Medicine and Health Sciences Commons^™

Icd-10 In The United States: Better Late Than Never, Holly Johns, Cara Havens, Danielle Robinson, Bala S. Pothakamuri, David P. Paul Iii, Alberto Coustasse

Management Faculty Research

The United States faces a revolution in the healthcare system soon, when the present coding system (ICD-9) will be replaced with what has for some years been the international standard: ICD-10. ICD-10 will provide a tremendous opportunity for better capturing the information in the increasingly complex delivery of healthcare. Although the transition to ICD-10 will undoubtedly result in substantial short-term costs, the long term benefits make the transition imperative.

Medical Tourism And International Healthcare Options, David Conley, Andrew Sikula Sr., William Willis, Alberto Coustasse

Management Faculty Research

Medical tourism has evolved from traveling to the United States (U.S.) and a select few other countries, such as India and Thailand, to a global trend in affordable alternative healthcare. Medical tourism in the U.S. and in other countries has evolved because of cost and lengthy waiting periods. Some insurance companies are marketing kidney transplants and joint replacements through medical choice programs in order to save overall expense. As an economical approach to controlling rising health care costs in the U.S., medical tourism is becoming a valid alternative.

Inhibition Of Cholinergic Signaling Causes Apoptosis In Human Bronchioalveolar Carcinoma, Jamie K. Lau, Kathleen C. Brown, Brent A. Thornhill, Clayton M. Crabtree, Aaron M. Dom, Theodore R. Witte, W. Elaine Hardman, Christopher A. Mcnees, Cody A. Stover, A. Betts Carpenter, Haitao Luo, Yi C. Chen, Brandon S. Shiflett, Piyali Dasgupta

Biochemistry and Microbiology

Recent case-controlled clinical studies show that bronchioalveolar carcinomas (BAC) are correlated with smoking. Nicotine, the addictive component of cigarettes, accelerates cell proliferation through nicotinic acetylcholine receptors (nAChR). In this study, we show that human BACs produce acetylcholine (ACh) and contain several cholinergic factors including acetylcholinesterase (AChE), choline acetyltransferase (ChAT), choline transporter 1 (CHT1, SLC5A7), vesicular acetylcholine transporter (VAChT, SLC18A3), and nACh receptors (AChRs, CHRNAs). Nicotine increased the production of ACh in human BACs, and ACh acts as a growth factor for these cells. Nicotine-induced ACh production was mediated by α7-, α3β2-, and β3-nAChRs, ChAT and VAChT pathways. We observed that …

A Review Of Radio Frequency Identification Technologies And Impacts On The Hospital Supply Chain: 2002–2012, Alberto Coustasse, Shane Tomblin, Chelsea Slack

Management Faculty Research

Supply costs are the second largest expenditure in hospitals, accounting for more than one third of the average operating budget. RFID technology can reduce these costs, improve patient safety, and supply chain management by increasing the ability to track and locate equipment, as well as monitoring theft prevention, distribution management, and patient billing. Findings of this study have shown that the application of RFID on medical equipment and supplies have resulted in efficiency increase in healthcare with lower costs and increased quality services. Even though the cost of RFID implementation is decreasing, the total expenditures are still significant and the …

Cyclooxygenase-2 Dependent Metabolism Of 20-Hete Increases Adiposity And Adipocyte Enlargement In Mesenchymal Stem Cell-Derived Adipocytes, Dong Hyun Kim, Nitin Puri, Komal Sodhi, John R. Falck, Nader G. Abraham, Joseph I. Shapiro M.D., Michal L. Schwartzman

Biochemistry and Microbiology

Abstract 20-Hydroxy-5,8,11,14-eicosatetraenoic acid (20-HETE), a product of the cytochrome P450 (CYP)-catalyzed [1] -hydroxylation of arachidonic acid, induces oxidative stress and, in clinical studies, is associated with increased body mass index (BMI) and the metabolic syndrome. This study was designed to examine the effects of exogenous 20- HETE on mesenchymal stem cell (MSC)-derived adipocytes.

The expression levels of CYP4A11 and CYP4F2 (major 20-HETE synthases in humans) in MSCs decreased during adipocyte differentiation; however, exogenous administration of 20-HETE (0.1–1 M) increased adipogenesis in a dose dependent manner in these cells ( P < 0.05). The inability of a 20-HETE analog to reproduce these effects suggested the involvement of a metabolic product of 20-HETE in mediating its pro-adipogenic effects. A cyclooxygenase (COX)-1 selective inhibitor enhanced, whereas a COX-2 selective or a dual COX-1/2 inhibitor attenuated adipogenesis induced by 20-HETE. The COX-derived metabolite of 20-HETE, 20-OH-PGE 2 , enhanced adipogenesis and lipid accumulation in MSCs. The pro-adipogenic effects of 20-HETE and 20-OH-PGE 2 resulted in the increased expression of the adipogenic regulators PPAR and -catenin in MSC-derived adipocytes. Taken together we show for the fi rst time that 20-HETE-derived COX-2-dependent 20-OH-PGE 2 enhances mature infl amed adipocyte hypertrophy in MSC undergoing adipogenic differentiation. — Kim, D. H., N. Puri, K. Sodhi, J. R. Falck, N. G. Abraham, J. Shapiro, and M. L. Schwartzman. Cyclooxygenase-2 dependent metabolism of 20-HETE increasesadiposity and adipocyte enlargement in mesenchymal stem cell-derived adipocytes.

Role Of Iron In Ethanol Derived Hepatic Stress, Jesse A. Thornton

Theses, Dissertations and Capstones

Chronic alcohol abuse is the third leading cause of preventable death in the United States. Ethanol metabolism causes liver injury through alterations in hepatic metabolic state, redox status, and acetaldehyde adduct formations. Increased iron absorption is associated with chronic ethanol consumption and may play a role in ethanol induced oxidative stress. We tested the hypothesis that normal labile iron in the liver plays a role in ethanol related pathological stress, using C57/Bl6 mice pair-fed Lieber-DeCarli liquid ethanol diets for 11 and 22 weeks. Normal iron group mice received 55mg/kg iron as ferric citrate, whereas the low iron groups received 5mg/kg. …

Toxicological Effects Of Cerium Oxide Nanoparticle Aggregates On Caenorhabditis Elegans, Steven N. Rogers

Theses, Dissertations and Capstones

Assessing the toxicity and unique reactivity of nanoparticles in biological systems has become an relevant and quickly growing area of environmental toxicology research. The broad use of nanoparticles in industrial and commercial commodities results in exposure of these nano-compounds to the environment, the ecosystems, and humans. While previous data has suggested that cerium oxide (CeO₂) nanoparticles are relatively safe to cultured cells much less is known about the potential toxicity of these materials at the organismal level. In this study we employed transgenic Caenorhabditis elegans (C. elegans) strains to assess the toxicity of CeO₂ nanoparticles under “real-world” …

Perceptions Of Nursing Education Administrators Regarding The Relationship Of Admission Criteria To Student Graduation, Joy F. Cline

Theses, Dissertations and Capstones

This research investigated admission criteria of baccalaureate nursing students related to their success in a multi-state sample of peer universities in the United States. The researcher used mixed methods to collect data that were analyzed using descriptive and phenomenological approaches. The sample of the study was chairpersons from peer institutions of nursing. Data were collected based on the lived experiences of the chairpersons. The purpose of the study was to identify admission criteria that the schools in the study were using and to identify the criteria that predicted success as defined by graduation. The premise of the study was that …

Intraoperative Hyperglycemia In Adult Patients Undergoing An Emergency Craniotomy Following A Traumatic Brain Injury As A Predictor Of Postoperative Outcomes And Mortality, Sara Lynn Hoover

Theses, Dissertations and Capstones

Abstract: The purpose of this study was to determine if there was an association between intraoperative blood glucose ≥150 mg/dl in patients undergoing an emergency craniotomy and Intensive Care Unit (ICU) Length of Stay (LOS), hospital LOS and mortality.

Introduction: Traumatic Brain Injuries (TBI)’s are associated with increased morbidity and mortality. The stress response by the body may cause an increase in blood glucose levels which can cause secondary brain injury. When a patient undergoes an emergency craniotomy following a TBI the increased stress on the body can cause an even higher blood glucose. There is no consensus in …

Traumatic Brain Injury: The Relationship Of Psychosocial Variables And Location Of Injury To Post-Injury Depression, Alicia L. Smith

Theses, Dissertations and Capstones

Traumatic Brain Injury (TBI) affects nearly 1.4 million people in the United States annually, and of these, 10% to 77% will experience post-injury depression. Psychosocial variables such as previous substance and alcohol abuse, prior mental illness, low educational attainment, and poverty have been identified as possible risk factors. Additionally, the location of injury appears to play a key role particularly if the injury occurs in the left hemisphere. This study examined archival data from brain-injured patients in an effort to better understand the factors related to post-TBI depression. Past medical records of brain-injured adults (N = 52) were reviewed …

Energy Balance And Its Relationship To Disordered Eating, Injury, And Menstrual Dysfunction In Soccer Athletes, Emily Lynn Miller

Theses, Dissertations and Capstones

Purpose of the Research: The purpose of this study is to examine the causes of negative energy balance in male and female collegiate soccer players who do not exhibit disordered eating. The study also looked at the prevalence of complications associated with disordered eating, injury and menstrual dysfunction to determine if these would be present in the participants in a negative or positive energy balance regardless of disordered eating status. A questionnaire will examine participants’ disordered eating risk, and a food and activity diary will examine energy balance. A third questionnaire regarding injury and menstrual history will determine their prevalence …

Transmission Rate In Partial Differential Equation In Epidemic Models, Alaa Elkadry

Theses, Dissertations and Capstones

The rate at which susceptible individuals become infected is called the transmission rate. It is important to know this rate in order to study the spread and the effect of an infectious disease in a population. This study aims at providing an understanding of estimating the transmission rate from mathematical models representing the population dynamics of an infectious diseases using two different methods. Throughout, it is assumed that the number of infected individuals is known. In the first chapter, it includes historical background for infectious diseases and epidemic models and some terminology needed to understand the problems. Specifically, the partial …

Mike & Molly -- An Other World, Maureen Elizabeth Johnson

Theses, Dissertations and Capstones

This thesis explores the impact of the television show Mike & Molly on the modern debate related to fat in America. The thesis uses the work of Michel Foucault as well as disability scholars such as Lennard Davis and feminist scholars such as bell hooks to examine how a comedy show like Mike & Molly can further disenfranchise fat people in society. The thesis shows that fat makes people an Other in society, and television shows and other forms of comedy that mock those who are fat just reinforce that Other status.

Adequate Ventilation: How Is It Defined And Does It Adequately Warn Consumers?, Christopher Blankenship

Theses, Dissertations and Capstones

The purpose of this research was to clarify and define the term “adequate ventilation.” Upon looking at regulations, court cases, and other elements, it is clear that the term is inadequate to inform consumers and does not instruct consumers on how to achieve proper ventilation. To find out if consumers understand this, random persons were asked to define it. The answers were given a numerical value to show the knowledge trend. The outcome showed that most people do not understand how to achieve proper ventilation. Conclusion: Diagrams showing how to set up a room with ventilation and new instructions are …

Principles Of Management Of Severe Hyponatremia, Antonios H. Tzamaloukas Md, Deepak Malhorta Md, Phd, Bradley H. Rosen Do, Dominic S. C. Raj S. C. Raj Md, Glen H. Murata Md, Joseph I. Shapiro Md

Pharmaceutical Science and Research

Hyponatremia represents a serious health hazard.¹ Hospitalized patients,² nursing home residents,³ women,^4,5 and children⁶ exhibit high frequency and/or severity of hyponatremia. Hyponatremia developing during the course of other morbid conditions increases their severity.^7–10 Estimates of direct costs for treating hyponatremia in the United States ranged between $1.61 and $3.6 billion.¹¹

Clinical manifestations of hyponatremia are universal^12,13 and range from subtle (disturbances of balance, problems in cognition detected only during specific testing) to life-threatening manifestations of increased intracranial pressure with life-threatening hypoxia^14–16 and noncardiac pulmonary edema.¹⁷ Although the treating physicians must …

An Update On Braf Inhibitors And Other New Molecular Targets For The Treatment Of Malignant Melanoma Of The Skin, M. O. Faruk Khan, Carroll L. Ramos

Pharmaceutical Science and Research

Malignant melanoma of the skin originates from mutations in melanocytes and can be lethal if unrecognized or untreated in its earlier stages. Deaths from melanoma are increasing in the United States and around the world every year. The available treatments produce low rates of response with modest survival impact. Among potential molecular targets under investigation, which are mostly in the tyrosine kinase pathway, the BRAF (V-raf murine sarcoma viral oncogene homolog B1) gene is the best studied and most frequently reported mutation in melanoma. The molecular targets for melanoma treatment, promising drugs for future melanoma treatment as well as the …

Local Dynamic Stability Associated With Load Carrying, Jian Liu, Thurmon E. Lockhart

Computer Sciences and Electrical Engineering Faculty Research

Objectives: Load carrying tasks are recognized as one of the primary occupational factors leading to slip and fall injuries. Nevertheless, the mechanisms associated with load carrying and walking stability remain illusive. The objective of the current study was to apply local dynamic stability measure in walking while carrying a load, and to investigate the possible adaptive gait stability changes.

Methods: Current study involved 25 young adults in a biomechanics research laboratory. One tri-axial accelerometer was used to measure three-dimensional low back acceleration during continuous treadmill walking. Local dynamic stability was quantified by the maximum Lyapunov exponent (maxLE) from a nonlinear …

Aging Effect On Foot Dynamics During Unexpected Slips, Jian Liu, Thurmon E. Lockhart

Computer Sciences and Electrical Engineering Faculty Research

Slip-induced fall accidents have been recognized as a serious threat to the health of the elderly.The objective of the current study was to investigate the aging effect on the biomechanical reactions of both perturbed foot and unperturbed foot to the unexpected slips. Nineteen younger (mean age: 25.0 years old) and twenty-one older (mean age: 71.2 years old) adults were involved in a laboratory study,in which slippery surface was induced during walking without their awareness.The reactive responses of both slipping foot and unperturbed foot were quantified by optical motion capture system and force platforms.The results indicate a characteristic toe-touch strategy by …

Effect Of Exercise Dosages On Adiposity Indices In Overweight Girls, Stephanie Kellam, Norma Olvera, Patrick Leung, Jian Liu, Dennis Smith

Computer Sciences and Electrical Engineering Faculty Research

Objective. The primary purpose of this study was to determine the impact of two exercise dosages on reducing adiposity in minority girls. Materials and methods. Sixty-two overweight Hispanic and African-American girls participated in one of two intense summer interventions in Houston, TX: Intervention A (exposure to about 40 hours physical activities) or Intervention B (exposure to 60 hours of physical activities). Adiposity indices (percent body fat, waist circumference, body mass index) were taken pre- and post-intervention.

Results.

Intervention B had a significantly greater decrease in adiposity indicators (p= 0.006) when compared to Intervention A. Waist circumference displayed the most significant …

Gender Differences In The Development Of Uremic Cardiomyopathy Following Partial Nephrectomy: Role Of Progesterone, Christopher A. Drummond, George Buddny, Steven T. Haller, Jiang Liu, Yanling Yan, Zijian Xie, Deepak Malhotra, Joseph I. Shapiro Md, Jiang Tian

Biochemistry and Microbiology

Gender difference has been suggested as a risk factor for developing cardiovascular and renal diseases in humans and experimental animals. As a major sex hormone, progesterone was reported to compete with cardiotonic steroid binding to Na/K-ATPase. Our previous publication demonstrated that cardiotonic steroids (e.g., marinobufagenin) play an important role in the development of experimental uremic cardiomyopathy. We also observed that the putative mineralocorticoid antagonists, spironolactone and its major metabolite canrenone, antagonize binding of cardiotonic steroids to Na/K-ATPase in a competitive manner and also ameliorate experimental uremic cardiomyopathy induced by partial nephrectomy. In the following studies, we noted that progesterone displayed …

The Impact Of A Community Pharmacist Conducted Comprehensive Medication Review (Cmr) On 30-Day Re-Admission Rates And Increased Patient Satisfaction Scores: A Pilot Study, Brittany Snodgrass, Charles K. Babcock, Anne Teichman

Pharmacy Practice & Administration

Objective: To determine the impact of pharmacist conducted Comprehensive Medication Review (CMR) follow-up within seven days after discharge on (1) readmission rates, (2) detection of drug related problems, (3) and changes in Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores.

Design: Rates of re-admission for pneumonia, congestive heart failure (CHF), or myocardial infarction (MI), within 30 days of discharge are compared between patients receiving a CMR from the pharmacist to a historical control group not receiving the service. The CMR documentation is reviewed to classify any detected drug related problems. Overall HCAHPS scores for the hospital are compared …

Antibiotic-Like Actions Of Vitamin D, Franklin D. Shuler Md, Phd, Josh Hendrix, Adam Short, Sammy Hodroge

Orthopaedics

Vitamin D is a secosteroid hormone that has expanding importance for a healthy lifestyle and disease prevention. A multitude of studies have highlighted that vitamin D acts not only in bone and calcium homeostasis but is critically important for human immunity. The discovery that the storage form of vitamin D (25-hydroxyvitamin D3) can be locally converted to the active form (1,25-hydroxyvitamin D3) in immune cells, epithelial cells and numerous other non-renal tissues highlights the importance of maintaining sufficient stores. When responding to a specific external stimulus, like bacterial invasion, intracrine synthesis of active vitamin D has the ability to regulate …

Cost-Savings Analysis Of Telemedicine Use For Ophthalmic Screening In A Rural Appalachian Health Clinic, D. Russell Richardson, Russell Fry Ii, Michael Krasnow Do, Phd

Ophthalmology

Life in mountainous, rural areas poses unique obstacles for ophthalmic care--notably, a lack of access to ophthalmologists and cost of care. Using telemedicine as a screening tool addresses both issues for diabetic retinopathy (DR) screening, as fundus photography has been determined to be sensitive and specific when screening for DR.^1,2 The American Diabetes Association places a Grade E recommendation on fundus photography as a screening tool.³ We analyze the financial impact of ophthalmic telemedicine in a mountainous, rural health clinic in West Virginia over a seven year period from 2003-2009. At-risk patients are screened with a fundus camera …

Screening Diabetic And Hypertensive Patients For Ocular Pathology Using Telemedicine Technology In Rural West Virginia: A Retrospective Chart Review, Rezwan Ahmed Md, Stephen M. Petrany, Russell Fry Ii, Michael Krasnow Do, Phd

Internal Medicine

Abstract: Purpose: There is a disparity between the number of people who need healthcare and availability of medical services in rural areas. This paper describes the experience of using telemedicine technologies for ophthalmologic evaluation in diabetic and hypertensive patients presenting to a community health center in rural West Virginia.

Methods: A registered nurse at a community health center in McDowell County, WV was trained to use a retinal camera to capture high-resolution digital images of the retina. Patients with diabetes or hypertension were screened during their routine primary care visits. Retinal photos were transmitted to an ophthalmologist for review and …