Medicine and Health Sciences Commons^™

Combinatorial Bcl2 Family Expression In Acute Myeloid Leukemia Stem Cells Predicts Clinical Response To Azacitidine/Venetoclax, Alexander Waclawiczek, Darja Karpova, Et Al.

2020-Current year OA Pubs

UNLABELLED: The BCL2 inhibitor venetoclax (VEN) in combination with azacitidine (5-AZA) is currently transforming acute myeloid leukemia (AML) therapy. However, there is a lack of clinically relevant biomarkers that predict response to 5-AZA/VEN. Here, we integrated transcriptomic, proteomic, functional, and clinical data to identify predictors of 5-AZA/VEN response. Although cultured monocytic AML cells displayed upfront resistance, monocytic differentiation was not clinically predictive in our patient cohort. We identified leukemic stem cells (LSC) as primary targets of 5-AZA/VEN whose elimination determined the therapy outcome. LSCs of 5-AZA/VEN-refractory patients displayed perturbed apoptotic dependencies. We developed and validated a flow cytometry-based "Mediators of …

Evaluating The Use Of Blood Pressure Polygenic Risk Scores Across Race/Ethnic Background Groups, Nuzulul Kurniansyah, C Charles Gu, Et Al.

2020-Current year OA Pubs

We assess performance and limitations of polygenic risk scores (PRSs) for multiple blood pressure (BP) phenotypes in diverse population groups. We compare "clumping-and-thresholding" (PRSice2) and LD-based (LDPred2) methods to construct PRSs from each of multiple GWAS, as well as multi-PRS approaches that sum PRSs with and without weights, including PRS-CSx. We use datasets from the MGB Biobank, TOPMed study, UK biobank, and from All of Us to train, assess, and validate PRSs in groups defined by self-reported race/ethnic background (Asian, Black, Hispanic/Latino, and White). For both SBP and DBP, the PRS-CSx based PRS, constructed as a weighted sum of PRSs …

Altered Signaling And Desensitization Responses In Pth1r Mutants Associated With Eiken Syndrome, Ignacio Portales-Castillo, Thomas Dean, Ross W Cheloha, Brendan A Creemer, Jean-Pierre Vilardaga, Sofya Savransky, Ashok Khatri, Harald Jüppner, Thomas J Gardella

2020-Current year OA Pubs

The parathyroid hormone receptor type 1 (PTH1R) is a G protein-coupled receptor that plays key roles in regulating calcium homeostasis and skeletal development via binding the ligands, PTH and PTH-related protein (PTHrP), respectively. Eiken syndrome is a rare disease of delayed bone mineralization caused by homozygous PTH1R mutations. Of the three mutations identified so far, R485X, truncates the PTH1R C-terminal tail, while E35K and Y134S alter residues in the receptor's amino-terminal extracellular domain. Here, using a variety of cell-based assays, we show that R485X increases the receptor's basal rate of cAMP signaling and decreases its capacity to recruit β-arrestin2 upon …

Ultrasound Visual Biofeedback Training For Speech Language Pathology Students: A Single Case Design, Ahmed Rivera Campos, Jyl Ristau

Teaching and Learning in Communication Sciences & Disorders

This study examined the effectiveness of an ultrasound visual biofeedback (UVB) training on speech-language pathology (SLP) students’ assessment of sonographic tongue configuration. This study examined the presence of a functional relation between an ultrasound visual biofeedback (UVB) training within the Participatory Adult Teaching Strategy framework and speech-language pathology (SLP) students’ assessment of sonographic tongue configuration. Method: This study employed a multiple baseline, single-case design across participants and behaviors for data collection and analysis. Four graduate and three undergraduate level SLP students participated. Results: Percentage of goal obtained indicated that training was effective across participants and behaviors for teaching SLP students …

Structured Ethics Education In Speech-Language Pathology Graduate Students, Jennifer N. Gaylord, Stephanie M. Schaaf, Laura Liljequist, Kristie Guffey Ed.D.

Teaching and Learning in Communication Sciences & Disorders

This investigation compared the effect of ethics training embedded within a curriculum to structured ethics training regarding the ethics knowledge and self-reported comfort levels of first-year graduate students in speech-language pathology. Two equal, non-randomized groups of participants completed an ethics test and survey at three different times over the course of the investigation. The test and survey were administered prior to and after structured ethics training and ethics training embedded within the curriculum. The results of this study showed a significant difference in ethics knowledge after completion of the structured ethics training module for both groups. After receiving structured ethics …

Student Preferences For Active Learning And Their Beliefs, Experiences, And Knowledge, Tammy Shilling, Jerome Thayer, Anneris Coria-Navia, Heather Ferguson

Teaching and Learning in Communication Sciences & Disorders

Active teaching methods are believed to facilitate higher-order thinking skills and prepare allied health students for independent clinical decision-making. This quantitative, correlational study aimed to explain the relationships between student preferences for active over traditional methods and their beliefs, the frequency and positiveness of their experiences, and the extent of knowledge they have received regarding active and traditional teaching methods. Two hundred and thirty students completed a 53-item online survey. Students were enrolled in a Doctor of Physical Therapy, Masters in Speech-language Pathology, or Bachelor of Science Nursing program in one of seventeen participating institutions across a ten-state Midwest region. …

Enriching Pre-Clinical Education With Near-Peer Learning Experiences, Alisha P. Springle, Danika L. Pfeiffer, Corrin Gillis

Teaching and Learning in Communication Sciences & Disorders

The purpose of this mixed methods study was to examine the outcomes of two instructional methodologies (traditional and peer-assisted learning; PAL) used in a clinical methods course for undergraduate speech-language pathology (SLP) students. The sample included 53 undergraduate SLP students (near-peer learners) as well as 27 graduate SLP students and 7 clinical fellows (near-peer tutors). Traditional instruction was used during the first half of the course and PAL was added during the second half. The undergraduate SLP students’ weekly written reflections and grades (mid-term and final) were collected for analysis. Students demonstrated a preference for peer- and near-peer learning experiences …

Use Of A Standardized Tracheostomy Patient Simulation To Evaluate Student Clinical Communication Skills, Amanda Stead, Jordan Tinsley, Kerry Mandulak, Paul Michael, Helene Deiner

Teaching and Learning in Communication Sciences & Disorders

Simulation is a valid pedagogical tool used to teach students, observe student clinical skills, and to assess clinical competencies. During the COVID-19 pandemic, a lack of medical speech-language pathology placements required graduate programs to re-examine clinical training. Simulation has proven useful in providing an alternative and safe learning modality. Standardized patients, which are one simulation modality, provide increased standardization and higher fidelity than medical manikins. This is particularly true in the context of both student learning and demonstration of clinical communication skills (CCS) within a simulated learning environment where the simulated patient can interact authentically with the student clinician. CCS …

Gender Diversity Cultural Responsiveness Education In Speech-Language Pathology Graduate Programs: A Pilot Survey, Tara E. Dickinson, Molly A. Normandin, Rachel W. Mulheren

Teaching and Learning in Communication Sciences & Disorders

Purpose: Gender-affirming voice therapy aims to align a person’s voice and communication with their gender identity. Historically, transgender and gender-nonconforming (TGNC) individuals have been marginalized and continue to face significant healthcare disparities. The goal of this research was to examine the self-perceived preparedness of recent speech-language pathology (SLP) graduates for working with TGNC clients. A survey was developed to include both multiple choice and open-ended questions. Topics included graduate-level training on working with TGNC individuals, perceived preparedness to work with this client population, educational resources sought by respondents, and suggested improvements for SLP graduate programs. Thirty recent (since 2016) …

Cognitive Processes Used By Graduate Students During Case-Based Aac Assessment And Intervention Think-Aloud Tasks, Allison M. Sauerwein, Jennifer J. Thistle

Teaching and Learning in Communication Sciences & Disorders

Think-alouds are a validated data collection method that have been used across disciplines in the scholarship of teaching and learning. Scholarly teachers in CSD can use think-alouds to uncover the cognitive processes students use when completing case-based learning assignments. The purpose of the study was to identify and describe graduate students’ thought processes when planning for AAC assessment and intervention during think-aloud tasks. A total of 19 CSD graduate students were given cases and completed think-alouds in groups while planning for AAC assessment and intervention. Students’ think-alouds were recorded, transcribed, and then coded using the revised Bloom’s taxonomy. All groups …

A Survey Of Communication Sciences And Disorders Graduate Students' Perceptions Of Critical Appraisal Skills, Amanda S. Mahoney, Kendrea L. Garand, Erin G. Lundblom

Teaching and Learning in Communication Sciences & Disorders

Research shows that prerequisite courses prepare students for participation in more challenging coursework and more advanced future learning. Despite being a field that heavily relies on research evidence to inform clinical decisions as part of evidence-based practice, many undergraduate Communication Sciences and Disorder (CSD) programs do not include prerequisite undergraduate coursework dedicated to research methods. The purpose of the present study was to explore speech-language pathology and audiology graduate students’ experiences with and opinions about critical appraisal of research articles. A total of 201 graduate students from institutions nationwide completed an online survey with questions related to exposure to research …

Establishing Cueing Skills When Treating Bilingual Speech Sound Disorders, Carlos D. Irizarry-Pérez, Mirza J. Lugo-Neris, Andrea Martinez-Fisher

Teaching and Learning in Communication Sciences & Disorders

Purpose: This study sought to train cueing skills in first-year graduate students when working with bilingual children with speech sound disorders to ensure fidelity of intervention of a larger research investigation.

Method: Before explicitly training cueing skills, three students were randomly assigned bilingual clients that had been previously diagnosed with a speech sound disorder and asked to administer trial therapy. During the instructional phase, we gave students a cueing protocol, a scoring template, and feedback. We assessed performance according to challenge-point criteria and adherence to our cueing protocol.

Results: Performance varied per student, but overall scores were higher during the …

“Same But Different”: The Role And Perceptions Of The Simulation Clinical Educator, Bronwyn Davidson, Simone Howells, Rachel Davenport, Sue Mcallister, Emma Caird, Danielle Aldridge, Adriana Penman, Sally Hewat, Joanne Walters, Elizabeth Cardell, Patricia Mccabe, Alison Purcell, Elizabeth Ward, Stacey Baldac, Anne E. Hill

Teaching and Learning in Communication Sciences & Disorders

Simulated learning programs are an important component of allied health education. Although the role of simulation clinical educators has been highlighted as critical for student learning within simulation, their perceptions of their role have not yet been investigated. This study aimed to explore the experiences of simulation clinical educators. Participants were ten simulation clinical educators who had supported speech-language pathology students’ learning during a 5-day simulation program focussed on speech-language pathology practice with adult clients in acute hospital and rehabilitation settings. Educators participated in individual semi-structured interviews exploring their role and their perceptions of the simulation-based learning program. Data were …

Comparison Of Vascular Dopplers In Measuring Limb Occlusion Pressure For Blood Flow Restriction Therapy, Kiara Barrett, Logan Page, Marcin Szczyglowski, Tyler Martin, J. Grant Mouser

Topics in Exercise Science and Kinesiology

Topics in Exercise Science and Kinesiology Volume 4: Issue 1, Article 7, 2023. The use of blood flow restriction is becoming more common and requires the use of individualized pressures in order to remain a safe and effective rehabilitation modality. Measuring limb occlusion pressure (LOP) allows the practitioner to set the restriction pressure so that full occlusion does not occur. Objective: Compare a research-grade clinical vascular doppler and a consumer-grade vascular doppler in the measurement of LOP. Design: A randomized crossover design measuring LOP in the upper and lower body. Methods: 20 participants (men=10) visited the laboratory on one occasion. …

Radiologic And Histologic Findings Of Locally Advanced Mucoepidermoid Carcinoma Managed With Total Surgical Excision, Christopher R. Huber, Don Truong, Joseph Hatem, Joel Thompson, Bryan Scott

Advances in Clinical Medical Research and Healthcare Delivery

The present case report provides images from computed tomography and histology of a patient with a salivary gland neoplasm consistent with mucoepidermoid carcinoma.

Comparing Pleural Fluid Removal Volume And Oxygenation Change In Therapeutic Thoracentesis: Is There A Relationship?, Hannah Zazulak, Ryanne Burke, Andrea Bodine

Advances in Clinical Medical Research and Healthcare Delivery

Background: During therapeutic thoracentesis (TT), pleural fluid is typically drained to completion. Fluid removal improves oxygenation, and the amount of fluid removed is directly associated with the risk of serious complications. A relationship between the amount of fluid removed during TT and the change in oxygenation has not been found in the literature. A direct relationship was hypothesized in this study. Differences in the change in oxygenation between sexes, age, and pre-procedure oxygen support were secondarily hypothesized. This information would assist in the guidance of future TT protocols.

Methods: Subjects of this retrospective cohort study were males and females aged …

Death After Marijuana Use In A 27-Year-Old Male: A Case Report, Samantha M. Lavertue*, Sadie Signorella*, Rohail Baig, Amarah Emerson, John Joyce, Roland Zhang

Advances in Clinical Medical Research and Healthcare Delivery

The dangers of marijuana use are well documented across most body systems. We report a 27-year-old male who ingested marijuana and then experienced an ST-elevation myocardial infarction, subsequent cerebrovascular accident, and death within the span of a week. Toxicology reports were positive for THC only, echocardiography revealed diffuse hypokinesis with an ejection fraction estimated at 15-20%, and troponins peaked at greater than 270,000 pg/mL. Due to decreased Glasgow Coma Score and hemodynamic instability, the patient was not taken for cardiac catheterization, but was subsequently sedated, intubated, and placed on pressor support in the ICU. Initial brain imaging was negative for …

Late-Onset Isolated Myositis Following Transobturator Mid-Urethral Sling: A Case Report, Bruce Lee, Mohamad Mahmoud

Advances in Clinical Medical Research and Healthcare Delivery

Late onset of isolated myositis following a Transobturator (TOT) mid-urethral sling (MUS) is a rare post-operative complication.

A 38-year-old gravida 3 para 3003 with a long standing history of mixed urinary incontinence, Stage 2 anterior prolapse, dysmenorrhea, and abnormal uterine bleeding underwent a hysteroscopy with dilation and curettage, levonorgestrel intrauterine device insertion, anterior colporrhaphy, MUS insertion using the TOT approach and cystoscopy. Eight weeks post-op, she presented to the emergency room with right inguinal and low back pain, difficulty ambulating, and fevers. Magnetic Resonance Imaging (MRI) of the right hip revealed inflammatory fluid collection within the adductor brevis with posterior …

Pedagogy Of Problems, Ryan Babineau

Advances in Clinical Medical Research and Healthcare Delivery

No abstract provided.

Covid-19 Vaccination Hesitancy In Pregnancy: A Retrospective Cohort Study Of Patients’ Perceptions, Molly Schassberger, Charlotte Kirk, Samantha Fields, Carol Brenner, Andrea M. Bodine Md

Advances in Clinical Medical Research and Healthcare Delivery

COVID-19 Vaccination Hesitancy in Pregnancy: A Retrospective Cohort Study of Patients’ Perceptions

Schassberger¹, M, MS III, Kirk¹, C, MS III, Fields¹, S, MS III, Brenner¹, C, Ph.D., Bodine², A, M.D.

¹University of New England College of Osteopathic Medicine, Biddeford, Maine

²Berkshire Medical Center, Pittsfield, Massachusetts

Introduction: The COVID-19 vaccination rate of US pregnant individuals of childbearing age was 42.3%, compared to 63.7% of the total population as of 1/15/2022 despite ACOG and CDC recommendations. Our objectives were to determine patients’ perceptions on COVID-19 vaccine safety and efficacy …

Quality Improvement Project To Increase Pneumococcal Vaccination Rates In Adults With Inflammatory Bowel Diseases (Ibd) Being Treated With Immunosuppressants., Le Yu Naing, Sheza Malik, Jay Bapaye, Nagesh Jadhav

Advances in Clinical Medical Research and Healthcare Delivery

Abstract

Patients with inflammatory bowel diseases (IBD) are at an increased risk of pneumonia, and using immunosuppressive medications further increases this risk. Hospitalized patients with IBD have a significantly higher mortality rate from infections with pneumonia being one of them. The American College of Gastroenterology recommends pneumococcal vaccination for all IBD patients as a part of preventative care for IBD patients. However, compliance rates of pneumococcal vaccination in IBD patients have been very low. Quality improvement projects in this regard have been successful at demonstrating increased immunization rates. Our quality improvement project was aimed at increasing pneumococcal vaccination rates in …

Rare Case Of Late-Onset Myasthenia Gravis In A 65-Year-Old Female With Prolonged Doxycycline Use, Angel Wong, Kayvan Mirhadi

Advances in Clinical Medical Research and Healthcare Delivery

Myasthenia gravis (MG) is a rare autoimmune condition caused by antibody-mediated disruption of acetylcholine receptors (AChR) or their associated proteins. The age of onset of MG has a bimodal distribution, with a predominance of female cases in the second and third decades and a predominance of male cases in the sixth to eighth decades. MG is often unmasked by stressors such as systemic illness, medication, surgery, and pregnancy. We present a case of late-onset MG in a 65-year-old female with a recent history of prolonged doxycycline use. However, there are aspects of her past medical history, including comorbidities involving the …

Extrinsic Allergic Alveolitis: A Systematic Review Of Hla-Dr In Pigeon Breeder’S Disease, Dylan Thibaut, Ryan A. Witcher, Anitha Kunnath, James Toldi

Advances in Clinical Medical Research and Healthcare Delivery

Abstract

Introduction: Pigeon Breeder’s Pneumonitis (PBP) results due to a complex pathophysiology that includes exposure to avian antigens. Susceptibility has been linked to human leukocyte antigen (HLA) class II, though consensus has not been reached. The goal of this systematic review is to further elucidate the association between PBP and HLA-DR subtypes.

Methods: Databases utilized included PubMed, Google Scholar, ScienceDirect, and Cochrane Library. Inclusion required a minimum of three studies in English presenting HLA-DR alleles of PBP and control subgroups. Exclusion was due to insufficient data or non-feasible control groups. Forest plots were created for HLA-DR subtypes’ association …

Journal Club: Glymphatic System In Neurodegenerative Diseases, Ronald G. Lott Iii, Xavier Zonna, Samuel Wlasowicz

Advances in Clinical Medical Research and Healthcare Delivery

Neurodegenerative diseases such as Alzheimer's Disease impact a multitude of individuals worldwide. The neural Glymphatic system is a relatively newly discovered cellular transport pathway within the brain that has been implicated in neurodegenerative diseases. This article serves to provide a journal club review of current literature on the Glymphatic system to raise awareness of this system and its potential for future treatment and prevention of neurodegenerative conditions.

The Effects Of Synovial Fluid And Inflammatory Cells On Orthopaedic Implant Alloys, Lisa Phan

Theses and Dissertations (ETD)

Introduction. Total knee arthroplasty (TKA) is a common surgical procedure used to treat end-stage osteoarthritis. The implants used in TKA typically consist of a Cobalt Chromium Molybdenum (CoCrMo) femoral component and a Titanium Aluminum Vanadium (TiAlV) alloy baseplate. These metal alloys are chosen for their mechanical properties, corrosion resistance, high affinity for bone, and biocompatibility. However, they can be susceptible to mechanical and electrochemical wear, leading to the release of metal ions. Osteoarthritis and inflammation can alter the composition of Synovial Fluid (SF), potentially causing implant corrosion and the release of metal ions into the surrounding tissue. These metal ions …

A Seven-Year Review Of Hospital- Onset Clostridioides Difficile Infection Reduction And The Case For A Multidisciplinary Taskforce Approach, Peggy Brown Mph, Cic, Michelle Charles Msn, Rn-Bc, Brittany S. Thorp Mph, Kristin Sims Mph Cic Cpps Fapic, R. Scott Stienecker Md

Infection Control

Presented at the 2023 APIC Annual Conference

Background: Hospital-onset Clostridioides difficile infection is a life-threatening disease that can prolong and complicate a patient's hospitalization. To reduce HO-CDIs and ensure positive health outcomes with reduced cost, utilization of a multi-disciplinary taskforce (MDT) is key to identify gaps, develop action plans, and implement and review interventions in the most efficient and effective manner.

Methods: Over the course of seven years, two rounds of interventions were executed consecutively across a nine-hospital healthcare system to reduce HO-CDI events. The first round (Round 1) driven solely by the Infection Prevention (IP) department spanned four years …

Candida Auris Screening In The Acute Care Setting: An Infection Control Partnership Between Hospitals And Skilled Nursing Facilities, Brittany S. Thorp Mph, Peggy Brown Mph, Cic, R. Scott Stienecker Md

Infection Control

Presented at 2023 APIC Annual Conference

Background: Candida auris (C. auris) is a drug-resistant fungus that can spread easily between hospitalized patients and nursing home residents. To mitigate risk of C. auris spread, a nine-hospital healthcare system developed a C. auris screening tool in January 2020. Infection Preventionists (IPs) use the screening tool to determine which patients qualify for C. auris screening, looking specifically at the facility type where the patient came from. The IP then initiates the isolation and testing protocol with the bedside nurse and provider.

Methods: Over the course of three years, the hospital epidemiologist collected data …

Methicillin-Resistant Staphylococcus Aureus Screening Of Neonatal Intensive Care Unit Staff In An Outbreak Setting, R. Scott Stienecker Md, Fidsa, Fshea, Cic, Brittany S. Thorp Mph

Infection Control

Presented at 2023 APIC Annual Conference

In December 2020, our infection prevention (IP) department noted an increase in Methicillin-resistant Staphylococcus aureus (MRSA) isolates over baseline in the Neonatal Intensive Care Unit (NICU). Our hospital sees a steady influx of parents colonized with MRSA and our weekly screening process regularly discovers neonates that subsequently become colonized with MRSA. A doubling of the number of cases per month led to deeper investigation. Epidemiologic data were collected on the neonates and matched to their mother’s screening cultures (when obtained). Sensitivity patterns were matched, and staff noted that a single sensitivity pattern predominated

Medical School Watercooler Newsletter - June 1, 2023, Lindsey Lyle

Watercooler Newsletter

This is the June 1, 2023 edition of the Frederick P. Whiddon College of Medicine's newsletter - Watercooler.

Contents include:

• Whiddon college of medicine grieves passing of first chair of pharmacology
• Residents and fellows present at annual academic exposition
• Meet a Med Student: Kelly Blacksher
• Sehgal earns national citation for critical care medicine contributions

Musculoskeletal Injury In American Football: A Bibliometric Analysis Of The Most Cited Articles., Sohil S. Desai, Craig S. Dent, Dany B. El-Najjar, Hasani W. Swindell, Charles A. Popkin

HPD Articles

BACKGROUND: Textbook knowledge and clinical dogma are often insufficient for effective evidence-based decision making when treating musculoskeletal injuries in American football players, given the variability in presentation and outcomes across different sports and different levels of competition. Key evidence can be drawn directly from high-quality published articles to make the appropriate decisions and recommendations for each athlete's unique situation.

PURPOSE: To identify and analyze the 50 most cited articles related to football-related musculoskeletal injury to provide an efficient tool in the arsenal of trainees, researchers, and evidence-based practitioners alike.

STUDY DESIGN: Cross-sectional study.

METHODS: The ISI Web of Science and …