Medicine and Health Sciences Commons^™

Correction Of Velopharyngeal Insufficiency Secondary To Palatal Gunshot Wound: Case Presentation And Review Of The Literature, Rogelio Martinez-Wagner, Cristopher Cardenas-Cruz, Ivan Ortiz-Monasterio, Edgar Vargas, Maria M. Cabrera, Pablo A. Ysunza, M. Del Carmen Pamplona, Diane E. Campos-Lopez

Articles

Reconstruction of midfacial traumatic defects secondary to a gunshot wound (GSW) is one of the most challenging head surgeries. The high impact on the functional and aesthetic quality of life, and the small margin of error to achieve a successful outcome are significant hurdles in the surgical treatment of these cases. Here we report a 33-years old patient who suffered a GSW with an entrance wound penetrating between the soft and hard palate and an exit wound on the right malar region. A description of the case and a systematic review of the literature were conducted. The treatment depends on …

Using Electronic Medical Record Data To Establish And Monitor The Distribution Of Refractive Errors, Sean Longwill, Michael Moore, Daniel Ian Flitcroft, James Loughman

Articles

Objective

To establish the baseline distribution of refractive errors and associated factors amongst a population that attended primary care optometry clinics.

Design

Retrospective cross sectional cohort study of electronic medical records (EMR).

Methods

Electronic medical record data was extracted from forty optometry clinics, representing a mix of urban and rural areas in Ireland. The analysis was confined to demographic and clinical data gathered over a sixty-month period between 2015 and 2019. Distribution rates were calculated using the absolute and relative frequencies of refractive error in the dataset, stratified for age and gender using the following definitions: high myopia ≤ -6.00 …

A Review Of Risk Concepts And Models For Predicting The Risk Of Primary Stroke, Elizabeth Hunter, John D. Kelleher

Articles

Predicting an individual's risk of primary stroke is an important tool that can help to lower the burden of stroke for both the individual and society. There are a number of risk models and risk scores in existence but no review or classification designed to help the reader better understand how models differ and the reasoning behind these differences. In this paper we review the existing literature on primary stroke risk prediction models. From our literature review we identify key similarities and differences in the existing models. We find that models can differ in a number of ways, including the …

Advances In 3d Culture Systems For Therapeutic Discovery And Development In Brain Cancer, Janith Wanigasekara, Patrick J. Cullen, Paula Bourke, Brijesh Tiwari, James F. Curtin

Articles

This review focuses on recent advances in 3D culture systems that promise more accurate therapeutic models of the glioblastoma multiforme (GBM) tumor microenvironment (TME), such as the unique anatomical, cellular, and molecular features evident in human GBM. The key components of a GBM TME are outlined, including microbiomes, vasculature, extracellular matrix (ECM), infiltrating parenchymal and peripheral immune cells and molecules, and chemical gradients. 3D culture systems are evaluated against 2D culture systems and in vivo animal models. The main 3D culture techniques available are compared, with an emphasis on identifying key gaps in knowledge for the development of suitable platforms …

Roundtable Discussion: 68-Year-Old Man With Mhspc, Jason M. Hafron

Articles

No abstract provided.

Case Discussion: 66-Year-Old Man With Low-Volume Prostate Cancer, Jason M. Hafron

Articles

An interview with Michigan Institute of Urology's Doctor Jason M. Hafron is presented. He presents a case of a 66-year-old male with low-volume prostate cancer to discuss his possible prognosis and the risk group he should be categorized. He explains his preferred approach to treat the patient like ordering a bone scan, computed tomography (CT) of the chest, abdomen and pelvis, and germline testing. He recommends some treatments for metastatic castration-sensitive prostate cancer (CSPC).

Visual Factors Associated With Physical Activity In Schoolchildren, Síofra Harrington, John Kearney Prof, Veronica O'Dwyer Dr

Articles

Clinical relevance Physical activity is an essential part of childhood physical and mental development. Recent research identified visual problems associated with a sedentary lifestyle in children in Ireland.

Background This study explored the association between visual function in children and their engagement with physical activities outside school.

Methods Participants were 1,626 schoolchildren (728 aged 6–7 years, 898 old 12–13 years) in randomly selected schools in Ireland. Before data collection, parents/legal guardians of participants completed a standardised questionnaire reporting physical activity as no activity (mostly on screens), light activity (occasional walking/cycling), moderate activity (/week engaged in sports), or regular activity ( …

Surgical Treatment Of Multiple Deforming Xanthomas Of The Foot And Ankle With Complete Excision And Rotational Skin Flaps: A Case Report, Qanita Ali, Rachelle Randall, Lawrence M. Fallat

Articles

Xanthomas are cholesterol rich nodular dermal lesions characterized by lipid-laden macrophages that accumulate in skin and tendons.1 These lesions are frequently associated with hyperlipidemia disorders characterized by impaired cholesterol metabolism and accelerated atherosclerotic plaque development.2 Until recently, xanthomas were considered mere cosmetic lesions, however extensive evidence has shown that the presence of xanthomas signify increased cardiovascular risk and reduced average lifespan.3 Treatment centers around lipid lowering agents and rarely are these masses large enough to require surgical resection, thus there is very little literature discussing proper surgical excision.4, 5 We present a rare case of a 65 year old female …

From Zero To Thrive: A Model Of Cross-System And Cross-Sector Relational Health To Promote Early Childhood Development Across The Child-Serving Ecosystem, Alison L. Miller, Sara F. Stein, Rebeccah Sokol, Rachel Varisco, Phoebe Trout, Megan M. Julian, Julie Ribaudo, Joshua B. Kay, Natasha V. Pilkauskas, Nicole Gardner-Neblett, Todd I. Herrenkohl, Kara Zivin, Maria Muzik, Katherine L. Rosenblum

Articles

Early relational health between caregivers and children is foundational for child health and well-being. Children and caregivers are also embedded within multiple systems and sectors, or a “child-serving ecosystem”, that shapes child development. Although the COVID-19 pandemic has made this embeddedness abundantly clear, systems remain siloed and lack coordination. Fostering relational health amongst layers of this ecosystem may be a way to systematically support young children and families who are facing adversity. We integrate theory, examples, and empirical findings to develop a conceptual model informed by infant mental health and public health frameworks that illustrates how relational health across the …

Estimating The Analytical Performance Of Raman Spectroscopy For Quantification Of Active Ingredients In Human Stratum Corneum, Hichem Kichou, Emilie Munnier, Yuri Dancik, Kamilia Kemel, Hugh Byrne, Ali Tfayli, Dominique Bertrand, Martin Soucé, Igor Chourpa, Franck Bonnier

Articles

Confocal Raman microscopy (CRM) has become a versatile technique that can be applied routinely to monitor skin penetration of active molecules. In the present study, CRM coupled to multivariate analysis (namely PLSR—partial least squares regression) is used for the quantitative measurement of an active ingredient (AI) applied to isolated (ex vivo) human stratum corneum (SC), using systematically varied doses of resorcinol, as model compound, and the performance is quantified according to key figures of merit defined by regulatory bodies (ICH, FDA, and EMA). A methodology is thus demonstrated to establish the limit of detection (LOD), precision, accuracy, sensitivity (SEN), and …

What Is Meaningful Participation For Physical Therapists In Multidisciplinary Cancer Conferences And Tumor Boards?, Stacy Weber, Athena A. Manzino, Christopher M. Wilson, Nicole D. Booms

Articles

Tumor boards are multidisciplinary team meetings composed of providers from different specialties who collaborate to provide comprehensive cancer care. Although the term “tumor board” may be used commonly in practice, these meetings are often referred to as multidisciplinary cancer conferences (MCCs) within the literature and are referred to as such in this article. At this time, there is no current literature describing the role of physical therapists (PTs) and rehabilitation professionals as part of the MCC or multidisciplinary tumor boards. Yet, PTs are often included as part of this multidisciplinary team in cancer care. This inclusion has not completely shifted …

A Case Series Of Three Patients With Rare Pantalar Dislocation, Marissa Mogavero, Andrew Robitaille, Lawrence M. Fallat

Articles

Total talar dislocations are rare, significant surgical challenges for foot and ankle surgeons. These dislocations can be very difficult to manually close-reduce, requiring immediate surgical intervention secondary to arterial impingement, pain and risk of skin necrosis attributable to skin tenting. In this case series, we report on three patients who presented to the emergency room following a traumatic ankle injury. Ankle radiographs and computed tomography (CT) scans were obtained, revealing pantalar dislocations. Closed reduction utilizing Charnley’s principles was attempted in the emergency room through manual accentuation of the deformity, traction and reduction. Closed reduction was unsuccessful in all three patients …

Big Data Analysis Of Vision Screening Standards Used To Evaluate Fitness To Drive, Michael Moore, John Butler, Daniel Ian Flitcroft, James Loughman

Articles

Purpose: Visual acuity (VA) assessment is the most commonly performed vision screening method for drivers. The standards and repeat assessment intervals used, however, are arbitrary, lack an evidence base and are highly variable across different countries. This study utilizes the power of Big Data to provide evidence-based recommendations for standardized driver vision screening.

Methods: Anonymized electronic medical record data were gathered from 40 Irish optometry practices comprising 81,184 unique patients. A Kaplan-Meier Survival (KMS) analysis was used to determine the effect of increasing age and time since screening on the likelihood of passing the VA standard for driving. A logistic …

Tibiotalocalcaneal Fusion With Bulk Femoral Head Allograft In A Patient With A Rare, Trauma Induced, Rigid, Cavovarus Foot Deformity, Josh Carroll, Joseph Wolf, Lawrence M. Fallat

Articles

Tibiotalocalcaneal (TTC) arthrodesis with bulk femoral head allograft is a commonly performed limb salvage procedure when dealing with complex deformity. However, little has been reported in patients who receive tibiotalocalcaneal arthrodesis with femoral head allografts for a rigid cavovarus foot type. The purpose of this case report was to examine the outcomes of a tibiotalocalcaneal arthrodesis with a femoral head allograft in a diabetic patient with a trauma induced rigid cavovarus deformity who had complete lateral dislocation of the talar body. The secondary purpose was to highlight the preservation of limb length in the surgical extremity when utilizing a tibiotalocalcaneal …

A Rare Benign Soft-Tissue Chondroma In The Plantar Foot: A Case Report, Ashley Mariano, Lawrence M. Fallat

Articles

Extraskeletal chondromas are rare, benign cartilaginous neoplasms that are usually found in adults and often present as a slow growing solitary mass. We present a case of a 78-year-old male who initially presented with a painful hyperkeratotic lesion to the plantar aspect of his right foot resembling a porokeratosis. He noted increased pain when bearing weight. Initial radiographs revealed no osseous pathology, bone spurs or foreign bodies that correlated with the area of pain. Due to failed conservative treatment that consisted of regular debridement, surgical excision of the lesion was performed which revealed a large underlying hard nodule. The nodular …

Advancing Ubiquitous Collaboration For Telehealth - A Framework To Evaluate Technology-Mediated Collaborative Workflow For Telehealth, Hypertension Exam Workflow Study, Christopher Bondy Ph.D., Linlin Chen Ph.D, Pamela Grover Md, Pengcheng Shi Ph.D

Articles

Healthcare systems are under siege globally regarding technology adoption; the recent pandemic has only magnified the issues. Providers and patients alike look to new enabling technologies to establish real-time connectivity and capability for a growing range of remote telehealth solutions. The migration to new technology is not as seamless as clinicians and patients would like since the new workflows pose new responsibilities and barriers to adoption across the telehealth ecosystem. Technology-mediated workflows (integrated software and personal medical devices) are increasingly important in patient-centered healthcare; software-intense systems will become integral in prescribed treatment plans [1]. My research explored the path to …

Childminding Professionalism And Professionalisation In Ireland: A Different Story, Miriam O'Regan, Ann Marie Halpenny, Noirin Hayes

Articles

This research focussed on documenting the praxis and paedagogy of paid, professional childminding (family childcare/day care) in Ireland. It explored professionalism and professionalisation among childminders in the context of the evolving understanding of professionalism in Early Childhood Education and Care (ECEC) nationally and internationally. The research was conducted within the framework of Ecocultural Theory (ECT) on the eve of mandatory regulation of childminding against the backdrop of Irish ECEC policy. A mixed method approach was adopted, using the Ecocultural Family Interview for Childminders (EFICh), including participants’ photographs, case study surveys, researcher field notes and holistic ratings. We present findings related …

Sociodemographic, Personal, Peer, And Familial Predictors Of E-Cigarette Ever Use In Espad Ireland: A Forward Stepwise Logistic Regression Model, Joan Hanafin, Salome Sunday, Luke Clancy

Articles

Introduction:
E-cigarette ever use has risen significantly in recent years in Ireland, similar to trends elsewhere in Europe, the United States, and Asia-Pacific region. Results from ESPAD Ireland (European School Survey Project on Alcohol and other Drugs) show teenage e-cigarette ever use increased from 18% (2015) to 37% (2019). Given this increase, our aim is to profile e-cigarette ever users and never users in this age group; to examine sociodemographic, personal, peer, and familial factors associated with e-cigarette ever use; and to suggest appropriate measures to reduce use.

Methods:
A nationally representative stratified random sample of 50 ESPAD schools was …

Vitamin B12 Deficiency In Nitrous Oxide Abuse, Colby Jones, Jordan Verlare, Reehan Ali

Articles

33yo F presents to ED with numbness & tingling in hands, feet for 10 days. History of recreational drug use, including nitrous oxide 'whippets.' Unremarkable Head CT was obtained.

What You Need To Know About Em Administration Fellowships, Michael Muradian

Articles

No abstract provided.

Impact Of Urgent Care Centers And Telehealth In The Ed, Javed Osmani, Michael Muradian, Christina Brown, Nicholas Stark

Articles

No abstract provided.

Ultrasound 96 Probe Device Protocol For Cancer Cell Treatment, Aisling Field, Brijesh K. Tiwari, James F. Curtin, Julie R M Mondala, Janith Wanigasekara

Articles

Ultrasound is a sound wave with frequencies ranging between 20 kHz and 20 MHz. Ultrasound is able to temporarily and repeatedly open the BBB safely and enhance chemotherapeutic delivery without adverse effects. This novel technique in drug delivery benefits from the powerful ability of ultrasound to produce cavitation activity. Cavitation is the generation and activity of gas-filled bubbles in a medium exposed to ultrasound. As the pressure wave passes through the media, gas bubbles expand at low pressure and contract at high pressure. This leads to oscillation which produces a circulating fluid flow known as microstreaming around the bubble with …

Plasma Induced Reactive Oxygen Species-Dependent Cytotoxicity In Glioblastoma 3d Tumourspheres, Janith Wanigasekara, Carlos Barcia, Patrick J. Cullen, Brijesh Tiwari, James F. Curtin

Articles

The aim of this study was to determine the effects of a pin‐to‐plate cold atmospheric plasma (CAP) on U‐251 MG three‐dimensional (3D) glioblastoma spheroids under different conditions. 3D tumorspheres showed higher resistance to the CAP treatment compared to 2D monolayer cells. A single CAP treatment was able to induce cytotoxicity, while multiple CAP treatments augmented this effect. CAP was also able to induce cytotoxicity throughout the tumoursphere, and we identified that reactive oxygen species(ROS) plays a major role, while H2O2plays a partial role in CAP‐induced cytotoxicity in tumour-spheres. We conclude that ROS‐dependent cytotoxicity is induced uniformly throughout glioblastoma and epidermoid …

Will Treating Progressive Myopia Overwhelm The Eye Care Workforce? A Workforce Modelling Study, Gareth Lingham, James Loughman, Stella Kuzmenko, Matilda Biba, Daniel Ian Flitcroft

Articles

Purpose

Treatments for myopia progression are now available, but implementing these into clinical practice will place a burden on the eye care workforce. This study estimated the full-time equivalent (FTE) workforce required to implement myopia control treatments in the UK and Ireland.

Methods

To estimate the number of 6- to 21-year-olds with myopia, two models utilising separate data sources were developed. The examination-based model used: (1) the number of primary care eye examinations conducted annually and (2) the proportion of these that are for myopic young people. The prevalence-based model used epidemiological data on the age-specific prevalence of myopia. The …

Robust Parameters Tuning Of Different Power System Stabilizers Using A Quantum Artificial Gorilla Troops Optimizer, Mahmoud A. El-Dabah, Mohamed H. Hassan, Saleh Kamel, Hossam Zawbaa

Articles

Electrical power system abnormalities may have several negative consequences on its stable operation. As a result, preserving its stability under such operational states has become an ongoing challenge for power engineers. PSSs are created as auxiliary controllers to address the instability issues produced upon disturbances. They dampen the oscillations induced by the disturbances by giving the system the necessary damping torque. This research aims at presenting a comprehensive study for the optimum tuning of power system stabilizer (PSS) of different structures. This aim is accomplished with the help of a novel modified optimization algorithm called Quantum Artificial Gorilla Troops Optimizer. …

Use And Awareness Of Heated Tobacco Products In Europe, Silvano Gallus, Alessandra Lugo, Xiaoqiu Liu, Elisa Borroni, Luke Clancy, Giuseppe Gorini, Maria José Lopez, Anna Odone, Krzysztof Przewozniak, Olena Tigova, Piet A. Van Den Brandt, Constantine Vardavas, Esteve Fernandez, Tackshs Project Investigators

Articles

Background: Heated tobacco products (HTP) are new forms of tobacco consumption with limited information available on their use among the general population. Our objective was to analyze the prevalence and associations of use of HTP across 11 countries in Europe.

Methods: Within the TackSHS Project, in 2017-2018 we conducted a cross-sectional study with information on HTP use in the following countries: Bulgaria, England, France, Germany, Greece, Italy, Latvia, Poland, Portugal, Romania and Spain. In each country, face-to-face interviews were performed on a representative sample of around 1,000 subjects aged ≥15 years, for a total of 10,839 subjects.

Results: Overall, 27.8% …

Development And Validation Of A Raman Spectroscopic Classification Model For Cervical Intraepithelial Neoplasia (Cin), Damien Traynor, Shiyamala Duraipandian, Ramya Bhatia, Kate Cuschieri, Prerna Tewari, Padraig Kearney, Tom D'Arcy, John J. O'Leary, Cara M. Martin, Fiona Lyng

Articles

The mortality associated with cervical cancer can be reduced if detected at the precancer stage, but current methods are limited in terms of subjectivity, cost and time. Optical spectroscopic methods such as Raman spectroscopy can provide a rapid, label-free and nondestructive measurement of the biochemical fingerprint of a cell, tissue or biofluid. Previous studies have shown the potential of Raman spectroscopy for cervical cancer diagnosis, but most were pilot studies with small sample sizes. The aim of this study is to show the clinical utility of Raman spectroscopy for identifying cervical precancer in a large sample set with validation in …

Mirna-Mediated Fibrosis In The Out-Of-Target Heart Following Partial-Body Irradiation, Barbara Tanno, Flavia Novelli Flavia Novelli, Simona Leonardi, Caterina Merla, Gabriele Babini, Paola Giardullo, Munira Kadhim, Damian Traynor, Dinesh Medipally, Aidan Meade, Fiona Lyng, Soile Tapio, Luca Marcetti, Anna Saran, Simonetta Pazzaglia, Mariateresa Mancuso

Articles

A causal association between radiation exposure and various types of non-malignant diseases, especially cardiovascular diseases, has been extensively reported [1,2]. The risks of radiation-induced heart disease (RIHD) were described in therapeutically exposed cohorts of patients with thoracic tumors in which a high incidence of long-term complications (i.e., pericarditis, cardiomyopathy, coronary artery disease, valvular heart disease, conduction abnormalities and myocardial fibrosis) increased the risk of heart-disease-related mortality [3]. Patients who received post-mastectomy radiotherapy for left-sided breast cancer were at a 2–3-time higher risk of developing cardiovascular disease, due to the apex and anterior wall of the heart being exposed to doses …

Os-Walk-Eu: An Open-Source Tool To Assess Health-Promoting Residential Walkability Of European City Structures, Stefan Fina, Christian Gerten, Brian Pondi, Lorraine D'Arcy, Niamh O' Reilly, David Sousa Vale, Mauro Pereira, Samuele Zilio

Articles

Introduction This paper introduces OS-WALK-EU, a new open-source walkability assessment tool developed specifically for urban neighbourhoods and using open-source spatial data. A free and open-source tool, OS-WALK-EU is accessible to the general public. It uses open data available worldwide and free online services to compute accessibility, while at the same time allowing users to integrate local datasets if available. Based on a review of existing measurement concepts, the paper adopts dimensions of walkability that were tested in European city environments and explains their conceptualization for software development. We invite the research community to collaboratively test, adopt and use the tool …

At War With A Silent Killer: An Ipa Study Of The Lived Experiences Of Community Pharmacists In Ireland During Covid-19, Regina Brady, Niamh Imbusch

Articles

Objectives: The purpose of this research was to give voice to the unique lived experiences of community pharmacists who continued to work in patient-facing roles throughout the COVID-19 pandemic. Research objectives sought to understand how they felt about working during this time including any risks felt, why they choose to continue working, and what the post-COVID future might hold for them and their profession. Method: The study was guided by the principles of traditional interpretative phenomenological analysis (IPA). Primary research was collated using semi-structured interviews of a small, purposively selected homogenous group of pharmacists. The research context was a …