Medicine and Health Sciences Commons^™

Caregiver Attitudes Of Risky Outdoor Play For Toddlers With Developmental Delays And Disabilities In St. Louis, Missouri: A Socio-Ecological Perspective, Emily Korte-Stroff, Ot/L

Post-Professional Occupational Therapy Doctorate Culminating Presentations

Abstract: Risky outdoor play fosters autonomy, emotional regulation, and resilience in early childhood, yet caregivers of toddlers with developmental delays and disabilities often face unique barriers to supporting such play. Limited research has examined how caregivers perceive the factors shaping these decisions, particularly in the United States context. This mixed-methods cross-sectional study explored how caregivers in the St. Louis, Missouri metropolitan area perceive the socio-ecological factors shaping their attitudes toward risky outdoor play for children aged 13 to 47 months with developmental delays or disabilities. The project sought to first explore caregivers' perceptions of how interpersonal and individual factors, shape …

Staff Education Program For Fall Prevention, Priya Sebastian Vadakkan

Walden Dissertations and Doctoral Studies

Falls are the most common adverse events leading to increased injury, length of hospital stay, and costs among hospitalized patients. I developed a staff education project to address the identified practice problem of increased fall rates on the cardiac floor of the project site. The practice-focused question guiding this Doctor of Nursing Practice (DNP) project was whether a comprehensive staff education program on evidence-based fall prevention strategies could improve the nurses’ knowledge when compared to standard fall prevention practices. The purpose of this DNP project was to provide staff education to increase nurses’ knowledge about the early identification of fall …

Enhancing Novice Nurse Educator Success: A Comprehensive Orientation And Mentorship Program, Emily R. Luther

Doctor of Nursing Practice Projects

Nursing education programs face challenges from faculty shortages, high turnover, and limited onboarding support for new educators. This Doctor of Nursing Practice (DNP) project assessed the effectiveness of a structured orientation and mentorship program aimed at improving competency, job satisfaction, and retention among novice nurse educators within a mid-sized nursing program in the southeastern United States. The project addressed gaps in existing onboarding processes that left new faculty unprepared, which contributed to dissatisfaction and attrition. A mixed-methods pre- and post-intervention design was utilized. Quantitative data were gathered through the Self-Assessment of Nurse Educator Competencies (SANE-C), the Minnesota Satisfaction Questionnaire (MSQ), …

Evaluation Of The User Experience For A Point Of Care Molecular Test For Causes Of Vaginitis, Barbara Van Der Pol, Rebecca Lillis, Irving Nachamkin, Stephen Young, La Shonda Crane, Jacqueline Brown, R. Lamar Parker, Alice Weissfeld, Xiaohong Liu, Christina Huang, Aarthi Raman

School of Medicine Faculty Publications

Background: Vaginitis is a major cause of healthcare visits in the US, costing over $1.2 billion annually. Point-of-care (POC) nucleic acid amplification tests (NAATs) could improve accuracy of diagnosis and treatment during initial visit for vaginitis compared to send-out NAATs. Methods: A secondary analysis of data was collected from test operators at POC testing sites where the Xpert Xpress Multiplex Vaginal Panel test (“MVP test”) was performed. Users completed a survey assessing their experience with the instrument system and the PCR-based MVP test. Results: The MVP test demonstrated consistent performance, measured by positive and negative percent agreement, across all user …

Quantile Index Predictors Using R Package Hyper.Gam, Tingting Zhan, Misung Yi, Inna Chervoneva

Department of Pharmacology, Physiology, and Cancer Biology Faculty Papers

MOTIVATION: Evaluation of single-cell protein expression from immunohistochemistry images is used increasingly in biomedical research. Many proteins are used solely for phenotyping cells in the tumor microenvironment. Other proteins with meaningfully quantitative expression levels provide so-called functional protein biomarkers. There is still a limited number of methods and software tools available for utilizing the entire distributions of single-cell expression levels.

RESULTS: We present the R package hyper.gam, providing a supervised learning framework for deriving biomarkers based on single-cell distribution quantiles. The single-cell data are first converted into sample quantile functions, which are then used as predictors in scalar-on-function regression models …

Trauma Resuscitation With Low-Titer Group O Whole Blood Or Products: Study Protocol For A Randomized Clinical Trial (The Troop Trial), Jan O Jansen, Claudia Pedroza, Luis Leon Novelo, Tianyao Hao, Gina R Dewildt, Charles F Coton, Kiran Mansoor, Shannon W Stephens, Marisa B Marques, James R Stubbs, Jillian R Richter, Henry E Wang, John B Holcomb, Stacia M Desantis

Faculty, Staff and Student Publications

Background: Hemorrhage is the most common cause of potentially preventable death after injury. Balanced transfusion with red blood cells, plasma, and platelets (component therapy, CT) has been shown to reduce mortality, and is the standard of care. Low-Titer Group O Whole Blood (LTOWB) is an attractive alternative to CT, but existing evidence comprises observational studies, and a small single center pilot randomized controlled trial, which evaluated a type of whole blood that is no longer in use. The aim of the "Trauma Resuscitation with Low-Titer Group O Whole Blood Or Products" (TROOP) trial is to compare the effectiveness and safety …

Development Of A Clinical Practice Guideline For Trauma-Informed Care In Interprofessional Health Care Settings, Ngwi Rita Etiendem

Walden Dissertations and Doctoral Studies

Developing a standardized Clinical Practice Guideline for Trauma Informed Care was a central objective of this Doctor of Nursing project. This project followed an evidence-based, collaborative, and structured methodology that prioritized interdisciplinary input, organizational alignment, and rigorous appraisal using the AGREE II instrument.

Staff Education To Same Day Surgery Nurses, Katherine Lutman

Walden Dissertations and Doctoral Studies

The aim of this doctor of nursing practice staff education project was to provide a staff education program to the same day surgery staff at the practicum site on the Enhanced Recovery After Surgery (ERAS) evidence-based approach to surgical care to improve patient outcomes. ERAS includes multiple modalities designed to optimize a patient’s condition before, during, and after surgery. When implemented correctly, ERAS can reduce the need for narcotics, shorten recovery time, and improve surgical outcomes. The practice gap identified was that the only ERAS modality being actively implemented and tracked was nutrition in colorectal surgical patients and that the …

Enhancing Communication Among New Nurses Using Scenario-Based Education, Anita Clark Chambers

Walden Dissertations and Doctoral Studies

This staff education project was designed to enhance communication among new nurses with 2 years or less of experience in a Level One trauma center emergency department (ED). The aim of this project initiative was to enhance learners’ communication strategy knowledge and confidence by using scenario-based education via a web-based format. When ineffective communication exchanges occur with healthcare personnel, such as with new nurses, negative patient care outcomes can occur such as sentinel events. Transitional challenges such as lack of prioritization, clinical decision-making skills and low confidence can affect the new nurse’s ability to appropriate effective communication strategies into their …

Rna Sequencing And Immunohistochemistry Jointly Improve Tumor Biomarker Interpretation, Vladimir Kushnarev, Danil Stupichev, Suren Davitavyan, Kirill Kriukov, Basavaraja U Shanthappa, Anna Butusova, Sofia Menshikova, Anna Belozerova, Anastasia Shvyrkova, Arina Tkachuk, Olga Khatenkova, Linda Balabanian, Ekaterina Postovalova, Jochen K Lennerz, Funda Meric-Bernstam, Alexander Bagaev

Faculty, Staff and Student Publications

This study aimed to assess the correlation between RNA sequencing (RNA-seq) and immunohistochemistry (IHC) in detecting key cancer biomarkers across solid tumors, and then, to establish RNA-seq thresholds that accurately reflect clinical IHC classifications. Expression levels of nine biomarkers-ESR1, PGR, AR, MKI67, ERBB2, CD274, CDX2, KRT7, and KRT20-were analyzed in 365 formalin-fixed, paraffin-embedded samples from breast, lung, gastrointestinal, and other solid carcinomas. Correlations between RNA-seq data and IHC scores were determined using Spearman's correlation coefficients, with RNA-seq cut-offs established to distinguish positive from negative IHC scores. The results revealed strong correlations for most biomarkers, with coefficients ranging from 0.53 to …

Limosilactobacillus Reuteri Enables Oral-To-Systemic Absorption Of Iberiotoxin For Treatment Of Collagen-Induced Arthritis In Rats, Mohamed R Kady, R Nicholas Elston, Lauren J Snyder, Jorie D Fleischman, Madilyn J Brandt, Duolong Zhu, Robert A Britton, Christine Beeton

Faculty, Staff and Students Publications

Background: Rheumatoid arthritis (RA) is an autoimmune disease characterized by joint inflammation and damage in which fibroblast-like synoviocytes (FLS) play a central role. Invasiveness and proliferation of FLS in RA is dependent on activity of the KCa1.1 potassium channel. Peptide blockers of KCa1.1, such as iberiotoxin (IbTX), can be delivered subcutaneously to treat animal models of RA. We tested whether an engineered probiotic oral delivery platform could effectively deliver IbTX systemically in a rat model of RA.

Results: A plasmid for inducible secretion of IbTX was constructed and transformed into probiotic Limosilactobacillus reuteri ATCC PTA-6475 to generate LrIbTX. No differences …

Rsph4a-Pcdx: An Index To Predict Lung Function Decline In Primary Ciliary Dyskinesia, Gabriel Román-Ríos, Gabriel Rosario-Ortiz, Marcos J Ramos-Benitez, Ricardo A Mosquera, Wilfredo De Jesús-Rojas

Faculty, Staff and Student Publications

Primary ciliary dyskinesia (PCD) is a rare, genetically heterogeneous disorder that impairs mucociliary clearance and leads to progressive lung disease. This study aimed to characterize lung function decline in a genetically homogeneous cohort of Puerto Rican patients with

Sporadic Als Induced Pluripotent Stem Cell Derived Neurons Reveal Hallmarks Of Tdp-43 Loss Of Function, Jeffrey D Rothstein, Olivia Keeley, Caroline Warlick, Timothy M Miller, Cindy V Ly, Jonathan D Glass, Alyssa N Coyne

2020-Current year OA Pubs

Nuclear loss and cytoplasmic buildup of the RNA-binding protein TDP-43 is a hallmark of ALS and related disorders. While studies using artificial TDP-43 depletion in neurons have revealed changes in gene expression and splicing, their relevance to actual patients remained unclear. Induced pluripotent stem cell (iPSC)-derived neurons (iPSNs) from 180 individuals, including controls, C9orf72 ALS/FTD, and sporadic ALS (sALS) patients were used to generate and analyze ~32,500 qRT-PCR data points across 20 genes which identified variable, time-dependent signatures of TDP-43 loss of function in individual lines. Notably, the same changes were also seen in postmortem brain tissue from the same …

Management Of Postoperative Pain In Septorhinoplasty: A Systematic Review, Caitlin M Coviello, Uma R Ramesh, Beatriz Varman, Krista L Olson, Sunthosh K Sivam

Library Staff Publications

Objective: Septorhinoplasties are a common surgery. Effectively managing postoperative pain and identifying opioid reduction techniques is of critical importance. This systematic review characterizes the literature regarding the management of postoperative pain with opioid-based and opioid alternative therapies in patients undergoing septorhinoplasty.

Data sources: Medline (Ovid), Embase (Elsevier), Cochrane Library (Wiley), and Web of Science (Clarivate).

Review methods: A literature search was conducted using multiple medical subject headings (MeSH) and keywords with adherence to preferred reporting items for systematic review and meta-analysis (PRISMA) guidelines. Full-text analysis was performed by two independent reviewers using the Critical Appraisal Skills Program (CASP) and National …

Inhibition Of Epithelial Cell Yap-Tead/Lox Signaling Attenuates Pulmonary Fibrosis In Preclinical Models, Darcy Elizabeth Wagner, Hani N Alsafadi, Nilay Mitash, Aurelien Justet, Qianjiang Hu, Ricardo Pineda, Claudia Staab-Weijnitz, Martina Korfei, Nika Gvazava, Kristin Wannemo, Ugochi Onwuka, Molly Mozurak, Adriana Estrada-Bernal, Juan Cala-Garcia, Katrin Mutze, Rita Costa, Deniz Bölükbas, John Stegmayr, Wioletta Skronska-Wasek, Stephan Klee, Chiharu Ota, Hoeke A Baarsma, Jingtao Wang, John Sembrat, Anne Hilgendorff, Jun Ding, Andreas Günther, Rachel Chambers, Ivan Rosas, Stijn De Langhe, Naftali Kaminski, Mareike Lehmann, Oliver Eickelberg, Melanie Königshoff

Faculty, Staff and Students Publications

Idiopathic pulmonary fibrosis (IPF) is a progressive and lethal disease characterized by excessive extracellular matrix deposition. Current IPF therapies slow disease progression but do not stop or reverse it. The (myo)fibroblasts are thought to be the main cellular contributors to excessive extracellular matrix production in IPF. Here we show that fibrotic alveolar type II cells regulate production and crosslinking of extracellular matrix via the co-transcriptional activator YAP. YAP leads to increased expression of Lysl oxidase (LOX) and subsequent LOX-mediated crosslinking by fibrotic alveolar type II cells. Pharmacological YAP inhibition via verteporfin reverses fibrotic alveolar type II cell reprogramming and LOX …

Impact Of Aspiration Thrombectomy On Microvascular Obstruction In Patients With St-Segment Elevation Myocardial Infarction, Mahmoud Ismaiel, Mohamed Shehata, Tamer Elwasify, Mohamed Hosny, Amir Anwar, Tarek A.N. Ahmed, Abdalla Elagha

Journal of the Saudi Heart Association

Background and objective:

Primary percutaneous coronary intervention (PPCI) is the gold standard for myocardial reperfusion in ST-segment elevation myocardial infarction (STEMI). Numerous studies have shown that thrombus aspiration can prevent distal embolization and reducing the risk of microvascular obstruction (MVO). Cardiac magnetic resonance (CMR) is considered the gold standard for the evaluation of MVO. The aim of this study is to evaluate the effect of thrombus aspiration in STEMI patients as an adjunctive technique to primary PCI in reducing the incidence and extent of MVO evaluated by CMR.

Methods

Ninety-three patients with heavy thrombus burden were enrolled in this study; …

Efficacy Of Infliximab Versus Vedolizumab In The Management Of Immune Checkpoint Inhibitor-Induced Colitis: A Systematic Review And Meta-Analysis., Shreya Shambhavi, Harmanjeet Singh, Ganesh Ramaprasad, Murod Khikmatov, Varun Vankeshwaram, Kumar Ashish, Carlos Valladares, Tanushree Bhatt, Seth D Cohen

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Immune checkpoint inhibitors (ICIs) can cause severe gastrointestinal immune-related adverse events (irAEs), often leading to treatment interruption and increased morbidity. Immune-mediated colitis (IMC) ranges from mild diarrhea to life-threatening colitis, sometimes requiring urgent intervention. While corticosteroids are the first-line treatment, selective immunosuppressive therapy (SIT) with either infliximab or vedolizumab is used for steroid-refractory or dependent cases. However, standardized practices are lacking, and treatment decisions are largely left to provider discretion. This study compares infliximab and vedolizumab for IMC, focusing on remission rates, recurrence, SIT dosing, and systemic steroid exposure duration.

METHODS: We identified six retrospective cohort studies that compared …

Joint Kinematics And Kinetics During Vertical Jump Landings With Progressively Increasing External Loads, Darcie L. Yount

Dissertations

This study examined sagittal and frontal plane kinematics and kinetics during countermovement jump (CMJ) landings performed with either a traditional barbell (BB) or a hexagonal bar (HEX) across increasing submaximal loads in recreationally active males. Generally, hip and knee flexion angles and joint mean angular velocities decreased as loads increased. Hip extension and knee flexion moments increased as load increased up to 20 kg, at which point these values decreased. Performing the CMJ with the HEX exhibited increased frontal plane stability compared with the BB group. Additionally, the BB group exhibited stiffer landing strategies, with decreased sagittal plane joint angles …

Exploring The Connection Between Emotional Intelligence And Academic Achievement In Senior Nursing Students, Kimberly Smith

Dissertations

The need for nurses is now greater than ever, with a projected shortage of nearly five million nurses by 2030. Several factors exist that hinder the number of practice-ready nurses, causing nursing programs worldwide to explore and re-examine admission practices and increase student retention rates. The American Association of Colleges of Nursing (AACN, 2024) reported that over 100,000 students were denied enrollment in baccalaureate and graduate nursing programs in 2024, indicating that maximizing admission processes is crucial in addressing the current nursing shortage. This emphasizes the need for greater participation to ensure that all students have access to the educational …

Adolescent Students’ Adaptability During The Covid-19 Pandemic Impacting Their Academic Preparedness In College: A Qualitative Exploration Of Resilience In Secondary School Disruptions, Nicole Tyanne Jameson

Dissertations

This study, conducted several years after the onset of the COVID-19 pandemic, takes a unique approach to investigating the long-term effects of the pandemic-induced disruptions on adolescents during secondary schooling and their academic preparedness in college. The study combined a descriptive qualitative analysis of academic routine data with quantifiable resilience scores, providing a comprehensive understanding of the challenges students faced, their adaptability and resilience, and the overall impact on their education journey into college. This comprehensive descriptive qualitative study utilizes triangulation of quantitative data and qualitative approaches to understand the subject matter thoroughly. The quantitative scores meticulously analyzed resiliency and …

Establishment Of Neonatal Sepsis Predictors Utilizing Non-Invasive Monitoring Techniques, Dalton Janssen

Dissertations

Neonatal sepsis remains one of the leading causes of global neonatal mortality. Reactionary approaches for diagnosis and treatment have dominated the tactics in addressing neonatal sepsis but clinical intuition is an untapped resource that could lead to earlier prediction of sepsis onset. Nurses and other staff with specialized training and experience who have served as routine caregivers for a specific patient are able to identify when the patient’s status is altered. This clinical intuition may be substantiated by referencing specific patient trends in non-invasive measures over time. This retrospective, exploratory study examined whether variation in non-invasive monitoring variables could serve …

Empowering Excellence: Nurse-Educator Led Ccrn Study Group, Mary Judson Msn, Rn, Ccrn, Cnl

Posters

Key Takeaway:

Implementation of a nurse-educator led study group for specialty certification exams can potentially increase the number of certified nurses in a unit.

Beyond Keeping The Lights On: Covid-19’S Impact On Lower Mississippi River Valley Museums And Public History Sites, Liz Skilton, Ian Beamish

Department of History

This article reviews the impact of the COVID-19 pandemic on public history sites and museums along the Lower Mississippi River Valley between 2020 and 2024. Constructed from interviews with sixty-seven sites across a four-year period, it uses a regional approach to examine how pandemic closures, reopening processes, and adaptations impacted public history sites and museums in the short-, medium-, and long-term, arguing that the pandemic created lasting changes through adaptation rather than large-scale closure of public history institutions. It concludes with an assessment of what can be learned from the pandemic period’s effect on public history.

The Impact Of Implementing A Nurse Residency Program, Lexus Freeman

Nurse Residency

Does a nurse residency program enhance retention among new graduate nurses compared to immediately entering practice?

Importance Of Mobility During Hospital Stays, Jennifer Davis

Nurse Residency

PICOT Question: In hospitalized patients, how does lack of mobility compared to regular ambulation affect mental health during their hospital stays?

What Sucks The Best? The Ducanto!, Gabe Gunning

Nurse Residency

Background: Airway management is a defining skill that demands mastery by emergency physicians. Airway emergencies pose considerable morbidity and mortality risks. Familiarity with, and mastery of, a variety of airway management approaches and equipment can prove invaluable for management of anatomically and physiologically difficult airways.

Delirium In Intubated Adult Icu Patients, Emily Martin, Colby Obrecht, Jacob Scott

Nurse Residency

PICOT Question: In intubated adult ICU patients, does sedation with Dexmedetomidine compared to Propofol reduce the incidence of hospital acquired delirium during the ICU stay?

Demographic Characteristics And Selected Personality Traits Of Women In Competitive Bodybuilding, Chloe A. Zeeuw

Master's Theses

This study investigated demographic characteristics and measures of personality (dimensions of performance perfectionism and five-factor model characteristics) in women in competitive bodybuilding between 18-25 years old. A total of 24 women completed an online survey which included a demographic questionnaire, the Five Factor Model Rating Form (FFMRF), and the Performance Perfectionism Scale for Sport (PPSS) inventories. Descriptive results for the FFMRF were Openness (18.17±3.12), Conscientiousness (25.58±3.33), Extraversion (19.96±3.46), Agreeableness (19.88±4.58), and Neuroticism (15.67±4.94), and for the PPS-S were Self-oriented performance perfectionism (20.96±3.53), Socially prescribed performance perfectionism (13.96±4.26), and Other-oriented performance perfectionism (10.54±4.23). Pearson’s correlation coefficients and Shapiro-Wilk tests revealed that …

The Relationship Between A School Psychologists Workplace Stressors To Their Home Life Functioning, Trevor Burns

Masters Theses & Specialist Projects

School psychologists face increasing professional demands due to rising caseloads, paperwork requirements, and staffing shortages, which contribute to elevated levels of occupational stress. Although prior research has examined job-related stress within the profession, little attention has been given to how these stressors may impact practitioners’ personal and home lives. The purpose of this study was to examine how occupational stress experienced by school psychologists relates to stress experienced in their home lives. A total of 176 practicing school psychologists from across the United States completed an anonymous online survey, which included the School Psychologist Distress Inventory (SPDI) and a newly …

Mouth Matters: Impact Of Therapeutic Communication On Inpatient Oral Hygiene Practices In Medical-Surgical Units, Duncan Macleod Rn, Terence Olds Rn, Acadia Birk Rn

Nurse Residency

PICOT Question: In adults over 18 years of age on a medical-surgical floor(P), how can therapeutic communication strategies be implemented to encourage oral hygiene practices(I), compare to providing the resources without therapeutic communication(C), in maintenance of daily oral hygiene practices(O), during length of hospital stay(T).