Medicine and Health Sciences Commons^™

Developing A Self-Assessment Instrument To Evaluate Practice-Readiness Among Student Pharmacists, Channing Ford, Kevin N. Astle, Erika L. Kleppinger, Jeanna Sewell, Amber Hutchison, Kimberly B. Garza

Research, Publications & Creative Work

This chapter explores the role of self-assessment in the development of professional identity formation within student pharmacists.

Exploring The Evolution Of Professional Identity Formation In Health Professions Education, Lindsey E. Moseley, Lauren Mcconnell, Kimberly B. Garza, Channing R. Ford

Research, Publications & Creative Work

This article provides a general overview of professional identity formation (PIF) in health professions education, a summary of relevant theories related to PIF, and a description of pedagogical models which promote PIF.

Evaluating The Impact Of A Longitudinal Patient Case On The Development Of Professionalism And Professional Identity, Kimberly B. Garza, Lindsey E. Moseley, Bradley M. Wright, Channing R. Ford

Research, Publications & Creative Work

This article explores the student outcomes of a progressive case on the development of professional identity and professionalism within first-year student pharmacists.

Effects Of Beetroot Juice Supplementation On Cognitive Function, Aerobic And Anaerobic Performances Of Trained Male Taekwondo Athletes: A Pilot Study, Hossein Miraftabi, Zahra Avazpoor, Erfan Berjisian, Amir Sarshin, Sajjad Rezaei, Raul Dominguez, Reid Reale, Emerson Franchini, Mohammad Hossein Samanipour, Majid S. Koozehchian, Mark E.T. Willems, Ramin Rafiei, Alireza Naderi

Research, Publications & Creative Work

: Studies have shown that nitrate (NO3 −)-rich beetroot juice (BJ) supplementation improves endurance and high-intensity intermittent exercise. The dose–response effects on taekwondo following BJ supplementation are yet to be determined. This study aimed to investigate two acute doses of 400 mg of NO3 − (BJ-400) and 800 mg of NO3 − (BJ-800) on taekwondo-specific performance and cognitive function tests compared with a placebo (PL) and control (CON) conditions. Eight trained male taekwondo athletes (age: 20 ± 4 years, height: 180 ± 2 cm, body mass: 64.8 ± 4.0 kg) completed four experimental trials using a randomized, double-blind placebo-controlled design: …

Exploring Standardized Persons' Expectations For Practice-Readiness Among Student Pharmacists, Channing R. Ford, Kevin N. Astle, Kimberly B. Garza, Erika L. Kleppinger

Research, Publications & Creative Work

Although patient expectations and preferences for healthcare selection have been described in the literature, there are no studies exploring what qualities and behaviors standardized persons (SPs) identify for the practice-ready pharmacist. This manuscript explores those qualities and behaviors within an objective structured clinical examination (OSCE) to determine SP interest in having the student as their pharmacy provider. Methods: Using open-ended questions via a Qualtrics survey, SPs were asked to provide qualities and behaviors they associated with each of three practice-readiness rating levels. Using a constant comparative approach, the researchers coded the collected data over multiple stages to allow for authentic …

Assessment Of Professional Identity Formation: Challenges And Opportunities, Kimberly B. Garza, Lindsey E. Moseley, Channing Ford

Research, Publications & Creative Work

This final chapter will discuss challenges of assessing PIF, available assessment tools, and future directions.

A New Aortic Arch Dissection Classification: The Fuwai Classification, Juntao Qiu, Xinjin Luo, Jinlin Wu, Wei Pan, Qian Chang, Xiangyang Qian, Xiaogang Sun, Bo Wei, Liang Zhang, Shen Liu, Wenxiang Jiang, Cuntao Yu

Faculty, Staff and Students Publications

Aims: We describe a new aortic arch dissection (AcD) classification, which we have called the Fuwai classification. We then compare the clinical characteristics and long-term prognoses of different classifications.

Methods: All AcD patients who underwent surgical procedures at Fuwai Hospital from 2010 to 2015 were included in the study. AcD procedures are divided into three types: Fuwai type Cp, Ct, and Cd. Type Cp is defined as the innominate artery or combined with the left carotid artery involved. Type Cd is defined as the left subclavian artery or combined with the left carotid artery involved. All other AcD surgeries are …

Rapid Induction Of The Unfolded Protein Response And Apoptosis By Estrogen Mimic Ttc-352 For The Treatment Of Endocrine-Resistant Breast Cancer, Balkees Abderrahman, Philipp Y Maximov, Ramona F Curpan, Sean W Fanning, Jay S Hanspal, Ping Fan, Charles E Foulds, Yue Chen, Anna Malovannaya, Antrix Jain, Rui Xiong, Geoffrey L Greene, Debra A Tonetti, Gregory R J Thatcher, V Craig Jordan

Faculty, Staff and Students Publications

Patients with long-term estrogen-deprived breast cancer (BC), after resistance to tamoxifen or aromatase inhibitors develops, can experience tumor regression when treated with estrogens. Estrogen’s anti-tumor effect is attributed to apoptosis via the estrogen receptor (ER). Estrogen treatment can have unpleasant gynecological and non-gynecological adverse events thus the development of safer estrogenic agents remains a clinical priority. Here, we study synthetic selective estrogen mimics (SEMs) BMI-135 and TTC-352, and the naturally-occurring estrogen estetrol (E4), which are proposed as safer estrogenic agents compared to 17β-estradiol (E2), for the treatment of endocrine-resistant BC. TTC-352 and E4 are being evaluated in BC clinical trials. …

Market Structure And Quality Of Service: Investigating Oligopolies And The Quality Of Nursing Home Care In California During The Covid-19 Pandemic, Tessa Ireton

Senior Independent Study Theses

Quality-of-service outcomes in nursing homes are of great social and human importance. However, especially during the COVID-19 pandemic, consistently maintaining markets with high quality care has been a pervading issue in the American nursing home industry. Furthermore, the industry is strongly characterized by oligopolies, a market structure that literature indicates may be less compatible with quality service than competitive markets. With this paper, I aim to investigate the possible intersection of oligopolist market structures and the quality of nursing home care during the COVID-19 pandemic. I start by describing quality of care in nursing homes, particularly during the COVID-19 pandemic, …

Pathologic Femur Fracture Through Osteoid Osteoma After Radiofrequency Ablation: Case Report And Review Of The Literature, Nathan B Rogers, Brennan P Roper, Alfred A Mansour

Faculty, Staff and Student Publications

This is a case report of a 4-year-old girl who sustained a femoral shaft fracture 2 weeks after radiofrequency ablation of an osteoid osteoma. The fracture occurred after a relatively low-energy impact, jumping off the second to last step of a staircase. The pathologic fracture was successfully treated with closed reduction and spica casting, with full return to activities. Cases have been reported in the literature of femoral shaft fractures in older patients after radiofrequency ablation, but all are farther out than 2 weeks and none in patients as young as 4 years.

N95 Respirator Reuse, Decontamination Methods, And Microbial Burden: A Randomized Controlled Trial, Zi Yang Jiang, Zhen Huang, Isaac Schmale, Eric L Brown, Michael C Lorenz, Scott J Patlovich, Karan Goswami, Hannah B Wilson, Jumah Ahmad, Ronda Alexander, William Bryan, Luke Burke, Martin J Citardi, Jose Elias, Tang Ho, Jack Jacob, Garren Low, Pedro Miramón, Aniruddha U Patki, William C Yao, Amber U Luong

Faculty, Staff and Student Publications

PURPOSE: To evaluate the effectiveness and ease of N95 respirator decontamination methods in a clinic setting and to identify the extent of microbial colonization on respirators associated with reuse.

METHODS: In a prospective fashion, N95 respirators (n = 15) were randomized to a decontamination process (time, dry heat, or ultraviolet C light [UVC]) in outpatient clinics. Each respirator was re-used up to 5 separate clinic sessions. Swabs on each respirator for SARS-CoV-2, bacteria, and fungi were obtained before clinic, after clinic and post-treatment. Mask integrity was checked after each treatment (n = 68). Statistical analyses were performed to determine factors …

N95 Respirator Reuse, Decontamination Methods, And Microbial Burden: A Randomized Controlled Trial, Zi Yang Jiang, Zhen Huang, Isaac Schmale, Eric L Brown, Michael C Lorenz, Scott J Patlovich, Karan Goswami, Hannah B Wilson, Jumah Ahmad, Ronda Alexander, William Bryan, Luke Burke, Martin J Citardi, Jose Elias, Tang Ho, Jack Jacob, Garren Low, Pedro Miramón, Aniruddha U Patki, William C Yao, Amber U Luong

Faculty, Staff and Student Publications

PURPOSE: To evaluate the effectiveness and ease of N95 respirator decontamination methods in a clinic setting and to identify the extent of microbial colonization on respirators associated with reuse.

METHODS: In a prospective fashion, N95 respirators (n = 15) were randomized to a decontamination process (time, dry heat, or ultraviolet C light [UVC]) in outpatient clinics. Each respirator was re-used up to 5 separate clinic sessions. Swabs on each respirator for SARS-CoV-2, bacteria, and fungi were obtained before clinic, after clinic and post-treatment. Mask integrity was checked after each treatment (n = 68). Statistical analyses were performed to determine factors …

Biomarkers In Acute Myeloid Leukemia: Leveraging Next Generation Sequencing Data For Optimal Therapeutic Strategies, Hanadi El Achi, Rashmi Kanagal-Shamanna

Faculty, Staff and Student Publications

Next generation sequencing (NGS) is routinely used for mutation profiling of acute myeloid leukemia. The extensive application of NGS in hematologic malignancies, and its significant association with the outcomes in multiple large cohorts constituted a proof of concept that AML phenotype is driven by underlying mutational signature and is amenable for targeted therapies. These findings urged incorporation of molecular results into the latest World Health Organization (WHO) sub-classification and integration into risk-stratification and treatment guidelines by the European Leukemia Net. NGS mutation profiling provides a large amount of information that guides diagnosis and management, dependent on the type and number …

Effects Of Image Quantity And Image Source Variation On Machine Learning Histology Differential Diagnosis Models, Elham Vali-Betts, Kevin J Krause, Alanna Dubrovsky, Kristin Olson, John Paul Graff, Anupam Mitra, Ananya Datta-Mitra, Kenneth Beck, Aristotelis Tsirigos, Cynthia Loomis, Antonio Galvao Neto, Esther Adler, Hooman H Rashidi

Faculty, Staff and Student Publications

Aims:

Histology, the microscopic study of normal tissues, is a crucial element of most medical curricula. Learning tools focused on histology are very important to learners who seek diagnostic competency within this important diagnostic arena. Recent developments in machine learning (ML) suggest that certain ML tools may be able to benefit this histology learning platform. Here, we aim to explore how one such tool based on a convolutional neural network, can be used to build a generalizable multi-classification model capable of classifying microscopic images of human tissue samples with the ultimate goal of providing a differential diagnosis (a list of …

The Bmal1/Hif2a Heterodimer Modulates Circadian Variations Of Myocardial Injury, Hui Li, Xinwei Kuang, Long Liang, Youqiong Ye, Yongchang Zhang, Jialu Li, Fangyu Ma, Juan Tao, Guang Lei, Shuang Zhao, Juan Su, Nong Yang, Cong Peng, Xiaowei Xu, Mien-Chie Hung, Leng Han, Hong Liu, Jing Liu, Xiang Chen

Faculty, Staff and Student Publications

Immune checkpoints blockades have shown promising clinical effects in various malignancies, but the overall response rate is low. Here, the immune features are comprehensively characterized in >10 000 cancer patients from The Cancer Genome Atlas and significantly positive correlations are observed between targets of Sunitinib and inhibitory immune checkpoints and suppressive immune cells. It is further confirmed that Sunitinib treatment increases the antitumor immunity in a phase III trial. Mechanistically, it is discovered that Sunitinib regulates the stability of tumor PD‐L1 via p62, that p62 can bind to PD‐L1 and specifically promote its translocation into autophagic lysosome for degradation. Preclinically, …

Pathologic Femur Fracture Through Osteoid Osteoma After Radiofrequency Ablation: Case Report And Review Of The Literature, Nathan B Rogers, Brennan P Roper, Alfred A Mansour

Faculty, Staff and Student Publications

This is a case report of a 4-year-old girl who sustained a femoral shaft fracture 2 weeks after radiofrequency ablation of an osteoid osteoma. The fracture occurred after a relatively low-energy impact, jumping off the second to last step of a staircase. The pathologic fracture was successfully treated with closed reduction and spica casting, with full return to activities. Cases have been reported in the literature of femoral shaft fractures in older patients after radiofrequency ablation, but all are farther out than 2 weeks and none in patients as young as 4 years.

Prevalence And Correlates Of Sex Selling And Sex Purchasing Among Adults Seeking Treatment For Cocaine Use Disorder, Emma C Lathan, Judy H Hong, Angela M Heads, Nicholas C Borgogna, Joy M Schmitz

Faculty, Staff and Student Publications

Exchange sex places individuals with cocaine use disorder (CUD) at particularly high risk for deleterious safety and health outcomes. A substance use treatment provider who is aware of a patient's exchange sex behavior is better able to provide appropriate screening, care, and/or referral to risk reduction services. However, little is known about exchange sex, especially purchasing, among treatment-seeking adults with CUD. The current study examined the prevalence and correlates of sex selling and sex purchasing among treatment-seeking men and women with CUD (

Customizing Early Intervention Treatment For Psychosis In The Uthealth - Harris County Psychiatric Center, Alia R Warner, Gordon C Shen, Jane E Hamilton, Luca Lavagnino, Scott D Lane

Faculty, Staff and Student Publications

High-need, high-cost patients include those with diagnosed serious mental illnesses (e.g., schizophrenia; SMI). They often delay or fail to seek treatment. If they receive treatment, care is often sought from generalist settings (e.g., primary care or emergency medicine) or is suboptimal due to the provision of limited, non-evidence-based intervention and lack of communication, integration, and coordination among providers. This results in high aggregate costs and poor outcomes. Value-based health care requires care coordination to address the medical and social needs of this population. We describe a unique early intervention program for SMI that emanates from an inpatient setting: The Early …

Convergent Evidence For The Antiviral Effects Of Several Fda-Approved Phenothiazine Antipsychotics Against Sars-Cov-2 And Other Coronaviruses, Rodrigo Machado-Vieira, João Quevedo, Lokesh Shahani, Jair C Soares

Faculty, Staff and Student Publications

No abstract provided.

Helicobacter Pylori Diagnosis And Therapy In The Era Of Antimicrobial Stewardship, Akiko Shiotani, Priya Roy, Hong Lu, David Y Graham

Faculty, Staff and Students Publications

The diagnosis and therapy of Helicobacter pylori infection have undergone major changes based on the use the principles of antimicrobial stewardship and increased availability of susceptibility profiling. H. pylori gastritis now recognized as an infectious disease, as such there is no placebo response allowing outcome to be assessed in relation to the theoretically obtainable cure rate of 100%. The recent recognition of H. pylori as an infectious disease has changed the focus to therapies optimized to reliably achieve high cure rates. Increasing antimicrobial resistance has also led to restriction of clarithromycin, levofloxacin, or metronidazole to susceptibility-based therapies. Covid-19 resulted in …

Stress Inoculation Training (Sit-Norcal), Part 1: The Development And Preliminary Evaluation Of A Psychological Performance Training Protocol, Sarah E Jackson, Matthew R Baity, Patrick R Thomas, Douglas Barba, Daniel Jacobson, Madeleine Goodkind, Diane Swick, A Sarah Ivey

Faculty, Staff and Student Publications

Background: Stress inoculation training (SIT) interventions have demonstrated promise within military contexts for human performance enhancement and psychological health applications. However, lack of manualized guidance on core content selection, delivery, and measurement processes has limited their use.

Purpose: The purpose of this study was to develop and evaluate a comprehensive SIT intervention protocol to enhance the performance and health of military personnel engaged in special warfare and first-response activities.

Methods: Multidisciplinary teams of subject matter experts (n = 19) were consulted in protocol generation. The performance improvement/human performance technology (HPT) model was used in the selection, refinement, and measurement of …

Stress Inoculation Training (Sit-Norcal), Part 2: A Pilot Study Among Explosive Ordnance Disposal Special Warfare Enablers, Sarah E Jackson, Matthew R Baity, Patrick R Thomas, Mark Walker, Madeleine Goodkind, Diane Swick, Douglas Barba, Daniel Jacobson, Eric Byrd, A Sarah Ivey

Faculty, Staff and Student Publications

Background: Despite being a well-supported strategy, Stress Inoculation Training (SIT) has not been fully incorporated in the advancement of human performance among most military personnel. The RAND Study recommendations for maximizing SIT's potential within high-risk/ high-intensity occupational groups were used in designing the Core Training protocol targeting psychological performance, SIT-NORCAL (Part 1).

Purpose: The current project (Part 2) sought to further develop the protocol as a health and human performance hybrid through quality improvement analysis of the content, process, and measurement elements for use in the human performance context.

Methods: Evidence-based/evidence-driven methodologies were used in collaborative design tailored to the …

Extensive Mycobacterium Abscessus Pneumonia In An Immunocompetent Infant With No Underlying Lung Pathology, Morouge M Alramadhan, James R Murphy, Michael L Chang

Faculty, Staff and Student Publications

Pulmonary infection due to Mycobacterium abscessus occurs in patients with cystic fibrosis, but rarely in immunocompetent children without underlying lung pathology. Treatment is complicated by frequent resistance to many antibiotics. We present a case report of a 4-month-old female infant with 2 months of cough, difficulty feeding, and failure to thrive, with extensive culture-confirmed M. abscessus pulmonary infection without identified immunodeficiency or underlying lung pathology following multidisciplinary evaluation. We describe our complete evaluation including immunodeficiency evaluation incorporating whole-exome sequencing, describe our antibiotic selection and treatment duration given complicated susceptibility pattern of the M. abscessus isolate, and review literature for nontuberculous …

Recognizing A Mis-Chievous Cause Of Acute Viral Gastroenteritis, Rohit Josyabhatla, Ankur A Kamdar, Shabba A Armbrister, Rhea Daniel, Konstantinos Boukas, Keely G Smith, Melissa R Van Arsdall, Kokila Kakarala, Anthony R Flores, Audrey Wanger, Yuying Liu, Jon Marc Rhoads

Faculty, Staff and Student Publications

Historically, children evaluated for vomiting and diarrhea secondary to viral enteritis have symptoms lasting 2-4 days and respond to supportive care, including oral rehydration and anti-emetics if required. Recently, within a 14-day timespan, we encountered three children with severe diarrhea who rapidly became dehydrated and went into hypotensive shock. Although SARS-CoV-2 molecular tests were negative by nasopharyngeal swab, all were later found to have MIS-C. This small case series underscores features reported in previous larger studies and emphasizes the rapid clinical evolution of this condition. We highlight the importance of early recognition of cardinal laboratory findings characteristic of MIS-C (i.e., …

Indications For Inpatient Magnetoencephalography In Children - An Institution's Experience, Michael W Watkins, Ekta G Shah, Michael E Funke, Stephanie Garcia-Tarodo, Manish N Shah, Nitin Tandon, Fernando Maestu, Christopher Laohathai, David I Sandberg, Jeremy Lankford, Stephen Thompson, John Mosher, Gretchen Von Allmen

Faculty, Staff and Student Publications

Magnetoencephalography (MEG) is recognized as a valuable non-invasive clinical method for localization of the epileptogenic zone and critical functional areas, as part of a pre-surgical evaluation for patients with pharmaco-resistant epilepsy. MEG is also useful in localizing functional areas as part of pre-surgical planning for tumor resection. MEG is usually performed in an outpatient setting, as one part of an evaluation that can include a variety of other testing modalities including 3-Tesla MRI and inpatient video-electroencephalography monitoring. In some clinical circumstances, however, completion of the MEG as an inpatient can provide crucial ictal or interictal localization data during an ongoing …

Clonidine For The Treatment Of Agitation After Dexmedetomidine Discontinuation In Pediatric Patients: A Retrospective Cohort Study, Thao L Nguyen, Weng Man Lam, Hillary Orr, Brian Gulbis, Riza Mauricio, Eric Tom, Vinai M Modem, Alvaro Coronado-Munoz

Faculty, Staff and Student Publications

OBJECTIVE: Dexmedetomidine has become a widely used drug in PICUs for sedation. We aim to determine the effects of clonidine on pediatric patients after dexmedetomidine use.

METHODS: This was a retrospective cohort study that evaluated all pediatric patients admitted to a tertiary PICU who received dexmedetomidine infusion for >48 hours. Outcomes in patients exposed to clonidine (CLON) were compared with those of patients who were not exposed (NoCLON).

RESULTS: A total of 216 patients were included in this study (43 CLON and 173 NoCLON). The primary outcome, agitation, was less in the CLON cohort (9.3%) than in the NoCLON cohort …

Awareness And Preparedness Of Healthcare Workers Against The First Wave Of The Covid-19 Pandemic: A Cross-Sectional Survey Across 57 Countries, Nguyen Tien Huy, R Matthew Chico, Vuong Thanh Huan, Hosam Waleed Shaikhkhalil, Vuong Ngoc Thao Uyen, Ahmad Taysir Atieh Qarawi, Shamael Thabit Mohammed Alhady, Nguyen Lam Vuong, Le Van Truong, Mai Ngoc Luu, Shyam Prakash Dumre, Atsuko Imoto, Peter N Lee, Dao Ngoc Hien Tam, Sze Jia Ng, Mohammad Rashidul Hashan, Mitsuaki Matsui, Nguyen Tran Minh Duc, Sedighe Karimzadeh, Nut Koonrungsesomboon, Chris Smith, Sharon Cox, Kazuhiko Moji, Kenji Hirayama, Le Khac Linh, Kirellos Said Abbas, Tran Nu Thuy Dung, Tareq Mohammed Ali Al-Ahdal, Emmanuel Oluwadare Balogun, Nguyen The Duy, Mennatullah Mohamed Eltaras, Trang Huynh, Nguyen Thi Linh Hue, Bui Diem Khue, Abdelrahman Gad, Gehad Mohamed Tawfik, Kazumi Kubota, Hoang-Minh Nguyen, Dmytro Pavlenko, Vu Thi Thu Trang, Le Thuong Vu, Tran Hai Yen, Nguyen Thi Yen-Xuan, Luong Thi Trang, Vinh Dong, Akash Sharma, Vu Quoc Dat, Mohammed Soliman, Jeza Abdul Aziz, Jaffer Shah, Pham Dinh Long Hung, Yap Siang Jee, Dang Thuy Ha Phuong, Tran Thuy Huong Quynh, Hoang Thi Nam Giang, Vy Thi Nhat Huynh, Nguyen Anh Thi, Nacir Dhouibi, Truc Phan, Vincent Duru, Nguyen Hai Nam, Sherief Ghozy, Tmgh-Global Covid-19 Collaborative

Faculty, Staff and Student Publications

BACKGROUND: Since the COVID-19 pandemic began, there have been concerns related to the preparedness of healthcare workers (HCWs). This study aimed to describe the level of awareness and preparedness of hospital HCWs at the time of the first wave.

METHODS: This multinational, multicenter, cross-sectional survey was conducted among hospital HCWs from February to May 2020. We used a hierarchical logistic regression multivariate analysis to adjust the influence of variables based on awareness and preparedness. We then used association rule mining to identify relationships between HCW confidence in handling suspected COVID-19 patients and prior COVID-19 case-management training.

RESULTS: We surveyed 24,653 …

Pediatric Thalassemic Patients Have Higher Incidence Of Asthma: A Nationwide Population-Based Retrospective Cohort Study, Hsin-Yi Hsieh, Lin-Chi Huang, Hong-Ren Yu, Kuang-Che Kuo, Wan-Hsuan Chen, Chung-Hao Su, Chuan-Pin Lee, Ko-Jung Chen, Yao-Hsu Yang, Jiunn-Ming Sheen

Faculty, Staff and Student Publications

INTRODUCTION: Patients with hemoglobinopathies have been reported to have higher rates of pulmonary complications. Few studies have investigated the association between thalassemia and asthma in children.

METHODS: We used the data of one million individuals randomly selected from the Registry for Beneficiaries of the National Health Insurance Research Database. One thalassemic child was matched with four control children without thalassemia according to sex, birth year, birth season, prematurity, and previous enteroviral infection.

RESULTS: A total of 800 hundred thalassemic children and 3200 controls were included. Children with thalassemia had higher rates of developing asthma (41.81 vs 25.70 per 1000 person-years, …

A Preliminary Dti Tractography Study Of Developmental Neuroplasticity 5–15 Years After Early Childhood Traumatic Brain Injury, Elisabeth A Wilde, Ilirjana Hyseni, Hannah M Lindsey, Jessica Faber, James M Mchenry, Erin D Bigler, Brian D Biekman, Laura L Hollowell, Stephen R Mccauley, Jill V Hunter, Linda Ewing-Cobbs, Mary E Aitken, Marianne Macleod, Zili D Chu, Linda J Noble-Haeusslein, Harvey S Levin

Faculty, Staff and Student Publications

Plasticity is often implicated as a reparative mechanism when addressing structural and functional brain development in young children following traumatic brain injury (TBI); however, conventional imaging methods may not capture the complexities of post-trauma development. The present study examined the cingulum bundles and perforant pathways using diffusion tensor imaging (DTI) in 21 children and adolescents (ages 10-18 years) 5-15 years after sustaining early childhood TBI in comparison with 19 demographically-matched typically-developing children. Verbal memory and executive functioning were also evaluated and analyzed in relation to DTI metrics. Beyond the expected direction of quantitative DTI metrics in the TBI group, we …

As Time Goes By: Understanding Child And Family Factors Shaping Behavioral Outcomes After Traumatic Brain Injury, Linda Ewing-Cobbs, Janelle J Montroy, Amy E Clark, Richard Holubkov, Charles S Cox, Heather T Keenan

Faculty, Staff and Student Publications

Objective: To model pre-injury child and family factors associated with the trajectory of internalizing and externalizing behavior problems across the first 3 years in children with pediatric traumatic brain injury (TBI) relative to children with orthopedic injuries (OI). Parent-reported emotional symptoms and conduct problems were expected to have unique and shared predictors. We hypothesized that TBI, female sex, greater pre-injury executive dysfunction, adjustment problems, lower income, and family dysfunction would be associated with less favorable outcomes.

Methods: In a prospective longitudinal cohort study, we examined the level of behavior problems at 12 months after injury and rate of change from …