Medicine and Health Sciences Commons^™

Surgical Research: Exploring Our History - Navigating The Future, Nadeem Ahmed Siddiqui, Muhammad Shahzad Shamim, Syed Ather Enam

Department of Surgery

No abstract provided.

Applications Of Unsupervised Machine Learning In Autism Spectrum Disorder Research: A Review, Chelsea Parlett-Pelleriti, Elizabeth Stevens, Dennis R. Dixon, Erik J. Linstead

Engineering Faculty Articles and Research

Large amounts of autism spectrum disorder (ASD) data is created through hospitals, therapy centers, and mobile applications; however, much of this rich data does not have pre-existing classes or labels. Large amounts of data—both genetic and behavioral—that are collected as part of scientific studies or a part of treatment can provide a deeper, more nuanced insight into both diagnosis and treatment of ASD. This paper reviews 43 papers using unsupervised machine learning in ASD, including k-means clustering, hierarchical clustering, model-based clustering, and self-organizing maps. The aim of this review is to provide a survey of the current uses of …

Forty Years, Mary I. Fisher

Physical Therapy Faculty Publications

No abstract provided.

Toward A Multimodal Computer-Aided Diagnostic Tool For Alzheimer’S Disease Conversion, Danilo Pena, Jessika Suescun, Mya Schiess, Timothy M. Ellmore, Luca Giancardo, Alzheimer’S Disease Neuroimaging Initiative

Publications and Research

Alzheimer’s disease (AD) is a progressive neurodegenerative disorder. It is one of the leading sources of morbidity and mortality in the aging population AD cardinal symptoms include memory and executive function impairment that profoundly alters a patient’s ability to perform activities of daily living. People with mild cognitive impairment (MCI) exhibit many of the early clinical symptoms of patients with AD and have a high chance of converting to AD in their lifetime. Diagnostic criteria rely on clinical assessment and brain magnetic resonance imaging (MRI). Many groups are working to help automate this process to improve the clinical workflow. Current …

Breakthrough Of Glycobiology In The 21st Century, Gehendra Mahara, Cuihong Tian, Xiaojia Xu, Jinxiu Zhu

Research outputs 2022 to 2026

As modern medicine began to emerge at the turn of the 20th century, glycan-based therapies advanced. DNA- and protein-centered therapies became widely available. The research and development of structurally defined carbohydrates have led to new tools and methods that have sparked interest in the therapeutic applications of glycans. One of the latest omics disciplines to emerge in the contemporary post-genomics age is glycomics. In addition, to providing hope for patients and people with different health conditions through a deeper understanding of the mechanisms of common complex diseases, this new specialty in system sciences has much to offer to communities involved …

Observed Concordance Of Prostate Lesions On Mri With Mri/Ultrasound Fusion Biopsy Results, Kelcie Foshag, Scott King, Chance Brock, Abigail Cone

View All Washington/Montana GME

Presented at the 2022 Virtual Northwest Medical Research Symposium

On-Treatment Changes In Pediatric Parameningeal Rhabdomyosarcoma Treated With Upfront Proton Therapy, Jacob Allen Jordan

Longitudinal Scholar's Project

The project is focused on the effects of longitudinal changes in patient and tumor anatomy on the delivered treatment plan during proton radiotherapy for the treatment of pediatric Para meningeal rhabdomyosarcoma. The study will investigate the effects of change on dose delivered to organs-at-risk near the tumor. This effort will extend the analysis of changes to the organs-at-risk to all the cases in the study and add an additional case meeting the study criteria.

Peptidomics Analysis Reveals Changes In Small Urinary Peptides In Patients With Interstitial Cystitis/Bladder Pain Syndrome, Md Shadman Ridwan Abid, Haowen Qiu, Bridget Tripp, Aline De Lima Leite, Heidi E. Roth, Jiri Adamec, Robert Powers, James W. Checco

Chemistry Department: Faculty Publications

Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic and debilitating pain disorder of the bladder and urinary tract with poorly understood etiology. A definitive diagnosis of IC/BPS can be challenging because many symptoms are shared with other urological disorders. An analysis of urine presents an attractive and non-invasive resource for monitoring and diagnosing IC/BPS. The antiproliferative factor (APF) peptide has been previously identified in the urine of IC/BPS patients and is a proposed biomarker for the disorder. Nevertheless, other small urinary peptides have remained uninvestigated in IC/BPS primarily because protein biomarker discovery efforts employ protocols that remove small endogenous peptides. …

Plasma-Based Assays Distinguish Hyperfibrinolysis And Shutdown Subgroups In Trauma-Induced Coagulopathy, Michael A. Lawson, Lori A. Holle, Nathan E. Dow, Grant Hennig, Bas De Laat, Hunter B. Moore, Ernest E. Moore, Mitchell J. Cohen, Beth A. Bouchard, Kalev Freeman, Alisa S. Wolberg

Larner College of Medicine Fourth Year Advanced Integration Teaching/Scholarly Projects

BACKGROUND

Trauma patients with abnormal fibrinolysis have increased morbidity and mortality. Knowledge of mechanisms differentiating fibrinolytic phenotypes is important to optimize treatment. We hypothesized that subjects with abnormal fibrinolysis identified by whole blood viscoelastometry can also be distinguished by plasma thrombin generation, clot structure, fibrin formation, and plasmin generation measurements.

METHODS

Platelet-poor plasma (PPP) from an observational cross-sectional trauma cohort with fibrinolysis shutdown (% lysis at 30 minutes [LY30] < 0.9, n = 11) or hyperfibrinolysis (LY30 > 3%, n = 9) defined by whole blood thromboelastography were studied. Noninjured control subjects provided comparative samples. Thrombin generation, fibrin structure and formation, and plasmin generation were measured by fluorescence, confocal …

Dermatologic Manifestations Of Rheumatic Disease: Cutaneous Manifestations Of Sarcoidosis, Sarah Shapiro, Sindhuja Koppu, Mavra Masood, Beth Rubinstein, Huzaefah Syed

Open and Affordable Course Content at VCU

Cutaneous Manifestations of Sarcoidosis is a Powerpoint based learning module that depicts fictional patient scenarios detailing sarcoidosis and erythema nodosum. It explores other cutaneous and non-cutaneous manifestations, diagnostic criteria, and medical evaluation of sarcoidosis and the possible etiologies, workup, treatment, and prognosis of erythema nodosum. Health and racial disparities experienced by patients with sarcoidosis are also highlighted and discussed. It takes approximately 25 minutes to complete. This module was created for use in the VCU School of Medicine M1 Movement block, Rheumatology and Dermatology sections.

It is part of the Dermatologic Manifestations of Rheumatic Disease project, which provides overviews of …

Use Of Point-Of-Care Ultrasound For Lung Assessment: A Practice Change Educational Program For Advanced Practice Providers And Students, Mark W. Owen

DNP Research Projects

Abstract Background: With over 130 million emergency room (ER) visits per year in the United States, many emergency departments (ED) are struggling with overcrowded conditions. Contributing to overcrowded conditions are those presenting with dyspnea, who are nearly 4 million in number. ED crowding has serious implications. Exploring and implementing evidence-based methods to alleviate congestion is critical. Problem: One method being explored is the integration of point-of-care ultrasound (POCUS) into the stretcher side assessment of dyspneic patients. Multiple pathologies can cause dyspnea and rapidly isolating the underlying etiology is critical. Various studies have demonstrated the efficiency of POCUS at identifying lung …

The Effects Of 465nm Blue Light On Sleepiness & Fatigue, Mark E. Childress

DNP Research Projects

Abstract

Background: Exhaustion is now accepted in nursing culture. Staff suffering from sleepiness and fatigue are more likely to commit medical errors and sentinel events. Emergency department nurses have the greatest risk of committing these errors. Currently, there is no relief provided to shift workers beyond a single 30-minute meal break within a 12-hour period. Other researched mitigation strategies have either failed or are unrealistic in this environment.

Local Problem: Emergency Department nurses at Parkridge Medical Center in Chattanooga, TN suffer from chronic sleepiness and fatigue that is exacerbated by shift duration, excessive workload, a stressful environment, and lack of …

Impact Of Care Handoff Methods On Emergency Department Throughput Times, Shelby Graves

DNP Research Projects

Abstract

Background: Emergency department (ED) overcrowding leads to detrimental results including increased morbidity and mortality, delay in evaluation of treatment, increased cost of care, increased length of stay, diminished staff satisfaction, increased ambulance diversion, and reputation damage for the entire institution (American College of Emergency Physicians, 2019). A study performed at three high volume community hospitals revealed inefficiency of nursing handover as one of the many contributors to prolonged ED length of stay (Salehi, 2019).

Local Problem: According to the 2018 Emergency Department Benchmarking Alliance (EDBA) data survey the average length of time from patient arrival to admission disposition was …

A Clinical Study Of Venereal And Non Venereal Genital Dermatoses In Women, Lakkireddygari Sujana, Savitha L. Beergouder, Alekhya Rallapalli, Prasanthi Chidipudi, Sujatha Alla

Engineering Management & Systems Engineering Faculty Publications

Background: Any genital lesion or related symptoms are erroneously considered to be sexually transmitted as it is the most covered regions of the body and seems truly to be a forgotten pelvic organ it is the significant and important group of dermatological conditions may be associated with considerable morbidity, discomfort, and embarrassment. The most common conditions seen in a Dermatology Clinic are vulvar dermatoses, which comprise of lichen sclerosis, lichen planus, vulvar eczema, and psoriasis. Other conditions such as vulvar pain syndromes, vulvar disorders associated with systemic diseases, and blistering diseases are also seen.

Materials and Methods: This was a …

Neuromotor Changes In Participants With A Concussion History Can Be Detected With A Custom Smartphone App, Christopher K. Rhea, Masahiro Yamada, Nikita A. Kuznetsov, Jason T. Jakiela, Chanel T. Lojacono, Scott E. Ross, F. J. Haran, Jason M. Bailie, W. Geoffrey Wright

Rehabilitation Sciences Faculty Publications

Neuromotor dysfunction after a concussion is common, but balance tests used to assess neuromotor dysfunction are typically subjective. Current objective balance tests are either cost- or space-prohibitive, or utilize a static balance protocol, which may mask neuromotor dysfunction due to the simplicity of the task. To address this gap, our team developed an Android-based smartphone app (portable and cost-effective) that uses the sensors in the device (objective) to record movement profiles during a stepping-in-place task (dynamic movement). The purpose of this study was to examine the extent to which our custom smartphone app and protocol could discriminate neuromotor behavior between …

Robust Testing Of Paired Outcomes Incorporating Covariate Effects In Clustered Data With Informative Cluster Size, Sandipan Dutta

Mathematics & Statistics Faculty Publications

Paired outcomes are common in correlated clustered data where the main aim is to compare the distributions of the outcomes in a pair. In such clustered paired data, informative cluster sizes can occur when the number of pairs in a cluster (i.e., a cluster size) is correlated to the paired outcomes or the paired differences. There have been some attempts to develop robust rank-based tests for comparing paired outcomes in such complex clustered data. Most of these existing rank tests developed for paired outcomes in clustered data compare the marginal distributions in a pair and ignore any covariate effect on …

Intraoperative Post Partum Hemorrhage In A Patient With Dengue Fever, Usama Ahmed, Asiyah Aman

Department of Anaesthesia

A 33 year old obstetric patient with mild fever of undiagnosed etiology underwent emergency caesarean section under general anesthesia. She had platelet count of 98,000 per microliter and increased APTT of 37.8 s at the time of surgery. After uneventful anesthetic induction and delivery of fetus, slow and oozing type of bleeding led to massive hemorrhage. Patient remained vitally stable throughout perioperative phase and was extubated. Next day, patient's dengue IgM antibody was reported positive. Neonate was well and his dengue test was negative. Pregnant women are at high risk of developing severe complications of dengue fever with unclear mechanisms …

Refinement Of Alphafold2 Models Against Experimental And Hybrid Cryo-Em Density Maps, Maytha Alshammari, Willy Wriggers, Jiangwen Sun, Jing He

Computer Science Faculty Publications

Recent breakthroughs in deep learning-based protein structure prediction show that it is possible to obtain highly accurate models for a wide range of difficult protein targets for which only the amino acid sequence is known. The availability of accurately predicted models from sequences can potentially revolutionise many modelling approaches in structural biology, including the interpretation of cryo-EM density maps. Although atomic structures can be readily solved from cryo-EM maps of better than 4 Å resolution, it is still challenging to determine accurate models from lower-resolution density maps. Here, we report on the benefits of models predicted by AlphaFold2 (the best-performing …

Quantitative Raman Analysis Of Carotenoid Protein Complexes In Aqueous Solution, Joy Udensi, Ekaterina Loskutova, James Loughman, Hugh Byrne

Datasets

Carotenoids are naturally abundant fat-soluble pigmented compounds, with dietary, antioxidant and vision protection advantages. The dietary carotenoids, Beta Carotene, Lutein and Zeaxanthin, complexed with in bovine serum albumin (BSA) in aqueous solution, were explored using Raman spectroscopy to differentiate and quantify their spectral signatures. UV visible absorption spectroscopy was employed to confirm the linearity of responses over the concentration range employed (0.05-1mg/ml) and, of the 4 source wavelengths, 785nm, 660nm, 532nm, 473nm, 532nm was chosen to provide the optimal response. After preprocessing to remove water and BSA contributions, and correct for self-absorption, a partial least squares model with R^{2 …}

Progression Through Return-To-Sport And Return-To-Academics Guidelines For Concussion Management And Recovery In Collegiate Student Athletes: Findings From The Ivy League–Big Ten Epidemiology Of Concussion Study, Douglas J. Wiebe, Abigail C. Bretzin, Bernadette A. D'Alonzo, Ivy League–Big Ten Epidemiology Of Concussion Study Investigators, Arthur C. Maerlender

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

Objective To examine the progression of collegiate student athletes through five stages of a return-to- activity protocol following sport-related concussion (SRC).

Methods In a multisite prospective cohort study, we identified the frequency of initial 24–48 hours physical and cognitive rest, and the sequence of (1) symptom resolution and return to (2) exertion activity, (3) limited sport, (4) full sport and (5) full academics. In resulting profiles we estimated the likelihood of return to full sport ≤14 days or prolonged >28 days and tested for variability based on timing of the stages.

Results Among 1715 athletes with SRC (31.6% females), 67.9% …

Head Impact Exposure In Youth And Collegiate American Football, Grace B. Choi, Eric P. Smith, Stefan M. Duma, Steven Rowson, Eamon Campolettano, Mireille E. Kelley, Derek A. Jones, Joel D. Stitzel, Jillian E. Urban, Amaris Genemaras, Jonathan G. Beckwith, Richard M. Greenwald, Arthur C. Maerlender, Joseph J. Crisco

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

The relationship between head impact and subsequent brain injury for American football players is not well defined, especially for youth. The objective of this study is to quantify and assess Head Impact Exposure (HIE) metrics among youth and collegiate football players. This multiseason study enrolled 639 unique athletes (354 collegiate; 285 youth, ages 9–14), recording 476,209 head impacts (367,337 collegiate; 108,872 youth) over 971 sessions (480 collegiate; 491 youth). Youth players experienced 43 and 65% fewer impacts per competition and practice, respectively, and lower impact magnitudes compared to collegiate players (95th percentile peak linear acceleration (PLA, g) competition: 45.6 vs …

Constructing Neural Network Models From Brain Data Reveals Representational Transformations Linked To Adaptive Behavior, Takuya Ito, Guangyu Robert Yang, Patryk Laurent, Douglas H. Schultz, Michael W. Cole

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

The human ability to adaptively implement a wide variety of tasks is thought to emerge from the dynamic transformation of cognitive information. We hypothesized that these transformations are implemented via conjunctive activations in “conjunction hubs”—brain regions that selectively integrate sensory, cognitive, and motor activations. We used recent advances in using functional connectivity to map the flow of activity between brain regions to construct a task-performing neural network model from fMRI data during a cognitive control task. We verified the importance of conjunction hubs in cognitive computations by simulating neural activity flow over this empirically-estimated functional connectivity model. These empiricallyspecified simulations …

Affective Flexibility As A Developmental Building Block Of Cognitive Reappraisal: An Fmri Study, Jordan E. Pierce, Eisha Haque, Maital Neta

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

Cognitive reappraisal is a form of emotion regulation that involves reinterpreting the meaning of a stimulus, often to downregulate one’s negative affect. Reappraisal typically recruits distributed regions of prefrontal and parietal cortex to generate new appraisals and downregulate the emotional response in the amygdala. In the current study, we compared reappraisal ability in an fMRI task with affective flexibility in a sample of children and adolescents (ages 6–17, N = 76). Affective flexibility was defined as variability in valence interpretations of ambiguous (surprised) facial expressions from a second behavioral task. Results demonstrated that age and affective flexibility predicted reappraisal ability, …

The Perspectives Of Augmentative And Alternative Communication Experts On The Clinical Integration Of Non-Invasive Brain-Computer Interfaces, Kevin Pitt, Miechelle L. Mckelvey, Kristy Weissling

Department of Special Education and Communication Disorders: Faculty Publications

As brain-computer interface for augmentative and alternative communication access (BCI-AAC) development continues to consider avenues for translation into the clinical setting, the perspectives of clinician experts in AAC should be considered. Therefore, 11 USA-based speech-language pathologists who are experts in AAC completed a semistructured interview along with Likert scale measures to assess their perspectives on BCI-AAC. The interviews and scales explored the potential impact of BCI-AAC, along with barriers and solutions to BCI-AAC implementation. Speech-language pathologists estimated that 1.5% to 50% of their caseload may benefit from BCI-AAC across various settings. Further, identified barriers and solutions included (a) BCI-AAC implementation …

Participant Use Of Digital Diaries In Qualitative Research: A Strong Structuration Analysis, Maureen L. Seguin, Jhaki A. Mendoza, Eunice Mallari, Gideon Lasco, Arianna Maever L. Amit, Lia M. Palileo-Villanueva, Benjamin Palafox, Alicia Renedo, Martin Mckee, Dina Balabanova

Development Studies Faculty Publications

Lived experiences of chronic conditions are marked by fluidity and change, which should be considered if care is to be truly patient-centered. Seeking to capture this fluidity, we used digital diaries via mobile phones to communicate with hypertensive patients in the Philippines over approximately 12 months. This paper draws on Strong Structuration Theory to conceptualize the complex array of factors shaping participants’ usage (and non-usage) of the diaries, thereby offering a comprehensive understanding of how the diaries were perceived and used. We draw on qualitative data from 42 participants (73 baseline/follow-up interviews and 37 digital diaries), purposively selected from a …

Stereotactic Radiosurgery For Pituitary Adenomas: A Review Of Literature, Kaynat Siddiqui, Saqib Kamran Bakhshi, Muhammad Shahzad Shamim

Section of Neurosurgery

Stereotactic radiosurgery (SRS) is a choice of treatment for pituitary adenomas (PA), particularly for residual or recurrent disease, apart from surgery. It has a progression free survival and endocrine remission rate comparable to surgery, with fewer side effects, making it an ideal tool for dealing with PA. In this review, we have discussed the role of SRS for primary as well as post-operative residual/ recurrent PA, and have assessed its safety and outcomes.

Dosage, Intensity, And Frequency Of Language Therapy For Aphasia: A Systematic Review-Based, Individual Participant Data Network Meta-Analysis, The Rehabilitation And Recovery Of People With Aphasia After Stroke (Release) Collaborators

Research outputs 2022 to 2026

Background and Purpose: Optimizing speech and language therapy (SLT) regimens for maximal aphasia recovery is a clinical research priority. We examined associations between SLT intensity (hours/week), dosage (total hours), frequency (days/week), duration (weeks), delivery (face to face, computer supported, individual tailoring, and home practice), content, and language outcomes for people with aphasia.

Methods: Databases including MEDLINE and Embase were searched (inception to September 2015). Published, unpublished, and emerging trials including SLT and ≥ 10 individual participant data on aphasia, language outcomes, and time post-onset were selected. Patient-level data on stroke, language, SLT, and trial risk of bias were independently extracted. …

Robust Meta-Analysis For Large-Scale Genomic Experiments Based On An Empirical Approach, Sinjini Sikdar

Mathematics & Statistics Faculty Publications

BACKGROUND: Recent high-throughput technologies have opened avenues for simultaneous analyses of thousands of genes. With the availability of a multitude of public databases, one can easily access multiple genomic study results where each study comprises of significance testing results of thousands of genes. Researchers currently tend to combine this genomic information from these multiple studies in the form of a meta-analysis. As the number of genes involved is very large, the classical meta-analysis approaches need to be updated to acknowledge this large-scale aspect of the data.

METHODS: In this article, we discuss how application of standard theoretical null distributional assumptions …

Why Do Family Members Reject Ai In Health Care? Competing Effects Of Emotions, Eun Hee Park, Karl Werder, Lan Cao, Balasubramaniam Ramesh

Information Technology & Decision Sciences Faculty Publications

Artificial intelligence (AI) enables continuous monitoring of patients’ health, thus improving the quality of their health care. However, prior studies suggest that individuals resist such innovative technology. In contrast to prior studies that investigate individuals’ decisions for themselves, we focus on family members’ rejection of AI monitoring, as family members play a significant role in health care decisions. Our research investigates competing effects of emotions toward the rejection of AI monitoring for health care. Based on two scenario-based experiments, our study reveals that emotions play a decisive role in family members’ decision making on behalf of their parents. We find …

Activation Of Cannabinoid-2 Receptor Protects Against Pseudomonas Aeruginosa Induced Acute Lung Injury And Inflammation, Nagaraja Nagre, Gregory Nicholson, Xiaofei Cong, Janette Lockett, Andrew C. Pearson, Vincent Chan, Woong-Ki Kim, K. Yaragudri Vinod, John D. Catravas

Bioelectrics Publications

Background

Bacterial pneumonia is a major risk factor for acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). Pseudomonas aeruginosa (PA), an opportunistic pathogen with an increasing resistance acquired against multiple drugs, is one of the main causative agents of ALI and ARDS in diverse clinical settings. Given the anti-inflammatory role of the cannabinoid-2 receptor (CB2R), the effect of CB2R activation in the regulation of PA-induced ALI and inflammation was tested in a mouse model as an alternative to conventional antibiotic therapy.

Methods

In order to activate CB2R, a selective synthetic agonist, JWH133, was administered intraperitoneally (i.p.) to C57BL/6J …