Medicine and Health Sciences Commons^™

Nasaclip: A New Comprehensive Device To Treat Nosebleeds, Jeffrey Y. Wang, Connor Perlin

URGENT Matters

No abstract provided.

Isolation: The Experience Of Adolescent Motherhood In Laos, Souksamone Thongmixay, Dirk Essink, Taewee Kahrs, Viengnakhone Vongxay, Pamela Wright Phd, Ms, Med, Rn, Cen, Vanphanom Sychareun, Jacqueline E. Broerse

Publications

BACKGROUND:Teenage pregnancy is a persistent public health problem with pervasive socio-economic consequences, particularly in in low- and middle-income countries, often related to low social participation and low economic security. The experiences of adolescent pregnancy and motherhood have seldom been described from a personal point of view. This study aimed to gain insights into how adolescent mothers in Laos experience their motherhood, how they perceive their situation and try to cope with it.

METHODS: This qualitative study was undertaken with 20 pregnant adolescents and young mothers living in peri-urban areas in two of the 18 provinces in Laos. Data were collected …

The Invisible Victims Of Commercial Sexual Exploitation: Boys And Their Barriers To Access To Services, Amanda L. Connella

USF Tampa Graduate Theses and Dissertations

While there has been a large body of research conducted on girl (under the age of 18) victims of commercial sexual exploitation, boy (under the age of 18) victims do not seem to receive the same attention. From the few studies that have been conducted, boys and young male victims of commercial sexual exploitation have been shown to have gender specific barriers that prevent them from getting help, yet not many papers explore this unique problem. Using survey data from key providers that work in programs that serve commercially sexually exploited boys, the present study fills this hole in the …

Toward An Evidence-Based Framework To Guide Health Care Responses For Patients Impacted By Human Trafficking: Evaluation Of The Heal Trafficking Protocol Toolkit, Susie B. Baldwin, Cathy L. Miller, Beth J. Maclin, Sacha Williams, Hanni Stoklosa

Nursing Faculty Publications and Presentations

Trafficked persons seek health care during exploitation, but few health professionals know how to respond appropriately, and few institutions have protocols to guide this response. Currently, no empirically tested framework exists to guide protocol development for human trafficking response protocols in health care settings. Our aim was to empirically evaluate the HEAL Trafficking Protocol Toolkit's usability and effectiveness through cross-sectional survey methodology. We invited users who downloaded the free Toolkit from January 2017 through January 2018 to participate in an electronic survey and conducted descriptive quantitative and qualitative thematic analyses. Survey respondents were professionally and geographically diverse. Eighty-four percent who …

Addressing Knowledge Deficit Around Narcan Administration In Unhoused Youth In The Greater Seattle Area, Olivia Boron, Lizzy Carlson, Macie Leach, Casey Burk, Michele Mojarro, Sydney Porter

Nursing Leadership in Community Engagement Projects

Introduction

For our project we worked with a non profit organization in downtown Seattle that serves houseless youth ages 18-25 with a day center and overnight shelter. Their day center has health clinics, serves lunches, and provides creative activities for the houseless to enjoy. Their overnight shelters are open every night for the houseless, providing 30 beds. The goal of the facility is to end homelessness among youth by partnering with them on their journey towards housing and sustainability. Recently, the center was approved to become a Narcan (naloxone) distribution site. When assessing the needs of the facility we identified …

Emphysematous Pyelonephritis Necessitating Bilateral Radical Nephrectomy: A Case Report And Literature Review., Christine E Wamsley, Arianna Morton, Christopher G Roth, Joseph K Izes, Li Li

Computational Medicine Center Faculty Papers

Emphysematous pyelonephritis (EPN) is a severe, acute necrotizing infection of the kidney with gas accumulation in the renal parenchyma, collecting ducts, and/or perirenal tissue. We report a case of EPN in a 66 year-old male with uncontrolled diabetes mellitus (DM), urinary tract infection and septic shock necessitating emergent bilateral radical nephrectomy. Morphologically, the kidney parenchyma revealed severe acute bacterial pyelonephritis with extensive abscesses, gas cysts, necrosis and foci of infarctions. The uninvolved background cortex parenchyma exhibited diabetic nephropathy (DN), Class IIB. Post-operatively, the patient remained dialysis-dependent with multiple re-admissions for recurrent multi-drug resistant

Surgeon Estimations Of Acetabular Cup Orientation Using Intraoperative Fluoroscopic Imagining Are Unreliable., Parker L Brush, Adrian Santana, Gregory R Toci, Eric Slotkin, Michael Solomon, Tristan Jones, Arjun Saxena

Rothman Institute Papers

BACKGROUND: Accurate acetabular cup orientation is associated with decreased revision rates and improved outcomes of primary total hip arthroplasty. This study assesses surgeon's ability to estimate both the acetabular component inclination and anteversion angles via intraoperative fluoroscopy (IF) images.

METHODS: We surveyed orthopedic surgeons to estimate acetabular component inclination and anteversion based on 20 IF images of total hip arthroplasty through a direct anterior approach. Postoperative computed-tomography scans were used to calculate the true inclination and anteversion component angles. The absolute difference between the true and estimated values was calculated to determine the mean and standard deviation of the survey …

A Comprehensive And Integrative Approach To Mecp2 Disease Transcriptomics, Alexander J Trostle, Lucian Li, Seon-Young Kim, Jiasheng Wang, Rami Al-Ouran, Hari Krishna Yalamanchili, Zhandong Liu, Ying-Wooi Wan

Faculty, Staff and Students Publications

Mutations in MeCP2 result in a crippling neurological disease, but we lack a lucid picture of MeCP2's molecular role. Individual transcriptomic studies yield inconsistent differentially expressed genes. To overcome these issues, we demonstrate a methodology to analyze all modern public data. We obtained relevant raw public transcriptomic data from GEO and ENA, then homogeneously processed it (QC, alignment to reference, differential expression analysis). We present a web portal to interactively access the mouse data, and we discovered a commonly perturbed core set of genes that transcends the limitations of any individual study. We then found functionally distinct, consistently up- and …

Moving Senolytics Closer To The Clinic In Ipf, Daniel Kramer, Gautam George, Ross Summer

Division of Pulmonary, Allergy, and Critical Care Medicine Faculty Papers

No abstract provided.

Occupational Therapists' Experience Of Using Home Adaptation And Assistive Products As Interventions For Older Individuals And Persons With Disabilities In Thailand, Peeradech Thichanpiang, Veerawat Sansri, Surachart Thongchoomsin, Sutinun Juntorn, Thitiya Wangkawan, Supatida Sorasak, Phichaya Baramee, Kannika Permpoonputtana, Chirathip Thawisuk, Chutikorn Nopparat, Anuchart Kaunnil Corresponding Author

The Qualitative Report

As Thailand becomes an aged society it is important to promote advancements in geriatric medicine to provide the best care for older individuals. The right assistive facilities and household mobility equipment are essential for everyday activities. The use of home adaptations and assistive products can maximize the quality of life for older individuals and make life more convenient for those with disabilities. This study aimed to investigate the experience of occupational therapists, using home adaptations and assistive products. An individual interview was conducted with eight occupational therapists who worked at regional hospitals and centers of excellence throughout Thailand using a …

Assessing Risk Factors For 90-Day Emergency Department Visits Status-Post Index Total Knee Arthroplasty: A Retrospective Case Control Study, Ian Penvose, Helen E. Huetteman, Phil Vartanyan, James Feng, Robert Runner, Drew Douglas Moore, Mark S. Karadsheh

Conference Presentation Abstracts

INTRODUCTION: With the increasing adoption of value-based healthcare initiatives in total knee arthroplasty (TKA), a greater emphasis has been placed on implementing cost-saving measures while maintaining or improving quality of care. One area of interest has been postoperative ED visits. Here we evaluate potential risk factors for 90-day ED visits. METHODS: This is a case control study from a large, tertiary, private, academic institution. All primary TKAs between 7/1/2013 to 12/31/2017 were obtained retrospectively from a prospective institutional database utilized for contribution to a state-wide joint arthroplasty database. All patient charts were subsequently verified and reviewed for all-cause 90-day ED …

Preparation And Synergy Of Supported Ru0 And Pd0 For Rapid Chlorate Reduction At Ph 7, Jinyu Gao, Shaohua Xie, Fudong Liu, Jinyong Liu

Faculty, Staff and Student Publications

Chlorate (ClO3–) is a common water pollutant due to its gigantic scale of production, wide applications in agriculture and industry, and formation as a toxic byproduct in various water treatment processes. This work reports on the facile preparation, mechanistic elucidation, and kinetic evaluation of a bimetallic catalyst for highly active ClO3– reduction into Cl–. Under 1 atm H2 and 20 °C, PdII and RuIII were sequentially adsorbed and reduced on a powdered activated carbon support, affording Ru0–Pd0/C from scratch within only 20 min. The Pd0 particles significantly accelerated the reductive immobilization of RuIII as >55% dispersed Ru0 outside Pd0. At …

Multifaceted Role For P53 In Pancreatic Cancer Suppression, Stephano S Mello, Brittany M Flowers, Pawel K Mazur, James J Lee, Fabian Müller, Sarah K Denny, Sofia Ferreira, Kathryn Hanson, Seung K Kim, William J Greenleaf, Laura D Wood, Laura D Attardi

Faculty, Staff and Student Publications

The vast majority of human pancreatic ductal adenocarcinomas (PDACs) harbor TP53 mutations, underscoring p53's critical role in PDAC suppression. PDAC can arise when pancreatic acinar cells undergo acinar-to-ductal metaplasia (ADM), giving rise to premalignant pancreatic intraepithelial neoplasias (PanINs), which finally progress to PDAC. The occurrence of TP53 mutations in late-stage PanINs has led to the idea that p53 acts to suppress malignant transformation of PanINs to PDAC. However, the cellular basis for p53 action during PDAC development has not been explored in detail. Here, we leverage a hyperactive p53 variant-p5353,54-which we previously showed is a more robust PDAC suppressor than …

A Nationwide Study Of The “July Effect” Concerning Postpartum Hemorrhage And Its Risk Factors At Teaching Hospitals Across The United States, Zahra Shahin, Gulzar H. Shah, Bettye Apenteng, Kristie Cason Waterfield, Hani M. Samawi

Health Policy & Community Health: Faculty Publications

Objective To assess the “July effect” and the risk of postpartum hemorrhage (PPH) and its risk factors across the U.S. teaching hospitals. Method This study used the 2018 Nationwide Inpatient Sample (NIS) and included 2,056,359 of 2,879,924 single live-birth hospitalizations with low-risk pregnancies across the U.S. teaching hospitals. The International Classification of Diseases, Tenth Revision (ICD-10) from the American Academy of Professional Coders (AAPC) medical coding was used to identify PPH and other study variables. Multivariable logistic regression models were used to compare the adjusted odds of PPH risk in the first and second quarters of the academic year vs. …

Stiff Knee Gait Disorders As Neuromechanical Consequences Of Spastic Hemiplegia In Chronic Stroke, Sheng Li

Faculty, Staff and Student Publications

Stiff knee gait (SKG) is defined as decreased knee flexion during the swing phase. It is one of the most common gait disorders following stroke. Knee extensor spasticity is commonly accepted as the primary cause. Clinical management has focused on the reduction in knee extensor spasticity. Recent advances in understanding of post-stroke hemiplegic gait suggest that SKG can present as mechanical consequences between muscle spasticity, weakness, and their interactions with ground reactions during walking. Various underlying mechanisms are presented through sample cases in this article. They include ankle plantar flexor spasticity, knee extensor spasticity, knee flexor and extensor coactivation, and …

Variable Shift Lengths Negatively Affect Emergency Medicine Resident Wellness, Marcus Fazzari, Joseph Longobardi, Joseph Mccarthy, Matthew Hysell, Sidney Hann

Journal of Wellness

Introduction: Burnout is very common in emergency medicine and there has been extensive research evaluating factors that contribute to burnout. We sought to examine the contributions of post-graduate year (PGY), shifts worked per month, patients seen per shift, and length of shifts to emergency medicine resident burnout.

Methods: All emergency medicine residents were surveyed with regards to their PGY, shifts worked per month, patients seen per shift, and length of shifts. They were administered the Stanford Wellness Survey and asked to globally rate their degree of burnout. We then modeled whether consideration of the surveyed factors increased the …

Anatomy Lab, Brian R. Smith

Journal of Wellness

No abstract provided.

Social Determinants, Cardiovascular Disease, And Health Care Cost: A Nationwide Study In The United States Using Machine Learning, Feinuo Sun, Jie Yao, Shichao Du, Feng Qian, Allison A Appleton, Cui Tao, Hua Xu, Lei Liu, Qi Dai, Brian T Joyce, Drew R Nannini, Lifang Hou, Kai Zhang

2020-Current year OA Pubs

Background Existing studies on cardiovascular diseases (CVDs) often focus on individual-level behavioral risk factors, but research examining social determinants is limited. This study applies a novel machine learning approach to identify the key predictors of county-level care costs and prevalence of CVDs (including atrial fibrillation, acute myocardial infarction, congestive heart failure, and ischemic heart disease). Methods and Results We applied the extreme gradient boosting machine learning approach to a total of 3137 counties. Data are from the

The Implementation Playbook: Study Protocol For The Development And Feasibility Evaluation Of A Digital Tool For Effective Implementation Of Evidence-Based Innovations, Melanie Barwick, Jacquie Brown, Kadia Petricca, Bonnie Stevens, Byron J Powell, Alexia Jaouich, Jill Shakespeare, Emily Seto

2020-Current year OA Pubs

BACKGROUND: Evidence-based innovations can improve health outcomes, but only if successfully implemented. Implementation can be complex, highly susceptible to failure, costly and resource intensive. Internationally, there is an urgent need to improve the implementation of effective innovations. Successful implementation is best guided by implementation science, but organizations lack implementation know-how and have difficulty applying it. Implementation support is typically shared in static, non-interactive, overly academic guides and is rarely evaluated. In-person implementation facilitation is often soft-funded, costly, and scarce. This study seeks to improve effective implementation by (1) developing a first-in-kind digital tool to guide pragmatic, empirically based and self-directed …

Molnupiravir And Risk Of Hospital Admission Or Death In Adults With Covid-19: Emulation Of A Randomized Target Trial Using Electronic Health Records, Yan Xie, Benjamin Bowe, Ziyad Al-Aly

2020-Current year OA Pubs

OBJECTIVE: To emulate a randomized target trial to estimate the association between the antiviral drug molnupiravir and hospital admission or death in adults with SARS-CoV-2 infection in the community during the omicron predominant era who were at high risk of progression to severe covid-19.

DESIGN: Emulation of a randomized target trial using electronic health records.

SETTING: US Department of Veterans Affairs.

PARTICIPANTS: 85 998 adults with SARS-CoV-2 infection between 5 January and 30 September 2022 and at least one risk factor for progression to severe covid-19: 7818 participants were eligible for and treated with molnupiravir and 78 180 received no …

Long-Term Gastrointestinal Outcomes Of Covid-19, Evan Xu, Yan Xie, Ziyad Al-Aly

2020-Current year OA Pubs

A comprehensive evaluation of the risks and 1-year burdens of gastrointestinal disorders in the post-acute phase of COVID-19 is needed but is not yet available. Here we use the US Department of Veterans Affairs national health care databases to build a cohort of 154,068 people with COVID-19, 5,638,795 contemporary controls, and 5,859,621 historical controls to estimate the risks and 1-year burdens of a set of pre-specified incident gastrointestinal outcomes. We show that beyond the first 30 days of infection, people with COVID-19 exhibited increased risks and 1-year burdens of incident gastrointestinal disorders spanning several disease categories including motility disorders, acid …

Hiv Screening Among Immigrants Establishing Care In Maine, 2017-2021, Elizabeth Mazzeo, Elizabeth Danielson, Benjamin Felix, Kimberly Toomire, Elizabeth Eisenhardt, Evelyn Roach, Katlyn Breton, Karen Thompson, Stephen Digiovanni, Kathleen M. Fairfield

Journal of Maine Medical Center

No abstract provided.

A Case Of Congenital Coronary Sinus Ostial Atresia With Persistent Left Superior Vena Cava, Laura Onderko, Thomas A. Miller, Sean Novak, Jeffrey Rosenblatt

Journal of Maine Medical Center

Introduction: The coronary sinus is responsible for venous drainage of the heart. Congenital anomalies of the coronary sinus are rare and typically associated with other anomalies, such as atrial septal defects or other congenital heart malformations.

Clinical Findings: We present a case of incidentally found atresia of the coronary sinus ostium with associated persistent left superior vena cava. This case involved a 52-year-old patient who initially presented with a supraventricular tachycardia and elevated troponin.

Clinical Course: The patient underwent cardiac workup with a coronary computed tomographic angiography scan. This scan showed no obstructive coronary artery disease, but did show congenital …

Weekly Review Of An Academic Checklist To Operationalize Improvements To A Surgical Residency Program, Sean Francois, James Whiting, Kartikey Pandya, Jaswin Sawhney

Journal of Maine Medical Center

Introduction: We report on the use of a weekly academic checklist to monitor proposed improvements to a surgical residency program.

Methods: A single-center, retrospective analysis of residency improvements with an academic checklist of quality initiatives reviewed weekly at morbidity and mortality conferences. The positive response rate for each of the 11 items were reviewed. Trends of positive responses during the year were reviewed. The effectiveness of the checklist was also assessed with 2 internal surveys completed by faculty and residents.

Results: Over 15 months, the checklist was reviewed 46 times. The rate of a positive response for items varied from …

Accuracy Of The Drug-Dependency Checkbox On The Maine Birth Certificate For Medicaid-Covered Births, 2016-2020, Julia Dudley Ba, Catherine Mcguire Bs, Apsara Kumarage Ba, Chinonye Anumaka Mph, Katherine Ahrens Phd

Journal of Maine Medical Center

Introduction: The accuracy of the drug-dependency checkbox on Maine birth certificates is unknown. Our objective was to compare the drug-dependency checkbox with information on substance use disorders (SUDs) documented in Medicaid claims.

Methods: Using rule-based deterministic matching, we linked Medicaid enrollment information to Maine birth-record data between 2016 and 2020 (N = 58 584). Among the linked records (n = 27 448), we identified maternal SUD diagnoses during the 280 days before through 7 days after delivery using ICD-CM-9/10 diagnosis codes. We used the following hierarchy to create mutually exclusive SUD categories: opioid use disorder (OUD), cannabis use disorder without …

Engaging Youth In The Development, Implementation, An Evaluation Of Sexual And Reproductive Health Programs, Pam Drake, Kristin Kennedy

National Youth Advocacy & Resilience Conference

This session will introduce the use of a group concept mapping process to create a conceptual model for engaging youth in sexual and reproductive health programming – particularly BIPOC LGBTQ+ youth and young men of color. We will walk through the gcm process, present the model, and explore ways to apply the model in various situations.

Secondary Traumatic Stress: Therapists' Past Trauma And Workplace Intervention [Poster], Morgan A. Wickman

Research in the Capitol

• Secondary traumatic stress (STS): type of indirect trauma wherein listening to the traumatic experiences of another causes causes a stress reaction and can lead to PTSD-like symptoms (6, 18, 13).
• Secondary traumatic stress affects mental health professionals at high rates because they have higher rates of exposure to traumatic content (1, 2, 6, 20).
• The current study analyzes the impact of personal history of trauma on the therapist and how the workplace environment impacts STS to identify ways to reduce the severity and frequency of STS occurring in therapists.

How To Not Save The World From Covid-19: The Dire Consequences Of Giving Away The Vaccine Formula [Poster], Tristen Prouse

Research in the Capitol

The debate over giving away the COVID-19 vaccine formula is a political hot topic. Violating intellectual property law (patents) to give away the vaccine is a tempting option for aiding other countries in the current global health crisis. In actuality, many problems exist with this proposed solution, including violating intellectual property law, disincentivizing innovation, undermining confidence in vaccine safety, harming America’s geopolitical objectives, and inefficiencies. The United States can and should aid the world in obtaining vaccines, but it should not do so by waiving patent law and giving away the vaccine formulas.

Develop Restorative Capacity, Don't Defund Your Safety Network, Louis L. Fletcher Phd, David Watson

National Youth Advocacy & Resilience Conference

The Executive Director of Facilities & Operations and the Director of Safety & Security for a Colorado School district with 27,000 students will share tools, techniques, and experiences, which have cultivated restorative practices (RP) in their district. The presenters will discuss the effectiveness of proactive techniques for training SROs and school security officers to provide successful restorative alternatives to traditional discipline approaches with the goal of helping participants evaluate whether getting rid of SROs versus retraining their approach to student discipline is the best alternative.

Ada News - 03/06/2023, American Dental Association, Publishing Division

ADA News

Established in 1970 as the official newspaper of the American Dental Association, the ADA News serves practicing dentists and others allied to the dental profession in the U.S. and internationally. It is the No. 1 source of news and information about the many benefits and services the ADA delivers to members daily as well as timely information on scientific, social, political and economic developments affecting dentistry and health care.