Medicine and Health Sciences Commons^™

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 …

Education Aimed To Increase Train-Of-Four Ratio Use, Frank Bougher

Doctor of Nursing Practice (DNP) Student Projects

Background and Review of Literature: The current state of practice surrounding non-depolarizing neuromuscular blocking drug monitoring is variable among practitioners and poses a safety risk to patients who may subsequently experience residual neuromuscular blockade and complications. The literature supports that train-of-four ratio monitoring, with an emphasis on use prior to extubation, is superior to other techniques and reduces the occurrence of complications related to residual neuromuscular blockade, improving patient safety and outcomes.

Purpose: The purpose of the project was to determine if an education intervention founded on evidence-based neuromuscular monitoring leads to increased use of train-of-four ratio in practitioner …

Educating Perioperative Nurses On Preventing Hypothermia In Surgical Patients, Bethany Geisler

Doctor of Nursing Practice (DNP) Student Projects

Perioperative hypothermia (PH) is a preventable complication of surgical procedures that has been linked to postoperative conditions such as coagulopathies, increased cardiac morbidity, surgical site infection, increased incidence of pressure ulcers, increased length of hospital stay, and increased financial expense. Anesthetic agents given to patients during surgery directly contribute to PH and associated complications.

Background: Perioperative is a time frame involving the three stages of surgery (preoperative, intraoperative, and postoperative). Hypothermia is defined as body core temperature below 36 degrees Celsius. The incidence of PH ranges from 11% to 90% depending on the anesthesia administered, type of surgery, length of …

Anesthesia Provider’S Use And Perception Of Emergency Cognitive Aids, Katie Mette

Doctor of Nursing Practice (DNP) Student Projects

Cognitive aids have been shown to increase proper use of evidence-based practice treatment strategies in emergent scenarios. These treatment strategies can be unfamiliar to the provider as emergencies are rare, and when coupled with a heightened stress level and sense of urgency, relying on memory alone can be challenging. The purpose of this project was to implement a set of emergency-use cognitive aids developed by Stanford University known as the Stanford Emergency Manual into a set of operating rooms and measure the anesthesia providers use and perception of the cognitive aid via pre-implementation and post-implementation e-mailed surveys.

Procedure For Handling And Storage Of Onchocerca Volvulus Microfilariae Obtained From Skin Snips For Downstream Genetic Work, Shannon M Hedtke, Anusha Kode, Tony O Ukety, Jöel L Mande, Germain M Abhafule, Anuarite A Raciu, Claude B Uvon, Stephen R Jada, An Hotterbeekx, Joseph Nelson Siewe Fodjo, Makedonka Mitreva, Wilson Sebit, Robert Colebunders, Warwick N Grant, Annette C Kuesel

2020-Current year OA Pubs

WHO and endemic countries target elimination of transmission of

Picobirnaviruses Encode Proteins That Are Functional Bacterial Lysins, Tianyu Gan, David Wang

2020-Current year OA Pubs

Picobirnaviruses (PBVs) are double-stranded RNA viruses frequently detected in human and animal enteric viromes. Associations of PBVs with enteric graft-versus-host disease and type I diabetes during pregnancy have been established. Since their discovery in 1988, PBVs have been generally assumed to be animal-infecting viruses despite the lack of culture system, animal model, or detection in animal cells or tissues. Recent studies have proposed that bacteria or fungi could be the hosts of PBVs based on genomic analysis. Here, we functionally demonstrate that multiple PBVs of different genome organizations encode bacterial lysins that lyse

Mosunetuzumab Monotherapy Is Active And Tolerable In Patients With Relapsed/Refractory Diffuse Large B-Cell Lymphoma, Nancy L Bartlett, Et Al.

2020-Current year OA Pubs

As part of a phase 1 or 2 study, this single-arm expansion cohort established the efficacy and safety of mosunetuzumab monotherapy in patients with relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL) (received ≥2 previous lines of therapy). Intravenous mosunetuzumab was administered with cycle (C) 1 step-up dosing for cytokine release syndrome (CRS) mitigation: C1 day (D) 1: 1 mg; C1D8 2 mg; C1D15 and C2D1: 60 mg; C3 + D1: 30 mg. Hospitalization was not mandatory. Patients with complete response (CR) completed treatment after C8; those with partial response or stable disease continued treatment for a total of 17 cycles. …

Impact Of Detectable Monoclonal Protein At Diagnosis On Outcomes In Marginal Zone Lymphoma: A Multicenter Cohort Study, Narendranath Epperla, Lauren Shea, Nancy L Bartlett, Et Al.

2020-Current year OA Pubs

Given the paucity of data surrounding the prognostic relevance of monoclonal paraprotein (M-protein) in marginal zone lymphoma (MZL), we sought to evaluate the impact of detecting M-protein at diagnosis on outcomes in patients with MZL in a large retrospective cohort. The study included 547 patients receiving first-line therapy for MZL. M-protein was detectable at diagnosis in 173 (32%) patients. There was no significant difference in the time from diagnosis to initiation of any therapy (systemic and local) between the M-protein and no M-protein groups. Patients with M-protein at diagnosis had significantly inferior progression-free survival (PFS) compared with those without M-protein …

Leadership Paper, Raquel Zeidlik

AI Assignment Library

The purpose of this formal paper is to explore effective nursing leadership characteristics. This essay will examine the leadership role of a nurse. Using evidence and supporting literature, the student will demonstrate their understanding of nursing leadership characteristics and skills and how they apply to clinical practice.

Promoting Personal Agency In Nursing Students' Ability To Evaluate Evidence, Kaitlyn Kelly

AI Assignment Library

In NURS450: Transition to Practice Seminar, the senior capstone for graduating nursing students and an essential studies class focused on information literacy, we examine research studies with a CASP Programme checklist, which helps students understand the validity and applicability of published research to their patient populations. In this assignment AI, specifically ChatGPT, is used to generate a fictional randomized controlled trial. Students are guided through the checklist and a group discussion on whether that study meets the requirements to be considered valid and applicable to a local population (with the assumption that the study was real). The purpose is to …

Public Health Ai Assignment, Amber Lyon-Colbert

AI Assignment Library

This assignment utilizes course foundational knowledge: Explain the social, political and economic determinants of health and how they contribute to population health and health inequities. This assignment addresses and strengthens our CEPH Competency #5 D2-11 Select methods to evaluate public health programs.

Sigra: Single-Cell Spatial Elucidation Through An Image-Augmented Graph Transformer, Ziyang Tang, Zuotian Li, Tieying Hou, Tonglin Zhang, Baijian Yang Ph.D., Jing Su, Qianqian Song

Publications

Recent advances in high-throughput molecular imaging have pushed spatial transcriptomics technologies to subcellular resolution, which surpasses the limitations of both single-cell RNA-seq and array-based spatial profiling. The multichannel immunohistochemistry images in such data provide rich information on the cell types, functions, and morphologies of cellular compartments. In this work, we developed a method, single-cell spatial elucidation through image-augmented Graph transformer (SiGra), to leverage such imaging information for revealing spatial domains and enhancing substantially sparse and noisy transcriptomics data. SiGra applies hybrid graph transformers over a single-cell spatial graph. SiGra outperforms state-of-the-art methods on both single-cell and spot-level spatial transcriptomics data …

Randomized Controlled Trial Of Mechanical Thrombectomy Vs Catheter-Directed Thrombolysis For Acute Hemodynamically Stable Pulmonary Embolism: Rationale And Design Of The Peerless Study, Carin F. Gonsalves, C Michael Gibson, Stefan Stortecky, Roger A Alvarez, Daren M Beam, James M Horowitz, Mitchell J Silver, Catalin Toma, John H Rundback, Stuart P Rosenberg, Craig D Markovitz, Thomas Tu, Wissam A Jaber

Department of Radiology Faculty Papers

BACKGROUND: The identification of hemodynamically stable pulmonary embolism (PE) patients who may benefit from advanced treatment beyond anticoagulation is unclear. However, when intervention is deemed necessary by the PE patient's care team, data to select the most advantageous interventional treatment option are lacking. Limiting factors include major bleeding risks with systemic and locally delivered thrombolytics and the overall lack of randomized controlled trial (RCT) data for interventional treatment strategies. Considering the expansion of the pulmonary embolism response team (PERT) model, corresponding rise in interventional treatment, and number of thrombolytic and nonthrombolytic catheter-directed devices coming to market, robust evidence is needed …

Biosafety And Biohazard Considerations Of Hsv-1-Based Oncolytic Viral Immunotherapy., Elizabeth Robilotti, Nathalie C Zeitouni, Marlana Orloff

Department of Medical Oncology Faculty Papers

Oncolytic viral immunotherapies are agents which can directly kill tumor cells and activate an immune response. Oncolytic viruses (OVs) range from native/unmodified viruses to genetically modified, attenuated viruses with the capacity to preferentially replicate in and kill tumors, leaving normal tissue unharmed. Talimogene laherparepvec (T-VEC) is the only OV approved for patient use in the United States; however, during the last 20 years, there have been a substantial number of clinical trials using OV immunotherapies across a broad range of cancers. Like T-VEC, many OV immunotherapies in clinical development are based on the herpes simplex virus type 1 (HSV-1), with …

Innovations In Health-Care Service Delivery During The Pandemic, Taryn Vian, Ankita Meghani Phd

Nursing and Health Professions Faculty Research and Publications

The COVID-19 pandemic disrupted health service delivery as countries implemented lockdowns and issued stay-at-home orders. Despite attempts to make essential health services available throughout, the pandemic strained health systems and resulted in rampant shortages of health commodities, beds and health-care staff. There were concomitant declines in tuberculosis screening, HIV testing, and maternal and child health services.2 However, the global pandemic also accelerated the pace of innovation. Some initiatives served as stopgap measures implemented to maintain health services, whereas others helped leapfrog progress in the areas of health information systems, telemedicine, and regulatory policy, bringing efficiencies that could be applied even …

The Endosomal Escape Vehicle Platform Enhances Delivery Of Oligonucleotides In Preclinical Models Of Neuromuscular Disorders, Xiang Li, Mahboubeh Kheirabadi, Patrick G Dougherty, Kimberli J Kamer, Xiulong Shen, Nelsa L Estrella, Suresh Peddigari, Anushree Pathak, Sara L Blake, Emmanuelle Sizensky, Carmen Del Genio, Arti B Gaur, Mohanraj Dhanabal, Mahasweta Girgenrath, Natarajan Sethuraman, Ziqing Qian

Faculty, Staff and Student Publications

Biological therapeutic agents are highly targeted and potent but limited in their ability to reach intracellular targets. These limitations often necessitate high therapeutic doses and can be associated with less-than-optimal therapeutic activity. One promising solution for therapeutic agent delivery is use of cell-penetrating peptides. Canonical cell-penetrating peptides, however, are limited by low efficiencies of cellular uptake and endosomal escape, minimal proteolytic stability, and toxicity. To overcome these limitations, we designed a family of proprietary cyclic cell-penetrating peptides that form the core of our endosomal escape vehicle technology capable of delivering therapeutic agent-conjugated cargo intracellularly. We demonstrated the therapeutic potential of …

Interaction Between Myelodysplasia-Related Gene Mutations And Ontogeny In Acute Myeloid Leukemia, Joseph G W Mccarter, David Nemirovsky, Christopher A Famulare, Noushin Farnoud, Abhinita S Mohanty, Zoe S Stone-Molloy, Jordan Chervin, Brian J Ball, Zachary D Epstein-Peterson, Maria E Arcila, Aaron J Stonestrom, Andrew Dunbar, Sheng F Cai, Jacob L Glass, Mark B Geyer, Raajit K Rampal, Ellin Berman, Omar I Abdel-Wahab, Eytan M Stein, Martin S Tallman, Ross L Levine, Aaron D Goldberg, Elli Papaemmanuil, Yanming Zhang, Mikhail Roshal, Andriy Derkach, Wenbin Xiao

Faculty, Staff and Student Publications

Accurate classification and risk stratification are critical for clinical decision making in patients with acute myeloid leukemia (AML). In the newly proposed World Health Organization and International Consensus classifications of hematolymphoid neoplasms, the presence of myelodysplasia-related (MR) gene mutations is included as 1 of the diagnostic criteria for AML, AML-MR, based largely on the assumption that these mutations are specific for AML with an antecedent myelodysplastic syndrome. ICC also prioritizes MR gene mutations over ontogeny (as defined in the clinical history). Furthermore, European LeukemiaNet (ELN) 2022 stratifies these MR gene mutations into the adverse-risk group. By thoroughly annotating a cohort …

Cell-Type-Specific Alternative Polyadenylation Promotes Oncogenic Gene Expression In Non-Small Cell Lung Cancer Progression, Kexin Huang, Yun Zhang, Xiaorui Shi, Zhiqin Yin, Weiling Zhao, Liyu Huang, Fu Wang, Xiaobo Zhou

Faculty, Staff and Student Publications

Disrupted alternative polyadenylation (APA) is frequently involved in tumorigenesis and cancer progression by regulating the gene expression of oncogenes and tumor suppressors. However, limited knowledge of tumor-type- and cell-type-specific APA events may lead to novel APA events and their functions being overlooked. Here, we compared APA events across different cell types in non-small cell lung cancer (NSCLC) and normal tissues and identified functionally related APA events in NSCLC. We found several cell-specific 3'-UTR alterations that regulate gene expression changes showed prognostic value in NSCLC. We further investigated the function of APA-mediated 3'-UTR shortening through loss of microRNA (miRNA)-binding sites, and …

Disease Modeling And Gene Correction Of Lgmdr21 Ipscs Elucidates The Role Of Poglut1 In Skeletal Muscle Maintenance, Regeneration, And The Satellite Cell Niche, Jose L Ortiz-Vitali, Jianbo Wu, Nasa Xu, Annie W Shieh, Nima Niknejad, Megumi Takeuchi, Carmen Paradas, Chunru Lin, Hamed Jafar-Nejad, Robert S Haltiwanger, Sidney H Wang, Radbod Darabi

Faculty, Staff and Student Publications

Autosomal recessive limb-girdle muscular dystrophy 21 (LGMDR21) is caused by pathogenic variants in protein O-glucosyltransferase 1 (POGLUT1), which is responsible for O-glucosylation of specific epidermal growth factor (EGF) repeats found in ∼50 mammalian proteins, including Notch receptors. Previous data from patient biopsies indicated that impaired Notch signaling, reduction of muscle stem cells, and accelerated differentiation are probably involved in disease etiopathology. Using patient induced pluripotent stem cells (iPSCs), their corrected isotypes, and control iPSCs, gene expression profiling indicated dysregulation of POGLUT1, NOTCH, muscle development, extracellular matrix (ECM), cell adhesion, and migration as involved pathways. They also exhibited reduced in vitro …

Description Of A New Pavlovskyella Species (Acari: Argasidae) From Chile, Sebastián Muñoz-Leal, José M Venzal, Alexander R Kneubehl, Job E Lopez, Thiago F Martins, Marcelo B Labruna

Faculty, Staff and Students Publications

Soft ticks (Argasidae) of the Pavlovskyella Pospelova-Shtrom subgenus are important vectors of relapsing fever spirochetes, which are agents of disease globally. South American representatives of the Pavlovskyella subgenus include 3 species: Ornithodoros (Pavlovskyella) brasiliensis Aragão, Ornithodoros (Pavlovskyella) furcosus Neumann, and Ornithodoros (Pavlovskyella) rostratus Aragão. Here, we describe a fourth species based on morphological and mitogenomic evidence of ticks collected in burrows of unknown hosts in central Chile. The larva of the new species separates from other South American soft ticks by the following combination of characters: 13 pairs of dorsolateral setae, dorsal plate hexagonal, hypostome blunt with denticles from apex …

Clinical Outcomes Following Bifurcation Techniques For Percutaneous Coronary Intervention, Chayakrit Krittanawong, Hafeez Ul Hassan Virk, Yusuf Kamran Qadeer, Umer Irshad, Zhen Wang, Mahboob Alam, Samin Sharma

Faculty, Staff and Students Publications

Bifurcation lesions account for 20% of all percutaneous coronary interventions and represent a complex subset which are associated with lower procedural success and higher rates of restenosis [...].

Lifetime Aortic Management In Marfan Syndrome: Puzzle Pieces And Rare Diseases, Joseph S Coselli, Lauren M Barron

Faculty, Staff and Students Publications

No abstract provided.

Impact Of Integrating A Unified Population Health And Systems Thinking Curriculum Into A Pa Program, Halley Barke, Georgia Luckey, Christy Hamilton, Taylor Sutton, Tracey Smith, Janet Albers

SIU Journal of Medical Science Scholarly Works

Purpose

This study shows the impact of a 3-part population health and interprofessional education (IPE) curriculum on Physician Assistant (PA) students’ knowledge and experience of population health and systems thinking (PHST) and to promote a team-based approach to patient care and improve patient health and preventative services.

Methods

Human Resources and Services Administration funded a 5-year Primary Care and Training Enhancement grant in PHST. With this funding, the Department of Family and Community Medicine developed a three-part plan emphasizing interprofessional learning. The impact was measured using a 22-item survey measuring knowledge and experience of PHST delivered to PA students annually. …

Severe Covid-19 Infection In An Infant With 8p Inverted Duplication/Deletion Syndrome: Is Vaccination Still A Debate?, Andrew M. Joseph, Monica Karas, Ernesto Joubran, Yaseen O. Ramadan, Blakley A. Fowler

HPD Articles

Despite having a milder course of coronavirus disease 2019 (COVID-19) in comparison to adults, children are at risk for more significant complications, including acute neurological, renal, respiratory, and cardiovascular complications. Acute complications can manifest as encephalopathy, renal injury, interstitial pneumonia, and heart failure. However, the most severe complication is multisystem inflammatory syndrome in children, which often requires intensive care to manage the subsequent respiratory failure. Moreover, children with comorbidities such as chronic lung disease, neurological disorders, and cardiovascular disease are at an elevated risk of morbidity and mortality. Here, we present the case of an 11- month-old white female patient, …

Ada News - 09/11/2023, American Dental Association, Publishing Division

ADA News

Established in 1970 as the official newspaper of the American Dental Association, the ADA News serves practicing dentists and others allied to the dental profession in the U.S. and internationally. It is the No. 1 source of news and information about the many benefits and services the ADA delivers to members daily as well as timely information on scientific, social, political and economic developments affecting dentistry and health care.

The Effects Of Inhaled Anesthetic Agents On Long-Term Cognitive Decline, Viktor Kunder, Matthew Tayem, Sneh Parekh

HPD Articles

Background: Anesthesia is generally considered safe, but studies have shown the potential relationship between anesthetic agents and dementia after surgery. Several studies have pointed out how the commonly used anesthetic drugs induce cytotoxicity, ultimately leading to neurodegeneration and even Alzheimer's Disease (AD). Specifically, inhaled anesthetics such as isoflurane, sevoflurane, and desflurane have been shown to impact the neurophysiology of the brain. However, there is no established relationship between aesthetics and long-term postoperative cognitive decline.

Objective: The objective of this study is to explore the available research on anesthetic agents and the potential role that they have played in postoperative cognitive …

Supporting Vulnerable Older Adults With Telehealth Through Wellness Calls And Tablet Distribution During Covid-19: Quality Improvement Project, Sweta Tewary, Nicole J. Cook, Marie Dezine, Oksana Shnayder, Naushira Pandya

HPD Articles

BACKGROUND: Loneliness, social isolation, and lack of technical literacy are associated with poorer health outcomes. To help improve social connection during the COVID-19 pandemic, Nova Southeastern University's South Florida Geriatric Workforce Enhancement Program partnered with a community-based organization to provide educational resources to promote telehealth services.

OBJECTIVE: This study aimed to provide educational resources to older adults with limited resources and promote the use of telehealth services in this population.

METHODS: Through this pilot project, we contacted 66 vulnerable older adults who expressed interest in telehealth support through wellness calls, with 44 participants moving on to participate in tablet usage. …

Improving Small-Volume Antibiotic Administration For Surgical Prophylaxis, Benjamin Thomas

Doctor of Nursing Practice (DNP) Student Projects

Background: Small-volume IV antibiotics are commonly administered for surgical prophylaxis, but no clear policy on administration method exists, leading to wide variation in anesthesia provider practice at a large academic medical center. Administration via a secondary tubing set is the recommended practice to minimize significant medication losses which could lead to poor patient outcomes. This large academic medical center performed below the national benchmark for one of these outcomes–surgical site infections.

Goals and Objectives: Objectives of this project included eliminating a potential systematic shortcoming in the administration of prophylactic antibiotics. The goal was to increase the use of …

Evaluating The Effectiveness Of The Clinical Care Of The Pediatric Patient Course: A Quality Improvement Project, Cassandra Elliot

Doctor of Nursing Practice Projects

The Clinical Care of the Pediatric Patient (CCPP) is a two-day course held monthly as part of the onboarding process. This mandatory course is intended to prepare onboarding clinical staff for the provision of evidence-based care to pediatric patients. CCPP contains over 17 hours of didactic and hands-on instruction in the assessment, management, and treatment of pediatric conditions. The goal of this quality improvement project was to determine the perceived effectiveness of the CCPP course and its impact on the confidence level of clinical staff as pediatric providers during their first few months of employment. A regression analysis was used …

Utilizing The Phq9 Survey To Improve Depressive Symptoms In Opioid Dependent Adults: A Quality Improvement Project, Taylor Fuhr

DNP Projects

Significance and Background: Opioid dependence continues to be a fighting battle in our country. While many individuals do well on maintenance therapy such as suboxone, they often are faced with comorbid challenges including depression and anxiety. Research shows that the risk for depressive symptoms in opioid dependent adults increases along with the duration of use and increase of dosage (Semenkovich et al., 2014). There is no consistency among depression screening for opioid dependent adults despite the research that suggests the two often coincide with one another. The goal of this quality improvement project was to implement routine depression screening using …