Resocialization Of An Inpatient Handoff Sepsis Bundle Checklist On A Medical-Surgical Unit, Sophia Kawada

Master's Projects and Capstones

Problem: In September 2023, it was found that only 25% of nurses were familiar with an inpatient handoff sepsis bundle checklist (IHSBC) on a Medical-Surgical Unit in Hospital A. This evidence-based project aimed to improve resocialization of the IHSBC such that compliance to the bundle continues to be maintained well above the benchmark of 75%. Context: Clinical Nurse Leader (CNL) students at the University of San Francisco conducted a microsystem assessment of the Medical-Surgical Unit at Hospital A. This hospital aimed to maintain high rates of compliance with the IHSBC. Interventions: Resocialization of the IHSBC was completed in October, and …

Optimizing Sepsis Management Through Enhanced Protocol Compliance In The Emergency Department, Efrain Perez Trujillo

Master's Projects and Capstones

Problem: This quality improvement (QI) project aims to optimize early sepsis management and sepsis bundle compliance among Emergency Department (ED) registered nurses in order to reduce the risk of sepsis-related deaths and associated hospital length of stay.

Context: Clinical Nurse Leader (CNL) students conducted a microsystem assessment on the ED at Hospital A, located within the greater San Francisco Bay Area. This microsystem, equipped with 115 nurses and 44 rooms, consists of an acuity of care for urgent to life-threatening medical conditions, including sepsis.

Intervention: Following time constraints, and limitations, implementation of an intervention was not feasible; however, CNL students …

Aspirin And Nonaspirin Nonsteroidal Antiinflammatory Drug Use And Occurrence Of Colorectal Adenoma In Black American Women, Lauren E Barber, Kimberly A Bertrand, Shanshan Sheehy, Laura F White, Hemant K Roy, Lynn Rosenberg, Julie R Palmer, Jessica L Petrick

Faculty, Staff and Students Publications

Evidence suggests that aspirin use reduces the occurrence of colorectal neoplasia. Few studies have investigated the association among Black Americans, who are disproportionately burdened by the disease. We assessed aspirin use in relation to colorectal adenoma among Black women. The Black Women's Health Study is a prospective cohort of self-identified Black American women established in 1995. Participants reported regular aspirin use on baseline and follow-up questionnaires. Beginning in 1999, participants reported undergoing a colonoscopy or sigmoidoscopy, the only procedures through which colorectal adenomas can be diagnosed. Multivariable logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals …

Self-Calibrated Subspace Reconstruction For Multidimensional Mr Fingerprinting For Simultaneous Relaxation And Diffusion Quantification, Jessie E.P. Sun, Ken Sakaie, Mark A. Griswold

Faculty Scholarship

Purpose: To propose a new reconstruction method for multidimensional MR fingerprinting (mdMRF) to address shading artifacts caused by physiological motion-induced measurement errors without navigating or gating. Methods: The proposed method comprises two procedures: self-calibration and subspace reconstruction. The first procedure (self-calibration) applies temporally local matrix completion to reconstruct low-resolution images from a subset of under-sampled data extracted from the k-space center. The second procedure (subspace reconstruction) utilizes temporally global subspace reconstruction with pre-estimated temporal subspace from low-resolution images to reconstruct aliasing-free, high-resolution, and time-resolved images. After reconstruction, a customized outlier detection algorithm was employed to automatically detect and remove images …

Association Of Covid-19 Coinfection With Increased Mortality Among Patients With Pseudomonas Aeruginosa Bloodstream Infection In The Veterans Health Administration System, Leila S. Hojat, Brigid M. Wilson, Federico Perez, Maria F. Mojica, Mendel E. Singer, Robert A. Bonomo

Faculty Scholarship

Objective: Pseudomonas aeruginosa bloodstream infection (PA-BSI) and COVID-19 are independently associated with high mortality. We sought to demonstrate the impact of COVID-19 coinfection on patients with PA-BSI. Design: Retrospective cohort study. Setting: Veterans Health Administration. Patients: Hospitalized patients with PA-BSI in pre-COVID-19 (January 2009 to December 2019) and COVID-19 (January 2020 to June 2022) periods. Patients in the COVID-19 period were further stratified by the presence or absence of concomitant COVID-19 infection. Methods: We characterized trends in resistance, treatment, and mortality over the study period. Multivariable logistic regression and modified Poisson analyses were used to determine the association between COVID-19 …

Reducing Hospital-Acquired Pressure Injury In An Inpatient Medical-Surgical Telemetry Adult Unit By Educating And Encouraging Basic Wound Care Prior To Wound Care Consult, See Wai (Amy) Kong

Master's Projects and Capstones

Problem: A medical center in the Diablo Service Area had one of the highest rates in hospital-acquired pressure injury (HAPI), benchmarking with other facilities, with the project unit one of the top offenders. The patients and the medical center both suffered from the harm. Barriers to HAPI prevention included lack of patient turnings, skin assessment, and early standard wound care treatment.

Context: This project focused on the primary care team standardizing early wound care treatment to avoid wound progression.

Interventions: Interventions included re-educating the primary care team on early basic wound care using a standard wound care guideline created by …

Mentoring Nurses After Specialty Training Or Orientation In Labor And Delivery, Benjamin Jlopleh Worji

Master's Projects and Capstones

Mentoring Nurses After Specialty Training or Orientation in Labor and Delivery

Abstract

Background: The setting for this project was a northern California hospital-based healthcare system referred to as “Hospital KV.” Hospital KV is a non-profit, integrated hospital that operates to improve the community’s health. Hospital KV’s maternal child health (MCH) department comprises a labor and delivery(L&D) unit, a mother and baby unit (MBU), also referred to as a postpartum unit, and an intermediate nursery (IMN).

Problem: The hospital KV MCH department faced the challenge of a nursing shortage. The nursing shortage was associated with substantial challenges to Hospital KV, its …

Enhancing Diabetic Patient Continuous Glucose Monitoring Access, Colleen Ildefonso

Master's Projects and Capstones

Problem: Diabetic patients utilize treatments that require frequent monitoring and medication changes based on their blood sugar results. Continuous Glucose Monitoring (CGM) is more commonly used for diabetes management as time in range is becoming more prevalent to measure diabetes outcomes. Many diabetic patients find CGM use more accessible than finger sticks and glucometers. In contrast, others utilize the technology to closely monitor their blood sugars for interventions throughout the day. However, older adults have difficulty facilitating new CGM technology and may require further reinforcement using additional education methods such as teach-back.

Context: The endocrinology clinic serves a patient population, …

Reducing Care Companion Utilization In Medical-Surgical And Telemetry Units, Mary Jane B. Sagabaen

Master's Projects and Capstones

Abstract

Problem: The facility highly utilized sitters or care companions, negatively impacting the staffing plan, budget, and productivity. An average of 56 hours of care companions were used daily. This greatly exceeded the budget of 33 hours a day. Reassigning Patient Care Technicians (PCT) as care companions resulted in inadequate nurse support for patient care and increased cost for additional staffing needs. Despite this, the fall rate remained higher than the target.

Context: The patient population is mainly 65 years old and above, sometimes with confusion, dementia, delirium, and at high risk for falls and elopement. The culture included promptly …

Gatekeeping At Bio, Daniel A Gorelick

Faculty, Staff and Students Publications

No abstract provided.

Utility Of T-Cell Immunosequencing In Distinguishing Mycosis Fungoides Progression From Treatment Related Cutaneous Adverse Events, Safiyyah Bhatti, Daniel Joffe, Lauren Banner, Sahithi Talasila, Jenna Mandel, Jason Lee, Pierluigi Porcu, Neda Nikbakht

Department of Dermatology and Cutaneous Biology Faculty Papers

Cutaneous adverse events of both topical and systemic drugs in patients with mycosis fungoides (MF) present a diagnostic challenge as it is often difficult to distinguish drug associated rash from disease progression in the skin. Mogamulizumab and mechlorethamine gel are approved treatments for MF, both of which can cause treatment related cutaneous adverse events. It can often be challenging to distinguish mogamulizumab associated rash (MAR) and mechlorethamine gel associated hypersensitivity dermatitis from MF progression both clinically and histologically. High-throughput sequencing (HTS) of the T-cell receptor (TCR), also known as immunosequencing, can be used to assess T-cell clonality to support a …

A Case Of Filgrastim-Induced Neutrophilic Dermatosis Of The Dorsal Hands In A Patient With Felty Syndrome, Tejas P Joshi, Yelena Dokic, Gordana Verstovsek, Theodore Rosen

Faculty, Staff and Students Publications

Neutrophilic dermatosis of the dorsal hands (NDDH) is a variant of Sweet syndrome that presents with erythematous bullae, papules/plaques, or pustules on the dorsal hands. It is most commonly associated with hematologic and solid organ malignancies, though cases of NDDH associated with inflammatory bowel disease, rheumatologic disorders, and medication exposure have also been described in the literature. Felty syndrome is a rare complication of long-standing rheumatoid arthritis characterized by neuropathy, splenomegaly, and neutropenia. Granulocyte colony stimulating factors (e.g., filgrastim) can be utilized to rescue the neutropenia observed in Felty syndrome, but this treatment may subsequently cause Sweet syndrome. Herein, we …

Lilrb3 Modulates Acute Myeloid Leukemia Progression And Acts As An Effective Target For Car T-Cell Therapy, Sunny Mai, Alan Hodges, Hui-Ming Chen, Jilu Zhang, Yi-Ling Wang, Yongbin Liu, Fumiko Nakatsu, Xiaoxuan Wang, Jing Fang, Yitian Xu, Vitaliy Davidov, Kyeongah Kang, Sai Ravi Pingali, Siddhartha Ganguly, Masataka Suzuki, Marina Konopleva, Brooke Prinzing, Youli Zu, Stephen Gottschalk, Yong Lu, Shu-Hsia Chen, Ping-Ying Pan

Faculty, Staff and Students Publications

Identifying novel cell surface receptors that regulate leukemia cell differentiation and can be targeted to inhibit cellular proliferation is crucial to improve current treatment modalities in acute myeloid leukemia (AML), especially for relapsed or chemotherapy-refractory leukemia. Leukocyte immunoglobulin-like receptor type B (LILRB) is an immunomodulatory receptor originally found to be expressed in myeloid cells. In this study, we found that LILRB receptors can be induced under inflammatory stimuli and chemotherapy treatment conditions. Blockade of LILRB3 inhibited leukemia cell proliferation and leukemia progression. Additionally, treatment with LILRB3 blocking antibodies upregulated myeloid lineage differentiation transcription factors, including PU.1, C/EBP family, and IRF, …

Enniatin A Inhibits The Chaperone Hsp90 And Unleashes The Immune System Against Triple-Negative Breast Cancer, Nada H Eisa, Vincent M Crowley, Asif Elahi, Vamsi Krishna Kommalapati, Michael A Serwetnyk, Taoufik Llbiyi, Sumin Lu, Kashish Kainth, Yasmeen Jilani, Daniela Marasco, Abdeljabar El Andaloussi, Sukyeong Lee, Francis T F Tsai, Paulo C Rodriguez, David Munn, Esteban Celis, Hasan Korkaya, Abdessamad Debbab, Brian Blagg, Ahmed Chadli

Faculty, Staff and Students Publications

Low response rates and immune-related adverse events limit the remarkable impact of cancer immunotherapy. To improve clinical outcomes, preclinical studies have shown that combining immunotherapies with N-terminal Hsp90 inhibitors resulted in improved efficacy, even though induction of an extensive heat shock response (HSR) and less than optimal dosing of these inhibitors limited their clinical efficacy as monotherapies. We discovered that the natural product Enniatin A (EnnA) targets Hsp90 and destabilizes its client oncoproteins without inducing an HSR. EnnA triggers immunogenic cell death in triple-negative breast cancer (TNBC) syngeneic mouse models and exhibits superior antitumor activity compared to Hsp90 N-terminal inhibitors. …

Targeting Eif4a Triggers An Interferon Response To Synergize With Chemotherapy And Suppress Triple-Negative Breast Cancer, Na Zhao, Elena B Kabotyanski, Alexander B Saltzman, Anna Malovannaya, Xueying Yuan, Lucas C Reineke, Nadia Lieu, Yang Gao, Diego A Pedroza, Sebastian J Calderon, Alex J Smith, Clark Hamor, Kazem Safari, Sara Savage, Bing Zhang, Jianling Zhou, Luisa M Solis, Susan G Hilsenbeck, Cheng Fan, Charles M Perou, Jeffrey M Rosen

Faculty, Staff and Students Publications

Protein synthesis is frequently dysregulated in cancer and selective inhibition of mRNA translation represents an attractive cancer therapy. Here, we show that therapeutically targeting the RNA helicase eIF4A with zotatifin, the first-in-class eIF4A inhibitor, exerts pleiotropic effects on both tumor cells and the tumor immune microenvironment in a diverse cohort of syngeneic triple-negative breast cancer (TNBC) mouse models. Zotatifin not only suppresses tumor cell proliferation but also directly repolarizes macrophages toward an M1-like phenotype and inhibits neutrophil infiltration, which sensitizes tumors to immune checkpoint blockade. Mechanistic studies revealed that zotatifin reprograms the tumor translational landscape, inhibits the translation of Sox4 …

Early Cellular And Molecular Signatures Correlate With Severity Of West Nile Virus Infection, Ho-Joon Lee, Yujiao Zhao, Ira Fleming, Sameet Mehta, Xiaomei Wang, Brent Vander Wyk, Shannon E Ronca, Heather Kang, Chih-Hung Chou, Benoit Fatou, Kinga K Smolen, Ofer Levy, Clary B Clish, Ramnik J Xavier, Hanno Steen, David A Hafler, J Christopher Love, Alex K Shalek, Leying Guan, Kristy O Murray, Steven H Kleinstein, Ruth R Montgomery

Faculty, Staff and Students Publications

Infection with West Nile virus (WNV) drives a wide range of responses, from asymptomatic to flu-like symptoms/fever or severe cases of encephalitis and death. To identify cellular and molecular signatures distinguishing WNV severity, we employed systems profiling of peripheral blood from asymptomatic and severely ill individuals infected with WNV. We interrogated immune responses longitudinally from acute infection through convalescence employing single-cell protein and transcriptional profiling complemented with matched serum proteomics and metabolomics as well as multi-omics analysis. At the acute time point, we detected both elevation of pro-inflammatory markers in innate immune cell types and reduction of regulatory T cell …

Timigp: An R Package To Depict The Tumor Microenvironment From Bulk Transcriptomics, Chenyang Li, Jianjun Zhang, Chao Cheng

Faculty, Staff and Students Publications

Exploring the clinical relevance of diverse immune cell types within the tumor microenvironment is pivotal for unraveling cancer intricacies and developing treatments. Here, we present a protocol for using tumor immune microenvironment illustration based on gene pairs, an R package to deduce cell-cell interactions, unveiling the association between immune cell relative abundance and patient prognoses from bulk gene expression and survival data. We describe steps for harnessing cell-type markers derived from single-cell RNA sequencing data to map the tumor immune microenvironment across a spectrum of cancer types. For complete details on the use and execution of this protocol, please refer …

The Effect Of Covid-19 On Antibiotic Resistance, Debra A. Woo Dds, Ma, Karen A. Schulze Dds, Phd, Mali K. Mcguire Dds, Ms

Pacific Journal of Health

Over three years have passed since the beginning of the COVID-19 pandemic. During these times we have experienced significant changes in all areas of our life. In healthcare, more attention was focused on COVID-19 than other concerns. An unexpected consequence of the pandemic was a silent progression of an increased spread of multi-resistant pathogens. While antibiotic use during the pandemic varied across healthcare settings, antibiotics were prescribed for COVID-19 patients, even though antibiotics are known not to be effective against viruses.¹ In dentistry, antibiotics were prescribed to prevent potential dental infections, since many dental offices were not open. Antimicrobial …

End Of Life In The Ed – Brain Death And Organ Transplantation, Madison Cohen, Donald Penney

The Journal of Integrated Primary Care

Every year thousands of Americans die awaiting an organ transplant. While our knowledge and experience with organ transplantation has only improved, organ availability continues to be a major issue due to a lack of suitable donor organs. A large population of organ donors are those who have been clinically diagnosed as brain dead. Brain death is defined as the irreversible loss of all brain and brainstem functions. Despite brainstem functions being lost, mechanical ventilation and perfusion techniques allow for proper organ maintenance. This gives brain-dead individuals a unique opportunity to serve as multiple organ donors. However, due to mistrust of …

Recovery Capital, Mental Health And Substance Use Among Individuals Initiating Office-Based Buprenorphine Treatment For Opioid Use Disorder, Hannah R. Callahan, Karen Dugosh, Emily Hurstak, Patty Mccarthy, Emily Garber, Daniel Dejoseph, Julia Dejoseph, Michelle R. Lent

The Journal of Integrated Primary Care

Recovery capital refers to the internal and external resources available to support an individual in their recovery from substance use disorders. Using data from an ongoing trial, the current study examined recovery capital among 225 individuals initiating office-based buprenorphine treatment for opioid use disorder (OUD) at Federally Qualified Health Centers in the mid-Atlantic region. At baseline, participants completed the Brief Assessment of Recovery Capital-10 (BARC-10), a validated measure assessing the 4 major domains of recovery capital and completed a urine toxicology screening. Participants reported BARC-10 scores of 49.22 on average (SD = 8.14). Average scores were highest for the …

Differential Diagnostic Considerations In A Patient With New Onset Apathy: A Case Study On Frontal Lobe Glioblastoma Multiforme, Joy Zarandy, Sarah Yoon, Sharnikha Saravanan, Sanjana Das, Sarah Thomas

The Journal of Integrated Primary Care

This case study involves a 50 year-old previously healthy female presenting with a two-week history of clinically significant apathy. The patient and her family assume her symptoms are due to a potential underlying psychiatric condition; however, neurologic and systemic disorders should also be considered when evaluating a patient with sudden personality change. After a thorough history and physical exam, further evaluation with neuroimaging is performed due to suspicion of neurological etiology. A sizable ring-enhancing lesion in the frontal lobe is noted on MRI, and a diagnosis of glioblastoma multiforme (GBM) is confirmed with biopsy. GBM, or grade 4 astrocytoma, is …

In Great Health: Basal Cell Carcinoma And Denial Of Progressive Disease In The Elderly, Yusur Alsalihi, Alexa Truong, Patrick Golden

The Journal of Integrated Primary Care

Basal Cell Carcinoma (BCC) is the most common skin cancer across the world and occurs predominantly on sun-exposed or sun-damaged skin, particularly on the head, face, and neck. Slow-growing and unremoved lesions can become destructive and progress to the rare Giant Basal Cell Carcinoma subtype that occurs in a very small subset of patients (

Test Event Example 12/14/23, Metzalli Demolastname

Annual Research Symposium

No abstract provided.

Supervaluation Of Pregnant Women Is Reductive Of Women, Jennifer Parks, Timothy F. Murphy

Philosophy: Faculty Publications and Other Works

Heloise Robinson argues that by certain threshold criteria pregnant women qualify for a higher moral status by reason of their pregnancies. While her intention is to make this a status upgrade for women we worry that it may result in a status downgrade for women as a class, by presupposing and reinforcing women’s value in relation to their reproductive labor. Historically central to feminist analysis is resistance to reductive accounts of women in relation to their reproductivity. For example, Simone de Beauvoir addressed men’s transcendence and contrasted it with women’s immanence, a status distinction possible because women are mired in …

Mapping Restricted Introgression Across The Genomes Of Admixed Indigenous African Cattle Breeds., Juliane Friedrich, Richard I Bailey, Andrea Talenti, Umer Chaudhry, Qasim Ali, Emmanuel F Obishakin, Chukwunonso Ezeasor, Jessica Powell, Olivier Hanotte, Abdulfatai Tijjani, Karen Marshall, James Prendergast, Pamela Wiener

Faculty Research 2023

BACKGROUND: The genomes of indigenous African cattle are composed of components with Middle Eastern (taurine) and South Asian (indicine) origins, providing a valuable model to study hybridization and to identify genetic barriers to gene flow. In this study, we analysed indigenous African cattle breeds as models of hybrid zones, considering taurine and indicine samples as ancestors. In a genomic cline analysis of whole-genome sequence data, we considered over 8 million variants from 144 animals, which allows for fine-mapping of potential genomic incompatibilities at high resolution across the genome.

RESULTS: We identified several thousand variants that had significantly steep clines ('SCV') …

Insight - Fall 2023, Dugoni School Of Dentistry

Insight

Welcome to the fall 2023 issue of Insight, a newsletter celebrating the accomplishments of our community of scholars. We aim to spotlight insights from people at the Dugoni School working in all areas of scholarship, including clinical or biomedical research, the scholarship of teaching and learning, improvement of the health care system, and professional partnerships that advance the field.

E-Cigarette Use And Respiratory Symptoms In Adults: A Systematic Review And Meta-Analysis, Mohammed M. Alqahtani, Faraj K. Alenezi, Mohammed A. Almeshari, Abdullah M. Alanazi, Ziyad Ben Taleb, Mohammad E Ebrahimi Kalan, Mary P. Martinasek, Rheese J. Mcnab, Rachel Culbreth, Mansour Alotaibi, Hassan Alijohani, Lynda T. Goodfellow, Taha T. Ismaeil, Saleh S. Algarni, Tareq F. Alotaibi, Mobarek K. Alqahtani, Hamoud Al-Ajel, Khalid S. Alwadeai, Nafea S. Almutairi, Eric Ford

APC Fund

Introduction:
Electronic cigarette (e-cigarette) use is gaining popularity among adults. Monitoring e-cigarette-induced respiratory symptoms is crucial for both clinical and regulatory purposes. We systematically reviewed the current literature to understand the prevalence of respiratory symptoms among exclusive e-cigarette users, dual users, and former smokers.

Methods:
Databases searched included PubMed, CINAHL, Cochrane Library, Embase, and Scopus. We included all English-language, empirical quantitative articles that explored the prevalence of e-cigarette-related respiratory symptoms. Random-effects models were utilized in conducting the meta-analyses. The quality of identified studies was evaluated using the NIH Study Quality Assessment Tools. This study is registered with PROSPERO(#CRD42020165973).

Results:
The …

Implementation Of Multipronged Approach In Patients With Chest Trauma Reduces Vap And Unplanned Admission To The Icu, Julie Donnelly, Msn, Rn, Trcn, Kristen Firely, Msn, Rn, Nicole Olszewski, Bsn, Rn, Jessica Byrne, Msn, Rn-Bc, Tiffani Stanley, Cstr, Joshua A. Marks, Md, Facs, Fccm, George Koenig

Department of Surgery Posters

Problem

The incidence of pulmonary complications in trauma patients with chest trauma has been reported to be as high as 49% (Ruibel L, 2022). However, all trauma patients are at risk for developing pulmonary complications due to a multitude of factors some pre-existing while others injury related sequela. Within our institution, we observed an increase in pulmonary complications through review of our TQIP (Spring 2020) and state registry data.

In Memoriam: Prof. Dr. Rer. Nat. Jeanette Erdmann, Pashmina Wiqar Shah, Satwat Hashmi, Tobias Reinberger, Nadine Odenthal, Luis Eichelmann, Daria Kosenko, Ilyas Ahmad, Jaafar Al-Hasani, Till Joscha Demal, Zouhair Aherrahrou

Department of Biological & Biomedical Sciences

No abstract provided.

Extracorporeal Pathogen Removal: A New Anti-Microbial Strategy To Combat Sepsis, Troy Mohamed, Emily Terrebonne, Susan Kartiko, Rahul Nadendla

URGENT Matters

No abstract provided.