Medicine and Health Sciences Commons^™

Investigation To Examine The Profile Of Auditory Brainstem And Hearing Thresholds Using Tone Burst Audiometry Brainstem Response In A Preclinical Migraine Model, Megan Huelsing

Graduate Theses/Dissertations

Migraine is a disabling neurological disease that is characterized by prominent auditory symptoms, including hyperacusis, which is defined as extreme sensitivity to sounds. The goal of this study was to investigate changes in hearing sensitivity and neural changes in the brainstem by measuring neural activity of the auditory brainstem in an established preclinical model of chronic migraine. To induce a chronic migraine state within the trigeminal system, male and female Sprague Dawley rats were subjected to three known human risk factors including neck muscle tension and REM sleep deprivation that promote latent sensitization, and exposure to a pungent odor, which …

The Effect Of Different Warm-Up Durations On Subjective And Objective Measures Of Singing In Choral Singers Over The Age Of 55, Jeremy A. Chesman

Graduate Theses/Dissertations

Choral singing is a popular activity in the United States. Choral singers are often encouraged to warm up vocally before they sing. Considering voice conditions, like presbyphonia, that can develop shortly after retirement, more research about vocal warm-ups is needed for those over the age of 55. This study assesses the effects of various durations of vocal warm-ups on subjective and objective measures of the singing voice using a within-groups design with randomized condition order. Nine participants performed vocal warm-ups for 0, 5, 10, and 15 minutes. A song sample was then recorded and sent to two expert raters who …

Continuing, Shauna Le Ann Smith

Graduate Theses/Dissertations

Taking something whole, breaking it apart, and making it into another form of wholeness is the essence of both papermaking and grief. The papermaking process involves separation, maceration, and forming of new life; the grieving process involves a similar evolution. Creating this body of work has been a pursuit of continuation—a part of me forming new life. Using papermaking processes, I create work that is visually quiet. The details are only noticeable through sustained attention and close proximity. The quiet visual qualities are intended to create a viewing experience that is meditative and slow. The lack of details of the …

Synthesis, Characterization, And Application Of Chitosan Nanoparticles For In Vitro Studies On Hela Cancer Cells, Rejeena Jha

Graduate Theses/Dissertations

Chitosan is a fibrous substance that is derived from chitin, a natural substance in the shells of crustaceans. It possesses all the necessary qualities for being used as carrier for the transport of drugs and genes into tumor, such as biodegradability, biocompatibility, hydrophilicity, and non-toxicity and cationic in nature. Ionic gelation method was used to synthesize chitosan (CS) nanoparticles (NPs). Ionic gelation is a very benign process chemically that requires mixing a CS aqueous solution with a sodium tripolyphosphate (TPP) aqueous solution at room temperature. In addition, a surfactant polyethylene oxide (PEO) alone and a diblock copolymer of PEO and …

Expert Search For "Direct Materials For Restoring Caries Lesions", Kelly K. O'Brien

Expert Search Strategies

This search strategy was constructed to support the research for the peer reviewed article listed above. Full article abstract:

Background

The goal of restoring caries lesions is to protect the pulp, prevent progression of the disease process, and restore the form and function of the tooth. The purpose of this systematic review was to determine the effect of different direct restorative materials for treating cavitated caries lesions on anterior and posterior primary and permanent teeth.

Type of Studies Reviewed

The authors included parallel and split-mouth randomized controlled trials comparing the effectiveness of direct restorative materials commercially available in the United …

Optimizing Biomechanical Models: Estimation Of Muscle Tendon Parameters And Ankle Foot Orthosis Stiffness, Sepehr Ramezani

Electronic Theses and Dissertations, 2020-2023

The complexity of the human musculoskeletal system presents challenges in accurately identifying its characteristics, particularly due to the presence of redundant actuators on a single joint. Non-invasive measures are necessary to overcome these challenges. Optimization algorithms have emerged as a crucial tool to advance subject-specific musculoskeletal modeling allows a more realistic representation of biomechanical behaviors, enhancing our understanding of human movement and enabling better clinical decision-making. Furthermore, optimization algorithms play a vital role in customizing rehabilitation and assistive devices, such as orthoses and prostheses. The current ankle-foot orthosis (AFO) stiffness measurement methods require bulky, complex designs, and often permanent modification …

Modeling Behavior And Vaccine Hesitancy For Predicting Daily Vaccination Inoculations Using Trends, Case, Death, And Twitter Sentiment Data, Talal Daghriri

Electronic Theses and Dissertations, 2020-2023

Over the past 100 years, epidemiological models have evolved to incorporate greater facets of the process. With the advent of social networking, massive computational power, population sentiment analysis can now be added to the epidemiological modeling process. Sentiment analysis is greater understanding of the fears, uncertainties, motivation, and trends of the public with respect to vaccination and associated events. Lack of public confidence in the efficacy of models, safety of vaccines, and appropriateness of policies confounds vaccine inoculation prediction. Sentiment analysis of social media is a seminal technique that accesses shared users' contents and tweets on the Twitter platform for …

Efficacy And Safety Of Vibegron For The Treatment Of Overactive Bladder In Women: A Subgroup Analysis From The Double-Blind, Randomized, Controlled Empowur Trial, Diane K. Newman Dnp, Elizabeth Thomas Ms, Heather Greene Mph, Cornelia Haag-Molkenteller Md, Susann Varano Md

Physician Associate Studies Faculty Publications

Importance The international phase 3 EMPOWUR trial demonstrated efficacy and safety of vibegron, a newer b3-adrenergic receptor agonist, in adults with overactive bladder (OAB). Women are disproportionately affected by OAB, especially those with bothersome symptoms, such as urge urinary incontinence (UUI). Objective This subgroup analysis from EMPOWUR assessed efficacy and safety of vibegron in women. Study Design In EMPOWUR, patients with OAB were randomized 5:5:4 to 12 weeks of treatment with once-daily vibegron 75 mg, placebo, or tolterodine 4-mg extended release. Efficacy end points included change from baseline at week 12 in mean daily number of micturitions, UUI episodes, and …

Biomonitoring Of Exposure To Multiple Metal Components In Urine, Hair And Nails Of Apprentice Welders Performing Shielded Metal Arc Welding (Smaw), Jairo Buitrago-Cortes, Philippe Sarazin, Denis Dieme, Jonathan Côté, Capucine Ouellet, Naïma El Majidi, Michèle Bouchard

Études primaires

Welding fumes are associated with various diseases. Increased air levels of metals were reported during welding. However, few multielement biomonitoring studies were conducted to assess the actual dose of metal components absorbed in apprentice welders in a learning environment. This research aimed to establish the nature and level of exposure to welding fumes and their metallic components in apprentice welders performing ‘Shielded Metal Arc Welding’ (SMAW), based on multi-element and multi-matrix analyses. A total of 86 apprentice welders were recruited in three different schools in Montreal, Québec, Canada. Twenty-one elements were measured in urine, hair, fingernail, and toenail samples collected …

Perinatal Mood And Anxiety Disorders: Exploring The Care Deficit, Alexandria Alford, Joanne Chopak-Foss, Alisha Riggins, Tobi Oloyede, Emmanuela Nwaonumah, Sarah Sejoro

Eagles Talking About the Public’s Health

No abstract provided.

An Eviction Notice: Why Increasing Rates Of Elective Cesarean Deliveries Are A Cause For Concern, Jessica Guerrette, Amber J. Culpepper, Logan Cowan

Eagles Talking About the Public’s Health

No abstract provided.

The Role Of K-12 Schools As Essential Public Health Partners, Wendy Kutten, Naa-Amy Wayne, Samuel T. Opoku, Bettye Apenteng

Eagles Talking About the Public’s Health

No abstract provided.

Tuberculosis: Screening, Treatment, And Eradication Battles Among Foreign-Born Residents In Georgia, Foram Patel, Linda Kimsey

Eagles Talking About the Public’s Health

No abstract provided.

Location Of The Fibronectin Binding Domain On The Fibronectin Attachment Protein Of Mycobacterium Avium Subsp. Paratuberculosis, Chrissy Rose Hattery

All Graduate Theses, Dissertations, and Other Capstone Projects

Mycobacterium avium paratuberculosis (MAP) is an acid-fast bacillus that causes a fatal granulomatous ileocolitis called Johne’s Disease that affects primarily ruminants. The impact of MAP infection in the US dairy industry is particularly severe, with up to 70.4% of the herds being infected and annual losses as high as $1.5 billion. MAP is capable of persisting for months in the livestock environment and surviving the pasteurization process. While several vaccines are available, none can prevent infection and treatment with antimycobacterial chemotherapy does not result in a cure. Management and control of MAP infection requires characterization of host-pathogen interaction at the …

Use Of A Nurse-Led Daily Goals Checklist To Improve Multidisciplinary Rounds In The Icu, Marissa Riley

DNP Projects

Research has shown a multidisciplinary rounding approach can improve patient care outcomes in the intensive care unit (ICU). Due to the complexity and wide range of the healthcare team, many patient details and treatment goals may be overlooked during daily patient rounds without a daily goals checklist to help ensure collaboration and communication of the multidisciplinary team. A nurse led daily goals checklist could be useful for framing nurse-provider conversations to promote comprehensive communication and collaboration. The purpose of this project was to improve adherence to a nurse-led daily goals checklist to improve communication and collaboration between the nurses and …

The Impact Of Flooding Events In Kentucky Counties On Preventable Asthma Hospitalizations, Mckaylee Copher

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Objective: Given the frequency and intensity of flooding, along with the disparities in respiratory illnesses in Kentucky, this study aims to determine if there is an association between flooding and asthma is crucial to the health of the state population.

Methods: Preventable asthma hospitalizations in adults aged 18-39 were obtained from the Kentucky Cabinet of Health and Family Services, Health and Facility Services Data and included the count of admissions of an ICD-9 diagnosis of asthma, as determined by hospital discharge data. FEMA disaster declarations were used to identify 69 counties that had floods during the period of 2008-2015. A …

Sociodemographic Factors Related To Late-Stage Lung Cancer Diagnosis In Kentucky, Kaylee Stickler

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Lung cancer is the leading cause of cancer mortality in the United States, and the state of Kentucky has a significant burden of lung cancer morbidity and mortality. The aim of this study is to examine the sociodemographic factors associated with late-stage lung cancer diagnosis in Kentucky. The present study is a retrospective, population-based cohort study that utilizes data from the Kentucky Cancer Registry to examine the associations between late-stage lung cancer diagnosis and sociodemographic factors. Descriptive, bivariate, and multivariable analyses were conducted to estimate the significance of these associations. Significant relationships between the variables of sex, age, Appalachian status, …

Implementation Of A Multipronged Approach To Improve Pre-Operative Efficiency And First Case On Time Start Performance, Melyssa A. Stokes

Master's Theses and Capstones

Background: Surgical services are an important source of revenue and important economic driver of hospital systems. Surgical services account for approximately 42% of a hospital’s annual revenue, however, it also constitutes 40% of facility operating costs (Gupta, et al., 2022 & Morel & Gomez, 2021). Despite the high costs associated with surgical services delays remain a significant issue across the nation. On-time starts for the first surgical cases of the day is a key performance metric tracked by surgical facilities to determine efficiency. Currently, 50 – 90% of first surgical cases are delayed throughout the United States and the most …

Implementation Of Point-Of-Care Tick-Borne Disease Powerplan™ And Algorithm For Early Detection And Treatment Of Tick-Borne Diseases, Ashley Pinkham

DNP Scholarly Projects

Abstract

Local Problem: The Concord Hospital system, serving 30+ communities, is situated in the heart of New Hampshire surrounded by densely wooded forests, lakes, and mountains and is a mecca for camping, vacationing, and sightseeing, doubling its population of 1.6 million residents during spring, summer, and fall months. Despite the serenity, there is a predator that lingers among the hiking trails and lake shorelines. From January 2021 through August 2022 there were a total of 41 hospitalizations from tick-borne diseases, some with life threatening symptoms. Unfortunately, nearly half (43%) of patients presented to their primary care provider first where the …

Increasing Access And Adherence To Cognitive Behavioral Therapy For Insomnia (Cbti) For Adults: A Quality Improvement Project, Kristen Newell

DNP Scholarly Projects

BACKGROUND: Insomnia is a sleep disorder that is becoming more prevalent. It can significantly impact a person's quality of life and it contributes to a substantial economic financial burden. Cognitive behavioral therapy for insomnia (CBTi) is the primary treatment for insomnia, but patients are rarely referred for this treatment. This quality improvement project focused on implementing motivational interviewing to increase patient utilization of CBTi. It also encouraged utilization of CBTi Coach, a free phone application that has all of the CBTi components, a rigid sleep behavioral plan and frequent follow-up appointments to improve sleep quantity and quality.

INTERVENTION: Patients that …

Improving Provider Retention Through Addressing Burnout At A Federally Qualified Health Center: A Quality Improvement Initiative, Emily Grattan

DNP Scholarly Projects

Background: Primary care providers employed by federally qualified health centers (FQHC) working with underserved populations experience high levels of burnout as patients are often medically complex, face healthcare disparities and societal stigmas. The aim of the project was to alleviate burnout and improve provider retention through introduction of organizational support measures. Participants involved were healthcare providers, as well as nurse management and senior leadership.

Methods: The quality improvement approach for this project utilized the Plan-Do-Study-Act (PDSA) cycle and a driver diagram to guide the selected interventions. Interventions were based on categories from Mayo’s Clinic’s Nine Organizational Strategies to Promote Engagement …

Intervention To Improve Screening Mammograms In Clinical Practice., Saida Khamooshi

DNP Scholarly Projects

Abstract

Breast cancer remains a challenging health issue in the United States, representing the second leading cause of cancer deaths for women. The key approach to tackle this issue is the early detection of breast cancer through annual mammography screening in asymptomatic women. This quality improvement project sought to improve the proportion of breast cancer screening documentation in a private obstetrics and gynecology practice that serves primarily Black women. In addition, the project is thought to improve the current utilization of office mammogram services and its mammogram completion rate. Comprehensive interventions implemented included establishing clear guidelines, staff education, using paper …

Decreasing Post-Operative Ventilator Time In The Cardiovascular Surgical Patient: A Nursing Education Quality Initiative, Amanda J. Bruno Roberts

DNP Scholarly Projects

Extended mechanical ventilation times after open heart surgery can contribute to complications prolonging recovery and length of stay, as well as increasing mortality. Standardized staff education of immediate post-open-heart recovery and ventilator weaning protocols, combined with the use of ABCDE and VAP bundles can reduce these complications. At Hospital X during summer of 2022, the average length of time patients remained mechanically ventilated after open heart surgery increased. After an initial needs survey was distributed to nursing staff, a set of novel QR codes was created to simplify and centralize training for staff in the ICU to facilitate early extubation …

Barriers To Outdoor Recreation For Marginalized Groups At The University Of Montana, Sabine R. Englert, Beatrix Frissell, Adrienne Liebert, Sophia Rodriquez, Margaret Jensen, Rachana Harris, Abby Doss

Undergraduate Theses, Professional Papers, and Capstone Artifacts

Exclusion from outdoor recreation reflects legacies of oppression of marginalized communities and makes access to the outdoors not equally available. In the United States, approximately 38% of Black Americans and 48% of Hispanic Americans participated in outdoor recreation in 2020. This is compared to 55% participation among Caucasian Americans. Many other intersecting identities are actively excluded, including people with disabilities, fat populations, and members of the LGBTQIA2S+ community; furthermore, class-based hierarchies are shown through the restricted outdoor access of low-income populations.

While numerous studies show a lack of diversity in outdoor recreation, little to no research has been conducted on …

The Write Stuff - Winter 2023 (Vol. 20, No. 1), Research Medical Library

Write Stuff 2023

• Protected health information
• Literature reviews: Which type should I write?
• Finding examples of funded NIH applications
• New NIH policy for data management and sharing now in effect
• Unusual terms used in scientific writing and publishing: Person-first language

Covid Vaccines For All?, Junaid Nabi

Faculty Journal Articles

Healthcare workers are still the best bet for increasing vaccine uptake, say behavioral economists.

The Synergy Between Physiologic Dendritic Cells And Mrna-Loaded Lipid Nanoparticles And Its Potential As A Cellular Immunotherapy, Brian Myles Wei

Yale Medicine Thesis Digital Library

Transimmunization (TI) is a dendritic cell (DC)-based immunotherapy derived from extracorporeal photochemotherapy (ECP), a widely used immunotherapy for cutaneous T cell lymphoma. TI builds upon the mechanistic understanding that ECP inducts large-scale monocyte-to-dendritic cell differentiation through physiologic platelet-monocyte interactions that occur during the passage of cells over a plastic plate. While TI and ECP have used apoptotic tumor cells treated with 8-methoxypsoralen (8-MOP) and ultraviolet-A (UVA) irradiation as the source of antigens by which to target its immunotherapeutic effects, there is investigational interest in alternative antigen sources, including mRNA-containing lipid nanoparticles (LNP). In this work, we developed a modified version …

Improving Delivery Of Immunomodulator Mpla With Biodegradable Nanoparticles, Jungsoo Chang

Yale Medicine Thesis Digital Library

Encapsulation of therapeutic agents within biodegradable nanoparticles (NP) allows for gradual drug release from the nanoparticle core. When injected intravenously, our nonadhesive NPs (NNP) have previously demonstrated longer circulatory time with “stealthy” features, thus allowing for prolonged drug exposure systemically. In the murine transplantable cutaneous squamous cell carcinoma (SCC) PDVC57 model, our bioadhesive NP (BNP) loaded with chemotherapy have shown increased retention of the active agent after intratumoral (i.t.) injection, thus allowing for prolonged drug exposure when locally delivered. Monophosphoryl lipid A (MPLA) is a low-toxicity derivative of LPS with immunomodulating properties. However, MPLA, like other TLR agonists, is a …

Emergency Medicine Resident Perceptions Of A Medical Wilderness Adventure Race (Medwar), Lake Crawford

Yale Medicine Thesis Digital Library

Effective Wilderness Medicine (WM) resident education can be challenging to achieve in the traditional classroom setting. The Medical Wilderness Adventure Race (MedWAR) was developed to teach and test WM using simulated scenarios in an austere setting under physical, environmental, and psychological stress. The objective of this study was to evaluate participant perceptions of simulation-based WM training in an Emergency Medicine (EM) residency MedWAR. A 20-question descriptive survey was administered to participants of an academic EM residency program’s annual MedWAR during 2021 and 2022. The event took place during weekly scheduled didactic time at local state parks in July. The questionnaire …

Nonoperative Management Of Shoulder Instability, Margie K. Olds, Timothy L. Uhl

Physical Therapy Faculty Publications

Non-operative management following a shoulder dislocation or subluxation remains a challenging and complex task. Accurate diagnosis of the condition, and shared decision-making regarding operative and non-operative management, as well as timing of return to play is required. This clinical concept paper introduces a shoulder instability framework that addresses these fundamental clinical dilemmas. Valid clinical prognostic tools which can predict recurrent shoulder instability are reviewed. The process of shared decision-making within the realm of shoulder instability is also presented. Finally, a framework for progressive rehabilitation that addresses deficits in motor control, strength, and endurance in scapula and shoulder musculature is presented …