Medicine and Health Sciences Commons^™

Brain Antigens Stimulate Proliferation Of T Lymphocytes With A Pathogenic Phenotype In Multiple Sclerosis Patients, Assaf Gottlieb, Hoai Phuong T Pham, John William Lindsey

Faculty, Staff and Student Publications

A method to stimulate T lymphocytes with a broad range of brain antigens would facilitate identification of the autoantigens for multiple sclerosis and enable definition of the pathogenic mechanisms important for multiple sclerosis. In a previous work, we found that the obvious approach of culturing leukocytes with homogenized brain tissue does not work because the brain homogenate suppresses antigen-specific lymphocyte proliferation. We now report a method that substantially reduces the suppressive activity. We used this non-suppressive brain homogenate to stimulate leukocytes from multiple sclerosis patients and controls. We also stimulated with common viruses for comparison. We measured proliferation, selected the …

A Multimodal Clinical Data Resource For Personalized Risk Assessment Of Sudden Unexpected Death In Epilepsy, Xiaojin Li, Shiqiang Tao, Samden D Lhatoo, Licong Cui, Yan Huang, Johnson P Hampson, Guo-Qiang Zhang

Faculty, Staff and Student Publications

Epilepsy affects ~2–3 million individuals in the United States, a third of whom have uncontrolled seizures. Sudden unexpected death in epilepsy (SUDEP) is a catastrophic and fatal complication of poorly controlled epilepsy and is the primary cause of mortality in such patients. Despite its huge public health impact, with a ~1/1,000 incidence rate in persons with epilepsy, it is an uncommon enough phenomenon to require multi-center efforts for well-powered studies. We developed the Multimodal SUDEP Data Resource (MSDR), a comprehensive system for sharing multimodal epilepsy data in the NIH funded Center for SUDEP Research. The MSDR aims at accelerating research …

Improving Colonoscopy Bowel Preparation In Adults Undergoing Screening Through Health Literacy Education, Kimmarie James-Ross

Walden Dissertations and Doctoral Studies

Colorectal cancer (CRC) is the third leading cause of cancer-related deaths among men and women in the United States. Colonoscopy is the gold standard for CRC screening; however, the diagnostic efficiency of a colonoscopy is highly dependent on bowel preparation (prep) quality. Up to 30% of colonoscopy patients present with poor bowel prep. Poor bowel prep is a significant clinical practice problem that can lead to missed lesions, increased risk for CRC, increased risks for procedure-related complications, ineffective use of resources, and increased health care costs. A huge barrier to effective colonoscopy is low health literacy. This quality improvement project …

Evidence-Based Approaches To Screening For Polypharmacy In Older Adults, Carmelo Maddy

Walden Dissertations and Doctoral Studies

AbstractPolypharmacy is the concomitant use of five or more medicines and is associated with a higher risk of being prescribed potentially inappropriate or interactive medications. Polypharmacy in adults over 60 years of age may correlate with adverse outcomes of multimorbidity such as functional impairment, low quality of life, high healthcare use, and increased costs. Health practitioners need to be aware of tools and methods to manage polypharmacy-related issues to optimize patient safety. The gap in practice is that a primary care practice did not have a comprehensive clinical guideline for a systematic and ongoing assessment of appropriateness of medication use …

Effectiveness Of Responsible Beverage Service Policies In Reducing Drunk-Driving In Maryland, Rhoda Makinde

Walden Dissertations and Doctoral Studies

In the State of Maryland and across the United States, driving under the influence (DUI) has led to a massive loss of lives and disability cases. Hence, responsible beverage service (RBS) policies and programs have been developed to prevent and control DUI incidence. This study sought to identify the effectiveness of these policies in addressing the DUI-related fatalities and injuries among young adults (18–30 years old) in the State of Maryland. Using program theory to evaluate the effectiveness of RBS policies and programs in reducing DUI, this qualitative research sampled bar patrons, club patrons, and alcohol servers/service staff in Baltimore. …

Perspectives Of Social Barriers To Accessing Health Care Insurance Among The Homeless Population, Abedalhakeem Damin Abukhalil

Walden Dissertations and Doctoral Studies

Access to healthcare services and healthcare insurance has been considered problematic for many populations in the United States. Despite many efforts to solve these issues, there is a significant gap in research related to the perceptions of the population experiencing homelessness associated with the social barriers they face with access to health insurance and health care. The behavioral-ecological framework best suited this study. In this qualitative descriptive study the perceptions of a sample of 10 individuals experiencing homelessness, who accepted to sit for 60-minute interviews, were investigated. Purposeful sampling was used to identify these individuals, whose age 18-60 years old, …

Accessibility To Vaping Products, Vaping, And Use Of Cigarettes Among Adolescents, Sherri Adeosun

Walden Dissertations and Doctoral Studies

There has been a continuous increase in the use of e-cigarettes among adolescents. The growth threatens to nullify the years of successfully reducing cigarette smoking among this age demographic. Additionally, the increase has been a concern for public healthcare workers due to the limited research on the effects of long-term use of e-cigarettes on adolescents. I investigated the possible side effects of exposure to e-cigarette advertisements and the use of e-cigarettes. Additionally, the study reviewed the relationship between the age e-cigarette use was initiated and the subsequent use of cigarettes. The conceptual framework was based on the multi-theory model and …

Collected Papers (On Neutrosophic Theory And Applications), Volume Vii, Florentin Smarandache

Branch Mathematics and Statistics Faculty and Staff Publications

This seventh volume of Collected Papers includes 70 papers comprising 974 pages on (theoretic and applied) neutrosophics, written between 2013-2021 by the author alone or in collaboration with 122 co-authors from 22 countries.

Collected Papers (On Physics, Artificial Intelligence, Health Issues, Decision Making, Economics, Statistics), Volume Xi, Florentin Smarandache

Branch Mathematics and Statistics Faculty and Staff Publications

This eleventh volume of Collected Papers includes 90 papers comprising 988 pages on Physics, Artificial Intelligence, Health Issues, Decision Making, Economics, Statistics, written between 2001-2022 by the author alone or in collaboration with 84 co-authors from 19 countries.

Collected Papers (On Neutrosophics, Plithogenics, Hypersoft Set, Hypergraphs, And Other Topics), Volume X, Florentin Smarandache

Branch Mathematics and Statistics Faculty and Staff Publications

This tenth volume of Collected Papers includes 86 papers in English and Spanish languages comprising 972 pages, written between 2014-2022 by the author alone or in collaboration with 105 co-authors from 26 countries.

Collected Papers (Neutrosophics And Other Topics), Volume Xiv, Florentin Smarandache

Branch Mathematics and Statistics Faculty and Staff Publications

This fourteenth volume of Collected Papers is an eclectic tome of 87 papers in Neutrosophics and other fields, such as mathematics, fuzzy sets, intuitionistic fuzzy sets, picture fuzzy sets, information fusion, robotics, statistics, or extenics, comprising 936 pages, published between 2008-2022 in different scientific journals or currently in press, by the author alone or in collaboration with 99 co-authors from 26 countries.

Analyzing The Sustainability Of Industry Affected In Covid-19 Pandemic Scenario Using Cosine Similarity Measure Under Svpns And Pnn Model, Priyanka Majumder, Florentin Smarandache

Branch Mathematics and Statistics Faculty and Staff Publications

COVID-19 outbreak is a reminder of the fact that the pandemics have happened in the past and will also occur in the future. The COVID-19 not only has affected the economy; but also it has affected the livelihood, which leads to the changes in businesses. This study aims to identify the most significant indicator (or parameter) that impacts the sustainability of industries. The study should also develop a realtime monitoring system for the sustainability of industries affected by COVID 19. In this work, the Polynomial Neural Network (PNN) and cosine similarity measure under SVPNS (Single-Valued Pentapartitioned Neutrosophic Set) environment have …

Robust Testing Of Paired Outcomes Incorporating Covariate Effects In Clustered Data With Informative Cluster Size, Sandipan Dutta

Mathematics & Statistics Faculty Publications

Paired outcomes are common in correlated clustered data where the main aim is to compare the distributions of the outcomes in a pair. In such clustered paired data, informative cluster sizes can occur when the number of pairs in a cluster (i.e., a cluster size) is correlated to the paired outcomes or the paired differences. There have been some attempts to develop robust rank-based tests for comparing paired outcomes in such complex clustered data. Most of these existing rank tests developed for paired outcomes in clustered data compare the marginal distributions in a pair and ignore any covariate effect on …

Tick Transmission Of Borrelia Burgdorferi To The Murine Host Is Not Influenced By Environmentally Acquired Midgut Microbiota, Sukanya Narasimhan, Nallakkandi Rajeevan, Morven Graham, Ming-Jie Wu, Kathleen Deponte, Solenne Marion, Orlanne Masson, Anya J. O'Neal, Daniel E. Sonenshine, Erol Fikrig

Biological Sciences Faculty Publications

Background

Ixodes scapularis is the predominant tick vector of Borrelia burgdorferi, the agent of Lyme disease, in the USA. Molecular interactions between the tick and B. burgdorferi orchestrate the migration of spirochetes from the midgut to the salivary glands—critical steps that precede transmission to the vertebrate host. Over the last decade, research efforts have invoked a potential role for the tick microbiome in modulating tick-pathogen interactions.

Results

Using multiple strategies to perturb the microbiome composition of B. burgdorferi-infected nymphal ticks, we observe that changes in the microbiome composition do not significantly influence B. burgdorferi migration from the midgut, invasion of …

The Effect Of Concussion History On Lower Extremity Injury Risk In College Athletes: A Systematic Review And Meta Analysis, Vanessa Ramirez, Ryan Mccann, Eric Schussler, Jessica Martinez

Rehabilitation Sciences Faculty Publications

INTRODUCTION: Collegiate athletes who suffer a concussion may possess prolonged impairments even after clearance for return-to-participation, which may place them at an increased risk of lower extremity injury.

OBJECTIVE: To conduct a systematic review and meta-analysis of studies examining risk of lower extremity musculoskeletal injury following a concussion in collegiate athletes.

METHODS: A literature search was performed using the following databases: PubMed, CINAHL, SPORTDiscus. The following search terms were used to identify relevant articles, ["concussion" OR "brain injury" OR "mild traumatic brain injury" OR "mTBI"] AND ["lower extremity injury" OR "musculoskeletal injury"]. Articles were included if they were published between …

Characteristics Of Athletic Training Students' Patient Encounters During Immersive And Nonimmersive Clinical Experiences: A Report From The Association For Athletic Training Education Research Network, Bailey C. Jones, Julie M. Cavallario, Cailee E. Welch Bacon, Stacy E. Walker, R. Curtis Bay, Bonnie L. Van Lunen

Rehabilitation Sciences Faculty Publications

Context: The 2020 Standards for the Accreditation of Professional Athletic Training Programs from the Commission on Accreditation of Athletic Training Education require programs to include at least one immersive clinical experience (ICE) in their clinical education curricula. Yet, it is unknown whether ICEs provide more opportunities and benefits than nonimmersive clinical experiences (N-ICEs). The purpose of this study was to compare characteristics of patient encounters (PEs) that occurred during ICEs and N-ICEs.

Design: Multisite panel design.

Setting: Twelve professional programs (5 undergraduate, 7 graduate).

Patients or Other Participants: Three hundred thirty-eight athletic training students logged PEs in the E*Value system. …

The Acute Physiological Response Of Polar Bears To Helicopter Capture, John P. Whiteman, Henry J. Harlow, George M. Durner, Eric V. Regehr, Steven C. Amstrup, Anthony M. Pagano, Merav Ben-David

Biological Sciences Faculty Publications

Many wildlife species are live captured, sampled, and released; for polar bears (Ursus maritimus) capture often requires chemical immobilization via helicopter darting. Polar bears reduce their activity for approximately 4 days after capture, likely reflecting stress recovery. To better understand this stress, we quantified polar bear activity (via collar‐mounted accelerometers) and body temperature (via loggers in the body core [T_abd] and periphery [T_per]) during 2–6 months of natural behavior, and during helicopter recapture and immobilization. Recapture induced bouts of peak activity higher than those that occurred during natural behavior for 2 of 5 bears, …

Observations Of Delayed Changes In Respiratory Function Among Allergy Clinic Patients Exposed To Wildfire Smoke, James Blando, Michael Allen, Hadiza Galadima, Timothy Tolson, Muge Akpinar-Elci, Mariana Szklo-Coxe

Community & Environmental Health Faculty Publications

Wildfires have increased in frequency and magnitude and pose a significant public health challenge. The principal objective of this study was to assess the impact of wildfire smoke on respiratory peak flow performance of patients exposed to two different wildfire events. This longitudinal study utilized an observational approach and a cohort study design with a patient-level clinical dataset from a local outpatient allergy clinic (n = 842). Meteorological data from a local weather station served as a proxy for smoke exposure because air quality measurements were not available. This study found that there were decreases in respiratory peak flow among …

The Online Ordering Behaviors Among Participants In The Oklahoma Women, Infants, And Children Program: A Cross-Sectional Analysis, Qi Zhang, Kayoung Park, Junzhou Zhang, Chuanyi Tang

Community & Environmental Health Faculty Publications

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a nutrition assistance program in the United States (U.S.). Participants in the program redeem their prescribed food benefits in WIC-authorized grocery stores. Online ordering is an innovative method being pilot-tested in some stores to facilitate WIC participants' food benefit redemption, which has become especially important in the COVID-19 pandemic. The present research aimed to examine the online ordering (OO) behaviors among 726 WIC households who adopted WIC OO in a grocery chain, XYZ (anonymous) store, in Oklahoma (OK). These households represented approximately 5% of WIC households who redeemed …

Rate Of Drug-Resistant Streptococcus Pneumoniae In Children With Invasive Pneumococcal Disease: A Decade Review, Thritsawan Thanyapalit, Suvaporn Anugulruengkitt, Watsamon Jantarabenjakul, Tuangtip Theerawit, Nattapong Jitrungruengnij, Thanyawee Puthanakit

Chulalongkorn Medical Journal

Background: Streptococcus pneumoniae is a common causative organism of pneumonia, bacteremia and meningitis in children. Rate of drug-resistant Streptococcus pneumoniae (DRSP) is an important information to guide appropriate empirical antibiotics. Objectives: This study aimed to describe rates of DRSP and clinical outcomes of patients with invasive pneumococcal disease (IPD). Methods: A retrospective study was conducted among pediatric patients with IPD from 2008 -2017. DRSP was defined as National Committee for clinical laboratory standards guidelines 2013. Results: From January 2008 to December 2017, 71 patients with diagnosis of IPD were identified. Median (interquartile range) age was 2 years (2 months - …

Prevalence And Type Of Kras Mutations In Endometrial Endometrioid Carcinoma, Supaporn Suwiwat, Papitchaya Watcharanuruk, Siriwong Lattakanjanang, Anupong Nitiruangjaras, Kobkul Tungsinmunkong

Chulalongkorn Medical Journal

Background: KRAS encodes a small G-protein that involves cell proliferation, differentiation, and survival. Objectives: To determine the prevalence and type of KRAS mutations in Southern Thai patients with endometrial endometrioid carcinoma as well as their correlation with clinicopathological variables. Methods: A total of 190 patients with endometrioid carcinoma were analyzed for KRAS exon 2 mutations using direct sequencing. The statistical correlation of KRAS mutations with clinicopathogical variables was also evaluated using the Chi-square or Fisher exact test. Results: KRAS mutations were detected in 17.4% (33/190) of cases. All of them were missense mutations and 72.7% (24/33) occurred in hotspot codons …

Political Economy Of Cannabis In Thailand, Mano Laohavanich

Chulalongkorn Medical Journal

Cannabis has been classified as category 5 addictive herb. However, the new tread of the world has found it useful resulting a change of policy by the Ministry of Public health in Thailand, i.e., to follow the California Model that allows cannabis to be grown no more than seven in a household. This review article aimed to explore the origin of policy on cannabis of the current government of Thailand, especially under the new Minister of Public Health, its applications, obstacles and plausible solutions and the policy suggestion for deregulation of cannabis. Literature reviews were conducted on history of cannabis, …

Game Addiction And Severity Of Adhd Symptoms Among Adolescent Adhd Patients, Nuttawut Suksamai, Napakkawat Buathong, Sasithorn Preechawuttidach

Chulalongkorn Medical Journal

Background: Children and adolescents who use the Internet and play games are at risk for the Internet and game addiction because they are still developing and learning new things. Problematic game players are more likely to have attention-deficit hyper activity disorder (ADHD) compared with the general population. The data about game addiction in Adolescents with ADHD in Thailand are still limited. Objectives: To examine the prevalence of game addiction and its association with the severity of ADHD symptoms and other factors in adolescent ADHD patients attending the Child and Adolescents Outpatient Psychiatric Clinic, King Chulalongkorn Memorial Hospital. Methods: This cross-sectional …

Spiritual Perspectives Of Thai Psychiatrists On Mental Health, Vasin Kosolsak, Buranee Kanchanatawan

Chulalongkorn Medical Journal

Background: Although the positive impact of spirituality on mental health has become more widely accepted in the past decade, it is a challenging subject due to its distinctive nature between beliefs and cultures. Objectives: This study aimed to define the term spirituality and its influence on mental health based on the viewpoint of Thai psychiatrists. Methods: This qualitative research was conducted in 20 Thai psychiatrists recruited from all regions across Thailand using a semi-structured in-depth interview, based on literature reviews. The collected data were analyzed via content analysis. Results: We found that Thai psychiatrists define spirituality as a belief, reliance, …

Diagnostic Accuracy Of Dual-Energy Ct To Determine Urinary Tract Stone Composition: Differentiating Between Uric Acid And Non-Uric Acid Urinary Tract Stone, Pawanaporn Rojanavijitkul, Pattama Tantigate, Supoj Ratchanon, Manint Usawachintachit, Krit Pongpirul, Bundit Chaopathomkul

Chulalongkorn Medical Journal

Background: The urinary tract stone is a worldwide condition with various clinical significances. Optimal treatment requires multiple considerations including stone composition. Dual-energy computed tomography (DECT) has been used to determine uric acid and non-uric acid urinary tract stones. Objective: To evaluate the diagnostic accuracy of rapid-kilovoltage (kV) switching DECT in differentiating between uric acid and non-uric acid stones compared with reference standard infrared spectroscopy (IRS). Methods: A prospective study enrolled patients from February 2018 to March 2020 who underwent a DECT scan for urinary tract stone with 3-mm stone (s). Post-processed material-density (MD) images were used to differentiate between uric …

Surgical Aspects Of Adrenal Tumors In Children, Sirima Liukitithara, Paisarn Vejchapipat, Katawaetee Decharun, Apirak Santingamkun

Chulalongkorn Medical Journal

Background: Adrenal tumors are uncommon in children. They can be divided into 2 categories, namely: adrenomedullary tumor and adrenocortical tumor. Surgical aspects of these conditions receive little attention. Objective: The objective of this study was to describe clinical data, operative findings, and operative complications in children with adrenal tumors. Methods: Patients, aged 0 - 15 years, undergoing adrenalectomy between January 2007 and December 2016 were retrospectively reviewed. Results: Thirty-seven patients underwent adrenalectomies. Male to female ratio was 1.31 to 1. Median age of the patients was 44 months (range, 2 months-14 years). Pathological examination revealed 27 adrenomedullary tumors (19 neuroblastomas, …

Quality Of Sleep In Stroke Patients At Phramongkutklao Hospital, Jirat Lothaka, Chavit Tunvirachaisakul, Naratorn Soponprapakorn

Chulalongkorn Medical Journal

Background: Stroke is one of the leading causes of death and serious long-term disability worldwide. A common consequence of stroke is reduced quality of sleep. Objective: To study the quality of sleep in patients with stroke, related factors and the compatibility of wearable tracker device for collecting sleep data. Methods: This cross-sectional study included 66 subjects with stroke at Phramongkutklao Hospital using questionnaires including demographic questions, sleep quality assessment (PSQI), and the satisfaction of Wearable tracker tool assessments. Each subject received a wearable tracker to examine the sleep quality. Results: According to the PSQI assessment, the majority of subjects had …

Validity And Reliability Of The Thai-Version Of Post Stroke Depression Scale (Psds-T), Kuankidnuttha Arunsri, Aurauma Chutinet, Sookjareon Tangwongchai

Chulalongkorn Medical Journal

Background: Currently, there has been limited effective and practical instruments for screening post-stroke depression (PSD) in Thailand. In 2014, Post-Stroke Depression Scale (PSDS) has been testified to be a valid and reliable self-rated questionnaire for evaluating Chinese patients with PSD. Objective: This study proposed to validate the Thai version of PSDS (PSDS-T) in Thai patients with acute ischemic stroke. Methods: The PSDS was translated into Thai language (PSDS-T). The validity and reliability were tested in 145 acute ischemic stroke patients. Subjects were consecutively recruited to complete PSDS-T; they were clinically evaluated for PSD using DSM-5 diagnosis of adjustment disorder with …

Comparative Accuracy Of Unenhanced And Iv-Contrast Enhanced Mdct In Detection Of Acute Appendicitis In Adult Patients, Sirivipa Charuswattanakul, Thitinan Chulroek

Chulalongkorn Medical Journal

Background: Computed tomography (CT) is the preferred imaging modality for suspected acute appendicitis. However, optimal CT technique remains controversial. Objectives: To compare the diagnostic accuracy of unenhanced CT with standard IV-contrast enhanced CT in the diagnosis of acute appendicitis in adult patients and whether body mass index (BMI) affects the diagnosis. Methods: A total of 209 patients (70 males and 139 females) with clinically suspected acute appendicitis underwent both unenhanced and IV-contrast enhanced CT with rectal contrast administration. We retrospectively reviewed radiographic findings of appendicitis, appendiceal visualization, likelihood of appendicitis and alternative diagnoses. Receiver operating characteristic (ROC) analysis, unpaired t …

Correlation Between Leg Length Discrepancy And Asymptomatic Sacroiliac Joint Dysfunction In Young Males, Taweewat Wiangkham, Pattamaporn Rinrit, Mananya Choprateep, Ralita Thamrongthanakul, Weerapong Chidnok

Chulalongkorn Medical Journal

Background: Sacroiliac joint dysfunction (SJD) is an important cause of low back pain (LBP), commonly overlooked. Although the association of leg length discrepancy (LLD) and LBP was established, no study has examined the association between LLD and asymptomatic SJD (ASJD). Objective: To examine the correlation between LLD and ASJD in young males. Methods: One hundred subjects wearing a comfortable and thin uniform were randomized into three rooms (consisting of leg length measurement, palpation and special test rooms). One high valid and reliable assessor was allocated in each room. All subjects were assessed three times (one time a room and then …