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Monitoring The Systemic Immune System To Understand And Improve The Efficacy Of Immunotherapy For Metastatic Osteosarcoma, justin edward markel 2022 West Virginia University

Monitoring The Systemic Immune System To Understand And Improve The Efficacy Of Immunotherapy For Metastatic Osteosarcoma, Justin Edward Markel

Graduate Theses, Dissertations, and Problem Reports

Osteosarcoma (OS) is a complex tumor with no effective targeted therapies due to its genomic heterogeneity and pleomorphism. The immune response it creates, particularly against metastatic lesions, is considerable; however, various suppressive mechanisms induced by the tumor prohibit its effectiveness. The presence of infiltrating lymphocytes suggests that therapeutic disinhibition through checkpoint blockade could increase antitumor immunity, though none have been successful in clinical trials. The complexities of the immune response to OS tumors have yet to be unraveled; however, there is evidence to suggest that cell-mediated immunity (CMI, specifically T cells, Natural Killer [NK] cells, and myeloid-lineage cells [MLCs]) plays ...


Increasing Continuous Positive Airway Pressure Compliance With Various Telemedicine Interventions: An Integrated Literature Review, Tracy Partington 2021 The University of San Francisco

Increasing Continuous Positive Airway Pressure Compliance With Various Telemedicine Interventions: An Integrated Literature Review, Tracy Partington

Doctor of Nursing Practice (DNP) Projects

Aims and Objectives. This literature review's objective was to synthesize evidence from previously published literature on telemedicine interventions' effectiveness on CPAP (Continuous Positive Airway Pressure) therapy compliance.

Background. It is estimated that 22 million Americans suffer from a form of Sleep Apnea (SA), and those up to 80 percent of the cases of moderate to severe Obstructive Sleep Apnea (OSA) are undiagnosed (Sleep Apnea, n,d). The first-line therapy for OSA is CPAP. However, CPAP therapy is associated with low compliance rates.

Design. Systematic review.

Method. A multi-database literature search was conducted to identify published literature between 2009 and ...


Disparities Among Black Women In Maternal Health, Josefina Teresa Estrada 2021 Dominican University of California

Disparities Among Black Women In Maternal Health, Josefina Teresa Estrada

Nursing | Senior Theses

The literature shows that Black women face many disparities in terms of health care access and the quality of care. These obstacles could negatively affect the health of the mother and their child. This paper includes a literature review and proposed research study. The objective of this research study is to identify the outcomes of Black women compared to White women and other women of color in terms of maternal health. A literature review is provided in order to identify how race affects the following factors: obstacles that limit access to healthcare, rates of obtaining prenatal care, postpartum outcomes and ...


Objective Structured Clinical Evaluation For Supraclavicular And Femoral Nerve Blocks Utilizing Ultrasound Guidance For Student Nurse Anesthetists, Mitchell Fowler, Christopher Bond 2021 The University of Southern Mississippi

Objective Structured Clinical Evaluation For Supraclavicular And Femoral Nerve Blocks Utilizing Ultrasound Guidance For Student Nurse Anesthetists, Mitchell Fowler, Christopher Bond

Doctoral Projects

The purpose of this DNP project was to create a tool to teach and evaluate student registered nurse anesthetists (SRNAs) at TheUniversity of Southern Mississippi (USM) on supraclavicular and femoral nerve blocks to promote safety in the clinical setting. An objective structured clinical evaluation (OSCE) for ultrasound-guided supraclavicular and femoral nerve blocks was created as the basis for this project. Best-practice techniques as identified by the AANA’s 14thstandard of nurse anesthesia practice were researched and used in the development of the OSCE to promote a culture of safety for SRNAs and patients (AANA, 2019).

A culture of ...


“Old People Problems”, Uncertainty And Legitimacy: Challenges With Diagnosing Parkinson's Disease In Kenya, Natasha Fothergill-Misbah, Richard Walker, Judith Kwasa, Juzar Hooker, Kate Hampshire 2021 Newcastle University, UK

“Old People Problems”, Uncertainty And Legitimacy: Challenges With Diagnosing Parkinson's Disease In Kenya, Natasha Fothergill-Misbah, Richard Walker, Judith Kwasa, Juzar Hooker, Kate Hampshire

Internal Medicine, East Africa

Very little is known about the experience of people living with Parkinson's disease (PD) in low- and middle-income countries, such as those in sub-Saharan Africa. The number of specialists in the region is low and awareness is limited among the population and healthcare professionals. Drawing on ten months of ethnographic fieldwork in urban and rural Kenya with 55 people living with PD (PwP), 23 family members and 22 healthcare professionals from public and private clinics, we set out to understand the experience of diagnosis among PwP in Kenya. The diagnostic journeys of our study participants were typically long, convoluted ...


A Phase 1b/2a Study Of Soticlestat As Adjunctive Therapy In Participants With Developmental And/Or Epileptic Encephalopathies., Jonathan J. Halford, Michael R. Sperling, Dimitrios Arkilo, Mahnaz Asgharnejad, Celia Zinger, Rengyi Xu, Matthew During, Jacqueline A. French 2021 Medical University of South Carolina

A Phase 1b/2a Study Of Soticlestat As Adjunctive Therapy In Participants With Developmental And/Or Epileptic Encephalopathies., Jonathan J. Halford, Michael R. Sperling, Dimitrios Arkilo, Mahnaz Asgharnejad, Celia Zinger, Rengyi Xu, Matthew During, Jacqueline A. French

Department of Neurology Faculty Papers

OBJECTIVE: To evaluate the safety, tolerability, and pharmacokinetics of soticlestat, a first-in-class cholesterol 24-hydroxylase inhibitor, in adults with developmental and/or epileptic encephalopathies (DEE).

METHODS: The study comprised a 30-day, randomized, double-blind, placebo-controlled phase (Part A), followed by a 55-day open-label phase (Part B) (ClinicalTrials.gov ID: NCT03166215) . In Part A, patients with DEE and at least one bilateral motor seizure during the 4-week prospective baseline period were randomized 4:1 to receive soticlestat or placebo, in addition to their usual antiseizure medication. In Part B, all patients received open-label soticlestat. Soticlestat doses were titrated according to tolerability to a ...


A Novel Backward Stepwise Logistic Regression And Classification And Regression Tree Model To Predict 180-Day Clinical Outcomes In Hepatitis B Virus-Acute-On-Chronic Liver Failure Patients, Shima Ghavimi 2021 Marshall University

A Novel Backward Stepwise Logistic Regression And Classification And Regression Tree Model To Predict 180-Day Clinical Outcomes In Hepatitis B Virus-Acute-On-Chronic Liver Failure Patients, Shima Ghavimi

Internal Medicine

As the era of precision and personalized medicine is gaining exponential positive gain in the field of medicine, there is a positive shift towards a more evidence-based patient care approach for patients with hepatological diseases. One factor that is crucial in any physician’s decision-making efforts involves the application of novel innovative approaches that can enhance predicting survival outcome. Acute-on-chronic liver failure (ACLF) is a perfect example of how liver can rapidly deteriorate, and the hepatitis B virus (HBV) is one crucial culprit. Patients can experience organ failure that leads to their mortality, and in this article the authors clearly ...


Nonbacterial Thrombotic Mitral Valve Endocarditis Presenting As Embolic Stroke In A Young Patient With Lupus And Anti-Phospholipid Syndrome, Andrew McCuen, Muhammad Saad, Erin JM Terpstra, Adam T. Stys 2021 USD SSOM

Nonbacterial Thrombotic Mitral Valve Endocarditis Presenting As Embolic Stroke In A Young Patient With Lupus And Anti-Phospholipid Syndrome, Andrew Mccuen, Muhammad Saad, Erin Jm Terpstra, Adam T. Stys

Aesculapius Journal (Health Sciences & Medicine)

A 37-year-old man on systemic immunosuppression for clinically and biochemically quiescent lupus nephritis, presented with left hemiparesis. Brain MRI was concerning for right sided embolic stroke. Workup was negative for atrial fibrillation, deep venous thrombosis, and heart failure. Transesophageal echocardiogram was remarkable for fixed mitral valve leaflet echodensities. In the absence of bacteremia and systemic signs of infection, and with a history of lupus, small vegetations on atrial and ventricular sides of mitral valve leaflets are suggestive of nonbacterial thrombotic endocarditis. Nonbacterial thrombotic vegetations are composed of fibrin deposits on otherwise-healthy valves. Mainstay of treatment is therapeutic anticoagulation with clinical ...


Evaluation Of The Spot™ Photoscreener’S Efficacy For Detecting Amblyopia Risk Factors Compared To Optometrists’ Examinations In 305 South Dakota Children, Jeremy J. Kudrna MD, Eric Habbe MD, Andrea Bordewyk MD, Hadly Carson Eisenbeisz MS-IV, Ryan Scarborough OD, Terrence Spencer MD 2021 Penn State College of Medicine, Department of Ophthalmology – Hershey, PA

Evaluation Of The Spot™ Photoscreener’S Efficacy For Detecting Amblyopia Risk Factors Compared To Optometrists’ Examinations In 305 South Dakota Children, Jeremy J. Kudrna Md, Eric Habbe Md, Andrea Bordewyk Md, Hadly Carson Eisenbeisz Ms-Iv, Ryan Scarborough Od, Terrence Spencer Md

Aesculapius Journal (Health Sciences & Medicine)

Purpose: This study sought to further validate the efficacy of the SPOTTM photoscreener version (v) 3.0.0500 as a screening device for amblyopia risk factors (ARF).

Methods: This was a cross-sectional study from five different western South Dakota outpatient clinics. Data from 610 eyes of 305 children aged 6 months to 13.5 years collected between July 2018 to September 2018 were analyzed, using both the out-of-box referral criteria and the 2013 American Association for Pediatric Ophthalmology and Strabismus (AAPOS) referral criteria. Optometrist (eye care provider or ECP) cycloplegia practice patterns were deferred to each clinics’ specific protocols ...


Loneliness In Primary Care Patients: Relationships With Body Mass Index And Health Care Utilization, Tamara K. Oser, Siddhartha Roy, Jessica Parascando, Rebecca Mullen, Julie Radico, Alexis Reedy-Cooper, Jennifer Moss 2021 University of Colorado School of Medicine

Loneliness In Primary Care Patients: Relationships With Body Mass Index And Health Care Utilization, Tamara K. Oser, Siddhartha Roy, Jessica Parascando, Rebecca Mullen, Julie Radico, Alexis Reedy-Cooper, Jennifer Moss

Journal of Patient-Centered Research and Reviews

Purpose: Rates of loneliness and obesity have increased in recent decades. Loneliness and obesity independently have been found to be risk factors for negative physical and mental health outcomes. This study examined the rates and interrelationships of loneliness, body mass index (BMI), and health care utilization in a primary care setting.

Methods: A cross-sectional survey of adult patients presenting for outpatient care at 7 family medicine clinical practices in Pennsylvania was conducted. Survey questions included self-reported measures of loneliness, height/weight, number of health care visits, and potential confounders (eg, sociodemographic variables, health status). Bivariate and multivariable linear regression models ...


Business Cards As A Mechanism To Encourage Patient Feedback About Trainees, Marc Atzenhoefer, Jodie Ruffin, David Parewski, Nicole Deklotz, M. Fuad Jan, Ana Cristina Perez Moreno, Suhail Q. Allaqaband 2021 Aurora Sinai/Aurora St. Luke’s Medical Centers

Business Cards As A Mechanism To Encourage Patient Feedback About Trainees, Marc Atzenhoefer, Jodie Ruffin, David Parewski, Nicole Deklotz, M. Fuad Jan, Ana Cristina Perez Moreno, Suhail Q. Allaqaband

Journal of Patient-Centered Research and Reviews

This project sought to evaluate if business card distribution improved the utility of Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys by serving as a feedback mechanism for trainees. Between fall 2018 and spring 2019, patient encounters for 6 cardiovascular disease fellows were tracked over two 60-day periods. Six weeks were allowed for HCAHPS surveys to be returned. Business cards were subsequently deployed and encounters similarly tracked. During the control-group monitoring period, 721 patient encounters were logged and 80 (11.1%) surveys were returned. Qualitative feedback, in the form of free-response comments, was provided in 41 (51.3 ...


Incidental Finding Of Anomalous Pulmonary Venous Return Of The Left Upper Lobe, A Rare Anatomical Variation, Anika Dutta, Loren Zuiderveld 2021 Chicago Medical School

Incidental Finding Of Anomalous Pulmonary Venous Return Of The Left Upper Lobe, A Rare Anatomical Variation, Anika Dutta, Loren Zuiderveld

Journal of Patient-Centered Research and Reviews

Partial anomalous pulmonary venous return (PAPVR) is a rare congenital abnormality in which 1 to 3 of the pulmonary veins connect to the right atrium rather than the left atrium. In this synthesis of the literature on PAPVR of the left upper lobe, we attempt to illustrate this clinical entity using a case detected incidentally on chest computed tomography, explain the anatomical aspects of this anomaly, and summarize the reported incidence and etiology of left-sided PAPVR. Lastly, differential diagnoses, clinical relevance, and management of left-sided PAPVR are presented. The identification of this variant is important, as it may have serious ...


The Experience Of Off Periods In Parkinson’S Disease: Descriptions, Triggers, And Alleviating Factors, Sneha Mantri, Madeline Lepore, Briana Edison, Margaret Daeschler, Catherine Kopil, Connie Marras, Lana Chahine 2021 Duke University

The Experience Of Off Periods In Parkinson’S Disease: Descriptions, Triggers, And Alleviating Factors, Sneha Mantri, Madeline Lepore, Briana Edison, Margaret Daeschler, Catherine Kopil, Connie Marras, Lana Chahine

Journal of Patient-Centered Research and Reviews

Purpose: Wearing off of Parkinson’s disease medication is common, but triggers and coping strategies for this transient phenomenon are poorly understood. We aimed to assess the lived experience of OFF periods for people with Parkinson’s disease.

Methods: Participants in the longitudinal Fox Insight study who endorsed OFF periods were invited to complete a survey consisting of both multiple-choice and free-text responses. Descriptive statistics were used to summarize multiple-choice responses, and free-text responses were classified into themes through iterative discussion by 3 movement disorders specialists.

Results: A total of 2110 participants (52.4% male) completed the survey. Tremor was ...


Cross-Sectional Analysis Of Patient-Centered Language Use In Journals Publishing Research Focused On Heart Failure, Vivian Pham, Benjamin Greiner, Ryan Ottwell, Matt Vassar, Micah L. Hartwell 2021 University of Oklahoma Medical Center; Oklahoma State University Center for Health Sciences

Cross-Sectional Analysis Of Patient-Centered Language Use In Journals Publishing Research Focused On Heart Failure, Vivian Pham, Benjamin Greiner, Ryan Ottwell, Matt Vassar, Micah L. Hartwell

Journal of Patient-Centered Research and Reviews

Purpose: Detrimental effects of using non–patient-centered language (nPCL) have been reported for diabetes, mental illness, and obesity, and both the American Medical Association (AMA) and International Committee of Medical Journal Editors (ICMJE) recommend using patient-centered language in medical literature. Heart failure is a common yet stigmatized disease, and nPCL may further propagate stigma. This study analyzed current use of nPCL in journals focused on heart failure research and also examined whether the journals steer authors to adhere to AMA or ICMJE guidelines regarding nPCL.

Methods: Following systematic search of PubMed for heart failure-related articles published from May 1, 2018 ...


Comprehensive Review And Update Of Burning Eye Syndrome, Stephen Giacomazzi, Ivan Urits, Briggs Hoyt, Ashley Hubble, Elyse M. Cornett, Kyle Gress, Karina Charipova, Amnon A. Berger, Hisham Kassem, Alan D. Kaye, Omar Viswanath 2021 Creighton University School of Medicine

Comprehensive Review And Update Of Burning Eye Syndrome, Stephen Giacomazzi, Ivan Urits, Briggs Hoyt, Ashley Hubble, Elyse M. Cornett, Kyle Gress, Karina Charipova, Amnon A. Berger, Hisham Kassem, Alan D. Kaye, Omar Viswanath

Journal of Patient-Centered Research and Reviews

Keratoconjunctivitis sicca (“dry eye”) is a common (14%–30% of adults over age 48) though difficult to treat condition that causes both discomfort and disability with associated dryness, pain, and visual disturbances. Etiology is not clearly understood but is likely varied, with a subset of patients suffering from chronic neuropathic pain referred to as “burning eye syndrome.” This review of existing literature summarizes the clinical presentation, natural history, pathophysiology, and treatment modalities of burning eye syndrome.

Chronicity of burning eye syndrome is likely secondary to increased nociception from the cornea, decrease in inhibitory signals, and nerve growth factor expression alterations ...


An Objective Structured Clinical Examination Case For Opioid Management: Standardized Patient Ratings Of Communication Skills As A Predictor Of Systems-Based Practice Scores, Heidi Kenaga, Tsveti Markova, R. Brent Stansfield, Sarwan Kumar, Pierre Morris 2021 Wayne State University School of Medicine

An Objective Structured Clinical Examination Case For Opioid Management: Standardized Patient Ratings Of Communication Skills As A Predictor Of Systems-Based Practice Scores, Heidi Kenaga, Tsveti Markova, R. Brent Stansfield, Sarwan Kumar, Pierre Morris

Journal of Patient-Centered Research and Reviews

The Wayne State University Office of Graduate Medical Education (WSUGME) uses an objective structured clinical examination (OSCE) to assess its programs’ contribution to enhancing residents’ communication skills. In response to revisions in Michigan’s opioid-prescribing mandates in 2017, WSUGME developed a pain management case in collaboration with faculty and the Wayne State University School of Medicine to educate residents about these mandates while gauging their skills in Systems-Based Practice (SBP), an Accreditation Council for Graduate Medical Education Core Competency. This study examined whether resident OSCE performance predicted year-end milestones scores in SBP1 (coordinates patient care within various health care delivery ...


Determining The Perception And Willingness Of Primary Care Providers To Prescribe Advanced Diabetes Technologies, Alexander O’Donovan, Sean M. Oser, Jessica Parascando, Arthur Berg, Donald E. Nease Jr., Tamara K. Oser 2021 Penn State College of Medicine

Determining The Perception And Willingness Of Primary Care Providers To Prescribe Advanced Diabetes Technologies, Alexander O’Donovan, Sean M. Oser, Jessica Parascando, Arthur Berg, Donald E. Nease Jr., Tamara K. Oser

Journal of Patient-Centered Research and Reviews

Advanced diabetes technologies have produced increasingly favorable outcomes compared to older treatments. Disparities in practice resources have led to a treatment disparity by clinical setting, where endocrinologists typically prescribe far more such technologies than primary care providers (PCPs). Fully automated artificial pancreas systems (APS), which combine technologies to deliver and adjust insulin dosing continuously in response to automatic and continuous glucose monitoring, may be more straightforward for PCPs to prescribe and manage, therefore extending their benefit to more patients. We aimed to assess willingness of PCPs to prescribe advanced diabetes technologies through a cross-sectional survey of PCPs from 4 geographically ...


Does Exercise Prevent Gestational Diabetes Mellitus In Pregnant Women? A Clin-Iq, Olivia Lust, Tana Chongsuwat, Elizabeth Lanham, Ann F. Chou, Elizabeth Wickersham 2021 University of Oklahoma Health Sciences Center

Does Exercise Prevent Gestational Diabetes Mellitus In Pregnant Women? A Clin-Iq, Olivia Lust, Tana Chongsuwat, Elizabeth Lanham, Ann F. Chou, Elizabeth Wickersham

Journal of Patient-Centered Research and Reviews

Excessive weight gain during pregnancy has been on the rise globally, leading to increased prevalence of gestational diabetes mellitus (GDM). A diagnosis of GDM often leads to pregnancy and infant-related complications. Regular exercise may have the potential to prevent GDM. However, evidence surrounding the utility of exercise during pregnancy as an effective risk reduction intervention has been mixed. This clinical inquiry examined the role of regular exercise during pregnancy in preventing GDM in both obese and normal-weight women and analyzed specific aspects of exercise that make it an effective preventive measure. The review of evidence included 3 meta-analyses, 3 systematic ...


Covid-19 Deliveries: Maternal Features And Neonatal Outcomes, Viviana Zlochiver, Blair Tilkens, Ana Cristina Perez Moreno, Fatima Aziz, M. Fuad Jan 2021 Advocate Aurora Research Institute, Advocate Aurora Health

Covid-19 Deliveries: Maternal Features And Neonatal Outcomes, Viviana Zlochiver, Blair Tilkens, Ana Cristina Perez Moreno, Fatima Aziz, M. Fuad Jan

Journal of Patient-Centered Research and Reviews

Integrated, data-driven criteria are necessary to evaluate delivery outcomes in pregnancies affected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the ongoing COVID-19 pandemic. This study analyzed maternal demographics, clinical characteristics, treatments, and delivery outcomes of 85 ethnically diverse, adult pregnant women who tested positive for SARS-CoV-2 at the time of delivery. Median maternal and gestational ages were 27 years (interquartile range [IQR]: 23–31) and 39 weeks (IQR: 37.3–40.0), respectively. Of the 85 SARS-CoV-2–positive participants, 67 (79%) had no COVID-19 symptoms at the time of routine COVID-19 admission testing, 14 (16%) reported mild COVID-19 ...


Physical Activity Barriers And Assets In Rural Appalachian Kentucky: A Mixed-Methods Study, Natalie Jones, Deirdre Dlugonski, Rachel Gillespie, Emily M. DeWitt, Joann Lianekhammy, Stacey A. Slone, Kathryn M. Cardarelli 2021 University of Kentucky

Physical Activity Barriers And Assets In Rural Appalachian Kentucky: A Mixed-Methods Study, Natalie Jones, Deirdre Dlugonski, Rachel Gillespie, Emily M. Dewitt, Joann Lianekhammy, Stacey A. Slone, Kathryn M. Cardarelli

Sports Medicine Research Institute Faculty Publications

Obesity is an increasing public health concern in the U.S. and a contributor to chronic illness, with trends revealing a rise in adult obesity and chronic disease rates among the most vulnerable and disadvantaged populations, including those in rural communities. A mixed-methods approach was used to examine perspectives on perceived physical activity barriers, resources, and level of community support. Researchers utilized the socioecological model to examine the multiple domains that support physical activity in rural Appalachia. The present study focuses on baseline data, including a cohort survey to assess physical activity, health status, and barriers to physical activity, and ...


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