Medicine and Health Sciences Commons^™

Through The Looking Glass, Sarah Glass Dds

Virginia Dental Journal

This article offers a sampling of the fantastical world of oral pathology It includes example images and discusses osseous choristoma, squamous cell carcinoma, traumatic ulcerative granuloma with stromal eosinophilia (TUGSE).

Take Action To Address Virginia’S Dental Workforce Needs, Ryan Dunn

Virginia Dental Journal

This article lays out the facts about the dental workforce situation in Virginia and offers potential solutions. The state's dental workforce is under pressure, with rising demand for dental assistants and hygienists and ongoing hiring challenges exacerbated by the pandemic. Despite having more dentists than the national average, rural areas still face shortages. The Virginia Dental Association (VDA) encourages members to support local dental programs, share their workforce challenges, and participate in advocacy efforts. The VDA is actively involved in finding both short-term and long-term solutions to meet the state's dental care needs.

Va Dent J January, February & March 2023

Virginia Dental Journal

In the January, February and March 2023 issue, the reader will find the following feature articles:

• An Interview with Dr. Richard Roadcap: Virginia Dental Journal Editor (2007 – 2023)
• Through the Looking Glass: The Fantastical World of Oral Pathology
• Treatment Access and Outcomes for Craniofacial Care: Patient and Parent Perspectives
• Cheiloscopy
• We’re Taking on the Fight tor Fairness and Transparency: We Need More Dentists to Join the Fight
• Serving the Petersburg Community: VDA Foundation Collaboration with Central Virginia Health Services

This issue includes regular columns with regional news impacting the Virginia membership including: editorial and perspectives columns, legal, association activities, …

Medical School Watercooler Newsletter - August 29, 2024, Lindsay Hughes

Watercooler Newsletter

This is the August 29, 2024 edition of the Frederick P. Whiddon College of Medicine’s newsletter - Watercooler.

Contents Include

• Medical students publish research study on match outcomes of neurosurgery residents
• Now accepting nominations for 2025 Medical Alumni Association Awards
• Alexeyev receives $1 million NSF grant to develop ‘designer' mitochondria
• Hall joins USA Health as emergency medicine physician
• New hospitalist volunteers her time and training here and abroad 

Combination Therapy Of Ido1 Inhibition And Anti-Pd1 Mediates Anti-Tumor Immunity By Promoting Memory Immunity Development And Cytotoxicity Of Γδ T And Nk Cells Via Il-2 Signaling And By Overcoming Pro-Tumor Effects Of Tgf-Β Signaling, Hyuk Jee

Dartmouth College Master’s Theses

Cutaneous melanoma is the most aggressive form of skin cancer even though it takes only about 1% of all skin cancers. Even among all cutaneous melanomas, NRAS-mutant melanoma is more aggressive than any other, and about 10-25% of all cutaneous melanoma cases have mutations in NRAS. NRAS is a member of the RAS family of proto-oncogenic GTPase proteins, and it plays a key role in signal transduction pathways responsible for cellular survival, proliferation, and metabolism. Immunotherapy is the first line of defense against NRAS-mutant melanoma because, despite tremendous efforts made for decades, it has not been successful to develop small …

Exploring Perinatal Ketamine For Postpartum Depression Following Cesarean Section: A Systematic Review, Jaylyn Thompson, David F Lo, Alexis Foschini, Suvan Sundaresh

Rowan-Virtua School of Osteopathic Medicine Departmental Research

The aim of this study was to explore the use of perinatal ketamine to see if it can be used for the reduction of postpartum depression (PPD) following cesarean section (C-section). PubMed, Cochrane, and Web of Science were the primary databases used for this review. Search terms used on January 5, 2024 incorporated "ketamine," "C-section," "postpartum depression," and related synonyms. The criteria for inclusion centered on studies published between January 1, 2008 and January 5, 2024. The final selection of articles was screened based on extraction criteria leaving eight randomized control trials in the final review. The selected data from …

Improving Nursing Communication Through Handoff Tool Education: A Staff Education Project, Linda Holt Anderson

Walden Dissertations and Doctoral Studies

The common practice of handoff of care communication is an integral part of patient care. However, ineffective handoff communication is associated with significant risks to patient outcomes. The issue of ineffective handoff of care is a local practice problem as well as a national issue. Strategies including standardized verbal, written, and electronic clinical handoff tools are emerging. However, many nurses are not knowledgeable regarding use of these standardized handoff of care tools. Therefore, the practice-focused question for this doctoral project asked whether an educational program on use of a standardized handoff tool could increase nursing knowledge as compared pre- and …

Acceptance And Commitment Therapy Versus Progressive Relaxation Training For Misophonia: Randomized Controlled Trial Protocol, Interventions, And Audiological Assessments, Emily M. Bowers, Mercedes G. Woolley, Karen Muñoz, Julie M. Petersen, Michael P. Twohig

Psychology Faculty Publications

Background: Misophonia is a disorder characterized by an intense emotional reaction to specific sounds, often leading to significant distress and impairment in daily functioning. Acceptance and commitment therapy (ACT) is a promising psychotherapy for treating misophonia, but has only been previously tested in case studies. This paper presents a protocol for the first randomized controlled trial (RCT) assessing the efficacy and feasibility of ACT supplemented by audiological interventions for misophonia versus progressive relaxation training (PRT).

Methods: The outlined protocol is a RCT with 60 adults with misophonia. After undergoing a comprehensive psychological and audiological evaluation, participants were randomly assigned to …

Lower Extremity Injury Rates On Artificial Turf Versus Natural Grass Surfaces In The National Football League During The 2021 And 2022 Seasons, Nikit Venishetty, Angel X Xiao, Ramesh Ghanta, Rohit Reddy, Nirav Kiritkumar Pandya, Brian T Feeley

SKMC Student Presentations and Publications

BACKGROUND: It has been argued that the use of artificial turf football fields in the National Football League (NFL) increases player injury risk compared with natural grass surfaces.

PURPOSE/HYPOTHESIS: The purpose of this study was to quantify the rate of lower extremity injuries occurring in NFL players on artificial turf compared with natural grass surfaces and characterize the time missed due to injury and proportion of injuries requiring surgery. It was hypothesized that lower extremity injuries requiring surgical intervention would occur at a higher rate on artificial turf than on natural grass.

STUDY DESIGN: Descriptive epidemiology study.

METHODS: Lower extremity …

Perceptions Of Substance Use And Sexual Risk Behaviors Among Adolescent Women Involved In Juvenile Justice, Catherine E. Dunlop, Aynsley H. M Scheffert, Allison Cowling, Maya Kohavi, Laura J. Benjamins, Danielle Parish

Department of Pediatrics

CHOICES-TEEN is a bundled intervention aimed at reducing the risks of unintended pregnancy, sexually transmitted infections, and alcohol- and tobacco-exposed pregnancies for adolescent girls involved in the juvenile justice system. We examined youths’ (N = 22) elicited pros and cons concerning alcohol, tobacco, condom, and contraception use to inform future iterations of CHOICES-TEEN and other prevention programming during a one-arm pilot study. Content analysis was used to identify recurring themes elicited and recorded during a decisional balance exercise with a counselor. The most recurrent pros and cons were factors that directly affected these adolescents, with more immediate consequences. The …

Milvexian Vs Apixaban For Stroke Prevention In Atrial Fibrillation: The Librexia Atrial Fibrillation Trial Rationale And Design, Sneha S Jain, Kenneth W Mahaffey, Karen S Pieper, Wataru Shimizu, Tatjana Potpara, Christian T Ruff, Hooman Kamel, Basil S Lewis, Jan H Cornel, Peter R. Kowey, Jay Horrow, John Strony, Alexei N Plotnikov, Danshi Li, Stephen Weng, Julia Donahue, C Michael Gibson, P Gabriel Steg, Roxana Mehran, Jeffrey I Weitz, S Claiborne Johnston, Graeme J Hankey, Robert A Harrington, Carolyn S P Lam

Department of Medicine Faculty Papers

BACKGROUND: Direct oral anticoagulants are the standard of care for stroke prevention in eligible patients with atrial fibrillation and atrial flutter; however, bleeding remains a significant concern, limiting their use. Milvexian is an oral Factor XIa inhibitor that may offer similar anticoagulant efficacy with less bleeding risk.

METHODS: LIBREXIA AF (NCT05757869) is a global phase III, randomized, double-blind, parallel-group, event-driven trial to compare milvexian with apixaban in participants with atrial fibrillation or atrial flutter. Participants are randomly assigned to milvexian 100 mg or apixaban (5 mg or 2.5 mg per label indication) twice daily. The primary efficacy objective is to …

Perceptions Of Desired Step 2 Ck Performance After Step 1 Grading Change, Michelle M. Pham

School of Medicine Publications

Introduction

In 2022, Step 1 shifted from providing a numerical score to a pass/fail categorization. Since the shift, there has been one matched graduating class in 2024. This paper aims to identify perceptions of desired Step 2 CK performance after the Step 1 score report alteration.

Methods

A survey was sent out to a medical school’s class of 2025. The anonymous survey required an email sign-in to verify only one response per respondent. The survey asked if the answering individual felt it was necessary to score higher or the same as the NRMP’s 2022 averages for their first-choice specialty and …

Identification Of A Specific Apoe Transcript And Functional Elements Associated With Alzheimer’S Disease, Qiang Chen, Luis Aguirre, Guoming Liang, Huanhuan Zhao, Tao Dong, Felix Borrego, Itziar De Rojas, Qichan Hu, Christopher Reyes, Harald Hh Goring

School of Medicine Publications

Background

The APOE gene is the strongest genetic risk factor for late-onset Alzheimer’s Disease (LOAD). However, the gene regulatory mechanisms at this locus remain incompletely characterized.

Methods

To identify novel AD-linked functional elements within the APOE locus, we integrated SNP variants with multi-omics data from human postmortem brains including 2,179 RNA-seq samples from 3 brain regions and two ancestries (European and African), 667 DNA methylation samples, and ChIP-seq samples. Additionally, we plotted the expression trajectory of APOE transcripts in human brains during development.

Results

We identified an AD-linked APOE transcript (jxn1.2.2) particularly observed in the dorsolateral prefrontal cortex (DLPFC). The …

Two-Year Clinical Performance Of Indirect Resin Composite Restorations In Endodontically Treated Teeth With Different Cavity Preparation Designs: A Randomized Clinical Trial, Hoda Omar Fouda, Mohamed Fouad Haridy, Hend Sayed Ahmed, Olfat Elsayed Hassanein, Shehabeldin Saber, Maha Elbaz, Ahmed Abouelezz

Dentistry

No abstract provided.

Linkage Facilitation For Opioid Use Disorder In Criminal Legal System Contexts: A Primer For Researchers, Clinicians, And Legal Practitioners, Milan F. Satcher, Steven Belenko, Anthony Coetzer-Liversage, Khirsten J. Wilson, Michael R. Mccart, Tess K. Drazdowski, Amanda Fallin-Bennett, Nickolas Zaller, Alysse M. Schultheis, Aaron Hogue, Noel Vest, Ashli J. Sheidow, Brandon Del Pozo, Dennis P. Watson, Patrick F. Hibbard, Randy Stevens, L. A. R. Stein

Dartmouth Scholarship

At the intersection of drug policy, the opioid crisis, and fragmented care systems, persons with opioid use disorder (OUD) in the United States are significantly vulnerable to contact with the criminal legal system (CLS). In CLS settings, provision of evidence-based treatment for OUD is variable and often secondary to punitive approaches. Linkage facilitation at every touch point along the CLS Sequential Intercept Model has potential to redirect persons with OUD into recovery-oriented systems of care, increase evidence-based OUD treatment connections, and therefore reduce CLS re-exposure risk. Research in this area is still nascent. Thus, this narrative review explores the state …

Detection Of Distant Relatedness In Biobanks To Identify Undiagnosed Cases Of Mendelian Disease As Applied To Long Qt Syndrome, Megan C Lancaster, Hung-Hsin Chen, M Benjamin Shoemaker, Matthew R Fleming, Teresa L Strickland, James T Baker, Grahame F Evans, Hannah G Polikowsky, David C Samuels, Chad D Huff, Dan M Roden, Jennifer E Below

Faculty, Staff and Student Publications

Rare genetic diseases are typically studied in referral populations, resulting in underdiagnosis and biased assessment of penetrance and phenotype. To address this, we develop a generalizable method of genotype inference based on distant relatedness and deploy this to identify undiagnosed Type 5 Long QT Syndrome (LQT5) rare variant carriers in a non-referral population. We identify 9 LQT5 families referred to a single specialty clinic, each carrying p.Asp76Asn, the most common LQT5 variant. We uncover recent common ancestry and a single shared haplotype among probands. Application to a non-referral population of 69,819 BioVU biobank subjects identifies 22 additional subjects sharing this …

Inflammatory Response And Parasite Regulation In Acute Toxoplasmosis: The Role Of P2x7 Receptor In Controlling Virulent Atypical Genotype Strain Of Toxoplasma Gondii, Thuany Prado-Rangel, Aline C.A. Moreira-Souza, Sthefani R.B. Da Silva, Thais Barboza-Araujo, Archimedes B. Castro-Junior, Isalira P.R. Ramos, Christina M. Takiya, Rossiane C. Vommaro, Robson Coutinho-Silva

Pacific Faculty Work

Toxoplasmosis is a globally significant disease that poses a severe threat to immunocompromised individuals, especially in Brazil, where a high prevalence of virulent and atypical strains of Toxoplasma gondii is observed. In 1998, the EGS strain, exhibiting a unique infection phenotype, was isolated in Brazil, adding to the complexity of strain diversity. The P2X7 receptor is critical in inflammation and controlling intracellular microorganisms such as T. gondii. However, its genetic variability can result in receptor dysfunction, potentially worsening susceptibility. This study investigates the role of the P2X7 receptor during acute infection induced by the EGS atypical strain, offering insight into …

Midazolam-Induced Seizure-Like Activity In Five Neonates: A Case Series, Heba Shaker, Fatema Al-Amrani, Hilal Al Mandhari

Sultan Qaboos University Medical Journal

An intravenous administration of midazolam may result in seizure-like activity or movement. This report describes five neonates who developed seizure-like movements after intravenous midazolam injection. The patients presented between 2019 and 2022. The abnormal movements occurred shortly after intravenous bolus administration of midazolam. None of our patients experienced seizure-like movements after receiving midazolam infusions. The seizure-like movements were aborted either spontaneously or by antiseizure medications. Also, we did not observe any seizure recurrence in any of the infants during the later stages of their treatment. Since this adverse effect might be related to the speed of the bolus administration, intravenous …

Prevalence, Clinico-Laboratory Features And Outcomes Of Paediatric Scrub Typhus Cases In A Tertiary Care Centre In Eastern India: A Prospective Observational Study, Raghunath Murmu, Gobinda Mondal, Koushik Biswas, Ashok K. Bala

Sultan Qaboos University Medical Journal

Objectives: Scrub typhus is the most common rickettsial disease in India, caused by Orientia tsutsugamushi and transmitted by chigger mites. Previously prevalent in South India, a resurgence of scrub typhus cases has recently affected Eastern India. This study aimed to estimate the prevalence and describe the clinico-laboratory profile of scrub typhus in paediatric patients (1–12 years old) living in Eastern India. Methods: This prospective observational study was conducted from January to December 2019 at the Dr B C Roy Post Graduate Institute of Paediatric Sciences, Kolkata, India. All acute undifferentiated cases of febrile illness, in patients aged between 1–12 years, …

Re: Efficacy And Safety Of Vildagliptin And Remogliflozin As Add-On Therapy To Metformin In Patients Of Type 2 Diabetes Mellitus, Hunain Raza, Muhammad E. Bhutta, Muhammad H. Siddique

Sultan Qaboos University Medical Journal

No abstract provided.

Determining The Effectiveness Of A Nurse-Led Heart Failure Education Program In Reducing 30-Day Hospital Heart Failure Readmissions, Amy Suzanne Cosby

Doctoral Dissertations and Projects

The purpose of this project was to determine if a nurse-led heart failure (HF) education program would reduce overall 30-day hospital readmissions related to. Affecting millions of adults in the United States, HF is a growing health epidemic as well as an economic burden to healthcare systems. The population for this project included patients admitted with a diagnosis of acute or chronic HF based on the International Statistical Classification of Diseases and Related Health Problems (ICD-10) codes. An electronic health record intervention indicated that when a healthcare provider diagnosed a patient with any HF ICD-10 code, the nurse-led HF education …

The Effectiveness Of An Interdisciplinary Care Team: An Integrative Review, Lindsey Marie Ellingford

Doctoral Dissertations and Projects

As health care is ever growing and changing, demands for interdisciplinary care team collaboration are crucial for collective competence and team performance across settings. In healthcare facilities across the county, interdisciplinary care teams are made up of multiple disciplines. The following is an integrative review with a purpose to determine if the existing literature supports the implementation of an interdisciplinary care team in the healthcare environment. After completion of this integrative review, the author concluded there should be a standardized tool in the healthcare system to guide the creation and implementation of an interdisciplinary care team. The Jerry Falwell Library …

Hyperlipidemia: Enhancing Patient Education And Clinical Support To Improve Self-Efficacy, Kelly L. Caniglia

Doctoral Dissertations and Projects

Hyperlipidemia is a chronic, progressive disorder routinely encountered in primary care practice. In the United States, coronary artery disease and cerebrovascular disease are the leading causes of death. Hyperlipidemia is a modifiable risk factor for the development of coronary artery disease, cerebrovascular disease, and peripheral artery disease. However, many individuals fail to recognize the severity of the health consequences associated with hyperlipidemia. Most often, hyperlipidemia is the direct result of unhealthy lifestyle behaviors. Comprehensive care falls short in primary care settings, often due to non-compliance with necessary lifestyle behavior changes. Primary care patients' lack of knowledge and awareness signals a …

Nursing Faculty Exposure To Student Incivility And Interventions In Place To Address: A Case Study, Kimberly Lowe

Doctoral Dissertations and Projects

The purpose of this qualitative case study was to explore nursing faculty exposure to nursing student incivility at a nursing college in the Mid-Atlantic region. Bandura's social learning theory provided this study’s theoretical framework. The continuum of workplace aggression and conceptual model fostering incivility in nursing education also guided this study. This study answered the following central research question: How have nursing faculty been exposed to incivility by nursing students? Data were collected for this study through one-on-one interviews with nursing faculty exposed to nursing student incivility and a focus group with the same nursing faculty to discuss the current …

Improved Clinical Outcomes Due To Gfr-Based Clinical Interventions For The Prevention And Treatment Of Renal Disease As It Relates To The Veteran Population Managed By A Patient-Aligned Care Team, Sidneca Evangella Hazward

Doctoral Dissertations and Projects

The purpose of this study was to understand if the use of eGFR (CKD-EPI 2021) in the absence of race modification influenced early detection of renal disease for veterans managed by patient-aligned care teams. A retrospective cohort study design was used, analyzing patient data from the Department of Veterans Affairs Medical Center (VAMC). The study included veterans with available serum creatinine, albumin, eGFR, CKD-EPI 2021, etc. measurements and demographic data. The study employed a systematic data review of electronic medical records from 2019 to 2024 and utilized electronic data collection through a computerized patient record system (CPRS) data collection system. …

Paths Initiative: Identifying Potential Sex Trafficking Victims In The Emergency Department Setting, Kayla Mabery

Doctoral Dissertations and Projects

The Physical signs, Appearance, Talk and communication, History and background, and Support and resources (PATHS) education initiative has proven to be a valuable tool in enhancing the identification and support of sex trafficking victims in healthcare settings, particularly in emergency departments. The training led to significant improvements in the participants' knowledge, confidence, and practical application of skills necessary to recognize potential victims. Despite the limitations of limited participant numbers and lack of face-to-face training, the initiative's positive impact underscores the need for continued efforts in this area. By incorporating the PATHS tool into regular professional development programs and standard operating …

Erdheim-Chester Disease Presenting As Bilateral Facial Masses: A Case Report And Review Of Literature, Asim Qureshi, Abdulaziz Bakathir, Fizza Qureshi, Amanullah Beg, Asem Shalaby

Sultan Qaboos University Medical Journal

Erdheim-Chester disease (ECD) is a rare form of non-Langerhans cell histiocytosis with unknown etiology. It is recently recognized to be neoplastic with genetic mutations affecting the mitogen-activating protein kinase (MAPK) pathway. We here present a case of a 49-year-old female who initially presented in 2012 with bilateral facial masses to a tertiary care center. These were removed but later recurred over a period of ten years. She then presented with xanthelasmas, bone lesions, secondary infertility due to hypothalamic hypogonadism, diabetes insipidus, and Hashimoto’s hypothyroidism. The facial masses were biopsied, and they showed classic morphological features in the form of diffuse …

The Prospect Of Indonesian Herbal As An Alternative Treatment For Covid-19 Patient: A Literature-Based Study, Hadi Sunaryo, Wahyu Hidayati

Indonesian Journal of Medical Chemistry and Bioinformatics

Coronavirus disease 2019 (COVID-19) is a new disease caused by a novel coronavirus, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The disease has several symptoms from mild to severe and could lead to death for comorbidities and the elderly. Therefore, the infections and mortality cases keep growing day by day, moreover many authorities are trying to suppress it by applying several health protocols, including medicines. Several studies were conducted on drug discovery from plants to cure the disease. The article aimed to do a narrative review about the prospect of JAMU becoming an alternative medicine to cure COVID-19 by mapping …

Contrast Enhanced Ultrasound Of Liver Lesions In Patients Treated For Childhood Malignancies., Ayatullah Mostafa, Zachary Abramson, Mina Ghbrial, Som Biswas, Sherwin S. Chan, Himani Darji, Jessica Gartrell, Seth E. Karol, Yimei Li, Daniel A. Mulrooney, Tushar Patni, Tarek M. Zaghloul, M Beth Mccarville

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Patients treated for cancer have a higher incidence of focal liver lesions than the general population and there is often concern for a malignant etiology. This can result in patient, caregiver and physician anxiety and is managed by a "wait and watch" approach, or immediate additional imaging, or biopsy, depending on the degree of clinical concern. Because it is a low-cost, easily accessible, radiation and sedation free modality, we investigated the value of contrast enhanced ultrasound (CEUS) to accurately distinguish benign from malignant liver lesions in patients treated for childhood malignancies.

METHODS: We performed an IRB approved retrospective study …

Evaluating The Impact Of The Nurse-Patient Relationship: An Integrative Review, Kathryn H. Creasey

Doctoral Dissertations and Projects

Home care agencies are rated by patients anonymously through surveys after patients’ care episodes. The star ratings on the surveys have a direct impact on the home care agency and all of the staff working there. The star rating affects insurance companies’ reimbursement, which ultimately impacts business revenue, while the goal is to provide quality patient care. In the home care setting, nurses and patients desire continuity of care and the building of trust for competent, safe, and quality care. The literature review explored the importance of fostering the nurse-patient relationship and its impact on patient satisfaction and quality. Utilizing …