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Application Of Informatics Tools To Facilitate The Practice Of Precision Medicine With Genomic Testing And Clinical Data, Michael Sayer

Pharmaceutical Sciences (PhD) Dissertations

The practice of precision medicine considers a variety of sources of information to optimize patient care. Factors such as patient demographics, clinical history, and lab test values have well understood effects on treatment outcomes and influence decision making. However, effective inclusion of biomolecular data such as protein expression and DNA sequencing data within the practice of precision medicine needs continued study. Informatics tools offer solutions to allow these complex data sources to be effectively embraced. Utilization of informatics tools to visualize data pertaining to the gene selection practices of pharmacogenomic (PGx) tests effectively communicated large amounts of information into concise …

Outcomes Following Extracorporeal Membrane Oxygenation For Severe Covid-19 In Pregnancy Or Post Partum, John J Byrne, Amir A Shamshirsaz, Alison G Cahill, Mark A Turrentine, Angela R Seasely, Joe Eid, Caroline E Rouse, Michael Richley, Nandini Raghuraman, Mariam Naqvi, Yasser Y El-Sayed, Martina L Badell, Cece Cheng, James Liu, Emily H Adhikari, Soha S Patel, Erika R O'Neil, Patrick S Ramsey

Faculty, Staff and Student Publications

IMPORTANCE: Existing reports of pregnant patients with COVID-19 disease who require extracorporeal membrane oxygenation (ECMO) are limited, with variable outcomes noted for the maternal-fetal dyad.

OBJECTIVE: To examine maternal and perinatal outcomes associated with ECMO used for COVID-19 with respiratory failure during pregnancy.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective multicenter cohort study examined pregnant and postpartum patients who required ECMO for COVID-19 respiratory failure at 25 hospitals across the US. Eligible patients included individuals who received care at one of the study sites, were diagnosed with SARS-CoV-2 infection during pregnancy or up to 6 weeks post partum by positive nucleic …

Gwas And Meta-Analysis Identifies 49 Genetic Variants Underlying Critical Covid-19, Erola Pairo-Castineira, Konrad Rawlik, Andrew D Bretherick, Ting Qi, Yang Wu, Isar Nassiri, Glenn A Mcconkey, Marie Zechner, Lucija Klaric, Fiona Griffiths, Wilna Oosthuyzen, Athanasios Kousathanas, Anne Richmond, Jonathan Millar, Clark D Russell, Tomas Malinauskas, Ryan Thwaites, Kirstie Morrice, Sean Keating, David Maslove, Alistair Nichol, Malcolm G Semple, Julian Knight, Manu Shankar-Hari, Charlotte Summers, Charles Hinds, Peter Horby, Lowell Ling, Danny Mcauley, Hugh Montgomery, Peter J M Openshaw, Colin Begg, Timothy Walsh, Albert Tenesa, Carlos Flores, José A Riancho, Augusto Rojas-Martinez, Pablo Lapunzina, Genomicc Investigators, Scourge Consortium, Isaricc Investigators, 23andme Covid-19 Team, Jian Yang, Chris P Ponting, James F Wilson, Veronique Vitart, Malak Abedalthagafi, Andre D Luchessi, Esteban J Parra, Raquel Cruz, Angel Carracedo, Angie Fawkes, Lee Murphy, Kathy Rowan, Alexandre C Pereira, Andy Law, Benjamin Fairfax, Sara Clohisey Hendry, J Kenneth Baillie

Faculty, Staff and Student Publications

Critical illness in COVID-19 is an extreme and clinically homogeneous disease phenotype that we have previously shown1 to be highly efficient for discovery of genetic associations2. Despite the advanced stage of illness at presentation, we have shown that host genetics in patients who are critically ill with COVID-19 can identify immunomodulatory therapies with strong beneficial effects in this group3. Here we analyse 24,202 cases of COVID-19 with critical illness comprising a combination of microarray genotype and whole-genome sequencing data from cases of critical illness in the international GenOMICC (11,440 cases) study, combined with other studies recruiting hospitalized patients with a …

Meeting, Moving, Mastering - A Text Analysis Of The Aesthetic Attractions Of 'Wild Swimming', Dagmar Dahl, Åsa I. Bäckström

International Journal of Aquatic Research and Education

Why are people fascinated by swimming in nature? This article addresses the aesthetic experiences of wild swimming as expressed by five wild swimming authors in their books. Drawing from aesthetic philosophy, we analyze the ways in which the appeal of wild swimming is described on three levels: the allure of water in the environment, the sensory encounter between water and the body, and the experience of moving in water. Furthermore, with reference to Seel’s concept of nature aesthetics (1996), the experience of wild swimming is analyzed in terms of contemplation, correspondence, and imagination. We can conclude that the special intensity …

Which Stroke Next? All Strokes Next! Part Two: Strokes For Intermediate And Advanced Swimmers, Robert Keig Stallman, Ebbe L. Horneman, Nils O. Vikander, Alexander Mwaipasi, Bente W. H. Laakso, Haakon - Paavo L. Nysted, Toni Ongala

International Journal of Aquatic Research and Education

The primary goal of this two-part project is to answer the rhetorical question of which strokes should be taught first, and which later (Langendorfer, 2013, Stallman, 2014a). As you have seen in Part One, we emphasize (as have many others) the need for a firm foundation before any stroke is introduced. When the learner is ready for propulsive motor competencies, there is no stroke which suits all as their first. In Part One we explored the “beginning strokes” all of which are candidates for any given learner’s first stroke. We also argued that after mastering their very first stroke the …

Dietary Determinants Of Stunting And Underweight In Under- Five Years Children In Pengasinan Health Center's (Puskesmas) Working Area, Depok, West Java, Muthia Syifa Rahmadina, Ratih Qamara Dewi, Arif Hidayat, Satria Yudistira, Fadila Wirawan

Indonesian Journal of Public Health Nutrition (IJPHN)

Stunting and underweight are public health problems, especially in under-five children. This study aims to explore the dietary determinants of stunting and underweight. Participants were 52 under-five children who visited Posyandu in Pengasinan and Bedahan, Depok. Body weight for age z-score (WAZ) and height for age z-score (HAZ) were measured with standardized measurement tools by trained operators. Questionnaires were administered to determine sociodemographic, maternal, and child health history, sanitation, disease history, and exclusive breastfeeding history. Data on food intake was obtained through the semi-quantitative Food Frequency Questionnaire and 24-hour recall. There was a significant correlation between the mother’s income with …

Conditional Concordance-Assisted Learning Under Matched Case-Control Design For Combining Biomarkers For Population Screening, Wen Li, Ruosha Li, Qingxiang Yan, Ziding Feng, Jing Ning

Faculty, Staff and Student Publications

Incorporating promising biomarkers into cancer screening practices for early-detection is increasingly appealing because of the unsatisfactory performance of current cancer screening strategies. The matched case-control design is commonly adopted in biomarker development studies to evaluate the discriminative power of biomarker candidates, with an intention to eliminate confounding effects. Data from matched case-control studies have been routinely analyzed by the conditional logistic regression, although the assumed logit link between biomarker combinations and disease risk may not always hold. We propose a conditional concordance-assisted learning method, which is distribution-free, for identifying an optimal combination of biomarkers to discriminate cases and controls. We …

Analysis Of Energy Balance In Obese Healthcare Workers, Nani Cahyani Sudarsono, Ria Lestari, Tiffany Georgine T’Sidkenu Widjaja

Indonesian Journal of Public Health Nutrition (IJPHN)

Obesity is a global health challenge that seriously affects developing countries, including Indonesia. It is important to discover the energy balance calculated from energy intake and energy expenditure in obese individuals, especially in obese healthcare workers. This study aimed to analyze the balance of energy intake and expenditure, body composition, and physical activity level in obese healthcare workers at the Exercise Center of Indonesia Medical Education and Research Institute (IMERI FKUI). A cross-sectional study was held at Exercise Center IMERI FKUI. Total sampling was the sampling method utilized in the study. Study participants (aged above 18 years) were screened by …

The Effectiveness Of Nem (Nutrizone Educational Media) Compared With Knowledge And Attitudes In Early Adults In The West Jakarta Region, Daniel Hartanto, Laras Sitoayu, Lintang Purwara Dewanti, Harna Harna, Mertien Sa’Pang

Indonesian Journal of Public Health Nutrition (IJPHN)

Metabolic syndrome is a disease that often occurs in early adulthood. Maintaining a good lifestyle to prevent non-communicable diseases is very important to maintain a good quality of life. In early adulthood, most of them are still not exposed to information related to metabolic syndrome, so it is necessary to provide interventions associated with it. This study uses the Nutrizone gameboard intervention media. Good early adults’ knowledge and attitude about Metabolic Syndrome may lead to a good lifestyle that prevents them from suffering from NCDs. An intervention media may improve their knowledge and attitude. The research design used was pre-experimental …

Associated Food Parenting Practices And Other Factors With Fruit And Vegetable Consumption In Students In Jakarta, Indonesia, Gina Amalia Chaerunnisa, Triyanti Triyanti

Indonesian Journal of Public Health Nutrition (IJPHN)

The increased risk of non-communicable diseases is still a problem in Indonesia, one of which is the lack of consumption of fruits and vegetables. The available data shows that although fruits and vegetables have a protective/protective effect on the incidence of non-communicable diseases but in real life, the average consumption of fruits and vegetables is still below the recommended intake. Thus, the protective effect cannot be seen clearly. This study aims to describe the consumption of fruits and vegetables and determine the factors of food parenting practices and other factors related to the consumption of fruits and vegetables in students …

Revisiting The Metaphorical Concept Of “No Strokes First - All Strokes First”: Part One - Beginning Strokes, Robert Keig Stallman Ph.D., Alex Mwaipasi, Ebbe Laakso Horneman, Nils Olof Vikander, Bente Wäinösdatter Horneman Laakso, Haakon-Paavo Laakso Nysted, Toni Ongala

International Journal of Aquatic Research and Education

The aim of this article is to address the familiar question “Which swimming stroke should be taught first?” The discussion is usually focused on breaststroke versus crawl. Provoked by these naïve discussions of which stroke should be taught first (as if stroking equals swimming, which it emphatically does NOT), the question was answered metaphorically in an earlier article “No Stroke First – All Strokes First” (Stallman, 2008a). Here in Part I we identify and describe six strokes, all of which might be a candidate for any learners ‘very first’ stroke. We describe them as beginning strokes. Having identified and learned …

Unmet Need For Family Planning In Indonesia And Its Associated Factors, Dewi Nuryana, Restu Adya Cahyani, Sukma Rahayu, Nohan Arum Romadlona, Elvira Liyanto, Lovely Daisy, Wira Hartiti, Maria Evi Ratnawati, Budi Utomo, Robert Joseph Magnani

Makara Journal of Health Research

Background: The unmet need for family planning in Indonesia has been stagnant since the early 2000s in the 10%–12% range with substantial socioeconomic and geographic disparities. This study sought to better understand the factors underlying the nonuse of contraceptives among women with an apparent need for family planning so that evidence-based corrective actions can be taken.

Methods: Three sources of quantitative data were used in the study—the 2017 Indonesia Demographic Health Survey, the 2018 Village Potential Survey, and the National Population and Family Planning Board service statistics. Further insights were obtained from online focus group discussions and in-depth …

Building An Infrastructure For Down Syndrome Care, Kate E. Martin

Instructional Design Capstones Collection

People with intellectual disabilities experience greater obstacles in attaining their full health potential. The most common identifiable cause of intellectual disability is Down syndrome. Established in September 2021, the Down Syndrome Program at The Kirk Kerkorian School of Medicine at the University of Nevada, Las Vegas (UNLV) aims to meet the healthcare needs of members of the Southern Nevada community with Down syndrome and their families. However, there is currently no infrastructure in place in Southern Nevada to provide Down syndrome care, or clinical services dedicated to individuals with the condition. This work discusses options that were explored to develop …

2023-04-26_Michiganoverview_Covidvaccinestats, Michigan Department Of Health & Human Services

Michigan COVID-19 Vaccine Data

The COVID Vaccine Dashboard page was obtained from Michigan's main COVID-19 page: https://www.michigan.gov/coronavirus/resources/covid-19-vaccine/covid-19-dashboard.

First-dose tracker above is for entire Michigan Population. Coverage maps below are for age 5+.

Previously reported numbers of administered vaccine doses may change as new data are received. A possible lag in reporting vaccine doses will result in increases in numbers previously reported.

This report is created by the Michigan Department of Health and Human Services Division of Immunization from data reported to the Michigan Care Improvement Registry (MCIR).

The dashboard contained the tabs Primary Series Doses Administered, Primary Series Doses by Vaccine, …

Communicating Health: Misinformation And Mistrust In The Age Of Coronavirus, Chris Anstead

Undergraduate Theses

With one of the most advanced medical systems in the world, the Untied States still experienced an exceedingly high COVID-19 death rate per capita. Because biomedical therapies for COVID-19 were available, the focus of this review is on the social aspects of the COVID-19 response. By observing how Americans reacted to vaccination, masking, and social distancing guidelines, as well as how those guidelines were communicated to the general population from the public and private sectors, this thesis argues that the social and political aspects of the COVID-19 pandemic played a significant role in the outcome of the pandemic response. Additionally, …

A Novel Method For Measuring The Burden Of Breast Cancer In Neighborhoods, Russell K. Mcintire, Hee-Soon Juon, Scott W. Keith, Nicole L. Simone, Dexter Waters, Eleanor Lewis, Charnita Zeigler-Johnson

College of Population Health Faculty Papers

Community-based breast cancer prevention efforts often focus on women who live in the same neighborhoods, as they tend to have similar demographic characteristics, health behaviors, and environmental exposures; yet little research describes methods of selecting neighborhoods of focus for community-based cancer prevention interventions. Studies frequently use demographics from census data, or single breast cancer outcomes (e.g., mortality, morbidity) in order to choose neighborhoods of focus for breast cancer interventions, which may not be optimal. This study presents a novel method for measuring the burden of breast cancer among neighborhoods that could be used for selecting neighborhoods of focus. In this …

2023-04-25_Michiganoverview_Covidlongtermcare, Michigan Department Of Health & Human Services

Michigan COVID-19 Long Term Care Data

The COVID Long Term Care Facilities page was obtained from Michigan's COVID-19 data page: https://www.michigan.gov/coronavirus/stats/data-about-places/long-term-care-data.

This report is created by the Michigan Department of Health & Human Services from data self-reported by long-term care facilities into EMResource. Data for all reporting facilities is posted weekly each Monday.

The information below represents COVID-19 data reported directly to MDHHS by licensed and operating Skilled Nursing, Home for the Aged and Adult Foster Care facilities (licensed to serve 13 or more individuals) in Michigan from January 1, 2020. All long-term care facilities additionally have an obligation to report COVID-positive residents and/or staff …

2023-04-25_Michiganoverview_Covidstats, Michigan Department Of Health & Human Services

Cumulative Michigan COVID-19 Data

The COVID Overview page was obtained from Michigan's main COVID-19 page: https://www.michigan.gov/coronavirus/stats.

The State of Michigan is working around the clock to test and treat COVID-19 patients. Below is the most recent data healthcare experts across the state have compiled. COVID case and testing data will be posted once a week on Tuesdays.

This report is provisional and subject to change. City of Detroit and Wayne County are reported separately. MDHHS began tracking probable cases April 5, 2020. FCI indicates federal correctional institute. MDOC indicates Michigan Department of Corrections. Diagnostic tests, including nucleic acid amplification/real-time polymerase chain reaction (NAAT/RT-PCR) …

The Effects Of Multiple Micronutrient Fortified Beverage And Responsive Caregiving Interventions On Early Childhood Development, Hemoglobin, And Ferritin Among Infants In Rural Guatemala, Alysse J. Kowalski, Victor Alfonso Mayen, Silvia De Ponce, Kaley B. Lambden, Nick Tilton, Lisa M. Villanueva, Ana M. Palacios, Greg A. Reinhart, Kristen M. Hurley, Maureen M. Black

Health Policy & Community Health: Faculty Publications

Undernutrition and a lack of learning opportunities can jeopardize long-term growth and development among infants in low- and middle-income countries. We conducted a 6-month 2 × 2 cluster-randomized trial to assess the effects of multiple micronutrient-fortified beverages and responsive caregiving interventions among infants 6–18 months in 72 community sectors in southwest Guatemala. We administered baseline and endline assessments of childhood development (Bayley Scales of Infant and Toddler Development) and socioemotional development (Brief Infant Toddler Socio-Emotional Assessment) and measured ferritin and hemoglobin on a subsample. The trial was analyzed using linear mixed models. At the baseline, the mean age (SD) was …

Covid-19 Coagulopathies: Highlights Of 2020–2021 Reported Data, Shreya Anil Kumar, Anushka Pradhan, Abdelrahman Elsebaie, Karina Fainchtein, Abdelrahman Noureldin, Yousra Tera, Sajida Kazi, Maha Othman

The University of Louisville Journal of Respiratory Infections

Background: The COVID-19 pandemic has evolved dramatically over the past two years, and literature on COVID-19 coagulopathy has been overwhelming, which complicates the process of understanding the literature or assessing the quality of the data available. The objective of this narrative review was to highlight and analyze data reported on COVID-19-induced coagulopathy and its outcomes in patients with severe or critical disease over two years of the pandemic.

Methods: Studies published in high-impact journals reporting on hospitalized adult COVID-19 patients, their coagulation parameters, and their thrombotic complications were included. We searched MEDLINE, Embase, and Ovid between Dec 1, 2019 and …

What Works For Aboriginal And Torres Strait Islander Men? A Systematic Review Of The Literature, Jack R. Menges, Marie L. Caltabiano, Alan Clough

Journal of the Australian Indigenous HealthInfoNet

Aboriginal and Torres Strait Islander men experience significantly higher rates of suicide, trauma, alcohol related deaths and unemployment than other Australian men. Despite significant levels of government intervention, rates of family violence, unemployment and incarceration continue to increase in Aboriginal and Torres Strait Islander communities. As a subset of the Aboriginal and Torres Strait Islander population, there has been a lesser focus on how to meaningfully improve the wellbeing of Aboriginal and Torres Strait Islander men. This systematic review seeks to understand what interventions, programs and activities are successful in improving the wellbeing of Aboriginal and Torres Strait Islander men …

A Better Life: Factors That Help And Hinder Entry And Retention In Mat From The Perspective Of People In Recovery, Adam D. Baus, Martha Carter, Jennifer Boyd, Erin Mcmullen, Trey Bennett, Alexandra Persily, Danielle M. Davidov, Christa Lilly

Journal of Appalachian Health

Introduction: Opioid addiction and opioid-related overdoses and deaths are serious public health problems nationally and in West Virginia, in particular. Medication-assisted treatment (MAT) is an effective yet underutilized treatment for opioid use disorder (OUD).

Purpose: Research examining factors that help individuals succeed in MAT has been conducted from provider and program perspectives, but little research has been conducted from the perspective of those in recovery.

Methods: This study, co-developed with individuals in recovery, took place in West Virginia-based MAT programs using an exploratory sequential mixed methods approach. The survey was open February through August 2021. Data were analyzed late 2021 …

Prevalence And Factors Of Self-Medication With Antibiotics In Claiborne County, Tennessee, Kimberly A. Carney, Lauren Wisnieski, Tristan Lackey, Donald Noah

Journal of Appalachian Health

Introduction: Antimicrobial resistance (AMR) is a serious concern to public health, causing an estimated 35,000 deaths annually in the U.S. Misuse of antimicrobials increases the rate of AMR. Self-medication with antibiotics (SMA) is a primary contributor to AMR that can be addressed through education. SMA has been reported at rates of 3% to 66% in the U.S. but has not been evaluated in Appalachia.¹ Low health literacy and barriers to accessing care have been correlated with SMA and are common in many areas of Appalachia.

Purpose: This study aims to assess factors associated with SMA, demographic differences in knowledge …

An Analysis Of Burnout And Wellness Of Healthcare Workers Based On Patient Population And Healthcare Worker Location, Spencer Brandenburg

Undergraduate Theses

Healthcare workers, even with all of the positive work that they do, often suffer from increased burnout and decreased wellness/quality of life. This problem is not new and has been steadily worsening for many years, however, there are factors which impact burnout and wellness that have not been analyzed or have produced mixed results in prior burnout and wellness literature. There has been little to no research done on the impact of patient population demographics on burnout and wellness in healthcare workers, and the research analyzing the impacts of demographic healthcare worker location has consistently produced mixed results often based …

Advance Care Planning: An Evidence-Based Practice Project, Gabrielle Alanna Harvey

Evidence-Based Practice Project Reports

Advance care planning (ACP) is a topic that can be difficult for patients and providers to discuss due to lack of time, knowledge, communication skills, and discomfort surrounding the subject (Barkley et al., 2019; Hafid et al., 2021; Halpert et al., 2022; Marin, 2022). Delayed or absent ACP discussions may lead to nonbeneficial care, increased healthcare costs, end of life suffering and increased post-death family distress (Halpert et al., 2022; O’Hanlon et al., 2018). The purpose of this evidence-based practice (EBP) project was to increase the discussions and documentation regarding ACP in a family practice setting. The PICOT question guiding …

A Cascade Of Care Of Patients With Hepatitis C Infection In A Rural State, Wollelaw Agmas, Wendy Craig, Kathleen Fairfield, Brian F. King, Elizabeth Eisenhardt, Kinna Thakarar

Journal of Maine Medical Center

Introduction: The substance misuse epidemic has fueled an increase in hepatitis C virus (HCV) infections. Despite the availability of sensitive screening and curative treatment, relatively few people are aware of their diagnosis and engaged in care. In this study, we aimed to identify local gaps in HCV care and inform strategies for improvement.

Methods: In this retrospective study, we assessed adult patients seen at a tertiary care center from 2015 to 2019 and who were eligible for HCV screening based on recommendations from the Centers for Disease Control and Prevention. Inclusion criteria were birth from 1945 to 1965, long-term dialysis …

Join Or Die: How Deontological Moral Intuitions Complicate Cooperation Amid The Covid-19 Pandemic, Alessandro Del Ponte

Political Science Faculty Articles and Research

Tackling COVID-19 requires universal collective action: everyone must play their part to reduce the spread of the virus and quell the pandemic. Yet, some people obstinately refuse to cooperate, irrespective of the consequences for themselves and others. In this note, I illustrate a key element of human psychology that hampers cooperation amid the pandemic: deontological moral intuitions. Deontological morality prescribes that moral taboos must be followed no matter the consequences. This means that people who consider Covid vaccines a moral taboo are prepared to suffer virtually any consequence rather than take the vaccine. I discuss the evolutionary basis of deontological …

Cost Effectiveness Of Buprenorphine When Used Long Term Versus Short Term Use, Ty Hudgens

MUSC Theses and Dissertations

Since 1999, nearly 841,000 people have died from a drug overdose (CDC, 2022), and substance use disorder (SUD) continues to be a crisis that faces communities across the country. As the crisis continues across communities, the need for medication-assisted opioid use disorder (MOUD) therapy continues to surge.

This was a retrospective analysis of archival data from large national data sources. We constructed well-matched cohorts of patients with short and long-term use of MOUD using propensity score matching of 3 months of baseline data. To measure the cost effectiveness of short-term buprenorphine use verse long-term buprenorphine use.

2023-04-19_Michiganoverview_Covidvaccinestats, Michigan Department Of Health & Human Services

Michigan COVID-19 Vaccine Data

The COVID Vaccine Dashboard page was obtained from Michigan's main COVID-19 page: https://www.michigan.gov/coronavirus/resources/covid-19-vaccine/covid-19-dashboard.

First-dose tracker above is for entire Michigan Population. Coverage maps below are for age 5+.

Previously reported numbers of administered vaccine doses may change as new data are received. A possible lag in reporting vaccine doses will result in increases in numbers previously reported.

This report is created by the Michigan Department of Health and Human Services Division of Immunization from data reported to the Michigan Care Improvement Registry (MCIR).

The dashboard contained the tabs Primary Series Doses Administered, Primary Series Doses by Vaccine, …

Family-Based Interventions Impact On Pediatric Obesity, Renee Camins

Nursing | Student Research Posters

Background: Obesity rates among children in the United States have been on the rise, with 19.7% of children aged 2-19 classified as obese (CDC, 2022). Low socioeconomic status is a risk factor for pediatric obesity,Children from low-income households are more likely to be overweight or obese than their peers from higher economic backgrounds. Obesity can lead to serious and chronic health problems such as diabetes, high blood pressure, and breathing difficulties, and is also a risk factor for leading causes of death in adults including stroke, cardiovascular disease, and cancer (CDC, 2022). Educational interventions and access to exercise resources may …