Medicine and Health Sciences Commons^™

Study Protocol: Identifying Transcriptional Regulatory Alterations Of Chronic Effects Of Blast And Disturbed Sleep In United States Veterans, Molly J. Sullan, Kelly A. Stearns-Yoder, Zhaoyu Wang, Andrew J. Hoisington, Adam D. Brenoweth, Walter Carr, Yongchao Ge, Hanga Galfalvy, Fatemah Haghighi, Lisa A. Brenner

Faculty Publications

Injury related to blast exposure dramatically rose during post-911 era military conflicts in Iraq and Afghanistan. Mild traumatic brain injury (mTBI) is among the most common injuries following blast, an exposure that may not result in a definitive physiologic marker (e.g., loss of consciousness). Recent research suggests that exposure to low level blasts and, more specifically repetitive blast exposure (RBE), which may be subconcussive in nature, may also impact long term physiologic and psychological outcomes, though findings have been mixed. For military personnel, blast-related injuries often occur in chaotic settings (e.g., combat), which create challenges in the immediate assessment of …

Association Of Blast Exposure In Military Breaching With Intestinal Permeability Blood Biomarkers Associated With Leaky Gut, Qingkun Liu, Zhaoyu Wang, Shengnan Sun, Jeffrey Nemes, Lisa A. Brenner, Miciej Skotak, Christina R. Lavalle, Yongchao Ge, Walter Carr, Fatemeh Haghighi

Faculty Publications

Injuries and subclinical effects from exposure to blasts are of significant concern in military operational settings, including tactical training, and are associated with self-reported concussion-like symptomology and physiological changes such as increased intestinal permeability (IP), which was investigated in this study. Time-series gene expression and IP biomarker data were generated from “breachers” exposed to controlled, low-level explosive blast during training. Samples from 30 male participants at pre-, post-, and follow-up blast exposure the next day were assayed via RNA-seq and ELISA. A battery of symptom data was also collected at each of these time points that acutely showed elevated symptom …

Emergent Potential Of The Terahertz Cmos Microprocessor, F. Matthew Mihelic

Faculty Publications

The terahertz speed CMOS microprocessor that has been designed by Averoses Incorporated (US11063118B1) utilizes nano-vacuum tube elements with plasma interconnect of those elements, and has the capability to emit, detect, conduct, and analyze electromagnetic signals in the terahertz range. Nano-vacuum tube systems are resistant to ionizing radiation and to high temperatures, and there are emergent potentials of such systems beyond the obvious speed-up of data processing. Such a microprocessor can provide a platform for compact terahertz spectroscopy, especially for organic molecules, and this can also include DNA sequencing and DNA fingerprinting. Another emergent quality of such a system is that, …

A Quantum Logic Gate In The Dna Deoxyribose Moiety, F. Matthew Mihelic

Faculty Publications

The deoxyribose moiety of a nucleotide in the DNA molecule can act as a quantumlogic gate, in which the enantiomeric shift between the C2-endo and C3-endo conformations of each nucleotide, occurs within a logically and thermodynamically reversible situation of electron spin qubits, that are coherently held within the topologically insulating DNA crystalline nanostructure, and that are coherently conducted along the delocalized electrons of the pi-stacked nucleotide base pairs. The enantiomeric symmetry between the C2-endo and C3-endo conformations is logically and thermodynamically reversible because it functions as a symmetry-breaking Szilard engine that is effectively built out of the physicality of the …

Enhancing Pastoralist Women's Knowledge Of Danger Signs Through Home-Based Life-Saving Skills Intervention In Northern Kenya: A Quasi Experimental Study, Dabo Galgalo Halake, Elijah Isinta Maranga, Japheth Mativo Nzioki, John Gachohi

Faculty Publications

Background: Maternal recognition of obstetric danger signs is crucial for reducing maternal mortality and delays in seeking emergency care. However, there is insufficient knowledge about obstetric danger signs among women in rural Kenya, especially in the hard-to-reach pastoralist communities. This study aimed to determine whether home-based life-saving skills intervention improves knowledge about obstetric danger signs among women in Marsabit County, Kenya. Methods: We conducted a quasi-experimental study with pre-posttests among 256 pregnant women, allocated to intervention and control groups. We implemented sensitization of pregnant women on obstetric danger signs and basic life-saving actions as components of home-based life-saving skills intervention. …

Development Of A Methodology For The Quantification Of Reaerosolization Of A Biological Contaminate Surrogate Particle From A Military Uniform Fabric, George Cooksey, Jeremy M. Slagley, Casey W. Cooper, Douglas Lewis, Alisha Helm

Faculty Publications

In a mass casualty medical evacuation after a bioaerosol (BA) dispersal event, a decontamination (DC) method is needed that can both decontaminate and prevent biological particle (BP) re-aerosolization (RA) of contaminated clothes. However, neither the efficacy of current DC methods nor the risk of BP RA is greatly explored in the existing literature. The goals of this study were to develop a repeatable method to quantify the RA of a biological contaminant off military uniform fabric swatches and to test the efficacy of one DC protocol (high-volume, low-pressure water) using 1 µm polystyrene latex (PSL) spheres as a surrogate. A …

The Noloco Strategy For Essential Hypertension, F. Matthew Mihelic Md

Faculty Publications

Ninety-nine percent of all “essential” hypertension can be controlled by using the NoLoCo strategy, without causing any significant side-effects and without an increase in insulin resistance. NoLoCo stands for Norvasc (amlodipine), Lozol (indapamide), and Cozaar (losartan), but the medicines are considered and used in reverse order.

Building Thriving Healthcare Teams Through Organizational Learning, Bret Lyman, Marie M. Prothero, Adrianna L. Watson

Faculty Publications

The purpose of this article is to provide practical steps nurse leaders can use to build thriving healthcare teams through organizational learning. The climate, culture, and activities associated with organizational learning are well-aligned with those needed to build thriving teams. Nurse leaders who leverage this alignment can effectively recruit and retain teams while enhancing their team’s ability to effectively navigate change.

Building Thriving Healthcare Teams Through Organizational Learning, Bret Lyman, Marie M. Prothero, Adrianna L. Watson

Faculty Publications

The purpose of this article is to provide practical steps nurse leaders can use to build thriving healthcare teams through organizational learning. The climate, culture, and activities associated with organizational learning are well-aligned with those needed to build thriving teams. Nurse leaders who leverage this alignment can effectively recruit and retain teams while enhancing their team’s ability to effectively navigate change.

Augmenting Project Echo For Opioid Use Disorder With Data-Informed Quality Improvement, Owen B. Murray, Marcy A. Doyle, Bethany M. Mcleman, Lisa A. Marsch, Elizabeth C. Saunders, Katherine Cox, Delitha Watts, Jeanne Ryer

Faculty Publications

Background

National opioid-related overdose fatalities totaled 650,000 from 1999 to 2021. Some of the highest rates occurred in New Hampshire, where 40% of the population lives rurally. Medications for opioid use disorder (MOUD; methadone, buprenorphine, and naltrexone) have demonstrated effectiveness in reducing opioid overdose and mortality. Methadone access barriers disproportionally impact rural areas and naltrexone uptake has been limited. Buprenorphine availability has increased and relaxed regulations reduces barriers in general medical settings common in rural areas. Barriers to prescribing buprenorphine include lack of confidence, inadequate training, and lack of access to experts. To address these barriers, learning collaboratives have trained …

Racial And Ethnic Disparities In Alcohol-Attributed Deaths In The United States, 1999–2020, Ibraheem M. Karaye, Nasim Maleki, Ismaeel Yunusa Ph.D.

Faculty Publications

The disparities in alcohol-attributed death rates among different racial and ethnic groups in the United States (US) have received limited research attention. Our study aimed to examine the burden and trends in alcohol-attributed mortality rates in the US by race and ethnicity from 1999 to 2020. We used national mortality data from the Centers for Disease Control and Prevention’s Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database and employed the ICD-10 coding system to identify alcohol-related deaths. Disparity rate ratios were calculated using the Taylor series, and Joinpoint regression was used to analyze temporal trends and calculate annual and …

The Global Fatty Liver Disease-Sustainable Development Goal Country Score For 195 Countries And Territories, Jeffrey V. Lazarus, Hannah Han, Henry E. Mark, Saleh A. Schattenberg, Jörn M. J., Ismaeel Yunusa Ph. D., Et Al.

Faculty Publications

Background & Aims:

Fatty liver disease is highly prevalent, resulting in overarching wellbeing and economic costs. Addressing it requires comprehensive and coordinated multisectoral action. We developed a fatty liver disease-Sustainable Development Goal (SDG) country score to provide insights into country-level preparedness to address fatty liver disease through a whole-of-society lens.

Approach & Results:

We developed two fatty liver disease-SDG score sets. The first included six indicators (child wasting, child overweight, non-communicable disease [NCD] mortality, universal health coverage service coverage index, health worker density, and education attainment), covering 195 countries between 1990-2017. The second included the aforementioned indicators plus an urban …

Barriers To Cataract Surgery In Africa: Providers’ Perspective (Research Protocol), Cougar Hall, Scott Herrod, Benjamin Crookston, Sadik Taju Sherief, Akwasi Ahmed, Grace Chipalo Mutati, John Welling, Boatang Wiafe, Michae Gyasi, Joshua West

Faculty Publications

Purpose: Millions of individuals in sub-Saharan Africa are needlessly blind from cataracts. While progress was made towards the Vision 2020: The Right to Sight goals, Ethiopia, Ghana, and Zambia fell short of the recommended cataract surgical rate (CSR) on a national level. The purposes of this study were to describe possible economic factors impacting surgeon surgical productivity, possible barriers to attaining the recommended CSR, and surgical services in each of these countries.

Methods: An online survey was sent to ophthalmologists practising in Ethiopia, Ghana, and Zambia. Responses were collected between June 25, 2021 and January 30, 2022.

Results …

Intensive Care Unit Mortality And Length Of Stay Among Critically Ill Patients With Sepsis Treated With Corticosteroids: A Retrospective Cohort Study, Eric E. Chinaeke, Ismaeel Yunusa Ph.D., Bryan L. Love Pharm. D., Joseph Magagnoli, Claiborne E. Reeder

Faculty Publications

Objectives: Sepsis is a major cause of morbidity and mortality in critically ill patients worldwide, and corticosteroids are commonly used to treat it. However, the evidence supporting the use of corticosteroids in sepsis patients admitted to the intensive care unit (ICU) is of low certainty, with conflicting results reported in previous studies. Thus, we aimed to investigate the potential association between corticosteroid treatment and various outcomes, including 30-day ICU mortality, ICU length of stay (LOS), mechanical ventilation use, new onset of infection, and hyperglycemia in patients diagnosed with sepsis and admitted to the ICU.

Materials and Methods: We conducted …

Menstrual Justice In Theoretical Context, Vivian E. Hamilton

Faculty Publications

This Essay reviews and places into theoretical contexts Bridget Crawford and Emily Waldman’s invaluable book Menstruation Matters. Although the authors themselves do not explicitly label the theoretical approach that undergirds their work, much of Menstruation Matters: Challenging the Law’s Silence on Periods falls within the liberal feminist legal tradition typical of post-civil rights second-wave feminism. Their work also embodies aspects of critical feminist approaches to law. Crawford & Waldman expose the discriminatory effects of facially neutral laws, the limits of formal equality, and the pitfalls of essentializing or making universal claims about categories of individuals—including women and menstruators. In …

Utilizing The System Engineering Trade Study Analysis Method To Analyze Patient Aeromedical Evacuation, Sara Shaghaghi, Jeremy M. Slagley, Michael E. Miller, Gaiven Varshney

Faculty Publications

The US Air Force has gone through many aeromedical patient isolation transport system designs. The first designs were developed in response to the Ebola outbreak in 2014 and, more recently, the COVID-19 pandemic. The trade study analysis part of the system engineering design method was used to analyze the historic and current aeromedical patient contamination control transport systems. A trade study is a process that evaluates alternatives based upon various “-ilities”, such as reconfigurability, flexibility, durability, cost, and more, and performs a systematic analysis to aid designers in producing a ‘good’ design alternative given the large set of possible solutions. …

Covid-19 Lockdown: Impact On College Students’ Lives, Wendy C. Birmingham, Lori L. Wadsworth, Jane H. Lassetter

Faculty Publications

Objective: In light of COVID-19, leaders issued stay-at-home orders, including closure of higher-education schools. Most students left campus, likely impacting their employment and social network. Leaders are making decisions about opening universities and modality of instruction. Understanding students' psychological, physiological, academic, and financial responses to the shut-down and reopening of campuses can help leaders make informed decisions. Participants: 654 students from a large western university enrolled during the pandemic shutdown. Methods: Students were invited via email to complete an online survey. Results: Students reported stress, depression, loneliness, lack of motivation, difficulty focusing on schoolwork, restless sleep, appetite changes, job loss …

Impacts Of Fda Approval And Medicare Restriction On Antiamyloid Therapies For Alzheimer’S Disease: Patient Outcomes, Healthcare Costs, And Drug Development, Rouen Brockmann, Joanna Nixon, Bryan L. Love Pharm D., Ismaeel Yunusa Ph. D.

Faculty Publications

In 2021, the US Food and Drug Administration (FDA) granted approval to aducanumab, an antiamyloid antibody for early-stage Alzheimer's disease, despite a lack of clear clinical evidence demonstrating the drug's cognitive benefits. The manufacturer initially priced the drug at a staggering $56,000 per year, a price that was later reduced to $28,200. Unfortunately, these costs do not include the additional expenses associated with monitoring the treatment. However, the Centers for Medicare and Medicaid Services (CMS) recently announced that they will only cover individuals enrolled in clinical trials and will limit coverage of future antiamyloid antibodies. This discrepancy between the FDA …

Meeting Patients Where They Are: A Nurse-Driven Quality Improvement Project To Provide Influenza Vaccinations In The Emergency Department, Stacie Hunsaker, Larry Garrett, Katreena Merrill, Rachelle Rhodes

Faculty Publications

Introduction: Influenza is highly contagious, vaccine-preventable, and may result in significant morbidity and mortality. While vaccination is the primary protection against influenza, vaccination rates remain low. Traditionally, primary care clinics, retail pharmacies, and public health departments offer influenza vaccines. However, offering influenza vaccines in new settings may increase their availability to the public and increase community uptake. This project aimed to add emergency departments as a new influenza vaccine location to increase the number of vaccines distributed during the 2020 to 2021 influenza season.

Methods: Adult patients discharged from 24 emergency departments were included in this pre- post-intervention project. A …

Student Preferences For Active Learning And Their Beliefs, Experiences, And Knowledge, Tammy Shilling, Jerome Thayer, Anneris Coria-Navia, Heather Ferguson

Faculty Publications

Active teaching methods are believed to facilitate higher-order thinking skills and prepare allied health students for independent clinical decision-making. This quantitative, correlational study aimed to explain the relationships between student preferences for active over traditional methods and their beliefs, the frequency and positiveness of their experiences, and the extent of knowledge they have received regarding active and traditional teaching methods. Two hundred and thirty students completed a 53-item online survey. Students were enrolled in a Doctor of Physical Therapy, Masters in Speech-language Pathology, or Bachelor of Science Nursing program in one of seventeen participating institutions across a ten-state Midwest region. …

Affective Depression Mediates Ptsd To Suicide In A Sample Of Treatment-Seeking First Responders, James Whitworth, Jeanine Galusha, Jose Carbajal, Warren Ponder, Donna Schuman

Faculty Publications

Objective: The aim of this study was to examine the associations of comorbid

posttraumatic stress disorder (PTSD), affective or somatic depression, and

suicide among first responders (FRs). Method: We used baseline data from

FRs (N = 232) who sought services at a nonprofit mental health agency specializing

in treating trauma exposed FRs. We conducted two PROCESS simple

mediation models with PTSD as the predictor, affective depression and somatic

depression as the mediators, and suicidality as the dependent variable.

Results: Affective depression significantly mediated the relationship between

PTSD and suicidality, whereas somatic depression did not. The direct effect …

Comparative-Effectiveness Of Oral Beta-Lactams And Fluoroquinolones For Stepdown Therapy In Patients With Enterobacterales Bloodstream Infections: A Retrospective Cohort Study, Lauren Bjork Ph.D., Teri Hopkins Ph.D., Linda Yang Ph.D., Chengwen Teng Pharm.D., Ph.D., Xavier Jones Bs, Jose Cadena, Elizabeth Walter, Christopher R. Frei Pham.D., Ms

Faculty Publications

Background: This study compares treatment failure for patients who received oral beta-lactams (BLs) and fluoroquinolones (FQs) for stepdown treatment of Enterobacterales bloodstream infections (BSIs).

Methods: We conducted a single-center, retrospective, age- and sex-matched, cohort study, at a Veterans Affairs (VA) hospital in South Texas. Eligible patients were at least 18 years of age with a monomicrobial BSI treated with a single oral BL or FQ antibiotic. Treatment failure was defined as recurrence or all-cause mortality within 90 days of documented BSI. Bivariate (chi-square, Fisher's Exact, and Wilcoxon Rank Sum) and multivariate (logistic regression) statistical tests were used to compare groups. …

Design And Characterization Of An Aerosol Test Chamber For Emergency Response Patient Contamination Control Simulation And Research, Megan L. Steele, Emily M. Spatz, George P. Lemmer, Jacob M. Denney, Casey Cooper, Jeremy M. Slagley, Robert M. Eninger

Faculty Publications

Contaminated or infected patients present a risk of cross-contamination for emergency responders, attending medical personnel and medical facilities as they enter a treatment facility. The controlled conditions of an aerosol test chamber are required to examine factors of contamination, decontamination, and cross-contamination. This study presents the design, construction, and a method for characterizing an aerosol test chamber for a full-sized manikin on a standard North Atlantic Treaty Organization litter. The methodology combined air velocity measurements, aerosol particle counts and size distributions, and computational fluid dynamics modeling to describe the chamber’s performance in three dimensions. This detailed characterization facilitates future experimental …

Global Investments In Pandemic Preparedness And Covid-19: Development Assistance And Domestic Spending On Health Between 1990 And 2026, Angela E. Micah, Kayleigh Bhangdia, Ian E. Cogswell, Dylan Lasher, Brendan Lidral-Porter, Ismaeel Yunusa Ph. D., Et Al.

Faculty Publications

Background The COVID-19 pandemic highlighted gaps in health surveillance systems, disease prevention, and treatment globally. Among the many factors that might have led to these gaps is the issue of the financing of national health systems, especially in low-income and middle-income countries (LMICs), as well as a robust global system for pandemic preparedness. We aimed to provide a comparative assessment of global health spending at the onset of the pandemic; characterise the amount of development assistance for pandemic preparedness and response disbursed in the first 2 years of the COVID-19 pandemic; and examine expectations for future health spending and put …

Effects Of Positive Social Comparative Feedback On Motor Sequence Learning And Performance Expectancies, Allison F. Lewis, Rachel Bohnenkamp, Lynn Johnson, Dirk B. Den Ouden, Sarah Wilcox Phd, Stacy L. Fritz, Jill Campbell Stewart Pt,Phd

Faculty Publications

Introduction: Positive social comparative feedback indicates to the learner that they are performing better than others. While this type feedback supports motor skill learning in some tasks, the effect of social comparative feedback on implicit motor sequence learning remains unknown. The aim of this study was to determine the effect of positive social comparative feedback on the learning of and expectancies for a motor sequence task. Methods: Forty-eight individuals practiced a joystick-based sequence task and were divided into three feedback groups: CONTROL (no performance feedback), RT ONLY (response time only feedback), and RT+POS (response time plus positive social comparison). Participants …

Building Organizational Learning Capacity: A Road Map For Nurse Executives, Bret Lyman, Marie M. Prothero, Joy Parchment

Faculty Publications

The purpose of this article is to guide nurse executives in building learning capacity within their organizations. The Organizational Learning Road Map provided is grounded in the American Organization for Nursing Leadership’s Nurse Leader Core Competencies. Key steps include: developing one’s self as a learning leader, sharing a learning-focused vision for the organization, establishing a culture of learning, charting a course toward becoming a learning organization, developing a leadership team to support learning throughout the organization, measuring progress toward the vision, and sustaining momentum.

Building Organizational Learning Capacity: A Road Map For Nurse Executives, Bret Lyman, Marie M. Prothero, Joy Parchment

Faculty Publications

The purpose of this article is to guide nurse executives in building learning capacity within their organizations. The Organizational Learning Road Map provided is grounded in the American Organization for Nursing Leadership’s Nurse Leader Core Competencies. Key steps include: developing one’s self as a learning leader, sharing a learning-focused vision for the organization, establishing a culture of learning, charting a course toward becoming a learning organization, developing a leadership team to support learning throughout the organization, measuring progress toward the vision, and sustaining momentum.

Perspective: Food Environment Research Priorities For Africa-Lessons From The Africa Food Environment Research Network, Amos K. Laar, Phyllis Addo, Richmond Aryeetey, Charles Agyemang, Francis Zotor, Gershim Asiki, Krystal K. Ramapalli, Gideon S. Anevinya, Akua Tandoh, Silver Nanema, Akosua Pokua Adjei, Matlida E. Laar, Kobby Mensah, Dennis Laryea, Daniel Sellen, Stefanie Vandevijvere, Christopher Turner, Hibbah Osei-Kwasi, Mark Spires, Christine E. Blake, Dominic Rowland, Suneetha Kadiyala, Isabel Madzorera, Adama Diouf, Namukolo Covic, Isaac M. Dzudzor, Reginald Annan, Peiman Milani, John Nortey, Nicholas Bricas, Sukati Mphumuzi, Kenneth Yongabi Anchang, Ali Jafri, Meenal Dhall, Amanda Kee, Sally Mckay, Samuel O. Oti, Karen Hofman, Edward A. Frongillo Jr. Ph.D., Michelle Holdsworth

Faculty Publications

Over the last 2 decades, many African countries have undergone dietary and nutrition transitions fueled by globalization, rapid urbanization, and development. These changes have altered African food environments and, subsequently, dietary behaviors, including food acquisition and consumption. Dietary patterns associated with the nutrition transition have contributed to Africa's complex burden of malnutrition—obesity and other diet-related noncommunicable diseases (DR-NCDs)—along with persistent food insecurity and undernutrition. Available evidence links unhealthy or obesogenic food environments (including those that market and offer energy-dense, nutrient-poor foods and beverages) with suboptimal diets and associated adverse health outcomes. Elsewhere, governments have responded with policies to improve food …

Dataset For Effects Of Single-Session Practice Structure On Motor Skill Acquisition And Alpha And Beta Eeg Oscillations, Audrey Porter, Ronald V. Croce, Wayne Smith

Faculty Publications

Although it is known that practicing a motor skill updates the associated internal model, it is still unclear as to how cortical oscillations linked with the motor skill change under differing practice schedules. The current study investigated α- and β-power changes associated with motor skill acquisition. Firstly, we investigated the behavioral effects of practice on motor learning and retention during repetitive (RP) and variable (VP) practice schedules on an anticipation timing task. Secondly, we investigated changes in cortical α (10-13 HZ) and β (15-30 Hz) event-related synchronization and dyssynchronization (ERS/ERD) under RP and VP during early (EP) and late …

Women's Power In Hospital-Based Nursing: A Critical Qualitative Study, Kaitlyn C. George, Bret Lyman, Andy Pilarte Alcantara, Maya Stephenson

Faculty Publications

Aim: To understand the factors that affect power in hospital-based nursing and reveal how the female gender affects an individual's ability to feel empowered.

Design: Critical qualitative research design.

Method: Semi-structured interviews were conducted with nurses working in inpatient hospital settings in Utah and New Mexico. Data were collected from February to March 2022. Interviews were analysed using thematic analysis.

Results: Sixteen participants were interviewed. Six themes were identified from the data, four of which related to nurses' power at work, and two of which specifically related to how gender affects a nurse's ability to use power and feel empowered. …