Medicine and Health Sciences Commons^™

Exploring Acute Pancreatitis Clinical Pathways Using A Novel Process Mining Method, Xue Yang, Wei Huang, Weiling Zhao, Xiaobo Zhou, Na Shi, Qing Xia

Faculty, Staff and Student Publications

Mining process models of medical behavior from electronic medical records is an effective way to optimize clinical pathways. However, clinical medical behavior is an extremely complex field with high nonlinearity and variability, and thus we need to adopt a more effective method. In this study, we developed a fuzzy process mining method for complex clinical pathways. Firstly, we designed a multi-level expert classification system with fuzzy values to preserve finer details. Secondly, we categorized medical events into long-term and temporary events for more specific data processing. Subsequently, we utilized electronic medical record (EMR) data of acute pancreatitis spanning 9 years, …

Bond Strength Of Reline Materials To 3d-Printed Provisional Crown Resins, Jorge Palavicini, Sherrod L. Quin, Wael Zakkour, Karim Zakkour, Safa Manafi Varkiani, Xiaoming Xu, Nathaniel C. Lawson, Amir Hossein Nejat

School of Dentistry Faculty Publications

(1) Purpose: The aim of the present study was to compare the bond strength between two 3D-printed resins designed for long-term provisional crowns and three different reline materials. (2) Materials and Methods: Rectangular specimens were prepared from two 3D-printed resins (Envision Tech and NextDent C&B) and a conventional self-cure PMMA. Transparent tubes filled with three different reline materials including composite resin, Bis-acryl, and PMMA were bonded to the 3D-printed specimens (n = 11 per group, total of 6 study groups). Tubes filled with PMMA were bonded to the prepared PMMA specimens which served as the control group (n = 11, …

Human Alcohol-Microbiota Mice Have Increased Susceptibility To Bacterial Pneumonia, Kelly C. Cunningham, Deandra R. Smith, Daniel N. Villageliú, Christi M. Ellis, Amanda E. Ramer-Tait, Jeffrey D. Price, Todd A. Wyatt, Daren L. Knoell, Mystera M. Samuelson, Patricia E. Molina, David A. Welsh, Derrick R. Samuelson

School of Medicine Faculty Publications

Preclinical studies have shown that chronic alcohol abuse leads to alterations in the gastrointestinal microbiota that are associated with behavior changes, physiological alterations, and immunological effects. However, such studies have been limited in their ability to evaluate the direct effects of alcohol-associated dysbiosis. To address this, we developed a humanized alcohol-microbiota mouse model to systematically evaluate the immunological effects of chronic alcohol abuse mediated by intestinal dysbiosis. Germ-free mice were colonized with human fecal microbiota from individuals with high and low Alcohol Use Disorders Identification Test (AUDIT) scores and bred to produce human alcohol-associated microbiota or human control-microbiota F1 progenies. …

Gut Barrier Defects, Intestinal Immune Hyperactivation And Enhanced Lipid Catabolism Drive Lethality In Ngly1-Deficient Drosophila, Ashutosh Pandey, Antonio Galeone, Seung Yeop Han, Benjamin A Story, Gaia Consonni, William F Mueller, Lars M Steinmetz, Thomas Vaccari, Hamed Jafar-Nejad

Faculty, Staff and Students Publications

Intestinal barrier dysfunction leads to inflammation and associated metabolic changes. However, the relative impact of gut bacteria versus non-bacterial insults on animal health in the context of barrier dysfunction is not well understood. Here, we establish that loss of Drosophila N-glycanase 1 (Pngl) in a specific intestinal cell type leads to gut barrier defects, causing starvation and JNK overactivation. These abnormalities, along with loss of Pngl in enterocytes and fat body, result in Foxo overactivation, leading to hyperactive innate immune response and lipid catabolism and thereby contributing to lethality. Germ-free rearing of Pngl mutants rescued their developmental delay but not …

Global Impact Of Somatic Structural Variation On The Cancer Proteome, Fengju Chen, Yiqun Zhang, Darshan S Chandrashekar, Sooryanarayana Varambally, Chad J Creighton

Faculty, Staff and Students Publications

Both proteome and transcriptome data can help assess the relevance of non-coding somatic mutations in cancer. Here, we combine mass spectrometry-based proteomics data with whole genome sequencing data across 1307 human tumors spanning various tissues to determine the extent somatic structural variant (SV) breakpoint patterns impact protein expression of nearby genes. We find that about 25% of the hundreds of genes with SV-associated cis-regulatory alterations at the mRNA level are similarly associated at the protein level. SVs associated with enhancer hijacking, retrotransposon translocation, altered DNA methylation, or fusion transcripts are implicated in protein over-expression. SVs combined with altered protein levels …

Shp2 Promotes Sarcoidosis Severity By Inhibiting Skp2-Targeted Ubiquitination Of Tbet In Cd8+ T Cells, Sherly I Celada, Clarice X Lim, Alexandre F Carisey, Scott A Ochsner, Carlos F Arce Deza, Praveen Rexie, Fernando Poli De Frias, Rafael Cardenas-Castillo, Francesca Polverino, Markus Hengstschläger, Konstantin Tsoyi, Neil J Mckenna, Farrah Kheradmand, Thomas Weichhart, Ivan O Rosas, Luc Van Kaer, Lindsay J Celada

Faculty, Staff and Students Publications

Sarcoidosis is an interstitial lung disease (ILD) characterized by IFNγ and TBET dysregulation. Although one-third of patients progress from granulomatous inflammation to severe lung damage, the molecular mechanisms underlying this process remain unclear. Here, we report that pharmacological inhibition of phosphorylated SH2 containing protein tyrosine phosphatase-2 (pSHP2), a facilitator of aberrant IFNγ levels, decreases large granuloma formation and macrophage infiltration in the lungs of mice with sarcoidosis-like disease. Positive treatment outcomes were dependent on the effective enhancement of TBET ubiquitination within CD8+ T cells. Mechanistically, our findings identified a previously unknown post-translational modification (PTM) pathway in which the E3 F-box …

The Impact Of Online Education On Families During Covid-19, Meghal Shah, Duaa Zahid, Heather Butts

Discovery Day

In the year 2020, the whole world was hit by a pandemic name COVID-19. It resulted in school closures across the world, which has impacted millions of children’s education. As a result, education has transitioned online via digital platforms. For many families, these transformations to online education have been difficult. For low-income families, people couldn’t afford or may not have had access to supplies needed for online education like high-speed internet and a computer. National Education Association (NEA) reports that 13.5 million children aged 5-7 years have no access to these technologies. It can be difficult for parents to understand …

Intranasal Sufentail Vs. Intravenous Morphine For Acute Pain In The Emergency Department, Billy Sin, Lilia Davenport, Gabriella Sikorska, Joi Yam Yau Lin

Discovery Day

Introduction: Acute pain management in the emergency department (ED) requires prompt administration of safe and effective analgesia. ¬Traditional routes of administration for analgesia includes the oral (PO), intravenous (IV), or intramuscular routes (IM). When these routes of administration are not feasible, the intranasal (IN) route may be considered. Furthermore, a rapid onset of therapeutic effects may be observed due to the rich capillary network of the respiratory mucosa that is able to promptly transport the drug into systemic circulation. There is emerging literature that supports the use of analgesia via the IN route in the Emergency Department (ED). However, its …

An Assessment Of Fetal Rhd Screening In Non-Invasive Prenatal Testing (Nipt) And Implementation Of Targeted Routine Antenatal Anti-D Prophylaxis (Traadp) In Enhancing Management Of Rhd-Negative Women At Risk Of Haemolytic Disease Of The Fetus/Newborn (Hdfn) In University Hospital Limerick Group (Uhlg), Anna Pohrebyannyk

International Undergraduate Journal of Health Sciences

Alloimmunisation, formerly isoimmunisation, or sensitisation can occur in pregnancy when a Rhesus D (RhD)-negative woman carries an RhD-positive fetus. Incompatibility of Rh status causes development of allo anti-D antibodies in response to antigen exposure from foreign fetal red cells in fetomaternal haemorrhages (FMHs) or potential sensitising events (PSEs) i.e., iatrogenic interventions (medical or surgical treatment), silent or spontaneous transplacental haemorrhages (STHs) in pregnancy, at birth or other traumas. Anti-D antibodies are immune-mediated and can cross the placenta and attach to fetal cells causing destruction and haemolysis. Offspring of primigravida women are unaffected usually and it is later pregnancies that may …

Chimeric Antigen Receptor (Car)-T Cell Therapy In The Treatment Of Haematological Malignancies, Karla O'Shea

International Undergraduate Journal of Health Sciences

The use of chimeric antigen receptor T (CAR-T) cells in the treatment of haematological malignancies, particularly relapsed/refractory (R/R) B cell malignancies, has resulted in quite a high success rate. The most popular CAR-T cell therapy targets currently are CD19 and B-cell maturation antigen (BCMA), though many other innovative therapeutic targets are being investigated. According to the National Cancer Institute BCMA is defined as an antigen found on the surfaces of B cells and is overexpressed on malignant plasma cells. Additionally, CD19 controls B cells in an antigen receptor-dependent way and is produced throughout the B cell differentiation process, particularly during …

The Use Of Prognostic Markers To Predict Disease Progression And Clinical Outcome In Monoclonal Gammopathy Of Undetermined Significance, Smouldering Multiple Myeloma And Multiple Myeloma., Róisín C. Mcmonagle

International Undergraduate Journal of Health Sciences

Multiple Myeloma (MM) is an incurable plasma cell malignancy with a complex and incompletely understood molecular pathogenesis. Monoclonal Gammopathy of Undetermined Significance (MGUS) and Smouldering Multiple Myeloma (SMM) precede MM, with variable risks and rates of disease progression. The continuing high relapse and death rate in MM cases has prompted research into more accurate prognostic markers to predict progression from MGUS and SMM to MM, as well as identify MM cases with aggressive disease, in order to begin early, targeted and effective therapeutic intervention. Many studies have focused on utilising current markers more effectively, including M-protein, serum-free light chain ratio, …

A Review Of Systemic Autoimmune Rheumatic Diseases And Analysis Of Antinuclear Antibody Testing Methods And Clinical Utility Of Elia Ctd Screen, Stephen Mckenna

International Undergraduate Journal of Health Sciences

Systemic autoimmune rheumatic diseases (SARDs) are diverse and complex inflammatory illnesses characterised by the production of autoantibodies leading to destruction of tissues and organs. The heterogeneity and ambiguity of signs and symptoms such as inflammation, fatigue, and arthralgia makes diagnosis challenging. In addition, SARDs are uncommon conditions meaning most physicians have little experience in identifying specific diseases and instead rely on an antinuclear antibody (ANA) screen for potential direction of treatment. Systemic lupus erythematosus (SLE), systemic sclerosis (SSc), and Sjögren syndrome (SjS) are discussed in this review due to the current practice by some Irish hospitals of screening for ANAs …

An Investigation Into The Effect Of Screen Time On Sleep Quality Amongst Third Level Students, Emma Kelly, Sarah Williams, Cliona Sutton

International Undergraduate Journal of Health Sciences

This paper aimed to research the effect of screen time on sleep quality based on the opinions of 356 third-level students from various Irish Universities. This study considers factors such as sleep duration, the effect of the COVID-19 pandemic concerning online college and its effect on sleep quality and screen time duration. This study was conducted using an anonymous Google Forms survey consisting of 10 questions and gained ethical approval before distribution.

Most participants (56.1%) slept between 7-9 hours, which is within the recommended guidelines of sleep duration by the Health Service Executive (HSE, 2022). When asked about the effect …

The Role Of Digital Pathology For Histological Diagnosis, Ellen Faherty

International Undergraduate Journal of Health Sciences

Digital pathology is on its way to becoming a widespread alternative for routine diagnostics. Rapid whole slide image scanning has accelerated this advancement, but large-scale implementation is complex on technical, logistical, and financial levels. Although validation studies have published encouraging data on safety and feasibility, implementation experiences highlight the importance of training and knowledge of possible consequences. International pathology organisations' guidelines are intended to safeguard digital pathology, from image capture to long-term image archiving, but they should only be viewed as a starting point. Cost-efficiency reviews and occupational health issues must be thoroughly addressed. Image analysis is incorporated into traditional …

The Role Of Molecular Thyroseq V3 Testing For Diagnosis And Management Of Indeterminate Thyroid Nodules., Ruth Delahunty

International Undergraduate Journal of Health Sciences

Worldwide, thyroid cancer is the 8^th most common malignancy (3^rd most common in women) and in recent years, there has been increased incidence of thyroid cancer worldwide. There is currently said to be a of thyroid nodules as of 2022. When it comes to the management of indeterminate thyroid nodules, clinical decision making can be challenging.

Thyroseq V3 testing may be used to determine the percentage probability of a thyroid nodule of being either malignant or benign, through a complex algorithm with next generation sequencing techniques, currently testing is done in the University of Pittsburgh and therefore is …

The Prevalence Of And Attitudes Towards Blood Donation Among Third Level Students In Cork, Ireland, Ava Coakley, Sarah Ferguson, Nicole Ardenaso

International Undergraduate Journal of Health Sciences

In Ireland, one in four people will require a blood transfusion at some point in their life, yet only 3% of the eligible population donate blood. This study aimed to investigate the prevalence of and attitudes towards blood donation among third level students in Cork, Ireland. The demographic of students most likely to donate blood and incentives to encourage blood donation were identified. Peer-reviewed research papers were used to aid in survey design, created using Google Forms. The survey was distributed to registered University College Cork (UCC) and Munster Technological University (MTU) students. Ethical approval and the informed consent of …

Effect Of Caffeine In Pattern Memory And Reaction Time Test Among College Students, William T. Clark, Micheal Lawson, Garrett Garnto, Evan Smith, Kelly Massey

International Undergraduate Journal of Health Sciences

Caffeine is commonly used by college students to aid in staying alert throughout the day. The purpose of this study was to determine the effects of caffeine on visual memory and reaction time performance on college students aged 18-25 years old. The Human Benchmark (https://humanbenchmark.com) Visual Memory (VM) and Reaction Time (RT) tests were used to assess participant’s baseline scores and scores 15min post treatment. Five male (19.0y ± 1.26) and four female (20.3y ± 0.43) college students volunteered to be participants in a three-week long cross-over, counterbalanced study. Blood pressure (BP) and heart rate (HR) were assessed before each …

Full Issue: The International Undergraduate Journal Of Health Sciences, Volume 3, Issue 1, September 2023, Sword Mtu

International Undergraduate Journal of Health Sciences

Full Issue: The International Undergraduate Journal of Health Sciences, Volume 3, Issue 1, September 2023

A Fleeting Glimpse Of Functional Benefit Of The Complete Dmd Gene In A Large Animal Model Of Duchenne Muscular Dystrophy, Eric P. Hoffman

Pharmacy Faculty Scholarship

No abstract provided.

Health Issues Among Nepalese Youth: A Literature Review, Veenah Stoll, Naomi Edwin, Kripa Dahal, John Barnes, Miranda Pfautsch, Lahana Maharjan, Cyril Blavo

HPD Articles

Nepal is one of the world's least-developed countries. Nepalese children are often vulnerable to a lack of resources which leads to suboptimal levels of health in turn. This review article aims to identify health issues and inequities faced by school-aged children greater than five years old in Nepal. A comprehensive search of the literature was conducted in PubMed and Global Health databases to gather relevant studies. Inclusion and exclusion criteria were applied to select appropriate articles, and 35 full-length articles were reviewed in-depth. The literature supports the association between inadequate resource distribution among Nepalese children and poorer health outcomes compared …

Nevada Medical Residencies, 2023, Annie J. Vong, Emily J. Daclan, Caitlin J. Saladino, William E. Brown Jr.

Health

This fact sheet highlights medical residency data for the 2021, 2022, 2023 graduating classes of the Kirk Kerkorian School of Medicine at the University of Nevada, Las Vegas (UNLV) and the University of Nevada, Reno (UNR) School of Medicine. This fact sheet presents the number of residency program matches at the Kirk Kerkorian School of Medicine at UNLV and the UNR School of Medicine and reveals where Nevada medical school students pursue their residencies, and updates findings from a 2022 fact sheet exploring 2021 and 2022 graduating class data.

Probing The Activation Mechanisms Of Agonist Dpi-287 To Delta-Opioid Receptor And Novel Agonists Using Ensemble-Based Virtual Screening With Molecular Dynamics Simulations., Emily Dean, Annemarie Dominique, Americus Palillero, Annie Tran, Nicholas Paradis, Chun Wu

College of Science & Mathematics Departmental Research

Pain drugs targeting mu-opioid receptors face major addiction problems that have caused an epidemic. The delta-opioid receptor (DOR) has shown to not cause addictive effects when bound to an agonist. While the active conformation of the DOR in complex with agonist DPI-287 has been recently solved, there are still no FDA-approved agonists targeting it, providing the opportunity for structure-based virtual screening. In this study, the conformational plasticity of the DOR was probed using molecular dynamics (MD) simulations, identifying two representative conformations from clustering analysis. The two MD conformations as well as the crystal conformation of DOR were used to screen …

A Bifactor Model Supports Unidimensionality Of The International Knee Documentation Committee Subjective Knee Form In Young Active Patients With Anterior Cruciate Ligament Tears: A Retrospective Analysis Of A Randomized Controlled Trial., Hana Marmura, Paul F Tremblay, Alan M J Getgood, Dianne M Bryant

Health and Rehabilitation Sciences Publications

BACKGROUND: The International Knee Documentation Committee Subjective Knee Form (IKDC) is the most highly recommended patient reported outcome measure for assessing patients with anterior cruciate ligament (ACL) injuries and those undergoing ACL reconstruction (ACLR) surgery. The IKDC was developed as a unidimensional instrument for a variety of knee conditions. Structural validity, which determines how an instrument is scored, has not been definitively confirmed for the IKDC in respondents with ACL injuries, and in fact an alternative two-factor/subscale structure has been proposed in this population. The purpose of this study was to determine the most appropriate structure and scoring system for …

Assessing Non-Invasive Imaging Devices To Detect Temperature Differentiation And Lymphatic/Venous Flow To The Head And Neck During Head Down Tilt, Supine, And Sitting Positions The Niid Study (Non-Invasive Imaging Device), Matthew Melin, Heather Hettrick, Frank Aviles, Johanna Pannunzio, Nathan Sirkis, Chantel Hubbard, Patrick Hardigan, Sabrina Ginsburg, Harvey N. Mayrovitz

HPD Articles

Under the influence of standard developmental physiology on the Earth’s surface (1 gravity equivalent known as “1G”), 70% of body fluids reside below the level of the heart.Fluid shifts towards the cephalic region during microgravity have also been speculated to contribute towards spaceflight associated neuroocular syndrome (SANS).Although a significant barrier to spaceflight, the underlying mechanism of SANS is not well understood, partially due to the spaceflight environment and limited medical capabilities including invasive diagnostic testing. Thus, non-invasive approaches to studying real-time fluid shifts in weightlessness could serve as critical areas of research to further SANS study and effective countermeasure protocol …

The Effect Of Long Covid Syndrome On Physical Activity, Patrisha Hanna Villarmea

Master of Science in Kinesiology

Long covid syndrome is a condition where individuals experience persistent symptoms and functional limitations that can last about three months to two years after the initial Covid-19 infection. While long-term health consequences of Covid-19 have garnered significant attention,the impact of long covid syndrome symptoms is poorly understood. The purpose of the study is to explore the effect of long covid syndrome symptoms to an individual’s physical activity. Furthermore, this research aims to provide an overview of the existing literature on the effect of long covid syndrome symptoms on physical activity. The research would invite participants to answer two surveys that …

Addressing The Gaps: Pain Management, Multimodal Analgesia, And Crna Education, Hunter Niemeyer

Doctor of Nursing Practice (DNP) Student Projects

Background and Review of Literature: Opioid consumption, addiction, and narcotic-related deaths are a prevalent public health issue in the United States. Opioids are often administered throughout the perioperative period, and their utilization can lead to unwanted side effects and negative patient outcomes. Certified Registered Nurse Anesthetists (CRNAs) are strategically placed in hospital systems; these clinicians may advocate for the responsible administration of opioids and utilize multimodal pain strategies.

Purpose: This project assessed the knowledge and attitudes of CRNAs before and after the implementation of an educational program based on the prevention of operative pain, multimodal approaches, and the perioperative use …

Standardizing Intraoperative Handoffs Amongst Certified Registered Nurse Anesthetists, Mallory Light

Doctor of Nursing Practice (DNP) Student Projects

Background and Review of Literature: Communication errors are a leading cause of preventable medical errors and inadequate handoffs have been linked to sentinel events. Research has shown that standardizing handoff processes can reduce errors, improving patient safety, and resulting in other positive outcomes including increased staff satisfaction, without impacting handoff duration.

Purpose: The purpose of this project was to determine how the implementation of a standardized handoff tool would impact perceptions of handoff communications, retention of important patient information relayed during handoffs, staff satisfaction, and handoff duration.

Implementation Plan and Methods: Information regarding use of the tool was sent to …

Efficacy Of A Mixed Methods Training Program For Transthoracic Echocardiography, Britni Tharp

Doctor of Nursing Practice (DNP) Student Projects

Background and Review of Literature: Currently, there is a knowledge gap in CRNA education. As anesthesia providers, CRNAs are licensed to perform cardiac diagnostic imaging such as TTE during surgery, yet it is often missing from CRNA school curriculum. Other studies have shown that simulation is an effective way of teaching this crucial skill.

Purpose: The project’s goal was to establish the efficacy of using a mixed model computerized and in-person simulation program for training CRNAs in the use of TTE during non-cardiac surgery.

Methods: A training program was created that uses a computerized training session along with a …

Gastric Point-Of-Care Ultrasound Education For Certified Registered Nurse Anesthetists, Robert Graham

Doctor of Nursing Practice (DNP) Student Projects

Background: Pulmonary aspiration is a significant risk of general anesthesia and is related to increased perioperative morbidity and mortality. Gastric point-of-care ultrasound (POCUS) has been shown to be a reliable indicator of gastric contents and volume, and it can be used in the perioperative setting to detect gastric contents and make informed clinical decisions to prevent aspiration events.

Purpose: This project aimed to educate Certified Registered Nurse Anesthetists (CRNAs) at Washington University in the use of point-of-care ultrasound to assess gastric contents prior to surgery with the overall goal of improving knowledge, skills, and attitudes towards this practice …

Anesthesia Provider Education On The Adherence To The Fourth Consensus Guidelines For The Management Of Postoperative Nausea And Vomiting, Christine Johnson

Doctor of Nursing Practice (DNP) Student Projects

Background and Review of Literature: The occurrence of postoperative nausea and vomiting (PONV) has been linked to unplanned admissions, longer post-anesthesia care recovery units (PACU) times, and decreased patient satisfaction. The Fourth Consensus Guidelines for the Management of PONV released new guidelines in 2020 outlining evidence-based practice to manage PONV. A literature review was conducted on a total of 10 studies. The findings support the methods these guidelines employ.

Purpose: This quality improvement (QI) project aims to provide education for anesthesia providers on the fourth consensus guidelines and improve provider adherence.

Methods: A six-minute educational video, post-education quiz, provider …