Medicine and Health Sciences Commons^™

Physician And Hospital Performance In Medicare’S Updated Bundled-Payment Model For Joint Replacement, Aidan P. Crowley, Austin S. Kilaru, Qian Erin Huang, Erkuan Wang, Jingsan Zhu, Ayush Arora, Torrey Shirk, Deborah S. Cousins, Kristin A. Linn, Said A. Ibrahim, Joshua M. Liao, Amol S. Navathe

Department of Medicine Faculty Papers

IMPORTANCE: Independent evaluations of Bundled Payments for Care Improvement Advanced (BPCI-A) have focused on hospitals and have not assessed the performance of physicians in participating physician group practices (PGPs). However, PGPs are accountable for a larger proportion of surgical procedures, including for lower-extremity joint replacement, in the BPCI-A model than are hospitals.

OBJECTIVE: To evaluate the association of treatment by BPCI-A-participating physicians and hospitals with health care spending, quality, and utilization for joint replacement procedures compared to nonparticipants.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study used Medicare claims of beneficiaries receiving lower-extremity joint replacement between April 2016 and September 2019 …

An Experimental Investigation Of Federal Messaging On Public Support For Enforcement- And Treatment-Based Approaches For Opioid Overdose Prevention In South Carolina, Lídia Gual-Gonzalez, Hunter M. Boehme, Peter Baker, Melissa Nolan Ph.D., Mph

Faculty Publications

Background

As the opioid overdose crisis continues to produce excessive morbidity and mortality in the United States, government agencies have applied various approaches to prevent overdoses, including law-enforcement efforts (e.g., arresting people who use drugs, interrupting drug traffickers, etc.) and treatment-based approaches (e.g., naloxone, medications for opioid use disorder, etc.). Public perception and support of these approaches are relevant for informing policy, allocating resources, and effectively implementing community interventions to prevent drug-related harms.

Methods

Using an embedded informational survey design, we experimentally assessed whether public support for strategies to prevent overdose in South Carolina is influenced by language from federal …

Human Ipsc-Based Breast Cancer Model Identifies S100p-Dependent Cancer Stemness Induced By Brca1 Mutation, Jingxin Liu, Cai Zhao, Jiahao Chen, Pengguihang Zeng, Qingjian Li, Xingqiang Lai, Jianing Chen, Xixi Zhu, Xinyi Liu, Jun Sun, Jia Wang, Peihang Fang, Tengfei Wang, Wenjie Chen, Diana Guallar, Nan Cao, Jianli Zhao, Shicheng Su, Andy Peng Xiang, Yi Arial Zeng, Jie Li, Junchao Cai, Dung-Fang Lee, Jinxin Bei, Yongliang Huo, Hai Hu, Shengbao Suo, Dong-Feng Huang, Jin Bai, Junjun Ding

Faculty, Staff and Student Publications

Breast cancer is the most common malignancy in females and remains the leading cause of cancer-related deaths for women worldwide. The cellular and molecular basis of breast tumorigenesis is not completely understood partly due to the lack of human research models which simulate the development of breast cancer. Here, we developed a method for generating functional mammary-like cells (MCs) from human-induced pluripotent stem cells (iPSCs). The iPSC-MCs closely resemble human primary MCs at cellular, transcriptional, and functional levels. Using this method, a breast cancer model was generated using patient-derived iPSCs harboring germline

Adaptive Bayesian Clinical Trials: The Past, Present, And Future Of Clinical Research, Donald A Berry

Faculty, Staff and Student Publications

Background/Objectives: Decision-analytic Bayesian approaches are ideally suited for designing clinical trials. They have been used increasingly over the last 30 years in developing medical devices and drugs. A prototype trial is a bandit problem in which treating participants is as important as treating patients in clinical practice after the trial.

Methods: This article chronicles the use of the Bayesian approach in clinical trials motivated by bandit problems. It provides a comprehensive historical and practical review of Bayesian adaptive trials, with a focus on bandit-inspired designs.

Results: The 20th century saw advances in Bayesian methodology involving computer simulation. In the …

Il-6 Predicts Cdk4/6 Inhibitor Resistance, Identifying Stat3 As A Target In Hr + /Her2-Negative Metastatic Breast Cancer, Nicole M Kettner, Tuyen N Bui, Juliana Navarro-Yepes, Sanaz Ghotbaldini, Bethanie Quintela, Nghi Lam, Akshara Singareeka Raghavendra, Yan Wang, Nancy Azizian, T Kris Eckols, Moses Makokha Kasembeli, Kurt Evans, Min Yi, Hannah Wingate, Jing Wang, Aysegul A Sahin, Funda Meric-Bernstam, Kelly K Hunt, Senthil Damodaran, David J Tweardy, Debu Tripathy, Khandan Keyomarsi

Faculty, Staff and Student Publications

Resistance to CDK4/6 inhibitors (CDK4/6i) is a major challenge in treating hormone receptor-positive, HER2-negative metastatic breast cancer. This study aimed to identify a biomarker predictive of resistance that could also serve as a therapeutic target. Circulating IL-6 levels in 166 patients significantly increased at progression, making IL-6 a non-invasive biomarker to predict CDK4/6i resistance. Knockdown of IL-6 re-sensitized resistant cells to palbociclib and endocrine therapy, underscoring IL-6's critical role in maintaining resistance. Patient-derived xenograft models from patients who progressed within 3 months versus ≥6 months of palbociclib therapy revealed distinct transcriptomic profiles, with later progressors exhibiting IL-6/STAT3 activation, epithelial-to-mesenchymal transition, …

Impact Of Food Insecurity Resource Navigation For Primary Care Patients With Diabetes And Hypertension: A Matched Cohort Study, Deeksha Gupta, Darin Thomas, Stella Self, Edward A. Frongillo Jr. Ph.D., Alain H. Litwin, J. Alex Ewing, Lynnette Ramos-Gonzalez, A. Carolina Rudisill

Faculty Publications

Background

Food insecurity contributes to poor health and increased healthcare costs among patients with chronic diseases. Resource navigators can facilitate community-based resource connections, addressing food insecurity, but the impact on healthcare costs and quality of life remains unclear.

Objective

To examine whether food insecurity resource navigation improves clinical outcomes, healthcare charges, and quality of life for patients with diabetes and/or hypertension.

Design

Matched-control quasi-experimental study.

Patients

Patients underwent screening for food insecurity from July 12, 2021, to December 31, 2022, in South Carolina’s largest health system. Eligible patients (18 + years, having food insecurity, and diabetes and/or hypertension) enrolled for …

U-Rich Elements Drive Pervasive Cryptic Splicing In 3' Utr Massively Parallel Reporter Assays, Khoa Dao, Courtney F Jungers, Sergej Djuranovic, Anthony M Mustoe

2020-Current year OA Pubs

Untranslated RNA sequences play essential roles in orchestrating gene expression. However, the sequence codes and mechanisms underpinning post-transcriptional regulation remain incompletely understood. Here, we revisit the finding from a prior massively parallel reporter assay (MPRA) that AU-rich elements in 3' untranslated regions (3' UTRs) can drive upregulation or downregulation of mRNA expression depending on 3' UTR context. We unexpectedly discover that this variable regulation arises from widespread cryptic splicing, predominately from an unannotated splice donor in the coding sequence of GFP to diverse acceptor sites in reporter 3' UTRs. Splicing is activated by U-rich sequences, which function as potent position-dependent …

Replication Of Sensor-Based Categorization Of Upper-Limb Performance In Daily Life In People Post Stroke And Generalizability To Other Populations, Chelsea E Macpherson, Marghuretta D Bland, Christine Gordon, Allison E Miller, Caitlin Newman, Carey L Holleran, Christopher J Dy, Lindsay Peterson, Keith R Lohse, Catherine E Lang

2020-Current year OA Pubs

BACKGROUND: Wearable movement sensors can measure upper limb (UL) activity, but single variables may not capture the full picture. This study aimed to replicate prior work identifying five multivariate categories of UL activity performance in people with stroke and controls and expand those findings to other UL conditions.

METHODS: Demographic, self-report, and wearable sensor-based UL activity performance variables were collected from 324 participants (stroke

RESULTS: Two PCs explained 70-90% variance: PC1 (overall UL activity performance) and PC2 (preferred-limb use). A five-variable, five-cluster model was optimal across samples. In comparison to clusters, two PCs and individual accelerometry variables showed higher convergent …

Perception Of Quality Of Life, Brain Regions, And Cognitive Performance In Hispanic Adults: A Canonical Correlation Approach, Juan C. Lopez-Alvarenga, Jesus D. Melgarejo, Jesus Rivera-Sanchez, Lorena Velazquez-Alvarez, Rosa V. Pirela, John Blangero, Jose E. Cavazos, Michael C. Mahaney, Joseph D. Terwilliger, Gladys E. Maestre

School of Medicine Publications

The quality of life (QoL) perception has been studied in neurological diseases; however, there is limited information linking brain morphological characteristics, QoL, and cognition. Human behavior and perception are associated with specific brain areas that interact through diffuse electrochemical networking. We used magnetic resonance imaging (MRI) to analyze the brain region volume (BRV) correlation with the scores of Rand’s 36-item Short Form Survey (SF-36) and cognitive domains (memory and dementia status). We analyzed data from 420 adult participants in the Maracaibo Aging Study (MAS). Principal component analysis with oblimin axis rotation was used to gather redundant information from brain parcels …

U-Rich Elements Drive Pervasive Cryptic Splicing In 3′ Utr Massively Parallel Reporter Assays, Anthony M Mustoe

Faculty, Staff and Students Publications

Untranslated RNA sequences play essential roles in orchestrating gene expression. However, the sequence codes and mechanisms underpinning post-transcriptional regulation remain incompletely understood. Here, we revisit the finding from a prior massively parallel reporter assay (MPRA) that AU-rich elements in 3' untranslated regions (3' UTRs) can drive upregulation or downregulation of mRNA expression depending on 3' UTR context. We unexpectedly discover that this variable regulation arises from widespread cryptic splicing, predominately from an unannotated splice donor in the coding sequence of GFP to diverse acceptor sites in reporter 3' UTRs. Splicing is activated by U-rich sequences, which function as potent position-dependent …

Assessment Of Dnase Activity By Ratiometric Fluorescence Resonance Energy Transfer

Faculty, Staff and Students Publications

The present protocol describes a simple and sensitive ratiometric Förster resonance energy transfer (FRET) assay for the detection and quantitative assessment of DNase activity. Ratiometric FRET measurements make use of the ratio of donor and acceptor emission signals. The assay detects single-stranded DNA breaks using a staple-shaped, dual-tagged 38-mer FRET oligoprobe, employed as a real-time DNA cleavage sensor. The main application of the described approach is the quantitative assessment of the effects of reaction conditions, such as pH, temperature, and buffer composition, on DNase activity. Due to its ability to detect even minor and slow DNA cleavage, the assay is …

Specialization Of Sesquiterpene Lactone Metabolites In Liriodendron Plant Defense, Colin Galliano, Era Srivastava, David C Rowley, Kathryn M Ramsey, Divita Mathur, Matthew J Bertin

Faculty, Staff and Students Publications

Tulip trees (Liriodendron tulipifera and Liriodendron chinense), members of the Magnolia family, are known for their distinctive morphology and ecological significance, but their chemical diversity remains understudied. In this study, we report the identification and characterization of an array of sesquiterpene lactones (SQLs) produced by L. tulipifera. Through comprehensive chemical analysis, including high-resolution mass spectrometry and nuclear magnetic resonance spectroscopy, we identified a series of STLs with distinct bioactivity profiles. Notably, one of these compounds exhibited antibacterial activity but was only present in L. tulipifera, being absent in L. chinense. Additionally, some STLs demonstrated significant …

Adhd In Youth With Major Depressive Disorder In The Texas Youth Depression And Suicide Research Network (Tx-Ydsrn): Clinical Correlates And Moderators, Blake M Upshaw, Samuel D Spencer, Caitlin M Pinciotti, Vadym Zhyrov, Abu Minhajuddin, Allyssa Abacan, Rachel A Walker, Joseph C Blader, Sarah L Martin, Jeffrey D Shahidullah, Jair C Soares, Robert Andrew Harper, Madelyn Guerra, Lynnel C Goodman, Wayne K Goodman, Sarah M Wakefield, Madhukar H Trivedi, Eric A Storch

Faculty, Staff and Student Publications

Objective: Depression is a major public health concern with a 19% lifetime prevalence in youth, often precipitating other concerns, including suicidal behavior, poor school performance, and worsened peer relationships. ADHD is also common among youth and frequently presents alongside major depressive disorder (MDD), with this comorbidity associated with increased impairment. More research is needed to elucidate the clinical characteristics of this comorbidity (MDD + ADHD), especially as it relates to youth with MDD and no ADHD (MDD - ADHD). The present study examined the clinical correlates of MDD + ADHD in youth and the presence of an ADHD diagnosis as …

Staff Education On Evidence-Based Transitional Care Interventions Toward The Goal Of Reducing Readmission Rates, Adebowale A. Oyebamiji

Walden Dissertations and Doctoral Studies

The staff education project was implemented in a behavioral health hospital in the Midwestern region of the United States. The behavioral healthcare setting experiences poor transitional care, resulting in high readmission rates of psychiatric patients. Poor transitional care is associated with inadequate knowledge of evidence-based transitional care strategies among psychiatric nurses. The practice-focused question was: For staff in an inpatient mental health unit, will education on evidence-based transitional care interventions improve knowledge toward reducing readmission rates? The project aimed to enhance psychiatric staff knowledge on evidence-based transitional care interventions to reduce readmission rates. The analysis, design, development, implementation, and evaluation …

A Qualitative Study Understanding The Effects Of Eye Movement Desensitization And Reprocessing In Equine Therapy, Linsey Adams, Tara Rava Zolnikov

People and Animals: The International Journal of Research and Practice

This qualitative descriptive study investigates the efficacy of EquiLateral™, an equine-assisted EMDR protocol, in treating PTSD. Amid increasing global cases of stress-related disorders, particularly in the United States, the study explores the experiences of current and former clients engaged in EquiLateral™ therapy with a licensed therapist. The absence of standardized procedures in equine-assisted therapy research has left a gap in understanding specific activities that effectively reduce PTSD symptoms. Through semi-structured interviews, the study captures participants’ experiences and perceptions, revealing transformative impacts of EquiLateral™ therapy on managing PTSD. Nine thematic findings emerged: life-changing, present moment, calmness, safety and trust, manageability, changed …

The Experience Of People Living With Dementia (Pwd) In Participating In Virtual Cognitive Stimulation Therapy (Vcst)—A Qualitative Systematic Review, Hau Ying Chan, Heather Bullen

Student Journal of Occupational Therapy

Background: This systematic review aims to explore the experiences of people living with dementia (PwD) participating in virtual cognitive stimulation therapy (vCST). With the global shift of cognitive stimulation therapy (CST) online during the COVID-19 pandemic, little research has explored how PwD experience telehealth interventions. This is the first qualitative systematic review on the experience of PwD participating in vCST.

Methods: Following the Joanna Briggs Institute (JBI) methodology for qualitative systematic reviews, a comprehensive search was conducted across six databases and the grey literature from January 1, 2013, to August 31, 2023.

Conclusion: Two synthesized findings were identified from two …

Food Literacy Program Among Adults In A Primary Care Setting, Marie K. Williams

Student Scholarly Projects

Practice problem: The increase in preventable chronic diseases is associated with food illiteracy, which arises from a lack of understanding of nutritional value and dietary guidelines (Silva et al., 2023).

PICOT: (P) In adult primary care patients aged 30-75 years, (I) does the implementation of evidence-based food literacy program (C) compared to standard practice (O) improve food literacy (T) in eight weeks?

Evidence: Using a validated food literacy questionnaire effectively measures improvements in food literacy. Customized programs that fill knowledge gaps are essential for enhancing overall food literacy. Intervention: Customized educational tools were provided to participants based on their knowledge …

Scoring Goals With Autistic Children: Decision Making And Successful Implementation, Victoria Henbest, Brenda L. Beverly

APLL Lab Presentations

No abstract provided.

The Sodium-Glutamate Antagonist Riluzole Improves Outcome After Acute Spinal Cord Injury: Results From The Riscis Randomised Controlled Trial Analysed Using A Global Statistical Analytic Technique, Michael G. Fehlings, Karlo M. Pedro, Mohammed Ali Alvi, Ali Moghaddamjou, James S. Harrop, Ralph Stanford, Jonathon Ball, Bizhan Aarabi, Paul M. Arnold, James D. Guest, Shekar N. Kurpad, James M. Schuster, Ahmad N. Nassr, Karl M. Schmitt, Jefferson R. Wilson, Darrel S. Brodke, Faiz U. Ahmad, Albert Yee, Wilson Z. Ray, Nathaniel P. Brooks, Jason Wilson, Diana S-L Chow, Elizabeth G. Toups, Kevin E. Thorpe, Jiaxin Huang, Peng Huang

Department of Neurosurgery Faculty Papers

BACKGROUND: Spinal cord injury (SCI) clinical trials typically rely on a single primary endpoint to assess drug efficacy. This strategy fails to adequately capture the full impact of treatment in heterogenous neurological conditions like SCI. A more patient-centric analysis requires assessment of neurological function, functional capacity, and quality of life, incorporating meaningful patient-reported outcomes. The global statistical test (GST) addresses this challenge using a unified statistical conclusion regarding the superiority of a treatment strategy over another by evaluating multiple trial endpoints simultaneously.

METHODS: The RISCIS trial (Safety and Efficacy of Riluzole in Acute Spinal Cord Injury Study) data was analysed …

The Sodium-Glutamate Antagonist Riluzole Improves Outcome After Acute Spinal Cord Injury: Results From The Riscis Randomised Controlled Trial Analysed Using A Global Statistical Analytic Technique, Michael G. Fehlings, Karlo M. Pedro, Mohammed Ali Alvi, Ali Moghaddamjou, James S. Harrop, Ralph Stanford, Jonathon Ball, Bizhan Aarabi, Paul M. Arnold, James D. Guest, Shekar N. Kurpad, James M. Schuster, Ahmad N. Nassr, Karl M. Schmitt, Jefferson R. Wilson, Darrel S. Brodke, Faiz U. Ahmad, Albert Yee, Wilson Z. Ray, Nathaniel P. Brooks, Jason Wilson, Diana S.L. Chow, Elizabeth G. Toups, Kevin E. Thorpe, Jiaxin Huang, Peng Huang

School of Medicine Faculty Publications

Background: Spinal cord injury (SCI) clinical trials typically rely on a single primary endpoint to assess drug efficacy. This strategy fails to adequately capture the full impact of treatment in heterogenous neurological conditions like SCI. A more patient-centric analysis requires assessment of neurological function, functional capacity, and quality of life, incorporating meaningful patient-reported outcomes. The global statistical test (GST) addresses this challenge using a unified statistical conclusion regarding the superiority of a treatment strategy over another by evaluating multiple trial endpoints simultaneously. Methods: The RISCIS trial (Safety and Efficacy of Riluzole in Acute Spinal Cord Injury Study) data was analysed …

Mediation Analysis To Investigate Differences In Prostate Cancer Diagnosis Stage Through Environmental Risk Factors In Louisiana, Nubaira Rizvi, Randy Hamilton, Xiao-Cheng Wu, Michael D. Celestin, Tung-Sung Tseng, Qingzhao Yu

School of Public Health Faculty Publications

Prostate Cancer (PCa) is the most commonly diagnosed cancer and the second leading cause of cancer death among men. In Louisiana (LA), Black men are disproportionately diagnosed at later stages compared to White men. This study explores environmental risk factors as potential intermediate variables linking race to cancer diagnosis stage. The Louisiana Tumor Registry data included 24,647 male patients diagnosed with PCa in LA between 2010 and 2018. Among them, 15,875 (64.40%) were Caucasian American (CA) and 8772 (35.59%) African American (AA). Mediation analysis using multiple additive regression trees (MART) identified possible intermediate variables that potentially explain the observed disparity. …

Public Understanding Of And Engagement With Community Health Workers And Promotores De Salud: Findings From Two National Surveys, Elizabeth A. Rohan, Julie S. Townsend, Andrea Torres, Hope L. Thompson, Dawn M. Holman, Avid Reza, Felicia Solomon Tharpe, Erin Caple, Ashley Wennerstrom

School of Public Health Faculty Publications

INTRODUCTION: Community health workers (CHWs) can improve health by helping people navigate health care services and systems and connecting them to community services that address nonmedical factors such as food insecurity, housing, and transportation. While CHWs have long been part of the US public health system, there are no data, to our knowledge, on the public's familiarity and interactions with CHWs. METHODS: We analyzed data from the 2022 Porter Novelli FallStyles and Estilos surveys, online market research surveys of the general public delivered in English (FallStyles) or primarily Spanish (Estilos). Each survey asked the same 4 questions on familiarity and …

Understanding Flow States To Inform Post-Secondary Pathways, Na'ciya Datus Bascus, Kerri Green Edd, Ms

Research Scholars

No abstract provided.

Understanding Interpreter Services, Mariana Castano Lizarazo, Joumana De Santiago

Research Scholars

No abstract provided.

Fitness Feedbacks And Improvements, Ganasia Lopez, Brielle Gregoli Ms, Dana Levano Ms

Research Scholars

No abstract provided.

Public Safety: Roles And Responsibilities, Yaritza Berrios, Joshua Houck Ba Nrp

Research Scholars

No abstract provided.

Evaluation Of Physical, Mental, And Mechanical Aspects Of An Extreme Military Training Event: A Continuous Monitoring Approach, Tirthankar Chatterjee, Debojyoti Bhattacharyya, Roshani Meena

Journal of Human Performance in Extreme Environments

Soldiers receive extensive training at extremes of environments and simulated terrains to improve their battle efficiency. A study was designed to evaluate the actual cost of a military physical efficiency test consisting of several physically engaging activities to quantify physiological, mechanical, and subjective demands. Sixteen Indian soldiers participated in a military training session consisting of events such as a 5-km run, 4-m vertical rope climbing, a 2.75-m jump, a 60-m dash, and a 9-m horizontal rope climbing with 6.5 kg of equipment in a hot dry environment. Their physiological status was monitored continuously. National Aeronautics and Space Administration Task Load …

Choline-An Essential Nutrient With Health Benefits And A Signaling Molecule, Brianne C. Burns, Jitendra D. Belani, Hailey N. Wittorf, Eugen Brailoiu, G. Cristina Brailoiu

College of Pharmacy Faculty Papers

Choline has been recognized as an essential nutrient involved in various physiological functions critical to human health. Adequate daily intake of choline has been established by the US National Academy of Medicine in 1998, considering choline requirements for different ages, sex differences and physiological states (e.g., pregnancy). By serving as a precursor for acetylcholine and phospholipids, choline is important for cholinergic transmission and the structural integrity of cell membranes. In addition, choline is involved in lipid and cholesterol transport and serves as a methyl donor after oxidation to betaine. Extracellular choline is transported across the cell membrane via various transport …

Small Current, Big Potential: Bridging Mechanistic Insight Of The Sk Channel With Translational Promise, Yang Zheng, Miao Zhang, Nipavan Chiamvimonvat

Pharmacy Faculty Articles and Research

"Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia, with a lifetime risk of approximately 1 in 4 for adults aged 40 years and above. Despite advances in clinical management, AF remains a major public health concern. Its burden extends beyond symptoms; it quadruples the risk of heart failure and increases the likelihood of stroke fivefold – strokes that are often more severe and fatal than those unrelated to AF. In the United States alone, AF-associated healthcare costs exceed $26 billion annually, and the cost is projected to grow as the population ages (Ko et al., 2025). Regarding current treatments, …

Anxious Traits Intensify The Impact Of Depressive Symptoms On Stigma In People Living With Hiv, Delfina Janiri, Flavio Cherubini, Paolo Vassalini, Letizia Santinelli, Gabriella D'Ettorre, Gabriele Sani, Giovanni Camardese

Faculty, Staff and Students Publications

Background/Objectives: Despite medical advances, stigma remains a major challenge for people living with HIV (PLWH). This study examined clinical, sociodemographic, and psychological predictors of HIV-related stigma, and explored whether affective temperament moderates the impact of depression on stigma.

Methods: This cross-sectional observational study included 97 PLWH attending a tertiary infectious disease unit in Rome, Italy. Participants completed a battery of validated psychometric instruments assessing depressive symptoms, anxiety, manic symptoms, mixed affective states, general psychopathology, impulsivity, and affective temperament. HIV-related stigma was evaluated using the Berger HIV Stigma Scale, which measures personalized stigma, disclosure concerns, negative self-image, and concerns …