Digital Commons Network^™

A Modified Delphi Study To Prioritize Content For A Simulation-Based Pediatric Curriculum For Emergency Medicine Residency Training Programs, J. Mitzman, I. Bank, R. A. Burns, M. C. Nguyen, P. Zaveri, M. J. Falk, M. Madhok, A. Dietrich, F. M. Bullaro, M. Auerbach, +9 Additional Authors

Journal Articles

© 2019 by the Society for Academic Emergency Medicine Objectives: Pediatric training is an essential component of emergency medicine (EM) residency. The heterogeneity of pediatric experiences poses a significant challenge to training programs. A national simulation curriculum can assist in providing a standardized foundation of pediatric training experience to all EM trainees. Previously, a consensus-derived set of content for a pediatric curriculum for EM was published. This study aimed to prioritize that content to establish a pediatric simulation-based curriculum for all EM residency programs. Methods: Seventy-three participants were recruited to participate in a three-round modified Delphi project from 10 stakeholder …

Locked-In With Covid-19, A. Avula, A. Gill, R. Nassar, K. Nalleballe, S. Siddamreddy, M. Chalhoub

Journal Articles

© 2020 Elsevier Ltd Coronavirus Disease 2019 (COVID-19) can be associated with various neurological manifestations including acute strokes. Hyper acute diagnosis and treatment are key factors which decrease mortality and morbidity in stroke patients. The COVID-19 pandemic has introduced a great strain on the healthcare system, and as a result clinicians are facing several barriers in diagnosing and treating strokes. Delayed presentation of strokes is a problem as some in the general population defer the decision to seek immediate medical attention fearing contracting the virus. Also playing a role is the paucity of healthcare professionals available during a pandemic. Recent …

Presenting Characteristics, Comorbidities, And Outcomes Among 5700 Patients Hospitalized With Covid-19 In The New York City Area, S Richardson, Js Hirsch, M Narasimhan, Jm Crawford, T Mcginn, Kw Davidson, Northwell Covid-19 Research Consortium

Journal Articles

No abstract provided.

Impact Of Cardiologist Intervention On Guideline-Directed Use Of Statin Therapy, M. Cassagnol, O. Hai, S. A. Sherali, K. D'Angelo, D. Bass, R. Zeltser, A. N. Makaryus

Journal Articles

© The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved. BACKGROUND Statins have an important and well-established role in the prevention of atherosclerotic cardiovascular disease (ASCVD). However, several studies have reported widespread underuse of statins in various practice settings and populations. Review of relevant literature reveals opportunities for improvement in the implementation of guideline-directed statin therapy (GDST). AIM To examine the impact of cardiologist intervention on the use of GDST in the ambulatory setting. METHODS Patients with at least one encounter at the adult Internal Medicine Clinic (IMC) and/or Cardiology Clinic (CC), who had an available serum …

Pneumatosis Intestinalis In Covid-19: Case Series., K. Wong, D. H. Kim, S. Khanijo, A. Melamud, G. Zaidi

Journal Articles

OBJECTIVE:To describe the clinical characteristics and outcomes of patients with coronavirus disease 2019 (COVID-19) who developed pneumatosis intestinalis (PI). METHODS:This case series was conducted in intensive care units at two large tertiary care centers within the Northwell Health System, located in New York State. Patients were included if they were identified as having confirmed COVID-19 as well as pneumatosis intestinalis from March 16, 2020 to July 31, 2020. Patient demographics, clinical characteristics, vasopressor use, anticoagulation use, opiate use, paralytic use, COVID-19 treatment regimen, serum lactate, arterial pH, serum bicarbonate, subsequent intervention, and outcomes during hospitalization were collected. Results: A total …

Hypermetabolism And Coronavirus Disease 2019, P. Yu, H. Cassiere, S. Derosa, K. Bocchieri, S. Yar, A. Hartman

Journal Articles

No abstract provided.

Demographics And Outcomes Of Patients With Eating Disorders Treated In Residential Care, M. Fisher, J. R. Henretty, S. A. Cox, R. Feinstein, V. Fornari, L. Moskowitz, M. Schneider, S. Levine, J. Malizio, J. Fishbein

Journal Articles

No abstract provided.

Evaluation And Management Of Overweight And Obesity In Children And Adolescents – Current Problems In Pediatric And Adolescent Health Care, J. Kerns, M. Fisher

Journal Articles

No abstract provided.

Association Of Anticoagulation Dose And Survival In Hospitalized Covid-19 Patients: A Retrospective Propensity Score-Weighted Analysis, F. Ionescu, I. Jaiyesimi, I. Petrescu, P. R. Lawler, E. Castillo, Y. Munoz-Maldonado, Z. Imam, M. Narasimhan, A. E. Abbas, G. B. Nair, +1 Additional Author

Journal Articles

© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd Background: Hypercoagulability may contribute to COVID-19 pathogenicity. The role of anticoagulation (AC) at therapeutic (tAC) or prophylactic doses (pAC) is unclear. Objectives: We evaluated the impact on survival of different AC doses in COVID-19 patients. Methods: Retrospective, multi-center cohort study of consecutive COVID-19 patients hospitalized between March 13 and May 5, 2020. Results: A total of 3480 patients were included (mean age, 64.5 years [17.0]; 51.5% female; 52.1% black and 40.6% white). 18.5% (n = 642) required intensive care unit (ICU) stay. 60.9% received pAC (n …

A Case Of Wernicke's Encephalopathy In A Pregnant Woman With A History Of Sleeve Gastrectomy., H. Kandlakunta, D. Gurala, J. Philipose, A. Polavarapu, J. R. Abergel

Journal Articles

Wernicke's encephalopathy (WE) is a neurological complication of thiamine deficiency characterized by a triad of acute confusion, ataxia, and ophthalmoplegia. Even though it is most common in chronic alcoholism, an increase in prevalence has been reported recently due to the increased popularity of bariatric surgeries. WE is a known neurological complication after gastric bypass surgery but rarely reported after sleeve gastrectomy. We present a unique case of WE in pregnant women four months after sleeve gastrectomy.

Comparison Of Low Carbohydrate Diets On Renal And Glucose Function In Subjects With Type 2 Diabetes: A Systematic Review And Meta-Analysis, Garrett A. Couch

Honors Undergraduate Theses

Background - Type 2 Diabetes Mellitus (T2DM) is a growing crisis that can lead to more problems if left untreated. One of these problems includes diabetic nephropathy or Chronic Kidney Disease (CKD). While there have been many advances in the field of treating CKD with medication, there are currently no medications with the capability of stopping the progression of or reversing diabetic nephropathy; however, recent studies have shown that diabetic nephropathy can be stopped and even reversed through dietary interventions. One of these studies went through the effects of a low protein diet on diabetic nephropathy and found very promising …

The Effects Of Modifiable And Non-Modifiable Risk Factors On The Severity Of Gastroparesis-Like Symptoms, Jonathon B. Nelson

Honors Undergraduate Theses

Gastroparesis (GP) is a clinical disorder recognized by measured delayed gastric emptying without mechanical obstruction, in addition to symptoms such as nausea, vomiting, chronic abdominal pain, heartburn, early satiety upon eating a regular-sized meal, and exaggerated postprandial fullness. While GP is considered a clinically rare disorder, there is much suspicion that a much larger number of patients experience GP-like symptoms without an official diagnosis. Furthermore, little work has been done to identify the causes and exacerbations of this gastrointestinal (GI) distress in the young adult population. This study's primary goal was to establish a relationship between modifiable and non-modifiable risk …

Gastrointestinal Stromal Tumor (Gist) In Long Standing Crohn’S Disease On Anti-Tnf Therapy, David Mendel, Taseen Syed, H R. Lippman, Brian Davis

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

Introduction

Patients suffering from inflammatory bowel disease (IBD) are at increased risk for developing cancer. Adenocarcinomas are the most commonly observed tumors of the gastrointestinal tract whereas data on gastrointestinal stromal tumor (GIST) in IBD patients is limited. GIST is a neoplasm that originates from the interstitial cells of Cajal in the smooth muscle layers of the gastrointestinal tract. [1] The association between GIST and Crohn’s disease (CD) is debated, as the tumor inconsistently present in areas of inflammatory activity. We report an interesting case of CD maintained on Infliximab, who presented with a flare that revealed GIST in the …

Prenatal Perception Of Wic Breastfeeding Recommendation Affects First Month Postpartum Breastfeeding Outcomes, Qi Zhang, Lamichhane Rajan, Joanne Guthrie

Community & Environmental Health Faculty Publications

No abstract provided.

Can The Fut 2 Gene Variant Have An Effect On The Body Weight Of Patients Undergoing Bariatric Surgery? - Preliminary, Exploratory Study, Natalia Komorniak, Alexandra Martynova-Van Kley, Armen Nalian, Wiktoria Wardziukiewicz, Karolina Skoniecznaa-Zydecka, Daniel Styburski, Joanna Palma, Bartosz Kowalewski, Krzysztof Kaseja, Ewa Stachowska

Faculty Publications

Background: The FUT2 gene (Se gene) encoding the enzyme α-1,2-L-fucosyltransferase 2 seems to have a significant effect on the number and type of bacteria colonizing the intestines. Methods: In a group of 19 patients after bariatric surgery, the polymorphism (rs601338) of FUT2 gene was analyzed in combination with body mass reduction, intestinal microbiome (16S RNA sequencing), and short chain fatty acids (SCFA) measurements in stools. Results: Among the secretors (Se/Se polymorphism of the FUT2 gene rs601338, carriers of GG variant), correlations between waist-hip ratio (WHR) and propionate content and an increase in Prevotella, Escherichia, Shigella, and Bacteroides were observed. On …

Stochastic Expression Of Sae-Dependent Virulence Genes During Staphylococcus Aureus Biofilm Development Is Dependent On Saes, Elizabeth A. Delmain, Derek E. Moormeier, Jennifer L. Endres, Rebecca E. Hodges, Marat R. Sadykov, Alexander R. Horswill, Kenneth W. Bayles

Journal Articles: Pathology and Microbiology

The intricate process of biofilm formation in the human pathogen Staphylococcus aureus involves distinct stages during which a complex mixture of matrix molecules is produced and modified throughout the developmental cycle. Early in biofilm development, a subpopulation of cells detaches from its substrate in an event termed “exodus” that is mediated by SaePQRS-dependent stochastic expression of a secreted staphylococcal nuclease, which degrades extracellular DNA within the matrix, causing the release of cells and subsequently allowing for the formation of metabolically heterogenous microcolonies. Since the SaePQRS regulatory system is involved in the transcriptional control of multiple S. aureus virulence factors, the …

Cardiovascular: Outcomes And Innovations Report, Maine Medical Center

Annual Reports

2020 Annual Report

Alteration Of The Gut Microbiome In Normal And Overweight School Children From Selangor With Lactobacillus Fermented Milk Administration, Narcisse Joseph, Jonathan B. Clayton, Susan L. Hoops, Carter A. Linhardt, Amalia Mohd Hashim, Barakatun Nisak Mohd Yusof, Suresh Kumar, Syafinaz Amin Nordin

Food for Health: Publications

Childhood obesity is a serious public health problem worldwide. Perturbations in the gut microbiota composition have been associated with the development of obesity in both children and adults. Probiotics, on the other hand, are proven to restore the composition of the gut microbiome which helps reduce the development of obesity. However, data on the effect of probiotics on gut microbiota and its association with childhood obesity is limited. This study aims to determine the effect of probiotics supplement intervention on gut microbiota profiles in obese and normal-weight children. A total of 37 children, 17 normal weight, and 20 overweight school …

Stool Microbiome, Ph And Short/Branched Chain Fatty Acids In Infants Receiving Extensively Hydrolyzed Formula, Amino Acid Formula, Or Human Milk Through Two Months Of Age, Car Reen Kok, Bradford Brabec, Maciej Chichlowski, Cheryl L. Harris, Nancy Moore, Jennifer L. Wampler, Jon Vanderhoof, Devin Rose, Robert Hutkins

Food for Health: Publications

CRISPR–Cas is an anti-viral mechanism of prokaryotes that has been widely adopted for genome editing. To make CRISPR–Cas genome editing more controllable and safer to use, anti-CRISPR proteins have been recently exploited to prevent excessive/prolonged Cas nuclease cleavage. Anti-CRISPR (Acr) proteins are encoded by (pro)phages/(pro)viruses, and have the ability to inhibit their host’s CRISPR–Cas systems. We have built an online database AcrDB (http://bcb.unl.edu/AcrDB) by scanning ∼19 000 genomes of prokaryotes and viruses with AcrFinder, a recently developed AcrAca (Acr-associated regulator) operon prediction program. Proteins in Acr-Aca operons were further processed by two machine learning-based programs (AcRanker and PaCRISPR) to obtain …

Quality And Clinical Care Development In Spine Surgery-Connecting The Dots: An Expanded Clinical Narrative., Sarah Hopkins, Polly Brune, Jens R Chapman, Marc Horton, Rod J Oskouian, Akshal Patel, Marc D Moisi

Articles, Abstracts, and Reports

Our health care system is an evidenced-based quality-centric environment. Pursuit of quality is a process that encompasses knowledge development and care advancements through collaboration and expertise. Depicted here is the foundational knowledge, process, and contributions that hallmark successful clinical quality programs. Beginning with methodology, followed by process and form, we create the foundational knowledge and exemplars demonstrating framework and continuum of process in pursuit and attainment of successful clinical quality and care development for patients. Although our protocol has been devised for complex spine care, this could be implemented across all health care specialties to provide individualized and high-quality care …

Helicobacter Pylori Infection And Its Importance In The Development Of Idiopathic Thrombocytopenic Purpura, Zilola Khashimova

Physician Assistant Studies | Faculty Scholarship

Helicobacter Pylori (HP) infection has been associated with chronic inflammation of the stomach and may also be associated with Idiopathic thrombocytopenic purpura (ITP). A literature review was conducted on the reported research of HP infection associated with ITP.

Congenital Morgagni Hernia Presenting As Complete Small Bowel Obstruction In The Adult - A Case Report, Sabah Uddin Saqib, Kulsoom Hamid, Tabish Umer Chawla

Section of General Surgery

Introduction: Congenital Diaphragmatic hernia (CDH) is a condition in which there is a defect in the diaphragm present at the time of birth. Morgagni hernia is one of the two most common types of CDH which constitutes 2%-4% of diaphragmatic hernias. They mostly remain silent or discovered as an incidental finding on radiological studies. Symptomatic adult Morgagni hernias are extremely rare.
Presentation of case: Elderly woman presented with a 1-day history of abdominal pain, vomiting, and acute onset of respiratory distress. There was no history of trauma to the chest or abdomen. After initial resuscitation, a Chest x-ray was performed …

Evaluation For Association Between Maternal Microbiota And Development Of Necrotizing Enterocolitis Or Gram-Negative Bacteremia In Preterm Infants, Mei Chi Quek

Master of Medicine in Paediatrics and Child Health

Background: Preterm birth is the leading cause of perinatal morbidity and mortality worldwide. There is a need for a better understanding of the correlation of vaginal microbiota with adverse preterm outcomes. Our study aimed to explore how the vaginal microbiota influences the outcome of the preterm infants, determine whether fecal microbiota in premature infants differs from that in term infants, and explore the microbiota pattern in preterm neonates who received multiple antibiotics. Method: A prospective cohort design was used to enroll 33 women admitted in spontaneous labor between 25 to 36 weeks, and 33 controls matched for age and parity …

Evaluating The Utility Of Diagnostic Workups For Biliary Atresia In Neonates With Cholestatic Jaundice Following Prolonged Tpn, Melissa Austin, Zubair H. Aghai

Phase 1

Introduction: Parenteral nutrition associated cholestasis (PNAC) develops in 40-60% of premature infants following TPN for 2-4+ weeks. The incidence of biliary atresia is low and there is a 60-day, post-term window for corrective surgery. There is limited data on both the natural history of PNAC in premature infants following prolonged TPN, as well as the utility of diagnostic tools investigating biliary atresia in these patients.

Methods: A retrospective chart review using EMR data from the Intensive Care Nursey was performed with the following criteria: premature babies diagnosed with cholestasis, born at <1500 grams, and received TPN for 14 days. Ultimately 61 babies met criteria and data was collected and pooled to produce descriptive statistics and graphs describing laboratory trends.

Results: Median gestational age was 26 [IQR 25, …

Assessment Of Dobhoff Tube Malposition On Radiographs Using Deep Learning, Kevin George, Paras Lakhani, Md

Phase 1

Introduction: Dobhoff tubes (DHT) are narrow-bore flexible devices that deliver enteral nutrition for critically ill patients. Tracheobronchial insertion of DHTs presents a significant risk for pulmonary complications. Thus, DHT insertion requires radiologist confirmation of correct placement with chest x-ray (CXR), increasing clinical delays. To address this, we demonstrate the novel application of Deep Convolutional Neural Networks (DCNNs) to automatically and accurately identify DHTs in CXRs in real time.

Methods: 141 de-identified HIPAA compliant frontal view chest radiographs containing DHTs in various positions were obtained. The DHTs were first manually segmented and verified by a board certified radiologist. Images were split …

Caring For Children In Child Welfare Systems: A Trauma-Informed Model Of Integrated Primary Care, Jill Mcleigh, Laura Lamminen, Heidi Roman

Integrated, Trauma-Informed Care

Children involved with the child welfare system have high rates of behavioral health concerns, chronic health conditions, and developmental disabilities. Further, as a result of the complicated relationships among the court system, child protective services, and caregivers (i.e., biological, kinship, and/or foster caregivers) and the high volume of health-, behavior-, and development-related services children in care need, the services they receive tend to be fragmented and problem driven. On top of these challenges, children involved with the child welfare system have been exposed to trauma, and often more than one form of trauma. Taken together, these factors point to the …

2020-2021 Com Student Research Fellowship During Covid-19, University Of New England College Of Osteopathic Medicine

Peter Morgane Research Fellowships

2020-2021 recipients of the University of New England College of Osteopathic Medicine's Peter Morgane Research Fellowship.

Prophylaxis Of Food Allergen Sensitivity, Dustin Gottfeld

Physician Assistant Studies | Student Authored Articles

Food allergies can have a severe and drastic effect on a person’s lifestyle, while prevention of allergic disease can help to ensure others do not have to live with this burden. There are a variety of differing hypotheses that offer explanations for the early development of food allergies, particularly peanut allergies. Two of the foremost hypotheses are the Hygiene Hypothesis and the Dual-Allergen Hypothesis. The Hygiene Hypothesis claims that the diversity of a child’s microbiota creates a beneficial balance of microorganisms which can help prevent the development of allergic disease. Alternatively, the Dual-Allergen Hypothesis states that early environmental exposure to …

Eyeballing Stroke: Blood Flow Alterations In The Eye And Visual Impairments Following Transient Middle Cerebral Artery Occlusion In Adult Rats, Jea-Young Lee, Vanessa Castelli, Brooke Bonsack, Julián García-Sánchez, Chase Kingsbury, Hung Nguyen, Naoki Tajiri, Cesar V. Borlongan

Neurosurgery and Brain Repair Faculty Publications

Middle cerebral artery occlusion in rodents remains a widely used model of ischemic stroke. Recently, we reported the occurrence of retinal ischemia in animals subjected to middle cerebral artery occlusion, owing in part to the circulatory juxtaposition of the ophthalmic artery to the middle cerebral artery. In this study, we examined the eye hemodynamics and visual deficits in middle cerebral artery occlusion-induced stroke rats. The brain and eye were evaluated by laser Doppler at baseline (prior to middle cerebral artery occlusion), during and after middle cerebral artery occlusion. Retinal function-relevant behavioral and histological outcomes were performed at 3 and 14 …

Potential Of Mesenchymal Stem Cells Alone, Or In Combination, To Treat Traumatic Brain Injury, Alison E. Willing, Mahasweta Das, Mark Howell, Shyam S. Mohapatra, Subhra Mohapatra

Neurosurgery and Brain Repair Faculty Publications

Traumatic brain injury (TBI) causes death and disability in the United States and around the world. The traumatic insult causes the mechanical injury of the brain and primary cellular death. While a comprehensive pathological mechanism of TBI is still lacking, the focus of the TBI research is concentrated on understanding the pathophysiology and developing suitable therapeutic approaches. Given the complexities in pathophysiology involving interconnected immunologic, inflammatory, and neurological cascades occurring after TBI, the therapies directed to a single mechanism fail in the clinical trials. This has led to the development of the paradigm of a combination therapeutic approach against TBI. …