Digital Commons Network^™

Achieving Surgical, Obstetric, Trauma, And Anesthesia (Sota) Care For All In South Asia, Siddhesh Zadey, Shirish Rao, Isha Gondi, Natalie Sheneman, Chaitrali Patil, Anveshi Nayan, Himanshu Iyer, Arti Raj Kumar, Arun Prasad, G Allen Finley, Chellapuram Raja Krishna Prasad, Chintamani, Dhananjaya Sharma, Dhruva Ghosh, Gnanaraj Jesudian, Irum Fatima, Jogi Pattisapu, Justin Sangwook Ko, Lovenish Bains, Mashal Shah, Mohammed Shadrul Alam, Narmada Hadigal, Naveen Malhotra, Nilmini Wijesuriya, Prateek Shukla, Sadaf Khan, Sunil Pandya, Tariq Khan, Tashi Tenzin, Venkat Raja Hadiga, Daniel Peterson

Faculty, Staff and Students Publications

South Asia is a demographically crucial, economically aspiring, and socio-culturally diverse region in the world. The region contributes to a large burden of surgically-treatable disease conditions. A large number of people in South Asia cannot access safe and affordable surgical, obstetric, trauma, and anesthesia (SOTA) care when in need. Yet, attention to the region in Global Surgery and Global Health is limited. Here, we assess the status of SOTA care in South Asia. We summarize the evidence on SOTA care indicators and planning. Region-wide, as well as country-specific challenges are highlighted. We also discuss potential directions-initiatives and innovations-toward addressing these …

Effects Of Covid-19 On Sleep Services Use And Its Recovery, Amin Ramezani, Amir Sharafkhaneh, Ahmed S Bahammam, Samuel T Kuna, Javad Razjouyan

Faculty, Staff and Students Publications

PURPOSE: The COVID-19 pandemic affected the utilization of various healthcare services differentially. Sleep testing services utilization (STU), including Home Sleep Apnea Testing (HSAT) and Polysomnography (PSG), were uniquely affected. We assessed the effects of the pandemic on STU and its recovery using the Veterans Health Administration (VHA) data.

PATIENTS AND METHODS: A retrospective cohort study from the VHA between 01/2019 and 10/2023 of veterans with age ≥ 50. We extracted STU data using Current Procedural Terminology codes for five periods based on STU and vaccination status: pre-pandemic (Pre-Pan), pandemic sleep test moratorium (Pan-Mor), and pandemic pre-vaccination (Pan-Pre-Vax), vaccination (Pan-Vax), and …

A Comprehensive Analysis Of Neuroblastoma Incidence, Survival, And Racial And Ethnic Disparities From 2001 To 2019, Kevin Campbell, David A Siegel, Puja J Umaretiya, Shifan Dai, Andras Heczey, Philip J Lupo, Jeremy M Schraw, Trevor D Thompson, Michael E Scheurer, Jennifer H Foster

Faculty, Staff and Students Publications

BACKGROUND: We characterize the incidence and 5-year survival of children and adolescents with neuroblastoma stratified by demographic and clinical factors based on the comprehensive data from United States Cancer Statistics (USCS) and the National Program of Cancer Registries (NPCR).

METHODS: We analyzed the incidence of neuroblastoma from USCS (2003-2019) and survival data from NPCR (2001-2018) for patients less than 20 years old. Incidence trends were calculated by average annual percent change (AAPC) using joinpoint regression. Differences in relative survival were estimated comparing non-overlapping confidence intervals (CI).

RESULTS: We identified 11,543 primary neuroblastoma cases in USCS. Age-adjusted incidence was 8.3 per …

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 …

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 …

Cisplatin Vestibulotoxicity: A Current Review, Tamara Fleihan, Marc Elie Nader, J David Dickman

Faculty, Staff and Students Publications

Cisplatin, a commonly used chemotherapy drug, is well-established for its ototoxic effects, primarily attributed to the damage it inflicts on cochlear hair cells. However, its impact on the vestibular system remains inadequately understood. Here, we provide a comprehensive review of existing literature concerning cisplatin-induced vestibulotoxicity. Animal studies have shown that cisplatin induces a vestibular hair cell loss that is dose-dependent, with the severity of damage also varying according to the route of administration. Notably, intratympanic and systemic injections in animal models have manifested significant damage primarily to utricular hair cells, with a lesser degree of damage observed for the other …

Gambian Mothers Lack Obstetric Danger Sign Knowledge, But Educational Intervention Shows Promise, Kara Shannon, Jocelyn Burridge, Brodus Franklin, Sheena Bhushan, Susan Hilsenbeck, Elena V Petrova, James N'Dow, Ibezimako Iwuh, Sharmila Anandasabapathy, Jeffrey P Wilkinson

Faculty, Staff and Students Publications

BACKGROUND: The Gambia has the 12th highest maternal mortality rate in the world, with 80% of deaths resulting from avoidable causes. Unawareness of pregnancy danger signs (DS) has been shown to be a barrier to seeking obstetric care, while app-based education intervention has shown promise.

OBJECTIVE: We aim to assess patient awareness of DS, identify barriers to awareness, and evaluate potential for implementing smartphone-based technologies for education.

METHODS: A cross-sectional semi-structured survey was administered to Gambian women (n = 100) across five hospitals/health centers. Data and informed consent were collected via an online survey portal. Analysis included bivariate analysis and …

Case Report: P40phox Deficiency Underlying Pediatric-Onset Systemic Lupus Erythematosus, Alejandro Nieto-Patlán, Natalia S Fernández Dávila, Yuqing Wang, Michelle Zelnick, Eyal Muscal, Martha Curry, James R Lupski, Steven M Holland, Bo Yuan, Douglas B Kuhns, Tiphanie P Vogel, Ivan K Chinn

Faculty, Staff and Students Publications

Introduction

Systemic lupus erythematosus is a multi-faceted autoimmune disorder of complex etiology. Pre-pubertal onset of pediatric systemic lupus erythematosus (pSLE) is uncommon and should raise suspicion for a genetic driver of disease. Autosomal recessive p40^phox deficiency is a rare immunologic disorder characterized by defective but not abolished NADPH oxidase activity with residual production of reactive oxygen species (ROS) by phagocytic cells.

Case presentation

We report the case of a now 18-year-old female with pSLE onset at 7 years of age. She presented with recurrent fever and malar rash. Aspects of her immune dysregulation over time have included typical pSLE …

Research Participants' Perspectives On Precision Diagnostics For Alzheimer's Disease, Hadley Stevens Smith, Jill O Robinson, Ariel Levchenko, Stacey Pereira, Belen Pascual, Kathleen Bradbury, Victoria Arbones, Jamie Fong, Joshua M Shulman, Amy L Mcguire, Joseph Masdeu

Faculty, Staff and Students Publications

BACKGROUND: Understanding research participants' responses to learning Alzheimer's disease (AD) risk information is important to inform clinical implementation of precision diagnostics given rapid advances in disease modifying therapies.

OBJECTIVE: We assessed participants' perspectives on the meaning of their amyloid positron emission tomography (PET) imaging results for their health, self-efficacy to understand their results, psychological impact of learning their results, experience receiving their results from the clinical team, and interest in genetic testing for AD risk.

METHODS: We surveyed individuals who were being clinically evaluated for AD and received PET imaging six weeks after the return of results. We analyzed responses …

Co-Expression Of Prepulse Inhibition And Schizophrenia Genes In The Mouse And Human Brain, Lillian Garrett, Dietrich Trümbach, Donghyung Lee, Silvia Mandillo, Rodney Samaco, Ann M Flenniken, Michelle Stewart, Impc Consortium, Jacqueline K White, Colin Mckerlie, Lauryl M J Nutter, Igor Vukobradovic, Surabi Veeraragavan, Lisa Yuva, Jason D Heaney, Mary E Dickinson, Hamid Meziane, Yann Hérault, Sara Wells, K C Kent Lloyd, Lynette Bower, Louise Lanoue, Dave Clary, Annemarie Zimprich, Valerie Gailus-Durner, Helmut Fuchs, Steve D M Brown, Elissa J Chesler, Wolfgang Wurst, Martin Hrabě De Angelis, Sabine M Hölter

Faculty, Staff and Students Publications

Schizophrenia is a complex psychiatric disorder with genetic and phenotypic heterogeneity. Accumulating rare and genome-wide association study (GWAS) common risk variant information has yet to yield robust mechanistic insight. Leveraging large-scale gene deletion mouse phenomic data thus has potential to functionally interrogate and prioritize human disease genes. To this end, we applied a cross-species network-based approach to parse an extensive mouse gene set (188 genes) associated with disrupted prepulse inhibition (PPI), a Schizophrenia endophenotype. Integrating PPI genes with high-resolution mouse and human brain transcriptomic data, we identified functional and disease coherent co-expression modules through hierarchical clustering and weighted gene co-expression …

Understanding Prescribing Practices And Patient Experiences With Renin Angiotensin System Inhibitors Use In Chronic Kidney Disease: A Qualitative Study, Jennifer Arney, L Parker Gregg, Sheena Wydermyer, Michael A Herrera, Peter A Richardson, Michael E Matheny, Julia M Akeroyd, Glenn T Gobbel, Adriana Hung, Salim S Virani, Sankar D Navaneethan

Faculty, Staff and Students Publications

Introduction: Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) improve outcomes but are underutilized in patients with chronic kidney disease (CKD). Little is known about reasons for discontinuation and lack of reinitiating these medications. We aimed to explore clinicians' and patients' experiences and perceptions of ACEI/ARB use in CKD.

Methods: A multi-profession sample of health care clinicians and patients with documented ACEI/ARB-associated side effects in the past 6 months. Participants were recruited from 2 Veterans Affairs healthcare systems in Texas and Tennessee. A total of 15 clinicians and 10 patients completed interviews. We used inductive and deductive qualitative data …

Variability In Chest Radiology Interpretation Between Thoracic And Non-Thoracic Radiologists: Implications For Pulmonary Fibrosis Care, Daniel M Guidot, Danielle Seaman, Roy A Pleasants, Armando Bedoya, Robert M Tighe, Bhavika Kaul

Faculty, Staff and Students Publications

No abstract provided.

Relationship Between Clinical Measures Of Hearing And Clinical Measures Of Vestibular Function, Helen S Cohen, Haleh Sangi-Haghpeykar, J Connor Sullivan, Nathan Silver, Liam D Ferreira, Jen Li Dong, Alex D Sweeney, Angela S Peng

Faculty, Staff and Students Publications

PURPOSE: Patients often have basic audiometry (BA) but not objective diagnostic tests of the vestibular system (VNG) when complaining of symptoms of a vestibular disorder. The relationship of BA results to VNG results is unknown. This study sought to determine if BA scores are related to impaired VNG scores.

MATERIALS AND METHODS: We reviewed electronic medical records at a tertiary care center, for patients seen between 2015 and 2021 who had had both a BA and a VNG (n = 651). BA subtests were pure tone averages, word recognition, and tympanogram. VNG subtests were cervical vestibular evoked myogenic potentials, Dix-Hallpike …

Corrigendum: Combining Charlson Comorbidity And Vacs Indices Improves Prognostic Accuracy For All-Cause Mortality For Patients With And Without Hiv In The Veterans Health Administration, Kathleen A Mcginnis, Amy C Justice, Vincent C Marconi, Maria C Rodriguez-Barradas, Ronald G Hauser, Krisann K Oursler, Sheldon T Brown, Kendall J Bryant, Janet P Tate

Faculty, Staff and Students Publications

[This corrects the article DOI: 10.3389/fmed.2023.1342466.].

Narratives Of Identity: An Autoethnographic Exploration Of Biracial Identity Construction And Performance In Family, Education, And Media, Eboni Springfield

Dissertations and Theses @ UNI

This thesis explores the complex construction and performance of biracial identity within the context of the United States, delving into the historical and ongoing impacts of race and racism, and the pervasive influence of white supremacy. Through an autoethnographic approach, this study investigates how personal narratives illuminate the processes of biracial identity construction, expression, and negotiation across three social institutions: family, education, and media. The findings reveal the intricate and intersecting interactions that contribute to identity formation, highlighting the expansive nature of intersectionality. The analysis demonstrates that biracial identity is continuously shaped in response to white supremacy, which complicates efforts …

Genetic Variation Between Small Bowel And Colon-Predominant Crohn's Disease, Halee Patel, R Alan Harris, Justin H Qian, Numan Oezguen, Ashleigh Watson, Reka G Szigeti, Stanley Cho, Wenly Ruan, Savini Britto, Antone Opekun, Geoffrey Preidis, Richard Kellermayer

Faculty, Staff and Students Publications

No abstract provided.

Self-Rectifying Magnetoelectric Metamaterials For Remote Neural Stimulation And Motor Function Restoration, Joshua C Chen, Gauri Bhave, Fatima Alrashdan, Abdeali Dhuliyawalla, Katie J Hogan, Antonios G Mikos, Jacob T Robinson

Faculty, Staff and Students Publications

Magnetoelectric materials convert magnetic fields into electric fields. These materials are often used in wireless electronic and biomedical applications. For example, magnetoelectrics could enable the remote stimulation of neural tissue, but the optimal resonance frequencies are typically too high to stimulate neural activity. Here we describe a self-rectifying magnetoelectric metamaterial for a precisely timed neural stimulation. This metamaterial relies on nonlinear charge transport across semiconductor layers that allow the material to generate a steady bias voltage in the presence of an alternating magnetic field. We generate arbitrary pulse sequences with time-averaged voltage biases in excess of 2 V. As a …

Rates And Predictors Of Rapid Eye Movement Sleep Behavior Disorder Symptoms Among Post-9/11 Veterans, Melissa B Jones, Juliann Tea, Matthew Meyers, Ruosha Li, Audri Villalon, Ritwick Agrawal, Ricardo E Jorge

Faculty, Staff and Students Publications

Objective: Posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI), which are prevalent conditions among post-9/11 veterans, increase risks of rapid eye movement (REM) sleep behavior disorder (RBD) and degenerative synucleinopathy. Rates and predictors of RBD symptoms were investigated by screening post-9/11 veterans for RBD with a validated questionnaire.

Methods: In this cross-sectional analysis, consecutive patients in the Houston Translational Research Center for TBI and Stress Disorders (TRACTS) were screened with the English translation of the RBD Questionnaire-Hong Kong (RBDQ-HK). In addition to data from the standard TRACTS battery, systematic chart review was used to identify known sleep disorders mimicking …

Editorial: Symmetry As A Guiding Principle In Artificial And Brain Neural Networks, Volume Ii, Fabio Anselmi, Ankit B Patel

Faculty, Staff and Students Publications

No abstract provided.

Dimensionality Reduction And Nearest Neighbors For Improving Out-Of-Distribution Detection In Medical Image Segmentation, Mckell Woodland, Nihil Patel, Austin Castelo, Mais Al Taie, Mohamed Eltaher, Joshua P Yung, Tucker J Netherton, Tiffany L Calderone, Jessica I Sanchez, Darrel W Cleere, Ahmed Elsaiey, Nakul Gupta, David Victor, Laura Beretta, Ankit B Patel, Kristy K Brock

Faculty, Staff and Students Publications

Clinically deployed deep learning-based segmentation models are known to fail on data outside of their training distributions. While clinicians review the segmentations, these models tend to perform well in most instances, which could exacerbate automation bias. Therefore, detecting out-of-distribution images at inference is critical to warn the clinicians that the model likely failed. This work applied the Mahalanobis distance (MD) post hoc to the bottleneck features of four Swin UNETR and nnU-net models that segmented the liver on T1-weighted magnetic resonance imaging and computed tomography. By reducing the dimensions of the bottleneck features with either principal component analysis or uniform …

The Use Of Fluorescence Lifetime Imaging (Flim) For In Situ Microbial Detection In Complex Mineral Substrates, Yekaterina G. Chmykh, Jay Nadeau

Physics Faculty Publications and Presentations

The utility of fluorescence lifetime imaging microscopy (FLIM) for identifying bacteria in complex mineral matrices was investigated. Baseline signals from unlabelled Bacillus subtilis and Euglena gracilis, and Bacillus subtilis labelled with SYTO 9 were obtained using two-photon excitation at 730, 750 and 800 nm, identifying characteristic lifetimes of photosynthetic pigments, unpigmented cellular autofluorescence, and SYTO 9. Labelled and unlabelled B. subtilis were seeded onto marble and gypsum samples containing endolithic photosynthetic cyanobacteria and the ability to distinguish cells from mineral autofluorescence and nonspecific dye staining was examined in parallel with ordinary multichannel confocal imaging. It was found that FLIM …

Asynchronous Movement Patterns Between Breeding And Stopover Locations In A Long-Distance Migratory Songbird, Theodore Zenzal, Andrea Contina, Hannah Vander Zanden, Leanne Kuwahara, Daniel Allen, Kristen Covino

Faculty Publications

The species-specific migratory patterns and strategies of many songbirds remain unknown or understudied, as research in animal ecology is biased toward the breeding period, with the fewest studies on the migratory period across taxa. Identifying large-scale spatiotemporal migratory patterns is challenging, as individuals within a species may vary in their migratory behavior and strategies. The Yellow Warbler (Setophaga petechia) is a Nearctic-Neotropical migrant that is relatively well studied during the breeding season, but its species-wide migratory patterns remain understudied. Our aim in studying Yellow Warbler movement ecology was to characterize temporal migration patterns during fall migration. We sought to determine …

X-Ray Polarization Of The Eastern Lobe Of Ss 433, Philip Kaaret, Riccardo Ferrazzoli, Stefano Silvestri, Michela Negro, Alberto Manfreda, Kinwah Wu, Enrico Costa, Paolo Soffitta, Samar Safi-Harb, Juri Poutanen, Alexandra Veledina, Alessandro Di Marco, Patrick Slane, Stefano Bianchi, Adam Ingram, Roger W. Romani, Nicolò Cibrario, Brydyn Mac Intyre, Romana Mikus̆Incová, Ajay Ratheesh, James F. Steiner, Jiri Svoboda, Stefano Tugliani, Iván Agudo, Lucio A. Antonelli

Faculty Publications

How astrophysical systems translate the kinetic energy of bulk motion into the acceleration of particles to very high energies is a pressing question. SS 433 is a microquasar that emits TeV γ-rays indicating the presence of high-energy particles. A region of hard X-ray emission in the eastern lobe of SS 433 was recently identified as an acceleration site. We observed this region with the Imaging X-ray Polarimetry Explorer and measured a polarization degree in the range 38%–77%. The high polarization degree indicates the magnetic field has a well-ordered component if the X-rays are due to synchrotron emission. The polarization angle …

Gnss Software Defined Radio: History, Current Developments, And Standardization Efforts, Thomas Pany, Dennis Akos, Javier Arribas, M. Zahidul H. Bhuiyan, Pau Closas, Fabio Dovis, Ignacio Fernandez-Hernandez, Carles Fernandez-Prades, Sanjeev Gunawardena, Todd Humphreys, Zaher M. Kassas, Jose A. Lopez Salcedo, Mario Nicola, Mario L. Psiaki, Alexander Rugamer, Yong-Jin Song, Jong-Hoon Won

Faculty Publications

Taking the work conducted by the global navigation satellite system (GNSS) software-defined radio (SDR) working group during the last decade as a seed, this contribution summarizes, for the first time, the history of GNSS SDR development. This report highlights selected SDR implementations and achievements that are available to the public or that influenced the general development of SDR. Aspects related to the standardization process of intermediate-frequency sample data and metadata are discussed, and an update of the Institute of Navigation SDR Standard is proposed. This work focuses on GNSS SDR implementations in general-purpose processors and leaves aside developments conducted on …

Introduction To The Special Issue Of The Emory International Law Review, Magdalena Tulibacka

Emory International Law Review

No abstract provided.

A Combatant Or Not A Combatant That Is The Question: Arguing The Case Of Combatant Status For Non-Military Government Personnel And Private Military Contractors Engaged On The Modern Battlefield, Ilan Fuchs, Shane Owens

Emory International Law Review

No abstract provided.

Green Poems, Lillian I. Emerick Valentine

Graduate Student Theses, Dissertations, & Professional Papers

With broad lyric range, the ecopoems in Green center around the ideology and ethics of the American West. The speaker’s position within that as a descendent of settler laborers is interrogated, as well as language itself. Grammar is used as a tool to perform deconstructive work, examining how labor intersects with colonialism and climate change. Melding intellectual analyses of etymology with the physical act of agricultural labor, these poems range from the conversational and playful to lyric explorations of loss.

Interwoven with this is the speaker’s self-examination of femininity and matrilinear inheritance. How do we use the language we’ve been …

Sudden Oak Death, Jeffrey William Guay

Graduate Student Theses, Dissertations, & Professional Papers

A novel set contemporaneously in rural Montana, Sudden Oak Death follows two protagonists, Wade and his teenage daughter Paige. Each are fighting different addictions, as Wade is in alcoholism recovery, and Paige recently came home from a drug treatment program. In order to succeed, Paige must reintegrate herself into public high school, despite suffering from undiagnosed dyslexia. Wade is raising his family as a single father, and struggles to maintain his emotional stability in the face of his own recovery.

Old Stock, Grace K. Butler

Graduate Student Theses, Dissertations, & Professional Papers

No abstract provided.

Phoenicians: Stories, Anthony Gregory Cardellini

Graduate Student Theses, Dissertations, & Professional Papers

No abstract provided.