Medicine and Health Sciences Commons^™

Inspire : Vol 6, Issue 9, Department Of Medicine

INSPIRE

• Message from the Chair
• Medicine at National and International Forums Dermatology & the Journey of Education
• Risk Management training
• Nuts and Bolts of Research Administration training research program
• Pitfalls of Harmful Cosmetics and Skincare Trend
• In-depth- featuring Dr Zeba Rasmussen | Visiting Faculty By Zahrah Rahmatullah & Shahnoor Ahmed
• What Academics Are Reading?
• Poem

An Examination Of The Relationships Between The Neighborhood Social Environment, Adiposity, And Cardiometabolic Disease Risk In Adolescence: A Cross-Sectional Study, Kara D. Denstel, Robbie A. Beyl, Denise M. Danos, Maura M. Kepper, Amanda E. Staiano, Katherine T. Theall, Tung Sung Tseng, Stephanie T. Broyles

School of Public Health Faculty Publications

Background: Disadvantaged neighborhood environments are a source of chronic stress which undermines optimal adolescent health. This study investigated relationships between the neighborhood social environment, specifically, chronic stress exposures, adiposity, and cardiometabolic disease risk factors among 288 Louisiana adolescents aged 10 to 16 years. Methods: This cross-sectional study utilized baseline data from the Translational Investigation of Growth and Everyday Routines in Kids (TIGER Kids) study. Adolescent data were obtained using self-reported questionnaires (demographics and perceived neighborhood disorder), anthropometry, body imaging, and a blood draw while objective neighborhood data for the concentrated disadvantage index were acquired from the 2016 American Community Survey …

A Real-World Comparison Of Apixaban And Rivaroxaban In Obese And Morbidly Obese Patients With Nonvalvular Atrial Fibrillation, Kevin T. Burnham, Tianrui Yang, Jessica Wooster

Pharmacy Faculty Publications and Presentations

Background: Contemporary guidelines for managing nonvalvular atrial fibrillation (NVAF) include apixaban and rivaroxaban as first-line anticoagulation treatment options. Minimal guidance is available regarding selecting anticoagulants for patients with class I-III obesity. Objective: This study aims to evaluate the comparative effectiveness and safety of apixaban and rivaroxaban in both obese and morbidly obese patients with NVAF. Methods: A retrospective cohort study was conducted at an outpatient cardiovascular clinic after Institutional Review Board approval. Patients were eligible if they were ≥18 years of age, had a BMI ≥30 kg/m2, and took apixaban or rivaroxaban for NVAF for ≥3 months. The primary endpoint …

What To Expect As Children Transition To Young Adults, Melissa Ponce-Rodas

Lake Union Herald

No abstract provided.

A Shorter Door-In-Door-Out Time Is Associated With Improved Outcome In Large Vessel Occlusion Stroke., Adam Sigal, Derek L Isenberg, Chadd K Kraus, Daniel Ackerman, Joseph Herres, Ethan S Brandler, Alexander Kuc, Jason T Nomura, Derek R Cooney, Michael T Mullen, Huaqing Zhao, Nina T Gentile

Einstein Health Papers

Introduction: Endovascular thrombectomy (EVT) significantly improves outcomes in large vessel occlusion stroke (LVOS). When a patient with a LVOS arrives at a hospital that does not perform EVT, emergent transfer to an endovascular stroke center (ESC) is required. Our objective was to determine the association between door-in-door-out time (DIDO) and 90-day outcomes in patients undergoing EVT. Methods: We conducted an analysis of the Optimizing Prehospital Stroke Systems of Care-Reacting to Changing Paradigms (OPUS-REACH) registry of 2,400 LVOS patients treated at nine ESCs in the United States. We examined the association between DIDO times and 90-day outcomes as measured by the …

Empowering Foot Health: Harnessing The Adaptive Weighted Sub-Gradient Convolutional Neural Network For Diabetic Foot Ulcer Classification, Abdullah Alqahtani, Shtwai Alsubai, Mohamudha Parveen Rahamathulla, Abdu Gumaei, Mohemmed Sha, Yu-Dong Zhang, Muhammad Attique Khan

School of Podiatric Medicine Publications and Presentations

In recent times, DFU (diabetic foot ulcer) has become a universal health problem that affects many diabetes patients severely. DFU requires immediate proper treatment to avert amputation. Clinical examination of DFU is a tedious process and complex in nature. Concurrently, DL (deep learning) methodologies can show prominent outcomes in the classification of DFU because of their efficient learning capacity. Though traditional systems have tried using DL-based models to procure better performance, there is room for enhancement in accuracy. Therefore, the present study uses the AWSg-CNN (Adaptive Weighted Sub-gradient Convolutional Neural Network) method to classify DFU. A DFUC dataset is considered, …

Full Issue, Volume 11, Number 2, Donna J. Peterson Dr.

Journal of Human Sciences and Extension

No abstract provided.

Electric Field Navigated 1-Hz Rtms For Poststroke Motor Recovery: The E-Fit Randomized Controlled Trial, Dylan J. Edwards, Charles Liu, Kari Dunning, Felipe Fregni, Jarmo Laine, Benjamin E. Leiby, Lynn M. Rogers, Richard L. Harvey

Research outputs 2022 to 2026

BACKGROUND: To determine if low-frequency repetitive transcranial magnetic stimulation targeting the primary motor cortex contralateral (M1CL) to the affected corticospinal tract in patients with hemiparetic stroke augments intensive training-related clinical improvement; an extension of the NICHE trial (Navigated Inhibitory rTMS to Contralesional Hemisphere Trial) using an alternative sham coil. METHODS: The present E-FIT trial (Electric Field Navigated 1Hz rTMS for Post-stroke Motor Recovery Trial) included 5 of 12 NICHE trial outpatient US rehabilitation centers. The stimulation protocol remained identical (1 Hz repetitive transcranial magnetic stimulation, M1CL, preceding 60-minute therapy, 18 sessions/6 wks; parallel arm randomized clinical trial). The sham coil …

Antibiotic-Induced Gut Dysbiosis And Cognitive, Emotional, And Behavioral Changes In Rodents: A Systematic Review And Meta-Analysis, Shivdeep S. Hayer, Soonjo Hwang, Jonathan B. Clayton

Food for Health: Publications

There are previous epidemiological studies reporting associations between antibiotic use and psychiatric symptoms. Antibiotic-induced gut dysbiosis and alteration of microbiota-gut-brain axis communication has been proposed to play a role in this association. In this systematic review and meta-analysis, we reviewed published articles that have presented results on changes in cognition, emotion, and behavior in rodents (rats and mice) after antibiotic-induced gut dysbiosis. We searched three databases—PubMed, Web of Science, and SCOPUS to identify such articles using dedicated search strings and extracted data from 48 articles. Increase in anxiety and depression-like behavior was reported in 32.7 and 40.7 percent of the …

Simtutor Module: Antibodies, Heather Gilbert

Teaching, Learning, and Scholarship (TLAS) Academy Projects

Antibody simulation module developed for use in MLS 226: Introduction to Clinical Immunology and Molecular Diagnostics. The module was designed to reinforce lecture material and was developed utilizing SimTutor software.

Learning outcomes:

1. Define antibody.
2. Differentiate between innate and adaptive immunity.
3. Differentiate between cellular and humoral immunity.
4. Describe the four pathways of antibody acquisition.
5. Identify the three functions of an antibody.
6. Identify and describe the structure of an antibody including the following components and regions: light chain, heavy chain, constant region, variable region, Fc Fragment, Fab Fragment, and hinge region.
7. List the antibody classes and their key features.
8. Differentiate between the …

Maximizing Wound Coverage In Full-Thickness Skin Defects: A Randomized-Controlled Trial Of Autologous Skin Cell Suspension And Widely Meshed Autograft Versus Standard Autografting, Sharon Henry, Steven Mapula, Mark Grevious, Kevin N. Foster, Herbert Phelan, Jeffrey Shupp, Rodney Chan, David Harrington, Neil Mashruwala, David A. Brown, Haaris Mir, George Singer, Alfredo Cordova, Lisa Rae, Theresa Chin, Lourdes Castanon, Derek Bell, William Hughes, Joseph A. Molnar

Department of Surgery Faculty Papers

BACKGROUND: Traumatic insults, infection, and surgical procedures can leave skin defects that are not amenable to primary closure. Split-thickness skin grafting (STSG) is frequently used to achieve closure of these wounds. Although effective, STSG can be associated with donor site morbidity, compounding the burden of illness in patients undergoing soft tissue reconstruction procedures. With an expansion ratio of 1:80, autologous skin cell suspension (ASCS) has been demonstrated to significantly decrease donor skin requirements compared with traditional STSG in burn injuries. We hypothesized that the clinical performance of ASCS would be similar for soft tissue reconstruction of nonburn wounds.

METHODS: A …

The Two-Step Approach To Allogeneic Hematopoietic Stem Cell Transplantation, Sikemi Ibikunle, Dolores Grosso, Usama Gergis

Department of Medical Oncology Faculty Papers

Allogeneic hematopoietic stem cell transplantation (HSCT) provides the only potentially curative option for multiple hematological conditions. However, allogeneic HSCT outcomes rely on an optimal balance of effective immune recovery, minimal graft-versus-host disease (GVHD), and lasting control of disease. The quest to attain this balance has proven challenging over the past few decades. The two-step approach to HSCT was conceptualized and pioneered at Thomas Jefferson University in 2005 and remains the main platform for allografting at our institution. Following administration of the transplant conditioning regimen, patients receive a fixed dose of donor CD3+ cells (HSCT step one-DLI) as the lymphoid portion …

Barriers And Facilitators Of Family Rules And Routines During Pediatric Cancer Treatment., Carolyn R. Bates, Isabella K. Pallotto, Rachel Moore, Lynne Covitz, Meredith Dreyer

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: Pediatric nurses work closely with families of children with new cancer diagnoses and can provide essential supports to promote coping and adjustment. This cross-sectional qualitative study aimed to gather caregiver perspectives on barriers and facilitators to adaptive family functioning during the early phases of cancer treatment, with a focus on family rules and routines.

METHODS: Caregivers (N = 44) of a child diagnosed with cancer and receiving active treatment completed a semi-structured interview about their engagement in family rules and routines. Time since diagnosis was abstracted from the medical record. A multi-pass inductive coding strategy was utilized to extract …

Detroit Mercy Dental: Empowering Leaders And Igniting Change, Mert N. Aksu Dds, Jd, Mhsa, Cert. Dph

The Journal of the Michigan Dental Association

This article is a review/recap of activities at the University of Detroit Mercy School of Dentistry over the past year, including information on community service programs, diversity and inclusion, research, faculty and staff accomplishments, student life, and demographic information.

Karen Burgess Remembered: Thoughts And Memories From Mda Leaders

The Journal of the Michigan Dental Association

This article is a collection of memories and remembrances of Karen Burgess, who served as Michigan Dental Association CEO/executive director from 2014 until her death on July 18, 2023.

Mda Services: Why Dental Cpas Are Warning About Potential Employee Dishonesty, Reva Darling

The Journal of the Michigan Dental Association

This article details scenarios in which embezzlement and employee dishonesty can occur in a dental office and the need to employ a dental CPA. The article also describes two vendors endorsed by the Michigan Dental Association for accounting and protection against embezzlement. This article is an installment of the MDA Journal’s bi-monthly MDA Services department.

Dental Student Report: Rotations At A Federally Qualified Health Center In North Dakota, Jordan Jaeger, Shawnda Schroeder

Indigenous Health Faculty Publications

North Dakota has no dental school to encourage student enrollment. Recognizing the need to address dental workforce shortages, and barriers to recruiting new dental professionals to the state, the North Dakota Department of Health & Human Services Oral Health Program (OHP) and the North Dakota Area Health Education Center financially support dental rotations at one Federally Qualified Health Center (FQHC) in North Dakota: Spectra Health

Parental Diabetes Distress Is A Stronger Predictor Of Child Hba1c Than Diabetes Device Use In School-Age Children With Type 1 Diabetes., Susana R. Patton, Nicole Kahhan, Jessica S. Pierce, Matthew Benson, Larry A. Fox, Mark A. Clements

Manuscripts, Articles, Book Chapters and Other Papers

INTRODUCTION: Diabetes distress (DD) describes the unrelenting emotional and behavioral challenges of living with, and caring for someone living with, type 1 diabetes (T1D). We investigated associations between parent-reported and child-reported DD, T1D device use, and child glycated hemoglobin (HbA1c) in 157 families of school-age children.

RESEARCH DESIGN AND METHODS: Parents completed the Parent Problem Areas in Diabetes-Child (PPAID-C) and children completed the Problem Areas in Diabetes-Child (PAID-C) to assess for DD levels. Parents also completed a demographic form where they reported current insulin pump or continuous glucose monitor (CGM) use (ie, user/non-user). We measured child HbA1c using a valid …

An Integrated Process For Co-Developing And Implementing Written And Computable Clinical Practice Guidelines, Dyann M. Matson-Koffman, Susan J. Robinson, Priya Jakhmola, Laura J. Fochtmann, Duwayne Willett, Ira M. Lubin, Matthew M. Burton, Amrita Tailor, Dana L. Pitts, Donald E. Casey, Frank G. Opelka, Ryan Mullins, Randy Elder, Maria Michaels

College of Population Health Faculty Papers

The goal of this article is to describe an integrated parallel process for the co-development of written and computable clinical practice guidelines (CPGs) to accelerate adoption and increase the impact of guideline recommendations in clinical practice. From February 2018 through December 2021, interdisciplinary work groups were formed after an initial Kaizen event and using expert consensus and available literature, produced a 12-phase integrated process (IP). The IP includes activities, resources, and iterative feedback loops for developing, implementing, disseminating, communicating, and evaluating CPGs. The IP incorporates guideline standards and informatics practices and clarifies how informaticians, implementers, health communicators, evaluators, and clinicians …

Use Of Mobile Technology To Identify Behavioral Mechanisms Linked To Mental Health Outcomes In Kenya: Protocol For Development And Validation Of A Predictive Model, Willie Njoroge, Rachel Maina, Frank Elena, Lukoye Atwoli, Anthony Ngugi, Srijan Sen, Stephen Wong, Linda Khakali, Andrew Aballa, James Orwa, Moses Nyongesa, Jasmit Shah, Amina Abubakar, Zul Merali

Brain and Mind Institute

Objective:This study proposes to identify and validate weighted sensor stream signatures that predict near-term risk of a major depressive episode and future mood among healthcare workers in Kenya.

Approach: The study will deploy a mobile application (app) platform and use novel data science analytic approaches (Artificial Intelligence and Machine Learning) to identifying predictors of mental health disorders among 500 randomly sampled healthcare workers from five healthcare facilities in Nairobi, Kenya.

Expectation: This study will lay the basis for creating agile and scalable systems for rapid diagnostics that could inform precise interventions for mitigating depression and ensure a healthy, resilient …

Associations Between Birth Weight And Adult Sleep Characteristics: A Cross-Sectional Analysis From The Uaehfs, Nirmin F. Juber, Abdishakur Abdulle, Amar Ahmad, Andrea Leinberger-Jabari, Ayesha S.Al Dhaheri, Fatma Al-Maskari, Fatme Alanouti, Mohammad Al-Houqani, Mohammed Hag Ali, Omar El-Shahawy, Scott Sherman, Syed M. Shah, Tom Loney, Youssef Idaghdour, Raghib Ali

All Works

Abnormal birth weight, particularly low birth weight (LBW), is known to have long-term adverse health consequences in adulthood, with disrupted sleep being suggested as a mediator or modifier of this link. We thus aimed to assess the associations between birth weight and self-reported adult sleep characteristics: sleep duration, difficulty waking up in the morning, daily nap frequency, sleep problems at night, snoring, daytime tiredness or sleepiness, and ever-stop breathing during sleep. This cross-sectional analysis used the United Arab Emirates Healthy Future Study data collected from February 2016 to March 2023 involving 2124 Emiratis aged 18–61 years. We performed a Poisson …

Prevalence Of Stress Among The Healthcare Providers In A Tertiary Care Hospital In Karachi, Saba Zaidi, Syeda Areeba Tabassum

Pakistan Journal of Neurological Sciences (PJNS)

Background and Objective: Healthcare workers are considered high risk for stress. This study aimed to study the prevalence of stress among the health care providers in a tertiary care hospital in Karachi.

Methods: A cross-sectional study was conducted at Liaquat National Hospital from July to December 2021. All healthcare workers in the vicinity of the hospital including doctors, nurses, allied health specialists, and other healthcare professionals who provide hands-on patient care were included in the study. Data was collected through a pre-designed questionnaire GHQ-12; related to stress symptoms and their impact on daily routine activities. It was in a Google …

Psychiatric Comorbidity In People With Epilepsy, Bushra Khalid, Zaid Waqar, Zakir Jan, Soban Khan, Amina Saddiqa, Anum Irfan, Waleed Malik, Samer Naik, Naheed Afzal, Hira Abbasi

Pakistan Journal of Neurological Sciences (PJNS)

Background and Objective: People with epilepsy often experience psychiatric comorbidity. This study aims to investigate the relationship among seizure regulation, psychiatric comorbidity, and antiepileptic drug use in a group of individuals with epilepsy in Pakistan.

Methods: This is an observational study conducted at Pakistan Institute of Medical Sciences, over a period of six months (1st June – 31st Dec 2022). One-hundred-twenty people (sample size) with epilepsy above the age of 18 with confirmed diagnosis of epilepsy were included in the study who completed a questionnaire that assessed their seizure control, psychiatric comorbidity, and antiepileptic drug use. Data was analyzed using …

A Comprehensive Electroencephalogram Audit In A Tertiary Care Center In Pakistan: Demographic Distribution, Referral Indications And Findings, Hina Imtiaz, Ayisha Farooq Khan, Dureshahwar Kanwar, Naima Javed, Sara Khan

Pakistan Journal of Neurological Sciences (PJNS)

Background and Objective: Electroencephalography (EEG) is a widely employed non-invasive technique for recording brain electrical activity, pivotal for diagnosing various neurological conditions. The study aims to provide insight into demographic distribution, referral indications, and EEG findings in a tertiary care hospital in Pakistan.

Methods: A retrospective cross-sectional analysis was conducted involving 2,924 patients who underwent routine EEG evaluations over a three-year period. Data was collected from the EEG records after approval from the ethical review committee. Demographic variables, referral reasons, and EEG findings were recorded and analyzed using descriptive statistics.

Results: The study revealed a gender distribution of 41.35 % …

Factors Influencing The Headaches And Their Impact On Daily Life Of Medical Students, Saba Zaidi, Ayesha Abdul Samad

Pakistan Journal of Neurological Sciences (PJNS)

Background and Objective:

Medical students are considered high risk for headaches due to various triggers in their daily routine. The objective of this study was to assess the factors influencing headaches and their impact on the daily life of medical students.

Methods: This cross-sectional study utilized a sample of 242 participants who were selected through a convenient method of sampling. Data was collected from medical students of Liaquat National Medical College for a period of six months (January to June 2021). Data was gathered using pre-designed questionnaires that assessed demographic information, lifestyle factors (such as consumption of tea, coffee, and …

Factors Associated With Dropout From Outpatient Tertiary Mental Health Services, Nasir Mahmood, Uroosa Talib

Pakistan Journal of Neurological Sciences (PJNS)

Background and objective: There is a paucity of mental health hospital-based studies from Pakistan that have observed the contributing factors of dropout. This study aims to understand contributing factors to dropouts from mental health services.

Method: This telephonic survey was conducted as a cross-sectional study from dropout outpatients of Karwan-e-Hayat Institute for Mental Health Care, a tertiary mental care hospital in Karachi, Pakistan. Using a simple questionnaire to assess socio-demographic variables, psychosocial assessment, and patient perspectives on treatment termination. A total of 158 participants out of 200 patients provided insight into their dropout experiences.

Result: Results revealed that younger adults, …

Neuro-Palliative Medicine, Shazia Faiz

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Cyclic Alternating Pattern Of Encephalopathy (Cape) In Cns Infection: A Case Report, Zaid Waqar, Soban Khan, Maryam Khalil, Bushra Khalid, Zakir Jan, Muhammad Adil, Amina Saddiqa

Pakistan Journal of Neurological Sciences (PJNS)

Cyclic Alternating Pattern of Encephalopathy (CAPE) is rare EEG phenomenon first described in 1944 in a comatose patient. It is similar to sleep EEG pattern of cyclic alternating pattern (CAP) which is a periodic electroencephalogram activity of non-REM sleep. The cyclic alternating pattern (CAP) is defined by sequences of transient electrocortical events that are different from the tonic background and repeat at intervals of up to one minute. CAPE, however, is abnormal EEG pattern. In this pattern of EEG abnormality slow wave activity of 1-2Hz alternates with fast activity of 6-10 hertz. Here we present a case of patient with …

Anti-Caspr 2 Antibody Encephalitis: A Case Report, Maryam Khalil, Zaid Waqar, Hira Badar Abbasi, Amina Saddiqa, Bushra Khalid, Soban Khan

Pakistan Journal of Neurological Sciences (PJNS)

Encephalitis is a term denoted to Inflammation in the brain which can be due to infection, autoimmunity, or can be a part of a paraneoplastic phenomenon with malignancy. Anti-CASPR 2 antibody encephalitis is a rare form of encephalitis that can be associated with malignancy, paraneoplastic phenomenon or can be an autoimmune disease. We present a case of a young boy who presented with new onset seizures and altered sensorium and was diagnosed with anti-CASPR 2 antibody encephalitis. Anti-CASPR 2 Antibody Encephalitis is a rare form of encephalitis which due to its great diverse presentation should be kept in the differential …

Primary Angiitis Of The Central Nervous System Presenting As Sudden Vision Loss In A Young Patient, Ayisha Farooq Khan, Lubna Jafri, Saad Shafqat

Pakistan Journal of Neurological Sciences (PJNS)

Primary angiitis of the central nervous system is a rare disorder that primarily affects the cerebral vessels and can prove to be a diagnostic challenge to the clinicians. It can present with a variety of clinical manifestations and lacks the evidence of any systemic disease. Digital subtraction angiography is often necessary to confirm the diagnosis of cerebral vasculitis but in cases where it may fail to do so, brain biopsy is eventually required. Obliviousness to this condition may lead to false management strategies and hence it is imperative to make an accurate diagnosis to facilitate proper treatment that mainly includes …