Medicine and Health Sciences Commons^™

Overcoming Challenges In The Assessment And Treatment Of Problem Behavior In Adults With Autism, Julia A. Iannaccone

Dissertations, Theses, and Capstone Projects

Problematic behaviors, such as self-injurious behavior or aggression, demonstrated by adults with autism spectrum disorder (ASD), create many significant life complications, some life-threatening. Applied Behavior Analysis (ABA) is established as an evidence-based approach to treat problem behavior for children with ASD and shows promise as an effective treatment for adults, yet little research has been conducted within the adult population. Assessment and treatment of problem behavior with adults is often challenging due to funding limitations, increased severity and complexity of problem behavior, and underqualified staff. The purpose of the present study was to overcome these challenges by (1) identifying a …

A Rare Presentation Of Acute Flaccid Myelitis In Covid-19 Patient: A Case Report, Liaquat Ali, Adnan Khan, Osama Elalamy, Beatriz Canibano, Mohammad Al Hatou, Ghulam Adeli, Islam Ahmed, Ambreen Iqrar, Ahmed Abdussalam, A Saif Ibrahim, Sundus Sardar

Pakistan Journal of Neurological Sciences (PJNS)

SARS-CoV-2 virus enters human cells via ACE-2 receptors and causes multiple organs dysfunction. These ACE-2 receptors are in cells surface of human lung, liver, heart, kidney and blood vessels. The expression of ACE2 receptors in cortical neurons, glial cells and spinal cord cells create nervous system susceptible to SARS-CoV-2 attack and may be a source of different neurological deficits including myelitis in COVID-19 patients.

Parkinson's Disease- "Move Together To End": Theme For World Brain Day 2020, Abdul Malik

Pakistan Journal of Neurological Sciences (PJNS)

World Federation of Neurology (WFN) promoting brain health through its educational, skills development & advocacy activities. Since 2014 WFN had been focused to organized dedicated awareness drive in all the WFN members countries round the globe.

Outcomes Of Cancer Patients Undergoing Transcatheter Aortic Valve Replacement., Vardhmaan Jain, Anas M Saad, Mohamed M Gad, Agam Bansal, Omar Abdelfattah, Medhat Farwati, Keerat R. Ahuja, James Yun, Amar Krishnaswamy, Samir R Kapadia

Reading Hospital Cardiovascular Medicine Fellowship

No abstract provided.

Quantifying The Decrease In Emergency Department Imaging Utilization During The Covid-19 Pandemic At A Multicenter Healthcare System In Ohio, Keval D. Parikh, Nikhil H. Ramaiya, Elias G. Kikano, Sree Harsha Tirumani, Jonathan Pierce, Carl Butcher, Jeffrey L. Sunshine, Donna M. Plecha

Faculty Scholarship

PURPOSE: To illustrate the change in emergency department (ED) imaging utilization at a multicenter health system in the state of Ohio during the COVID-19 pandemic. METHODS: A retrospective observational study was conducted assessing ED imaging volumes between March 1, 2020, and May 11, 2020, during the COVID-19 crisis. A rolling 7-day total value was used for volume tracking and comparison. Total imaging utilization in the ED was compared with new COVID-19 cases in our region. Utilization was first categorized by modality and then by plain films and computed tomography (CT) scans grouped by body part. CT imaging of the chest …

Barriers And Facilitators In Implementing A Pilot, Pragmatic, Telemedicine-Delivered Healthy Lifestyle Program For Obesity Management In A Rural, Academic Obesity Clinic, John A. Batsis, Auden C. Mcclure, Aaron B. Weintraub, Diane Sette, Sivan Rotenberg, Courtney J. Stevens, Diane Gilbert-Diamond, David Kotz, Stephen Bartels, Summer B. Cook, Richard I. Rothstein

Dartmouth Scholarship

Few evidence-based strategies are specifically tailored for disparity populations such as rural adults. Two-way video-conferencing using telemedicine can potentially surmount geographic barriers that impede participation in high-intensity treatment programs offering frequent visits to clinic facilities. We aimed to understand barriers and facilitators of implementing a telemedicine-delivered tertiary-care, rural academic weight-loss program for the management of obesity.

Covid-19: What Lies Ahead For Homoeopathy?, Anil Khurana

Indian Journal of Research in Homoeopathy

No abstract provided.

Prevalence Of Homoeopathic Polar Symptoms: A Follow-Up Pilot Study Conducted In Mumbai In 2017, Vaishali Shinde, Lex Rutten, Anil Khurana, Raj Manchanda, Ramesh Bawaskar

Indian Journal of Research in Homoeopathy

Background: Prospective assessment of homoeopathic symptoms is different from eliciting symptoms in daily practice. In prognostic factor research, we apply symptom questionnaires with Likert scales to assess symptoms in different intensities. In former research, we tested a 5-point Likert scale, which rendered a rather high prevalence for some symptoms even the strongest intensity, not useful in daily practice. A longer, 7-point Likert scale might render more useful outcome. Objective: To study if a longer Likert scale perform better in homoeopathic prognostic factor research. Methods: A 7-point Likert scale questionnaire with 30 polar symptoms was tested on 300 patients. Responses to …

Effects Of Pre-Defined Homoeopathic Medicines To Mitigate Adverse Dermatological Effects Of Radiotherapy And Vomiting Of Chemotherapy In Breast Carcinoma: A Randomised, Double-Blind, Placebo-Controlled, Pilot Trial In The Context Of Usual Care, Purnima Shukla, Chaturbhuja Nayak, Mirza Baig, Purak Misra

Indian Journal of Research in Homoeopathy

Background: Radiotherapy and chemotherapy are used in breast cancer, but they cause an array of adverse effects including dermatological changes and vomiting. Objective: The objective of the study was to examine whether Usual Care (UC) plus pre-defined homoeopathic remedies can produce different effect beyond UC plus placebo in dermatological adverse effects of radiotherapy and vomiting of chemotherapy in breast carcinoma. Methods: In this double-blind, randomised, placebo-controlled, parallel-arm trial, 88 females suffering from dermatological adverse effects due to radiotherapy (n = 41) or vomiting due to chemotherapy (n = 47) were randomised to receive either UC + Homoeopathy (verum; n = …

Optimising The Use Of Polar Symptoms In Homoeopathy: Introduction To A Pilot Study Of Prognostic Factor Research In Chronic Cough, Harleen Kaur, Chetna Lamba, Jyoti Sachdeva, Lex Rutten, Anil Khurana, Praveen Oberai, Raj Manchanda, Sonia Raizada, Sujata Chaudhury

Indian Journal of Research in Homoeopathy

Background: Polar symptoms represent the most challenging rubrics in the homoeopathic repertories, despite their frequent use. Objective: The study objective was to assess the relationship between 27 polar cough symptoms, 3 non-polar cough symptoms and 30 general polar symptoms and successful response to specific homoeopathic medicines. Materials and Methods: A multi-centre, explorative, prospective, observational study was conducted at ten centres under the Central Council for Research in Homoeopathy. Two hundred and sixteen patients were enrolled with chronic cough, lasting >8 weeks. The patients were enrolled as per four underlying diagnoses of chronic upper airway cough syndrome (CUACS), gastro-oesophageal reflux disease …

Management Of Post-Intubation Subglottic Stenosis With Individualised Homoeopathic Therapy: A Case Report, Shelly Sharma, Seema Mahesh, George Vithoulkas

Indian Journal of Research in Homoeopathy

Introduction: Subglottic stenosis is a narrowing of the airway just below the vocal cords. This narrowing can cause serious breathing difficulties. Subglottic stenosis can be congenital or acquired. Frequent or long-term intubation is the most common cause of acquired subglottic stenosis. Case Summary: In this case report, adjuvant homoeopathic treatment helped prevent tracheal stent implantation surgery, otherwise deemed necessary in such a state and improved the overall general state. This case report gives ground to further investigate the extent to which individualised Homoeopathy may be applied in postintubation subglottic stenosis.

Research Highlights (January 2020–May 2020), Swati Pandey

Indian Journal of Research in Homoeopathy

No abstract provided.

Simplify The Complexity And Replicate The Simplicity: Book Review Of Standard Treatment Guidelines In Homoeopathy, Aaron To Ka Lun

Indian Journal of Research in Homoeopathy

No abstract provided.

Life Expectancy And Active Life Expectancy By Disability Status In Older U.S. Adults, Haomiao Jia, Erica I. Lubetkin

Publications and Research

Objectives

The Medicare Health Outcome Survey (HOS) is the largest longitudinal survey of the U.S. community-dwelling elderly population. This study estimated total life expectancy, active life expectancy (ALE), and disability-free life expectancy (DFLE) by disability status among HOS participants.

Methods

Data were from the Medicare HOS Cohort 15 (baseline 2012, follow-up 2014). We included respondents aged ≥ 65 years (n = 164,597). Participants’ disability status was assessed based on the following six activities of daily living (ADL): bathing, dressing, eating, getting in or out of chairs, walking, and using the toilet. The multi-state models were used to estimate life expectancy, …

Patterns And Predictors Of Older Adult Medicare Part D Beneficiaries’ Receipt Of Medication Therapy Management, Antoinette B. Coe, Omolola A. Adeoye-Olatunde, Deborah L. Pestka, Margie Snyder, Alan Zillich, Karen B. Farris, Joel F. Farley

Department of Pharmacy Practice Faculty Publications

Background

Medicare Part D medication therapy management (MTM) includes an annual comprehensive medication review (CMR) as a strategy to mitigate suboptimal medication use in older adults.

Objectives

To describe the characteristics of Medicare beneficiaries who were eligible, offered, and received a CMR in 2013 and 2014 and identify potential disparities.

Methods

This nationally representative cross-sectional study used a 20% random sample of Medicare Part A, B, and D data linked with Part D MTM files. A total of 5,487,343 and 5,822,188 continuously enrolled beneficiaries were included in 2013 and 2014, respectively. CMR use was examined among a subset of 620,164 …

The Application Of Drones In Healthcare And Health-Related Services In North America: A Scoping Review, Bradley Hiebert, Elysée Nouvet, Vyshnave Jeyabalan, Lorie Donelle Phd, Rn, Fcan

Publications

Using drone aircraft to deliver healthcare and other health-related services is a relatively new application of this technology in North America. For health service providers, drones represent a feasible means to increase their efficiency and ability to provide services to individuals, especially those in difficult to reach locations. This paper presents the results of a scoping review of the research literature to determine how drones are used for healthcare and health-related services in North America, and how such applications account for human operating and machine design factors. Data were collected from PubMed, CINAHL, Scopus, Web of Science, and IEEE Xplore …

Context-Specific Challenges, Opportunities, And Ethics Of Drones For Healthcare Delivery In The Eyes Of Program Managers And Field Staff: A Multi-Site Qualitative Study, Vyshnave Jeyabalan, Elysée Nouvet, Patrick Meier, Lorie Donelle Phd, Rn, Fcan

Publications

Unmanned aerial vehicles (UAVs), also known as drones, have significant potential in the healthcare field. Ethical and practical concerns, challenges, and complexities of using drones for specific and diverse healthcare purposes have been minimally explored to date. This paper aims to document and advance awareness of diverse context-specific concerns, challenges, and complexities encountered by individuals working on the front lines of drones for health. It draws on original qualitative research and data from semi-structured interviews (N = 16) with drones for health program managers and field staff in nine countries. Directed thematic analysis was used to analyze interviews and identify …

Variation In Hiv-1 Nef Function Within And Among Viral Subtypes Reveals Genetically Separable Antagonism Of Serinc3 And Serinc5, Steven W. Jin, Francis M. Mwimanzi, Jaclyn K. Mann, Mwebesa Bosco Bwana, Guinevere Q. Lee, Chanson Brumme, Peter W. Hunt, Jeff N. Martin, David R. Bangsberg, Thumbi Ndung'u, Zabrina L. Brumme, Mark A. Brockman

OHSU-PSU School of Public Health Faculty Publications and Presentations

HIV Nef counteracts cellular host restriction factors SERINC3 and SERINC5, but our understanding of how naturally occurring global Nef sequence diversity impacts these activities is limited. Here, we quantify SERINC3 and SERINC5 internalization function for 339 Nef clones, representing the major pandemic HIV-1 group M subtypes A, B, C and D. We describe distinct subtype-associated hierarchies for Nef-mediated internalization of SERINC5, for which subtype B clones display the highest activities on average, and of SERINC3, for which subtype B clones display the lowest activities on average. We further identify Nef polymorphisms that modulate its ability to counteract SERINC proteins, including …

Evidence-Based Homoeopathy: A Case Report Of Nodular Episcleritis, Sandeep Sathye

Indian Journal of Research in Homoeopathy

Introduction: Nodular episcleritis (NE) is a variety of episcleritis characterised by inflammation of subconjunctival connective tissue leading to development of a localised raised congested nodule with mild pain and tenderness. It can last for weeks with a tendency to recur and is often considered as an allergic reaction to endogenous toxins. Conventional treatment includes the use of topical steroids and non-steroidal anti-inflammatory drugs which give a temporary relief. Case Summary: The case of a 62-year-old male patient suffering from NE in the right eye for 15 days not responding to conventional treatment is reported here. Homoeopathic Mercurius solubilis 30C prescribed …

Ferrum Phosphoricum 3x And Ferrum Metallicum 3x In The Treatment Of Iron Deficiency Anaemia In Children: Randomized Parallel Arm Study, Anil Khurana, Renu Mittal, Padmalaya Rath, Karunakara Moorthy, Divya Taneja, Uttam Singh, Kabita Mishra, Raj Manchanda

Indian Journal of Research in Homoeopathy

Background: Anaemia in children has significant adverse health consequences and is a major public health problem. Objective: The objective of this study is to identify efficacy of Ferrum phosphoricum 3X (FP) and Ferrum metallicum 3X (FM) in changing haemoglobin (Hb) levels in school-going children, 12–14 years of age with Iron Deficiency Anaemia (IDA). Materials and Methods: School children were screened for Hb levels using a portable haemoglobinometer at Noida, Kottayam, Guwahati and Imphal. Children with Hb levels ≤11.9 g% and ≥8 g% were investigated for IDA by measuring serum ferritin level and other parameters. Children enrolled were divided into two …

Long Noncoding Rna H19x Is A Key Mediator Of Tgf-Β-Driven Fibrosi, Elena Pachera, Shervin Assassi, Gloria A Salazar, Mara Stellato, Florian Renoux, Adam Wunderlin, Przemyslaw Blyszczuk, Robert Lafyatis, Fina Kurreeman, Jeska De Vries-Bouwstra, Tobias Messemaker, Carol A Feghali-Bostwick, Gerhard Rogler, Wouter T Van Haaften, Gerard Dijkstra, Fiona Oakley, Maurizio Calcagni, Janine Schniering, Britta Maurer, Jörg Hw Distler, Gabriela Kania, Mojca Frank-Bertoncelj, Oliver Distler

Faculty, Staff and Student Publications

TGF-β is a master regulator of fibrosis, driving the differentiation of fibroblasts into apoptosis-resistant myofibroblasts and sustaining the production of extracellular matrix (ECM) components. Here, we identified the nuclear long noncoding RNA (lncRNA) H19X as a master regulator of TGF-β-driven tissue fibrosis. H19X was consistently upregulated in a wide variety of human fibrotic tissues and diseases and was strongly induced by TGF-β, particularly in fibroblasts and fibroblast-related cells. Functional experiments following H19X silencing revealed that H19X was an obligatory factor for TGF-β-induced ECM synthesis as well as differentiation and survival of ECM-producing myofibroblasts. We showed that H19X regulates DDIT4L gene …

Machine Learning Can Identify Abnormal Chromosomes To Facilitate Initial Screening In The Cytogenomics Laboratory, Mark Micale, Zhenhong Qu, Blake Martin

Conference Presentation Abstracts

Context: Artificial intelligence/machine learning (AI-ML) has made great strides in recent years with applications in diagnostic medicine. We tested the hypothesis that AI-ML can permit initial screening for structural chromosome abnormalities at various band levels of resolution. Such technology could markedly reduce the downstream laboratory workload and increase turnaround time in cases positive for a clinically significant chromosome abnormality.

Design: We utilized partial karyotypes of normal chromosomes 4, 5, 7, 9, 13, 21, and 22 and abnormal derivative chromosomes 9 and 22 from the t(9;22)(q34;q11.2) associated with chronic myeloid leukemia to train our AI-ML system to identify normal from abnormal …

Health Outcomes Of Tourism Development: A Longitudinal Study Of The Impact Of Tourism Arrivals On Residents’ Health, Maksim Godovykh, Jorge Ridderstaat

Faculty Scholarship and Creative Works

This study investigates the influence of the number of tourism arrivals on the physical health of local people in one of the most-visited destinations in the world. Although the literature traditionally describes the economic, social, and cultural impacts of tourism, there is a gap related to the effects of tourism on residents' health. The methodology involves applying the limited-information maximum likelihood instrumental variable approach. The results demonstrate that tourism arrivals negatively influence residents’ health in the short term, yet have positive impacts on long-term health outcomes. The study contributes to the theory and practice by offering a new approach to …

Nanoparticles As Antibiotic-Delivery Vehicles (Advs) Overcome Resistance By Mrsa And Other Mdr Bacterial Pathogens: The Grenade Hypothesis, Amjed Alabresm, Yung Pin Chen, Savannah Wichter-Chandler, Jamie Lead, Brian C. Benicewicz

Faculty Publications

Objectives

The aim of this study was to examine how the concentrated delivery of less effective antibiotics, such as the Β-lactam penicillin G, by linkage to nanoparticles (NPs), could influence the killing efficiency against various pathogenic bacteria, including methicillin-resistant Staphylococcus aureus (MRSA) and other multidrug resistant (MDR) strains.

Methods

The Β-lactam antibiotic penicillin G (PenG) was passively sorbed to fluorescent polystyrene NPs (20 nm) that were surface-functionalized with carboxylic acid (COO⁻-NPs) or sulfate groups (SO₄⁻-NPs) to form a PenG-NP complex. Antimicrobial activities of PenG-NPs were evaluated against Gram-negative and Gram-positive bacteria, including antibiotic resistant strains. …

Splicing Of The Cake Can Affect The Severity Of Epidermolysis Bullosa, D Murrell, Jouni Uitto

Department of Dermatology and Cutaneous Biology Faculty Papers

No abstract provided.

Effect Of Motor-Assisted Elliptical Training Speed And Body Weight Support On Center Of Pressure Movement Variability, Farahnaz Fallahtafti, Chase M. Pfeifer, Thad W. Buster, Judith M. Burnfield

Department of Mechanical and Materials Engineering: Faculty Publications

Background: A motor-assisted elliptical trainer is being used clinically to help individuals with physical disabilities regain and/or retain walking ability and cardiorespiratory fitness. Unknown is how the device’s training parameters can be used to optimize movement variability and regularity. This study examined the effect of motor-assisted elliptical training speed as well as body weight support (BWS) on center of pressure (CoP) movement variability and regularity during training. Methods: CoP was recorded using in-shoe pressure insoles as participants motor-assisted elliptical trained at three speeds (20, 40, and 60 cycles per minute) each performed at four BWS levels (0%, 20%, 40%, and …

Reorienting Nurturing Care For Early Childhood Development During The Covid-19 Pandemic In Kenya: A Review, Constance Shumba, Rose Maina, Gladys Mbuthia, Rachel Kimani, Stella Mbugua, Sweta Shah, Amina Abubakar, Stanley Luchters, Sheila Shaibu, Eunice Ndirangu

School of Nursing & Midwifery, East Africa

In Kenya, millions of children have limited access to nurturing care. With the Coronavirus disease 2019 (COVID-19) pandemic, it is anticipated that vulnerable children will bear the biggest brunt of the direct and indirect impacts of the pandemic. This review aimed to deepen understanding of the effects of COVID-19 on nurturing care from conception to four years of age, a period where the care of children is often delivered through caregivers or other informal platforms. The review has drawn upon the empirical evidence from previous pandemics and epidemics, and anecdotal and emerging evidence from the ongoing COVID-19 crisis. Multifactorial impacts …

The Vaso-Occlusive Pain Crisis In Sickle Cell Disease: Definition, Pathophysiology, And Management., Deepika S. Darbari, Vivien A. Sheehan, Samir K. Ballas

Cardeza Foundation for Hematologic Research

Early diagnosis, treatment, and prevention of a vaso-occlusive crisis (VOC) are critical to the management of patients with sickle cell disease. It is essential to differentiate between VOC-associated pain and chronic pain, hyperalgesia, neuropathy, and neuropathic pain. The pathophysiology of VOCs includes polymerization of abnormal sickle hemoglobin, inflammation, and adhesion. Hydroxyurea, L-glutamine, crizanlizumab, and voxelotor have been approved by the US Food and Drug Administration for reducing the frequency of VOCs; the European Medicines Agency has approved only hydroxyurea. Other novel treatments are in late-stage clinical development in both the United States and the European Union. The development of agents …

Challenges For Cancer Care During Covid-19 Pandemic In Kenya: Policy Implications, Diana Kassaman, Rachel Kimani, Adelaide Lusambili

School of Nursing & Midwifery, East Africa

Cancer accounts for roughly 7 percent of Kenyan mortality, making it the country's third leading cause of death [1]. Available statistics indicate that 70–80 percent of cancer cases in Kenya are first diagnosed only in later stages [2]. Despite its high prevalence and the care needed to treat late-stage cancer, Kenya has few facilities and qualified healthcare workers (HCWs) that are dedicated to cancer treatment. In periods of a pandemic like COVID-19, both patients and HCWs may be at an additional risk of contracting the disease if tailored measures and strategies are not implemented for continuity of services.

Improving Adherence To Adjuvant Hormonal Therapy Among Disadvantaged Women Diagnosed With Breast Cancer In South Carolina: Proposal For A Multimethod Study, Tisha M. Felder, Sue Heiney, James R. Hébert, Daniela B. Friedman, Ronit Elk, Regina Franco, Lucy Gansauer, Barbara Christensen, Marvella E. Ford

Faculty Publications

Background: Current clinical guidelines recommend that hormone receptor-positive breast cancer survivors take adjuvant hormonal therapy (AHT) for 5 to 10 years, following the end of definitive treatment. However, fewer than half of patients adhere to the guidelines, and suboptimal adherence to AHT is associated with an increased risk of breast cancer mortality. Research has extensively documented sociodemographic and disease-specific factors associated with adherence to AHT, but very little evidence exists on behavioral factors (eg, knowledge, patient-provider communication) that can be modified and targeted by interventions. Objective: The goal of this study is to develop and test a theory-based, multilevel intervention …