Medicine and Health Sciences Commons^™

Implementation Of Vanderbilt Acuity Tool In The Emergency Department, Ogemdi Millicent Asaa

Walden Dissertations and Doctoral Studies

No abstract provided.

Co-Occurring Clonal Hematopoiesis Exhibits Strong Selection And High Leukemia Risk, Kara M Barnao, Aubrey K Hubbard, Irenaeus C C Chan, Weiyin Zhou, Yasminka A Jakubek, Giulio Genovese, Wendy S W Wong, Rebecca L Kelly, Corey D Young, Derek W Brown, Wen-Yi Huang, Neal D Freedman, Kristine Jones, Amy Hutchinson, Belynda Hicks, Duc Tran, Donna Arnett, Kathleen C Barnes, Joshua C Bis, Eric Boerwinkle, Jennifer A Brody, April P Carson, Daniel I Chasman, Michael H Cho, Pinkal Desai, Margaret F Doyle, Myriam Fornage, Xiuqing Guo, Nancy Heard-Costa, Marguerite Ryan Irvin, Andrew D Johnson, Sharon L R Kardia, Charles Kooperberg, Daniel Levy, Joshua P Lewis, Yun Li, Ruth J F Loos, Taralynn M Mack, Rasika A Mathias, Braxton D Mitchell, Kari E North, Nathan Pankratz, Patricia A Peyser, Michael H Preuss, Bruce M Psaty, Laura M Raffield, Susan Redline, Stephen S Rich, Jerome I Rotter, Edwin K Silverman, Albert V Smith, Jennifer A Smith, Adrienne Stilp, Yin Cao, Paul Scheet, Alexander P Reiner, Alexander G Bick, Stephen J Chanock, Paul L Auer, Kelly L Bolton, Mitchell J Machiela

Faculty, Staff and Student Publications

Clonal hematopoiesis of indeterminate potential (CHIP) and mosaic chromosomal alterations (mCAs) are two types of clonal hematopoiesis (CH) associated with hematological parameters and malignancy risk. Here we show, in genomic data from 546,090 biobank participants, that co-occurring CH (≥2 CH mutations detected) is present in 1.6% of cancer-free individuals and shows strong evidence for selection (up to 804x enrichment). Co-occurrence is more frequent in those with a prior cancer (3.6%), suggesting treatment-induced selection. Acquisition of CHIP usually precedes mCAs with co-occurrences manifesting stronger phenotypic disruptions in telomere attrition and hematologic parameters than component CH events. Individuals with co-occurring CH have …

Hiv/Aids-Related Awareness And Misconceptions Among Grade 10 Students In Muttrah Wilayat, Muscat, Oman: A Descriptive, Cross-Sectional Study, Rahma Abdullah Al Riyami, Balqees Ahmed Al -Maawali, Nabila Hamood Al Wahaibi, Mariam Rashid Al Rashdi, Fatma Ahmed Al Hinai

Sultan Qaboos University Medical Journal

Objectives: Despite Oman having a low HIV prevalence, stigma and lack of knowledge among young people may hinder prevention efforts. This study aimed to assess HIV/AIDS-related knowledge and misconceptions among Grade 10 students in Muttrah wilayat in Oman. Methods: This cross-sectional study was conducted in February 2025 and included Grade 10 students from 4 governmental schools in Muttrah selected via proportional stratified sampling. The sample size was calculated depending on the number of students in Grade 10. Data collection was performed during face-to-face interviews using a validated Arabic-language questionnaire. Results: A total of 271 Grade 10 students were included in …

Childcare Challenges Among Surgical Trainees And Faculty: A Single-Institution Study, Emma G Burke, Sarah Peiffer, Melissa Koci, Lindsay Dean, Kristy L Rialon, Michele Loor, Alice King

Faculty, Staff and Students Publications

Background: Previous studies have demonstrated the challenges of parenthood in surgical training and careers. However, certain aspects of childrearing for surgeons remain understudied. We aim to leftacterize the complexity and costs of childcare amongst surgical trainees and faculty.

Methods: An anonymous, self-administered survey was conducted within the Department of Surgery at a large academic medical center. Both male and female trainees and faculty were included in the analysis. Chi-square or Fisher's Exact test was performed.

Results: Forty-six respondents provided information about childcare costs, with 37% of respondents being residents or fellows. Trainees worked longer workhours (p = 0.003) than their …

Circulating Metabolites Associated With Protection Against Mycobacterium Tuberculosis Infection And Inhibition Of Mycobacterial Growth, Todia P Setiabudiawan, Lika Apriani, Julian Avila-Pacheco, Edwin Ardiansyah, Vinod Kumar, Bachti Alisjahbana, Ayesha J Verrall, Andrew R Dinardo, Agnes R Indrati, Vera P Mourits, L Charlotte J De Bree, Simone J C F M Moorlag, Clary B Clish, Leo A B Joosten, Arjan Van Laarhoven, Krista E Van Meijgaarden, Mihai G Netea, Simone A Joosten, Valerie A C M Koeken, Philip C Hill, Reinout Van Crevel

Faculty, Staff and Students Publications

A significant proportion of individuals who are heavily exposed to infectious tuberculosis patients do not acquire Mycobacterium tuberculosis (Mtb) infection, as detected by an interferon gamma release assay (IGRA). We examined circulating metabolite profiles and metabolic genotypes in 199 heavily exposed IGRA-negative tuberculosis household contacts in Indonesia. Based on differentially abundant metabolites, activity of several pathways including arachidonic acid, arginine and proline, glutathione, and tryptophan metabolism, correlated with a negative IGRA at three months. SNPs near PRODH (involved in arginine and proline metabolism) were associated with circulating proline concentrations and persistently negative IGRA results, while SNPstudys near AFMID (involved in …

The Perijunctional Zone Is A Molecularly Distinct Muscle Subdomain Altered In Duchenne Muscular Dystrophy, Seth G Haddix, Chuansheng Zhang, Yanhong Liu, Juan Oses-Prieto, Alma L Burlingame, Matthew N Rasband

Faculty, Staff and Students Publications

The neuromuscular junction (NMJ) is a well-established model for synapse development, structure, and function. Surrounding the NMJ is a narrow perijunctional zone (PJZ), enriched in muscle-specific voltage-gated sodium channels that prevent synaptic fatigue. Despite this role, the PJZ remains poorly characterized. To determine its molecular composition, we engineered mice to express the biotin ligase TurboID fused to the cell adhesion molecule neurofascin (Nfasc), and that localizes to the PJZ through ankyrin scaffolding proteins. Using proximity proteomics, we identify numerous PJZ-associated proteins, including Perilipin 4 (Plin4), that are highly enriched and clustered at the PJZ. We also perform proximity proteomics on …

Evidence-Based Approaches To Managing Adolescent Aggression, April Dade

Walden Dissertations and Doctoral Studies

No abstract provided.

Exploring The Impact Of Mental Health On Childhood Obesity In Southern African American Youth Ages 12-18, Shari Scott Robinson

Walden Dissertations and Doctoral Studies

No abstract provided.

Teaching Motivational Interviewing Techniques To Nursing Staff To Improve Glycemic Control In Patients With Diabetes, Augustine Ngouondjyou Fotsing

Walden Dissertations and Doctoral Studies

No abstract provided.

Standardized Pediatric Obesity Screening Guideline For Children Ages 5–17 Years, Jennifer Nacius

Walden Dissertations and Doctoral Studies

No abstract provided.

Using The Socio-Ecological Model To Explore Parents' Resilience And Perceptions Of Adverse Childhood Experiences: A Qualitative Study In The Southeastern United States, Maribel G Dominguez, Christine Markham, Andrew E Springer, Louis D Brown

Faculty, Staff and Student Publications

Background: The negative impact of adverse childhood experiences (ACEs) on child development is documented. The parent-child relationship protects against ACEs and improves healthy child development, playing a crucial role in preventing and mitigating ACEs by strengthening parental resilience. However, there is a gap in the literature on our understanding of parental resilience's impact on the parent-child relationship within the social-ecological model (SEM) (i.e., intra- and interpersonal, community, and societal levels). Objective: This study explores parents' perspectives on parental resilience as a protective factor for preventing and mitigating ACEs at every level of the SEM. Method: This study uses a thematic …

Implementing Trauma Informed Care Practices In An Inpatient Psychiatric Unit, Clara Eyra Dedzo Amenuvor

Walden Dissertations and Doctoral Studies

No abstract provided.

Clinical Practice Guideline Emergency Department Discharge Acuity Scale To Improve Care Transitions, Charlisa Hedrick

Walden Dissertations and Doctoral Studies

No abstract provided.

Staff Education On Nonpharmacological Sleep Hygiene Strategies, Miranda Akateh Morfaw

Walden Dissertations and Doctoral Studies

No abstract provided.

Improving Staff Competence In Phq-9 Administration, Obinna C. Okonkwo

Walden Dissertations and Doctoral Studies

No abstract provided.

Repurposing Semaglutide As An Adjunctive Treatment For Cocaine Use Disorder: Protocol For A Randomised Controlled Trial, Luba Yammine, Francesco Versace, Charles E Green, Heather E Webber, Jin Ho Yoon, Absalon D Gutierrez, Samuel J Leonard, Michael F Weaver, Joy Schmitz

Faculty, Staff and Student Publications

Introduction: Cocaine use disorder (CUD) is a significant public health concern in the USA, with considerable prevalence and mortality and no Food and Drug Administration (FDA)-approved pharmacotherapies. Recent advances in addiction science emphasise the need for novel, mechanism-based treatments. Glucagon-like peptide-1 receptor agonists, such as semaglutide, have shown promise in modulating reward-related behaviours and may offer therapeutic benefits for CUD. We present a study protocol evaluating semaglutide, as an adjunct to cognitive behavioural therapy (CBT), as a novel approach for treating CUD.

Methods and analysis: This is a randomised, double-blind, placebo-controlled trial enrolling 75 treatment-seeking adults with CUD. Participants will …

Factors Associated With Vaping Frequency Among University Students, Oluwatosin Marylyn Oduneye

Masters Theses

Electronic cigarette use among university students is a growing public health concern, with approximately 20-25% reporting current use. Despite extensive research on vaping initiation, factors associated with vaping frequency among established users remain understudied. This study examined stress-coping mechanisms, peer influence, and health risk perceptions as predictors of vaping frequency, guided by Bandura's Social Cognitive Theory (SCT). A quantitative cross-sectional survey was administered via Microsoft Forms to 399 university students aged 21-25 with recent vaping experience, recruited nationally through campus flyers and online platforms. Multiple linear regression was conducted in SAS OnDemand for Academics, with stress-coping, peer influence, and health …

Predictive Models Of Student Mental Health: The Correlation Between Academic Burnout And Depression In The Higher Education Environment, Hyejoon Song

Masters Theses

Importance: Over 80% of U.S. college students report significant emotional difficulties, and 58% endorse academic burnout as a persistent concern, yet institution-specific data at faith-integrated universities such as Liberty University remain scarce, limiting evidence-based programmatic response.

Objective: To examine the correlation between academic burnout and depressive symptomatology at Liberty University, identify the most predictive individual burnout item via Random Forest machine learning, and characterize distinct student risk profiles via KMeans clustering. Design, Setting, Participants: Cross-sectional survey (IRB-FY24-25-1491, Exempt) of 236 Liberty University students (mean age 36.9 ± 14.3 years; 84.0% female; 61.0% graduate-level), 2025–2026 academic year.

Main Outcome and Measures: …

Improving A1c Levels Through An Individualized Diabetes Education Among Patients Living With Type 2 Diabetes, David W. Cardona Jr.

Doctor of Nursing Practice Final Manuscripts

Type 2 diabetes mellitus (T2DM) represents an increasing global health, social, and financial burdens. Nutrition, among other diabetes self-management topics, is a foundational aspect in managing T2DM. Significant knowledge gaps persist among patients regarding the impact of mindful eating habits in relation to euglycemia. Individualized diabetes education focused on healthy eating habits offers a promising strategy to address this gap. The quality improvement (QI) project aimed to evaluate the impact of diabetes education, focused on nutritional awareness, and mindful eating habits on hemoglobin (A1c) levels, weight, and diabetes self-management questionnaire scores (DSMQ-R) were assessed among adults living with T2DM. The …

The Impact Of Translated Phq-9 And Gad-7 Scales On Treatment Recommendations In An Adult Vietnamese Population: A 3-Month Primary Care Evaluation, Vivienne Bui

Doctor of Nursing Practice Final Manuscripts

Depression and anxiety are prevalent yet underdiagnosed in limited-English-proficient (LEP) populations due to language barriers, cultural stigma, and provider bias. Vietnamese-speaking patients are particularly vulnerable to under-recognition in primary care. This quality improvement project evaluated whether implementing Vietnamese-translated Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) tools would improve mental health diagnosis and referral rates. Guided by the Johns Hopkins Evidence-Based Practice Model, a pre–post design was conducted at a San Diego clinic from March 26 to June 26, 2025. Vietnamese-speaking adults (≥18 years) completed translated PHQ-9 and GAD-7 forms during intake. Providers used scores in conjunction with clinical …

When Qtc Shrinks After Rhythm Conversion, Mohammed Hussein Kamareddine, Alyssa Zakala, Farid Farkouh, Ibrahim Alameh, Gan-Xin Yan

Department of Medicine Faculty Papers

CASE SUMMARY: An 83-year-old man with a history of atrial fibrillation on amiodarone therapy was admitted for direct-current cardioversion because of recurrent atrial fibrillation with a ventricular rate of approximately 105 beats per minute. Cardioversion successfully restored sinus rhythm. Postcardioversion 12-lead electrocardiography revealed an unexpectedly short QTc of 344 ms despite chronic treatment with a QT-prolonging agent. This finding was attributed to QT hysteresis, reflecting delayed adaptation of ventricular repolarization to the abrupt reduction in heart rate after rhythm conversion.

TAKE-HOME MESSAGE: QT hysteresis can result in transient QTc shortening and has important implications for interpretation of QT intervals during …

Pr Interval Alternans And The Mystery Of Inverse Decremental Conduction, Alyssa Zakala, Mohammed Hussein Kamareddine, Farah Olleik, Ali Keramati, Gan-Xin Yan

Department of Medicine Faculty Papers

CASE SUMMARY: A 73-year-old man with severe aortic stenosis and preexisting right bundle branch block (RBBB) underwent transcatheter aortic valve replacement. Postprocedural day 4 mobile cardiac outpatient telemetry revealed intermittent atrioventricular block. A 12-lead electrocardiogram obtained in the emergency department revealed PR interval alternans with RBBB, with longer PR following longer preceding RP intervals, and shorter PR following shorter RP intervals. He suddenly experienced cardiac arrest due to proximal atrioventricular block, requiring cardiopulmonary resuscitation.

TAKE-HOME MESSAGES: Inverse decremental conduction, known as Yan conduction, demonstrates an inverse relationship between conduction time and frequency of upstream stimulation. Inverse decremental conduction within the …

Early Chemical Markers Of Spoilage In Thermally Processed Tomato Paste: A Rapid Approach For Shelf-Stable Foods, Hussein Ali Shaghati, Rawia Mahmood Yousif

Al-Nisour Journal for Medical Sciences

This study aims to reduce the incubation period (commercial sterility test) of tomato paste cans before the bacteriological inspection in quality control laboratories. 62 cans of tomato paste were incubated under temperatures (mesophilic 25,37°C and thermophilic 55°C) to accelerate potential spoilage. Chemical indicators(pH, titratable acidity, and lactic acid) and microbial indicators (Total plate count and yeast/molds) were monitored daily to identify the earliest reliable spoilage signals. Incubation at elevated temperatures accelerated acid buildup. D+L lactic acid levels measured using a rapid enzyme assay increased with titratable acidity, while pH decreased. Meanwhile, total platelet counts remained at very low levels, while …

Elucidating The Potential Impact Of Solute Carrier Family2 (Glut4) In Newly Diagnosed Dm-2 Patients, Marwa Ghanim Hashim, Zahra'a Abdul Al-Aziz Yousif, Farah A. Al-Waeely, Raya Khalel Ibrahem

Al-Nisour Journal for Medical Sciences

Background: Diabetes mellitus is a progressive metabolic condition marked by hyperglycemia due to irregularities in insulin production or activity, leading to poor carbohydrate, protein, and fat metabolism. Dysfunctional glucose transporter-4 (GLUT4) activity, characterized by insufficient expression or poor redistribution to the cell membrane, is a critical element in the pathogenesis of type 2 diabetes mellitus (T2DM). This defect limits cellular glucose uptake, leading to energy deficits and elevated blood glucose levels. Objective: What is the clinical diagnostic potential of serum GLUT4 levels in newly identified type 2 diabetic people, and how do these levels correspond with established metabolic parameters? Materials …

Environmental Impact Of Benzo[A]Anthracene Exposure On Liver Biomarkers And Covid-19 Severity: Evaluation Of Combined Clinical And Molecular Modeling, Osamah Alkilidar, Hayder G. Jawad, Hasan K. Nimr

Al-Nisour Journal for Medical Sciences

This study aimed to evaluate the relationship between exposure to environmental pollutants, particularly benzo[a]anthracins (BaA), and the severity of the inflammatory response and liver dysfunction in COVID-19 patients, using a combination of statistical analysis and molecular modeling. Molecular docking studies revealed stable and robust interactions between benzo[a]anthracins and cytochrome P450 (CYP450) enzymes, suggesting that these interactions may contribute to increased oxidative stress and hepatocyte damage. The statistical analysis included 70 COVID-19 patients, stratified by benzo[a] anthracene exposure. The results showed statistically significant associations between exposure to this pollutant and elevated C-reactive protein (CRP) levels, as well as a significant increase …

Predicting The Risk Of Diabetes Using Machine Learning Algorithms, Noor Ismail Ibrahim, Jamal Kamil Alrudaini, Hytham Falih Hassan, Sahar Faeq Jaafar

Al-Nisour Journal for Medical Sciences

Diabetes is a chronic disorder that many people suffer from. This disease develops when the blood glucose level is high. Serious side effects, such as harm to the heart, kidneys, eyes, and other organs may result from diabetes neglected treatment. Diabetes has numerous causes, including aging, obesity, inactivity, genetics, poor food and lifestyle choices. Early identification of this illness helps lessen its negative consequences. There are many traditional methods for predicting this disease, but they are expensive. Early prediction of diabetes benefits all those at risk by providing early treatment. With the advancement of healthcare technology, machine learning algorithms can …

Evaluation Of Complement Deficiency In Systemic Lupus Erythematosus Patients And Its Effect On Clinical Manifestations And Immunological Markers, Zahra'a Abdul Al-Aziz Yousif

Al-Nisour Journal for Medical Sciences

Background and Aim:\ Systemic Lupus Erythematosus is an autoimmune chronic disease resulting in multi organ damage and impairment of immune response. Complements such as C3 and C4 are considered important in disease progression and often used for disease activity measurements. The purpose of this research is to assess the frequency of complements deficiencies in SLE patients, and identify associations with symptoms and disease severity. Material and Methods:\ This single-center, cross sectional study involved 50 SLE patients classified in to four groups according to their serum C3 and C4 values. Symptoms, signs of disease severity, immunologic indicators [Erythrocyte Sedimentation …

Measuring Radon Concentration In The College Of Education For Pure Sciences At The University Of Anbar And Its Effects On Public Health, Ahmed O. Frhan, Omar Abboosh, Mazin H. Hasan, Dhafar Th. Altaan

Al-Nisour Journal for Medical Sciences

This study aimed to reduce the risks of lung cancer linked to radon gas concentrations. To ensure public safety in the college and avoid the danger of radiation, and to achieve the goals of sustainable development in providing a suitable, clean, and hazard-free environment. These reasons led to research on measuring indoor radon levels in the Physics department, which is part of the College of Education at Anbar University. The study was conducted over a period of approximately 40 days, during which CR-39 detectors were exposed to indoor air in the halls and laboratories. After that, take the detectors to …

Methyldopa: Chemistry, Structural Modifications, Pharmacological Activities, And Clinical Applications — A Comprehensive Review, Rania Kadhim, Emad Yousif, Suhad Ibrahim, Nany Hairunisa

Al-Nisour Journal for Medical Sciences

Methyldopa (α -methyldopa) is a centrally acting antihypertensive drug that has been extensively prescribed for the management of hypertension, particularly in pregnant women, due to its established safety profile and non-teratogenic nature. Beyond its clinical use, methyldopa has attracted increasing scientific interest because of its unique chemical structure, which contains multiple oxygen- and nitrogen-donor functional groups capable of undergoing structural modification and metal coordination. This comprehensive review highlights the chemical structure of methyldopa, its synthesis pathways, spectroscopic characteristics—particularly FTIR analysis—and its pharmacological mechanisms of action as an α ₂-adrenergic receptor agonist. Special attention is given to methyldopa-induced adverse effects, …

Effect Of Covid-19 Treatments On Kidney Function Within Type 2 Diabetic Iraqi Patients, Esraa Abd Al-Karim Marouf

Al-Nisour Journal for Medical Sciences

Recent studies have shown that the use of anti-inflammatory corticosteroids (especially dexamethasone) in individuals with COVID-19 can help prevent respiratory damage and death by modifying the inflammatory injury that occurs in the lung. This research was conducted to evaluate the effect of the use of anti-inflammatory corticosteroids on the level of diabetes and kidney function in patients with COVID-19. The study was conducted at Al-Shifa Hospital for quarantine in Ramadi city on 160 patients with COVID age range (40-70 years), some of whom had diabetes and the other did not have diabetes. They were treated with corticosteroids such as dexamethasone, …