Medicine and Health Sciences Commons^™

Ten-Year Review Of St-Segment Elevation Myocardial Infarction (Stemi) In Tanzania: A Single Center Retrospective Review, Nadeem Kassam, Mohamed Varwani, Mzee Ngunga, Jeilan Mohamed, Mangaro Mabusi, James Orwa, Salim Surani, Robert Mvungi, Nasiruddin Jamal

Internal Medicine, East Africa

Introduction: Ischemic Heart Disease (IHD) is an emerging epidemic in sub-Saharan Africa (SSA). Although the true burden may be underreported in the African continent, it still remains one of the leading causes of death among adults aged above 60 years. ST-Segment Elevation Myocardial Infarction (STEMI) is a clinically time-sensitive fatal sequela of IHD with timely reperfusion by primary Percutaneous Coronary Intervention (PCI) being the gold standard of care. There has been steady progress in coronary care services in Tanzania, alongside a rise in IHD-related risk factors. However, data on this is limited. This study aimed to examine trends in …

The Reverse Lunge: A Descriptive Electromyographic Study, Barbara J. Hoogenboom, Madison Ferguson, Zac Krauss, Stephanie Tran

Open Access Publishing Support Funded Articles

Limited studies exist examining the reverse lunge. The purpose of this study was to describe the activation of the rectus femoris (RF), biceps femoris (BF), gluteus medius (GMed), and gluteus maximus (GMax) of both limbs during a bodyweight reverse lunge movement. A secondary purpose was to describe the phases of the stationary (non-moving) and lead (moving) limbs during the reverse lunge. Surface electromyography (EMG) was used to record the activity of the target muscles in 20 healthy adults (10 male, 10 female; aged 22–25). Root mean squared values for mean maximum and average percent activation normalized to maximum voluntary isometric …

Building A Meditation Room To Improve Critical Care Nurse’S Work Environment: An Evidence-Based Practice Project, Jennifer Alonso, Daphne Pierre, Stephanie Wald, Stephen Breazeale

Nursing & Health Sciences Research Journal

Background: Burnout, stress, and compassion fatigue are common among nurses, especially for those working in intensive care and during night shifts, and may contribute to the global nursing shortage. Thus, nursing organizations have issued recommendations to improve workplace health. Aligned with these initiatives, we sought to improve nurses' stress by creating a meditation room in the intensive care unit at a hospital in Miami. Methods: This evidence-based practice project took place from March to August 2023. The meditation room opened in May 2023 with a variety of therapeutic modalities, including meditation, music, and aromatherapy. We conducted two custom-designed surveys to …

Exploring Intensive Care Registered Nurses’ Perceptions Of The Family Support Person During Family-Witnessed Resuscitation, Carmen Petersen, Martha O. Morales, Natalie Bermudez

Nursing & Health Sciences Research Journal

Background: In-hospital cardiac arrests are common occurrences that family members may be present for. Family-witnessed resuscitation (FWR) is a well-studied, evidence-based practice with positive outcomes for family members. However, some nurses disagree with FWR because of the potential for family member disruptions. The presence of a hospital-employed family support person (FSP) dedicated to providing care to family members during FWR may be beneficial in improving nurses’ perspectives on FWR. While evidence shows the benefits of the FSP for family members during FWR, there is little evidence related to nurses’ perceptions of the FSP. Therefore, the purpose of this qualitative descriptive …

Addressing End-Of-Life Care Education Gaps For Registered Nurses: A Quality Improvement Project, Mayra Villalba, Alejandra Angel, Arvinder Singh

Nursing & Health Sciences Research Journal

Background: As the global elderly population grows rapidly, end-of-life care (EOLC) needs have expanded, warranting comprehensive nursing education. There is a significant gap in exposure to EOLC during nursing undergraduate education, clinical experiences, and training opportunities in the professional setting. The purpose of this quality improvement project was to educate nurses about end-of-life care. Methods: In an established medical-surgical unit, hospice patients with comfort-only measures were placed into a cohort labeled Transitional Care Unit (TCU). Between October 2023 and May 2024, nurses working in the TCU were surveyed on their knowledge regarding EOLC. Staff attended mandatory education sessions after the …

Impact Of An Interdisciplinary Team On Patients Seen At A Heart Failure Clinic, Nilda Pelegrino, Faaria Quadri, Elaina Rosario, Jacqualine Igwe, Sandra Chaparro, Lourdes Labrada, Sara Panella, Maria Pulido, Stephen Breazeale, Zhenwei Zhang

Nursing & Health Sciences Research Journal

Background: Heart failure is a complex clinical syndrome that requires the involvement of interdisciplinary teams to address patient needs and optimize therapy. Interdisciplinary teams, including physicians, advanced practice practitioners, and pharmacists, play a crucial role in implementing guideline-directed medical therapy and addressing barriers to self-care that ultimately improve patients’ overall survival. This study assessed the impact of an interdisciplinary team on patients’ heart failure outcomes compared to patients solely managed by clinical cardiologists. Methods: This was a single-center retrospective chart review study of Baptist Health patients seen at the heart failure clinic. The study compared patients seen by an interdisciplinary …

Beyond “C”: A Nurse Navigator-Led Education Project To Increase Survivorship Referrals And Cancer Survivorship Attendance, Carem Irma Costa Castro, Morgan Nestingen, Tania Silva Santos, Pamela Delongchamp, Luz Morales, Barbara Quintana, Marguerite Rowell, Merly Alonso, Natalie Bermudez

Nursing & Health Sciences Research Journal

Introduction: Recent advancements in cancer care have improved the prognosis of many cancer survivors who are living longer due to early detection and improvements in treatment. These survivors remain at risk for long-term physical treatment side effects. Survivors may also experience depression and anxiety related to fear of recurrence. Studies show many benefits for patients who participate in survivorship programs; however, participation remains low due to various barriers. The purpose of this evidence-based practice project was to implement an oncology nurse navigator (ONN)-led survivorship patient education initiative and evaluate its effectiveness on survivorship program referrals and participation. Methods: Baptist Health’s …

Letter From The Editor: Nurse Scientists At Baptist Health, Nohemi Sadule Rios

Nursing & Health Sciences Research Journal

No abstract provided.

Nurse-Led Advocacy In Reducing 30-Day Readmission Rates For Heart Failure Patients With Reduced Ejection Fraction, Lourdes M. Talavera, Madeleine Turco, Hector Gonzalez, Catherina Chang Martinez, Daniela Wintersteen, Stephanie Villadamigo, Alexandra Palau, Maria L. Perez, Cindy Delgado, Stephani Cardona, Christina Davis, Gustavo Ramirez, Marta Larranaga, Betty Muniz, Jessica G. Bundy

Nursing & Health Sciences Research Journal

Background: Heart failure with reduced ejection fraction (HFrEF) is associated with increased mortality, morbidity, and readmission rates. Evidence-based practice outlines that HFrEF patients should be on guideline-directed medical therapy (GDMT), including medication from four categories: renin-angiotensin system inhibitors, β-blockers approved for the treatment of heart failure, aldosterone antagonists, and sodium-glucose cotransporter 2 inhibitors. Nurse-led patient advocacy for patients to be discharged on GDMT can help reduce 30-day readmission rates in patients with HFrEF in an inpatient heart failure unit. The purpose of this project was to implement a new practice involving the utilization of a discharge form and empowering nurses …

Implementing And Assessing Climate Change Education In A Pediatrics Residency Curriculum, Mark Mcshane, Shelley Kumar, Linessa Zuniga

Center for Medical Ethics and Health Policy Staff Publications

Background For physicians to effectively combat the growing health crisis that is climate change, they should begin learning during medical training about its health implications. However, there is little data on residents' knowledge of the climate crisis, and even less data regarding the effectiveness and acceptability of climate change education in graduate medical training programs. Objective To incorporate a new educational session on the health implications of climate change into a residency curriculum and evaluate the acceptability of the session and its effects on residents' knowledge, attitudes, and perceptions of the topic.

Methods In July 2021, a 90-minute, interactive, small-group …

Challenging A Sacred Cow: Implementing Clear Liquids During Labor, Paloma Casemeiro, Carey B. Acosta, Judith E. Bowling

Nursing & Health Sciences Research Journal

Background: Traditionally, patients in labor could not have anything to eat or drink (nothing by mouth [NPO]) due to long-standing beliefs, often labeled "sacred cows." However, recent research indicated that clear liquids during labor can be safe and beneficial. Methods: Prior to implementing this project, the team collected information from 20 low-risk laboring mothers regarding their satisfaction level and their perception of the overall childbirth experience. Clear liquids were permitted for low-risk mothers and data were collected from the same population to evaluate the impact on their labor experience. The primary goal of this project was to challenge the “sacred …

Improving Mobility In Acute Care Patients With A Mobility Technician: A Quality Improvement Pilot Project, Oscar A. Acosta, Erin Shea, Madelyn Lliteras, Mary B. Gomes, Tiffany D. Baker, Catherina Chang Martinez

Nursing & Health Sciences Research Journal

Background: Early mobilization during hospitalization remains an important element in the patient’s recovery and is associated with good clinical outcomes. Despite these benefits, nurses and physical therapists experience challenges from time constraints and competing responsibilities. Mobility technicians present an alternative for safe and early patient mobilization during hospitalization. Methods: The purpose of this quality improvement project was to implement a mobility technician program to improve patients’ mobility during their hospital stay. The setting was a medical-surgical nursing unit of a hospital in South Florida. A protocol was implemented in December 2023. Patients who met the criteria for ambulation using the …

Exploring Relationships And Predictors Of Job Embeddedness And Intent To Stay In Acute Care Registered Nurses, Nada Wakim, Myriam Bigaud-Ambroise, Laurie Cogar, Natalie Bermudez

Nursing & Health Sciences Research Journal

Background: Registered nurse turnover is an enduring, ubiquitous global concern exacerbated by the COVID-19 pandemic. An estimated 13 million worldwide nursing shortage is projected with increased domestic U.S. 2021 turnover and vacancy rates. Examining phenomena, such as job embeddedness (JE), may provide further insight into nurses’ multifaceted reasons for remaining in a position. Evidence shows that nurse-leader influence and nurses’ financial situations are also factors associated with JE and intent to stay (ITS). Therefore, the purpose of this study was to explore the relationships and predictors between nurse participants’ characteristics (including direct nurse leader [DNL] influence, familial financial contribution [FFC], …

Effects Of The Low-Dose, High-Frequency Cardiopulmonary Resuscitation Education On Nurses’ Competency And Confidence, Claudia C. Sabogal-Rodriguez

Nursing & Health Sciences Research Journal

Background: Despite advances in resuscitation science, sudden cardiac arrest remains a leading cause of death in the United States, with substandard intra-hospital survival-to-discharge rates. High-quality resuscitation skills for nurses are needed, including effective cardiopulmonary resuscitation (CPR) education. Methods: This study followed a quantitative, four-group, cross-sectional correlational approach and aimed to measure the relationship between competency and confidence when using the low-dose, high-frequency CPR educational method over time. The Modified Basic Resuscitation Skills Self-Efficacy Scale was used to measure confidence, and the Resuscitation Quality Improvement (RQI) program measured competency. Results: The results came from a sample size of 100 participants, with …

A Multi-Pronged Collaborative Approach To Harness The Implementation And Sustainability Of Bedside Shift Report, Diane S. Kramer, Lourdes C. Castaneda, Catherina Chang Martinez, Shelli A. Chernesky, Lisette Hurtado, Harold Girado, Yessenia Muniz

Nursing & Health Sciences Research Journal

Background: Implementing nurse bedside shift report (BSR) remains a critical practice during shift changes that improves the delivery of safe patient care. The practice of BSR remains susceptible to variability and sustainability in the acute care setting. The purpose of this quality improvement project was to harness the implementation and sustainability of BSR using a multi-pronged approach. We aimed to improve nurse-sensitive indicators discussed during the BSR process and include patients in the BSR process. Methods: Implementing Lorenzi and Riley's change cycle methodology, executives, leaders, and educators collaborated to create a multi-pronged approach to standardize the BSR process for nurses …

Retrospectively Exploring Differences, Relationships, And Predictors Associated With The Bedside Mobility Assessment Tool And Patient Outcomes​, Sandra Torres, Angela Ramirez, Nicole Boswell, Sigrid Somarriba, Simone Cheong, Natalie Bermudez

Nursing & Health Sciences Research Journal

Background: Prolonged immobility in hospitalized patients is prevalent and associated with hospital-acquired functional decline and other adverse hospital outcomes. Early mobilization (EM) of hospitalized patients reduces the incidence of hospital-acquired conditions. Therefore, early identification of patients’ mobility status and EM are essential. Evidence shows that using the Bedside Mobility Assessment Tool (BMAT) promotes early mobility and improved patient outcomes. The purpose of this study was to explore the impact of the BMAT assessment on patient outcomes (falls, hospital-acquired pressure injuries [HAPIs], and length of stay [LOS]). Methods: This was an IRB-approved retrospective research study. Data were collected from patient records …

Excellent Registry: A Prospective, Multicenter, Global Registry Of Endovascular Stroke Treatment With The Embotrap Device., Raul G Nogueira, Tommy Andersson, Diogo C Haussen, Albert J Yoo, Ricardo A Hanel, Osama O Zaidat, Werner Hacke, Tudor G Jovin, Jens Fiehler, Simon F De Meyer, Waleed Brinjikji, Karen M Doyle, David F Kallmes, David S Liebeskind, Renu Virmani, Malgosia A Kokoszka, Violiza Inoa, William Humphries, Keith B Woodward, Pascal M Jabbour, Olivier François, Elad I Levy, Hormozd Bozorgchami, Stephan Boor, Jose E Cohen, Shervin R Dashti, Muhammad A Taqi, Ronald F Budzik, Clemens M Schirmer, M Shazam Hussain, Laurent Estrade, Reade A De Leacy, Ajit S Puri, Rohan V Chitale, Caspar Brekenfeld, Adnan H Siddiqui

Neuroscience Articles

BACKGROUND: The EXCELLENT registry aimed to evaluate the effectiveness of the EMBOTRAP Revascularization Device in an all-comer population in a real-world setting, with a focus on the composition of retrieved clots.

METHODS: EXCELLENT is a prospective, global registry of patients with acute ischemic stroke treated with EMBOTRAP as the first-line mechanical thrombectomy device conducted at 34 sites (25 sites contributing clot) from September 2018 to March 2021, utilizing core imaging and central histology laboratories blinded to clinical data, independent 90-day modified Rankin Scale assessment and Clinical Events Committee.

RESULTS: After screening 3799 patients, a total of 997 subjects (mean age, …

Understanding The Association Between Neighborhoods And Adolescent Sleep: Evidence From Add Health, Sam J Neally, Breanna J P Rogers, Yangyang Deng, Mohammad Moniruzzaman, Qian Xiao, Kosuke Tamura

Faculty, Staff and Student Publications

INTRODUCTION: Research suggests that perceived neighborhood social environments (PNSE) may contribute to gender and race/ethnicity-based sleep disparities. Our study aimed to examine associations between PNSE factors and adolescents' sleep patterns. As a secondary aim, we examined how gender and race/ethnic groups might moderate these associations.

METHOD: Data came from the National Longitudinal Study of Adolescent to Adult Health (n=5158; mean age=15.34 years). Four self-reported sleep outcomes were created: 1) sleep duration (hours/night), 2) short sleep (≥8 hours [reference] vs <8 >hours), 3) parental set bedtime (10:00 PM/earlier [reference] among girls vs by 11:00PM vs by/after 12:00AM), and 4) sleep satisfaction (enough …

Genetic Architecture Of Cerebrospinal Fluid And Brain Metabolite Levels And The Genetic Colocalization Of Metabolites With Human Traits, Ciyang Wang, Chengran Yang, Daniel Western, Muhammad Ali, Yueyao Wang, Chia-Ling Phuah, John Budde, Lihua Wang, Priyanka Gorijala, Jigyasha Timsina, Agustin Ruiz, Pau Pastor, Maria Victoria Fernandez, Dominantly Inherited Alzheimer Network (Dian), Alzheimer’S Disease Neuroimaging Initiative (Adni), Daniel J Panyard, Corinne D Engelman, Yuetiva Deming, Merce Boada, Amanda Cano, Pablo Garcia-Gonzalez, Neill R Graff-Radford, Hiroshi Mori, Jae-Hong Lee, Richard J Perrin, Laura Ibanez, Yun Ju Sung, Carlos Cruchaga

Faculty, Staff and Student Publications

Brain metabolism perturbation can contribute to traits and diseases. We conducted a genome-wide association study for cerebrospinal fluid (CSF) and brain metabolite levels, identifying 205 independent associations (47.3% new signals, containing 11 new loci) for 139 CSF metabolites, and 32 independent associations (43.8% new signals, containing 4 new loci) for 31 brain metabolites. Of these, 96.9% (CSF) and 71.4% (brain) of the new signals belonged to previously analyzed metabolites in blood or urine. We integrated the metabolite quantitative trait loci (MQTLs) with 23 neurological, psychiatric and common human traits and diseases through colocalization to identify metabolites and biological processes implicated …

Navigating Physical Activity Promotion And Policy In The Post-Covid-19-Pandemic Era, Justin Richards, Katja Siefken, Michael Pratt, Adrian Bauman, Juliana Mejía-Grueso, Catherine B Woods, Wanda Wendel-Vos, Erica Hinckson, Deborah Salvo, Pedro C Hallal, Andrea Ramírez Varela

Faculty, Staff and Student Publications

Background: There is limited evidence on the priorities and opportunities associated with promoting population physical activity (PA) participation for the post-COVID-19-pandemic future.

Purpose: This study assessed government-led PA promotion efforts before and during the COVID-19 pandemic, along with post-COVID-19-pandemic priorities and recommendations.

Methods: Two separate cross-sectional surveys conducted in 2023. Survey 1 was targeted at the Global Observatory for Physical Activity (GoPA!) Country Contacts. Survey 2 also included key international informants representing influential stakeholders in PA policy implementation.

Results: There were 68 respondents to Survey 1, collectively representing 61 countries. An additional 37 people, including representatives from 14 key international …

Continuous Vital Sign Monitoring On Surgical Wards: The Cosmos Pilot, Nikola Anusic, Alper Gulluoglu, Elyad Ekrami, Edward J Mascha, Shuyi Li, René Coffeng, Alparslan Turan, Amber Clemens, Christine Perez, John W Beard, Daniel I Sessler

Faculty, Staff and Student Publications

Study objectives: Alerts for vital sign abnormalities seek to identify meaningful patient instability while limiting alarm fatigue. Optimal vital sign alarm settings for postoperative patients remain unknown, as is whether alerts lead to effective clinical responses reducing vital sign disturbances. We conducted a 2-phase pilot study to identify thresholds and delays and test the hypothesis that alerts from continuous monitoring reduce the duration of vital sign abnormalities.

Design: Two-phase pilot.

Patients: 250 adults having major non-cardiac surgery.

Setting: Surgical wards.

Intervention: All patients had routine vital sign monitoring by nurses at 4-h intervals. We initially continuously recorded clinician-blinded saturation, heart …

Off-Protocol Radiation Therapy In Phase 3 Metastatic Solid Tumor Trials, Alexander D Sherry, Timothy A Lin, Zachary R Mccaw, Esther J Beck, Ramez Kouzy, Joseph Abi Jaoude, Adina H Passy, Avital M Miller, Gabrielle S Kupferman, Clifton David Fuller, Charles R Thomas, Eugene J Koay, Chad Tang, Pavlos Msaouel, Ethan B Ludmir

Faculty, Staff and Student Publications

Purpose: Increasing data suggest that radiation therapy, particularly ablative radiation therapy, alters the natural history of metastatic disease. For patients with metastatic disease enrolled in prospective trials testing systemic therapy, the use of off-protocol radiation therapy to improve clinical symptoms or extend the duration of study systemic therapy may influence study endpoints. We sought to evaluate how often off-protocol radiation therapy was permitted among systemic therapy phase 3 trials, how often off-protocol radiation therapy is used, and whether off-protocol radiation therapy correlated with study outcomes.

Methods and materials: Two-arm, superiority-design, phase 3 randomized trials testing systemic therapy were screened from …

Prediagnostic Amino Acid Metabolites And Risk Of Gout, Accounting For Serum Urate: Prospective Cohort Study And Mendelian Randomization, Natalie Mccormick, Amit D Joshi, Chio Yokose, Bing Yu, Adrienne Tin, Robert Terkeltaub, Tony R Merriman, Oana Zeleznik, A Heather Eliassen, Gary C Curhan, Hang-Korng Ea, Matthew Nayor, Laura M Raffield, Hyon K Choi

Faculty, Staff and Student Publications

Objective: Our objective was to prospectively investigate prediagnostic population-based metabolome for risk of hospitalized gout (ie, most accurate, severe, and costly cases), accounting for serum urate.

Methods: We conducted prediagnostic metabolome-wide analyses among 249,677 UK Biobank participants with nuclear magnetic resonance metabolomic profiling (N = 168 metabolites, including eight amino acids) from baseline blood samples (2006-2010) without a history of gout. We calculated multivariable hazard ratios (HRs) for hospitalized incident gout, before and after adjusting for serum urate levels; we included patients with nonhospitalized incident gout in a sensitivity analysis. Potential causal effects were evaluated with two-sample Mendelian randomization.

Results: …

Associations Between Metabolic Disorders And Sjögren’S Disease, Chihiro Iwaya, Junichi Iwata

Faculty, Staff and Student Publications

Sjögren’s disease (SjD) is a systemic autoimmune disorder characterized by dry eyes and mouth caused by chronic inflammation and is often accompanied by various extra-glandular manifestations, including fatigue and diffuse pain. Although the pathogenesis of the disease remains elusive, several factors (e.g. environmental, genetic and hormonal factors, abnormal metabolic status) are associated with this condition. Accumulating evidence suggests a potential role of cholesterol metabolism in immune and non-immune modulation in various diseases. In this review, we summarize the current findings on the associations between cholesterol metabolism and SjD.

Whole-Of-School Physical Activity Promotion: Findings From Elementary Schools In The United States, Derek W Craig, Christopher D Pfledderer, Natalia I Heredia, Kevin Lanza, Kempson Onadeko, Andjelka Pavlovic, Jizyah Injil, Laura F Defina, Timothy J Walker

Faculty, Staff and Student Publications

INTRODUCTION: Schools can support students' participation in physical activity by offering opportunities consistent with a Whole-of-School (WOS) approach; however, the extent to which physical activity opportunities are provided and how school-level characteristics associate with their use remains unclear. This study examined how elementary schools' use a WOS approach to promote physical activity, as well as associations between school-level characteristics and physical activity opportunities provided.

METHODS: Survey data was collected from 162 elementary schools participating in the NFL PLAY 60 FitnessGram Project during the 2022-2023 school year. A WOS index (ranging from 0 to 12) was created from responses by school …

Economic Disadvantage During Childhood, Obesity, And Diabetes Across Three Birth Cohorts Of Older Mexicans, Jesús-Daniel Zazueta-Borboa, Rafael Samper-Ternent, Rebeca Wong, Neil Mehta

Faculty, Staff and Student Publications

OBJECTIVES: Diabetes prevalence has increased markedly in Mexico. We examined the individual and joint contributions of economic disadvantage during childhood (EDDC) and elevated body weight on diabetes prevalence in 3 cohorts of Mexican adults.

METHODS: Data on those 60-69 years old from the 1930-1939, 1940-1949, and 1950-1959 birth cohorts in Waves 1 (2001), 3 (2012), and 5 (2018) of the Mexican Health and Aging Study were used. EDDC was defined as the absence of a toilet in the household before age 10. Body mass status was defined using self-reported perceived body image at age 50. Diabetes was based on respondent …

Hpv Vaccine-Related Articles Shared On Facebook From 2019 To 2021: Did Covid Make A Difference?, L Aubree Shay, Ashley Mckenzie, Elaine Avshman, Lara S Savas, Ross Shegog

Faculty, Staff and Student Publications

OBJECTIVE: HPV vaccination is recommended for children beginning at age 9 to prevent several types of cancer. Many parents turn to Facebook for health information. This study describes changes in HPV vaccine-related articles shared on Facebook amidst the COVID-19 pandemic.

METHODS: HPV-related articles shared on Facebook (2019-2021) were collected using Buzzsumo, a social media analytics tool and analyzed using content analysis. Articles were categorized by valence, misinformation, evidence types, persuasive tactics, and framing. We quantified these data and tested for difference by article year.

RESULTS: Of the 138 included articles, 51% had positive valence towards the vaccine and 36% had …

Smooth Muscle Cell Stress Response: Essential In Atherosclerotic Pathogenesis, Pujun Guan

Dissertations and Theses (Open Access)

Atherosclerosis remains the leading cause of death worldwide. Recent research using lineage tracing and single-cell RNA sequencing unveiled a previously undescribed and prominent role of smooth muscle cells (SMCs) in atherosclerotic plaque formation. SMCs undergo complex phenotypic modulation characterized by de-differentiation of SMCs and heterogeneously increased expression of markers for macrophages, fibroblasts, chondrocytes, and mesenchymal stem cells as plaques form. Cultured SMCs exposed to exogenous cholesterol mimic many of the phenotypic changes associated with plaque formation, and our lab determined this SMC modulation is driven by cholesterol entering the endoplasmic reticulum (ER) and triggering ER stress and PERK signaling. Further, …

Factors Impacting Ehr Implementation: A Case Study In Belize, Jessica Y. Resendiz

Electronic Theses and Dissertations

Electronic health record systems are a tool used throughout healthcare organizations to provide safe and efficient patient care. They are used to record and retrieve patient information related to health history, diagnostics, and treatment plans. Electronic health records have become increasingly integrated into healthcare practice and are demonstrative of safe and quality care. Healthcare organizations that do not have electronic health record systems in place jeopardize safe and efficient patient care. In addition, access and financial means to implement electronic health record systems in developing countries are challenging as resources are often restricted. This project aims to identify factors that …

The Life And Discoveries Of Yellapragada Subbarow, Nikhil R, Varuni Pragya, Subramanian Ramaswamy, Shiva Prasad B N, Mahabaleshwar Mamadapur

Digital Journal of Clinical Medicine

Dr. Yellapragada Subbarow was a researcher, teacher, and a wizard of wonder drugs who constantly made efforts in the discoveries/ inventions such as vitamins, anti-vitamins, antibiotics, and many more by disentangling the mysteries of nature for the betterment of the people. He inspired the youngsters to take up the challenges and to stand up above mediocrity. The reward for his achievement was delayed. The article describes a true humanist's journey, discoveries, and his achievements that are largely unknown to date.