Digital Commons Network^™

Modified Frailty Index Associates With Transoral Robotic Surgery Complications And Survival: A National Database Study, Amiti Jain, Zachary N. Goldberg, Erin Briggs, Dev R. Amin, Zachary D. Urdang, Richard A. Goldman, David M. Cognetti, Joseph M. Curry

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

OBJECTIVE: The modified frailty index (mFI-5) is a National Surgical Quality Improvement Program-derived 5-factor index that has been proven to reflect frailty and predict morbidity and mortality. We hypothesize that mFI-5 is a valid predictive measure in the transoral robotic surgery (TORS) population.

METHODS: Retrospective study utilizing the TriNetX US-collaborative health records network querying for TORS patients. Cohorts were stratified by mFI-5 score which uses five ICD-10 codes: nonindependent functional status, hypertension, obstructive respiratory disease, heart failure, and diabetes mellitus. Cohorts were matched by age using propensity score matching. Outcome measures included survival, infection, pneumonia, tracheostomy dependence, and percutaneous endoscopic …

Academic Detailing As A Health Information Technology Implementation Method: Supporting The Design And Implementation Of An Emergency Department-Based Clinical Decision Support Tool To Prevent Future Falls, Hanna J Barton, Apoorva Maru, Margaret A Leaf, Daniel J Hekman, Douglas A Wiegmann, Manish N Shah, Brian W Patterson

Faculty, Staff and Student Publications

BACKGROUND: Clinical decision support (CDS) tools that incorporate machine learning-derived content have the potential to transform clinical care by augmenting clinicians' expertise. To realize this potential, such tools must be designed to fit the dynamic work systems of the clinicians who use them. We propose the use of academic detailing-personal visits to clinicians by an expert in a specific health IT tool-as a method for both ensuring the correct understanding of that tool and its evidence base and identifying factors influencing the tool's implementation.

OBJECTIVE: This study aimed to assess academic detailing as a method for simultaneously ensuring the correct …

Brief Report: Substance Use Care Continuum In Women With And Without Hiv In The Southern United States, Aditi Ramakrishnan, Ayako W. Fujita, C. Christina Mehta, Tracey E. Wilson, Steve Shoptaw, Adam Carrico, Adaora A. Adimora, Ellen F. Eaton, Deborah L. Jones, Aruna Chandran, Anandi N. Sheth

2020-Current year OA Pubs

BACKGROUND: Substance use (SU) contributes to poor outcomes among persons living with HIV. Women living with HIV (WWH) in the United States are disproportionately affected in the South, and examining SU patterns, treatment, and HIV outcomes in this population is integral to addressing HIV and SU disparities.

METHODS: WWH and comparable women without HIV (WWOH) who enrolled 2013-2015 in the Women's Interagency HIV Study Southern sites (Atlanta, Birmingham/Jackson, Chapel Hill, and Miami) and reported SU (self-reported nonmedical use of drugs) in the past year were included. SU and treatment were described annually from enrollment to the end of follow-up. HIV …

Mental Healthcare Differences Between The United States, Costa Rica, And Sweden, Michaela Diehm

Honors Program: Senior Projects (Public)

Countries such as the United States, Costa Rica, and Sweden differ in the ways that they approach treatment of mental health disorders, which is due to the structure of their healthcare as well as the culture, affordability, accessibility, and type of treatment that is available to the people of that country. A literature review did not reveal a comparison of the three countries related to the topic of mental healthcare, nor use of the three selected countries to review their structures to determine the best approach to combating mental disorders before. Costa Rica and Sweden are both countries with universal …

A Structured Curriculum Supporting Biomedical Trainees’ Transition Into Independent Academic Positions And Early Career Success, Mabel Perez-Oquendo, Gabriele Romano, David P Farris, Varsha Gandhi, Ignacio I Wistuba, Robert E Tillman, Ryan Udan, Paolo Mangahas, Rama Soundararajan

Faculty, Staff and Student Publications

The United States government makes a substantial investment in biomedical training programs each year. However, for most trainees, these opportunities do not translate into career progression in academic research pathways. Only about one-fifth of postdoctoral fellows eventually secure a tenure-track faculty position, and even among these candidates, attrition is high. Although a number of factors govern career choices and career longevity, the transition from trainee to faculty is a challenging process and requires knowledge and skills that are not necessarily developed during a traditional university experience. Many postdoctoral fellows receive adequate training in research skills and scientific communication, but new …

More Than Just A Number: Perspectives From Black Male Participants On Community-Based Interventions And Clinical Trials To Address Cardiovascular Health Disparities., Faith E Metlock, Sarah Addison, Alicia Mckoy, Yesol Yang, Aarhea Hope, Joshua J Joseph, Jing Zhang, Amaris Williams, Darrell M Gray, John Gregory, Timiya S Nolan

Ambulatory and Primary Care Articles

BACKGROUND: Black Americans remain significantly underrepresented and understudied in research. Community-based interventions have been increasingly recognized as an effective model for reckoning with clinical trial participation challenges amongst underrepresented groups, yet a paucity of studies implement this approach. The present study sought to gain insight into Black male participants' perception of clinical trials before and after participating in a community-based team lifestyle intervention in the United States.

METHODS: Black Impact, a 24-week community-based lifestyle intervention, applied the American Heart Association's Life's Simple 7 (LS7) framework to assess changes in the cardiovascular health of seventy-four Black male participants partaking in weekly …

Money Laundering In The United States: A Review Of Current Regulations And Threats, Grace Hutchinson

Senior Honors Theses

Money laundering is the act of hiding illegally obtained money in the financial system. There are three stages of money laundering: placing, layering, and integration. In the United States, the Bank Secrecy Act, monitored by the Financial Crimes Enforcement Network (FinCEN), requires companies to establish an anti-money laundering (AML) compliance program and to exercise customer due diligence as preventative measures. The US government can detect money laundering through Suspicious Activity Reports, Currency Transaction Reports, and whistleblower tips. However, AML threats and vulnerabilities such as Professional Money Launderers, cryptocurrency, and the global art market allow criminals to continue to launder money …

Hepatocellular Carcinoma Screening In A Contemporary Cohort Of At-Risk Patients, Darine Daher, Karim Seif El Dahan, Nicole E Rich, Nabihah Tayob, Vincent Merrill, Daniel Q Huang, Ju Dong Yang, Anand V Kulkarni, Fasiha Kanwal, Jorge Marrero, Neehar Parikh, Amit G Singal

Faculty, Staff and Students Publications

IMPORTANCE: Cohort studies demonstrating an association of hepatocellular carcinoma (HCC) screening with reduced mortality are prone to lead-time and length-time biases.

OBJECTIVE: To characterize the clinical benefits of HCC screening, adjusting for lead-time and length-time biases, in a diverse, contemporary cohort of at-risk patients.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study of patients with HCC was conducted between January 2008 and December 2022 at 2 large US health systems. Data analysis was performed from September to November 2023.

MAIN OUTCOMES AND MEASURES: The primary outcome was screen-detected HCC, defined by abnormal screening-intent abdominal imaging or α-fetoprotein level within 6 …

The Impact Of Government Subsidies On Ev Manufacturers, Connor Quinton

Senior Honors Theses

Government subsidies play a pivotal role in shaping the landscape of the electric vehicle (EV) industry in the United States. This research delves into the relationship between government support and the financial performance of EV manufacturers. This research aims to examine financial statements and market data to analyze the impact of government subsidies and incentives influence the revenue of EV manufacturers to provide a comprehensive understanding of the economic aspects of these policies on both individual companies and the EV sector as a whole. Beyond the financial aspects, this study will also address the ethical considerations associated with government support …

Prescription And Dispensation Of Qt-Prolonging Medications In Individuals Receiving Hemodialysis, Virginia Wang, Chin-Hua Lily Wang, Magdalene M Assimon, Patrick H Pun, Wolfgang C Winkelmayer, Jennifer E Flythe

Faculty, Staff and Students Publications

IMPORTANCE: Individuals with dialysis-dependent kidney failure have numerous risk factors for medication-related adverse events, including receipt of care by multiple clinicians and initiation of some QT-prolonging medications with known risk of torsades de pointes (TdP), which is associated with higher risk of sudden cardiac death. Little is known about the prescription and dispensation patterns of QT-prolonging medications among people receiving dialysis, hindering efforts to reduce drug-related harm from these and other medications in this high-risk population.

OBJECTIVE: To examine prescription and dispensation patterns of QT-prolonging medications with known TdP risk and selected interacting medications prescribed to individuals receiving hemodialysis.

DESIGN, …

What Figures Lurk On Madame Elysé’S Path? Reflections On Philippe Sands’ The Last Colony, Diane Marie Amann

Scholarly Works

One person’s life forms the core around which Philippe Sands’ The Last Colony explores the events leading up to the advisory opinion on the Legal Consequences of Chagos Archipelago from Mauritius in 1965. That person is Liseby Bertrand Elysé, who was born in 1953 in Chagos, then forcibly removed to Mauritius in 1973. Her efforts to return home eventually brought her to a 2018 hearing at The Hague, where she spoke to the International Court of Justice bench by means of a subtitled video. This essay, which appears in a symposium issue on Sands’ book, investigates the ethics, the effectiveness, …

Clinical Care For Life's Essential 8 By Medical Specialty In The United States, An Observational Cohort Study., Michael E Johansen, Madeline R Sterling, Jeremy B Sussman

Heart and Vascular Articles

No abstract provided.

Disease Progression, Survival, And Molecular Disparities In Black And White Patients With Endometrioid Endometrial Carcinoma In Real-World Registries And Gog/Nrg Oncology Randomized Phase Iii Clinical Trials, Zachary A Kopelman, Chunqiao Tian, Jordyn Tumas, Neil T Phippen, Christopher M Tarney, Erica R Hope, Stuart S Winkler, Suzanne Jokajtys, Calen W Kucera, John K Chan, Michael T Richardson, Daniel S Kapp, Chad A Hamilton, Charles A Leath, Nathaniel L Jones, Rodney P Rocconi, John H Farley, Angeles Alvarez Secord, Casey M Cosgrove, Matthew A Powell, Ann Klopp, Joan L Walker, Gini F Fleming, Nicholas W Bateman, Thomas P Conrads, G Larry Maxwell, Kathleen M Darcy

Faculty, Staff and Student Publications

OBJECTIVE: Investigate racial disparities in outcomes and molecular features in Black and White patients with endometrioid endometrial carcinoma (EEC).

METHODS: Black and White patients diagnosed with EEC who underwent hysterectomy ± adjuvant treatment in SEER, National Cancer Database (NCDB), the Genomics Evidence Neoplasia Information Exchange (GENIE) project (v.13.0), and eight NCI-sponsored randomized phase III clinical trials (RCTs) were studied. Hazard ratio (HR) and 95% confidence interval (CI) were estimated for cancer-related death (CRD), non-cancer death (NCD), and all-cause death.

RESULTS: Black (n = 4397) vs. White (n = 47,959) patients in SEER had a HR (95% CI) of 2.04 (1.87-2.23) …

Analytical Challenges In Omics Research On Asthma And Allergy: A National Institute Of Allergy And Infectious Diseases Workshop, Supinda Bunyavanich, Patrice M Becker, Matthew C Altman, Jessica Lasky-Su, Carole Ober, Karsten Zengler, Evgeny Berdyshev, Richard Bonneau, Talal Chatila, Nilanjan Chatterjee, Kian Fan Chung, Colleen Cutcliffe, Wendy Davidson, Gang Dong, Gang Fang, Patricia Fulkerson, Blanca E Himes, Liming Liang, Rasika A Mathias, Shuji Ogino, Joseph Petrosino, Nathan D Price, Eric Schadt, James Schofield, Max A Seibold, Hanno Steen, Lisa Wheatley, Hongmei Zhang, Alkis Togias, Kohei Hasegawa

Center for Medical Ethics and Health Policy Staff Publications

Studies of asthma and allergy are generating increasing volumes of omics data for analysis and interpretation. The National Institute of Allergy and Infectious Diseases (NIAID) assembled a workshop comprising investigators studying asthma and allergic diseases using omics approaches, omics investigators from outside the field, and NIAID medical and scientific officers to discuss the following areas in asthma and allergy research: genomics, epigenomics, transcriptomics, microbiomics, metabolomics, proteomics, lipidomics, integrative omics, systems biology, and causal inference. Current states of the art, present challenges, novel and emerging strategies, and priorities for progress were presented and discussed for each area. This workshop report summarizes …

Concrete Legacy: The Effects Of The Interstate Highway System On Black Communities In The U.S., Laurel M. O'Hare

Tapestries: Interwoven voices of local and global identities

This article examines the role that racism, racial capitalism, neoliberalism, and classism played in the construction of the Interstate Highway System as a part of 20th-century urban renewal. It will first understand the context of American urban renewal and then look at the policy specific to the Interstate Highway System. After that, I will discuss the resistance many communities portrayed and how bureaucracy stood firm against grassroots organizing. Then, this paper will explore the process of highway removal and new construction, as well as reparations for the communities most affected by the Interstate Highway System. Finally, I will give warnings …

Trends In Cardiovascular Mortality In The United States From 1968 To 2019: Analysis Of The Cdc Wonder Database, Abdul Mannan Khan Minhas, Kartik Gupta, Vardhmaan Jain, Tanya Singh Kakar, Anwar T Merchant, Michael D Shapiro, Layla A Abushamat, Vijay Nambi, Salim S Virani

Faculty, Staff and Students Publications

No abstract provided.

A Representative Clinical Course Of Progression, With Molecular Insights, Of Hormone Receptor-Positive, Her2-Negative Bone Metastatic Breast Cancer, Elizabeth Magno, Karen M. Bussard

Department of Pharmacology, Physiology, and Cancer Biology Faculty Papers

Despite treatment advances, breast cancer remains a leading cause of death of women in the United States, mostly due to metastatic disease. Bone is a preferential site for breast cancer metastasis, and most metastatic breast cancer patients experience bone involvement at the time of death. The majority of patients with bone metastatic breast cancer are first diagnosed with and treated for early-stage disease, and from development of early-stage breast cancer to the recurrence of cancer in the bones, up to 30 years may elapse. Throughout this timeframe, a typical patient undergoes many treatments that have effects on the bone microenvironment. …

Federal Home Loan Banks: Actions Related To The Spring 2023 Bank Failures, United States: Governmant Accountability Office (Gao)

Documents

No abstract provided.

The Unknown Drug Dealers In The Nhl: Nhl Players, Drug Addiction, And The Need For Regulation Of Prescriptive Drug Use In The Nhl, Keith O'Brien

Hofstra Law Review

The article examines the pervasive issue of painkiller addiction among NHL (National Hockey League) players, which is exacerbated by a league culture that valorizes playing through injuries. It highlights the shortcomings of the current Collective Bargaining Agreement (CBA) in managing and regulating prescription drug use, alongside the inadequate oversight and accountability from the NHL and regulatory bodies like OSHA (Occupational Safety & Health Administration).

From Compromise To Confrontation: The American Secretary Of State James F. Byrnes And His Attempts To Mitigate Disagreements With The Soviet Union As The Cold War Began, John Karl

Comparative Civilizations Review

James F. Byrnes as United States Secretary of State pursued a policy based on compromise with the Soviet Union during the first year following the end of the Second World War. He was determined to use his political skill for engineering compromise in order to bring about an agreement with the Soviet Union which would lead to an era of peace. While the crucial question facing American policymakers in the wake of World War II was the creation of a new world order, a most important part of this question was the future of American-Soviet relations, the two nations that …

Evaluation Of A Collaborative Model Between Managed Care And Affordable Housing On Acute Care Costs, Jack Tsai, Suja Rajan, Chau Truong, Vanessa Schick, Cecilia Ganduglia Cazaban

Faculty, Staff and Student Publications

Objectives: This study evaluated a collaborative service model between the largest Medicaid managed care organization (MCO) in Texas, Superior HealthPlan, and the affordable housing provider Prospera Housing Community Services.

Study design: Using a quasi-experimental 2-groups research design, we compared health care outcomes and costs between a sample of 104 participants served by the Prospera+Superior collaborative model and a group of 104 participants who had health care coverage through the Superior HealthPlan Medicaid MCO but did not live at Prospera properties (ie, Superior-only group).

Methods: Data from medical claims were analyzed to examine change in outcomes 12 months before and after …

Association Between Medication Adherence And Asthma Among Latinos In The United States, Denisse Silva

Walden Dissertations and Doctoral Studies

Prior research has shown that Latinos in the United States face disproportionate challenges in managing their asthma symptoms. Therefore, this study aimed to identify factors that may influence medication adherence and asthma episodes among Latinos in the United States and was guided by Andersen’s health behavior theory. Data from 2020 Latinos who participated in the National Health Interview System in 2020 were analyzed. Findings indicated that nearly 23% of respondents reported an asthma episode. Approximately 25% of the sample reported an asthma episode during the last 12 months. A total of 43.6% of the sample reported not taking medication every …

Watching The Fall Of Roe V Wade: Media Exposure Relates To Us Women's Alcohol Use Intentions, Stacy M Post, Mary C Jobe, Arianne N Malekzadeh, Katarina E Aubuchon, Rebecca K Hoffman, Michelle L Stock, Lisa Bowleg

Faculty, Staff and Student Publications

OBJECTIVE: The Supreme Court of the United States’ decision in Dobbs v. Jackson Women’s Health Organization in June 2022 overturned Roe v. Wade and ended federal protection of abortion rights. Given the drastic policy changes as a result of the ruling and high exposure to media related to abortion, women opposed to the decision may have experienced distress, which could trigger maladaptive coping strategies, such as alcohol use. The present research examined how consuming abortion-related media in the weeks following the Dobbs decision impacted alcohol use intentions among women of reproductive age residing in the 13 “trigger law” states that …

Obstetric Racism, Education, And Racial Concordance, Terri L Major-Kincade

Faculty, Staff and Student Publications

The United States holds the distinction of being the developed country with the worst perinatal outcomes despite spending the most per capita on health care. Black women are three to four times more likely than White women to experience adverse birth outcomes. These outcomes persist despite access to prenatal care, insurance, and college education. A long overdue racial reckoning has arrived, beginning with acknowledging the fallacy of race-based medicine and the role of enduring systemic racism as foundational to obstetric racism in the reproductive lives of Black women. Centering voices of Black women and honoring their lived experiences are essential …

Empirically Derived Principles For Research Funding Success: A Primer For Early Career Academic Investigators, Kareem A Wahid, Michael K Rooney, Jillian R Gunther, Amy C Moreno, Chelsea C Pinnix, Charles R Thomas, Clifton D Fuller

Faculty, Staff and Student Publications

No abstract provided.

A Job Satisfaction Evaluation Of Nursing In The United States And Greece Utilizing The American Nurses Association's Scope And Standards Of Practice, Audrey Narhi

Honors Projects

Nursing is a multifaceted profession that is constantly evolving with the health needs of the populations it serves. Professional organizations within the field utilize evidence-based practice to provide guidelines of what best-practice nursing is. This study aims to evaluate if the American Nurse's Association (ANA), a professional nursing organization in the United States, supports the realities of nursing in a rural US hospital. An international perspective is also considered by evaluating the same principles to a urban hospital in Athens, Greece. Categories that align with ANA Scope and Standards, including workplace environment, career development, supervisor relationships, and personal work practice, …

The Lymphoma Epidemiology Of Outcomes Cohort Study: Design, Baseline Characteristics, And Early Outcomes, James R Cerhan, Matthew J Maurer, Brian K Link, Andrew L Feldman, Thomas M Habermann, David L Jaye, W Richard Burack, Timothy J Mcdonnell, Francisco Vega, Jennifer R Chapman, Sergei Syrbu, Kiran R Vij, Giorgio Inghirami, John P Leonard, Leon Bernal-Mizrachi, Umar Farooq, Thomas E Witzig, George J Weiner, Yucai Wang, Juan P Alderuccio, Susan L Slager, Melissa C Larson, Shaun M Riska, Brianna J Gysbers, Julianne J Lunde, Tanner W Reicks, Amy A Ayers, Colin B O'Leary, Kathleen J Yost, Hongfang Liu, Grzegorz S Nowakowski, Jia Ruan, Dai Chihara, Jean L Koff, Carla Casulo, Carrie A Thompson, Jonathon B Cohen, Brad S Kahl, Loretta J Nastoupil, Izidore S Lossos, Jonathan W Friedberg, Peter Martin, Christopher R Flowers

Faculty, Staff and Student Publications

To address the current and long-term unmet health needs of the growing population of non-Hodgkin lymphoma (NHL) patients, we established the Lymphoma Epidemiology of Outcomes (LEO) cohort study (NCT02736357; https://leocohort.org/). A total of 7735 newly diagnosed patients aged 18 years and older with NHL were prospectively enrolled from 7/1/2015 to 5/31/2020 at 8 academic centers in the United States. The median age at diagnosis was 62 years (range, 18-99). Participants came from 49 US states and included 538 Black/African-Americans (AA), 822 Hispanics (regardless of race), 3386 women, 716 age <40 >years, and 1513 rural residents. At study baseline, we abstracted clinical, …

Racial Discrimination, Knowledge, And Health Outcomes: The Mediating Role Of Hepatitis B-Related Stigma Among Patients With Chronic Hepatitis B, Julia G. Katcher, Ann C. Klassen, Hie-Won Hann, Mimi Chang, Hee-Soon Juon

Department of Medical Oncology Faculty Papers

It is well described in current literature that Hepatitis B virus (HBV) affects Asian Americans more than any other racial group in the United States and that there is a stigma attached to this condition. The effects of stigma can be lasting, penetrating physiologically and psychologically, yet few studies have focused on the consequences of this phenomenon. The purpose of this study was to examine the mediating role of stigma in the effect of racial discrimination and knowledge (of HBV sequelae) on health status of Korean Americans with chronic hepatitis B (CHB). Three hundred sixty-five CHB patients were recruited and …

Impact Of Local Wellness Policies On District Level Physical Activities, Minh Le, Hoang K. Dao, Mia Putnam, Jacob Szeszulski

International Journal of Exercise Science: Conference Proceedings

Local wellness policies (LWPs) are state required documents that outline school districts’ goals for improving the physical activity of their students. In Texas, most districts use a template for developing their LWP, which has seven prespecified goals that districts may include or further expand upon to include additional goals. PURPOSE: Determine if physical activity components of districts’ LWPs were related to practices within the district. METHODS: LWPs published by public school districts in Texas were collected from district websites, analyzed for content related to physical activity, and assessed to determine if the district text matched the template. Then, responses were …

Association Of Risk Factors And Comorbidities With Chronic Pain In The Elderly Population., Neil Mookerjee, Nicole Schmalbach, Gianna Antinori, Subhadra Thampi, Dylan Windle-Puente, Amy Gilligan, Ha Huy, Megha Andrews, Angela Sun, Roshni Gandhi, William Benedict, Austin Chang, Ben Sanders, Justin Nguyen, Maanika Reddy Keesara, Janet Aliev, Aneri Patel, Isaiah Hughes, Ian Millstein, Krystal Hunter, Satyajeet Roy

Cooper Medical School of Rowan University Departmental Research

INTRODUCTION/OBJECTIVE: Chronic pain disorders affect about 20% of adults in the United States, and it disproportionately affects individuals living in the neighborhoods of extreme socioeconomic disadvantage. In many instances, chronic pain has been noted to arise from an aggregation of multiple risk factors and events. Therefore, it is of importance to recognize the modifiable risk factors. The aim of this study was to investigate the comorbid medical conditions and risk factors associated with chronic pain disorders in patients aged 65 years and older.

METHODS: Our team retrospectively reviewed medical records of elderly patients (65 years and older) who were evaluated …