Medicine and Health Sciences Commons^™

Resilience: Insights From The U.S. Longterm Ecological Research Network, Jane Cowles, Laura Templeton, John J. Battles, Peter J. Edmunds, Robert C. Carpenter, Stephen R. Carpenter, Michael Paul Nelson, Natalie L. Cleavitt, Timothy J. Fahey, Peter M. Groffman, Joe H. Sullivan, Maile C. Neel, Gretchen J. A. Hansen, Sarah Hobbie, Sally J. Holbrook, Clare E. Kazanski, Eric W. Seabloom, Russell J. Schmitt, Emily H. Stanley, Alan J. Tepley, Natalie S. Van Doorn, Jake M. Vander Zanden

Advanced Science Research Center

Ecosystems are changing in complex and unpredictable ways, and analysis of these changes is facilitated by coordinated, long-term research. Meeting diverse societal needs requires an understanding of what populations and communities will be dominant in 20, 50, and 100 yr. This paper is a product of a synthesis effort of the U.S. National Science Foundation funded Long-Term Ecological Research (LTER) network addressing the LTER core research area of populations and communities. This analysis revealed that each LTER site had at least one compelling story about what their site would look like in 50 or 100 yr. As the stories were …

The Atr-Chek1 Pathway Inhibits Axon Regeneration In Response To Piezo-Dependent Mechanosensation, Feng Li, Tsz Y. Lo, Leann Miles, Qin Wang, Harun N. Noristani, Dan Li, Jingwen Niu, Shannon Trombley, Jessica I. Goldshteyn, Chuxi Wang, Shuchao Wang, Jingyun Qiu, Katarzyna Pogoda, Kalpana Mandal, Megan Brewster, Panteleimon Rompolas, Ye He, Pau A. Janmey, Gareth M. Thomas, Shuxin Li, Yuanquan Song

Advanced Science Research Center

Atr is a serine/threonine kinase, known to sense single-stranded DNA breaks and activate the DNA damage checkpoint by phosphorylating Chek1, which inhibits Cdc25, causing cell cycle arrest. This pathway has not been implicated in neuroregeneration. We show that in Drosophila sensory neurons removing Atr or Chek1, or overexpressing Cdc25 promotes regeneration, whereas Atr or Chek1 overexpression, or Cdc25 knockdown impedes regeneration. Inhibiting the Atr-associated checkpoint complex in neurons promotes regeneration and improves synapse/behavioral recovery after CNS injury. Independent of DNA damage, Atr responds to the mechanical stimulus elicited during regeneration, via the mechanosensitive ion channel Piezo and its downstream NO …

Connectivity: Insights From The U.S. Long Term Ecological Research Network, David M. Iwaniec, Michael Gooseff, Katharine N. Suding, David Samuel Johnson, Daniel C. Reed, Debra P. C. Peters, Byron Adams, John E. Barrett, Brandon T. Bestelmeyer, Max C. N. Castorani, Elizabeth M. Cook, Melissa J. Davidson, Peter M. Groffman, Niall P. Hanan, Laura F. Huenneke, Pieter T. J. Johnson, Diane M. Mcknight, Robert J. Miller, Gregory S. Okin, Daniel L. Preston, Andrew Rassweiler, Chris Ray, Osvaldo E. Sala, Robert L. Schooley, Timothy Seastedt, Marko J. Spasojevic, Enrique R. Vivoni

Advanced Science Research Center

Ecosystems across the United States are changing in complex and surprising ways. Ongoing demand for critical ecosystem services requires an understanding of the populations and communities in these ecosystems in the future. This paper represents a synthesis effort of the U.S. National Science Foundation-funded Long-Term Ecological Research (LTER) network addressing the core research area of “populations and communities.” The objective of this effort was to show the importance of long-term data collection and experiments for addressing the hardest questions in scientific ecology that have significant implications for environmental policy and management. Each LTER site developed at least one compelling case …

Systematic Review Shows Tele-Rehabilitation Might Achieve Comparable Results To Office-Based Rehabilitation For Decreasing Pain In Patients With Knee Osteoarthritis, Tamila Latif-Zade, Brian Tucci, Danna Verbovetskaya, Elizabeth Bialkin, Brian Ng, Stephan Heddon, Jean-Philippe Berteau

Advanced Science Research Center

Background and Objectives: This systematic review aims to evaluate the efficacy of Tele- Rehabilitation for decreasing pain in patients with knee osteoarthritis (OA). Materials and Methods: Following the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), three electronic databases (CINAHL, PubMed, PEDro), along with the addition of grey literature, were used to collect information. Randomized control trials (RCTs) comparing tele- rehabilitation (TR) to office-based-rehabilitation (OB) were critically appraised using the 2005 Uni- versity of Oxford Standard. A total of 139 articles (PubMed = 132, CINAHL = 5, PEDro = 0, grey literature = 2) were acquired. Results: …

Distinct Cellular Profiles Of Hif1a And Vegf Mrna Localization In Microglia, Astrocytes And Neurons During A Period Of Vascular Maturation In The Auditory Brainstem Of Neonate Rats, Daphne Chang, Quetanya Brown, Grace Tsui, Ye He, Jia Liu, Lingyan Shi, Adrián Rodríguez-Contreras

Advanced Science Research Center

Defining the relationship between vascular development and the expression of hypoxia-inducible factors (Hifs) and vascular endothelial growth factor (Vegf) in the auditory brainstem is important to understand how tissue hypoxia caused by oxygen shortage contributes to sensory deficits in neonates. In this study, we used histology, molecular labeling, confocal microscopy and 3D image processing methods to test the hypothesis that significant maturation of the vascular bed in the medial nucleus of the trapezoid body (MNTB) occurs during the postnatal period that precedes hearing onset. Isolectin-B4 histochemistry experiments suggested that the MNTB vasculature becomes more elaborate between …

Interpersonal Psychotherapy Delivered By Nonspecialists For Depression And Posttraumatic Stress Disorder Among Kenyan Hiv–Positive Women Affected By Genderbased Violence: Randomized Controlled Trial, Susan M. Meffert, Thomas C. Neylan, Charles E. Mcculloch, Kelly Blum, Craig R. Cohen, Elizabeth Bukusi, Helen Verdel, John C. Markowitz, James G. Kahn, David Bukusi

Obstetrics and Gynaecology, East Africa

Background: HIV–positive women suffer a high burden of mental disorders due in part to gender-based violence (GBV). Comorbid depression and posttraumatic stress disorder (PTSD) are typical psychiatric consequences of GBV. Despite attention to the HIV-GBV syndemic, few HIV clinics offer formal mental healthcare. This problem is acute in sub-Saharan Africa, where the world’s majority of HIV–positive women live and prevalence of GBV is high.

Methods and findings: We conducted a randomized controlled trial at an HIV clinic in Kisumu, Kenya. GBV-affected HIV–positive women with both major depressive disorder (MDD) and PTSD were randomized to 12 sessions of interpersonal psychotherapy (IPT) …

Learning From Changes Concurrent With Implementing A Complex And Dynamic Intervention To Improve Urban Maternal And Perinatal Health In Dar Es Salaam, Tanzania, 2011-2019, Brenda Sequeira Dmello, Ziada Sellah, Grace Magembe, Natasha Housseine, Nanna Maaløe, Thomas Van Den Akker, Dan W. Meyrowitsch, Timothy Mushi, Mangalu Masweko, Hussein Kidanto

Obstetrics and Gynaecology, East Africa

Introduction: Rapid urbanisation in Dar es Salaam, the main commercial hub in Tanzania, has resulted in congested health facilities, poor quality care, and unacceptably high facility-based maternal and perinatal mortality. Using a participatory approach, the Dar es Salaam regional government in partnership with a non-governmental organisation, Comprehensive Community Based Rehabilitation in Tanzania, implemented a complex, dynamic intervention to improve the quality of care and survival during pregnancy and childbirth. The intervention was rolled out in 22 public health facilities, accounting for 60% of the city’s facility births.

Methods: Multiple intervention components addressed gaps across the maternal and perinatal continuum of …

Covid-19 And Teleneurology In Sub-Saharan Africa: Leveraging The Current Exigency, Philip Adebayo, Olusegun John Oluwole, Funmilola Tolulope

Internal Medicine, East Africa

Africa has over 1.3 billion inhabitants, with over 60% of this population residing in rural areas that have poor access to medical experts. Despite having a ridiculously huge, underserved population, very few African countries currently have any form of sustained and organized telemedicine practice, and even fewer have dedicated tele-neurology services. The ongoing COVID-19 pandemic has proved to be one of the most significant disruptors of vital sectors of human endeavor in modern times. In the healthcare sector, there is an increasing advocacy to deliver non-urgent care via telemedicine. This paper examined the current state of tele-neurology practice and infrastructural …

Designing Your Qi Project With Publication In Mind, Richard Alweis

CHED Talks

This presentation describes a process for designing your QI project with publication in mind, taking a step-by-step approach. Examples are given of successful QI project publications with analysis of what may have made them successful.

Maternal Feeding Practices And Toddlers’ Fruit And Vegetable Consumption: Results From The Dit - Coombe Hospital Birth Cohort In Ireland, Xiyao Liu, Qianling Zhou, Keara Clarke, Katherine Younger, Meijing An, Zhouyinuo Li, Yang Tan, John Kearney

Articles

Health benefits of fruit and vegetable have been well recognized. However, insufficient consumption of fruit and vegetable is prevalent among toddlers, and has become a global public health issue. Maternal feeding practices are potential factors influencing toddlers’ dietary intake, including fruit and vegetable intake. This study was conducted to explore the influence of maternal feeding practices on toddlers’ fruit and vegetable consumption in Ireland.

Diagnosis And Intervention Of Posterior Shoulder Impingement In A Non-Throwing Athlete, K Orrick

Clinical Practice in Athletic Training

Background: Posterior impingement, also commonly called internal impingement, is identified by a repetitive compression of the posterosuperior aspect of the glenoid by the greater tuberosity of the humeral head when the arm is in an abducted and externally rotated position. There are multiple possible causes of this impingement. One of the most frequent contributors is scapular dyskinesis, where the scapula does not track properly with overhead movement due to weakness. Other contributors include kinetic chain instabilities found in the spine, core, and lower extremity, as well as glenohumeral instability causing a shift in the humeral head. Posterior impingement is commonly …

Treatment And Management Of Complex Knee Injury: A Case Report, K Braunreiter, S Kerwin

Clinical Practice in Athletic Training

Background: The “unhappy triad” injury includes tears of the anterior cruciate ligament, medial collateral ligament, and medial meniscus. There is limited research on the prevalence and outcome of this injury. The unique surgical repair consisting of lateral extra-articular tenodesis (LET) was utilized to reinforce the anterior cruciate ligament repair (ACLR) and to prevent rerupture. Due to this extensive surgery, the patient struggled to regain full range of motion and quadriceps activation. This case is a Level 2 case study that explores the different interventions used to address the aforementioned objective deficits and return him safely to play. Patient: The patient …

A Proposed Return-To-Ride Protocol For United States Jockeys Following Concussion, Carolina Quintana, Kimberly I. Tumlin, Matthew C. Hoch, Nicholas R. Heebner, Bianca L. Grimshaw, Carl G. Mattacola

Clinical Practice in Athletic Training

Professional horse racing jockeys participate in a high-risk sport, however there is limited research and policies regarding welfare and safety. Despite the high incidence and risk of concussions, there are not standardized protocols for returning these unique athletes to participation following concussion. A return-to-ride concussion protocol for thoroughbred horse racing athletes must take into account the unique considerations and practices of the sport. Current concussion management strategies suggest removal from riding and activity when a concussion is suspected. This is followed by further evaluation for diagnosis, a period of both cognitive and physical rest before a gradual return-to-activity prior to …

Racial And Ethnic Disparities In Pain Management, Nicolette A. Harris, Samar Long

Clinical Practice in Athletic Training

Pain is subjective, which makes its management a complicated task. The challenge of medical decision-making associated with pain often requires health care providers to rely heavily on their individual discretion and experience. This often creates an avenue for biases to play a role in the selection of the best available and most appropriate pain management interventions. Therefore, the overall purpose of this review is to summarize the current literature related to racial and ethnic disparities in pain management. Electronic searches of four databases revealed 2,112 articles; however, only six studies met criteria for inclusion in this review. Even when the …

Redeployment Of Athletic Trainers During A Pandemic, James Caiola

Clinical Practice in Athletic Training

Before COVID-19 was recognized as a global pandemic involving the United States of America in March of 2020, MedStar Health employed 40 Athletic Trainers (ATs) in multiple settings. While ATs worked in the traditional setting at 17 high schools, 2 universities, and with 2 professional teams in the Baltimore, MD and Washington, DC area, they also have been used in nontraditional ways. They are used in the physician practice setting to manage clinic flow, evaluate patients and present to the physician, provide pre- and post-surgical patient education, and being an overall patient point of contact in a busy clinic. They …

Identifying Sleep-Related Factors Associated With Cognitive Function In A Hispanics/Latinos Cohort: A Dual Random Forest Approach, Li Xiaojin, Cui Licong, Wang Fei, Paul E Schulz, Guo-Qiang Zhang

Faculty, Staff and Student Publications

Disordered sleep is associated with poor cognitive function and cognitive decline. However, little is known regarding the association of sleep-related factors with cognitive function in underrepresented cohorts such as the Hispanic/Latino population. Leveraging the National Sleep Research Resource, one of the most comprehensive collections of sleep studies, we identified a Hispanic/Latino cohort of 1,031 lower cognitive function cases and 2,062 normal controls. We developed a novel dual random forest (DRF) approach to discriminate cases against controls for estimating the potential impact of sleep-related variables related to the decline of cognitive function. Several important sleep-related factors were identified which may be …

Routine Outpatient Electrocardiogram: What Is The Diagnosis?, Muzamil Khawaja, Vincent R J Siebert, John Allison, Yochai Birnbaum

The Texas Heart Institute Journal

No abstract provided.

Improper Use Of Temporary Epicardial Pacing Wires, Emre Kubat, Isil Tasoz, Kubilay Karabacak, Suat Doganci

The Texas Heart Institute Journal

No abstract provided.

Aadej Comm 7 3 2021

AADEJ - The Communicator

The Communicator is the official journal of the American Association of Dental Editors and Journalists (AADEJ). It is published quarterly, distributed digitally via email to members, and posted on the Association's website, AADEJ.org. Each issue includes regular updates from the editorial team and AADEJ board, as well as feature articles on current issues in the field.

Aadej Comm 7 4 2021

AADEJ - The Communicator

The Communicator is the official journal of the American Association of Dental Editors and Journalists (AADEJ). It is published quarterly, distributed digitally via email to members, and posted on the Association's website, AADEJ.org. Each issue includes regular updates from the editorial team and AADEJ board, as well as feature articles on current issues in the field.

Single-Dose Del Nido Cardioplegia Compared With Standard Cardioplegia During Coronary Artery Bypass Grafting At A Veterans Affairs Hospital, Michael R Reidy, Ernesto Jimenez, Shuab Omer, Lorraine D Cornwell, Sabrina X Runbeck, Ourania Preventza, Gabriel Loor, Todd K Rosengart, Joseph S Coselli

The Texas Heart Institute Journal

Del Nido cardioplegic solution (DNC), used chiefly in pediatric patients, rapidly induces prolonged cardiac arrest during cardiac surgery. To determine whether surgical outcomes after coronary artery bypass grafting in a United States military veteran population differed when DNC was used instead of our standard Plegisol cardioplegia, we retrospectively reviewed 155 consecutive operations performed from July 2016 through June 2017. Del Nido cardioplegia was used to induce cardiac arrest in 70 patients, and Plegisol in 85. Compared with the Plegisol group, the DNC group had a shorter mean cardiopulmonary bypass time (96.8 vs 117 min; P48 hours, atrial fibrillation, tracheostomy, reintubation, …

Benign Metastasizing Leiomyoma In The Heart Of A 45-Year-Old Woman, Mohamad Karnib, Isaac Rhea, Robin Elliott, Saneka Chakravarty, Sadeer G Al-Kindi

The Texas Heart Institute Journal

We report a rare case of benign metastasizing leiomyoma in the heart of a 45-year-old woman 2 years after a uterine leiomyoma had been discovered during hysterectomy. Computed tomograms at presentation showed a large mixed cystic mass in the pelvis and bilateral lung nodules suggestive of metastatic disease. A large cardiac mass, attached to the chordae of the tricuspid valve and later shown to be histopathologically consistent with uterine leiomyoma, was successfully resected through a right atriotomy. This case suggests that benign metastasizing leiomyoma should be considered in the differential diagnosis of right-sided cardiac tumors.

Contraceptive Accessibility And Reproductive Outcomes In Adolescents Seeking Care At School-Based Health Centers: A Systematic Review, Jamie Jenkins

All Graduate Theses, Dissertations, and Other Capstone Projects

Context: Adolescent pregnancy continues to be a public health concern in the United States. School-based health centers are an ideal setting for providing affordable, accessible, and confidential reproductive services for adolescents that can help prevent unintended pregnancies. However, there are great variations in the reproductive services offered at school-based health centers across the United States. Objective: This study aims to explore the question: Do school-based health centers that provide on-site contraception access have lower adolescent pregnancy rates and higher reported contraception use when compared to school-based health centers that do not provide on-site contraception? Methods: A literature …

The Primary Care Provider’S Role In Screening And Intervening In The Human Trafficking Of Adolescents: A Systematic Literature Review, Brittany Schmid

All Graduate Theses, Dissertations, and Other Capstone Projects

Human trafficking (HT) is a growing concern within the United States (U.S.) and internationally. With the alarming number of HT victims presenting for medical care, primary care providers (PCPs) are in a unique and privileged position to encounter HT victims within the healthcare system. Adolescents, in particular, are vulnerable to HT because of minimal life experiences, inadequate social support, and limited coping mechanisms (Ertl et al., 2020). Failure to recognize and intervene in cases involving HT victims who are minors is detrimental to the individual’s health, wellbeing, and safety. With the assistance of education and training, community resources, guideline adoption, …

The Impact Of Social Isolation And Cognitive Decline In Older Adults: A Systematic Literature Review, Jody L. Doll-Wilhelm

All Graduate Theses, Dissertations, and Other Capstone Projects

Background: During the COVID-19 pandemic, deaths of Alzheimer’s Disease (AD) and dementia patients surged. Increased social isolation and decreased activity levels in older adults have been suggested as contributing factors to accelerating AD and dementia. However, assessment tools to gauge interventions and outcomes of cognitive decline are variable among the literature.

Objective: Examine the impact of social engagement versus social isolation, like that experienced with the COVID-19 pandemic, on cognitive decline/dementia in older adults (greater than 60 years of age).

Method: A systematic search for studies evaluating the relationship between social isolation and social activity in cognitive …

Factors Influencing Contraception Use In Sexual Minority Women: A Systematic Literature Review, Grace M. Hudson

All Graduate Theses, Dissertations, and Other Capstone Projects

Contrary to widespread beliefs that lesbian, gay, bisexual, transgender, queer, plus (LGBTQ+) women do not need contraceptive care, sexual minority women (SMW) engage in vaginal-penile sexual contact which puts them at risk for unintended pregnancy. SMW assigned female gender at birth are at higher risk for less reliable and consistent contraceptive use and thus unintended pregnancy (Everett et al., 2017). This leads to the question of factors which cause SMW to be less engaged in contraceptive services. Through synthesis of studies addressing SMW and contraceptives, four themes developed: attitudes towards contraception, obstacles to care, knowledge gaps, and ways to improve …

Effectiveness Of Behavior-Based Counseling For Weight Loss Maintenance: A Systematic Literature Review, Jaime V. Stanczyk

All Graduate Theses, Dissertations, and Other Capstone Projects

Obesity is linked to the development of chronic health conditions such as diabetes, hypertension, and atherosclerotic cardiovascular disease (ASCVD) at an annual expense of $147 billion in related healthcare costs. Effective lifestyle modification treatment for long-term WLM remains elusive. Traditional advice from primary care providers regarding dietary modification and increased physical activity has not led to WLM as a long-term outcome. Newer guidelines for the treatment of obesity now recommend high-intensity behavior-based counseling (BBC) programs that deliver traditional weight loss education in tandem with behavior-change strategies. Methods: A database search was conducted for peer reviewed literature published in 2012-2020 on …

Advance Care Planning And Palliative Care In Heart Failure: A Literature Review, Laura Dack

All Graduate Theses, Dissertations, and Other Capstone Projects

Despite advancing therapies, heart failure remains a progressive disease with high symptom burden. Advance care planning and palliative care assist in maximizing the quality of life for affected individuals. These interventions are supported by current heart failure guidelines yet application into practice is poor. The purpose of this literature review is to investigate the relationship between advance care planning and palliative care interventions on the quality of life of adults with heart failure. A search of the literature was completed between October 20^th, 2020 to November 10^th, 2020. Databases searched include Academic Search Premier, CINAHL Plus, …

Choosing Between Medical Surveillance And Preventive Surgical Interventions Among Asymptomatic Brca Positive Women, Hillary Zupan

All Graduate Theses, Dissertations, and Other Capstone Projects

Women with a known BRCA 1 or BRCA 2 genetic mutation are at an increased risk for the development of cancer, most commonly breast and uterine types. Risk reduction strategies to manage cancer risk include increased medical surveillance and various preventive surgeries. This is a deeply personal decision and one that is influenced by a variety of factors. The aim of this literature review is to identify the key factors impacting the decision-making process of a woman with a BRCA mutation and how a woman ultimately decides between the cancer risk management strategies. Six electronic databases were used to obtain …

Why End-Of-Life Discussion Matters: A Systematic Literature Review, Emily Grandson

All Graduate Theses, Dissertations, and Other Capstone Projects

End-of-life (EOL) discussions are a challenging yet vital topic of conversation in intensive care units (ICU) between healthcare providers, patients, and their families. There is great disparity in where, when, and how EOL discussions take place, but the consequences of neglecting their importance can be devastating physically, psychologically, and financially for all parties involved. Multiple inadequacies in the EOL discussion process have not only contributed to a personal and societal financial burden but an unacceptable quality of death for many ICU patients. A literature review was performed to determine what practice and policy changes could be made to improve EOL …