Medicine and Health Sciences Commons^™

Time To Bring Curiosity Back Into The Practice Of Medicine, Robert Bing-You

Journal of Maine Medical Center

No abstract provided.

Medical School Watercooler Newsletter - January 5, 2020, Lindsey Lyle

Watercooler Newsletter

This is the January 5, 2020 edition of the Frederick P. Whiddon College of Medicine's newsletter - Watercooler.

Contents Include:

• Mark Your Calendar: Upcoming grand rounds
• Muslims in Medicine interest group addresses physician burnout
• USA Health and USA College of Medicine represented in Mobile Bay’s 40 Under 40
• Student-Run Free Clinic makes an impact in 2019

Response By Endodontists To The Sars-Cov-2 (Covid−19) Pandemic: An International Survey, Johnah C. Galicia, Rahma Mungia, Melanie V. Taverna, Marissa J. Mendoza, Carlos Estrela, Alexis Gaudin, Chengfei Zhang, B. A. Vaughn, Asma A. Khan

Pacific Faculty Work

As SARS-CoV-2 continues to wreak havoc, health care workers are on the front lines to protect our communities. Dentists, particularly endodontists who manage dental emergencies, are engaged in high risk procedures that necessitate the modification of their treatment strategies in order to protect themselves, their staff and their patients from exposure to SARS-CoV-2. This study gathered international data from 448 endodontists to describe their awareness, their clinical care modifications, their strategies for re-opening and their reflection on the effects of the pandemic on their lives. Most endodontic practitioners (78%, n = 350) provided but limited their treatments to emergency care …

Key Regeneration-Free Ciphertext-Policy Attribute-Based Encryption And Its Application, Hui Cui, Robert H. Deng, Baodong Qin, Jian Weng

Research Collection School Of Computing and Information Systems

Attribute-based encryption (ABE) provides a promising solution for enabling scalable access control over encrypted data stored in the untrusted servers (e.g., cloud) due to its ability to perform data encryption and decryption defined over descriptive attributes. In order to bind different components which correspond to different attributes in a user's attribute-based decryption key together, key randomization technique has been applied in most existing ABE schemes. This randomization method, however, also empowers a user the capability of regenerating a newly randomized decryption key over a subset of the attributes associated with the original decryption key. Because key randomization breaks the linkage …

Study Of Cost Utilization Of Organophosphate And Zinc Phosphide Poisoning: A Prospective Observational Study, Girish P. Thunga Dr

Manipal College of Pharmaceutical Sciences, Manipal Theses and Dissertations

Introduction and Aim: Pesticides and rodenticides have been useful for killing pests and rodents respectively but at the same time proven to be harmful to humans as well. They are easily available and accessible to the common people due to which they are often misused for self-harm predominantly in developing countries. There is a lot of burden on the healthcare system due to limited healthcare resources. This study aims to estimate the various costs incurred by the patients during the complete hospitalization period. Methodology: A prospective observational study was conducted in a tertiary care hospital. The patient related data was …

To Study The Treatment Pattern Of Paraquat Poisoning In A Tertiary Care Hospital: A Retrospective Analysis, Girish P. Thunga Dr

Manipal College of Pharmaceutical Sciences, Manipal Theses and Dissertations

Introduction Paraquat poisoning is a major medical problem in many parts of Asia, Pacific nations, and America [1] . It is rapidly-acting, nonselective and relatively inexpensive due to which widespread use in the developing world is.An increased rate of morbidity and mortality is associated with Paraquat poisoning. General treatment includes gastrointestinal decontamination like treatment with activated charcoal and fuller's earth given to minimize the absorption Haemodialysis and Hemoperfusion also plays important role for elimination of poison. Immunosuppression is also widely practised with Dexamethasone, Cyclophosphamide and Methylprednisolone. Many evidences showed antioxidants such as N-Acetylcysteine also beneficial. However, there are no clear …

Effect Of Metformin In Wound Healing In Diabetic Foot Ulcer Patients –A Prospective Observational Study, Sonal M. Sekhar Dr

Manipal College of Pharmaceutical Sciences, Manipal Theses and Dissertations

Background: Diabetic foot ulcers (DFUs) are one of the major complications of poorly controlled diabetes. The DFUs result due to the damage and breaking of the skin beneath it. The most commonly affected locations of DFUs are the extreme proximities of the toes. The wounds associated with foot ulcerations are the leading causes of the leg amputation. Metformin, a widely used anti- diabetic agent has a vital role in AMPK activation as well as plays an inhibitory effect on the mTOR, and Cyclin D1 pathways. Thereby causing a delay in the usual process of healing of wound in the patients. …

Evaluation Of Antimicrobial Agents With Potential To Develop Adverse Mental Health In Geriatrics, Sonal M. Sekhar Dr

Manipal College of Pharmaceutical Sciences, Manipal Theses and Dissertations

Background: With advanced age, there is increased risk of various infections. Antimicrobial agents are majorly prescribed for management of these infections. Due to age-related physiological changes, many of the antimicrobial agents cause adverse mental health. Therefore, we evaluated the geriatric antimicrobial prescription to determine its potential to cause mental health issue. Objectives:  To prepare a checklist for antimicrobials which have the potential to cause adverse mental health.  Evaluate the geriatric antimicrobial prescription to determine its potential to cause mental health issue.  To determine antimicrobial-related mental health problems in geriatric patients. Methods: A prospective observational study was conducted …

Effectiveness Of Pictograms In Patients Or Caregivers In Healthcare Settings: A Systematic Review, Rajesh V Dr

Manipal College of Pharmaceutical Sciences, Manipal Theses and Dissertations

Background: Pictograms are a graphical symbol that conveys a concept through its pictorial resemblance to a physical object, pictorial representation has shown to have a potential in enhancing patient knowledge. Methodology: The systematic review was conducted according to PRISMA guidelines. Randomized controlled trials including participants over 18 years older were included in the review. RCTs were included as it reduces certain type of bias by randomly allocating the participants. The risk of bias was assessed using Cochrane risk of bias tool, which assessed 5 different domains and scores were given according to their indication of low, high and unclear risk. …

Potential Drug- Drug Interactions Between Anti- Tumor Agents And Other Prescribed Medications In Lung Cancer Patients: A Retrospective Study, Mahadev Rao Dr

Manipal College of Pharmaceutical Sciences, Manipal Theses and Dissertations

Background: Cancer patients are more prone to drug interactions as multiple medications are administered concomitantly along with cytotoxic agents in addition with drugs targeted to treat underlying comorbidities, and these are poorly evaluated. In the challenging field of cancer where the number of patients diagnosed increases in a geometric manner, the difficulties faced by healthcare professionals to treat the patients poses a great deal of arduous task in designing an optimum therapeutic regimen. This study addresses the current dilemma and suggests to bring about a resolution to the existing problem. Objectives: The primary objective of this study is to characterize, …

Study Of Drug Related Problems In Type Ii Diabetes Mellitus Patients With Comorbidities In A Tertiary Care Hospital -A Retrospective Study, Leelavathi D. Acharya Dr

Manipal College of Pharmaceutical Sciences, Manipal Theses and Dissertations

IntroductionDiabetes Mellitus is a metabolic disorder characterised by high sugar level over a prolonged period of time. It is associated with the developing of complication due to a number of factors like the degree of vulnerability, susceptibility, age, health status and immune system condition.(1) Patients with Diabetes Mellitus along with morbidities receiving medications lead to different Drug related problems like polypharmacy, drug-drug interaction, adverse drug reactions etc.ObjectivesTo assess the Drug related problems in Type 2 Diabetes Mellitus patients with comorbidities using PCNE classification and Hepler Strand classification in a tertiary care hospital in South India.Methodology A retrospective observational study conducted …

Physiologically Based Pharmacokinetic Modelling Of Aminophylline And Caffeine, Surulivelrajan Mallayasamy Dr

Manipal College of Pharmaceutical Sciences, Manipal Theses and Dissertations

Background: Irregularity in temperature regulation and control of breathing during the first few days are the reasons for the abrupt deaths in preterm neonates, of which apnea in premature neonates constitutes the major reason for these deaths. Methylxanthine’s (aminophylline and caffeine) are used in its treatment. Majority of the hospitals follow a standard treatment regimen for both aminophylline and caffeine irrespective of preterm’s age and body weight which leads to toxic or sub-therapeutic concentrations of the drug. Using Physiologically based pharmacokinetic modelling (PBPK), various drug characteristics and its deportment can be studied. This helps in predicting the Pharmacokinetic parameters of …

Prevalence And Factors Influencing Inappropriate Medication Use In Elderly Patients - A Retrospective Study Using Updated Beers Criteria, Sreedharan Nair Dr

Manipal College of Pharmaceutical Sciences, Manipal Theses and Dissertations

Background: A major safety concern in elderly population is the use of inappropriate medication. Owing to aging associated with anatomic and physiologic changes, pharmacokinetic and pharmacodynamics of drugs are prone to alter in these elderlies. Inappropriate drug prescribing and polypharmacy in this population elevates the risk of adverse drug reactions. Objectives: To assess the prevalence and factors influencing Potentially Inappropriate Medication (PIM) use in elderly patients according to updated Beers Criteria. Methodology: A retrospective observational study was carried out. Case records of 580 patients aged 65 years and above were reviewed. Every case record was identified for at least one …

Prenatal Choline Supplementation During High-Fat Feeding Improves Long-Term Blood Glucose Control In Male Mouse Offspring, Hunter W. Korsmo, Kaydine Edwards, Bhoomi Dave, Chauntelle Jack-Roberts, Huanling Yu, Anjana Saxena, Marie Salvador, Moshe Dembitzer, Jaskomal Phagoora, Xinyin Jiang

Publications and Research

Maternal obesity increases the risk of metabolic dysregulation in rodent offspring, especially when offspring are exposed to a high-fat (HF), obesogenic diet later in life. We previously demonstrated that maternal choline supplementation (MCS) in HF-fed mouse dams during gestation prevents fetal overgrowth and excess adiposity. In this study, we examined the long-term metabolic influence of MCS. C57BL/6J mice were fed a HF diet with or without choline supplementation prior to and during gestation. After weaning, their pups were exposed to either a HF or control diet for 6 weeks before measurements. Prenatal and post-weaning dietary treatments led to sexually dimorphic …

Attitudes Towards Mental Illness In American Evangelical Communities, Supernaturalism, And Stigmatization, Nahanni Freeman, Isaac Baldwin

Faculty Publications - Psychology Department

Social-cognitive variables and religious attributions regarding mental illness were examined with a homogeneous sample of 180 American Evangelical Christians, using a novel tool and the Mental Health Knowledge Scale (MAKS). In the first trial, participants were randomly assigned to one of two Bible verse priming conditions, which made salient willpower, faith and anxiety-reduction or the suffering Christ. Priming effects revealed that those exposed to the willpower-faith admonishment condition showed lower stigma on the MAKS and stronger condition recognition scores. Participants who endorsed unilateral religious causes and solutions to mental illness also presented with less knowledge about mental health disorders and …

Prevalence Of Sensorineural Hearing Loss In Children With Palliated Or Repaired Congenital Heart Disease., Lalitha Gopineti, Mane Paulpillai, Andrea Rosenquist, Andrew H. Van Bergen

Manuscripts, Articles, Book Chapters and Other Papers

Background Children with congenital heart disease (CHD) are at increased risk of neurodevelopmental deficits, and the presence of sensorineural hearing loss (SNHL) may further lead to poor language skills acquisition and speech delays. Prevalence of SNHL in the general pediatric population is estimated to be 0.2% at birth to 0.35% during adolescence. Very few studies have attempted to estimate SNHL prevalence in children who have undergone congenital heart surgery. Methods This retrospective study aimed to estimate SNHL prevalence in children who underwent congenital heart surgery in our institution and were followed up in our high-risk pediatric cardiology clinics for four …

Geospatial Variation In Caesarean Delivery, Jennifer Vanderlaan, Johnathan A. Edwards, Anne Dunlop

Nursing Faculty Research

Aim: The purpose of this study was to evaluate the variation in caesarean delivery rates across counties in Georgia and to determine whether county-level characteristics were associated with clusters. Design: This was a retrospective, observational study.

Methods: Rates of primary and repeat caesarean by maternal county of residence were calculated for 2008 through 2012. Global Moran's I (Spatial Autocorrelation) was used to identify geographic clustering. Characteristics of high and low-rate counties were compared using student's t test and chi squared test.

Results: Spatial analysis of both primary and repeat caesarean rate identified the presence of clusters (Moran's I = 0.375; …

To Study Disease Activity And Various Counseling Techniques In Rheumatoid Arthritis Patients, Kanav Khera Dr

Manipal College of Pharmaceutical Sciences, Manipal Theses and Dissertations

Background: Education and counseling creates awareness amongst RA patients regarding the nature of their disease, drugs and lifestyle. Often, early diagnosis of RA prevents permanent disability. However, this does not happen in many cases. With the intention of coping with RA related complications and promoting healthy living, this study assessed the importance of counseling interventions with the aid of patient information leaflets and digital media as an adjunct for better patient care. Objectives: To study three counseling interventions, drug utilization, disease activity and quality of life in Rheumatoid Arthritis patients. Methods: A prospective study was conducted where 30 patients were …

To Study Drug Utilization And Qol In Patients With Bronchial Asthma, Kanav Khera Dr

Manipal College of Pharmaceutical Sciences, Manipal Theses and Dissertations

Background: Bronchial Asthma (BA) is a chronic inflammatory of the airways.[1] It is generally known that asthma can cause an impact on a patient’s Quality of Life (QoL), mostly in a negative manner. To perceive the impact it has on the population, ‘Questionnaires on Quality of Life’ in asthmatic patients were made. Improving the QoL of patients with asthma mainly aims at reducing the risk of exacerbation and preventing morbidity related to asthma. Drug Utilization studies are important in order to assess the current prescription patterns against standard guidelines and can help in rationalizing the management. The economic burden of …

Implementing Routine Communication About Costs Of Cancer Treatment: Perspectives Of Providers, Patients, And Caregivers, Marie Haverfield, A. E. Singer, C. Gray, A. Shelley, A. Nash, K. A. Lorenz

Faculty Publications

Objectives Rising costs in oncology care often impact patients and families directly, making communication about costs and financial impacts of treatment crucial. Cost expenditures could offer opportunities for estimation and prediction, affording personalized conversations about financial impact. We sought to explore providers’, patients’, and caregivers’ preferences towards implementing communication about cost, including when, how, and by whom such information might be provided.

Methods We conducted semi-structured phone interviews with a diverse population including 12 oncology providers, 12 patients, and 8 patient caregivers (N = 32). The constant comparative method was used to identify mutually agreed upon themes.

Results Participant groups …

College Of Public Health News, Georgia Southern University

College of Public Health: News & Publications

• Reports on Mixture Ranked Set Sampling for Estimation of Population Mean and Median

Grk6 Regulates The Hemostatic Response To Injury Through Its Rate-Limiting Effects On Gpcr Signaling In Platelets., Xi Chen, Shuchi Gupta, Matthew Cooper, Daniel Dehelian, Xuefei Zhao, Meghna U. Naik, Jeremy G.T. Wurtzel, Timothy J. Stalker, Lawrence E. Goldfinger, Jeffrey Benovic, Lawrence F. Brass, Steven E. Mckenzie, Ulhas P. Naik, Peisong Ma

Cardeza Foundation for Hematologic Research

G protein-coupled receptors (GPCRs) mediate the majority of platelet activation in response to agonists. However, questions remain regarding the mechanisms that provide negative feedback toward activated GPCRs to limit platelet activation and thrombus formation. Here we provide the first evidence that GPCR kinase 6 (GRK6) serves this role in platelets, using GRK6-/- mice generated by CRISPR-Cas9 genome editing to examine the consequences of GRK6 knockout on GPCR-dependent signaling. Hemostatic thrombi formed in GRK6-/- mice are larger than in wild-type (WT) controls during the early stages of thrombus formation, with a rapid increase in platelet accumulation at the site of injury. …

Endoscopic Rhizotomy For Chronic Lumbar Zygapophysial Joint Pain., Yuntao Xue, Tao Ding, Dajie Wang, Jianli Zhao, Huilin Yang, Xiaofeng Gu, Dehong Feng, Yafeng Zhang, Hao Liu, Fenglin Tang, Wanyi Wang, Miao Lu, Chao Wu

Department of Anesthesiology Faculty Papers

BACKGROUND: Chronic lumbar zygapophysial joint pain is a common cause of chronic low back pain. Percutaneous radiofrequency ablation (RFA) is one of the effective management options; however, the results from the traditional RFA need to be improved in certain cases. The aim of this study is to investigate the effect of percutaneous radiofrequency ablation under endoscopic guidance (ERFA) for chronic low back pain secondary to facet joint arthritis.

METHODS: This is a prospective study enrolled 60 patients. The cases were randomized into two groups: 30 patients in the control group underwent traditional percutaneous radiofrequency ablation, others underwent ERFA. The lumbar …

Biophysical Changes Caused By Altered Muc13 Expression In Pancreatic Cancer Cells, Andrew E. Massey, Kyle Doxtater, Murali M. Yallapu, Subhash C. Chauhan

School of Medicine Publications

Background

Pancreatic cancer is one of the most lethal cancers in the United States. This is partly due to the difficulty in early detection of this disease as well as poor therapeutic responses to currently available regimens. Our previous reports suggest that mucin 13 (MUC13, a transmembrane mucin common to gastrointestinal cells) is aberrantly expressed in this disease state, and has been implicated with a worsened prognosis and an enhanced metastatic potential in PanCa. However, there is virtually no information currently to describe the biophysical ramifications of this protein.

Methods

To demonstrate the biophysical effect of MUC13 in PanCa, we …

A&P Workshop Summary—Uniting Anatomy And Physiology Through Case Studies, Angela Horner, Stuart Sumida, Tomasz Owercowicz

Q2S Enhancing Pedagogy

Introducing problem-solving based methods of pedagogy is one approach to engage students early in their careers with developing analytic and diagnostic skills. PBL approaches in anatomy and medical teaching are a logical extension of clinical case studies, wherein an example of a pathology or clinical procedure is provided, and students must ascertain the anatomical and/or physiological basis for it. Students report a deeper understanding of material presented in clinical case studies, as the ‘real world’ relevance and importance is immediately clear (Cliff and Wright, 1996).

Sex Differences In The Effects Of Exercise On Cognition Post-Stroke: Secondary Analysis Of A Randomized Controlled Trial, Shereen Khattab, Janice J. Eng, Teresa Liu-Ambrose, Julie Richardson, Joy Macdermid, Ada Tang

Bone and Joint Institute

OBJECTIVE: To determine whether there are differences in exercise-associated changes in cognitive func-tion between males and females living with stroke. DESIGN: Secondary analysis of data from a prospective assessor-blinded randomized controlled trial. PARTICIPANTS: Fifty participants (50-80 years, > 1 year post-stroke, able to walk ≥ 5 m). METHODS: Participants were allocated into a 6-month aerobic exercise programme (14 males, 11 females) or balance and flexibility programme (15 males, 10 females). Working memory (Verbal Digit Span Backwards Test), selective attention and conflict resolution (Stroop Colour-Word Test), and set shifting/cognitive flexibility (Trail-Making Test B) were assessed before and after the programmes. RESULTS: There …

Effects Of The Affordable Care Act On The Receipt Of Colonoscopies Among The Insured Elderly, Minjee Lee, M Mahmud Khan, Heather M. Brandt, Ramzi G. Salloum, Brian Chen

Faculty Publications

BACKGROUND: The Affordable Care Act (ACA) waived deductibles and eliminated coinsurance for colonoscopies for Medicare beneficiaries beginning in January 1, 2011. This study investigated the effect of the ACA's directive to remove the financial barriers on the receipt of colonoscopies among the elderly insured, who are predominantly covered by Medicare. METHODS: Data from the 2008-2016 Behavioral Risk Factor Surveillance System (BRFSS) were used to examine the receipt of colonoscopies in two years prior to the implementation of the ACA (2008 and 2010) and three years after the change (2012, 2014, and 2016). Multivariate logistic regressions were estimated to examine the …

Detecting Invasive Fungal Disease In Surgical Patients: Utility Of The (1 3)- B-D-Glucan Assay, Jeffrey Skubic, Sharven Taghavi, Manuel Castillo-Angeles, Ramsis Ramsis, Ali Salim, Reza Askari

School of Medicine Publications

Background: The specificity and sensitivity of the (1 3)-b-d-glucan (BDG) assay in surgical patients needs further investigation. We hypothesized that the BDG assay would have lower sensitivity/specificity compared with that of medical patients.

Methods: We reviewed patients who had undergone laparotomy, gastrectomy, hepatectomy, or colectomy and had a BDG assay post-operatively.

Results: A total of 71 patients met study criteria. There were 29 (40.8%) who had proven/probable invasive fungal infection. Sensitivity for BDG level ‡80 diagnosed within one week of the assay draw was 77.3% (95% confidence interval [CI], 54.6–92.2%), and specificity was 44.9% (95% CI, 30.7–59.8). The positive predictive …

Toward Improving Practices For Submission Of Diagnostic Tissue Blocks For National Cancer Institute Clinical Trials, Hala Makhlouf, Mark A Watson, Heather A Lankes, Carol Weil, Maura Dickler, Michael Birrer, Christopher Moskaluk, Nilsa C Ramirez, Nader Okby, Edgar Alonsozana, Mark Barnes, Edward B Goldman, Rebecca Enos, Irina Lubensky

2020-Current year OA Pubs

OBJECTIVES: The National Cancer Institute (NCI) National Clinical Trials Network performs phase II and III clinical trials, which increasingly rely on the submission of diagnostic formalin-fixed, paraffin-embedded tissue blocks for biomarker assessment. Simultaneously, advances in precision oncology require that clinical centers maintain diagnostic specimens for ancillary, standard-of-care diagnostics. This has caused tissue blocks to become a limited resource for advancing the NCI clinical trial enterprise and the practice of modern molecular pathology.

METHODS: The NCI convened a 1-day workshop of multidisciplined experts to discuss barriers and strategic solutions to facilitate diagnostic block submission for clinical trial science, from the perspective …

Local Adaptation Constrains Drought Tolerance In A Tropical Foundation Tree, Kasey E. Barton, Casey Jones, Kyle F. Edwards, Aaron B. Shiels, Tiffany Knight

United States Department of Agriculture Wildlife Services: Staff Publications

1. Plant species with broad climatic ranges might be more vulnerable to climate change than previously appreciated due to intraspecific variation in climatic stress tolerance. In tropical forests, drought is increasingly frequent and severe, causing widespread declines and altering community dynamics. Yet, little is known about whether foundation tropical trees vary in drought tolerance throughout their distributions, and how intraspecific variation in drought tolerance might contribute to their vulnerability to climate changE.
2. We tested for local adaptation in seedling emergence and establishment with a full-factorial reciprocal transplant experiment including 27 populations and 109,350 seeds along a 3,500 mm precipitation gradient for …