Medicine and Health Sciences Commons^™

Adiponectin-Regulated Macrophage Responses In Aspergillus Fumigatus Infection: Mechanisms Of Uptake And Killing, Sri Harshini Goli

All-Inclusive List of Electronic Theses and Dissertations

Invasive aspergillosis (IA), caused by Aspergillus fumigatus, is a life-threatening infection in immunocompromised individuals, necessitating novel host-directed therapies. Macrophages are pivotal in antifungal defense, yet their function can be dysregulated; the influence of the adipokine adiponectin (APN) on this process is not fully understood. This thesis investigated the role of APN signaling in alveolar macrophage (AM) and bone marrow-derived macrophage (BMDM) responses to A. fumigatus and assessed the therapeutic potential of the APN receptor agonist, AdipoRon. Initial studies revealed that genetic deficiency in APN or its receptors renders AMs intrinsically pro-inflammatory and significantly impaired fungicidal activity against A. fumigatus. Subsequent …

The Influence Of High Iq On Adhd Symptom Presentation And Outcomes In Children, David A. Lee

All-Inclusive List of Electronic Theses and Dissertations

Research suggests that a high intelligence quotient (IQ) may contribute to the underdiagnosis and misdiagnosis of Attention-Deficit/Hyperactivity Disorder (ADHD) in children. High IQ may allow children to compensate for executive functioning-related deficits inherent in ADHD and/or may influence behaviors such as high activity level or not following rules that mimic ADHD symptoms. To gain a better understanding of the relationship between IQ and ADHD, the present study aimed to investigate how high IQ impacts symptoms of inattention and hyperactivity as well as outcomes related to academic performance, emotional regulation, and peer relationships in children. The study utilized archival data from …

Dermatoglyphic Fluctuating Asymmetry In Schizotypy, Marcus R. Thomas

All-Inclusive List of Electronic Theses and Dissertations

Schizotypy has been linked with many of the proposed endophenotypes of schizophrenia, but research is limited on the relationship between schizotypy and dermatoglyphic fluctuating asymmetry. The present study sought to examine relationships between schizotypy, dermatoglyphic fluctuating asymmetry, handedness, and season of birth. 146 undergraduate students were identified as schizotypes (n = 52) or controls (n = 94) based on the Multidimensional Schizotypy Scale and had their finger and palm prints collected along with completing additional measures of schizotypy and handedness. Schizotypes did not exhibit a greater degree of dermatoglyphic fluctuating asymmetry, negative schizotypy was associated with increased absolute finger ridge …

A Word From The Writing Team (August 2025), Pam Walter, Mfa

A Word From the Writing Team (Newsletter)

This issue includes:

• Publications Spotlight
• Join the Last Summer Writing Warriors Session Tomorrow
• Check out our Fall Workshops
• Two Ways to Fund Open Access Fees

A Phase 2 Trial Of Niraparib Plus Bevacizumab Maintenance Therapy Following First-Line Platinum-Based Chemotherapy With Bevacizumab In Advanced Ovarian Cancer: Final Analysis And Overall Survival Results From Ovario., Melissa M Hardesty, Thomas C Krivak, Gail S Wright, Erika Hamilton, Evelyn L Fleming, Jimmy Belotte, Shelby Gorman, Natalie Compton, Aine Clements, Heidi J Gray, Gottfried E Konecny, Richard G Moore, Debra L Richardson

Oncology Articles

OBJECTIVE: To report long-term outcomes from the OVARIO trial of niraparib plus bevacizumab maintenance following first-line platinum-based chemotherapy with bevacizumab in advanced ovarian cancer.

METHODS: The phase 2, single-arm, open-label trial enrolled adult patients with stage IIIB-IV epithelial ovarian, fallopian tube, or primary peritoneal cancer (NCT03326193). Patients were required to have attempted debulking surgery and have a complete or partial response or no evidence of disease following first-line, platinum-based chemotherapy with ≥3 cycles of bevacizumab. The primary endpoint was 18-month progression-free survival (PFS) rate, per RECIST. Secondary endpoints included PFS, overall survival (OS), safety, and health-related quality of life (HRQOL) …

Dementia- Friendly Interventions In The Hospital Setting And Positive Patient Outcomes, Breanna Wenger

Nurse Residency

PICOT Question: In patients with dementia, what impact does a “dementia-friendly” hospital have on their outcomes in comparison to hospitals that do not employ dementia-friendly practices during their stay?

Caregiver Perceptions, Knowledge, And Likelihood To Intervene With Suicidal Youth, Amber L. Willwerth

All-Inclusive List of Electronic Theses and Dissertations

This study utilized an online survey to target primary caregivers of a child aged 5-18. The survey highlighted factors regarding caregiver involvement in suicide prevention efforts, such as their knowledge, comfort and confidence intervening with a youth experiencing suicidality, and barriers to doing so. It was found that caregivers who had experienced suicide prevention training reported higher levels of comfort and confidence intervening with their own child and another child than those who had not, as well as lower levels of worry. Higher levels of education were also found to predict lower levels of worry, suggesting that further training and …

Factors Associated With Postpartum Depression Among Women Attending Postnatal Clinics In A Tertiary Care Hospital In Nairobi, Kenya, Cecilia Muthoni Njoga

Master of Medicine in Family Medicine

Background 

Postpartum depression (PPD) is a major mental health disorder affecting women during the postpartum period with a global prevalence of up to 17.22%. This prevalence has been shown to be higher in low and middle-income countries. In Kenya, about a fifth of women are affected. PPD can lead to poor infant growth and interference with maternal-child bonding. Additionally, women with PPD experience a lower quality of life and their children have an increased risk of developing and psychotic disorders later in life. Understanding the factors associated with PPD is crucial for early diagnosis and intervention. The study aimed to …

Factors Informing Referral Of Adult Patients To Palliative Care Services In A Tertiary Facility In Kenya: Physicians' Perspective, Donnah A. Opiyo

Master of Medicine in Family Medicine

Background The growing burden of chronic diseases underscores the urgent need for palliative care integration into healthcare systems worldwide. Despite its benefits, palliative care remains underutilized due to various barriers, including health system limitations, institutional challenges, infrastructure gaps, and individual provider factors. However, limited research has explored the specific factors influencing physicians' decisions to refer patients to palliative care. This study sought to fill that gap by examining the key determinants shaping referral practices in a tertiary facility in Kenya.

Design and Methods This exploratory qualitative study examined 22 physician specialists from five departments at Aga Khan University Hospital, Nairobi. …

Specificity Of Interaction Of Antimicrobial Peptide With Cell Membrane, Srishhti Kumar Jha

Pharmaceutical Sciences (MS) Theses

Antimicrobial resistance (AMR) is an increasing global health threat due to its rising incidence worldwide. Resistant microbial infections have become difficult to treat and pose serious risks to patients. In 2019, AMR was responsible for approximately 1.27 million deaths globally, with numbers continuing to rise. The World Health Organization (WHO) has highlighted the urgent need for new antibiotics with novel mechanisms of action and low toxicity to combat this issue. Antimicrobial peptides (AMPs) represent a promising solution. These peptides exhibit broad-spectrum antimicrobial activity and rapid killing kinetics, reducing the likelihood of resistance development. AMPs primarily target bacterial cell membranes. Their …

Incidence Of Peripheral Intravenous Cannula Complications And Associated Factors Among Paediatric Patients At A Tertiary-Care Referral Hospital, Vanessa Minsari Ogega

Master of Medicine in Paediatrics and Child Health

Introduction: Peripheral intravenous catheters (PIVCs) are widely used in clinical practice and are a major source of procedure-related pain in children. Their use is associated with complications including occlusion, dislodgement, infiltration, extravasation, phlebitis, and, rarely, bloodstream infections.

Objectives: To determine the incidence and risk factors associated with PIVC complications among paediatric patients aged 1 day to 18 years at Aga Khan University Hospital, Nairobi. The study also assessed the average survival time of PIVCs.

Methods: A prospective cohort study was conducted on 320 PIVCs among 192 children admitted between August and October 2024. Data collected included patient demographics, clinical characteristics, …

Kenyan Dietitians’ Knowledge Of Ketogenic Dietary Therapies For Drug-Resistant Epilepsy, Pauline Samia, Violet Naanyu, Perry Ndila, Helen Cross, Richard Idro, Paul Boon, Jo Wilmshurst, Stanley Luchters

Paediatrics and Child Health, East Africa

Background: Ketogenic dietary therapy (KDT) has been proven to be efficacious for people with drug-resistant epilepsy. However, it is rarely utilized in low-resource settings. Due to the complexity of implementation, dietitians play a crucial role in managing KDT.

Methods: We conducted a cross-sectional survey of 253 out of the 1,000 registered dietitians. We assessed their knowledge of and interest in further training in KDT.

Results: Most participants were female (78%), with a median age of 33 years (IQR=28–38). A total of 171 (67.6%) reported knowledge of KDT. However, only 13 respondents (7.6%) answered all five knowledge-specific questions correctly. A …

Interview With Former Chairman Of Cardiology E. Berry Hey, Jr. Md, Caitlin Moss

Historic Narratives

No abstract provided.

Polyphenols For The Mitigation Of Vascular Calcification; In Vitro And In Vivo Studies, Abdullah Altuhami

All Theses

Globally, cardiovascular diseases, in most cases associated with calcification, are the main cause of death. However, currently, the only effective cure is to undergo surgery to augment or receive a healthy donor heart, which could be very difficult due to the long waiting list and the associated risks. The possibility of body rejection of the foreign organs is attributed to immunoreaction or the risk of infection, since the donor must be on immunosuppressant drugs that lower the body's immunity and facilitate the body's acceptance of the new organ as one of its own. Taking that into consideration, using tissue-engineered vascular …

Improving Antipsychotic Compliance By Addressing Client Experience Of Metabolic Syndrome, Lurinda N. Paulsen

Doctor of Nursing Practice

Abstract

Purpose: This project was undertaken to increase medication adherence in clients diagnosed with mental illnesses that necessitate the use of antipsychotic (second generation, atypical or first generation, typical) medications.

Background: Medication compliance in the treatment of schizophrenia, schizoaffective disorder, and bipolar disorder is essential to ensure consistent medication levels and symptom stabilization. There are many reasons clients stop taking their medications, and symptoms of metabolic syndrome are often a cause for self-discontinuation. Metabolic syndrome is a cluster of symptoms including obesity, hypertension, hyperglycemia, hypoalphalipoproteinemia, and/or hypertriglyceridemia, which increases risk for cardiovascular disease and diabetes.

Methods: This project was completed …

Exploring The Effect Of Social Determinants Of Health (Sdoh) Factors On The Time To Kidney Transplant Evaluation Completion For African American End Stage Renal Disease (Esrd) Patients, Kesha Levesque

MUSC Theses and Dissertations

Purpose – The purpose of this dissertation is to investigate the relationship between demographics and Social Determinants of Health (SDOH) variables on diagnostic testing time completion in patients being evaluated for kidney transplant waitlisting.

Aims - Compared to White Americans, African Americans who are eligible to receive a kidney transplant are less likely to complete the required testing in order to be placed on the kidney transplant waiting list which puts African Americans at risk for morbidity and mortality due to prolonged exposure to dialysis. The COVID-19 pandemic was directly associated with a decrease in the number of patients placed …

Navigating Childhood Asthma Care In Kenya: Barriers Identified By Children And Their Caregivers, Joan Ahimbisibwe, Roselyter Riang’A, Angela Migowa, Samuel Otido

Paediatrics and Child Health, East Africa

Background: Asthma is one of the most common chronic conditions in children, with significant morbidity and mortality, especially in Africa. Achieving adequate asthma control in children remains challenging because of gaps between standard recommended management strategies and actual treatment practices. This study explored barriers to asthma management as perceived by children and their caregivers in a private tertiary care setting in Kenya.

Methods: An exploratory phenomenological qualitative study was conducted at Aga Khan University Hospital (AKUH), Nairobi. Children aged 6–18 years with a confirmed diagnosis of asthma and their caregivers were recruited. The participants had been receiving treatment for at …

Dissecting The Heterogeneous Effects Of Opioid Prescribing Limit Laws On Pediatric Mortality: A Multidimensional And Negative Binomial Modeling Approach, Francine R. Vega

Dissertations and Theses (Open Access)

Opioid prescribing for children and adolescents continues to be a significant health crisis in the United States. Early naïve exposure to opioid prescriptions has been linked to later misuse, opioid use disorder, and death. In response to the crisis, many states have implemented opioid prescribing limit laws (OPLLs) aimed at reducing exposure to opioids. These laws vary widely in their approach, including differences in dosage restrictions, prescription duration limits, informed consent requirements, educational provisions, and whether they offer explicit protections specifically for minors. Despite their widespread adoption, there is limited understanding of how heterogeneity in legal regulations affects outcomes for …

Rethinking Health Systems Responsiveness In Low–And Middle-Income Countries, Meesha Iqbal

Dissertations and Theses (Open Access)

Health systems responsiveness (HSR) refers to a health system’s ability to meet legitimate non-health expectations of the population. Traditionally, HSR has been conceptualized across eight domains: respect for dignity, autonomy, confidentiality, prompt attention to health needs, availability of basic amenities, choice of provider, access to social support networks, and clarity of communication. However, as the expectations of populations in high-income countries (HICs) and low- and middle-income countries (L&MICs) differ significantly due to diverse social and cultural contexts, the conceptualization of HSR also varies. We conducted a systematic review of literature to adapt and contextualize the HSR framework for L&MICs based …

Resonant Disruptions: Understanding Canadian Nurses’ Practice With Youth Survivors Of Sexual Exploitation, Danielle E. Giebelhaus, Andrew Estefan Phd, Rpn

Dignity: A Journal of Analysis of Exploitation and Violence

The sexual exploitation of youth is a global concern. Youth survivors of sexual exploitation present to and require healthcare services, but most nurses do not feel effectively equipped to care for this population. There is currently little nursing literature to guide nurses in their practice with youth survivors. In this article, we report on a qualitative, hermeneutic study undertaken to explore nursing practice with youth survivors of sexual exploitation. Hermeneutics is concerned with understanding, and is a helpful way to conduct research when little is known about a topic. In this study, we asked the research question, “How might we …

Delusional Parasitosis With Depression, Hypertension And Migraine, Mouli Mandal, M Kishor, Mr Murali

Digital Journal of Clinical Medicine

Delusional Parasitosis (DP) , also known as Ekbom Syndrome, is a psychiatric disorder characterised by the unshakeable belief of infestation by parasites, insects or other organisms, despite the absence of objective medical evidence.
This case report presents a 49 year old female with a history of chronic headaches, progressively worsening insect crawling sensations. She was initiated on treatment and supportive psychotherapy.
This case highlights the importance of a thorough multidisciplinary approach in managing Delusional Parasitosis, emphasising the need to differentiate between primary and secondary forms, address the potential medical and psychiatric comorbidities, and implement appropriate pharmacological and psychotherapeutic interventions.

New Dentist News (August 2025), Ada Committee On The New Dentist

New Dentist News

New Dentist News offers timely information on scientific, social, educational, political and economic developments affecting new dentists. This collection is historical and items may not reflect current standards. For up-to-date information contact the ADA. The New Dentist News was alternately titled ADA Lifeline, 1997-June 2001.

A Guide To Sexual Intimacy Following Spinal Cord Injury, Jillian M. Olenick

Entry Level Occupational Therapy Doctoral Capstone Projects Class of 2025

A Guide to Sexual Intimacy Following Spinal Cord Injury is a two-part manual that was created to increase the knowledge related to how sex can be impacted following a spinal cord injury. The first manual was created as a guide for individuals with spinal cord injuries and their partners to enhance their knowledge on how their spinal cord injury may impact their sexual functioning. The second manual was created as a guide for occupational therapy practitioners to use as a resource when addressing sex with their clients following a spinal cord injury. Each manual provides information related to sexual intimacy, …

Large-Scale Copy Number Variant Analysis In Genes Linked To Parkinson’S Disease, Zied Landoulsi, Katja Lohmann, Eva-Juliane Vollstedt, Emily Wedgwood-Benn, Lisa-Marie Niestroj, Björn-Hergen Laabs, Sebastian Sendel, Alexander Balck, Max Borsche, Dennis Lal, Anne Grünewald, Norbert Brüggemann, Andre Franke, Andrew Hicks, Meike Kasten, Kirsten E Zeuner, Lara M Lange, Wolfgang Lieb, Brit Mollenhauer, Heike Pawlack, Peter P Pramstaller, Amke Caliebe, Inke R König, Patrick May, Christine Klein

Faculty, Staff and Student Publications

Genetic studies of Parkinson's disease (PD) have focused on single nucleotide variants (SNVs), with limited attention to copy number variants (CNVs). This study investigates CNVs in PD using candidate PD-related genes and genome-wide approaches. We identified CNVs from the ProtectMove project genotyping data of 2364 PD patients and 2909 controls using PennCNV. We validated 119 of 137 detected CNVs in PD-related genes (87%) using MLPA/qPCR, including 104 in PRKN, six in PARK7, four in SNCA, and others in LRRK2, RAB32, and VPS35. CNVs were present in 2.4% of patients and 1.5% of controls. Notably, 0.9% of patients carried potentially disease-causing …

Management Approaches To Spastic Gait Disorders, Sheng Li, Tulsi Pandat, Bradley Chi, Daniel Moon, Manuel Mas

Faculty, Staff and Student Publications

Spastic gait presents clinically as the net mechanical consequence of neurological impairments of spasticity, weakness, and abnormal synergies and their interactions with the ground reaction force in patients with upper motor neuron syndromes and with some neuromuscular diseases. It is critical to differentiate whether the primary problem is weakness or spasticity, thus better understanding different phenotypes of spastic gait disorders. Pelvic girdle abnormality plays a pivotal role in determining the clinical presentation of gait disorders, since it determines the body vector and compensatory kinetic chain reactions in the knee and ankle joints. Knee joint abnormality can be a mechanical compensation …

Patient-Specific Preoperative Plans Can Optimize Femoral Head Coverage And Range Of Motion After Periacetabular Osteotomies, Shuyang Han, Carey A Clark, Nicholas J Dunbar, Madison Brenner, Alexis H Aboulafia, Alfred A Mansour Iii, Philip C Noble

Faculty, Staff and Student Publications

Background: The goal of a periacetabular osteotomy is to increase the coverage of the femoral head, primarily in the antero-lateral region, through rotation of the acetabulum in three anatomical planes. The present study was undertaken to determine whether specific combinations of lateral rotation, anterior rotation, and anteversion of the acetabular fragment can be targeted to provide the best balance between femoral head coverage and joint motion.

Methods: Three-dimensional patient-specific hip models were reconstructed from preoperative computerized tomography scans of 15 patients diagnosed with hip dysplasia. Each model was placed in a standard coordinate system with neutral pelvic tilt and femoral …

Exploring Ict Adoption In Teaching And Learning Of Science: A Case Of Senior Teachers In Kenya, David Odhiambo, Winston Edward Massam, Fredrick Mtenzi

Institute for Educational Development, East Africa

This study was conducted in Homa Bay Sub County, Kenya to explore the adoption of ICT among senior teachers, aged between 45-60 years, in teaching and learning of science. A qualitative research approach using a case study design was employed. Eight secondary school senior teachers of science, 2 females and 6 males, within Homa Bay Sub County were purposefully selected. Semi structured interviews were conducted one-on-one basis followed by classroom observation and document analysis. Analysis of the data revealed that senior teachers of science generally integrate ICTs in planning, assessment and in classroom teaching; however pedagogical preferences and teacher’s workload …

Evaluating Quadrupedal Locomotion In Bats: A Geometric Morphometric Comparison Of Vertebral Adaptations Across Mammals, Jessica Upham

Electronic Theses and Dissertations

Flight is the primary locomotion of bats, while quadrupedal locomotion is not often observed and is widely variable among bats. Frugivorous bats in Pteropodidae are more efficient climbers than frugivorous bats in Phyllostomidae and insectivorous bats in Vespertilionidae, while phyllostomids and vespertilionids are better at walking on horizontal surfaces. The aim of this study is to investigate whether bats with differing modes of nonflight locomotion also exhibit disparity in thoracolumbar vertebral morphology. Using geometric morphometrics, we compared the thoracolumbar vertebral shapes of these bat families with other terrestrial and arboreal mammals. The results revealed distinct vertebral shapes among bat families …

Strength Beyond Cancer: An Occupational Therapy Guidebook For African American Breast Cancer Survivors, Taihia A. Wilson

Student Capstone Papers

This capstone project aims to explore the nuanced and often underrepresented experiences of African American women (AAW) who have survived breast cancer (BC), with a specific focus on the recovery phase. By examining the physical, cognitive, and psychosocial obstacles encountered during survivorship, the project seeks to highlight significant gaps in care and support. The primary goal of this project is to develop an accessible and culturally responsive guidebook that provides healthy strategies to enhance quality of life (QoL), promote occupational wellbeing, and empower AAW to manage their overall health beyond treatment. This paper will begin by presenting the background and …

Genetic Study Of Von Willebrand Factor Antigen Levels ≤ 50 Iu/Dl Identifies Variants Associated With Increased Risk Of Vwd And Bleeding, Rachel K. Friedman, Adam S. Heath, Jennifer E. Huffman, James T. Baker, Natalie R. Hasbani, Sarah A. Gagliano Taliun, Ming-Huei Chen, Tom Howard, Joanne E. Curran, John Blangero

School of Medicine Publications

Background: von Willebrand disease (VWD) is a common inherited bleeding disorder caused by low levels or activity of circulating von Willebrand factor (VWF). Genetic susceptibility to VWF antigen (VWF:Ag) below normal (≤50 IU/dL) in the general population is underexplored.

Methods: To identify genetic variants influencing VWF:Ag levels ≤50 IU/dL, we performed a genome-wide association study in 926 cases with VWF:Ag levels ≤50 IU/dL and 12,846 controls from 7 studies from the TOPMed program. We then examined whether genome-wide significant findings were also associated with clinical diagnosis of VWD in 5 biobanks with 708 VWD cases and 1,286,069 controls, and with …