Digital Commons Network^™

Project Task Force - Conceptual Framework, Independence Standards Board

Association Sections, Divisions, Boards, Teams

No abstract provided.

Detection Of Β-Amyloid Positivity In Alzheimer's Disease Neuroimaging Initiative Participants With Demographics, Cognition, Mri And Plasma Biomarkers, Duygu Tosun, James Bollinger, Vitaliy Ovod, Kwasi G Mawuenyega, Randall J Bateman, Et Al.

2020-Current year OA Pubs

No abstract provided.

A Modified Delphi Approach To Develop A Trial Protocol For Antibiotic De-Escalation In Patients With Suspected Sepsis, Michael E Yarrington, Rebekah W Moehring, Michael Z David, Keith W Hamilton, Michael Klompas, Chanu Rhee, Kevin Hsueh, Elizabeth Dodds Ashley, Ronda L Sinkowitz-Cochran, Matthew Ryan, Deverick J Anderson, Detours Expert Panel Of The Cdc Prevention Epicenters Program

2020-Current year OA Pubs

Background: Early administration of antibiotics in sepsis is associated with improved patient outcomes, but safe and generalizable approaches to de-escalate or discontinue antibiotics after suspected sepsis events are unknown.

Methods: We used a modified Delphi approach to identify safety criteria for an opt-out protocol to guide de-escalation or discontinuation of antibiotic therapy after 72 hours in non-ICU patients with suspected sepsis. An expert panel with expertise in antimicrobial stewardship and hospital epidemiology rated 48 unique criteria across 3 electronic survey rating tools. Criteria were rated primarily based on their impact on patient safety and feasibility for extraction from electronic health …

Evaluation Of A Hybrid Antimicrobial Restriction Process At A Large Academic Medical Center, Jesse D Smith, Linh H Nguyen, Tamara Krekel, Jerrica Waggoner, David J Ritchie, Michael J Durkin, Kevin Hsueh, Elizabeth A Neuner

2020-Current year OA Pubs

We conducted a retrospective review of a hybrid antimicrobial restriction process demonstrating adherence to appropriate use criteria in 72% of provisional-only orders, in 100% of provisional orders followed by ID orders, and in 97% of ID-initiated orders. Therapy interruptions occurred in 24% of provisional orders followed by ID orders.

Transmission Dynamics: Data Sharing In The Covid-19 Era, Randi E Foraker, Albert M Lai, Thomas G Kannampallil, Keith F Woeltje, Anne M Trolard, Philip R O Payne

2020-Current year OA Pubs

Problem: The current coronavirus disease 2019 (COVID-19) pandemic underscores the need for building and sustaining public health data infrastructure to support a rapid local, regional, national, and international response. Despite a historical context of public health crises, data sharing agreements and transactional standards do not uniformly exist between institutions which hamper a foundational infrastructure to meet data sharing and integration needs for the advancement of public health.

Approach: There is a growing need to apply population health knowledge with technological solutions to data transfer, integration, and reasoning, to improve health in a broader learning health system ecosystem. To achieve this, …

Incidentally Found Rib Hemangioma: Case Report And Discussion Of Management, Deniz B. Morkan, Jason M. Gauthier, Daniel Kreisel, Varun Puri, Ruben G. Nava

2020-Current year OA Pubs

Rib hemangioma is a rare chest wall tumor for which few reports in the literature exist to help guide treatment. The clinical presentation, radiographic findings, and treatment strategies vary in the literature, with the majority of patients undergoing surgical resection to definitively rule out malignancy. Here, we report a 23-year-old woman with an incidentally discovered rib hemangioma, who had a history of migraines, during the workup of a severe headache refractory to medical treatment. Imaging revealed a solitary, expansile tumor arising from the posterior left third rib. Spinal magnetic resonance imaging (MRI) showed a fat-containing lesion with multiple vascular flow …

Differentiating Wide Complex Tachycardias: A Historical Perspective, Anthony H Kashou, Christopher M Evenson, Peter A Noseworthy, Thoddi R Muralidharan, Christopher V Desimone, Abhishek J Deshmukh, Samuel J Asirvatham, Adam M May

2020-Current year OA Pubs

One of the most critical and challenging skills is the distinction of wide complex tachycardias into ventricular tachycardia or supraventricular wide complex tachycardia. Prompt and accurate differentiation of wide complex tachycardias naturally influences short- and long-term management decisions and may directly affect patient outcomes. Currently, there are many useful electrocardiographic criteria and algorithms designed to distinguish ventricular tachycardia and supraventricular wide complex tachycardia accurately; however, no single approach guarantees diagnostic certainty. In this review, we offer an in-depth analysis of available methods to differentiate wide complex tachycardias by retrospectively examining its rich literature base - one that spans several decades.

Gene Therapy Potential For Genetic Disorders Of Surfactant Dysfunction, Ashley L Cooney, Jennifer A Wambach, Patrick L Sinn, Paul B Mccray

2020-Current year OA Pubs

Pulmonary surfactant is critically important to prevent atelectasis by lowering the surface tension of the alveolar lining liquid. While respiratory distress syndrome (RDS) is common in premature infants, severe RDS in term and late preterm infants suggests an underlying genetic etiology. Pathogenic variants in the genes encoding key components of pulmonary surfactant including surfactant protein B (SP-B,

Rethinking Immune Checkpoint Blockade: Beyond The T Cell, Xiuting Liu, Graham D Hogg, David G Denardo

2020-Current year OA Pubs

The clinical success of immune checkpoint inhibitors has highlighted the central role of the immune system in cancer control. Immune checkpoint inhibitors can reinvigorate anti-cancer immunity and are now the standard of care in a number of malignancies. However, research on immune checkpoint blockade has largely been framed with the central dogma that checkpoint therapies intrinsically target the T cell, triggering the tumoricidal potential of the adaptive immune system. Although T cells undoubtedly remain a critical piece of the story, mounting evidence, reviewed herein, indicates that much of the efficacy of checkpoint therapies may be attributable to the innate immune …

Disease-Modifying Therapy Prescription Patterns In People With Multiple Sclerosis By Age, Yinan Zhang, Amber Salter, Shan Jin, William J Culpepper, Gary R Cutter, Mitchell Wallin, Olaf Stuve

2020-Current year OA Pubs

BACKGROUND: Disease-modifying therapies (DMTs) for multiple sclerosis (MS) are approved for their ability to reduce disease activity, namely clinical relapses and signal changes on magnetic resonance imaging (MRI). Disease activity appears age dependent. Thus, the greatest benefit would be expected in younger people with MS (PwMS) whereas benefits in the elderly are uncertain.

METHODS: Real-world data were obtained from PwMS from the North American Research Committee on Multiple Sclerosis (NARCOMS) registry and the US Department of Veterans Affairs Multiple Sclerosis Surveillance Registry (MSSR).

RESULTS: 6948 PwMS were surveyed from NARCOMS, and the MSSR had 1719 participants. In younger adult PwMS …

Improved Gastrointestinal Profile With Diroximel Fumarate Is Associated With A Positive Impact On Quality Of Life Compared With Dimethyl Fumarate: Results From The Randomized, Double-Blind, Phase Iii Evolve-Ms-2 Study, Annette Wundes, Sibyl Wray, Ralf Gold, Barry A Singer, Elzbieta Jasinska, Tjalf Ziemssen, Jerome De Seze, Pavle Repovic, Hailu Chen, Jerome Hanna, Jordan Messer, Catherine Miller, Robert T Naismith

2020-Current year OA Pubs

BACKGROUND: Diroximel fumarate (DRF) is a novel oral fumarate approved for relapsing forms of multiple sclerosis (MS). DRF demonstrated significantly improved gastrointestinal (GI) tolerability

METHODS: A

RESULTS: In total, 504 patients (DRF,

CONCLUSIONS: The improved GI tolerability with DRF translated into clinically meaningful benefits to QoL, as patients experienced less impact on daily life and work and required less concomitant symptomatic medication use.

TRIAL REGISTRATION: [ClinicalTrials.gov identifier: NCT03093324].

Veterans Health Administration's Whole Health System Of Care: Supporting The Health, Well-Being, And Resiliency Of Employees, Kavitha P Reddy, Tamara M Schult, Alison M Whitehead, Barbara G Bokhour

2020-Current year OA Pubs

The Veterans Health Administration (VHA) is implementing a Whole Health System (WHS) of care that empowers and equips Veterans to take charge of their health and well-being and live their lives to the fullest, and increasingly leaders recognize the need and value in implementing a similar approach to support the health and well-being of employees. The purpose of this paper is to do the following: 1) provide an overview of the WHS of care in VHA and applicability in addressing employee resiliency; 2) provide a brief history of employee well-being efforts in VHA to date; 3) share new priorities from …

Climate Change And Antibiotic Resistance: A Deadly Combination, Jason P Burnham

2020-Current year OA Pubs

Climate change is driven primarily by humanity's use of fossil fuels and the resultant greenhouse gases from their combustion. The effects of climate change on human health are myriad and becomingly increasingly severe as the pace of climate change accelerates. One relatively underreported intersection between health and climate change is that of infections, particularly antibiotic-resistant infections. In this perspective review, the aspects of climate change that have already, will, and could possibly impact the proliferation and dissemination of antibiotic resistance are discussed.

Immunotherapy As A Treatment Strategy In Advanced Stage And Recurrent Endometrial Cancer: Review Of Current Phase Iii Immunotherapy Clinical Trials, Ramez N Eskander, Matthew A Powell

2020-Current year OA Pubs

The treatment of advanced stage, metastatic or recurrent endometrial cancer remains a clinically difficult scenario. Although combination carboplatin and paclitaxel is an effective standard-of-care regimen, alternate strategies have shown promise, particularly in biomarker select populations. In an effort to improve oncologic outcomes, investigators are exploring novel immunotherapy combinations. In this review, we discuss the clinical rationale and design of current phase III immuno-oncology clinical trials in patients with advanced stage or recurrent endometrial cancer.

Anabolic Resistance Of Muscle Protein Turnover Comes In Various Shapes And Sizes, Kevin J M Paulussen, Colleen F Mckenna, Joseph W Beals, Kenneth R Wilund, Amadeo F Salvador, Nicholas A Burd

2020-Current year OA Pubs

Anabolic resistance is defined by a blunted stimulation of muscle protein synthesis rates (MPS) to common anabolic stimuli in skeletal muscle tissue such as dietary protein and exercise. Generally, MPS is the target of most exercise and feeding interventions as muscle protein breakdown rates seem to be less responsive to these stimuli. Ultimately, the blunted responsiveness of MPS to dietary protein and exercise underpins the loss of the amount and quality of skeletal muscle mass leading to decrements in physical performance in these populations. The increase of both habitual physical activity (including structured exercise that targets general fitness characteristics) and …

Convalescent Plasma Therapy For Covid-19: A Graphical Mosaic Of The Worldwide Evidence, Stephen A Klassen, Brenda J Grossman, Jeffrey P Henderson, Et Al.

2020-Current year OA Pubs

Convalescent plasma has been used worldwide to treat patients hospitalized with coronavirus disease 2019 (COVID-19) and prevent disease progression. Despite global usage, uncertainty remains regarding plasma efficacy, as randomized controlled trials (RCTs) have provided divergent evidence regarding the survival benefit of convalescent plasma. Here, we argue that during a global health emergency, the mosaic of evidence originating from multiple levels of the epistemic hierarchy should inform contemporary policy and healthcare decisions. Indeed, worldwide matched-control studies have generally found convalescent plasma to improve COVID-19 patient survival, and RCTs have demonstrated a survival benefit when transfused early in the disease course but …

Immune Cell Analysis Of Pilocytic Astrocytomas Reveals Sexually Dimorphic Brain Region-Specific Differences In T-Cell Content, Jie Chen, Namita Sinha, Olivia Cobb, Collin Liu, Ayca Ersen, Joanna J Phillips, Tarik Tihan, David H Gutmann, Sonika Dahiya

2020-Current year OA Pubs

No abstract provided.

Profiles Of Hiv Care Disruptions Among Adult Patients Lost To Follow-Up In Zambia: A Latent Class Analysis, Aaloke Mody, Kombatende Sikombe, Laura K. Beres, Sandra Simbeza, Njekwa Mukamba, Ingrid Eshun-Wilson, Sheree Schwartz, Jake Pry, Nancy Padian, Charles B. Holmes, Carolyn Bolton-Moore, Izukanji Sikazwe, Elvin H. Geng

2020-Current year OA Pubs

BACKGROUND: Patients report varied barriers to HIV care across multiple domains, but specific barrier patterns may be driven by underlying, but unobserved, behavioral profiles.

METHODS: We traced a probability sample of patients lost to follow-up (>90 days late) as of July 31, 2015 from 64 clinics in Zambia. Among those found alive, we ascertained patient-reported reasons for care disruptions. We performed latent class analysis to identify patient subgroups with similar patterns of reasons reported and assessed the association between class membership and care status (ie, disengaged versus silently transferred to a new site).

RESULTS: Among 547 patients, we identified …

Exploring Intentional Medication Non-Adherence In Patients With Systemic Lupus Erythematosus: The Role Of Physician-Patient Interactions, Jerik Leung, Elizabeth A Baker, Alfred H J Kim

2020-Current year OA Pubs

OBJECTIVE: Medication non-adherence contributes to worse health outcomes among SLE patients. The underlying mechanisms that drive medication non-adherence are poorly understood. The purpose of this study was to explore possible mechanisms of medication non-adherence by eliciting patient experiences.

METHODS: Consented adult patients with ACR- or SLICC-classified SLE were recruited. Ten semi-structured interviews were conducted across six participants. Interviews were audio recorded, transcribed, and analysed using an iterative process. The findings were presented to an interactive public forum with SLE patients, family members and friends of patients, and health-care professionals to assess validity and for elaboration of the concepts developed.

RESULTS: …

Nonliteral Language Processing Across The Lifespan, Kathrin Rothermich, Cristal Giorio, Sharon Falkins, Lindsay Leonard, Angela Roberts

2020-Current year OA Pubs

Studies investigating the effects of aging on nonliteral language processing have mainly focused on one sensory modality, for example written vignettes. In the current study, we used a video-based task to examine the effect of healthy aging on social communication perception using a novel database called RISC (Relation Inference in Social Communication). By means of an online recruitment platform, we asked young, middle-aged, and older adults between the ages of 18 and 76 (N = 100) to evaluate videos of actors using different forms of literal and nonliteral language, such as sarcasm or teasing. The participants' task was to infer …

Context-Responsive Anticoagulation Reduces Complications In Pediatric Extracorporeal Membrane Oxygenation, John C Lin, Lauren M Barron, Adam M Vogel, Ryan M Colvin, Sirine A Baltagi, Allan Doctor, Avihu Z Gazit, Mary Mehegan, Nicole O'Connor, Ahmed S Said, Mark Shepard, Michael Wallendorf, Philip C Spinella

2020-Current year OA Pubs

No abstract provided.

The Genomics Of Heart Failure: Design And Rationale Of The Hermes Consortium, R. Thomas Lumbers, Douglas Mann, Et Al.

2020-Current year OA Pubs

No abstract provided.

Peer-Taught Virtual Research Workshops For Surgical Residents: Protocol For A Novel And Sustainable Solution To Improving Surgical Research In Pakistan, Russell S. Martins, Ronika Devi Ukrani, Mohummad Hassan Raza Raja, Maria Khan, Haissan Iftikhar, Syeda Sadia Fatima, Saulat Fatimi

Medical College Documents

Objective: To generate a protocol describing the methodology for a study assessing the effectiveness of a comprehensive series of peer-taught online research workshops for surgical residents across Pakistan in terms of improving research-related knowledge and skills, and long-term research involvement and output.
Methods: The quasi-experimental study will consist of a series of six online research workshops conducted over Zoom for surgical residents across Pakistan. An online sign-up form will be circulated on social media to current surgical residents throughout Pakistan. Curricular content covered in the workshops will be developed in collaboration with experienced research faculty at the Departments of Surgery …

The Role Of Simulators In Improving Vitreoretinal Surgery Training - A Systematic Review, Taha Muneer Ahmed, Rehman Siddiqui

Medical College Documents

Objective: To conduct an appraisal of current evidence regarding the effectiveness of EyeSi®-based training of vitreoretinal surgery.
Methods: The systematic review was conducted in July 2020, and comprised literature search on Cochrane Library, PubMed and Embase for articles regarding simulation training in vitreoretinal surgery. The shortlisted articles were subjected to qualitative analysis. Existing evidence was assessed, and predictions on how outcomes may be applied to improve vitreoretinal surgery training were made. The risk of bias of each study was calculated in line with the guidelines of the Cochrane Handbook.
Results: Of the 124 articles identified, 7(5.6%) were shortlisted; 5(71.4%) established …

Student-Led Surgical Research Network: Enhancing Medical Student Research Opportunities, Ronika Devi Ukrani, Muhammad Musaab Munir, Areesh Bhatti, Shahryar Noordin

Medical College Documents

The current paper was planned to describe a student-led surgical research network established by the Research Division of the Surgery Interest Group at the Aga Khan University, Karachi. The project involved the creation of a collaborative network to provide opportunities to medical students to work with faculty on research projects. Over 25 students were directly connected with faculty and research mentors to work on research projects in the surgical specialty of their choice. The initiative of establishing a student-led surgical research network was successfully implemented and provided medical students with novel research opportunities by helping bridge the gap between the …

Harassment And Mental Health In Surgical Training: A Pilot Survey Of Surgical Trainees In Pakistan, Russell S. Martins, Syeda Amrah Hashmi, Hina Inam, Mahin Janjua, Mahim Malik

Medical College Documents

Objective: To assess harassment among surgical trainees and its effects on mental health, and to explore its association with gender.
Methods: The nationwide cross-sectional pilot study was conducted by the Association of Women Surgeons of Pakistan from July to September 2019, and included surgical trainees of either gender working in both public and private hospitals. Data was collected using an anonymous online survey form to assess harassment and self-perceived burnout and depression. Data was analysed using SPSS 22.
Results: Of the 147 respondents, 49(33.3%) were males; 98(66.6%) were females; and 118(80.3%) were residents. Workplace harassment was reported by 80(54.4%) trainees. …

Human Cortical Serotonin 2a Receptor Occupancy By Psilocybin Measured Using [11c]Mdl 100,907 Dynamic Pet And A Resting-State Fmri-Based Brain Parcellation, Frederick S Barrett, Yun Zhou, Theresa M Carbonaro, Joshua M Roberts, Gwenn S Smith, Roland R Griffiths, Dean F Wong

2020-Current year OA Pubs

Psilocybin (a serotonin 2A, or 5-HT

Sources And Dissemination Of Information In The Music Community, Dadang Sugiana, Hanny Hafiar

Library Philosophy and Practice (e-journal)

Message or information is the content or substance of communication activities. Communication activities that occur within the Koes Music Fans Club-Jiwa Nusantara Community, have their own uniqueness. The uniqueness are seen in the aspects of information types, sources of literacy, and communication symbols among Koes Plus Band fans. The purpose of this study is to attempt to describe aspects of the type of information, literacy sources, and communication symbols among members of the Koes Music Fans Club-Soul Nusantara community. The method used is a phenomenological method using the constructivist paradigm. The results of this study are messages or information which …

Research Trend On Robotics During 2009-2018: Ascientometric Analysis Based On Scopus Database, Ajay Kumar

Library Philosophy and Practice (e-journal)

The present study aims to analysis the research productivity trend on the title “Robotics” research publications worldwide during 2009-2018 on the base of the Scopus database. A total of 97480 articles has been published on the title “Robotics” in the worldwide during 2008-2018. The highest 11950 (12.26%) articles were published in the year 2018and the publication pattern was gradually in increasing order during the period of study. The maximum AGR 15.36 was calculated in the year 2010, the RGR has been counted 0.77 to 0.13during the period of study. The relative growth rate was always in decreasing order and respective …

Knowledge Sharing Idiosyncrasies Of Research Scholars At Ccs Haryana Agricultural University, Hisar, India, Bhanu Partap, Rajive Kumar Pateria

Library Philosophy and Practice (e-journal)

The main aim of the present study is to investigate the knowledge sharing behaviour of research scholars at Chaudhary Charan Singh Haryana Agricultural University (CCS HAU), Hisar, India. To understand and reveal the knowledge sharing idiosyncrasies of research scholars, various factors have been covered such as knowledge sharing definition, knowledge sharing attitude, communication channels preferred for knowledge sharing, barriers of knowledge sharing, knowledge sharing motivators, and other factors related to knowledge sharing in an academic institution. For the present study, survey method was adopted with the aid of online structured questionnaire for the purpose of data collection. Total 125 research …