Medicine and Health Sciences Commons^™

Establishing A Variant Allele Frequency Cutoff For Manual Curation Of Medical Exome Sequencing Data, Kate Sears, Caylin Hickey, Ryan Vincent, Jennifer Stocks-Candelaria, Jason Tate, Cody Bumgardner, Shulin Zhang, Justin B. Miller

Pathology and Laboratory Medicine Faculty Publications

Medical exome sequencing pipelines consist of various preprocessing steps to prioritize credible causal variants before a pathologist or variant curation scientist manually interprets potential findings that are then reported to patients. The variant allele frequency (VAF), reported as the fraction of sequencing reads supporting a variant call, can be used to screen for technical artifacts, yet a specific filtering threshold has yet to be established. A total of 13,122 manually curated variants, sequenced from 289 patients using the Agilent SureSelect Focused Exome enrichment kit at the University of Kentucky Clinical Genomics laboratory from October 2019 to May 2023, were evaluated. …

Implementation Of A Code Sepsis Response Protocol In A Large Emergency Department Increases Rate Of Timely Antibiotic Administration In Patients With Suspected Sepsis, Leah Shults, Kailey Cox, Destiny Kramer, Grace Mariano, Amy Pinkos, Jordan Sanders, Kimberly Patterson

Articles, Abstracts, and Reports

No abstract provided.

Make It Your Hobby, To Check On The Lobby, Kenda Bishop, Berlyn Davis, Daveena Maple

Articles, Abstracts, and Reports

No abstract provided.

Zoll® Immediate Pad Placement (Zipp) Pilot: Optimizing Aed Pad Placement And Reducing Time To Defibrillation, Jonathan Eyestone, Dana Gilbreth, Amanda Maloney, Tina Pham

Articles, Abstracts, and Reports

No abstract provided.

Sirs Alert In Emergency Department Triage, Reilly Gardner, Alaine Schauer

Articles, Abstracts, and Reports

No abstract provided.

Increasing Special Pathogen Preparedness At A Frontline Hospital: A Quality Improvement Project, Mckenna Freed, Christa Arguinchona, Barbara Bennett-Wolcott

Articles, Abstracts, and Reports

No abstract provided.

Nurse Education For Perinatal Substance Use Disorder And Mental Health, Michelle Simpson

Articles, Abstracts, and Reports

No abstract provided.

Providing Skilled Mentorship For A Newly Forming Research And Evidence-Based Practice (Ebp) & Education Council, Bedane Geleta, Gale Springer, So Young Pak

Articles, Abstracts, and Reports

No abstract provided.

“Nothing Is Going To Replace An In-Person Visit”: Canadian Long-Term Care Providers’ And Recipients’ Perspectives On When Telehealth For Physician Visits Is Not Appropriate, Tyler R Cole, Valorie A Crooks, Janice Sorensen, Sherin Jamal, Akber Mithani, Lillian Hung, Jeremy Snyder, Catherine Youngren

Faculty and Staff Publications

Background: Within long-term care (LTC) homes, telehealth use has been found to reduce unnecessary emergency department transfers, support the care needs of rural and underserved communities, and supplement in-person physician care. Despite these benefits, it is not well understood when telehealth is not an appropriate medium for providing physician care to residents with complex health needs. This knowledge gap must be addressed given the recent rise in telehealth use in LTC homes in many health systems following the COVID-19 pandemic, when virtual care use increased in many health care sectors to limit travel and in-person exposure risks, that is expected …

Whether To Offer Interventions At The End Of Life: What Physicians Consider And How Clinical Ethicists Can Help, Joelle Robertson-Preidler, Mikaela Kim, Sophia Fantus, Janet Malek

Faculty and Staff Publications

Background: Advances in life-prolonging technologies increasingly create dilemmas for physicians who must decide whether to offer various interventions to patients nearing the end of life. Clinical ethicists are often consulted to support physicians in making these complex decisions and can do so most effectively if they understand physicians' reasons for making recommendations in this context.

Methods: Semi-structured interviews were conducted with surgeons, nephrologists, intensivists, emergency physicians, and oncologists regarding the considerations they have used to make decisions about offering interventions for patients nearing the end of life. Interview transcripts were thematically analyzed.

Results: We identified six types of considerations physicians …

A Randomized Controlled Trial Of A Compassion-Centered Spiritual Health Intervention To Improve Hospital Inpatient Outcomes, Jennifer S Mascaro, Patricia K Palmer, Marcia J Ash, Marianne P Florian, Deanna M Kaplan, Roman Palitsky, Steven P Cole, Maureen Shelton, Charles L Raison, George H Grant

Faculty and Staff Publications

Background: Inpatient medical settings lack evidence-based spiritually integrated interventions to address patient care needs within a pluralistic religious landscape. To address this gap, CCSH™ (Compassion-Centered Spiritual Health) was developed to leverage the skillsets of healthcare chaplains to improve patient outcomes through spiritual consultation. Here, we report the results of a randomized, wait-list controlled, pre-registered (NCT03529812) study that evaluated the impact of CCSH on patient-reported depression and explored putative mediators of CCSH's effects.

Method: Chaplain residents were randomized to be trained in CCSH as part of their clinical pastoral education (CPE) residency in the fall (n = 8) or …

[Review Of The Book The Pioneer And The Innkeeper: Adventures In Uncertainty And Faith Around The World, By C. & M. Wilson], John E. Snellings

Department of Family and Community Medicine Faculty Publications

[First paragraph] The full breadth and powerful impact of family medicine as a global specialty is on full display in The Pioneer and the Innkeeper: Adventures in Uncertainty and Faith Around the World. In this compelling memoir, readers follow the life and career of Dr Cal Wilson, a family physician and global health expert, as he and his family pursue medical missions across the world. Not to be outdone by her husband, Mimi Wilson’s life story is co-featured in the book, and her own heart for service (in forms slightly different from those of her husband), create a dynamic …

Analysis Of Errors In The Management Of Cutaneous Disorders, Robert J. Pariser, Sarah Alnaif

Department Dermatology Faculty Publications

In this study, we prospectively and retrospectively evaluated the occurrence of errors in the management of cutaneous disorders from patient visits and medical records in a single dermatology practice in southeast Virginia over a 3-year period (June 2020-July 2023). Providers should be able to improve diagnostic accuracy by utilizing established rapid bedside diagnostic techniques.

Engaging The Community, Providing Hopes, Mackenzie Peeke, Margaret West, Alyssa Wilkinson, Matthew Serrata, Michael Baroody, Conner Tembe, Chrisney Yerena

HOPES Free Clinic Publications

Founded in the 1970s as a grassroots effort to provide care to the underserved population of Hampton Roads, Eastern Virginia Medical School (EVMS) has long been committed to community-centered care. The HOPES Free Clinic is a manifestation of that mission. Launched in 2011 as a student-run phone triage service, the Health Outreach Partnership of EVMS Students (HOPES) later transitioned to provide direct clinical services—becoming the first student-run free clinic in the Commonwealth of Virginia. In 2014, HOPES integrated into Community Engaged Learning to enhance and solidify its efforts. Since its inception, medical and health professions students have partnered with volunteer …

Systemic Therapy Targeting Psoriatic Inflammation Is Associated With Decreased Incidence Of Dementia: An Observational Retrospective Cohort Study, Madison P. Olexson, Ana Ormaza Vera, Chunghwan Ro, Clinton W. Enos

Department Dermatology Faculty Publications

[Introduction] To the Editor: Psoriasis, an immune-mediated chronic inflammatory skin disorder, has been implicated in cognitive impairment and dementia.1, 2, 3 Emerging evidence suggests that systemic inflammation contributes to neuroinflammation and resultant cytokine-driven neurodegeneration, although findings remain inconclusive.1, 2, 3 While systemic therapies such as biologics and conventional disease-modifying antirheumatic drugs are routinely used in psoriasis management, their role in modulating dementia in this population remains underexplored, with research yielding mixed results.1, 2, 3 We conducted a large-scale, retrospective cohort study to investigate the relationship between psoriasis and dementia and whether systemic treatments for psoriasis impact this association.

Barriers And Facilitators To Accessing Mental And Physical Health Care Among Sexual Minority Women: A Qualitative Exploration, Charlotte A. Dawson, A. Moulder, Kristin E. Heron

Department Psychiatry & Behavioral Science Faculty Publications

Cisgender sexual minority women (SMW, e.g., lesbian, queer) are at greater risk for poor mental and physical health compared to heterosexual women and face challenges when accessing health care. Previous research has largely focused on general sexual and gender minority barriers to health care, but more research is needed on the experiences of specific subgroups, including cisgender SMW. The current study qualitatively explored barriers and facilitators for cisgender SMW seeking health care. Twenty cisgender SMW aged 18-40 recruited using Meta advertisements and past participant lists completed 45 min semi-structured interviews and a brief survey. Thematic analysis conducted by two coders …

Strategies To Enhance Gme Program Coordinator Job Satisfaction And Well-Being, Stuart Slavin, Julie Beckerdale, April L. Mcguire, Linda Ortiz Morrison, Melanie Pigott, Carrie L. Racsumberger, Evangelina Rangel, Bret Stevens, Ramona Tirado, Cynthia D. Thompson, Latoya Wright

Department Dermatology Faculty Publications

[Introduction] Program and institutional coordinators in graduate medical education (GME) have very complex jobs that are often highly pressured and demanding, requiring a diverse skill set to manage effectively. While these positions can be immensely gratifying, the demands and pressures inherent in the roles pose threats to job satisfaction as well as risks to mental health and well-being. A national survey of 6372 coordinators found that 20.4% reported being dissatisfied or very dissatisfied with work, and 27.9% reported being likely or very likely to leave their job in the next year. ¹ Of the coordinators surveyed 36.3% screened positive for …

Igf-1 As A Biomarker For Symptom Severity In Adult Traumatic Brain Injury: Evidence From An Observational Study, Justin Weppner, Kimberly Rosenthal, Jennifer Bath, Tonja Locklear, Melissa Martinez

Department of Physical Medicine & Rehabilitation Faculty Publications

Traumatic brain injury (TBI)-related growth hormone deficiency is often undertreated, despite documented physical, metabolic, and neuropsychiatric effects. Insulin-like growth factor (IGF-1), with neuroreceptors located in brain regions responsible for learning, memory, and mood, regulates cerebral blood flow, neurogenesis, and neuroplasticity. The aim of this study was to determine associations between IGF-1 levels and post-TBI symptom severity, anxiety, and depression. This retrospective observational study at an Academic Brain Injury Center included participants evaluated 3-12 months post-TBI with available IGF-1 values and complete Rivermead Post-Concussion Symptoms Questionnaire (RPQ-13), Generalized Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-9 (PHQ-9) responses. Patients under 18 or …

Public Perceptions Of Neurotechnologies Used To Target Mood, Memory, And Motor Symptoms, Rémy A. Furrer, Amanda R. Merner, Ian Stevens, Peter Zuk, Theresa Williamson, Francis X. Shen, Gabriel Lázaro-Muñoz

Articles

Public attitudes toward four neurotechnologies for treating three types of brain disorders (mood, motor, and memory) vary on a range of metrics, such as perceived risk, invasiveness, and likelihood of use. In a survey of 1,052 US participants, deep brain stimulation (DBS) was seen as the most invasive and risky among the surveyed methods, involving the greatest perceived change to the person and the least likely to be used personally. Non-surgical options like transcranial magnetic stimulation (TMS) and pills were viewed as more acceptable. Devices targeting motor symptoms were rated as more beneficial and acceptable than those for mood or …

Standardization And Accuracy Of Race And Ethnicity Data: Equity Implications For Medical Ai, Alexandra Tsalidis, Lakshmi Bharadwaj, Francis X. Shen

Articles

Abstract

The rapid integration of artificial intelligence (AI) into healthcare has raised many concerns about race bias in AI models. Yet, overlooked in this dialogue is the lack of quality control for the accuracy of patient race and ethnicity (r/e) data in electronic health records (EHR). This article critically examines the factors driving inaccurate and unrepresentative r/e datasets. These include conceptual uncertainties about how to categorize races and ethnicity, shortcomings in data collection practices, EHR standards, and the misclassification of patients’ race or ethnicity. To address these challenges, we propose a two-pronged action plan. First, we present a set of …

Revoluntionizing Brain Research Using Portable Mri In Field Settings: Public Perspectives On The Ethical And Legal Challenges, Molly K. Madzelan, Frances Lawrenz, Susan Wolf, Francis X. Shen

Articles

Introduction

New, highly portable MRI (pMRI) technology promises to revolutionize brain research by facilitating field-based studies that can expand research to new settings beyond the traditional MRI suite in a medical center. At this early stage of development, understanding public knowledge and attitudes about pMRI research is crucial.

Objective In this article we present the first empirical study of the general public’s willingness to participate in pMRI research, and their perceptions of expected benefits and concerns.

Methods & Results

We conducted a nationally representative online survey (N = 2,001) administered Aug. 15-31, 2022. We found that respondents were overwhelmingly willing …

Converting “Nonlesional” Imaging Occult Epilepsy Into A Focal Lesional Entity Using Advanced Imaging Techniques: Illustrative Case, Muhammad Usman Khalid, Flavius D. Raslau, Valentinos Zachariou, David Powell, Zachary Winder, Ryan Cloyd, Sarah Helen Thomas, John Kuipers, Rachel Ward Mitchell, Riham H. El Khouli, Timothy J. Ainger, Sally Mathias, Farhan A. Mirza

Neurosurgery Faculty Publications

BACKGROUND To achieve the best possible outcome in surgical refractory epilepsy, the seizure onset zone must be accurately identified prior to treatment.

OBSERVATIONS A 38-year-old man presented with tonic-clonic and focal seizures 2–3 times per month, refractory to antiseizure medications. Scalp EEG, MRI, PET, ictal SPECT, magnetoencephalography, and stereo-EEG (SEEG) did not provide conclusive seizure onset zone localization. Subsequently, the patient was included in the authors’ ongoing postictal arterial spin labeling (ASL) study and additional postprocessing was performed with a morphometric analysis program (MAP) and texture analysis. Using these results, the authors reexamined the original structural MR images, with attention …

New Insights Into The Ovulatory Process In The Human Ovary, Misung Jo, Mats Brännström, James W. Akins, Thomas E. Curry

UK CARES Faculty Publications

BACKGROUND: Successful ovulation is essential for natural conception and fertility. Defects in the ovulatory process are associated with various conditions of infertility or subfertility in women. However, our understanding of the intra-ovarian biochemical mechanisms underlying this process in women has lagged compared to our understanding of animal models. This has been largely due to the limited availability of human ovarian samples that can be used to examine changes across the ovulatory period and delineate the underlying cellular/molecular mechanisms in women. Despite this challenge, steady progress has been made to improve our knowledge of the ovulatory process in women by: (i) …

Clinicians Perspective On The Implementation Of Person-Centered Care In Persons With Aphasia, Carmen S. Alderman

Theses and Dissertations--Communication Sciences and Disorders

This paper examines speech-language pathologist perspective on implementing person-centered care for persons with aphasia. Person-centered care is based on the social model, which emphasizes the importance of including the client. The survey addressed clinicians’ use of person-centered care related to collaborative goal setting and treatment planning, as well as facilitators and barriers to implementing person-centered care for individuals with aphasia based on the view of practicing clinicians across a variety of settings. The results indicated most speech-language pathologists have heard of person-centered care, understand the importance of involving clients in goal setting, ask clients about their preferences when setting goals, …

Summary Of Eco Groups Learning Evaluation, Claire Devine, Abby Bush, Lisa Angus

Articles, Abstracts, and Reports

No abstract provided.

Mindfulness Intervention In A Public Health Class, Marygrace Kasprzak, Gracie Kauffman

Student Research Design & Innovation Symposium

Mindfulness is a practice defined as “paying attention on purpose,” and involves practicing activities such as yoga and meditation. These practices have been consistently linked to numerous benefits, including stress reduction, improved wellbeing, and a more positive outlook on life. Additionally, there is evidence that suggests mindfulness may enhance academic performance among college students. This mindfulness intervention experiment aimed to assess the impact of a regular mindfulness meditation practice on academic performance, engagement, and overall student wellbeing in a college setting. The experiment was conducted with two health sciences courses (HSC1100 and HSC2130) at Johnson & Wales University. The HSC1100 …

The Correlation Between Insomnia & Student Status, Monee Hall, Bridget Vanderveer, Joey Cobbett

Student Research Design & Innovation Symposium

The purpose of the study is to understand the correlation between insomnia and student status. Student status refers to a person being enrolled in a course of study. This project focused specifically on college level students for this research with the goal to understand the factors that relate to insomnia within college students. Other researchers have posed recommendations within their studies such as better health care within the universities, as well as better sleep habits. Throughout these studies, there were comparisons made between majors, general public v. student status, on which populations struggle more with insomnia-based symptoms. Understanding the correlation …

Resilience And Reality: Exploring The Lived Experiences Of People Living With Hiv In Texas During The Covid-19 Pandemic – A Qualitative Study., Ahmed F. Alanazi

Social Work Dissertations - Archive

This study investigated the lived experiences of individuals living with HIV (PLWH) in the Dallas-Fort Worth (DFW) area of Texas during the COVID-19 pandemic, using an Interpretative Phenomenological Analysis (IPA) framework. The research examined the intersection of health, social dynamics, and psychological resilience among PLWH, who faced compounded vulnerabilities due to systemic inequities and the dual public health crises of HIV and COVID-19. Through semi-structured interviews with ten participants from diverse backgrounds, the study captured the profound impacts of disrupted healthcare systems, heightened stigma, and social isolation on this marginalized population. The findings reveal that the pandemic exacerbated existing inequities …

Biomedical Relation Extraction In The Era Of (Large) Language Models, Yuhang Jiang

Theses and Dissertations--Computer Science

Biomedical relation extraction is a key task in information extraction supporting downstream applications such as knowledge discovery, information retrieval, and question answering. As such, improvements in relation extraction (RE) are expected to have major implications for other information needs in biomedicine. In this dis- sertation, we pursue biomedical relation extraction in several advanced settings with recent advances in large language models (LLMs) and retrieval augmented generation (RAG). First, we address an important slot filling task on social media that arose during the Covid-19 pandemic, using the idea of continuous prompts with encoder models. Next, we handle a tricky dynamic n-ary …

Evolution, Karen Jackson

Quill & Scope

Sparked by a Microbiology II lecture on plague, this piece reflects on the evolution of medicine across centuries. From herbs and leeches to vaccines and antibiotics, our tools have changed, but the plague doctor and the modern scientist are united by a shared desire to help and heal.