Medicine and Health Sciences Commons^™

Detection Of Distant Relatedness In Biobanks To Identify Undiagnosed Cases Of Mendelian Disease As Applied To Long Qt Syndrome, Megan C Lancaster, Hung-Hsin Chen, M Benjamin Shoemaker, Matthew R Fleming, Teresa L Strickland, James T Baker, Grahame F Evans, Hannah G Polikowsky, David C Samuels, Chad D Huff, Dan M Roden, Jennifer E Below

Faculty, Staff and Student Publications

Rare genetic diseases are typically studied in referral populations, resulting in underdiagnosis and biased assessment of penetrance and phenotype. To address this, we develop a generalizable method of genotype inference based on distant relatedness and deploy this to identify undiagnosed Type 5 Long QT Syndrome (LQT5) rare variant carriers in a non-referral population. We identify 9 LQT5 families referred to a single specialty clinic, each carrying p.Asp76Asn, the most common LQT5 variant. We uncover recent common ancestry and a single shared haplotype among probands. Application to a non-referral population of 69,819 BioVU biobank subjects identifies 22 additional subjects sharing this …

Inflammatory Response And Parasite Regulation In Acute Toxoplasmosis: The Role Of P2x7 Receptor In Controlling Virulent Atypical Genotype Strain Of Toxoplasma Gondii, Thuany Prado-Rangel, Aline C.A. Moreira-Souza, Sthefani R.B. Da Silva, Thais Barboza-Araujo, Archimedes B. Castro-Junior, Isalira P.R. Ramos, Christina M. Takiya, Rossiane C. Vommaro, Robson Coutinho-Silva

Pacific Faculty Work

Toxoplasmosis is a globally significant disease that poses a severe threat to immunocompromised individuals, especially in Brazil, where a high prevalence of virulent and atypical strains of Toxoplasma gondii is observed. In 1998, the EGS strain, exhibiting a unique infection phenotype, was isolated in Brazil, adding to the complexity of strain diversity. The P2X7 receptor is critical in inflammation and controlling intracellular microorganisms such as T. gondii. However, its genetic variability can result in receptor dysfunction, potentially worsening susceptibility. This study investigates the role of the P2X7 receptor during acute infection induced by the EGS atypical strain, offering insight into …

Midazolam-Induced Seizure-Like Activity In Five Neonates: A Case Series, Heba Shaker, Fatema Al-Amrani, Hilal Al Mandhari

Sultan Qaboos University Medical Journal

An intravenous administration of midazolam may result in seizure-like activity or movement. This report describes five neonates who developed seizure-like movements after intravenous midazolam injection. The patients presented between 2019 and 2022. The abnormal movements occurred shortly after intravenous bolus administration of midazolam. None of our patients experienced seizure-like movements after receiving midazolam infusions. The seizure-like movements were aborted either spontaneously or by antiseizure medications. Also, we did not observe any seizure recurrence in any of the infants during the later stages of their treatment. Since this adverse effect might be related to the speed of the bolus administration, intravenous …

Prevalence, Clinico-Laboratory Features And Outcomes Of Paediatric Scrub Typhus Cases In A Tertiary Care Centre In Eastern India: A Prospective Observational Study, Raghunath Murmu, Gobinda Mondal, Koushik Biswas, Ashok K. Bala

Sultan Qaboos University Medical Journal

Objectives: Scrub typhus is the most common rickettsial disease in India, caused by Orientia tsutsugamushi and transmitted by chigger mites. Previously prevalent in South India, a resurgence of scrub typhus cases has recently affected Eastern India. This study aimed to estimate the prevalence and describe the clinico-laboratory profile of scrub typhus in paediatric patients (1–12 years old) living in Eastern India. Methods: This prospective observational study was conducted from January to December 2019 at the Dr B C Roy Post Graduate Institute of Paediatric Sciences, Kolkata, India. All acute undifferentiated cases of febrile illness, in patients aged between 1–12 years, …

Re: Efficacy And Safety Of Vildagliptin And Remogliflozin As Add-On Therapy To Metformin In Patients Of Type 2 Diabetes Mellitus, Hunain Raza, Muhammad E. Bhutta, Muhammad H. Siddique

Sultan Qaboos University Medical Journal

No abstract provided.

Determining The Effectiveness Of A Nurse-Led Heart Failure Education Program In Reducing 30-Day Hospital Heart Failure Readmissions, Amy Suzanne Cosby

Doctoral Dissertations and Projects

The purpose of this project was to determine if a nurse-led heart failure (HF) education program would reduce overall 30-day hospital readmissions related to. Affecting millions of adults in the United States, HF is a growing health epidemic as well as an economic burden to healthcare systems. The population for this project included patients admitted with a diagnosis of acute or chronic HF based on the International Statistical Classification of Diseases and Related Health Problems (ICD-10) codes. An electronic health record intervention indicated that when a healthcare provider diagnosed a patient with any HF ICD-10 code, the nurse-led HF education …

The Effectiveness Of An Interdisciplinary Care Team: An Integrative Review, Lindsey Marie Ellingford

Doctoral Dissertations and Projects

As health care is ever growing and changing, demands for interdisciplinary care team collaboration are crucial for collective competence and team performance across settings. In healthcare facilities across the county, interdisciplinary care teams are made up of multiple disciplines. The following is an integrative review with a purpose to determine if the existing literature supports the implementation of an interdisciplinary care team in the healthcare environment. After completion of this integrative review, the author concluded there should be a standardized tool in the healthcare system to guide the creation and implementation of an interdisciplinary care team. The Jerry Falwell Library …

Hyperlipidemia: Enhancing Patient Education And Clinical Support To Improve Self-Efficacy, Kelly L. Caniglia

Doctoral Dissertations and Projects

Hyperlipidemia is a chronic, progressive disorder routinely encountered in primary care practice. In the United States, coronary artery disease and cerebrovascular disease are the leading causes of death. Hyperlipidemia is a modifiable risk factor for the development of coronary artery disease, cerebrovascular disease, and peripheral artery disease. However, many individuals fail to recognize the severity of the health consequences associated with hyperlipidemia. Most often, hyperlipidemia is the direct result of unhealthy lifestyle behaviors. Comprehensive care falls short in primary care settings, often due to non-compliance with necessary lifestyle behavior changes. Primary care patients' lack of knowledge and awareness signals a …

Nursing Faculty Exposure To Student Incivility And Interventions In Place To Address: A Case Study, Kimberly Lowe

Doctoral Dissertations and Projects

The purpose of this qualitative case study was to explore nursing faculty exposure to nursing student incivility at a nursing college in the Mid-Atlantic region. Bandura's social learning theory provided this study’s theoretical framework. The continuum of workplace aggression and conceptual model fostering incivility in nursing education also guided this study. This study answered the following central research question: How have nursing faculty been exposed to incivility by nursing students? Data were collected for this study through one-on-one interviews with nursing faculty exposed to nursing student incivility and a focus group with the same nursing faculty to discuss the current …

Improved Clinical Outcomes Due To Gfr-Based Clinical Interventions For The Prevention And Treatment Of Renal Disease As It Relates To The Veteran Population Managed By A Patient-Aligned Care Team, Sidneca Evangella Hazward

Doctoral Dissertations and Projects

The purpose of this study was to understand if the use of eGFR (CKD-EPI 2021) in the absence of race modification influenced early detection of renal disease for veterans managed by patient-aligned care teams. A retrospective cohort study design was used, analyzing patient data from the Department of Veterans Affairs Medical Center (VAMC). The study included veterans with available serum creatinine, albumin, eGFR, CKD-EPI 2021, etc. measurements and demographic data. The study employed a systematic data review of electronic medical records from 2019 to 2024 and utilized electronic data collection through a computerized patient record system (CPRS) data collection system. …

Paths Initiative: Identifying Potential Sex Trafficking Victims In The Emergency Department Setting, Kayla Mabery

Doctoral Dissertations and Projects

The Physical signs, Appearance, Talk and communication, History and background, and Support and resources (PATHS) education initiative has proven to be a valuable tool in enhancing the identification and support of sex trafficking victims in healthcare settings, particularly in emergency departments. The training led to significant improvements in the participants' knowledge, confidence, and practical application of skills necessary to recognize potential victims. Despite the limitations of limited participant numbers and lack of face-to-face training, the initiative's positive impact underscores the need for continued efforts in this area. By incorporating the PATHS tool into regular professional development programs and standard operating …

Erdheim-Chester Disease Presenting As Bilateral Facial Masses: A Case Report And Review Of Literature, Asim Qureshi, Abdulaziz Bakathir, Fizza Qureshi, Amanullah Beg, Asem Shalaby

Sultan Qaboos University Medical Journal

Erdheim-Chester disease (ECD) is a rare form of non-Langerhans cell histiocytosis with unknown etiology. It is recently recognized to be neoplastic with genetic mutations affecting the mitogen-activating protein kinase (MAPK) pathway. We here present a case of a 49-year-old female who initially presented in 2012 with bilateral facial masses to a tertiary care center. These were removed but later recurred over a period of ten years. She then presented with xanthelasmas, bone lesions, secondary infertility due to hypothalamic hypogonadism, diabetes insipidus, and Hashimoto’s hypothyroidism. The facial masses were biopsied, and they showed classic morphological features in the form of diffuse …

The Prospect Of Indonesian Herbal As An Alternative Treatment For Covid-19 Patient: A Literature-Based Study, Hadi Sunaryo, Wahyu Hidayati

Indonesian Journal of Medical Chemistry and Bioinformatics

Coronavirus disease 2019 (COVID-19) is a new disease caused by a novel coronavirus, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The disease has several symptoms from mild to severe and could lead to death for comorbidities and the elderly. Therefore, the infections and mortality cases keep growing day by day, moreover many authorities are trying to suppress it by applying several health protocols, including medicines. Several studies were conducted on drug discovery from plants to cure the disease. The article aimed to do a narrative review about the prospect of JAMU becoming an alternative medicine to cure COVID-19 by mapping …

Contrast Enhanced Ultrasound Of Liver Lesions In Patients Treated For Childhood Malignancies., Ayatullah Mostafa, Zachary Abramson, Mina Ghbrial, Som Biswas, Sherwin S. Chan, Himani Darji, Jessica Gartrell, Seth E. Karol, Yimei Li, Daniel A. Mulrooney, Tushar Patni, Tarek M. Zaghloul, M Beth Mccarville

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Patients treated for cancer have a higher incidence of focal liver lesions than the general population and there is often concern for a malignant etiology. This can result in patient, caregiver and physician anxiety and is managed by a "wait and watch" approach, or immediate additional imaging, or biopsy, depending on the degree of clinical concern. Because it is a low-cost, easily accessible, radiation and sedation free modality, we investigated the value of contrast enhanced ultrasound (CEUS) to accurately distinguish benign from malignant liver lesions in patients treated for childhood malignancies.

METHODS: We performed an IRB approved retrospective study …

Evaluating The Impact Of The Nurse-Patient Relationship: An Integrative Review, Kathryn H. Creasey

Doctoral Dissertations and Projects

Home care agencies are rated by patients anonymously through surveys after patients’ care episodes. The star ratings on the surveys have a direct impact on the home care agency and all of the staff working there. The star rating affects insurance companies’ reimbursement, which ultimately impacts business revenue, while the goal is to provide quality patient care. In the home care setting, nurses and patients desire continuity of care and the building of trust for competent, safe, and quality care. The literature review explored the importance of fostering the nurse-patient relationship and its impact on patient satisfaction and quality. Utilizing …

A Non-Parametric Approach To Predict The Recruitment For Randomized Clinical Trials: An Example In Elderly Inpatient Settings, Alejandro Villasante-Tezanos, Yong-Fang Kuo, Christopher Kurinec, Yisheng Li, Xiaoying Yu

Faculty, Staff and Student Publications

BACKGROUND: Accurate prediction of subject recruitment, which is critical to the success of a study, remains an ongoing challenge. Previous prediction models often rely on parametric assumptions which are not always met or may be difficult to implement. We aim to develop a novel method that is less sensitive to model assumptions and relatively easy to implement.

METHODS: We create a weighted resampling-based approach to predict enrollment in year two based on recruitment data from year one of the completed GRIPS and PACE clinical trials. Different weight functions accounted for a range of potential enrollment trajectory patterns. Prediction accuracy was …

Linkage Facilitation For Opioid Use Disorder In Criminal Legal System Contexts: A Primer For Researchers, Clinicians, And Legal Practitioners, Milan F. Satcher, Steven Belenko, Anthony Coetzer-Liversage, Khirsten J. Wilson, Michael R. Mccart, Tess K. Drazdowski, Amanda Fallin-Bennett, Nickolas Zaller, Alysse M. Schultheis, Aaron Hogue, Noel Vest, Ashli J. Sheidow, Brandon Del Pozo, Dennis P. Watson, Patrick F. Hibbard, Randy Stevens, L. A. R. Stein

Nursing Faculty Publications

At the intersection of drug policy, the opioid crisis, and fragmented care systems, persons with opioid use disorder (OUD) in the United States are significantly vulnerable to contact with the criminal legal system (CLS). In CLS settings, provision of evidence-based treatment for OUD is variable and often secondary to punitive approaches. Linkage facilitation at every touch point along the CLS Sequential Intercept Model has potential to redirect persons with OUD into recovery-oriented systems of care, increase evidence-based OUD treatment connections, and therefore reduce CLS re-exposure risk. Research in this area is still nascent. Thus, this narrative review explores the state …

Improving Nursing Retention Through Mentorship In A Long-Term Care Facility: An Educational Toolkit, Adriane Nichole Anthony-Cupil

Doctoral Dissertations and Projects

A major nursing shortage in the healthcare industry is made worse by high turnover rates. Healthcare organizations have used mentoring programs that have been found to enhance job satisfaction, thus improving nurse retention. To address this challenge, this study examined the use of a mentorship program supplemented by an educational toolkit that is specially made to improve nurse retention in long-term care facilities. By offering an organized learning path with resources that address support, effective communication, and cultural competency, the educational toolkit has the potential to enhance mentorship. The objective of this initiative was to equip registered nurses with the …

Trauma-Informed Care Education Program To Increase Provider Confidence In Caring For Patients With Trauma, Lillian Priante

Doctoral Dissertations and Projects

This scholarly project addressed the critical need for education on trauma-informed care and birth trauma among birth center providers and staff. The project aimed to enhance the knowledge and skills of birth center professionals to better support birthing individuals who have experienced trauma, ensuring a more compassionate and effective care environment. A comprehensive educational program was administered to birth center midwives and staff exploring the principles of trauma-informed care, the psychological and physiological impacts of birth trauma, and evidence-based strategies for mitigating these effects. The curriculum of trauma-informed care included interactive training sessions using the City Birth Trauma Scale tool …

Leveraging Simulation For Excellence, Alecia Kimberly Liburd

Doctoral Dissertations and Projects

This project aims to identify and address the factors hindering the effective utilization of the simulation lab at Grady Memorial Hospital. Despite the simulation lab’s potential to enhance clinical skills and decision-making abilities through realistic medical scenarios, it remains underutilized. This evaluation project was a pretest and posttest design to assess the impact of educational interventions. Educational workshops, email communications, and awareness campaigns were the primary methods used to increase the understanding and utilization of the simulation lab.

Data analysis involved descriptive and thematic analyses of lab usage metrics and pre- and posttest responses. The findings indicate that simulation-based learning …

Increasing Self-Efficacy Of Nurse Practitioner Preceptors In Primary Care By Using The One-Minute Preceptor Model, Amy J. Lancaster

Doctoral Dissertations and Projects

Nurse practitioners represent the fastest growing profession in the United States, with 385,000 practitioners currently licensed. Over 70% of these licensed practitioners are serving in primary care settings. As the growth of this workforce continues, so does the need for nurse practitioner preceptors. The preceptor plays an essential role in championing clinical competencies for nurse practitioner students. This project was implemented in a primary care setting with an aim to improve the self-efficacy of nurse practitioner preceptors by using the One-Minute Preceptor teaching method to improve the practicum experience for both the preceptor and the nurse practitioner student. The One-Minute …

Speech-Language Pathologists’ Perceptions Of A Clinical Doctorate In Speech-Language Pathology: A Phenomenological Study, Dawn Mckee

Doctoral Dissertations and Projects

The purpose of this phenomenological study was to explore the perspectives of speech-language pathologists regarding a clinical doctorate as a potential entry-level degree for practicing speech-language pathologists. The central research question sought to determine the overall attitudes of speech-language pathologists about a clinical doctorate. The theories guiding this study were social constructionism and experiential learning theory, as this study attempted to construct the perceived reality of practicing speech-language pathologists regarding clinical doctorates and involved their educational and work experiences. The methodology utilized was transcendental phenomenology and included three data collection approaches: interviews, letter-writing, and focus groups. The data were analyzed …

Diabetes Health Literacy, Diabetes Numeracy, And Cognitive Function As Predictors Of Type 2 Diabetes Mellitus Self-Management, Twinkle Gupta

Doctoral Dissertations and Projects

The present study assessed older adults (≥ 45 years old) diabetes health literacy, diabetes numeracy, cognitive function, and its association with their Type 2 Diabetes Mellitus (T2DM) self-management outcomes. These factors are of concern as diabetes is a lifelong condition affecting the body’s conversion of food into energy and may lead to complications and comorbidities if this condition is not properly self-managed. Diabetes health literacy refers to having the necessary capabilities in finding and analyzing diabetes-related information to make informed decisions regarding their health. Numeracy in diabetes has to do with being able to compute diabetes-related math such as insulin …

Theory Informed Audit And Feedback To Decrease Medication Administration Errors, Victoria Martin

Doctoral Dissertations and Projects

Medication administration errors remain a serious and preventable cause of morbidity and mortality in health care. Technology at the point of care is often bypassed in the medication administration process despite the intention to prevent adverse drug events through the addition of a layer of cross-checks and alerts. The purpose of this project was to understand if human behavior could be influenced using effective audit and feedback, data transparency, and communication tactics to decrease administration-related errors, such as wrong patient, wrong medication, wrong dose, and adverse drug events, with the use of barcode medication administration (BCMA) in the emergency department. …

Facilitators And Barriers To Initiating And Completing Tuberculosis Preventive Treatment Among Children And Adolescents Living With Hiv In Uganda: A Qualitative Study Of Adolescents, Caretakers And Health Workers, Pauline Mary Amuge, Denis Ndekezi, Moses Mugerwa, Dickson Bbuye, Diana Antonia Rutebarika, Lubega Kizza, Christine Namugwanya, Angella Baita, Peter James Elyanu, Patricia Nahirya Ntege, Dithan Kiragga, Carol Birungi, Adeodata Rukyalekere Kekitiinwa, Agnes Kiragga, Moorine Peninah Sekadde, Nicole-Austin Salazar, Anna Maria Mandalakas, Philippa Musoke

Faculty, Staff and Students Publications

INTRODUCTION: People living with HIV (PLHIV) have a 20-fold risk of tuberculosis (TB) disease compared to HIV-negative people. In 2021, the uptake of TB preventive treatment among the children and adolescents living with HIV at the Baylor-Uganda HIV clinic was 45%, which was below the national target of 90%. Minimal evidence documents the enablers and barriers to TB preventive treatment (TPT) initiation and completion among children and adolescents living with HIV(CALHIV). We explored the facilitators and barriers to TPT initiation and completion among CALHIV among adolescents aged 10-19years and caretakers of children below 18years.

METHODS: We conducted a qualitative study …

Elevated Level Of Extracellular Vimentin Is Associated With An Increased Fibrin Formation Potential In Sepsis: Ex Vivo Swine Study, Marina Martinez-Vargas, Arun Saini, Subhashree Pradhan, Luis Gardea, Barbara Stoll, Inka C Didelija, K Vinod Vijayan, Trung C Nguyen, Miguel A Cruz

Faculty, Staff and Students Publications

BACKGROUND: Sepsis can lead to coagulopathy and microvascular thrombosis. Prior studies, including ours, reported an increased level of extracellular vimentin in blood derived from septic patients. Moreover, we identified the contribution of extracellular vimentin to fibrin formation and to the fibrin clot structure ex vivo in plasma from septic patients. Here, we tested the status of plasma vimentin and its impact on fibrin clots using our recently described swine model of methicillin-resistant Staphylococcus aureus (MRSA) sepsis-induced coagulopathy.

RESULTS: We employed ELISA, size-exclusion chromatography, vimentin antibodies, confocal microscopy, and turbidity assays on piglet plasma obtained at pre- and post-MRSA inoculation. Plasma …

David Taylor Memorial Lecture: Insights Into The Origins Of Intracardiac Surgery, James K. Kirklin

The VAD Journal

David Taylor was an eminent luminary in the field of advanced heart failure and transplantation. As past president of the International Society for Heart and Lung Transplantation, he significantly impacted the field and was a mentor to many young heart failure cardiologists. In addition to many professional activities, David was an integral part of Brano meetings, including numerous eastern European trips promoting education and training in advanced heart failure, mechanical circulatory support, and transplantation

Time From Dose To Delivery And Efficacy Of Maternal Azithromycin Prophylaxis In Planned Vaginal Births, Rupsa Boelig, A Kavi, J Moore, B Babineau, W Carlo, A Tita

Department of Obstetrics and Gynecology Posters

Objective

• A Multicenter international placebo controlled randomized trial (APLUS) found that 2g oral azithromycin in labor reduced risk of maternal sepsis and death, but not newborn sepsis
• Efficacy in prevention of maternal or neonatal infections may be impacted by timing of antibiotics in labor

Emerin Deficiency Drives Mcf7 Cells To An Invasive Phenotype, Emily Hansen, Christal Rolling, Matthew Wang, James M Holaska

Rowan-Virtua School of Osteopathic Medicine Departmental Research

During metastasis, cancer cells traverse the vasculature by squeezing through very small gaps in the endothelium. Thus, nuclei in metastatic cancer cells must become more malleable to move through these gaps. Our lab showed invasive breast cancer cells have 50% less emerin protein resulting in smaller, misshapen nuclei, and higher metastasis rates than non-cancerous controls. Thus, emerin deficiency was predicted to cause increased nuclear compliance, cell migration, and metastasis. We tested this hypothesis by downregulating emerin in noninvasive MCF7 cells and found emerin knockdown causes smaller, dysmorphic nuclei, resulting in increased impeded cell migration. Emerin reduction in invasive breast cancer …

Evolution Of The Substance Use Landscape: Implications For Contingency Management., Shelby Goodwin, Kimberly C Kirby, Bethany Raiff

College of Science & Mathematics Departmental Research

Contingency management (CM), which involves the delivery of incentives upon meeting behavioral goals, has the potential to improve substance use treatment outcomes. The intervention allows for flexibility through numerous modifiable components including changes to incentive magnitude and schedule, target behavior, and intervention structure. Unfortunately, numerous changes in the substance use landscape have occurred in the past 10 to 15 years: Substances are more potent, overdose risk has increased, new substances and methods of use have been introduced, and substance classes are increasingly being intentionally and unintentionally mixed. These developments potentially undermine CM outcomes. We explored recent substance use changes due …