Medicine and Health Sciences Commons^™

Professional Development For Clerkship Administrators: A 16-Year Overview Of The Clerkship Administrator Certificate Program, Donnita Pelser, Cathy Chavez, Lindsey Allison, Virginia Cleppe, Gary L Beck Dallaghan

Medical Education Faculty Publications

Background: Increasing accreditation requirements as well as transformations in medical school curricula necessitate administrative staff who are not only invested in the clerkship coordinator role but also view what they do as a career. To date, there has been a lack of professional development opportunities for clerkship administrators.

Methods: In 2003, the Central Group on Educational Affairs of the Association of American Medical Colleges recognized a need for professional development for clerkship administrators. The Clerkship Administrator Certificate Program emerged from that decision and presented for the first time in 2004 in Omaha, Nebraska. This article provides an overview of the …

A Phase 1 Study Of Intravenous Busulfan As A Conditioning Regimen For Multiple Myeloma, Sabarinath V. Radhakrishnan, Michael Boyer, Catherine M. Sherwin, Maurizio Zangari, Guido Tricot

Pediatrics Faculty Publications

The efficacy of melphalan (MEL) 140 mg/m 2 pre-transplant conditioning versus MEL 200 mg/m 2 for the elderly is still debated. We hypothesized that single-agent intravenous busulfan (BU) would show significant anti-myeloma efficacy and be better tolerated by elderly patients. A prospective 3+3 dose escalation study enrolled symptomatic multiple myeloma (MM) patients 65 years or older with SWOG performance 0–2 for treatment with intravenous BU pre-transplant at different administration levels. The primary objective was to determine the maximum tolerated dose (MTD) of BU that could be safely given over the least number of days. All patients, except one, received maintenance …

Totally Robotic Vs Hybrid Abdominoperineal Resection: A Retrospective Multicenter Analysis, Jonathan Douissard, Vincent Obias, Craig S. Johnson, Monika E. Hagen, Deborah Keller, James R. Ouellette, Minia Hellan

Department of Surgery Faculty Publications

Introduction

Laparoscopic abdominoperineal resection (APR) for low rectal cancers is technically demanding. Robotic assistance may be of help and can be hybrid (HAPR) or totally robotic (RAPR). The present study describes outcomes of robotic APR and compares both approaches.

Material and methods

A multicentric retrospective analysis of rectal cancer patients undergoing either HAPR or RAPR was conducted. Patients' demographics, surgeons' experience, oncologic results, and intraoperative and postoperative outcomes were collected.

Results

One hundred twenty‐five patients were included, 48 in HAPR group and 77 in RAPR group. Demographics and comorbidities were comparable. Operative time was reduced in RAPR group (266.9 ± …

The Missing Metric: An Evaluation Of Fungal Importance In Wetland Assessments, Megan A. Rúa

Biological Sciences Faculty Publications

To preserve wetland ecosystem function, federal and state agencies have developed assessment procedures to better manage remaining wetland areas. Currently, wetland assessments do not consider microorganisms when determining wetland quality. This is notable, because fungi are often the primary decomposers of organic material and thus important players in nutrient cycling. The objective of this study is to quantify how wetland quality, as measured using the Ohio Rapid Assessment Method (ORAM), relates to fungal community composition. We sampled soils from six depressional emergent marshes in Ohio belonging to each of the three ORAM quality categories, assessed soil physicochemical properties, and recovered …

Statistical Multiscale Mapping Of Idh1, Mgmt, And Microvascular Proliferation Inhuman Braintumors From Multiparametric Mr And Spatially-Registered Core Biopsy, Jason G. Parker, Emily E. Diller, Sha Cao, Jeremy T. Nelson, Kristen W. Yeom, Chang Ho, Robert M. Lober

Pediatrics Faculty Publications

We propose a statistical multiscale mapping approach to identify microscopic and molecular heterogeneity across a tumor microenvironment using multiparametric MR (mp-MR). Twenty-nine patients underwent pre-surgical mp-MR followed by MR-guided stereotactic core biopsy. The locations of the biopsy cores were identified in the pre-surgical images using stereotactic bitmaps acquired during surgery. Feature matrices mapped the multiparametric voxel values in the vicinity of the biopsy cores to the pathologic outcome variables for each patient and logistic regression tested the individual and collective predictive power of the MR contrasts. A non-parametric weighted k-nearest neighbor classifier evaluated the feature matrices in a leave-one-out cross …

Management Of Traumatic Subarachnoid Hemorrhage By The Trauma Service: Is Repeat Ct Scanning And Routine Neurosurgical Consultation Necessary?, Stephen W. Cooper, Kimberly B. Bethea, Trevor J. Skrobut, Rod G. Gerardo, Juan Torres-Reveron, Akpofure Peter Ekeh

Department of Surgery Faculty Publications

Subarachnoid hemorrhage (SAH) results frequently from traumatic brain injury (TBI). The standard management for these patients includes brief admission by the acute care surgery (trauma) service with neurological checks, neurosurgical consultation and repeat head CT within 24 hours to identify any progression or resolution. Recent studies have questioned the need for repeat CT imaging and specialty consultation in mild TBI. We reviewed patients with mild TBI specifically with isolated SAH to determine progression of the pathology and need for neurosurgical involvement. All patients with SAH secondary to mild TBI (Glasgow Coma Score (GCS) of 13-15) who presented over a 5-year …

Myeloid-Derived Suppressor Cells And Pancreatic Cancer: Implications In Novel Therapeutic Approaches, Anita Thyagarajan, Mamdouh Salman A. Alshehri, Kelly L.R. Miller, Catherine M. Sherwin, Jeffery B. Travers, Ravi P. Sahu

Pediatrics Faculty Publications

Pancreatic ductal adenocarcinoma (PDAC) remains a devastating human malignancy with poor prognosis and low survival rates. Several cellular mechanisms have been linked with pancreatic carcinogenesis and also implicated in inducing tumor resistance to known therapeutic regimens. Of various factors, immune evasion mechanisms play critical roles in tumor progression and impeding the efficacy of cancer therapies including PDAC. Among immunosuppressive cell types, myeloid-derived suppressor cells (MDSCs) have been extensively studied and demonstrated to not only support PDAC development but also hamper the anti-tumor immune responses elicited by therapeutic agents. Notably, recent efforts have been directed in devising novel approaches to target …

Boonshoft School Of Medicine Central Research Forum Program - 2019, Office Of Research Affairs, Boonshoft School Of Medicine

Central Research Forum

An 88 page program which includes a schedule and abstracts from the 2019 Central Research Forum held by the Boonshoft School of Medicine's Office of Research Affairs.

Vital Signs, Fall 2019, Boonshoft School Of Medicine

Vital Signs

A thirty-two page newsletter created by the Boonshoft School of Medicine to document the current affairs of the school. This issue includes a variety of feature articles, alumni profiles, class notes, and more.

Antibiotic Treatment Of Suspected And Confirmed Neonatal Sepsis Within 28 Days Of Birth: A Retrospective Analysis, Jadon S. Wagstaff, Robert J. Durrant, Michael G. Newman, Rachael Eason, Robert M. Ward, Catherine M.T. Sherwin, Elena Y. Enioutina

Pediatrics Faculty Publications

Neonatal sepsis causes significant mortality and morbidity worldwide. Diagnosis is usually confirmed via blood culture results. Blood culture sepsis confirmation can take days and suffer from contamination and false negatives. Empiric therapy with antibiotics is common. This study aims to retrospectively describe and compare treatments of blood culture-confirmed and unconfirmed, but suspected, sepsis within the University of Utah Hospital system. Electronic health records were obtained from 1,248 neonates from January 1, 2006, to December 31, 2017. Sepsis was categorized into early-onset (≤3 days of birth, EOS) and late-onset (>3 and ≤28 days of birth, LOS) and categorized as culture-confirmed …

Implementing A Novel Quality Improvement-Based Approach To Data Quality Monitoring And Enhancement In A Multipurpose Clinical Registry, Jesse Pratt, Daniel Jeffers, Eileen C. King, Michael D. Kappelman, Jennifer Collins, Peter Margolis, Howard Baron, Julie A. Bass, Mikelle D. Bassett, Genie L. Beasley, Keith J. Benkov, Jeffrey A. Bornstein, Jose M. Cabrera, Wallace Crandall, Liz D. Dancel, Monica P. Garin-Laflam, John E. Grunow, Barry Z. Hirssch, Edward Hoffenberg, Esther Israel, Traci W. Jester, Fevronia Kiparissi, Arathi Lakhole, Sameer P. Lapsia, Phillip Minar, Fernando A. Navarro, Haley Neef, Kt Park, Dinesh S. Pashankar, Ashish S. Patel, Victor M. Pineiro, Chrles M. Samson, Kelly C. Sandberg, Steven J. Steiner, Jennifer A. Strople, Boris Sudel, Jillian S. Sullivan, David L. Suskind, Vikas Uppal, Prateek D. Wali

Pediatrics Faculty Publications

Objective: To implement a quality improvement based system to measure and improve data quality in an observational clinical registry to support a Learning Healthcare System.

Data Source: ImproveCareNow Network registry, which as of September 2019 contained data from 314,250 visits of 43,305 pediatric Inflammatory Bowel Disease (IBD) patients at 109 participating care centers.

Study Design: The impact of data quality improvement support to care centers was evaluated using statistical process control methodology. Data quality measures were defined, performance feedback of those measures using statistical process control charts was implemented, and reports that identified data items not following data quality checks …

Sciatic Nerve Cut And Repair Using Fibrin Glue In Adult Mice, Erica T. Akhter, Travis M. Rotterman, Arthur W. English, Francisco J. Alvarez

Neuroscience, Cell Biology & Physiology Faculty Publications

Peripheral nerve injury (PNI) is an excellent model for studying neural responses to injury and elucidating the mechanisms that can facilitate axon regeneration. As such, several animal models have been employed to study regenerative mechanisms after PNI, including Aplysia, zebrafish, rabbits, cats and rodents. This protocol describes how to perform a sciatic nerve injury and repair in mice, one of the most frequently used models to study mechanisms that facilitate recovery after PNI, and that takes advantage of the availability of many genetic models. In this protocol, we describe a method for using fibrin glue to secure the proximal …

Laparoscopic Cholecystectomy In The Acute Care Surgery Model: Risk Factors For Complications, Emily Fletcher, Erica Seabold, Ronald J. Markert, Alyssa J. Gans, Akpofure Peter Ekeh

Department of Surgery Faculty Publications

Background: The Acute Care Surgery (ACS) model developed during the last decade fuses critical care, trauma, and emergency general surgery. ACS teams commonly perform laparoscopic cholecystectomy (LC) for acute biliary disease. This study reviewed LCs performed by an ACS service focusing on risk factors for complications in the emergent setting. Methods: All patients who underwent LC on an ACS service during a 26-month period were identified. Demographic, perioperative, and complication data were collected and analyzed with Fisher's exact test, χ ² test, and Mann-Whitney U Test. Results: During the study period, 547 patients (70.2% female, mean age 46.1±18.1, …

Quantifying Skin Photodamage With Spatial Frequency Domain Imaging: Statistical Results, Jeffrey B. Travers, Chien Poon, Trevor J. Bihl, Benjamin Rinehart, Christina E. Borchers, Daniel J. Rohrbach, Samia Borchers, Julian J. Trevino, Max Rubin, Heidi Donnelly, Karl Kellawan, Lydia Carpenter, Shalini Bahl, Craig A. Rohan, Elizabeth Muennich, Scott Guenthner, Holly Hahn, Ali Rkein, Marc Darst, Nico Mousdicas, Elizabeth E. Cates, Ulas Sunar

Dermatology Faculty Publications

We investigated the change in optical properties and vascular parameters to characterize skin tissue from mild photodamage to actinic keratosis (AK) with comparison to a published photodamage scale. Multi-wavelength spatial frequency domain imaging (SFDI) measurements were performed on the dorsal forearms of 55 adult subjects with various amounts of photodamage. Dermatologists rated the levels of photodamage based upon the photographs in blinded fashion to allow comparison with SFDI data. For characterization of statistical data, we used artificial neural networks. Our results indicate that optical and vascular parameters can be used to quantify photodamage and can discriminate between the stages as …

Learning From Experience: Avoiding Common Pitfalls In Multicenter Quality Improvement Collaboratives, Jonathan D. Thackeray, Carrie A. Baker, Rachel P. Berger

Pediatrics Faculty Publications

Clinicians and researchers often tout the newest breakthrough or latest successful intervention. Sharing wins, however, is often done at the expense of sharing obstacles, failures, and subsequent adjustments, which are the cornerstone of quality improvement (QI).^1–3 Here, we share 3 key lessons from 2 hospital-based QI initiatives—the Ohio Timely Recognition of Abuse Injuries (TRAIN) Collaborative and the University of Pittsburgh Medical Center (UPMC) Child Abuse Initiative (UPMC-CAI). Both focus on early identification, proper evaluation, and accurate reporting of child maltreatment. These are important clinical issues because many children who die or nearly die from maltreatment had been …

Predicted Disease Compositions Of Human Gliomas Estimated From Multiparametric Mri Can Predict Endothelial Proliferation, Tumor Grade, And Overall Survival, Emily E. Diller, Sha Cao, Beth Ey, Robert M. Lober, Jason G. Parker

Pediatrics Faculty Publications

Background and Purpose: Biopsy is the main determinants of glioma clinical management, but require invasive sampling that fail to detect relevant features because of tumor heterogeneity. The purpose of this study was to evaluate the accuracy of a voxel-wise, multiparametric MRI radiomic method to predict features and develop a minimally invasive method to objectively assess neoplasms. Methods: Multiparametric MRI were registered to T1-weighted gadolinium contrast-enhanced data using a 12 degree-of-freedom affine model. The retrospectively collected MRI data included T1-weighted, T1-weighted gadolinium contrast-enhanced, T2-weighted, fluid attenuated inversion recovery, and multi-b-value diffusion-weighted acquired at 1.5T or 3.0T. Clinical experts provided voxel-wise annotations …

Genetically Distinct Behavioral Modules Underlie Natural Variation In Thermal Performance Curves, Gregory W. Stegeman, Scott E. Baird, William S. Ryu, Asher D. Cutter

Biological Sciences Faculty Publications

Thermal reaction norms pervade organismal traits as stereotyped responses to temperature, a fundamental environmental input into sensory and physiological systems. Locomotory behavior represents an especially plastic read-out of animal response, with its dynamic dependence on environmental stimuli presenting a challenge for analysis and for understanding the genomic architecture of heritable variation. Here we characterize behavioral reaction norms as thermal performance curves for the nematode Caenorhabditis briggsae, using a collection of 23 wild isolate genotypes and 153 recombinant inbred lines to quantify the extent of genetic and plastic variation in locomotory behavior to temperature changes. By reducing the dimensionality of the …

Preparing Learners For Learning In The Engaged Learning Classroom, Maryam Alizadeh, Dean Parmelee, Irina Overman, Mohamad Aljasem

Medical Education Faculty Publications

This set of Tips is written to make the best use of an Engaged Learning Classroom (ELC), which some may refer to as the ‘flipped classroom.’ Strategies for the ELC include Team-Based Learning (TBL), Peer Instruction (PI), Case-Based Learning (CBL). Our focus will be on the design and implementation of the out-of-class phase for any ELC activity since this is as important as the in-class phase, but often neglected. Experience has shown that the quality of learning from the ELC is highly dependent on the preparation before, and follow-up to the class session. The instructor’s designation of material (written, audio-visual, …

Development And Use Of Performance Composite Scores In Dispatch Teams, Christopher R. Bearden, Michael B. Hein, Glenn E. Littlepage

International Symposium on Aviation Psychology - 2019

Teams perform a variety of functions within organizations and should therefore be evaluated on multiple criteria. This paper argues for the use of a single value. We review the literature on team performance composites and briefly describe two approaches to developing evaluative performance composites in an academic setting by combining performance indicator data: A qualitative approach for performance feedback as well as an empirical approach for research purposes.

Examining Pilot Decision Making In Information-Rich Cockpits, Meredith Carroll, Donna Forsyth Wilt, Paige Sanchez, Deborah Carstens

International Symposium on Aviation Psychology - 2019

Pilots are faced with making decisions based on a range of different information sources. One challenge pilots often face is the presentation of conflicting information between sources. This effort examined pilot decision making with conflicting information by conducting structured interviews with 13 pilots, including seven airline, three corporate, and three GA pilots. Pilots were asked questions regarding their experience with conflicting sources of weather, traffic, and navigation information on the flight deck or cockpit. Further, they were asked to describe how they responded to the information conflict, including which source they trusted, which source they ultimately acted on, and why …

Understanding Current Ways Of Reporting Runway Incursion Incidents At Towered Airports, Divya Bhargava, Karen Marais

International Symposium on Aviation Psychology - 2019

Runway incursions occur when an unauthorized aircraft, vehicle or pedestrian operates on a runway. While most incursions are near-misses, they have the potential of turning into fatal accidents such as the Tenerife accident. Despite various efforts to reduce runway incursions, the number of incursions has been increasing. Learning from past incidents can help us develop effective preventive strategies but lack of in-depth investigations limits our understanding of the causes of incursions. At towered airports, the controller on duty reports the incident to the FAA using a form asking them to describe the incident in their own words. Our research question …

Individualized Landing Flare Training Using Both Flight Performance And Psychophysiological Measures, Jorg Onno Entzinger

International Symposium on Aviation Psychology - 2019

In this paper, we propose the analysis of various measures of eye and heart-rate data in addition to the flown trajectories and landing result, to get a better understanding of a trainee’s learning phase and optimize the time spent on and exercises used for the flare training. A problem often experienced is that the trainee knows what to do and tries to a level that (s)he even believes to be doing just that, without actually doing it. Objective, visual feedback can be used to provide the trainee with tangible points to focus on, instead of the often heard comments like …

Lost Of Situation Awareness During Commercial Flight Over Colombian Mountains, Oscar Sarmiento Mejia

International Symposium on Aviation Psychology - 2019

According to the report received by the commander of the aircraft, the 48 hours prior to the event were instructional flights with high workloads, as they were aspirants who expected to be linked to the company, the assignment of the flight began in Medellin(Colombia) under the condition of additional crew member ( tripadi) to the city of Cali, there he made his first flight covering the Cali-Bogota route, without any novelty with the student, they had a stopover in Bogota of approximately three (3) hours and departed to Cali in order to perform an initial operational training (IOT) for the …

Assessing Human-System Resilience Potential Throughout The Development Lifecycle*, Amy L. Alexander, Dan Herschler

International Symposium on Aviation Psychology - 2019

We worked with subject matter experts to create a human-system resilience checklist that can be utilized during Independent Operational Assessments (IOAs) of air traffic control systems as part of the system acquisition process. The checklist focuses on four key areas for evaluating human-system resilience characteristics: procedures, system use, workload, and training. A resilience scoring method indicates areas where a human-machine system under consideration does or does not have resilient characteristics. Overall resilience scores can be compared among design alternatives, or across different points in system development for a particular design. The ultimate intent is to provide guidance and metrics that …

The Nasa Matb-Ii Predicts Prospective Memory Performance During Complex Simulated Flight, Kathleen Van Benthem, Caitlin Shanahan, Chunyun Ma, Adam Fraser, Chris M. Herman

International Symposium on Aviation Psychology - 2019

Prospective memory is essential for flight, where failures can result in incorrect flight control settings, leading to loss of life and equipment. Furthermore, prospective memory is highly-sensitive to pilot age, cognition, and experience. This research reports on the relation of the NASA Multi-Attribute Test Battery-II (MATB-II) to prospective memory during simulated VFR flight (N=51). Prospective memory was indexed with specialized radio calls that were associated with non-focal visual cues. Linear regression models examined the relative association of MATB-II variables to prospective memory in low and high workloads. System monitoring, psychomotor tracking, and resource management, generally at higher difficulty levels, were …

Design Of Air Traffic Control Weather Related Training Program, Emma Pierson, Chen Ling, Ali Alshaqah, Joseph James, Shengyong Wang

International Symposium on Aviation Psychology - 2019

Essential components of a new scenario-based air traffic control (ATC) training platform whose effectiveness is being analyzed are outlined with respect to its use in the decision-making skills of trainees when confronted with emergency situations. The custom designed platform allows the trainee to interact with the program such that the 10-minute ramification of a proposed aircraft redirection can be explored visually before a decision is made. Actual previous extreme weather incidences are used. Testing of the platform is ongoing with ATC students from Kent State University. Data from subjective pre- and postquestionnaires as well as objective decision parameters are currently …

Resilience And Safety For In-Time Monitoring, Prediction, And Mitigation Of Emergent Risks In Commercial Aviation, Jon Holbrook, Lawrence J. Prinzell Iii, Michael J. Stewart, Brian E. Smith, Bryan L. Matthews

International Symposium on Aviation Psychology - 2019

Safety in aviation has been historically defined in terms of the occurrence of accidents or recognized risks; that is, safety is typically defined in terms of things that go wrong. An alternative and complementary approach is to focus on what goes right, and identify how to make that happen again. Focusing on the rare cases of failures attributed to “human error” provides little information about why human performance almost always goes right. Similarly, focusing on the lack of safety provides limited information about how to improve safety. This work builds upon a growing literature on resilience engineering and new approaches …

Traffic Flow Management For Trajectory Based Operations: Supporting Effective Predeparture Reroutes, Philip J. Smith, Mark Evans, Amy Spencer

International Symposium on Aviation Psychology - 2019

There are a number of tools and procedures identified as applicable to initial Trajectory Based Operations (iTBO). This includes Strategic Planning and Traffic Flow Management such as the use of Ground Delay Programs, Airspace Flow Programs and Collaborative Trajectory Operations Program initiatives (CTOPs). It also includes a focus on route management (including the Pre-Departure ReRoute (PDRR) and AirBorne ReRoute (ABRR) tools and airport surface management (as part of the Tower Flight Data Management program or TFDM). This paper focuses on enhancements to support the effective use of the Pre- Departure ReRoute tool (PDRR). These enhancements emphasize the importance of integration …

Pilot Wellbeing & Work Related Stress (Wrs), Joan Cahill, Paul Cullen, Keith Gaynor

International Symposium on Aviation Psychology - 2019

This paper presents the preliminary findings of an anonymous web-based survey addresing pilot work related stress (WRS) and wellbeing. The initial analysis indicates that pilots are under stress and experiencing wellbeing problems. Specific features of the job can result in wellbeing problems, spanning the three pillars of wellbeing. Critically, sources of WRS can increase a pilot’s risk in terms of developing a mental health (MH) issue. Further, sources of WRS can impact on performance and safety. Considerable barriers still remain in relation to reporting MH issues at work. Coping mechanisms addressing sleep/fatigue, diet, exercise and communication/reporting, enable some pilots to …

Towards A Meta-Model To Specify And Design Human-Agent Teams, Michael F. Schneider, Michael E. Miller, John M. Mcguirl

International Symposium on Aviation Psychology - 2019

This paper describes work towards developing a meta-model useful in the design and specification of Human-Agent Teams. The meta-model adapts components from the cognitive systems, human factors, software and systems engineering literature to form a model and language which can be applied early in the system design process. The resulting model provides a description of desired system behavior. More importantly, the model produces artifacts useful in deriving requirements for both the human and the artificial agents, as well as for the software/hardware human interface. Insight is also provided for manpower, training, and personnel requirements; as well as, requirements for agent …