Digital Commons Network^™

Clinical Characteristics, Microbiology And Outcomes Of A Cohort Of Patients Treated With Ceftolozane/Tazobactam In Acute Care Inpatient Facilities, Houston, Texas, Usa, Truc T Tran, Nicolo L Cabrera, Anne J Gonzales-Luna, Travis J Carlson, Faris Alnezary, William R Miller, Aki Sakurai, An Q Dinh, Kirsten Rydell, Rafael Rios, Lorena Diaz, Blake M Hanson, Jose M Munita, Claudia Pedroza, Samuel A Shelburne, Samuel L Aitken, Kevin W Garey, Ryan Dillon, Laura Puzniak, Cesar A Arias

Faculty, Staff and Student Publications

BACKGROUND: Ceftolozane/tazobactam is a β-lactam/β-lactamase inhibitor combination with activity against a variety of Gram-negative bacteria, including MDR

METHODS: We conducted a multicentre retrospective study of patients receiving at least 48 h of ceftolozane/tazobactam therapy from January 2016 through to September 2019 at two hospital systems in Houston. Demographic, clinical and microbiological data were collected, including the infecting bacterial isolate, when available. The primary outcome was composite clinical success at hospital discharge. Secondary outcomes included in-hospital mortality and clinical disposition at 14 and 30 days post ceftolozane/tazobactam initiation. Multivariable logistic regression analysis was used to identify predictors of the primary outcome …

Monoclonal Antibody For The Prevention Of Respiratory Syncytial Virus In Infants And Children: A Systematic Review And Network Meta-Analysis, Mingyao Sun, Honghao Lai, Feiyang Na, Sheng Li, Xia Qiu, Jinhui Tian, Zhigang Zhang, Long Ge

Faculty, Staff and Student Publications

IMPORTANCE: Respiratory syncytial virus (RSV) is the leading cause of acute lower respiratory infection in children younger than 5 years; effective prevention strategies are urgently needed.

OBJECTIVE: To compare the efficacy and safety of monoclonal antibodies for the prevention of RSV infection in infants and children.

DATA SOURCES: In this systematic review and network meta-analysis, PubMed, Embase, CENTRAL, and ClinicalTrials.gov were searched from database inception to March 2022.

STUDY SELECTION: Randomized clinical trials that enrolled infants at high risk of RSV infection to receive a monoclonal antibody or placebo were included. Keywords and extensive vocabulary related to monoclonal antibodies, RSV, …

Cross-Institutional Virtual Mock Oral Examination: A New Paradigm?, Arvind D Manisundaram, Sairandri Sathyanarayanan, Janhavi V Govande, Erik S Marques, Phuong D Nguyen

Faculty, Staff and Student Publications

Mock oral examinations (MOEs) are shown to be valuable in preparation for national board oral examinations. Although traditionally conducted in-person, improved technological advances have supported exploring virtual alternatives. Furthermore, the cornoavirus disease 2019 pandemic has necessitated virtual learning. We hypothesized that the virtual platform would improve and expand the MOE experience to include collaborative institutions while approximating a board examination environment.

METHODS: Sixteen senior plastic surgery residents and 14 faculty from three separate programs participated in a cross-institutional virtual MOE. Over a single day, each trainee was evaluated by two faculty from a separate institution on six scenarios, including digitally …

The Influence Of Posttraumatic Stress Disorder Treatment On Anxiety Sensitivity: Impact Of Prolonged Exposure, Sertraline, And Their Combination, Matthew T Luciano, Sonya B Norman, Carolyn B Allard, Ron Acierno, Naomi M Simon, Kristin L Szuhany, Amanda W Baker, Murray B Stein, Brian Martis, Peter W Tuerk, Sheila A M Rauch, Progress Study Team

Faculty, Staff and Student Publications

Trauma-informed beliefs often decrease during posttraumatic stress disorder (PTSD) treatment. This may also extend to anxiety sensitivity (AS), defined as a fear of anxiety-related sensations and beliefs that anxiety is dangerous and/or intolerable. However, little is known about how AS changes during exposure-based and psychopharmacological PTSD treatments. Further, high AS may be a risk factor for diminished PTSD symptom improvement and increased treatment dropout. To better understand how AS impacts and is impacted by PTSD treatment, we conducted a secondary analysis of a randomized clinical trial with a sample of 223 veterans (87.0% male, 57.5% White) with PTSD from four …

Telehealth Trials To Address Health Equity In Stroke Survivors, Anjail Z Sharrief, Amy K Guzik, Erica Jones, Munachi Okpala, Mary F Love, Tamra Ishan Jayenda Ranasinghe, Cheryl Bushnell

Faculty, Staff and Student Publications

Telehealth has seen rapid expansion into chronic care management in the past 3 years because of the COVID-19 pandemic. Telehealth for acute care management has expanded access to equitable stroke care to many patients over the past two decades, but there is limited evidence for its benefit for addressing disparities in the chronic care of patients living with stroke. In this review, we discuss advantages and disadvantages of telehealth use for the outpatient management of stroke survivors. Further, we explore opportunities and potential barriers for telehealth in addressing disparities in stroke outcomes related to various social determinants of health. We …

Inflation-Adjusted Medicare Reimbursement For Hip Arthroscopy Fell By 211% On Average Between 2011 And 2022, Allison Y Kufta, David R Maldonado, Cammille C Go, Andrew J Curley, Paulo Padilla, Benjamin G Domb

Faculty, Staff and Student Publications

PURPOSE: To examine Medicare reimbursement for hip arthroscopy from 2011 to 2022.

METHODS: The seven most common procedures performed with hip arthroscopy by a single surgeon were gathered. The Physician Fee Schedule Look-Up Tool was utilized to access financial data of the associated Current Procedural Terminology (CPT) codes. The reimbursement data for each CPT were gathered from the Physician Fee Schedule Look-Up Tool. With the consumer price index database and inflation calculator, reimbursement values were adjusted for inflation to 2022 U.S. dollars.

RESULTS: Following an adjustment for inflation, it was found that reimbursement rate for hip arthroscopy procedures on average …

Metallosis And Nonunion: A Case Series And Literature Review, Muzaffar Mushtaq, Owais A Qureshi, Anmol Dua, Sabina Khan, Meesa Mehraj

Faculty, Staff and Student Publications

Metallosis, defined as the presence of free metal particles in the tissue, including bone and soft tissue, is a rare phenomenon seen in orthopedic practice. It is more commonly seen in arthroplasty surgeries, but its occurrence in the presence of other metal implants is also well recognized. Multiple hypotheses are suggested to explain the genesis of metallosis, but it is traditionally believed that abnormal contact between the metal surfaces leads to abrasive wear causing the release of metal particles into the surrounding tissue eliciting foreign body reactions from the body's immune system. The consequences can be local effects, which can …

Emergency Department Virtual Happy Hour: A Novel Approach To Peer Group Support During A Pandemic, Adeola A Kosoko, Shabana Walia, Ryan Huebinger

Faculty, Staff and Student Publications

Introduction Communities responded to the coronavirus disease 2019 (COVID-19) pandemic with mandatory social-distancing regulations. Pandemic and disaster research shows that social isolation can often cause negative emotions and medical provider burnout. The primary objective of this study was to create and evaluate a novel wellness program, the Happy Hour Wellness Initiative (HHWI), based on peer support group concepts to foster resilience for emergency healthcare providers in response to a novel disaster. Methods The study was performed at a large emergency department with physicians, advanced practice providers, and staff invited to attend weekly "virtual happy hour" sessions. Participants individually opted into …

Expression And Functions Of Transient Receptor Potential Channels In Liver Diseases, Wenhui Wang, Pengyu Liu, Yalin Zhang, Li Yan, Michael X Zhu, Jin Wang, Ye Yu

Faculty, Staff and Student Publications

Liver diseases constitute a major healthcare burden globally, including acute hepatic injury resulted from acetaminophen overdose, ischemia-reperfusion or hepatotropic viral infection and chronic hepatitis, alcoholic liver disease (ALD), non-alcoholic fatty liver disease (NAFLD) and hepatocellular carcinoma (HCC). Attainable treatment strategies for most liver diseases remain inadequate, highlighting the importance of substantial pathogenesis. The transient receptor potential (TRP) channels represent a versatile signalling mechanism regulating fundamental physiological processes in the liver. It is not surprising that liver diseases become a newly explored field to enrich our knowledge of TRP channels. Here, we discuss recent findings revealing TRP functions across the fundamental …

Percutaneous Revascularization For The Treatment Of Refractory Digital Ischemia In Systemic Sclerosis, Lily A Romero-Karam, Kevin A Honan, Salman A Arain, Maureen D Mayes

Faculty, Staff and Student Publications

OBJECTIVE: The objective of this study is to explore the role of adjunctive percutaneous revascularization of the hand in the management of patients with systemic sclerosis-associated refractory digital ischemia.

METHODS: We present our initial experience of using percutaneous upper extremity interventions to treat patients with systemic sclerosis and symptomatic Raynaud's phenomenon who presented with either refractory digital ischemia or non-healing ulcers. We discuss patient characteristics, procedural findings, and short-term clinical outcomes of these interventions.

RESULTS: We performed 14 interventions in 6 patients with non-healing digital ulcers or refractory ischemia secondary to systemic sclerosis. Angioplasty was performed at or below the …

Association Of Frailty And The Expanded Operative Stress Score With Preoperative Acute Serious Conditions, Complications, And Mortality In Males Compared To Females: A Retrospective Observational Study, Qi Yan, Jeongsoo Kim, Daniel E Hall, Myrick C Shinall, Katherine Moll Reitz, Karyn B Stitzenberg, Lillian S Kao, Elizabeth L George, Ada Youk, Chen-Pin Wang, Jonathan C Silverstein, Elmer V Bernstam, Paula K Shireman

Faculty, Staff and Student Publications

OBJECTIVE: The aim of this study was to expand Operative Stress Score (OSS) increasing procedural coverage and assessing OSS and frailty association with Preoperative Acute Serious Conditions (PASC), complications and mortality in females versus males.

SUMMARY BACKGROUND DATA: Veterans Affairs male-dominated study showed high mortality in frail veterans even after very low stress surgeries (OSS1).

METHODS: Retrospective cohort using NSQIP data (2013-2019) merged with 180-day postoperative mortality from multiple hospitals to evaluate PASC, 30-day complications and 30-, 90-, and 180-day mortality.

RESULTS: OSS expansion resulted in 98.2% case coverage versus 87.0% using the original. Of 82,269 patients (43.8% male), 7.9% …

Assessment Of Symptom, Disability, And Financial Trajectories In Patients Hospitalized For Covid-19 At 6 Months, Andrew J Admon, Theodore J Iwashyna, Lee A Kamphuis, Stephanie J Gundel, Sarina K Sahetya, Ithan D Peltan, Steven Y Chang, Jin H Han, Kelly C Vranas, Kirby P Mayer, Aluko A Hope, Sarah E Jolley, Ellen Caldwell, Max L Monahan, Katrina Hauschildt, Samuel M Brown, Neil R Aggarwal, B Taylor Thompson, Catherine L Hough

Faculty, Staff and Student Publications

IMPORTANCE: Individuals who survived COVID-19 often report persistent symptoms, disabilities, and financial consequences. However, national longitudinal estimates of symptom burden remain limited.

OBJECTIVE: To measure the incidence and changes over time in symptoms, disability, and financial status after COVID-19-related hospitalization.

DESIGN, SETTING, AND PARTICIPANTS: A national US multicenter prospective cohort study with 1-, 3-, and 6-month postdischarge visits was conducted at 44 sites participating in the National Heart, Lung, and Blood Institute Prevention and Early Treatment of Acute Lung Injury Network's Biology and Longitudinal Epidemiology: COVID-19 Observational (BLUE CORAL) study. Participants included hospitalized English- or Spanish-speaking adults without severe prehospitalization …

Let’S Keep This Between You, Me, And My Cell Phone: Huawei, Espionage, & International Law, Anya Hovanic

North Carolina Journal of International Law

No abstract provided.

Text And Structure In Historical Context: A Theory About The Fate Of The Exclusive Treaty Power, Jonathan Williams

North Carolina Journal of International Law

No abstract provided.

Torture And Its Consequences: How Victims Of The Taliban’S Acts Of Torture Can Hold The Taliban Responsible, Andrew Draper

North Carolina Journal of International Law

No abstract provided.

Stop Trashing The Planet: Addressing Global Warming And Climate Change From The Perspective Of Food Waste Reduction, Dorothy Chen

North Carolina Journal of International Law

No abstract provided.

Noise2clean: Cross-Device Side-Channel Traces Denoising With Unsupervised Deep Learning, Honggang Yu, Mei Wang, Xiyu Song, Haoqi Shan, Hongbing Qiu, Junyi Wang, Kaichen Yang

Michigan Tech Publications, Part 1

Deep learning (DL)-based side-channel analysis (SCA) has posed a severe challenge to the security and privacy of embedded devices. During its execution, an attacker exploits physical SCA leakages collected from profiling devices to create a DL model for recovering secret information from victim devices. Despite this success, recent works have demonstrated that certain countermeasures, such as random delay interrupts or clock jitters, would make these attacks more complex and less practical in real-world scenarios. To address this challenge, we present a novel denoising scheme that exploits the U-Net model to pre-process SCA traces for “noises” (i.e., countermeasures) removal. Specifically, we …

2023 February, Morehead State University. Office Of Communications & Marketing.

Morehead State Press Release Archive, 1961 to the Present

Press releases for February of 2023.

Executive Function Deficits And Borderline Personality Disorder Symptomatology In A Nonclinical Adult Sample: A Latent Variable Analysis, Keisha D. Veerapandian, Gabriel X. D. Tan, Nadyanna M. Majeed, Andree Hartanto

Research Collection School of Social Sciences

While borderline personality disorder (BPD) symptomatology has been studied extensively in clinical populations, the mechanisms underlying its manifestation in nonclinical populations remain largely understudied. One aspect of BPD symptomatology in nonclinical populations that has not been well studied is cognitive mechanisms, especially in relation to executive functions. To explore the cognitive mechanisms underlying BPD symptomatology in nonclinical populations, we analysed a large-scale dataset of 233 young adults that were administered with nine executive function tasks and BPD symptomatology assessments. Our structural equation modelling did not find any significant relations between latent factors of executive functions and the severity of BPD …

What Are The Relationships Between Public Transit And Gentrification Progress? An Empirical Study In The New York-Northern New Jersey-Long Island Areas, Yefu Chen, Hao Xi, Junfeng Jiao

Research Collection College of Integrative Studies

Transit-oriented development has been a widely accepted tool among transportation planning practitioners; however, there are concerns about the risk of increasing residential property values leading to gentrification or displacements. Therefore, it is critical to provide precise investigations of the relationships between public transit and gentrification. Although numerous studies have explored this topic, few have discussed these relationships based on detailed measurements of gentrification from a regional perspective. This study aims to fill the research gap by measuring the gentrification subcategories through a hierarchical definition based on data in the New York–Northern New Jersey–Long Island areas and applying the transit desert …

Models Of School Recess For Combatting Overweight In The United States, David Kahan, Allison Poulos

Teacher Education

Objectives: The aim of the study was to quantify and compare potential energy expenditure associated with school recess in the U.S. based on four scenarios: professional recommendations and state policies for the conduct of recess, previous studies that measured physical activity intensity during recess (i.e., reality), and no daily recess. Methods: Estimated energy expenditure (kcal) was modeled using secondary data over six years of elementary school for boys and girls using a standard formula: Intensity × duration × frequency × mass. Results: Boys and girls would expend similar energy under the professional recommendation (boys, 69,146 kcal; girls, 63,993 kcal) and …

Cryptocurrencies And Climate Change: A Net-Zero Paradox, Jason Maclean

Canadian Journal of Law and Technology

Cryptocurrencies pose a number of complex law and policy problems, the most pressing of which are the industry’s climate and environmental impacts. This article examines the climate and environmental impacts of crypto-assets in the broader law and policy context of the UN Paris Agreement and the global goal of reaching net-zero emissions by 2050 or earlier. This approach not only illuminates the limitations and paradoxical nature of the crypto-industry’s climate commitments, but also the limitations and paradoxical nature of ‘‘net zero” itself as the predominant framing of national, subnational, and nonstate actors’ climate pledges. The article concludes by examining the …

From Cartier To Codification: Website-Blocking Injunctions And Third-Party Internet Service Provider Respondents, Dan Mackwood

Canadian Journal of Law and Technology

In recent years, the proliferation of commercial-scale copyright infringement through unauthorized online content streaming has created persisting legal hurdles for Canadian rights holders seeking redress. John Doe defendants in online copyright disputes can easily preserve their anonymity and operate their infringing enterprises from unknown locations, undeterred by injunctions issued against them directly. These anonymized administrators of illicit streaming platforms offer users unauthorized access to content for a lower cost than or as a free alternative to the access provided by the legitimate rights holder. This form of copyright infringement has reportedly resulted in up to hundreds of thousands of lost …

Regulating Uncertain States: A Risk-Based Policy Agenda For Quantum Technologies, Tina Dekker, Florian Martin-Bariteau

Canadian Journal of Law and Technology

Many countries are taking a national approach to developing quantum strategies with a strong focus on innovation. However, societal, ethical, legal, and policy considerations should not be an afterthought that is pushed aside by the drive for innovation. A responsible, global approach to quantum technologies that considers the legal, ethical, and societal dimensions of quantum technologies is necessary to avoid exacerbating existing global inequalities. Quantum technologies are expected to disrupt other transformative technologies whose legal landscape is still under development (e.g., artificial intelligence [‘‘AI”], blockchain, etc.). The shortcomings of global policies regarding AI and the digital context teach lessons that …

Crowdsourcing Justice, Matthew Dylag

Canadian Journal of Law and Technology

Social media has become ubiquitous in the daily lives of Canadians. Beyond connecting with friends and family, people also turn to social media to find information and seek advice on any number of topics, be it home cooking, workout routines, or automobile purchases. Indeed, social media is a flexible vehicle that can be leveraged for communication on almost any topic. It is not surprising, therefore, that individuals are also turning to social media to help resolve their legal problems. Even a cursory examination of social media will reveal that it is not uncommon for individuals who are experiencing legal difficulties …

Paxlovid-Induced Tacrolimus Toxicity In The Treatment Of Covid-19: A Case Report., Stephanie Michael, Rachel Heilbronner, Christopher M Lloyd, Howard W Levitin

Pharmacy Articles

Paxlovid^TM (nirmaltrelvir/ritonavir) received emergency use authorization from the Food and Drug Administration (FDA) in December 2021 to treat coronavirus disease 2019 (COVID-19). Given the actions of Paxlovid on cytochrome P450-3A4 (CYP3A4) enzymes, it is imperative to check for potential drug-drug interactions before prescribing. We describe a case in which the common emergency department presentation of generalized weakness was found to be caused by interactions between Paxlovid and a patient's home medications resulting in tacrolimus toxicity.

A Novel Measure Of Narrative Self-Functioning And Its Role In The Transformative Potential Of Psychedelic Experience Across Clinical And Non-Clinical Participants, Nicole M. Amada

Dissertations, Theses, and Capstone Projects

The eudaimonic field of well-being is founded on the idea that self-knowledge and the realization of one’s potential is at the heart of what it means to strive for well-being. While the “self” is at the core of this perspective, theories derived from this field have yet to incorporate neurocognitive conceptualizations of the self, and account for the collection of self-referential cognitions that influence striving for well-being. Such a theory and measure could fill this theoretical gap and be applied in person centered interventions to capture change in these processes over time. One such intervention utilizes psychedelic experience as a …

Incarceration-Related Stigma And Caring Self-Efficacy Among Long-Term Care Nurses, Sandra D. Langston

Dissertations, Theses, and Capstone Projects

Background: A silver tsunami is occurring in U.S. prisons because of an unprecedented increase in the older population. Prisons are structurally ill-suited to care for this population and financially burdened with providing the necessary medical and nursing care. States have enacted legislation to afford justice-involved persons parole to manage chronic conditions in community-based long-term care (LTC) facilities. Changes in Medicaid regulations provide a seamless transition from prison to community long-term care for this population. However, it is not known if the stigma of justice involvement impacts the perception of long-term nurses concerning this population.

Aims/Purpose: This study examined the effects …

Engineered Plga Nanofibers For Drug Delivery, Andrew Mancuso

Dissertations, Theses, and Capstone Projects

Poly-lactic-co-glycolic acid (PLGA) polymers are rapidly gaining momentum as a platform for next-generation drug delivery systems due to their ease and low cost of synthesis, favorable biocompatibility and biodegradability, and lack of toxicity. In particular, the application of drug-loaded PLGA nanofibers directly to a target tissue may represent a promising alternative to traditional routes of drug administration (e.g., oral, injectable) as they offer the potential to greatly improve bioavailability, increase efficacy, and reduce off-target toxicity. Furthermore, the use of such a system may potentially allow for greater flexibility in clinical drug development, by enabling the use of compounds which have …

Genetic Determinants Involved In Acquisition Of Iron In The Opportunistic Pathogen Mycobacterium Abscessus, Manal F. Farhat

Dissertations, Theses, and Capstone Projects

The opportunistic pathogen Mycobacterium abscessus subsp. abscessus (Mab) has become an emerging public health threat due to the increasing number of Mab-associated chronic pulmonary disease cases. Infection cure rates are only 50% due to the complex resistance of Mab to most antimicrobial drugs and chemotherapy.

Deeper knowledge of Mab biology is needed to illuminate potential candidates for development of improved therapeutics against Mab infections. The ESX-3 type VII protein secretion system of Mab plays an important role in host inflammatory and pathological responses during infection.

In this study, we demonstrate a functional link between the ESX-3 secretion …