Medicine and Health Sciences Commons^™

Epidemiology And Preventability Of Hospital-Onset Bacteremia And Fungemia In 2 Hospitals In India, Sumanth Gandra, Dorothy Sinclair, Dustin Stwalley, Jacaranda Van Rheenen, David K Warren, Et Al.

2020-Current year OA Pubs

OBJECTIVE: Studies evaluating the incidence, source, and preventability of hospital-onset bacteremia and fungemia (HOB), defined as any positive blood culture obtained after 3 calendar days of hospital admission, are lacking in low- and middle-income countries (LMICs).

DESIGN, SETTING, AND PARTICIPANTS: All consecutive blood cultures performed for 6 months during 2020-2021 in 2 hospitals in India were reviewed to assess HOB and National Healthcare Safety Network (NHSN) reportable central-line-associated bloodstream infection (CLABSI) events. Medical records of a convenience sample of 300 consecutive HOB events were retrospectively reviewed to determine source and preventability. Univariate and multivariable logistic regression analyses were performed to …

Structural Biases In Disordered Proteins Are Prevalent In The Cell, David Moses, Karina Guadalupe, Feng Yu, Eduardo Flores, Anthony R Perez, Ralph Mcanelly, Nora M Shamoon, Gagandeep Kaur, Estefania Cuevas-Zepeda, Andrea D Merg, Erik W Martin, Alex S Holehouse, Shahar Sukenik

2020-Current year OA Pubs

Intrinsically disordered proteins and protein regions (IDPs) are prevalent in all proteomes and are essential to cellular function. Unlike folded proteins, IDPs exist in an ensemble of dissimilar conformations. Despite this structural plasticity, intramolecular interactions create sequence-specific structural biases that determine an IDP ensemble's three-dimensional shape. Such structural biases can be key to IDP function and are often measured in vitro, but whether those biases are preserved inside the cell is unclear. Here we show that structural biases in IDP ensembles found in vitro are recapitulated inside human-derived cells. We further reveal that structural biases can change in a sequence-dependent …

Primary Non-Function Of Hepatic Allograft With Preexisting Microvesicular Steatosis/Foamy Degeneration And Mild Large-Droplet Macrovesicular Steatosis, Melissa E Limia, Xiu Li Liu, Jennifer Yu, Kathleen Byrnes

2020-Current year OA Pubs

It has been established that more than mild large-droplet macrovesicular steatosis (LD-MAS) is associated with increased risk of graft non-function. In contrast, even severe small-droplet macrovesicular steatosis (SD-MAS) has been found to be less prognostically significant. It remains unclear if a donor liver with diffuse microvesicular steatosis is associated with an increased risk of graft dysfunction. A 56-year-old male with alcoholic cirrhosis was transplanted with a liver from a 42-year-old overweight male donor after brain death. The frozen section of the donor liver biopsy taken at harvest showed diffusely enlarged clear/foamy hepatocytes and mild LD-MAS (about 5-10% of total tissue). …

Core Requirements Of Frailty Screening In The Emergency Department: An International Delphi Consensus Study, Elizabeth Moloney, Christopher R Carpenter, Et Al.

2020-Current year OA Pubs

INTRODUCTION: Frailty is associated with adverse outcomes among patients attending emergency departments (EDs). While multiple frailty screens are available, little is known about which variables are important to incorporate and how best to facilitate accurate, yet prompt ED screening. To understand the core requirements of frailty screening in ED, we conducted an international, modified, electronic two-round Delphi consensus study.

METHODS: A two-round electronic Delphi involving 37 participants from 10 countries was undertaken. Statements were generated from a prior systematic review examining frailty screening instruments in ED (logistic, psychometric and clinimetric properties). Reflexive thematic analysis generated a list of 56 statements …

Multiomic Profiling Reveals Metabolic Alterations Mediating Aberrant Platelet Activity And Inflammation In Myeloproliferative Neoplasms, Fan He, Angelo Ba Laranjeira, Tim Kong, Shuyang Lin, Katrina J. Ashworth, Alice Liu, Nina M. Lasky, Daniel Ac Fisher, Maggie J. Cox, Mary C. Fulbright, Lilian Antunes-Heck, Layow Yu, Molly Brakhane, Bei Gao, Stephen M. Sykes, Angelo D'Alessandro, Jorge Di Paola, Stephen T. Oh

2020-Current year OA Pubs

Platelets from patients with myeloproliferative neoplasms (MPNs) exhibit a hyperreactive phenotype. Here, we found elevated P-selectin exposure and platelet-leukocyte aggregates indicating activation of platelets from essential thrombocythemia (ET) patients. Single-cell RNA-seq analysis of primary samples revealed significant enrichment of transcripts related to platelet activation, mTOR, and oxidative phosphorylation in ET patient platelets. These observations were validated via proteomic profiling. Platelet metabolomics revealed distinct metabolic phenotypes consisting of elevated ATP generation accompanied by increases in the levels of multiple intermediates of the tricarboxylic acid cycle, but lower α-ketoglutarate (α-KG) in MPN patients. Inhibition of PI3K/AKT/mTOR signaling significantly reduced metabolic responses and …

Optimal Approaches To Analyzing Functional Mri Data In Glioma Patients, Ki Yun Park, Joshua S Shimony, Satrajit Chakrabarty, Aaron B Tanenbaum, Carl D Hacker, Kara M Donovan, Patrick H Luckett, Mikhail Milchenko, Aristeidis Sotiras, Daniel S Marcus, Eric C Leuthardt, Abraham Z Snyder

2020-Current year OA Pubs

BACKGROUND: Resting-state fMRI is increasingly used to study the effects of gliomas on the functional organization of the brain. A variety of preprocessing techniques and functional connectivity analyses are represented in the literature. However, there so far has been no systematic comparison of how alternative methods impact observed results.

NEW METHOD: We first surveyed current literature and identified alternative analytical approaches commonly used in the field. Following, we systematically compared alternative approaches to atlas registration, parcellation scheme, and choice of graph-theoretical measure as regards differentiating glioma patients (N = 59) from age-matched reference subjects (N = 163).

RESULTS: Our results …

What's Going Well: A Qualitative Analysis Of Positive Patient And Family Feedback In The Context Of The Diagnostic Process, Stephen K Liu, Fabienne Bourgeois, Joe Dong, Kendall Harcourt, Elizabeth Lowe, Liz Salmi, Eric J Thomas, Natalie Riblet, Sigall K Bell

Journal Articles

OBJECTIVES: Accurate and timely diagnosis relies on close collaboration between patients/families and clinicians. Just as patients have unique insights into diagnostic breakdowns, positive patient feedback may also generate broader perspectives on what constitutes a "good" diagnostic process (DxP).

METHODS: We evaluated patient/family feedback on "what's going well" as part of an online pre-visit survey designed to engage patients/families in the DxP. Patients/families living with chronic conditions with visits in three urban pediatric subspecialty clinics (site 1) and one rural adult primary care clinic (site 2) were invited to complete the survey between December 2020 and March 2022. We adapted the …

Antiviral Potency Of Long-Acting Islatravir Subdermal Implant In Shiv-Infected Macaques, Fernanda P Pons-Faudoa, Nicola Di Trani, Simone Capuani, Ilaria Facchi, Anthony M Wood, Bharti Nehete, Ashley Delise, Suman Sharma, Kathryn A Shelton, Lane R Bushman, Corrine Ying Xuan Chua, Michael M Ittmann, Jason T Kimata, Peter L Anderson, Pramod N Nehete, Roberto C Arduino, Alessandro Grattoni

Journal Articles

Treatment nonadherence is a pressing issue in people living with HIV (PLWH), as they require lifelong therapy to maintain viral suppression. Poor adherence leads to antiretroviral (ARV) resistance, transmission to others, AIDS progression, and increased morbidity and mortality. Long-acting (LA) ARV therapy is a promising strategy to combat the clinical drawback of user-dependent dosing. Islatravir (ISL) is a promising candidate for HIV treatment given its long half-life and high potency. Here we show constant ISL release from a subdermal LA nanofluidic implant achieves viral load reduction in SHIV-infected macaques. Specifically, a mean delivery dosage of 0.21 ± 0.07 mg/kg/day yielded …

Gut Microbiome Of Patients With Breast Cancer In Vietnam, Sang M Nguyen, Huong T T Tran, Jirong Long, Martha J Shrubsole, Hui Cai, Yaohua Yang, Lan M Nguyen, Giang H Nguyen, Chu V Nguyen, To V Ta, Jie Wu, Qiuyin Cai, Wei Zheng, Thuan V Tran, Xiao-Ou Shu

Journal Articles

PURPOSE: Gut microbiota play an important role in human health, including cancer. Cancer and its treatment, in turn, may alter the gut microbiome. To understand this complex relationship, we profiled the gut microbiome of 356 Vietnamese patients with breast cancer.

MATERIALS AND METHODS: Stool samples were collected before chemotherapy, with 162 pre- and 194 postsurgery. The gut microbiome was measured by shotgun metagenomic sequencing. Associations of gut microbial diversity, taxa abundance, and gut microbiome health index (GMHI) with sociodemographic, clinical factors, and tumor characteristics were evaluated.

RESULTS: Postsurgery samples were associated with significantly lower α- and β-diversities (

CONCLUSION: Our …

The Role Of Palliative Care Consultation In Withdrawal Of Life-Sustaining Treatment Among Icu Patients Receiving Veno-Venous Extracorporeal Membrane Oxygenation (Vv-Ecmo): A Retrospective Case-Control Study., Gabriel Patarroyo-Aponte, Saeed Shoar, Deptmer M Ashley, Ali Noorbaksh, Dev Patel, Alisha Y Young, Bindu H Akkanti, Mark T Warner, Maria M Patarroyo-Aponte, Biswajit Kar, Igor D Gregoric, Caroline Ha, Bela Patel

Journal Articles

No abstract provided.

Human Zoo Healthcare At The 1904 World’S Fair, Angel Blake

Undergraduate Research Symposium

Human Zoo Healthcare at the 1904 World’s Fair

Were precautions taken or put into place for the Human Zoo performers at the 1904 World’s Fair? This topic has been overlooked and understudied by historians, there are few articles written and we do not know the true death toll which shows the racism towards these indigenous peoples. The research for this project was conducted at the State Historical Society of Missouri, the St. Louis Mercantile Library, Newspapers.com, Archives.com, St. Louis Public Library, and the Missouri Historical Society, including research on primary sources such as official World’s Fair committee meeting minutes, hospital …

Telehealth Treatment For Opioid Use Disorder In Missouri’S Urban And Rural Areas Prior To And Since Covid-19, Aurora Rojo, Rashmi Ghonasgi, Zachary Budesa, Rachel Winograd

Undergraduate Research Symposium

Opioid use disorder (OUD) is a chronic health condition that can be adequately treated when individuals have access to needed services. Telehealth services can be delivered remotely through audio-visual technological communications rather than in-person visits, which can greatly improve care accessibility. Following the onset of COVID-19, there were swift clinical and policy adaptations to promote telehealth services across medical and behavioral health fields. This study aims to identify changes in the frequency of telehealth for OUD treatment in Missouri’s rural and urban counties prior to and since the onset of COVID-19. Chi-square tests and analysis of changes between years and …

Examining Immune Markers As Determinants Of Cognitive Difficulties Among Perinatally Infected Youth With Hiv, Addie Halbrook, Jacob Bolzenius, Julie Mannarino, Robert Paul

Undergraduate Research Symposium

This research explores the relationship between immune markers and cognitive performance in perinatally HIV-infected youth. While the use of antiretroviral therapy has greatly improved the mortality rate among children with perinatal HIV, these children still experience various health consequences, including cognitive difficulties. Previous studies have reported that children with perinatal HIV have worse cognitive performance in domains of learning, memory, processing speed, executive function, and motor function when compared to their HIV-uninfected peers. However, there is substantial heterogeneity in cognitive performance reported across studies, possibly due to significant heterogeneity in psychosocial and demographic backgrounds. This study aims to investigate whether …

High-Grade Avm. Educational Vignette And Clinical Cases, Marcos Devanir Silva Da Costa, Marcelo Augusto Acosta Goiri, Daniela Coelho, Juan Alberto Paz Archila, Talita Helena Martins Sarti, Feres Chaddad-Neto

Archives of Neurosurgery

The arteriovenous malformation (AVM) is a vascular malformation characterized by fistulas between arteries and veins forming a nidus, without interposition of capillary vessels and of which early draining vein is identified at the digital angiography. Potential reports of its existence date from the second century AD. Spetzler and Martin (S-M) proposed a classification considering three features and Lawton then added new predictors. A maximum of 10 score can be achieved by applying the modified S-M grade system. This classification guides decision-making and the possible choice of the multimodal treatment (surgery, radiosurgery and embolization). We discuss historical, pathological, clinical and therapeutic …

Boarding Of Older Adults: A Concerning Trend In The Emergency Department, Julie Van Baardwijk, Eric Tharmathurai, Ariba Khan

Journal of Geriatric Emergency Medicine

Emergency department (ED) boarding (EDB) is the practice of holding admitted patients in the ED due to a lack of hospital beds. We identified one ED in our health system with a high rate of EDB. We sought to identify factors associated with EDB in this hospital by comparing it to a similar hospital in our health care system.

Methods: We conducted a retrospective study comparing two community hospitals in our healthcare system. Boarding was defined as a patient waiting ≥8 hours in ED for disposition. One hospital, located in a rural area with 55beds was chosen as it was …

The Effects Of Loneliness And Suicidal Ideation On U.S. Veterans, Sean Donnelly

Walden Dissertations and Doctoral Studies

No abstract provided.

The Relationship Between Certified Nurse Aides’ Staffing Hours And Resident Medicare Quality Measure Outcomes In Missouri Long-Term Care Facilities, Sharlletta Idella Jackson

Walden Dissertations and Doctoral Studies

No abstract provided.

Improved Network Integrity And Patient Follow-Up After In-Office Needle Arthroscopy Compared To Outpatient Advanced Diagnostic Imaging For Intra-Articular Pathology, Elizabeth Ford, Rachel Frank, Manuel C. Pontes, Sean Mcmillan

Rohrer College of Business Faculty Scholarship

Purpose

Methods

Potential Causal Association Between Gut Microbiome And Posttraumatic Stress Disorder, Qiang He, Wenjing Wang, Dingkang Xu, Yang Xiong, Chuanyuan Tao, Chao You, Lu Ma, Junpeng Ma, Caroline M. Nievergelt, Adam X. Maihofer, Torsten Klengel, Elizabeth G. Atkinson, Chia Yen Chen, Karmel W. Choi, Jonathan R.I. Coleman, Shareefa Dalvie, Laramie E. Duncan, Mark W. Logue, Allison C. Provost, Andrew Ratanatharathorn, Murray B. Stein, Katy Torres, Allison E. Aiello, Lynn M. Almli, Ananda B. Amstadter, Søren B. Andersen, Ole A. Andreassen, Paul A. Arbisi, Ariane Rung, Et Al

School of Public Health Faculty Publications

Background: The causal effects of gut microbiome and the development of posttraumatic stress disorder (PTSD) are still unknown. This study aimed to clarify their potential causal association using mendelian randomization (MR). Methods: The summary-level statistics for gut microbiome were retrieved from a genome-wide association study (GWAS) of the MiBioGen consortium. As to PTSD, the Freeze 2 datasets were originated from the Psychiatric Genomics Consortium Posttraumatic Stress Disorder Working Group (PGC-PTSD), and the replicated datasets were obtained from FinnGen consortium. Single nucleotide polymorphisms meeting MR assumptions were selected as instrumental variables. The inverse variance weighting (IVW) method was employed as the …

The Urologist’S Role In Bowel Management Of Adult Spina Bifida: A Narrative Review, Malcolm Sundell, George E. Koch, Melissa Kaufman

School of Medicine Faculty Publications

Background and Objective: Urologists are central to the coordinated care of patients with spina bifida (SB), and efforts to optimize bladder management and protection of the upper tracts are well established. However, the urologist’s role in treating this population often extends to the management of bowel dysfunction which may be less defined. The methods available to the urologist for bowel management range from lifestyle modifications to medical and surgical therapy, with many patients requiring combinations of multiple strategies to combat conflicting symptoms of constipation and fecal incontinence (FI). This narrative review aims to compile a detailed algorithm of management options, …

Factors Affecting Superoxide Dismutase Activity In Railway Workers In Jakarta, Indonesia, Vera Winata, Muhammad Ilyas, Aria Kekalih, Suryo Wibowo, Muchtaruddin Mansyur

Occupational and Environmental Medicine Journal of Indonesia

Introduction. Railway workers are exposed to many occupational health risk factors that may cause oxidative stress. Superoxide dismutase (SOD) activity is one of the response biomarkers of oxidative stress.

Methods. A cross-sectional study was conducted from July-October 2021. Eighty-four participants were included in this study. Data about participants’ characteristics, physical activity intensity as measured by the Global Physical Activity Questionnaire (GPAQ) version 2, and stress levels as measured by Holmes-Rahe Stress Inventory were collected using Google Forms. The physical examination yielded data on blood pressure, ear condition, and waist circumference. Blood Superoxide dismutase activity and HbA1c levels were determined using …

Dynamic Prognosis Prediction For Patients On Dapt After Drug-Eluting Stent Implantation: Model Development And Validation, Fang Li, Laila Rasmy, Yang Xiang, Jingna Feng, Ahmed Abdelhameed, Xinyue Hu, Zenan Sun, David Aguilar, Abhijeet Dhoble, Jingcheng Du, Qing Wang, Shuteng Niu, Yifang Dang, Xinyuan Zhang, Ziqian Xie, Yi Nian, Jianping He, Yujia Zhou, Jianfu Li, Mattia Prosperi, Jiang Bian, Degui Zhi, Cui Tao

School of Medicine Faculty Publications

BACKGROUND: The rapid evolution of artificial intelligence (AI) in conjunction with recent updates in dual antiplatelet therapy (DAPT) management guidelines emphasizes the necessity for innovative models to predict ischemic or bleeding events after drug-eluting stent implantation. Leveraging AI for dynamic prediction has the potential to revolutionize risk stratification and provide personalized decision support for DAPT management. METHODS AND RESULTS: We developed and validated a new AI-based pipeline using retrospective data of drug-eluting stent-treated patients, sourced from the Cerner Health Facts data set (n=98 236) and Optum’s de-identified Clinformatics Data Mart Database (n=9978). The 36 months following drug-eluting stent implantation were …

The Association Between Mental Workload And Nonspecific Chronic Low Back Pain Among Operators Of An On Shore Oil And Gas Company In South Sumatera, Ardi Artanto, Suryo Wibowo, Nuri Purwito Adi

Occupational and Environmental Medicine Journal of Indonesia

Background: Work location influences the proportion of operators with low back pain (LBP) at a South Sumatera onshore oil and gas company. This study aimed to determine the prevalence of nonspecific chronic LBP among the company's operators, as well as the association between quantitative and qualitative mental workload and nonspecific chronic LBP.

Methods: This study was cross-sectional in design, with 96 samples collected through purposive sampling. Questionnaires and physical examinations were used to collect data.

Results: Nonspecific chronic LBP was found in 32.3 percent of people. According to the multivariate analysis, moderate-heavy qualitative mental workload (OR: 5.14; 95 percent CI: …

Prognosis Of Covid-19 On Workers With History Of Asthma: An Evidence-Based Case Report, Parmitasari Parmitasari, Dewi Yunia Fitriani, Indah S. Widyahening

Occupational and Environmental Medicine Journal of Indonesia

Background. As the COVID-19 pandemic occurs, those with asthma were thought to have an increased risk of infection. Question arisen whether special preparation for severe clinical outcomes might be needed for remote site workers. Method. A literature search was conducted through PubMed, Scopus and ProQuest databases, as well as hand searched. The inclusion criteria were systematic review, cohort study, retrospective study, cross sectional study, COVID-19, asthma, and ICU. Then, they were critically appraised based on Center of Evidence-Based Medicine, Oxford University, Critical Appraisal for Prognostic Studies and Systematic Reviews. Result. Three systematic review studies and three retrospective cohort studies were …

The Effectiveness Of Education Through Web-Based Seminar In Increasing Knowledge About The Early Detection And Reporting Of Occupational Diseases, Keyne Christa Monintja, Dewi Sumaryani Soemarko, Dewi Yunia Fitriani, Herqutanto Herqutanto, Suryo Wibowo

Occupational and Environmental Medicine Journal of Indonesia

Background: In 2022, the Indonesian Occupational Medicine Association (IOMA) collaborated with oil and gas companies and conducted a web-based seminar (webinar) to enable participants to recognize occupational disease earlier and enhance reporting in companies. We aimed to investigate the effectiveness of the webinar in increasing the intended knowledge.

Method: The webinar was separated into three batches, with different participants per batch. Using a one-group pretest-posttest design, we utilized secondary data from IOMA. The effectiveness of the webinar was determined by participants' satisfaction and knowledge as measured by pre-test and post-test. After performing item analysis, we removed poor discriminating items in …

Psychosocial Factors In The Workplace, Suryo Wibowo

Occupational and Environmental Medicine Journal of Indonesia

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Analysis Of Knowledge Of Hospital Manager About Occupational Tuberculosis And Associated Factors, Aditya Agung Prasetyo, Suryo Wibowo, Muhammad Ilyas, Ahmad Fuady, Feni Fitriani Taufik

Occupational and Environmental Medicine Journal of Indonesia

Introduction.Knowledge of hospital managers about occupational tuberculosis can affect occupational tuberculosis services in the hospital. This study aims was to identify associated factors with knowledge of hospital manager about occupational tuberculosis in order to improve occupational tuberculosis services in hospitals as seen in the four management functions.

Method.Concurrent embedded mixed approaches are used in this cross-sectional study. Focus group discussions (FGD) are used in qualitative research, whereas questionnaires are used in quantitative research. The questionnaire was evaluated using the difficulty level and discriminating index tests. The ten questions were examined both univariate and bivariate. Thematic analysis was used …

Validity And Reliability Of The Indonesian Version Of Expanded Nursing Stress Scale (Enss) As A Job-Stress Assessment Tool For Nurses, Hasto Harsono, Herqutanto Herqutanto, Suryo Wibowo, Aria Kekalih, Astrid Sulistomo

Occupational and Environmental Medicine Journal of Indonesia

ABSTRACT

Background: Job stress is a serious health problem in the 21st century because of its high incidence and impact. Nurses are known as a profession that has high risks of stress, has distinctive characteristics, and hence requires a work stress assessment instrument that suits its peculiarities. The Expanded Nursing Stress Scale (ENSS) is a nurse-specific stress assessment instrument that has high validity and reliability (Cronbach's alpha = 0.96) and is widely used in many countries but is not yet available in Indonesian. This study aims to obtain the Indonesian version of ENSS and evaluate its reliability and validity.

Method: …

Basis Of Executive Functions In Fine-Grained Architecture Of Cortical And Subcortical Human Brain Networks, Moataz Assem, Sneha Shashidhara, Matthew F Glasser, John Duncan

2020-Current year OA Pubs

Theoretical models suggest that executive functions rely on both domain-general and domain-specific processes. Supporting this view, prior brain imaging studies have revealed that executive activations converge and diverge within broadly characterized brain networks. However, the lack of precise anatomical mappings has impeded our understanding of the interplay between domain-general and domain-specific processes. To address this challenge, we used the high-resolution multimodal magnetic resonance imaging approach of the Human Connectome Project to scan participants performing 3 canonical executive tasks: n-back, rule switching, and stop signal. The results reveal that, at the individual level, different executive activations converge within 9 domain-general territories …

Reaction Hijacking Inhibition Of Plasmodium Falciparum Asparagine Trna Synthetase, Stanley C Xie, Eva S Istvan, Daniel E Goldberg, Et Al.

2020-Current year OA Pubs

Malaria poses an enormous threat to human health. With ever increasing resistance to currently deployed drugs, breakthrough compounds with novel mechanisms of action are urgently needed. Here, we explore pyrimidine-based sulfonamides as a new low molecular weight inhibitor class with drug-like physical parameters and a synthetically accessible scaffold. We show that the exemplar, OSM-S-106, has potent activity against parasite cultures, low mammalian cell toxicity and low propensity for resistance development. In vitro evolution of resistance using a slow ramp-up approach pointed to the Plasmodium falciparum cytoplasmic asparaginyl-tRNA synthetase (PfAsnRS) as the target, consistent with our finding that OSM-S-106 inhibits protein …