Medicine and Health Sciences Commons^™

Decision Making In Patients With Initial Positive Deep Margins On Diagnostic Biopsy Of Melanoma, Ana Eliza Souza Cunha

Yale School of Medicine Physician Associate Program Theses

Background: Current guidelines recommend SLN biopsy (SLNB) among patients with initial Breslow Thickness (BRES) ≥0.8mm at initial screening. However, there is limited guidance regarding SLNB among patients who have deeper final depth after initial biopsy.

Methods: We conducted a retrospective cohort study of 62 thin melanoma patients with primary lesions with initial Breslow Thickness (BRES)

Results: Approximately 55% of patients (n = 34) included in our study underwent SLNB. After adjustment, there was no association between SLNB status and recurrence. Immunosuppressive drug use was associated with higher odds of local (OR= 28.56 CI 1.87- 435.53; p =0.016) and regional recurrence …

Differences In Predicted Risk Of Mortality After Coronary Artery Bypass Graft Between Black And White Patients With Identical Clinical Profiles Using The Society Of Thoracic Surgeons Calculator: An In-Silico Cohort Study, Kiara Marmolejos

Yale School of Medicine Physician Associate Program Theses

Abstract/Summary:

Background: “The Society of Thoracic Surgeons mortality risk calculator”, which includes a race variable, is recommended for estimating Short- term (30 day) predicted risk of mortality after isolated coronary artery bypass graft, with a risk estimate of 3-4% stratifying patients into intermediate risk, a risk estimate above 5% stratifying patients into high risk for surgery and a risk estimate above 8% stratifying patients into the very high-risk category. We compared differences between Black and White individuals in Society of Thoracic Surgeons-predicted risk of mortality across various plausible risk factor combinations with the aim of evaluating if using the predictive …

Narrative Therapy And Quality Of Life In Functional Neurological Disorder, Amber Wilder

Yale School of Medicine Physician Associate Program Theses

Functional Neurological Disorder is a severely disabling and stigmatized condition in which motor or sensory neurological symptoms cannot be attributed to a known neurological condition and are considered to be psychological in nature. Cognitive behavioral therapy improves depression and neurological symptoms for some patients, but many do not respond to therapy, and treatment adherence is extremely low. Narrative therapy is a psychotherapeutic model based in reframing one’s life story, and it is associated with decreased self-stigma and improved treatment adherence and engagement, but it has not been studied in Functional Neurological Disorder. In this randomized controlled trial, we will compare …

Telemedicine Slashes ‘No Show’ Rates And Achieves Comparable Outcomes In Diabetes Care, Jay Gandhi

Yale School of Medicine Physician Associate Program Theses

Abstract

Telemedicine Slashes ‘No-Show’ Rates and Achieves Comparable Outcomes in Diabetes Care

Jay Gandhi, PA-SII, and Jonathan Weber, MA, PA-C, DFAAPA, Yale Medicine Diabetes Center at Yale-New Haven Hospital, Yale Physician Associate Program

Background

Patients with type 2 diabetes (T2D) require continuous management to achieve optimal outcomes. Patients confronting barriers to care face higher risks of complications. Socioeconomic barriers including inability to afford transportation, work release, childcare or parking fees are factors affecting patient attendance. During the Covid-19 pandemic, telemedicine likely reduced common barriers affecting patient attendance compared to in-person visits. This study investigated the impact of telemedicine on no-show …

Heterogeneity In Macrophages Along The Cochlear Spiral In Mice: Insights From Sem And Functional Analyses, Celia Zhang, Mengxiao Ye, Peter Bush, Bo Hua Hu

Pacific Faculty Work

The susceptibility of sensory cells to pathological conditions differs between the apical and basal regions of the cochlea, and the cochlear immune system may contribute to this location-dependent variability. Our previous study found morphological differences in basilar membrane macrophages between the apical and basal regions of the cochlea. However, the details of this site-dependent difference and its underlying structural and biological basis are not fully understood. In this study, we utilized scanning electron microscopy to examine the ultrastructure of macrophages and their surrounding supporting structures. Additionally, we examined the phagocytic activities of macrophages and the expression of immune molecules in …

Targeting Breast Cancer: The Familiar, The Emerging, And The Uncharted Territories, Hamidreza Montazeri Aliabadi, Arthur Manda, Riya Sidgal, Co Chung

Pharmacy Faculty Articles and Research

Breast cancer became the most diagnosed cancer in the world in 2020. Chemotherapy is still the leading clinical strategy in breast cancer treatment, followed by hormone therapy (mostly used in hormone receptor-positive types). However, with our ever-expanding knowledge of signaling pathways in cancer biology, new molecular targets are identified for potential novel molecularly targeted drugs in breast cancer treatment. While this has resulted in the approval of a few molecularly targeted drugs by the FDA (including drugs targeting immune checkpoints), a wide array of signaling pathways seem to be still underexplored. Also, while combinatorial treatments have become common practice in …

Sustainable Development For Mobile Health Apps Using The Human-Centered Design Process, Qingfan An, Marjorie M Kelley, Audra Hanners, Po-Yin Yen

2020-Current year OA Pubs

Well-documented scientific evidence indicates that mobile health (mHealth) apps can improve the quality of life, relieve symptoms, and restore health for patients. In addition to improving patients' health outcomes, mHealth apps reduce health care use and the cost burdens associated with disease management. Currently, patients and health care providers have a wide variety of choices among commercially available mHealth apps. However, due to the high resource costs and low user adoption of mHealth apps, the cost-benefit relationship remains controversial. When compared to traditional expert-driven approaches, applying human-centered design (HCD) may result in more useable, acceptable, and effective mHealth apps. In …

Effects Of Velocity-Based Training And Resistance Training On Acute Recovery Based On Sport-Specific Performance In Soccer Players, Viorel Cristian Ravar Ladislau

Student Theses and Dissertations

This study aimed to examine the effects of velocity-based training (VBT) and resistance training (RT) on acute recovery, as determined by sport-specific performance (SSP). Twenty experienced male soccer players completed five training sessions, including VBT and RT, with sport-specific training (SST) tests conducted after each session. Statistical analysis revealed significant differences (p < 0.05) in performance between VBT and RT for all six SST tests. VBT resulted in superior performance in the 30-meter dash (p < 0.0001), vertical jump (p < 0.0001), double leg bounds (p = 0.001), 505-agility drill (p < 0.0001), zigzag sprint and shuffle drill (p < 0.0001), and 5-10-15-meter shuttle run (p < 0.0001) tests. These findings support the hypothesis that VBT can lead to superior SSP outcomes compared to traditional RT in male soccer players. Results have practical implications for strength and conditioning professionals working with soccer players to improve recovery and performance outcomes.

Prenylated Stilbenoids As Paclitaxel Adjuvants In Triple-Negative Breast Cancer Treatment, Sepideh Mohammadhosseinpour

Student Theses and Dissertations

Triple-negative breast cancer (TNBC), the most fatal breast cancer subtype, lacks three main receptors (the human epidermal growth factor 2 receptor (ERBB2, formerly HER2), estrogen (ER) and progesterone (PR) receptors) and represents about 15% of all breast tumors. The most common treatment for TNBC is chemotherapy, being paclitaxel one of the most prescribed drugs. One of the main issues of paclitaxel is its high level of toxicity to non-cancerous cells and the development of paclitaxel resistance in the TNBC cells. Adjuvant therapy has been proposed as an alternative approach to increase the efficacy of a drug or circumvent drug resistance. …

David Remmert Touts The Importance Of Educating The Next Wave Of Health Care Workers, Eric Stock

Interviews for WGLT

With his past experience working for public health departments, Assistant Professor of Public Health David Remmert touts the importance of educating the next wave of health care workers through the new public health program in IWU's School of Nursing and Health Sciences.

Analyzing The Effects Of Body Mass Index In Total Hip Arthroplasty Cases. Does It Influence Patient Characteristics, Operative Planning, And Postoperative Outcomes?, Cesar A. Sevilla Jr, Vanessa Elena Lopez, Mauricio Burbano, Michael Sander

MEDI 9331 Scholarly Activities Clinical Years

Background: Total hip arthroplasty (THA) is one of the most performed orthopaedic procedures commonly used for the treatment of osteoarthritis (OA). There are several underlying factors that lead to the formation of this condition. Not only is obesity one of the main contributors, but it is also a modifiable risk factor and one of the leading causes of end-stage arthrosis of the hip. Though there have been advancements in agricultural and health technologies, rates of obesity continue to rise causing similar increases in the demands for hip replacement surgeries. Therefore, we sought to investigate the effects of BMI on …

Camkii: A Link Between Metabolic Disorders And Cardiac Arrhythmias, Marilen Federico, C.A. Valverde, L.A. Gonano, J. Palomeque, A. Matiazzi

Center for Translational Medicine Faculty Papers

The prevalence of metabolic diseases -such as obesity, prediabetes, metabolic syndrome or diabetes-has increased globally over the years. These diseases, mainly diabetes mellitus (DM), are among the leading causes of mortality and morbidity worldwide, with increased risk of diabetic cardiomyopathy (DC), cardiac arrhythmias, and heart failure (HF). In metabolic diseases several steps and proteins involved in excitation-contraction coupling (ECC) are compromised, precluding an efficient and rhythmic cardiac contraction; moreover, calcium/calmodulin-dependent protein kinase II (CaMKII) a kinase involved in ECC, is upregulated in several metabolic maladies and significantly contributes to cardiac remodeling and arrhythmias, among which are calcium (Ca2+)-triggered arrhythmias. CaMKII …

Intrinsic Disorder In Prame And Its Role In Uveal Melanoma, Michael Antonietti, David J. Taylor Gonzalez, Mak Djulbegovic, Guy W. Dayhoff, Vladimir N. Uversky, Carol L. Shields, Carol L. Karp

Wills Eye Hospital Papers

Introduction

The PReferentially expressed Antigen in MElanoma (PRAME) protein has been shown to be an independent biomarker for increased risk of metastasis in Class 1 uveal melanomas (UM). Intrinsically disordered proteins and regions of proteins (IDPs/IDPRs) are proteins that do not have a well-defined three-dimensional structure and have been linked to neoplastic development. Our study aimed to evaluate the presence of intrinsic disorder in PRAME and the role these structureless regions have in PRAME( +) Class 1 UM.

Methods

A bioinformatics study to characterize PRAME’s propensity for the intrinsic disorder. We first used the AlphaFold tool to qualitatively assess the …

Novel Diagnostic And Therapeutic Approaches To Temporomandibular Dysfunction: A Narrative Review, Brendan Moxley, William Stevens, Joel Sneed, Craig Pearl

Faculty, Staff and Student Publications

Temporomandibular dysfunction (TMD) is a burgeoning area of study within the dental field. TMD is caused by abnormalities in the temporomandibular joint or muscles of mastication and can lead to pain, loss of function, and other complications. As this area of patient care receives increased focus, the ability to accurately diagnose TMD becomes paramount. The aim of this review is to summarize novel diagnostic and therapeutic techniques that have been proposed within the last approximately 3 years in order to inform readers of the cutting-edge advances in the field of TMD diagnosis and management, while also analyzing the clinical relevance …

Metastatic Papillary Thyroid Carcinoma Gone Wild, Khulood Talpur, Ambreen Soomro, Afrah Talpur

Abington Jefferson Health Papers

Thyroid cancers account for only 1.5% of all cancers in adults and 3% of all cancers in children. In females, however, thyroid cancers are the fifth most common cancer, comprising 4% of all cases. Of all thyroid cancers, 74-80% of cases are papillary cancer. The prevalence of thyroid cancer is rising worldwide. Although thyroid cancer has a favorable prognosis, up to 20% of patients experienced recurrent disease during the follow-up period. Extra-thyroidal extension occurs in 8% to 32% of cases. Local or regional recurrences occur in 5-15% of patients with papillary thyroid carcinoma (PTC). Distant metastasis occurs in only 1% …

Structures Of The Insecticidal Toxin Complex Subunit Xpta2 Highlight Roles For Flexible Domains, Cole L Martin, David W Chester, Christopher D Radka, Lurong Pan, Zhengrong Yang, Rachel C Hart, Elad M Binshtein, Zhao Wang, Lisa Nagy, Lawrence J Delucas, Stephen G Aller

Faculty, Staff and Students Publications

The Toxin Complex (Tc) superfamily consists of toxin translocases that contribute to the targeting, delivery, and cytotoxicity of certain pathogenic Gram-negative bacteria. Membrane receptor targeting is driven by the A-subunit (TcA), which comprises IgG-like receptor binding domains (RBDs) at the surface. To better understand XptA2, an insect specific TcA secreted by the symbiont

Smad8 Is Increased In Duchenne Muscular Dystrophy And Suppresses Mir-1, Mir-133a, And Mir-133b, Meghan L Royle, Eric J Connolly, Sara Nowakowski, Jeff R Temple

Faculty, Staff and Student Publications

OBJECTIVES: Studies are beginning to document an association between sleep duration and a range of adolescent delinquent behaviors, including weapon carrying. However, little is known about whether and to what extent sleep quality - another dimension of sleep for healthy adolescent functioning - is associated with weapon carrying. We address this gap in knowledge by evaluating the role of restless sleep and sleep duration in adolescent weapon carrying.

METHODS: We analyze data from a diverse sample of 994 adolescents from Texas, USA collected in 2010. Multivariate logistic regression models estimate the association of sleep duration and restless sleep on weapon …

Ant-Dependent Mptp Underlies Necrotic Myofiber Death In Muscular Dystrophy, Michael J Bround, Julian R Havens, Allen J York, Michelle A Sargent, Jason Karch, Jeffery D Molkentin

Faculty, Staff and Students Publications

Mitochondrial permeability transition pore (MPTP) formation contributes to ischemia-reperfusion injury in the heart and several degenerative diseases, including muscular dystrophy (MD). MD is a family of genetic disorders characterized by progressive muscle necrosis and premature death. It has been proposed that the MPTP has two molecular components, the adenine nucleotide translocase (ANT) family of proteins and an unknown component that requires the chaperone cyclophilin D (CypD) to activate. This model was examined in vivo by deleting the gene encoding ANT1 (Slc25a4) or CypD (Ppif) in a δ-sarcoglycan (Sgcd) gene–deleted mouse model of MD, revealing …

Microglial Rev-Erbα Regulates Inflammation And Lipid Droplet Formation To Drive Tauopathy In Male Mice, Jiyeon Lee, Julie M Dimitry, Jong Hee Song, Minsoo Son, Patrick W Sheehan, Melvin W King, G Travis Tabor, Young Ah Goo, Mitchell A Lazar, Leonard Petrucelli, Erik S Musiek

2020-Current year OA Pubs

Alzheimer's disease, the most common age-related neurodegenerative disease, is characterized by tau aggregation and associated with disrupted circadian rhythms and dampened clock gene expression. REV-ERBα is a core circadian clock protein which also serves as a nuclear receptor and transcriptional repressor involved in lipid metabolism and macrophage function. Global REV-ERBα deletion has been shown to promote microglial activation and mitigate amyloid plaque formation. However, the cell-autonomous effects of microglial REV-ERBα in healthy brain and in tauopathy are unexplored. Here, we show that microglial REV-ERBα deletion enhances inflammatory signaling, disrupts lipid metabolism, and causes lipid droplet (LD) accumulation specifically in male …

Rapid Direct Detection Of Sars-Cov-2 Aerosols In Exhaled Breath At The Point Of Care, Dishit P Ghumra, Nishit Shetty, Kevin R Mcbrearty, Joseph V Puthussery, Benjamin J Sumlin, Woodrow D Gardiner, Brookelyn M Doherty, Jordan P Magrecki, Jane A O'Halloran, Rachel M Presti, Traci L Bricker, Adrianus C M Boon, Carla M Yuede, John R Cirrito, Rajan K Chakrabarty, Et Al.

2020-Current year OA Pubs

Airborne transmission via virus-laden aerosols is a dominant route for the transmission of respiratory diseases, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Direct, non-invasive screening of respiratory virus aerosols in patients has been a long-standing technical challenge. Here, we introduce a point-of-care testing platform that directly detects SARS-CoV-2 aerosols in as little as two exhaled breaths of patients and provides results in under 60 s. It integrates a hand-held breath aerosol collector and a llama-derived, SARS-CoV-2 spike-protein specific nanobody bound to an ultrasensitive micro-immunoelectrode biosensor, which detects the oxidation of tyrosine amino acids present in SARS-CoV-2 viral particles. Laboratory …

Genetic Modifiers Of Mendelian Monogenic Collagen Iv Nephropathies In Humans And Mice, Constantinos Deltas, Gregory Papagregoriou, Stavroula F Louka, Apostolos Malatras, Frances Flinter, Daniel P Gale, Susie Gear, Oliver Gross, Julia Hoefele, Rachel Lennon, Jeffrey H Miner, Alessandra Renieri, Judy Savige, A Neil Turner

2020-Current year OA Pubs

Familial hematuria is a clinical sign of a genetically heterogeneous group of conditions, accompanied by broad inter- and intrafamilial variable expressivity. The most frequent condition is caused by pathogenic (or likely pathogenic) variants in the collagen-IV genes,

(2018) Shaping Trauma-Responsive Schools With Relational-Cultural Theory, Sarah C. Demarais

Louisiana Journal of Counseling

Traumatized students often struggle to meet the academic and behavioral expectations of schools. Interpersonal trauma in particular can damage children’s capacities for healthy social relationships and participation in community. In this article, I explore some of the detrimental effects of interpersonal trauma on students. I then offer relational-cultural theory as a lens for conceptualizing how interpersonal trauma affects children’s relational skills and for promoting mutually empathetic relationships that foster healing. Finally, I recommend strategies for school counselors to cultivate trauma-responsive school environments by working directly with traumatized students, advocating for safe and inclusive school cultures, and training educators in skills …

(2018) Test Questions For Licensed Professional Counselors, Test Questions

Louisiana Journal of Counseling

No abstract provided.

(2018) An Exploratory Study Of Advanced Technology In Supervision: Results From A Counselor Education Program, June Williams, Josette David, Aliah Esmaeili

Louisiana Journal of Counseling

As the profession of counseling continues to develop in a technological world, the need for quality supervision and training is crucial (Aasheim, 2012). The Council for Accreditation of Counseling and Other Educational Programs (CACREP) (2016) recognizes the benefits of technology, and requires graduate programs to demonstrate evidence of the integration of technology throughout the curriculum. The authors aimed to explore if counselor educators could utilize advanced technology tools to enhance teaching and learning in counselor education and supervision. The findings from this exploratory study and grant experience suggest that the incorporation of a play analyzer software can greatly enhance the …

(2018) Editorial, Meredith Nelson, Timothy P. Winter

Louisiana Journal of Counseling

How a Counseling Degree has Helped Me

(2018) Practicing What We Preach: Faculty Level Factors Impact On Service Learning, John A. Dewell, Yu-Yun Liu

Louisiana Journal of Counseling

Service learning has theoretical and empirical support as a pedagogy that can address the need to infuse social justice advocacy into the counselor education curriculum. Unfortunately, it is not widely utilized and there is a dearth of data shedding light on why this is. This study sought to address this by investigating how faculty level factors impact the use of service learning. The data indicates that faculty perception of the importance of professional roles, perceived teaching efficacy, and epistemic beliefs significantly predict the use of service learning. The data further indicates that faculty level factors predict attitudes towards service learning. …

(2018) Entire Issue, Meredith Nelson, Peter Emerson

Louisiana Journal of Counseling

No abstract provided.

(2019) Test Questions For Licensed Professional Counselors, Test Questions

Louisiana Journal of Counseling

No abstract provided.

(2019) The Relationship Between Hegemonic Masculinity And Multicultural Competence In Male Counselors, Erik Braun, Madeline Clark, George Armitage

Louisiana Journal of Counseling

The purpose of this study was to explore hegemonic masculinity, an expression of the male identity whereby value is placed on attitudes and behaviors which may be destructive, and Multicultural Competence (MCC) in male counselors. Data were collected using the Multicultural Counseling Knowledge and Awareness Scale (MCKAS; Ponterotto, et al., 2002) and the Male Norm Roles Inventory (MRNI-SF; Levant, Hall, & Rankin, 2013). Hierarchical Linear Regression (HLR) and correlational analyses were used. Results support that hegemonic masculine attitudes are negatively related to MCC, and sexual identity is related to hegemonic masculine attitudes and MCC.

(2019) A Silent Epidemic: Prevalence Of Suicide Among Asian American Adolescents, Kacie Blalock, Ashton Nance, Anna-Katrina Keco, Britney Cubley

Louisiana Journal of Counseling

The suicide rate among Asian American adolescents has sharply increased in recent years. This article examines the factors which influence suicidal ideation, predictors of suicide, and treatment approaches for Asian American adolescents. It is imperative that mental health professionals understand the risk factors which may predict suicidal ideation. Predictors of suicide for Asian American adolescents include mental health issues, family dynamics, and academic and societal expectations and perceived pressures. Asian American adolescents report higher levels of depression and anxiety than their European American counterparts. The risk of suicide is likely to decrease when Asian American adolescents have supportive families. In …