Medicine and Health Sciences Commons^™

Changes In Utilization Of Birth Control And Prep During Covid‑19 In The Usa: A Mixed‑Method Analysis, Rachel A. Fikslin, Alison J. Goldberg, Amanda N. Gesselman, Mora A. Reinka, Omaima Pervez, Elissia T. Franklin, Olivia Ahn, Devon M. Price

Publications and Research

In the USA, the COVID-19 pandemic has created challenges beyond the direct consequences of the infection. Because of shifting resources in response to need, many domains within the healthcare sector unrelated to COVID-19 have had inter - rupted abilities to provide care. In the current study, we focus on preventative sexual health care during the pandemic. In a sample of 511 (mean age = 27.7) people, we examined quantitative data regarding continuation and discontinuation of birth control and PrEP during the pandemic, along with qualitative data illustrating the underlying reasons for participants’ (dis) continuation. Results showed that most (92.5%) of …

The Temperature-Dependent Conformational Ensemble Of Sars-Cov-2 Main Protease (Mpro), Ali Ebrahim, Blake T. Riley, Desigan Kumaran, Babak Andi, Martin R. Fuchs, Sean Mcsweeney, Daniel A. Keedy

Publications and Research

The COVID-19 pandemic, instigated by the SARS-CoV-2 coronavirus, continues to plague the globe. The SARS-CoV-2 main protease, or M^pro, is a promising target for development of novel antiviral therapeutics. Previous X-ray crystal structures of M^pro were obtained at cryogenic temperature or room temperature only. Here we report a series of high-resolution crystal structures of unliganded M^pro across multiple temperatures from cryogenic to physiological, and another at high humidity. We interrogate these datasets with parsimonious multiconformer models, multi-copy ensemble models, and isomorphous difference density maps. Our analysis reveals a temperature-dependent conformational landscape for M^pro, including …

The Effect Of Body Mass Index On Brain Volume And Cognitive Function In Relapsing – Remitting Multiple Sclerosis: A Combirx Secondary Analysis, Aliza Bitton Ben-Zacharia, Malvin N. Janal, Abraham A. Brody, Jerry Wolinsky, Fred Lublin, Gary Cutter

Publications and Research

BACKGROUND: Multiple sclerosis (MS) is an autoimmune disease leading to physical, emotional and cognitive disability. High body mass index (BMI) may impact cognitive function and brain volume in MS. Yet, there is paucity of evidence addressing the impact of BMI on cognitive function and brain volume in MS.

OBJECTIVES: The purpose of this study was to examine the effects of BMI on normal appearing brain volume and cognitive function in patients with relapsing – remitting MS.

METHODS: A secondary data analysis of the NIH CombiRx study was conducted. Multivariate regression and mixed model analyses were executed to analyze …

Impact Of Forensic Medical Evaluations On Immigration Relief Grant Rates And Correlates Of Outcomes In The United States., Holly G. Atkinson, Katarzyna Wyka, Kathryn Hampton, Christian Seno, Elizabeth Yim, Deborah Ottenheimer, Nermeen Arastu

Publications and Research

The purpose of this study was to investigate the impact of forensic medical evaluations on grant rates for applicants seeking immigration relief in the United States (U.S.) and to identify significant correlates of grant success. We conducted a retrospective analysis of 2584 cases initiated by Physicians for Human Rights between 2008-2018 that included forensic medical evaluations, and found that 81.6% of applicants for various forms of immigration relief were granted relief, as compared to the national asylum grant rate of 42.4%. Among the study’s cohort, the majority (73.7%) of positive outcomes were grants of asylum. A multivariable regression analysis revealed …

Changes In Histone H3 Acetylation On Lysine 9 Accompany Aβ 1-40 Overexpression In An Alzheimer’S Disease Yeast Model, Muna M. Hugais, Samantha N. Cobos, Seth A. Bennett, Jailene Paredes, Genevieve Foran, Mariana P. Torrente

Publications and Research

Alzheimer’s Disease (AD), the most common type of dementia, is a neurodegenerative disease characterized by plaques of amyloid-beta (Aβ) peptides found in the cerebral cortex of the brain. The pathological mechanism by which Aβ aggregation leads to neurodegeneration remains unknown. Interestingly, genetic mutations do not explain most AD cases suggesting that other mechanisms are at play. Epigenetic mechanisms, such as histone post-translational modifications (PTMs), may provide insight into the development of AD. Here, we exploit a yeast Aβ overexpression model to map out the histone PTM landscape associated with AD. We find a modest decrease in the acetylation levels on …

An Innovative Approach For Integrating Mandatory, Longitudinal Spirituality Training Into The Medical School Curriculum, David W. Fleenor, Holly G. Atkinson, Reena Karani, Susan Lerner, Staci Leisman, Deborah Marin

Publications and Research

Problem:

Most Americans indicate they are religious and/or spiritual and wish to have their beliefs taken into account when engaging with health care providers, yet gaps in medical education and health care practice remain. To underscore the importance of spirituality as a significant social determinant of health, a team at the Icahn School of Medicine at Mount Sinai in New York developed mandatory spirituality and health training for students integrated into all 4 years of the undergraduate medical education curriculum.

Approach:

From 2014 to 2020, a small group of faculty took an innovative approach, launching the initiative and expanding the …

Psychosocial Factors Associated With Mask-Wearing Behavior During The Covid-19 Pandemic, Cliff (Yung-Chi) Chen, Mengjia Lei

Publications and Research

Although increasing evidence has supported the efficacy of masks to prevent the spread of the coronavirus (COVID-19), inconsistent and noncompliant mask-wearing behavior has been observed among members of the society. Because mask-wearing is often considered a social contract, it is important to understand the psychosocial factors that influence people’s mask-wearing behavior in order to implement the necessary steps to respond to the pandemic. Based on the protection motivation theory (PMT), this study examined the cognitive factors (threat and coping appraisals) that contribute to mask-wearing behavior and the intention to engage in health protective behavior until the end of the pandemic. …

Racial And Ethnic Data Reported For Peanut Allergy Epidemiology Do Little To Advance Its Cause, Treatment, Or Prevention, Nigel Mark Thomas

Publications and Research

No abstract provided.

Electrocardiographic Changes In Emphysema, Puneet Gupta, Hitangee Jain, Misbah Gill, Gurpreet Bharaj, Nauman Khalid, Waseem Chaudhry, Lovely Chhabra

Publications and Research

Chronic obstructive lung disease (COPD), predominantly emphysema, causes several thoracic anatomical and hemodynamic changes which may cause changes in various electrocardiographic parameters. A 12-lead electrocardiogram (ECG), which is often a part of routine evaluation in most clinical settings, may serve as a useful screening modality for diagnosis of COPD or emphysema. Our current article aims to provide a comprehensive review of the electrocardiographic changes encountered in COPD/emphysema utilizing published PubMed and Medline literature database. Several important ECG changes are present in COPD/emphysema and may serve as a good diagnostic tool. Verticalization of Pvector, changes in QRS duration, pattern recognition of …

A Systematic Review Of Diet Quality Index And Obesity Among Chinese Adults, Isma'il Kadam, Sudeep Neupane, Jingkai Wei, Lee Ann Fullington, Tricia Li, Ruopeng An, Li Zhao, Amy Ellithorpe, Xinyin Jiang, Liang Wang

Publications and Research

Diet quality scores are designed mainly based on Western-style dietary patterns. They were demonstrated to be good indicators of obesity in developed but not developing countries. Several diet quality scores were developed based on the Chinese dietary guidelines, yet no systematic review exists regarding how they were related to obesity. We searched research articles published between 2000 and 2021 in PubMed, CINAHL, and Scopus databases. Both cross-sectional and prospective studies that examined the relationship between a diet quality score and weight, body mass index, obesity, or waist circumference conducted in a Chinese population were selected. From the 602 articles searched, …

Health Promotion Within High-Risk Communities: Become An Agent Of Change To Enhance Vaccination Acceptance In Communities, Natalie A. Fischetti Dr., Susan Mee Dr.

Open Educational Resources

This is a course of six self-paced modules for nursing students to learn about vaccines, vaccine safety and patient education regarding vaccines.

Addressing Structural Racism In The Health Workforce, Randl B. Dent, Anushree Vichare, Jaileessa Casimir

Publications and Research

One of the greatest challenges facing the United States are health inequities among racial/ethnic and other marginalized populations. The deep-rooted structural racism embedded in our social systems, including our health care system and health workforce, is a core cause of racial health inequities. 1 Among many definitions of institutionalized or structural racism, Dr Jones 2 best defines it as: “Differential access to goods, services and opportunities of society by race ... It is structural, having been codified in our institutions of custom, practice, and law, so there need not be an identifiable perpetrator.” Dr Jones further explains that to set …

Urgent Need For Integrated Pandemic Policies On Pathogen Spillover, Pallavi A. Kache, Sonila Cook, Nigel Sizer, Lee Hannah, Neil M. Vora

Publications and Research

No abstract provided.

Who Needs To Be “Burned-Out”? Time For A New Approach To Job-Related Distress, Renzo Bianchi, Irvin Sam Schonfeld

Publications and Research

Burnout is a popular indicator of job-related distress, notably in research on the ill-being of medical professionals. The burnout construct is, however, plagued by definitional and measurement problems. Often unnoticed, these problems undermine findings and conclusions emanating from burnout research. The definitional and measurement problems affecting the burnout construct hamper knowledge growth, waste resources, and impede our ability to make informed decisions and take effective action to support personnel. It is time for occupational health specialists to abandon the idea of burnout and focus on occupational depression.

Shifting Taxonomies In Home Care Nursing Information Behavior: Patients, Pandemic, Community, Richard P. Smiraglia, Edmund Pajarillo, Elizabeth Milonas, Sergey Zherebchevsky

Publications and Research

IKOS has continued to monitor the nursing information behavior (NIB) of home care nurses. In earlier reports we described how we developed an online taxonomy of NIB. We then took on a qualitative analysis of video representations of home care nursing in the pandemic. Merging the codes from two rounds of open coding yielded a set of categories (or axes) that could be used to construct a narrative analysis. Contextual quotations from the video transcripts further reveal the intensity of the potential taxonomic extension. The importance of this research for knowledge organization is the understanding we develop concerning shifting taxonomies …

Effectiveness And Safety Of Apixaban Versus Warfarin Among Older Patients With Venous Thromboembolism With Different Demographics And Socioeconomic Status, Alexander T. Cohen, Janvi Sah, Amol Dhamane, Theodore Lee, Lisa Rosenblatt, Patrick Hlavacek, Birol Emir, Allison V. Keshishian, Huseyin Yuce, Xuemei Luo

Publications and Research

Introduction

Impact of demographics and socioeconomic status (SES) on anticoagulant treatment outcomes among patients with venous thromboembolism (VTE) is not well understood. This study evaluated risks of recurrent VTE, major bleeding (MB), and clinically relevant non-major bleeding (CRNMB) among older patients with VTE initiating apixaban or warfarin stratified by demographics and SES.

Methods

Adult patients (≥ 65 years) who initiated apixaban or warfarin after a VTE event were selected from the US CMS Medicare database (September 2014–December 2017). Stabilized inverse probability treatment weighting (IPTW) was used to balance patient characteristics between treatment cohorts. Patients were stratified by age, gender, race, …

Intergenerational Differences In Dietary Acculturation Among Ghanaian Immigrants Living In New York City: A Qualitative Study, Margrethe F. Horlyck-Romanovsky, Terry T.-K Huang, Ramatu Ahmed, Sandra E. Echeverria, Katarzyna Wyka, May May Leung, Anne E. Sumner, Melissa Fuster

Publications and Research

Dietary acculturation may explain the increasing risk of diet-related diseases among African immigrants in the United States (US). We interviewed twenty-five Ghanaian immigrants (Youth n 13, Age (Mean ± SD) 20 y±5⋅4, Parents (n 6) and Grandparents (n 6) age 58⋅7± 9⋅7) living in New York City (NYC) to (a) understand how cultural practices and the acculturation experience influence dietary patterns of Ghanaian immigrants and (b) identify intergenerational differences in dietary acculturation among Ghanaian youth, parents and grandparents. Dietary acculturation began in Ghana, continued in NYC and was perceived as a positive process. At the interpersonal level, parents encouraged youth …

Leveraging High-Resolution 7-Tesla Mri To Derive Quantitative Metrics For The Trigeminal Nerve And Subnuclei Of Limbic Structures In Trigeminal Neuralgia, Judy Alper, Alan C. Seifert, Gaurav Verma, Kuang-Han Huang, Yael Jacob, Ameen Al Qadi, John W. Rutland, Sheetal Patel, Joshua Bederson, Raj K. Shrivastava, Bradley N. Delman, Priti Balchandani

Publications and Research

Background: Trigeminal Neuralgia (TN) is a chronic neurological disease that is strongly associated with neurovascular compression (NVC) of the trigeminal nerve near its root entry zone. The trigeminal nerve at the site of NVC has been extensively studied but limbic structures that are potentially involved in TN have not been adequately characterized. Specifically, the hippocampus is a stress-sensitive region which may be structurally impacted by chronic TN pain. As the center of the emotion-related network, the amygdala is closely related to stress regulation and may be associated with TN pain as well. The thalamus, which is involved in the trigeminal …

Editorial: Pathogens, Pathobionts, And Autoimmunity, Linda A. Spatz, Gregg J. Silverman, Judith A. James

Publications and Research

No abstract provided.

Aurora Kinase A Inhibition Reverses The Warburg Effect And Elicits Unique Metabolic Vulnerabilities In Glioblastoma, Trang T. T. Nguyen, Enyuan Shang, Chang Shu, Sungsoo Kim, Angeliki Mela, Nelson Humala, Aayushi Mahajan, Hee Won Yang, Hasan Orhan Akman, Catarina M. Quinzii, Guoan Zhang, Mike-Andrew Westhoff, Georg Karpel-Massler, Jeffrey N. Bruce, Peter Canoll, Markus D. Siegelin

Publications and Research

Aurora kinase A (AURKA) has emerged as a drug target for glioblastoma (GBM). However, resistance to therapy remains a critical issue. By integration of transcriptome, chromatin immunoprecipitation sequencing (CHIP-seq), Assay for Transposase-Accessible Chromatin sequencing (ATAC-seq), proteomic and metabolite screening followed by carbon tracing and extracellular flux analyses we show that genetic and pharmacological AURKA inhibition elicits metabolic reprogramming mediated by inhibition of MYC targets and concomitant activation of Peroxisome Proliferator Activated Receptor Alpha (PPARA) signaling. While glycolysis is suppressed by AURKA inhibition, we note an increase in the oxygen consumption rate fueled by enhanced fatty acid oxidation (FAO), which was …

Acoustic Changes Following Clear Speech Intervention, Polina Shuminsky

Dissertations, Theses, and Capstone Projects

Studies have shown that the speech perception of individuals with hearing loss and other perceptual difficulties improves when talkers deliberately use clear speech. Several investigations have reported increased recognition scores of 11 to 34 percentage points for various listener groups in response to naturally produced clear speech. Studies show that clear speech production is highly variable across talkers. Therefore, a consistent method of eliciting clear speech that leads to more unified and consistent production outcomes is needed. Limited evidence suggests that a training program on how to speak clearly may yield greater listener benefit than clear speech produced naturally. The …

Synthesis, Characterization And Applications Of Peptide-Coated Nanoparticles, Mina Sadat Poursharifi

Dissertations, Theses, and Capstone Projects

Ovarian Cancer (OC) is the most lethal female malignancy worldwide, mainly due to its high recurrence rate and poor diagnosis. Most patients present with late stage of the disease, and less than 25% of patients survive the five years mark. Nanotherapy provides significant and unique benefits for drug efficacy, as nanoparticles (NPs) can increase the solubility, bioavailability, and permeability of many potent drugs. Poly(lactic-co-glycolic acid) (PLGA) is one of the most successful biodegradable polymers used in NPs formulations, mainly due to its biocompatibility and biodegradability. Polyethylene glycol (PEG) is one of the most commonly used moieties to prolong the NPs …

Intent To Stay, Moral Distress, And Nurse Practice Environment Among Long-Term Care Nurses, Amil Tan

Dissertations, Theses, and Capstone Projects

Background: Many long-term care facilities in the United States face significant problems with nurse retention and turnover. These challenges are attributed at least in part to moral distress and a negative nurse practice environment. Licensed nurses working in long-term care facilities experience ethical challenges such as lack of resources, use of restraints, end-of-life issues, and caring for residents with dementia that, if not resolved, can lead to moral distress- especially if left unresolved. Long-term care administrators and nurse managers increasingly strive to improve leadership support for long-term care staff that will positively affect the nurse practice environment.

Aim/Purpose: The purpose …

The Association Of Demographics, Social And Personal/Family Characteristics With Treatment Utilization Among Young Adults With Opioid Use Disorder In The United States, Marva L. Frederick

Dissertations, Theses, and Capstone Projects

Background

Opioid use disorder is a life-threatening medical condition and an ongoing public health problem in the United States. Treatment is necessary to combat opioid use disorder and to minimize the health-associated problems. Opioid use disorder is treatable with life-extending medications. Studies that examined treatment utilization among young adults with opioid use disorder in the United States was scarce. This study investigated the characteristics posited in the Andersen Behavioral Model of health utilization which may be associated with treatment utilization, among young adults with opioid use disorder in the United States. The urgency posed by the continuing opioid crisis in …

Molecular Dynamics Simulations Of Self-Assemblies In Nature And Nanotechnology, Phu Khanh Tang

Dissertations, Theses, and Capstone Projects

Nature usually divides complex systems into smaller building blocks specializing in a few tasks since one entity cannot achieve everything. Therefore, self-assembly is a robust tool exploited by Nature to build hierarchical systems that accomplish unique functions. The cell membrane distinguishes itself as an example of Nature’s self-assembly, defining and protecting the cell. By mimicking Nature’s designs using synthetically designed self-assemblies, researchers with advanced nanotechnological comprehension can manipulate these synthetic self-assemblies to improve many aspects of modern medicine and materials science. Understanding the competing underlying molecular interactions in self-assembly is always of interest to the academic scientific community and industry. …

A Randomized Controlled Trial Of Psychological Outcomes Of Mobile Guided Resonant Frequency Breathing In Young Adults With Elevated Stress During The Covid-19 Pandemic, Al Amira Safa Shehab

Dissertations, Theses, and Capstone Projects

Deep breathing practices have shown promise in reducing stress, anxiety, and depression in different populations, including young adults. Specifically, resonant frequency breathing can exert an impact on stress response systems through the vagus nerve and the hypothalamo-pituitary-adrenal (HPA) axis. This may induce reductions in stress and improvement in emotion regulation. Young adults, including college students, tend to be at a higher risk for psychological distress, as they face several psychosocial challenges. The COVID-19 pandemic has imposed new and unique stressors that resulted in higher levels of stress and emotional symptoms and it has been shown that this may have placed …

Informed Consent: Foundations And Applications, Joanna Smolenski

Dissertations, Theses, and Capstone Projects

Since its advent in the 20th century, informed consent has become a cornerstone of ethical healthcare, and obtaining it a core obligation in medical contexts. In my dissertation, I aim to examine the theoretical underpinnings of informed consent and identify what values it is taken to protect. I will suggest that the fundamental motivation behind informed consent rests in something I’ll call bodily self-sovereignty, which I argue involves a coupling of two groups of values: autonomy and non-domination on the one hand, and self-ownership and personal integrity on the other. I will then go on to consider two 'case …

Health-Illness Transition Experiences Among Patients With Pancreatic Cancer, Jessica Goldberg

Dissertations, Theses, and Capstone Projects

Pancreatic cancer is one of the most commonly diagnosed cancers and is associated with a poor prognosis measured in terms of months and with significant palliative care needs, including psychological distress. Self-management describes a patient’s ability to manage the sequelae of serious illness, which can have an impact on quality of life and psychological health. One of the fundamental self-management skills is the management of transitions. A transition is a change in life situation or status that causes a shift in a patient’s identity, role, behavior, or interpersonal relationships. Patients with cancer experience multiple, often overlapping transitions that can influence …

Food Restriction And Body Image Distortion In Pregnant Mothers: Outcomes For Exposed Children, Kathryn M. Dana

Dissertations, Theses, and Capstone Projects

Background: Developmental trajectories in the growing child do not originate at birth. Rather, critical periods may exist in pregnancy, during which the determinants of malnutrition are especially vulnerable to the effects of stress and other complications. Prenatal malnutrition has been consistently associated with negative consequences for the growth, development, and overall physical and mental health of affected offspring in both human and animal models. While most available literature on human prenatal malnutrition comes from famine research, there is some evidence that restrictive eating disorders in pregnant women may be associated with similar outcomes.

Hypotheses: We hypothesize that prenatal exposure to …

School-Based Sex Education In The United States And Its Association With Sexual And Reproductive Health Outcomes, 2000-2020, Priscilla M. Lopez

Dissertations and Theses

Background: There are significant sexual and reproductive health disparities in the United States (US). A significant proportion of sexual health disparities among adolescents is likely due in-part to inadequate school-based sex education. Sex education encourages sustainable and informed sexual behavior and has the potential reach adolescents prior to sexual debut and throughout the years at highest risk for adverse sexual health outcomes. However, the way in which sex education is defined and operationalized, as described in the literature, varies substantially, which may lead to wide variation in implementation in schools and this might explain the disparities seen. State-level sex …