Medicine and Health Sciences Commons^™

Evaluating The Impact Of Proactive Care Management With Idstrat, D.J. Donahue, Lauren Staples

Published and Grey Literature from PhD Candidates

This purpose of this study is to quantify potential cost savings and member care improvements as a result of engagement through BlueCross BlueShield of Tennessee’s (BCBST) Identification and Stratification (IDStrat) process. Commercial members engaged in clinical management that were identified through IDStrat were compared to commercial members identified through other means across several metrics including per-member, per-month (PMPM) cost and physician visits. Members identified by IDStrat experienced a statistically significant 7% greater reduction in costs after being engaged when compared with those identified by other methods. Members identified by IDStrat also experienced a significant reduction in emergency room visits after …

Holep Vs Bipolar Turp As Same Day Surgery: Analysis Of Length Of Stay And Costs, Michael Su Ms4, Sarah Azari Ms4, Jacob Rust Md, Alexis R. Brown Pa-C, Clifford Georges Md, James Johannes Md

Department of Medicine

No abstract provided.

Identifiying High Risk Areas Of Zika Virus Infection By Meteorological Factors In Columbia, Lung-Chang Chien, Francisco Sy, Adriana Perez

Environmental & Global Health Faculty Research

Background Several Zika virus (ZIKV) outbreaks have occurred since October 2015. Because there is no effective treatment for ZIKV infection, developing an effective surveillance and warning system is currently a high priority to prevent ZIKV infection. Despite Aedes mosquitos having been known to spread ZIKV, the calculation approach is diverse, and only applied to local areas. This study used meteorological measurements to monitor ZIKV infection due to the high correlation between climate change and Aedes mosquitos and the convenience to obtain meteorological data from weather monitoring stations. Methods This study applied the Bayesian structured additive regression modeling approach to include …

Patient And Provider Perspectives On How Trust Influences Maternal Vaccine Acceptance Among Pregnant Women In Kenya, Stacy W. Nganga, Nancy A. Otieno, Maxwell Adero, Dominic Ouma, Sandra S. Chaves, Jennifer R. Verani, Marc-Alain Widdowson, Andrew Wilson, Irina Bergenfeld, Courtni Andrews, Vincent L. Fenimore, Ines Gonzalez-Casanova, Paula M. Frew, Saad B. Omer, Fauzia A. Malik

Environmental & Global Health Faculty Research

Background Pregnant women and newborns are at high risk for infectious diseases. Altered immunity status during pregnancy and challenges fully vaccinating newborns contribute to this medical reality. Maternal immunization is a strategy to protect pregnant women and their newborns. This study aimed to find out how patient-provider relationships affect maternal vaccine uptake, particularly in the context of a lower middle- income country where limited research in this area exists. Methods We conducted semi-structured, in-depth narrative interviews of both providers and pregnant women from four sites in Kenya: Siaya, Nairobi, Mombasa, and Marsabit. Interviews were conducted in either English or one …

An Evaluation Of Food Insecurity And Its Correlates In A Filipino American Study Sample Residing In Clark County, Nevada, Prescott Cheong, Courtney Coughenour, Maya Shegog, Saruna Ghimire, Lawrence Sagadraca, Francisco Sy

Environmental & Global Health Faculty Research

Purpose: Filipino Americans comprise over half of the Asian American population in Clark County, Nevada. Despite their large numbers, food insecurity rates are aggregated with the entire Asian American population. In 2016, 1.6% of Asian American households in Clark County were food insecure, yet, 22% of households reported annual incomes at or below 200% of the federal poverty level. This study aimed to assess the status and correlates of food insecurity specific to Filipino Americans in Clark County, Nevada. Methods: The United States Department of Agriculture (USDA) Short Form Food Security Module was administered among 192 Filipino Americans residing in …

Systematic Review Of Doppler For Detecting Intrapartum Fetal Heart Abnormalities And Measuring Perinatal Mortality In Low‐ And Middle‐Income Countries, Marya Plotkin, Benjamin Kamala, Jim Ricca, Linda Fogarty, Sheena Currie, Hussein Kidanto, Stephanie B. Wheeler

Obstetrics and Gynaecology, East Africa

Background: Using Doppler to improve detection of intrapartum fetal heart rate (FHR) abnormalities coupled with appropriate, timely intrapartum care in low-and middle-income countries (LMIC) can save lives.

Objective: To review studies using Doppler to improve detection of intrapartum FHR abnormalities and intrapartum care quality in LMIC health facilities.

Search strategy: PubMed, Web of Science, Embase, Global Health, and Scopus were searched from inception to October 2018 by combining terms for Doppler, perinatal outcomes, and FHR monitoring.

Selection criteria: Selected studies compared Doppler and Pinard stethoscope for detecting/monitoring intrapartum FHR, or described provider and maternal preferences for FHR monitoring in LMIC …

Corneal Refractive Surgery In Patients With History Of Optic Neuritis, Majid Moshirfar, William D. Wagner, Steven H. Linn, Tanner W. Brown, Jackson L. Goldberg, Aaron T. Gomez, Yasmyne C. Ronquillo, Phillip C. Hoopes

School of Medicine Publications

Purpose

The purpose of this study was to evaluate the risk of recurrence of optic neuritis after corneal refractive surgery in patients with a history of optic neuritis and to examine the safety and efficacy of the procedure in this population.

Methods

This was a retrospective chart review of patients with a history of optic neuritis who underwent laser-assisted in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK) at a single tertiary center from June 1996 to December 2014. Fifteen eyes of 14 patients were included in this study. Visual acuity before and after the surgery was recorded. Patients were followed-up …

Women And Children Living In Areas Of Armed Conflict In Africa: A Geospatial Analysis Of Mortality And Orphanhood, Zachary Wagner, Sam Heft-Neal, Paul H. Wise, Robert E. Black, Marshall Burke, Ties Boerma, Zulfiqar Ahmed Bhutta, Eran Bendavid

Department of Paediatrics and Child Health

Background:
The population effects of armed conflict on non-combatant vulnerable populations are incompletely understood. We aimed to study the effects of conflict on mortality among women of childbearing age (15–49 years) and on orphanhood among children younger than 15 years in Africa.
Methods:
We tested the extent to which mortality among women aged 15–49 years, and orphanhood among children younger than 15 years, increased in response to nearby armed conflict in Africa. Data on location, timing, and intensity of armed conflicts were obtained from the Uppsala Conflict Data Program, and data on the location, timing, and outcomes of women and …

Year 2019 Position Statement: Principles And Guidelines For Early Hearing Detection And Intervention Programs

Journal of Early Hearing Detection and Intervention

No abstract provided.

A Web-Based Alcohol Screening And Brief Intervention Training Module Within Physician Assistant Programs In The Midwest To Increase Knowledge, Attitudes, And Confidence: Evaluation Study, Leigh Tenkku Lepper, Tracy Cleveland, Genevieve Delrosario, Katherine Ervie, Catherine Link, Lara Oakley, Abdelmoneim Elfagir, Debra Sprague

Missouri Institute for Mental Health

Background: Preventing and reducing risky alcohol use and its side effects remains a public health priority. Discussing alcohol use with patients can be difficult; dedicated training for health care providers is needed to facilitate these conversations. A Web-based alcohol screening and brief intervention (SBI), comprising didactic and skills application training, was designed for physician assistant students. Objective: This paper details experiences and outcomes in developing an alcohol SBI training curriculum and coordinating virtual encounters with standardized patients. We also explain challenges faced with developing an alcohol SBI training and a Web-based learning management site to fit the needs of 5 …

Inferring A Consensus Problem List Using Penalized Multistage Models For Ordered Data, Philip S. Boonstra, John C. Krauss

The University of Michigan Department of Biostatistics Working Paper Series

A patient's medical problem list describes his or her current health status and aids in the coordination and transfer of care between providers, among other things. Because a problem list is generated once and then subsequently modified or updated, what is not usually observable is the provider-effect. That is, to what extent does a patient's problem in the electronic medical record actually reflect a consensus communication of that patient's current health status? To that end, we report on and analyze a unique interview-based design in which multiple medical providers independently generate problem lists for each of three patient case abstracts …

Jefferson Center For Interprofessional Practice And Education (Jcipe): Enhancing Services To Underserved Populations Through Innovative Virtual World Training And Collaborative Partnerships, Susan Toth-Cohen, Phd, Otr/L, Brooke Salzman, Md, Oksana Kazharova, Lcsw, Lcadc

Department of Occupational Therapy Posters and Presentations

Objectives

After attending this presentation, participants will be able to:

1. Discuss the development, implementation, and evaluation of two interprofessional virtual training programs focused on vulnerable populations
2. Articulate the key role of community partners in creating and sustaining virtual training programs
3. Identify useful strategies for implementing virtual training incorporating the flexible learning framework
4. Apply basic information and lessons learned to your own ideas about current or potential training programs

The Relationship Between Psychological Contract Breach, Organizational Identification, And Organizational Agility Among Nursing Faculty Members, Yaldez Zeineldin

Nursing

Psychological contract is defined as the unwritten or hidden agreement between both the employers and the employees to ensure reciprocity and safe productive work environment. The concept of the relationship between Psychological Contract Breach (PCB) as one of many recognized antecedents of organizational identification has been emphasises for years. Organizational Identification (OI) is defined as the extent to which both the organisation and the employee’s identities are overlapped. Organizational Identification (OI) has many benefits. For instance, it has a robust effect on the employees’ cognitive abilities, attitude, and behavior including their organizational agility and acceptance to the external and internal …

2103. Emergency Department (Ed) Stewardship: Stratifying Ed Sepsis Order Sets By Penicillin (Pcn) Allergy Severity, Mary L. Staicu, Maryrose Laguio-Vila, Allison Ramsey, Kelly Conn, Kristin Woodring

Pharmacy Faculty/Staff Publications

Background:

The Surviving Sepsis Campaign Guidelines recommends administration of broad-spectrum antibiotics within 1 hour of sepsis diagnosis; electronic order sets drive antibiotic selection with pre-populated regimens based on the suspected infectious indication. Given the low rate of cephalosporin cross-reactivity in patients with a PCN allergy, we modified our ED sepsis order set (Images 1 and 2) to include cephalosporin options in patients with reported mild-to-moderate PCN reaction histories. This was a single-center, retrospective analysis evaluating the impact of this change on antibiotic prescribing and associated outcomes.

Methods:

An electronic medical record (EMR) report identified patients ≥18 years of age with …

172. Risk Factors For 30-Day Mortality In Patients With Staphylococcus Aureus Bacteremia At A Community Hospital: A Prospective Case–Control Study, Charles Hoffmann, Gordon Watkins, Patrick Desimone, Peter Hallisey, David Hutchinson, Stephen Colodny, Jeffrey Burkey, Amanda Michael, Jo-Anne Klein, Christina Welc

Pharmacy Faculty/Staff Publications

Background:

Staphylococcus aureus bacteremia (SAB) is associated with 30-day all-cause mortality rates approaching 20–30%. The purpose of this case–control study was to evaluate risk factors for 30-day mortality in patients with SAB at a community hospital.

Methods:

As part of an antimicrobial stewardship program (ASP) initiative mandating Infectious Diseases consultation for episodes of SAB, our ASP prospectively monitored all cases of SAB at a 341-bed community hospital in Jefferson Hills, PA from April 2017–February 2019. Cases included patients with 30-day mortality from the initial positive blood culture. Only the first episode of SAB was included; patients were excluded if a …

Tilapia Consumption And Scombroid Poisoning., Ehizogie Edigin, Prasanth Lingamaneni, Juan Sarmiento, Hafeez Shaka, Sanjay A Patel

Ambulatory and Primary Care Articles

Scombroid poisoning, also known as histamine fish poisoning, typically occurs after eating dark meat fish. Higher levels of histidine, which is converted to histamine, causes anaphylaxis-like symptoms upon ingestion. There are few reported cases of scombroid in humans secondary to light meat fish. We present a case secondary to tilapia consumption.

North American Hard Yellow Liver Disease: An Old Problem Readdressed, Bryan L. Stegelmeier, Meredyth Jones, Christopher P. Womack, T Zane Davis, Dale R. Gardner

Poisonous Plant Research (PPR)

Hard yellow liver disease or fatty cirrhosis periodically affects cattle, sheep, goats, pronghorn antelope (Antilocapra americana) and whitetail deer (Odocoileus virginianus texanus) within several Texas counties in the United States. Clinically it presents as chronic liver disease with progressive hepatic necrosis and fibrosis, icterus and liver failure. The damaged livers are yellow and many have multiple firm, often gritty foci that are scattered throughout all lobes. Early investigations included feeding studies using potential toxic plants, climate and forage studies, infectious disease surveys and various mycotoxin studies and analyses. None have definitively reproduced the disease or identified the inciting …

Drug-Induced Autoimmune Hepatitis From Hydralazine Leading To Acute Liver Failure And Liver Transplantation, Jasleen Grewal, Angela Doan, Annie S. Hong, Arpit Amin, Jason V. Scapa, Ramy Hanna, Francisco Durazo, Beshoy Yanny

School of Medicine Faculty Research

We describe a woman with no previous liver disease who developed drug-induced autoimmune hepatitis from hydralazine prescribed to her for hypertension. Despite the discontinuation of the medication, she developed acute liver failure and subsequently underwent successful liver transplantation. She survived and had a good clinical outcome.

The Association Between Dietary Inflammatory Index (Dii) And Cancer Risk In Korea: A Prospective Cohort Study Within The Koges-Hexa Study, Injeong Ryu, Minji Kwon, Cheongmin Sohn, Nitin Shivappa, James R. Hébert, Woori Na, Mi Kyung Kim

Faculty Publications

Several epidemiological studies have shown that there are consistently positive associations between dietary inflammatory index (DII (R)) scores and cancer incidence in Western populations. However, few DII-cancer studies have been conducted in East Asian populations. In a large cohort representative of the general Korean population, we investigated whether the DII is associated with overall cancer risk. A total of 163,660 participants (56,781 males and 106,879 females) had evaluable data for analyses. This follow-up study was carried out over the course of 7.9 years. DII scores were calculated based on Semi-Quantitative Food-Frequency Questionnaire (SQ-FFQ) data for 106 food items. Cancers were …

Cross-Linked Polyphenol-Based Drug Nano-Self-Assemblies Engineered To Blockade Prostate Cancer Senescence, Prashanth K.B. Nagesh, Pallabita Chowdhury, Elham Hatami, Sonam Kumari, Vivek K. Kashyap, Manish Tripathi, Santosh Wagh, Bernd Meibohm, Subhash C. Chauhan, Meena Jaggi, Murali M. Yallapu

School of Medicine Publications

Cellular senescence is one of the prevailing issues in cancer therapeutics that promotes cancer relapse, chemoresistance, and recurrence. Patients undergoing persistent chemotherapy often develop drug-induced senescence. Docetaxel, an FDA-approved treatment for prostate cancer, is known to induce cellular senescence which often limits the overall survival of patients. Strategic therapies that counter the cellular and drug-induced senescence are an unmet clinical need. Towards this an effort was made to develop a novel therapeutic strategy that targets and removes senescent cells from the tumors, we developed a nanoformulation of tannic acid−docetaxel self-assemblies (DSAs). The construction of DSAs was confirmed through particle size …

Health Engagement Challenges And Strategic Perspectives For The 2023 Health Financing Transition In The Federated States Of Micronesia And The Republic Of The Marshall Islands, Alex Wheatley, Subroto Banerji

Pacific Journal of Health

The Federated States of Micronesia (FSM) and the Republic of the Marshall Islands (RMI) are small sovereign island nations in the Pacific. These nations maintain a special relationship with the US Government (USG) through the Compacts of Free Association (COFA), first signed into law in 1986. One component of COFA—the more than $60 million in direct USG annual financial assistance to FSM and RMI through Compact Sector grants—will end in 2023. This financing shift brings an opportunity to re-assess FSM-RMI-USG engagement specifically around health systems strengthening moving forward. At present, FSM-RMI are included in HHS’ domestic appropriations and authorizations framework; …

Stable Nanopalladium Hydride In Water For Sustainable And Selective Reductions, Jesse Klus, Sachin Handa

Posters-at-the-Capitol

The synthesis of air-stable ligand-free nanopalladium hydride (PdNHx) in water was achieved and applied to various organic transformations, including (1) reduction of heteroaromatics such as (iso)quinolines, phenanthrolines, benzotriazole, and naphthyridines, (2) regio- and chemoselective reduction of nitroarenes, (3) alkyne reductions, (4) chemoselective dehalogenation, and (5) base-free detriflation. Both the synthesis of PdNHx and the reductions were carried out under mild conditions in a micellar medium using our designer surfactant PS-750-M, which eliminates the need for toxic organic solvents and extremely high hydrogen pressure and temperature. Notably, PS-750-M is also a replacement of hazardous polar-aprotic solvents. This newer approach for selective …

The Combination Of Valsartan And Sacubitril Does Not Improve Effectiveness Against Angii-Induced Aaas, Jenny (Ching Ling) Liang, Sean Thatcher

Posters-at-the-Capitol

Abdominal aortic aneurysm (AAA) is defined as permanent dilation of the abdominal aorta by more than 50% of its normal diameter. As AAAs grow progressively, the aorta can rupture and cause life-threatening bleeding. Preliminary data demonstrates that angiotensin II (AngII), which can induce AAA, plus testosterone were powerful stimulants for expression of neprilysin in abdominal aortic smooth muscle cells from male mice. Neprilysin is a metalloendopeptidase, which can cleave and inactivate AngII and natriuretic peptides. Because natriuretic peptides might be beneficial for reducing the growth of AAAs through decreasing blood pressure, inhibition of neprilysin along with blocking AngII receptor would …

Cyberbullying And Teenage Mental Health, Emma Renfro, Melony Shemberger

Posters-at-the-Capitol

Abstract Cyberbullying is something that is becoming prevalent in today’s digital society. It is something that impacts more than one age group, but the primary age group seems to be aged 13-18. As a society, it is recognized that cyberbullying happens. However, how often does one stop to think deeper? In this research, I will approach cyberbullying from a mental health standpoint. I will demonstrate things such as why certain demographics are more susceptible to the impact of cyberbullying, what mental illnesses are caused by cyberbullying, and present statistics that, hopefully, motivate people to begin to combat this issue. Over …

Determination Of Cannabinoids, Cathinones, And Synthetic Fentanyls Using Wastewater-Based Epidemiology, Catherine O'Rourke, Bikram Subedi

Posters-at-the-Capitol

Unregulated new psychoactive substances (NPS) in “pure” or “preparation” forms are designed to mimic the effects of controlled substances, and are introduced and reintroduced in the market as a cheap substitute for established regulated drugs in quick succession to loophole the law enforcement efforts on combating drugs. For example, carfentanil, a synthetic opioid activates the opioid receptors similar to morphine but it is astoundingly potent compared to a typical drug of abuse (100 times more potent than fentanyl and 10,000 times more powerful than morphine). Based on the cost- and time-intensive forensic analysis, National Drug Early Warning System reported the …

Cannibidiol (Cbd) Supplementation In Horses: A Pilot Study, Kiara Jones, Evan Thomas, Shea Porr

Posters-at-the-Capitol

Cannibidiol (CBD) is sold for various uses in humans and animals. Thus far, CBD has not demonstrated effects similar to delta-9 tetrahydrocannabinol (THC), the psychoactive component of marijuana. While some animal species have demonstrated responses to CBD supplementation, published literature on equines is absent. The lack of FDA approval and studies to support claimed benefits make regulating product quality and recommending dosages difficult. The objectives of this project were to: 1) determine dosages that allowed for CBD detection in equine blood; and 2) evaluate time required for the appearance of maximum concentration and half-life of CBD in equine blood. Two …

Foundational Pharmaceutical Sciences I Bps 337, Joanna Burkhardt

Library Impact Statements

No abstract provided.

Immunoreactive Trypsinogen Levels In Newborn Screened Infants With An Inconclusive Diagnosis Of Cystic Fibrosis., Chee Y Ooi, Rosie Sutherland, Carlo Castellani, Katherine Keenan, Margaret Boland, Joe Reisman, Candice Bjornson, Mark A Chilvers, Richard Van Wylick, Steven Kent, April Price, Dimas Mateos-Corral, Daniel Hughes, Melinda Solomon, Peter Zuberbuhler, Janna Brusky, Peter R Durie, Felix Ratjen, Tanja Gonska

Paediatrics Publications

BACKGROUND:
Newborn screening (NBS) for cystic fibrosis (CF) not only identifies infants with a diagnosis of CF, but also those with an uncertain diagnosis of cystic fibrosis (CF), i.e. CF transmembrane conductance regulator (CFTR)-related metabolic syndrome (CRMS) or CF screen positive inconclusive diagnosis (CFSPID). These infants have an uncertain long-term outcome and it is currently unclear around time of diagnosis, which infants are at higher risk of later fulfilling a CF diagnosis. In this study, we hypothesised that immunoreactive trypsinogen (IRT) levels, used in NBS as a marker of pancreatic disease and function, may reflect the degree of CFTR dysfunction …

Chronic Obstructive Pulmonary Disease: Thoracic Ct Texture Analysis And Machine Learning To Predict Pulmonary Ventilation, Andrew Westcott, Dante P I Capaldi, David G Mccormack, Aaron D Ward, Aaron Fenster, Grace Parraga

Medical Biophysics Publications

Background Fixed airflow limitation and ventilation heterogeneity are common in chronic obstructive pulmonary disease (COPD). Conventional noncontrast CT provides airway and parenchymal measurements but cannot be used to directly determine lung function. Purpose To develop, train, and test a CT texture analysis and machine-learning algorithm to predict lung ventilation heterogeneity in participants with COPD. Materials and Methods In this prospective study (

Clinical And Therapeutic Sciences I Php 327, Joanna Burkhardt

Library Impact Statements

No abstract provided.