Medicine and Health Sciences Commons^™

Precision Requirements And Data Compression In Cryoem/Cryoet, Adam C Fluty, Steven J Ludtke

Faculty, Staff and Students Publications

With larger, higher speed detectors and improved automation, individual CryoEM instruments are capable of producing a prodigious amount of data each day, which must then be stored, processed and archived. While it has become routine to use lossless compression on raw counting-mode movies, the averages which result after correcting these movies no longer compress well. These averages could be considered sufficient for long term archival, yet they are conventionally stored with 32 bits of precision, despite high noise levels. Derived images are similarly stored with excess precision, providing an opportunity to decrease project sizes and improve processing speed. We present …

Accumulation Of Copy-Back Viral Genomes During Respiratory Syncytial Virus Infection Is Preceded By Diversification Of The Copy-Back Viral Genome Population Followed By Selection, Sébastien A Felt, Emna Achouri, Sydney R Faber, Carolina B López

2020-Current year OA Pubs

RNA viruses generate nonstandard viral genomes during their replication, including viral genomes of the copy-back (cbVGs) type that cannot replicate in the absence of a standard virus. cbVGs play a crucial role in shaping virus infection outcomes due to their ability to interfere with virus replication and induce strong immune responses. However, despite their critical role during infection, the principles that drive the selection and evolution of cbVGs within a virus population are poorly understood. As cbVGs are dependent on the virus replication machinery to be generated and replicated, we hypothesized that host factors that affect virus replication exert selective …

Rapidplan Hippocampal Sparing Whole Brain Model Version 2-How Far Can We Reduce The Dose?, Hefei Liu, Ryan Clark, Anthony Magliari, Robert Foster, Francisco Reynoso, Matthew Schmidt, Vinai Gondi, Christopher Abraham, Heather Curry, Patrick Kupelian, Deepak Khuntia, Sushil Beriwal

2020-Current year OA Pubs

Whole-brain radiotherapy has been the standard palliative treatment for patients with brain metastases due to its effectiveness, availability, and ease of administration. Recent clinical trials have shown that limiting radiation dose to the hippocampus is associated with decreased cognitive toxicity. In this study, we updated an existing Knowledge Based Planning model to further reduce dose to the hippocampus and improve other dosimetric plan quality characteristics. Forty-two clinical cases were contoured according to guidelines. A new dosimetric scorecard was created as an objective measure for plan quality. The new Hippocampal Sparing Whole Brain Version 2 (HSWBv2) model adopted a complex recursive …

Quality Of Life, Illness Perceptions, And Parental Lived Experiences In Tango2-Related Metabolic Encephalopathy And Arrhythmias, Chaya N Murali, Seema R Lalani, Mahshid S Azamian, Christina Y Miyake, Hadley Stevens Smith

Faculty, Staff and Students Publications

TANGO2 disorder is a rare genetic disease with multi-system effects that causes episodic crises. Quality of life and psychosocial effects of this rare disease have not previously been studied. To examine health-related quality of life (HRQoL), illness perceptions, and lived experience, we surveyed 16 children and 31 parents of children with TANGO2 disorder identified via a disease-specific social media group and research foundation email distribution list. We assessed HRQoL by parent proxy-report and child self-report using the Pediatric Quality of Life Inventory (PedsQL™). Parental perceptions of their child's condition were assessed using the revised illness perceptions questionnaire adapted for TANGO2 …

Adolescent And Young Adult Preferences For Financial Incentives To Support Adherence To Antiretroviral Therapy In Kenya: A Mixed Methods Study, Ingrid Eshun-Wilson, Eliud Akama, Fridah Adhiambo, Zachary Kwena, Bertha Oketch, Sarah Obatsa, Sarah Iguna, Jayne L Kulzer, James Nyanga, Everlyne Nyandieka, Ally Scheve, Elvin H Geng, Elizabeth A Bukusi, Lisa Abuogi

2020-Current year OA Pubs

INTRODUCTION: To develop a patient-centred financial incentive delivery strategy to improve antiretroviral treatment adherence in adolescents and young adults (AYA) living with HIV in Kisumu, Kenya, we conducted a mixed methods study exploring preferences.

METHODS: A discrete choice experiment (DCE) and focus group discussion (FGD) were conducted simultaneously to identify preferences for five incentive delivery strategy features: value, eligibility, recipient, format and disbursement frequency. We used consecutive sampling to recruit AYA (14-24 years) living with HIV attending three health facilities in Kisumu, Kenya. We calculated mean preferences, willingness to trade, latent class membership and predictors of latent class membership. The …

An Ips-Derived In Vitro Model Of Human Atrial Conduction, Sherri M Biendarra-Tiegs, Sergey Yechikov, Bhupinder Shergill, Brittany Brumback, Kentaro Takahashi, Venktesh S Shirure, Ruth Estelle Gonzalez, Laura Houshmand, Denise Zhong, Kuo-Chan Weng, Jon Silva, Timothy W Smith, Stacey L Rentschler, Steven C George

2020-Current year OA Pubs

Atrial fibrillation (AF) is the most common arrhythmia in the United States, affecting approximately 1 in 10 adults, and its prevalence is expected to rise as the population ages. Treatment options for AF are limited; moreover, the development of new treatments is hindered by limited (1) knowledge regarding human atrial electrophysiological endpoints (e.g., conduction velocity [CV]) and (2) accurate experimental models. Here, we measured the CV and refractory period, and subsequently calculated the conduction wavelength, in vivo (four subjects with AF and four controls), and ex vivo (atrial slices from human hearts). Then, we created an in vitro model of …

A Randomized Controlled Trial In Schools Aimed At Exploring Mechanisms Of Change Of A Multifaceted Implementation Strategy For Promoting Mental Health At The Workplace, Lydia Kwak, Anna Toropova, Byron J Powell, Rebecca Lengnick-Hall, Irene Jensen, Gunnar Bergström, Liselotte Schäfer Elinder, Kjerstin Stigmar, Charlotte Wåhlin, Christina Björklund

2020-Current year OA Pubs

BACKGROUND: This study will explore implementation mechanisms through which a single implementation strategy and a multifaceted implementation strategy operate to affect the implementation outcome, which is fidelity to the Guideline For The Prevention of Mental Ill Health within schools. The guideline gives recommendations on how workplaces can prevent mental ill health among their personnel by managing social and organizational risks factors in the work environment. Schools are chosen as the setting for the study due to the high prevalence of mental ill health among teachers and other personnel working in schools. The study builds on our previous research, in which …

Minimal Change Prion Retinopathy: Morphometric Comparison Of Retinal And Brain Prion Deposits In Creutzfeldt-Jakob Disease, Vanessa S Goodwill, Ian Dryden, Jihee Choi, Chiara De Lillo, Katrin Soldau, Jorge Llibre-Guerra, Henry Sanchez, Christina J Sigurdson, Jonathan H Lin

2020-Current year OA Pubs

Sporadic Creutzfeldt-Jakob disease (sCJD) is the most commonly diagnosed human prion disease caused by the abnormal misfolding of the 'cellular' prion protein (PrP

Telemedicine And Healthcare Implications For Central Virginia: A Systematic Review Of The Literature, Patricia A. Lynch, Charletta H. Barringer-Brown, Daniel N. Brown, Taneisha D. Brown

Journal of Research Initiatives

Background: Uncertainties and challenges associated with COVID-19 have affected the efficient delivery of health care in Central Virginia. Integrating and redesigning health systems could boost the quality and efficiency of care delivery. Telemedicine has been suggested as a viable solution to increase virtual access to patient advocacy healthcare education and training programs and has the potential to help facilitate the delivery of health services to rural and remote areas. It is projected that access to quality telehealth services can minimize the need for in-person hospital visitation amid the pandemic. The innovation also facilitates remote assessment of patients and monitoring of …

The Utilization Of Crispr/Cas9 In Monogenic Disorders Authors, Shauna M. Mellor

Spectra Undergraduate Research Journal

This paper is a literature review of various scientific research papers, exploring the recent scientific advancement in the field of genetic engineering. The research presented is a foundational tool, building awareness on the implications of CRISPR/ Cas9 technology. CRISPR/ Cas9 was first discovered through the study of bacterial immune systems, fighting against viral infections. Manipulation of the Cas9 protein would eventually lead to target specific, gene-altering medicines for human organisms. CRISPR/ Cas 9 technology has begun to show promise as an effective treatment for certain monogenic disorders. Despite this, time is required before its efficacy as a proven genetic treatment …

Narrative Review Of Covid-19 Vaccine Hesitancy: Evidence In Late 2021, Ambree Papa Schoetker, Manoj Sharma

Spectra Undergraduate Research Journal

The coronavirus disease, COVID-19, has changed daily life dramatically since early 2020. Although COVID-19 vaccines are available in the United States, many express distrust in this primary prevention measure and doubt both the seriousness of COVID-19 and its associated morbidity and mortality. Vaccine hesitancy, also described as the reluctance or refusal of vaccines despite availability, exists on a continuum and was a known public health threat prior to the coronavirus pandemic. This narrative review examines studies related to the determinants of COVID-19 vaccine hesitancy among adults in the United States. Also explored are the factors related to COVID-19 vaccine risk …

Comprehensive Care To Improve Quality Of Life: A Case Of Childhood Adrenoleukodystrophy, Miraal S. Dharamsi, Adrian A. Mejia, Cecilia De Vargas

HCA Healthcare Journal of Medicine

The childhood cerebral form of adrenoleukodystrophy (ALD) causes rapid demyelination of cerebral white matter and is clinically characterized by hyperactivity, emotional changes, and poor school performance, as well as progressive cognitive, visual, auditory, speech, and motor decline. While aggressive behavior is a known complication of ALD, treatment of the disease is limited. Moreover, behavioral management is not well described in the available literature, particularly from a psychiatric standpoint. In this case presentation, the patient’s parents reported significant agitation and aggression, which may have been secondary to verbal deficits, in addition to the general neuropathological implications of this disease. Although this …

Covid-19 And Lung Cavitation: A Clue To Pathogenesis?, Tanner W. Norris, Blake M. Snyder, Patryk Purta, Ryan P. Spilman, Vanessa J. Craig

HCA Healthcare Journal of Medicine

Lung cavitation as a complication of COVID-19 is rare. A 56-year-old male presented with lung cavitation, small volume hemoptysis, and violaceous discoloration of the right great toe, 5 weeks after diagnosis with COVID-19 pneumonia. The digital changes were consistent with previously described microvascular changes called "COVID toe." CT angiography of the chest was negative for pulmonary embolism but showed a 2.5 x 3.1 x 2.2 cm cavitation within the right lung. Extensive evaluation for commonly implicated infectious and autoimmune causes was negative. We concluded that the cavitary lung lesions were likely a complication of COVID-19 pneumonia and may implicate microangiopathy …

Acyclovir-Resistant Anogenital Herpes Simplex Virus In An Hiv Patient With Pseudoepitheliomatous Hyperplasia Resembling Squamous Cell Carcinoma, Jean Elizze M. Charles, Stephen E. Weis, Gregory A. Hosler

HCA Healthcare Journal of Medicine

Background

Herpes simplex virus (HSV) is a common infection. However, it may present atypically when patients are immunocompromised, such as with slowly expanding, long-lasting ulcerative or hypertrophic lesions. The histopathologic finding of pseudoepitheliomatous hyperplasia (PEH) can occur in a variety of situations where there is chronic inflammation and can be seen in patients with chronic HSV. Atypical presentations of HSV, particularly hypertrophic lesions with histopathologic findings of PEH, can be misinterpreted as squamous cell carcinoma, create difficulty in diagnosis and hinder appropriate treatment.

Case Description

We report a case of a 59-year-old female with a past medical history of human …

Antineutrophil Cytoplasmic Antibody (Anca)-Associated Aortitis Presenting With Acute Dissection: Case Report And Comprehensive Literature Review, Obteene Azimi-Ghomi, Jorge De La Portilla

HCA Healthcare Journal of Medicine

Vasculitides are a group of diseases that produces vasculitis, which is characterized by inflammatory infiltrates within blood vessel walls and results in intimal injury as well as progressive mural destruction. Infiltrates are characterized per the Chapel Hill classification, into large, medium, and small-vessel vasculitides. ANCA-associated vasculitis (AAV) is a disease that has been described as involving small-sized vessels. However, some cases of large vessel disease involvement have been documented. ANCA-associated aortitis is a rare entity poorly described in the literature. Due to the rarity of this pathology, there is no Level I evidence available regarding diagnosis and treatment. We present …

Co2 Levels Behind And In Front Of Different Protective Mask Types, Hossein Akhondi, Sassan Kaveh, Kimball Kaufman, Tina Danai, Napatkamon Ayutyanont

HCA Healthcare Journal of Medicine

Objectives

Many individuals have difficulty adapting to face mask use and report symptoms while using masks. Our primary objective was to determine whether continuous mask-wearing causes elevated levels of carbon dioxide (CO₂) behind the facemasks.

Methods

CO₂ concentrations were measured behind 3 different types of face masks and were compared to CO^₂ concentrations at the mask front in 261 subjects who continuously wore masks for at least 5 minutes. These CO₂ concentrations were also measured in several randomly selected subjects after a 5-minute walk.

Results

There were significantly higher CO₂ concentrations behind the mask …

Complications Of Tavr From An Anesthesia Perspective, David R. Kingery Jr., Alex Roberts, Derek Horstemeyer, Russell Stahl

HCA Healthcare Journal of Medicine

Transcatheter aortic valve replacement (TAVR) has become the predominant technique for aortic valve replacement in the United States. Initially approved for high surgical risk patients, TAVR is now approved for most patients requiring valve therapy, including younger, lower-risk patients. The procedure is ideally performed in a hybrid operating room equipped with fluoroscopic equipment and transesophageal echocardiogram (TEE) imaging that can be viewed simultaneously by the operating team. The operating room should also be equipped to allow initiation of cardiopulmonary bypass, if necessary. Cardiac anesthesia teams are often involved with the management of these patients. This mini-review is designed to summarize …

An Acknowledgement To The Hca Healthcare Journal Of Medicine’S Reviewers And Editors For The 1st Half Of 2022, Bruce Deighton, Hossein Akhondi, David Scott Lind, Graig Donini

HCA Healthcare Journal of Medicine

The HCA Healthcare Journal of Medicine would like to thank those behind the scenes who make this publication possible. Our journal would not be possible without the assistance of our reviewers, authors and board members.

Medical School Watercooler Newsletter - August 31, 2022, Lindsey Lyle

Watercooler Newsletter

This is the August 31, 2022 edition of the Frederick P. Whiddon College of Medicine's newsletter - Watercooler.

Contents include:

• Meet a Med Student: Naden Kreitz
• USA scientist receives $2.3 million grant renewal for flea pathogen research

Model Autonomy Of Self-Finance Management For Primary Health Care To Enhance Workers’ Satisfaction, Ahmad Jet Alamin, Ossama Issac, Lina Teo, Atikah Adyas

Kesmas

This study aimed to find an appropriate model of autonomous self-finance management in primary health care (PHC) to enhance workers' satisfaction. This was a cross-sectional study in which data were collected through self-administered questionnaires from 204 workers in ten Regional Public Service Agency for Primary Health Care (RPSAPHC)/Badan Layanan Umum Daerah Pusat Kesehatan Masyarakat (BLUD Puskesmas) in Tangerang District, Banten Province, Indonesia using the partial least squares and structural equation model (PLS-SEM). A total of 73 indicators were used to examine the PHC transformation process to enhance workers' satisfaction. The indicators were grouped into three variables depending on workers' satisfaction: …

Association Of Methylenetetrahydrofolate Reductase Rs1801133 Genetic Variants With Type 2 Diabetes Mellitus And Diabetic Nephropathy, Aysegul Bayramoglu, Gokhan Bayramoglu, Halil Ibrahım Guler, Nezaket Coban, Mustafa Çagatay Korkmaz

Makara Journal of Health Research

Background: Type 2 diabetes mellitus (T2DM) is a complex metabolic disease with a genetic predisposition. Methylenetetrahydrofolatereductase (MTHFR) gene is one of the candidate genes associated with T2DM and diabetic nephropathy (DN). This research was carried out to determine the frequency of the C677T polymorphism (rs1801133) of the MTHFR gene and examine the role of rs1801133 polymorphism in T2DM and DN development.

Methods: DNA was obtained from peripheral blood samples (273 samples) using a DNA isolation kit. MTHFR rs1801133 polymorphism was determined using polymerase chain reaction (PCR), restriction fragment length polymorphism (RFLP), and electrophoresis. PCR products were cut by …

2022-08-31_Michiganoverview_Covidvaccinestats, Michigan Department Of Health & Human Services

Michigan COVID-19 Vaccine Data

The COVID Vaccine Dashboard page was obtained from Michigan's main COVID-19 page: https://www.michigan.gov/coronavirus/resources/covid-19-vaccine/covid-19-dashboard.

First-dose tracker above is for entire Michigan Population. Coverage maps below are for age 5+.

Previously reported numbers of administered vaccine doses may change as new data are received. A possible lag in reporting vaccine doses will result in increases in numbers previously reported.

This report is created by the Michigan Department of Health and Human Services Division of Immunization from data reported to the Michigan Care Improvement Registry (MCIR).

The dashboard contained the tabs Primary Series Doses Administered, Primary Series Doses by Vaccine, …

2022-08-31_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.

Factors Influencing The Choice Of Toothpaste And Investigation Of Those Most Commercialized By Students In Settat, Morocco, Abdellatif Rahim, Wissal El Karfi, Lalla Asmaa Katir Masnaoui, Bouchra El Amiri, Abdel Khalid Essamadi

Makara Journal of Health Research

Background: This study aimed to determine the factors influencing the choice of toothpaste by students in Settat (Morocco) and investigate the characteristics of those most commercialized in this region.

Methods: A close-ended questionnaire was developed and filled out. This was a cross-sectional study of 429 students who agreed to participate. Based on questionnaire data, the 15 most commercialized toothpaste by respondents were purchased, and their packaging was investigated.

Results: After analysis using Excel 2019, the results revealed that the major factors influencing the choice of toothpaste are brand 55%, family choice 48%, and media advertisements 40%. Moreover, …

Exploratory Analysis Of Outpatient Visits For Us Adults Diagnosed With Lupus Erythematosus: Findings From The National Ambulatory Medical Care Survey 2006–2016, Salena Marie Preciado, Khaled A. Elsaid, Souhiela Fawaz, Lawrence Brown, Enrique Seoane-Vazquez, Marc Fleming, Yun Wang

Pharmacy Faculty Articles and Research

The study aims to assess office-based visit trends for lupus patients and evaluate their medication burden, chronic conditions, and comorbidities. This cross-sectional study used data from the National Ambulatory Medical Care Survey (NAMCS), a survey sample weighted to represent national estimates of outpatient visits. Adult patients diagnosed with lupus were included. Medications and comorbidities that were frequently recorded were identified and categorized. Descriptive statistics and bivariate analyses were used to characterize visits by sex, age, race/ethnicity, insurance type, region, and reason for visit. Comorbidities were identified using diagnosis codes documented at each encounter. There were 27,029,228 visits for lupus patients …

Patient Experience Of Inpatient Care And Services Received At A Teaching Hospital In Malaysia: A Cross-Sectional Study, Wan Nor Fatihah Wan Nawawi, Vimala Ramoo, Mei Chan Chong, Nor Zehan Ahmad

Makara Journal of Health Research

Background: Patients’ experience reflects the quality of healthcare services from the end user’s perspective and therefore is an essential indicator of healthcare quality. This study aimed to measure patient experience of inpatient care and services received at a teaching hospital.

Methods: A total of 321 patients were enrolled in this quantitative, cross-sectional study during their discharge. Data were collected from May to September 2018 through a validated self-administered questionnaire adapted from the Hospital Consumer Assessment of Healthcare Providers and Systems survey. Analysis of patient experience and overall hospital quality rating was conducted using SPSS version 25.

Results: …

Accrual-Monitoring Practices For Various Disease Trials Among Aaci Member Cancer Centers, Zachary T Elliott, Zachary N. Goldberg, Ramez Philips, Jennifer Johnson, Margaret Kasner, William Kevin Kelly, Sarah Osipowicz, Rachael Dampman, Joseph Curry

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Progress in the management of rare diseases, including rare cancers, is dependent upon clinical trials; however, as many as 32% of rare-disease trials go uncompleted or unpublished due to insufficient accrual. Monitoring practices may differ between institutions. We sought to survey the regulatory standards for various trial types among major U.S. cancer centers. A 10-question survey was designed using Qualtrics assessment software. The survey was sent via email to an internal server of member institutions of the Association of American Cancer Institutes (AACI). Of 103 AACI centers, 31% completed the survey (n = 32). Respondents differed in their definitions …

The Role Of Bariatric And Metabolic Surgery In The Development, Diagnosis, And Treatment Of Endometrial Cancer, Robert C. Ross, Yetunde M. Akinde, Philip R. Schauer, Carel W. Le Roux, Donal Brennan, Amelia M. Jernigan, Marco Bueter, Vance L. Albaugh

School of Medicine Faculty Publications

The obesity pandemic continues to contribute to a worsening burden of disease worldwide. The link between obesity and diseases such as diabetes, cardiovascular disease, and cancer has been well established, yet most patients living with obesity remain untreated or undertreated. Metabolic and bariatric surgery is the most effective and durable treatment for obesity, is safe, and may have a protective benefit with respect to cancer incidence. In this review, an overview of the link between obesity, metabolic surgery, and cancer is discussed with emphasis on indications for endometrial cancer, the malignancy most strongly associated with obesity. Considerable evidence from retrospective …

Spatial Analysis For Enhancing The Use Of Health Data Availability From Different Sources To Help The Decision-Making Process, Tris Eryando

Kesmas

Spatial analysis in public health has become a common method used by researchers to understand the distribution of public health aspects related to the surrounding environment. It can also be used to analyze individual information in the form of a dot and the location or line of aggregated information in a specific area of study. Another benefit is the possibility of using different data sources to be analyzed in one statistical model analysis, as long as the identification area is sufficiently clear as a key variable. Spatial analysis can show an object's distribution on a locational map and explain the …

Sars-Cov-2 Antibody Seroprevalence In Jakarta, Indonesia, Iwan Ariawan, Hafizah Jusril, Muhammad N Farid, Pandu Riono, Wiji Wahyuningsih, Widyastuti Widyastuti, Dwi Oktavia T L Handayani, Endang Sri Wahyuningsih, Rebekka Daulay, Retno Henderiawati, Safarina G. Malik, Rintis Noviyanti, Leily Trianty, Nadia Fadila, Khin Saw Aye Myint, Frilasita A. Yudhaputri, Neeraja Venkateswaran, Kodumudi Venkateswaran, Venkatachalam Udhayakumar, William A. Hawley, Juliette Morgan, Paul M. Pronyk

Kesmas

The SARS-CoV-2 transmission dynamics in low- and middle-income countries remain poorly understood. This study aimed to estimate the SARS-CoV-2 antibodies seroprevalence in Jakarta, Indonesia, and to increase knowledge of SARS-CoV-2 transmission in urban settings. A population-based serosurvey among individuals aged one year or older was conducted in Jakarta. Employing a multistage sampling design, samples were stratified by district, slum, and non-slum residency, sex, and age group. Blood samples were tested for IgG against three different SARS-CoV-2 antigens. Seroprevalence was estimated after applying sample weights and adjusting for cluster characteristics. In March 2021, this study collected 4,919 respondents. The weighted estimate …