Medicine and Health Sciences Commons^™

Epidemiology Of Island And Mainland Populations: How Does Culture Influence Health Risk Factors Of Non-Communicable, Chronic, And Metabolic Diseases?, Jake Thomas D. Palisoc

Honors Projects

Non-communicable diseases (NCDs), including chronic and metabolic diseases, are responsible for 74% of global mortality and are strongly influenced by health risk factors. Geographical differences in NCDs have been identified in several countries but have not been completely explained through cultural factors, specifically island and mainland cultures. This study aimed to develop an epidemiological framework for determining diseases with the highest mortality for further investigation regarding different health risk factors rooted in a specific population’s cultural foundations. Preliminary findings indicated diabetes type II (D2) and CKD caused by hypertension and D2 to have the highest risk factor and mortality percentage …

Acute Diplopia After Glabellar Hyaluronic Acid Filler Injection, Caroline W. Chung, Eric J. Shiuey, César A. Briceño, Vivian Lee

SKMC Student Presentations and Publications

Purpose: Blindness is a well-known complication of filler injection in the glabellar region. Acute diplopia from filler injection without vision loss is a rare complication that typically results in clinical ophthalmoplegia which can have permanent sequelae. Here, we describe a patient who presented with acute diplopia with grossly intact full extraocular motility after glabella hyaluronic acid filler injection that resolved after 1 month.

Observations: A previously healthy 43-year-old woman underwent her first hyaluronic acid injection in the glabella and developed immediate binocular double vision with severe pain and skin mottling above her right eyebrow and central forehead. Hyaluronidase injections, nitroglycerin …

The Role Of Complement In Stroke And Traumatic Brain Injury, Christine Couch

MUSC Theses and Dissertations

Brain and neural injury are a non-specific disease category that includes traumatic brain injury (TBI) and stroke. Both TBI and stroke are common, costly, and leading causes of severe disability in adults. Both stroke and TBI are responsible for substantial disability in working age adults, with stroke being the second leading cause of death worldwide [1] and TBI a major cause of disability in people younger than their 40's [2]. The immune response after brain injury is multifactorial and involves both local and systemic events at the cellular and molecular level. The complement system is a component of both the …

Photoisomerizable Membrane Active Peptides, Cristina Ventura

Seton Hall University Dissertations and Theses (ETDs)

Membrane active peptides (MAPs) bind and partition into the cell membrane thus causing permeabilization. Many α-helical membrane active peptides contain central proline residues that distinguish the hydrophobic and hydrophilic faces of the helix. The proline induces a bend that produces a helix-hinge-helix motif. Mutation of these proline residues has a significant effect on the activity of the MAP. Azobenzene is a photoisomerizable molecule that switches from its trans to cis isomer upon excitation with ultraviolet (UV) light and from its cis to trans isomer upon excitation with visible light (VL). In this work it is hypothesized that the hinge function …

Synthesis, Characterization And Biological Evaluation Of Polyarginine Derived Bone-Targeting Peptides, Gina L. Antuono

Seton Hall University Dissertations and Theses (ETDs)

Osteoblast-targeting peptides in the treatment of bone disease is a new and novel approach to offering effective treatment of various cancers and can be used in bio-medical, medicinal chemistry and biotechnology applications. By targeting adhesion proteins produced by osteoblast cells, certain cancers which migrate and metastasize to the bone may be more effectively treated. An osteoblast-targeting peptide composed of Ser-Asp-Ser-Ser-Asp (SDSSD) which selectively binds to osteoblast cells via periostin has recently been identified. This peptide was functionalized with polyurethane, generating nanomicelles which encapsulated RNA for the therapeutic treatment of osteoporosis. This study has served as the basis for the research …

Creating Warm Hand-Offs For Patients Who Have Experienced A Recent Suicide Attempt, Edward R. Norris Md, Fapa, Fapm, Brian Chilcote Lcsw, Ashley Felker Lpc

Department of Psychiatry

No abstract provided.

Using Drama Therapy To Foster Peer Support Among Nurse Leaders, Chyela Rowe

Expressive Therapies Dissertations

This study explored the use of drama therapy to support the social-emotional experiences of nurse leaders at a mid-sized regional hospital system in the Southeastern United States. Nurse leaders have experienced profound changes to their work environments in recent years and burnout has been at an all-time high among healthcare workers globally. Organizational supports for nurses and nurse leaders are both inadequate to meet the needs and under-resourced. The research questions explored 1) whether the drama therapy peer support initiative improved outcomes and 2) whether there was a significant relationship between measures, and 3) what nurse leaders described as facilitators …

How Alzheimer's Disease Is Taking Over (Your Brain), Hoda Aboueich

Honors Projects

As the population continues to age and the burden on our care system grows, it is urgent to understand, treat, and cure Alzheimer’s Disease (AD). Despite decades of research, there is currently no known cause for the development of dementia or AD. There are two prominent explanations currently dominant in neuroscience: amyloid plaques and neurofibrillary tangles. I will delve into the hypotheses and definitions of each of these pathologies and specifically address how they affect overall neural activity that is proposed to result in the neurodegenerative symptoms of AD. I will also discuss the recent research surrounding biomarkers, age-related neurodegeneration, …

Social Creatures: The Impact Of Solitary Confinement On Psychophysiological Health And How Inmates Percieve Their Humanity And Social Well-Being, Julia Austin

Honors Projects

This paper will define and examine the use of solitary confinement within the United States prison system and review its mental, physical, and social impacts. As social creatures, human mental and physical well-being depends on meaningful social interactions absent in segregation units. As it currently stands, vulnerable populations, including racial minorities, LGBTQIA+ individuals, and those with developmental disabilities or psychological disorders, are at risk of irrevocable harm and abuse within these facilities from staff as well as other inmates. With a rotating 80,000 inmates held in solitary confinement every day, the current structure of the prison system deemphasizes rehabilitation and …

Healthcare Employees’ Perceptions On The Effects Of Internal Audits, Jeremy Mason

MUSC Theses and Dissertations

With limited research on the perceptions of internal audits, this study was

able to add more literature to the subject. The study’s aim was to survey

employee perceptions of the effects of internal audits. This study will provide organizations with results pertaining to how employees perceive the usefulness of internal audits. The study team conducted a single-site study and invited the healthcare organization's employee population to participate in the study. The survey captured 40 responses from 361 invitees (11%). The survey explored the perceptions on six categories of internal audits: Efficiency, Ethical Behavior, Effectiveness, Auidotr-Auditee Relationship Exchange, Learning from Audit, …

Trends Over 20 Years Of Antimicrobial Prophylaxis For Artificial Urinary Sphincter Surgery, Helen H. Sun, Michael Callegari, Eric Zhou, Erin Jesse, Megan Prunty, Jonathan E. Shoag, Kyle Scarberry, Kirtishri Mishra, Shubham Gupta

Faculty Scholarship

Introduction and Objective: Perioperative antimicrobial prophylaxis is crucial for prevention of prosthesis and patient morbidity after artificial urinary sphincter (AUS) placement. While antibiotic guidelines exist for many urologic procedures, adoption patterns for AUS surgery are unclear. We aimed to assess trends in antibiotic prophylaxis for AUS and outcomes relative to American Urological Association (AUA) Best Practice guidelines. Methods: The Premier Healthcare Database was queried from 2000 to 2020. Encounters involving AUS insertion, revision/removal, and associated complications were identified via ICD and CPT codes. Premier charge codes were used to identify antibiotics used during the insertion encounter. AUS‐related complication events were …

Gp38 As A Vaccine Target For Crimean-Congo Hemorrhagic Fever Virus, Gabrielle Scher, Dennis A. Bente, Megan C. Mears, Maria N.B. Cajimat, Matthias J. Schnell

Department of Microbiology and Immunology Faculty Papers

Crimean-Congo Hemorrhagic Fever Virus (CCHFV) is a tick-borne virus that causes severe hemorrhagic disease in humans. There is a great need for effective vaccines and therapeutics against CCHFV for humans, as none are currently internationally approved. Recently, a monoclonal antibody against the GP38 glycoprotein protected mice against lethal CCHFV challenge. To show that GP38 is required and sufficient for protection against CCHFV, we used three inactivated rhabdoviral-based CCHFV-M vaccines, with or without GP38 in the presence or absence of the other CCHFV glycoproteins. All three vaccines elicited strong antibody responses against the respective CCHFV glycoproteins. However, only vaccines containing GP38 …

Facilitators And Barriers To Effective Scale-Up Of Evidence-Based Nonprofit-Level Hiv Prevention And Treatment Interventions Among Black Men Who Have Sex With Men (Msm), Ugochukwu C. Uzoeghelu

Master's Projects and Capstones

Since the scale-up of HIV/AIDS prevention evidence-based interventions (EBIs) has not been simple in nonprofit settings, it is crucial to examine processes that occur in the translation of the EBIs into practice that affect successful implementation through the lens of nonprofit principles and practices. This paper examines the facilitators and barriers to effective scale-up of evidence-based HIV prevention and treatment services for nonprofit health organizations that serve Black men who have sex with men (MSM). I interviewed nonprofit health organizations (n = 4) engaged in the global response to end the HIV epidemic, specifically those who provide HIV prevention and …

Burnout: An Examination Of How Human Services’ Cultures Impact Person-Centered Care And Job Satisfaction, Ebony Webb

Master's Projects and Capstones

In a world that demands the constant requirement of adaptability and technology, the need for ‘hands on the ground’ continues to persist, and perhaps even grow. This research project explores burnout in the healthcare and nonprofit settings, as a pre-existing and ongoing issue, that was brought to centre-stage during the Covid-19 pandemic. The researcher explores the intersections of burnout with workplace culture, person-centered care (PCC), sweat equity and duty-of-care, through expert interviews and literature reviews. Data collected provides an immediate understanding of current workplace cultures and environments for human service providers, in both healthcare and nonprofit sectors. While the data …

Phase Ii Clinical Trial Of Axitinib And Avelumab In Patients With Recurrent/Metastatic Adenoid Cystic Carcinoma, Renata Ferrarotto, Luana G Sousa, Lei Feng, Frank Mott, George Blumenschein, Mehmet Altan, Diana Bell, Flavia Bonini, Kaiyi Li, Mario L Marques-Piubelli, Eduardo A Dal Lago, Jason J Johnson, Yoshitsugu Mitani, Myrna Godoy, Anna Lee, Michael Kupferman, Ehab Hanna, Bonnie S Glisson, Yasir Elamin, Adel El-Naggar

Faculty, Staff and Student Publications

Purpose: We conducted a phase II trial evaluating the efficacy of VEGFR inhibitor axitinib and PD-L1 inhibitor avelumab in patients with recurrent/metastatic adenoid cystic carcinoma (R/M ACC).

Patients and methods: Eligible patients had R/M ACC with progression within 6 months before enrollment. Treatment consisted of axitinib and avelumab. The primary end point was objective response rate (ORR) per RECIST 1.1; secondary end points included progression-free survival (PFS), overall survival (OS), and toxicity. Simon's optimal two-stage design tested the null hypothesis of ORR ≤5% versus ORR ≥20% at 6 months; ≥4 responses in 29 patients would reject the null hypothesis.

Results: …

Magrolimab In Combination With Azacitidine In Patients With Higher-Risk Myelodysplastic Syndromes: Final Results Of A Phase Ib Study, David A Sallman, Monzr M Al Malki, Adam S Asch, Eunice S Wang, Joseph G Jurcic, Terrence J Bradley, Ian W Flinn, Daniel A Pollyea, Suman Kambhampati, Tiffany N Tanaka, Joshua F Zeidner, Guillermo Garcia-Manero, Deepa Jeyakumar, Rami Komrokji, Jeffrey Lancet, Hagop M Kantarjian, Lin Gu, Yajia Zhang, Anderson Tan, Mark Chao, Carol O'Hear, Giridharan Ramsingh, Indu Lal, Paresh Vyas, Naval G Daver

Faculty, Staff and Student Publications

Purpose: Magrolimab is a monoclonal antibody that blocks cluster of differentiation 47, a don't-eat-me signal overexpressed on cancer cells. Cluster of differentiation 47 blockade by magrolimab promotes macrophage-mediated phagocytosis of tumor cells and is synergistic with azacitidine, which increases expression of eat-me signals. We report final phase Ib data in patients with untreated higher-risk myelodysplastic syndromes (MDS) treated with magrolimab and azacitidine (ClinicalTrials.gov identifier: NCT03248479).

Patients and methods: Patients with previously untreated Revised International Prognostic Scoring System intermediate-/high-/very high-risk MDS received magrolimab intravenously as a priming dose (1 mg/kg) followed by ramp-up to a 30 mg/kg once-weekly or once-every-2-week …

Hiv-1 Transmission Among Injecting Drug Users Is Principally Derived From Local Circulating Strains In Guangxi, China, Ping Cen, Hua Yue Liang, Yuan Yang, Fei Zhang, Shi Xiong Yang, Ju Cong Mo, Yi Feng, Jie Gang Huang, Chuan Yi Ning, Chun Yuan Huang, Yao Yang, Na Liang, Bing Yu Liang, Li Ye, Hao Liang

Faculty, Staff and Student Publications

OBJECTIVE: The mode of human immunodeficiency virus (HIV) transmission

METHODS: We performed a molecular epidemiological investigation of infections across Guangxi from 2009 to 2019. Phylogenetic and Bayesian time-geographic analyses of HIV-1 sequences were performed to confirm the characteristics of transmission between IDUs in combination with epidemiological data.

RESULTS: Among the 535 subjects, CRF08_BC (57.4%), CRF01_AE (28.4%), and CRF07_BC (10.7%) were the top 3 HIV strains; 72.6% of infections were linked to other provinces in the transmission network; 93.6% of sequence-transmitted strains were locally endemic, with the rest coming from other provinces, predominantly Guangdong and Yunnan; 92.1% of the HIV transmission …

Efficacy Of A Smoking Cessation Intervention For Survivors Of Cervical Intraepithelial Neoplasia Or Cervical Cancer: A Randomized Controlled Trial, Jennifer I Vidrine, Steven K Sutton, David W Wetter, Ya-Chen Tina Shih, Lois M Ramondetta, Linda S Elting, Joan L Walker, Katie M Smith, Summer G Frank-Pearce, Yisheng Li, Sarah R Jones, Darla E Kendzor, Vani N Simmons, Damon J Vidrine

Faculty, Staff and Student Publications

PURPOSE: Women who smoke and have a history of cervical intraepithelial neoplasia (CIN) or cervical cancer represent a vulnerable subgroup at elevated risk for recurrence, poorer cancer treatment outcomes, and decreased quality of life. The purpose of this study was to evaluate the long-term efficacy of Motivation And Problem Solving (MAPS), a novel treatment well-suited to meeting the smoking cessation needs of this population.

METHODS: Women who were with a history of CIN or cervical cancer, age 18 years and older, spoke English or Spanish, and reported current smoking (≥100 lifetime cigarettes plus any smoking in the past 30 days) …

Insight Into The Desolvation Of Quaternary Ammonium Cation With Acetonitrile As A Solvent In Hydroxyl-Flat Pores: A First-Principles Calculation, Fudong Liu, Shaobin Yang, Xu Zhang, Shuwei Tang, Yingkai Xia

Faculty, Staff and Student Publications

Supercapacitors have a wide range of applications in high-technology fields. The desolvation of organic electrolyte cations affects the capacity size and conductivity of supercapacitors. However, few relevant studies have been published in this field. In this experiment, the adsorption behavior of porous carbon was simulated with first-principles calculations using a graphene bilayer with a layer spacing of 4-10 Å as a hydroxyl-flat pore model. The reaction energies of quaternary ammonium cations, acetonitrile, and quaternary ammonium cationic complexes were calculated in a graphene bilayer with different interlayer spacings, and the desolvation behavior of TEA+ and SBP+ ions was described. The critical …

Toll-Like Receptors 2, 4, And 9 Modulate Promoting Effect Of Copd-Like Airway Inflammation On K-Ras-Driven Lung Cancer Through Activation Of The Myd88/Nf-ĸb Pathway In The Airway Epithelium, Walter V Velasco, Nasim Khosravi, Susana Castro-Pando, Nelly Torres-Garza, Maria T Grimaldo, Avantika Krishna, Michael J Clowers, Misha Umer, Sabah Tariq Amir, Diana Del Bosque, Soudabeh Daliri, Maria Miguelina De La Garza, Marco Ramos-Castaneda, Scott E Evans, Seyed Javad Moghaddam

Faculty, Staff and Student Publications

INTRODUCTION: Toll-like receptors (TLRs) are an extensive group of proteins involved in host defense processes that express themselves upon the increased production of endogenous damage-associated molecular patterns (DAMPs) and pathogen-associated molecular patterns (PAMPs) due to the constant contact that airway epithelium may have with pathogenic foreign antigens. We have previously shown that COPD-like airway inflammation induced by exposure to an aerosolized lysate of nontypeable

METHODS: In the present study, we have dissected the role of TLRs in this process by knocking out TLR2, 4, and 9 and analyzing how these deletions affect the promoting effect of COPD-like airway inflammation on …

Mitochondrial Replication Assay (Mira) For Efficient In Situ Quantification Of Nascent Mtdna And Protein Interactions With Nascent Mtdna (Mitosirf), Macy Lozen, Yue Chen, Rebecca A Boisvert, Katharina Schlacher

Faculty, Staff and Student Publications

Mitochondria play decisive roles in bioenergetics and intracellular communication. These organelles contain a circular mitochondrial DNA (mtDNA) genome that is duplicated within one to two hours by a mitochondrial replisome, independently from the nuclear replisome. mtDNA stability is regulated in part at the level of mtDNA replication. Consequently, mutations in mitochondrial replisome components result in mtDNA instability and are associated with diverse disease phenotypes, including premature aging, aberrant cellular energetics, and developmental defects. The mechanisms ensuring mtDNA replication stability are not completely understood. Thus, there remains a need to develop tools to specifically and quantifiably examine mtDNA replication. To date, …

Parent Perspectives Of School/Daycare Experiences In Young Children Newly Diagnosed With Diabetes, Alexa Stern, Brenda Duran, Randi Streisand, Christine H Wang, Carrie Tully, Lauren Clary, Katherine Gallagher, Fran Cogen, Lefkothea Karaviti, Maureen Monaghan, Marisa E Hilliard

Faculty, Staff and Students Publications

OBJECTIVE: A central part of family adjustment to a new diagnosis of type 1 diabetes (T1D) is integrating T1D management into the child's school/daycare. This may be particularly challenging for young children who rely on adults for their diabetes management. This study aimed to describe parent experiences with school/daycare during the first 1.5 years following a young child's T1D diagnosis.

METHODS: As part of a randomized controlled trial of a behavioral intervention, 157 parents of young children with new-onset (<2 >months) T1D reported on their child's school/daycare experience at baseline and at 9- and 15-month post-randomization. We used a mixed-methods …

Integrating Tobacco Treatment Into Oncology Care: Reach And Effectiveness Of Evidence-Based Tobacco Treatment Across National Cancer Institute-Designated Cancer Centers, Sarah D Hohl, Alex T Ramsey, Li-Shiun Chen, Et Al.

2020-Current year OA Pubs

PURPOSE: Quitting smoking improves patients' clinical outcomes, yet smoking is not commonly addressed as part of cancer care. The Cancer Center Cessation Initiative (C3I) supports National Cancer Institute-designated cancer centers to integrate tobacco treatment programs (TTPs) into routine cancer care. C3I centers vary in size, implementation strategies used, and treatment approaches. We examined associations of these contextual factors with treatment reach and smoking cessation effectiveness.

METHODS: This cross-sectional study used survey data from 28 C3I centers that reported tobacco treatment data during the first 6 months of 2021. Primary outcomes of interest were treatment reach (reach)-the proportion of patients identified …

Serum Metabolomic Signatures Of Fatty Acid Oxidation Defects Differentiate Host-Response Subphenotypes Of Acute Respiratory Distress Syndrome, Tomeka L Suber, Stacy G Wendell, Steven J Mullett, Benjamin Zuchelkowski, William Bain, Georgios D Kitsios, Bryan J Mcverry, Prabir Ray, Anuradha Ray, Rama K Mallampalli, Yingze Zhang, Faraaz Shah, Seyed Mehdi Nouraie, Janet S Lee

2020-Current year OA Pubs

BACKGROUND: Fatty acid oxidation (FAO) defects have been implicated in experimental models of acute lung injury and associated with poor outcomes in critical illness. In this study, we examined acylcarnitine profiles and 3-methylhistidine as markers of FAO defects and skeletal muscle catabolism, respectively, in patients with acute respiratory failure. We determined whether these metabolites were associated with host-response ARDS subphenotypes, inflammatory biomarkers, and clinical outcomes in acute respiratory failure.

METHODS: In a nested case-control cohort study, we performed targeted analysis of serum metabolites of patients intubated for airway protection (airway controls), Class 1 (hypoinflammatory), and Class 2 (hyperinflammatory) ARDS patients …

Confidence And Exercise: Is There A Link Between Exercise And Percieved Confidence?, Jocelyn I. Simpson, Tatum R. Dickison

2023 Symposium

High self-confidence is crucial in social, work, and academic settings. Previous research suggests that individuals with greater confidence tend to be healthier and happier. (ŞAHİN et al., 2016).

PURPOSE: To investigate whether exercise intervention (resistance training (RT), aerobic training (AT), no exercise (NE)) could increase perceived confidence levels before an academic test. It was hypothesized that participants who exercised before the test would have higher perceived confidence levels compared to those who did not.

METHODS: Eastern Washington University students (n=18, 12 males), between the ages of 18-40 were recruited. Participants were randomized into one of the interventions (AT, RT, NE). …

Medical School Watercooler Newsletter - May 19, 2023, Lindsey Lyle

Watercooler Newsletter

This is the May 19, 2023 edition of the Frederick P. Whiddon College of Medicine's newsletter - Watercooler.

Contents include:

• Biomedical library hosts 'Opening Doors: Contemporary African American Physicians'
• Meet a Med Student: Jonathan Lee
• M3 Case Symposium set for June 9
• Office of faculty affairs to offer medical education research certificate program

Managing Refractory Status Epilepticus With Early Ketamine Administration, Ashlyn Shavers

Yale School of Medicine Physician Associate Program Theses

Status epilepticus is a time-sensitive neurological emergency that can be associated with severe disability and mortality. Approximately 20% of patients with status epilepticus will fail to respond to existing first and second-line therapies that act on similar receptors. There is a need for additional therapeutic options. One candidate drug, ketamine, has a novel mechanism of action and may work synergistically to terminate seizures. This study seeks to examine whether ketamine administration along with other second-line medications can reduce seizure burden in patients with status epilepticus. Using an open-label randomized clinical trial of 436 patients, we will examine the proportion of …

Providing Trauma Informed Care For Individuals On Opioid Agonist To Increase Contraception, Devon Knight

Yale School of Medicine Physician Associate Program Theses

Individuals with opioid use disorder report having less reproductive and sexual health knowledge and are at greater risk of unintended pregnancy than their peers. This has led to increased neonatal opioid withdrawal syndrome and an increased healthcare burden, yet providing contraception and trauma informed care at treatment centers for individuals engaging in medication treatment has not been emphasized. Co-locating trauma informed reproductive and sexual health education and contraception access at substance use treatment centers provides a unique opportunity to improve knowledge and access to care for this population. We propose a randomized control trial to determine whether trauma informed care …

Spinal Fusion For Adult Degenerative Scoliosis: Rct Of Robot-Assisted Versus Navigation Guidance, Kyle Hanks

Yale School of Medicine Physician Associate Program Theses

Adult degenerative scoliosis is characterized by the side-to-side curvature of the spine due to the degeneration of facet joints and intervertebral discs. Life-limiting cases of adult degenerative scoliosis are corrected by spinal fusion, the success of which is determined by pedicle screw accuracy. Robot-assisted guidance has become more commonly used in spinal surgery to ensure pedicle screw placement. However, there is limited evidence for the role of robot-assisted guidance in the correction of adult degenerative scoliosis. Here, in this randomized controlled trial, we aim to investigate whether robot-assisted guidance can more consistently produce accurate pedicle screw placement than neuronavigation …

The Effect Of Neurologic Music Therapy On Speech Intelligibility In Children With Cerebral Palsy, Paulina Perez-Curiel

Yale School of Medicine Physician Associate Program Theses

Cerebral palsy is the most common motor disability in children and is caused by abnormal development of or damage to the brain. Children with cerebral palsy often have speech disorders, most commonly dysarthria, due to deficits in speech-motor control. The inability to communicate effectively can lead to needs not being met, self-isolation, and an overall decrease in self-perception and quality of life. In this randomized control trial, we will evaluate whether Neurologic Music Therapy improves word-level speech intelligibility in children with Cerebral Palsy. Fifty children will be exposed to Neurologic Music Therapy and fifty children will receive standard speech therapy. …