Medicine and Health Sciences Commons^™

Post-Traumatic Hallux Valgus: A Modified Surgical Technique, Zylyftar Gorica, Kimberly Mcfarland, John S. Lewis Jr, Karl M. Schweitzer Jr, Alexander R. Vap

Orthopaedic Surgery Publications

Post-traumatic hallux valgus, a turf toe variant, is a rare, yet limiting injury. According to the literature, the deformity has been associated with acute medial collateral ligament tears, turf toe variant injuries, Lisfranc injury patterns, and first metatarsal fractures. There have been few documented cases of post-traumatic hallux valgus secondary to medial collateral ligament tears, and the treatment has been variable. Some authors have described direct end-to-end repair of the ligament to address the deformity, while others have described a modified McBride bunionectomy involving a Silver bunionectomy, lateral soft tissue release, and medial capsular and ligamentous repair. We propose a …

On Wisdom, Gerontology, And Personal Aging: Through A Looking Glass, Edward F. Ansello

Director's Editorials from Age in Action

Personal discussion on the perspective of aging and teaching more interiority and self-reflection in the field of gerontology.

Leading From The Middle, Edward F. Ansello

Director's Editorials from Age in Action

A reminiscent farewell to colleagues and the Virginia Center on Aging (VCoA) as Edward F. Ansello, Ph.D., retires as Director of VCoA.

Actively Engaging With Virginia Center On Aging’S Retired Community, Leland "Bert" Waters

Director's Editorials from Age in Action

VCU is the receiver of an Age-Friendly University (AFU) Global Network designation in June 2021. The Virginia Geriatric Education Center (VGEC) maintains a diverse team, including those who make "mid/late-career" changes into the Gerontology field. Bert Waters gives examples and history on some who make up this diverse team.

Metabolic Syndrome And How To Fight It, Edward F. Ansello

Director's Editorials from Age in Action

The health condition Metabolic Syndrome is becoming increasingly prevalent. To combat this, dietary improvements and incorporating movement into our daily routines are the basics suggested.

Strengthening Capacities To Respond To Dementia With Lifelong Disabilities: Using The Project Echo Model, Edward F. Ansello

Case Studies from Age in Action

Educational Objectives

1. To discuss the need for interprofessional training about aging with lifelong disabilities and dementia.

2. To demonstrate the continuing heterogeneity among adults growing older with these conditions.

3. To report the relevance of the Project ECHO model as a means of collaborative training and practice improvement.

Lucy Corr Dental Clinic: Addressing Dental Needs Of Uninsured Older Adults, Patricia B. Bonwell

Case Studies from Age in Action

Educational Objectives

1. Discuss the critical importance of oral health and the oral-systemic relationship in older adults.

2. Describe how dental insurance determines receipt of dental treatment in older adults.

3. Share how the Lucy Corr Dental Clinic (LCDC) increases access to dental care for uninsured older adults.

4. Describe valuable collaborations with community foundations, the Virginia Dental Association, and Virginia Commonwealth University that enable the success of the LCDC.

The Vcu Nursing Home Echo, A Member Of The National Covid-19 Action Network, Bert Water, Kimberly Ivey, Annie Rhodes, Christian Bergman, Daniel Bluestein, Jenni Mathews, Laura Finch, Shannon Arnette, Joanne Coleman, Maddie Mcintyre, Tara Rouse

Case Studies from Age in Action

Educational Objectives

1. To demonstrate the tremendous impact of COVID-19 on long-term care facilities.

2. To discuss the need for continuous, current, interprofessional education of both administrative and clinical staff within long-term care facilities.

3. To discuss the value of building interconnective and interprofessional relationships between both academic health science centers and nursing homes.

Improving Guardianship Practices Through Collaborative Stakeholder Action, Erica Wood, Shasta Douglass

Case Studies from Age in Action

Educational Objectives

1. Describe the purpose of adult guardianship and its effect on fundamental rights.

2. Explain the need for guardianship reform, the obstacles to reform, and what issues need attention in Virginia.

3. Discuss the purpose of state Working Interdisciplinary Networks of Guardianship Stakeholders (WINGS) and the creation and accomplishments of Virginia WINGS.

4. Review cases in which a WINGS pilot project supported the needs and rights of adults with guardians.

Evaluating Racial And Ethnic Disparities In Access To Primary Care Among Gay And Bisexual Men In The Us, A Population At High-Risk Of Hiv Infection, Jessica S. Kiernan, April D. Kimmel

Graduate Research Posters

BACKGROUND: 69% of new HIV diagnoses in the US are among gay and bisexual men, with disparities by race and ethnicity. Primary care providers increasingly provide HIV prevention. Racial and ethnic disparities in primary care access are well-documented, but their persistence among gay and bisexual men is unknown. We examined racial and ethnic disparities in access to primary care among this population.

METHODS: We used nationally representative person-level sociodemographic, health status and utilization data, and data on organizational- and socially determinant barriers to care, from the National Health Interview Survey, 2013-2018. Outcomes were: 1) general physician visit

RESULTS: The sample …

Carotid Artery Dissections From Tcar As Reported By The Food And Drug Administration, Dongjin Suh Bs, Yuchi Ma Bs, Daniel H. Newton Md, Michael F. Amendola Md, Kedar S. Lavingia Md

Graduate Research Posters

BACKGROUND: Transcarotid artery revascularization (TCAR) is hybrid procedure that allows carotid stenting using direct surgical access of the carotid artery to restore blood flow through the carotid artery. It has shown the lowest perioperative stroke rate when compared with any prospective trial of transfemoral carotid artery stenting. However, intraoperative injuries related to the procedure and its management are not well characterized. We anticipate that this analysis will add qualitative insight in further characterizing adverse outcomes of this novel technology.

METHODS: The FDA maintains a database called the MAUDE (Manufacturer and User Facility Device Experience) for surveillance of all medical devices …

Modeling Longitudinal Change In Cervical Length Across Pregnancy, Hope M. Wolf, Shawn J. Latendresse, Jerome F. Strauss Iii, Timothy P. York

Graduate Research Posters

Introduction: A short cervix (cervical length < 25 mm) in the mid-trimester (18 to 24 weeks) of pregnancy is a powerful predictor of spontaneous preterm delivery (gestational age at delivery < 37 weeks). Although the biological mechanisms of cervical remodeling have been the subject of extensive investigation, very little is known about the rate of change in cervical length over the course of a pregnancy, or the extent to which rapid cervical shortening increases maternal risk for spontaneous preterm delivery.

Methods: A cohort of 5,160 unique women carrying 5,971 singleton pregnancies provided two or more measurements of cervical length during pregnancy. Cervical length was measured in millimeters using a transvaginal 12-3 MHz ultrasound endocavity probe (SuperSonic Imagine). Maternal characteristics, including relevant medical history and birth outcome data, were collected for each participant. Gestational age at delivery was measured from the first day of each woman’s last menstrual period and confirmed by ultrasound. Repeated measurements of cervical length during pregnancy were modeled as a longitudinal, multilevel growth curve in MPlus. A three-level variance structure was …

Device-Related Adverse Events From Watchman Flx Implants As Reported By The Food And Drug Administration, Dongjin Suh Bs, Paul Eugene Kim Bs, Emmanuel Magsino Bs, Tae Shik Park

Graduate Research Posters

No abstract provided.

Influence Of Telephone Preoperative Evaluations On Patient Medication Compliance On Day Of Surgery, Emmanuel Magsino, Michael Jung, Olga Suarez Md

Graduate Research Posters

Patient compliance with medication instructions on day of surgery (DOS) is an important part of the preoperative assessment, as failure to comply with these may lead to serious perioperative consequences. Prior studies have shown that compliance increases with multimodal interventions. However due to the recent COVID-19 pandemic, many in-person visits transitioned to telephone visits and providers had to rely on patients to follow solely verbal instructions.

To determine medication compliance, this study compared the medication instructions provided by the VCU Preoperative Assessment Communication and Education Clinic, per chart review, with each patient’s own report of which medications they took on …

Epigenetic Histone Acetylation And Bdnf Dysregulation In The Hippocampus Of Rats Exposed To Repeated, Low-Dose Diisopropylfluorophosphate, Laxmikant Deshpande

Neurology Publications

Aims: Deployment-related exposures to organophosphate (OP) compounds are implicated for Gulf War Illness (GWI) development in First GW veterans. However, reasons for the persistence of GWI are not fully understood. Epigenetic modifications to chromatin are regulatory mechanisms that can adaptively or maladaptively respond to external stimuli. These include DNA methylation and histone acetylation. DNA methylation changes have been reported in GWI but the role of histone acetylation in GWI has been less explored, despite its importance as an epigenetic mechanism for neurological disorders.

Main methods: Male Sprague-Dawley rats were exposed to OP diisopropyl fluorophosphate (DFP, 0.5 mg/kg s.c., 5-d) and …

Sleep-Related Problems, Sleep-Related Distress, And Sleep-Related Functional Status Among Adult Inpatients Receiving Palliative Care, Lisa C. Sievers

Theses and Dissertations

Palliative care patients may be at a higher risk for sleep-related problems and their negative effects compared to the general population, yet limited sleep research has been done with this population. The purpose of this dissertation was to determine prevalence rates for excessive sleepiness, insomnia, restless legs syndrome (RLS), and high risk for sleep apnea (HRSA); examine relationships between the aforementioned sleep-related problems, sleep-related distress (SD), and sleep-related functional status (SFS); and to determine which sleep-related problem measures along with age and gender predicted SD and SFS among a sample of adult palliative care inpatients. Secondary aims were to understand …

A Deep Learning U-Net For Detecting And Segmenting Liver Tumors, Vidhya Cardozo

Theses and Dissertations

Visualization of liver tumors on simulation CT scans is challenging even with contrast-enhancement, due to the sensitivity of the contrast enhancement to the timing of the CT acquisition. Image registration to magnetic resonance imaging (MRI) can be helpful for delineation, but differences in patient position, liver shape and volume, and the lack of anatomical landmarks between the two image sets makes the task difficult. This study develops a U-Net based neural network for automated liver and tumor segmentation for purposes of radiotherapy treatment planning. Non-contrast simulation based abdominal CT axial scans of 52 patients with primary liver tumors were utilized. …

Evaluating The Clinical Utility Of A Novel Electroencephalography System For Assessing Perioperative Neurocognition In Older Surgical Patients, Lloyd H. Barnwell Iii

Theses and Dissertations

Postoperative delirium (POD) is a public health and research priority (American Society of Anesthesiologists, 2019). POD is a risk factor for long-term neurocognitive decline, and the rate of decline is directly proportional to the severity of POD (Vasunilashorn et al., 2018). Baseline cognitive function is a strong, independent predictor for POD (Culley et al., 2017). The International Perioperative Neurotoxicity Working Group recommends baseline cognitive function be assessed for older patients prior to surgery and anesthesia (Berger, et al., 2018). Perioperative cognitive screening tools trialed in anesthesia are not routinely incorporated into clinical practice related to validity, reliability, or practicality problems …

The Effects Of Interleukin-1Β On Cardiac Reserve And Exercise Capacity In The Mouse, Habeebah Z. Vohra

Theses and Dissertations

Heart failure (HF) is characterized by dyspnea, fatigue, and exercise intolerance. Clinical evidence points to increased interleukin-1β (IL-1β) activity in patients with HF, with an IL-1 blockade improving the exercise capacity in HF patients. In healthy mice, recombinant-mouse IL-1β (rmIL-1β) induces acute systolic dysfunction, peaking 4 hours after administration. However, the direct effects of rmIL-1β on exercise capacity are unknown. We hypothesized that rmIL-1β diminishes the exercise capacity in the mouse. Adult mice were trained to run on a treadmill and exercise capacity was assessed before, 4 hours, and 96 hours after intraperitoneal administration of rmIL-1β (3 μg/kg) or vehicle …

Nebulizer-Based Systems To Improve Pharmaceutical Aerosol Delivery To The Lungs, Benjamin M. Spence

Theses and Dissertations

Combining vibrating mesh nebulizers with additional new technologies leads to substantial improvements in pharmaceutical aerosol delivery to the lungs across therapeutic administration methods. In this dissertation, streamlined components, aerosol administration synchronization, and/or Excipient Enhanced Growth (EEG) technologies were utilized to develop and test several novel devices and aerosol delivery systems. The first focus of this work was to improve the poor delivery efficiency, e.g., 3.6% of nominal dose (Dugernier et al. 2017), of aerosolized medication administration to adult human subjects concurrent with high flow nasal cannula (HFNC) therapy, a form of continuous-flow non-invasive ventilation (NIV). The developed Low-Volume Mixer-Heater (LVMH) …

Strengthening Mental Health Diagnostic Detection In Integrated Primary Care, Julia Brechbiel

Theses and Dissertations

Primary care behavioral health (PCBH) is crucial for providing mental health treatment to underserved, minority, and uninsured populations. There is a lack of knowledge about accurate mental health diagnoses at PCBH. Underdetection of mental health symptoms has the potential to worsen racial and socioeconomic disparities. Using an expert review process, I developed an abbreviated diagnostic clinical interview (ADCI) for integrated primary care. Next, patients (N = 82) completed the interview after attending PCBH appointments. According to the interview, 63.4% of participants met criteria for a diagnosis, while 64.7% received a diagnosis from their provider. A large portion of patients …

A Multilevel Mixed Methods Examination Of Treatment Nonadherence Among Rural Cancer Survivors, Bonny Morris

Theses and Dissertations

While mortality rates have been decreasing over the last 40 years, cancer remains a leading cause of death in the United States. Over 1.7 million people were diagnosed with cancer in 2019, and there were more than 600,000 cancer deaths. Of the 15 million cancer survivors in the US, nearly 3 million reside in rural areas and experience 3% higher cancer incidence and 10% higher cancer mortality compared to their nonrural counterparts. During 2006-2015, the annual age-adjusted mortality rates for all cancer sites combined decreased at a slower pace in rural areas versus nonrural areas (-1.0% vs -1.6% per year, …

Using The Memorial Sloan Kettering Frailty Index To Identify Patients At High Risk For Postoperative Intensive Care Unit Admission, Specialized Advanced Care Unit Admission, And 30-Day Readmission, Timothy J. Donoghue

Theses and Dissertations

Frailty is roughly defined as an accumulation of physiological, emotional, cognitive, and social deficits that impair a person’s response to stressful events. A frailty diagnosis has been associated with poor outcomes following surgical procedures. Cancer surgical patients aged 65 or older represent a vulnerable population susceptible to being frail and the potential associated complications that can accompany frailty. Measuring frailty is an objective risk assessment that identifies increased risk better than age or American Society of Anesthesiologists Physical Status (ASA-PS) score such that frailty can independently predict poor surgical outcomes.

Frailty is not specifically a result of having cancer, disability, …

How Does Direct Volunteering Affect The Onset Of Alzheimer’S Dementia In Elderly Patients With Preexisting Cardiac Comorbidities?, Sneha R. Gade

Undergraduate Research Posters

Alzheimer's Dementia is a disease that affects memory, thinking, and behavior. The Alzheimer's Association reported Alzheimer's as the sixth-leading cause of death in the United States, and a cure does not exist. Donepezil, a cholinesterase inhibitor drug, is frequently prescribed to treat Alzheimer's disease. Still, patients must continuously take the medication for years to receive any measurable improvement in quality of life after developing Alzheimer's Dementia. Further, research shows prolonged use of Donepezil can lead to other health problems, such as QTc prolongation, for cardiac disease patients. Therefore, the effectiveness of non-drug interventions, such as volunteering to prevent the disease's …