Medicine and Health Sciences Commons^™

The Kinetic Modulation Of Α - Synuclein Fibrillation And Toxicity By 4-Phenylbutyric Acid, Kristos Awuah Baffour

Graduate Theses/Dissertations

ABSTRACT

The Protein misfolding and aggregation of alpha-synuclein (α-syn) into neurotoxic amyloids underlies the pathogenesis of neurodegenerative diseases such as Parkinson's disease (PD). 4-Phenylbutyrate (PBA), an FDA drug approved for treating urea cycle disorders, has garnered significant attention as a potential chemical chaperone for targeting alpha-synuclein (α-syn) aggregation. Using in vitro assays, we demonstrated that PBA treatment alters the pattern of α-syn aggregation, as evidenced by reduced formation of oligomeric species and its increased susceptibility to proteolytic cleavage under the influence of PBA. Proteinase K assay, surface plasmon resonance, and Nile red studies indicate that PBA interacts with the extensive …

Development Of Functional Plasmonic Nanoceria For The Ultrasensitive Detection Of Ebola Glycoprotein, Carissa A. Sutton

Graduate Theses/Dissertations

Infectious diseases have been increasing in both severity and prevalence, leading to increasing economic burdens and health concerns. Ebola hemorrhagic fever is an infectious disease that is both highly communicable and highly fatal. Current detection methods for the virus have high specificity and sensitivity but have long and/or complicated procedures that do not allow for early virus detection in highly affected areas. Compared to the lengthy procedure of reverse transcription-polymerase chain reaction (RT-PCR), real-time RT-PCR is more time-efficient; however, specificity and sensitivity are reduced. Since early detection of the virus is the only way to increase survival rates, sensitive detection …

The Efficacy Of Zuranolone Versus Placebo In Postpartum Depression And Major Depressive Disorder: A Systematic Review And Meta-Analysis, Mackenzie Winslow, Emily White, Suzanne J. Rose, Elijah Salzar, Eric C. Nemec

Physician Associate Studies Faculty Publications

Background Zuranolone, an oral version of allopregnanolone and neurosteroid, is a novel drug for the treatment of major depressive disorder (MDD) and postpartum depression (PPD).

Aim The purpose of this systematic review and meta-analysis was to assess the efficacy of zuranolone in the treatment of MDD and PPD.

Method A systematic search was conducted using EBSCOhost to simultaneously search Academic Search Premier, APA PsycArticles, APA PsycInfo, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, CINAHL Ultimate, and MEDLINE with Full Text. Two independent reviewers screened the articles and completed a full-text review using Covidence. The quality of …

Vacuum-Induced Tamponade For Managing Postpartum Hemorrhage: A Systematic Review, Laura M. Card, Alexandra V. Klinkowski, Elijah Salzar, Eric C. Nemec, Suzanne J. Rose

Physician Associate Studies Faculty Publications

Objective: Postpartum hemorrhage is a leading cause of maternal mortality and morbidity around the globe. The novel low-suction vacuum hemorrhage device (VHD) provides an alternative treatment option for cases of postpartum hemorrhage when first-line uterotonic agents fail. This systematic review aims to review current data evaluating the overall efficacy and safety of VHDs in treating postpartum hemorrhage.

Methods: We searched CINAHL Ultimate, Academic Search Premier, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, MEDLINE with Full Text, and PubMed and reference lists of retrieved studies for eligible studies that included outcomes of effectiveness, efficacy, or safety. Two …

Disability Reduction Following A Lumbar Stabilization Exercise Program For Low Back Pain: Large Vs. Small Improvement Subgroup Analyses Of Physical And Psychological Variables, Christian Larivière, Richard Preuss, Marie-France Coutu, Michael J. Sullivan, Nicolas Roy, Sharon M. Henry

Études primaires

Background: Little is known about why patients with low back pain (LBP) respond differently to treatment, and more specifically, to a lumbar stabilization exercise program. As a first step toward answering this question, the present study evaluates how subgroups of patients who demonstrate large and small clinical improvements differ in terms of physical and psychological changes during treatment. Methods: Participants (n = 110) performed the exercise program (clinical sessions and home exercises) over eight weeks, with 100 retained at six-month follow-up. Physical measures (lumbar segmental instability, motor control impairments, range of motion, trunk muscle endurance and physical performance tests) were …

Effect Of Personalized Spinal Profile On Its Biomechanical Response In An Emg-Assisted Optimization Musculoskeletal Model Of The Trunk, C. Larivière, A.H. Eskandari, H. M., F. Ghezelbash, D. Gagnon, A. Shirazi-Adl

Études primaires

Recent developments in musculoskeletal (MS) modeling have been geared towards model customization. Personalization of the spine profile could affect estimates of spinal loading and stability, particularly in the upright standing posture where large inter-subject variations in the lumbar lordosis have been reported. This study investigates the biomechanical consequences of changes in the spinal profile. In 31 participants (healthy and with back pain), (1) the spine external profile was measured, (2) submaximal contractions were recorded in a dynamometer to calibrate the EMG-driven MS model and finally (3) static lifting in the upright standing challenging spine stability while altering load position and …

Availability, Use, And Impact Of Workplace Mental Health Supports During The Covid-19 Pandemic In A Canadian Cohort Of Healthcare Workers, Shannon Ruzycki, Anil Adisesh, Igor Burstyn, Quentin Durand-Moreau, France Labreche, Tanis Zadunayski, Nicola Cherry

Études primaires

We investigated the availability and use of workplace mental health (MH) supports during the COVID-19 pandemic in a Canadian cohort of healthcare workers (HCW) and measured anxiety and depression by the Hospital Anxiety and Depression Scale (HADS) completed at four contacts 2020–2022. Reports were available for 4400 HCW working with patients. Half the HCWs had a clinically significant HADS score at one or more contacts Access to MH supports increased during the pandemic, with 94% reporting access to some workplace support by 2022: 47% had made use of at least one support. 25% of those with high HADS scores used …

Hitting The Right Spot: How Inclusion Of Pleasure In Sexual Education Can Lead To Safer Sex Practices, Jessica Guerrette, Tara Hassani Goodarzi, Joanne Chopak-Foss, Logan Cowan

Eagles Talking About the Public’s Health

No abstract provided.

Cheers To Change: How Gen-Z Is Redefining Drinking Culture, Savannah Steedley, James Thomas

Eagles Talking About the Public’s Health

No abstract provided.

Advocacy: Public Health In Its Truest Form, Tobi Oloyede, Wandoo Abwa, Katie M. Mercer

Eagles Talking About the Public’s Health

No abstract provided.

Firearms, Intimate Partner Violence, And Maternal Mortality: A Call For Action And Reform, Alisha Riggins, Jessica Guerrette, Nazish Masud, Tobi Oloyede, Sarah Sejoro, Logan Cowan

Eagles Talking About the Public’s Health

No abstract provided.

Clinical Significance Of Gutta Percha Variability, Alex R. Pancake

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction: The production of gutta percha points as root canal therapy filling materials vary from hand processing to machine processing with a range of acceptable levels of error (tolerance). Similarly, endodontic files manufactured to complement corresponding gutta percha points exhibit specified levels of tolerance. Investigations into the consistency among manufacturers of files and gutta percha points is limited. The aim of this study is to see how variability in apical gauge and taper of gutta percha points affected the clinical performance during cone try in. The null hypothesis of this study is that there is no difference in two gutta …

A Quality Improvement Initiative To Reduce Preanalytical Blood Gas Errors, Layla Haver Newbrough

Graduate Theses, Dissertations, and Problem Reports (ETD)

Abstract

Introduction: Laboratory testing is one of the most commonly performed procedures in healthcare and resulting data are paramount to clinical decision making. Background: Preanalytical blood gas laboratory errors often stem from the incorrect recording of a patient’s fraction of inspired oxygen (FiO2) within the laboratory collection application. Incorrect FiO2 may cause erroneous results or delays in reporting results that have the potential to negatively impact patient safety and medical management.

Purpose: The purpose of this quality improvement initiative was to reduce the occurrence of preanalytical blood gas laboratory errors. Methods/Interventions: This initiative combined modification of the laboratory collection application …

Pathways To Health: Linking Accessible Green Space To Improved Health And Well‐Being In Rural Appalachia., Udday Shankur Datta

Graduate Theses, Dissertations, and Problem Reports (ETD)

Green spaces are essential for our physical health. The quality of its green space often determines the health of a community. The presence of green space in our lives is associated with reduced stress levels, better sleep, and increased feelings of safety. Lack of access to green space can lead to many health issues, such as high blood pressure, diabetes, and cardiovascular diseases, and has been linked to obesity and physical inactivity.

The Appalachian Regional Commission (ARC) defines Appalachia as a region covering 420 counties across 13 states in the eastern United States. A large part of this region is …

Efficient Classification Of Very High Resolution Images, Mohammad I. Nouyed

Graduate Theses, Dissertations, and Problem Reports (ETD)

In recent decades, deep learning approaches have shown significant improvement in various image understanding tasks. However, analysis of high-resolution images remains a major challenge. In this work, we address the challenge of very high-resolution histopathological image (VHRHI) classification using a new information-theoretic discriminative patch selection approach. We show results on a high-resolution image dataset, namely, gigapixel whole slide tissue images for cancer tumors. Then we address how to efficiently classify challenging histopathology images, such as gigapixel whole-slide images for cancer diagnostics with image-level annotation. These ``weak labels'' are applied throughout the image but describe tumor regions of variable sizes and …

Improving Healthcare Provider Knowledge And Confidence With Treating The Lgbtq Population Through A Web-Based Education Module, Logan Price

DNP Projects

Background: There is a need for improved healthcare staff and provider knowledge and confidence when treating the LGBTQ population, as many healthcare providers are insufficiently prepared to treat LGBTQ patients (Rowe et al., 2017). This population is at greater risk for mental illness, substance use, and physical illness than the general population due to societal factors such as minority stress and stigma (Cochran et al., 2004; Cochran & Mays 2007; Cochran et al., 2003; Meyer, 2003). Purpose: The purpose of this project is to educate healthcare staff and providers about the LGBTQ population to improve their knowledge and confidence when …

Point Of Care Ultrasound (Pocus) For Advanced Practice Providers (Apps), Crystal S. Rogers

DNP Projects

Background: Advanced practice providers (APPs) routinely lack the skillset to perform Point of Care Ultrasound (POCUS) because currently, there is not a standardized curriculum within scholarly programs (Santos et al., 2018) and/or inadequate hospital training to perform these competencies (Huang et al., 2021). The absence of a standard curriculum has limited the ability of APPs to practice with full scope, provide care that is comparable to physician partners in the acute care setting, and deliver highest quality of patient care. Implementing standard education to train APPs for POCUS addresses this identified gap.

Purpose: The purpose of this project was to …

Investigating The Correlation Between Social Determinants Of Health And Drug Selling Among People Who Use Drugs In Rural Appalachia, Kentucky, Grace A. Debo

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Abstract

Aims: To identify demographic, socioeconomic, health and access to resources, and drug use correlates associated with drug selling among adult, people who use drugs (PWUD) in rural Appalachia.

Methods: This cross-sectional study analyzed survey data from the ongoing KyOSK and SNAP projects. The surveys included information on participant characteristics (demographic, socioeconomic), and health and drug use behaviors. Our analysis was restricted to only those who answered the question regarding drug selling (n=738). Both univariate and multivariate logistic regression models were employed to identify correlates of drug selling.

Results: Among 738 participants, 20.6% reported selling or attempting to sell drugs …

Pharmacy Involvement In Increased Access To Opioid Treatment Programs, Catherine O'Rourke

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

The opioid epidemic still affects many Americans today. Despite approved medication treatments for opioid use disorder (OUD), a majority of the population with OUD have not received treatment. Since pharmacists are the most accessible health care professional and had an important role providing care during the COVID-19 pandemic, there has been a push to expand pharmacists’ scope of practice. The primary purpose of this investigation was to identify the benefits and barriers to community pharmacist-led treatment of OUD. The secondary purpose was to determine whether pharmacist participation in opioid treatment programs (OTPs) or office based opioid treatment (OBOT) would be …

The Effects Of Stigma Within The Prep Care Cascade Among People Who Inject Drugs In Rural Kentucky, Abby Burton

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Background: Injection drug use has increased HIV burden in low-prevalence communities, specifically within rural Kentucky. Pre-exposure prophylaxis (PrEP) has been successful in terms of HIV prevention, yet uptake remains low among people who inject drugs (PWID). PWID living in rural areas face unique challenges to receiving PrEP care, including significant barriers of substance use- and HIV-related stigma. Recent studies have only started to explore the overlapping effects of these two stigmas. Considering the barriers each stigma independently poses to PrEP care, it is important to investigate their role in tandem for any compounding effects. This paper is a secondary analysis …

A Case Study In Program Evaluation, Lydia Williams

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

The three core functions of public health are assessment, policy development, and assurance, and program evaluation falls under the latter category. A program is incomplete without an in-depth understanding of how well it works and what steps can be taken to make sure there is continuous progress and improvement.

In this case study, I developed an evaluation plan for the Lexington-Fayette County Health Department’s (LFCHD) infectious disease outbreak education program. The need for such a program was realized after a MRSA outbreak among a Kentucky high school football team. This case study employed the Center for Disease Control and Prevention …

Trust In Local Health Departments: A Cross-Sector Analysis Of Urban And Rural Communities, Kelsie Kwok

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Cross-sector collaboration is being looked to as best-practice for addressing complex issues. Given that trust is an important aspect of a well-functioning network, partners may have varying perceptions of trust regarding their counterparts. The primary objective is to examine partnerships and trust scores among six Kentucky communities (three urban, three rural) and their efforts to address unmet social needs. The secondary objective is to discuss differences among urban and rural communities regarding local health departments and the role of trust. A social network analysis (SNA) was conducted using the Program to Analyze, Record, and Track Networks to Enhance Relationships (PARTNER) …

Patterns Into Pathways For Improving Safety Culture: Refined Latent Class Analysis Informs Tailored Decision Support For South Carolina Dss Safety Culture Improvements, Michaela Voit

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

The rising prevalence of exposures to adverse childhood experiences (ACEs) demands a coordinated public health response, as a significant body of research details the cumulative impact of ACEs on chronic morbidities contributing to reduced life expectancy. Child welfare workers (CWW) are embedded in this public health effort, tasked with preventing and mitigating the impacts of ACEs through family and prevention services. The National Partnership for Child Safety (NPCS) may improve the wellbeing of CWWs and the effectiveness of Child Welfare (CW) services by improving the quality of safety culture within CW organizations. To inform NPCS quality improvement efforts, our project …

A Word From The Writing Team (January 2024), Pam Walter, Mfa, Liz Declan, Ma, Mfa

A Word From the Writing Team (Newsletter)

This issue includes:

• Virtual Writing Retreats Return in February
• The OPWPC Canvas Page Offers Helpful Tools
• Academic Commons Will Host a Presentation on Refugee Health in Philadelphia
• Publication Spotlight
• The OPWPC Helps with Scholarly Communication and Publication
• Scott Memorial Library Renovations Continue
• Wiley Open Access Fees Waived for Jefferson Authors

Health-Related Social Needs Before And After Critical Illness Among Medicare Beneficiaries, Tamar A. Kaminski

Yale Medicine Thesis Digital Library

Health-Related Social Needs (HRSNs), such as financial strain, food insecurity, social isolation, and transportation disadvantage, are unmet social needs associated with poor health outcomes and increased healthcare utilization. In qualitative work, survivors of the intensive care unit (ICU) report financial strain; however, little is known about food insecurity, social isolation, and transportation disadvantage after critical illness. The objectives of this study were twofold: (1) to ascertain changes in three HRSNs—food insecurity, social isolation, and transportation disadvantage—from the year before critical illness to the year following discharge among older adult survivors of critical illness, and (2) to evaluate demographic, pre-admission, and …

Evaluating The Length Of Clinical Rotations In Medical Laboratory Science Education, Kendal Beazer

Dissertations and Theses

Medical laboratory scientists and technicians play a crucial role in healthcare by utilizing advanced methods to aid in the diagnosis, monitoring, and prevention of a wide range of diseases. Certifying as an MLS or MLT professional is detailed and specific, requiring years of laboratory training that is crucial to accurately perform testing that impacts patient care. Shortages of qualified medical laboratorians have persisted for decades, causing laboratory administrators to hire individuals who lack basic laboratory training. Laboratory education programs are not keeping up with the staffing demands, in part due to the lack of clinical rotation placements needed for MLS …

A Cost-Effectiveness Analysis Of Oropharyngeal Cancer Post-Treatment Surveillance Practices, Rema Shah

Yale Medicine Thesis Digital Library

Post-treatment surveillance imaging for oropharyngeal squamous cell carcinoma (OPSCC) is guided by the National Comprehensive Cancer Network (NCCN) and often is routinely performed beyond the suggested guidelines. With the advent of biomarker-based disease surveillance, there may be an alternative option that can reduce the cost-burden of post-treatment imaging for OPSCC. This study investigates the comparative cost-effectiveness of a hypothetical miRNA biomarker test for specifically HPV-negative (HPV-) OPSCC post-treatment surveillance and also investigates whether the extra imaging practices that are often employed for both HPV+ and HPV- OPSCC are truly cost-effective in order to inform evidence-based decision making after OPSCC treatment. …

Prevalence Of Metabolic Comorbidities And Viral Infections In Monoclonal Gammopathy, Mansen Yu

Yale Medicine Thesis Digital Library

Monoclonal gammopathy (MG) encompasses a spectrum of related diseases, with monoclonal gammopathy of undetermined significance (MGUS) being the most prevalent, serving as a precursor of smoldering and clinical multiple myeloma. While the association between gammopathies, metabolic conditions and antigenic stimulation has long been recognized, the precise mechanism remains unclear. Prior research has shown that a subset of MGUS and MM is driven by chronic antigenic stimulation of B cells by endogenous lipids and exogenous microbial antigens. The aim of this study is to assess the prevalence of metabolic comorbidities and viral infections in a large population with monoclonal gammopathy, providing …

Racial Disparities In Behavioral Crisis Care: Investigating Restraint Patterns In Emergency Departments, Erika Chang-Sing

Yale Medicine Thesis Digital Library

AbstractImportance: Black patients were more likely than White patients to be brought to the hospital by police, and they were also more likely to be restrained and sedated during behavioral crises in emergency departments (EDs). Although the perils of policing mental health conditions for Black individuals are recognized, it is unclear whether or to what extent police transport mediates the relationship between Black race and physical restraint use in emergency departments. Hispanic/Latino patients were less likely than White patients to be restrained in Emergency departments but more likely to be brought to the hospital by police. They were also less …

Preoperative Psychosocial Risk Burden Among Patients Undergoing Major Thoracic And Abdominal Surgery, Emily Park

Yale Medicine Thesis Digital Library

Objective: Patient-related, biological risk factors such as age, diabetes, and smoking are associated with worse outcomes and increased postoperative complications rates in patients. However, not much is known about the effects of psychosocial risk factors on surgical outcomes. This study aimed to characterize the psychosocial risk burden in patients undergoing major surgery for malignant and benign conditions. Methods: A prospective, comprehensive psychosocial risk assessment of adult patients undergoing major thoracic or abdominal surgery within the Yale New Haven Health system was conducted from July 2023 to December 2023. The study was delivered over telephone, and was comprised of validated survey …