When You Got It, Bump It: A Lost Showgirl’s Cabaret

For my Capstone project, I developed an original cabaret entitled “When You Got It, Bump It: A Lost Showgirl’s Cabaret.” The story follows Mazeppa, the lost showgirl, as she travels the vaudeville “circuit” in an attempt to regain her fame. I portray this leading character, while two other women portray her friends and co-stars. All three characters are based on perhaps some of the most famous showgirls on Broadway, Mazeppa, Tessie Tura and Electra of the 1959 musical, Gypsy. I performed the cabaret twice, on the evenings of April 2nd and 3rd, at the First Unitarian Universalist Church on Waring Road in Syracuse, New York. The piece is comprised of approximately sixteen songs and is about forty minutes in length. The performances also featured the talents of two of my peers within the drama department. In the development of this piece, I sought to showcase two of my greatest artistic strengths: my flair for vocal jazz and dancing. I worked closely with a wonderful pianist who helped me transform my ideas into reality. She created flawless musical transitions from one song to the next, constantly underscoring my character’s dialogue, which helped string together her story. I designed the cabaret within three acts. The first act introduces each of the three characters and highlights the awkwardness that Mazeppa faced in her youth. In the second act, Mazeppa falls in love and has her heart broken; and in the third act, she overcomes this sorrow. With this story, I strove to illuminate a message of embracing one’s true self, thus the title of the closing number and the name of the piece, “When You Got It, Bump It.” I sought to create a piece that would emphasize this concept through the character’s discovery amidst a deep emotional journey. The significance of creating this work of art is one that will renew itself as I continue to maintain and improve upon it over the next several years. As an artist, the value of having a personal piece is priceless. A cabaret is an incredible tool to have at my disposal, especially as I prepare to move to New York City next spring. Not only did this project provide me with the opportunity to strengthen my performance technique, it also granted me the chance to act as a writer, director, and producer. Additionally, I gained valuable experience in collaboration, something that will have an even greater impact as experience in planning for large projects in any arena outside of theatre

Cost analysis : switching from alteplase to tenecteplase for management of acute ischemic stroke

Background: Acute ischemic stroke (AIS) occurs due to obstructed blood flow into blood vessels to the brain and is considered a medical emergency. Thrombolytic therapy is the mainstay of AIS's acute management due to its benefit in improving neurological function within three months. Alteplase is a tPA approved for the treatment of AIS and is widely studied. Tenecteplase is another tPA approved for the treatment of Acute Myocardial Infarction (AMI) but not AIS. Although tenecteplase is not FDA-approved for AIS, it has theoretical advantages over alteplase, such as cost savings. Methods: Estimated cost savings in the form of avoided costs due to a reduction in hospital days, ICU days, emergency department (ED) visits and tPA costs as a consequence of moving from the current standard of care (SoC), alteplase, to the new drug scenario, tenecteplase, for patients with AIS were analyzed based on hospital claims data. Results: A total of 336 patients received alteplase (n = 166) or tenecteplase (n = 170) between August 2018 to August 2020. There was no significant difference in the hospital, ICU, inpatient and emergency department (ED) length of stay between the tenecteplase and alteplase groups. The estimated annual savings to Ascension for switching from tenecteplase to alteplase for the management of AIS was $563,001. The cost per patient was lower for patients treated with tenecteplase ($9,969) then alteplase ($13,054), resulting in a savings of$3,065 per patient. Conclusions: Tenecteplase is less expensive, easier to dose and administer, and may have less adverse events such as bleeding complications than alteplase. Thus, hospitals should consider using tenecteplase rather than alteplase for thrombolysis of acute ischemic stroke.Pharmaceutical Science

Comparative analysis of cancer genes in the human and chimpanzee genomes

BACKGROUND: Cancer is a major medical problem in modern societies. However, the incidence of this disease in non-human primates is very low. To study whether genetic differences between human and chimpanzee could contribute to their distinct cancer susceptibility, we have examined in the chimpanzee genome the orthologous genes of a set of 333 human cancer genes. RESULTS: This analysis has revealed that all examined human cancer genes are present in chimpanzee, contain intact open reading frames and show a high degree of conservation between both species. However, detailed analysis of this set of genes has shown some differences in genes of special relevance for human cancer. Thus, the chimpanzee gene encoding p53 contains a Pro residue at codon 72, while this codon is polymorphic in humans and can code for Arg or Pro, generating isoforms with different ability to induce apoptosis or interact with p73. Moreover, sequencing of the BRCA1 gene has shown an 8 Kb deletion in the chimpanzee sequence that prematurely truncates the co-regulated NBR2 gene. CONCLUSION: These data suggest that small differences in cancer genes, as those found in tumor suppressor genes, might influence the differences in cancer susceptibility between human and chimpanzee. Nevertheless, further analysis will be required to determine the exact contribution of the genetic changes identified in this study to the different cancer incidence in non-human primates

Caring for a dying spouse at the end of life: 'It's one of the things you volunteer for when you get married': a qualitative study of the oldest carers' experiences.

older people aged 80 and over are increasingly providing end-of-life care to spouses at home and often do so for long periods of time, while also trying to manage their own illnesses and disabilities. Little of the research on older spousal carers has focussed on the oldest carers; hence, the needs of this particular population are not fully known.to explore the experiences of the 'oldest carers' in caring for a dying spouse at home.secondary analysis was undertaken on a subset of data from a larger qualitative interview study; this dataset comprised 17 interviews from participants aged 80 or over. Framework analysis methods were used, with items derived from the thematic analysis of the main study.the oldest carers in this subset demonstrated high levels of resilience and the ability to adapt to their caring role. Caring until death was accepted as an integral part of the commitment made to their partner as part of the 'wedding contract'. Carers felt they benefitted from the support provided by family, friends and care services; however, their own care needs were not always recognised by health and social care services.these findings underscore the complexity of the oldest carers' experiences and challenges in times of illness and end of life. Healthcare professionals should be alerted to the myriad ways caregiving is enacted in serious illness and seek opportunities for developing supportive interventions specifically for older carers

Diamond Blackfan Anemia: A Nonclassical Patient With Diagnosis Assisted by Genomic Analysis

Diamond Blackfan anemia (DBA) is an inherited syndrome usually presenting with severe macrocytic anemia in infancy, paucity of erythroid precursors in the bone marrow, and congenital anomalies. We describe a child with mild, transfusion independent normocytic anemia whose diagnosis of DBA was established by identification of a novel de novo mutation disrupting normal splicing of the ribosomal protein RPL5. The diagnosis of DBA was confirmed by elevated erythrocyte adenosine deaminase levels and an abnormal ribosomal RNA profile. This case demonstrates the usefulness of genomic analysis in establishing the diagnosis of DBA in patients with a nonclassical presentation of the disease

Staphylococcus aureus Infections in US Veterans, Maryland, USA, 1999–20081

Trends in Staphylococcus aureus infections are not well described. To calculate incidence in overall S. aureus infection and invasive and noninvasive infections according to methicillin susceptibility and location, we conducted a 10-year population-based retrospective cohort study (1999–2008) using patient-level data in the Veterans Affairs Maryland Health Care System. We found 3,674 S. aureus infections: 2,816 (77%) were noninvasive; 2,256 (61%) were methicillin-resistant S. aureus (MRSA); 2,517 (69%) were community onset, and 1,157 (31%) were hospital onset. Sixty-one percent of noninvasive infections were skin and soft tissue infections; 1,112 (65%) of these were MRSA. Ten-year averaged incidence per 100,000 veterans was 749 (± 132 SD, range 549–954) overall, 178 (± 41 SD, range 114–259) invasive, and 571 (± 152 SD, range 364–801) noninvasive S. aureus infections. Incidence of all S. aureus infections significantly increased (p<0.001), driven by noninvasive, MRSA, and community-onset infections (p<0.001); incidence of invasive S. aureus infection significantly decreased (p<0.001)

Cisplatin +/− rucaparib after preoperative chemotherapy in patients with triple-negative or BRCA mutated breast cancer

Patients with triple-negative breast cancer (TNBC) who have residual disease after neoadjuvant therapy have a high risk of recurrence. We tested the impact of DNA-damaging chemotherapy alone or with PARP inhibition in this high-risk population. Patients with TNBC or deleterious BRCA mutation (TNBC/BRCAmut) who had >2 cm of invasive disease in the breast or persistent lymph node (LN) involvement after neoadjuvant therapy were assigned 1:1 to cisplatin alone or with rucaparib. Germline mutations were identified with BROCA analysis. The primary endpoint was 2-year disease-free survival (DFS) with 80% power to detect an HR 0.5. From Feb 2010 to May 2013, 128 patients were enrolled. Median tumor size at surgery was 1.9 cm (0-11.5 cm) with 1 (0-38) involved LN; median Residual Cancer Burden (RCB) score was 2.6. Six patients had known deleterious BRCA1 or BRCA2 mutations at study entry, but BROCA identified deleterious mutations in 22% of patients with available samples. Toxicity was similar in both arms. Despite frequent dose reductions (21% of patients) and delays (43.8% of patients), 73% of patients completed planned cisplatin. Rucaparib exposure was limited with median concentration 275 (82-4694) ng/mL post-infusion on day 3. The addition of rucaparib to cisplatin did not increase 2-year DFS (54.2% cisplatin vs. 64.1% cisplatin + rucaparib; P = 0.29). In the high-risk post preoperative TNBC/BRCAmut setting, the addition of low-dose rucaparib did not improve 2-year DFS or increase the toxicity of cisplatin. Genetic testing was underutilized in this high-risk population

Promoting smoking cessation during pregnancy: A feasibility and pilot trial of a digital storytelling intervention delivered via text?messaging

ObjectiveSmoking during pregnancy causes risks to mother and infant health. We investigated the feasibility and likely success of SKIP-IT, a narrative and picture-based smoking cessation intervention delivered via text messages.MethodsA feasibility and pilot trial. We aimed to recruit 70 pregnant women who smoked, randomised to usual care alone, or usual care and the SKIP-IT intervention, between 12 weeks of pregnancy and 6 weeks post due-date. Outcomes assessed were recruitment, retention, acceptability of, and engagement with the intervention, smoking behaviour, intentions, perceived risk, and self-efficacy.ResultsOf 312 women initially approached by smoking cessation services only 54 (17%) agreed to be contacted by the research team. Twenty were then either ineligible or uncontactable and 28 (82%) participated. Most women reported texts to be entertaining and helpful. The proportion of women not smoking at follow-up was lower in the intervention group, but numbers were too small to draw conclusions about effectiveness.ConclusionThe intervention was acceptable, but difficulty in making initial and follow-up contacts meant our methods were unfeasible for a larger trial.Practice implicationsDigital Storytelling interventions could help women quit smoking, but further research is required to identify alternative methods for studies with pregnant women who smoke