A Clinical Overview Of Endometriosis, Adriane Strawn

Lynchburg Journal of Medical Science

Endometriosis, the finding of endometrial tissue in areas of the body other than the interior of the uterus, affects about 10% of menstruating women worldwide and is a common reason for dysmenorrhea and infertility. The underlying pathophysiology is not fully known but thought to be mostly due to retrograde menstruation through the oviducts into the abdominopelvic cavity. Other major pathogenic theories include vascular and lymphatic spread and coelomic metaplasia. Patient symptoms may include dysmenorrhea, dyschezia, dyspareunia, pelvic pain, infertility, and fatigue, but patients can also be asymptomatic. Endometriosis is difficult to diagnose, and although it is possible to visualize certain …

Testosterone Replacement Therapy In The Middle-Aged Male, Gina N. Demilt

Lynchburg Journal of Medical Science

The purpose of this review was to investigate the use of testosterone supplementation in the middle-aged male with a focus on the pathophysiology of testosterone throughout the lifespan, current supplementation options and their adverse effects, and the overall benefit of supplementing to enhance quality of life. A comprehensive search of electronic databases was conducted identifying studies that assessed clinical outcomes, pathophysiology, supplementation options, adverse effects and benefits of treatments. The findings suggested that testosterone levels naturally decline with age with most men developing symptoms of hypogonadism around age 60. Testosterone supplementation outside of current guidelines is not recommended, however men …

Effective Interventions For Preventing Burnout In Health Education Students, Heidi Vonderheide

Lynchburg Journal of Medical Science

This article aims to investigate effective interventions to reduce burnout in health education students. A comprehensive electronic literature search of PubMed and Google Scholar identified articles discussing the prevalence and effects of burnout in health care providers and students, as well as interventions to reduce burnout and improve the quality of life of health education students. The findings suggest pass-fail grading, physical exercise, mindfulness training, and mental health programming significantly reduce burnout among health education students. Significant variability in both intervention design and outcome measurement highlights the limitations of the findings and underscores the need for future research. Effective burnout …

Optimizing Interventions For Major Depressive Disorder And Provider Burnout: Self-Speak Exercise Dosing (Sed), Laureen Maloney-Gepfert

Lynchburg Journal of Medical Science

ABSTRACT

Major Depressive Disorder (MDD) is ranked highest among mental illnesses in the United States (US) and significantly contributes to the mental health care crisis. Patients experience resistance to pharmacologic interventions, side effects, co-morbidities, and mental health provider shortages. Subsequently, 33 % of Serious Mental Illnesses (SMIs) are being redirected to Primary Care Providers (PCPs). Concurrently, prescriber mental health is in crisis. Growing workloads for physicians and Advanced Practice Providers (APPs) have increased provider burnout syndrome (BOS). Major Depressive Disorder and BOS are positively affected by exercise, Cognitive Restructuring (CR), and Behavioral Activation (BA). Sports medicine and psychology research shows …

Roadmap To Better Mental Health Care, James R. Kilgore, James C. Somers, Jenna Rolfs, Everett Allen, Tom Colletti, Blake Rogers, Maggie Banger, Nikoleta Delis, Debra S. Munsell Dhsc, Pa-C

Lynchburg Journal of Medical Science

This article will describe the current providers involved in delivering mental health services, the projected needs for mental health providers in the next decade, and interventional strategies that may enhance their delivery of care. By adopting comprehensive, patient-centered interdisciplinary strategies, and utilizing new and innovative tools and pharmaceutical agents healthcare providers can mitigate the adverse effects of lack of access and the delivery of mental health care.

Spirituality And Ptsd Outcomes Among Service Members And Military Veterans, Jennifer Urbina Dmsc, Pa-C

Lynchburg Journal of Medical Science

Post-traumatic stress disorder (PTSD) is a prevalent and debilitating condition among military service members and veterans, often co-occurring with moral injury (MI) and spiritual distress (SD). While conventional PTSD treatments include cognitive behavioral therapy (CBT), exposure-based therapies, and pharmacological interventions, growing evidence suggests that spirituality may play a vital role in improving PTSD outcomes. This paper explores the integration of spirituality in PTSD treatment, examining its potential to mitigate symptoms, enhance resilience, and facilitate post-traumatic growth. Military chaplaincy, spiritually integrated therapies, and Department of Defense (DoD) holistic health models provide frameworks for addressing the spiritual dimensions of PTSD. Studies indicate …

Image Quality Analysis Of Head Cts Obtained On A New Portable Scanner Compared To Stationary Ct, Mara M. Kunst, Juan E. Small, Sebastian E. Flacke, Joseph D. Burns, Maximilian Smith, Christoph D. Wald

The Lahey Journal

Background/Purpose: The use of mobile head CT scanning in the ICU setting has both clinical and economic advantages, particularly if able to provide image quality close or equal to fixed CT scanners.

The purpose of the study is to evaluate the image quality of a new portable CT scanner, compared to a fixed CT platform.

Materials/Methods: Inpatients (n=11), age> 60 requiring head CT evaluation were enrolled and consented to obtain an additional head CT on the portable CT, following their fixed exam.

Nine patients were able to complete the study; seven patients received duplicate exams with matched imaging technique, and …

Comparing Testosterone Suppression In Intramuscular And Subcutaneous Leuprolide Acetate Formulations, Annalise Mcdonald, Kali Sullivan, Cara Cloghessy, Benjamin Sweigart, Brendan J. Connell

The Lahey Journal

Introduction

Androgen deprivation therapy (ADT) is commonly used to treat prostate cancer. Leuprolide acetate (LA) is a common ADT, manufactured as an intramuscular injection, Lupron® (LA-IM), and a subcutaneous injection, Eligard® (LA-SC) with the goal of testosterone < 50 ng/dL. We investigated for differences in testosterone suppression between the two formulations in patients with prostate cancer.

Methods

Clinical data was abstracted from our medical records system for patients with prostate cancer who started leuprolide acetate between January 2016 through March 2022 with a subsequent testosterone value checked. Primary endpoint was the proportion of subjects with testosterone levels < 50mg/dL, with secondary endpoints including the proportion of subject achieving testosterone levels < 20ng/dL and median testosterone levels.

Results

525 subjects were included. The LA-IM and LA-SC groups were balanced for age and race but the doses of leuprolide differed …

Assessing The Impact Of Covid-19 Pandemic On Surgical Trends Of Ophthalmology Residents Graduating After 2020, Max Liu, Meghana Kalavar, Vamsee Vemulapalli, Mustapha Tahiru, Thuy Le, Andrew J. Hendershot

Journal of Academic Ophthalmology

Purpose: To examine the effects of the COVID-19 pandemic on surgical volumes of ophthalmology residents who completed training after 2020. Methods: Aggregated average case logs of primary surgeon and surgeon + assist (S+A) procedures for graduating ophthalmology residents in the U.S. between 2012 and 2023 were gathered from the Accreditation Council for Graduate Medical Education (ACGME). Trends for primary surgeon and S+A procedures were assessed. The annual percent change in primary surgeon and S+A procedures was determined using linear regression to compare changes over three time periods: 2012-2019, 2019- 2020, and 2020-2023. Results: Total cases as a primary surgeon and …

Cross-Sectional Analysis Of International Rotations Among Ophthalmology Residency Programs, Malcolm M Kates, Riley Ct Duke, Krupa H. Patel, Russell W Read

Journal of Academic Ophthalmology

Background: Applicants to ophthalmology residency programs have increasingly expressed interest in international surgical rotations. As such, ophthalmology residency program directors (PDs) have expanded international offerings to meet this desire but the true number of residency programs with international offerings is unknown. Methods: In February 2023, the official residency websites of all 125 accredited US-based ophthalmology residency programs were analyzed for any mention of international rotations. Websites were identified using a Google™ search by entering the program name and “ophthalmology residency.” All websites were surveyed for information regarding international rotations including the presence/absence of an international rotation and any additional information …

The Relationship Between Open Access Article Publishing And Short-Term Citations In Ophthalmology, Hassaam S Choudhry, Carter Burton, Luis Cupertino, Matthew Montani, Riya Patel, Sri Guttikonda, Albert S Khouri

Journal of Academic Ophthalmology

Purpose: In recent years academic journals have increasingly transitioned to a paid open access (OA) model. The present study aims to identify whether OA or subscription access (SA) influences short-term citations of articles in ophthalmology. Methods: The Dimensions database was queried in October 2022 for articles published in 2019 in the following journals with both open and subscription access options: Ophthalmology, American Journal of Ophthalmology, JAMA Ophthalmology, Graefe's Archive for Clinical and Experimental Ophthalmology, and British Journal of Ophthalmology. Article access, citations, country, article type (review, letter/viewpoint/comment, original investigation), study type (basic science/animal model, case report/series, clinical trial, NA, observational) …

Implementing Standardized Patients In Simulation In Undergraduate Nursing Education, Taylor A. Murray

SACAD: Scholarly Activities

Abstract

The integration of standardized patients (SPs) in simulation-based learning has emerged as a transformative approach in undergraduate nursing education. By providing nursing students with the opportunity to engage with trained actors simulating real-life patient scenarios, SPs offer a safe and controlled environment to develop essential clinical skills. This research explores the impact of SPs on promoting student confidence and enhancing their practical skills in nursing practice. Implementing SPs into nursing education not only supports students in refining their assessment and communication abilities but also prepares them for the complexities of patient care in real-world settings. Ultimately, this study aims …

Development Of A Synthetic Biomarker System For Early Detection Of Myocardial Infarction, Kennedy Alexis Bietz

Honors Thesis

Every year, thousands of Americans suffer from the event of a heart attack, i.e., myocardial infarction (MI). Currently, the early detection of MI remains a challenge. We intend to solve the problem by constructing a synthetic biomarker system that would be able to recognize early warning signs of MI, such as cellular inflammation and oxidative stress. We have proposed two different pathology specific genetic sensors that act as artificial promoters to transcribe a peptide that can be secreted into the blood stream and eventually work its way into the urine and act as a reporter that can be detected through …

Obesity Awareness Among Pregnant Hispanic Women In Urban New Jersey, Cloris Bustamante

Walden Dissertations and Doctoral Studies

The rising prevalence of obesity among pregnant women presents significant health risks for mothers and children, beginning as early as intrauterine life throughout adulthood. The purpose of this quantitative cross-sectional study was to investigate whether demographic factors influenced obesity awareness as a personal issue in pregnant Hispanic women. The precaution adoption process model guided the study, a theoretical framework focusing on stages of health behavior change, including awareness, decision making, and action. A purposive sample of 134 pregnant Hispanic women aged 18 years or older receiving prenatal care in urban New Jersey was surveyed using the English (15) and Spanish …

A Life Course Approach To Understanding Preserved Cognition In Late Life, Cassidy E. Doyle

USF Tampa Graduate Theses and Dissertations

Some level of cognitive decline is generally expected with advanced age. However, a subgroup of individuals – commonly labeled as ‘SuperAgers’ – maintain youthful memory abilities into their 80s and beyond. Relatively little is known about factors across the life course related to this phenotype. This dissertation used population-based data from the Health and Retirement Study (HRS) to investigate lifestyle factors related to the most youthful cognitive trajectory in the United States and assess how their cognition fares over time. Three research questions were addressed: (1) Can samples of youthful cognitive agers be identified longitudinally in a population-based dataset? (2) …

Breast Cancer Diagnoses Are Increasing Among Racial And Ethnic Minority Women In The U.S., Esther Oshaji

Population Health Research Brief Series

Breast cancer is the second most common cancer and a leading cause of cancer deaths among women in the United States. This data slice uses data from the Surveillance, Epidemiology and End Results Program (SEER) Incidence Database to examine trends in breast cancer incidence rates among women by race and ethnicity in the U.S. from 2000 to 2021. The author finds that, while incidence rates remain highest among non-Hispanic White women, the largest increases in diagnoses have been among American Indian/Alaska Native Asian/Pacific Islander women.

Role Of Eye-Tracking Technology And Software Algorithms In Enhancing Adhd Detection And Diagnosis: A Systematic Literature Review, Lauren E. Perkins

Honors College Theses

This systematic literature review explores the role of eye-tracking technology and software algorithms in enhancing the detection and diagnosis of ADHD. ADHD, a neurodevelopmental disorder affecting both children and adults, is traditionally diagnosed through behavioral assessments, which may lack objectivity. Recent studies suggest that eye-tracking, specifically focusing on saccades, fixations, and blink rates, offers the potential for more accurate and objective measures of ADHD. The review examines clinical trials, observational studies, and machine learning research to assess the correlation between ADHD and eye movement patterns. Results indicate that individuals with ADHD exhibit distinct eye movement patterns, which can be quantified …

Standardizing Warming Measures For Surgical Patients, Brachelle Williams, Bsn, Rn

Doctor of Nursing Practice Final Project Abstract

Purpose

The quality improvement project aimed to address the risk of perioperative hypothermia in surgical patients by standardizing warming measures at a Houston, Texas boutique hospitals surgical department. The focus was to achieve normothermia (≥ 96.8°F) within 10 minutes of PACU arrival and increase patient satisfaction by at least 50% through the implementation of a forced air warming system.

Background

Maintaining normothermia is crucial for surgical patients, as hypothermia can lead to delayed recovery and increased postoperative discomfort. The Houston’s boutique hospital previously solely relied on warm blankets, resulting in inconsistent temperature management.

Methodology

The Plan-Do-Study-Act (PDSA) model guided the …

Multicilia Dynamically Transduce Sonic Hedgehog Signaling To Regulate Choroid Plexus Functions, Suifang Mao, Michael J Holtzman, Et Al.

2020-Current year OA Pubs

The choroid plexus is a major site for cerebrospinal fluid (CSF) production, characterized by a multiciliated epithelial monolayer that regulates CSF production. We demonstrate that defective choroid plexus ciliogenesis or intraflagellar transport yields neonatal hydrocephalus, at least in part due to increased water channel Aqp1 and ion transporter Atp1a2 expression. We demonstrate choroid plexus multicilia as sensory cilia, transducing both canonical and non-canonical Sonic Hedgehog (Shh) signaling. Interestingly, it is the non-canonical Shh signaling that represses Aqp1 and Atp1a2 expression by the Smoothened (Smo)/Gαi/cyclic AMP (cAMP) pathway. Choroid plexus multicilia exhibit unique ciliary ultrastructure, carrying features of both primary and …

American Society Of Hematology Living Guidelines On Use Of Anticoagulation For Thromboprophylaxis For Patients With Covid-19: Executive Summary, Deborah M Siegal, Kristen M Sanfilippo, Yazan Al Jabiri, Et Al.

2020-Current year OA Pubs

BACKGROUND: COVID-19-related critical and acute illness is associated with an increased risk of venous thromboembolism (VTE). These evidence-based recommendations of the American Society of Hematology (ASH) are intended to support patients, clinicians, and other health care professionals in decisions about using anticoagulation for thromboprophylaxis for patients with COVID-19-related critical illness; patients with COVID-19-related acute illness; and those being discharged from the hospital, who do not have suspected or confirmed VTE.

METHODS: ASH formed a multidisciplinary panel, including patient representatives. The Michael G. DeGroote Cochrane Canada and MacGRADE Centres at McMaster University supported guideline development, including performing systematic reviews (up to …

Tissue-Resident Ccr2+ Macrophage Trem-1/3 Signaling Is Necessary For Monocyte And Neutrophil Recruitment To Injured Hearts, Yuriko Terada, Wenjun Li, Junedh M Amrute, Amit I Bery, Charles R Liu, Venkatrao Nunna, Christian Corbin Frye, Hao Dun, Andrew L Koenig, Hannah P Luehmann, Gyu Seong Heo, Macee C Owen, Alexander N Wein, Yongjian Liu, Jon H Ritter, Sumanth D Prabhu, Ruben G Nava, Andrew E Gelman, Marina Cella, Marco Colonna, Kory J Lavine, Daniel Kreisel

2020-Current year OA Pubs

Triggering receptor expressed on myeloid cells 1 (TREM-1) has been shown to amplify inflammatory signals, such as Toll-like receptor signaling, after infection and sterile injury. While previous studies have demonstrated that TREM-1 activation in circulating immune cells promotes injury, the role of TREM-1 signaling in tissue-resident cells in the context of sterile inflammation remains poorly understood. Here, we used a cardiac transplantation model to dissect how Trem1/3 expression on heart-resident cells regulates sterile inflammation. TREM-1 is expressed in heart-resident C-C chemokine receptor 2 (CCR2)

A Network Correspondence Toolbox For Quantitative Evaluation Of Novel Neuroimaging Results, Ru Kong, Evan M Gordon, Et Al.

2020-Current year OA Pubs

The brain can be decomposed into large-scale functional networks, but the specific spatial topographies of these networks and the names used to describe them vary across studies. Such discordance has hampered interpretation and convergence of research findings across the field. We have developed the Network Correspondence Toolbox (NCT) to permit researchers to examine and report spatial correspondence between their novel neuroimaging results and multiple widely used functional brain atlases. We provide several exemplar demonstrations to illustrate how researchers can use the NCT to report their own findings. The NCT provides a convenient means for computing Dice coefficients with spin test …

Cell-Matrix Feedback Controls Stretch-Induced Cellular Memory And Fibroblast Activation, Yuan Hong, Xiangjun Peng, Haomin Yu, Delaram Shakiba, Yuxuan Huang, Chengqing Qu, Aliza Mujahid, Yin-Yuan Huang, Jacob A Sandler, Kenneth M Pryse, Justin M Sacks, Elliot L Elson, Guy M Genin, Et Al.

2020-Current year OA Pubs

Mechanical stretch can activate long-lived changes in fibroblasts, increasing their contractility and initiating phenotypic transformations. This activation, critical to wound healing and procedures such as skin grafting, increases with mechanical stimulus for cells cultured in two-dimensional but is highly variable in cells in three-dimensional (3D) tissue. Here, we show that static mechanical stretch of cells in 3D tissues can either increase or decrease fibroblast activation depending upon recursive cell-extracellular matrix (ECM) feedback and demonstrate control of this activation through integrated in vitro and mathematical models. ECM viscoelasticity, signaling dynamics, and cell mechanics combine to yield a predictable, but nonmonotonic, relationship …

Molecular Basis For Human Respiratory Syncytial Virus Transcriptional Regulator Ns1 Interactions With Med25, Parismita Kalita, Oam Khatavkar, Grace Uwase, Yulia Korshunova, Yuying Hu, Nicole D Wagner, Jian Xu, Jiehong Pan, Jay C Nix, Michael L Gross, Steven L Brody, Dominika Borek, Gaya K Amarasinghe, Jacqueline E Payton, Daisy W Leung

2020-Current year OA Pubs

The Mediator complex facilitates interactions between transcription factors and RNA polymerase II, a process that is required for host gene transcription, including in response to viral infections. Among the many subunits in the Mediator complex, the MED25 subunit has been shown to be a target for viral activators during infection. Here we provide the molecular basis for the interaction between human respiratory syncytial virus (hRSV) nonstructural 1 protein (NS1) and the activator interaction domain (ACID) of MED25. The X-ray crystal structure of the complex revealed that NS1 straddles and binds two faces of MED25 ACID. This interaction is distinct from …

A Green Validated Hplc-Uv Method For Determining And Quantifying Pholcodine, Paracetamol, And Pseudoephedrine In Laboratory-Prepared Mixtures And Their Fdc Capsule, Ekram Hany Mohamed, Mennatallah Ahmed Hesham, Ehab Elkady Prof, Sally Mahmoud Tarek

Pharmacy

A validated technique has been developed for the sequential determination of pholcodine, paracetamol, and pseudoephedrine. This method allows for their separation either in different ratios within a ternary mixture or in their fixed-dose combination (FDC) using HPLC. The chromatographic conditions involved the utilization of an X-select C18 column (5µ, 4.6 × 150 mm) and a mobile phase consisting of 0.05 M KH2PO4: Methanol (75:25, v/v), with orthophosphoric acid added to adjust the pH to 2.6. The separation was conducted at a 1.2 ml/min flow rate, while a UV detector was set at a wavelength of 206 nm to monitor the …

Aerosolized Transmissible Diseases Guidance Document, J. David Miller, John P. (Jack) Springston Jr., Cheryl L. Marcham, J. David Krause, Ling-Ling Hung, Wane A. Baker

Publications

Prior to COVID-19, pandemic influenza viruses have emerged four times in the previous one hundred years. This includes “Spanish” influenza (H1N1) in 1918, “Asian” influenza (H2N2) in 1957, “Hong Kong” influenza (H3N2) in 1968, and H1N1 “swine” influenza in 2009 (Saunders-Hastings & Krewski, 2016; Taubenberger, 2005). In early May 2024, the first reported human case of avian flu (H5N1) that had also infected cows in the US appeared in the literature (Uyeki et al., 2024). In late August 2024, OSHA released a hazard alert providing information for dairy workers on avian influenza in dairy cattle, together with personal protective equipment …

The Incidence Between Carpal Tunnel Syndrome (Cts) And De Quervain’S Tenosynovitis (Dqt) Using Electrophysiological And Ultrasonography Study., Shaimaa M. Abd El Aziz, Lamis Safwat

Journal of Medicine in Scientific Research

One of the most common entrapment neuropathies affecting the upper limbs is carpal tunnel syndrome (CTS). de Quervain tenosynovitis (DQT) is a condition that affects the wrist's first dorsal compartment and is characterized by tendon entrapment and thickening of sheaths around the abductor pollicis longus and extensor pollicis brevis. The association of idiopathic CTS and idiopathic DQT has been studied in a few researches. In this study, we would like to summarize the most recent knowledge about the occurrence of CTS and DQT on the same hand using electrophysiological and ultrasonography studies.

Does Coronary Artery Bypass Grafting Surgery Affect The Right Ventricular Function Postoperatively?, Ahmed A Faragalla, Ahmed M Elshiemy, Sherif A Elhindawy, Ahmed A Abdelhamid

Journal of Medicine in Scientific Research

Background A well-established benefit of coronary artery surgery (CABG) is to improve the left ventricular (LV) performance meanwhile, its impact on the right ventricular (RV) chamber is obscure and an issue of continuous investigations. Aim This study explores the influence of CABG on the RV performance. Methods This study employed a prospective longitudinal, observational design to evaluate function in 30 patients undergoing isolated CABG. Echocardiography with a transthoracic approach was accomplished preoperatively, one week and one-month post-surgery. The myocardial performance index (Tei index), tricuspid annular plane systolic excursion (TAPSE), and peak systolic (Sm) and early diastolic (Em) myocardial velocities at …

Paving The Way To Practice For International Nurses, Jaime Kupillas Msn, Rn, Kaitlyn Goodson Msn, Rn

Department of Education

No abstract provided.

Pediatric Relapsed/Refractory Alk-Positive Anaplastic Large Cell Lymphoma Treatment And Outcomes In The Targeted-Drug Era., Lianna J. Marks, Victor Ritter, Jennifer E. Agrusa, Kala Y. Kamdar, Julie Rivers, Rebecca Gardner, Matthew J. Ehrhardt, Kaitlin J. Devine, Charles A. Phillips, Anne Reilly, Keith August, Joanna Weinstein, Prakash Satwani, Christopher J. Forlenza, Christine Moore Smith, Chelsee Greer, Zeinab Afify, Carol H. Lin, Jennifer A. Belsky, Hilda Ding, David Hoogstra, Keri Toner, Michael P. Link, Liora M. Schultz, Eric J. Lowe, Catherine Aftandilian

Manuscripts, Articles, Book Chapters and Other Papers

Treatment options for patients with relapsed or refractory (R/R) anaplastic large cell lymphoma (ALCL) have increased in the era of targeted therapies such as brentuximab vedotin (BV) and anaplastic lymphoma kinase (ALK) inhibitors. However, there is no standard treatment and published data evaluating their use are limited. The goal of this retrospective study was to describe current real-world treatment and outcomes of pediatric, adolescent, and young adult patients with R/R ALK-positive ALCL. We conducted a retrospective, multi-institutional study identifying 81 patients with R/R ALK-positive ALCL aged ≤21 years at initial diagnosis treated between 2011 and 2022 across 18 institutions. Median …