eScholarship@UMassChan
eScholarship@UMassChan is a digital archive for UMass Chan Medical School's research and scholarship, including journal articles, theses, datasets and more. We welcome submissions from our faculty, staff, and students. eScholarship@UMassChan is a service of the Lamar Soutter Library, Worcester, MA, USA. See also our open access journal publishing services.
Questions? See the Help menu or contact escholarship@umassmed.edu.
Communities in eScholarship@UMassChan
Select a community to browse its collections.
Recent Publications
Publication Measuring Burnout in Pediatric ICU Nurses: Development and Pilot Validation of a PICU RN Burnout Scale(UMass Chan Medical School, 2025-07-09)Background. Burnout among Pediatric Intensive Care Unit (PICU) nurses is a significant issue. Existing Burnout scales are limited and fail to address factors like moral distress and resource constraints or the emotionally frought nature of pediatric critical care. There is a need for a more specific tool to assess burnout in PICU nurses, which often exceeds 50%. Objectives. This study aimed to develop and validate the first PICU RN Burnout Scale, designed to assess burnout specific to PICU nursing practice. Methods. A cross-sectional, observational design was used to pilot the PICU RN Burnout Scale nationwide. Validity was assessed through comparison with the MBI and McCloskey/Mueller Satisfaction Scale. Reliability was measured using Cronbach’s alpha, and factor structure was evaluated via Exploratory Factor Analysis (EFA). Results. Seventy-one nurses participated. EFA revealed a three-factor structure: Peer Incivility, Psychophysical Stress, and Leadership Support, explaining 74% of the variance. The scale showed excellent internal consistency (α = 0.93) and moderate concurrent validity with the MBI (ρ = 0.56, p < 0.001). Discriminant validity was confirmed with a negative correlation (ρ = -0.61, p < 0.001) with the McCloskey-Mueller Scale. Conclusions. The PICU RN Burnout Scale offers a tailored assessment of burnout, addressing unique stressors not captured by the MBI. It demonstrated strong reliability and validity, suggesting its utility in identifying burnout in PICU nurses. Further research is needed to validate the scale and inform targeted future interventions.Publication Petechial hemorrhage in mechanical thrombectomy for distal and medium-vessel occlusions: technical considerations and outcomes(2025-07-04)Objective: Mechanical thrombectomy (MT) is well established for large-vessel occlusion (LVO) strokes, but its safety in distal and medium-vessel occlusions (DMVOs) requires further investigation. This study analyzed the relationship between procedural approaches, petechial hemorrhage (PetH), and clinical outcomes in DMVO thrombectomy, with particular attention to technical considerations and the complex interplay between tissue injury and hemorrhagic complications. Methods: A retrospective cohort study was conducted on DMVO stroke patients treated with MT at 37 stroke centers worldwide from 2016 to 2024. Patients were categorized based on follow-up imaging into those with or without PetH. Four logistic regression models analyzed the association of PetH with favorable functional outcomes (modified Rankin Scale score ≤ 2) at 90 days, early neurological improvement (≥ 4-point National Institutes of Health Stroke Scale score decrease at 24 hours), all-cause mortality, and independent determinants of PetH. Adjusted odds ratios (aORs), 95% confidence intervals, and p values were reported. Results: Of 1428 patients, 439 (30.7%) developed PetH. Factors independently associated with PetH were multiple thrombectomy passes (aOR 1.58, 95% CI 1.21-2.06; p = 0.001), IV thrombolysis (aOR 1.31, 95% CI 1.01-1.69; p = 0.04), and the combined use of a stent retriever with aspiration as the first-line method compared with aspiration alone (aOR 1.66, 95% CI 1.15-2.38; p = 0.007). Conversely, general anesthesia (aOR 0.55, 95% CI 0.40-0.77; p < 0.001), higher Alberta Stroke Program Early CT Scores (aOR 0.76, 95% CI 0.69-0.83; p < 0.001), and successful recanalization (aOR 0.56, 95% CI 0.39-0.80; p = 0.002) were significantly associated with a lower odds of PetH. PetH was associated with a decreased odds of favorable functional outcomes (aOR 0.51, 95% CI 0.36-0.73; p < 0.001), reduced early neurological improvement (aOR 0.59, 95% CI 0.44-0.79; p < 0.001), and increased all-cause mortality (aOR 1.84, 95% CI 1.23-2.76; p < 0.001). Conclusions: PetH is a frequent sequela following MT in DMVO strokes and is associated with poorer outcomes, likely reflecting underlying ischemic injury rather than direct causation. Procedural factors influence PetH risk, suggesting medical treatment as first-line therapy for DMVOs, with MT reserved for refractory cases using less aggressive approaches.Publication The Somatic Mosaicism across Human Tissues Network(2025-07-02)From fertilization onwards, the cells of the human body acquire variations in their DNA sequence, known as somatic mutations. These postzygotic mutations arise from intrinsic errors in DNA replication and repair, as well as from exposure to mutagens. Somatic mutations have been implicated in some diseases, but a fundamental understanding of the frequency, type and patterns of mutations across healthy human tissues has been limited. This is primarily due to the small proportion of cells harbouring specific somatic variants within an individual, making them more challenging to detect than inherited variants. Here we describe the Somatic Mosaicism across Human Tissues Network, which aims to create a reference catalogue of somatic mutations and their clonal patterns across 19 different tissue sites from 150 non-diseased donors and develop new technologies and computational tools to detect somatic mutations and assess their phenotypic consequences, including clonal expansions. This strategy enables a comprehensive examination of the mutational landscape across the human body, and provides a comparison baseline for somatic mutation in diseases. This will lead to a deep understanding of somatic mutations and clonal expansions across the lifespan, as well as their roles in health, in ageing and, by comparison, in diseases.Publication Silk Vista Baby for the treatment of distal anterior cerebral artery aneurysms(2025-07-02)Purpose: Treating small-caliber vessel aneurysms with flow diverters poses challenges due to narrow luminal diameters and tortuous vasculature, which complicate the navigation and deployment of conventional devices using standard microcatheters. The Silk Vista Baby (SVB, Balt, Montmorency, France) flow diverter was developed to treat intracranial aneurysms located in smaller vessels or more distal segments and is compatible with 0.017″ microcatheters. We present the largest multicenter analysis to date evaluating the outcomes of SVB use in unruptured distal anterior cerebral artery (DACA) aneurysms. Methods: Retrospective data from 20 centers were reviewed for patients with unruptured DACA aneurysms treated with the SVB. Demographic information, clinical presentation, radiographic characteristics, complications, and outcomes were recorded. Results: Seventy-nine patients (79 DACA aneurysms) were treated between January 2018 and December 2022; 59 were female (74.7%), and the median age was 61 years (IQR 53-67). Most aneurysms were saccular (89.9%), and 65.8% involved a branch. The median parent vessel diameter was 1.9 mm (IQR 1.7-2.1). A single stent was implanted in 97.5% of cases; 2.5% required two stents. The median imaging follow-up duration was 12 months (IQR 9.5-24). At the last follow-up, 76% of aneurysms showed complete or near-complete occlusion (O'Kelly-Marotta scale C or D, Raymond-Roy 1 or 2). Overall, thromboembolic or hemorrhagic complications occurred in 14% of patients, with two cases being symptomatic. The mortality rate was 0%, and the retreatment rate was 1.3%. Conclusion: In this multicenter series, the SVB flow diverter represented a valuable treatment option for distal anterior cerebral artery (DACA) aneurysms.Publication Adulting Shorts: Let’s Talk About Getting Your Teen Ready for a Job(UMass Chan Medical School, 2025-07-01)Pre-ETS, or Pre-Employment Transition Services, are a set of services designed to help students with disabilities, including those with mental health conditions, typically aged 14-22, prepare for post-secondary education or employment. These services offer an early start on career exploration and skill development, often preceding or supplementing traditional Vocational Rehabilitation (VR) services. This comic is used to increase the awareness of Pre-ETS.