Medicine and Health Sciences Commons^™

Machine Independence Of Ultrasound-Based Quantification Of Vitreous Echodensities, Cameron Hoerig, Justin H Nguyen, Jonathan Mamou, Cedric Venuat, J Sebag, Jeffrey A Ketterling

Faculty, Staff and Student Publications

PURPOSE: Quantitative ultrasound (QUS) provides objective indices of Vision Degrading Myodesopsia (VDM) that correlate with contrast sensitivity (CS). To date, QUS methods were only tested on a single ultrasound machine. Here, we evaluate whether QUS measurements are machine independent.

METHODS: In this cross-sectional study, 47 eyes (24 subjects; age = 53.2 ± 14.4 years) were evaluated with Freiburg acuity contrast testing (%Weber), and ultrasonography using 2 machines: one with a 15-MHz single-element transducer and one with a 5-ring, 20-MHz annular-array. Images were acquired from each system in sequential scans. Artifact-free, log-compressed envelope data were processed to yield three parameters (mean …

Trial Participation And Outcomes Among English-Speaking And Spanish-Speaking Patients With Appendicitis Randomized To Antibiotics: A Secondary Analysis Of The Coda Randomized Clinical Trial, Elina Serrano, Emily C Voldal, David Machado-Aranda, Daniel A Deugarte, Lillian Kao, Thurston Drake, Robert Winchell, Joseph Cuschieri, Anusha Krishnadasan, David A Talan, Nicole Siparsky, Patricia Ayoung-Chee, Wesley H Self, Patrick Mcgonagill, Katherine A Mandell, Mike K Liang, Shan-Jahan Dodwad, Callie M Thompson, Reynaldo M Padilla, Ross Fleischman, Thea P Price, Alan Jones, Karla Bernardi, Luis Garcia, Heather L Evans, Sabrina E Sanchez, Stephen Odom, Bryan A Comstock, Patrick J Heagerty, Sarah O Lawrence, Sarah E Monsell, Erin E C Fannon, Larry G Kessler, David R Flum, Giana H Davidson

Faculty, Staff and Student Publications

IMPORTANCE: Spanish-speaking participants are underrepresented in clinical trials, limiting study generalizability and contributing to ongoing health inequity. The Comparison of Outcomes of Antibiotic Drugs and Appendectomy (CODA) trial intentionally included Spanish-speaking participants.

OBJECTIVE: To describe trial participation and compare clinical and patient-reported outcomes among Spanish-speaking and English-speaking participants with acute appendicitis randomized to antibiotics.

DESIGN, SETTING, AND PARTICIPANTS: This study is a secondary analysis of the CODA trial, a pragmatic randomized trial comparing antibiotic therapy with appendectomy in adult patients with imaging-confirmed appendicitis enrolled at 25 centers across the US from May 1, 2016, to February 28, 2020. The trial …

Differentiating Urgent From Elective Cases Matters In Minority Populations: Developing An Ordinal "Desirability Of Outcome Ranking" To Increase Granularity And Sensitivity Of Surgical Outcomes Assessment, Michael A Jacobs, Susanne Schmidt, Daniel E Hall, Karyn B Stitzenberg, Lillian S Kao, Chen-Pin Wang, Laura S Manuel, Paula K Shireman

Faculty, Staff and Student Publications

BACKGROUND: Surgical analyses often focus on single or binary outcomes; we developed an ordinal Desirability of Outcome Ranking (DOOR) for surgery to increase granularity and sensitivity of surgical outcome assessments. Many studies also combine elective and urgent procedures for risk adjustment. We used DOOR to examine complex associations of race/ethnicity and presentation acuity.

STUDY DESIGN: NSQIP (2013 to 2019) cohort study assessing DOOR outcomes across race/ethnicity groups risk-adjusted for frailty, operative stress, preoperative acute serious conditions, and elective, urgent, and emergent cases.

RESULTS: The cohort included 1,597,199 elective, 340,350 urgent, and 185,073 emergent cases with patient mean age of 60.0 …

Assessing The Severity Of Cervical Dystonia: Ask The Doctor Or Ask The Patient?, Adam C Cotton, Laura Scorr, William Mcdonald, Cynthia Comella, Joel S Perlmutter, Christopher G Goetz, Joseph Jankovic, Laura Marsh, Stewart Factor, H A Jinnah

Faculty, Staff and Students Publications

BACKGROUND: Assessing disease severity can be performed using either clinician-rated scales (CRS) or patient-rated outcome (PRO) tools. These two measures frequently demonstrate poor correlations.

OBJECTIVES: To determine if the correlation between a CRS and PRO for motor features of cervical dystonia (CD) improves by accounting for non-motor features.

METHODS: Subjects with CD (N = 209) were evaluated using a CRS (Toronto Western Spasmodic Torticollis Rating Scale, TWSTRS) and a PRO (Cervical Dystonia Impact Profile, CDIP-58).

RESULTS: Linear regression revealed a weak correlation between the two measures, even when considering only the motor subscales of each. The strength of this relationship …

Acceptance Of Communication Technology, Emotional Support And Subjective Well-Being For Chinese Older Adults Living Alone During Covid-19: A Moderated Mediation Model, Ze Ling Nai, Woan Shin Tan, William Tov

Research Collection School of Social Sciences

Stringent social distancing measures implemented to control the spread of COVID-19 affected older adults living alone by limiting their social interaction beyond their households. During these restrictions, interactions beyond the household could be facilitated by communication technology (CT) such as voice calls, instant messages. Our study provides evidence on how CT acceptance could influence the emotional support and in turn, subjective well-being (SWB) of older adults living alone. We did a cross-sectional survey with 293 community-dwelling Chinese older adults. Participants were surveyed from September to November 2020 and had completed measures on CT acceptance (competency), emotional support, and SWB. PROCESS …

Deficiencies With Cage-Aid Questionnaire In Identifying Nonmedical Opioid Use-A Report Of Two Cases, Jaya Amaram-Davila, Patricia Bramati, Laura Gammon, Tarun Mallipeddi, Olivia Jastrzemski, Matthew D Clark, Joseph Arthur, Akhila Reddy, Eduardo Bruera

Faculty, Staff and Students Publications

Background: The CAGE-AID questionnaire (Cut-down, Annoyed, Guilty, Eye-opener scale Adapted to Include Drugs) is used to screen patients for substance use disorder and nonmedical opioid use (NMOU). Major pain guidelines encourage using such screening tools for all patients including cancer patients before initiating opioids. We present two cases where the CAGE-AID results did not accurately identify the risk for NMOU.

Case description: Patient 1 is a male in his 60s with metastatic prostate cancer was admitted for uncontrolled pain. Imaging revealed extensive spinal metastasis, needing initiation of methadone and hydromorphone. The CAGE-AID score was positive, placing him at risk for …

Social Distancing And Extremely Preterm Births In The Initial Covid-19 Pandemic Period, Christopher M Orlando, Carlos A Pérez, Paunel Agyei, Marwah Elsehety, Sonia Kaur Singh, Joseph Thomas, Omar Alaina, John A Lincoln

Faculty, Staff and Student Publications

Background:

Black and Hispanic patients with multiple sclerosis (MS) have been shown to accumulate greater multiple sclerosis–associated disability (MSAD) than White patients. Disparities in social determinants of health (SDOH) among these groups have also been reported.

Objective:

To determine the extent to which associations of race and ethnicity with MSAD may be attributable to differences in SDOH.

Methods:

Retrospective chart analysis of patients at an academic MS center grouped by self-identified Black (n = 95), Hispanic (n = 93), and White (n = 98) race/ethnicity. Individual patient addresses were geocoded and matched with neighborhood-level area deprivation index …

Exploring The Effects Of Christian Worldviews On Heart Rate, Stress, And Adjustment After Loss In Bereaved Individuals, Emma Radini Ratnavel

Honors Scholar Theses

The objective of this study is to investigate the correlation between Christian values, perceptions of God, and physiological stress, assessed through heart rate, among individuals who are experiencing grief due to the loss of a loved one. Previous studies have analyzed various physiological effects on the body. There are very few studies that examine the correlation between Christian values and heart rate in bereaved participants. To explore these topics further, this study analyzes 59 undergraduate students who have recently lost a loved one, identify as a Christian, and are at least 18 years old. The participants' perceptions of God and …

The Ninth Myth Of Appalachia, Randolph Wykoff

Journal of Appalachian Health

Many stereotypes afflict our much-maligned region, and the Jonesborough­­–Washington County History Museum displays eight of these "myths of Appalachia." Here, our Editor-in-Chief suggests a ninth—that the people of Appalachia "do not care" about their health—and argues that regional health disparities result not from apathy but from a confluence of socioeconomic factors.

Self-Reported Consumption Of Bottled Water V. Tap Water In Appalachian And Non-Appalachian Kentucky, Jason W. Marion

Journal of Appalachian Health

Introduction: Quantitative studies on drinking water perceptions in Appalachia are limited. High-profile water infrastructure failures in the U.S. and Eastern Kentucky, coupled with human-made and natural disasters in the Appalachian Region, have likely impacted opinions regarding tap water.

Purpose: To use existing unexplored data to describe baseline tap water v. bottled water consumption in Kentucky.

Methods: Telephone-based cross-sectional data were obtained from the 2013 Kentucky Health Issues Poll (KHIP) directed by the Foundation for a Healthy Kentucky. Among many items in KHIP, self-reported consumption of bottled water over tap water, reasons for bottled water use, and demographic data were obtained. …

The Prevalence Of Human Papillomavirus Vaccination Among Racial And Ethnic Minority Adolescents During The Covid-19 Pandemic, Chinenye Lynette Ejezie, Lara S Savas, Casey Durand, Ross Shegog, Paula Cuccaro

Faculty, Staff and Student Publications

BACKGROUND: Human papillomavirus (HPV) vaccination among adolescents has steadily improved over the past several years. However, research conducted to determine whether the COVID-19 pandemic disrupted this positive trend in HPV vaccine initiation among racial and ethnic minority adolescents is limited. Therefore, this study was conducted to determine if the COVID-19 pandemic and the resulting changes in the US health-care sector affected the increasing HPV vaccine initiation among non-Hispanic Black and Hispanic adolescents aged 13-17 years.

METHODS: Using a cross-sectional design to examine data from the National Immunization Survey-Teen (2019-2021), logistic regression and moderation analysis were used to model race-specific variations …

Oral Leukoplakia: Diagnosis And Management Revisited, Isaäc Van Der Waal

Journal of Dentistry Indonesia

The definition of oral leukoplakia has not much changed during the past five decades and is still a definition by exclusion of ‘known’ lesions. Therefore, a diagnosis of leukoplakia is not always a straightforward one for the clinicians and, to some extent, also for the pathologists. The traditional clinical classification in homogeneous and nonhomogeneous leukoplakia may just be simplified into leukoplakia (thin and thick/verrucous) and erythroleukoplakia. In spite of numerous reported predictive molecular and genetic parameters of malignant transformation, the presence and grade of epithelial dysplasia as assessed by histopathological examination is still the most important one. Of the various …

How To Manage Fan’S C Shape Canals Along With S Shape Morphology In Indian Population: A Case Series And Narrative Review, A Lavanya, Rajendra Kumar Tewari

Journal of Dentistry Indonesia

The C-shaped root canals offer greater negotiation, debridement, and obturation difficulty as they present with intercommunications, lateral canals, and reduced dentin thickness.

Objective: This case series elaborates on the recognition that these varying configurations is important to enhance adequate cleaning, shaping, and sealing of the root canal.

Case Reports: On clinical examination, all the teeth showed caries were nonresponsive to sensibility tests and toother diagnostic tests, suggestive of pulp necrosis with apical periodontitis. Conventional root canal treatment with different techniques and obturation systems have been used. This case series presents the successful management of various C-shaped configurations classified by Fan …

Mental Health And Experiences Of Pregnancy Among Black Women And Birthing People With Type 1 Diabetes (T1d), Madeleine E. Marcus

Doctoral Dissertations

This dissertation explored the potential effects of intersections of oppression (i.e., anti-Black racism, diabetes discrimination, and sexism) on mental health and pregnancy experiences among Black women and birthing people with Type 1 diabetes (T1D). Previous studies about pregnancy and T1D have included mainly white, cisgender women. Three participants qualified for inclusion in the present study and participated in semi-structured interviews, which the researcher analyzed using an interpretative phenomenological analysis (IPA) framework. Participants described feeling uncertain about whether aspects of their pregnancy experiences were related to obstetric and/or medical racism. Similarly, participants sometimes seemed uncertain about how racism may affect their …

Evaluation Of A Faculty Fellows Program In Science Communication, Stacy Stanifer, Beverly Delidow, Kathy Rademacher, Luz Huntington-Moskos, Kelly Kennoy, Amanda Thaxton-Wiggins, Craig Wilmhoff, Ellen J. Hahn

Journal of Appalachian Health

Introduction: Science communication plays a crucial role in tackling pressing regional, national, and global health issues. Effective communication with various audiences is integral to dissemination of science findings.

Purpose: This study evaluates changes in self-efficacy and attitudes toward science communication skills over time and also assesses program outcomes and satisfaction with a Faculty Fellows in Science Communication (FFSC) program among faculty (N = 30) with interest in environmental health science and/or education in Appalachia Kentucky.

Methods: A mixed methods program evaluation was employed using longitudinal data on behaviors, attitudes, and program outcomes from three cohorts of Faculty Fellows who participated …

Healthcare Providers’ Perceptions Of Deaf-Hearing Interpreter Teams: Impact Of Interpreting Approaches, Julayne Feilbach

Journal of Interpretation

This study explores the perceptions and preferences of healthcare providers who work with Deaf Interpreter-Hearing Interpreter (DI-HI) teams. Healthcare providers depend on interpreters' ability to bridge the communication and cultural gap to assess and treat patients accurately. Although there have been studies on healthcare providers’ perceptions of interpreters to date, none of the research explores the impact of healthcare providers’ perceptions on their experiences with DI-HI teams. To address this, interviews with nine healthcare practitioners were conducted. As part of the interview, participants were shown a video of two interpreting samples to illustrate different approaches to interpreting. Data were analyzed …

Piloting A Peer Support Program For Patients Who Screen Positive For Intimate Partner Violence, Suicidal Ideation, And Depression, Michelle Drouin, Mindy Flanagan, Jeanne Carroll, Connie Kerrigan, Heather Henry, Tammy Toscos

Health Services and Informatics Research

Peer support programs have been utilized for a variety of mental-health-related needs, including suicidality and depression. In this pilot program, we developed a peer support network to address multimorbidity involving intimate partner violence (IPV), suicidal ideation, and depression. Over one year, our Suicide Obviation Support (SOS) navigators enrolled and provided at-elbow support to 108 patients (67.6% women) who screened positive for IPV, many of whom also screened at moderate or high risk for suicidality (64.8%) and/or exhibited depression symptoms. At a 6-month follow-up, 63 participants (58.3%) were retained. Those who stayed enrolled in the program for six months were less …

A Polygenic Risk Score For Alzheimer’S Disease Constructed Using Apoe-Region Variants Has Stronger Association Than Apoe Alleles With Mild Cognitive Impairment In Hispanic/Latino Adults In The Us, Tamar Sofer, Nuzulul Kurniansyah, Einat Granot-Hershkovitz, Matthew O Goodman, Wassim Tarraf, Iris Broce, Richard B Lipton, Martha Daviglus, Melissa Lamar, Sylvia Wassertheil-Smoller, Jianwen Cai, Charles S Decarli, Hector M Gonzalez, Myriam Fornage

Faculty, Staff and Student Publications

INTRODUCTION: Polygenic Risk Scores (PRSs) are summaries of genetic risk alleles for an outcome.

METHODS: We used summary statistics from five GWASs of AD to construct PRSs in 4,189 diverse Hispanics/Latinos (mean age 63 years) from the Study of Latinos-Investigation of Neurocognitive Aging (SOL-INCA). We assessed the PRS associations with MCI in the combined set of people and in diverse subgroups, and when including and excluding the APOE gene region. We also assessed PRS associations with MCI in an independent dataset from the Mass General Brigham Biobank.

RESULTS: A simple sum of 5 PRSs ("PRSsum"), each constructed based on a …

The Impact Of Vaccinations And Chronic Disease On Covid Death Rates, James L. Doti

Economics Faculty Articles and Research

This study presents a theoretical and empirical regression model to measure the efficacy of vaccinations in reducing COVID death rates across states over the 3/10/21 to 12/28/22 period. During that period, it was estimated that the availability of vaccinations resulted in a reduction of 427,000 COVID deaths in the nation. To arrive at that estimate, other covariants were held constant. In particular, it was found that chronic disease should be included as an explanatory variable to arrive at unbiased measures of the efficacy of vaccinations in reducing deaths. In addition, the percentage of people over the age of 65 was …

Pimavanserin Treatment Increases Plasma Brain-Derived Neurotrophic Factor Levels In Rats, Ashutosh Tripathi, Henry A Nasrallah, Anilkumar Pillai

Faculty, Staff and Student Publications

BACKGROUND: Pimavanserin, a serotonin 5HT-2A receptor inverse agonist is the first-line, FDA-approved treatment of hallucinations and delusions associated with Parkinson's Disease psychosis (PDP), which occurs in up to 50% of PD patients. The neurobiological mechanism underlying the therapeutic effectiveness of Pimavanserin in PDP remains unknown. Several earlier studies have shown that treatment with 5HT-2A antagonists and other drugs acting on the serotonergic system such as SSRIs increase Brain derived neurotrophic factor (BDNF) levels in rodents. BDNF is synthesized as the precursor proBDNF, that undergoes cleavage intra or extracellularly to produce a mature BDNF (mBDNF) protein. mBDNF is believed to play …

Improving Pilot Boarding Arrangements To Prevent Transfer Accidents, Wenduan Song

World Maritime University Dissertations

No abstract provided.

High Foxa1 Levels Induce Er Transcriptional Reprogramming, A Pro-Metastatic Secretome, And Metastasis In Endocrine-Resistant Breast Cancer, Xiaoyong Fu, Resel Pereira, Chia-Chia Liu, Carmine De Angelis, Martin J Shea, Sarmistha Nanda, Lanfang Qin, Tamika Mitchell, Maria L Cataldo, Jamunarani Veeraraghavan, Vidyalakshmi Sethunath, Mario Giuliano, Carolina Gutierrez, Balázs Győrffy, Meghana V Trivedi, Ofir Cohen, Nikhil Wagle, Agostina Nardone, Rinath Jeselsohn, Mothaffar F Rimawi, C Kent Osborne, Rachel Schiff

Center for Medical Ethics and Health Policy Staff Publications

Aberrant activation of the forkhead protein FOXA1 is observed in advanced hormone-related cancers. However, the key mediators of high FOXA1 signaling remain elusive. We demonstrate that ectopic high FOXA1 (H-FOXA1) expression promotes estrogen receptor-positive (ER+) breast cancer (BC) metastasis in a xenograft mouse model. Mechanistically, H-FOXA1 reprograms ER-chromatin binding to elicit a core gene signature (CGS) enriched in ER+ endocrine-resistant (EndoR) cells. We identify Secretome14, a CGS subset encoding ER-dependent cancer secretory proteins, as a strong predictor for poor outcomes of ER+ BC. It is elevated in ER+ metastases vs. primary tumors, irrespective of ESR1 mutations. Genomic ER binding near …

A Study Of Approaches To Mitigate Seafarer Fatigue Based On Workload Self-Assessment By Ship's Crew, Jun Liu

World Maritime University Dissertations

No abstract provided.

Research On Prevention And Management Of Seafarer Fatigue, Yiheng Xu

World Maritime University Dissertations

No abstract provided.

Addendum: Transformative Reimagination: A Framework For A Vincentian College Of Business, Krieg Tidemann, Madhurima (Rima) Bhattacharyay, Kris Principe

Journal of Vincentian Social Action

The mission identity and intellectual tradition of Vincentian schools of business affords a unique opportunity for these institutions to produce business leaders prepared to address systemic breakdowns in business ethics and corporate social responsibility. In order to achieve this goal, this paper proposes the HEET (Hire Encourage Equip Train) framework for mission integration. At the heart of the HEET framework is a recognition that successful mission integration requires college-level administrators who promote mission integration throughout the curriculum and center its importance within the strategic operations of the school of business. As every component of HEET centers on developing an industry-leading …

Examining Student Resilience By Observing The Effect Of Social Support And Optimism, Erlina Estiyanti Widuri, Mujidin Mujidin, Husnul Khotimah Rustam, Miftakhur Rohmah, Miftakhur Rohmah

Jurnal Kajian Bimbingan dan Konseling

There are many negative situations that make students depressed and very stressed with their academics. Students who lack endurance need conducive conditions through social support and strong optimism. This study aimed to test the effect of social support and optimism on the resilience of students working on their thesis. The subjects involved were 79 active students of the faculty of psychology. This study was conducted with quantitative methods using three scales: resilience, social support, and optimism. Sampling was performed using the purposive sampling technique, while the analysis employed the multiple linear regression technique. The results of the major hypothesis analysis …

A Tale Of Two Situations: A Case Report Of The Merger Between Dermatology Outcomes And Prescription Drug Access, Kara Ye, Yasseen Amellal, Will Evans, Theresa Rohr-Kirchgraber

Cooper Rowan Medical Journal

This case report illustrates a case of guttate psoriasis in a young adult and the logistical role dermatologists can play in patients acquiring their prescriptions and improving the quality of their care.

Cognitive-Behavioral Counseling: A Strategy To Overcome Students’ Addiction To Tiktok Through Self-Instruction Method, Fiki Prayogi, Prio Utomo, Siti Zahra Bulantika

Jurnal Kajian Bimbingan dan Konseling

TikTok has influenced the development of student behavior. Therefore, a service strategy is needed to overcome TikTok addiction in students. This study aimed to determine whether there was a decrease in TikTok addiction in students after being given cognitive-behavioral counseling with the self-instruction method. The researchers employed experimental research with one group pretest-posttest designs as the research design. The research samples consisted of 18 students. The researchers utilized the TikTok addiction scale as the research instrument for collecting the data. The validity result of the instrument was in KMO value of 0.791 with Sig. of 0.000 (0.791 greater than 0.5). …

Indonesia And Malaysia Students’ Quality Of Life After The Covid-19 Pandemic: A Mixed Methods Study, Juster Juster Sinaga, Mawaddah Sarif, Siti Aishah Hassan

Jurnal Kajian Bimbingan dan Konseling

Learning from home during the COVID-19 pandemic and learning face-to-face at school with strict health protocols during the COVID-19 pandemic have long-term negative effects on the psychological health of students. This situation may impact life quality (QoL). To measure students’ quality of life, mixed methods were adopted. Participants in this research ranged in age from 12 to 19 years. The study involved a total of 139 research participants. Kidscreen-27 questionnaires with a reliability coefficient of 0.913 percent were used. The interviews were conducted according to a set of defined rules. This data was collected online. The analysis was quantitative, qualitative, …

Analyzing Children’S Trauma During The Covid-19 Pandemic Using Relational-Cultural Theory: A Literature Review, Septinda Rima Dewanti, Yuejiao Wu

Jurnal Kajian Bimbingan dan Konseling

The impact of the Covid-19 pandemic has been extensively discussed, but only a limited number of studies investigate how pandemics are related to traumatic experiences for children. Using a literature review of 38 peer-reviewed articles, both qualitative and quantitative published in the reputable international journals, this study examines how pandemic situations trigger trauma in children. From the literature review, we concluded a number of impacts of Covid 19 on children, including their experience of sudden and shocking changes of events, loss, grief, domestic violence, Covid-19 infections, being surrounded by an adult experiencing mental health disturbance, and becoming the victim of …