Medicine and Health Sciences Commons^™

The Enhanced Brief Structured Observation Model: Efficiently Assess Trainee Competence And Provide Feedback., Scott Baumgartner, Dewesh Agrawal, Larrie Greenberg

Health Sciences Education Research

Introduction: The regular observation of trainees is essential to ascertain trainee proficiency in competency-based assessments. Unfortunately, observation of residents is not frequent enough to facilitate entrustment decisions, and the busy clinician-educator may not have the tools or time to conduct effective and efficient observations.

Methods: We created a hands-on faculty development workshop utilizing an enhanced variation of the brief structured observation (BSO) technique to train both primary care and subspecialty pediatric faculty on how to effectively and efficiently observe trainees. The workshop has provided faculty a practical approach to observing trainees in a focused fashion and providing effective feedback on …

Residents' Confidence In Performing Robotic Hysterectomy In Obstetrics And Gynecologic Training Programs., Gregory M Gressel, Karen George, Mark B Woodland, Erika Banks

Health Sciences Education Research

STUDY OBJECTIVE: To compare residents' perceptions of readiness to perform robotic-assisted laparoscopic hysterectomy with the perceptions of residency program directors in obstetrics and gynecology programs throughout the United States.

DESIGN: A survey was administered to all residents taking the 2019 Council on Resident Education in Obstetrics and Gynecology Exam and concurrently to program directors in all Accreditation Council for Graduate Medical Education-accredited training programs.

SETTING: The survey was designed to assess resident confidence to perform robotic hysterectomies by the time of graduation.

PATIENTS: No patients were included in the study.

INTERVENTIONS: The only intervention was administration of the survey.

MEASUREMENTS …

2021-05-05_Michiganoverview_Covidstats, Michigan Department Of Health & Human Services

Cumulative Michigan COVID-19 Data

The COVID Overview page was obtained from Michigan's main COVID-19 page: https:/www.michigan.gov/coronavirus/0,9753,7-406-98163-520743--,00.html.

The State of Michigan is working around the clock to test and treat COVID-19 patients. Below is the most recent data healthcare experts across the state have compiled. It is updated Monday - Saturday.
This report is provisional and subject to change. City of Detroit and Wayne County are reported separately. MDHHS began tracking probable cases April 5, 2020. FCI indicates federal correctional institute. MDOC indicates Michigan Department of Corrections. Diagnostic tests, including nucleic acid amplification/real-time polymerase chain reaction (NAAT/RT-PCR) and rapid virus antigen detection point of …

Doctoral Capstone Experience In Program Development - Valley Rescue, Kyra P. Brown

Department of Occupational Therapy Entry-Level Capstone Projects

Homelessness is an increasing problem with various implications on individual’s physical, mental, and occupational wellness (Tsang et al., 2013). Occupational therapy is positioned to provide holistic, client-centered, and trauma-informed care to those experiencing homelessness (Salsi et al., 2017). While residents at Valley Rescue Women and Children’s Center (Valley Rescue) have access to a variety of services, occupation-based education and interventions are extremely limited. This paper describes the completion of a capstone experience at Valley Rescue, with a focus in program development and advocacy. Residents of the shelter expressed interest in education on mental health and wellness and occupational engagement. Throughout …

Control Of Perivascular Adipose Tissue Differentiation During Cardiovascular Disease, Katie Stieber

Costas T. Lambrew Research Retreat 2021

Hypothesis: Lower BMI will correlate with lower RAB27a expression

Chemical Exposure From Manufactured Gas Plants: Demographic & Governmental Research, Aneeza Hussain

Publications and Research

There are thousands of brownfields in New York on former Manufactured Gas Plants (MGP) similar to the Public Place site in Gowanus, Brooklyn. Public Place is an active brownfield abutting an EPA Superfund site currently undergoing remediation. After consulting recent literature finding that populations living on and near superfund sites have lower life expectancy that also correlate with “sociodemographic factors” like income and race, we used American Community Survey data to conduct a demographic analysis of census districts within the rezone area. Assessment of current demographic data shows that Gowanus residents living within census districts overlapping with the rezone area …

Evaluation Of A Keratin 1 Targeting Peptide-Doxorubicin Conjugate In A Mouse Model Of Triple-Negative Breast Cancer, Azam Saghaeidehkordi, Shiuan Chen, Sun Yang, Kamaljit Kaur

Pharmacy Faculty Articles and Research

Chemotherapy is the main treatment for triple-negative breast cancer (TNBC), a subtype of breast cancer that is aggressive with a poor prognosis. While chemotherapeutics are potent, these agents lack specificity and are equally toxic to cancer and nonmalignant cells and tissues. Targeted therapies for TNBC treatment could lead to more safe and efficacious drugs. We previously engineered a breast cancer cell targeting peptide 18-4 that specifically binds cell surface receptor keratin 1 (K1) on breast cancer cells. A conjugate of peptide 18-4 and doxorubicin (Dox) containing an acid-sensitive hydrazone linker showed specific toxicity toward TNBC cells. Here, we report the …

2021-05-05_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 daily.

Syndromic Surveillance System data is obtained from approximately 183 facilities participating in syndromic surveillance (132 Emergency Departments (ED), 51 Urgent Cares) 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, triage notes, and clinical impression) for fever or …

2021-05-05_Michigandaily_Covidmap, Michigan Department Of Health & Human Services

Daily Michigan COVID-19 Update

The "WHERE WE STAND WITH COVID-19" map was obtained from Michigan's main COVID-19 page: https://www.michigan.gov/coronavirus. Data was compiled by the Michigan Department of Health and Human Services (MDHHS). The information was updated daily at 3p.m., Monday - Saturday.

The State of Michigan is working around the clock to test and treat COVID-19 patients. Below is the most recent data healthcare experts across the state have compiled.

The image contained a map, indicating total cases by county, and also provides statistics on Total Confirmed Cases, Total COVID-19 Deaths, Daily Confirmed Cases, and Daily COVID-19 Deaths. There …

2021-05-05_Michiganoverview_Covidbedppe, Michigan Department Of Health & Human Services

Michigan COVID-19 Hospital Data

Contains the tables Statewide Hospital Capacity Report for COVID-19, COVID-19 Metrics, Statewide Hospital Available PPE Tracking for COVID-19, as well as the tables PPE Days On Hand and Patient Census.

2021-05-05_Michiganoverview_Covidtestingtimes, Michigan Department Of Health & Human Services

Michigan COVID-19 Testing Turnaround Data

The COVID Testing Turnaround Time page was obtained from Michigan's COVID-19 data page: https://www.michigan.gov/coronavirus/0,9753,7-406-98163_98173-545615--,00.html.

This report was created by the Michigan Department of Health & Human Services, providing data for the past 14 days on the average time it takes for a diagnostic COVID-19 laboratory test to be reported to the state health department. Testing turnaround time data will be updated weekly on Friday mornings.

MDHHS receives results from commercial labs, hospitals, and public health labs. However, public health laboratories perform limited diagnostic testing and disease surveillance for infectious diseases. Total turnaround time is calculated from the difference of …

Interfacial Dynamics And Ionic Transport Of Radiologic Contrast Media In Carbohydrate Matrix: Utility And Limits Of X-Ray Imaging, Lin Mousa, Hayley Sanchez, Subhendra Sarkar, Zoya Vinokur

Publications and Research

Hello, our names are Lin Mousa and Hayley Sanchez, this semester we participated in a research project dedicated to analyzing the interactions of contrast media with the molecular components of fruits to compare how they would react with the human brain. This project involved the injection of fruits with varying contrasts and the imaging of the diffusion and interactions of the contrast within the fruits with X-rays. With setup technical parameters on the x-ray equipment images were taken with identical setups at an hourly rate for several days. The final results of this experiment indicated that contrasts such as Gadolinium …

The Therapeutic Benefits Of Attunement Through Lindy Hop, Sarah Trowbridge

Expressive Therapies Capstone Theses

Dance/movement therapy (DMT) was developed as a tool to aide in therapeutic healing. A foundational aspect of DMT is attunement, the emotional/kinesthetic connection between two people that allows for meaningful and healing bonds to emerge. Lindy Hop is a partnered dance that fosters an environment of attunement, as it is accessed both subconsciously and consciously. This research explores Lindy Hop as a possible method of therapeutic treatment. The literature indicates the physiological need for attunement and how safety plays a key role in strengthening senses of self-identity, nervous system development, and worldview. Four experienced Lindy Hoppers were recruited to engage …

Additive Vs. Subtractive Manufacturing In Dental Laboratory Technology, Aneeza Hussain

Publications and Research

Have you seen technicians using milling and 3d printing machines yet? The development of computer-aided manufacturing and the medical application of this industrial technology have provided an alternative way of fabricating oral and facial prostheses. This narrative review aims to evaluate the different streams of computer-aided manufacturing in dental technology. To date, there are two streams: the subtractive and the additive approaches. The differences reside in the processing protocols, materials used, and their respective accuracy. In general, there is a tendency for the subtractive method to provide more homogeneous objects with acceptable accuracy that may be more suitable for the …

Cardiovascular Complications Of Systemic Lupus Erythematosus: Impact Of Risk Factors And Therapeutic Efficacy--A Tertiary Centre Experience In An Appalachian State, Elise Danielle Mcveigh, Amna Batool, Arnold J. Stromberg, Ahmed K. Abdel-Latif, Nayef Mohammed Kazzaz

Statistics Faculty Publications

OBJECTIVES: Cardiovascular complications became a notable cause of morbidity and mortality in patients with lupus as therapeutic advancements became more efficient at managing other complications. The Appalachian community in Kentucky has a higher prevalence of traditional cardiovascular risk factors, predisposing them to cardiovascular events. Namely, the mean body mass index of the members of the Kentucky Appalachian community was reported at 33 kg/m² and 94.3% of male members of this community use tobacco. We sought to identify risk factors that predispose patients with lupus to cardiovascular morbidities and examine the effect of immunomodulatory drugs.

METHODS: We identified 20 UKHS …

Water Exchange Rate Across The Blood-Brain Barrier Is Associated With Csf Amyloid-Β 42 In Healthy Older Adults, Brian T. Gold, Xingfeng Shao, Tiffany L. Sudduth, Gregory A. Jicha, Donna M. Wilcock, Elayna R. Seago, Danny J. J. Wang

Sanders-Brown Center on Aging Faculty Publications

INTRODUCTION: We tested if water exchange across the blood-brain barrier (BBB), estimated with a noninvasive magnetic resonance imaging (MRI) technique, is associated with cerebrospinal fluid (CSF) biomarkers of Alzheimer's disease (AD) and neuropsychological function.

METHODS: Forty cognitively normal older adults (67–86 years old) were scanned with diffusion‐prepared, arterial spin labeling (DP‐ASL), which estimates water exchange rate across the BBB (k_w). Participants also underwent CSF draw and neuropsychological testing. Multiple linear regression models were run with kw as a predictor of CSF concentrations and neuropsychological scores.

RESULTS: In multiple brain regions, BBB kw was positively associated with CSF amyloid …

The Health Insurance Portability And Accountability Act And Its Impact On Privacy And Confidentiality In Healthcare, Allyssa Stadler

Senior Honors Theses

The world of healthcare and technology has continued to grow and expand into the future while HIPAA (the Health Insurance Portability and Accountability Act), the foundational patient privacy law in the United States of America, is attempting to keep up with this new world. This thesis reviews HIPAA and other health-related laws necessary to understanding patient privacy. It analyzes peer-reviewed studies on patient confidentiality and HIPAA to elicit the patient’s and provider’s opinion on HIPAA and patient confidentiality. Lastly, the current challenges of patient confidentiality and HIPAA are discussed, and potential solutions are suggested to improve these issues.

Don't Be Such A Buzzy®Kill: Reducing Pain During Vaccinations In College-Age Students, Katherine Long

Evidence-Based Practice Project Reports

Immunizations play a fundamental role in reducing the occurrence of preventable diseases in the population. Injections related to immunization are the most frequent pain-producing medical procedure implemented worldwide and account for nearly 12 billion injections annually (CDC, 2019; Taddio et al., 2015). These procedures are often perceived as simple but can have a variety of complications including pain. This evidence-based practice project addressed the following PICOT question: In college-aged students receiving immunizations (P), does the Buzzy® device (I) when compared to non-intervention standard of care (C) effectively reduce injection site pain (O) over a 12-week time period (T)? The Buzzy® …

Influences Of Sleep Disturbances And Mild Traumatic Brain Injury On Gait Performance Among College Student-Athletes, Narjes Asgari

Health and Kinesiology Theses

Sleep disturbances from stress are common among college students. In addition, student-athletes in contact sports (e.g., football and soccer) are at a higher risk of receiving a mild traumatic brain injury(mTBI). Stress-related sleep disturbances and mTBI may provoke cognitive and brain changes associated with gait abnormalities. Therefore, the purpose of this study was to examine the association between stress, sleep disturbances, mTBI, and gait performance among college student-athletes. Twelve college student-athletes from men’s and women’s soccer teams who indicated a history of mTBI (experimental group) and twenty-eight college students without a history of mTBI (control group) were recruited and asked …

Influence Of Resilience, Emotional Intelligence, And Teamwork On Registered Nurse Circulator Intent To Leave, Mary Alice Anderson

Nursing Theses and Dissertations

Registered Nurse (RN) circulator attrition is detrimental to the future of the nursing profession. The high average age of perioperative nursing leaders and high intent to leave of younger nurses in the perioperative setting leads to a high vacancy percentage and high expense to retrain and recruit nurses. The purpose of this dissertation was to explore the influence of resilience, emotional intelligence (EI), and teamwork on intent to leave RN circulator positions in full-time nurses who are members of the Association of periOperative Registered Nurses (AORN). Understanding factors that influence RN circulators’ intent to leave is key to developing interventions …

Use Of Electronic Pharmacy Transaction Data And Website Development To Assess Antibiotic Use In Nursing Homes, Sunah Song, Brigid M. Wilson, Robin L.P. Jump

Faculty Scholarship

Background: In 2017, the Centers for Medicare and Medicaid Services required all long-term care facilities, including nursing homes, to have an antibiotic stewardship program. Many nursing homes lack the resources, expertise, or infrastructure to track and analyze antibiotic use measures. Here, we demonstrate that pharmacy invoices are a viable source of data to track and report antibiotic use in nursing homes. Methods: The dispensing pharmacy working with several nursing homes in the same healthcare corporation provided pharmacy invoices from 2014 to 2016 as files formatted as comma separated values. We aggregated these files by aligning elements into a consistent set …

A Two-Year Longitudinal Study Of Bone Mineral Density In Collegiate Distance Runners, Olivia E. Brimacomb, William P. Mccormack, Hawley C. Almstedt

Honors Thesis

Research has shown that weight-bearing physical activity such as running results in osteogenesis; distance runners, however, may experience deficiencies at specific sites. The purpose of this investigation was to examine changes in bone mineral density (BMD) of male and female collegiate cross-country runners over two years. Methods: BMD of 29 collegiate distance runners (16 men and 13 women) were measured five times over 24 months using dual-energy x- ray absorptiometry (DXA) at the anterior-posterior (AP) and lateral (LAT) spine, femoral neck (FN), total hip (TH), whole body (WB), and ultra-distal (UD) forearm. A repeated measures multivariate analysis of covariance, …

Collapsible Prosthetic Shower Leg, Amanuel Matias, Mahsa Ebrahim

Honors Thesis

The purpose of this capstone project is to build a collapsible prosthetic shower leg that can provide a transtibial amputee with reliable support while showering. Phil Tamoush, an 83-year old transtibial amputee, was the inspiration for this work. Phil’s constant travel for his arbitration work leaves him without the option to bring along his usual shower leg due to the additional space it takes up in his travel bag. There are currently no commercially available prosthetic shower legs that can collapse into a condensed unit, so this capstone project explores an unexplored field for which there is a significant need. …

Apigenin And Structurally Related Flavonoids Allosterically Potentiate The Function Of Human Α7-Nicotinic Acetylcholine Receptors Expressed In Sh-Ep1 Cells, Waheed Shabbir, Keun-Hang Susan Yang, Bassem Sadek, Murat Oz

Biology, Chemistry, and Environmental Sciences Faculty Articles and Research

Phytochemicals, such as monoterpenes, polyphenols, curcuminoids, and flavonoids, are known to have anti-inflammatory, antioxidant, neuroprotective, and procognitive effects. In this study, the effects of several polyhydroxy flavonoids, as derivatives of differently substituted 5,7-dihydroxy-4H-chromen-4-one including apigenin, genistein, luteolin, kaempferol, quercetin, gossypetin, and phloretin with different lipophilicities (cLogP), as well as topological polar surface area (TPSA), were tested for induction of Ca²⁺ transients by α7 human nicotinic acetylcholine (α7 nACh) receptors expressed in SH-EP1 cells. Apigenin (10 μM) caused a significant potentiation of ACh (30 μM)-induced Ca²⁺ transients, but did not affect Ca²⁺ transients induced by high K^{+ …}

Integrated Trajectories Of The Maternal Metabolome, Proteome, And Immunome Predict Labor Onset, Ina A. Stelzer, Mohammad Sajjad Ghaemi, Xiaoyuan Han, Kazuo Ando, Julien J. Hédou, Dorien Feyaerts, Laura S. Peterson, Kristen K. Rumer, Eileen S. Tsai, Edward A. Ganio, Dyani K. Gaudillière, Amy S. Tsai, Benjamin Choisy, Lee P. Gaigne, Franck Verdonk, Danielle Jacobsen, Sonia Gavasso, Gavin M. Traber, Mathew Ellenberger, Natalie Stanley, Martin Becker, Anthony Culos, Ramin Fallahzadeh, Ronald J. Wong, Gary L. Darmstadt, Maurice L. Druzin, Virginia D. Winn, Ronald S. Gibbs, Xuefeng B. Ling

All Dugoni School of Dentistry Faculty Articles

Estimating the time of delivery is of high clinical importance because pre- and postterm deviations are associated with complications for the mother and her offspring. However, current estimations are inaccurate. As pregnancy progresses toward labor, major transitions occur in fetomaternal immune, metabolic, and endocrine systems that culminate in birth. The comprehensive characterization of maternal biology that precedes labor is key to understanding these physiological transitions and identifying predictive biomarkers of delivery. Here, a longitudinal study was conducted in 63 women who went into labor spontaneously. More than 7000 plasma analytes and peripheral immune cell responses were analyzed using untargeted mass …

Biostimulatory Effects Of Low-Intensity Pulsed Ultrasound On Rate Of Orthodontic Tooth Movement And Associated Pain, Applied At 3-Week Intervals: A Split-Mouth Study, Irfan Qamruddin, Mohammad Khursheed Alam, Verda Mahroof, Meenaz Karim, Mubassar Fida, Mohd Fadhli Khamis, Adam Husein

Section of Dental-Oral Maxillofacial Surgery

Objective: Low-intensity pulsed ultrasound (LIPUS) is a noninvasive modality to stimulate bone remodeling (BR) and the healing of hard and soft tissues. This research evaluates the biostimulatory effect of LIPUS on the rate of orthodontic tooth movement (OTM) and associated pain, when applied at 3-week intervals.
Methods: Twenty-two patients (11 males and 11 females; mean age 19.18 ± 2.00 years) having Angle's Class II division 1 malocclusion needing bilateral extractions of maxillary first bicuspids were recruited for this split-mouth randomized clinical trial. After the initial stage of alignment and leveling with contemporary edgewise MBT (McLaughlin-Bennett-Trevisi) prescription brackets (Ortho Organizers, Carlsbad, …

Tapering Buprenorphine, Alexis Diane Snyder

Student Works

Opioid use disorder (OUD) is increasing in incidence in the United States. Buprenorphine is the mainstay of medication-assisted treatment for OUD. Nurse practitioners play an essential role in solving the opioid epidemic and are increasingly relied on to prescribe buprenorphine. Even though buprenorphine is considered a long-term therapy, many patients request to taper off the drug. Evidence suggests that tapering from buprenorphine is frequently unsuccessful and remains as a challenge. The purpose of this article is to provide the best available evidence regarding the taper of buprenorphine in patients with OUD. Considering a buprenorphine taper should begin by evaluating if …

Utilization Of Enteral Tranexamic Acid To Stabilize Gastrointestinal Hemorrhage In Pediatric Patients On Ecmo, Gina Patel, Jenna Miller, Thomas M. Attard, Asdis Finnsdottir Wagner

Presentations

Background:

Incidence and management of Gastrointestinal (GI) bleeding on ECMO isn’t well reported Patients on ECMO require systemic anticoagulation making GI bleeding difficult to manage We describe the use of enteral tranexamic acid (TXA) in two pediatric patients with GI hemorrhage on ECMO

The Population Affected By The Syndemic Of Covid-19 And Poverty Is More Likely To Be Hospitalized With Sars-Cov-2 Pneumonia, Julio A. Ramirez, Stephen P. Furmanek, Meredith Cahill, Stephen S. Hanson, Ruth Carrico, Forest W. Arnold

The University of Louisville Journal of Respiratory Infections

Background

Lockdown measures to control COVID-19 have exacerbated the poverty epidemic. We hypothesized that the synergistic interaction of COVID-19 and poverty epidemics favors the development of more severe forms of COVID-19 in the population living in poverty. To test this hypothesis, we assessed whether an ecological association exists between the geographic distribution of hospitalized patients with SARS-CoV-2 pneumonia and markers of poverty in the city of Louisville, KY.

Methods

Using the geomasked home addresses of hospitalized patients with SARS-CoV-2 pneumonia in the city of Louisville, a kernel density heatmap was created. Kuldorff’s spatial scan statistic was used to calculate areas …

Understanding Of Aerosol Transmission Of Covid 19 In Indoor Environment - Part 2: Approaches To Mitigation, Adama Barro, Cathal O'Toole, Jacob S. Lopez, Matthew Quinones, Sherene Moore

Publications and Research

The challenge we face in implementing solutions for new HVAC ventilation and filtration design, is to effectively improve air quality for virus mitigation without losing performance efficiency. The purpose of this improvement is to decontaminate the occupied enclosed areas, reducing the transmission of the corona virus aerosol transmission. Our research seeks reliable approaches to mitigate the further spread of aerosol transmission in indoor spaces. The methodology is to examine innovative HVAC engineering solutions that combat epidemiological problems of Covid-19 for the post-pandemic era, by researching scholarly articles and ASHRAE journals. We are achieving the goal of finding highly efficient resolutions …