Medicine and Health Sciences Commons^™

Examination Of Fully Automated Mammographic Density Measures Using Libra And Breast Cancer Risk In A Cohort Of 21,000 Non-Hispanic White Women, Laurel A Habel, Stacey E Alexeeff, Ninah Achacoso, Vignesh A Arasu, Aimilia Gastounioti, Lawrence Gerstley, Robert J Klein, Rhea Y Liang, Jafi A Lipson, Walter Mankowski, Laurie R Margolies, Joseph H Rothstein, Daniel L Rubin, Li Shen, Adriana Sistig, Xiaoyu Song, Marvella A Villaseñor, Mark Westley, Alice S Whittemore, Martin J Yaffe, Pei Wang, Despina Kontos, Weiva Sieh

Faculty, Staff and Student Publications

BACKGROUND: Breast density is strongly associated with breast cancer risk. Fully automated quantitative density assessment methods have recently been developed that could facilitate large-scale studies, although data on associations with long-term breast cancer risk are limited. We examined LIBRA assessments and breast cancer risk and compared results to prior assessments using Cumulus, an established computer-assisted method requiring manual thresholding.

METHODS: We conducted a cohort study among 21,150 non-Hispanic white female participants of the Research Program in Genes, Environment and Health of Kaiser Permanente Northern California who were 40-74 years at enrollment, followed for up to 10 years, and had archived …

Sars-Cov-2 Infection In Unvaccinated High-Risk Pregnant Women In The Bronx, Ny, Usa Is Associated With Decreased Apgar Scores And Placental Villous Infarcts, Sandra E. Reznik, Patricia M. Vuguin, Alexa Cohen, Rasha Khoury, Olivier Loudig, Ridin Balakrishnan, Susan A. Fineberg, Francine Hughes, Malini Harigopal, Maureen J. Charron

School of Medicine Faculty Publications

Babies born to severe acute respiratory syndrome corona virus-2 (SARS-CoV-2)-infected mothers are at greater risk for perinatal morbidity and more likely to receive a neurodevelopmental diagnosis in the first year of life. However, the effect of maternal infection on placental function and neonatal outcomes varies depending upon the patient population. We set out to test our hypothesis that maternal SARS-CoV-2 infection in our underserved, socioeconomically disadvantaged, mostly unvaccinated, predominantly African American and Latina population in the Bronx, NY would have effects evident at birth. Under IRB approval, 56 SARS-CoV-2-positive patients infected during the “first wave” of the pandemic with alpha …

Mandatory Child Abuse And Neglect Reporting Behaviors Among Registered Nurses In New Mexico: A Statewide Comparative Study, Ingrid Ann Wilson

Nursing ETDs

Child abuse and/or neglect (CAN) is a global problem. Although nurses are mandated CAN reporters, a lack of reporting has been an issue. New Mexico (NM) is faced with higher child poverty and CAN-related substance-abuse compared to other U.S. states. This quantitative study aimed to explore factors influencing intended/actual CAN reporting behaviors among NM registered nurses (RN)s, examine relationships of these factors, and compare differences in reporting behaviors between rural and urban locations. A survey to a sample of RNs (N=146) showed factors associated with CAN reporting intended behaviors were work status (r=.21, p < .05), cues to action (r=.20, …

Examination Of Fully Automated Mammographic Density Measures Using Libra And Breast Cancer Risk In A Cohort Of 21,000 Non-Hispanic White Women, Laurel A Habel, Aimilia Gastounioti, Et Al.

2020-Current year OA Pubs

BACKGROUND: Breast density is strongly associated with breast cancer risk. Fully automated quantitative density assessment methods have recently been developed that could facilitate large-scale studies, although data on associations with long-term breast cancer risk are limited. We examined LIBRA assessments and breast cancer risk and compared results to prior assessments using Cumulus, an established computer-assisted method requiring manual thresholding.

METHODS: We conducted a cohort study among 21,150 non-Hispanic white female participants of the Research Program in Genes, Environment and Health of Kaiser Permanente Northern California who were 40-74 years at enrollment, followed for up to 10 years, and had archived …

Analyzing Pseudomonas Aeruginosa With Bacteriophage Tags Using Photoacoustic Flow Cytometry, Jennifer C. Schinke

Electronic Theses and Dissertations

The number of daily bacterial infections is climbing and the CDC explains that this is due to the antibiotic-resistant threat in the United States. Finding a faster way of bacterial identification is necessary as it currently takes 1-4 days for a medical lab to culture and identify bacteria. Photoacoustic flow cytometry (PAFC) can be used as an alternative method resulting in swift identification within an hour (Edgar, 2019). Pseudomonas aeruginosa, cell line PA01, will be coated in up to a few hundred red dyed phages making it detectible by the photoacoustic flow cytometry system. Bacteriophages (phages) are viruses that …

Examining School Nurses' Knowledge And Confidence Related To Their Intention To Screen For And Report Child Sexual Abuse: A Descriptive Cross-Sectional Study, Suzanne Ackers

Electronic Theses and Dissertations

Background: Child sexual abuse (CSA) in a preventable national public health problem that results in adverse health consequences. Research suggests many victims are currently attending school. Screening for early detection of health issues is integral to school nurse (SN) practice but there is little evidence that screening for CSA is occurring in schools despite recommendations that it should be. Lack of confidence and knowledge related to screening for suspected CSA contribute to a SN’s missed opportunity for early intervention.

Purpose: To describe SNs knowledge and self-efficacy associated with screening for and reporting CSA in school settings.

Methods: A descriptive cross-sectional …

“One University’S Covid-19 Pandemic Mitigation Response And Anxiety Construct: A Summative Program Evaluation”, Ann Hodgin

Doctor of Nursing Practice (DNP) Manuscripts

Abstract

The effects of the COVID-19 pandemic continue to ripple through everyday life. In December 2019, an outbreak occurred in China. Subsequently, the World Health Organization identified SARS-CoV-2 as a new type of coronavirus that quickly spread around the globe (Nazario, 2022). As of May 31, 2023, there were 6,938,353 confirmed deaths worldwide from COVID-19 (WHO, 2023).

A needs assessment completed by the University identified that a program evaluation of the university’s COVID-19 response was warranted. Therefore, this program evaluation was conducted to assess the effectiveness of the policies and protocols implemented at a Catholic University in Southwestern Pennsylvania to …

Effectiveness Of A New Graduate Nurse Residency Program: A Program Evaluation, Christine Meyer

Doctor of Nursing Practice (DNP) Manuscripts

Healthcare organizations continue to face challenges in the retention of new graduate registered nurses (NGRNs) within the first year of hire. Accredited nurse residency programs are designed to provide support to NGRNs and help make the transition from student to graduate nurse by developing their knowledge and skills. This project evaluates a nurse residency program at a rural, community hospital. The project aims to analyze both qualitative and quantitative data to evaluate the program outcomes as it relates to nurse retention, turnover, and job satisfaction. The sample includes 94 new graduate registered nurses that were part of the yearlong residency …

Improving Ostomy Patient’S Self-Efficacy And Quality Of Living Through Prehabilitation And Prevention Of Complications Using Telehealth Visits: A Quality Improvement Project, Shabnam Pratik Bagh

Doctor of Nursing Practice (DNP) Manuscripts

Due to the rise in colorectal cancer and diverticular diseases in the United States, approximately 100,000 to 150,000 intestinal stomas (fecal diversions) are created annually. With approximately 80% of readmissions experiencing post-discharge complications (Agri et al., 2020), quality improvement (QI) initiatives to increase ostomy patient’s self-efficacy and quality of living (QOL) are needed. The purpose of this QI project was to enhance the current continuum of care for ostomy patients by adding a Prehabilitation Session prior to surgery followed up with 24-hour Telehealth visits after discharge from the hospital to support their living with an ostomy. The resulting Comprehensive Ostomy …

Evaluating Outcomes Of An Integrated Medical Care Model In An Acute Care Hospital: A Program Evaluation, Erin Flanagan

Doctor of Nursing Practice (DNP) Manuscripts

Background: Increased awareness of disparities for people with co-occurring medical and behavioral health disorders identified a gap in their individualized health care plan. This gap provides opportunities for hospitals and acute care centers to evaluate current care models for this specific patient population. Problem: Hospitals are challenged to meet the growing needs of patients while working to decrease operational costs. Patients with behavioral health disorders also have significantly greater spending for general medical conditions than patients without a behavioral health disorder (Chu et al., 2019). Methods: Hospitals are attempting to address this gap in care through interdisciplinary or collaborative care …

A Program Evaluation Of An Internship Program And Its Effectiveness On Retention During The First Year Of Professional Practice, Jamie Kilpatrick

Doctor of Nursing Practice (DNP) Manuscripts

Background and Significance: The registered nurse is an essential component of the healthcare team. Successful efforts have occurred worldwide for recruitment to the nursing profession. However, vacancy plagues the nursing profession through turnover, with the new graduate registered nurse remaining the most vulnerable with the highest rate of turnover. This program evaluation will review one organization’s retention project to support the senior nursing student with a paid clinical internship, and additional support through the vulnerable first year of practice within the chosen care setting. Methods: This summative program evaluation will utilize a systems-oriented approach and quasi-experimental methodology with quantitative data …

Implementation Of A Structured Hybrid Training Program To Improve Clinical Skills And Staff Confidence In The Care Of Maternal And Neonatal Patients In The Emergency Department: A Quality Improvement Project, Melissa Hewitt

Doctor of Nursing Practice (DNP) Manuscripts

Caring for a pregnant woman or compromised newborn is often a stressful situation for all healthcare workers regardless of their experience or expertise. This stress is only heightened when the patient presents to a unit that may not be comfortable with the situation such as the Emergency Department (ED). Often units such as the ED do not receive adequate training in caring for maternal and neonatal patients. The infrequency of patient interactions coupled with their lack of knowledge can leave staff with decreased levels of confidence. Various research articles recommend that hospitals provide interdisciplinary team training for high acuity low …

Implementation Of A Nursing Peer Mentorship Program To Improve Nursing Retention And Job Satisfaction In An Acute Care Hospital: A Quality Improvement Project, Rebecca Cassel

Doctor of Nursing Practice (DNP) Manuscripts

Background and Significance: Currently staffing shortages are impacting patients and communities nationwide. This problem has been on the rise since the before the pandemic. COVID-19 has certainly increased the rate of nursing turnover, and vacancy, especially in acute care (Krofft & Stewart, 2021). Many factors contribute to nursing turnover, including nursing satisfaction, interprofessional relationships, and organizational support, and it is apparent that swift and effective action is needed, to ensure that safe, skilled nursing professionals are available to provide the necessary treatment that those seeking healthcare need. Nursing Mentorship programs have been shown to improve retention of nursing staff, …

Isolation And Total Synthesis Of Sigma-2 Ligands From Marine Cyanobacteria, Andrea Hough

Electronic Theses and Dissertations

Cyanobacteria have been studied for over 50 years as a source of new antibiotics, antiviral, and anticancer drugs. The research described in this dissertation investigates marine cyanobacteria as a source of natural products with activity within the central nervous system and with cytotoxicity against breast cancer cells. Barbamide (1) is a known cyanobacterial metabolite that has been re-isolated from a variety of species and collection sites suggesting broad utility as a signaling molecule. Utilizing the psychoactive drug screening program, we screened barbamide for CNS activity and found that barbamide exhibited affinity for the kappa opioid receptor (KOR) and …

Systematic Product And Process Design Of Versatile Perfluorocarbon Nanoemulsions For Elimination Of Hypoxia And Reactive Oxygen Species, Eric Lambert

Electronic Theses and Dissertations

According to a 2022 report, organs destined for transplantation are discarded 15% of the time for various reasons (Israni et al. 2022). This highlights a critical need in transplant practices. Transplant donor tissues are in need of essential nutrients, including molecular oxygen, to maintain integrity during preservation. A current trend in preservation is to perfuse the ex vivo tissue graft with nutrient-rich aqueous perfusate on a closed circuit. This practice, known as machine perfusion (MP) is limited by the absence of an oxygen-carrying component in the perfusate. Additionally, injuries to the recipient are sustained on reperfusion of the transplanted …

Investigating The Impact On Private Water Supply Of Hydraulic Fracturing Communication With An Abandoned Conventional Gas Well In New Freeport, Pa, Kiley Miller

Electronic Theses and Dissertations

In June of 2022 a “frac out” occurred in New Freeport, PA when an unconventional gas well under development by hydraulic fracturing, communicated with an abandoned gas well to the surface. An initial “zone of impact” encompassed much of the town’s main thoroughfare. Water samples were obtained from 17 private water wells, 5 springs and 1 pond (31 total samples) and analyzed for cations, anions, and light hydrocarbons. Methane was found in 18 of the samples, both located within and outside of the “zone of impact”. Mass ratio analyses indicated contamination from both unconventional and conventional wells. Interferometric Synthetic Aperture …

Mindfulness Meditation To Reduce Nurse Burnout: An Ebp Implementation Project, Lester Denson Jr

MSN Capstone Projects

Hospitals across the United States are suffering from poor staffing (American Nurses Foundation, 2021). A common thread throughout those facilities is that nurses are leaving their jobs due to self-reported burnout, contributing to the staffing shortage and low morale (Shah et al., 2021).

Mindfulness training plays a part in decreasing emotional exhaustion for staff nurses. A reduction of emotional exhaustion has been discovered after the implementation of mindfulness-based intervention programs, with continued improvement after completion of the program (Sarazine et al., 2021; Bianchini & Copeland, 2021). The benefit of this implementation would be a reduction of nurse burnout which ultimately …

Improving Nursing Provision Of Patient Care In High Acuity Medical Units And Fostering Their Wellbeing By Providing Education On End-Of-Life Care And Finding Joy And Meaning In Work: A Quality Improvement Project, Donna Durant

Doctor of Nursing Practice (DNP) Manuscripts

Abstract

Palliative care employs a multidisciplinary approach focusing on the quality of life for patients and their families experiencing the complexity of serious illness (Nelson, 2021). Due to shortages of palliative care specialists and a lack of nurse proficiency in caring for people with serious illnesses, integrating a palliative care approach is an ethical obligation for nursing (Parekh de Campos, 2022). Gaps in palliative care and end-of-life education for new nurses coming to the acute care setting in a large tertiary hospital in Southwestern Pennsylvania were identified.

Evidence-based education was delivered by advanced practice providers trained in this content area. …

"Reducing Heart Failure Readmission Rates Through Implementation Of Heart Failure Diuretic", Caley Tatrn, Yvonne Weideman, Venkatraman Srinivasan

Doctor of Nursing Practice (DNP) Manuscripts

Background and significance: heart disease was the number one cause of death in the United States in 2021, with 696, 962 deaths (Leading Causes of Death, 2022). There are about 6.2 million individuals in the U.S. total with heart failure (Kilgore et al., 2017). About one-quarter of patients with heart failure are readmitted within thirty days of discharge, while one-quarter of hospital readmissions are preventable. Between 2010-2017, over seven million patients were admitted for heart failure in the United States. Eighteen percent had a readmission within thirty days and thirty-one percent had a readmission within ninety days (Khan et …

Refractive Outcomes Of Phacoemulsification Wtih Endocyclophotocoagulation Vs. Phacoemulsification Alone, Truman Silvasi

Conference Presentation Abstracts

No abstract provided.

Richter Syndrome And The Retina, Sahal Saleh

Conference Presentation Abstracts

No abstract provided.

Ex Vivo Drug Sensitivity Imaging-Based Platform For Primary Acute Lymphoblastic Leukemia Cells, Lauren Rowland, Brandon Smart, Anthony Brown, Gino M Dettorre, Yoshihiro Gocho, Jeremy Hunt, Wenjian Yang, Satoshi Yoshimura, Noemi Reyes, Guoqing Du, August John, Dylan Maxwell, Wendy Stock, Steven Kornblau, Mary V Relling, Hiroto Inaba, Ching-Hon Pui, Jean-Pierre Bourquin, Seth E Karol, Charles G Mullighan, William E Evans, Jun J Yang, Kristine R Crews

Faculty, Staff and Student Publications

Resistance of acute lymphoblastic leukemia (ALL) cells to chemotherapy, whether present at diagnosis or acquired during treatment, is a major cause of treatment failure. Primary ALL cells are accessible for drug sensitivity testing at the time of new diagnosis or at relapse, but there are major limitations with current methods for determining drug sensitivity ex vivo. Here, we describe a functional precision medicine method using a fluorescence imaging platform to test drug sensitivity profiles of primary ALL cells. Leukemia cells are co-cultured with mesenchymal stromal cells and tested with a panel of 40 anti-leukemia drugs to determine individual patterns of …

Sentinel Lymph Node Biopsy: Pioneering Precision In Breast Cancer Management, Vikram C Bellur, Anirudh Venkatesh, Rakshith G Maiya, Harshith Reddy

MELIORA 2023-THE STUDENT MEDICAL CONFERENCE OF KMC MANIPAL

No abstract provided.

Parkinson’S Disease : Insight On Pathophysiology And Pharmacotherapy, Ashwin K, Ahad Ansar, Aditi K, Viha Jain

MELIORA 2023-THE STUDENT MEDICAL CONFERENCE OF KMC MANIPAL

No abstract provided.

Osteoarthritis Knee And Mesenchymal Stromal Cell Therapy, Maneesha Sarma, Arathi B, Kalyani Gopal

MELIORA 2023-THE STUDENT MEDICAL CONFERENCE OF KMC MANIPAL

No abstract provided.

Understanding Pain: The Truth Behind Torment, Jayalakshmi Chandrasekaran, Shreya Dutta, Varshini Shetty

MELIORA 2023-THE STUDENT MEDICAL CONFERENCE OF KMC MANIPAL

No abstract provided.

‘Safe Couch, Safe House’ Program (Scshp): Reducing Exposure To Toxic Flame Retardants For Children In A Low-Income Public Housing At Hunters View, Bayview-Hunters Point, San Francisco., Aliza Khan

Master's Projects and Capstones

Since the 1970s, flame retardants have been used extensively in consumer goods, including furniture, textile, and electronics, to meet California’s flammability standards. (Gibson et al.,2019) Polybrominated Diphenyl Ethers (PBDEs), once the most widely used flame retardants being used in consumer products, were phased out from use in manufacturing as evidence emerged about PBDEs persistence and toxicity. (Hoffman et al.,2017) PBDEs were replaced by Organophosphate Flame Retardants (OPFRs), which has proven to be a case of ‘regrettable substitution’ as exposure to OPFRs is ubiquitous and pervasive in humans due to their volatility and propensity to leach from products into the environment. …

Recognition Of And Response To Obstetric Emergencies: Developing A Virtual Competency-Based Orientation Program, Susan Morrison

Student Scholarly Projects

In order to improve outcomes in the perinatal setting, the development of a Virtual Competency-Based Orientation Program (CBO) toolkit is vital. Two toolkits, namely the Alliance for Innovation on Maternal Health (AIM) and the California Maternal Quality Care Collaborative (CMQCC), have been identified as effective in enhancing perinatal outcomes. AIM is a national initiative focused on improving maternal health outcomes, promoting safer birth practices, and saving lives through the implementation of best practices. CMQCC is a multi-stakeholder organization in California committed to eliminating preventable morbidity, mortality, and racial disparities in maternity care. Both AIM and CMQCC CBO toolkits incorporate research, …

Initial Examination Of The Mental Health Disorders: Screening Instrument For Athletes, Brad C. Donohue, Jesse Scott, Grace Goodwin, Kimberly Barchard, Greg Bohall, Daniel N. Allen

Psychology Faculty Research

Introduction: There is a need to psychometrically develop assessment instruments capable of screening mental health disorders in athlete populations. The current study was conducted to determine reliability, validity and clinical utility of the Mental Health Disorders Screening Instrument for Athletes (MHDSIA).

Methods and results:: 259 collegiate athletes completed the MHDSIA. Factor analysis determined a single factor with good internal consistency, and this factor was positively correlated with an established measure of psychiatric symptomology (Symptom Checklist 90-R), demonstrating its concurrent validity. An optimum clinical cutoff score (i.e., 32) was determined using Receiver Operating Characteristic (ROC) analyses to assist appropriate mental health …

Early Identification Of Postpartum Depression Symptoms During The Antenatal Period Through The Utilization Of The Edinburgh Postnatal Depression Scale, Cherie Didier

Doctor of Nursing Practice Projects

Postpartum depression (PPD) is a prevalent mental health disorder that negatively impacts maternal behavior and infant development. Despite a global incidence of around 12% (Ti & Curtis, 2019), current screening practices are inadequate. The American College of Obstetricians and Gynecologists (ACOG, 2018) recommends universal screening using the Edinburgh Postnatal Depression Scale (EPDS) at least once during pregnancy. However, the project site in an obstetrical clinic currently does not screen during pregnancy. This quantitative quality improvement project in a Memphis, TN, obstetrical clinic used systematic data collection of EPDS scores of pregnant women and analysis to investigate the effectiveness of implementing …