Digital Commons Network^™

The Efficacy Of Glp-1 Agonists In Pediatric Patients With Type 2 Diabetes And Obesity, Cayla Mahrer

Physician Assistant Scholarly Project Papers

In recent years, GLP-1 therapies have emerged as promising inventions for managing type 2 diabetes and obesity in adolescents. This comprehensive literature review synthesizes findings from fundamental studies, highlighting the efficacy, safety considerations, and potential variations in treatment outcomes associated with GLP-1 therapies in this demographic. The literature consistently supports the effectiveness of GLP-1 therapies, such as liraglutide, dulaglutide, and exenatide, in improving glycemic control, as evidenced by significant reductions in HbA1c levels. Additionally, these therapies often lead to favorable outcomes in terms of weight reduction, addressing a critical aspect of type 2 diabetes and obesity management in adolescents. However, …

Sebaceous Carcinoma: A Commitment To A Standard Of Care, Stephany Janice Sophia Dimoulas

Physician Assistant Scholarly Project Papers

Sebaceous carcinomas (SC) have their origin in the sebaceous glands of the dermis and may develop as a result of de novo mutations, from benign sebaceous neoplasms, or as a result of microsatellite instability and loss of mismatch repair gene expression secondary to Muir-Torre Syndrome (MTS). SCs may also arise from the Meibomian glands, the glands of Zeis, or the sebaceous glands of the caruncle if occurring periocularly. Although SCs may occur at any sebaceous gland-containing location, the most common areas of involvement include the periocular, head, and neck regions. Given its capacity for nodal and distal metastasis as well …

Treating Rheumatoid Arthritis: Immunosuppression Versus Stem Cell Therapy, Bailee Blickensderfer

Physician Assistant Scholarly Project Papers

methotrexate monotherapy, rheumatoid, arthritis, mesenchymal stem cell transplantation, anti-TNF, CXCL8, CXCL12, CXCL13, umbilical cord mesenchymal stem cell, and adipose tissue mesenchymal stem cell

Supplementation With Vitamin D And Calcium And Pre-Eclampsia Compared With Daily Prophylactic Aspirin, Katja Berge

Physician Assistant Scholarly Project Papers

Pre-eclampsia is a hypertensive disorder that occurs during pregnancy. Onset is typically around the 20th week of gestation and serious complications may occur if it is not properly managed. Complications from pre-eclampsia include preterm delivery, disease progression to eclampsia, organ damage, placental abruption, and neonatal complications. Initial management involves the use of antihypertensive medications. Current guidelines recommend the initiation of 81 mg aspirin starting at 12 weeks gestation for women with increased risk factors. The goal of this literature review is to examine the effectiveness of calcium and vitamin D supplementation compared to daily prophylactic aspirin use for prevention of …

Comparison Of Platelet-Rich Plasma Injections And Hyaluronic Acid Injections In The Treatment Of Knee Osteoarthritis, Isaac Knutson

Physician Assistant Scholarly Project Papers

Osteoarthritis is one of the most common diseases that people can suffer from in today’s society. This degenerative disease can affect any of the body’s joints, but is most common in the knees, hands and spine. Osteoarthritis occurs when the protective cartilage that covers the ends of bones in joints wears down. This lack of protective cartilage leads to the bones grinding on each other causing loss of range of motion, pain, and limited function. This review studied the effects of two specific treatments for knee osteoarthritis: platelet-rich plasma injections and hyaluronic acid injections. Both of these treatments can be …

The Effect Of Exercise On Gestational Weight Gain And Diabetes Risk In Women Of Elevated Bmi, Lauren Staton

Physician Assistant Scholarly Project Papers

Maternal obesity is a risk factor that may increase the likelihood of adverse outcomes during pregnancy such as excessive weight gain, gestational diabetes, macrosomia, and cesarean delivery. As obesity has become a more prevalent diagnosis, the healthcare field is begining to see its effects on an abundance of patient profiles, including pregnant women. In the primary care setting, providers are the source of information for patients as to what healthy weight gain during pregnancy looks like. By implementing recommendations for exercise throughout gestation, excessive weight gain and its associated adverse outcomes may decrease in frequency. This literature review examines the …

Comparison Of Cryopreservation Of Ovarian Tissue Versus Cryopreservation Of Oocytes In Fertility Preservation, Madison Nitschke

Physician Assistant Scholarly Project Papers

This literature review aims to compare ovarian tissue cryopreservation (OTC) and oocyte cryopreservation as methods for fertility preservation. Electronic health science databases including PubMed, Clinical Key, ScienceDirect, and UpToDate were utilized. Seven articles met the inclusion criteria and were analyzed for this comprehensive review. This review indicates that both oocyte and ovarian tissue cryopreservation can effectively preserve fertility, however, ovarian tissue cryopreservation is deemed most effective for prepubertal girls at high risk of iatrogenic primary ovarian insufficiency (POI), or women who are unable to postpone gonadotoxic treatment. Ovarian tissue cryopreservation offers advantages that oocyte cryopreservation does not, such as multiple …

Patient Outcomes With Tele-Emergency Medicine Services In Rural Areas, Andrea Rieder

Physician Assistant Scholarly Project Papers

The purpose of this literature review was to examine patient outcomes with the use of teleemergency medicine. Tele-emergency medicine serves as a tool to expand the healthcare team in rural facilities by connecting them with specialized providers, typically via video conference call, for assistance in surge or low-staff situations, or for guidance in more complicated cases that rural providers might typically transfer to a larger hospital. A benefit of adopting a teleemergency medicine service is that it can shorten time to care and reduce the need for transfers, thereby reducing associated costs. The question arises as to whether patient outcomes …

Delivering Multidisciplinary Rehabilitation Care In Parkinson's Disease: An International Consensus Statement, Jennifer G Goldman, Daniele Volpe, Terry D Ellis, Mark A Hirsch, Julia Johnson, Julia Wood, Ana Aragon, Roberta Biundo, Alessandro Di Rocco, Glenn S Kasman, Robert Iansek, Janis Miyasaki, Victor M Mcconvey, Marten Munneke, Serge Pinto, Karen A St Clair, Santiago Toledo, Michele K York, Ronnie Todaro, Nicole Yarab, Kristin Wallock

Faculty, Staff and Students Publications

BACKGROUND: Parkinson's disease (PD) is a complex neurodegenerative disorder impacting everyday function and quality of life. Rehabilitation plays a crucial role in improving symptoms, function, and quality of life and reducing disability, particularly given the lack of disease-modifying agents and limitations of medications and surgical therapies. However, rehabilitative care is under-recognized and under-utilized in PD and often only utilized in later disease stages, despite research and guidelines demonstrating its positive effects. Currently, there is a lack of consensus regarding fundamental topics related to rehabilitative services in PD.

OBJECTIVE: The goal of the international Parkinson's Foundation Rehabilitation Medicine Task Force was …

Probiotic Therapy For The Treatment And Prevention Of Bacterial Vaginosis, Chelsea Scheil

Physician Assistant Scholarly Project Papers

Bacterial vaginosis (BV) is a common presenting complaint in healthcare, and patients often experience recurrences at a frustrating rate. The mainstay of current treatment is antibiotic therapy, either via oral or vaginal route. When recurrences occur, stronger antibiotics are often employed. This current method of treatment does not address an underlying component that impacts infection recurrence and rate of recurrence- the patient’s baseline vaginal microbiome and the healthy bacteria that support it. To determine the efficacy and safety of probiotic therapy for the treatment of bacterial vaginosis, a literature review was completed using databases PubMed and Embase. The results of …

Statin Therapy Vs. Plant-Based Diet For Reduction Of Plaque Burden In Coronary Artery Disease, Molly Zak

Physician Assistant Scholarly Project Papers

Coronary artery disease is one of the most common chronic health conditions to affect adults in the United States, with heart disease being the leading cause of death. Contributing factors include high prevalence of processed foods containing saturated fats, low fiber diets and poor overall nutrition, and physical inactivity. These practices increase risk of low-density lipoprotein cholesterol (LDL-C) plaque buildup and calcification within arteries that supply the heart, leading to decreased blood flow and subsequent oxygen supply. Treatment for coronary artery disease has traditionally been dominated by HMG CoA-reductase inhibitors, or statins. These medications are more effective than the alternative …

Monoclonal Antibodies Vs. Symptomatic Treatment Of Hospitalized Patients With Covid-19, Robert White

Physician Assistant Scholarly Project Papers

The SARS-CoV-2 virus, or COVID-19, was the virus responsible for the worldwide pandemic declared in March, 2020. Individuals can experience a wide variety of symptoms ranging from fever, fatigue, cough, and, in more severe cases, hypoxia requiring invasive mechanical ventilation (IMV). Until recently, symptomatic care was the protocol for patients infected with COVID-19. The use of oxygen for mild hypoxia and antipyretics for fevers was considered the standard of care (SOC). The use of antiviral medications, such as monoclonal antibodies, has been proposed in the treatment of acute COVID-19 infection. The purpose of this literature review is to determine if …

Screening For Adhd In Adult Patients With Epilepsy: Prevalence Of Symptoms And Challenges To Diagnosis, Trung Nguyen, Emily Xiao, Allison Clark, Afroz Shamim, Atul Maheshwari

Faculty, Staff and Students Publications

OBJECTIVE: Given the complex nature of seizure disorders and their treatments, ADHD may be underdiagnosed in this population. We hypothesized that a higher percentage of patients presenting to a seizure clinic would endorse ADHD symptoms compared to rates reported in the general population and that formal screening for ADHD symptoms would identify patients with previously undiagnosed comorbid ADHD.

METHODS: In this study, we surveyed 312 adults in a seizure clinic using the Adult ADHD Self-Report Scale (ASRS-v1.1).

RESULTS: We found that 90 patients (28.8%) screened positive with the ASRS-v1.1, but only nine of these patients were able to complete neuropsychological …

Comparing The Efficacy Of Heart-Conserving Measures And Retransplantation For Chronic Rejection In The Pediatric Population, Lacey Zeiszler

Physician Assistant Scholarly Project Papers

Coronary allograft vasculopathy (CAV) is the leading cause of morbidity and mortality among pediatric heart transplant recipients and faces unsuccessful treatment for prevention and management. Post-transplant immunosuppressive therapy has been modified over the years to determine the most effective regimen for rejection. Tacrolimus has been the superior immunosuppressant used for rejection since the early 2000s. It has been shown to have substantial immunosuppressive effects, least number of adverse effects, and decreased comorbidities compared to other regimens. Despite these advantages, CAV is still prevalent. Heart retransplantation is currently the only curative treatment. Google Scholar, PubMed, ClinicalKey, ScienceDirect, Elsevier, Wiley Online Library, …

Continuous Subcutaneous Foslevodopa/Foscarbidopa Infusion For The Treatment Of Motor Fluctuations In Parkinson’S Disease: Considerations For Initiation And Maintenance, Victor S C Fung, Jason Aldred, Martha P Arroyo, Filip Bergquist, Agnita J W Boon, Manon Bouchard, Sarah Bray, Sara Dhanani, Maurizio F Facheris, Nahome Fisseha, Eric Freire-Alvarez, Robert A Hauser, Anna Jeong, Jia Jia, Pavnit Kukreja, Michael J Soileau, Amy M Spiegel, Saritha Talapala, Arjun Tarakad, Enrique Urrea-Mendoza, Jorge Zamudio, Rajesh Pahwa

Faculty, Staff and Students Publications

BACKGROUND: As Parkinson's disease (PD) advances, management is challenged by an increasingly variable and inconsistent response to oral dopaminergic therapy, requiring special considerations by the provider. Continuous 24 h/day subcutaneous infusion of foslevodopa/foscarbidopa (LDp/CDp) provides steady dopaminergic stimulation that can reduce symptom fluctuation.

OBJECTIVE: Our aim is to review the initiation, optimization, and maintenance of LDp/CDp therapy, identify possible challenges, and share potential mitigations.

METHODS: Review available LDp/CDp clinical trial data for practical considerations regarding the management of patients during LDp/CDp therapy initiation, optimization, and maintenance based on investigator clinical trial experience.

RESULTS: LDp/CDp initiation, optimization, and maintenance can be …

Multiple Sclerosis In Central America And Caribbean Countries: Frequency And Clinical Characterization Of An Emergent Disease, Fernando Gracia, Deyanira A Ramírez Navarro, Nicia E Ramírez Sánchez, Roberto Weiser, Alexander Parajeles-Vindas, Ligia I Portillo Rivera, Ericka López Torres, Luis A García Valle, Alfredo Sanabria-Castro, César Abdón López, Pahola Araujo, Maria J Ayerdis Zamora, Andrea Balmaceda-Meza, Aron Benzadon Cohen, Awilda Candelario Cueto, Diego Castillo, Romy Castro-Escobar, Karla Z Corea Urbina, Anyeri De Peña Rivas, Octavio Duarte Sotelo, Temís Enamorado Claros, José L Giroud Benítez, Karla Gracia, Mario Larreategui, Jorge A Martínez Cerrato, Josmarlin P Medina Báez, Carlos E Menjivar Samayoa, Gustavo Miranda-Loria, Priscilla Monterrey-Alvarez, Lilliam A Morales Arguello, Michelle Ortiz, Carlos D Pérez Baldioceda, Lizeth Pinilla Aguilar, Luis C Rodríguez Salinas, Virginia Rodríguez-Moreno, Sebastián Rojas-Chaves, Norbel Román-Garita, Biany Santos Pujols, Carlos Valderrama, Ivonne Van Sijtveld, Indhira Zabala Angeles, Victor M Rivera, Blas Armien

Faculty, Staff and Students Publications

BACKGROUND: Multiple Sclerosis (MS) is a common neurological disease among white populations of European origin. Frequencies among Latin Americans continue to be studied, however, epidemiologic, and clinical characterization studies lack from Central American and Caribbean countries. Ethnicity in these countries is uniformly similar with a prevalent Mestizo population.

METHODS AND RESULTS: Data from January 2014 to December 2019 from Guatemala, El Salvador, Honduras, Nicaragua, Costa Rica, Panama, Dominican Republic, and Aruba on demographic, clinical, MRI and phenotypic traits were determined in coordinated studies: ENHANCE, a population-based, retrospective, observational study on incidence and clinical characteristics, and from the subgroup with MS …

A Case Of Claims And Facts: Automated Fact-Checking The Future Of Journalism’S Authority, Patrick R. Johnson

College of Communication Faculty Research and Publications

This article investigates the role of automated fact-checking on journalistic authority. Using metajournalistic discourse analysis, this article analyzes 137 articles from January 2015 to December 2022 about automated fact-checking to attempt to understand its role in the evolution of the profession’s boundaries. The data reveals three core themes: shifts of labor and experiences, social and civic responsibilities, and attribution and accuracy as contested issues. Each theme offers a different perspective on journalism’s dialogue of itself. Labor shifts illuminate making the work environment easier. Social and civic responsibilities represent the contention between fact and fiction. And attribution and accuracy highlight the …

Optimization Of A Low-Cost Corona Dielectric-Barrier Discharge Plasma Wastewater Treatment System Through Central Composite Design/Response Surface Methodology With Mechanistic And Efficiency Analysis, Yiting Xiao, Yang Tian, Yuanhang Zhan, Jun Zhu

Biological and Agricultural Engineering Faculty Publications and Presentations

Water pollution, which is intensified by the release of hard-to-degrade pollutants, poses severe threats to ecosystems, human health, and economic development. The existing advanced oxidation processes often involve high operational costs and can potentially result in secondary pollution, highlighting the necessity for innovative and more sustainable solutions. To address these challenges, our study introduces a cost-effective and eco-friendly corona dielectric-barrier discharge for wastewater treatment. Using the central composite design/response surface methodology, a high decolorization rate of 98% of methylene blue (MB) was achieved within 10 min by optimizing parameters such as pH and voltage. Furthermore, the mechanisms underlying the generation …

Prediction Of Chlorophyll-A As An Index Of Harmful Algal Blooms Using Machine Learning Models, Ibrahim Busari, Debrabata Sahoo, R. Daren Harmel, Brian E. Haggard

Biological and Agricultural Engineering Faculty Publications and Presentations

The complex dynamics of freshwater harmful algal blooms (HABs) necessitate proactive monitoring approaches to mitigate their impacts. The rapid breakthrough in computing prowess and statistical advances is triggering the development of data-driven techniques such as machine learning (ML) models, which have been shown in different fields to be instrumental in finding patterns for explaining relationships in observed data. This study assesses the ability of ML models for HABs monitoring in a lake using chlorophyll-a concentration as the index. The selected models for this study were regression tree, random forest (RF), multilayer perceptron (MLP), support vector regression (SVR), long short-term memory …

Rectifying Harm Through Care-Based Practices: How Journalists Might Tend To Disengaged Communities, Sue Robinson, Patrick R. Johnson

College of Communication Faculty Research and Publications

Journalists struggle to engage with disengaged communities, especially conservative and BIPOC groups. In this research, we suggest that an ethic of care, born from developmental psychology, can be a strategy for trust building. Using a multi-phased, multi-method approach through interviews, surveys, and a focus group, we found that community members believe journalists must be more careful and intentional with cultural and political language relating to ideology, racial identity, and sexual orientation. This study shows that journalists must address harm by contending with negative news experiences, nuancing labels and language associated with their communities, and adopting a combination of five care-based …

Extending Athlete Reputational Crises: Theorizing Underperformance Crises And The Flip Appeal, Lillian B. Feder, Diana Zulli

College of Communication Faculty Research and Publications

Crisis management scholarship recommends matching crisis response with crisis type to repair reputational damage. However, focusing on the corporate context has limited our understanding of crisis types and available responses. One crisis context yet to be extensively explored is sport/fan interactions online, an increasing site for athlete crises. This article addresses this gap, developing a theoretical framework for underperformance crises, where online publics perceive athletic underperformance as a norm violation that merits excessive hate toward athletes. Using the crisis case of basketball player E. J. Liddell, whose underperformance during a 2021 March Madness game resulted in widespread online harassment, we …

Gun Control Agendas In Networked Digital Environment: An Intermedia Comparison Between News Outlets, Activism Media, And Ephemeral Websites, Qian Li, Chun Shao, Shawn Walker, K. Hazel Kwon

College of Communication Faculty Research and Publications

This study explores the intermedia agenda-setting of the U.S. gun control movement in 2018, with a specific focus on the role of activism/advocacy media and ephemeral websites in shaping the movement discourse in news outlets. Structural topic modeling and cross-lagged correlation analyses of the Facebook URLs Share dataset show that activism/advocacy media played an important role in proposing unique agendas and aligning them with other news outlets. Meanwhile, ephemeral websites were prone to containing conspiratorial information, which could have been purposive to influence the movement. The study provides empirical insights into how various media actors interact to shape social movement …

Physical Violence And Aggression In Parkinson's Disease: A Systematic Review, Melissa B Jones, Lakeshia Gibson, Malena Gimenez-Zapiola, Ana Guerra, Gursimrat Bhatti, Dakota Broadway, Juliann Tea, Aksa Prasad, Rachel Gates, Elizabeth Hinton, Ricardo E Jorge, Laura Marsh

Faculty, Staff and Students Publications

Background: Physical violence and aggression (PVA), defined as behaviors with the potential to cause bodily injury, are unfortunate risks in the management of all-cause neurodegenerative dementias. While dementia in Parkinson's disease (PD) may not be evident for many years after clinical onset, neuropsychiatric disturbances occur at all stages of the disease. At issue is whether PVA in PD is associated with clinical factors that can be targets for prevention and management in the absence of a prevailing dementia syndrome.

Objective: This systematic review examined the extent to which PVA in PD without dementia is a clinically significant concern and whether …

Use Of A Borate-Based Bioactive Glass Martix On Infected, Exposed Hardware, Stephanie N. Campbell, Cyaandi V. Dove, Connor Krolikowski

School of Podiatric Medicine Publications

Hardware exposure is a challenging complication following foot and ankle surgery due to the high risk of infection, biofilm formation, and delayed healing. In two consecutive cases, the bioactive glass matrix combined with particulate micromatrix successfully eradicated the wound infection and biofilm, resulting in full granulation of the wound and successful wound closure. Here we present a novel bioactive glass matrix that successfully managed exposed hardware in an infected foot, providing a promising treatment strategy for managing these complications and preventing further morbidity.

Critical Dialogue And Capacity-Building Projects Reduced Alcohol And Substance Use In A Randomized Clinical Trial Among Formerly Incarcerated Men, Liliane Cambraia Windsor, Ellen Benoit, Carol Lee, Alexis Jemal, Kari Kugler, Douglas C Smith, Rogério M Pinto, Salma Musaad

Faculty, Staff and Students Publications

Background:

Rates of alcohol and/or substance use (ASU) among residents of predominantly Black and marginalized communities are similar to ASU rates in White communities. Yet ASU has worse consequences in predominantly Black and marginalized communities (e.g., higher incarceration).

Objective:

We randomized participants to one of 16 intervention conditions using a 2⁴ full factorial design to optimize a multilevel intervention reducing ASU among 602 formerly incarcerated men with substance-use-disorders (SUD). Candidate intervention components included (1) critical dialogue (CD; six weekly 2-hour-long group sessions vs. no CD sessions), (2) Quality of Life Wheel (QLW; six weekly 1-hour-long group sessions vs. no …

Citrulline And Adi-Peg20 Reduce Inflammation In A Juvenile Porcine Model Of Acute Endotoxemia, Caitlin Vonderohe, Barbara Stoll, Inka Didelija, Trung Nguyen, Mahmoud Mohammad, Yava Jones-Hall, Miguel A Cruz, Juan Marini, Douglas Burrin

Faculty, Staff and Students Publications

BACKGROUND: Arginine is a conditionally essential amino acid that is depleted in critically ill or surgical patients. In pediatric and adult patients, sepsis results in an arginine-deficient state, and the depletion of plasma arginine is associated with greater mortality. However, direct supplementation of arginine can result in the excessive production of nitric oxide (NO), which can contribute to the hypotension and macrovascular hypo-reactivity observed in septic shock. Pegylated arginine deiminase (ADI-PEG20, pegargiminase) reduces plasma arginine and generates citrulline that can be transported intracellularly to generate local arginine and NO, without resulting in hypotension, while maintaining microvascular patency. The objective of …

Association Of Circulating Ketone Bodies With Cognitive Performance And Dementia In The Multi-Ethnic Study Of Atherosclerosis (Mesa), Parag Anilkumar Chevli, Christopher L Schaich, Alexis C Wood, Luqman A Tk, Anurag Mehta, Vardhmaan Jain, Margery Connelly, Suzanne Craft, Elad Shemesh, José A Luchsinger, Kathleen M Hayden, Bonnie Colleen Sachs, Timothy M Hughes, Michael D Shapiro

Faculty, Staff and Students Publications

Introduction

Growing interest centers on the association between circulating ketone bodies (KB) and cognitive function, notably in aging and neurodegenerative diseases.

Methods

Associations of plasma KB with incident dementia and cognitive performances were examined among Multi‐Ethnic Study of Atherosclerosis (MESA) participants. KB were measured using plasma samples collected following an overnight fasting at Exam 1 (2000–02) and detailed cognitive testing at Exam 5 (2010–2012, N = 4392), Exam 6 (2016–2018, N = 1838), and in MESA‐MIND (2019–2021, N = 2060).

Results

Over 16.7 years, a doubling of total KB was associated with a greater risk of incident dementia (hazard ratio …

Call The Experts: Identifying Stakeholders In The Long-Term Care Of Youth With Hypospadias, Vinaya P Bhatia, Kristin Ebert, Shannon Cannon, Walid A Farhat, Heidi W Brown, Jane Mahoney, Marisa E Hilliard, Kristina L Penniston

Faculty, Staff and Students Publications

Long-term follow-up for individuals with hypospadias remains a critical area of need, yet evidence-based guidelines for such follow-up are lacking, and the role of involvement of relevant experts is not yet established. Using our hypospadias-specific health-related quality of life conceptual framework and a subsequent qualitative study of prepubertal males and parents of males with hypospadias, we identified potential priorities for long-term follow-up of youth with hypospadias. Using thematic codes from our patient and parent interviews, we searched PubMed for relevant articles and identified the specialties represented by all the authors of these articles. Our search strategy revealed consistent expertise across …

Predictors Of Making A Referral To Child Protective Services Prior To Expert Consultation, Danielle Zamalin, Irene Hamlin, Justine Shults, M Katherine Henry, Kristine A Campbell, James D Anderst, Angela N Bachim, Rachel P Berger, Lori D Frasier, Nancy S Harper, Megan M Letson, John D Melville, Daniel M Lindberg, Joanne N Wood

Faculty, Staff and Students Publications

OBJECTIVE: Suspicion for child abuse is influenced by implicit biases. Evaluation by a Child Abuse Pediatrician (CAP) may reduce avoidable child protective services (CPS) referrals. Our objective was to investigate the association of patient demographic, social and clinical characteristics with CPS referral before consultation by a CAP (preconsultation referral).

METHODS: Children <5 years-old undergoing in-person CAP consultation for suspected physical abuse from February 2021 through April 2022 were identified in CAPNET, a multicenter child abuse research network. Marginal standardization implemented with logistic regression analysis examined hospital-level variation and identified demographic, social, and clinical factors associated with pre-consultation referral adjusting for CAP’s final assessment of abuse likelihood.

RESULTS: Among the 61% (1005/1657) of cases with preconsultation referral, the CAP consultant had low concern for abuse in 38% (384/1005). Preconsultation referrals ranged from 25% to 78% of cases across 10 hospitals (P < .001). In multivariable analyses, preconsultation referral was associated with public insurance, caregiver history of CPS involvement, history of intimate partner violence, higher CAP level of concern for abuse, hospital transfer, and near-fatality (all P < .05). The difference in preconsultation referral prevalence for children with public versus private insurance was significant for children with low CAP concern for abuse (52% vs 38%) but not those with higher concern for abuse (73% vs 73%), (P = .023 for interaction of insurance and abuse likelihood category). There were no differences in preconsultation referral based on race or ethnicity.

CONCLUSIONS: Biases based on socioeconomic status and social factors may impact decisions to refer to …

5-Htp Inhibits Eosinophilia Via Intracellular Endothelial 5-Htrs; Snps In 5-Htrs Associate With Asthmatic Lung Function, Matthew T Walker, Jeffrey C Bloodworth, Timothy S Kountz, Samantha L Mccarty, Jeremy E Green, Ryan P Ferrie, Jackson A Campbell, Samantha H Averill, Kenneth B Beckman, Leslie C Grammer, Celeste Eng, Pedro C Avila, Harold J Farber, William Rodriguez-Cintron, Jose R Rodriguez-Santana, Denise Serebrisky, Shannon M Thyne, Max A Seibold, Esteban G Burchard, Rajesh Kumar, Joan M Cook-Mills

Faculty, Staff and Students Publications

BACKGROUND: Previous research showed that 5-hydroxytryptophan (5HTP), a metabolic precursor of serotonin, reduces allergic lung inflammation by inhibiting eosinophil migration across endothelial monolayers.

OBJECTIVE: It is unknown if serotonin receptors are involved in mediating this 5HTP function or if serotonin receptor (HTR) single nucleotide polymorphisms (SNPs) associate with lung function in humans.

METHODS: Serotonin receptor subtypes were assessed by qPCR, western blot, confocal microscopy, pharmacological inhibitors and siRNA knockdown. HTR SNPs were assessed in two cohorts.

RESULTS: Pharmacological inhibition or siRNA knockdown of the serotonin receptors HTR1A or HTR1B in endothelial cells abrogated the inhibitory effects of 5HTP on eosinophil …