Medicine and Health Sciences Commons^™

N Y State Dent J November 2020

The New York State Dental Journal

The New York State Dental Journal (NYSDJ) is produced by the New York State Dental Association (NYSDA) six times a year, in January, March, April, July, September and November. Each issue features clinical and scientific articles written by researchers and practitioners from around the globe and is subject to review by a panel of specialists convened by the Editor.

Issues include cover and feature articles alongside regular columns with regional news impacting the New York membership including editorial and perspectives columns, legal, association activities, component news, continuing education opportunities, and classifieds.

Surveying The Safety Culture Of Academic Laboratories, Emily Faulconer, Zachary Dixon, John C. Griffith, Hayden Frank

Publications

The university traditionally has been the foundation for young adults’ professional development, yet the proclivity toward safety culture has garnered less focus in higher education than in the workforce. A survey of faculty at a medium-sized, research-active, private institution revealed specific areas of policy noncompliance as well as specific safety attitudes that can be targeted for interventions. Albeit a snapshot view, the survey implies that safety needs better representation in the classroom, teaching laboratories, and research facilities at universities. Safety is not abandoned by any means, and there is a strong presence of safety-oriented individuals, but the data show barriers …

Caring For Children In Foster And Kinship Care During A Pandemic: Lessons Learned And Recommendations, Hilda Loria, Jill Mcleigh, Erinne Conner, Valerie Smith, Rachel Keefe, Christopher Greeley, Kristin Wolfe

Health Status, Outcomes, and Literacy and Healthcare Utilization

Through qualitative feedback from professionals in healthcare, mental health, and child welfare, this study explored the impact of the COVID-19 pandemic on the health and well-being of children in the child welfare system. Positive outcomes and challenges related to the care of children in foster or kinship care in Texas during the COVID-19 pandemic are described. Themes identified included disparities in the child welfare system; utilization of telehealth; cross-sector communication and collaboration; safety considerations; and placement stability and support. The article concludes with recommendations in each of these areas for ensuring the health and well-being of children in foster and …

College Students' Health Insurance: A Focus On Foreign-Born Students' Healthcare, Phuong Le

Undergraduate Research Symposium Podium Presentations

This research is to explore the uninsured rates of foreign-born students from the age of 18 to 24, including those who study abroad in the United States from foreign countries, immigrants of the U.S. who are green-card holders, and residents/citizens who were not born in the U.S. It is found that there is no significant difference between Asian foreign-born students and other racial groups of foreign-born students, suggesting that there may not be a big cultural difference in perceiving health insurance among foreign-born students. In general, foreign-born students are 19.34 percentage points more likely to be uninsured. Statistical analysis has …

Decreasing Readmissions In Medically Complex Children, Colleen Bartlett

Student Scholarly Projects

Practice Problem: There was a report of an existing practice problem of increased 30-day readmission rates in medically complex children at an outpatient clinic within an extensive hospital system. Hospital readmissions can cause clinical, social, and financial burdens to the patients and their families and thus reflected a need for interventions to reduce readmissions.

PICOT: The PICOT question that guided this change project: In medically complex pediatric patients ages 0-17, what is the effect of a discharge intervention bundle in reducing all-cause 30-day hospital readmissions compared to current practice within an 8-week timeframe?

Evidence: The literature revealed 18 …

Patient Engagement: A Key Concept To Surgical Site Infection Reduction In Colorectal Patients, Vanessa Strieff

Master's Projects and Capstones

Abstract

Problem: Colorectal surgery is a procedure with one of the highest surgical site infection (SSI) rates; therefore, necessary efforts were implemented to reduce harm (Harris, 2018). Approximately 60% of these surgical infections are preventable (Ban et al., 2017). SSIs can have severe consequences, including extended length of stay, high morbidity and mortality rates, delayed recovery, and high healthcare costs (Harris, 2018). The financial burden of SSI is substantial.

Context: This project aimed to explore opportunities for enhancing patient engagement and awareness of SSI preventive measures. After an extensive microsystem analysis, a knowledge gap in patient education on …

Adverse Health Effects Associated With Household Air Pollution: A Systematic Review, Meta-Analysis, And Burden Estimation Study, Kuan Ken Lee, Rong Bing, Joanne Kiang, Sophia Bashir, Nicholas Spath, Dominik Stelzle, Kevin Mortimer, Anda Bularga, Dimitrios Doudesis, Michael Chung

Internal Medicine, East Africa

Background: 3 billion people worldwide rely on polluting fuels and technologies for domestic cooking and heating. We estimate the global, regional, and national health burden associated with exposure to household air pollution.

Methods: For the systematic review and meta-analysis, we systematically searched four databases for studies published from database inception to April 2, 2020, that evaluated the risk of adverse cardiorespiratory, paediatric, and maternal outcomes from exposure to household air pollution, compared with no exposure. We used a random-effects model to calculate disease-specific relative risk (RR) meta-estimates. Household air pollution exposure was defined as use of polluting fuels (coal, wood, …

Twitter Reveals Human Mobility Dynamics During The Covid-19 Pandemic, Xiao Huang, Zhenlong Li, Yuqin Jiang, Xiaoming Li, Dwayne Porter

Geosciences Faculty Publications and Presentations

The current COVID-19 pandemic raises concerns worldwide, leading to serious health, economic, and social challenges. The rapid spread of the virus at a global scale highlights the need for a more harmonized, less privacy-concerning, easily accessible approach to monitoring the human mobility that has proven to be associated with viral transmission. In this study, we analyzed over 580 million tweets worldwide to see how global collaborative efforts in reducing human mobility are reflected from the user-generated information at the global, country, and U.S. state scale. Considering the multifaceted nature of mobility, we propose two types of distance: the single-day distance …

Robotic Deep Brain Stimulation (R-Dbs)-"Awake" Deep Brain Stimulation Using The Neuromate Robot And O-Arm., Girish K Hiremath

Neuroscience Articles

BACKGROUND: Deep brain stimulation (DBS) is an effective surgical technique used to ameliorate the motor symptoms associated with Parkinson's disease. One of the key elements that determine successful patient outcomes is the accurate positioning of the DBS electrode during surgery.

OBJECTIVE: To describe a robotic DBS (R-DBS) procedure using "awake" technique.

METHODS AND MATERIALS: This procedure was performed using a frame-based approach with the NeuroMate surgical robot and intraoperative image verification of DBS electrode placement using the O-arm mobile x-ray system. The procedure was performed "Awake" using microelectrode recording (MER), stimulation, and macro-electrode testing.

RESULTS: The accurate placement of DBS …

Efficacy Of Alemtuzumab Over 6 Years In Relapsing-Remitting Multiple Sclerosis Patients Who Relapsed Between Courses 1 And 2: Post Hoc Analysis Of The Care-Ms Studies., Bart Van Wijmeersch, Barry A Singer, Aaron Boster, Simon Broadley, Óscar Fernández, Mark S Freedman, Guillermo Izquierdo, Jan Lycke, Carlo Pozzilli, Basil Sharrack, Brian Steingo, Heinz Wiendl, Sibyl Wray, Tjalf Ziemssen, Luke Chung, David H Margolin, Karthinathan Thangavelu, Patrick Vermersch

Neuroscience Articles

BACKGROUND: Alemtuzumab is administered as two annual courses for relapsing-remitting multiple sclerosis (MS). Patients may relapse before completing the two-course regimen.

OBJECTIVE: The objective was to evaluate 6-year outcomes in patients who relapsed between alemtuzumab Courses 1 and 2 (early relapsers).

METHODS: Post hoc analysis of patients from the Comparison of Alemtuzumab and Rebif

RESULTS: Early relapsers (CARE-MS I: 15%; CARE-MS II: 24%) had more relapses in 1-2 years pre-alemtuzumab and higher mean baseline Expanded Disability Status Scale score than patients without relapse. Their annualized relapse rate declined from Year 1 (CARE-MS I: 1.3; CARE-MS II: 1.2) to Year 2 …

Safety Results Of Administering Ocrelizumab Per A Shorter Infusion Protocol In Patients With Primary Progressive And Relapsing Multiple Sclerosis., Timothy L Vollmer, Jeffrey A Cohen, Enrique Alvarez, Kavita V Nair, Aaron Boster, Joshua Katz, Gabriel Pardo, Jinglan Pei, Pranil Raut, Sharmin Merchant, Elizabeth Maclean, Ashish Pradhan, Brandon Moss

Neuroscience Articles

BACKGROUND: Ocrelizumab is an approved MS treatment administered as two 300-mg intravenous infusions 2 weeks apart (Dose 1), each lasting approximately 2.5 hours, followed by single 600-mg infusions every 6 months lasting approximately 3.5 hours. Our objective was to evaluate shorter-duration ocrelizumab infusions in the Phase IIIb open-label SaROD study (NCT03606460).

METHODS: Eligible patients received ocrelizumab 600-mg Dose 2 or 3 infused over approximately 2 hours (Cohort 1) or ocrelizumab 300-mg Dose 1, Infusion 2 over approximately 1.5 hours (Cohort 2). The primary endpoint was the number and proportion of patients experiencing Grade 3-4 infusion-related reactions (IRRs) in Cohort 1. …

A Noteworthy Case Report Of Neuroborreliosis In An Unvaccinated Pediatric Patient., Amber R Walker, Teresita Morales-Yurick

Neuroscience Articles

INTRODUCTION: Lyme disease typically presents with viral-like symptoms and a pathognomonic rash. With disease progression, symptoms of nervous system involvement usually include facial nerve palsy and meningitis, but other atypical neurologic manifestations have less commonly been documented.

CASE REPORT: A six-year-old male presented with prolonged fevers, rash, headache, and non-specific neurologic symptoms. The diagnosis of neuroborreliosis with meningitis and polyradiculitis was confirmed with laboratory evaluation and lumbar puncture.

CONCLUSION: Neuroborreliosis is a disseminated form of Lyme disease. While meningitis is a common sign, the presentation of polyradiculitis in children is rare and can lead to misdiagnosis and delay in treatment.

A New Era: Utilizing Technology Tools To Enhance Elder Independence, April Lisa Phelps

Doctoral Dissertations and Projects

The goal of this integrative review was to examine the multitude of technology tools and the evidence which supports their use to enhance elders’ independence when residing at home. Multiple journal articles and books published between July 2015 and July 2020 were examined using the PRISMA model for evidence to support or oppose the use of technology to enhance the elders’s independence. A total of 27 articles were included in the final review. An exploration of gaps in knowledge related to the issue of elders using technology tools such as wearable sensors, artificial intelligence, home monitoring, robots, mHealth, Internet of …

The Potential Impacts Of Covid-19 On The Global Value Chains: Gvc Positioning And Linkages, Gerald Foong, Pao-Li Chang

Research Collection School Of Economics

Apart from the public health crisis entailed by the Coronavirus Disease 2019 (COVID-19) pandemic, it has also propagated a pandemic-induced economic shock globally. One transmission channel is via the inter-country linkages arising from the trade in intermediate inputs, which is a pertinent characteristic of global value chains (GVCs), and resulting in a "supply-chain contagion" as termed by Baldwin and Tomiura (2020). In this paper, we propose measures of bilteral downstreamness and upstreamness, the extent of a country's GVC participation, and the position of a country in GVCs by leveraging upon the gross export decomposition framework as laid out by Borin …

Pharmacy Internal Controls: A Call For Greater Vigilance During The Covid-19 Pandemic, Andrew N. Mason

Faculty Publications - The LeMoyne Smith School of Business

For businesses that store physical goods, managing product inventories and financial cost accounting controls are critical. Pharmacies are under considerable scrutiny, due to the nature of their merchandise, making internal controls even more vital. Due to the emergence of COVID-19 and government mitigation strategies, the US economy has seen significant macro- and microeconomic effects. COVID-19 has changed the pharmacy working environment, which could theoretically increase rates of employee drug diversion. Therefore, better inventory management could reduce the misuse of pharmaceutical drugs from fraudulent and drug diversion activities. The author explored secondary findings to create a multidisciplinary conceptual analysis of the …

Erica: Enabling Real-Time Mistake Detection And Corrective Feedback For Free-Weights Exercises, Meeralakshmi Radhakrishnan, Darshana Rathnayake, Koon Han Ong, Inseok Hwang, Archan Misra

Research Collection School Of Computing and Information Systems

We present ERICA, a digital personal trainer for users performing free weights exercises, with two key differentiators: (a) First, unlike prior approaches that either require multiple on-body wearables or specialized infrastructural sensing, ERICA uses a single in-ear "earable" device (piggybacking on a form factor routinely used by millions of gym-goers) and a simple inertial sensor mounted on each weight equipment; (b) Second, unlike prior work that focuses primarily on quantifying a workout, ERICA additionally identifies a variety of fine-grained exercising mistakes and delivers real-time, in-situ corrective instructions. To achieve this, we (a) design a robust approach for user-equipment association that …

3d - Printed Patient Specific Instrumentation In Corrective Osteotomy Of The Femur And Pelvis: A Review Of The Literature, Njalalle Baraza, Chris Chapman, Sima Zakani, Kishore Mulpuri

General Surgery, East Africa

Background: The paediatric patient population has considerable variation in anatomy. The use of Computed Tomography (CT)-based digital models to design three-dimensionally printed patient specific instrumentation (PSI) has recently been applied for correction of deformity in orthopedic surgery. This review sought to determine the existing application of this technology currently in use within paediatric orthopaedics, and assess the potential benefits that this may provide to patients and surgeons.

Methods: A review was performed of MEDLINE, EMBASE, and CENTRAL for published literature, as well as Web of Science and clinicaltrials.gov for grey literature. The search strategy revolved around the research …

Global Safety In Anaesthesia And Surgery: Implications For Anaesthesia In Pakistan, Fauzia Khan

Department of Anaesthesia

The Lancet Commission report in 2015 highlighted the role of safe surgery and anaesthesia. They also gave a framework of recommendations, indicators and targets to achieve universal access to safe surgery. This article explores the applicability of these indicators in Pakistan namely; access to timely surgery, specialist surgical workforce diversity, surgical volumes, perioperative mortality rate, protection against impoverishing expenditure and protection against catastrophic expenditure.

Reliability And Validity Of The Rs14 In Orphaned And Separated Adolescents And Youths In Western Kenya, Sarah C. Sutherland, Harry S. Shannon, David Ayuku, David L. Streiner, Olli Saarela, Lukoye Atwoli, Paula Braitstein

Internal Medicine, East Africa

Purpose: The 14-item Resilience Scale (RS14) is a tool designed to measure psychological resilience. It has been used effectively in diverse populations. However, its applicability is largely unknown for Sub-Saharan adolescent populations and completely unknown for orphaned and separated adolescents and youths (OSAY), a highly vulnerable population for whom resilience may be critical. This study assesses the RS14's psychometric properties for OSAY in Uasin Gishu County, Kenya.

Methods: Survey responses from a representative sample of 1016 OSAY (51.3% female) aged 10-25 (mean = 16; SD = 3.5) living in institutional and home-based environments in Uasin Gishu County were analyzed. The …

Factors Related To Maternal Adverse Outcomes In Pregnant Women With Cardiac Disease In Low-Resource Settings, Philippe Amubuomombe Poli, Elkanah Omenge, Ann Mwangi, Felix Ayub Barasa

Obstetrics and Gynaecology, East Africa

Background: Cardiac disease is an important life-threatening complication during pregnancy. It is frequently seen in pregnant women living in resource-limited areas and often results in premature death.

Aim: The aim of this hospital-based longitudinal study was to identify factors related to adverse maternal and neonatal outcomes in pregnant women with cardiac disease in low-resource settings.

Methods: The study enrolled 91 pregnant women with congenital or acquired cardiac disease over a period of 2 years in Kenya.

Results: Maternal and early neonatal deaths occurred in 12.2% and 12.6% of cases, respectively. The risk of adverse outcomes was significantly …

Characterizing Prenatal Maternal Distress With Unique Prenatal Cortisol Trajectories, Gage Peterson, Emma V. Espel, Elyssia Poggi Davis, Curt A. Sandman, Laura M. Glynn

Psychology Faculty Articles and Research

Objective: It is widely assumed that glucocorticoids represent a primary mechanism through which exposure to adversity and maternal psychological distress shape prenatal developmental trajectories of both mother and fetus. However, despite repeated investigations and the fact that prenatal cortisol has been reliably linked to developmental outcomes, the empirical evidence supporting an association between prenatal cortisol and maternal distress is scarce. In this study, a novel approach to assessing links between maternal prenatal psychological distress and gestational cortisol profiles, general growth mixture modeling (GGMM), was applied. Method: Measures of pregnancy anxiety, perceived stress, and state anxiety and depressive symptoms as well …

Atrioventricular Nodal Reentrant Tachycardia Ablation With A Power-Controlled, Contact-Force Catheter., Chase J Contino, Max Weiss, Michael P Riley, Daniel R Frisch

Division of Cardiology Faculty Papers

Radiofrequency catheter ablation is a safe and effective treatment option for atrioventricular nodal reentrant tachycardia (AVNRT). A nonirrigated ablation catheter used in a temperature-controlled mode is traditionally used for AVNRT ablation due to the shallow lesion depth required for successful slow-pathway ablation. In this case, a nonirrigated ablation catheter established inadequate lesions to ablate the slow pathway successfully. The adoption of an irrigated contact-force ablation catheter used in a power-controlled mode was necessary to provide higher power and possibly create a deeper lesion to ablate the slow pathway successfully, thus eliminating AVNRT inducibility in this patient.

Law Library Blog (November 2020): Legal Beagle's Blog Archive, Roger Williams University School Of Law

Law Library Newsletters/Blog

No abstract provided.

Feasibility And Acceptability Of Implementing Early Infant Diagnosis Of Hiv In Papua New Guinea At The Point Of Care: A Qualitative Exploration Of Health Worker And Key Informant Perspectives, Yasmin Mohamed, Martha Kupul, Janet Gare, Steven G. Badman, Selina Silim, Andrew J. Vallely, Stanley Luchters, Angela Kelly-Hanku

Population Health, East Africa

Introduction: Early infant diagnosis (EID) of HIV and timely initiation of antiretroviral therapy can significantly reduce morbidity and mortality among HIV-positive infants. Access to EID is limited in many low-income and middle-income settings, particularly those in which standard care involves dried blood spots (DBS) sent to centralised laboratories, such as in Papua New Guinea (PNG). We conducted a qualitative exploration of the feasibility and acceptability of implementing a point-of-care (POC) EID test (Xpert HIV-1 Qualitative assay) among health workers and key stakeholders working within the prevention of mother-to-child transmission of HIV (PMTCT) programme in PNG.

Methods: This qualitative substudy was …

Prenatal Depression And Risk Of Short Interpregnancy Interval In A Predominantly Puerto Rican Population, Sami Backley, Alex Knee, Penelope Pekow, Glenn Markenson, Katharine O White, Corina Schoen, Lisa Chasan-Taber

Faculty, Staff and Student Publications

Background: Short interpregnancy interval (IPI) is associated with risk of adverse pregnancy outcomes; however, few studies have evaluated the role of depression as a risk factor for short IPI. Puerto Rican women in the United States experience disparities in adverse birth outcomes and have the highest birth rates.

Methods: We analyzed the association between prenatal depressive symptoms and IPI in Proyecto Buena Salud, a prospective cohort of predominantly Puerto Rican women in Western Massachusetts (2006–2011). Depression was measured using the Edinburgh Postnatal Depression Scale (EPDS) in early, mid, and late pregnancy. We calculated follow-up time as the difference between the …

Aerosol Generation With Common Rhinologic Devices: Cadaveric Study Conducted In A Surgical Suite, Bailey Leconte, Garren M I Low, Martin J Citardi, William C Yao, Arturo A Eguia, Amber U Luong

Faculty, Staff and Student Publications

No abstract provided.

Variable Expression Of Msh6 In Endometrial Carcinomas With Intact Mismatch Repair And With Mlh1 Loss Due To Mlh1 Methylation, Nidhi Tandon, Courtney Hudgens, Bryan Fellman, Michael T Tetzlaff, Russell R Broaddus

Faculty, Staff and Student Publications

Immunohistochemistry for mismatch repair proteins MLH1, MSH2, MSH6, and PMS2 is an effective screen to detect individuals at risk for Lynch syndrome. College of American Pathologists guidelines stipulate that protein expression should be reported as present versus absent, as most patients with germline mutations in a mismatch repair gene have complete loss of protein expression in tumor cells. A similar approach is employed to screen for cancer patients eligible for immune checkpoint blockade. This "all or none" interpretive approach ignores substantial evidence that mismatch repair may be more finely regulated by other mechanisms. We have observed clinically that MSH6 expression …

Determining The Effectiveness Of A Peer Support Person In Individuals With Depression Symptoms, Donna K. Reeves

Electronic Theses and Dissertations

Abstract

This study’s aim was to evaluate the effectiveness of an existing peer support program as an adjunct treatment for patients with depression. This retrospective evaluation analyzed the total scores of 110 patients with depression on the PHQ-9 questionnaire at the initial assessment (Time 1), at 6-weeks (Time 2), and then at 12-weeks (Time 3). The participants were divided into two groups, those who enrolled in a peer support program (n = 55) and those without peer support (n = 55). PHQ-9 total scores for each time interval were compared for the two groups utilizing independent sample t-tests …

Lowering Perceived Stress Levels In Undergraduate Nursing Students, Caitlin Dodd

Electronic Theses and Dissertations

This project analyzed the effects of guided meditations and a stress management class on undergraduate, prelicensure nursing students’ perceived stress levels. College students and professional nurses are both susceptible to having high stress levels. Mindfulness activities have been shown to lower stress levels. Undergraduate, prelicensure nursing students participated in this project determining the effects of guided meditations and a stress management class on perceived stress levels in a quantitative, pre- and postinterventional study. Participants in the project completed a stress management class and 18 guided meditation sessions in an undergraduate classroom setting. The researcher used the Perceived Stress Scale-10 (PSS-10) …

Identification Of Novel Candidate Risk Genes For Myelomeningocele Within The Glucose Homeostasis/Oxidative Stress And Folate/One-Carbon Metabolism Networks, Paul Hillman, Craig Baker, Luke Hebert, Michael Brown, James Hixson, Allison Ashley-Koch, Alanna C Morrison, Hope Northrup, Kit Sing Au

Faculty, Staff and Student Publications

BACKGROUND: Neural tube defects (NTDs) are the second most common complex birth defect, yet, our understanding of the genetic contribution to their development remains incomplete. Two environmental factors associated with NTDs are Folate and One Carbon Metabolism (FOCM) and Glucose Homeostasis and Oxidative Stress (GHOS). Utilizing next-generation sequencing of a large patient cohort, we identify novel candidate genes in these two networks to provide insights into NTD mechanisms.

METHODS: Exome sequencing (ES) was performed in 511 patients, born with myelomeningocele, divided between European American and Mexican American ethnicities. Healthy control data from the Genome Aggregation database were ethnically matched and …