Medicine and Health Sciences Commons^™

All Payer Hospital Regulations, Sam Lovejoy, Heath Ashford, William K. Willis, Alberto Coustasse

Management Faculty Research

Introduction: An all-payer system is a price setting system where rates of payment for healthcare services have not been negotiated between a hospital or health system or a payer but instead by a third party organization, such as Maryland’s Health Services Cost Review Commission (HSCRC), who sets most hospital rates that all payers agree to honor. All payer hospitals focus is on legislative principles in an effort to control costs.

Methods: The methodology for this study was a literature review compiled with overview of All-payer hospital systems and its utilization in a hospital setting. All articles prior to 2000 were …

Use Of Robots On Cardiac Surgery, Heath Ashford, Alex Hunter, Connie Phung, Alberto Coustasse

Management Faculty Research

Surgical robots are computer-assisted electromechanical devices that aid surgeons and are designed to replicate human movements into more steady precise motions, giving more accurate and delicate operations. The purpose of this research was to study the evolution of technical features of surgical robots on cardiology to determine technical advantages and barriers of these technologies. In one study out of all 50 patients that had endoscopic atraumatic coronary artery bypass robotic surgery, 49 reported they would recommend the surgery to another. Features make instrument manipulation more intuitive by eliminating the fulcrum effect, which removes the surgeon from twisting and turning in …

Pancreas: Do All Roads Lead To Mitochondria?, Amit Mukherji, Omobola Onikoyi, Vasudeva G. Kamath

Touro College of Osteopathic Medicine (Middletown) Publications and Research

Over several millions of years of evolution, mitochondria have transformed into specialized organelles. Today, they cannot live outside the cell nor can the host cell live without them, resulting in a symbiotic relationship. Richard Altmann, in 1894, documented them as cell organelles and called them “bioblasts”. Later, the term “mitochondria” itself was coined by Carl Benda in 1898. Ever since these findings, we in the field of medicine have learned a lot about this tiny organelle, but numerous aspects continue to be discovered. In this article, we will review the significance of this organelle in terms of pancreatic dysfunctions.

Empagliflozin In The Treatment Of Type 2 Diabetes: Evidence To Date, Jay H. Shubrook, Babak Baradar Bokaie, Sarah E. Adkins

Faculty Publications & Research of the TUC College of Osteopathic Medicine

In the last decade, researchers have gained a greater understanding of the pathophysiologic mechanisms of type 2 diabetes as a chronic and progressive disease. One of the more recent treatment targets is the kidney. The kidneys become maladaptive in diabetes by increasing the reabsorption of glucose above the normal physiologic renal threshold. This discovery has led to the development of the sodium/glucose cotransporter 2 inhibitors (SGLT2). These agents readjust the renal threshold for glucose reabsorption to a lower level and decrease glucose reabsorption, while increasing urinary glucose when the glucose is above the renal threshold and subsequently lowering plasma glucose. …

Assessment Of Longitudinal Efficacy Of Community Based Intervention For Schistosomiasis In Mara District, Lake Victoria Region Of Tanzania, Lauren Ogawa, Guy Bennallack, Aaron Heffner, Jason Duong, Robin Rosenblatt, Yasmin Nibbe, Eiman Mahmoud

Faculty Publications & Research of the TUC College of Osteopathic Medicine

Program/Project Purpose: An estimated 200 million people are infected with schistosomiasis, making the disease one of the top neglected tropical diseases and a major global health concern. In Tanzania, with a population just over 42 million, about 33 million are in need of treatment or preventative chemotherapy. The disease is of particular concern in the Lake Victoria region, due to daily use of lake water. In conjunction with the Shirati district hospital, Touro University-CA has led control programs carried out in mobile clinics at local villages by providing screening, treatment, and education. Recently there has been a push for …

The Effect Of Statin Therapy On Heart Failure Events: A Collaborative Meta-Analysis Of Unpublished Data From Major Randomized Trials, David Preiss, Ross T. Campbell, Heather M. Murray, Ian Ford, Chris J. Packard, Naveed Sattar, Michael B. Clearfield

Faculty Publications & Research of the TUC College of Osteopathic Medicine

Aims: The effect of statins on risk of heart failure (HF) hospitalization and HF death remains uncertain. We aimed to establish whether statins reduce major HF events.

Methods and results: We searched Medline, EMBASE, and the Cochrane Central Register of Controlled Trials for randomized controlled endpoint statin trials from 1994 to 2014. Collaborating trialists provided unpublished data from adverse event reports. We included primary- and secondary-prevention statin trials with >1000 participants followed for >1 year. Outcomes consisted of first non-fatal HF hospitalization, HF death and a composite of first non-fatal HF hospitalization or HF death. HF events occurring(MI) were excluded. …

What To Do After Basal Insulin: 3 Tx Strategies For Type 2 Diabetes, Lubaina Presswala, Jay H. Shubrook

Faculty Publications & Research of the TUC College of Osteopathic Medicine

While many family physicians have become comfortable with using once-daily basal insulin such as glargine or detemir, what to do after basal insulin is much more complex. This review builds upon an earlier article in this journal, “Insulin for type 2 diabetes: How and when to get started,” by explaining 3 strategies to consider when basal insulin alone isn't enough.

Obstructive Sleep Apnea, Joy A. Moverley, Matthew J. Fagan

Faculty Publications & Research of the TUC College of Osteopathic Medicine

The authors provide an overview of obstructive sleep apnea, including what it is, how it is diagnosed, and how it is treated.

Insulin Pumps: Beyond Basal-Bolus, Richard Millstein, Nancy Mora Becerra, Jay H. Shubrook

Faculty Publications & Research of the TUC College of Osteopathic Medicine

Insulin pumps are a major advance in diabetes management, making insulin dosing easier and more accurate and providing great flexibility, safety, and efficacy for people who need basal-bolus insulin therapy. They are the preferred treatment for people with type 1 diabetes and many with type 2 diabetes who require insulin. This article reviews the basics of how insulin pumps work, who benefits from a pump, and how to manage inpatients and outpatients on insulin pumps.

Managing Denture Biofilm Related Diseases, Tingxi Wu, Wenyuan Shi, Zvi G. Loewy, Xuesong He

Touro College of Pharmacy (New York) Publications and Research

The oral cavity harbors more than 700 microbial species and is one of the most complex ecosystems ever described. While the majority of these microbes are considered commensal, some of them are responsible for oral infectious diseases such as dental caries, periodontitis, halitosis and stomatitis. The advancement of modern science has greatly furthered our understanding of oral microbes and their roles in host health and disease. It has also led to the development of new tools for early detection, effective treatment, and prevention of oral microbial infections. This perspective provides a general understanding of oral microbiology, and its clinical relationship …

Primary Cutaneous Peripheral T-Cell Lymphoma Not Otherwise Specified: A Rapidly Progressive Variant Of Cutaneous T-Cell Lymphoma., Kimberly Aderhold, Lisa Carpenter, Krysta Brown, Anthony Donato

Reading Hospital Internal Medicine Residency

Primary Cutaneous Peripheral T-Cell Lymphoma NOS (PTL-NOS) is a rare, progressive, fatal dermatologic disease that presents with features similar to many common benign plaque-like skin conditions, making recognition of its distinguishing features critical for early diagnosis and treatment (Bolognia et al., 2008). A 78-year-old woman presented to ambulatory care with a single 5 cm nodule on her shoulder that had developed rapidly over 1-2 weeks. Examination was suspicious for malignancy and a biopsy was performed. Biopsy results demonstrated CD4 positivity, consistent with Mycosis Fungoides with coexpression of CD5, CD47, and CD7. Within three months her cancer had progressed into diffuse …

Training Toys ... Bells, Ropes, And Balls - Oh My!, Dixie Stanforth, Jason Brumitt, Nicholas Ratamess, Whitney Atkins, Steven J. Keteyian

Faculty Publications - College of Physical Therapy

Participation in regular moderate-to-vigorous physical activity often decreases with increasing age (16), and among people who do exercise, long-term adherence often is a challenge because of various factors including lack of enjoyment, intrinsic motivation, or social support; poor environment; inconvenience; fear of injury; and health-related issues. During the past decade, general fitness professionals and personal trainers have incorporated numerous adjunct modalities (‘‘toys’’) to ‘‘break up’’ the rigors of fitness training and as a means to introduce some diversion and goal-specific activities. Three popular modalities are kettlebells, battling ropes, and medicine balls. This article briefly reviews each device and presents some …

Temporal Trends In Results Of 9170 Myocardial Perfusion Imaging Studies (2004 To 2013)., Nosheen Fatima

Department of Surgery Docs

Abstract

BACKGROUND:

To assess the frequency of normal and abnormal myocardial perfusion imaging (MPI) in a consecutive cohort of patients from Pakistan over a period of 8.5 years.

MATERIAL AND METHODS:

We assessed 9170 patients who had undergone stress-rest MPI between January 2004 and June 2013. Patients were assessed for change in demographics, risk factors, and frequency of abnormal and normal MPI.

RESULTS:

Overall mean age and male predominance of studied cohort was ≈ 55 years and ≈ 55:45 (M:F), respectively, with no appreciable decline or rise. Marked decline in exercise as mode of stress (from 71% to 35%, p …

Acute Kidney Injury Risk Prediction In Patients Undergoing Coronary Angiography In A National Veterans Health Administration Cohort With External Validation, Jeremiah R. Brown, Todd A. Mackenzie, Thomas M. Maddox, James Fly, Thomas T. Tsai, Mary E. Plomondon, Christopher D. Nielson, Edward D. Siew, Frederic S. Resnic, Clifton R. Baker, John S. Rumsfeld, Michael E. Matheny

Dartmouth Scholarship

Background:

Acute kidney injury (AKI) occurs frequently after cardiac catheterization and percutaneous coronary intervention. Although a clinical risk model exists for percutaneous coronary intervention, no models exist for both procedures, nor do existing models account for risk factors prior to the index admission. We aimed to develop such a model for use in prospective automated surveillance programs in the Veterans Health Administration.

Methods and Results:

We collected data on all patients undergoing cardiac catheterization or percutaneous coronary intervention in the Veterans Health Administration from January 01, 2009 to September 30, 2013, excluding patients with chronic dialysis, end‐stage renal disease, renal …

Media: Mean Distance Association And Its Applications In Nonlinear Gene Set Analysis., Hesen Peng, Junjie Ma, Yun Bai, Jianwei Lu, Tianwei Yu

PCOM Scholarly Works

Probabilistic association discovery aims at identifying the association between random vectors, regardless of number of variables involved or linear/nonlinear functional forms. Recently, applications in high-dimensional data have generated rising interest in probabilistic association discovery. We developed a framework based on functions on the observation graph, named MeDiA (Mean Distance Association). We generalize its property to a group of functions on the observation graph. The group of functions encapsulates major existing methods in association discovery, e.g. mutual information and Brownian Covariance, and can be expanded to more complicated forms. We conducted numerical comparison of the statistical power of related methods under …

Isoproterenol Increases Uncoupling, Glycolysis, And Markers Of Beiging In Mature 3t3-L1 Adipocytes., Colette N Miller, Jeong-Yeh Yang, Emily England, Amelia Yin, Clifton A Baile, Srujana Rayalam

PCOM Scholarly Works

Beta-adrenergic activation stimulates uncoupling protein 1 (UCP1), enhancing metabolic rate. In vitro, most work has studied brown adipocytes, however, few have investigated more established adipocyte lines such as the murine 3T3-L1 line. To assess the effect of beta-adrenergic activation, mature 3T3-L1s were treated for 6 or 48 hours with or without isoproterenol (10 and 100 μM) following standard differentiation supplemented with thyroid hormone (T3; 1 nM). The highest dose of isoproterenol increased lipid content following 48 hours of treatment. This concentration enhanced UCP1 mRNA and protein expression. The increase in UCP1 following 48 hours of isoproterenol increased oxygen consumption rate. …

The Injustice Of Inclusion And Fair Opportunity: Exploiting Children In Medical Research For The Benefit Of An Unworthy Society, Ruqaiijah Yearby

All Faculty Scholarship

The history of pediatric medical research has been characterized as a history of child abuse. Usually, the debate regarding the use of children in medical research has centered on questions of Autonomy (informed consent) and Beneficence (the best interest of the child based on a benefit risk analysis). The debate has rarely focused on the question of which children should participate in medical research by discussing the legal principle of Justice (prohibits use of vulnerable populations for medical research who are already overly burdened for medical research unrelated to health issues affecting them and requires that populations who participate in …

Economic Impact Of Waste In Prescribing, Dispensing, And Medication Consumption In The United States, Sarah Almanie

Theses and Dissertations

Abstract

ECONOMIC IMPACT OF WASTE IN PRESCRIBING, DISPENSING, AND MEDICATION CONSUMPTION IN THE UNITED STATES

By Sarah A. Almanie, M.S.

A thesis submitted in partial fulfillment of the requirements for the degree of Master of Science at Virginia Commonwealth University.

Virginia Commonwealth University, 2015.

Major Director: David A. Holdford, R.Ph., M.S., Ph.D., FAPhA

Professor

Department of Pharmacotherapy and Outcomes Science

OBJECTIVES: This research examines waste associated with the medication use process which consists of unfilled prescriptions, abandoned prescriptions, or unused prescription medications. The aim of this study is to quantify the direct medical costs of medication waste in delivery of …

Accidental Opioid Overdose Fatalities In Western Australia, 2008-2012: A Case For More Targeted Intervention, Natalie J. Castalanelli

Theses : Honours

While there are current opioid overdose prevention strategies in Western Australia, these strategies are targeted at illicit opioid users and rely on bystander presence to intervene. The aim of the current study was to identify disparities between current overdose prevention strategies and the actual circumstances surrounding opioid related fatalities, to inform the development of best-practice opioid overdose prevention strategies for Western Australia. To do this, coronial files were drawn from the National Coronial Information System for accidental illicit opioid related fatalities (N = 329) and accidental prescription opioid related fatalities (N = 126) for the years 2008 to 2012. Each …

Conceiving Of Products And The Products Of Conception: Reflections On Commodification, Consumption, Art, And Abortion, Jody L. Madeira

Articles by Maurer Faculty

This paper rejects the dichotomy between patient and consumer roles and focuses instead on how attributes of each are meaningful to those seeking health care. Arguing that health care is already commodified, it suggests that both medicine and the market offer strategies for handling commodification. The important questions are how we understand these attributes and their role in care relationships, and which attributes we should encourage. The medical profession and patient role have long accommodated commodification, using fiduciary roles, flat fees and opaque pricing to distance payment and pricing from care provision. In contrast, the market and consumer role emphasize …

Factors Influencing Depression In Men: A Qualitative Investigation, Lori A. Mutiso

Theses and Dissertations--Nursing

The purpose of this qualitative descriptive study is to describe men’s experiences of depression in order to provide direction for future research of the screening, diagnosing, and treatment of men's depression. Previous research indicates that men experience different depressive symptoms than women, and there is a possibility that men's depression is not being adequately captured by current screening standards, which would theoretically lead to a large number of men with unrecognized, undiagnosed, and untreated depression. If this is the case, this may explain the disproportionately low number of men diagnosed with depression compared to women, in contrast to the disproportionately …

Fruit And Vegetable Consumption Of Division I Collegiate Football And Volleyball Players Pre- And Post-Deregulation Of Snacks By The Ncaa, Emily Ludwig

Theses and Dissertations--Nutrition and Food Systems

The deregulation of snacks by the National Collegiate Athletic Association (NCAA) permits institutions to provide enhanced snacks incidental to participation. Athletes may now have the opportunity to improve their diet quality. The purpose of this research was to assess the consumption of fruits and vegetables as well as body composition of Division I collegiate athletes. The sample included 19 American football players and 8 volleyball players. Paired t-tests were performed to compare fruit intake, vegetable intake, and body fat percentage pre- and post-deregulation of snacks. Linear regression models were used to determine correlations between change in fruit intake and change …

Servsafe® Exam: Student's Memory Retention Two Years Later, Laura E. Tincher

Theses and Dissertations--Nutrition and Food Systems

This study analyzed the memory retention of University of Kentucky Dietetic and Hospitality students as it relates to food safety and sanitation knowledge originally presented on the ServSafe® certification exam. Dietetic and hospitality students take the ServSafe® certification course during the sophomore year of their degree program, but they are responsible for the sanitation and food safety information throughout their entire program of undergraduate study. The final sample consisted of 25 participants, with 84% (n=21) in the Dietetics program and 16% (n=4) in the Hospitality, Management and Tourism program. The mean difference in total score, domain one, domain two, domain …

Physician Density And Location Of Physician Training : The Impact On Avoidable Hospitalizations, Robert Martiniano

Legacy Theses & Dissertations (2009 - 2024)

Avoidable hospitalizations are those hospitalizations that could have been avoided had there been appropriate levels of primary care, and higher levels of avoidable hospitalizations have been linked to higher rates of poverty and of race/ethnicity and to individuals who are on Medicaid or who are uninsured. The association with physician density has, however, been inconsistent, with research linking both better and worse physician density to higher rates of avoidable hospitalizations. Very little research, however, has been conducted on other physician characteristics and the rate of avoidable hospitalizations.

The Impact Of Heat Event On Emergency Department Visits Due To Cardiovascular Diseases Among Elderly During Transitional Seasons And Summer In New York State, 2005-2013, Mengxuan Li

Legacy Theses & Dissertations (2009 - 2024)

Background: Prior studies have reported the association between heat exposure and cardiovascular diseases (CVDs) in summer, but transitional season effects are rarely studied. Additionally, the elderly has not received enough attention as a high risk group. Emergency department (ED) visits can capture heat response at the early stage, but few studies have used it as an outcome.

Untreated Depression In Persons Living With Hiv In Kazakhstan, Dina Terloyeva

Legacy Theses & Dissertations (2009 - 2024)

Objective:This study investigates the occurrence of depressive symptoms among persons living with HIV, and the relationship between depressive symptoms and HIV treatment initiation and adherence.

Essays On Income Inequality, Minority Health And Healthcare Spending, Rui Cheng

Legacy Theses & Dissertations (2009 - 2024)

This set of essays addresses issues related to income inequality, public healthcare supply and population health. Income inequality has been found to affect health in a number of studies. Using data from Behavioral Risk Factor Surveillance System (BRFSS), a telephone survey of adults in the United States, the first chapter of my dissertation studies the effect of state level and county level income inequality on health status and the pathway via public health spending. By using multiple imputation method applied to BRFSS income data, it derives synthetic Gini coefficient at state level and county level for each year from 2000 …

The Effects Of Landscape On Malaria Vectors Of The Neotropics, William David Lainhart

Legacy Theses & Dissertations (2009 - 2024)

Worldwide malaria control efforts have had varying degrees of success, leaving many countries either eliminating malaria or controlling malaria. In order to maintain forward momentum toward malaria elimination, malaria-eliminating and –controlling countries require different information regarding risk factors, spatial distributions of cases and vectors, vector biology metrics, and vector population genetics. The goal of this dissertation work was to provide information that addresses the knowledge gaps preventing the creation of effective vector and malaria control programs in one malaria-eliminating country (Panama) and two malaria-controlling countries (Peru and Brazil). Case data from Panama were analyzed to assess differences in risk factors …

Grid-Based Fourier Transform Phase Contrast Imaging, Sajjad Tahir

Legacy Theses & Dissertations (2009 - 2024)

Low contrast in x-ray attenuation imaging between different materials of low electron density is a limitation of traditional x-ray radiography. Phase contrast imaging offers the potential to improve the contrast between such materials, but due to the requirements on the spatial coherence of the x-ray beam, practical implementation of such systems with tabletop (i.e. non-synchrotron) sources has been limited. One recently developed phase imaging technique employs multiple fine-pitched gratings. However, the strict manufacturing tolerances and precise alignment requirements have limited the widespread adoption of grating-based techniques. In this work, we have investigated a technique recently demonstrated by Bennett et al.1 …

Rna Aptamers For Molecular Chaperones Hsp27 And Hsp90, Sathishkumar Kumar Munusamy

Legacy Theses & Dissertations (2009 - 2024)

Hsp90 and Hsp27 are members of the heat shock protein family of chaperones that perform multiple roles in cellular maintenance through protein folding and inhibition of apoptosis. They are abundantly expressed in cells and are over-expressed during conditions of stress. Hsp90 requires ATP for its chaperone function while Hsp27 self-associates into higher order oligomers enclosing its substrate. Their ability to interact with other proteins or with themselves lies at the heart of their mechanisms. The specific consequences of each of their interactions on global cellular health have not yet been fully discovered. The sheer diversity of proteins that interact with …