Digital Commons Network^™

Time To Continuous Renal Replacement Therapy Initiation And 90-Day Major Adverse Kidney Events In Children And Young Adults, Katja M Gist, Shina Menon, Pilar Anton-Martin, Amee M Bigelow, Gerard Cortina, Akash Deep, Sara De La Mata-Navazo, Ben Gelbart, Stephen Gorga, Isabella Guzzo, Kenneth E Mah, Nicholas J Ollberding, H Stella Shin, Sameer Thadani, Amanda Uber, Huaiyu Zang, Michael Zappitelli, David T Selewski, We-Rock Investigators

Faculty, Staff and Students Publications

IMPORTANCE: In clinical trials, the early or accelerated continuous renal replacement therapy (CRRT) initiation strategy among adults with acute kidney injury or volume overload has not demonstrated a survival benefit. Whether the timing of initiation of CRRT is associated with outcomes among children and young adults is unknown.

OBJECTIVE: To determine whether timing of CRRT initiation, with and without consideration of volume overload (VO;

DESIGN, SETTING, AND PARTICIPANTS: This multinational retrospective cohort study was conducted using data from the Worldwide Exploration of Renal Replacement Outcome Collaborative in Kidney Disease (WE-ROCK) registry from 2015 to 2021. Participants included children and young …

C1q Is Elevated During Chronic Staphylococcus Epidermidis Central Nervous System Catheter Infection, Matthew K. Beaver, Lara Bergdolt, Anna Dunaevsky, Tammy Kielian, Gwenn Skar

Journal Articles: Pathology and Microbiology

INTRODUCTION: Significant neurologic morbidity is caused by pediatric cerebrospinal fluid (CSF) shunt infections. The underlying mechanisms leading to impaired school performance and increased risk of seizures are unknown, however, a better understanding of these mechanisms may allow us to temper their consequences. Recent evidence has demonstrated important roles for complement proteins in neurodevelopment and neuroinflammation.

METHODS: We examined complement activation throughout

RESULTS: We found that MASP2 predominated early in catheter infection, but that Factor B was elevated at intermediate time points. Unexpectedly C1q was elevated at late timepoints when bacterial burdens were low or undetectable. Based on these findings and …

Predictors Of Utilization Of Preventive Gynecologic Health Services Among Women Veterans, Jennifer Lynn Milore

PCOM Psychology Dissertations

As the number of women veterans in the United States increases, additional attention has been given to understanding their healthcare experiences within the Veterans Health Administration. However, much of the current literature exploring women veterans has been qualitative and little research has examined quantitative relationships between experiences in the VA healthcare system and gynecologic health behaviors and outcomes. The purpose of this study was to evaluate potential factors (health literacy, social problem-solving abilities, and perceived gender discrimination) that may predict gynecologic health behaviors in women veterans. This study included 145 anonymous participants. Participants completed screening questions and demographic and health …

Athletic Trainers' Perceptions Of Salary Negotiation Decision-Making During The Hiring Process, Julie M. Cavallario, Kim Detwiler, Leanne Jones, Indigo White, Cailee E. Welch

Rehabilitation Sciences Faculty Publications

Context: Appropriate salaries for athletic trainers (ATs) have been a contentious topic for decades. While professional advocacy efforts to increase ATs' salaries have gained traction, little is known about ATs' experiences with negotiation during the hiring process.

Objective: To explore the reasons, influences, and factors influencing ATs' negotiation decisions.

Design: Qualitative study.

Setting: Individual video interviews.

Patients or other participants: 28 ATs who participated in a previous study and indicated a willingness to participate in the qualitative follow-up were interviewed (17 women, 10 men, 1 non-binary individual; age = 37.8±8.9 years; athletic training experience = 15.1±8.3 years). Of the 28 …

Ever Use Of Telehealth In Nebraska By March 2021: Cross-Sectional Analysis, Lisa C. Smith, George Johnson, Snehal Jadhav, Josiane Kabayundo, Muskan Ahuja, Hongmei Wang, Kendra L. Ratnapradipa

Journal Articles: Epidemiology

BACKGROUND: Nationally, COVID-19 spurred the uptake of telehealth to facilitate patients' access to medical care, especially among individuals living in geographically isolated areas. Despite the potential benefits of telehealth to address health care access barriers and enhance health outcomes, there are still disparities in the accessibility and utilization of telehealth services. Hence, identifying facilitators and barriers to telehealth should be prioritized to ensure that disparities are mitigated rather than exacerbated.

OBJECTIVE: This study aims to identify factors associated with ever use of telehealth in Nebraska, a primarily rural state with a significant portion of its population living in nonmetropolitan areas. …

Hour Of Life At Enteral Feeding Initiation And Associated Clinical Morbidity In Extremely Low-Birth-Weight Infants, Melissa Thoene, Lauren Ridgway, Elizabeth Lyden, Ann Anderson-Berry

Journal Articles: Pediatrics

BACKGROUND/OBJECTIVES: Identifying nutritional interventions in extremely low-birth-weight (ELBW) infants (<1000 >g) that are associated with favorable clinical outcomes is important. Delayed enteral feeding initiation (>3 days) has been associated with increased odds of developing morbidity. Therefore, the aim of this study is to evaluate the relationship between hour of life at enteral feeding initiation and associated clinical outcomes.

METHODS: An IRB-approved retrospective chart review evaluated ELBW infants. Birth acuity was evaluated using CRIB II scoring and incidence of various morbidities (bronchopulmonary dysplasia (BPD), retinopathy of prematurity (ROP), necrotizing enterocolitis (NEC), and spontaneous intestinal perforation (SIP)) and mortality was assessed …

Allied Dental Students' Perceived Knowledge, Confidence, And Attitudes Regarding Disaster Victim Identification Topics, Samantha C. Vest, Brenda T. Bradshaw, Marsha A. Voelker, Ann M. Bruhn, Tara L. Newcomb, Sinjini Sikdar

Dental Hygiene Faculty Publications

Purpose Disaster victim identification (DVI) service requires knowledge, confidence, and an attitude (KCA) of readiness. The purpose of this study was to assess allied dental students’ perceived KCA regarding DVI skills and topics.

Methods A convenience sample of senior dental hygiene students (n=27) and senior dental assistant students (n=14) were recruited by email then presented mismatched simulated antemortem (AM) and postmortem (PM) bitewing radiographs and asked to indicate correct matches. Collectively, participants made 205 radiographic matches and indicated 205 degrees of certainty binarily as “positive” or “possible” (one per match). Participants also completed a researcher designed pretest/posttest electronic survey with …

Effects Of Ultrasonic Use On Hearing Loss In Dental Hygienists: A Matched Pairs Design Study, Jessica Suedbeck, Emily A. Ludwig, James Blando, Nathan Michalak

Dental Hygiene Faculty Publications

Purpose: Dental professionals are exposed to hazardous noise levels on a daily basis in clinical practice. The purpose of this study was to compare the hearing status of dental hygienists who utilize ultrasonic scalers in the workplace compared to age-matched control participants (non-dental hygienists) who were not exposed to ultrasonic noise.

Methods: A convenience sample of nineteen dental hygienists (experimental) and nineteen non-dental hygienists (control) was recruited for this study. A matched pairs design was utilized; participants in each group were matched based on age and gender to eliminate confounding variables. The testing procedure consisted of an audiologist performing a …

Prediction Of Recurrent Lateral Ankle Sprain And Ankle Pain Using Applied Care Strategies And Patient-Reported Outcomes, Ryan S. Mccann, Elisabeth Ohrnberger, Kyle B. Kosik, Phillip A. Gribble

Rehabilitation Sciences Faculty Publications

Context

Patients with lateral ankle sprains (LASs) often have deficient patient-reported outcomes (PROs) at return to activity (RTA), potentially increasing risk for recurrent LAS and ankle pain. Additionally, applied care strategies are known to correct impairments, but their ability to mitigate risk for long-term consequences remains unknown.

Objective

To determine if applied care strategies and PRO scores at RTA and 6 months after RTA predict recurrent LAS and ankle pain 12 months after an acute LAS. DESIGN: Prospective cohort study.

Setting

Online survey.

Patients or Other Participants

We enrolled 63 individuals within 1 week of sustaining an acute LAS.

Main …

Models Of Video Feedback For Youth Athletes Performing An American Football Tackle, Eric Schussler, Richard J. Jagacinski, Ajit Chaudhari, John A. Buford, James A. Onate

Rehabilitation Sciences Faculty Publications

Context: Video feedback is an expeditious method for improving athlete safety when performing activities with an inherent risk of injury. Providing appropriate and validated feedback during tackling training in American football may be a mechanism for athletes to learn safe tackling performance.

Objective: To determine the effect of video feedback in the instruction of tackling form.

Design: Controlled laboratory study.

Setting: Laboratory.

Patients or Other Participants: A total of 32 youth football athletes (28 boys, 4 girls; age ¼ 11.8 6 0.8 years) participated in 1 day of training. Of those, 14 participants completed 2 additional days of training and …

The Impact Of Recreational Cannabinoid Legalization On Utilization In A Pregnant Population, Jacob Torres, Colton Miller, Michael Apostol, Jessica Gross, Jessie R. Maxwell

Pediatrics Research and Scholarship

BACKGROUND: Marijuana potency and utilization both continue to increase across the United States. While the overall prevalence of cannabinoid utilization during pregnancy has been surveyed in various studies, the direct impact of changing governmental policies on pregnancy use is less characterized. Thus, we aimed to investigate how the legalization of recreational cannabinoid products impacted use during pregnancy in the state of New Mexico.

METHODS: Participants who had a live birth during two study epochs were included: pre-legalization (Epoch 1: 1 January 2019-31 March 2021) and post-legalization (Epoch 2: 1 November 2021-30 November 2022). Participants were further divided into case group …

Examining Menstrual Health Experiences In Philadelphia, Pa: A Qualitative Investigation, Allison Casola, Oriana Pando, Lynette Medley, Brianna Kunes, Nya Mcglone, Olivia Rea

Department of Family & Community Medicine Faculty Papers

BACKGROUND: While menstruation is a physiologic process, it remains highly stigmatized. Despite the sheer number of menstruators, menstruation is a highly individualized experience, with wide variation in duration, symptoms, and management. This wide variability lends itself to large disparities in access to menstruation management products and subsequently the lived experience of menstruators.

OBJECTIVES: The research team sought to understand lived menstrual experiences, symptoms, management tactics, and commonly used and desired resources among 20 cisgendered women aged 18-45 years in Philadelphia.

DESIGN: This project was a qualitative research study.

METHODS: We used a collaborative, community-based participatory research approach with No More …

Risk-Stratified Treatment For Drug-Susceptible Pulmonary Tuberculosis., Vincent K. Chang, Marjorie Z. Imperial, Patrick P. J. Phillips, Gustavo E. Velásquez, Payam Nahid, Andrew Vernon, Ekaterina V. Kurbatova, Susan Swindells, Richard E. Chaisson, Susan E. Dorman, John L. Johnson, Marc Weiner, Amina Jindani, Thomas Harrison, Erin E. Sizemore, William Whitworth, Wendy Carr, Kia E. Bryant, Deron Burton, Kelly E. Dooley, Melissa Engle, Pheona Nsubuga, Andreas H. Diacon, Nguyen Viet Nhung, Rodney Dawson, Radojka M. Savic, Aids Clinical Trial Group, Tuberculosis Trials Consortium

Journal Articles: Infectious Diseases

The Phase 3 randomized controlled trial, TBTC Study 31/ACTG A5349 (NCT02410772) demonstrated that a 4-month rifapentine-moxifloxacin regimen for drug-susceptible pulmonary tuberculosis was safe and effective. The primary efficacy outcome was 12-month tuberculosis disease free survival, while the primary safety outcome was the proportion of grade 3 or higher adverse events during the treatment period. We conducted an analysis of demographic, clinical, microbiologic, radiographic, and pharmacokinetic data and identified risk factors for unfavorable outcomes and adverse events. Among participants receiving the rifapentine-moxifloxacin regimen, low rifapentine exposure is the strongest driver of tuberculosis-related unfavorable outcomes (HR 0.65 for every 100 µg∙h/mL increase, …

Pyrazinamide Safety, Efficacy, And Dosing For Treating Drug-Susceptible Pulmonary Tuberculosis: A Phase 3, Randomized Controlled Clinical Trial, Ava Y. Xu, Gustavo E. Velásquez, Nan Zhang, Vincent K. Chang, Patrick P. J. Phillips, Payam Nahid, Susan E. Dorman, Ekaterina V. Kurbatova, William C. Whitworth, Erin Sizemore, Kia Bryant, Wendy Carr, Nicole E. Brown, Melissa L. Engle, Nguyen Viet Nhung, Pheona Nsubuga, Andreas Diacon, Kelly E. Dooley, Richard E. Chaisson, Susan Swindells, Radojka M. Savic

Journal Articles: Infectious Diseases

Optimizing pyrazinamide dosing is critical to improve treatment efficacy while minimizing toxicity during tuberculosis treatment. Study 31/AIDS Clinical Trials Group A5349 represents the largest phase 3 randomized controlled therapeutic trial to date for such an investigation. Objectives: We sought to report pyrazinamide pharmacokinetic parameters, risk factors for lower pyrazinamide exposure, and relationships between pyrazinamide exposure and efficacy and safety outcomes. We aimed to determine pyrazinamide dosing strategies that optimize risks and benefits. Methods: We analyzed pyrazinamide steady-state pharmacokinetic data using population nonlinear mixed-effects models. We evaluated the contribution of pyrazinamide exposure to long-term efficacy using parametric time-to-event models and safety …

Ispad Clinical Practice Consensus Guidelines 2024: Screening, Staging, And Strategies To Preserve Beta-Cell Function In Children And Adolescents With Type 1 Diabetes, Michael J Haller, Kirstine J Bell, Rachel E J Besser, Kristina Casteels, Jenny J Couper, Maria E Craig, Helena Elding Larsson, Laura Jacobsen, Karin Lange, Tal Oron, Emily K Sims, Cate Speake, Mustafa Tosur, Francesca Ulivi, Anette-G Ziegler, Diane K Wherrett, M Loredana Marcovecchio

Faculty, Staff and Students Publications

The International Society for Pediatric and Adolescent Diabetes (ISPAD) guidelines represent a rich repository that serves as the only comprehensive set of clinical recommendations for children, adolescents, and young adults living with diabetes worldwide. This guideline serves as an update to the 2022 ISPAD consensus guideline on staging for type 1 diabetes (T1D). Key additions include an evidence-based summary of recommendations for screening for risk of T1D and monitoring those with early-stage T1D. In addition, a review of clinical trials designed to delay progression to Stage 3 T1D and efforts seeking to preserve beta-cell function in those with Stage 3 …

Prevalence Of Congenital Anomalies According To Maternal Race And Ethnicity, Texas, 1999–2018, Jeremy M Schraw, Elwin Jaime, Charles J Shumate, Mark A Canfield, Philip J Lupo

Faculty, Staff and Students Publications

BACKGROUND: Few studies of congenital anomalies provide prevalence estimates stratified by maternal race/ethnicity. We sought to determine whether the prevalence of a broad spectrum of anomalies varies among offspring of women from different race/ethnic groups.

METHODS: We obtained information on cases with anomalies from the population-based Texas Birth Defects Registry, and denominator data on livebirths among Texas residents during 1999-2018 from the Texas Center for Health Statistics. We estimated the prevalence ratio (PR) and 95% confidence interval (CI) of N = 145 anomalies among offspring of Hispanic and non-Hispanic Black relative to non-Hispanic White women using Poisson regression, adjusting for …

Lessons Learned From The Moment Study On How To Recruit And Retain A Target Population Online, Across Borders, And With Automated Remote Data Collection, Andrew Belfiglio, Shayleigh Dickson Page, Sara Pettersson, Michelle Van Rijn, Ercole Vellone, Heleen Westland, Kenneth E. Freedland, Christopher Lee, Anna Strömberg, Douglas Wiebe, Subhash Aryal, Barbara Riegel, Tiny Jaarsma

2020-Current year OA Pubs

Increasingly, studies use social media to recruit, enroll, and collect data from participants. This introduces a threat to data integrity: efforts to produce fraudulent data to receive participant compensation, e.g., gift cards. MOMENT is an online symptom-monitoring and self-care study that implemented safeguards to protect data integrity. Facebook, Twitter, and patient organizations were used to recruit participants with chronic health conditions in four countries (USA, Italy, The Netherlands, Sweden). Links to the REDCap baseline survey were posted to social media accounts. The initial study launch, where participants completed the baseline survey and were automatically re-directed to the LifeData ecological momentary …

Baseline Characteristics Of Sars-Cov-2 Vaccine Non-Responders In A Large Population-Based Sample, Ashraf Yaseen, Stacia M Desantis, Rachit Sabharwal, Yashar Talebi, Michael D Swartz, Shiming Zhang, Luis Leon Novelo, Cesar L Pinzon-Gomez, Sarah E Messiah, Melissa Valerio-Shewmaker, Harold W Kohl, Jessica Ross, David Lakey, Jennifer A Shuford, Stephen J Pont, Eric Boerwinkle

Faculty, Staff and Student Publications

INTRODUCTION: Studies indicate that individuals with chronic conditions and specific baseline characteristics may not mount a robust humoral antibody response to SARS-CoV-2 vaccines. In this paper, we used data from the Texas Coronavirus Antibody REsponse Survey (Texas CARES), a longitudinal state-wide seroprevalence program that has enrolled more than 90,000 participants, to evaluate the role of chronic diseases as the potential risk factors of non-response to SARS-CoV-2 vaccines in a large epidemiologic cohort.

METHODS: A participant needed to complete an online survey and a blood draw to test for SARS-CoV-2 circulating plasma antibodies at four-time points spaced at least three months …

Increased Resolvin E1 Production By Peripheral Blood Mononuclear Cells In Periodontitis Patients: Pilot Study, Lina J Suárez, Wilmer González-Duarte, Rodrigo Torrez-Velasco, Viviana Salinas, Nelly S Roa-Molina, Sindy M Muñoz, Luz-Stella Rodríguez, Roger M Arce, Jamil A Shibli, Adriana Rodríguez-Ciodaro

Faculty, Staff and Student Publications

This study quantified the production of the pro-resolving agent Resolvin E1 by peripheral blood mononuclear cells (PBMC) from 20 systemically healthy volunteers with and without periodontitis after stimulation with lipopolysaccharide (LPS) from Porphyromonas gingivalis (Pg). Ten periodontitis patients and 10 healthy volunteers (30-50 years old), matched by age and sex, were recruited. Peripheral blood mononuclear cells were isolated and stimulated in culture plates for 24 hours with Pg LPS. Resolvin E1 levels were measured in the supernatants by enzyme-linked immunosorbent assay. Significantly higher production of Resolvin E1 was observed in both groups when stimulated with LPS compared to baseline levels …

Variant Of The Lactase Lct Gene Explains Association Between Milk Intake And Incident Type 2 Diabetes, Kai Luo, Guo-Chong Chen, Yanbo Zhang, Jee-Young Moon, Jiaqian Xing, Brandilyn A Peters, Mykhaylo Usyk, Zheng Wang, Gang Hu, Jun Li, Elizabeth Selvin, Casey M Rebholz, Tao Wang, Carmen R Isasi, Bing Yu, Rob Knight, Eric Boerwinkle, Robert D Burk, Robert C Kaplan, Qibin Qi

Faculty, Staff and Student Publications

Cow's milk is frequently included in the human diet, but the relationship between milk intake and type 2 diabetes (T2D) remains controversial. Here, using data from the Hispanic Community Health Study/Study of Latinos, we show that in both sexes, higher milk intake is associated with lower risk of T2D in lactase non-persistent (LNP) individuals (determined by a variant of the lactase LCT gene, single nucleotide polymorphism rs4988235 ) but not in lactase persistent individuals. We validate this finding in the UK Biobank. Further analyses reveal that among LNP individuals, higher milk intake is associated with alterations in gut microbiota (for …

Fetal Abdominal Obesity In Women With One Value Abnormality On Diagnostic Test For Gestational Diabetes Mellitus, Wonjin Kim, Soo Kyung Park, Yoo Lee Kim

The Brown Foundation: Institute of Molecular Medicine

Previous studies have shown that fetal abdominal obesity (FAO) was already observed at the time of gestational diabetes mellitus (GDM) diagnosis and persisted until delivery despite management in older and/or obese women. In this study, we investigated whether fetuses of women with milder hyperglycemia than GDM have accelerated abdominal growth, leading to adverse pregnancy outcomes. We retrospectively reviewed the medical records of 7,569 singleton pregnant women who were universally screened using a 50-g glucose challenge test (GCT) and underwent a 3-h 100-g oral glucose tolerance test (OGTT) if GCT result was ≥140mg/dL. GDM, one value abnormality (OVA), and normal glucose …

Acceptability Of Anal Human Papillomavirus Home Self-Sampling And Clinician Sampling Among Sexual And Gender Minority Individuals In Milwaukee, Wisconsin: The Prevent Anal Cancer Self-Swab Study, Jenna Nitkowski, Anna R Giuliano, Tim Ridolfi, Elizabeth Chiao, Maria E Fernandez, Vanessa Schick, Michael D Swartz, Jennifer S Smith, Alan G Nyitray

Faculty, Staff and Student Publications

Purpose: Anal cancer has disproportionately high incidence among sexual minority men. We compared acceptability of home versus clinic human papillomavirus (HPV) anal swabbing.

Methods: The Prevent Anal Cancer Self-Swab Study recruited sexual and gender minority individuals in Milwaukee, Wisconsin. Eligible participants were randomized to a home or clinic arm. Home participants received a mailed anal HPV self-sampling kit. Clinic participants attended a clinic appointment where a clinician collected an anal HPV swab. We examined acceptability (overall thoughts, comfort with method, pain, and future willingness to swab) of home versus clinic swabbing using postswab survey responses.

Results: A total of 191 …

A Randomized Controlled Study Of Auricular Point Acupressure To Manage Chemotherapy-Induced Neuropathy: Study Protocol, Nada Lukkahatai, Michael V Nguyen, Jingyu Zhang, Yu-Min Cho, Chitchanok Benjasirisan, Heijingzi Monica Jia, Claudia M Campbell, Jennifer Kawi, Hulin Wu, Hongyu Wang, Rupsikha Bora, Johannes Thrul, Constance M Johnson, Thomas J Smith

Faculty, Staff and Student Publications

Objective: Chemotherapy-induced neuropathy (CIN) significantly impacts cancer patients, leading to functional disability, diminished quality of life, and increased healthcare costs amid the ongoing opioid crisis. Auricular point acupressure (APA), a non-invasive and non-pharmacological alternative, has shown potential for alleviating the pain, numbness, and tingling associated with CIN. This study aims to assess the efficacy of APA for CIN symptoms and physical function and to examine the mechanisms underlying APA's effects on CIN.

Methods: This is a three-arm randomized controlled clinical trial protocol. Patients aged 18 and older who are experiencing CIN are randomly assigned to one of the three groups: …

Athletic Trainer's Perceptions Of And Experiences With Professional Development Approaches For Enhancing Clinical Documentation, Sarah L. Nottingham, Tricia M. Kasamatsu, Julie M. Cavallario, Cailee E. Welch Bacon

Rehabilitation Sciences Faculty Publications

Context

Little is known about how athletic trainers (ATs) learn clinical documentation, but previous studies have identified that ATs have a need for more educational resources specific to documentation.

Objective

To obtain ATs' perspectives on learning clinical documentation.

Design

Qualitative study.

Setting

Web-based audio interviews.

Patients or Other Participants

Twenty-nine ATs who completed 2 different continuing education (CE) clinical documentation modules. Participants averaged 36.2 ± 9.0 years of age and included 16 women and 13 men representing 21 US states and 8 clinical practice settings.

Data Collection and Analysis

Participants were recruited from a group of ATs who completed 1 …

An Objective Assessment Of Neuromotor Control Using A Smartphone App After Repeated Subconcussive Blast Exposure, Charlend K. Howard, Masahiro Yamada, Marcia Dovel, Rie Leverett, Alexander Hill, Kenneth A. Manlapaz, David O. Keyser, Rene S. Hernandez, Sheilah S. Rowe, Walter S. Carr, Michael S. Roy, Christopher K. Rhea

Rehabilitation Sciences Faculty Publications

Subconcussive blast exposure has been shown to alter neurological functioning. However, the extent to which neurological dysfunction persists after blast exposure is unknown. This longitudinal study examined the potential short- and long-term effects of repeated subconcussive blast exposure on neuromotor performance from heavy weapons training in military personnel. A total of 214 participants were assessed; 137 were exposed to repeated subconcussive blasts and 77 were not exposed to blasts (controls). Participants completed a short stepping-in-place task while an Android smartphone app placed on their thigh recorded movement kinematics. We showed acute suppression of neuromotor variability 6 h after subconcussive blast …

Evolution Of Whole Blood Trauma Resuscitation In Childbearing Age Females: Practice Patterns And Trends, Alexandra Mp Brito, Mark H Yazer, Jason L Sperry, James F Luther, Stephen R Wisniewski, Frances Guyette, Ernest E Moore, Bryan A Cotton, Laura Vincent, Erin Fox, Jeremy W Cannon, Nicholas Namias, Joseph P Minei, Lee Anne Ammons, Skye Clayton, Martin Schreiber

Faculty, Staff and Student Publications

Background: The use of low titer group O whole blood (LTOWB) for resuscitation of patients with traumatic hemorrhage is becoming increasingly common. Practices regarding the administration of RhD-positive LTOWB to childbearing age females (CBAFs) vary between institutions due to concerns about RhD alloimmunization. This study examined practices related to LTOWB transfusion as they pertain to age and sex.

Methods: This was a secondary analysis of the Shock, Whole blood, and Assessment of TBI (traumatic brain injury) trial, a prospective, multicenter observational cohort study where outcomes following LTOWB transfusion were analyzed at seven level 1 trauma centers between 2018 and 2021, …

Practical Quality Improvement Changes For A Low-Resourced Pediatric Unit, Phoebe H Yager, Kevin Mary Callans, Aubrey Samost-Williams, Jose A Bonilla, Luis J G Flores, Susana C A Hasbun, Angel E A Rodríguez, Alejandra B A Cárdenas, Alexia M L Núñez, Asitha D L Jayawardena, Evelyn J Zablah, Christopher J Hartnick

Faculty, Staff and Student Publications

Background: This work describes a sustainable and replicable initiative to optimize multi-disciplinary care and uptake of clinical best practices for patients in a pediatric intensive care unit in Low/Middle Income Countries and to understand the various factors that may play a role in the reduction in child mortality seen after implementation of the Quality Improvement Initiative.

Methods: This was a longitudinal assessment of a quality improvement program with the primary outcome of intubated pediatric patient mortality. The program was assessed 36 months following implementation of the quality improvement intervention using a t-test with linear regression to control for co-variates. …

Patient-Reported Outcomes Following Severe Abdominal Trauma: A Secondary Analysis Of The Damage Control Laparotomy Trial, Shah-Jahan M Dodwad, Kayla D Isbell, Krislynn M Mueck, James M Klugh, David E Meyer, Charles E Wade, Lillian S Kao, John A Harvin

Faculty, Staff and Student Publications

Introduction: Little is known about patient-reported outcomes (PROs) following abdominal trauma. We hypothesized that patients undergoing definitive laparotomy (DEF) would have better PROs compared to those treated with damage control laparotomy (DCL).

Methods: The DCL Trial randomized DEF versus DCL in abdominal trauma. PROs were measured using the European Quality of Life-5 Dimensions-5 Levels (EQ-5D) questionnaire at discharge and six months postdischarge (1 = perfect health, 0 = death, and < 0 = worse than death) and Posttraumatic Stress Disorder (PTSD) Checklist-Civilian. Unadjusted Bayesian analysis with a neutral prior was used to assess the posterior probability of achieving minimal clinically important difference.

Results: Of 39 randomized patients (21 DEF versus 18 DCL), 8 patients died (7 DEF versus 1 DCL). Of those who survived, 28 completed the EQ-5D at discharge (12 DEF …

Combining Neuroimaging And Brain Stimulation To Test Alternative Causal Pathways For Nicotine Addiction In Schizophrenia, Xiaoming Du, Fow-Sen Choa, Joshua Chiappelli, Heather Bruce, Mark Kvarta, Ann Summerfelt, Yizhou Ma, William T Regenold, Kevin Walton, George F Wittenberg, Stephanie Hare, Si Gao, Andrew Van Der Vaart, Zhiwei Zhao, Shuo Chen, Peter Kochunov, L Elliot Hong

Faculty, Staff and Student Publications

The smoking rate is high in patients with schizophrenia. Brain stimulation targeting conventional brain circuits associated with nicotine addiction has also yielded mixed results. We aimed to identify alternative circuitries associated with nicotine addiction in both the general population and schizophrenia, and then test whether modulation of such circuitries may alter nicotine addiction behaviors in schizophrenia. In Study I of 40 schizophrenia smokers and 51 non-psychiatric smokers, cross-sectional neuroimaging analysis identified resting state functional connectivity (rsFC) between the dorsomedial prefrontal cortex (dmPFC) and multiple extended amygdala regions to be most robustly associated with nicotine addiction severity in healthy controls and …

Absolute Concentration Estimation Of Covid-19 Convalescent And Post-Vaccination Igg Antibodies, Melvin E Klegerman, Tao Peng, Ira Seferovich, Mohammad H Rahbar, Manouchehr Hessabi, Amirali Tahanan, Audrey Wanger, Carolyn Z Grimes, Luis Z Ostrosky-Zeichner, Kent Koster, Jeffrey D Cirillo, Dinuka Abeydeera, Steve De Lira, David D Mcpherson

Faculty, Staff and Student Publications

Soon after commencement of the SARS-CoV-2 disease outbreak of 2019 (COVID-19), it became evident that the receptor-binding domain of the viral spike protein is the target of neutralizing antibodies that comprise a critical element of protective immunity to the virus. This study addresses the relative lack of information regarding actual antibody concentrations and binding affinities in convalescent plasma (CP) samples from COVID-19 patients and extends these analyses to post-vaccination (PV) samples to estimate protective IgG antibody (Ab) levels. A direct enzyme-linked immunosorbent assay (ELISA) was used to measure IgG anti-spike protein (SP) antibodies (Abs) relative to human chimeric spike S1 …