Medicine and Health Sciences Commons^™

Identifying Gaps And Launching Resident Wellness Initiatives: The 2017 Resident Wellness Consensus Summit., Fareen Zaver, Nicole Battaglioli, William Denq, Anne Messman, Arlene Chung, Michelle Lin, Emberlynn L Liu

Emergency Medicine Faculty Publications

Introduction: Burnout, depression, and suicidality among residents of all specialties have become a critical focus for the medical education community, especially among learners in graduate medical education. In 2017 the Accreditation Council for Graduate Medical Education (ACGME) updated the Common Program Requirements to focus more on resident wellbeing. To address this issue, one working group from the 2017 Resident Wellness Consensus Summit (RWCS) focused on wellness program innovations and initiatives in emergency medicine (EM) residency programs.

Methods: Over a seven-month period leading up to the RWCS event, the Programmatic Initiatives workgroup convened virtually in the Wellness Think Tank, an online, …

Canadian Network For Mood And Anxiety Treatments (Canmat) And International Society For Bipolar Disorders (Isbd) 2018 Guidelines For The Management Of Patients With Bipolar Disorder., Lakshmi N Yatham, Sidney H Kennedy, Sagar V Parikh, Ayal Schaffer, David J Bond, Robert M Post, +Several Additional Authors

Psychiatry and Behavioral Sciences Faculty Publications

The Canadian Network for Mood and Anxiety Treatments (CANMAT) previously published treatment guidelines for bipolar disorder in 2005, along with international commentaries and subsequent updates in 2007, 2009, and 2013. The last two updates were published in collaboration with the International Society for Bipolar Disorders (ISBD). These 2018 CANMAT and ISBD Bipolar Treatment Guidelines represent the significant advances in the field since the last full edition was published in 2005, including updates to diagnosis and management as well as new research into pharmacological and psychological treatments. These advances have been translated into clear and easy to use recommendations for first, …

Comparison Of Interactive Video Test Performance To Overall Class Performance In A Biomechanics Course, Guinevere S. Bennett

Occupational Therapy Faculty Research

Objective:

This study compared interactive video test performance and students' overall class performance. The hypothesis was that there would be a difference in video test performance compared to overall class performance.

Methods:

A total of 30 students participated in the pilot study from a master's level biomechanics course. Students completed four interactive video tests using EduCanon; content of videos included base of support, lever systems, scapulohumeral rhythm, and postural analysis. This content was reviewed with class discussion after completion of the interactive video test. The tests administered counted toward the participation portion of the final student grade. Student performance on …

Treatment For Depression And Health-Related Quality Of Life Among Adults With Arthritis, Drishti Shah, Pragya Rai, Nilanjana Dwibedi, Usha Sambamoorthi

Clinical and Translational Science Institute

Depression treatment has been proven to relieve depressive symptoms and pain and may therefore improve the health-related quality of life (HRQoL) among adults with arthritis. The objective of the current study was to examine the HRQoL associated with depression treatment among adults with arthritis and depression. A retrospective longitudinal cohort study design using data from the Medical Expenditure Panel Survey (2009–2012) was adopted. The study sample consisted of adults (≥21 years) with co-existing arthritis and depression (N = 1692). Depression treatment was categorized into: antidepressants only, psychotherapy with or without antidepressants, and neither antidepressants nor psychotherapy. Multivariable Ordinary Least Square …

Alzheimer Disease And Related Disorders And Out-Of-Pocket Health Care Spending And Burden Among Elderly Medicare Beneficiaries, Nilanjana Dwibedi, Patricia A. Findley, R. Constance Wiener, Chan Shen, Usha Sambamoorthy

Clinical and Translational Science Institute

Objective—To estimate the excess burden of out-of-pocket healthcare spending associated with Alzheimer’s disease and related disorders (ADRD) among older individuals (age ≥ 65 years). Methods—We adopted a retrospective, cross-sectional study design with data from 2012 Medicare Current Beneficiary Survey. The study sample comprised of elderly community dwelling individuals who had positive total healthcare expenditures, and enrolled in Medicare throughout the calendar year (462 with ADRD, and 7,160 without ADRD). We estimated the percapita total annual out-of-pocket spending on healthcare and out-of-pocket spending by service type: inpatient, outpatient, home health, prescription drugs, and other services. We measured outof-pocket spending burden by …

Exploring The Genomic Basis Of Early Childhood Caries: A Pilot Study, Jami L. Ballantine, Jenna C. Carlson, Andrea G. Ferreira Zandoná, Cary Agler, Leslie P. Zeldin, Richard Gary Rozier, Michael W. Roberts, Patricia V. Basta, Jason Luo, Mikafui E. Antonio-Obese, Daniel W. Mcneil, Robert J. Weyant, Richard J. Crout, Rebecca L. Slayton, Steven M. Levy, John R. Shaffer, Mary L. Marazita, Kari E. North, Kimon Divaris

Clinical and Translational Science Institute

Objective. A genetic component in early childhood caries (ECC) is theorized, but no genomewide investigations of ECC have been conducted. This pilot study is part of a long-term research program aimed to: (1) determine the proportion of ECC variance attributable to the human genome and (2) identify ECC-associated genetic loci. Methods. The study’s community-based sample comprised 212 children (mean age=39 months; range = 30–52 months; males = 55%; Hispanic/ Latino = 35%, African-American = 32%; American Academy of Pediatric Dentistry definition of ECC prevalence = 38%). Approximately 2.4 million single nucleotide polymorphisms (SNPs) were genotyped using DNA purified from saliva. …

Evaluation Of An Intimate Partner Violence Training For Home Visitors Using The Theory Of Planned Behavior, Christiaan G. Abildso, Angela Dyer, Alfgeir L. Kristjansson, Michael J. Mann, Thomas Bias, Jessica Coffman, Emily Vasile, Danielle Davidov

Clinical and Translational Science Institute

Introduction—Intimate partner violence (IPV) is a public health issue with recent intervention focus by home visiting programs with at-risk families in the United States. Home visitors are typically required to assess IPV but feel unprepared to do so and desire training. Our aim was to evaluate the impact of a daylong IPV training on the intention to enact three key IPV behaviors (screening, making referrals, and safety planning) using the theory of planned behavior. Method—Survey of 125 home visitors in West Virginia was conducted before and after a daylong IPV training. Results—The IPV training had a positive impact on intention …

Triarylmethyl-Based Biradical As A Superoxide Probe, Martin Poncelet, Benoit Driesschaert, Andrey A. Bobko, Valery V. Khramtsov

Clinical and Translational Science Institute

Superoxide radical represents one of the most biologically relevant reactive oxygen species involved in numerous physiological and pathophysiological processes. Superoxide measurement through the decay of an EPR signal of a triarylmethyl (TAM) radical possesses the advantage of a high selectivity and relatively high rate constant of TAM reaction with the superoxide. Hereby we report a straightforward synthesis and characterization of a TAM-TAM biradical showing a high reactivity with superoxide (second-order rate constant, (6.7±0.2)·103 M-1 s-1) enabling the measurement of superoxide radical by following the increase of a sharp EPR signal associated with the formation of a TAM-quinone methide monoradical product.

Lpa Signaling Is Regulated Through The Primary Cilium: A Novel Target In Glioblastoma, Yuriy V. Loskutov, Caryn L. Griffin, Kristina M. Marinak, Andrey Bobko, Naira V. Margaryan, Werner J. Geldenhuys, Jann N. Sarkaria, Elena N. Pugacheva

Clinical and Translational Science Institute

The primary cilium is a ubiquitous organelle presented on most human cells. It is a crucial signaling hub for multiple pathways including growth factor and G-protein coupled receptors. Loss of primary cilia, observed in various cancers, has been shown to affect cell proliferation. Primary cilia formation is drastically decreased in glioblastoma (GBM), however, the role of cilia in normal astrocyte or glioblastoma proliferation has not been explored. Here we report that loss of primary cilia in human astrocytes stimulates growth rate in a lysophosphatidic acid (LPA)-dependent manner. We show that lysophosphatidic acid receptor 1 (LPAR1) is accumulated in primary cilia. …

A Two-Tiered Strategy For Preventing Complications Of Bereavement In The First Thirteen Months Post-Loss: A Pilot Study Using Peer Supports With Professional Therapist Back-Up, Mark D. Miller, Jacqueline Stack, Charles F. Reynolds Iii

Clinical and Translational Science Institute

This feasibility and acceptance pilot study for preventing complications of bereavement within the first year post loss recruited 20 adult grievers within 9 months of becoming bereft and assigned consenting subjects to peer supporters trained by a non-profit bereavement support organization for weekly or bi-weekly telephone-based peer support until month 13 post-loss. Subjects who met DSM-5 criteria for major depressive disorder or showed an Inventory of Complicated Grief (ICG) score exceeding 19, 6 months or more post loss, were assigned to 12 to 16 weeks of interpersonal psychotherapy (IPT) with an experienced therapist. Eight and six subjects completed the protocol …

Treating Women With Opioid Use Disorder During Pregnancy In Appalachia: Initial Neonatal Outcomes Following Buprenorphine + Naloxone Exposure, Linda Nguyen, Laura R. Lander, Kevin E. O'Grady, Patrick J. Marshalek, Adrienne Schmidt, Audra K. Kelly, Hendrée E. Jones

Clinical and Translational Science Institute

Background and Objectives—Rising concerns regarding diversion and misuse of monobuprenorphine for treatment of pregnant women with opioid use disorders have sparked interest in the use of buprenorphine +naloxone to reduce misuse and diversion rates. Examined the relationship of prenatal buprenorphine +naloxone exposure to neonatal outcomes. Methods—This is a retrospective chart review of 26 mother infant dyads in comprehensive medication-assisted treatment with buprenorphine +naloxone during pregnancy. Results—All neonatal birth outcome parameters were within normal ranges, albeit on the lower side of normal for gestational age and birth weight. Only 19% of neonates required morphine pharmacology for NAS. Conclusions—Use of buprenorphine +naloxone …

The Use Of Del Nido Cardioplegia In Adult Cardiac Surgery: A Prospective Randomized Trial, Niv Ad, Sari D. Holmes, Paul S. Massimiano, Anthony J. Rongione, Lisa M. Fornaresio, David Fitzgerald

Clinical and Translational Science Institute

Objectives—The del Nido cardioplegia solution has been used extensively in congenital heart surgery for more than 20 years and more recently for adults. This randomized controlled trial examined whether expanding this technique to adult cardiac surgery confers benefits in surgical workflow and clinical outcome compared with blood-based cardioplegia. Methods—Adult first-time coronary artery bypass grafting (CABG), valve, or CABG/valve surgery patients requiring cardiopulmonary bypass (CPB) were randomized to del Nido cardioplegia (n = 48) or whole blood cardioplegia (n = 41). Primary outcomes assessed myocardial preservation. Troponin I was measured at baseline, 2 hours after CPB termination, 12 and 24 hours …

Long-Term Outcome Following Concomitant Mitral Valve Surgery And Cox Maze Procedure For Atrial Fibrillation, Niv Ad, Sari D. Holmes, Paul S. Massimiano, Anthony J. Rongione, Lisa M. Fornaresio

Clinical and Translational Science Institute

Objective—Atrial fibrillation (AF) is associated with increased early and long-term morbidity/ mortality following valve surgery. This study examined long-term influence of concomitant full Cox maze (CM) and mitral valve procedures on freedom from atrial arrhythmia and stroke. Methods—This sample comprised patients who underwent CM with a mitral valve procedure (N = 473). Data on rhythm, medication status, and clinical events captured according to Heart Rhythm Society guidelines at 6, 9, 12, 18, and 24 months and yearly thereafter up to 7 years. Results—Mean age was 65 years, mean left atrium size was 5.3 cm, and 15% had paroxysmal AF. Perioperative …

A Novel Method Of Identifying Motor Primitives Using Wavelet Decomposition, Anton Popov, Erienne V. Olesh, Sergiy Yakovenko, Valeriya Gritsenko

Clinical and Translational Science Institute

This study reports a new technique for extracting muscle synergies using continuous wavelet transform. The method allows to quantify coincident activation of muscle groups caused by the physiological processes of fixed duration, thus enabling the extraction of wavelet modules of arbitrary groups of muscles. Hierarchical clustering and identification of the repeating wavelet modules across subjects and across movements, was used to identify consistent muscle synergies. Results indicate that the most frequently repeated wavelet modules comprised combinations of two muscles that are not traditional agonists and span different joints. We have also found that these wavelet modules were flexibly combined across …

The Dosimetric Effects Of Limited Elective Nodal Irradiation In Volumetric Modulated Arc Therapy Treatment Planning For Locally Advanced Non-Small Cell Lung Cancer, Mark C. Kenamond, R. Alfredo Siochi, Malcolm D. Mattes

Clinical and Translational Science Institute

Objective—Contemporary radiotherapy guidelines for locally advanced non-small cell lung carcinoma (LA-NSCLC) recommend omitting elective nodal irradiation, despite the fact that evidence supporting this came primarily from older reports assessing comprehensive nodal coverage using 3D conformal techniques. Herein, we evaluated the dosimetric implications of the addition of limited elective nodal irradiation (LENI) to standard involved field irradiation (IFI) using volumetric modulated arc therapy (VMAT) planning. Method—Target volumes and organs-at-risk (OARs) were delineated on CT simulation images of 20 patients with LA-NSCLC. Two VMAT plans (IFI and LENI) were generated for each patient. Involved sites were treated to 60 Gy in 30 …

Healthcare Provider Perceptions Of The Role Of Interprofessional Care In Access To And Outcomes Of Primary Care In An Underserved Area, Shaowei Wan, Peter G. Teichman, David Latif, Jennifer Boyd, Rahul Gupta

Clinical and Translational Science Institute

To meet the needs of an aging population who often have multiple chronic conditions, interprofessional care is increasingly adopted by patient-centred medical homes and Accountable Care Organisations to improve patient care coordination and decrease costs in the United States, especially in underserved areas with primary care workforce shortages. In this cross-sectional survey across multiple clinical settings in an underserved area, healthcare providers perceived overall outcomes associated with interprofessional care teams as positive. This included healthcare providers’ beliefs that interprofessional care teams improved patient outcomes, increased clinic efficiency, and enhanced care coordination and patient follow-up. Teams with primary care physician available …

Differences In Faculty And Standardized Patient Scores On Professionalism For Second-Year Podiatric Medical Students During A Standardized Simulated Patient Encounter, James M. Mahoney, Vassilios Vardaxis, Noreen Anwar, Jacob Hagenbucher

Clinical and Translational Science Institute

Background: This study examined the differences between faculty and trained standardized patient (SP) evaluations on student professionalism during a second-year podiatric medicine standardized simulated patient encounter. Methods: Forty-nine second-year podiatric medicine students were evaluated for their professionalism behavior. Eleven SPs performed an assessment in real-time, and one faculty member performed a secondary assessment after observing a videotape of the encounter. Five domains were chosen for evaluation from a validated professionalism assessment tool. Results: Significant differences were identified in the professionalism domains of “build a relationship” (P = .008), “gather information” (P = .001), and share information (P = .002), where …

Special Issue For The International Conference On Electron Paramagnetic Resonance Spectroscopy And Imaging Of Biological Systems (Epr-2017), Valery V. Khramtsov, Michael Jonathan Davies

Clinical and Translational Science Institute

No abstract provided.

The History Of Proximal Carotid Protection And Flow Reversal To Prevent Stent Angioplasty Embolization, Juan Parodi, Mark C. Bates, Takao Ohki, Claudio Schönholz

Clinical and Translational Science Institute

Innovation in medicine is often driven by the observations of imaginative physicians who are blessed with insatiable curiosity, coupled with the inability to accept technical boundaries, the status quo of patient care, or the acceptance of procedural morbidity. Few examples illustrate this truism better than the physician-originated clinical research that transformed the safety of carotid stent angioplasty over the last 2 decades. Initial clinical application of carotid stenting suggested that proximal protection may be a better approach to prevent embolic stroke during the angioplasty procedure. The history of how this innovation was developed is particularly relevant as vascular surgeons adopt …

Tobacco Dependence Treatment In The Emergency Department: A Randomized Trial Using The Multiphase Optimization Strategy., Steven L Bernstein, James Dziura, June Weiss, Ted Miller, Katrina A Vickerman, Lauretta E Grau, Michael V Pantalon, Lorien Abroms, Linda M Collins, Benjamin Toll

Prevention and Community Health Faculty Publications

Background

Tobacco dependence remains the leading preventable cause of death in the developed world. Smokers are disproportionately from lower socioeconomic groups, and may use the hospital emergency department (ED) as an important source of care. A recent clinical trial demonstrated the efficacy of a multicomponent intervention to help smokers quit, but the independent contributions of those components is unknown.

Methods

This is a full-factorial (16-arm) randomized trial in a busy hospital ED of 4 tobacco dependence interventions: brief motivational interviewing, nicotine replacement therapy, referral to a telephone quitline, and a texting program. The trial utilizes the Multiphase Optimization …

The Effects Of A Korean Ginseng, Ginst15, On Perceptual Effort, Psychomotor Performance, And Physical Performance In Men And Women, Lydia K. Caldwell, William H. Dupont, Matthew K. Beeler, Emily M. Post, Emily C. Barnhart, Vincent H. Hardesty, John P. Anders, Emily C. Borden, Jeff S. Volek, William J. Kraemer

Health and Sport Sciences Faculty Scholarship

The purpose of this double-blind, placebo-controlled investigation was to examine the effects of a Korean Ginseng (GINST15) on measures of perception and physical performance following an acute bout of resistance exercise. Ten women (age: 38.7 ± 7.8 years; height: 1.64 ± 0.05 m; body mass: 76.0 ± 11.6 kg) and nine men (age: 41.2. ± 9.7 years; height: 1.77 ± 0.05 m; body mass: 88.5 ± 5.0 kg) completed the investigation. Participants were randomized to a three-cycle testing scheme consisting of high dose ginseng (HIGH: 960 mg/day), low dose ginseng (LOW: 160 mg/day) and placebo (PBO: 0 mg/day). After 14 …

Combined Exercise/Weight Bearing Program Influences Of Foot Function In People With Asymptomatic Flat Feet, Alison Modafferi, Angela Foster, Brenden Thompson, Jean Jarbath, Shanna Howland, Tyler Whited, Jeff Houck, Marcey Keefer Hutchison

Student-Faculty Research - College of Physical Therapy

No abstract provided.

Taking Care Of Palliative Care, Jolene Baker, Kristina Larsen, Amanda Schumacher

Master of Social Work Student Policy Advocacy Briefs

Minnesota has done well with the amount of palliative care services provided across the state. However, rural communities in Minnesota have far less access to palliative care programs than those living in urban settings. This is in part due to the lack of availability of health care professionals in rural communities, and the lower reimbursement rates provided for palliative care programs in rural settings. Although the majority of large hospitals in Minnesota offer palliative care programs, most hospitals with fifty beds or less do not. Palliative care has been shown to improve the quality of life of individuals living with …

New Dentist News (March 2018), Ada Committee On The New Dentist

New Dentist News

New Dentist News offers timely information on scientific, social, educational, political and economic developments affecting new dentists. This collection is historical and items may not reflect current standards. For up-to-date information contact the ADA. The New Dentist News was alternately titled ADA Lifeline, 1997-June 2001.

Himmelfarb Library Liaison Letter - March 2018, George Washington University, Himmelfarb Health Sciences Library

Himmelfarb Library Liaison Letters

No abstract provided.

Humanized Mice In Studying Efficacy And Mechanisms Of Pd-1-Targeted Cancer Immunotherapy., Minan Wang, Li-Chin Yao, Mingshan Cheng, Danying Cai, Jan Martinek, Chong-Xian Pan, Wei Shi, Ai-Hong Ma, Ralph W De Vere White, Susan Airhart, Edison T Liu, Jacques Banchereau, Michael A Brehm, Dale L Greiner, Leonard D. Shultz, Karolina Palucka, James G. Keck

Faculty Research 2018

Establishment of an in vivo small animal model of human tumor and human immune system interaction would enable preclinical investigations into the mechanisms underlying cancer immunotherapy. To this end, nonobese diabetic (NOD).Cg- Prkdc^scidIL2rg^tm1Wjl/Sz (null; NSG) mice were transplanted with human (h)CD34⁺ hematopoietic progenitor and stem cells, which leads to the development of human hematopoietic and immune systems [humanized NSG (HuNSG)]. HuNSG mice received human leukocyte antigen partially matched tumor implants from patient-derived xenografts [PDX; non-small cell lung cancer (NSCLC), sarcoma, bladder cancer, and triple-negative breast cancer (TNBC)] or from a TNBC cell line-derived xenograft (CDX). …

Primary Hepatic Neuroendocrine Carcinoma: Report Of Two Cases And Literature Review., Zi-Ming Zhao, Jin Wang, Ugochukwu C Ugwuowo, Liming Wang, Jeffrey P Townsend

Faculty Research 2018

Background: Primary hepatic neuroendocrine carcinoma (PHNEC) is extremely rare. The diagnosis of PHNEC remains challenging-partly due to its rarity, and partly due to its lack of unique clinical features. Available treatment options for PHNEC include surgical resection of the liver tumor(s), radiotherapy, liver transplant, transcatheter arterial chemoembolization (TACE), and administration of somatostatin analogues.

Case presentation: We report two male PHNEC cases and discuss the diagnosis and treatment options. Both cases presented with abdominal pain; case two also presented with symptoms of jaundice. The initial diagnosis for both cases was poorly differentiated grade 3 small-cell neuroendocrine carcinoma, based on imaging characteristics …

Department Of Surgery Update, March 2018, Wright State University Department Of Surgery

Department of Surgery Updates

A three page newsletter created by the Department of Surgery documenting changes to the department. This issue contains a message from the chair, a list of important dates, committee meetings, and more.

College Of Health Sciences E-Newsletter, March 2018, Irvin B. Harrell (Editor)

Ellmer College of Health Sciences Newsletters

March 2018 issue of Old Dominion University's College of Health Sciences Newsletter.

Is It Time To Revisit Vitamin B12 For Mental Health And Cognitive Functions In Elderly?, Lina Begdache, Rani Marhaba

Health & Wellness Studies Faculty Scholarship

Decline in cognitive and motor functions and in mental health are commonly seen with aging. Although many reports attribute their etiology to aging, these conditions may have vitamin B12 deficiency as an underlying mechanism. Laboratory tests to assess vitamin B12 deficiency lack sensitivity and specificity largely due to absence of a gold standard for diagnosis. Additionally, patients with subclinical vitamin B12 deficiency have typically normal serum concentration levels and do not exhibit the classical symptoms of vitamin B12 deficiency. Furthermore, many comorbidities that exist with aging decrease vitamin B12 and bioavailaibility from the gut. If left untreated, vitamin B12 deficiency …