Medicine and Health Sciences Commons^™

Assessing The Reliability, Internal Consistency, And Sensitivity Of A Nutrition Knowledge Questionnaire For Four-Year-Old Pre-K Children, Lin Wang, Karla Cortez, Brenda Rodriguez, Joseph Reyes, Moises Cisneros, Elizabeth Alanis, Zasha Romero, Lisa Michelle Belzer Salinas, Juan López Alvarenga, Roberto Treviño-Peña

Research Symposium

Introduction: Assessing nutrition knowledge in four-year-olds, a developmental stage marked by limited attention spans and varying comprehension abilities, is challenging with traditional methods. A reliable test is pivotal for establishing a foundation for future health interventions. We evaluated a 13-question nutrition and healthy habits test in Pre-K4 children to assess reliability and sensitivity to detect differences.

Methods: Calculations included Cronbach's alpha, kappa coefficient, McNemar analysis by item, and Bland-Altman plots for test-retest differences. Mixed model regression assessed the questionnaire's sensitivity by sex and association with age. Item response theory (IRT) models were employed, generating latent abilities for students and individual …

An Unusual Presentation Of The Severe Hypothyroidism Presenting As Shortness Of Breath, Shreel H. Patel, Kashif Ali, Eunbee Cho, Fatimah Bello, Andres Suarez Parraga, Alcibiades Fleires

Research Symposium

Background: Hypothyroidism is defined as failure of the thyroid gland to produce sufficient thyroid hormone to meet the metabolic demands of the body. Untreated hypothyroidism can contribute to hypertension, dyslipidemia, infertility, cognitive impairment, and neuromuscular dysfunction. It may occur as a result of primary gland failure or insufficient thyroid gland stimulation by the hypothalamus or pituitary gland. Primary gland failure can result from the congenital abnormalities, autoimmune destruction, iodine deficiency, and infiltrative diseases. Patients can clinically present with weight gain, cold intolerance, depression, muscle fatigue, poor concentration, and menstrual irregularities. The best laboratory test for the thyroid assessment is serum …

Assessing Gait Metrics For Early Parkinson's Disease Prediction: A Preliminary Analysis Of Underfit Models, Daniel Salinas, Gerardo Medellin, Katherine Bolado, Tomas Gomez, Kelsey Potter-Baker, Nawaz Khan Abdul Hack, Ramu Vadukapuram

Research Symposium

Background: Parkinson's Disease (PD) is characterized by both motor and non-motor symptoms, and its diagnosis primarily relies on clinical presentation. There is a growing need for diagnostic tools to identify the early signs of PD, particularly the initial motor impairments often manifested as gait abnormalities. Here we seek to present preliminary findings to address this need. Our study focuses on using Machine Learning techniques (ML) to predict the PD clinical stage most efficiently and accurately. Specifically, we have sought to evaluate how spatiotemporal characteristics and other locomotor performance variables obtained on a walkway system can be utilized to identify the …

A True Bloody Emergency: An Unusual Case Of Thrombotic Thrombocytopenic Purpura, Joshua M. Ninan

Research Symposium

Background: Thrombotic thrombocytopenic purpura (TTP) is a primary thrombotic microangiopathy that is classically characterized by thrombocytopenia and microangiopathic hemolytic anemia (MAHA). Although rare with an annual incidence of 3.7 cases per one million adults, it is considered a true hematological emergency due to its fatality rate of almost 100% if appropriate treatment is not initiated immediately. This makes it vitally important to identify and treat patients with TTP, a task that becomes unusually challenging in the absence of the disorder’s other characteristically diagnostic clinical features such as mucosal bleeding, fever, or presence of schistocytes.

Case Presentation: A 30-year-old gentleman with …

Circular Gene Mapping Of Identified Amr Genes In Multi-Drug Resistant Escherichia Coli Isolated From Potable Water, Shikha Sharma, Abhishek Chauhan, Tanu Jindal, Vivek Narayan Singh, Anuj Ranjan

Research Symposium

Background: Escherichia coli is a Gram-negative & facultative anaerobe bacterium ubiquitously found in all environments. It is a waterborne and foodborne pathogen associated with many diarrhoea and GI tract diseases inclusive of UTIs in humans. The rise in the number of bacteria resistant to antimicrobial drugs has a major impact on disease control efforts. Antibiotic-resistant bacteria can be found in a variety of water sources. As a result, the objective of the current study is to construct a circular AMR gene map based on the assessment of the antibiotic susceptibility profiling of E. coli isolated from twenty various potable water …

Assessment Of Mucin 13 (Muc13) As An Imaging Target For Guiding Colorectal Cancer Treatment: A Pathway Towards Theranostic Development, Ryan P. Coll, Aiko Yamaguchi, Jianbo Wang, Xiaoxia Wen, Denise Hernandez, Subhash C. Chauhan, H. Charles Manning

Research Symposium

Background: A theranostic strategy combining diagnostic imaging and targeted therapy in a single regimen is proposed for improved management and treatment of colorectal cancer (CRC). Increased specificity in detection by the noninvasive imaging technique positron emission tomography (PET) can be achieved by radiolabeling antibodies (Abs) designed to target tumor-associated antigens with increased expression post-translational modifications present in cancer cells. In this study, an Ab designed to target the transmembrane glycoprotein mucin 13 (MUC13) was radiolabeled with the positron-emitting radionuclide zirconium-89 (⁸⁹Zr) for PET imaging of a xenograft mouse model of CRC. Specified uptake of this radioimmunoconjugate was observed …

Antibody Mediated Targeted Drug Delivery Approach For Pancreatic Tumors, Nirnoy Dan, Saini Setua, Murali Yallapu, Stephen Behrman, Subhash Chauhan, Sheema Khan

Research Symposium

Background: Pancreatic ductal adenocarcinomas, originating from the epithelial cell lining of ducts, account for approximately 95% of tumors in this category, showcasing a survival rate of less than 5-7%. Unfortunately, little progress has been seen in the outcomes of patients with PDAC as tumor develops high desmoplasia and chemo-resistance to chemotherapeutic drugs, such as gemcitabine (Gem). The therapies are unable to penetrate to the fibrotic tumors leading to insufficient availability of the therapeutic drugs at the tumor site. We and others have shown that MUC13 is aberrantly expressed in pancreatic tumors but not in normal pancreas, which makes MUC13 as …

Evaluating The Management Trends For Priapism And Assessing The Risk Of Priapism After In-Office Intracavernosal Injections: A Cross-Sectional Analysis, Joon Yau Leong, Zachary J. Prebay, David Ebbott, Michael Li, Paul H. Chung

Department of Urology Faculty Papers

We describe the management trends of patients suffering from any priapism and evaluate the risks of developing priapism after intracavernosal injections (ICI) performed in office. We queried TriNetX for two separate male adult cohorts - those presenting with any priapism based on International Classification of Disease code, N48.3 (priapism) and those who underwent ICI in office based on Current Procedural Terminology code, 54235 (injection of corpora cavernosa with pharmacologic agent[s]). We evaluated treatment options for these patients after any priapism and described demographic risks for developing priapism after ICI performed in office. There were 17,545 priapism encounters and 26,104 usages …

Modifying Aha Stress Management And Physical Activity Modules For Senior Communities, Madai Molina Apolinar, Kristina Luu, Sarah Allen, Samantha Isabel Pio Argueta, Annalise P. Sanders, Emil Visaya

Nursing Leadership in Community Engagement Projects

Modifying AHA Stress Management and Physical Activity Modules for Senior Communities

This quarter our group was given the opportunity to partner with two organizations to conduct work surrounding blood pressure and heart health education. One of our partners was a senior living organization whose mission is to transform beliefs about affordable housing through supporting communities where seniors and families can thrive. We also collaborated with the American Heart Association (AHA), which seeks to combat cardiovascular disease and stroke for the improvement and overall health of the population.

For this project, we were tasked with simplifying the AHA “Check. Change. Control.” …

Healthy Coping Mechanisms Within The Recovery Setting, Ingrid Erickson, Izzi Hill, Ylliam Umipig, Hallie Hicks, Hanin Ghazal, Hannah Haynes

Nursing Leadership in Community Engagement Projects

Healthy Coping Mechanisms Within the Recovery Setting

Introduction

Nineteen percent of the Seattle-Tacoma Metropolitan Statistical Area (MSA) population ages 12 and older are using illicit drugs (Brief, 2012). And twenty-two percent have an excessive alcohol use disorder (Brief, 2012). Six Seattle Pacific University nursing students (the team) were assigned a leadership project at a recovery center in downtown Seattle. The recovery center is a non-profit organization that aims to provide hope, healing, and community to those within the recovery community. Members have experienced anything from homelessness to addiction, trauma, and mental health struggles and the center provides a way to …

A Rare Occurrence Of Digital Fibromyxoma To The Hallux Distal Phalanx, Heather V. Tran, Nikita Gambhir, Craig J. Verdin, Luis Caporusso, Stephanie N. Campbell

School of Podiatric Medicine Publications

A paucity of literature exists for superficial acral fibromyxoma, which typically affects the acral regions of the hands and feet. Because of its indolent nature and clinical mimicry of other ungual and periungual tumors, delays in diagnosis are common. This report aims to augment our understanding of this pathology and improve recognition for prompt diagnosis, as well as provide an addition to the literature.

A Phenomenological Study On Preschool Educator Experience In Re-Imagining Play And Play-Based Learning During The Covid-19 Pandemic, Ronabeth Keh So

College of Education Theses and Dissertations

This phenomenological study explores how play-based preschool educators experienced and re-imagined play and play-based learning throughout the Covid-19 pandemic. Semistructured interviews were conducted with six teachers and three administrators from three private Midwest play-based institutions. This study uncovers preschool educators’ experiences of engaging in play-based learning throughout the different phases of the pandemic and delves into the issues and challenges of online learning and the subsequent return to the classroom. Results show that despite pedagogical adjustments and limitations brought about by online learning modalities and pandemic related restrictions, the nature of play remains unchanged and continues to be vital to …

Developing A Caregiver Educational Tool For Children With Behavior Issues, Grace Healy, Elise Arkills, Joshua Anderson, Emma Vetter, David Njeri, Avery Strieby

Nursing Leadership in Community Engagement Projects

Developing a Caregiver Educational Tool for Children with Behavior Issues

The team was tasked to create a health-based solution for problems facing a non-profit agency. The agency is a branch of an organization in King County, where providing critical familial needs, strengthening familial bonds, and preventing homelessness are the primary aims. Last year, the agency was able to assist 669 families, and the numbers are continuing to grow as more resources become available.

The team included six Seattle Pacific University nursing students, who are enrolled in a Nursing Leadership in Community Engagement course. After collaborative meetings with the managers at …

A Video Based Training Review, Sarah Kessel, Rachel Cyers, Alicia Johnson, Macky Juan, Malia Lafrance, Julia Zajac

Nursing Leadership in Community Engagement Projects

A Video Based Training Review

This project addresses the issue of homeless youth in Seattle by supporting those working with this population. Our intervention intends to provide staff with training materials to better support the homeless youth in Seattle. The agency that we are partnering with provides temporary housing for homeless youth and seeks to find permanent housing solutions. The purpose of our project is to help agency employees review and assess their knowledge on selected topics relevant to their initial training. This project compiles a collection of evidence-based training videos with knowledge competency quizzes to help strengthen understanding on …

Social Determinants Of Health And Treatment Center Affiliation: Analysis From The Sickle Cell Disease Implementation Consortium Registry, Gustavo G Mendez, Oladipo Cole, Allison A King, Et Al.

2020-Current year OA Pubs

BACKGROUND: Adults with sickle cell disease (SCD) suffer early mortality and high morbidity. Many are not affiliated with SCD centers, defined as no ambulatory visit with a SCD specialist in 2 years. Negative social determinants of health (SDOH) can impair access to care.

HYPOTHESIS: Negative SDOH are more likely to be experienced by unaffiliated adults than adults who regularly receive expert SCD care.

METHODS: Cross-sectional analysis of the SCD Implementation Consortium (SCDIC) Registry, a convenience sample at 8 academic SCD centers in 2017-2019. A Distressed Communities Index (DCI) score was assigned to each registry member's zip code. Insurance status and …

The Importance Of Community Resources For Breastfeeding, Jennifer Locasale-Crouch, Margaret Kathleen Wallace, Timothy Heeren, Stephen Kerr, Yitong Yue, Genevieve Deeken, Khara Turnbull, Brianna Jaworski, Mayaris Cubides Mateus, Rachel Moon, Fern Robin Hauck, Ann Kellams, Eve Colson, Michael Jay Corwin

2020-Current year OA Pubs

BACKGROUND: Breastfeeding has long-lasting effects on children's cognition, behavioral, mental and physical health. Previous research shows parental characteristics (e.g., education, race/ethnicity, income level) are associated with breastfeeding initiation and duration. Further, research shows significant variation in access to community resources by race/ethnicity. It is unclear how community resources may impact breastfeeding practices and how this might intersect with maternal race/ethnicity.

METHODS: This study combined nationally-representative data from the Study of Attitudes and Factors Effecting Infant Care (SAFE), which surveyed US mothers immediately after the infant's birth and at two to six months of infant age, with the Child Opportunity Index …

Increased Hif-2Α Activity In The Nucleus Pulposus Causes Intervertebral Disc Degeneration In The Aging Mouse Spine, Shira N Johnston, Maria Tsingas, Rahatul Ain, Ruteja A Barve, Makarand Risbud

Department of Orthopaedic Surgery Faculty Papers

Hypoxia-inducible factors (HIFs) are essential to the homeostasis of hypoxic tissues. Although HIF-2α, is expressed in nucleus pulposus (NP) cells, consequences of elevated HIF-2 activity on disc health remains unknown. We expressed HIF-2α with proline to alanine substitutions (P405A; P531A) in the Oxygen-dependent degradation domain (HIF-2αdPA) in the NP tissue using an inducible, nucleus pulposus-specific K19^CreERT allele to study HIF-2α function in the adult intervertebral disc. Expression of HIF-2α in NP impacted disc morphology, as evident from small but significantly higher scores of degeneration in NP of 24-month-old K19^CreERT; HIF-2α^dPA (K19-dPA) mice. Noteworthy, comparisons of grades …

Deep Learning Model For Personalized Prediction Of Positive Mrsa Culture Using Time-Series Electronic Health Records, Masayuki Nigo, Laila Rasmy, Bingyu Mao, Bijun Sai Kannadath, Ziqian Xie, Degui Zhi

Faculty, Staff and Student Publications

Methicillin-resistant Staphylococcus aureus (MRSA) poses significant morbidity and mortality in hospitals. Rapid, accurate risk stratification of MRSA is crucial for optimizing antibiotic therapy. Our study introduced a deep learning model, PyTorch_EHR, which leverages electronic health record (EHR) time-series data, including wide-variety patient specific data, to predict MRSA culture positivity within two weeks. 8,164 MRSA and 22,393 non-MRSA patient events from Memorial Hermann Hospital System, Houston, Texas are used for model development. PyTorch_EHR outperforms logistic regression (LR) and light gradient boost machine (LGBM) models in accuracy (AUROC

Neuronal Npr-15 Modulates Molecular And Behavioral Immune Responses Via The Amphid Sensory Neuron-Intestinal Axis In C Elegans, Benson Otarigho, Anna Frances Butts, Alejandro Aballay

Faculty, Staff and Student Publications

The survival of hosts during infections relies on their ability to mount effective molecular and behavioral immune responses. Despite extensive research on these defense strategies in various species, including the model organism

Single-Cell Cd4 And Cd8 T-Cell Secretome Profiling Reveals Temporal And Niche Differences In Acute Myeloid Leukemia Following Immune Checkpoint Blockade Therapy, Jessica L Root, Poonam N Desai, Christopher Ly, Bofei Wang, Fatima Zahra Jelloul, Jing Zhou, Sean Mackay, Mansour Alfayez, Jairo Matthews, Sherry Pierce, Patrick K Reville, Naval Daver, Hussein A Abbas

Faculty, Staff and Student Publications

UNLABELLED: Acute myeloid leukemia (AML) is a heterogeneous malignancy of the blood primarily treated with intensive chemotherapy. The allogeneic T-cell antileukemic activity via donor lymphocyte infusions and stem cell transplantation suggests a potential role for checkpoint blockade therapy in AML. While clinical trials employing these treatments have fallen short of expected results, a deeper exploration into the functional states of T cells in AML could bridge this knowledge gap. In this study, we analyzed the polyfunctional activity of T cells in a cohort of patients with relapsed/refractory (RelRef) AML treated on the clinical trial (ClinicalTrials.gov identifier: NCT02397720) of combination therapy …

Catatonia As A Result Of A Traumatic Brain Injury, Jessica Berthelot, Jacob Cambre, Madeline Erwin, Jennifer Phan

School of Medicine Faculty Publications

Catatonia is a neuropsychiatric syndrome typically marked by disturbances in motor activity, speech, and behavior. It has historically been associated with psychiatric illness, but acute medical illness, neurocognitive disorders, and neurodevelopmental disorders can cause catatonia as well. Catatonia is likely underrecognized and underdiagnosed in the general medical hospital, despite high risks of morbidity and mortality and the availability of rapidly effective treatment. Here, we present a case of catatonia secondary to traumatic brain injury that responded to lorazepam after a delayed diagnosis. A young male patient who was incarcerated and assaulted was sent to the emergency department multiple times for …

Environmental Detection Of Parasites In The Marginalized Paiute Reservations Compared To A Nearby Area, Shannon Mckim, Kristen Kopystynsky, Nathaniel Wolf, Fahim A Akbar, Maria Elena Bottazzi, Peter J Hotez, Rojelio Mejia

Center for Medical Ethics and Health Policy Staff Publications

The amounts of parasite DNA in soil samples from different playgrounds and other public areas can help identify areas of possible microbe transmission and give indications of the possible occurrence of parasite infection in nearby communities. We collected 207 soil samples from parks in Paiute indigenous tribal areas in southwestern Utah and from the higher income city of St. George, Utah, and tested them for 11 parasites that can cause human disease. Molecular tests revealed an elevated odds ratio (OR) of 3.072 (range, 1.114-8.065) for detecting the helminth Trichuris trichiura and an elevated OR of 3.036 (range, 1.101-7.966) for any …

Liax Is A Surrogate Marker For Cell Envelope Stress And Daptomycin Non-Susceptibility In Enterococcus Faecium, Dierdre B Axell-House, Shelby R Simar, Diana Panesso, Sandra Rincon, William R Miller, Ayesha Khan, Orville A Pemberton, Lizbet Valdez, April H Nguyen, Kara S Hood, Kirsten Rydell, Andrea M Detranaltes, Mary N Jones, Rachel Atterstrom, Jinnethe Reyes, Pranoti V Sahasrabhojane, Geehan Suleyman, Marcus Zervos, Samuel A Shelburne, Kavindra V Singh, Yousif Shamoo, Blake M Hanson, Truc T Tran, Cesar A Arias

Faculty, Staff and Student Publications

Daptomycin (DAP) is often used as a first-line therapy to treat vancomycin-resistant

Chimeric Oncolytic Adenovirus Evades Neutralizing Antibodies From Human Patients And Exhibits Enhanced Anti-Glioma Efficacy In Immunized Mice, Dong Ho Shin, Hong Jiang, Andrew G Gillard, Debora Kim, Xuejun Fan, Sanjay K Singh, Teresa T Nguyen, Sagar S Sohoni, Andres R Lopez-Rivas, Akhila Parthasarathy, Chibawanye I Ene, Joy Gumin, Frederick F Lang, Marta M Alonso, Candelaria Gomez-Manzano, Juan Fueyo

Faculty, Staff and Student Publications

Oncolytic viruses are a promising treatment for patients with high-grade gliomas, but neutralizing antibodies can limit their efficacy in patients with prior virus exposure or upon repeated virus injections. Data from a previous clinical trial using the oncolytic adenovirus Delta-24-RGD showed that generation of anti-viral neutralizing antibodies may affect the long-term survival of glioma patients. Past studies have examined the effects of neutralizing antibodies during systemic virus injections, but largely overlooked their impact during local virus injections into the brain. We found that immunoglobulins colocalized with viral proteins upon local oncolytic virotherapy of brain tumors, warranting a strategy to prevent …

Inhibition Of Mer Proto-Oncogene Tyrosine Kinase By An Antisense Oligonucleotide Enhances Treatment Efficacy Of Immunoradiotherapy, Yun Hu, Alexey Revenko, Hampartsoum Barsoumian, Genevieve Bertolet, Natalie Wall Fowlkes, Hadi Maazi, Morgan Maureen Green, Kewen He, Duygu Sezen, Tiffany A Voss, Claudia S Kettlun Leyton, Fatemeh Masrorpour, Zahid Rafiq, Nahum Puebla-Osorio, Carola Leuschner, Robert Macleod, Maria Angelica Cortez, James W Welsh

Faculty, Staff and Student Publications

Background: The combination of radiotherapy and immunotherapy (immunoradiotherapy) has been increasingly used for treating a wide range of cancers. However, some tumors are resistant to immunoradiotherapy. We have previously shown that MER proto-oncogene tyrosine kinase (MerTK) expressed on macrophages mediates resistance to immunoradiotherapy. We therefore sought to develop therapeutics that can mitigate the negative impact of MerTK. We designed and developed a MerTK specific antisense oligonucleotide (ASO) and characterized its effects on eliciting an anti-tumor immune response in mice.

Methods: 344SQR cells were injected into the right legs on day 0 and the left legs on day 4 of 8-12 …

Immuno-Molecular Targeted Therapy Use And Survival Benefit In Patients With Stage Ivb Cervical Carcinoma In Commission On Cancer, Collin A Sitler, Chunqiao Tian, Chad A Hamilton, Michael T Richardson, John K Chan, Daniel S Kapp, Charles A Leath, Yovanni Casablanca, Christina Washington, Nicole P Chappell, Ann H Klopp, Craig D Shriver, Christopher M Tarney, Nicholas W Bateman, Thomas P Conrads, George Larry Maxwell, Neil T Phippen, Kathleen M Darcy

Faculty, Staff and Student Publications

PURPOSE: To investigate IMT use and survival in real-world stage IVB cervical cancer patients outside randomized clinical trials.

METHODS: Patients diagnosed with stage IVB cervical cancer during 2013-2019 in the National Cancer Database and treated with chemotherapy (CT) ± external beam radiation (EBRT) ± intracavitary brachytherapy (ICBT) ± IMT were studied. The adjusted hazard ratio (AHR) and 95% confidence interval (CI) for risk of death were estimated in patients treated with vs. without IMT after applying propensity score analysis to balance the clinical covariates.

RESULTS: There were 3164 evaluable patients, including 969 (31%) who were treated with IMT. The use …

Caldendrin Is A Repressor Of Piezo2 Channels And Touch Sensation In Mice, Josue A Lopez, Luis O Romero, Wai-Lin Kaung, J Wesley Maddox, Valeria Vásquez, Amy Lee

Faculty, Staff and Student Publications

The sense of touch is crucial for cognitive, emotional, and social development and relies on mechanically activated (MA) ion channels that transduce force into an electrical signal. Despite advances in the molecular characterization of these channels, the physiological factors that control their activity are poorly understood. Here, we used behavioral assays, electrophysiological recordings, and various mouse strains (males and females analyzed separately) to investigate the role of the calmodulin-like Ca2+ sensor, caldendrin, as a key regulator of MA channels and their roles in touch sensation. In mice lacking caldendrin (Cabp1 KO), heightened responses to tactile stimuli correlate with enlarged …

Transcriptomic, Proteomic, And Genomic Mutational Fraction Differences Based On Hpv Status Observed In Patient-Derived Xenograft Models Of Penile Squamous Cell Carcinoma, Niki M Zacharias, Luis Segarra, Keiko Akagi, Natalie Wall Fowlkes, Huiqin Chen, Angelita Alaniz, Carolyn De La Cerda, Pedro Pesquera, Yuanxin Xi, Jing Wang, Jad Chahoud, Xin Lu, Priya Rao, Magaly Martinez-Ferrer, Curtis A Pettaway

Faculty, Staff and Student Publications

Simple Summary

Penile cancer is a rare but aggressive cancer. After it metastasizes, the median survival time is less than 12 months. The overall response rate to common first-line combination chemotherapy treatments is approximately 50%. There is an urgent need in advanced-penile-cancer treatment to find novel therapies that would generate better response rates than standard chemotherapy thus far and have less toxicity. Partially due to its rarity, there are few animal models and cell lines of penile cancer. We report on the generation of seven penile cancer animal models that were created by directly implanting human tumor tissue into immunocompromised …

Tgf-Β Signaling Pathways In The Development Of Diabetic Retinopathy, Andrew Callan, Sonal V. Jha, Laura Garcia, Lois F. Baldado, Andrew Tsin

School of Medicine Publications

Diabetic retinopathy (DR), a prevalent complication of diabetes mellitus affecting a significant portion of the global population, has long been viewed primarily as a microvascular disorder. However, emerging evidence suggests that it should be redefined as a neurovascular disease with multifaceted pathogenesis rooted in oxidative stress and advanced glycation end products. The transforming growth factor-β (TGF-β) signaling family has emerged as a major contributor to DR pathogenesis due to its pivotal role in retinal vascular homeostasis, endothelial cell barrier function, and pericyte differentiation. However, the precise roles of TGF-β signaling in DR remain incompletely understood, with conflicting reports on its …

Nigerian Nurses' Perceptions Of Caring For Women With Female Genital Mutilation, Jane-Frances Echeozo

Walden Dissertations and Doctoral Studies

There are numerous health problems associated with female genital mutilation (FGM) practice. In Nigerian healthcare, professionals need to ensure culturally sensitive care for FGM cases. However, there was a literature gap involving culturally sensitive care for Nigerian women with FGM complications, evidenced by some northern Nigerian nurses who were not able to identify FGM categories or cultural given names associated with FGM types. Thus, this qualitative study involved ascertaining the worldview of Nigerian nurses and midwives in Owerri regarding providing culturally competent nursing care for FGM complications, guided by the process of cultural competence in the delivery of healthcare services …