Medicine and Health Sciences Commons^™

Development And Validation Of Predictive Risk And Multiple Criteria Decision Analysis Models To Evaluate Cardiovascular Outcomes Among Cancer Patients, Purva N. Parab

Theses and Dissertations

Objective: The objectives of our study were to characterize the study population with cancer and cardiovascular diseases (CVD) both as compared to those without and to build a predictive model using machine learning (ML) algorithms that can predict the risk of CVD in cancer patients. In addition, our objective was also to evaluate characteristics associated with cardiotoxic adverse events of breast cancer therapies and develop a multiple criteria decision analysis (MCDA) model to conduct benefit-risk assessment of breast cancer therapy regimens. Methods: We used Medical Expenditure Panel Survey (MEPS) and FDA Adverse Events Reporting System (FAERS) 2005-2015 files along with …

Differential Identification Of Hyperacusis And Misophonia: Implications Of Discrete Decreased Sound Tolerance (Dst) Condition Subtypes, Rachel E. Wallace

Theses and Dissertations

Hyperacusis and misophonia are two conditions of decreased sound tolerance (DST) studied in the psychological literature due to their association with psychological symptoms and mechanisms. DSTs are differentiated from normal sound sensitivity due to the reported impairment and distress individuals experience. Researchers suggest that DSTs are differentiated by types of sounds and emotional reactions elicited, such that hyperacusis is a fear and pain response to ordinary environmental sounds perceived as uncomfortably loud, and misophonia is an anger and disgust response to human-made sounds, but these distinctions, and associated characteristics, have not been empirically demonstrated. Undergraduate students (N = 1572) …

Development Of A Screening Assay For Type Iii Secretion System Inhibitors And High Throughput Screening Campaign Of Inhibitors Of Prp Of Staphylococcus Aureus, Heather A. Pendergrass

Theses and Dissertations

Antibiotics inhibit the growth or survival of bacteria by targeting their essential functions.¹ Due to weaknesses in traditional antibiotics and the increasing prevalence of antibiotic resistance genes, virulence factors are being targeted for therapeutic treatment of bacterial infection.² We have developed an assay to quantify and observe type III secretion system (T3SS) activity. The type III secretion system (T3SS) is a virulence factor present in some Gram-negative pathogens including enteropathogenic and enterohemorrhagic E. coli (EPEC and EHEC, respectively),³ and others.^4–9 The T3SS between EPEC and EHEC are highly conserved and share over 90% sequence identity with …

Kinematic And Coordination Variability In Runners With And Without Patellofemoral Pain, Jessica Mutchler, Klarie Macias, Barry Munkasy, Samuel J. Wilson, John C. Garner Iii, Li Li

Health Sciences & Kinesiology: Faculty Publications

Background: Patellofemoral pain (PFP) is a common overuse injury that has been suggested to cause abnormal gait kinematics and variability in runners with PFP. Conflicting results have been presented as to the variability of joint kinematics and joint coordination. Objective: The purpose of this study was to examine the variability of lower extremity kinematics and joint coordination in the presence of PFP and exertion. Methods: Six female runners with PFP and matched controls (CON) ran at a self-selected pace on an instrumented treadmill until exertion or pain criteria was met. Sixteen anatomical retroreflective markers and seven tracking clusters were placed …

Non-Thrust Cervical Manipulations Reduce Short-Term Pain And Decrease Systolic Blood Pressure During Intervention In Mechanical Neck Pain: A Randomized Clinical Trial, Emmanuel Yung, Cheongeun Oh, Michael Wong, Jason K. Grimes, Erica M. Barton, Muhammad I. Ali, Allison Breakey

Physical Therapy Faculty Publications

Objectives: To evaluate the association of resting blood pressure with pain response and evaluate the cardiovascular effects of anterior-to-posterior [AP] versus lateral [LAT] techniques of cervical spine non-thrust manipulation [NTM].

Methods: Forty-three (23 females) participants with non-chronic neck pain (mean age 29.00 ± SD 9.09 years) randomly received AP or LAT NTM to the cervical spine. Blood pressure and heart rate were measured before, during, and after the intervention. Disability and pain were measured pre- and post-intervention.

Results: Resting systolic blood pressure (SBP) was significantly associated with average pain reduction two days later on univariate and multivariate analyses (coefficients −0.029 …

Sustained Acoustic Medicine Combined With A Diclofenac Ultrasound Coupling Patch For The Rapid Symptomatic Relief Of Knee Osteoarthritis: Multi-Site Clinical Efficacy Study, Alex Madzia, Chirag Agrawal, Paddy Jarit, Stephanie Petterson, Kevin Plancher, Ralph Ortiz

Physical Therapy Faculty Publications

Background:

Sustained Acoustic Medicine (SAM) is an emerging, non-invasive, non-narcotic, home-use ultrasound therapy for the daily treatment of joint pain. The aim of this multi-site clinical study was to examine the efficacy of long-duration continuous ultrasound combined with a 1% diclofenac ultrasound gel patch in treating pain and improving function in patients with knee osteoarthritis.

Methods:

The Consolidated Standards of Reporting Trials (CONSORT) were followed. Thirty-two (32) patients (18-males, 14-females) 54 years of average age with moderate to severe knee pain and radiographically confirmed knee osteoarthritis (Kellgren-Lawrence (KL) grade II/III) were enrolled for treatment with the SAM device and diclofenac …

Uncovering The Complex Genetics Of Human Personality: Response From Authors On The Pgmra Model, Igor Zwir, Pashupati Mishra, Coral Del-Val, C. Charles Gu, Gabriel A. De Erausquin, Terho Lehtimäki, C. Robert Cloninger

School of Medicine Publications

Following publication of our two articles [1, 2], a critique of the methodology of Phenotype-Genotype Many-to-Many Relations Analysis (PGMRA) [1, 3, 4] questioned the validity of our results from the perspective of polygenic risk scores (PRS) [5]. We appreciate the importance of these questions, and here provide a concise discussion of the assumptions and mathematical constraints of both approaches. We thank this commentator and others who have discussed our articles with us for their thoughtful questions and critiques

Transition To Practice: Perceptions Of Nursing By Foreign Educated Physicians Enrolled In An Fnp Program, Gail K. Baumlein, Debbie Conner

All Faculty and Staff Scholarship

This study explores changes in the perceptions of nursing of the FNP students as they progressed through the 27 month FNP program. Literature revealed a limited number of studies of this unique population, including the barriers to role transition; citing language, understanding the U.S. healthcare system, cultural transitions, and discrimination as concerns.

An Image Of Perfection

AWE (A Woman’s Experience)

No abstract provided.

La Posible Consolación De La Música, Antoni Pizà

Publications and Research

Resumen:

La música, y por extensión el arte en general, no ofrece remedios terapéuticos adecuados frente al dolor provocado por situaciones de desespero personal. Sin embargo, esto no ha evitado que muchos oyentes y músicos profesionales intentaran usar la música como terapia. Este ensayo presenta una amplia muestra de composiciones, de J. S. Bach a Terry Riley, que se han usado como terapia de superación personal. Como puede preverse y a pesar de notables excepciones, el lenguaje de los clásicos, sobre todo si está basado en la armonía funcional, tiende a alcanzar esta misión mejor que las formas angulares e …

A Five-Sample Confirmatory Factor Analytic Study Of Burnout-Depression Overlap, Renzo Bianchi, Irvin Sam Schonfeld, Jay Verkuilen

Publications and Research

Objective: It has been asserted that burnout—a condition ascribed to unresolvable job stress—should not be mistaken for a depressive syndrome. In this confirmatory factor analytic study, the validity of this assertion was examined.

Methods: Five samples of employed individuals, recruited in Switzerland and France, were mobilized for this study (N = 3,113). Burnout symptoms were assessed with the Shirom–Melamed Burnout Measure, the Maslach Burnout Inventory (MBI)—General Survey, and the MBI for Educators. Depressive symptoms were measured with the PHQ‐9.

Results: In all five samples, the latent factors pertaining to burnout’s components correlated on average more highly with the latent Depression …

Recanalization Of The Chronically Occluded Internal Carotid Artery: Review Of The Literature., Mario Zanaty, Jorge A. Roa, Pascal Jabbour, Edgar A. Samaniego, David M. Hasan

Department of Neurosurgery Faculty Papers

Introduction: We reviewed the literature on interventions for patients with medically refractory chronically occluded internal carotid artery (COICA) to assess the risks and/or benefits after recanalization via an endovascular technique (ET) or hybrid surgery (HS, i.e., ET plus carotid endarterectomy).

Methods: A systematic search of the electronic databases was performed. Patients with COICA were classified into 4 different categories according to Hasan et al classification.

Results: Eighteen studies satisfied the inclusion criteria. Only 6 studies involved an HS procedure. We identified 389 patients with COICA who underwent ET or HS; 91% were males. The overall perioperative complication rate was 10.1% …

Early Surgery For Traumatic Spinal Cord Injury: Where Are We Now?, Jefferson R. Wilson, Christopher D. Witiw, Jetan Badhiwala, Brian K. Kwon, Michael G. Fehlings, James Harrop

Department of Neurosurgery Faculty Papers

Study Design: Narrative review.

Objective: There is a strong biological rationale to perform early decompression after traumatic spinal cord injury (SCI). With an enlarging clinical evidence base, most spine surgeons internationally now favor early decompression for the majority of SCI patients; however, a number of pertinent questions remain surrounding this therapy.

Methods: A narrative review evaluating the status of early surgery for SCI. In particular, we addressed the following questions: (1) Which patients stand to benefit most from early surgery? 2) What is the most appropriate time threshold defining early surgery?

Results: Although heterogeneity exists, the evidence generally seems to …

Minimizing Blood Loss In Spine Surgery., Christopher Mikhail, Zach Pennington, Paul M Arnold, Darrel S Brodke, Jens R Chapman, Norman Chutkan, Michael D Daubs, John G Devine, Michael G Fehlings, Daniel E Gelb, George M Ghobrial, James S Harrop, Christian Hoelscher, Fan Jiang, John J Knightly, Brian K Kwon, Thomas E Mroz, Ahmad Nassr, K Daniel Riew, Lali H Sekhon, Justin S Smith, Vincent C Traynelis, Jeffrey C Wang, Michael H Weber, Jefferson R Wilson, Christopher D Witiw, Daniel M Sciubba, Samuel K Cho

Department of Neurosurgery Faculty Papers

Study Design: Broad narrative review.

Objective: To review and summarize the current literature on guidelines, outcomes, techniques and indications surrounding multiple modalities of minimizing blood loss in spine surgery.

Methods: A thorough review of peer-reviewed literature was performed on the guidelines, outcomes, techniques, and indications for multiple modalities of minimizing blood loss in spine surgery.

Results: There is a large body of literature that provides a consensus on guidelines regarding the appropriate timing of discontinuation of anticoagulation, aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), and herbal supplements prior to surgery. Additionally, there is a more heterogenous discussion the utility of preoperative autologous …

Implementation Of A Spine-Centered Care Pathway At A Regional Academic Spine Center., George M Ghobrial, Jefferson Wilson, Daniel Franco, Kristen Vogl, Alexander R Vaccaro, James S Harrop

Department of Neurosurgery Faculty Papers

Study Design: Retrospective case series.

Objective: To describe the early implementation of an inpatient spinal surgery unit and measure the impact on cost and length of stay (LOS).

Methods: A retrospective case review was performed for frequent spine-related diagnosis-related groups (DRGs) cared for by a dedicated multidisciplinary team: combined anterior/posterior (AP) spinal fusion with major complicating or comorbid condition (MCC), combined (AP) spinal fusion with CC, combined (AP) spinal fusion without complicating or comorbid (CC)/MCC, cervical spinal fusion with MCC, cervical spinal fusion with CC, and cervical spinal fusion without CC/MCC. Four time periods were compared: historical control, initial pathway …

Leveraging Technology To Blend Large-Scale Epidemiologic Surveillance With Social And Behavioral Science Methods: Successes, Challenges, And Lessons Learned Implementing The Unite Longitudinal Cohort Study Of Hiv Risk Factors Among Sexual Minority Men In The United States, H. Jonathon Rendina, Ali J. Talan, Nicola F. Tavella, Jonathan Lopez Matos, Ruben H. Jimenez, S. Scott Jones, Brian Salfas, Drew Westmoreland

Publications and Research

The use of digital technologies to conduct large-scale research with limited interaction (i.e., no in-person contact) and objective endpoints (i.e., biological testing) has significant potential for the field of epidemiology, but limited research to date has been published on the successes and challenges of such approaches. We analyzed data from a cohort study of sexual minority men across the United States, collected using digital strategies during a 10-month period from 2017 to 2018. Overall, 113,874 individuals were screened, of whom 26,000 were invited to the study, 10,691 joined the study, and 7,957 completed all enrollment steps, including return of a …

Effects Of A Single Mutation In Chikungunya Virus Non-Structural Protein On Virus Infection In Aedes Albopictus And Mammalian Cell Lines, Yin Ling Jolene Fu

Student Works (2020-2029)

Chikungunya virus (CHIKV) has caused large-scale epidemics of fever, rash and arthritis since 2004. This unprecedented re-emergence has been mainly associated with mutations in genes encoding structural envelope proteins, providing increased fitness in the secondary vector Aedes (Ae.) albopictus. In the 2008-2013 CHIKV outbreaks across Southeast Asia, an R82S mutation in non-structural protein 4 (nsP4) emerged early in Malaysia or Singapore and quickly became predominant. To determine whether this nsP4-R82S mutation provides a selective advantage in host cells which may have contributed to the epidemic, the fitness of infectious clone-derived CHIKV with nsP4- 82R and nsP4-82S were compared in Ae. …

Functional Significance Of Senescence And Autophagy In Cancer-Associated Fibroblasts From Oral Squamous Cell Carcinoma, May Leng Tan

Student Works (2020-2029)

Oral squamous cell carcinoma (OSCC) is a malignancy that arises from the epithelial cells within the oral cavity. It accounts for approximately 355,000 new cases worldwide and is exceptionally prevalent in particular geographical areas such as Papua New Guinea, the Indian subcontinent and South-East Asian countries. Despite advances in surgical management and therapeutic approaches, the five-year survival rate of OSCC patients has not improved significantly over the past few decades. The mortality associated with OSCC is particularly high often due to late presentation, locoregional recurrence, distant metastases and the development of second primary tumours. A comprehensive understanding of the molecular …

Impacts Of Self-Perceived Malocclusion On The Oral Health-Related Quality Of Life Of Young Adults In Malaysia, Mohd Tajudin Zawani

Student Works (2020-2029)

Objectives: To assess the prevalence, severity and extent of impacts of self-perceived malocclusion on the oral health-related quality of life (OHRQoL) related to dental aesthetics among young Malaysian adults, to compare between those with and without self-perceived malocclusion and to investigate the influence of demographics on the outcome. Methods: Multi-stage random sampling method was used to recruit 589 subjects from tertiary institutions in Malaysia. Study instruments comprised the Aesthetic Component of the Index of Orthodontic Treatment Need (AC-IOTN) and Malaysian version of the Psychosocial Impact of Dental Aesthetics (PIDA) to measure selfperceived malocclusion and its impacts. Analyses included multifactorial ANOVA …

Anticancer Activity Of Ficus Deltoidea And Tualang Honey On Oral Cancer Cells: An In Vivo Study, Alkoshab May Ameen Saeed

Student Works (2020-2029)

The use of natural products have been gaining interest, notably in the area of cancer therapy and in this study, natural products rich in antioxidants such as Tualang Honey (Malaysian wild local honey) and Ficus deltoidea (Malaysian local herbal plant), were selected to assess their chemo-preventive and chemotherapeutic activities on oral cancer. The aim of this study is to evaluate the chemo-preventive and chemotherapeutic activities of Ficus deltoidea (FD) and Tualang Honey (TH) in an animal model induced for oral cancer using 4-Nitroquinoline1-oxide (4NQO). A total of 70 male Sprague-Dawley (SD) rats were distributed into ten groups (n=7 per group); …

Expression Of Ki-67, Fscni And Tnfrsf 12a In Histologically Non-Involved Mucosal Surgical Margins As Predictive Markers For Local Relapse In Oral Squamous Cell Carcinoma, Zainul Abidin Nur Fauziani

Student Works (2020-2029)

Introduction: The presence tumour-related genetic alterations in histologically noninvolved mucosal surgical margins was linked to development of local relapse in OSCC. Aims: The present study aimed to determine the association between expression of Ki67, FSCN1 and TNFRSF12A in histologically non-involved mucosal surgical margins of OSCC patients and local relapse. Materials and methods: The study involved a total of 34 OSCC cases including 15 cases of patients who had relapse within the 5 years followup period and 19 cases of patients who did not had relapse. Two-stage sampling was carried out to select the margins’ site, followed by the representative sections …

Clinicopathological Study Of Oral Lichen Planus And Oral Linchenoid Reaction, Gubod Eb Robson

Student Works (2020-2029)

Introduction: Oral lichen planus is a chronic inflammatory disease that affects the mucosa of the oral cavity. Oral lichenoid reactions/ lesions share many clinical and histopathological features with oral lichen planus, and represent a response to extrinsic or causative factors (drugs, allergens). Aim: The purpose of this study was to evaluate the clinical and histopathological features of oral lichen planus and oral lichenoid reactions/ lesions. Objectives: The objectives of this study were to assess the clinical and histopathological features of patients diagnosed with oral lichen planus and oral lichenoid reaction/ lesions. This study also sought to investigate the association between …

Occupational Burnout Among Healthcare Professionals In Obstetrics And Gynecology Department Of A Public Hospital In Islamabad, Pakistan, Kashif Sabin

Student Works (2020-2029)

The general purpose of this study was to investigate the extent of burnout experienced by healthcare professionals working in obstetrics & gynaecology units in public hospital of Islamabad, Pakistan. Specifically, this research attempted to explore the contributing factors of burnout, by correlating the burnout scores of exhaustion and disengagement, with the sociodemographic variables. The main objectives of the study were: (i) to assess the levels of burnout as determined by the extent of exhaustion and disengagement among the study participants, and (ii) to compare the mean scores of exhaustion and disengagement among healthcare professionals based on different demographic characteristics: (a) …

Attitude Towards Patient Undergraduate Medical Students In The University Of Malaya, Jeevitha Rajasingam

Student Works (2020-2029)

In the last two decades, patient safety awareness has become one of the emerging themes. To prevent from doing harm to patients, safe medical practices should be implemented and followed strictly. Therefore, a basic understanding of human factor principles need to be instilled into all health care workers. Medical universities play a vital role in fostering patient safety attitudes of their students towards the importance of patient safety during their practise. However, the medical curricula still face challenges regarding the correct timing and appropriate methods of instruction in their understanding of their principles. Experiments have shown that patient safety classes …

Impact Of Learning Support Intervention On Preclinical Students' Conception Of Self-Regulated Learning: A Quasi-Experimental Study Based On The Motivated Strategies For Learning Questionnaire, Kodiappan Radha

Student Works (2020-2029)

Self-regulated learning (SRL), which includes the ability to regulate motivational, cognitive and metacognitive strategies based on the contextual and task demand, is recognized as a critical element for lifelong learning. However, past literature indicate a deficit in undergraduate medical students’ capabilities to self-regulate their learning and shortcoming of implicit methods to develop students’ SRL in medical schools. Thus, the objectives of this research were to analyse (i) the baseline level of the preclinical students’ SRL and (ii) the impact of the learning support intervention on the students’ conception of SRL. These objectives were approached from the perspectives of the students’ …

Educational Needs Of Newly Diagnosed Cancer Patients In Learning About Cancer: A Qualitative Study In The Malaysian Urban Setting, Munisamy Murallitharan

Student Works (2020-2029)

Patients with chronic diseases such as cancer are able to have better outcomes if they understand about all aspects of the disease, develop the correct attitude to manage themselves and their disease better; and engage in preventive practices that can help them prevent worsening of disease or recurrence. Patient education is an intervention that has proven to be effective in different settings for this. However in the Malaysian cancer setting, the educational needs of patients are poorly understood. The aim of this study was to explore and understand the educational needs of newly diagnosed cancer patients in learning about cancer …

Mixed Features Specifier In Mood Disorder: The Prevalence And Associated Factors, M. Paramannantha Veloo Tesini

Student Works (2020-2029)

Introduction: Mixed episode has been an unrelieved source of discussion in the field of psychiatry over the course of two decades as the DSM-IV criteria for both a depressive and manic episode had to be fulfilled to make this diagnosis. Nevertheless, in practice, this threshold was demonstrated to be too high. Therefore, the DSM-5 introduced a less stringent ‘specifier’ in which three symptoms of the opposite pole suffice thereby creating depression and mania with mixed features, respectively. Literatures points out that approximately 40% of patients have mixed episodes, but this figure may be much higher within the context of DSM-5. …

Psychometric Properties Of Bergen Social Media Addiction Scale (Bsmas) In Malay Version, Kee Hui Romi Tiong

Student Works (2020-2029)

Background The percentage of internet users in Malaysia has recorded continuous increment annually, in which it increased from 76.9% in 2016 to 87.4% of users in 2018. The prevalent use of all sorts of social media platform and the convenient access to the internet regardless of time and place has massively enhance the potential of social media addiction. After many years of research, the researchers have yet to reach the consensus in identifying criteria to diagnose problematic attachment to social media. The aim of the study was to validate the Malay version of Bergen Social Media Addiction Scale (BSMAS), by …

Psychiatric Morbidity Among Orang Asli In Bukit Lanjan, Iberahim Muhammad Ilham

Student Works (2020-2029)

Prevalence of Psychiatric Morbidity Among Orang Asli In Bukit Lanjan, Selangor, Malaysia Introduction Orang Asli, the indigenous people of peninsular Malaysia, are those peoples who were born among Orang Asli, lives according to their distinguished culture and beliefs, and spoke their native languages. Malaysia has evolved rapidly over the years in the socioeconomic development especially in the rural areas. More jungle areas are open up for land development scheme such as Federal Land Development Authority (FELDA), housing projects, commercial farms and many more. Indigenous people are forced to face this rapid urbanization. The questions arise whether they are able to …

A Three Dimensional Age Estimation Using Cone Beam Ct In Malaysian Population, Asif Muhammad Khan

Student Works (2020-2029)

Forensic odontology plays a vital role in the age estimation and identification process during criminal investigations. Forensic science in the past have mainly employed two-dimensional (2D) radiographic assessment of developmental and physiological age related dental parameters for age estimation. However, 2D radiograph doesn’t represent the three-dimensional (3D) anatomical structures. Rapidly evolving CBCT imaging modality can be effectively employed in forensic sciences to overcome the limitations of 2D imaging. The current study aimed to develop a novel method of dental age estimation using 3D surface area analyses of root apices of the developing permanent maxillary canines and mandibular third molars among …