Medicine and Health Sciences Commons^™

A New Wave Of The Overdose Epidemic Arises During The Covid-19 Pandemic, Tolga Suvar Md, Asokumar Buvanendran Md, Stephen Music Do, Wilson M. Compton Md, Mpe

Advances in Clinical Medical Research and Healthcare Delivery

Abstract

Objective:

The goal of this manuscript is to highlight the notoriety of the overdose epidemic which has been masked by the Coronavirus pandemic.

Methods:

A thorough literature review of PubMed and the latest statistics from the Centers for Disease Control and Prevention (CDC) was performed for the most relevant and updated data regarding overdose deaths.

Conclusion:

The global health crisis known as the Coronavirus Disease 2019 (COVID-19) pandemic collided with the opioid epidemic in March of 2020, with devastating consequences for the United States. By overwhelming the healthcare system, the pandemic impacted patients who require continued mental health services, …

A Case Of Maintenance Prednisone In Anca Glomerulonephritis, Arjun Sekar, Pulkit Gandhi, Vijay Sheldon, Aswanth Reddy, Ruth Campbell

Advances in Clinical Medical Research and Healthcare Delivery

Anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis (AAV) is a rare condition that can cause rapid renal failure. Treatment involves steroids and other immunosuppressive agents. Agents for induction include rituximab, cyclophosphamide, pulse dose steroids and avacopan.

Maintenance regimens include tapered doses of steroids, azathioprine and rituximab

We present a case of severe AAV that maintained remission with a protracted course of low dose prednisone without maintenance rituximab or azathioprine.

A 70-year-old woman was admitted for acute kidney injury (AKI), with a serum creatinine (sCr) of 6.93 mg/dL (baseline sCr of 0.9 mg/dL, nil proteinuria.) Serologic work-up was positive for P-ANCA. She …

Telemedicine, Not The Panacea We Thought It Would Be. A Tale Of Caution, Ahmed Elkhapery, Syed Faiz Abbas, Basil George Verghese

Advances in Clinical Medical Research and Healthcare Delivery

In the last few decades, the growing use of telemedicine has allowed access to healthcare at reduced costs and increased monitoring of chronic conditions, especially in underserved and rural areas. It is a tool of great value in low-income countries where there is a paucity of specialists. In the height of the COVID-19 pandemic, telemedicine was used to screen patients with COVID-19 like symptoms and send them to test sites directly. This helped minimize unnecessary healthcare staff and patient exposure to the infection and helped decompress ERs. Due to a lack of testing resources, many mildly symptomatic patients were presumed …

Racial Disparities In Access To Pain Management Services During Covid Pandemic At An Urban Safety-Net Hospital, Mohammad Ghorbanhoseini, Akhil Venkat Uppalapati, Allen Yang, Rafael Ortega, Eduard Vaynberg

Advances in Clinical Medical Research and Healthcare Delivery

Background: Race has been identified as one of the great divisions of mankind, associated with differences in healthcare access in the US. The COVID pandemic has shed light on a variety of disparities, including access to pain management services.

Method: All the adult patients who were referred to the pain clinic at Boston Medical Center (BMC) from December 2019- December 2020 were included in this study. A total of 2023 cases (1243 White Race and 790 People of Color) were recruited.

Result: Patients of WR received care at a younger age. COVID-19 increased the average age of WR by 2.5 …

Graves' Disease And Major Histocompatibility Complex Class Ii: A Meta-Analysis Of Hla-Dq And Hla-Drb1, Dylan Thibaut, Connor Sweeney, Shannon South, Mohamed Hussein

Advances in Clinical Medical Research and Healthcare Delivery

Background: Human leukocyte antigen (HLA) class II has shown potential in determining prognosis, understanding medication reactions, and predicting onset of Graves’ disease. The aim of this study is to further investigate the association between Graves’ disease and HLA class II, specifically HLA-DQ and HLA-DR, via meta-analysis to find HLAs that can be further examined for prognostic reasons.

Methods: Statistical analysis was performed to determine if variants of HLA-DQA1, HLA-DQB1, or HLA-DRB1 were associated with significantly altered odds of Graves’ disease. A minimum of three studies pertaining to a particular HLA was required for inclusion. Studies were excluded if …

In Honor Of Our Peer Reviewers, Richard Alweis, Elizabeth Mamo, Christina Goodermote

Advances in Clinical Medical Research and Healthcare Delivery

This editorial is our annual recognition of our peer reviewers.

2023-03-13 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.

Scholarly Works Is Celebrating 10 Years: Explore Our Archival Repository And Learn How You Can Use It To Tell Lvhn’S Story, Lehigh Valley Health Network

Historical Archives

No abstract provided.

Varied Performance Of Picture Description Task As A Screening Tool Across Mci Subtypes, Joan A. Mefford, Zilong Zhao, Leah Heilier, Man Xu, Guifeng Zhou, Rachel Mace, Kelly L. Sloane, Shannon M. Sheppard, Shenly Glenn

Communication Sciences and Disorders Faculty Articles and Research

A picture description task is a component of Miro Health’s platform for self-administration of neurobehavioral assessments. Picture description has been used as a screening tool for identification of individuals with Alzheimer’s disease and mild cognitive impairment (MCI), but currently requires in-person administration and scoring by someone with access to and familiarity with a scoring rubric. The Miro Health implementation allows broader use of this assessment through self-administration and automated processing, analysis, and scoring to deliver clinically useful quantifications of the users’ speech production, vocal characteristics, and language. Picture description responses were collected from 62 healthy controls (HC), and 33 participants …

Alternative Techniques For Amplification: A Capstone Case Series, Toryn Davis, Antony Joseph

AuD Capstone Projects - Communication Sciences and Disorders

Abstract 1- Introduction: Charcot-Marie-Tooth (CMT) disease is a rare and chronic hereditary disorder that causes motor and sensory damage to the peripheral nervous system. As the disease progresses, hearing sensitivity may worsen. Case Presentation: A young adult-aged patient presented to the clinic with congenital hearing loss and difficulty with conversational speech in quiet and noisy conditions. Discussion: When encountering a patient with CMT, clinicians should be cognoscente of amplification options, especially if nerve pathways begin to deteriorate. When audiologic testing reveals a progression of hearing loss, alternative amplification may be indicated because conventional hearing aids may not provide enough …

Audiological Intervention For Late-Identified Children And Teenagers With Hearing Loss, Melissa Wiedeman, Antony Joseph

AuD Capstone Projects - Communication Sciences and Disorders

Abstract 1 - Introduction: The family of every child referred for definitive care after a newborn hearing screening should follow up with an audiologist to rule out hearing impairment. Early identification, diagnosis, and intervention are crucial for individualized planning and outcomes. Children who need binaural amplification and are not managed appropriately become exposed to sound deprivation, which leads to diminished speech audibility, sound localization, and speech and language development. Case Presentation: A young child presented to the clinic with an unspecified bilateral mild to moderate hearing loss at 500, 2000, and 4000 Hz. Discussion: Children with monaural amplification have shown …

The Investigation Of First-Year Wellness Programming In College To Reduce Stress And Anxiety Levels, Charlotte Muriel

Graduate Student Dissertations, Theses, Capstones, and Portfolios

The COVID-19 pandemic brought mental health to light, although college students have long been experiencing mental health struggles. First-year experience courses have been shown to relieve some of the stresses associated with the college transition (Holliday, 2014); however, the existing programming does not meet the needs of college students affected by the COVID-19 pandemic. Due to the increased need for mental health services and counseling on college campuses, there is a need for additional support for students dealing with wellness concerns.

This action research study used a three-phase exploratory sequential mixed methods design. Phase One included two audio-recorded focus group …

Greater New Haven Community Wellbeing Index 2023, Mark Abraham, Camille Seaberry, Kelly Davila, Andrew Carr

Reports

No abstract provided.

Prognostication Of Dna Damage Response Protein Expression Patterns In Chronic Lymphocytic Leukemia, Ti'ara L Griffen, Fieke W Hoff, Yihua Qiu, Jan Burger, William Wierda, Steven M Kornblau

Faculty, Staff and Student Publications

Proteomic DNA Damage Repair (DDR) expression patterns in Chronic Lymphocytic Leukemia were characterized by quantifying and clustering 24 total and phosphorylated DDR proteins. Overall, three protein expression patterns (C1-C3) were identified and were associated as an independent predictor of distinct patient overall survival outcomes. Patients within clusters C1 and C2 had poorer survival outcomes and responses to fludarabine, cyclophosphamide, and rituxan chemotherapy compared to patients within cluster C3. However, DDR protein expression patterns were not prognostic in more modern therapies with BCL2 inhibitors or a BTK/PI3K inhibitor. Individually, nine of the DDR proteins were prognostic for predicting overall survival and/or …

Reverse Phase Protein Array Profiling Identifies Recurrent Protein Expression Patterns Of Dna Damage-Related Proteins Across Acute And Chronic Leukemia: Samples From Adults And The Children's Oncology Group, Fieke W Hoff, Ti'ara L Griffen, Brandon D Brown, Terzah M Horton, Jan Burger, William Wierda, Stefan E Hubner, Yihua Qiu, Steven M Kornblau

Faculty, Staff and Student Publications

DNA damage response (DNADR) recognition and repair (DDR) pathways affect carcinogenesis and therapy responsiveness in cancers, including leukemia. We measured protein expression levels of 16 DNADR and DDR proteins using the Reverse Phase Protein Array methodology in acute myeloid (AML) (n = 1310), T-cell acute lymphoblastic leukemia (T-ALL) (n = 361) and chronic lymphocytic leukemia (CLL) (n = 795) cases. Clustering analysis identified five protein expression clusters; three were unique compared to normal CD34+ cells. Individual protein expression differed by disease for 14/16 proteins, with five highest in CLL and nine in T-ALL, and by age in …

Myo1e Overexpression In Lung Adenocarcinoma Is Associated With Increased Risk Of Mortality, Ignacio Jusue-Torres, Richies Tiv, Julio C. Ricarte-Filho, Apurva Mallisetty, Leglys Contreras-Vargas, Maria Jose Godoy-Calderon, Karam Khaddour, Kathleen Kennedy, Klara Valyi-Nagy, Odile David, Martha Menchaca, Anastasia Kottorou, Angelos Koutras, Foteinos Dimitrakopoulos, Khaled M. Abdelhady, Malek Massad, Israel Rubinstein, Lawrence Feldman, John Stewart, Takeshi Shimamura, Ludmila Danilova, Alicia Hulbert

School of Medicine Faculty Publications

This study aims to perform a comprehensive genomic analysis to assess the influence of overexpression of MYO1E in non-small cell lung carcinoma (NSCLC) and whether there are differences in survival and mortality risk in NSCLC patients depending on both DNA methylation and RNA expression of MYO1E. The DNA methylation probe cg13887966 was inversely correlated with MYO1E RNA expression in both LUAD and LUSC subpopulations showing that lower MYO1E RNA expression was associated with higher MYO1E DNA methylation. Late stages of lung cancer showed significantly lower MYO1E DNA methylation and significantly higher MYO1E RNA expression for LUAD but not for LUSC. …

Health Experiences Of Sexual And Gender Minority People Living With Dementia And Their Care Partners: Protocol For A Scoping Review, Jennifer T. May Phd, Rn, Anp-Bc, Melissa Louise Harris

Publications

Background: People living with dementia and their care partners who identify as a sexual and gender minority (SGM) often experience specific health inequities and disparities due to discrimination related to age, cognitive impairment, and being SGM.

Objective: The purpose of this scoping review is to identify, explore, and synthesize the state of the science regarding the health and health care experiences of SGM people living with dementia and their care partners. This review also aims to identify gaps in research and set forth key recommendations to improve the health and health care experiences of SGM people living with dementia and …

Intouch Week Of March 13, 2023, New York Medical College

InTouch

• NYMC Proudly Displays Donated Portrait of William Cullen Bryant
• NYMC Supports Relief Efforts for Victims of Turkey and Syria Earthquake
• NYMC and TU Set to Host Webinar Series: “Ninety Minutes: The Medical Magazine of the Web”
• Carl Edouard Jn Pierre, M.D. ’22, Aided Haitians During the 2010 Earthquake and Gained a New Interest in Medicine

Clinicopathological Classification Of Immune Checkpoint Inhibitor-Associated Myocarditis: Possible Refinement By Measuring Macrophage Abundance, Jesus Jimenez, Nicolas Kostelecky, Joshua D Mitchell, Kathleen W Zhang, Chieh-Yu Lin, Daniel J Lenihan, Kory J Lavine

2020-Current year OA Pubs

BACKGROUND: Immune checkpoint inhibitor (ICI) myocarditis is associated with high morbidity and mortality. While endomyocardial biopsy (EMB) is considered a gold standard for diagnosis, the sensitivity of EMB is not well defined. Additionally, the pathological features that correlate with the clinical diagnosis of ICI-associated myocarditis remain incompletely understood.

METHODS: We retrospectively identified and reviewed the clinicopathological features of 26 patients with suspected ICI-associated myocarditis based on institutional major and minor criteria. Seventeen of these patients underwent EMB, and the histopathological features were assessed by routine hematoxylin and eosin (H&E) staining and immunohistochemical (IHC) staining for CD68, a macrophage marker.

RESULTS: …

Nature, Nurture, And The Meaning Of Educational Attainment: Differences By Sex And Socioeconomic Status, Thalida Em Arpawong, Margaret Gatz, Catalina Zavala, Tara L. Gruenewald, Ellen E. Walters, Carol A. Prescott

Psychology Faculty Articles and Research

Estimated heritability of educational attainment (EA) varies widely, from 23% to 80%, with growing evidence suggesting the degree to which genetic variation contributes to individual differences in EA is highly dependent upon situational factors. We aimed to decompose EA into influences attributable to genetic propensity and to environmental context and their interplay, while considering influences of rearing household economic status (HES) and sex. We use the Project Talent Twin and Sibling Study, drawn from the population-representative cohort of high school students assessed in 1960 and followed through 2014, to ages 68−72. Data from 3552 twins and siblings from 1741 families …

Functional States Of Myeloid Cells In Cancer, Lilian Van Vlerken-Ysla, Yulia Y Tyurina, Valerian E Kagan, Dmitry I Gabrilovich

Faculty, Staff and Student Publications

Myeloid cells, comprised of macrophages, dendritic cells, monocytes, and granulocytes, represent a major component of the tumor microenvironment (TME) and are critically involved in regulation of tumor progression and metastasis. In recent years, single-cell omics technologies have identified multiple phenotypically distinct subpopulations. In this review, we discuss recent data and concepts suggesting that the biology of myeloid cells is largely defined by a very limited number of functional states that transcend the narrowly defined cell populations. These functional states are primarily centered around classical and pathological states of activation, with the latter state commonly defined as myeloid-derived suppressor cells. We …

The P323l Substitution In The Sars-Cov-2 Polymerase (Nsp12) Confers A Selective Advantage During Infection, Hannah Goldswain, Xiaofeng Dong, Rebekah Penrice-Randal, Muhannad Alruwaili, Ghada T Shawli, Tessa Prince, Maia Kavanagh Williamson, Jayna Raghwani, Nadine Randle, Benjamin Jones, I'Ah Donovan-Banfield, Francisco J Salguero, Julia A Tree, Yper Hall, Catherine Hartley, Maximilian Erdmann, James Bazire, Tuksin Jearanaiwitayakul, Malcolm G Semple, Peter J M Openshaw, J Kenneth Baillie, Isaric4c Investigators, Stevan R Emmett, Paul Digard, David A Matthews, Lance Turtle, Alistair C Darby, Andrew D Davidson, Miles W Carroll, Julian A Hiscox

Faculty, Staff and Student Publications

BACKGROUND: The mutational landscape of SARS-CoV-2 varies at the dominant viral genome sequence and minor genomic variant population. During the COVID-19 pandemic, an early substitution in the genome was the D614G change in the spike protein, associated with an increase in transmissibility. Genomes with D614G are accompanied by a P323L substitution in the viral polymerase (NSP12). However, P323L is not thought to be under strong selective pressure.

RESULTS: Investigation of P323L/D614G substitutions in the population shows rapid emergence during the containment phase and early surge phase during the first wave. These substitutions emerge from minor genomic variants which become dominant …

Clinical Impact Of Standardized Tavr Technique And Care Pathway: Insights From The Optimize Pro Study., Kendra J Grubb, Hemal Gada, Suneet Mittal, Tamim Nazif, Josep Rodés-Cabau, Douglas G W Fraser, Lang Lin, Joshua D Rovin, Ramzi Khalil, Ibrahim Sultan, Blake Gardner, David Lorenz, Stanley J Chetcuti, Nainesh C Patel, James E Harvey, Paul Mahoney, Brian Schwartz, Zubair Jafar, John Wang, Srinivasa Potluri, Amit N Vora, Carlos Sanchez, Amy Corrigan, Shuzhen Li, Steven J Yakubov

Heart and Vascular Articles

BACKGROUND: Procedural success and clinical outcomes after transcatheter aortic valve replacement (TAVR) have improved, but residual aortic regurgitation (AR) and new permanent pacemaker implantation (PPI) rates remain variable because of a lack of uniform periprocedural management and implantation.

OBJECTIVES: The Optimize PRO study evaluates valve performance and procedural outcomes using an "optimized" TAVR care pathway and the cusp overlap technique (COT) in patients receiving the Evolut PRO/PRO+ (Medtronic) self-expanding valves.

METHODS: Optimize PRO, a nonrandomized, prospective, postmarket study conducted in the United States, Canada, Europe, Middle East, and Australia, is enrolling patients with severe symptomatic aortic stenosis and no pre-existing …

Post Hoc Analysis Examining Symptom Severity Reduction And Symptom Absence During Food Challenges In Individuals Who Underwent Oral Immunotherapy For Peanut Allergy: Results From Three Trials, Katharina Blumchen, Andreas Kleinheinz, Ludger Klimek, Kirsten Beyer, Aikaterini Anagnostou, Christian Vogelberg, Sergejus Butovas, Robert Ryan, David Norval, Stefan Zeitler, George Du Toit

Faculty, Staff and Students Publications

PURPOSE: Peanut allergy and its current management, involving peanut avoidance and use of rescue medication during instances of accidental exposure, are burdensome to patients and their caregivers and can be a source of stress, uncertainty, and restriction. Physicians may also be frustrated with a lack of effective and safe treatments other than avoidance in the current management of peanut allergy. Efficacy, determined using double-blind, placebo-controlled food challenges (DBPCFCs), of oral immunotherapy with peanut (Arachis hypogaea) allergen powder-dnfp (PTAH; Palforzia

METHODS: Symptom data recorded during screening and/or exit DBPCFCs from participants aged 4 to 17 years receiving PTAH or placebo were …

Allopregnanolone Effects On Inhibition In Hippocampal Parvalbumin Interneurons, Xinguo Lu, Peter Lambert, Ann Benz, Charles F. Zorumski, Steven J. Mennerick

2020-Current year OA Pubs

Allopregnanolone (AlloP) is a neurosteroid that potentiates ionotropic GABAergic (GABA

A Gap-Free Genome Assembly Of Chlamydomonas Reinhardtii And Detection Of Translocations Induced By Crispr-Mediated Mutagenesis, Zachary L Payne, Gervette M Penny, Tychele N Turner, Susan K Dutcher

2020-Current year OA Pubs

Genomic assemblies of the unicellular green alga Chlamydomonas reinhardtii have provided important resources for researchers. However, assembly errors, large gaps, and unplaced scaffolds as well as strain-specific variants currently impede many types of analysis. By combining PacBio HiFi and Oxford Nanopore long-read technologies, we generated a de novo genome assembly for strain CC-5816, derived from crosses of strains CC-125 and CC-124. Multiple methods of evaluating genome completeness and base-pair error rate suggest that the final telomere-to-telomere assembly is highly accurate. The CC-5816 assembly enabled previously difficult analyses that include characterization of the 17 centromeres, rDNA arrays on three chromosomes, and …

The Satisfaction And Recovery Index, David Walton

Physical Therapy Publications

User Manual for the Satisfaction and Recover Index, including versions of the tool in English, French-Canadian, Persian, and Japanese translations

Male Hormonal Contraceptives: Associations Between Students’ Perception Of And Trust In Usage And Endorsement Of Gender Norms, Zoe Keese

Honors Program: Senior Projects (Public)

As clinical trials continue to test the safety and efficacy of new male contraceptive options, evaluating attitudes towards them is critical in expanding access to reproductive healthcare. The present study sought to investigate the relationship of endorsement of traditional masculine and feminine gender norms with attitudes towards male hormonal contraceptive pills. Using a Qualtrics survey, 45 participants rated their attitudes towards different measures, including attitude towards the male contraceptive pill, willingness to use male hormonal contraception, and endorsement of traditional masculine and feminine gender norms. The results of the survey indicated that there was a significant positive correlation between endorsing …

Chatgpt As Metamorphosis Designer For The Future Of Artificial Intelligence (Ai): A Conceptual Investigation, Amarjit Kumar Singh (Library Assistant), Dr. Pankaj Mathur (Deputy Librarian)

Library Philosophy and Practice (e-journal)

Abstract

Purpose: The purpose of this research paper is to explore ChatGPT’s potential as an innovative designer tool for the future development of artificial intelligence. Specifically, this conceptual investigation aims to analyze ChatGPT’s capabilities as a tool for designing and developing near about human intelligent systems for futuristic used and developed in the field of Artificial Intelligence (AI). Also with the helps of this paper, researchers are analyzed the strengths and weaknesses of ChatGPT as a tool, and identify possible areas for improvement in its development and implementation. This investigation focused on the various features and functions of ChatGPT that …

Intravenously Administered Interleukin-7 To Reverse Lymphopenia In Patients With Septic Shock: A Double-Blind, Randomized, Placebo-Controlled Trial, Thomas Daix, Armelle Mathonnet, Scott Brakenridge, Pierre-François Dequin, Jean-Paul Mira, Frederique Berbille, Michel Morre, Robin Jeannet, Teresa Blood, Jacqueline Unsinger, Jane Blood, Andrew Walton, Lyle L Moldawer, Richard Hotchkiss, Bruno François

2020-Current year OA Pubs

BACKGROUND: Profound lymphopenia is an independent predictor of adverse clinical outcomes in sepsis. Interleukin-7 (IL-7) is essential for lymphocyte proliferation and survival. A previous phase II study showed that CYT107, a glycosylated recombinant human IL-7, administered intramuscularly reversed sepsis-induced lymphopenia and improved lymphocyte function. Thepresent study evaluated intravenous administration of CYT107. This prospective, double-blinded, placebo-controlled trial was designed to enroll 40 sepsis patients, randomized 3:1 to CYT107 (10 µg/kg) or placebo, for up to 90 days.

RESULTS: Twenty-one patients were enrolled (fifteen CYT107 group, six placebo group) at eight French and two US sites. The study was halted early because …