Digital Commons Network^™

Quantitative Evaluation Of 90y-Pet/Ct And 90y-Spect/Ct-Based Dosimetry Following Yttrium-90 Radioembolization, Srinivas Cheenu Kappadath, Eric Courtney Henry, Benjamin P Lopez, Armeen Mahvash

Faculty, Staff and Student Publications

Background: Following yttrium-90 radioembolization (90Y-RE), 90Y-PET/CT and 90Y-SPECT/CT imaging provide the means to calculate the voxelized absorbed dose distribution. Given the widespread use of the two imaging modalities and lack of well-established standardized dosimetry protocols for 90Y-RE, there is a clinical need to systematically investigate and evaluate differences in the performance of voxel-based dosimetry between 90Y-PET/CT and 90Y-SPECT/CT.

Purpose: To quantitatively analyze and compare 90Y-PET/CT and 90Y-SPECT/CT-based dosimetry following 90Y-RE.

Methods: 90Y-PET/CT and 90Y-SPECT/CT imaging was acquired for 35 patients following 90Y-RE with TheraSphere for the treatment of unresectable hepatocellular carcinoma. Dosimetry was performed using the local deposition method with …

Tuberculosis Prevention: Current Strategies And Future Directions, Anca Vasiliu, Leonardo Martinez, Rishi K Gupta, Yohhei Hamada, Tara Ness, Alexander Kay, Maryline Bonnet, Martina Sester, Stefan H E Kaufmann, Christoph Lange, Anna M Mandalakas

Faculty, Staff and Students Publications

BACKGROUND: An estimated one fourth of the world's population is infected with Mycobacterium tuberculosis, and 5-10% of those infected develop tuberculosis in their lifetime. Preventing tuberculosis is one of the most underutilized but essential components of curtailing the tuberculosis epidemic. Moreover, current evidence illustrates that tuberculosis manifestations occur along a dynamic spectrum from infection to disease rather than a binary state as historically conceptualized. Elucidating determinants of transition between these states is crucial to decreasing the tuberculosis burden and reaching the END-TB Strategy goals as defined by the WHO. Vaccination, detection of infection, and provision of preventive treatment are key …

Age Modifies The Association Between Severe Sleep Apnea And All-Cause Mortality, Amin Ramezani, Mehrnaz Azarian, Amir Sharafkhaneh, Arash Maghsoudi, Melissa B Jones, Thomas Penzel, Javad Razjouyan

Faculty, Staff and Students Publications

Purpose: While sleep apnea (SA) gets more prevalent with advancing age, the impact of age on the association between SA and health outcomes is not well known. We assessed the association between the severity of SA and all-cause mortality in different age groups using large longitudinal data.

Method: We applied a Natural Language Processing pipeline to extract the apnea-hypopnea index (AHI) from the physicians' interpretation of sleep studies performed at the Veteran Health Administration (FY 1999-2022). We categorized the participants as no SA (n-SA, AHI< 5) and severe SA (s-SA, AHI≥30). We grouped the cohort based on age: Young≤40; Middle-aged:40-65; and Older adults≥65; and calculated the odds ratio (aOR) of mortality adjusted for age, sex, race, ethnicity, BMI, and Charlson-Comorbidity Index (CCI) using n-SA as the reference.

Results: We identified 146,148 participants (age 52.23 ± 15.02; BMI 32.11 ± 6.05; male 86.7 …

Prevalence Of Non-Communicable Diseases Among Household Contacts Of People With Tuberculosis: A Systematic Review And Individual Participant Data Meta-Analysis, Yohhei Hamada, Matteo Quartagno, Farihah Malik, Keolebogile Ntshamane, Anna Tisler, Sanjay Gaikwad, Carlos Acuna-Villaorduna, Perumal Kannabiran Bhavani, Bachti Alisjahbana, Blanca I. Restrepo

School of Medicine Publications

Objective

To investigate the prevalence of non-communicable diseases among household contacts of people with tuberculosis.

Methods

We conducted a systematic review and individual participant data meta-analysis. We searched Medline, Embase and the Global Index Medicus from inception to 16 May 2023. We included studies that assessed for at least one non-communicable disease among household contacts of people with clinical tuberculosis. We estimated the non-communicable disease prevalence through mixed effects logistic regression for studies providing individual participant data, and compared it with estimates from aggregated data meta-analyses. Furthermore, we compared age and sex-standardised non-communicable disease prevalence with national-level estimates standardised for …

Analysis Of Fluid Intake During Pregnancy, Irem Dilaver, Busra Parlak Somuncu, Murat Topbas, Kubra Sahin, Medine Gozde Ustundag, Cansu Agrali Gundogmus, Gamze Can, Nazim Ercument Beyhun

Makara Journal of Health Research

Background: Pregnancy is an important process that affects the body’s daily water requirements through various mechanisms. Adequate fluid intake also plays a critical role in pregnancy. This research aimed to determine levels of water/fluid intake and influencing factors among pregnant women presenting to a university hospital in Trabzon, Türkiye.

Methods: A total of 1,082 pregnant women were included in this cross-sectional research. A questionnaire was used during the face-to-face interviews to collect data. SPSS version 23.0 software was employed during data analysis, and logistic regression was applied to identify factors that affect adequate daily fluid intake.

Results: …

Health Services Students’ Knowledge Of Sexually Transmitted Diseases, Özge Akbaba, Ezgi Demirtürk Selçuk

Makara Journal of Health Research

Background: The rising incidence of sexually transmitted diseases (STDs) among young people is a significant public health issue. This study aims to assess the level of knowledge of sexually transmitted diseases among students at a vocational health school.

Methods: A descriptive study was conducted at a university in eastern Turkey from January to June 2024. The sample consisted of 621 students who agreed to participate. Data were collected from a sociodemographic form and the Sexually Transmitted Diseases Knowledge Questionnaire.

Results: Knowledge was higher among males, second-year students, those in the emergency and disaster management program, those with …

The Role Of Indonesian Doctors As Content Creators In Fighting Health Hoaxes, Myths, And Stigma On Social Media, Lydia Okva Anjelia, Deddy Mulyana, Jenny Ratna Suminar

JURNAL KOMUNIKASI INDONESIA

Amidst the proliferation of disinformation and misinformation related to health on social media, the public must ensure that the sources of information are trustworthy. This research aims to explain the role of doctors in the fight against health hoaxes, myths, and stigma spread through social media. The study adopts qualitative research with a phenomenological approach to understand doctors' experiences and perceptions regarding their efforts to address health hoaxes, myths, and stigma on social media. Fifteen doctors as content creators in Jakarta and Bandung were selected as informants using purposive sampling. The data was collected through interviews, observation participation, and documentation …

Global Perspective Of The Risks Of Falsified And Counterfeit Medicines: A Critical Review Of The Literature, Aonghus J. Feeney, Jeffery A. Goad, Gerard T. Flaherty

Pharmacy Faculty Articles and Research

Background

Methods

A Non-Parametric Approach To Predict The Recruitment For Randomized Clinical Trials: An Example In Elderly Inpatient Settings, Alejandro Villasante-Tezanos, Yong-Fang Kuo, Christopher Kurinec, Yisheng Li, Xiaoying Yu

Faculty, Staff and Student Publications

BACKGROUND: Accurate prediction of subject recruitment, which is critical to the success of a study, remains an ongoing challenge. Previous prediction models often rely on parametric assumptions which are not always met or may be difficult to implement. We aim to develop a novel method that is less sensitive to model assumptions and relatively easy to implement.

METHODS: We create a weighted resampling-based approach to predict enrollment in year two based on recruitment data from year one of the completed GRIPS and PACE clinical trials. Different weight functions accounted for a range of potential enrollment trajectory patterns. Prediction accuracy was …

Diabetes Health Literacy, Diabetes Numeracy, And Cognitive Function As Predictors Of Type 2 Diabetes Mellitus Self-Management, Twinkle Gupta

Doctoral Dissertations and Projects

The present study assessed older adults (≥ 45 years old) diabetes health literacy, diabetes numeracy, cognitive function, and its association with their Type 2 Diabetes Mellitus (T2DM) self-management outcomes. These factors are of concern as diabetes is a lifelong condition affecting the body’s conversion of food into energy and may lead to complications and comorbidities if this condition is not properly self-managed. Diabetes health literacy refers to having the necessary capabilities in finding and analyzing diabetes-related information to make informed decisions regarding their health. Numeracy in diabetes has to do with being able to compute diabetes-related math such as insulin …

A Metabolite-Based Liquid Biopsy For Detection Of Ovarian Cancer, Johannes F Fahrmann, Seyyed Mahmood Ghasemi, Chae Y Han, Ranran Wu, Jennifer B Dennison, Jody Vykoukal, Joseph Celestino, Karen Lu, Zhen Lu, Charles Drescher, Kim-Anh Do, Samir Hanash, Robert C Bast, Ehsan Irajizad

Faculty, Staff and Student Publications

Serial CA125 and second line transvaginal ultrasound (TVS) screening in the UKCTOCS indicated a shift towards detection of earlier stage ovarian cancer (OvCa), but did not yield a significant mortality reduction. There remains a need to establish additional biomarkers that can complement CA125 for even earlier and at a larger proportion of new cases. Using a cohort of plasma samples from 219 OvCa cases (59 stage I/II and 160 stage III/IV) and 409 female controls and a novel Sensitivity Maximization At A Given Specificity (SMAGS) method, we developed a blood-based metabolite-based test consisting of 7 metabolites together with CA125 for …

Adenovirus Vaccine Targeting Kinases Induces Potent Antitumor Immunity In Solid Tumors, Fei Zhu, Zheng Lu, Wenjing Tang, Guangya Zhao, Yingxiang Shao, Bowen Lu, Jiage Ding, Yanyan Zheng, Lin Fang, Huizhong Li, Gang Wang, Renjin Chen, Junnian Zheng, Dafei Chai

Faculty, Staff and Students Publications

BACKGROUND: Targeting kinases presents a potential strategy for treating solid tumors; however, the therapeutic potential of vaccines targeting kinases remains uncertain.

METHODS: Adenovirus (Ad) vaccines encoding Aurora kinase A (AURKA) or cyclin-dependent kinase 7 (CDK7) were developed, and their therapeutic potentials were investigated by various methods including western blot, flow cytometry, cytotoxic T lymphocyte assay, and enzyme-linked immunospot (ELISpot), in mouse and humanized solid tumor models.

RESULTS: Co-immunization with Ad-AURKA/CDK7 effectively prevented subcutaneous tumor growth in the Renca, RM-1, MC38, and Hepa1-6 tumor models. In therapeutic tumor models, Ad-AURKA/CDK7 treatment impeded tumor growth and increased immune cell infiltration. Administration of …

“Dead Or Alive?” Regression Imputation Of The Binary End-Of-Event Outcome Indicator For The Nemsis Public Research Dataset, Mary E. Helander

Social Science - All Scholarship

Objectives: Recent studies address missing survival outcomes in the National Emergency Medical Services Information System (NEMSIS), a system that stores and shares standardized EMS data from U.S. States and Territories. This study aspired to improve imputed EMS outcome accuracy and establish benchmarks for common medical emergencies treated in prehospital care. Methods: This retrospective cohort study of ground-transported EMS patients with definitive end-of-EMS-event outcomes, based on dataset years 2017 to 2023, predicted the probability of “dead” or “alive” status using logistic regression. K-fold cross-validation assessed over-fitting and internal generalization. Threshold optimization and machine learning classification metrics enabled comparison with a …

Phe 302 Social And Environmental Determinants Of Health, Tailisha Gonzalez

Open Educational Resources

This course is an introduction to the social, behavioral, and commercial factors that influence health. Theoretical and methodological approaches to the study of these determinants will be discussed from a social ecological perspective. Social determinants cover five domains: economic stability, education access and quality, health care access and quality, neighborhood and built environment, and social and community context. Behavioral determinants include such factors as smoking, physical activity, and alcohol use. Commercial determinants include economic and political domains with examples such as cigarette marketing and the placement of toxic waste sites in low-income communities.

“Dead Or Alive?” Assessment Of The Binary End-Of-Event Outcome Indicator For The Nemsis Public Research Dataset, Mary E. Helander

Social Science - All Scholarship

OBJECTIVE: The broad absence of definitive patient outcomes in the NEMSIS public release data hinders research that seeks to understand the impact of pre-hospital care, operations, and overall patterns of population health – including geospatial and demographic differences. This study evaluated the recently proposed binary end-of-event outcome indicator to provide additional validity of the method, to evangelize its employment for more studies to analyze survival impact following an emergency medical event, and to identify appropriate use and interpretation given imperfection in predicted outcomes. METHODS: A recently published binary end-of-event outcome indicator was applied to datasets for each year from 2017 …

Food Hygiene And Sanitation At The Jakarta Pondok Gede Hajj Embarkation Dormitory: Food Safety Efforts For The Hajj Pilgrims, Fauziah Hayati, Al Asyary, Bambang Wispriyono, Harunor Rashid, Z Memish

Kesmas

Several health risks are associated with performing Hajj pilgrimage. Food poisoning is a major cause of diarrhea and vomiting during Hajj. Food hygiene is an effort to control aspects of food, people, places, and equipment that could cause disease or health problems. This study aimed to describe food hygiene and sanitation efforts implemented in 2023 at the Jakarta Pondok Gede Hajj Embarkation Dormitory in Jakarta, implemented in 2023 to safeguard foods for the Hajj pilgrims. Using a descriptive qualitative design with a document analysis approach, this study examined activities during the pre-embarkation and embarkation periods. Pre-embarkation efforts included inspecting the …

Needs Of Family Caregivers Of Hospitalised Adults With Dementia During Care Transitions: A Qualitative Study In A Us Department Of Veterans Affairs Hospital, Molly J Horstman, Tracy L Evans, Crystal Guo, Mandi Sonnenfeld, Aanand D Naik, Alan Stevens, Mark E Kunik

Faculty, Staff and Student Publications

OBJECTIVE: To identify the needs of caregivers of hospitalised adults with dementia in the hospital and during care transitions.

DESIGN: Pragmatic qualitative inquiry with semi-structured interviews.

SETTING: Michael E. DeBakey Veterans Affairs Medical Center in Houston, Texas, USA.

PARTICIPANTS: 12 family caregivers (family member (n=11); friend (n=1)) and 15 health professionals (hospital medicine physicians (n=4), inpatient nurse case managers (n=2), social workers (n=4), outpatient geriatrics providers (n=2), a primary care provider (n=1), geriatric psychiatrists (n=2)) were interviewed. Caregivers were recruited while their care recipient was hospitalised and were interviewed at least 2 weeks after the care recipient was discharged from …

Teacher Implementation Profiles: A Response To Top-Down Mandate Of Movement Integration, Zack Beddoes, Jeanne Barcelona, Darla Castelli

International Journal of Physical Activity and Health

This study examined teacher implementation practices to meet a state mandate requiring 135 minutes of student physical activity (PA) weekly. Teachers were required to implement a video-based movement integration (MI) program. Using an embedded mixed-methods design, provider characteristics of 42 teachers and the organizational capacity of six schools were developed from interviews, surveys, observations, and artifacts. Data analysis revealed three teacher profiles (a) Dynamic Experientialists, (b) Coachable Constructivists, and (c) Cautious Behaviorists, and three school profiles (a) Whole Child Approach, (b) Grade Level Champions, and (c) Back to Basics. Findings suggest that school, teacher, …

Epigenome-Wide Association Study Of Prostate Cancer In African American Men Identified Differentially Methylated Genes, Anders Berglund, Kosj Yamoah, Steven A. Eschrich, Rana Falahat, James J. Mulé, Sungjune Kim, Jaime Matta, Julie Dutil, Gilberto Ruiz-Deya, Carmen Ortiz Sanchez, Liang Wang, Hyun Park, Hirendra N. Banerjee, Tamara Lotan, Kathryn Hughes Barry, Ryan M. Putney, Seung Joon Kim, Clement Gwede, Jacob K. Kresovich, Youngchul Kim, Hui Yi Lin, Jasreman Dhillon, Ratna Chakrabarti, Jong Y. Park

School of Public Health Faculty Publications

Introduction: Men with African ancestry have the highest incidence and mortality rates of prostate cancer (PCa) worldwide. Methods: This study aimed to identify differentially methylated genes between tumor vs. adjacent normal and aggressive vs. indolent PCa in 121 African American patients. Epigenome-wide DNA methylation patterns in tumor DNA were assessed using the human Illumina Methylation EPIC V1 array. Results: Around 5,139 differentially methylated CpG-sites (q < 0.01, lΔβl > 0.2) were identified when comparing normal vs. tumor, with an overall trend of hypermethylation in prostate tumors. Multiple representative differentially methylated regions (DMRs), including immune-related genes, such as CD40, Galectin3, OX40L, and STING, were detected …

Microvascular Autologous Breast Reconstruction With The Lateral Thigh Perforator Flap, Stefania M.H. Tuinder, Joep A.F. Van Rooij, Robert J. Allen

School of Medicine Faculty Publications

The lateral thigh perforator flap is an excellent alternative to the deep inferior epigastric artery perforator (DIEP) flap for patients with absolute or relative contraindications for a DIEP flap and adequate volume at the lateral thigh. Preoperative physical examination, preoperative markings, and radiological perforator mapping are essential for adequate surgical preparation. The flap is based on septocutaneous perforators of the lateral circumflex femoral artery, located in the posterior septum between the tensor fascia latae and the gluteus medius muscle. Being relatively stiff, septocutaneous perforators are sensitive to kinking and compression, which is important to keep in mind during flap inset. …

Associations Between The Use Of Ssri Medication In Older Adults And Cognitive Decline And Impairment, Paige Jones

Theses and Dissertations

Previous research has indicated that depression is a risk factor for dementia. Since SSRI medication is the most common treatment for depression, it is important to determine if SSRIs are associated with reduced dementia and better cognitive outcomes. Using longitudinal data from the 2004-2014 waves of the Health and Retirement Study merged with the 2005 Prescription Drug Study, we examined potential associations between SSRI and TCA medication and cognitive impairment and cognitive decline. The study population consisted of 1,775 older adults who participated in the PDS in 2005. We found that SSRIs were associated with significantly higher odds of cognitive …

Inhalational Drug Devices: Revisiting The Linchpin Of Asthma Management, Damini Saxena, Neveda Murugesan, Uyioghosa D Evbayiro, Marina K Ngassa, Muhammad Adrish

Faculty, Staff and Students Publications

Asthma remains a prevalent condition among all age groups globally. First-line treatment requires the delivery of medications into the distal respiratory tract via inhalers. Using appropriate inhaler techniques is a significant challenge in achieving disease control. A variety of inhalers are available for treating asthma, and selecting the appropriate inhaler type for any given patient is crucial to achieving and maintaining symptomatic control. This review will discuss the anatomy and physiology behind drug delivery via inhalers, the types of inhalers currently available for use, nebulizers, and future directions in the delivery of inhaled medications for asthma.

Concussions And Their Relationship With Cheerleading, Jazmin Hampton

Walden Dissertations and Doctoral Studies

Concussions are a major public health issue that impacts a variety of persons. Cheerleading is an emerging popular sport that has seen increased participation. Minimal information about cheerleading and concussions is known. This study aimed to investigate sustaining a concussion as a cheerleader while accounting for demographics (age, race, and gender), mechanism of injury, and injury setting. The precaution adoption process model was the theoretical framework for this study. Chi-square analysis and binary logistic regression were applied to address research questions. Data from 3,536 patients were obtained from the 2018-2022 National Electronic Injury Surveillance System. Findings indicated there were associations …

Redoma: Bayesian Random-Effects Dose-Optimization Meta-Analysis Using Spike-And-Slab Priors, Cheng-Han Yang, Evan Kwiatkowski, J Jack Lee, Ruitao Lin

Faculty, Staff and Student Publications

The rise of cutting-edge precision cancer treatments has led to a growing significance of the optimal biological dose (OBD) in modern oncology trials. These trials now prioritize the consideration of both toxicity and efficacy simultaneously when determining the most desirable dosage for treatment. Traditional approaches in early-phase oncology trials have conventionally relied on the assumption of a monotone relationship between treatment efficacy and dosage. However, this assumption may not hold valid for novel oncology therapies. In reality, the dose-efficacy curve of such treatments may reach a plateau at a specific dose, posing challenges for conventional methods in accurately identifying the …

Recruitment And Retention Of Physician Assistants In Rural Medicine: A Novel Approach, Sean Grabbe

Theses and Graduate Projects

Improving the health of patients requires having access to well trained medical providers. This is one of the main goals of the physician assistant profession. For many years research has documented how to recruit and retain physician assistants in the rural areas of the United States. Although created to fill the gaps in primary care medicine physician assistants have moved as all of medicine has into specialization. This gap in primary care has not closed and is most significant in rural areas. This paper reviews the plethora of research and elaborates on the known and best methods for recruitment and …

Writing For The Journal: A Guide For Community-Based Organizations, Randy Wykoff, Rachel E. Dixon

Journal of Appalachian Health

The Journal of Appalachian Health welcomes submissions from a variety of stakeholders interested in and contributing to improvement of health across the Appalachian Region. This editorial provides basic guidelines for those working in community settings who may with to make JAH (or any other journal) their publication home.

A Social Media Game To Increase Physical Activity Among Older Adult Women: Protocol Of A Randomized Controlled Trial To Evaluate Challenge, Michael C Robertson, Maria Chang Swartz, Karen M Basen-Engquist, Yisheng Li, Kristofer Jennings, Debbe Thompson, Tom Baranowski, Elena Volpi, Elizabeth J Lyons

Faculty, Staff and Student Publications

BACKGROUND: Older adult women often do not engage in sufficient physical activity (PA) and can encounter biological changes that exacerbate the negative effects of inadequate activity. Wearable activity monitors can facilitate PA initiation, but evidence of sustained behavior change is lacking. Supplementing wearable technologies with intervention content that evokes enjoyment, interest, meaning, and personal values associated with PA may support long term adherence. In this paper, we present the protocol of an NIA-funded study designed to evaluate the efficacy of CHALLENGE for increasing step count and motivation for PA in insufficiently active older women (Challenges for Healthy Aging: Leveraging Limits …

Association Of Self-Report Measures With Salivary Biomarkers In Post-Menopausal Women, Laree M. Hiser, Karen Arrant, Jung Hye S. Lee, Lei Zhang

Journal of Public Health in the Deep South

Background: Symptoms of menopause include inadequate sleep, depression, and anxiety. Studies of healthy aging frequently use self-report tools that are unverified by objective measures.

Purpose: To investigate the correlation between self-report measures of sleep or affect and salivary biomarkers in a small (n=32) sample of post-menopausal women.

Methods: Salivary cortisol and a-amylase were quantified by laboratory tests. Self-report data included hours of sleep and Patient-Reported Outcomes Measurement Information System (PROMIS^®) tools for sleep disturbance, anxiety, and depression. Correlation analyses were conducted between self-reported measures and biomarker concentrations.

Results: No statistically significant correlations were found between cortisol …

Unveiling Healthcare Disparities By Addressing Historical Traumas To Build Inclusive Spaces For Marginalized Communities: An Autoethnographic Study, Helena Humphreys

Theses and Graduate Projects

This paper delves into the pervasive disparities within the healthcare system, rooted in historical injustices that are perpetuated by systemic biases, particularly affecting Black, Indigenous, and People of Color (BIPOC) communities, as well as the LGBTQIA2S+ community. Through a comprehensive literature review and autoethnographic study, the paper examines the deep-seated issues faced by these marginalized groups, including access barriers, discrimination, mistrust of healthcare providers, and the enduring impact these have on health outcomes. Historical traumas such as the Tuskegee Syphilis Study and the use of HeLa cells underscore the enduring impact of past injustices on present-day healthcare experiences. Moreover, the …

The Mental Effect Of Obesity On Active-Duty Service Members In The United States: A Phenomenological Approach, Tegan M. Quigley

Doctoral Dissertations and Projects

This phenomenological research was intended to explore the impact that obesity has on the mental health of soldiers in the U.S. military. The U.S. military has stringent physical fitness standards that must be met by each soldier regardless of sex. These standards can be challenging to maintain. Obesity is an increasing issue in the United States, and soldiers are not immune. Research regarding the physical issues that occur from obesity has been performed, but this study aimed to explore the behavioral or mental health effects that obesity can have within the military community. This study explored the following questions: In …