Medicine and Health Sciences Commons^™

Study Of Plan Of The Day Adaptive Radiation Therapy Validity, Zane W. Burnett

UNLV Theses, Dissertations, Professional Papers, and Capstones

Radiation therapy is the use of radiation sources or generators to treat patients. The most common usage is in the treatment of cancers. Adaptive radiation therapy (ART) is the use of either multiple radiation therapy plans or adjusting a radiation therapy plan for daily anatomical changes. Soft tissue in the lower abdomen and pelvis can be greatly displaced depending on a variety of factors, especially bladder and rectum fill. This paper focuses on the creation of multiple plans prior to treatment to have options each day. Depending on the alignment and anatomical changes, clinicians can choose which one is most …

Linking Scholarly Learning Activities And Professional Identity In Otd Students, Andrew Loc Ho

UNLV Theses, Dissertations, Professional Papers, and Capstones

Professional identity formation is a critical aspect of education, training, and becoming an occupational therapist in Occupational Therapy Doctorate (OTD) programs. This capstone study explores the potential influences of learning activities related to research and scholarly writing professional identity development amongst OTD students using a cross-sectional descriptive design. This research study involved 32 OTD students across six cohorts participating in focus groups from the University of Nevada, Las Vegas (UNLV), and Kansas University Medical Center (KUMC). Through convenience sampling and latent content analysis managed with ATLAS.ti, the study identified categories underpinned by the Kawa Model to describe the dynamic interplay …

Increasing Self-Efficacy With Menstrual Management For Young Adults Experiencing Homelessness Using The Inclusive “U N Me” Education Program, Edellene Ignacio

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of the study was to increase self-efficacy with the occupation of menstrual management in young adults experiencing homelessness using the "Understanding and Navigating Menstrual Experience" or "U N ME" program. The objectives of this study were a reported increase in self-efficacy with menstrual management, the development of the U N ME program, and to promote the spread of accurate information to other menstruators in the community.

This study was a convergent parallel mixed-method study rooted in a phenomenological approach. The intervention featured four weekly workshops featuring education, group discussion, and an activity to tie the topic of the …

Osteoarthritis In The Temporomandibular Joint And Knee Joint: A Macroscopic Study Of Cadaver Specimens, Jeremy James

UNLV Theses, Dissertations, Professional Papers, and Capstones

In this study, thirty-one TMJs and twenty-eight knee joints were dissected from seventeen cadaveric subjects aged 69 to 95. Degenerative/osteoarthritic changes on the mandibular condyles, mandibular fossae, and femoral condyles were evaluated macroscopically and assigned a score on a disease severity scale (DSS) from 0 signifying “normal cartilage” to 4 signifying “severe OA”. Osteoarthritic changes were found in all TMJ and knee specimens. The average mandibular condyle DSS score was 2.68 ± 0.96, while the average mandibular fossa score was 2.90 ± 0.76; this difference in scores was significant (P = 0.035). Additionally, the mandibular fossa was equally or more …

Promoting Positive Dementia Attitudes Through Occupational Engagement: The Development Of A Dementia Awareness Program For Community Older Adults, Cynthia Lee

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: This capstone project explored the effects of adding occupational engagement into a dementia awareness program on attitudes toward dementia among community-dwelling older adults, aiming to challenge dementia myths and promote an inclusive environment through occupational therapy perspectives. Methods: This project used a pre-test, post-test design with convenience sampling to develop and assess a dementia awareness program based on insights from Silverado Red Rock Memory Care Community and participation from members of the Osher Lifelong Learning Institute (OLLI) at the University of Nevada, Las Vegas in the program. Changes in positive attitudes toward dementia were measured using the Dementia Attitudes …

Seated Athletes' Motivation For Participation In Wheelchair Sports: A Qualitative Study, Audrey Lynn Miller

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose for this phenomenological design qualitative analysis was to gain an understanding of the perspectives of seated athletes’ motivation for participation in adapted athletics and argues that there is a component of seating that affects motivation. Occupational therapists build client interventions using meaningful occupations. This study aimed to increase awareness of adapted athletics impact on occupational performance. There was a gap in the literature for qualitative research exploring the lens of adapted sports participation through the perspective of seated athletes. This study utilized one-time individual semi-structured interviews with five participants that currently participate on a wheelchair court sports team …

Feasibility Of An Occupation-Based Intervention Manual For Outpatient Hand Clinics, Mia Moralez

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose

The purpose of this quality improvement study was to determine the usefulness of an Occupation-based Intervention Manual (OBI) for hand therapists in Southern Nevada and if the utilization of the OBI manual supported client-centered outcomes regardless of diagnosis, age, or population.

Methods

Convenience sampling was used, and five participants met the inclusion criteria in the twelve-week study. Pre-interview questionnaire responses from the therapists were used to develop the OBI manual content and corresponding Utilization Tracker. Post-interview questionnaire responses were used to determine the application and outcomes of the OBI manual. Descriptive statistics, frequency distribution, and thematic analysis were used …

Effectiveness Of An Occupational Therapy-Focused Stroke Transitional Care Program In An Inpatient Rehabilitation Facility, Danniel Tapat

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: As a global health issue, stroke is one of the most common causes of disability for individuals around the world. The American Heart Association (2024) mentions that stroke is the fifth-highest cause of mortality and the top cause of disability in the United States. Objective: This project aimed to assess the change in the perceived readiness of individuals after implementing an occupational therapy (OT)-focused transitional care program for patients with stroke and their caregivers before returning home. Methods: The recruitment process for participants involved purposive sampling methods. The study utilized both the Readiness for Hospital Discharge Scale-Short Form (RHDS-SF) …

Mixed Methods Approach To Assess ‘Placental Opioid-Enhancing Factor’ Activity Within ‘Alternative’ Health Contexts Of Human Maternal Placentophagy, Jacob C. White

UNLV Theses, Dissertations, Professional Papers, and Capstones

Rats with elevated opioid levels experience an even greater increase in pain threshold after placenta or amniotic fluid consumption via placental opioid-enhancing factor (POEF) in the afterbirth. POEF only enhances opioid hypoalgesia; it cannot produce hypoalgesia alone. Although the POEF molecule remains unidentified and its efficacy in humans is unknown, it could be a safe, novel pain treatment. People who consume placenta as an alternative postpartum health practice are ideal for testing POEF bioactivity. Though rat models show that bioactive POEF is highly sensitive, some forms of the practice in humans may conserve POEF.

This project is the first attempt …

An Educational Toolkit For Addressing Women’S Sexual Health And Activity: Preparation For Occupational Therapists, Brittan Wright

UNLV Theses, Dissertations, Professional Papers, and Capstones

Despite being an activity of daily living within the scope of Occupational Therapy, issues and concerns related to sexual health are infrequently addressed within practice. This gap is especially prevalent as it relates to women's sexual health and sexual activity specifically. This capstone project evaluated Occupational Therapists' level of knowledge and comfort when discussing sexual activity and women's sexual health. It measured the effectiveness of creating an online educational toolkit to increase knowledge and confidence. The project used a quality improvement approach with pre-and post-test surveys to determine the effectiveness of the educational toolkit to enhance knowledge and confidence in …

Complement Regulation In The Eye: Implications For Age-Related Macular Degeneration, Georgia A. Wilke, Rajendra S. Apte

2020-Current year OA Pubs

Careful regulation of the complement system is critical for enabling complement proteins to titrate immune defense while also preventing collateral tissue damage from poorly controlled inflammation. In the eye, this balance between complement activity and inhibition is crucial, as a low level of basal complement activity is necessary to support ocular immune privilege, a prerequisite for maintaining vision. Dysregulated complement activation contributes to parainflammation, a low level of inflammation triggered by cellular damage that functions to reestablish homeostasis, or outright inflammation that disrupts the visual axis. Complement dysregulation has been implicated in many ocular diseases, including glaucoma, diabetic retinopathy, and …

Alport Syndrome And Alport Kidney Diseases - Elucidating The Disease Spectrum, Pongpratch Puapatanakul, Jeffrey H. Miner

2020-Current year OA Pubs

PURPOSE OF REVIEW: With the latest classification, variants in three collagen IV genes, COL4A3 , COL4A4 , and COL4A5 , represent the most prevalent genetic kidney disease in humans, exhibiting diverse, complex, and inconsistent clinical manifestations. This review breaks down the disease spectrum and genotype-phenotype correlations of kidney diseases linked to genetic variants in these genes and distinguishes "classic" Alport syndrome (AS) from the less severe nonsyndromic genetically related nephropathies that we suggest be called "Alport kidney diseases".

RECENT FINDINGS: Several research studies have focused on the genotype-phenotype correlation under the latest classification scheme of AS. The historic diagnoses of …

Patient Engagement In Designing, Conducting, And Disseminating Clinical Pain Research: Immpact Recommended Considerations, Simon Haroutounian, Katherine J. Holzer, Et Al.

2020-Current year OA Pubs

In the traditional clinical research model, patients are typically involved only as participants. However, there has been a shift in recent years highlighting the value and contributions that patients bring as members of the research team, across the clinical research lifecycle. It is becoming increasingly evident that to develop research that is both meaningful to people who have the targeted condition and is feasible, there are important benefits of involving patients in the planning, conduct, and dissemination of research from its earliest stages. In fact, research funders and regulatory agencies are now explicitly encouraging, and sometimes requiring, that patients are …

Interferons And Tuft Cell Numbers Are Bottlenecks For Persistent Murine Norovirus Infection, Somya Aggarwal, Forrest C. Walker, James S. Weagley, Broc T. Mccune, Xiaofen Wu, Lawrence A. Schriefer, Heyde Makimaa, Dylan Lawrence, Pratyush Sridhar, Megan T. Baldridge

2020-Current year OA Pubs

Noroviruses (NoVs) are a leading cause of viral gastroenteritis. Despite global clinical relevance, our understanding of how host factors, such as antiviral cytokines interferons (IFNs), modulate NoV population dynamics is limited. Murine NoV (MNoV) is a tractable in vivo model for the study of host regulation of NoV. A persistent strain of MNoV, CR6, establishes a reservoir in intestinal tuft cells for chronic viral shedding in stool. However, the influence of host innate immunity and permissive cell numbers on viral population dynamics is an open question. We generated a pool of 20 different barcoded viruses (CR6BC) by inserting 6-nucleotide barcodes …

National Hiv And Hcv Screening Rates For Hospitalized People Who Use Drugs Are Suboptimal And Heterogeneous Across 11 Us Hospitals, Leo Knudsen Westgard, Laura R Marks, Et Al.

2020-Current year OA Pubs

BACKGROUND: To end the HIV and hepatitis C virus (HCV) epidemics, people who use drugs (PWUD) need more opportunities for testing. While inpatient hospitalizations are an essential opportunity to test people who use drugs (PWUD) for HIV and HCV, there is limited research on rates of inpatient testing for HIV and HCV among PWUD.

METHODS: Eleven hospital sites were included in the study. Each site created a cohort of inpatient encounters associated with injection drug use. From these cohorts, we collected data on HCV and HIV testing rates and HIV testing consent policies from 65 276 PWUD hospitalizations.

RESULTS: Hospitals …

Preexisting Diabetes And Breast Cancer Treatment Among Low-Income Women, Bayu Begashaw Bekele, Min Lian, Chester Schmaltz, Tracy Greever-Rice, Pratibha Shrestha, Ying Liu

2020-Current year OA Pubs

IMPORTANCE: Diabetes is associated with poorer prognosis of patients with breast cancer. The association between diabetes and adjuvant therapies for breast cancer remains uncertain.

OBJECTIVE: To comprehensively examine the associations of preexisting diabetes with radiotherapy, chemotherapy, and endocrine therapy in low-income women with breast cancer.

DESIGN, SETTING, AND PARTICIPANTS: This population-based cohort study included women younger than 65 years diagnosed with nonmetastatic breast cancer from 2007 through 2015, followed up through 2016, continuously enrolled in Medicaid, and identified from the linked Missouri Cancer Registry and Medicaid claims data set. Data were analyzed from January 2022 to October 2023.

EXPOSURE: Preexisting …

Genetic Complexities Of Cerebral Small Vessel Disease, Blood Pressure, And Dementia, Muralidharan Sargurupremraj, Chia-Ling Phuah, Carlos Cruchaga, Et Al.

2020-Current year OA Pubs

IMPORTANCE: Vascular disease is a treatable contributor to dementia risk, but the role of specific markers remains unclear, making prevention strategies uncertain.

OBJECTIVE: To investigate the causal association between white matter hyperintensity (WMH) burden, clinical stroke, blood pressure (BP), and dementia risk, while accounting for potential epidemiologic biases.

DESIGN, SETTING, AND PARTICIPANTS: This study first examined the association of genetically determined WMH burden, stroke, and BP levels with Alzheimer disease (AD) in a 2-sample mendelian randomization (2SMR) framework. Second, using population-based studies (1979-2018) with prospective dementia surveillance, the genetic association of WMH, stroke, and BP with incident all-cause dementia was …

Red Flag Signs And Symptoms For Patients With Early-Onset Colorectal Cancer: A Systematic Review And Meta-Analysis, Joshua Demb, Cassandra D L Fritz, Yin Cao, Et Al.

2020-Current year OA Pubs

IMPORTANCE: Early-onset colorectal cancer (EOCRC), defined as a diagnosis at younger than age 50 years, is increasing, and so-called red flag signs and symptoms among these individuals are often missed, leading to diagnostic delays. Improved recognition of presenting signs and symptoms associated with EOCRC could facilitate more timely diagnosis and impact clinical outcomes.

OBJECTIVE: To report the frequency of presenting red flag signs and symptoms among individuals with EOCRC, to examine their association with EOCRC risk, and to measure variation in time to diagnosis from sign or symptom presentation.

DATA SOURCES: PubMed/MEDLINE, Embase, CINAHL, and Web of Science were searched …

High Rates Of Missed Hiv Testing Among Oral Prep Users In The United States From 2018-2021: A National Assessment On Compliance With Hiv Testing Recommendations Of The Cdc Prep Guidelines, Jason Baron, Tamar Tchelidze, Benjamin Labrot, Joseph Yao, Kenneth H Mayer, Daniel Kuritzkes, Nicole Robinson, Rupa R Patel

2020-Current year OA Pubs

BACKGROUND: The US Centers for Disease Control and Prevention recommends HIV testing every 3 months in oral PrEP users. We performed a national assessment of HIV testing compliance among oral PrEP users.

METHODS: We analyzed 408 910 PrEP prescriptions issued to 39 809 PrEP users using a national insurance claims database that contained commercial and Medicaid claims. We identified PrEP use based on pharmacy claims and outpatient diagnostic coding. We evaluated the percentage of PrEP prescription refills without HIV testing (identified by CPT codes) within the prior 3, 6, and 12 months using time to event methods. We performed subgroup …

Decade-Long Trends In Incidence Of Slipped Capital Femoral Epiphysis In The United States: A Nationwide Database Analysis Of Over 33 Million Patients, Aaron Singh, Travis Kotzur, Beltran Torres-Izquierdo, David Momtaz, Rishi Gonuguntla, Amir Human Hoveidaei, Ali Seifi, María Galán-Olleros, Pooya Hosseinzadeh

2020-Current year OA Pubs

PURPOSE: Slipped capital femoral epiphysis (SCFE) is a prevalent pediatric hip disorder linked to severe complications, with childhood obesity as a crucial risk factor. Despite the rising obesity rates, contemporary data on SCFE's epidemiology remain scarce in the United States. This study examined SCFE incidence trends and demographic risk factors in the United States over a decade.

METHODS: A decade-long (2011 to 2020) retrospective cohort study was undertaken using the Healthcare Cost and Utilization Project National Inpatient Sample. Patients aged younger than 18 years were identified and further analyzed if diagnosed with SCFE through ICD-9 or ICD-10 codes. Key metrics …

Outcomes Of Limited Stage Primary Bone Diffuse Large B-Cell Lymphoma In The Rituximab Era: A Multicenter, Retrospective Study, Alexandra Rezazadeh, Nancy L. Bartlett, Et Al.

2020-Current year OA Pubs

Primary bone diffuse large B-cell lymphoma is a rare variant of extranodal non-Hodgkin lymphoma historically treated with induction chemotherapy followed by consolidative radiation therapy (RT). It remains unknown whether RT confers additional benefit following rituximab-based chemoimmunotherapy (CIT) induction in patients with limited stage disease. We conducted a multicenter, retrospective analysis of patients treated between 2005 and 2019 using rituximab-based CIT regimens with or without consolidative RT to discern whether consolidative RT adds benefit in patients with stage I-II disease that could be encompassed in one radiation field. A total of 112 patients were included: 78 received CIT and radiation (RT …

Onc201 (Dordaviprone) In Recurrent H3 K27m-Mutant Diffuse Midline Glioma, Isabel Arrillaga-Romany, Andrew Cluster, Et Al.

2020-Current year OA Pubs

PURPOSE: Histone 3 (H3) K27M-mutant diffuse midline glioma (DMG) has a dismal prognosis with no established effective therapy beyond radiation. This integrated analysis evaluated single-agent ONC201 (dordaviprone), a first-in-class imipridone, in recurrent H3 K27M-mutant DMG.

METHODS: Fifty patients (pediatric, n = 4; adult, n = 46) with recurrent H3 K27M-mutant DMG who received oral ONC201 monotherapy in four clinical trials or one expanded access protocol were included. Eligible patients had measurable disease by Response Assessment in Neuro-Oncology (RANO) high-grade glioma (HGG) criteria and performance score (PS) ≥60 and were ≥90 days from radiation; pontine and spinal tumors were ineligible. The …

Ligand Efficacy Modulates Conformational Dynamics Of The Μ-Opioid Receptor, Jiawei Zhao, Matthias Elgeti, Evan S O'Brien, Cecília P Sár, Amal Ei Daibani, Jie Heng, Xiaoou Sun, Elizabeth White, Tao Che, Wayne L Hubbell, Brian K Kobilka, Chunlai Chen

2020-Current year OA Pubs

The µ-opioid receptor (µOR) is an important target for pain management

Computationally Restoring The Potency Of A Clinical Antibody Against Omicron, Thomas A Desautels, Suzanne M Scheaffer, Bradley Whitener, James B Case, Larissa B Thackray, Michael S Diamond, Et Al.

2020-Current year OA Pubs

The COVID-19 pandemic underscored the promise of monoclonal antibody-based prophylactic and therapeutic drugs

A Precision Functional Atlas Of Personalized Network Topography And Probabilities, Robert J M Hermosillo, Ally Dworetsky, Babatunde Adeyemo, Caterina Gratton, Steven Petersen, Nico U F Dosenbach, Et Al.

2020-Current year OA Pubs

Although the general location of functional neural networks is similar across individuals, there is vast person-to-person topographic variability. To capture this, we implemented precision brain mapping functional magnetic resonance imaging methods to establish an open-source, method-flexible set of precision functional network atlases-the Masonic Institute for the Developing Brain (MIDB) Precision Brain Atlas. This atlas is an evolving resource comprising 53,273 individual-specific network maps, from more than 9,900 individuals, across ages and cohorts, including the Adolescent Brain Cognitive Development study, the Developmental Human Connectome Project and others. We also generated probabilistic network maps across multiple ages and integration zones (using a …

Phase Ii Trial Of Nab- Sirolimus In Patients With Advanced Malignant Perivascular Epithelioid Cell Tumors (Ampect): Long-Term Efficacy And Safety Update, Andrew J Wagner, Vinod Ravi, Richard F Riedel, Kristen Ganjoo, Brian A Van Tine, Rashmi Chugh, Lee Cranmer, Erlinda M Gordon, Jason L Hornick, Heng Du, Li Ding, Anita N Schmid, Willis H Navarro, David J Kwiatkowski, Mark A Dickson

2020-Current year OA Pubs

No abstract provided.

Guardians Of Precision: Advancing Radiation Protection, Safety, And Quality Systems In Nuclear Medicine, Francesco Giammarile, Peter Knoll, Jolanta Kunikowska, Diana Paez, Enrique Estrada Lobato, Miriam Mikhail-Lette, Richard Wahl, Ola Holmberg, May Abdel-Wahab, Andrew M Scott, Roberto C Delgado Bolton

2020-Current year OA Pubs

BACKGROUND: In the rapidly evolving field of nuclear medicine, the paramount importance of radiation protection, safety, and quality systems cannot be overstated. This document provides a comprehensive analysis of the intricate regulatory frameworks and guidelines, meticulously crafted and updated by national and international regulatory bodies to ensure the utmost safety and efficiency in the practice of nuclear medicine.

METHODS: We explore the dynamic nature of these regulations, emphasizing their adaptability in accommodating technological advancements and the integration of nuclear medicine with other medical and scientific disciplines.

RESULTS: Audits, both internal and external, are spotlighted for their pivotal role in assessing …

Epidemiology Of Dsm-5 Psychiatric Disorders In Kenyan Youth With Low And High Psychosis Risk, Rebekka H Sæle, David M Ndetei, Victoria N Mutiso, Daniel Mamah

2020-Current year OA Pubs

INTRODUCTION: There are few psychiatric epidemiology studies among Kenyan youth and fewer among those at high psychosis risk (HR).

METHODS: This study assessed the epidemiology of DSM-5 psychiatric disorders in HR and low-risk (LR) individuals to inform research and mental health services. 567 participants (aged 15-25) in HR (n = 246) and LR (n = 260) groups based on Washington Early Recognition Center Affectivity and Psychosis (WERCAP) Screen scores. Diagnostic Interview Schedule, version 5 (DIS-5) assessed DSM-5 psychiatric disorder prevalence. Diagnostic comorbidity and demographic relationships were investigated.

RESULTS: A higher prevalence was observed for all DSM-5 disorders in the HR …

Gut Microbiome Correlates Of Recurrent Urinary Tract Infection: A Longitudinal, Multi-Center Study, Joohee Choi, Robert Thänert, Kimberly A Reske, Katelin B Nickel, Margaret A Olsen, Tiffany Hink, Anna Thänert, Meghan A Wallace, Bin Wang, Candice Cass, Margaret H Barlet, Emily L Struttmann, Zainab Hassan Iqbal, Steven R Sax, Victoria J Fraser, Carey-Ann D Burnham, Erik R Dubberke, Gautam Dantas, Jennie H Kwon, Et Al.

2020-Current year OA Pubs

BACKGROUND: Urinary tract infections (UTI) affect approximately 250 million people annually worldwide. Patients often experience a cycle of antimicrobial treatment and recurrent UTI (rUTI) that is thought to be facilitated by a gut reservoir of uropathogenic

METHODS: 125 patients with UTI caused by an antibiotic-resistant organism (ARO) were enrolled from July 2016 to May 2019 in a longitudinal, multi-center cohort study. Multivariate statistical models were used to assess the relationship between uropathogen colonization and recurrent UTI (rUTI), controlling for clinical characteristics. 644 stool samples and 895 UPEC isolates were interrogated for taxonomic composition, antimicrobial resistance genes, and phenotypic resistance. Cohort …

Coenzyme Q4 Is A Functional Substitute For Coenzyme Q10 And Can Be Targeted To The Mitochondria, Laura H Steenberge, Sean Rogers, Andrew Y Sung, Jing Fan, David J Pagliarini

2020-Current year OA Pubs

Coenzyme Q10 (CoQ