Medicine and Health Sciences Commons^™

The American Cancer Society National Lung Cancer Roundtable Strategic Plan: Methods For Improving Turnaround Time Of Comprehensive Biomarker Testing In Non-Small Cell Lung Cancer, Sinchita Roy-Chowdhuri, Haresh Mani, Adam H Fox, Anne Tsao, Lynette M Sholl, Farhood Farjah, Bruce E Johnson, Raymond U Osarogiagbon, M Patricia Rivera, Gerard A Silvestri, Robert A Smith, Ignacio I Wistuba

Faculty, Staff and Student Publications

Comprehensive biomarker testing for patients with non-small cell lung cancer is critical for selecting appropriate targeted therapy or immunotherapy. Ensuring timely ordering, processing, and reporting is key to optimizing patient outcomes. However, various factors can prevent or delay patients from being offered the option of treatment selection based on comprehensive biomarker testing. These factors include problems with access to testing, tissue adequacy, turnaround time, and health insurance coverage and billing practices. Turnaround time depends on several logistical and tissue handling factors, which involve institutional policies, processes, resources, testing methodology, and testing algorithms that vary across different practices. In this article, …

Impact Of Site-Specific Conjugation Strategies On The Pharmacokinetics Of Antibody Conjugated Radiotherapeutics, Ábel Nagy, David Ulmert, Wahed Zedan, Claire M Storey, Julie Park, Susanne Geres, Katharina Lückerath, Kjell Sjöström, Hadis Westin, Norbert Peekhaus, Daniel Lj Thorek, Amelie Eriksson Karlström, Mohamed Altai

2020-Current year OA Pubs

Antibody radionuclide conjugates are an emerging modality for targeted imaging and potent therapy of disseminated disease. Coupling of radionuclides to monoclonal antibodies (mAbs) is typically achieved by applying non-site-specific labelling techniques. With the ambition of reducing variability, increasing labelling efficacy and stability, several site-specific conjugation strategies have been developed in recent years for toxin- and fluorophore-mAb conjugates. In this study, we studied two site-specific labelling strategies for the conjugation of the macrocyclic chelating agent, DOTA, to the anti-Leucine Rich Repeat Containing 15 (LRRC15) mAb DUNP19. Specifically, one approach utilized a DOTA-bearing peptide (FcIII) with a strong affinity for the fragment …

A Practical Clinical Approach To Navigate Pulmonary Embolism Management: A Primer And Narrative Review Of The Evolving Landscape, Kevin Benavente, Bradley Fujiuchi, Hafeez Ul Hassan Virk, Pavan K Kavali, Walter Ageno, Geoffrey D Barnes, Marc Righini, Mahboob Alam, Rachel P Rosovsky, Chayakrit Krittanawong

2020-Current year OA Pubs

Advances in imaging, pharmacological, and procedural technologies have rapidly expanded the care of pulmonary embolism. Earlier, more accurate identification and quantification has enhanced risk stratification across the spectrum of the disease process, with a number of clinical tools available to prognosticate outcomes and guide treatment. Direct oral anticoagulants have enabled a consistent and more convenient long-term therapeutic option, with a greater shift toward outpatient treatment for a select group of low-risk patients. The array of catheter-directed therapies now available has contributed to a more versatile and nuanced armamentarium of treatment options, including ultrasound-facilitated thrombolysis and mechanical thrombectomy. Research into supportive …

The State Of (Mis) Trust: Human-Centered Technology Development & Implementation In Intensive Mental Health Settings, Jessa Lin Westheimer, Ryan P Smith, Peter Iacobelli, Hyuntaek Oh, Lacey Tezino, Raheela Khan, Jared Broussard, Gordon Meltzer, Nadine Obeid, Stephanie Cunningham, Robert J Boland, Michelle A Patriquin

Staff and Researcher Publications

Innovative technology-based solutions in mental healthcare promise significant improvements in care quality and clinical outcomes. However, their successful implementation is profoundly influenced by the levels of trust patients hold toward their treatment providers, organizations, and the technology itself. This paper delves into the complexities of building and assessing patient trust within the intensive mental health care context, focusing on inpatient settings. We explore the multifaceted nature of trust, including interpersonal, institutional, and technological trust. We highlight the crucial role of therapeutic trust, which comprises both interpersonal trust between patients and providers, and institutional trust in treatment organizations. The manuscript identifies …

Global Impact Of Aging On The Hemodynamic Response Function In The Gray Matter Of Human Cerebral Cortex, Nooshin J Fesharaki, Amanda Taylor, Keisjon Mosby, Ruosha Li, Jung Hwan Kim, David Ress

Faculty, Staff and Students Publications

In functional magnetic resonance imaging, the hemodynamic response function (HRF) is a stereotypical response to local changes in cerebral hemodynamics and oxygen metabolism due to briefly (< 4 s) evoked neural activity. Accordingly, the HRF is often used as an impulse response with the assumption of linearity in data analysis. In cognitive aging studies, it has been very common to interpret differences in brain activation as age-related changes in neural activity. Contrary to this assumption, however, evidence has accrued that normal aging may also significantly affect the vasculature, thereby affecting cerebral hemodynamics and metabolism, confounding interpretation of fMRI cognitive aging studies. In this study, use was made of a multisensory task to evoke the HRF in ~87% of cerebral cortex in cognitively intact adults with ages ranging from 22 to 75 years. This widespread activation enabled us to investigate age trends in the spatial distributions of HRF characteristics within the majority of cortical gray matter, which we termed as global age trends. The task evoked both positive and negative HRFs, which were characterized using model-free parameters in native-space coordinates. We found significant global age trends in the distributions of HRF parameters in terms of both amplitudes (e.g., peak amplitude and contrast-to-noise ratio) and temporal dynamics (e.g., full-width-at-half-maximum). Our findings offer insight into how age-dependent changes affect neurovascular coupling and show promise for use of HRF parameters as non-invasive indicators for age-related pathology.

A Practical Clinical Approach To Navigate Pulmonary Embolism Management: A Primer And Narrative Review Of The Evolving Landscape, Kevin Benavente, Bradley Fujiuchi, Hafeez Ul Hassan Virk, Pavan K Kavali, Walter Ageno, Geoffrey D Barnes, Marc Righini, Mahboob Alam, Rachel P Rosovsky, Chayakrit Krittanawong

Faculty, Staff and Students Publications

Advances in imaging, pharmacological, and procedural technologies have rapidly expanded the care of pulmonary embolism. Earlier, more accurate identification and quantification has enhanced risk stratification across the spectrum of the disease process, with a number of clinical tools available to prognosticate outcomes and guide treatment. Direct oral anticoagulants have enabled a consistent and more convenient long-term therapeutic option, with a greater shift toward outpatient treatment for a select group of low-risk patients. The array of catheter-directed therapies now available has contributed to a more versatile and nuanced armamentarium of treatment options, including ultrasound-facilitated thrombolysis and mechanical thrombectomy. Research into supportive …

Development, Progression, And Mortality Of Suspected Interstitial Lung Disease In Copdgene, Jonathan A Rose, Ann-Marcia C Tukpah, Claire Cutting, Noriaki Wada, Mizuki Nishino, Matthew Moll, Sean Kalra, Bina Choi, David A Lynch, Benjamin A Raby, Ivan O Rosas, Raúl San José Estépar, George R Washko, Edwin K Silverman, Michael H Cho, Hiroto Hatabu, Rachel K Putman, Gary M Hunninghake

Faculty, Staff and Students Publications

Rationale: Some with interstitial lung abnormalities (ILA) are suspected to have interstitial lung disease (ILD), a subgroup with adverse outcomes. Rates of development and progression of suspected ILD and their effect on mortality are unknown. Objectives: To determine rates of development, progression, and mortality in those with suspected ILD and assess effects of individual ILD and progression criteria.

Methods: Participants from COPDGene (Genetic Epidemiology of Chronic Obstructive Pulmonary Disease) with ILA characterization and FVC at enrollment and 5-year follow-up were included. ILD was defined as ILA and fibrosis and/or FVC < 80% predicted. Prevalent ILD was assessed at enrollment and incident ILD and progression were assessed at 5-year follow-up. Computed tomography (CT) progression was assessed visually and FVC decline as relative change. Multivariable Cox regression tested associations between mortality and prevalent ILD, incident ILD, and progression groups.

Measurements and Main Results: Of 9,588 participants at enrollment, 268 …

Effectiveness Of Pharmacist-Managed Oncology Ambulatory Care For Patients With Non–Small Cell Lung Cancer In Taiwan, Ding-Cheng Liu, Chuan-Lun Hung, Yi-Wen Chen, Li-Na Kuo, Yen-Chun Hsin, Chun-Nan Kuo

Journal of Food and Drug Analysis

Non-small cell lung cancer (NSCLC) is commonly treated with tyrosine kinase inhibitors (TKIs). However, adverseevents from such treatment can lead to treatment discontinuation and additional medical expenditures. Ambulatory carefrom oncology pharmacists in patient education and symptom management can benefit patients with NSCLC. In thisstudy, we evaluated the effectiveness of an oncology pharmacy service at a medical center in Taiwan. We retrospectivelyenrolled 137 patients with NSCLC who initiated treatment with afatinib, gefitinib, or erlotinib between January 2017 andDecember 2021; 40 of them utilized the oncology pharmacy service (intervention group), and the remaining 97 did not(nonintervention group). To determine the effectiveness of …

A Mini Review Of Plant Tissue Culture: The Role Of Media Optimization, Growth Regulators In Modern Agriculture, Callus Induction And The Applications, Norrizah Jafaar Sidik, Hasan M. Agha, Abdulmutalib Alabeed Alkamil, Muneer Mohammed Saleh Alsayadi, Amjad Abdulhadi Mohammed

AUIQ Complementary Biological System

Plant tissue culture is an innovative biotechnological approach developed to meet the escalating global demand for agricultural production with enhanced nutritional value. This aseptic, in vitro technique allows for the cultivation of plant cells, tissues, or entire plants under controlled environmental and nutritional conditions, facilitating the generation of genetically identical clones. The method is indispensable in preserving endangered plant species, boosting crop yield and quality, and enabling year-round production of disease-free plants. Central to plant tissue culture is the composition of the growth medium, which must include a precise balance of macronutrients, micronutrients, amino acids, vitamins, and plant growth regulators …

Remote Functional Assessment: Experiences Of People Living With Spinal Cord Injury, Adrian David, Mot, Otr/L

Post-Professional Occupational Therapy Doctorate Culminating Presentations

Background: As telerehabilitation gains traction in occupational therapy, validating functional measures is crucial. Understanding clients' views on telehealth is essential, yet literature on spinal cord injury (SCI) in this context is sparse.

Objective: This study aims to describe the experiences of people living with SCI regarding remote and in-person functional testing.

Methods: A qualitative design was used, involving participants from a previous study validating the GRASSP, SCIM, and SCI-MovIN for remote use. Semi-structured interviews explored experiences, and transcripts were coded for thematic analysis. Twenty-five individuals with SCI, aged 18-80 and at least nine months post-injury, were included.

Results: Four themes …

Facilitators And Barriers For Occupational Therapy Using Ayres Sensory Integration® (Ot-Asi) For School-Aged Autistic Students: Special Education Team Perspectives, Brooke E. Loughery, Ms, Otr/L

Post-Professional Occupational Therapy Doctorate Culminating Presentations

Introduction: Occupational therapy using Ayres Sensory Integration® (OT-ASI) is an evidence-based approach that addresses sensory integration differences to support participation for autistic students in daily occupations, including education (Hume et al., 2021; Schaaf & Mailloux, 2015). However, its evidence for its use in school-based practice is still emerging (Whiting et. al., 2023; Whiting et al., 2025). A recent study showed that occupational therapists feel this approach is valuable and are interested in using it in schools (Cerase McKeon et al., 2024), but more information is needed to explore teacher and school administrators’ perception of its use.

Objectives: To explore the …

Development And Content Validation Of A Social-Emotional Learning Workshop Series For Teachers Of Preschool English Language Learners And Newcomers From The Middle East, Linda M. Lilly, Otd, Mot, Otr/L

Post-Professional Occupational Therapy Doctorate Culminating Presentations

The United States is the destination for many individuals to take refuge from the Middle East (Arab American Institute Foundation, 2021; Shryock & Abraham, 2000). Many of the refugees and immigrants (newcomers) have fled war and political oppression (Mossad, 2016; U.S. Department of Homeland Security, 2016), and thus may be at higher risk of developing adverse mental health outcomes (Mawani, 2014). Core stressors related to the newcomer status for many students in a metro-Detroit public school district can contribute to the overall mental health needs and interfere with performance in the educational setting. Social-emotional learning (SEL) programs are a typical …

The Development Of A Self-Reflection Training Module For Enhancing Students Professional Behavior Growth During Level Ii Fieldwork, Tarah Romano, Ms, Otr/L

Post-Professional Occupational Therapy Doctorate Culminating Presentations

Introduction: Occupational therapy students are expected to demonstrate competence in professional behavior skills, such as communication and incorporating constructive feedback, to be considered ready for entry-level practice. Poor professional behavior skills have been linked to challenges and failure during level II fieldwork (Gutman et al. 1998; James & Musselman, 2005). A growing body of research has supported the importance of students’ professional behaviors during fieldwork (Andonian, 2013; Brown et al., 2021; Jensen & Daniel, 2010; Mason & Mathieson, 2018); however, there is a gap in the occupational therapy research on effective methods for teaching professional behaviors to support fieldwork performance. …

Perceived Facilitators And Barriers To The Implementation Of Ayres Sensory Integration® In South African Primary School Settings, Celiané Van Der Westhuizen, Bot

Post-Professional Occupational Therapy Doctorate Culminating Presentations

Introduction

Ayres Sensory Integration^® is a highly preferred evidence-based occupational therapy approach that is utilized worldwide (Benson et al., 2019; Cerase et al., 2023; van der Merwe et al., 2011). However, more data is needed on its application and utilization in school settings (Schaaf et al., 2018; van der Merwe et al., 2011), which is a major working environment for occupational therapists (American Occupational Therapy Association, 2023; Frolek Clark & Hollenbeck, 2019; Jackson, 2007; Sonday et al., 2012).

Objectives

This study assessed the use of OT-ASI intervention in South Africa and explored the perceived facilitators and barriers of South …

High-Dose Psilocybin Reduces Depressive Symptoms In Patients With Major Depressive Disorder, Brandon Lien, Jason A. Mckechnie

Physician Assistant Capstones, 2020-current

No abstract provided.

Improved Detection Of Great Lakes Water Quality Anomalies Using Remote Sensing, Karl Bosse, Robert Shuchman, Michael Sayers, John Lekki, Roger Tokars

Michigan Tech Publications

Due to their immense economic and recreational value, the monitoring of Great Lakes water quality is of utmost importance to the region. Historically, this has taken place through a combination of ship-based sampling, buoy measurements, and physical models. However, these approaches have spatial and temporal deficiencies which can be improved upon through satellite remote sensing. This study details a new approach for using long time series of satellite remote sensing data to identify historical and near real-time anomalies across a range of data products. Anomalies are traditionally detected as deviations from historical climatologies, typically assuming that there are no long-term …

Dental Hygiene Programs’ Use Of Oral Health Literacy Techniques For Special Needs Patients And Caregivers, Socorro D. Tejeda Diaz

Dental Hygiene ETDs

This study examined oral health literacy communication techniques in dental hygiene programs across the U.S. for special needs patients and their caregivers. The study surveyed 46 U.S. dental hygiene program directors on communication techniques, degrees offered, and subject areas. Two-sample t-tests compared differences in communication techniques between AAS and BAS and subject areas. Most respondents routinely employed printed materials with 2 or 3 concepts, speak slowly, and simple language. When comparing the variances in communication techniques offered in AAS and BAS, we observed a t-statistic of 2.06 with a corresponding p-value of 0.54. This suggests that the mean communication techniques …

Does Physician-Hospital Vertical Integration Affect Hospital Output?, Soumya Upadhyay, Neeraj Bhandari

Healthcare Administration and Policy Faculty Research

Background: Physician-hospital vertical integration is gaining steam but it is unclear how they affect hospital output.

Objective: To examine the direct impact of vertical integration on hospital output.

Design: A pooled design with 6-year data using linear regressions was used. Then, panel data design with hospital fixed effects was used.

Methods: We linked American Hospital Association data (2016-2021) with AHRQ Comparative Health System Performance Initiative’s Compendium (2018, 2020, 2021; 34 987 hospital-year observations) to develop new measures of vertical integration and assess its relationship with several measures of hospital output including annualized total admissions, total number of inpatients days, …

Reduction Of Seclusion And Restraint Among Children And Adolescents In An Inpatient Psychiatric Hospital: A Health Policy Analysis, Huma Moez

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Background: Seclusion and restraint (SR) or restrictive intervention in inpatient/ acute psychiatric hospitals, emergency departments, crisis stabilization units, residentials, or group homes is a pressing and an immediate concern in mental health settings, particularly for children and adolescents, for whom SR rates are higher. The Joint Commission and other national organizations have made significant strides in prioritizing the reduction and elimination of SR among children and adolescents due to its negative physical and psychological consequences.

Objective: This DNP project will aim to provide the results of a policy analysis to present evidence-based techniques and a resulting re-envisioned policy recommendation to …

Advanced Practice Clinician Outcomes: Pre/Post Implementation Of An Advanced Practice Clinician Council, Jeannine M. Moss

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Improving access to quality, affordable, and timely healthcare is a national priority. Health systems across the United States are utilizing Advanced Practice Clinicians (APCs) to fill the void in healthcare delivery. As provider shortages continue and the demand for APCs increases, organizations must develop robust structures to support APC engagement, retention, job satisfaction, and professional growth. Currently, 44% of the provider workforce within a large urban health system are APCs, yet despite substantial APC provider labor pool representation, the organization had little infrastructure to support APC professional growth and no mechanism for organizational involvement. This quality improvement (QI) project aimed …

Reducing No-Shows In A Behavioral Health Setting: A Program Evaluation, Meagan Evans

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Mental healthcare in America faces many significant challenges; this is especially true in rural regions like Southwest Virginia. When patients miss their scheduled appointments, it represents a lost opportunity to deliver the critical mental health services that other individuals in need could have benefited from. A significant access issue presents itself when patients are not able to get the mental health support they need. The lack of outpatient access leads to patients utilizing emergency rooms inappropriately for what could have been routine care visits. A multitude of factors can contribute to patients failing to attend their scheduled appointments, including transportation …

Implementation Of An Advanced Practice Provider Into The Outpatient Neurology Clinic To Improve Access To Care And Medication Compliance, Sean O'Laughlin

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

The American Association of Neurology (AAN) recommended that post-stroke and TIA patients receive follow-up care within 2–4 weeks of discharge to reduce complications, improve medication adherence, and decrease readmission rates (2023). However, in 2022, a Central Virginia neurology practice reported an average wait time of 98.66 days for outpatient follow-up appointments, significantly exceeding the AAN recommendation, while medication adherence was only 72.23%, compared to the national average of 80%. Research by the American Academy of Neurology Workforce Task Force (2013) and Woo et al. (2017) highlighted that incorporating advanced practice nurses into outpatient settings could enhance access to care and …

Naloxone Prescribing At Hospital Discharge: A Quality Improvement Initiative, Timothy Ford

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Opioid overdose deaths remain one of the largest public health challenges in the United States. Naloxone allocation is an important tool to help combat opioid overdose deaths. The literature supports that hospitalized patients are generally receptive to receiving naloxone and opioid education and interdisciplinary teams working together can help facilitate identification of high-risk patients for naloxone allocation. This quality improvement change, guided by the IHI Triple Aims and Model for Healthcare Improvement frameworks, sought to increase the rate of patients leaving the Hospital Medicine Service with naloxone. To accomplish this, during the target units’ daily interdisciplinary rounds, providers were prompted …

Implementation Of A Standardized Screening And Referral Process For Social Determinants Of Health For Families With Children Within Two Rural Health Clinics, Laura Britton Stace

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Abstract

The American Academy of Pediatrics Bright Futures Guidelines recommends social determinants of health (SDOH) screening at well-child checks (WCCs). Social determinants of health are environmental factors, including food accessibility, mental health, and substance use, that can affect quality of life.

Rural health clinics (RHCs) in a county in Virginia did not routinely use a standardized screener to identify pediatric SDOH risks, nor did they have a standardized referral process for identifying SDOH risks. A hospital community needs assessment found that over 20% of the county households were below the federal poverty level. It is estimated that many children in …

The Living Document, Camilla Lyckblad

Proceedings from the Document Academy

This physical interactive art piece of thesis research in progress aims to deepen comprehension of information behavior in clinical contexts, where the contemporary medical record, with its increasing digital properties such as open record access for patients, can be viewed as an entity that both listens and influences. The art piece sheds light on the complex dynamics of truth within clinical environments, where patients and healthcare professionals might selectively disclose or withhold information, aiming to protect both patient, clinician and the information itself. Set within a small, dimly lit room, the exhibit features eight aged medical records, each inscribed with …

The Living Document: Medical Records As A Malleable Presence, Camilla Lyckblad

Proceedings from the Document Academy

Understanding why individuals might safeguard information or keep secrets in working documents such as medical records is essential for the development of good quality care, fostering an environment where both patients and staff feel secure to part with sensitive information, encouraging more honest and open communication as well as improved quality of care. This ongoing research aims to deepen comprehension of information behavior in clinical contexts, where the contemporary medical record, with its increasing properties such as open record access for patients, can be viewed as an entity that both listens and influences. This examination sheds light on the complex …

Perspectives Of Policymakers On Barriers To And Enablers Of The Uptake Of Cardiac Rehabilitation In Saudi Arabia: A Qualitative Study, Ahmed Mohammed Almoghairi, Jane O’Brien, Jed Duff

Journal of the Saudi Heart Association

• Objectives: This study aimed to identify the barriers to and enablers of secondary prevention care and cardiac rehabilitation (CR) utilization by patients with coronary heart disease (CHD) following percutaneous coronary intervention (PCI) from the perspective of policymakers.
• Methods: A qualitative study involving an interpretive descriptive design was conducted through recorded semi-structured interviews with key decision-makers in cardiology care in Saudi Arabia. The analysis was guided by the updated Consolidated Framework for Implementation Research (CFIR), which informed the resulting themes.
• Results: Interviews were conducted with nine key decision-makers: four directors of major cardiac centers, four heads of cardiac rehabilitation units, and …

Early Host Defense Against Virus Infections, Søren R. Paludan, Thomas Pradeu, Andreas Pichlmair, K. Brad Wray, Jacob Giehm Mikkelsen, David Olagnier, Trine H. Mogensen

Presidential Fellows Articles and Research

Early host defense eliminates many viruses before infections are established while clearing others so they remain subclinical or cause only mild disease. The field of immunology has been shaped by broad concepts, including the pattern recognition theory that currently dominates innate immunology. Focusing on early host responses to virus infections, we analyze the literature to build a working hypothesis for the principles that govern the early line of cellular antiviral defense. Aiming to ultimately arrive at a criteria-based theory with strong explanatory power, we propose that both controlling infection and limiting inflammation are key drivers for the early cellular antiviral …

Improving Immunization Rates In Children Under Two Years Of Age In Linn County, Kansas Through Nursing Education, Heather L. Webber

Doctor of Nursing Practice Scholarly Project

Immunizations are one of the most beneficial preventive health measures available to children under two years of age. Failing to receive these preventative immunizations during these crucial years could result in the child developing serious diseases that may lead to long term disability or even be fatal. By increasing immunization rates, children will be more protected against common childhood diseases which will allow them to grow and thrive. The purpose of this scholarly project was to identify ways to improve vaccination rates in children under two years of age at specific clinics in Linn County, Kansas, using healthcare professional education. …

Improving Nursing Deployment Readiness, George Mcenroe

Doctor of Nursing Practice (DNP) Projects

Improving Air Force Nursing Deployment Readiness

Abstract

Background. Air Force nurses must be prepared for deployment to support military missions on short notice. During deployments, they may be asked to practice in demanding and austere wartime environments. The required competencies for deployment include the care of multi-trauma patients, mass casualty care, and military-specific skills.

Problem. Air Force nurses are required to maintain an annual Comprehensive Medical Readiness Program (CMRP) checklist, a list of clinical skills based on their nursing specialty. Assessing and maintaining deployment readiness is an ongoing challenge. The Air Force does not currently use any …