Medicine and Health Sciences Commons^™

The Role Of Emergency Departments For Antimicrobial Stewardship In Covid-19 Pandemic; The Time Is Now, Madiha Ismail, Nazeer Najeeb Kapadia, Sara Usman

Department of Emergency Medicine

No abstract provided.

Severe Mixed Mitral Valve Disease Due To Massive Mitral Annular Calcification: A Case Report And Literature Review, Fateh Ali Tipoo Sultan, Sheema Saadia

Section of Cardiology

We present an unusual case of massive mitral annular calcification (MAC) leading to severe mixed mitral valve disease, viz severe mitral regurgitation and severe mitral stenosis. To our knowledge, severe mixed mitral valve disease secondary to MAC is extremely rare. The patient (a 65-year-old lady) presented with worsening shortness of breath and signs of congestive heart failure. Echocardiographic examination revealed massive mitral annular calcification. Despite the massive annular calcification, she had experienced neither embolism nor endocarditis in the past. Because of severe symptomatic mitral regurgitation and mitral stenosis, surgery was advised; however, the patient declined it.

Mechanisms Of Memory Updating: State Dependency Vs. Reconsolidation, Christopher Kiley, Colleen M. Parks

Psychology Faculty Research

Reactivating a memory trace has been argued to put it in a fragile state where it must undergo a stabilization process known as reconsolidation. During this process, memories are thought to be susceptible to interference and can be updated with new information. In the spatial context paradigm, memory updating has been shown to occur when new information is presented in the same spatial context as old information, an effect attributed to a reconsolidation process. However, the integration concept holds that memory change can only occur when reactivation and test states are the same, similar to a state-dependent effect. Thus, in …

Analysis Of Race And Sex Bias In The Autism Diagnostic Observation Schedule (Ados-2), Luther G. Kalb, Vini Singh, Ji Su Hong, Calliope Holingue, Natasha N. Ludwig, Danika Pfeiffer, Rachel Reetzke, Alden L. Gross, Rebecca Landa

Communication Disorders & Special Education Faculty Publications

Importance: There are long-standing disparities in the prevalence of autism spectrum disorder (ASD) across race and sex. Surprisingly, few studies have examined whether these disparities arise partially out of systematic biases in the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2), the reference standard measure of ASD.

Objective: To examine differential item functioning (DIF) of ADOS-2 items across sex and race.

Design, Setting, and Participants: This is a cross-sectional study of children who were evaluated for ASD between 2014 and 2020 at a specialty outpatient clinic located in the Mid-Atlantic region of the US. Data were analyzed from July 2021 to …

Pulmonary Capillary Recruitment And Distention In Mammalian Lungs: Species Similarities, David Langleben, Benjamin D. Fox, Stylianos E. Orfanos, Michele Giovinazzo, John D. Catravas

Bioelectrics Publications

Pulmonary arterial pressure rises minimally during exercise. The pulmonary microcirculation accommodates increasing blood flow via recruitment of pulmonary capillaries and, at higher flows, by distention of already perfused capillaries. The flow transition range between recruitment and distention has not been studied or compared across mammalian species, including humans. We hypothesised that the range would be similar. Functional pulmonary capillary surface area (FCSA) can be estimated using validated metabolic techniques. We reviewed data from previous studies in three mammalian species (perfused rabbit lungs and dog lung lobes, and exercising humans) and generated blood flow-FCSA curves over a range of flows. We …

In Vitro And In Vivo Correlation Of Skin And Cellular Responses To Nucleic Acid Delivery, M. Bosnjak, K. Znidar, A. Sales Conniff, T. Jesenko, B. Markelc, Nina Semenova, J. Tur, K. Kohena, S. Kranjc Brezar, L. Heller, M. Cemazar

Bioelectrics Publications

Skin, the largest organ in the body, provides a passive physical barrier against infection and contains elements of the innate and adaptive immune systems. Skin consists of various cells, including keratinocytes, fibroblasts, endothelial cells and immune cells. This diversity of cell types could be important to gene therapies because DNA transfection could elicit different responses in different cell types. Previously, we observed the upregulation and activation of cytosolic DNA sensing pathways in several non-tumor and tumor cell types as well in tumors after the electroporation (electrotransfer) of plasmid DNA (pDNA). Based on this research and the innate immunogenicity of …

The Paradox Of Pulmonary Vascular Resistance: Restoration Of Pulmonary Capillary Recruitment As A Sine Qua Non For True Therapeutic Success In Pulmonary Arterial Hypertension, David Langleben, Stylianos E. Orfanos, Benjamin D. Fox, Nathan Messas, Michele Giovinazzo, John D. Catravas

Bioelectrics Publications

Exercise-induced increases in pulmonary blood flow normally increase pulmonary arterial pressure only minimally, largely due to a reserve of pulmonary capillaries that are available for recruitment to carry the flow. In pulmonary arterial hypertension, due to precapillary arteriolar obstruction, such recruitment is greatly reduced. In exercising pulmonary arterial hypertension patients, pulmonary arterial pressure remains high and may even increase further. Current pulmonary arterial hypertension therapies, acting principally as vasodilators, decrease calculated pulmonary vascular resistance by increasing pulmonary blood flow but have a minimal effect in lowering pulmonary arterial pressure and do not restore significant capillary recruitment. Novel pulmonary arterial hypertension …

Exploring Nurse Burnout And Perceived Features For Break Area Support Among Nurses Before And During Covid-19 Pandemic, Sahar Mihandoust, Jamie Roney, Gisele Nicole Bazan, Stephanie Dunkle, Joann Long

Articles, Abstracts, and Reports

No abstract provided.

Eye Movement And Pupil Measures: A Review, Bhanuka Mahanama, Yasith Jayawardana, Sundararaman Rengarajan, Gavindya Jayawardena, Leanne Chukoskie, Joseph Snider, Sampath Jayarathna

Computer Science Faculty Publications

Our subjective visual experiences involve complex interaction between our eyes, our brain, and the surrounding world. It gives us the sense of sight, color, stereopsis, distance, pattern recognition, motor coordination, and more. The increasing ubiquity of gaze-aware technology brings with it the ability to track gaze and pupil measures with varying degrees of fidelity. With this in mind, a review that considers the various gaze measures becomes increasingly relevant, especially considering our ability to make sense of these signals given different spatio-temporal sampling capacities. In this paper, we selectively review prior work on eye movements and pupil measures. We first …

Introducing A Real-Time Advanced Eye Movements Analysis Pipeline, Gavindya Jayawardana

Computer Science Faculty Publications

Real-Time Advanced Eye Movements Analysis Pipeline (RAEMAP) is an advanced pipeline to analyze traditional positional gaze measurements as well as advanced eye gaze measurements. The proposed implementation of RAEMAP includes real-time analysis of fixations, saccades, gaze transition entropy, and low/high index of pupillary activity. RAEMAP will also provide visualizations of fixations, fixations on AOIs, heatmaps, and dynamic AOI generation in real-time. This paper outlines the proposed architecture of RAEMAP.

Loss Of Acta2 In Cardiac Fibroblasts Does Not Prevent The Myofibroblast Differentiation Or Affect The Cardiac Repair After Myocardial Infarction, Yuxia Li, Chaoyang Li, Qianglin Liu, Leshan Wang, Adam X. Bao, Jangwook P. Jung, Sanjeev Dodlapati, Jingwen Sun, Peidong Gao, Xujia Zhang, Joseph Francis, Jeffery D. Molkentin, Xing Fu

Computer Science Faculty Publications

In response to myocardial infarction (MI), quiescent cardiac fibroblasts differentiate into myofibroblasts mediating tissue repair. One of the most widely accepted markers of myofibroblast differentiation is the expression of Acta2 which encodes smooth muscle alpha-actin (SMαA) that is assembled into stress fibers. However, the requirement of Acta2/SMαA in the myofibroblast differentiation of cardiac fibroblasts and its role in post-MI cardiac repair remained unknown. To answer these questions, we generated a tamoxifen-inducible cardiac fibroblast-specific Acta2 knockout mouse line. Surprisingly, mice that lacked Acta2 in cardiac fibroblasts had a normal post-MI survival rate. Moreover, Acta2 deletion did …

Visual Rehabilitation As A Treatment Tool For Collegiate Athletes Post-Mtbi To Improve Return To Sport Outcomes, Maria Asimakis

Featured Student Work

Introduction: Fifty percent of the 46 000 concussions seen in Canada are sports related, with post-concussive syndrome (PCS) impacting up to 30% of those patients. Individuals who experience PCS will often report headaches, dizziness, and blurred vision with visual disturbances reported in 20-85% depending on the nature of the visual deficit. A concussion is a type of traumatic brain injury (TBI) and results from an external insult leading to axonal shearing of nerve fibers, which are responsible for the signs and symptoms experienced. Current best practice in treatment involves initial rest followed by increasing aerobic activity as well as visual …

Identification Of Biomarkers For The Prediction Of Radiation Toxicity In Prostate Cancer Patients, Daniel Cullen

Doctoral

The success of radiotherapy in tumour control depends on the total dose given. However, the tolerance of the normal tissues surrounding the tumour limits this dose. It is not known why some patients develop radiation toxicity and, currently, it is not possible to predict before treatment which patients will experience adverse effects. Thus, there is an unmet clinical need for a new test to identify patients at risk of radiation toxicity. The aim of this study was to determine if spectral variations in blood lymphocytes from PCa patients may suggest Raman spectral bands that could be used in future research …

Authorship Equity And Gender Representation In Global Oncology Publications, Paula Hornstein, Hubert Tuyishime, Miriam Mutebi, Nwamaka Lasebikan, Fidel Rubagumya, Temidayo Fadelu

General Surgery, East Africa

Purpose: Authorship gender disparities persist across academic disciplines, including oncology. However, little is known about global variation in authorship gender distribution.

Methods: This retrospective cross-sectional study describes the distribution of author gender as determined from the first name across variables such as authorship position (first, middle, and last), country region, and country income level. The 608 articles with 5,302 authors included in this analysis were published in the Journal of Clinical Oncology Global Oncology, from its inception in October 2015 through March 2020. Primary outcome measure was author gender on the basis of first name probabilities assessed by …

Childhood Trauma And Chronic Disease, Breanna Urena

Graduate Research Projects

No abstract provided.

Does Tight Glycemic Control Slow The Progression Of Chronic Kidney Disease?, Elani Dodd

Graduate Research Projects

No abstract provided.

Induction Immunotherapy Followed By Thoracic Radiation Without Chemotherapy In Unresectable Stage Iii Non-Small Cell Lung Cancer: A Case Series., Srikiran Dasari, Takefumi Komiya Md

PCI Publications and Projects

OBJECTIVE: Although concurrent chemoradiation has been the standard of care for unresectable stage III non-small cell lung cancer (NSCLC) due to increased survival and decreased disease progression, patients with poor performance status cannot tolerate chemotherapy toxicity well. Durvalumab, an immune checkpoint inhibitor targeting the programmed death receptor-1 (PD-1) / programmed death-ligand 1 (PD-L1) axis, demonstrated efficacy as maintenance therapy after definitive chemoradiation. However, the role of immunotherapy in those who cannot tolerate chemoradiation is unclear.

METHODS: This retrospective case series reports adult patients with PD-L1-expressing stage III NSCLC diagnosed at Parkview Cancer Institute from 2019-2021 and treated initially with pembrolizumab …

Harm Reduction For Sthc Patients With Opioid Use Disorder, Michael P. Kinney, Amy G Burns

View All Washington/Montana GME

Presented at the 2022 Virtual Northwest Medical Research Symposium

Naloxone Prescription At Discharge To Reduce Incidence Of Opioid Overdose, Shelly Haferkamp, Kelly Wurzel, Benjamin Jones, James M Scanlan, Michael G Sutcliffe

View All Washington/Montana GME

Presented at the 2022 Virtual Northwest Medical Research Symposium

Duty To Warn Notifications In Residency Training, Savannah Patterson, Kelly Wurzel

View All Washington/Montana GME

Presented at the 2022 Virtual Northwest Medical Research Symposium

Utilization Of Prime Screening Questionnaire In Clinical Practice, Daniel Yang, Samuel Murray

View All Washington/Montana GME

Presented at the 2022 Virtual Northwest Medical Research Symposium

Transition Readiness Tools To Improve Health Care Transitions Among Adolescents With Inflammatory Bowel Disease, Meagan Moffett

Doctor of Nursing Practice (DNP) Projects

Inflammatory bowel disease is associated with severe disease in pediatric patients often requires treatment through adulthood. Collaborative efforts of patients, families, and health providers are needed to foster a smooth transition of care from pediatric to adult health care.

The purpose of this quality improvement project was to establish a baseline understanding of transition readiness among adolescents at one gastroenterology clinic to improve transition to adult care. A cross-sectional design was used to assess adolescents’ readiness for transition of care over a three-month period. Transitioning Readiness Assessment Questionnaire (TRAQ) was administered followed by individualized education on topics covered in the …

Repeated Exposure To Chlorpyrifos Is Associated With A Dose-Dependent Chronic Neurobehavioral Deficit In Adult Rats, Ana C. R. Ribeiro, Elisa Hawkins, Fay M. Jahr, Joseph L. Mcclay, Laxmikant Deshpande

Neurology Publications

Organophosphate (OP) chemicals include commonly used pesticides and chemical warfare agents, and mechanistically they are potent inhibitors of the cholinesterase (ChE) enzyme. Epidemiological studies report long-term neuropsychiatric issues, including depression and cognitive impairments in OP-exposed individuals. Chlorpyrifos (CPF) is one of the most widely used pesticides worldwide. Multiple laboratory studies have reported on either the long-term behavioral effect of an acute high-dose CPF (30-250 mg/kg) or studied sub-chronic behavioral effects, particularly the motor and cognitive effects of repeated low-dose CPF. However, studies are lacking on chronic mood and depression-related morbidities following repeated CPF doses that would mimic occupationally relevant OP …

End Stage Kidney Disease Patient Experiences Of Renal Supportive Care In An Australian Teaching Hospital: A Qualitative Study, Eloise Sobels, Megan Best, Steve Chadban, Riona Pais

IES Papers and Journal Articles

Context

Renal Supportive Care Services (RSCS) were introduced in Australia to provide patient-centred care with a focus on better symptom management and improved quality of life in end stage kidney disease (ESKD) patients managed with or without dialysis. While RSCS have demonstrated clinical benefits with reduced length of hospital stay and symptom burden, there is a gap in understanding the experience of patients referred to RSCS.

Objectives

To identify patient attitudes, beliefs, and perspectives on the RSCS.

Methods

Qualitative interviews were conducted with 20 participants from both dialysis and conservative treatment pathways. Transcripts were then thematically analysed and primary themes …

Analyzing The Effect Of Interview Time And Day On Emergency Medicine Residency Interview Scores, Alanna O’Connel, Sean Greco, Peter Tomaselli, Megan Stobart Gallagher, Robin Naples, Dimitrios Papanagnou

Department of Emergency Medicine Faculty Papers

Learning Objectives: To analyze whether interview date or time has an effect on residency interview score for applicants to Emergency Medicine residency programs.

Efficacy Of Dexmedetomidine As An Opioid Sparing Adjunct To Regional Anesthesia For Shoulder Surgery, Matthew Austin

Nurse Anesthesia Student Capstones

Regional anesthetics are often the preferred route for patients who are having orthopedic shoulder procedures (Rai & Bhutia, 2017). Traditionally, plain local anesthetics, like bupivacaine or ropivacaine, are used as the local anesthetic of choice because of their fast onset and relatively predictable duration of action. However, several different additives have been trialed to prolong the duration or improve the density of regional blocks. When looking at additives to regional anesthetic techniques, side effects and duration of the block can be unpredictable and unpleasant. For example, additives like fentanyl, morphine, and dexamethasone have been trialed in regional techniques and have …

The Dangers Of Aces, Olivia Carey, Thea Forrest, Adna Abdi

Maine Medical Center

ACEs stands for Adverse Childhood Experiences, included (but not limited to) physical, emotional, and sexual abuse, substance abuse, neglect, dysfunctional families, and mental illness'. ACEs impacts childhood development and increases chances of future health implications.

Relationships Of Serum Cc16 Levels With Smoking Status And Lung Function In Copd, Kelli C. Gribben, Jill A. Poole, Amy J. Nelson, Paraskevi A. Farazi, Christopher S. Wichman, Art J. Heires, Debra J. Romberger, Tricia D. Levan

Journal Articles: Pulmonary & Critical Care Med

Background: The club cell secretory protein (CC16) has anti-inflammatory and antioxidant effects, and low CC16 serum levels have been associated with both risk and progression of COPD, yet the interaction between smoking and CC16 on lung function outcomes remains unknown.

Methods: Utilizing cross-sectional data on United States veterans, CC16 serum concentrations were measured by ELISA and log transformed for analyses. Spirometry was conducted and COPD status was defined by post-bronchodilator FEV₁/FVC ratio < 0.7. Smoking measures were self-reported on questionnaire. Multivariable logistic and linear regression were employed to examine associations between CC16 levels and COPD, and lung function with adjustment for covariates. Unadjusted Pearson correlations described relationships between CC16 level and lung function measures, pack-years smoked, and years since smoking cessation.

Results: The study population (N = 351) was mostly male, white, with an average age over 60 years. An interaction between CC16 and smoking status on …

Digging For Data: How Sleep Is Losing Out To Roster Design, Sleep Disorders, And Lifestyle Factors, Gemma Maisey, Marcus Cattani, Amanda Devine, Johnny Lo, Shih Ching Fu, Ian C. Dunican

Research outputs 2014 to 2021

Shift workers employed at a remote mining operation may experience sleep loss, impaired alertness, and consequently negative health and safety outcomes. This study determined the sleep behaviors and prevalence of risk for sleep disorders among shift workers; and quantified alertness for a roster cycle. Sleep duration was significantly less following; night shift by 77 ± 7 min and day shift by 30 ± 7 min. The wake after sleep onset was less by 23 ± 3 min for night shifts and 22 ± 3 min for day shifts (p < 0.05 for all). The prevalence of risk for sleep apnea was 31%, insomnia was 8%, and shiftwork disorder was 44%. Average alertness for all working hours was 75%. Shiftwork in remote mining operations is a significant factor that leads to sleep loss and reduced alertness, which is exacerbated by the high prevalence of risk for sleep disorders.

Clinical Cell Therapy Guidelines For Neurorestoration (Ianr/Canr 2017), Hongyun Huang, Wise Young, Lin Chen, Shiqing Feng, Ziad M. Zoubi, Hari Shanker Sharma, Hooshang Saberi, Gustavo A. Moviglia, Xijing He, Dafin F. Muresanu, Alok Sharma, Ali Otom, Russell J. Andrews, Adeeb Al-Zoubi, Andrey S. Bryukhovetskiy, Elena R. Chernykh, Krystyna Domańska-Janik, Emad Jafar, W. Eustace Johnson, Ying Li, Daqing Li, Zuo Luan, Gengsheng Mao, Ashok K. Shetty, Dario Siniscalco, Stephen Skaper, Tiansheng Sun, Yunliang Wang, Lars Wiklund, Qun Xue, Si-Wei You, Zuncheng Zheng, Milan R. Dimitrijevic, W. S. Masri, Paul R. Sanberg

Neurosurgery and Brain Repair Faculty Publications

Cell therapy has been shown to be a key clinical therapeutic option for central nervous system diseases or damage. Standardization of clinical cell therapy procedures is an important task for professional associations devoted to cell therapy. The Chinese Branch of the International Association of Neurorestoratology (IANR) completed the first set of guidelines governing the clinical application of neurorestoration in 2011. The IANR and the Chinese Association of Neurorestoratology (CANR) collaborated to propose the current version “Clinical Cell Therapy Guidelines for Neurorestoration (IANR/CANR 2017)”. The IANR council board members and CANR committee members approved this proposal on September 1, 2016, and …