Medicine and Health Sciences Commons^™

Hooked On Sight: Teen With Eye Trauma, Anjeza Cipi, Emily Sealy

Department of Emergency Medicine Faculty Publications

[Case presentation] A 14-year-old male with no prior ocular history presented to the emergency department after accidentally striking his left eye on a metal garden hook while on vacation. He experienced a brief flash of light but denied floaters, vision changes, pain, or diplopia. Visual acuity was 20/20 bilaterally with correction. Pupils were equal and reactive, intraocular pressures were normal, and extraocular movements were intact. The injury noted is seen in Figures 1 and 2. There was no evidence of scleral penetration or foreign body on slit lamp examination. Intraocular pressure measurements were deferred until globe rupture was ruled out …

Letter Of Concern From The Association Of Academic Chairs Of Emergency Medicine Regarding Acgme Proposed Changes, Richard J. Hamilton, Lance B. Becker, Richard E. Wolfe, D. Adam Algren, Arnold Thomas, Michael Baumann, Ross P. Berkeley, Terrell S. Caffery, Chad Cannon, Theodore J. Corbin, Michael E. Chansky, Harinder S. Dhindsa, Charles L. Emerman, David A. Farcy, Chris Fox, Michael A. Gibbs, Christopher S. Goode, Steven "Andy" Godwin, Dietrich Jehle, David Johnson, Samuel M. Keim, Babak Khazaeni, Barry J. Knapp, Clint Hawthorne, John D. Hoyle Jr., Michael Christopher Kurz, Evan Leibner, Robert Mcnamara, Robert F. Mccormack, Edward A. Michelson, Chadwick Miller, Ashley Norse, Andrew Nugent, Brian J. O'Neil, David T. Overton, Edward A. Panacek, William F. Paolo, Denis R. Pauzé, Amanda L. Perez, Ralph J. Riviello, Scott W. Rodi, Peter S. Pang, Juan A. Gonzalez Sanchez, David P. Sklar, Ben C. Smith, Jeffrey R. Stowell, Marc D. Squillante, J. Jeremy Thomas, Terry Vanden Hoek, Gregory A. Volturo, E. Lea Walters, Thomas E. Wyatt, Donald M. Yealy

Department of Emergency Medicine Faculty Publications

This letter, signed by over 50 academic chairs of emergency medicine, urges the ACGME to reconsider a proposed mandate requiring all emergency medicine residency programs to adopt a four-year training model. The authors argue that current three-year programs are supported by data demonstrating equivalent educational and clinical outcomes compared to four-year formats. They criticize the flawed survey methodology underpinning the proposal, note the loss of milestone-based training flexibility, and highlight the lack of added scholarly or clinical value in the fourth year. The letter also outlines negative consequences for fellowship participation, workforce development, trainee debt, and diversity. The signatories advocate …

A 40-Week Phase 2b Randomized, Multicenter, Double-Blind, Placebo-Controlled Study Evaluating The Safety And Efficacy Of Memantine In Amyotrophic Lateral Sclerosis, Salman Bhai, Todd Levine, Dan Moore, Robert Bowser, Andrew J. Heim, Maureen Walsh, Aziz Shibani, Zachary Simmons, James Grogan, Namita A. Goyal, Raghav Govindarajan, Yessar Hussain, Tania Papsdorf, Tiffany Schwasinger-Schmidt, Nick Olney, Kim Goslin, Michael Pulley, Edward J. Kasarskis, Michael Weiss, Susan W. Katz, Suzan Moser, Duaa Jabari, Omar Jawdat, Jeffrey Statland, Mazen M. Dimachkie, Richard Barohn, Neuromuscular Study Group And Western Als Consortium Memantine Als Study Group

Neurology Faculty Publications

Introduction: Amyotrophic lateral sclerosis (ALS) is a rapidly progressive neurodegenerative disease with no known cure, limited treatment options with minimal benefits, and significant unmet need for disease modifying therapies.

Aims: This study investigated memantine's impact on ALS progression, with an additional focus on the effects of memantine on cognitive and behavioral changes associated with the disease.

Methods: A randomized, double-blind, placebo-controlled clinical trial was conducted from December 2018 to September 2020. ALS patients were enrolled in-person and remotely across 13 sites in the United States. Participants were randomized to memantine (20 mg twice daily) or placebo in a 2:1 ratio …

Interaction Between Riluzole Treatment And Dietary Glycemic Index In The Disease Progression Of Amyotrophic Lateral Sclerosis, Ikjae Lee, Hiroshi Mitsumoto, Seonjoo Lee, Edward J. Kasarskis, Michael Rosenbaum, Pam Factor-Litvak, Jeri W. Nieves

Neurology Faculty Publications

Objective: We examined whether riluzole treatment modifies the associations between the dietary glycemic index (GI) and load (GL) and disease progression in amyotrophic lateral sclerosis (ALS).

Methods: Sporadic ALS patients in the Multicenter Cohort Study of Oxidative Stress who completed a baseline food frequency questionnaire were included (n = 304). Interactions between baseline riluzole treatment and GI/GL on functional decline and tracheostomy-free survival were examined using linear regression and Cox proportional hazard models adjusted for covariates. Age, sex, disease duration, diagnostic certainty, body mass index, bulbar onset, revised ALS functional rating scale (ALSFRS-r) total score, and forced vital capacity, from …

Blood Biomarkers In Down Syndrome: Facilitating Alzheimer’S Disease Detection And Monitoring, Melissa E. Petersen, Lisi Flores-Aguilar, Elizabeth Head, Laia Montoliu-Gaya, Andre Strydom, Sarah E. Pape, Juan Fortea, Nicholas J. Ashton, Chinedu Udeh-Momoh, Sid E. O’Bryant, Dwight German, Florin Despa, Mark Mapstone, Henrik Zetterberg

Neurology Faculty Publications

Blood-based biomarkers continue to be explored for disease detection, monitoring of progression, and therapeutic outcomes as the diagnostic determination of Alzheimer’s Disease in Down Syndrome (DS-AD) remains challenging in clinical settings. This perspective highlights the current status of this effort. Overall, amyloid (A), tau (T), and neurodegeneration (AT[N]) blood-based biomarkers have been shown to increase with disease pathology for individuals with DS. Phosphorylated tau biomarkers (p-tau217, p-tau181) have been consistently shown to track disease progression for DS-AD and are likely good candidates for use in clinical settings. Biomarkers of inflammation (glial fibrillary acidic protein) also show promise; however, additional work …

This Is Where The Fantasy Begins, Terry Horstman

Textbooks

Terry Horstman tips off This Is Where the Fantasy Begins with the whirr, click, and the faint swish of a dusty VHS copy of Zack Snyder’s Michael Jordan’s Playground. Full of tangential analysis of Michael Jordan’s mythology, the game of basketball itself, and the film that started it all for Horstman, This Is Where the Fantasy Begins is a blend of memoir and sports writing. Horstman takes readers through the rules of the game and the nostalgia of the Jordan era.

Efficacy Of Intradermal Injection Of Tranexamic Acid And Ascorbic Acid Versus Tranexamic Acid And Placebo In The Treatment Of Melasma: A Split-Face Comparative Trial, Wafaa H. A. Mahmoud, Bothaina M. Ghanem, Amal Wagdy

Mansoura Medical Journal

Background: Melasma is a common hyperpigmentation disorder affecting millions worldwide. This study was done to evaluate effectiveness of combined intradermal injections of Tranexamic acid (TxA) and ascorbic acid compared to TxA alone with placebo in managing facial melasma. Methods: This randomized controlled study included twenty patients diagnosed with epidermal melasma were divided into two groups. In Group A, one side of the face received 0.5 ml of TxA (50 mg) with 0.5 ml of normal saline; in Group B, the other side received 0.5 ml of TxA plus 0.5 ml of ascorbic acid. Treatment efficacy was assessed by measuring the …

Evaluation Of The Stigmatizing Attitude Towards Mental Illness Among A Group Of Egyptian Nonpsychiatric Physicians, Mohamed Elhasanein Elshehedy, Mahmoud Ahmed Elwasify, Ibtihal Mohamed Aly Ibrahim, Roshdy Mohamed El Gamal

Mansoura Medical Journal

Background Stigmatizing attitudes toward persons had mental illness remain a major barrier to effective mental healthcare. While psychiatrists’ perspectives have been studied extensively, less attention has been paid to non-psychiatric physicians, whose attitudes significantly influence early detection and referral. Objective To evaluate stigmatizing attitudes toward mental illness among Egyptian nonpsychiatric physicians. Methods This cross-sectional research has been performed on a sample of non-psychiatric physicians in various Egyptian events and occasions, including the Mansoura University conference, the Ain Shams University conference, and the Alexandria University conference over the year 2023. Participants completed a socio-demographic questionnaire and the Mental Illness Clinicians’ Attitudes …

Does A Preoperative Caffeine Tablet Affect The Characteristics Of Post-Dural Puncture Headache In Caesarian Section Under Spinal Anesthesia?, Mahmoud Abdelfattah, Karim Ali Awad, Ahmed Amin Eisa, Abdullah Elsayed Abdullah Gheith, Shimaa Abd El-Satar Mohamed

Mansoura Medical Journal

Background: The current study aim was to evaluate the effectiveness of administering caffeine tablets before surgery in preventing post-dural puncture headache (PDPH) in adult patients who underwent cesarian delivery with spinal anesthesia (SA). Methods: This randomized controlled study (RCT) enrolled patients aged 18–45 years who underwent elective caesarian section under SA. Patients were allocated to receive either a caffeine or placebo tablet prior to SA. Those in the intervention group received a 200 mg caffeine tablet, while those in the control group received a placebo. The primary outcome measured was the incidence of PDPH, with secondary outcomes including the severity …

Leveraging Data Science For Resilience: Improving Trauma-Informed Care Practice For Adverse Childhood Experience With Ai & Data Science Application, Mohmmad Arif Shaik

Master's Theses

Adverse Childhood Experiences (ACEs) have long-lasting effects on physical health, mental well-being, education, and socioeconomic outcomes. Resilient Georgia (RG), a statewide initiative, seeks to address ACEs through trauma-informed care and data-driven strategies. However, challenges in data collection, analysis, and tracking set back the effectiveness of these efforts. This study explores the role of data science and interactive visualization tools in improving outcomes for individuals and communities affected by ACEs. A key focus of this research is the development of a data science management application designed to enhance data collection and improve real-time decision-making. The application features interactive dashboards that allow …

An Analytical Model Of Motion Artifacts In A Measured Arterial Pulse Signal—Part I: Accelerometers And Ppg Sensors, Md Mahfuzur Rahman, Subodh Toraskar, Mamun Hasan, Zhili Hao

Mechanical & Aerospace Engineering Faculty Publications

This paper, the first of two parts, presents an analytical model of motion artifacts (MAs) in measured pulse signals by accelerometers and photoplethysmography (PPG) sensors. As the transmission path from the true pulse signal in an artery to the sensor output (measured pulse signal), the tissue-contact-sensor (TCS) stack is modeled as a 1DOF (degree-of-freedom) system. MAs cause baseline drift of the mass and simultaneously time-varying system parameters (TVSPs) of the TCS stack. With arterial wall displacement and pulsatile pressure serving separately as the true pulse signal, an analytical model is developed to mathematically relate baseline drift and TVSP to a …

Motion Artifacts Removal From Measured Arterial Pulse Signals At Rest: A Generalized Sdof-Model-Based Time-Frequency Method, Zhili Hao

Mechanical & Aerospace Engineering Faculty Publications

Motion artifacts (MA) are a key factor affecting the accuracy of a measured arterial pulse signal at rest. This paper presents a generalized time–frequency method for MA removal that is built upon a single-degree-of-freedom (SDOF) model of MA, where MA is manifested as time-varying system parameters (TVSPs) of the SDOF system for the tissue–contact-sensor (TCS) stack between an artery and a sensor. This model distinguishes the effects of MA and respiration on the instant parameters of harmonics in a measured pulse signal. Accordingly, a generalized SDOF-model-based time–frequency (SDOF-TF) method is developed to obtain the instant parameters of each harmonic in …

A Case Study In Program Evaluation, Soma Dutta

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Program evaluation is a systematic process of assessing a program’s design, implementation, and outcomes to determine its effectiveness, efficiency, and impact, guiding data-driven improvements and decision-making. The Centers for Disease Control and Prevention (CDC) Evaluation Framework provides a structured approach to assessing public health programs, ensuring they are effective, accountable, and continuously improving. By systematically applying this framework, evaluations can provide actionable insights that inform program improvements, guide resource allocation, and ensure that evaluations are practical and meaningful to all stakeholders involved (Centers for Disease Control and Prevention, 2024).

The Bourbon County Health Department (BCHD) has implemented a Physical Activity …

A Case Study In Program Evaluation: Evaluation Of The Bourbon County Physical Activity Initiative, Michaela D. Amburgey

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

This evaluation examines the Bourbon County Physical Activity Initiative, which aims to increase physical activity levels in Bourbon County, Kentucky. The initiative includes increased access to exercise opportunities, community events, and an incentive-based activity tracking system. This evaluation assesses the program’s implementation, effectiveness, and provides recommendations for improvement. By utilizing evaluation findings, public health practitioners can enhance decision-making, optimize resource allocation, and improve population health outcomes.

Bones And Brains: The Association Between Osteoporosis And Depression, Mason Taylor

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Introduction: Osteoporosis and depression are two public health problems that are increasing in prevalence. Previous studies have found a positive association between the two variables in women and men and women together, but there is a gap when looking at men. Therefore, it was important to investigate the odds of depression in men, women, and men and women together to make comparisons by sex.

Methods: 1,602 participants aged 65 and older were included in the study from the National Health and Nutrition Examination Survey (NHANES) 2017 – March 2020 Pre-Pandemic dataset. One unadjusted and seven adjusted models were created for …

Evaluation Of The Bourbon County Health Department Physical Activity Program, Walker S. Hancock

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Bourbon County has a low physical activity rate. A program has been implemented to increase rates of physical activity. An evaluation has been performed using the CDC’s 6-step program evaluation process framework.

According the the framework, two recommendations were made. The first one is to increase access to parks or exercise facilities for those outside of Paris city limits. The second one is to increase the number of indoor facilities for people to use during the cold, winter months.

A Case Study In Program Evaluation: Evaluation Of A Program To Increase Physical Activity, Megan M. Harper

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Public health revolves around 3 core functions: assessment, policy development, and assurance.¹ For public health initiatives to have long-term success, we must determine if the intended effects of those programs are met in the beginning stages of program development and implementation; thus, program evaluation relates to the core function of assessment. The Centers for Disease Control and Prevention (CDC) developed a framework to facilitate this process and enable subsequent informed decisions on how to improve public health programs, which relates to policy development.² The CDC framework is comprised of 6 interconnected steps and 4 groups of standards; together, …

Understanding The Impact Of Pharmacist Prescriptive Authority On Hiv Pre-Exposure Prophylaxis At The State Level, Cameron G. King

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

HIV transmission, with relative risk reductions of up to 99%. However, real world data have revealed that even with large increases in PrEP use, new HIV diagnoses may only slightly decline. This disparity suggests that access to PrEP may be suboptimal, especially among high-risk subgroups, who are often hard to maintain on the continuum of HIV care. Pharmacists, because of their accessibility, trusted role in their communities, and growing scope of practice, could serve as an intervention point to improve access to PrEP.

A previously validated algorithm using National Drug Codes (NDCs) and the International Classification of Disease, 10^{th …}

How Sleep Disorders And Sleep Duration Impact Memory, Alexandria J. Sims

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

INTRODUCTION: Sleep duration and sleep disorders can cause changes in memory function as populations age. Previous studies have shown that disordered sleep is associated with increased risk of cognitive dysfunction and long and short sleep durations can cause memory impairment. This study studies aims to find if there is an association between sleep disorders and sleep duration and the impacts on memory.

METHODS: In this study, 3,478 participants aged 60 year and older from the National Health and Nutrition Examination Survey (NHANES) 2013-2014 dataset were included in adjusted and unadjusted models, comparing the sleep disorders and sleep duration exposures to …

Environmental And Behavioral Determinants Of Congenital Defects: An Ecologic Study In Kentucky, Amelia G. Floyd

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Congenital defects are a significant contributor to infant morbidity and mortality. The multifactorial etiology of such defects presents complex challenges for public health. This ecologic study investigates the association between environmental and behavioral exposures and congenital defects rates at the county level in Kentucky from 2010 to 2019. The Kentucky Department for Public Health, Office of Vital Statistics, provided all relevant defect data. County-level exposure data was collected from multiple sources.

Descriptive and geospatial analyses revealed substantial geographic variability, with notable high defect rates in northeastern Kentucky. Negative binomial regression models identified behavioral and socioeconomic factors to be the strongest …

Assessing The Impact Of A Physical Activity Program In Bourbon County Using The Cdc Evaluation Framework, Abigail Lay

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Physical inactivity is a significant public health concern, contributing to increased risks of chronic diseases such as obesity, cardiovascular disease, and diabetes (Centers for Disease Control and Prevention [CDC], 2022). To address this issue, communities across the United States have implemented physical activity programs to promote healthier lifestyles, including Bourbon County. This project evaluates the impact of a physical activity program in Bourbon County, KY, using the CDC Framework for Program Evaluation to assess its effectiveness, sustainability, and areas for improvement (CDC, 1999).

The primary objective of this evaluation is to determine whether the program has successfully increased participants' physical …

Changes In Local Public Health System Characteristics Before And After The Implementation Of Ohio’S Public Health Accreditation Board Policy For Local Public Health Departments., Christine Lynn Vazquez

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

The Public Health Accreditation Board is a nationally recognized nonprofit organization that manages a series of programs including the national public health accreditation program. Public health accreditation is awarded to health departments that achieve a set of nationally recognized goals and standards for departments to adopt. The state of Ohio initiated policy requiring that Local Health Departments to achieve accreditation by 2018. In result, Ohio has the largest number of accredited local health departments. This study looked at the local health departments in Ohio responses to the National Longitudinal Survey of Public Health Systems to understand if services provided improved …

Evaluating Hiv Testing Strategies And Screening In The University Of Kentucky’S Target 4 Project, Emily E. Wagoner

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

The University of Kentucky’s Target 4 project aims to expand HIV testing and provide accessible, confidential services throughout Kentucky, focusing on individuals at highest risk for HIV and Hepatitis C. In December 2023, the Target 4 project implemented a new, expanded HIV screening form, increasing the number of questions from seven to eighteen. This study analyzes the impact of the new screening form on risk factor identification and HIV positivity rates in Region 9, a 16-county area in central Kentucky, from September 2021 to November 2023. Data from 11,187 encounters before the implementation of the new screening form and 2,585 …

Prevalence Of Covid-19 Associated Xerostomia, Taste And Smelldisturbances Over 3 Years In An Egyptian Sample: A Cross-Sectional Study, Dalia Ghalwash, Ahmed Hamdy, Asmaa Abou-Bakr

Dentistry

Aim: Although xerostomia, smell, and taste dysfunctions are prominent signs of COVID-19 infection, long-term data regarding their prevalence and recovery rates is scarce. Accordingly, this study aimed to evaluate the frequency and persistence of xerostomia, taste, and smell disturbances in COVID-19 survivors over 3 years in an Egyptian sample. Methods: This cross-sectional study used an online questionnaire to assess the oral symptoms ofxerostomia, which include altered taste and smell. Data was collected from 826 patients recovered from COVID-19. Results: Xerostomia was the most frequent finding affecting 73.6% of the studied sample, followed bysmell disturbances affecting 67.8%, and altered taste reported …

Protective Effects Of Nigella Sativa Against Acrylamide-Induced Toxicity In Submandibular Salivary Glands Of Albino Rats: A Histological And Molecular Study, Salma Awad Taghyan, Elham Fathy Mahmoud, Rasha Mohamed Taha, Mohamed Shamel

Dentistry

No abstract provided.

Augmenting The Posterior Mandible Using Xeno Grafts: A Randomized Clinical Trial, Moataz Bahaa Dr., Amr Amin Ghanem Prof, Mohamed Sobhy Dr., Karim Abdelmohsen Prof

Dentistry

Aim: To assess the vertical height gain in atrophic posterior mandible using different forms of xenograft through an interpositional bone grafting procedure (sandwich technique). Materials and methods: Patient were separated into two groups, Group A (Study Group): received augmentation through the use of an organic bovine bone particulate. Group B (Control Group): received augmentation through the application of an organic bovine bone block. This study was conducted on 16 patients suffering from posterior mandibular partial edentulism with an inadequate bone height enough for favorable implant placement. The alveolar vertical dimension measured ranges from or equal to 5-8 mm from roof …

Evaluation Of Marginal And Internal Fit In Cad/Cam-Fabricated Indirect Restorations, Hend Sayed Ahmed, Mohamed Samy Salama, Sarah Adel Botros, Ayman Helmy Helmy

Dentistry

No abstract provided.

Intracanal Microbial Reduction After Root Canal Preparation With Different Tapered Instruments. An Ex-Vivo Study, Hala Fayek Khalil, Shehab Eldin Moahmed Saber, Mostafa Kholy, Soha Elhady, Esraa Abdelwahab

Dentistry

Aim: The objective of this ex vivo study was to assess the dual impact of instruments taper and irrigation activation methods on bacterial reduction in infected root canals. Materials and methods:42 extracted human molar teeth were inoculated with Enterococcus faecalis for 2 weeks to develop a mature biofilm. The samples were divided into four experimental groups and two control groups. The experimental groups underwent root canal preparation using two different instruments: XP Shaper (taper 0.04) and Reciproc Blue R25 (taper 0.08). Additionally, two different activation methods were tested: mechanical (XP Finisher) and sonic (EDDY). Bacterial reduction was assessed using Colony …

Introducing Flowable Resin Composite As A Novel Palatal Dressing After Free Gingival Graft Harvesting: A Randomized Clinical Trial, Dalia Ghalwash, Mohamed Temraz, Ahmed Elbarbary, Eman Khalil, Nesma Shemais

Dentistry

Objectives This study aimed to evaluate the effectiveness of using a flowable resin composite compared to periodontal pack in reducing postoperative morbidity after free gingival graft (FGG) harvesting. Materials and methods In this randomized controlled clinical trial, 34 patients requiring FGG were allocated into two equal groups. The intervention group received a flowable resin composite dressing over the palatal wound, while the control group received Coe-Pak. Postoperative pain was assessed using a Visual Analogue Scale (VAS) and mean analgesic consumption over 14 days. Secondary outcomes included wound size and color match of the healing site assessed at weeks 1, 2, …

Cytocompatibility, Osteogenic Potential, Antibacterial And Antibiofilm Efficacy Of A Calcium‑Silicate‑Based Intracanal Medication, Shehabeldin Mohamed Saber Prof.Dr., Shereen Nader

Dentistry

This study assessed the biological and antimicrobial properties of a calcium silicate-based material and calcium hydroxide (CH) when used as intracanal medications. MTT assay, osteogenic differentiation of human periodontal stem cells (hPDLSCs), cell mineralization-assay, and determination of ALP activity were assessed to investigate the biological properties. While the agar well diffusion, crystal violet (CRV) assay and LIVE/DEAD staining of dentin slices infected with a mature E. faecalis biofilm were used to assess the antimicrobial properties. Normally distributed data were analyzed using one and two-way ANOVA and post hoc Tukey test, while for non-normally distributed data Kruskal Wallis and Dunn's tests …