Medicine and Health Sciences Commons^™

Who's Included? A Systematic Review Of Socio-Demographics And Participant Recruitment Within The Investigation Of Periodontal Disease And Its Treatment Effect On Hemoglobin A1c, Jaclyn L. Johnson

All Master's Theses

Diabetes mellitus and periodontal disease are major global public health concerns. Within the United States (U.S.) over 34 million adults have diagnosed diabetes (Centers for Disease Control and Prevention [CDC], 2020a), and 64 million U.S. adults have periodontitis (American Academy of Periodontology [AAP], 2021a). Research has shown that persons with diabetes have a coinfection with periodontal disease at a rate between 2.6 and 2.9 times higher than persons without diabetes (Wang et al., 2014). Diabetes and periodontal disease collectively and disproportionately affect persons of low socioeconomic status (SES), age, and particular racial/ethnic identities (AAP, n.d.b; CDC, 2021; Connolly et al., …

Investigating The Effects Of Body Weight Fluctuations On Insulin Resistance In Adults: A Nhanes Study, Jessica Claire Burke

All Master's Theses

The aim of this study was to investigate the effects of a history of weight cycling on insulin resistance (IR) utilizing the 2015-2020 NHANES database. A value greater than 3.2 for homeostatic model assessment of insulin resistance (HOMA-IR) was used to define IR. No study to date has examined the weight cycling question since its application in the NHANES 2015-2016 cycle year. RESULTS 53% of the total 4100 participants reported weight cycling at least once and 33% of the total were classified as having IR. Prevalence of IR and obesity were highest amongst those who weight cycled 3 times or …

Factors Influencing Intestinal Parasite In Black-And-White Ruffed Lemurs (Varecia Variegata), Eliette Noromalala

All Master's Theses

Ecological factors, such as feeding behavior and climatic seasonality, might influence intestinal parasite infection and patterns in non-human primates. Here, we examined if frugivory levels and climate (i.e., temperature and rainfall) were associated with parasite patterns in black-and-white ruffed lemurs (Varecia variegata). Feeding data using 5-min focal sampling, climate data, and fecal samples from V. variegata (n = 23) at the “Mangevo” site were collected from February through May 2019. Microscopic examinations of fecal flotation and sedimentation were done to identify and count parasites. Nematoda (Callistoura vauceli, and Strongyloides sp.) Ciliophora (Balantidium sp.), Coccidia ( …

Determining The Effects Of Chemical Exposure On Hepatocyte Mitochondrial Networks And Cell Viability, Bethany Eaton

All Master's Theses

Mitochondria are cellular organelles that are becoming more recently studied. One of their main functions is the production of energy through cellular respiration, which is crucial to cell life. However, they are also associated with numerous disease states. It is hypothesized that reactive oxygen species (ROS), largely produced in mitochondria, induce oxidative stress and affect mitochondrial morphology along with cell viability. This study compares chemical exposure of menadione, an ROS producer, and phthalates (plasticizers) on two mouse hepatocyte cell lines to determine the effects they have on mitochondrial morphology and cell viability. Three experiments were performed to analyze the effects …

Education And Awareness Of Workplace Hazards: An Educational Intervention For First Responder Trainees, Emily Portune

All Master's Theses

First responder paramedics, emergency medical technicians (EMTs), and firefighters provide emergency services to communities everywhere, often in life-threatening circumstances. At the same time, these first responders face high-stress life and death situations and may also endure unique workplace hazards like racism, sexual harassment and discrimination, verbal and physical patient assault, and extreme sleep deprivation. These hazards make prehospital providers vulnerable to mental illness, a fact proven by preexisting research that found more than 85% of first responders reported negative mental health symptoms and outcomes directly related to their career. Not only are prehospital providers at high risk of mental illness; …

Effects Of An Interdisciplinary Communication Partner Training Program On Student Learning, Tyson G. Harmon, Mei-Ling Lin, Gabrielle Scronce, Adam Jacks

Faculty Publications

BACKGROUND: Communication partner training (CPT) involves educating conversation partners to implement communication strategies that facilitate improved interactions with people with aphasia (PWA). This study aimed to investigate (1) whether a CPT program increased the knowledge and confidence of students with and without a communication disorders background and (2) the differential effects of this training on students from different allied health disciplines. METHODS: Quasi-experimental design study with 6 adult volunteers with aphasia and 36 students (18 speech-language pathology [SLP] students and 18 physical therapy/occupational therapy [PT/OT] students). The CPT program was provided twice (in 2015 and 2016) as a single seminar …

Beta-Adrenergic Antagonist Tolerance In Amyloid Cardiomyopathy, Stuart Ramsell, Carlos Arias Bermudez, Cyril Ayuk Mbeng Takem Baiyee, Brandon Rodgers, Samir Parikh, Salem Almaani, Nidhi Sharma, Samantha Lorusso, Miriam Freimer, Elyse Redder, Naresh Bumma, Ajay Vallkati, Yvonne Efebera, Rami Kahwash, Courtney M Campbell

2020-Current year OA Pubs

Background: Beta-adrenergic antagonists or blockers (BB) are a cornerstone of cardiac therapy for multiple indications. However, BB are considered relatively contraindicated in amyloid cardiomyopathy due to poor tolerance. This intolerance is hypothesized to be due to concomitant neuropathy and significant restrictive cardiomyopathy. This study analyzes the incidence and characteristics of BB tolerance in patients with amyloid cardiomyopathy.

Methods: Through a single-center retrospective chart review, patients with amyloid cardiomyopathy, confirmed by endomyocardial biopsy or technetium-99 pyrophosphate scan, were identified and clinical data was collected. Statistical methods included Chi-square test and two sample

Results: Of 135 cardiac amyloidosis patients, 27 patients (20.0%) …

Monosynaptic Targets Of Utricular Afferents In The Larval Zebrafish, Yizhen Jia, Martha W Bagnall

2020-Current year OA Pubs

The larval zebrafish acquires a repertoire of vestibular-driven behaviors that aid survival early in development. These behaviors rely mostly on the utricular otolith, which senses inertial (tilt and translational) head movements. We previously characterized the known central brainstem targets of utricular afferents using serial-section electron microscopy of a larval zebrafish brain. Here we describe the rest of the central targets of utricular afferents, focusing on the neurons whose identities are less certain in our dataset. We find that central neurons with commissural projections have a wide range of predicted directional tuning, just as in other vertebrates. In addition, somata of …

Population-Based Screening Of Newborns: Findings From The Nbs Expansion Study (Part One), Amy Brower, Michael Watson, Et Al

2020-Current year OA Pubs

Each year, through population-based newborn screening (NBS), 1 in 294 newborns is identified with a condition leading to early treatment and, in some cases, life-saving interventions. Rapid advancements in genomic technologies to screen, diagnose, and treat newborns promise to significantly expand the number of diseases and individuals impacted by NBS. However, expansion of NBS occurs slowly in the United States (US) and almost always occurs condition by condition and state by state with the goal of screening for all conditions on a federally recommended uniform panel. The Newborn Screening Translational Research Network (NBSTRN) conducted the NBS Expansion Study to describe …

Academic Medical Center Clinical Research Professional Workforce: Part 2 - Issues In Staff Onboarding And Professional Development, Jacqueline M Knapke, Michelle Jenkerson, Peg Tsao, Stephanie Freel, Jessica Fritter, Shirley L Helm, Penelope Jester, H Robert Kolb, Angela Mendell, Megan Petty, Carolynn T Jones

2020-Current year OA Pubs

Background: Defining key barriers to the development of a well-trained clinical research professional (CRP) workforce is an essential first step in identifying solutions for successful CRP onboarding, training, and competency development, which will enhance quality across the clinical and translational research enterprise. This study aimed to summarize barriers and best practices at academic medical centers related to effective CRP onboarding, training, professional development, identify challenges with the assessment of and mentoring for CRP competency growth, and describe opportunities to improve training and professionalization for the CRP career pathway.

Materials/Methods: Qualitative data from a series of Un-Meeting breakout sessions and open-text …

Detection Of Emerging Neurodegeneration Using Bayesian Linear Mixed-Effect Modeling, Yann Cobigo, Richard J Perrin, Et Al.

2020-Current year OA Pubs

Early detection of neurodegeneration, and prediction of when neurodegenerative diseases will lead to symptoms, are critical for developing and initiating disease modifying treatments for these disorders. While each neurodegenerative disease has a typical pattern of early changes in the brain, these disorders are heterogeneous, and early manifestations can vary greatly across people. Methods for detecting emerging neurodegeneration in any part of the brain are therefore needed. Prior publications have described the use of Bayesian linear mixed-effects (BLME) modeling for characterizing the trajectory of change across the brain in healthy controls and patients with neurodegenerative disease. Here, we use an extension …

Altered Peroxisome Proliferator-Activated Receptor Alpha Signaling In Variably Diseased Peripheral Arterial Segments, Connor Engel, Rodrigo Meade, Nikolai Harroun, Amanda Penrose, Mehreen Shafqat, Xiaohua Jin, Gayan Desilva, Clay Semenkovich, Mohamed Zayed

2020-Current year OA Pubs

OBJECTIVE: Peripheral atherosclerosis that accumulates in the extracranial carotid and lower extremity arteries can lead to significant morbidity and mortality. However, atherosclerotic disease progression is often not homogenous and is accelerated by diabetes. We previously observed increased phospholipid content in minimally (Min)-diseased arterial segments compared to maximally (Max)-diseased segments. Since Peroxisome Proliferator-Activated Receptor alpha (PPARα) is a key regulator of lipid metabolism, we hypothesized that it may have differential expression and signaling in Min vs. Max-diseased peripheral arterial segments.

METHODS: Eighteen patients who underwent carotid endarterectomy (CEA), and 34 patients who underwent major lower extremity amputation were prospectively enrolled into …

The Longitudinal Impact Of Maternal Depression And Neighborhood Social Context On Adolescent Mental Health, Daphne Lew, Hong Xian, Travis Loux, Enbal Shacham, Darcell Scharff

2020-Current year OA Pubs

PURPOSE: Maternal depression and neighborhood characteristics are known to be associated both with each other and with adolescent mental health outcomes. These exposures are also subject to change throughout the life of a child. This study sought to identify multi-trajectories of maternal depression (MD) and self-reported neighborhood collective efficacy (NCE) over a 12-year period and determine whether these trajectories are differentially associated with adolescent mental health.

METHODS: Data from the Fragile Families and Child Wellbeing study, a longitudinal cohort study of new parents and their children, were used. Maternal depression (MD) and self-reported NCE when the child was 3, 5, …

The Chasm In Percutaneous Coronary Intervention And In-Hospital Mortality Rates Among Acute Myocardial Infarction Patients In Rural And Urban Hospitals In China: A Mediation Analysis, Miao Cai, Echu Liu, Peng Bai, Nan Zhang, Siyu Wang, Wei Li, Hualiang Lin, Xiaojun Lin

2020-Current year OA Pubs

No abstract provided.

What Does It Mean To Be Affiliated With Care?: Delphi Consensus On The Definition Of "Unaffiliation" And "Specialist" In Sickle Cell Disease, Andrea E. Lamont, Lewis L. Hsu, Sara Jacobs, Robert Gibson, Marsha Treadwell, Yumei Chen, Richard Lottenberg, Kathleen Axelrod, Taniya Varughese, Cathy Melvin, Sharon Smith, Ifeanyi Beverly Chukwudozie, Julie Kanter, Sickle Cell Disease Implementation Consortium

2020-Current year OA Pubs

Accruing evidence reveals best practices for how to help individuals living with Sickle Cell Disease (SCD); yet, the implementation of these evidence-based practices in healthcare settings is lacking. The Sickle Cell Disease Implementation Consortium (SCDIC) is a national consortium that uses implementation science to identify and address barriers to care in SCD. The SCDIC seeks to understand how and why patients become unaffiliated from care and determine strategies to identify and connect patients to care. A challenge, however, is the lack of agreed-upon definition for what it means to be unaffiliated and what it means to be a "SCD expert …

The Impact Of A Virtual Orthopaedic Surgery Symposium On Medical Students: Increasing Awareness And Knowledge Of The Field, Theodore Quan, Alex Gu, Amil R. Agarwal, Simone A. Bernstein, Alisa Malyavko, William N. Levine, Lisa K. Cannada, Medical Student Orthopedic Society

2020-Current year OA Pubs

UNLABELLED: Orthopaedic surgery has become an increasingly popular field of residency training for medical students. Many institutions offer elective time to explore areas of interest through clinical rotations and research; however, most of these opportunities are reserved for senior medical students. The purpose of this study was to evaluate the impact of a dedicated medical student orthopaedic surgery symposium to increase awareness about the field and to assess students' interest and knowledge of orthopaedic surgery before and after the symposium.

METHODS: Medical students were invited to submit orthopaedic surgery-related research to a free, 1-day virtual symposium held in April 2022. …

Differentiating Amyloid Beta Spread In Autosomal Dominant And Sporadic Alzheimer's Disease, Elizabeth Levitis, Jacob W Vogel, Thomas Funck, Vladimir Hachinski, Serge Gauthier, Jonathan Vöglein, Johannes Levin, Brian A Gordon, Tammie Benzinger, Yasser Iturria-Medina, Alan C Evans, Dominantly Inherited Alzheimer Network, Alzheimer’S Disease Neuroimaging Initiative

2020-Current year OA Pubs

Amyloid-beta deposition is one of the hallmark pathologies in both sporadic Alzheimer's disease and autosomal-dominant Alzheimer's disease, the latter of which is caused by mutations in genes involved in amyloid-beta processing. Despite amyloid-beta deposition being a centrepiece to both sporadic Alzheimer's disease and autosomal-dominant Alzheimer's disease, some differences between these Alzheimer's disease subtypes have been observed with respect to the spatial pattern of amyloid-beta. Previous work has shown that the spatial pattern of amyloid-beta in individuals spanning the sporadic Alzheimer's disease spectrum can be reproduced with high accuracy using an epidemic spreading model which simulates the diffusion of amyloid-beta across …

Socioecological Model-Based Design And Implementation Principles Of Lower Limb Preservation Programs As Partners For Limb-Loss Rehabilitation Programs- A Mini-Review, Vipul Khetarpaul, John P Kirby, Patrick Geraghty, John Felder, Prateek Grover

2020-Current year OA Pubs

People with lower limb loss, especially of dysvascular etiology, are at substantial risk for both ipsilateral and contralateral reamputation. Additionally, while not as well documented for reamputation, there is recognition that amputation incidence is influenced by not only sociodemographic factors such as sex, race, socioeconomic status, but also by system factors such as service access. A systems strategy to address this disparity within the field of limb-loss rehabilitation is for Limb-loss Rehabilitation Programs (LRP) to partner with medical specialists, mental health professionals, and Limb Preservation Programs (LPP) to provide comprehensive limb care. While LPPs exist around the nation, design principles …

Postnatal Osterix But Not Dmp1 Lineage Cells Significantly Contribute To Intramembranous Ossification In Three Preclinical Models Of Bone Injury, Evan G Buettmann, Susumu Yoneda, Pei Hu, Jennifer A Mckenzie, Matthew J Silva

2020-Current year OA Pubs

Murine models of long-bone fracture, stress fracture, and cortical defect are used to discern the cellular and molecular mediators of intramembranous and endochondral bone healing. Previous work has shown that Osterix (Osx

Neurology Resident Eeg Training In Europe, Fábio A Nascimento, Jay R Gavvala, Hatice Tankisi, Sándor Beniczky

2020-Current year OA Pubs

OBJECTIVE: To detail current European EEG education practices and compare European and U.S. EEG teaching systems.

METHODS: A 19-question online survey focused on EEG clinical practices and residency training was emailed to all 47 European Academy of Neurology Societies.

RESULTS: Thirty-two (68 %) out of the 47 Societies completed the survey. In half of countries, general neurologists are either among the providers or the only providers who typically read EEGs. The number of weeks devoted to EEG learning required to graduate ranged from none to 26, and it was expected to be continuous in one country. In most countries (n …

Sexual Minority Stress And Mental Health: An Investigation Of Rural-Urban Differences In Social Support, Justin T. Miller

College of Graduate Studies: Theses & Dissertations

As mental health disparities and discrimination facing the LGB (sexual minority) community continues to come into public focus, researchers and clinicians are moving toward identifying LGB-specific mental health interventions to support well-being efforts within this population. Furthermore, much of the current literature on sexual minority mental health is focused on predominantly urban samples failing to consider the sociocultural impacts of living in low resourced and geographically isolated regions of the United States (US). To this end, social support is a promising prevention factor, but few studies to date examine its influence on different minority stress models. As such, the current …

Effects Of Various Golf Bag Loading Strategies On Perceived Exertion And Vertical Jump Performance, Austen Arnold

College of Graduate Studies: Theses & Dissertations

INTRODUCTION: The sport of golf is increasing in popularity among both novice and skilled players alike. A round of golf necessitates players to cope with a range of physically demanding movement patterns. At the collegiate level, golfers must transport their clubs by loading them onto the body. Previous literature has yet to determine how different golf bag carrying positions influence periodic, unloaded jump performance and perceived exertion of the load carrying task. PURPOSE: The purpose of this study is to investigate how different golf bag load carriage methods may influence vertical jump performance and perceived exertion. METHODS: Five golf bag …

Bridging The Gaps: Exploring Factors Associated With Goal Achievement Within An Accountable Care Organization Care Coordination Program, Jessica L. Polk

College of Graduate Studies: Theses & Dissertations

Background: Healthcare cost in the U.S. has been increasing at an unsustainable rate due to the growing population diagnosed with multiple chronic conditions and a fragmented healthcare system. The high-risk patient population includes persons who over utilize the healthcare system with frequent avoidable hospitalizations, emergency room visits, and exacerbations of their chronic conditions. This high-risk population makes up five percent of the U.S. but accounts for over fifty percent of all healthcare spending. Care coordination models have emerged to focus proactive health interventions for the highest-risk patient populations to reduce overutilization and empower patients to improve long-term health. Evidence has …

Modelling Muscle Activation Using Emg Signal, Mercy U. Okonna

College of Graduate Studies: Theses & Dissertations

(EMG) is a method for measuring muscle activity by an electrical signal, and is useful in studying motor control, postural control, and in physical therapy. A current research topic is creating an algorithm that can use the EMG signal to reliably classify a muscle as active or inactive. This thesis presents a classification algorithm for leg muscles with a single activation spike while walking. Time is rescaled into steps, which are identified using data from cameras measuring joint angles while walking. The algorithm is based on moving averages and a convex combination of mean signal strength in active and inactive …

A Proportionality-Based Framework For Government Regulation Of Digital Tracing Apps In Times Of Emergency, Sharon Bassan

Dickinson Law Review (2017-Present)

Times of emergency present an inherent conflict between the public interest and the preservation of individual rights. Such times require granting emergency powers to the government on behalf of the public interest and relaxing safeguards against government actions that infringe rights. The lack of theoretical framework to assess governmental decisions in times of emergency leads to a polarized and politicized discourse about potential policies, and often, to public distrust and lack of compliance.

Such a discourse was evident regarding Digital Tracing Apps (“DTAs”), which are apps installed on cellular phones to alert users that they were exposed to people who …

Primary Care Characteristics And Medication Management Among Patients Receiving Office Based Opioid Treatment With Buprenorphine, Xinxin Du

Yale Medicine Thesis Digital Library

AbstractBackground: Office-based opioid treatment (OBOT) is an evidence-based treatment model for opioid use disorder (OUD) offered by both addiction and general primary care providers (PCPs). Calls exist for more PCPs to offer OBOT. Few studies have been conducted on the primary care characteristics of OBOT patients. Objective: To characterize medical conditions, medications, and treatment outcomes among patients receiving office-based opioid treatment (OBOT) with buprenorphine for OUD, and to describe differences among patients by age and by time in care. Methods: This study is a retrospective review of medical records on or before 4/29/2019 at an outpatient primary care clinic within …

Environmental Racism In Baltimore: A Geographical Study Into The Connections Between Environmental Toxins And Public Health, Genevieve Block

Honors Theses

An investigation into the relationship between environmental toxins and environmental racism in Baltimore City, Maryland.

Nurses’ Perceptions Of Their Role Utilizing Eat, Sleep, Console, In The Management Of Neonatal Abstinence Syndrome, Cerys Eldred

Honors Theses and Capstones

Background: There is a rising prominence of infants being born and diagnosed with Neonatal Abstinence Syndrome (NAS) in the United States. In recent years, a new non-pharmacological method of managing these infants called Eat, Sleep, Console (ESC) has emerged. While there is mounting evidence demonstrating the positive outcomes for infants treated with this method, there is limited research regarding nurses’ perceptions of this new intervention. This study seeks to understand the nurse’s experience and role during caring for infants with NAS utilizing the ESC method in comparison to the past practices.

Methods: This study used a qualitative descriptive design to …

Neuromotor Changes In Participants With A Concussion History Can Be Detected With A Custom Smartphone App, Christopher K. Rhea, Masahiro Yamada, Nikita A. Kuznetsov, Jason T. Jakiela, Chanel T. Lojacono, Scott E. Ross, F. J. Haran, Jason M. Bailie, W. Geoffrey Wright

Rehabilitation Sciences Faculty Publications

Neuromotor dysfunction after a concussion is common, but balance tests used to assess neuromotor dysfunction are typically subjective. Current objective balance tests are either cost- or space-prohibitive, or utilize a static balance protocol, which may mask neuromotor dysfunction due to the simplicity of the task. To address this gap, our team developed an Android-based smartphone app (portable and cost-effective) that uses the sensors in the device (objective) to record movement profiles during a stepping-in-place task (dynamic movement). The purpose of this study was to examine the extent to which our custom smartphone app and protocol could discriminate neuromotor behavior between …

Storytelling Of Interprofessional Teamwork, Jessica Lee, Ashley Ronzo, Kendall Dolan, Daniel Bergeron

CECE Spring Poster Session 2022

We are an interprofessional team that worked together to discuss and treat a patient suffering from Long COVID-19. At the beginning, we came in with assumptions of other professions and carried our biases into the group. However, as we witnessed these professions interact with our Long COVID-19 patient, Amanda, our views and biases began to change. We were privileged to see how interprofessional teams interact and come together for the betterment of our patient.