Medicine and Health Sciences Commons^™

Structural Insights Into Ssna1 Self-Assembly And Its Microtubule Binding For Centriole Maintenance, Lorenzo Agostini, Jason A Pfister, Nirakar Basnet, Jienyu Ding, Rui Zhang, Christian Biertümpfel, Kevin F O'Connell, Naoko Mizuno

2020-Current year OA Pubs

SSNA1 is a fibrillar protein involved in dynamic microtubule remodeling, including nucleation, co-polymerization, and microtubule branching. The underlying molecular mechanism has remained unclear due to a lack of structural information. Here, we determine the cryo-EM structure of C.elegans SSNA-1 at 4.55-Å resolution and evaluate its role in embryonic development. We find that SSNA-1 forms an anti-parallel coiled-coil, with self-assembly facilitated by an overhang of 16 C-terminal residues that form a triple-stranded helical junction. The microtubule-binding region is within the triple-stranded junction, suggesting that self-assembly of SSNA-1 creates hubs for effective microtubule interaction. Genetical analysis elucidates that SSNA-1 deletion significantly reduces …

Macrophage Phagocytosis Of Human Norovirus-Infected Cells In An Ex Vivo Human Enteroid-Macrophage Coculture Model, Ngan Fung Li, Sue E Crawford, Sydney R Mittiga, Cristian Coarfa, Hoa Nguyen-Phuc, Budi Utama, Sarah E Blutt, Sasirekha Ramani, Mary K Estes

Faculty, Staff and Students Publications

Human norovirus (HuNoV) causes acute gastroenteritis in immunocompetent hosts and chronic infection in immunocompromised individuals. Many recent studies of replication and innate immune responses following HuNoV infection have utilized epithelium-only human intestinal enteroids (HIEs), which lack immune cells. Here, we utilized an ex vivo enteroid-macrophage coculture model consisting of HIEs and different subtypes of human peripheral blood mononuclear cell-derived macrophages to better recapitulate in vivo gut biology and explore the role of macrophages in HuNoV replication and pathogenesis. We show that HuNoV infection in HIEs polarized on Transwells leads to bilateral release of the viral genome, with predominant apical virus …

Staff Education Program On Medication Reconciliation In Primary Care, Virginia Ann Bloomer

Walden Dissertations and Doctoral Studies

Medication errors represent a persistent threat to patient safety, particularly during transitions of care in outpatient settings. Despite recognition of the problem, standardized medication reconciliation practices among primary care physicians and nurse practitioners (NPs) remain inconsistent, hindered by varied workflows, unclear responsibilities, and knowledge gaps. To address these issues, a staff education program focusing on medication reconciliation was introduced to seven NPs and three physicians in a primary care clinic. Pre- and post-intervention surveys measured participants’ knowledge and confidence in conducting medication reconciliation and documenting medications in electronic medical records. The average test score improved from 68% to 92%, demonstrating …

Autosomal Recessive Spastic Ataxia Of Charlevoix-Saguenay With Early-Onset Epilepsy And Novel Clinical Features: A Rare Entity From Morocco In The Middle East And North Africa Region, Azzeddine Laaraje, Basma Alaoui, Abdelilah Radi, Amal Hasani, Aomar Agadr, Rachid Abilkassem

Sultan Qaboos University Medical Journal

We report a novel presentation of autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS) in a 9-year-old Moroccan male patient born to consanguineous parents, expanding the known clinical spectrum of the disease. The patient presented to a tertiary care hospital in Rabat, Morocco, in 2023. This case presents an unusual phenotype with early-onset epilepsy beginning at age 5, significantly broadening the known phenotypic spectrum of ARSACS. While initial neuroimaging was unremarkable, the patient exhibited classical retinal involvement with bilateral nerve fibre layer thickening. Genetic analysis revealed a previously unreported homozygous frameshift mutation in the SACS gene (c.12429delT), representing the first documented …

Vitamin D Deficiency And Its Role In Pathologies Of Oxidative Stress: A Literature Review, Philippe Dentino, Johanna Mora, Li Zuo

School of Medicine Publications

Vitamin D (VD) is a key mineral providing critical modulation of reduction-oxidation homeostasis within biological systems. VD and the VD receptor coordinate essential cellular activities, including mitochondrial electron transport, respiration, antioxidation, gene regulation, and calcium transportation. Reactive oxygen species (ROS), a natural by-product of cellular metabolism, play a prominent role in the mechanisms of biological antioxidant systems and form the basis of antioxidant therapies. However, ROS may also perpetuate pathological processes when produced in excess secondary to inflammatory pathways. Aging processes within cells rely on this reduction-oxidation homeostasis. Thus, the interaction with VD, its receptor, mitochondria, and oxidative stress forms …

Established And Emerging Asthma Biomarkers With A Focus On Biologic Trials: A Narrative Review, Philip F Lavere, Kaitlin M Phillips, Nicola A Hanania, Muhammad Adrish

Faculty, Staff and Students Publications

Chronic airway inflammation with variable airflow obstruction is clinical asthma, and it arises from distinct molecular and pathological mechanisms called endotypes. Biomarkers allow for precise endotype characterization and have been used in clinical trials to design, monitor, and evaluate outcomes for asthma biologic therapies. This review will highlight the central and evolving role of biomarkers for past, present, and future asthma, with a focus on regulatory-approved biologic therapies and emerging biomarkers. Established biomarkers, including serum immunoglobulin E (IgE), blood eosinophils, the fraction of exhaled nitric oxide (FeNO), and serum periostin, helped elucidate the complex pathophysiology of the eosinophilic type 2 …

Military Launching! To Adulthood: A Cultural Adaptation Of A Group Therapy Program For Military-Dependent Young Adults With Autism Spectrum Disorder Transitioning To Adulthood, Antonio F Pagán, Jordan Kenemore, Linda Hernandez, Stephen Armstrong, Katherine A Loveland, Mark Ahlenius, Ron Acierno

Faculty, Staff and Student Publications

Objectives: The transition to adulthood poses distinct challenges for young adults with autism spectrum disorder (ASD) (ages 18-25), particularly in establishing and achieving long-term goals. This is further complicated for those within the military and veteran communities. This study aimed to evaluate the feasibility, acceptability, and cultural fit of "Launching! to Adulthood," a 12-week telehealth intervention, adapted for military-dependent young adults with ASD and their military/veteran parents.

Methods: Building on previous research and incorporating stakeholder feedback, the intervention addressed key transition challenges such as executive functioning, mental health, vocational skills, and social engagement, while also aligning with military cultural values. …

Cardiovascular Autonomic Neuropathy Defined By Indices Of Heart Rate Variability Is Associated With Cardiovascular Disease: A Longitudinal Cohort Study Of Participants With Type 1 Diabetes, Barbara H Braffett, Laure El Ghormli, Catherine Martin, Neil H White, Irl B Hirsch, Anne Bantle, Anders Carlson, Ellen Leschek, Rose Gubitosi-Klug, Elsayed Z Soliman, Adrian Vella, Bruce A Perkins, Ionut Bebu, Rodica Pop-Busui, Dcct/Edic Research Group

2020-Current year OA Pubs

BACKGROUND: To describe longitudinal prevalence and risk factors associated with cardiovascular autonomic neuropathy (CAN), defined by heart rate variability (HRV) indices, and evaluate the impact of CAN on cardiovascular disease (CVD), in adults with type 1 diabetes (T1D) from the Epidemiology of Diabetes Interventions and Complications (EDIC) study.

METHODS: Standard resting electrocardiogram (ECG) recordings were obtained annually in 997 participants (mean ± SD age 56.2 ± 6.8 years; T1D duration 34.7 ± 7.9 years; 48% female) between 2015 and 2022. The standard deviation of normally conducted R-R intervals (SDNN) and root mean square of successive differences between normal-to-normal R-R intervals …

Senior Living: Filling The Gap, Katy J. Johnson

The Interactive Journal of Global Leadership and Learning

This white paper explores how colleges and universities can help address the housing crisis for Americans aged 65 and older by integrating seniors into college campuses. This approach not only helps to fill dormitories but also provides students with valuable work experience. The paper examines three key issues: the Silver Tsunami (the growing senior population), declining enrollment leading to campus housing vacancies, and the financial burden of higher education. By advocating for intergenerational living, the proposal offers an innovative solution that benefits seniors, students, and universities.

Implementing Age-Appropriate, School-Based Comprehensive Sexuality Education, Emira Romero

DNP Qualifying Manuscripts

Background: Sexual and reproductive health (SRH) education is a critical component of early health literacy and health promotion. Yet, there are no federal education requirements for sexuality education in the United States, leading to inconsistent and inadequate instruction.

Methods: In an effort to better understand the barriers beyond policy variability that affect successful implementation of SRH education, a literature search was conducted on CINAHL and ERIC with the following search terms and Boolean operators: (sex* education OR reproductive educat*) AND (elementary school OR school based) AND (United States OR California). The years of publication were limited to the past five …

Development Of Emerin Mrna Lipid Nanoparticles To Rescue Myogenic Differentiation., Nicholas Marano, Liza Elif Guner, Rachel S Riley, James M Holaska

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Emery-Dreifuss muscular dystrophy 1 (EDMD1) arises from mutations in EMD. Most EDMD1 patients lack detectable emerin expression. They experience symptoms such as skeletal muscle wasting, joint contractures, and cardiac conduction defects. Currently, physicians rely on treating patient symptoms without addressing the underlying cause-lack of functional emerin protein. Thus, there is a need for therapeutic approaches that restore emerin protein expression to improve patient outcomes. One way would be to deliver emerin mRNA or protein directly to affected tissues to restore tissue homeostasis. Here, we evaluated the utility of lipid nanoparticles (LNPs) to deliver emerin mRNA to diseased cells. LNPs …

Effect Of Whole-Food Plant-Based Diet On Ldl Cholesterol: A Scoping Literature Review, Joel Gregory Mueller

Nursing Capstones

Background: The whole-food, plant-based (WFPB) diet includes whole grains, whole plants, unrefined sugars, beans, and legumes. The diet excludes meat, dairy, and added fats. The diet has been popularized by documentaries .The diet claims to lower total and LDL cholesterol to a safe level as both a primary and secondary mode of prevention.

Purpose: Review existing studies to see whether the WFPB diet will lower LDL cholesterol in adult males over a 14 day or more duration.

Methods: A scoping literature review was completed of the University of North Dakota’s library system for keyword combinations. The returned 102 studies were …

Factors That Contribute To Occupational Burnout Among Occupational Therapists And Certified Occupational Therapy Assistants: A Qualitative Design, M'Kayla Davis, Kim Broussard, Mary Jan Greer

Summer 2025 OTD Capstone Symposium

This capstone project investigates the prevalence, contributing factors, and impact of occupational burnout and compassion fatigue among occupational therapists (OTs) and certified occupational therapy assistants (COTAs) in inpatient rehabilitation facilities. Using a qualitative research design, structured interviews and thematic analysis, the study identifies heavy workloads, staffing limitations, emotional demands, and sleep deprivation as primary contributors to burnout. The research employs occupational adaptation theory to explore adaptive strategies practitioners utilize, such as boundary setting and seeking professional or interrelationship support, to mitigate these effects. Findings highlight the pervasive nature of burnout among participants on professional performance and personal well-being, and the …

Variability In Long Covid Definitions And Validation Of Published Prevalence Rates, Lauren E. Wisk, Michelle L'Hommedieu, Kate Diaz Roldan, Imtiaz Ebna Mannan, Erica S. Spatz, Robert A. Weinstein, Arjun K. Venkatesh, Michael Gottlieb, Ryan Huebinger, Kristin L. Rising, Juan Carlos C. Montoy, Kari A. Stephens, Robert M. Rodriguez, Mandy J. Hill, Kelli N. O'Laughlin, Nicole L. Gentile, Ahamed H. Idris, Shu-Xia Li, Michelle Santangelo, Efrat R. Kean, Samuel A. Mcdonald, Kristyn Gatling, Joann G Elmore

Jefferson Center for Connected Care Faculty Papers

IMPORTANCE: Long COVID definitions vary widely, and no consensus exists on how to accurately measure its prevalence, complicating both clinical care and research.

OBJECTIVE: To assess long COVID prevalence using various definitions from published literature.

DESIGN, SETTING, AND PARTICIPANTS: This prospective, multicenter cohort study used data from the longitudinal Innovative Support for Patients With SARS-CoV-2 Infections Registry (INSPIRE). Participants aged 18 years or older with symptoms suggestive of COVID-19 illness at the time of their index SARS-CoV-2 test enrolled at 8 sites across the US from December 11, 2020, through August 29, 2022, with follow-up surveys collected through February 28, …

Quality Improvement Project Integrating Educational Program For School Faculty In Childhood Diabetes, Sharon Anna-Marie Hill

Doctor of Nursing Practice Projects

In the United States, diabetes affects approximately 38.4 million individuals, including over 304,000 children and adolescents diagnosed with type 1 diabetes. As the most common chronic condition in children, diabetes management in school settings is critical to ensure health, safety, and academic success. However, a lack of standardized training for school faculty often results in inadequate knowledge and confidence in managing diabetes, exacerbating student health risks. This Doctor of Nursing Practice (DNP) quality improvement (QI) project aimed to develop and implement an educational program for school faculty, focusing on managing and treating childhood diabetes. A paired sample t-test was used …

Quality Improvement Project Integrating Clinical Decision-Making Tools Within An Ehr System For Provider-Enhanced Diagnosis And Treatment Of Depression In Primary Care, Theresa Ojoye

Doctor of Nursing Practice Projects

The inconsistent management of depression in primary care settings persists despite numerous available treatments, which current behavioral health literature frequently addresses.  A review of the project site highlighted the inconsistency in diagnosing and managing depression due to varying levels of provider familiarity with current guidelines and a lack of integrated decision-support tools within the Electronic Health Record (EHR) system. This project aims to evaluate the impact of integrating a clinical decision-making tool and patient outcomes in managing depression. This Quality Improvement (QI) project implemented UpToDate as an evidence-based clinical resource within the EHR system to address inconsistent application of evidence-based …

Assessment Of Faculty Perception Of Flipped Classroom Pedagogy, Jincymol Thomas

Doctor of Nursing Practice Projects

This DNP project assesses the faculty's perception of the flipped classroom (FC) pedagogy, which is an evidence-based teaching strategy to promote active learning and student success. The purpose of this project is to assess faculty members’ perception of implementing FC. The problem identified is the low progression and graduation rates for associate degree nursing (ADN) students at a North Central Texas Community College. This indicates that current teaching strategies need to be revised. As healthcare is constantly evolving and becoming more complex, the traditional methods of teaching nursing students are no longer sufficient. This QI project is aiming to educate …

Dnp Project: Research Study Using Mindfulness Meditation For Stress Reduction In Undergraduate Nursing Students, Jennifer Williams

Doctor of Nursing Practice Projects

Undergraduate nursing students often experience high stress from academic rigor, clinical demands, and personal challenges, contributing to mental health concerns and increased attrition. Unmanaged stress, when met with insufficient coping strategies, may contribute to students failing, leaving, or withdrawing from a nursing program. This research project addressed the need for a structured coping strategy within the curriculum at a State College to promote student resilience and reduce stress. As a quality improvement process change, the project’s purpose was to evaluate the impact of a four-week mindfulness meditation (MM) intervention on perceived stress levels of first-semester Associate Degree in Nursing (ADN) …

Comparative Analysis Of Risk Factors Associated With Guinea Worm Disease In Five Endemic Countries, Junerlyn Virrey Agua

Walden Dissertations and Doctoral Studies

Guinea worm disease (GWD) has persisted in a small number of endemic countries despite decades of eradication efforts. Ongoing GWD transmission in these countries underscores the need to examine behavioral, environmental, and surveillance-related drivers. The purpose of this quantitative study was to assess associations among risk factors, including dog tethering, pond treatment with Abate, and community awareness, and GWD incidence. The study also examined the relationship between climate-related environmental factors and GWD case distribution, as well as the influence of awareness levels on GWD rumor reports. Guided by the PRECEDE–PROCEED framework, this retrospective secondary analysis used data from national eradication …

Volume Ii | Issue I | 2025

Dartmouth Undergraduate Journal of Politics, Economics and World Affairs

No abstract provided.

Strategies For Sustainable Recruitment, Retention, And Engagement In State Nurse Organization, Carolyn E. Hunter Layne

Doctor of Nursing Practice Projects

Many state nurse organizations are experiencing minimal and stagnant membership, which hinders involvement in policy advocacy, professional development, and workforce stability in healthcare. Policy changes are needed to offer state nurse organization memberships under the umbrella of a single organization that operates multiple medical clinics and employs at least one nurse. This research examined strategic policy interventions designed to increase membership within a state-level nursing organization. The problem is that a minimum number of state-licensed nurses are choosing to join professional nursing organizations, and membership models must be identified. The literature review drew on research from various scholarly sources specific …

Quality Improvement Project Implementing A Structured Communication Program For Academic Clinical Nursing Education, Ashley Daniel

Doctor of Nursing Practice Projects

Effective communication between healthcare professionals is a critical component of safe and high-quality patient care. Structured tools like SBAR (situation, background, assessment, and recommendation) provide a framework to enhance clarity and reduce miscommunication. This quality improvement project implemented SBAR as a structured communication program in debriefing after simulation to improve communication confidence among practical nursing students. The purpose of this project was to evaluate whether the integration of SBAR into debriefing would increase students’ self-reported communication confidence. The problem addressed was the lack of confidence in clinical communication among nursing students, which can impact patient safety and team collaboration. The …

Implementing Education On Music Therapy To Healthcare Professionals In Acute Psychiatric Inpatient Units To Decrease Incidences Of Aggression Among Patients, Judy Murua

Doctor of Nursing Practice Projects

Aggression in psychiatric inpatient units presents a significant barrier to therapeutic care and staff safety, often resulting in the overuse of pharmacological interventions or restraints. Despite strong evidence supporting music therapy as a non-pharmacological option, limited exposure and confidence among healthcare team members hinder its use in practice. This quality improvement project evaluated whether an educational intervention on music therapy could improve staff‘s confidence in utilizing this technique to manage aggression. A quasi-experimental, one-group pre- and post-test design was employed in an adult inpatient psychiatric unit, involving participation from nurses and behavioral health technicians. A structured 30–45-minute educational session was …

Enhancing Clinical Understanding And Management Of Hypertensive Disorders Of Pregnancy Among Ob-Gyn Providers, Jenelle Camino

Walden Dissertations and Doctoral Studies

Hypertensive disorders of pregnancy (HDP), including gestational hypertension, preeclampsia, and chronic hypertension, are among the leading causes of maternal and neonatal morbidity and mortality globally, affecting approximately 10% of pregnancies. Despite established clinical guidelines, a significant gap remains in provider knowledge and the consistent application of evidence-based practices, particularly during the postpartum period and among marginalized populations. This Doctor of Nursing Practice (DNP) project addressed this gap by implementing a staff education program using the evidence-based California Maternal Quality Care Collaborative (CMQCC, 2021) toolkit. The intervention consisted of a pretest to assess baseline knowledge, an interactive PowerPoint presentation based on …

Cognitive Impairment In Adult Attention Deficit Hyperactivity Disorder: Clinical Implications And Novel Treatment Strategies, Alexis J. Vega, Gabriel V. Hernandez, Ahmed I. Anwar, Bahareh Sharafi, Rahib K. Islam, Sahar Shekoohi, Alan D. Kaye

School of Medicine Faculty Publications

Attention Deficit Hyperactivity Disorder (ADHD) is a lifelong condition; however, traditional treatment focuses on hyperactivity and inattention, which is largely a manifestation of pediatric ADHD. Studies are limited regarding cognitive difficulties, as seen in adult ADHD, as well as treatment strategies for this population. This review of the literature examines multiple recent studies that discuss various novel treatment strategies for cognitive impairment in adults with ADHD. A targeted literature review was conducted using PubMed to identify recent studies on cognitive dysfunction in adults with ADHD, with an emphasis on emerging treatment strategies. Data collected included sample size, intervention strategies, cognitive …

The Swib Domain-Containing Dna Topoisomerase I Of Chlamydia Trachomatis Mediates Dna Relaxation, Li Shen, Abigail R. Swoboda, Caitlynn Diggs, Shomita Ferdous, Andrew Terrebonne, Amanda Santos, Noel Wolf, Luis Lorenzo Carvajal, Guangming Zhong, Scot P. Ouellette, Yuk Ching Tse-Dinh

School of Graduate Studies Faculty Publications

Chlamydia trachomatis has a DNA topoisomerase I with a unique C-terminal domain (CTD) homologous to eukaryotic SWIB domains. This study focused on determining the function of the SWIB domain-containing TopA from C. trachomatis (CtTopA). We demonstrated that, despite the lack of sequence similarity at the CTDs between CtTopA and TopA from Escherichia coli (EcTopA), full-length CtTopA removed negative DNA supercoils in vitro and complemented the growth defect of a topA mutant of E. coli. CtTopA is less processive in DNA relaxation than EcTopA in dose-response and time course studies. An antibody generated against the SWIB domain of CtTopA specifically recognized …

Inflation Targeting And Inertial Rules, Araha Uday

Dartmouth Undergraduate Journal of Politics, Economics and World Affairs

No abstract provided.

Restrictions On Veto Power: Holding The Permanent Five Accountable In The Face Of Intervention And Peacekeeping Operations, Theo Aldrighi

Dartmouth Undergraduate Journal of Politics, Economics and World Affairs

ABSTRACT: This article examines the structural constraints of the United Nations Security Council, with a focus on the veto power of its permanent members and its implications for intervention and peacekeeping. Through a realist lens and grounded in structural analysis, it contends that the recurrent paralysis of the Council in the face of mass atrocities stems from entrenched power asymmetries. The paper advances a bifold proposal: the adoption of the French-Mexican initiative to suspend veto use in cases of mass atrocities, and the entrenchment of the Council’s authority to authorize the use of force under defined conditions. Drawing on case …

Clickbait Economics: When Narratives Outshine Fundamentals, Esther Eisenstat

Dartmouth Undergraduate Journal of Politics, Economics and World Affairs

No abstract provided.

Judicial Lustration In Backsliding Democracies: Causes And Solutions For Publication, Collin Mcdonnell

Dartmouth Undergraduate Journal of Politics, Economics and World Affairs

No abstract provided.