Medicine and Health Sciences Commons^™

Prior Incarceration And Dental Insurance Trajectories Throughout Older Adulthood, A Testa, L Mijares, D B Jackson, V Maroufy, R Samper-Ternent, A C Neumann, R Mungia, K T Ganson, J M Nagata, T Oates

Faculty, Staff and Student Publications

Objectives: This study examines the relationship between prior incarceration and dental insurance trajectories throughout older adulthood.

Methods: A nationally representative sample of adults aged 55 y and older who participated in the 2012-2020 Health and Retirement Survey was analyzed (n = 6,383). Group-based trajectory modeling was used to identify distinct patterns of dental insurance coverage across the 8 survey waves. Multinomial logistic regression was used to assess the association between prior incarceration and dental insurance trajectory group membership.

Results: Four dental insurance trajectories were identified: persistent dental insurance (30.0%), intermittent high insurance (16.4%), intermittent low insurance (20.4%), and no …

Predicting The Response Of Triple Negative Breast Cancer To Neoadjuvant Systemic Therapy Via Biology-Based Modeling And Habitat Analysis, Casey E Stowers, Chengyue Wu, Clinton Yam, Jingfei Ma, Gaiane M Rauch, Thomas E Yankeelov

Faculty, Staff and Student Publications

Despite being the standard-of-care treatment, neoadjuvant therapy (NAT) attains a complete response only in approximately half of the patients with triple negative breast cancer. Thus, methods to predict and optimize patient response to NAT are needed. Previously, we employed patient-specific MRI data to calibrate a biology-based mathematical model that describes cell movement, proliferation, and death due to drug at the tumor level and cell proliferation at an image voxel level. We now extend our approach by using MRI data to group voxels into "habitats" whereby tumor cells of a habitat share the same proliferation. With this approach, we now calibrate …

Impact Of Atrial Fibrillation, Diabetes Mellitus, And Obesity On Outcomes With Aspirin Avoidance And Hemocompatibility With A Left Ventricular Assist Device: An Analysis From The Aries-Hm3 Trial, Nir Uriel, Ivan Netuka, Ulrich P Jorde, Francis D Pagani, Jason N Katz, Jean M Connors, Peter Ivak, Daniel Zimpfer, Yuriy Pya, Jennifer Conway, Finn Gustafsson, Sriram Nathan, Anna Mara Scandroglio, Christopher Hayward, David A D'Alessandro, Morgan Collins, Nicholas Dirckx, Mandeep R Mehra

Faculty, Staff and Student Publications

Background: The ARIES-HM3 trial demonstrated the safety and effectiveness of aspirin elimination from the antithrombotic regimen after HeartMate 3 (HM3) left ventricular assist device (LVAD) implantation. We explored the interaction of atrial fibrillation, diabetes mellitus, and obesity (AF/DM/Ob) with aspirin elimination on hemocompatibility-related adverse events at 1-year postimplant.

Methods: This prospective, double-blind, placebo-controlled trial randomized patients with an HM3 LVAD implant to receive aspirin (100 mg/d) or placebo, in addition to a vitamin K antagonist. The primary endpoint was survival free of nonsurgical (>14 days postimplant) hemocompatibility-related adverse events, including stroke, pump thrombosis, bleeding, and arterial peripheral thromboembolism at …

Loss Of Idh1 And Idh2 Mutations During The Evolution Of Metastatic Chondrosarcoma, William Cross, Iben Lyskjær, Christopher Davies, Abigail Bunkum, Ana Maia Rocha, Tom Lesluyes, Fernanda Amary, Roberto Tirabosco, Cristina Naceur-Lombardelli, Mariam Jamal-Hanjani, Charles Swanton, Nischalan Pillay, Simone Zaccaria, Adrienne M Flanagan, Peter Van Loo

Faculty, Staff and Student Publications

Driver mutations in IDH1 and IDH2 are initiating events in the evolution of chondrosarcoma and several other cancer types. Here, we present evidence that mutant IDH1 is recurrently lost in metastatic central chondrosarcoma. This may reflect either relaxed positive selection for the mutant IDH1 locus, or negative selection for the hypermethylation phenotype later in tumor evolution. This finding highlights the challenge for therapeutic intervention by mutant IDH1 inhibitors in chondrosarcoma.

Interplay Of Menopause, Coronary Artery Calcium Score And Cardiovascular Disease Risk, Tanisha Mishra, Diksha Sanjana Pasnoor, Murtaza Gandhi, Nida Mohamed, Shaylika Chauhan, Kokou Adompreh-Fia, Kesha Mayank Doshi, Prerana Sevella, Rupak Desai

Abington Jefferson Health Papers

BACKGROUND: Postmenopausal women face an increased risk of cardiovascular disease (CVD) due to estrogen withdrawal, which exacerbates traditional cardiovascular risk factors such as dyslipidemia, glucose intolerance, and hypertension. Coronary Artery Calcium Score (CACS), a well-established marker of subclinical atherosclerosis, has emerged as a key predictor of adverse cardiovascular events. Despite the recognized association between menopause and heightened CVD risk, there remains a paucity of literature exploring the specific role of menopause in influencing CACS and its implications for cardiovascular morbidity and mortality.

AIM: To examine the interplay between menopause, CACS, and cardiovascular health by synthesizing existing literature.

METHODS: A comprehensive …

The Pitfalls Of Multiple-Choice Questions In Generative Ai And Medical Education, Shrutika Singh, Anton Alyakin, Daniel Alexander Alber, Jaden Stryker, Ai Phuong S Tong, Karl Sangwon, Nicolas Goff, Mathew De La Paz, Miguel Hernandez-Rovira, Ki Yun Park, Eric Claude Leuthardt, Eric Karl Oermann

2020-Current year OA Pubs

The performance of Large Language Models (LLMs) on multiple-choice question (MCQ) benchmarks is frequently cited as proof of their medical capabilities. We hypothesized that LLM performance on medical MCQs may in part be illusory and driven by factors beyond medical content knowledge and reasoning capabilities. To assess this, we created a novel benchmark of free-response questions with paired MCQs (FreeMedQA). Using this benchmark, we evaluated three state-of-the-art LLMs (GPT-4o, GPT-3.5, and LLama-3-70B-instruct) and found an average absolute deterioration of 39.43% in performance on free-response questions relative to multiple-choice (p = 1.3 * 10

Maternal Obesogenic Diet Exposure Regulates The Offspring Gut Liver Axis And Fibroinflammatory Liver Disease, Naresh Naik Ramavath, Oğuz Özler, Holly Hinrichs, Francisco R Victorino, Vung Lian, Monica Young, Tarin M Bigley, Michael D Thompson

2020-Current year OA Pubs

Maternal obesogenic diet exposure (MODE) promotes fibroinflammatory liver disease in offspring via vertical transfer of an altered microbiome. The mechanism for how an altered offspring microbiome increases susceptibility to liver disease is not clear. A critical early life event termed the 'weaning reaction' is dependent on the early microbiome and when altered, results in worse pathologic inflammation. MODE attenuates the weaning reaction promoting worse liver disease in mice in an early microbiome-dependent manner. Using our MODE model and cross-fostering approaches we assessed the effect of MODE on neonatal gut-liver axis development. MODE shifts the bile acid (BA) profile, expression of …

Oligomerisation Of Ku From Mycobacterium Tuberculosis Promotes Dna Synapsis, Sayma Zahid, Ankita Chadda, Eric Galburt, Et Al.

2020-Current year OA Pubs

Mycobacterium tuberculosis (Mtb), the causative agent of tuberculosis (TB), is estimated to infect nearly one-quarter of the global population. A key factor in its resilience and persistence is its robust DNA repair capacity. Non-homologous end joining (NHEJ) is the primary pathway for repairing DNA double-strand breaks (DSBs) in many organisms, including Mtb, where it is mediated by the Ku protein and the multifunctional LigD enzyme. In this study, we demonstrate that Ku is essential for mycobacterial survival under DNA-damaging conditions. Using cryogenic electron microscopy (cryo-EM), we solved high-resolution structures of both the apo and DNA-bound forms of the Ku-Mtb homodimer. …

Strengthening Implementation Science Research To Improve Adolescent And Young Adult Hiv-Prevention And Care In Sub-Saharan Africa: Patc3h-In, Geri R Donenberg, Ucheoma Nwaozuru, Sylvia Adebajo, Joseph D Tucker, Juliet Iwelunmor, Lisa M Kuhns, Brenda Gati Mirembe, Lisa Hightow-Weidman, Brian Zanoni, Tapiwa A Tembo, Maria Felix Lupogo, Franklin Yates

2020-Current year OA Pubs

BACKGROUND: Despite significant progress in HIV prevention and treatment, uptake of evidence-based interventions among adolescents and young adults (AYA), particularly in low- and middle-income countries (LMICs), remains low. Implementation research can optimize strategies to enhance reach, uptake, and equitable access to these innovations. The Prevention and Treatment through a Comprehensive Care Continuum for HIV-affected Adolescents in Resource-Constrained Settings Implementation Science Network (PATC

METHODS: The PATC

RESULTS: The PATC

CONCLUSIONS: The PATC

CLINICAL TRIAL NUMBER: Not Applicable.

Successful Implementation Of Stroke Risk Screening For Sickle Cell Anemia In The Displace Study: Results Of A Cluster Randomized Trial, Alyssa M Schlenz, Monica L Hulbert, Et Al.

2020-Current year OA Pubs

BACKGROUND: Stroke risk screening using transcranial Doppler (TCD) is a critical evidence-based tool for children with sickle cell anemia (SCA) that has been poorly implemented in the United States. The Dissemination and Implementation of Stroke Prevention Looking at the Care Environment (DISPLACE) study was designed to improve rates of stroke risk screening for SCA using interventions informed by an extensive multi-level barriers and facilitators assessment. This report describes the final outcomes of a large, randomized implementation trial comparing two intervention arms: 1) an application designed to track TCD implementation, ProviderMinder™, versus 2) ProviderMinder™ plus a single coordinator intervention. All sites …

Molecular Basis Of Nfib-Mediated Regulation Of Oncogenic Transcription, Ci Zhu, Ding Xiao, Yueyu Wang, Hong Han, Chengxiao Qin, Shuang Liu, Xi Chen, Hejin Xiao, Xin Chen, Junfeng Shi, Juyu Tang, Jie Shen, He Song

2020-Current year OA Pubs

The Nuclear Factor I (NFI) family of transcription factors orchestrates key regulatory programs in development, differentiation, and metabolism, with dysregulation implicated in diverse pathological conditions, including cancer. Among the paralogs, NFIB has emerged as an oncogenic driver in multiple tumor types, yet the mechanisms through which it engages DNA and directs oncogenic transcriptional programs remain undefined. Here, using cancer cells with high NFIB expression, we demonstrate that NFIB promotes malignant phenotypes, as CRISPR-Cas9 knockout impairs proliferation, migration, and invasion. Transcriptomic profiling reveals that NFIB regulates a cancer-enriched gene network that includes FGFR3 and PDGFRB. Biophysical analyses show that NFIB, including …

Clinical And Implementation Outcomes Of An Antimicrobial Stewardship Intervention For Rapid Blood Culture Diagnostics, Monica Abdelnour, Christine R Lockowitz, Evan E Facer, Andrew Atkinson, Sara Malone, Virginia R Mckay, Rebekah E Dumm, Alexander S Plattner, Matthew M Sattler, Jason G Newland

2020-Current year OA Pubs

OBJECTIVE: To evaluate the clinical and implementation outcomes of an antimicrobial stewardship program (ASP) intervention to improve antibiotic therapy for a rapid diagnostic test (RDT) for bloodstream infections (BSIs).

DESIGN: Retrospective pre and postintervention study.

SETTING: Single pediatric tertiary center from August 2022 to May 2024.

PARTICIPANTS: Patients presenting with a positive blood culture accompanied by the Verigene (VG) Gram-positive Blood Culture Nucleic Acid (BC-GP) assay. Implementation outcomes surveys were completed by infectious diseases (ID) clinicians and non-ID clinicians.

METHODS: We implemented a 24 hours a day, 7 days a week (24/7) ASP intervention to improve response to BC-GP assay …

Implementation Outcomes From The Hypertension Treatment In Nigeria Program: Results From A Type 2 Hybrid Interrupted Time Series Trial, Jiancheng Ye, Erica L Jamro, Guhan Iyer, Mark D Huffman, Et Al.

2020-Current year OA Pubs

BACKGROUND: The Hypertension Treatment in Nigeria Program was implemented across 60 primary healthcare centers (PHCs) in Nigeria to improve hypertension treatment and control using the World Health Organization's HEARTS package. This study reports the program's implementation outcomes.

METHODS: The Hypertension Treatment in Nigeria Program used a type 2 hybrid interrupted time series design, and data were collected from January 2020 to December 2023. The RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework guided the evaluation, focusing on key metrics such as patients' and clinics' characteristics, prescription rate of fixed dose combination (FDC) drugs, medication availability, and retention.

RESULTS: Among 21,922 …

Cognitive Testing Of Candidate Items In A Wellbeing Measure Developed For Aboriginal And Torres Strait Islander Peoples, Alana Gall, Gail Garvey, Kate Anderson, Abbey Diaz, Kirsten Howard

Journal of the Australian Indigenous HealthInfoNet

Purpose Health and wellbeing for Aboriginal and Torres Strait Islander peoples is poorly understood, due to commonly used measures of quality of life and wellbeing not aligning with their collectivist worldviews. The need to develop a wellbeing measure, grounded in the aspects of life that Aboriginal and Torres Strait Islander people identify themselves as important, was therefore a priority. The current study aimed to cognitively assess the face and content validity of a new wellbeing measure under development for Aboriginal and Torres Strait Islander adults. Methods We employed a qualitative cross-sectional cohort design. Forty-nine unique draft wellbeing statements underwent cognitive …

Quality Improvement Project: Effects Of Ongoing Clinical Education Training On Nursing Faculty’S Self-Efficacy In Clinical Education, Sarah Ferguson

Doctor of Nursing Practice Projects

Clinical education is essential for bridging theory and practice in nursing education, yet many clinical instructors transition from expert bedside nurses to novice educators without adequate orientation and training. This quality improvement project examined the effects of ongoing clinical education training on nursing faculty self-efficacy at a satellite nursing school in North Texas. This project, guided by Patricia Benner’s Novice to Expert framework and Lewin’s change model, aimed to determine whether continuous professional development throughout the term would increase clinical faculty confidence compared to standard onboarding alone. A descriptive pre/post design was used, with the Clinical Nursing Teacher Self-Efficacy Scale …

Current Status And Future Directions For The Use Of Artificial Intelligence In Pediatric Critical Care Nephrology, Sameer Thadani, Christopher M Horvat, Christin Silos, Bronwyn Sutherland, Kristin Dolan, Jin Chen, Ayse Akcan-Arikan, Javier A Neyra

Library Staff Publications

Artificial intelligence (AI) has the potential to significantly improve the practice of medicine. However, its application in pediatric critical care nephrology remains underdeveloped. This scoping review investigates the current state of AI/machine learning (ML) algorithms developed and implemented in the field of pediatric critical care nephrology over more than two decades (2000-2024). We identified 24 articles related to commonly encountered pathologies including acute kidney injury (AKI), electrolyte and acid-base imbalances, fluid management, and dialysis. Twenty (80%) of these articles focused on AKI (prediction and/or detection) and only two articles (4%) investigated the impact of implemented AI/ML models on clinical care …

Possible Involvement Of Keratinocyte-Derived Microvesicle Particles In Human Photosensitivity Disorders, Risha Annamraju, Madison S. Owens, Anita Thyagarajan, Danielle A. Corbin, Catherine M.T. Sherwin, Jade Bryant, Garrett W. Fisher, Winston R. Owens, Alycia Ketter, Craig A. Rohan, Michael G. Kemp, Robyn K. Crow, Jeffrey B. Travers

Pediatrics Faculty Publications

BACKGROUND: Previous murine studies have implicated acid sphingomyelinase-(aSMase) generated subcellular microvesicle particles (MVP) in photosensitivity. Objective: The current double-blinded placebo-controlled studies examined if a single localized ultraviolet B radiation (UVB) treatment generated more MVP in human subjects with self-identified photosensitivity versus normal controls. A topical 4% formulation of the aSMase inhibitor imipramine applied immediately after UVB blocked the MVP release and erythema responses. Erythema responses at 24 and 72 h in response to multiple UVB fluences and minimal erythema doses (MED) at 24 h and effects of imipramine were also tested.

RESULTS: Small cohorts of 10 adult self-identified photosensitive subjects …

Quality Improvement Project: Improving Providers’ Self-Efficacy In Facilitating Mat Usage Through Educational Training, Joshua W. Moore

Doctor of Nursing Practice Projects

Opioid Use Disorder (OUD) and Alcohol Use Disorder (AUD) are common diseases treated in detox facilities around the world. Medication-assisted treatment (MAT) is the most effective treatment for OUD and AUD. Despite the need for MAT, many providers do not prescribe lifesaving medications due to a lack of knowledge and confidence. The purpose of this quality improvement project at a local detox facility is to answer the question: What effect on providers’ self-efficacy in facilitating MAT usage upon discharge does educational training have? Under the Social Cognitive Theory (SCT), self-efficacy was targeted using the Plan-Do-Study-Act (PDSA) change model. The aim …

Exploring Future Educators’ Roles In Classroom Aac Use: Insight Into Knowledge, Skills, And Attitudes, Katrina M. King

Honors College Theses

The United States public school system requires the provision of a free and appropriate public education (FAPE) in the least restrictive environment (LRE) for qualifying students with disabilities (U.S. Department of Education, n.d.). Speech, language, and hearing related disabilities are among the qualifying categories (U.S. Department of Education, n.d.). Students with these disabilities may have complex communication needs (CCN), or significant limitations in their speech, language, and communication abilities (Communication Rights Australia, 2018). Augmentative and alternative communication (AAC), a type of assistive technology, offers support for these students, however, several barriers inhibit full communicative participation (American Speech-Language-Hearing Association [ASHA], n.d.-a). …

Fraud Detection And Explanation In Medical Claims Using Gnn Architectures, Reem Muhammad, Dina Tbaishat, Amril Nazir, Seif Yacoub, Mustafa Abdulrazek, Mohamed Ahmed Abo El-Enen, Ahmed T. Sahlol

All Works

This paper addresses the critical challenge of fraud detection in medical insurance claims-a pervasive issue causing significant financial losses in healthcare-using Graph Neural Networks (GNNs). Given the intricate nature of healthcare data, traditional fraud detection methods do not inherently capture the complex relationships and patterns among different entities. We explore the potential of GNNs to effectively identify fraudulent claims by modeling the interactions among various entities-such as patients, healthcare providers, diagnoses, and services-as a heterogeneous graph. We employ two state-of-the-art heterogeneous GNN architectures, HINormer (Heterogeneous Information Network Transformer) and HybridGNN, along with a modified homogeneous GNN, RE-GraphSAGE (GraphSAGE Graph Sample …

Single-Cell Transcriptomic Analysis Of Peripheral Blood Mononuclear Cells Reveals Key Immune Responses In St-Segment Elevation Myocardial Infarction, Zheng Zhang, Shengfang Wang, Yahui Liu, Gaohan Li, Qianqian Cheng, Wei Yang, Gan-Xin Yan, Chuanyu Gao

Department of Medicine Faculty Papers

BACKGROUND: Inflammation plays a crucial role in the pathogenesis of ST-segment elevation myocardial infarction (STEMI). However, the precise immunological mechanisms remain incompletely understood. Single-cell RNA sequencing (scRNA-seq) provides a powerful approach to dissect immune cell heterogeneity and dynamic changes at single-cell resolution.

METHODS: Peripheral blood mononuclear cells (PBMCs) were collected from 7 STEMI patients (within 6h after primary percutaneous coronary intervention) and 3 healthy controls. Single-cell suspensions were prepared and subjected to scRNA-seq using the 10x Genomics Chromium platform and Illumina NovaSeq 6000. Data were processed using Cell Ranger and analyzed with Seurat for quality control, clustering, and annotation. Differentially …

Bilateral Endogenous Fungal Endophthalmitis Following Elective Surgical Abortion: A Single Center Case Series, Viet Q. Chau, Jesse D. Sengillo, Flavius A. Beca, Julia L. Hudson, Thomas A. Albini, Harry W. Flynn

Wills Eye Hospital Papers

BACKGROUND: To describe the clinical features and management of three cases of bilateral endogenous fungal endophthalmitis following elective surgical abortion performed at the same outpatient surgical center.

METHODS: Case series.

OBSERVATIONS: Three immunocompetent women presented with vision loss days to weeks following elective surgical abortions performed at a single outpatient clinic. Initial visual acuities ranged from 20/20 to 20/300. Fundoscopic examination revealed multiple white round chorioretinal lesions with vitreous infiltration bilaterally in all three patients. Vitreous tap samples were obtained for culture and broad-spectrum intravitreal antimicrobials were administered. Despite negative cultures and systemic workup, the clinical presentation was consistent with …

Ash Sickle Cell Disease Cpkd Guidelines Report, Robert I. Liem, Madeleine Verhovsek, Ted Wun, Sophie Lanzkron

Cardeza Foundation for Hematologic Research

No abstract provided.

Exploring The Experiences Of Bahamian Men Diagnosed With Hypertension And Medication Adherence, Bianca Edwards

Walden Dissertations and Doctoral Studies

Hypertension (HTN) is associated with significant health complications, including stroke, myocardial infarction, heart failure, and kidney disease. Despite advances in the treatment and management of HTN, a lack of medication adherence contributes to the persistence of HTN-related morbidity and mortality affecting men in The Bahamas. The purpose of this qualitative descriptive phenomenological study, guided by Pender’s health promotion model and Bandura’s social cognitive theory, was to explore the lived experiences of Bahamian men diagnosed with hypertension regarding their adherence to prescribed medications. Using Giorgi’s descriptive phenomenological method, in-depth, semistructured interviews were conducted with 11 participants. Data were analyzed through repeated …

Impact Of Community Factors On Naloxone Overdose Reduction In Ohio, Theophilus Oduro Frimpong

Walden Dissertations and Doctoral Studies

The opioid crisis in Ohio, driven by fentanyl, persists due to inequitable access to naloxone despite its proven effectiveness. This study examined how socioeconomic status (SES), race/ethnicity, population density, and hospital availability per capita predicted naloxone overdose reversals (dependent variable) in Ohio. Social-ecological theory guided this quantitative historical correlational analysis of Ohio’s Project DAWN index data (N = 5,280). Inclusion criteria included individuals ages 18 to 65 with naloxone-related overdose reversals (dependent), naloxone distribution (moderator), and community factors (independent). Multiple linear regression results showed that SES (p >.50), race/ethnicity (% White, p = .588; % Black, p = .495; % …

Hemolysis Detection Using The Gem 7000 At The Point Of Care In A Pediatric Hospital Setting: Does It Affect Outcomes?, Ridwan B Ibrahim, Nazmin Bithi, Charlene Hernandez, Hanna Uhrova, Brandy D Recio, Sridevi Devaraj

Faculty, Staff and Students Publications

No abstract provided.

Hemorrhage-Related Maternal Morbidity Of Secondary Compared To Primary Postpartum Hemorrhage, Matthew R Carroll, Sarah Tounsi, Jessica L Gerard, Susan M Leong-Kee, Laurie S Swaim, Mark A Turrentine

Faculty, Staff and Students Publications

Objectives: To compare a composite hemorrhage-related maternal morbidity in individuals with secondary to primary postpartum hemorrhage and treatment interventions utilized.

Methods: A retrospective case-control study of deliveries complicated by secondary postpartum hemorrhage was performed at a tertiary care center. To estimate a clinically relevant increase of 50 % in the composite maternal hemorrhage-related maternal morbidity (35-53 % absolute increase) in individuals with secondary postpartum hemorrhage, a correlation coefficient of 0.2, at an 80 % power with a p < 0.05 with a two-sided test would require 95 individuals with secondary postpartum hemorrhage be matched to 95 individuals with a primary postpartum hemorrhage. Logistic regression analysis was used to evaluate the outcome of the composite of hemorrhage-related maternal morbidity.

Results: From January 2018 through December 2022, 33,026 deliveries occurred, and 94 individuals were identified that were admitted with secondary postpartum hemorrhage, …

Field Validation Of Multiple Species Distribution Models Shows Variation In Performance For Predicting Aedes Albopictus Distributions At The Invasion Edge, Anna V. Shattuck, Brandon D. Hollingsworth Ph.D., Jared Skrotzki, Scott R. Campbell, Christopher L. Romano, Courtney C. Murdock

Faculty Publications

Background

Climate and land use changes have resulted in range expansion of many species. In this shifting disease landscape, it is important to leverage tools that can predict the distributions of invading vectors to target surveillance and control efforts and identify at-risk populations. Species distribution models (SDMs) are used to predict ranges of invasive species; however, invasive species often violate assumptions of equilibrium and niche conservatism. Moreover, these studies are rarely validated using independent data.

Methods 

We use long-term surveillance data for Aedes albopictus, a highly invasive mosquito capable of transmitting several arboviruses, at its range edge to evaluate a …

Development Of An Evidence-Based Guideline For Nurse-Led Interventions To Improve Medication Adherence In Patients With Severe Mental Illness, Grace Uche Kalu

Walden Dissertations and Doctoral Studies

I conducted this Doctor of Nursing Practice (DNP) project to address medication nonadherence among adults with severe mental illness (SMI) in a psychiatric care setting by developing an evidence-based clinical practice guideline (CPG) for nurse-led interventions. The identified practice gap was the absence of a standardized, evidence-informed framework to guide nurses in enhancing pharmacotherapy adherence, which is a critical issue linked to relapse, rehospitalization, and diminished quality of life in this population. This project was guided by the following practice question: Will an evidence-based guideline on nurse-led interventions to improve medication adherence in patients with SMI be approved by a …

Optimizing Lower Intensity Triplet Therapy In Acute Myeloid Leukemia: A Practical Guide, Wei-Ying Jen, Curtis A Lachowiez, Jennifer Marvin-Peek, Jessica K Altman, Musa Yilmaz, Jacqueline S Garcia, Yasmin Abaza, Nicholas J Short, Joshua F Zeidner, Naval G Daver, Andrew H Wei, Ghayas C Issa, Courtney D Dinardo

Faculty, Staff and Student Publications

Venetoclax-based doublets with azacitidine or low dose cytarabine are the standard of care for the treatment of acute myeloid leukemia (AML) in older patients or those unfit for intensive chemotherapy. However, some patients do not attain complete remission, and over time, most patients relapse. Frontline triplet therapy incorporating a targeted therapy (FLT3, IDH or menin inhibitor) is an emerging treatment concept under investigation for this population. Initial triplet regimens have yielded encouraging composite complete remission and measurable residual disease negativity rates, enabling the transition to allogeneic stem cell transplantation for eligible patients. While effective, triplets are associated with myelosuppression and …