Medicine and Health Sciences Commons^™

Readmission Rates And Their Impact On Hospital Financial Performance: A Study Of Washington Hospitals, Soumya Upadhyay, Amber L. Stephenson, Dean G. Smith

School of Public Health Faculty Research

This longitudinal study examines whether readmission rates, made transparent through Hospital Compare, affect hospital financial performance by examining 98 hospitals in the State of Washington from 2012 to 2014. Readmission rates for acute myocardial infarction (AMI), pneumonia (PN), and heart failure (HF) were examined against operating revenues per patient, operating expenses per patient, and operating margin. Using hospital-level fixed effects regression on 276 hospital year observations, the analysis indicated that a reduction in AMI readmission rates is related with increased operating revenues as expenses associated with costly treatments related with unnecessary readmissions are avoided. Additionally, reducing readmission rates is related …

Twenty-Three Unsolved Problems In Hydrology (Uph) -- A Community Perspective, Günter Blöschl, Marc F.P. Bierkens, Antonio Chambel, Christophe Cudennec, Georgia Destouni, Aldo Fiori, James W. Kirchner, Jeffrey J. Mcdonnell, Hubert H.G. Savenjie, Murugesu Sivapalan, Christine Stumpp, Elena Toth, Elena Volpi, Gemma Carr, Claire Lupton, Jose Salinas, Borbala Szeles, Alberto Viglione, Hafzullah Aksoy, Scott T. Allen, Anam Amin, Vazken Andreassian, Berit Arheimer, Santosh K. Aryal, Victor Baker, Earl Bardsley, Marlies H. Barendrecht, Alena Bartosova, Okke Batelaan, Wouter R. Berghuijs, Keith Beven

Geoscience Faculty Research

This paper is the outcome of a community initiative to identify major unsolved scientific problems in hydrology motivated by a need for stronger harmonisation of research efforts. The procedure involved a public consultation through online media, followed by two workshops through which a large number of potential science questions were collated, prioritised, and synthesised. In spite of the diversity of the participants (230 scientists in total), the process revealed much about community priorities and the state of our science: a preference for continuity in research questions rather than radical departures or redirections from past and current work. Questions remain focused …

Dissociation Between The Growing Opioid Demands And Drug Policy Directions Among The U.S. Older Adults With Degenerative Joint Diseases, Pearl Kim Phd, Takashi Yamashita Phd, Mph, Ma, Jay J. Shen Phd, Seong-Min Park Phd, Sung-Youn Chun Phd, Sun Jung Kim Phd, Mhsa, Jinwook Hwang Md, Phd, Se Won Lee Md, Georgia Dounis Dds, Ms, Hee-Taik Kang Md, Phd, Yong-Jae Lee Md, Phd, Dong-Hun Han Dds, Phd, Ji Eun Kim Phd, Hyeyoung Yeom Md, David Byun Do, Tsigab Bahta Md, Ji Won Yoo Md

School of Public Health Faculty Research

We aim to examine temporal trends of orthopedic operations and opioid-related hospital stays among seniors in the nation and states of Oregon and Washington where marijuana legalization was accepted earlier than any others. As aging society advances in the United States (U.S.), orthopedic operations and opioid-related hospital stays among seniors increase in the nation. A serial cross-sectional cohort study using the healthcare cost and utilization project fast stats from 2006 through 2015 measured annual rate per 100,000 populations of orthopedic operations by age groups (45–64 vs 65 and older) as well as annual rate per 100,000 populations of opioid-related hospital …

Safety And Efficacy Of Combined Antegrade And Retrograde Endoscopic Dilation For Complete Esophageal Obstruction: A Systematic Review And Meta-Analysis, Mahendran Jayaraj, Babu P. Mohan, Harneet Mashiana, Rajesh Krishnamoorthi, Douglas G. Adler

School of Medicine Faculty Research

Background Complete esophageal obstruction (CEO) due to occlusive proximal stricture occurs after chemoradiation for head and neck cancers. A combined antegrade and retrograde endoscopic technique with controlled recanalization and dilation (CARD) has been shown to be an effective and safe method for regaining and maintaining esophageal luminal patency in the short term. Methods We conducted a comprehensive search of multiple electronic databases and conference proceedings, including PubMed, EMBASE, and Web of Science databases (from inception through November 2018), to identify studies that reported the outcomes of CARD. The primary outcomes were the pooled rates of technical and clinical success, specifically …

Risk Of Cancer Death Among White, Black, And Hispanic Populations In South Florida, Paulo S. Pinheiro, Karen E. Callahan, Tulay Koru-Sengul, Justine Ransdell, Layla Bouzoubaa, Clyde P. Brown, Erin Kobetz

Environmental & Global Health Faculty Research

Background: The cancer burden in South Florida, with a population of more than 6 million with a heavily Hispanic and large Afro-Caribbean population, has not been quantified. Methods: We analyzed 2012–2016 cancer mortality data from South Florida for white, Hispanic, and black populations with disaggregation for Cuban, Puerto Rican, South American, African American, and Afro-Caribbean groups. We calculated cancer site-specific and all-sites combined age-adjusted mortality rates, and we used negative binomial regression to determine mortality rate ratios to compare South Florida’s cancer mortality rates with those of the rest of the nation. Results: We analyzed 53,837 cancer deaths. Per 100,000 …

Is Intimate Partner Violence A Risk Factor For Cardiovascular Disease In Women? A Review Of The Preponderance Of The Evidence, Rose Eva Constantino, Alona D. Angosta, Andrew Thomas Reyes, Brayden Kameg, Linden Wu, Jordan Cobb, Vivian Hui, Daisy Palompon, Reema Safadi, Mayada Daibes, Elizabeth Schlenk

Nursing Faculty Research

This paper examines the relationship between intimate partner violence (IPV) experience in women and cardiovascular disease (CVD), and determines if there is a preponderance of literature evidence. Research is reviewed dealing with the different biopsychosocial factors affecting the relationship between IPV and CVD. As a result of our review, we propose a framework on the biopsychosocial pathway of IPV as a risk factor of CVD of women. Our proposed framework portrays how IPV experiences contribute to long-term biopsychosocial changes that increase the risk of CVD among female victims of IPV. These biopsychosocial changes include chronic inflammation and hypothalamus-pituitary-adrenal axis dysfunction, …

Liver Cancer: A Leading Cause Of Cancer Death In The United States And The Role Of The 1945–1965 Birth Cohort By Ethnicity, Paulo S. Pinheiro, Karen E. Callahan, Patricia D. Jones, Cyllene Morris, Justine M. Ransdell, Deukwoo Kwon, Clyde Perry Brown, Erin N. Kobetz

Environmental & Global Health Faculty Research

No abstract provided.

A 24-Week Double-Blind Placebo-Controlled Study Of The Efficacy And Safety Of The Ampa Modulator S47445 In Patients With Mild To Moderate Alzheimer's Disease And Depressive Symptoms, Eileen M. Bulger, Sylvie Gouttefangeas, Sylvie Bretin, Stéphanie Galtier, Philippe Robert, Vjera Holthoff-Detto, Jeffrey Cummings, Maria Pueyo

School of Medicine Faculty Research

Introduction S47445 is a novel positive allosteric modulator of alpha-amino-3-hydroxy-5-methyl-4-isoxazole-propionic acid receptors that may emerge as a favorable candidate for the symptomatic treatment of cognitive and depressive disorders in patients suffering from Alzheimer's disease (AD) of mild to moderate severity and with depressive symptoms. Methods For this double-blind, placebo-controlled 24-week phase II trial, 520 outpatients aged between 55 and 85 years, with probable AD at mild to moderate stages (a Mini-Mental State Examination score of 24-15 inclusive) and exhibiting depressive symptoms (Cornell Scale for Depression in Dementia [CSDD] ≥ 8) were recruited in twelve countries and randomized to 3 doses …

Associations Between Comorbid Tdp-43, Lewy Body Pathology And Neuropsychiatric Symptoms In Alzheimer's Disease, Ece Bayram, Guogen Shan, Jeffrey L. Cummings

School of Public Health Faculty Research

More than half of the patients with Alzheimer’s disease (AD) have comorbidities including TDP-43 and Lewy bodies, which are also associated with frontotemporal lobar degeneration and dementia with Lewy bodies, respectively. These comorbidities may help explain the overlapping neuropsychiatric symptoms between AD and other dementias. Data on 221 AD patients with Neuropsychiatric Inventory-Questionnaire were obtained from the National Alzheimer’s Coordinating Center. TDP-43 was associated with aberrant motor activity, whereas Lewy bodies were associated with anxiety, irritability, sleep behavior, and appetite problems. The associations between these comorbidities and neuropsychiatric symptoms were more significant for patients with sparse diffuse plaques.

Efficacy Of A Dissolvable Strip With Calcium Sodium Phosphosilicate (Novamin®) In Providing Rapid Dentine Hypersensitivity Relief, John Gallob, Martin R. Ling, Pejmon Amini, Avinash Patil, Mounir Atassi

Dental Medicine Faculty Research

Objective To evaluate the efficacy of a dissolvable strip containing 15% w/w calcium sodium phosphosilicate (CSPS) (Novamin®) in providing rapid relief from dentine hypersensitivity (DH). Methods In this examiner-blind, proof-of-principle study, 120 healthy adults with DH were randomized 1:1 to the Test strip, professionally applied to facial surfaces of two selected teeth, or to No treatment. Sensitivity was assessed at baseline and 10 min, 2 h and 4 h post-application in response to evaporative (air) and tactile stimuli (measured by Schiff sensitivity scale/a numeric rating scale and tactile threshold, respectively). Change from baseline was analyzed by ANCOVA. Results At 10 …

Integrative Review On Cognitive Behavioral Therapy In Chronic Diseases: The Responses Predictors, Nada Lukkahatai, Jillian Inouye, Diane Thomason, Jennifer Kawi, Bruce Leonard, Kirsten Connelly

Nursing Faculty Research

Background: Cognitive behavioral therapy (CBT) is a self-management strategy used by patients with chronic diseases. Studies consistently report the effectiveness of this therapy in managing symptoms and improving patients’ quality of life. However, evidence also shows that not all patients benefit from the therapy. Methods: This article presents findings from an integrative review of studies published between 2010 and 2014 that investigated outcome predictors of CBT in chronic illness. The use of CBT in psychological disorders was excluded from the review. Result: Eleven studies were included into this review. Every study supported the effectiveness of CBT for both immediate and …

Epidemiologic Evaluation Of Nhanes For Environmental Factors And Periodontal Disease, P. Emecen-Huja, H-F Li, Jeffrey L. Ebersole, J. Lambert, H. Bush

Dental Medicine Faculty Research

Periodontitis is a chronic inflammation that destroys periodontal tissues caused by the accumulation of bacterial biofilms that can be affected by environmental factors. This report describes an association study to evaluate the relationship of environmental factors to the expression of periodontitis using the National Health and Nutrition Examination Study (NHANES) from 1999–2004. A wide range of environmental variables (156) were assessed in patients categorized for periodontitis (n = 8884). Multiple statistical approaches were used to explore this dataset and identify environmental variable patterns that enhanced or lowered the prevalence of periodontitis. Our findings indicate an array of environmental variables were …

The Anti-Sigma Factor Muca Of Pseudomonas Aeruginosa: Dramatic Differences Of A Muca22 Vs. A Δmuca Mutant In Anaerobic Acidified Nitrite Sensitivity Of Planktonic And Biofilm Bacteria In Vitro And During Chronic Murine Lung Infection, Warunya Panmanee, Shengchang Su, Michael J. Schurr, Gee W. Lau, Xiaoting Zhu, Zhaowei Ren, Cameron T. Mcdaniel, Long J. Lu, Dennis E. Ohman, Daniel A. Muruve, Ralph J. Panos, Hongwei D. Yu, Thomas B. Thompson, Boo Shan Tseng, Daniel J. Hassett

Life Sciences Faculty Research

Mucoid mucA22 Pseudomonas aeruginosa (PA) is an opportunistic lung pathogen of cystic fibrosis (CF) and chronic obstructive pulmonary disease (COPD) patients that is highly sensitive to acidified nitrite (A-NO2-). In this study, we first screened PA mutant strains for sensitivity or resistance to 20 mM A-NO2- under anaerobic conditions that represent the chronic stages of the aforementioned diseases. Mutants found to be sensitive to A-NO2- included PA0964 (pmpR, PQS biosynthesis), PA4455 (probable ABC transporter permease), katA (major catalase, KatA) and rhlR (quorum sensing regulator). In contrast, mutants lacking PA0450 (a putative phosphate transporter) and PA1505 (moaA2) were A-NO2- resistant. However, …

Approach Bias For Erotic Stimuli In Heterosexual Male College Students Who Use Pornography, Shane Kraus, Skyler Sklenarik, Marc N. Potenza, Mateusz Gola, Ariel Kor, Robert S. Astur

Psychology Faculty Research

Background and Aims: Addicted individuals often demonstrate relatively automatic action tendencies in response to addiction-related stimuli, whereby they approach rather than avoid addictive stimuli. This study assessed whether an approach bias for erotic stimuli exists among heterosexual college-aged males who report using pornography. Methods: We tested 72 male undergraduate students using an approach–avoidance task employing erotic stimuli, during which participants were instructed to push or pull a joystick in response to image orientation. To simulate approach and avoidance movements, pulling the joystick enlarged the image and pushing shrunk the image. Frequency and severity of pornography use was assessed using a …

Local Electronic Structure Of The Peptide Bond Probed By Resonant Inelastic Soft X-Ray Scattering, L. Weinhardt, A. Benkert, F. Meyer, M. Blum, D. Hauschild, R. G. Wilks, M. Bär, W. Yang, M. Zharnikov, F. Reinert, C. Heske

Chemistry and Biochemistry Faculty Research

The local valence orbital structure of solid glycine, diglycine, and triglycine is studied using soft X-ray emission spectroscopy (XES), resonant inelastic soft X-ray scattering (RIXS) maps, and spectra calculations based on density-functional theory. Using a building block approach, the contributions of the different functional groups of the peptides are separated. Cuts through the RIXS maps furthermore allow monitoring selective excitations of the amino and peptide functional units, leading to a modification of the currently established assignment of spectral contributions. The results thus paint a new-and-improved picture of the peptide bond, enhance the understanding of larger molecules with peptide bonds, and …

2019 Graduate Medical Education Research Day Compendium, Unlv School Of Medicine

Graduate Medical Education Research Day Compendium

Anyone engaged in research knows that the process can be daunting. Add the rigors of training in a graduate medical education program to this, and it might seem all but impossible to accomplish anything meaningful. However, the individuals highlighted in our 2019 Graduate Medical Education Research Day Compendium were able to overcome those odds. Their abstracts are showcased here and their efforts to advance the collective knowledge in their respective fields are commendable. We thank these Resident and Fellow Physicians and all who have supported them in their endeavors to reach this point with their research. Most of all, we …

Recovery And Person-Centered Care In Gambling Disorder, Angels Gonzalez-Ibanez Phd In Psychology, Adjunct Professor

International Conference on Gambling & Risk Taking

No abstract provided.

Get Engaged: Results Of Ncpg 2018 National Survey Of Gambling Attitudes & Experiences, Keith Whyte, Don Feeney

International Conference on Gambling & Risk Taking

The National Survey of Gambling Attitudes and Gambling Experiences (NGAGE) is the largest published survey of gambling participation and problems in the US. This unprecedented look into how Americans gamble, what they gamble, how they think about it in every state. Includes a special focus on sports gambling. Presenters will review the findings and implications for everyone involved in gambling issues.

Mental Health Profiles Of Adolescents With Co-Occurring Gambling Behaviours And Benzodiazepine Misuse, Emilie Fletcher, Jeremie Richard, Jeffrey Derevensky Dr, William Ivoska Dr, Caroline Temcheff Dr

International Conference on Gambling & Risk Taking

No abstract provided.

Gender Differences In Non-Suicidal Self-Injury In A Sample Of Treatment-Seeking Gamblers, Megan Cowie

International Conference on Gambling & Risk Taking

Gambling Disorder (GD) is a public health concern with tremendous implications (Smith & Wynne, 2002). The disorder rarely occurs in isolation, often presenting with other conditions. Suicidal ideation and attempts are common among treatment-seeking gamblers (Maccallum & Blaszczynski, 2003). An important yet overlooked risk factor for suicidality is non-suicidal self-injury (NSSI; Klonsky et al., 2013). NSSI can serve many functions: relief of negative emotions; generation of positive states; escape from interpersonal obligations; attention or facilitation of resources (Nock & Prinstein, 2004). Previous research has found gender differences in NSSI. Despite NSSI’s relationship to suicidality and the noted gender differences, literature …

Redesigning Gambling Treatment Programs For Success: A Model Based Approach Toward Program Development, Jeffrey J. Marotta, Greta Coe

International Conference on Gambling & Risk Taking

Abstract

This presentation will describe a program improvement initiative launched by Oregon Problem Gambling Services to assist with the development of its 47 publicly-funded gambling treatment programs. The development approach incorporated best practices as identified by SAMHSA, the gambling disorders literature, and expert review. The resulting Technical Assistance Visit Toolkit & Gambling Treatment Program Capability Index (GTPCI) offer a streamline program improvement protocol for use specifically with gambling treatment programs. The presenters will share their experience in implementing this program development approach, merits of the model, and program results.

Implications

This presentation will introduce participants to a model and evaluation …

Interventions For Problem And Pathological Gambling: Status, Innovations, And Challenges, Matthew P. Martens

International Conference on Gambling & Risk Taking

The purpose of this presentation is to address research on the effectiveness of problem gambling interventions and offer insights for new directions. Dr. Martens has led two clinical trials over the past five years that have integrated technology into problem gambling interventions for young adults. In the first trial (Martens et al., 2015), he found that a computerized personalized feedback intervention reduced gambling problems among at-risk young adult gamblers. In the second trial (Martens et al., in preparation), he found that an intervention delivered via cell phone and text-message had an indirect effect on gambling-related problems. Although effect sizes for …

Effects Of Vascular Endothelial Growth Factor (Vegf) On Dental Pulp Stem Cells (Dpsc), Cale Forgues, Eric Mullins, Karl Kingsley

Dental Medicine Faculty Research

Dental Pulp Stem Cells (DPSCs) are non-embryonic, mesenchymal stem cells that may have significant potential for therapeutic and regenerative biomedical applications. Studies of DPSC differentiation have demonstrated the potential to form many tissue types, including neural, osteogenic and vascular precursors using cytokines and growth factors, such as Vascular Endothelial Growth Factor (VEGF). Eight previously isolated Dental Pulp Stem Cell (DPSC) isolates were grown in culture and treated with VEGF to evaluate any effects on growth, viability or biomarker expression. Administration of VEGF at 10 ng/mL significantly inhibited growth in two rapidly dividing or rDT DPSC isolates, with no other measurable …

Sub-Region Based Radiomics Analysis For Survival Prediction In Oesophageal Tumours Treated By Definitive Concurrent Chemoradiotherapy, Congying Xie, Pengfei Yang, Xuebang Zhang, Lei Xu, Xiaoju Wang, Xiadong Li, Luhan Zhang, Ruifei Xie, Ling Yang, Zhao Jing, Hongfang Zhang, Lingyu Ding, Yu Kuang, Tianye Niu, Shixiu Wu

Health Physics and Diagnostic Sciences Faculty Research

Background: Evaluating clinical outcome prior to concurrent chemoradiotherapy remains challenging for oesophageal squamous cell carcinoma (OSCC) as traditional prognostic markers are assessed at the completion of treatment. Herein, we investigated the potential of using sub-region radiomics as a novel tumour biomarker in predicting overall survival of OSCC patients treated by concurrent chemoradiotherapy. Methods: Independent patient cohorts from two hospitals were included for training (n = 87) and validation (n = 46). Radiomics features were extracted from sub-regions clustered from patients' tumour regions using K-means method. The LASSO regression for ‘Cox’ method was used for feature selection. The survival prediction model …

Author Correction: Fuctional Eubacteria Species Along With Transdomain Gut Inhabitants Favour Dysgenic Diversity In Oxalate Stone Disease, Mangesh V. Suryananshi, Shrikant S. Bhute, Rahul P. Gune, Yogesh S. Shouche

Life Sciences Faculty Research

This Article contains an error in the order of the Figures. Figures 2, 3 and 4 were published as Figures 4, 2, and 3 respectively. The correct Figures 2, 3 and 4 appear below as Figs 1, 2 and 3respectively. The Figure legends are correct.

Men’S Experiences Of Miscarriage: A Passive Phenomenological Analysis Of Online Data, Megan Story Chavez, Valerie Handley, Rebecca Lucero Jones, Brandon Eddy, Von Poll

Couple & Family Therapy Program Faculty Research

Miscarriage is a pervasive health care concern for couples. The impacts of miscarriage on men have not received adequate attention in the literature. The aim of this research was to understand the lived experience of 31 male participants whose partners had miscarried a child. This study analyzed online data using a passive phenomenological methodology. Researchers found four overarching themes including isolation, overwhelmed, protector, and coping. Results found that health professionals might overlook men when a woman experiences a miscarriage. Results suggest that professionals working with these couples could provide greater care by addressing the experiences of both men and women …

Microbiome Profiles Of Ligature-Induced Periodontitis In Nonhuman Primates Across The Life Span, Sreenatha Kirakodu, Jin Chen, Janis Gonzalez Martinez, Octavio A. Gonzalez, Jeffrey Ebersole

Dental Medicine Faculty Research

This investigation compared the microbiomes colonizing teeth during the initiation, progression, and resolution of periodontitis in nonhuman primates (Macaca mulatta) at different ages. Subgingival plaque samples were collected at baseline; 0.5, 1, and 3 months following ligature-induced periodontitis; and following naturally occurring disease resolution at 5 months. Samples were analyzed using 16S amplicon sequencing to identify bacterial profiles across age groups: young ( 3 years of age), adolescent (3 to 7 years), adult (12 to 15 years), and aged (17 to 23 years).-Diversity of the microbiomes was greater in the adult/aged samples than in the young/adolescent samples.-Diversity of the samples …

The Effect Of Physical Therapy On Patient Self-Reported Outcomes And Perceptions Of Mobility After Lower Extremity Amputations, Gregory Amaya, Rosman Gante, Zachary Meinzer, Abbas Sadrossadat

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: The number of people with limb loss is rapidly growing, partly due to an aging society and the prevalence of diabetes. Physical Therapy (PT) has been shown to improve perceived functional outcomes and quality of life in older adults and individuals with diabetes, but it is unclear why certain patients do not receive PT after amputation and whether the beneficial outcomes shown in other populations translate to individuals with limb loss. The purpose of this study was to determine whether receiving PT among patients with limb loss correlates with an improved quality of life, better mobility, and …

Lumbopelvic Muscle Performance And Morphology Differences: Implications For Low Back Pain In Individuals With Unilateral Above-The-Knee Amputation, Melissa Damele, Rachel Gross, Ronauldo Robina

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: The number of people living with an amputation in the United States is rising at a rate of almost 200,000 cases a year [1]. The incidence of low back pain (LBP) in individuals with lower limb amputation (LLA) has been shown to be much greater than in the general population at 52%- 72% [2-4]. High amputation level, disuse, and abnormal movement patterns associated with prosthetic gait have been theorized to lead to decreased lower back muscle performance, contributing to the high prevalence of LBP in individuals with LLA [5-7]. However, lumbar muscle morphology and performance have not …

Modulation Of Corticospinal Excitability Using Cathodal Transcranial Direct Current Stimulation To Improve Walking In Individuals With Chronic Post Stroke Hemiparesis, Neil Drobitch, Kylie Henry, Sage Lyons, James Schomig

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Individuals who have experienced a pyramidal cerebrovascular accident (pCVA) often exhibit impairments to volitional control of corresponding motor tasks. Promising effects in motor response, post-application of transcranial direct current stimulation (tDCS), have been reported in studies on individuals with the ability to achieve independent gait for 20 minutes. These studies mainly examined the effects of combined tDCS with locomotor training on lower extremity function among higher functioning individuals post-stroke. The purpose of this study was to determine the effect of tDCS among individuals post-stroke who may not have independent ambulatory capabilities, focusing on motor response and less …