Medicine and Health Sciences Commons^™

Understanding The Impact Of Covid-19 On Yoga Instruction: Examining Teaching Methodology, Class Components, And Injury Patterns In The Northeastern Us, Sojung Kim, June Solow, Donald H Lein, Harshvardhan Singh

Rowan-Virtua School of Osteopathic Medicine Departmental Research

OBJECTIVES: This study aimed to examine the impact of COVID-19 on the perspectives of yoga instructors (YIs) regarding teaching methodology, class components, and yoga-related injuries among their clients DESIGN: A cross-sectional design in this study.

SETTING: A total of 407 YIs from Northeastern United States completed a customized, web-based survey.

MAIN OUTCOME MEASURES: Chi-square tests were carried out to determine changes in yoga teaching format before and during the pandemic, as well as the counts of yoga related injuries between face-to-face (FtoF) and online teaching format. Independent t tests were used to compare the characteristics of yoga teaching elements.

RESULTS: …

Multi-Omic Human Pancreatic Islet Endoplasmic Reticulum And Cytokine Stress Response Mapping Provides Type 2 Diabetes Genetic Insights., Eishani K Sokolowski, Romy Kursawe, Vijay Selvam, Redwan M Bhuiyan, Asa Thibodeau, Chi Zhao, Cassandra N Spracklen, Duygu Ucar, Michael L. Stitzel

Faculty Research 2024

Endoplasmic reticulum (ER) and inflammatory stress responses contribute to islet dysfunction in type 2 diabetes (T2D). Comprehensive genomic understanding of these human islet stress responses and whether T2D-associated genetic variants modulate them is lacking. Here, comparative transcriptome and epigenome analyses of human islets exposed ex vivo to these stressors revealed 30% of expressed genes and 14% of islet cis-regulatory elements (CREs) as stress responsive, modulated largely in an ER- or cytokine-specific fashion. T2D variants overlapped 86 stress-responsive CREs, including 21 induced by ER stress. We linked the rs6917676-T T2D risk allele to increased islet ER-stress-responsive CRE accessibility and allele-specific β …

What Makes An Effective Chief Of Pediatric Cardiology: Insights From Chiefs Of North American Pediatric Programs, Michael E. Kim, Wayne Franklin, Anne M. Dubin, Jeffrey J. Kim, Shubhayan Sanatani, R. Krishna Kumar, Shubhika Srivastava, Thomas R. Kimball, Mark Lewin, Joseph Rossano, Colin J. Mcmahon

Department of Medicine Faculty Papers

BACKGROUND: Although the position of a pediatric cardiology chief is often seen as the apex of one's academic career, its roles, responsibilities, and qualifications are not well defined in the literature. This study was done to gain further insight of the role and attributes of a pediatric cardiology chief by surveying those who are currently serving the position across North American centers.

METHODS AND RESULTS: This was a mixed-methods study with a survey given to North American pediatric cardiology chiefs at programs with fellowship training programs. The survey was a semistructured questionnaire that was independently reviewed by 3 cardiologists. Smaller …

Nkp46+ Ilc3s Promote Early Neutrophil Defense Against Clostridioides Difficile Infection Through Gm-Csf Secretion, José L Fachi, Sarah De Oliveira, Susan Gilfillan, Alina Ulezko Antonova, Jinchao Hou, Marco A R Vinolo, Marco Colonna

2020-Current year OA Pubs

No abstract provided.

Facilitating And Restraining Virus Infection Using Cell-Attachable Soluble Viral Receptors, Heng Zhang, Zhengli Wang, Huong T T Nguyen, Marjorie Cornejo Pontelli, Wanrong Qi, Liem Rao, Zhuoming Liu, Sean P J Whelan, Jieqing Zhu

2020-Current year OA Pubs

SARS-CoV-2 uses the receptor binding domain (RBD) of its spike protein to recognize and infect host cells by binding to the cell surface receptor angiotensin converting enzyme 2 (ACE2). The ACE2 receptor is composed of peptidase domain (PD), collectrin-like domain, transmembrane domain, and short cytoplasmic domain, and may exist as a dimer on cell surface. The RBD binding site is located atop of the ACE2 PD, but the involvement of other domains in virus infection is uncertain. We found that the ACE2 PD alone, whether anchored to cell membrane via a glycosylphosphatidylinositol anchor or attached to another surface protein, is …

The Upfront Project: Tailored Implementation And Evaluation Of A Patient Decision Aid To Support Shared Decision-Making About Management Of Symptomatic Uterine Fibroids, Rachel C Forcino, Mary Politi, Et Al.

2020-Current year OA Pubs

OBJECTIVE: To evaluate implementation of a patient decision aid for symptomatic uterine fibroid management to improve shared decision-making at five clinical settings across the United States.

METHODS: We used a type 3 hybrid effectiveness-implementation stepped-wedge design and the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) planning and evaluation framework. We conducted clinician training, monthly reach tracking with feedback to site clinical leads, patient and clinician surveys, and visit audio-recordings. Implementation strategies included assessment of organizational readiness for shared decision-making, synchronous clinician training, audit and feedback of decision aid reach, and access to multiple decision aid formats. Outcomes and analyses included patient-level …

The Personality Profile And Leadership Style Of U.S. Vice President And 2024 Democratic Presidential Nominee Kamala Harris, Aubrey Immelman, Anne Marie Griebie, Elise Vomacka

Psychology Faculty Publications

The paper presents the results of an indirect personality assessment of U.S. vice president Kamala Harris, Democratic presidential nominee in the 2024 U.S. presidential election, from the conceptual perspective of personologist Theodore Millon.

Psychodiagnostically relevant data about Harris were collected from biographical sources and media reports and synthesized into a personality profile using the Millon Inventory of Diagnostic Criteria (MIDC), which yields 34 normal and maladaptive personality classifications congruent with DSM-III-R, DSM-IV, and DSM-5-TR.

The personality profile yielded by the MIDC was analyzed in accordance with interpretive guidelines provided in the MIDC and Millon Index of Personality …

Mitral Annular Disjunction In Heritable Thoracic Aortic Disease: Insights From The Montalcino Aortic Consortium, Kishan L Asokan, Alan Braverman, Et Al.

2020-Current year OA Pubs

BACKGROUND: Mitral annular disjunction (MAD), posterior displacement of the mitral valve leaflet hinge point, predisposes to arrhythmias or sudden cardiac death. We evaluated the burden of MAD, mitral valve prolapse (MVP), and mitral regurgitation (MR) by heritable thoracic aortic disease gene in a cross-sectional analysis of 2014-2023 data in the Montalcino Aortic Consortium registry.

METHODS AND RESULTS: MAD was determined by direct measurement of echocardiographic images. MR and MVP were defined according to current clinical guidelines. Associations were evaluated using χ

CONCLUSIONS: Pathological mitral valve phenotypes are more prevalent in individuals with PV in transforming growth factor-β pathway genes, particularly

Benchmarking Machine Learning Models To Predict Low Birthweight Baby Outcomes And Identify Associated Risk Factors From An Extremely Unbalanced Large-Scale Dataset, Yang Ren, Dezhi Wu, Yan Tong Ph.D., Ana Lopez-De Fede Ph.D., Sarah J. Gareau

Publications

Background: Low birthweight (LBW) is one of the leading causes of neonatal mortality in the United States (US), and also is a major causative factor of short- and long-term adverse health effects in newborns. To prevent adverse birth outcomes, it is critical to precisely predict and identify which mothers are at high risk of bearing LBW babies in the early stage of their pregnancy. Previous studies proposed various LBW prediction models from different ML algorithms primarily on small datasets. However, their model performance is significantly limited by data access barriers and data quality issues with one major technical challenge of …

The Association Of Individual Characteristics, Treatment Type, Treatment Satisfaction, Symptoms Of Pain And Fatigue With Health-Related Quality Of Life Among Adults With Gaucher Disease Type 1, Shauna L. Mangum

Nursing ETDs

People with rare disease have lower health-related quality of life (HRQoL) than the general population. Gaucher disease type 1 (GD1) is a rare, autosomal recessive, lysosomal storage disorder that affects multiple bodily systems. HRQoL improved with enzyme replacement and/or substrate reduction therapies, however, little is known about specific variables associated with HRQoL in GD1. This study explored associations between individual characteristics (gender, race, ethnicity, age, and genotype), treatment variables (treatment type, length of time on treatment, and treatment satisfaction) and symptoms of fatigue and pain with HRQoL among 97 adults with GD1. No significant associations were found among individual characteristics …

Digital Health Intervention For Children With Adhd To Improve Mental Health Intervention, Patient Experiences, And Outcomes: A Study Protocol, Nancy Herrera, Franceli L. Cibrian, Lucas M. Silva, Jesus Armando Beltran, Sabrina E. B. Schuck, Gillian R. Hayes, Kimberley D. Lakes

Engineering Faculty Articles and Research

Background

Attention Deficit Hyperactivity Disorder (ADHD) is the most prevalent childhood psychiatric condition with profound public health, personal, and family consequences. ADHD requires comprehensive treatment; however, lack of communication and integration across multiple points of care is a substantial barrier to progress. Given the chronic and pervasive challenges associated with ADHD, innovative approaches are crucial. We developed the digital health intervention (DHI)—CoolTaCo [Cool Technology Assisting Co-regulation] to address these critical barriers. CoolTaCo uses Patient-Centered Digital Healthcare Technologies (PC-DHT) to promote co-regulation (child/parent), capture patient data, support efficient healthcare delivery, enhance patient engagement, and facilitate shared decision-making, thereby improving access to …

Failure To Rescue Black And Brown Maternity Patients, Dorothy Marie Glisson

Walden Dissertations and Doctoral Studies

Reducing maternal mortality rates is one of the leading health indicators in the nation. Pregnant and postpartum Black mothers make up a disproportionate number of maternal deaths. Many result from failure to rescue (FTR), defined as the inability to prevent a death from a disease, illness, or complication. Over 700 women die daily from preventable causes related to pregnancy. Black patients are attributable to almost 40% of maternity mortality rates and represent over 50% of pregnancy-related deaths due to complications. Black women are more likely to die during pregnancy or after pregnancy, with heart disease causing almost half of pregnancy-related …

Gpr56: Gpcr As A Guardian Against Ferroptosis, Yuelong Yan, Li Zhuang, Boyi Gan

Faculty, Staff and Student Publications

Transmembrane receptor proteins are proficient in sensing external signals and initiating downstream pathways to control cell survival. Lin et al. demonstrated that GPR56, a G-protein-coupled receptor, can be activated by its agonist to suppress ferroptosis-a form of cell death-and effectively mitigate ferroptosis-associated liver damage.

Mitral Annular Disjunction In Heritable Thoracic Aortic Disease: Insights From The Montalcino Aortic Consortium, Kishan L Asokan, Jennifer R Landes, Wannes Renders, Laura Muiño Mosquera, Julie De Backer, David W Jantzen, Anji T Yetman, Gisela Teixido-Tura, Arturo Evangelista, Richmond Jeremy, Edward G Jones, Shaine Morris, Tam Doan, Maral Ouzonian, Alan Braverman, Guillaume Jondeau, Olivier Milleron, Dianna M Milewicz, Siddharth K Prakash

Faculty, Staff and Student Publications

Background: Mitral annular disjunction (MAD), posterior displacement of the mitral valve leaflet hinge point, predisposes to arrhythmias or sudden cardiac death. We evaluated the burden of MAD, mitral valve prolapse (MVP), and mitral regurgitation (MR) by heritable thoracic aortic disease gene in a cross-sectional analysis of 2014-2023 data in the Montalcino Aortic Consortium registry.

Methods and results: MAD was determined by direct measurement of echocardiographic images. MR and MVP were defined according to current clinical guidelines. Associations were evaluated using χ2 or Fisher exact tests. MR and MVP were enriched in Montalcino Aortic Consortium participants (672) with pathogenic variants (PV) …

Extending The Translational Science Benefits Model To Implementation Science For Cancer Prevention And Control, Karen M Emmons, Ross C Brownson, Douglas A Luke

2020-Current year OA Pubs

INTRODUCTION: There is increasing pressure on the federal research budget and shifting public opinions about the value of the academic enterprise. We must develop and apply metrics that demonstrate the broad benefits of research for health and society. The Translational Science Benefits Model (TSBM) measures the impact of large-scale translational science initiatives, such as the National Cancer Institute's Cancer Moonshot. TSBM provides the scaffolding to illustrate how science has real-world health impacts. We propose an expansion of the TSBM to explicitly include implementation-focused outcomes.

METHODS: TSBM includes four categories of benefits, including (1) clinical and medical, (2) community and public …

Kratom: A Narrative Review Of The Possible Clinical Uses And Dangers Of This Opioid-Like Plant, Amber N. Edinoff, Sarah E. Kaufman, Taylor C. Mahoney, William C. Upshaw, Jay Gong, Elyse M. Cornett, Kevin S. Murnane, Adam M. Kaye, Giustino Varrassi, Sahar Shekoohi, Alan D. Kaye

School of Medicine Faculty Publications

The term "kratom" refers to a plant species formally known as Mitragyna speciosa. Kratom is composed of over 40 alkaloids, a type of organic compound that contains nitrogen. These compounds work primarily via binding to opioid receptors expressed on neurons, where they stimulate signal transduction mechanisms involving the activation of G proteins. Kratom has been shown to cause both a stimulant-like effect and a sedative effect in humans. These studies have shown that use is highest among European-American, middle-class men living in suburban areas. Additionally, individuals who have a history of opioid misuse are also more likely to take kratom. …

White Matter Hyperintensities And Mild Tbi In Post-9/11 Veterans And Service Members, David F Tate, Erin D Bigler, Gerald E York, Mary R Newsome, Brian A Taylor, Andrew R Mayer, Mary Jo Pugh, Angela P Presson, Zhining Ou, Elizabeth S Hovenden, Josephine Dimanche, Tracy J Abildskov, Rajan Agarwal, Heather G Belanger, Aaron M Betts, Timothy Duncan, Blessen C Eapen, Carlos A Jaramillo, Michael Lennon, Jennifer E Nathan, Randall S Scheibel, Matthew B Spruiell, William C Walker, Elisabeth A Wilde

Faculty, Staff and Student Publications

Introduction: The neurobehavioral significance of white matter hyperintensities (WMHs) seen on magnetic resonance imaging after traumatic brain injury (TBI) remains unclear, especially in Veterans and Service Members with a history of mild TBI (mTBI). In this study, we investigate the relation between WMH, mTBI, age, and cognitive performance in a large multisite cohort from the Long-term Impact of Military-relevant Brain Injury Consortium-Chronic Effects of Neurotrauma Consortium.

Materials and methods: The neuroimaging and neurobehavioral assessments for 1,011 combat-exposed, post-9/11 Veterans and Service Members (age range 22-69 years), including those with a history of at least 1 mTBI (n = 813; median …

Gene Discovery From Microbial Gene Libraries I: Protection Against Reactive Oxygen Species-Driven Dna Damage, John C Taylor, Carmen Gu Liu, James D Chang, Brianna E Thompson, Anthony W Maresso

Faculty, Staff and Students Publications

Reactive oxygen species (ROS) pose a lethal risk for all life forms by causing damage to cell processes, genome-wide DNA damage-driving mutation, replicative instability, and death. Thus, the development of mechanisms to resist or repair ROS-induced DNA damage is critical for the reliable replication of nucleic acids. DNA repair and protection mechanisms have been discovered in all forms of life. However, the vast array of microbes that may harbor novel repair or protection mechanisms, especially bacterial viruses, have not been adequately assessed. Here, we screened a microbial gene library composed primarily of phage open reading frames (ORFs) to uncover elements …

Trends In Transcatheter Versus Surgical Aortic Valve Replacement Outcomes In Patients With Low-Surgical Risk: A Systematic Review And Meta-Analysis Of Randomized Trials, Sina Kazemian, Parisa Fallahtafti, Mohammad Sharifi, Negin Sadat Hosseini Mohammadi, Hamidreza Soleimani, Arman Soltani Moghadam, Elaheh Karimi, Yaser Sattar, Yaser Jenab, Mehdi Mehrani, Alimohammad Hajizeinali, Mina Iskander, Mehrshad Fathian Sabet, Negar Salehi, Karim Al-Azizi, Diaa Hakim, Mahboob Alam, Kaveh Hosseini

Faculty, Staff and Students Publications

Background: Limited data exist on long-term outcomes after transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR). This meta-analysis aims to elucidate outcome trends following TAVR versus SAVR in patients with severe aortic stenosis and low-surgical risk.

Methods and results: A systematic search was conducted in PubMed, Embase, Scopus, and the Cochrane Library databases from inception until May 2024, to identify studies comparing TAVR versus SAVR in patients with low-surgical risk (Society of Thoracic Surgeons predicted risk of mortality score < 4%). The primary outcome was all-cause mortality. Secondary outcomes included cardiovascular mortality, stroke, disabling stroke, rehospitalization, myocardial infarction, aortic valve reintervention, permanent pacemaker implantation, and new-onset atrial fibrillation. Binary random-effects models were used to compare the risk of each outcome across various follow-up intervals and the risk of bias was assessed using the Cochrane Collaboration's Risk of Bias-2 tool. The meta-analysis included 6 randomized trials including 4682 patients. TAVR was associated with a lower risk of all-cause mortality than SAVR in the 30-day (hazard ratio [HR: 0.45] [95% CI: 0.26-0.77], I2: 0%) and 30-day to 1-year (HR: 0.55 [95% CI: 0.37-0.81], I2: 16%) follow-ups. However, the …

Activation Of A Gpcr, Orl1 Receptor: A Novel Therapy To Prevent Heart Failure Progression, Saliha S Pathan, Aarthi Pugazenthi, Beverly R E A Dixon, Theodore G Wensel, Todd K Rosengart, Megumi Mathison

Faculty, Staff and Students Publications

The number of ischemic heart failure (HF) patients is growing dramatically worldwide. However, there are at present no preventive treatments for HF. Our previous study showed that Gata4 overexpression improved cardiac function after myocardial infarction in rat hearts. We also found that Gata4 overexpression significantly increased the expression of a Pnoc gene, an endogenous ligand for the cell membrane receptor ORL1. We hypothesized that the activation of the ORL1 receptor would suppress HF in a rat ischemic heart model. Adult Sprague Dawley rats (8 weeks old, six males and six females) underwent left anterior descending coronary artery ligation. Three weeks …

Management Of Post-Operative Pain In Those With A Drug History, Emelyn Stockton, Maddie Griggs

Scholars Week

Addressing postoperative pain management in patients with a history of opioid abuse is essential for enhancing patient safety and quality care. Implementing evidence-based practices and standardized protocols can reduce the risk of relapse and improve the outcomes for this population. By focusing on staff education and training, healthcare providers can gain the necessary skills to effectively manage pain while minimizing the reliance on opioids. Ultimately, a comprehensive approach that includes alternative therapies and consistent monitoring will foster better recovery experiences for patients.

Benefits To Swaddle Bathing, Brenna Dotson, Kori Redden, Cassidy Payne

Scholars Week

Swaddle bathing is a technique that entails bathing an infant while they are comforted in a swaddle. This technique is rarely seen in everyday hospital practice, even though there is ample evidence of its benefits and advantages. Our project aimed to combine research proving the effectiveness of swaddle bathing through scoring methods that consider pain, vital signs, temperature, crying duration, and more. The research is combined to support the impact that swaddle bathing can have on not only infants but parents as well. Parents implementing the swaddle bath enjoy improved confidence and attachment, along with decreased stress. The evidence was …

Benefits Of Nitrous Oxide For Pain Management During Labor, Hannah Young, Madison Smith

Scholars Week

Nitrous oxide is widely used in the United States, but is still limited in our area. Nitrous oxide used during labor is a way for mothers to avoid adverse effects that other forms of pain management can cause. Nitrous oxide is used to increase pain tolerance for laboring mothers, and has also been proven to reduce anxiety. Nitrous oxide has limited adverse effects on the mother and no know adverse effects to the fetus. If a side effect is caused by nitrous oxide, the effects will wear off almost immediately after discontinuation of use. It also is more cost effective …

A Case Of Cecal Volvulus In The Setting Of Multiple Sclerosis, S. Jiaming Lin, Paige M. Kieper, Michael Mullinax, Jake W. Vogel, Kimberly Syres

Advances in Clinical Medical Research and Healthcare Delivery

This case report describes a patient with a history of multiple sclerosis (MS) and optic neuritis, who presented with acute onset of generalized abdominal pain. The patient was ultimately diagnosed with cecal volvulus requiring emergent laparotomy and right hemicolectomy. This case highlights the relationship between neurogenic bowel dysfunction (NBD) associated constipation in patients with MS and intestinal volvulus. Additionally, this case demonstrates the importance of NBD associated constipation management through various modalities including laxative regimens, behavioral and diet modification, and reduction of polypharmacy, with an emphasis on individualized patient management.

How Did Dat Happen? A Coombs Negative Delayed Hemolytic Transfusion Reaction In A Patient With Myelodysplastic Syndrome: A Case Report, Aniket Vijay Rao Dr, Aditya Sanjeevi, Daniel Jose Idoate, Nagesh Jadhav, Basil Verghese, Himal Kharel

Advances in Clinical Medical Research and Healthcare Delivery

Delayed hemolytic transfusion reactions (DHTRs) present significant challenges in diagnosis and management despite advancements in pre-transfusion testing. We report a case of a 76-year-old female with myelodysplastic syndrome (MDS) who developed severe hemolytic anemia following a seemingly compatible blood transfusion and appropriate pretransfusion testing. Evaluation revealed characteristics consistent with DHTR. Diagnostic uncertainty arose due to a negative Direct Antiglobulin Test (DAT) in the setting of a concomitant Vitamin B-12 deficiency. She was supported with prednisone and B12 supplementation. We discuss challenges in diagnosis, including the limitation of DAT, and propose strategies for comprehensive antibody identification. The case underscores the importance …

Interactive Virtual Presence: A New Tool For Remote Healthcare, David C. Schwebel

Advances in Clinical Medical Research and Healthcare Delivery

The COVID-19 pandemic transformed use of telemedicine for healthcare. Many healthcare objectives can be successfully delivered through traditional telemedicine platforms, and others must be delivered in person. Lying between those extremes is a subset of healthcare objectives that might benefit from use of interactive virtual presence, a form of augmented reality that can be delivered on standard smartphones to offer immersive presence as well as simultaneous voice and visual stimuli. Using interactive virtual presence, a healthcare provider can communicate both verbally and visually with a remotely-located patient, but also can interact with that patient through merged reality by pointing with …

Could Sigmoid Diverticulitis, Drug-Induced Liver Injury, And Drug-Induced Pancreatitis Co-Occur?, Rutwik Pradeep Sharma, Ryan Tam, Michael Labuzetta, Richard Alweis

Advances in Clinical Medical Research and Healthcare Delivery

Sigmoid diverticulitis is a leading cause of gastrointestinal pathology etiology, which causes hospital admissions in Western society. Recent studies have shown its prevalence to be 1-4%. Drug-induced liver injury (DILI) is a primary cause of acute liver failure in the West^. The incidence of DILI is between 14-19 cases per 100,000 population. The prevalence of drug-induced pancreatitis (DIP) is 2-5%, although this is hard to estimate given the lack of large-scale studies. Sulfasalazine is a disease-modifying antirheumatic drug that is indicated for the treatment of chronic inflammatory diseases such as rheumatoid arthritis and ulcerative colitis. It has been associated …

Cardiac Arrest Following Svc Intravascular Stenting: A Case Report, Afrah Ali, Shahtaj Shah, Varun Mehta, Lubna Ziauddin, Asma Khan, Sameen Khurshid, Fawaz Ali

Advances in Clinical Medical Research and Healthcare Delivery

Superior vena cava (SVC) syndrome is a known collection of symptoms caused by obstruction of blood flow through the superior vena cava. Symptoms notably seen include difficulty breathing, coughing, hoarse voice, and swelling of the head, neck, and arm. It is most commonly seen secondary to malignancy from tumor infiltration of the vessel wall and is frequently associated with lung cancer due to anatomic location.

Treatment of SVC syndrome largely depends on severity of symptoms. While treatment of underlying cause is considered first line, intravascular stenting is also commonly considered in life threatening cases and for symptomatic relief.

We report …

From Infection To Encapsulation; A Case Report On Encapsulating Peritoneal Sclerosis, Clinical Challenges And Management, Sidra Memon Md, Jacob Seth Psomiadis Md, Syed Uzair Mahmood, Jennifer Hoffman Md

Advances in Clinical Medical Research and Healthcare Delivery

Encapsulating Peritoneal Sclerosis (EPS) is a rare but deadly sequlae of peritoneal dialysis resulting in intraperitoneal inflammation and fibrosis. The disease itself can present in a variety of ways and is associated with significant morbidity and mortality. Here we present the case of a man in his 50's with a history of chronic peritoneal aspergillus as well as end-stage renal disease on peritoneal dialysis that had multiple admissions for abdominal fluid collections as well as bowel obstruction. After a multidisciplinary approach, the patient was diagnosed with encapsulating peritoneal sclerosis and then started the recommended therapy of tamoxifen and prednisone.

Exploring Disparities In Palliative Care Utilization For Patients With End-Stage Liver Failure: A Nationwide Cohort Analysis (2016-2020), Sheza Malik, Hajra Khan, Amatul Mueed Taqiyyah Fatima Syeda, Mohammed Faisaluddin, Babu Mohan Md, Asim Mushtaq, Karin Dunnigan

Advances in Clinical Medical Research and Healthcare Delivery

Background: Despite the very high symptom burden, palliative care (PC) services are underutilized in patients with End-stage liver disease (ESLD). Herein, we investigated the disparities in the utilization of PC services among patients with ESLD hospitalized in the United States.

Method: We conducted a retrospective cohort analysis by utilizing the Nationwide Inpatient Sample from 2016 to 2020. All patients greater than 18 years old admitted with ESLD were included in the analysis. A multivariate logistic regression model predicting referral to PC was created.

Results: In our analysis, significant racial disparities were observed in the utilization of palliative care services among …