Medicine and Health Sciences Commons^™

Obstetric Education For Critical Care Nurses, Anna Forberg

DNP Projects

Background The purpose of this study was to educate ICU nurses on the care of obstetric women in critical care through the use of a toolkit with intentions to increase knowledge and confidence.

Method The toolkit was created via the platform WordPress™ and topics were chosen based on the most common admission diagnoses found during the literature review. Data were collected via forms manager and voluntary participation among ICU nursing staff was obtained.

Results Mean scores from the pretest to the post-test showed improvement from 7.08 to 8.50 and the minimum and maximum scores increased from pretest to post-test supporting …

Dna Methylation Patterns In Umbilical Cord Blood From Infants Of Methadone Maintained Opioid Dependent Mothers, Oluwatobi Adegboyega, Suhita Gayen Nee' Betal, Pedro Urday, Rachel Huang, Katherine Bodycot, Huda Al-Kouatly, Kolawole Solarin, Joanna Chan, Sankar Addya, Rupsa Boelig, Zubair Aghai

Department of Pediatrics Faculty Papers

Methadone maintenance treatment for opioid dependent mothers is standard of care. Infants of methadone maintained opioid dependent (MMOD) mothers have better outcomes compared to infants of opioid dependent mothers without treatment. However, when compared to non-exposed infants, infants of MMOD mothers are associated with worse outcomes. We conducted a pilot study to examine genome wide differential DNA methylation using cord blood samples from sixteen term and near-term infants of MMOD and opioid naïve mothers, excluding Infants with chorioamnionitis. A total of 152 differentially methylated loci were identified at a difference >  + 2, < - 2 and p-value < 0.05. There were 90 hypermethylated loci (59 annotated genes) and 62 hypomethylated loci (38 annotated genes) observed. The hypermethylated and hypomethylated DNA changes involved multiple genes, pathways and networks that may explain some of the changes seen in infants of MMOD mothers. Top hypermethylated and hypomethylated genes involved areas of cell growth, neurodevelopment, vision and xenobiotic metabolism functions. Our data may explain the role of key pathways and genes relevant to neonatal outcomes seen from methadone exposure in pregnancy. Functional studies on the identified pathways and genes could lead to improved understanding of the mechanisms and identify areas for intervention.

Phase Ii Basket Trial Of Dual Anti-Ctla-4 And Anti-Pd-1 Blockade In Rare Tumors (Dart) Swog S1609: Adrenocortical Carcinoma Cohort, Sandip P Patel, Megan Othus, Young Kwang Chae, Tridu Huynh, Benjamin Tan, Timothy Kuzel, Christine Mcleod, Gabby Lopez, Helen X Chen, Elad Sharon, Howard Streicher, Christopher W Ryan, Charles Blanke, Razelle Kurzrock

2020-Current year OA Pubs

OBJECTIVES: Multiple common cancers benefit from immunotherapy; however, less is known about efficacy in rare tumors. We report the results of the adrenocortical carcinoma cohort of NCI/SWOG S1609 Dual Anti-CTLA-4 and Anti-PD-1 blockade in Rare Tumors.

DESIGN/SETTING: A prospective, phase 2 clinical trial of ipilimumab plus nivolumab was conducted by the SWOG Early Therapeutics and Rare Cancers Committee for multiple rare tumor cohorts across >1,000 National Clinical Trial Network sites.

PARTICIPANTS: 21 eligible patients were registered. Median age was 53 years (range 26-69); 16 (76%) were women.

INTERVENTIONS: Ipilimumab 1 mg/kg intravenously every 6 weeks with nivolumab 240 mg intravenously …

Demystifying The Virtualization Process: A Call For Standard Reporting Of Virtual Modifications To Evidence-Based Psychotherapies, Using The Frame Model, Derrecka M Boykin, Tracey L Smith, Barbara Rakel, Merlyn Rodrigues, Jennie Embree, Ken Woods, Angelic D Chaison, Lilian Dindo

Faculty, Staff and Students Publications

The sudden onset of the coronavirus disease led to a rapid expansion of video telehealth to deliver mental healthcare. Although video telehealth was not a new clinical practice, there was limited guidance on how best to modify evidence-based psychotherapies (EBPs) for virtual delivery (a process also referred to as virtualization). The virtualization process for EBPs remains unclear as newly emerging reports on this topic do not consistently report modification decisions. This commentary calls attention to the need to improve documentation practices to allow a greater understanding of modifications needed to maximize the positive effects of EBPs transported to a virtual …

Using Real Patients In Physical Therapy Didactic Education: A Mixed-Methods Investigation, Stacia Hall Thompson, Mary Shotwell, Hina Garg, Michelle Webb

Internet Journal of Allied Health Sciences and Practice

Purpose: Physical therapy educators use various strategies to promote student learning. One such way is to use real patients (RP) in the classroom to learn course material during simulation-based learning experiences (SLE). This study aimed to identify student physical therapist (SPT) perceptions regarding value, satisfaction, and confidence with SLE using RP, explore SPT perceptions and lived experiences regarding RP use in SLE during didactic physical therapy education, and determine differences in value, satisfaction, and confidence in cognitive, affective, and psychomotor learning domains based on demographic variables. Methods: The study used a convergent parallel mixed-methods design to simultaneously gather quantitative (survey) …

An Executive Summary On The Global Conceptual Definition Of Sarcopenia, Ben Kirk, Ellen F Binder, Et Al.

2020-Current year OA Pubs

No abstract provided.

Social Marketing And The Challenges Of Participant Recruitment, Tom Baranowski, Teresia M O'Connor, John A Jimenez-Garcia, Kavita Radhakrishnan, Elva M Arrendondo, Debbe Thompson

Children’s Nutrition Research Center Staff Publications

Recruitment of research participants often has not obtained a desired sample size, thereby becoming a major problem inhibiting investigators' ability to adequately test the specified hypotheses. Social marketing with its four Ps, originally developed by the business world to sell products and adapted for public health initiatives, is proposed as a dynamic comprehensive conceptual framework to apply marketing principles and practices to enhance participant recruitment. Applying a social marketing approach to research recruitment would require initial investigation to understand the motivations of the target audience in regard to research participation, and continued research throughout the main project to adapt the …

Nucleolytic Processing Of Abasic Sites Underlies Parp Inhibitor Hypersensitivity In Alc1-Deficient Brca Mutant Cancer Cells, Natasha Ramakrishnan, Tyler M Weaver, Lindsey N Aubuchon, Ayda Woldegerima, Taylor Just, Kevin Song, Alessandro Vindigni, Bret D Freudenthal, Priyanka Verma

2020-Current year OA Pubs

Clinical success with poly (ADP-ribose) polymerase inhibitors (PARPi) is impeded by inevitable resistance and associated cytotoxicity. Depletion of Amplified in Liver Cancer 1 (ALC1), a chromatin-remodeling enzyme, can overcome these limitations by hypersensitizing BReast CAncer genes 1/2 (BRCA1/2) mutant cells to PARPi. Here, we demonstrate that PARPi hypersensitivity upon ALC1 loss is reliant on its role in promoting the repair of chromatin buried abasic sites. We show that ALC1 enhances the ability of the abasic site processing enzyme, Apurinic/Apyrimidinic endonuclease 1 (APE1) to cleave nucleosome-occluded abasic sites. However, unrepaired abasic sites in ALC1-deficient cells are readily accessed by APE1 at …

Demystifying The Virtualization Process: A Call For Standard Reporting Of Virtual Modifications To Evidence-Based Psychotherapies, Using The Frame Model, Derrecka M Boykin, Tracey L Smith, Barbara Rakel, Merlyn Rodrigues, Jennie Embree, Ken Woods, Angelic D Chaison, Lilian Dindo

Faculty, Staff and Students Publications

The sudden onset of the coronavirus disease led to a rapid expansion of video telehealth to deliver mental healthcare. Although video telehealth was not a new clinical practice, there was limited guidance on how best to modify evidence-based psychotherapies (EBPs) for virtual delivery (a process also referred to as virtualization). The virtualization process for EBPs remains unclear as newly emerging reports on this topic do not consistently report modification decisions. This commentary calls attention to the need to improve documentation practices to allow a greater understanding of modifications needed to maximize the positive effects of EBPs transported to a virtual …

Intermittent Fasting As An Adjuvant To Standard Drug Therapy For Drug Resistant Epilepsy, Jake Smiech

Yale School of Medicine Physician Associate Program Theses

Epilepsy affects about 70 million people worldwide, making it the world’s second most common neurological disease. The first line treatment for epilepsy are anti-seizure medications, but only two-thirds of patients respond to the first two medications given. We propose a randomized controlled study utilizing intermittent fasting as a therapeutic lifestyle modification as an adjuvant to standard drug therapy for those that experience drug-resistant epilepsy. We will assess the efficacy and safety of intermittent fasting for a period of six months, and statistically determine if there is a significant reduction in the mean frequency of seizures participants experience compared to a …

Utility Of Serum Uromodulin In Predicting Kidney Injury In Acute Decompensated Heart Failure, Isabel Bautista

Yale School of Medicine Physician Associate Program Theses

Heart failure is widespread and associated with high mortality and healthcare costs. Patients hospitalized with acute decompensated heart failure are at risk for developing kidney injury, a high-risk complication known as cardiorenal syndrome. Elevated uromodulin has reno-protective effects and is associated with a lower risk of kidney dysfunction. Compelling evidence suggests that elevations in uromodulin levels may help improve clinical outcomes among other kidney disease populations yet, it has not been explored in patients with heart failure. This study aims to investigate the relationship between baseline serum uromodulin levels and risk of incident acute kidney injury among acute decompensated heart …

Cardiovascular Versus Resistance Training In Lgbtq+ Adolescents With Overweight Or Obesity, Cordelia Cluett

Yale School of Medicine Physician Associate Program Theses

Obesity prevalence in the U.S. is predicted to reach 50% by 2030, accompanied by negative health consequences. At-risk populations, including LGBTQ+ youth, are disproportionately afflicted by obesity. Exercise is known to help improve obesity and reduce associated comorbidities; however, the research community lacks consensus on the best type of exercise for reducing obesity parameters. We seek to determine whether aerobic training or resistance training results in a greater reduction of adiposity within an adolescent LGBTQ+ population. Our randomized control trial will compare mean change in waist circumference and body fat percentage after a yearlong resistance training intervention compared to an …

Transesophageal Echocardiography During Prehospital Cardiopulmonary Resuscitation, Carlie Dominguez

Yale School of Medicine Physician Associate Program Theses

Cardiac arrest is a sudden, life-threatening emergency that demands rapid and effective intervention. Ultrasound is used during cardiac arrest to guide resuscitation, characterize cardiac rhythm, and possibly identify cardiac arrest etiology. However, it is associated with significant limitations. Transesophageal echocardiography is a type of ultrasound that overcomes the limitations associated with traditional ultrasound and provides unique advantages, including the ability to optimize chest compressions and provide continuous cardiac imaging throughout CPR. The aim of this study is to investigate whether the use of transesophageal echocardiography during prehospital resuscitation of adults experiencing nontraumatic out-of-hospital cardiac arrest improves the proportion of sustained …

Alpha Angle And Anterior Femoral Neck Offset Identify Different Cohorts Of Cam Morphology: An Osteologic Study, Grigory A. Manyak

Faculty Scholarship

Purpose: To explore differences in cam morphology defined by alpha angle (AA) and anterior femoral neck offset (AFNO) in the context of other anthropometric parameters in an osteologic collection to further elucidate whether each measurement tool is identifying the same underlying pathology. Methods: Anthropometric measurements of 992 cadaveric hips from the Hamann-Todd Osteological Collection were analyzed. Femurs with cam morphology were identified by AA >55° or AFNO <7 mm. Anthropometric parameters stratified by cam morphology were assessed with Wilcoxon rank-sum and Pearson χ2 tests. Multivariate logistic regressions were performed on significant variables in univariate analysis to examine the predictive ability of anthropometric variables to cam morphology. Results: Cam morphology was identified in 242 hips via AA, 344 hips via AFNO, and 123 hips via both measures. Multivariate logarithmic regression analysis demonstrated that sex negatively predicted AA (females with less pathology, β = –0.14, P = .04), race negatively predicted AA (Blacks with less pathology, β = –0.21, P < .01), and proximal femoral osteoarthritis was positively associated with AA (β = 0.16, P = .02), while none of these were associated with AFNO. On the other hand, right-side specimens were associated with AA (β = 0.15, P = .02) and AFNO (β = 0.25, P < .01), whereas the combined version was unassociated with both measures. Conclusions: In conclusion, cam morphology was identified in a modest percentage of osteologic specimens by both AA and AFNO in our study. Further, associations of multiple demographic, anthropometric, and anatomical parameters to AA and AFNO suggest they may identify different subsets of cam morphology. Clinical Relevance: Cam morphology identified by AA versus AFNO may represent 2 different pathologic entities. Future studies should assess differences between these measures in a clinical cohort and determine whether these 2 definitions of cam morphology identify different clinical populations.

N-Myc And Stat Interactor Is An Endometriosis Suppressor, Yuri Park, Xiaoming Guan, Sang Jun Han

Faculty, Staff and Students Publications

In patients with endometriosis, refluxed endometrial fragments evade host immunosurveillance, developing into endometriotic lesions. However, the mechanisms underlying this evasion have not been fully elucidated. N-Myc and STAT Interactor (NMI) have been identified as key players in host immunosurveillance, including interferon (IFN)-induced cell death signaling pathways. NMI levels are markedly reduced in the stromal cells of human endometriotic lesions due to modulation by the Estrogen Receptor beta/Histone Deacetylase 8 axis. Knocking down NMI in immortalized human endometrial stromal cells (IHESCs) led to elevated RNA levels of genes involved in cell-to-cell adhesion and extracellular matrix signaling following IFNA treatment. Furthermore, NMI …

Influence Of Adiposity And Sex On Sars-Cov-2 Antibody Response In Vaccinated University Students: A Cross-Sectional Esfuerso Study, Adriana L. Perales-Torres, Lucia M. Perez-Navarro, Esperanza M. Garcia-Oropeza, Alvaro Diaz-Badillo, Yoscelina Estrella Martinez-Lopez, Marisol Rosas-Diaz, Octelina Castillo-Ruiz, Laura Yanneth Ramirez-Quintanilla, Leonel Vela, Beatriz Tapia, Juan C. Lopez-Alvarenga

School of Medicine Publications

Prior studies have identified various determinants of differential immune responses to COVID-19. This study focused on the Ig-G anti-RBD marker, analyzing its potential correlations with sex, vaccine type, body fat percentage, metabolic risk, perceived stress, and previous COVID-19 exposure. In this study, data (available in S1 Data) were obtained from 108 participants from the ESFUERSO cohort, who completed questionnaires detailing their COVID-19 experiences and stress levels assessed through the SISCO scale. IgG anti-RBD concentrations were quantified using an ELISA assay developed by UNAM. Multiple regression analysis was employed to control for covariates, including sex, age, body fat percentage, body …

Sociocultural Effects On Suicidal Ideation Among South Asian Immigrants, Rezwana Ahmed Choudhury

Walden Dissertations and Doctoral Studies

With the growing South Asian immigrant population in the West, it is necessary to conduct suicide-related studies among this population to understand the reasons behind suicidal ideation faced by this population. This quantitative cross-sectional survey design study aimed to examine sociocultural factors that may be associated to the risk level of suicidal ideation among South Asian immigrants in the United States. A survey questionnaire was developed using a combination of demographic questions and existing instruments: the Suicide Ideation Attributes Scale, Religious Belief Salience Scale, Suinn-Lew Asian Self-Identity Acculturation Scale, and Rapid Eating Assessment for Participants—S. Data were collected from a …

Systemic Arterial Function After Multisystem Inflammatory Syndrome In Children Associated With Covid-19, Ketaki Mukhopadhyay, Marla S. Johnston, James S. Krulisky, Shengping Yang, Thomas R. Kimball

School of Medicine Faculty Publications

Introduction: Multisystem inflammatory syndrome in children (MIS-C) is a new disease entity occurring in the pediatric population two to six weeks after coronavirus exposure due to a systemic arteritis. We investigated post-hospital-discharge arterial function at short- and mid-term intervals using pulse wave velocity. We assessed associations between arterial function, left ventricular diastolic and systolic function and left ventricular mass. Materials and methods: Retrospective data collection was carried out on 28 patients with MIS-C with at least two outpatient pediatric cardiology clinic visits post hospital admission. The patients underwent assessment of systemic arterial function and cardiac function. Data included pulse wave …

Global Burden Of Five Major Types Of Gastrointestinal Cancer, Arjun Singh

Division of Gastroenterology and Hepatology Faculty Papers

Gastrointestinal (GI) cancers cause major global morbidity and mortality, with over 5 million new cases and 3.5 million deaths in 2020. The most prevalent GI malignancies are colorectal, gastric, liver, oesophageal, and pancreatic cancers. Marked geographic variations exist, with high incidence in developed regions contrasting with high mortality in developing areas. These patterns reflect disparities in risk factors and cancer control capacities. However, GI cancer incidence is rising with economic growth and lifestyle changes. Poor prognosis and increasing burden underscore the critical need for expanded prevention and research. This review examines global epidemiology, risks, prevention, detection, treatment, and priorities for …

Identifying And Addressing Equity Gaps Among Lvhn Health Plan Members, Jessica Berman, Cynthia Kusorgbor-Narh Mph, Ches, Brigid Tray Mph, Ches, Lori Piltz Bs, Rn, Cphq

Research Scholars

No abstract provided.

The Efficacy Of An Integrated Visual-Vestibular Rehabilitation Model In Concussion Patients Suffering From Prolonged Vestibulo-Ocular Dysfunction, Megan Hammer, Mark Cipolle Md, David Clark, Eden Hunt Md, Daniele Shollenberger Crnp

Research Scholars

No abstract provided.

The Direct Index: A Tool For Equity, Inclusion, And Relationship-Centered Care, Kwame Otoo Appiah, Ashwini Kamath Mulki Md, Mbbs, Mph

Research Scholars

No abstract provided.

Telling The Story: Long-Term Experiences Of Valley Preferred Quality Improvement (Qi) Program Participants, Kourtney Keim, Johnny Stoeckle Md

Research Scholars

No abstract provided.

Evaluation Of Specimen Collection And Processing Workflows To Improve Ed Throughput, Rose Morgan, Shelbi Taylor Msn, Mba, Rn-Bc, Kathleen E. Kane Md

Research Scholars

No abstract provided.

Assessing Emergency Computed Tomography Throughput, Cayden Rex, Kathleen E. Kane Md

Research Scholars

No abstract provided.

Assessing The Need For A Therapeutic Thermoregulation Protocol (Ttp) For The Burn Surgical Patient, Morgan Strecker, Gwendolyn Minogue, Jill Krystofinski Dnapc, Crna

Research Scholars

No abstract provided.

Epic Education: The Value Of Utilizing Outpatient Billable Notes And The Creation Of Efficient Training, Maggie Cygan, Kerri Green Edd, Katerina C. Valavanis Md, Anne Vanderpool Mba

Research Scholars

No abstract provided.

Impact Of The Emerging Health Professionals Program On Nursing Career Trajectory Within The Lehigh Valley Health Network, Brooke Wunderler, Kerri Green Edd, Ms

Research Scholars

No abstract provided.

Unentered Patient Surveys: How To Collect Sexual Orientation And Gender Identity (Sogi) Data, Julianna Ehm, Karlee Posivak, Kay Young Msn, Rnc-Ob

Research Scholars

No abstract provided.

Long-Term Outcomes Of Transcatheter Aortic Valve Replacement (Tavr) In Patients With Renal Failure On Dialysis, Shree Manivel, Bryan D. Nelson Mba, Nr-P, James K. Wu Md

Research Scholars

No abstract provided.