Medicine and Health Sciences Commons^™

Regulation, Quality Reporting And Third-Party Certification Of Healthcare Providers, Amir Jahan Khan, Muhammad Ashar Malik

Community Health Sciences

The newly established provincial healthcare commissions in Pakistan have started certification of healthcare providers. The policy-makers perceive that without third-party certification or licencing the healthcare quality will be suboptimal in the country. This paper reviews the current literature on third-party certification and studies objectives and progress of the largest healthcare commission in Pakistan. It analyses the certification role of the Punjab Healthcare Commission and draw lessons for future regulation and strengthening of the quality reporting process. It also documents the short-term and long-term trade-off resulting from the enforcement of quality certification in the absence of appropriate alternative investment in medical …

Bonding Crowns And Bridges With Resin Cement, Nathaniel C. Lawson, Sharukh Khajotia, Ana K. Bedran-Russo, Kevin Frazier, Jacob Park, Ariene A. Leme-Kraus, Olivia Urquhart

School of Dentistry Faculty Research and Publications

Background

Bonding crowns and bridges with resin cement can improve retention and reinforcement of the restoration. However, there is variation in the steps taken by different practitioners to achieve this goal.

Methods

The authors developed a survey on bonding dental crowns and bridges with resin cement and distributed it electronically to the American Dental Association Clinical Evaluators (ACE) Panel on May 22, 2020. The survey remained open for 2 weeks. Descriptive data analysis was conducted using SAS Version 9.4.

Results

A total of 326 panelists responded to the survey, and 86% of respondents who place crowns or bridges use resin …

Measures Of Pediatric Function And Physical Activity In Arthritis, Anna E. Greer, Maura D. Iversen

Exercise Science Faculty Publications

Physical function can be assessed through physical examination with the use of performance-based measures and patient-reported outcome measures (PROMs). Each form of assessment provides a unique contribution to the understanding of the impact of rheumatologic conditions on the patient. PROMs of physical function (PF) are an important component of the assessment of children with arthritis and have been included in the recommended core set of measures for childhood arthritis and musculoskeletal conditions. These measures provide the child’s or parent’s perspective of function within the context of daily living. Measures of PF include both generic measures, which are designed for use …

Sublingual Emphysema Following Alveoloplasty: A Case Report, Austin Dodge, Katelyn Kreh, Vrisiis Kofina, Swati Y. Rawal

School of Dentistry Faculty Research and Publications

Various cases of introduction of air into soft tissues have been reported in the dental literature. Here, we report a rare case of localized sublingual emphysema after alveoloplasty. There was no facial involvement. The patient responded to treatment and recovered uneventfully.

Inspire : Vol 2, Issue 2, Department Of Medicine

INSPIRE – Department of Medicine Archives

Content

• Message from The Chair
• Accelerating the elimination of viral hepatitis:
• a Lancet Gastroenterology & Hepatology Commission
• Peritoneal Dialysis Program by Syed Farrukh Umair
• Department of Medicine at National and International Forums
• What Are Academics Around the World Reading This Month?
• Featured Faculty Profile
• Dr. Saman Ali; “Stay true to yourself, stay humble, work hard but also try to have fun while doing it.”
• Publications

Lar Inhibitory Peptide Promotes Recovery Of Diaphragm Function And Multiple Forms Of Respiratory Neural Circuit Plasticity After Cervical Spinal Cord Injury., Lan Cheng, Armin Sami, Biswarup Ghosh, Mark W Urban, Nicolette M Heinsinger, Sophia S Liang, George M Smith, Megan C Wright, Shuxin Li, Angelo C Lepore

Farber Institute for Neuroscience Faculty Papers

Chondroitin sulfate proteoglycans (CSPGs), up-regulated in and around the lesion after traumatic spinal cord injury (SCI), are key extracellular matrix inhibitory molecules that limit axon growth and consequent recovery of function. CSPG-mediated inhibition occurs via interactions with axonal receptors, including leukocyte common antigen- related (LAR) phosphatase. We tested the effects of a novel LAR inhibitory peptide in rats after hemisection at cervical level 2, a SCI model in which bulbospinal inspiratory neural circuitry originating in the medullary rostral ventral respiratory group (rVRG) becomes disconnected from phrenic motor neuron (PhMN) targets in cervical spinal cord, resulting in persistent partial-to-complete diaphragm paralysis. …

Orthopedic Principles To Facilitate Enhanced Recovery After Cardiac Surgery, Marc W Gerdisch, Keith B Allen, Yoshifumi Naka, Mark R Bonnell, Kevin P Landolfo, John Grehan, Kendra J Grubb, David J Cohen, T. Sloane Guy, Nirav C Patel, Vinod H Thourani

Department of Surgery Faculty Papers

Enhanced recovery after surgery (ERAS) protocols recognize early postoperative mobilization as a driver of faster postoperative recovery, return to normal activities, and improved long-term patient outcomes. For patients undergoing open cardiac surgery, an opportunity for facilitating earlier mobilization and a return to normal activity lies in the use of improved techniques to stabilize the sternal osteotomy. By following the key orthopedic principles of approximation, compression, and rigid fixation, a more nuanced approach to sternal precaution protocols is possible, which may enable earlier patient mobilization, physical rehabilitation, and recovery.

Breast Carcinoma Metastasis In A Resected Meningioma With Early Diagnosis Of Oligometastatic Disease: A Case Report., Christian Fernandez, Louis Cappelli, Sara Chapin,, Lawrence Kenyon, Christopher J Farrell, Wenyin Shi

Department of Radiation Oncology Faculty Papers

Tumor-to-tumor metastasis describes the ability of primary tumors to metastasize to other primary tumors. These events generally occur in aggressive and widely-metastatic disease, with the appropriate management and significance of these events unknown. A 56-year-old woman with a history of bilateral, localized, invasive lobular breast carcinoma treated with surgery, systemic therapy, and adjuvant radiation presented five and two years post-treatment with progressive neurological symptoms. Imaging revealed an intracranial meningioma, and the patient underwent resection. Pathology revealed metastatic invasive lobular carcinoma cells within the resected meningioma, and the patient was treated with postoperative radiation without sequelae. Subsequent staging scans revealed a …

We Know Health Is Not Elective: Impacts Of Covid-19., David B. Nash, Mark Angelo, Esther J Nash, Jonathan L Gleason, Bruce A Meyer

College of Population Health Faculty Papers

Several months into the impact of the global COVID-19 pandemic, the authors use the framework of "radical uncertainty" and specific regional health care data to understand current and future health and economic impacts. Four key areas of discussion included are: (1) How did structural health care inequality manifest itself during the closure of all elective surgeries and visits?; (2) How can we really calculate the so-called untold burden that resulted from the closure, with a special emphasis on primary care?; (3) The Pennsylvania experience - using observations from the population of one major delivery ecosystem (Jefferson Health), a major accountable …

Caseous Mitral Valve Calcification And Concurrent Hypertrophic Obstructive Cardiomyopathy: A Rare Cause Of Stroke, Waqas Ullah, Donald C. Haas, Talal Almas, Aws- Al-Mukhtar, Asad Inayat

Division of Cardiology Faculty Papers

No abstract provided.

Ssh1 Impedes P62/Sqstm1 Flux And Tau Clearance Independent Of Cofilin Activation, Cenxiao Fang

USF Tampa Graduate Theses and Dissertations

Accumulation of toxic protein assemblies and damaged mitochondria are key features of neurodegenerative diseases, which arise in large part from clearance defects in the autophagy-lysosome system. The autophagy cargo receptor p62/SQSTM1 plays a major role in the clearance of ubiquitinated cargo through Ser403 phosphorylation by multiple kinases. However, no phosphatase is known to physiologically dephosphorylate p62 on this activating residue. RNAi-mediated knockdown and overexpression experiments using genetically encoded fluorescent reporters and defined mutant constructs in cell lines, primary neurons, and brains show that SSH1, the canonical cofilin phosphatase, mediates the dephosphorylation of phospho-Ser403-p62, thereby impairing p62 flux and phospho-tau clearance. …

Predictors Of Positive Outcomes In Treating Individuals Diagnosed With Idd And Comorbid Psychiatric Disorders, Jacob Omondi Wasonga

Dissertations

The purpose of this research was to evaluate the use of a new treatment protocol, the systemic treatment plan (STP) by identifying the predictors of positive treatment outcomes for individuals diagnosed with intellectual and developmental disabilities (IDD) and comorbid mental health conditions. This study examined the relationship between challenging behaviors, psychiatric conditions, and positive treatment outcomes for individuals with IDD and co-occurring disorders, particularly those individuals whose treatment was driven by the STP. A linear regression analysis was conducted to determine which challenging behaviors and psychiatric disorders best predict positive outcomes in systemically engaged treatment. The results from this study …

Cryo‑Electron Microscopy Structure Of The 70s Ribosome From Enterococcus Faecalis, Eileen L. Murphy, Kavindra V. Singh, Bryant Avila, Torsten Kleffmann, Steven T. Gregory, Barbara E. Murray, Kurt L. Krause, Reza Khayat, Gerwald Jogl

Publications and Research

Enterococcus faecalis is a gram-positive organism responsible for serious infections in humans, but as with many bacterial pathogens, resistance has rendered a number of commonly used antibiotics ineffective. Here, we report the cryo-EM structure of the E. faecalis 70S ribosome to a global resolution of 2.8 Å. Structural differences are clustered in peripheral and solvent exposed regions when compared with Escherichia coli, whereas functional centres, including antibiotic binding sites, are similar to other bacterial ribosomes. Comparison of intersubunit conformations among five classes obtained after three-dimensional classification identifies several rotated states. Large ribosomal subunit protein bL31, which forms intersubunit bridges to …

Site-Specific Multi Disciplinary Tumour Board Is An Important Milestone In Cancer Patient's Treatment Journey, Ahmed Nadeem Abbasi, Sehrish Abrar, Bilal Mazhar Qureshi

Department of Radiation Oncology

No abstract provided.

The Tuskegee Syphilis Experiment: The Implications Of Its Legacy, Joshua Barash, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Objectives

• Discuss details of the Tuskegee Study
• Summarize ethical issues
• Explore the legacy of Tuskegee: Distrust of the Medical Establishment

Proposal Of Rt-Pcrebased Mass Population Screening For Severe Acute Respiratory Syndrome Coronavirus 2 (Coronavirus Disease 2019), Nikhil S. Sahajpal, Ashis K. Mondal, Allan Njau, Sudha Ananth, Kimya Jones, Pankaj K. Ahluwalia, Meenakshi Ahluwalia, Yasmeen Jilani, Alka Chaubey, Madhuri Hegde, Vamsi Kota, Amyn Rojiani, Ravindra Kolhe

Pathology, East Africa

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing has lagged in many countries because of test kit shortages and analytical process bottlenecks. This study investigated the feasibility and accuracy of a sample pooling approach for wide-scale population screening for coronavirus disease 2019. A total of 940 nasopharyngeal swab samples (934 negative and 6 positive) previously tested for SARS-CoV-2 were deidentified and assigned random numbers for analysis, and 94 pools of 10 samples each were generated. Automated RNA extraction, followed by RT-PCR, was performed in a 96-well plate. Positive pools were identified, and the individual samples were reanalyzed. Of the 94 …

Serially Assessed Bisphenol A And Phthalate Exposure And Association With Kidney Function In Children With Chronic Kidney Disease In The Us And Canada: A Longitudinal Cohort Study., Melanie H. Jacobson, Yinxiang Wu, Mengling Liu, Teresa M. Attina, Mrudula Naidu, Rajendiran Karthikraj, Kurunthachalam Kannan, Bradley A. Warady, Susan Furth, Suzanne Vento, Howard Trachtman, Leonardo Trasande

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Exposure to environmental chemicals may be a modifiable risk factor for progression of chronic kidney disease (CKD). The purpose of this study was to examine the impact of serially assessed exposure to bisphenol A (BPA) and phthalates on measures of kidney function, tubular injury, and oxidative stress over time in a cohort of children with CKD.

METHODS AND FINDINGS: Samples were collected between 2005 and 2015 from 618 children and adolescents enrolled in the Chronic Kidney Disease in Children study, an observational cohort study of pediatric CKD patients from the US and Canada. Most study participants were male (63.8%) …

Sirolimus For Kaposiform Hemangioendothelioma And Kasabach-Merritt Phenomenon In A Neonate, Trevor B Cabrera, Allison L Speer, Matthew R Greives, Donna A Goff, Neethu M Menon, Eric W Reynolds

Faculty, Staff and Student Publications

We present a case of a neonate born with kaposiform hemangioendothelioma (KHE), complicated by Kasabach-Merritt phenomenon (KMP) and other serious conditions, who was successfully treated with sirolimus. In addition to complications from thrombocytopenia and fluid overload, during the course of therapy, our patient experienced supratherapeutic drug levels at the commonly accepted starting dose of sirolimus. Patients with KHE and KMP should be closely monitored for potential complications of both the initial disease and unexpected side effects of treatments.

Policies And Practices Of Shea Research Network Hospitals During The Covid-19 Pandemic., Michael S. Calderwood, Valerie M. Deloney, Deverick J. Anderson, Vincent Chi-Chung Cheng, Shruti Gohil, Jennie H. Kwon, Lona Mody, Elizabeth Monsees, Valerie M. Vaughn, Timothy L. Wiemken, Matthew J. Ziegler, Eric Lofgren

Manuscripts, Articles, Book Chapters and Other Papers

To understand hospital policies and practices as the COVID-19 pandemic accelerated, the Society for Healthcare Epidemiology of America (SHEA) conducted a survey through the SHEA Research Network (SRN). The survey assessed policies and practices around the optimization of personal protection equipment (PPE), testing, healthcare personnel policies, visitors of COVID-19 patients in relation to procedures, and types of patients. Overall, 69 individual healthcare facilities responded in the United States and internationally, for a 73% response rate.

Anesthetic Drugs And Cancer Progression, Juan P Cata, Anil K Sood, Holger K Eltzschig

Faculty, Staff and Student Publications

No abstract provided.

Positive Religious Coping And Mental Health Among Christians And Muslims In Response To The Covid-19 Pandemic, Justin Thomas, Mariapaola Barbato

All Works

© 2020 by the authors. Licensee MDPI, Basel, Switzerland. Positive religious coping has frequently been associated with better mental health outcomes when dealing with stressful life events (e.g., natural disasters, domestic abuse, divorce). The COVID-19 pandemic, and the associated infection prevention and control measures (curfew, quarantine, restricted travel, social distancing), represent a society-wide stressor. This study explored positive religious coping among the Muslim and Christian residents of the United Arab Emirates (UAE) during the early stages of the national response to the COVID-19 pandemic. Participants (N = 543) completed an online survey assessing religious coping in response to the pandemic, …

The Effect Of An Online Educational Intervention On The Community Knowledge Of Physical Health, Mental Health And Self-Efficacy During The Covid-19 Pandemic, Kerstin Ashby Ferguson

Doctor of Nursing Practice Projects

Background

Community health education during times of pandemic is of utmost importance to disseminate information regarding safety precautions, educate the public regarding the disease process, and provide accurate health information during a time when individuals are specifically vulnerable to inaccurate sources of information. During the COVID-19 pandemic, physical gatherings were highly restricted; therefore, it became important to incorporate technology into the educational process.

Purpose

The purpose of this project was to determine if a thirty-day, online community health education program would increase the health knowledge and self-efficacy of participants.

Methods

This project utilized a quantitative quasi-experimental pre-test/post-test design from a …

The Effect Of An Online Mental Health Promotion Program During Covid-19, Juliana Maldonado

Doctor of Nursing Practice Projects

Background

The negative impact of Coronavirus 19 (COVID-19) on mental health has been observed through the pandemic. People have had to adapt to a new norm of social distancing, wearing a mask, and abstaining from big group gatherings. These changes have impacted all levels of society and the rise of mental health care continues to grow as COVID-19 continues at this time. Mental health promotion strategies may be enhanced through the use of telehealth.

Purpose

To determine if a six-week online mental health promotion intervention would improve the GAD-7 scores of participants.

Methods

This project utilized a quantitative quasi-experimental pre-test/post-test …

Canakinumab To Reduce Deterioration Of Cardiac And Respiratory Function In Sars-Cov-2 Associated Myocardial Injury With Heightened Inflammation (Canakinumab In Covid-19 Cardiac Injury: The Three C Study), Calvin C Sheng, Debasis Sahoo, Siddharth Dugar, Robier Aguillon Prada, Tom Kai Ming Wang, Ossama K Abou Hassan, Danielle Brennan, Daniel A Culver, Prabalini Rajendram, Abhijit Duggal, A Michael Lincoff, Steven E Nissen, Venu Menon, Paul C Cremer

Faculty, Staff and Student Publications

BACKGROUND: In patients with Covid-19, myocardial injury and increased inflammation are associated with morbidity and mortality. We designed a proof-of-concept randomized controlled trial to evaluate whether treatment with canakinumab prevents progressive respiratory failure and worsening cardiac dysfunction in patients with SARS-CoV2 infection, myocardial injury, and high levels of inflammation.

HYPOTHESIS: The primary hypothesis is that canakiumab will shorten time to recovery.

METHODS: The three C study (canakinumab in Covid-19 Cardiac Injury, NCT04365153) is a double-blind, randomized controlled trial comparing canakinumab 300 mg IV, 600 mg IV, or placebo in a 1:1:1 ratio in hospitalized Covid-19 patients with elevations in troponin …

Yebc Regulates Variable Surface Antigen Vlse Expression And Is Required For Host Immune Evasion In Borrelia Burgdorferi, Yan Zhang, Tong Chen, Sajith Raghunandanan, Xuwu Xiang, Jing Yang, Qiang Liu, Diane G Edmondson, Steven J Norris, X Frank Yang, Yongliang Lou

Faculty, Staff and Student Publications

Borrelia burgdorferi, the Lyme disease pathogen causes persistent infection by evading the host immune response. Differential expression of the surface-exposed lipoprotein VlsE that undergoes antigenic variation is a key immune evasion strategy employed by B. burgdorferi. Most studies focused on the mechanism of VlsE antigen variation, but little is known about VlsE regulation and factor(s) that regulates differential vlsE expression. In this study, we investigated BB0025, a putative YebC family transcriptional regulator (and hence designated BB0025 as YebC of B. burgdorferi herein). We constructed yebC mutant and complemented strain in an infectious strain of B. burgdorferi. The yebC mutant could …

Effect Of Covid-19 Pandemic On Mechanical Thrombectomy For Acute Ischemic Stroke Treatment In United States, Adnan Qureshi, Farhan Siddiq, Brandi R. French, Camilo R. Gomez, Vishal Jani, Ameer E. Hassan, M.Fareed K. Suri

School of Medicine Publications

There is accumulating data suggesting that the ischemic stroke may be increased in patients with corona virus disease 2019 (COVID-19) due to hyper coagulopathy. An increase in acute ischemic stroke patients who require mechanical thrombectomy is to be expected particularly in regions with high rates of COVID-19.

Epidemiological Implications Of The Genetic Diversification Of Dengue Virus (Denv) Serotypes And Genotypes In Mexico, Ericel Hernandez-Garcia, Maria De Lourdes Munoz, Randy E. David, Gerardo Perez-Ramirez, Joel Navarrete-Espinosa, Alvaro Diaz-Badillo, Eduardo Dominguez-De-La-Cruz, Miguel Moreno-Galeana, Cesar Armando Brito-Carreon

School of Medicine Publications

Variation and clade shifts in dengue virus (DENV) genotypes are responsible for numerous dengue fever outbreaks throughout Latin America in the past decade. Molecular analyses of dengue serotypes have revealed extensive genetic diversification and the emergence of new genotypes in Brazil (DENV-4 genotype I) and elsewhere in tropical and subtropical America. The goal of the present study is to assess the extent to which the adventitious introduction of DENV genotypes and their increasing genetic diversity affects dengue epidemiology in Mexico. A nuanced sequence inspection and phylogenetic analysis of the C-prM nucleotide region of DENV was performed for specimens collecting in …

Withania Somnifera As A Potential Future Drug Molecule For Covid-19, Vivek K. Kashyap, Anupam Dhasmana, Murali M. Yallapu, Subhash C. Chauhan, Meena Jaggi

School of Medicine Publications

COVID-19 is an infection disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 is a mild to severe respiratory illness which has caused significant disruption to normal life over the past few months, nearly bringing parts of the world to a halt. As of 26 August 2020, more than 24 million COVID-19 infections have been reported and 821,000 deaths are associated with this disease [1]. According to the WHO (Geneva, Switzerland) and the US CDC (MD, USA), the clinical manifestation of COVID-19 is the presence of fever or chills, sore throat, dry cough, fatigue, muscle/body aches, headache, loss …

Tobacco Smoke Carcinogens Induce Dna Repair Machinery Function Loss: Protection By Carbon Nanotubes, Anukriti Dhasmana, Anupam Dhasmana, Hobani Yahya H, Abdullah Farasani, Mahmoud Habibullah, Freah L. Alshammary, Saif Khan, Shafiul Haque, Mohtashim Lohani

School of Medicine Publications

Purpose: DNA damage is a continuous process occurring within the cells caused by intrinsic and extrinsic factors, but it gets repaired regularly. If the DNA repair process is faulty, the incidences of damages/mutations can accumulate in cells resulting in cell transformation. It is hypothesized that the negative variations in DNA repair pathways in even at one point viz. genetic, translational or posttranslational stage may fairly be crucial for the beginning and development of carcinogenesis. Therefore, we investigated the potential of tobacco specific nitrosamines (TSNs) related carcinogens to interact with the enzymes involved in DNA repair mechanisms in the current study. …

Stratifying Chronic Stroke Patients Based On The Influence Of Contralesional Motor Cortices: An Inter-Hemispheric Inhibition Study, Yin-Liang Lin, Kelsey A. Potter-Baker, David A. Cunningham, Manshi Li, Vishwanath Sankarasubramanian, John Lee, Stephen Jones, Ken Sakaie, Xiaofeng Wang, Andre G. Machado

School of Medicine Publications

Objective:

A recent “bimodal-balance recovery” model suggests that contralesional influence varies based on the amount of ipsilesional reserve: inhibitory when there is a large reserve, but supportive when there is a low reserve. Here, we investigated the relationships between contralesional influence (inter-hemispheric inhibition, IHI) and ipsilesional reserve (corticospinal damage/impairment), and also defined a criterion separating subgroups based on the relationships.

Methods:

Twenty-four patients underwent assessment of IHI using Transcranial Magnetic Stimulation (ipsilateral silent period method), motor impairment using Upper Extremity Fugl-Meyer (UEFM), and corticospinal damage using Diffusion Tensor Imaging and active motor threshold. Assessments of UEFM and IHI were repeated …