Medicine and Health Sciences Commons^™

Investigating Preventable Hospitalizations And Potentially Related Factors In Ohio, Seth Guillozet

Scholarship in Medicine - All Papers

Objective: This research study aims to examine preventable hospitalization rates in Ohio and several variables to may be associated with changes in these rates. First, I will investigate how preventable hospitalization rates (PHRs) have changed in Ohio from 2016 to 2020. Additionally, Primary Care Physician (PCP) ratio will be compared from 2016 to 2020 in Ohio, looking for any change that has occurred between the years. Next, PHRs will be correlated to the percentage of population uninsured in Ohio to look for any relationship between these two variables. Finally, Ohio’s PHRs will be compared to Indiana’s for 2020, to look …

Universal Health Coverage And Hiv In Hispanic America, Jenna Frantz

Scholarship in Medicine - All Papers

Objective: This study analyzes differences between HIV statistics in Hispanic American countries that have passed UHC legislation versus those that have not passed UHC legislation. In 2017, 0.4% of the population of Latin America and 1.2% of the population of the Caribbean was living with Human Immunodeficiency Virus (HIV).1 Because of these high rates of HIV in Hispanic America, as well as the lethality of HIV if untreated, HIV statistics and treatment outcomes in Hispanic America are of great concern. Relationships between HIV statistics and Universal Health Coverage (UHC) legislation could serve as a metric for UHC performance in Hispanic …

Effectiveness Of The Mini-Balance Evaluation Systems Test (Mini-Bestest) In Evaluating Balance In The Controlled Hypertensive Elderly Population, Melanie Sich

Scholarship in Medicine - All Papers

Objective: Provide additional evidence about the relationship between controlled hypertension and balance control by evaluating individuals’ gait stability, sensorial orientation, reactive postural response, and anticipatory postural adjustment using the Mini-Balance Evaluation Systems Test (Mini-BESTest).

Methods: A total of 76 (28 controlled hypertensive, 48 non-hypertensive) individuals were evaluated with the Mini-BESTest protocol. Each of the subscores obtained from the test represented the different subdomains of postural control, and they were compared between controlled hypertensive and non-hypertensive groups using a one-way analysis of variance (ANOVA) statistical analysis.

Results: Hypertensive individuals tended to score lower than non-hypertensive individuals in the anticipatory postural adjustment …

Incidence Of Female Breast Cancer In The United States By Race And Region, Tiffany Le

Scholarship in Medicine - All Papers

Objective: Assess the distribution and incidence of female breast cancer in the United States in different races and regions of the United States. Methods: Collect and analyze CDC WONDER data from the Center for Disease and Control to see if there are varying rates of female breast cancer incidence between races and in different regions of the United States. Results: The results are expected to show a significant difference in female breast cancer incidence between races and a non-significant difference in female breast cancer incidence among different regions of the United States.

Age, Gender, And Racial Differences Between Acute Myocardial Infarction, Type 2 Diabetes, And Their Comortality, Steven Borchers

Scholarship in Medicine - All Papers

Acute myocardial infarction and type two diabetes are within the top seven causes of death in the United States and their impact on society is costly. Although there are many studies conducted about these diseases, some of the research is aged and requires more recent datasets. The objective of this research is to revel trends in these diseases, as well as in their comorbidity, relating to age, gender, and race. To conduct this research, data has been collected from the CDC Wonder dataset using their comorbidity database. This comorbidity data uses USA death certificates from 1999-2017 to retrieve the medical …

Correlations Between Quality Of Life, Daily Sunlight, And Suicide Risk, Brittany Abeldt

Scholarship in Medicine - All Papers

Methods: Data was collected from the archives provided by the CDC Wonder database; including The Behavioral Risk Factor Surveillance System, The North America Land Data Assimilation System, and The Web-Based Injury Statistic Query and Reporting System. The variables used were quality of life (as measured by mental health days and physical health days), suicide rates, and daily sunlight. Data was obtained for all the states in the United States, excluding Alaska and Hawaii due to lack of available data from these states. Quality of life and suicide rate data was from 2016 and daily sunlight data was from January 1st, …

Cardiovascular Fitness And Muscle Strength In Asthmatic Children, Kaitlynne Pak

Scholarship in Medicine - All Papers

Objective: The aim of this retrospective study is to evaluate the cardiovascular fitness and muscle strength performance of children with asthma versus without.

Methods: Participants include patients who were involved in the 2012 NHANES National Youth Fitness Survey (NNYFS) as published by the Centers for Disease Control and Prevention. The average cardiovascular fitness and muscle strength scores will be appreciated by analyzing the averages of time spent on treadmill, maximal heart rate, heart rate at end of exam, recovery time, maximal endurance time, cardiovascular fitness report, upper body strength and lower body strength using two-tailed T-tests between patients with asthma …

The Impact Of Food Insecurity On Diabetes Prevalence In The Us: A Look At The Northeast And The Midwest, Richard Mensah

Scholarship in Medicine - All Papers

Diabetes is one of the most common chronic conditions globally. Various risk factors have been found to be associated with the incidence of diabetes. These include genetic predispositions, physical activity and diet. However, less attention has been given to the potential risk of food insecurity to diabetes prevalence. Therefore, the goal of this study was to look at the prevalence of food insecurity and diabetes in New York and Ohio, and try to see if a correlation exists between food insecurity and diabetes prevalence in these states.

In our methods, we used the 2019 data from County Health Rankings (CHR) …

Long-Term Survival Of Bladder Cancer Metastatic To Femoral Neck Treated With Chemotherapy, Radiation, And Arthroplasty: A Case Report, John Defant, Scott Huff, Joseph D. Henningsen, Anil Krishnamurthy

Scholarship in Medicine - All Papers

Case: A 64-year-old male suffered a pathologic left femoral neck fracture. Biopsy demonstrated metastatic urothelial cancer with a non-muscle invasive bladder cancer primary confirmed by cystoscopy. Patient underwent hemiarthroplasty, chemotherapy, radiation, and eventually, a conversion to total hip arthroplasty. Today, over a decade from initial surgery, the patient remains alive and highly functional. To our knowledge, this is the only report of bone metastatic bladder cancer with over 10-year survival. Conclusion: Bladder cancer metastatic to bone has a 5-year survival rate of 3%. Surgical resection of metastasis with reconstruction may confer a survival benefit in bony oligometastatic bladder cancer.

A Metacognitive Triggering Mechanism For Anticipatory Thinking, Alexander R. Hough, Othalia Larue, Ion Juvina

Psychology Faculty Publications

Current autonomous systems have the ability to adapt to envi-ronmental changes in real-time, but limited ability to engage inanticipatory thinking (AT) with the flexibility to generalize andconsider hypothetical future situations. We argue that metacog-nitive processes are important for an and provide supporting lit-erature primarily from psychology. As an example, we presenta metacognitive monitoring mechanism implemented in a cog-nitive model and discuss ways to extend the mechanism to allowfor dynamic behavior and anticipatory thinking capabilities.

The Role Of Igf-1 In Geriatric Skin, Amber Castellanos

Browse all Theses and Dissertations

Keratinocytes are cells that largely occupy the epidermis layer of our skin and function to protect against DNA damage induced by ultraviolet radiation. Keratinocytes rely on the activation of the IGF-1 receptor in order to carry out an appropriate response to UV-B radiation. Keratinocytes themselves do not express the IGF-1 ligand; IGF-1 is produced by fibroblasts found in the dermis layer of the skin. With age, fibroblasts become senescent and this interferes with their ability to produce IGF-1 for the epidermal IGF-1R. This occurrence may aid in understanding why geriatric individuals are at greatest risk for developing nonmelanoma skin cancers, …

Impact Of Passive Range Of Motion Exercises And Stretching In Knee Osteoarthritis Pain During Walking, Dominique Marchelle Ottonello

Browse all Theses and Dissertations

Knee osteoarthritis (KOA), is globally prevalent source of disability for the elderly. This degenerative malady progresses with age and has no cure. It manifests in gait changes and affects overall quality of life. Exercise therapy has been shown to improve knee joint range of motion, stiffness and pain due to KOA. This improvement is due in part to the direct relationship between muscle strength and joint stability. The purpose of this study is to examine how a passive range of motion (ROM) exercises and stretching regimens affect gait-alterations and associated pain from KOA experienced during walking. Nine KOA subjects were …

Determining Effects Of The Paf-R And Anti-Hypertensive Drugs Mediated Microvesicle Particle Release In Modulating Anti-Tumor Response Of Lung Cancer, Andrew Stephen Forino

Browse all Theses and Dissertations

Lung cancer is one of the world’s leading causes of cancer-related deaths with poor prognosis, and difficult to treat malignancy. Several genetic, and environmental factors including cigarette smoking and hypertension have been linked as the common risk factors for lung cancer. To that end, multiple mechanisms have been proposed in regulating tumor growth, angiogenesis, and metastasis, as well as the efficacy of cancer therapy in experimental lung cancer models. Importantly, studies including ours, have shown that exposure to reactive oxygen species (ROS)-generating stimuli such as cigarette smoking, and cancer therapy produced oxidized lipids with platelet-activating factor (PAF) agonistic activity from …

Discovery And Characterization Of Pathways Involved In Fus And Tdp43-Induced Toxicity In Yeast, Weston Joseph Shaw

Browse all Theses and Dissertations

High-throughput genome-scale studies are becoming increasingly common as a means to discover genetic interactions. This methodology is particularly efficient when performed in the budding yeast Saccharomyces cerevisiae. Here, we (1) overexpress a large human gene library in yeast to assess how many of them are toxic, and (2) use the list of genes generated above to refine and analyze human genes previously identified to enhance toxicity of two ALS-associated proteins, FUS and TDP-43. By introducing each of 13,500 human genes into yeast, we demonstrated that the majority of these genes (about 97%) are not toxic to yeast when overexpressed. These …

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 …

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 ± …

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 …

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 …

Antioxidant Enzyme-Mimetic Activity And Neuroprotective Effects Of Cerium Oxide Nanoparticles Stabilized With Various Ratios Of Citric Acid And Edta, Ana Y. Estevez, Mallikarjunarao Ganesana, John F. Trentini, James E. Olson, Guang Ze Li, Yvonne O. Boateng, Jennifer M. Lipps, Sarah E.R. Yablonski, William T. Donnelly, James C. Leiter, Joseph S. Erlichman

Emergency Medicine Faculty Publications

Cerium oxide (CeO2) nanoparticles (CeNPs) are potent antioxidants that are being explored as potential therapies for diseases in which oxidative stress plays an important pathological role. However, both beneficial and toxic effects of CeNPs have been reported, and the method of synthesis as well as physico-chemical, biological, and environmental factors can impact the ultimate biological effects of CeNPs. In the present study, we explored the effect of different ratios of citric acid (CA) and EDTA (CA/EDTA), which are used as stabilizers during synthesis of CeNPs, on the antioxidant enzyme-mimetic and biological activity of the CeNPs. We separated the CeNPs into …

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, …

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 …

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 …