Medicine and Health Sciences Commons^™

Reimagining A Caregiver-Friendly Society, Jodi L. Southerland

Journal of Appalachian Health

Demographic aging is accelerating in the Appalachian Region, resulting in a growing proportion of caregivers living in areas that lack services to support their needs. Strategies are urgently needed in Appalachia to address deficiencies in the region’s long-term supports and services for older adults and their caregivers. Strengthening equitable access to care and community supports for family caregivers is a policy priority for state and community leaders in Appalachia.

Microstructural Alterations Of Major Thalamic Nuclei In The Chronic Pediatric Spinal Cord Injured Population, K. Kang, K. Fleming, A. Sathe, J. Muller, J. Harrop, D. Middleton, J. Heller, A. Sharan, F. Mohamed, L. Krisa, M. Alizadeh

Department of Radiology Faculty Papers

BACKGROUND: The brain undergoes reorganization following spinal cord injury (SCI), but little is known about how the thalamus is affected in pediatric SCIs.

PURPOSE: To characterize microstructural alterations in the thalamus after SCI with diffusion tensor imaging (DTI) metrics.

METHODS: 18 pediatric participants with chronic SCI (8-20 years) were stratified using the American Spinal Injury Association Impairment Scale (AIS) into groups: A, B, and C/D. DTI of the brain used a 3 T Siemens Verio MRI using the parameters: 20 directions, number of averages = 3, b = 1000 s/mm

DATA ANALYSIS: DTI metrics were acquired by superimposing the AAL3 …

Detection Of Prions In The Urine Of Patients Affected By Sporadic Creutzfeldt-Jakob Disease, M Talke

Faculty, Staff and Student Publications

Objective

Currently, it is unknown whether infectious prions are present in peripheral tissues and biological fluids of patients affected by sporadic Creutzfeldt–Jakob disease (sCJD), the most common prion disorder in humans. This represents a potential risk for inter‐individual prion infection. The main goal of this study was to evaluate the presence of prions in urine of patients suffering from the major subtypes of sCJD.

Methods

Urine samples from sCJD patients spanning the six major subtypes were tested. As controls, we used urine samples from people affected by other neurological or neurodegenerative diseases as well as healthy controls. These samples were …

Decreasing Surgical Complications In Diabetic Patients, Bandana Mahato

DNP Qualifying Manuscripts

Executive Summary

Objective: This manuscript aims to determine if controlling diabetes prior to undergoing low back surgery could decrease complications and disability.

Contexts: Despite the overwhelming information on the complications of uncontrolled diabetes, patients continue to have elevated HgA1C before having surgery. Furthermore, there is a plethora of data showing uncontrolled diabetic patients will have higher complications after surgery, yet patients continue to have elective surgery despite having unchecked diabetes. There are no clear guidelines for primary care providers or surgeons on when they should allow patients to have elective surgery. Therefore, it is vital that HgA1c needs to be …

The Development And Evaluation Of Nurse-Created Video Modules To Encourage Healthy Behaviors Among Women With Polycystic Ovarian Syndrome (Pcos), Rebecca Akers

Doctoral Projects

Problem Statement: Women with PCOS have a higher prevalence of overweight and obesity, a problem that is directly linked with many of the symptoms and long-term health problems experienced by these individuals. Research studies indicate that lifestyle modifications, including dietary changes and increased physical activity aimed at promoting weight loss, are often the initial approach to treatment, but many women fail to adopt those health-promoting behaviors, which may be due to insufficient teaching and support provided by healthcare professionals.

Purpose: Utilize Pender’s Health Promotion Model to develop and evaluate a set of educational video modules focused on encouraging women with …

Reconceptualizing Complex Post-Traumatic Stress Disorder: An Evolutionary Concept Analysis And Clinical Guide, Jessica Livingston

Doctoral Projects

Conflicting models of how trauma manifests into identifiable symptoms have been a source of controversy and perplexity among practicing mental health clinicians and diagnosticians. Complex post-traumatic stress disorder (CPTSD) is now an internationally recognized diagnosis since its inclusion in the 11^th version of the World Health Organization’s (WHO) International Classification of Diseases (ICD-11) in 2018. The American Psychological Association (APA) does not share this recognition of CPTSD as an individual diagnosis and instead opted to update the diagnostic criteria for PTSD to include DSO and a 4^th category of dissociative features rather than include CPTSD as a separate …

1756 Evaluating The Impact Of Prophylactic Intrathecal Chemotherapy In Diffuse Large B Cell Lymphoma (Dlbcl) Patients With High Central Nervous System International Prognostic Index (Cns-Ipi) Scores: A Comprehensive Review And Meta-Analysis, Kadhim Al-Banaa, Alfarooq Alshaikhli, Shyam Poudel, Shiva Shrotria, Can Wang, Paul Hanona, Swathi Gopishetty, Precious Idogun, Daniel Ezekwudo, Ishmael Jaiyesimi

Conference Presentation Abstracts

No abstract provided.

Diet And Nutrition In Inflammatory Bowel Disease: A Review Of The Literature, Scott Manski, Nicholas Noverati, Tatiana Policarpo, Emily Rubin, Raina Shivashankar

Division of Gastroenterology and Hepatology Faculty Papers

Diet is thought to contribute to the development of inflammatory bowel disease (IBD) and may act as a mediator of inflammation in patients with IBD. Patients commonly associate their diet with symptoms and inquire about dietary modifications to manage their IBD. Without clinical guidelines and well-established nutritional data, healthcare providers managing patients with IBD may find it difficult to provide recommendations. Strong evidence for enteral nutrition, particularly in the pediatric population, has been established in Crohn's disease (CD) as a therapeutic option. Enteral nutrition may also serve as an adjunct to an exclusion diet. Recent studies such as the randomized …

Cm-Ii Meditation As An Intervention To Reduce Stress And Improve Attention: A Study Of Ml Detection, Spectral Analysis, And Hrv Metrics, Sreekanth Gopi

Master of Science in Computer Science Theses

Students frequently face heightened stress due to academic and social pressures, particularly in de- manding fields like computer science and engineering. These challenges are often associated with serious mental health issues, including ADHD (Attention Deficit Hyperactivity Disorder), depression, and an increased risk of suicide. The average student attention span has notably decreased from 21⁄2 minutes to just 47 seconds, and now it typically takes about 25 minutes to switch attention to a new task (Mark, 2023). Research findings suggest that over 95% of individuals who die by suicide have been diagnosed with depression (Shahtahmasebi, 2013), and almost 20% of students …

Sirtuin 6 Activation Rescues The Age-Related Decline In Dna Damage Repair In Primary Human Chondrocytes, Michaela E. Copp, Jacqueline Shine, Hannon L. Brown, Kirti R. Nimmala, Oliver B. Hansen, Susan Chubinskaya, John A. Collins, Richard F. Loeser, Brian O. Diekman

Department of Orthopaedic Surgery Faculty Papers

While advanced age is widely recognized as the greatest risk factor for osteoarthritis (OA), the biological mechanisms behind this connection remain unclear. Previous work has demonstrated that chondrocytes from older cadaveric donors have elevated levels of DNA damage as compared to chondrocytes from younger donors. The purpose of this study was to determine whether a decline in DNA repair efficiency is one explanation for the accumulation of DNA damage with age, and to quantify the improvement in repair with activation of Sirtuin 6 (SIRT6). After acute damage with irradiation, DNA repair was shown to be more efficient in chondrocytes from …

Beyond Scale-Free Networks: Integrating Multilayer Social Networks With Molecular Clusters In The Local Spread Of Covid-19, Kayo Fujimoto, Jacky Kuo, Guppy Stott, Ryan Lewis, Hei Kit Chan, Leke Lyu, Gabriella Veytsel, Michelle Carr, Tristan Broussard, Kirstin Short, Pamela Brown, Roger Sealy, Armand Brown, Justin Bahl

Faculty, Staff and Student Publications

This study evaluates the scale-free network assumption commonly used in COVID-19 epidemiology, using empirical social network data from SARS-CoV-2 Delta variant molecular local clusters in Houston, Texas. We constructed genome-informed social networks from contact and co-residence data, tested them for scale-free power-law distributions that imply highly connected hubs, and compared them to alternative models (exponential, log-normal, power-law with exponential cutoff, and Weibull) that suggest more evenly distributed network connections. Although the power-law model failed the goodness of fit test, after incorporating social network ties, the power-law model was at least as good as, if not better than, the alternatives, implying …

Knowledge Of School-Based Occupational Therapists: Role In Concussion-Related Visual Impairments, Elise Cassidy, Kailyn Ebeling, Brenda O'Connell, Mackenzie Rutz, Alyson Snyder, Carla Floyd-Slabaugh

Masters Projects

Background: This study examined knowledge of school-based occupational therapists (SBOTs) regarding current concussion-related vision impairment practice patterns. There is a lack of literature on how SBOTs treat students who sustained a mild traumatic brain injury (mTBI), also known as a concussion.

Method: A mixed-methods survey was distributed online to SBOTs to understand what assessments and interventions are used for concussion-related visual impairments, the perceived role of SBOTs, and difficulties faced treating students with mTBIs.

Results: There were 124 potential participants that started the survey, and 35 (28.23%) completed the survey. Assessments and interventions used amongst therapists differed …

Capacity Assessment And Spatial Analysis Of Cervical Cancer Services In The Gambia, Meghan E Mali, Ousman Sanyang, Katherine L Harris, Justin Sorensen, Mustapha Bittaye, Jonathan Nellermoe, Raymond R Price, Edward K Sutherland

Faculty, Staff and Student Publications

Background

Cervical cancer is the most common cancer and the leading cause of cancer-related death in Gambian women. The Gambian Ministry of Health is striving to improve access to screening, diagnostic, and treatment services for cervical cancer, but comprehensive data on currently available services is limited making it challenging to appropriately prioritize the ideal next steps for expanding care. This study aims to describe the current services available for the prevention, screening, and treatment of cervical cancer in The Gambia and provide suggestions for expanding geographic access to care.

Methods

A survey aimed at assessing the availability of key cervical …

Fully-Automated, Ct-Only Gtv Contouring For Palliative Head And Neck Radiotherapy, Skylar S Gay, Carlos E Cardenas, Callistus Nguyen, Tucker J Netherton, Cenji Yu, Yao Zhao, Stephen Skett, Tina Patel, Delali Adjogatse, Teresa Guerrero Urbano, Komeela Naidoo, Beth M Beadle, Jinzhong Yang, Ajay Aggarwal, Laurence E Court

Faculty, Staff and Student Publications

Planning for palliative radiotherapy is performed without the advantage of MR or PET imaging in many clinics. Here, we investigated CT-only GTV delineation for palliative treatment of head and neck cancer. Two multi-institutional datasets of palliative-intent treatment plans were retrospectively acquired: a set of 102 non-contrast-enhanced CTs and a set of 96 contrast-enhanced CTs. The nnU-Net auto-segmentation network was chosen for its strength in medical image segmentation, and five approaches separately trained: (1) heuristic-cropped, non-contrast images with a single GTV channel, (2) cropping around a manually-placed point in the tumor center for non-contrast images with a single GTV channel, (3) …

A Drosophila Heart Optical Coherence Microscopy Dataset For Automatic Video Segmentation, Matthew Fishman, Abigail Matt, Fei Wang, Elena Gracheva, Jiantao Zhu, Xiangping Ouyang, Andrey Komarov, Yuxuan Wang, Hongwu Liang, Chao Zhou

2020-Current year OA Pubs

The heart of the fruit fly, Drosophila melanogaster, is a particularly suitable model for cardiac studies. Optical coherence microscopy (OCM) captures in vivo cross-sectional videos of the beating Drosophila heart for cardiac function quantification. To analyze those large-size multi-frame OCM recordings, human labelling has been employed, leading to low efficiency and poor reproducibility. Here, we introduce a robust and accurate automated Drosophila heart segmentation algorithm, called FlyNet 2.0+, which utilizes a long short-term memory (LSTM) convolutional neural network to leverage time series information in the videos, ensuring consistent, high-quality segmentation. We present a dataset of 213 Drosophila heart videos, equivalent …

The Dna Glycosylase Neil2 Is Protective During Sars-Cov-2 Infection, Nisha Tapryal, Anirban Chakraborty, Kaushik Saha, Azharul Islam, Lang Pan, Koa Hosoki, Ibrahim M Sayed, Jason M Duran, Joshua Alcantara, Vanessa Castillo, Courtney Tindle, Altaf H Sarker, Maki Wakamiya, Victor J Cardenas, Gulshan Sharma, Laura E Crotty Alexander, Sanjiv Sur, Debashis Sahoo, Gourisankar Ghosh, Soumita Das, Pradipta Ghosh, Istvan Boldogh, Tapas K Hazra

Faculty, Staff and Students Publications

SARS-CoV-2 infection-induced aggravation of host innate immune response not only causes tissue damage and multiorgan failure in COVID-19 patients but also induces host genome damage and activates DNA damage response pathways. To test whether the compromised DNA repair capacity of individuals modulates the severity of COVID-19 infection, we analyze DNA repair gene expression in publicly available patient datasets and observe a lower level of the DNA glycosylase NEIL2 in the lungs of severely infected COVID-19 patients. This observation of lower NEIL2 levels is further validated in infected patients, hamsters and ACE2 receptor-expressing human A549 (A549-ACE2) cells. Furthermore, delivery of recombinant …

Doctor Of Physical Therapy Students’ Experience With Microaggressions In The Clinic: A Call To Action, Jocelin T. Friedman, Todd E. Davenport

Pacific Journal of Health

As Doctor of Physical Therapy (DPT) students fulfill off-campus clinical experience requirements at healthcare institutions, they are mentored by clinical instructors who are employees of said healthcare institutions. Clinical instructors, patients, or other staff members there may commit microaggressions against physical therapy students with varying subject matters, intentions, and effects on the students. Microaggressions are brief verbal humiliations which may or may not be intentional, but nonetheless convey derogatory slights or insults towards a target group. This article explores DPT students’ real-life experiences with microaggressions within the clinical education realm and the challenges a Director of Clinical Education faced in …

Criminal Justice Interventions For Individuals With Mental Health Disabilities: A Systematic Literature Review, Fidelis Azeke, Nassrine Noureddine

Pacific Journal of Health

In the criminal law, with few exceptions, for a finding of guilt, the physical act and the state of mind to commit the offense must be present at the time of the commission of the offense. People with mental disabilities often lack the state of mind required to commit the offense for which they are eventually charged for and or convicted. This paper examines the effectiveness of some past and present criminal justice system interventions that addresses the mental health disabilities of criminal offenders pre-adjudicative proceedings. A systematic review of the literature was used to examine past and present criminal …

Medical School Watercooler Newsletter - December 8, 2023, Lindsey Lyle

Watercooler Newsletter

This is the December 8, 2023 edition of the Frederick P. Whiddon College of Medicine's newsletter - Watercooler.

Contents Include:

• USA breaks ground on $200 million Whiddon College of Medicine building
• Rayner awarded grant funding for biotechnology research center
• Meet a Med Student: Caroline Kinchler
• USA to break ground on new Whiddon COM building
• Alumnus and board-certified pediatrician joins pediatrics faculty

Sex And Race Differences In Obesity-Related Genetic Susceptibility And Risk Of Cardiometabolic Disease In Older Us Adults, Hairui Yu, Nicole Armstrong, Greg Pavela

APC Fund

Importance The fat mass and obesity–associated gene (FTO) is associated with obesity phenotypes, but the association is inconsistent across populations. Within-population differences may explain some of the variability observed.

Objective To investigate sex differences in the association between FTO single-nucleotide variants (SNVs) and obesity traits among self-identified non-Hispanic Black and non-Hispanic White US adults, to examine whether the SNVs were associated with cardiometabolic diseases, and to evaluate whether obesity mediated the association between FTO SNVs and cardiometabolic diseases.

Design, Setting, and Participants This cross-sectional study used data from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) …

C-Case 2023: Promoting Excellence In Surgical Education: Canadian Conference For The Advancement Of Surgical Education, Oct. 12-13, 2023, Montréal, Quebec, Jeffrey Sioufi, Brandon Hall, Ryan Antel, Sarah Moussa, Mathushan Subasri, Mustafa Fakih, Nehal Islam, Reggie C. Hamdy, Sonaina Chopra, Karim Damji

Department of Ophthalmology & Visual Sciences

No abstract provided.

Preoperative Computed Tomography Scan In Distal Radius Fractures And The Effect On Preoperative Planning, Adam L. Haydel, Ryan C. Roubion, Cristina T. Graphia, Corinne E. Cloud, Claudia Leonardi, Christopher E. Marrero

School of Medicine Faculty Publications

Purpose: It is unclear whether computed tomography (CT) scans alter the surgical plan when ordered before surgery for fixation of intra-articular distal radius fractures (DRFs). The purpose of this study was to determine whether a preoperative CT scan alters the planned approach (PA) or planned fixation strategy (PFS) for open reduction internal fixation of intra-articular DRFs. Methods: Radiology records were retrospectively reviewed by one trauma surgeon and two hand surgeons for 33 intra-articular DRFs that met the inclusion criteria and previously underwent open reduction internal fixation. Surgeons were initially provided only preoperative radiographs; they were asked for their PA and …

Exosome Shedding Is Concordant With Objective Treatment Response Rate And Stratifies Time To Progression In Treatment Naïve, Non-Resectable Hepatocellular Carcinoma, Kelley G. Núñez, Dorota Wyczechowska, Mina Hibino, Tyler Sandow, Juan Gimenez, Ali R. Koksal, Yucel Aydin, Srikanta Dash, Ari J. Cohen, Paul T. Thevenot

School of Medicine Faculty Publications

Translational strategies to characterize and monitor extracellular vesicles such as exosome (EX) shedding and the clinical impact of this data within hepatocellular carcinoma (HCC) remains unclear. In this study, EX shedding was assessed in early-stage HCC and evaluated as a stratification factor for time to progression (TTP) following first-cycle liver-directed therapy (LDT). Plasma EXs were isolated from HCC patients undergoing LDT using ultracentrifugation. Purified EXs were stained using markers CD9 and CD63 and quantified using an ImageStreamX flow cytometer. Circulating EXs expressing CD9 were isolated at 10-fold higher levels compared to CD63. The intensity of CD9+ EX shedding following LDT …

Aged And Induced-Premature Ovarian Failure Mouse Models Affect Diestrus Profile And Ovarian Features, Ana Carolina Zucon Bacelar, Nataira Regina Momesso, Felipe Haddad Martim Pederro, Alaíde Gonçalves, Edilson Ervolino, Antonio Hernandes Chaves-Neto, Cláudia Cristina Biguetti, Mariza Akemi Matsumoto

School of Podiatric Medicine Publications

Sex hormones exert a wide influence on several systems of the human body, especially in women, who undergo intense changes in the trans and postmenopausal periods. Different experimental models are used to mimic these conditions; however, the impact on hormonal profile may be different. This study aimed to analyze and compare vaginal cytology of different post-estropausal mice models, along with their microscopical ovarian features. Forty-six C57BL/6J female mice with the ages of 4, 6 and 18 months at the beginning of the experiment, weighing about 25–28 grams, constituted five groups: NC–(negative control) animals with no treatment, OVX-SHAM—sham ovariectomized, OVX–ovariectomized, VCD–medicated …

Comparison Of Molecular Methods For Absolute Quantification Of Low-Abundant Bacterial Communities In Milk, Carmina Chavez, Janet E. Williams, Michelle K. Mcguire, Mark A. Mcguire

Undergraduate Research Symposium Posters

Milk was historically thought to be generally sterile. However, use of culture-dependent and culture-independent methods has provided strong evidence that milk has a microbiome (Figure 1). Culture-independent methods (e.g., high-throughput sequencing) have demonstrated the diversity of microbes in milk but provide relative abundance data. Culture-dependent methods have indicated microbial communities in milk are of low abundance, but it is challenging to measure absolute quantities accurately. Real-time quantitative polymerase chain reaction (RT-qPCR) has been used to quantify bacterial taxa in milk, However, concentrations often fall below the detection limit (Figure 2 & 3). Digital droplet PCR (ddPCR) allows detection of low-abundant …

Animal-Assisted Therapy In Mental Illness, Chanae Cypress

MSN Capstone Projects

Mental health disorders are a significant global health concern, with a growing need for alternative therapeutic approaches. Animal-assisted therapy has gained recognition for its potential to improve the emotional and psychological well-being of individuals struggling with these disorders.

This Capstone Benchmark proposed project explores the potential positive impact of animal-assisted therapy (AAT) on patients with mental health disorders during inpatient hospitalization. The project outlines a 4-week intervention program involving 45-60 minutes sessions with dogs, which patients receive 2-3 times per week. For this Capstone Benchmark project, the selected PICOT question is: In patients with mental health disorder (P) how does …

The Impact Of Evidence-Based Diabetes Self-Management Education In A1c Levels In Adults With Type 2 Diabetes, Concepcion Fanous

MSN Capstone Projects

Diabetes Mellitus II is a leading cause of death in the United States, imposing a significant healthcare cost. According to the Centers for Disease Control and Prevention (CDC, 2020), one out of every ten Americans have been diagnosed with diabetes, with 90 to 95% of them having type 2 diabetes (T2d). Effective management T2d is crucial to prevent clinical complications, expensive medical care, and a diminished quality of life. Uncontrolled diabetes can lead to severe medical complications including atherosclerotic cardiac cardiovascular disease, renal disease, and microvascular disease (American Diabetes Association [ADA], 2021). The economic burden of diabetes complications amounted to …

Implementing New Staffing Ratios In The Emergency Room To Improve Nurse And Patient Outcomes, Analicia Solis

MSN Capstone Projects

The significance of appropriate nurse staffing in enhancing patient outcomes and mitigating nurse burnout is well-documented. Inadequate nurse staffing can lead to negative consequences, including burnout, decreased nurse retention, and potential safety risks (Shin et al. 2018; Wynendaele et al. 2019) Research has also established a strong connection between nurse-to-patient ratios, well-being, and job dissatisfaction among nursing staff (Andel et al. 2021; Thompson-Munn et al. 2021).

Given this evidence, there is a compelling rationale for aligning nurse staffing ratios with proposed federal standards to address burnout, improve well-being, and enhance patient outcomes. Implementing these changes necessitates careful planning and assessment. …

How Simulation Influences Self-Confidence In First Semester Nursing Students, Veronica Arredondo

Doctor of Nursing Practice Projects

First-semester nursing students lack confidence and competency in performing nursing skills and providing direct patient care. Nursing students are expected to be prepared before going to the clinical setting to provide direct patient care. The purpose of this quality improvement project is to examine the confidence levels of first-semester nursing students before and after the application of high-fidelity simulation (HFS). A controlled environment using HFS where nursing students can safely practice and achieve the understanding needed to develop their critical thinking skills is a potential solution. Using simulation education can increase the ability of an individual to complete nursing skills …

Improving Access To Early Interventions For Prediabetic Patients, Kimberleigh M. Telling

Doctor of Nursing Practice Projects

Approximately 88 million Americans, or nearly one-third of the population, have prediabetes. This condition has a high rate of progression to type 2 diabetes, reaching 70%. However, early identification, diagnosis, and participation in lifestyle interventions can effectively reduce the risk and promote euglycemia. Regrettably, 85% of those with prediabetes are unaware. The goal of this quantitative quality improvement project was to enhance the use of the prediabetes diagnosis code by primary care providers, who play a crucial role in preventing type 2 diabetes. The purpose was to improve access to early intervention for individuals with prediabetes, following the guidelines of …