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Final Scholarly Project: Enhanced Recovery After Surgery (Eras) Guidelines For Pancreaticoduodenectomies, Rebecca Wheeler 2025 Otterbein University

Final Scholarly Project: Enhanced Recovery After Surgery (Eras) Guidelines For Pancreaticoduodenectomies, Rebecca Wheeler

Doctor of Nursing Practice Scholarly Projects

A pancreaticoduodenectomy, or Whipple procedure, is the only curative option for pancreatic cancer. For those eligible for tumor resection, the Whipple procedure is a difficult surgery for both the patient and provider. Complications following pancreaticoduodenectomy are numerous and include infection, delayed gastric emptying, high hospital costs, and pancreatic fistulas. Enhanced Recovery After Surgery (ERAS) protocols exist to provide evidence supporting standardization of practices that lead to the improvement of these patient outcomes. An ERAS protocol for the pancreaticoduodenectomy, first established in 2012, is inconsistently implemented in healthcare facilities. Researchers collected data involving the use of the Whipple procedure ERAS guidelines …


The Effects Of Short-Term, Progressive Exercise Training On Disease Activity In Smouldering Multiple Myeloma And Monoclonal Gammopathy Of Undetermined Significance: A Single-Arm Pilot Study, A. Emery, S. Moore, J. Crowe, J. Murray, O. Peacock, D. Thompson, F. Betts, S. Rapps, L. Ross, D. Rothschild-Rodriguez, A. A. Echarri, R. Davies, R. Lewis, D. X. Augustine, A. Whiteway, Z. Afzal, J. L. J. Heaney, M. T. Drayson, J. E. Turner, John P. Campbell 2024 Edith Cowan University

The Effects Of Short-Term, Progressive Exercise Training On Disease Activity In Smouldering Multiple Myeloma And Monoclonal Gammopathy Of Undetermined Significance: A Single-Arm Pilot Study, A. Emery, S. Moore, J. Crowe, J. Murray, O. Peacock, D. Thompson, F. Betts, S. Rapps, L. Ross, D. Rothschild-Rodriguez, A. A. Echarri, R. Davies, R. Lewis, D. X. Augustine, A. Whiteway, Z. Afzal, J. L. J. Heaney, M. T. Drayson, J. E. Turner, John P. Campbell

Research outputs 2022 to 2026

Background: High levels of physical activity are associated with reduced risk of the blood cancer multiple myeloma (MM). MM is preceded by the asymptomatic stages of monoclonal gammopathy of undetermined significance (MGUS) and smouldering multiple myeloma (SMM) which are clinically managed by watchful waiting. A case study (N = 1) of a former elite athlete aged 44 years previously indicated that a multi-modal exercise programme reversed SMM disease activity. To build from this prior case study, the present pilot study firstly examined if short-term exercise training was feasible and safe for a group of MGUS and SMM patients, and secondly …


Association Between Inflammatory Bowel Disease And Cancer Risk: Evidence Triangulation From Genetic Correlation, Mendelian Randomization, And Colocalization Analyses Across East Asian And European Populations, Di Liu, Meiling Cao, Haotian Wang, Weijie Cao, Chenguang Zheng, Yun Li, Youxin Wang 2024 Edith Cowan University

Association Between Inflammatory Bowel Disease And Cancer Risk: Evidence Triangulation From Genetic Correlation, Mendelian Randomization, And Colocalization Analyses Across East Asian And European Populations, Di Liu, Meiling Cao, Haotian Wang, Weijie Cao, Chenguang Zheng, Yun Li, Youxin Wang

Research outputs 2022 to 2026

Background: Inflammatory bowel disease (IBD), which includes Crohn’s disease (CD) and ulcerative colitis (UC), has been associated with several cancer risks in observational studies, but the observed associations have been inconsistent and may face the bias of confounding and reverse causality. The potential causal relationships between IBD and the risk of cancers remain largely unclear. Methods: We performed genome-wide linkage disequilibrium score regression (LDSC), standard two-sample Mendelian randomization (MR), and colocalization analyses using summary genome-wide association study (GWAS) data across East Asian and European populations to evaluate the causal relationships between IBD and cancers. Sensitivity analyses for the MR approach …


Exploring Post-Covid-19 Health Effects And Features With Advanced Machine Learning Techniques, Muhammad N. Islam, Md S. Islam, Nahid H. Shourav, Iftiaqur Rahman, Faiz A. Faisal, Md M. Islam, Iqbal H. Sarker 2024 Edith Cowan University

Exploring Post-Covid-19 Health Effects And Features With Advanced Machine Learning Techniques, Muhammad N. Islam, Md S. Islam, Nahid H. Shourav, Iftiaqur Rahman, Faiz A. Faisal, Md M. Islam, Iqbal H. Sarker

Research outputs 2022 to 2026

COVID-19 is an infectious respiratory disease that has had a significant impact, resulting in a range of outcomes including recovery, continued health issues, and the loss of life. Among those who have recovered, many experience negative health effects, particularly influenced by demographic factors such as gender and age, as well as physiological and neurological factors like sleep patterns, emotional states, anxiety, and memory. This research aims to explore various health factors affecting different demographic profiles and establish significant correlations among physiological and neurological factors in the post-COVID-19 state. To achieve these objectives, we have identified the post-COVID-19 health factors and …


Spatial Transcriptomics Reveals Discrete Tumour Microenvironments And Autocrine Loops Within Ovarian Cancer Subclones, Elena Denisenko, Leanne de Kock, Adeline Tan, Aaron B. Beasley, Maria Beilin, Matthew E. Jones, Rui Hou, Dáithí Ó Muirí, Sanela Bilic, G. Raj K. A. Mohan, Stuart Salfinger, Simon Fox, Khaing P. W. Hmon, Yen Yeow, Youngmi Kim, Rhea John, Tami S. Gilderman, Emily Killingbeck, Elin S. Gray, Paul A. Cohen, Yu Yu, Alistair R. R. Forrest 2024 Edith Cowan University

Spatial Transcriptomics Reveals Discrete Tumour Microenvironments And Autocrine Loops Within Ovarian Cancer Subclones, Elena Denisenko, Leanne De Kock, Adeline Tan, Aaron B. Beasley, Maria Beilin, Matthew E. Jones, Rui Hou, Dáithí Ó Muirí, Sanela Bilic, G. Raj K. A. Mohan, Stuart Salfinger, Simon Fox, Khaing P. W. Hmon, Yen Yeow, Youngmi Kim, Rhea John, Tami S. Gilderman, Emily Killingbeck, Elin S. Gray, Paul A. Cohen, Yu Yu, Alistair R. R. Forrest

Research outputs 2022 to 2026

High-grade serous ovarian carcinoma (HGSOC) is genetically unstable and characterised by the presence of subclones with distinct genotypes. Intratumoural heterogeneity is linked to recurrence, chemotherapy resistance, and poor prognosis. Here, we use spatial transcriptomics to identify HGSOC subclones and study their association with infiltrating cell populations. Visium spatial transcriptomics reveals multiple tumour subclones with different copy number alterations present within individual tumour sections. These subclones differentially express various ligands and receptors and are predicted to differentially associate with different stromal and immune cell populations. In one sample, CosMx single molecule imaging reveals subclones differentially associating with immune cell populations, fibroblasts, …


Highly Toxic Aβ Begets More Aβ, Merc M. Kemeh, Noel Lazo 2024 Clark University

Highly Toxic Aβ Begets More Aβ, Merc M. Kemeh, Noel Lazo

Chemistry

No abstract provided.


Severe Vitamin B12 Deficiency Presenting With Pseudo-Thrombotic Microangiopathy And Anasarca, Aleksandra Kolnick, Polly Fraga, Jing-Lun James XU, Muhammad Awidi 2024 Lahey Hospital & Medical Center

Severe Vitamin B12 Deficiency Presenting With Pseudo-Thrombotic Microangiopathy And Anasarca, Aleksandra Kolnick, Polly Fraga, Jing-Lun James Xu, Muhammad Awidi

The Lahey Journal

Introduction

This report describes the case of a woman with severe vitamin B12 deficiency from pernicious anemia. Her clinical presentation, which involved microangiopathic hemolytic anemia (MAHA), was presumed to be thrombotic thrombocytopenic purpura (TTP). TTP is a rare life-threatening condition with high mortality and morbidity rates. It is caused by a severe deficiency of ADAMTS13, an enzyme which cleaves the von Willebrand factor in the clotting cascade. This case report highlights the importance of early recognition of TTP and other causes of MAHA. We explore the pathogenesis and management of severe, life-threatening vitamin B12 deficiency.

Case Presentation

A 51-year-old woman …


Colocalization Of Odc And Amyloid Plaques In Patients With Alzheimer’S Disease And Down Syndrome, Julia S. Gielczynski 2024 University of Denver

Colocalization Of Odc And Amyloid Plaques In Patients With Alzheimer’S Disease And Down Syndrome, Julia S. Gielczynski

Undergraduate Theses, Capstones, and Recitals

Polyamines, and their rate-limiting enzyme ornithine decarboxylase (ODC), are crucial for many functions in the central nervous system but levels decrease with age. In neurodegenerative diseases, like Alzheimer’s Disease (AD), polyamine levels begin to increase again. Yet, there are still many unanswered questions surrounding polyamine’s possible role in AD, especially in those with Down Syndrome (DS), who also have an extra copy of the amyloid precursor protein (APP) and tend to get AD far earlier than the general population. We aim to investigate if there is colocalization between amyloid plaques and Ornithine Decarboxylase (ODC) in patients with AD and AD/DS, …


Unlikely Cohabitants: A Collision Tumor Of Metastatic Small Cell Lung Carcinoma And Adrenal Adenoma, Michael DeMeritt, Savanna Atwal, Stefan Johnson, Kevin Lightner, Joel Thompson 2024 Lake Erie College of Osteopathic Medicine

Unlikely Cohabitants: A Collision Tumor Of Metastatic Small Cell Lung Carcinoma And Adrenal Adenoma, Michael Demeritt, Savanna Atwal, Stefan Johnson, Kevin Lightner, Joel Thompson

Advances in Clinical Medical Research and Healthcare Delivery

This case report is the second known publication of a very specific collision tumor, where small cell lung cancer metastasized to an adrenal adenoma. The focus is primarily on multimodal radiologic findings of the developing neoplasm, including CT, MRI, and FDG PET/CT. These findings are compared with established diagnostic criteria for adrenal adenomas and metastases, as identified by the literature and content expert review. Epidemiological data regarding collision tumors is discussed, as well as proposed treatment strategies. Similar topics are elucidated for small cell lung carcinoma. Reporting of this collision tumor adds to the relatively thin body of knowledge of …


Abdominal Aortic Aneurysm Screening And Surveillance – Can We Do Better? A Qi Project, Hassan Saeed, Hania Liaqat, Vidisha Master, Binita Neupane 2024 Rochester Regional Health System

Abdominal Aortic Aneurysm Screening And Surveillance – Can We Do Better? A Qi Project, Hassan Saeed, Hania Liaqat, Vidisha Master, Binita Neupane

Advances in Clinical Medical Research and Healthcare Delivery

Abstract

Background:

Abdominal aortic aneurysm (AAA) has a global prevalence of about 5% and its first presentation can be acute and fatal. USPSTF recommends one time screening for men aged 65 to 75 years who have ever smoked. We designed a study to evaluate the effect of resident education on AAA screening ordered in our outpatient primary care clinic.

Methods:

All men aged 65 to 75 years of age attending appointments in the resident run clinic were included in the study. Pre-intervention data was collected retrospectively for 5 weeks which included patient demographics and the rates of appropriate AAA screening …


Anomalous Presentation And Endoscopic Findings Of Acute Esophageal Necrosis: A Case Report, Ahmed Shehadah, Abdullah A. Orakzai, Sheza Malik, Alshaima Yousef, Ali Jaan, Patrick Okolo 2024 Rochester General Hospital

Anomalous Presentation And Endoscopic Findings Of Acute Esophageal Necrosis: A Case Report, Ahmed Shehadah, Abdullah A. Orakzai, Sheza Malik, Alshaima Yousef, Ali Jaan, Patrick Okolo

Advances in Clinical Medical Research and Healthcare Delivery

Introduction:

Acute esophageal necrosis (AEN), is a rare disorder with an estimated incidence of 0.01-0.28%. It typically affects the distal third of the esophagus. Approximately 90% of patients with acute esophageal necrosis present with upper gastrointestinal (GI) bleeding, primarily due to ischemic insult or severe hemodynamic compromise. In this report, we describe a case in which the patient presented with odynophagia and dysphagia, but without upper GI bleeding. The patient exhibited pan mucosal involvement of the esophagus, which extended to the gastric antrum.

Case: A 55-year-old man with a history of type 2 diabetes mellitus and substance abuse presented with …


Effect Of Plumbagin On Chemo-Resistant Metastatic Retinoblastoma, John J. Soto 2024 CUNY Lehman College

Effect Of Plumbagin On Chemo-Resistant Metastatic Retinoblastoma, John J. Soto

Theses

Retinoblastoma, which is an ocular malignancy, usually results in poor prognoses in pediatric patients worldwide. Retinoblastoma in some events, can develop metastatic phenotypes which can lead to secondary tumor formation, furthering deleterious patient outcomes. It is of paramount importance to identify and research potent novel compounds that can be used to increase the likelihood of remission. Plumbagin (PLB) is a plant-derived, neuroprotective agent, which exhibits significant anticancer activities during in vitro study. PLB has been shown to have a high therapeutic efficacy against chemoresistant sublines as well as their normal counterparts. We attempted to show that the chemoresistant ABCC1 could …


A Single-Center, Assessor-Blinded, Randomized Controlled Clinical Trial To Test The Safety And Efficacy Of A Novel Brain-Computer Interface Controlled Functional Electrical Stimulation (Bci-Fes) Intervention For Gait Rehabilitation In The Chronic Stroke Population, Piyashi Biswas, Lucy Dodakian, Po T. Wang, Christopher A. Johnson, Jill See, Vicky Chan, Cathy Chou, Wendy Lazouras, Alison L. McKenzie, David J. Reinkensmeyer, Danh V. Nguyen, Steven C. Cramer, An H. Do, Zoran Nenadic 2024 University of California, Irvine

A Single-Center, Assessor-Blinded, Randomized Controlled Clinical Trial To Test The Safety And Efficacy Of A Novel Brain-Computer Interface Controlled Functional Electrical Stimulation (Bci-Fes) Intervention For Gait Rehabilitation In The Chronic Stroke Population, Piyashi Biswas, Lucy Dodakian, Po T. Wang, Christopher A. Johnson, Jill See, Vicky Chan, Cathy Chou, Wendy Lazouras, Alison L. Mckenzie, David J. Reinkensmeyer, Danh V. Nguyen, Steven C. Cramer, An H. Do, Zoran Nenadic

Physical Therapy Faculty Articles and Research

Background

In the United States, there are over seven million stroke survivors, with many facing gait impairments due to foot drop. This restricts their community ambulation and hinders functional independence, leading to several long-term health complications. Despite the best available physical therapy, gait function is incompletely recovered, and this occurs mainly during the acute phase post-stroke. Therapeutic options are limited currently. Novel therapies based on neurobiological principles have the potential to lead to long-term functional improvements. The Brain-Computer Interface (BCI) controlled Functional Electrical Stimulation (FES) system is one such strategy. It is based on Hebbian principles and has shown promise …


Mechanistic Study Of Antimicrobial Effectiveness Of Cyclic Amphipathic Peptide [R4W4] Against Methicillin-Resistant Staphylococcus Aureus Clinical Isolates, Ajayi David Akinwale, Keykavous Parang, Rakesh Kumar Tiwari, Jason Yamaki 2024 Chapman University

Mechanistic Study Of Antimicrobial Effectiveness Of Cyclic Amphipathic Peptide [R4W4] Against Methicillin-Resistant Staphylococcus Aureus Clinical Isolates, Ajayi David Akinwale, Keykavous Parang, Rakesh Kumar Tiwari, Jason Yamaki

Pharmacy Faculty Articles and Research

Antimicrobial peptides (AMPs) are being explored as a potential strategy to combat antibiotic resistance due to their ability to reduce susceptibility to antibiotics. This study explored whether the [R4W4] peptide mode of action is bacteriostatic or bactericidal using modified two-fold serial dilution and evaluating the synergism between gentamicin and [R4W4] against Escherichia coli (E. coli) and methicillin-resistant Staphylococcus aureus (MRSA) by a checkered board assay. [R4W4] exhibited bactericidal activity against bacterial isolates (MBC/MIC ≤ 4), with a synergistic effect with gentamicin against E. coli (FICI = 0.3) but …


Controversy In Consciousness: Is The Brainstem Sufficient For Sentience?, Shadia Kawkabani, Kevin P. Kaut 2024 University of Akron

Controversy In Consciousness: Is The Brainstem Sufficient For Sentience?, Shadia Kawkabani, Kevin P. Kaut

Journal of Neuropsychology and Behavioral Processes

Our understanding of consciousness is quite possibly in need of further discussion, elaboration, and updating. What was once principally the domain of philosophical inquiry has entered the era of advanced research methods and biomedical ethics – both of which have influenced the need to reconsider this most challenging of topics. The challenge for those interested in consciousness is at least twofold: 1) to further operationally define what is meant by consciousness, with a greater understanding of how consciousness can be manifest, and 2) to better identify the neural mechanisms subserving the diverse presentations/manifestations of consciousness, and reconcile the developing literatures …


Reply To: Correlation Between Right Ventricular Echocardiography Measurements And Functional Capacity In Patients With Pulmonary Arterial Hypertension, Annalisa Caputo, Gianmarco Scoccia 2024 The Texas Medical Center Library

Reply To: Correlation Between Right Ventricular Echocardiography Measurements And Functional Capacity In Patients With Pulmonary Arterial Hypertension, Annalisa Caputo, Gianmarco Scoccia

The Texas Heart Institute Journal

No abstract provided.


Postoperative Bioactive Adrenomedullin Is Associated With The Onset Of Ards And Adverse Outcomes In Patients Undergoing Open Thoracoabdominal Aortic Surgery, Panagiotis Doukas, Oliver Hartmann, Jelle Frankort, Birte Arlt, Hanif Krabbe, Michael Johan Jacobs, Andreas Greiner, Jan Paul Frese, Alexander Gombert 2024 The Texas Medical Center Library

Postoperative Bioactive Adrenomedullin Is Associated With The Onset Of Ards And Adverse Outcomes In Patients Undergoing Open Thoracoabdominal Aortic Surgery, Panagiotis Doukas, Oliver Hartmann, Jelle Frankort, Birte Arlt, Hanif Krabbe, Michael Johan Jacobs, Andreas Greiner, Jan Paul Frese, Alexander Gombert

Journal Articles

Cytokine-mediated systemic inflammation after open thoracoabdominal aortic aneurysm (TAAA) repairs plays a pivotal role in disrupting circulatory homeostasis, potentially leading to organ dysfunction. The bioactive form of adrenomedullin (bio-ADM) is a peptide hormone with immunomodulatory and vasomotor effects, making it a potential diagnostic agent in these cases. This retrospective, bicentric study, conducted between January 2019 and December 2022, recruited 36 elective open TAAA repair patients in two German centres. Serum and plasma samples were collected at multiple time points to measure bio-ADM levels. The primary objective was to evaluate the association of bio-ADM levels with the onset of acute respiratory …


Effectiveness Of Empiric Carbapenem Versus Non-Carbapenem Therapy For Extended-Spectrum Β-Lactamase Producing Enterobacterales Infections In Non-Intensive Care Unit Patients: A Real-World Investigation In A Hospital With High-Prevalence Of Extended-Spectrum Β-Lactamase Producing Enterobacterales, Amy Y. Kang, Mary Elkomos, Danny Pham, Michelle Guerrero, Deborah Kupferwasser, Loren G. Miller 2024 Chapman University

Effectiveness Of Empiric Carbapenem Versus Non-Carbapenem Therapy For Extended-Spectrum Β-Lactamase Producing Enterobacterales Infections In Non-Intensive Care Unit Patients: A Real-World Investigation In A Hospital With High-Prevalence Of Extended-Spectrum Β-Lactamase Producing Enterobacterales, Amy Y. Kang, Mary Elkomos, Danny Pham, Michelle Guerrero, Deborah Kupferwasser, Loren G. Miller

Pharmacy Faculty Articles and Research

Objective:

To investigate whether empiric carbapenem therapy, compared to empiric non-carbapenem therapy, was associated with improved clinical outcomes among hospitalized, non-intensive care unit (ICU) patients with extended-spectrum β-lactamase (ESBL)-producing Enterobacterales infections.

Methods:

We performed a retrospective cohort study of adult, non-ICU patients admitted with ESBL-producing Enterobacterales infections. Primary outcome was time to clinical stability from the first empiric antibiotic dose. Secondary outcomes were early clinical response and 30-day all-cause hospital readmission. We used multivariate regression methods to examine time to clinical stability.

Results:

Of the 142 patients, 59 (42%) received empiric carbapenems and 83 (58%) received empiric …


Medmicromaps, A Novel Decision-Tree Guide For Infectious Diseases Differential Diagnoses, And Evaluation Of Pre- And Post-Pandemic User Engagement By Preclinical Medical Students, Jason Ceballos, Tavsimran Luthra, Lucia Garces-Torres, Valerie Lentz, Jack Nelson, Claudia Carceles-Roman, Ian Holyoak, Jane Harrington 2024 St. George's University

Medmicromaps, A Novel Decision-Tree Guide For Infectious Diseases Differential Diagnoses, And Evaluation Of Pre- And Post-Pandemic User Engagement By Preclinical Medical Students, Jason Ceballos, Tavsimran Luthra, Lucia Garces-Torres, Valerie Lentz, Jack Nelson, Claudia Carceles-Roman, Ian Holyoak, Jane Harrington

International Journal of Emerging and Disruptive Innovation in Education : VISIONARIUM

Background: Medical education has undergone major changes in the past 5 years to adapt to the digital-centered student population with diverse learning preferences. To address the challenges of shifting delivery modalities, multimedia resources were created to provide interactive e-learning material on infectious diseases for year 2 medical students.

Methods: Medical students at a USA-accredited Caribbean medical school were provided with supplemental e-learning materials including animations, illustrations, diagnostic algorithms aka MedMicroMaps, and Case-Based tutorials. Participants were classified by semester and lecture delivery: In-person: Cohort 1 (n=526); Virtual: Cohort 2 (n=651); and Hybrid: Cohort 3 ( …


A “Fishy” Situation, Rare Pathogen And Presentation In Prosthetic Valve Infective Endocarditis, Nichole Schtupak, Patrick Kennedy, Darko Pucar, Linda Godinez, Jodi-Ann Chin, Kristen Selema, Dipan Uppa, Antonio Lewis, Marcelo Helguera 2024 A.T. Still University and Cleveland Clinic Florida

A “Fishy” Situation, Rare Pathogen And Presentation In Prosthetic Valve Infective Endocarditis, Nichole Schtupak, Patrick Kennedy, Darko Pucar, Linda Godinez, Jodi-Ann Chin, Kristen Selema, Dipan Uppa, Antonio Lewis, Marcelo Helguera

DMSc Student Publications

Lactococcus garviae (L. garviae) is a gram-positive coccus belonging to the Streptococcaceae family. While primarily a pathogen in fish farms causing hemorrhagic sepsis, it can act as a rare opportunistic pathogen in humans. A 2021 case report by Bravo et al. documented less than 30 cases of infective endocarditis caused by L. garviae worldwide at that time. This case report describes the 27th documented case globally and 7th documented case in the USA of L. garviae causing infective endocarditis of a prosthetic valve.
L. garviae is found in unpasteurized dairy products, raw fish, and meat (pork, beef, and …


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