Digital Commons Network^™

Early Intervention And Intensive Management Of Patients With Diabetes, Cardiorenal, And Metabolic Diseases, Yehuda Handelsman, Samuel Klein, Et Al.

2020-Current year OA Pubs

Increasing rates of obesity and diabetes have driven corresponding increases in related cardiorenal and metabolic diseases. In many patients, these conditions occur together, further increasing morbidity and mortality risks to the individual. Yet all too often, the risk factors for these disorders are not addressed promptly in clinical practice, leading to irreversible pathologic progression. To address this gap, we convened a Task Force of experts in cardiology, nephrology, endocrinology, and primary care to develop recommendations for early identification and intervention in obesity, diabetes, and other cardiorenal and metabolic diseases. The recommendations include screening and diagnosis, early interventions with lifestyle, and …

The Diagnosis Of Severe Combined Immunodeficiency: Implementation Of The Pidtc 2022 Definitions, Christopher C Dvorak, Jeffrey J Bednarski, Et Al.

2020-Current year OA Pubs

BACKGROUND: Shearer et al in 2014 articulated well-defined criteria for the diagnosis and classification of severe combined immunodeficiency (SCID) as part of the Primary Immune Deficiency Treatment Consortium's (PIDTC's) prospective and retrospective studies of SCID.

OBJECTIVE: Because of the advent of newborn screening for SCID and expanded availability of genetic sequencing, revision of the PIDTC 2014 Criteria was needed.

METHODS: We developed and tested updated PIDTC 2022 SCID Definitions by analyzing 379 patients proposed for prospective enrollment into Protocol 6901, focusing on the ability to distinguish patients with various SCID subtypes.

RESULTS: According to PIDTC 2022 Definitions, 18 of 353 …

Nyls Students Weigh In With Their Advice For 1ls, Julia Sonenshein

NYLS Community News

No abstract provided.

Missed Opportunities In The Diagnosis Of Tuberculosis Meningitis, Niamh Simmons, Margaret A Olsen, Joanna Buss, Thomas C Bailey, Carlos Mejia-Chew

2020-Current year OA Pubs

BACKGROUND: Tuberculosis meningitis (TBM) has high mortality and morbidity. Diagnostic delays can impact TBM outcomes. We aimed to estimate the number of potentially missed opportunities (MOs) to diagnose TBM and determine its impact on 90-day mortality.

METHODS: This is a retrospective cohort of adult patients with a central nervous system (CNS) TB

RESULTS: Of 893 patients with TBM, median age at diagnosis was 50 years (interquartile range, 37-64), 61.3% were male, and 35.2% had Medicaid as primary payer. Overall, 407 (45.6%) had a prior hospital or ED visit with an MO code. In-hospital 90-day mortality was not different between those …

Trade And Transportation Talent Pipeline Blueprints: Building Universityindustry Talent Pipelines In Colleges Of Continuing And Professional Education, Tyler D. Reeb, Stacey Park

Mineta Transportation Institute

The rapid adoption of transformational technologies along with other economic and cultural shifts, have created a gap between workers and the skills and knowledge necessary for in-demand occupations. Trade and Transportation Talent Pipeline Blueprints: Building University-Industry Talent Pipelines in Colleges of Continuing and Professional Education identifies the steps required to build talent pipelines that target in-demand trade and transportation occupations requiring specific degrees, certificates, and non-credit professional development. This report provides a literature review and labor market data analysis. It also includes documentation of methodology in planning a pilot program for Colleges of Professional and Continuing Education housed within each …

Analysis Of Freight Movements In The San Joaquin Valley, Aly Tawfik, Utsav Shah

Mineta Transportation Institute

Freight transportation plays a primary role in supply chains, costs, and availability of goods and is a major part of the economy. This study identifies, assesses, and utilizes different data sources to uncover and understand the patterns and movements of different types of freight in the San Joaquin Valley’s (SJV's) different counties. The San Joaquin Valley region consists of eight counties: San Joaquin, Stanislaus, Merced, Madera, Fresno, Kings, and Tulare. This research explored some major datasets with freight information, such as Global Trade Atlas (GTA), Port Imports and Exports Reporting Systems (PIERS), and Streetlight data insights for the year 2019 …

Evaluation, Comparison, And Improvement Recommendations For Caltrans Financial Programming Processes And Tools, Wenbin Wei, Nigel Blampied, Raajmaathangi Sreevijay

Mineta Transportation Institute

The California Transportation Improvement Program System (CTIPS) is the main tool used by Caltrans’ Division of Financial Programming to support the business of transportation programming. It is a multi-agency joint-use project programming database system applied to develop and manage various state and federal transportation programming documents. The goal of this project is to evaluate CTIPS and explore various new options that will maintain the current functionality of CTIPS, meet legislative guidelines for ADA compliance, ensure security of the system, and have sufficient scalability and capabilities for integration with other systems in the future. The research is based on the review …

Identification Of Bradycardia Following Remdesivir Administration Through The Us Food And Drug Administration American College Of Medical Toxicology Covid-19 Toxic Pharmacovigilance Project, Jason M Devgun, Rongmei Zhang, Jeffrey Brent, Paul Wax, Keith Burkhart, Alison Meyn, Sharan Campleman, Stephanie Abston, Kim Aldy, Toxicology Investigators Consortium Fact Study Group

2020-Current year OA Pubs

IMPORTANCE: The rapid spread and mortality associated with COVID-19 emphasized a need for surveillance system development to identify adverse events (AEs) to emerging therapeutics. Bradycardia is a remdesivir infusion-associated AE listed in the US Food and Drug Administration-approved prescribing information.

OBJECTIVE: To evaluate the magnitude and duration of bradycardic events following remdesivir administration.

DESIGN, SETTING, AND PARTICIPANTS: A multicenter cohort study of patients with recorded heart rate less than 60 beats per minute within 24 hours after administration of a remdesivir dose was conducted between November 23, 2020, and October 31, 2021. Participants included patients hospitalized with COVID-19 at 15 …

Final Results From A Phase 2b Randomized, Placebo-Controlled Clinical Trial Of Rbx2660: A Microbiota-Based Drug For The Prevention Of Recurrent Clostridioides Difficile Infection, Erik R Dubberke, Robert Orenstein, Sahil Khanna, Beth Guthmueller, Christine Lee

2020-Current year OA Pubs

INTRODUCTION: Effective treatments for recurrent Clostridioides difficile infection (rCDI) are urgently needed. RBX2660 is an investigational microbiota-based live biotherapeutic to reduce CDI recurrence following standard-of-care antibiotic treatment in individuals with rCDI. Here we report the final safety data through 24 months of follow-up as well as final efficacy data, reflecting alignment of the pre-specified statistical analysis plan definitions with the data presented.

METHODS: The PUNCH CD2 clinical trial was a prospective, multicenter, randomized, double-blinded, placebo-controlled, three-arm phase 2b study conducted to evaluate the efficacy and safety of RBX2660 for the reduction of rCDI compared to placebo. Eligible patients were at …

Multi-Ancestry Transcriptome-Wide Association Analyses Yield Insights Into Tobacco Use Biology And Drug Repurposing, Fang Chen, Lisa De Las Fuentes, Et Al.

2020-Current year OA Pubs

Most transcriptome-wide association studies (TWASs) so far focus on European ancestry and lack diversity. To overcome this limitation, we aggregated genome-wide association study (GWAS) summary statistics, whole-genome sequences and expression quantitative trait locus (eQTL) data from diverse ancestries. We developed a new approach, TESLA (multi-ancestry integrative study using an optimal linear combination of association statistics), to integrate an eQTL dataset with a multi-ancestry GWAS. By exploiting shared phenotypic effects between ancestries and accommodating potential effect heterogeneities, TESLA improves power over other TWAS methods. When applied to tobacco use phenotypes, TESLA identified 273 new genes, up to 55% more compared with …

Real-World Covid-19 Vaccine Effectiveness Against The Omicron Ba.2 Variant In A Sars-Cov-2 Infection-Naive Population, Jonathan J Lau, Chao Wu, Gaya K Amarasinghe, Et Al.

2020-Current year OA Pubs

The SARS-CoV-2 Omicron variant has demonstrated enhanced transmissibility and escape of vaccine-derived immunity. Although first-generation vaccines remain effective against severe disease and death, robust evidence on vaccine effectiveness (VE) against all Omicron infections, irrespective of symptoms, remains sparse. We used a community-wide serosurvey with 5,310 subjects to estimate how vaccination histories modulated risk of infection in infection-naive Hong Kong during a large wave of Omicron BA.2 epidemic in January-July 2022. We estimated that Omicron infected 45% (41-48%) of the local population. Three and four doses of BNT162b2 or CoronaVac were effective against Omicron infection 7 days after vaccination (VE of …

Dissecting Cell Identity Via Network Inference And In Silico Gene Perturbation, Kenji Kamimoto, Blerta Stringa, Christy M Hoffmann, Kunal Jindal, Lilianna Solnica-Krezel, Samantha A Morris

2020-Current year OA Pubs

Cell identity is governed by the complex regulation of gene expression, represented as gene-regulatory networks

Brainwave: A Flexible Method For Noninvasive Stimulation Of Brain Rhythms Across Species, Matthew K. Attokaren, Nuri Jeong, Lou Blanpain, Abigail L. Paulson, Kristie M. Garza, Ben Borron, Michael Walelign, Jon Willie, Annabelle C. Singer

2020-Current year OA Pubs

Rhythmic neural activity, which coordinates brain regions and neurons to achieve multiple brain functions, is impaired in many diseases. Despite the therapeutic potential of driving brain rhythms, methods to noninvasively target deep brain regions are limited. Accordingly, we recently introduced a noninvasive stimulation approach using flickering lights and sounds ("flicker"). Flicker drives rhythmic activity in deep and superficial brain regions. Gamma flicker spurs immune function, clears pathogens, and rescues memory performance in mice with amyloid pathology. Here, we present substantial improvements to this approach that is flexible, user-friendly, and generalizable across multiple experimental settings and species. We present novel open-source …

A Systematic Review And Meta-Analysis Of The Association Between Sars-Cov-2 Vaccination And Myocarditis Or Pericarditis, Juan Gao, Linya Feng, Yaru Li, Scott Lowe, Zhichun Guo, Rachel Bentley, Chuman Xie, Birong Wu, Peng Xie, Weihang Xia, Shaodi Ma, Haixia Liu, Xianwei Guo, John Patrick Nanola Uy, Qin Zhou, Hina Wazir, Chenyu Sun

Student Publications

Introduction: There have been reports of potential negative cardiovascular effects from the COVID-19 vaccine, such as myocarditis or pericarditis. This study sought to ascertain the risk of myocarditis/pericarditis after COVID-19 vaccination by conducting an extensive meta-analysis of published cases.

Methods: A systematic literature search was conducted in 7 online databases by March 31, 2022. Heterogeneity was tested by I2 index. RR and 95% CI were pooled through either random-effect or fixed-effect models. Sensitivity analysis and publication bias were also conducted.

Results: A total of 11 studies with 58,620,611 subjects were included. COVID-19 vaccination correlated with an increased risk of myocarditis …

Sex-Specific Hypnotic Effects Of The Neuroactive Steroid (3Β,5Β,17Β)-3-Hydroxyandrostane-17-Carbonitrile Are Mediated By Peripheral Metabolism Into An Active Hypnotic Steroid, Francesca M Manzella, Omar H Cabrera, Davis Wilkey, Brier Fine-Raquet, Jelena Klawitter, Kathiresan Krishnan, Douglas F Covey, Vesna Jevtovic-Todorovic, Slobodan M Todorovic

2020-Current year OA Pubs

BACKGROUND: The novel synthetic neuroactive steroid (3β,5β,17β)-3-hydroxyandrostane-17-carbonitrile (3β-OH) blocks T-type calcium channels but does not directly modulate neuronal γ-aminobutyric acid type A (GABA

METHODS: We used a combination of behavioural loss of righting reflex, neuroendocrine, pharmacokinetic, in vitro patch-clamp electrophysiology, and in vivo electrophysiological approaches in wild-type mice and in genetic knockouts of the Ca

RESULTS: Adult male mice were less sensitive to the hypnotic effects of 3β-OH compared with female mice, and these differences appeared during development. Adult males had higher 3β-OH brain concentrations despite being less sensitive to its hypnotic effects. Females metabolised 3β-OH into the active GABA …

Relationship Between Electrode Position And Temporal Modulation Sensitivity In Cochlear Implant Users: Are Close Electrodes Always Better?, Ning Zhou, Xuyang Shi, Omkar Dixit, Jill B Firszt, Timothy A Holden

2020-Current year OA Pubs

Temporal modulation sensitivity has been studied extensively for cochlear implant (CI) users due to its strong correlation to speech recognition outcomes. Previous studies reported that temporal modulation detection thresholds (MDTs) vary across the tonotopic axis and attributed this variation to patchy neural survival. However, correlates of neural health identified in animal models depend on electrode position in humans. Nonetheless, the relationship between MDT and electrode location has not been explored. We tested 13 ears for the effect of distance on modulation sensitivity, specifically targeting the question of whether electrodes closer to the modiolus are universally beneficial. Participants in this study …

Building Resilience In Graduate Nurses Through Online Virtual Simulation, Robert Grant Harmon

Electronic Theses and Dissertations

Resilience has become a popular topic in nursing research. Nurses experience enormous stress throughout their training process that extends into their first employment as they transition into practice. Simulation training is a standard for training nurses and for continuing professional education within academia. Most simulation training for nurses is focused on building critical thinking skills. While critical thinking is an essential quality equipping nurses to meet professional demands, resilience is a crucial quality to overcome the stress of both training and practice. Resilience is believed to play an essential role in the retention of new graduate nurses and preventing burnout …

Pediatric Obesity In Primary Care, Lynne C. Liggins

Electronic Theses and Dissertations

The purpose of this evidence-based quantitative quasi-experimental research was to compare if providing the parents with information on the health risk associated with childhood obesity would cause the parents to make healthier food choices and encourage their children to be involved in a full hour of physical activity a day. Participants included parents and pediatric and adolescent children 5 to 18 years of age at a solo practice primary care office in a large city in Southern, California, which specializes in treating pediatric and adolescent patients. A pre- and postquantitative intervention design were used and analyzed using the paired t …

Pathways To Success For Black Women Leaders In Online Higher Education: Intersectionality Of Gender, Race, And Personality Traits, Shanaya Kuykendahl Anderson

Electronic Theses and Dissertations

Previous literature has been used by researchers to suggest that Black women face challenges and obstacles seeking leadership roles at higher education institutions (HEIs). Many of these Black women have consistently and pervasively faced prevailing stereotypes, biases, and barriers as they seek career advancements at online HEIs (Nigar, 2020; Tarbutton, 2019). This qualitative phenomenological study was undertaken in order to examine the intersectionality of gender, race, and personality traits of Black women leaders who hold positions of department chair level or higher in HEIs. Using the theoretical framework of Black feminist thought, this research was conducted to understand better the …

Female Ex-Offenders Transitioning Into Society, Stacey L. Forte

Electronic Theses and Dissertations

The purpose of this qualitative study was to examine female ex-offenders’ perceptions of their lived experience(s) while transitioning into society after incarceration. This study examined risk factors that female ex-offenders faced while transitioning into society asking the question, “What are the lived experiences of female ex-offenders who utilized transitional housing for reentry with regard to their perception of the benefits of certain services/offerings and staff support?” Nine participants were part of the study ranging from 25–64 years of age, with the majority being between the ages of 25 and 55 years old, residing originally in five different states. Sixty percent …

Dexamethasone To Prevent Everolimus-Induced Stomatitis (Alliance Mist Trial: A221701), Kathryn J Ruddy, David Zahrieh, Jun He, Blake Waechter, Julianne L Holleran, Lionel D Lewis, Selina Chow, Jan Beumer, Matthias Weiss, Nikolaos Trikalinos, Bryan Faller, Maryam Lustberg, Hope S Rugo, Charles Loprinzi

2020-Current year OA Pubs

mTOR inhibitors such as everolimus may cause oral stomatitis, often a dose-limiting toxicity. Prior clinical research has suggested that a dexamethasone mouth rinse might help prevent and/or treat this. Alliance A221701 was a randomized phase III trial of patients initiating 10 mg daily oral everolimus that compared dexamethasone mouthwash taken preventively (initial dexamethasone group) versus therapeutically (initial placebo group) to assess two coprimary endpoints: the incidence of mTOR inhibitor-associated stomatitis (mIAS), and the area under the curve (AUC) of mIAS-associated pain over an 8-week treatment period. A Fisher's exact test was used to compare the incidences while a Wilcoxon rank-sum …

Leadership Style In A Faith-Based Athletic Department Setting, Adam P. Ybarra

Electronic Theses and Dissertations

In this intrinsic case study, the researcher sought to explore athletic directors’ leadership styles with their coaches’ and administrators’ workplace satisfaction at a Christian-affiliated college in the Southwestern United States. The study explored which leadership style is likely to encourage motivation (i.e., achievement, recognition, growth) and hygiene factors (i.e., policies, supervision, work conditions), which could potentially increase or decrease job satisfaction. The data collection method was semistructured interviews conducted with athletic department personnel. The researcher transcribed and quality-checked the interviews against the audio recordings. The transcripts were member-checked by sharing them with each of the study participants. The researcher analyzed …

Mindfulness Based Stress Reduction Techniques In Chronic Illness, Anna Celia Gil

Electronic Theses and Dissertations

Abstract

Chronic stress and its effect on both physical and mental health have been a topic of increasing interest in the past several decades. There is mounting evidence that recurrent, persistent stress of both a physiologic and psychological nature leads to a dysfunction in the hypothalamic pituitary axis (HPA), the system which helps the body recover and adapt to short term stress. In long term stress, this HPA dysfunction leads to impairment of the immune and neuroendocrine systems resulting in chronic low-grade inflammation. This type of chronic inflammation acts as a precursor to several chronic illnesses such as diabetes, hypertension, …

Exploring A Cooperative Learning Model With A Mixed Methods Design, Zhidong Zhang, Liza Ramos

Teaching and Learning Faculty Publications

The exploratory sequential design was used in this study. The mixed methods design consisted of two modules: a qualitative module and a quantitative module. The qualitative module was used to code the data into categories and further into the structure in terms of Saldana’s model. Based on the analysis of the interview transcripts, three themes were recognized to support the cooperative learning models. These three themes were Knowing by Undergone Events and Contexts (KUEC), Implementation and Action (I&A), and Opinions and Perceptions (OP). These three themes consisted of a Collaborative Learning Model describing and evaluating different topic patterns.

Fixed-Dose Combination Therapy-Based Protocol Compared With Free Pill Combination Protocol: Results Of A Cluster Randomized Trial, Olutobi A Sanuade, Mark D Huffman, Et Al.

2020-Current year OA Pubs

Fixed-dose combination (FDC) therapy is recommended for hypertension management in Nigeria based on randomized trials at the individual level. This cluster-randomized trial evaluates effectiveness and safety of a treatment protocol that used two-drug FDC therapy as the second and third steps for hypertension control compared with a protocol that used free pill combinations. From January 2021 to June 2021, 60 primary healthcare centers in the Federal Capital Territory of Nigeria were randomized to a protocol using FDC therapy as second and third steps compared with a protocol that used the same medications in free pill combination therapy for these steps. …

Lgmdd1 Natural History And Phenotypic Spectrum: Implications For Clinical Trials, Andrew R Findlay, Sarah E Robinson, Stephanie Poelker, Michelle Seiffert, Rocio Bengoechea, Conrad C Weihl

2020-Current year OA Pubs

OBJECTIVE: To delineate the full phenotypic spectrum and characterize the natural history of limb girdle muscular dystrophy type D1 (LGMDD1).

METHODS: We extracted age at clinical events of interest contributing to LGMDD1 disease burden via a systematic literature and chart review. Manual muscle testing and quantitative dynamometry data were used to estimate annualized rates of change. We also conducted a cross-sectional observational study using previously validated patient-reported outcome assessments (ACTIVLIM, PROMIS-57) and a new LGMDD1 questionnaire. Some individuals underwent repeat ACTIVLIM and LGMDD1 questionnaire assessments at 1.5 and 2.5 years.

RESULTS: A total of 122 LGMDD1 patients were included from …

Do We Need Patient-Specific Qa For Adaptively Generated Plans? Retrospective Evaluation Of Delivered Online Adaptive Treatment Plans On Varian Ethos, Xiaodong Zhao, Dennis N Stanley, Carlos E Cardenas, Joseph Harms, Richard A Popple

2020-Current year OA Pubs

BACKGROUND: The clinical introduction of dedicated treatment units for online adaptive radiation therapy (OART) has led to widespread adoption of daily adaptive radiotherapy. OART allows for rapid generation of treatment plans using daily patient anatomy, potentially leading to reduction of treatment margins and increased normal tissue sparing. However, the OART workflow does not allow for measurement of patient-specific quality assurance (PSQA) during treatment delivery sessions and instead relies on secondary dose calculations for verification of adapted plans. It remains unknown if independent dose verification is a sufficient surrogate for PSQA measurements.

PURPOSE: To evaluate the plan quality of previously treated …

The Insurance Landscape For Implant- And Autologous-Based Breast Reconstruction In The United States, Louisa C. Boyd, Jason A. Greenfield, Sravya S. Ainapurapu, Rachel Skladman, Gary Skolnick, Durai Sundaramoorthi, Justin M. Sacks

2020-Current year OA Pubs

UNLABELLED: Insurance coverage of postmastectomy breast reconstruction is mandated in America, regardless of reconstructive modality. Despite enhanced patient-reported outcomes, autologous reconstruction is utilized less than nonautologous reconstruction nationally. Lower reimbursement from Medicare and Medicaid may disincentivize autologous-based reconstruction. This study examines the impact of insurance and sociodemographic factors on breast reconstruction.

METHODS: A retrospective analysis of the Healthcare Cost and Utilization Project National Inpatient Sample Database from 2014 to 2017 was performed. International Classification of Diseases Clinical Modification and Procedure Coding System codes were used to identify patients for inclusion. De-identified sociodemographic and insurance data were analyzed using

RESULTS: In …

Autophagy Requirements For Eye Lens Differentiation And Transparency, Lisa Brennan, M Joseph Costello, J Fielding Hejtmancik, A Sue Menko, S Amer Riazuddin, Alan Shiels, Marc Kantorow

2020-Current year OA Pubs

Recent evidence points to autophagy as an essential cellular requirement for achieving the mature structure, homeostasis, and transparency of the lens. Collective evidence from multiple laboratories using chick, mouse, primate, and human model systems provides evidence that classic autophagy structures, ranging from double-membrane autophagosomes to single-membrane autolysosomes, are found throughout the lens in both undifferentiated lens epithelial cells and maturing lens fiber cells. Recently, key autophagy signaling pathways have been identified to initiate critical steps in the lens differentiation program, including the elimination of organelles to form the core lens organelle-free zone. Other recent studies using ex vivo lens culture …

Machine Learning Approximations To Predict Epigenetic Age Acceleration In Stroke Patients, Isabel Fernández-Pérez, Joan Jiménez-Balado, Uxue Lazcano, Eva Giralt-Steinhauer, Lucía Rey Álvarez, Elisa Cuadrado-Godia, Ana Rodríguez-Campello, Adrià Macias-Gómez, Antoni Suárez-Pérez, Anna Revert-Barberá, Isabel Estragués-Gázquez, Carolina Soriano-Tarraga, Jaume Roquer, Angel Ois, Jordi Jiménez-Conde

2020-Current year OA Pubs

Age acceleration (Age-A) is a useful tool that is able to predict a broad range of health outcomes. It is necessary to determine DNA methylation levels to estimate it, and it is known that Age-A is influenced by environmental, lifestyle, and vascular risk factors (VRF). The aim of this study is to estimate the contribution of these easily measurable factors to Age-A in patients with cerebrovascular disease (CVD), using different machine learning (ML) approximations, and try to find a more accessible model able to predict Age-A. We studied a CVD cohort of 952 patients with information about VRF, lifestyle habits, …