Digital Commons Network^™

Removal Of Common Antimicrobial Agents By Sustained Low- Efficiency Dialysis, Joanna Q. Hudson Pharmd, Bcps, Fasn, Fccp, Madelyn N. Hilgers Bs, Pharmd Candidate, Elvira O. Gosmanova Md

Faculty Publications

Adequate dosing of antimicrobials is paramount for treating infections in critically ill patients undergoing kidney replacement therapy; however, little is known about antimicrobial removal by sustained low-efficiency dialysis (SLED). The objective was to quantify the removal of cefepime, daptomycin, meropenem, piperacillin–tazobactam, and vancomycin in patients undergoing SLED. Adult patients ≥18 years with acute kidney injury (AKI) or end-stage kidney disease receiving one of the select antimicrobials and requiring SLED were included. Blood and dialysate flow rates were maintained at 250 and 100 mL/min, respectively. Simultaneous arterial and venous blood samples for the analysis of antibiotic concentrations were collected hourly for …

Covering The Care: Most Prevalent Health Conditions And Their Associated Costs Among Nh’S Insured Population – Behavioral Health And Cardiovascular Disease Top The List, Bethany Swanson, Erica Plante, Deborah Fournier

Faculty Publications

This data brief presents an analysis of available claims data from New Hampshire’s commercial, Medicaid, and Medicare insured populations. Specifically, the study identifies the top ten most prevalent health conditions, the cost of treatment for those conditions, and the overall medical cost for those with one of the identified conditions. The analysis is based on the most recent calendar year of available claims data (January – December 2022).

The Acceptability Of Relationship-Centered Communication Partner Training For Couples Impacted By Aphasia: A Mixed Methods Pilot Investigation, Kathryn-Anne Pertab, Tyson G. Harmon, Jonathan Sandberg, Jon L. Pertab, William S. Evans

Faculty Publications

Purpose: This study explored the acceptability and impact of Relationship-Centered Communication Partner Training (RC-CPT) in couples impacted by aphasia. In particular, couples considered whether discussing their relationship roles and responsibilities was important and relevant to the changes they desire. Preliminary quasi-experimental data regarding perceived communication confidence and the marriage relationship were also obtained.

Method: Three couples participated in RC-CPT across two sessions. Surveys were used to measure communication confidence and the marital relationship before and after participation in RC-CPT. The quantitative findings were analyzed using descriptive statistics. Couples also participated in a semi-structured interview about the acceptability of RC-CPT, during …

Covid-19 Vaccine Effectiveness Among People Living With And Without Hiv In South Carolina, Usa: Protocol Of A Population-Based Cohort Study, Xueying Yang, Jiajia Zhang Ph.D., Bankole Olatosi, Sharon Weissman, Xiaoming Li Ph.D.

Faculty Publications

Introduction Despite the effectiveness of COVID-19 vaccines in preventing severe COVID-19 outcomes, a small percentage of fully vaccinated persons will develop symptomatic or asymptomatic infections with SARSCoV-2, which is referred to as ‘breakthrough COVID-19’. People living with HIV (PLWH) appear to have an elevated risk of severe COVID-19 outcomes, yet the effectiveness of the COVID-19 vaccine in this population remains unclear due to the limited research efforts in this population in the real world. This study aims to characterise and compare the breakthrough COVID-19 (eg, prevalence and disease severity) between PLWH and non-PLWH and then examine whether HIV markers play …

Study Protocol: Identifying Transcriptional Regulatory Alterations Of Chronic Effects Of Blast And Disturbed Sleep In United States Veterans, Molly J. Sullan, Kelly A. Stearns-Yoder, Zhaoyu Wang, Andrew J. Hoisington, Adam D. Brenoweth, Walter Carr, Yongchao Ge, Hanga Galfalvy, Fatemah Haghighi, Lisa A. Brenner

Faculty Publications

Injury related to blast exposure dramatically rose during post-911 era military conflicts in Iraq and Afghanistan. Mild traumatic brain injury (mTBI) is among the most common injuries following blast, an exposure that may not result in a definitive physiologic marker (e.g., loss of consciousness). Recent research suggests that exposure to low level blasts and, more specifically repetitive blast exposure (RBE), which may be subconcussive in nature, may also impact long term physiologic and psychological outcomes, though findings have been mixed. For military personnel, blast-related injuries often occur in chaotic settings (e.g., combat), which create challenges in the immediate assessment of …

Emergent Potential Of The Terahertz Cmos Microprocessor, F. Matthew Mihelic

Faculty Publications

The terahertz speed CMOS microprocessor that has been designed by Averoses Incorporated (US11063118B1) utilizes nano-vacuum tube elements with plasma interconnect of those elements, and has the capability to emit, detect, conduct, and analyze electromagnetic signals in the terahertz range. Nano-vacuum tube systems are resistant to ionizing radiation and to high temperatures, and there are emergent potentials of such systems beyond the obvious speed-up of data processing. Such a microprocessor can provide a platform for compact terahertz spectroscopy, especially for organic molecules, and this can also include DNA sequencing and DNA fingerprinting. Another emergent quality of such a system is that, …

A Quantum Logic Gate In The Dna Deoxyribose Moiety, F. Matthew Mihelic

Faculty Publications

The deoxyribose moiety of a nucleotide in the DNA molecule can act as a quantumlogic gate, in which the enantiomeric shift between the C2-endo and C3-endo conformations of each nucleotide, occurs within a logically and thermodynamically reversible situation of electron spin qubits, that are coherently held within the topologically insulating DNA crystalline nanostructure, and that are coherently conducted along the delocalized electrons of the pi-stacked nucleotide base pairs. The enantiomeric symmetry between the C2-endo and C3-endo conformations is logically and thermodynamically reversible because it functions as a symmetry-breaking Szilard engine that is effectively built out of the physicality of the …

Association Of Blast Exposure In Military Breaching With Intestinal Permeability Blood Biomarkers Associated With Leaky Gut, Qingkun Liu, Zhaoyu Wang, Shengnan Sun, Jeffrey Nemes, Lisa A. Brenner, Miciej Skotak, Christina R. Lavalle, Yongchao Ge, Walter Carr, Fatemeh Haghighi

Faculty Publications

Injuries and subclinical effects from exposure to blasts are of significant concern in military operational settings, including tactical training, and are associated with self-reported concussion-like symptomology and physiological changes such as increased intestinal permeability (IP), which was investigated in this study. Time-series gene expression and IP biomarker data were generated from “breachers” exposed to controlled, low-level explosive blast during training. Samples from 30 male participants at pre-, post-, and follow-up blast exposure the next day were assayed via RNA-seq and ELISA. A battery of symptom data was also collected at each of these time points that acutely showed elevated symptom …

Enhancing Pastoralist Women's Knowledge Of Danger Signs Through Home-Based Life-Saving Skills Intervention In Northern Kenya: A Quasi Experimental Study, Dabo Galgalo Halake, Elijah Isinta Maranga, Japheth Mativo Nzioki, John Gachohi

Faculty Publications

Background: Maternal recognition of obstetric danger signs is crucial for reducing maternal mortality and delays in seeking emergency care. However, there is insufficient knowledge about obstetric danger signs among women in rural Kenya, especially in the hard-to-reach pastoralist communities. This study aimed to determine whether home-based life-saving skills intervention improves knowledge about obstetric danger signs among women in Marsabit County, Kenya. Methods: We conducted a quasi-experimental study with pre-posttests among 256 pregnant women, allocated to intervention and control groups. We implemented sensitization of pregnant women on obstetric danger signs and basic life-saving actions as components of home-based life-saving skills intervention. …

Association Between Sociodemographics And Change In Alcohol Or Tobacco Use Behaviors During The Covid-19 Pandemic, Selam Habtemariam, Chloe M. Hery, Xiaochen Zhang, Mengda Yu, Darren Mays, Toyin Adeyanju, Brittany Bernardo, Electra D. Paskett

Faculty Publications

No abstract provided.

Effects Of Cognitive And Social Demands On Linguistic Production For People With Moderate, Mild, Or No Aphasia, Tyson G. Harmon, Emily Mcdonald, Kyle Steele

Faculty Publications

Background: Most everyday communication occurs in situations where cognitive and social demands are present. These types of situations may compound language deficits for people with aphasia (PWA). An understanding of the language interference that may occur from cognitive and social demands is an important precursor for assessment and intervention that addresses everyday communication situations.

Aims: To determine how cognitively and socially demanding conditions affect micro- and macrolinguistic production for people with moderate, mild, or no aphasia during narrative discourse and to compare effects among groups.

Method: Thirty participants with mild (n = 9), moderate (n = 9), or no (n …

How Individuals’ Opinions Influence Society’S Resistance To Epidemics: An Agent-Based Model Approach, Geonsik Yu, Michael J. Garee, Mario Ventresca, Yuehwern Yih

Faculty Publications

Background: Protecting public health from infectious diseases often relies on the cooperation of citizens, especially when self-care interventions are the only viable tools for disease mitigation. Accordingly, social aspects related to public opinion have been studied in the context of the recent COVID-19 pandemic. However, a comprehensive understanding of the effects of opinion-related factors on disease spread still requires further exploration. Methods: We propose an agent-based simulation framework incorporating opinion dynamics within an epidemic model based on the assumption that mass media channels play a leading role in opinion dynamics. The model simulates how opinions about preventive interventions change over …

Understanding And Addressing The Individualized Emotional Impact Of Aphasia: A Framework For Speech-Language Pathologists, Tyson G. Harmon

Faculty Publications

Emotion plays an integral role in communication and has long been considered relevant to aphasia rehabilitation. Speech-language pathologists (SLPs), however, may sometimes wonder how or whether to address emotional responses. The purpose of the present tutorial was to (1) present a framework that clinicians can use to understand individualized emotional responses in aphasia and (2) discuss examples of how the framework informs practical strategies that SLPs can use to provide emotional support to PWA. Drawing upon a cognitive-motivational-relational theory of emotions perspective combined with emerging research in aphasia, I show that emotion impacts and is impacted by both language processing …

Development Of A Methodology For The Quantification Of Reaerosolization Of A Biological Contaminate Surrogate Particle From A Military Uniform Fabric, George Cooksey, Jeremy M. Slagley, Casey W. Cooper, Douglas Lewis, Alisha Helm

Faculty Publications

In a mass casualty medical evacuation after a bioaerosol (BA) dispersal event, a decontamination (DC) method is needed that can both decontaminate and prevent biological particle (BP) re-aerosolization (RA) of contaminated clothes. However, neither the efficacy of current DC methods nor the risk of BP RA is greatly explored in the existing literature. The goals of this study were to develop a repeatable method to quantify the RA of a biological contaminant off military uniform fabric swatches and to test the efficacy of one DC protocol (high-volume, low-pressure water) using 1 µm polystyrene latex (PSL) spheres as a surrogate. A …

Therapeutics To Treat Psychiatric And Neurological Disorders: A Promising Perspective From Algerian Traditional Medicine, Farida Larit, Francisco León Ph.D.

Faculty Publications

Ancient people sought out drugs in nature to prevent, cure, and treat their diseases, including mental illnesses. Plants were their primary source for meeting their healthcare needs. In Algeria, folk medicine remains a fundamental part of the local intangible knowledge. This study aims to conduct a comprehensive ethnomedicinal investigation and documentation of medicinal plants and the different plant formulations traditionally used in Algeria for the treatment of pain, psychiatric, and neurological disorders. It also intends to improve the current knowledge of Algerian folk medicine. Several scientific databases were used to accomplish this work. Based on this investigation, we identified 82 …

Physiological Arousal, Attentiveness, Emotion, And Word Retrieval In Aphasia: Effects And Relationships, Tyson G. Harmon, Angela Johnson, Vivian Ward, Shawn Nissen

Faculty Publications

Purpose: To (a) compare physiological arousal and attentiveness during a confrontational naming task between participants with aphasia and a control group across four conditions that varied according to emotionality of presented stimuli and (b) explore relationships among physiological arousal, attentiveness, perceived arousal, and naming performance. We hypothesized that participants with aphasia would show lower levels of arousal and attentiveness than control participants and that emotional conditions would lead to increased physiological arousal and attentiveness.

Method: Eight participants with aphasia and 15 control participants completed a confrontational naming task under positive, negative, and neutral conditions and rated their perceived arousal after …

Telling Stories In Noise: The Impact Of Background Noises On Spoken Language For People With Aphasia, Tyson G. Harmon, Brenna Scadden Nelson, Christopher Dromey, Kirsten Dixon Clawson

Faculty Publications

Purpose: Determine how different background noise conditions affect the spoken language of participants with aphasia during a story retell task.

Method: Participants included 11 adults with mild to moderate aphasia and 11 age- and gender-matched controls. Participants retold stories in a silent baseline and five background noise conditions (conversation, monologue, phone call, cocktail, pink noise). Dependent measures of speech acoustics (fundamental frequency, mean intensity), speech fluency (speech rate, disfluent words), and language production (correct information units, lexical errors, lexical diversity, and cohesive utterances) were compared between groups and across conditions.

Results: Background noise resulted in higher fundamental frequency (F_{0 …}

Low-Rate Tens As An Effective Treatment For Pelvic Pain - A Retrospective Case Report, Michelle Allyn, Ryan Kamienseski

Faculty Publications

Purpose: Chronic pelvic pain (CPP) affects 27% of the world’s female population. The purpose of this case report was to investigate the use of low-rate transcutaneous electrical nerve stimulation (TENS) for pain relief in a woman with CPP. Few studies have investigated the effects of low-rate TENS on gynecological related pelvic pain. Methods: A 21-year-old woman presented with a six-month history of pelvic pain and decreased quality of life. Persistent pain led the patient to seek physical therapy treatment. Single-channel low-rate TENS (five hertz frequency, 250 microseconds phase duration) was provided for 30 minutes daily at the maximum tolerated intensity, …

The Noloco Strategy For Essential Hypertension, F. Matthew Mihelic Md

Faculty Publications

Ninety-nine percent of all “essential” hypertension can be controlled by using the NoLoCo strategy, without causing any significant side-effects and without an increase in insulin resistance. NoLoCo stands for Norvasc (amlodipine), Lozol (indapamide), and Cozaar (losartan), but the medicines are considered and used in reverse order.

Pattern-Based Target Selection For Treatment Of Irregular Past Tense: A Single-Case Experimental Design For Children With Dld, Kirsten M. Hannig Russell, Amy Wilder, Julie L. Wambaugh

Faculty Publications

Purpose: Many children with developmental language disorder (DLD) demonstrate difficulty inflecting irregular past tense verbs. We evaluated using phonological-based patterns (i.e., schemas) to select targets for treatment of irregular verb inflection for children with DLD. We hypothesized this approach would result in acquisition of treated verbs, generalization to untreated verbs within the same phonological schema, and increased use of correct irregular verbs in naturalistic contexts.

Method: Treatment was provided to three 7-year-old participants with DLD in the context of multiple baseline design across behaviors and participants. Phonological schemas included vowel change, final alveolar, and dual change irregular verbs. Treatment was …

Building Thriving Healthcare Teams Through Organizational Learning, Bret Lyman, Marie M. Prothero, Adrianna L. Watson

Faculty Publications

The purpose of this article is to provide practical steps nurse leaders can use to build thriving healthcare teams through organizational learning. The climate, culture, and activities associated with organizational learning are well-aligned with those needed to build thriving teams. Nurse leaders who leverage this alignment can effectively recruit and retain teams while enhancing their team’s ability to effectively navigate change.

Building Thriving Healthcare Teams Through Organizational Learning, Bret Lyman, Marie M. Prothero, Adrianna L. Watson

Faculty Publications

The purpose of this article is to provide practical steps nurse leaders can use to build thriving healthcare teams through organizational learning. The climate, culture, and activities associated with organizational learning are well-aligned with those needed to build thriving teams. Nurse leaders who leverage this alignment can effectively recruit and retain teams while enhancing their team’s ability to effectively navigate change.

Early Assurance Model For Physical Therapy Education: A Descriptive Study, Kimberly Coleman-Ferreira, Ivan Mulligan, Lora Packel

Faculty Publications

Introduction: Various curriculum models for Doctor of Physical Therapy (DPT) education exist across the country. The purpose of this study was to provide an updated description of the Early Assurance (EA) program model, including administrative variables for institutional leaders to consider. This descriptive study may help equip students to choose an educational program that suits their desires and enable institutions to consider models that fit their needs given their typical admission draw, the local environment, student debt, and resources available. Applications to DPT programs are on the decline while there continues to be an expansion of programs. Institutions are looking …

Predicting Adolescent Intervention Non-Responsiveness For Precision Hiv Prevention Using Machine Learning, Bo Wang, Feifan Liu, Lynette Deveaux, Arlene Ash, Ben Gerber, Jeroan Allison, Carly Herbert, Maxwell Poitier, Karen Macdonell, Xiaoming Li Ph.D., Bonita Stanton

Faculty Publications

Interventions to teach protective behaviors may be differentially effective within an adolescent population. Identifying the characteristics of youth who are less likely to respond to an intervention can guide program modifications to improve its effectiveness. Using comprehensive longitudinal data on adolescent risk behaviors, perceptions, sensation-seeking, peer and family influence, and neighborhood risk factors from 2564 grade 10–12 students in The Bahamas, this study employs machine learning approaches (support vector machines, logistic regression, decision tree, and random forest) to identify important predictors of non-responsiveness for precision prevention. We used 80% of the data to train the models and the rest for …

Augmenting Project Echo For Opioid Use Disorder With Data-Informed Quality Improvement, Owen B. Murray, Marcy A. Doyle, Bethany M. Mcleman, Lisa A. Marsch, Elizabeth C. Saunders, Katherine Cox, Delitha Watts, Jeanne Ryer

Faculty Publications

Background

National opioid-related overdose fatalities totaled 650,000 from 1999 to 2021. Some of the highest rates occurred in New Hampshire, where 40% of the population lives rurally. Medications for opioid use disorder (MOUD; methadone, buprenorphine, and naltrexone) have demonstrated effectiveness in reducing opioid overdose and mortality. Methadone access barriers disproportionally impact rural areas and naltrexone uptake has been limited. Buprenorphine availability has increased and relaxed regulations reduces barriers in general medical settings common in rural areas. Barriers to prescribing buprenorphine include lack of confidence, inadequate training, and lack of access to experts. To address these barriers, learning collaboratives have trained …

Racial And Ethnic Disparities In Alcohol-Attributed Deaths In The United States, 1999–2020, Ibraheem M. Karaye, Nasim Maleki, Ismaeel Yunusa Ph.D.

Faculty Publications

The disparities in alcohol-attributed death rates among different racial and ethnic groups in the United States (US) have received limited research attention. Our study aimed to examine the burden and trends in alcohol-attributed mortality rates in the US by race and ethnicity from 1999 to 2020. We used national mortality data from the Centers for Disease Control and Prevention’s Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database and employed the ICD-10 coding system to identify alcohol-related deaths. Disparity rate ratios were calculated using the Taylor series, and Joinpoint regression was used to analyze temporal trends and calculate annual and …

The Global Fatty Liver Disease-Sustainable Development Goal Country Score For 195 Countries And Territories, Jeffrey V. Lazarus, Hannah Han, Henry E. Mark, Saleh A. Schattenberg, Jörn M. J., Ismaeel Yunusa Ph. D., Et Al.

Faculty Publications

Background & Aims:

Fatty liver disease is highly prevalent, resulting in overarching wellbeing and economic costs. Addressing it requires comprehensive and coordinated multisectoral action. We developed a fatty liver disease-Sustainable Development Goal (SDG) country score to provide insights into country-level preparedness to address fatty liver disease through a whole-of-society lens.

Approach & Results:

We developed two fatty liver disease-SDG score sets. The first included six indicators (child wasting, child overweight, non-communicable disease [NCD] mortality, universal health coverage service coverage index, health worker density, and education attainment), covering 195 countries between 1990-2017. The second included the aforementioned indicators plus an urban …

Barriers To Cataract Surgery In Africa: Providers’ Perspective (Research Protocol), Cougar Hall, Scott Herrod, Benjamin Crookston, Sadik Taju Sherief, Akwasi Ahmed, Grace Chipalo Mutati, John Welling, Boatang Wiafe, Michae Gyasi, Joshua West

Faculty Publications

Purpose: Millions of individuals in sub-Saharan Africa are needlessly blind from cataracts. While progress was made towards the Vision 2020: The Right to Sight goals, Ethiopia, Ghana, and Zambia fell short of the recommended cataract surgical rate (CSR) on a national level. The purposes of this study were to describe possible economic factors impacting surgeon surgical productivity, possible barriers to attaining the recommended CSR, and surgical services in each of these countries.

Methods: An online survey was sent to ophthalmologists practising in Ethiopia, Ghana, and Zambia. Responses were collected between June 25, 2021 and January 30, 2022.

Results …

Intensive Care Unit Mortality And Length Of Stay Among Critically Ill Patients With Sepsis Treated With Corticosteroids: A Retrospective Cohort Study, Eric E. Chinaeke, Ismaeel Yunusa Ph.D., Bryan L. Love Pharm. D., Joseph Magagnoli, Claiborne E. Reeder

Faculty Publications

Objectives: Sepsis is a major cause of morbidity and mortality in critically ill patients worldwide, and corticosteroids are commonly used to treat it. However, the evidence supporting the use of corticosteroids in sepsis patients admitted to the intensive care unit (ICU) is of low certainty, with conflicting results reported in previous studies. Thus, we aimed to investigate the potential association between corticosteroid treatment and various outcomes, including 30-day ICU mortality, ICU length of stay (LOS), mechanical ventilation use, new onset of infection, and hyperglycemia in patients diagnosed with sepsis and admitted to the ICU.

Materials and Methods: We conducted …

The Polypharmacological Effects Of Cannabidiol, Jorge Castillo-Arellano, Ana Canseco-Alba, Stephen J. Cutler Ph.D., Francisco León Ph.D.

Faculty Publications

Cannabidiol (CBD) is a major phytocannabinoid present in Cannabis sativa (Linneo, 1753). This naturally occurring secondary metabolite does not induce intoxication or exhibit the characteristic profile of drugs of abuse from cannabis like Δ⁹-tetrahydrocannabinol (∆⁹-THC) does. In contrast to ∆⁹-THC, our knowledge of the neuro-molecular mechanisms of CBD is limited, and its pharmacology, which appears to be complex, has not yet been fully elucidated. The study of the pharmacological effects of CBD has grown exponentially in recent years, making it necessary to generate frequently updated reports on this important metabolite. In this article, a …