Medical Specialties Commons^™

Evaluation Of Sleep Benefits Following A 16-Week Judo Program For Children With Autism Spectrum Disorder, Neha R. Chittaluru

Honors Undergraduate Theses

Autism Spectrum Disorder is a neurodevelopmental disorder characterized by language and communication deficits, and difficulties with social interaction (Twisk, 2001). Research has shown that 80% of youth with ASD experience sleep challenges which can lead to sleep-related health issues, exacerbate problematic behaviors, and increase vulnerability to anxiety and depression (Wachob & Lorenzi, 2015; Williams et al., 2004; Richdale & Schreck, 2009). Sleep plays a central role in adaptive functioning, and insufficient sleep can hinder learning, memory, and neuroplasticity for children with ASD (Cohen et al., 2014). As these unhealthy behavior patterns can lead to more adverse long-term health consequences, it …

Comparison Of Health-Related Quality Of Life Trajectories In Older Breast Cancer Patients And Noncancerous Controls Over Ten Years, Maria Eduarda De Azevedo Daruge

Honors Undergraduate Theses

The adverse effects of cancer treatment on health-related quality of life (HRQL) are the primary concern of elderly women diagnosed with breast cancer. The interplay of transient and progressive functional impairments caused by cancer therapies, alongside the accelerated physical declines associated with the normal aging process, are all negatively correlated to HRQL. This study compared the HRQL trajectories between cases and controls for ten years after diagnosis. The cancer group included 1467 women (age ≥ 65), diagnosed with primary breast cancer, registered in the Surveillance Epidemiology and End Results (SEER) cancer registry, and completed the Medicare Health Outcomes Survey (MHOS) …

Testicular Cancer And Firefighters: An Umbrella Review, Andre Naguib Guirguis

Honors Undergraduate Theses

Purpose: The relationship between testicular cancer and working as a firefighter has been a relatively brushed off scope of concentration until recent years and recent developments in hopes of presenting new protocols and better guidelines to screen for testicular cancer in this occupation. The purpose of this study was to perform a scoping review to present the current data concerning testicular cancer and its association to the occupation of firefighters.

Methods: PubMed as a data base was used and articles concerning firefighters and testicular cancer were found and screened for eligibility with respect to the kind of study and the …

The Relationship Between Evening Screen Time Use And Objectively Measured Sleep Outcomes In U.S. College Students, Donya Sedaghat

Honors Undergraduate Theses

Research suggests that elevated levels of screen time in the evening can negatively impact sleep outcomes (sleep duration, quality, and latency). Yet, there is a lack of evidence exploring if this relationship exists in college students. The purpose of this study is to investigate the relationship between evening screen time use and objectively measured sleep outcomes in US college students. College students (N = 29) junior or senior standing in a Health Sciences major were recruited to participate in this cross-sectional study. Participants wore accelerometers on their wrist for 24hr/day for seven days to capture sleep duration, efficiency, awakenings, and …

The Influence Of Genetics, Insulin Resistance, Oxidative Stress, And Energy Deficit On Migraine, Victoria Dm Maldonado Llinas

Honors Undergraduate Theses

The pathomechanism of migraine attacks is not understood well, however, is currently believed to be a brain disorder. Migraine is a multifactorial disorder that needs to be investigated in multiple research areas to shed light into its mechanism and find ways to treat it effectively. Migraine episodes come from one or many things at the same time, and such vary from person to person. However, sufficient evidence in recent studies show there is a strong relationship between genetics with patients having specific genes that may be responsible for the disease or a genetic sequence passed down through generations in families, …

Effect Of Estrogen On Chondrogenesis In Female Articular Chondrocytes, Ebony R. Parsons

Honors Undergraduate Theses

As women age and transition into menopause they face a higher risk of developing osteoarthritis leading to total joint replacements. Estrogen is the primary female reproductive hormone. As a woman approaches menopause, estrogen production decreases by 100-fold. Previous research has shown that Estrogen Replacement Therapy (ERT) reduced joint replacements in post-menopausal women. However, there is a lack of research surrounding ERT's effect on chondrocyte proliferation and extracellular matrix production, particularly 3D culture extracellular matrix production. Chondrogenesis is a process of skeletal development resulting in the formation of cartilage. Chondrocytes, derived from mesenchymal progenitors, serve as the fundamental cellular component in …

Family Structure And Child Behavior Problems In Australia, The United Kingdom, And The United States, Nina A. Stoddard-Bennett, Jordan Coburn, Mikaela J. Dufur, Jonathan A. Jarvis, Shana L. Pribesh

Educational Leadership & Workforce Development Faculty Publications

A large body of literature suggests that children living with two married, biological parents on average have fewer behavior problems than those who do not. What is less clear is why this occurs. Competing theories suggest that resource deficiencies and parental selectivity play a part. We suggest that examining different contexts can help adjudicate among different theoretical explanations as to how family structure relates to child behavior problems. In this paper, we use data from the Growing Up in Australia: Longitudinal Study of Australian Children (LSAC), the UK Millennium Cohort Study (MCS), and the US Early Childhood Longitudinal Study (ECLS-K) …

Impact Of A Parent Education Program On Parents Of Children With Complex Congenital Heart Disease Prior To Discharge Home, Laura Elkhoury

DNP Projects

Abstract

Background and Purpose: Children with complex medical needs, such as children with complex congenital heart disease, are at risk for hospital readmission, morbidity, and mortality related to disease complications. Parents must be adequately prepared to care for their children following hospital discharge to prevent hospital readmission and complications. This study seeks to evaluate the impact of an education intervention on parental knowledge and stress related to caring for their child with complex medical needs.

Methods: The study design is a quasi-experimental, nonequivalent control pre-test/post-test design. The pre-test was administered prior to the educational intervention, with the post-test …

Optimization Of Orally Bioavailable Inhibitors Of Defective In Cullin Neddylation 1 (Dcn-1), Leah Kovalic

Theses and Dissertations--Pharmacy

Ubiquitin (UB) and ubiquitin-like protein (UBL) pathways have emerged as important targets for oncology drug discovery based on the success of proteasome inhibitors (bortezomib or carfilzomib), E3 inhibitors, and the NEDD8 E1 inhibitor pevonedistat (MLN42924). Chemical inhibitors have also proven to be useful probes for identifying and dissecting multifactor UB and UBL regulatory networks. Toward this end, we have pursued approaches to target NEDD8 ligation to Cullins, through developing small molecule inhibitors of DCN1 (defective in Cullin Neddylation 1). DCN1 was discovered as a potentiating RBX1-dependent NEDD8-ligation, through recognizing the acetylated N-terminal methionine of the NEDD8 E2s UBE2M and UBE2F. …

Enhancing Dna-Damaging Therapy Through The Inhibition Of Dntp Synthesis Using A Synergistic Drug Combination To Treat Pancreatic Neuroendocrine Neoplasms, Jennifer Castle Md

Theses and Dissertations--Clinical and Translational Science

Despite clinical advances, pancreatic neuroendocrine neoplasms (pNEN) remain a difficult clinical entity to treat and can carry a poor prognosis. Systemic therapy is used to treat pNENs which are not amenable to surgical resection. Peptide receptor radionuclide therapy, a form of radiation therapy (RT) and cisplatin are two different forms of DNA-damaging therapy in current use to treat pNENs. However, their efficacy remains poor as single agents. This study aimed to increase the sensitivity of pNENs to the DNA-damaging agents, RT and cisplatin, by inhibiting deoxynucleotide triphosphate (dNTP) synthesis. Triapine, a ribonucleotide reductase inhibitor (RNRi), and ataxia telangiectasia and Rad3-related …

High Cholesterol Diet Induces Sudden Death In Mice With Impaired Reverse Cholesterol Transport, Misa Ito

Theses and Dissertations--Pharmacology and Nutritional Sciences

Unexplained sudden death continues to be a major public health crisis as AHA reports that 1,000 people suffer sudden cardiac arrest each day in the U.S. with only 10% surviving. A number of ongoing challenges hinder to understand the sudden death. Thus, investigating underlined mechanisms of sudden death is urgent. Unexpectedly, I found a high cholesterol diet (HCD)-induced sudden death preclinical model. Although HCD is associated with a higher risk of cardiovascular disease (CVD) and the subendothelial lipoprotein retention theory is well established for atherosclerosis development, these theories cannot explain the sudden death in my model because atherosclerosis and CVD …

Improving Radiotherapy Workflow: Evaluation And Implementation Of Deep Learning Auto-Segmentation In A Multi-User Environment, And Development Of Automatic Contour Quality Assurance System, Jingwei Duan

Theses and Dissertations--Radiation Medicine

Radiotherapy is a frequently used therapeutic modality for cancer patients. Accurately contouring of tumors and organs at risk (OARs) is critical for developing optimal treatment plans in radiotherapy, especially after the implementation of Intensity-modulated radiation therapy (IMRT) and Stereotactic Body Radiation Therapy (SBRT). The manual contouring process is time-consuming and suffers from inter-observer variations. However, manual contouring is often hindered by laborious clinical duties, leading to reduced effectiveness, and increased segmentation errors due to fatigue. Additionally, online adaptive radiation therapy(ART), which has been shown to benefit patient outcomes, places higher demands on contouring and quality assurance (QA) speed.

Recently, deep …

Development Of A Community-Based Plan For An Effective Behavioral Intervention To Reduce Childhood Obesity In A Rural Appalachian Community, Jennifer Stacy Wells

Theses and Dissertations--Nutrition and Food Systems

Rural children experience increased rates of obesity and reduced access to specialized weight management facilities, which makes receiving the recommended frequency of care difficult. Clinical-community partnerships, recommended by the American Academy of Pediatrics (AAP) to expand access, have been shown to be a feasible strategy of care delivery. Examination of literature and stakeholder interviews were used to inform the development of a collaborative pediatric weight management program in a rural, Appalachian community. Screening articles as well as intervention articles were reviewed. Outcomes of screening articles reviewed included BMI measures (3), screening practices (7), and referral practices (4). Common outcomes of …

Alternative Pharmacology: Exploring Ketamine Use For Treatment Resistant Mental Health Disorders, Kiersten L. Ash

Soaring: A Journal of Undergraduate Research

No abstract provided.

Implementation Of A Multipronged Approach To Improve Pre-Operative Efficiency And First Case On Time Start Performance, Melyssa A. Stokes

Master's Theses and Capstones

Background: Surgical services are an important source of revenue and important economic driver of hospital systems. Surgical services account for approximately 42% of a hospital’s annual revenue, however, it also constitutes 40% of facility operating costs (Gupta, et al., 2022 & Morel & Gomez, 2021). Despite the high costs associated with surgical services delays remain a significant issue across the nation. On-time starts for the first surgical cases of the day is a key performance metric tracked by surgical facilities to determine efficiency. Currently, 50 – 90% of first surgical cases are delayed throughout the United States and the most …

Implementation Of Point-Of-Care Tick-Borne Disease Powerplan™ And Algorithm For Early Detection And Treatment Of Tick-Borne Diseases, Ashley Pinkham

DNP Scholarly Projects

Abstract

Local Problem: The Concord Hospital system, serving 30+ communities, is situated in the heart of New Hampshire surrounded by densely wooded forests, lakes, and mountains and is a mecca for camping, vacationing, and sightseeing, doubling its population of 1.6 million residents during spring, summer, and fall months. Despite the serenity, there is a predator that lingers among the hiking trails and lake shorelines. From January 2021 through August 2022 there were a total of 41 hospitalizations from tick-borne diseases, some with life threatening symptoms. Unfortunately, nearly half (43%) of patients presented to their primary care provider first where the …

Intervention To Improve Screening Mammograms In Clinical Practice., Saida Khamooshi

DNP Scholarly Projects

Abstract

Breast cancer remains a challenging health issue in the United States, representing the second leading cause of cancer deaths for women. The key approach to tackle this issue is the early detection of breast cancer through annual mammography screening in asymptomatic women. This quality improvement project sought to improve the proportion of breast cancer screening documentation in a private obstetrics and gynecology practice that serves primarily Black women. In addition, the project is thought to improve the current utilization of office mammogram services and its mammogram completion rate. Comprehensive interventions implemented included establishing clear guidelines, staff education, using paper …

The Write Stuff - Winter 2023 (Vol. 20, No. 1), Research Medical Library

Write Stuff 2023

• Protected health information
• Literature reviews: Which type should I write?
• Finding examples of funded NIH applications
• New NIH policy for data management and sharing now in effect
• Unusual terms used in scientific writing and publishing: Person-first language

Addition Of Pericapsular Nerve Group And Transversus Abdominis Plane Blocks Significantly Reduces Opioid Use In Patients Undergoing Concomitant Hip Arthroscopy And Periacetabular Osteotomy., Sean Ellis, Joshua D Harris, Derek P Flemming, Thomas J Ellis, Robert C Kollmorgen

Surgery Articles

INTRODUCTION: Previous studies have evaluated the effect of the pericapsular nerve group block for hip arthroscopy and the transverse abdominis plane block for periacetabular osteotomy and have shown decreased narcotic consumption in both groups. No published study has evaluated the effectiveness of combining the blocks when performing hip arthroscopy and periacetabular osteotomy under the same general anesthesia. It was hypothesized that patients treated for hip dysplasia with hip arthroscopy and concomitant periacetabular osteotomy using a pericapsular nerve group block, transverse abdominis plane block, and general anesthesia would have decreased postoperative pain and require less narcotic consumption than those undergoing the …

The Kynurenine Pathway In Alzheimer’S Disease: A Meta-Analysis Of Central And Peripheral Levels, Brisa S Fernandes, Mehmet Enes Inam, Nitesh Enduru, Joao Quevedo, Zhongming Zhao

Faculty, Staff and Student Publications

OBJECTIVE: Changes in the kynurenine pathway are recognized in psychiatric disorders, but their role in Alzheimer's disease (AD) is less clear. We aimed to conduct a systematic review and meta-analysis to determine whether tryptophan and kynurenine pathway metabolites are altered in AD.

METHODS: We performed a systematic review and random-effects meta-analyses. Inclusion criteria were studies that compared AD and cognitively normal (CN) groups and assessed tryptophan or kynurenine pathway metabolites in cerebrospinal fluid or peripheral blood.

RESULTS: Twenty-two studies with a total of 1,356 participants (664 with AD and 692 CN individuals) were included. Tryptophan was decreased only in peripheral …

An Online Intervention To Improve The Health And Well-Being Of Informal Caregivers Of Individuals With Alzheimer's Disease: A Pilot Study, Yujun Liu, M. Courtney Hughes, Abby Baumbach, Lily Derain

Faculty Articles, Papers, and Other Scholarship

Objective: Describe an intervention to improve the health and well-being of informal caregivers of individuals with Alzheimer's disease (AD) and present pilot program findings.

Methods: Participants (N = 31, mean age = 45.7) were randomly assigned to one of two conditions: an online synchronous didactic lesson and peer support session series or an asynchronous didactic only session series. Outcome variables included physical health, nutrition intake, and stress. One-way ANOVA was conducted to examine the effects of the intervention. The least significant difference (LSD) post hoc test was used to analyze the difference pattern between means.

Results: Participants in both conditions …

The Burden And Characteristics Of Hiv Infected Covid-19 Patients At A Tertiary Care Hospital In Sub-Saharan Africa, Alok Iyer

Master of Medicine in Internal Medicine

Background: Since the first case of COVID-19, which was caused by the novel SARS-CoV-2 virus, was identified in Wuhan, China in December 2019, the infection has rapidly spread throughout the world. By March 2020, the World Health Organization declared COVID-19 to be a pandemic. On March 12, 2020, Kenya announced its first COVID-19 infection case. Since then, the number of cases has risen steadily, reaching 5190 cases and 144 fatalities (as of June 30, 2020), endangering the nation's healthcare system. In Kenya, where the prevalence of HIV is 4.9%, 1.38 million adults and 105,000 children are estimated to be HIV …

Factors Associated With Non-Uptake Of Implantable Cardioverter-Defibrillator (Icd) Among Eligible Patients At A Tertiary Hospital In Kenya, Emmanuel Benge Aluoch

Master of Medicine in Internal Medicine

Background: Sudden Cardiac Death (SCD) is a major cause of mortality among patients with cardiovascular disease accounting for about 50% of deaths. Several studies have demonstrated the safety and efficacy of Implantable Cardioverter-Defibrillator (ICD) implantation in both primary and secondary prevention of SCD in at-risk populations. Despite well-publicized guidelines, ICD implantation rates remain low particularly in Africa with a paucity of data regarding factors associated with non-uptake and reasons for implant refusal. The study aimed to characterize these factors and identify reasons for ICD refusal. Understanding these factors and reasons for non-implantation will provide an opportunity to optimize ICD uptake …

Obstructive Sleep Apnea Syndrome Among Hypertensive Patients At A Tertiary Hospital In Kenya, Salim Abdallah Salim

Master of Medicine in Internal Medicine

Introduction: Obstructive sleep apnea (OSA) is a type of breathing problem during sleep caused by the blockage of the upper airway, which can cause a reduction or complete cessation of airflow. Warning signs of OSA include snoring, night sweats, and high blood pressure. However, there is limited research on the prevalence of OSA in hypertensive patients in sub-Saharan Africa (SSA). This study purposed to elucidate the likelihood and clinical characteristics of OSA among hypertensive patients at a tertiary hospital in Nairobi, Kenya. Methods: This prospective cross-sectional study occurred at the Aga Khan University Hospital in Nairobi, Kenya. A total of …

Prediction Of Mortality And Major Adverse Kidney Events In Critically Ill Patients With Acute Kidney Injury, Javier A. Neyra, Victor M. Ortiz-Soriano, Lucas J. Liu, Taylor D. Smith, Xilong Li, Donglu Xie, Beverly Adams-Huet, Orson W. Moe, Robert D. Toto, Jin Chen

Markey Cancer Center Faculty Publications

Rationale & Objective: Risk prediction tools for assisting acute kidney injury (AKI) management have focused on AKI onset but have infrequently addressed kidney recovery. We developed clinical models for risk stratification of mortality and major adverse kidney events (MAKE) in critically ill patients with incident AKI.

Study Design: Multicenter cohort study.

Setting & Participants: 9,587 adult patients admitted to heterogeneous intensive care units (ICUs; March 2009 to February 2017) who experienced AKI within the first 3 days of their ICU stays.

Predictors: Multimodal clinical data consisting of 71 features collected in the first 3 days of ICU stay.

Outcomes: (1) …

An International Real-World Analysis Of Relapsed/Refractory Lymphoma Occurring During Pregnancy, Faheem Farooq, Justin S. Brandt, Elyce Cardonick, Evgeniya Polushkina, Julie M. Vose, Sairah Ahmed, Praveen Ramakrishnan Geethakumari, Adam J. Olszewski, Hesham Yasin, Umar Farooq, Nada Hamad, Yong Lin, Charlotte Maggen, Robert Fruscio, Mina Mhallem Gziri, Karina Dahl Steffensen, Frédéric Amant, Andrew M. Evens

Journal Articles: Oncology and Hematology

No abstract provided.

The Salento Prognostic Model For Limited-Stage Peripheral T-Cell Lymphoma From The International T-Cell Project Network, Greg Hapgood, Monica Civallero, Yana Stepanishyna, Julie M. Vose, Monica Elena Cabrera, Ranjana H Advani, Stefano A. Pileri, Martina Manni, Steven M. Horwitz, Francine M. Foss, Felicitas Hitz, John Radford, Ivan Dlouhy, Carlos Chiattone, Won Seog Kim, Tetiana Skrypets, Arnon Nagler, Judith Trotman, Stefano Luminari, Massimo Federico

Journal Articles: Oncology and Hematology

The natural history of limited-stage peripheral T-cell lymphomas (PTCLs) remains poorly defined. We investigated outcomes and prognostic variables in patients registered in the T-Cell Project (TCP) (#NCT01142674) to develop a model to predict overall survival (OS) for the common nodal PTCL subtypes (PTCL-NOS, AITL, ALCL). The model was validated in an independent data set from Australian and Brazilian registries. 211 patients registered in the TCP between 2006-2018 were studied. The median age was 59 years (range 18-88) and median follow-up was 49 months. One hundred twenty-seven patients (78%) received anthracycline-based regimens, 5 patients (3%) radiotherapy alone (RT), 24 patients (15%) …

Women In Lymphoma: A 4-Year Journey In Promoting Gender Equity, Judith Trotman, Ann Lacasce, Wendy Osborne, Anna Steiner, Eliza Hawkes, Carla Casulo, Florence Broussais, Kate Cwynarski, Paola Ghione, Justine Kahn, Sharyn Kurtz, Kim Linton, Carolina Mahuad, Monique Minnema, Loretta Nastoupil, Wendy Osborne, Astrid Pavolvsky, Michelle Poon, Clementine Sarkozy, Laurie Sehn, Soni Smith, Anna Sureda, Carrie Thompson, Judith Trotman, Julie M. Vose

Journal Articles: Oncology and Hematology

No abstract provided.

High-Grade B-Cell Lymphoma, Not Otherwise Specified: A Multi-Institutional Retrospective Study, Adam S. Zayac, Daniel J. Landsburg, Mitchell E. Hughes, Allison M. Bock, Grzegorz S. Nowakowski, Emily C. Ayers, Mark Girton, Marie Hu, Amy K. Beckman, Shaoying Li, L Jeffrey Medeiros, Julie E. Chang, Adam Stepanovic, Habibe Kurt, Jose Sandoval-Sus, M Ali Ansari-Lari, Shalin K. Kothari, Anna Kress, Mina L. Xu, Pallawi Torka, Suchitra Sundaram, Stephen D. Smith, Kikkeri N. Naresh, Yasmin H. Karimi, Narendranath Epperla, David A. Bond, Umar Farooq, Mahak Saad, Andrew M. Evens, Karan Pandya, Seema G. Naik, Manali Kamdar, Bradley Haverkos, Reem Karmali, Timothy S. Oh, Julie M. Vose, Heather Nutsch, Paul G. Rubinstein, Amina Chaudhry, Adam J. Olszewski

Journal Articles: Oncology and Hematology

In this multi-institutional retrospective study, we examined the characteristics and outcomes of 160 patients with high-grade B-cell lymphoma, not otherwise specified (HGBL-NOS)-a rare category defined by high-grade morphologic features and lack of MYC rearrangements with BCL2 and/or BCL6 rearrangements ("double hit"). Our results show that HGBL-NOS tumors are heterogeneous: 83% of patients had a germinal center B-cell immunophenotype, 37% a dual-expressor immunophenotype (MYC and BCL2 expression), 28% MYC rearrangement, 13% BCL2 rearrangement, and 11% BCL6 rearrangement. Most patients presented with stage IV disease, a high serum lactate dehydrogenase, and other high-risk clinical factors. Most frequent first-line regimens included dose-adjusted cyclophosphamide, …

Integrative Analysis Of Clinicopathological Features Defines Novel Prognostic Models For Mantle Cell Lymphoma In The Immunochemotherapy Era: A Report From The North American Mantle Cell Lymphoma Consortium, Julie M. Vose, Kai Fu, Lu Wang, Adnan Mansoor, Douglas Stewart, Hongxia Cheng, Lynette M. Smith, Ji Yuan, Hina Naushad Qureishi, Brian K. Link, Melissa H. Cessna, Paul M. Barr, Brad S. Kahl, Matthew S. Mckinney, Nadia Khan, Ranjana H. Advani, Peter Martin, Andre H. Goy, Tycel J. Phillips, Amitkumar Mehta, Manali Kamdar, Michael Crump, Barbara Pro, Christopher R. Flowers, Caron A. Jacobson, Sonali M. Smith, Deborah M. Stephens, Veronika Bachanova, Zhaohui Jin, Shishou Wu, Francisco Hernandez-Ilizaliturri, Pallawi Torka, Andrea Anampa-Guzmán, Farshid Kashef, Xing Li, Sunandini Sharma, Timothy Greiner, James O. Armitage, Matthew A. Lunning, Dennis D. Weisenburger, Gregory Bociek, Javeed Iqbal, Guohua Yu, Chengfeng Bi, North American Mantle Cell Lymphoma Consortium

Journal Articles: Oncology and Hematology

BACKGROUND: Patients with mantle cell lymphoma (MCL) exhibit a wide variation in clinical presentation and outcome. However, the commonly used prognostic models are outdated and inadequate to address the needs of the current multidisciplinary management of this disease. This study aims to investigate the clinical and pathological features of MCL in the immunochemotherapy era and improve the prognostic models for a more accurate prediction of patient outcomes.

METHODS: The North American Mantle Cell Lymphoma Project is a multi-institutional collaboration of 23 institutions across North America to evaluate and refine prognosticators for front-line therapy. A total of 586 MCL cases diagnosed …