Medicine and Health Sciences Commons^™

Metabolic Liver Cancer: Associations Of Rare And Common Germline Variants In One-Carbon Metabolism And Dna Methylation Genes, Samuel O Antwi, Michael Heckman, Launia White, Irene Yan, Vivekananda Sarangi, Kimberly P Lauer, Joseph Reddy, Fowsiyo Ahmed, Swathi Veliginti, Ellis D Mejías Febres, Rikita I Hatia, Ping Chang, Laura Izquierdo-Sanchez, Loreto Boix, Angela Rojas, Jesus M Banales, Maria Reig, Per Stål, Manuel Romero Gómez, Amit G Singal, Donghui Li, Manal M Hassan, Lewis R Roberts, Tushar Patel

Faculty, Staff and Student Publications

Animal studies implicate one-carbon metabolism and DNA methylation genes in hepatocellular carcinoma (HCC) development in the setting of metabolic perturbations. Using human samples, we investigated the associations between common and rare variants in these closely related biochemical pathways and risk for metabolic HCC development in a multicenter international study. We performed targeted exome sequencing of 64 genes among 556 metabolic HCC cases and 643 cancer-free controls with metabolic conditions. Multivariable logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for multiple comparisons. Gene-burden tests were used for rare variant associations. Analyses were performed in …

Metabolic Liver Cancer: Associations Of Rare And Common Germline Variants In One-Carbon Metabolism And Dna Methylation Genes, Samuel O Antwi, Michael Heckman, Launia White, Irene Yan, Vivekananda Sarangi, Kimberly P Lauer, Joseph Reddy, Fowsiyo Ahmed, Swathi Veliginti, Ellis D Mejías Febres, Rikita I Hatia, Ping Chang, Laura Izquierdo-Sanchez, Loreto Boix, Angela Rojas, Jesus M Banales, Maria Reig, Per Stål, Manuel Romero Gómez, Amit G Singal, Donghui Li, Manal M Hassan, Lewis R Roberts, Tushar Patel

Faculty, Staff and Student Publications

Animal studies implicate one-carbon metabolism and DNA methylation genes in hepatocellular carcinoma (HCC) development in the setting of metabolic perturbations. Using human samples, we investigated the associations between common and rare variants in these closely related biochemical pathways and risk for metabolic HCC development in a multicenter international study. We performed targeted exome sequencing of 64 genes among 556 metabolic HCC cases and 643 cancer-free controls with metabolic conditions. Multivariable logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for multiple comparisons. Gene-burden tests were used for rare variant associations. Analyses were performed in …

Quantitative Flow Ratio As A Continuous Predictor Of Myocardial Infarction, Changdong Guan, Nils P Johnson, Rui Zhang, Lihua Xie, Miao Chu, Yanyan Zhao, Zheng Qiao, Sheng Yuan, Zhongwei Sun, Kefei Dou, Shengxian Tu, Lei Song, Shubin Qiao, Bo Xu

Faculty, Staff and Student Publications

Background: The quantitative flow ratio (QFR) identifies functionally ischaemic lesions that may benefit more from percutaneous coronary intervention (PCI) than from medical therapy.

Aims: This study investigated the association between QFR and myocardial infarction (MI) as affected by PCI versus medical therapy.

Methods: All vessels requiring measurement (reference diameter ≥2.5 mm and existence of at least one stenotic lesion with diameter stenosis of 50-90%) in the FAVOR III China (5,564 vessels) and PANDA-III trials (4,471 vessels) were screened and analysed for offline QFR. The present study reported clinical outcomes on a per-vessel level. Interaction between vessel treatment and QFR as …

Pediatric Firearm Injury Epidemiology At A Level 1 Trauma Center From 2019 To 2021: Including Time Of The Covid-19 Pandemic, Cynthia Orantes, Hei Kit Chan, Daniel Walter, Summer Chavez, Irma T Ugalde

Faculty, Staff and Student Publications

BACKGROUND: Firearms are a leading cause of death in children. The demand for firearms increased following COVID-19 "stay-at home orders" in March 2020, resulting in record-breaking firearm sales and background checks. We aim to describe the changes in pediatric firearm-related injuries, demographics, and associated risk factors at a Level 1 trauma center in Houston before and during the COVID 19 pandemic.

RESULTS: The total number of pediatric firearm-related injury cases increased during March 15th to December 31st, 2020 and 2021 compared to the same time period in 2019 (104 verses 89 verses 78). The demographic group most affected across years …

Implementation And Assessment Of A Laparotomy-Assisted Three-Port Fetoscopic Spina Bifida Repair Program, Corinna Keil, Siegmund Köhler, Benjamin Sass, Maximilian Schulze, Gerald Kalmus, Michael Belfort, Nicolas Schmitt, Daniele Diehl, Alice King, Stefanie Groß, Caitlin D Sutton, Luc Joyeux, Mirjam Wege, Christopher Nimsky, Wiliam E Whitehead, Eberhard Uhl, Thierry A G M Huisman, Bernd A Neubauer, Stefanie Weber, Helmut Hummler, Roland Axt-Fliedner, Ivonne Bedei

Faculty, Staff and Students Publications

Open spina bifida (OSB) is a congenital, non-lethal malformation with multifactorial etiology. Fetal therapy can be offered under certain conditions to parents after accurate prenatal diagnostic and interdisciplinary counseling. Since the advent of prenatal OSB surgery, various modifications of the original surgical techniques have evolved, including laparotomy-assisted fetoscopic repair. After a two-year preparation time, the team at the University of Giessen and Marburg (UKGM) became the first center to provide a three-port, three-layer fetoscopic repair of OSB via a laparotomy-assisted approach in the German-speaking area. We point out that under the guidance of experienced centers and by intensive multidisciplinary preparation …

A Dosimetric Comparison Of Coplanar And Non-Coplanar Beam Arrangement For Apbi Treatment Techniques, Reuben Granger

Masters Projects

Abstract

Introduction

Breast cancer is a prevalent malignancy among women in the United States, necessitating a variety of treatment strategies. Accelerated Partial Breast Irradiation (aPBI) has emerged as an effective treatment technique for early-stage breast cancer, offering reduced treatment duration and potential benefits in terms of cosmesis and patient convenience. One of the critical factors influencing the success of APBI is the choice of beam arrangement during radiation delivery. This research paper presents a dosimetric comparison of coplanar and non-coplanar beam arrangements for APBI treatment techniques.

Methods

The study includes 15 patients with left-sided breast cancer. The patients underwent two …

Characteristics And Outcomes Of Patients Who Underwent Coronary Atherectomy In Centers With And Without On-Site Cardiac Surgery, Mohamed Dafaalla, Muhammad Rashid, Saadiq Moledina, Tim Kinnaird, Peter Ludman, Nick Curzen, Sarah Zaman, James Nolan, Mamas A. Mamas

Department of Medicine Faculty Papers

We aimed to describe the clinical characteristics and outcomes of patients who underwent atherectomy at the time of percutaneous coronary intervention in centers with on-site surgical centers (SCs) versus nonsurgical centers (NSCs). Patients treated with coronary atherectomy between January 1, 2006, to December 31, 2019, from the British Cardiovascular Society Intervention (BCIS) registry were included. Primary outcomes were in-hospital all-cause mortality and major adverse cardiovascular and cerebrovascular events. A total of 20,833 patients were treated with coronary atherectomy, of which 7,983 (38%) were performed at NSC. The proportion of coronary atherectomies performed in NSC increased from 12.5% in 2006 to …

Examining Factors Impacting The Service Needs Of Unhoused Women, Holly Brott

Dissertations and Theses

Women account for a sizeable proportion of the unhoused population in the U.S. Over one-third (38.7%) of unhoused individuals are women, which is a 17% increase from 2016 (United States Department of Housing and Urban Development, 2019). The increased prevalence of women experiencing homelessness calls for a renewed examination of their service needs. This dissertation presents three studies examining factors impacting the service needs of unhoused women. The first manuscript examined factors contributing to unhoused mothers’ successful completion of transitional housing; highlighted participant-identified programmatic strengths; and investigated differences in facilitators to success across two geographic contexts: one rural and one …

A Biologic-Device Combination Product Delivering Tumor-Derived Antigens Elicits Immunogenic Cell Death-Associated Immune Responses Against Glioblastoma, Christopher Cultrara, Christopher Uhl, Kenneth Kirby, Essam Abed Elrazaq, Amelia Zellander, David W. Andrews, Charles B. Scott, Lorenzo Galluzzi, Mark A. Exley, Jenny Zilberberg

Department of Neurosurgery Faculty Papers

Background IGV-001 is a personalized, autologous cancer cell-based immunotherapy conceived to deliver a tumor-derived antigenic payload in the context of immunostimulatory signals to patients with glioblastoma (GBM). IGV-001 consists of patient-derived GBM cells treated with an antisense oligodeoxynucleotide against insulin-like growth factor 1 receptor (IGF1R) and placed in proprietary biodiffusion chambers (BDCs). The BDCs are then exposed to 5–6 Gy radiation and implanted at abdominal sites for ~48 hours. IGV-001 has previously been shown to be generally safe with promising clinical activity in newly diagnosed GBM patients.

Methods Mouse (m) or human (h) variants of IGV-001 …

Quercetin As An Anticancer Candidate For Glioblastoma Multiforme By Targeting Akt1, Mmp9, Abcb1, And Vegfa: An In Silico Study, Muhammad Hermawan Widyananda, Setyaki Kevin Pratama, Arif Nur Muhammad Ansori, Yulanda Antonius, Viol Dhea Kharisma, Ahmad Affan Ali Murtadlo, Vikash Jakhmola, Maksim Rebezov, Mars Khayrullin, Marina Derkho, Emdad Ullah, Raden Joko Kuncoroningrat Susilo, Suhailah Hayaza, Alexander Patera Nugraha, Annise Proboningrat, Amaq Fadholly, Mada Triandala Sibero, Rahadian Zainul

Karbala International Journal of Modern Science

Quercetin, a natural compound present in various fruits and vegetables, shows promise as a potential inhibitor for glioblastoma multiforme (GBM) development. This study aims to examine the anti-GBM potential of Quercetin. The protein target of Quercetin is identified and analyzed using databases such as NCBI, SEA, CTD, and STRING. Protein-protein interaction (PPI) and functional annotation are carried out based on the obtained target proteins. Molecular docking and dynamics simulations are employed using AutoDock Vina and WebGro tools to analyze the interaction between Quercetin and its target proteins. The prediction of protein targets reveals that Quercetin directly targets four proteins associated …

Elucidation Of Antibacterial, Synergistic, Antioxidant, And Anticancer Activities Of Green Synthesized Copper Oxide Nanoparticles Against Human Breast Cancer Cells, Ravindran Muthukumarasamy, Muhammad Luqman Bin Nisa, Nur Absarina Binti Rosli, Nurul Syazwani Binti Kamaruddin, Mohammad Danish, Afzan Binti Mahmad, M.N. Mohamad Ibrahim, Shahnaz Majeed

Karbala International Journal of Modern Science

The study conducted biosynthesis of copper oxide nanoparticles using an aqueous extract of Aspergillus niger and in-vestigated their potential biomedical applications. The nanoparticles were characterized using various techniques in-cluding UV-Vis, SEM, TEM, and EDX, revealing their spherical to crystalline shape with sizes ranging from 21 nm to 48 nm. The nanoparticles demonstrated notable antimicrobial activity against Staphylococcus aureus with a zone of 8 mm and Escherichia coli recorded high synergistic activity with 20.93%, as well as antioxidant properties. Furthermore, selective cytotoxicity towards breast cancer cells was observed with an IC50 of 107.81 ug/ml and an IC50 of 250.93 ug/ml on …

Education And Training For Clients And Caregivers Related To Assistive Technology, Tristin Jones, Lisa Griggs-Stapleton, Lee Ann Hoffman

Summer 2023 Virtual OTD Capstone Symposium

Education and training are extremely important element when prescribing assistive technology of any kind. Often, clients and caregivers return home with unanswered questions related to said devices. For the client to return home and be successful appropriate and adequate education and training is required for both the client and caregiver. The goal of this project was to ensure that clients returning home experienced increased independence and decreased assistive technology abandonment. This poster presentation outlines the benefits of increased education and training prior to discharge throughout an occupational therapy capstone program.

Lymphedema Management For Those Living With Spinal Cord Disorders To Address Caregiver Burden, Nia L. Bolen-Daniels

Department of Occupational Therapy Entry-Level Capstone Projects

The following capstone project focused on the creation of a booklet that identified the needs determined by caregivers and providers. The booklet includes beneficial resources to aid in reducing caregiver burden for those with spinal cord injuries (SCI) with lymphedema needs with a concentration of the Amyotrophic Lateral Sclerosis (ALS) population. This capstone project’s primary goal was to understand the caregiver’s perspective and their needs to assist with any gaps identified to further aid them and their providers.

Accommodated Gymnastics Program For Atypically Developing Children, Ashtin Callahan

Department of Occupational Therapy Entry-Level Capstone Projects

No abstract provided.

Incorporating An Occupational Therapy Perspective In A Pediatric Early Developmental Clinic, Olivia Mahoney

Department of Occupational Therapy Entry-Level Capstone Projects

No abstract provided.

Clinical Research Capstone At The National Institutes Of Health Clinical Center, Deborah J. Kofsky

Department of Occupational Therapy Entry-Level Capstone Projects

No abstract provided.

Geriatric Interest Plan For Individuals With Dementia: Improved Quality Of Life, Alexis T. Francois

Department of Occupational Therapy Entry-Level Capstone Projects

The purpose of this Capstone experience was to identify the specific needs to improve the quality of life for individuals with Dementia and Alzheimer’s. According to the Alzheimer’s Association (2022a), 1 in 9 people aged 65 and older have dementia. It is imperative for people living with this disease to be actively involved in meaningful activities that can reduce their negative symptoms. People with dementia constitute 40% of patients with significant depression (Alzheimer’s Association, 2022a). The common risk factors that increase the likelihood of depression in these adults include social isolation and loneliness, lack of exercise, and functional limitations that …

Physical Wellness Programming For Community-Dwelling Seniors In Local Senior Center For Improved Social, Physical, And Mental Well-Being, Steven A. Dinnen

Department of Occupational Therapy Entry-Level Capstone Projects

The capstone project was creating an eight-week physical wellness program for community-dwelling seniors at the Senior Sunshine Center, a local senior center, that improved the social, physical, and mental well-being of those participating. The project population is community-dwelling senior adults over 55 who participate at the Sunshine Senior Center, and the focus areas are program development. The capstone project adds to the limited research about physical activity programs created by occupational therapists for community-dwelling older adults. Lastly, it highlights the importance of physical, mental, and social well-being for community-dwelling older adults. My capstone goals were met by using a pre …

Fall Prevention & Vision Therapy Program For Inpatient Rehab, James P. Ryan

Department of Occupational Therapy Entry-Level Capstone Projects

Falls and vision impairments are common areas of concern for many adult and geriatric individuals currently residing in inpatient rehabilitation facilities. While most facilities have a fall prevention program in place, many are inadequate at determining a patients true fall risk and reducing the number of falls sustained by these populations. Through the creation and consistent implementation of an evidence-based fall prevention and vision therapy program via screenings, assessments and patient specific interventions the number of falls sustained by these populations within an inpatient rehab facility was reduced over a three month period compared the three months prior to the …

Implementing A Bedside Rounding Tool To Reduce Inpatient Falls, Steven W. Garcia

Master's Projects and Capstones

Problem: Each year, thousands of patients sustain falls while hospitalized, resulting in an increase in serious injuries or death. In a Neuroscience Step Down Unit (NSDU), fall rates in 2022 were higher than the NDNQI benchmark. Despite a thorough fall prevention policy, nurses inconsistently implemented preventative interventions, resulting in increased falls.

Context: The NSDU is a 15-bed inpatient unit providing intermediate-level care for patients with neurological and neurosurgical diagnoses. The unit is part of a 459-bed academic medical center and safety net hospital providing tertiary and quaternary care in southern California.

Interventions: A bedside safety rounds checklist for charge nurses …

Robot Revolution: Impacting Adoption Of The Technology, Cece Noland

MSN Capstone Projects

The author examined the value of robotic guidance platforms in spine surgery, and then implemented an improvement project to positively impact internal (Medtronic employee) adoption of the technology. By promoting adoption, robotics will continue to advance the standard of care for spine surgery patients. This paper is to meet fulfillment of requirements for NURS5382 Capstone.

Assessing The Impact Of Daily Chlorhexidine Baths In Prevention Of Central Line Associated Bloodstream Infections: An Evidence Based Project, Brooke Rea

MSN Capstone Projects

Background: The rates of central line associated bloodstream infections (CLABSI) is a major concern in the healthcare industry. It is imperative that healthcare professionals take every precaution to prevent these life-threatening infections to the already critically ill patient.

Objective: The reason for this paper is to assess the effectiveness of the use of daily chlorhexidine baths in patients with central lines in the prevention of CLABSIs.

Narrative Review: A narrative review of evidence was conducted to assess the effectiveness of daily chlorhexidine bathing in patients with central lines. Twelve studies were moved forward in the project. Each of the twelve …

Pain In The Dying Patient, Shanna Selph

MSN Capstone Projects

This benchmark aims to educate nurses, doctors, and families on the importance of proper pain management in dying patients. The evidence in this benchmark will be appraised to improve practice, improve outcomes, and reduce healthcare costs (Melnyk, 2018). Feelings of being overwhelmed, fatigue, confusion, and guilt can occur in healthcare professionals without the proper knowledge of pain in the dying patient. Health professionals are responsible for ensuring proper care of patients is taken during the most difficult time of their lives to ensure they have the best quality of life through the end of their lives. The question to be …

Implementation Of An Evidence-Base Hospital Acquired Pressure Injury Prevention Program, Brenda Miner

MSN Capstone Projects

Covid-19 hindered many quality improvement projects. As the stressors from the pandemic began to disappear the healthcare industry was struck with new struggles. These new struggles were ensuring quality care was being provided to all patients. The decline in quality care also led to a decline in reimbursement from payor sources, such as Medicare. During the pandemic the healthcare industry was at their most vulnerable state and now that the dust is settling the ramifications of just surviving are staring the industry right in the eyes. Change is difficult, but it is even more difficult following traumatic events such as …

Early Mobilization In Critical Care: A Benchmark Study, Monica Paige Voelkel

MSN Capstone Projects

Critically ill patients often have complex injuries to multiple organ systems creating barriers to mobilization and a decrease in functional status (Bergbower et al., 2020). Early mobilization (EM) in hospitalized patients has shown to improve patient outcomes and decrease length of stay (LOS) (Bergbower et al., 2020). The link between EM and LOS is one that warrants further investigation with the PICOT question: In critically ill patients (P), how does early mobilization (I), compared to standard mobility (C) improve patient outcomes (O) over a three-month period (T)? The purpose of this paper is to discuss the rationale for the benchmark …

Preventing Deep Vein Thrombosis In Surgical Patients, Ariel D. Roberson

MSN Capstone Projects

Deep vein thrombosis (DVT) is a significant medical issue that incurs thrombi formation in the venous system which can result in major medical problems. DVT’s often occur because of complications after orthopedic surgery. Common risks factors for DVT are vein injury, slow blood movement, increase estrogen, and chronic medical illness (Centers for Disease Control and Prevention [CDC], 2018). As many as 900,000 individuals are impacted by DVT each year (CDC, 2020). Consequently, recent estimates show that 60,000 to 100,000 Americans die each year because of DVT. Even more alarming, 10 to 30% of individuals will die of DVT within a …

Safe Staffing, Safe Patients Benchmark Project, Sarah Barton

MSN Capstone Projects

With the most recent pandemic, nurses have been overworked, overwhelmed, and understaffed at dangerous levels. Nurses are leaving full time employment at this facility in droves to seek better wages through traveling. In turn, our patient outcomes have taken a large hit, with an increase in falls, pressure ulcers, and catheter-acquired urinary tract infections, to name a few. This is costly for the hospital, not to mention the damper it puts on the hospital’s vision and goals. With the implementation of a nursing incentive program, the hospital could cut overall spending in half within 2 years with an investment of …

Improving Safety In The Emergency Department: Utilizing Metal Detectors To Mitigate Weapon Possession, Jonathan Garcia

MSN Capstone Projects

Today’s high risk-healthcare environment has prioritized patient safety with great initiatives and, unfortunately, placed staff safety second. However, safety for both groups should be equal priorities. Evidence suggests that Emergency Departments (ED) often care for patients with a history of crime and mental health diagnoses, creating an environment where the threat of violence and weapons is increasingly prevalent compared to other clinical settings. (Erlyana, 2019) Risk mitigation is possible if we consider studies by Malka et al. (2015) and Laidlaw et al. (2017) that indicate the efficacy of metal detectors in accurately identifying concealed weapons. To improve clinician and patient …

Early Mobilization For Adult Mechanically Ventilated Patients, Stephanie Miller

MSN Capstone Projects

Approximately 13 million people worldwide receive treatment in intensive care units (ICUs) annually. Many patients admitted to the intensive care unit require mechanical ventilation for their survival and attempts to mobilize these critically ill patients is frequently restricted for their own safety. It has been suggested that this lack of mobility may have a significant negative impact on the recovery process and lengthen the time of the patient’s overall hospital stay and recovery. Additionally, survivors report significant physical impairments and deconditioning that present obstacles towards their recovery and well-being after prolonged ventilation.

Gsk-J4 Inhibition Of Kdm6b Histone Demethylase Blocks Adhesion Of Mantle Cell Lymphoma Cells To Stromal Cells By Modulating Nf-Κb Signaling, Laia Sadeghi, Anthony P H Wright

Faculty, Staff and Student Publications

Multiple signaling pathways facilitate the survival and drug resistance of malignant B-cells by regulating their migration and adhesion to microenvironmental niches. NF-κB pathways are commonly dysregulated in mantle cell lymphoma (MCL), but the exact underlying mechanisms are not well understood. Here, using a co-culture model system, we show that the adhesion of MCL cells to stromal cells is associated with elevated levels of KDM6B histone demethylase mRNA in adherent cells. The inhibition of KDM6B activity, using either a selective inhibitor (GSK-J4) or siRNA-mediated knockdown, reduces MCL adhesion to stromal cells. We showed that KDM6B is required both for the removal …