Medicine and Health Sciences Commons^™

Characterization Of Small Abdominal Aortic Aneurysms' Growth Status Using Spatial Pattern Analysis Of Aneurismal Hemodynamics, Mostafa Rezaeitaleshmahalleh, Zonghan Lyu, Nan Mu, Xiaoming Zhang, Todd E. Rasmussen, Robert D. Mcbane, Jingfeng Jiang

Michigan Tech Publications

Aneurysm hemodynamics is known for its crucial role in the natural history of abdominal aortic aneurysms (AAA). However, there is a lack of well-developed quantitative assessments for disturbed aneurysmal flow. Therefore, we aimed to develop innovative metrics for quantifying disturbed aneurysm hemodynamics and evaluate their effectiveness in predicting the growth status of AAAs, specifically distinguishing between fast-growing and slowly-growing aneurysms. The growth status of aneurysms was classified as fast (≥ 5 mm/year) or slow (< 5 mm/year) based on serial imaging over time. We conducted computational fluid dynamics (CFD) simulations on 70 patients with computed tomography (CT) angiography findings. By converting hemodynamics data (wall shear stress and velocity) located on unstructured meshes into image-like data, we enabled spatial pattern analysis using Radiomics methods, referred to as "Hemodynamics-informatics" (i.e., using informatics techniques to analyze hemodynamic data). Our best model achieved an AUROC of 0.93 and an accuracy of 87.83%, correctly identifying 82.00% of fast-growing and 90.75% of slowly-growing AAAs. Compared with six classification methods, the models incorporating hemodynamics-informatics exhibited an average improvement of 8.40% in AUROC and 7.95% in total accuracy. These preliminary results indicate that hemodynamics-informatics correlates with AAAs' growth status and aids in assessing their progression.

Cerebral Small Vessel Disease Burden Is Associated With Decreased Abundance Of Gut Barnesiella Intestinihominis Bacterium In The Framingham Heart Study, Bernard Fongang, Claudia Satizabal, Tiffany F. Kautz, Yannick N. Wadop, Jazmyn A. S. Muhammad, Erin Vasquez, Julia Mathews, Monica Gireud-Goss, Michael Mahaney, Gladys Maestre

School of Medicine Publications

A bidirectional communication exists between the brain and the gut, in which the gut microbiota influences cognitive function and vice-versa. Gut dysbiosis has been linked to several diseases, including Alzheimer's disease and related dementias (ADRD). However, the relationship between gut dysbiosis and markers of cerebral small vessel disease (cSVD), a major contributor to ADRD, is unknown. In this cross-sectional study, we examined the connection between the gut microbiome, cognitive, and neuroimaging markers of cSVD in the Framingham Heart Study (FHS). Markers of cSVD included white matter hyperintensities (WMH), peak width of skeletonized mean diffusivity (PSMD), and executive function (EF), estimated …

Stability Analyses On The Effect Of Vaccination And Contact Tracing In Monkeypox Virus Transmission, Solomon Eshun, Richmond Essieku, James Ladzekpo

School of Mathematical & Statistical Sciences Faculty Publications

Monkeypox is a significant health concern due to its potential for morbidity and occasional mortality. Vaccination and effective contact tracing play pivotal roles in controlling infectious diseases, including monkeypox. This study aims to contribute to our understanding of monkeypox dynamics by developing a comprehensive mathematical model that incorporates key factors such as vaccination, quarantining, and contact tracing. Through rigorous sensitivity analysis, we explore the impact of varying vaccination coverage and contact tracing on the disease’s dynamics. In particular, we investigate the dynamics of the disease in relation to variable vaccination coverage and contact tracing. Our findings highlight the critical role …

A Longitudinal Resource For Population Neuroscience Of School-Age Children And Adolescents In China, Xue-Ru Fan, Yin-Shan Wang, Da Chang, Ning Yang, Meng-Jie Rong, Zhe Zhang, Ye He, Xiaohui Hou, Quan Zhou, John Blangero

School of Medicine Publications

During the past decade, cognitive neuroscience has been calling for population diversity to address the challenge of validity and generalizability, ushering in a new era of population neuroscience. The developing Chinese Color Nest Project (devCCNP, 2013–2022), the first ten-year stage of the lifespan CCNP (2013–2032), is a two-stages project focusing on brain-mind development. The project aims to create and share a large-scale, longitudinal and multimodal dataset of typically developing children and adolescents (ages 6.0–17.9 at enrolment) in the Chinese population. The devCCNP houses not only phenotypes measured by demographic, biophysical, psychological and behavioural, cognitive, affective, and ocular-tracking assessments but also …

Identifying The Reactive Metabolites Of Tyrosine Kinase Inhibitor Pexidartinib In Vitro Using Lc-Ms-Based Metabolomic Approaches, Xuan Qin, Yong Wang, Kevin R Mackenzie, John M Hakenjos, Si Chen, Saleh M Khalil, Sung Yun Jung, Damian W Young, Lei Guo, Feng Li

Faculty, Staff and Students Publications

Pexidartinib (PEX, TURALIO), a selective and potent inhibitor of the macrophage colony-stimulating factor-1 receptor, has been approved for the treatment of tenosynovial giant cell tumor. However, frequent and severe adverse effects have been reported in the clinic, resulting in a boxed warning on PEX for its risk of liver injury. The mechanisms underlying PEX-related hepatotoxicity, particularly metabolism-related toxicity, remain unknown. In the current study, the metabolic activation of PEX was investigated in human/mouse liver microsomes (HLM/MLM) and primary human hepatocytes (PHH) using glutathione (GSH) and methoxyamine (NH2OMe) as trapping reagents. A total of 11 PEX-GSH and 7 PEX-NH2OMe adducts were …

Correction: Long Noncoding Rna Pvt1 Promotes Breast Cancer Proliferation And Metastasis By Binding Mir-128-3p And Upf1, Shuiyi Liu, Weiqun Chen, Hui Hu, Tianzhu Zhang, Tangwei Wu, Xiaoyi Li, Yong Li, Qinzhi Kong, Hongda Lu, Zhongxin Lu

Faculty, Staff and Students Publications

No abstract provided.

The Role Of Pharmacogenetics On Breast Cancer Treatment Efficacy And Toxicity, Noor Alani, Nicholas Barber, Britt Benn, Justin M. Gambini

Doctor of Medical Science (DMSc)

Purpose: This research article aims to shed light on the pivotal role of pharmacogenetics in breast cancer treatment by examining genetic variations that influence the efficacy and toxicity of commonly used drugs. Furthermore, this study highlights the significance of personalized treatment approaches in optimizing patient outcomes.

Method: A comprehensive literature search was conducted using databases such as PubMed. Search terms included "pharmacogenetics," "breast cancer treatment," "genetic markers," and "adverse effects." This review critically analyzes relevant studies that focus on the impact of genetic variations on the response to drugs used in breast cancer treatment.

Results: The review …

Clearing The Smoke Around Marijuana Laws For Healthcare Organizations: Evaluating Certified Registered Nurse Anesthetists' Perceived Knowledge Of Their Organization’S Cannabis Use Policies, Jessica Aspan

College of Science and Health Theses and Dissertations

The legalization of marijuana in many U.S. states, despite its federal illegality, has resulted in an influx of positive marijuana drug screens across the healthcare sector.1 To better understand this problem, CRNAs in the Illinois Association of Nurse Anesthetists (IANA) were surveyed regarding their perceived knowledge of their organization’s policies regarding cannabis use using an online survey. The survey had a response rate of approximately 8.2% (n=148) and a majority (70%) of CRNAs disagreed or were neutral when asked if their organization’s policies were well-communicated regarding cannabis use. These results make clear that CRNAs lack clarity and communication from employers …

Pediatric Fiberoptic Intubation Education Utilizing Simulation: A Quality Improvement Study, Aladin Bihorac, Jonathan Mangan

College of Science and Health Theses and Dissertations

Fiberoptic intubation has been used as a secondary option to intubate pediatric patients with difficult airways. Failure to understand how to properly use a fiberoptic scope could have severe consequences, such as increased trauma or mortality. This is a quality improvement research study that examines the effect of simulation training utilizing a pediatric flexible fiberoptic scope on the confidence and competence of Nurse Anesthesia Trainees (NATs). Competence was measured using time to successful intubation. The authors developed a survey tool to assess the confidence of the participants in intubating pediatric patients’ airways with a fiberoptic scope after educational training and …

A Systematic Review Examining The Efficacy Of Existing Child Abuse Screening Tools Used In The Emergency Department, Kaitlan Meyers, Alyssa Strapko

College of Science and Health Theses and Dissertations

Child abuse and neglect is a major health problem in the United States and has lasting and detrimental effects. This review examines the screening instruments that are in existence today to detect child maltreatment. The instruments are compared and evaluated for their feasibility of use in an emergency department setting.

Four electronic databases were searched to identify screening instruments that assessed for child physical, emotional, and sexual abuse and neglect. The following subject heading keywords were used: ‘child abuse or child maltreatment or child mistreatment or child neglect or child sexual abuse or non-accidental trauma or head trauma or battered …

Tefra 7 Requirements: Assessment Of Education On Crna Knowledge, Erin Tienhaara

College of Science and Health Theses and Dissertations

Failure to follow the seven requirements of the Tax Equality and Fiscal Responsibility Act (TEFRA) when working in a medical direction model can place a CRNA at increased liability related to Medicare fraud. CRNAs and SRNAs often lack basic knowledge about the TEFRA 7 requirements which puts them at risk of committing inadvertent medical billing fraud. The purpose of this study was to determine if the investigator-developed educational flyer improved CRNA and SRNA knowledge regarding the TEFRA 7 requirements. A convenience sample of CRNAs and SRNAs (n=61) completed an online knowledge pre-test about TEFRA, reviewed the investigator-developed educational flyer about …

Increasing Anesthesia Bar Code Medication Administration Scanning Compliance, Andrew Calderon

College of Science and Health Theses and Dissertations

Purpose: This study aimed to determine whether the multimodal implementation of visual aids in anesthesia drug drawers, dissemination of virtual reminders through email and scheduling software, and alteration of the barcode scanner location to a more convenient location will improve barcode medication administration (BCMA) compliance.

Design: This study was a time series design study utilizing a retrospective chart review.

Methods: The data collection points included pre- vs. post-intervention, anesthesia provider type, medication type (ephedrine or phenylephrine), and whether the barcode was scanned or not. Chi-squared tests and logistic regression analysis were performed.

Findings: The Chi-squared tests indicated that the type …

Just-In-Time Training Videos For Specialty Operating Room Setups For Student Registered Nurse Anesthetists, Michelle Murray, Emily Miller

College of Science and Health Theses and Dissertations

Background: Just-in-time training (JITT) is an accepted training method in healthcare education that can be used for newer concepts or for procedures that are not performed often. JITT training is focused, brief, and intended to be used in the moment to address a knowledge or skill deficit. This makes JITT videos an appropriate solution for when the student registered nurse anesthetist (SRNA) needs a timely reminder on how to set up an operating room for a unique case, such as a pediatric case or a neonatal micrognathia case.

Purpose: The purpose of this study was to examine the efficacy of …

State Of The Art Bowel Management For Pediatric Colorectal Problems: Hirschsprung Disease., Elizaveta Bokova, Ninad Prasade, Sanjana Janumpally, John Rosen, Irene Isabel P. Lim, Marc A. Levitt, Rebecca M. Rentea

Manuscripts, Articles, Book Chapters and Other Papers

After an initial pull-though, patients with Hirschsprung disease (HD) can present with obstructive symptoms, Hirschsprung-associated enterocolitis (HAEC), failure to thrive, or fecal soiling. This current review focuses on algorithms for evaluation and treatment in children with HD as a part of a manuscript series on updates in bowel management. In constipated patients, anatomic causes of obstruction should be excluded. Once anatomy is confirmed to be normal, laxatives, fiber, osmotic laxatives, or mechanical management can be utilized. Botulinum toxin injections are performed in all patients with HD before age five because of the nonrelaxing sphincters that they learn to overcome with …

Just-In-Time Training Improves Knowledge And Confidence In Neuraxial Anesthesia In Student Registered Nurse Anesthetists, Amanda Arredondo, Victoria Willis

College of Science and Health Theses and Dissertations

Background: Student registered nurse anesthetists (SRNAs) are required by the Council on Accreditation to complete a minimum of ten spinal and ten epidural procedures. Neuraxial anesthesia, which includes spinal and epidural techniques, are challenging skills to master, requiring deliberate practice and active learning to achieve competency. There may be an extended period between when SRNAs learn the steps and implications of neuraxial procedures, and when they begin performing these skills in the clinical setting. Just-In-Time Training (JITT) is proven to be a successful teaching adjunct to bridge knowledge gaps for healthcare professionals. Purpose: To determine if using JITT, , as …

Airway Management Simulation With Ppe To Improve Nat Education And Comfort, Blake Butler, Marius Zymantas

College of Science and Health Theses and Dissertations

Guidelines for the use of proper personal protective equipment (PPE) were created by the Center of Disease Control and Prevention (CDC) half a century ago but PPE compliance remains low. To effectively protect healthcare workers from becoming infected and spreading infectious agents, PPE compliance must be improved. The purpose of this study was to assess the efficacy of an educational tool and simulation on improving NAT (nurse anesthesia trainee) knowledge of PPE protocols as well as perceived comfort performing airway management procedures while wearing PPE. This study used a pre- and post- survey design to assess both knowledge of proper …

Playing Darts Blindfolded: A Quasi-Experimental Study On Crnas And Srnas Knowledge On Pre-Procedural Ultrasound For Neuraxial Anesthesia, Drew Golden, Kristine Kim

College of Science and Health Theses and Dissertations

Pre-procedural ultrasound is an emerging technique among anesthesia providers to increase procedural efficiency and safety of neuraxial procedures on patients with increased technical difficulty. The use of pre-procedural ultrasound in neuraxial anesthesia among certified registered nurse anesthetists (CRNAs) and student registered nurse anesthetists (SRNAs) has not been previously described. This study examined the efficacy of an educational intervention on CRNAs’ and SRNAs’ knowledge and future intent to use pre-procedural ultrasound to identify lumbar intervertebral spaces. We utilized a pre-and post-test design with convenience sampling. This study demonstrated a statistically significant improvement in the participants’ knowledge in four out of seven …

Sphenopalatine Ganglion Block For Post-Dural Puncture Headaches: A Video And Simulation For Nurse Anesthesia Trainees, Nicole Kwolek, Samantha Tarnoff

College of Science and Health Theses and Dissertations

Purpose: Dural punctures can cause debilitating headaches known as post-dural puncture headaches (PDPHs). The sphenopalatine ganglion (SPG) block can be used to treat PDPHs. This study aimed to determine if an educational video and simulation focused on the SPG block for PDPHs increased nurse anesthesia trainees’ (NAT) knowledge of the SPG block and confidence in performing the block for PDPHs. Design: The study design utilized a one-group quasi experimental study with a pre-test and posttest to assess NATs’ knowledge of the SPG block and their confidence in the placement of the block. Methods: The design consisted of a pre-test, an …

Evaluating The Effectiveness Of Simulation-Based Education Of Venous Gas Embolism On Novice Nurse Anesthesia Trainees, Angelica Rejczak, Jenna Fitzpatrick

College of Science and Health Theses and Dissertations

Background: Simulation-based education is a learning modality utilized in healthcare curriculum among nurse anesthesia trainees (NATs) for crisis management training. This learning modality may improve confidence and knowledge in novice NATs responding to a crisis scenario, such as a venous gas embolism (VGE).

Purpose: Evaluate the effectiveness of simulation-based education in effectively managing a crisis scenario, VGE, as measured by novice NATs confidence and knowledge levels.

Methods: An observational, cross-sectional study with a pretest-posttest design on a group of novice second-year NATs (NAT-2s) from NorthShore University HealthSystems (NorthShore) School of Nurse Anesthesia was utilized. A total of 15 NATs participated …

Examining Certified Registered Nurse Anesthetists’ Perspective On The Utilization Of Regional Anesthesia In Outpatient Orthopedic Surgery, Hannah M. Robert, Jessica O. Stasinski

College of Science and Health Theses and Dissertations

Regional anesthesia has played a significant role in the reduction of perioperative opioid consumption while still providing high-quality analgesia, making it a fundamental practice in outpatient orthopedic surgery. The purpose of this study was to qualitatively examine the experiences and perspectives of CRNAs surrounding the utilization of regional anesthesia in outpatient orthopedic surgery. A qualitative study design using semistructured interviews was conducted (N =14). Study participants described their current practices and experiences with regional anesthesia utilization in the outpatient orthopedic surgery setting. In particular, four themes describing factors that promote CRNAs’ utilization of regional anesthesia for outpatient orthopedic surgery emerged: …

Podcasting As An Education Modality On The Environmental Effect Of Desflurane, Jacob Bonnema

College of Science and Health Theses and Dissertations

Background: Climate crisis is well-documented as posing a major threat to the population. The provision of anesthesia utilizes gases that contribute to this problem. Podcasts may serve as a useful modality to educate anesthesia providers on best practices.

Purpose: The purpose of this study was to evaluate the effectiveness of an evidence-based educational intervention in the form of a podcast which focuses on the evaluation of knowledge, attitudes, and practice habits related to the use of desflurane among anesthesia providers.

Methods: An observational cross-section study using survey methodology was utilized in this pre-test post-test design. Knowledge, attitudes, and practice habits …

Gender Affirming Anesthesia: It’S More Than Pronouns, Matthew Klimesh, Angela Kurth

College of Science and Health Theses and Dissertations

Transgender individuals experience healthcare-related discrimination, resulting in significant disparities and negative health outcomes in comparison to the general population. Many CRNAs do not receive formal or adequate education before being expected to care for transgender patients that contributes to these negative health outcomes. To correct this problem, an educational intervention was created to improve anesthesia providers' knowledge of genderaffirming therapies and to survey anesthesia provider attitudes towards transgender patients and knowledge, beliefs, and preferences towards treating transgender patients. A sample of anesthesia providers was collected (n=27) that included SRNAs and CRNAs at varying levels of professional experience from diverse sociodemographic …

Isolated & Impulsive: A Quality Improvement Pilot Survey Of The Perceived Icu Nurse Workload Implementing The A2f Care Bundle For Isolated Covid-19 Patients With Delirium., Ranier Calimlim

College of Science and Health Theses and Dissertations

Background: Existing research focused on A2F Care Bundle efficacy to optimize patient care and improve patient outcomes among ICU patients. Perceived workflow evaluation has been validated for healthcare task analysis endorsed by the Agency for Healthcare Research and Quality. A needs assessment was identified to evaluate nursing challenges with the A2F Care Bundle interventions, inform allocation where support and resources may be necessary when providing patient care for isolated patients with COVID-19 delirium.

Purpose: The purpose of this study was to evaluate the perceived workload of ICU nurses when implementing the A2F Care Bundle among isolated COVID-19 patients with delirium. …

Multiple Myeloma: Validation Of The Values And Preferences Elicitation Questionnaire- Cure And Survival Preference Scale (Vpeq-Csps), Anastasiia Savchenko

College of Science and Health Theses and Dissertations

Background: With the emergence of many novel therapies, the treatment decisions for multiple myeloma (MM) are increasingly guided by concerns of quality of life, achievement of cancerfree remission, living a longer overall survival, and a relentless search for a cure; however, the impact of these various treatment options on patients’ choices and lives is mainly unknown. Oncology clinicians face the challenge of uncovering their patient’s preferences and values and putting them into the actual treatment decision-making. Purpose: This study examined the psychometric properties of the Values and Preferences Elicitation Questionnaire-Cure and Survival Preference Scale (VPEQ-CSPS) instrument. Methods: The VPEQ-CSPS instrument …

Phytochemical Profile And Cervical Anticancer Activity Of An In Vitro N-Hexane Extract Of Kunto Dewo Fruit (Kigelia Pinnata) Peel And Flesh, Swarnasari Nurandita Isbandiputri, Surya Dwira, Diyah Kristanty

Indonesian Journal of Medical Chemistry and Bioinformatics

Cervical cancer is the fourth highest cancer occurring and causes death in women. Therefore, adequate management is needed to prevent its development. Currently, the treatment has a variety of adverse side effects, so it needs alternative treatments that are supportive and with minimal side effects. One way is to use herbal plants, such as the Kunto Dewo (Kigelia pinnata) plant which is often used as traditional medicine. This plant has antimicrobial and cytotoxic effects on cancer cells. Knowing the phytochemical profile and in-vitro anticancer activity of the n-hexane extract of peel and flesh of Kunto Dewo (Kigelia pinnata) fruit against …

Pirtobrutinib In Covalent Bruton Tyrosine Kinase Inhibitor Pretreated Mantle-Cell Lymphoma, Michael L Wang, Wojciech Jurczak, Pier Luigi Zinzani, Toby A Eyre, Chan Y Cheah, Chaitra S Ujjani, Youngil Koh, Koji Izutsu, James N Gerson, Ian Flinn, Benoit Tessoulin, Alvaro J Alencar, Shuo Ma, David Lewis, Ewa Lech-Maranda, Joanna Rhodes, Krish Patel, Kami Maddocks, Nicole Lamanna, Yucai Wang, Constantine S Tam, Talha Munir, Hirokazu Nagai, Francisco Hernandez-Ilizaliturri, Anita Kumar, Timothy S Fenske, John F Seymour, Andrew D Zelenetz, Binoj Nair, Donald E Tsai, Minna Balbas, Richard A Walgren, Paolo Abada, Chunxiao Wang, Junjie Zhao, Anthony R Mato, Nirav N Shah

Faculty, Staff and Student Publications

Purpose: Pirtobrutinib is a highly selective, noncovalent (reversible) Bruton tyrosine kinase inhibitor (BTKi). We report the safety and efficacy of pirtobrutinib in patients with covalent Bruton tyrosine kinase inhibitor (cBTKi) pretreated mantle-cell lymphoma (MCL), a population with poor prognosis.

Methods: Patients with cBTKi pretreated relapsed/refractory (R/R) MCL received pirtobrutinib monotherapy in a multicenter phase I/II trial (BRUIN; ClinicalTrials.gov identifier: NCT03740529). Efficacy was assessed in the first 90 consecutively enrolled patients who met criteria for inclusion in the primary efficacy cohort. The primary end point was overall response rate (ORR). Secondary end points included duration of response (DOR) and safety. …

Patient-Reported Value Of A Standardized Welcome Letter For Huntington Disease Clinic, Kirthan S. Reddy, Shayan Abdollah Zadegan, Jorge Patino, Frank Ramirez, Amber Mccarthy, Natalia Pessoa Rocha, Erin Furr Stimming

Teaching in Clinics

Communication is an essential component of patient satisfaction, which can be especially challenging in patients with neurobehavioral symptoms. As an effective form of communication, Patient Welcome Letter (PWL) should be designed in a way to cover a wide range of literacy. We designed a PWL for our Huntington Disease (HD) clinic using readability and suitability measures. Of the 80 patients that received the PWL, 47 filled out the survey. A majority of patients (>90%) found the PWL clear, understandable, and well-organized. The PWL was deemed valuable overall by 91.4% of participants.

The Effect Of An Intersectionality Elective On The Perceived Self-Efficacy Of Medical Students In Addressing Health Inequity, Patrick Rollo, Noel Higgason, Kaitlyn Stark, Amina Aslam, Mason Motakef, Olivia Kerr, Asia Mccleary-Gaddy

Teaching in Clinics

Background: Intersectionality is a theoretical framework that contextualizes an individual’s experience as more than the sum of their cultural identifiers.

Aims: The current study investigates the effect of a 10-week intersectionality curriculum supplemented with student-led discussions on medical students’ self-efficacy in addressing bias and health inequity.

Methods: First- and second-year medical students volunteered to participate in a ten-week pilot elective entitled “Intersectionality in Medicine.” Participants enrolled in the course were required to complete a ten-minute online pre-elective and post-elective survey.

Results: Results showed that after completing the elective, medical students were significantly more confident in identifying their personal biases, assessing …

Uthealth Quality Symposium 2023 Abstracts-2, Salih Selek

Teaching in Clinics

UTHealth Quality Symposium 2023 Abstracts

Uthealth Quality Symposium 2023 Abstracts-1, Salih Selek

Teaching in Clinics

UTHealth Quality Symposium 2023 Abstracts