Medicine and Health Sciences Commons^™

Low Vitamin B12: The Need For Updated Provider Education, Tracy Coltharp

Doctor of Nursing Practice Scholarly Project

Vitamin B12 deficiency is a notable clinical problem with multi-factorial risk factors and a multitude of clinical manifestations. It is associated with polyglandular autoimmune syndromes, some familiar and some lesser well known. The specific aim of this scholarly project was to evaluate whether education aimed at providers such as nurse practitioners, nurse practitioner students, physician assistants, and physicians regarding updated diagnostic criteria for vitamin B12 deficiencies as well as associated diseases, specifically autoimmune gastritis, and pernicious anemia, increased their knowledge and ultimately improved clinical practice. The project utilized a pre-test/post-test design with education provided in between. There was an improvement …

The Effect Of Education Path And Nursing Specialty On Knowledge And Attitude Survey Regarding Pain Scores, Justin Cope

Doctor of Nursing Practice Scholarly Project

Pain is reported as the number one fear of patients, and has been shown to stop patients from seeking necessary medical treatment in a timely manner. Therefore, it is important that health care professionals be able to properly assess and treat pain. One area not previously studied is how degree path affects knowledge acquisition.

The purpose of this study is to determine the effect of structured education and clinical experience on general pain knowledge between traditional and non-traditional Bachelors of Science in Nursing students. Participants of this study include RN-BSN students and pre-licensure BSN students who have completed the Adult …

Dynamic Obstruction Of The Subglottis: A Subglottic Stenosis Mimic., Razmig Garabet, Lauren E Melley, Omar Ramadan, Robert T Sataloff

Otolaryngology (ENT) Resident Research

Laryngomalacia is characterized by dynamic obstruction of the upper airway. Early detection using dynamic observation across the respiratory cycle helps assume accurate diagnosis and effective management. We present a case of laryngomalacia that mimicked characteristics of subglottic stenosis which could have resulted in unnecessary surgery.

Within-Day Reliability Of Submaximal Running Economy Testing: Implications For Advanced Footwear Testing, Garrett Oehlert

Electronic Theses and Dissertations

Running economy (RE) has been identified as a critical component of endurance performance. Alterations in footwear have shown to significantly impact RE. Quantifying reliability of within-day RE measures may determine differences that could be expected when testing footwear. PURPOSE: Assess within-day reliability of RE testing on a calibrated metabolic system. METHODS: Trained male distance runners (n=10) were recruited to perform 4 × 5-minute trials (set speed, in habitual running shoes) at their estimated marathon pace (5-minute rest period) during a single visit to the lab. Oxygen consumption (VO2) data were collected during the final two minutes of each stage and …

How Can Art Therapy Help Individuals With Chronic Illnesses? A Literature Review, Emily Heidler

Expressive Therapies Capstone Theses

This literature review examines the influence of art therapy on the self-esteem of individuals who suffer from chronic pain. The research question was: How can art therapy help individuals with chronic illnesses? Through an exploration of the topics of art therapy, chronic pain, parenting style, and self-esteem, it was noted that there is a gap in literature about art therapy’s influence on self-esteem resulting from chronic pain. However, an analysis of the literature reveals that art therapy can influence the self-esteem of individuals who suffer from chronic pain. Art therapy can influence this population by providing a sense of belonging, …

Dnp Final Report: Central Line Dressing Change Regimen To Decrease Central Line-Associated Bloodstream Infections, Ann Campbell

DNP Final Reports

Central line associated bloodstream infections (CLABSI) are dangerous and costly occurrences in healthcare facilities. This evidence-based project's purpose is to implement interventions to reduce CLABSIs in a healthcare facility that has higher than the national average of reported cases. The practice problem PICOT question is: In inpatients with indwelling central venous access devices at the facility, (P) how does implementation of evidence-based guidelines for central line dressing changes every seven days and as needed (I) compared to the current practice of dressing changes on Fridays (C) affect CLABSI rates over a three-month period (O). The body of evidence obtained in …

Enhancing The Culture Of Safety Among Hospital Personnel By Implementing A Just Culture Program: A Quality Improvement Project, Lawson Stuart

Doctor of Nursing Practice (DNP) Manuscripts

Objectives

The purpose of this study was to assess employee perceptions of a healthcare organization’s existing climate of psychological safety regarding reporting patient care errors or near-miss events. Based on data obtained from the use of a valid and reliable survey tool, a plan was developed for the introduction and implementation of Just Culture throughout a large multi-hospital healthcare system.

Methods

Employee perceptions of the organization’s culture and current barriers to improving patient safety were identified by administering the JCAT survey to a population of 25,893 frontline staff, middle leaders, and senior leaders (clinical and non-clinical) at 26 separate hospitals …

Cerebral Near‐Infrared Spectroscopy Use In Neonates: Current Perspectives, Zachary A. Vesoulis, Danielle P. Sharp, Natasha Lalos, Devon P. Swofford, Valerie Y. Chock

2020-Current year OA Pubs

No abstract provided.

Pembrolizumab Versus Placebo As Adjuvant Therapy In Resected Stage Iib Or Iic Melanoma: Final Analysis Of Distant Metastasis-Free Survival In The Phase Iii Keynote-716 Study, Jason J. Luke, Paolo A. Ascierto, Muhammad A. Khattak, Luis De La Cruz Merino, Michele Del Vecchio, Piotr Rutkowski, Francesco Spagnolo, Jacek Mackiewicz, Vanna Chiarion-Sileni, John M. Kirkwood, Caroline Robert, Jean Jacques Grob, Federica De Galitiis, Dirk Schadendorf, Matteo S. Carlino, Xi Lawrence Wu, Mizuho Fukunaga-Kalabis, Clemens Krepler, Alexander M.M. Eggermont, Georgina V. Long

Research outputs 2022 to 2026

Clinical trials frequently include multiple end points that mature at different times. The initial report, typically based on the primary end point, may be published when key planned co-primary or secondary analyses are not yet available. Clinical Trial Updates provide an opportunity to disseminate additional results from studies, published in JCO or elsewhere, for which the primary end point has already been reported.Pembrolizumab adjuvant therapy was shown to significantly improve recurrence-free survival (RFS) and distant metastasis-free survival (DMFS) in patients with resected stage IIB or IIC melanoma in earlier analyses of the randomized, double-blind, phase III KEYNOTE-716 study (ClinicalTrials.gov identifier: …

The Ethical Justification Of Medical Interventions Across The Spectrum Of Healthcare For Patients Preceding The Age Of Consent: The Tension Between Surrogate Consent And Minor Assent, Erin Scroggins

Electronic Theses and Dissertations

This dissertation, The Ethical Justification of Medical Interventions Across the Spectrum of Healthcare for Patients Preceding the Age of Consent: the Tension Between Surrogate Consent and Minor Assent, will aim to provide ethical justification for medical intervention for patients preceding the age of consent. To begin, decision-making for medical intervention in all forms will be examined. Followed by, beginning of life interventions into complex and controversial situations for medical intervention which then leads into end-of-life considerations for patients preceding the age of consent. These chapters will pose various ethical considerations for some more contentious dilemmas. It has been pondered …

Targeting Cancer- One Carbon At A Time: Design And Synthesis Of Pyrimidine Based Heterocycles As Potential Cancer Chemotherapeutics, Md Junayed Nayeen

Electronic Theses and Dissertations

With over 6 million death counts, cancer is the second leading cause of death in the United States. Lung cancer was the leading cause of cancer death, accounting for 23% (136,084 death count) of all cancer deaths. Other than that, colon and rectal (9%, 51,869 death count), pancreas (8%, 46,774 death count), female breast (7%, 42,275 death count), prostate (5%, 32,707 death count), and liver and intrahepatic bile duct (5%, 28,227 death count). Other cancers individually accounted for less than 5% of cancer deaths. Although cancer death rates decreased about 27% from 2001 to 2020, the therapeutic options are limited …

Fundal Anterior To Posterior Hysterotomy And Cesarean Myomectomy In Fibroid Uterus, Ashni Nadgauda, Sarah Dreibelbis, Jonathan D. Rodger, Andrew Fieo

Cooper Rowan Medical Journal

Fibroids are a common benign tumor located in the female reproductive tract and affect up to 10 percent of women, leading to challenges during cesarean section. Few cases of myomectomy at the time of cesarean section have been described and most describe uteri with only a few fibroids present. Our case describes a 39 year old G1P0101female with extensive fibroids including large fibroids located at the lower uterine segment. This patient underwent cesarean section and myomectomy at 27 weeks and five days gestation with a fundal, vertical hysterotomy, extending from the anterior to posterior wall of uterus. This is the …

Metabolic Changes Enhance Necroptosis Of Type 2 Diabetes Mellitus Mice Infected With Mycobacterium Tuberculosis, Abhinav Vankayalapati, Olamipejo Durojaye, Tanmoy Mukherjee, Padmaja Paidipally, Bismark Owusu-Afriyie, Ramakrishna Vankayalapati, Rajesh Kumar Radhakrishnan

School of Medicine Faculty Publications and Presentations

Previously, we found that Mycobacterium tuberculosis (Mtb) infection in type 2 diabetes mellitus (T2DM) mice enhances inflammatory cytokine production which drives pathological immune responses and mortality. In the current study, using a T2DM Mtb infection mice model, we determined the mechanisms that make T2DM mice alveolar macrophages (AMs) more inflammatory upon Mtb infection. Among various cell death pathways, necroptosis is a major pathway involved in inflammatory cytokine production by T2DM mice AMs. AntiTNFR1 antibody treatment of Mtb-infected AMs from T2DM mice significantly reduced expression of receptor interacting protein kinase 3 (RIPK3) and mixed lineage kinase domain-like (MLKL) (necroptosis markers) and …

The Contribution Of Pope Francis’ Integral Ecology To Global Ethics, Salvatore Enzo Del Brocco

Electronic Theses and Dissertations

The defense of the dignity and inviolability of human life has always gained prominence in the doctrine of the Catholic Church. With Pope Francis' concept of integral ecology, Catholic bioethics is expanded to a broader understanding. His vision of integral ecology, global bioethics, and solidarity emphasizes the interconnectedness of all things and the importance of caring for one another and the planet. It calls us to recognize our common humanity and to work together for the common good by facing the numerous emerging problems of our times, which threaten the dignity of human life and the future life of the …

Keratin 17 Modulates The Immune Topography Of Pancreatic Cancer, Lyanne Delgado-Coka, Michael Horowitz, Mariana Torrente-Goncalves, Lucia Roa-Peña, Cindy Leiton, Mahmudul Hasan, Sruthi Babu, Danielle Fassler, Jaymie Oentoro, Ji-Dong Bai, Emanuel Petricoin, Lynn Matrisian, Edik Matthew Blais, Natalia Marchenko, Felicia Allard, Wei Jiang, Brent Larson, Andrew Hendifar, Chao Chen, Shahira Abousamra, Dimitris Samaras, Tahsin Kurc, Joel Saltz, Luisa Escobar-Hoyos, Kenneth Shroyer

Kimmel Cancer Center Faculty Papers

BACKGROUND: The immune microenvironment impacts tumor growth, invasion, metastasis, and patient survival and may provide opportunities for therapeutic intervention in pancreatic ductal adenocarcinoma (PDAC). Although never studied as a potential modulator of the immune response in most cancers, Keratin 17 (K17), a biomarker of the most aggressive (basal) molecular subtype of PDAC, is intimately involved in the histogenesis of the immune response in psoriasis, basal cell carcinoma, and cervical squamous cell carcinoma. Thus, we hypothesized that K17 expression could also impact the immune cell response in PDAC, and that uncovering this relationship could provide insight to guide the development of …

Perinatal Ethics: The Role Of Ethics Consultation Around Parental Dilemmas Before And After Birth, Giulia Adele Dinicola

Electronic Theses and Dissertations

This dissertation, “Perinatal Ethics: the Role of Ethics Consultation around Parental Dilemmas Before and After Birth,” aims to examine the nuances of clinical ethics consultations in the field of perinatal ethics. Perinatal ethics entails ethical quandaries that emerge during a life-changing shift in prospective parents’ lives: pregnancy, childbirth, and the first days to months of their child’s life. Although pregnancy and childbirth often come with happy and joyful memories; this is not always the case. When fetal anomalies are diagnosed either with prenatal screening tests, or when maternal health complications develop during pregnancy, or when delivery-related emergencies occur during childbirth, …

Transforming Chaplain Ethics: The Clinical Ethics Of Spiritual Care In A Pluralistic Healthcare Environment In The United States, Robert Alan Price

Electronic Theses and Dissertations

This dissertation, “Transforming Chaplain Ethics: The Clinical Ethics of Spiritual Care in a Pluralistic Healthcare Environment in the United States,” aims to examine the clinical ethics of religious and spiritual care provided by clinical chaplains for patients and families receiving treatment in a pluralistic healthcare context in the United States.

Clinical chaplains are more than clergypersons and they are more than clinicians; they are a highly specialized marriage of both worlds. There is a fundamental asymmetry between functioning as a leader in a local religious community or faith tradition and providing clinical spiritual care in a pluralistic healthcare environment. This …

Evaluating Nurse Comfort Levels Assessing For Depression In An Urban Hospital Setting, Jonathan Shafer, Riley R. Clubb

Doctor of Nursing Practice Projects

Evidence shows that a fraction of nurses are uncomfortable assessing patients for depression. When depression assessments are uncomfortable for the clinician, there may be inconsistencies in practice which can negatively affect patient outcomes. An evidence-based survey was developed and distributed to nurses at an urban hospital in Missouri. The survey assessed nurse's confidence, frequency of assessment, and understanding in evaluating patients for depression. Seventy-three nurses took part in the confidential survey. Thirty percent of the participants reported that they sometimes ask about mood and twenty-one percent reported that they rarely ask about mood. Although results showed that nurses were not …

Fake Xanax: Designer Emerging Benzodiazepine Epidemic Linked To Morbidity And Mortality A Narrative Review, Alan D. Kaye, Joseph P. Tassin, William C. Upshaw, Camille M. Robichaux, Mark V. Frolov, Mark M. Dupaquier, Julia E. Fox, Jeffrey Sterritt, Jibin Mathew, Sahar Shekoohi, Adam M. Kaye, Amber N. Edinoff

Pacific Faculty Work

Etizolam is a thienodiazepine derivative which produces an anxiolytic effect similar to benzodiazepines such as alprazolam (Xanax). Like classic benzodiazepines, etizolam has a high affinity towards the GABAA receptor, and allosterically potentiates the effects of GABA resulting in neuronal hyperpolarization related to chloride influx. When taken in therapeutic doses, etizolam produces a similar effect to Xanax. Counterfeit Xanax tablets contain variable amounts of etizolam. Tablets with high amounts of etizolam can cause toxicity if ingested, especially when combined with other substances. When toxic symptoms occur in patients, they may include severe sedation, unconsciousness, and depression of the medullary respiratory center. …

Gut Microbiota, Blood Metabolites, And Left Ventricular Diastolic Dysfunction In Us Hispanics/Latinos, Kai Luo, Alkis Taryn, Eun-Hye Moon, Brandilyn A Peters, Scott D Solomon, Martha L Daviglus, Mayank M Kansal, Bharat Thyagarajan, Marc D Gellman, Jianwen Cai, Robert D Burk, Rob Knight, Robert C Kaplan, Susan Cheng, Carlos J Rodriguez, Qibin Qi, Bing Yu

Faculty, Staff and Student Publications

BACKGROUND: Left ventricular diastolic dysfunction (LVDD) is an important precursor of heart failure (HF), but little is known about its relationship with gut dysbiosis and microbial-related metabolites. By leveraging the multi-omics data from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a study with population at high burden of LVDD, we aimed to characterize gut microbiota associated with LVDD and identify metabolite signatures of gut dysbiosis and incident LVDD.

RESULTS: We included up to 1996 Hispanic/Latino adults (mean age: 59.4 years; 67.1% female) with comprehensive echocardiography assessments, gut microbiome, and blood metabolome data. LVDD was defined through a composite criterion …

Structural And Blood Co-Factor Binding Studies Of A Red Algal Sulfated Galactan, Anderson R. Dewitt

Honors Theses

The red alga Botryocladia occidentalis presents three distinct fractions of sulfated polysaccharides. The elucidation of structures of various B. occidentalis fractions has been explored in prior research. In this study, the first fraction with the least sulfation underwent NMR structure elucidation. Additionally, this sulfated polysaccharide underwent analysis following chemical modifications. Findings have unveiled the presence of both 4-linked α- and 3-linked β-galactose units with the following chemical characteristics: over half of the total galactose units are unsulfated, the α-units are primarily 3,6-anhydrogalactose units either 2-O-methylated or 2-O-sulfated, and the β-galactose units can be 4-O-sulfated or 2,4-O-disulfated. Results from SPR-based assays …

Extension-Clinical Approach To Covid-19 Testing And Vaccination, Camden Bryan, Rhonda Matthews, Kapri Kreps, David Thornal, Danielle Mcfall, David Sudduth, Michelle Parisi

Journal of Extension

Vaccination rates against COVID-19 are lower in rural areas across the country, including SC. This paper highlights the work conducted by Clemson Cooperative Extension Service in SC to increase rural access to COVID-19 testing and vaccine services. Extension Agents engaged in clinical and community partnerships to coordinate COVID-19 vaccine and testing clinics in rural and underserved communities. Agents established 204 test clinics and 220 vaccination clinics. The total number of people tested and vaccinated was 9,331 and 2,037, respectively. The success of this project shows Extension agents can be instrumental in bridging the gap between clinical resources and rural communities.

A Needs Assessment Of Extension Staff To Implement Inclusive Programming For Adults With Intellectual/Developmental Disabilities, E. Andrew Pitchford, Christine Hradek, Jody Gatewood, Debra M. Sellers

Journal of Extension

This study is a needs assessment of Extension staff in the state of Iowa to implement inclusive programming for individuals with intellectual and developmental disabilities (IDD). Electronic surveys were completed by Extension staff on their attitudes and beliefs toward people with IDD, inclusive programming, and training needs. Results showed that Extension staff had positive views, but that staff reporting personal experience with people with IDD had more positive attitudes and beliefs (p

Disparities In Accessing Specialty Behavioral Health Services During The Covid-19 Pandemic And Why We Need Pediatric Integrated Primary Care., Ayanda Chakawa, Trista Perez Crawford, Leslee Belzer, Hung-Wen Yeh

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: Youth unmet behavioral health needs are at public health crisis status and have worsened since the onset of the coronavirus disease 2019 pandemic (Covid-19). Integrating behavioral health services into pediatric primary care has shown efficacy in addressing youth behavioral health needs. However, there is limited guidance on facilitating equitable access to care in this setting, including in triaging access to co-located services (i.e., onsite outpatient behavioral health services with only the behavioral health provider) or to specialty behavioral health services in other clinics within larger health systems.

METHODS: A retrospective, comparative study was conducted to examine variability in access …

A Case Of Cervical Chordoma, Michael Nicolette, Swar Vimawala, Xinmin Zhang, Corey Mossop, Brian Swendseid

Cooper Rowan Medical Journal

A 48 year old male presented with neck pain and left arm pain that worsened with movement alongside left arm weakness, numbness, and tingling. The differential diagnosis for a patient with symptoms of a neck mass includes benign tumors like neurofibromas, malignant tumors like chordomas, and non-neoplastic conditions like cervical spondylitis. A magnetic resonance imaging (MRI) study of the cervical spine with and without contrast identified a T1 hypointense, T2 hyperintense, heterogeneously enhancing prevertebral mass with parapharyngeal extension. A direct laryngoscopy with biopsy was performed and revealed a paraspinal tumor. The patient’s diagnosis of cervical chordoma was confirmed upon detection …

Early Gfap And Uch-L1 Point-Of-Care Biomarker Measurements For The Prediction Of Traumatic Brain Injury And Progression In Patients With Polytrauma And Hemorrhagic Shock, Jason L Sperry, James F Luther, David O Okonkwo, Laura E Vincent, Vikas Agarwal, Bryan A Cotton, Jeremy W Cannon, Martin A Schreiber, Ernest E Moore, Nicholas Namias, Joseph P Minei, Kelly L Urbanek, Mark H Yazer, Ava M Puccio, Erin E Fox, Joshua B Brown, Matthew D Neal, Frank X Guyette, Stephen R Wisniewski

Faculty, Staff and Student Publications

Objective: Traumatic brain injury (TBI) and hemorrhage are responsible for the largest proportion of all trauma-related deaths. In polytrauma patients at risk of hemorrhage and TBI, the diagnosis, prognosis, and management of TBI remain poorly characterized. The authors sought to characterize the predictive capabilities of glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase L1 (UCH-L1) measurements in patients with hemorrhagic shock with and without concomitant TBI.

Methods: The authors performed a secondary analysis on serial blood samples derived from a prospective observational cohort study that focused on comparing early whole-blood and component resuscitation. A convenience sample of patients was …

Evaluation Of Fusobacterium Nucleatum Enoyl-Acp Reductase (Fabk) As A Narrow-Spectrum Drug Target, Jacob T Rutherford, Kristiana Avad, Chetna Dureja, Krissada Norseeda, Bibek Gc, Chenggang Wu, Dianqing Sun, Kirk E Hevener, Julian G Hurdle

Faculty, Staff and Student Publications

Fusobacterium nucleatum, a pathobiont inhabiting the oral cavity, contributes to opportunistic diseases, such as periodontal diseases and gastrointestinal cancers, which involve microbiota imbalance. Broad-spectrum antimicrobial agents, while effective against F. nucleatum infections, can exacerbate dysbiosis. This necessitates the discovery of more targeted narrow-spectrum antimicrobial agents. We therefore investigated the potential for the fusobacterial enoyl-ACP reductase II (ENR II) isoenzyme FnFabK (C4N14_ 04250) as a narrow-spectrum drug target. ENRs catalyze the rate-limiting step in the bacterial fatty acid synthesis pathway. Bioinformatics revealed that of the four distinct bacterial ENR isoforms, F. nucleatum specifically encodes FnFabK. Genetic studies revealed …

Strict Conservation Yet Non-Essential Nature Of Plasmid Gene Bba40 In The Lyme Disease Spirochete Borrelia Burgdorferi, Yuqi Zhu, Yili Zhang, Hui Chen, Lisha Zhang, Chensi Shen

Faculty, Staff and Student Publications

The increasing concern over climate change has spurred significant interest in exploring the potential of microalgae for wastewater treatment. Among the various types of industrial wastewaters, high-salinity NH₄⁺-N wastewater stands out as a common challenge. Investigating microalgae’s resilience to NH₄⁺-N under high-salinity conditions and their efficacy in NH₄⁺-N utilization is crucial for advancing industrial wastewater microalgae treatment technologies. This study evaluated the effectiveness of employing nitrogen-efficient microalgae, specifically Oocystis lacustris, for NH₄⁺-N removal from saline wastewater. The results revealed Oocystis lacustris’s tolerance to a Na_{2 …}

Substrate Mechanics Unveil Early Structural And Functional Pathology In Ipsc Micro-Tissue Models Of Hypertrophic Cardiomyopathy, Jingxuan Guo, Huanzhu Jiang, David Schuftan, Jonathan D Moreno, Ghiska Ramahdita, Lavanya Aryan, Druv Bhagavan, Jonathan Silva, Nathaniel Huebsch

2020-Current year OA Pubs

Hypertension is a major cause of morbidity and mortality in patients with hypertrophic cardiomyopathy (HCM), suggesting a potential role for mechanics in HCM pathogenesis. Here, we developed an

Hyper-Physiologic Mechanical Cues, As An Osteoarthritis Disease-Relevant Environmental Perturbation, Cause A Critical Shift In Set Points Of Methylation At Transcriptionally Active Cpg Sites In Neo-Cartilage Organoids, Niek G C Bloks, Amanda Dicks, Zainab Harissa, Rob G H H Nelissen, Ghazaleh Hajmousa, Yolande F M Ramos, Rodrigo Coutinho De Almeida, Farshid Guilak, Ingrid Meulenbelt

2020-Current year OA Pubs

BACKGROUND: Osteoarthritis (OA) is a complex, age-related multifactorial degenerative disease of diarthrodial joints marked by impaired mobility, joint stiffness, pain, and a significant decrease in quality of life. Among other risk factors, such as genetics and age, hyper-physiological mechanical cues are known to play a critical role in the onset and progression of the disease (Guilak in Best Pract Res Clin Rheumatol 25:815-823, 2011). It has been shown that post-mitotic cells, such as articular chondrocytes, heavily rely on methylation at CpG sites to adapt to environmental cues and maintain phenotypic plasticity. However, these long-lasting adaptations may eventually have a negative …