Medicine and Health Sciences Commons^™

How Does The Use Of Telemonitoring In Adult Patients With Uncontrolled Hypertension Improve Blood Pressure Control? An Integrative Review, Lucie Bakop

Doctoral Dissertations and Projects

Hypertension is an evolving problem worldwide and it constitutes a great risk for cardiovascular diseases. Despite the research and new drugs on the market to manage high blood pressure, hypertension remains the leading cause of disability-adjusted life and death worldwide. With many people suffering from hypertension around the world, and the burden of uncontrolled hypertension, it is imperative to find an intervention that can improve blood pressure control. To better target uncontrolled hypertension, the conventional method of management of high blood pressure based on in-person visits has shown some limitations and it must be combined with a contemporary approach that …

The Importance Of Pediatric Provider Awareness Of Social Determinants Of Health And The Impact On Health Outcomes: An Integrative Review, Whitney Lenelle Dowd

Doctoral Dissertations and Projects

Social determinants of health have become a global concern over the past several years. Efforts to reduce negative health outcomes related to social determinants of health are of high priority. Awareness of this issue by providers, especially pediatric providers, must be considered to help combat this major concern. A researcher seeks through an integrative review to determine provider perspective on social determinants of health, impact of social determinants of health on outcomes, and ways of integrating social determinants into prescriptive practice. The integrative review will inform stakeholders about the importance of pediatric provider assessment of social determinants of health and …

Interdisciplinary Telementoring For Therapists In Snfs To Improve Dementia Care Knowledge And Skills, Gina Tucker-Roghi

Occupational Therapy | Faculty Scholarship

Occupational, physical, and speech therapists possess knowledge and skills that have the potential to reduce the burden of care and improve the quality of life of skilled nursing facility (SNF) residents living with dementia. Despite this opportunity to impact the well-being of residents with dementia, many therapy practitioners lack specialized training on the management of dementia. Therapy practitioners (n=31) from 22 SNFs participated in eight weekly interdisciplinary educational sessions using the Project ECHO (Extension for Community Health Outcomes) tele-mentoring model. An interdisciplinary team of therapy experts collaborated on the development of the curriculum, which included didactic content on dementia-care best …

How To Manage The Initiation Of Apomorphine Therapy Without Antiemetic Pretreatment: A Review Of The Literature, Stuart H. Isaacson, Richard B. Dewey, Rajesh Pahwa, Daniel E. Kremens

Department of Neurology Faculty Papers

Introduction

Pretreatment with the antiemetic trimethobenzamide has been recommended practice in the United States (US) to address the risk of nausea and vomiting during initiation of apomorphine treatment. However, trimethobenzamide is no longer being manufactured in the US, and despite the recent update to the US prescribing information, there may be uncertainty regarding how to initiate apomorphine.

Methods

To better understand why antiemetic pretreatment was recommended and if it is necessary when initiating apomorphine therapy, we performed a literature review of subcutaneous apomorphine therapy initiation with and without antiemetic pretreatment in patients with PD.

Results

Three studies were identified as …

Best Strategies To Address Burnout Among Healthcare Professionals: An Integrative Review, Kimberly Ann Delbo

Doctoral Dissertations and Projects

The purpose of this integrative literature review (ILR) is to provide a comprehensive summary and analysis of past empirical and theoretical literature related to the phenomenon of burnout while sharing a synthesis of literature. This ILR explores, critiques, summarizes, and analyzes best practices and interventions to address burnout and promote engagement and well-being among health care workers within acute care hospitals. The scientific basis for this ILR was the premise that a relationship exists between burnout interventions and organizational cultures which can be positively influenced by relational and social leadership styles that reduce work-related stressors and create positive, professional, healthy …

Initial Single Surgeon Evaluation Comparing C-Arm Fluoroscopy With The Cirq Robotic Assistance Device For Instrumentation Of The Thoracolumbar Spine, Sohum K. Desai, Jennifer Adams

MEDI 9331 Scholarly Activities Clinical Years

Objective

To compare our experience with pedicle screw insertion of the thoracolumbar spine utilizing the Cirq robot assistance device compared with traditional paradigm using fluoroscopy.

Methods

We prospectively collected data of patients undergoing pedicle screw instrumentation in the thoracolumbar spine performed by a single surgeon at three different centers. One center took delivery of the Cirq robotic assistance device. Remaining two centers used C-arm fluoroscopy. Demographic information, diagnosis, total OR time, intraoperative complications, unexpected return to the operating room, and hospital readmissions within 90 days was compared between the two cohorts.

Results

A total of 166 screws were placed during …

Impacts Of Telemonitoring On Weight Obesity In African Americans, Miranda Bessem Mbutambe

Doctoral Dissertations and Projects

Obesity has become a complex public health issue among African Americans over the last few decades, due to the health risks it poses to this population. Obesity exposes African Americans to a variety of chronic diseases, including, but not limited to, diabetes and cardiovascular diseases. Owing to the complexity inherent in obesity, healthcare practitioners have developed various strategies and interventions to manage weight among vulnerable populations. In this regard, telemonitoring, a continuous or non-continuous process that allows medical practitioners to remotely monitor, collect, and interpret data necessary for medical follow-up and, if necessary, make medical decisions regarding the health state …

Data Driven Classification Of Opioid Patients Using Machine Learning - An Investigation, Saddam Al Amin, Md Saddam Hossain Mukta, Md Sezan Mahmud Saikat, Md Ismail Hossain, Md Adnanul Islam, Mohiuddin Ahmed, Sami Azam

Research outputs 2022 to 2026

The opioid crisis has led to an increased number of drug overdoses in recent years. Several approaches have been established to predict opioid prescription by health practitioners. However, due to the complex nature of the problem, the accuracy of such methods is not yet satisfactory. Dependable and reliable classification of opioid dependent patients from well-grounded data sources is essential. Majority of the previous studies do not focus on the users’ mental health association for opioid intake classification. These studies do not also employ the latest deep learning based techniques such as attention and knowledge distillation mechanism to find better insights. …

Antibody Epitope Profiling Of The Kshv Lana Protein Using Virscan, Sydney J. Bennett, Dicle Yalcin, Sara R. Privatt, Owen Ngalamika, Salum J. Lidenge, John T. West, Charles Wood

School of Medicine Faculty Publications

The humoral antibody response against Kaposi sarcoma-associated herpesvirus (KSHV) in infected individuals has been characterized demonstrating the latency-associated nuclear antigen (LANA) as the most antigenic KSHV protein. Despite the antigenicity of the protein, specific LANA epitopes have not been systematically characterized. Here, we utilized a bacteriophage T7 library, which displays 56-amino acid KSHV LANA peptides with 28-amino acid overlap (VirScan), to define those epitopes in LANA targeted by antibodies from a cohort of 62 sub-Saharan African Kaposi Sarcoma (KS) patients and 22 KSHV-infected asymptomatic controls. Intra- and inter-patient breadth and magnitude of the anti-LANA responses were quantified at the peptide …

Sinonasal Outcomes Using Oral Corticosteroids In Patients With Chronic Rhinosinusitis With Nasal Polyps And Positive Sinonasal Cultures, Jhon F. Martinez Paredes, Angela M. Donaldson, Michael Marino, Garret Choby, Osarenoma Olomu, Razan Alfakir, Janalee K. Stokken, Erin O'Brien, Devyani Lal

School of Medicine Publications and Presentations

Introduction Patients with chronic rhinosinusitis with nasal polyps (CRSwNP) and positive sinonasal bacterial cultures may be recalcitrant to topical therapy alone due to the additional local inflammatory burden associated with bacterial infection/colonization.

Objective To evaluate sinonasal outcomes in CRSwNP patients with a positive perioperative bacterial culture, who were treated with postoperative intranasal corticosteroids (INCS) alone versus INCS in combination with a short-term course of oral corticosteroids (OCS).

Methods This is a retrospective chart review of CRSwNP patients. A total of 59 patients met inclusion criteria, including positive perioperative bacterial culture and treatment with INCS with or without concomitant use of …

A Non-Invasive Artificial Intelligence Approach For The Prediction Of Human Blastocyst Ploidy: A Retrospective Model Development And Validation Study, Josue Barnes, Matthew Brendel, Vianne R. Gao, Suraj Rajendran, Junbum Kim, Qianzi Li, Jonas E. Malmsten, Jose T. Sierra, Pantelis Zisimopoulos, Alexandros Sigaras, Pegah Khosravi, Marcos Meseguer, Qiansheng Zhan, Zev Rosenwaks, Olivier Elemento, Nikica Zaninovic, Iman Hajirasouliha

Publications and Research

Summary

Background

One challenge in the field of in-vitro fertilisation is the selection of the most viable embryos for transfer. Morphological quality assessment and morphokinetic analysis both have the disadvantage of intra-observer and inter-observer variability. A third method, preimplantation genetic testing for aneuploidy (PGT-A), has limitations too, including its invasiveness and cost. We hypothesised that differences in aneuploid and euploid embryos that allow for model-based classification are reflected in morphology, morphokinetics, and associated clinical information.

Methods

In this retrospective study, we used machine-learning and deep-learning approaches to develop STORK-A, a non-invasive and automated method of embryo evaluation that uses artificial …

The Impact Of Vitamin A Deficiency On Tuberculosis Progression, Brendan K Podell, Omowunmi Aibana, Chuan-Chin Huang, James E Dilisio, Macallister C Harris, David F Ackart, Kody Armann, Alexander Grover, Patrice Severe, Marc Antoine Jean Juste, Kathryn Dupnik, Randall J Basaraba, Megan B Murray

Faculty and Staff Publications

BACKGROUND: Although previous studies have shown that vitamin A deficiency is associated with incident tuberculosis (TB) disease, the direction of the association has not been established. We investigated the impact of vitamin A deficiency on TB disease progression.

METHODS: We conducted a longitudinal cohort study nested within a randomized clinical trial among HIV-infected patients in Haiti. We compared serial vitamin A levels in individuals who developed TB disease to controls matched on age, gender, follow-up time, and time to antiretroviral therapy initiation. We also evaluated histopathology, bacterial load, and immune outcomes in TB infection in a guinea pig model of …

Arginine Methylation Of The Pgc-1Α C‑Terminus Is Temperature- Dependent, Meryl Mendoz, Mariel Mendoza, Tiffany Lubrino, Sidney Briski, Immaculeta Osuji, Janielle Cuala, Brendan Ly, Ivan Ocegueda, Harvey Peralta, Benjamin A. Garcia, Cecilia Zurita-Lopez

Biology, Chemistry, and Environmental Sciences Faculty Articles and Research

We set out to determine whether the C-terminus (amino acids 481–798) of peroxisome proliferator-activated receptor gamma coactivator-1 alpha (PGC-1α, UniProt Q9UBK2), a regulatory metabolic protein involved in mitochondrial biogenesis, and respiration, is an arginine methyltransferase substrate. Arginine methylation by protein arginine methyltransferases (PRMTs) alters protein function and thus contributes to various cellular processes. In addition to confirming methylation of the C-terminus by PRMT1 as described in the literature, we have identified methylation by another member of the PRMT family, PRMT7. We performed in vitro methylation reactions using recombinant mammalian PRMT7 and PRMT1 at 37, 30, 21, 18, and 4 °C. …

Relationship Of Cognition And Alzheimer’S Disease With Gastrointestinal Tract Disorders: A Large-Scale Genetic Overlap And Mendelian Randomisation Analysis, Emmanuel O. Adewuyi, Eleanor K. O’Brien, Tenielle Porter, Simon M. Laws

Research outputs 2022 to 2026

Emerging observational evidence suggests links between cognitive impairment and a range of gastrointestinal tract (GIT) disorders; however, the mechanisms underlying their relationships remain unclear. Leveraging large-scale genome-wide association studies’ summary statistics, we comprehensively assessed genetic overlap and potential causality of cognitive traits and Alzheimer’s disease (AD) with several GIT disorders. We demonstrate a strong and highly significant inverse global genetic correlation between cognitive traits and GIT disorders — peptic ulcer disease (PUD), gastritis-duodenitis, diverticulosis, irritable bowel syndrome, and gastroesophageal reflux disease (GERD), but not inflammatory bowel disease (IBD). Further analysis detects 35 significant (p < 4.37 × 10 ^{− 5}) bivariate local genetic …

An Isochroman Analog Of Cd3254 And Allyl-, Isochroman-Analogs Of Net-Tmn Prove To Be More Potent Retinoid-X-Receptor (Rxr) Selective Agonists Than Bexarotene, Peter W Jurutka, Orsola Di Martino, Et Al.

2020-Current year OA Pubs

Bexarotene is an FDA-approved drug for the treatment of cutaneous T-cell lymphoma (CTCL); however, its use provokes or disrupts other retinoid-X-receptor (RXR)-dependent nuclear receptor pathways and thereby incites side effects including hypothyroidism and raised triglycerides. Two novel bexarotene analogs, as well as three unique CD3254 analogs and thirteen novel NEt-TMN analogs, were synthesized and characterized for their ability to induce RXR agonism in comparison to bexarotene (

Reflecting On The Advancements Of Hfref Therapies Over The Last Two Decades And Predicting What Is Yet To Come, Iliana L. Piña, Gregory T. Gibson, Shelley Zieroth, Rachna Kataria

Division of Cardiology Faculty Papers

What was once considered a topic best avoided, managing heart failure with reduced ejection fraction (HFrEF) has become the focus of many drug and device therapies. While the four pillars of guideline-directed medical therapies have successfully reduced heart failure hospitalizations, and some have even impacted cardiovascular mortality in randomized controlled trials (RCTs), patient-reported outcomes have emerged as important endpoints that merit greater emphasis in future studies. The prospect of an oral inotrope seems more probable now as targets for drug therapies have moved from neurohormonal modulation to intracellular mechanisms and direct cardiac myosin stimulation. While we have come a long …

Covid-19 Induces Cns Cytokine Expression And Loss Of Hippocampal Neurogenesis, Allison L Soung, Abigail Vanderheiden, Xiaoping Jiang, Traci Bricker, Adrianus C M Boon, Robyn S Klein, Et Al.

2020-Current year OA Pubs

Infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is associated with acute and postacute cognitive and neuropsychiatric symptoms including impaired memory, concentration, attention, sleep and affect. Mechanisms underlying these brain symptoms remain understudied. Here we report that SARS-CoV-2-infected hamsters exhibit a lack of viral neuroinvasion despite aberrant blood-brain barrier permeability. Hamsters and patients deceased from coronavirus disease 2019 (COVID-19) also exhibit microglial activation and expression of interleukin (IL)-1β and IL-6, especially within the hippocampus and the medulla oblongata, when compared with non-COVID control hamsters and humans who died from other infections, cardiovascular disease, uraemia or trauma. In the …

How Healthcare Providers Can Support Timely Cervical And Breast Cancer Screenings For Individuals With Disabilities, Rachel Byers, Timothy Keady

All Current Publications

This fact sheet outlines how healthcare providers can apply current evidence and best practices in screening for cervical cancer and breast cancer in individuals with disabilities.

Nuclear S6k1 Enhances Oncogenic Wnt Signaling By Inducing Wnt/Β-Catenin Transcriptional Complex Formation, Min Gyu Lee, Hwamok Oh, Jong Woo Park, Jueng Soo You, Jeung-Whan Han

Student and Faculty Publications

Ribosomal protein S6 kinase 1 (S6K1), a key downstream effector of the mammalian target of rapamycin (mTOR), regulates diverse functions, such as cell proliferation, cell growth, and protein synthesis. Because S6K1 was previously known to be localized in the cytoplasm, its function has been mainly studied in the cytoplasm. However, the nuclear localization and function of S6K1 have recently been elucidated and other nuclear functions are expected to exist but remain elusive. Here, we show a novel nuclear role of S6K1 in regulating the expression of the Wnt target genes. Upon activation of the Wnt signaling, S6K1 translocated from the …

Ccl4 Regulates Eosinophil Activation In Eosinophilic Airway Inflammation, Hanh Hong Chu, Yoshiki Kobayashi, Dan Van Bui, Yasutaka Yun, Linh Manh Nguyen, Akitoshi Mitani, Kensuke Suzuki, Mikiya Asako, Akira Kanda, Hiroshi Iwai

Faculty and Staff Publications

Eosinophilic chronic rhinosinusitis (ECRS) is a refractory airway disease accompanied by eosinophilic inflammation, the mechanisms of which are unknown. We recently found that CCL4/MIP-1β-a specific ligand for CCR5 receptors-was implicated in eosinophil recruitment into the inflammatory site and was substantially released from activated eosinophils. Moreover, it was found in nasal polyps from patients with ECRS, primarily in epithelial cells. In the present study, the role of epithelial cell-derived CCL4 in eosinophil activation was investigated. First, CCL4 expression in nasal polyps from patients with ECRS as well as its role of CCL4 in eosinophilic airway inflammation were investigated in an in …

Research Infrastructure Core Facilities At Research Centers In Minority Institutions: Part I-Research Resources Management, Operation, And Best Practices, Paul B Tchounwou, Mohamad Malouhi, Elizabeth O Ofili, Emma Fernández-Repollet, Daniel F Sarpong, Richard Yanagihara, Renato J Aguilera, Cecilia Ayón, Xiaoxin Chen, Asok Dasmahapatra, Song Gao, Cimona V Hinton, Robert Holt, Vladimir Kolesnichenko, Michael D Powell, Fatima Merchant, Kinfe K Redda, Abiel Roche-Lima, Cecilia M Shikuma, Jacqueline J Stevens, Jose A Torres, Robert T Trotter, James Wachira, Paul Wang, Kristen J Wells, Jason White, Yanyuan Wu

Student and Faculty Publications

Funded by the National Institutes of Health (NIH), the Research Centers in Minority Institutions (RCMI) Program fosters the development and implementation of innovative research aimed at improving minority health and reducing or eliminating health disparities. Currently, there are 21 RCMI Specialized (U54) Centers that share the same framework, comprising four required core components, namely the Administrative, Research Infrastructure, Investigator Development, and Community Engagement Cores. The Research Infrastructure Core (RIC) is fundamentally important for biomedical and health disparities research as a critical function domain. This paper aims to assess the research resources and services provided and evaluate the best practices in …

Integrated Multi-Omic Analysis Of Low-Grade Ovarian Serous Carcinoma Collected From Short And Long-Term Survivors, Kwong-Kwok Wong, Nicholas W Bateman, Chun Wai Ng, Yvonne T M Tsang, Charlotte S Sun, Joseph Celestino, Tri V Nguyen, Anais Malpica, R Tyler Hillman, Jianhua Zhang, P Andrew Futreal, Christine Rojas, Kelly A Conrads, Brian L Hood, Clifton L Dalgard, Matthew D Wilkerson, Neil T Phippen, Thomas P Conrads, George L Maxwell, Anil K Sood, David M Gershenson

Student and Faculty Publications

BACKGROUND: Low-grade serous ovarian cancer (LGSOC) is a rare disease that occurs more frequently in younger women than those with high-grade disease. The current treatment is suboptimal and a better understanding of the molecular pathogenesis of this disease is required. In this study, we compared the proteogenomic analyses of LGSOCs from short- and long-term survivors (defined as < 40 and > 60 months, respectively). Our goal was to identify novel mutations, proteins, and mRNA transcripts that are dysregulated in LGSOC, particularly in short-term survivors.

METHODS: Initially, targeted sequencing of 409 cancer-related genes was performed on 22 LGSOC and 6 serous borderline ovarian tumor samples. …

Investigating The Effectiveness Of Prehospital Recognition And Administration Of Intravenous Antibiotics In Septic Patients, Laura Keane, Ian Peterson

Physician Assistant Capstones, 2020-current

Objective: To compare the 30-day mortality rate of suspected sepsis patients who received prehospital (Emergency Medical Services- EMS) antibiotic administration in an ambulance as compared to antibiotic administration in the hospital. Design: Systematic literature review. Methods: Research was conducted in PubMed and Google Scholar with the search terms: sepsis, antibiotics, prehospital, EMS, ambulance. The 3 articles selected were chosen after removing articles not from a randomized control trial, no antibiotic administration, and not a free article. Results: From our meta-analysis of the three studies, we concluded that providing antibiotics before arriving at the hospital for patients with suspected septic infections. …

Educating School Nurses To Improve Bowel Continence In Children With Spina Bifida, Mckinley J. Waugh, Tracy L. Brewer, Lisa Wagoner

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Children born with spina bifida, a neural tube defect, can have associated loss of bowel control resulting in bowel incontinence. The National Patient Spina Bifida Registry found that 87% of those living with spina bifida had bowel incontinence, and less than 30% were bowel continent (Sawin et al., 2015; Wiener et al., 2017). Unfortunately, providers may never start a child living with spina bifida on a bowel management program. Evidence suggests that children with spina bifida should begin a bowel management program early, using a stepwise approach. School nurses, who interact with children living with spinal bifida while attending school, …

2022-12-16_Michiganoverview_Covidbedppe, Michigan Department Of Health & Human Services

Michigan COVID-19 Hospital Data

Contains the tables Statewide Hospital Capacity Report for COVID-19, COVID-19 Metrics, Statewide Hospital Available PPE Tracking for COVID-19, as well as the tables PPE Days On Hand and Patient Census.

Use Of Cardiomems Hf Sensor In Management Of Nyha Class Iii Heart Failure, Trevor Andrunik, Anne Eady

Physician Assistant Capstones, 2020-current

Objective: Assess the ability of continuous pulmonary artery pressure monitoring via implantable CardioMEMs HF device to reduce hospitalization in New York Heart Association (NYHA) Class III heart failure patients over the age of 18. Design: Systematic literature review. Methods: Searches were conducted via PubMed and ClinicalTrials.gov using the single search term “CardioMEMs.” Inclusion criteria narrowed results to studies performed in the last 10 years, randomized control trials, cohort studies, and utilizing heart failure related hospitalization as the primary endpoint. Results: The current data unanimously asserts that the CardioMEMs HF device is effective at reducing heart failure related hospitalizations, with secondary …

The Safety And Efficacy Of Pravastatin In The Treatment Of Preeclampsia, Miranda Shelly, Tara Riley

Physician Assistant Capstones, 2020-current

Objective: Assess the efficacy of pravastatin in the prevention or treatment of preeclampsia in women who are at risk. Design: Systematic literature review. Methods: A search was performed using Pubmed utilizing the terms preeclampsia and pravastatin. The results were limited to studies that were double blind and placebo controlled and that occurred in the last 5 years. Results: None of the studies found statistical significance in the rate of preeclampsia between the experimental and control groups. Only one study found statistically significant differences in fetal birth weight and age at delivery. The other two studies found no differences between groups …

The Use Of Kernig’S And Brudzinski’S Sign In Determining Meningitis: A Review, Crystal T. Duong, Ashton Hughes, Kerem Yilmaz

Physician Assistant Capstones, 2020-current

Objective: Assess the diagnostic value of Kernig’s and Brudzinski’s signs in determining meningitis among individuals aged 18 to 64. Design: Systematic literature review. Methods: Searches done in PubMed utilizing the terms Kernig and Brudzinski. In PubMed, studies were excluded if not in English, older than 2000 or done on animals, and meta-analyses. Results: Three studies were found including Nakao JH, et al, Thomas KE, et al, and Waghdhare S, et al. Conclusion: Kernig’s and Brudzinski’s signs have high specificity but yield a low sensitivity in determining meningitis. They are great tools to be utilized by medical providers, but only support …

Use Of Long-Acting Injectable Cabotegravir And Rilpivirine In Hiv Maintenance Therapy, Andrea K. Ferrero, Nabil Naim

Physician Assistant Capstones, 2020-current

To determine if long-acting injectables cabotegravir and rilpivirine are non-inferior to oral antiretroviral therapy at maintaining viral load suppression below 50 copies per milliliter of serum. Design: Systematic literature review. Methods: A search was done in PubMed using the terms “HIV + cabotegravir” or “HIV + cabotegravir, rilpivirine drug combination.” Limitations included non-randomized control trials, comparison of injectable regimens directly or injectables to placebo, studies that evaluate compliance or side effects only, and studies with small sample sizes. Results: Meta-analysis revealed that continued use of injectables was sufficient in maintaining viral suppression at 93.6%, 92.5%, and 94% in each of …

Integrating A Biblical Worldview In Nursing Practice, Hannah Malafy

Honors Senior Colloquium

The Christian of today has the weighty task of discerning biblical truth in the midst of widely varying perspectives on every matter imaginable—especially in the healthcare setting. This essay aims to bring clarity to this mission by outlining the basic content of a biblical worldview, the defining characteristics of the nursing profession, and how the Christian with a biblical worldview approaches two specific areas of contention within the nursing profession.