Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons^™

Comparison Of A Dynamic Ankle Orthosis To A Walking Boot For Preserving Ankle Joint Motion And Reducing Tibial Bone Load And Strain, Perri Johnson Jr.

Theses and Dissertations (ETD)

Tibial stress fractures are a common overuse injury accounting for 21.9 – 69% of stress fractures among runners and 24 – 51.2% of stress fractures in military cadets. Current treatment involves wearing a walking boot for 3 – 12 weeks, which limits ankle motion and causes lower limb muscle atrophy. A Dynamic Ankle Orthosis (DAO) provided a distractive force that offloaded the ankle and retained sagittal ankle excursion during walking. It remains unclear how tibial loading is affected by a walking boot or the DAO. This thesis presents a feasibility study confirming the offloading effects of the DAO on tibial …

Computer-Aided Drug Discovery For Helicobacter Pylori, Nicole Ann Vita

Theses and Dissertations (ETD)

Helicobacter pylori is a high-priority drug-resistant pathogen and is currently the only bacteria considered to be a class I carcinogen and there is a critical need to identify novel chemical matter to treat H. pylori infections. Hp is responsible for greater than 60% of gastric cancer related deaths and 89% of all gastric cancer morbidities. In a previous study, our lab identified novel Hp thienopyrmidine inhibitors that target respiratory complex I, an essential enzyme in respiration. Respiratory complex I is a large asymmetric multidomain and membrane bound enzyme and due to these innate features, it is not practical for biophysical …

Methods Development In Inflammatory Bowel Disease, Andrew B. Steimke

Theses and Dissertations (ETD)

Inflammatory bowel disease (IBD) is a disease that is classified into two subtypes: ulcerative colitis (UC) and Crohn’s disease (CD). Symptoms can range from mild discomfort to requiring surgical intervention and affects approximately 1-in-200 adults in America alone, with global incidence rates increasing. While many treatments exist for IBD, perhaps the main reason for the lack of a cure is that there are many different pathogeneses that all lead to a very similar expression of symptoms. Over 240 IBD loci have been identified to date, yet the causative allele that drives the association has only been identified in ~60 of …

The Uncertainty And Psychological Health Of Family Caregivers Of Patients With Delirium In Intensive Care Units, Amal Shokri Haji Assa

Theses and Dissertations (ETD)

Each year, more than 5 million patients are admitted to an intensive care unit (ICU) in the United States, and up to 80 % of these patients develop delirium. Delirium is a common indicator of acute brain dysfunction in the ICU and a predictor of mortality, longer ICU/hospital stay, and long-term cognitive impairment. Family caregivers are a valuable resource in preventing, detecting, and managing delirium in the ICU. However, witnessing delirium episodes can generate adverse psychological symptoms in family caregivers that may compromise their health and well-being. Research in this area has demonstrated a gap in the literature regarding how …

Screening For Social Determinants Of Health To Improve Care In Pediatric Patients With Recurrent Urinary Tract Infections: A Scoping Review, Emily Gray Msn, Fnp-C, Michelle Rickard Dnp, Cpnp-Ac

Doctor of Nursing Practice Projects

Purpose: To describe what is known about how SDoH screening impacts adherence to treatment in pediatric patients with recurrent UTIs.

Depression Awareness Programs For Adolescents: A Scoping Review, Kincharska N. Freeman Msn, Aprn, Fnp-C, Cnor, Michelle Rickard Dnp, Cpnp-Ac

Doctor of Nursing Practice Projects

The purpose of this DNP project is to determine if receiving school-based depression awareness education affects the depression scores of adolescents between 10 and 19 years of age.

Review: Management Of Midshaft Clavicle Fractures In Adolescents , Matthew B. Holloway

Longitudinal Scholar's Project

Clavicle fractures are common injuries that occur across all age ranges, but are largely seen in young, active males. The majority of these fractures (70-80%) occur in the midshaft of the clavicle. The purpose of this review was to compare non-operative treatment to operative treatment of midclavicular fractures and determine whether treatment for adolescent clavicle fractures more closely aligns with pediatric or adult management. Adolescent clavicle fractures are increasingly treated with open reduction and internal fixation, especially in the 15 to 19 age group. Nevertheless, there remains a lack of high-level studies comparing outcomes of operative and conservative treatment specifically …

Efficacy Of Various Interventions For Achieving Target Hba1c Levels For Patients With Type Ii Diabetes Mellitus And On Exogenous Insulin, Caitlin S. Welch, Archie Troxel

Longitudinal Scholar's Project

Objective: To learn the rates at which patients at UT Family Medicine–St. Francis (UTFM–SF) with type II diabetes mellitus are being prescribed recommended medications—namely metformin, sodium-glucose cotransporter 2 (SGLT2) inhibitors, and glucagon-like peptide 1 receptor agonists (GLP1RAs)—whether these rates correspond to the severity of hyperglycemia (as indicated by HbA1C level). A secondary goal of the study was to investigate if HbA1C levels are being checked at recommended intervals.

Methods: A retrospective chart review was conducted using records of patients seen at the clinic in the previous four years between the ages of 18 and 65 who had visits with ICD …

Total Joint Implant Alloy Oxide Layer Cell-Induced Damage, Chandler K. Sears

Longitudinal Scholar's Project

Cobalt-Chromium alloy is commonly used in total joint arthroplasty (TJA). Several studies have investigated evidence of inflammatory-cell-induced-corrosion (ICIC) causing pitting in TJA retrieved implants. Others have determined that placing orthopedic alloys into lower pH solutions will increase the rate of corrosion. We have determined that electrochemical potential and corrosion rates of human knee synovial fluid show a variation greater than an order of magnitude. This means there is going to be a significant variation between a patient’s local environment of the TJA implant and may affect how macrophages interact with alloy oxide layers. Knee disability can be quantified by using …

Investigating The Correlation Between Lpr & Obesity, Andrew S. Franklin Bs, Chad A. Nieri Bs, M. Boyd Gillespie Md

Longitudinal Scholar's Project

Objectives: To determine whether Drug-Induced Sleep Endoscopy (DISE) findings of Laryngopharyngeal Reflux (LPR) correlate with obesity, gender, Epworth Sleepiness scale, and OSA severity.

Study design: Single center retrospective cohort study.

Methods: Patients greater than 18 years of age who underwent DISE by one surgeon at a tertiary care center from July 2016 to July 2022 were included. DISE findings, patient characteristics, demographics, polysomnogram(s), and Epworth Sleepiness Scale(s) were extracted. Fisher’s exact test was used to compare categorical variables, and independent sample t-test was used to compare continuous variables. All statistical analyses were performed using IBM SPSS Statistics 28.

Results: …

Effects Of Dietary Ω-3 Polyunsaturated Fatty Acids (N-3 Pufa) In Light Sensitivity Of Retinas Of Mice Models To Prevent Retinal Damage, Aaron Eugene Rice

Longitudinal Scholar's Project

Light-induced retinal degeneration (LIRD) causes photoreceptor cell death in albino mice after exposure to high intensity light for a set period of time (6-24 hours). This causes retinal photoreceptor cell death through apoptosis. From several previous studies, Dr. Mandal’s lab concluded that de novo biosynthesis of ceramide mediates photoreceptor cell death in a LIRD model. Previous studies in Dr. Mandal’s lab has shown that mouse models with higher endogenous ω-3 Polyunsaturated Fatty Acids (n-3 PUFA) generates less ceramide upon neuronal injury and prevent neurodegeneration (Mol Neurobio 2021). There are currently not many available effective therapies for retinal degeneration in humans …

Provider Attitude Towards Postpartum Sexual Health, Katie Shearer, Pallavi Khanna

Longitudinal Scholar's Project

Background: The prevalence of female sexual dysfunction (FSD) worldwide is estimated to be 41%. FSD is even more prevalent in postpartum patients. There are significant barriers to addressing FSD in a busy clinic, and the use of a standardized screening questionnaire could be used to improve outcomes during postpartum appointments.

Methodology: Providers that care for postpartum patients at Regional One Health in Memphis, TN, were asked to complete an anonymous survey online. General knowledge and practices of providers were assessed.

Results: 79% of respondents answered that they felt very comfortable assessing for postpartum sexual health, and 88% …

Comparison Of Routine Health Screening Rates Between Two Emr Systems, Lauren M. Cancio, Caleb J. Berta

Longitudinal Scholar's Project

An EMR, electronic medical record, system refers to the software widely adopted by medical practitioners to reduce the use of hard-copy files, and improve the documentation, storage, and retrieval of patient information. Some EMR systems can generate automatic alerts reminding providers when patients are due for certain preventive services or meet the criteria for various screening measures. Epic, one of the leading EMR systems in use today, contains this additional feature. The screening recommendations built into Epic are derived from a committee of USPSTF, U.S. Preventive Services Task Force, medical experts whose focus is to improve patient health across the …

Inflammatory Response Following Hemorrhagic Stroke: The Role Of Cytokines, Patrick Devlin

Theses and Dissertations (ETD)

Hemorrhagic stroke is a dangerous form of stroke resulting from the rupturing of weakened blood vessels, releasing blood that increases intracranial pressure and causes the death of surrounding tissue. Treatment options are improving but remain limited, as evidenced by this condition being characterized by high rates of mortality as well as long-term morbidity. Unregulated inflammatory responses that occur following injury may be partially to blame for these poor outcomes. In response to any injury, the immune system releases cytokines to recruit immune cell activation and promote inflammation. But after hemorrhagic stroke, whether aneurysmal subarachnoid hemorrhage (aSAH) or intracerebral hemorrhage (ICH), …

Associations Between Postpartum Depression And Child Overweight And Obesity: Mediating Effect Of Maternal Feeding Behaviors And Beliefs, Michelle Harrison

Theses and Dissertations (ETD)

Purpose. Postpartum depression (PPD) is a mental condition that significantly affects 10% to 25% of women within the first year after the birth of their child. The mother-infant relationship is key to child growth. Previous studies have shown that PPD has a detrimental effect on children’s physical and psychological well-being as it affects the child through the mother’s parenting behavior. Depressed mothers show a lack of engagement with their children, which could extend to feeding practices influencing weight gain. The prevalence and severity of childhood overweight and obesity is a global public health problem. An increase in weight gain in …

Ribonucleotide Reductase Subunit Switching In Hepatoblastoma Drug Response And Relapse, Anthony Brown

Theses and Dissertations (ETD)

Hepatoblastoma is the most common primary liver cancer in infants and young children. Despite being a very rare cancer that accounts for only 0.5-2% if all childhood cancer cases, HB has the largest increase in incidence among childhood cancers in the United States and worldwide. The five-year survival rate of children with the aggressive forms of HB, including those that have developed metastatic or recurrent diseases, is less than 40% due to the lack of effective treatment. We aim to identify targetable mechanisms underlying the progression and drug resistance of high-risk HB. Our recent work on HB mouse and organoid …

Nursing Perspectives And Opinions On Early Or Delayed Sepsis Treatment: A Mixed Methods Approach, Pamela L. Harris

Theses and Dissertations (ETD)

Purpose. Each year at least 1.7 million adults in America develop sepsis. Sepsis can lead to life threatening organ dysfunction, severe hypotension, and death when severe sepsis or septic shock is involved. Sepsis is responsible for 50% of acute kidney injury (AKI), which is the most common form of organ dysfunction seen in critical care. Sepsis associated AKI results in loss of, or decreased renal function, is associated with adverse long-term outcomes, and carries a higher mortality rate than non-septic AKI, sepsis without AKI, or septic shock without AKI. Surviving sepsis guidelines suggests a 1-hour window from the time of …

Utility Of Av Nodal Characteristics In Identification Of Atrioventricular Nodal Reentrant Tachycardia And Risk Of Recurrence, Kimberly M. Decarr

Longitudinal Scholar's Project

Background: Catheter ablation of the slow atrioventricular (AV) nodal pathway is a safe and effective treatment for atrioventricular nodal reentrant tachycardia (AVNRT). While AVNRT occurs frequently in both children and adults, pediatric patients experience higher rates of AVNRT recurrence.

Objective: The purpose of this study was to characterize changes in AV nodal conduction properties following catheter ablation and correlate these properties with AVNRT recurrence in pediatric patients.

Methods: This was a retrospective review of patients aged(AVRT) at a single tertiary care center between January 01, 2010 and September 01, 2021. Demographics, pre- and post-ablation ECG intervals, and AV nodal conduction …

Sepsis: Do The Clinical Criteria Support The Medical Coding?, April M. Insco

Theses and Dissertations (ETD)

Background: Sepsis is a condition that can be very costly and very deadly. Diagnosing sepsis can be challenging as there is not one specific test that will identify whether a patient has sepsis and there are varying opinions as to the true definition of sepsis. The definition of sepsis used for this research is a combination of System Inflammatory Response Syndrome (SIRS) with an identified infection. Medical Coders must review the documentation provided in a medical record to accurately assign an ICD-10-CM code. Administrative data is then used to provide statistical information for research purposes. When coded data is not …

Otulin's Novel Regulatory Mechanisms In Genotoxic And Inflammatory Nf-Kb Signaling, Mingqi Li

Theses and Dissertations (ETD)

Triple negative breast cancer (TNBC) is aggressive but cannot be treated with hormone therapy or molecular therapy due to the lack of a target. Chemotherapy is a systemic treatment that works by attacking rapidly growing cells, which is initially more effective for TNBC patients than those individuals with the hormone receptor-positive breast cancer. However, patients with TNBC tend to develop resistance to chemo drugs, called chemoresistance. After years of effort, the signaling pathways involved in TNBC chemoresistance are gradually revealed, including the nuclear factor-kappa B (NF-kB) pathway. Transcription factor NF-kB is widely involved in cancer development and progression, and its …

Targeting Myeloid Protein Kinase C Signaling To Overcome Immune Suppression And Improve Immunotherapy In Cancer, Mehdi Chaib

Theses and Dissertations (ETD)

Checkpoint immunotherapy unleashes T cell antitumor potential which has revolutionized cancer treatment showing unprecedented long-term responses. However, most patients do not respond to immunotherapy which often correlates with a dysfunctional or immunosuppressive myeloid compartment. Immunosuppressive myeloid cells comprise Myeloid-derived suppressor cells (MDSCs) and tumor-associated macrophages (TAMs) and can suppress T cells via production of immunosuppressive factors. Conversely, efficient cytotoxic T cell priming is dependent on the ability of antigen-presenting cells (APCs), mainly conventional dendritic cells (cDCs) and macrophages, to present or cross-present tumor antigens to T cells. Thus, targeting immunosuppressive myeloid cells while simultaneously enhancing APCs represents a promising strategy …

The Role And Immunogenicity Of Cbfa2t3-Glis2 In Pediatric Acute Megakaryoblastic Leukemia, Elizabeth A. Garfinkle

Theses and Dissertations (ETD)

CBFA2T3-GLIS2 is the most prevalent fusion oncogene in pediatric acute megakaryoblastic leukemia in patients without Down syndrome (non-DS-AMKL) and is associated with an event free survival of only 8% even with high intensity chemotherapy and stem cell transplant in first remission. A cryptic inversion event on chromosome 16 joins the three nervy homology regions (NHR) of CBFA2T3 to the five zinc fingers of GLIS2. This configuration enables the encoded chimeric transcription factor to bind GLIS consensus sequences throughout the genome and recruit transcriptional activators and repressors to alter gene expression and enhance self-renewal capability. Few cooperating mutations have been identified …

Feasibility And Effectiveness Of A Prehabilitation Program Prior To Breast Cancer Surgery: A Critically Appraised Topic, Emma Choi, Alissa Lee, Kayla Woods, Morgan Mills, Carol Houston

Master of Occupational Therapy Student Critically Appraised Topics

The purpose of our project is to determine the feasibility and effectiveness of a prehabilitation (prehab) program for patients undergoing breast cancer surgery as compared to only receiving post-surgical rehabilitation. Our clinical mentor has recently obtained certification as a lymphedema specialist and is assisting with the opening of an outpatient mastectomy clinic through the Methodist University systems. Through our research process, we critically appraised two Level II articles, two Level III articles, and one Level IV article. Positive outcomes related to the feasibility were identified, however there is limited significant evidence supporting the effectiveness of the intervention. We recommend using …

Effect Of Botox And Therapy On Spasticity In Cerebral Palsy: A Critically Appraised Topic, Rachel Bray Mot/S, Tatum Cabot Mot/S, Peyton Clark Mot/S, Cameron Goodman Mot/S, Tarason Moore Mot/S, Claire Napier Mot/S

Master of Occupational Therapy Student Critically Appraised Topics

Children diagnosed with Cerebral Palsy often experience upper limb spasticity. Research has shown Botox injections in combination with occupational therapy can reduce the effects of spasticity in the upper limb. This literature review aims to determine how long is the appropriate duration of occupational therapy to administer after Botox injections to see decreased spasticity in the upper limbs.

Effects Of Sensory Intervention On Neurological Development In The Neonatal Intensive Care Unit: A Critically Appraised Topic, Paulina Bullard Mot/S, Emma Gadberry Mot/S, Siham Sherif Mot/S, Virginia Strawn Mot/S, Courtney Travis Mot/S, Delaney Weller Mot/S

Master of Occupational Therapy Student Critically Appraised Topics

The final portfolio contains four research articles from both national and international journals. Study designs include a randomized clinical trial, a randomized control trial, a systematic review and meta-analysis, and an integrative review. All studies relate directly to components of the evidence-based practice question and will be used to recommend sensory intervention for neurological development of premature infants in the neonatal intensive care unit (NICU). One of the articles describes statistically significant effects. One of the articles describes both statistically significant and non-statistically significant effects of sensory intervention on neurological development of premature infants in the NICU. The other two …

The Effects Of Air-Cell Based Cushions On Pressure Relief For Adults With Spinal Cord Injury: A Critically Appraised Topic, Audrey Carr Mot/S, Olivia Hamby Mot/S, Hailey Hanson Mot/S, Olivia Kincaid Mot/S, Molly Mcwilliams Mot/S, Anna Pollan Mot/S

Master of Occupational Therapy Student Critically Appraised Topics

Most acute care level patients with a SCI are dependent in performing pressure relief. Research was appraised and synthesized to answer the question: Are air-filled cushions effective for reducing pressure and development of pressure ulcers among adults with a spinal cord injury who are unable to independently perform pressure relief?

Group Therapy For Adults With Hip Replacements, Riley Burford Mot/S, Hillary Talley Mot/S, Elizabeth Seals Mot/S, Alishah Pirwani Mot/S, Tylan Wakefield Mot/S

Master of Occupational Therapy Student Critically Appraised Topics

The purpose of our critically appraised topic is to synthesize the best current evidence regarding the feasibility of group occupational therapy and outcomes related to ADL performance. The final portfolio contains a total of four research articles. Study designs include two randomized control trials, one cohort design, and one systematic review. All studies related directly to the PICO question and were used to determine best evidence for the feasibility of group therapy of the older adult population who have hip replacements in a rehabilitation setting.

Effect Of Early Mobilization On Length Of Hospital Stay In Covid-19 Patients: A Critically Appraised Topic, Ashlee Hodges, Anna Claire Briscoe, Anna Beth Willoughby, Carlton Hubbard, Nathan Smith

Master of Occupational Therapy Student Critically Appraised Topics

For this project, we created a critically appraised topic to study the effects of early mobilization on length of hospital stay in COVID-19 patients in the ICU.

Updates In The Pharmacologic Prophylaxis And Treatment Of Invasive Candidiasis In The Pediatric And Neonatal Intensive Care Units, James Hunter Fly, Seerat Kapoor, Kelly Bobo, Jeremy S. Stultz

Faculty Publications

Purpose of review The goal of this review was to provide an update on the prevention and treatment options for invasive candidiasis (IC) in the neonatal intensive care unit (NICU) and pediatric intensive care unit (PICU).

Recent findings Studies have further validated the use of fluconazole for IC prophylaxis among high-risk patients in the NICU. It remains unclear if prophylaxis leads to resistance development and the ideal dosage regimen is still not clear. Recent studies have been published comparing caspofungin and micafungin to amphotericin B and illustrated similar efficacy outcomes in the NICU. Micafungin now has approval from the United …

Dexmedetomidine To Reduce Ponv, Amanda Johnson Srna, Joshua Lawrence Srna, Staci Martinez Srna, Taylor Mayberry Srna, Dwayne Accardo Dnp, Crna, Aprn

Doctor of Nursing Practice Projects

Purpose/Background Postoperative nausea and vomiting (PONV) contribute to patient dissatisfaction, discomfort, adverse outcomes, and increased healthcare costs. Despite current protocols that aim to reduce PONV by prevention/antiemetic administration, PONV continues to be a common manifestation in many postoperative patients (Elvir-Lazo et al., 2020). This scoping review aimed to analyze available research on the efficacy of dexmedetomidine to reduce perioperative opioid requirements and PONV.

Methods Synthesis of this scoping review began with a systematic approach to search databases and identify eligibility criteria articles. Of the 21 articles that met criteria, a synthesis table was formed to visualize the qualitative (smoking status, …