Medicine and Health Sciences Commons^™

Occupational Fatality Surveillance Data: Communication Issues, Misunderstandings, And Misuses, Roger C. Jensen

Safety Health & Industrial Hygiene

Every occupational fatality is a tragedy for the person, family, fellow employees, and the employer. Efforts for preventing these deaths involve a multi-faceted approach, one of which is tracking the cases in order to increase understanding of the circumstances involved in the fatal incident. In the United States, the Bureau of Labor Statistics maintains an extensive collection of data on occupational fatalities and publishes the information in multi-page spreadsheets. When properly used, fatality data can be useful for setting research priorities and documenting the importance of particular fatality-related subject matter. For justifying research on prevention, the most useful data involves …

2024 May 21 - Medical Student Education Committee Minutes, Medical Student Education Committee, East Tennessee State University

Medical Student Education Committee Minutes

No abstract provided.

Effects Of High-Intensity Interval Training On Body Composition In Individuals With Polycystic Ovary Syndrome, Allyson A. Wahus, Kensi L. Tenhouse, Rachel K. Drucker, Autumn R. Tucker, Gilberto G. Buitrago, Isabella G. Empoliti, Lauren M. Lipscomb

The Corinthian

This study aimed to investigate the effects of a high-intensity interval training (HIIT) program on body composition between individuals with and without polycystic ovary syndrome (PCOS). PCOS patients have a difficult time maintaining healthy body composition. With time being a significant factor determining exercise adherence, it is vital to observe short-term training programs for any possible effect on health measures. Four participants with PCOS (21.3y ± 1.05) and six participants without PCOS (21.2y ± 1.34) volunteered to participate. All participants performed a three-week HIIT program consisting of three HIIT workouts per week. The participants submitted a 24-hour dietary recall and …

Evaluation Of Breastfeeding Interventions To Improve Duration In Women At Risk For Breastfeeding Attrition, Anthonia Anukam

The Corinthian

Children that are optimally breastfed have the healthiest start in life. The World Health Organization and the CDC recommend that mothers optimally breastfeed. Benefits of breastfeeding to children include the receipt of antibodies, reduction of ear, respiratory, and gastrointestinal infections, decreased sudden infant death syndrome, allergies, diabetes, and childhood leukemia. Several research studies have reported a strong positive correlation between breastfeeding and reduced infant morbidity and mortality. Evidence illustrates that the health benefits from breastfeeding are dose-dependent, thus the longer the breastfeeding duration the greater the acquisition of the enumerated benefits. However, premature cessation of breastfeeding less than the WHO …

The Use And Effectiveness Of Diet And Physical Activity As Interventions For Polycystic Ovary Syndrome. A Review., Caroline C. Jones, Jinkyung Park

The Corinthian

Polycystic Ovary Syndrome (PCOS) is a hormonal disorder that is common among women who are of reproductive age, most commonly in ages between 15 and 44 years of age (Moran et al., 2010). While the exact cause of PCOS is unknown, it is widely believed by many experts that genetic factors including excess levels of insulin and excess androgen are attributing factors (Moran et al., 2010) . Women with PCOS experience several different signs and symptoms including; infrequent or prolonged menstrual periods leading to infertility and the development of cysts (Iatrakis et al., 2006). Some other common symptoms of PCOS …

Urgent Care Program Influences On An Integrated Health Care System, Craig H. Carter

Dissertations and Theses

The Veterans Health Administration (VHA) is the most extensive integrated health care delivery system in the world with over 20,000 physicians, 1,600 facilities, and more than 400,000 employees, caring for nine million veterans. The health care provided covers traditional outpatient and hospital-based services such as primary care, surgery, critical care, mental health, orthopedics, pharmacy, radiology, and physical therapy. Most VHA facilities offer additional medical and surgical specialties such as audiology, speech pathology, dermatology, dental, geriatrics, urology, oncology, podiatry, prosthetics, and vision care. Some of the more extensive VHA facilities offer advanced health care services, such as organ transplants and plastic …

Robust Ai-Driven Segmentation Of Glioblastoma T1c And Flair Mri Series And The Low Variability Of The Mrimath© Smart Manual Contouring Platform, Yassine Barhoumi, Abdul Hamid Fattah, Nidhal Carla Bouaynaya, Fanny Moron, Jinsuh Kim, Hassan M. Fathallah-Shaykh, Rouba A. Chahine, Houman Sotoudeh

Henry M. Rowan College of Engineering Departmental Research

Patients diagnosed with glioblastoma multiforme (GBM) continue to face a dire prognosis. Developing accurate and efficient contouring methods is crucial, as they can significantly advance both clinical practice and research. This study evaluates the AI models developed by MRIMath© for GBM T1c and fluid attenuation inversion recovery (FLAIR) images by comparing their contours to those of three neuro-radiologists using a smart manual contouring platform. The mean overall Sørensen–Dice Similarity Coefficient metric score (DSC) for the post-contrast T1 (T1c) AI was 95%, with a 95% confidence interval (CI) of 93% to 96%, closely aligning with the radiologists’ scores. For true positive …

Mainehealth Cancer Care Network Ticket Intake Process, Lauren Couture, Brett Cropp, Gavin Carr, Ashok Kunche, Heather Boulier, Evelyn Taylor

Operations Transformation

The MaineHealth Cancer Care Network informatics team is manually submitting most reporting tickets for oncology customers. The current intake ticket process includes various communication channels to the business intelligence developers [BID] when a reporting need is identified resulting in workflow deficiencies and redundancies. As of FY23, MaineHealth has moved to a new ticket reporting system called ServiceHub which includes new customer self-service tools that have not yet been utilized.

Creating Capacity To Accommodate Additional Cardiac Catheterization Procedures, Kristin Anthony

Operations Transformation

Patient access to diagnostic outpatient (OP) cardiac catheterization is limited by a perceived lack of capacity. Outpatient cardiac cath pts flow through the ACU for pre/post procedure care. Current schedule limits pts that may be scheduled through the ACU to two OP procedures/day. Cardiologists request the ability to schedule beyond the two procedures/day allowed. Significant variation in pre/postoperative care orders exist amongst cardiologists resulting in variability in length of stay. Cardiac procedures are booked either as 60/90/120 minutes – Epic case averaging technology is not active in the cath lab. As a result, the case minutes in the cath lab …

Key Performance Indicator (Kpi) Development Pathway, Christopher Lloyd, Amy Giles, David Spaulding, Sarah Rines

Operations Transformation

In Q1 FY24 as more team members started to take Operational Excellence classes and subsequently become more engaged in quality improvement it was observed there was much enthusiasm but also some gaps in the understanding of available tools, resources, data collection strategies, and what elevates something to a KPI, etc. There is a need to create a guide that supported gaps, streamlined tracking process, and aligned teams in this new approach.

From Immune Checkpoint Inhibition To Intubation, Sabena Toor, Samridhi Gulati, Shaiva G. Meka

Conference Presentation Abstracts

No abstract provided.

Disasters And Impacts In Appalachian Kentucky: A Behavioral Health Analysis, Walter David Mathews Phd, Joseph M. Clark, Amy S. Potts

Journal of Appalachian Health

Introduction: Major disasters continue to occur in Appalachian Kentucky with devastating consequences. A major disaster, defined by the Federal Emergency Management Agency (FEMA) as an event too large for a community to manage without outside help, involves emergency responders from the local, state, and federal disaster agencies, plus national volunteers.

Purpose: This paper reports on recent disasters in eight southeast Kentucky counties, the changing nature of these disasters, and the behavioral health impact on the people affected.

Methods: In this large-scale disaster survey in the Appalachian counties in Southeast Kentucky, over 3,500 people were asked about their recent disaster experiences …

A Fungal Protein Organizes Both Glycogen And Cell Wall Glucans, Liza Loza, Tamara L Doering

2020-Current year OA Pubs

Glycogen is a glucose storage molecule composed of branched α-1,4-glucan chains, best known as an energy reserve that can be broken down to fuel central metabolism. Because fungal cells have a specialized need for glucose in building cell wall glucans, we investigated whether glycogen is used for this process. For these studies, we focused on the pathogenic yeast

Legal Outcomes Of Litigation After Iatrogenic Genitourinary Trauma, Helen H. Sun, Crystal An, Andrew Drozd, Nicholas Sellke, Kimberly Tay, Kirtishri Mishra, Kyle Scarberry, Shubham Gupta, Nannan Thirumavalavan

Researchers, Instructors, & Staff Scholarship

Objective: To evaluate plaintiff and defendant characteristics associated with iatrogenic genitourinary (GU) trauma litigation and outcomes of closed claims. Methods: LexisNexis was queried in April 2023 using terms related to GU organs and injury, and manually reviewed for iatrogenic cases. Case details including defendant, organ involvement, and legal outcome were obtained. Multinomial regression analysis was performed to identify factors associated with outcome. Results: Four hundred ten cases involving 611 defendants were identified, with the ureter the most commonly affected organ (202/410, 49.3%). Most cases involved adult plaintiffs (380, 92.7%) and resulted in favor of the defense (227, 55.4%). Injuries resulted …

Nanobodies In The Fight Against Infectious Diseases: Repurposing Nature's Tiny Weapons, Dina Mohamed Moustafa, Soha S. Rizk, Shahira A. Elbanna, Hanzada Tawfik Nour El-Din, Ahmed Sherif Attia

Dentistry

Nanobodies are the smallest known antigen-binding molecules to date. Their small size, good tissue penetration, high stability and solubility, ease of expression, refolding ability, and negligible immunogenicity in the human body have granted them excellence over conventional antibodies. Those exceptional attributes of nanobodies make them promising candidates for various applications in biotechnology, medicine, protein engineering, structural biology, food, and agriculture. This review presents an overview of their structure, development methods, advantages, possible challenges, and applications with special emphasis on infectious diseases-related ones. A showcase of how nanobodies can be harnessed for applications including neutralization of viruses and combating antibiotic-resistant bacteria …

Moving Forward With Ketamine Therapy: Ensuring Safety, Efficacy, And Accessibility In Depression Treatment, Julienne Desanto

Undergraduate Honors Theses

Ketamine, a medication long used in anesthesia, has emerged as a promising treatment for depression and other mental health disorders. Its rapid onset of action and mechanism, which differs from traditional antidepressants by targeting NMDA receptors, offers a novel approach to managing depressive symptoms. Despite its potential, ketamine's use outside anesthesia, particularly in off-label ketamine clinics, is fraught with regulatory, safety, and accessibility challenges. This paper explores the historical medical use of ketamine and its emerging role in mental health treatment. It compares the efficacies and administration routes of different forms of ketamine, including intravenous (IV) and intranasal (nasal spray) …

Sustained Response To Atogepant In Episodic Migraine: Post Hoc Analyses Of A 12-Week Randomized Trial And A 52-Week Long-Term Safety Trial, Richard Lipton, Stephanie J. Nahas, Patricia Pozo-Rosich, Tanya Bilchik, Peter Mcallister, Michelle Finnegan, Yingyi Liu, Natty Chalermpalanupap, Brett Dabruzzo, David Dodick

Department of Neurology Faculty Papers

BACKGROUND: Atogepant is an oral calcitonin gene-related peptide receptor antagonist approved for the preventive treatment of migraine in adults. These analyses evaluated the proportions of clinical trial participants who experienced sustained responses to atogepant over 12 or 52 weeks of treatment.

METHODS: These were post hoc analyses of ADVANCE, a 12-week, double-blind, randomized trial of atogepant 10, 30, and 60 mg once daily vs. placebo for the preventive treatment of episodic migraine, and a separate open-label long-term safety (LTS) trial of atogepant 60 mg once daily over 52 weeks. The 60 mg dose of atogepant was used to detect safety …

Community Needs Assessment Collaboration Following The July 2022 Flooding In Eastern Kentucky, Melissa Slone Dsw, Frances Feltner Dnp, William M. Baker Rn, Anthony S. Lockard Msw, Csw, Angela Raleigh Rd

Journal of Appalachian Health

Rapidly rising waters due to flash floods and thunderstorms on the night of July 27, 2022, resulted in hundreds of water rescues throughout 14 rural Appalachian Kentucky counties. Lives were lost, thousands were injured, homes and property were damaged or destroyed, and many roadways were unpassable. Community partners serving these counties collaborated to design and conduct an assessment to gain a better understanding of the needs of individuals residing in certain remote sections within the communities. The assessment, conducted three months after the flood, collected information regarding flooding impact on housing, physical and behavioral health, transportation, work, and finances.

Increased Usage Of Doxycycline For Young Children With Lyme Disease, Amy Thompson, Desiree Neville, Laura Chapman, Fran Balamuth, Meagan Ladell, Anupam Kharbanda, Rachael Aresco, Lise Nigrovic

Department of Emergency Medicine Faculty Papers

Background: The 2018 Infectious Disease Committee of the American Academy of Pediatrics stated that up to 3 weeks or less of doxycycline is safe in children of all ages. Our goal was to examine trends in doxycycline treatment for children with Lyme disease.

Methods: We assembled a prospective cohort of children aged 1 to 21 years with Lyme disease who presented to one of eight participating Pedi Lyme Net centers between 2015 and 2023. We defined a Lyme disease case with an erythema migrans (EM) lesion or positive two-tier Lyme disease serology categorized by stage: early-localized (single EM lesion), early-disseminated …

Age-Specific Induction Of Mutant P53 Drives Clonal Hematopoiesis And Acute Myeloid Leukemia In Adult Mice, Rasoul Pourebrahim, Rafael Heinz Montoya, Hiroki Akiyama, Lauren Ostermann, Shayuan Khazaei, Muharrem Muftuoglu, Natalia Baran, Ran Zhao, Tom Lesluyes, Bin Liu, Joseph D Khoury, Mihai Gagea, Peter Van Loo, Michael Andreeff

Faculty, Staff and Student Publications

The investigation of the mechanisms behind p53 mutations in acute myeloid leukemia (AML) has been limited by the lack of suitable mouse models, which historically have resulted in lymphoma rather than leukemia. This study introduces two new AML mouse models. One model induces mutant p53 and Mdm2 haploinsufficiency in early development, showing the role of Mdm2 in myeloid-biased hematopoiesis and AML predisposition, independent of p53. The second model mimics clonal hematopoiesis by inducing mutant p53 in adult hematopoietic stem cells, demonstrating that the timing of p53 mutation determines AML vs. lymphoma development. In this context, age-related changes in hematopoietic stem …

Selective Refueling Of Car T Cells Using Ada1 And Cd26 Boosts Antitumor Immunity, Yue Hu, Abhijit Sarkar, Kevin Song, Sara Michael, Magnus Hook, Ruoning Wang, Andras Heczey, Xiaotong Song

Faculty, Staff and Student Publications

Chimeric antigen receptor (CAR) T cell therapy is hindered in solid tumor treatment due to the immunosuppressive tumor microenvironment and suboptimal T cell persistence. Current strategies do not address nutrient competition in the microenvironment. Hence, we present a metabolic refueling approach using inosine as an alternative fuel. CAR T cells were engineered to express membrane-bound CD26 and cytoplasmic adenosine deaminase 1 (ADA1), converting adenosine to inosine. Autocrine secretion of ADA1 upon CD3/CD26 stimulation activates CAR T cells, improving migration and resistance to transforming growth factor β1 suppression. Fusion of ADA1 with anti-CD3 scFv further boosts inosine production and minimizes tumor …

Recent Findings On The Effectiveness Of Peer Support For Patients With Type 2 Diabetes, James J. Werner, Kelsey Ufholz, Prashant Yamajala

Faculty Scholarship

Purpose of Review: To review randomized controlled trials (RCTs) published from 2021–2023 that reported the effects of peer support interventions on outcomes in patients with type 2 diabetes (T2DM). Recent Findings: Literature searches yielded 137 articles and nine RCTs were ultimately reviewed. The reviewed trials involved in-person support groups, peer coach/mentor support, cultural peer support by community health workers, peer support during shared medical appointments (SMAs) including virtual reality-based SMAs, telehealth-facilitated programs, and telephone peer support. Most interventions combined two or more peer support strategies. Peer support was associated with significant decreases in HbA1c in 6 of the 9 reviewed …

Comprehensive Proteogenomic Characterization Of Rare Kidney Tumors, Ginny Xiaohe Li, Yize Li, Nataly Naser Al Deen, Feng Chen, Wagma Caravan, Andrew Houston, Siqi Chen, Li Ding, Et Al.

2020-Current year OA Pubs

Non-clear cell renal cell carcinomas (non-ccRCCs) encompass diverse malignant and benign tumors. Refinement of differential diagnosis biomarkers, markers for early prognosis of aggressive disease, and therapeutic targets to complement immunotherapy are current clinical needs. Multi-omics analyses of 48 non-ccRCCs compared with 103 ccRCCs reveal proteogenomic, phosphorylation, glycosylation, and metabolic aberrations in RCC subtypes. RCCs with high genome instability display overexpression of IGF2BP3 and PYCR1. Integration of single-cell and bulk transcriptome data predicts diverse cell-of-origin and clarifies RCC subtype-specific proteogenomic signatures. Expression of biomarkers MAPRE3, ADGRF5, and GPNMB differentiates renal oncocytoma from chromophobe RCC, and PIGR and SOSTDC1 distinguish papillary RCC …

Phytochemical Assay And In – Vitro Cytotoxicity Assessment Of Cassava Peel (Manihot Esculenta) From Ethanol And Ethyl Acetate Extract Against Cervical Cancer Cells (Hela), Alice Hari Soejono, Surya Dwira, Puji Sari

Indonesian Journal of Medical Chemistry and Bioinformatics

Introduction: Cervical cancer is a type of cancer that develops in a woman’s cervix. It is a result of HPV (Human Papilloma Virus) and is one of the deadliest types of cancer. Some cervical cancer management including chemotherapy, which until recently continues to develop to cure the condition, is relatively expensive and comes with multiple different side effects.

Method: Manihot esculenta undergoes multilevel maceration with the solvent of ethanol and ethyl acetate. This leads to the formation of ethanol extract and ethyl acetate extract of Manihot esculenta that is analyzed through phytochemical assay and thin layer chromatography (TLC) to determine …

Commencement, Georgia (2024), Philadelphia College Of Osteopathic Medicine

Commencements

Georgia Campus Commencement Program, 2024. Degrees include Doctor of Osteopathic Medicine, Doctor of Pharmacy, Doctor of Physical Therapy, Master of Science in Biomedical Sciences, Master of Science in Health Sciences - Physician Assistant Studies, and Master of Science in Medical Laboratory Sciences.

Commencement Speaker: Nick Masino, President & CEO, Gwinnett Chamber and Partnership Gwinnett

Neurodevelopmental Outcomes After Late Preterm Antenatal Corticosteroids: The Alps Follow-Up Study, Cynthia Gyamfi-Bannerman, Rebecca G Clifton, Alan T N Tita, Sean C Blackwell, Monica Longo, Jessica A De Voest, T Michael O'Shea, Sabine Z Bousleiman, Felecia Ortiz, Dwight J Rouse, Torri D Metz, George R Saade, Kara M Rood, Kent D Heyborne, John M Thorp, Geeta K Swamy, William A Grobman, Kelly S Gibson, Yasser Y El-Sayed, George A Macones, Eunice Kennedy Shriver Maternal-Fetal Medicine Units Network

Faculty, Staff and Student Publications

Importance: The Antenatal Late Preterm Steroids (ALPS) trial changed clinical practice in the United States by finding that antenatal betamethasone at 34 to 36 weeks decreased short-term neonatal respiratory morbidity. However, the trial also found increased risk of neonatal hypoglycemia after betamethasone. This follow-up study focused on long-term neurodevelopmental outcomes after late preterm steroids.

Objective: To evaluate whether administration of late preterm (34-36 completed weeks) corticosteroids affected childhood neurodevelopmental outcomes.

Design, setting, and participants: Prospective follow-up study of children aged 6 years or older whose birthing parent had enrolled in the multicenter randomized clinical trial, conducted at 13 centers that …

A Microcosting Approach For Planning And Implementing Community-Based Mental Health Prevention Program: What Does It Cost?, Sharmily Roy, Henry Shelton Brown, Lisa Sanger Blinn, Sarah Carter Narendorf, Jane E Hamilton

Faculty, Staff and Student Publications

BACKGROUND: Estimating program costs when planning community-based mental health programs can be burdensome. Our aim was to retrospectively document the cost for the first year of planning and implementing Healthy Minds Healthy Communities (HMHC), a mental health promotion and prevention multi-level intervention initiative. This Program is among the first to use the Community Initiated Care (CIC) model in the US and is aimed at building community resilience and the capacity for communities to provide mental health support, particularly among those disproportionately impacted by COVID-19. Our objective is to share our methods for costing a program targeting 10 zip codes that …

A Microcosting Approach For Planning And Implementing Community-Based Mental Health Prevention Program: What Does It Cost?, Sharmily Roy, Henry Shelton Brown, Lisa Sanger Blinn, Sarah Carter Narendorf, Jane E Hamilton

Faculty, Staff and Student Publications

BACKGROUND: Estimating program costs when planning community-based mental health programs can be burdensome. Our aim was to retrospectively document the cost for the first year of planning and implementing Healthy Minds Healthy Communities (HMHC), a mental health promotion and prevention multi-level intervention initiative. This Program is among the first to use the Community Initiated Care (CIC) model in the US and is aimed at building community resilience and the capacity for communities to provide mental health support, particularly among those disproportionately impacted by COVID-19. Our objective is to share our methods for costing a program targeting 10 zip codes that …

Overall Polyp Detection Rate As A Surrogate Measure For Screening Efficacy Independent Of Histopathology: Evidence From National Endoscopy Database, Mark Aloysius, Hemant Goyal, Tejas Nikumbh, Niraj Shah, Ganesh Aswath, Savio John, Amol Bapaye, Sushovan Guha, Nirav Thosani

Faculty, Staff and Student Publications

Adenoma detection rate (ADR) is challenging to measure, given its dependency on pathology reporting. Polyp detection rate (PDR) (percentage of screening colonoscopies detecting a polyp) is a proposed alternative to overcome this issue. Overall PDR from all colonoscopies is a relatively novel concept, with no large-scale studies comparing overall PDR with screening-only PDR. The aim of the study was to compare PDR from screening, surveillance, and diagnostic indications with overall PDR and evaluate any correlation between individual endoscopist PDR by indication to determine if overall PDR can be a valuable surrogate for screening PDR. Our study analyzed a prospectively collected …

Lacl3-Based Sodium Halide Solid Electrolytes With High Ionic Conductivity For All-Solid-State Batteries, Chengyu Fu, Yifan Li, Wenjie Xu, Xuyong Feng, Weijian Gu, Jue Liu, Wenwen Deng, Wei Wang, A M Milinda Abeykoon, Laisuo Su, Lingyun Zhu, Xiaojun Wu, Hongfa Xiang

Faculty, Staff and Student Publications

To enable high performance of all solid-state batteries, a catholyte should demonstrate high ionic conductivity, good compressibility and oxidative stability. Here, a LaCl3-based Na+ superionic conductor (Na1−xZrxLa1−xCl4) with high ionic conductivity of 2.9 × 10−4 S cm−1 (30 °C), good compressibility and high oxidative potential (3.80 V vs. Na2Sn) is prepared via solid state reaction combining mechanochemical method. X-ray diffraction reveals a hexagonal structure (P63/m) of Na1−xZrxLa1−xCl4, with Na+ ions forming a one-dimensional diffusion channel along the c-axis. First-principle calculations combining with …