Medicine and Health Sciences Commons^™

American Society For Metabolic And Bariatric Surgery Review Of The Body Mass Index, Jonathan Carter, Farah Husain, Pavlos Papasavas, Salvatore Docimo, Vance Albaugh, Laura Aylward, Cynthia Blalock, Sue Benson-Davies

School of Medicine Faculty Publications

The body mass index was first described almost 200 years ago and has since been used as a measure of obesity. This review describes the history, advantages, disadvantages, and alternatives to the body mass index in the care of the metabolic and bariatric surgical patient.

Staff Education To Increase Knowledge And Awareness Of Hand Hygiene, Karamjeet Kaur

Walden Dissertations and Doctoral Studies

Hospital-acquired infections (HAIs) are a significant concern in healthcare, contributing to increased morbidity, mortality, and healthcare costs. Despite the effectiveness of hand hygiene in preventing HAIs, compliance among healthcare providers remains suboptimal. This Doctor of Nursing Practice (DNP) project aimed to evaluate whether an educational intervention could improve healthcare professionals’ knowledge and awareness of hand hygiene practices in a clinical setting. A convenience sample of 11 participants attended a 10-day educational intervention. Participants completed pretests and posttests to measure knowledge and awareness. The mean pretest score for knowledge was 8.73 (SD = 1.19), while the mean posttest score was 10.00 …

Early Recognition And Management Of Aggressive Behaviors In Delirium, Melissa Dawn Martin

Walden Dissertations and Doctoral Studies

Patients experiencing delirium are challenging for nurses, especially when aggressive behavior is also present. Nurses from all specialties have the potential to encounter patients who have or develop delirium during their hospitalization, particularly in the intensive care unit. Nurses may lack the experience needed to recognize impending aggression which often presents as subtle cognitive changes or do not know the proper way to manage these types of patients. This makes standardized guidelines crucial for the safety of both the nurse and the patient. This project addresses that practice gap through developing an evidence-based clinical practice guideline (CPG) that will help …

Effectiveness Of Interventions To Address Nursing Students' Mental Health: An Integrative Review, Aimee Dickson, Shelby Carter

Master's Projects

Background:

The rigors of the nursing school curriculum are associated with higher levels of stress, anxiety, and depression, resulting in unhealthy habits and ineffective coping strategies that lead to initial difficulties in the academic environment and burnout as professional nurses advance into their careers. This phenomenon further burdens the already taxed workforce, leading to ongoing turnover and compromising care. This integrative review aims to look at what coping strategies have proven most successful in fostering nursing students' well-being, leading to lifelong practices that promote strength while addressing the rigors of academia and, later, the workforce.

Methods:

The literature review search …

Risk Factors Of Covid-19 Infection Among Health Workers Post-Vaccination In Jakarta, Rahmat Saputra, Nurhayati Adnan Prihartono, Mondastri Korib Sudaryo, Renti Mahkota, Yeni Devita, Ni Wayan Deisy Arisanti

Kesmas

One of the best approaches to stop the COVID-19 pandemic is vaccination. In Indonesia, the first round of vaccinations was prioritized for health workers on January 14, 2021 (first dose) and March 1, 2021 (second dose). However, some health workers who have been vaccinated were found to be reinfected after receiving the second dose. This cross-sectional study examined the risk factors for COVID-19 infection among health workers after vaccination using secondary and primary data. The data analysis was carried out in univariate (examining the frequency distribution and proportion of independent variables), bivariate (Chi-square test to explore the relationship between independent …

An Assessment Of The Impact Of Fentanyl On Post-Mortem Interval From A Decomposition And Biochemical Perspective, Kaylene Mcdonald

Senior Honors Theses

In the realm of body decomposition, bodies undergo a plethora of different metabolic and chemical changes. The human body follows a very consistent pattern and predictable time frame, with the exclusion of extenuating circumstances. The presence of fentanyl at the time of death provides the possibility of changes in decomposition rates, potentially skewing the time of death estimations. This research analyzes the varying decompositional stages of a body and their subsequent close relations with activity in the environment around it, specifically investigating the impacts of fentanyl on those surroundings and postmortem interval estimation determinations. This research found evidence that fentanyl …

Mortalidad Por Cirrosis En Guatemala 2018: Patrones E Inequidades, Cristian Ramírez, Luis Pablo Méndez-Alburez, María Fernanda Piedrasanta, Alejandro Cerón

Anthropology: Faculty Scholarship

El presente estudio busca analizar la mortalidad por cirrosis en Guatemala. El propósito es identificar posibles criterios epidemiológicos que orienten la priorización de acciones de salud pública. El riesgo de morir por cirrosis en Guatemala muestra marcadas desigualdades por departamento, las cuales son mayores al comparar por municipio. El riesgo de morir es también más alto en hombres, en personas mestizas o ladinas, en niveles educativos bajos, y en personas que se dedican a ocupaciones elementales. Las medidas de salud pública orientadas a los municipios y grupos en mayor riesgo son de suma importancia para la prevención de muerte por …

Site-Specific Prevalence Of Human Papillomavirus Infection In Malaysian Men, Mohd Khairul Anwar Shafii

Student Works (2020-2029)

Human papillomavirus (HPV) infection is among one of the common infections among the female population and is closely associated with cervical cancer. It has gained attention since the introduction of prophylactic HPV vaccines. However, the epidemiology of HPV infection among the male population in the Asian context remains largely unknown. The worldwide report on the prevalence of HPV infection among men varies depending on the target population and method of sampling. This study aims to determine the knowledge, and site-specific prevalence of anogenital HPV infection, and its associated factors among sexually active men in an urban middle-income Asian setting. The …

Staff Education Presentation: Addressing Polypharmacy As A Risk Factor For Falls Among Older Adults With Psychiatric Disorders, Yetunde E. Adegoroye

Walden Dissertations and Doctoral Studies

The focus of this doctoral project was to address the practice problem of polypharmacy and its association with falls among older adults with psychiatric conditions. The existing evidence shows that polypharmacy, which is defined as the concurrent use of five or more medications, increases the risk of falls, which leads to hospitalization, higher healthcare costs, and reduced quality of life (Varghese et al., 2024). Within the practice setting, it is Crucial to manage polypharmacy to enhance patient safety. The purpose of this project was to enhance medical staff knowledge regarding effective evidence-based strategies for reducing polypharmacy, through an educational presentation. …

Psychoeducation On Addiction For Healthcare Providers, Lovester Duncan

Walden Dissertations and Doctoral Studies

Summary Walden University College of Nursing This is to certify that the doctoral study by Lovester Duncan has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Review Committee Dr. Kristina Bohm, Committee Chairperson, Nursing Faculty Dr. Mary Martin, Committee Member, Nursing Faculty Chief Academic Officer and Provost Sue Subocz, Ph.D. Walden University 2024 The DNP project aimed to increase healthcare providers’ knowledge, awareness, and comfort with prescribing medication-Assisted Treatments (MATs). Inadequate treatment and higher overdose and death risks result from providers lacking experience with …

Staff Education: Improving Nursing Knowledge On Patient Medication Adherence Strategies Using Teach-Back, Janie Fleming

Walden Dissertations and Doctoral Studies

A staff education program was implemented for this Doctor of Nursing Practice project to improve nursing knowledge of the teach-back method. The identified practice problem was inadequate nurse-patient communication, which contributes to low patient comprehension, poor adherence to medication regimens, and suboptimal health outcomes. The practice-focused question guiding the project was, “Does an educational program on the teach-back method for patient medication adherence improve nursing knowledge as compared pre to post education?” The purpose of the project was to enhance nurses’ knowledge and skills regarding the teach-back method to improve patient communication, ultimately leading to better patient adherence and outcomes. …

Mortality Disparities Amongst African American Infants In Wisconsin, Enica C. Saffold

Walden Dissertations and Doctoral Studies

African American mothers have the highest infant mortality rate of any other racial group, in the United States. In Milwaukee, the rates for non-Hispanic African Americans were two to three times higher than those for non-Hispanic Whites and Hispanics between 2016 and 2018. According to the Wisconsin Department of Health Services in 2022, the infant mortality rate in 2021 was 12.9 for every 1,000 live births. This cross-sectional quantitative epidemiological study explores risk factors correlated with high infant mortality rates among Wisconsin African American mothers who gave birth to live infants between 2011 and 2021. To determine whether there is …

Staff Education For Identifying And Screening Of Depression Using An Appropriate Tool In The Crisis Stabilization Unit, Esther Chiedu

Walden Dissertations and Doctoral Studies

Executive Summary: Staff Education Project Staff Education for Identifying and Screening of Depression Using an Appropriate Tool In the Crisis Stabilization Unit by Esther Chiedu MS, Walden University, 2023. BS, Madonna University, 2010. Executive Summary Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice. Walden University November 2024

Staff Education On Antihypertensive Medication Compliance Post-Stroke, Ernestina Serwaa Bonsu

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project was staff education to address the practice problem of staff knowledge deficit related to hypertensive medications compliance for post-stroke patients. The practice question was: Will staff education on antihypertensive medication compliance enhance nursing staff knowledge? It is essential to address the practice problem and question within the context of nursing practice because studies have shown that targeted nursing education promotes patient adherence. Participants were 42 nurses from neurology units who were evaluated before and after face-to-face education sessions. Nurses completed a pre-education survey questionnaire first, followed by education sessions and a post-education survey …

Akt Kinases As Therapeutic Targets, Dalal Hassan, Craig Menges, Joseph Testa, Alfonso Bellacosa

Student Papers, Posters & Projects

AKT, or protein kinase B, is a central node of the PI3K signaling pathway that is pivotal for a range of normal cellular physiologies that also underlie several pathological conditions, including inflammatory and autoimmune diseases, overgrowth syndromes, and neoplastic transformation. These pathologies, notably cancer, arise if either the activity of AKT or its positive or negative upstream or downstream regulators or effectors goes unchecked, superimposed on by its intersection with a slew of other pathways. Targeting the PI3K/AKT pathway is, therefore, a prudent countermeasure. AKT inhibitors have been tested in many clinical trials, primarily in combination with other drugs. While …

Heart Failure Beyond The Diagnosis: A Narrative Review Of Patients' Perspectives On Daily Life And Challenges, Michelle Shigi Yang, Mohamed Bilal Abdallah, Zubair Bashir, Wissam Khalife

Faculty, Staff and Student Publications

Heart failure (HF) is a complex syndrome that significantly affects patients' physical, psychological, and socioeconomic well-being. Despite advances in guideline-directed medical therapy (GDMT), such as ACE inhibitors, beta-blockers, and SGLT2 inhibitors, HF continues to have a high global burden, with over 64 million affected worldwide and a five-year mortality rate of 50%. HF disrupts various life aspects, especially for younger patients (aged 35-55), who often face career interruptions due to severe symptoms like fatigue and frequent hospitalizations. These patients may struggle to maintain employment, resulting in financial instability compounded by high healthcare costs. Moreover, reduced exercise capacity and sexual dysfunction …

A Tetramer Of Bcl11a Is Required For Stable Protein Production And Fetal Hemoglobin Silencing, Ge Zheng, Maolu Yin, Stuti Mehta, I-Te Chu, Stacy Wang, Alia Alshaye, Kirstin Drainville, Altantsetseg Buyanbat, Frédérique Bienfait, Karin Tenglin, Qian Zhu, Stuart H Orkin

Faculty, Staff and Students Publications

Down-regulation of BCL11A protein reverses the fetal (HbF, α2γ2) to adult (HbA, α2β2) hemoglobin switch and is exploited in gene-based therapy for hemoglobin disorders. Due to reliance on ex vivo cell manipulation and marrow transplant, such therapies cannot lessen disease burden. To develop novel small molecule approaches, we interrogated the state of BCL11A protein in erythroid cells. We report that tetramer formation mediated by a single zinc-finger (ZnF0) is required for production of steady-state protein. Beyond its role in protein stability, the tetramer state is necessary for γ-globin gene repression, as an engineered monomer fails to engage a critical corepressor …

Psychological Interventions For Internalized Weight Stigma: A Systematic Scoping Review Of Feasibility, Acceptability, And Preliminary Efficacy, Laura D'Adamo, Abigail T Shonrock, Lawrence Monocello, Jake Goldberg, Lauren H Yaeger, Rebecca L Pearl, Denise E Wilfley

2020-Current year OA Pubs

BACKGROUND: Internalized weight stigma (IWS) is highly prevalent and associated with deleterious mental and physical health outcomes. Initiatives are needed to address IWS and promote effective coping and resilience among individuals who are exposed to weight stigma. We conducted a systematic scoping review of the literature on psychological interventions for IWS and explored their intervention components, feasibility, acceptability, and preliminary efficacy at reducing IWS and related negative physiological and psychological health outcomes.

METHODS: Eight databases were searched. Inclusion criteria included: (1) Psychological intervention; (2) Published in English; and (3) Included IWS as an outcome. Exclusion criteria included: (1) Commentary or …

Building Capacity In Dissemination And Implementation Research: The Presence And Impact Of Advice Networks, Allison J L'Hotta, Rebekah R Jacob, Stephanie Mazzucca-Ragan, Russell E Glasgow, Sharon E Straus, Wynne E Norton, Ross C Brownson

2020-Current year OA Pubs

BACKGROUND: As dissemination and implementation (D&I) research increases, we must continue to expand training capacity and research networks. Documenting, understanding, and enhancing advice networks identifies key connectors and areas where networks are less established. In 2012 Norton et al. mapped D&I science advice and collaboration networks. The current study builds on this work and aims to map current D&I research advice networks.

METHODS: D&I researchers in the United States (US) and Canada were identified through a combination of publication metrics, and key persons identified networks and were invited to participate (n = 1,576). In this social network analysis study, participants …

A Comprehensive Analysis Of In-Hospital Adverse Events After Scopolamine Administration: Insights From A Retrospective Cohort Study Using A Large Nationwide Inpatient Database, George Sun, Marc Torjman, Kevin Min

Department of Anesthesiology Faculty Papers

BACKGROUND: Scopolamine is a widely used antiemetic in anesthetic practice, particularly for postoperative and post-discharge nausea and vomiting. Despite its frequent usage and recognized efficacy, concerns have emerged regarding the potential for increased side effects, particularly in elderly patients. Further research is needed to assess safety and determine age thresholds for adverse events. This study hypothesizes associations between perioperative scopolamine use, worse clinical outcomes, increased pneumonia, delirium, urinary retention, and readmissions.

METHODS: A large, retrospective cohort study was performed using the TriNetX Analytics Network database on patients undergoing major surgical procedures between Jan 1, 2009, and March 21, 2018, to …

The Laboratory Opossum (Monodelphis Domestica) Is A Unique Model For Research On Zika Virus: Robust Immune Response, Widespread Dissemination, And Long-Term Persistence, André Filipe Pastor, Susan M. Mahaney, Juan Garcia Jr., Marisol Morales, Oscar Quintanilla, Marco Arriaga, John M. Thomas, John L. Vandeberg

School of Medicine Publications

The Zika virus (ZIKV) epidemic elicited a rapid commitment to the development of animal models for ZIKV research. Non-human primates (NHPs) and mice have made significant contributions to this research, but NHPs are expensive, have a long gestation period, and are available only in small numbers; non-genetically modified mice are resistant to infection. To address these deficiencies, we have established the laboratory opossum, Monodelphis domestica, as a small animal model that complements the mouse and monkey models. We developed and validated an indirect ELISA for measuring antibodies to ZIKV in opossums, as well as an immunohistochemistry (IHC) method to detect …

“Medical Tent Scenes - Spectrum Of Musculoskeletal Injuries In Runners During A Distance Run In Coastal South India”, Santosh Pv Rai, Abhavya Jha, Ashish Prabhakar, Jeedhu Radhakrishna, Kausthubh Hegde

Manipal Journal of Medical Sciences

Problem Statement : Musculoskeletal injuries encountered by runners, especially during competitive sporting events like marathons and distance runs have a longstanding and significant impact on the well being and may result in a dip in the performance of the runners. They may be the cause of recurrent injuries in the future and can lead to complicated injuries, thus compounding the morbidity associated with initial injuries. In such cases, it is essential to allocate medical supplies and facilities based on the incidence of common injuries encountered by runners in the respective geographical and climate settings.

Approach : This cross sectional study …

Fragile Foundations: Unravelling Osteogenesis Imperfecta, From The Womb To The Afterlife, Santosh Rai, Shreya Matele Dr., Sharada Rai Dr., Urvi Ahlawat, Sunita Hegde Dr., Arvind Natarajan Dr.

Manipal Journal of Medical Sciences

Abstract: We report the case of a 36-year-old multiparous woman whose routine antenatal ultrasound at 28 weeks gestation raised suspicion of severe skeletal dysplasia. At 38 weeks, she presented with decreased fetal movements, and intrauterine fetal demise was confirmed. An emergency cesarean section revealed a stillborn fetus with craniofacial deformities, large head with soft scalp bones, and blackish skin discoloration.

Post-mortem imaging, including CT and X-ray, showed severe skeletal abnormalities, including pneumocephalus, pneumothorax, wormian skull bones, extensive demineralization, spina bifida, and multiple fractures with bowing of long bones. Based on antenatal ultrasound and postnatal radiological findings, a diagnosis of …

Telerehabilitation For Aphasia (Terra) Phase Ii Trial Design, Christy Cassarly, Alexandra Basilakos, Lisa Johnson, Janina Wilmskoetter, Jordan Elm, Argye E. Hillis, Leonardo Bonilha, Chris Rorden, Gregory Hickok, Dirk B. Den Ouden, Julius Fridriksson

Communication Sciences and Disorders Faculty Articles and Research

Background and purpose

Methods

The Dual Timescales Of Gait Adaptation: Initial Stability Adjustments Followed By Subsequent Energetic Cost Adjustments, Sasha A. Brinkerhoff, Natalia Sánchez, Meral N. Culver, William M. Murrah, Austin T. Robinson, J. Danielle Mccullough, Matthew W. Miller, Jaimie A. Roper

Physical Therapy Faculty Articles and Research

Gait adaptation during bipedal walking allows people to adjust their walking patterns to maintain balance, avoid obstacles and avoid injury. Adaptation involves complex processes that function to maintain stability and reduce energy expenditure. However, the processes that influence walking patterns during different points in the adaptation period remain to be investigated. We assessed split-belt adaptation in 17 young adults aged 19–35. We also assessed individual aerobic capacity to understand how aerobic capacity influences adaptation. We analyzed step lengths, step length asymmetry (SLA), mediolateral margins of stability, positive, negative and net mechanical work rates, as well as metabolic rate during adaptation. …

Munchausen Syndrome By Proxy Presentation, Giovanna Tomassoni, Meredith Mackenzie

Master's Projects

Munchausen syndrome by proxy (MSBP) is a serious form of child abuse in which the perpetrator is typically the victim’s maternal caregiver. Assessing for MSBP can be very challenging for medical providers due to symptom mimicry and a dearth of information about the disorder. This Integrative Review seeks to shine a light on common symptomatology of MSBP and to make sure that providers leave it on the differential diagnosis until alternative diagnoses can effectively exclude it. A total of 240 records from online databases were reviewing for content, currency, and rigor. This search was narrowed to 10 records for in-depth …

Association Of Acute Rejection And De Novo Renal Cell Carcinoma In Kidney Transplant Patients: An Optn Data Analysis, Molly Casey, Emmalie Yanacek, Hitesh Kaul, John Knorr, Kamran Khanmoradi, Afshin Parsikia, Nikolaos Chandolias, Kevin Zarrabi, Radi Zaki

Einstein Health Papers

Background: Kidney Transplant Recipients (KTRs) are at risk of renal cell carcinoma (RCC). The risk of RCC in KTRs is approximated to be 5–10 times higher compared with the general population. A relation between kidney rejection and renal malignancy has been described and relates to the effect of immunosuppression at the genomic level. We decided to investigate any suggestive clinical evidence of this in the OPTN database. Methods: KTRs with de novo RCC between July 2004 and June 2022 were identified. Demographics, baseline characteristics, virology, and immunology data were compared between patients with and without RCC. Our follow-up period was …

Host Dna Depletion On Frozen Human Respiratory Samples Enables Successful Metagenomic Sequencing For Microbiome Studies, Minsik Kim, Raymond C Parrish, Michael J Tisza, Viral S Shah, Thi Tran, Matthew Ross, Juwan Cormier, Aribah Baig, Ching-Ying Huang, Laura Brenner, Isabel Neuringer, Katrine Whiteson, J Kirk Harris, Amy D Willis, Peggy S Lai

Faculty, Staff and Students Publications

Most respiratory microbiome studies use amplicon sequencing due to high host DNA. Metagenomics sequencing offers finer taxonomic resolution, phage assessment, and functional characterization. We evaluated five host DNA depletion methods on frozen nasal swabs from healthy adults, sputum from people with cystic fibrosis (pwCF), and bronchoalveolar lavage (BAL) from critically ill patients. Median sequencing depth was 76.4 million reads per sample. Untreated nasal, sputum, and BAL had 94.1%, 99.2%, and 99.7% host reads, respectively. Host depletion effects varied by sample type, generally increasing microbial reads, species and functional richness; this was mediated by higher effective sequencing depth. Rarefaction curves showed …

A Virtual Scalable Model Of The Hepatic Lobule For Acetaminophen Hepatotoxicity Prediction, Stelian Camara Dit Pinto, Jalal Cherkaoui, Debarshi Ghosh, Valentine Cazaubon, Kenza E Benzeroual, Steven M Levine, Mohammed Cherkaoui, Gagan K Sood, Sharmila Anandasabapathy, Sadhna Dhingra, John M Vierling, Nicolas R Gallo

Faculty, Staff and Students Publications

Addressing drug-induced liver injury is crucial in drug development, often causing Phase III trial failures and market withdrawals. Traditional animal models fail to predict human liver toxicity accurately. Virtual twins of human organs present a promising solution. We introduce the Virtual Hepatic Lobule, a foundational element of the Living Liver, a multi-scale liver virtual twin. This model integrates blood flow dynamics and an acetaminophen-induced injury model to predict hepatocyte injury patterns specific to patients. By incorporating metabolic zonation, our predictions align with clinical zonal hepatotoxicity observations. This methodology advances the development of a human liver virtual twin, aiding in the …

Role Of Myeloid Cell-Specific Adenylyl Cyclase Type 7 In Lipopolysaccharide- And Alcohol-Induced Immune Responses, Yawen Hu, Sonika Patial, Yogesh Saini, Masami Yoshimura

School of Graduate Studies Faculty Publications

Clinical and experimental evidence indicates that alcohol use causes various abnormalities in the immune system and compromises immune functions. However, the mechanistic understanding of ethanol’s effects on the immune system remains limited. Cyclic AMP (cAMP) regulates multiple processes, including immune responses. Earlier research indicated that type 7 adenylyl cyclase (AC7) regulates the immune system and is highly responsive to ethanol. Therefore, we hypothesized that AC7 is a central player in regulating the effects of alcohol on innate immune responses. To test this hypothesis, we utilized a myeloid lineage-specific AC7 KO mouse model and compared the effects of acute and chronic …