Medicine and Health Sciences Commons^™

Staff Education To Nurses To Lmprove Routine Foot Examinations For Diabetic Patients, Sarah Abrefi

Walden Dissertations and Doctoral Studies

Diabetes-related foot complications remain a significant cause of morbidity, hospitalization, and lower-extremity amputation, despite strong evidence supporting routine preventive assessments. In many outpatient settings, variability in nursing knowledge, skill, and documentation practices contributes to inconsistent implementation of comprehensive diabetic foot examinations. The purpose of this practice-focused quality improvement project was to evaluate the effectiveness of a structured staff education program designed to improve nurses’ knowledge and competency in performing comprehensive diabetic foot assessments in an outpatient diabetes clinic.A pretest–posttest evaluative design was used to measure changes in knowledge following the educational intervention. Ten registered nurses participated in a structured educational …

Small Patients, Big Gaps: Why Adult Crrt Timing Evidence Does Not Translate To Children, Katja M Gist, Dana Y Fuhrman, Ayse Akcan-Arikan

Faculty, Staff and Students Publications

No abstract provided.

Improving Blood Pressure Control In Home Care Patients Through Implementation Of Acc/Aha Hypertension Guidelines And Structured Blood Pressure Monitoring, Farrah Lynn Yuille

Walden Dissertations and Doctoral Studies

This clinical practice guideline addressed the practice problem of the lack of standardized and consistent hypertension management in the home setting. Addressing this practice problem is important within nursing practice, as uncontrolled blood pressure increased the risk of hospitalizations, emergency department visits, and long-term cardiovascular complications. The practice question focused on translating evidence-based hypertension guidelines into clinical practice and evaluating their impact on patient outcomes in the home care setting. The purpose of the project was to engage three voluntary participants in evaluating the clinical practice guideline per the American College of Cardiology and American Heart Association hypertension guidelines within …

Staff Education Using A Workplace Violence Reduction Bundle, Julla Panneh

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) quality improvement project addressed the ongoing issue of workplace violence (WPV) among medical-surgical nurses in an acute care setting. WPV poses significant risks to staff safety, psychological well-being, and the overall care environment. Guided by current evidence and professional guidelines, the project implemented a structured educational intervention focused on the Workplace Violence Reduction Bundle, incorporating the Broset Violence Checklist (BVC) and evidence-based de-escalation strategies. Medical-surgical nursing staff participated in tailored educational sessions; knowledge was assessed through pre- and post-intervention surveys, and program acceptability was evaluated through staff feedback. Data analysis revealed modest improvements in …

Prevalence And Factors Associated With Delayed Surgery Among Children With Wilms Tumor At Mulago Hospital: A Mixed-Method Study, Lule Daniel, Shamim Nabidda, Abraham Muhwezi, Ronald Naitala, Anne Akullo, Enid Kawala Kagoya, Ruth Namazzi, Nasser Kakembo, Joan N. Kalyango

School of Nursing & Midwifery, East Africa

Introduction:  Wilms tumor (WT) is a highly treatable form of childhood cancer, with five-year survival rates greater than 90% in high-income countries. In low- and middle-income countries, survival is still low. Delayed surgery is one of the leading factors for poor survival, as it leads to tumor complications, making subsequent treatment more complex. However, there is a paucity of information in Uganda on the prevalence and factors associated with delayed surgery. This study aimed to determine the prevalence and factors associated with delayed surgery, and to explore the barriers and facilitators of timely surgery among children with WT at …

Prevalence Of Gout In The Sincan District Of Ankara, Türkiye: A Primary Care-Based Cross-Sectional Study, Riza Can Kardaş, Yasemi̇n Ünsal, Derya Yildirim, Hakan Tüzün, Mustafa Necmi̇ İlhan, Hami̇t Küçük, Abdurrahman Tufan, M. Aki̇f Öztürk

Turkish Journal of Medical Sciences

Background/aim: Gout, the most prevalent form of inflammatory arthritis, has shown a global increase in prevalence; however, data from Türkiye remain scarce, inconsistent, and largely confined to western regions. This study aimed to estimate the prevalence of gout among adults in the Sincan district of Ankara, Türkiye, and to provide updated data from a previously understudied region.

Materials and methods: This cross-sectional, community-based study employed a multistage design. Adults aged ≥18 years who presented to selected family health centers in Sincan between February and June 2023 were screened using a structured questionnaire. Individuals with suspected gout underwent comprehensive clinical evaluation, …

Clinical Outcome Of Extremity Arterial Injuries In The Modern Era, Ali̇ Kuşsan, Selçuk Coşkun, Alp Şener, Ferhat İçme, Pinar Köksal Coşkun, Gülhan Kurtoğlu Çeli̇k

Turkish Journal of Medical Sciences

Background/aim: Extremity arterial injuries (EAIs) present a significant clinical challenge due to the risk of limb ischemia, amputation, and mortality. This retrospective cohort study aimed to delineate the clinical course, treatment strategies, and patient outcomes following trauma-induced EAIs, and to identify independent predictors of adverse outcomes.

Materials and methods: Retrospectively analyzed were data from 168 consecutive patients with traumatic EAIs who underwent computed tomography angiography at a tertiary care center between 2019 and 2025. Data extracted from electronic medical records included demographics, injury mechanisms, clinical presentation, laboratory findings, imaging results, treatment modalities (primary repair, grafting, endovascular intervention, conservative management), and …

The Perk Signaling Pathway As A Marker Of The Unfolded Protein Response In Patients With Acute Myeloid Leukemia, Nergi̇z Erkut, Turhan Köksal, Seli̇m Demi̇r, Ahmet Menteşe, Özlen Balta, Mehmet Sönmez

Turkish Journal of Medical Sciences

Background/aim: The protein kinase RNA-like endoplasmic reticulum kinase (PERK) pathway plays a critical role in preventing the accumulation of misfolded or unfolded proteins within the endoplasmic reticulum. In this study, the role of the PERK signaling pathway was evaluated in newly diagnosed, treatment-naïve patients with acute myeloid leukemia (AML).

Materials and methods: Plasma levels of eukaryotic translation initiation factor 2-alpha kinase 3 (eIF2AK3), glucose-regulated protein 78 (GRP78), activating transcription factor 6 (ATF6), CCAAT/enhancer-binding protein homologous protein (CHOP), hypoxia-inducible factor-1 alpha (HIF-1α), and caspase 3 were measured by enzyme-linked immunosorbent assay in peripheral blood samples obtained from AML patients and healthy …

Comment On “Survival Of Patients With 2014 Figo Stage Iiic High‑Grade Serous Ovarian Cancer Treated With Platinum‑Based Adjuvant Chemotherapy”, Abdullah Saad, Syeda Abeeha Hasan, Syeda Aki̇fa Sajid

Turkish Journal of Medical Sciences

No abstract provided.

Rmzyme: Regulations Of Rna-Modifying Enzymes In Humans, Ruihan Luo, Haixia Xu, Qingbo Zhou, Shanli Ding, Min Qiang, Jianguo Wen, Pora Kim, Xiaojuan Yang, Yunshi Cai, Kunlin Xie, Jiang Zhu, Yungang Xu, Tian Lan, Xiaobo Zhou, Hong Wu

Faculty, Staff and Student Publications

RNA modifications represent a dynamic layer of gene expression regulation, RNA stability, and translation with profound implications for cellular function and disease. However, the critical regulation and functions of RNA-modifying proteins (RMPs) remain poorly understood. Here, we present a large-scale characterization of RMPs through 378 multiomics datasets encompassing genomics, bulk and single-cell transcriptomics, epitranscriptomics, proteomics, and posttranslational modifications (PTMs) across 63 human tissues. Our analysis of experimental perturbations of RMPs revealed dynamic differential modification peaks and expressed genes. We applied nonnegative matrix factorization to annotate RMP-mediated cell types in single-cell transcriptomes. Functional annotations in acute myeloid leukemia (AML) revealed RMPs …

Albumin-Binding Domains In Therapeutic Protein Engineering: A Structural And Computational Perspective On Rational Design, Matthew Argyle, Dallin M. Chipman, Anna Claire Woolley, Bradley C. Bundy, Dennis Della Corte

Faculty Publications

Therapeutic proteins face a critical pharmacokinetic challenge: rapid clearance from circulation limits their clinical efficacy. Albumin-binding domains (ABDs) offer an elegant solution by enabling therapeutic proteins to “hitchhike” on serum albumin’s favorable 19-day half-life through FcRn-mediated recycling. Clinical validation through approved therapeutics like ozoralizumab demonstrates the success of this approach, with preclinical studies showing fusion to an ABD extended half-life to 18 days. This review provides an analysis of ABD-fusion protein design, integrating structural biology, computational prediction, and rational engineering principles. We catalog the major classes of albumin-binding modalities, including bacterial three-helix bundle domains, engineered peptides, antibody-derived binders, and alternative …

Primary Tumor Size And Tumor-Vessel Interface Following Capecitabine And Temozolomide For Pancreatic Neuroendocrine Tumor, Jin Guo, Kever A Lewis, Laura Prakash, Priya Bhosale, Ajaykumar Morani, Matthew H G Katz, Ching-Wei D Tzeng, Naruhiko Ikoma, Rebecca Snyder, Michael P Kim, Chandrikha Chandrasekharan, Arvind Dasari, James C Yao, Jeffrey E Lee, Jessica E Maxwell, Daniel M Halperin

Faculty, Staff and Student Publications

Capecitabine/temozolomide (CAPTEM) is an established regimen for patients with metastatic pancreatic neuroendocrine tumors (PanNET) that is being increasingly used for tumor volume reduction in patients with borderline anatomically resectable disease. We sought to understand the response of the primary tumor, defined as changes in the tumor–vascular interface (TVI). This is a retrospective, single-institution study of patients with locally advanced or metastatic PanNET treated with CAPTEM between 2010 and 2020. RECISTv1.1 measurements and TVI assessments of the primary tumor were performed on pre- and post-therapy images. Patients with locally advanced or metastatic PanNET at presentation (n = 47) were included. …

Tumor-Immune-Neural Circuit Disrupts Energy Homeostasis In Cancer Cachexia, Xiuhui Shi, Alex X Arreola, Zhijun Zhou, Jingxuan Yang, Mingyang Liu, Yang Cai, Yu Ren, Hao Yuan, Qun Chen, Xinjie Chen, Xinyu Yang, Yimei Meng, Jingyi Wang, Wenyi Luo, Michael C Rudolph, Rohan Varshney, Kar-Ming Fung, Chao Xu, Wei R Chen, Michael S Bronze, Lei Zheng, Yi-Ping Li, Courtney W Houchen, Yuqing Zhang, Min Li

Faculty, Staff and Student Publications

Cancer-induced cachexia and anorexia are debilitating complications across many cancers, yet effective treatments remain limited due to a poor understanding of the underlying mechanisms. Here, we identify an uncharacterized tumor-immune-neural circuit driving these syndromes, centered on growth and differentiation factor 15 (GDF15). Using genetically engineered mouse models, we find that loss of GDF15 protects against appetite loss, muscle wasting, and fat loss in pancreatic, lung, and skin cancers. Single-cell RNA sequencing reveals macrophages as a major source of GDF15, induced by tumor-derived colony-stimulating factor 1 (CSF1). GDF15 acts via the central nervous system to enhance β-adrenergic signaling in the tumor …

Weight Loss Patterns And Clinical Outcomes Of Glp1 Receptor Agonists In Breast Cancer Survivors, Jasmine S Sukumar, Akshara Singareeka Raghavendra, Sarah Pasyar, Roland L Bassett, Debu Tripathy, Carlos H Barcenas, Karen M Basen-Engquist, Banu K Arun

Faculty, Staff and Student Publications

Use of glucagon-like peptide-1 receptor agonists (GLP1-RA) for weight loss is increasing; implications in breast cancer (BC) survivors remain unclear.This retrospective cohort study evaluated treatment patterns, weight loss, and outcomes in BC survivors at an academic institution receiving GLP1-RA. We evaluated patients with non-metastatic (ductal carcinoma in situ (DCIS), stage 1-3) BC who received GLP1-RA (2005 - 2024). Linear regression models estimated associations between weight change and clinical factors. After excluding DCIS, propensity score matching (1:2) was used to match patients who received GLP1-RA with patients who did not, based on confounding covariates. Kaplan-Meier estimates and log-rank tests compared disease-free …

Targeting Oxalate Production By Combining Enzyme Inhibition And Proteolysis Activation: A Novel Therapeutic Approach For Primary Hyperoxaluria Type 1, Fabio Arias, Sumati Rohilla, Yudibeth Sixto-López, Koral S E Richard, Sandeep Das, Sumit K Anand, Pilar Maria Luque-Navarro, Guillermo Bañuelos-Sanchez, Juan Luis Pacheco-García, Reethika Gade, M Peyton Mckinney, Dhananjay Kumar, Jemiah Maxie, W Rylan Corr, Nilesh Pandey, Harpreet Kaur, Jibin Ding, Lin Tan, Elisha Scott, Hyung Nam, Eyal Gottlieb, A Wayne Orr, Nirav Dhanesha, Arif Yurdagul, Angel L Pey, Francisco Franco-Montalbán, José A Gómez Vidal, Oren Rom, Mónica Díaz-Gavilán

Faculty, Staff and Student Publications

Primary hyperoxaluria type 1 (PH1) is a rare genetic disorder caused by hepatic oxalate overproduction due to alanine-glyoxylate aminotransferase (AGXT) deficiency. Therapeutic strategies targeting glycolate oxidase (GO) and lactate dehydrogenase A (LDHA), key enzymes in glyoxylate metabolism, have shown promise in reducing oxalate burden. However, recently approved siRNA therapies remain limited by high cost, unfavorable pharmacokinetics, and limited global accessibility. We report the development of compound 2, a dual GO/LDHA inhibitor (K i = 390 and 40 nM, respectively) that also promotes hydrophobic tag-mediated autophagic degradation of LDHA. Its efficacy was evaluated in Agxt –/– mice, both in primary …

Serial False Lumen Patency Evaluation Of A Type B Dissection Represented With Malperfusion Following Medical Management, S Taha Zaidi, Quang Le, Firas Mussa, Akiko Tanaka, S Keisin Wang, Arash Keyhani, Kourosh Keyhani

Faculty, Staff and Student Publications

False lumen evolution in type B aortic dissection, particularly with medical management and anticoagulation, remains incompletely understood. We report a 55-year-old man on apixaban for pulmonary embolism with a subacute zone 3-10L TBAD without malperfusion. He was managed medically initially and represented twice over 2 months with back pain and acute right lower extremity ischemia. Serial imaging demonstrated dynamic remodeling with progression from partial to near-complete thrombosis to full reperfusion with true lumen compression. Urgent endovascular repair was performed successfully. This case illustrates the unpredictable course of medically managed TBAD and need for judicious use of anticoagulation.

Menopause 101, Stephanie Carlson, Emma Parkhurst, Ashley Yaugher, Cris Meier

All Current Publications

This fact sheet provides women with basic information about perimenopause, menopause, and postmenopause, along with helpful tips and resources to better prepare for or manage these phases of life.

What Did We Learn About Vads In 2024-2025?, Maya Guglin

The VAD Journal

This is our 11th annual literature review on left ventricular assist devices (LVADs). Our previous reports were well received by readers.^1-10 In prior years, we also included other forms of mechanical circulatory support (MCS); however, this year, we present a separate review focused exclusively on temporary MCS.

In this article, we summarize the most interesting, from our standpoint, publications from 2024 and 2025, with some inclusion of late 2023 studies that were initially released online before print. For the first time, we provide an independent review on short-term MSC devices, including the intra-aortic balloon pump, Impella (Abiomed), and extracorporeal …

Cytotoxic And Antimicrobial Effects Of Plant-Derived Compounds Used In Traditional Chinese Medicine, Amanda Ly, Diane Sun, Shelbi Salinas, Victor M. Jimenez

Annual Research Symposium

No abstract provided.

A Pilot Study Evaluating Child Resistant Closures In Pharmaceuticals In The Developing Nation Of Ghana: Informing Global Paediatric Safety And Usability Standards, Samuel Ofosu, Kojo Agyapong Afrifah, Laura Bix

Journal of Applied Packaging Research

Despite their proven effectiveness in preventing unintentional paediatric medication poisoning in high-income countries, the performance and usability of Child Resistant Closures (CRCs) remain underexplored in low and middle-income countries (LMICs).

To provide pilot data regarding the potential efficacy of using CRCs in LMICs, we conducted a study of the approach in a low-resourced region (Ghana, West Africa) by adapting testing protocols utilized in the United States (16 CFR Part 1700.20). The study utilized a convenience sample of children (n=50; 42-51 months) and adults (n=50; 50-70 years) to develop preliminary data related to the efficacy of a single design of CRC …

Cardiac Implantable Electronic Device Infections In Saudi Arabia: Incidence, Timing, Causative Organisms, And Outcomes – A Multicenter Study, Saad Albogami, Wael Alqarawi, Ahmed Alfagih, Hiatham Alenzi, Mohammad Alshehri, Mossab Aljuaid, Saeed Alqahtani, Norah Alswaidan, Mohammad Alharbi, Norah Alkaltham, Lama Alasmri, Rghd Sadkh, Muna Albashari, Nour Alhouda, Imad Tleyjeh

Journal of the Saudi Heart Association

Background: Cardiac implantable electronic devices (CIEDs) substantially improve outcomes in cardiac patients, but device-related infection can negate these benefits. Data on the epidemiology of CIED infections in Saudi Arabia are limited. Methods: We performed a multicenter retrospective cohort study of consecutive patients receiving CIEDs (pacemakers [PPM], implantable cardioverter-defibrillators [ICD], and cardiac resynchronization devices [CRT]) at three tertiary hospitals in Riyadh, Saudi Arabia, from January 2017 through December 2021. Patients were followed for at least one year post-implantation. Data collected included patient demographics, device type (new implant, replacement, revision), infection timing and microbiology, management (device extraction vs conservative treatment), and outcomes. …

Post-Traumatic Stress And Post-Traumatic Growth: A Literary Lens On Trauma, Meaning, And Survival, Audrey Gruben

CAFE Symposium 2026

This project examines how literature provides insight into these differing trauma responses by comparing Man’s Search for Meaning by Viktor Frankl and Slaughterhouse-Five by Kurt Vonnegut. Drawing on contemporary psychological frameworks of PTSD and PTG, this analysis argues that psychological distress and growth are not mutually exclusive responses to trauma. Instead, they can coexist along a spectrum shaped by meaning-making, responsibility, avoidance, and engagement with suffering.

The Need For Accessible Cpr Training, Madilyn Cataloni

CAFE Symposium 2026

For my project, I researched how CPR certification can affect an emergency response. From this, I researched Gettysburg College's CPR certification requirements for different departments. I then brainstormed different plans to make CPR certification more accessible to students and employees.

Comparing Sociological Suicide Studies In The 1800s To Psychological Suicide Studies Now, Amanda Mic

CAFE Symposium 2026

Sociology can look at the numbers and explain to us the physical, concrete facts about when, where, and how suicides happen, but psychology gives us an explanation as to why it happens. This project looks into the ways that 19th century societal stigmas around suicide caused inaccuracies in the statistics that sociologists studied, and therefore their findings, as well as the abundance of discoveries on suicide and mental conditions by psychologists in more recent times.

Depression, Education, And Quality Of Life In Women With Endometriosis, Ria N. Gajar

Walden Dissertations and Doctoral Studies

Endometriosis is a chronic gynecologic condition associated with substantial physical, psychological, and social burden, and depressive symptoms are consistently linked to poorer health-related quality of life (HRQoL) among affected women. However, limited population-based research has examined how depressive symptoms intersect with social factors. Guided by Engel’s biopsychosocial model, nationally representative data from the 2005–2006 National Health and Nutrition Examination Survey (NHANES)—the most recent cycle to include an item on endometriosis diagnosis—were analyzed among U.S. women with self-reported endometriosis (N = 4,137). Complex samples logistic regression models were used to examine associations between depressive symptoms and HRQoL across general, physical, and …

Designing A Wellness Initiative Residents Actually Use: Data From Four Years Of Opt-Out Check-Ins, Meghan O’Meara, Phd, Lpc, Alexandra Hughes, Lcsw, Shawn Blue, Psyd, Emily Lisco, Md

Department of Psychiatry and Human Behavior Posters

Background

• Resident well-being remains a critical concern in GME, with increasing rates of burnout, mental health challenges, and persistent barriers to accessing care.^2,4
• Burnout among residents is linked to higher rates of medical errors and lower patient satisfaction.^4,5
• ACGME emphasizes the importance of fostering a culture of wellness including the opportunity for residents to attend healthcare appointments during working hours; however, programs often struggle to translate these goals into sustainable, practical interventions.¹
• Opt-out programs have been used to target residents and medical students to increase help-seeking and provide access to mental health care with limited barriers.
• Stigma, …

Evaluating The Residential Lead Remediation Program In The City Of Lancaster, Kaitlin Mcgowan, Divine Oludi, Harriet Okatch

Phase 1

Introduction: Residential lead remediation is an effective primary prevention approach for addressing lead exposure. Current guidelines require residents of a home get relocated during the remediation. Relocation is often for a period of ten days; however, no study has explored the effect of relocation on families. This study aims to understand the experiences of relocated families with a goal to develop a framework for relocation informed by the experiences of previously relocated families.

Methods. Ten semi-structured interviews were conducted with individuals from the city of Lancaster whose homes had been remediated during the last two years. Participants described their …

Asian Reference Values For Handgrip Strength, Gait Speed, Five-Times-Sit-To-Stand Test, Muscle Mass And Calf Circumference, Jozo Grgic, Siew Ling Tey, Dieu Thi Huynh, Yen Ling Low, Zeljko Pedisic, Nina Schaller, Vanessa Kristina Wazny, Weilan Wang, Yasuhiko Saito, Ravindra P. Rannan-Eliya, Hala Ghattas Ph.D., Monique Chaaya, Carlos Mendes De Leon, Preeti Gupta, Ecosse L. Lamoureux, Mythily Subramaniam, Edimansyah Abdin, Rahul Malhotra, Angelique Chan, Bayasgalan Tumenbayar, Et. Al.

Faculty Publications

Background:

Handgrip strength, gait speed, Five-Times-Sit-to-Stand Test (FTSST) performance, skeletal muscle mass and calf circumference are important health outcomes, particularly useful for diagnosing sarcopenia. The aim of this study was to establish reference (normative) values for handgrip strength, gait speed, FTSST performance, skeletal muscle mass and calf circumference by pooling individual participant data from national cohorts in Asia.

Methods:

We conducted a pooled analysis of individual participant data from 20 national cohorts representing 12 Asian countries (China, India, Indonesia, Israel, Japan, Lebanon, Malaysia, Mongolia, Philippines, Republic of Korea, Singapore and Sri Lanka). We included cohorts with data on at least …

Resident Mental Health: Creating An Innovative, Sustainable, And Scalable Counseling Program, Emily Lisco, Md, Alexandra Hughes, Lcsw, Shawn Blue, Psyd Thomas Jefferson University, Meghan O’Meara, Phd, Lpc

Department of Psychiatry and Human Behavior Posters

Background

• The ACGME Common Program Requirements emphasize resident well-being and expect GME programs to support resident mental health.¹
• There are limited specific guidelines on how mental health support should be delivered, resulting in wide variability.^1,3
• Research on resident-specific mental health services is limited, making best practices difficult to define.
• Medical students typically receive care through student counseling centers; but this support ends after graduation.³
• Residents occupy a dual role as both hospital employees and learners, creating gaps in existing support models, as employee assistance programs are often underutilized by residents.
• Residents experience higher rates of burnout than …

Editorial: Unveiling The Next Generation Of Cancer Immunity & Immunotherapy, Mohanraj Sadasivam, Nethaji Muniraj, Chellappagounder Thangavel

Center for Translational Medicine Faculty Papers

[This corrects the article DOI: 10.3389/fimmu.2025.1769324.].