Medicine and Health Sciences Commons^™

Distribution Of Hand Function By Age In Individuals With Rett Syndrome, Jeffrey L Neul, Tim A Benke, Eric D Marsh, Jane B Lane, David N Lieberman, Steven A Skinner, Daniel G Glaze, Bernhard Suter, Peter T Heydemann, Arthur A Beisang, Shannon M Standridge, Robin C C Ryther, Richard H Haas, Lloyd J Edwards, Amitha Ananth, Alan K Percy

Faculty, Staff and Students Publications

OBJECTIVE: To determine the longitudinal distribution of hand function skills in individuals with classic Rett Syndrome (RTT), an X-linked dominant neurodevelopmental disorder, and correlate with

METHOD: We conducted a longitudinal study of 946 girls and young women with typical RTT seen between 2006 and 2021 in the US Natural History Study (NHS) featuring a structured clinical evaluation to assess the level of hand function skills. The specific focus in this study was to assess longitudinal variation of hand skills from age 2 through age 18 years in relation to specific

RESULTS: Following the initial regression period, hand function continues to …

Enhancing Pathology Report Analysis With Artificial Intelligence: A Validation Study Of Chatgpt's Effectiveness In 444 Cases, Zhenhong Qu, Megan Wang, Christian Santiago, Jack W. Qu, Ping Zhang

Conference Presentation Abstracts

Context: Despite years of efforts, the pathology report lacks standardization for its gross description. This inevitably leads to the occasional omission of key data elements, and difficulty to identify key elements in a lengthy unstructured report. A novel artificial intelligence (AI) tool, ChatGPT by OpenAI (San Francisco, California), was reportedly proficient in extracting keywords from text content. We assess the effectiveness of ChatGPT to quickly find multiple data elements in reports and detect missing data elements.

Design: Gross description of 444 pathology reports of several common organ types was submitted to ChatGPT (https://chat.openai.com/chat) that extracted and listed key data elements …

Examining Whether Genetic Variants Moderate The Skeletal Effects Of Selective Serotonin Reuptake Inhibitors In Older Adolescents And Young Adults, Ifeoma Ezenwabachili, Emira Deumic Shultz, James A Mills, Vicki Ellingrod, Chadi A Calarge

Faculty, Staff and Students Publications

Objective: To examine whether serotonin (5-HT) related genetic variants moderate the effects of selective serotonin reuptake inhibitors (SSRIs) on skeletal outcomes. Methods: Trabecular bone mineral density (BMD) at the radius, lumbar spine (LS) BMD, total body less head (TBLH) bone mineral content (BMC) and markers of bone metabolism (osteocalcin, C-terminal telopeptide of type I collagen [CTX-1], and bone specific alkaline phosphatase to CTX-1 ratio) were examined in an observational study, enrolling 15- to 20-year-old participants, unmedicated or within a month of SSRI initiation. Variants in HTR1A (rs6295), HTR1B (rs6296), HTR1D (rs6300), HTR2A (rs6311 and rs6314), HTR2B (rs6736017), and the serotonin …

Robot-Assisted Resection Of Tricuspid Valve Papillary Fibroelastoma, Nancy Wang, Zachary Gray, Joseph G Rogers, Kenneth K Liao

Faculty, Staff and Students Publications

We report 3 cases of papillary fibroelastoma of the tricuspid valve. Two of them manifested with atypical symptoms of chest pressure and chest pain. Robot-assisted resection was performed to remove the mass while preserving the native valve. All patients recovered well. The 2 symptomatic patients experienced complete symptom resolution. We demonstrate the safety and feasibility of robotic resection in treating tricuspid valve papillary fibroelastoma.

Perioperative Opioids And Survival Outcomes In Resectable Head And Neck Cancer: A Systematic Review., Eric V Mastrolonardo, Derek S Mann, Harleen K. Sethi, Bo H Yun, Elliott M Sina, Maria Armache, Brooke Worster, Christopher E Fundakowski, Leila J Mady

Otolaryngology (ENT) Resident Research

BACKGROUND: Opioids are a mainstay in pain control for oncologic surgery. The objective of this systematic review is to evaluate the associations of perioperative opioid use with overall survival (OS) and disease-free survival (DFS) in patients with resectable head and neck cancer (HNC).

METHODS: A systematic review of PubMed, SCOPUS, and CINAHL between 2000 and 2022 was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies investigating perioperative opioid use for patients with HNC undergoing surgical resection and its association with OS and DFS were included.

RESULTS: Three thousand three hundred seventy-eight studies met initial inclusion …

Insights From A Study On Multimodal Experiences In A Plaza, Yohany Albornoz, Gladys E. Maestre

School of Medicine Publications

In the emerging field of neuroarchitecture, understanding the neurophysiological responses elicited by urban spaces is crucial for enhancing the quality of life. This study investigates the modulation of neurophysiological responses in relation to the perception of protection in urban environments. By exploring the impact of immediate, previously visited, or contiguous spaces on the sensory experiences of individuals, we aim to uncover insights into the interplay between architectural design, multisensorial experiences, and the modulation of perceived protection.

Using a holistic phenomenological approach, we designed an experiment involving 100 participants to examine how the atmosphere of preceding spaces influences the perception of …

Sotatercept For The Treatment Of Pulmonary Arterial Hypertension: A Meta-Analysis Of Randomized Controlled Trials, Vikash Jaiswal, Song Peng Ang, Vibhor Agrawal, Vamsikalayan Borra, Dhrubajyoti Bandyopadhyay, Aayusha Dhakal, Teresa Demarco, Gregg C. Fonarow

School of Medicine Publications

No abstract provided.

Low-Cost Pm2.5 Sensors Can Help Identify Driving Factors Of Poor Air Quality And Benefit Communities, Tim Keyes, Rea Domingo, Samantha Dynowski, Royal Graves, Martha Klein, Melissa Leonard, John Pilgrim, Alison Sanchirico, Kate Trinkaus

WCBT Faculty Publications

Air quality is critical for public health. Residents rely chiefly on government agencies such as the Environmental Protection Agency (EPA) in the United States to establish standards for the measurement of harmful contaminants including ozone, sulfur dioxide, carbon monoxide, volatile organic chemicals (VOCs), and fine particulate matter at or below 2.5 μm. According to the California Air Resources Board [1], “short-term PM2.5 exposure (up to 24-h duration) has been associated with premature mortality, increased hospital admissions for heart or lung causes, acute and chronic bronchitis, asthma attacks, emergency room visits, respiratory symptoms, and restricted activity days”. While public agency resources …

Perio Presentation - The Gummy Smile

Journal of the Macomb Dental Society

Presentation summary: Ninety-two attendees ranging from dental specialists, generalists, and hygienists gathered at Andiamos as a team to learn treatment modalities for “Gummy Smiles.” Beautifully documented and photographed cases were shared. Classifications of “Gummy Smile” patients were reviewed. Dental teams can feel confident discussing treatment options concerning high smile lines thanks to Drs. Kinaia and Hasso.

Kneiffiella Palmae: A Non-Aspergillus Fungal Infection Isolated From A Pulmonary Nodule In A Child With Chronic Granulomatous Disease, Bianca E. Ituarte, Connie Canete-Gibas, Nathan P. Wiederhold, Liset Olarte

Manuscripts, Articles, Book Chapters and Other Papers

We report the first known human case of Kneiffiella palmae in the medical literature. K. palmae was isolated from a pulmonary nodule in a 7-year-old male with chronic granulomatous disease. The mold was identified as K. palmae at a national reference laboratory, where 17 other human respiratory samples tested positive for K. palmae from 2013 to 2021. Optimal antimicrobial treatment is unknown, but azoles and amphotericin B demonstrated in vitro activity against each tested isolate.

Validation Of A Clinical Prediction Rule For Distinguishing Bacterial And Aseptic Meningitis In Pediatric Patients, Amelia L Gurley, Matt Fukuda, Ashwin Sharma, Ethan Lee, Erica Junqueira, Michael Kang, Tommy Y Kim

Children’s Nutrition Research Center Staff Publications

Introduction

The treatments and prognosis of bacterial meningitis differ greatly from those of aseptic meningitis, making early identification and differentiation essential. Several different clinical prediction rules have been developed to distinguish bacterial meningitis from aseptic meningitis. We sought to validate one clinical prediction rule for pediatric patients utilizing a centralized data warehouse that collects daily data from 184 hospitals across the United States.

Methods

We retrospectively collected data on all patients aged 29 days to 14 years who presented to Hospital Corporation of America (HCA) Healthcare hospitals from January 1, 2016, to May 31, 2021, with a diagnosis of meningitis. …

Impact Of Physical Inactivity On Glucose Metabolism And Skeletal Muscle Secretions In Healthy Trained Rats And Potential Counteracting Effect Of Exercise And Protocatechuic Acid, Hira Shakoor

Dissertations

Modern societies have significantly transformed people's lifestyles, leading to a substantial increase in physical inactivity, which concerns 23% of adults and 81% of adolescents worldwide. Physical inactivity is a major factor contributing to the emergence of chronic diseases, most prominently Type 2 Diabetes (T2D), which exhibits a high prevalence in many countries. T2D is characterized by elevated blood glucose levels due to cells’ responsiveness to insulin. The shift towards inactivity likely occurred more rapidly than the genome's capacity to adapt, resulting in the metabolic dysfunctions underlying the development of T2D. Skeletal muscle is crucial in the onset of these metabolic …

Maximizing Wound Coverage In Full-Thickness Skin Defects: A Randomized-Controlled Trial Of Autologous Skin Cell Suspension And Widely Meshed Autograft Versus Standard Autografting, Sharon Henry, Steven Mapula, Mark Grevious, Kevin N. Foster, Herbert Phelan, Jeffrey Shupp, Rodney Chan, David Harrington, Neil Mashruwala, David A. Brown, Haaris Mir, George Singer, Alfredo Cordova, Lisa Rae, Theresa Chin, Lourdes Castanon, Derek Bell, William Hughes, Joseph A. Molnar

School of Medicine Faculty Publications

BACKGROUND Traumatic insults, infection, and surgical procedures can leave skin defects that are not amenable to primary closure. Split-thickness skin grafting (STSG) is frequently used to achieve closure of these wounds. Although effective, STSG can be associated with donor site morbidity, compounding the burden of illness in patients undergoing soft tissue reconstruction procedures. With an expansion ratio of 1:80, autologous skin cell suspension (ASCS) has been demonstrated to significantly decrease donor skin requirements compared with traditional STSG in burn injuries. We hypothesized that the clinical performance of ASCS would be similar for soft tissue reconstruction of nonburn wounds. METHODS A …

Low-Rate Tens As An Effective Treatment For Pelvic Pain - A Retrospective Case Report, Michelle Allyn, Ryan Kamienseski

Faculty Publications

Purpose: Chronic pelvic pain (CPP) affects 27% of the world’s female population. The purpose of this case report was to investigate the use of low-rate transcutaneous electrical nerve stimulation (TENS) for pain relief in a woman with CPP. Few studies have investigated the effects of low-rate TENS on gynecological related pelvic pain. Methods: A 21-year-old woman presented with a six-month history of pelvic pain and decreased quality of life. Persistent pain led the patient to seek physical therapy treatment. Single-channel low-rate TENS (five hertz frequency, 250 microseconds phase duration) was provided for 30 minutes daily at the maximum tolerated intensity, …

Knowledge And Use Of Paced Bottle-Feeding Among Mothers Of Young Infants, Alison K. Ventura, Vivian M. Drewelow

Kinesiology and Public Health

Objective: To describe mothers’ awareness and use of paced bottle-feeding (PBF) and to investigate whether the use of PBF was associated with maternal characteristics and infant feeding practices.

Methods: Cross-sectional, online survey. Participants were mothers of infants < 12 months of age (n =197). Participants self-reported their awareness and use of PBF, demographic characteristics, and infant feeding practices.

Results: Of the 41% of participants who indicated they had or maybe had heard of PBF, 23% used PBF and 35% sometimes used PBF. Use of PBF was not associated with mother or infant characteristics. Participants who used PBF were significantly less likely to encourage their infant to finish the bottle (odds ratio,0.04; 95% confidence interval, 0.01−0.79).

Conclusions and Implications: Paced bottle-feeding was …

Stop-Bang Questionnaire For Screening Obstructive Sleep Apnea Syndrome Among Hypertensive Patients In Kenya, Salim Abdallah, Jasmit Shah, Jumaa Bwika, Sayed Karar

Internal Medicine, East Africa

Introduction: Obstructive sleep apnea (OSA) is a type of breathing problem during sleep caused by the blockage of the upper airway, which can cause cessation of airflow. There is limited research on the prevalence of OSA in hypertensive patients in sub-Saharan Africa (SSA). The study aimed to describe the prevalence and clinical characteristics of OSA among hypertensive patients at a tertiary hospital in Nairobi, Kenya.

Methods: This cross-sectional study was conducted at the Aga Khan University Hospital in Nairobi, Kenya. Two hundred and fifty-one hypertensive patients were screened for OSA risk using the STOP-Bang questionnaire (SBQ). Patients with a SBQ …

Kenyan Palliative Care Providers’ And Leaders’ Perceptions Of Palliative Care Research Needs And Support To Facilitate Rigorous Research, K. Cartmell, E. Doherty, Nancy Gikaara, Z. Ali, S. Qanungo, E. S. Melikam, R. A. Powell

Internal Medicine, East Africa

Background: Palliative care (PC) can reduce symptom distress and improve quality of life for patients and their families experiencing life-threatening illness. While the need for PC in Kenya is high, PC service delivery and research is limited. Qualitative research is needed to explore potential areas for PC research and support needed to enable that research. This insight is critical for informing a national PC research agenda and mobilizing limited resources for conducting rigorous PC research in Kenya.

Objectives: To explore perceptions of priority areas for PC research and support needed to facilitate rigorous research from the perspective of Kenyan PC …

Gall Bladder Schistosomiasis Diagnosed Incidentally Post Laparoscopic Cholecystectomy: A Case Report, Willbroad Kyejo, Sajida Panjwani, Ally Zain Ismail, Blessing Mathew, Caroline Ngimba, Ally Mwanga

Internal Medicine, East Africa

Introduction and importance: Schistosomiasis is a neglected tropical disease caused by parasitic worms of the genus Schistosoma. It primarily affects the intestines, liver, and urinary tract however, rare cases have been reported where the parasite invades other organs. This case report presents an incidental finding of schistosomiasis, upon histopathology evaluation, in a patient who underwent laparoscopic cholecystectomy for symptomatic gallstone disease with recurrent attacks of cholecystitis.

Case presentation: We present the case of a 42-year-old female patient who presented to the emergency department with symptoms and signs suggestive of acute cholecystitis. She underwent conservative management with interval laparoscopic cholecystectomy …

Emotional Distress And Cardiovascular Disease Risk Among Participants Enrolled In The Glycemia Reduction Approaches In Diabetes: A Comparative Effectiveness (Grade) Study, Gladys Crespo-Ramos, Ionut Bebu, Heidi Krause-Steinrauf, Claire J Hoogendoorn, Ran Fang, Dominic Ehrmann, Caroline Presley, Aanand D Naik, Aimee Katona, Elizabeth A Walker, Andrea Cherrington, Jeffrey S Gonzalez

Faculty, Staff and Student Publications

AIMS: People with type 2 diabetes (T2DM) have an increased risk of cardiovascular disease (CVD). We examined depressive symptoms (DS) and diabetes distress (DD) in relation to the estimated 10-year risk of CVD in adults with T2DM enrolled in the GRADE Emotional Distress Substudy.

METHODS: Linear regression models examined the associations of baseline DS and DD with estimated 10-year risk of CVD using the Atherosclerotic Cardiovascular Disease (ASCVD) risk score, adjusting for age, sex, race/ethnicity, education, income, diabetes duration, diabetes-related complications, and HbA1c.

RESULTS: A total of 1,605 GRADE participants were included: 54% Non-Latino (NL) White, 18% Latino, 19% NL-Black, …

Prediagnostic Glycoprotein Acetyl Levels And Incident And Recurrent Flare Risk Accounting For Serum Urate Levels: A Population-Based, Prospective Study And Mendelian Randomization Analysis, Amit D Joshi, Natalie Mccormick, Chio Yokose, Bing Yu, Adrienne Tin, Robert Terkeltaub, Tony R Merriman, A Heather Eliassen, Gary C Curhan, Laura M Raffield, Hyon K Choi

Faculty, Staff and Student Publications

OBJECTIVE: To prospectively investigate population-based metabolomics for incident gout and reproduce the findings for recurrent flares, accounting for serum urate.

METHODS: We conducted a prediagnostic metabolome-wide analysis among 105,615 UK Biobank participants with nuclear magnetic resonance metabolomic profiling data (168 total metabolites) from baseline blood samples collected 2006-2010 in those without history of gout. We calculated hazard ratios (HRs) for incident gout, adjusted for gout risk factors, excluding and including serum urate levels, overall and according to fasting duration before sample collection. Potential causal effects were tested with 2-sample Mendelian randomization. Poisson regression was used to calculate rate ratios (RRs) …

Exceptional Responses To Selpercatinib In Ret-Fusion Driven Metastatic Pancreatic Cancer, Deepak Bhamidipati, Sireesha Yedururi, Jason Huse, Sri Veda Chinapuvvula, Jie Wu, Vivek Subbiah

Faculty, Staff and Student Publications

No abstract provided.

Ras Gtpases And Interleaflet Coupling In The Plasma Membrane, Junchen Liu, Neha Arora, Yong Zhou

Faculty, Staff and Student Publications

RAS genes are frequently mutated in cancer. The primary signaling compartment of wild-type and constitutively active oncogenic mutant RAS proteins is the inner leaflet of the plasma membrane (PM). Thus, a better understanding of the unique environment of the PM inner leaflet is important to shed further light on RAS function. Over the past few decades, an integrated approach of superresolution imaging, molecular dynamic simulations, and biophysical assays has yielded new insights into the capacity of RAS proteins to sort lipids with specific headgroups and acyl chains, to assemble signaling nanoclusters on the inner PM. RAS proteins also sense and …

Cancer In Louisiana: 2016-2020, Volume 38, Louisiana Tumor Registry, Lauren Maniscalco, Mei-Chin Hsieh, Christina Lefante, Yong Yi, Lisa Pareti, Brent Mumphrey, Mary Anne Lynch, Xiao-Cheng Wu, Simon Zulu

Policy & Position Papers

Mission:

To collect and report complete, high-quality, and timely population-based cancer data in Louisiana to support cancer research, control, and prevention.

Vision:

To reduce suffering and death from cancer using information collected by the Louisiana Tumor Registry.

History:

Cancer registration in Louisiana began in 1947 at the Charity Hospital Tumor Registry in New Orleans. In 1974, as part of its Surveillance, Epidemiology and End Results (SEER) Program, the National Cancer Institute provided funds for a population-based cancer incidence and survival registry covering Jefferson, Orleans, and St. Bernard parishes. Five years later, the Louisiana Tumor Registry (LTR) was transferred to the …

Epigenome-Wide Dna Methylation Association Study Of Circulating Ige Levels Identifies Novel Targets For Asthma, Kathryn Recto, Priyadarshini Kachroo, Tianxiao Huan, David Van Den Berg, Gha Young Lee, Helena Bui, Dong Heon Lee, Jessica Gereige, Chen Yao, Shih-Jen Hwang, Roby Joehanes, Scott T Weiss, George T O'Connor, Daniel Levy, Dawn L Demeo

Faculty, Staff and Student Publications

BACKGROUND: Identifying novel epigenetic signatures associated with serum immunoglobulin E (IgE) may improve our understanding of molecular mechanisms underlying asthma and IgE-mediated diseases.

METHODS: We performed an epigenome-wide association study using whole blood from Framingham Heart Study (FHS; n = 3,471, 46% females) participants and validated results using the Childhood Asthma Management Program (CAMP; n = 674, 39% females) and the Genetic Epidemiology of Asthma in Costa Rica Study (CRA; n = 787, 41% females). Using the closest gene to each IgE-associated CpG, we highlighted biologically plausible pathways underlying IgE regulation and analyzed the transcription patterns linked to IgE-associated CpGs …

Multivariate Genetic Analysis Of Personality And Cognitive Traits Reveals Abundant Pleiotropy, Guy Hindley, Alexey A Shadrin, Dennis Van Der Meer, Nadine Parker, Weiqiu Cheng, Kevin S O'Connell, Shahram Bahrami, Aihua Lin, Naz Karadag, Børge Holen, Thomas Bjella, Ian J Deary, Gail Davies, W David Hill, Jan Bressler, Sudha Seshadri, Chun Chieh Fan, Torill Ueland, Srdjan Djurovic, Olav B Smeland, Oleksandr Frei, Anders M Dale, Ole A Andreassen

Faculty, Staff and Student Publications

Personality and cognitive function are heritable mental traits whose genetic foundations may be distributed across interconnected brain functions. Previous studies have typically treated these complex mental traits as distinct constructs. We applied the 'pleiotropy-informed' multivariate omnibus statistical test to genome-wide association studies of 35 measures of neuroticism and cognitive function from the UK Biobank (n = 336,993). We identified 431 significantly associated genetic loci with evidence of abundant shared genetic associations, across personality and cognitive function domains. Functional characterization implicated genes with significant tissue-specific expression in all tested brain tissues and brain-specific gene sets. We conditioned independent genome-wide association studies …

An Unusual Case Of Acute Scrotal Pain, Thomas Damrow, Ryan Bellinger, Judy Lin, Jennifer A Walker

Faculty, Staff and Student Publications

Patients frequently present to the emergency department with complaints of scrotal or testicular pain. Generally, there is an algorithmic approach to workup, which includes assessment for torsion, infection, or vascular causes, and musculoskeletal causes of pain are also sometimes considered. Spinal cord pathology, however, is less often explored as a cause of testicular pain. Here, we present a case of a 45-year-old man with end-stage renal disease and hypertension who presented with acute testicular pain. After a comprehensive workup, however, the source of pain was not initially found. Progression of the patient's symptoms led to the diagnosis of spontaneous spinal …

Tepotinib Treatment In Patients With Met Exon 14-Skipping Non-Small Cell Lung Cancer: Long-Term Follow-Up Of The Vision Phase 2 Nonrandomized Clinical Trial, Julien Mazieres, Paul K Paik, Marina C Garassino, Xiuning Le, Hiroshi Sakai, Remi Veillon, Egbert F Smit, Alexis B Cortot, Jo Raskin, Santiago Viteri, Yi-Long Wu, James C H Yang, Myung-Ju Ahn, Rui Ma, Jun Zhao, Aurora O'Brate, Karin Berghoff, Rolf Bruns, Gordon Otto, Andreas Johne, Enriqueta Felip, Michael Thomas

Faculty, Staff and Student Publications

Importance: MET inhibitors have recently demonstrated clinical activity in patients with MET exon 14 (METex14)-skipping non-small cell lung cancer (NSCLC); however, data with longer follow-up and in larger populations are needed to further optimize therapeutic approaches.

Objective: To assess the long-term efficacy and safety of tepotinib, a potent and highly selective MET inhibitor, in patients with METex14-skipping NSCLC in the VISION study.

Design, setting, and participants: The VISION phase 2 nonrandomized clinical trial was a multicohort, open-label, multicenter study that enrolled patients with METex14-skipping advanced/metastatic NSCLC (cohorts A and C) from September 2016 to May 2021. Cohort C (>18 …

Microfluidic Paper-Based Device Coupled With 3d Printed Imaging Box For Colorimetric Detection In Resource-Limited Settings, Vijay Vaishampayan, Oinam Robita Chanu, Balasubramanian Sivasamy, Muthamilselvi Ponnuchamy, Varshini Karthik, Ambar Pendharkar, Lohith Srinivas Thotakura, Aryan Prabhu, Venkatesan Dhananjeyan, Ashish Kapoor

Faculty, Staff and Student Publications

Rapid and effective methods for the detection of analytes such as water contaminants, food adulterants and biomolecules are essential for the protection of public health and environmental protection. Most of the currently established analytical techniques need sophisticated equipment, centralized testing facilities, costly operations, and trained personnel. Such limitations make them inaccessible to the general populace, particularly in regions with limited resources. The emergence of microfluidic devices offers a promising alternative to overcome several such constraints. This work describes a protocol for fabricating a low-cost, open-source paper-based microfluidic device using easily available tools and materials for colorimetric detection of analytes. The …

Identifying Brain Hierarchical Structures Associated With Alzheimer’S Disease Using A Regularized Regression Method With Tree Predictors, Yi Zhao, Bingkai Wang, Chin-Fu Liu, Andreia V Faria, Michael I Miller, Brian S Caffo, Xi Luo

Faculty, Staff and Student Publications

Brain segmentation at different levels is generally represented as hierarchical trees. Brain regional atrophy at specific levels was found to be marginally associated with Alzheimer's disease outcomes. In this study, we propose an ℓ1 -type regularization for predictors that follow a hierarchical tree structure. Considering a tree as a directed acyclic graph, we interpret the model parameters from a path analysis perspective. Under this concept, the proposed penalty regulates the total effect of each predictor on the outcome. With regularity conditions, it is shown that under the proposed regularization, the estimator of the model coefficient is consistent in ℓ2 -norm …

Examining Readiness For Implementing Practice Changes In Federally Qualified Health Centers: A Rapid Qualitative Study, Emanuelle M Dias, Timothy J Walker, Derek W Craig, Robert Gibson, Jacob Szeszulski, Heather M Brandt, Hiluv Johnson, Andrea Lamont, Abraham Wandersman, Maria E Fernandez

Faculty, Staff and Student Publications

Implementing evidence-based interventions remains slow in federally qualified health centers (FQHCs). The purpose of this study is to qualitatively examine the R = MC2 (Readiness = motivation × innovation specific capacity × general capacity) heuristic subcomponents in the context of implementing general and colorectal cancer screening (CRCS)-related practice changes in FQHCs. We conducted 17 interviews with FQHC employees to examine (1) experiences with successful or unsuccessful practice change efforts, (2) using approaches to promote CRCS, and (3) opinions about R = MC2 subcomponents. We conducted a rapid qualitative analysis to examine the frequency, depth, and spontaneity of subcomponents. Priority, compatibility, …