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Articles 10021 - 10050 of 15191
Full-Text Articles in Medicine and Health Sciences
Management Of Gastrointestinal Tract Arteriovenous Malformations In Adults: A Literature Review, Febiansyah Ibrahim, Angie Beatrice
Management Of Gastrointestinal Tract Arteriovenous Malformations In Adults: A Literature Review, Febiansyah Ibrahim, Angie Beatrice
The New Ropanasuri Journal of Surgery
Introduction. Arteriovenous malformations (AVMs) of the gastrointestinal (GI) tract are rare vascular lesions that can cause significant GI bleeding, posing a diagnostic challenge in clinical practice. This literature review examines the management strategies for AVMs in adults, focusing on identifying optimal treatment approaches and minimizing recurrence, particularly in Indonesia where no standardized treatment guidelines are available.
Method. A literature search was conducted from August 24, 2022, to September 11, 2023, using PUBMED®, Cochrane®, Proquest®, and Scopus® databases. The inclusion criteria were studies published in English or Indonesian within the last 25 years, including case series, cohort studies, or systematic reviews …
The Outcome Of Snare Loop Catheter For Foreign Body Removal In Superior Vena Cava: An Evidence-Based Case Report, Hutomo Rezky Noorsukma, Patrianef Darwis
The Outcome Of Snare Loop Catheter For Foreign Body Removal In Superior Vena Cava: An Evidence-Based Case Report, Hutomo Rezky Noorsukma, Patrianef Darwis
The New Ropanasuri Journal of Surgery
Introduction. In recent years, the utilization of central venous catheters (CVC) in medical practice has become increasingly common. One of the complications associated with central venous catheterization is embolization of catheter fragments, which arefound in 1% of cases. Currently, endovascular techniques, such as snare loop catheter, have been developed for the extraction of intravascular foreign bodies. However, there is no strong evidence regarding this method. Thisliterature review aims toevaluate the efficacy and safety of snare loop catheters for foreign body removal within the superior vena cava (SVC).
Method. We searched four databases, that is Cochrane, PubMed, EBSCO, and …
Roux-En-Y Duodenojejunostomy As Surgical Treatment For Congenital Duodenal Obstruction: A Case Report, Ahmad Yani, Albireza Ruhimat
Roux-En-Y Duodenojejunostomy As Surgical Treatment For Congenital Duodenal Obstruction: A Case Report, Ahmad Yani, Albireza Ruhimat
The New Ropanasuri Journal of Surgery
Introduction. Congenital duodenal obstruction is an anatomical abnormality in newborns. Various intrinsic and extrinsic etiologies can cause duodenal obstruction. The surgical treatment that is commonly performed on duodenal obstruction in neonates is duodenoduodenostomy. However, several etiological conditions, such as preduodenal portal vein (PDPV) and pancreatic annulare cause duodenoduodenostomy nearly impossible to perform, so an alternative surgery procedure with a good outcome is necessary.
Case Illustration. A female neonate had been suspected congenital duodenal obstruction since pregnancy due to polyhydramnios. An OGT was inserted with greenish yellow residue after the baby was born. Based on abdominal x-ray examination, a …
Whipple Procedure For High-Grade Pediatric Pancreatic Injury After Blunt Trauma: A Case Report, David C. El Gah, Tri H. Rahayatri, Asri D. Rachmawati, Adianto Nugroho
Whipple Procedure For High-Grade Pediatric Pancreatic Injury After Blunt Trauma: A Case Report, David C. El Gah, Tri H. Rahayatri, Asri D. Rachmawati, Adianto Nugroho
The New Ropanasuri Journal of Surgery
Introduction: Pediatric pancreatic injury isuncommon but carries significant morbidity. While non-operative management is standard for low-grade injuries, the optimal approach for high-grade trauma (AAST grade III–V) remains debated. Pancreaticoduodenectomy (Whipple procedure) is rarely performed due to high procedural risks and is typically reserved for severe pancreatic head injury with concomitant duodenal damage.
Case presentations: A 13-year-old boy presented three days after blunt abdominal trauma with epigastric pain and bilious vomiting. CT imaging revealed free fluid, a large retroperitoneal hematoma, and suspected pancreatic head injury. Despite initial stability and conservative management in the High Care Unit, worsening abdominal distension prompted an …
Staff Education To Improve Medication Adherence Among Nurses, Philip Nkemgang
Staff Education To Improve Medication Adherence Among Nurses, Philip Nkemgang
Walden Dissertations and Doctoral Studies
Medication nonadherence among individuals with severe mental illness (SMI) contributes to relapse, hospital readmissions, and poor patient outcomes. Psychiatric nurses are central to promoting adherence, yet many lack standardized, evidence-based training. This Doctor of Nursing Practice project evaluated the effect of a structured nurse education program on medication adherence strategies, including psychoeducation and motivational interviewing, on nurses’ knowledge and confidence. Using the Johns Hopkins nursing evidence-based practice model, an online educational intervention was developed and implemented with 18 psychiatric nurses. Pre- and post-education surveys measured changes in knowledge and self-reported confidence, with data analyzed using descriptive statistics. Results demonstrated significant …
Staff Education For Timely Sepsis Intervention At The Medical Center, Latonya Summers-Oliver
Staff Education For Timely Sepsis Intervention At The Medical Center, Latonya Summers-Oliver
Walden Dissertations and Doctoral Studies
This project developed a staff education program to clarify the concept of “time zero,” essential for timely sepsis intervention, in alignment with the SEP-1 core measure by CMS, which prescribes evidence-based treatment bundles within specific time frames. Aiming to improve staff knowledge in sepsis identification, treatment, and management, the program incorporated a literature review supporting educational strategies that enhance mortality rates and clinical outcomes. Using pre- and posttest assessments, the study demonstrated significant improvements in staff knowledge following targeted education on sepsis recognition and timely management. The findings underscore the importance of standardized, accessible training programs to improve clinical response, …
Staff Education To Improve Detection And Treatment Of Adult Adhd In An Outpatient Psychiatric Clinic, Eveline Manyie Fohtung
Staff Education To Improve Detection And Treatment Of Adult Adhd In An Outpatient Psychiatric Clinic, Eveline Manyie Fohtung
Walden Dissertations and Doctoral Studies
Summary Adult attention-deficit/hyperactivity disorder (ADHD) remains significantly underdiagnosed in outpatient psychiatric settings despite its substantial impact on functioning and long-term mental health outcomes. At the project site, inconsistent screening practices, limited clinician familiarity with DSM-5-TR adult diagnostic criteria, and variable application of the Adult ADHD Self-Report Scale (ASRS) contributed to delayed or missed diagnoses, representing a clear practice gap. This Doctor of Nursing Practice (DNP) project implemented a structured, nurse-led staff education program to improve clinician knowledge, diagnostic accuracy, and standardized workflow adoption for adult ADHD screening using the ASRS. Guided by national evidence-based guidelines, the intervention emphasized DSM-5-TR criteria, …
Locoregional Management In Breast Cancer With Brca1/2 Mutation: Evidence Based Case Report, Adlina Karisyah, Sonar S. Panigoro
Locoregional Management In Breast Cancer With Brca1/2 Mutation: Evidence Based Case Report, Adlina Karisyah, Sonar S. Panigoro
The New Ropanasuri Journal of Surgery
Introduction. Breast cancer is still one of the top health issues worldwide. Hereditary predisposition is linked with morbidity and mortality of breast cancer patients. BRCA 1/2 genetic mutation, one of mutations in breast cancer that has been extensively observed, has tremendous effects on the carrier. Studies showed that patients with BRCA1/2 mutation are often associated with poor pathological characteristics. Further research isyet to identify the effect of the mutation with prognosis including locoregional recurrences. This study aims to understand the risk of locoregional recurrences on the patients with breast cancer and BRCA 1/2 genetic mutation who had BCT or …
Primary Care Providers' Perspectives On Telehealth Medicare Annual Wellness Visits For Older Adults In A Midwestern Health System, Vaibhavi Mone, Paul Estabrooks, Jane Potter, Hongmei Wang, Jungyoon Kim
Primary Care Providers' Perspectives On Telehealth Medicare Annual Wellness Visits For Older Adults In A Midwestern Health System, Vaibhavi Mone, Paul Estabrooks, Jane Potter, Hongmei Wang, Jungyoon Kim
Health Services and Informatics Research
Background
Medicare annual wellness visits (AWVs) are vital for older adults' preventive care, which was transitioned to telehealth modalities during COVID-19. This study examined primary care providers' perceptions of telehealth-delivered AWVs and explored the factors influencing telehealth implementation using the Practical Robust Implementation and Sustainability Model (PRISM).
Participants and Setting
Twenty-five primary care providers from eight clinics within an integrated health system in the Midwestern United States were interviewed. Eligibility required having conducted at least one telehealth AWV for patients aged 65 or older between March 2023 and October 2023.
Methods
Semi-structured interviews lasting 30–45 min were conducted using purposeful …
Staff Education To Reduce The Incidence Of Bias In Managing Patients With Opioid Use Disorder In A Rehabilitation Center, Almarie Alison Mclaren
Staff Education To Reduce The Incidence Of Bias In Managing Patients With Opioid Use Disorder In A Rehabilitation Center, Almarie Alison Mclaren
Walden Dissertations and Doctoral Studies
This Doctor of Nursing Practice (DNP) project addressed stigma and implicit bias toward individuals with opioid use disorder (OUD) within a rehabilitation subacute care setting. OUD remains a significant public health concern and at the project site, inconsistent staff education was identified as a practice gap requiring intervention. The purpose of this practice-focused DNP project was to evaluate the impact of a structured staff education intervention on healthcare staff knowledge, attitudes, and confidence in caring for patients with OUD. The project was guided by a thorough evidence search. The project was implemented using brief, unit-based educational sessions delivered to interdisciplinary …
Staff Education To Stop The Bleed Training, Sherron L. Butler
Staff Education To Stop The Bleed Training, Sherron L. Butler
Walden Dissertations and Doctoral Studies
Uncontrolled hemorrhage remains a leading cause of preventable mortality, and timely intervention is critical to improving patient outcomes. The purpose of this Doctor of Nursing Practice staff education project was to evaluate the effect of a standardized Stop the Bleed (STB) education program on emergency department and outpatient clinic nursing staff readiness and confidence in managing hemorrhage emergencies. A pre- and post-education design was used to assess changes in participants’ knowledge, confidence, and technical proficiency related to hemorrhage-control skills, including tourniquet application, wound packing, and direct pressure techniques. Data were collected using pre- and post-training surveys and skills-demonstration assessments and …
Staff Education Program To Improve Pediatric Medication Adherence Knowledge In Primary Care, Coby Anderson
Staff Education Program To Improve Pediatric Medication Adherence Knowledge In Primary Care, Coby Anderson
Walden Dissertations and Doctoral Studies
This Doctor of Nursing Practice project was focused on a staff education program aimed at addressing the knowledge gaps of primary healthcare providers regarding pediatric medication adherence. Nonadherence among pediatric patients is a significant issue leading to adverse health outcomes and increased healthcare costs. The project underscores the necessity of enhancing provider knowledge and communication skills, alongside implementing systematic strategies to promote adherence. My objective with the project was to elevate primary healthcare providers’ understanding and practical application of pediatric adherence techniques through targeted, evidence-based education. I developed the practice-focused question to examine whether this tailored staff education could bolster …
Targeting Tau In Alzheimer's Disease: Rationale, Approach And Challenges, Aram Aslanyan, Martha S Foiani, Tatiana A Giovannucci, Eric Mcdade, Karen E Duff, Catherine J Mummery, Michael Schöll, Kristin R Wildsmith, Ross W Paterson
Targeting Tau In Alzheimer's Disease: Rationale, Approach And Challenges, Aram Aslanyan, Martha S Foiani, Tatiana A Giovannucci, Eric Mcdade, Karen E Duff, Catherine J Mummery, Michael Schöll, Kristin R Wildsmith, Ross W Paterson
2020-Current year OA Pubs
Alzheimer’s Disease (AD) is the most common neurodegenerative disorder and the leading cause of dementia characterised by the accumulation of beta amyloid (Aβ) plaques and neurofibrillary tangles (NFT). Several monoclonal antibodies against amyloid in early AD have shown the utility of reducing brain amyloid in large phase 3 studies, resulting in modest clinical benefit. To further slow, or even halt disease progression, targeting additional pathobiological pathways is likely to be necessary. In this review, we aim to appraise the scientific rationale for targeting tau in AD. The burden of tau pathology is correlated with disease severity and its role in …
Sclerostin Deficiency Sensitizes White Adipocytes To Thermogenic Signals That Induce Beiging In Mice, Gillian M Choquette, Soohyun P Kim, Kevin J Wilkinson, Belen C Avelar, Sushrut Pathy, Zhu Li, Jasmine Wu, Susan Aja, Daniel L J Thorek, Michael J Wolfgang, Ryan C Riddle
Sclerostin Deficiency Sensitizes White Adipocytes To Thermogenic Signals That Induce Beiging In Mice, Gillian M Choquette, Soohyun P Kim, Kevin J Wilkinson, Belen C Avelar, Sushrut Pathy, Zhu Li, Jasmine Wu, Susan Aja, Daniel L J Thorek, Michael J Wolfgang, Ryan C Riddle
2020-Current year OA Pubs
Maintenance of bone mass is coordinated with adipose tissue function through the secretion of hormones and endocrine factors that act on the opposing tissue. Sclerostin, a small glycoprotein produced by osteocytes embedded within the bone matrix, potently suppresses bone formation by antagonizing Wnt/β-catenin signaling while stimulating adipose tissue accumulation via the same mechanism of action. Since sclerostin-deficient mice develop pockets of multilocular adipocytes in subcutaneous adipose, we investigate the influence of sclerostin on thermogenic and β3-adrenergic stimuli-induced white adipose tissue beiging. Here, we report that Sost gene expression in bone and serum sclerostin levels are induced by β3-adrenergic agonists via …
Pro-Tip For Pro-Calcitonin: Fill It Up Or Miss The Mark, Megan Dones, Yenci Marquez, Reese Parrish, Sanam Mistry
Pro-Tip For Pro-Calcitonin: Fill It Up Or Miss The Mark, Megan Dones, Yenci Marquez, Reese Parrish, Sanam Mistry
2025
No abstract provided.
Staff Education On Implementation Of De-Escalation Techniques In An Adult Psychiatry Facility: A Quality Improvement Program To Enhance Knowledge And Reduce Aggressive Behavior, Lilian Agbonzebeta Azenabor
Staff Education On Implementation Of De-Escalation Techniques In An Adult Psychiatry Facility: A Quality Improvement Program To Enhance Knowledge And Reduce Aggressive Behavior, Lilian Agbonzebeta Azenabor
Walden Dissertations and Doctoral Studies
Managing aggression and violence is a persistent issue in adult psychiatric facilities. Frequent aggression and violence can cause serious harm to staff, increase absenteeism and burnout, and lower job satisfaction. Stakeholders’ reports from the project site indicated inconsistent staff use of de-escalation techniques, highlighting gaps and the need to improve staff knowledge. The practice-focused question was: Will a staff education program specifically designed to implement a comprehensive staff training on de-escalation strategies increase staff’s knowledge? The purpose of this staff education project was to evaluate the effectiveness of an evidence-based training program designed to enhance staff knowledge on de-escalation techniques. …
Staff Education On Mindfulness-Based Intervention To Reduce Burnout Among Mental Health Clinicians, Abosede Oyeronke Oyedele
Staff Education On Mindfulness-Based Intervention To Reduce Burnout Among Mental Health Clinicians, Abosede Oyeronke Oyedele
Walden Dissertations and Doctoral Studies
Clinician burnout is increasingly prevalent in outpatient mental health settings due to high emotional demands, heavy caseloads, and limited organizational resources, contributing to reduced job satisfaction, increased turnover, and diminished quality of care. The gap in practice at the project center revealed a deficiency in knowledge among mental health clinic staff regarding effective stress management and burnout prevention, which led to the practice question: Does educating providers and staff on mindfulness-based interventions improve knowledge, as evidenced by pre- and postsurveys? To close this gap, this Doctor of Nursing Practice (DNP) project educated staff members on mindfulness-based interventions (MBIs). The Walden …
Staff Education To Use Mindfulness Strategies To Prevent Burnout In Psychiatric Health Settings, Rebecca Ikeoluwa Gabriel
Staff Education To Use Mindfulness Strategies To Prevent Burnout In Psychiatric Health Settings, Rebecca Ikeoluwa Gabriel
Walden Dissertations and Doctoral Studies
There was a significant gap in practice at an outpatient psychiatric mental health clinic regarding organized, evidence-based training on mindfulness techniques to reduce stress and emotional exhaustion among psychiatric mental health staff. This project’s practice-focused question was “Does educating psychiatric mental health staff on mindfulness strategies for burnout improve their knowledge, as evidenced by pre- and post-surveys?” This educational intervention was developed, implemented, and evaluated using the Johns Hopkins Evidence-Based Practice paradigm and the ADDIE instructional design model. A literature search was conducted using CINAHL Complete, MEDLINE/PubMed, ProQuest, and the Cochrane Library, with assistance from the librarians at Walden University. …
Lgbtq+ Cultural Competency Training For Mental Health Care Workers, Shyla Noelle Herndon-Dye
Lgbtq+ Cultural Competency Training For Mental Health Care Workers, Shyla Noelle Herndon-Dye
Walden Dissertations and Doctoral Studies
The purpose of the staff education project was to address a noticeable gap in training regarding lesbian, gay, bisexual, transgender, and queer (LGBTQ+) cultural competencies for the multidisciplinary mental health care workers of an inpatient child and adolescent psychiatry unit. LGBTQ+ individuals commonly encounter discriminatory barriers to care, resulting in mental health disparities and medical distrust; thus, mental health care workers must engage in professional allyship and improve their capability to sufficiently care for this population. The practice question that guided this project was the following: Will a staff education program designed to educate multidisciplinary mental health care workers on …
Staff Education To Improve Tirzepatide Education And Lifestyle Counseling, Daisy Asemota
Staff Education To Improve Tirzepatide Education And Lifestyle Counseling, Daisy Asemota
Walden Dissertations and Doctoral Studies
This Doctor of Nursing Practice (DNP) project was a practice-focused staff education initiative designed to improve clinical staff knowledge, confidence, and readiness to educate adult patients enrolled in a Tirzepatide weight-management program. Tirzepatide has demonstrated superior weight-loss outcomes compared to other glucagon-like peptide-1 (GLP-1) receptor agonists; however, inconsistent staff education practices related to medication administration, adverse-event management, and lifestyle counseling present a gap in practice. Variability in staff knowledge and teaching approaches may reduce confidence, contribute to inconsistent patient education, and limit the effectiveness of evidence-based care delivery. The purpose of this DNP project was to address this practice gap …
Staff Education In Standardizing A Nurse-Led Fall Prevention Bundle To Reduce Inpatient Falls In Teleneurology Units, Tiffany Scott
Staff Education In Standardizing A Nurse-Led Fall Prevention Bundle To Reduce Inpatient Falls In Teleneurology Units, Tiffany Scott
Walden Dissertations and Doctoral Studies
Due to complex neurological deficits that raise the risk of falls, falls among persons admitted to inpatient tele-neurology units represent a substantial and continuous problem in nursing practice. A preliminary evaluation conducted at the project site revealed inconsistent fall prevention procedures, inconsistent use of risk assessments, and a lack of a standardized, evidence based strategy to lower fall risk in this especially susceptible group. A practice focused investigation into whether the adoption of a standardized, nurse led fall prevention bundle would improve staff adherence to fall prevention protocols and lower the incidence of inpatient falls over a six month period …
Ecologic Factors Contributing To West Nile Virus Hyperendemicity In Central South Carolina: An Integrated Vector–Human–Environmental Study, Elba S. Fridriksson, Ahayla Muraleedharan, Kyndall C. Dye-Braumuller, Madeleine M. Meyer, Kia Zellars, Hiuxuan Li, Melissa S. Nolan Ph.D., Mph
Ecologic Factors Contributing To West Nile Virus Hyperendemicity In Central South Carolina: An Integrated Vector–Human–Environmental Study, Elba S. Fridriksson, Ahayla Muraleedharan, Kyndall C. Dye-Braumuller, Madeleine M. Meyer, Kia Zellars, Hiuxuan Li, Melissa S. Nolan Ph.D., Mph
Faculty Publications
West Nile virus (WNV) is an endemic arboviral infection in the United States that has undergone phyloge-netic evolution since its introduction 25 years ago. An integrated vector–human–pathogen study was conducted in the summer of 2023 to unearth contemporary Culex quinquefasciatus habitat patterns and human transmission spillover foci in South Carolina, a state with historically little WNV data. A serosurvey revealed WNV seroprevalence 10 times the national average (22% versus 2%, respectively), with unusual epidemiologic risk factors. Female Culex quinquefas-ciatus WNV positivity was low (2.7%), with viral phylogenetics 100% homologous to the WN02 clade. Mosquito vectors clustered in affluent urban neighborhoods …
Transient Protein Structure Guides Surface Diffusion Pathways For Electron Transport In Membrane Supercomplexes, Chun Kit Chan, Jonathan Nguyen, Corey F Hryc, Chitrak Gupta, Kevin Redding, William Dowhan, Matthew L Baker, Alberto Perez, Eugenia Mileykovskaya, Abhishek Singharoy
Transient Protein Structure Guides Surface Diffusion Pathways For Electron Transport In Membrane Supercomplexes, Chun Kit Chan, Jonathan Nguyen, Corey F Hryc, Chitrak Gupta, Kevin Redding, William Dowhan, Matthew L Baker, Alberto Perez, Eugenia Mileykovskaya, Abhishek Singharoy
Faculty, Staff and Student Publications
The exact biological role of mitochondrial supercomplexes remains debated, particularly their role in guiding redox proteins across membranes during energy conversion. We integrate multiscale modeling and single particle cryo-electron microscopy (cryo-EM) to examine electron transfer in mitochondrial supercomplexes composed of complexes III and IV (CIII and CIV). Using bioinformatic and entropy-based methods, we generated structural ensembles capturing conformations of CIII's disordered QCR6 hinge within the yeast CIII2CIV2 supercomplex. Molecular and Brownian Dynamics simulations reveal that these negatively charged hinge states electrostatically couple with redox proteins, promoting their binding and directional diffusion across the membrane on millisecond timescales. Rather than hindering …
The Setd2 L1609p Mutation Found In Leukemia Disrupts Methyltransferase Activity And Reduces Histone H3k36 Trimethylation, Christina Michail, Jérémy Berthelet, Ariel E Mechaly, Linh-Chi Bui, Haopeng Yang, Duo Cai, Amira Al Mahi, Aowei Xie, Valeria Bisio, Valentina Sirri, Jean-Marie Dupret, Fabien Guidez, Ximing Xu, Nicolas Joly, Leslie Regad, Mireille Viguier, Frédérique Deshayes, Nicolas Dulphy, Michael R Green, Ahmed Haouz, Fernando Rodrigues Lima
The Setd2 L1609p Mutation Found In Leukemia Disrupts Methyltransferase Activity And Reduces Histone H3k36 Trimethylation, Christina Michail, Jérémy Berthelet, Ariel E Mechaly, Linh-Chi Bui, Haopeng Yang, Duo Cai, Amira Al Mahi, Aowei Xie, Valeria Bisio, Valentina Sirri, Jean-Marie Dupret, Fabien Guidez, Ximing Xu, Nicolas Joly, Leslie Regad, Mireille Viguier, Frédérique Deshayes, Nicolas Dulphy, Michael R Green, Ahmed Haouz, Fernando Rodrigues Lima
Faculty, Staff and Student Publications
SETD2 is the primary methyltransferase responsible for generating H3K36me3, an epigenetic mark that is essential for transcriptional regulation and chromatin integrity. SETD2 mutations are frequently observed in various cancers and tend to cluster within its catalytic SET domain. Despite the clinical relevance of SETD2 missense mutations in cancer, their biochemical and structural consequences remain insufficiently characterized. Here, we present the enzymatic and structural characterization of the SETD2 L1609P mutant enzyme identified in leukemia. The L1609 residue is located in the SET domain within a conserved hydrophobic pocket that is involved in substrate H3K36 recognition. Interestingly, site-directed mutagenesis of residues within …
Evidence-Based Team Intervention To Reduce Diagnostic Errors In Anaemia And Ckd Diagnoses In Primary Care: Protocol For A Stepped-Wedge Cluster Rct, Zhanna Novikov, Nikhilesh Mehra, Xiao Li, Rebecca Wells, Madelene Ottosen, Kevin Hwang, Elenir B C Avritscher, Charles Green, Kyung Hyun Lee, Xochitl Oguin, Mariesa Janecka, Mary Espinoza, Bolanle Adebowale, Alejandro Araya, Amer Wahed, Eric Thomas
Evidence-Based Team Intervention To Reduce Diagnostic Errors In Anaemia And Ckd Diagnoses In Primary Care: Protocol For A Stepped-Wedge Cluster Rct, Zhanna Novikov, Nikhilesh Mehra, Xiao Li, Rebecca Wells, Madelene Ottosen, Kevin Hwang, Elenir B C Avritscher, Charles Green, Kyung Hyun Lee, Xochitl Oguin, Mariesa Janecka, Mary Espinoza, Bolanle Adebowale, Alejandro Araya, Amer Wahed, Eric Thomas
Faculty, Staff and Student Publications
Introduction: Diagnostic errors in primary care are common, particularly in the interpretation and follow-up of abnormal haemoglobin (Hgb) and estimated glomerular filtration rate (eGFR) results. These errors frequently result in missed or delayed diagnoses of serious conditions such as anaemia and chronic kidney disease. This protocol describes a stepped-wedge cluster randomised controlled trial designed to evaluate a novel, evidence-based, team-based intervention aimed at improving diagnostic safety and efficiency.
Methods and analysis: The study will be conducted across 12 University of Texas Physicians (UTPs) primary care clinics in Houston, Texas, USA. Adult patients (≥18 years) with newly identified abnormal Hgb or …
Phase I Study Of Bevacizumab And Temsirolimus Combination Therapy In Advanced Malignancies: Safety, Efficacy, And Ovarian Cancer Expansion, Sarina A Piha-Paul, Chieh Tseng, Emily Thompson, R Jason Stafford, Hung Le, Lei Kang, Siqing Fu, Apostolia Tsimberidou, George Blumenschein, Jordi Rodon Ahnert, John M Slopis, David Hong, Aung Naing, Funda Meric-Bernstam, Chaan S Ng, Shannon Westin, Anil K Sood
Phase I Study Of Bevacizumab And Temsirolimus Combination Therapy In Advanced Malignancies: Safety, Efficacy, And Ovarian Cancer Expansion, Sarina A Piha-Paul, Chieh Tseng, Emily Thompson, R Jason Stafford, Hung Le, Lei Kang, Siqing Fu, Apostolia Tsimberidou, George Blumenschein, Jordi Rodon Ahnert, John M Slopis, David Hong, Aung Naing, Funda Meric-Bernstam, Chaan S Ng, Shannon Westin, Anil K Sood
Faculty, Staff and Student Publications
Background: Bevacizumab and temsirolimus target angiogenic and mTOR pathways in cancer progression.
Methods: This phase I study enrolled 48 heavily pretreated patients with advanced solid tumors, including an ovarian cancer expansion cohort. Patients received bevacizumab biweekly plus temsirolimus weekly in a 3 + 3 design to assess safety, maximum tolerated dose (MTD) and dose-limiting toxicities (DLTs). Exploratory analyses included tumor genomic profiling and dynamic contrast-enhanced MRI (DCE-MRI).
Results: Patients had a median age of 59 and median four prior therapies. Common tumor types were ovarian (27%) and head and neck (15%). Treatment-related adverse events occurred in 93.8%, with 31.3% ≥grade …
Zingiber Officinale-Mediated Zinc Oxide Nanoparticles: Antimicrobial Activity Against Multidrug-Resistant Bacteria, Maureen Bakor Tabe, Ovgu Isbilen, Jennifer N Walker, Ender Cinar
Zingiber Officinale-Mediated Zinc Oxide Nanoparticles: Antimicrobial Activity Against Multidrug-Resistant Bacteria, Maureen Bakor Tabe, Ovgu Isbilen, Jennifer N Walker, Ender Cinar
Faculty, Staff and Student Publications
Background: The fight against infectious diseases has transformed over the past century with the emergence of multidrug-resistant bacteria, where pathogens that exhibit resistance to multiple antibiotic classes leading to significant challenges to modern medicine. Zingiber officinale is well-documented to exhibit diverse biological activities, including strong antioxidant, antimicrobial, and anti-neuroinflammatory effects. Zinc oxide nanoparticles can be synthesized cost-effectively and are widely utilized in biomedical applications, including their use as anticancer agents and drug-delivery systems, as well as for their intrinsic antibacterial and anti-inflammatory properties. In this study, we aimed to take a combinatorial approach to investigate the antimicrobial effects of Z. …
Pain Prevalence And Pain Management At The End Of Life: Regional And Urban-Rural Differences From A National-Representative Survey Of Chinese Older Adults, Yaolin Pei, Xiang Qi, Zexi Zhou, Yifan Lou, Jing Wang, Yang Li, Bei Wu
Pain Prevalence And Pain Management At The End Of Life: Regional And Urban-Rural Differences From A National-Representative Survey Of Chinese Older Adults, Yaolin Pei, Xiang Qi, Zexi Zhou, Yifan Lou, Jing Wang, Yang Li, Bei Wu
Faculty, Staff and Student Publications
Background: Effective pain management is essential for improving quality of life at the end of life. However, challenges persist globally, particularly in China, where palliative care remains underdeveloped. This study investigates pain prevalence and the associations between pain severity, place of death, and the quality of pain management among older adults in China, with a focus on regional and urban-rural disparities.
Methods: We used data from the 2014, 2016, 2018, and 2020 waves of the China Longitudinal Aging Social Survey. The final sample included 1,525 older adults who died during the study period. We conducted OLS regression analyses to examine …
Comparative Analysis Of Ctdna Monitoring Strategies In Advanced Nsclc With Met Exon 14 Skipping Mutations Treated With Ensartinib, Mo Zhou, Yin Zhu, Xuqi Sun, Ying Han, Rui Jin, Panwen Tian, Jun Zhao, Yang Jin, Zhiyuan Guo, Yongchang Zhang, Yiran Meng, Fei Liu, Wen Li, Xiuning Le, Haifeng Shen, Yang Xia
Comparative Analysis Of Ctdna Monitoring Strategies In Advanced Nsclc With Met Exon 14 Skipping Mutations Treated With Ensartinib, Mo Zhou, Yin Zhu, Xuqi Sun, Ying Han, Rui Jin, Panwen Tian, Jun Zhao, Yang Jin, Zhiyuan Guo, Yongchang Zhang, Yiran Meng, Fei Liu, Wen Li, Xiuning Le, Haifeng Shen, Yang Xia
Faculty, Staff and Student Publications
Mesenchymal-epithelial transition exon 14 skipping mutations (METex14) define a targetable molecular subset of non-small cell lung cancer (NSCLC), but optimal circulating tumor DNA (ctDNA) biomarkers to guide MET tyrosine kinase inhibitor therapy remain undefined. Within the EMBRACE trial of ensartinib, we conducted a prospective biomarker analysis with plasma collected at baseline (V0) and 4 weeks after treatment initiation (V1). ctDNA was profiled using a hybrid-capture next-generation sequencing panel covering 229 cancer-related genes, and mutations were classified into three monitoring paradigms: MET-specific alterations, canonical alterations (tier I/II), and pan-alterations (any variant in any gene on the panel). Baseline ctDNA positivity rates …
Recommendations From The Blue Ribbon Panel On Fluoroscopy Safety, Dustin A Gress, M Mahesh, Kevin W Dickey, John F Angle, D Duane Baldwin, Stephen Balter, Wayne Batchelor, Lisa Bruedigan, Christopher Davis, Deirdre Elder, R Paul Guillerman, Maged N Guirguis, David Hardwick, Carrie M Hayes, Jeremy J Heit, A Kyle Jones, Melissa Kirkwood, Andrew Kuhls-Gilcrist, Bonnie Martin-Harris, William W Mayo-Smith, Sarah E Mckenney, Richard Miguel, Donald L Miller, Eric Monroe, Kristi Moore, Thomas L Morgan, Kari J Nelson, Kathryn Petrovic, Shellie Pike, Carlos A Pino, Travis Prowant, Jonathan W Revels, Vinil Shah, Andrew Y Wang, David B Weiss, Darcy J Wolfman, Kevin A Wunderle, Jessica Zarzour, Michael E Zychowicz, Alan H Matsumoto
Recommendations From The Blue Ribbon Panel On Fluoroscopy Safety, Dustin A Gress, M Mahesh, Kevin W Dickey, John F Angle, D Duane Baldwin, Stephen Balter, Wayne Batchelor, Lisa Bruedigan, Christopher Davis, Deirdre Elder, R Paul Guillerman, Maged N Guirguis, David Hardwick, Carrie M Hayes, Jeremy J Heit, A Kyle Jones, Melissa Kirkwood, Andrew Kuhls-Gilcrist, Bonnie Martin-Harris, William W Mayo-Smith, Sarah E Mckenney, Richard Miguel, Donald L Miller, Eric Monroe, Kristi Moore, Thomas L Morgan, Kari J Nelson, Kathryn Petrovic, Shellie Pike, Carlos A Pino, Travis Prowant, Jonathan W Revels, Vinil Shah, Andrew Y Wang, David B Weiss, Darcy J Wolfman, Kevin A Wunderle, Jessica Zarzour, Michael E Zychowicz, Alan H Matsumoto
Faculty, Staff and Student Publications
There are many challenges associated with the safe use of fluoroscopy. These challenges include but are not limited to highly variable regulatory requirements, scope of practice concerns, inconsistent education and training, and lack of staff empowerment. Challenges are further compounded by the increasing use of fluoroscopy across a wide range of medical specialties. To facilitate consensus on how to address the issues, the ACR convened the multidisciplinary Blue Ribbon Panel on Fluoroscopy Safety (BRP-FS), with 32 organizations represented. The goal of the BRP-FS is to establish multi- and interspecialty consensus standards for the safe use of fluoroscopy in health care, …