the second most common cause of death in cancer patients. Early management of sepsis through use of sepsis bundles have been shown to improve patient outcomes, yet bundle adherence is unfortunately inconsistent.

Methods: A two-nurse team, called the Sepsis Sidekicks, was a process improvement initiative to increase compliance with the center for Medicare and Medicaid Services (CMS) sepsis bundle and improve patient outcomes related to sepsis. The observational quality improvement project utilized a Plan-Do-Study-Act (PDSA) model over a six-week period where quantitative data was collected using a retrospective chart review. …

Evaluating The Effectiveness Of Implementing Depression Screenings With Uninsured African American Adults, Pamela Talley

Dissertations

Problem: Uninsured African Americans are underdiagnosed and often untreated for depression. Individuals usually do not present to their primary care provider with a complaint of depressed mood, however, may report symptoms such as decreased energy, general body aches, digestive concerns, somatic complaints, or older adults' memory or cognitive problems. The purpose of this quality improvement pilot project was to examine the results of the implementation of a depression screening (PHQ-9) in a primary care setting for uninsured adults for detection, diagnosis, and treatment of depression in African American clients.

Results: The PHQ-9 screening questionnaire was given to 100% (N …

Screening For Social Determinants Of Health In A Comprehensive Pediatric Sickle Cell Disease Clinic, Marie Turner

Dissertations

Problem: Social determinants of health (SDOH) affect health outcomes across the lifespan. The American Academy of Pediatrics recommends routine screening for SDOH. Poverty is a SDOH affecting health outcomes in children, especially in children with a chronic disease such as sickle cell disease (SCD). Children with sickle cell disease have a high burden of SDOH. This project sought to describe the SDOH barriers experienced by pediatric patients with SCD.

Methods: A descriptive survey/observational design, using a convenience sample of pediatric patients ages 0-19 years old in a comprehensive SCD clinic at a large, urban, Midwestern academic medical center was utilized …

Readmit Clinical Risk Index: Identifying Risk Factors To Reduce 30-Day Psychiatric Readmissions, Victoria Faulkner

Dissertations

Abstract

Problem: There has been a growing concern in the past decades over the increase in community-based adults who require readmission to psychiatric care shortly after discharge. It is estimated that nearly half of discharged psychiatric patients will be readmitted within twelve months after discharge. This has been primarily attributed to the absence of screening tools and resources to assists behavioral healthcare providers in identifying socio-demographic factors contributing to readmissions. Screening tools like the READMIT Clinical Risk Index identify patients at risk for psychiatric readmission. This quality improvement project aims to identify socio-demographic factors that lead to 30-day readmission …

Evaluating Mindfulness On Loneliness In An Older Adult Population, Jessica Tieskoetter

Dissertations

Problem: Loneliness is a widespread public health concern and has negatively impacted mortality and health outcomes among older adults. This quality improvement project’s purpose was to evaluate mindfulness on loneliness and quality of life among adults aged 65 years and older, participating in a weekly befriending socialization program.

Methods: A descriptive cohort design was utilized to assess loneliness pre-and post-implementation of a mindfulness telephone line over three months. A convenience sample of 22 older adults enrolled in a befriending socialization program was used. The Iowa Model of Evidence-Based Practice framework was applied to guide the implementation of a practice change …

Initiation Of Procalcitonin Screening As A Marker In Antibiotic Therapy De-Escalation, Briana Kile

Dissertations

Problem: The overuse of antibiotics has created antimicrobial resistance (AMR)

resulting in treatment failure for bacterial infections. To combat AMR, clinicians should

only prescribe antibiotic therapy when clinically warranted. It is easy to misdiagnose a

viral infection. However, any delay in the initiation of antibiotic therapy in a bacterial

infection may lead to increased morbidity and mortality. These patients with non-specific

clinical symptoms may be misdiagnosed without a rapid and definitive diagnostic test.

Methods: This quality improvement (QI) initiative utilized an evidence-based clinical

guideline for procalcitonin (PCT) levels for antibiotic therapy de-escalation. WBC counts

were collected two-days and one-day before …

Implementation Of A Protocol Nurse In The Emergency Department, Marissa Kramer

Dissertations

Abstract

Problem: Increased wait times and extended length of stay (LOS) of patients in the Emergency Department (ED) are contributing to overcrowding, burdening EDs worldwide. A nurse can initiate patient care using protocol order sets while a patient is in the waiting room; however, triage nurses are often too busy to complete these orders. Scheduling a nurse to complete these protocol order sets could reduce ED overcrowding and patient LOS.

Method: A convenience sample was used to retrospectively chart review and collect data utilizing an excel spreadsheet with patients 40 years of age and older with a chief complaint of …

Standardized Approach To Early Mobilization Of The Critically Ill Pediatric Patient, Courtney Mccarty

Dissertations

Problem: Many pediatric intensive care units (PICU) do not have early mobilization guidelines in place. Early mobilization (EM) is defined as any exercise initiated for a patient within 48 hours after PICU admission. Several studies show that use of early mobilization in this setting can lead to improved outcomes for pediatric patients such as reduced delirium, maintenance of muscle strength, and little reduction in functional deficits. Initiation of an EM guideline should be done to improve patient outcomes by discharge.

Methods: This QI project used a descriptive design to collect prospective data after a new EM guideline was implemented. …