Medicine and Health Sciences Commons^™

Factors Associated With The Prevalence Of Iron Deficiency And Anemia In Women Of Reproductive Age In The U.S.: Nhanes 2015-2020, Catherine Wise

All Master's Theses

Iron deficiency (ID) is well recognized as the most prevalent nutrient insufficiency and a leading cause of anemia. Women of reproductive age (WRA), females 15 to 49, are at an increased risk of ID and anemia. This is due to the heightened iron demands of this life stage, including puberty, menstruation, and pregnancy, which require iron intakes ranging from 15 to 27 mg/day. Poor health and nutrition increase the risk of ID and progression to anemia. Consequences of ID and anemia range from exhaustion and decreased cognitive function to an increased risk of mortality. This study aimed to assess the …

Supporting Interoceptive Learning Across Environments: A Guide For Educators And Caregivers, Jamie M. Steinhoff

Occupational Therapy Capstones

Introduction: Children aged four to six experience rapid brain development, advancing language skills, and understanding of the human body (Schaan et al., 2019). This developmental stage highlights the importance of educators and caregivers teaching interoception to improve preschool-aged children's occupational engagement and emotional regulation. Children lacking developed interoceptive skills may encounter difficulties regulating their emotions, impacting activities such as play, social participation, education, and health management (Arnold et al., 2019). This product was developed to offer caregivers and educators a comprehensive understanding of interoception through a handbook and training sessions containing strategies, exercises, tools, and activities to facilitate interoceptive development …

Increasing Success For Children With Sensory Processing Difficulties: Education And Support For Individuals Working With Children In Community Settings, Alyssia D. Pucel

Occupational Therapy Capstones

Integration into community settings with limited ability to control one’s exposure to sensory stimuli is often challenging for children with sensory processing difficulties (Isamel et al., 2018). To self-regulate, children often exhibit behaviors that appear to others as abnormal or inappropriate to the expectations within the social environment but are out of the child’s control (Brown et al., 2019). Individuals who do not know about sensory processing may respond to the behavior in a way that is unsupportive to the child’s sensory needs and overall daily functioning. To advocate for children in natural community contexts, Success with Sensory provides individuals …

The Role Of Occupational Therapy To Support Engagement In Activities For Adults Throughout The Cancer Continuum, Alexis Brolsma

Occupational Therapy Capstones

Purpose: More than 18 million people currently living in the United States have received a cancer diagnosis sometime throughout their lives. Advancements in treatment for cancer are increasing the livelihood of those surviving cancer, but there are lasting challenges. More than 40% of individuals within the cancer continuum continue to experience performance challenges with their daily tasks. Occupational therapy can target these challenges, but this profession is underutilized within cancer care. The purpose of this project was to increase awareness of occupational therapy’s role in cancer care, educate providers, and create a resource to address the needs of the cancer …

Effects Of Probiotic Supplementation On Pcos Outcomes, Allison Stoeffler

Physician Assistant Scholarly Project Papers

Polycystic ovarian syndrome (PCOS) is a multifactorial metabolic, endocrinologic, and gynecologic condition affecting up to 5 million women in the United States. It is a disease characterized by oligo- or anovulation, hyperandrogenism, and/or polycystic ovaries. Phenotypic presentation can include irregular menstrual cycles, obesity, hirsutism, insulin resistance, or difficulty conceiving. If untreated, PCOS can result in a sequelae of chronic disease burden. Current standard of care consists of metformin for blood sugar control, oral contraceptives for menstrual regularity, and spironolactone for androgen imbalance, but newer research is identifying gut dysbiosis as a possible contributing etiology to disease development and symptomology. This …

You Don’T Have Celiac Disease: A Patient Perspective On Potential Issues With Stress Leading To Misdiagnosis, Ashley M. Snyder

Public Health Faculty Publications

No abstract provided.

Stroke Rehabilitation Through The Continuum Of Care: Integrating Evidence And Occupation-Based Practice, Emily Geissler

Frank Low Research Day Posters

Purpose: The purpose of this scholarly project was to provide patients with knowledge on the rehabilitation process and practitioners with a resource to assist in implementing occupation and evidence-based practice in stroke rehabilitation throughout the entire continuum of care.

Methods: An extensive literature review was conducted regarding evidence-based and occupation-based interventions within stroke rehabilitation. The author partnered with a midwestern healthcare agency to experience stroke rehabilitation as an occupational therapy practitioner across the continuum of care. Through a needs assessment, it was found patients lack knowledge regarding the rehabilitation process and practitioners lack knowledge of other settings. The …

Postoperative Antibiotics For Diabetic Patients With Complicated Appendicitis, Bill D. Pope Iii, Alejandro J. Candil

MEDI 9331 Scholarly Activities Clinical Years

This retrospective study, conducted at Valley Baptist Medical Center from March 14, 2020, to December 3, 2023, explores the impact of postoperative antibiotics on diabetic patients with complicated appendicitis. Out of 494 appendectomy patients, 17 diabetic patients with complicated appendicitis were analyzed. Of these, 15 received postoperative antibiotics, with 2 developing infections (13%), while the 2 did not receive postoperative antibiotics and remained infection-free. The study acknowledges limitations in sample size and the subjective nature of defining complicated appendicitis. These findings contribute to ongoing discussions on postoperative antibiotic practices, particularly in diabetic patients with complicated appendicitis.

Demographic Profile And Clinical Characteristics Of Fuchs Endothelial Corneal Dystrophy In Thai Patients: A Retrospective Cohort In A Tertiary Referral Center, Trakanta Wannapanich

Chulalongkorn University Theses and Dissertations (Chula ETD)

Objective: This study aimed to describe the demographic profiles, clinical characteristics, and the 5-year clinical course of Fuchs endothelial corneal dystrophy (FECD) in Thai patients. Secondary objectives included identifying the risk factors associated with corneal transplantation and evaluating surgical trends, particularly the types of corneal transplantation performed. Methods: This retrospective cohort study analyzed clinical data from 900 Thai patients (1,743 eyes) diagnosed with FECD. Demographic information, clinical characteristics, and follow-up data over five years were collected. Statistical methods, including logistic regression, were used to identify factors predicting corneal transplantation. Results: The mean age of the cohort was 63.84 ± 11.89 …

Epigenetic Regulation Of Cancer Testis Antigens In Hepatocellular Carcinoma, Rinrada Klankajorn

Chulalongkorn University Theses and Dissertations (Chula ETD)

Hepatocellular carcinoma (HCC) represents one of the most common causes of cancer-related death worldwide, with few available treatment options. Cancer-testis antigens (CTAs), notably from the MAGE gene family, have opened new possibilities for improving immunotherapy in HCC due to their tumor-specific expression and high immunogenicity. However, the mechanisms regulating MAGE gene expression are largely unknown. This study explored mechanisms controlling the expression of MAGE-A3 and MAGE-C2. We utilized HCC organoid cultures derived from patient HCC tissues known to represent cancer epigenetic status more accurately than cell lines to study the MAGE gene family expression patterns and promoter methylation patterns. Our …

Acute Toxicity Study Of Canine Mesenchymal Stem Cell (Msc)-Derived Exosome Preparation For Drug Registration, Anatcha Thongsit

Chulalongkorn University Theses and Dissertations (Chula ETD)

Exosomes, spherical vesicles secreted by cells containing diverse biomolecules, are gaining attention in veterinary medicine. Mesenchymal stem cell (MSC)-derived exosomes show promise for treating animal diseases. However, their safety profile, particularly the acute toxicity of canine MSC-derived exosomes, has yet to be adequately explored. This study evaluates the acute toxicity of canine MSC-derived exosomes on rat systemic health, adhering to ISO 10993-11 guidelines for systemic toxicity testing to support veterinary drug registration and development. The study tested acute toxicity in five female Sprague Dawley rats by administering exosomes at a concentration of 1×109 particles/mL via intravenous injection into the tail …

Comparative Electron Microscopy Analysis Of Internal Limiting Membrane And Epiretinal Membrane Ultrastructure From Pars Plana Vitrectomy, Thananop Pothikamjorn

Chulalongkorn University Theses and Dissertations (Chula ETD)

Background: Histopathological difference and biomarkers related between the internal limiting membrane (ILM) in eyes with and without epiretinal membrane (ERM) remains unknown. This study characterizes the ultrastructural and histopathological features of the internal limiting membrane (ILM) in eyes with and without epiretinal membrane (ERM) undergoing vitrectomy.Methods: ILM specimens were intraoperatively collected and analyzed using light microscopy (LM) to assess nuclei counts, and transmission electron microscopy (TEM) to evaluate vacuolization, specimen consistency, cell types and other ultrastructural features. One eye per participant was included. Histopathological features were compared between ILM with and without ERM, as well as between idiopathic and secondary …

Incidence, Risk Factors, And Outcome Of Anti-Tuberculosis Drug-Induced Hepatotoxicity In People With And Without Hiv In Thailand And The Philippines, Ryan Christopher Atuel

Chulalongkorn University Theses and Dissertations (Chula ETD)

Background: Anti-tuberculosis drug-induced hepatotoxicity (DIH) is a common complication among people living with HIV (PLWH), potentially leading to treatment interruptions. Objective: To determine the incidence of DIH and identify risk factors in Thai and Filipino PLWH on tuberculosis (TB) treatment, compared with those with TB mono-infection. Materials and Methods: We conducted a cohort study of Thai and Filipino adults with active TB using retrospective data from Thailand (2000–2024) and prospective data from the Philippines (2024). Eligible participants had AST/ALT results at TB treatment initiation and follow-up. DIH was defined as AST or ALT ≥3 times the upper limit of normal. …

Expression Optimization And Characterization Of Plant-Produced Human Interleukin-15, Chalatorn Charnsatabut

Chulalongkorn University Theses and Dissertations (Chula ETD)

Human interleukin-15 (hIL-15) is a cytokine that plays a crucial role in immune responses like T cell proliferation, activation, and prolongation of natural killer (NK) cells. This cytokine also impacts the cell proliferation of human adult low calcium temperature (HaCaT) keratinocytes which can lead to the wound-healing effect. This study aimed to optimize the expression and characterize the recombinant hIL-15 in Nicotiana benthamiana with the Agrobacterium-mediated transient expression system. The hIL-15 gene was fused with the Fc domain from the IgG1 antibody for purification. The expression cassette was optimized for sub-cellular targeting and agroinfiltration. The transiently expressed hIL-15-Fc was purified …

Molecular Mechanism Of Lusianthridin On Platelet Aggregation Inhibition And Endothelial Cell Protection, Fozia -

Chulalongkorn University Theses and Dissertations (Chula ETD)

Lusianthridin (LST), a bioactive compound isolated from Dendrobium venustum, exhibits notable vasoprotective properties. This study aimed to elucidate the underlying molecular mechanisms of LST by evaluating its effects on platelet function and endothelial cell activation in vitro. In human platelets, LST significantly inhibited collagen-induced aggregation, an effect associated with elevated phosphorylation of vasodilator-stimulated phosphoprotein (VASP) and suppression of Akt phosphorylation. In EA.hy926 endothelial cells, LST attenuated tumor necrosis factor-alpha (TNF-α)-induced endothelial dysfunction by reducing nitric oxide (NO) production and suppressing the expression of pro-inflammatory cytokines, including interleukin-6 (IL-6) and interleukin-1β (IL-1β). Mechanistic investigations revealed that LST inhibited key inflammatory signaling …

Predicting The Eq-5d-5l Utility Scores From The Impact Of Vision Impairment (Ivi) Questionnaire In Thai Patients, Emilia Audrey Tunmas Pasenggong

Chulalongkorn University Theses and Dissertations (Chula ETD)

Objectives : (1) This study aims to predict the EQ-5D-5L utility scores from the impact of vision impairment (IVI) questionnaire in Thai patients using mapping techniques. (2) To investigate the association between sociodemographic and clinical variables with the EQ-5D-5L index scores. Methods : This is a secondary data analysis. A total of 499 patients with multiple levels of visual impairment were recruited from King Chulalongkorn Memorial Hospital Thailand between February and July 2022. Ordinary least square (OLS), Tobit, Censored least absolute deviation (CLAD), and Adjusted limited dependent variable mixture model (ALDVMM) regression models were used to map the IVI questionnaire …

Development Of Granule Product Containing Curcuminoid Extract And Hyaluronic Acid Derivative For Oral Administration, Natkhanang Boonpetcharat

Chulalongkorn University Theses and Dissertations (Chula ETD)

Curcumin is widely recognized for its various pharmacological properties, including antioxidant, anti-inflammatory, and anti-tumor activities. Nevertheless, the development of curcumin as a therapeutic agent is impeded by its limited oral bioavailability, which stems from its chemical instability, poor aqueous solubility, and rapid degradation. This study aimed to develop granule formulations incorporating hyaluronic acid graft poly(N-isopropylacrylamide) or HA-g-pNIPAM to enhance dissolution and protect curcumin from degradation. Three formulations were developed: F10 (HA-g-pNIPAM physically mixed with curcumin), F10 Encap (curcumin encapsulated within HA-g-pNIPAM), and F11 (curcumin granules without HA-g-pNIPAM). The stability results showed that F10 Encap effectively maintained curcumin content throughout the …

The Effect Of Stilbene Derivatives On Modulation Of P-Gp Efflux Transporter, Shahnila Mukhtar

Chulalongkorn University Theses and Dissertations (Chula ETD)

Drug efflux by transporters of the ATP-binding cassette (ABC) family such as P-glycoprotein is the earliest and most well-studied multidrug resistant (MDR) mechanism. Overexpression of ATP-binding cassette transporters can decrease the effectiveness of chemotherapy by pumping anti-cancer drugs out of cancer cells. This study was to predict the best-fit of certain stilbenoids isolated from Thai orchids as a specific P-gp moderator, using the molecular docking approach to compare and specify the binding interaction between each stilbenoids and the P-gp binding domains. Furthermore, the in vitro substrate uptake assays of eight stilbenoids with phenanthrene core structure were conducted for assessing their …

Factors Contributing To Self-Medication And Quality Of Life Of Myanmar Immigrants In The Covid-19 Pandemic Situation, Su Myat Thin

Chulalongkorn University Theses and Dissertations (Chula ETD)

Background: Due to numerous difficulties in accessing necessary healthcare and standard medication, immigrants might be more likely to rely on self-medication to solve health problems they suffered. Although it might provide immediate relief, it could also bring some risks such as adverse drug reactions, antimicrobial resistance progression, drug side effects, and toxicity. This study aimed to identify the healthcare service accessibility and self-medication of immigrants in Thailand for COVID-19. Additionally, this study also aimed to evaluate the effect of immigrants’ COVID-19 perception on their self-medication uses and quality of life. This study had two phases in which the first phase …

The Effect Of Artogomezianone On Apoptosis Induction In Non-Small-Cell Lung Cancer, Worawich Somboonvoravong

Chulalongkorn University Theses and Dissertations (Chula ETD)

NSCLC severity is driven by dysregulation of the EGFR/PI3K/Akt pathway, promoting tumor growth and drug resistance. Hyperactive EGFR/PI3K/Akt signaling results in aggressive tumors and poor outcomes, further worsened by resistance to EGFR inhibitors. Targeting this pathway could inhibit tumor growth and resistance. artogomezianone, a compound derived from Artocarpus gomezianus, has shown considerable anti-cancer efficacy, mainly by inducing apoptosis and decreasing the proliferation of several cancers. This study investigated artogomezianone’s effects on the EGFR/PI3K/Akt pathway. Cytotoxic and apoptotic effects were assessed using MTT assay and Hoechst 33342/PI double staining, with confirmation by Western blot analysis. Protein levels and binding affinity were …

Current Clinical Concepts: Nonoperative Management Of Shoulder Instability, Margie K. Olds, Timothy L. Uhl

Physical Therapy Faculty Publications

Nonoperative management after shoulder dislocation or subluxation remains a challenging and complex task. Accurate diagnosis of the condition and shared decision-making regarding operative and nonoperative management and timing of return to play is required. In this Current Clinical Concepts paper, we introduce a shoulder instability framework that addresses these fundamental clinical dilemmas. Valid clinical prognostic tools that can be used to predict recurrent shoulder instability are reviewed. The process of shared decision-making in the realm of shoulder instability is presented. Finally, a framework for progressive rehabilitation that addresses deficits in motor control, strength, and endurance in scapular and shoulder musculature …

Comparison Of Primary Percutaneous Coronary Intervention (Ppci) Vs. Pharmacoinvasive Strategy As Reperfusion Strategies In Patients With St-Elevation Myocardial Infarction (Stemi), Siu Wai For

Journal of the Hong Kong College of Cardiology

Background – Guidelines recommended primary percutaneous coronary intervention (PPCI) as the preferred reperfusion strategy in the treatment of patients with ST-elevation myocardial infarction (STEMI). However, PPCI might not be readily available in the real-world situations due to the limitation of resources. A pharmacoinvasive strategy consisting of early thrombolytic therapy followed by PCI was suggested as an alternative reperfusion approach. Prior studies had shown that clinical outcomes of pharmacoinvasive strategy were comparable to PPCI. The purpose of this retrospective study was to assess the outcomes of reperfusion strategies in patients with STEMI in the North Territories East of Hong Kong, comparing …

Prehabilitation-Reconditioning Of Teenage Heart Transplant Candidates, Chan Myr, Hui Ww, Chan Ww, Lun Ks

Journal of the Hong Kong College of Cardiology

Progression of Dilated Cardiomyopathy to advanced heart failure necessitates the use of a Left Ventricular Assistive Device (LVAD) as a bridge to heart transplantation (1,8,10). Two teenagers with cardiomyopathy who were on the waiting list for heart transplantation and had LVADs were given a physical training intervention tailored by physiotherapist. This case report reviewed the efficacy of prehabilitation conducted by physiotherapists at the Hong Kong Children's Hospital. After the prehabilitation program both patients demonstrated significant improvements in functional capacity, respiratory effort, and hand strength. Physical training is a promising approach for patients who have undergone heart transplantation.

Atorvastatin In Preventing Anthracycline-Induced Cardiotoxicity In Low-Risk Breast Cancer Patients: A Randomized Controlled Trial (Atopact-Low), Chonthicha Tanking, Chanwit Wuttichaipradit, Chayanee Samdaengpan, Jomtana Siripaibun, Siriwan Manahwan,R.N, Bundhitwong Trikesornnopamas, Phakawan Budchala, Viroj Muangsillapasart

Journal of the Hong Kong College of Cardiology

Background: According to the current guideline, statins should be provided to prevent anthracycline cardiotoxicity in high-risk cancer patients. This study aims to investigate the role of atorvastatin in preventing anthracycline-induced cardiac dysfunction among low-risk breast cancer patients. Methods: In this randomized, double-blinded, placebo-controlled trial, newly diagnosed breast cancer patients with low risk of cancer therapy-related cardiac dysfunction (CTRCD) were assigned to receive atorvastatin 40 mg or placebo. Echocardiography was performed before, at 3 and 6 months after the anthracycline treatment to determine changes in LVEF as a primary outcome. The secondary outcome included changes in global longitudinal strain (GLS), LV …

A Guide To Otoliths Of Minnesota Fishes, Baylor J. Short

Journal of Earth and Life Science

Investigations into the diet patterns of piscivores can provide crucial information on predator-prey relationships, population dynamics, and responses to changing ecosystems. However, digestive processes often remove or alter physical characteristics that are traditionally used to identify consumed fish. This problem has been addressed to some degree with advances in molecular technologies, although these methods can be costly and require specific training and equipment to do so. In contrast, bony structures such as otoliths, vertebrae, cleithra, and others frequently have morphologies that are unique among families, genera, and species. Because these structures are resistant to digestion, they can be used to …

Improving Patient Safety And Continuity Of Care By Educating Nurses About Standardized Handoffs In The Post-Anesthesia Care Unit: A Quality Improvement Project, Remi Dos Santos

Master's Theses and Capstones

Background: Effective communication during patient handoffs is crucial for ensuring patient safety and continuity of care. The I-PASS handoff tool has been identified as an effective method to standardize communication and reduce errors during these critical transitions.

Local Problem: In the Post-Anesthesia Care Unit (PACU) of a hospital in New England, the lack of standardized procedures for nurse handoffs posed a risk to patient safety and care quality.

Methods: A quality improvement project was conducted using the Plan-Do-Study-Act (PDSA) cycle to implement and evaluate an educational intervention aimed at improving PACU nurses' proficiency with the I-PASS handoff tool. Pre- and …

Role Of Edaravone Nanosuspension In Preterm Labor And Birth Outcomes, Sruthi Sarvepalli

Theses and Dissertations

Annually, preterm birth (PTB) affects fifteen million infants, posing a significant risk of infant mortality and lifelong disability. Among various triggers, it is well-established that infection-associated oxidative stress and inflammation can induce preterm labor. There is no FDA approved medication for the prevention of PTB except tocolytics which provide marginal benefit at a later stage. Scarcity of therapeutic intervention and unmet medical need propelled us in investigating a novel drug molecule. Our current research is focused on investigating the potential of Edaravone (EDA), an FDA-approved antioxidant and anti-inflammatory medication, in delaying preterm labor and improving neonatal outcomes. Our goal is …

Effectiveness Of Education-Based Programs And Preventative Strategies On Oral Health Outcomes For Older Adults In Rural Communities: A Critically Appraised Topic, Meagan Barnes Pearson, Abby Ellenberger, Becca Valdez

Critically Appraised Topics

Elderly adults in rural populations are facing difficulties with oral health due to accessibility difficulties, lower socioeconomic status, and decreased OHL. Limited research has been conducted on occupational therapy interventions within this specific occupational domain, or with this particular population. This CAT investigates the positive impacts oral health education programs that incorporate preventative strategies have on the oral health outcomes of the aging population living in rural locations when implemented by occupational therapists alongside an interdisciplinary team.

Occupational Therapy’S Role In Transitioning & Community Integration, Payton Baumann, Madison Thomas, Anna Voegel

Critically Appraised Topics

This critically appraised topic paper will concentrate on the most effective formatting of transition programs necessary to improve a sense of community belonging and overall quality of life (QOL). The main factors to consider in the scenario are accessibility to programs, funding for programs, social stigmas and attitudes, and mental health of individuals who are experiencing a transition. Populations experiencing a transition may include those transitioning from incarceration, experiencing homelessness, educational programs, employment opportunities, hospital care settings, active-duty status, and migration. To develop a sense of community belonging, social participation will be an important aspect to integrate into interventions, which …

Contexts Contributing To Burnout And Potential Coping Strategies To Support Work-Life Balance And Health Management Among Occupational Therapy Practitioners, Nora Duren, Kearyn Nelsen, Jada Welke

Critically Appraised Topics

The focus of this critically appraised topic paper is the aspects of burnout that occupational therapy (OT) practitioners face in a professional capacity, as well as environmental and personal contexts (AOTA, 2020) that have been shown to reduce the intensity of burnout within the profession. According to the American Occupational Therapy Association (AOTA), context can be described as the “broad context that encompasses environment and personal factors” (p. 36). “Environmental factors are aspects of the physical, social, and attitudinal surroundings in which people live and conduct their lives” (AOTA, 2020, p. 36). Additionally, the AOTA defines personal factors as the …