Medicine and Health Sciences Commons^™

A Fleeting Glimpse Of Functional Benefit Of The Complete Dmd Gene In A Large Animal Model Of Duchenne Muscular Dystrophy, Eric P. Hoffman

Pharmacy Faculty Scholarship

No abstract provided.

Health Issues Among Nepalese Youth: A Literature Review, Veenah Stoll, Naomi Edwin, Kripa Dahal, John Barnes, Miranda Pfautsch, Lahana Maharjan, Cyril Blavo

HPD Articles

Nepal is one of the world's least-developed countries. Nepalese children are often vulnerable to a lack of resources which leads to suboptimal levels of health in turn. This review article aims to identify health issues and inequities faced by school-aged children greater than five years old in Nepal. A comprehensive search of the literature was conducted in PubMed and Global Health databases to gather relevant studies. Inclusion and exclusion criteria were applied to select appropriate articles, and 35 full-length articles were reviewed in-depth. The literature supports the association between inadequate resource distribution among Nepalese children and poorer health outcomes compared …

Nevada Medical Residencies, 2023, Annie J. Vong, Emily J. Daclan, Caitlin J. Saladino, William E. Brown Jr.

Health

This fact sheet highlights medical residency data for the 2021, 2022, 2023 graduating classes of the Kirk Kerkorian School of Medicine at the University of Nevada, Las Vegas (UNLV) and the University of Nevada, Reno (UNR) School of Medicine. This fact sheet presents the number of residency program matches at the Kirk Kerkorian School of Medicine at UNLV and the UNR School of Medicine and reveals where Nevada medical school students pursue their residencies, and updates findings from a 2022 fact sheet exploring 2021 and 2022 graduating class data.

Probing The Activation Mechanisms Of Agonist Dpi-287 To Delta-Opioid Receptor And Novel Agonists Using Ensemble-Based Virtual Screening With Molecular Dynamics Simulations., Emily Dean, Annemarie Dominique, Americus Palillero, Annie Tran, Nicholas Paradis, Chun Wu

College of Science & Mathematics Departmental Research

Pain drugs targeting mu-opioid receptors face major addiction problems that have caused an epidemic. The delta-opioid receptor (DOR) has shown to not cause addictive effects when bound to an agonist. While the active conformation of the DOR in complex with agonist DPI-287 has been recently solved, there are still no FDA-approved agonists targeting it, providing the opportunity for structure-based virtual screening. In this study, the conformational plasticity of the DOR was probed using molecular dynamics (MD) simulations, identifying two representative conformations from clustering analysis. The two MD conformations as well as the crystal conformation of DOR were used to screen …

A Bifactor Model Supports Unidimensionality Of The International Knee Documentation Committee Subjective Knee Form In Young Active Patients With Anterior Cruciate Ligament Tears: A Retrospective Analysis Of A Randomized Controlled Trial., Hana Marmura, Paul F Tremblay, Alan M J Getgood, Dianne M Bryant

Health and Rehabilitation Sciences Publications

BACKGROUND: The International Knee Documentation Committee Subjective Knee Form (IKDC) is the most highly recommended patient reported outcome measure for assessing patients with anterior cruciate ligament (ACL) injuries and those undergoing ACL reconstruction (ACLR) surgery. The IKDC was developed as a unidimensional instrument for a variety of knee conditions. Structural validity, which determines how an instrument is scored, has not been definitively confirmed for the IKDC in respondents with ACL injuries, and in fact an alternative two-factor/subscale structure has been proposed in this population. The purpose of this study was to determine the most appropriate structure and scoring system for …

Assessing Non-Invasive Imaging Devices To Detect Temperature Differentiation And Lymphatic/Venous Flow To The Head And Neck During Head Down Tilt, Supine, And Sitting Positions The Niid Study (Non-Invasive Imaging Device), Matthew Melin, Heather Hettrick, Frank Aviles, Johanna Pannunzio, Nathan Sirkis, Chantel Hubbard, Patrick Hardigan, Sabrina Ginsburg, Harvey N. Mayrovitz

HPD Articles

Under the influence of standard developmental physiology on the Earth’s surface (1 gravity equivalent known as “1G”), 70% of body fluids reside below the level of the heart.Fluid shifts towards the cephalic region during microgravity have also been speculated to contribute towards spaceflight associated neuroocular syndrome (SANS).Although a significant barrier to spaceflight, the underlying mechanism of SANS is not well understood, partially due to the spaceflight environment and limited medical capabilities including invasive diagnostic testing. Thus, non-invasive approaches to studying real-time fluid shifts in weightlessness could serve as critical areas of research to further SANS study and effective countermeasure protocol …

The Effect Of Long Covid Syndrome On Physical Activity, Patrisha Hanna Villarmea

Master of Science in Kinesiology

Long covid syndrome is a condition where individuals experience persistent symptoms and functional limitations that can last about three months to two years after the initial Covid-19 infection. While long-term health consequences of Covid-19 have garnered significant attention,the impact of long covid syndrome symptoms is poorly understood. The purpose of the study is to explore the effect of long covid syndrome symptoms to an individual’s physical activity. Furthermore, this research aims to provide an overview of the existing literature on the effect of long covid syndrome symptoms on physical activity. The research would invite participants to answer two surveys that …

Addressing The Gaps: Pain Management, Multimodal Analgesia, And Crna Education, Hunter Niemeyer

Doctor of Nursing Practice (DNP) Student Projects

Background and Review of Literature: Opioid consumption, addiction, and narcotic-related deaths are a prevalent public health issue in the United States. Opioids are often administered throughout the perioperative period, and their utilization can lead to unwanted side effects and negative patient outcomes. Certified Registered Nurse Anesthetists (CRNAs) are strategically placed in hospital systems; these clinicians may advocate for the responsible administration of opioids and utilize multimodal pain strategies.

Purpose: This project assessed the knowledge and attitudes of CRNAs before and after the implementation of an educational program based on the prevention of operative pain, multimodal approaches, and the perioperative use …

Standardizing Intraoperative Handoffs Amongst Certified Registered Nurse Anesthetists, Mallory Light

Doctor of Nursing Practice (DNP) Student Projects

Background and Review of Literature: Communication errors are a leading cause of preventable medical errors and inadequate handoffs have been linked to sentinel events. Research has shown that standardizing handoff processes can reduce errors, improving patient safety, and resulting in other positive outcomes including increased staff satisfaction, without impacting handoff duration.

Purpose: The purpose of this project was to determine how the implementation of a standardized handoff tool would impact perceptions of handoff communications, retention of important patient information relayed during handoffs, staff satisfaction, and handoff duration.

Implementation Plan and Methods: Information regarding use of the tool was sent to …

Efficacy Of A Mixed Methods Training Program For Transthoracic Echocardiography, Britni Tharp

Doctor of Nursing Practice (DNP) Student Projects

Background and Review of Literature: Currently, there is a knowledge gap in CRNA education. As anesthesia providers, CRNAs are licensed to perform cardiac diagnostic imaging such as TTE during surgery, yet it is often missing from CRNA school curriculum. Other studies have shown that simulation is an effective way of teaching this crucial skill.

Purpose: The project’s goal was to establish the efficacy of using a mixed model computerized and in-person simulation program for training CRNAs in the use of TTE during non-cardiac surgery.

Methods: A training program was created that uses a computerized training session along with a …

Gastric Point-Of-Care Ultrasound Education For Certified Registered Nurse Anesthetists, Robert Graham

Doctor of Nursing Practice (DNP) Student Projects

Background: Pulmonary aspiration is a significant risk of general anesthesia and is related to increased perioperative morbidity and mortality. Gastric point-of-care ultrasound (POCUS) has been shown to be a reliable indicator of gastric contents and volume, and it can be used in the perioperative setting to detect gastric contents and make informed clinical decisions to prevent aspiration events.

Purpose: This project aimed to educate Certified Registered Nurse Anesthetists (CRNAs) at Washington University in the use of point-of-care ultrasound to assess gastric contents prior to surgery with the overall goal of improving knowledge, skills, and attitudes towards this practice …

Anesthesia Provider Education On The Adherence To The Fourth Consensus Guidelines For The Management Of Postoperative Nausea And Vomiting, Christine Johnson

Doctor of Nursing Practice (DNP) Student Projects

Background and Review of Literature: The occurrence of postoperative nausea and vomiting (PONV) has been linked to unplanned admissions, longer post-anesthesia care recovery units (PACU) times, and decreased patient satisfaction. The Fourth Consensus Guidelines for the Management of PONV released new guidelines in 2020 outlining evidence-based practice to manage PONV. A literature review was conducted on a total of 10 studies. The findings support the methods these guidelines employ.

Purpose: This quality improvement (QI) project aims to provide education for anesthesia providers on the fourth consensus guidelines and improve provider adherence.

Methods: A six-minute educational video, post-education quiz, provider …

Education Aimed To Increase Train-Of-Four Ratio Use, Frank Bougher

Doctor of Nursing Practice (DNP) Student Projects

Background and Review of Literature: The current state of practice surrounding non-depolarizing neuromuscular blocking drug monitoring is variable among practitioners and poses a safety risk to patients who may subsequently experience residual neuromuscular blockade and complications. The literature supports that train-of-four ratio monitoring, with an emphasis on use prior to extubation, is superior to other techniques and reduces the occurrence of complications related to residual neuromuscular blockade, improving patient safety and outcomes.

Purpose: The purpose of the project was to determine if an education intervention founded on evidence-based neuromuscular monitoring leads to increased use of train-of-four ratio in practitioner …

Educating Perioperative Nurses On Preventing Hypothermia In Surgical Patients, Bethany Geisler

Doctor of Nursing Practice (DNP) Student Projects

Perioperative hypothermia (PH) is a preventable complication of surgical procedures that has been linked to postoperative conditions such as coagulopathies, increased cardiac morbidity, surgical site infection, increased incidence of pressure ulcers, increased length of hospital stay, and increased financial expense. Anesthetic agents given to patients during surgery directly contribute to PH and associated complications.

Background: Perioperative is a time frame involving the three stages of surgery (preoperative, intraoperative, and postoperative). Hypothermia is defined as body core temperature below 36 degrees Celsius. The incidence of PH ranges from 11% to 90% depending on the anesthesia administered, type of surgery, length of …

Anesthesia Provider’S Use And Perception Of Emergency Cognitive Aids, Katie Mette

Doctor of Nursing Practice (DNP) Student Projects

Cognitive aids have been shown to increase proper use of evidence-based practice treatment strategies in emergent scenarios. These treatment strategies can be unfamiliar to the provider as emergencies are rare, and when coupled with a heightened stress level and sense of urgency, relying on memory alone can be challenging. The purpose of this project was to implement a set of emergency-use cognitive aids developed by Stanford University known as the Stanford Emergency Manual into a set of operating rooms and measure the anesthesia providers use and perception of the cognitive aid via pre-implementation and post-implementation e-mailed surveys.

Leadership Paper, Raquel Zeidlik

AI Assignment Library

The purpose of this formal paper is to explore effective nursing leadership characteristics. This essay will examine the leadership role of a nurse. Using evidence and supporting literature, the student will demonstrate their understanding of nursing leadership characteristics and skills and how they apply to clinical practice.

Promoting Personal Agency In Nursing Students' Ability To Evaluate Evidence, Kaitlyn Kelly

AI Assignment Library

In NURS450: Transition to Practice Seminar, the senior capstone for graduating nursing students and an essential studies class focused on information literacy, we examine research studies with a CASP Programme checklist, which helps students understand the validity and applicability of published research to their patient populations. In this assignment AI, specifically ChatGPT, is used to generate a fictional randomized controlled trial. Students are guided through the checklist and a group discussion on whether that study meets the requirements to be considered valid and applicable to a local population (with the assumption that the study was real). The purpose is to …

Public Health Ai Assignment, Amber Lyon-Colbert

AI Assignment Library

This assignment utilizes course foundational knowledge: Explain the social, political and economic determinants of health and how they contribute to population health and health inequities. This assignment addresses and strengthens our CEPH Competency #5 D2-11 Select methods to evaluate public health programs.

Sigra: Single-Cell Spatial Elucidation Through An Image-Augmented Graph Transformer, Ziyang Tang, Zuotian Li, Tieying Hou, Tonglin Zhang, Baijian Yang Ph.D., Jing Su, Qianqian Song

Publications

Recent advances in high-throughput molecular imaging have pushed spatial transcriptomics technologies to subcellular resolution, which surpasses the limitations of both single-cell RNA-seq and array-based spatial profiling. The multichannel immunohistochemistry images in such data provide rich information on the cell types, functions, and morphologies of cellular compartments. In this work, we developed a method, single-cell spatial elucidation through image-augmented Graph transformer (SiGra), to leverage such imaging information for revealing spatial domains and enhancing substantially sparse and noisy transcriptomics data. SiGra applies hybrid graph transformers over a single-cell spatial graph. SiGra outperforms state-of-the-art methods on both single-cell and spot-level spatial transcriptomics data …

Randomized Controlled Trial Of Mechanical Thrombectomy Vs Catheter-Directed Thrombolysis For Acute Hemodynamically Stable Pulmonary Embolism: Rationale And Design Of The Peerless Study, Carin F. Gonsalves, C Michael Gibson, Stefan Stortecky, Roger A Alvarez, Daren M Beam, James M Horowitz, Mitchell J Silver, Catalin Toma, John H Rundback, Stuart P Rosenberg, Craig D Markovitz, Thomas Tu, Wissam A Jaber

Department of Radiology Faculty Papers

BACKGROUND: The identification of hemodynamically stable pulmonary embolism (PE) patients who may benefit from advanced treatment beyond anticoagulation is unclear. However, when intervention is deemed necessary by the PE patient's care team, data to select the most advantageous interventional treatment option are lacking. Limiting factors include major bleeding risks with systemic and locally delivered thrombolytics and the overall lack of randomized controlled trial (RCT) data for interventional treatment strategies. Considering the expansion of the pulmonary embolism response team (PERT) model, corresponding rise in interventional treatment, and number of thrombolytic and nonthrombolytic catheter-directed devices coming to market, robust evidence is needed …

Biosafety And Biohazard Considerations Of Hsv-1-Based Oncolytic Viral Immunotherapy., Elizabeth Robilotti, Nathalie C Zeitouni, Marlana Orloff

Department of Medical Oncology Faculty Papers

Oncolytic viral immunotherapies are agents which can directly kill tumor cells and activate an immune response. Oncolytic viruses (OVs) range from native/unmodified viruses to genetically modified, attenuated viruses with the capacity to preferentially replicate in and kill tumors, leaving normal tissue unharmed. Talimogene laherparepvec (T-VEC) is the only OV approved for patient use in the United States; however, during the last 20 years, there have been a substantial number of clinical trials using OV immunotherapies across a broad range of cancers. Like T-VEC, many OV immunotherapies in clinical development are based on the herpes simplex virus type 1 (HSV-1), with …

Innovations In Health-Care Service Delivery During The Pandemic, Taryn Vian, Ankita Meghani Phd

Nursing and Health Professions Faculty Research and Publications

The COVID-19 pandemic disrupted health service delivery as countries implemented lockdowns and issued stay-at-home orders. Despite attempts to make essential health services available throughout, the pandemic strained health systems and resulted in rampant shortages of health commodities, beds and health-care staff. There were concomitant declines in tuberculosis screening, HIV testing, and maternal and child health services.2 However, the global pandemic also accelerated the pace of innovation. Some initiatives served as stopgap measures implemented to maintain health services, whereas others helped leapfrog progress in the areas of health information systems, telemedicine, and regulatory policy, bringing efficiencies that could be applied even …

The Endosomal Escape Vehicle Platform Enhances Delivery Of Oligonucleotides In Preclinical Models Of Neuromuscular Disorders, Xiang Li, Mahboubeh Kheirabadi, Patrick G Dougherty, Kimberli J Kamer, Xiulong Shen, Nelsa L Estrella, Suresh Peddigari, Anushree Pathak, Sara L Blake, Emmanuelle Sizensky, Carmen Del Genio, Arti B Gaur, Mohanraj Dhanabal, Mahasweta Girgenrath, Natarajan Sethuraman, Ziqing Qian

Faculty, Staff and Student Publications

Biological therapeutic agents are highly targeted and potent but limited in their ability to reach intracellular targets. These limitations often necessitate high therapeutic doses and can be associated with less-than-optimal therapeutic activity. One promising solution for therapeutic agent delivery is use of cell-penetrating peptides. Canonical cell-penetrating peptides, however, are limited by low efficiencies of cellular uptake and endosomal escape, minimal proteolytic stability, and toxicity. To overcome these limitations, we designed a family of proprietary cyclic cell-penetrating peptides that form the core of our endosomal escape vehicle technology capable of delivering therapeutic agent-conjugated cargo intracellularly. We demonstrated the therapeutic potential of …

Interaction Between Myelodysplasia-Related Gene Mutations And Ontogeny In Acute Myeloid Leukemia, Joseph G W Mccarter, David Nemirovsky, Christopher A Famulare, Noushin Farnoud, Abhinita S Mohanty, Zoe S Stone-Molloy, Jordan Chervin, Brian J Ball, Zachary D Epstein-Peterson, Maria E Arcila, Aaron J Stonestrom, Andrew Dunbar, Sheng F Cai, Jacob L Glass, Mark B Geyer, Raajit K Rampal, Ellin Berman, Omar I Abdel-Wahab, Eytan M Stein, Martin S Tallman, Ross L Levine, Aaron D Goldberg, Elli Papaemmanuil, Yanming Zhang, Mikhail Roshal, Andriy Derkach, Wenbin Xiao

Faculty, Staff and Student Publications

Accurate classification and risk stratification are critical for clinical decision making in patients with acute myeloid leukemia (AML). In the newly proposed World Health Organization and International Consensus classifications of hematolymphoid neoplasms, the presence of myelodysplasia-related (MR) gene mutations is included as 1 of the diagnostic criteria for AML, AML-MR, based largely on the assumption that these mutations are specific for AML with an antecedent myelodysplastic syndrome. ICC also prioritizes MR gene mutations over ontogeny (as defined in the clinical history). Furthermore, European LeukemiaNet (ELN) 2022 stratifies these MR gene mutations into the adverse-risk group. By thoroughly annotating a cohort …

Cell-Type-Specific Alternative Polyadenylation Promotes Oncogenic Gene Expression In Non-Small Cell Lung Cancer Progression, Kexin Huang, Yun Zhang, Xiaorui Shi, Zhiqin Yin, Weiling Zhao, Liyu Huang, Fu Wang, Xiaobo Zhou

Faculty, Staff and Student Publications

Disrupted alternative polyadenylation (APA) is frequently involved in tumorigenesis and cancer progression by regulating the gene expression of oncogenes and tumor suppressors. However, limited knowledge of tumor-type- and cell-type-specific APA events may lead to novel APA events and their functions being overlooked. Here, we compared APA events across different cell types in non-small cell lung cancer (NSCLC) and normal tissues and identified functionally related APA events in NSCLC. We found several cell-specific 3'-UTR alterations that regulate gene expression changes showed prognostic value in NSCLC. We further investigated the function of APA-mediated 3'-UTR shortening through loss of microRNA (miRNA)-binding sites, and …

Disease Modeling And Gene Correction Of Lgmdr21 Ipscs Elucidates The Role Of Poglut1 In Skeletal Muscle Maintenance, Regeneration, And The Satellite Cell Niche, Jose L Ortiz-Vitali, Jianbo Wu, Nasa Xu, Annie W Shieh, Nima Niknejad, Megumi Takeuchi, Carmen Paradas, Chunru Lin, Hamed Jafar-Nejad, Robert S Haltiwanger, Sidney H Wang, Radbod Darabi

Faculty, Staff and Student Publications

Autosomal recessive limb-girdle muscular dystrophy 21 (LGMDR21) is caused by pathogenic variants in protein O-glucosyltransferase 1 (POGLUT1), which is responsible for O-glucosylation of specific epidermal growth factor (EGF) repeats found in ∼50 mammalian proteins, including Notch receptors. Previous data from patient biopsies indicated that impaired Notch signaling, reduction of muscle stem cells, and accelerated differentiation are probably involved in disease etiopathology. Using patient induced pluripotent stem cells (iPSCs), their corrected isotypes, and control iPSCs, gene expression profiling indicated dysregulation of POGLUT1, NOTCH, muscle development, extracellular matrix (ECM), cell adhesion, and migration as involved pathways. They also exhibited reduced in vitro …

Lifetime Aortic Management In Marfan Syndrome: Puzzle Pieces And Rare Diseases, Joseph S Coselli, Lauren M Barron

Faculty, Staff and Students Publications

No abstract provided.

Clinical Outcomes Following Bifurcation Techniques For Percutaneous Coronary Intervention, Chayakrit Krittanawong, Hafeez Ul Hassan Virk, Yusuf Kamran Qadeer, Umer Irshad, Zhen Wang, Mahboob Alam, Samin Sharma

Faculty, Staff and Students Publications

Bifurcation lesions account for 20% of all percutaneous coronary interventions and represent a complex subset which are associated with lower procedural success and higher rates of restenosis [...].

Description Of A New Pavlovskyella Species (Acari: Argasidae) From Chile, Sebastián Muñoz-Leal, José M Venzal, Alexander R Kneubehl, Job E Lopez, Thiago F Martins, Marcelo B Labruna

Faculty, Staff and Students Publications

Soft ticks (Argasidae) of the Pavlovskyella Pospelova-Shtrom subgenus are important vectors of relapsing fever spirochetes, which are agents of disease globally. South American representatives of the Pavlovskyella subgenus include 3 species: Ornithodoros (Pavlovskyella) brasiliensis Aragão, Ornithodoros (Pavlovskyella) furcosus Neumann, and Ornithodoros (Pavlovskyella) rostratus Aragão. Here, we describe a fourth species based on morphological and mitogenomic evidence of ticks collected in burrows of unknown hosts in central Chile. The larva of the new species separates from other South American soft ticks by the following combination of characters: 13 pairs of dorsolateral setae, dorsal plate hexagonal, hypostome blunt with denticles from apex …

Mosunetuzumab Monotherapy Is Active And Tolerable In Patients With Relapsed/Refractory Diffuse Large B-Cell Lymphoma, Nancy L Bartlett, Et Al.

2020-Current year OA Pubs

As part of a phase 1 or 2 study, this single-arm expansion cohort established the efficacy and safety of mosunetuzumab monotherapy in patients with relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL) (received ≥2 previous lines of therapy). Intravenous mosunetuzumab was administered with cycle (C) 1 step-up dosing for cytokine release syndrome (CRS) mitigation: C1 day (D) 1: 1 mg; C1D8 2 mg; C1D15 and C2D1: 60 mg; C3 + D1: 30 mg. Hospitalization was not mandatory. Patients with complete response (CR) completed treatment after C8; those with partial response or stable disease continued treatment for a total of 17 cycles. …