Medicine and Health Sciences Commons^™

Small Island Risks: Research Reflections For Disaster Anthropologists And Climate Ethnographers, Crystal A. Felima

UK CARES Faculty Publications

Disasters and climate-related events, including tropical storms, droughts, coastal erosion, and ocean acidification, threaten small island nations. Given the urgency of reducing disaster risks and the effects of climate change on vulnerable populations, this reflection essay pursues three objectives. First, it highlights the role of anthropology, ethnography, and multi-sited research in exploring disaster impacts, climate crises, and public policy in island communities. It then highlights national planning and inter-regional activities to build awareness of various risk reduction efforts by island nations and multi-governmental organizations. This article concludes with discussion prompts to engage researchers, scholars, students, and practitioners studying and working …

Wastewater Surveillance For Xylazine In Kentucky, Chris Delcher, Dana Quesinberry, Soroosh Torabi, Scott Berry, James W. Keck, Abhya Rani, Bikram Subedi

UK CARES Faculty Publications

Introduction: In the U.S., xylazine, the veterinary non-opioid sedative, has emerged as a major threat to people who use illicitly manufactured fentanyl and other drugs. The aim of this study was to compare wastewater detection of xylazine with other public health and safety surveillance data from 2019 to 2023 in Kentucky.

Methods: Wastewater samples from 5 rest areas, 2 truck weigh stations, and 4 wastewater treat- ment plants were tested for xylazine. Wastewater xylazine positivity rates were compared with xyla- zine-positive submission rates from the National Forensic Laboratory Information System and Kentucky’s fatal overdoses in 6-month periods (Period 1=January−June; Period …

Neural Mechanisms Of Respiratory Interoception, Pei-Ying Sarah Chan, Lu-Yuan Lee, Paul W. Davenport

UK CARES Faculty Publications

Respiratory interoception is one of the internal bodily systems that is comprised of different types of somatic and visceral sensations elicited by different patterns of afferent input and respiratory motor drive mediating multiple respiratory modalities. Respiratory interoception is a complex system, having multiple afferents grouped into afferent clusters and projecting into both discriminative and affective centers that are directly related to the behavioral assessment of breathing. The multi-afferent system provides a spectrum of input that result in the ability to interpret the different types of respiratory interceptive sensations. This can result in a response, commonly reported as breathlessness or dyspnea. …

Advances In Bone And Orthopedics 2024 Edition, Jean-Philippe Berteau, Laurent Pujo-Menjouet

Publications and Research

We are delighted to present the latest edition of ”Advances in Bone and Orthopedics,” a comprehensive compilation of pioneering research and innovative developments in the field. This volume brings together a selection of peer-reviewed abstracts from BONITOS 2024, the Fourth Season of the Bone and Orthopedics Interdisciplinary Symposium, held on May 31st, 2024, at the College of Staten Island in New York. This symposium, a hallmark event in the calendar of professionals dedicated to bone health and orthopedic excellence. The contributions within this volume reflect the breadth and depth of research presented at BONITOS 2024. These abstracts represent cutting-edge studies …

Post-Operative Diagnosis Of Anomalous Left Coronary Artery From The Right Pulmonary Artery Via Transthoracic Echocardiogram, Lavina Desai, Sanket Shah, Edo Bedzra, Christopher Mathis

Posters

A term infant female was diagnosed with a ventricular septal defect (VSD) and aortic coarctation. Preoperative echocardiography and computed tomography angiography (CTA) showed a normal right coronary artery origin, but inconclusive left coronary artery (LCA) origin. There was a normal flow profile in the LCA by echocardiography. She underwent repair with extended end-to-end anastomosis and VSD closure during which surgical inspection revealed a usual appearing, retro pulmonary path of the LCA towards the left sinus of Valsalva. Postoperative echocardiogram revealed mild global dysfunction but no regional wall motion abnormalities.   Repeat echocardiogram revealed severe dysfunction most prominent in the anterolateral and …

Intussusception, Children's Mercy Kansas City

Clinical Pathways

No abstract provided.

Quiet Time On Family Maternity Center, Deanna Conley, Shelbie Clement

Articles, Abstracts, and Reports

Background: A stay at the hospital is full of interruptions from family visitors, lab draws, hearing screens, nurses and doctors, social workers, and environmental services. All these interruptions during the postpartum stay negatively affect parents and newborns by interrupting breastfeeding, sleep, and family bonding time. Evidence from AWHONN (Association of Women's Health Obstetric and Neonatal Nurses) research, in the articles referenced, demonstrates overwhelming support of Quiet Time in the Postpartum period. Quiet Time has been shown to improve exclusive breastfeeding rates, decrease emotional and physical exhaustion, enhance shared decision making and set realistic expectations, increase nurse satisfaction, decrease nursing stress …

“Effects Of Semaglutide With And Without Concomitant Sglt2 Inhibitor Use In Participants With Type 2 Diabetes And Chronic Kidney Disease In The Flow Trial.”, Katherine Tuttle

Articles, Abstracts, and Reports

No abstract provided.

“The Garabedians: Father And Son Cardiologists Share Legacy In The Critical Care Of Spokane’S Children”, Carl Garabedian

Articles, Abstracts, and Reports

No abstract provided.

Tight Squeeze!: The Implications Of Prolonged Tourniquet Time In The Pediatric Emergency Department, Kaitlyn Beresford, Kayla Bhakta, Jared Grace, Samantha Swift

2023

No abstract provided.

Head, Shoulders, Heels And Toes: Are Toes An Appropriate Option For Capillary Blood Sampling, Camille Chicoine, Nina De Leon, Ahley Diaz, Roe Ronia Eminikhah, Laisha Killian, Brianna Leal, Adalie Lepoire, Genesia Rivera, Genesis Rivera

2023

No abstract provided.

Heat Check: Comparing Temporal And Axillary Temperatures, Carmen Tobias, Brissa Campos, Lana Nowar, Bailee Troyer- Womack, Oluwatimilehin Tope-Ojo, Montserrat Meza, Stephanie Delarosa, Michelle Amoah

2023

No abstract provided.

Improving Sleep In The Pediatric Inpatient Population, Courtney Brooks, Julie Fraustro, Brooke Martin, Sydney Mcwilliam, Samantha Ortiz Rios, Lesly Reveles, Claire Zempel

2023

No abstract provided.

Turbulence: Full Issue Download

Quill & Scope

Turbulence is an essential part of the natural world. Opposing currents churn the deep waters of the ocean, strong winds clear the air of pollutants, and powerful storms drench the earth with life-sustaining water. Yet, when we humans find ourselves experiencing turbulence, our gut reaction is often to bear down and anchor ourselves. Perhaps you, like us, have found yourself closing your eyes and tightly grasping the armrests of your airplane seat as the wings rock, or trying to keep your eyes on the horizon to prevent seasickness from taking hold in choppy waters. Anchoring ourselves allows us to maintain …

Assessment Of Brain-Derived Extracellular Vesicle Enrichment For Blood Biomarker Analysis In Age-Related Neurodegenerative Diseases: An International Overview, Amanpreet Badhwar, Yael Hirschberg, Natalia Valle-Tamayo, Florencia Iulita, Chinedu Momoh, Anna Matton, Rawan Tarawneh, Robert Rissman, Aurélie Ledreux, Charisse Winston

Brain and Mind Institute

INTRODUCTION Brain-derived extracellular vesicles (BEVs) in blood allows for minimally-invasive investigations of central nervous system (CNS) -specific markers of age-related neurodegenerative diseases (NDDs). Polymer-based EV- and immunoprecipitation (IP)-based BEV-enrichment protocols from blood have gained popularity. We systematically investigated protocol consistency across studies, and determined CNS-specificity of proteins associated with these protocols.

METHODS NDD articles investigating BEVs in blood using polymer-based and/or IP-based BEV enrichment protocols were systematically identified, and protocols compared. Proteins used for BEV-enrichment and/or post-enrichment were assessed for CNS- and brain-cell-type-specificity, extracellular domains (ECD+), and presence in EV-databases.

RESULTS A total of 82.1% of studies used polymer-based (ExoQuick) …

Cognitive Reserve, Cortisol, And Alzheimer's Disease Biomarkers: A Memory Clinic Study, Manasa Yerramalla, Alexander Darin-Mattsson, Chinedu Momoh, Jasper Holleman, Ingemar Kåreholt, Malin Aspö, Göran Hagman, Miia Kivipelto, Alina Solomon, Anna Marseglia

Brain and Mind Institute

INTRODUCTION Cognitive reserve might mitigate the risk of Alzheimer's dementia among memory clinic patients. No study has examined the potential modifying role of stress on this relation.

METHODS We examined cross-sectional associations of the cognitive reserve index (CRI; education, occupational complexity, physical and leisure activities, and social health) with cognitive performance and AD-related biomarkers among 113 memory clinic patients. The longitudinal association between CRI and cognition over a 3-year follow-up was assessed. We examined whether associations were influenced by perceived stress and five measures of diurnal salivary cortisol.

RESULTS Higher CRI scores were associated with better cognition. Adjusting for cortisol …

Rhabdomyolysis As A Cause Of Pth Independent Hypocalcemia In A Child With Acute Influenza Infection, Samhita Bhattarai, Kelsee Halpin

Posters

INTRODUCTION Hypocalcemia is characterized by abnormally low level of calcium in the blood. Normal reference range for calcium for children between 12- 19-year-old is 8.5-10.6 mg/dl . Severe hypocalcemia is considered as serum calcium level of <7 mg/dl and can present with tetany, seizures, and life-threatening cardiac arrhythmias. Etiology of hypocalcemia varies but hypoparathyroidism, pseudohypoparathyroidism and Vitamin D deficiency are some of the most common causes encountered by pediatrician endocrinologists. Association of rhabdomyolysis with hypocalcemia and elevated PTH is a rare presentation that should be considered, particularly for those children presenting with acute viral illness. We present a rare case of rhabdomyolysis associated with hypocalcemia not related to hypoparathyroidism. CASE A 12-year-old female presented to the emergency department with body ache, decreased oral intake and vomiting. She was found to be influenza positive. Electrolytes showed hypocalcemia (4.8 mg/dl). She subsequently had an undetectable 25-OH vitamin D level (<5 ng/ml) and elevated iPTH level (609 pg/ml). We discussed the possibility of her etiology of hypocalcemia to be Vitamin D deficiency although her presentation was atypical at an older age with a negative imaging for rickets, hyperphosphatemia (6.0 mg/dl), and normal alkaline phosphatase (334 unit/L). She also did not have any phenotypic features of Albright’s hereditary osteodystrophy and renal function was within normal limits. She was identified to have elevated creatinine kinase (4829 U/L) supporting rhabdomyolysis secondary to acute influenza as a cause of her hypocalcemia. Rhabdomyolysis, a known complication of influenza infection, causes cell membrane destruction which impairs the normal function of Na-K-ATPase channel. This leads to increase in intracellular sodium activating Na/Ca exchanger which in turn causes influx of calcium intracellularly causing hypocalcemia. Additionally, any injury or infection leads to high phosphorus release from cells due to cell lysis. High phosphorus is also caused by reduced oxidative metabolism in muscles impairing phosphate use. This excess of phosphate then combines with calcium and causes calcium-phosphate complex in soft tissues. Hyperphosphatemia also additionally inhibits 1 alpha hydroxylase limiting formation of calcitriol leading to hypocalcemia. CONCLUSION Our patient had severe hypocalcemia due to influenza-related rhabdomyolysis. Rhabdomyolysis is an important consideration as a cause of hypocalcemia in children, especially with acute viral illness. Accordingly, it is also important to obtain serum electrolytes in patients presenting with rhabdomyolysis as hypocalcemia may lead to complications like seizures and cardiac arrhythmia if not appropriately recognized and treated.

Pediatric Cancers And Family Financial Toxicity In The Philippines: Insights For Southeast Asia And Similarly Resourced Settings, Rod Carlo Columbres, Erin Jay G. Feliciano, Kathleen Joy Taleon-Tampo, Katelyn Edelwina Y. Legaspi, Michelle Ann B. Eala, Kenrick Ng, Fumiko Chino, Frederic Ivan L. Ting, Edward Christopher Dee

Ateneo School of Medicine and Public Health Publications

Cancer is a leading cause of death among children in the Philippines, a low-middle-income country of over 110 million people. In this Comment, we describe how financial toxicity affects families of pediatric patients with cancer in the Philippines. We explore direct costs of care, indirect costs such as transportation and lodging, and psychosocial sequelae, in the Filipino medical system and sociocultural contexts. We present examples of successful interventions in the Philippines and in similarly resourced settings, with the goal of galvanizing further research, clinical interventions, and policy-level changes, aimed at mitigating family financial toxicity for pediatric patients with cancer in …

One Health In The Philippines: A Review And Situational Analysis, Lystra Zyrill A. Dayapera, Jenica Clarisse Y. Sy, Sary Valenzuela, Samantha Julia L. Eala, Ciara Maria Ines P. Del Rosario, Karen Nicole C. Buensuceso, Adrian S. Dy, Danielle A. Morales, Anna Giselle Gibson, Geminn Louis C. Apostol

Ateneo School of Medicine and Public Health Publications

The Philippines faces a complex and interconnected web of human, animal, and environmental health issues, including zoonotic and reverse zoonotic diseases, antimicrobial resistance, food insecurity and contamination, and threats from environmental degradation. This paper examines these issues, existing interventions, and their implementation challenges. The overall framework used to analyze the level of operationalization of the One Health approach is the Multi-sectoral One Health Coordination Framework developed by the World Health Organization, Food and Agriculture Organization, and the World Organization for Animal Health. A two-step process was conducted: literature review, followed by consultations with government and non-government stakeholders across national, subnational, …

Clinical Application Of Intraoperative Neurophysiological Monitoring During Resection Of A Spinal Tumor: A Case Report, Chia-Hung Hou, Sanford P C Hsu, Pang-Wei Chang, Chen-Liang Chou, Tsui-Fen Yang

Rehabilitation Practice and Science

Surgical resection of a spinal tumor is the first choice of treatment in clinical practice, however it carries a significant risk of creating new postoperative neurological deficits. It is believed that the concomitant use of intraoperative neurophysiological monitoring (IONM) during tumor resection can not only increase safety of the procedure, but also improve surgical outcomes.

Case description:

A 52-year-old female who was in good health and neurologically intact presented with intermittent claudication, numbness and weakness of bilateral lower extremities, and bowel and urinary incontinence in June 2021. L-spine MRI revealed an intradural extramedullary tumor at T8 level. She received T7-9 …

Early Intervention In A Child With Aymé-Gripp Syndrome: A Case Report, Liang-Jun Ou-Yang, Pei-Hsuan Huang, Hsiang-Ning Chang, Chih-Chi Chen, Chia-Ling Chen, Chia-Ying Chung

Rehabilitation Practice and Science

Aymé-Gripp syndrome is an autosomal dominant inherited disease. The de novo pathogenic variant of the MAF gene, located at 16q23.2, is considered the primary common cause of this disease. The pathogenic variant causes interference with lens and eye development and embryonic development. Patients with Aymé-Gripp syndrome typically present with bilateral cataracts, bilateral congenital sensorineural hearing loss, and Down syndrome-like facial features. Dual sensory impairment is observed in these patients. Delayed developmental milestones in the aspect of gross motor, fine motor, speech, and language, cognitive function, and social interaction can be detected early in life. Here we presented a 4-year-old male …

Evaluations Of Exercise Intolerance With Cardiopulmonary Exercise Tests In A 24-Year-Old Young Male With Obesity With Tetrahydrobiopterin Deficiency: A Case Report, Chun-Yu Chen, Shin-Tsu Chang, Ko-Long Lin, Mu-Hsun Wu

Rehabilitation Practice and Science

Phenylketonuria (PKU) is a rare amino acid metabolism genetic disorder. Tetrahydrobiopterin (BH4) metabolism defects cause variant PKU. BH4 coenzyme deficiency disables phenylalanine metabolism into tyrosine, causing brain damage and intellectual impairment. Patients follow a low-phenylalanine diet for life, increasing the risk of obesity, hypertension, and metabolic syndrome. A 24-year-old male patient with BH4 deficiency underwent a pulmonary function test and cardiopulmonary exercise test (CPET). Forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) were within normal values, with an 80.68% ratio. The 20-watt bicycle exercise test indicated moderate functional impairment (27.3 ml/kg/min of peak oxygen intake). The …

Evaluating Dysphagia In Patients With Cervical Spinal Cord Injury Using The Modified Barium Swallow Impairment Profile, Ting-Huan Chen, Bai-Hong Chen, Shih-Chung Chang

Rehabilitation Practice and Science

Background/Purpose: To clarify the characteristics of dysphagia in patients with cervical spinal cord injury (CSCI) by using modified barium swallow impairment profile (MBSImP) scoring in a videofluoroscopic swallowing study (VFSS). Methods: This retrospective study included the data of 10 patients with CSCI (9 men and 1 woman) with dysphagia admitted to the rehabilitation ward of a university medical hospital who had undergone VFSS. The patients’ oral, pharyngeal, and esophageal impairments were evaluated using the MBSImP. Results: Comprising the MBSImP overall score, the median oral impairment total score (OT) was 10.5 (interquartile range [IQR]: 9–11), the median pharyngeal impairment total score …

Effect Of Robotic Training On The Mobility Of Children With Cerebral Palsy: A Systematic Review And Meta-Analysis Of Randomized Controlled Trials, Fu-An Yang, Ya-Chu Shih, Li-Fong Lin, Chih-Wei Peng, Chien-Hung Lai, Tsan-Hon Liou, Reuben Escorpizo, Hung-Chou Chen

Rehabilitation Practice and Science

In this study, we conducted a systematic review and meta-analysis to investigate the effect of robotic training on the mobility of children with cerebral palsy. The PubMed, Cochrane Library, PEDro, and Embase databases were searched for relevant studies from their inception to June 17, 2023. We selected studies that (1) were randomized controlled trials (RCTs), (2) included patients with cerebral palsy aged years, (3) compared robotic training with conventional rehabilitation alone, and (4) reported mobility outcomes. Continuous variables are expressed as standardized mean differences (SMDs) with 95% confidence intervals (CIs). The analysis was performed using RevMan 5.4 software. We included …

Effectiveness Of Specialized Oral Care For Post-Acute Stroke Patients, Hui-Chuan Chen, Hsiao-Han Wei, Yi-Hsuan Yang, Hsial-Lun To, Hsiao-Fan Wang, Ying-Han Hong

Rehabilitation Practice and Science

(1) Background: Poor oral health is a common problem in stroke patients. In Taiwan, there are professional oral care processes for patients with special needs such as stroke patients, which are guided by dental hygienists. This study sought to investigate the effectiveness of specialized oral care for hospitalized stroke patients; (2) Methods: This prospective study was conducted in the Rehabilitation ward at the Taipei City Hospital. Sixty-six patients were randomly divided into two groups. The specialized oral care group (n=34) was guided by dental hygienists. The control group (n=32) received only routine oral care. The oral health outcome measure was …

Design And Implementation Of A Vision-Based Deep-Learning Protocol For Kinematic Feature Extraction With Application To Stroke Rehabilitation, Juan Diego Luna Inga

Master's Theses

Stroke is a leading cause of long-term disability, affecting thousands of individuals annually and significantly impairing their mobility, independence, and quality of life. Traditional methods for assessing motor impairments are often costly and invasive, creating substantial barriers to effective rehabilitation. This thesis explores the use of DeepLabCut (DLC), a deep-learning-based pose estimation tool, to extract clinically meaningful kinematic features from video data of stroke survivors with upper-extremity (UE) impairments.

To conduct this investigation, a specialized protocol was developed to tailor DLC for analyzing movements characteristic of UE impairments in stroke survivors. This protocol was validated through comparative analysis using peak …

Catheter-Directed Thrombolysis, Children's Mercy Kansas City

Clinical Pathways

No abstract provided.

Periacetabular Osteotomy Eras, Children's Mercy Kansas City

Clinical Pathways

No abstract provided.

Limbic-Predominant Age-Related Tdp-43 Encephalopathy (Late-Nc): Co-Pathologies And Genetic Risk Factors Provide Clues About Pathogenesis, Peter T. Nelson, David Fardo, Xian Wu, Khine Zin Aung, Matthew D. Cykowski, Yuriko Katsumata

Neurology Faculty Publications

Limbic-predominant age-related TDP-43 encephalopathy neuropathologic change (LATE-NC) is detectable at autopsy in more than one- third of people beyond age 85 years and is robustly associated with dementia independent of other pathologies. Although LATE-NC has a large impact on public health, there remain uncertainties about the underlying biologic mechanisms. Here, we review the literature from human studies that may shed light on pathogenetic mechanisms. It is increasingly clear that certain combinations of pathologic changes tend to coexist in aging brains. Although “pure” LATE-NC is not rare, LATE-NC often coexists in the same brains with Alzheimer disease neuropathologic change, brain arteriolosclerosis, …

Comprehensive Assessment Of Tdp‑43 Neuropathology Data In The National Alzheimer’S Coordinating Center Database, Davis C. Woodworth, Katelynn M. Nguyen, Lorena Sordo, Kiana A. Scambray, Elizabeth Head, Claudia H. Kawas, María M. Corrada, Peter T. Nelson, S. Ahmad Sajjadi

Neurology Faculty Publications

TDP-43 proteinopathy is a salient neuropathologic feature in a subset of frontotemporal lobar degeneration (FTLD-TDP), in amyotrophic lateral sclerosis (ALS-TDP), and in limbic-predominant age-related TDP-43 encephalopathy neuropathologic change (LATE-NC), and is associated with hippocampal sclerosis of aging (HS-A). We examined TDP-43-related pathology data in the National Alzheimer’s Coordinating Center (NACC) in two parts: (I) availability of assessments, and (II) associations with clinical diagnoses and other neuropathologies in those with all TDP-43 measures available. Part I: Of 4326 participants with neuropathology data collected using forms that included TDP-43 assessments, data availability was highest for HS-A (97%) and ALS (94%), followed by …