Medicine and Health Sciences Commons^™

Emergency Medical Services Transport Delays For Suspected Stroke And Myocardial Infarction Patients, Ashley Pedigo Golden, Agricola Odoi

Agricola Odoi

Background: Prehospital delays in receiving emergency care for suspected stroke and myocardial infarction (MI) patients have significant impacts on health outcomes. Use of Emergency Medical Services (EMS) has been shown to reduce these delays. However, disparities in EMS transport delays are thought to exist. Therefore the objective of this study was to investigate and identify disparities in EMS transport times for suspected stroke and MI patients. Methods: Over 3,900 records of suspected stroke and MI patients, reported during 2006–2009, were obtained from two EMS agencies (EMS 1 & EMS 2) in Tennessee. Summary statistics of transport time intervals were computed. …

Vaccine Introduction In The Democratic People's Republic Of Korea., F Marks, B Nyambat, Zy Xu, V Von Kalckreuth, Paul E. Kilgore, Hj Seo, Y Du, Se Park, J Im, F Konings, Cg Meyer, Tf Wierzba

Paul E. Kilgore

The feasibility of mass vaccination campaigns for Japanese encephalitis and Haemophilus influenzae type b infections was explored in the Democratic People's Republic of Korea using pilot vaccination studies. The experiences from these initial studies were then used to support larger vaccination campaigns in children at risk of these infections. We discuss the challenges and requirements for the inclusion of additional vaccines into the existing expanded program on immunization in the country.

Bystander Performance Using Automated External Defibrillators During Simulated Cardiac Arrest, Richard N. Bradley, Lynda M. Schoenstein, Wesley H. Hamilton, Mark R. Boyle

Richard N Bradley

Objective: Automated external defibrillators (AEDs) are becoming widely available to the public. This study examined the hypothesis that less than 75% of the general population can defibrillate using an AED in less than three minutes.

Methods: This was a survey of the behavior of individuals over age 12 in a major airport on Jan. 2–3, 2003. After obtaining consent, an investigator told the subject that he/she was walking down the concourse and saw a person collapse. The subject demonstrated his/her response, using only a telephone and an AED simulating ventricular fibrillation. Data were analyzed using a one-sample test of proportions. …

American Red Cross Sac Advisory On Obstructed Airway-Adults, Richard N. Bradley, Stamatios Lerakis

Richard N Bradley

INTRODUCTION: There were 4,700 deaths due to choking in the United States in 2012. This study was a structured literature review with the objective of determining whether in adults, either conscious or unconscious, with acute foreign body airway obstructions, if any specific resuscitation technique, compared to other techniques, leads to different outcomes.

METHODS: We developed an a priori search definition, and searched PubMed, Google, and OneSearch@IU. We sought additional articles by reviewing the reference lists of articles that we included. We included articles if they addressed original research of treatment of foreign body airway obstruction in adults. We excluded articles …

American Red Cross Scientific Review On Obstructed Airway-Adults, Richard N. Bradley, Stamatios Lerakis

Richard N Bradley

INTRODUCTION: There were 4,700 deaths due to choking in the United States in 2012. This study was a structured literature review with the objective of determining whether in adults, either conscious or unconscious, with acute foreign body airway obstructions, if any specific resuscitation technique, compared to other techniques, leads to different outcomes.

METHODS: We developed an a priori search definition, and searched PubMed, Google, and OneSearch@IU. We sought additional articles by reviewing the reference lists of articles that we included. We included articles if they addressed original research of treatment of foreign body airway obstruction in adults. We excluded articles …

Resistant Hypertension: Risk Factors, Subclinical Atherosclerosis, And Comorbidities Among Adults—The Brazilian Longitudinal Study Of Adult Health (Elsa-Brasil), Paulo A. Lotufo

Paulo A Lotufo

The frequency of resistant hypertension—defined as blood

pressure (BP) ≥140/90 mm Hg with proven use of three

antihypertensive medications, or as the use of four antihypertensive drug classes regardless of BP—is unknown in low-middle–income countries. Using data from the Brazilian Longitudinal Study of Adult Health, a cohort of 15,105 civil servants aged 35 to 74 years, the authors identified 4116 patients taking treatment for hypertension, 11% of who had resistant hypertension. These participants were more likely to be older, black, less educated, poorer, and obese. The adjusted prevalence ratios (95% confidence intervals) were diabetes, 1.44 (1.20–1.72); glomerular filtration rate ( …

Community Health Worker Interventions For Latinos With Type 2 Diabetes: A Systematic Review Of Randomized Controlled Trials, Tariana V. Little, Monica L. Wang, Eida M. Castro, Julio Jiménez, Milagros C. Rosal

Tariana V. Little

This systematic review aimed to synthesize glucose (HbA1c) outcomes of community health worker (CHW)-delivered interventions for Latinos with type 2 diabetes that were tested in randomized controlled trials and to summarize characteristics of the targeted populations and interventions, including the background, training, and supervision of the CHWs. Searches of PubMed and Google Scholar databases and references from selected articles identified 12 studies that met the inclusion criteria. Of these, seven reported statistically significant improvements in HbA1c. Study participants were largely low-income, female, and Spanish-speaking and had uncontrolled diabetes. The CHWs led the interventions alone, in pairs, or as part of …

Fuzzy Mathematical Models For The Analysis Of Fuzzy Systems With Application To Liver Disorders, R.W. W. Hndoosh

R. W. Hndoosh

The main objective of this model is to focus on how to use the model of fuzzy system to solve fuzzy mathematics problems. Some mathematical models based on fuzzy set theory, fuzzy systems and neural network techniques seem very well suited for typical technical problems. We have proposed an extension model of a fuzzy system to N-dimension, using Mamdani's minimum implication, the minimum inference system, and the singleton fuzzifier with the center average defuzzifier. Here construct two different models namely a fuzzy inference system and an adaptive fuzzy system using neural network. We have extended the theorem for accuracy of …

Fuzzy Mathematical Model For Detection Of Lung Cancer Using A Multi-Nfclass With Confusion Fuzzy Matrix For Accuracy, R.W. W. Hndoosh

R. W. Hndoosh

and detection of lung cancer data. This model depends on a generic model of a fuzzy perceptron, which can be used to derive a neural fuzzy system for specific domains. The multi neuron-fuzzy classification (Multi-NFClass) model proposed that uses input, hidden layers, output, and subclasses that have a multitude in each class. This model derives fuzzy rules to classify patterns into a number of crisp classes. Firstly, an attempt is made to describe fuzzy if–then rules, and construction of the fuzzy if–then rule, that are determined by the simple steps when its antecedent fuzzy sets are specified by genetic operations, …

The Scientific Foundations Of The American Red Cross Cpr Training Standards, Richard N. Bradley

Richard N Bradley

The CPR (cardiopulmonary resuscitation) training and certification standards established by the ARC (American Red Cross) are based on a scientific review of the best available published literature. Minimal difference are present between the ARC and other national training organizations. These differences result from differing organizational opinions on the best way to implement standards from limited scientific evidence.

Sphincter-Sparing Surgery For Adenocarcinoma Of The Distal 3 Cm Of The True Rectum: Results After Neoadjuvant Therapy And Minimally Invasive Radical Surgery Or Local Excision, Dr. John Marks, Dr, George Nassif, Dr. Henry Schoonyoung, Dr. Al Denittis, Dr. Eric Zeger, Dr. Mohammed Mohiuddin, Dr. Gerald Marks

Dr. John Marks

Background Ideal treatment of rectal cancer includes controlling the cancer; minimizing trauma, morbidity, and mortality; and avoiding a colostomy with preservation of adequate function. These goals become more challenging the further distal in the rectum the cancer is located. We sought to determine whether minimally invasive sphincter-preservation surgery (SPS) can accomplish good cancer control, maintaining sphincter function with minimal morbidity and mortality in rectal cancers of the distal 3 cm after receiving neoadjuvant chemoradiotherapy.

Methods We retrospectively reviewed a prospectively maintained rectal cancer database of a single colorectal surgeon to identify all patients with cancers of the distal 3 cm …

How To Reduce Obesity, Hirdyesh Kumar Singh

Hirdyesh Kumar Singh

Obesity is a medical condition in which excess body fats has accumulated to the extent that it may have an adverse effect on health, leading to reduced life expectancy and also increased other health problems, viz. heart disease, type 2 diabetes, obstructive sleep apnea, certain types of cancer, and osteoarthritis Obesity increases the risk of many physical and mental conditions. These co morbidity are most commonly shown in metabolic syndrome, a combination of medical disorders which includes: DM diabetes mellitus type 2, High BP high blood pressure, high blood cholesterol, and high triglyceride levels. People is consider as Obese when …

Could You Repeat That Please? Forty-Five Years Of Testing Pesticides On People, Barbara R. Leiterman Esq.

Barbara R. Leiterman Esq.

Little has been published in the literature about pesticide experiments conducted on human subjects. Yet there were at least twenty-two tests between 1967 and 2011 in which people were intentionally exposed to specific doses of pesticides. Almost all of these experiments violated scientific ethics and human rights. This article aims to describe those tests and their shortcomings, and explore the laws and regulations that incentivize such human experimentation. Ironically, as the public desire for pesticide safety increases, so does the industry’s motivation to test pesticides on people. Bringing these pesticide experiments to light, expanding the public discourse on the subject …

Bone Morphogenetic Protein 4 Inhibition Of Tgfβ-2 Induced Cross-Linked Actin Networks In Human Trabecular Meshwork Cells, Rafael A. Lima, Michela Montecchi-Palmer, Jaclyn Bermudez, Abbot F. Clark Phd, Robert J. Wordinger Phd

ral5@rice.edu

Bone Morphogenetic Protein 4 Inhibition of TGFβ-2 Induced Cross-Linked Actin Networks (CLANs) in Human Trabecular Meshwork Cells

RAFAEL A. LIMA1, MICHELA MONTECCHI-PALMER2,3, JACLYN BERMUDEZ2 ABBOT F. CLARK2, AND ROBERT J. WORDINGER2

1 Rice University, Houston, Texas, 2 Department of Cell Biology and Anatomy, North Texas Eye Research Institute, University of North Texas Health Science Center, Fort Worth, Texas, 3 Alcon Research, Ltd., Fort Worth, Texas

Background:

Primary open-angle glaucoma (POAG) is a degenerative eye disease characterized by irreversible loss of retinal ganglion cells. One of the most significant risk factors for POAG is increased intraocular pressure (IOP). Elevated IOP is …

Investigating Effects Of Between- And Within- Host Variability On Escherichia Coli O157 Shedding Pattern And Transmission, Shi Chen, Mike Sanderson, Cristina Lanzas

Cristina Lanzas

Healthy cattle and their environment are the reservoir for the human pathogen Escherichia coli O157. In E. coli O157 epidemiology, supershedders have been loosely defined as cattle that shed high concentrations of E. coli O157 (≥104 colony-forming cells (CFU)/g of feces) at a single (or multiple) cross-section in time. Due to the variability in the pathogen shedding level among animals (between-host variability), as well as fluctuations in the level shed by a single animal (within-host variability), it is difficult to interpret fecal bacteria distributions, as well as to parse the relative contribution of between- and within-host variability to the observed …

Concussion 101: Knowing The Basics To Protect Your Athletes, Theresa Miyashita

Theresa Miyashita

Sport-related concussions have recently been at the forefront of mainstream media, where the attention is now turning to the safety of our young athletes. With the recent rise of concussion lawsuits, coaches need to know concussion basics to protect their athletes and themselves. What we know about concussions has evolved, and it is critical that coaches understand these changes and how they impact the management of their teams’ injuries. In the absence of medical personnel, coaches are responsible for removing athletes from play if they have potentially sustained a concussion. Coaches must therefore understand the different mechanisms of injury, signs …

An Assessment Of The Effects Of Desertification In Yobe State, Nigeria, Jibril Musa Phd

Confluence Journal Environmental Studies (CJES), Kogi State University, Nigeria

Desertification is one of the most serious environmental and socio-economic problems of our time. Desertification describes circumstances of land degradation in arid, semi-arid and dry sub-humid regions resulting from the climatic variation and human activities. The fundamental goal of this thesis was to assess the effects of desertification in Yobe State, Nigeria. The present threat of desertification in the sahel has reached an alarming stage where crops cultivation and animal rearing/grazing are no more productive, soil has lost its nutrient/fertility, various infrastructure had given way because of windstorm from the neighbouring Niger Republic and sand dunes had taken over. The …

Using Remote Sensing Data To Improve Rice Production In Kutigi, Niger State, Nigeria, Jibril Musa Phd, M B. Yunusa

Confluence Journal Environmental Studies (CJES), Kogi State University, Nigeria

This research work looked in the used of Remote Sensing to improve Agricultural production in Kutigi, Niger State. The aim of the study is to use remote sensing to improve rice farming activities in Kutigi, Niger State. It is very important to identify such methods to improve Agricultural production because experts are always interested in new researches and findings to better the standard of living in any environment. In view of this, Remotely-sensed data could be used or employed to elevate most of these agricultural problems in Kutigi through the following objectives: Using Landsat imagery to assess the present landuse …

Cardiopulmonary Resuscitation With Rescue Breathing Is Superior To Hands-Only Cardiopulmonary Resuscitation For Children And Infants: Results Of A Systematic Review, Joseph W. Rossano, Richard N. Bradley

Richard N Bradley

Introduction

Evidence supports teaching hands-only CPR for the initial treatment of cardiac arrest in adults. Unlike adults, however, children and infants with cardiac arrest are more likely to have non-cardiac causes.

Hypothesis: The objective of this project was to conduct a structured literature review to answer the question, “In children and infants with cardiac arrest treated in an out-of-hospital setting, does compression-only CPR, alone or with supplemental oxygen, compared to CPR with rescue breathing lead to improved outcomes?”

Results

Sixty-nine records were identified and screened. Fifty-four of these did not meet inclusion/exclusion criteria, leaving fifteen full-text articles that we assessed …

Existing Research Is Inadequate For The Development Of Guidelines For The Basic Lifesupport Management Of Airway Obstruction In Adults: Results Of A Systematic Review, Richard N. Bradley, Joseph W. Rossano, Siobán Kennedy

Richard N Bradley

Introduction

There has been considerable controversy and several changes in guidelines for the basic life support (BLS) management of choking since the introduction of the Heimlich procedure in 1974.

Hypothesis: The objective of this project was to conduct a structured literature review to answer the question, “For adults, either conscious or unconscious, with obstructed airway, does any specific resuscitation techniques compared to currently recommended techniques, lead to different outcomes?”

Results

We identified 475 records after duplicates were removed; we screened all of these and excluded 454. This left 22 full-text articles which we assessed for eligibility; we excluded 19 of …

Variations In Climatic Parameters And Food Crop Yields: Implications On Food Security In Benue State, Nigeria., Emmanuel Adamgbe, Fanan Ujoh

Confluence Journal Environmental Studies (CJES), Kogi State University, Nigeria

Agricultural production in Nigeria like in other developing countries is highly vulnerable to variations in climatic parameters which may have inverse or direct effect on the performance of food crops. This paper examines the patterns and trends of the variations in the climatic parameters and the implications of such variations on efficient yield rates of some food crops in Benue State using data on climatic variables (rainfall, temperature, sunshine) and the yield of some crops per hectare for 25 years (1986-2010). Data on the climatic variables were collected from the Nigerian Meteorological Agency, AirForce Base, Makurdi while the data on …

Bugs In The News: Arbovirus And Hantavirus, Richard N. Bradley

Richard N Bradley

The objectives of this presentation are:

(1) Recognize zoonotic infections of public health importance that are currently in the news

(2) Understand the clinical presentations of arbovirus and hantavirus

(3) Describe actions a physician should take when suspecting one of these infections

Arc Sac Advisory Pulse Check For Cardiac Arrest, Sarah Clarke, Richard N. Bradley, Siobán Kennedy

Richard N Bradley

One good quality study (LOE 4) supports omitting a pulse check after defibrillation for patients in cardiac arrest.

One fair quality study (LOE 4) opposes the performance of simultaneous as opposed to sequential pulse and breathing check to determine cardiac arrest.

There is insufficient evidence to support a recommendation on the preferred method for the initial determination of cardiac arrest.

CPR courses should specifically teach the recognition of agonal breathing and the understanding that agonal breathing is not normal breathing and that it indicates the need for CPR.

Dynamics Of Land Use/Land Cover Changes And Its Implication On Food Security In Anyigba, North Central, Nigeria, Tokula E. Arome, Sunday P. Ejaro (Phd)

Confluence Journal Environmental Studies (CJES), Kogi State University, Nigeria

This study assessed land use/land cover changes and its effect on Agricultural land in Anyigba. The objectives were to identify and delineate different land use / land cover categories, assess the rate of change that occurred and examine the impact of land use/land cover change on food security using satellite remote sensing data collected at three different years (1987 Land sat TM, 2001 Land Sat TM and 2011 Land Sat ETM). The study utilized GIS software such as Idrisi Andes academic and ArcGIS 9.3. The study area covers approximately 31.8km2, and four major land use/cover classes were utilized (built up, …

Medical Direction Of Wilderness And Other Operational Emergency Medical Services Programs, Craig R. Warden, Michael G. Millin, Seth C. Hawkins, Richard N. Bradley

Richard N Bradley

Within a healthcare system, operational emergency medical services (EMS) programs provide prehospital emergency care to patients in austere and resource-limited settings. Some of these programs are additionally considered to be wilderness EMS programs, a specialized type of operational EMS program, as they primarily function in a wilderness setting (eg, wilderness search and rescue, ski patrols, water rescue, beach patrols, and cave rescue). Other operational EMS programs include urban search and rescue, air medical support, and tactical law enforcement response. The medical director will help to ensure that the care provided follows protocols that are in accordance with local and state …

Brazilian Longitudinal Study Of Adult Health (Elsa-Brasil): Objectives And Design., Paulo A. Lotufo

Paulo A Lotufo

The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) aims to contribute relevant information with respect to the development and progression of clinical and subclinical chronic diseases, particularly cardiovascular diseases and diabetes. In this report, the authors delineate the study's objectives, principal methodological features, and timeline. At baseline, ELSA-Brasil enrolled 15,105 civil servants from 5 universities and 1 research institute. The baseline examination (2008-2010) included detailed interviews, clinical and anthropometric examinations, an oral glucose tolerance test, overnight urine collection, a 12-lead resting electrocardiogram, measurement of carotid intima-media thickness, echocardiography, measurement of pulse wave velocity, hepatic ultrasonography, retinal fundus photography, and an …

Socio-Economic Effects Of Demolishing Squatter Settlements And Illegal Structures In Abuja Metropolis, Federal Capital Territory, Nigeria, Ishaku Iy Mallo Phd, Victor G. Obasanya

Confluence Journal Environmental Studies (CJES), Kogi State University, Nigeria

Abuja the Federal Capital Territory and study area is located between latitudes 8o25’ and 9o25’ North of the Equator and longitudes 6o45’ and 7o45’ East of the Greenwich Meridian. The study was carried out in Abuja Phase 1, and it is aimed at highlighting various socioeconomic effects of demolition of illegal structures and informal or squatter settlements on the people within the study area. Data was collected through reconnaissance survey, personal interviews with respondents, and a well laid out questionnaire. The results indicate that the demolition exercise embarked upon by the authorities in the Federal Capital Territory was a response …

Rainfall Variability And Crop Zones Classification For The Federal Capital Territory, Nigeria, Shaibu M. Hassan Phd

Confluence Journal Environmental Studies (CJES), Kogi State University, Nigeria

This study aims at analyzing agro-climatological parameters and establishing a link between some selected agro-climatological indices and sustainability of agricultural production in the Federal Capital Territory (FCT). Two sets of data, climatic and crop yield data were collected and subjected to various agro-climatological analyses. Agro-climatological analyses include the derivation of Onset, Cessation and Length of Rainy Season (LRS), Seasonality Index, Drought Index and Precipitation Periodicity Index. The statistical analyses include monthly and annual means, deviation from the mean, trend line. The result of moisture index in line with crops optimum moisture requirement was used to classify the Territory into agro-climatic …

The Effect Of Load On Movement Coordination During Sled Towing, Michael Lawrence, Daniel Leib, Cara Masterson, Erin Hartigan

Daniel Leib

INTRODUCTION Towing sleds while walking is a popular resistance exercise for the healthy athlete. One reason for the popularity of sled towing is that it is widely believed to be a ‘functional’ exercise. Preliminary research suggests towing while walking can increases lower extremity moment impulses; however whether towing a sled utilizes the same coordination patterns as un-resisted walking is unknown. While altered patterns may not be as relevant to a healthy athlete, sled towing is also sometimes used in the rehabilitation of athletes who sustained a lower extremity injury (anterior cruciate ligament rupture) with the goal of regaining movement symmetry. …

Effects Of Fatigue On Golf Performance, Daniel J. Leib, Nicholas R. Higdon, W. Holmes Finch, Eric L. Dugan

Daniel Leib

No abstract provided.