Medicine and Health Sciences Commons^™

The Extreme Effects Of ‘Not-So-Minor’ Concussions: Chronic Traumatic Encephalopathy Literature Review, Alyssa Pierson

Honors Program: Senior Projects (Public)

Many of the concerns that people have with chronic traumatic encephalopathy (CTE) have already been researched for almost a century, but recently, there has been a big push in CTE research. Previous research was done on boxing and football and has now expanded to other contact sports and the military. Risk factors for CTE include repetitive head trauma, the Apoe4 allele, and age of first exposure to brain trauma. A wide range of symptoms may present with CTE, from motor impairment to suicidal ideation. It is believed that a biopsychosocial model should be used when approaching the symptoms of CTE …

Fleischner Society Guidelines And Indications For Follow-Up Of Low Dose Computed Tomography Screening For Lung Cancer, Jenna Arnold

Nursing Capstones

No abstract provided.

Medicaid Work Requirements: State-Based Innovation Or Punitive Policymaking?, Diane Sherwin

Honors Program: Senior Projects (Public)

In March 2017, officials appointed to the Center for Medicare and Medicaid Services by President Donald Trump signaled to state governments their intent to support states who would choose to utilize Medicaid’s Section 1115 waiver provision to alter their state’s Medicaid program by introducing a work requirement. As of October 1, 2018, 13 states have heeded this signal and proposed a work requirement component for their Medicaid programs. The purpose of this paper is to determine if Medicaid work requirements are an innovative policy approach to improve independence among Medicaid enrollees, or if these requirements are a punitive, partisan approach …

Biomechanical Characteristics Of Lumbar Manipulation Performed By Expert, Resident, And Student Physical Therapists, Joseph M. Derian, Jo Armour Smith, Yue Wang, Wilson Lam, Kornelia Kulig

Physical Therapy Faculty Articles and Research

Background

Lumbar manipulation is a commonly used treatment for low back pain, but little research evidence exists regarding practitioner biomechanics during manipulation. Most existing evidence describes rate of force production through the hands into instrumented manikins and it is unclear how the practitioner moves their body and legs to generate this force.

Objectives

To identify and characterize important kinetic and kinematic factors in practitioners of varying experience performing lumbar manipulation in order to identify which factors distinguish experts from less experienced practitioners.

Study design

This was a cohort observational laboratory study.

Methods

43 male physical therapists (PT) and PT students …

Performance Evaluation Of Cardiac Troponin I Assay: A Comparison Between The Point-Of-Care Testing Radiometer Aqt90 Flex And The Central Laboratory Siemens Advia Centaur Analyzer, Sibtain Ahmed, Lena Jafri, Ahmed Raheem Buksh, Shahid Shakeel, Imran Siddiqui

Department of Pathology and Laboratory Medicine

Background: To validate the point of care testing (POCT) Trop-I analyzer and compare it with a central laboratory-based chemiluminescence immunoassay, in order to evaluate its performance for use in critical care areas. Moreover, for clinical decision-making, it is imperative to know the extent to which patient stratification will differ based on the analytic method being used. In particular, the aim of this study was to evaluate the analytical performance of the point-of-care analyzer and demonstrate the agreement with the central laboratory measurements in patients presenting to the emergency department (ED) with chest pain and suspected acute coronary syndrome (ACS).
Methods: …

Week Of March 11, 2019, New York Medical College

InTouch

• NYMC Days of Giving Set for March 26 and 27
• School of Medicine Class of 2019 Gets Ready for Match Day

Å-Indentation For Non-Destructive Elastic Moduli Measurements Of Supported Ultra-Hard Ultra-Thin Films And Nanostructures, Filippo Cellini, Yang Gao, Elisa Riedo

Publications and Research

During conventional nanoindentation measurements, the indentation depths are usually larger than 1–10 nm, which hinders the ability to study ultra-thin films (<10 >nm) and supported atomically thin two-dimensional (2D) materials. Here, we discuss the development of modulated Å-indentation to achieve sub-Å indentations depths during force-indentation measurements while also imaging materials with nanoscale resolution. Modulated nanoindentation (MoNI) was originally invented to measure the radial elasticity of multi-walled nanotubes. w, by using extremely small amplitude oscillations (<<1 Å) at high frequency, and stiff cantilevers, we show how modulated nano/Å-indentation (MoNI/ÅI) enables non-destructive measurements of the contact stiffness and indentation modulus of ultra-thin ultra-stiff films, including CVD diamond films (~1000 GPa stiffness), as well as the transverse modulus of 2D materials. Our analysis demonstrates that in presence of a standard laboratory noise floor, the signal to noise ratio of MoNI/ÅI implemented with a commercial atomic force microscope (AFM) is such that a dynamic range of 80 dB –– achievable with commercial Lock-in amplifiers –– is sufficient to observe superior indentation curves, having indentation depths as small as 0.3 Å, resolution in indentation <0.05 Å, and in normal load <0.5 nN. Being implemented on a standard AFM, this method has the potential for a broad applicability.

Medical School Watercooler Newsletter - March 10, 2019, Lindsey Lyle

Watercooler Newsletter

This is the March 10, 2019 edition of the Frederick P. Whiddon College of Medicine's Newsletter - Watercooler.

Contents Include:

Signed, Sealed and Delivered: Match Day 2019

USA researchers study progression of deadly lung syndrome

USA Health welcomes new pediatric critical care physician

USA Health Endocrinology recognized by American Diabetes Association

Management Of Subclinical Hypothyroidism And Its Effects On Cardiovascular Endpoints, Dennis Chakua

Nursing Capstones

No abstract provided.

Social Emotional Learning Through Depression Education In A High School Setting, Antonette Minniti

Theses and Dissertations

Education on depression is an important part of social emotional learning. Lacking emotion regulation skills tend to lead to larger problems, such as academic struggles, disconnect from peers, strife at home and trouble in interpersonal relationships. Research in depression education or educational programs connected to mental health literacy are minimal, especially at the high school level. The purpose of this research will focus on examining the impact of one depression education program, John Hopkins Hospital’s Adolescent Depression Awareness Program (ADAP). ADAP is a three-day program that informs students about the facts of depression, how it is treated, and what to …

Multidisciplinary Care For Adult Hermansky-Pudlak Syndrome Patients In Puerto Rico, Isabel Becerra, Shirley Martinez, Atencio Xavier, Torrens Jonathan, Juan Alemany, Eric Cruz, Felix Rivera Borges, Monica Egozcue, Jesse Roman, Rosa Roman

Division of Pulmonary, Allergy, and Critical Care Medicine Posters

Background: Hermansky-Pudlak syndrome (HPS) is an autosomal recessive rare disease characterized by oculo-cutaneous albinism, bleeding diathesis due to platelet dysfunction, and is sometimes accompanied by immunodeficiency, granulomatous colitis, and/or interstitial lung disease / pulmonary fibrosis. Puerto Rico houses the highest concentration of patients with HPS, especially HPS-1, which is considered quite severe and often associated with pulmonary fibrosis. We believe that the establishment of an HPS Multidisciplinary Clinic in Puerto Rico would improve outcomes.

Methods: A multidisciplinary clinic was started in November 2018 and another was held in February 2019 at the Mayaguez Medical Center located in the Southwest region …

Treatment Of Pediatric Graves’ Disease With Thyroidectomy, Danielle J. Mullin

Nursing Capstones

No abstract provided.

Developing Self-Directed Learners, Alexander Dorado

Q2S Enhancing Pedagogy

The goal of this paper is to reflect on methods of peer review and self review, to better prepare students for presentations.

Considering Physical Well-Being, Self-Perceptions, And Support Variables In Understanding Youth Academic Achievement, Erin E. Centeio, Cheryl L. Somers, E. Whitney G. Moore, Alex Garn, Noel Kulik, Jeffrey Martin, Bo Shen, Nate Mccaughtry

Kinesiology, Health and Sport Studies

The purpose of this study was to examine the relation between measures of students’ physical well-being and self-perception and their academic achievement. Specifically, we look at students’ social support for physical activity, physical activity perceptions, self-concept, self-efficacy, health behaviors, and cardiorespiratory fitness (as measured by the progressive aerobic cardiovascular endurance run [PACER] test). Students (n = 697 fifth graders) were surveyed at the beginning of the school year. A two-group path analysis revealed notable relationships between the predictor variables and proximal and distal outcomes, with some paths moderated by sex. One relationship that was significant for both sexes was …

Evaluating Naloxone Access And Prescribing Requirements In The Opioid Epidemic Across The United States, Krista Brooks, Tom Davis, Khoa Nguyen, Ngan-Dinh Nguyen, Tashrique Rahman, Lucero Villa

Faculty Articles & Research

• Deaths related to opioid overdose has been an increasing problem in the United States
• Deaths related to opioid overdoses can be prevented by the use of naloxone which reverses the effects of opioids
• Approaches to promote naloxone access have been described by federal agencies, including the Substance Abuse and Mental Health Services Administration

Medication Therapy Management: Empowering The Patient, Aimee Henderson, Krista Brooks, Jordyn Richey, Victoria Thompson

Faculty Articles & Research

Medication Therapy Management provides the community with many benefits. In order to demonstrate the importance, we used pharmacist surveys to convey how often MTM is utilized, pharmacists perspectives on service utilization and challenges, and goals and expectations of the outcomes of MTM services.

The Impact Of Naloxone Training And Education In The Community, Tom Davis, Krista Brooks, Saleena Brownell, Kayley Humann, Carla Williams

Faculty Articles & Research

The issue of opioid overdose has become a national crisis and is receiving a lot of attention in the media. In the state of Oklahoma, 388 people died from opioid overdose in 2017. Nationally, there were over 47,600 opioid-related drug overdose deaths in 2017.

Pharmacy Law And Social Administrative Services Iv Php 408, Joanna Burkhardt

Library Impact Statements

No abstract provided.

Pharmacy Law And Social Administrative Services Iii Php 407, Joanna Burkhardt

Library Impact Statements

No abstract provided.

Cardiac Phenotype In Mouse Models Of Systemic Autoimmunity., Chandan Sanghera, Lok Man Wong, Mona Panahi, Amalia Sintou, Muneer G. Hasham, Susanne Sattler

Faculty Research 2019

Patients suffering from systemic autoimmune diseases are at significant risk of cardiovascular complications. This can be due to systemically increased levels of inflammation leading to accelerated atherosclerosis, or due to direct damage to the tissues and cells of the heart. Cardiac complications include an increased risk of myocardial infarction, myocarditis and dilated cardiomyopathy, valve disease, endothelial dysfunction, excessive fibrosis, and bona fide autoimmune-mediated tissue damage by autoantibodies or auto-reactive cells. There is, however, still a considerable need to better understand how to diagnose and treat cardiac complications in autoimmune patients. A range of inducible and spontaneous mouse models of systemic …

Systematic Literature Review Of Quetiapine For The Treatment Of Psychosis In Patients With Parkinsonism, Jack J. Chen, Henry Hua, Lilian Massihi, Ivan Portillo, Azita Alipour, William Ondo, Khashayar Dashtipour

Library Articles and Research

Objective:

The purpose of this article was to determine the efficacy and tolerability of quetiapine compared with placebo or other interventions for psychosis in parkinsonism.

Methods:

Participants with a diagnosis of parkinsonism participated in randomized controlled trials (RCTs) investigating the efficacy and tolerability of quetiapine for psychotic symptoms within a defined follow-up period. The authors conducted searches on PubMed, Cochrane Controlled Register of Trials, and EMBASE for articles published from January 1991 to October 2017. Study methodology and patient- and treatment-level data were independently extracted and summarized by using descriptive statistics. Studies underwent quality assessment for risk of bias.

Results: …

Functional Swallow-Related Outcomes Following Transoral Robotic Surgery For Base Of Tongue Carcinoma: A Pilot Study, Kelly Salmon, Slpd, Ccc-Slp, Bcs-S, Clt-Lana, Cesar Ruiz, Slpd, Ccc-Slp, Bcs-S

Department of Rehabilitation Medicine Posters

In an era where the incidence of oropharyngeal cancer has been growing steadily, there is a limited amount of research exploring functional outcomes for individuals whose definitive cancer management approach includes transoral robotic surgical (TORS) resection with or without adjuvant treatment.

This study was designed to examine functional outcome measures related to tongue strength, swallow function, oral intake, and quality of life in individuals newly diagnosed with base of tongue (BOT) cancer whose treatment plan included surgical resection via TORS, with or without a plan for subsequent adjuvant treatment in the form of radiation or chemoradiation. Data was collected preoperatively …

Managing Healthcare Data Assets As A Complex Adaptive System, Katie Clifton

Systems Science Friday Noon Seminar Series

A major project is underway to develop a shared platform for data and analytics in a highly federated healthcare delivery organization. In the status quo data environment, analysts have integrated information from various domains — medical records, claims, membership — to produce a multitude of reports and analysis. Duplicative, mis-aligned, and siloed datasets were created as an unintended consequence.

One objective of the project is to produce outcomes (reports, analysis) that are more standardized and efficient than the status quo without sacrificing adaptability. Standards and practices are being intentionally developed as a mechanism for this emerging system to achieve more …

Delays In Perioperative Patient Flow: An Initial Analysis, David Nelson, Md, Mba, Kent Berg, Md, Mba, Rebecca Barnett, Md, Mbchb, Oren Guttman, Md, Mba

Department of Anesthesiology Posters

• When considering the operating room (OR) suite as a hospital business unit, one must not only acknowledge its revenue-earning contribution to financial solvency but also the potential for margin-eroding cost when utilized inefficiently. 1
• One particularly challenging contributor to perioperative inefficiency is when patients are prevented from moving out of the OR into downstream phases of care once surgery has been completed. These so-called “PACU delays” (also known as recovery room admission delays) are particularly concerning for OR leadership because they increase direct labor costs and result in opportunity cost when additional surgery is prevented from being performed
• At Thomas …

Développement D’Une Antenne Microphonique Intégrant Un Système Optique Pour Identifier La Position Des Sources Sonores Les Plus Bruyantes En Milieu Industriel, Thomas Padois, Olivier Doutres, Franck Sgard, Alain Berry

Rapports de recherche scientifique

Dans un contexte industriel, le bruit émis par des machines peut nuire à la santé des travailleurs et générer des problèmes de surdité ou de pertes auditives. Pour pallier ces problèmes, des solutions acoustiques efficaces doivent être mises en place en amont. La première étape d'une étude acoustique de réduction de bruit consiste à localiser la position des sources et à hiérarchiser leurs contributions. Dans un environnement industriel, les travailleurs sont répartis autour des machines et le nombre de celles-ci peut être important. Cela rend le champ acoustique complexe à cause des multiples réflexions sur les murs et objets; il …

Global Monitoring Of Antimicrobial Resistance Based On Metagenomics Analyses Of Urban Sewage, Rene S. Hendriksen, Patrick Munk, Patrick Njage, Bram Van Bunnik, Luke Mcnally, Oksana Lukjancenko, Timo Röder, David Nieuwenhuijse, Rumina Hasan, Sadia Shakoor

Department of Pathology and Laboratory Medicine

Antimicrobial resistance (AMR) is a serious threat to global public health, but obtaining representative data on AMR for healthy human populations is difficult. Here, we use metagenomic analysis of untreated sewage to characterize the bacterial resistome from 79 sites in 60 countries. We find systematic differences in abundance and diversity of AMR genes between Europe/North-America/Oceania and Africa/Asia/South-America. Antimicrobial use data and bacterial taxonomy only explains a minor part of the AMR variation that we observe. We find no evidence for cross-selection between antimicrobial classes, or for effect of air travel between sites. However, AMR gene abundance strongly correlates with socio-economic, …

The Effects Of Huntingtin-Lowering: What Do We Know So Far?, William F. Kaemmerer, Richard C. Grondin

Neuroscience Faculty Publications

Therapies targeting mutant huntingtin DNA, mRNA, and protein have a chance at becoming the first disease-modifying treatments for Huntington’s disease, a fatal inherited neurodegenerative disorder for which only symptom management treatments are available today. This review focuses on evidence addressing several key questions pertinent to huntingtin-lowering, ranging from the functions of wild-type huntingtin (wtHTT) that may be disrupted by huntingtin-lowering treatments through the various ways huntingtin can be lowered, the tolerability of wtHTT-lowering in mice and primates, what has been found in the Ionis Pharmaceutical safety trial of a huntingtin-lowering therapy, and to the question of how much mutant huntingtin …

A Rare Case Of Wilson Disease In A 72-Year-Old Patient., Christopher Cao, Timothy Colangelo, Raja Koteswar Dhanekula, Daniel Brandt, Indira Laothamatas, Manish Thapar, Steven K. Herrine, Jesse M. Civan

Division of Gastroenterology and Hepatology Faculty Papers

Wilson disease is an autosomal recessive disorder of abnormal copper metabolism that is prevalent in the younger population, rarely presenting in patients older than 40 years. Clinical presentation may be variable, and diagnosis is often aided by clinical and biochemical tests. We report the case of a 72-year-old woman who presented with acute liver failure initially of unclear etiology. Our patient was initially managed for presumed drug-induced liver injury but ultimately diagnosed with Wilson disease on the basis of clinical presentation, laboratory testing, liver biopsy, quantitative hepatic copper, and abnormal genetic testing.

Nmd-12: A New Machine-Learning Derived Screening Instrument To Detect Mild Cognitive Impairment And Dementia, Pai-Yi Chiu, Haipeng Tang, Cheng-Yu Wei, Chaoyang Zhang, Guang-Uei Hung, Weihua Zhou

Faculty Publications

Introduction

Using machine learning techniques, we developed a brief questionnaire to aid neurologists and neuropsychologists in the screening of mild cognitive impairment (MCI) and dementia.

Methods

With the reduction of the survey size as a goal of this research, feature selection based on information gain was performed to rank the contribution of the 45 items corresponding to patient responses to the specified questions. The most important items were used to build the optimal screening model based on the accuracy, practicality, and interpretability. The diagnostic accuracy for discriminating normal cognition (NC), MCI, very mild dementia (VMD) and dementia was validated in …

Cationic Antimicrobial Peptides: Alternatives And/Or Adjuvants To Antibiotics Active Against Methicillin-Resistant Staphylococcus Aureus And Multidrug-Resistant Pseudomonas Aeruginosa, Regina Geitani, Carole Ayoub Moubareck, Lhousseine Touqui, Dolla Karam Sarkis

All Works

© 2019 The Author(s). Background: Methicillin-resistant Staphylococcus aureus and multidrug-resistant Pseudomonas aeruginosa are becoming difficult to treat with antibiotics whereas Cationic Antimicrobial Peptides (CAMPs) represent promising alternatives. The effects of four CAMPs (LL-37: human cathelicidin, CAMA: cecropin(1-7)-melittin A(2-9) amide, magainin-II and nisin) were investigated against clinical and laboratory S. aureus (n = 10) and P. aeruginosa (n = 11) isolates either susceptible or resistant to antibiotics. Minimal Inhibitory Concentrations (MICs), Minimal Bactericidal Concentrations (MBCs), and bacterial survival rates (2 h post-treatment) were determined by microbroth dilution. The antipseudomonal effects of the antibiotics colistin or imipenem combined to LL-37 or CAMA …