Medicine and Health Sciences Commons^™

Atrial Fibrillation Management In Hispanic Adults, Tania Borja

Dissertations

Background: Research has found atrial fibrillation (AF) to be the primary or a contributing cause of death on 183,321 death certificates, and an underlying cause of death for 26,535 Americans in 2019. Findings indicate an increased AF diagnosis in White people compared to racial and ethnic minorities, contrasting widespread findings of increased prevalence of cardiovascular disease and ischemic strokes in minorities. Significant disparities—by race and socioeconomic status in disease distribution and access to testing and lifesaving treatments—have been documented, specifically associated with social determinants of health (SDOH); i.e., the conditions in which people are born, grow, live, work, and age. …

Perioperative Pembrolizumab For Early-Stage Non-Small-Cell Lung Cancer, Heather Wakelee, Moishe Liberman, Terufumi Kato, Masahiro Tsuboi, Se-Hoon Lee, Shugeng Gao, Ke-Neng Chen, Christophe Dooms, Margarita Majem, Ekkehard Eigendorff, Gastón L Martinengo, Olivier Bylicki, Delvys Rodríguez-Abreu, Jamie E Chaft, Silvia Novello, Jing Yang, Steven M Keller, Ayman Samkari, Jonathan D Spicer, Keynote-671 Investigators

Faculty, Staff and Student Publications

BACKGROUND: Among patients with resectable early-stage non-small-cell lung cancer (NSCLC), a perioperative approach that includes both neoadjuvant and adjuvant immune checkpoint inhibition may provide benefit beyond either approach alone.

METHODS: We conducted a randomized, double-blind, phase 3 trial to evaluate perioperative pembrolizumab in patients with early-stage NSCLC. Participants with resectable stage II, IIIA, or IIIB (N2 stage) NSCLC were assigned in a 1:1 ratio to receive neoadjuvant pembrolizumab (200 mg) or placebo once every 3 weeks, each of which was given with cisplatin-based chemotherapy for 4 cycles, followed by surgery and adjuvant pembrolizumab (200 mg) or placebo once every 3 …

Using The Multi-Theory Model (Mtm) Of Health Behavior Change To Explain The Seeking Of Stool-Based Tests For Colorectal Cancer Screening, Manoj Sharma, Christopher Johansen, Kavita Batra, Chia-Liang Dai, Ravi Batra, Traci Hayes, Aditi Singh

Social and Behavioral Health Faculty Research

Colorectal cancer is the third most common cancer worldwide and is the second leading cause of cancer-associated deaths. While colorectal cancer is on the decline in the United States (US), disparities still exist, despite the non-invasive screening modalities, such as stool-based tests have shown themselves to be effective in the detection of colorectal cancer. Many of the existing stool-based test interventions lack the use of a contemporary theory-based approach. Given the paucity of theory-based interventions intended to promote stool-based tests, this cross-sectional study utilizes the multi-theory model (MTM) of health behavior change to explain the seeking of stool-based tests for …

Deep Brain Stimulation For Substance Use Disorder: A Systematic Review And Meta-Analysis, Nour Shaheen, Ahmed Shaheen, Can Sarica, Arun Singh, Mario Zanaty, Karim Johari, Andrew Yang, Theresa Zesiewicz, Brian Dalm, Yarema Bezchlibnyk, Andres M Lozano, Oliver Flouty

Department of Neurosurgery Faculty Papers

OBJECTIVE: Substance use disorder (SUD) is a significant public health issue with a high mortality rate. Deep brain stimulation (DBS) has shown promising results in treating SUD in certain cases. In this study, we conducted a meta-analysis to evaluate the efficacy of DBS in the treatment of SUD and reduction of relapse rates.

METHODS: We performed a thorough and methodical search of the existing scientific literature, adhering to the PRISMA guidelines, to identify 16 original studies that fulfilled our inclusion criteria. We used the evidence levels recommended by the Oxford Centre for Evidence-Based Medicine to assess bias. The R version …

Unlocking The Potential Of Kinase Targets In Cancer: Insights From Canceromicsnet, An Ai-Driven Approach To Drug Response Prediction In Cancer, Manali Singha, Limeng Pu, Gopal Srivastava, Xialong Ni, Brent A. Stanfield, Ifeanyi K. Uche, Paul J.F. Rider, Konstantin G. Kousoulas, J. Ramanujam, Michal Brylinski

School of Medicine Faculty Publications

Deregulated protein kinases are crucial in promoting cancer cell proliferation and driving malignant cell signaling. Although these kinases are essential targets for cancer therapy due to their involvement in cell development and proliferation, only a small part of the human kinome has been targeted by drugs. A comprehensive scoring system is needed to evaluate and prioritize clinically relevant kinases. We recently developed CancerOmicsNet, an artificial intelligence model employing graph-based algorithms to predict the cancer cell response to treatment with kinase inhibitors. The performance of this approach has been evaluated in large-scale benchmarking calculations, followed by the experimental validation of selected …

A Cryptic Microdeletion Del(12)(P11.21p11.23) Within An Unbalanced Translocation T(7;12)(Q21.13;Q23.1) Implicates New Candidate Loci For Intellectual Disability And Kallmann Syndrome, Afif Ben-Mahmoud, Shotaro Kishikawa, Vijay Gupta, Natalia T. Leach, Yiping Shen, Oana Moldovan, Himanshu Goel, Bruce Hopper, Kara Ranguin, Nicolas Gruchy, Saskia M. Maas, Yves Lacassie, Soo Hyun Kim, Woo Yang Kim, Bradley J. Quade, Cynthia C. Morton, Cheol Hee Kim, Lawrence C. Layman, Hyung Goo Kim

School of Medicine Faculty Publications

In a patient diagnosed with both Kallmann syndrome (KS) and intellectual disability (ID), who carried an apparently balanced translocation t(7;12)(q22;q24)dn, array comparative genomic hybridization (aCGH) disclosed a cryptic heterozygous 4.7 Mb deletion del(12)(p11.21p11.23), unrelated to the translocation breakpoint. This novel discovery prompted us to consider the possibility that the combination of KS and neurological disorder in this patient could be attributed to gene(s) within this specific deletion at 12p11.21-12p11.23, rather than disrupted or dysregulated genes at the translocation breakpoints. To further support this hypothesis, we expanded our study by screening five candidate genes at both breakpoints of the chromosomal translocation …

Implementing Text-Messaging To Support And Enhance Delivery Of Health Behavior Change Interventions In Low- To Middle-Income Countries: Case Study Of The Lifestyle Africa Intervention., Frank T. Materia, Joshua M. Smyth, Thandi Puoane, Lungiswa Tsolekile, Kathy Goggin, Stephen R. Kodish, Andrew T. Fox, Ken Resnicow, Scott Werntz, Delwyn Catley

Manuscripts, Articles, Book Chapters and Other Papers

The prevalence of non-communicable diseases, such as diabetes and cardiovascular disease, is rising in low- and middle-income countries (LMICs). Health behavior change (HBC) interventions such as the widely used Diabetes Prevention Program (DPP) are effective at reducing chronic disease risk, but have not been adapted for LMICs. Leveraging mobile health (mHealth) technology such as text messaging (SMS) to enhance reach and participant engagement with these interventions has great promise, yet we lack evidence-informed approaches to guide the integration of SMS specifically to support HBC interventions in LMIC contexts. To address this gap, we integrated guidance from the mHealth literature with …

Multifocal And Multicentric Glioblastoma: Imaging Signature, Molecular Characterization, Patterns Of Spread, And Treatment, Maguy Farhat, Gregory N Fuller, Max Wintermark, Caroline Chung, Vinodh A Kumar, Melissa Chen

Faculty, Staff and Student Publications

Multifocal and multicentric glioblastoma (GBM) or collectively, m-GBM, is an imaging diagnosis present in up to 34% of patients with GBM. Compared to unifocal disease, patients with m-GBM have worse outcomes owing to the enhanced aggressive nature of the disease and its resistance to currently available treatments. To improve the understanding of its complex behavior, many associations have been established between the radiologic findings of m-GBM and its gross histology, genetic composition, and patterns of spread. Additionally, the holistic knowledge of the exact mechanisms of m-GBM genesis and progression is crucial for identifying potential targets permitting enhanced diagnosis and treatment. …

Strategies For The Genomic Analysis Of Admixed Populations, Taotao Tan, Elizabeth G Atkinson

Faculty, Staff and Students Publications

Admixed populations constitute a large portion of global human genetic diversity, yet they are often left out of genomics analyses. This exclusion is problematic, as it leads to disparities in the understanding of the genetic structure and history of diverse cohorts and the performance of genomic medicine across populations. Admixed populations have particular statistical challenges, as they inherit genomic segments from multiple source populations-the primary reason they have historically been excluded from genetic studies. In recent years, however, an increasing number of statistical methods and software tools have been developed to account for and leverage admixture in the context of …

Generation Of A Novel Stra8-Driven Cre Recombinase Strain For Use In Pre-Meiotic Germ Cells In Mice†, Avery A Ahmed, Ernesto Salas, Denise G Lanza, Jason D Heaney, Stephanie A Pangas

Faculty, Staff and Students Publications

The development of oocytes occurs over a broad time frame, starting at the earliest stages of embryogenesis and continuing into adulthood. Conditional knockout technologies such as the Cre/loxP recombination system are useful for analyzing oocyte development at specific stages, but not every time frame has appropriate Cre drivers, for instance, during oocyte meiotic initiation through early prophase I in the embryo. Here, we generated a novel knockin mouse line that produces a bicistronic transcript from the endogenous Stra8 locus that includes a "self-cleaving" 2A peptide upstream of cre. This allows for high efficiency cleavage and production of both proteins individually …

Author Correction: Membrane Translocation Process Revealed By In Situ Structures Of Type Ii Secretion System Secretins, Zhili Yu, Yaoming Wu, Muyuan Chen, Tong Huo, Wei Zheng, Steven J Ludtke, Xiaodong Shi, Zhao Wang

Faculty, Staff and Students Publications

No abstract provided.

Understanding Disruptions In Cancer Care To Reduce Increased Cancer Burden, Kia L Davis, Nicole Ackermann, Lisa M Klesges, Nora Leahy, Callie Walsh-Bailey, Sarah Humble, Bettina Drake, Vetta L Sanders Thompson

2020-Current year OA Pubs

BACKGROUND: This study seeks to understand how and for whom COVID-19 disrupted cancer care to understand the potential for cancer health disparities across the cancer prevention and control continuum.

METHODS: In this cross-sectional study, participants age 30+residing in an 82-county region in Missouri and Illinois completed an online survey from June-August 2020. Descriptive statistics were calculated for all variables separately and by care disruption status. Logistic regression modeling was conducted to determine the correlates of care disruption.

RESULTS: Participants (N=680) reported 21% to 57% of cancer screening or treatment appointments were canceled/postponed from March 2020 through the end of 2020. …

First-Line, Fixed-Duration Nivolumab Plus Ipilimumab Followed By Nivolumab In Clinically Diverse Patient Populations With Unresectable Stage Iii Or Iv Melanoma: Checkmate 401, Reinhard Dummer, Pippa Corrie, Ralf Gutzmer, Tarek M. Meniawy, Michele Del Vecchio, Céleste Lebbé, Michele Guida, Caroline Dutriaux, Brigitte Dreno, Nicolas Meyer, Pier F. Ferrucci, Stéphane Dalle, Muhammad A. Khattak, Jean-Jacques Grob, Karen Briscoe, James Larkin, Sandrine Mansard, Thierry Lesimple, Massimo Guidoboni, Silvia Sabatini, Erika Richtig, Rudolf Herbst, Maurice Lobo, Margarita Askelson, Paolo A. Ascierto, Michele Maio

Research outputs 2022 to 2026

PURPOSE: To address the paucity of data in patients with historically poor outcomes, we conducted the single-arm phase IIIb CheckMate 401 study to evaluate the safety and efficacy of nivolumab plus ipilimumab followed by nivolumab monotherapy in clinically diverse patient populations with advanced melanoma. METHODS: Treatment-naive patients with unresectable stage III-IV melanoma received nivolumab 1 mg/kg plus ipilimumab 3 mg/kg once every 3 weeks (four doses) followed by nivolumab 3 mg/kg (240 mg following a protocol amendment) once every 2 weeks for ≤ 24 months. The primary end point was the incidence of grade 3-5 select treatment-related adverse events (TRAEs). …

Optimizing Psychological Safety: Using A Focus Group To Acquire Perspectives From Standardized Patients Who Identify As Lgbtq+, Brandy Brown, Rachel Kupferman, Bethany Rocheleau, Christine Mallar, Karissa Hannifan, Beth Gray, Victoria Hayes, Leah Mallory

Journal of Maine Medical Center

Introduction: Gender and sexual minority (lesbian, gay, bisexual, transgender, questioning; LGBTQ+) patients report poor health care experiences, partly because health care providers are not trained to meet their needs. Simulation can help learners practice competencies related to diversity, equity, and inclusion, but there are psychological safety considerations when recruiting standardized patients (SPs). Our objective was to incorporate the expertise of members of the LGBTQ+ community in our SP pool as we developed related curriculum.

Methods: All SPs were invited to participate in a focus group if they identified as LGBTQ+ and wanted to contribute. Content experts developed a focus group …

Improving Inclusive Communication: Pilot Results From A Simulation-Based Learning Opportunity To Practice Taking A Sexual Health History, Rachel Kupferman, Beth Gray, Bethany Rocheleau, Christine Mallar, Karissa Hannifan, Victoria Hayes, Leah Mallory, Brandy Brown

Journal of Maine Medical Center

Introduction: Sexual and gender minority (lesbian, gay, bisexual, transgender, questioning; LGBTQ+) patients experience health care inequities. Simulation using standardized patients (SPs) is an effective tool for communication-based training. To promote equitable practice, we created an experiential learning opportunity for residents to practice inclusive communication and improve their comfort in caring for LGBTQ+ patients while maintaining the psychological safety of SPs.

Methods: Our interdisciplinary team explored relevant simulation curricula, conducted a focus group with LGBTQ+ SPs, created a didactic presentation, and designed and implemented a simulated case. Family medicine residents participated in the training and completed pre- and post-training surveys rating …

A.T. Still, School Of Osteopathic Medicine - Volume 1 Issue 1, August 2023 Full Issue, Editors ,

Intellectus

No abstract provided.

Under One Roof – An Integrated Clinic For Substance Use Disorder And Viral Hepatitis/Hiv Treatment, Sarah Hipkens, Emily Caron, Wendy Craig, Kinna Thakarar

Journal of Maine Medical Center

Introduction: Integration of viral hepatitis/HIV care and substance use disorder (SUD) treatment has been shown to improve patient outcomes, but data are lacking in rural states like Maine. Our study objective was to assess the baseline characteristics and outcomes of patients with SUD who receive combined substance use and viral hepatitis/HIV treatment at a recently established “Bridge Program” in our rural state.

Methods: We conducted a retrospective chart review of patients enrolled in the Bridge Program between January 2020 and November 2021. We then performed a descriptive analysis of demographics, health characteristics, preventive services, and treatment outcomes.

Results: A total …

Breastfeeding Education Of Medical Students And Resident Physicians, Kathleen E.H. Douangchak D.O.

Intellectus

Breastfeeding is widely recognized for its medical and neurodevelopmental benefits, leading to the American Academy of Pediatrics (AAP) recommending exclusive breastfeeding for the first 6 months of an infant’s life with continuation through 2 years of age and beyond.1 However, this literature review finds that despite the 2022 update to the AAP’s recommendations, education on breastfeeding for physicians-in-training is inadequate. Though interventions have been shown to increase the breastfeeding knowledge and confidence of physicians, more research is needed to evaluate the efficacy of educational interventions. This paper emphasizes the urgency of implementing comprehensive interventions that address the gaps in breastfeeding …

Preparing For Pandemics: Lesson Plan Design For Children In Elementary School, Daniella Rivera, Enkhtsogt (Steve) Sainbayar, Saleem Choudry, Brittany Vaughn Pierce, Roxana Nouri-Nikbakht, Joy H. Lewis D.O., Phd

Intellectus

Context: The COVID-19 pandemic necessitated distance learning to attenuate the spread of the virus, and school-aged children were particularly affected by this change. Because of their age and education level, children generally lacked understanding about the pandemic and the preventive measures necessary to prevent the spread of this and other infectious diseases. It is unknown how many schools nationwide incorporated disease-prevention education in their curriculums during the pandemic. Therefore, developing distance learning interventions that convey these topics at their level of understanding is important to improve health literacy and raise their awareness of factors that positively influence health.

Objective: To …

Integration Of A Culturally Appropriate Method Of Delivering Health Information In A Non-Clinical Setting, Nancy Nguyen, Merett Saad, Andrew Vo, Alejandro Castaneda, Uriel Martinez, Jonathan Do, Kevin Trembley, Imran Javaid, Hargurbir Alhuwalia, Jaskirat Malhi, Carolina Quezada M.D., Joy H. Lewis D.O., Phd

Intellectus

Context:

A.T. Still University School of Osteopathic Medicine in Arizona (ATSU-SOMA) has an established partnership with Family HealthCare Network (FHCN). Initial meetings with the local community outreach department identified that a substantial majority of the Hispanic population served by this health center may lack access to health education. In particular, Spanish-speaking patients at the health center may face language barriers that impair the transfer of health education between the providers, patients, and their families.

Objective:

The purpose of this study was to provide health educational presentations in Spanish in order to improve health knowledge relating to women’s and children’s health. …

Covid-19 Infection With Severe Hypothermia In A Fully Vaccinated Patient, Kathleen E.H. Douangchak

Intellectus

Hypothermia is an uncommon presentation of COVID-19 infection, typically observed in patients with severe disease prior to the availability of vaccines. However, the occurrence of hypothermia in vaccinated patients with COVID-19 disease has not yet been documented. This case reports a rare presentation of severe hypothermia in a 41-year-old female with COVID-19 disease, who suffered from several comorbidities, including heart failure with preserved ejection fraction, chronic pericardial effusion, nephrotic syndrome, CKD 4, hypertension, type 2 diabetes, thyroid cancer status post-thyroidectomy with resultant postsurgical hypothyroidism, glaucoma, and anemia of chronic disease. Upon presentation, the patient was encephalopathic with hypothermia of 27.2 …

Responding To Disproportionate Skin Cancer Rates Affecting Adult Men Aged 18-60, Aaron Thompson

Capstone Collection

Skin cancer is a deadly disease that kills significantly more men than women every year. At the same time, women are more than twice as likely to apply daily sun protection factor (SPF) than men. This research study explores how key stakeholders within the skin care industry have responded to the data showing increasing disparities between male and female skin cancer rates. To fulfill the objectives of this research study, qualitative data was collected from six semi-structured interviews with adult males between the ages of 18 and 60. The interviews were intentionally designed to engage with the American, adult male’s …

Ots Role In The Interdisciplinary Team With Partial Hand Amputations And Prosthetics, Ashley Soebbing, Amy Lyons-Brown

Summer 2023 Virtual OTD Capstone Symposium

A mixed methods study that explores the barriers within the healthcare system to receiving a referral to a prosthetist after partial hand amputation.

Micromanagement In Clinical Supervision: A Scoping Review., Jihyun Lee, Solmoe Ahn, Marcus A. Henning, J M Monica Van De Ridder, Vijay Rajput

HPD Articles

Micromanagement in clinical supervision in health professions education generally refers to supervision characterized by unproductive excessive control and attention to detail. It can affect autonomy, competence, well-being of learners, teamwork, and ultimately patient care. Despite its potential negative impact on learners and patients, no comprehensive review of this phenomenon has been conducted. This scoping review aims to explore the breadth of extant literature concerning micromanagement in clinical supervision in health professions education and map the body of research on the topic. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis: Extension for Scoping Review (PRISMA-ScR). We searched eight …

Supporting Oaxacan Youth Mental Health, Academic Achievement, And Cultural Connection, Itahi Arteaga, Jazminne Orozco Arteaga, Rebecca Heymann

Summer 2023 Virtual OTD Capstone Symposium

Oaxacan Indigenous youth in the U.S. experience generational, cultural, and social conflicts that impact their participation, performance, and well-being, yet there are no occupation-based programs that address their mental health, academic achievement, and cultural connection In San Diego.

The purpose of the capstone project was to develop a culturally-informed occupational therapy program for Oaxacan indigenous youth that will motivate and provide the skills needed to navigate different cultures while encouraging belonging.

A Website To Prepare Older Adults For Driving Cessation, Shelbi Picard, Steven M. Gerardi, Elizabeth Deluca

Summer 2023 Virtual OTD Capstone Symposium

Driving cessation, or the complete discontinuation of operating a vehicle, can result in a loss of independence and a decrease in life satisfaction (Chihuri, et al., 2016). This loss of independence is linked to a lack of knowledge on alternative options on community mobility (Liddle, et al., 2014). This leads to drivers to not want to stop driving when they are no longer safe to drive. Although there are some resources on driving cessation available online for guiding older adults in transition from driving to non-driving, they are not consolidated in one place for ease of understanding.

Identifying Ebp Using The Moho Framework To Address Generalized Anxiety Disorder (Gad): A Scoping Review, Alexus Njemanze, Karen Aranha, Angela Labrie Blackwell

Summer 2023 Virtual OTD Capstone Symposium

Individuals with Generalized Anxiety Disorder (GAD) have poorer physical rehabilitation. Identifying this condition and providing targeted interventions is necessary better to address the needs of this population's rehabilitation. This study examined the literature to identify screens, assessments, and interventions to address GAD to improve Occupational Therapy (OT) rehabilitation outcomes.

Profiling And Verifying The Substrates Of E3 Ubiquitin Ligase Rsp5 In Yeast Cells, Shuai Fang, Geng Chen, Yiyang Wang, Rakhee Ganti, Tatiana A Chernova, Li Zhou, Savannah E Jacobs, Duc Duong, Hiroaki Kiyokawa, Yury O Chernoff, Ming Li, Natalia Shcherbik, Bo Zhao, Jun Yin

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Yeast is an essential model organism for studying protein ubiquitination pathways; however, identifying the direct substrates of E3 in the cell presents a challenge. Here, we present a protocol for using the orthogonal ubiquitin transfer (OUT) cascade to profile the substrate specificity of yeast E3 Rsp5. We describe steps for OUT profiling, proteomics analysis, in vitro and in cell ubiquitination, and stability assay. The protocol can be adapted for identifying and verifying the ubiquitination targets of other E3s in yeast. For complete details on the use and execution of this protocol, please refer to Wang et al.

Raising Awareness For Occupational Therapy's Role With Systemic Lupus Erythematosus (Sle), Madelyn Cabrera, Jazminne Orozco Arteaga, Amy Lyons-Brown

Summer 2023 Virtual OTD Capstone Symposium

This capstone project aims to raise awareness for occupational therapy's (OT) role in managing systemic lupus erythematosus (SLE) through education and to advocate OT's role within the SLE healthcare team. This project aims to understand the daily barriers that SLE patients experience and raise awareness for OT's role with SLE patients, OTs in practice, OT students, and healthcare professionals involved in SLE care. It also advocates for OT's role in comprehensive care for SLE patients to assist in disease/lifestyle management and improved quality of life.

The Dnp Is A Mess, Martin Schiavenato

Nursing Faculty Scholarship

No abstract provided.