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Etsu Health Annual Report - 2024, Etsu Health, East Tennessee State University

ETSU Health Annual Reports

No abstract provided.

The Differential Proteomic Response To Ischemic Stroke In Appalachian Subjects Treated With Mechanical Thrombectomy, Christopher J. Mclouth, Benton Maglinger, Jacqueline A. Frank, Kristin J. Hazelwood, Jordan P. Harp, Will Cranford, Shivani Pahwa, David Dornbos Iii, Amanda L. Trout, Ann M. Stowe, Justin F. Fraser, Keith R. Pennypacker

Neurology Faculty Publications

Introduction The Appalachia region of North America is known to have significant health disparities, specifically, worse risk factors and outcomes for stroke. Appalachians are more likely to have comorbidities related to stroke, such as diabetes, obesity, and tobacco use, and are often less likely to have stroke interventions, such as mechanical thrombectomy (MT), for emergent large vessel occlusion (ELVO). As our Comprehensive Stroke Center directly serves stroke subjects from both Appalachian and non-Appalachian areas, inflammatory proteomic biomarkers were identified associated with stroke outcomes specific to subjects residing in Appalachia. Methods There were 81 subjects that met inclusion criteria for this …

Screening Incarcerated Women For Opioid Use Disorder, Michele Staton, Martha Tillson, Mary M. Levi, Matthew Webster, Carrie B. Oser, Carl Leukefeld

Behavioral Science Faculty Publications

The overall aim of the present study is to examine the utility of the DSM OUD Checklist and the NM-ASSIST screening tools to identify symptoms consistent with OUD among incarcerated women in county jails. This study contributes to the existing literature because research on screening and assessment approaches for incarcerated women has been limited. The focus of the current study is to describe the screening procedures and study recruitment for a larger parent study focused on increasing treatment linkages. Study findings indicate a positive correlation between indicators of OUD using the two screening tools, as well as a high degree …

A Social History Of Opioids’ Crimedical Cycle, Jerel M. Ezell, Alex Rains, Babatunde Patrick Ajayi, Kyle Miller, Erin Augustine, Dawn Goddard-Eckrich, Elizabeth N. Kinnard, Michelle R. Lofwall

Behavioral Science Faculty Publications

Historically, public and political discourse around people who nonmedically use opioids has largely been rendered via a deficits-oriented lens, presenting this population as weak, disinterested, and deviant,and thus undesirable and ill-positioned for wellness and communal integration. These narratives, and subsequent policies used to engage people who use opioids, are intermittently formed and disrupted by geopolitical changes, as public and institutional attitudes, often driven by racial and class-related considerations, shift. As part of what we term the crimedical cycle, a population’s behaviors fluctuate between periods of medicalization and criminalization. Strengths-based theory, an offshoot of ‘positive psychology’ that helps contextualize the crimedical …

Rare Variant Analyses Validate Known Als Genes In A Multi-Ethnic Population And Identifies Antxr2 As A Candidate In Pls, Tess D. Pottinger, Joshua E. Motelow, Gundula Povysil, Cristiane A. Martins Moreno, Zhong Ren, Hemali Phatnani, The New York Genome Center Als Sequencing Consortium, Timothy J. Aitman, Javier Santoyo‑Lopez, Scottish Genomes Partnership, Hiroshi Mitsumoto, Als Cosmos Study Group, Pls Cosmos Study Group, Gtac Investigators, David B. Goldstein, Matthew B. Harms

Neurology Faculty Publications

Background Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease affecting over 300,000 people world‑ wide. It is characterized by the progressive decline of the nervous system that leads to the weakening of muscles which impacts physical function. Approximately, 15% of individuals diagnosed with ALS have a known genetic variant that contributes to their disease. As therapies that slow or prevent symptoms continue to develop, such as antisense oligonucleotides, it is important to discover novel genes that could be targets for treatment. Additionally, as cohorts continue to grow, performing analyses in ALS subtypes, such as primary lateral sclerosis (PLS), becomes possible …

Importance Of Tropical Medicine, Chia-Chi Angela Fu, A Clinton White, Miguel Cabada, Ryan Northup

Posters

Overviews the importance of tropical medicine to society and global health.

Enhancing People's Subjective Wellbeing: Assessing The Impact Of Universal Health Coverage Through Wellbeing Adjusted Life Years, Ryan Joseph R. Dizon

Economics Department Faculty Publications

The establishment of public health programs, such as universal health coverage (UHC), aims to ensure health and wellbeing for all throughout the life course. These health programs have far-reaching impacts that extend beyond physical health. This study examines the impact of UHC on people's subjective wellbeing through a cross-country analysis using a multidimensional measure of health: the wellbeing adjusted life years (WALYs). WALYs are derived from life satisfaction data from the European Values Study and World Values Survey (1990–2014). The study employs an instrumental variable approach and Lewbel's method—a heteroscedasticity-based identification strategy, and additionally incorporates personality into the model. Findings …

Astrocytic Stress Response Is Induced By Exposure To Astrocyte-Binding Antibodies Expressed By Plasmablasts From Pediatric Patients With Acute Transverse Myelitis, Chad Smith, Kiel M. Telesford, Sara G. M. Piccirillo, Yamhilette Licon‑Munoz, Wei Zhang, Key M. Tse, Jacqueline R. Rivas, Chaitanya Joshi, Dilan S. Shah, Angela X. Wu, Ritu Trivedi, Scott Christley, Yu Qian, Lindsay G. Cowell, Richard H. Scheuermann, Ann M. Stowe, Linda Nguyen, Benjamin M. Greenberg, Nancy L. Monson

Neurology Faculty Publications

Background Pediatric acute transverse myelitis (ATM) accounts for 20–30% of children presenting with a first acquired demyelinating syndrome (ADS) and may be the first clinical presentation of a relapsing ADS such as multiple sclerosis (MS). B cells have been strongly implicated in the pathogenesis of adult MS. However, little is known about B cells in pediatric MS, and even less so in pediatric ATM. Our lab previously showed that plasmablasts (PB), the earliest B cell subtype producing antibody, are expanded in adult ATM, and that these PBs produce self‑reactive antibodies that target neurons. The goal of this study was to …

Evaluating A High School Mrsa Prevention Program: A Case Study, Jamie Henning

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

MRSA poses a significant health risk to athletes nationwide. This case study examines the application of an online training module to address knowledge gaps regarding Methicillin-resistant Staphylococcus aureus (MRSA) among key decision-makers for high school athletes. It reviews the development and initial evaluation of a web-based training program designed to empower decision-makers with the knowledge to prevent MRSA infection and respond to suspected cases. Program evaluation recommended expanding the training module to wrestling staff with improved evaluation methods while continuing implementation and effectiveness assessment for the football staff. Despite initial data quality limitations, the online training module evaluation offered valuable …

A Case Study In Program Evaluation: Evaluation Of A Mrsa Education Program, Kangai Miriti

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Program evaluations provide a deeper understanding of program components to promote effective program implementation. This evaluation follows the CDC’s 6-step Framework for Program Evaluation in Public Health to evaluate a MRSA education program. This evaluation has been prepared to be presented to the Lexington- Fayette County Health Department.

A Case Study In Evaluation, Laura Nagle

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

The Lexington – Fayette County Health Department is proposing a comprehensive evaluation of programming focused on preventing MRSA infections among high school athletes within Fayette County Public Schools. This document describes the recommended evaluation process.

A Case Study In Program Evaluation, Kayla Shepherd

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

A program evaluation of a case study presented by the College of Public Health. This case study included a fictitious MRSA outbreak at a Kentucky high school football camp and the response of the Fayette County Public School System (FCPS) and the Lexington-Fayette County Health Department (LFCHD). Using the Centers for Disease Control and Prevention's Framework for Program Evaluation, I evaluated the Educational Infectious Disease Program designed by the FCPS and LFCHD. I provided recommendations to help improve the success of the program.

A Case Study In Program Evaluation, Sydney Wilcoxson

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Evaluation is a critical component of a successful evidence-based health promotion program or intervention. In public health, evaluations ensure that interventions are achieving their intended objectives, provide feedback on program strengths and weaknesses, and serve as a mechanism of accountability and transparency to stakeholders so that they know their invested resources are being utilized in the most efficient manner. Without evaluation, it would be much more difficult to understand how well the intervention is working, and communication between stakeholders would be significantly affected.

A recently confirmed Methicillin-resistant staphylococcus aureus (MRSA) outbreak on a Fayette County Public Schools (FCPS) high school …

Adolescent Vaccination Rates And Pharmacists' Ability To Prescribe And Administer, Paul Jake Faulkner

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Vaccines are arguably the most significant advancement in healthcare in the prevention of diseases. The CDC has created a series of recommendations to help guide providers and patients toward a healthier future with vaccines. These recommendations were adopted by the Health People Goals 2020 and 2030 to increase each state's rates of completing specific vaccination series by defined age thresholds. This capstone aims to assess if there is a correlation between vaccination rates and pharmacists; specifically to see if states that give less restrictions about vaccinating would have higher rates. It is also important to see if states with more …

Comorbidities And Final Outcome Of Post Covid-19 Associated Oral Mucormycosis Patients: A Cross-Sectional Study, Dalia Ghalwash, Asmaa Abou-Bakr, Ayman El-Gawish

Dentistry

Background

Mucormycosis is an invasive and possibly fatal fungal infection that frequently affects the mouth. Co-infection in post COVID-19 patients is an emerging concern, owing to their complex nature and higher mortality. Therefore, this study aimed to report the underlying risk factors, clinical characteristics, presentation, and final outcome of COVID-19 associated oral mucormycosis cases.

Results

This study included 51 patients with oral mucormycosis 28 (55%) males and 23 (45%) females. Twenty-three patients (45%) presented with deep necrotic ulcer, 16 patients (31%) presented with superficial ulcer, and 12 patients (23%) of them presented with fistula. The overall survival rate was 51% …

The Impacts Of Gut-Supporting Feed Additives On The Growth Performance, Gut Health, Blood Chemistry, And Immune Status Of Broiler Chickens Exposed To Different Stressors, Richard A. Adefioye

Theses and Dissertations--Animal and Food Sciences

Three experiments were conducted to examine the effects of different feed additives in mitigating stress in broiler chickens. Experiment 1 used 504-day-old male by-product Cobb breeder chicks with 8 treatments replicated 9 times with 7 birds per replicate cage, structured as a 2x4 factorial arrangement of treatments. All birds were on the experimental diets for 20 days. There were 2 levels of lipopolysaccharide (LPS) challenge [no challenge vs. LPS challenge at 1 mg/kg BW) and 4 types of feed additives [no additive, 0.05% PostB, 0.1% PostB, and 0.1% Tynagen^TM]. In experiment 2, 672-day-old male by-product Cobb breeder chicks …

Healthcare Providers’ Willingness To Prescribe Buprenorphine To Adolescents And Young Adults With Opioid Use Disorder, Nicole M. Fusco

PCOM Psychology Dissertations

The opioid epidemic is a public health crisis, with opioid use frequently beginning during adolescence and young adulthood. Opioid-related overdoses have continued to increase among adolescents and young adults. Despite the efficacy of medications for opioid use disorder (MOUD) in treating opioid use disorder (OUD), they remain underutilized. A critical step to addressing this issue is identifying the barriers that prevent physicians, nurse practitioners, and physician assistants from prescribing MOUD. This study investigates healthcare providers' willingness to prescribe buprenorphine to adolescents and young adults with OUD. Participants included physicians, nurse practitioners, and physician assistants who currently treat adolescents and young …

Signals Of Positive Selection In Genomes Of Palearctic Myotis-Bats Coexisting With A Fungal Pathogen, V. G. Twort, V. N. Laine, K. A. Field, F. Whiting-Fawcett, Ito, M. Reiman, T. Bartonicka, M. Fritze, V. A. Ilyukha, V. V. Belkin, E. A. Khizhkin, D. M. Reeder, D. Fukui, T. L. Jiang, T. M. Lilley

Faculty Journal Articles

Disease can act as a driving force in shaping genetic makeup across populations, even species, if the impacts influence a particularly sensitive part of their life cycles. White-nose disease is caused by a fungal pathogen infecting bats during hibernation. The mycosis has caused massive population declines of susceptible species in North America, particularly in the genus Myotis. However, Myotis bats appear to tolerate infection in Eurasia, where the fungal pathogen has co-evolved with its bat hosts for an extended period of time. Therefore, with susceptible and tolerant populations, the fungal disease provides a unique opportunity to tease apart factors contributing …

Unm Health Sciences Center Data Book 2023-24, University Of New Mexico - Health Sciences Center

Health Sciences Center Databook (1990-ongoing)

No abstract provided.

Optimizing Ventilator-Associated Pneumonia Prevention And Education: In Adult Icu Settings, Danielle Gonzalez

Nursing | Student Research Posters

Background: Ventilator associated pneumonia (VAP) in adult intensive care patient units (ICU) is one of the most common and deadly nosocomial infections today. Studies have identified a gap in intensive care nurse ventilator education and compliance with hospital protocols. Overall increasing the rates of VAP and morbidity. Hospitals worldwide have shown a decrease in VAP rates after inheriting "VAP-bundles''. This includes nurse specific interventions and assessments as a preventative measure. However, studies failed to demonstrate which bundle interventions directly correspond to the prevention of VAP. Purpose: Address all components of education, a nurse’s ability to properly identify and understand the …

Nurses Current State Of Knowledge On Prion Disease, Chelsy Grande

Nursing | Student Research Posters

Human prion disease is a rare and fatal neurodegenerative disorder. Creutzfeldt- Jakob prion disease rapidly progresses, and is caused by prion, an infectious protein that damages the central nervous system (Bailey et al., 2000). The infectious pathogen is different from other infectious diseases as the normal prion protein misfolds, changing the structures and results in an accumulation of cellular prion proteins (Rentz, 2003). There is no cure for Creutzfeldt- Jakob disease, only palliative care to improve their symptoms and provide support as the disease progresses. How much do nurses know and understand about prion disease, and how can this influence …

Abolition Of What?, Christopher Lewis, Adaner Usmani

Journal of Criminal Law and Criminology

This Article defends a structural theory of the brutality of the carceral state. We argue that American penal systems are destined to be inhumane, barring sweeping changes to the social and economic order of the United States; and that prison and police abolition are neither sufficient nor necessary to bring these kinds of changes about.

This theory stands on two premises. First, we defend The Principle of Less Eligibility, which holds that it is politically infeasible for capitalist democracies to permit the incentives to defy the law to exceed those to obey it. As we show, the Principle of Less …

Community Health Workers To Strengthen Hiv Care Continuum And Prep Delivery In The Us/Hics: A Scoping Review, Vanessa Abigail Nunez

Public Health Theses

Introduction: With the ongoing global HIV/AIDS burden, community-based service delivery models are increasingly recognized, with community health workers (CHWs) at the forefront. In high-income countries (HICs) like the United States, CHWs have long served marginalized communities, gaining recent legislative attention. Despite this, there's still a need for comprehensive evidence on CHW integration in healthcare delivery.

Methodology: We conducted a scoping review to gather available evidence on community health workers (CHWs) and their impact on HIV outcomes in HICs, and to identify evidence gaps in the use of community-based HIV/PrEP services in HICs. Using the American Public Health Association’s definition of …

Investigating Antimicrobial Producing Bacteria Within The Soil, Adam Zwawi

A with Honors Projects

Genetic sequencing techniques used to identify soil antibiotic bacteria

Rna Therapeutics For Fibrolamellar Hepatocellular Carcinoma, Christoph Neumayer

Student Theses and Dissertations

Fibrolamellar hepatocellular carcinoma (FLC) is a rare liver cancer characterized by a recurrent fusion of the heat shock protein DNAJB1 and the catalytic subunit of protein kinase A (PRKACA). Due to limited efficacy of conventional treatments such as chemotherapy and radiation my work explored new therapeutic options. As DNAJB1::PRKACA is known to initiate tumorigenesis, I reasoned that it would be an ideal target for a therapeutic. However, it was not known if FLC tumors are still dependent on DNAJB1::PRKACA or if cells achieved independence of the initial oncogene. To test if FLC is dependent on the oncokinase I screened short …

‘News Reporting On Possible Origins Of The Covid-19 Pandemic: A Critical Review And Case Study’, Raya M. Fanuzzi

Undergraduate Theses, Professional Papers, and Capstone Artifacts

This project is a critical analysis of news reports that discuss the potential origins of the 'COVID-19' pandemic for the purposes of identifying themes and trends in the actual reporting. Around 500 news reports published in the U.S. were analyzed and over 100 of them were selected for the critical review. Articles were found using 'Access News Archive' and Google search engine. Original methods for analyzing and reviewing articles were developed and used. A case study is included aside from the review which focuses specifically on trends in fact-check reporting during the pandemic.

Reducing Wait Times In The Medical Clinic Of The Homeless Intake Center: A Quality Improvement Project, Otuodichinma Christy Nwankpa, Otuodichinma Christy Nwankpa

DNP Scholarly Projects

Background: Homelessness in the U.S. is a critical issue, with New York City experiencing significant challenges due to an increasing number of families requiring shelter. The Department of Homeless Services (DHS-NYC) faces operational inefficiencies, particularly in the medical clinic at the intake center, leading to prolonged wait times.

Local Problem: Families with children experience long wait times in the DHS-NYC medical clinic, which impacts their overall health and well-being. Reducing these wait times is essential for improving service delivery and families satisfaction.

Purpose:

This quality improvement project aims to reduce wait times for families with children at the medical clinic …

Financial Implications Associated With Laboratories Performing Laboratory Developed Tests For Medicare And Commercial Patients, Summer Hartig

MUSC Theses and Dissertations

Objective: To quantify missed reimbursements associated with specific CPT codes for Laboratory Developed Tests (LDTs) via polymerase chain reaction (PCR) in the United States during 2021.

Study Design: Quantitative, retrospective observational study to identify the dollar amount of missed reimbursements associated with 19 specific CPT codes billed for Medicare patients who had LDTs performed via PCR in the United States in 2021.

Data Sources: 19 specific CPT codes from Medicare and Commercial patients with LDT PCR testing performed using 2021 Meridian MarketScan data.

Key Results: Medicare represented 1.7% of the sample size with a potential lost revenue of $1M where …

Mema Matures: Minnesota Emergency Law Post-Covid, Liz Kramer

Mitchell Hamline Law Review

No abstract provided.

The New Eu-Us Data Protection Framework's Implications For Healthcare, Charlotte A. Tschider, Marcelo Corrales Compagnucci, Timo Minssen

Faculty Publications & Other Works

In July 2023, the United States and the European Union introduced the Data Privacy Framework (DPF), introducing the third generation of cross-border data transfer agreements constituting adequacy with respect to personal data transfers under the General Data Protection Regulation (GDPR) between the European Union (EU) and the US. This framework may be used in cross-border healthcare and research relationships, which are highly desirable and increasingly essential to innovative health technology development and health services deployment. A reliable model meeting EU adequacy requirements could enhance the transfer of patient and research participant data. While the DPF might present a familiar terrain …