Medicine and Health Sciences Commons^™

The Fulcrum Podcast, Shannon Jacobs

Virginia Dental Journal

In this issue we feature the latest episodes of The Fulcrum Podcast.

Vda Pac Update, Laura Givens

Virginia Dental Journal

No abstract provided.

Vda Advocacy And Your Membership, Frank Iuorno

Virginia Dental Journal

This article outlines the advocacy efforts by the Virginia Dental Association (VDA). It emphasizes the importance of membership to support legislative initiatives, outlines key issues affecting dental providers, and discusses the impact of ERISA exemptions on dental plans. Additionally, it details the ADA's federal advocacy actions to limit ERISA preemption and strengthen state regulatory authority over dental benefits.

How Are Oral Preventive Assistants Impacting Access To Dental Care In Other States?, Paul Logan

Virginia Dental Journal

Oral Preventive Assistants (OPAs), a type of Expanded Function Dental Assistant, are improving access to dental care in states like Kansas, Missouri, and through the Indian Health Service. Studies and pilot programs show increased patient access, enhanced workflow, and high satisfaction among patients and dental teams. OPAs support hygienists and dentists by performing preventive tasks, allowing specialists to focus on complex care, without replacing existing roles. These models address workforce gaps and bottlenecks in dental care delivery.

Virginia’S Dental Workforce Shortage: A Three-Step Solution To Strengthen The Preventative Dental Workforce And Expand Access To Care, Laura Givens

Virginia Dental Journal

Virginia faces a critical shortage of dental hygienists, particularly in rural and underserved areas, leading to delays in preventative care. The Virginia Dental Association (VDA) proposes a three-step solution: leveraging internationally educated dentists, expanding the role of dental assistants, and increasing funding for dental hygiene education programs. These measures aim to address workforce shortages, improve access to care, and alleviate the education bottleneck. The VDA is actively monitoring legislative developments and advocating for solutions to strengthen Virginia’s dental workforce.

Artificial Intelligence And Dentistry: The Emerging Landscape Of Legislation In Virginia And Nationwide, Paul Supan Dds, Munira Muluke Dmd, Ms, Rick Jackomis Dds, Jd

Virginia Dental Journal

This article focuses on the integration of artificial intelligence (AI) in dentistry and the evolving legislative landscape surrounding its use. AI enhances diagnostics, treatment planning, and clinical outcomes, but its adoption requires both federal and state-level regulatory approval. The document highlights key legislative trends, including transparency in AI-driven healthcare decisions, restrictions on AI usage to ensure patient welfare, and the need for human oversight in clinical decision-making. Examples of state-level AI-related healthcare legislation from Virginia, California, Maryland, and other states are provided, showcasing diverse approaches to regulating AI in healthcare.

The Drill, Ryan Dunn

Virginia Dental Journal

The Fulcrum Podcast's "The Drill" episodes explore key topics in Virginia dentistry. Episode 16 highlights legislative efforts to address workforce shortages, VDA Member Perks, professional development opportunities, and upcoming events like Dental Days at the Capitol. Episode 19 features Ryan Dunn and Paul Logan discussing advocacy strategies for the 2026 General Assembly, focusing on dental workforce programs, expedited licensure for international dentists, and preventative assistant roles. Both episodes emphasize active member participation in shaping the future of dentistry.

Moving Forward With Purpose: An Ada Leadership Update, James Mercer Dds

Virginia Dental Journal

The ADA Board of Trustees is advancing financial sustainability, enhancing membership systems, and shaping the future of dentistry through the Oral Health Strategy 2050 initiative. The ADA Credit Union was launched to provide tailored financial services for the dental community.

Just Be Nice, Sarah Friend Dds

Virginia Dental Journal

The article "Just Be Nice" by Dr. Sarah Friend explores the increasing challenges of working with the public, particularly in high-stress professions like teaching and dentistry, exacerbated by the COVID-19 pandemic. It highlights the decline in emotional intelligence, empathy, and social connection, as supported by research from Six Seconds and Jolanta Burke. The pandemic has led to significant personality changes, increased stress, and a rise in disrespectful behavior. Dr. Friend emphasizes the importance of focusing on personal physical, emotional, and mental well-being to counteract these societal challenges and improve overall quality of life.

Building A Sustainable Dental Workforce As Virginia Enters A Pivotal Legislative Year, Marlon Goad Dds

Virginia Dental Journal

Dr. Marlon Goad, President of the Virginia Dental Association (VDA), addresses the critical dental workforce shortages in Virginia, emphasizing the need for systemic changes in dental hygiene education and infrastructure. The VDA is advocating for regulatory updates to expand educational capacity and modernize training facilities, including support for funding a new dental facility at VCU School of Dentistry. Collaboration with the American Dental Association and efforts to influence CODA standards are key components of the strategic plan. Dr. Goad highlights the importance of collective action to ensure a sustainable dental workforce and high-quality patient care in Virginia.

Virginia Dental Journal Announces Excellence Awards - Call For Submissions, Shannon Jacobs

Virginia Dental Journal

The Virginia Dental Journal is introducing the Excellence Awards in 2026 to honor outstanding contributions in writing, clinical relevance, and advancing the dental profession in Virginia. Articles published in Volume 103 (2026) are eligible, with submissions due by September 1, 2026. Award categories include the Horizon Award, Image Award, The Source Award, and Editor’s Choice. Winners will be recognized at the Virginia Dental Association’s Annual Business Meeting in January 2027. More details and guidelines are available on the Virginia Dental Journal website.

Va Dent J January, February And March 2026

Virginia Dental Journal

The January-March 2026 issue of the Virginia Dental Journal highlights key updates and initiatives from the Virginia Dental Association (VDA). It addresses Virginia’s dental workforce shortage with a proposed three-step legislative solution to expand access to care and strengthen the dental workforce pipeline. The issue features upcoming events, including the VDA Legislative Reception, Lobby Day, and the Virginia Dental Showcase. It also provides educational opportunities, such as the Dental Assisting II Program and the Virginia Dental Journal Excellence Awards. Advocacy updates focus on legislative efforts, Medicaid budget cuts, and AI regulations in dentistry. Resources for members include discounts through VDA …

Multidisciplinary Approach To Reducing Healthcare-Associated Infections: A Dnp Project, Jovinsky Jonaldo Eliscard

Walden Dissertations and Doctoral Studies

Healthcare-associated infections are increasingly common in healthcare facilities due to multiple concerns, including negligence, human error, and poor conditions. According to Chuwa (2024), secondary infections are a significant threat to patient safety and wellness, reducing an organization’s ability to realize clinical objectives. The facility is a large healthcare provider operating numerous hospitals and care homes across the United States. The organization continues to report increased infection rates across its branches owing to a lack of standardized infection prevention and control protocols, reducing its efficiency and appeal. Internal audits point to inconsistencies in general sanitation, cleanliness, and hygiene. The organization also …

Cortical Hierarchy And Aphasia Severity: The Sensorimotor–Association Gradient Modulates Lesion Effects Within Language-Specific Networks, Ida Rangus, Natalie Busby, Nicholas Riccardi, Sigfus Kristinsson, Janina Wilmskoetter, Dirk B. Den Ouden, Chris Rorden, Roger Newman-Norlund, Julius Fridriksson Ph.D., Leonardo Bonilha

Faculty Publications

Aphasia severity after stroke varies widely and is not fully explained by lesion size or location. We propose that incorporating the brain’s sensorimotor-association (S-A) gradient, reflecting cortical hierarchy, offers a biologically grounded framework for predicting language outcomes. In 236 individuals with chronic left-hemisphere stroke, we examine whether the hierarchical position of lesions in language-specific (LS) and domain-general (DG) areas modulates aphasia severity. We parcellate lesions using a cortical atlas and weigh them by each region’s S-A rank. We apply hierarchical linear regression to test whether S-A ranking and its interaction with lesion volume improves prediction of Western Aphasia Battery-Revised Aphasia …

Developing A Multidisciplinary Approach To Complex Pediatric Areodigestive Care- Where We've Been, Where We're Going, And What We've Learned Along The Way, Jason R. Brown

Grand Rounds

1. Enhance competence and expand expertise in pediatric surgical conditions prevalent in our geographical area and nationally.
2. Develop strategies to enhance communication and collaboration among interdisciplinary team members addressing pediatric surgical conditions.
3. List barriers to multidisciplinary care.

Structural Basis For The Subtype-Selectivity Of KCa2.2 Channel Activators, Young-Woo Nam, Alena Ramanishka, Yang Xu, Rose Marie Haynes Yasuda, Joshua A. Nasburg, Dohyun Im, Meng Cui, K. George Chandy, Heike Wulff, Miao Zhang

Pharmacy Faculty Articles and Research

Small-conductance (K_Ca2.2) and intermediate-conductance (K_Ca3.1) Ca²⁺-activated K⁺ channels are gated by a Ca²⁺-calmodulin dependent mechanism. NS309 potentiates the activity of both K_Ca2.2 and K_Ca3.1, while rimtuzalcap selectively activates K_Ca2.2. Rimtuzalcap has been used in clinical trials for the treatment of spinocerebellar ataxia and essential tremor. We report cryo-electron microscopy structures of NS309-bound K_Ca2.2 and K_Ca3.1, in addition to structures of rimtuzalcap-bound K_Ca2.2 and mutant K_Ca3.1_R355K. The different conformations of calmodulin and the cytoplasmic HC helices in the …

Renal Piezo2 Is An Essential Regulator Of Renin, Rose Z Hill, Jeffrey H Miner, Et Al.

2020-Current year OA Pubs

Renin synthesis and release is the rate-limiting step of the renin-angiotensin-aldosterone system (RAAS) that controls fluid homeostasis. A major activator of the RAAS is a decrease in perfusion pressure within the kidneys, suggesting a link between renal mechanotransduction and renin. However, the identity of the mechanosensor(s) in the kidneys and their physiological significance to the RAAS remain unclear. We find that loss of the force-gated nonselective cation channel PIEZO2 in cells of renin lineage dysregulates the RAAS by elevating renin. We observe that PIEZO2 is expressed in renin-producing juxtaglomerular granular cells and is required for their calcium dynamics in vivo. …

Regional Anesthesia Utilizing Liposomal Bupivacaine, With Or Without Dexamethasone, Provides Excellent Pain Control And Minimizes Opioid Consumption Following Anterior Cruciate Ligament Reconstruction, William L. Johns, Armen Voskeridjian, Benjamin Miltenberg, Rahul Muchintala, Christopher C. Dodson, Steven B. Cohen, John Salvo, Matthew Sherman, Michael G. Ciccotti, Sommer Hammoud

Rothman Institute Papers

BACKGROUND: Perioperative nerve blocks are commonly used for regional analgesia with anterior cruciate ligament (ACL) reconstruction (ACLR). Liposomal bupivacaine (LB) is a long-acting anesthetic agent providing up to 72 hours of nerve blockade. It is theorized that the addition of dexamethasone to LB (LB+dex) may prolong the analgesic duration.

PURPOSE: To characterize pain control and opioid consumption with adductor canal block (ACB), interspace between the popliteal artery and capsule of the posterior knee (iPACK), and suprasartorial infiltration (SSI) regional anesthetic techniques utilizing LB after ACLR and to compare LB versus LB+dex.

STUDY DESIGN: Randomized controlled trial; Level of evidence, 1. …

Effect Of Remineralization And Resin Infiltration On Microhardness, Mineral Content And Cervical Leakage Of Restored Demineralized Enamel., Caroline Maged Massieh, Sarah Adel Botros

Dentistry

Purpose: To evaluate the effect of remineralization and resin infiltration on microhardness, mineral content and microleakage in artificially-induced cervical enamel lesions. Materials and Methods: 50 human central incisors were assigned to 5 study groups (n=10) according to different surface intervention: Group 1: Positive Control (sound teeth not subjected to demineralization); Group 2: Negative Control (teeth subjected to demineralization); Group 3: CPP-ACP paste (remineralization of demineralized lesions with CPP-ACP, Tooth Mousse, GC); Group 4: HAp toothpaste (remineralization of demineralized lesions subjected with HAp, Herbadent Remin); Group 5: Resin infiltration (resin infiltration of demineralized lesions with ICON, DMG). Microhardness (MH) was evaluated …

Predictors Of Caregiver Burden Among The Caregivers Of Bedridden Patients In Muscat, Oman, Rawan Al Abdulsalam, Hajer Al Shaaibi, Manar Al Sanaa Al Zeedi, Rahma Al Hadhrami

Sultan Qaboos University Medical Journal

Objectives: Caring for bedridden patients is physically and emotionally demanding, often resulting in significant caregiver burden. This study aimed to assess caregiver burden and associated factors among caregivers of adult bedridden patients in Muscat, Oman. Methods: This cross-sectional study was conducted from January 2024 to February 2025 among caregivers of adult bedridden patients registered to get community services in Muscat Governorate and provided care for more than 1 month. Data were collected using the 12-item Zarit Burden Interview and the Katz Index of Independence in Activities of Daily Living. Results: A total of 200 caregivers participated; 66% were female, with …

Novel Repurposing Of Empagliflozin-Loaded Buccal Composite (Chitosan/Silk Fibroin/Poly(Lactic Acid)) Nanofibers For Alzheimer’S Disease Management Via Modulation Of Aβ–Ager–P-Tau Pathway, Samar A. Salim

Nanotechnology Research Centre

Background/Objectives: Empagliflozin (EMPA) was repurposed for Alzheimer’s disease (AD) treatment via buccal delivery, exploiting novel nanofibers (NFs) integrating chitosan (Cs), silk fibroin (Fb), and poly(lactic acid) (PLA). Methods: EMPA-loaded Cs/Fb/PLA NFs were electrospun in different formulations to optimize the formulation parameters. The optimized formulation was then investigated for its enhanced in vivo effect. Results: Optimized nanofiber diameters ranged from 459 ± 173 to 668 ± 148 nm, possessing bead-free morphology confirmed by SEM and satisfactory mechanical properties. EMPA was successfully well-dispersed in the polymer matrix as evidenced by FTIR, XRD, and drug content. The optimized NFs displayed a hydrophilic surface …

Fibrinogen-Associated Plasma Metabolites And Implications For Coagulation, Inflammation, And Vascular Diseases, Jayna C Nicholas, Taryn Alkis, Joshua C Bis, Eric Boerwinkle, Jennifer A Brody, Clary B Clish, Paul S De Vries, Yan Gao, Robert E Gerzsten, Xiuqing Guo, Andrew D Johnson, Martin G Larson, Rozenn N Lemaitre, Bruce M Psaty, Vasan Ramachandran, Alexander P Reiner, Stephen S Rich, Benjamin Rodriguez, Jian Rong, Jerome I Rotter, Jeanette Simino, Nicholas L Smith, James Wilson, Jie Yao, Alanna C Morrison, Bing Yu, Laura M Raffield

Faculty, Staff and Student Publications

Background: Fibrinogen is a critical coagulation factor that plays an essential role in thrombosis and is elevated in individuals with chronic inflammation. Here, we used fibrinogen as a representative quantitative measure of pro-coagulant risk and evaluated metabolites associated with fibrinogen levels through non-targeted plasma metabolomic profiling (Broad and Metabolon platforms).

Methods: Our analysis included 10,533 individuals across six U.S. based cohorts representing diverse population groups. The cross-sectional relationship between each of 789 tested metabolites and plasma fibrinogen concentration was assessed with adjustment for relevant covariates such as age, sex, body mass index, and circulating lipoprotein levels.

Results: Meta-analysis of per-cohort …

Optimal Timing Of Cranioplasty Post-Decompressive Craniectomy In Traumatic Brain Injury: A Systematic Review, Meta-Analysis, And Overview Of Ongoing Trials, Ashviniy Thamilmaran, Shaan Patel, Shiva A. Nischal, Honey Panchal, Kush Kale, Pious D. Patel, Jack Jallo, James S. Harrop

Department of Neurosurgery Faculty Papers

BACKGROUND: The optimal timing of cranioplasty (CP) following decompressive craniectomy (DC) for the management of traumatic brain injury (TBI) remains debated. Prior studies comparing early CP (EC) and late CP (LC) report conflicting outcomes, compounded by inconsistent timing thresholds and limited attention to effect modifiers such as implant material.

OBJECTIVE: To perform a systematic review and meta-analysis comparing outcomes of EC (≤ 90 days) versus LC (> 90 days) after DC for TBI, with particular evaluation of ultra-EC (<  35 days) and implant material.

METHODS: MEDLINE, Embase, and CENTRAL were electronically searched from inception to April 2025, supplemented by manual screening of references and grey …

Gh Alters Lymphatic Vessels In Female Mice And Stat5 Phosphorylation In Human Lymphatic Endothelial Cells, Christopher Walsh, Emily Scott, Elise Wagner, Jerome Walsh, Shashank Reddy, Arshad Ahmad, Reetobrata Basu, Eva Sevick-Muraca, Rich Brody, Uday Sandbhor, Sebastian Neggers, John J Kopchick

The Brown Foundation: Institute of Molecular Medicine

Disruption of lymphatic function underlies a broad spectrum of inflammatory and metabolic disorders, yet the hormonal pathways that regulate lymphatic biology remain poorly defined. GH, which is implicated in similar disease states, has an unclear role in lymphatic homeostasis. To address this gap, we investigated how chronic alterations in GH signaling alter lymphatic structure and function. Using transgenic mouse lines with increased, decreased, or absent GH action, we quantified the effect of GH on lymphatic pumping rate and lymphangiogenic remodeling during wound healing using near-infrared fluorescent imaging. We also measured markers of lymphatic endothelial cells using Western blot and immunohistochemistry …

Eeg Pressure Injuries, Paula Ebert

Nursing Grand Rounds

EEG Pressure Injuries. Paula Ebert, MS, RN, CNS, ACCNS-AG, CCRN, SCRN

Objectives:

• Understand the clinical impact of pressure injuries related to EEG
• Understand the implemented changes to reduce pressure injuries related to EEG
• Understand the multidisciplinary approach to addressing the problem

Utilizing Machine Learning Techniques For Computer-Aided Covid-19 Screening Based On Clinical Data, Honglun Xu, Andrews T. Anum, Michael Pokojovy, Sreenath Chalil Madathil, Yuxin Wen, Md. Fashiar Rahman, Tzu-Liang Bill Tseng, Scott Moen, Eric Walser

Engineering Faculty Articles and Research

The COVID-19 pandemic has highlighted the importance of rapid clinical decision-making to facilitate the efficient usage of healthcare resources. Over the past decade, machine learning (ML) has caused a tectonic shift in healthcare, empowering data-driven prediction and decision-making. Recent research demonstrates how ML was used to respond to the COVID-19 pandemic. This paper puts forth new computer-aided COVID-19 disease screening techniques using six classes of ML algorithms (including penalized logistic regression, random forest, artificial neural networks, and support vector machines) and evaluates their performance when applied to a real-world clinical dataset containing patients’ demographic information and vital indices (such as …

Defining Rna Oligonucleotides That Reverse Deleterious Phase Transitions Of Rna-Binding Proteins With Prion-Like Domains., Lin Guo, Jacob Mann, Jocelyn Mauna, Katie Copley, Hejia Wang, Jack Rubien, Cristian Bergmann, Jenny Carey, Jessica Merjane, Marilyn Ngo, Jiazhen Xu, Hana Odeh, Jiabei Lin, Bo Lim Lee, Laura Ganser, Emma Robinson, Kevin Kim, Anastasia Murthy, Tapas Paul, Bede Portz, Amanda Gleixner, Zamia Diaz, Ashleigh Smirnov, George Padilla, Ellen Lavorando, Carolann Espy, Yulei Shang, Eric Huang, Alessandra Chesi, Nicolas Fawzi, Sua Myong, Christopher Donnelly, James Shorter

Department of Biochemistry and Molecular Biology Faculty Papers

RNA-binding proteins (RBPs) with prion-like domains (PrLDs), such as FUS and TDP-43, condense into functional liquids, which can transform into pathological fibrils that underpin fatal neurodegenerative disorders, including amyotrophic lateral sclerosis (ALS)/frontotemporal dementia (FTD). Here, we define short RNAs that prevent FUS fibrillization by promoting liquid phases and distinct short RNAs that prevent and reverse FUS condensation and fibrillization. These activities require interactions with multiple RNA-binding domains of FUS and are encoded by RNA sequence, length, and structure. We define a short RNA that dissolves cytoplasmic FUS aggregates, restores nuclear FUS, and mitigates FUS toxicity in optogenetic models and ALS …

Development Of A New Clinical Prediction Rule For Candidaemia, Diego U Vazquez-Omana, Paula Beltran-Reyes, Jorge E Alonso-Montoya, Nayeli E Avalos-Celis, Edgar D Centeno-Matus, Sandra Rajme-Lopez, Karla M Tamez-Torres, Bernardo A Martinez-Guerra, Carla M Román-Montes, Luis Ostrosky-Zeichner, Alfredo Ponce-De-Leon, María F Gonzalez-Lara

Faculty, Staff and Student Publications

Background: Candidaemia is a leading cause of hospital-acquired bloodstream infections, especially in intensive care unit (ICU) patients, and is associated with high mortality and healthcare costs. Prediction rules aid in the identification of patients at risk of developing candidaemia. This study aimed to develop a prediction rule for candidaemia within our population and evaluate its performance against two established rules: the Ostrosky-2 and the Nebraska Medical Center (NMC).

Methods: We conducted a case-control study at a tertiary care center in Mexico City. Data were collected from candidaemia patients and controls matched by sex, age, admission area, and prior hospitalization at …

Multi-Institutional Normal Tissue Complication Probability (Ntcp) Prediction Model For Mandibular Osteoradionecrosis: Results From The Predmorn Study, Laia Humbert-Vidan, Christian R Hansen, Steven Petit, Carles Muñoz-Montplet, Katrina Hueniken, Abdallah S R Mohamed, Deborah P Saunders, Vinod Patel, Gerda M Verduijn, Wilma D Heemsbergen, Arjen Van Der Schaaf, Max Witjes, Suzanne P M De Vette, Mohammad Moharrami, Abdul A Khan, Jordi Marruecos Querol, Irene Oliveras Cancio, Mike Oliver, Peter Reich, Stacey A Santi, Andrew G Pearce, Stephen Y Lai, Andrew P King, Ali Hosni, Andrew J Hope, Erin E Watson, Johannes A Langendijk, Jørgen Johansen, Amy C Moreno, Clifton D Fuller, Lisanne V Van Dijk, Teresa Guerrero Urbano

Faculty, Staff and Student Publications

Purpose: Mandibular osteoradionecrosis (ORN) is a severe late complication affecting patients with head and neck cancer (HNC) treated with radiation therapy (RT) that significantly impacts patients' quality of life and can require costly interventions. Although radiation dose is a key factor, other clinical and demographic risk factors also influence ORN development. Previous predictive models have primarily been single-institutional, limiting their generalizability. In this first analysis from the PREDMORN Consortium, we have aimed to reproduce existing statistical association and modeling analyses on the largest and most diverse mandibular ORN cohort worldwide to allow comparison with previous studies.

Methods and materials: This …

Comparison Of Surgery And Medicine On The Impact Of Diverticulitis (Cosmid) Trial: A Protocol For A Pragmatic Randomised Study Of Diverticulitis Treatment In The Usa, Mariam N Hantouli, Robert H Schmicker, Janice E Tufte, Fadwa G Ali, Robert D Bennett, Jessica N Cohan, Bryan A Comstock, Thomas Curran, Giana H Davidson, Samuel Eisenstein, Katherine N Fischkoff, Fergal J Fleming, Irena Gribovskaja-Rupp, Mehraneh Dorna Jafari, Larry G Kessler, Mukta K Krane, Sarah O Lawrence, James T Mccormick, Stefanos G Millas, Arden M Morris, Kelsey M Pullar, Caroline E Reinke, Julia T Saraidaridis, Vlad V Simianu, Suzanne P Watkins, Nicole B White, Elizabeth C Wick, Nicole Wieghard, David R Flum, Thomas E Read

Faculty, Staff and Student Publications

Introduction: Each year, millions of people experience recurrent diverticulitis episodes. Elective sigmoid colon resection reduces the risk of recurrence, but The American Society of Colon and Rectal Surgeons recommends individualising surgical decisions based on the impact of the condition on a patient's quality of life (QoL). However, no threshold for QoL impairment has been established to guide decision-making, and evidence comparing elective colectomy with medical management in terms of QoL limitation is limited. To address these gaps and to guide treatment decision-making, we designed the Comparison of Surgery and Medicine on the Impact of Diverticulitis (COSMID) trial.The COSMID trial is …