Digital Commons Network^™

Robotic-Assisted Single-Site Abdominal Cerclage In The Bicornuate Uterus Patient With Cervical Insufficiency, Xiaoming Guan

Faculty, Staff and Students Publications

Objective: To demonstrate the surgical techniques for improving safety in robotic-assisted abdominal cerclage in patients with bicornuate uteri complicated by recurrent pregnancy loss and cervical insufficiency.

Design: Stepwise demonstration with narrated video footage.

Setting: An academic tertiary care hospital.

Patients: Our patient is a 22-year-old G2P0020 with a history of recurrent pregnancy loss. During her first pregnancy, she was asymptomatic until 19 weeks and delivered because of a preterm premature rupture of membranes. A transvaginal cerclage was performed for her second pregnancy at 14 weeks, which ended at 16 weeks because of preterm premature rupture of membranes. The final magnetic …

Social Determinants Of Health And Risk Of Stillbirth In The United States, Mariana Baroni, Eunique Williams, Priscilla Ehieze, Rhanna Wilson, Alexia Awoseyi, Hamisu M Salihu

Faculty, Staff and Students Publications

Objective: Our aim was to evaluate the impact of social determinants of health (SDoH) risk factors on stillbirth among pregnancy-related hospitalizations in the United States.

Study design: We conducted a cross-sectional analysis of delivery-related hospital discharges using annualized data (2016-2017) from the Healthcare Cost and Utilization Project's Nationwide Inpatient Sample. The International Classification of Diseases, 10th Revision ICD-10-CM codes were used to select women with singleton stillbirth. Z-codes were utilized to identify SDoH risk factors and their subtypes. The association between SDoH risk factors and stillbirth was assessed using survey logistic regression models.

Results: We analyzed 8,148,646 hospitalizations, out of …

Systematic Evaluation Of Machine Learning-Enhanced Trifocal Iol Power Selection For Axial Myopia Cataract Patients, Jianheng Liang, Qian Tan, Qiong Lei, Maoyan Li, Hao Cheng, Li Wang, Weiwei Dai

Faculty, Staff and Students Publications

Purpose: This study aimed to evaluate and optimize intraocular lens (IOL) power selection for cataract patients with high axial myopia receiving trifocal IOLs.

Design: A multi-center, retrospective observational case series was conducted. Patients having an axial length ≥26 mm and undergoing cataract surgery with trifocal IOL implanted were studied.

Methods: Preoperative biometric and postoperative outcome data from 139 eyes were collected to train and test various machine learning (ML) models (support vector machine, linear regression, and stacking regressor) using five-fold cross-validation. The models' performance was further validated externally using data from 48 eyes enrolled from other hospitals. Performance of seven …

Prospects For Leveraging The Microbiota As Medicine For Hypertension, Tao Yang, Ishan Manandhar, Sachin Aryal, Rikeish R Muralitharan, Hong-Bao Li, Ying Li, Justine M Abais-Battad, Jennifer L Pluznick, Dominik N Muller, Francine Z Marques, Bina Joe

Faculty, Staff and Students Publications

No abstract provided.

Deep Image Segmentation For Cardiomyocyte Proliferation

Faculty, Staff and Students Publications

No abstract provided.

Contemporary American And European Guidelines For Heart Failure Management: Jacc: Heart Failure Guideline Comparison, Ralph J Riello, Biykem Bozkurt, Paul A Heidenreich, Muthiah Vaduganathan

Faculty, Staff and Students Publications

This review serves to compare contemporary clinical practice recommendations for the management of heart failure (HF), as codified in the 2021 European Society of Cardiology (ESC) guideline, the 2022 American College of Cardiology (ACC)/American Heart Association (AHA)/Heart Failure Society of America (HFSA) guideline, and the 2023 focused update of the 2021 ESC document. Overall, these guidelines aim to solidify significant advances throughout the HF continuum since the publication of previous full guideline iterations (2013 and 2016 for the ACC/AHA and ESC, respectively). All guidelines provide new recommendations for an increasingly complex landscape of HF care, with focus on primary HF …

Impact Of Obesity And Age On Mouse Corneal Innervation At The Epithelial-Stromal Interface

Faculty, Staff and Students Publications

PURPOSE: The corneal epithelium is the most highly innervated structure in the body. Previously, we reported a novel event whereby stromal axons fuse with basal epithelial cells, limiting nerve penetration into the epithelium. Although corneal-epithelial nerves undergo changes in sensitivity and distribution throughout life and in response to an obesogenic diet, it is unknown if neuronal-epithelial cell fusion is altered. Here, we sought to determine if neuronal-epithelial cell fusion frequency correlates with obesogenic diet consumption and age.

METHODS: Corneas were collected from C57BL/6 mice and evaluated for neuronal-epithelial cell fusion frequency using serial block-face scanning electron microscopy. To assess the …

Predictors And Impact Of Prolonged Vasoplegia After Continuous-Flow Left Ventricular Assist Device Implantation, Andrew B Civitello, Ajith P Nair, Leo Simpson, J Patrick Herlihy, O H Frazier, Joseph G Rogers, Gabriel Loor, Kenneth K Liao, Alexis E Shafii, Subhasis Chatterjee

Faculty, Staff and Students Publications

BACKGROUND: Vasoplegia after cardiac surgery is associated with adverse outcomes. However, the clinical effects of vasoplegia and the significance of its duration after continuous-flow left ventricular assist device (CF-LVAD) implantation are less known.

OBJECTIVES: This study aimed to identify predictors of and outcomes from transient vs prolonged vasoplegia after CF-LVAD implantation.

METHODS: The study was a retrospective review of consecutive patients who underwent CF-LVAD implantation between January 1, 2005, and December 31, 2017. Vasoplegia was defined as the presence of all of the following: mean arterial pressure ≤65 mm Hg, vasopressor (epinephrine, norepinephrine, vasopressin, or dopamine) use for >6 hours …

Chlorthalidone Vs Hydrochlorothiazide For Hypertension Treatment After Myocardial Infarction Or Stroke: A Secondary Analysis Of A Randomized Clinical Trial, Sarah M Leatherman, Robert A Lew, Peter A Glassman, Addison A Taylor, Ryan E Ferguson

Faculty, Staff and Students Publications

IMPORTANCE: Patients with prior myocardial infarction (MI) or stroke have a greater risk of recurrent cardiovascular (CV) events.

OBJECTIVE: To evaluate the association of chlorthalidone (CTD) vs hydrochlorothiazide (HCTZ) with CV outcomes and noncancer deaths in participants with and without prior MI or stroke.

DESIGN, SETTING, AND PARTICIPANTS: This was a prespecified secondary analysis of the Diuretic Comparison Project (DCP), a pragmatic randomized clinical trial conducted within 72 participating Veterans Affairs health care systems from June 2016 to June 2021, in which patients aged 65 years or older with hypertension taking HCTZ at baseline were randomized to continue HCTZ or …

Adult-Onset Cancer Predisposition Syndromes In Children And Adolescents-To Test Or Not To Test?, Christian P Kratz, Philip J Lupo, Kristin Zelley, Jaclyn Schienda, Kim E Nichols, Douglas R Stewart, David Malkin, Garrett M Brodeur, Kara Maxwell, Sharon E Plon, Michael F Walsh

Faculty, Staff and Students Publications

With the increasing use of comprehensive germline genetic testing of children and adolescents with cancer, it has become evident that pathogenic variants (PV) in adult-onset cancer predisposition genes (aoCPG) underlying adult-onset cancer predisposition syndromes, such as Lynch syndrome or hereditary breast and ovarian cancer, are enriched and reported in 1% to 2% of children and adolescents with cancer. However, the causal relationship between PVs in aoCPGs and childhood cancer is still under investigation. The best-studied examples include heterozygous PVs in mismatch repair genes associated with Lynch syndrome in children with mismatch repair deficient high-grade glioma, heterozygous PVs in BARD1 in …

Population Pharmacokinetic Analysis Of Atomoxetine And Its Metabolites In Children And Adolescents With Attention-Deficit/Hyperactivity Disorder., Shen Cheng, Mahmoud Al-Kofahi, J Steven Leeder, Jacob T. Brown

Manuscripts, Articles, Book Chapters and Other Papers

Atomoxetine (ATX) is a non-stimulant used to treat attention-deficit/hyperactivity disorder (ADHD) and systemic exposure is highly variable due to polymorphic cytochrome P450 2D6 (CYP2D6) activity. The objective of this study was to characterize the time course of ATX and metabolites (4-hydroxyatomoxetine (4-OH); N-desmethylatomoxetine (NDA); and 2-carboxymethylatomoxetine (2-COOH)) exposure following oral ATX dosing in children with ADHD to support individualized dosing. A nonlinear mixed-effect modeling approach was used to analyze ATX, 4-OH, and NDA plasma and urine, and 2-COOH urine profiles obtained over 24-72 hours from children with ADHD (n = 23) following a single oral ATX dose. Demographics and CYP2D6 …

Availability And Utilization Of Endoscopic Retrograde Cholangiopancreatography At Children's Hospitals., Sagar J. Pathak, Thomas M. Attard, Matthew Hall, Mustafa Arain, Melvin B. Heyman, Emily R. Perito

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: No study has explored whether availability of endoscopic retrograde cholangiopancreatography (ERCP) is adequate and equitable across US children's hospitals. We hypothesized that ERCP availability and utilization differs by geography and patient factors.

METHODS: Healthcare encounter data from 2009 to 2019 on children with pancreatic and biliary diseases from the Pediatric Health Information System were analyzed. ERCP availability was defined as treatment at a hospital that performed pediatric ERCP during the year of service.

RESULTS: From 2009 to 2019, 37,946 children (88,420 encounters) had a potential pancreatic or biliary indication for ERCP; 7066 ERCPs were performed. The commonest pancreatic diagnoses …

Delta Like 4 Regulates Cerebrovascular Development And Endothelial Integrity Via Dll4-Notch-Cldn5 Pathway And Is Vulnerable To Neonatal Hyperoxia., Xingrao Ke, Sheng Xia, Wei Yu, Sherry M. Mabry, Qi Fu, Heather Menden, Venkatesh Sampath, Robert H. Lane

Manuscripts, Articles, Book Chapters and Other Papers

The mechanisms governing brain vascularization during development remain poorly understood. A key regulator of developmental vascularization is delta like 4 (DLL4), a Notch ligand prominently expressed in endothelial cells (EC). Exposure to hyperoxia in premature infants can disrupt the development and functions of cerebral blood vessels and lead to long-term cognitive impairment. However, its role in cerebral vascular development and the impact of postnatal hyperoxia on DLL4 expression in mouse brain EC have not been explored. We determined the DLL4 expression pattern and its downstream signalling gene expression in brain EC using Dll4^+/+ and Dll4^+/LacZ mice. We also …

Use Of Topical Methylene Blue To Image Nuclear Morphometry With A Low-Cost Scanning Darkfield Microendoscope, Ann M Gillenwater, Sharmila Anandasabapathy, Rebecca R Richards-Kortum

Faculty, Staff and Students Publications

SIGNIFICANCE: Fiber-optic microendoscopy is a promising approach to noninvasively visualize epithelial nuclear morphometry for early cancer and precancer detection. However, the broader clinical application of this approach is limited by a lack of topical contrast agents available for

AIM: The aim of this study was to evaluate the ability to image nuclear morphometry in vivo with a novel fiber-optic microendoscope used together with topical application of methylene blue (MB), a dye with FDA approval for use in chromoendoscopy in the gastrointestinal tract.

APPROACH: The low-cost, high-resolution microendoscope implements scanning darkfield imaging without complex optomechanical components by leveraging programmable illumination and …

Pragmatic Strategies To Address Health Disparities Along The Continuum Of Care In Chronic Liver Disease, Arpan Patel, David Goldberg, Amit Mathur, Julius Wilder, Jennifer Vittorio, Andrew Yeoman, Nicole E Rich, Mariana Lazo, Ani Kardashian, Sumeet Asrani, Ashley Spann, Nneka Ufere, Manisha Verma, Elizabeth Verna, Dinee Simpson, Jesse D Schold, Russell Rosenblatt, Lisa Mcelroy, Sharad I Wadhwani, Tzu-Hao Lee, Alexandra T Strauss, Raymond T Chung, Ignacio Aiza, Rotonya Carr, Jin Mo Yang, Carla Brady, Brett E Fortune

Faculty, Staff and Students Publications

Racial, ethnic, and socioeconomic disparities exist in the prevalence and natural history of chronic liver disease, access to care, and clinical outcomes. Solutions to improve health equity range widely, from digital health tools to policy changes. The current review outlines the disparities along the chronic liver disease health care continuum from screening and diagnosis to the management of cirrhosis and considerations of pre-liver and post-liver transplantation. Using a health equity research and implementation science framework, we offer pragmatic strategies to address barriers to implementing high-quality equitable care for patients with chronic liver disease.

Metamemory And Disconfirming Feedback: An Evaluation Of The Blank Lineup Procedure, James Robert Owens

Theses and Dissertations

Evaluating an eyewitness for their efficacy is a difficult endeavor. Traditionally, scientists have used post-identification confidence to gauge the accuracy of an eyewitness. Recently, other methods are being explored to evaluate the efficacy of an eyewitness, such as, using blank lineups, measures of metamemory, and pre-identification confidence. The present study evaluated a blank lineup procedure where participants were given disconfirming feedback when they made an incorrect decision on an initial blank lineup. Participants then moved to a target present or target absent final lineup. I sought to evaluate the potential effects of disconfirming feedback using the Eyewitness Metamemory Scale (EMS) …

Contributing Factors To Low Airspeed On Climbout Events As A Precursor To Loss Of Control Within The National General Aviation Flight Information Database, Owen Dae Poborsky

Theses and Dissertations

The nature of aviation is not without inherent risk. Conducting flight training operations increases the overall risks due to inexperience of the student pilot and the challenges of the learning environment. Flight data seeks to reduce these risks; as seen in its success for commercial airlines. These successes are slowly coming to general aviation through programs like the National General Aviation Flight Information Database (NGAFID). This study seeks to determine if the type of takeoff performed by the flight crew led to a lower indicated airspeed (IAS) during a low airspeed on climbout event. Using 262 individual low airspeed on …

Additives Impact On Wet Strength And Size Development In Papermaking- Polyamide Epichlorohydrin (Pae), Alkenyl Succinic Anhydride (Asa) And Alkyl Ketene Dimer (Akd) Cases, Yao Parnell Ntifafa

Theses and Dissertations

Additives are ingredients used in papermaking to enhance fiber properties, introduce special properties to the paper and improve the efficiency of the paper making process. Wet strength agents, sizing agents, dry strength agents, fillers, retention aids, defoamers, dyes and pigments are common additives used in paper mills. Poor retention of wet strength additive such as PAAE (polyamide epichlorohydrin) and hydrophobicity loss due to ASA (alkenyl succinic anhydride) and AKD (alkyl ketene dimer) size reversion not only increase cost and reduce product quality in the mill but also increase customer complaints and rejections.In this study, a method was developed to quantify …

Using An Airship Design To Extend A Small Uncrewed Aircraft Flight Endurance, Joseph Reilly

Theses and Dissertations

One limitation of uncrewed aircraft is being unable to fly as long as needed for some operations, such as linear inspection. This research explores the flight endurance of an uncrewed aircraft using airship design. It investigates the benefits of using an airship design to increase the efficiency and extension of the flight of a small, uncrewed aerial system (sUAS). Thus, it is crucial to find ways to augment flight endurance. Two different airframes were built, and flight tested using a lifting gas to provide the lifting force and vectored thrust needed to move. Flight testing captured time in the air …

Assessment Of High-Performance Steels Through Additive Manufacturing And Ultrasonic Impact Peening, Md Touhidul Islam Rimon

Theses and Dissertations

This abstract focuses on the treatment of three distinct materials: 17-4 PH stainless steel, a nickelbased super alloy, and AISI 4140 stainless steel. The treatment process involves a combination of laser deposition and ultrasonic impact peening.

The study explores the effects of this treatment on the mechanical and microstructural properties of the mentioned materials. Laser deposition is utilized to enhance surface characteristics, such as hardness, wear resistance, and corrosion resistance. Nickel-based super alloys are known for their exceptional high-temperature strength and corrosion resistance, making them suitable for demanding applications in aerospace and power generation industries. AISI 4140 stainless steel is …

Vehicle Crashes In Minnesota: Spatial And Temporal Patterns And Contributing Factors To Crash Severity, Bastien Koralalage Pavithra Navodi Rodrigo

Theses and Dissertations

Vehicle crashes represent a critical global issue, resulting in numerous fatalities, injuries, and significant economic and societal impacts. In response, government officials worldwide are developing strategies and policies to enhance road safety and promote sustainable transportation systems, aiming for zero fatalities and injuries. Understanding the causes of crashes is essential for these efforts. This study focuses on identifying spatial and temporal patterns and contributing factors for the crash severity of vehicle crashes in Minnesota. Spatial distribution of crash hotspots is identified and visualized using spatial autocorrelation (global Moran I), hotspot analysis (Getis–Ord Gi*), and kernel density estimation in ArcGIS Pro. …

Inter-Comparison Of Lunar Reflectance-Based & City Light-Based Aerosol Optical Depth Retrievals Using Viirs Dnb, Aanan Schlief

Theses and Dissertations

Atmospheric aerosols play an important part in maintaining and altering Earth’s radiation balance and often pose a threat to human health. For this reason, atmospheric aerosols have been studied, typically, during daytime hours, through the use of space-borne instruments and ground-based observations. Currently, however, there are no operational nighttime aerosol retrieval methods available from passive-based satellite observations. The Visible Infrared Imaging Radiometer Suite (VIIRS) instrument, which is aboard the Suomi National Polar-Orbiting Partnership (NPP) satellite, includes a Day/Night Band (DNB) that is sensitive to faint light signals at nighttime opening the door for nighttime aerosol studies. Using observations from the …

Black Lives Matter: Protesting As A Form Of Communication, Tiffany Tara Sonterre

Theses and Dissertations

On May 25, 2020 in Minneapolis, Minnesota, Officer Derek Chauvin knelt on the neck of George Floyd for 9 minutes and 29 seconds, resulting in Floyd’s death; protests and riots broke out not only in Minnesota, but around the United States (Taylor, 2021). This was just the most recent event in the repeated police brutality against people of color. This dissertation is a case study examining protesting as a form of communication in regards to the Black Lives Matter movement. The deaths of 15 Black people which generated notable media attention are examined via a variety of news sources, starting …

An Exploration Of Education Strategies In National Board Of Health And Wellness Coaching Programs, Brenna Joy Swanson

Theses and Dissertations

Health and wellness coaching (HWC) is a vital and growing profession effective in preventing and managing chronic diseases. The National Board for Health and Wellness Coaching (NBHWC) established comprehensive training guidelines to advance and uphold the field. Each NBHWC-approved program develops a unique curriculum blending education strategies with NBHWC content requirements that prepare individuals to become aspiring health and wellness coaches (HWCs). Pedagogical approaches are well studied; however, education strategies utilized in NBHWC programs and across competency categories are not widely known. Thus, this three-article dissertation provides an understanding of educational strategies used within NBHWC programs. This study aims to …

Advancing Nutrition And Dietetics Students' Preparation For Clinical Practice Through Simulation-Based Learning Experiences, Danielle Marie Villano

Theses and Dissertations

The use of Simulation-Based Learning (SBL) has increased in Nutrition and Dietetic (N&D) programs, although the research supporting its usability in N&D students is lacking. There are limited quality SBL instruments available that have been validated and tested for reliability in N&D students preparing for clinical practice. This three-article dissertation was to test the reliability of three SBL instruments for N&D students completing the Nutrition Care Process (NCP) during SBL activities. During the first phase of this study, two instruments were developed, and one instrument was modified from another SBL instrument that had been previously validated and used for nursing …

Determination Of The Water To Cement Ratio Of Fresh Concrete Using Nir Hyperspectral Imagery, Eric Edwin Wiken

Theses and Dissertations

The water to cement ratio (w/c) is the primary mix design parameter that will control the strength of a concrete mix. Although a specific w/c is usually stated in concrete mix specifications, there is currently no practical test available that can quickly measure this critical property from fresh concrete. Near-infrared (NIR) Hyperspectral Imagery (HSI) can identify a material by measuring the response of the material to the incident NIR light reflecting off its surface in a range of wavelengths. This measured response can be used to differentiate between unique materials and identify variations of similar materials. This thesis studies the …

Parent’S Perspectives On The Impact Of Recurrent Otitis Media On Speech And Language Development, Andrea Rose Wilson

Theses and Dissertations

The purpose of this study is to investigate the parent’s perspective on whether otitis media delayed their child’s speech and language development. It also focuses on intervention options and the parent’s relationship with their medical providers regarding intervention options for otitis media. Research has shown the importance of early intervention; however, when it comes to recurrent otitis media, many physicians require patients to express symptoms for extended periods before surgical solutions are considered (Granath, 2021). An electronic survey was distributed to parents and caregivers on various parenting Facebook pages. The study was open for one month before the research was …

Clinical Reasoning Development Following A Simulation-Based Learning Experience In Doctor Of Physical Therapy Education, Benjamin Wolden

Theses and Dissertations

Clinical Reasoning (CR) integrates thinking and decision-making in clinical practice (Huhn et al., 2019). CR is an established area of research in Doctor of Physical Therapy (DPT) education (Musolino & Jensen, 2019; Jensen & Mostrom, 2012) and has been acknowledged as a core competency of physical therapist residency education (APTA Residency Competency Work Group, 2020). Despite the established research, the assessment of CR has emerged as a topic of importance due to the need for standardized assessment of CR in DPT education that can lead to high-quality research and implementation of evidence-informed teaching and learning (Reilly et al. 2021; Furze …

The Application Of Machine Learning Algorithms On Co2 Eor, Chenyu Wu

Theses and Dissertations

CO2 Enhanced Oil Recovery (EOR) is increasingly recognized worldwide for its dual benefits of enhancing oil production and addressing environmental concerns related to greenhouse gas emissions. However, traditional methods for assessing the feasibility of CO2 EOR in a specific field, such as pilot tests and simulations, are often time-consuming and labor-intensive. A critical factor in determining the suitability of a field for CO2 EOR is the CO2 Minimum Miscibility Pressure (MMP), as miscible flooding is more feasible when the reservoir pressure exceeds the CO2 MMP. Traditional determination of CO2 MMP relies heavily on extensive experimentation, which, despite its accuracy, incurs …

Modeling Ash Deposition During Oxy-Coal Combustion Of A High Alkali Earth Metal (Powder River Basin) Coal: Insights From Turbulence Modeling, Mohamed Zamzam

Theses and Dissertations

Coal production has waned in recent years despite its historical significance, driven by mounting concerns over climate change and the escalating adoption of renewable energy sources. With coal production in the U.S. expected to continue its decline and stricter environmental regulations looming due to increasing greenhouse gases and SO2 emissions, there is a critical need to identify an economically viable and environmentally friendly coal type. Embracing carbon capture-based technologies such as oxy-fuel combustion without compromising boiler performance is essential in this endeavor. Sub-bituminous coal varieties like Powder River Basin (PRB) coal boast lower sulfur and nitrogen content compared to bituminous …