Medicine and Health Sciences Commons^™

Cdk8 And Cdk19: Positive Regulators Of Signal-Induced Transcription And Negative Regulators Of Mediator Complex Proteins, Mengqian Chen, Jing Li, Li Zhang, Lili Wang, Chen Cheng, Hao Ji, Serena Altilia, Xiaokai Ding, Guoshuai Cai, Diego Altomare, Michael Shtutman, Stephanie D. Byrum, Samuel G. Mackintosh, Alexey Feoktistov, Nataliya Soshnikova, Vladislav A. Mogila, Victor Tatarskiy, Maksim Erokhin, Darya Chetverina, Angga Prawira, Yi Ni, Stephan Urban, Campbell Mcinnes, Eugenia Broude, Igor Roninson

Faculty Publications

We have conducted a detailed transcriptomic, proteomic and phosphoproteomic analysis of CDK8 and its paralog CDK19, alternative enzymatic components of the kinase module associated with transcriptional Mediator complex and implicated in development and diseases. This analysis was performed using genetic modifications of CDK8 and CDK19, selective CDK8/19 small molecule kinase inhibitors and a potent CDK8/19 PROTAC degrader. CDK8/19 inhibition in cells exposed to serum or to agonists of NFκB or protein kinase C (PKC) reduced the induction of signal-responsive genes, indicating a pleiotropic role of Mediator kinases in signal-induced transcriptional reprogramming. CDK8/19 inhibition under basal conditions initially downregulated a small …

Changes In Medicaid Fee-For-Service Benefit Design For Substance Use Disorder Treatment During The Opioid Crisis, 2014 To 2021, Angela Shoulders, Christina Andrews, Melissa A. Westlake, Amanda J. Abraham, Colleen M. Grogan

Faculty Publications

Importance: Medicaid is the largest payer of substance use disorder treatment in the US and plays a key role in responding to the opioid epidemic. However, as recently as 2017, many state Medicaid programs still did not cover the full continuum of clinically recommended care. Objective: To determine whether state Medicaid fee-for-service (FFS) programs have expanded coverage and loosened restrictions on access to substance use disorder treatment in recent years. Design, Setting, and Participants: In 2014, 2017, and 2021, a survey on coverage for substance use disorder treatment was conducted among state Medicaid programs and the District of Columbia with …

The Impact Of Access And Quality Of Antenatal Care On Maternal Mortality Rates Among Women In Pakistan, Fauzia Waqar

Master's Projects and Capstones

This paper focuses on the factors contributing to high maternal mortality rates in Pakistan, emphasizing the crucial role of inadequate antenatal care (ANC) and limited access to quality health services. Prominent risk factors include poverty and financial constraints, healthcare workforce shortages, lack of women empowerment, and low socioeconomic conditions. The cultural and traditional context in Pakistan also plays an influential role in shaping these factors. For a substantial reduction in maternal mortality rates among Pakistani women and girls, a shift within the cultural perception of women's health, specifically regarding ANC, is crucial. To effectively reduce maternal mortality rates in the …

Add-On Soft Electronic Interfaces For Continuous Cuffless Blood Pressure Monitoring, Myeong Namkoong, Balaji Baskar, Lakhvir Singh, Heng Guo, Justin Mcmurray, Kimberly Branan, Md Saifur Rahman, Chin-To Hsiao, Josh Kuriakose, Joanna Hernandez, Arda A Arikan, Luis E Garza-Rivera, Gerard L Coté, Limei Tian

Faculty, Staff and Student Publications

Continuous monitoring of arterial blood pressure is clinically important for the diagnosis and management of cardiovascular diseases. Soft electronic devices with skin-like properties show promise in a wide range of applications, including the human-machine interface, the Internet of things, and health monitoring. Here, we report the use of add-on soft electronic interfaces to address the connection challenges between soft electrodes and rigid data acquisition circuitry for bioimpedance monitoring of cardiac signals, including heart rate and cuffless blood pressure. Nanocomposite films in add-on electrodes provide robust electrical and mechanical contact with the skin and the rigid circuitry. We demonstrate bioimpedance sensors …

Understanding The Compositional And Contextual Factors Influencing Maternal Health Experiences And Outcomes, Tambudzai P. Ndashe

Theses & Dissertations

Despite being preventable, adverse maternal health outcomes continue to be a problem in the United States, which fares worse at preventing these issues than other industrialized nations. Although our understanding of the factors that play a role in the etiology of adverse maternal health outcomes has improved over time, there is still a lot left to understand regarding the role of contextual factors, the upward trajectory of outcomes such as severe maternal morbidity (SMM), and the disproportionate impact of adverse maternal health outcomes on non-Hispanic Black women. This thesis attempted to evaluate the factors that influence procedure-related severe maternal morbidity …

Reducing Oral Health Disparities: Effectiveness Of Preventive Dental Care On Treatment Use, Expenditures And Determinants Of Service Utilization, Rashmi Lamsal

Theses & Dissertations

Given the importance of oral health in maintaining the general health and well-being of an individual, this dissertation includes three independent studies examining dental care utilization and expenditures among adults in the U.S. The first study examines the effectiveness of preventive dental visits on treatment utilization and expenditures among adults aged 18 and above. The second study focuses on the impact of paid sick leave on different types of dental services utilization among working adults aged 18-64. Finally, the last paper compares the differences in dental care utilization and related expenditure between foreign-born and US-born adults with diabetes. The paper …

Health Risks Of Herbal Medicine In The Us: Recommendations To Improve Awareness And Advance Safety, Darya Sinkevich

Master's Projects and Capstones

Adults in the U.S. use herbal medicine as an alternative and in conjunction with conventional healthcare, in many cases because of cultural and economic considerations. With insufficient governmental regulation of the content of herbal supplements, and limited education of healthcare providers on the potential risks and benefits consumers can experience unexpected and potentially harmful health impacts from using herbal medicine.

The health risks associated with these products include but are not limited to, herbal and prescription drug interactions and heavy metal toxicity. For this project, a scoping literature review was conducted using multiple databases to identify the prevalence, health risk, …

Enhancing Compliance Rates: The Impact Of Implementing A Bed Bath Bundle, Lizeth Rosales, Destinee Unabia, Dennisse Espinoza, Nicole Razi, Russell Hall

Master's Projects and Capstones

Abstract Problem: Bed baths are routine bedside procedures offered in hospitals to support patients'

cleanliness and promote comfort and overall well-being. This bedside procedure represents fundamental care provided by healthcare professionals. Ensuring proper bed bathing compliance in the healthcare setting of a medical-surgical observation and telemetry unit has been significantly challenging. After thorough monitoring of the unit, key factors contributing to low bed bath compliance include time constraints, staffing shortage, and barriers specific to patients and staff. The evidence-based interventions to improve bed bath compliance include a bed bath bundle emphasizing teamwork and effective communication, as identified through an extensive …

“Am I Light Enough?”: Mercury Poisoning Due To Skin-Lightening Products, A Policy, And A Culturally Competent Solution, Raven Joyce Redaniel Uayan

Master's Projects and Capstones

Introduction: This paper aims to declare skin-lightening products containing mercury as a public health issue that deserves recognition in health and attention in health policy reforms.

Background and Literature Review: The public health issue analyzed with research and literature review encompasses worldwide mercury poisoning cases, databases of illegal skin-lightening creams, cosmetic safety laws, and policies on online selling platforms. The literature review addresses the existing knowledge regarding mercury in skin-lightening products and identifies the gaps in health policy and awareness surrounding this issue.

Methods: The paper includes many articles analyzing the issue from a global perspective, utilizing …

Tav-In-Tav And Beyond: How Far Can We Go?, Taramasso Maurizio, Ana Paula Tagliari, David L. Fischman

Division of Cardiology Faculty Papers

No abstract provided.

Fall Risk Identification And Reduction Among The Gerontological Population At A Long-Term Care Facility, Esther A. Lowe, Breanna Cates, Lisa James, Ashley Samson, Jowel Ochoa, Matthew Ng

Master's Projects and Capstones

Abstract

Problem: Data obtained from the facility from February 2022 to July 2023 showed that there were a total of 110 falls at the facility with 51% resulting in injury. The facility also lacked a standardized fall assessment tool with minimal follow up after fall incidents.

Context: A microsystem assessment of the geriatric population at the long-term care facility indicated the need for a standardized fall risk screening tool to accurately assess patients.

Interventions: A staff presentation was created highlighting the high rate of falls at the facility as well as to educate on the implementation of the Morse Fall …

Swarmdeepsurv: Swarm Intelligence Advances Deep Survival Network For Prognostic Radiomics Signatures In Four Solid Cancers, Qasem Al-Tashi, Maliazurina B Saad, Ajay Sheshadri, Carol C Wu, Joe Y Chang, Bissan Al-Lazikani, Christopher Gibbons, Natalie I Vokes, Jianjun Zhang, J Jack Lee, John V Heymach, David Jaffray, Seyedali Mirjalili, Jia Wu

Faculty, Staff and Student Publications

Survival models exist to study relationships between biomarkers and treatment effects. Deep learning-powered survival models supersede the classical Cox proportional hazards (CoxPH) model, but substantial performance drops were observed on high-dimensional features because of irrelevant/redundant information. To fill this gap, we proposed SwarmDeepSurv by integrating swarm intelligence algorithms with the deep survival model. Furthermore, four objective functions were designed to optimize prognostic prediction while regularizing selected feature numbers. When testing on multicenter sets (n = 1,058) of four different cancer types, SwarmDeepSurv was less prone to overfitting and achieved optimal patient risk stratification compared with popular survival modeling algorithms. Strikingly, …

In Situ Characterization Of 17-4ph Stainless Steel By Small-Angle Neutron Scattering, Shibo Yan, Zijun Wang, Tianfu Li, Zhong Chen, Xiaoming Du, Yuntao Liu, Dongfeng Chen, Kai Sun, Rongdeng Liu, Bing Bai, Xinfu He, Kaitai Liu, Shuanzhu Wang

Faculty, Staff and Student Publications

17-4PH martensitic steel is usually used as valve stems in nuclear power plants and it suffers from thermal aging embrittlement due to long-time service in a high-temperature and high-pressure environment. Here, we characterized the evolution of microstructures at the nano-scale in 17-4PH steel by in situ small-angle neutron scattering (SANS) with a thermo-mechanically coupled loading device. The device could set different temperatures and tensile so that an in situ SANS experiment could dynamically characterize the process of nanoscale structural changes. The results showed that with increasing thermal aging time, the ε-Cu phase precipitates and grows as the temperature is 475 …

Advancing Kidney Health In Hispanic/Latino Communities In The Us: Promotoras, Health Education, And Food Security, Estefania Huerta

Master's Projects and Capstones

Chronic Kidney Disease (CKD) is not only a public health concern that affects the health of people living in the United States, but also a global health concern affecting millions worldwide. Diabetes is the leading cause of CKD and when CKD is not managed, it can turn into a life-threatening condition known as End-Stage Renal Disease (ESRD) where life is not sustainable without dialysis or a kidney transplant. Although CKD is prevalent among all populations in the United States, the Hispanic/Latino population suffers the most complications (Desai et al., 2019). In 1973, Congress extended Medicare services to people with ESRD …

Certified Community Behavioral Health (Ccbhc) Outpatient Redesign For Behavioral Health Care, Fatmata Kula Jah

Master's Projects and Capstones

The purpose of this study is to review and utilize components of the Certified Community Behavioral Health Clinic (CCBHC) model to create an outpatient redesign model for behavioral health (without duplicating it). This was accomplished by recommending greater use of, and comprehensive integration of, Peer Support Specialists within the current behavioral health continuum of care by increasing funding for the CCBHC demonstration program through legislative expansion by using Medicaid eligibility. This study also recommends enhanced utilization of technological innovations in order to provide equitable access to populations in rural areas. This will enable CCBHCs to fulfill their mandate of providing …

Improving Minors' Access To Treatment For Opioid Use Disorder: A Policy Analysis, Sara Jane Hamilton

Master's Projects and Capstones

As the opioid epidemic continues to have devastating effects on our communities, medications to treat opioid use disorder (MOUDs) are severely underutilized especially for adolescents. Unlike adults, minors need parental approval before obtaining MOUDs presenting a key barrier to timely treatment. Being able to treat adolescents as soon as they are ready is critically important for people with OUD, and while cost and other barriers have been addressed in the literature, there is a paucity on how parental consent affects the accessibility of treatment. This paper aims to explore a potential policy in California that addresses the lack of access …

Prevention And Reduction Of Catheter-Associated Urinary Tract Infection, Lea F. Garin

Master's Projects and Capstones

Abstract

Problem: Fifteen to twenty-five percent of hospitalized patients receive indwelling urinary catheters (IUCs) during their hospital stay and are at high risk for catheter-associated urinary tract infections, according to the Centers for Disease Control and Prevention (CDC, 2015).

Context: A CAUTI Prevention program was implemented in a community hospital surgical unit to address concerns of high rates of CAUTI.

Interventions: Staff training/education, pre-CAUTI and post-CAUTI prevention survey, hand hygiene, bundle care audit, and staff competency for indwelling urinary catheter insertion were implemented to prevent and reduce CAUTI cases in the surgical unit.

Measures: The Standardized Infection Ratio …

Expanding The Volunteer Role To Include Advance Care Planning Knowledge, Andrea C. Leomo

Master's Projects and Capstones

Problem: Transition patients at the end-of-life are those patients who are not mentally ready or physically eligible for hospice thus not enrolled in a Palliative or Hospice Program. Only one-third of the Transition patient census had completed and filed advance care plans. Healthcare providers are obligated to perform life-saving measures unless documented otherwise. A lack of advance care planning can create complicated scenarios and cause discordant care incidents.

Context: End-of-life care is a delicate subject to navigate conversations with patients. With holistic care being a large component of hospice and palliative care, it is important to have updated and accurate …

Evaluating The Feasibility And Impact Of A Well-Being Retreat For Physicians And Advanced Practice Providers, Amanda K. Bailey, Amanda T. Sawyer, Hong Tao, Leila Durr, Alexandra Lajeunesse, Ravindran Sabapathy, Tyon L. Hall

Journal of Wellness

Introduction: Work stress experienced by physicians and advanced practice providers (APPs) can have a detrimental psychological and physical impact. Targeted interventions that focus on self-awareness, peer connection, and intentional self-care may reduce stress and improve well-being and professional fulfillment.

Methods: This is a summative program evaluation of a two-day well-being retreat for physicians and APPs employed at a healthcare system headquartered in Florida. Led by mental health professionals in May 2022, this retreat combined facilitator-led workshops and experiential practice activities with opportunities for peer connection and designated time with family members. The retreat objectives were to facilitate social …

A Retrospective Comparison Of Dose Distribution Within Density Override And Avoidance Structures In Volumetric Arc Therapy Prostate Plans With Hip Prosthetics: A Dosimetric Evaluation, Jared Richard Brinkman

Masters Projects

Introduction

Prostate cancer is one of the most common cancers among men, and its incidence is a significant health concern. The optimal radiation treatment for prostate cancer patients needs to be tailored to reduce toxicities to organs at risk within the treated area. This study aims to retrospectively evaluate the dose distribution to organs at risk (OARs) in patients with hip prosthetics for volumetric modulated arc therapy (VMAT) prostate cancer plans.

Methods

The study included ten prostate cancer patients with at least one prosthetic hip who received VMAT plans at a Midwest Radiation Oncology Center. Various data points, including target …

Clinical Outcome Of Tavi Vs Savr In Patients With Severe Aortic Stenosis, Chayakrit Krittanawong, Hafeez Ul Hassan Virk, Joshua Hahn, Zhen Wang, Fu'ad Al-Azzam, Mahboob Alam, Samin Sharma, Hani Jneid

Faculty, Staff and Students Publications

The utilization of transcatheter aortic valve implantation (TAVI) has become the treatment of choice in patients with severe aortic stenosis (AS) with intermediate-to-high surgical risk for surgical aortic valve replacement (SAVR) [...].

A Phenomenological Study Of Faith In Catholic Persons Living With The Diagnosis Of Cancer, Macrina Reyes

Seton Hall University Dissertations and Theses (ETDs)

Background: There were an estimated 1.9 million new cases of cancer diagnosed the United States and over 600,000 deaths from cancer in 2022. Cancer is also known as the 2nd most common cause of death behind heart disease in the US. In 2019, there were an estimated 16.9 million cancer survivors in the US. Furthermore, the number of cancer survivors is expected to increase to 22.2 million by 2030. Unfortunately, the persons' spiritual needs are not being addressed or considered by healthcare practitioners as part of the plan of care, especially Catholics. In order to truly provide person-centered care, healthcare …

Our Search Of Immune Invaders In The Aged Lacrimal Gland, Claudia M Trujillo-Vargas, Cintia S De Paiva

Faculty, Staff and Students Publications

No abstract provided.

Structural Underpinnings Of Mutation Rate Variations In The Human Genome, Zian Liu, Md Abul Hassan Samee

Faculty, Staff and Students Publications

Single nucleotide mutation rates have critical implications for human evolution and genetic diseases. Importantly, the rates vary substantially across the genome and the principles underlying such variations remain poorly understood. A recent model explained much of this variation by considering higher-order nucleotide interactions in the 7-mer sequence context around mutated nucleotides. This model's success implicates a connection between DNA shape and mutation rates. DNA shape, i.e. structural properties like helical twist and tilt, is known to capture interactions between nucleotides within a local context. Thus, we hypothesized that changes in DNA shape features at and around mutated positions can explain …

A Multicenter, Controlled Human Infection Study Of Influenza A(H1n1)Pdm09 In Healthy Adults, Justin R Ortiz, David I Bernstein, Daniel F Hoft, Christopher W Woods, Micah T Mcclain, Sharon E Frey, Rebecca C Brady, Christopher Bryant, Ashley Wegel, Robert W Frenck, Emmanuel B Walter, Getahun Abate, Sarah R Williams, Robert L Atmar, Wendy A Keitel, Nadine Rouphael, Mathew J Memoli, Mamodikoe K Makhene, Paul C Roberts, Kathleen M Neuzil

Faculty, Staff and Students Publications

BACKGROUND: We evaluated the associations between baseline influenza virus-specific hemagglutination inhibition (HAI) and microneutralization (MN) titers and subsequent symptomatic influenza virus infection in a controlled human infection study.

METHODS: We inoculated unvaccinated healthy adults aged 18-49 years with an influenza A/California/04/2009/H1N1pdm-like virus (NCT04044352). We collected serial safety labs, serum for HAI and MN, and nasopharyngeal swabs for reverse-transcription polymerase chain reaction (RT-PCR) testing. Analyses used the putative seroprotective titer of ≥40 for HAI and MN. The primary clinical outcome was mild-to-moderate influenza disease (MMID), defined as ≥1 postchallenge positive qualitative RT-PCR test with a qualifying symptom/clinical finding.

RESULTS: Of 76 …

Characterization Of Vascular Morphology Of Neovascular Age-Related Macular Degeneration By Indocyanine Green Angiography, Anish Attarde, Thomas S Riad, Zhao Zhang, Manisha Ahir, Yingbin Fu

Faculty, Staff and Students Publications

Age-related macular degeneration (AMD) is a leading cause of blindness among older individuals, and its prevalence is rapidly increasing due to the aging population. Choroidal neovascularization (CNV) or wet AMD, which accounts for 10%-20% of all AMD cases, is responsible for an alarming 80%-90% of AMD-related blindness. Current anti-VEGF therapies show suboptimal responses in approximately 50% of patients. Resistance to anti-VEGF treatment in CNV patients is often associated with arteriolar CNV, while responders tend to have capillary CNV. While fluorescein angiography (FA) is commonly used to assess leakage patterns in wet AMD patients and animal models, it does not provide …

Asset: Auto-Segmentation Of The Seventeen Segments For Ventricular Tachycardia Ablation In Radiation Therapy, Eric Morris, Robert Chin, Trudy Wu, Clayton Smith, Siamak Nejad-Davarani, Minsong Cao

2020-Current year OA Pubs

There has been a recent effort to treat high-risk ventricular tachycardia (VT) patients through radio-ablation. However, manual segmentation of the VT target is complex and time-consuming. This work introduces ASSET, or Auto-segmentation of the Seventeen SEgments for Tachycardia ablation, to aid in radiation therapy (RT) planning. ASSET was retrospectively applied to CTs for 26 thoracic RT patients (13 undergoing VT ablation). The physician-defined parasternal long-axis of the left ventricle (LV) and the axes generated from principal component analysis (PCA) were compared using mean distance to agreement (MDA) and angle of separation. The manually selected right ventricle insertion point and LVs …

The Effects Of Advanced Factor Analysis Approaches On Outcomes In Randomised Trials For Depression: Protocol For Secondary Analysis Of Individual Participant Data, Frank Doyle, David Byrne, Robert M Carney, Pim Cuijpers, Alexandra L Dima, Kenneth Freedland, Suzanne Guerin, David Hevey, Bishember Kathuria, Shane Kelly, Stephen Mcbride, Emma Wallace, Fiona Boland

2020-Current year OA Pubs

BACKGROUND: Modern psychometric methods make it possible to eliminate nonperforming items and reduce measurement error. Application of these methods to existing outcome measures can reduce variability in scores, and may increase treatment effect sizes in depression treatment trials.

AIMS: We aim to determine whether using confirmatory factor analysis techniques can provide better estimates of the true effects of treatments, by conducting secondary analyses of individual patient data from randomised trials of antidepressant therapies.

METHOD: We will access individual patient data from antidepressant treatment trials through Clinicalstudydatarequest.com and Vivli.org, specifically targeting studies that used the Hamilton Rating Scale for Depression (HRSD) …

Unknown Rectal Lesions: A Case Of Severe Proctitis Secondary To Mpox In The Setting Of Concomitant Hiv, Syphilis, Hsv, And Chlamydia, Nicole Robertson Mph, James Crosby Do, Cynthia R. Young Md, Msc, Anne E. Sayers Md, Nicholas J. Van Sickles Md

ePublications of Emerging Medical Research Scholars

Introduction:

Mpox emerged as a public health crisis with limited research describing co-occurring HIV and sexually transmitted infections (STIs). We present a case of severe proctitis secondary to Mpox with concomitant HIV (Human Immunodeficiency Virus), syphilis, HSV (Herpes Simplex Virus), and chlamydia and review presentation, diagnosis, treatment, and prevention of Mpox with concurrent STIs.

Case Presentation:

34-year-old male living with HIV (LWH) presenting with worsening rectal pain, multiple anal papules, and fever. His laboratory workup revealed simultaneous positive results for orthopoxvirus, chlamydia, and HSV-1 PCR. We initiated tecovirimat due to rectal involvement and uncontrolled pain. He subsequently developed lesions on …

Expanding The Primary Care Interprofessional Team: Creating Space For Behavioral Health Consultants, Rachelle Rene, Phd, Bcb, Hsmi, Cgp, Mollie Cherson, Mphil, Lcsw

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

Statement of issue or problem addressed

Despite a growing need for mental and behavioral health services, access to these services has been limited due to constraints in insurance coverage and location of services outside of medical care. As a result, mental and behavioral health needs have frequently fallen to the primary care system to support.