Medicine and Health Sciences Commons^™

Bayesian Nonparametric Model For Heterogeneous Treatment Effects With Zero-Inflated Data, Chanmin Kim, Yisheng Li, Ting Xu, Zhongxing Liao

Faculty, Staff and Student Publications

One goal of precision medicine is to develop effective treatments for patients by tailoring to their individual demographic, clinical, and/or genetic characteristics. To achieve this goal, statistical models must be developed that can identify and evaluate potentially heterogeneous treatment effects in a robust manner. The oft-cited existing methods for assessing treatment effect heterogeneity are based upon parametric models with interactions or conditioning on covariate values, the performance of which is sensitive to the omission of important covariates and/or the choice of their values. We propose a new Bayesian nonparametric (BNP) method for estimating heterogeneous causal effects in studies with zero-inflated …

The Role Of Social Health Insurance In Achieving Universal Health Coverage In Asia: A Systematic Review, Afaf Jauhar, Mardiati Nadjib

Jurnal Ekonomi Kesehatan Indonesia

Universal Health Coverage (UHC) aims to ensure that all individuals have access to essential health services without financial hardship. Social Health Insurance (SHI) is critical in achieving this goal, especially in low- and middle-income countries. This systematic review explores the role of SHI systems in advancing UHC across 14 Asian countries, focusing on healthcare access, financial protection, and equity. A comprehensive search across PubMed, Scopus, and ScienceDirect identified 768 articles, and 37 studies were selected after screening, following the PRISMA guidelines. The chosen studies cover countries with varying SHI models across Asia. The findings reveal that high-income countries such as …

Analisis Klaim Pending, Verifikasi Dan Audit Pascaklaim Jaminan Kesehatan Nasional, Anugrah Aulia Ulil Amri, Atik Nurwahyuni

Jurnal Ekonomi Kesehatan Indonesia

The implementation of Indonesia’s National Health Insurance (JKN) poses new challenges for hospitals as service providers. Badan Penyelenggara Jaminan Sosial (BPJS) Kesehatan, the program’s administrator, now routinely conducts post-claim verifications and audits after claims have been paid. This often results in claim adjustments or even full reversals of previously reimbursed amounts. This case study examines JKN claim management at a Type D General Hospital in 2022, focusing on pending claims, verification, and post-claim audits, using a systems theory framework. Key issues in pending claims include incomplete medical records (29%), insufficient supporting documents (24%), and coding errors (21%). Post-claim problems primarily …

Evaluasi Ekonomi Total Hip Arthroplasty Protokol Enhance Recovery After Surgery Dibandingkan Konvensional Di Rsup Fatmawati Jakarta, Hanna Elisabet Lumbangaol, Mardiati Nadjib

Jurnal Ekonomi Kesehatan Indonesia

Total hip arthroplasty (THA) is a common orthopedic procedure performed to replace damaged hip joints with prostheses. The demand for this procedure is expected to rise in the future. Enhanced Recovery After Surgery (ERAS) has been introduced as an evidence-based, multidisciplinary approach aimed at optimizing postoperative recovery and reducing hospital length of stay. This study aims to evaluate the costs and effectiveness, including hospital stay duration and surgical success rates, of THA using the ERAS protocol compared to conventional approaches. This cross-sectional study involved data collection from healthcare providers between January 2020 and May 2023. The analysis showed that both …

Efisiensi Biaya Dalam Perawatan Stroke Non-Hemoragik: Studi Kasus Di Rumah Sakit Islam Sunan Kudus, Chusnul Mubarok, Chriswardani Suryawati, Puji Harto

Jurnal Ekonomi Kesehatan Indonesia

Stroke is one of the leading causes of morbidity and mortality globally, with over 12 million new cases each year. In Indonesia, the prevalence of stroke increased from 8.3% in 2007 to 12.1% in 2013, with the age group of 55-64 years recording the highest prevalence. This study aims to analyse the actual costs of non-hemorrhagic stroke care for patients under the National Health Insurance (JKN) at the Islamic Hospital of Sunan Kudus using the Activity-Based Costing (ABC) method. A descriptive quantitative method was applied, collecting data from hospitalised non-hemorrhagic stroke patients during 2023. The results showed a discrepancy between …

Cultivating Compassion: A Cross-Sectional Evaluation Of Empathy Among Medical Undergraduate Students, Anchu R Nath, Ishika Jindal, Nayanabai Shabadi, Sunil Kumar D

Digital Journal of Clinical Medicine

ABSTRACT:

BACKGROUND: Empathy plays a crucial role in medical practice, profoundly affecting patient outcomes and treatment. Understanding the factors that influence empathy among medical students can help in developing strategies to enhance empathetic skills during medical training. This study aims to evaluate the correlates of empathy among medical undergraduate students using an epidemiological cross-sectional design.

MATERIALS AND METHODS:

A cross-sectional study was conducted among 270 medical undergraduate students from various academic years at JSS Medical College for four months (September 2023-December 2023). Convenient sampling was used to select study participants. Participants completed a standardized empathy questionnaire, the Jefferson Scale …

Hiding In Plain Sight: Eating Disorders In Diverse Populations - A Case For Comprehensive Medical Education, Tashalee R Brown, Madeline O Jansen, Drew Hirsch, Habiba Amir, Alexis E Duncan, Ginger E Nicol

2020-Current year OA Pubs

BACKGROUND: Training gaps regarding the diagnosis and management of eating disorders in diverse populations, including racial, ethnic, sexual, and gender minoritized groups, have not been thoroughly examined.

OBJECTIVE: This study aimed to examine resident physicians' knowledge and attitudes regarding eating disorders in diverse populations, with a focus on areas for improved training and intervention.

METHODS: Ninety-two resident physicians in internal medicine, emergency medicine, obstetrics/gynecology, psychiatry, and surgery at an academic center completed an online survey from 12/1/2020-3/1/2021, which comprised multiple choice and vignette-style open-ended questions to assess knowledge and attitudes toward the management and clinical presentations of eating disorders. Overall, …

Approaches And Outcomes Of Adalimumab Discontinuation In Patients With Well-Controlled Inflammatory Arthritis: A Systematic Search And Review, Erin Balay-Dustrude, Jessica Fennell, Kevin Baszis, Y Ingrid Goh, Daniel B Horton, Tzielan Lee, Chloe Rotman, Anna Sutton, Marinka Twilt, Olha Halyabar, Carra Jia Inactive Disease Workgroup

2020-Current year OA Pubs

OBJECTIVE: This systematic search and review aimed to evaluate the available literature on discontinuation of adalimumab and other tumor necrosis factor inhibitors (TNFi) for patients with well-controlled chronic inflammatory arthritides.

METHODS: We conducted a publication search on adalimumab discontinuation from 2000-2023 using PubMed, CINAHL, EMBASE, and Cochrane Library. Included studies evaluated adalimumab discontinuation approaches, tapering schemes, and outcomes including successful discontinuation and recapture after flare, in patients with well-controlled disease. Studies included evaluated rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, and juvenile idiopathic arthritis (JIA).

RESULTS: Forty-nine studies were included. Studies evaluating adalimumab alone were limited, and many reported TNFi outcomes …

Effectiveness Of An Online Food Shopping Intervention To Reduce Salt Purchases Among Individuals With Hypertension - Findings Of The Saltswitch Online Grocery Shopping (Ogs) Randomised Trial, Jason Hy Wu, Damian Maganja, Liping Huang, Kathy Trieu, Fraser Taylor, Eden M Barrett, Clare Arnott, Xiaoqi Feng, Aletta E Schutte, Gian Luca Di Tanna, Cliona Ni Mhurchu, Adrian J Cameron, Mark D Huffman, Bruce Neal

2020-Current year OA Pubs

BACKGROUND: Online grocery shopping is a growing source of food purchases in many countries. We investigated the effect of nudging consumers towards purchases of lower sodium products using a web browser extension.

METHODS: This trial was conducted among individuals with hypertension who shopped for their groceries online in Australia. From July 2021 to June 2023, participants were randomised to use the SaltSwitch Online Grocery Shopping web browser extension or continue their usual grocery shopping for 12 weeks. The SaltSwitch extension modified a retailer's online shopping interface to suggest similar but lower sodium alternative products to those initially selected. The primary …

Oxidized Phospholipid And Transcriptomic Signatures Of Thc-Related Vaping Associated Lung Injury, Tomeka L Suber, Zeyu Xiong, Janet S Lee, Et Al.

2020-Current year OA Pubs

E-cigarette/vaping-associated lung injury (EVALI) is strongly associated with vitamin E acetate and often occurs with concomitant tetrahydrocannabinol (THC) use. To uncover pathways associated with EVALI, we examined cytokines, transcriptomic signatures, and lipidomic profiles in bronchoalveolar lavage fluid (BALF) from THC-EVALI patients. At a single center, we prospectively enrolled mechanically ventilated patients with EVALI from THC-containing products (N = 4) and patients with non-vaping acute lung injury and airway controls (N = 5). BALF samples were analyzed by Luminex multiplex assay, RNA sequencing, and mass spectrometry. After treating BEAS-2B lung epithelial cells with vaping and non-vaping BALF, LDH release was quantified. …

Comparison Of Three Chimeric Zika Vaccine Prototypes Developed On The Genetic Background Of The Clinically Proven Live-Attenuated Japanese Encephalitis Vaccine Sa14-14-2, Byung-Hak Song, Jordan C. Frank, Sang-Im Yun, Justin G. Julander, Jeffrey B. Mason, Irina A. Polejaeva, Christopher J. Davies, Kenneth L. White, Xin Dai, Young-Min Lee

Animal, Dairy, and Veterinary Science Student Research

Zika virus (ZIKV) is a medically important mosquito-borne orthoflavivirus, but no vaccines are currently available to prevent ZIKV-associated disease. In this study, we compared three recombinant chimeric viruses developed as candidate vaccine prototypes (rJEV/ZIKV^MR-766, rJEV/ZIKV^P6-740, and rJEV/ZIKV^PRVABC-59), in which the two neutralizing antibody-inducing prM and E genes from each of three genetically distinct ZIKV strains were used to replace the corresponding genes of the clinically proven live-attenuated Japanese encephalitis virus vaccine SA₁₄-14-2 (rJEV). In WHO-certified Vero cells (a cell line suitable for vaccine production), rJEV/ZIKV^P6-740 exhibited the slowest viral growth, formed …

From Surviving To Thriving: Key Considerations For Weight Control Across Diverse Cancer Survivorship Populations, Justin C. Brown, Marlyn Allicock, Carmina G. Valle, Tanya Agurs-Collins

School of Medicine Faculty Publications

BACKGROUND: Obesity is a chronic, relapsing, progressive disease of excess adiposity that increases the risk of dying from at least 16 types of cancer. The prevalence of obesity has increased more rapidly in cancer survivors compared with the general population. Tailored weight management strategies are needed to improve prognosis and health outcomes in the growing population of cancer survivors. However, certain cancer survivor population subgroups require unique consideration when developing weight management strategies. METHODS: In a symposium convened by The Obesity Society during ObesityWeek 2023 titled "From Surviving to Thriving: Key Considerations for Weight Control Across Diverse Cancer Survivorship Populations," …

Role Of Nf2 Mutation In The Development Of Eleven Different Cancers, Shervin Hosseingholi Nouri, Vijay Nitturi, Elizabeth Ledbetter, Collin W English, Sean Lau, Tiemo J Klisch, Akash J Patel

Faculty, Staff and Students Publications

Background/Objectives: With the rise in prevalence of diagnostic genetic techniques like RNA sequencing and whole exome sequencing (WES), as well as biological treatment regiments for cancer therapy, several genes have been implicated in carcinogenesis. This review aims to update our understanding of the Neurofibromatosis 2 (NF2) gene and its role in the pathogenesis of various cancers. Methods: A comprehensive search of five online databases yielded 43 studies that highlighted the effect of sporadic NF2 mutations on several cancers, including sporadic meningioma, ependymoma, schwannoma, mesothelioma, breast cancer, hepatocellular carcinoma, prostate cancer, glioblastoma, thyroid cancer, and melanoma. Of note were key biological …

Vaccines Targeting P53 Mutants Elicit Anti-Tumor Immunity, Dafei Chai, Xu Wang, Chunmei Fan, Junhao Wang, Jing Ming Lim, Xinfang Yu, Ken H Young, Yong Li

Faculty, Staff and Students Publications

The p53 tumor suppressor is commonly mutated in cancer; however, there are no effective treatments targeting p53 mutants. A DNA vaccine gWIZ-S237G targeting the p53 S237G mutant, which is highly expressed in A20 murine tumor cells, was developed and administered intramuscularly via electroporation, either alone or in combination with PD1 blockade. The anti-p53-S237G immunization elicited a robust protective response against subcutaneous A20 tumors and facilitated the infiltration of immune cells including CD8+ T cells, NK cells, and DCs. The vaccine enhanced the induction and maturation of CD11c+, CD103+CD11c+, and CD8+CD11c+ cells, which in turn promoted tumor-specific antibody production, as well …

Supporting Holistic Health And Gestational Diabetes Mellitus Risk Reduction Among Young Native Females Prior To Pregnancy: A Qualitative Exploration., Sarah A. Stotz, Luciana E. Hebert, Lisa Scarton, Kelli Begay, Kelly L. Gonzales, Heather Garrow, Melanie Charley, Melanie Aspaas, Denise Charron-Prochownik, Spero M. Manson

OHSU-PSU School of Public Health Faculty Publications and Presentations

AI/AN communities are disproportionately impacted by food insecurity and gestational diabetes mellitus (GDM). Decreasing the risk of GDM can interrupt the intergenerational cycle of diabetes in AI/AN families, and can decrease diabetes-related health disparities. The goal of this study was to explore ways of supporting holistic health and reducing the risk of GDM among young American Indian and Alaska Native (AI/AN) females prior to pregnancy. Semi-structured interviews were conducted with adult AI/AN women (>18 years) who had GDM or who have young female relatives (e.g., daughters) (n = 41), AI/AN females between 12 and 24 years (n = 18), …

Real-World Safety Profile Of Therapy With Ibrutinib Or Acalabrutinib In Patients With Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma, Ramsay Hafer, Francesco Iadevaia, Thomas Z. Rohan, Teresa Duong, Maria Poluch, Gina Keiffer, Michael Li, Andres Ferber, Luca Laurenti, Alan Khoo, Pierluigi Porcu

Department of Medical Oncology Faculty Papers

No abstract provided.

Lack Of Association Of The Pld4 Snp Rs2841277 With Systemic Sclerosis In A European American Population, Yunqing Ma, Maureen D Mayes, Xinjian Guo, Shervin Assassi, Xiaodong Zhou

Faculty, Staff and Student Publications

This study aimed to examine whether a reported SSc-associated SNP rs2841277 in the PLD4 gene identified in an Asian population was also associated with SSc in European American (EA). The EA cohort consisting of 1005 SSc patients and 961 healthy controls was examined in this study. TaqMan genotyping assays were performed to examine the SNP. Exact P-values were obtained from 2 × 2 tables of allele counts and disease status. In contrast to the previous reports in a Japanese population, SSc patients of EA did not show an association of PLD4 rs2841277 with SSc in general (P = 0.231, OR …

Aperiodic Spectral Slope Tracks The Effects Of Brain State On Saliency Responses In The Human Auditory Cortex, Madaline Mocchi, Eleonora Bartoli, John Magnotti, Jan Willem De Gee, Brian Metzger, Bailey Pascuzzi, Raissa Mathura, Suhruthaa Pulapaka, Wayne Goodman, Sameer Sheth, Matthew J Mcginley, Kelly Bijanki

Faculty, Staff and Students Publications

Alteration of responses to salient stimuli occurs in a wide range of brain disorders and may be rooted in pathophysiological brain state dynamics. Specifically, tonic and phasic modes of activity in the reticular activating system (RAS) influence, and are influenced by, salient stimuli, respectively. The RAS influences the spectral characteristics of activity in the neocortex, shifting the balance between low- and high-frequency fluctuations. Aperiodic '1/f slope' has emerged as a promising composite measure of these brain state dynamics. However, the relationship of 1/f slope to state-dependent processes, such as saliency, is less explored, particularly intracranially in humans. Here, we record …

Cancer Organoids As Reliable Disease Models To Drive Clinical Development Of Novel Therapies, Giovanni Blandino, Ronit Satchi-Fainaro, Ingeborg Tinhofer, Giovanni Tonon, Sarah C Heilshorn, Yong-Jun Kwon, Ana Pestana, Carlotta Frascolla, Luca Pompili, Aurora Puce, Sara Iachettini, Annalisa Tocci, Sofia Karkampouna, Marianna Kruithof-De Julio, Piera Tocci, Nicla Porciello, Klizia Maccaroni, Daniela Rutigliano, Xiling Shen, Gennaro Ciliberto

Faculty, Staff and Student Publications

On September 23-24 (2024) the 6th Workshop IRE on Translational Oncology, titled "Cancer Organoids as Reliable Disease Models to Drive Clinical Development of Novel Therapies," took place at the IRCCS Regina Elena Cancer Institute in Rome. This prominent international conference focused on tumor organoids, bringing together leading experts from around the world.A central challenge in precision oncology is modeling the dynamic tumor ecosystem, which encompasses numerous elements that evolve spatially and temporally. Patient-derived 3D culture models, including organoids, explants, and engineered or bioprinted systems, have recently emerged as sophisticated tools capable of capturing the complexity and diversity of cancer cells …

Parp Inhibition Radiosensitizes Brca1 Wildtype And Mutated Breast Cancer To Proton Therapy, Mariam Ben Kacem, Scott J Bright, Emma Moran, David B Flint, David K J Martinus, Broderick X Turner, Ilsa Qureshi, Rishab Kolachina, Mandira Manandhar, Poliana C Marinello, Simona F Shaitelman, Gabriel O Sawakuchi

Faculty, Staff and Student Publications

Aggressive breast cancers often fail or acquire resistance to radiotherapy. To develop new strategies to improve the outcome of aggressive breast cancer patients, we studied how PARP inhibition radiosensitizes breast cancer models to proton therapy, which is a radiotherapy modality that generates more DNA damage in the tumor than standard radiotherapy using photons. Two human BRCA1-mutated breast cancer cell lines and their isogenic BRCA1-recovered pairs were treated with a PARP inhibitor and irradiated with photons or protons. Protons (9.9 and 3.85 keV/µm) induced higher cell kill independent of BRCA1 status. PARP inhibition amplified the cell kill effect to both photons …

Refinement Of An Algorithm To Detect And Predict Freezing Of Gait In Parkinson Disease Using Wearable Sensors, Allison M Haussler, Lauren E Tueth, David S May, Gammon M Earhart, Pietro Mazzoni

2020-Current year OA Pubs

Freezing of gait (FOG) is a debilitating symptom of Parkinson disease (PD). It is episodic and variable in nature, making assessment difficult. Wearable sensors used in conjunction with specialized algorithms, such as our group's pFOG algorithm, provide objective data to better understand this phenomenon. While these methods are effective at detecting FOG retrospectively, more work is needed. The purpose of this paper is to explore how the existing pFOG algorithm can be refined to improve the detection and prediction of FOG. To accomplish this goal, previously collected data were utilized to assess the prediction ability of the current algorithm, the …

Carboxyl Ester Lipase Hybrid 1 (Cel-Hyb1) Haplotypes Confer Varying Risk For Chronic Pancreatitis, Gergő Berke, Xunjun K Xiao, Mark E Lowe, Et Al.

2020-Current year OA Pubs

The CEL-HYB1 hybrid allele of the carboxyl ester lipase (CEL) gene and its pseudogene (CELP) has been associated with chronic pancreatitis (CP). Recent work indicated that amino acid positions 488 and 548 in CEL-HYB1 determined pathogenicity. Haplotype Thr488-Ile548 was associated with CP while haplotypes Thr488-Thr548 and Ile488-Thr548 were benign. However, functional analysis revealed that Thr488 is the primary determinant of CEL-HYB1 misfolding and associated endoplasmic reticulum (ER) stress. To address this contradiction, we analyzed a cohort from Hungary and found significantly increased CEL-HYB1 carrier frequency in CP cases (9/319, 2.8%) versus controls (5/618, 0.8%), yielding an odds ratio of 3.6 …

Student National Dental Association Hosts Oral Cancer Walk, Jaycee Cureton

Virginia Dental Journal

The Virginia Commonwealth University’s Student National Dental Association (SNDA) hosted its 12th Annual Oral Cancer Walk on April 16, 2023, to raise awareness and funds for oral cancer research. Proceeds were donated to the Philips Institute for Oral Health Research and included in the VCU School of Dentistry Giving Day fund. Oral cancer, more common in men, is linked to tobacco, alcohol, and HPV, but early detection can significantly reduce mortality. The SNDA, founded in 1970, focuses on supporting minority dental students and improving access to care for underserved communities.

Vda Dental Days At The Capitol Record High Student Turnout, Lakshya Ramani

Virginia Dental Journal

Dental Days at the Capitol 2023, held on January 27, saw a record turnout of students from VCU School of Dentistry. The event, organized by the Virginia Dental Association (VDA), provided students with the opportunity to engage in political advocacy for the first time. Key issues addressed included amending the mental health attestation question on licensure applications and advocating for harsher penalties for violence against healthcare providers. Additionally, the Cosmetic Botox Bill SB 1539, allowing dentists to administer Botox injections, was passed. The event highlighted the importance of student involvement in shaping the future of dentistry.

The Soft Skills Of The Clinical Experience, Michaela Banks

Virginia Dental Journal

Michaela Banks, a Class of 2024 student at VCU School of Dentistry, shares her experiences in developing soft skills during her clinical training. Initially overwhelmed, she found that mastering patient communication and management was more challenging than the technical aspects of dentistry. With guidance from faculty, she learned to effectively communicate treatment plans and reassure anxious patients. By improving her soft skills, she has built trusting relationships with patients, enhanced her time management, and strengthened her empathy, which she believes will benefit her throughout her career.

Through The Looking Glass, Sarah Glass

Virginia Dental Journal

"Through the Looking Glass with Dr. Sarah Glass" explores various cases in oral pathology. It includes the diagnosis of a surgical ciliated cyst in a 51-year-old male with a radiolucent lesion in the mandible, verrucous xanthoma in a 45-year-old male with a growth on his gums, and an adenomatoid odontogenic tumor in an 11-year-old female with an impacted canine. Dr. Sarah Glass, a board-certified Oral and Maxillofacial Pathologist and assistant professor at VCU School of Dentistry, provides insights into these conditions.

A Partnership With Special Olympics, Organized Dentistry, The Community, And Two Dental Schools, Phillip Ashkar

Virginia Dental Journal

The document discusses a partnership involving Special Olympics, organized dentistry, the community, and two dental schools to address the oral health disparities faced by individuals with special needs, particularly those with Intellectual or Developmental Disabilities (IDD). It highlights the challenges these individuals face in accessing appropriate dental care due to a lack of specialized resources and providers. The partnership's efforts include providing free dental services through events like the one held on June 10, 2023, where dental students and professionals offered comprehensive care to underserved populations. Despite these efforts, the document emphasizes the ongoing need for systemic changes to improve …

Answering Your Frequent Delta Dental Questions, Brad Guyton

Virginia Dental Journal

Delta Dental of Virginia (DDVA) is part of the national Delta Dental Plans Association, serving over two million members and 5,000 employer groups in Virginia. DDVA processes over four million dental claims annually and handles numerous inquiries from dentists. Claims for out-of-state patients are processed using a National Provider File system to ensure correct fee arrangements. Participating in DDVA's network offers access to a large population of insured patients, though fee amounts are regularly evaluated to remain competitive. Fee increases were implemented in 2021 and 2023, with another anticipated in January 2024.

Our Regional Workforce Needs, Paul Logan

Virginia Dental Journal

The Virginia Dental Workforce Council, led by VDA President Dr. Cindy Southern, is addressing regional imbalances in the dental workforce, particularly in Northern Virginia and Richmond. The council emphasizes the need for state resources and local partnerships to make it easier for dentists to practice in underserved areas. Despite challenges, Virginia saw an increase in licensed dental hygienists in 2022. Efforts include supporting dental programs, recruiting faculty, aiding student retention, and advocating for flexible accreditation standards. The council aims to improve oral health across Virginia through collaboration and innovative solutions.

Reusing And Adapting Marketing Content To Make Your Life Easier, Michaela Mishoe

Virginia Dental Journal

Creating an efficient, long-term content plan for your dental practice's marketing can save time and effort. Key strategies include using an editorial calendar to plan content around important dates, building a bank of photos, quotes, and testimonials, and recycling content by slicing it into smaller pieces for various platforms. Tools like Google Sheets, Canva, and third-party content from organizations like the ADA can help streamline the process. This approach ensures consistent, strategic, and creative content aligned with your marketing goals.