Medicine and Health Sciences Commons^™

Technology-Enabled Health Care Collaboration In Pediatric Chronic Illness: Pre-Post Interventional Study For Feasibility, Acceptability, And Clinical Impact Of An Electronic Health Record–Linked Platform For Patient-Clinician Partnership, Shehzad Ahmed Saeed, Lisa Opipari-Arrigan, Dana M. H. Dykes, Sunny Thakkar, Lisa Burns, Barbara A. Chini, Gary L. Mcphail, Ian Eslick, Peter A. Margolis, Heather C. Kaplan

Pediatrics Faculty Publications

Background: Mobile health (mHealth) technology has the potential to support the Chronic Care Model's vision of closed feedback loops and patient-clinician partnerships. Objective: This study aims to evaluate the feasibility, acceptability, and short-term impact of an electronic health record-linked mHealth platform (Orchestra) supporting patient and clinician collaboration through real-time, bidirectional data sharing. Methods: We conducted a 6-month prospective, pre-post, proof-of-concept study of Orchestra among patients and parents in the Cincinnati Children's Hospital inflammatory bowel disease (IBD) and cystic fibrosis (CF) clinics. Participants and clinicians used Orchestra during and between visits to complete and view patient-reported outcome (PRO) measures …

Provider Perception And Office Practices Of The Initial Prenatal Visit Pre – Coronavirus 2019 Pandemic, Arlin Delgado, Emma Hale, Jay Schulkin, Charles Macri, Kimberly Fryer

Florida Public Health Review

Background Prenatal Care is a critical aspect of women’s health and current literature shows adequate care significantly reduces risk of adverse outcomes. With scientific advancement, the initial prenatal visit is increasingly tasked with more objectives that leave providers with barriers to provide appropriate and adequate care.

Purpose The aim of this survey study was to determine clinical practices of the initial prenatal visit – regarding history taking, counseling, lab work and screening prior to the onset of COVID-19 Pandemic.

Methods A one-time anonymous provider survey was distributed electronically to all obstetrics providers in the Tampa Bay Region in Florida. Descriptive …

Cardiac Rehabilitation Benchmark Study, Catherine Cottle

MSN Capstone Projects

This benchmark study attempts to evaluate the effectiveness of cardiac rehabilitation in reducing mortality and hospital readmission rates of post-myocardial infarction patients. Several peer-reviewed articles were reviewed assessing the efficacy of cardiac rehabilitation. It was discovered that cardiac rehabilitation reduced several negative effects regarding heart disease, including the reduction of mortality and hospital readmission rates.

A Narrative Review Of Closing Bundles To Prevent Surgical Site Infections, James G. Tucker

MSN Capstone Projects

Each year, surgical site infections (SSIs) ravage patients and our healthcare system. The amount of pain, suffering, and money lost each year to a mostly preventable complication places a great deal of strain on our already fragile healthcare system. In the following paragraphs, sound, quantifiable data is presented indicating the effectiveness of closing bundles. While no "one size fits all" bundle can be recommended, the evidence presented suggests that using additional evidence-based interventions in surgical patients' care drastically lowers SSI rates. The need for future research revolves around tailoring bundles to meet the needs of individual patients. No two patients …

College Students’ Well-Being During The Covid-19 Pandemic: A Systematic Review Of The Literature, Michaela Q. Iglesia, Ming-Tsan Lu

School of Medicine Publications

Studies have shown increased levels of distress during the coronavirus disease-19 (COVID-19) pandemic, and college students are becoming more recognized as a vulnerable population. This narrative systematic review aims to synthesize the current understanding of mental health, lifestyle, and socioeconomic impacts that the pandemic had on college students in the United States. A search was conducted on PubMed, PsycInfo, and Web of Science. A total of 34 observational studies were included which examined aspects of college students’ health and experiences during the COVID-19 pandemic in the United States. A great deal of students was shown to experience a moderate level …

Editorial: Thrombotic Microangiopathies, Diagnostic And Therapeutic Advances, Robert W. Maitta, Hollie M. Reeves

Faculty Scholarship

Thrombotic microangiopathies (TMAs) as a disease group represent a diagnostic and clinical challenge to practitioners. Presentations, which at times have overlapping symptomatology or have undetermined etiologies, emphasize the need for a constant reassessment of what is known about this disease group in order to determine not only how to best treat patients but also to develop targeted approaches to test for a given etiology. Likewise, in those instances when excluding diagnoses is the only available option, timely adjustment of therapy due to lack of therapeutic response needs to be achieved in the most efficient way. It is with this in …

Resident-Led Physical Wellness Initiative Linked To Less Burnout For Emergency Physicians During Covid-19 Pandemic, Camila A. Calderón, Adeola A. Kosoko, Salil K. Bhandari, Jason A. Lesnick, Derek R. Herkes, Ryan M. Huebinger

Journal of Wellness

Introduction: The COVID-19 pandemic has taken a significant toll on societal, physical, and psychological health. Emergency physicians (EPs) are susceptible to burnout under ordinary circumstances and may be particularly vulnerable during the pandemic. To reduce pandemic-related burnout, we implemented a residency-led physical wellness initiative and evaluated the effect on burnout among EPs.

Methods: In the spring of 2020, we invited all resident and attending EPs in our department to participate in a four-week physical wellness initiative as part of a prospective study. After completing or opting out of this wellness initiative, EPs responded to an online survey comprised …

Attenuated Negative Feedback In Monocyte-Derived Macrophages From Persons Living With Hiv: A Role For Ikaros, Celeste Faia, Karlie Plaisance-Bonstaff, Cecilia Vittori, Dorota Wyczechowska, Adam Lassak, Mary Meyaski-Schluter, Krzysztof Reiss, Francesca Peruzzi

School of Medicine Faculty Publications

Persons living with HIV (PLWH) are at higher risk of developing secondary illnesses than their uninfected counterparts, suggestive of a dysfunctional immune system in these individuals. Upon exposure to pathogens, monocytes undergo epigenetic remodeling that results in either a trained or a tolerant phenotype, characterized by hyper-responsiveness or hypo-responsiveness to secondary stimuli, respectively. We utilized CD14+ monocytes from virally suppressed PLWH and healthy controls for in vitro analysis following polarization of these cells toward a pro-inflammatory monocyte-derived macrophage (MDM) phenotype. We found that in PLWH-derived MDMs, pro-inflammatory signals (TNFA, IL6, IL1B, miR-155-5p, and IDO1) dominate over negative feedback signals (NCOR2, …

Non-Invasive Monitoring Of Human Hygiene Using Vibration Sensor And Classifier, Shashank Trivedi, Maria Valero, Hossain Shahriar, Liang Zhao

Master of Science in Information Technology Theses

This paper presents a concept and an idea of a non-invasive monitoring system for human hygiene using vibration sensors. The approach is based on a combination of geophone sensor, a digitizer, and a cost-efficient computer board in a Raspberry Shake enclosure. People’s personal hygiene habits speak volume about how they take care of their bodies and health. Maintaining good hygiene practices not only reduce your chances of contracting a disease, but it could also reduce the risk of spreading illness within your community. Given the current pandemic, daily habits such as washing hands or taking regular showers have taken major …

Using Artificial Intelligence To Decipher Epigenetic Code Of Drug Resistance In The Deadliest Human Malaria Parasite, Samira Jahangiri

USF Tampa Graduate Theses and Dissertations

Malaria remains one of the immense global public health challenges, with an estimated ~200 million cases worldwide in 2019 despite the remarkable gains in reducing this deadly disease over the past decade. The recent emergence and spread of artemisinin resistance (ART-R) in Plasmodium falciparum will increasingly impede global efforts to control and eliminate malaria. Previous studies have observed broad transcriptional changes and identified several noncoding genetic variants strongly associated with ART-R. The broad transcriptional variations suggest that the malaria parasite uses sophisticated epigenetic regulation to survive under drug pressure. Therefore, evaluating the regulatory effects of noncoding-variants in malaria parasites is …

Case Report: Molecular Diagnosis Of Cystoisospora Belli In A Severely Immunocompromised Patient With Hiv And Kaposi Sarcoma, Roumen Borilov Iordanov, Lauren M Leining, Meng Wu, Galant Chan, Andrew R Dinardo, Rojelio Mejia

Faculty, Staff and Students Publications

Diarrhea in an immunocompromised patient has a broad infectious differential. Diagnosis is difficult despite advances in diagnostic modalities. We report a case of a 45-year-old Nigerian woman who immigrated to the United States 2 years ago. She presented to the hospital with gastrointestinal bleeding, newly diagnosed HIV, and disseminated Kaposi sarcoma. During hospitalization, the patient had an onset of watery diarrhea and high eosinophilia. Subsequent stool analysis using multi-parallel real-time quantitative polymerase chain reaction for 13 parasites was positive for Cystoisospora belli. The patient was treated with trimethoprim-sulfamethoxazole, but had relapsed disease when her antibiotics were stopped prematurely. After restarting …

A Systematic Review Of Health State Utility Values In The Plastic Surgery Literature, Adrienne Christopher, Martin P Morris, Viren Patel, Kevin Klifto, John P Fischer

Department of Surgery Faculty Papers

Cost-utility analyses assess health gains acquired by interventions by incorporating weighted health state utility values (HSUVs). HSUVs are important in plastic and reconstructive surgery (PRS) because they include qualitative metrics when comparing operative techniques or interventions. We systematically reviewed the literature to identify the extent and quality of existing original utilities research within PRS.

Methods: A systematic review of articles with original PRS utility data was conducted in accordance with the Preferred Reporting Items for a Systematic Review and Meta-Analysis guidelines. Subspecialty, survey sample size, and respondent characteristics were extracted. For each HSUV, the utility measure [direct (standard gamble, time …

Exclusive Breastfeeding And Professionals From The Family Health Strategy, Marialda Moreira Christoffel, Ana Leticia Monteiro Gomes, Cássia Leoneuza Augusto Julio, Julia Florentino De Barros, Elisa Da Conceição Rodrigues, Fernanda Garcia Bezerra Góes, Ana Maria Linares

Nursing Faculty Publications

OBJECTIVES: to analyze the perception of health professionals about exclusive breastfeeding in Family Health Strategy units in the city of Macaé.

METHODS: qualitative study carried out in four units of the Family Health Strategy in the city of Macaé, Rio de Janeiro. Thirty health professionals were interviewed from March to May 2019. Textual contents were processed in the IRaMuTeQ^® software by the Descending Hierarchical Classification.

RESULTS: professionals use different strategies for actions to promote, protect and support breastfeeding in prenatal consultations, but social and cultural determinants are important issues that interfere in this process, the involvement of the family …

Outcomes Of Patients With Double/Triple Expressor Diffuse Large B-Cell Lymphoma (Dlbcl) Treated With R-Da-Epoch/R-Chop: A Single-Center Experience, Kanta Devi, Mohammad Usman Shaikh, Natasha Bahadur Ali, Salman Adil, Maria Khan, Salman Muhammad Soomar

Section of Haematology/Oncology

In Pakistan 76.4% of all NHLs to be diagnosed as DLBCLs. The survival of R-CHOP is better compared to the DA-REPOCH treatment regimen. A prospective follow-up study was conducted with 113 patients to study the outcomes of treatment. Multivariable cox-proportional hazard model was used to estimate the hazard ratios in patients receiving these treatment regimens considering p-value ≤0.05 significant. The survival rate among double/triple expressor lymphoma patients received R-DA-EPOCH was 82.8%, and 83.3% received R-CHOP. For double/triple expressor lymphoma patients received R-DA-EPOCH. The findings of our study demonstrated that the survival rate in both R-CHOP and R-DA-EPOCH is mostly …

A Role For Adipocytes And Adipose Stem Cells In The Breast Tumor Microenvironment And Regenerative Medicine, Courtney K. Brock, Katherine L. Hebert, Maria Artiles, Maryl K. Wright, Thomas Cheng, Gabrielle O. Windsor, Khoa Nguyen, Madlin S. Alzoubi, Bridgette M. Collins-Burow, Elizabeth C. Martin, Frank H. Lau, Bruce A. Bunnell, Matthew E. Burow

School of Medicine Faculty Publications

Obesity rates are climbing, representing a confounding and contributing factor to many disease states, including cancer. With respect to breast cancer, obesity plays a prominent role in the etiology of this disease, with certain subtypes such as triple-negative breast cancer having a strong correlation between obesity and poor outcomes. Therefore, it is critical to examine the obesity-related alterations to the normal stroma and the tumor microenvironment (TME). Adipocytes and adipose stem cells (ASCs) are major components of breast tissue stroma that have essential functions in both physiological and pathological states, including energy storage and metabolic homeostasis, physical support of breast …

Case Report: Molecular Diagnosis Of Cystoisospora Belli In A Severely Immunocompromised Patient With Hiv And Kaposi Sarcoma, Roumen Borilov Iordanov, Lauren M Leining, Meng Wu, Galant Chan, Andrew R Dinardo, Rojelio Mejia

Faculty, Staff and Students Publications

Diarrhea in an immunocompromised patient has a broad infectious differential. Diagnosis is difficult despite advances in diagnostic modalities. We report a case of a 45-year-old Nigerian woman who immigrated to the United States 2 years ago. She presented to the hospital with gastrointestinal bleeding, newly diagnosed HIV, and disseminated Kaposi sarcoma. During hospitalization, the patient had an onset of watery diarrhea and high eosinophilia. Subsequent stool analysis using multi-parallel real-time quantitative polymerase chain reaction for 13 parasites was positive for Cystoisospora belli. The patient was treated with trimethoprim-sulfamethoxazole, but had relapsed disease when her antibiotics were stopped prematurely. After restarting …

Sex Modifies Apoe Ε4 Dose Effect On Brain Tau Deposition In Cognitively Impaired Individuals, Shaozhen Yan, Chaojie Zheng, Manish D Paranjpe, Yanxiao Li, Weihua Li, Xiuying Wang, Tammie L S Benzinger, Jie Lu, Yun Zhou

2020-Current year OA Pubs

Recent studies in cognitively unimpaired elderly individuals suggest that the APOE ε4 allele exerts a dosage-dependent effect on brain tau deposition. The aim of this study was to investigate sex differences in APOE ε4 gene dosage effects on brain tau deposition in cognitively impaired individuals using quantitative 18F-flortaucipir PET. Preprocessed 18F-flortaucipir tau PET images, T1-weighted structural MRI, demographic information, global cortical amyloid-β burden measured by 18F-florbetapir PET, CSF total tau and phosphorylated tau measurements were obtained from the Alzheimer's Disease Neuroimaging Initiative database. Two hundred and sixty-eight cognitively impaired individuals with 146 APOE ε4 non-carriers and 122 carriers (85 heterozygotes …

Igg4-Mediated Neurologic Autoimmunities: Understanding The Pathogenicity Of Igg4, Ineffectiveness Of Ivig, And Long-Lasting Benefits Of Anti-B Cell Therapies, Marinos Dalakas

Department of Neurology Faculty Papers

Background and objectives: Describe the unique functions of immunoglobulin G4 (IgG4) in IgG4-neurologic disorders (IgG4-ND) and explain why, in contrast to their IgG1-counterparts, they respond poorly to intravenous immune globulin (IVIg) but effectively to anti-B cell therapies.

Methods: The IgG4 structure and isotype switch, B cells and plasmablasts relevant to IgG4 production, and IgG4-induced disruption of the targeted antigens are reviewed and compared with IgG1-mediated autoimmune ND, where IVIg inhibits IgG1-triggered inflammatory effects.

Results: The main IgG4-ND include muscle-specific kinase myasthenia; nodal/paranodal chronic inflammatory demyelinating polyradiculoneuropathy with antibodies to neurofascin-155, contactin-1/caspr-1, or pan-neurofascins; antileucine-rich, glioma-inactivated-1 and contactin-associated protein-like 2 associated-limbic …

I Am Different, Should I Be Scared Of That-News Article, Naomy Jose

Manipal College of Health Professions, Manipal Theses and Dissertations

This newspaper article talks about the need for inclusion of individuals with different needs in our society.

2021-11-28_Michiganoverview_Covidsymptoms, Michigan Department Of Health & Human Services

Michigan COVID-19 Syndromic Surveillance System Data

The Syndromic Surveillance System Data report was obtained from Michigan's COVID-19 dashboard, from under the link "​Coronavirus Symptoms": https://www.michigan.gov/coronavirus. Data was compiled by the Michigan Department of Health and Human Services (MDHHS). The information was updated three times a week on Mondays, Wednesdays and Fridays.

Syndromic Surveillance System data is obtained from approximately 216 facilities participating in syndromic surveillance (139 Emergency Departments (ED), 77 Urgent Care) across the State of Michigan. The reporting is based on individuals who present at EDs and may not be representative of the overall population. The coronavirus-like symptoms query searches visit free-text (chief complaint, …

Leadership Rounding To Improve Patient Satisfaction In Pediatric Ambulatory Care, Tara J. Haskell

Student Scholarly Projects

Practice Problem: Low patient satisfaction has been linked to poor treatment compliance, patients leaving the practice, staff decreased job satisfaction, and high staff turnover (Haskard Zolnierek & DiMatteo, 2009; Prakash, 2010). Magnet reporting has identified wide discrepancies in ambulatory clinics, with some clinics reporting below benchmark patient satisfaction ratings.

PICOT: In pediatric ambulatory and primary care services, how will the implementation of leader-led customer service rounding, compared to current practice, increase family and/or patient satisfaction over 4 weeks?

Evidence: Key findings are that the rounding needs to be population-specific, intentional, and swiftly followed up when problems are identified. The body …

Rare Case Of Mediastinal Myeloid Sarcoma, Kanta Devi, Salman Adil, Natasha Bahadur Ali, Nasir Ali, Hammad Khan

Section of Haematology/Oncology

Myeloid sarcoma is a rare tumor mass with extra medullary growth pattern, composed of myeloblast or immature myeloid cells. Myeloid sarcoma (MS) is a distinct clinical presentation of acute myeloid leukemia (AML) where less than 1% of patients present with prominent extra medullary disease which most commonly involves the bone, skin, lymph node, soft tissues, gastrointestinal tract or testes. The recommended treatment regimen in isolated myeloid sarcoma or with bone marrow involvement is upfront systemic chemotherapy. We report a case of a young female with anterior mediastinal mass diagnosed as myeloid sarcoma which was refractory to chemotherapy.

Mortality Risk Stratification In Isolated Severe Traumatic Brain Injury Using The Revised Cardiac Risk Index., Maximilian Peter Forssten, Gary Alan Bass, Kai-Michael Scheufler, Ahmad Mohammad Ismail, Yang Cao, Niels Douglas Martin, Babak Sarani, Shahin Mohseni

Surgery Faculty Publications

No abstract provided.

Exploring The Role Of Immune Pathways In The Risk And Development Of Depression In Adolescence: Research Protocol Of The Idea-Flame Study., Valeria Mondelli, Annamaria Cattaneo, Naghmeh Nikkheslat, Laila Souza, Annabel Walsh, Zuzanna Zajkowska, Valentina Zonca, Moira Marizzoni, Helen L Fisher, Brandon A. Kohrt, Christian Kieling, Paola Di Meglio

Psychiatry and Behavioral Sciences Faculty Publications

No abstract provided.

Reducing Burnout Through Guaranteed Breaks In Nurses In The Acute Care Setting: A Benchmark Study, Stefan D. Arias

MSN Capstone Projects

This benchmark study attempts to promulgate the issue of burnout and the importance of addressing at least one way to mitigate further damage to the profession of nursing.

Biocompatible Fepo4 Nanoparticles: Drug Delivery, Rna Stabilization, And Functional Activity, Sagar Rayamajhi, Sarah Wilson, Santosh Aryal, Robert Delong

Pharmacy Faculty Publications and Presentations

FePO4 NPs are of special interest in food fortification and biomedical imaging because of their biocompatibility, high bioavailability, magnetic property, and superior sensory performance that do not cause adverse organoleptic effects. These characteristics are desirable in drug delivery as well. Here, we explored the FePO4 nanoparticles as a delivery vehicle for the anticancer drug, doxorubicin, with an optimum drug loading of 26.81%±1.0%. This loading further enforces the formation of Fe3+ doxorubicin complex resulting in the formation of FePO4-DOX nanoparticles. FePO4-DOX nanoparticles showed a good size homogeneity and concentration-dependent biocompatibility, with over 70% biocompatibility up to 80 µg/mL concentration. Importantly, cytotoxicity …

2021-11-26_Michiganoverview_Covidsymptoms, Michigan Department Of Health & Human Services

Michigan COVID-19 Syndromic Surveillance System Data

The Syndromic Surveillance System Data report was obtained from Michigan's COVID-19 dashboard, from under the link "​Coronavirus Symptoms": https://www.michigan.gov/coronavirus. Data was compiled by the Michigan Department of Health and Human Services (MDHHS). The information was updated three times a week on Mondays, Wednesdays and Fridays.

Syndromic Surveillance System data is obtained from approximately 216 facilities participating in syndromic surveillance (139 Emergency Departments (ED), 77 Urgent Care) across the State of Michigan. The reporting is based on individuals who present at EDs and may not be representative of the overall population. The coronavirus-like symptoms query searches visit free-text (chief complaint, …

Physician-Perceived Barriers To Treating Opioid Use Disorder In The Emergency Department, Gideon Logan, Amber Mirajkar, Jessica Houck, Fernando Rivera-Alvarez, Emily Drone, Parth Patel, Alexandra Craen, Larissa Dub, Nubaha Elahi, David Lebowitz, Ayanna Walker, Latha Ganti

Emergency Medicine Faculty Publications

Objective

We aimed to assess physicians' perceptions of barriers to starting medication-assisted treatment (MAT) in the Emergency Department (ED), views of the utility of MAT, and abilities to link patients with opioid use disorder (OUD) to MAT programs in their respective communities.

Methods

This was a cross-sectional survey study of American emergency medicine (EM) physicians with a self-administered online survey via SurveyMonkey (Survey Monkey, San Mateo, California). The survey was emailed to the Council of Residency Directors in Emergency Medicine (CORD) listserv and HCA Healthcare affiliated EM residency programs' listservs. Attendings and residents of all post-graduate years participated. Questions assessed …

Nucleic Acid-Sensing And Interferon-Inducible Pathways Show Differential Methylation In Mz Twins Discordant For Lupus And Overexpression In Independent Lupus Samples: Implications For Pathogenic Mechanism And Drug Targeting., Miranda C Marion, Paula S Ramos, Prathyusha Bachali, Adam C Labonte, Kip D Zimmerman, Hannah C Ainsworth, Sarah E Heuer, Robert D Robl, Michelle D Catalina, Jennifer A Kelly, Timothy D Howard, Peter E Lipsky, Amrie C Grammer, Carl D Langefeld

Faculty Research 2021

Systemic lupus erythematosus (SLE) is a chronic, multisystem, autoimmune inflammatory disease with genomic and non-genomic contributions to risk. We hypothesize that epigenetic factors are a significant contributor to SLE risk and may be informative for identifying pathogenic mechanisms and therapeutic targets. To test this hypothesis while controlling for genetic background, we performed an epigenome-wide analysis of DNA methylation in genomic DNA from whole blood in three pairs of female monozygotic (MZ) twins of European ancestry, discordant for SLE. Results were replicated on the same array in four cell types from a set of four Danish female MZ twin pairs discordant …

Full Breastfeeding Protection Against Common Enteric Bacteria And Viruses: Results From The Mal-Ed Cohort Study, Benjamin J J. Mccormick, Stephanie A. Richard, Laura E. Murray-Kolb, Gagandeep Kang, Aldo A M. Lima, Estomih Mduma, Margaret N. Kosek, Elizabeth T Rogawski Mcquade, Eric R. Houpt, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background: Breastfeeding is known to reduce risk of enteropathogen infections, but protection from specific enteropathogens is not well characterized.
Objective: To estimate the association between full breastfeeding (days fed breast milk exclusively or with non-nutritive liquids) and enteropathogen detection.
Design: 2,145 newborns were enrolled in eight sites, of whom 1,712 had breastfeeding and key enteropathogen data through 6 months. We focused on eleven enteropathogens: adenovirus 40/41, norovirus, sapovirus, astrovirus, and rotavirus, enterotoxigenic Escherichia coli (ETEC), Campylobacter spp, and typical enteropathogenic E. coli as well as entero-aggregative E. coli, Shigella and Cryptosporidium. Logistic regression was used to estimate the risk of …