Medicine and Health Sciences Commons^™

Feasibility Of Using Somatosensory Input On Pediatric Patients Receiving Dental Treatment, Liara D. Vinson

Theses and Dissertations

Purpose: The aim of this randomized, cross-over designed feasibility study is to evaluate patient anxiety, patient cooperation, and patient acceptance of a vibrating weighted vest used during the restorative treatment compared to when no device is used.

Methods: Children aged 5 to 15 years, needing at least two appointments for restorative treatment requiring local anesthesia under basic behavior guidance techniques were recruited. Patients were randomly allocated to wearing a vibrating weighted vest at one of the appointments. At both appointments, behavior was evaluated using Frankl scores and anxiety was evaluated at the beginning and at the end of …

The Feasibility Of Health Professional Student Delivered Social Visits For Stroke Survivors With Loneliness, Jason Burnett, Jordan Broussard, Bronson Ciavarra, Louisa Smitherman, Mary Li, Emma Thames, Sharon Zachariah, Grace Kim, Rachel Pijnnaken, Hannah Zeller, John Halphen, Sean I Savitz, Namkee Choi, Jennifer E S Beauchamp

Faculty, Staff and Student Publications

Objectives: To examine the feasibility of a social phone call program to address social isolation and loneliness in stroke survivors.

Materials and methods: We paired 14 lonely community-living stroke survivors with 14 health professional students for 6-weekly unstructured social phone calls. Feasibility data and measures of social isolation, loneliness and other psychosocial metrics were collected pre- and post-intervention. Students journaled following each unstructured call to capture the informal conversation and their sentiments.

Results: Sixty-two percent of the targeted sample was interested. Fourteen eligible and interested participants were enrolled. The 13 (93%) participants completing all calls and surveys were an average …

Electrospun Pt-Tio₂ Nanofibers Doped With Hpa For Catalytic Hydrodeoxygenation, Amos Taiswa, Randy L. Maglinao, Jessica M. Andriolo, Sandeep Kumar, Jack L. Skinner

Civil & Environmental Engineering Faculty Publications

Electrospinning is utilized to fabricate catalytic nanofiber scaffold for biocrude upgrading in hydrodeoxygenation (HDO) following computational studies suggesting the need for nano-catalysts for efficient HDO conversion and selectivity. Here, Pt-TiO₂ nanofibers are fabricated through electrospinning, followed by wet impregnation with a heteropoly acid (HPA), tungstosilicic acid. Intensive heat treatments were incorporated during and after processes to obtain a HPA doped Pt-TiO₂ nano-catalyst. Catalytic HDO was performed in a batch reactor with phenol as the raw biocrude dissolved in hexadecane. The HPA doped Pt-TiO₂ catalyst demonstrated promising HDO performance of 37.2% conversion and a 78.9% selectivity to oxygen …

Riemannian Frameworks For The Harmonization Of Resting-State Functional Mri Scans, Nicolas Honnorat, Sudha Seshadri, Ron Killiany, John Blangero, David C. Glahn, Peter T. Fox, Mohamad Habes

School of Medicine Publications

Magnetic Resonance Imaging provides unprecedented images of the brain. Unfortunately, scanners and acquisition protocols can significantly impact MRI scans. The development of statistical methods able to reduce this variability without altering the relevant information in the scans, often coined harmonization methods, has been the topic of an increasing research effort supported by the recent growth of publicly available neuroimaging data sets and new possibilities for combining them to achieve greater statistical power. In this work, we focus on the challenges specifically raised by the harmonization of resting-state functional MRI scans. We propose to harmonize resting-state fMRI scans by reducing the …

Targeting Of Oncogenic Aaa-Atpase Trip13 Reduces Progression Of Pancreatic Ductal Adenocarcinoma, Farrukh Afaq, Sumit Agarwal, Prachi Bajpai, Sameer Al Diffalha, Hyung-Gyoon Kim, Shajan Peter, Moh'd Khushman, Subhash Chauhan, Priyabrata Mukherjee, Sooryanarayana Varambally, Upender Manne

School of Medicine Publications

Thyroid hormone receptor-interacting protein 13 (TRIP13) is involved in cancer progression, but its role in pancreatic ductal adenocarcinoma (PDAC) is unknown. Thus, we assessed the expression, functional role, and mechanism of action of TRIP13 in PDAC. We further examined the efficacy of TRIP13 inhibitor, DCZ0415, alone or in combination with gemcitabine on malignant phenotypes, tumor progression, and immune response. We found that TRIP13 was overexpressed in human PDACs relative to corresponding normal pancreatic tissues. TRIP13 knockdown or treatment of PDAC cells with DCZ0415 reduced proliferation and colony formation, and induced G2/M cell cycle arrest and apoptosis. Additionally, TRIP13 knockdown …

Inhaling The Unseen: Exploring The Presence Of Microplastics In The Human Respiratory Tract, Kara Coffman-Rea

Graduate Research Theses & Dissertations

Microplastics (plastic pieces less than 5 mm) have emerged as a pervasive form of pollution acknowledged as a universal threat to both environmental and human health. Their small size and widespread distribution pose significant risks to marine life, terrestrial ecosystems, and ultimately human health. Microplastics have been reported in food and drink items designated for human consumption, in cosmetics and consumer goods designed for human use, and within the air we breathe, each providing an entry route for microplastics to enter the human body. Recently, microplastic particles have been detected in a variety of human tissue samples (e.g., lung tissue). …

Evaluation Of A Novel 3d-Printed Task Trainer For The Simulation Of Gynecological Procedures At A Medical Academic Center, Jami Monico, Karen S. Carlson

Manuscripts: Obstetrics & Gynecology

Introduction

Learning and mastering the performance of gynecological procedures in a secure and supervised simulation setting is important for learners, especially in the early phases of medical education. This project aims to assess the efficacy of an innovative gynecological task trainer for diverse simulation sessions. Following engagement with the task trainer, learners evaluated their experiences with a comprehensive questionnaire. The results of the survey were scientifically analyzed and interpreted.

Methods

The innovative gynecological task trainer was created with 3D-printed plastic, silicone, and a tabletop base. Learners engaged in simulations in which they performed gynecologic procedures using the task trainer. Subsequently, …

Promoting Cultural Competence Through Clinical Education, Katie Coakley

Graduate Research Theses & Dissertations

Purpose: The purpose of this dissertation was to explore how clinical education can be leveraged to promote the cultural competence of aspiring clinicians. Cultural competence training is important in addressing health disparities and recommended in health professions education, but barriers exist to its implementation. This dissertation seeks to explore and appraise the literature on cultural competence instruction in rehabilitation education, evaluate the impact of a clinical education experience for speech language pathology (SLP) students on their perceived cultural competence, and assess the outcomes for clients receiving feeding therapy services from supervised SLP students, including the client perceptions of cultural competence …

An Exploration Of The Sense Of Belonging For African American Women Licensed Clinicians In A Voluntary Professional Counseling Organization, Raushanah Jackson

Graduate Research Theses & Dissertations

Due to historical oppression in academe, the voices of African American women have been excluded, or unjustifiably limited, in academic research and from mainstream psychological thought. This study was one aim at understanding the experiences of belonging of women of African American ancestry who were clinically licensed professional members in a volunteer member counseling organization. Centering African American women’s voices was used through a lens of critical race theory and Black Feminist Thought to illuminate the structural, representational, and sociopolitical barriers that African American women face. An Interpretive Phenomenological Analysis approach was used to center the voices of five licensed …

Clinical Reasoning Development: Exploring The Role Of Instructor Feedback During Health Professions Clinical Education Experiences, Ryan T. Orrison

Graduate Research Theses & Dissertations

The growing complexity of the healthcare environment and the need to equitably address the health and well-being of a diverse patient population has increased the requirement for practical instruction and assessment of clinical reasoning in the training of health professionals. Formative assessment, in the form of feedback, is recognized as an essential instructional component in teaching clinical reasoning. This study aimed to investigate the role of feedback in developing clinical reasoning during clinical education.

This investigation consisted of three unique studies completed in phases. The scoping review methodology in phase one revealed six themes from the included articles (n = …

Latine Caregiver Perspectives Of Their Child’S Speech And Language Services, Marisol Perez

Graduate Research Theses & Dissertations

Early Intervention (EI) speech-language pathologists (SLPs) are mandated to provide culturally responsive services to culturally and linguistically diverse (CLD) clients. However, little is known about Latine caregivers’ perspectives on receiving these services. The purpose of this study was to examine Latine caregivers’ perspectives on their child’s speech and language services by answering the following research questions: 1) How do intrinsic factors relate to Latine caregiver satisfaction with their family’s speech and language services? 2) Does perception of clinician cultural sensitivity relate to Latine caregiver satisfaction with speech and language services? 3) What do Latine caregivers perceive as determinants (facilitators and …

Implementing A Nurse-Driven Clostridium Difficile Screening Protocol, Sandrela Magnuson

Graduate Theses, Dissertations, and Problem Reports (ETD)

ABSTRACT

Background: Clostridium difficile infection (CDI) is a prevalent infection often contracted in hospitals. CDI is also increasingly originating from community settings. In addition to the health risks associated with CDI, diagnosis of a hospital-acquired CDI can have a significant financial impact on hospital systems. When hospital acquired, hospital systems are no longer reimbursed by payers. Secondary to the increasing prevalence of community-acquired CDI, mechanisms for early detection and isolation are warranted.

Local Problem: J.W. Ruby Memorial Hospital has an integrated Clostridium difficile (C. difficile) electronic health record (EHR) screening questionnaire that requires updating to align with current guidelines.

Purpose: …

Molecular Investigation Of Tick-Borne Pathogens In Feral Swine (Sus Scrofa) From Seven Us States, Sofiane Aiche

Masters Theses

Feral swine (Sus scrofa) have been proposed as part of the lifecycles of multiple tickborne pathogens (TBP). This is a result of the increase in feral swine populations and increased tick populations and geographic ranges. Few surveys exist on the TBP relevant to human and wildlife of feral swine in the US. The aim of this study is to investigate the prevalence of 10 TBP: Anaplasma spp., Borrelia spp., Cytauxzoon felis, Hepatozoon spp., Babesia spp., Mycoplasma spp., Trypanosoma cruzi, Toxoplasma gondii, Yersinia pestis, and Rickettsia spp. A total of 87 feral swine blood samples …

Influence Of Attack Performance On The Ovc Volleyball Regular Seasons 2022 & 2023, Ignacio Valdemoros

Masters Theses

Understanding the outcome of volleyball games is necessary for coaches before, after, and during a season. There are several ways to gain this understanding, but statistical analysis is fundamental to see the minimum patterns of behavior that influence wins and losses in Volleyball. Furthermore, this analysis helps identify the optimal approach to achieving a goal and determining the most effective alternative to success. Scoring points in Volleyball involves three key skills: serving, blocking, and attacking. Among these skills, attacking plays the most relevant role in determining the outcome of a match. The position on the court (e.g. Outside Hitter, Middle …

Development Of An Order Set To Improve Consistency Of Blood Glucose Monitoring For Hospitalized Patients On Enteral Feeding, Kristen Calebaugh

Graduate Theses, Dissertations, and Problem Reports (ETD)

Abstract

Development of an Order set to Improve Consistency of Blood Glucose Monitoring for Adult Hospitalized Patients on Enteral Feeding

Kristen Calebaugh, BSN, RN

Background

Hospitalized patients often require artificial nutrition through either enteral feeding, placing the patient at risk for glucose alterations related to physiological responses of nutritional metabolism. Historically, there has been no standard of care or consistency aligning tube feedings times with point of care blood glucose testing. Without a standardized order set to guide blood glucose monitoring orders, patients on artificial nutrition may experience undetected hypo or hyperglycemia or inadequate glycemic control, which can cause adverse …

Hack24f: Ai And Mental Health: Addressing The Therapy Gap, Samatrai Piam, Digvijay Mahawar, Meric Kinali, Luxman Surentha, Jackson Comeau, Gail Rauch, Cody Turner

Paul English Applied Artificial Intelligence (AI) Institute Publications

Real-World Problem: There is a global shortage of mental health professionals, especially in underserved areas. AI-based chatbots could help fill this gap, but there are serious ethical concerns about the quality of care and efficacy of such chatbots.

Solution: This is a non-technical project that involved conversing with existing chatbots in an effort to develop a normative framework that could be used by future AI therapy bot developers. This framework seeks to build on, and operationalize, some of the insights from the recently published whitepaper on the ethics of chatbot therapy by the UMass Boston Applied Ethics Center. This presentation …

The Bulletin: Sidney Kimmel Medical College At Thomas Jefferson University, Volume 102, Issue 1, Winter 2024

The Bulletin (formerly the Jefferson Medical College Alumni Bulletin)

This issue includes:

• 6 - Dean’s Column
• 8 - Bicentennial Celebrations
• 10 - ICYMI (In Case You Missed It)
• 12 - Cancer Moonshot Award
• 14 - SKMC Student Blends the Medical Field With the Sports Field: Azra Dees
• 16 - Leading Medicine’s Next Generation Into a New Century: Welcoming Said Ibrahim, MD, MBA, MPH
• 22 - Healthcare Quality and Patient Safety
• 26 - My First Mentee: Robert M. Stein, MD
• 28 - A Message From the SKMC Alumni Board President
• 30 - Alumni Weekend Recap
• 36 - A Message From a Class Agent
• 38 - Meet Cute, SKMC Graduates Find …

Dna Methylation In Aging And Alzheimer's Disease, Raymond Cheng, Jingmin Shu, Hai Chen, Ming Li, Xiaodong Cheng, Li Liu

The Brown Foundation: Institute of Molecular Medicine

DNA methylation undergoes significant changes with age. These alterations play a pivotal role in the development of age-related diseases, including Alzheimer's disease (AD). Recent advancements in DNA methylome profiling have revealed global hypomethylation patterns, particularly within repetitive elements, as well as gene-specific changes that are associated with neurodegeneration. Age-related alterations in DNA methylation have been implicated in the disruption of key cellular processes, such as inflammation and proteostasis, both central to AD pathology. However, several challenges persist in this field. One major issue is the inconsistency of findings across different brain regions and tissue types, which complicates result interpretation. Furthermore, …

A Simple And Rapid In Vitro Assay For Identification Of Direct Inhibitors Of O6-Methylguanine-Dna Methyltransferase, Vahid Khalaj, Solmaz Aghaamiri, Sukhen C Ghosh, Servando Hernandez Vargas, Majid Momeny, Ali Azhdarinia

The Brown Foundation: Institute of Molecular Medicine

O6-Methylguanine-DNA methyltransferase (MGMT) is a DNA repair enzyme that is overexpressed in certain tumors and is associated with resistance to the DNA alkylating agent temozolomide. MGMT inhibitors show potential in combating temozolomide resistance, but current assays for MGMT enzyme activity and inhibition, primarily oligonucleotide-based and fluorescent probe-based, are laborious and costly. The clinical relevance of temozolomide therapy calls for more convenient methodologies to study MGMT inhibition. Here, we extended the application of SNAP-Capture magnetic beads to develop a novel MGMT inhibition assay that demonstrated efficacy not only with known MGMT inhibitors, but also with the aldehyde dehydrogenase inhibitor, disulfiram. The …

Fetal Abdominal Obesity In Women With One Value Abnormality On Diagnostic Test For Gestational Diabetes Mellitus, Wonjin Kim, Soo Kyung Park, Yoo Lee Kim

The Brown Foundation: Institute of Molecular Medicine

Previous studies have shown that fetal abdominal obesity (FAO) was already observed at the time of gestational diabetes mellitus (GDM) diagnosis and persisted until delivery despite management in older and/or obese women. In this study, we investigated whether fetuses of women with milder hyperglycemia than GDM have accelerated abdominal growth, leading to adverse pregnancy outcomes. We retrospectively reviewed the medical records of 7,569 singleton pregnant women who were universally screened using a 50-g glucose challenge test (GCT) and underwent a 3-h 100-g oral glucose tolerance test (OGTT) if GCT result was ≥140mg/dL. GDM, one value abnormality (OVA), and normal glucose …

Reorganization Of Dopamine Circuitry In The Anterior Corpus Callosum Between Early Adolescence And Adulthood In The Mouse, Megan Caldwell, Josue Criollo Mendoza, Xin Yan Zhu Jiang, Colin Alarcon, Vanessa Ayo-Jibunoh, Shelby Louis, Daniel Maronna, Rania Darwish, Jaquelyn Tomaio, Susana Mingote, Leora Yetnikoff

Advanced Science Research Center

The maturation of forebrain dopamine circuitry occurs over multiple developmental periods, extending from early postnatal life until adulthood, with the precise timing of maturation defined by the target region. We recently demonstrated in the adult mouse brain that axon terminals arising from midbrain dopamine neurons innervate the anterior corpus callosum and that oligodendrocyte lineage cells in this white matter tract express dopamine receptor transcripts. Whether corpus callosal dopamine circuitry undergoes maturational changes between early adolescence and adulthood is unknown but may be relevant to understanding the dramatic micro- and macro-anatomical changes that occur in the corpus callosum of multiple species …

Uterine Rupture In The First Trimester: A Case Report And Review Of The Literature., Steve Mutiso, Felix Oindi, Debbie Mundia

Obstetrics and Gynaecology, East Africa

Background: Uterine rupture is a rare complication that can occur in the frst trimester of pregnancy. It can lead to serious maternal morbidity or mortality, which is mostly due to catastrophic bleeding. First trimester uterine rupture is rare; hence, diagnosis can be challenging as it may be confused with other causes of early pregnancy bleeding such as an ectopic pregnancy. We present a case of frst trimester scar dehiscence and conduct a literature review of this rare condition.

Case presentation: A 39-year-old African patient with four previous hysterotomy scars presented with severe lower abdominal pain at 11 weeks of gestation. …

Evaluation Of Potential Biomarkers For Lenvatinib Plus Pembrolizumab Among Patients With Advanced Endometrial Cancer: Results From Study 111/Keynote-146, Vicky Makker, Matthew H. Taylor, Carol Aghajanian, Allen L. Cohn, Marcia S. Brose, Christopher Di Simone, Zhu Alexander Cao, Leah Suttner, Andrey Loboda, Razvan Cristescu, Petar Jelinic, Robert Orlowski, Lea Dutta, Junji Matsui, Corina E. Dutcus, Yukinori Minoshima, Mark J. Messing

Department of Medical Oncology Faculty Papers

Background Lenvatinib plus pembrolizumab demonstrated clinically meaningful benefit in patients with previously treated advanced endometrial carcinoma in Study 111/KEYNOTE-146 (NCT02501096). In these exploratory analyses from this study, we evaluated the associations between clinical outcomes and gene expression signature scores and descriptively summarized response in biomarker subpopulations defined by tumor mutational burden (TMB) and DNA variants for individual genes of interest.

Methods Patients with histologically confirmed metastatic endometrial carcinoma received oral lenvatinib 20 mg once daily plus intravenous pembrolizumab 200 mg every 3 weeks for 35 cycles. Archived formalin-fixed paraffin-embedded tissue was obtained from all patients. T-cell–inflamed gene expression …

Regulatory Approval Of Clinical Trials: Is It Time To Reinvent The Wheel?, Mansoor Saleh, Karishma Sharma, Aisleen Shamshudin, Innocent Abayo, Stacey Gondi, Noureen Karimi

Haematology and Oncology, East Africa

Less than 1% of all clinical trials are conducted in Africa. In 2019, only six of 26 oncology clinical trials conducted in Africa were conducted in countries with subjects of African ancestry. There are multiple barriers that hinder the conduct of cancer clinical trials in Africa. Time to trial activation (TTA) is the administrative and regulatory process required before a study can be activated—an important metric and often a major barrier for site selection. In Kenya, TTA involves review by Institutional Review Board (IRB), Pharmacy and Poisons Board, National Commission for Science, Technology and Innovation and Ministry of Health, all …

Does Serum Uric Acid To Creatinine Ratio Predict Mortality Risk In Patients With Heart Failure, Xiaoqing Xi, Jinfeng Cai, Chen Zhang, Xuefei Wang

The Texas Heart Institute Journal

BACKGROUND: Previous studies have established a positive correlation between serum uric acid to creatinine (SUA/Cr) ratio and cardiovascular disease, but the relationship between SUA/Cr ratio and the prognosis of heart failure (HF) remains unknown. This study investigated the potential of SUA/Cr ratio as a prognostic predictor for patients with HF.

METHODS: This single-center prospective cohort study enrolled 2,122 patients with HF between March 2013 and June 2017. All patients were divided into 3 groups according to SUA/Cr ratio tertiles and were followed up with until December 31, 2022. The association between SUA/Cr ratio and the prognosis of HF was assessed …

Use Of Extracorporeal Membrane Oxygenation-Facilitated Large-Bore Catheter Embolectomy In The Treatment Of Acute Pulmonary Embolism Complicated By Shock, Hugh A Glazier, Amir Kaki

The Texas Heart Institute Journal

This article reports the case of a 42-year-old man who presented with a saddle pulmonary embolus complicated by normotensive cardiogenic shock. The patient was first stabilized with venoarterial extracorporeal membrane oxygenation. Then, while the patient was still on extracorporeal membrane oxygenation, thrombectomy with a large-bore catheter device was performed that resulted in a large decrease in pulmonary artery pressures and a clinically significant increase in cardiac index, with rapid clinical improvement. Complete recovery of the patient's cardiopulmonary status has been maintained at intermediate-term follow-up. This treatment strategy should be considered favorably in the treatment of patients presenting with pulmonary embolism …

Examining Anti-Racist Attitudes In Maternity Care Workers, Angelina Aduke Toluhi

All ETDs from UAB

Racism in maternity care has been identified as one of the major contributors to the persistent racial disparities in maternal health outcomes in the United States (US). Antiracism is a term used to describe the practice of actively identifying and opposing racism with the goal of changing policies, attitudes, behaviors, and beliefs that continue to foster racist ideas and actions. The results of this convergent mixed method research study reveal that racism and other forms of racial discrimination during maternity care may lead to adverse pregnancy outcomes in Non-Hispanic Black (NHB) pregnant patients in Southern US. In the first aim, …

Non-Catalytic Regulators Of The Secretory Pathway, Peyton Vanwinkle

All ETDs from UAB

This thesis focuses on two key questions: 1) how are bone development and regeneration regulated by the CREB3L1 transcription factor; and 2) what is the mechanism of action of the endoplasmic reticulum resident protein JAGN1, which when dysregulated, causes severe congenital neutropenia (SCN)? CREB3L1 regulates bone development and regeneration in mammalian models by facilitating the expression of COL1A1 and components of the secretory pathway required for collagen secretion. We generated two zebrafish models of Creb3l1 dysfunction (creb3l1ΔbZIP/ΔbZIP and creb3l1TA+/TA+). Both models showed that Creb3l1 functions in regulating col1a1a transcription and overall regenerate size are conserved in zebrafish. However, we also …

Screening For And Addressing Social Determinants Of Health In Hospitals Participating In Accountable Care Organizations, Heather Lee

All ETDs from UAB

There is a growing recognition among hospitals, payers, and policymakers in the United States that addressing social needs of patients is important to improving quality of care, patient outcomes, and lowering health care spending. Accountable care organizations (ACOs) may be especially incentivized to address social needs of patients to meet population health goals related to patient outcomes and costs. This cross-sectional study used data from the American Hospital Association Annual Survey to explore to explore how hospitals participating in or leading ACOs are screening for and addressing individual-level HRSNs of patients and to understand the extent to which ACOs are …

The Multifaceted Role Of Neutrophil Heterogeneity In Covid-19 Pathogenesis, Marcus Darrell Davis

All ETDs from UAB

COVID-19 is a respiratory illness caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The disease is characterized by an excessive inflammatory response and dysfunction of the immune system triggered by immunopathological mechanisms. Neutrophils are the most abundant circulating leukocytes, playing a critical role in the pathogenesis of multiple inflammatory conditions. Several studies have demonstrated that neutrophils are key contributors to COVID-19 disease pathogenesis; however, their role in disease progression remains unclear. Here, we demonstrate immune dysregulation in COVID-19 patients characterized by a significant expansion of neutrophil numbers and reduced frequency of T-cell populations. We identify an immature …