Medicine and Health Sciences Commons^™

Extracorporeal Machine Perfusion May Be A Way To Increase Transplant Donor Reserves, Troy Mohamed, Emily Terrebonne, Susan Kartiko

URGENT Matters

No abstract provided.

Association Of Sustained Low Or High Income And Income Changes With Risk Of Incident Type 2 Diabetes Among Individuals Aged 30 To 64 Years, Jimin Clara Park, Ga Eun Nam, Jinna Yu, Ketrell L. Mcwhorter, Junxiu Liu, Hong Seok Lee, Seong-Su Lee, Kyungdo Han

UK CARES Faculty Publications

IMPORTANCE Evidence of the association between income fluctuation and risk of type 2 diabetes (T2D) is scarce.

OBJECTIVE To investigate whether sustained low or high income and income changes are associated with incidence of T2D.

DESIGN, SETTING, AND PARTICIPANTS In this population-based cohort study, more than 7.8 million adults without T2D aged 30 to 64 years from a nationally representative sample from the Korean Health Insurance Service database were enrolled in 2012 and followed up to 2019 (median follow-up, 6.3 years [IQR, 6.1-6.6 years]).

EXPOSURES Twenty quantiles of monthly health insurance premiums determined income levels. Income quartiles were annually analyzed …

Self-Care Narratives: Life Stories Of Rural Adults Managing Chronic Illness Without Insurance, Jean E. Montgomery

Nursing Dissertations - Archive

Uninsured rural adults with chronic illness are more likely to experience worse outcomes than insured individuals. Without access to healthcare or insurance, self-care is an important variable in the management of chronic illness in this rural population. Although rural safety-net programs have been implemented for decades, research on the effectiveness of these programs and self-care is rare and limited. Rural health disparity persists while voices from this marginalized population have gone unheard. The purpose of this study was to give them a voice by capturing first person storied accounts of self-care from chronically ill, uninsured, rural non-elderly adults and to …

The Relationship Between Nurse Professional Development Practitioners’ Perceptions Of Empowerment In The Workplace And Intent To Stay Post Covid-19 Pandemic, Tashiana Roberts-Jackson

Nursing Dissertations - Archive

Nurse Professional Development (NPD) practitioners in the acute care hospital setting are often undervalued despite their crucial role. During the COVID-19 pandemic, they demonstrated adaptability by rapidly transitioning to virtual formats for onboarding nursing staff, while also shouldering the responsibility of ensuring staff competency in caring for COVID-19 patients. Additionally, NPD practitioners faced heavy workloads, having to retrain nursing staff who worked in indirect patient care roles, while also filling in during critical staffing shortages. To date, no studies have been found that explored key factors that predict intent to stay in the NPD practitioner population pre- or post-pandemic. Thereby, …

Association Of Amnioinfusion Volume At The Time Of Surgery For Twin-Twin Transfusion Syndrome And Latency To Delivery., Braxton Forde, Foong-Yen Lim, David N Mckinney, Mounira Habli, Kara B Markham, Mallory Hoffman, Sammy Tabbah, Marc Oria, Jose L Peiro

Women’s Health Articles

OBJECTIVE: To evaluate the impact of amnioinfusion and other peri-operative factors on pregnancy outcomes in the setting of Twin-twin transfusion syndrome (TTTS) treated via fetoscopic laser photocoagulation (FLP).

METHODS: Retrospective study of TTTS treated via FLP from 2010 to 2019. Pregnancies were grouped by amnioinfusion volume during FLP (< 1 L vs. ≥1 L). The primary outcome was latency from surgery to delivery. An amnioinfusion statistic (AIstat) was created for each surgery based on the volume of fluid infused and removed and the preoperative deepest vertical pocket. Regression analysis was planned to assess the association of AIstat with latency.

RESULTS: Patients with amnioinfusion of ≥1 L at the time of FLP had decreased latency from surgery to delivery (61 ± 29.4 vs. 73 ± 28.8 days with amnioinfusion < 1 L, p < 0.001) and increased preterm prelabor rupture of membranes (PPROM) < 34 weeks (44.7% vs. 33.5%, p = 0.042). Amnioinfusion ≥1 L was associated with an increased risk of delivery < 32 weeks (aRR 2.6, 95% CI 1.5-4.5), 30 weeks (aRR 2.4, 95% CI 1.5-3.8), and 28 weeks (aRR 1.9, 95% CI 1.1-2.3). Cox-proportional regression revealed that AIstat was inversely associated with latency (HR 1.1, 95% CI 1.1-1.2).

CONCLUSION: Amnioinfusion ≥1 L during FLP was associated with decreased latency after surgery and increased PPROM < 34 weeks.

Prevention And Reversal Of Elastin-Associated And Phosphate-Dependent Arterial Calcification Using Targeted Nanotherapeutics In Pre-Clinical Models, Fatema Tuj Zohora

All Dissertations

Vascular calcification can be life-threatening, involving calcium phosphate crystal deposits in the blood vessels. The calcification in the intimal layer of the arterial wall is usually associated with atherosclerotic plaque build-up that, in the advanced stage, harbors ‘dispersed’ and ‘spotty’ deposits of calcium phosphate crystals in the necrotic core of the plaque. In contrast, medial arterial calcification (MAC) can form independently of atherosclerosis and appears as ‘Railroad-like’ calcific deposits along degraded elastin lamellae in the medial layer of arteries. The mechanisms of such elastin-associated medial arterial calcification and potential therapies are the key concerns of this dissertation. MAC is common …

Reducing Time From Door To Ct In Stroke Alert Patients, Jennifer Kelso Rn, Nicole Stong Rn, Dakoha Zelinsky Rn

Vizient/ AACN Nurse Residency Program™ EBP Projects

No abstract provided.

Fall Prevention In The Emergency Department, Janel Bullard Adn, Rn, Emily Clouse Bsn, Rn, Ashleigh Falcione Bsn, Rn, Tristan Heim Bsn, Rn

Vizient/ AACN Nurse Residency Program™ EBP Projects

No abstract provided.

Racial Disparities In Access To Dbs: Results Of A Real-World U.S. Claims Data Analysis, Michael Frassica, Drew S Kern, Mitra Afshari, Allison T Connolly, Chengyuan Wu, Nathan Rowland, Juan Ramirez-Castaneda, Mwiza Ushe, Claudia Salazar, Xenos Mason

Farber Institute for Neuroscience Faculty Papers

INTRODUCTION: Deep brain stimulation (DBS) is an effective and standard-of-care therapy for Parkinson's Disease and other movement disorders when symptoms are inadequately controlled with conventional medications. It requires expert care for patient selection, surgical targeting, and therapy titration. Despite the known benefits, racial/ethnic disparities in access have been reported. Technological advancements with smartphone-enabled devices may influence racial disparities. Real-world evidence investigations can shed further light on barriers to access and demographic disparities for DBS patients.

METHODS: A retrospective cross-sectional study was performed using Medicare claims linked with manufacturer patient data tracking to analyze 3,869 patients who received DBS. Patients were …

Pulmonary & Critical Care Insider: Issue 1, Bharat Bajantri Md, Sarah Ellsworth Mls

Critical Care & Pulmonary

Pulmonary & Critical Care Insider Issue 1

Compiled by Bharat Bajantri, MD, and librarian Sarah Ellsworth, MLS for the clinicians of the Pulmonary and Critical Care team of Parkview.

The goal of this newsletter is to give a brief summary of the most pertinent articles to everyday practice and an attempt to keep up with literature as best as possible. Newsletters go out every 1-2 months.

Summaries/Topics in this issue:

• Comparison of two commonly prescribed regimens of empiric antibiotics.
• Vancomycin and piperacillin-tazobactam (VPT)
• The efficacy and safety of Dupilumab in patients with COPD
• The BOREAS trial
• Simple aspiration versus chest …

Low Volume-High Risk: Pulmonary Artery Catheter Care, Tamia Lopez Bsn, Rn, Christopher Morton Bsn, Rn, Ashley Strouphauer Bsn, Rn

Vizient/ AACN Nurse Residency Program™ EBP Projects

No abstract provided.

Restrictions Are Lifted: The Effect Of Risk Perception Of Covid-19 On Future Travel Intentions Of Dutch Travellers, Rami K. Isaac

Journal of Global Hospitality and Tourism

This study aims to understand better the psychological impact of COVID-19, the risk perception, travel and destination risks of Dutch travellers and their intention to travel when travel restrictions due to COVID-19 are lifted. This study takes a step toward closing the gap in the literature as it provides new insights into the risk perceptions regarding COVID-19 and the travel intentions of Dutch travellers now that travel restrictions are lifted. This study employed a quantitative approach to market research. Questionnaire research was applied. The questionnaire is created with the web-based survey tool Qualtrics. 343 respondents filled in the questionnaire. The …

Treatment Of Post-Operative Pain In Children With Severe Neurologic Impairment, Jordan Keys, Jessica L. Bettenhausen, Jessica L. Markham, Matthew Hall

Posters

Introduction The assessment of pain in children with severe neurologic impairment (SNI) can be more challenging than in neurotypical children. Objective To describe: 1) the type, number of classes, and duration of post-operative pain medications for common procedures among children with SNI and 2) the variability in pain management strategies across children's hospitals, specifically for opioid administration. Methods This retrospective cohort study, using the Pediatric Health Information System database, included children aged 0-21 years hospitalized with SNI who underwent common procedures during 2019. We defined SNI using previously described high-intensity neurologic impairment (HINI) diagnosis codes and identified six common ( …

Patient-Therapist Congruence On Aspects Of The Therapeutic Alliance In Psychotherapy For Medically Unexplained Symptoms, Sarah Daehler

All Graduate Theses and Dissertations, Spring 1920 to Summer 2023

Medically unexplained symptoms (MUS) are physical symptoms that cannot be explained or are not sufficiently explained by medical examination. These symptoms most typically present as pain or other discomfort, and are associated with significant psychological distress, healthcare utilization, and disability. Both psychologists and medical professionals have struggled to treat this population, and MUS patients have noted their dissatisfaction with the care they receive. The present study analyzed a sample of 174 patient-therapist dyads to explore the role of congruence, or agreement, on aspects of the therapeutic alliance in therapy for MUS as congruence research has not yet been conducted in …

Positron Emission Tomography And Magnetic Resonance Imaging Methods And Datasets Within The Dominantly Inherited Alzheimer Network (Dian), Nicole S. Mckay, Brian A. Gordon, Russ C. Hornbeck, Aylin Dincer, Shaney Flores, Sarah J. Keefe, Nelly Joseph-Mathurin, Clifford R. Jack, Robert Koeppe, Peter R. Millar, Beau M. Ances, Charles D. Chen, Alisha Daniels, Diana A. Hobbs, Kelley Jackson, Deborah Koudelis, Parinaz Massoumzadeh, Austin Mccullough, Michael L. Nickels, Farzaneh Rahmani, Laura Swisher, Qing Wang, Ricardo F. Allegri, Sarah B. Berman, Adam M. Brickman, William S. Brooks, David M. Cash, Jasmeer P. Chhatwal, Gregory S. Day, Martin R. Farlow, Christian La Fougère, Nick C. Fox, Michael Fulham, Bernardino Ghetti, Neill Graff-Radford, Takeshi Ikeuchi, William Klunk, Jae-Hong Lee, Johannes Levin, Ralph Martins, Colin L. Masters, Jonathan Mcconathy, Hiroshi Mori, James M. Noble, Gerald Reischl, Christopher Rowe, Stephen Salloway, Raquel Sanchez-Valle, Peter R. Schofield, Hiroyuki Shimada, Mikio Shoji, Yi Su, Kazushi Suzuki, Jonathan Vöglein, Igor Yakushev, Carlos Cruchaga, Jason Hassenstab, Celeste Karch, Eric Mcdade, Richard J. Perrin, Chengjie Xiong, John C. Morris, Randall J. Bateman, Tammie L. S. Benzinger, Dominantly Inherited Alzheimer Network

Research outputs 2022 to 2026

The Dominantly Inherited Alzheimer Network (DIAN) is an international collaboration studying autosomal dominant Alzheimer disease (ADAD). ADAD arises from mutations occurring in three genes. Offspring from ADAD families have a 50% chance of inheriting their familial mutation, so non-carrier siblings can be recruited for comparisons in case–control studies. The age of onset in ADAD is highly predictable within families, allowing researchers to estimate an individual’s point in the disease trajectory. These characteristics allow candidate AD biomarker measurements to be reliably mapped during the preclinical phase. Although ADAD represents a small proportion of AD cases, understanding neuroimaging-based changes that occur during …

Examining The Effects Of Iron-Oxide Nanoparticles On Primary Gingival Keratinocytes For The Prevention Of Oral Disease, Jennifer C. Carranza

Dental Hygiene ETDs

Oral plaque biofilm has been identified as the primary contributor to dental conditions such as dental caries and periodontal disease that promotes a diverse and pervasive collection of microbial species to inhabit the oral cavity. Disrupting the plaque matrix early could help combat this global disease burden. This study evaluated the effect of IONPs on primary gingival keratinocytes.

Purpose: This study aimed to examine existing research regarding nanoparticles and determine if IONPs affect the PGK cell membranes with preliminary research to find the maximum lysis possible with PGK cells.

Methods: IONP core/shell syntheses were performed. Considering keratinocyte characteristics, examining data …

The Incidence And Modifiable Risk Factors For Necrotizing Enterocolitis Inpreterm Infants A Retrospective Cohort Study, Kelvin Gitau, Roseline Ochieng, Mary Limbe, Caroline Kathomi, James Orwa

Paediatrics and Child Health, East Africa

Objectives: To evaluate the incidence and modifiable risk factors for Necrotizing enterocolitis (NEC) in preterm infants born at ≤32 weeks of gestation weighing <1500 grams, at a private tertiary care hospital in Kenya.

Materials and methods: This retrospective cohort study was conducted at the Aga Khan University Hospital Neonatal Intensive Care Unit (NICU). Preterm infants born at ≤ 32 weeks’ gestation and weighing <1500 grams admitted to NICU between 2009 and 2019, were recruited into the study. The primary outcome was NEC Bell Stage IIa-IIIb based on Modified Bell’s criteria. Maternal and neonatal characteristics were evaluated. The association between variables of interest and NEC was determined using logistic regression analysis and the incidence of NEC for the study period was calculated.

Results: A total of 261 charts of infants born at ≤ 32 weeks’ gestation, weighing <1500 were reviewed, and 200 charts met the inclusion criteria. Fifteen preterm infants developed the primary outcome of interest: NEC Stage ≥2a within the first 30 days of admission. The overall incidence of NEC for the study period was 7.5%. Three risk factors were identified as significantly associated with NEC on multivariate logistic regression analysis: antenatal exposure to steroids (OR = 0.056 CI = 0.003-0.964 p = 0.047), cumulative duration of exposure to invasive mechanical ventilation (OR = 2.172 CI = 1.242-3.799 p = 0.007) and cumulative duration of exposure to umbilical vein catheter (OR = 1.344 CI = 1.08-1.672 p = 0.008).

Conclusions: The overall incidence for the study period of NEC Stage ≥ II a was 7.5%. Exposure to antenatal steroids, duration of mechanical ventilation, and duration of umbilical vein catheterization were …

Pitfalls In Machine Learning-Based Assessment Of Tumor-Infiltrating Lymphocytes In Breast Cancer: A Report Of The International Immuno-Oncology Biomarker Working Group On Breast Cancer, Jeppe Thagaard, Glenn Broeckx, Chowdhury Arif Jahangir, Sara Verbandt, Rajarsi Gupta, Reena Khiroya, Khalid Abduljabbar, Gabriela Acosta Haab, Balazs Acs, Shahin Sayed

Pathology, East Africa

Abstract: The clinical significance of the tumor-immune interaction in breast cancer is now established, and tumor-infiltrating lymphocytes (TILs) have emerged as predictive and prognostic biomarkers for patients with triple-negative (estrogen receptor, progesterone receptor, and HER2-negative) breast cancer and HER2-positive breast cancer. How computational assessments of TILs might complement manual TIL assessment in trial and daily practices is currently debated. Recent efforts to use machine learning (ML) to automatically evaluate TILs have shown promising results. We review state-of-the-art approaches and identify pitfalls and challenges of automated TIL evaluation by studying the root cause of ML discordances in comparison to manual TIL …

Spatial Analyses Of Immune Cell Infiltration In Cancer: Current Methods And Future Directions: A Report Of The International Immuno-Oncology Biomarker Working Group On Breast Cancer, David Page, Chowdhury Jahangir, Sara Verbandt, Rajarsi Gupta, Jeppe Thagaard, Reena Khiroya, Zuzana Kos, Khalid Abduljabbar, Sunil Badve, Shahin Sayed

Pathology, East Africa

Abstract: Modern histologic imaging platforms coupled with machine learning methods have provided new opportunities to map the spatial distribution of immune cells in the tumor microenvironment. However, there exists no standardized method for describing or analyzing spatial immune cell data, and most reported spatial analyses are rudimentary. In this review, we provide an overview of two approaches for reporting and analyzing spatial data (raster versus vector-based). We then provide a compendium of spatial immune cell metrics that have been reported in the literature, summarizing prognostic associations in the context of a variety of cancers. We conclude by discussing two well-described …

Dorsal Pancreas Agenesis, An Incidental Finding During Acute Appendicitis Diagnosis; A Case Report, Willbroad Kyejo, Ally Zain Ismail, Sajida Panjwani, Nancy Matillya, Ahmed Jusabani, Adil Datoo, Pilly Ally

Family Medicine, East Africa

Introduction and importance: Dorsal pancreas agenesis is a rare congenital anomaly characterized by the absence or severe underdevelopment of the dorsal pancreatic bud. We report a case of a man who presented with features of appendicitis only to the incidentally discovery of dorsal pancreas agenesis during the diagnosis of acute appendicitis. We describe our experience on radiological diagnostic formulation and work up.

Case presentation: We present the case of a 45-year-old male patient who presented to the emergency department with symptoms and signs suggestive of acute appendicitis. A computed tomography scan and laboratory investigations confirmed the diagnosis of appendicitis. Incidentally, …

An Exploratory Study Examining The Relationship Between Social Media Use And Covid-19 Vaccine Uptake In Pregnant People, Kalie Peccerillo

Health Science Doctoral Thesis

There are more than 14 million pregnancies each year in the United States and more than 85% of those pregnant people seek information online about concerns they may have relating to pregnancy complications, the newborn period, and stress. The Coronavirus (COVID-19) pandemic compounded pregnancy challenges and health considerations due to uncertainty surrounding the virus and vaccine despite the experts’ recommendations about the importance and safety of the vaccine for pregnant people. Among online information sources, social media is a key source for pregnant people seeking information. Unfortunately, social media’s impact on health decision-making is poorly understood. This is especially pronounced …

Hyperbilirubinemia, Children's Mercy Kansas City

Clinical Pathways

No abstract provided.

Laser-Induced Forward Transfer (Lift) Based Bioprinting Of The Collagen I With Retina Photoreceptor Cells, Md Shakil Arman, Ben Xu, Andrew Tsin, Jianzhi Li

Manufacturing & Industrial Engineering Faculty Publications

This study focuses on the 3D bioprinting of retina photoreceptor cells using a laser-induced forward transfer (LIFT) based bioprinting system. Bioprinting has a great potential to mimic and regenerate the human organoid system, and the LIFT technique has emerged as an efficient method for high-resolution micropatterning and microfabrication of biomaterials and cells due to its capability of creating precise, controlled microdroplets. In this study, the parameters for an effective femtosecond laser-based LIFT process for 3D bioprinting of collagen biomaterial were studied. Different concentrations of collagen I solutions were tested and 0.75 mg/ml to 1 mg/ml collagen Ⅰ was identified as …

The Mediation Effects Of Adaptive Blindness Strategies On The Relation Between Institutional Betrayal From Military Sexual Assault And Mental Health Symptoms, Rachel L. Davies

Psychology Theses & Dissertations

Military sexual assault is a serious and prevalent issue. The frequency with which military sexual assault occurs and the nature of the response to these events within the military system may contribute to institutional betrayal. Institutional betrayal is the failure of an institution, such as the military, to prevent sexual assault from occurring and/or the failure to support a survivor after sexual assault. Adaptive blindness strategies are forms of coping strategies that help individuals navigate a relationship they depend on when there is a betrayal. Two adaptive blindness strategies are self-blame and minimization. Although the adaptive blindness strategies may allow …

The Lived Experiences Of 911 Dispatchers With Compassion Fatigue: An Interpretive Phenomenology, Angela Johnson

Counseling & Human Services Theses & Dissertations

911 dispatchers are the “first” first responders in an emergency and play an intrinsic role in the public safety continuum. 911 dispatchers are exposed to daily and cumulative stress from the repeated empathic engagement of those they serve, and from shift work, staffing shortages, and inability to make mistakes. However, there is a dearth of peer reviewed literature on 911 dispatchers and compassion fatigue (CF). CF is described as the emotional and physical exhaustion experienced due to the constant exposure to the trauma of others. CF symptomology in 911 dispatchers has far reaching implications for not only the citizens …

Teaching Social Determinants Of Health In Physical Therapist Professional Education Programs: Exploring Curricular Approaches And Examining An Assessment Tool, Emily Jordan Hawkins

Rehabilitation Sciences Theses & Dissertations

There is a growing emphasis and need for physical therapists (PTs) to serve not only as clinicians but also as advocates to pursue health equity. Clinical practice for preventing and rehabilitating injuries and promoting physical activity will not eliminate health disparities resulting from the social determinants of health (SDH). Leaders in the field of physical therapy have charged physical therapist professional education programs to teach future PTs to address SDH, however, as of August 2023, the Standards and Required Elements for Accreditation of Physical Therapist Education Programs does not specifically require curricular content regarding SDH. The purposes of this dissertation …

Antipsychotics And Weight Gain Education, Gabrielle Altieri Bsn, Rn, Jennifer Bush Bsn, Rn, Ashley Gonzalez Bsn, Rn, Jessica Groelly Adn, Rn, Ruth Morales Bsn, Rn

Vizient/ AACN Nurse Residency Program™ EBP Projects

No abstract provided.

Initiating Consistent Bedside Shift Report, Amanda Mclean Listopad Adn, Rn, Jacquelin Campbell Adn, Rn, Bruse Ogilvie Adn, Rn, Stephanie Kunkle Adn, Rn

Vizient/ AACN Nurse Residency Program™ EBP Projects

No abstract provided.

Behavioral Health Patient Contraband/Belongings Checklist Use At Schuylkill Emergency Department, Luciano Yourey Bsn, Rn, Tess Spitler Bsn, Rn

Vizient/ AACN Nurse Residency Program™ EBP Projects

No abstract provided.

Improved Discharge Teaching, Amanda Dickison Bsn, Rn, Yea Jin Jang Bsn, Rn, Brianna Argenziano Adn, Rn, Amanda Peters Adn, Rn, Lyndsey Dellisanti Bsn, Rn

Vizient/ AACN Nurse Residency Program™ EBP Projects

No abstract provided.