Medicine and Health Sciences Commons^™

Identifying Key Factors Associated With Assistive Technology Availability For Dementia Care Using Machine Learning, Wai Hang Kwok, Syed Afaq Ali Shah, Guanjin Wang

Research outputs 2022 to 2026

This study explores the factors influencing the availability of assistive technology for people with dementia through the application of machine learning. The analysis identified key factors, including carer support, protective legislation, and access to reimbursable products from the WHO Global Health Observatory. A random forest model with high accuracy emphasises the importance of targeted resources and policies in improving dementia care infrastructure.

Determining Size In An Era When Size Matters: How Accurate Are Lung Cancer Measurements On Preoperative Computed Tomography?, Katelyn Ward, Ryan Davis, Gayaneh Nazarian, Sayf Al-Katib, Kiran Nandalur, Antonela Muca, Thomas Watson

Conference Presentation Abstracts

No abstract provided.

When Patients Say No - Outcomes Of Opting Against Recommended Treatment After Total Neoadjuvant Therapy For Stage Ii/Iii Rectal Cancer, Danielle Hurst, Scarlett Hao, Jacob Applegarth, Erin Mueller, Harry Wasvary, Matthew Ziegler, Bradley Krasnick

Conference Presentation Abstracts

Introduction: Patients with stage II/III rectal cancer may be recommended total mesorectal excision (TME) or a watch-and-wait (WW) approach depending on clinical response to total neoadjuvant therapy (TNT). In shared decision-making, patients may decide for or against surgery regardless of recommendation. This study aimed to describe the clinical outcomes of patients with locally advanced rectal cancer (LARC) who decide against physician recommendations. Methods: A retrospective cohort study of all patients diagnosed with AJCC clinical stage II/III LARC between 2021-2023 and treated at a single tertiary center with TNT was performed. Patients with IBD, genetic syndromes, synchronous tumors, those who did …

Intraoperative Code Status: Moving From Misinformation To Respect For Patient Autonomy, Jacob Applegarth, Nathan M. Novotny, Ngan Nguyen, Abram Brummett

Conference Presentation Abstracts

No abstract provided.

Group Therapy For Young Adults With Intellectual Disabilities And Anxiety, Rayah Secrist

Educational Specialist, 2020-current

The purpose of this Ed.S. project is to propose a therapy group for individuals with intellectual disabilities who are struggling with anxiety. This paper will explore the literature on social and emotional barriers, mental health access inequality, and evidence-based practices in therapy for young adults with intellectual disabilities. Drawing on the research, this paper aims to provide clinicians with a guide for leading effective therapy groups tailored to this specific demographic.

Trauma-Informed Care: A Therapeutic Approach In Communication, Nicole A. Leonce

Doctor of Nursing Practice (DNP) Projects

As medical providers, it is crucial to use therapeutic communication when building relationships with patients. Bias, stigma, and judgment often manifest through a provider’s body language and choice of words, exacerbating patient trauma and leading to health disparities. Trauma-informed care (TIC) addresses these issues by emphasizing respect, compassion, and empathy. TIC has been extensively studied in high-income regions such as Australia, Europe and the United States, but its application in low- and middle-income countries (LMIC) such as Kenya, is less understood. The aim of this study was to assess the knowledge, attitudes, and skills of nurses working in a rural …

Bridging The Gap: Enhancing Medical Interpreter Utilization For Patients With Limited English Proficiency In Healthcare Settings, Rocio J. Tapia-Nuss

Doctor of Nursing Practice (DNP) Projects

The Impact of Utilizing Medical Interpreters and Associated Patient Outcomes

Abstract

Background: In the United States, approximately 21% of households speak a language other than English, emphasizing the need for accessible language services for patients with limited English proficiency (LEP).

Problem: Despite legal mandates, medical interpreters remain underutilized, leading to adverse health outcomes, such as misunderstanding discharge instructions, medication use, and disease processes.

Methods: This DNP student-led evidence-based project explored barriers to medical interpreter utilization among healthcare professionals.

Intervention: A continuing education module was implemented by a DNP student at the University of San Francisco’s School of Nursing and Health …

Saving Lives: Naloxone Education And Training For Mental Health Re-Entry Program Providers, Remigus C. Nwaokoro

Doctor of Nursing Practice (DNP) Projects

Background Opioid overdose fatalities are a major public health concern with significant cost implications. Naloxone effectively reverses opioid overdose symptoms and prevents fatalities, yet many healthcare professionals lack the confidence and knowledge to administer it. This knowledge gap delays efforts to combat opioid overdose. Local Problem Opioid-related fatalities are among the leading causes of preventable deaths. In a northern California county, opioid overdose deaths increased by 20% from 2018 to 2021, with 48 fatalities in 2021. A needs assessment revealed that healthcare providers at a reentry program in that county had limited knowledge and confidence in using naloxone. Methods A …

Empowering Schools: Suicide Prevention Education For School Nurses, Navjot K. Singh

Doctor of Nursing Practice (DNP) Projects

Background: Suicide among adolescents and youth is a serious public health issue that requires immediate intervention to reduce ideation and death. The increasing rate of suicide among children and adolescents has a profound effect on families, friends, and the community.

Problem: Suicide among school aged children and adolescents can create significant challenges for school nurses, who are often the first contact for students who recognize suicidal ideation and mental health crises. This issue is particularly significant for the Alameda school nurses in California, as they play a significant role in identifying and supporting students in a crisis.

Methods: A …

Trauma-Informed Care: A Therapeutic Communication, Nicole Anne Leonce

Doctor of Nursing Practice (DNP) Projects

As medical providers, it is crucial to use therapeutic communication when building relationships with patients. Bias, stigma, and judgment often manifest through a provider’s body language and choice of words, exacerbating patient trauma and leading to health disparities. Trauma-informed care (TIC) addresses these issues by emphasizing respect, compassion, and empathy. TIC has been extensively studied in high-income regions such as Australia, Europe and the United States, but its application in low- and middle-income countries (LMIC) such as Kenya, is less understood. The aim of this study was to assess the knowledge, attitudes, and skills of nurses working in a rural …

Educating Community Health Workers: To Improve Maternal And Infant Health In Rural Areas, Katerina Markova Shikhvarg

Doctor of Nursing Practice (DNP) Projects

Background

Community Health Workers (CHW) are lay workers who are beneficial in reducing health disparities, in their communities. They provide culturally sensitive home visits and help coordinate resources for their patients. These visits have been shown to benefit the psychological, behavioral, and social health of their patients.

Local Problem

Despite the benefits of CHW involvement, they lack standardized training that could improve their services.

Methods

A partnership was entered by the University of San Francisco (USF) and an international philanthropic organization, focused on helping children. The partnership developed a certification program for CHWs in the Tulare County with USF Nurse …

Thinking Long-Term: Nursing Education On Long-Acting Injectable Antipsychotics, Arslan Amir Rashid

Doctor of Nursing Practice (DNP) Projects

Background Schizophrenia cases and their associated healthcare costs have drastically increased over time in the United States. Antipsychotic nonadherence is a primary contributor to the high rates of relapse and rehospitalization among adult patients with schizophrenia. The development of long-acting injectable antipsychotics (LAIs) has positively impacted medication adherence, however, this treatment modality is still underutilized in practice due to barriers, such as physician and patient negative attitudes toward LAIs and lack of education. Nurses hold a unique position to potentially change practice and address some of the barriers to LAI usage. Local Problem A Mental Health Rehabilitation Center in California …

Leading The School Team: A Professional Development Training On Eating Disorders For School Nurses, Michelle Samaniego Concepcion

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: The COVID-19 pandemic sharply increased the prevalence of eating disorders (EDs) among youth. These conditions are associated with high treatment costs and have the second-highest mortality rate among mental illnesses, surpassed only by opioid overdose, making them a critical concern for school communities.

Local Problem: A learning needs assessment conducted by the Alameda County School Nurses Network identified gaps in school nurses’ knowledge and confidence regarding ED identification, referral, and care coordination. Methods: In response, a Doctor of Nursing Practice (DNP) student scholar developed and implemented an evidence-based, virtual professional development training focused on EDs. The module was …

Abridging The 22-Item Sino-Nasal Outcome Test (Snot-22) In People With Cystic Fibrosis: Limiting Survey Burden, Haidee Chen, Jakob L. Fischer, Tristan D. Tibbe, Ahmad R. Sedaghat, Ethan J. Han, Jess C. Mace, Jeremiah A. Alt, Todd E. Bodner, Naweed I. Chowdhury, Yuqing A. Gao, Peter H. Hwang, Ashoke Khanwalkar, Adam J. Kimple, Jivianne T. Lee, Douglas A. Li, Multiple Additional Authors

Psychology Faculty Publications and Presentations

Chronic rhinosinusitis (CRS) affects quality-of-life (QoL) in people with cystic fibrosis (PwCF), despite the reduction in symptoms and symptom severity associated with cystic fibrosis transmembrane conductance regulator (CFTR) modulators [1]. To precisely assess sinus symptoms and treatment needs in the post-modulator period, patient-related QOL instruments should be revisited. The 22-item SinoNasal Outcome Test (SNOT-22) measures CRS burden and QoL. Abbreviated surveys can lessen respondent fatigue. Item response theory (IRT) can help refine surveys by identifying the most informative survey items while maintaining reliability [2–4]. IRT assesses item discrimination (ɑ), the ability to differentiate trait levels, and difficulty (β), which defines …

Sickle Cell Mice Exhibit Elevated Plasma Bilirubin And Altered Intracranial Cerebral Blood Velocities That Are Exacerbated By Hypoxia-Reoxygenation, Francisco J. Nunez, Ashraf M. Mohieldin, Amy Y. Pan, Sean P. Palecek, Rahima Zennadi, Ramani Ramchandran, Kevin R. Rarick, Surya M. Nauli

Pharmacy Faculty Articles and Research

Sickle cell disease (SCD) is a genetic disorder characterized by sickle red blood cells (RBCs). Sickle RBCs cause cerebral vasculopathies including vaso-occlusive events, leading to ischemia-reperfusion injury and hypoxic tissue environment. To date, the physiological blood flow velocities in cerebral vessels of preclinical SCD models has not been evaluated under hypoxic-reoxygenation. In our study, we used transcranial ultrasound techniques to measure abnormal blood flow velocities in the internal carotid (ICA) and middle cerebral arteries (MCA) of transgenic sickle cell mice (SS) challenged with hypoxia-reoxygenation. Our study showed that SS mice that underwent hypoxic stress exhibited lower relative mean velocities in …

Community Health Workers’ Lived Experience Of Using Videoconferencing With Community Members, Valdora Lejune Avery

Walden Dissertations and Doctoral Studies

Community health workers in the United States faced significant challenges in conducting in-person community practice during the COVID-19 pandemic, which adversely affected their communication, training, and service delivery outcomes. Videoconferencing enabled workers to connect with underserved populations for individual and community crisis response. The purpose of this study was to describe the lived experiences of community health workers in the Rural Community Health Worker Network (RCHWN) regarding the use of videoconferencing among community members in practice and how members in RCHWN perceive the availability of videoconferencing devices to communicate in the community. Transcendental phenomenology provided the conceptual framework and research …

Divergent Dna Methylation Dynamics In Marsupial And Eutherian Embryos, Bryony J. Leeke, Wazeer Varsally, Sugako Ogushi, Jasmin Zohren, Sergio Menchero, Aurélien Courtois, Daniel M. Snell, Aurélie Teissandier, Obah Ojarikre, John L. Vandeberg

School of Medicine Publications

Based on seminal work in placental species (eutherians)1,2,3,4,5,6,7,8,9,10, a paradigm of mammalian development has emerged wherein the genome-wide erasure of parental DNA methylation is required for embryogenesis. Whether such DNA methylation reprogramming is, in fact, conserved in other mammals is unknown. Here, to resolve this point, we generated base-resolution DNA methylation maps in gametes, embryos and adult tissues of a marsupial, the opossum Monodelphis domestica, revealing variations from the eutherian-derived model. The difference in DNA methylation level between oocytes …

Mapping Pain Management In Maine Participant Flyer, Ling Cao

Maine Pain Registry

Flyer calling for participation in UNE project Mapping Pain Management in Maine.

Peripheral Neuroimmune Mechanisms Of Chronic Back Pain, Aleyah Esther Goins

Biomedical Sciences ETDs

Chronic back pain (CBP) affects 1 in 10 people worldwide, reducing mobility, productivity, and quality of life. Despite its prevalence, non-addictive treatments remain limited due to an incomplete understanding of chronic pain mechanisms. This dissertation examines peripheral neuroimmune interactions in CBP using a urokinase-type plasminogen activator (uPA)-induced mouse model (uPA-CBP). uPA, a pro-inflammatory serine protease, was injected into the L2/L3 lumbar spinous ligament, inducing prolonged mechanical and cold hypersensitivity. Flow cytometry of dorsal root ganglia (DRG) showed increased CD45+CD11b+ myeloid cells in males and CD45+CD3+CD4+ lymphocytes in females. DRG neurons from male uPA-CBP mice exhibited heightened action potential firing. Pharmacological …

St6galnac-I Regulates Tumor Cell Sialylation Via Nectin2/Muc5ac-Mediated Immunosuppression And Angiogenesis In Non-Small Cell Lung Cancer, Muthamil Iniyan Appadurai, Sanjib Chaudhary, Ashu Shah, Gopalakrishnan Natarajan, Zahraa W. Alsafwani, Parvez Khan, Dhananjay D. Shinde, Subodh M. Lele, Lynette M. Smith, Mohd W. Nasser, Surinder K. Batra, Apar Kishor Ganti, Imayavaramban Lakshmanan

Journal Articles: Biochemistry & Molecular Biology

Glycosylation controls immune evasion, tumor progression, and metastasis. However, how tumor cell sialylation regulates immune evasion remains poorly characterized. ST6GalNAc-I, a sialyltransferase that conjugates sialic acid to the glycans in glycoproteins, was overexpressed in an aggressive-type KPA (KrasG12D/+ Trp53R172H/+ Ad-Cre) lung adenocarcinoma (LUAD) model and patient samples. Proteomic and biochemical analysis indicated that ST6GalNAc-I mediated NECTIN2 sialylation in LUAD cells. ST6GalNAc-I-deficient tumor cells cocultured with T cells were more susceptible to T cell-mediated tumor cell killing, indicating a key role for NECTIN2 in T cell dysfunction. Mice injected with St6galnac-I-knockdown syngeneic cells showed reduced lung tumor incidence and Nectin2/Tigit-associated immunosuppression. …

Finite Element Analysis Of Stress Distribution In Unilateral Distal Extension Partial Dentures: A Comparison Of Four Attachment Designs, Maha Nagy Kamal, Haitham Amr, Abdallah Shokry

Dentistry

No abstract provided.

Hypersensitivity Assessment Of Non-Carious Cervical Lesions After Treatment With Different Desensitizing Protocols: A Randomized Clinical Trial, Mohamed Fouad Haridy, Hoda Omar Fouda, Mohamed Tarek Heiba, Ahmed Fawzy Aboelezz, Amr Faisal

Dentistry

No abstract provided.

Implementation Of Standardized Mobilization Assessment Tools To Promote Patient Ambulation At Medical Surgical Units, Yunxuan Su

Master's Projects and Capstones

The objective is the cardiac medical surgical unit in a hospital in San Francisco not meeting the ambulation goal. This study aims to provide a context for enhancing patients' ambulation levels by using standardized assessment tools Prior Level of Functional (PLOF) and Current Level of Functional (CLOF) in daily practice, thereby strengthening care plans and shortening hospital stay. The methods are microsystem evaluation, SWOT analysis, causal analysis, cost-benefit analysis, Gantt chart, pre & post survey, and flyer education for staff to guide the project implementation. The results are that after the intervention, the compliance of PLOF and CLOF documentation and …

Healthy Bytes: Enhancing Health Literacy In Older Adults Through Technology Services, Gianna M. Susa

Master's Projects and Capstones

This quality improvement project aimed to enhance health literacy among senior residents through interactive technology workshops. Aim During a twelve-week period from January 22, 2025, to March 31, 2025, this project aimed to increase technology proficiency among senior residents from 0% to 75%. Methods A 5P Microsystem assessment and preliminary survey revealed residents' interest in technology workshops. Based on this feedback technology workshops were implemented once a week for a twelve-week period. Each session provided one on one support to help residents navigate online health portals, communicate with providers, and interpret health information. A SWOT analysis and Fishbone analysis were …

Optimizing Pediatric Peri-Anesthesia Care: A Donna Wright Nursing Competency Framework, Marisa Elise Gauna

Master's Projects and Capstones

Problem: Preventable hospital errors are often associated with inconsistent nursing competency, especially in high-acuity areas such as pediatric peri-anesthesia units. Traditional evaluation tools like checklists have limited effectiveness, as they frequently fail to engage staff or adapt to changing clinical demands (Wright, 2005). Context: At a Bay Area children’s hospital, baseline data from August 2024 revealed that only 65% of peri-anesthesia nurses reported feeling “very” or “somewhat” comfortable with key clinical skills. To address this, a quality improvement project was launched with the goal of increasing comfort levels by 15% using the Donna Wright Competency Model, which emphasizes staff engagement, …

From Silence To Clarity: Enhancing Surgical Icu Communication Through Personalized Whiteboards, Braeden R. Woods

Master's Projects and Capstones

Objective: Critically ill patients in the intensive care unit (ICU) are at heightened risk of dehumanization due to sedation, mechanical ventilation, and prolonged hospitalization. This quality improvement (QI) initiative aimed to enhance patient-centered communication in the Surgical Intensive Care Unit (SICU) at a Northern California academic quaternary care hospital through the implementation of personalized communication whiteboards. Aim: To develop a personalized communication board that, once implemented, would achieve at least 75% utilization in patient rooms by May 2025. Methods: Guided by a Plan-Do-Study-Act (PDSA) framework, surveys were conducted with SICU patients, families, and staff to gather stakeholder input and inform …

Movement Disorders In Relapsing And Progressive Ms: A Comprehensive Prospective Evaluation Of A Large Real-Life Cohort, Hannah Kelly, Rongyi Sun, Mohamed Elkasaby, Alexander Wang, Hesham Abboud

Faculty Scholarship

Background: Recent studies suggest that movement disorders are common in early MS. However, the frequency and clinical characteristics of movement disorders at all stages of MS remain unknown. Objectives: To evaluate the frequency, clinical characteristics, and anatomical generators of movement disorders in relapsing and progressive MS. Methods: We conducted a prospective study of adult MS patients from 2016 to 2022 at a neuroimmunology clinic. Patients were evaluated for demyelination-related movement disorders via a survey and focused examination. We classified movement disorders based on phenomenology and identified anatomic correlates according to lesion locations and relation to relapses. Findings were compared between …

High Ligation Versus Floor Repair For Adolescent Inguinal Hernias: A Matched Comparison Of Recurrence And Complications, Katelyn Ward, Melanie Ermler, Elizabeth Theirl, Ryan Davis, Huong Tran, Begum Akay, Anthony Stallion, Nathan Novotny, Pavan Brahmamdam

Conference Presentation Abstracts

Background: The optimal surgical approach for inguinal hernias in adolescent patients remains an area of debate. While high ligation (HL) for indirect hernias is standard in younger children, floor repair (FR), usually with mesh, is preferred in adults due to the higher incidence of direct hernias and weakness of the abdominal wall. This study compares recurrence rates and perioperative complications between HL and FR in adolescent patients.

Methods: A retrospective study was performed on 10-17 year old patients who underwent inguinal hernia repair within a single hospital system between 7/2013 and 6/2023. Operations were performed by pediatric surgeons, pediatric urologists, …

Diagnostic Considerations For Gastrointestinal Stromal Tumors With Altered Immunophenotype Following Imatinib Treatment: A Case Report And Literature Review, Jihuan Chen, Liz M. Yang, Jonathan Somma, Yujun Gan, Zengying Wu, Zhiyan Fu

School of Medicine Faculty Publications

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors in the gastrointestinal tract and have a high rate of recurrence and metastasis. Using an immunohistochemical (IHC) panel including KIT/CD117 and DOG1 allows for accurate diagnosis in more than 98% of cases. However, after tyrosine kinase inhibitor treatment, some cases can exhibit histologic dedifferentiation and loss of KIT/CD117 and DOG1 expression that may cause difficulty in confirming recurrent or persistent disease. We present such a case of an Imatinib treated, CD117 and DOG1 dual negative, metastatic GIST to the liver in a 55-year-old female which required molecular analysis to confirm …

Assessments Of Social Vulnerability On Laryngeal Cancer Treatment & Prognosis In The Us: Epidemiology, David J. Fei-Zhang, Camaren M. Cuenca, Angela D. Haskins, Andrew P. Stein, David G. Lott, Urjeet A. Patel, Stephanie S. Smith, Amy L. Dimachkieh, Nosayaba Osazuwa-Peters, Jill N. D’Souza, Anthony M. Sheyn, Jeffrey C. Rastatter, Daniel C. Chelius

School of Medicine Faculty Publications

Background: Previous social determinants of health (SDoH) studies on laryngeal cancer (LC) have assessed individual factors of socioeconomic status and race/ethnicity but seldom investigate a wider breadth of SDoH-factors for their effects in the real-world. This study aims to delineate how a wider array of SDoH-vulnerabilities interactively associates with LC-disparities. Methods: This retrospective cohort study assessed 74,495 LC-patients between 1975 and 2017 from the Surveillance-Epidemiology-End Results (SEER) database using the Social Vulnerability Index (SVI) from the CDC, total SDoH-vulnerability from 15 SDoH variables across specific vulnerabilities of socioeconomic status, minority-language status, household composition, and infrastructure/housing and transportation, which were measured …