Medicine and Health Sciences Commons^™

Three-Year Outcomes Following Tavr In Younger (<75 Years) Low-Surgical-Risk Severe Aortic Stenosis Patients., Thomas Modine, Didier Tchétché, Nicolas M Van Mieghem, G Michael Deeb, Stanley J Chetcuti, Steven J Yakubov, Paul Sorajja, Hemal Gada, Mubashir Mumtaz, Basel Ramlawi, Tanvir Bajwa, John Crouch, Paul S Teirstein, Neal S Kleiman, Ayman Iskander, Rodrigo Bagur, Michael W A Chu, Pierre Berthoumieu, Arnaud Sudre, Rik Adrichem, Saki Ito, Jian Huang, Jeffrey J Popma, John K Forrest, Michael J Reardon

Heart and Vascular Articles

BACKGROUND: Transcatheter aortic valve replacement (TAVR) is an alternative to surgery in patients with severe aortic stenosis, but data are limited on younger, low-risk patients. This analysis compares outcomes in low-surgical-risk patients agedsurgery.

METHODS: The Evolut Low Risk Trial randomized 1414 low-risk patients to treatment with a supra-annular, self-expanding TAVR or surgery. We compared rates of all-cause mortality or disabling stroke, associated clinical outcomes, and bioprosthetic valve performance at 3 years between TAVR and surgery patients aged < 75 >years.

RESULTS: In patients < 75 >years, 352 were randomized to TAVR and 351 to surgery. Mean age was 69.1±4.0 years (minimum 51 and maximum …

Impact Of Obstructive Sleep Apnea On Masticatory Muscle Function, Diana Russo, Luis Eduardo Almeida, Vincenzo Ronsivalle, Marco Cicciù, Gabriele Cervino, Maria Maddalena Marrapodi, Giuseppe Minervini

School of Dentistry Faculty Research and Publications

Obstructive sleep apnea (OSA) is a common and potentially serious sleep disorder characterized by repetitive episodes of complete or partial upper airway obstruction during sleep. These obstructions result in a reduction or cessation of airflow, leading to oxygen desaturation, and disruptions in sleep patterns.1,2 Common symptoms of OSA include loud snoring, gasping or choking during sleep, excessive daytime sleepiness, morning headaches, and irritability. Obstructive sleep apnea is often associated with other medical conditions, such as obesity, hypertension, cardiovascular disease, and diabetes. Diagnosis typically involves polysomnography to assess the frequency and severity of apneic episodes.

Comparison Of Accuracy Of Different Dental Age Estimation Methods In Finnish And Turkish Populations, Aysima Darici, Merih Seval Olmez, H. Cem Güngör, Paivi Rajavaara, Annina Sipola, Vuokko Anttonen, Jari Pakkila

School of Dentistry Faculty Research and Publications

Objective: The aims of this study were to assess the accuracy of Cameriere’s and Demirjian’s methods in Finnish children, and compare the findings with those of the Turkish children according to dental age.

Material and methods: Dental panoramic tomography (DPT) of children (482 Finnish, 423 Turkish) aged between 5 and 15 years were evaluated. Comparison of mean difference between estimated and chronological age was evaluated. The difference between two means was analysed using paired t-test at 95% confidence interval (CI). Pearson correlation coefficients were used to estimate the correlation between chronological and estimated ages.

Results: Demirjian’s method resulted in …

Short- And Long-Term Effects Of Conventional And Miniscrew-Assisted Rapid Palatal Expansion On Hard Tissues Using Voxel-Based Superimposition Of Serial Cone-Beam Computed Tomography Scans, Isaac R. Empson, Marinho Del Santo Jr., Chia-Ling Kuo, Manuel Lagravere Vich, Dawei Liu, Sumit Yadav, Shivam Yogesh Mehta

School of Dentistry Faculty Research and Publications

Introduction

The objective of this study was to evaluate the short-term and long-term hard-tissue changes with miniscrew-assisted rapid palatal expansion (MARPE) and rapid palatal expansion (RPE) compared with a matched control group with voxel-based superimposition using 3-dimensional cone-beam computed tomography (CBCT) scans.

Methods

A total of 180 CBCT scans were analyzed for 60 patients with a mean age of 13.9 years at 3 time points: pretreatment (T1), postexpansion (T2), and posttreatment (T3). Patients were divided into 3 groups: MARPE, RPE, and controls. Voxel-based superimposition was performed for CBCTs from T1 to T2 and T1 to T3 using the anterior cranial …

Summary Of: Reaching Structurally Vulnerable Populations Using Low-Barrier Covid-19 Testing Clinics Co-Created With Community Based Organizations, David Ngandu, Gloria Sclar, Ambia Ahmed, Sumayo A Awale, Caroline Fernandes, Joshua Goldstein, Hina Hashmi, Shruti Joshi, Et Al.

Northern New England Clinical & Translational Research

The COVID-19 pandemic disproportionately affected people from structurally vulnerable communities. There was a need to improve COVID-19 testing in these communities to reduce viral spread and connect to treatment.

Study @ "Reaching Structurally Vulnerable Populations Using Low-Barrier COVID-1" by David Ngandu, Gloria D Sclar et al.

Left, Then Right Internal Carotid Artery Dissection: A Case Report, Jeffrey M. Kalczynski, John Douds, Michael E. Silverman

SKMC Student Presentations and Publications

INTRODUCTION: We present a unique case of a patient who presented to the emergency department with stroke-like symptoms found to have a spontaneous, left-sided internal carotid artery dissection (ICAD).

CASE REPORT: The patient was treated successfully with thrombectomy and subsequently developed contralateral symptoms caused by a right-sided ICAD. This was managed with a second contra-lateral thrombectomy. The patient's course was complicated by persistent and mild hypotension, postulated to be secondary to bilateral carotid baroreceptor trauma from the dissections.

CONCLUSION: This case highlights the importance of close neurological monitoring for patients, preferably in a neurologic critical care setting, during and after …

Association Between E-Scooter Temporal Usage Patterns With Injuries Resulting In Admission To A Level One Trauma Center, Kevin C Rix, Andrew E Springer, Katelyn Jetelina, Nalini Ranjit, Catherine C Mcdonald, Douglas J Wiebe, Thomas B Coopwood

Faculty, Staff and Student Publications

Background: As e-scooters have become common modes of transportations in urban environments, riding e-scooters has become a common mechanism of injury. This study examines the relationship between when riders are using these devices (i.e. day of week, and time of the day) and injury incidence based on data from a large U.S. city.

Methods: This study is a retrospective cohort study of patients in the trauma registry at a level one trauma center. Registry data were combined with a publicly available dataset of all e-scooter trips that occurred during the study period. Frequency of injuries and trips were analyzed using …

Roflumilast Cream, 015%, For Atopic Dermatitis In Adults And Children: Integument-1 And Integument-2 Randomized Clinical Trials, Eric L Simpson, Lawrence F Eichenfield, Javier Alonso-Llamazares, Zoe D Draelos, Laura K Ferris, Seth B Forman, Melinda Gooderham, Mercedes E Gonzalez, Adelaide A Hebert, Leon H Kircik, Mark Lomaga, Angela Moore, Kim A Papp, Vimal H Prajapati, Diane Hanna, Scott Snyder, David Krupa, Patrick Burnett, Erin Almaraz, Robert C Higham, David H Chu, David R Berk

Faculty, Staff and Student Publications

Importance: Safe, effective, and well-tolerated topical treatment options available for long-term use in patients with atopic dermatitis (AD) are limited and associated with low adherence rates.

Objective: To evaluate efficacy and safety of once-daily roflumilast cream, 0.15%, vs vehicle cream in patients with AD.

Design, setting, and participants: Two phase 3, randomized, double-blind, vehicle-controlled trials (Interventional Trial Evaluating Roflumilast Cream for the Treatment of Atopic Dermatitis 1 and 2 [INTEGUMENT-1 and INTEGUMENT-2]), included patients from sites in the US, Canada, and Poland. Participants were 6 years or older with mild to moderate AD based on Validated Global Assessment for Atopic …

Combined Single-Shot Intra-Articular Injection Of Ropivacaine And Contrast Media For Magnetic Resonance Imaging: Surgical Decision Making For Hip Arthroscopy In Young Patients, Neil Sarna, Gabriel I. Onor, Kathleen E. Schenker, Alvin W. Su

Rothman Institute Papers

Introduction:

Hip impingement syndrome with labral tear is debilitating for young patients. When magnetic resonance arthrogram (MRA) is equivocal for surgical decision making, an additional intra-articular diagnostic injection (IA) can further confirm the diagnosis. We assessed the effectiveness on surgical decision making by combining hip MRA + IA in one single procedure.

Methods:

We conducted a retrospective review of a prospectively enrolled cohort of patients with hip impingement syndrome who underwent a combined MRA + IA procedure. A 10-mL cocktail containing 0.2% ropivacaine and Omnipaque 300 contrast media was injected into the hip joint, followed by magnetic resonance scanning, in …

Variation In Craniodental Pathologies Among Cercopithecoid Primates, Claire A. Kirchhoff, Siobhán B. Cooke, Jessica C. Gomez, D. Rex Mitchell, Tyler Stein, Claire E. Terhune

Biomedical Sciences Faculty Research and Publications

Pathologies of the skull and teeth are well documented for many human populations, but there are fewer studies of other primates. We contrast lesion prevalence and patterning among cercopithecoid primates and map variation onto socioecological variables. We compare craniodental lesions in six species: Nasalis larvatus (n = 54), Colobus polykomos (n = 64), Cercopithecus mitis (n = 65), Macaca fascicularis (n = 109), Theropithecus gelada (n = 13), and Papio anubis (n = 76). One of us (C.A.K.) evaluated each adult skull for multiple lesion types using standard criteria. We also tested for a …

A Study Of Management Of Marine Oil Spills In Malaysia, Mohd Arma Noramin Bin A Rashid

World Maritime University Dissertations

No abstract provided.

Simulation In An Entry-Level Respiratory Therapy Program, Nikonya Godwin

MSHS Student Capstones

In response to the complex clinical environments respiratory therapy students face, there is a need for hands-on learning experiences that closely replicate real-life scenarios. There is a significant gap in the literature regarding respiratory therapy simulation-based training. A new simulation training program is being developed for Catawba Valley Community College’s (CVCC) respiratory therapy program to address this gap. The simulation training program will enhance critical thinking, decision-making, and technical skills by integrating realistic simulated respiratory case scenarios into the curriculum each semester of the two-year program. Central to the simulated program design are high and mid-fidelity multi-functional patient simulators and …

Decreasing Sepsis Mortality With A Standard Screening Tool, Bailey Kee, Trina Smith, Katie Anderson, Ryan Huerta, Dr. Rachel Valentz, Dr. Jamie Larie Kitchens

Anna Vaughn School of Nursing Undergraduate Work

Sepsis is a life-threatening condition that affects 1.7 million people annually. Since sepsis is so prevalent and deadly, this necessitates an evaluation of the current standard of care regarding tools evaluating the early identification of sepsis. The research presented compares current sepsis screening tools: qSOFA, MEWS, and SIRS. The question posed for this systematic review was, “Which screening tool is the most effective in the early identification of sepsis?” Multiple methods were used in the discovery process, the most common being searching online databases for relevant scholarly articles, particularly utilizing the Oral Roberts University Library and Google Scholar. As a …

The Acid Sphingomyelinase Inhibitor Imipramine Enhances The Release Of Uv Photoproduct-Containing Dna In Small Extracellular Vesicles In Uvb-Irradiated Human Skin, M. Alexandra Carpenter, Anita Thyagarajan, Madison Owens, Christina E. Borchers, Jeffrey B. Travers, Michael G. Kemp

Dermatology Faculty Publications

Nucleic acids, lipids, and other cell components can be found within different types of extracellular vesicles (EVs), which include apoptotic bodies (ABs), large extracellular vesicles (LEVs), and small extracellular vesicles (SEVs). Release of LEVs from cells can be reduced by genetic or pharmacological inhibition of the enzyme acid sphinogomyelinase (aSMase), and indeed several studies have demonstrated a role for the clinically approved aSMase inhibitor imipramine in blocking LEV release, including in response to UVB exposure. Given that exposure of keratinocytes to UVB radiation results in the generation of UVR photoproducts in DNA that can subsequently be found in association with …

Shooter’S Abscess: Foot Infections In People Who Inject Drugs, Amanda L. Killeen, Randi Heming, Peter A. Crisologo, Michael C. Siah, Lawrence A. Lavery

School of Podiatric Medicine Publications

Musculoskeletal infections are common among people who inject drugs. Little is known about the prevalence and characteristics of skin and soft-tissue infections in this patient population, especially in the lower extremity. The aim of this study is to describe the clinical characteristics, bacterial pathogens, and clinical outcomes in adults with foot infections due to intravenous drug use. Nine patients for whom the podiatric service was consulted for lower-extremity abscess secondary to intravenous drug use were included in this study. Most infections (66.7%) were located on the dorsal foot. Two of the abscesses (22.2%) resulted in amputation, with one toe amputation …

Management Of Group B Streptococcus Necrotizing Fasciitis Secondary To Puncture Wound In Diabetic Patient Using Xenograft* Therapy, Nikita V. Gambhir, Heather V. Tran, Stephanie N. Campbell

School of Podiatric Medicine Publications

Necrotizing soft tissue infection (NSTI) is a rapidly progressive skin and soft tissue infection that primarily affects deeper layers of adipose tissue, fascia and muscle. Once a patient becomes symptomatic, the disease typically progresses within hours. The standard treatment consists of broad-spectrum IV antibiotics, serial debridement and supportive care. However, long-term goals should include prevention of atherosclerotic disease, cardiovascular and cerebrovascular events, and ultimately, a reduction in mortality rates. Following debridement for NSTI, it is not uncommon for patients to require multiple surgeries and secondary wound healing given the extent of soft tissue loss.

Use Of A Borate-Based Bioactive Glass Matrix On Infected, Exposed Hardware, Stephanie N. Campbell, Cyaandi Dove, Connor V. Krolikowski

School of Podiatric Medicine Publications

A dreaded complication of implanting surgical hardware is a wound dehiscence resulting in hardware exposure; which places the wound at risk for infection and biofilm formation. Once established, biofilms are difficult to eradicate, with a high rate of recurrence even after surgical debridement. As such, there exists a significant need for novel technologies that can help us expedite healing in wounds with exposed hardware. Here we evaluate a borate-based bioactive glass matrix* in this challenging setting.

Frequency Of Low Impact Scores Among Adolescent And Young Adult Student-Athletes With Attention-Deficit/Hyperactivity Disorder And/Or Learning Disorder, Philip Schatz, John Cuzzupe, Justin E. Karr, Nathan E. Cook, Grant L. Iverson

Neurology Faculty Publications

Introduction: Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by attention problems, excessive activity, and impulsivity - occurring in approximately 13% of children 12– 17 years of age, and as many as 16% of older adolescents 18–22 years of age, with a greater prevalence in boys than girls. ADHD frequently co-occurs with specific learning disorder (LD), a neurodevelopmental disorder characterized by difficulties learning and using academic skills, such as reading, writing, and mathematics. Taken together, ADHD and/or LD are common among high school students and college students and can influence performance on computerized tests used in concussion management. However, normative …

The Role Of A Dental Healthcare Provider, Jeffrey P. Okeson

Neurology Faculty Publications

No abstract provided.

Nevada Problem Gambling Treatment System, Annual Report - Fiscal Year 2024, Andrea Dassopoulos, Jared Weissman, Bo J. Bernhard

International Gaming Institute Faculty Research

In FY2024, Nevada Problem Gambling Services offered outpatient, residential treatment, and crisis intervention across five Problem Gambling Specialty Clinics statewide. Collectively, these clinics served 427 Nevada residents. Northern Nevada’s Bristlecone Family Resources and New Frontier Treatment Center provided both outpatient and residential services, while Southern Nevada’s Dr. Robert Hunter International Problem Gambling Center, Mental Health Counseling and Consulting (MHCC), and Hope Medical Center offered outpatient services to individuals affected by gambling and their concerned others.

Outpatient enrollments increased by 19% this fiscal year, while residential enrollments remained steady at the state-funded clinics. Additionally, 809 Nevadans were screened for gambling-related issues …

A Word From The Writing Team (November 2024), Pam Walter, Mfa

A Word From the Writing Team (Newsletter)

This issue includes:

• Publication Spotlight
• Attend our Friday Writing Retreat online
• Check out Biorender’s resources to build better graphics
• And check out Proofig to secure your graphics
• The Theresa and Charles Yeo Writing Prize deadline is December 31st
• The OPWPC Canvas Page offers helpful tools

Rectovaginal Fistula Due To Undiagnosed Rectal Tuberculosis In A Nulliparous Young Woman: A Case Report, Daudi Gidion, Brenda Moshi, Gregory Ntiyakunze, James Chapa, Peter Majinge, Munawar Kaguta

Obstetrics and Gynaecology, East Africa

Introduction: Rectovaginal fistulas (RVFs) can arise from various etiologies, the most common cause especially in developing countries is obstetric injury. Uncommonly, rectal tuberculosis can present as RVF, posing a diagnostic and treatment challenge especially in a patient without established risk factors. The first case of rectal tuberculosis was reported by Davis et al., in 1957, and a 2022 systematic review identified only 28 cases reported since then.

Presentation of Case: we report the case of a 25-year-old college woman who presented with a 3-month history of lower abdominal pain and fecal passage per vagina. She had undergone a failed …

Characterization Of Aromatic Stationary Phases For Uses In High Performance Liquid Chromatography, Anastasia Davis

Honors Theses

High Performance Liquid Chromatography (HPLC) is an analytical chemist technique used to separate a sample into its components to characterize and study a specific molecule or compound. Traditionally, High-Performance Liquid Chromatography in different industries, such as the environmental and pharmaceutical fields, uses stationary phases that are already well characterized, such as the C18 stationary phase for separation. However, aromatic stationary phases have recently been produced, which have phenyl groups bonded to the interior surface of the column. Still, they have not been well characterized because of how modern they are. This project characterized several aromatic stationary phases (Biphenyl, pentafluorophenyl, and …

Dentistry And The Law: Data Bank Reporting: A Consequence Of An Administrative Complaint, Daniel Schulte Jd

The Journal of the Michigan Dental Association

In this month's Dentistry and the Law column, MDA's Legal Counsel Dan Schulte explains that a Michigan dentist who settled a licensing complaint and agreed to probation, continuing education, and a fine, is surprised to learn the action was reported to the National Practitioner Data Bank (NPDB). The dentist assumed the settlement would be confidential. The column clarifies that the NPDB report is mandatory under federal law for formal proceedings, which includes compliance conferences, regardless of whether an administrative hearing occurs. The author advises that legal representation could have clarified this and outlines limited options to avoid NPDB reporting.

Attention Deficit Hyperactivity Disorder, Cannabis Use, And The Endocannabinoid System: A Scoping Review, Jennie Ryan, Mitchell Fruchtman, Andrea Sparr-Jaswa, Amy Knehans, Brooke Worster

Department of Medicine Faculty Papers

There is emerging evidence that the endocannabinoid system (ECS) plays a significant role in the pathophysiology of many psychiatric disorders, including attention deficit hyperactivity disorder (ADHD). Increasing evidence suggests that a number of neurobiological correlates between endogenous cannabinoid function and cognitive dysfunction are seen in ADHD, making the ECS a possible target for therapeutic interventions. Cannabis use and cannabis use disorder are more prevalent in individuals with ADHD, compared to the general population, and there is growing popular perception that cannabis is therapeutic for ADHD. However, the relationship between cannabis use and ADHD symptomology is poorly understood. Further understanding of …

Dean's Research Newsletter, November 2024, Neil W. Schluger

SOM Dean's Research Newsletter

No abstract provided.

Community Perspectives Of Heat And Weather Warnings For Pregnant And Postpartum Women In Kilifi, Kenya, Adelaide Lusambili, Veronique Filippi, Britt Nakstad, Julian Natukunda, Cathryn Birch, John Marsham, Nathalie Roos, Peter Khaemba, Sari Kovats

Institute for Human Development, East Africa

Background: Extreme weather is a recognised risk factor for stillbirth and preterm birth, disrupts women’s access to healthcare during pregnancy and childbirth, and negatively affects the care of newborns. Reliable and accessible heat and weather warning systems are key in alerting individuals to undertake protective measures. There is a notable gap in understanding how women and caregivers in rural East Africa perceive and utilize weather information. We investigated community members’ heat and weather warning information-seeking behaviour, identified available sources, assessed their reliability and utility, and examined their influence on behaviour.

Settings: Our research was conducted in rural Kilifi County in …

Mental Fatigue And Self-Care In Informal Oncology Caregivers: A Descriptive Mixed Methods Study, Megan Wayne

MUSC Theses and Dissertations

Purpose:

This dissertation study aimed to enhance understanding of informal caregiver wellbeing by exploring the presence of mental fatigue, the relationships among mental fatigue, self-care, and informal oncology caregiver quality of life (QOL), and determining whether differences exist in self-care engagement and QOL between caregivers who report high and low levels mental fatigue.

Problem:

Healthcare is becoming increasingly reliant on informal caregivers for the management and care of individuals with serious illnesses such as cancer. Previous research has shown that informal caregivers routinely experience many negative effects as a result of providing care including decreased mental health and …

Dementia Risk Reduction In The African Context: Multi-National Implementation Of Multimodal Strategies To Promote Healthy Brain Aging In Africa (The Africa-Fingers Project), Chinedu Momoh, Rachel Maina, Lukoye Atwoli, Karen Blackmon, Edna Bosire, Gloria Chemutai, Linda Khakali, Sylvia Mbugua, Zul Merali, Olivera Nesic Taylor,, Anthony Ngugi, Cyprian Mostert, Eunice Muthoni, Roselyter Riang’A, Mansoor Saleh, Shahin Sayed, Jasmit Shah

Brain and Mind Institute

Dementia prevention in Africa is critically underexplored, despite the continent's high prevalence of modifiable risk factors. With a predominantly young and middle-aged population, Africa presents a prime opportunity to implement evidence-based strategies that could significantly reduce future dementia cases and mitigate its economic impact. The multinational Africa-FINGERS program offers an innovative solution, pioneering culturally sensitive, multidomain interventions tailored to the unique challenges of the region. Leveraging insights from landmark global studies such as Worldwide-FINGERS and Alzheimer's Disease Neuroimaging Initiative, the program employs a multideterminant precision prevention framework, grounded in community based systems dynamics. Africa-FINGERS further integrates cutting-edge state-of-the-art multimodal biomarker …

Roger Williams University Law Review Symposium: Trauma-Informed Lawyering: Approaches To Advocating For Diverse Populations November 15, 2024, Roger Williams University School Of Law

School of Law Conferences, Lectures & Events

No abstract provided.