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A Scoping Review Of Patient Safety Checklists In Pediatrics, Kawtar Zouaidi, Tate W Miner, Muhammad F Walji, Kristin N Ray, Elsbeth Kalenderian, Donald B Rindal, Katie J Suda Jan 2025

A Scoping Review Of Patient Safety Checklists In Pediatrics, Kawtar Zouaidi, Tate W Miner, Muhammad F Walji, Kristin N Ray, Elsbeth Kalenderian, Donald B Rindal, Katie J Suda

Faculty, Staff and Student Publications

Objective: To examine the utilization and effectiveness of safety checklists in pediatric clinical care.

Methods: A comprehensive literature search was conducted using Medline to identify studies related to the development and/or implementation of patient safety checklists in pediatrics. All study designs were included for citations published through September 2023.

Results: Following abstract and full-text screening, 74 studies remained for data extraction and analysis. Pediatric surgery emerged as the main setting for checklists use (n = 35), followed by Intensive Care Units (n = 21), and Emergency Departments (n = 9). Of the 74 reviewed papers, 37 (50%) designed and developed …


Time Of Urine Sampling May Influence The Association Between Urine Specific Gravity And Body Composition, Patrick B. Wilson, Brian K. Ferguson, Ian P. Winter Jan 2025

Time Of Urine Sampling May Influence The Association Between Urine Specific Gravity And Body Composition, Patrick B. Wilson, Brian K. Ferguson, Ian P. Winter

Exercise Science Faculty Publications

Urine specific gravity (USG) is frequently utilized in sports practice and research to assess hydration status. Prior research suggests that individuals with large amounts of fat-free mass (FFM) and muscle have elevated USG, but little is known about whether the time of collection (first-morning vs. spot sampling) and various nutritional factors influence these relationships. This cross-sectional, observational study assessed fasted first-morning (n = 55) and non-fasted spot USG (n = 51) samples in adults and evaluated relationships of USG with body composition and nutrition intake. The InBody 770 was used to estimate FFM, skeletal muscle mass (SMM), and total body …


Whether To Offer Interventions At The End Of Life: What Physicians Consider And How Clinical Ethicists Can Help, Joelle Robertson-Preidler, Mikaela Kim, Sophia Fantus, Janet Malek Jan 2025

Whether To Offer Interventions At The End Of Life: What Physicians Consider And How Clinical Ethicists Can Help, Joelle Robertson-Preidler, Mikaela Kim, Sophia Fantus, Janet Malek

Faculty and Staff Publications

Background: Advances in life-prolonging technologies increasingly create dilemmas for physicians who must decide whether to offer various interventions to patients nearing the end of life. Clinical ethicists are often consulted to support physicians in making these complex decisions and can do so most effectively if they understand physicians' reasons for making recommendations in this context.

Methods: Semi-structured interviews were conducted with surgeons, nephrologists, intensivists, emergency physicians, and oncologists regarding the considerations they have used to make decisions about offering interventions for patients nearing the end of life. Interview transcripts were thematically analyzed.

Results: We identified six types of considerations physicians …


A Randomized Controlled Trial Of A Compassion-Centered Spiritual Health Intervention To Improve Hospital Inpatient Outcomes, Jennifer S Mascaro, Patricia K Palmer, Marcia J Ash, Marianne P Florian, Deanna M Kaplan, Roman Palitsky, Steven P Cole, Maureen Shelton, Charles L Raison, George H Grant Jan 2025

A Randomized Controlled Trial Of A Compassion-Centered Spiritual Health Intervention To Improve Hospital Inpatient Outcomes, Jennifer S Mascaro, Patricia K Palmer, Marcia J Ash, Marianne P Florian, Deanna M Kaplan, Roman Palitsky, Steven P Cole, Maureen Shelton, Charles L Raison, George H Grant

Faculty and Staff Publications

Background: Inpatient medical settings lack evidence-based spiritually integrated interventions to address patient care needs within a pluralistic religious landscape. To address this gap, CCSH™ (Compassion-Centered Spiritual Health) was developed to leverage the skillsets of healthcare chaplains to improve patient outcomes through spiritual consultation. Here, we report the results of a randomized, wait-list controlled, pre-registered (NCT03529812) study that evaluated the impact of CCSH on patient-reported depression and explored putative mediators of CCSH's effects.

Method: Chaplain residents were randomized to be trained in CCSH as part of their clinical pastoral education (CPE) residency in the fall (n = 8) or …


Analysis Of Errors In The Management Of Cutaneous Disorders, Robert J. Pariser, Sarah Alnaif Jan 2025

Analysis Of Errors In The Management Of Cutaneous Disorders, Robert J. Pariser, Sarah Alnaif

Department Dermatology Faculty Publications

In this study, we prospectively and retrospectively evaluated the occurrence of errors in the management of cutaneous disorders from patient visits and medical records in a single dermatology practice in southeast Virginia over a 3-year period (June 2020-July 2023). Providers should be able to improve diagnostic accuracy by utilizing established rapid bedside diagnostic techniques.


Barriers And Facilitators To Accessing Mental And Physical Health Care Among Sexual Minority Women: A Qualitative Exploration, Charlotte A. Dawson, A. Moulder, Kristin E. Heron Jan 2025

Barriers And Facilitators To Accessing Mental And Physical Health Care Among Sexual Minority Women: A Qualitative Exploration, Charlotte A. Dawson, A. Moulder, Kristin E. Heron

Department Psychiatry & Behavioral Science Faculty Publications

Cisgender sexual minority women (SMW, e.g., lesbian, queer) are at greater risk for poor mental and physical health compared to heterosexual women and face challenges when accessing health care. Previous research has largely focused on general sexual and gender minority barriers to health care, but more research is needed on the experiences of specific subgroups, including cisgender SMW. The current study qualitatively explored barriers and facilitators for cisgender SMW seeking health care. Twenty cisgender SMW aged 18-40 recruited using Meta advertisements and past participant lists completed 45 min semi-structured interviews and a brief survey. Thematic analysis conducted by two coders …


Targeted Deletion Of Cxcl1 In Mscs Regulates Osteogenesis And Suppresses Bone-Metastatic Prostate Cancer, Catherine S. Johnson, Diane L. Costanzo-Garvey, Julio C. Valencia, Sanjana Rajgopal, Theodore Reed, Emma R. Brannon, Jeremy S. Frieling, Deanna Mosley, Todd A. Wyatt, Elijah F. Edmondson, Kabhilan Mohan, Grinu Mathew, Leah M. Cook Jan 2025

Targeted Deletion Of Cxcl1 In Mscs Regulates Osteogenesis And Suppresses Bone-Metastatic Prostate Cancer, Catherine S. Johnson, Diane L. Costanzo-Garvey, Julio C. Valencia, Sanjana Rajgopal, Theodore Reed, Emma R. Brannon, Jeremy S. Frieling, Deanna Mosley, Todd A. Wyatt, Elijah F. Edmondson, Kabhilan Mohan, Grinu Mathew, Leah M. Cook

Journal Articles: Environmental, Agricultural & Occupational Health

Bone metastasis continues to be the greatest challenge in treating patients with prostate cancer despite ongoing research. In bone, prostate cancer tumors hijack normal bone remodeling processes to drive cancer progression. However, it is unclear how these interactions drive bone-metastatic prostate cancer growth in the bone environment. To understand the mechanisms associated with bone-metastatic prostate cancer regulation of mesenchymal stem cells (MSC), we previously identified that bone-metastatic prostate cancer induces MSC expression of the pro-inflammatory chemokine CXCL8 and its mouse functional homologue Cxcl1. To date, there has been little to no information about the role of CXCL1/8 in MSC biology …


Maternal Health Predictors In Ohio, Sritha Donepudi, Humza Khan Jan 2025

Maternal Health Predictors In Ohio, Sritha Donepudi, Humza Khan

Scholarship in Medicine - All Papers

Background: Ohio has continued to have a maternal mortality rate higher than the average which has posed the question of how geographic location, socioeconomic status, and demographics affect these rates.
Objective: This paper aims to investigate the relationship between variables affecting maternal mortality rates in Ohio such as teen birth rates and primary care physician access with where one lives between Rural and Urban areas and their household income in order to provide more information for future research.
Methods: This paper utilized County Health Rankings and statistical and correlation analysis with SPSS to analyze rates across counties in Ohio.
Results: …


Employee Perspectives On Genetic Testing In The Workplace: Results From A National Survey., J Scott Roberts, Wendy R Uhlmann, Drew Blasco, Anya E R Prince, Sarah Mccain, Subhamoy Pal, Kunal Sanghavi, Elizabeth Charnysh, Charles Lee Jan 2025

Employee Perspectives On Genetic Testing In The Workplace: Results From A National Survey., J Scott Roberts, Wendy R Uhlmann, Drew Blasco, Anya E R Prince, Sarah Mccain, Subhamoy Pal, Kunal Sanghavi, Elizabeth Charnysh, Charles Lee

Faculty Research 2025

INTRODUCTION: Genetic testing for health-related purposes is now offered in some workplace wellness programs, with notable ethical, legal, and social implications. However, little is known about employee perspectives on workplace genetic testing (wGT).

METHODS: We surveyed a large, diverse national sample of 2,000 employed adults (mean age = 43 years; 51% female). Survey measures assessed respondents' wGT beliefs, perceptions of employer motivations for offering wGT, and privacy concerns.

RESULTS: Most respondents (57.4%) agreed that wGT would improve employees' health, and 46.7% agreed it could aid recruitment and retention of employees. Many respondents attributed legally prohibited motivations to employers offering wGT, …


Harnessing The Human Gut Microbiota: An Emerging Frontier In Combatting Multidrug-Resistant Bacteria., Wenwen Ding, Yiwen Cheng, Xia Liu, Zhangcheng Zhu, Lingbin Wu, Jie Gao, Wenhui Lei, Yating Li, Xin Zhou, Jian Wu, Yongtao Gao, Zongxin Ling, Ruilai Jiang Jan 2025

Harnessing The Human Gut Microbiota: An Emerging Frontier In Combatting Multidrug-Resistant Bacteria., Wenwen Ding, Yiwen Cheng, Xia Liu, Zhangcheng Zhu, Lingbin Wu, Jie Gao, Wenhui Lei, Yating Li, Xin Zhou, Jian Wu, Yongtao Gao, Zongxin Ling, Ruilai Jiang

Faculty Research 2025

Antimicrobial resistance (AMR) has become a major and escalating global health threat, undermining the effectiveness of current antibiotic and antimicrobial therapies. The rise of multidrug-resistant bacteria has led to increasingly difficult-to-treat infections, resulting in higher morbidity, mortality, and healthcare costs. Tackling this crisis requires the development of novel antimicrobial agents, optimization of current therapeutic strategies, and global initiatives in infection surveillance and control. Recent studies highlight the crucial role of the human gut microbiota in defending against AMR pathogens. A balanced microbiota protects the body through mechanisms such as colonization resistance, positioning it as a key ally in the fight …


Marmosets As Model Systems For The Study Of Alzheimer's Disease And Related Dementias: Substantiation Of Physiological Tau 3r And 4r Isoform Expression And Phosphorylation., Hasi Huhe, Sarah M Shapley, Duc M Duong, Fang Wu, Seung-Kwon Ha, Sang-Ho Choi, Julia Kofler, Yongshan Mou, Thais Rafael Guimaraes, Amantha Thathiah, Caroline M Watson, Lauren K H Schaeffer, Gregory W. Carter, Nicholas T Seyfried, Afonso C Silva, Stacey J Sukoff Rizzo Jan 2025

Marmosets As Model Systems For The Study Of Alzheimer's Disease And Related Dementias: Substantiation Of Physiological Tau 3r And 4r Isoform Expression And Phosphorylation., Hasi Huhe, Sarah M Shapley, Duc M Duong, Fang Wu, Seung-Kwon Ha, Sang-Ho Choi, Julia Kofler, Yongshan Mou, Thais Rafael Guimaraes, Amantha Thathiah, Caroline M Watson, Lauren K H Schaeffer, Gregory W. Carter, Nicholas T Seyfried, Afonso C Silva, Stacey J Sukoff Rizzo

Faculty Research 2025

INTRODUCTION: Marmosets spontaneously develop pathological hallmarks of Alzheimer's disease (AD) including amyloid beta plaques. However, tau expression in the marmoset brain has been understudied.

METHODS: Isoforms of tau were examined by western blot, mass spectrometry, immunofluorescence, and immunohistochemical staining.

RESULTS: 3R and 4R tau isoforms are expressed in marmoset brains at both the transcript and protein levels across ages. Mass spectrometry analysis revealed that tau peptides in marmoset corresponded to the 3R and 4R peptides in human brain, with 3R predominating at birth and an ≈40%:60% 3R:4R ratios in adolescents and adults; tau was distributed widely in neurons, with localization …


Comprehensive Single-Cell Aging Atlas Of Healthy Mammary Tissues Reveals Shared Epigenomic And Transcriptomic Signatures Of Aging And Cancer., Brittany Lynn Angarola, Siddhartha Sharma, Neerja Katiyar, Hyeon Gu Kang, Djamel Nehar-Belaid, Sunghee Park, Rachel Gott, Giray N Eryilmaz, Mark A Labarge, Karolina Palucka, Jeffrey Chuang, Ron Korstanje, Duygu Ucar, Olga Anczuków Jan 2025

Comprehensive Single-Cell Aging Atlas Of Healthy Mammary Tissues Reveals Shared Epigenomic And Transcriptomic Signatures Of Aging And Cancer., Brittany Lynn Angarola, Siddhartha Sharma, Neerja Katiyar, Hyeon Gu Kang, Djamel Nehar-Belaid, Sunghee Park, Rachel Gott, Giray N Eryilmaz, Mark A Labarge, Karolina Palucka, Jeffrey Chuang, Ron Korstanje, Duygu Ucar, Olga Anczuków

Faculty Research 2025

Aging is the greatest risk factor for breast cancer; however, how age-related cellular and molecular events impact cancer initiation is unknown. In this study, we investigated how aging rewires transcriptomic and epigenomic programs of mouse mammary glands at single-cell resolution, yielding a comprehensive resource for aging and cancer biology. Aged epithelial cells exhibit epigenetic and transcriptional changes in metabolic, pro-inflammatory and cancer-associated genes. Aged stromal cells downregulate fibroblast marker genes and upregulate markers of senescence and cancer-associated fibroblasts. Among immune cells, distinct T cell subsets (Gzmk+, memory CD4+, γδ) and M2-like macrophages expand with age. …


Exploring The Composition Of Placental Microbiome And Its Potential Origin In Preterm Birth., Marwa Saadaoui, Mohamed Nadhir Djekidel, Selvasankar Murugesan, Manoj Kumar, Duaa Elhag, Parul Singh, Basirudeen Syed Ahamed Kabeer, Alexandra Katharina Marr, Tomoshige Kino, Tobias Brummaier, Rose Mcgready, François Nosten, Damien Chaussabel, Annalisa Terranegra, Souhaila Al Khodor Jan 2025

Exploring The Composition Of Placental Microbiome And Its Potential Origin In Preterm Birth., Marwa Saadaoui, Mohamed Nadhir Djekidel, Selvasankar Murugesan, Manoj Kumar, Duaa Elhag, Parul Singh, Basirudeen Syed Ahamed Kabeer, Alexandra Katharina Marr, Tomoshige Kino, Tobias Brummaier, Rose Mcgready, François Nosten, Damien Chaussabel, Annalisa Terranegra, Souhaila Al Khodor

Faculty Research 2025

INTRODUCTION: For years, the placenta was believed to be sterile, but recent studies reveal it hosts a unique microbiome. Despite these findings, significant questions remain about the origins of the placental microbiome and its effects on pregnancy and fetal health. Some studies suggest it may originate from the vaginal tract, while others indicate that oral bacteria can enter the maternal bloodstream and seed the placenta. However, research analyzing the vaginal, oral, and placental microbiomes within the same cohort is lacking. Additionally, it's unclear whether the placental microbiome differs between healthy pregnancies and those with complications like preterm birth (PTB), which …


Addressing Deaths Of Despair: The Impact Of Loneliness On Excessive Alcohol Use And Alcohol-Involved Driving Deaths In Ohio, Juliana Zacher, Akshey Suresh, Dylan Timperman Jan 2025

Addressing Deaths Of Despair: The Impact Of Loneliness On Excessive Alcohol Use And Alcohol-Involved Driving Deaths In Ohio, Juliana Zacher, Akshey Suresh, Dylan Timperman

Scholarship in Medicine - All Papers

Alcohol-related driving deaths and excessive alcohol consumption continue to rise across the United States. These trends have had a large impact on historically disadvantaged populations, such as Appalachia, being disproportionately affected. Previous literature suggests factors such as loneliness, mental distress, segregation, and immigration status amongst others may contribute to this increase in drinking. Although delineating a clear role of the nature of the impact at a community level still remains unclear. Our objective was to explore these very factors as well as to identify social and economic predictors to explain alcohol-related driving deaths and excessive drinking in Ohio between 2016 …


The Ptp4a3 Inhibitor Kvx-053 Reduces Severe Acute Respiratory Syndrome Coronavirus 2 (Sars-Cov-2) Virulence, Inflammation, And Development Of Acute Lung Injury In K18-Hace2 Mice, Ruben M. L. Colunga-Biancatelli, Pavel A. Solopov, Caitlin M. Woodson, Irving Coy Allen, Ivan Akhrymuk, Maryna Akhrymuk, Brittany N. Heath, Hannah M. Ivester, Tierney Day, Dan E. Austin, Kylene Kehn-Hall, John S. Lazo, Elizabeth R. Sharlow, John D. Catravas Jan 2025

The Ptp4a3 Inhibitor Kvx-053 Reduces Severe Acute Respiratory Syndrome Coronavirus 2 (Sars-Cov-2) Virulence, Inflammation, And Development Of Acute Lung Injury In K18-Hace2 Mice, Ruben M. L. Colunga-Biancatelli, Pavel A. Solopov, Caitlin M. Woodson, Irving Coy Allen, Ivan Akhrymuk, Maryna Akhrymuk, Brittany N. Heath, Hannah M. Ivester, Tierney Day, Dan E. Austin, Kylene Kehn-Hall, John S. Lazo, Elizabeth R. Sharlow, John D. Catravas

Bioelectrics Publications

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has caused a global health crisis, marked by high transmissibility and virulence. Despite widespread vaccination efforts, effective treatments for COVID-19, particularly for severe cases leading to Acute Respiratory Distress Syndrome (ARDS), remain limited. This study investigates the efficacy of KVX-053, a protein tyrosine phosphatase type IVA (PTP4A3) small molecule inhibitor, in modulating SARS-CoV-2-induced inflammation and lung injury using in vitro cell models and in vivo K18-hACE2 transgenic mice. KVX-053 reduced in vitro pro-inflammatory cytokine expression, including TNFα, CXCL10, and CXCL11, without impacting viral replication or cell viability. K18-hACE2 mice treated with KVX-053 demonstrated …


Accidental Left Ventricular Placement Of A Leadless Micra Pacemaker Through A Patent Foramen Ovale, Hamza Alkowatli, Mahmoud Kutmah, Adnan Shaik, Osama Hallak Jan 2025

Accidental Left Ventricular Placement Of A Leadless Micra Pacemaker Through A Patent Foramen Ovale, Hamza Alkowatli, Mahmoud Kutmah, Adnan Shaik, Osama Hallak

The Texas Heart Institute Journal

The Micra device is a leadless pacemaker implanted in the right ventricle via a femoral vein transcatheter approach. There are several indications for and advantages to using a leadless pacemaker, and the device's role in the field of cardiology will probably continue to increase. This article presents the case of a rare complication probably due to inadvertent placement of the device in the left ventricle across an undiagnosed patent foramen ovale.


Early Structural Valve Deterioration And Cusp Tear Leading To Acute Heart Failure In A Second-Generation Trifecta Glide Technology Heart Valve, Akiyoshi Yamamoto, Kenji Kuwaki, Hidekazu Furuya, Yasunori Cho Jan 2025

Early Structural Valve Deterioration And Cusp Tear Leading To Acute Heart Failure In A Second-Generation Trifecta Glide Technology Heart Valve, Akiyoshi Yamamoto, Kenji Kuwaki, Hidekazu Furuya, Yasunori Cho

The Texas Heart Institute Journal

This report highlights a case of early structural valve deterioration with a cusp tear in a second-generation Abbott Trifecta Glide Technology bioprosthetic heart valve. A 70-year-old man had undergone aortic valve replacement with a Trifecta Glide Technology valve 30 months earlier for severe bicuspid aortic valve stenosis. He suddenly developed acute heart failure with dyspnea resulting from severe aortic valve regurgitation, with a cusp tear in the Trifecta Glide Technology valve, as demonstrated by transthoracic echocardiography. The patient was successfully treated with urgent repeat aortic valve replacement.


Midterm Outcomes Of Pediatric Mitral Valvuloplasty For Moderate To Severe Mitral Valve Regurgitation And Associated Risk Factors For Postoperative Deterioration, Hongyuan Fu, Aijun Liu, Ming Yang, Zeyu Liu, Junwu Su Jan 2025

Midterm Outcomes Of Pediatric Mitral Valvuloplasty For Moderate To Severe Mitral Valve Regurgitation And Associated Risk Factors For Postoperative Deterioration, Hongyuan Fu, Aijun Liu, Ming Yang, Zeyu Liu, Junwu Su

The Texas Heart Institute Journal

BACKGROUND: Mitral valvuloplasty is considered the best treatment for pediatric mitral valve regurgitation. The objective of this analysis was to identify risk factors for postoperative mitral valve regurgitation progression and evaluate valvuloplasty effectiveness.

METHODS: This retrospective, single-center study investigated the clinical efficacy of mitral valvuloplasty and identified factors that affect prognosis. Pediatric patients with moderate or severe mitral valve regurgitation who had undergone mitral valvuloplasty between September 2016 and August 2023 were included. Kaplan-Meier survival analysis was used to assess freedom from both mitral valve deterioration and cardiovascular death. Univariate and multivariate Cox regression analyses were performed to identify potential …


Contributions Of Pathobiological And Translational Science To Understanding And Managing Ischemic Heart Disease: Progress, Impediments, And Future Directions, L Maximilian Buja Jan 2025

Contributions Of Pathobiological And Translational Science To Understanding And Managing Ischemic Heart Disease: Progress, Impediments, And Future Directions, L Maximilian Buja

The Texas Heart Institute Journal

Key pathobiological components of ischemic heart disease have been identified as follows: (1) In 1970 to 1973, myocardial infarct size was found to be the primary determinant of prognosis after acute myocardial infarction (AMI); (2) in 1973 to 1989, vulnerable coronary artery plaques were found to predispose individuals to coronary plaque disruption and thrombosis, causing major AMI; (3) in 1972, timely coronary reperfusion was demonstrated to limit the size of evolving AMI but with risk of reperfusion injury; and (4) in 1986, myocardial conditioning was found to be a clinically significant modulator capable of delaying AMI progression. Promising cardioprotective strategies …


Robot-Assisted Surgical Treatment Of Caseoma, Nancy Wang, Abdussalam Elsenousi, Kenneth K Liao Jan 2025

Robot-Assisted Surgical Treatment Of Caseoma, Nancy Wang, Abdussalam Elsenousi, Kenneth K Liao

The Texas Heart Institute Journal

This report reviews 5 cases of mitral annular caseoma. Four patients presented with fatigue, stroke, or mitral stenosis. Robot-assisted resection of caseoma with or without mitral valve replacement was successfully performed in all patients with good outcomes. These cases demonstrate the safety and efficacy of robotic surgery in treating caseoma.


Characterizing Fermentable Carbohydrate Foods In The Diets Of Children With Abdominal Pain-Related Disorders Of Gut-Brain Interaction And Healthy Children, Vishnu Narayana, Jocelyn Chang, Ann R Mcmeans, Tasha Murphy, Rona L Levy, Robert J Shulman, Bruno P Chumpitazi Jan 2025

Characterizing Fermentable Carbohydrate Foods In The Diets Of Children With Abdominal Pain-Related Disorders Of Gut-Brain Interaction And Healthy Children, Vishnu Narayana, Jocelyn Chang, Ann R Mcmeans, Tasha Murphy, Rona L Levy, Robert J Shulman, Bruno P Chumpitazi

Children’s Nutrition Research Center Staff Publications

Objectives: Restricting dietary fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) can alleviate symptoms in children with disorders of gut-brain interaction (DGBI). Due to the restrictions of a low FODMAP diet (LFD), a less restrictive FODMAP Gentle diet (FGD) has been suggested. However, the types and amounts of high FODMAP foods and carbohydrates commonly consumed by children have not been studied. We aimed to identify the high FODMAP foods and proportions of FODMAP carbohydrates consumed by children with DGBI and healthy children (HC) and to determine which usually ingested FODMAPs would be restricted on the FGD.

Methods: Three-day diet records from …


A Hybrid Cloud Data Lake Architecture Supporting The Integration Of Clinical And Genomics Data, Apollo Mcowiti, Heidi Dowst, Fei Zheng, Susan Hilsenbeck, Christopher Amos Jan 2025

A Hybrid Cloud Data Lake Architecture Supporting The Integration Of Clinical And Genomics Data, Apollo Mcowiti, Heidi Dowst, Fei Zheng, Susan Hilsenbeck, Christopher Amos

Center for Medical Ethics and Health Policy Staff Publications

Objective: Cancer centers must quickly integrate clinical genomics data from different vendors for oncology operations and research. Clinical data warehouse architectures are costly to construct and brittle, and they are not readily amenable to the rapid changes in oncology research. We introduce a cost-effective hybrid cloud Data Lake architecture for storing clinical genomic data from different vendors, aiding both clinical and research workflows.

Methods: We created a Data Lake architecture based on the zone architecture, with four layers: ingestion, storage, transformation, and interaction. The layers are implemented with a hybrid cloud architecture. Rich metadata created from patient and genomic data …


Talking About Suffering In The Intensive Care Unit, Brent M Kious, Judith B Vick, Peter A Ubel, Olivia Sutton, Jennifer Blumenthal-Barby, Christopher E Cox, Deepshikha Ashana Jan 2025

Talking About Suffering In The Intensive Care Unit, Brent M Kious, Judith B Vick, Peter A Ubel, Olivia Sutton, Jennifer Blumenthal-Barby, Christopher E Cox, Deepshikha Ashana

Center for Medical Ethics and Health Policy Staff Publications

Background: Some have hypothesized that talk about suffering can be used by clinicians to motivate difficult decisions, especially to argue for reducing treatment at the end of life. We examined how talk about suffering is related to decision-making for critically ill patients, by evaluating transcripts of conversations between clinicians and patients' families.

Methods: We conducted a secondary qualitative content analysis of audio-recorded family meetings from a multicenter trial conducted in the adult intensive care units of five hospitals from 2012-2017 to look at how the term "suffering" and its variants were used. A coding guide was developed by consensus-oriented discussion …


Ethical Implications Of Neurotechnology In Industry-Academia Partnerships: Insights From Patient And Research Participant Interviews, Meredith V. Parsons, Maya Skolnik, Judith Mwobobia, Erin D Solomon, James M. Dubois, Tristan Mcintosh Jan 2025

Ethical Implications Of Neurotechnology In Industry-Academia Partnerships: Insights From Patient And Research Participant Interviews, Meredith V. Parsons, Maya Skolnik, Judith Mwobobia, Erin D Solomon, James M. Dubois, Tristan Mcintosh

2020-Current year OA Pubs

BACKGROUND: Neurotechnologies often advance through industry-academia (IA) partnerships and offer insight into brain and nervous system functions, bringing improved diagnosis and treatment options to patients. Both neurotechnology and IA partnerships pose ethical challenges that can impact research participation experiences, patient treatment, and health outcomes.

METHODS: Investigators conducted interviews with 16 patients who used neurotechnology devices in therapeutic or research settings. Interviews explored participants' experiences using neurotechnology, perspectives on IA partnerships, preferences for neural data use and long-term care, and advice for future neurotechnology device users. Data were analyzed using inductive thematic analysis.

RESULTS: Participants were generally supportive of IA partnerships. …


Digital Otoscopy With Computer-Aided Composite Image Generation: Impact On The Correct Diagnosis, Confidence, And Time, Seda Camalan, Carl D Langefeld, Amy Zinnia, Brigham Mckee, Matthew L Carlson, Nicholas L Deep, Michael S Harris, Taha A Jan, Vivian F Kaul, Nathan R Lindquist, Jameson K Mattingly, Jay Shah, Kevin Y Zhan, Metin N Gurcan, Aaron C Moberly Jan 2025

Digital Otoscopy With Computer-Aided Composite Image Generation: Impact On The Correct Diagnosis, Confidence, And Time, Seda Camalan, Carl D Langefeld, Amy Zinnia, Brigham Mckee, Matthew L Carlson, Nicholas L Deep, Michael S Harris, Taha A Jan, Vivian F Kaul, Nathan R Lindquist, Jameson K Mattingly, Jay Shah, Kevin Y Zhan, Metin N Gurcan, Aaron C Moberly

Faculty, Staff and Student Publications

Objective: This study investigated the comparative performance of ear, nose, and throat (ENT) physicians in correctly detecting ear abnormalities when reviewing digital otoscopy imaging using 3 different visualization methods, including computer-assisted composite images called "SelectStitch," single video frame "Still" images, and video clips. The study also explored clinicians' diagnostic confidence levels and the time to make a diagnosis.

Study design: Clinician diagnostic reader study.

Setting: Online diagnostic survey of ENT physicians.

Methods: Nine ENT physicians reviewed digital otoscopy examinations from 86 ears with various diagnoses (normal, perforation, retraction, middle ear effusion, tympanosclerosis). Otoscopy examinations used artificial-intelligence (AI)-based computer-aided composite image …


Deep Brain Stimulation For Childhood Treatment-Resistant Obsessive-Compulsive Disorder: Mental Health Clinician Views On Candidacy Factors, Ilona Cenolli, Tiffany A Campbell, Natalie Dorfman, Meghan Hurley, Jared N Smith, Kristin Kostick-Quenet, Eric A Storch, Jennifer Blumenthal-Barby, Gabriel Lázaro-Muñoz Jan 2025

Deep Brain Stimulation For Childhood Treatment-Resistant Obsessive-Compulsive Disorder: Mental Health Clinician Views On Candidacy Factors, Ilona Cenolli, Tiffany A Campbell, Natalie Dorfman, Meghan Hurley, Jared N Smith, Kristin Kostick-Quenet, Eric A Storch, Jennifer Blumenthal-Barby, Gabriel Lázaro-Muñoz

Center for Medical Ethics and Health Policy Staff Publications

Introduction: Deep brain stimulation (DBS) is approved under a humanitarian device exemption to manage treatment-resistant obsessive-compulsive disorder (TR-OCD) in adults. It is possible that DBS may be trialed or used clinically off-label in children and adolescents with TR-OCD in the future. DBS is already used to manage treatment-resistant childhood dystonia. Evidence suggests it is a safe and effective intervention for certain types of dystonia. Important questions remain unanswered about the use of DBS in children and adolescents with TR-OCD, including whether mental health clinicians would refer pediatric patients for DBS, and who would be a good candidate for DBS.

Objectives: …


Perspective On Alcohol-Induced Organ Damage Via Autophagy-Dependent Cellular Changes, Ahmed Bakheet, Murugadas Anbazhagan, Shirish Barve, Srinivasan Dasarathy, John Dickinson, Wen-Xing Ding, Terrence Donohue, Thiyagarajan Gopal, Anna Gukovskaya, Kusum K. Kharbanda, John J. Lemasters, Natalia A. Osna, Pal Pacher, Lucy Sloan, Luis F. Vilches, Viswanathan Saraswathi, Xiao-Ming Yin, Zhi Zhong, Paul G. Thomes Jan 2025

Perspective On Alcohol-Induced Organ Damage Via Autophagy-Dependent Cellular Changes, Ahmed Bakheet, Murugadas Anbazhagan, Shirish Barve, Srinivasan Dasarathy, John Dickinson, Wen-Xing Ding, Terrence Donohue, Thiyagarajan Gopal, Anna Gukovskaya, Kusum K. Kharbanda, John J. Lemasters, Natalia A. Osna, Pal Pacher, Lucy Sloan, Luis F. Vilches, Viswanathan Saraswathi, Xiao-Ming Yin, Zhi Zhong, Paul G. Thomes

Journal Articles: Internal Medicine

Alcohol-induced organ damage is a major global health concern and a leading cause of disability and mortality. In addition to the liver, chronic alcohol consumption adversely affects multiple organ systems, including the cardiovascular and neuromuscular systems, the gastrointestinal tract, adipose tissue, kidneys, pancreas, and the brain. Organ damage begins with necrosis (cell death) followed by tissue injury, which triggers immune responses aimed at tissue repair. However, with continued heavy drinking, these reparative responses transition into inflammatory responses which exacerbate tissue injury and accelerate disease progression. Macroautophagy, commonly referred to as autophagy, is a vital and evolutionarily-conserved digestive process in eukaryotic …


Why Ai Monitoring Faces Resistance And What Healthcare Organizations Can Do About It: An Emotion-Based Perspective, Karl Werder, Lan Cao, Eun Hee Park, Balasubramaniam Ramesh Jan 2025

Why Ai Monitoring Faces Resistance And What Healthcare Organizations Can Do About It: An Emotion-Based Perspective, Karl Werder, Lan Cao, Eun Hee Park, Balasubramaniam Ramesh

Information Technology & Decision Sciences Faculty Publications

Continuous monitoring of patients' health facilitated by artificial intelligence (AI) has enhanced the quality of health care, that is, the ability to access effective care. However, AI monitoring often encounters resistance to adoption by decision makers. Healthcare organizations frequently assume that the resistance stems from patients' rational evaluation of the technology's costs and benefits. Recent research challenges this assumption and suggests that the resistance to AI monitoring is influenced by the emotional experiences of patients and their surrogate decision makers. We develop a framework from an emotional perspective, provide important implications for healthcare organizations, and offer recommendations to help reduce …


Hearing Rehabilitation In Serac1 Related Megd(H)El Syndrome – Implications From A Multi-Center Retrospective Cohort Study, Sebastian Roesch, Anna O'Sullivan, Stefan Tschani, Anna Baghdasaryan, Shanti Balasubramaniam, Ivo Barić, Lonneke De Boer, Sarah C Grünert, Anna Guzek, Mirian Janssen, Zita Krumina, Mary Kay Koenig, Ashleigh M Lewkowitz, Fanny Mochel, Arianne Monge Naldi, Barbara Plecko, Kerem Öztürk, Lauren O'Grady, Gillian Riordan, Daisy Rymen, Inderneel Sahai, René Santer, Manuel Schiff, Georg M Stettner, Konstantinos Tsiakas, Sema Kalkan Uçar, Özlem Ünal Uzun, Corina Weigel, Peter Witters, Kajus Merkevicius, Johannes A Mayr, Saskia B Wortmann, Katarzyna Iwanicka-Pronicka Jan 2025

Hearing Rehabilitation In Serac1 Related Megd(H)El Syndrome – Implications From A Multi-Center Retrospective Cohort Study, Sebastian Roesch, Anna O'Sullivan, Stefan Tschani, Anna Baghdasaryan, Shanti Balasubramaniam, Ivo Barić, Lonneke De Boer, Sarah C Grünert, Anna Guzek, Mirian Janssen, Zita Krumina, Mary Kay Koenig, Ashleigh M Lewkowitz, Fanny Mochel, Arianne Monge Naldi, Barbara Plecko, Kerem Öztürk, Lauren O'Grady, Gillian Riordan, Daisy Rymen, Inderneel Sahai, René Santer, Manuel Schiff, Georg M Stettner, Konstantinos Tsiakas, Sema Kalkan Uçar, Özlem Ünal Uzun, Corina Weigel, Peter Witters, Kajus Merkevicius, Johannes A Mayr, Saskia B Wortmann, Katarzyna Iwanicka-Pronicka

Faculty, Staff and Student Publications

Objective: 3-methylglutaconic aciduria (MEG), dystonia-deafness (D), (hepatopathy (H)), encephalopathy (E), and Leigh-like-syndrome (L) (MEGD(H)EL) syndrome is a rare, severely disabling progressive mitochondrial disease associated with biallelic pathogenic variants in SERAC1. Knowledge about hearing loss (HL) and hearing rehabilitation is scarce but highly sought after for best possible care in the absence of causative treatment.

Methods: Retrospective cross-sectional study.

Results: This study analyzed the audiometric data of 36 MEGD(H)EL patients (14 unpublished). Bilateral HL was diagnosed in 31 individuals (86 %). Detailed audiometric data, available for 23 of 31 patients, did not allow for general statements on site and degree of …


An Evaluation Of The Decline In Primary Care Physician Visits, 2010 To 2021, Anuradha Jetty, Marie Ezran, Alison Huffstetler, Yalda Jabbarpour Jan 2025

An Evaluation Of The Decline In Primary Care Physician Visits, 2010 To 2021, Anuradha Jetty, Marie Ezran, Alison Huffstetler, Yalda Jabbarpour

Department of Family & Community Medicine Faculty Papers

INTRODUCTION: Primary care is the backbone of the United States healthcare system, yet it continues to be underfunded and inaccessible to many. Previous studies explored primary care visit patterns until 2016, leaving gaps in our understanding of how recent factors like state Medicaid expansions, the Coronavirus Disease 2019 (COVID-19) pandemic, and population growth have influenced these patterns. Hence, the objective of the current study was to analyze the trends in primary care visits provided by outpatient clinicians over time and by visit type and contextualize study findings within the changing healthcare landscape.

METHODS: The Medical Expenditure Panel Survey data (2010-2021) …