Medicine and Health Sciences Commons^™

Breast Cancer Molecular Subtype Classification According To Immunohistochemistry Markers And Its Association With Pathological Characteristics Among Women Attending Tertiary Hospitals In Tanzania, Allyzain Ismail, Sajida Panjwani, Neelam Ismail, Caroline Ngimba, Innocent Mosha, Philip Adebayo, Ally Mwanga, Ali Zehri, Aidan Njau, Ali Athar

Family Medicine, East Africa

Background: Breast cancer immunohistochemistry is a biological characteristic of the tumour which has a role to diagnose molecular subtype, prognosticate and guide treatment and is categorised into 4 subtypes. Data in Tanzania was lacking and was based off data extrapolated from studies in Western Africa thus hypothesizing that women of African ancestry predominately develop Triple Negative Breast Cancer (TNBC).

Methods: A retrospective cross-sectional study was carried out at two tertiary referral hospitals on participants who were recruited from the cancer registries from 2015 to 2022. Prevalence of each molecular subtype was determined and association between molecular subtype to demographic and …

Vesicular Monoamine Transporter-2 Inhibitor Jpc-141 Prevents Methamphetamine-Induced Dopamine Toxicity And Blocks Methamphetamine Self-Administration In Rats, Cassie M. Chandler, Justin R. Nickell, A. George Wilson, John P. Culver, Peter A. Crooks, Michael T. Bardo, Linda P. Dwoskin

Psychology Faculty Publications

Previous research has demonstrated therapeutic potential for VMAT2 inhibitors in rat models of methamphetamine use disorder. Here, we report on the neurochemical and behavioral effects of 1-(2-methoxyphenethyl)-4-phenethypiperazine (JPC-141), a novel analog of lobelane. JPC-141 potently inhibited (Ki = 52 nM) [3H]dopamine uptake by VMAT2 in striatal vesicles with 50 to 250-fold greater selectivity for VMAT2 over dopamine, norepinephrine and serotonin plasmalemma transporters. Also, JPC-141 was 57-fold more selective for inhibiting VMAT2 over [3H]dofetilide binding to hERG channels expressed by HEK293, suggesting relatively low potential for cardiotoxicity. When administered in vivo to rats, JPC-141 prevented the METH-induced reduction in striatal dopamine …

Veggierx, A Healing Produce Prescription Yielding Positive Health Outcome Data, M. Bojrab-Wray, Michelle Drouin, L. Knoop, Lauren Reining, Dana Albright, K. Wehrle

Health Services and Informatics Research

Learning Outcome

Upon completion of reviewing the abstract content, attendees will be able to evaluate VeggieRx’s benefits, understand data analysis methods, and recognize best-practices for utilizing electronic health data in program assessment.

Background

Produce prescription programs are becoming popular across the U.S., as health care providers and dietitians work together to provide healthy food, resources, and education to individuals with chronic diseases, such as diabetes, heart disease, and at-risk pregnant mothers. Since 2021, our USDA GusNIP-funded program has provided these services to food insecure patients with these conditions. As this program exists within a health care system, we have unique …

A Retrospective Study Of Virtual Hospital Experiential Learning Across Clerkship And Pre-Clerkship Doctor Of Osteopathic Medicine Students At A Medical School Based In The United States., Lydia Kersh, Anthony Sciuva, Jennifer H. Shaw

PCOM Scholarly Works

INTRODUCTION: During the COVID-19 pandemic, a medical institution in the United States implemented a virtual clerkship rotation to replicate the skills that students would develop during an in-person clinical site rotation. The primary objective of this study was to identify the efficacy and benefits following the implementation of the Virtual Hospital Experiential Learning (VHEL) model, as demonstrated by increased perceived confidence and skill growth among medical students.

METHODS: Cases were presented to five to six medical students each week. On the Monday of the week, students entered a virtual conference platform for a standardized patient encounter. Staff and faculty randomly …

Pharmacy Newsletter : October 2024, Pharmacy Department

Department of Pharmacy Archives

• Pharmacy Newsletter provides information regarding the decisions of P&TC, current concepts in drug therapy, warnings and cautions issued by various regulatory agencies, drug interactions, ADRs, and matters related to drug usage.
• AKUH Clinical Pharmacy Accolades
• Treatment & Management Guidelines for Rodenticide Poisonings
• Drug & Poison Information Center
• Levetiracetam & Clobazam linked to Drug Reaction with Eosinophilia & Systemic Symptoms (DRESS)
• AKUH Antimicrobial Stewardship Committee (ASP)
• World Pharmacists Day 2024 at AKUH | “Pharmacists: Meeting global health needs”
• Clinical Pharmacists in Multidisciplinary Rounds

2024 Eacts/Eactaic Guidelines On Patient Blood Management In Adult Cardiac Surgery In Collaboration With Ebcp, Filip Casselman, Marcus Lance, Aamer Ahmed, Alice Ascari, Juan Blanco-Morillo, Daniel Bolliger, Maroua Eid, Gabor Erdoes, Renard Gerhardus Haumann

Anaesthesiology, East Africa

Clinical practice guidelines consolidate and evaluate all pertinent evidence available at their time of formulation on a specific topic, the goal being to assist physicians in determining the most effective management strategies for patients with a particular condition. These guidelines assess the impact on patient outcomes and weigh the risk–benefit ratio of various diagnostic or therapeutic approaches. Although not a replacement for textbooks, they provide supplementary information on topics relevant to current clinical practice, becoming an essential tool to support physicians' decision making in daily practice. Nonetheless, it is crucial to understand that these recommendations are intended to guide but …

Child Maltreatment And Behavioral Health Outcomes In Child Welfare: Exploring The Roles Of Severity And Polyvictimization, Lauren Malthaner, Jill Mcleigh, Gregory Knell, Katelyn Jetelina, Folefac Atem, Sarah Messiah

Behavioral Health/Developmental Delay

Child maltreatment and polyvictimization are known risk factors for long-term detrimental health and development outcomes, including behavioral health challenges. However, effects from specific types and combinations of maltreatments are unclear. This study examined the association between maltreatment or polyvictimization and behavioral health in a child welfare sample.

For questions about this study or others, please email [email protected]

childrens.com/fostercare

Soprano: Macitentan In Patients With Pulmonary Hypertension Following Left Ventricular Assist Device Implantation, Robert P. Frantz, Shashank S. Desai, Gregory Ewald, Veronica Franco, Antoine Hage, Evelyn M. Horn, Shane J. Larue, Michael A. Mathier, Stacy Mandras, Myung H. Park, Ashwin K. Ravichandran, Joel D. Schilling, I-Wen Wang, Ronald Zolty, Gabriela Gomez Rendon, Mark A. Rocco, Mona Selej, Carol Zhao, J. Eduardo Rame

Jefferson Hospital Staff Papers and Presentations

Macitentan is a dual endothelin receptor antagonist (ERA) approved for treating pulmonary arterial hypertension (PAH). SOPRANO evaluated the efficacy and safety of macitentan versus placebo in pulmonary hypertension (PH) patients after left ventricular assist device (LVAD) implantation. SOPRANO was a phase 2, multicenter, double-blind, randomized, placebo-controlled, parallel-group study. Patients with an LVAD implanted within the prior 90 days who had persistent PH (i.e., mean pulmonary arterial pressure ≥25 mmHg, pulmonary artery wedge pressure [PAWP] ≤18 mmHg, and pulmonary vascular resistance [PVR] >3 Wood units [WU]) were randomized (1:1) to macitentan 10 mg or placebo once daily for 12 weeks. The …

Enhancing Advocacy Through Nursing Interventions For Hospitalized Pediatric Oncology Patients With Absent Parents, Ma Seandee Mae Corrales

Nursing | Student Research Posters

Pediatric oncology patients require consistent, specialized care that is strongly supported by parental advocacy. Advocacy is critical for ensuring timely interventions, articulating the child’s needs, and providing emotional support during hospitalization. However, some pediatric patients face gaps in advocacy when parents are unable to be consistently present due to unavoidable obligations, such as work commitments or caregiving responsibilities for other children. This lack of consistent parental presence can impact the quality of care, potentially causing delays in treatment and unmet health needs (Brady et al., 2020).

Nurses are uniquely positioned to bridge these gaps by stepping in as advocates to …

Enhancing Inclusivity In Primary Care On A College Campus, Amanda Finkle Plyler

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Individuals who identify as lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ+) face higher health disparities and are less likely to seek healthcare due to fear of being misgendered or judged by staff. Purpose: The purpose of this DNP project was to implement an intervention for college students seeking care at Student Health Services (SHS) that includes a question addressing preferred pronouns during establishment of care, creating the opportunity for staff to address patients appropriately and to provide gender-affirming care. Method(s): A pre and post intervention patient satisfaction survey related to sexual orientation and gender identity (SOGI), …

Assessing The Impact Of Mindfulness-Based Stress Reduction (Mbsr) On Emergency Nurses' Absenteeism And Receptive Awareness Of And Attention To What Is Taking Place In The Present, Rachael Moore Drake

Doctor of Nursing Practice Scholarly Projects

Problem: The changing terrain of modern healthcare has made emergency nurses' well-being a top priority. Within the small community hospital where this project was conducted, the issue of employee work-related stress was identified through managers' feedback and employee surveys. Purpose: Leaders employ a comprehensive mindfulness program based on assessed employee needs to understand the practical interventions to address work-related stress. This project implemented mindfulness-based stress reduction (MSBR) interventions and assessed emergency nurses' absenteeism and receptive awareness of and attention to what is taking place in the present. Method: The project utilized the Mindful Attention Awareness Scale (MAAS) to assess emergency …

Identifying Adolescent Depression In The Public School System, Laura Lee Griffith

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Twenty percent of United States adolescents experience major depression at some point. Elevated school dropout rates, substance abuse, chronic disease, mortality and morbidity rates, and impaired growth remain because 60 % of adolescents with unidentified depression do not receive treatment. Purpose: This evidence-based project identified adolescents aged 16-19 in a South Carolina high school who had symptoms of depression. Counseling and resource information were provided for students with scores of 10 or greater, or thoughts of self-harm on the PHQ-9. Method: Students were screened using the PHQ-9. Data was organized in Excel and analyzed using the T-tests and …

The Impact Of A Visual Remote Patient Monitoring Device (Leaf) On Hospital-Acquired Pressure Injuries (Hapi), Tyler Andrew Gunther

Doctor of Nursing Practice Scholarly Projects

Problem Statement: The Critical Care Department at a large academic hospital in the Southeast has experienced a significant increase in healthcare-acquired pressure injuries (HAPIs), contributing to elevated mortality rates. Factors such as insufficient adherence to turning protocols and resource limitations impact patient safety, thus increasing the potential for adverse outcomes and increased costs. Purpose: The purpose of this DNP scholarly project was to evaluate the impact of a turn monitoring device, specifically the LEAF system by Smith and Nephew, on HAPI incidence in the critical care setting. The project aimed to address the identified barriers to compliance, enhance patient safety, …

Implementation Of Eat Sleep Console For Neonatal Abstinence Syndrome: A Quality Improvement Project, Harley Addison Kennington

Doctor of Nursing Practice Scholarly Projects

Problem Statement: A level III NICU and mother-baby unit within an inpatient hospital in the Southeast United States transitioned from the Finnegan Neonatal Abstinence Scale (FNASS) to the Eat, Sleep, Console (ESC) for treating Neonatal Abstinence Syndrome (NAS). Prior to ESC implementation, there was limited nursing education of ESC practice guidelines or consideration for proper implementation protocol. Purpose: The purpose of this evidence-based quality improvement project was to reintroduce nursing staff to the ESC NAS Care Tool and ESC charting guidelines within the NICU and mother-baby units. Methods: This project followed the PDSA process – Plan, Do, Study, Act, underscored …

Increasing Pre-Procedure Communications To Decrease Colonoscopy Cancellations, Natalie Brooke Midkiff

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Colonoscopies play a vital role in early colorectal disease detection and prevention. Yet, the field of gastroenterology faces a persistent challenge - frequent procedure cancellations and incomplete examinations due to suboptimal bowel preparation. This not only compromises the effectiveness of colonoscopies but also poses potential health risks.

Purpose: This project aimed to reduce procedure cancellations and incomplete examinations by regularly communicating pre-procedure instructions and reminders through text messages and phone calls.

Inclusion Criteria: The criteria were clearly defined, targeting patients aged 18 and older who needed colonoscopies. This focus ensured the project's relevance to specialized gastrointestinal intervention. Establishing …

Identification Of Obstructive Sleep Apnea Symptoms Among Veterans In The Primary Care Setting, John Dominic Rosella Iv

Doctor of Nursing Practice Scholarly Projects

Untreated obstructive sleep apnea (OSA) has long-term cardiovascular and metabolic health implications, impacting quality of life and increasing health expenditures. Veterans have a higher prevalence rate of OSA attributed to an aging population and higher rates of comorbid conditions. The problem of under recognition of OSA symptoms partly relates to clinicians needing to elicit relevant symptoms routinely. At the same time, the lack of primary-care-based screening protocols contributes to the percentage of undiagnosed OSA. The purpose of this evidence-based project was to implement routine screening to identify OSA risk among veterans in primary care settings in South Carolina. The method …

Depression In Individuals With Chronic Liver Disease: Improving Screening In The Outpatient Setting, Kayla Corine Wright

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Individuals with chronic conditions such as chronic liver disease experience higher rates of depression, often underdiagnosed and placing high risk demographics in jeopardy of adverse outcomes, including worsening prognosis, decreased quality of life, and increased symptomatology.

Purpose: Evidence advocates for routine depression screening within high-risk patient populations. This paper outlines the implementation of a quality improvement initiative aimed at enhancing depression screening at a selected outpatient liver clinic within an extensive hospital system by implementing the PHQ-9 questionnaire during patient clinic visits, where no standardized screening protocol was previously in place.

Methods: The Plan-Do-Study-Act cycle guided the implementation …

Menopause And Autism: Towards A Public Health Framework, Amanda Birnbaum, Alicia Broderick, Caprice Benoit, Bhumi Patel

Department of Public Health Scholarship and Creative Works

Despite volumes of autism publications, there are enormous gaps in what we know about autism in adults and women. Yet, a large UK study reported that recent surges in autism diagnoses have been greatest in these populations. As the understanding of who is autistic expands, so too must our understanding of autism across the lifecourse.

Menopause is one (of many) underexplored aspects of the autistic lifecourse. Based on the sparse literature on autism and menstruation, there is reason to believe the hormonal changes of menopause may create more challenges for autistic than neurotypical adults. Some qualitative research suggests that …

A Word From The Writing Team (October 2024), Pam Walter, Mfa

A Word From the Writing Team (Newsletter)

This issue includes:

• Publication Spotlight
• Call is Open for Submission to the Theresa and Charles Yeo Writing Prize
• Mark Your Calendars: First Friday Writing Retreats Are Back!
• Are you looking for grant funding? We have resources for that
• We are seeking a Research Communication Specialist
• Jefferson has no-fee agreements with specific publishers
• Sign up for the OPWPC Canvas Page

Endosomal Fusion Of Ph-Dependent Enveloped Viruses Requires Ion Channel Trpm7, Catherine A Doyle, Marta E Stremska, Louis-Marie Bloyet, Cassandra E Thompson, Paul W Rothlauf, Sean P J Whelan, Et Al.

2020-Current year OA Pubs

The majority of viruses classified as pandemic threats are enveloped viruses which enter the cell through receptor-mediated endocytosis and take advantage of endosomal acidification to activate their fusion machinery. Here we report that the endosomal fusion of low pH-requiring viruses is highly dependent on TRPM7, a widely expressed TRP channel that is located on the plasma membrane and in intracellular vesicles. Using several viral infection systems expressing the envelope glycoproteins of various viruses, we find that loss of TRPM7 protects cells from infection by Lassa, LCMV, Ebola, Influenza, MERS, SARS-CoV-1, and SARS-CoV-2. TRPM7 ion channel activity is intrinsically necessary to …

Postprostatectomy Radiotherapy Timing And Long-Term Health-Related Quality Of Life, Sagar A Patel, Jeff M Michalski, Et Al.

2020-Current year OA Pubs

IMPORTANCE: The association between radiotherapy (RT) timing after radical prostatectomy and long-term patient-reported health-related quality of life (HRQOL) in men with prostate cancer is unknown.

OBJECTIVE: To measure long-term HRQOL in men with prostate cancer up to 15 years after prostatectomy with or without RT and examine whether early vs late postprostatectomy RT is associated with differences in sexual, urinary, and bowel HRQOL.

DESIGN, SETTING, AND PARTICIPANTS: A prospective, multicenter, longitudinal cohort analysis using HRQOL data from the PROST-QA (2003-2006) and RP2 consortium (2010-2013) studies was conducted. Men with localized prostate cancer undergoing radical prostatectomy were included. Data were analyzed …

Response To Letter To The Editor Concerning The Article "The Clinical And Economic Impact Of Extended Battery Longevity Of A Substernal Extravascular Implantable Cardioverter Defibrillator"., Bradley P Knight, Nicolas Clémenty, Anish Amin, Ulrika Maria Birgersdotter-Green, Henri Roukoz, Reece Holbrook, Jaimie Manlucu

Heart and Vascular Articles

No abstract provided.

Impact Of Functional Recovery On Patients Having Heart Surgery., Richard J Snow, Lauren Mckown, Geoffrey Blossom, Karen Vogel, Amy Creighton, Jason Shriver, Linda Will, Katie Lentz, Elizabeth Snow, Teresa Caulin-Glaser

Heart and Vascular Articles

OBJECTIVE: To describe the results of a program developed to manage institutional postacute care (IPAC) (postacute skilled nursing, inpatient rehabilitation facility, and long-term acute care) in a CMS Bundled Payments for Care Improvement (BPCI) project for coronary artery bypass graft (CABG) surgery.

STUDY DESIGN: We compared pre- and postutilization patterns during a 3-year period by evaluating risk-adjusted national, state, and other BPCI participant comparisons using a difference-in-differences (DID) analysis in a large urban community tertiary center with a CABG surgery program. Included in the analysis were all Medicare patients receiving CABG surgery at the institution (n = 504), across the …

The Nature Of Adverse Events In Dentistry, Bunmi Tokede, Alfa Yansane, Muhammad F. Walji, D. B. Rindal, Don Worley, Joel White, Elsbeth Kalenderian

School of Dentistry Faculty Research and Publications

Objectives

Learning from clinical data on the subject of safety with regards to patient care in dentistry is still largely in its infancy. Current evidence does not provide epidemiological estimates on adverse events (AEs) associated with dental care. The goal of the dental practice study was to quantify and describe the nature and severity of harm experienced in association with dental care, and to assess for disparities in the prevalence of AEs.

Methods

Through a multistaged sampling procedure, we conducted in-depth retrospective review of patients’ dental and medical records.

Results

We discovered an AE proportion of 1.4% (95% CI, 1.1% …

Deletion Of Tissue Factor Pathway Inhibitor Isoform Beta Or Gamma, But Not Alpha, Improves Clotting In Hemophilic Mice, Irem Eldem, Lilian Antunes-Heck, Renumathi Subramanian, Nina M Lasky, Katrina Ashworth, Jorge Di Paola, Thomas J Girard

2020-Current year OA Pubs

BACKGROUND: Tissue factor pathway inhibitor (TFPI) regulates tissue factor-triggered coagulation. Humans and mice express transcripts encoding for multidistributed (endothelial, platelet, and plasma) 3-Kunitz domain TFPIα and endothelial membrane-anchored 2-Kunitz TFPIβ. Mice express a third transcript, γ, that encodes plasma lipoprotein-associated 2-Kunitz TFPI. In humans, proteolysis of α and/or β produces plasma lipoprotein-associated 2-Kunitz TFPI at lower levels. In clinical trials, monoclonal antibodies that target all TFPI isoforms extend coagulation and correct bleeding in hemophilic patients but with some thrombosis risks.

OBJECTIVES: To determine the impact of TFPI isoform-specific deletions on promoting clotting in hemophilic mice.

METHODS: Engineered TFPI isoform-specific, hemophilic …

Addressing Risk For Poor Health Outcomes By Establishing A Culturally Appropriate Community Nutrition Education Event, Tamara Bow

Doctor of Nursing Practice Projects

Problem Description

Poverty, decreased health literacy, and lack of community educational opportunities result in nutritional deficits. Students in the Umatilla School District and the surrounding community lack knowledge of the components of a nutritious diet. If not addressed, students and families are at risk of poor health outcomes.

Setting

The city of Umatilla has a population of 7,363, and the mean household income is $51,790 (United States Census Bureau, 2022). In the 2021-2022 school year, Umatilla School District 6R had 54% Ever English Learners, which included students who speak a language other than English at home (Oregon Department of Education, …

Atrial Fibrillation Status And Physical Rehabilitation In Older Patients With Acute Decompensated Heart Failure: An Analysis From The Rehab-Hf Trial, Douglas Corsi, Sean Dikdan, Naman Upadhyay, Haiying Chen, Dalane W Kitzman, Robert Mentz, David J Whellan, Daniel R Frisch

SKMC Student Presentations and Publications

BACKGROUND: The REHAB-HF (Rehabilitation Therapy in Older Acute Heart Failure Patients) trial demonstrated that a transitional, tailored, progressive rehabilitation intervention improved physical function, 6-minute walk distance, frailty, quality-of-life, and depression in older patients hospitalized for acute decompensated heart failure. This analysis assessed the impact of atrial fibrillation (AF) on intervention benefits.

METHODS AND RESULTS: Of 349 enrolled patients hospitalized for acute decompensated heart failure (mean age 72.7±8.1 years), 176 (50.4%) had AF. Participants were randomly assigned to 12-week rehabilitation intervention or attention control. The primary outcome was Short Physical Performance Battery score at 3 months. Participants with AF were older …

Non-Partner Sexual Violence Among International College Students In The United States, Kruti S. Chaliawala, Rebecca A. Vidourek, Keith A. King

Dignity: A Journal of Analysis of Exploitation and Violence

The prevalence of non-partner sexual violence among college students is a pressing concern that demands urgent attention. Although an integral part of the education system, international college students are often underrepresented in various studies. This calls attention to understanding the cultural nuances and multiple factors affecting this population. The current research delves into the experiences of sexual abuse among international students within the last 12 months, focusing specifically on incidents where sexual penetration or unwanted sexual touching occurred without consent. The study sheds light on the frequency and demographics associated with these distressing incidents using data from a large-scale survey …

From Crisis To Closure: Use Of Kerecis© Omega3 And Negative Pressure Wound Therapy In Treating Necrotizing Soft Tissue Infection, Nikita Gambhir, Heather V. Tran, Stephanie N. Campbell, Mihir Panchal

School of Podiatric Medicine Publications

The aim of this case study was to evaluate the effectiveness of Kerecis© Omega3 MariGen Micro for the treatment of a necrotizing soft tissue infection (NSTI) in a diabetic patient, including wound healing progress and closure outcomes post-application.

The application of acellular dermal micromatrix allograft in conjunction with NPWT and STSG, facilitated significant wound healing in a patient with NSTI, without amputation. This case highlights the unique properties of Kerecis Omega3, a fish-derived skin substitute rich in omega-3 fatty acids, significantly contributed to tissue regeneration and wound healing, even in a high-risk patient with multiple comorbidities, including diabetes and obesity. …

Who Is Treating Periprosthetic Femur Fractures? An Analysis Of The Periprosthetic Research Consortium, Nicholas Pohl, Arjun Saxena, Jeffrey Stambough, John Martin, Simon Mears, Paul Lichstein, Eric Jordan, Cameron Egan, Antonia Chen, Greg Erens, Samir Chabib, Bryce Wall, Navin Fernando, Jordan Nichols, Ran Schwarzkopf, Katherine Lygrisse, Derek Amanatullah, Prerna Arora, David Ivanov, Galvin Loughran, James Browne, Danielle Hogarth, Parke Hudson, Thomas Donaldson, Frank Buttacavoli, Ravi Kari, Galen Mills

Rothman Institute Papers

Background: Periprosthetic femur fractures (PPFFs) following total hip arthroplasty (THA) have increased in the past decade as the demand for primary surgery continues to grow. Although there is now more evidence to describe the treatment of Vancouver B fractures, there is still limited knowledge regarding factors that cause surgeons to perform either an open reduction and internal fixation (ORIF) or revision THA (rTHA). The purpose of this study was to determine what type of surgeons treat Vancouver B PPFFs at 11 major academic institutions and if there are trends in treatment decision-making regarding the use of ORIF or rTHA based …