Digital Commons Network^™

Personalization Of Sudep Risk: A Survey Of Transient Subclinical Comorbid Changes, Kristina A Simeone, Dawn M Martenz, Shruthi H Iyer, Cameron P Booth, Shelby E Herr, Stephanie A Matthews, Samantha B Draves, Laura L Heinemann, Pierce L Greenberg, Samden D Lhatoo, Elizabeth Donner, Timothy A Simeone

Faculty, Staff and Student Publications

Objective: Preclinical data report within subject modifiable ailments emerge weeks prior to SUDEP, including sleep disorders and cardiorespiratory changes; findings which support anecdotal clinical data. Here, we bridge preclinical findings with future clinical/preclinical studies, and survey whether caretakers or family members of victims noticed transient changes prior to SUDEP. The aim of this pilot study is to identify potential modifiable changes that may synergistically increase SUDEP risk for future research.

Methods: A mobile electronic survey was posted on SUDEP community websites. The survey queried whether changes in seizures, sleep, physical well-being, emotional well-being, cognition, breathing, or heart rate were noticed …

20-Year Inflation-Adjusted Medicare Reimbursements (Years: 2000-2020) For Common Lumbar And Cervical Degenerative Disc Disease Procedures, Pedram Honarpisheh, Samantha L Parker, Christopher R Conner, Sami Anjum, Jessica R Stark, John C Quinn, John M Caridi

Faculty, Staff and Student Publications

OBJECTIVE: Reimbursement trends for common procedures have persistently declined over the past 2 decades. Spinal instrumentational and fusion procedures are increasingly utilized and have increased in clinical complexity, yet longitudinal inflation-adjusted data for Medicare reimbursements of these procedures have not been evaluated.

METHODS: The Centers for Medicare and Medicaid Services (CMS) Physician Fee Schedule Look-Up Tool was used to extract Medicare reimbursements for the 5 most common spinal procedures and associated instrumentations from 2000-2020. Current Procedural Terminology (CPT) codes include 22551, 22600, 22633, 63030, and 63047 as well as instrumentation CPT codes 22840 and 22842-6. The nominal values were adjusted …

Does An Early, Balanced Resuscitation Strategy Reduce The Incidence Of Hypofibrinogenemia In Hemorrhagic Shock?, David T Lubkin, Krislynn M Mueck, Gabrielle E Hatton, Jason B Brill, Mariela Sandoval, Jessica C Cardenas, Charles E Wade, Bryan A Cotton

Faculty, Staff and Student Publications

OBJECTIVES: Some centers have recommended including concentrated fibrinogen replacement in massive transfusion protocols (MTPs). Given our center's policy of aggressive early balanced resuscitation (1:1:1), beginning prehospital, we hypothesized that our rates of hypofibrinogenemia may be lower than those previously reported.

METHODS: In this retrospective cohort study, patients presenting to our trauma center November 2017 to April 2021 were reviewed. Patients were defined as hypofibrinogenemic (HYPOFIB) if admission fibrinogen

RESULTS: Of 29 782 patients, 6618 level 1 activations, and 1948 patients receiving emergency release blood,

CONCLUSIONS: Low rates of hypofibrinogenemia were found in our center which treats hemorrhage with early, balanced …

Scoping Review: The Effects Of Interrupted Onabotulinumtoxin A Treatment For Chronic Migraine Prevention During The Covid-19 Pandemic, Qing Zhao Ruan, Daniel J Pak, Amitabh Gulati, Moises Dominguez, Sudhir Diwan, Jamal Hasoon, Timothy R Deer, R Jason Yong, Abdulrazaq Albilali, Amanda Macone, Sait Ashina, Christopher L Robinson

Faculty, Staff and Student Publications

Objective: To systematically examine the literature on the clinical consequences of inadvertent delays in scheduled onabotulinumtoxin A (OTA) therapy for chronic migraine during the COVID-19 pandemic and assess recommendations when access to OTA is limited.

Background: The coronavirus (COVID-19) pandemic was unprecedented in its impact on the global medical community. Most healthcare institutions in the United States (US) and the world had begun significantly limiting elective procedures, undermining management of many debilitating chronic conditions. OTA injections, were similarly involuntarily postponed, leading to significant setbacks in symptom control.

Methods: A comprehensive literature search was conducted on databases of Medline and Embase …

Preparation Of Uniformly Oriented Inverted Inner (Cytoplasmic) Membrane Vesicles From Gram-Negative Bacterial Cells, Mikhail Bogdanov

Faculty, Staff and Student Publications

The complex double-membrane organization of the envelope in Gram-negative bacteria places unique biosynthetic and topological constraints that can affect translocation of lipids and proteins synthesized on cytoplasm facing leaflet of cytoplasmic (inner) membrane (IM), across IM and between IM and outer membrane (OM). Uniformly oriented inside-out (ISO) vesicles became functional requisite for many biochemical reconstitution functional assays, vectorial proteomics, and vectorial lipidomics. Due to these demands, it is necessary to develop simple and reliable approaches for preparation of uniformly oriented IM membrane vesicles and validation of their sidedness. The uniformly ISO oriented membrane vesicles which have the cytoplasmic face of …

Exploring Uniform, Dual, And Dynamic Topologies Of Membrane Proteins By Substituted Cysteine Accessibility Method (Scam™), Mikhail Bogdanov

Faculty, Staff and Student Publications

A described simple and advanced protocol for Substituted Cysteine Accessibility Method as applied to transmembrane (TM) orientation (SCAM™) permits a topology analysis of proteins in their native state and can be universally adapted to any membrane system to either systematically map an uniform or identify and quantify the degree of mixed topology or establish transmembrane assembly dynamics from relatively static experimental data such as endpoint topologies of membrane proteins. In this approach, noncritical individual amino acids that are thought to reside in the putative extracellular or intracellular loops of a membrane protein are replaced one at the time by cysteine …

Association Between Emergency Medical Service Agency Volume And Mortality In Trauma Patients, David S Silver, Jason L Sperry, Jamison Beiriger, Liling Lu, Francis X Guyette, Stephen Wisniewski, Ernest E Moore, Martin Schreiber, Bellal Joseph, Chad T Wilson, Bryan Cotton, Daniel Ostermayer, Erin E Fox, Brian G Harbrecht, Mayur Patel, Joshua B Brown

Faculty, Staff and Student Publications

Objective: The aim of this study was to evaluate the association of annual trauma patient volume on outcomes for emergency medical services (EMS) agencies.

Background: Regionalization of trauma care saves lives. The underlying concept driving this is a volume-outcome relationship. EMS are the entry point to the trauma system, yet it is unknown if a volume-outcome relationship exists for EMS.

Methods: A retrospective analysis of prospective cohort including 8 trauma centers and 20 EMS air medical and metropolitan ground transport agencies. Patients 18 to 90 years old with injury severity scores ≥9 transported from the scene were included. Patient and …

Benign Disorders Of The Mediastinum: A Narrative Review, Saad Farooq, Sabiha Armin, Daniel Ocazionez, Rosa M Estrada-Y-Martin, Sujith V Cherian

Faculty, Staff and Student Publications

Background and objective: There are several benign processes that affect the mediastinum with considerable morbidity that may range from reactive entities to neoplastic disorders. This review article will focus on non-neoplastic benign mediastinal diseases which include large vessel vasculitis such as Takayasu and giant cell arteritis, mediastinal granulomas, fibrosing mediastinitis and mediastinal infections. These diseases can cause significant morbidity and mortality; therefore, we aim to familiarize readers with the pathophysiology, epidemiology and diagnosis of these mediastinal diseases and provide an update on the treatment options available.

Methods: We searched various databases such as PubMed and Google Scholar from August 2023 …

The Contribution Of Amyloid Deposition In The Aortic Valve To Calcification And Aortic Stenosis, Romeesa Khan, Claudia M Di Gesù, Juneyoung Lee, Louise D Mccullough

Faculty, Staff and Student Publications

Trillions of microbes live symbiotically in the host, specifically in mucosal tissues such as the gut. Recent advances in metagenomics and metabolomics have revealed that the gut microbiota plays a critical role in the regulation of host immunity and metabolism, communicating through bidirectional interactions in the microbiota-gut-brain axis (MGBA). The gut microbiota regulates both gut and systemic immunity and contributes to the neurodevelopment and behaviors of the host. With aging, the composition of the microbiota changes, and emerging studies have linked these shifts in microbial populations to age-related neurological diseases (NDs). Preclinical studies have demonstrated that gut microbiota-targeted therapies can …

The Emerging Role Of Notch3 Receptor Signalling In Human Lung Diseases, Grant W Goodman, Patrick Devlin, Bryce E West, Rodney M Ritzel

Faculty, Staff and Student Publications

The recent identification of skull bone marrow as a reactive hematopoietic niche that can contribute to and direct leukocyte trafficking into the meninges and brain has transformed our view of this bone structure from a solid, protective casing to a living, dynamic tissue poised to modulate brain homeostasis and neuroinflammation. This emerging concept may be highly relevant to injuries that directly impact the skull such as in traumatic brain injury (TBI). From mild concussion to severe contusion with skull fracturing, the bone marrow response of this local myeloid cell reservoir has the potential to impact not just the acute inflammatory …

Impact Of Maternal Depressive Symptoms On Offspring Executive Functions: A Systematic Review, Júlia De Souza Rodrigues, María Pastor-Valero, Lucas R Trambaiolli, Ana Beatriz Bozzini, Alicia Matijasevich

Faculty, Staff and Student Publications

OBJECTIVE: To conduct a thorough examination of the current understanding of the effect of maternal depression exposure on the executive functions (EFs) of offspring.

METHODS: Following the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) statement, a comprehensive search for peer-reviewed cohort studies was performed on the MEDLINE (via PubMed), ScienceDirect, LILACS, PsycINFO, and SciELO databases. Study quality was assessed using the National Heart, Lung, and Blood Institute (NHLBI) Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. The evidence was evaluated using the Grading of Recommendation, Assessment, Development, and Evaluation framework.

RESULTS: Thirty-three cohort studies from different countries, …

Endoscopic Innovations In Diagnosis And Management Of Pancreatic Cancer: A Narrative Review And Future Directions, Prateek Suresh Harne, Vaishali Harne, Curtis Wray, Nirav Thosani

Faculty, Staff and Student Publications

Pancreatic cancer serves as the third leading cause of cancer-associated morbidity and mortality in the United States, with a 5-year survival rate of only 12% with an expected increase in incidence and mortality in the coming years. Pancreatic ductal adenocarcinomas constitute most pancreatic malignancies. Certain genetic syndromes, including Lynch syndrome, hereditary breast and ovarian cancer syndrome, hereditary pancreatitis, familial adenomatous polyposis, Peutz-Jeghers syndrome, familial pancreatic cancer mutation, and ataxia telangiectasia, confer a significantly higher risk. Screening for pancreatic malignancies currently targets patients with germline mutations or those with significant family history. Screening the general population is not currently viable owing …

Develop And Validate A Computable Phenotype For The Identification Of Alzheimer’S Disease Patients Using Electronic Health Record Data, Xing He, Ruoqi Wei, Yu Huang, Zhaoyi Chen, Tianchen Lyu, Sarah Bost, Jiayi Tong, Lu Li, Yujia Zhou, Zhao Li, Jingchuan Guo, Huilin Tang, Fei Wang, Steven Dekosky, Hua Xu, Yong Chen, Rui Zhang, Jie Xu, Yi Guo, Yonghui Wu, Jiang Bian

Faculty, Staff and Student Publications

Introduction: Alzheimer's disease (AD) is often misclassified in electronic health records (EHRs) when relying solely on diagnosis codes. This study aimed to develop a more accurate, computable phenotype (CP) for identifying AD patients using structured and unstructured EHR data.

Methods: We used EHRs from the University of Florida Health (UFHealth) system and created rule-based CPs iteratively through manual chart reviews. The CPs were then validated using data from the University of Texas Health Science Center at Houston (UTHealth) and the University of Minnesota (UMN).

Results: Our best-performing CP was "patient has at least 2 AD diagnoses and AD-related keywords …

Predictors Of Postpartum Hemorrhage And Associated Outcomes At A Midwest Academic Medical Center, Megan Mooberry, Natalie Voss, Linder Wendt, Kimberly A Kenne, J Brooks Jackson, Mary B Rysavy

Faculty, Staff and Student Publications

Background: Postpartum hemorrhage (PPH) remains a significant cause of maternal morbidity and mortality around the world, with rates increasing in the United States. The objective of this study was to determine predictors of, and outcomes associated with, PPH at a Midwest academic health center.

Methods: Demographic and clinical data were obtained from the electronic medical record on all consecutive delivering patients between May 1, 2020, and April 30, 2021. Associations between PPH and perinatal characteristics and outcomes were assessed using logistic regression models. A significance threshold of 0.05 was used for all comparisons.

Results: Of the 2497 delivering patients during …

Unmet Need In Early-Onset Parkinson's Disease: Deep Brain Stimulation And Pregnancy, Katarzyna Smilowska, Raja Mehanna, Jori E Fleisher, Roy N Alcalay, Kishore Raj Kumar, Connie Marras, Annelien M Oosterbaan, Bart Post, Owen A Ross, Maria Elisa Pimentel Piemonte, Valerie Fraix, Elena Moro, Eng King Tan, Rodolfo Savica, Eopd Task Force

Faculty, Staff and Student Publications

Pregnancy in women with early-onset Parkinson's disease (PD) is likely to have a higher frequency given the trend toward increasing maternal age, thus resulting in a greater overlap time between childbearing age and PD risk. Deep brain stimulation (DBS) therapy is nowadays offered to PD patients at earlier stage of the disease, when women can still be pre-menopausal. However, few data are available about DBS safety during pregnancy. From a review of the available literature, only one article was published on this topic so far. Therefore, we have developed a clinical consensus on the safety of DBS during pregnancy in …

Effect Of Plant Based Nutritional Education On A1c Levels In Type 2 Diabetic Adults, Candice Kim

Master of Science in Nursing Family Nurse Practitioner

Type 2 diabetic adults are those with a condition that prevents production of enough insulin and are also resistant to the effects of insulin itself (American Diabetes Association, 2018). According to the U.S. Department of Health and Human Services, “diabetes mellitus affects an estimated 29.1 million people in the United States, and is the 7th leading cause of death,” (Office of Disease Prevention and Health Promotion, 2022, section 3). Risk factors that affect type 2 diabetic adults include being overweight, aged 45 or older, high blood pressure, and high level of triglycerides (National Institute of Diabetes and Digestive and Kidney …

Cover And Contents

Turkish Journal of Medical Sciences

No abstract provided.

A Word From The Writing Team (January 2024), Pam Walter, Mfa, Liz Declan, Ma, Mfa

A Word From the Writing Team (Newsletter)

This issue includes:

• Virtual Writing Retreats Return in February
• The OPWPC Canvas Page Offers Helpful Tools
• Academic Commons Will Host a Presentation on Refugee Health in Philadelphia
• Publication Spotlight
• The OPWPC Helps with Scholarly Communication and Publication
• Scott Memorial Library Renovations Continue
• Wiley Open Access Fees Waived for Jefferson Authors

Planting Law And Democracy In Sustainable Soil, Bruce Ledewitz

Nebraska Law Review

Constitutional democracy is threatened today in America. Both sides of the angry political aisles claim that they are defending democracy. But they are not. Constitutional democracy can only be protected by planting it in the sustainable soil of forbearance. At one time, that soil was a common religiously grounded ontological realism that did not consider opponents to be enemies. With the “Death of God,” that soil became unavailable. Only when we recover from the cultural nihilism engendered by the “Death of God,” which has undermined the rule of law, can we find new sustainable soil in which constitutional democracy can …

Leveraging Redundancy As A Link Between Spreading Dynamics On And Of Networks, Felipe Xavier Costa

Electronic Theses & Dissertations (2024 - present)

A constant quest in network science has been in the development of methods to identify the most relevant components in a dynamical system solely via the interaction structure amongst its subsystems. This information allows the development of control and intervention strategies in biochemical signaling and epidemic spreading. We highlight the relevant components in heterogeneous dynamical system by their patterns of redundancy, which can connect how dynamics affect network topology and which pathways are necessary to spreading phenomena on networks. In order to measure the redundancies in a large class of empirical systems, we develop the backbone of directed networks methodology, …

The Role Of Familial Support And Gender In Asian American Students’ Stem Career Development: A Test Of Social Cognitive Career Theory, Xiao Ting Wang

Electronic Theses & Dissertations (2024 - present)

This study, based on Social Cognitive Career Theory (SCCT; Lent et al., 1994, 2000), investigated the role of familial support in the STEM career development of Asian American college students. Participants included 446 first-year undergraduate students who identified as Asian or Asian American and had not declared an academic major. Due to multicollinearity, four initial familial support variables—instrumental assistance, career-related modeling, verbal encouragement, and emotional support—were regrouped into two: performance motivation (instrumental assistance and verbal encouragement) and career mentoring (career-related modeling and emotional support). Structural equation modeling showed acceptable fit for a modified model, and the results partially supported the …

The Exceptionalist-Normalist Continuum: Contents, Correlates, And Consequences Of Beliefs About The Psychological (A)Typicality Of Perpetrators Of Mass Atrocities, Dylan Campbell

Electronic Theses & Dissertations (2024 - present)

A consensus view within the literature on perpetrator behavior in mass atrocities holds that perpetrators tend to be psychologically typical rather than atypical and thus, that even “ordinary” people are capable of extreme acts of violence against civilians when the right combination of social-psychological forces is at work. Whereas much prior research speaks in some way to this claim’s validity, no prior study of which I am aware has directly investigated laypeople’s beliefs regarding the truth of this proposition. Here, I report findings from four preregistered studies (total N = 1,256) investigating the contents, correlates, and consequences of lay theories …

Informational Principles And Structures In Quantum Theory, Yang Yu

Electronic Theses & Dissertations (2024 - present)

This thesis examines the concept of information within the realm of quantum physics, investigating the nuanced relationship between information and physical laws as applied to quantum systems. With no consensus on a single definition of information in the physical sciences, our exploration is partitioned into two significant studies, each addressing distinct aspects of information in quantum contexts.

In the first study, we concentrate on the information that can be obtained from measurement results on identical quantum systems. The traditional approach of using Shannon entropy is limited due to its applicability primarily to discrete probability distributions. By incorporating a Bayesian update …

Factors That Influence Clinicians' Intention To Use A Trauma-Informed Approach To Care In Women's Substance Use Disorder Treatment, Lauren Cestone

Electronic Theses & Dissertations (2024 - present)

Aims: Regardless of literature citing the effectiveness of trauma-informed care (TIC) (e.g., Capezza & Najavits, 2012; Covington, 2008; Morgan et al., 2020), implementation is lacking in settings that serve women with substance use disorders (SUD) (Bartholow & Huffman, 2023; Capezza & Najavits, 2012; Terplan et al., 2015). Not implementing TIC often results in methods that are trauma-inducing, may prevent the achievement desired outcomes, and lead to negative outcomes such as drop-out and relapse (Brown et al., 2013; Capezza & Najavits, 2012; Claus & Kindleberger, 2002; Hales et al., 2019; SAMHSA, 2014). This study aims to provide a theoretically driven empirical …

Advancing Small Molecule Therapies For Myotonic Dystrophy Type 1, Sawyer M. Hicks

Electronic Theses & Dissertations (2024 - present)

Myotonic dystrophy type 1 (DM1) is a multisystemic disorder caused by the expression of expanded CUG (CUG^exp) repeat RNA from the myotonic dystrophy protein kinase (DMPK) gene. This CUG^exp repeat RNA’s gain-of-function mechanism leads to the sequestration of muscleblind-like (MBNL) proteins, resulting in widespread alternative splicing dysregulation across tissues. Despite significant research, there are currently no approved therapeutics targeting the underlying causes of DM1. This dissertation explores the development and optimization of a novel class of small molecules, Modified Polycyclic Compounds (MPCs), designed to address splicing dysregulation in DM1. MPCs were designed from previously published …

Validation Of The Intolerance Of Uncertainty Scale-12 In A Sample Of Pregnant People, Kayla Costello

Electronic Theses & Dissertations (2024 - present)

Background: Intolerance of uncertainty (IU) has been proposed as a transdiagnostic mechanism driving anxiety, depression, and eating disorder symptoms. Pregnancy is a time of significant uncertainty, yet few studies have examined the measurement of IU and its impacts on pregnant people. The current study aimed to examine the psychometric performance of two versions of the Intolerance of Uncertainty Scale (IUS-27 and IUS-12) and its associations with psychopathologies common in pregnancy.

Methods: This study is a secondary analysis of participants (n = 254) recruited for a larger study of a single-session intervention targeting disordered eating in pregnancy. We examined fit …

Stratifying The Social: The Race/Class Dialectic And The Fetishization Of Race In Our Neoliberal Contemporary, Steven D. Delmagori

Electronic Theses & Dissertations (2024 - present)

This dissertation utilizes the lens of Social Reproduction Theory to examine the consequences of viewing race and racism and other systems of oppression like Patriarchy as separate or additive autonomous ontologies. Intersectionality Theory posits oppressions as independent systems that “add” or “intersect” onto oppressed subjects in particular circumstances. On the other hand, responding to Intersectionality Theory, Social Reproduction Theory understands systems of oppression as mutually constitutive social relations. Social Reproduction Theory therefore allows for a more thorough understanding of the relationship between racism and other systems of oppression and their own relationship to capitalism. Rather than theorizing these social relations …

The Forest Watches: A Hybrid Study On The Reintroduction Of Extinct Animals, Devin H. Jinadasa

Electronic Theses & Dissertations (2024 - present)

Rewilding is said to be the hope for the future. Rewilding will rebalance ecosystems, potentially saving those on the point of collapse. But how can you rewild an ecosystem? Reintroduction. The bringing back of extinct animals to fill a vacant role in the ecosystem. Now most would associate reintroduction with dinosaurs and prehistoric creatures. However, this specific project will seek to combine speculative fiction with contemporary environmental concerns around the subject of reintroducing a modern extinct animal into an ecosystem. This will be undertaken through a narrative told through the voices and perspectives of respective animal characters in third person …

Applying The Fair Use Doctrine In Music Copyright "Borrowing" Infringement Cases, Shea Bettwy

University of Richmond Law Review

Copyright fair use is a broad, statutory doctrine that permits fair use of any type of copyrighted work. But the fair use defense is virtually nonexistent in copyright infringement cases involving musical compositions, such as the famous “Blurred Lines” case. Defendants and courts neglect to consider it for reasons unknown. One might conjecture that this simply reflects a tacit understanding in the music industry that original music should be untouched. In fact, musical borrowing is a longstanding and accepted tradition, which makes copyright fair use particularly amenable to musical compositions. Disconcertingly, ignoring fair use of musical compositions in infringement cases …

Mlp And Rbf Algorithms In Finance: Predicting And Classifying Stock Prices Amidst Economic Policy Uncertainty, Bushra Ali, Khder Alakkari, Mostafa Abotaleb, Maad M. Mijwil, Klodian Dhoska

Mesopotamian Journal of Big Data

In the realm of stock market prediction and classification, the use of machine learning algorithms has gained significant attention. In this study, we explore the application of Multilayer Perceptron (MLP) and Radial Basis Function (RBF) algorithms in predicting and classifying stock prices, specifically amidst economic policy uncertainty. Stock market fluctuations are greatly influenced by economic policies implemented by governments and central banks. These policies can create uncertainty and volatility, which in turn makes accurate predictions and classifications of stock prices more challenging. By leveraging MLP and RBF algorithms, we aim to develop models that can effectively navigate these uncertainties and …