Medicine and Health Sciences Commons^™

Awareness With Paralysis And Symptoms Of Post-Traumatic Stress Disorder Among Mechanically Ventilated Emergency Department Survivors (Ed-Awareness-2 Trial): Study Protocol For A Pragmatic, Multicenter, Stepped Wedge Cluster Randomized Trial, Brian M Fuller, Brian E Driver, Michael B Roberts, Christa A Schorr, Kathryn Thompson, Brett Faine, Julianne Yeary, Nicholas M Mohr, Ryan D Pappal, Robert J Stephens, Yan Yan, Nicholas J Johnson, Brian W Roberts

2020-Current year OA Pubs

BACKGROUND: Awareness with paralysis (AWP) is memory recall during neuromuscular blockade (NMB) and can cause significant psychological harm. Decades of effort and rigorous trials have been conducted to prevent AWP in the operating room, where prevalence is 0.1-0.2%. By contrast, AWP in mechanically ventilated emergency department (ED) patients is common, with estimated prevalence of 3.3-7.4% among survivors given NMB. Longer-acting NMB use is a critical risk for AWP, and we have shown an association between ED rocuronium use and increased AWP prevalence. As NMB are given to more than 90% of ED patients during tracheal intubation, this trial provides a …

Occlusive Membranes For Guided Regeneration Of Inflamed Tissue Defects., Woojin Choi, Utkarsh Mangal, Jin-Young Park, Ji-Yeong Kim, Taesuk Jun, Ju Won Jung, Moonhyun Choi, Sungwon Jung, Milae Lee, Ji-Yeong Na, Du Yeol Ryu, Jin Man Kim, Jae-Sung Kwon, Won-Gun Koh, Sangmin Lee, Patrick T J Hwang, Kee-Joon Lee, Ui-Won Jung, Jae-Kook Cha, Sung-Hwan Choi, Jinkee Hong

Henry M. Rowan College of Engineering Departmental Research

Guided bone regeneration aided by the application of occlusive membranes is a promising therapy for diverse inflammatory periodontal diseases. Symbiosis, homeostasis between the host microbiome and cells, occurs in the oral environment under normal, but not pathologic, conditions. Here, we develop a symbiotically integrating occlusive membrane by mimicking the tooth enamel growth or multiple nucleation biomineralization processes. We perform human saliva and in vivo canine experiments to confirm that the symbiotically integrating occlusive membrane induces a symbiotic healing environment. Moreover, we show that the membrane exhibits tractability and enzymatic stability, maintaining the healing space during the entire guided bone regeneration …

Effect Of Menstrual Cycle And Contraceptive Pill Phase On Aspects Of Exercise Physiology And Athletic Performance In Female Athletes: Protocol For The, Kirsty J Elliott Sale, Tessa R Flood, Shawn M Arent, Eimear Dolan, Bryan Saunders, Mette Hansen, Johanna K Ihalainen, Ritva S Mikkonen, Clare Minahan, Jane S Thornton, Kathryn E Ackerman, Constance M Lebrun, Craig Sale, Trent Stellingwerff, Paul A Swinton, Anthony C Hackney

Family Medicine Publications

The idiom 'more high-quality research is needed' has become the slogan for sport and exercise physiology-based research in female athletes. However, in most instances, it is challenging to address this gap of high-quality research in elite female athletes at a single study site due to challenges in recruiting enough participants with numerous menstrual cycle and contraceptive pill permutations. Accordingly, we have assembled an international multisite team to undertake an innovative project for female athletes, which investigates the effects of changes in endogenous and exogenous oestrogen and progesterone/progestins across the menstrual cycle and in response to second-generation combined monophasic contraceptive …

The Effect Of Caregiver Communication On Self-Care Outcomes For African Americans With Heart Failure, Adrienne Michelle Johnson

Walden Dissertations and Doctoral Studies

No abstract provided.

Adverse Childhood Experiences And Sports Participation Among Lesbian, Gay, And Bisexual Adolescents, Robert John O'Brien

Walden Dissertations and Doctoral Studies

No abstract provided.

Smoking And The Likelihood Of Hiv Testing Among Transgender Women Of Color, Cariny Nunez

Walden Dissertations and Doctoral Studies

No abstract provided.

Assessing Medication Self-Management Challenges And Self-Efficacy During Emergency Department Medication Reconciliation: An Evidence-Based Quality Improvement Project, Mitchel Erickson, Jyu-Lin Chen, Yoonmee Joo, Stephanie Rogers, Thomas Hoffman, Claire Bainbridge

Journal of Geriatric Emergency Medicine

Abstract

Background

Older adult patients (≥65) accessing emergency departments (ED) represent a significant demographic. Recidivism secondary to adverse drug events (ADE) ranges between 6-24% and levels of prescribed medication non-adherence is common among older adults. The ED pharmacist medication reconciliation workflow may mitigate self-management challenges in real time and reduce medication-related harm while potentially impacting recidivism, medication adherence, and patient self-efficacy. The purposes of this evidence-based project were to (1) evaluate the impact of a modified Medication Management for Deficiencies in the Elderly (MedMalDE) intervention on Self-Efficacy for Appropriate Medication Use (SEAMS) and 30-day return to care and (2) identify …

Chimeric Antigen Receptor T Cells To Target Cd79b In B-Ceall Lymphomas, Fuliang Chu, Jingjing Cao, Jingwei Liu, Haopeng Yang, Timothy J Davis, Shao-Qing Kuang, Xiaoyun Cheng, Zheng Zhang, Swathi Karri, Long T Vien, Laura Bover, Ryan Sun, Francisco Vega, Michael Green, Richard Eric Davis, Sattva S Neelapu

Faculty, Staff and Student Publications

BACKGROUND: Chimeric antigen receptor (CAR) T cells targeting CD19 mediate potent and durable effects in B-cell malignancies. However, antigen loss or downregulation is a frequent cause of resistance. Here, we report development of a novel CAR T-cell therapy product to target CD79b, a pan B-cell antigen, widely expressed in most B-cell lymphomas.

METHODS: We generated a novel anti-CD79b monoclonal antibody by hybridoma method. The specificity of the antibody was determined by testing against isogenic cell lines with human CD79b knock-in or knock-out. A single-chain variable fragment derived from the monoclonal antibody was used to make a panel of CD79b-targeting CAR …

Innovation Process And Industrial System Of Us Food And Drug Administration-Approved Software As A Medical Device: Review And Content Analysis, Jiakan Yu, Jiajie Zhang, Shintaro Sengoku

Faculty, Staff and Student Publications

BACKGROUND: There has been a surge in academic and business interest in software as a medical device (SaMD). SaMD enables medical professionals to streamline existing medical practices and make innovative medical processes such as digital therapeutics a reality. Furthermore, SaMD is a billion-dollar market. However, SaMD is not clearly understood as a technological change and emerging industry.

OBJECTIVE: This study aims to review the landscape of SaMD in response to increasing interest in SaMD within health systems and regulation. The objectives of the study are to (1) clarify the innovation process of SaMD, (2) identify the prevailing typology of such …

Understanding Patient-Centered Care: Perception Of Hispanic Physicians In Teaching Hospitals Of The United States, Santiago Rivera

Walden Dissertations and Doctoral Studies

No abstract provided.

Multifocal Ectopic Recurrence Of A C2 Chordoma, Maikerly Reyes, Allison Kayne, Sarah Collopy, Giyarpuram Prashant, Patrick Kelly, James J. Evans

Department of Neurosurgery Faculty Papers

Background

Chordomas are histologically benign but locally aggressive tumors with a high propensity to recur. Our case highlights the importance of long-term vigilance in patients who have undergone chordoma resection.

Case Report

We report the case of a 47-year-old man with a cervical chordoma who developed multiple musculoskeletal ectopic recurrences in the left supraclavicular region, the proximal right bicep, and the left submandibular region without recurrence in the primary tumor site. Primary tumor resection was achieved via a combination of surgery, adjuvant radiation therapy, and imatinib. All recurrences were successfully resected and confirmed via pathology to be ectopic chordoma.

Discussion …

Effects Of Water Access On Childhood Linear Growth In Zimbabwe, Robert Ntozini

Walden Dissertations and Doctoral Studies

No abstract provided.

Improving Self-Management In Patients With Diabetes: A Staff Education Project, Tanja Ganues

Walden Dissertations and Doctoral Studies

No abstract provided.

Nursing Practice Rn's Interest, Experience, Confidence And Attitude Of Research Conduct, Candida Suzanne Barlow

Walden Dissertations and Doctoral Studies

No abstract provided.

Health Literacy In Patients Tested For Alpha-One Antitrypsin Deficiency, Gina Lyn Workman

Walden Dissertations and Doctoral Studies

No abstract provided.

Genetic Separation Of Brca1 Functions Reveal Mutation-Dependent Polθ Vulnerabilities, John J. Krais, David J. Glass, Ilse Chudoba, Yifan Wang, Wanjuan Feng, Dennis Simpson, Pooja Patel, Zemin Liu, Ryan Neumann-Domer, Robert G. Betsch, Andrea J. Bernhardy, Alice M. Bradbury, Jason Conger, Wei-Ting Yueh, Joseph Nacson, Richard T. Pomerantz, Gaorav P. Gupta, Joseph R. Testa, Neil Johnson

Department of Biochemistry and Molecular Biology Faculty Papers

Homologous recombination (HR)-deficiency induces a dependency on DNA polymerase theta (Polθ/Polq)-mediated end joining, and Polθ inhibitors (Polθi) are in development for cancer therapy. BRCA1 and BRCA2 deficient cells are thought to be synthetic lethal with Polθ, but whether distinct HR gene mutations give rise to equivalent Polθ-dependence, and the events that drive lethality, are unclear. In this study, we utilized mouse models with separate Brca1 functional defects to mechanistically define Brca1-Polθ synthetic lethality. Surprisingly, homozygous Brca1 mutant, Polq−/− cells were viable, but grew slowly and had chromosomal instability. Brca1 mutant cells proficient in DNA end resection were …

Growth Rates And Histopathological Outcomes Of Small (6-9 Mm) Colorectal Polyps Based On Ct Colonography Surveillance And Endoscopic Removal, B Dustin Pooler, David H Kim, Kristina A Matkowskyj, Michael A Newton, Richard B Halberg, William M Grady, Cesare Hassan, Perry J Pickhardt

Faculty, Staff and Student Publications

BACKGROUND AND AIMS: The natural history of small polyps is not well established and rests on limited evidence from barium enema studies decades ago. Patients with one or two small polyps (6-9 mm) at screening CT colonography (CTC) are offered CTC surveillance at 3 years but may elect immediate colonoscopy. This practice allows direct observation of the growth of subcentimetre polyps, with histopathological correlation in patients undergoing subsequent polypectomy.

DESIGN: Of 11 165 asymptomatic patients screened by CTC over a period of 16.4 years, 1067 had one or two 6-9 mm polyps detected (with no polyps ≥10 mm). Of these, …

Exploring Alternative Treatment Choices For Multidrug-Resistant Clinical Strains Of Helicobacter Pylori In Mongolia, Ayush Khangai, Batsaikhan Saruuljavkhlan, Dashdorj Azzaya, Boldbaatar Gantuya, Khasag Oyuntsetseg, Junko Akada, Takashi Matsumoto, Yoshio Yamaoka

Faculty, Staff and Students Publications

Helicobacter pylori is a pathogen related to severe diseases such as gastric cancer; because of rising antimicrobial-resistant strains, failure to eradicate H. pylori with antibiotics has increased worldwide. Multidrug-resistant H. pylori and gastric cancer is common in Mongolia; therefore, we aimed to explore alternative antimicrobial treatments and the genomes of resistant strains in this country. A total of 361 H. pylori strains isolated from patients in Mongolia were considered. Minimal inhibitory concentrations for two fluoroquinolones (ciprofloxacin and moxifloxacin), rifabutin, and furazolidone were determined via two-fold agar dilution. Genomic mutations in antibiotic-resistant strains were identified by next-generation sequencing using the Illumina …

Dynamical Control Enables The Formation Of Demixed Biomolecular Condensates, Andrew Z Lin, Kiersten M Ruff, Furqan Dar, Ameya Jalihal, Matthew R King, Jared M Lalmansingh, Ammon E Posey, Nadia A Erkamp, Ian Seim, Amy S Gladfelter, Rohit V Pappu

2020-Current year OA Pubs

Cellular matter can be organized into compositionally distinct biomolecular condensates. For example, in Ashbya gossypii, the RNA-binding protein Whi3 forms distinct condensates with different RNA molecules. Using criteria derived from a physical framework for explaining how compositionally distinct condensates can form spontaneously via thermodynamic considerations, we find that condensates in vitro form mainly via heterotypic interactions in binary mixtures of Whi3 and RNA. However, within these condensates, RNA molecules become dynamically arrested. As a result, in ternary systems, simultaneous additions of Whi3 and pairs of distinct RNA molecules lead to well-mixed condensates, whereas delayed addition of an RNA component results …

Evaluating 17 Methods Incorporating Biological Function With Gwas Summary Statistics To Accelerate Discovery Demonstrates A Tradeoff Between High Sensitivity And High Positive Predictive Value, Amy Moore, Jesse A Marks, Bryan C Quach, Yuelong Guo, Laura J Bierut, Nathan C Gaddis, Dana B Hancock, Grier P Page, Eric O Johnson

2020-Current year OA Pubs

Where sufficiently large genome-wide association study (GWAS) samples are not currently available or feasible, methods that leverage increasing knowledge of the biological function of variants may illuminate discoveries without increasing sample size. We comprehensively evaluated 17 functional weighting methods for identifying novel associations. We assessed the performance of these methods using published results from multiple GWAS waves across each of five complex traits. Although no method achieved both high sensitivity and positive predictive value (PPV) for any trait, a subset of methods utilizing pleiotropy and expression quantitative trait loci nominated variants with high PPV (>75%) for multiple traits. Application …

Genetic Separation Of Brca1 Functions Reveal Mutation-Dependent Polθ Vulnerabilities, John J Krais, Et Al.

2020-Current year OA Pubs

Homologous recombination (HR)-deficiency induces a dependency on DNA polymerase theta (Polθ/Polq)-mediated end joining, and Polθ inhibitors (Polθi) are in development for cancer therapy. BRCA1 and BRCA2 deficient cells are thought to be synthetic lethal with Polθ, but whether distinct HR gene mutations give rise to equivalent Polθ-dependence, and the events that drive lethality, are unclear. In this study, we utilized mouse models with separate Brca1 functional defects to mechanistically define Brca1-Polθ synthetic lethality. Surprisingly, homozygous Brca1 mutant, Polq

Association Between The Introduction Of A National Targeted Intervention Program And The Incidence Of Surgical Site Infections In Swiss Acute Care Hospitals, Marcus Eder, Rami Sommerstein, Arlette Szelecsenyi, Alexander Schweiger, Matthias Schlegel, Andrew Atkinson, Stefan P Kuster, Danielle Vuichard-Gysin, Nicolas Troillet, Andreas F Widmer, For Swissnoso

2020-Current year OA Pubs

BACKGROUND: In Switzerland, the national surgical site infection (SSI) surveillance program showed a modest decrease in SSI rates for different procedures over the last decade. The study aimed to determine whether a multimodal, targeted intervention program in addition to existing SSI surveillance is associated with decreased SSI rates in the participating hospitals.

METHODS: Prospective multicenter pre- and postintervention study conducted in eight Swiss acute care hospitals between 2013 and 2020. All consecutive patients > 18 years undergoing cardiac, colon, or hip/knee replacement surgery were included. The follow-up period was 30 days and one year for implant-related surgery. Patients with at least …

Editorial: Perspectives On Music And Pain: From Evidence To Theory And Application, Annabel J. Cohen, Andrea Mcgraw Hunt, Eduardo A. Garza-Villarreal, Xuejing Lu

College of Performing Arts Departmental Research

No abstract provided.

Use Of Behavior Management Training To Improve Nurses' Confidence In Managing Patient Aggression, Chasity Long

Doctoral Projects

Workplace aggression and violence toward healthcare workers are documented extensively throughout the literature and unfortunately, this behavior has increased during the COVID-19 pandemic. Challenges brought on by the pandemic, such as visitor restrictions and short staffing, have only exacerbated patient aggression and violence. Workplace aggression and violence can cause not only psychological or physical injury to nurses and nursing staff, but it also impacts patient care, job satisfaction, absenteeism, and nurse retention. Training programs to improve nurses’ assessment skills to predict aggressive behaviors and de-escalate violent situations can help nurses better predict and manage patient aggression. A behavior management training …

Sexual Identity And Sexual Behavioral Risks Among Black Men In The United States, Darnell Winston Walker

Walden Dissertations and Doctoral Studies

No abstract provided.

Lactic Acid Bacterial Surface Display Of Scytovirin Inhibitors For Anti-Ebolavirus Infection, Joshua Wiggins, Ngan Nguyen, Wenzhong Wei, Leah Liu Wang, Haley Hollingsead Olson, Shi-Hua Xiang

Nebraska Center for Virology: Faculty Publications

Scytovirin (SVN) is a lectin from cyanobacteria which has a strong inhibitory activity against Ebola virus infection. We engineered scytovirin as the inhibitor for surface display of lactic acid bacteria to block Ebola virus infection. Two different bacterial strains (Lactobacillus casei and Lactococcus lactis) were successfully engineered for scytovirin expression on the bacterial surface. These bacteria were found to be effective at neutralizing pseudotyped Ebolavirus in a cell-based assay. This approach can be utilized for prophylactic prevention, as well as for treatment. Since lactic acid bacteria can colonize the human body, a long-term efficacy could be achieved. Furthermore, …

Isolated Small Airways Obstruction Predicts Future Chronic Airflow Obstruction: A Multinational Longitudinal Study, Ben Knox Brown, James Potts, Valentina Quintero Santofimio, Cosetta Minelli, Jaymini Patel, Peter Gj Burney, Andre Fs Amaral, Najlaa Mohammed Abass, Dhiraj Agarwal, Asaad A. Nafees

Community Health Sciences

Background: Chronic airflow obstruction is a key characteristic of chronic obstructive pulmonary disease. We investigated whether isolated small airways obstruction is associated with chronic airflow obstruction later in life.
Methods: We used longitudinal data from 3957 participants of the multinational Burden of Obstructive Lung Disease study. We defined isolated small airways obstruction using the prebronchodilator mean forced expiratory flow rate between 25% and 75% of the forced vital capacity (FVC) (FEF25-75) if a result was less than the lower limit of normal.
Results: Median follow-up time was 8.3 years. Chronic airflow obstruction was more likely to develop in participants with …

An Assessment Of The Move Your Way Program Among Hispanic Adults In Las Vegas, Nevada, Timothy J. Bungum, Jennifer R. Pharr, Courtney A. Coughenour, Maxim Gakh

Environmental & Global Health Faculty Research

Physical activity (PA) is important because of its associated health benefits. However, many Americans remain inactive. The 2018 guidelines recognize that PA bouts of less than 10 min are beneficial. The U.S. Department of Health and Human Services’ Office of Disease Prevention and Health Promotion created the Move Your Way® (MYW) campaign to provide PA resources for communities and healthcare providers. This study aims to describe the reach of the MYW campaign, and assess whether having seen, heard, or read (SHR) about MYW, or having seen the MYW logo, was associated with PA knowledge, self-efficacy, and behavior among Hispanics residing …

A Pulse For Progress – Examining The Efficacy Of Best Nursing Developmental Care Practices For Children With Congenital Heart Disease At Risk For Developmental Delay In The Pcicu: A Prospective Quasi-Experimental Cohort Study, Jasmyn H. Jansen

Nursing | Student Research Posters

This paper examines the efficacy current best developmental care nursing practices in the pediatric cardiac intensive care unit (PCICU) for children with congenital heart disease (CHD). The proposed study explores the implications of the Cardiac Inpatient Neurodevelopmental Care Optimization (CINCO) program, a recent comprehensive developmental care bundle, as a universal implementation for PCICUs.

Clinical And Dosimetric Impact Of 2d Kv Motion Monitoring And Intervention In Liver Stereotactic Body Radiation Therapy., Andrew Santoso, Yevgeniy Vinogradskiy, Tyler Robin, Karyn Goodman, Tracey Schefter, Moyed Miften, Bernard Jones

Department of Radiation Oncology Faculty Papers

PURPOSE: Positional errors resulting from motion are a principal challenge across all disease sites in radiation therapy. This is particularly pertinent when treating lesions in the liver with stereotactic body radiation therapy (SBRT). To achieve dose escalation and margin reduction for liver SBRT, kV real-time imaging interventions may serve as a potential solution. In this study, we report results of a retrospective cohort of liver patients treated using real-time 2D kV-image guidance SBRT with emphasis on the impact of (1) clinical workflow, (2) treatment accuracy, and (3) tumor dose.

METHODS AND MATERIALS: Data from 33 patients treated with 41 courses …