Open Access. Powered by Scholars. Published by Universities.®

Public Health

2021

Institution
Keyword
Publication
Publication Type
File Type

Articles 1 - 30 of 43

Full-Text Articles in Analytical, Diagnostic and Therapeutic Techniques and Equipment

Deep Convolutional Neural Networks For Accurate Diagnosis Of Covid-19 Patients Using Chest X-Ray Image Databases From Italy, Canada, And The Usa, Amgad A. Salama, Samy H. Darwish, Samir M. Abdel-Mageed, Radwa A. Meshref, Ehab I. Mohamed Dec 2021

Deep Convolutional Neural Networks For Accurate Diagnosis Of Covid-19 Patients Using Chest X-Ray Image Databases From Italy, Canada, And The Usa, Amgad A. Salama, Samy H. Darwish, Samir M. Abdel-Mageed, Radwa A. Meshref, Ehab I. Mohamed

The University of Louisville Journal of Respiratory Infections

Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), famously known as COVID-19, has quickly become a global pandemic. Chest X-ray (CXR) imaging has proven reliable, fast, and cost-effective for identifying COVID-19 infections, which proceeds to display atypical unilateral patchy infiltration in the lungs like typical pneumonia. We employed the deep convolutional neural network (DCNN) ResNet-34 to detect and classify CXR images from patients with COVID-19 and Viral Pneumonia and Normal Controls.

Methods: We created a single database containing 781 source CXR images from four different international sub-databases: the Società Italiana di Radiologia Medica e Interventistica (SIRM), the GitHub Database, the …


Self-Measured Blood Pressure Monitoring: A Patient Empowerment Project, Alison Cusmano Dec 2021

Self-Measured Blood Pressure Monitoring: A Patient Empowerment Project, Alison Cusmano

Doctor of Nursing Practice Final Manuscripts

Hypertension is a public health issue estimated to affect 112 million adults by 2030. Primary care patients in an outpatient clinic in Southern California with elevated blood pressure readings in the office did not have an organized system for close follow-up. The purpose of this evidence-based project (EBP) was to educate patients on self-measured blood pressure monitoring (SMBP), Dietary Approaches to Stop Hypertension (DASH), diet interventions, and healthy weight loss to improve hypertension rates. Through these interventions, patients developed an understanding of their systolic and diastolic blood pressure goals. Nurse practitioners, medical assistants, and licensed vocational nurses screened for high …


Ecology Of Hantaviruses In Rodent Reservoirs And Their Early Innate Immune Responses In Human Model Systems, Evan Peter Williams Dec 2021

Ecology Of Hantaviruses In Rodent Reservoirs And Their Early Innate Immune Responses In Human Model Systems, Evan Peter Williams

Theses and Dissertations (ETD)

The spillover of zoonotic RNA viruses is responsible for a great deal of the disease outbreaks in human populations. These spillover events are set to continue due to anthropogenic and environmental changes that impact the distribution of these viruses. The viruses in the family Hantaviridae are classified as one of these emerging zoonotic RNA viruses. The spillover of the viruses in this family are responsible for two severe human diseases, hemorrhagic fever with renal syndrome (HFRS) and hantavirus pulmonary syndrome (HPS). These viruses are distributed across the globe and are responsible for a large number of human disease cases with …


Treatment Considerations For Obstructive Sleep Apnea In Pediatric Down Syndrome, Erica Gastelum, Marcus Cummins, Amitoj Singh, Manuel Montoya, Gino Luis Urbano, Mary Anne Tablizo Nov 2021

Treatment Considerations For Obstructive Sleep Apnea In Pediatric Down Syndrome, Erica Gastelum, Marcus Cummins, Amitoj Singh, Manuel Montoya, Gino Luis Urbano, Mary Anne Tablizo

Goal 3: Good Health and Well-Being

Children with Down syndrome (DS) are at high risk for developing obstructive sleep apnea (OSA) compared to children without DS. The negative impact of OSA on health, behavior, and cognitive development in children with DS highlights the importance of timely and effective treatment. Due to the higher prevalence of craniofacial and airway abnormalities, obesity, and hypotonia in patients with DS, residual OSA can still occur after exhausting first-line options. While treatment commonly includes adenotonsillectomy (AT) and continuous positive airway pressure (CPAP) therapy, additional therapy such as medical management and/or adjuvant surgical procedures need to be considered in refractory OSA. Given …


Geriatric Emergency Medicine Fellowship Journal Club: Frailty, Sarah Keene, Rebecca Fisher, Lauren Cameron-Comasco Nov 2021

Geriatric Emergency Medicine Fellowship Journal Club: Frailty, Sarah Keene, Rebecca Fisher, Lauren Cameron-Comasco

Journal of Geriatric Emergency Medicine

No abstract provided.


Trends In The Incidence Of Early-Onset Colorectal Adenocarcinoma Among Black And White Us Residents Aged 40 To 49 Years, 2000-2017., Eric M Montminy, Meijiao Zhou, Lauren Maniscalco, Harrison Penrose, Timothy Yen, Swati G Patel, Xiao-Cheng Wu, Jordan J Karlitz Nov 2021

Trends In The Incidence Of Early-Onset Colorectal Adenocarcinoma Among Black And White Us Residents Aged 40 To 49 Years, 2000-2017., Eric M Montminy, Meijiao Zhou, Lauren Maniscalco, Harrison Penrose, Timothy Yen, Swati G Patel, Xiao-Cheng Wu, Jordan J Karlitz

School of Public Health Faculty Publications

Key Points: Question: What are the trends in early-onset colorectal cancer incidence rates when people aged 40 to 49 years are assessed specifically and stratification by race, sex, and adenocarcinoma histology (the target of screening and prevention) is performed? Findings: In this cross-sectional study of 45 429 individuals aged 40 to 49 years with colorectal adenocarcinoma from 2000 to 2017, beginning in 2014, overall colorectal adenocarcinoma incidence rates were the same in Black and White populations, and rectal adenocarcinoma rates were 39.3% lower in Black individuals compared with White individuals with a widening disparity in rectal cancer between Black women …


Responding To The Pandemic: A Multicountry Study On Social-Political Factors And Health Outcomes Of Covid-19, Lan Yao Nov 2021

Responding To The Pandemic: A Multicountry Study On Social-Political Factors And Health Outcomes Of Covid-19, Lan Yao

Theses and Dissertations (ETD)

Introduction. Coronavirus Disease 2019 (COVID-19) poses a major global threat to human beings, which has caused devastating consequences of population health, political, and economic crises in many countries. This dissertation was composed of three research activities to study the following aims: (1) review the existing literature focusing on political factors and health outcomes of COVID-19; (2) assess the relationship between democracy and case fatality rate of COVID-19 by controlling for the effect of age, comorbidity, health expenditure, healthcare workforce, and population density; and (3) identify the trajectory pattern cases peak days, deaths peak days, and peak periods.

Methods. We accessed …


Refining A Postpandemic Approach To Cancer Screening, Michael A. Thompson Oct 2021

Refining A Postpandemic Approach To Cancer Screening, Michael A. Thompson

Journal of Patient-Centered Research and Reviews

In introducing Volume 8, Issue 4 of Journal of Patient-Centered Research and Reviews — a specially themed issue comprised of several works focused on improving cancer screening processes in clinical practice — JPCRR editor and hematologist/oncologist Michael Thompson reflects on the current state of various screening modalities and how the pandemic has already begun to shape ongoing research in this area. A delicate balance must be struck between avoiding overtesting or overdiagnosis and identifying the presence of malignant tumors early enough to allow for successful treatment.


Conference Proceedings: Select Abstracts Presented At 2021 Advocate Aurora Health Scientific Day Oct 2021

Conference Proceedings: Select Abstracts Presented At 2021 Advocate Aurora Health Scientific Day

Journal of Patient-Centered Research and Reviews

Abstracts published within this supplement were presented at the 47th annual Advocate Aurora Health Scientific Day, held virtually on May 26, 2021. This research symposium provides a forum for disseminating results from studies conducted by faculty, fellows, residents, and other allied health professionals associated with Midwest-based health system Advocate Aurora Health, which publishes the Journal of Patient-Centered Research and Reviews.


J Mich Dent Assoc October 2021 Oct 2021

J Mich Dent Assoc October 2021

The Journal of the Michigan Dental Association

Every month, The Journal of the Michigan Dental Association brings news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists!

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

  • A cover story, “Welcoming Colleagues from Different Practice Models”.
  • A feature article from the Journal’s DEI series, “Diversity, Equity, and Inclusion: Perspectives from an LGBTQ Dentist”.
  • A feature article, “Congratulations, 2021 MDA Life Members!”.
  • News you need, Editorial and regular department articles on MDA Foundation activities, Dentistry and the Law, Staff Matters, and component news. …


A Retrospective Review Of Lvhn Compliance With Diagnostic Workup For Pancreatic Cancer Per Nccn Guidelines, Caitlin Scialla, Dennis Sopka Md, Savitri Skandan Md, Melissa Kratz Rn, Msn, Aocn Aug 2021

A Retrospective Review Of Lvhn Compliance With Diagnostic Workup For Pancreatic Cancer Per Nccn Guidelines, Caitlin Scialla, Dennis Sopka Md, Savitri Skandan Md, Melissa Kratz Rn, Msn, Aocn

Research Scholars

No abstract provided.


Triple Negative Breast Cancer In An Appalachian Region: Exponential Tumor Grade Increase With Age Of Diagnosis, Gina Sizemore, Toni Marie Rudisill Jul 2021

Triple Negative Breast Cancer In An Appalachian Region: Exponential Tumor Grade Increase With Age Of Diagnosis, Gina Sizemore, Toni Marie Rudisill

Journal of Appalachian Health

Introduction: Triple negative breast cancer is an aggressive breast cancer with decreased five-year survival, increased risk for recurrence, and higher risk for metastases. Unlike other breast cancers, it has no targeted treatment and has heterogeneous genetics which make classification and treatment difficult.

Purpose: The purpose of our research was to compare triple negative breast cancer to non-triple negative breast cancer to identify key epidemiologic factors that might lead to improved basic science directives for biomarkers, treatments, and classification.

Methods: The state cancer registry was used to provide the first West Virginia state-wide population evaluation of triple negative breast cancer.

Results: …


Prevalencia Mensual De Trastorno De Ansiedad Generalizada Durante La Pandemia Por Covid-19 En México, Pablo Gaitán-Rossi, Víctor Pérez-Hernández, Mireya Vilar-Compte, Graciela Teruel-Belismelis Jul 2021

Prevalencia Mensual De Trastorno De Ansiedad Generalizada Durante La Pandemia Por Covid-19 En México, Pablo Gaitán-Rossi, Víctor Pérez-Hernández, Mireya Vilar-Compte, Graciela Teruel-Belismelis

Department of Public Health Scholarship and Creative Works

Objective. Estimate the prevalence of generalized anxiety disorder (GAD) from April to June 2020. Materials and methods. Repeated cross-sections design based in the Encovid-19, a series of monthly mobile surveys with represen- tative samples of Mexico (N= 833-1 674).The questionnaire includes the GAD-2 scale, and, in July, the GAD-7 scale was added; we examined its internal validity with confirmatory factor analysis and its concurrent validity with sociodemo- graphic variables. Using GAD-7 as criterion, we analyzed the predictive validity of the GAD-2.We estimated the monthly prevalence with the GAD-2. Results. The GAD-7 and the GAD-2 are reliable and valid.The GAD-2 has …


Impacts Of Covid-19 On Rural Medical Business Models, Kendra L. Stefan Jun 2021

Impacts Of Covid-19 On Rural Medical Business Models, Kendra L. Stefan

Anthós

This paper is concerned with the question of how COVID-19 impacts the medical delivery system in a rural community. It presents findings from interviews of medical professionals participating in an isolated rural community and public health officials that coordinate preparedness planning. This paper reviews barriers of access to healthcare in an already constricted system. Then looks at the implications of COVID-19 as an additional strain. Interviews of professionals will survey preparedness, regulatory impacts, repercussions to the business model, impact on service capacity, and opportunities for improvement. Interested parties would include patient advocates, patients, healthcare workers, politicians, and employers.


Feasibility And Acceptability Of Using Mobile Health Apps In Underserved Patients With Diabetes, Jieyu Luo Jun 2021

Feasibility And Acceptability Of Using Mobile Health Apps In Underserved Patients With Diabetes, Jieyu Luo

Theses and Dissertations (ETD)

Introduction. Diabetes mellitus is a condition with a growing morbidity and mortality burden. An estimated 30 million adults currently live with diabetes, with each individual spending over $9500 annually on medical care. The successful management of diabetes is a lifelong endeavor. This involves balancing a variety of factors including diet, medications, and glucose monitoring. It has been well established that successful control of diabetes depends largely upon patients’ daily lifestyle habits and activities. Not all patients, however, have the resources necessary for effective diabetes management. Health disparities lead to a higher rate of diabetes development in minority and poor populations. …


Exploring The Usefulness Of Mindfulness Practices Through Zoom Meetings In Reducing Anxiety And/Or Stress Of Adults With Learning And Developmental Disabilities During The Covid-19 Pandemic, Thatiane Abra May 2021

Exploring The Usefulness Of Mindfulness Practices Through Zoom Meetings In Reducing Anxiety And/Or Stress Of Adults With Learning And Developmental Disabilities During The Covid-19 Pandemic, Thatiane Abra

Expressive Therapies Capstone Theses

This thesis explored which mindfulness meditations or mindfulness practices could be beneficial in the online sessions, the extent to which adults with learning and developmental disabilities could learn the practices remotely, and how stress and anxiety disorders could be reduced through online mindfulness interventions. Furthermore, it was also necessary to address the online sessions as the only mental health treatment possibility during the Coronavirus pandemic for the clients observed and the benefits and limitations of these interventions. Additionally, the importance of structure and routine for this population, the multi-modal structure of the interventions, and how attunement plays an important role …


Effects Of Social Determinants Of Health In Progression To Type 2 Diabetes, Folabi I. Ariganjoye May 2021

Effects Of Social Determinants Of Health In Progression To Type 2 Diabetes, Folabi I. Ariganjoye

Applied Research Projects

The prevalence of prediabetes and diabetes in the United States and around the world has increased faster than expected in the last 30 years. The economic burden this costs a nation can be astronomic both in terms of expense and loss in productivity. One-third of U.S. adults, 86 million people, have prediabetes. Effective management is needed that can reach these 86 million, and others at high risk, to reduce their progression to diagnosed Type 2 diabetes. After the literature review, there was not enough literature to support how these led to the progression to diabetes. The abundant literature is centered …


Rule Out Screening For Undiagnosed Dementia And Alzheimer’S Disease Using An Ehr Based Machine Learning Solution, Branum Stephan, David A. Julovich, Dustin Bracy, Jeff Nguyen May 2021

Rule Out Screening For Undiagnosed Dementia And Alzheimer’S Disease Using An Ehr Based Machine Learning Solution, Branum Stephan, David A. Julovich, Dustin Bracy, Jeff Nguyen

SMU Data Science Review

Abstract. Current detection methods for Dementia and Alzheimer’s disease include cerebral spinal fluid (CSF) markers and/or the use of positron emission tomography (PET) imaging, both being high-cost, highly invasive testing methods. The need for low-cost, minimally invasive methods to prescreen individuals for cognitive impairment has been a challenge for many years. Today’s costs associated with an annual screen for all adults 65 and above using current methods (CSF, PET) reach well beyond trillions of dollars per year. Motivated by the limited accessibly and high costs, an alternative tool presented within this paper demonstrates an effective rule out screening for Dementia …


Lip Biopsy Trends In The United States: A 7-Year Review Of Medicare Provider Utilization And Payment Database, Nardin Awad, Fady Awad, Amanda Azer May 2021

Lip Biopsy Trends In The United States: A 7-Year Review Of Medicare Provider Utilization And Payment Database, Nardin Awad, Fady Awad, Amanda Azer

Rowan-Virtua Research Day

Biopsy of the lip is a procedure most used by dermatologists in order to obtain histopathological evaluation of a lesion. It has remained the definitive method of diagnosis for many pathologies, including malignancy. However, although the incidence of lip malignancy has been relatively unchanged since 2012, the number of lip biopsies performed has not followed the same trend, but rather steeply declined since. In this study, the national trends in lip biopsies are evaluated. The Medicare Provider Utilization and Payment (MPUP) database was used to evaluate these practice trends in Medicare providers.


Ring Based Wearable Bioelectrical Impedance Analyzer For Body Fat Estimation, Muhammad Usman, Adarsh Gupta, Wei Xue May 2021

Ring Based Wearable Bioelectrical Impedance Analyzer For Body Fat Estimation, Muhammad Usman, Adarsh Gupta, Wei Xue

Rowan-Virtua Research Day

Introduction

  • Obesity is the most serious public health problem because it is linked to cardiovascular diseases.
  • Measuring fat mass is necessary to study the obesity epidemic.
  • Fat mass can be estimated by measuring impedance of the human body.

Conclusions

  • A novel bioelectrical impedance analyzer for body fat estimation.
  • Device validated for 40 healthy human subjects against commercial analyzer.
  • Great potential to replace commercial analyzers for wearable real-time body fat monitoring.


Case Report: The Value Of Vigilance And Iterative Evaluations With An Uncooperative Patient In The Emergency Department, Duwayne Campbell May 2021

Case Report: The Value Of Vigilance And Iterative Evaluations With An Uncooperative Patient In The Emergency Department, Duwayne Campbell

Rowan-Virtua Research Day

Discussion

A Flexible and Vigilant Approach: The initial presenting information from EMS could have led to anchoring bias. A flexible approach led to new information, which led to interative testing.

Iterative physical examination. There are cases, as seen in this case report, where the physical examination was unreliable or even impossible. Iterative evaluations ultimately led to appropriate imaging and accurate diagnosis.

Iterative testing: In the case presented, the radiologist reported a finding as being present on a prior CXR; however, given the patient’s clinical presentation, further imaging studies were necessary.


Don't Be Such A Buzzy®Kill: Reducing Pain During Vaccinations In College-Age Students, Katherine Long May 2021

Don't Be Such A Buzzy®Kill: Reducing Pain During Vaccinations In College-Age Students, Katherine Long

Evidence-Based Practice Project Reports

Immunizations play a fundamental role in reducing the occurrence of preventable diseases in the population. Injections related to immunization are the most frequent pain-producing medical procedure implemented worldwide and account for nearly 12 billion injections annually (CDC, 2019; Taddio et al., 2015). These procedures are often perceived as simple but can have a variety of complications including pain. This evidence-based practice project addressed the following PICOT question: In college-aged students receiving immunizations (P), does the Buzzy® device (I) when compared to non-intervention standard of care (C) effectively reduce injection site pain (O) over a 12-week time period (T)? The Buzzy® …


Identification And Characterization Of Butyrate-Producing Species In The Human Gut Microbiome, Grace Maline May 2021

Identification And Characterization Of Butyrate-Producing Species In The Human Gut Microbiome, Grace Maline

Theses/Capstones/Creative Projects

Inflammatory Bowel Diseases (IBD) including ulcerative colitis, indeterminate colitis, and Crohn’s disease are increasingly common conditions that places a high physical and financial burden on individuals and global healthcare systems. Though many treatments exist for these conditions, their unpredictable nature and causation make them difficult to manage across the variety of IBD patients. Additionally, many of these treatments come with undesirable side effects or modes of delivery. Therefore, it is worthwhile to explore the use of Short Chain Fatty Acids (SCFAs) such as butyrate whose affects in the human gut include decreased inflammation and decreased risk of colorectal cancer. As …


The Future Of Artificial Intelligence In The Healthcare Industry, Erika Bonnist May 2021

The Future Of Artificial Intelligence In The Healthcare Industry, Erika Bonnist

Honors Theses

Technology has played an immense role in the evolution of healthcare delivery for the United States and on an international scale. Today, perhaps no innovation offers more potential than artificial intelligence. Utilizing machine intelligence as opposed to human intelligence for the purposes of planning, offering solutions, and providing insights, AI has the ability to alter traditional dynamics between doctors, patients, and administrators; this reality is now producing both elation at artificial intelligence's medical promise and uncertainty regarding its capacity in current systems. Nevertheless, current trends reveal that interest in AI among healthcare stakeholders is continuously increasing, and with the current …


Treatment Access For Dual Diagnosis Substance Use And Mental Health Disorders, Pedro Banuelos May 2021

Treatment Access For Dual Diagnosis Substance Use And Mental Health Disorders, Pedro Banuelos

Electronic Theses, Projects, and Dissertations

In 2018, of 1.3 million Latinx adults in the United States facing concurrent issues with substance use disorders (SUD) and mental health disorders (MHD) 93% remained untreated for either diagnosis. This is concerning since Substance Abuse and Mental Health Services Administration (SAMHSA) data reveals that this population is at greater risk for suicidal thoughts, plans, and attempts. They also face structural barriers such as employment, housing, legal involvement, and insurability that further impede access to treatment.

This study’s purpose was to examine barriers to accessing treatment for Latinx populations confronting co-occurring SUDs and MHDs. This study used a qualitative design …


Dance/Movement Therapy In Response To Continuous Race-Based Trauma, Aliesha Bryan May 2021

Dance/Movement Therapy In Response To Continuous Race-Based Trauma, Aliesha Bryan

Dance/Movement Therapy Theses

Trauma is concomitant with a lack of safety; as such, where there is a threat to safety, there is likely to be trauma. Afrodescendants living in the United States, through an ongoing lack of human regard, are often powerless to ensure their safety, and are regularly subjected to continuous, race-based trauma. Racism is deeply embedded in the nation’s institutions as well as in every relationship, and this deeply pervasive and penetrating ideology influences strongly how individuals of any race interact with others. Race-based aggression, from micro- to macro-, has a profound and continuously traumatizing effect on Afrodescendants, with similarly profound …


Psychedelics Can Save: The Scientific And Social Case For Rescheduling Psychedelic Compounds, Galen M. Fader May 2021

Psychedelics Can Save: The Scientific And Social Case For Rescheduling Psychedelic Compounds, Galen M. Fader

Chancellor’s Honors Program Projects

No abstract provided.


Supply, Demand, And Quality: A Three-Pronged Approach To Blood Product Management In Developing Countries, Kyle L. Gress, Karina Charipova, Ivan Urits, Omar Viswanath, Alan D. Kaye Apr 2021

Supply, Demand, And Quality: A Three-Pronged Approach To Blood Product Management In Developing Countries, Kyle L. Gress, Karina Charipova, Ivan Urits, Omar Viswanath, Alan D. Kaye

Journal of Patient-Centered Research and Reviews

While transfusion of blood and blood products is instinctively linked to the provision of emergent care, blood and blood products are also routinely used for the treatment of subacute and chronic conditions. Despite the efforts of the World Health Organization and others, developing countries are faced with a three-part problem when it comes to access to and delivery of transfusions: insufficient supply, excessive demand, and inadequate quality of available supply. Developing countries rely heavily on replacement and remunerated donors rather than voluntary nonremunerated donors due to concerns regarding donation- and transfusion-transmitted infection as well as local and cultural beliefs. While …


Musings On Patient Willingness To Pay, Dennis J. Baumgardner Apr 2021

Musings On Patient Willingness To Pay, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

The editor-in-chief of the Journal of Patient-Centered Research and Reviews introduces an original research article published within Volume 8, Issue 2, and comments on the relative willingness-to-pay values placed on various medical tests, treatments, and cures. How do we adequately educate patients on the risk of chronic disease and inspire them to embrace advisable lifestyle changes before there is a bigger bill to balk at?


Preprocedure Covid-19 Testing In Early Phase Of Pandemic, Renuka Jain, Bradley Kruger, Robert Citronberg, Stacie Kroboth, Ana Cristina Perez Moreno, Bijoy K. Khandheria Apr 2021

Preprocedure Covid-19 Testing In Early Phase Of Pandemic, Renuka Jain, Bradley Kruger, Robert Citronberg, Stacie Kroboth, Ana Cristina Perez Moreno, Bijoy K. Khandheria

Journal of Patient-Centered Research and Reviews

The COVID-19 pandemic led to a nationwide shutdown of elective medical procedures. Upon resumption of services, preprocedure nasopharyngeal swab testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was introduced for all patients requiring surgical or other aerosol-generating procedures. We investigated preprocedure COVID-19 testing in one of the largest U.S. health systems. Patients included in this retrospective, observational study were asymptomatic and scheduled for a procedure or surgery. All patients underwent a nasopharyngeal swab test for SARS-CoV-2 performed 24–72 hours prior to a planned procedure. Clinical demographics, type of procedure, test results, and subsequent procedure status were evaluated. Of 38,608 …