Medicine and Health Sciences Commons^™

Genetic Contributors Of Incident Stroke In 10,700 African Americans With Hypertension: A Meta-Analysis From The Genetics Of Hypertension Associated Treatments And Reasons For Geographic And Racial Differences In Stroke Studies, Nicole D. Armstrong, Vinodh Srinivasasainagendra, Amit Patki, Rikki M. Tanner, Bertha A. Hidalgo, Hemant K. Tiwari, Nita A. Limdi, Ethan M. Lange, Leslie A. Lange, Donna K. Arnett, Marguerite R. Irvin

Epidemiology and Environmental Health Faculty Publications

Background: African Americans (AAs) suffer a higher stroke burden due to hypertension. Identifying genetic contributors to stroke among AAs with hypertension is critical to understanding the genetic basis of the disease, as well as detecting at-risk individuals.

Methods: In a population comprising over 10,700 AAs treated for hypertension from the Genetics of Hypertension Associated Treatments (GenHAT) and Reasons for Geographic and Racial Differences in Stroke (REGARDS) studies, we performed an inverse variance-weighted meta-analysis of incident stroke. Additionally, we tested the predictive accuracy of a polygenic risk score (PRS) derived from a European ancestral population in both GenHAT and REGARDS AAs …

2021-12-21_Michiganoverview_Covidlongtermcare, Michigan Department Of Health & Human Services

Michigan COVID-19 Long Term Care Data

The COVID Long Term Care Facilities page was obtained from Michigan's COVID-19 data page: https://www.michigan.gov/coronavirus/0,9753,7-406-98163_98173-526911--,00.html.

This report is created by the Michigan Department of Health & Human Services from data self-reported by long-term care facilities into EMResource. Data for all reporting facilities is posted weekly each Monday.

The information below represents COVID-19 data reported directly to MDHHS by licensed and operating Skilled Nursing, Home for the Aged and Adult Foster Care facilities (licensed to serve 13 or more individuals) in Michigan from January 1, 2020. All long-term care facilities additionally have an obligation to report COVID-positive residents and/or staff …

Late-Life Exercise Mitigates Skeletal Muscle Epigenetic Aging, Kevin A. Murach, Andrea L. Dimet-Wiley, Yuan Wen, Camille R. Brightwell, Christine M. Latham, Cory M. Dungan, Christopher S. Fry, Stanley J. Watowich

Center for Muscle Biology Faculty Publications

There are functional benefits to exercise in muscle, even when performed late in life, but the contributions of epigenetic factors to late-life exercise adaptation are poorly defined. Using reduced representation bisulfite sequencing (RRBS), ribosomal DNA (rDNA) and mitochondrial-specific examination of methylation, targeted high-resolution methylation analysis, and DNAge™ epigenetic aging clock analysis with a translatable model of voluntary murine endurance/resistance exercise training (progressive weighted wheel running, PoWeR), we provide evidence that exercise may mitigate epigenetic aging in skeletal muscle. Late-life PoWeR from 22–24 months of age modestly but significantly attenuates an age-associated shift toward promoter hypermethylation. The epigenetic age of muscle …

Recombinant Human Proteoglycan 4 Regulates Phagocytic Activation Of Monocytes And Reduces Il-1Β Secretion By Urate Crystal Stimulated Gout Pbmcs, Sandy Elsayed, Gregory D. Jay, Ralph Cabezas, Marwa Qadri, Tannin A. Schmidt, Khaled A. Elsaid

Pharmacy Faculty Articles and Research

Objectives

To compare phagocytic activities of monocytes in peripheral blood mononuclear cells (PBMCs) from acute gout patients and normal subjects, examine monosodium urate monohydrate (MSU) crystal-induced IL-1β secretion ± recombinant human proteoglycan 4 (rhPRG4) or interleukin-1 receptor antagonist (IL-1RA), and study the anti-inflammatory mechanism of rhPRG4 in MSU stimulated monocytes.

Methods

Acute gout PBMCs were collected from patients in the Emergency Department and normal PBMCs were obtained from a commercial source. Monocytes in PBMCs were identified by flow cytometry. PBMCs were primed with Pam3CSK4 (1μg/mL) for 24h and phagocytic activation of monocytes was determined using fluorescently labeled latex beads. MSU …

The “Ebb And Flow” Of Documentation: Does The Transition Between Two Electronic Medical Records Systems Affect Emergency Department Efficiency?, Michelle Angeline Md, Erica B. Shaver Md, Christopher Kiefer Md, Kimberly D. Quedado Phd, Melinda Sharon, Stephen Davis Phd, Kyle Hurst Md, Christopher S. Goode Md, Thomas C. Marshall Md

Faculty & Staff Scholarship

Background: Electronic Medical Record (EMR) systems are electronic databases for compiling patient records. As healthcare networks expand, it is critical for providers to have access to patient data more broadly. As a result individual healthcare facilities must adjust to enterprise wide EMRs.

Objective: This study examined the operational effects of transitioning from an Emergency Department (ED) specific EMR to an enterprise wide EMR by evaluating throughput metrics in a community ED.

Methods: During a 6-month transition period (July-December 2017) in a community-based, academic ED located in North Central West Virginia, length of stay (LOS) and the following operational metrics were …

Dysregulation Of Dna Methylation And Epigenetic Clocks In Prostate Cancer Among Puerto Rican Men, Anders Berglund, Jaime Matta, Jarline Encarnación-Medina, Carmen Ortiz-Sanchéz, Julie Dutil, Raymond Linares, Joshua Marcial, Caren Abreu-Takemura, Natasha Moreno, Ryan Putney, Ratna Chakrabarti, Hui Yi Lin, Kosj Yamoah, Carlos Diaz Osterman, Liang Wang, Jasreman Dhillon, Youngchul Kim, Seung Joon Kim, Gilberto Ruiz-Deya, Jong Y. Park

School of Public Health Faculty Publications

In 2021, approximately 248,530 new prostate cancer (PCa) cases are estimated in the United States. Hispanic/Latinos (H/L) are the second largest racial/ethnic group in the US. The objective of this study was to assess DNA methylation patterns between aggressive and indolent PCa along with ancestry proportions in 49 H/L men from Puerto Rico (PR). Prostate tumors were classified as aggressive (n = 17) and indolent (n = 32) based on the Gleason score. Genomic DNA samples were extracted by macro-dissection. DNA methylation patterns were assessed using the Illumina EPIC DNA methylation platform. We used ADMIXTURE to estimate global ancestry proportions. …

Regaining Motion Among Patients With Shoulder Pathology - Are All Exercises Equal?, Alon Rabin, Eran Maman, Oleg Dolkart, Efi Kazum, Zvi Kozol, Timothy L. Uhl, Ofir Chechik

Physical Therapy Faculty Publications

Background: Little information exists to guide the choice of exercise for regaining shoulder range of motion (ROM). The purpose of this study was to compare the maximal ROM reached, pain and difficulty associated with 4 commonly prescribed exercises.

Methods: Forty (9 females) patients with various shoulder disorders and a limited flexion ROM performed 4 exercises for regaining shoulder flexion ROM in a randomized order. Exercises included the self-assisted flexion, forward bow, table slide and rope-and-pulley. Participants were videotaped while performing all exercises and the maximal flexion angle reached during each exercise was recorded using Kinovea motion analysis freeware (Kinovea 0.8.15). …

The Efficacy Of Sequential Biologic Agents In Refractory Rheumatoid Arthritis After Failure Of Initial Dmard And Anti-Tumor Necrosis Factor Therapy, Antonio Giovanni Versace, Caterina Oriana Aragona, Daniela La Rosa, Marianna Chiappalone, Maria Concetta Tringali, Alberta De Gaetano, Charles Frederick Moore Jr., Donatella Sangari, William Neal Roberts, Gianluca Bagnato

Internal Medicine Faculty Publications

Introduction/Objective: The efficacy of biologic therapy in the treatment of rheumatoid arthritis (RA) has been well-established but, in practice, a quarter of patients will either not respond to the first biologic agent or will suffer an adverse event requiring a switch to a different drug. While clinical guidelines exist to help guide therapy and previous studies have examined sequential use of anti-TNF agents, there is little data to inform a multiple switch strategy. Our aim was to measure the efficacy of multiple switches of biologic in severe refractory RA. Methods: We enrolled 111 patients whose therapy with one anti-TNF agent …

Is A Forensic Cohabitation Program Recovery-Oriented? A Logic Model Analysis, Shu-Ping Chen, Wen-Pin Chang, Bryan Fleet, Santoch Rai, Steve Panteluk, Alberto Choy, Deann Hunter

Occupational Therapy Faculty Publications

Background. Recovery orientation is a movement in mental health practice. Although general mental health services have taken the lead in promoting recovery, forensic psychiatric systems have lagged behind because of the need to reconcile recovery principles with the complexities of legal mandates. Advocating recovery and making systemic changes can be challenging because they require seeking a balance between the competing duties to the patient and the public. This paper used a logic model framework to demonstrate a cohabitation program that placed a woman and her newborn infant in a secure forensic rehabilitation unit, and analyzed the key assumptions of recovery …

Adipose-Specific Pparα Knockout Mice Have Increased Lipogenesis By Pask–Srebp1 Signaling And A Polarity Shift To Inflammatory Macrophages In White Adipose Tissue, Terry D. Hinds, Jr., Zachary A. Kipp, Mei Xu, Frederique B. Yiannikouris, Andrew J. Morris, Donald F. Stec, Walter Wahli, David E. Stec

Pharmacology and Nutritional Sciences Faculty Publications

The nuclear receptor PPARα is associated with reducing adiposity, especially in the liver, where it transactivates genes for β-oxidation. Contrarily, the function of PPARα in extrahepatic tissues is less known. Therefore, we established the first adipose-specific PPARα knockout (Ppara^FatKO) mice to determine the signaling position of PPARα in adipose tissue expansion that occurs during the development of obesity. To assess the function of PPARα in adiposity, female and male mice were placed on a high-fat diet (HFD) or normal chow for 30 weeks. Only the male Ppara^FatKO animals had significantly more adiposity in the inguinal white …

Attention Deficit Hyperactivity Disorder And Bipolar Disorder: Diagnosis, Treatments, And Clinical Considerations: A Narrative Review, Amber N. Edinoff, Tucker L. Apgar, Jasmine J. Rogers, Joshua D. Harper, Elyse M. Cornett, Adam M. Kaye, Alan D. Kaye

Pacific Faculty Work

Attention-deficit Hyperactivity Disorder is one of the most common childhood mental health disorders, affecting about 5.6% of the population worldwide. Several studies have specifically shown a high prevalence of comorbid mood disorders, such as depression and bipolar disorder (BD), in those diagnosed with ADHD. Several common symptoms of ADHD are also found in BD, which are characterized by alternating periods of euthymia and mood disturbances. The inattention and impulsivity of ADHD can be seen in manic and hypomanic episodes of BD. Over the past decade, there has been an increased interest in research between the correlation of ADHD and pediatric …

Ongoing Genocides And The Need For Healing: The Cases Of Native And African Americans, Benjamin P. Bowser, Carl O. Word, Kate Shaw

Genocide Studies and Prevention: An International Journal

The elimination of Native peoples and the enslavement of Africans in the U.S. more than qualify as acts of historical state sponsored genocide. A feature of both genocides is that they ended as institutional practices but have continued culturally and psychologically. The primary contemporary legacy of these genocides is racism which reinforces historical trauma and grief. Suggestions are made for how healing for Native and African Americans can begin despite ongoing racism. This includes psychological counseling for White Americans with beliefs in White supremacy. Suggestions are also made for how reconciliation can begin at the county-level between descendants of slave …

A Next Generation Sequencing-Based Protocol For Screening Of Variants Of Concern In Autism Spectrum Disorder, Jie Huang, Jun Liu, Ruiyi Tian, Kevin Liu, Patrick Zhuang, Hannah Tayla Sherman, Christoph Budjan, Michelle Fong, Min-Seo Jeong, Xue-Jun Kong

2020-Current year OA Pubs

Autism spectrum disorder (ASD) is a neurodevelopmental disorder with strong genetic influences. There is an increasing demand for ASD genetic testing beyond the traditionally recommended microarray and syndromic autism testing; however, the current whole genome sequencing (WGS) and whole exome sequencing (WES) methods are lacking an academic standard for WGS variant annotation, reporting, and interpretation, tailored towards patients with ASD and offer very limited interpretation for clinical significance. Using WGS data from six family trios, we demonstrate the clinical feasibility and technical implementation of an evidence-based, fully transparent bioinformatics pipeline and report framework for an ASD-focused WGS genetic report. We …

Recurrent High-Impact Mutations At Cognate Structural Positions In Class A G Protein-Coupled Receptors Expressed In Tumors, Eunna Huh, Jonathan Gallion, Melina A Agosto, Sara J Wright, Theodore G Wensel, Olivier Lichtarge

Faculty, Staff and Students Publications

G protein-coupled receptors (GPCRs) are the largest family of human proteins. They have a common structure and, signaling through a much smaller set of G proteins, arrestins, and effectors, activate downstream pathways that often modulate hallmark mechanisms of cancer. Because there are many more GPCRs than effectors, mutations in different receptors could perturb signaling similarly so as to favor a tumor. We hypothesized that somatic mutations in tumor samples may not be enriched within a single gene but rather that cognate mutations with similar effects on GPCR function are distributed across many receptors. To test this possibility, we systematically aggregated …

Pulsed Chronopotentiometry With Polymer-Based Potassium-Selective Electrodes, Roland A. Long, Kebede L. Gemene Dr.

Posters-at-the-Capitol

This research aimed to develop ion-selective electrodes selective to potassium for use in measuring potassium concentration in blood. Potassium is an important electrolyte within the body, orchestrating nerve excitation, muscular function, and heart rate. Excessive or insufficient potassium levels can cause breakdowns in these systems difficult to differentiate from other potential causes. Isolating potassium concentration as the sole cause necessitates selective measurement. Pulsed Chronopotentiometry with polymer-based membrane electrodes offered a versatile route of interrogation: membrane composition and magnitude of applied current can be altered to assess selectivity in a fast and controlled manner. All potential measurements recorded corresponded to known …

Longs Peak Overlooking Bear Lake In Rocky Mountain National Park, David Wessling

Graduate Medical Education Research Journal

No abstract provided.

Symmetrical Drug-Related Intertriginous And Flexural Exanthema Induced By Cellulitis Prophylaxis, Tiffany Truong, Jonathan H. Ryder, Erica Lee, Clayton Mowrer, Ashley Wysong, Jasmine R. Marcelin

Graduate Medical Education Research Journal

Penicillin VK and hydroxyzine are typically well-tolerated antipruritic agents that are indicated in the prophylaxis of cellulitis. We herein report a case of a unique rash occurring during penicillin VK and hydroxyzine treatment in combination with the ingestion of cashews.

A 77-year-old male presented with new onset rash. Eleven days after the administration of penicillin VK and hydroxyzine for cellulitis prophylaxis, he developed a symmetric, erythematous, scaling rash on his buttocks and perineal region with associated pruritus and bleeding without fevers, chills, adenopathy, night sweats, or any other symptoms. He was diagnosed with symmetrical drug-related intertriginous and flexural exanthema (SDRIFE) …

Endotracheal Tube Dislodgment In A High Risk Pulmonary Hypertensive Patient Due To Undiagnosed Tracheomegaly: A Case Report, Andrew Peck, Tammer N. Ghaly, Austin J. Adams, Daniel W. Johnson, Rebecca A. Aron

Graduate Medical Education Research Journal

Introduction

Airway enlargement was first described histologically in 1872, but it was not clinically reported until 1932, when Dr. Mounier-Kuhn published his seminal radiographic studies.¹ Since then, it is estimated that several hundred case reports have been published on congenital Mounier-Kuhn Syndrome (MKS), acquired tracheomegaly, and tracheobronchomegaly (TBM), yet only a few comprehensive literature reviews exist.²

Case

This case report details an elective nasal procedure for a patient with a history of significant pulmonary hypertension ad COPD on 5L home O₂ who had a symptomatic facial trauma. He was considered high risk secondary to his pulmonary disease, …

Paroxysmal Exertion-Induced Dyskinesia Effectively Treated With Methocarbamol, Deepmala Nandanwar, Julia Pavelka, Diego Torres-Russotto

Graduate Medical Education Research Journal

No abstract provided.

Preventing Bleeding Complications Of Paracentesis Using Point-Of-Care Ultrasound: An N-Of-1 Case Study, Adam Karevoll, Willie Talbert, Christopher J. Smith

Graduate Medical Education Research Journal

Abdominal paracentesis is a common bedside procedure, and the advent of point-of-care ultrasound has provided an opportunity to reduce the associated risks. Multiple society guidelines now recommend both site and vascular marking to avoid potential complications. This case illustrates the importance of vascular marking specifically to avoid damage to adjacent blood vessels.

Retropharyngeal Abscess And Pott’S Disease Due To Tuberculosis: A Case Report, Bailey N. Hassman, Steven D. Curry, Jonathan H. Ryder, Angela L. Hewlett, Jayme R. Dowdall

Graduate Medical Education Research Journal

Introduction: Extrapulmonary mycobacterial infection can lead to vertebral spondylitis and osteomyelitis (Pott’s disease). Retropharyngeal abscess with concurrent spinal osteomyelitis is a rare presentation of tuberculosis in the US. Chart review on a patient was completed, and the relevant published literature was reviewed.

Case Presentation: A previously healthy 34-year-old male originally from Sudan presented to an outside hospital with a 2-month history of neck pain, sore throat, odynophagia, fevers, and chills. MRI showed a retropharyngeal abscess and suspected cervical spine osteomyelitis. Acid-fast bacillus (AFB) smear was positive from a neck drain specimen, but sputum was negative. Chest imaging did not show …

Post-Operative Prescription Of Opioid Medications And Patient Education: A Pilot Study, Gavin Stormont, Alexandra Colvin, Shawna Boyle

Graduate Medical Education Research Journal

Abstract

Introduction:

Opioid medications are essential in the management of pain. 80-85% of surgical patients and 51% of inpatients are discharged with opioid prescriptions. With increased prescriptions, an increase in opioid abuse and overdose was identified. In 2018, nearly 47,000 deaths were reported secondary to opioids. Also, in 2015, 504 billion dollars were spent on the opioid crisis.

Our aim was to determine if our division, urology, was prescribing opioids appropriately in the post-operative setting. We sought to identify gaps in patient knowledge of opioid risks, storage, and disposal.

Methods:

Our institution initiated an after-visit summary (AVS) detailing opioid abuse, …

Assessing The Educational Quality Of Training Videos For Collection Of A Nasopharyngeal Swab, Evan M. Ryan, Matthew T. Solverson, Dallin N. Christensen, Kristy J. Carlson, Kaeli K. Samson, Samuel K. Pate, Jayme R. Dowdall, Christie A. Barnes

Graduate Medical Education Research Journal

Introduction: The SARS-CoV-2 pandemic has forced healthcare systems to disseminate their training materials quickly and broadly, including instruction on identifying cases of infection through correct nasopharyngeal swabbing. Incorrect nasopharyngeal swabbing technique leads to substandard sampling, patient discomfort, and increased risk of complications. We set out to evaluate the quality of educational videos on the nasopharyngeal swab procedure.

Methods: Using video search engines, videos on nasopharyngeal swabbing were identified and distributed to two reviewers. The quality of videos was assessed using a scoring system that examined indications, contraindications, personal protective equipment use, swab depth, swab angle, and audiovisual quality. Descriptive statistics …

A Content Analysis Of The Scholarly Activity Requirements In Acgme-Accredited Residency And Fellowship Programs, Kari Nelson, Jacob Pfeifer, Emily Zurbuchen, Chandrakanth Are

Graduate Medical Education Research Journal

Background: The Accreditation Council for Graduate Medical Education (ACGME) common and specialty program requirements stipulate that residents/fellows participate in scholarly activities. The ACGME provides a reporting template tool for scholarly activity to be utilized by all specialties for evaluation annually. In this study, we aimed to: 1) Conduct a content analysis of the specialty scholarly activity requirements for all ACGME-accredited training programs to identify commonalities and variations, and 2) Assess alignment between the specialty scholarly activity requirements and the reporting template tool provided by the ACGME.

Methods: The scholarly activity requirements for all ACGME-accredited residency and fellowship specialties …

Point Of Care Spirometry Assessment For Pediatric Asthma Prevalence In A Family Homeless Shelter In Omaha, Nebraska, Nathaniel Mattison, Dale Agner, Breanne Parets, Haley Mathews, Emily Saliga, Maria Vacha, Jamicah Harris, Ryan Saliga

Graduate Medical Education Research Journal

Abstract:

Introduction: The few studies on pediatric asthma in US homeless shelters describe a 27.9 – 39.8% prevalence, and historically Omaha has had a high incidence of fatal pediatric asthma. Thereby, Clarkson Family Medicine (CFM) residency began a pediatric asthma outreach to a local family-homeless shelter to assess the prevalence of pediatric asthma and follow-up appointment attendance.

Methods: We obtained a voluntary parent-child assessment of the child’s respiratory history and an Asthma Control Test (ACT) between ages 4-18 for children residing at the family-homeless shelter. We obtained a pre-albuterol and post-albuterol mobile spirometer assessment using the Global Initiative for …

From The Levee, Jimmy Mccluskey

Graduate Medical Education Research Journal

No abstract provided.

Demographic Analysis Of African Americans Enrolled In A Community-Based Diabetes Prevention Program, Kennedy Palmer, Lovoria B. Williams, Hannah Bowman

Posters-at-the-Capitol

Type 2 diabetes (T2D) is preventable. While all racial and ethnic groups are susceptible to the condition, African Americans (AAs) are among the groups with the highest T2D prevalence (13.3%:9.4 %) among their white counterparts. Lifestyle interventions, such as the Diabetes Prevention Program (DPP) effectively decrease incident diabetes by 58%. Moreover, evidence indicates that culturally adapted health interventions enhance subject participation and increase adherence to lifestyle programs. The purpose of this project is to examine the baseline demographics of AA participants of Fit & Faithful, a culturally adapted DPP. Fit & Faithful concentrates on the prominent religious aspect of AA …

Effects Of Covid-19 On Kentucky Air Pollutant Levels, Sarah Hartman, Ritchie Taylor, Jacqueline Basham

Posters-at-the-Capitol

The COVID-19 pandemic is the first of the 21^st century. Nearly 100 years ago, the Spanish Flu killed nearly 50 million people worldwide, including an estimated 675,000 people in the US.₁₂ COVID-19 has proved a deadly disease as well, with nearly 28.1 million cases and 496,000 deaths in the US alone as of February 20^th, 2021.₄ Only a few studies have been conducted regarding air quality response before and after the start of the pandemic. The study found that the NO2 levels decreased and the PM levels also decreased from before to after the beginning …

Measuring The Quality Of Postgraduate Physician Assistant Fellowship/Residency Programs With A Surgical Focus, Lesley Davies, Jacqueline Guarino, Caitlin Justus, Cassandra Mueller Pa-C, Ryan Krasnosky, Jordan Rodriguez, Angelo P. Giardino

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Introduction

Postgraduate programs for PAs provide formal postgraduate training for clinical specialty areas. These programs are intended to provide intense specialty training in various fields, as well as to standardize education beyond the entry level. The purpose of this descriptive study was to determine if there are consistent trends or clear differences in program length, approach to training, validation of learning, and accreditation through the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) for postgraduate programs with a surgical focus in the United States.

Methods

This study is a non-experimental and descriptive research design. Program directors were mailed …

2021-12-20_Michiganoverview_Covidcounts, Michigan Department Of Health & Human Services

Michigan COVID-19 Confirmed Cases by Date of Onset Data

Data was downloaded as an Excel spreadsheet which appeared in the Public Use Datasets section under the Cumulative Data link of Michigan's Coronavirus webpage, under the url https://www.michigan.gov/coronavirus/0,9753,7-406-98163_98173---,00.html.

Cases are aggregated by the date of onset of COVID-19 symptoms, if known, otherwise by laboratory specimen date if known, otherwise by case referral date. Deaths are aggregated by the date of death if known, otherwise by the last date of a change to the case status.