Medicine and Health Sciences Commons^™

Perspective On Macroscale Complexity In The National Transplant System, Morgan Stuart, Andrew Placona, Gabe Vece, Kelsi Lindblad, Saikou Diallo, Bob Carrico

VMASC Publications

We present a perspective of the national transplant program based on organizational theory and complexity theory, framing the system’s allocation of donor organs as an interorganizational directed multiplex of agents with diverse belief formation in a cooperative-competitive environment. Simulation and analysis of this macroscale complexity may help explain known behavioural variations across member organizations. However, the transplant community still relies on system-scale simulations since effective macroscale methodologies are not well established. Therefore, we offer this perspective of the national transplant program as a means to stimulate new methods that capture macroscale impacts of policy development for deceased donor organ allocation.

Healthcare 5.0 Security Framework: Applications, Issues And Future Research Directions, Mohammad Wazid, Ashok Kumar Das, Noor Mohd, Youngho Park

VMASC Publications

Healthcare 5.0 is a system that can be deployed to provide various healthcare services. It does these services by utilising a new generation of information technologies, such as Internet of Things (IoT), Artificial Intelligence (AI), Big data analytics, blockchain and cloud computing. Due to the introduction of healthcare 5.0, the paradigm has been now changed. It is disease-centered to patient-centered care where it provides healthcare services and supports to the people. However, there are several security issues and challenges in healthcare 5.0 which may cause the leakage or alteration of sensitive healthcare data. This demands that we need a robust …

Neuromotor Changes In Participants With A Concussion History Can Be Detected With A Custom Smartphone App, Christopher K. Rhea, Masahiro Yamada, Nikita A. Kuznetsov, Jason T. Jakiela, Chanel T. Lojacono, Scott E. Ross, F. J. Haran, Jason M. Bailie, W. Geoffrey Wright

Rehabilitation Sciences Faculty Publications

Neuromotor dysfunction after a concussion is common, but balance tests used to assess neuromotor dysfunction are typically subjective. Current objective balance tests are either cost- or space-prohibitive, or utilize a static balance protocol, which may mask neuromotor dysfunction due to the simplicity of the task. To address this gap, our team developed an Android-based smartphone app (portable and cost-effective) that uses the sensors in the device (objective) to record movement profiles during a stepping-in-place task (dynamic movement). The purpose of this study was to examine the extent to which our custom smartphone app and protocol could discriminate neuromotor behavior between …

Educators' Perceptions Of Characteristics That Define Athletic Training Student Competence: A Report From The Association For Athletic Training Education Research Network, Cailee E. Welch Bacon, Julie M. Cavallario, Alicia M. Pike Lacy, Stacy E. Walker, Lindsey E. Eberman

Rehabilitation Sciences Faculty Publications

Context

As health professions education continues to transition toward competency-based education, it is essential that educators have an in-depth understanding of student competence and how it is achieved. However, little is known concerning the perceptions of educators regarding student competence in athletic training.

Objective

To explore athletic training educators' perceptions of student competence.

Design

Cross-sectional.

Setting

Online survey with open-ended questions.

Patients or Other Participants

In total, 368 of 1577 athletic training educators accessed the survey (23.3% access rate); 327 were included in data analysis because they indicated they served as an athletic training educator at the time of data …

Perceived Instability, Pain, And Psychological Factors Predict Function And Disability In Individuals With Chronic Ankle Instability, Ashley M.B. Suttmiller, Julie M. Cavallario, Shelby E. Baez, Jessica C. Martinez, Ryan S. Mccann

Rehabilitation Sciences Faculty Publications

Context:

Chronic ankle instability (CAI) is associated with residual instability, pain, decreased function, and increased disablement. Injury-related fear has been associated with CAI, although its relationship to other impairments is unclear. The Fear-Avoidance Model is a theoretical framework hypothesizing a relationship between injury-related fear, chronic pain, pain catastrophizing, and disability. It has been useful in understanding fear's influence in other musculoskeletal conditions but has yet to be studied in those with CAI.

Objective:

To explore relationships between instability, pain catastrophizing, injury-related fear, pain, ankle function, and global disability in individuals with CAI.

Design:

Cross-Sectional Study

Setting:

Anonymous online survey

Patients …

Characteristics Of Patient Encounters For Athletic Training Students During Clinical Education: A Report From The Aate Research Network, Cailee E. Welch Bacon, Julie M. Cavallario, Stacy E. Walker, R.Curtis Bay, Bonnie L. Van Lunen

Rehabilitation Sciences Faculty Publications

Context: To enhance the quality of patient care, athletic training students (ATSs) should experience a wide variety of clinical practice settings, interact with diverse patient populations, and engage with patients that have a wide variety of conditions. It is unclear in what ways, if any, ATSs have diverse opportunities during clinical experiences.

Objective: To describe the characteristics of patient encounters (PEs) ATSs engage in during clinical experiences. Design: Multi-site, panel design.

Setting: 12 professional athletic training programs (ATPs; 5 Bachelor, 7 Master's).

Patients or Other Participants: 363 ATSs from the ATPs that used E*Value software to document PEs during clinical …

Core Competency-Related Professional Behaviors During Patient Encounters: A Report From The Association For Athletic Training Education Research Network, Cailee E. Welch Bacon, Julie M. Cavallario, Stacy E. Walker, Curtis Bay, Bonnie L. Van Lunen

Rehabilitation Sciences Faculty Publications

Context: To enhance the quality of patient care, it is important that athletic trainers integrate the components of the core competencies (CCs; evidence-based practice [EBP], patient-centered care [PCC], health information technology [HIT], interprofessional education and collaborative practice [IPECP], quality improvement [QI], professionalism) as a part of routine clinical practice. In what ways, if any, athletic training students (ATSs) are currently integrating CCs into patient encounters (PEs) during clinical experiences is unclear.

Objective: To describe which professional behaviors associated with the CCs were implemented by ATSs during PEs that occurred during clinical experiences.

Design: Multisite panel design.

Setting: A total of …

Preventive Training Program Feedback Complexity, Movement Control, And Performance In Youth Athletes, Hayley J. Root, Eleanor M. Beltz, Julie P. Burland, Jessica C. Martinez, R. Curt Bay, Lindsay J. Distefano

Rehabilitation Sciences Faculty Publications

Context: Preventive training programs (PTPs) reduce injury risk by improving movement control. Corrective feedback is important; however, many cues at once may be too complicated for athletes.

Objective: To compare movement control and long-jump (LJ) changes in youth athletes participating in a season-long PTP, with simplified feedback, traditional feedback, or a warmup of the coaches' choosing.

Design: Cluster-randomized controlled trial.

Setting: Soccer fields.

Patients or Other Participants: A total of 420 athletes (simplified feedback = 173, traditional feedback = 118, and control = 129; age = 11 ± 3 years).

Intervention(s): Teams were randomized into the simplified PTP, traditional PTP, …

Cross-Education Balance Effects After Unilateral Rehabilitation In Individuals With Chronic Ankle Instability: A Systematic Review, Briana Lawry-Popelka, Sunghoon Chung, Ryan S. Mccann

Rehabilitation Sciences Faculty Publications

Objective: To conduct a systematic review of existing literature on cross-education balance effects after unilateral training in the population with chronic ankle instability (CAI).

Data Sources: PubMed, SPORTDiscus, CINAHL Plus.

Study Selection: To be included in the systematic review, studies were required to have been published in English, included participants with CAI, had participants undergo a unilateral therapeutic exercise for the lower extremity, and measured balance performance of the untrained lower extremity before and after the intervention.

Data Extraction: The certainty of evidence in each included study was assessed via the Downs and Black checklist. A score of 24 to …

Trust In Human-Robot Interaction Within Healthcare Services: A Review Study, Dedra Townsend, Amirhossein Majidirad

Mechanical & Aerospace Engineering Faculty Publications

There has always been a dilemma of the extent to which human can rely on machines in different activities of daily living. Ranging from riding on a self-driving car to having an iRobot vacuum clean the living room. However, when it comes to healthcare settings where robots are intended to work next to human, making decision gets difficult because repercussions may jeopardize people’s life. That has led scientists and engineers to take one step back and think out of the box. Having concept of trust under scrutiny, this study helps deciphering complex human-robot interaction (HRI) attributes. Screening essential constituents of …

Ascp-Iomt: Ai-Enabled Lightweight Secure Communication Protocol For Internet Of Medical Things, Mohammad Wazid, Jaskaran Singh, Ashok Kumar Das, Sachin Shetty, Muhammad Khurram Khan, Joel J.P.C. Rodrigues

VMASC Publications

The Internet of Medical Things (IoMT) is a unification of smart healthcare devices, tools, and software, which connect various patients and other users to the healthcare information system through the networking technology. It further reduces unnecessary hospital visits and the burden on healthcare systems by connecting the patients to their healthcare experts (i.e., doctors) and allows secure transmission of healthcare data over an insecure channel (e.g., the Internet). Since Artificial Intelligence (AI) has a great impact on the performance and usability of an information system, it is important to include its modules in a healthcare information system, which will be …

Rickettsial Pathogen Perturbs Tick Circadian Gene To Infect The Vertebrate Host, Supreet Khanal, Vikas Taank, John F. Anderson, Hameeda Sultana, Girish Neelakanta

Biological Sciences Faculty Publications

Ixodes scapularis is a medically important tick that transmits several microbes to humans, including rickettsial pathogen Anaplasma phagocytophilum. In nature, these ticks encounter several abiotic factors including changes in temperature, humidity, and light. Many organisms use endogenously generated circadian pathways to encounter abiotic factors. In this study, we provide evidence for the first time to show that A. phagocytophilum modulates the arthropod circadian gene for its transmission to the vertebrate host. We noted a circadian oscillation in the expression of arthropod clock, bmal1, period and timeless genes when ticks or tick cells were exposed to alternate 12 h …

Bone Morphogenetic Proteins Shape TReg Cells, Piotr Kraj

Biological Sciences Faculty Publications

The transforming growth factor-β (TGF-β) family includes cytokines controlling cell behavior, differentiation and homeostasis of various tissues including components of the immune system. Despite well recognized importance of TGF-β in controlling T cell functions, the immunomodulatory roles of many other members of the TGF-β cytokine family, especially bone morphogenetic proteins (BMPs), start to emerge. Bone Morphogenic Protein Receptor 1α (BMPR1α) is upregulated by activated effector and Foxp3+ regulatory CD4+ T cells (Treg cells) and modulates functions of both of these cell types. BMPR1α inhibits generation of proinflammatory Th17 cells and sustains peripheral Treg cells. This finding underscores the importance of …

Streamlining Sporozoite Isolation From Mosquitoes By Leveraging The Dynamics Of Migration To The Salivary Glands, Ashutosh K. Pathak, Justine C. Shiau, Blandine Franke-Fayard, Lisa M. Shollenberger, Donald A. Harn, Dennis E. Kyle, Courtney C. Murdock

Biological Sciences Faculty Publications

Background: Sporozoites isolated from the salivary glands of Plasmodium-infected mosquitoes are a prerequisite for several basic and pre-clinical applications. Although salivary glands are pooled to maximize sporozoite recovery, insufficient yields pose logistical and analytical hurdles; thus, predicting yields prior to isolation would be valuable. Preceding oocyst densities in the midgut is an obvious candidate. However, it is unclear whether current understanding of its relationship with sporozoite densities can be used to maximize yields, or whether it can capture the potential density-dependence in rates of sporozoite invasion of the salivary glands.

Methods: This study presents a retrospective analysis of Anopheles …

Compassion, Discrimination, And Prosocial Behaviors: Young Diasporic Chinese During The Covid-19 Pandemic, Youli Chen, Zicong Wang, Qi Zhang, Weizhen Dong, Jia Huei, Chen Xu, Sizhe Ji Wu, Xiangyang Zhang, Chun Chen

Community & Environmental Health Faculty Publications

The coronavirus disease 2019 (COVID-19) pandemic has fueled anti-Asian, especially anti-Chinese sentiments worldwide, which may negatively impact diasporic Chinese youths' adjustment and prosocial development. This study examined the association between compassion, discrimination and prosocial behaviors in diasporic Chinese youths during the COVID-19 pandemic. 360 participants participated and completed the multi-country, cross-sectional, web-based survey between April 22 and May 9, 2020, the escalating stage of the pandemic. This study found compassion as prosocial behaviors' proximal predictor, while discrimination independently predicted participation in volunteering, and could potentially enhance the association between compassion and charitable giving. These findings suggest that prosociality among young …

Vitamin D Level In Relation To Depression Symptoms During Adolescence, Reem Al-Sabah, Abdullah Al-Taiar, Lemia Shaban, Ahmed N. Albatineh, Reem Sharaf Alddin, Praveen K. Durgampudi

Community & Environmental Health Faculty Publications

BACKGROUND: This study aimed to investigate the association between 25-hydroxyvitamin D (25(OH)D) and depression symptoms among adolescents in Kuwait, a country with a high prevalence of vitamin D deficiency.

METHODS: A school based cross-sectional study was conducted on randomly selected 704 adolescents in middle schools. Data on depression symptoms were collected using the Children's Depression Inventory (CDI). Data on covariates were collected from the parents by self-administered questionnaire and from adolescents by face-to-face interview. Blood samples were analyzed in an accredited laboratory; and 25(OH)D was measured using liquid chromatography-tandem mass spectrometry.

RESULTS: Of 704 adolescents, 94 (13.35%; 95%CI:10.35-17.06%) had depression …

Advanced Practice Nursing Roles, Regulation, Education, And Practice: A Global Study, Kathy J. Wheeler, Minna Miller, Joyce Pulcini, Deborah Gray, Elissa Ladd, Mary Kay Rayens

Ellmer School of Nursing Faculty Publications

Background and Objectives: Several subgroups of the International Council of Nurses Nurse Practitioner/Advanced Practice Nurse Network (ICN NP/APNN) have periodically analyzed APN (nurse practitioner and clinical nurse specialist) development around the world. The primary objective of this study was to describe the global status of APN practice regarding scope of practice, education, regulation, and practice climate. An additional objective was to look for gaps in these same areas of role development in order to recommend future initiatives.

Methods: An online survey was developed by the research team, and included questions on APN practice roles, education, regulation/credentialing, and practice climate. The …

A Comparison Of Factors That Impact Retention Of Nursing Students With And Without Military Experience: A Mixed Method Study, Janice E. Hawkins, Karen Higgins, Jamela Martin, Lynn Wiles, Ingrid Mahoney, Robert Hawkins, Beth Tremblay

Ellmer School of Nursing Faculty Publications

Military veteran students have unique characteristics and challenges that influence their academic success. The factors impacting retention of nursing students with prior military experience may differ from students with no military experience. This mixed methods study used an anonymous survey guided by Jeffreys' Nursing Undergraduate Retention and Success Model to identify factors that support or restrict prelicensure nursing program retention of military veteran students compared to students with no history of military service. Statistically significant differences between groups were detected for three factors including financial status, membership in nursing organizations or clubs, and financial aid and/or scholarship. There was a …

Mechanism For Selective Binding Of Aromatic Compounds On Oxygen-Rich Graphene Nanosheets Based On Molecule Size/Polarity Matching, Heyun Fu, Bingyu Wang, Dongqiang Zhu, Zhicheng Zhou, Shidong Bao, Xiaolei Qu, Yong Guo, Lan Ling, Shourong Zheng, Pu Duan, Jingdong Mao, Klaus Schmidt-Rohr, Shu Tao, Pedro J.J. Alvarez

Chemistry & Biochemistry Faculty Publications

Selective binding of organic compounds is the cornerstone of many important industrial and pharmaceutical applications. Here, we achieved highly selective binding of aromatic compounds in aqueous solution and gas phase by oxygen-enriched graphene oxide (GO) nanosheets via a previously unknown mechanism based on size matching and polarity matching. Oxygen-containing functional groups (predominately epoxies and hydroxyls) on the nongraphitized aliphatic carbons of the basal plane of GO formed highly polar regions that encompass graphitic regions slightly larger than the benzene ring. This facilitated size match–based interactions between small apolar compounds and the isolated aromatic region of GO, resulting in high binding …

Core Point Pixel-Level Localization By Fingerprint Features In Spatial Domain, Xueyi Ye, Yuzhong Shen, Maosheng Zeng, Yirui Liu, Huahua Chen, Zhijing Zhao

Computational Modeling & Simulation Engineering Faculty Publications

Singular point detection is a primary step in fingerprint recognition, especially for fingerprint alignment and classification. But in present there are still some problems and challenges such as more false-positive singular points or inaccurate reference point localization. This paper proposes an accurate core point localization method based on spatial domain features of fingerprint images from a completely different viewpoint to improve the fingerprint core point displacement problem of singular point detection. The method first defines new fingerprint features, called furcation and confluence, to represent specific ridge/valley distribution in a core point area, and uses them to extract the innermost Curve …

Healthcare Transformation In Saudi Arabia: An Overview Since The Launch Of Vision 2030, Ahmed Ali Alasiri, Viqaruddin Mohammed

University Administration Publications

Saudi Arabia’s Vision 2030 has taken a centre stage in the development of its healthcare sector through privatization adopting Public Private Partnerships (PPPs). The objective of this study is to provide an overview of healthcare transformation in Saudi Arabia since the launch of the ambitious Vision 2030, identifying issues those need to be addressed and steps taken towards provision of health systems transformation. Literature review was based on extensive review of published and unpublished articles, where different search engines and databases searched using the key words: ‘Saudi Healthcare’, ‘Healthcare transformation’, ‘Saudi vision: 2030’, ‘Public-Private Partnerships’ and ‘Privatization’, in addition to …

Parent Reports Of Executive Functions In Students With Learning Disability, Jane Roitsch, Annemarie L. Horn, Lisa Morin

Communication Disorders & Special Education Faculty Publications

This study examines the results of the Behavior Rating Inventory of Executive Function (BRIEF-2) (Gioia et al., 2015) reported by parents of children with Specific Learning Disability (LD) and/or other comorbid disabilities. LD is most notably associated with comorbid attention deficit hyperactivity disorder (ADHD) (Alloway & Stein, 2014; Westby &Watson, 2004; Willcutt et al., 2013). A total of 43 parents completed the BRIEF-2 rating scale. Findings suggest children with LD and ADHD display greater challenges with inhibition, working memory, planning, along with greater challenges in organization and metacognition. Parents of children with LD reported their children have greater levels of …

Administrators' Roles In The Use And Training Of Evidence-Based Practices For Students With Autism Spectrum Disorder, Selena J. Layden, Ann S. Maydosz, Teresa G. Crowson, Annemarie L. Horn, Amanda Faye Working

Communication Disorders & Special Education Faculty Publications

Federal mandates require special education teachers to use instructional practices grounded in scientific research. Accordingly, the National Professional Development Center on Autism Spectrum Disorder (NPDC) identified 27 evidence-based practices specific to teaching students with autism spectrum disorder (ASD; Wong et al., 2014). Though these practices have undergone a rigorous identification process, less is known about the level of training and confidence in implementation of these instructional practices by education professionals who work with students with ASD. Our study assessed education professionals' (including administrators, teachers, and related services personnel) ratings of their level of training, confidence in implementation, and frequency of …

Profiles And Correlates Of Language And Social Communication Differences Among Young Autistic Children, Rachel Reetzke, Vini Singh, Ji Su Hong, Calliope B. Holingue, Luther G. Kalb, Natasha N. Ludwig, Deepa Menon, Danika L. Pfeiffer, Rebecca J. Landa

Communication Disorders & Special Education Faculty Publications

Delays in early language development are characteristic of young autistic children, and one of the most recognizable first concerns that motivate parents to seek a diagnostic evaluation for their child. Although early language abilities are one of the strongest predictors of long-term outcomes, there is still much to be understood about the role of language impairment in the heterogeneous phenotypic presentation of autism. Using a personcentered, Latent Profile Analysis, we first aimed to identify distinct patterns of language and social communication ability in a clinic-based sample of 498 autistic children, ranging in age from 18 to 60 months (M = …

Conversation As An Outcome Of Aphasia Treatment: A Systematic Scoping Review, Jamie H. Azios, Brent Archer, Nina Simmons-Mackie, Anastasia Raymer, Marcella Carragher, Shriya Shashikanth, Eleanor Gulick

Communication Disorders & Special Education Faculty Publications

PURPOSE: Conversation-focused speech-language pathology services are a top priority for people living with aphasia, but little is known about how researchers measure conversation as an outcome of treatment. This scoping review was undertaken to systematically review the evidence regarding the measurement of conversation in aphasia studies and to identify current practices and existing gaps.

METHOD: A systematic literature search was conducted for studies published between January 1995 and September 2019 in multiple electronic databases. Covidence software was used to manage search results, study selection, and data charting processes. Data were extracted from each study and then collated and organized to …

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

Communication Disorders & Special Education Faculty Publications

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

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

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

Reproductive Regrets Among A Population-Based Sample Of U.S. Women, Arthur L. Greil, Michele H. Lowry, Andrea R. Burch, Kathleen Slauson-Blevins, Nicholas Park, Julia Mcquillan

Sociology & Criminal Justice Faculty Publications

Women have many reproductive options, but little is known about their regrets regarding prior reproductive choices and outcomes. Guided by the life-course and stratified reproduction perspectives, this study draws on an open-ended question about reproductive regrets from wave I of the National Survey of Fertility Barriers, a representative telephone survey of reproductive aged U.S. women conducted from 2004 to 2006. The authors classified regrets into five broad categories: (1) none, (2) problematic fertility, (3) unfulfilled fertility desires, (4) family, and (5) pregnancy experiences. The authors conducted the analyses separately by motherhood status. Logistic regression analysis revealed that regardless of parental …

Radiomic Texture Feature Descriptor To Distinguish Recurrent Brain Tumor From Radiation Necrosis Using Multimodal Mri, M. S. Sadique, A. Temtam, E. Lappinen, K. M. Iftekharuddin

Electrical & Computer Engineering Faculty Publications

Despite multimodal aggressive treatment with chemo-radiation-therapy, and surgical resection, Glioblastoma Multiforme (GBM) may recur which is known as recurrent brain tumor (rBT), There are several instances where benign and malignant pathologies might appear very similar on radiographic imaging. One such illustration is radiation necrosis (RN) (a moderately benign impact of radiation treatment) which are visually almost indistinguishable from rBT on structural magnetic resonance imaging (MRI). There is hence a need for identification of reliable non-invasive quantitative measurements on routinely acquired brain MRI scans: pre-contrast T1-weighted (T1), post-contrast T1-weighted (T1Gd), T2-weighted (T2), and T2 Fluid Attenuated Inversion Recovery (FLAIR) that can …

Robust Testing Of Paired Outcomes Incorporating Covariate Effects In Clustered Data With Informative Cluster Size, Sandipan Dutta

Mathematics & Statistics Faculty Publications

Paired outcomes are common in correlated clustered data where the main aim is to compare the distributions of the outcomes in a pair. In such clustered paired data, informative cluster sizes can occur when the number of pairs in a cluster (i.e., a cluster size) is correlated to the paired outcomes or the paired differences. There have been some attempts to develop robust rank-based tests for comparing paired outcomes in such complex clustered data. Most of these existing rank tests developed for paired outcomes in clustered data compare the marginal distributions in a pair and ignore any covariate effect on …

Prenatal And Pediatric Oral Health Education Among Dental Hygiene Programs In The United States, Denise M. Claiborne, Shillpa Naavaal

Dental Hygiene Faculty Publications

Purpose: Health care and dental providers must be prepared to address the oral health needs of mothers and children in order to reduce the burden of dental disease in these populations. The purpose of this study was to describe the curriculum and clinical experiences related to prenatal and pediatric oral health in the university and community college dental hygiene programs in the United States (US).

Methods: Dental hygiene program directors (PDs) from across the US were invited to participate in a cross-sectional electronic survey regarding the prenatal and pediatric oral health curriculum at their institution. In addition to program characteristics, …