Digital Commons Network^™

Minimizing Blood Loss In Spine Surgery., Christopher Mikhail, Zach Pennington, Paul M Arnold, Darrel S Brodke, Jens R Chapman, Norman Chutkan, Michael D Daubs, John G Devine, Michael G Fehlings, Daniel E Gelb, George M Ghobrial, James S Harrop, Christian Hoelscher, Fan Jiang, John J Knightly, Brian K Kwon, Thomas E Mroz, Ahmad Nassr, K Daniel Riew, Lali H Sekhon, Justin S Smith, Vincent C Traynelis, Jeffrey C Wang, Michael H Weber, Jefferson R Wilson, Christopher D Witiw, Daniel M Sciubba, Samuel K Cho

Department of Neurosurgery Faculty Papers

Study Design: Broad narrative review.

Objective: To review and summarize the current literature on guidelines, outcomes, techniques and indications surrounding multiple modalities of minimizing blood loss in spine surgery.

Methods: A thorough review of peer-reviewed literature was performed on the guidelines, outcomes, techniques, and indications for multiple modalities of minimizing blood loss in spine surgery.

Results: There is a large body of literature that provides a consensus on guidelines regarding the appropriate timing of discontinuation of anticoagulation, aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), and herbal supplements prior to surgery. Additionally, there is a more heterogenous discussion the utility of preoperative autologous …

The Chironian 2020, New York Medical College

The Chironian

No abstract provided.

Processing And Characterization Of Ceria-Zirconia Containing Graphene Quantum Dots, Andrew Dina

Master's Theses

Zirconia-based nanoparticles have been used in various applications, such as catalyst, filters, oxygen storage, and sensors. Among many synthesis methods to produce zirconia (ZrO2) nanoparticles, aqueous sodium borohydride (NaBH4) precipitation has shown to be simple and capable of large-scale production. In this work, the NaBH4 precipitation of ZrO2 was extended to include ceria (CeO2) and graphene quantum dots (GQDs). The resulting nanocomposites were characterized by thermal, crystallographic, compositional, and electron microscopy analysis techniques. The presence of CeO2 lowered the amorphous to tetragonal phase transformation temperature by ~40 ℃. The presence of GQDs did not affect the amorphous to tetragonal transformation …

Nexgen D-Tcp: Next Generation Dynamic Tcp Congestion Control Algorithm, Madhan Raj Kanagarathinam, Sukhdeep Singh, Irlanki Sandeep, Hanseok Kim, Mukesh Kumar Maheshwari, Jaehyun Hwang, Abhishek Roy, Navrati Saxena

Faculty Research, Scholarly, and Creative Activity

With the advancement of wireless access networks and mmWave New Radio (NR), new applications emerged, which requires a high data rate. The random packet loss due to mobility and channel conditions in a wireless network is not negligible, which degrades the significant performance of the Transmission Control Protocol (TCP). The TCP has been extensively deployed for congestion control in the communication network during the last two decades. Different variants are proposed to improve the performance of TCP in various scenarios, specifically in lossy and high bandwidth-delay product (high- BDP) networks. Implementing a new TCP congestion control algorithm whose performance is …

Third-Party Effects In Stakeholder Interviews, Melissa Beresford, J. Leah Jones, Julia C. Bausch, Clinton F. Williams, Amber Wutich, Sarah Porter, Barbara Quimby, Weston M. Eaton, Kathryn J. Brasier

Faculty Research, Scholarly, and Creative Activity

This paper examines the effect of having a third-party scientific expert present in stakeholder interviews. The study was conducted as part of a larger project on stakeholder engagement for natural resource management in the Verde Valley region of Arizona. We employed an experimental design, conducting stakeholder interviews both with and without an identified scientific expert present. Our sample consisted of 12 pairs of interviewees (24 total participants) who we matched based on their occupation, sex, and spatial proximity. For each pair, the scientific expert was present as a third party in one interview and absent in the other. We used …

Improvement Of Tcad Augmented Machine Learning Using Autoencoder For Semiconductor Variation Identification And Inverse Design, Kashyap Mehta, Sophia Susan Raju, Ming Xiao, Boyan Wang, Yuhao Zhang, Hiu Yung Wong

Faculty Research, Scholarly, and Creative Activity

A machine learning (ML) model by combing two autoencoders and one linear regression model is proposed to avoid overfitting and to improve the accuracy of Technology Computer-Aided Design (TCAD)-augmented ML for semiconductor structural variation identification and inverse design, without using domain expertise. TCAD-augmented ML utilizes TCAD simulations to generate sufficient data for ML model development when experimental data are inadequate. The ML model can then be used to identify semiconductor structural variation for given experimental electrical measurements. In this study, the variation of layer thicknesses in the p-i-n diode is used as a demonstration. An ML model is developed to …

Energy Filtering Effect At Source Contact On Ultra-Scaled Mosfets, Johan Saltin, Nguyen Cong Dao, Philip H.W. Leong, Hiu Yung Wong

Faculty Research, Scholarly, and Creative Activity

We postulate that in ultra-scaled Field Effect Transistors (FET), such as nanowires in sub-7nm technology, the source contact will act as an energy filter and increase the effective temperature of carriers arriving at the channel barrier. This is due to the absence of inelastic scattering in the short source-contact-to-channel region. As a result, the Sub-threshold Slope (SS) will increase substantially. In this paper, we verify this energy filtering effect through numerical calculations and Technology Computer-Aided-Design (TCAD) simulations calibrated to quantum solvers for electrostatics. It is found that SS degradation increases as the source metal workfunction increases. At 300K, in the …

Conceptual Cognitive Modeling For Fine-Grained Annotation Quality Assessment Of Object Detection Datasets, Lei Guo, Xinying Xu, Gang Xie, Jerry Gao

Faculty Research, Scholarly, and Creative Activity

No abstract provided.

The 2018 Camp Fire: Meteorological Analysis Using In Situ Observations And Numerical Simulations, Matthew J. Brewer, Craig B. Clements

Faculty Research, Scholarly, and Creative Activity

The November 2018 Camp Fire quickly became the deadliest and most destructive wildfire in California history. In this case study, we investigate the contribution of meteorological conditions and, in particular, a downslope windstorm that occurred during the 2018 Camp Fire. Dry seasonal conditions prior to ignition led to 100-h fuel moisture contents in the region to reach record low levels. Meteorological observations were primarily made from a number of remote automatic weather stations and a mobile scanning Doppler lidar deployed to the fire on 8 November 2018. Additionally, gridded operational forecast models and high-resolution meteorological simulations were synthesized in the …

Spatial Particulate Fields During Highwinds In The Imperial Valley, California, Frank R. Freedman, Paul English, Jeff Wagner, Yang Liu, Akula Venkatram, Daniel Q. Tong, Mohammad Z. Al-Hamdan, Meytar Sorek-Hamer, Robert Chatfield, Ana Rivera, Patrick L. Kinney

Faculty Research, Scholarly, and Creative Activity

We examined windblown dust within the Imperial Valley (CA) during strong springtime west-southwesterly (WSW) wind events. Analysis of routine agency meteorological and ambient particulate matter (PM) measurements identified 165 high WSW wind events between March and June 2013 to 2019. The PM concentrations over these days are higher at northern valley monitoring sites, with daily PM mass concentration of particles less than 10 micrometers aerodynamic diameter (PM10) at these sites commonly greater than 100 μg/m3 and reaching around 400 μg/m3, and daily PM mass concentration of particles less than 2.5 micrometers aerodynamic diameter (PM2.5) commonly greater than 20 μg/m3 and …

Screening Gender Minority People For Harmful Alcohol Use, Annesa Flentje, Branden T. Barger, Matthew R. Capriotti, Micah E. Lubensky, Matthew Tierney, Juno Obedin-Maliver, Mitchell R. Lunn

Faculty Research, Scholarly, and Creative Activity

This study identifies how to screen for harmful alcohol use among gender minority (e.g., transgender and gender-expansive) people using brief screening methods and identifies which screening methods perform best among gender-expansive, transfeminine, and transmasculine subgroups, as screening recommendations are not currently available. Using 2018 Annual Questionnaire data from The PRIDE Study, area under the curve (AUC) values were compared to identify which screening methods (“4 or more” or “5 or more” drinks on one occasion in the past year, or one or more items from the Alcohol Use Disorders Identification Test [AUDIT]) best predicted (i) harmful alcohol use and (ii) …

Innovation Institutions And The Opioid Crisis, Daniel J. Hemel, Lisa Larrimore Ouellette

Coase-Sandor Institute for Law & Economics Research Paper Series

The United States has recently—and belatedly—come to recognize opioid addiction as a public health crisis. What has gone mostly unrecognized is the degree to which this crisis is intertwined with U.S. intellectual property law and related elements of U.S. innovation policy. Innovation institutions—the legal arrangements that structure incentives for production and allocation of knowledge goods—encouraged the development and commercialization of addictive painkillers, restricted access to opioid antidotes, and (perhaps most importantly) failed to facilitate investments in alternative, non-addictive treatments for chronic pain. Although innovation policy does not bear all the blame for the opioid wave that has washed over communities …

Drugs, Patents, And Well-Being, Christopher Buccafusco, Jonathan S. Masur

Coase-Sandor Institute for Law & Economics Research Paper Series

The ultimate end of patent law must be to spur innovations that improve human welfare—innovations that make people better off. But firms will only invest resources in developing patentable inventions that will allow them to make money—that is, inventions that people will want to use and buy. This can gravely distort the types of incentives that firms face and the types of inventions they pursue. Nowhere is this truer than in the pharmaceutical field. There is by now substantial evidence that treatments for diseases that primarily afflict poorer people—including the citizens of developing nations—are dramatically under-produced, compared with drugs that …

Antibiotic Development — Economic, Regulatory And Societal Challenges, Christine Årdal, Manica Balasegaram, Ramanan Laxminarayan, David Mcadams, Kevin Outterson, John H. Rex, Nithima Sumpradit

Faculty Scholarship

Antibiotic resistance is undoubtedly one of the greatest challenges to global health, and the emergence of resistance has outpaced the development of new antibiotics. However, investments by the pharmaceutical industry and biotechnology companies for research into and development of new antibiotics are diminishing. The public health implications of a drying antibiotic pipeline are recognized by policymakers, regulators and many companies. In this Viewpoint article, seven experts discuss the challenges that are contributing to the decline in antibiotic drug discovery and development, and the national and international initiatives aimed at incentivizing research and the development of new antibiotics to improve the …

Racial Purges, Robert L. Tsai

Faculty Scholarship

In a two-year period, 1885-86, over 168 communities in America forcibly expelled Chinese residents from their midst. This essay, inspired by historian Beth Lew-Williams's book, THE CHINESE MUST GO, investigates the nineteenth-century purges of Chinese residents that occurred throughout the American west. I make three arguments. First, these acts of racial and political terror complicate our understanding of racial violence in America. Many of the actions were denounced, but they were also surprisingly effective in forcing business and political leaders to support the indefinite suspension of Chinese migration. Perpetrators faced almost no legal repercussions, and unlike for freed persons, racial …

The Growth And Need For Veterans Treatment Courts, Chad Lennon

Touro Law Review

No abstract provided.

Foreword To The Symposium: Jewish Law And American Law: A Comparative Study, Samuel J. Levine

Touro Law Review

No abstract provided.

Herman Melville’S Billy Budd: Why This Classic Law And Literature Novel Endures And Is Still Relevant Today, Rodger Citron

Touro Law Review

No abstract provided.

Trajectories Of Hiv-Related Internalized Stigma And Disclosure Concerns Among Art Initiators And Non-Initiators In South Africa, Brian T. Chan, Brendan G. Maughan-Brown, Laura M. Bogart, Valerie A. Earnshaw, Gugulethu Tshabalala, Ingrid Courtney, Janan J. Dietrich, Catherine Orrell, Glenda Gray, David R. Bangsberg, Alexander C. Tsai, Ingrid T. Katz

OHSU-PSU School of Public Health Faculty Publications and Presentations

HIV-related stigma among people living with HIV (PLHIV) is associated with worse health outcomes. We used longitudinal data from a multisite cohort in South Africa to assess changes over time in stigma after HIV diagnosis and determine whether antiretroviral therapy (ART) initiation is associated with stigma reduction. We administered the Internalized AIDS-Related Stigma Scale (IARSS, a six-item dichotomous scale questionnaire) at baseline, 3 months, and 6 months to newly diagnosed ART-eligible participants between 2014 and 2015. A confirmatory factor analysis indicated that the IARSS contained a four-item internalized stigma factor (α = .80) and a two-item disclosure concerns factor (α …

Mobile Health Technologies May Be Acceptable Tools For Providing Social Support To Tuberculosis Patients In Rural Uganda: A Parallel Mixed-Method Study, Angella Musiimenta, Wilson Tumuhimbise, Esther Atukunda, Aaron T. Mugaba, Conrad Muzoora, Mari Armstrong-Hough, David Bangsberg, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background. Social support has been shown to mitigate social barriers to medication adherence and improve tuberculosis (TB) treatment success rates. The use of mobile technology to activate social support systems among TB patients, however, has not been well explored. Moreover, studies that tie supportive SMS (Short Message Service) texts to electronic monitoring of TB medication adherence are lacking.

Objective. To explore TB patients’ current access to social support and perceptions of utilizing real-time adherence monitoring interventions to support medication adherence. Methods. We purposively selected TB patients who owned phones, had been taking TB medications for ≥1 month, were receiving their …

Time-To-Completed-Imaging, Survival And Function In Patients With Spinal Epidural Abscess: Description Of A Series Of 34 Patients, 2015–2018, Caroline King, Cameron Fisher, Patrick C.M. Brown, Kelsey C. Priest, Mary Tanski, Peter Sullivan

OHSU-PSU School of Public Health Faculty Publications and Presentations

Introduction: Spinal epidural abscess (SEA) is a rare and life-threatening infection with increasing incidence over the past two decades. Delays in diagnosis can cause significant morbidity and mortality among patients.

Objective: The objective of this study was to describe trends in time-to-imaging and intervention, risk factors, and outcomes among patients presenting to the emergency department with SEA at a single academic medical center in Portland, Oregon.

Methods: This retrospective cohort study analyzed data from patients with new SEA diagnosis at a single hospital from October 1, 2015 to April 1, 2018. We describe averages to time-to-imaging and …

Super Learner Analysis Of Real-Time Electronically Monitored Adherence To Antiretroviral Therapy Under Constrained Optimization And Comparison To Non-Differentiated Care Approaches For Persons Living With Hiv In Rural Uganda, Alejandra E. Benitez, Nicholas Musinguzi, David Bangsberg, Mwebesa B. Bwana, Conrad Muzoora, Peter Hunt, Jeffrey N. Martin, Jessica E. Haberer, Maya L. Petersen

OHSU-PSU School of Public Health Faculty Publications and Presentations

Introduction

Real‐time electronic adherence monitoring (EAM) systems could inform on‐going risk assessment for HIV viraemia and be used to personalize viral load testing schedules. We evaluated the potential of real‐time EAM (transferred via cellular signal) and standard EAM (downloaded via USB cable) in rural Uganda to inform individually differentiated viral load testing strategies by applying machine learning approaches.

Methods

We evaluated an observational cohort of persons living with HIV and treated with antiretroviral therapy (ART) who were monitored longitudinally with standard EAM from 2005 to 2011 and real‐time EAM from 2011 to 2015. Super learner, an ensemble machine learning method, …

Hiv Care Continuum Characteristics Among People With Opioid Use Disorder And Hiv In Vietnam: Baseline Results From The Bravo Study, Caroline King, Le Minh Giang, Gavin Bart, Lynn Elizabeth Kunkel, P. Todd Korthuis

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background

Little is known about patient characteristics that contribute to initiating antiretroviral therapy (ART) and achieving viral suppression among HIV people with opioid use disorder in Vietnam. The primary objective of this analysis was to evaluate associations between participant characteristics and the critical steps in the HIV care continuum of ART initiation and HIV viral suppression among people with opioid use disorder and HIV in Vietnam.

Methods

We assessed baseline participant characteristics, ART status, and HIV viral suppression (HIV RNA PCR < 200 copies/mL) enrolled in a clinical trial of HIV clinic-based buprenorphine versus referral for methadone among people with opioid use disorder in Vietnam. We developed logistic regression models to identify characteristics associated with ART status and HIV viral suppression.

Results

Among 283 study participants, 191 (67.5%) were prescribed ART at baseline, and 168 of those on ART (90%) …

A Sexual Health Promotion App For Transgender Women (Trans Women Connected): Development And Usability Study, Christina J. Sun, Kirsten M. Anderson, Tamara Kuhn, Liat Tzvia Mayer, Charles H. Klein

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: HIV severely impacts the transgender communities in the United States, and transgender women have the highest HIV incidence rates among any identified risk group. Guided by formative research with transgender women and by an expert advisory panel of transgender women, we designed a prototype mobile app to promote HIV prevention among transgender women.

Objective: This study aimed to develop and test the usability and acceptability of the prototype Trans Women Connected mobile app.

Methods: We engaged in a 3-phase prototype development process. After conducting formative research about the health needs of this population, we outlined a theory-based app framework …

Sildenafil For The Treatment Of Alzheimer’S Disease: A Systematic Review, Owen Sanders

OHSU-PSU School of Public Health Faculty Publications and Presentations

Nitric oxide/cyclic guanosine monophosphate (cGMP) signaling is compromised in Alzheimer’s disease (AD), and phosphodiesterase 5 (PDE5), which degrades cGMP, is upregulated. Sildenafil inhibits PDE5 and increases cGMP levels. Integrating previous findings, we determine that most doses of sildenafil (especially low doses) likely activate peroxisome proliferator-activated receptor-γ coactivator 1α (PGC1α) via protein kinase G-mediated cyclic adenosine monophosphate (cAMP) response element binding protein (CREB) phosphorylation and/or Sirtuin-1 activation and PGC1α deacetylation. Via PGC1α signaling, low-dose sildenafil likely suppresses β-secretase 1 expression and amyloid-β (Aβ) generation, upregulates antioxidant enzymes, and induces mitochondrial biogenesis. Plus, sildenafil should increase brain perfusion, insulin sensitivity, long-term potentiation, …

Validation Of Microrna Biomarkers For Alzheimer’S Disease In Human Cerebrospinal Fluid, Jack T. Wiedrick, Jay I. Phillips, Theresa A. Lusardi, Trevor J. Mcfarland, Babbet Lind, Ursula K. Sandau, Christina A. Harrington, Jodi A. Lapidusa, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

We previously discovered microRNAs (miRNAs) in cerebrospinal fluid (CSF) that differentiate Alzheimer’s disease (AD) patients from Controls. Here we examined the performance of 37 candidate AD miRNA biomarkers in a new and independent cohort of CSF from 47 AD patients and 71 Controls on custom TaqMan arrays. We employed a consensus ranking approach to provide an overall priority score for each miRNA, then used multimarker models to assess the relative contributions of the top-ranking miRNAs to differentiate AD from Controls. We assessed classification performance of the top-ranking miRNAs when combined with apolipoprotein E4 (APOE4) genotype status or CSF amyloid-β42 (Aβ42):total …

Analysis Of Covid-19 Transmission: Low Risk Of Presymptomatic Spread?, Mark K. Slifka, William B. Messer, Ian J. Amanna

OHSU-PSU School of Public Health Faculty Publications and Presentations

More than 6 million confirmed cases of COVID-19 (coronavirus disease 2019) have been identified worldwide and a number of case reports1-5 have indicated that COVID-19 has the potential to be transmitted prior to disease onset. Studies have also shown that infectious virus can be isolated from presymptomatic COVID-19 cases6 and although it is unknown what level of infectious virus is needed to confer efficient transmission potential, detection of infectious virus in the upper respiratory tract indicates that presymptomatic transmission of COVID-19 is plausible. Fear of asymptomatic and presymptomatic transmission of COVID-19 has led to considerable concern among public health policy …

Improving Smoking Cessation Outcomes Through Tailored-Risk Patient Messages At A University Hospital Tobacco Cessation Service, David Gonzales, Wendy G. Bjornson, Catherine J. Markin, Trisha M. Coleman, Frances Favela, Noal Clemons, Caroline Koudelka, Jodi Lapidus

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Postdischarge follow-up is a critical step for increasing effectiveness of hospital smoking cessation treatment. A quality improvement project was undertaken at an academic medical center tobacco cessation consult service to evaluate whether a tailored message (TM) linking immediate risks of continued smoking—particularly carbon monoxide exposure— to hospital recovery would stimulate more patient interest in the hospital’s cessation treatment, including agreement to postdischarge follow-up, compared to patients receiving the usual treatment protocol with a standard message (SM) regarding more general health benefits of abstinence. Methods: Data from 697 smokers ordered/referred for smoking cessation treatment in 2013 who received either the …

Tracking Multimorbidity Changes In Diverse Racial/Ethnic Populations Over Time: Issues And Considerations, Ana R. Quiñones, Heather G. Allore, Anda Botoseneanu, Jason T. Newsom, Corey L. Nagel, David A. Dorr

OHSU-PSU School of Public Health Faculty Publications and Presentations

Multimorbidity is widely recognized as having adverse effects on health and wellbeing and may threaten the ability of older adults to live independently. Much of what is known about multimorbidity rests on research that has largely focused on one point in time, or from a static perspective. Given that there remains a lack of agreement in the field on how to standardize multimorbidity definitions and measurement, it is not surprising that analyzing and predicting multimorbidity development, progression over time, and its impact are still largely unaddressed. As a result, there are important gaps and challenges to measuring and studying multimorbidity …

Screening For Unhealthy Drug Use: Updated Evidence Report And Systematic Review For The Us Preventive Services Task Force, Carrie D. Patnode, Leslie A. Perdue, Megan Rushkin, Tracy Dana, Ian Blazina, Christina Bougatsos, Sara Grusing, Elizabeth A. O'Connor, Rongwei Fu, Roger Chou

OHSU-PSU School of Public Health Faculty Publications and Presentations

IMPORTANCE

Illicit drug use is among the most common causes of preventable morbidity and mortality in the US.

OBJECTIVE

To systematically review the literature on screening and interventions for drug use to inform the US Preventive Services Task Force.

DATA SOURCES MEDLINE, PubMed, PsycINFO, Embase, and Cochrane Central Register of Controlled Trials through September 18, 2018; literature surveillance through September 21, 2019. STUDY SELECTION Test accuracy studies to detect drug misuse and randomized clinical trials of screening and interventions to reduce drug use. DATA EXTRACTION AND SYNTHESIS Critical appraisal and data abstraction by 2 reviewers and random-effects meta-analyses. MAIN OUTCOMES …