Medicine and Health Sciences Commons^™

Why The Neurosurgeon Should Apply The Concepts Of Neuroethics In Their Daily Clinical Practice, Miguel Antonio Sandoval Balanzario, Lizbeth Itzel Sandoval Olivares, Noe Santiago Ramírez, Noe Santiago Rea

Archives of Neurosurgery

The human being is a community and social being, thus, he was capable to establish rules and humanize he's environment, allowed by the development of he's intelligence, as well as moral behavior. Nevertheless, morals and ethics have also evolved along the history, allowing the birth of neuroethics in 2002 with the objective to study ethical behavior of neurological research procedures and study ethics from the neuroscientific point.

A 2‑Year Longitudinal Randomized Control Trial Of Speed Of Processing Cognitive Training In Aging Adults With Hiv‑Associated Neurocognitive Disorder: Results Of The Think Fast Study, David E. Vance, Pariya L. Fazeli, Andres Azuero, Jennifer S. Frank, Virginia G. Wadley, James L. Raper, Caitlin N. Pope, Karlene K. Ball

Epidemiology and Environmental Health Faculty Publications

Nearly 40% of people with HIV (PWH) experience HIV-associated Neurocognitive Disorder (HAND). In this 3-group efficacy study, 216 PWH 40 + years with HAND or borderline HAND were randomized to either: (1) 10 h of SOP training (n = 70); (2) 20 h of SOP training (n = 73), or (3) 10 h of Internet navigation training (n = 73; contact control group). Participants were administered a measure of SOP [i.e., the Useful Field of View Test (UFOV®)] at baseline, at posttest immediately after training, and at year 1 and year 2 follow up. Intent-to-treat linear mixed-effect models with subject-specific …

Late Have I Loved Thee: Reintroducing The Journal Of Health Ethics Twenty Years Later, Peter A. Depergola Ii

Journal of Health Ethics

The Editor-in-Chief provides an overview of Volume 20, Issue 1.

Methodological Assessment Of A Review Of Knowledge, Attitude And Practice About Human Papilloma Virus Vaccination In India, Abraham Degarege, Purnima Madhivanan

Journal Articles: Epidemiology

A well-conducted review provides quality evidence to inform policy and practice. It is important that the review is as rigorous and as fully reported as possible if the evidence from the review is incorporated into clinical practice. We are writing in response to an article titled, ‘Evidence of Knowledge, Attitude, and Practice Regarding Human Papilloma Virus Vaccination at the Community Level in India: A Systematic Review and Meta-Analysis’ by Pal et al published in Asian Pacific Journal of Cancer Prevention in March 2024. There are some major methodological flaws in the paper that might have biased the conclusions drawn from …

Investigating Fit Kit Completion For Crc Screening In Younger Adults In Rural Areas, Cheryl Beseler, Jungyoon Kim, Melissa Leypoldt, Roma Subramanian, Tamara Robinson, Karen Funkenbusch, Jason M. Foster, Susan Harris, Aaron Yoder, Emma Hymel, Shinobu Watanabe-Galloway

Journal Articles: Epidemiology

Rural regions have higher incidence rates of colorectal cancer (CRC) than urban regions, while screening is lower in rural residents than in urban residents. Rural residents experience barriers to CRC screening due to a lack of access to healthcare, perceived lack of privacy, and other cultural factors. The fecal immunochemical tests (FITs) may provide an inexpensive and convenient alternative for those lacking access to a colonoscopy or sigmoidoscopy. In a clinical trial, we investigated factors that influenced the return of a FIT kit for CRC screening among 1,230 rural residents in a midwestern U.S. state. Participants were selected from two …

Lipid Genetics In Pregnant Women: Maneuvering The Challenges Of Using Degraded Samples, Kylee Meece

Mahurin Honors College Capstone Experience/Thesis Projects

The results of this project will explore a novel approach to lipid metabolism in pregnant women by exploring the relationship between maternal gene expression of genes critical for fat metabolism, protein expression, and maternal and neonatal outcomes. The study will also examine gene expression in lean pregnant women compared to obese pregnant women, shedding light into the adverse pathology of obesity during pregnancy. These findings may uncover a mechanism related to gene-expression that connects unfavorable maternal fat metabolism to inflammation and/or insulin resistance, which may help to uncover future targets for interventions.

The analysis of lipid gene expression requires the …

The Influence Of Vitamin D On The Severity Of Depressive Symptoms In Children And Adolescents: A Systematic Review, Haley Flanagan

2024 Awards for Excellence in Student Research and Creative Activity - Documents

This review aims to investigate the influence vitamin D has on the severity of depressive symptoms in children and adolescents. Current studies have shown the potential role of vitamin D on mental health in adults, but results have been inconclusive among children. Using PubMed, Scopus, and CINAHL Complete, studies were selected by searching the terms “Vitamin D, depression, children and adolescents.” The inclusion criteria consisted of data over the last five years, presenting vitamin D intake or status in subjects between the ages of 2-17, and a diagnosis of depression. Eleven studies met the eligibility criteria. Nine of the studies …

Management Of Factor Xa Inhibitor-Related Traumatic Non-Intracranial Bleeding Events With Andexanet Alfa Or Four-Factor Prothrombin Complex Concentrate In A Us Multicenter Observational Study, Paul P. Dobesh, Craig I. Coleman, Mark Danese, Eva Lesén, Raymond C. Chang, Onivefu Odelade, Gregory J. Fermann

Journal Articles: Pharmacy Practice

OBJECTIVES: This study describes clinical characteristics and management strategies for patients with factor Xa (FXa) inhibitor-related traumatic non-intracranial bleeds who were treated with andexanet alfa or four-factor prothrombin complex concentrate (4F-PCC).

METHODS: An observational cohort study (ClinicalTrials.gov Identifier: NCT05548777) was conducted using electronic health records from 354 US hospitals. Included patients were hospitalized with rivaroxaban- or apixaban-related bleeding, had received andexanet alfa or 4F-PCC treatment during their hospitalization, and were discharged between May 2018 and September 2022. This analysis was performed in the subgroup of patients with traumatic non-intracranial critical compartment/non-compressible bleeds or other traumatic bleeds.

RESULTS: The study population …

Metabolism Shapes Immune Responses To Staphylococcus Aureus., Prabhakar Arumugam, Tammy Kielian

Journal Articles: Pathology and Microbiology

BACKGROUND: Staphylococcus aureus (S. aureus) is a common cause of hospital- and community-acquired infections that can result in various clinical manifestations ranging from mild to severe disease. The bacterium utilizes different combinations of virulence factors and biofilm formation to establish a successful infection, and the emergence of methicillin- and vancomycin-resistant strains introduces additional challenges for infection management and treatment.

SUMMARY: Metabolic programming of immune cells regulates the balance of energy requirements for activation and dictates pro- versus anti-inflammatory function. Recent investigations into metabolic adaptations of leukocytes and S. aureus during infection indicate that metabolic crosstalk plays a crucial role in …

Elucidating Granulocytic Myeloid-Derived Suppressor Cell Heterogeneity During Staphylococcus Aureus Biofilm Infection, Blake P. Bertrand, Cortney E. Heim, Scott A. Koepsell, Tammy Kielian

Journal Articles: Pathology and Microbiology

Myeloid-derived suppressor cells (MDSCs) are pathologically activated immature myeloid cells with immunosuppressive activity that expand during chronic inflammation, such as cancer and prosthetic joint infection (PJI). Myeloid-derived suppressor cells can be broadly separated into 2 populations based on surface marker expression and function: monocytic myeloid-derived suppressor cells (M-MDSCs) and granulocytic myeloid-derived suppressor cells (G-MDSCs). Granulocytic myeloid-derived suppressor cells are the most abundant leukocyte infiltrate during PJI; however, how this population is maintained in vivo and cellular heterogeneity is currently unknown. In this study, we identified a previously unknown population of Ly6G+Ly6C+F4/80+MHCII+ MDSCs during PJI that displayed immunosuppressive properties ex vivo. …

C1q Is Elevated During Chronic Staphylococcus Epidermidis Central Nervous System Catheter Infection, Matthew K. Beaver, Lara Bergdolt, Anna Dunaevsky, Tammy Kielian, Gwenn Skar

Journal Articles: Pathology and Microbiology

INTRODUCTION: Significant neurologic morbidity is caused by pediatric cerebrospinal fluid (CSF) shunt infections. The underlying mechanisms leading to impaired school performance and increased risk of seizures are unknown, however, a better understanding of these mechanisms may allow us to temper their consequences. Recent evidence has demonstrated important roles for complement proteins in neurodevelopment and neuroinflammation.

METHODS: We examined complement activation throughout

RESULTS: We found that MASP2 predominated early in catheter infection, but that Factor B was elevated at intermediate time points. Unexpectedly C1q was elevated at late timepoints when bacterial burdens were low or undetectable. Based on these findings and …

Antimicrobial Activity Of Gallium(Iii) Compounds: Pathogen-Dependent Targeting Of Multiple Iron/Heme-Dependent Biological Processes, Seoung-Ryoung Choi, Mohammed A. Hassan, Bradley E. Britigan, Prabagaran Narayanasamy

Journal Articles: Pathology and Microbiology

Metals play vital roles in biological systems, with iron/heme being essential for cellular and metabolic functions necessary for survival and/or virulence in many bacterial pathogens. Given the rise of bacterial resistance to current antibiotics, there is an urgent need for the development of non-toxic and novel antibiotics that do not contribute to resistance to other antibiotics. Gallium, which mimics iron, has emerged as a promising antimicrobial agent, offering a novel approach to combat bacterial infections. Gallium does not have any known functions in biological systems. Gallium exerts its effects primarily by replacing iron in redox enzymes, effectively inhibiting bacterial growth …

Aconitate Decarboxylase 1 Mediates The Acute Airway Inflammatory Response To Environmental Exposures, Aaron Schwab, Amy J. Nelson, Angela Gleason, Oliver Schanze, Todd A. Wyatt, Dhananjay Shinde, Peng Xiao, Vinai Chittezham Thomas, Chittibabu Guda, Kristina L. Bailey, Tammy Kielian, Geoffrey M. Thiele, Jill A. Poole

Journal Articles: Pathology and Microbiology

Background: Environmental lipopolysaccharide (LPS) and microbial component-enriched organic dusts cause significant lung disease. These environmental exposures induce the recruitment and activation of distinct lung monocyte/macrophage subpopulations involved in disease pathogenesis. Aconitate decarboxylase 1 (Acod1) was one of the most upregulated genes following LPS (vs. saline)exposure of murine whole lungs with transcriptomic profiling of sorted lung monocyte/macrophage subpopulations also highlighting its significance. Given monocyte/macrophage activation can be tightly linked to metabolism, the objective of these studies was to determine the role of the immunometabolic regulator ACOD1 inenvironmentalexposure-induced lung inflammation.

Methods: Wild-type (WT) mice were intratracheally (i.t.) instilled with 10 …

Perception Of Students As Partners In Learning Among Students And Faculty Members Of Sonam Karachi, Pakistan, Anum Shiraz Gujrati

MBE 2024

Background: Students as Partners (SaP) has emerged as a student-centred approach where students are taken as active partners in determining learning outcomes and pedagogies rather than being merely passive learners and consumers in Higher Education (HE). It shifts the focus from the teacher-centred to the student learning environment and from a product to process-orientated outcomes. There is still a need to explore the perception of students as partners in HE among undergraduate and graduate nursing students and faculty members.
Purpose: The purpose of the study is to explore the perception of students and faculty members regarding students as partners in …

The Impact Of Local Physiology On The Corrosion Of Orthopedic Alloys, Madison Nicole Brown

Theses and Dissertations (ETD)

Introduction. Total knee arthroplasty (TKA) is used in the treatment of end-stage osteoarthritis of the knee. It is one of the most common elective surgeries performed with predictions expecting significant increases in the number of procedures performed over the next decade. However, the patient satisfaction rate after TKA is as low as 80%. Cobalt-chromium-molybdenum (CoCrMo) is regularly used for TKA protheses due to the alloy’s mechanical strength, biocompatibility, and corrosion resistance. The corrosion resistance of this alloy relies on a passive oxide layer. This oxide layer can be impacted by phagocytic cells which can leave pits and craters on implant …

A Rare Case Of A Giant Cell Tumor Of The Peroneal Tendon Sheath, Francois M. Lokenye Dpm, Breana Marine Dpm, Orlexia Thomas Dpm, Mariam Kamil Bs

Posters

This case report discusses a 31-year-old male with TGCT in the peroneal tendon sheath, detailing clinical and radiological features.

his study explores the surgical interventions, diagnostic challenges, treatment options, and outcomes of TGCT, emphasizing its consideration in the differential diagnoses of painful foot and ankle masses.

Breaking The Bamboo Ceiling And De-Bunking The Model Minority Myth, Yun Saksena

Journal Articles: College of Dentistry

Leadership roles must incorporate representation from all involved individuals for the resulting decision-making process to reflect the interests and expertise of a diverse organization. Many resources have rightly focused on developing historically underrepresented racial and ethnic (HURE) leaders. Though numbers of Black and Hispanic dental school deans have increased, more work is needed for these and other HURE groups such as American Indians. Asians are not classified as HURE. As an aggregated group they have robust presence in the dental workforce in North America, the United Kingdom and Australia. The assumption is they are fine, so the group is ignored. …

Reducing Blood Culture Contamination In The Emergency Department: A Multi-Method Quality Improvement Projec, Daryn Brauner, Marlene Schmidt, Nikki Campbell, Keri Bill, April Alfano

Abstracts

Blood cultures are a diagnostic tool used to determine the presence of bacteremia. Blood culture contamination (BCC) can lead to inappropriate use of antibiotics, increased length of stay, and increased healthcare costs. Many hospitals should have benchmarked BCC rates of <3%. However, BCC rates or false positives are known to be highest in emergency departments and there has been limited research on integrating multi-method approaches to reduce BCC rates. Purpose: The aim of this quality improvement project was to reduce the monthly percentage of BCC in an academic emergency department through implementation of a robust multi-method intervention targeting nurses and patient care technicians who perform phlebotomy for blood cultures.

The intervention was implemented in four approaches beginning in June 2022: Focused Education, Dashboard Utilization, Campaign Initiatives, and Improvement to RN Workflow. Focused education consisted of numerous electronic and in-person trainings. Dashboard utilization involved consistently updating staff of real time metrics of BCC. Campaign Initiatives involved increased hand hygiene prior to BCC draws. Finally, workflow for RNs were improved by …

Speech Language Pathology Graduate Handbook - 2023-2024, Department Of Audiology And Speech-Language Pathology, East Tennessee State University

Speech-Language Pathology Handbooks

No abstract provided.

Incidence Of Pathologic Nodal Disease In Clinically Node Negative, Microinvasive/T1a Breast Cancers, Pranammya Dey

Yale Medicine Thesis Digital Library

Axillary staging in early-staged breast cancer can impact adjuvant treatment options but is also associated with increased morbidity. The incidence of pathologic nodal positivity in patients with microinvasive or T1a disease by histologic subtype is not well characterized and thus, the value of sentinel node biopsy remains controversial in these patients. We sought to analyze patient demographics and tumor characteristics associated with pathologic nodal disease in patients with clinically node negative (cN0), microinvasive and T1a breast cancers.Women >18 years old with clinically node negative (cN0) and pathologic microinvasive or T1a breast cancer who underwent upfront surgery were identified from the …

Barriers To Methadone For Hiv Prevention Among People Who Inject Drugs In Kazakhstan, Amanda Rachel Liberman

Yale Medicine Thesis Digital Library

Background: In Eastern Europe and Central Asia, HIV incidence and mortality continue to increase, and this epidemic is concentrated among people who inject drugs (PWID). In Kazakhstan, the prevalence of HIV among PWID is higher than for any other key population. Opioid agonist therapies like methadone are the only evidence-based treatment for opioid use disorder and thus are crucial tools for HIV prevention. Though methadone has been provided for free in Kazakhstan since 2008, less than 1% of PWID currently access this service. An intervention to increase methadone scale-up is necessary, and the Exploration, Preparation, Implementation, and Sustainment (EPIS) Framework …

Ballistic And Explosive Orthopaedic Trauma Epidemiology And Outcomes In A Global Population, Jamieson M. O'Marr

Yale Medicine Thesis Digital Library

Introduction:This thesis critically examines the epidemiological trends and clinical outcomes associated with ballistic and explosive orthopedic trauma, focusing exclusively on data coming from low- and middle-income countries (LMICs). Given the rising prevalence of civilian casualties in contemporary conflict zones and incidents of urban gun violence, there is an amplified need to bolster our understanding of these injuries. This is particularly important in LMIC civilian settings where a majority of this trauma is occurring but where the current literature is extremely lacking. This research aims to contribute significantly to the global medical community's capacity to provide informed, LMIC relevant evidence-based care …

Fusion, 2024, George Washington University, William H. Beaumont Medical Research Honor Society

Fusion

No abstract provided.

Exploration Of Associations Between Asthma And Depression In Older American Adults: A Pooled Cross-Sectional Analysis Of Medicare Recipients, Brian Ring

Graduate Research Theses & Dissertations

Background

While unclear in older populations within the US, individuals with asthma are disproportionally affected by depression relative to those without asthma. This work explores the associations between asthma, depression, sociodemographic, and disease-related factors in a US population ≥ 65 years of age.

Methods

A pooled cross-sectional analysis of Medicare Current Beneficiary Survey (MCBS) data was utilized to determine the association between asthma and depression from 2018 to 2020. Depression was defined as a score of ≥ 10 from the Patient Health Questionnaire-9 (PHQ-9). Disease-related variables were recorded if the subject met Medicare claims criteria for the calendar year. Multivariable …

Research Makes A Difference: Changing Post Surgical Vital Signs, Elizabeth Plante, Sadie Seezs, Jennifer Burris, Tiffany Omann-Bidinger

Nursing Posters

Research Question:

Are reduced frequency of vital signs as effective in identifying patient deterioration in postoperative adult orthopedic and spine patients after a post anesthesia care unit stay with transfer to orthopedic and neuroscience spine units when compared to current practice?

Conclusions/Implications:

• Changing the frequency of post operative vital signs provides the same quality, not directly affecting an increased risk of death.
• Reduction in number of times vital signs needed completion, saving time for nurses to complete other duties.
• System wide change to routine post operative vital signs for floor level patients was implemented.
• Recommend future research for obstetric and …

Eye Code Protocol, Christina Anderson Md, Maiya Dietz, Kelsey Bade, Mallory Mondloch

Nursing Posters

Purpose of EYE CODE:

• Retinal artery occlusion (RAO) is a rare but detrimental adverse effect of cosmetic facial filler injections.
• Requires prompt treatment and reversal to avoid patient blindness.
• EYE CODE is a new protocol in place to avoid this complication.
• Assist staff during a high stress event. •Improve patient safety & staff confidence. Way to receive continuing education credits through the clinic.

Discussing Systemic Racism And Racial Privilege At A Large, Academic Health Center Using A Modified Privilege Walk, Elizabeth A. Brown, Rosemarie Jones

Community & Environmental Health Faculty Publications

Background: There is a motivation for organizations to understand race and racism from the perspective of minoritized individuals. Academic health centers (AHC) are ideal organizations to have these conversations as they educate healthcare providers, support research in health disparities, and care for diverse patients.

Methods: We piloted and evaluated a virtual Modified Privilege Walk (MPW) with faculty, staff, and students at an AHC in July 2020 to promote difficult conversations about race/racism, social class, and privilege. Each MPW session was voluntary, held virtually over Zoom, and lasted one hour and thirty minutes. Before attending, participants answered questions based on their …

Patient Perceptions Of Audio-Only Versus Video Telehealth Visits: A Qualitative Study Among Patients In An Academic Medical Center Setting, Ryan Kruis, Elizabeth A. Brown, Jada Johnson, Kit N. Simpson, James Mcelligott, Jillian Harvey

Community & Environmental Health Faculty Publications

Introduction: Telehealth utilization surged during the COVID-19 pandemic, offering expanded health care access. Audio-only visits emerged as a crucial tool for patients facing technology or connectivity barriers to still use telehealth. This qualitative study aims to better understand patient perceptions of audio-only versus video telehealth visits during the COVID-19 pandemic, and how patients perceive the role of each in their overall health care. Methods: Semi-structured interviews were conducted with 14 adult patients seeking care at an academic medical center located in the Southeast region of the United States. Patients had experienced both an audio-only and video telehealth visit within the …

A Comparison Of Machine Learning Surrogate Models Of Street-Scale Flooding In Norfolk, Virginia, Diana Mcspadden, Steven Goldenberg, Binata Roy, Malachi Schram, Jonathan L. Goodall, Heather Richter

Community & Environmental Health Faculty Publications

Low-lying coastal cities, exemplified by Norfolk, Virginia, face the challenge of street flooding caused by rainfall and tides, which strain transportation and sewer systems and can lead to personal and property damage. While high-fidelity, physics-based simulations provide accurate predictions of urban pluvial flooding, their computational complexity renders them unsuitable for real-time applications. Using data from Norfolk rainfall events between 2016 and 2018, this study compares the performance of a previous surrogate model based on a random forest algorithm with two deep learning models: Long Short-Term Memory (LSTM) and Gated Recurrent Unit (GRU). The comparison of deep learning to the random …

Polycystic Ovary Syndrome And The Effects Of A Ketogenic Diet: A Scoping Review, Dayelise Fleigle

Doctor of Medical Science (DMSc)

Polycystic ovary syndrome (PCOS) is the most common endocrinopathy in females of reproductive age.¹ It is estimated that 7% of women worldwide are impacted.¹ Diagnosis of PCOS is based on the widely adopted Rotterdam Criteria, though there are other proposed criteria.² Using the Rotterdam Criteria, two out of three of the following must be present to establish a diagnosis of PCOS: clinical or biochemical signs of hyperandrogenism, oligo-anovulation, and/or polycystic ovaries seen on ultrasound.² Patients with PCOS may also present with one or more of the following: overweight/obese body mass index (BMI), infertility, insulin resistance, dyslipidemia, …