Digital Commons Network^™

Implementation Of Delirium Screening In The Emergency Department: A Qualitative Study With Early Adopters, Anita N Chary, Annika R Bhananker, Elise Brickhouse, Beatrice Torres, Ilianna Santangelo, Kyler M Godwin, Aanand D Naik, Christopher R Carpenter, Shan W Liu, Maura Kennedy

Faculty, Staff and Students Publications

Introduction: Delirium affects 15% of older adults presenting to emergency departments (EDs) but is detected in only one-third of cases. Evidence-based guidelines for ED delirium screening exist, but are underutilized. Frontline staff perceptions about delirium and time and resource constraints are known barriers to ED delirium screening uptake. Early adopters of ED delirium screening can offer valuable lessons about successful implementation.

Methods: We conducted semi-structured interviews with clinician-administrators leading ED delirium screening initiatives from 20 EDs in the United States and Canada. Interviews focused on experiences of planning and implementing ED delirium screening. Interviews lasted 15 to 50 minutes and …

A Transgenic Mouse Model Of Down Syndrome Acute Lymphoblastic Leukemia Identifies Targetable Vulnerabilities, Jacob J Junco, Max Rochette, Michelle Alozie, Raushan Rashid, Maci Terrell, Barry Zorman, Pavel Sumazin, Lauren Rowland, Gino Dettorre, Reid T Powell, Clifford C Stephan, Peter J Davies, Margarita Martinez-Moczygemba, Jun J Yang, Karen R Rabin

Faculty, Staff and Students Publications

No abstract provided.

Efficacy Of Letermovir For Cytomegalovirus Prophylaxis Following Alemtuzumab T-Cell Depleted Allogeneic Hematopoietic Stem Cell Transplant, Ibrahim N Muhsen, Kristen E Shaver, Tao Wang, Mengfen Wu, Premal Lulla, Carlos A Ramos, Rammurti T Kamble, Helen E Heslop, George Carrum, Laquisa C Hill

Faculty, Staff and Students Publications

In vivo T-cell depletion (TCD) using alemtuzumab decreases the risk of Graft vs Host Disease (GvHD) in recipients of allogeneic hematopoietic stem cell transplant (allo-HSCT). However, this approach increases the risk of infections post-allo-HSCT, including Cytomegalovirus (CMV). Letermovir is approved for the use in CMV prophylaxis post-allo-HSCT. Few studies have investigated the efficacy of letermovir in patients receiving alemtuzumab. This is a single-center retrospective study describing our institutional experience using letermovir in recipients of alemtuzumab TCD allo-HSCT from unrelated donors (URD). The primary outcome was the cumulative incidence of significant CMV infection (defined as viremia leading to preemptive antiviral therapy …

Testosterone Acts Through The Membrane Protein Gprc6a To Cause Cardiac Edema In Zebrafish Embryos, Vahid Zadmajid, Shayan Shahriar, Daniel A Gorelick

Faculty, Staff and Students Publications

Androgens are classically thought to act through intracellular androgen receptors (AR/NR3C4), but they can also trigger non-genomic effects via membrane proteins. Although several membrane androgen receptors have been characterized in vitro, their functions in vivo remain unclear. Using a chemical-genetic screen in zebrafish, we found that GPRC6A, a G-protein-coupled receptor, mediates non-genomic androgen actions during embryonic development. Exposure to androgens (androstanedione, DHT and testosterone) caused cardiac edema or tail curvature in wild-type embryos, as well as in ar mutants, suggesting AR-independent pathways. We then mutated putative membrane androgen receptors [gprc6a, hcar1-4 and zip9 (slc39a9)] and found that only gprc6a mutants …

Pathophysiology And Treatment Of Prediabetes And Type 2 Diabetes In Youth, Fida Bacha, Tamara S Hannon, Mustafa Tosur, Julie M Pike, Ashley Butler, Kalie L Tommerdahl, Philip S Zeitler

Faculty, Staff and Students Publications

Youth-onset type 2 diabetes is a heterogeneous disease with increasing prevalence in relation to increased rates of obesity in children. It has genetic, epigenetic, social, and environmental determinants. Youth-onset type 2 diabetes is alarming given a rapidly progressive course compared with the course of adult-onset disease, early-onset vascular complications, and long-term exposure to hyperglycemia and associated complications. It is often preceded by prediabetes, a disease phase where defects in β-cell function relative to insulin sensitivity emerge. Herein, we review the current understanding of the pathophysiology of prediabetes and type 2 diabetes in youth. We describe the mechanisms underlying insulin resistance, …

Are Prediction Models Moving Closer To Clinical Application In The Diagnosis Of Type Of Diabetes In Youth?, Fida Bacha

Faculty, Staff and Students Publications

No abstract provided.

Shared Genetic Architecture Of Non-Viral Cirrhosis With Several Pleiotropic Traits: A Nested Case-Control Study In The Uk Biobank, Jinyoung Byun, Hyun-Seok Kim, Younghun Han, Aaron P Thrift, Sabrina M Lin, Xiangjun Xiao, Hyeyeun Lim, Goo Jun, Stacia M Desantis, Hashem B El-Serag, Fasiha Kanwal, Christopher I Amos

Faculty, Staff and Students Publications

Background & aims: Cirrhosis is a leading cause of liver-related mortality and a multifactorial disease. To date, the complex genetic architecture of non-viral cirrhosis has not been fully explored. Cross-trait genetic correlations can elucidate the common genetic etiology of genetically correlated phenotypes. This study aims to identify polygenic and pleiotropic traits associated with cirrhosis using the linkage disequilibrium score regression analysis.

Methods: We conducted genome-wide association analysis of 9,622,842 imputed SNPs on 3,368 non-viral cirrhosis cases and 258,258 controls, and cross-trait analysis between non-viral cirrhosis and various polygenic and pleiotropic traits using the UK Biobank cohort study. We further performed …

Parental Report Of Indoor Air Pollution Is Associated With Respiratory Morbidities In Bronchopulmonary Dysplasia, Jessica L Rice, Joseph M Collaco, Michael C Tracy, Catherine A Sheils, Lawrence M Rhein, Antonia P Popova, Paul E Moore, Audrey N Miller, Winston M Manimtim, Khanh Lai, Jacob A Kaslow, Lystra P Hayden, Julie L Fierro, Manvi Bansal, Eric D Austin, Brianna Aoyama, Stamatia Alexiou, Gangaram Akangire, Amit Agarwal, Natalie Villafranco, Roopa Siddaiah, Joanne M Lagatta, Mehtap Haktanir Abul, A Ioana Cristea, Christopher D Baker, Steven H Abman, Sharon A Mcgrath-Morrow

Faculty, Staff and Students Publications

Objective: To determine the association between indoor air pollution and respiratory morbidities in children with bronchopulmonary dysplasia (BPD) recruited from the multicenter BPD Collaborative.

Study design: A cross-sectional study was performed among participants < 3 years old in the BPD Collaborative Outpatient Registry. Indoor air pollution was defined as any reported exposure to tobacco or marijuana smoke, electronic cigarette emissions, gas stoves, and/or wood stoves. Clinical data included acute care use and chronic respiratory symptoms in the past 4 weeks.

Results: A total of 1011 participants born at a mean gestational age of 26.4 ± 2.2 weeks were included. Most (66.6%) had severe BPD. More than 40% of participants were exposed to ≥1 source of indoor air pollution. The odds of reporting an emergency department visit (OR, 1.7; 95% CI, 1.18-2.45), antibiotic use (OR, 1.9; 95% CI, 1.12-3.21), or a systemic steroid course (OR, 2.18; 95% CI, …

Understanding Health-Related Quality Of Life After Hypospadias Repair: A Qualitative Study With Pre-Adolescent Males And Parents, Vinaya Bhatia, Shannon Cannon, Anjali N Patel, Heidi W Brown, Walid A Farhat, Marisa E Hilliard

Faculty, Staff and Students Publications

Introduction: Hypospadias is a common disease that affects approximately 1 in every 200 live male births in the United States, and long-term studies of individuals who have undergone repair demonstrate complication rates of 15%-70%. The Hypospadias-Specific Health-related Quality of Life (HRQOL) Conceptual Framework for youth and adults suggests that additional morbidity may be incurred from poor psychological, social, and sexual health. The current study sought to clarify hypospadias-specific HRQOL and care priorities in a pre-pubertal population.

Material and methods: This IRB-approved, semi-structured interview study used rigorous qualitative research methods. Eligible patients were English-speaking 8-12-year-old males with hypospadias and their parents. …

Cadasil: A Notch3-Associated Cerebral Small Vessel Disease, Lamei Yuan, Xiangyu Chen, Joseph Jankovic, Hao Deng

Faculty, Staff and Students Publications

BACKGROUND: Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is the most common hereditary cerebral small vessel disease (CSVD), pathologically characterized by a non-atherosclerotic and non-amyloid diffuse angiopathy primarily involving small to medium-sized penetrating arteries and leptomeningeal arteries. In 1996, mutation in the notch receptor 3 gene (NOTCH3) was identified as the cause of CADASIL. However, since that time other genetic CSVDs have been described, including the HtrA serine peptidase 1 gene-associated CSVD and the cathepsin A gene-associated CSVD, that clinically mimic the original phenotype. Though NOTCH3-associated CSVD is now a well-recognized hereditary disorder and the number of …

Pediatric High Blood Pressure Recognition Associated With Electronic Decision Support: A Cohort Analysis, Justin P Zachariah, Tavleen Singh, Shannon Collinson, Justin Rahman, Alisa A Acosta, Jessica F Campbell, Mary Hoang, Katharine E Sigler, Elizabeth A Onugha, Shweta S Shah, S Kristen Sexson-Tejtel, Mark Farrior, Scott Watson

Faculty, Staff and Students Publications

Background: Pediatric high blood pressure (BP) predicts future cardiovascular disease events. High BP is improperly measured, underrecognized, and undermanaged especially in disadvantaged populations. In a large, diverse, academic pediatric practice, we detail the associations of a comprehensive initiative with high BP provider recognition.

Methods: A comprehensive BP initiative was promulgated including (1) retraining providers and staff on BP management; (2) deploying equipment at 55+ sites; and (3) electronic decision support tool alerting staff and clinicians and suggesting management. During the 14-month preintervention and 14-month postintervention periods, data on BP and patient characteristics were collected. The outcome was incident BP recognition …

Fournier's Gangrene Severity Index And Charlson Comorbidity Index Predict Mortality, Intensive Care Unit Admission, And Length Of Hospital Stay In Patients With Fournier's Gangrene: An Analysis Of 264 Consecutive Patients, Nicholas Hauser, Chenlin Huang, Girija Vaidya, Timothy Chrusciel, Krithika Narayana Kumarasan, John Culhane, Sameer Siddiqui

Faculty, Staff and Students Publications

Introduction: Fournier’s gangrene (FG) is a rapidly progressing necrotizing fasciitis. The Fournier's Gangrene Severity Index (FGSI), in conjunction with the Charlson Comorbidity Index (CCI), has been used as a mortality predictor during hospitalization. Patients with diabetes have also been shown to be at an increased risk for the development of FG. This study explores the potential of using FGSI, CCI, and patient diabetes status in predicting more extensive patient outcomes, including intensive care unit (ICU) admission and length of hospital stay.

Methods: From 2013 to 2023, inpatient admissions with the diagnosis of FG were selected from the EPIC Clarity database …

External Validation Of The Epic Sepsis Predictive Model In 2 County Emergency Departments, Daniel G Ostermayer, Benjamin Braunheim, Amit M Mehta, Jeremy Ward, Sara Andrabi, Anwar Mohammad Sirajuddin

Faculty, Staff and Student Publications

Objective: To describe the diagnostic characteristics of the proprietary Epic sepsis predictive model best practice advisory (BPA) alert for physicians in the emergency department (ED).

Materials and methods: The Epic Sepsis Predictive Model v1.0 (ESPMv1), a proprietary algorithm, is intended to improve provider alerting of patients with a likelihood of developing sepsis. This retrospective cohort study conducted at 2 county EDs from January 1, 2023 to December 31, 2023 evaluated the predictive characteristics of the ESPMv1 for 145 885 encounters. Sepsis was defined according to the Sepsis-3 definition with the onset of sepsis defined as an increase in 2 points …

Efficacy And Feasibility Of Intradialytic Plantar Electrical Stimulation In Patients With Diabetes: A Randomized Double-Blind Controlled Trial, Myeounggon Lee, Abdullah Hamad, Mehrnaz Azarian, Jaewon Beom, Abderrahman Ouattas, Mohammad Dehghan Rouzi, Naima Rodriguez, Nhi Quach, Rania Ibrahim, Mincy Mathew, Talal Talal, Fadwa Al-Ali, Bijan Najafi

Center on Aging Staff Publications

Objective: This study investigates the efficacy and feasibility of electrical stimulation (E-Stim) on sensory fibers of the plantar region during hemodialysis sessions, aiming to improve mobility in patients with diabetes by providing a connection between E-Stim and enhanced mobility with minimal patient effort required.

Research design and methods: Participants aged ≥18 years with diabetes undergoing hemodialysis and able to walk at least 10 m with or without aid were recruited and divided into an intervention group receiving 1-h intradialytic E-Stim three times a week and a control group using an identical nonfunctional device for 12 weeks. Gait, physical activity, patient-reported …

Individual Dynamic Prediction For Cure And Survival Based On Longitudinal Biomarkers, Can Xie, Xuelin Huang, Ruosha Li, Alexander Tsodikov, Kapil Bhalla

Faculty, Staff and Student Publications

To optimize personalized treatment strategies and extend patients' survival times, it is critical to accurately predict patients' prognoses at all stages, from disease diagnosis to follow-up visits. The longitudinal biomarker measurements during visits are essential for this prediction purpose. Patients' ultimate concerns are cure and survival. However, in many situations, there is no clear biomarker indicator for cure. We propose a comprehensive joint model of longitudinal and survival data and a landmark cure model, incorporating proportions of potentially cured patients. The survival distributions in the joint and landmark models are specified through flexible hazard functions with the proportional hazards as …

Corrigendum To “The Systemic Availability Of Indispensable Amino Acids From Orally Ingested Algal And Legume Protein In Young Children At Risk Of Environmental Enteric Dysfunction” [Am J Clin Nutr 188 (2024) 96–102], Nirupama Shivakumar, Sindhu Kashyap, Farook Jahoor, Sarita Devi, Thomas Preston, Tinku Thomas, Anura V Kurpad

Faculty, Staff and Students Publications

No abstract provided.

Microbiota-Gut-Brain Axis In Psychiatry: Focus On Depressive Disorders, I-Ching Wang, Shelly A Buffington, Ramiro Salas

Faculty, Staff and Students Publications

Purpose of review: Gut microbiota contribute to several physiological processes in the host. The composition of the gut microbiome is associated with different neurological and neurodevelopmental diseases. In psychiatric disease, stress may be a major factor leading to gut microbiota alterations. Depressive disorders are the most prevalent mental health issues worldwide and patients often report gastrointestinal symptoms. Accordingly, evidence of gut microbial alterations in depressive disorders has been growing. Here we review current literature revealing links between the gut microbiome and brain function in the context of depression.

Recent findings: The gut-brain axis could impact the behavioral manifestation of depression …

Shaping Preferences With Pigouvian Taxes, Gary M. Lucas Jr.

Faculty Scholarship

A Pigouvian tax is a tax that is imposed to correct an externality, which arises when a person engages in behavior that harms others without their consent. Pigouvian taxes are popular among academics—with prominent economists and legal scholars arguing for their imposition on myriad goods and activities that harm third parties, like carbon emissions and alcohol. Policymakers have recently been receptive to at least some of these arguments as evidenced by taxes imposed on or proposed for a variety of externality-generating goods, including guns, plastic bags, and sugary drinks.

The conventional economic rationale for Pigouvian taxes assumes that they affect …

Book Review: Transformative Negotiation: Strategies For Everyday Change And Equitable Futures, Peter R. Reilly

Faculty Scholarship

This volume makes an immense contribution to the field of negotiation and to dispute resolution more generally. The book covers a vast amount of ground, effectively connecting theory to practice and harnessing large amounts of research to support its arguments and advice. Perhaps most importantly, this reviewer found reading the book to be—as the title suggests—a transformative experience.

Reliability Of A Short Diet And Vitamin Supplement Questionnaire For Retrospective Collection Of Maternal Nutrient Intake, Rebecca J Schmidt, Amanda J Goodrich, Lauren Granillo, Yunru Huang, Paula Krakowiak, Adrianne Widaman, J Erin Dienes, Deborah H Bennett, Cheryl K Walker, Daniel J Tancredi

Faculty, Staff and Students Publications

Background: Gestational nutrition can protect against adverse neurodevelopmental outcomes.

Objectives: We developed a short tool for collecting maternal nutritional intake during pregnancy to facilitate research in this area and compared its retrospective use to prospectively-collected food frequency questionnaires (FFQ).

Methods: Maternal nutritional intake was retrospectively assessed using three versions (full interview, full self-administered online, and shortened interview) of the Early Life Exposure Assessment Tool (ELEAT) among participants of the MARBLES pregnancy cohort study of younger siblings of autistic children. Retrospective responses were compared with responses to supplement questions and the validated 2005 Block FFQ prospectively collected in MARBLES during pregnancies …

Systemic Sirolimus Therapy Is Associated With Reduced Intervention Frequency In Pulmonary Vein Stenosis, Alyssa B Kalustian, Joseph L Hagan, Paige E Brlecic, Ionela Iacobas, Rachel D Vanderlaan, Joseph Burns, Thao T Wu, Ravi Birla, Sharada Gowda, Manish Bansal, Srinath T Gowda, Lindsay F Eilers, Asra Khan, Juan Pablo Sandoval-Jones, Michiaki Imamura, Yishay Orr, Christopher A Caldarone, Athar M Qureshi

Faculty, Staff and Students Publications

BACKGROUND: Early clinical outcomes data for adjunctive systemic sirolimus therapy (SST) for moderate to severe pediatric pulmonary vein stenosis (PVS) are promising but limited.

OBJECTIVES: The authors aimed to characterize a cohort of patients treated with SST to determine if SST was associated with a reduction in frequency of PVS interventions.

METHODS: Medical records of 45 patients with PVS treated with SST for ≥1 month from 2015 to 2022 were retrospectively reviewed. PVS intervention rates pre-SST and on-SST were compared using generalized Poisson mixed models, accounting for paired intervals within each patient. In addition to an unadjusted model, an adjusted …

More Than Semantics? Navigating The "Policy ∗ Design" Concepts' Landscape, Diana Pamela Villa-Alvarez, Adam Wellstead

Michigan Tech Publications

Scholarship from the design discipline and policy sciences has produced rich empirical and theoretical knowledge on the intersection of policy and design. However, using concepts that pair “policy” and “design” in various ways, often with different meanings, can confuse practitioners and scholars alike. This confusion is further exacerbated by the sheer variety of online information, including peer-reviewed articles, books, reports, blogs, courses, and the websites of prominent scholars, practitioners, and policy actors. To address this, we analyze “Policy * Design” concepts from a Google Search Engine scraping tool and, in doing so, identify four distinct approaches: “policy design,” “design for …

A Word From The Writing Team (December 2024), Pam Walter, Mfa

A Word From the Writing Team (Newsletter)

This issue includes:

• Publication Spotlight
• Enter the Annual Theresa and Charles Yeo Writing Prize by December 31, 2024
• Sign up for the December 6th Writing Retreat (Online)
• Write that Baby in 9 Weeks
• The OPWPC Canvas Page offers helpful tools

Adverse Childhood Experiences And Early Life Adversity And Their Effects On Chronic Health: A Literature Review, Ella Weatherford

The Eleanor Mann School of Nursing Undergraduate Honors Theses

With more than 439,000 annual U.S. deaths associated with childhood adversity, it is important to understand and prevent exposure to Adverse Childhood Events and Early Life Adversity. The purpose of this literature review is to identify and examine the pathophysiology between adverse childhood experiences (ACE’s) and their negative effects on health across the lifespan. Fifteen peer-reviewed articles that were published in notable journals were analyzed to include in this review. The results of these articles show that Adverse Childhood Experiences and Early Life Adversity can lead to the development of chronic inflammatory conditions across the lifespan. Using Barker Hypothesis and …

Building Bridges: A Cohort Model For Content-Based Language Learning And Multilingual Learner Success, Marry E. Royers

Teacher Education Theses, Dissertations, and Student Creative Activity

Building Bridges: Cohort Model Preliminary Steps

1: Identify the need within the school.

2: Cohort Selection

3.Attitudes and experiences pre-test for both teachers and students

Teachers gather student pre-PD survey data

PLC CYCLE STEP 1 Review student survey data Micro PD part 1 with ML teacher Set goals for the PLC cycle.

Professional Development Cycle

PLC CYCLE STEP 2 Reflection or progress, affirmations, and group troubleshooting. Micro PD part 2 with ML teacher

PLC CYCLE STEP 3 Reflection or progress, affirmations, and group troubleshooting.

Focus of Professional Development:

1.Content-Based Language Learning 2.Asset-based Pedagogy & Culturally Relevant Teaching 3.Implementing Academic Conversations …

An Exploration Of Refugee Policy Using Social Construction Theory & The Narrative Policy Framework, Daniel S. Amoruso

Boise State University Theses and Dissertations

Social Construction Theory and Narrative Policy Framework are cohesive products to assess policymaking by examining social construction variables and the formation of narratives. Although I use each independently and together, using them in conjunction helps to ascertain the difference between what someone does and says. Often, there is a substantive disconnect between the two. As with many policy arenas, interest in refugee policy has ebbed and flowed over the past ten years as the United States fluctuates from Democrat to Republican and back to Democrat administrations. Various administrations, media outlets, and separate communities often portray refugees differently; some favorably toward …

Immersive Simulations In Tourism Education: A Case Study, Eric Hawkinson

Boise State University Theses and Dissertations

This research employed a mixed-method case study approach to explore the experiences of participants in immersive tourism simulations within vocational tourism studies. Utilizing the ”My Hometown Project,” a virtual tourism platform, the study designed and deployed tourism simulations where groups of students guided guests through virtual tours, blending immersive technology with face-to-face interaction in the ”Future Hub,” an innovative immersive learning laboratory. A mixed-methods approach was adopted, collecting reports from groups post-simulation (Shared Immersive Experience Reports - SIER) for qualitative insights and administering post-simulation surveys to measure presence and motivation quantitatively. This approach aimed to provide a comprehensive understanding of …

A Delphi Study Exploring Scope And Sequence Of Trauma Education In Counselor Education Master Level Council Of Accreditation Of Counseling Related Education Programs, Alexis A. Hauck

Dissertations

The growing awareness of trauma and its impacts on the social, emotional, and overall wellness of individuals, couples, and families underscores the need for counselor educators to prepare counselors to address trauma symptoms effectively. To bridge this gap, counselor education programs can benefit from expert guidance on the content scope and course sequencing of trauma education in master’s programs.

This research aimed to articulate trauma education scope and sequencing by gathering expert recommendations on best practices for trauma knowledge, awareness, and skill development through clinical experiences in counselor education programs. The grand research question explored expert opinions and beliefs about …

The Workings Of Legal Exceptionalism: Arbitration As A Portal To Stateless Law-In-Action Regimes, Thomas Schultz

Buffalo Law Review

This Essay seeks to explores the fertility of thinking about arbitration as a portal to stateless legal regimes. Using the distinction between law in books and law in action, as well as the concepts of social and political disembeddedness and quiet politics, it argues that under the current paradigm of arbitration, it operates as a porous portal, getting corporate and natural citizens to escape into stateless law-in-action legal regimes (though in practice not into a law-in-books stateless legal regime). This raises questions of control of and accountability for the political effects of such stateless law-inaction legal regimes on the rest …

When European State Courts Face Post-Colonial Legality: A Private International Law Approach Inspired By Decolonial Theory, Sandrine Brachotte

Buffalo Law Review

This Essay develops avenues for private international law (PIL) to deal with cases involving the interaction between Western state law and distinctive forms of law that citizens from post-colonial states, especially African states, bring with them to Europe. Laws of the second type, which I call “postcolonial legality,” incorporate both traditional forms of legality usually dubbed “religious” and “customary” law along with state law that originates from colonial law. Drawing on some lessons from decolonial theory, I try to apply to this particular context a “less colonial” PIL theory and subsequent PIL rules and reasoning. The argument builds on the …