Medical Specialties Commons^™

Mimicking The Effect Of Prolactin On Stat3/Stat5 Activity In Breast Cancer, Jennifer N. Barbuto, Sarah R. Walker

Honors Theses and Capstones

Signal transducers and activators of transcription (STAT) 3 and 5 are commonly constitutively activated in breast cancer. STAT5 can outcompete STAT3 and reduce cell proliferation and metastasis. STAT5 activation is stimulated by prolactin, a natural hormone that can be harmful at high levels. The aim of this study is to identify some possible previously developed drugs that mimic the effect of prolactin and STAT5 without the added risk in MDA-MB231 breast cancer cells. Using the CLUE database query app and STAT5 up- and downregulation signatures, three drugs (X, K, and M) were chosen based on their similarity in signatures to …

Orthostatic Headaches Associated With Spontaneous Intracranial Hypotension And Autonomic Dysfunction-A Case Series In Young Patients, Ankita Ghosh, Yen X Tran, Leon Grant, Mohammed T Numan, Rajan Patel, Ian J Butler

Faculty, Staff and Student Publications

Background: Orthostatic headaches can be noted in spontaneous intracranial hypotension and orthostatic intolerance. We present a case series of young patients diagnosed with spontaneous intracranial hypotension and were treated for the same but subsequently developed orthostatic intolerance. Methods: We retrospectively reviewed charts for seven young patients with orthostatic headaches related to spontaneous intracranial hypotension and orthostatic intolerance. Results: Patients were diagnosed with spontaneous intracranial hypotension. Diagnosis was confirmed by identifying epidural contrast leakage and three of seven patients were noted to have early renal contrast excretion on computerized tomography myelography. Patients were treated with epidural blood patches. All patients showed …

Development Of An Integrated Medical And Behavioral Health Care Model For Children In Foster Care: The Rees-Jones Center For Foster Care Excellence, Kimberly Stone, Sara Moore, Sara Pollard

Integrated, Trauma-Informed Care

Children in foster care are classified as a population with special health care needs. They face multiple adverse childhood experiences and disrupted relationships, yet face barriers accessing consistent, high-quality health care. The American Academy of Pediatrics recommends integrated physical and behavioral health care for children in foster care, but little is known about the implementation of integrated care for this population. As a pediatrician, doctor of nursing practice, and psychologist in an academic medical setting, we describe the development and implementation of the Rees-Jones Center for Foster Care Excellence, emphasizing the role of medical and behavioral health providers in promoting …

Application Of Big-Data For Epidemiological Studies Of Refractive Error, James Loughman

Articles

To examine whether data sourced from electronic medical records (EMR) and a large industrial spectacle lens manufacturing database can estimate refractive error distribution within large populations as an alternative to typical population surveys of refractive error.

Imaging Patterns Of Encephalopathy In Patients With Covid-19, Kumail Khandwala, Fatima Mubarak, Nadeem Ahmad

Department of Radiology

The aim of this retrospective observational study was to describe the neuroimaging manifestations of patients with COVID-19. This study was conducted at Aga Khan University Hospital, Karachi, Pakistan from March to July 2020. COVID-19 patients with neurological symptoms and positive neuroimaging were included after confirmation of COVID-19 by polymerase chain reaction test (PCR). In the 12 included patients, seizures and altered mentation were predominant neurological manifestations. Three cases had acute watershed infarcts (25%), two cases had posterior cerebral artery territorial infarcts (16.7%), two cases had periventricular corona radiata infarcts (16.7%), three cases had hypoxic ischemic encephalopathy (25%), two cases had …

Interdisciplinary Community-Based Support For Caregivers Of Individuals Living With Dementia, Gina Tucker-Roghi, Jamie Escoubas, Renee Tolliver, Sarah Tucker

Occupational Therapy | Faculty Scholarship

Evidence indicates family caregivers of individuals living with dementia (ILwD) are at risk for diminished physical and mental health; which may decrease their quality of life and directly impact their ability to provide care. An interdisciplinary approach to self-care and skill-building for caregivers is provided in a virtual support group offered by Council on Aging in Sonoma County, CA. As part of the nonprofit’s Adult Day Program, the group is offered to client caregivers and has two goals: First, creating a communitybased, long-term support system for ILwD who are agingin-place; second, fostering a safe and supportive community for family caregivers, …

Neuroimaging On Brain Aging And Neurodegeneration, Katelynn Nguyen

Scripps Senior Theses

Alzheimer’s disease (AD) is a progressive neurodegenerative disorder that usually affects but not limited to the elder population. We see that when an individual develops AD, the brain cells are degenerating and dying at rates that are uncontrollable. Worldwide AD has affected at least 50 million people and we will continue to see this number increase. Although the research done on AD has made great strides, much is still unknown and being studied. Previous studies have allowed us to understand that many of the impacts of AD are correlated to various regions of the brain experiencing atrophy. This causes an …

The Write Stuff - Winter 2021 (Vol. 18, No. 1), Research Medical Library

Write Stuff 2021

• Resources for making your research more rigorous
• Best practices for presenting with Zoom
• Research articles: Establishing authorship and author order
• Unusual terms used in scientific writing and publishing: Megajournal

A Weight-Loss Intervention Augmented By A Wearable Device In Rural Older Adults With Obesity: A Feasibility Study, John A. Batsis, Curtis L. Petersen, Matthew L. Clark, Summer B. Cook, Francisco Lopez-Jimenez, Rima I. Al-Nimer, Dawna Pidgeon, David Kotz, Todd A. Mackenzie, Stephen J. Bartels

Dartmouth Scholarship

Background

Older persons with obesity aged 65+ residing in rural areas have reduced access to weight management programs due to geographic isolation. The ability to integrate technology into health promotion interventions shows a potential to reach this underserved population. Methods

A 12-week pilot in 28 older rural adults with obesity (body mass index [BMI] ≥ 30 kg/m2) was conducted at a community aging center. The intervention consisted of individualized, weekly dietitian visits focusing on behavior therapy and caloric restriction with twice weekly physical therapist-led group strengthening training classes in a community-based aging center. All participants were provided a Fitbit Flex …

Gaps In Worker Protections That Increase Essential Workers’ Exposure To Covid-19, Ruqaiijah Yearby

All Faculty Scholarship

States and localities designated more than 55 million Americans as essential workers. Essential workers not only comprise those employed by the health care and food and agriculture industry, but also include teachers, grocery store workers, transit and airline workers, mail and delivery workers, energy sector and utility workers, and domestic workers (Petition for Emergency, 2020). Racial and ethnic minorities are disproportionately employed as essential workers, with Black Americans the most likely to be essential workers (Petition for Emergency, 2020). Essential workers have been left vulnerable to workplace COVID-19 infections and deaths in large part due to the federal and state …

Development And Clinical Validation Of Knowledge-Based Planning Models For Stereotactic Body Radiotherapy Of Early-Stage Non-Small-Cell Lung Cancer Patients, Justin David Visak

Theses and Dissertations--Radiation Medicine

Lung stereotactic body radiotherapy (SBRT) is a viable alternative to surgical intervention for the treatment of early-stage non-small-cell lung cancer (NSCLC) patients. This therapy achieves strong local control rates by delivering ultra-high, conformal radioablative doses in typically one to five fractions. Historically, lung SBRT plans are manually generated using 3D conformal radiation therapy, dynamic conformal arcs (DCA), intensity-modulated radiation therapy, and more recently via volumetric modulated arc therapy (VMAT) on a C-arm linear accelerator (linac). Manually planned VMAT is an advanced technique to deliver high-quality lung SBRT due to its dosimetric capabilities and utilization of flattening-filter free beams to improve …

Therapy And Medical Imaging Applications Of Focusing Polycapillary X-Ray Optics, Weiyuan Sun

Legacy Theses & Dissertations (2009 - 2024)

Focusing polycapillary optics yield high gains in intensity and increased spatial resolution for a variety of clinical, lab-based, synchrotron, or in situ analysis applications. In this dissertation we investigate the extension of two applications of focusing polycapillary optics. The first is the application of polycapillary optics in radiation therapy. This discussion includes measurements and calculation of dose for focused beam orthovoltage therapy. A system has been designed to investigate whether the polycapillary optics can produce an X-ray beam which can give more accurate dose painting due to the higher dose concentration at the focal spot. X-ray exposures were measured with …

Applied Methodologies Demonstrated Through Three Independent Studies For Assessing The Effects Of Socioeconomic, Environmental Chemical Exposure, And Therapeutic Factors On Oncological Diseases And Covid-19, Bayarmagnai Maggie Munkhjargal

Legacy Theses & Dissertations (2009 - 2024)

When trying to understand risk factors for a disease, even before we know the causal agents, it is necessary to create a surveillance data set that answers the questions of who, when, and where, and includes any potential covariates which may either promote or prevent the disease. There are a wide variety of surveillance data. For example, hospital discharge data, such as the New York Statewide Planning and Research Cooperative System (SPARCS) data, encompass all hospitalized cases in the state, while clinical datasets cover a specially constructed population in pursuit of research of a certain disease type. Analysis of surveillance …

The Modern Use Of The Extended Humeral Head (Cuff Tear Arthropathy) Hemiarthroplasty., Tyler J Smith, Sarav S Shah, Justin W Peterson, Glen Ross

Orthopedic Surgery Resident Research

Today, the treatment of osteoarthritis in the rotator cuff-deficient population is largely dominated by reverse shoulder arthroplasty (RSA). Despite the popularity of and increased familiarity with this procedure, the complication rate of RSA remains significant. An extended humeral head hemiarthroplasty may provide a less invasive alternative for select patients with cuff tear arthropathy (CTA) and preserved glenohumeral active elevation. With the indications for reverse arthroplasty expanding to younger patients, there are concerns about the longevity of this implant, as well as the associated revision burden. In the setting of failed RSA, the bone stock available for glenosphere baseplate fixation can …

Digest Of The Philadelphia College Of Osteopathic Medicine (2021 No. 1), Philadelphia College Of Osteopathic Medicine

PCOM Digest 2020s

The 2021 No. 1 issue of the Digest of the Philadelphia College of Osteopathic Medicineincludes the following articles:

• Updates
• Institutional Heritage: Founders’ Day
• Meta L. Christy, DO: The First African American Osteopathic Physician
• Standing on Her Shoulders: Celebrating Meta L. Christy, DO, and African American Alumnae Trailblazers
• Class Notes

Validity, Reliability, And Measurement Error Of A Sit-To-Stand Power Test In Older Adults: A Pre-Registered Study, Anoop T. Balachandran

Publications and Research

Objectives: Lower body power declines with age and is associated with decreased physical function in older adults. However, the majority of the tools available to measure power are expensive and require considerable space and expertise to operate. The purpose of this study was to assess the validity, reliability, and measurement error of a sit-to-stand power test (STSp) to assess lower body power. Methods: 51 community-dwelling adults, 65 years or older, completed a power test using a pneumatic leg press (LP), the Short Physical Performance Battery (SPPB) that includes a test of balance, usual walking speed, and chair stand tests; Timed …

Palliative Performance Scale As A Prognostic Tool For Patients With Dementia In Hospice, Alexandria Nasr

Scholarship in Medicine - All Papers

Objective: Palliative and hospice care have been shown to benefit people with dementia and their families. However, for patients with dementia who are nearing the end of life, hospice referral can be challenging because of the difficulty in predicting prognosis. The objective of this retrospective, exploratory study is two-fold: (1) to describe trajectories by analyzing trends in Palliative Performance Scale (PPS) scores for patients admitted to hospice with a neurocognitive disorder from time of enrollment to time of disenrollment and (2) to determine the relationship between PPS and length of stay (LOS) in hospice care.

Methods: The setting for the …

Digest Of The Philadelphia College Of Osteopathic Medicine, Philadelphia College Of Osteopathic Medicine

PCOM Digest 2020s

The (2021 No. 2) issue of the Digest of the Philadelphia College of Osteopathic Medicine includes the following articles:

• Updates
• Advancing Alumni
• Reimagining Public Health: Pivoting from Pandemic Response to Future Prevention
• Rethinking Burnout, Mental Health and Well-being
• A Pandemic Within a Pandemic: Addressing Marginalized and Minoritized Communities to Foster Recovery
• Class Notes

The Safe Environment For Every Kid Model: Analyzing Demographics Related To Higher Risks Of Child Maltreatment In High-Risk Pediatric Population, Hannah Redding

Scholarship in Medicine - All Papers

Background: The Safe Environment for Every Kid (SEEK) screener was developed by Dr. Howard Dubowitz for primary care clinicians to identify and address risk factors for child maltreatment. The instrument queries parents/guardians regarding their families' needs (e.g. food insecurity) and screens for depressive symptoms in the parent/guardian.

Objective: To examine the frequency of social determinants of health (e.g., food insecurity) and its correlates using the SEEK screener during pediatric visits at a Federally Qualified Health Center in south central Ohio.

Design/Methods: The SEEK screener was distributed to parents/guardians (PG) at Rocking Horse Community Health Center, a Federally Qualified Health Center …

Outcomes And Complications Of Scfe Surgery, Tyler Sanda

Scholarship in Medicine - All Papers

Objective: Slipped capital femoral epiphysis (SCFE) is a common hip disorder affecting children and adolescents. There is much debate concerning best treatment with regards to adverse outcomes, specifically avascular necrosis (AVN). This study analyzed the rates of adverse outcomes after the surgical treatment of SCFEs. It examined risk factors which may lead to the development adverse outcomes. This research will aid clinical decision-making, helping determine optimal surgical treatment of SCFEs and adding to external datasets of SCFE treatment.

Methods: This was a retrospective review of patient health records at a level 2 pediatric trauma hospital. The study included all SCFE …

Determining The Appropriate Technique For Appendix Stump Closure, Cynthia White

Scholarship in Medicine - All Papers

Background In a laparoscopic appendectomy, closure of the appendeceal stump can be done using an endostapler or endoloop. We compared outcome data of the two techniques in patients who underwent laparoscopic appendectomy.

Method We included all patient > 18 years who underwent laparoscopic appendectomy for acute appendicitis at a single institution over a 4-year period. Demographic and outcome data were compared between both groups. Results 501 patients, with no significant differences in age, gender or BMI, were identified for the study. No differences were noted in procedure length, readmission rates, complication rates (including intra-abdominal abscess) or hospital charges. There was a …

New Evidence For P-Gp-Mediated Export Of Amyloid-Β Peptides In Molecular, Blood-Brain Barrier And Neuronal Models, Amanda B. Chai, Anika M. S. Hartz, Xuexin Gao, Alryel Yang, Richard Callaghan, Ingrid C. Gelissen

Sanders-Brown Center on Aging Faculty Publications

Defective clearance mechanisms lead to the accumulation of amyloid-beta (Aβ) peptides in the Alzheimer’s brain. Though predominantly generated in neurons, little is known about how these hydrophobic, aggregation-prone, and tightly membrane-associated peptides exit into the extracellular space where they deposit and propagate neurotoxicity. The ability for P-glycoprotein (P-gp), an ATP-binding cassette (ABC) transporter, to export Aβ across the blood-brain barrier (BBB) has previously been reported. However, controversies surrounding the P-gp–Aβ interaction persist. Here, molecular data affirm that both Aβ₄₀ and Aβ₄₂ peptide isoforms directly interact with and are substrates of P-gp. This was reinforced ex vivo by the …

Uptake And Determinants Of Cervical Cancer Screening Among Health Care Workers In Aga Khan University Hospital, Nairobi Kenya., Doreen Moraa Osoro

Master of Medicine in Obstetrics and Gynecology

Background: The cancer burden has been rising globally. The reported incidence of cervical cancer is 13.1 / 100,000 globally and 40 / 100,000 in Kenya. Up to 88% of all cervical cancer deaths have been reported in lower to middle-income countries. In comparison, developed countries had up to two to four times lower rates of cervical cancer incidence and mortality. The burden of cancers attributable to carcinogenic infections has potentially modifiable risk factors, for which prevention tools already exist. There is a gap in the implementation of evidence-based interventions including primary prevention with the HPV vaccine and secondary prevention with …

Neither “Post-War” Nor Post-Pregnancy Paranoia: How America’S War On Drugs Continues To Perpetuate Disparate Incarceration Outcomes For Pregnant, Substance-Involved Offenders, Becca S. Zimmerman

Pitzer Senior Theses

This thesis investigates the unique interactions between pregnancy, substance involvement, and race as they relate to the War on Drugs and the hyper-incarceration of women. Using ordinary least square regression analyses and data from the Bureau of Justice Statistics’ 2016 Survey of Prison Inmates, I examine if (and how) pregnancy status, drug use, race, and their interactions influence two length of incarceration outcomes: sentence length and amount of time spent in jail between arrest and imprisonment. The results collectively indicate that pregnancy decreases length of incarceration outcomes for those offenders who are not substance-involved but not evenhandedly -- benefitting white …

Experiences Of Women With Ovarian Cancer During The Covid-19 Pandemic: Examining Intolerance Of Uncertainty And Fear Of Covid-19 In Relation To Psychological Distress, Erin M. Hill, Andriana Frost, Jamie D. Martin

Psychology Faculty Publications

Purpose: Our research aimed to examine the role of intolerance of uncertainty (IU) in psychological distress (PD) among women with ovarian cancer. Fear of COVID-19 (FCOV) was examined as a mediator, and participant health status and the reopening status of their geographic region were examined as moderators. Design: A cross-sectional quantitative design was employed. Participants: Participants (n ¼ 100) were recruited through various online sources and completed the study via Qualtrics. Methods: Moderated mediation models and post-hoc linear regression analyses were used to determine the role of predictor variables in PD. Results: No significant moderators or mediators were found. Despite …

Concomitant Guillain-Barre Syndrome With Covid-19, Skylar A. Morongell

Honors Undergraduate Theses

The current Coronavirus disease 2019 (COVID-19) outbreak, caused by a virus called severe acute respiratory syndrome 2 (SARS-CoV-2), has become a global health emergency. Recent findings in case studies assert that the transmigration of SARS-CoV-2 to the nervous system implicates severe neurotropic pathologies, including the onset of the rare autoimmune disease called Guillain-Barré syndrome (GBS). GBS is recognized as several disorders characterized by immune-mediated polyradiculoneuropathy, which is typically preceded by an infection or other immune stimulation. The symptoms of GBS initially present as acute symmetrical ascending paresthesia, weakness, and paralysis.

This meta-analysis serves to help understand the predisposing factors (such …

Influence Of Geography On The Healthy Gut Microbiome And The Role Of The Gut Microbiome In Ibd Symptom And Disease Progression, Sayf Al-Deen Hassouneh

Electronic Theses and Dissertations, 2020-2023

The human gut microbiome is believed to play an integral role in host health and disease. In a microbial community, associations between constituent members play an important role in determining the overall structure and function of the community. To understand the nature of bacterial associations at the species level in healthy human gut microbiomes, we analyzed previously published collections of whole-genome shotgun sequence data, from fecal samples obtained from four different healthy human populations. Using a Random Forest Classifier, we identified bacterial species that were prevalent in these populations and whose relative abundances could be used to accurately distinguish between …

Blue Light And Adult Sleep Outcomes, Andrew Caddas

Undergraduate Distinction Papers

This study investigated the effects blue light from self-luminous devices has on adult sleeping patterns. We investigated sleep quality and duration qualitatively with a randomized, double-blind, cross-over, placebo-controlled design with a wash-out period. Participants wore blue light blocking lenses or placebo lenses whenever they were using a self-luminous device throughout each day for one week. Each morning, participants filled out a survey to report their number of hours slept, time to fall asleep, and amount of time spent on self-luminous devices. Participants took the Pittsburgh Insomnia Rating Scale (PIRS) at the end of the one week trial (See Appendix A). …

Improving Emergency Department Quality Of Care, Carmen Smith

Doctor of Nursing Practice Projects

Emergency department (ED) crowding can cause an extended length of stay (LOS) and high rates of patients who leave without being seen (LWBS). This quality improvement ED project sought to reduce LOS and LWBS by implementing a triage (PIT) team. The design included an outcomes evaluation with available data and a staff pre and posttest. Length of stay and LWBS rates were compared before and after implementation. Results indicated a reduction in the average LOS and LWBS rates for the 30 days of project implementation compared to the 30 days before the project initiation. The overall goal of the PIT …

Developing An End-Of-Life Discussion Protocol In Primary Care Clinics, James L. Hawley

Doctor of Nursing Practice Projects

End-of-life (EOL) issues are far too often addressed reactively in Emergency Departments when patients can no longer express their wishes. This scenario can result in unwanted futile care, increased healthcare costs, and emotional hardships for family and healthcare workers. The purpose of this quality improvement project was to implement a protocol that would shift advanced directive conversations proactively back into primary health care settings. This action would allow patients to make and document informed decisions with their Primary Care Providers (PCPs). A pilot study conducted in November 2020 at a rural clinic provided feedback from PCPs on perceived barriers to …