Medicine and Health Sciences Commons^™

Erdheim-Chester Disease Presenting As Bilateral Facial Masses: A Case Report And Review Of Literature, Asim Qureshi, Abdulaziz Bakathir, Fizza Qureshi, Amanullah Beg, Asem Shalaby

Sultan Qaboos University Medical Journal

Erdheim-Chester disease (ECD) is a rare form of non-Langerhans cell histiocytosis with unknown etiology. It is recently recognized to be neoplastic with genetic mutations affecting the mitogen-activating protein kinase (MAPK) pathway. We here present a case of a 49-year-old female who initially presented in 2012 with bilateral facial masses to a tertiary care center. These were removed but later recurred over a period of ten years. She then presented with xanthelasmas, bone lesions, secondary infertility due to hypothalamic hypogonadism, diabetes insipidus, and Hashimoto’s hypothyroidism. The facial masses were biopsied, and they showed classic morphological features in the form of diffuse …

The Prospect Of Indonesian Herbal As An Alternative Treatment For Covid-19 Patient: A Literature-Based Study, Hadi Sunaryo, Wahyu Hidayati

Indonesian Journal of Medical Chemistry and Bioinformatics

Coronavirus disease 2019 (COVID-19) is a new disease caused by a novel coronavirus, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The disease has several symptoms from mild to severe and could lead to death for comorbidities and the elderly. Therefore, the infections and mortality cases keep growing day by day, moreover many authorities are trying to suppress it by applying several health protocols, including medicines. Several studies were conducted on drug discovery from plants to cure the disease. The article aimed to do a narrative review about the prospect of JAMU becoming an alternative medicine to cure COVID-19 by mapping …

The Effectiveness Of An Interdisciplinary Care Team: An Integrative Review, Lindsey Marie Ellingford

Doctoral Dissertations and Projects

As health care is ever growing and changing, demands for interdisciplinary care team collaboration are crucial for collective competence and team performance across settings. In healthcare facilities across the county, interdisciplinary care teams are made up of multiple disciplines. The following is an integrative review with a purpose to determine if the existing literature supports the implementation of an interdisciplinary care team in the healthcare environment. After completion of this integrative review, the author concluded there should be a standardized tool in the healthcare system to guide the creation and implementation of an interdisciplinary care team. The Jerry Falwell Library …

Determining The Effectiveness Of A Nurse-Led Heart Failure Education Program In Reducing 30-Day Hospital Heart Failure Readmissions, Amy Suzanne Cosby

Doctoral Dissertations and Projects

The purpose of this project was to determine if a nurse-led heart failure (HF) education program would reduce overall 30-day hospital readmissions related to. Affecting millions of adults in the United States, HF is a growing health epidemic as well as an economic burden to healthcare systems. The population for this project included patients admitted with a diagnosis of acute or chronic HF based on the International Statistical Classification of Diseases and Related Health Problems (ICD-10) codes. An electronic health record intervention indicated that when a healthcare provider diagnosed a patient with any HF ICD-10 code, the nurse-led HF education …

Hyperlipidemia: Enhancing Patient Education And Clinical Support To Improve Self-Efficacy, Kelly L. Caniglia

Doctoral Dissertations and Projects

Hyperlipidemia is a chronic, progressive disorder routinely encountered in primary care practice. In the United States, coronary artery disease and cerebrovascular disease are the leading causes of death. Hyperlipidemia is a modifiable risk factor for the development of coronary artery disease, cerebrovascular disease, and peripheral artery disease. However, many individuals fail to recognize the severity of the health consequences associated with hyperlipidemia. Most often, hyperlipidemia is the direct result of unhealthy lifestyle behaviors. Comprehensive care falls short in primary care settings, often due to non-compliance with necessary lifestyle behavior changes. Primary care patients' lack of knowledge and awareness signals a …

Paths Initiative: Identifying Potential Sex Trafficking Victims In The Emergency Department Setting, Kayla Mabery

Doctoral Dissertations and Projects

The Physical signs, Appearance, Talk and communication, History and background, and Support and resources (PATHS) education initiative has proven to be a valuable tool in enhancing the identification and support of sex trafficking victims in healthcare settings, particularly in emergency departments. The training led to significant improvements in the participants' knowledge, confidence, and practical application of skills necessary to recognize potential victims. Despite the limitations of limited participant numbers and lack of face-to-face training, the initiative's positive impact underscores the need for continued efforts in this area. By incorporating the PATHS tool into regular professional development programs and standard operating …

Increasing Self-Efficacy Of Nurse Practitioner Preceptors In Primary Care By Using The One-Minute Preceptor Model, Amy J. Lancaster

Doctoral Dissertations and Projects

Nurse practitioners represent the fastest growing profession in the United States, with 385,000 practitioners currently licensed. Over 70% of these licensed practitioners are serving in primary care settings. As the growth of this workforce continues, so does the need for nurse practitioner preceptors. The preceptor plays an essential role in championing clinical competencies for nurse practitioner students. This project was implemented in a primary care setting with an aim to improve the self-efficacy of nurse practitioner preceptors by using the One-Minute Preceptor teaching method to improve the practicum experience for both the preceptor and the nurse practitioner student. The One-Minute …

Speech-Language Pathologists’ Perceptions Of A Clinical Doctorate In Speech-Language Pathology: A Phenomenological Study, Dawn Mckee

Doctoral Dissertations and Projects

The purpose of this phenomenological study was to explore the perspectives of speech-language pathologists regarding a clinical doctorate as a potential entry-level degree for practicing speech-language pathologists. The central research question sought to determine the overall attitudes of speech-language pathologists about a clinical doctorate. The theories guiding this study were social constructionism and experiential learning theory, as this study attempted to construct the perceived reality of practicing speech-language pathologists regarding clinical doctorates and involved their educational and work experiences. The methodology utilized was transcendental phenomenology and included three data collection approaches: interviews, letter-writing, and focus groups. The data were analyzed …

Theory Informed Audit And Feedback To Decrease Medication Administration Errors, Victoria Martin

Doctoral Dissertations and Projects

Medication administration errors remain a serious and preventable cause of morbidity and mortality in health care. Technology at the point of care is often bypassed in the medication administration process despite the intention to prevent adverse drug events through the addition of a layer of cross-checks and alerts. The purpose of this project was to understand if human behavior could be influenced using effective audit and feedback, data transparency, and communication tactics to decrease administration-related errors, such as wrong patient, wrong medication, wrong dose, and adverse drug events, with the use of barcode medication administration (BCMA) in the emergency department. …

Midazolam-Induced Seizure-Like Activity In Five Neonates: A Case Series, Heba Shaker, Fatema Al-Amrani, Hilal Al Mandhari

Sultan Qaboos University Medical Journal

An intravenous administration of midazolam may result in seizure-like activity or movement. This report describes five neonates who developed seizure-like movements after intravenous midazolam injection. The patients presented between 2019 and 2022. The abnormal movements occurred shortly after intravenous bolus administration of midazolam. None of our patients experienced seizure-like movements after receiving midazolam infusions. The seizure-like movements were aborted either spontaneously or by antiseizure medications. Also, we did not observe any seizure recurrence in any of the infants during the later stages of their treatment. Since this adverse effect might be related to the speed of the bolus administration, intravenous …

A Non-Parametric Approach To Predict The Recruitment For Randomized Clinical Trials: An Example In Elderly Inpatient Settings, Alejandro Villasante-Tezanos, Yong-Fang Kuo, Christopher Kurinec, Yisheng Li, Xiaoying Yu

Faculty, Staff and Student Publications

BACKGROUND: Accurate prediction of subject recruitment, which is critical to the success of a study, remains an ongoing challenge. Previous prediction models often rely on parametric assumptions which are not always met or may be difficult to implement. We aim to develop a novel method that is less sensitive to model assumptions and relatively easy to implement.

METHODS: We create a weighted resampling-based approach to predict enrollment in year two based on recruitment data from year one of the completed GRIPS and PACE clinical trials. Different weight functions accounted for a range of potential enrollment trajectory patterns. Prediction accuracy was …

Linkage Facilitation For Opioid Use Disorder In Criminal Legal System Contexts: A Primer For Researchers, Clinicians, And Legal Practitioners, Milan F. Satcher, Steven Belenko, Anthony Coetzer-Liversage, Khirsten J. Wilson, Michael R. Mccart, Tess K. Drazdowski, Amanda Fallin-Bennett, Nickolas Zaller, Alysse M. Schultheis, Aaron Hogue, Noel Vest, Ashli J. Sheidow, Brandon Del Pozo, Dennis P. Watson, Patrick F. Hibbard, Randy Stevens, L. A. R. Stein

Nursing Faculty Publications

At the intersection of drug policy, the opioid crisis, and fragmented care systems, persons with opioid use disorder (OUD) in the United States are significantly vulnerable to contact with the criminal legal system (CLS). In CLS settings, provision of evidence-based treatment for OUD is variable and often secondary to punitive approaches. Linkage facilitation at every touch point along the CLS Sequential Intercept Model has potential to redirect persons with OUD into recovery-oriented systems of care, increase evidence-based OUD treatment connections, and therefore reduce CLS re-exposure risk. Research in this area is still nascent. Thus, this narrative review explores the state …

Improving Nursing Retention Through Mentorship In A Long-Term Care Facility: An Educational Toolkit, Adriane Nichole Anthony-Cupil

Doctoral Dissertations and Projects

A major nursing shortage in the healthcare industry is made worse by high turnover rates. Healthcare organizations have used mentoring programs that have been found to enhance job satisfaction, thus improving nurse retention. To address this challenge, this study examined the use of a mentorship program supplemented by an educational toolkit that is specially made to improve nurse retention in long-term care facilities. By offering an organized learning path with resources that address support, effective communication, and cultural competency, the educational toolkit has the potential to enhance mentorship. The objective of this initiative was to equip registered nurses with the …

A Qualitative Study On Transnational Caregiving For Older Parents In China, Silai Dong

Lingnan Theses (MPhil & PhD)

The increasing number of international migrations in China poses challenges for the care of older parents who are left behind, considering China’s emphasis on family support. This study aims to investigate transnational care arrangements for older parents whose children are overseas. It mainly addresses three research questions:1) What are the contents of filial piety in the context of international migration? 2) How do Chinese transnational family members negotiate and distribute elder care responsibilities? 3) To what extent can the transnational caregiving model explain elder care in Chinese transnational families?

The transnational caregiving model proposed by Baldassar, Baldock, and Wilding, in …

Acceptance And Commitment Therapy Versus Progressive Relaxation Training For Misophonia: Randomized Controlled Trial Protocol, Interventions, And Audiological Assessments, Emily M. Bowers, Mercedes G. Woolley, Karen Muñoz, Julie M. Petersen, Michael P. Twohig

Psychology Faculty Publications

Background: Misophonia is a disorder characterized by an intense emotional reaction to specific sounds, often leading to significant distress and impairment in daily functioning. Acceptance and commitment therapy (ACT) is a promising psychotherapy for treating misophonia, but has only been previously tested in case studies. This paper presents a protocol for the first randomized controlled trial (RCT) assessing the efficacy and feasibility of ACT supplemented by audiological interventions for misophonia versus progressive relaxation training (PRT).

Methods: The outlined protocol is a RCT with 60 adults with misophonia. After undergoing a comprehensive psychological and audiological evaluation, participants were randomly assigned to …

Identification Of A Specific Apoe Transcript And Functional Elements Associated With Alzheimer’S Disease, Qiang Chen, Luis Aguirre, Guoming Liang, Huanhuan Zhao, Tao Dong, Felix Borrego, Itziar De Rojas, Qichan Hu, Christopher Reyes, Harald Hh Goring

School of Medicine Publications

Background

The APOE gene is the strongest genetic risk factor for late-onset Alzheimer’s Disease (LOAD). However, the gene regulatory mechanisms at this locus remain incompletely characterized.

Methods

To identify novel AD-linked functional elements within the APOE locus, we integrated SNP variants with multi-omics data from human postmortem brains including 2,179 RNA-seq samples from 3 brain regions and two ancestries (European and African), 667 DNA methylation samples, and ChIP-seq samples. Additionally, we plotted the expression trajectory of APOE transcripts in human brains during development.

Results

We identified an AD-linked APOE transcript (jxn1.2.2) particularly observed in the dorsolateral prefrontal cortex (DLPFC). The …

Perceptions Of Desired Step 2 Ck Performance After Step 1 Grading Change, Michelle M. Pham

School of Medicine Publications

Introduction

In 2022, Step 1 shifted from providing a numerical score to a pass/fail categorization. Since the shift, there has been one matched graduating class in 2024. This paper aims to identify perceptions of desired Step 2 CK performance after the Step 1 score report alteration.

Methods

A survey was sent out to a medical school’s class of 2025. The anonymous survey required an email sign-in to verify only one response per respondent. The survey asked if the answering individual felt it was necessary to score higher or the same as the NRMP’s 2022 averages for their first-choice specialty and …

Milvexian Vs Apixaban For Stroke Prevention In Atrial Fibrillation: The Librexia Atrial Fibrillation Trial Rationale And Design, Sneha S Jain, Kenneth W Mahaffey, Karen S Pieper, Wataru Shimizu, Tatjana Potpara, Christian T Ruff, Hooman Kamel, Basil S Lewis, Jan H Cornel, Peter R. Kowey, Jay Horrow, John Strony, Alexei N Plotnikov, Danshi Li, Stephen Weng, Julia Donahue, C Michael Gibson, P Gabriel Steg, Roxana Mehran, Jeffrey I Weitz, S Claiborne Johnston, Graeme J Hankey, Robert A Harrington, Carolyn S P Lam

Department of Medicine Faculty Papers

BACKGROUND: Direct oral anticoagulants are the standard of care for stroke prevention in eligible patients with atrial fibrillation and atrial flutter; however, bleeding remains a significant concern, limiting their use. Milvexian is an oral Factor XIa inhibitor that may offer similar anticoagulant efficacy with less bleeding risk.

METHODS: LIBREXIA AF (NCT05757869) is a global phase III, randomized, double-blind, parallel-group, event-driven trial to compare milvexian with apixaban in participants with atrial fibrillation or atrial flutter. Participants are randomly assigned to milvexian 100 mg or apixaban (5 mg or 2.5 mg per label indication) twice daily. The primary efficacy objective is to …

Evaluating The Impact Of The Nurse-Patient Relationship: An Integrative Review, Kathryn H. Creasey

Doctoral Dissertations and Projects

Home care agencies are rated by patients anonymously through surveys after patients’ care episodes. The star ratings on the surveys have a direct impact on the home care agency and all of the staff working there. The star rating affects insurance companies’ reimbursement, which ultimately impacts business revenue, while the goal is to provide quality patient care. In the home care setting, nurses and patients desire continuity of care and the building of trust for competent, safe, and quality care. The literature review explored the importance of fostering the nurse-patient relationship and its impact on patient satisfaction and quality. Utilizing …

Trauma-Informed Care Education Program To Increase Provider Confidence In Caring For Patients With Trauma, Lillian Priante

Doctoral Dissertations and Projects

This scholarly project addressed the critical need for education on trauma-informed care and birth trauma among birth center providers and staff. The project aimed to enhance the knowledge and skills of birth center professionals to better support birthing individuals who have experienced trauma, ensuring a more compassionate and effective care environment. A comprehensive educational program was administered to birth center midwives and staff exploring the principles of trauma-informed care, the psychological and physiological impacts of birth trauma, and evidence-based strategies for mitigating these effects. The curriculum of trauma-informed care included interactive training sessions using the City Birth Trauma Scale tool …

Leveraging Simulation For Excellence, Alecia Kimberly Liburd

Doctoral Dissertations and Projects

This project aims to identify and address the factors hindering the effective utilization of the simulation lab at Grady Memorial Hospital. Despite the simulation lab’s potential to enhance clinical skills and decision-making abilities through realistic medical scenarios, it remains underutilized. This evaluation project was a pretest and posttest design to assess the impact of educational interventions. Educational workshops, email communications, and awareness campaigns were the primary methods used to increase the understanding and utilization of the simulation lab.

Data analysis involved descriptive and thematic analyses of lab usage metrics and pre- and posttest responses. The findings indicate that simulation-based learning …

Nursing Faculty Exposure To Student Incivility And Interventions In Place To Address: A Case Study, Kimberly Lowe

Doctoral Dissertations and Projects

The purpose of this qualitative case study was to explore nursing faculty exposure to nursing student incivility at a nursing college in the Mid-Atlantic region. Bandura's social learning theory provided this study’s theoretical framework. The continuum of workplace aggression and conceptual model fostering incivility in nursing education also guided this study. This study answered the following central research question: How have nursing faculty been exposed to incivility by nursing students? Data were collected for this study through one-on-one interviews with nursing faculty exposed to nursing student incivility and a focus group with the same nursing faculty to discuss the current …

Diabetes Health Literacy, Diabetes Numeracy, And Cognitive Function As Predictors Of Type 2 Diabetes Mellitus Self-Management, Twinkle Gupta

Doctoral Dissertations and Projects

The present study assessed older adults (≥ 45 years old) diabetes health literacy, diabetes numeracy, cognitive function, and its association with their Type 2 Diabetes Mellitus (T2DM) self-management outcomes. These factors are of concern as diabetes is a lifelong condition affecting the body’s conversion of food into energy and may lead to complications and comorbidities if this condition is not properly self-managed. Diabetes health literacy refers to having the necessary capabilities in finding and analyzing diabetes-related information to make informed decisions regarding their health. Numeracy in diabetes has to do with being able to compute diabetes-related math such as insulin …

Improved Clinical Outcomes Due To Gfr-Based Clinical Interventions For The Prevention And Treatment Of Renal Disease As It Relates To The Veteran Population Managed By A Patient-Aligned Care Team, Sidneca Evangella Hazward

Doctoral Dissertations and Projects

The purpose of this study was to understand if the use of eGFR (CKD-EPI 2021) in the absence of race modification influenced early detection of renal disease for veterans managed by patient-aligned care teams. A retrospective cohort study design was used, analyzing patient data from the Department of Veterans Affairs Medical Center (VAMC). The study included veterans with available serum creatinine, albumin, eGFR, CKD-EPI 2021, etc. measurements and demographic data. The study employed a systematic data review of electronic medical records from 2019 to 2024 and utilized electronic data collection through a computerized patient record system (CPRS) data collection system. …

Facilitators And Barriers To Initiating And Completing Tuberculosis Preventive Treatment Among Children And Adolescents Living With Hiv In Uganda: A Qualitative Study Of Adolescents, Caretakers And Health Workers, Pauline Mary Amuge, Denis Ndekezi, Moses Mugerwa, Dickson Bbuye, Diana Antonia Rutebarika, Lubega Kizza, Christine Namugwanya, Angella Baita, Peter James Elyanu, Patricia Nahirya Ntege, Dithan Kiragga, Carol Birungi, Adeodata Rukyalekere Kekitiinwa, Agnes Kiragga, Moorine Peninah Sekadde, Nicole-Austin Salazar, Anna Maria Mandalakas, Philippa Musoke

Faculty, Staff and Students Publications

INTRODUCTION: People living with HIV (PLHIV) have a 20-fold risk of tuberculosis (TB) disease compared to HIV-negative people. In 2021, the uptake of TB preventive treatment among the children and adolescents living with HIV at the Baylor-Uganda HIV clinic was 45%, which was below the national target of 90%. Minimal evidence documents the enablers and barriers to TB preventive treatment (TPT) initiation and completion among children and adolescents living with HIV(CALHIV). We explored the facilitators and barriers to TPT initiation and completion among CALHIV among adolescents aged 10-19years and caretakers of children below 18years.

METHODS: We conducted a qualitative study …

Heparan Sulfate Roles In Amyloid-Beta Clearance And Alzheimer’S Disease Pathogenesis, Ilayda Ozsan

USF Tampa Graduate Theses and Dissertations

Alzheimer's disease (AD) is the most common form of dementia yet remains without an effective treatment due to its poorly understood etiology. Mounting evidence points to the accumulation and aggregation of amyloid-β peptides (Aβ), which constitute amyloid plaques in the brain, as pivotal in initiating and accelerating AD pathogenesis. Extensive efforts have focused on uncovering the molecular underpinnings and fundamental origins of impaired Aβ metabolism in AD. Heparan sulfate (HS), a linear polysaccharide of the glycosaminoglycan family, co-deposits with Aβ in plaques within the AD brain. It directly binds to and accelerates Aβ aggregation, interacts with key players in Aβ …

Linkage Facilitation For Opioid Use Disorder In Criminal Legal System Contexts: A Primer For Researchers, Clinicians, And Legal Practitioners, Milan F. Satcher, Steven Belenko, Anthony Coetzer-Liversage, Khirsten J. Wilson, Michael R. Mccart, Tess K. Drazdowski, Amanda Fallin-Bennett, Nickolas Zaller, Alysse M. Schultheis, Aaron Hogue, Noel Vest, Ashli J. Sheidow, Brandon Del Pozo, Dennis P. Watson, Patrick F. Hibbard, Randy Stevens, L. A. R. Stein

Dartmouth Scholarship

At the intersection of drug policy, the opioid crisis, and fragmented care systems, persons with opioid use disorder (OUD) in the United States are significantly vulnerable to contact with the criminal legal system (CLS). In CLS settings, provision of evidence-based treatment for OUD is variable and often secondary to punitive approaches. Linkage facilitation at every touch point along the CLS Sequential Intercept Model has potential to redirect persons with OUD into recovery-oriented systems of care, increase evidence-based OUD treatment connections, and therefore reduce CLS re-exposure risk. Research in this area is still nascent. Thus, this narrative review explores the state …

Elevated Level Of Extracellular Vimentin Is Associated With An Increased Fibrin Formation Potential In Sepsis: Ex Vivo Swine Study, Marina Martinez-Vargas, Arun Saini, Subhashree Pradhan, Luis Gardea, Barbara Stoll, Inka C Didelija, K Vinod Vijayan, Trung C Nguyen, Miguel A Cruz

Faculty, Staff and Students Publications

BACKGROUND: Sepsis can lead to coagulopathy and microvascular thrombosis. Prior studies, including ours, reported an increased level of extracellular vimentin in blood derived from septic patients. Moreover, we identified the contribution of extracellular vimentin to fibrin formation and to the fibrin clot structure ex vivo in plasma from septic patients. Here, we tested the status of plasma vimentin and its impact on fibrin clots using our recently described swine model of methicillin-resistant Staphylococcus aureus (MRSA) sepsis-induced coagulopathy.

RESULTS: We employed ELISA, size-exclusion chromatography, vimentin antibodies, confocal microscopy, and turbidity assays on piglet plasma obtained at pre- and post-MRSA inoculation. Plasma …

West Nile Virus Triggers Intestinal Dysmotility Via T Cell-Mediated Enteric Nervous System Injury, Hana Janova, Fang R. Zhao, Pritesh Desai, Matthias Mack, Larissa B. Thackray, Thaddeus S. Stappenbeck, Michael S. Diamond

2020-Current year OA Pubs

Intestinal dysmotility syndromes have been epidemiologically associated with several antecedent bacterial and viral infections. To model this phenotype, we previously infected mice with the neurotropic flavivirus West Nile virus (WNV) and demonstrated intestinal transit defects. Here, we found that within 1 week of WNV infection, enteric neurons and glia became damaged, resulting in sustained reductions of neuronal cells and their networks of connecting fibers. Using cell-depleting antibodies, adoptive transfer experiments, and mice lacking specific immune cells or immune functions, we show that infiltrating WNV-specific CD4+ and CD8+ T cells damaged the enteric nervous system (ENS) and glia, which led to …

Structural Basis For Mouse Lag3 Interactions With The Mhc Class Ii Molecule I-Ab, Qianqian Ming, Daniel Antfolk, David A Price, Anna Manturova, Elliot Medina, Srishti Singh, Charlotte Mason, Timothy H Tran, Keiran S M Smalley, Daisy W Leung, Vincent C Luca

2020-Current year OA Pubs

The immune checkpoint protein, Lymphocyte activation gene-3 (LAG3), binds Major Histocompatibility Complex Class II (MHC-II) and suppresses T cell activation. Despite the recent FDA approval of a LAG3 inhibitor for the treatment of melanoma, how LAG3 engages MHC-II on the cell surface remains poorly understood. Here, we determine the 3.84 Å-resolution structure of mouse LAG3 bound to the MHC-II molecule I-A