Medicine and Health Sciences Commons^™

A Quantitative Investigation Into Isotropic Variations Of Treatment Planning Isocenters To Model Patient Misalignment During Radiation Therapy Delivery And Its Impact On Evaluated Dose Metrics For Hypofractionated Dibh Left Breast Cancer Patients, Mckenzie Gemeiner

Masters Projects

Introduction

This research was conducted for carcinoma of the left breast without nodal involvement using the 3D deep inspiration breath hold (DIBH) treatment technique. Limiting dose to healthy tissues is crucial in radiation treatment planning. The impact of dosimetric uncertainty due to isotropic variations on constraints and goals is often overlooked. This study investigates dose metric differences due to inherent patient misalignment modeled by isotropic variations in treatment planning.

Methods

10 patient subjects were randomly selected with carcinoma of the left breast without nodal involvement, each using the 3D hypofractionated, deep inspiration breath hold (DIBH) technique. All plans had 24 …

Evaluating The Use Of A Standardized Prebriefing Tool With Novice Simulation Facilitators, Ciara Berry

Doctor of Nursing Practice Projects

The International Association for Clinical Simulation and Learning (INACSL) Best Practice Standards related to prebriefing recommends establishing a prebriefing plan to prepare the learners for a simulation activity. A simulation briefing should orient the learner, promote learner engagement, and reinforce psychological safety. The nursing faculty’s unfamiliarity with an established prebriefing tool at the clinical site and reliance on the single simulation educator resulted in self-guided briefings and reduced the faculty facilitators' competency. The quality improvement project aimed to reorient nursing faculty in an associate degree nursing program to a prebriefing tool available at the clinical site. After reorientation, the PI …

Debriefing Orientation For Novice Simulation Faculty, Cindy M. Carter

Doctor of Nursing Practice Projects

Faculty new to the simulation environment lack the knowledge, skills, and confidence to deliver proper debriefing methods. The Doctor of Nursing Practice (DNP) project’s problem is the need for a standardized, evidence-based debriefing process in the undergraduate RN program at the College of Nursing in Oklahoma. The study aims to follow the International Nursing Association for Clinical Simulation and Learning (INACSL) best practices to implement a debriefing simulation for novice faculty to improve faculty self-efficacy with the debriefing process (Decker et al., 2021). The DNP student evaluated faculty using pre-and post-tests containing questions from the Debriefing Assessment for Simulation in …

Navigating Change: Cultivating Faculty Support For Curriculum Revision Through The 4ms Framework, Sarah Dearing

Doctor of Nursing Practice Projects

Public campaigns have increased awareness of Alzheimer’s disease and other dementias, however, education for healthcare providers concerning brain health and appropriate screenings to identify elderly patients at risk is not present. This curricular policy change project outlines the need for faculty buy-in to complete a curriculum change that addresses the lack of geriatric-evidence based education within an Associate of Applied Science in Nursing (AASN) program. Qualitative data identifies the amount of geriatric-evidence based education present in the current AASN curriculum map. Using Lewin’s change management theory (CMT) and the Cognitive-Affective-Social Theory of Learning Environments (CASTLE), an educational module teaching the …

Enhancing Family Nurse Practitioner Education Through End-Of-Life Simulation: A Quality Improvement Project, Deborah Jamison

Doctor of Nursing Practice Projects

Providing compassionate and effective end-of-life care is a crucial skill for Family Nurse Practitioners (FNP) students (Collins & Small, 2019). However, many students experience significant anxiety and lack confidence in such challenging situations. The problem identified for the Doctor of Nursing Practice (DNP) Quality Improvement (QI) project is the lack of training focused on end-of-life care in the FNP program at a College of Nursing (CON) within an academic clinical center. The project’s purpose was to improve confidence and anxiety levels among FNP students in providing end-of-life care. The project aimed to create an inventive and immersive end-of-life simulation with …

Quality Improvement Project: The Bidirectional Relationship Among Type Ii Diabetes Mellitus And Periodontal Disease, Sarah Martinez

Doctor of Nursing Practice Projects

Individuals with Type 2 Diabetes Mellitus (T2DM) are at increased risk for oral health conditions such as periodontal disease. Moreover, there is an established bidirectional relationship that has been well documented in the literature among periodontal disease and T2DM. However, oral health is rarely being discussed with patients who have T2DM from the primary care setting. The objective for this Doctor of Nursing Practice (DNP) project was to bridge the gap in this area by assessing the efficacy of implementing an educational program to promote education and awareness in individuals with T2DM who are at risk for periodontal disease. This …

Improving Hypertension Management In The Family Care Practice Through The Education Of Clinical Staff On Jnc-8 Guidelines, Shiny Michael

Doctor of Nursing Practice Projects

Hypertension is a major public health challenge, contributing significantly to global morbidity and mortality. Despite the availability of JNC-8 guidelines, adherence in clinical practice is often lacking. This project aimed to improve hypertension management in a primary care setting by educating clinical staff on the JNC-8 guidelines to enhance adherence to evidence-based practices. The primary purpose of this project was to address the lack of knowledge and suboptimal hypertension control through targeted educational interventions for clinical staff. The methodological approach involved a pre- and post-intervention design, with educational sessions conducted for medical assistants. Data on blood pressure control and staff …

Increasing High-Alert Medication Administration Competence In Undergraduate Nursing Students Using An Unfolding Obstetrical Simulation, Jenna A. Warf

Doctor of Nursing Practice Projects

This DNP project aimed to increase medication competence in undergraduate nursing students through an unfolding high-fidelity simulation. Before the implementation of this project, students at the project site had experienced minimal exposure to obstetrical nursing care and medication administration. This quality improvement project occurred at a community college in Texas, with undergraduate nursing students (n=18). The participants completed an Evolve pretest, unfolding high-fidelity simulation, Simulation Effectiveness Tool-Modified (SET-M) survey, and an Evolve posttest. The unfolding simulation consisted of a three-part simulation with a preeclamptic obstetrical patient that started at a physician’s office, progressed to triage, and ended as an inpatient …

08.05.2024 Orsp Connect, Liz Williamson

ORED Newsletter

Dr. John C. Higginbotham, Federal Demonstration Partnership (FDP), COPE (Clinic for Outreach and Personal Enrichment)

08.05.2024 Ored Connect, Liz Williamson

ORED Newsletter

Meet the new Vice Chancellor for Research and Economic Development, Dr. John C. Higginbotham.

FDP Meeting Summaries link

Collaborate with COPE

Occupational Therapy And Self-Awareness For Adolescents With Mental Health Concerns, Deriyon Johnson, Rebecca King

Summer 2024 OTD Capstone Symposium

The project created an occupation-based program to address the unique needs of adolescents at risk of mental health concerns and promote improved occupational success. The problem presented is the lack of support available to assist adolescents experiencing profound emotional and behavioral challenges, triggering negative impacts on social participation, academics, self-care, and leisure. In addition, the program will introduce coping strategies and improve daily functions to increase motivation for engagement in desired activities. The purpose of the program was to improve these areas through a series of structured activities focusing on mental health awareness, emotional regulation, and personal development. The results …

Occupational Therapy And Expressive Strategies For Youth Trauma Recovery, Darin Lewis, Rebecca King

Summer 2024 OTD Capstone Symposium

The purpose of this capstone project was to develop a program to address youth mental health concerns through expressive strategies and interventions.

Enablement Of Fishing Among Those With Physical Impairments, Tony Lozada, Cassandra Nelson

Summer 2024 OTD Capstone Symposium

The poster explains the capstone process for the development and implementation of a fishing-based program for people with upper extremity impairments.

Disability In Cluster Headache Is More Than Attack Frequency – Results From And Validation Of The English Version Of The Cluster Headache Impact Questionnaire (Chiq), Katharina Kamm, Andreas Straube, Mark Burish, Ruth Ruscheweyh

Faculty, Staff and Student Publications

BACKGROUND: Cluster headache (CH) is associated with high disability. The Cluster Headache Impact Questionnaire (CHIQ) is a short, disease-specific disability questionnaire first developed and validated in German. Here, we validated the English version of this questionnaire.

METHODS: The CHIQ was assessed together with nonspecific headache-related disability questionnaires in CH patients from a tertiary headache center and an American self-help group.

RESULTS: 155 active episodic and chronic CH patients were included. The CHIQ showed good internal consistency (Cronbach's α = 0.91) and test-retest reliability (ICC = 0.93, n = 44). Factor analysis identified a single factor. Convergent validity was shown by …

Summary Report Of Discussions At The Ana Forum 2024, Berkeley, Ca “How Can The North American Nepali Diaspora Contribute To Nepal’S Economic Development?”,, Ambika P. Adhikari

Himalayan Research Papers Archive

The ANA 2024 annual convention, organized on ANA’s 42nd founding anniversary, was held in the San Francisco Bay Area (Berkeley and Oakland) in California, where hundreds of ANA members and friends had gathered. The convention consisted of several forums, sessions, and cultural programs. As always, the convention included a Nepal-related forum “How Can the North American Nepali Diaspora Contribute to Nepal’s Economic Development?” The Forum took place from 1:30-2:30 pm on Saturday July 20, 2024. Four panelists, including the moderator, spoke at the forum. About 45-50 individuals attended the session. Guest panelist, Dr. Minendra Rijal sent a message as he …

A Quantitative Investigation Into The Daily Variation Of Bladder And Rectum Volumes Among Prostate Cancer Patients Receiving Radiation And When It Violates Dose Constraints At Any Given Fraction., Joseph Pape

Masters Projects

When planning radiation therapy treatments for prostate cancer, the bladder and rectum are important organs at risk (OAR). The purpose of this retrospective study was to establish guidelines for bladder and rectal volumes for men receiving hypofractionated radiation therapy to their prostate and seminal vesicles. Ten patients were included in the study and radiation doses to the bladder and rectum were recorded based on the daily change in the OAR volumes. The bladder and rectal volumes were contoured on each patient’s daily treatment CBCT and those volumes were compared to that on the treatment planning CT. The results showed that …

Brca1 Secondary Splice-Site Mutations Drive Exon-Skipping And Parp Inhibitor Resistance, Ksenija Nesic, John J Krais, Et Al.

2020-Current year OA Pubs

PARP inhibitor (PARPi) therapy has transformed outcomes for patients with homologous recombination DNA repair (HRR) deficient ovarian cancers, for example those with BRCA1 or BRCA2 gene defects. Unfortunately, PARPi resistance is common. Multiple resistance mechanisms have been described, including secondary mutations that restore the HR gene reading frame. BRCA1 splice isoforms △11 and △11q can contribute to PARPi resistance by splicing out the mutation-containing exon, producing truncated, partially functional proteins. However, the clinical impacts and underlying drivers of BRCA1 exon skipping are not fully understood.We analyzed nine ovarian and breast cancer patient derived xenografts (PDX) with BRCA1 exon 11 frameshift …

Affect Regulation And Allostatic Load Over Time, Amanda E. Ng, Tara Gruenewald, Robert-Paul Juster, Claudia Trudel-Fitzgerald

Psychology Faculty Articles and Research

Objective

Emerging work suggests that affect regulation strategies (e.g., active coping, anger expression) predict disease and mortality risk, with sometimes divergent estimates by sex or education levels. However, few studies have examined potential underlying biological mechanisms. This study assessed the longitudinal association of affect regulation with future allostatic load.

Method

In 2004–2006, 574 participants from the Midlife in the United States study completed validated scales assessing use of nine general and emotion-specific regulatory strategies (e.g., denial, anger expression). As a proxy for how flexibly participants regulate their affect, variability in the use of regulatory strategies was operationalized using a standard …

Prostate Specific Antigen-Based Cancer Screening In The United States, Treves M. Dennis

Walden Dissertations and Doctoral Studies

In 2012, the U.S. Preventive Services Task Force revised its prostate cancer screening recommendations to advocate against the routine use of prostate-specific antigen-based testing. This cross-sectional study of a large dataset from the Surveillance, Epidemiology, and End Results Program compared PSA-based diagnoses made from 2006 to 2011 to those from 2013 to 2018. The study aimed to address the impact of the change in recommendation on survival and stage at diagnosis in prostate cancer patients. The socioecological model was used as the theoretical foundation for the study. A total of 205,129 men diagnosed with prostate cancer comprised the study population. …

Pregnancy Intention, Perinatal Depression, Birth Weight, And Premature Delivery Among Black Women, Chantay Philease Mcneil

Walden Dissertations and Doctoral Studies

Perinatal depression among Black women results in significant public health burdens, interacting with systemic disparities to create disproportionate risks of adverse birth outcomes. The present study explored the moderating effect of pregnancy intention on the relationship between perinatal depression and adverse birth outcomes such as low birth weight and preterm delivery among Black women living in the southern United States. Using secondary data from the 2016-2020 Pregnancy Risk Assessment Monitoring System (PRAMS), data were analysed from 9825 black women across eight southern states including Alabama, Arkansas, Florida, Georgia, Louisiana, Mississippi, Tennessee, and Virginia. The statistical approach included chi-square tests and …

Podocyte Cell-Specific Npr1 Is Required For Blood Pressure And Renal Homeostasis In Male And Female Mice: Role Of Sex-Specific Differences, Chandramohan Ramasamy, Kandasamy Neelamegam, Samivel Ramachandran, Huijing Xia, Daniel R. Kapusta, Farhad R. Danesh, Kailash N. Pandey

School of Graduate Studies Faculty Publications

Atrial and brain natriuretic peptides (ANP and BNP) bind to guanylyl cyclase A/natriuretic peptide receptor A (GC-A/NPRA), stimulating natriuresis and diuresis and reducing blood pressure (BP), but the role of ANP/NPRA signaling in podocytes (highly specialized epithelial cells covering the outer surfaces of renal glomerular capillaries) remains unclear. This study aimed to determine the effect of conditional deletion of podocyte-specific Npr1 (encoding NPRA) gene knockout (KO) in male and female mice. Tamoxifen-treated wild-type control (PD Npr1 f/f; WT), heterozygous (PD-Cre-Npr1 f/+; HT), and KO (PD-Cre-Npr1 f/-) mice were fed a normal-, low-, or high-salt diet for 4 wk. Podocytes isolated …

Adjuvant External Beam Radiotherapy Combined With Brachytherapy For Intermediate-Risk Cervical Cancer, Nuria Agusti, David Viveros-Carreño, Alexander Melamed, Rene Pareja, Alexa Kanbergs, Chi-Fang Wu, Roni Nitecki, Lauren Colbert, Jose Alejandro Rauh-Hain

Faculty, Staff and Student Publications

Objective: Patients with intermediate-risk cervical cancer receive external beam radiotherapy (EBRT) as adjuvant treatment. It is commonly administered with brachytherapy without proven benefits. Therefore, we evaluated the frequency of brachytherapy use, the doses for EBRT administered alone or with brachytherapy, and the overall survival impact of brachytherapy in patients with intermediate-risk, early-stage cervical cancer.

Methods: This retrospective cohort study was performed using data collected from the National Cancer Database. Patients diagnosed with cervical cancer from 2004 to 2019 who underwent a radical hysterectomy and lymph node staging and had disease limited to the cervix but with tumors larger than 4 …

Women In Stem Becoming Independent: Our Shared Motivation And Enthusiasm Are Our Driving Force, Liudmila Andreeva, Lidia Bosurgi, Shu Zhen Chong, Coco Chu, Yejing Ge, Esther Hoste, Kellie A Jurado, Jette Lengefeld, Archita Mishra, Stefanie Wculek, Arabella Young

Faculty, Staff and Student Publications

This year at JEM, we are highlighting women in science by sharing their stories and amplifying their voices. In this Viewpoint, we hear from a cross section of women, across multiple research fields, discussing their science and the process of setting up a lab as an independent researcher.

The Oncolytic Adenovirus Delta-24-Rgd In Combination With Onc201 Induces A Potent Antitumor Response In Pediatric High-Grade And Diffuse Midline Glioma Models, Daniel De La Nava, Iker Ausejo-Mauleon, Virginia Laspidea, Marisol Gonzalez-Huarriz, Andrea Lacalle, Noelia Casares, Marta Zalacain, Lucía Marrodan, Marc García-Moure, Maria C Ochoa, Antonio Carlos Tallon-Cobos, Reyes Hernandez-Osuna, Javier Marco-Sanz, Laasya Dhandapani, Irati Hervás-Corpión, Oren J Becher, Javad Nazarian, Sabine Mueller, Timothy N Phoenix, Jasper Van Der Lugt, Mikel Hernaez, Elizabeth Guruceaga, Carl Koschmann, Sriram Venneti, Joshua E Allen, Matthew D Dun, Juan Fueyo, Candelaria Gomez-Manzano, Jaime Gallego Perez-Larraya, Ana Patiño-García, Sara Labiano, Marta M Alonso

Faculty, Staff and Student Publications

BACKGROUND: Pediatric high-grade gliomas (pHGGs), including diffuse midline gliomas (DMGs), are aggressive pediatric tumors with one of the poorest prognoses. Delta-24-RGD and ONC201 have shown promising efficacy as single agents for these tumors. However, the combination of both agents has not been evaluated.

METHODS: The production of functional viruses was assessed by immunoblotting and replication assays. The antitumor effect was evaluated in a panel of human and murine pHGG and DMG cell lines. RNAseq, the seahorse stress test, mitochondrial DNA content, and γH2A.X immunofluorescence were used to perform mechanistic studies. Mouse models of both diseases were used to assess the …

Phase Ii Study Of Vemurafenib In Children And Young Adults With Tumors Harboring Braf V600 Mutations: Nci-Cog Pediatric Match Trial (Apec1621) Arm G, Marie V Nelson, Aerang Kim, P Mickey Williams, Sinchita Roy-Chowdhuri, David R Patton, Brent D Coffey, Joel M Reid, Jin Piao, Lauren Saguilig, Todd A Alonzo, Stacey L Berg, Nilsa C Ramirez, Alok Jaju, Elizabeth Fox, Brenda J Weigel, Douglas S Hawkins, Margaret M Mooney, Naoko Takebe, James V Tricoli, Katherine A Janeway, Nita L Seibel, D Williams Parsons

Center for Medical Ethics and Health Policy Staff Publications

Background: This is a phase II subprotocol of the NCI-COG Pediatric MATCH study evaluating vemurafenib, a selective oral inhibitor of BRAF V600 mutated kinase, in patients with relapsed or refractory solid tumors harboring BRAF V600 mutations.

Methods: Patients received vemurafenib at 550 mg/m2 (maximum 960 mg/dose) orally twice daily for 28-day cycles until progression or intolerable toxicity. The primary aim was to determine the objective response rate and secondary objectives included estimating progression-free survival and assessing the tolerability of vemurafenib.

Results: Twenty-two patients matched to the subprotocol and 4 patients (18%) enrolled. Primary reasons for non-enrollment were ineligibility due to …

Resistance, Rebound, And Recurrence Regrowth Patterns In Pediatric Low-Grade Glioma Treated By Mapk Inhibition: A Modified Delphi Approach To Build International Consensus-Based Definitions-International Pediatric Low-Grade Glioma Coalition, Patricia O'Hare, David H Gutmann, Et Al.

2020-Current year OA Pubs

Pediatric low-grade glioma (pLGG) is the most common childhood brain tumor group. The natural history, when curative resection is not possible, is one of a chronic disease with periods of tumor stability and episodes of tumor progression. While there is a high overall survival rate, many patients experience significant and potentially lifelong morbidities. The majority of pLGGs have an underlying activation of the RAS/MAPK pathway due to mutational events, leading to the use of molecularly targeted therapies in clinical trials, with recent regulatory approval for the combination of BRAF and MEK inhibition for BRAFV600E mutated pLGG. Despite encouraging activity, tumor …

Maturation Of Germinal Center B Cells After Influenza Virus Vaccination In Humans, Katherine M Mcintire, Wooseob Kim, Sameer Kumar Malladi, Bassem M Mohammed, Julian Q Zhou, Aaron J Schmitz, Teresa Suessen, William D Middleton, Sharlene A Teefey, Rachel M Presti, Jackson S Turner, Ali H. Ellebedy, Et Al.

2020-Current year OA Pubs

Germinal centers (GC) are microanatomical lymphoid structures where affinity-matured memory B cells and long-lived bone marrow plasma cells are primarily generated. It is unclear how the maturation of B cells within the GC impacts the breadth and durability of B cell responses to influenza vaccination in humans. We used fine needle aspiration of draining lymph nodes to longitudinally track antigen-specific GC B cell responses to seasonal influenza vaccination. Antigen-specific GC B cells persisted for at least 13 wk after vaccination in two out of seven individuals. Monoclonal antibodies (mAbs) derived from persisting GC B cell clones exhibit enhanced binding affinity …

A Human Stat3 Gain-Of-Function Variant Drives Local Th17 Dysregulation And Skin Inflammation In Mice, Kelsey A Toth, Erica G Schmitt, Ana Kolicheski, Zev J Greenberg, Elizabeth Levendosky, Nermina Saucier, Kelsey Trammel, Vasileios Oikonomou, Michail S Lionakis, Eynav Klechevsky, Brian S Kim, Laura G Schuettpelz, Naresha Saligrama, Megan A Cooper

2020-Current year OA Pubs

Germline gain-of-function (GOF) variants in STAT3 cause an inborn error of immunity associated with early-onset poly-autoimmunity and immune dysregulation. To study tissue-specific immune dysregulation, we used a mouse model carrying a missense variant (p.G421R) that causes human disease. We observed spontaneous and imiquimod (IMQ)-induced skin inflammation associated with cell-intrinsic local Th17 responses in STAT3 GOF mice. CD4+ T cells were sufficient to drive skin inflammation and showed increased Il22 expression in expanded clones. Certain aspects of disease, including increased epidermal thickness, also required the presence of STAT3 GOF in epithelial cells. Treatment with a JAK inhibitor improved skin disease without …

Benefits And Challenges Of Geographic Information Systems (Gis) For Data-Driven Outreach In Black Communities Experiencing Overdose Disparities: Results Of A Stakeholder Focus Group, Devin E Banks, Maria Paschke, Rashmi Ghonasgi, Vetta L Sanders Thompson

2020-Current year OA Pubs

BACKGROUND: Black individuals in the U.S. face increasing racial disparities in drug overdose related to social determinants of health, including place-based features. Mobile outreach efforts work to mitigate social determinants by servicing geographic areas with low drug treatment and overdose prevention access but are often limited by convenience-based targets. Geographic information systems (GIS) are often used to characterize and visualize the overdose crisis and could be translated to community to guide mobile outreach services. The current study examines the initial acceptability and appropriateness of GIS to facilitate data-driven outreach for reducing overdose inequities facing Black individuals.

METHODS: We convened a …

Epigenetic Associations With Neonatal Age In Infants Born Very Preterm, Particularly Among Genes Involved In Neurodevelopment., Kenyaita M. Hodge, Amber A. Burt, Marie Camerota, Brian S. Carter, Jennifer Check, Karen N. Conneely, Jennifer Helderman, Julie A. Hofheimer, Anke Hüls, Elisabeth C. Mcgowan, Charles R. Neal, Steven L. Pastyrnak, Lynne M. Smith, Sheri A. Dellagrotta, Lynne M. Dansereau, T Michael O'Shea, Carmen J. Marsit, Barry M. Lester, Todd M. Everson

Manuscripts, Articles, Book Chapters and Other Papers

The time from conception through the first year of life is the most dynamic period in human development. This time period is particularly important for infants born very preterm (< 30 weeks gestation; VPT), as they experience a significant disruption in the normal developmental trajectories and are at heightened risk of experiencing developmental impairments and delays. Variations in the epigenetic landscape during this period may reflect this disruption and shed light on the interrelationships between aging, maturation, and the epigenome. We evaluated how gestational age (GA) and age since conception in neonates [post-menstrual age (PMA)], were related to DNA methylation in buccal cells collected at NICU discharge from VPT infants (n = 538). After adjusting for confounders and applying Bonferroni correction, we identified 2,366 individual CpGs associated with GA and 14,979 individual CpGs associated with PMA, as well as multiple differentially methylated regions. Pathway enrichment analysis identified pathways involved in axonogenesis and regulation of neuron projection development, among many other growth and developmental pathways (FDR q < 0.001). Our findings align with prior work, and also identify numerous novel associations, suggesting that genes important in growth and development, particularly neurodevelopment, are subject to substantial epigenetic changes during early development among children born VPT.