Digital Commons Network^™

Challenging Dyads As Defaults In Research On Childhood Social Cognition, Roman Stengelin, Patricia Kanngiesser

School of Psychology

Early in life, children develop the socio-cognitive tools to benefit and learn from interactions with others, allowing them to thrive in the diverse social and cultural niches of their respective communities. Over the past decades, developmental science has critically deepened our understanding of childhood social cognition and its ontogenetic foundations.

Perceived School Climate Norms Of Equality, Perspective-Taking And Youth Collective And Civic Actions, Shelley Mckeown, Cd Schaefer, Jaysan Charlesford, Thia Sagherian-Dickey, Gian Antonio Di Bernardo, Loris Vezzali

School of Psychology

Schools can play a crucial role in encouraging young people to make constructive societalcontributions that transcend group lines and that benefit communities more generally.Recognising this potential, the present research examined the relationship between perceivedschool climate norms of equality, and in turn perspective-taking on two forms of constructivecontributions amongst youth in England: civic engagement and collective action intentions insupport of refugees. A total of 696 youth (aged 11 to 12) were asked to complete a survey inschool as part of a larger study on youth interaction experiences. Bootstrapped mediationanalysis conducted in Mplus found that perspective-taking mediated the link between perceivedschool climate …

Transformational Leadership Disparities Within Nonprofit Organizations, Hillman Evans Iv

Electronic Theses and Dissertations

Leadership development is a primary organizational development function. It provides an opportunity for professional growth and is essential to assisting personal evolution for individuals in any capacity. This qualitative case study explored incorporating the transformational leadership style in a multilocation nonprofit organization. Eight participants participated in semistructured interviews. Each interview lasted approximately 30–45 minutes. The interview format consisted of asking open-ended semistructured questions and allowing participants to respond based on their organizational experiences. The researcher employed three coding passes in the data analysis (open, axial, and selective) and identified eight themes. The findings suggested that managers desired a leader who …

Nursing Education For Type 2 Diabetes And Nutrition Using Individual 1:1 Sessions In Rural Health Care, Meagan F. Wheat

Electronic Theses and Dissertations

What if proper nutrition were a nonpharmacological treatment for health problems? Nutrition is an important key to overall wellness. When patients receive the right education, they not only get the proper nutrition in their diet but also can manage their diabetes and live a better quality of life. In rural U.S. health areas, lack of access to nutrition is a barrier to patient care. Rural areas are at an even higher risk due to a lack of resources for good nutrition. One-to-one nutrition education with a nurse specialized in diabetes helps teach patients at a learning level they will comprehend. …

Career Advising Utilization: A Quantitative Archival Analysis Of Student Engagement Across Academic Levels And Colleges At A Southeast University, Edward Raimundi Iii

Electronic Theses and Dissertations

This quantitative ex-post facto study examined patterns of career advising utilization at a large, R1 public university in the southeastern region of the United States. Institutional advising data from the 2023–24 advising year was utilized to identify usage patterns across different demographics such as college affiliation and academic level. The descriptive stats from the archival data were used to measure topic distributions, undergraduate–graduate usage by college, and contact engagement. The sample size included over 35,000 students with 10 different college affiliation labels. Significant differences across advising usage in the different colleges were found during the study. Undergraduate students had higher …

Differences In Peer Social Connections Between Traditional And Online Nurse Residency Programs, Tatum Leonard

Electronic Theses and Dissertations

The anticipated retirement of baby boomer nurses by 2030 will intensify the global nursing shortage, a crisis that demands innovative strategies for onboarding and retaining new graduate nurses. Nurse residency programs (NRPs) are designed to ease the transition from student to practicing nurse, reduce turnover, and foster professional resilience. Amid the COVID-19 pandemic, many NRPs rapidly transitioned from traditional, in-person seminars to synchronous, online formats. This study explored differences in peer social connections between traditional and online NRPs, focusing on three constructs: sense of community, collaborative learning, and peer social support. Using a quasi-experimental, mixed methods approach, this secondary data …

Racial Moderation Of Infant Mortality Risk And Protective Factors In The United States, Temitope Oluwaseun Akinsola

Walden Dissertations and Doctoral Studies

The rate of infant mortality is a pressing health issue in the United States, as ethnic minorities are disproportionately affected. This study addressed how race controls the predictive power of demographic, socioeconomic, and geographic factors on infant mortality. Using a quantitative correlational design, secondary data from 181 individuals listed in the CDC-National Vital Statistics System database were used, which contains nationally aggregated data related to infant mortality rates. Bronfenbrenner’s social ecological model guided the study, and multiple regression and moderation models were used to examine socioeconomic status and access to healthcare on infant mortality outcomes. Results indicated that race significantly …

Exploring The Contextual Antecedents Of Nonfamilial Aggression In Women Arrested For Aggressive Behavior, Tatiana Pouncy

Walden Dissertations and Doctoral Studies

The prevalence of physical aggression among women has increased, challenging traditional gender norms that portray women as nurturing and nonviolent. While most research on aggression has focused on men, children, or intimate partner violence, research is sparse concerning female aggression outside familial contexts. In this qualitative multiple-case study, the contextual antecedents of nonfamilial aggression in women arrested for aggressive behavior were explored using the general aggression model as the theoretical framework. Data were obtained from 20 publicly documented cases using archival sources such as media stories, court documents, and video recordings. According to thematic and document analysis, aggressive behavior was …

Exploring The Lived Experiences Of Former Lagos State Male Public High School Teachers About Their Onboarding Process., Agboola Clement Ikuyinminu

Walden Dissertations and Doctoral Studies

Lagos State, Nigeria, faces male teacher retention challenges in public high schools, including destabilizing the educational environment, reducing the availability of experienced mentors, and negatively impacting student performance and outcomes. School leaders need to understand the challenges leading to male teacher turnover. The purpose of this qualitative phenomenological study was to explore the lived experiences of Lagos State male public high school teachers who left the profession, focusing particularly on their perceptions of onboarding and reasons for leaving the profession. This study was grounded in Herzberg’s two-factor theory, Bauer and Erdogan’s onboarding theory, Maslow’s hierarchy of needs, and Bandura’s social …

Clinical Staff Education Initiative Designed To Improve Communication And Collaboration Among Interdisciplinary Clinical Staff, Youlen Duffus

Walden Dissertations and Doctoral Studies

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A Multi-Institutional Multi-Methods Analysis Of Jeopardy Systems In Academic Hospital Medicine, Kirsten N Kangelaris, Angela Keniston, Andrew D Auerbach, Gregory Bowling, Marisha Burden, Shradha A Kulkarni, Luci K Leykum, Anne S Linker, Matthew Sakumoto, Jeffrey Schnipper, Gopi Astik

Faculty, Staff and Students Publications

Background: Hospital medicine programs use backup ("jeopardy") systems to cover unexpected staffing gaps, but little is known about their structures or optimal practices.

Objectives: To describe jeopardy structures, assess clinician perceptions, and identify potential approaches across a broad sample of hospital medicine groups.

Methods: This multi-methods study, conducted within a national hospitalist consortium, used virtual focus groups and an email survey to (1) describe the presence and structure of jeopardy systems and (2) explore features perceived as fair, equitable, and tolerable. Rapid qualitative analysis identified major themes, while descriptive methods analyzed survey data.

Results: Twenty-five individuals participated in focus groups, …

Comparative Effectiveness Of Less Vs More Frequent Hydrocortisone Dosing In Septic Shock, Alan Hao, Tianshi David Wu, Keegan Collins, Danielle Guffey, Rebecca Kessinger, Meghna Vallabh, Ali Omranian

Faculty, Staff and Students Publications

Objectives: Guidelines recommend hydrocortisone as an adjunctive treatment in septic shock, but the optimal dosing regimen is unknown. A national shortage of hydrocortisone in 2023 prompted a change in institutional practice for hydrocortisone administration from 50 mg every 6 hours to 100 mg every 12 hours in an effort to reduce waste and conserve vials, creating an opportunity to evaluate the comparative effectiveness of these two regimens. The primary efficacy outcome was time to shock resolution, and secondary outcomes evaluated in this study were mortality, renal replacement therapy (RRT), medication costs, and maximum vasopressor dose attained.

Design: Single-center, retrospective cohort …

Patient-Centered Management Of Heavy Menstrual Bleeding While On Anticoagulation: A Survey Study, Benjamin Barnett, Rushad Patell, Dana Angelini, Leben Tefera, Jordan K Schaefer, Ang Li, Alejandra Gutierrez Bernal, Shruti Chaturvedi, Anjlee Mahajan, Leslie Lake, Jori May, Anna L Parks

Faculty, Staff and Students Publications

Background: Nearly three-quarters of women experience heavy menstrual bleeding (HMB) during anticoagulation treatment for venous thromboembolism (VTE). HMB can lead to medical interventions, impact school or work and diminish quality of life (QOL). While there are several management options for HMB in patients with VTE, we lack information on how patients approach HMB treatment decisions.

Objectives: We examined patients' experience with, perceptions of, and preferences for treatment of HMB while on anticoagulation.

Methods: Clinicians and patient advocates developed a web-based survey that was distributed via patient advocacy organizations and social media between May and June 2024, targeting participants 18 years …

Optical Coherence Tomography Enables The Depth-Resolved Measurement Of Cilia Beat Frequency In Ex Vivo Human Fallopian Tubes, Dilara J Long, Tian Xia, Photini F Rice, Deirdre M Scully, Makayla Johnson, Ryan Mistifer, Andrea Aguirre, John M Heusinkveld, Irina V Larina, Jennifer K Barton

Faculty, Staff and Students Publications

Objectives: The movement of cilia in the fallopian tubes (FTs) facilitates important processes involved in fertility, and abnormalities in cilia function are linked with diseases including endometriosis and pelvic inflammatory disease. For the first time, we demonstrate the use of optical coherence tomography (OCT) to create depth-resolved mapping of motile cilia locations and quantify cilia beat frequency (CBF) in human FT samples ex vivo.

Methods: Segments of the FT ampulla were acquired from five patients following salpingectomy under an IRB approved protocol. The samples were longitudinally opened to expose the luminal surface for imaging. A sequence of at least 500 …

Heightened Risk: Childhood Trauma And Anticipatory Grief Exacerbate The Impact Of Loneliness On Depressive Symptoms And Lps-Stimulated Cytokines In Dementia Caregivers, Kelly N Brice, Jensine Paoletti-Hatcher, E Lydia Wu-Chung, Vincent D Lai, Daniel L Argueta, Michelle A Chen, Itee Mahant, Bryan T Denny, Charles Green, Luis D Medina, Paul Schulz, Jennifer Stinson, Samantha K Henry, Cobi Heijnen, Christopher P Fagundes

Faculty, Staff and Student Publications

Dementia spousal caregivers are at a disproportionate risk for adverse mental and physical health outcomes. Loneliness is associated with depressive symptoms and proinflammatory cytokine production among caregivers. Additionally, childhood trauma, anticipatory grief, and poor sleep quality are all associated with enhanced stress reactivity. This study used a cross-sectional design to investigate whether loneliness is associated with proinflammatory cytokine production and depressive symptoms in caregivers, and whether these relationships are strongest among caregivers who report high levels of childhood trauma, high amounts of anticipatory grief, or poor sleep quality. A sample of 111 dementia spousal caregivers provided blood samples and completed …

Microbiome Signatures And Inflammatory Biomarkers In Culture-Negative Neonatal Sepsis, Morcos Hanna, Shixia Huang, Matthew Ross, Anaid Reyes, Dimuthu Perera, Anil Surathu, Sara Javornik Cregeen, Joseph Hagan, Mohan Pammi

Faculty and Staff Publications

Overuse of antibiotics is a concern in 'culture-negative sepsis' but it is unclear whether this is due to infection with viruses, fungi or other microbes that are not easily cultured, or whether it results from inflammatory processes. In a prospective study, we enrolled 50 preterm neonates with culture-positive sepsis (CP), culture-negative sepsis (CN), and asymptomatic preterm controls (CO). The microbiome of stool, skin, and blood, including bacterial, viral and fungal components and serum cytokine profiles were evaluated. The microbiome alpha or beta diversity did not differ between CN and CO groups. A MaAsLin analysis revealed increased relative abundances of specific …

A Metabolomics Study Of Cardiac Dysfunction In Hyperglycemia: Findings From The Atherosclerosis Risk In Communities (Aric) Study And The Hispanic Community Health Study/Study Of Latinos (Hchs/Sol), Yilin Yoshida, Ngoc Quynh Nguyen, Eun Hye Moon, Casey Rebholz, Hicham Skali, Victoria Arthur, Justin B Echouffo-Tcheugui, Christie Ballantyne, Elizabeth Selvin, Amil Shah, Robert Kaplan, Carlos J Rodriguez, Qibin Qi, Susan Cheng, Bing Yu

Faculty, Staff and Student Publications

Objective: Hyperglycemic states (prediabetes and diabetes) are associated with heart failure (HF) risk. We aimed to identify distinct metabolites for subclinical cardiac dysfunction, a precursor of HF, in hyperglycemic or euglycemic individuals.

Research design and methods: We conducted cross-sectional and prospective analyses of 2,492 HF-free participants from the Atherosclerosis Risk in Communities (ARIC) study visit 5, 2011-2013. A total of 1,297 participants were hyperglycemic (assessed on the basis of hemoglobin A1c >5.7%, fasting glucose >100 mg/dL, use of diabetes medication, or diagnosis), and 1,195 were euglycemic. We used logistic regression for analysis of association between 790 metabolites and cardiac dysfunction, …

From Imaging To Impact: A Multi-Disciplinary T32 Program Framework And Initial Insights For Training In Image-Guided Cancer Therapy, Kari J Brewer Savannah, Stephen Y Lai, Clifton D Fuller, Kristy K Brock

Faculty, Staff and Student Publications

As multi-disciplinary image-guided assessment and therapies become increasingly important for precision oncology, the need for comprehensive training opportunities that effectively prepare the next generation of clinician-scientists and scientists is evident. We present an innovative, evidence-based research training framework that integrates the following critical features: 1) intentional and personalized mentoring and career development, 2) immersive research in image-guided cancer therapy, 3) strategic mentored clinical exposure, 4) structured didactic learning and professional development opportunities, and 5) mentored grant writing. Designed to foster scientific rigor, translational thinking, and multi-disciplinary collaboration, the Image-Guided Cancer Therapy T32 Training Program (IGCT-T32) aims to prepare postdoctoral fellows …

Time-Frequency Fingerprint Analysis In Seeg Source-Space To Identify The Epileptogenic Zone, Yash Shashank Vakilna, Deniz Atilgan, Johnson Hampson, Chinmay Chinara, Takfarinas Medani, Richard M Leahy, Nuria Lacuey, Samden D Lhatoo, Sandipan Pati, John C Mosher, Jay R Gavvala

Faculty, Staff and Student Publications

This case study highlights the application of seizure fingerprint analysis in the source-space of stereo-EEG (SEEG) data to accurately localize the epileptogenic zone (EZ) in patients with complex cortical malformations. A 25-year-old female with extensive bilateral perisylvian polymicrogyria (PMG) presented with intractable focal seizures. The source-level analysis performed in Brainstorm using the sLORETA imaging algorithm subsequently showed EZ fingerprint analysis. The patient underwent MR-guided laser interstitial thermal therapy (LITT), targeting the identified EZ, resulting in postoperative seizure freedom with minimal complications. Extending the analysis from the sensor-space to the source-space could further enhance surgical planning and improve outcomes in complex …

Current Controversies In Prenatal Diagnosis 2: Conventional Postmortem Examination Remains The Gold Standard For The Anatomical Examination Of Fetal Loss, J Ciaran Hutchinson, Lorraine Potocki, Ignatia B Van Den Veyver

Duncan NRI Faculty and Staff Publications

A comprehensive postmortem examination is an essential component of a work-up after stillbirth. Its findings can support accurate counseling of parents about causes and risk of recurrence. It also supports providers' decisions about most appropriate testing and management plans for future pregnancy to prevent recurrence. Informing parents about fetal autopsy and obtaining their consent is challenging, and conducting a fetal autopsy requires expertise that is, not universally available. Newer non-invasive or minimally invasive methods such as postmortem MRI and targeted biopsies can replace or supplement autopsies, but one must recognize that expertise in these methods is likewise not broadly available. …

The Effect Of Tert Promoter Mutation On Predicting Meningioma Outcomes: A Multi-Institutional Cohort Analysis, Karenna J Groff, Ruchit V Patel, Yang Feng, Hia S Ghosh, Miguel A Millares Chavez, Joseph O'Brien, William C Chen, Vijay Nitturi, Akshay V Save, Mark W Youngblood, Craig M Horbinski, James P Chandler, Felix Ehret, Chloe Gui, Justin Z Wang, Kristen Park, Sonia Ajmera, Marc Rosenblum, Abigail K Suwala, Catena Kresbach, Christopher W Mount, Ulrich Schüller, Sandro Santagata, Felix Sahm, Tejus A Bale, Christina Jackson, Timothy E Richardson, Chunyu Cai, Farshad Nassiri, Gelareh Zadeh, David Kaul, David Capper, Stephen T Magill, John G Golfinos, Chandra Sen, Akash J Patel, David R Raleigh, Jennifer Moliterno, Donato Pacione, Matija Snuderl, Wenya Linda Bi

Duncan NRI Faculty and Staff Publications

Background: Molecular aberrations have been incorporated into tumour classification guidelines of meningioma. TERT-promoter (TERTp) mutation is associated with worse prognosis and is designated a WHO grade 3 biomarker. However, it remains unclear whether TERTp mutation is context-dependent, with other co-occurring genetic alterations potentially driving its association with prognosis. We sought to characterise the role of TERTp mutation in meningioma and guide TERTp sequencing.

Methods: We identified 1492 patients of all ages who had previously received surgery for meningioma across 14 medical centres in the USA, Canada, and Germany. Patients were eligible if they had post-surgical clinical or radiographical assessment of …

The Ethics Of Clinical Ethics, Matthew Shea

Center for Medical Ethics and Health Policy Staff Publications

The concept ethics defines health care ethics as a professional practice. Yet the meaning of "ethics" is often unclear in the theory and practice of clinical ethics. Clarity on this matter is crucial for understanding the nature of clinical ethics and for debates about the professional identity and proper role of ethicists, the sort of training and skills they should possess, and whether they have ethics expertise. This article examines two different ways the ethics of clinical ethics can be understood: Real Ethics, which consists of objective moral norms grounded in moral truth; and Conventional Ethics, which consists of conventional …

Postoperative Staphylococcal Toxic Shock Syndrome In A Patient Following Right Knee Fracture Repair: A Case Report, Nicole Nyamongo, James Garritano, Daniel Rosen, Theodore Rosen

Faculty, Staff and Students Publications

Toxic shock syndrome (TSS) is a rare but life-threatening multisystem disorder most commonly caused by Staphylococcus aureus. It is characterized by the acute onset of high fever, hypotension, a diffuse macular rash, and multiorgan involvement. We report the case of a male in his late 30s who sustained a patellar fracture with associated retinacular injury following trauma and subsequently underwent open reduction and internal fixation. Several days after discharge, he developed fever, chills, hypotension, and a pruritic, erythematous rash. He was readmitted and initially evaluated by the orthopedic service, which did not recommend additional imaging or surgical intervention, as …

Diagnostic Yield Of Exome Sequencing For Pregnancies With And Without Fetal Anomalies And For Stillbirth, Roni Zemet, Christian M Parobek, April D Adams, Mohamad Ali Maktabi, Lena Shay, Linyan Meng, Pengfei Liu, Hongzheng Dai, Fan Xia, Christine Eng, Ignatia B Van Den Veyver, Liesbeth Vossaert

Duncan NRI Faculty and Staff Publications

Objective: Exome sequencing (ES) benefits the genetic work-up for fetuses with structural anomalies, but data on its utility for fetuses without anomalies and stillbirths is more limited. We report our experience with prenatal ES for all three indications.

Method: We retrospectively reviewed results from 344 trio-ES performed for fetuses with structural anomalies (N = 262), stillbirths (N = 39), and fetuses without anomalies (N = 43), many of which had a relevant family history. We classified pathogenic variants (P), likely pathogenic variants (LP), or variants of uncertain significance (VUS) favoring pathogenicity in a gene consistent with the fetal phenotype as …

The Immeasurable Value Of Plankton To Humanity, Maria Grigoratou, Susanne Menden-Deuer, Abigail Mcquatters-Gollop, George Arhonditsis, Luis Felipe Artigas, Sakina-Dorothée Ayata, Dalida Bedikoğlu, Beatrix E Beisner, Bingzhang Chen, Claire Davies, Lillian Diarra, Owoyemi W Elegbeleye, Jason D Everett, Tatiane M Garcia, Wendy C Gentleman, Rodrigo Javier Gonçalves, Tamar Guy-Haim, Svenja Halfter, Jana Hinners, Richard R Horaeb, Jenny A Huggett, Catherine L Johnson, Maria T Kavanaugh, Ana Lara-Lopez, Christian Lindemann, Celeste López-Abbate, Monique Messié, Klas Ove Möller, Enrique Montes, Frank E Muller-Karger

School of Biological and Marine Sciences

Plankton, a diverse group of aquatic organisms, make Earth livable, regulate aquatic life, and provide benefits to human societies such as access to clean water, food security, and well-being. They also support economies and inspire biotechnological innovations. This article aims to raise awareness of the value of plankton to humanity and serves as an informative guide for aquatic professionals, policymakers, and anyone interested in plankton. We present the value of plankton across six themes of human interest: biogeochemistry; ecology; climate; the evolution of science; economy; and culture, recreation, and well-being. Guided by the 2022 Intergovernmental Science-Policy Platform on Biodiversity and …

Scale Model And Ship Simulator Towing Of The Iea 15 Mw Wind Turbine On The Umaine Volturnus-S Platform, Adam Roberts, Frédéric Le Pivert, Saied Kazemi, Tom Tosdevin, Adán López-Santander, Matthew J. Craven, Lars Johanning

School of Engineering, Computing and Mathematics

Floating offshore wind turbines are expected to be deployed in significant numbers across the globe in the coming decades, with wet towing of these structures between ports and farms a key operation in their installation, maintenance, and decommissioning. Platforms are likely to be towed across large distances, and accurate understanding of tow dynamics will be crucial to optimising these journeys to minimise costs, timescales, emissions, and risk. This paper presents experimental and ship simulator modelling of the oceanic towing of the IEA 15 MW turbine on the UMaine VolturnUS-S platform. The work provides indicative data for floating offshore wind turbines …

Comparative Outcomes Following Candida Bloodstream Infection In Patients With Left Ventricular Assist Devices, Armaghan-E-Rehman Mansoor, Gayathri Krishnan, Julio C Zuniga-Moya, Benjamin Papadopoulus, Andrej Spec, Ige George

2020-Current year OA Pubs

BACKGROUND: Candida bloodstream infections (BSI) carry a high risk of adverse outcomes. Left ventricular assist devices (LVADs) are increasingly used to manage end-stage heart failure; however, they carry a risk of infection. This study evaluates the impact of LVAD presence on outcomes in patients with

METHODS: A total of 1233 patients with

RESULTS: Patients with

CONCLUSIONS: In patients with

Rezafungin Versus Caspofungin For The Treatment Of Candidemia And Invasive Candidiasis: Results From The Double-Blind, Randomized, Phase 3 Restore Trial Including The China Extension Study, George R Thompson, Haihui Huang, Sizhou Feng, Yunsong Yu, Alex Soriano, Oliver A Cornely, Bart Jan Kullberg, Peter G Pappas, Marin Kollef, Jose A Vazquez, Patrick M Honore, Laura Cox, Matteo Bassetti

2020-Current year OA Pubs

BACKGROUND: Rezafungin is approved for use in adults with candidemia and/or invasive candidiasis (IC) based on data from the ReSTORE trial (NCT03667690), which demonstrated noninferior efficacy to caspofungin. For regulatory purposes, an additional cohort of patients from China was recruited to ReSTORE. Here, we compared rezafungin and caspofungin in patients with candidemia and/or IC through analysis of the ReSTORE global data plus the China extension study.

METHODS: Adults with candidemia/IC were randomized (1:1) to receive weekly rezafungin (400/200 mg) or daily caspofungin (70/50 mg) for ≤28 days. Noninferiority was concluded for primary efficacy endpoints if the upper bound of the …

Variation In Recommended Treatment Strategies Among American Surgeons For Actual Adult Traumatic Brachial Plexus Injury Cases, Michele N Christy, Christopher J Dy, R Glenn Gaston, Bryan J Loeffler, Mihir J Desai, Steve K Lee, Harvey Chim, Jeffrey B Friedrich, Sameer K Puri, Jason H Ko, Planet Study Group

2020-Current year OA Pubs

PURPOSE: The surgical management of adult traumatic brachial plexus injuries (BPI) is challenging, with no consensus on optimal strategies. This study aimed to gather preferred reconstructive strategies from BPI surgeons for actual cases from a multicenter cohort to identify areas of agreement.

METHODS: Four case files (history, physical examination, and imaging and electrodiagnostic testing results) were distributed to eight self-designated Level IV expert BPI surgeons in the United States. Each surgeon independently reviewed the cases and provided a preferred reconstructive plan via free text response.

RESULTS: For a pan-plexus case after blunt trauma (67 years old; 3 months from injury): …

Identifying Care Gaps Along The Hiv Treatment Failure Cascade: A Multistate Analysis Of Viral Load Monitoring, Re-Suppression, And Regimen Switches In Zambia, Kombatende Sikombe, Noelle Le Tourneau, Brian Rice, Jake M. Pry, Sandra Simbeza, Laura K. Beres, Anjali Sharma, Njekwa Mukamba, Alison Wringe, James R. Hargreaves, Jacob Mutale, Carolyn Bolton Moore, Izukanji Sikazwe, Elvin Geng, Aaloke Mody

2020-Current year OA Pubs

BACKGROUND: Timely response to treatment failure is critical for improved outcomes and viral re-suppression among people living with HIV, but care gaps along the treatment failure cascade can occur due to delays by both clients (e.g., retention and adherence) and health systems (e.g., fidelity to viral load [VL] monitoring guidelines). We used multistate analysis to identify drivers of implementation gaps in the treatment failure cascade, including time to HIV VL monitoring, re-suppression, and regimen switches, in Zambia.

METHODS AND FINDINGS: We used national electronic HIV health records to identify adults on antiretroviral therapy (ART) for more than 6 months who …