Digital Commons Network^™

Advances In Our Clinical Understanding Of Autonomic Regulation Therapy Using Vagal Nerve Stimulation In Patients Living With Heart Failure, Marvin A Konstam, Douglas L Mann, John James E Udelson, Jeffrey L Ardell, Gaetano M De Ferrari, Martin R Cowie, Helmut U Klein, Douglas D Gregory, Joseph M Massaro, Imad Libbus, Lorenzo A Dicarlo, Javed Butler, John D Parker, John R Teerlink

2020-Current year OA Pubs

The ANTHEM-HF, INOVATE-HF, and NECTAR-HF clinical studies of autonomic regulation therapy (ART) using vagus nerve stimulation (VNS) systems have collectively provided dose-ranging information enabling the development of several working hypotheses on how stimulation frequency can be utilized during VNS for tolerability and improving cardiovascular outcomes in patients living with heart failure (HF) and reduced ejection fraction (HFrEF). Changes in heart rate dynamics, comprising reduced heart rate (HR) and increased HR variability, are a biomarker of autonomic nerve system engagement and cardiac control, and appear to be sensitive to VNS that is delivered using a stimulation frequency that is similar to …

Maya-Kwobabiny: Re-Embedding Language At Kepa Kurl, Western Australia, Clint Bracknell, Amy Budrikis, Roma Yibiyung Winmar

Research outputs 2022 to 2026

This paper describes a Nyungar language revitalisation project in the southern region of Western Australia conducted in partnership between a university research team and the Esperance Tjaltjraak Native Title Aboriginal Corporation. It discusses how linguistic analysis of historical Nyungar documentation was essential to addressing community aims of re-embedding the language into the community, developing and using pedagogical resources, and exploring new domains for language use. In particular, this paper focuses on the community’s desire for the reclamation of a dialectal flavour of Nyungar that is distinctive to the Esperance region, and the factors contributing to a successful partnership between the …

Myth-Busting In An Aboriginal Pre-University Bridging Program: Embedding Transformative Learning Pedagogy, Rebecca Bennett, Karin Strehlow, Braden Hill

Research outputs 2022 to 2026

Pre-university bridging programs can address the significant under-representation of Indigenous students in Australian universities by providing culturally supported alternative pathways into undergraduate study. However, successful completion of bridging programs does not always correlate with university enrolment for Indigenous students. This paper offers a pedagogical rationale for an Indigenous bridging program that aims to address this discrepancy. The program curriculum challenges deficit myths about Aboriginal and Torres Strait Islander Australians and education, while developing foundational academic skills for university study. Leveraging Transformative Learning and Cultural Interface theories, the program aims to empower students with the opportunity to develop their own narratives …

Nexus Between Constructs Of Social Cognitive Theory Model And Diabetes Self-Management Among Ghanaian Diabetic Patients: A Mediation Modelling Approach, Yaa Obirikorang, Emmanuel Acheampong, Enoch Odame Anto, Ebenezer Afrifa-Yamoah, Eric Adua, John Taylor, Linda Ahenkorah Fondjo, Sylvester Yao Lokpo, Evans Asamoah Adu, Bernard Adutwum, Enoch Ofori Antwi, Emmanuella Nsenbah Acheampong, Michael Adu Gyamfi, Freeman Aidoo, Eddie-Williams Owiredu, Christian Obirikorang

Research outputs 2022 to 2026

The promotion of Diabetes Self-Management (DSM) practices, education, and support is vital to improving the care and wellbeing of diabetic patients. Identifying factors that affect DSM behaviours may be useful to promote healthy living among these patients. The study assessed the determinants of DSM practices among Type 2 diabetes mellitus (T2DM) patients using a model-based social cognitive theory (SCT). This cross-sectional study comprised 420 (T2DM) patients who visited the Diabetic Clinic of the Komfo Anokye Teaching Hospital (KATH), Kumasi-Ghana. Data was collected using self-structured questionnaires to obtain socio-demographic characteristics, T2DM-related knowledge, DSM practices, SCT constructs; beliefs in treatment effectiveness, level …

Perspectives On Wider Integration Of The Health-Assistive Smart Home, Gordana Dermody, Jenna Mikus, Davina Porock, Dov Sugarman, Naeem K. Janjua, Christopher How, Roschelle Fritz

Research outputs 2022 to 2026

Most older adults desire to be as independent as possible and remain living in their ancestral home as they age. Aging-in-place maximizes the independence of older adults, enhancing their wellbeing and quality of life while decreasing the financial burden of residential care costs. However, due to chronic disease, multimorbidity, and age-related changes, appropriate conditions are required to make aging-in-place possible. Remote monitoring with smart home technologies could provide the infrastructure that enables older adults to remain living independently in their own homes safely. The health-assistive smart home shows great promise, but there are challenges to integrating smart homes on a …

Selective Harmonic Mitigation Based Two-Scale Frequency Control Of Cascaded Modified Packed U-Cell Inverters, Hasan Iqbal, Mohd Tariq, Mohammad Sarfraz, Arif I. Sarwat, Waleed Alhosaini, Obaid Aldosari, Asma Aziz

Research outputs 2022 to 2026

A new Modified Packed U-Cell (MPUC) converter architecture with cascading is proposed in this paper. To provide an output voltage of 25 levels, the proposed cascaded MPUC needs only twelve power switches and four power sources. The converter comprises two cascaded MPUCs with DC supply in a ratio of 5 : 1. One converter is operating at low frequency (LF) and the other at high frequency (HF) that leads to lower power losses and higher levels. Besides, a variable frequency method is anticipated to produce a 25-level output voltage which has low harmonic content (THD) with the help of Selective …

Speaking Of Online Learning: Alternative Practice-Based Learning Experiences For Speech Pathologists In Australia, Ghana And Hong Kong, Jemma Skeat, Josephine Ohenewa Bampoe, Susan Booth, Emily Brogan, Maya Conway, Rachel Davenport, Simone Howells, Peggy Kan, Michelle Krahe, Sally Hewat, Abigail Lewis, Alex Little, Joanne Walters, Gwendalyn Webb, Nikki Worthington

Research outputs 2022 to 2026

Speech Pathology programs usually send students to workplaces to learn clinical skills necessary for practice. During COVID-19, programs needed to respond quickly to ensure that students continued to gain the necessary experiences and skills required to progress through their program and graduate as clinicians, while simultaneously complying with COVID-19 requirements. Case studies from seven different universities in Australia, Ghana and Hong Kong described the diverse ways in which placements were adapted to be COVID-safe, taking into account local needs. Some practices which had been included in placement education prior to the pandemic, such as telepractice and simulation-based learning, were extended …

Statistical Analysis Plan For The Stepped-Wedge Clinical Trial Healing Right Way - Enhancing Rehabilitation Services For Aboriginal Australians After Brain Injury, Elizabeth Armstrong, Tapan Rai, Deborah Hersh, Sandra Thompson, Juli Coffin, Natalie Ciccone, Leon Flicker, Dominique Cadilhac, Erin Godecke, Deborah Woods, Colleen Hayward, Graeme J. Hankey, Meaghan Mcallister, Judith Katzenellenbogen

Research outputs 2022 to 2026

Background: Aboriginal Australians are known to suffer high levels of acquired brain injury (stroke and traumatic brain injury) yet experience significant barriers in accessing rehabilitation services. The aim of the Healing Right Way trial is to evaluate a culturally secure intervention for Aboriginal people with newly acquired brain injury to improve their rehabilitation experience and quality of life. Following publication of the trial protocol, this paper outlines the statistical analysis plan prior to locking the database. Methods: The trial involves a stepped wedge design with four steps over 3 years. Participants were 108 adult Aboriginal Australians admitted to one of …

The Knowledge Produced Through Student Drawings, Vesife Hatisaru

Research outputs 2022 to 2026

Drawings have been extensively used as a research method to gather data from research participants including school students regarding their perceptions of mathematics and its teaching and learning. What is valued in drawing-based research in mathematics education, and what kind of knowledge is produced through student drawings, however, is not known. This study examines drawing-based research studies to understand these questions by applying a novel framework – the legitimation code theory (LCT). The study focuses on two cases: one of which looked at middle school students’ images of mathematicians (draw a mathematician) and the other examined the same age group …

Deep Learning Inspired Feature Engineering For Classifying Tremor Severity, Ahmed Al Taee, Seyedehmarzieh Hosseini, Rami N. Khushaba, Tanveer Zia, Chin-Teng Lin, Adel Al-Jumaily

Research outputs 2022 to 2026

Bio-signals pattern recognition systems can be impacted by several factors with a potential to limit their associated performance and clinical translation. Among these factors, selecting the optimum feature extraction method, that can effectively exploit the interaction between the temporal and spatial information, is the most prominent. Despite the potential of deep learning (DL) models for extracting temporal, spatial, or temporal-spatial information, they are typically restricted by their need for a large amount of training data. The deep wavelet scattering transform (WST) is a relatively recent advancement within the DL literature to replace expensive convolution neural networks models with computationally less …

Effectiveness Of Universal Newborn Hearing Screening: A Systematic Review And Meta-Analysis, Karen Edmond, Shelly Chadha, Cynthia Hunnicutt, Natalie Strobel, Vinaya Manchaiah, Christine Yoshinaga-Itano, Universal Newborn Hearing Screening (Unhs) Review Group

Research outputs 2022 to 2026

Background:

Permanent bilateral hearing loss (PBHL) is a serious condition in newborns, with a prevalence of at least one per 1000 live births. However, there has been no recent systematic review and meta-analysis of the effectiveness of universal newborn hearing screening programs (UNHS).

Methods:

We registered our study protocol on PROSPERO CRD42020175451. Primary outcomes were any identification of PBHL (ie, PBHL diagnosed at any time), age of identification of PBHL, and neurodevelopment. Two reviewers searched standard databases to March 2022 and extracted data. We used fixed and random effects meta-analysis to pool data and graded the certainty of evidence using …

Sepsis Prediction For The General Ward Setting, Sean C Yu, Aditi Gupta, Kevin D Betthauser, Patrick G Lyons, Albert M Lai, Marin H Kollef, Philip R O Payne, Andrew P Michelson

2020-Current year OA Pubs

OBJECTIVE: To develop and evaluate a sepsis prediction model for the general ward setting and extend the evaluation through a novel pseudo-prospective trial design.

DESIGN: Retrospective analysis of data extracted from electronic health records (EHR).

SETTING: Single, tertiary-care academic medical center in St. Louis, MO, USA.

PATIENTS: Adult, non-surgical inpatients admitted between January 1, 2012 and June 1, 2019.

INTERVENTIONS: None.

MEASUREMENTS AND MAIN RESULTS: Of the 70,034 included patient encounters, 3.1% were septic based on the Sepsis-3 criteria. Features were generated from the EHR data and were used to develop a machine learning model to predict sepsis 6-h ahead …

Using Innovation-Corps (I-Corps™) Methods To Adapt A Mobile Health (Mhealth) Obesity Treatment For Community Mental Health Settings, Rita Haddad, Carolina Badke D'Andrea, Amanda Ricchio, Bradley Evanoff, Elaine H Morrato, Joseph Parks, John W Newcomer, Ginger E Nicol

2020-Current year OA Pubs

BACKGROUND: We employed Innovation Corps (I-Corps™) methods to adaptation of a mobile health (mHealth) short-message-system (SMS) -based interactive obesity treatment approach (iOTA) for adults with severe mentall illness receiving care in community settings.

METHODS: We hypothesized "jobs to be done" in three broad stakeholder groups: "decision makers" (DM = state and community clinic administrators), "clinician consumers" (CC = case managers, peer supports, nurses, prescribers) and "service consumers" (SC = patients, peers and family members). Semistructured interviews (

RESULTS: Four themes emerged across groups: education, inertia, resources and ownership. Sub-themes in education and ownership differed between DM and CC groups on …

Stt Kadesi’S Disrupting The Teaching And Learning Process During Covid-19, Muner Daliman, Hana Suparti, Jonathan D. James, Eudia Anggelia Ika Agustin, Hengky Wijaya

Research outputs 2022 to 2026

In this paper we report on a pilot study of the teaching and learning at Sekolah Tinggi Teologi KADESI (STTK), a tertiary theological institution in Yogyakarta, during the Covid-19 pandemic in 2020. Our methods for collecting data were to survey the 40 students and conduct one-to-one interviews with the 10 lecturers at STTK. The analysis of data drew on two theoretical constructs: Donald Schön’s reflection-in-action and the notion of empowerment in an educational context. We found challenges and difficulties to do with the logistics of teaching and the barriers to communication between instructors and students. And on the positive side, …

Biometric Security: A Novel Ear Recognition Approach Using A 3d Morphable Ear Model, Md Mursalin, Mohiuddin Ahmed, Paul Haskell-Dowland

Research outputs 2022 to 2026

Biometrics is a critical component of cybersecurity that identifies persons by verifying their behavioral and physical traits. In biometric-based authentication, each individual can be correctly recognized based on their intrinsic behavioral or physical features, such as face, fingerprint, iris, and ears. This work proposes a novel approach for human identification using 3D ear images. Usually, in conventional methods, the probe image is registered with each gallery image using computational heavy registration algorithms, making it practically infeasible due to the time-consuming recognition process. Therefore, this work proposes a recognition pipeline that reduces the one-to-one registration between probe and gallery. First, a …

Influenza: Toward Understanding The Immune Response In The Young, Sonia Sakleshpur, Ashley L Steed

2020-Current year OA Pubs

Annually influenza causes a global epidemic resulting in 290,000 to 650,000 deaths and extracts a massive toll on healthcare and the economy. Infants and children are more susceptible to infection and have more severe symptoms than adults likely mitigated by differences in their innate and adaptive immune responses. While it is unclear the exact mechanisms with which the young combat influenza, it is increasingly understood that their immune responses differ from adults. Specifically, underproduction of IFN-γ and IL-12 by the innate immune system likely hampers viral clearance while upregulation of IL-6 may create excessive damaging inflammation. The infant's adaptive immune …

Understanding The Contribution Of Metabolism To Mycobacterium Tuberculosis Drug Tolerance, Amanda N Samuels, Erin R Wang, Gregory A Harrison, Joy C Valenta, Christina L Stallings

2020-Current year OA Pubs

Treatment of

Deep Profiling Of Multiple Ischemic Lesions In A Large, Multi-Center Cohort: Frequency, Spatial Distribution, And Associations To Clinical Characteristics, Anna K Bonkhoff, Laura Heitsch, Chia-Ling Phuah, Et Al.

2020-Current year OA Pubs

BACKGROUND PURPOSE: A substantial number of patients with acute ischemic stroke (AIS) experience multiple acute lesions (MAL). We here aimed to scrutinize MAL in a large radiologically deep-phenotyped cohort.

MATERIALS AND METHODS: Analyses relied upon imaging and clinical data from the international MRI-GENIE study. Imaging data comprised both Fluid-attenuated inversion recovery (FLAIR) for white matter hyperintensity (WMH) burden estimation and diffusion-weighted imaging (DWI) sequences for the assessment of acute stroke lesions. The initial step featured the systematic evaluation of occurrences of MAL within one and several vascular supply territories. Associations between MAL and important imaging and clinical characteristics were subsequently …

Binary Acoustic Metasurfaces For Dynamic Focusing Of Transcranial Ultrasound, Zhongtao Hu, Yaoheng Yang, Lu Xu, Yao Hao, Hong Chen

2020-Current year OA Pubs

Transcranial focused ultrasound (tFUS) is a promising technique for non-invasive and spatially targeted neuromodulation and treatment of brain diseases. Acoustic lenses were designed to correct the skull-induced beam aberration, but these designs could only generate static focused ultrasound beams inside the brain. Here, we designed and 3D printed binary acoustic metasurfaces (BAMs) for skull aberration correction and dynamic ultrasound beam focusing. BAMs were designed by binarizing the phase distribution at the surface of the metasurfaces. The phase distribution was calculated based on time reversal to correct the skull-induced phase aberration. The binarization enabled the ultrasound beam to be dynamically steered …

Classical And Γδ T Cells Are Each Independently Sufficient To Establish Protection Against A Classical Strain Of Klebsiella Pneumoniae, Joseph J Mackel, Catherine Morffy Smith, Rachel K Wasbotten, Joy Twentyman, David A Rosen

2020-Current year OA Pubs

Infections with classical strains of the Gram-negative bacterium

Mesenchymal Gene Expression Subtyping Analysis For Early-Stage Human Papillomavirus-Negative Head And Neck Squamous Cell Carcinoma Reveals Prognostic And Predictive Applications, Gregory M Mayhew, Joshua M Uronis, David Neil Hayes, Jose P Zevallos

2020-Current year OA Pubs

Patients with oral cavity squamous cell carcinoma (OCSCC) are predominantly human papillomavirus (HPV)(-), and treatment typically involves surgical resection ± neck dissection, followed by radiation ± chemotherapy. We previously described four mRNA expression patterns (classical, atypical, basal, and mesenchymal), each with unique genomic features and prognosis. Here, we examine the clinical utility of gene expression subtyping in head and neck squamous cell carcinoma (HNSCC) and introduce potentially predictive applications in HPV(-) OCSCC. A retrospective genomic database analysis was performed including 562 HNSCC patients from MD Anderson (MDA-GSE41116) and The Cancer Genome Atlas (TCGA). Samples were assigned molecular subtypes (classical, atypical, …

A Role For An Htlv-1 Vaccine?, Lee Ratner

2020-Current year OA Pubs

HTLV-1 is a global infection with 5-20 million infected individuals. Although only a minority of infected individuals develop myelopathy, lymphoproliferative malignancy, or inflammatory disorders, infection is associated with immunosuppression and shorter survival. Transmission of HTLV-1 is through contaminated blood or needles, mother-to-child exposure through breast-feeding, and sexual intercourse. HTLV-1 is a delta retrovirus that expresses immunogenic Gag, Envelope, TAX, and Hbz proteins. Neutralizing antibodies have been identified directed against the surface envelope protein, and cytotoxic T-cell epitopes within TAX have been characterized. Thus far, there have been few investigations of vaccines directed against each of these proteins, with limited responses, …

In And Out: Leishmania Metastasis By Hijacking Lymphatic System And Migrating Immune Cells, Baijayanti Jha, Marta Reverte, Catherine Ronet, Florence Prevel, Florence D Morgenthaler, Chantal Desponds, Lon-Fye Lye, Katherine L Owens, Leonardo Scarpellino, Lalit Kumar Dubey, Amélie Sabine, Tatiana V Petrova, Sanjiv A Luther, Stephen M Beverley, Nicolas Fasel

2020-Current year OA Pubs

The lymphatic system plays a crucial role in mounting immune response against intracellular pathogens, and recent studies have documented its role in facilitating tumor dissemination linked largely with cancer cells. However, in mucocutaneous leishmaniasis (MCL) caused by

Survival After Simultaneous Pancreas-Kidney Transplantation In Type 1 Diabetes: The Critical Role Of Early Pancreas Allograft Function, Mengmeng Ji, Mei Wang, Wenjun Hu, Mohamed Ibrahim, Krista L. Lentine, Massini Merzkani, Haris Murad, Yazen Al-Hosni, Ronald Parsons, Jason Wellen, Su-Hsin Chang, Tarek Alhamad

2020-Current year OA Pubs

Simultaneous pancreas-kidney transplantation (SPK) carries about a 7%-22% risk of technical failure, but the impact of early pancreas allograft loss on subsequent kidney graft and patient survival is not well-defined. We examined national transplant registry data for type 1 diabetic patients who received SPK between 2000 and 2021. Associations of transplant type (i.e., SPK, deceased-donor kidney transplant [DDKA], living-donor kidney transplant [LDKA]) with kidney graft failure and patient survival were estimated by multivariable inverse probability of treatment-weighted accelerated failure-time models. Compared to SPK recipients with a functioning pancreas graft 3 months posttransplant (SPK,P+), LDKA had 18% (Time Ratio [TR] 0.82, …

Enhancing Neuroimaging Genetics Through Meta-Analysis For Tourette Syndrome (Enigma-Ts): A Worldwide Platform For Collaboration, Peristera Paschou, Emily D Bihun, Tamara Hershey, Jonathan M Koller, Kevin J. Black, Et Al.

2020-Current year OA Pubs

Tourette syndrome (TS) is characterized by multiple motor and vocal tics, and high-comorbidity rates with other neuropsychiatric disorders. Obsessive compulsive disorder (OCD), attention deficit hyperactivity disorder (ADHD), autism spectrum disorders (ASDs), major depressive disorder (MDD), and anxiety disorders (AXDs) are among the most prevalent TS comorbidities. To date, studies on TS brain structure and function have been limited in size with efforts mostly fragmented. This leads to low-statistical power, discordant results due to differences in approaches, and hinders the ability to stratify patients according to clinical parameters and investigate comorbidity patterns. Here, we present the scientific premise, perspectives, and key …

Examining Virtual Driving Test Performance And Its Relationship To Individuals With Hiv-Associated Neurocognitive Disorders, David Grethlein, Vanessa Pirrone, Kathryn N Devlin, Will Dampier, Zsofia Szep, Flaura K Winston, Santiago Ontañón, Elizabeth A Walshe, Kim Malone, Shinika Tillman, Beau M Ances, Venk Kandadai, Dennis L Kolson, Brian Wigdahl

2020-Current year OA Pubs

SIGNIFICANCE: Existing screening tools for HIV-associated neurocognitive disorders (HAND) are often clinically impractical for detecting milder forms of impairment. The formal diagnosis of HAND requires an assessment of both cognition and impairment in activities of daily living (ADL). To address the critical need for identifying patients who may have disability associated with HAND, we implemented a low-cost screening tool, the Virtual Driving Test (VDT) platform, in a vulnerable cohort of people with HIV (PWH). The VDT presents an opportunity to cost-effectively screen for milder forms of impairment while providing practical guidance for a cognitively demanding ADL.

OBJECTIVES: We aimed to: …

Cd4+ T-Lymphocytes Exhibit Biphasic Kinetics Post-Myocardial Infarction, Vinay Kumar, Sumanth D Prabhu, Shyam S Bansal

2020-Current year OA Pubs

CD4

Endogenous Opioid Systems Alterations In Pain And Opioid Use Disorder, Jessica A Higginbotham, Tamara Markovic, Nicolas Massaly, Jose A Morón

2020-Current year OA Pubs

Decades of research advances have established a central role for endogenous opioid systems in regulating reward processing, mood, motivation, learning and memory, gastrointestinal function, and pain relief. Endogenous opioid systems are present ubiquitously throughout the central and peripheral nervous system. They are composed of four families, namely the μ (MOPR), κ (KOPR), δ (DOPR), and nociceptin/orphanin FQ (NOPR) opioid receptors systems. These receptors signal through the action of their endogenous opioid peptides β-endorphins, dynorphins, enkephalins, and nociceptins, respectfully, to maintain homeostasis under normal physiological states. Due to their prominent role in pain regulation, exogenous opioids-primarily targeting the MOPR, have been …

Dosage, Intensity, And Frequency Of Language Therapy For Aphasia: A Systematic Review-Based, Individual Participant Data Network Meta-Analysis, The Rehabilitation And Recovery Of People With Aphasia After Stroke (Release) Collaborators

Research outputs 2022 to 2026

Background and Purpose: Optimizing speech and language therapy (SLT) regimens for maximal aphasia recovery is a clinical research priority. We examined associations between SLT intensity (hours/week), dosage (total hours), frequency (days/week), duration (weeks), delivery (face to face, computer supported, individual tailoring, and home practice), content, and language outcomes for people with aphasia.

Methods: Databases including MEDLINE and Embase were searched (inception to September 2015). Published, unpublished, and emerging trials including SLT and ≥ 10 individual participant data on aphasia, language outcomes, and time post-onset were selected. Patient-level data on stroke, language, SLT, and trial risk of bias were independently extracted. …

Sport-Specific Crossover Point Differences During A Maximal Oxygen Consumption Test, Joseph R. Stanzione, George A. Brooks, Michael L. Bruneau, Duncan N. French, Jennifer A. Nasser, Sinclair A. Smith, Stella L. Volpe

Research outputs 2022 to 2026

Introduction/Purpose: The crossover point occurs during exercise when one transitions energy substrates from fat to carbohydrate predominance. The crossover point varies in an intensity-dependent manner; however, less is known about its specificity in sports with varying metabolic demands. The purpose of our study was to determine if various sports yield differences in the time to crossover and heart rate and percentage of maximal oxygen consumption (V O2max) at crossover during a standardized exercise protocol.

Methods: A total of 77 athletes (39 women, 38 men; 39.1 + 10.4 yr of age) were measured for respiratory exchange ratio during a modified Taylor …