Medicine and Health Sciences Commons^™

Cms Emergency Preparedness Rule: Examining The Relationship Between Nursing Home Facility Characteristics And Regulatory Deficiencies, Tihara Richardson Sommers

School of Public Service Theses & Dissertations

The effects of Hurricane Katrina and other natural disasters have increased the focus on nursing homes, particularly nursing home emergency preparedness. Nursing home administrators and direct care employees have described the challenges faced when responding to an emergency event. Due to numerous emergency preparedness insufficiencies, requirements were implemented to protect the vulnerable population of older adults who reside in nursing homes. In 2016, the Centers for Medicare & Medicaid (CMS) added specific emergency preparedness requirements to the existing fire safety requirements for regulated nursing homes. These deficiency evaluations are the only routinely collected source of information detailing compliance with the …

Opensim-Based Musculoskeletal Modeling: Foundation For Interactive Obstetric Simulator, Bahador Dodge

Electrical & Computer Engineering Theses & Dissertations

The use of mathematical and computational models to understand complex biological systems, such as the human birth process, is a rapidly growing field in medicine. These models can be used to optimize and personalize medical treatments for individual patients, enhance training, and aid in educational efforts. While recent advancements in healthcare, particularly in obstetrics, have improved care for mothers and babies, studies and government reports indicate a rising rate of maternal mortality in the United States.

Despite this rising trend, there is a lack of detailed studies concerning the use of modeling and simulation to develop an interactive obstetrics simulator …

10-Minute Ebd: Do Posterior Composite Restorations Have Longer-Term Success Than Glass Ionomer?, Eleni E. Langas Dds, Mridula Manoj Dds, Kelsey Carreras-Simons Dds

The Journal of the Michigan Dental Association

This Ten Minute Evidence Based Dentistry Article provides an example of the implementation of the evidence based dentistry search process with trusted search engines, and identification of the best literature through critical appraisal to answer the clinical question on long-term success of posterior resin vs. posterior glass ionomer restorations.

Oral Manifestations Of Acute Lymphocytic Leukemia, Angela Yepes Dds, Ms, Mba, Juan Yepes Dds, Md, Mph, Ms, Drph, James E. Jones Dmd, Msd, Edd, Phd

The Journal of the Michigan Dental Association

Leukemia is the most prevalent malignancy of leukocytes and can occur in children and adults. Oral manifestations are part of the complexity of signs and symptoms in patients with leukemia and, in some patients, oral manifestations precede systemic manifestations. Oral signs of leukemia include spontaneous bleeding, gingival enlargement, and whiteness of the oral mucosa. Head and neck lymphadenopathy is common in patients with leukemia. Oral manifestations are the result of the direct invasion of immature cells in the oral cavity tissues or indirectly caused by the replacement of the normal blood cells for immature cells causing anemia, leucopenia, and thrombocytopenia. …

The Human Role In Artificial Intelligence, Christopher J. Smiley Dds

The Journal of the Michigan Dental Association

The success of AI requires human involvement to ensure that it is used safely and effectively. Transparency, collaboration, and standardization are necessary.

J Mich Dent Assoc May 2023

The Journal of the Michigan Dental Association

In this issue, the reader will find the following original content:

• A case study on recognizing the oral signs of Acute Lymphatic Leukemia
• A special pull-out section to assist clinicians in identifying and treating common oral lesions
• Advice on personal Wellness: "Finding Calm Amidst Chaos."
• State of Michigan C.E. Requirements for License Renewal of Dentists, Hygienists, and Registered Dental Assistants.
• A 10Minute EBD contrasting clinical success of composite restorations vs. glass ionomers.
• Guest commentary "Pretty Good Dentistry."
• News you need, Editorial, and an Advocacy Spotlight.

Use, Durability, And Risks For Discontinuation Of Initial And Subsequent Biologics In A Large Pediatric-Onset Ibd Cohort., Jess L. Kaplan, Chunyan Liu, Eileen C. King, Julie A. Bass, Ashish S. Patel, Jeanne Tung, Shiran Chen, Trevor Lissoos, Ninfa Candela, Shehzad Saeed, Richard B. Colletti, Improvecarenow Network

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Biologic medications are recommended for treatment of moderately-to-severely active Crohn disease (CD) or ulcerative colitis (UC) in children. However, many patients require sequential biologic treatment because of nonresponse or loss of response to the initial biologic.

METHODS: We analyzed pediatric inflammatory bowel disease (IBD) data from the ImproveCareNow Network registry between May 2006 and September 2016, including time to biologic initiation, choice of first subsequent biologics, biologic durability, and reasons for discontinuation.

RESULTS: Of 17,649 patients with IBD [CD: 12,410 (70%); UC: 5239 (30%)], 7585 (43%) were treated with a biologic agent before age 18 (CD: 50%; UC: 25%). …

Real-World Experience Of Pediatric Patients Treated With Peanut (Arachis Hypogaea) Allergen Powder-Dnfp., Jay M. Portnoy, Jodi Shroba, Stephen Tilles, Hela Romdhani, Sarah M. Donelson, Dominick Latremouille-Viau, Rebecca Bungay, Kathleen Chen, William Mccann

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Peanut (Arachis hypogaea) allergen powder-dnfp (PTAH) is the first oral immunotherapy indicated for children aged 4 to 17 years with peanut allergy. There are limited real-world data on patients treated with PTAH.

OBJECTIVE: To characterize pediatric patients treated with PTAH and associated treatment patterns in US clinical practice.

METHODS: US-based physicians with allergy and immunology training treating patients with peanut allergy aged 4 to 17 years with PTAH were recruited from an existing physician panel and completed an online case report form (October to December 2021) with data abstracted from patient medical charts. Physician practice circumstances, patient characteristics, and …

Salivary Microrna As A Concussion Biomarker And The Implications For Athletic Trainers' Practices, Thomas Richard Campbell

Rehabilitation Sciences Theses & Dissertations

Many concussions are sustained globally each year; however, research suggests that a large number may go undiagnosed due to a reliance on subjective information from patients and limitations of current objective measures. Recently, efforts have been focused on identifying clinical biomarkers of concussions, including salivary microRNA (miRNA), to improve healthcare professionals’ concussion management practices. Even if salivary miRNA were shown to be a valid and reliable measure for managing concussions, healthcare professionals, such as athletic trainers (ATs), must be familiar with the tool and have positive attitudes toward the implementation into clinical practice. Therefore, the purpose of this dissertation was …

Therapeutic Approaches To Working With Perinatal Loss Clients: A Grounded Theory Study, Heather H. Olivier

LSU New Orleans Theses and Dissertations

Perinatal loss (i.e., miscarriage, stillbirth, termination, and infant death) is commonly referred to in the literature as an invisible loss, non-loss, and even medical event. It is an ambiguous loss exhibiting the dialectical contradiction between the physical absence and psychological presence of the baby accompanied by disenfranchised grief, a reaction to a loss that is unacknowledged by society. Despite the likelihood of mental health clinicians working with clients who have experienced perinatal loss, there has yet to be a therapeutic model designed specifically for the unique grief and trauma reactions presented in this population. Existing grief models do not address …

Food Insecurity, Snap Participation And Glycemic Control In Low-Income Adults With Predominantly Type 2 Diabetes: A Cross-Sectional Analysis Using Nhanes 2007-2018 Data, Oluwatobi Alawode, Sarah Humble, Cynthia J Herrick

2020-Current year OA Pubs

INTRODUCTION: Diabetes, characterized by elevated blood glucose levels, affects 13% of US adults, 95% of whom have type 2 diabetes (T2D). Social determinants of health (SDoH), such as food insecurity, are integral to glycemic control. The Supplemental Nutrition Assistance Program (SNAP) aims to reduce food insecurity, but it is not clear how this affects glycemic control in T2D. This study investigated the associations between food insecurity and other SDoH and glycemic control and the role of SNAP participation in a national socioeconomically disadvantaged sample.

RESEARCH DESIGN AND METHODS: Adults with likely T2D and income

RESULTS: The study population included 2084 …

Blockade Of Trpv Channels By Intracellular Spermine, Grigory Maksaev, Peng Yuan, Colin G Nichols

2020-Current year OA Pubs

The Vanilloid thermoTRP (TRPV1-4) subfamily of TRP channels are involved in thermoregulation, osmoregulation, itch and pain perception, (neuro)inflammation and immune response, and tight control of channel activity is required for perception of noxious stimuli and pain. Here we report voltage-dependent modulation of each of human TRPV1, 3, and 4 by the endogenous intracellular polyamine spermine. As in inward rectifier K channels, currents are blocked in a strongly voltage-dependent manner, but, as in cyclic nucleotide-gated channels, the blockade is substantially reduced at more positive voltages, with maximal blockade in the vicinity of zero voltage. A kinetic model of inhibition suggests two …

Bk Channels Of Five Different Subunit Combinations Underlie The De Novo Kcnma1 G375r Channelopathy, Yanyan Geng, Ping Li, Alice Butler, Bill Wang, Lawrence Salkoff, Karl L Magleby

2020-Current year OA Pubs

The molecular basis of a severe developmental and neurological disorder associated with a de novo G375R variant of the tetrameric BK channel is unknown. Here, we address this question by recording from single BK channels expressed to mimic a G375R mutation heterozygous with a WT allele. Five different types of functional BK channels were expressed: 3% were consistent with WT, 12% with homotetrameric mutant, and 85% with three different types of hybrid (heterotetrameric) channels assembled from both mutant and WT subunits. All channel types except WT showed a marked gain-of-function in voltage activation and a smaller decrease-of-function in single-channel conductance, …

Mitos And King's Staging As Clinical Outcome Measures In Als: A Retrospective Analysis Of The Fortitude-Als Trial, Paulos Gebrehiwet, Lisa Meng, Stacy A Rudnicki, Phil Sarocco, Jenny Wei, Andrew A Wolff, Adriano Chiò, Jinsy A Andrews, Angela Genge, Carlayne E Jackson, Noah Lechtzin, Timothy M Miller, Jeremy M Shefner

2020-Current year OA Pubs

OBJECTIVE: To evaluate the Milano-Torino staging (MiToS) and King's staging systems as potential outcome measures for clinical trials in amyotrophic lateral sclerosis (ALS) by assessing these outcomes in FORTITUDE-ALS.

METHODS: This was a

RESULTS: The full analysis set consisted of 456 patients randomized 3:1 (

CONCLUSION: This exploratory analysis showed the feasibility of MiToS and King's staging as potential outcome measures in ALS. Additional studies of these staging systems are needed to further explore their utility in ALS clinical trials.

Association Of Sex With Neurobehavioral Markers Of Executive Function In 2-Year-Olds At High And Low Likelihood Of Autism, Tanya St John, Natasha Marrus, Kelly N Botteron, Et Al.

2020-Current year OA Pubs

IMPORTANCE: Children with autism and their siblings exhibit executive function (EF) deficits early in development, but associations between EF and biological sex or early brain alterations in this population are largely unexplored.

OBJECTIVE: To investigate the interaction of sex, autism likelihood group, and structural magnetic resonance imaging alterations on EF in 2-year-old children at high familial likelihood (HL) and low familial likelihood (LL) of autism, based on having an older sibling with autism or no family history of autism in first-degree relatives.

DESIGN, SETTING, AND PARTICIPANTS: This prospective cohort study assessed 165 toddlers at HL (n = 110) and LL …

Transition To Surgery After Pessary Among Female Medicare Beneficiaries With Pelvic Organ Prolapse, Melanie R L Meister, Oyomoare L Osazuwa-Peters, Jerry L Lowder, Victoria L Handa

2020-Current year OA Pubs

BACKGROUND: The American College of Obstetricians and Gynecologists recommends offering a vaginal pessary to women seeking treatment of pelvic organ prolapse. However, single-institution series have suggested that a sizable proportion of women fitted with a pessary will transition to surgery within the first year.

OBJECTIVE: This study aimed to estimate the proportion of female US Medicare beneficiaries with pelvic organ prolapse who undergo surgery after pessary fitting, to describe the median time to surgery from pessary fitting, and to identify factors associated with the transition from pessary to surgery.

STUDY DESIGN: The Medicare 5% Limited Data Set was queried from …

Contraceptive Decision-Making Through The Lens Of Social Determinants Of Health Among Female Sex Workers: A Qualitative Descriptive Study, Jessica L. Zemlak, Kamila A. Alexander, Deborah Wilson, Susan G. Sherman

College of Nursing Faculty Research and Publications

Aims

The aim of the study was to examine how female sex worker's motivations, desires, intentions and behaviours towards childbearing and childbearing avoidance inform their contraceptive decision-making. We explored the influence of social determinants of health in the domains of social context (sexual partners and experiences of violence), healthcare access, economic instability on the contraceptive decision-making process.

Design

We conducted a qualitative descriptive study informed by Miller's Theory of Childbearing Motivations, Desires and Intentions through the lens of social determinants of health.

Methods

Participants were recruited from a parent study, EMERALD, in July–September, 2020. Data were collected from 22 female …

Effectiveness Of A Postpartum Breastfeeding Protocol For Avoiding Pregnancy, Mary Schneider, Richard J. Fehring, Thomas Bouchard

College of Nursing Faculty Research and Publications

The uses of cervical mucus and basal body temperature as indicators of return to fertility postpartum have resulted in high unintended pregnancy rates. In 2013, a study found that when women used urine hormone signs in a postpartum/breastfeeding protocol this resulted in fewer pregnancies. To improve the original protocol's effectiveness, three revisions were made: (1) women were to increase the number of days tested with the Clearblue Fertility Monitor, (2) an optional second luteinizing hormone test could be done in the evening, and (3) instructions were given to manage the beginning of the fertile window for the first six cycles …

Scoping Review Of Early Toxic Stress And Epigenetic Alterations In The Neonatal Intensive Care Unit, Kathryn J. Malin, Kaboni W. Gondwe, Alissa V. Fial, Rachel Moore, Yvette P. Conley, Rosemary White-Traut, Thao Griffith

College of Nursing Faculty Research and Publications

Background

Preterm infants are uniquely vulnerable to early toxic stress exposure while in the neonatal intensive care unit (NICU) and also being at risk for suboptimal neurodevelopmental outcomes. However, the complex biological mechanisms responsible for variations in preterm infants’ neurodevelopmental outcomes because of early toxic stress exposure in the NICU remain unknown. Innovative preterm behavioral epigenetics research offers a possible mechanism and describes how early toxic stress exposure may lead to epigenetic alterations, potentially affecting short- and long-term outcomes.

Objective

The aim of this study was to review the relationships between early toxic stress exposures in the NICU and epigenetic …

An In-Vitro Analysis Of The Accuracy Of Different Guided Surgery Systems – They Are Not All The Same, Arndt Guentsch, Jennifer Bjork, Reagan Saxe, Shengtong Han, Andrew R. Dentino

School of Dentistry Faculty Research and Publications

Objectives

Different static computer-assisted implant surgery (sCAIS) systems are available that are based on different design concepts. The objective was to assess seven different systems in a controlled environment.

Materials and Methods

Each n = 20 implants were placed in identical mandible replicas (total n = 140). The systems utilized either drill-handles (group S and B), drill-body guidance (group Z and C), had the key attached to the drill (group D and V), or combined different design concepts (group N). The achieved final implant position was digitized utilizing cone-beam tomography and compared with the planned position. The angular deviation was …

Clerkship Director Confidence In Medical Student Career Advising In Obstetrics And Gynecology, Shireen Madani Sims, Susan M Cox, Rashmi Bhargava, Elise N Everett, Angela Fleming, Scott Graziano, Helen K Morgan, Laura Baecher-Lind, Celeste Royce, Tammy S Sonn, Jill M Sutton, Christopher M Morosky

2020-Current year OA Pubs

BACKGROUND: Given the increasing complexities of the residency application processes, there is an ever-increasing need for faculty to serve in the role of fourth-year medical student career advisors.

OBJECTIVE: This study aimed to investigate obstetrics and gynecology clerkship directors' confidence and fulfillment with serving in the role of faculty career advisors.

STUDY DESIGN: A 25-item electronic survey was developed and distributed to the 225 US obstetrics and gynecology clerkship directors in university-based and community-based medical schools with active memberships in the Association of Professors of Gynecology and Obstetrics. Items queried respondents on demographics, confidence in fourth-year advising, satisfaction with this …

Ligand And G-Protein Selectivity In The Κ-Opioid Receptor, Jianming Han, Jingying Zhang, Antonina L Nazarova, Sarah M Bernhard, Brian E Krumm, Lei Zhao, Jordy Homing Lam, Vipin A Rangari, Susruta Majumdar, David E Nichols, Vsevolod Katritch, Peng Yuan, Jonathan F Fay, Tao Che

2020-Current year OA Pubs

The κ-opioid receptor (KOR) represents a highly desirable therapeutic target for treating not only pain but also addiction and affective disorders

Outcomes Following Extracorporeal Membrane Oxygenation For Severe Covid-19 In Pregnancy Or Post Partum, John J Byrne, Nandini Raghuraman, Et Al.

2020-Current year OA Pubs

IMPORTANCE: Existing reports of pregnant patients with COVID-19 disease who require extracorporeal membrane oxygenation (ECMO) are limited, with variable outcomes noted for the maternal-fetal dyad.

OBJECTIVE: To examine maternal and perinatal outcomes associated with ECMO used for COVID-19 with respiratory failure during pregnancy.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective multicenter cohort study examined pregnant and postpartum patients who required ECMO for COVID-19 respiratory failure at 25 hospitals across the US. Eligible patients included individuals who received care at one of the study sites, were diagnosed with SARS-CoV-2 infection during pregnancy or up to 6 weeks post partum by positive nucleic …

Examining Mental Health, Education, Employment, And Pain In Sickle Cell Disease, Kelly M Harris, Liliana Preiss, Taniya Varughese, Anna Bauer, Cecelia L Calhoun, Marsha Treadwell, Rita Masese, Jane S Hankins, Faiz Ahmed Hussain, Jeffrey Glassberg, Cathy L Melvin, Robert Gibson, Allison A King, Sickle Cell Disease Implementation Consortium

2020-Current year OA Pubs

IMPORTANCE: Pain related to sickle cell disease (SCD) is complex and associated with social determinants of health. Emotional and stress-related effects of SCD impact daily quality of life and the frequency and severity of pain.

OBJECTIVE: To explore the association of educational attainment, employment status, and mental health with pain episode frequency and severity among individuals with SCD.

DESIGN, SETTING, AND PARTICIPANTS: This is a cross-sectional analysis of patient registry data collected at baseline (2017-2018) from patients treated at 8 sites of the US Sickle Cell Disease Implementation Consortium. Data analysis was performed from September 2020 to March 2022.

MAIN …

Neighborhood Deprivation And Association With Neonatal Intensive Care Unit Mortality And Morbidity For Extremely Premature Infants, Brynne A Sullivan, Ayush Doshi, Pavel Chernyavskiy, Ameena Husain, Alexandra Binai, Rakesh Sahni, Karen D Fairchild, J Randall Moorman, Colm P Travers, Zachary A Vesoulis

2020-Current year OA Pubs

IMPORTANCE: Socioeconomic status affects pregnancy and neurodevelopment, but its association with hospital outcomes among premature infants is unknown. The Area Deprivation Index (ADI) is a validated measure of neighborhood disadvantage that uses US Census Bureau data on income, educational level, employment, and housing quality.

OBJECTIVE: To determine whether ADI is associated with neonatal intensive care unit (NICU) mortality and morbidity in extremely premature infants.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study was performed at 4 level IV NICUs in the US Northeast, Mid-Atlantic, Midwest, and South regions. Non-Hispanic White and Black infants with gestational age of less than 29 …

Patterns In Use And Transplant Outcomes Among Adult Recipients Of Kidneys From Deceased Donors With Covid-19, Mengmeng Ji, Amanda J Vinson, Su-Hsin Chang, Massini Merzkani, Krista L Lentine, Yasar Caliskan, Kristin Progar, Nicole Nesselhauf, Casey Dubrawka, Tarek Alhamad

2020-Current year OA Pubs

IMPORTANCE: While the COVID-19 pandemic enters a new phase and the proportion of individuals with a previous COVID-19 diagnosis increases, the national patterns in kidney use and medium-term kidney transplant (KT) outcomes among patients receiving kidneys from active or resolved COVID-19-positive donors remain unknown.

OBJECTIVE: To evaluate the patterns in kidney use and KT outcomes among adult recipients of kidneys from deceased donors with active or resolved COVID-19.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study was conducted using national US transplant registry data from 35 851 deceased donors (71 334 kidneys) and 45 912 adult patients who received KTs …

Propranolol Reduces Ifn-Γ Driven Pd-L1 Immunosuppression And Improves Anti-Tumour Immunity In Ovarian Cancer, M Falcinelli, G Al-Hity, S Baron, M Mampay, M C Allen, M Samuels, W Jones, C Cilibrasi, Renee L Flaherty, G Giamas, P H Thaker, M S Flint

2020-Current year OA Pubs

The immune system plays an important role in controlling epithelial ovarian cancer (EOC). EOC is considered to be a "cold tumour," a tumour that has not triggered a strong response by the immune system. However, tumour infiltrating lymphocytes (TILs) and the expression of programmed cell death ligand (PD-L1) are used as prognostic indicators in EOC. Immunotherapy such as PD-(L)1 inhibitors have shown limited benefit in EOC. Since the immune system is affected by behavioural stress and the beta-adrenergic signalling pathway, this study aimed to explore the impact of propranolol (PRO), a beta-blocker, on anti-tumour immunity in both in vitro and …

The Natural History Of Curve Behavior After Brace Removal In Adolescent Idiopathic Scoliosis: A Literature Review, Scott Luhmann, Daphna Zaaroor-Regev, Vidyadhar V Upasani, Harry Shufflebarger

2020-Current year OA Pubs

PURPOSE: Brace treatment is the most common nonoperative treatment to prevent curve progression in adolescent idiopathic scoliosis (AIS). The goal of this review and analysis is to characterize curve behavior after completion of brace treatment and to identify factors that may facilitate the estimation of long-term curve progression.

METHOD: A review of the English language literature was completed using the MEDLINE (PUBMED) database of publications after 1990 until September 2020. Studies were included if they detailed a minimum of 1 year post-brace removal follow-up of AIS patients. Data retrieved from the articles included Cobb angle measurements of the major curves …

Position Paper: Models Of Post-Transplant Care For Individuals With Cystic Fibrosis, Edward Mckone, Joshua Blatter, Ramsey Hachem, Et Al.

2020-Current year OA Pubs

There is no consensus on the best model of care for individuals with CF to manage the non-pulmonary complications that persist after lung transplant. The CF Foundation virtually convened a group of international experts in CF and lung-transplant care. The committee reviewed literature and shared the post-lung transplant model of care practiced by their programs. The committee then developed a survey that was distributed internationally to both the clinical and individual with CF/family audiences to determine the strengths, weaknesses, and preferences for various models of transplant care. Discussion generated two models to accomplish optimal CF care after transplant. The first …

Pecha Kucha: An Innovative Pedagogy To Cultivate Cultural Competency In 21St Century Nursing Students, Anne White, Kaitlyn Louis

Faculty Articles

Nurse educators are challenged to develop educational methodologies that meet the characteristics of today's learners. Millennial and Generation Z students often prefer to use technology and smartphones rather than traditional formats. An alternative teaching strategy for a written journal that may have a pedagogical advantage for this group of learners is the Pecha Kucha 20 × 20 method (Pecha Kucha). The Pecha Kucha's anecdotal structure paired with its use of technology support students' twenty-first-century literacies. This paper discusses using this learner-centered approach in a study abroad in Italy to foster reflection of their cultural encounters.