Medicine and Health Sciences Commons^™

Interactions Between The Deaf Community And Healthcare, Sarah E. Mcfadden

Honors Theses

Background.

This study investigates the issues regarding interactions between the Deaf community and healthcare, focusing on communication barriers, negative experiences, and inaccessibility to health information. Despite the Americans with Disabilities Act (ADA) guidelines requiring healthcare offices to provide interpreters, many health care professionals (HCPs) do not comply for various reasons. The alternatives to an interpreter create gaps in conditions, treatment plans, or post-appointment care.

Methods.

This study involved a review of existing literature and interviews with Deaf individuals and HCPs, including a physician, nurse practitioner, dentist, and registered nurse. The interviewed HCPs work in various settings.

Results. …

Effects Of Acute Exercise On Cognition: Consideration Of Potential Moderators, Mary G. Jackson, Lucy Wilson, Mara Liston, Elizabeth Gaines, Mckenzie Cotten, Reese Carwile

Honors Theses

The present thesis aims to determine the effects, if any, of six potential moderators on the effects of acute moderate-intensity exercise on cognitive functioning. The modes of exercise undertaken by the participants included treadmill (Experiment 1) and stationary bike (Experiment 2) exercise. Participants in each experiment either exercised or rested for twenty minutes and then participated in either a memory recall task or cognitive functioning (“Stroop”) task. The bouts of either exercise or rest on the stationary bike were followed by a rest period during which the participant would be exposed to either standard air oxygen levels (normoxia) or hypoxic …

A Chemical Investigation: Monitoring Cannabidiol Concentration In The Presence Of Ionic Liquids, Hannah E. Mabie

Honors Theses

Cannabidiol (CBD) is a non-psychoactive cannabinoid from the plant, Cannabis sativa. CBD’s structure degrades over time and other minor cannabinoids are formed when in contact with organic solvents. This is a growing area of interest due to the Agriculture Improvement Act (The Farm Bill) in 2018, which led to growing marijuana consumption and increased CBD markets. Monitoring the concentration of CBD can be used by forensic investigators and researchers to determine how CBD interacts with solvents, like ionic liquids. In this study, different ionic liquids were used to determine the best route of solubility and if choline based ionic liquids …

A Modified Sir Model Used To Investigate The Relationship Between Congenital And Adult Syphilis, Kaleesta R. Waysman

Honors Thesis

A complex SIR model integrating the relationship between adult and congenital syphilis was developed. The goal of the project was to determine the specific population(s) or control strategies that should be enforced, altered, or removed to decrease the number of children experiencing clinical sequelae due to congenital syphilis. Early clinical sequelae include hydrops fetalis, preterm birth, central nervous system infection, hepatosplenomegaly, hyperbilirubinemia, cholestasis, hemolytic anemia, snuffles, osteochondritis, and lesions or rashes in the palms and soles. Late clinical sequelae include interstitial keratitis, hearing loss, Hutchinson teeth, saber shins, Clutton joints, mulberry molars, and saddle nose. After implementing real-world data into …

Yoga Therapy For Psychological Safety In Healthcare Staff, Kristen Fabiszewski

Doctoral Projects

Establishing a culture of psychological safety is a necessary foundation for creating a High Reliability Organization. Healthcare professionals must practice emotional self-regulation to maintain equanimity and facilitate positive communications with their colleagues. This can be exceptionally challenging when increasing numbers of healthcare professionals are experiencing burnout. Using the framework of Polyvagal Theory, yoga practices have been demonstrated to support emotional self-regulation and reduce symptoms of burnout. The purpose of this project was to implement yoga therapy to increase the perception of psychological safety in healthcare staff. Veterans Affairs Long Beach Healthcare System (VALBHS) staff invited to attend one 45minute yoga …

Healthcare Experiences And Pain Dismissal By Healthcare Professionals, Amanda Warren

Honors Theses

Background. Pain dismissal by healthcare professionals has gained recent attention in popular culture as people have come forward to discuss their own experiences with this issue. Pain dismissal is prevalent within the healthcare system, and college-aged young adults may be particularly vulnerable to experiencing pain dismissal because of their age. College students may also be influenced by societal factors that may affect their attitudes towards seeking help and advocating for themselves during healthcare visits. There is limited research on college students' attitudes and behaviors on seeking help after experiencing pain dismissal by a healthcare provider. This study aims to 1) …

Physical Therapists’ Confidence With Patients Expressing Suicidal Thoughts Or Behaviors, Amber J. Schwanebeck

Honors Thesis

This study was conducted as part of an undergraduate honors thesis, and it explored how physical therapists feel and manage situations involving patients experiencing suicidal thoughts and behaviors. Assessed via survey, the researchers gathered responses from practicing physical therapists, examining demographic information, confidence levels in managing suicidal situations, and a qualitative question about their perceived role in suicide prevention. Key findings revealed that most physical therapists did not routinely discuss suicide with patients. Despite this, many reported feeling confident in identifying patients with suicidal ideations, even in the absence of training. Individuals who received training after earning their physical therapy …

Revenue Cycle Management: Audit Of A Primary Care Clinic, Strategy, & Future Improvements, Izaak Colgrove

Capstone: Master of Health Administration

Healthcare practices that offer primary care, an essential service, are dependent upon financial liquidity for survival. This project evaluated the financial wellbeing of a local primary care clinic through the process of revenue cycle evaluation. The clinic has transitioned from the startup phase into a period of growth and as the clinic scales up, it faces new challenges related to revenue cycle management (RCM) and overall operational efficiency.

For any practice, the process of evaluating the revenue cycle, formally known as Revenue Cycle Management (RCM), is critical to help ensure financial stability. Central to managing the revenue cycle is the …

Evaluation Of The Usage And Effectiveness Of The Gross Anatomy Osteology E-Learning Module, Conor Young

Theses & Dissertations

Supplementary online learning modalities have reached near ubiquity in graduate health sciences education, yet evidence about their effectiveness remains mixed. The Department of Genetics, Cell Biology, and Anatomy at UNMC recently introduced their own bespoke electronic study platform called the Osteology e-Learning Module to aid gross anatomy students in the study of osteology. To assess its effectiveness, osteology and whole gross lab practical exam scores were compared in four different content units across three school year cohorts of graduate students in the same gross anatomy class. A survey was also distributed to one cohort to capture subjective information about the …

From Vector To Consequence: Integrating Vector Surveillance, Environmental Drivers, And Public Health Impact Into Lyme Disease Risk Management, Kathleen E. Angell

Theses & Dissertations

Lyme disease is the most common vector-borne disease in North America. This dissertation examines (1) how crowd-sourced compares to active vector surveillance and whether they are associated with Lyme disease, (2) how ecological factors relate to tick abundance and whether they can predict high disease years, and (3) estimated health and economic burden of Lyme disease and savings when interventions are applied. Tick abundance data from active and passive surveillance were compared and tested for association with Lyme disease in the first aim. We found differences in tick life-stage, species, and seasonality. Tick observations were positively correlated with Lyme disease. …

Cholestasis And Fluid Flow Are Biomechanic Regulators Of Cholangiocarcinoma Progression, Andrew Oleksijew

Theses & Dissertations

Cholestasis, altered or absent bile flow, is associated with poor survival in patients with cholangiocarcinoma, an aggressive cancer of the biliary epithelium. Changes in bile flow often result in stricture or obstruction. Experimental cholestasis promoted tumor growth and progression. However, studies are needed that directly assess the mechanical interaction between bile flow, or bile shear stress, and cholangiocarcinoma signaling. We hypothesized that cholestasis and absent bile shear stress activated cancer signaling and increased aggressive cellular behaviors such as proliferation and migration. Fluid shear stress approximating bile flow was applied by orbital culture plate method and compared to identical static culture …

Validating The Ability Of Iag933 To Block The Interaction Of Yap1 And Tead In Ovarian Cancer Cells, Alex Sage

Theses & Dissertations

Ovarian cancer is the most common and deadliest gynecologic malignancy. Approximately 40% of ovarian cancer patients exhibit chemoresistance after receiving initial treatment in the form of neoadjuvant chemotherapy or interval debulking surgery, of which YAP1 (Yes-associated protein 1) has been implicated in enhancing the resistance of ovarian cancer to Cisplatin and Taxol.^1,2. This highlights the need to develop new therapeutic strategies that target the Hippo pathway to overcome resistance to traditional therapies.

YAP1 is a protein that acts as a transcription coregulator, promoting the transcription of genes involved in cellular proliferation and suppressing apoptotic genes. It is a …

Allogeneic Chimeric Antigen Receptor T-Cell Products Cemacabtagene Ansegedleucel/Allo-501 In Relapsed/Refractory Large B-Cell Lymphoma: Phase I Experience From The Alpha2/Alpha Clinical Studies, Frederick L Locke, Javier L Munoz, Michael T Tees, Lazaros J Lekakis, Sven De Vos, Rajneesh Nath, Don A Stevens, Shahbaz A Malik, Geoffrey P Shouse, Mehdi Hamadani, Olalekan O Oluwole, Miguel-Angel Perales, David B Miklos, Paul W Fisher, Amy Feng, Lynn Navale, John B Le Gall, Sattva S Neelapu

Faculty, Staff and Student Publications

Purpose: Off-the-shelf, allogeneic CD19 chimeric antigen receptor (CAR) T-cell products may improve access to treatment versus autologous ones. We report the phase I experience of the allogeneic CD19 CAR T-cell product cemacabtagene ansegedleucel (cema-cel) and its predecessor, ALLO-501, in CD19 CAR T-naïve patients with relapsed/refractory large B-cell lymphoma (R/R LBCL).

Methods: In the ALPHA2/ALPHA studies, the safety and efficacy of allogeneic CD19 CAR T cells were evaluated in CD19 CAR T treatment-naïve patients with R/R LBCL. Patients received healthy donor-derived, human leukocyte antigen-unmatched cema-cel/ALLO-501 following a 3-day lymphodepletion regimen of fludarabine (30 mg/m2 once daily), cyclophosphamide (300 or 500 mg/m2 …

Knowledge, Skills, And Barriers To Palliative Care Referrals By Oncology Providers, Audra Meador, Bailey Waldron

Doctor of Nursing Practice Projects: College of Nursing

Palliative Care is an evidence based and integrative aspect of cancer care that has demonstrated improved quality of life and diminished symptomology, however, barriers to referrals exist. With the growing interest in and demand for specialized healthcare services, more research on integration and referral practices surrounding palliative care is necessary. This study aimed to explore the knowledge, attitudes, perceptions, and barriers to referring cancer patients to outpatient palliative care at a teaching and research hospital. In one cancer center, 50 physicians, Advance Practice Providers, and nurse case managers responded to an electronic survey regarding interest and support for palliative care …

Multi-Parametric Quantitative Evaluation Of Murine Cervical Remodeling During Pregnancy And Postpartum, Yan Yan, Jose Galaz, Joshua Marvald, Tanzy Love, Steven Yellon, Nardhy Gomez-Lopez, Mohammad Mehrmohammadi

2020-Current year OA Pubs

Cervical remodeling during pregnancy is a critical process that, if untimely, can lead to complications such as preterm birth (PTB). This study introduces a novel multi-parametric approach combining non-invasive imaging modalities to quantify cervical tissue changes during pregnancy and postpartum in a murine model. By integrating ultrasound-based measurements of cervical length, photoacoustic imaging of the collagen-to-water ratio, and elastography for tissue elasticity alongside histological assessments, this method provides a comprehensive evaluation of cervical remodeling. The findings reveal that combining these parameters significantly improves the accuracy of gestational age prediction compared to individual measurements, with a tri-parametric model achieving 85.3% prediction …

Multilevel Considerations For Youth Attention-Deficit/Hyperactivity Disorder Prognosis And Management: Examining The Relationship Between Health Care Factors And Familial Factors In Families Of Children And Adolescents With Adhd, Carey A. Wheelhouse

Theses & Dissertations

Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder impacting up to 10% of U.S. youth, and is associated with several negative social, health, and academic or occupational outcomes. Risk and prognostic factors for ADHD are multifactorial, and the management of youth ADHD is multimodal. Familial environments are one prognostic factor for ADHD, with family resilience being positively associated with youth ADHD prognosis. Researchers exploring multilevel interventions for the management of youth ADHD have proposed health care systems as a setting for interventions targeting family resilience, however little research examines the relationship between health care system factors and family factors in families …

Schistosoma Haematobium Infection In Ethiopian Children: Evaluating Praziquantel Efficacy, Nutritional Effects, And Diagnosis Using Flukecatcher, Louis Fok

Theses & Dissertations

Urogenital schistosomiasis continues to impact the wellbeing of hundreds of millions of people worldwide and remains a significant public health challenge across Ethiopia. Despite existing knowledge on the disease, there remain significant unanswered questions with regard to its treatment and diagnosis. This dissertation evaluated the efficacy of praziquantel at treating urogenital schistosomiasis, improving nutritional parameters among children and the performance of FlukeCatcher at detecting and determining the intensity of infection. In effecting this, a total of 977 children aged 5 through 15 from the Afar and Gambella regions of Ethiopia were screened for S. haematobium infection using urine filtration microscopy …

Navigating Lipid Nanoparticle Design: From Microfluidic Optimization For Rna Delivery In Pancreatic Cancer To Extended-Release Formulations For Hiv-1 Therapy., Farhana Islam

Theses & Dissertations

Lipid nanoparticles (LNPs) have emerged as a powerful platform for the delivery of RNA and small-molecule therapeutics, enabling improved drug stability, biodistribution, and cellular uptake. This study explores the formulation and optimization of LNPs for two distinct therapeutic applications: (1) mRNA-based therapy for pancreatic cancer (PC) and (2) extended-action fostemsavir (FTR) delivery for HIV-1 treatment. For PC therapy, a library of 48 mRNA-LNP formulations was developed for intraperitoneal (IP) administration in an orthotopic pancreatic tumor mouse model. Using microfluidic assembly, LNPs were engineered with varying lipid compositions and characterized based on size, zeta potential, and cytotoxicity. Biodistribution and mRNA expression …

Evaluating The Therapeutic Potential Of Geranylgeranyl Diphosphate Synthase Inhibitor, Ram2061, In Myeloma Bone Disease, Molly Muehlebach

Theses & Dissertations

Multiple myeloma (MM) is a hematological malignancy of the plasma cells which often results in lytic bone disease. Myeloma bone disease (MBD), characterized by diffuse osteopenia, bone lesions, or pathological fracture, results from MM mediated promotion of osteoclast resorption and dual inhibition of bone formation, drastically reducing bone strength and integrity. Development of MBD is known to significantly impact patient quality of life and increase risk of mortality. Considering that up to 80-95% of MM patients are expected to develop bone disease post-initial MM diagnosis, there is a significant need within this population for therapeutics which address both MM disease …

Letter To The Editor On “Timing Of Puberty Suppression In Transgender Adolescents And Sexual Functioning After Vaginoplasty (Van Der Meulen Et Al., 2024)”, Alison Clayton, Jilles Smids, Kathleen Mcdeavitt

Faculty, Staff and Students Publications

No abstract provided.

New First Trimester Circulating Angiogenic Biomarkers In Predicting Early-Onset And Late-Onset Fetal Growth Restriction: A Case-Control Study, Xiaoyi Bai, Wei Li, Wenjing Ding, Oi Ka Chan, Maran Bo Wah Leung, So Ling Lau, Daljit Singh Sahota, Chi Chiu Wang, Tak Yeung Leung

Faculty, Staff and Students Publications

Background: First trimester prediction of fetal growth restriction (FGR) remain suboptimal. We aimed to search for new circulating angiogenic biomarkers for improvement.

Methods: This case-control study compared 73 singleton pregnancies with early or late-onset FGR based on Delphi consensus and 73 matched normal controls. Their maternal serum samples stored during 11-13 weeks were retrieved for measurement of 36 angiogenic biomarkers by MILLIPLEX® human angiogenesis magnetic bead panels. Those biomarkers that showed significant differences between the study groups were further analysed with receiver operating characteristic (ROC) curve.

Results: In the early-onset FGR group, log10MoM of soluble neuropilin-1 (sNRP-1: 0.08 ± 0.11 …

Let-7 Restrains An Epigenetic Circuit In At2 Cells To Prevent Fibrogenic Intermediates In Pulmonary Fibrosis, Matthew J Seasock, Md Shafiquzzaman, Maria E Ruiz-Echartea, Rupa S Kanchi, Brandon T Tran, Lukas M Simon, Matthew D Meyer, Phillip A Erice, Shivani L Lotlikar, Stephanie C Wenlock, Scott A Ochsner, Anton Enright, Alex F Carisey, Freddy Romero, Ivan O Rosas, Katherine Y King, Neil J Mckenna, Cristian Coarfa, Antony Rodriguez

Faculty, Staff and Students Publications

MicroRNA-mediated post-transcriptional regulation of lung alveolar type 2 (AT2) and AT1 cell differentiation remains understudied. Here, we demonstrate that the let-7 miRNA family plays a homeostatic role in AT2 quiescence by preventing the uncontrolled accumulation of AT2 transitional cells and promoting AT1 differentiation. Using mouse and organoid models, we show that genetic ablation of let-7a1/let-7f1/let-7d cluster (let-7afd) in AT2 cells prevents AT1 differentiation and leads to KRT8 transitional cell accumulation in progressive pulmonary fibrosis. Integration of AGO2-eCLIP with RNA-sequencing identified direct let-7 targets within an oncogene feed-forward regulatory network, including BACH1/EZH2/MYC, which drives an aberrant fibrotic cascade. Additional CUT&RUN-sequencing analyses …

A Scoping Review Of Remote And Unsupervised Digital Cognitive Assessments In Preclinical Alzheimer's Disease, Sarah E Polk, Fredrik Öhman, Jason Hassenstab, Alexandra König, Kathryn V Papp, Michael Schöll, David Berron

2020-Current year OA Pubs

Characterizing subtle cognitive changes in preclinical Alzheimer's disease (AD) is difficult using traditional neuropsychological assessments. Remote and unsupervised digital assessments can improve scalability, measurement reliability, and ecological validity, enabling the capture of subtle changes. We evaluate such tools for use in preclinical AD, or cognitively unimpaired individuals with abnormal levels of AD pathology. We screened 1904 reports for studies remotely assessing cognition in preclinical AD samples. Twenty-three tools were identified, and their usability, reliability, and validity, including construct and criterion validity based on in-person neuropsychological and Aβ/tau measures, was reported. We present a necessary update to a rapidly evolving field, …

Recombinant Interleukin-7 Treatment Of Refractory Refractory Mycobacterium Avium Complexlung Disease (Impulse-7): A Pilot Phase Ii, Single-Center, Randomized, Clinical Trial, Carlos Mejia-Chew, Andrej Spec, Andrew H Walton, Alina Ulezko Antonova, Alexandra Dram, Sanjeev Bhalla, Marco Colonna, Michel Morre, Richard Hotchkiss

2020-Current year OA Pubs

BACKGROUND: Nontuberculous mycobacteria disease is an emerging opportunistic infection that is often refractory to therapy. Interleukin 7 (IL-7) is a pleiotropic cytokine with broad-ranging effects that enhance immunity and augment monocyte/macrophage anti-

OBJECTIVES: This study evaluated IL-7 in patients with refractory

DESIGN: Prospective, single-center, randomized, study of IL-7 in patients with refractory MAC-LD.

METHODS: Randomization (two sets of 4 weekly IL-7 injections) was stratified based on the presence of pulmonary cavities. The primary outcome was sputum culture conversion to negative within 6 months. Exploratory outcomes included investigation of potential molecular mechanisms of immunosuppression via single-cell RNA sequencing (scRNA-seq).

RESULTS: Of …

Outcomes Of 1,021 Consecutive Cases Utilizing A Triple Tapered Collared Stem And Automated Broaching System, Ravi R Agrawal, Maria T Schwabe, Helena F Barber, Ethan Blum, Joseph T Gibian, Ryan M Nunley, Ilya Bendich

2020-Current year OA Pubs

No abstract provided.

Optimizing Peptide Nucleic Acid-Based Pretargeting For Enhanced Targeted Radionuclide Therapy, Mohamed Altai, Ábel Nagy, Pauline Granit, Wahed Zedan, Myriam Cerezo-Magaña, Julie Park, Katharina Lückerath, Susanne Geres, Marie Sydoff, Daniel L J Thorek, Kristina Westerlund, David Ulmert, Amelie Eriksson Karlström

2020-Current year OA Pubs

Radiolabeled targeting agents have emerged as valuable tools for the treatment of disseminated cancer. Monoclonal antibodies (mAbs) are widely employed as carriers for diagnostic and therapeutic radionuclides due to their exceptional specificity and affinity. However, their prolonged circulatory half-life can diminish diagnostic efficacy and increase radiation exposure to non-target tissues in therapeutic applications, resulting in dose-limiting toxicities. To overcome this limitation, pretargeting technologies emerge as promising strategies to enhance tumor-to-background ratio and reduce radiation exposure of healthy tissues. Our previous work introduced a pretargeting concept leveraging the specific interaction between two peptide nucleic acid (PNA) probes, HP1 and HP2, as …

Molecular Basis Of Trpv3 Channel Blockade By Intracellular Polyamines, Jingying Zhang, Peng Yuan, Colin G Nichols, Grigory Maksaev

2020-Current year OA Pubs

ThermoTRPV1-4 channels are involved in the regulation of multiple physiological processes, including thermo- and pain perception, thermoregulation, itch, and nociception and therefore tight control of their activity is a critical requirement for correct perception of noxious stimuli and pain. We previously reported a voltage-dependent inhibition of TRPV1-4 channels by intracellular polyamines that could be explained by high affinity spermine binding in, and passage through, the permeation path. Here, using electrophysiology and cryo-electron microscopy, we elucidate molecular details of TRPV3 blockade by endogenous spermine and its analog NASPM. We identify a high-affinity polyamine interaction site at the intracellular side of the …

A Virtual Wellness Program To Enhance Well-Being For Pediatric Oncology Staff During The Covid-19 Pandemic, Karen Moody, Maria Swartz, Zachary Gresham, Martha Askins, Laura Cahalan, Pavilia Francis, Christine Geistkemper, Amy Heaton, Ruitao Lin, Melissa Melo, Alakh Rajan, Madeline Smith, Priti Tewari, Keyana R. Williams, Cheng-Han Yang, Rhonda Robert

Advances in Cancer Education and Quality Improvement

In response to the COVID-19 global health crisis and mandated social isolation, Pediatric leadership at MD Anderson Children’s Cancer Hospital was concerned for the psychological impact on its workforce and encouraged wellness programming. A grassroots wellness taskforce was assembled for the Division of Pediatrics. The task force’s primary mission was to promote the well-being of clinicians and non-clinical staff members through a broadly accessible, sustainable, and effective virtual wellness program. Guided by the Stanford Model for Professional Fulfillment, a virtual program entitled, “Weekly Wellness Webex” for Pediatrics staff was launched. Weekly Wellness Webex is a 1-hour live-streamed program with varied …

Reducing The Percentage Of Intubation Time On Continuous Infusion Midazolam, Arsemen Brown, Emily Highsmith, Michelle Horng

Advances in Cancer Education and Quality Improvement

This quality improvement study was conducted at a comprehensive cancer care center with the aim to decrease the percentage of on continuous infusion (CI) midazolam by 30% by May 5, 2023. The pre-intervention and post-intervention data collection phases occurred from January 1, 2022, to October 31, 2022, and March 7, 2023, to May 5, 2023, respectively. Sedation was assessed utilizing the Richmond Agitation and Sedation Scale (RASS), and delirium was assessed utilizing the Intensive Care Delirium Screening Checklist (ICDSC). A sedation pathway and associated educational materials were developed by a multidisciplinary team and frontline staff. Interventions in the sedation pathway …

Impact Of A Goal Of Care Communication Training Program For Oncology Clinical Staff, Gary Martinez

Advances in Cancer Education and Quality Improvement

Abstract

Goals of care (GoC) refers to medical care decisions made by patients and families that are consistent with their personal values and preference choices. However, the oncology health care system does not always align with the patient’s GoC values and preferences. Clinical experts suggest formalized GoC education to improve this practice gap. Accordingly, MD Anderson Cancer Center implemented GoC training for front-line clinical staff using the evidence-based COMFORT Model to enhance the participants’ ability to have connected GoC conversations and enhance their comfort levels in responding to patients’ emotions. Our institution’s GoC education team compared the pretest and posttest …