Medicine and Health Sciences Commons^™

Evaluating Indoor Air Phthalates And Volatile Organic Compounds In Nail Salons In The Greater New York City Area: A Pilot Study, Inkyu Han, Jin Young Seo, Dana Boyd Barr, Parinya Panuwet, Volha Yakimavets, Priya Esilda D'Souza, Heyreoun An-Han, Masoud Afshar, Ying-Yu Chao

Publications and Research

The Greater New York City area ranks highest in the United States in the number of nail salon technicians, primarily Asian immigrant women. Nail salon technicians are exposed to toxic phthalates and volatile organic compounds daily in nail salons. The purpose of this pilot study was to measure a mixture of phthalates and volatile organic compounds in nail salons in the Greater New York City area, and to characterize work-related determinants of indoor air quality in these nail salons. Working with four Asian nail salon organizations in the Greater New York City area, we measured indoor air phthalates and volatile …

Effectiveness And Safety Of Apixaban Vs Warfarin Among Venous Thromboembolism Patients At High-Risk Of Bleeding, Alexander T. Cohen, Janvi Sah, A. D. Dhamane, Theodore Lee, Lisa Rosenblatt, Patrick Hlavacek, Birol Emir, Allison V. Keshishian, Huseyin Yuce, Xuemei Luo

Publications and Research

This study evaluated effectiveness and safety of apixaban versus warfarin among venous thromboembolism patients at high-risk of bleeding (defined as having at least one of the following bleeding risk factors: ≥75 years; used antiplatelet, NSAIDs, or corticosteroids; had prior gastrointestinal bleeding or gastrointestinal-related conditions; late stage chronic kidney disease). Adult venous thromboembolism patients initiating apixaban or warfarin with ≥1 bleeding risk factor were identified from Medicare and four commercial claims databases in the United States. To balance characteristics between apixaban and warfarin patients, stabilized inverse probability treatment weighting was conducted. Cox proportional hazards models were used to estimate the risk …

Antidepressant Effect Of Ketamine On Inflammation-Mediated Cytokine Dysregulation In Adults With Treatment-Resistant Depression: Rapid Systematic Review, Shiryn D. Sukhram, Grozdena Yilmaz, Jianying Gu

Publications and Research

Background. Major depressive disorder (MDD) and treatment-resistant depression (TRD) represent a global source of societal and health burden. To advise proper management of inflammation-related depression among TRD patients, it is important to identify therapeutic clinical treatments. A key factor is related to proinflammatory cytokines such as interleukin- (IL-) 1β, IL-6, and tumor necrosis factor- (TNF-) α which have been implicated in the pathogenesis of depressive symptoms in MDD patients. Ketamine may provide an anti-inflammatory therapeutic strategy by targeting proinflammatory pathways associated with depressive disorders, which may be exacerbated in the ageing population with TRD.

Objective. Despite a burgeoning body of …

Novel Technologies To Characterize And Engineer The Microbiome In Inflammatory Bowel Disease, Alba Boix-Amorós, Hilarly Monaco, Elisa Sambataro, Jose C. Clemente

Publications and Research

We present an overview of recent experimental and computational advances in technology used to characterize the microbiome, with a focus on how these developments improve our understanding of inflammatory bowel disease (IBD). Specifically, we present studies that make use of flow cytometry and metabolomics assays to provide a functional characterization of microbial communities. We also describe computational methods for strain-level resolution, temporal series, myco - biome and virome data, co-occurrence networks, and compositional data analysis. In addition, we review novel techniques to therapeutically manipulate the microbiome in IBD. We discuss the benefits and drawbacks of these technologies to increase awareness …

Effect Of Body Mass Index, Testosterone, And Insulin On Breast Cancer: A Mendelian Randomization Study And Investigation Of Selection Bias, Kezhen Fei

Dissertations and Theses

BACKGROUND: Female breast cancer is the most studied cancer, and the second leading cause of cancer death in women, whose aetiology is still not completely clear. The parallel increase of incident obesity and breast cancer in women worldwide raises the question of the role of adiposity, measured by body mass index (BMI), and of major anabolic hormones, such as insulin and testosterone, on breast cancer. Observational studies are open to confounding making it difficult to clearly demonstrate causal effects. Several mendelian randomization (MR) studies have shown inverse association of BMI with breast cancer. To assess selection bias in MR …

Toward Informatics-Enabled Preparedness For Natural Hazards To Minimize Health Impacts Of Climate Change, Jimmy Phuong, Naomi O. Riches, Luca Calzoni, Gora Datta, Deborah Duran, Asiyah Yu Lin, Ramesh P. Singh, Anthony E. Solomonides, Noreen Y. Whysel, Ramakanth Kavuluru

Publications and Research

Natural hazards (NHs) associated with climate change have been increasing in frequency and intensity. These acute events impact humans both directly and through their effects on social and environmental determinants of health. Rather than relying on a fully reactive incident response disposition, it is crucial to ramp up preparedness initiatives for worsening case scenarios. In this perspective, we review the landscape of NH effects for human health and explore the potential of health informatics to address associated challenges, specifically from a preparedness angle. We outline important components in a health informatics agenda for hazard preparedness involving hazard-disease associations, social determinants …

Burned-Out With Burnout? Insights From Historical Analysis, Renzo Bianchi, Katarzyna Wac, James Francis Sowden, Irvin Sam Schonfeld

Publications and Research

Fierce debates surround the conceptualization and measurement of job-related distress in occupational health science. The use of burnout as an index of job-related distress, though commonplace, has increasingly been called into question. In this paper, we first highlight foundational problems that undermine the burnout construct and its legacy measure, the Maslach Burnout Inventory (MBI). Next, we report on advances in research on job-related distress that depart from the use of the burnout construct. Tracing the genesis of the burnout construct, we observe that (a) burnout’s definition was preestablished rather than derived from a rigorous research process and (b) the MBI …

Activity Measure For Post-Acute Care “ 6-Clicks ” Basic Mobility Scores Predict Discharge Destination After Acute Care Hospitalization In Select Patient Groups: A Retrospective, Observational Study, Burke Rehabilitation Hospital, Divya Rajaraman, Sarah Taylor, Kirollos Agayaby, Suzanne Babyar

Publications and Research

Objectives

To establish cutoff scores for the Activity Measure for Post-Acute Care “6-Clicks” standardized Basic Mobility scores (sBMSs) for predicting discharge destination after acute care hospitalization for diagnostic subgroups within an acute care population and to evaluate the need for a second score to improve predictive ability.

Design

Retrospective, observational design.

Setting

Major medical center in metropolitan area.

Participants

Electronic medical records of 1696 adult patients (>18 years) admitted to acute care from January to October 2018. Records were stratified by orthopedic, cardiac, pulmonary, stroke, and other neurological diagnoses (N=1696). Interventions: None

Main Outcome Measure

Physical therapists scored patients’ …

The Storytelling Cure: Medicine And Narrative From Galen To Shahrazad And Rousseau, Ryan A. Milov-Cordoba

Dissertations, Theses, and Capstone Projects

Are stories healing? This dissertation introduces and explores an idea that I call “the storytelling cure.” With this term I capture a set of related notions about the healing power of stories that span literary studies, intellectual history, philosophy, and medical practice. Through a comparative study I make the case for “the storytelling cure” as a cross-cultural, multiconfessional, and multilingual phenomenon of great age, complexity, and power, worthy of the most sustained attention by the contemporary field of Comparative Literature. Concretely, this dissertation presents three extended case studies of “storytelling cures” from three different kinds of texts (case history, frame …

The Differential Effects Of Acoustic Discriminations On Operant Learning Performance And Neurogenesis In Male And Female Zebra Finches, Kristena L. Newman

Dissertations, Theses, and Capstone Projects

Adult neurogenesis, the creation of new neurons, occurs throughout the lifespan in most organisms. However, though neuronal proliferation occurs daily, most of these neurons do not survive to become incorporated into preexisting neural circuitry and become fully functioning neurons. In the mammalian brain, adult neurogenesis occurs within the hippocampus, a brain region known to be important in learning and memory. In rats, successful acquisition of certain learning tasks increased new neuron numbers when the learning was sufficiently challenging (Curlik and Shors, 2011). It has also been demonstrated that a spatial discrimination task requires new neurons when the discrimination is more …

Biomarker, Treatment, And Socio-Demographic Factors Affecting Opioid Use Disorder Treatment Retention, Fernand A. De Los Reyes

Dissertations, Theses, and Capstone Projects

ABSTRACT

Biomarker, Treatment, and Socio-Demographic Factors

Affecting Opioid Use Disorder Treatment Retention

by

Fernand A. De Los Reyes

Advisor: Martha Velasco-Whetsell

Increasing mortality from opioid overdose and low treatment engagement are significant public health concerns. Along with increasing health care and criminal justice enforcement costs, there is an urgent need to study the factors associated with treatment retention in opioid use disorder. The study investigated the relative impact of the biomarker cholesterol on treatment retention in an opioid treatment program (OTP) clinic. Further, it examined the medical comorbidities, treatment, and socio-demographic variables that impact opioid use disorder treatment retention. This …

Prenatal Choline Supplementation During Maternal Obesity Alters Offspring Response To Western Diets, Hunter W. Korsmo

Dissertations, Theses, and Capstone Projects

Maternal obesity has led to an increase in adverse offspring developmental outcomes and a greater risk for long-term metabolic diseases. Choline, a semi-essential nutrient, can be incorporated into phosphatidylcholine (PC) as well as sphingomyelin (SM) and donate its labile methyl group for the remethylation of homocysteine after choline is oxidized to betaine. Prenatal choline insufficiency has been related to maternal obesity and metabolic diseases, such as metabolic associated fatty liver disease (MAFLD). Choline may interact with maternal obesity to influence the programming offspring.

Chapter 1 presents an introduction of choline and the various clinical outcomes associated with choline supplementation during …

A Survey Study Of Speech-Language Therapists’ Experiences With Teletherapy At The Onset Of The Covid-19 Crisis, Jason A. Rosas

Dissertations, Theses, and Capstone Projects

The present study aimed to understand how delivering pediatric treatment services via ‘teletherapy’ affected speech-language therapists (SLTs) during the initial outbreak of the COVID-19 pandemic crisis in 2020. SLTs reported on their experiences with the change from in-person to remote service delivery via two national surveys distributed at the start of the pandemic between April 2020 and July 2020. To explain SLTs’ survey responses, this dissertation introduced the Professional Adaptation Model (PA Model). The PA Model facilitated evaluation of the SLTs’ professional environment and the psychological constructs of their professional identity believed to influence the transition to speech-language teletherapy. Specifically, …

The Impossible Situation? Impasse As Psychotherapeutic Paralysis, Possibility, And Progress, Leo Cancelmo

Dissertations, Theses, and Capstone Projects

Psychotherapeutic impasse has long been understood in the clinical literature as treatment stagnation and even failure, both from one-person and two-person psychodynamic perspectives. However, there is a dearth of empirical research that delves deeper to understand this complex and rich phenomenon. Using semi-structured interviews with nine psychodynamic therapists speaking about individual adult patients, this study examined experiences of impasse to better understand treatments that become embroiled in a kind of paralysis. Qualitative analyses revealed dyads where patients were conceptualized as struggling chronically with negative feelings about themselves and others, and who experienced traumatic personal histories. Impasse in and of itself …

Efficacy, Acceptance, And Feasibility Of Virtual Reality For Chronic Pain Relief In Older Adult Veterans Residing In Long Term Care, Valicia Philibert

Dissertations, Theses, and Capstone Projects

Older adults residing in Long-Term Care (LTC) have a high prevalence of chronic pain. Pain management strategies have primarily focused on pharmacological approaches, but with physiological changes associated with aging, this population is at an increased risk for adverse effects from prescribed medications. More research is needed on innovative non-pharmacological interventions in the LTC setting. This study examined the feasibility, acceptance, and preliminary efficacy of Virtual Reality (VR) for chronic pain among older adult veterans in LTC. In this quasi-experimental, 12 older adult participants living with chronic pain in a long-term care facility received two sessions of VR. Pain intensity …

Neuroanatomy In Mild Cognitive Impairment: Relationship To Functional Skills, Treatment Expectancy, And Comorbid Depression, Sara Rushia

Dissertations, Theses, and Capstone Projects

Mild cognitive impairment (MCI) is a neurocognitive disorder defined by cognitive decline in older adults. Although MCI has been studied for decades, there remain important areas to be explored in order to adequately characterize aspects of this disorder that provide information valuable for possible interventions and disease progression to dementia, including a better understanding of the neuroanatomical variables relevant to this disorder. Such neuroanatomical variables include cortical thickness, hippocampal volume, and white matter hyperintensities (WMHs). This dissertation consists of three separate studies aimed at addressing gaps in the literature on MCI in relation to brain morphometrics and under-studied characteristics involved …

Effects Of Telesimulation On The Health Literacy Knowledge, Confidence And Application Of Nursing Students, Susan Patton

Dissertations, Theses, and Capstone Projects

Background: Assessing and addressing health literacy (HL) in patients is an essential role of the nurse and a critical component of nursing student education. Yet, large gaps exist within nursing school curricula with regard to the development of HL knowledge and skills, and the confidence to implement practices that target HL. Furthermore, effective training modalities that examine the transformation of nursing students’ knowledge into practice through the development of confidence during experiential learning have not been well explored.

Purpose: Evaluate the effectiveness of a HL information and a HL telesimulation intervention on the HL Knowledge, Application and Confidence of first-semester …

A Polypharmacological Approach To Relapse Prevention In An Animal Model Of Heroin Addiction, Scott T. Ewing

Dissertations, Theses, and Capstone Projects

Chemical compounds that target dopamine (DA) D1 or D3 receptors have shown promise as potential interventions in animal models of cue-induced relapse. However, undesirable side effects or pharmacodynamic profiles have limited the advancement of new compounds in preclinical studies when administered as independent treatments. In this series of experiments, we explored the effects of co-administration of a D1-recepter partial agonist (SKF 77434) and a D3-receptor antagonist (NGB 2904) in heroin-seeking rats within a ‘conflict’ model of abstinence and cue-induced relapse. Rats were first trained to press a lever to self-administer heroin and drug delivery was paired contingently with cues (e.g., …

Role Of The G Protein Beta Gamma Subunits In Serotonin Transporter Dynamics, Nora Awadallah

Dissertations, Theses, and Capstone Projects

Serotonin is a vital neurotransmitter and hormone with significant roles in almost every organ system. In the central nervous system, serotonin mediates physiological functions that in turn guide behavior and mood. Here, serotonin is released from serotonergic neurons and exerts its effects through serotonin receptors. Regulation of serotonin neurotransmission is important for the maintenance of its physiological functions; thus, extracellular serotonin must be sequestered to limit the intensity and duration of serotonin transmission. Disproportionate transmission is strongly linked with neurological and psychiatric ailments.

Extracellular serotonin levels are primarily mediated by the serotonin transporter (SERT), a critically important plasma membrane protein …

Risk Levels And Adverse Clinical Outcomes Among Patients With Nonvalvular Atrial Fibrillation Receiving Oral Anticoagulants, Gregory Lip, Richard R. Murphy, Farhad Sahiar, Timothy J. Ingall, Amol Dhamane, Mauricio Ferri, Patrick Hlavacek, Madison T. Preib, Allison V. Keshishian, Cristina Russ, Lisa Rosenblatt, Huseyin Yuce, Steve Deitelzweig

Publications and Research

Importance The CHA₂DS₂-VASc score (calculated as congestive heart failure, hypertension, age 75 years and older, diabetes, stroke or TIA, vascular disease, age 65 to 74 years, and sex category) is the standard for assessing risk of stroke and systemic embolism and includes age and thromboembolic history. To our knowledge, no studies have comprehensively evaluated safety and effectiveness outcomes among patients with nonvalvular atrial fibrillation receiving oral anticoagulants according to independent, categorical risk strata.

Objective To evaluate the incidence of key adverse outcomes among patients with nonvalvular atrial fibrillation receiving oral anticoagulants by CHA₂DS_{2 …}

Development And Modification Of A Culturally Tailored Education Program To Prevent Breast Cancer In Korean Immigrant Women In New York City, Jin Young Seo, So-Hyun Park, Sung-Eun Choi, Minkyung Lee, Shiela M. Strauss

Publications and Research

Breast cancer (BC) is the most common cancer in Korean American (KA) women. In view of its high prevalence in these women, their low screening rates, and the cultural influence of BC risk factors in their lifestyles, we developed a community-based culturally tailored BC prevention program, the Korean Breast Cancer Risk Reduction Program (KBCRRP). Guided by the PRECEDE-PROCEDE and health belief models, the KBCRRP was developed to achieve four goals: (1) healthy weight, (2) physically active lifestyle, (3) healthy diet, and (4) BC screening and adherence. KBCRRP combines effective multicomponent strategies for BC screening and a group-based lifestyle intervention incorporating …

Lgbtq+ And Dental Education: Analyzing The Present And Recommendations For The Future, Diana V. Macri, Colin Haley Dds, Herminio Perez Dmd, Scott Schwartz Dds

Publications and Research

LGBTQ+ populations constitute increasing proportions of children, adolescents, and adults in the United States. Compared to their heterosexual counterparts, this group suffers from health inequities, including oral health. The report “Oral Health: Advances and Challenges” identified the LGBTQ+ community as an underserved population which faces significant barriers in accessing oral health care. Coverage of LGBTQ+ topics in formal education settings in both dental schools and dental hygiene programs is scarce, which contributes to inequities within this group. Increasing curriculum content related to LGBTQ+ populations is of utmost importance to promote optimal patient-provider interactions while improving oral health outcomes. Ensuring equity …

Recognizing And Disrupting Stigma In Implementation Of Hiv Prevention And Care: A Call To Research And Action, Sarit A. Golub, Rachel A. Fikslin

Publications and Research

Introduction: There is robust evidence that stigma negatively impacts both people living with HIV and those who might benefit from HIV prevention interventions. Within healthcare settings, research on HIV stigma has focused on intra-personal processes (i.e. knowledge or internalization of community-level stigma that might limit clients’ engagement in care) or inter-personal processes (i.e. stigmatized interactions with service providers). Intersectional approaches to stigma call us to examine the ways that intersecting systems of power and oppression produce stigma not only at the individual and interpersonal levels, but also within healthcare service delivery systems. This commentary argues for the importance of analysing …

Oral Anticoagulant Underutilization Among Elderly Patients With Atrial Fibrillation: Insights From The United States Medicare Database, Muhammad Bilal Munir, Patrick Hlavacek, Allison V. Keshishian, Jennifer D. Guo, Rajesh Mallampati, Mauricio Ferri, Cristina Russ, Birol Emir, Matthew Cato, Huseyin Yuce, Jonathan C. Hsu

Publications and Research

Background

Oral anticoagulants (OACs) mitigate stroke risk in patients with atrial fibrillation (AF). The study aim was to analyze prevalence and predictors of OAC underutilization.

Methods

Newly diagnosed AF patients with a CHA2DS2-VASc score ≥ 2 were identified from the US CMS Database (January 1, 2013–December 31, 2017). Patients were stratified based on having an OAC prescription versus not and the OAC prescription group was stratified by direct OAC (DOACs) versus warfarin. Multivariable logistic regression models were used to examine predictors of OAC underutilization.

Results

Among 1,204,507 identified AF patients, 617,611 patients (51.3%) were not prescribed an OAC during follow-up …

Community Engagement Education In Academic Health Centers, Colleges, And Universities, Chyke A. Doubeni, David Nelson, Elizabeth Gross Cohn, Electra Paskett, Seleshi Ayalew Asfaw, Mehek Sumar, Syed M. Ahmed, Rhonda Mcclinton-Brown, Mark L. Wieland, Anita Kinney, Sergio Aguilar-Gaxiola, Lisa G. Rosas, Cecilia M. Patino

Publications and Research

Community engagement (CE) is critical for advancing health equity and a key approach for promoting inclusive clinical and translational science. However, it requires a workforce trained to effectively design, implement, and evaluate health promotion and improvement strategies through meaningful collaboration with community members. This paper presents an approach for designing CE curricula for research, education, clinical care, and public health learners. A general pedagogical framework is presented to support curriculum development with the inclusion of community members as facilitators or faculty. The overall goal of the curriculum is envisioned as enabling learners to effectively demonstrate the principles of CE in …

Developing Standards For Cultural Competency Training For Health Care Providers To Care For Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, And Asexual Persons: Consensus Recommendations From A National Panel, Mandi L. Pratt-Chapman, Kristen Eckstrand, Amorie Robinson, Lauren B. Beach, Charles Kamen, Alex S. Keuroghlian, Scott Cook, Asa Radix, Markus P. Bidell, Daniel Bruner, Liz Margolies

Publications and Research

Purpose: Lesbian, gay, bisexual, transgender, queer, intersex, and/or asexual and other sexual and gender diverse persons (LGBTQIA + or SGD persons) experience barriers to equitable health care. The purpose of this article is to describe a collaborative process that resulted in core cultural competency recommendations addressing training for those who provide health care and/or social services to LGBTQIA + patients.

Methods: In 2018 and 2019, Whitman-Walker Health, a Federally Qualified Community Health Center in Washing- ton, DC, and the National LGBT Cancer Network purposively selected leaders of community clinics and community-based organizations, cultural competency trainers, and clinicians and researchers with …

Precision Dentistry In Practice, Diana V. Macri

Publications and Research

A paradigm shift is necessary to improve healthcare delivery and outcomes. Precision medicine and precision dentistry may be able to shift the burden of disease and improve the nation’s oral and overall health.

Cmv-Responsive Cd4 T Cells Have A Stable Cytotoxic Phenotype Over The First Year Post-Transplant In Patients Without Evidence Of Cmv Viremia, Lauren E. Higdon, Ayah A. Amad, Steven Schaffert, Kenneth B. Margulies, Jonathan S. Maltzman

Publications and Research

Cytomegalovirus (CMV) infection is a known cause of morbidity and mortality in solid organ transplant recipients. While primary infection is controlled by a healthy immune system, CMV is never eradicated due to viral latency and periodic reactivation. Transplantation and associated therapies hinder immune surveillance of CMV. CD4 T cells are an important part of control of CMV reactivation. We therefore investigated how CMV impacts differentiation, functionality, and expansion of protective CD4 T cells from recipients of heart or kidney transplant in the fi rst year post-transplant without evidence of CMV viremia. We analyzed longitudinal peripheral blood samples by flow cytometry …

Student Self-Grading Form, Brett Whysel

Open Educational Resources

This is a word document that students use at the beginning, midpoint, and end of a semester to set relevant goals, measure progress towards goals, and self-grade. It is intended to build motivation, metacognition, and accountability. Instructors may use it on its own or to supplement other assessment tools, and improve the accuracy, validity, and fairness of final grades.

Impact Of The Covid-19 Pandemic On The Care Continuum Of Youth Living With Hiv: Qualitative Study Of The Scale It Up Program Clinical Sites, Tyra Dark, Sitaji Gurung, Mary Dooley, Kit N. Simpson, Seyram A. Butame, Sylvie Naar

Publications and Research

The study objective was to explore the impact of COVID-19 pandemic restrictions on the clinics’ ability to provide continuous healthcare services to youth (15–24 years) living with HIV (YLWH). One focused semi-structured interview was conducted with each HIV clinic site—resulting in ten interviews. Data were analyzed using thematic analysis techniques assisted by NVIVO coding software and themes indicating barriers and facilitators to providing uninterrupted healthcare were elicited. Six themes were identified that affected the care continuum of YLWH: Timeframe of clinic preparation to address COVID-19 restrictions; impact on treatment cascade monitoring data; impact on patient care; impact on staff and …