Medicine and Health Sciences Commons^™

Analysis Of The Patient Information Quality And Readability On Esophagogastroduodenoscopy (Egd) On The Internet, P. Priyanka, Yousaf B. Hadi, G. J. Reynolds

Clinical and Translational Science Institute

Objective. Patients are increasingly using the Internet to inform themselves of health-related topics and procedures, including EGD. We analyzed the quality of information and readability of websites afer a search on 3 diferent search engines. Methods. We used an assessment tool for website quality analysis that we developed in addition to using validated instruments for website quality, Global Quality Score (GQS) and Health on Net (HON) certifcation. Te readability was assessed using Flesch-Kincaid Reading Ease (FRE) and Flesch-Kincaid Grade level (FKG). 30 results of each search terms ‘EGD’ and ‘Upper Endoscopy’ from Google and 15 each from Bing and Yahoo …

The Humanistic And Economic Burden Associated With Anxiety And Depression Among Adults With Comorbid Diabetes And Hypertension, Kimberly Wallace, Xiaohui Zhao, Ranjita Misra, Usha Sambamoorthi

Clinical and Translational Science Institute

We conducted a retrospective cross-sectional study to estimate the humanistic and economic burden associated with depression and anxiety among adults with comorbid diabetes and hypertension. Pooled data from the 2013 and 2015 Medical Expenditure Panel Survey were used to include adults (≥18 years old) who were alive and diagnosed with both diabetes and hypertension during the observation period. We assessed the humanistic burden with health-related quality of life (HRQoL) and economic burden with the total annual healthcare expenditures. Depending on the presence/absence of depression and anxiety, the study sample was divided into four groups (i.e., no depression/anxiety, depression only, anxiety …

Will Artificial Intelligence Replace The Human Echocardiographer?, Partho P. Sengupta, Donald A. Adjeroh

Clinical and Translational Science Institute

No abstract provided.

Qualitative Case Study Of Needle Exchange Programs In The Central Appalachian Region Of The United States, Stephen M. Davis, Danielle Davidov, Alfgeir L. Kristjansson, Keith Zullig, Adam Baus, Melanie Fisher

Clinical and Translational Science Institute

Background

The Central Appalachian region of the United States is in the midst of a hepatitis C virus epidemic driven by injection of opioids, particularly heroin, with contaminated syringes. In response to this epidemic, several needle exchange programs (NEP) have opened to provide clean needles and other supplies and services to people who inject drugs (PWID). However, no studies have investigated the barriers and facilitators to implementing, operating, and expanding NEPs in less populous areas of the United States.

Methods

This qualitative case study consisted of interviews with program directors, police chiefs, law enforcement members, and PWID affiliated with two …

Self-Reported Vs. Measured Height, Weight, And Bmi In Young Adults, Melissa D. Olfert, Makenzie L. Barr, Camille M. Charlier, Oluremi A. Famodu, Wenjun Zhou, Anne E. Mathews, Carol Byrd-Bredbenner, Sarah E. Colby

Clinical and Translational Science Institute

Self-reported height and weight, if accurate, provide a simple and economical method to track changes in body weight over time. Literature suggests adults tend to under-report their own weight and that the gap between self-reported weight and actual weight increases with obesity. This study investigates the extent of discrepancy in self-reported height, weight, and subsequent Body Mass Index (BMI) versus actual measurements in young adults. Physically measured and self-reported height and weight were taken from 1562 students. Male students marginally overestimated height, while females were closer to target. Males, on average, closely self-reported weight. Self-reported anthropometrics remained statistically correlated to …

Capturing The Statewide Incidence Of Neonatal Abstinence Syndrome In Real Time: The West Virginia Experience, Amna Umer, Sean Loudin, Stefan Maxwell, Christa Lilly, Meagan E. Stabler, Lesley Cottrell, Candice Hamilton, Janine Breyel, Christina Mullins, Collin John

Clinical and Translational Science Institute

Background Neonatal abstinence syndrome (NAS) is one of the consequences at birth affecting the newborn after discontinuation of prenatal drug exposure to mainly opioids. The objective of this study was to determine the extent of the problem in the state of West Virginia (WV) using a real-time statewide surveillance system. Methods Project WATCH is a surveillance tool that since 1998 collects data on all infants born in the state of WV. NAS surveillance item was added to the tool in October 2016. This study examined all births (N = 23,667) in WV from October to December 2017. The data from …

Artificial Light At Night As An Environmental Pollutant: An Integrative Approach Across Taxa, Biological Functions, And Scientific Disciplines, Davide M. Dominoni, Randy J. Nelson

Clinical and Translational Science Institute

With each day, the world is becoming number of people move into urban areas, and consequently these increase in area to consume rural and natural land (Seto, Guneralp, & Hutyra, 2012). Among the numerous changes that accompany urban sprawl, artificial light at night (ALAN) is one of the most immediate and evident (Falchi et al., 2016; Longcore & Rich, 2004). From a variety of anthropogenic sources, artificial light is introduced at times (the night) and in places where it does not naturally occur (Falchi et al., 2016). The characteristics of the introduced light sources are also very different from natural …

Comparative Analysis Of The Views Of Oncologic Subspecialists And Palliative/Supportive Care Physicians Regarding Advanced Care Planning And End-Of-Life Care, Phillip M. Pifer, Mark K. Farrugia, Malcolm D. Mattes

Clinical and Translational Science Institute

Background—Early palliative/supportive care (PSC) consultation and advance care planning (ACP) improve outcomes for patients with incurable cancer. However, PSC is underutilized in the United States. Objective—To examine philosophical differences among PSC, radiation oncology (RO), and medical oncology (MO) physicians in order to understand barriers to early PSC referral. Design—An electronic survey collected views of a nationwide cohort of health-care professionals regarding ACP and end-of-life care. Setting/Participants/Measurements—A subgroup analysis compared the responses from all 51 PSC, 178 RO, and 81 MO physician participants (12% response rate), using Pearson χ2 and Mann-Whitney U tests for categorical and ordinal data, respectively. Results—More statistically …

Social Influences On Microglial Reactivity And Neuronal Damage After Cardiac Arrest/Cardiopulmonary Resuscitation, Monica M. Gaudier-Diaz, Adam H. Haines, Ning Zhang, A. Courtney Devries

Clinical and Translational Science Institute

Social isolation presents a risk factor and worsens outcome to cerebrovascular diseases; however, the underlying mechanisms remain underspecified. This study examines the effect of social environment on microglial reactivity after global cerebral ischemia, to test the hypothesis that social isolation leads to greater microglial responses. Adult female and male mice were pair-housed or socially isolated for one week prior to cardiac arrest/cardiopulmonary resuscitation (CA/CPR) or the sham procedure, and following either 2 or 24 hours of reperfusion, microglia samples were enriched and analyzed for gene expression. At the 2-hour time point, microglia from both females and males exhibited ischemia-induced inflammation, …

An Effective Approach To Teaching Pharmacogenomics In The First Year Of Pharmacy Curriculum, Marina Gálvez-Peralta, Grazyna D. Szklarz, Werner J. Geldenhuys, Paul R. Lockman

Clinical and Translational Science Institute

Objective. To develop an effective method in teaching pharmacogenomics as a part of a new course, Biopharmaceutics and Pharmacogenomics. Methods. Teaching effectiveness was measured by quizzes, retrospective pre- and post-surveys, team activities, and journal reflections. Four team activities were included in the course: genomic disease, patient case, genetic counselor and a debate about personalized medicine. Outcomes and course impact were evaluated at the end of the course. The evaluation methods included the assessment of knowledge, students’ perceptions regarding the utility of team activities, the impact of the course on students’ confidence to discuss pharmacogenomics with health care providers or patients, …

Executive (Dys)Function After Traumatic Brain Injury: Special Considerations For Behavioral Pharmacology, Jenny E. Ozga, Jessica M. Povroznik, Elizabeth B. Engler-Chiurazzi, Cole Vonder Haar

Clinical and Translational Science Institute

Executive function is an umbrella term that includes cognitive processes such as decision-making, impulse control, attention, behavioral flexibility, and working memory. Each of these processes depends largely upon monoaminergic (dopaminergic, serotonergic, and noradrenergic) neurotransmission in the frontal cortex, striatum, and hippocampus, among other brain areas. Traumatic brain injury (TBI) induces disruptions in monoaminergic signaling along several steps in the neurotransmission process – synthesis, distribution, and breakdown – and in turn, produces long-lasting deficits in several executive function domains. Understanding how TBI alters monoamingeric neurotransmission and executive function will advance basic knowledge of the underlying principles that govern executive function and …

Executive (Dys)Function After Stroke: Special Considerations For Behavioral Pharmacology, Jessica M. Povroznik, Jenny E. Ozga, Cole Vonder Haar, Elizabeth B. Engler-Chiurazzi

Clinical and Translational Science Institute

Stroke is a world-wide leading cause of death and long-term disability with concurrent secondary consequences that are largely comprised of mood dysfunction, as well as sensory, motor, and cognitive deficits. This review focuses on the cognitive deficits associated with stroke specific to executive dysfunction (including decision making, working memory, and cognitive flexibility) in humans, non-human primates, and additional animal models. Further, we review some of the cellular and molecular underpinnings of the individual components of executive dysfunction and their neuroanatomical substrates after stroke, with an emphasis on the changes that occur during biogenic monoamine neurotransmission. We concentrate primarily on changes …

Artificial Light At Night Alters Behavior In Laboratory And Wild Animals, Kathryn L. G. Russart, Randy J. Nelson

Clinical and Translational Science Institute

Life has evolved to internalize and depend upon the daily and seasonal light cycles to synchronize physiology and behavior with environmental conditions. The nightscape has been vastly changed in response to the use of artificial lighting. Wildlife is now often exposed to direct lighting via streetlights or indirect lighting via sky glow at night. Because many activities rely on daily and seasonal light cues, the effects of artificial light at night could be extensive, but remain largely unknown. Laboratory studies suggest exposure to light at night can alter typical timing of daily locomotor activity and shift the timing of foraging/food …

Correlations Of Self-Reported Androgen Deficiency In Ageing Males (Adam) With Stress And Sleep Among Young Adult Males, Camille M. Charlier, Makenzie L. Barr, Sarah E. Colby, Geoffrey W. Greene, Melissa D. Olfert

Clinical and Translational Science Institute

Androgen deficiency in males has traditionally been predominantly limited to older men aged 50+ years. However, little is known of the correlation between hormonal disruption, stress, and sleep in college-aged males. This cross-sectional study investigates lifestyle behavior patterns in young men and a screening for potential androgen deficiency. A survey of 409 male students, as part of a larger USDA-funded GetFruved study, was analyzed for this subproject. Survey instruments used include the Androgen Deficiency in the Aging Male Questionnaire (ADAM) to assess for inadequate ADAM scores, the Perceived Stress Scale to measure stress levels and the Pittsburgh Sleep Quality Index …

Comparison Of Dental Students' Self-Evaluation And Faculty Evaluation Of Communication Skills During A Standardized Patient Exercise, R. Constance Wiener, Christopher Waters, Joan Doris, Daniel W. Mcneil

Clinical and Translational Science Institute

The aims of this retrospective study, conducted in 2017, were to explore dental students’ perceptions of their first standardized patient encounters and to assess the relationship between students’ self-evaluation and faculty members’ evaluation of students’ communication skills in those encounters. Data from a simulation training laboratory at one U.S. dental school were obtained for all 46 second-year students, who had a standardized patient communication learning session. The students had completed self-evaluations before and after a debriefing with a clinical psychology and/or social work faculty member and three or four student peers. The faculty members had also completed evaluations of the …

Mobile Health (Mhealth) Use Or Non-Use By Residents Of West Virginia, Peter Giacobbi Jr, Patrick Cushing, Alexis Popa, Treah Haggerty, Adam Hansell, Cara Sedney

Clinical and Translational Science Institute

Objective: To compare mobile health (mHealth) usage by residents of West Virginia with national estimates. Methods: Pew Research Center data from its Internet and American Life Project were accessed for secondary data analysis. These data, available to the public, are a probability sample of Internet use in the United States, differences in use based on selected variables (eg, education, household income), and how usage affects the lives of Americans. Using SAS software, diagnostics were performed on the data, revealing that the variables of interest were prepared and represented without any need for information. Data were used as is, with categorical …

Meta-Analysis Comparing The Frequency Of Stroke After Transcatheter Versus Surgical Aortic Valve Replacement, Kuldeep Shah, Zakeih Chaker, Tatiana Busu, Vinay Badhwar, Fahad Alqahtani, Muhammad Alvi, Amelia Adcock, Mohamad Alkhouli

Clinical and Translational Science Institute

Stroke is one of the most feared complications of aortic valve replacement. Although the out-comes of transcatheter aortic valve implantation (TAVI) improved substantially over time,concerns remained about a potentially higher incidence of stroke with TAVI compared withsurgical replacement (SAVR). However, comparative data are sparse. We performed ameta-analysis comparing the incidence of stroke among patients undergoing TAVI versusSAVR. Of the 5067 studies screened, 28 eligible studies (22 propensity-score matched studiesand 6 randomized trials) were analyzed. Primary endpoints were 30-day stroke and disablingstroke. Secondary endpoints were 1-year stroke and disabling stroke. A total of 23,587patients were included, of whom 47.27% underwent TAVI …

Rational Identification Of A Cdc42 Inhibitor Presents A New Regimen For Long- Term Hematopoietic Stem Cell Mobilization, Wei Liu, Wei Du, Xun Shang, Lei Wang, Chris Evelyn, Maria Carolina Florian, Marnie A. Ryan, Ahmad Rayes, Xueheng Zhao, Kenneth Setchell, Jarek Meller, Fukun Guo, Nicolas Nassar, Hartmut Geiger, Qishen Pang, Yi Zheng

Clinical and Translational Science Institute

Mobilization of hematopoietic stem cells (HSCs) from bone marrow (BM) to peripheral blood (PB) by cytokine granulocyte colony-stimulating factor (G-CSF) or the chemical antagonist of CXCR4, AMD3100, is important in the treatment of blood diseases. Due to clinical conditions of each application, there is a need for continued improvement of HSC mobilization regimens. Previous studies have shown that genetic ablation of the Rho GTPase Cdc42 in HSCs results in their mobilization without affecting survival. Here we rationally identified a Cdc42 activity-specific inhibitor (CASIN) that can bind to Cdc42 with submicromolar affinity and competitively interfere with guanine nucleotide exchange activity. CASIN …

Remote Cerebellar Haemorrhage: A Potential Iatrogenic Complication Of Spinal Surgery, Muhammad Atif Naveed, Rajiv Mangla, Hajra Idrees, Rashi I. Mehta

Clinical and Translational Science Institute

We report the case of a 51-year-old man with no significant past medical history, who underwent elective revision spinal surgery and subsequently developed intracranial hypotension, remote cerebellar haemorrhage (RCH), and mild hydrocephalus on the fourth postoperative day. Remote cerebellar haemorrhage is a known complication of supratentorial surgery. This iatrogenic phenomenon may also occur following spinal surgery, due to dural tearing and rapid cerebral spinal fluid (CSF) leakage, resulting in intracranial hypotension and cerebellar haemorrhage. This complication may result in severe permanent neurologic sequelae; hence, it is of pertinence to diagnose and manage it rapidly in order to optimise patient outcome.

Imaging Of Enzyme Activity By Electron Paramagnetic Resonance: Concept And Experiment Using A Paramagnetic Substrate Of Alkaline Phosphatase, Urikhan Sanzhaeva, Xuan Xu, Priyaankadevi Guggilapu, Mark Tseytlin, Valery V. Khramtsov, Benoit Driesschaert

Clinical and Translational Science Institute

Enzyme activities are well established biomarkers of many pathologies. Imaging enzyme activity directly in vivo may help to gain insight into the pathogenesis of various diseases but remains extremely challenging. In this communication, we report the use of EPR imaging (EPRI) in combination with a specially designed paramagnetic enzymatic substrate to map alkaline phosphatase activity with a high selectivity, thereby demonstrating the potential of EPRI to map enzyme activity.

Combination Of Cabazitaxel And Plicamycin Induces Cell Death In Drug Resistant B-Cell Acute Lymphoblastic Leukemia, Rajesh R. Nair, Debbie Piktel, Werner J. Geldenhuys, Laura F. Gibson

Clinical and Translational Science Institute

Bone marrow microenvironment mediated downregulation of BCL6 is critical for maintaining cell quiescence and modulating therapeutic response in B-cell acute lymphoblastic leukemia (ALL). In the present study, we have performed a high throughput cell death assay using BCL6 knockdown REH ALL cell line to screen a library of FDA-approved oncology drugs. In the process, we have identified a microtubule inhibitor, cabazitaxel (CAB), and a RNA synthesis inhibitor, plicamycin (PLI) as potential anti-leukemic agents. CAB and PLI inhibited cell proliferation in not only the BCL6 knockdown REH cell line, but also six other ALL cell lines. Furthermore, combination of CAB and …

Efficacy And Safety Of Mechanical Versus Manual Compression In Cardiac Arrest - A Bayesian Network Meta-Analysis, Safi U. Khan, Ahmad N. Lone, Swapna Talluri, Muhammad Z. Khan, Muhammad U. Khan, Edo Kaluski

Clinical and Translational Science Institute

Aim: To compare relative efficacy and safety of mechanical compression devices (AutoPulse and LUCAS) with manual compression in patients with cardiac arrest undergoing cardiopulmonary resuscitation (CPR). Methods: For this Bayesian network meta-analysis, seven randomized controlled trials (RCTs) were selected using PubMed/Medline, EMBASE, and CENTRAL (Inception- 31 October 2017). For all the outcomes, median estimate of odds ratio (OR) from the posterior distribution with corresponding 95% credible interval (Cr I) was calculated. Markov chain Monte Carlo (MCMC) modeling was used to estimate the relative ranking probability of each intervention based on surface under the cumulative ranking curve (SUCRA). Results: In analysis …

Early Versus Late Gamma Knife Radiosurgery Following Transsphenoidal Surgery For Nonfunctioning Pituitary Macroadenomas: A Multicenter Matched-Cohort Study, I. Jonathan Pomeraniec, Hideyuki Kano, Zhiyuan Xu, Brandon Nguyen, Zaid A. Siddiqui, Danilo Silva, Mayur Sharma, Hesham Radwan, Jonathan A. Cohen, Robert F. Dallapiazza, Christian Iorio-Morin, Amparo Wolf, John A. Jane Jr., Inga S. Grills, David Mathieu, Douglas Kondziolka, Cheng-Chia Lee, Chih-Chun Wu, Christopher P. Cifarelli, Tomas Chytka, Gene H. Barnett, L. Dade Lunsford, Jason P. Sheehan

Clinical and Translational Science Institute

OBJECTIVE—Gamma Knife radiosurgery (GKRS) is frequently used to treat residual or recurrent nonfunctioning pituitary macroadenomas. There is no consensus as to whether GKRS should be used early after surgery or if radiosurgery should be withheld until there is evidence of imaging-defined progression of tumor. Given the high incidence of adenoma progression after subtotal resection over time, the present study intended to evaluate the effect of timing of radiosurgery on outcome. METHODS—This is a multicenter retrospective review of patients with nonfunctioning pituitary macroadenomas who underwent transsphenoidal surgery followed by GKRS from 1987 to 2015 at 9 institutions affiliated with the International …

Emergency Department Visits For Sexual Assault By Emerging Adults: Is Alcohol A Factor?, Allison Tadros, Melinda J. Sharon, Shelley M. Hoffman, Danielle M. Davidov

Clinical and Translational Science Institute

Introduction: Emerging adults (18-25 years of age) are at increased risk for sexual assault. There is little Emergency Department (ED) data on sexual assaults that involve alcohol among this population. The purpose of this study was to analyze ED visits for sexual assault and determine if alcohol consumption by the patient was noted. Methods: This study was a retrospective chart review of patients aged 18-25 presenting to an ED in a college town over a four-year period. Extracted variables included age, gender, delay in seeking care, sexual assault nurse examiner (SANE) evaluation, and alcohol consumption by the patient. For analysis …

A Non-Myeloablative Conditioning Approach For Long-Term Engraftment Of Human And Mouse Hematopoietic Stem Cells, Wei Du, Wei Liu, Benjamin Mizukawa, Xun Shang, Jared Sipple, Mark Wunderlich, Hartmut Geiger, Stella Davies, James Mulloy, Qishen Pang, Yi Zheng

Clinical and Translational Science Institute

No abstract provided.

An Examination Of The Perceived Impact Of A Continuing Interprofessional Education Experience On Opiate Prescribing Practices, Roberto Cardarelli, William Elder, Sarah Weatherford, Karen L. Roper, Dana King, Charlotte Workman, Kathryn Stewart, Chong Kim, William Betz

Clinical and Translational Science Institute

Chronic pain is increasingly recognized as a public health problem. We assessed the effectiveness of a multi-modal, interprofessional educational approach aimed at empowering healthcare professionals to make deliberative changes, especially in opiate prescribing practices. Education activities included enduring webcasts, regional interprofessional roundtable events, and state-level conference presentations within targeted Kentucky and West Virginia regions of the United States. Over 1,000 participants accessed the various activities. For the live events, the largest groups reached included nurses (38.1%), nurse practitioners (31.2%), and physicians (22.1%). In addition to our reach, higher levels of educational effectiveness were measured, specifically, learner’s intentions to change practice …

Associations Between Use Of Antimalarial Medications And Health Among U.S. Veterans Of The Wars In Iraq And Afghanistan., Aaron I. Schneiderman, Yasmin S. Cypel, Erin K. Dursa, Robert M. Bossarte

Clinical and Translational Science Institute

Mefloquine (Lariam®; Roche Holding AG, Basel, Switzerland) has been linked to acute neuropsychiatric side effects. This is a concern for U.S. veterans who may have used mefloquine during recent Southwest Asia deployments. Using data from the National Health Study for a New Generation of U.S. Veterans, a population-based study of U.S. veterans who served between 2001 and 2008, we investigated associations between self-reported use of antimalarial medications and overall physical and mental health (MH) using the twelve-item short form, and with other MH outcomes using the post-traumatic stress disorder Checklist-17 and the Patient Health Questionnaire (anxiety, major depression, and self-harm). …

Selective Bladder Denervation For Overactive Bladder (Oab) Syndrome: From Concept To Healing Outcomes Using The Ovine Model, James Fugett Ii, Lynette Phillips, Emily Tobin, Eric Whitbrook, Haydon Bennett, Joshua Shrout, James E. Coad

Clinical and Translational Science Institute

Aims: We evaluated a Selective Bladder Denervation (SBD) device, which uses radiofrequency ablation, for the treatment of overactive bladder syndrome in terms of its nerve denervation, ablation characteristics, and post-treatment healing. Methods: Using the SBD device, eight fresh extirpated ovine bladder trigones were treated (90°C set point for 60 s) and nitroblue tetrazolium viability stained to characterize the ablation. In addition, 12 trigones were treated in vivo with three adjacent ablations and divided into survival cohorts: Day 7, Day 30, and Day 90 to assess the ablations and their associated healing. Results: The ex vivo single trigone ablations had a …

Predictors Of Preoperative Program Non-Completion In Adolescents Referred For Bariatric Surgery, Cassie Brode, Megan Ratcliff, Jennifer Reiter-Purtill, Sanita Hunsaker, Michael Helmrath, Meg Zeller

Clinical and Translational Science Institute

Background—Factors contributing to adolescents’ non-completion of bariatric surgery, defined as self-withdrawal during the preoperative phase of care, independent of program or insurance denial, are largely unknown. Recent adolescent and adult bariatric surgery literature indicate that psychological factors and treatment withdrawal play a role; however, for adolescents, additional age-salient (family/caregiver) variables might also influence progression to surgery. Objectives—The present study examined demographic, psychological, and family/caregiver variables as predictors of whether adolescents completed surgery (“completers”) or withdrew from treatment (“non-completers”). Setting—Adolescents were from a bariatric surgery program within a pediatric tertiary care hospital. Methods—A retrospective chart review was conducted of consecutive patients …

Editorial, Audrey Duarte, Marc Haut, Natasha Rajah

Clinical and Translational Science Institute

No abstract provided.