Medicine and Health Sciences Commons^™

Establishing Bedside Report In The Emergency Care Center, Alexandra Rowen

Providence Nursing Research Conference 2023 – Present

No abstract provided.

The Lived Experiences Of Registered Nurses In The Icu In Utilizing A Novel Prophylactic Clear Sacral Gel Dressing, Jason Miranda, Rofelina Madlambayan, Paolo Roca

Providence Nursing Research Conference 2023 – Present

No abstract provided.

Triaging Dizziness: An Adapted Tool To Capture Posterior Circulation Stroke, Shayna Brewer, Benedict Pereira, Aaron Acquisto, Shalina Steccato

Providence Nursing Research Conference 2023 – Present

No abstract provided.

Impact Of Specialized Nurse Crosstraining On Cath Lab Door To Balloon Metric, Jo Zarnegar

Providence Nursing Research Conference 2023 – Present

No abstract provided.

Program Evaluation: The Chronic Suicide Pathway (Csp), Brittney Stoll, Julia Victoria B Salve

Providence Nursing Research Conference 2023 – Present

No abstract provided.

Implementing Signage To Identify And Prevent Workplace Violence In The Hospital Setting, Katie Whitehead, Rosa Hernandez, Jamie Margain, Lisa Balesteri

Providence Nursing Research Conference 2023 – Present

No abstract provided.

Using Pre-Operative Education To Improve Oncology Patient Outcomes, Michelle Clevenger, Michelle Tabar, Sarah Hunt, Charm Silveo

Providence Nursing Research Conference 2023 – Present

No abstract provided.

Reducing Hospital-Acquired Infections: Implementing Dual Registered Nurse Verification For Foley Catheter And Central Line Indications, Carmyle Seville, Jaiden Tanaleon

Providence Nursing Research Conference 2023 – Present

No abstract provided.

Improving Evidence-Based Nursing Culture And Competency: A Council-Driven Approach, Karis Pickett

Providence Nursing Research Conference 2023 – Present

No abstract provided.

Enhancing Staff Knowledge And Confidence In Depression Screening Using The Patient Health Questionnaire-9, Melkamzer Chari

Walden Dissertations and Doctoral Studies

Depression is a serious public health concern affecting over 280 million people globally and leading to significant morbidity and mortality if left undetected and untreated. At the local organization, leadership identified inconsistent depression screening as a practice problem among nursing staff. Thus, the purpose of this doctor in nursing practice (DNP) project was to determine if an educational intervention focused on depression, the importance of depression screening, and the use of the Patient Health Questionnaire-9 (PHQ-9) increased knowledge and confidence among nursing staff working in a local organization. Fifteen participants volunteered to participate in the project. The average age was …

Cutaneous Rosai-Dorfman Disease Misdiagnosed As Granulomatous Dermatitis: A Diagnostic Pitfall, Sri Naidnur, Jamie Hedrick, Smaran Marupudi, Kara Asbury, Kelly Maedo, Bryan Gammon, Rick Lin

School of Medicine Publications

Cutaneous Rosai-Dorfman disease (CRDD) is an uncommon non-Langerhans cell histiocytosis that may occur without systemic involvement and lacks specific clinical features. We report a 17-year-old female with a slowly enlarging chest lesion initially diagnosed as granulomatous dermatitis on a 4-mm punch biopsy. The lesion was treated as an inflammatory process without improvement. Complete excision revealed a multinodular dermal and subcutaneous infiltrate of large histiocytes demonstrating emperipolesis, confirming CRDD. Systemic evaluation was negative. The initial limited biopsy did not capture defining features, delaying diagnosis.

Persistent nodular lesions that fail to respond to therapy should prompt reconsideration and more representative tissue sampling. …

Gadolinium Nanoparticles: Emerging Platforms Beyond Imaging For Drug Delivery And Theranostics, Amir Nasrolahi Shirazi, Rajesh Vadlapatla, Ajoy Koomer, Heyam Zayed, Paris Marabut, Keykavous Parang

Pharmacy Faculty Articles and Research

Gadolinium nanoparticles (GdNPs) have gained increasing attention as multifunctional metal-based nanoplatforms that extend far beyond their traditional use as magnetic resonance imaging (MRI) contrast agents. Their specific magnetic properties, tunable physicochemical features, and tunable biocompatibilities with biocompatible coatings give them great potential as drug delivery and theranostic applications. They offer greater stability, lower systemic toxicity, and more surface modification options compared to molecular gadolinium chelates. The functionalized GdNPs not only show excellent properties as drug carriers for their specific indications but also serve as agents in various imaging modalities with superior therapeutic efficacy by means of radio sensitization and magnetically …

Symptomatic Manifestations Of Hip Dysplasia In Young Adults: How Do Patients Present Before Or After Surgery? Results From A Social Media Cohort, John M. Gaddis, Amanda J. Wheeler, Erika Shults, Charles South, Stephen T. Duncan, Joel Wells

School of Medicine Publications

This study aimed to analyse the symptomatic differences of hip dysplasia before or after separate surgical interventions, including pain location and characteristics, severity, patient-reported outcomes, and a body pain diagram. A REDCap-based survey was distributed through social media from October 2023 to May 2024 and targeted individuals with current or past hip pain. The survey gathered data on demographics, comprehensive hip-specific history, and various patient-reported outcome measures. Of 509 completed surveys, 287 respondents reported a diagnosis of hip dysplasia and were divided into cohorts based on treatment history: no surgery (n = 65), post-periacetabular osteotomy (PAO) (n = 162), post-THA …

Gastrointestinal Symptoms After Sport-Related Concussion In Irish Athletes, Emma Finnegan, Ed Daly, Katherine Hunzinger, Lisa Ryan

Department of Exercise Science Faculty Papers

Background/Objectives: Sport-related concussion (SRC) elicits multi-systemic symptoms, including nausea, fatigue, and cognitive changes. Gastrointestinal (GI) symptoms are not well captured in current concussion assessments and may be under-recognised in clinical follow-up. GI disturbances may influence intake tolerance and day-to-day fuelling during post-SRC recovery. This study investigated the prevalence and severity of self-reported GI symptoms in Irish athletes after their most recent SRC, examined sex-based patterns, and evaluated the rationale for integrating GI symptom checks into standard concussion tools (e.g., SCAT6) and post-injury monitoring. Methods: An online survey was completed by recreational, competitive, and elite athletes who retrospectively self-reported concussion history, …

Breaking Into Hiv-1'S Epigenetic Vault: Cure Strategies To Eliminate The Viral Reservoir, Joanna Jones, Chelsea Gunderson, Brian Wigdahl, Michael Nonnemacher

Kimmel Cancer Center Faculty Papers

Human immunodeficiency virus type 1 (HIV-1) is a retrovirus that integrates into the host cell's DNA as a provirus. Transcription from the provirus is regulated in large part by cellular proteins and epigenetic factors. These may be repressive or permissive to productive infection. The host factors that regulate this balance are therefore attractive targets for HIV-1 therapeutics. Indeed, proviral chromatin is the focus of two of the current HIV-1 cure strategies. "Shock and Kill" uses latency reversal agents to open the provirus's chromatin, promoting high levels of gene expression that induce the killing of infected cells. "Block and Lock" uses …

Cost-Effectiveness Of Blood-Based Fibrosis Screening In High-Risk Metabolic Liver Diseases With Emerging Therapies, Wanyi Chen, Stephanie T. Chang, Ramsey C. Cheung, Donald B. Chalfin, Kinpritma Sangha, Szu-Yu Zoe Kao, Artem T. Boltyenkov

College of Population Health Faculty Papers

BACKGROUND AND AIMS: Metabolic dysfunction-associated steatotic liver disease (MASLD) remains a global public health threat. With emerging effective pharmacologic therapies, early identification of significant fibrosis in primary care is critical. We evaluated the cost-effectiveness of blood-based noninvasive tests incorporating real-world diagnostic performance in the contemporary MASLD treatment era.

METHODS: We developed a decision-analytic model for MASLD natural history and treatment to compare 6 noninvasive test strategies using Fibrosis-4 (FIB-4) and/or enhanced liver fibrosis (ELF) tests at varying cutoffs. Patients identified with significant fibrosis were referred for hepatology staging (biopsy and/or imaging-based), and eligible individuals were considered for Resmetirom ($47,400/y; mean …

Computed Tomography-Guided Percutaneous Core Needle Biopsy Of Lung Lesions: Factors Influencing Diagnostic Yield And Complications, Raza Sayani, Jayakrishnan B, Rashid Al Sukaiti, Zahida Niaz, Muhammad Sharjeel Usmani, Mustafa Talib Yousif Al Ani, Hasan Al-Sayegh, Subhash Chand Kheruka

Sultan Qaboos University Medical Journal

Objectives: This study aimed to evaluate the diagnostic yield and complications associated with computed tomography (CT)-guided transthoracic core-needle biopsy (CNB) of lung lesions and to identify factors influencing biopsy outcomes. Methods: This retrospective study included patients who underwent CT-guided CNB of lung lesions at Sultan Qaboos Comprehensive Cancer Care & Research Centre, University Medical City, Muscat, Oman, from November 2021 to December 2024. Patients were categorised as either having undiagnosed lung masses/nodules or suspected pulmonary metastases from known malignancies. Biopsies were performed using an 18-gauge coaxial needle, following standard protocols. Diagnostic yield, sample adequacy for molecular analysis and complications were …

Staff Education To Improve Nurse Confidence In Managing Co-Occurring Conditions, Gloria Johnston

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) staff education project addressed a lack of confidence and training for nursing staff who care for patients with co-occurring substance use and mental health disorders. The practice problem identified at the local project site was the inconsistent care of this patient population. Addressing this gap was essential because inadequate training can reduce care quality among patients with co-occurring conditions. The practice-focused question for this project was: In nursing staff caring for patients with co-occurring mental health and substance use disorders, how does an evidence-based staff education program on integrated treatment approaches compare to standard …

Staff Education To Optimize Pain Management In Home Health Care, Marie Natacha Francis

Walden Dissertations and Doctoral Studies

This DNP project is a nurse-led quality improvement initiative that responds to the age-old issue of ineffective pain management in the home healthcare setting. The issue is the absence of standardization in staff education regarding pain assessment and intervention, leading to unfavorable patient outcomes and a reduced quality of life. The purpose of the project is to assess the efficacy of educational interventions delivered by nurses to enhance staff knowledge, confidence, and consistency in the management of pain procedures. The project question is: How effective are nurse-led educational interventions in improving staff knowledge and practices in pain assessment and management, …

Staff Education To Improve Nurses’ De-Escalation Skills In Substance Abuse Treatment Settings, Joy Atufunwa

Walden Dissertations and Doctoral Studies

Nearly 50% of patients in substance abuse treatment settings exhibit aggressive behaviors, placing staff and other patients at risk. In the absence of structured de-escalation training, clinicians frequently rely on physical restraints or pharmacologic interventions, which contribute to staff burnout, injury, and ethical concerns. The project implemented an evidence-based staff education program to improve nurses’ knowledge, confidence, and competence in managing aggression using nonviolent de-escalation strategies. The project question guiding this initiative was: Can education improve nurses’ de-escalation skills in a substance abuse treatment setting? Using an evidence-based practice (EBP) approach and the PICO framework, the project evaluated the impact …

Quality Of Prenatal Care, Provider Preference, And Preeclampsia Among African American Women In Georgia, Lyteasha Bass

Walden Dissertations and Doctoral Studies

African American women experience disproportionately high rates of preeclampsia in the United States; however, the contributions of prenatal care provider type, health care access, and quality of care to this disparity were insufficiently defined. Guided by the quality health outcomes model, this quantitative case-control study used primary data to examine associations between these factors and the occurrence of preeclampsia among African American women age 18–40 who had given birth within the previous 5 years in Georgia. Descriptive statistics and binary and multinomial logistic regression analyses were conducted. Prenatal care quality was measured using the Quality of Prenatal Care Questionnaire (QPCQ), …

Gut Microbiota Modulation Via Repeated Donor Fecal Transplantation Improves Motor And Gastrointestinal Symptoms In Drug-Naïve Parkinson’S Disease: A Randomized Phase 2 Trial, Rui Zhang, Renyi Feng, Jiuqi Wang, Yongkang Chen, Han Liu, Qingyong Zhu, Haiyan Tian, Chi Qin, Junfang Teng, Beisha Tang, Min Wu, Jinsheng Zeng, Erxi Wu, Xuebing Ding, Xuejing Wang

Faculty, Staff and Students Publications

The gut-brain axis is increasingly recognized as a critical contributor to Parkinson's disease (PD) pathogenesis, yet the therapeutic impact of microbiota modulation remains unclear due to lack of clinical trials in drug-naïve patients. We conducted a randomized, double-blind, placebo-controlled phase 2 trial to evaluate the safety, tolerability, and efficacy of repeated donor fecal microbiota transplantation (dFMT) in de novo PD. FMT was administered for seven days (200 mL on days 1-3; 50 mL on days 4-7) per 4-week cycle. Seventy-two patients were randomized 1:1 to receive dFMT or autologous FMT (aFMT), and 66 completed the trial. At 35 weeks, the …

Enhancing Staff Education On Antidepressant Side Effects For Adolescents At Discharge, Mingdi Gao

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) evidence-based staff education project aimed to improve the quality and consistency of discharge medication education for adolescents prescribed antidepressants. Adolescents are at increased risk for antidepressant-related adverse effects, including suicidal ideation, particularly during the early stages of treatment. The identified practice problem was the lack of consistent, developmentally appropriate, and culturally sensitive discharge teaching for adolescents and their families. This gap in practice contributes to poor adherence, preventable readmissions, and diminished safety outcomes. The project was guided by the PICO question: For adolescents discharged from inpatient or outpatient behavioral health care, how does a …

Authors’ Response To Letter To The Editor From Aphale, P, Et Al., Resident Autonomy In Pathology: Bridging Gaps Between Training And Practice, Bronwyn H. Bryant, Balaram Puligandla, Hailey L. Gosnell, Kristen Johnson, Stephanie Barak, Mary P. Berg, Julie Karp, Amanda Lofgreen, Cindy B. Mccloskey, Barbara E. C. Knollmann-Ritschel, Kristie L. White, W. Stephen Black-Schaffer

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

No abstract provided.

A Survey-Based Exploratory Study Of Factors Influencing Women's Intentions To Utilise Pre-Exposure Prophylaxis In The Eastern Cape Province, South Africa: Sociodemographic Characteristics, Hiv Risk Behaviours And Transactional Sex, Rosemary Kalenga, Gary Sharp, Anne M. Teitelman, Monde Makiwane, Larry D. Icard, John B. Jemmott

College of Nursing Faculty Papers & Presentations

BACKGROUND: South Africa has the third-highest adult prevalence rate globally, with women comprising 64% of cases. Despite the accessibility of pre-exposure prophylaxis (PrEP), its adoption among women, particularly young women, remains alarmingly low.

OBJECTIVES: The objective of this initial investigation is to explore factors influencing the intentions of South African women to use PrEP, focusing on sociodemographic factors, HIV sexual risk behaviours and involvement in transactional sex.

DESIGN: The research utilised an exploratory design employing surveys.

METHODS: Surveys were conducted in 2015 with 64 women aged 19-49 residing in the Eastern Cape Province of South Africa. The data were analysed …

Cannabis Stigma And Symptom Management Considerations In Cancer Survivors: A Mixed-Methods Exploration Of Patient Perspectives, Sera Levy, Salimah Meghani, Brooke Worster, Colleen Kilanowski, Danielle Smith, Amy A. Case, Rebecca L. Ashare

Department of Medical Oncology Faculty Papers

PURPOSE: This study aims to assess for indications of stigma and attitudes toward cannabis among cancer survivors (CS) who use or consider the use of cannabis.

METHODS: This study employed a convergent, parallel mixed methods design utilizing focus group and questionnaire data to assess the presence of stigma among a sample of CS (n = 23) who use (n = 10) and do not use (n = 13) cannabis to manage symptoms. CS were recruited from a multi-site observational study in the Northeast U.S. region that assesses cannabis use among oncology patients.

RESULTS: A total of 23 CS participated in …

Glycative Stress Disrupts The Mitochondrial-Lysosome Axis And Promotes Geroconversion In Aging Cardiomyocytes, Diana Bou-Teen, Simonas Valiuska, Elisabet Miro-Casas, Chiara Rubeo, Elena Bonzon-Kulichenko, Zuzana Nichtova, Celia Fernandez-Sanz, Javier Inserte, Antonio Rodriguez-Sinovas, Begoña Benito, Eduard Ródenas-Alesina, Jesús Vázquez, Ignacio Ferreira-González, Marisol Ruiz-Meana

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Aging is a major risk factor for heart failure, yet the molecular mechanisms linking cardiac aging to the inflammatory pathophysiology of heart failure remain elusive. Mitochondrial dysfunction and defective organelle quality control are emerging hallmarks of the aging heart, but their biochemical underpinnings are poorly defined. Using comprehensive glycomics, we found that cardiac mitochondria from physiologically aged mice (≥ 20 months) are the major intracellular reservoirs of advanced glycation end products (AGEs), derived primarily from the chemical attack of some α-oxoaldehydes on proteins. This was associated with mild mitochondrial dysfunction and structural remodeling. Lysosomes in aged hearts were enlarged, more …

The Efficacy And Safety Of Serratus Anterior Plane Block In Patients Undergoing Cardiac Surgery: A Systematic Review And Meta-Analysis, Xu-Bo Cui, Ming-Zhu Cui, Qiu-Ju Yang, Yang Liu, Meng-Qi Yi, Xiao-Yang Zhang, Yun-Tai Yao

Faculty, Staff and Student Publications

Background: Serratus anterior plane block (SAPB) is a widely used fascial block that reduces postoperative pain and perioperative opioid consumption. This meta-analysis assessed the efficacy and safety of SAPB in cardiac surgery patients.

Methods: We systematically searched PubMed, Web of Science, Cochrane Library, Embase, China National Knowledge Infrastructure, and Wanfang databases on May 10, 2024. Pooled relative risks and mean differences (MD) with 95% confidence intervals (CI) were calculated for dichotomous and continuous outcomes, respectively. Heterogeneity was assessed using the I2 statistic, and publication bias was evaluated using Egger test. Subgroup analyses were stratified by study design (randomized controlled trials …

Telemedicine As A Gateway To Early-Phase Oncology Trials: Lessons From 14,000 Patients And Future Directions For Global Access And Equity, Carlos Torrado, Clark R Andersen, Lei Kang, Amanda L Brink, Taiwo Adesoye, Hung Le, Clover J Patterson, Anna Poullard, Jessica A Osburn, Harold N Tan, Mohamed A Gouda, Sheena Charles, Gabriele E Urschel, Tin-Yun Tang, David S Hong, Stephane Champiat, Aung Naing, Apostolia M Tsimberidou, Ecaterina E Dumbrava, Sarina A Piha-Paul, Jordi Rodon, Timothy A Yap, Paula R Pohlmann, Funda Meric-Bernstam, Siqing Fu

Faculty, Staff and Student Publications

Background: Telemedicine expanded rapidly during the COVID-19 pandemic, but its role in early-phase oncology trials remains uncertain. We evaluated its impact on recruitment, enrollment, equity, and access in a large phase I program.

Patients and methods: We retrospectively analyzed patients seen for first consultation in the MD Anderson Phase I Program (2016-2023). Recruitment (consent) and enrollment (treatment initiation) were compared by visit type, race/ethnicity, and geography across pre-pandemic (2016-2019), pandemic (2020-March 11, 2023), and post-public health emergency (PHE; March-December 2023) periods. A chart review of 400 patients validated findings.

Results: Of 14,085 patients, 7,247 were evaluated post-pandemic, with 36% (n …

Pan-Cancer Evolution Signatures Link Clonal Expansion To Dynamic Changes In The Tumor Immune Microenvironment, Xinyu Yang, Wei Liu, Geoff Macintyre, Peter Van Loo, Florian Markowetz, Peter Bailey, Ke Yuan

Faculty, Staff and Student Publications

Cancer is an evolutionary process characterized by profound intratumor heterogeneity (ITH), which can be quantified using in silico estimates of cancer cell fractions (CCFs) of tumor-specific somatic mutations. We demonstrate a data-driven approach based on CCF distributions to identify 4 robust pan-cancer evolutionary signatures from 4,146 tumors across 17 cancer types in The Cancer Genome Atlas (TCGA). These signatures define a continuum of cancer cell fractions reflecting neutral evolution, clonal expansion, and clonal fixation. Correlating evolutionary signatures with mutational and biological programs reveals that tumors enriched for clonal expansion and fixation are associated with immune evasion and distinct changes in …