Medicine and Health Sciences Commons^™

Trauma And Resiliency, Madelyn Ferguson

Honors Projects

Life is a series of events, some overwhelmingly positive and others devastatingly negative. Because of the inevitability of adversity, one must learn to adapt to negative circumstances. However, people react to trauma in different ways with some seeking to take their own lives and others finding a healthy outlet. What causes such a difference in our reactions to trauma? Is it simply the power of thought or is there a genetic component? What can I do to build my own resilience and promote the resilience of others around me? The purpose of this paper is to explore the relationship between …

Analyzing The Patient-Provider Relationship And Assessing Shortages In Oral Healthcare In Arenac County, Michigan, Aaron Norfleet

Honors Projects

The purpose of this prospective study will be to assess the patient-provider relationship in Arenac County, Michigan, analyze barriers to treatment for rural patients, and develop a meaningful plan to improve upon these categories. The intended outcomes of this study will be the development of a resource for rural oral healthcare providers to better understand and treat the needs of their patients based on knowledge from beyond the chairside, as well as the development of an easily repeatable model for patient-provider analysis. Furthermore, the questionnaires and data collected from this could assist in informing governmental or non-governmental organizations in identifying …

Modeling Immune System Dynamics During Hiv Infection And Treatment With Differential Equations, Nicole Rychagov

CODEE Journal

An inquiry-based project that discusses immune system dynamics during HIV infection using differential equations is presented. The complex interactions between healthy T-cells, latently infected T-cells, actively infected T-cells, and the HIV virus are modeled using four nonlinear differential equations. The model is adapted to simulate long term HIV dynamics, including the AIDS state, and is used to simulate the long term effects of the traditional antiretroviral therapy (ART). The model is also used to test viral rebound over time of combined application of ART and a new drug that blocks the reactivation of the viral genome in the infected cells …

The Jackson/Cubbin Skin Risk Assessment Tool: Implementing An Evidence-Based Practice Change Initiative In The Intensive Care Unit, Andrew Riddle Msn, Rn, Npd-Bc, Ccrn-K

Doctor of Nursing Practice Projects

Background: Pressure injuries in acute care patients cause thousands of deaths and billions of losses annually. The Braden Scale has been an American standard of pressure injury risk assessment yet demonstrates poor predictability in the Intensive Care Unit (ICU) population. Recent evidence indicates that the Jackson/Cubbin Scale performs similarly or superiorly to the standard.

Purpose: To compare the Jackson/Cubbin Scale to the Braden Scale in assessing ICU patients’ risk for pressure injuries and resulting nursing interventions. Methods: Using a pretest-posttest and comparative design, trained nurses in two ICUs applied both Jackson/Cubbin Scale and Braden Scale to assess patients’ risks twice …

Impact Of An Automated Text And Phone Call Post-Discharge Follow-Up Program On Patient Satisfaction Scores And 30-Day Hospital Readmission Among Adult Patients, Michael Clarke

Doctor of Nursing Practice Projects

Background: The Center for Medicare & Medicare (CMS) withholds reimbursement from hospitals that fail to meet established benchmarks for the rate of 30-day hospital readmission and patient satisfaction.

Objective: This project aimed to improve patient satisfaction scores and decrease 30-day hospital readmissions among adult patients at the project hospital by implementing an automated phone call and text message post-discharge follow-up program.

Methods: This quality improvement project utilized a Plan-Do-Study-Act (PDSA) method. Program participants’ 30-day readmission data and patient satisfaction scores were collected and analyzed throughout the 90-day project and up to 30 days after the project ended. Program participants received …

Roadmap To Reduce Barriers To Medical Aid In Dying For Rural Coloradans: A Health Policy Analysis And Advocacy Campaign, Ashley D. Fry Msn, Apn, Agacnp-Bc, Achpn

Doctor of Nursing Practice Projects

Background: Medical aid in dying (MAID) is a process by which a terminally ill adult with a prognosis of six months or less can request prescription medications to end their life. Colorado’s End-of-Life Options Act requires that two physicians participate in the process to certify terminal illness and prescribe medications. Nearly all rural and frontier counties face shortages of medical professionals. These conditions challenge rural residents who want to access MAID. Advanced practice registered nurses and physician assistants can address gaps in rural and frontier counties; on average, they outnumber physicians in these communities.

Aims: The aims of this health …

Cultivating Unit-Based Leaders Through A Tiered, Structured Mentorship Program, Brittney Daley Msn, Rn, Ccrn

Doctor of Nursing Practice Projects

Background: Succession planning and mentorship is an essential need in developing future nursing leaders. The IOM and published literature strongly support the importance of mentorship programs in nursing (IOM, 2021). The current succession plan and mentorship program is not sufficient.

Purpose: The purpose of this project was to create and implement an evidence-based, 3-tiered unit-based leadership mentorship program (LMP) for bedside registered nurses to support growth and professional development between tiers over a 4-month period.

Aims/Objectives: Using the completion of a pre and post survey the mentee was assigned a tier from novice to experienced leaders. Through the program, the …

Impacts Of Emotional Intelligence Skill Development Training On Nurse Leaders, Denise A. Holyoak Dnp, Rn, Ccrn-K, Nea-Bc

Doctor of Nursing Practice Projects

Background: Emotional intelligence (EI) skills are recognized as an essential tool for leaders’ success in their organization. Research shows that an EI skill development training program is effective at improving this skill set of nurse leaders and thus positively influence individual and organizational outcomes.

Aims: The purpose of this evidence-based practice (EBP) project was to design an EI skill development curriculum for frontline inpatient nurse managers and to evaluate its impact on three aims: EI skill scores of nurse managers, patient satisfaction scores related to nurse communication and nurse manager leadership communication scores.

Methods: Eleven inpatient nurse managers from a …

Addressing Verbal Aggression To Reduce Workplace Violence Against Nurses, Rebecca Harris

Doctor of Nursing Practice Projects

Background: Almost three-quarters of non-fatal workplace violence-related injuries requiring time away from the workplace occur in the healthcare and social services sector. More than 90 percent of assaults against nurses are from patients. Verbal aggression was correlated with physical violence and could contribute to nurses’ stress and dissatisfaction and compromise patient care. Policies and guidelines addressing verbal aggression against nurses are often unclear and not well-supported by evidence. This can leave nurses unprepared to recognize and respond to verbal aggression or threats of physical harm without compromising their safety.

Aim: This health policy analysis aimed to explore a range of …

Management Of Stage I And Stage Ii Labor Arrest Disorder To Reduce Primary Cesarean Section Birth Rate For African American Women, Ariam Yitbarek Mha, Bsn, Rn, Nea-Bc

Doctor of Nursing Practice Projects

Background: Cesarean section delivery rate in the United States has reached an alarming rate of over 30%. African American women experience a higher cesarean birth rate compared to Caucasian Women. The repeat c-section rate for all patients is greater than 80%. These findings underscore the need for intervention to reduce primary cesarean section deliveries in African American Women.

Objective: This quality improvement project aimed to implement caregiver education on the ACOG/SMFM definition of the first and second-stage labor arrest disorder to reduce primary cesarean section birth for African American women.

Method: This pre-and post-intervention quality improvement project was conducted on …

The Impact Of Nurse-To-Nurse Change Of Shift Report At The Bedside On Patient Satisfaction Scores And Patient Safety, Tonya Washington

Doctor of Nursing Practice Projects

Background: Nursing shift report is an essential part of the clinical practice. It allows nursing staff to exchange necessary patient information to ensure continuity of care and patient safety. Traditionally, nursing shift report was done at the nurses’ station or behind closed doors and did not involve the patient.

Objective: This project aims to implement an evidenced-based bedside shift report (BSR) on two medical and two surgical inpatient units to improve patient safety and patient satisfaction scores in the Communication with Nurses domain of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey.

Methods: The project utilized a …

Jurisgenerative Tissues: Sociotechnical Imaginaries And The Legal Secretions Of 3d Bioprinting, Roxanne Mykitiuk, Joshua Shaw

Articles & Book Chapters

Three-dimensional ‘bioprinting’ is under development, which may produce living human organs and tissues to be surgically implanted in patients. Like tissue engineering and regenerative medicine generally, the process of bioprinting potentially disrupts experience of the human body by redefining understandings of, and becoming actualised in new practices and regimes in relation to, the body. The authors consider how these novel sociotechnical imaginaries may emerge, having regard to law’s contribution to, as well as its possible transformation by, the process of 3D bioprinting. The authors draw on Gilbert Simondon and corporeal, material feminists to account for these disruptions as ‘ontogenetic,’ in …

Coherence Between Electromyographic Signals Of Anterior Tibialis, Soleus, And Gastrocnemius During Standing Balance Tasks, Anuj Ojha, Gordon Alderink, Samhita Rhodes

Open Access Publishing Support Funded Articles

Introduction: Knowledge about the mechanics and physiological features of balance for healthy individuals enhances understanding of impairments of balance related to neuropathology secondary to aging, diseases of the central nervous system (CNS), and traumatic brain injury, such as concussion.

Methods: We examined the neural correlations during muscle activation related to quiet standing from the intermuscular coherence in different neural frequency bands. Electromyography (EMG) signals were recorded from six healthy participants (fs = 1,200 Hz for 30 s) from three different muscles bilaterally: anterior tibialis, medial gastrocnemius, and soleus. Data were collected for four different postural stability conditions. In decreasing order …

Regeneration Of Neurons In Human Brain Tissue; A Revolutionary Concept With Therapeutic Potential, Mackenzie R. Dunn

Biomedical Sciences Undergraduate Research

There is current research to suggest that endogenous neuronal regeneration, exogenous neuronal stem cell transplantation and glial cell reprogramming could be prospective therapeutic treatments for neurodegeneration and traumatic injury. With these conditions, there is significant brain atrophy, loss of neurons and loss of synaptic connections which can have devastating effects on executive functioning, cognition, learning and memory. This review will examine these modern approaches to adult neurogenesis, and assess the viable mechanisms and future outlook of these three therapies for neurological regenerative medicine.

Case Studies In Physiology: Male To Female Transgender Swimmer In College Athletics, Jonathon Senefeld, Sandra K. Hunter, Doriane Coleman, Michael J. Joyner

Exercise Science Faculty Research and Publications

There is current scientific and legal controversy about sports competition eligibility regulations for transgender athletes. In this case study, we quantified performances by an elite, transgender woman (male sex, female gender identity) college swimmer who competed in both the men’s and women’s National Collegiate Athletic Association (NCAA) categories. We also contextualized her performances with respect to world-record performances and contemporary elite college swimmers. These data demonstrate that the declines in freestyle swimming performances of a transgender woman after about 2 yr of reported feminizing gender-affirming hormone treatment (0.5% for the 100 to 7.3% for the 1,650 yard distance) are smaller …

A Process For Converting An In-Person Training To Increase Church Capacity To Implement Physical Activity And Healthy Eating Practices And Policies To An Online Format, Sara Wilcox Phd, Ruth P. Saunders Ph.D., Jessica Stucker, Andrew T. Kaczynski Ph.D., Kelsey R. Day, Deborah Kinnard, Lindsay Decker, John A. Bernhart Ph.D., Mph, Ches

Faculty Publications

The implementation of evidence-based public health programs into practice is critical for improving health, but trainings for organizational change agents are often not scalable. To describe the process of converting a training that targets faith-based organizational capacity development from an in-person to an online format. We engaged in an iterative process to convert the training delivery mode from in-person to online that included assessing stakeholder support, consulting the literature on best practices, seeking a design team, consolidating content, designing engaging lessons, and building an online site. Feedback from end-users and other audiences was incorporated throughout. Pilot participants with characteristics like …

The Economic, Mental Health, And Social Stressors During The Covid-19 Pandemic Among Native Americans In South Dakota, Savannah E. Lukkes

Honors Thesis

American Indian/Alaska Native (AI/AN) communities test positive for COVID-19 and experience higher mortality than other racial and ethnic groups. These high rates of vulnerability could be connected to the systemic inequalities that have been experienced for centuries. This study aimed to compare socioeconomic stressors, concerns, and mental health experiences during the early COVID-19 pandemic between AI/AN and non-AIAN populations in South Dakota. The study sample (n=1,586) was grouped by AI/AN and non-AI/AN status based on self-identification of being AI/AN alone or in combination with another race/ethnicity. Participant responses to socioeconomic stressors and concerns (e.g., top concerns, level of concern, self-isolation, …

Acute Necrotizing Encephalopathy In An Infant: A Case Report, Elisamia Ngowi, Zeenat Juneja, Jacqueline Gabone, Maria Bulimba, Mohamedraza Ebrahim, Yaser Abdallah

Paediatrics and Child Health, East Africa

Background: Acute necrotizing encephalopathy is a rare, severe neurological condition, characterized by symmetrical necrotic brain lesions affecting the thalamus, cerebral white matter, brain stem, and cerebellum. Diagnosis relies on characteristic clinical and radiological features.

Methodology: We describe a 10-month-old female infant presenting with multiple seizures following a brief febrile upper respiratory illness.

Findings: MRI of the brain showed bilateral symmetrical abnormal signal intensities involving both thalami and caudate nucleus, consistent with ANE. Management of ANE is symptom-related but high-dose steroids and IVIG have been used.

Conclusion: This case highlights the importance of recognizing ANE beyond its …

Area Deprivation Index And Segregation On The Risk Of Hiv: A U.S. Veteran Case-Control Study, Abiodun O Oluyomi, Angela L Mazul, Yongquan Dong, Donna L White, Christine M Hartman, Peter Richardson, Wenyaw Chan, Jose M Garcia, Jennifer R Kramer, Elizabeth Chiao

2020-Current year OA Pubs

BACKGROUND: Preventing HIV infection remains a critically important tool in the continuing fight against HIV/AIDS. The primary aim is to evaluate the effect and interactions between a composite area-level social determinants of health measure and an area-level measure of residential segregation on the risk of HIV/AIDS in U.S. Veterans.

METHODS: Using the individual-level patient data from the U.S. Department of Veterans Affairs, we constructed a case-control study of veterans living with HIV/AIDS (VLWH) and age-, sex assigned at birth- and index date-matched controls. We geocoded patient's residential address to ascertain their neighborhood and linked their information to two measures of …

The Next Phase In Patient Safety Education: Towards A Standardized, Tools-Based Pathology Patient Safety Curriculum: A Call To Action From The Association Of Pathology Chairs' Residency Program Directors Section Training Residents In Patient Safety Workgroup, Cynthia K Harris, Ronald Jackups Jr, Et Al.

2020-Current year OA Pubs

Patient safety education is a mandated Common Program Requirement of the Accreditation Council for Graduate Medical Education and for the Royal College of Physicians and Surgeons of Canada in all medical residency and fellowship programs. Although many hospitals and healthcare environments have general patient safety education tools for trainees, few to none focus on the unique training milieu of pathologists, including a mix of highly automated and manual error-prone processes, frequent multiplicity of events, and lack of direct patient relationships for error disclosure. We established a national Association of Pathology Chairs-Program Directors Section Workgroup focused on patient safety education for …

Circadian Rhythm Disrupting Behaviours And Cancer Outcomes In Breast Cancer Survivors: A Systematic Review, Kelly D'Cunha, Yikyung Park, Melinda M Protani, Marina M Reeves

2020-Current year OA Pubs

PURPOSE: Circadian rhythm disruptors (e.g., night-shift work) are risk factors for breast cancer, however studies on their association with prognosis is limited. A small but growing body of research suggests that altered sleep patterns and eating behaviours are potential mechanistic links between circadian rhythm disruptors and breast cancer. We therefore systematically summarised literature examining the influence of circadian rhythm disrupting behaviours on cancer outcomes in women with breast cancer.

METHODS: A systematic search of five databases from inception to January 2021 was conducted. Original research published in English, assessing the relationship between post-diagnosis sleep patters and eating behaviours, and breast …

Visual Autism, Margaret Reynolds, Susan M. Culican

2020-Current year OA Pubs

No abstract provided.

Strategies To Prevent Clostridioides Difficile Infections In Acute-Care Hospitals: 2022 Update, Larry K Kociolek, Dale N Gerding, Ruth Carrico, Philip Carling, Curtis J Donskey, Ghinwa Dumyati, David T Kuhar, Vivian G Loo, Lisa L Maragakis, Monika Pogorzelska-Maziarz, Thomas J Sandora, David J Weber, Deborah Yokoe, Erik R Dubberke

2020-Current year OA Pubs

No abstract provided.

Melanoma In A Patient With Dnmt3a Overgrowth Syndrome, David Y Chen, Leslie A Sutton, Sai Mukund Ramakrishnan, Eric J Duncavage, Sharon E Heath, Leigh A Compton, Christopher A Miller, Timothy J Ley

2020-Current year OA Pubs

Alterations in epigenetic regulators are increasingly recognized as early events in tumorigenesis; thus, patients with acquired or inherited variants in epigenetic regulators may be at increased risk for developing multiple types of cancer. DNMT3A overgrowth syndrome (DOS), caused by germline pathogenic variants in the DNA methyltransferase gene

Cis Interactions In The Irf8 Locus Regulate Stage-Dependent Enhancer Activation, Tian-Tian Liu, Feiya Ou, Julia A Belk, Prachi Bagadia, David A Anderson Iii, Vivek Durai, Winnie Yao, Ansuman T Satpathy, Theresa L Murphy, Kenneth M Murphy

2020-Current year OA Pubs

Individual elements within a superenhancer can act in a cooperative or temporal manner, but the underlying mechanisms remain obscure. We recently identified an

Myt1l Is Required For Suppressing Earlier Neuronal Development Programs In The Adult Mouse Brain, Jiayang Chen, Nicole A Fuhler, Kevin K Noguchi, Joseph D Dougherty

2020-Current year OA Pubs

In vitro studies indicate the neurodevelopmental disorder gene myelin transcription factor 1-like (MYT1L) suppresses non-neuronal lineage genes during fibroblast-to-neuron direct differentiation. However, MYT1L's molecular and cellular functions in the adult mammalian brain have not been fully characterized. Here, we found that MYT1L loss leads to up-regulated deep layer (DL) gene expression, corresponding to an increased ratio of DL/UL neurons in the adult mouse cortex. To define potential mechanisms, we conducted Cleavage Under Targets & Release Using Nuclease (CUT&RUN) to map MYT1L binding targets and epigenetic changes following MYT1L loss in mouse developing cortex and adult prefrontal cortex (PFC). We found …

Insights Into The Pathogenesis Of Hereditary Angioedema Using Genetic Sequencing And Recombinant Protein Expression Analyses, Zhen Ren, Shuangxia Zhao, Tiandao Li, H James Wedner, John P Atkinson

2020-Current year OA Pubs

BACKGROUND: The pathogenesis of hereditary angioedema (HAE) type I and type II is linked to defective C1 esterase inhibitor (C1-INH) encoded by the SERPING1 gene. There are substantial variabilities in the clinical presentations of patients with HAE that are not directly correlated to the serum levels of C1-INH. The impact of SERPING1 variants on C1-INH expression, structure, and function is incompletely understood.

OBJECTIVE: To investigate the influence of SERPING1 variants on the C1-INH expression, structure, and function of 20 patients with HAE from 14 families with no prior genetic diagnosis.

METHODS: Patients underwent whole-exome sequencing (WES). If no variants were …

Utilization Of Microwave Ablation As A Novel Approach For Refractory Chylothorax Following Esophagectomy: A Case Report, Khashayar Farahnak, Alejandro De Filippis Falcon, Hailey M Shepherd, Carlos J Guevara, Mayank R Patel, G Alexander Patterson, Varun Puri, Daniel Kreisel, Ruben G Nava

2020-Current year OA Pubs

No abstract provided.

Logistical, Technical, And Radiation Safety Aspects Of Establishing A Radiopharmaceutical Therapy Program: A Case In Lutetium-177 Prostate-Specific Membrane Antigen (Psma) Therapy, Jacqueline E Zoberi, Jose Garcia-Ramirez, David Luechtefeld, Nichole M Maughan, Maxwell Amurao, Reiko Oyama, Brian C Baumann, Hiram A Gay, Jeff M Michalski

2020-Current year OA Pubs

Prostate-specific membrane antigen (PSMA) is a cell surface protein highly expressed in nearly all prostate cancers, with restricted expression in some normal tissues. The differential expression of PSMA from tumor to non-tumor tissue has resulted in the investigation of numerous targeting strategies for therapy of patients with metastatic prostate cancer. In March of 2022, the FDA granted approval for the use of lutetium-177 PSMA-617 (Lu-177-PSMA-617) for patients with PSMA-positive metastatic castration-resistant prostate cancer (mCRPC) who have been treated with androgen receptor pathway inhibition and taxane-based chemotherapy. Therefore, the use of Lu-177-PSMA-617 is expected to increase and become more widespread. Herein, …

Management Of Infusion-Related Reactions (Irrs) In Patients Receiving Amivantamab In The Chrysalis Study, Keunchil Park, Ramaswamy Govindan, Et Al.

2020-Current year OA Pubs

BACKGROUND: Amivantamab, a fully humanized EGFR-MET bispecific antibody, has antitumor activity in diverse EGFR- and MET-driven non-small cell lung cancer (NSCLC) and a safety profile consistent with associated on-target activities. Infusion-related reaction(s) (IRR[s]) are reported commonly with amivantamab. We review IRR and subsequent management in amivantamab-treated patients.

METHODS: Patients treated with the approved dose of intravenous amivantamab (1050 mg, <80 kg; 1400 mg, ≥80 kg) in CHRYSALIS-an ongoing, phase 1 study in advanced EGFR-mutated NSCLC-were included in this analysis. IRR mitigations included split first dose (350 mg, day 1 [D1]; remainder, D2), reduced initial infusion rates with proactive infusion interruption, and steroid premedication before initial dose. For all doses, pre-infusion antihistamines and antipyretics were required. Steroids were optional after the initial dose.

RESULTS: As of 3/30/2021, 380 patients received amivantamab. IRRs were reported in 256 (67%) patients. Signs/symptoms of IRR included chills, dyspnea, flushing, nausea, chest discomfort, and vomiting. Most of the 279 IRRs were grade 1 or 2; grade 3 and 4 …