Medicine and Health Sciences Commons^™

An Implementation Research Of Hiv Prevention, Testing, And Care Through Community-Based Services Among Msm Population In South Sulawesi, Indonesia, Sudirman Sudirman

Chulalongkorn University Theses and Dissertations (Chula ETD)

Indonesia is one of the countries with the most rapidly growing HIV epidemics in Asia. Indonesia is also one of the countries that failed to meet the target of 90 UNAIDS by 2020, despite various programs and services that have been issued. In 2015, the WHO recommended the expansion of HIV services beyond the clinical setting, of which community-based service (CBS) is one of the recommendations. This study aims to identify the challenge in HIV prevention, testing, and care and how to improve it by implementing community-based services (CBS) among the MSM population in South Sulawesi, Indonesia. This research is …

The Causal Relationships Of Work-Life Balance, Psychological Well-Being, Burnout, And Related Factors Among Public Secondary School Teachers In Bangkok: A Mixed-Method Research, Gunchanon Khawda

Chulalongkorn University Theses and Dissertations (Chula ETD)

This study is a parallel mixed-method research, consisting of quantitative and qualitative studies. The objective is to examine the causal relationships among work-life balance, psychological well-being, burnout, emotional intelligence, emotion regulation, and psychological capital among public secondary school teachers in Bangkok. The quantitative results revealed that the study comprised 436 teachers, with an average age of 35.12 years old (SD = 9.56). The structural equation modeling analysis found that the model fit the empirical data (Chi-square = 348.89, df = 172, p < 0.001, Chi-square/df = 2.03, RMSEA = 0.05, GFI = 0.93, AGFI = 0.91, CFI = 0.97). Emotional intelligence had a significant positive effect on work-life balance (Beta = 0.43, p = 0.002) and psychological well-being (Beta = 0.29, p = 0.001). Psychological capital also had a significant positive effect on work-life balance (Beta = 0.35, p = 0.03) and psychological well-being (Beta = 0.51, p < 0.001). The qualitative study included in-depth interviews with 6 school administrators and focus group discussions with 20 teachers. The qualitative results demonstrated that school administrators and teachers had a convergent opinion on factors contributing to poor work-life balance, such as workload apart from teaching, urgent work during holidays, the burden of caring for family members, and financial debt. Additionally, factors contributing to teacher burnout, such as excessive workload, disliked assignments, monotonous tasks, and students lacking motivation to study, were identified. The merged results of the quantitative and qualitative studies can be summarized in four topics: (1) Teachers’ good work-life balance affects better psychological well-being and happiness, while poor work-life balance might affect greater burnout; (2) Teachers’ emotional intelligence and psychological capital affect good work-life balance; (3) Teachers’ emotional intelligence and psychological capital might reduce burnout; and (4) Teachers' emotional intelligence and psychological capital positively influence psychological well-being. In conclusion, teachers with high levels of emotional intelligence and psychological capital are likely to have better work-life balance and psychological well-being; in turn, these might reduce their burnout.

ความสัมพันธ์ระหว่างความสามารถในการฟื้นพลัง ภาวะซึมเศร้า รูปแบบการเผชิญปัญหา และคุณภาพชีวิตในผู้ป่วยโรคซึมเศร้าที่รักษาแบบผู้ป่วยนอก ที่แผนกจิตเวช โรงพยาบาลธรรมศาสตร์เฉลิมพระเกียรติ, จุฑามาศ สุดชื่น

Chulalongkorn University Theses and Dissertations (Chula ETD)

วัตถุประสงค์ : เพื่อศึกษาความสัมพันธ์ระหว่างความสามารถในการฟื้นพลัง รูปแบบการเผชิญปัญหา และคุณภาพชีวิตในผู้ป่วยนอกที่มีภาวะซึมเศร้าที่เข้ารับการตรวจรักษาที่โรงพยาบาลธรรมศาสตร์เฉลิมพระเกียรติ วิธีการวิจัย : การวิจัยเชิงพรรณนา ณ จุดเวลาใดเวลาหนึ่ง ในกลุ่มตัวอย่างผู้ป่วยนอกที่มีภาวะซึมเศร้า ที่เข้ารับการตรวจรักษาที่โรงพยาบาลธรรมศาสตร์เฉลิมพระเกียรติ จำนวน 110 คน ผ่านการใช้แบบสอบถาม ได้แก่ แบบสอบถามข้อมูลส่วนบุคคล แบบประเมินโรคซึมเศร้า (PHQ-9) แบบวัดความแข็งแกร่งและยืดหยุ่นของชีวิต (CD-RISC) แบบสอบถามการเผชิญปัญหา และแบบวัดคุณภาพชีวิต (WHOQOL-BREF) ทดสอบความสัมพันธ์เชิงสาเหตุระหว่างการฟื้นพลัง ภาวะซึมเศร้า รูปแบบการเผชิญปัญหา และคุณภาพชีวิต ผลการศึกษา : จากกลุ่มตัวอย่าง 110 คน พบว่า ค่าเฉลี่ยคะแนนความสามารถในการฟื้นพลังเท่ากับ 20.5 (ส่วนเบี่ยงเบนมาตราฐาน 7) ร้อยละ 60 ใช้กลวิธีเผชิญปัญหาแบบมุ่งจัดการกับปัญหาอยู่ในระดับดีมาก ร้อยละ 77.3 มีคุณภาพชีวิตโดยรวมอยู่ในระดับกลาง ภาวะซึมเศร้าและรูปแบบการเผชิญปัญหาสามารถอธิบายความแปรผันของการฟื้นพลังร้อยละ 26 และการฟื้นพลังสามารถอธิบายความผันแปรของคุณภาพชีวิตร้อยละ 55.30 สรุป: ภาวะซึมเศร้าและรูปแบบการเผชิญปัญหามีความสัมพันธ์กับคุณภาพชีวิตผ่านการฟื้นพลัง

ความชุกของประชากรที่มีการเมตาบอลิสมยาไม่ดี จากโพลิมอร์ฟิซัมไซโตโครมพีสี่ห้าศูนย์เอนไซม์ซิปสองซีสิบเก้า ในผู้ป่วยโรคสมองขาดเลือดที่มีอาการเนื่องจากการแข็งหลอดเลือดแดงในสมองในโรงพยาบาลจุฬาลงกรณ์, ธนกฤต พงพิทักษ์เมธา

Chulalongkorn University Theses and Dissertations (Chula ETD)

บทนำ โรคสมองขาดเลือดที่มีอาการเนื่องจากการแข็งหลอดเลือดแดงในสมอง (symptomatic intracranial atherosclerotic disease; sICAD) เป็นโรคสมองขาดเลือดที่พบได้บ่อยมากเป็นอันดับที่ 2 ของผู้ป่วยโรคสมองขาดเลือดในคนไทย และมีอัตราการเป็นซ้ำที่สูง ประมาณ ร้อยละ 15 ในปีแรก เมื่อเทียบกับกลุ่มอื่นที่ประมาณ ร้อยละ 5% ในปีแรก ทำให้งานวิจัยและแนวทางการรักษาในระดับชาติและนานาชาติ จึงแนะนำให้ใช้ยาต้านเกล็ดเลือดสองชนิดควบคู่กันระยะสั้น (short term dual antiplatelet; DAPT) โดยเฉพาะสูตรที่มียาโคพิโดเกรล (clopidogrel) เป็นส่วนผสม เพื่อป้องกันการเกิดโรคหลอดเลือดสมองซ้ำต่อไป อย่างไรก็ตามยา clopidogrel นั้นจำเป็นที่จะต้องเปลี่ยนแปลงโดยผ่านเอนไซม์ไซโตโครมพีสี่ห้าศูนย์ เอนไซม์ซิปสองซีสิบเก้า (CYP2C19) เพื่อให้ยาอยู่ในสภาพออกฤทธิ์และป้องกันโรคต่อไป จากการศึกษาก่อนหน้าพบว่าความชุกของประชากรที่มีการเมตาบอลิสมยาไม่ดี (poor metabolizers; PM) ของเอนไซม์ CYP2C19 ในประชากรไทยมีสัดส่วนจากมากแตกต่างจากประชากรชาติตะวันตก อย่างไรก็ตามจากการศึกษาในอดีตเกี่ยวกับของการเปลี่ยนแปลงทางเภสัชพันธุศาสตร์ของเอนไซม์ CYP2C19 ต่อผลการรักษาทางคลินิกในผู้ป่วยโรคสมองขาดเลือดที่มีอาการเนื่องจากการแข็งหลอดเลือดแดงในสมอง ยังมีอยู่อย่างจำกัดและผลไม่สอดคล้องกันในหลายงานวิจัย วัตถุประสงค์ วัตถุประสงค์หลักของงานวิจัย (primary objective) คือศึกษาความชุกของประชากรที่มีการเมตาบอลิสมยาไม่ดีของเอนไซม์ CYP2C19 ผู้ป่วยโรคสมองขาดเลือดที่มีอาการเนื่องจากการแข็งหลอดเลือดแดงในสมองในโรงพยาบาลจุฬาลงกรณ์ วัตถุประสงค์รองของงานวิจัย (secondary objectives) คือเพื่อศึกษาผลของการเสียการทำงานของ CYP2C19 allele (LOF allele status) ต่ออุบัติการณ์การเกิดโรคหลอดเลือดสมองตีบซ้ำ (recurrent stroke) การเกิดภาวะแทรกซ้อนทางหัวใจที่รุนแรง (major adverse cardiac event; MACE) การเกิดเลือดออก (bleeding event) ที่ 90 วันหลังเกิดโรคสมองขาดเลือดที่มีอาการเนื่องจากการแข็งหลอดเลือดแดงในสมอง วิธีการทำวิจัย เก็บข้อมูลผู้ป่วยจากการศึกษาไปข้างหน้าเชิงพรรณนา (ongoing prospective study) ตั้งแต่เดือนกรกฎาคม พ.ศ. 2565 โดยเก็บผู้ป่วยอายุมากกว่าหรือเท่ากับ 40 ปี ที่มีอาการ อาการแสดง ผลตรวจทางรังสีวิทยาที่เข้าได้กับโรคสมองขาดเลือดที่มีอาการเนื่องจากการแข็งหลอดเลือดแดงในสมอง (หลอดเลือดตีบ 50-99%) และมีผลตรวจทางรังสีวิทยามีผลการตรวจหลอดเลือดสมองทางรังสีวิทยายืนยัน โดยผู้วิจัยจะได้เก็บข้อมูลทางคลินิก ข้อมูลทางยา การตรวจทางห้องปฏิบัติการ การตรวจทางรังสีวิทยา จากการทบทวนข้อมูลในเวชระเบียนระหว่างมานอนโรงพยาบาลและที่ตรวจติดตาม …

The Comparison Between Alternative And Standard Methods For Quality Control Of Diphtheria Toxoid In Thai-Gpo’S Dtp And Dt Vaccines (Adsorbed), Wanlop Leeden

Chulalongkorn University Theses and Dissertations (Chula ETD)

In response to the country's vaccine security policy and to make Thailand self-reliant in vaccine supply, the Government Pharmaceutical Organization has been successfully established he the production process of dT and DTP vaccine (Adsorbed). According to WHO recommendation, the quality control scheme for dT, DTP vaccines (adsorbed) includes identity test, toxicity and reversion to toxicity test, potency test, and antigen content and degree of absorption. Therefore, it is of interest to study and develop appropriate methods for use in quality control and for inclusion in the product registration application process. The comparison study of the quality testing methods can categorized …

Investigation Of Alpha Kinase 3 (Alpk3)-Associated Cardiomyopathy Using Multiomics And An Induced Pluripotent Stem Cell (Ipsc)-Derived Cardiomyocyte And Cardiac Organoid Model, Chanatjit Cheawsamoot

Chulalongkorn University Theses and Dissertations (Chula ETD)

Hypertrophic cardiomyopathy and dilated cardiomyopathy together make up one of the highest prevalence genetic diseases in the world, estimated to have a prevalence of around 1 in 200 to 1 in 600 individuals. Most of the genes implicated in causing cardiomyopathy are those that encode sarcomeric components in cardiomyocytes, such as MYBPC3 and MYH7. Numerous genes that encode non-sarcomeric proteins or have unknown function have been increasingly associated with cardiomyopathy and it was thought that the resulting disease from variants in these genes tend to be mild and low penetrant. However, recent evidence of one of these unknown protein coding …

Efficiency Of Mrna Vaccine Against House Dust Mite Allergy In Mouse Model, Chanatip Thanasarnthungcharoen

Chulalongkorn University Theses and Dissertations (Chula ETD)

Through the capacity to mediate Th1-biased immune responses and the induction of neutralizing antibodies, the mRNA-lipid nanoparticle (LNP) platform could represent an innovative approach for shorter, safer, and more effective treatment of house dust mite (HDM) allergy. Our previous study showed that nucleoside-modified mRNA encoding recombinant forms of HDM allergens Der p 1 and Der p 2 (ProDer p 1 and Der p 2 K96A) and formulated with ionizable LNP, induced Th1-biased immune responses and potent specific blocking IgG responses, while being non-reactogenic in sensitized mice. This present study evaluated the immunotherapeutic efficacy of HDM-specific mRNA-LNP-based AIT in a mouse …

Advocating For Comprehensive Sex Education In Kentucky, Kylie Higgins

Lewis Honors College Thesis Collection

Legislation surrounding sexual education, comprehensive sexual education in particular, has always been a point of controversy. Recently however, this controversy has been brought to the forefront of political debates and media coverage. With sexual education, and the repercussions of a lack thereof, being such a timely issue, this thesis project will explore the current written literature to create an evidence-based presentation to educate future nurses on the issue and their role in promoting the implementation of comprehensive education in schools and providing it in the clinical setting. Comprehensive sex education is medically accurate, age appropriate, evidence based, and LGBTQIA+ inclusive, …

Dietary Antioxidant Insufficiency Is Associated With Increased Inflammatory Markers And Poorer Health-Related Quality Of Life In Patients With Heart Failure, Jia-Rong Wu, Eun Kyeung Song, Debra K. Moser, Terry A. Lennie

UK CARES Faculty Publications

Background: Antioxidant insufficiency, elevated inflammatory markers, and poor health-related quality of life (HRQOL) are prevalent in patients with heart failure (HF). Objective: The objective of this study was to examine the associations among dietary antioxidant intake, inflammatory markers, and HRQOL in patients with HF. Methods: This was a secondary analysis of 265 patients with HF who completed a 4-day food diary. We assessed intake of 10 antioxidants: alpha carotene, beta carotene, beta cryptoxanthin, lutein, zeaxanthin, lycopene, vitamins C and E, zinc, and selenium. Antioxidant insufficiency was reflected by a measured level for each antioxidant that was below the estimate average …

A Biomarker Of Stress And Self-Reported Caregiving Distress Predict Poor Quality Of Life In Family Caregivers Of Patients With Heart Failure, Ya-Ching Liu, Man-Chun Chou, Ming-Chu Chiang, Chih-Ling Hang, Shyh-Ming Chen, Misook L. Chung, Chin-Yen Lin, Tsuey-Yuan Huang

Nursing Faculty Publications

Background: Family caregivers are at a high risk for low quality of life due to caregiving-related stress. Caregivers' stress is commonly assessed using self-reported measures, which reflect relatively subjective and long-term stress related to caregiving, but objective biological markers of stress are rarely used for caregivers. The purposes of this study were (1) to determine whether caregiver characteristics were associated with stress assessed using a stress biomarker (serum cortisol) and a self-reported caregiving distress measure (Caregiver Burden Inventory) and (2) to determine the predictability of both stress measures for quality of life in caregivers of patients with heart failure. Methods: …

Autism For The Professions: One University, Three Colleges And One Undergraduate Course, Mary E. Carlson, Wendy Krueger, Amy V. Van Hecke

College of Education Faculty Research and Publications

Purpose

This paper discusses the elements of successful university-level, cross-disciplinary course development using best practices to foster richer relational networks and to meet the complex demands of education and treatment for children with autism spectrum disorder (ASD).

Design/methodology/approach

The three authors created and taught a class on best practices in autism nine times. The authors assessed the knowledge base and attitudinal changes of undergraduates (most in psychology, speech pathology and audiology, and education) for two of the nine cohorts who were being prepared to work with individuals with ASD.

Findings

Pre- and postmeasures indicated significant improvement in knowledge and a …

Evaluating A Rapid Response Team Performance To Implement Best Practice In Rapid Response Team Protocol, Pansy Samuel

Doctor of Nursing Practice Projects

Background

Rapid Response Teams (RRT) provide clinical resources to improve patient safety outcomes at healthcare institutions. This team promptly responds to deteriorating patient conditions to prevent further deterioration and reduce mortality rates. Rapid response teams do not always perform optimally. Reasons for this performance failure include breakdowns in communication, team dynamics, or other variables that can often be adjusted when the team members understand the role these variables play in undermining the performance of the RRT. An understanding of the perceptions of the RRT members regarding their roles and potential areas of improvement did provide valuable data that was utilized …

Lower-Limb Wearable Resistance Overloads Joint Angular Velocity During Early Acceleration Sprint Running, Erin H. Feser, Jonathon Neville, Danny Wells, Shelley Diewald, Mai Kameda, Neil E. Bezodis, Kenneth Clark, Ryu Nagahara, Paul Macadam, Aaron M. Uthoff, Farhan Tinwalla, John B. Cronin

Funded Scholarship

Lower-limb wearable resistance (WR) facilitates targeted resistance-based training during sports-specific movement tasks. The purpose of this study was to determine the effect of two different WR placements (thigh and shank) on joint kinematics during the acceleration phase of sprint running. Eighteen participants completed maximal effort sprints while unloaded and with 2% body mass thigh- or shank-placed WR. The main findings were as follows: 1) the increase to 10 m sprint time was small with thigh WR (effect size [ES] = 0.24), and with shank WR, the increase was also small but significant (ES = 0.33); 2) significant differences in peak …

Identities Of Women In Indian Art And History, Nalini Rao

Monsoon: South Asian Studies Association Journal

The stereotypical image of Indian women portrayed in the art of stone sculpture is often interpreted as images of beauty that are sensuous, religious as well depict social life. There are historical reasons for depicting her as such. This paper inquires into the changing depiction and social forces that influenced feminine imagery. This paper examines the portrayal of beauty through idealization of female body which has evolved over the centuries in India. It also aims to understand their changing status and explores issues of feminine identity, status, and empowerment largely in ancient and medieval India. It also provides a brief …

Needs Assessment For Faculty Development In Health Professions Education At A Medical University In Karachi, Pakistan, Tabassum Zehra, Sana Saeed, Rahila Ali, Amber Sultan, Areeba Hussain

Department for Educational Development

Faculty Development (FD) embraces all educational activities used by teachers to improve their knowledge and skills for enhancing their academic competencies. This study aimed to identify the areas in Health Professions Education (HPE) in which formal faculty development is required. A needs assessment survey was conducted from among the faculty members at the Aga Khan University (AKU), Karachi, Pakistan, and the French Medical Institute for Mother and Children, Afghanistan. Data was analysed using SPSS 20.0 and reported frequencies and percentages according to various academic tracks. Competency-based curricula (51%), providing effective feedback (51%), developing Objective Structured Clinical Exam (51%), and clinical …

Assessing The Validity Of Admission Test Into The Internship Programme At A Private University In Pakistan, Qamar Riaz, Naveed Yousuf, Muhammad Shahzad Shamim

Department for Educational Development

Objective: To report the development and validity assessment of a comprehensive model of assessment method comprising written test and multiple mini interviews for selection in a medical internship programme.
Method: The psychometric validation study was conducted at the Aga Khan University, Karachi, and comprised anonymised scores of written admission test, multiple mini interviews and exit written exams for all the interns who completed their internships in 2018 and 2019. Correlation between admission and exit tests, and predictions were assessed. Data was analysed using SPSS 20.
Results: There were 160 interns; 80(50%) each in 2018 and 2019. Mean scores were …

The Impact Of Breast Awareness On The Early Detection Of Breast Cancer In Young Women: A Systematic Review, Dorsa Banihashemi, Meagan E. Brennan

Medical Papers and Journal Articles

Background: “Breast awareness” is a recommendation that women understand the symptoms of breast cancer and become familiar with the usual look and feel of their breasts. It is recommended for women of all ages in breast cancer screening guidelines around the world. The objective of this study was to assess the evidence for breast awareness by investigating its effect on breast cancer outcomes in women of pre-mammographic-screening age (under age 40), at average risk of breast cancer.

Methods: A systematic review was performed using PRISMA methodology. Following the search, abstracts and full-text articles were assessed against eligibility criteria. Data …

Humans Versus Robots: Converting Golf Putter Trajectories For Robotic Guidance, Stephen R. Bested, Valentin A. Crainic, Gerome A. Manson, Luc Tremblay

Medical Papers and Journal Articles

Robotic devices are used to provide physical guidance when teaching different movements. To advance our knowledge of robotic guidance in training complex movements, this investigation tested different kinematic data filtering methods of individual’s golf putts to convert them into trajectories to be employed by a robot arm. The purpose of the current study was to identify a simple filtering method to aptly replicate participants’ individual golf putter trajectories which could be used by the robot to execute them with greater consistency and accuracy than their human counterpart.

Participants putted towards 3 targets where three-dimensional data of the putter’s head was …

'Ice In The Family': Exploring The Experiences Of Close Family Members When Another Family Member Is Using Methamphetamine: A Longitudinal Qualitative Study, Douglas Greg Gordon, Kylie Russell, Tracey Coventry

Medical Papers and Journal Articles

Objective: To explore the experiences of close family members when another family member is using methamphetamine and how the family member responds over time.

Background: Methamphetamine use has widespread implications and harms for both people who use the drug and those that live with them. While there is a significant representation in the literature relating to family members of people who use drugs or alcohol, there are limited studies specifically considering family members experiences of methamphetamine use. Families have been shown to have both positive and negative impacts on people using drugs, but less is known on the impact on …

Focused Ultrasound Thalamotomy: Correlation Of Postoperative Imaging With Neuropathological Findings, Sarah E Blitz, Matthew Torre, Melissa M J Chua, Sarah L Christie, Nathan J Mcdannold, G Rees Cosgrove

Duncan NRI Faculty and Staff Publications

Magnetic resonance-guided high-intensity focused ultrasound (MRgFUS) is a rapidly developing technique used for tremor relief in tremor-predominant Parkinson's disease (PD) and essential tremor that has demonstrated successful results. Here, we describe the neuropathological findings in a woman who died from a fall 10 days after successful MRgFUS for tremor-predominant PD. Histological analysis demonstrates the characteristic early postoperative MRI findings including 3 distinct zones on T2-weighted imaging: (1) a hypointense core, (2) a hyperintense region with hypointense rim, and (3) a slightly hyperintense, poorly marginated surrounding area. Histopathological analyses also demonstrate the suspected cellular processes composing each of these regions including …

Impact Of Multimorbidity On Mortality In Heart Failure With Reduced Ejection Fraction: Which Comorbidities Matter Most? An Analysis Of Paradigm-Hf And Atmosphere, Pooja Dewan, Joao P. Ferreira, Jawad H. Butt, Mark C. Petrie, William T. Abraham, Akshay S. Desai, Kenneth Dickstein, Lars Kober, Milton Packer, Jean L. Rouleau, Simon Stewart, Karl Swedberg, Michael R. Zile, Scott D. Solomon, Pardeep S. Jhund, John Jv Mcmurray

IHR Papers and Journal Articles

Aims: Multimorbidity, the coexistence of two or more chronic conditions, is synonymous with heart failure (HF). How risk related to comorbidities compares at individual and population levels is unknown. The aim of this study is to examine the risk related to comorbidities, alone and in combination, both at individual and population levels.

Methods and results: Using two clinical trials in HF – the Prospective comparison of ARNI (Angiotensin Receptor–Neprilysin Inhibitor) with ACEI (Angiotensin-Converting Enzyme Inhibitor) to Determine Impact on Global Mortality and morbidity in HF trial (PARADIGM-HF) and the Aliskiren Trial to Minimize Outcomes in Patients with Heart Failure trials …

Economic Cost Of Secondary Postpartum Haemorrhage: A Case-Control Study At A Tertiary Hospital In Australia, Nicole Young, Julie Quinlivan, Rachael Fox, Jess Anderson, Laura Davis, Samantha S. Mooney

IHR Papers and Journal Articles

Background

Secondary postpartum haemorrhage (PPH) is a condition which affects 0.2–3.0% of women. Despite its impact on maternal morbidity, there is a lack of understanding of the cost burden of disease.

Aims

To determine the economic cost of secondary PPH in the postpartum period, compared to the costs for women without this diagnosis.

Materials and methods

Data were prospectively collected on a cohort of 97 women who presented with secondary PPH to the emergency department (ED) between July 2020 and February 2021. A case–control design was then used to compare postpartum cost data from these patients to a group of …

Technology-Guided Assessment Of Vocalisations And Their Diagnostic Value As Pain Indicators For People Living With Dementia, Kreshnik Hoti, Atee Mustafa, Paola Chivers, Ipsit Vahia, Jeff Hughes

IHR Papers and Journal Articles

Background

during pain assessment in persons unable to self-report, such as people living with dementia, vocalisations are commonly used as pain indicators. However, there is a lack of evidence from clinical practice regarding their diagnostic value and relationship with pain. We aimed to explore vocalisations and pain in people with dementia undergoing pain assessments in clinical practice settings. Methods

a total of 22,194 pain assessments were reviewed in people with dementia (n = 3,144) from 34 different Australian aged care homes and two dementia specific programs. Pain assessments were conducted by 389 purposely trained health care professionals and cares …

Outcomes Of Completed Quality Activities In An Australian Tertiary Hospital, 2015-2019, Qun Catherine Li, Jonathan Karnon, Jim Codde

IHR Papers and Journal Articles

Quality activities including quality assurance and quality improvement are an integral part of safety and quality governance for hospitals. Previous studies identified that (i) majority are for quality assurance and knowledge-acquiring purposes and (ii) adherence to the quality cycle as well as impact on patient-related outcomes at the hospital level are unclear, neither associated with costs. This study aims to (i) assess adherence to the quality cycle for quality activities in a large Australian tertiary hospital; (ii) report outcomes of quality activities at the hospital level, including impact on patient-related outcomes measured by the occurrence of hospital-acquired complications; and (iii) …

Reactome Pathway Analysis From Whole-Blood Transcriptome Reveals Unique Characteristics Of Systemic Sclerosis Patients At The Preclinical Stage, Chiara Bellocchi, Xuan Wang, Marka A Lyons, Maurizio Marchini, Maurizio Lorini, Vincenzo Carbonelli, Nicola Montano, Shervin Assassi, Lorenzo Beretta

Faculty, Staff and Student Publications

OBJECTIVE: This study aims to characterize differential expressed pathways (DEP) in subjects with preclinical systemic sclerosis (PreSSc) characterized uniquely by Raynaud phenomenon, specific autoantibodies, and/or capillaroscopy positive for scleroderma pattern.

METHODS: Whole-blood samples from 33 PreSSc with clinical prospective data (baseline and after 4 years of follow-up) and 16 matched healthy controls (HC) were analyzed for global gene expression transcriptome analysis via RNA sequencing. Functional Analysis of Individual Microarray Expression method annotated Reactome individualized pathways. ANOVA analysis identified DEP whose predictive capability were tested in logistic regression models after extensive internal validation.

RESULTS: At 4 years, 42.4% subjects progressed (evolving …

The Rising Tide Of Revisional Surgery: Tracking Changes In Index Cases Among Bariatric-Accredited Fellowships, Lincoln N Strickland, Erika Y Faraoni, Wei Ruan, Xiaoyi Yuan, Holger K Eltzschig, Jennifer M Bailey-Lundberg

Faculty, Staff and Student Publications

Pancreatic ductal adenocarcinoma (PDAC) is characterized by a dense desmoplastic stroma that impedes drug delivery, reduces parenchymal blood flow, and suppresses the anti-tumor immune response. The extracellular matrix and abundance of stromal cells result in severe hypoxia within the tumor microenvironment (TME), and emerging publications evaluating PDAC tumorigenesis have shown the adenosine signaling pathway promotes an immunosuppressive TME and contributes to the overall low survival rate. Hypoxia increases many elements of the adenosine signaling pathway, resulting in higher adenosine levels in the TME, further contributing to immune suppression. Extracellular adenosine signals through 4 adenosine receptors (Adora1, Adora2a, Adora2b, Adora3). Of …

Cytological Diagnosis Of Pilomatrixoma And Its Diagnostic Pitfalls, Sabina Khan, Inara Abeer, Musharraf Husain, Sujata Jetley

Faculty, Staff and Student Publications

BACKGROUND: Pilomatrixoma (PMX) is a relatively uncommon benign cutaneous neoplasm arising from skin adnexa. It presents as a subcutaneous asymptomatic nodule mostly in the head and neck region and is frequently misdiagnosed by the clinicians. Although easily diagnosed on histopathology, the cytologic features of PMX are less distinctive, depending on the stage and evolution of disease and may mimic other benign or even malignant lesions.

AIM: To study the cyto-morphological features of this uncommon neoplasm and identify its potential diagnostic pitfalls on fine needle aspiration cytology (FNAC).

MATERIAL AND METHODS: Archival records of histopathologically diagnosed Pilomatrixoma were analyzed during study …

Chronic Restraint Stress Impairs Voluntary Wheel Running But Has No Effect On Food-Motivated Behavior In Mice, Kiersten Scott, Thien Trong Phan, Nabila Boukelmoune, Cobi J Heijnen, Robert Dantzer

Faculty, Staff and Student Publications

Chronic restraint stress is known to cause significant alterations of mitochondrial biology. However, its effects on effort-based behavior and the sensitivity of these effects to treatments that restore mitochondrial function have not been assessed. Based on the hypothesis that the behavioral consequences of this stressor should be more severe for an energy demanding activity than for an energy procuring activity, we compared the effects of chronic restraint stress on the performance of male mice trained to use a running wheel or to nose poke for a food reward in an operant conditioning cage. In accordance with our hypothesis, we observed …

Henry Gas Solubility Optimization Double Machine Learning Classifier For Neurosurgical Patients, Diana T Mosa, Amena Mahmoud, John Zaki, Shaymaa E Sorour, Shaker El-Sappagh, Tamer Abuhmed

Faculty, Staff and Student Publications

This study aims to predict head trauma outcome for Neurosurgical patients in children, adults, and elderly people. As Machine Learning (ML) algorithms are helpful in healthcare field, a comparative study of various ML techniques is developed. Several algorithms are utilized such as k-nearest neighbor, Random Forest (RF), C4.5, Artificial Neural Network, and Support Vector Machine (SVM). Their performance is assessed using anonymous patients' data. Then, a proposed double classifier based on Henry Gas Solubility Optimization (HGSO) is developed with Aquila optimizer (AQO). It is implemented for feature selection to classify patients' outcome status into four states. Those are mortality, morbidity, …

Radiographic Response To Neoadjuvant Therapy In Pleural Mesothelioma Should Serve As A Guide For Patient Selection For Cytoreductive Operations, Nathaniel Deboever, Nicolas Zhou, Daniel J Mcgrail, Katarzyna Tomczak, Jacqueline L Oliva, Hope A Feldman, Edwin Parra, Jianjun Zhang, Percy P Lee, Mara B Antonoff, Wayne L Hofstetter, Reza J Mehran, Ravi Rajaram, David C Rice, Jack A Roth, Stephen S Swisher, Ara A Vaporciyan, Mehmet Altan, Annikka Weissferdt, Anne S Tsao, Cara L Haymaker, Boris Sepesi

Faculty, Staff and Student Publications

BACKGROUND: Malignant pleural mesothelioma (MPM) is associated with poor prognosis despite advances in multimodal therapeutic strategies. While patients with resectable disease may benefit from added survival with oncologic resection, patient selection for mesothelioma operations often relies on both objective and subjective evaluation metrics. We sought to evaluate factors associated with improved overall survival (OS) in patients with mesothelioma who underwent macroscopic complete resection (MCR).

METHODS: Patients with MPM who received neoadjuvant therapy and underwent MCR were identified in a prospectively maintained departmental database. Clinicopathologic, blood-based, and radiographic variables were collected and included in a Cox regression analysis (CRA). Response to …