Health Information Technology Commons^™

Evaluation Of Telephone Cardiopulmonary Resuscitation Performance In Current Practice In Saudi Arabia, Meshary Binhotan, Joanne Turnbull, Graham Petley, Nawfal Aljerian, Mohammad Altuwaijri

Journal of the Saudi Heart Association

Objectives: Out-of-hospital cardiac arrest (OHCA) is a global health problem with a low survival rate. Telephone cardiopulmonary resuscitation (T-CPR) guidance by emergency medical services (EMS) dispatchers can improve CPR performance and, consequently, survival rates. Accordingly, the American Heart Association (AHA) has released performance standards for T-CPR in current practice to improve its quality. However, no study has examined T-CPR performance in Saudi Arabia. Therefore, this study aims to evaluate T-CPR performance in the Saudi Arabian EMS system.

Methods: A retrospective observation of OHCA calls in current practice was conducted in Riyadh, Saudi Arabia. OHCA calls were reviewed to identify those …

Comparing Two Telehealth Approaches For Treating Psychiatric Disorders In Primary Care, Reach Dissemination Committee, Maine, Usa

REACH: Research Evidence-to-Action for Community Health

Federally Qualified Health Centers (FQHCs) are community clinics that provide primary care in rural and other underserved areas. FQHCs often don’t have enough mental health specialists to treat patients with complex mental health conditions.

Patient And Provider Perceptions Of Rapid Telehealth Implementation During The Covid-19 Pandemic, Ryan G. Seibert, Amanda K. Stephenson, Aubrey K. Podell, Yuxiu K. Lei, Sheri K. Keitz

The Lahey Journal

Introduction: Despite unprecedented telehealth adoption during the COVID-19 pandemic, its post-pandemic preservation remains uncertain. Understanding key stakeholders’ perspectives on telehealth during the pandemic can inform evidence-based policies and promote effective, sustainable virtual-based care.

Methods: Patients and providers who completed telehealth visits during the early pandemic in primary care, subspecialty, and surgical outpatient clinics at a large community-based academic medical center in New England were surveyed via telephone interviews or electronic surveys. Thematic analyses of qualitative comments further characterized experiences.

Results: Of 1,729 eligible patients called, 969 were contacted and 778 participated (response rate 80.3% among contacted patients). Among 753 eligible …

Evaluation Of Negative Binomial And Zero-Inflated Negative Binomial Models For The Analysis Of Zero-Inflated Count Data: Application To The Telemedicine For Children With Medical Complexity Trial, Kyung Hyun Lee, Claudia Pedroza, Elenir B C Avritscher, Ricardo A Mosquera, Jon E Tyson

Faculty, Staff and Student Publications

BACKGROUND: Two characteristics of commonly used outcomes in medical research are zero inflation and non-negative integers; examples include the number of hospital admissions or emergency department visits, where the majority of patients will have zero counts. Zero-inflated regression models were devised to analyze this type of data. However, the performance of zero-inflated regression models or the properties of data best suited for these analyses have not been thoroughly investigated.

METHODS: We conducted a simulation study to evaluate the performance of two generalized linear models, negative binomial and zero-inflated negative binomial, for analyzing zero-inflated count data. Simulation scenarios assumed a randomized …

A Retrospective Review Of 30-Day Hospital Readmission Risk After Open Heart Surgery In Patients With Atrial Fibrillation, Varun Ashutosh Rao, Genaro Deleon, Aish Thamba, Mindy Flanagan, Kathleen Nickel, Douglas Gray Md

Medical Student Research

Introduction

Readmission rates after open heart surgery (OHS) remain an important clinical issue. The causes are varied, with identifying risk factors potentially providing valuable information to reduce healthcare costs and the rate of post-operative complications. This study aimed to characterize the reasons for 30-day hospital readmission rates of patients after open heart surgery.

Methods

All patients over 18 years of age undergoing OHS at a community hospital from January 2020 through December 2020 were identified. Demographic data, medical history, operative reports, post-operative complications, and telehealth interventions were obtained through chart review. Descriptive statistics and readmission rates were calculated, along with …

Narrative Review Of The Role Of Technology In Pediatric Diabetes: From Testing Blood Glucose To Subcutaneous Automated Therapy And Hope For Cure, Michael Yafi, Avni Shah, Katherine Velez

Faculty, Staff and Student Publications

BACKGROUND AND OBJECTIVE: Type 1 diabetes, the most common cause of diabetes in pediatrics, is defined by the hyperglycemia that results from the permanent autoimmune damage to the pancreas. The Diabetes Control and Complications Trial (DCCT) demonstrated that strict glycemic control targeting lower HbA1c goals can both delay the onset and progression of its complications that include diabetic neuropathy, nephropathy, retinopathy, and increased cardiovascular events. Our primary objective is to review the literature available regarding the technology applied for the treatment of diabetes, not only aiding patients' quality of life but addressing its effects on hypoglycemia and reduced risk of …

Poster: Improving Emergency Department Belongings Inventory Electronic Medical Record Documentation, Shanekia Garrett, Stefanie Lai, Jairo Pagan, Wendy Lu, Katie Whitehead

2023 South Division Nursing Research Conference

Improving Emergency Department Belongings Inventory Electronic Medical Record Documentation Rates Background: Electronic Medical Record (EMR) education and training for RNs should be multifaceted and targeted to the RN clinical workflow. Input from direct care RNs is essential to ensure EMR education is relevant and effective. Shared Governance at a community hospital identified quality and safety concerns among inpatient RNs. RNs reported that belongings inventories were not consistently documented in the EMR for Emergency Department (ED) admissions. Hospital policy requires belongings inventory EMR documentation for all admitted patients. An audit of charts for ED admissions over three months revealed only 5% …

Abnormal Motion Capture In Acute Stroke (Bionics): A Low-Cost Tele-Evaluation Tool For Automated Assessment Of Upper Extremity Function In Stroke Patients, Syed A Zamin, Kaichen Tang, Emily A Stevens, Melissa Howard, Dorothea M Parker, Allyson Seals, Xiaoqian Jiang, Sean Savitz, Shayan Shams

Faculty, Staff and Student Publications

BACKGROUND: The incidence of stroke and stroke-related hemiparesis has been steadily increasing and is projected to become a serious social, financial, and physical burden on the aging population. Limited access to outpatient rehabilitation for these stroke survivors further deepens the healthcare issue and estranges the stroke patient demographic in rural areas. However, new advances in motion detection deep learning enable the use of handheld smartphone cameras for body tracking, offering unparalleled levels of accessibility.

METHODS: In this study we want to develop an automated method for evaluation of a shortened variant of the Fugl-Meyer assessment, the standard stroke rehabilitation scale …

Cancer Patients' Preferences And Perceptions Of Advantages And Disadvantages Of Telehealth Visits During The Covid-19 Pandemic, Deepika Kumar, Nancy Gordon, Constanza Zamani, Tammy Sheehan, Ernesto Martin, Olga Egorova, Jessica Payne, Tatjana Kolevska, Elad Neeman, Raymond Liu

Faculty, Staff and Student Publications

PURPOSE: We aimed to ascertain oncology patients' perceptions of telehealth versus in-person (IP) visits for different types of clinical encounters.

METHODS: We surveyed adults undergoing cancer treatment at Kaiser Permanente Northern California infusion centers between November 2021 and May 2022 using a self-administered questionnaire. Patients were asked about visit modality preferences (video, phone, and IP) for six types of clinical discussions, overall advantages and disadvantages of telehealth (video or phone) versus IP modalities, and barriers to video visit use.

RESULTS: The 839 patients who completed surveys in English were 63% female; median age 63 years; 64% White; and 73% college-educated …

Wearable Biosensor With Molecularly Imprinted Conductive Polymer Structure To Detect Lentivirus In Aerosol, Jaskirat Singh Batra, Ting-Yen Chi, Mo-Fan Huang, Dandan Zhu, Zheyuan Chen, Dung-Fang Lee, Jun Kameoka

Faculty, Staff and Student Publications

The coronavirus disease (COVID-19) pandemic has increased pressure to develop low-cost, compact, user-friendly, and ubiquitous virus sensors for monitoring infection outbreaks in communities and preventing economic damage resulting from city lockdowns. As proof of concept, we developed a wearable paper-based virus sensor based on a molecular imprinting technique, using a conductive polyaniline (PANI) polymer to detect the lentivirus as a test sample. This sensor detected the lentivirus with a 4181 TU/mL detection limit in liquid and 0.33% to 2.90% detection efficiency in aerosols at distances ranging from 30 cm to 60 cm. For fabrication, a mixture of a PANI monomer …

A Novel Virtual-Based Comprehensive Clinical Approach To Headache Care, Thomas Berk, Stephen Silberstein, Peter Mcallister

Department of Jefferson Headache Center Papers and Presentations

One major innovation, a result of the coronavirus pandemic, has been the proliferation of telemedicine. Telehealth can help solve the access problems that plague headache medicine, allowing patients in areas with no headache expertise to consult and work with a headache specialist. This is a retrospective chart review of patients seen by Neura Health, a comprehensive app-based telehealth headache center. Patients are seen by a specialist and, in addition to any medical recommendations, are given care plans individualized to their condition and recommendations at the end of their clinical appointments. The primary outcome of this study is a decrease in …

Effectiveness Of An Emergency Department-Based Machine Learning Clinical Decision Support Tool To Prevent Outpatient Falls Among Older Adults: Protocol For A Quasi-Experimental Study, Daniel J Hekman, Amy L Cochran, Apoorva P Maru, Hanna J Barton, Manish N Shah, Douglas Wiegmann, Maureen A Smith, Frank Liao, Brian W Patterson

Faculty, Staff and Student Publications

Background

Emergency department (ED) providers are important collaborators in preventing falls for older adults because they are often the first health care providers to see a patient after a fall and because at-home falls are often preceded by previous ED visits. Previous work has shown that ED referrals to falls interventions can reduce the risk of an at-home fall by 38%. Screening patients at risk for a fall can be time-consuming and difficult to implement in the ED setting. Machine learning (ML) and clinical decision support (CDS) offer the potential of automating the screening process. However, it remains unclear whether …

Leveraging Telehealth Supportive Oncology Services To Combat Covid-19 Isolation In Breast Cancer Patients: A Cancer Center’S Perspective, Jake R. Erickson, Maranda K. Pahlkotter, Paul D. Thielking, Jane M. Porretta, Regina Rosenthal, Cindy B. Matsen, Kirstyn E. Brownson

Patient Experience Journal

During the COVID-19 pandemic, breast cancer patient in-person visits were converted to telehealth visits. Given our concerns about increased isolation amongst breast cancer patients during the pandemic, and the deleterious effects of such isolation on patient outcomes, we investigated utilization rates of psycho-social services amongst newly diagnosed breast cancer patients at our institution. We explored visit platforms (telehealth versus in-person) and time points prior to and encompassing the early pandemic. Despite decreased new breast cancer visits, there was a greater than 2-fold increase in supportive oncology service encounters in breast cancer patients during COVID-19 suggesting increased need for psycho-oncology resources. …

Neuroimaging Manifestatations In Covid-19 And Its Sequelae, Abhigna M, Vikram Patil

Digital Journal of Clinical Medicine

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged as a novel pathogenic virus in late 2019, infecting millions of people with severe pulmonary infections. It spread worldwide in a short time and became a pandemic, after which the World Health Organization (WHO) declared it a public health emergency. Central nervous system involvement by COVID-19 is already an established entity in the literature. The aim of this study was to evaluate in detail the acute and delayed neurological manifestations of COVID -19.

RESULTS: COVID-19 infection can cause various neurologic manifestations and imaging findings. The most common neuroradiological abnormality is cerebrovascular …

Racial Disparities In Access To Dbs: Results Of A Real-World U.S. Claims Data Analysis, Michael Frassica, Drew S Kern, Mitra Afshari, Allison T Connolly, Chengyuan Wu, Nathan Rowland, Juan Ramirez-Castaneda, Mwiza Ushe, Claudia Salazar, Xenos Mason

Farber Institute for Neuroscience Faculty Papers

INTRODUCTION: Deep brain stimulation (DBS) is an effective and standard-of-care therapy for Parkinson's Disease and other movement disorders when symptoms are inadequately controlled with conventional medications. It requires expert care for patient selection, surgical targeting, and therapy titration. Despite the known benefits, racial/ethnic disparities in access have been reported. Technological advancements with smartphone-enabled devices may influence racial disparities. Real-world evidence investigations can shed further light on barriers to access and demographic disparities for DBS patients.

METHODS: A retrospective cross-sectional study was performed using Medicare claims linked with manufacturer patient data tracking to analyze 3,869 patients who received DBS. Patients were …

Weighted Mean Difference Statistics For Paired Data In The Presence Of Missing Values, Yuntong Li, Brent J. Shelton, William St Clair, Heidi L. Weiss, John L. Villano, Arnold Stromberg, Chi Wang, Li Chen

Markey Cancer Center Faculty Publications

Missing data is a common issue in many biomedical studies. Under a paired design, some subjects may have missing values in either one or both of the conditions due to loss of follow-up, insufficient biological samples, etc. Such partially paired data complicate statistical comparison of the distribution of the variable of interest between the two conditions. In this article, we propose a general class of test statistics based on the difference in weighted sample means without imposing any distributional or model assumption. An optimal weight is derived from this class of tests. Simulation studies show that our proposed test with …

Effectiveness Of Amiodarone, Propafenone And Synchronized Electrical Cardioversion For Conversion Of Atrial Fibrillation Paroxysm To Sinus Rhythm In Rigas Stradins University Hospital Department Of Emergency Medicine., Mihails Tracevskis

Digital Journal of Clinical Medicine

Abstract

Introduction: Atrial fibrillation remains a pervasive global health concern, contributing significantly to the incidence of stroke, heart failure, sudden death, and overall cardiovascular morbidity.

Materials and methods: The present study undertook a retrospective analysis involving a meticulous examination of 127 patients, representing a diverse cohort of individuals encompassing 73 men (with a median age of 62 and a range of 37-75) and 54 women (with a median age of 60 and a range of 42-78) duration of atrial fibrillation 48 hours or less.

Results: The results highlighted amiodarone's remarkable efficiency, as it successfully converted 81.2% of cases (56 …

Feasibility Of Delivering A Virtual 1-Day Acceptance And Commitment Therapy Workshop To Rural Veterans Through Community Partnerships, Lilian Dindo, Angelic Chaison, Merlyn Rodrigues, Ken Woods, Alicia Mark, Derrecka Boykin

Faculty, Staff and Students Publications

Background: This single-arm, open pilot study examined the feasibility and initial efficacy of a 1-day virtual Acceptance and Commitment Therapy (ACT) group workshop for distressed veterans.

Methods: We collaborated with veteran-serving community-based organizations to enhance outreach to veterans, especially those in rural areas. Veterans completed a baseline assessment and two follow-up assessments (1 month, 3 months) after workshop participation. Feasibility outcomes included reach (workshop recruitment and completion rates; veteran characteristics) and acceptability (open-ended survey question about satisfaction). Clinical outcomes included psychological distress (Outcome Questionnaire-45), stressor-related distress (PTSD Checklist-5), community reintegration (Military to Civilian Questionnaire), and meaning and purpose (PROMIS Short …

A Review On Anatomical And Surgical Importance Of Mammary Gland, Sneha Jm Sneha Jm Dr, Pushpa Nb Dr, Vidya Cs Dr, Manjappa M Dr

Digital Journal of Clinical Medicine

ABSTRACT

The mammary gland is an exocrine gland present in female mammals responsible for the production and secretion of milk during the process of lactation. It is mainly composed by epithelial cells and adipocytes. The features that make mammary gland unique are 1) its highly plastic properties displayed during pregnancy, lactation and involution (all steps belonging to the lactation cycle) and 2) its requirement to grow in close association with adipocytes which are absolutely necessary to ensure mammary gland development at puberty and remodelling during the lactation cycle. (Georgia colleluori, Jessica perugini, Giorgio barbatelli, and saverio cintr (2021).

Conclusion

The …

Covid-19 Proactive Disease Management Using Covid Virtual Hospital In A Rural Community, Gandhari Loomis, Regina Rhodes, Ed Bujold, Golnosh Sharafsaleh, Ellen Collett, Mark Irwin, Elizabeth W. Staton, John M. Westfall

Journal of Patient-Centered Research and Reviews

Purpose: A community teaching hospital serving a rural population established an intensive “hospital at home” program for patients with COVID-19 utilizing disease risk stratification and pulse oximeter readings to dictate nurse and clinician contact. Herein, we report patient outcomes and provider experiences resulting from this “virtual” approach to triaging pandemic care.

Methods: COVID-19-positive patients appropriate for outpatient management were enrolled in our COVID Virtual Hospital (CVH). Patients received pulse oximeters and instructions for home monitoring of vital signs. CVH nurses contacted the patient within 12–48 hours. The primary care provider was alerted of the patient’s diagnosis and held a virtual …

Effectiveness Of An Electronic Health Record Embedded Evidence-Based Testing Algorithm For Clostridioides Difficile Infection., Sarah Marie Bishop

Doctor of Nursing Practice Papers

Background: Clostridioides difficile infection (CDI) commonly impacts hospitalized patients with almost half a million cases reported in the United States annually. C. difficile colonization is more common than infection. Identifying true infection versus colonization is critical to avoiding inappropriate treatment, unnecessary exposure to antibiotics, and increased cost of care. Implementation of evidenced-based CDI testing criteria can help reduce inappropriate CDI testing and avoid the misidentification of colonized patients as true CDI.

Purpose: The purpose of this project was to evaluate the effectiveness of an evidence-based electronic health record (EHR) integrated CDI testing algorithm in reducing inappropriate CDI testing among adult …

Candidemia In Patients With Cardiovascular Implantable Electronic Devices: Uncertainty In Management Based On Current International Guidelines, Supavit Chesdachai, Larry M Baddour, M Rizwan Sohail, Bharath Raj Palraj, Malini Madhavan, Hussam Tabaja, Madiha Fida, Douglas W Challener, Daniel C Desimone

Faculty, Staff and Students Publications

BACKGROUND: In contrast to bloodstream infection due to a variety of bacteria in patients with cardiovascular implantable electronic devices (CIED), there are limited data regarding candidemia and risk of CIED infection.

METHODS: All patients with candidemia and a CIED at Mayo Clinic Rochester between 2012 and 2019 were reviewed. Cardiovascular implantable electronic device infection was defined by (1) clinical signs of pocket site infection or (2) echocardiographic evidence of lead vegetations.

RESULTS: A total of 23 patients with candidemia had underlying CIED; 9 (39.1%) cases were community onset. None of the patients had pocket site infection. The duration between CIED …

On The Respiratory Syncytial Virus Vaccine, Forest W. Arnold

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Barriers And Facilitators To Achieving Well-Being In Pediatric Providers, Whitney Marvin, Jillian Harvey, Natasha Ruth

Journal of Wellness

Introduction: Physician well-being has become increasingly important for health systems across the country due to the strong ties between quality, safety, and overall patient outcomes. Burnout has increased steadily and has been exacerbated by the COVID-19 pandemic. This study seeks to successfully identify factors that both enhance and detract from well-being in a cohort of pediatric faculty and advanced practice providers (APPs).

Methods: This study utilized a multimethod approach including surveys and a total of 8 semi-structured, virtual focus groups of pediatricians and advanced practice providers (orchestrated through Microsoft Teams) to understand perspectives on burnout and well-being. Each …

Impact Of Social Media And Multimedia Platforms: View From The Jacc: Case Reports Some Editors, Estefania Oliveros, Yevgeniy Brailovsky, Alessandro Beneduce, Hooman Bakshi, Edoardo Zancanaro, Indah Sukmawati, Mrinali Shetty, Gina Lundberg

Division of Cardiology Faculty Papers

No abstract provided.

Non-Melanoma Skin Cancer Detection In The Age Of Advanced Technology: A Review, Haleigh Stafford, Jane Buell, Elizabeth Chiang, Uma Ramesh, Michael Migden, Priyadharsini Nagarajan, Moran Amit, Dan Yaniv

Faculty, Staff and Student Publications

Skin cancer is the most common cancer diagnosis in the United States, with approximately one in five Americans expected to be diagnosed within their lifetime. Non-melanoma skin cancer is the most prevalent type of skin cancer, and as cases rise globally, physicians need reliable tools for early detection. Artificial intelligence has gained substantial interest as a decision support tool in medicine, particularly in image analysis, where deep learning has proven to be an effective tool. Because specialties such as dermatology rely primarily on visual diagnoses, deep learning could have many diagnostic applications, including the diagnosis of skin cancer. Furthermore, with …

Deep Single-Cell Rna-Seq Data Clustering With Graph Prototypical Contrastive Learning, Junseok Lee, Sungwon Kim, Dongmin Hyun, Namkyeong Lee, Yejin Kim, Chanyoung Park

Faculty, Staff and Student Publications

MOTIVATION: Single-cell RNA sequencing enables researchers to study cellular heterogeneity at single-cell level. To this end, identifying cell types of cells with clustering techniques becomes an important task for downstream analysis. However, challenges of scRNA-seq data such as pervasive dropout phenomena hinder obtaining robust clustering outputs. Although existing studies try to alleviate these problems, they fall short of fully leveraging the relationship information and mainly rely on reconstruction-based losses that highly depend on the data quality, which is sometimes noisy.

RESULTS: This work proposes a graph-based prototypical contrastive learning method, named scGPCL. Specifically, scGPCL encodes the cell representations using Graph …

Use Of Telemedicine For Postdischarge Assessment Of The Surgical Wound: International Cohort Study, And Systematic Review With Meta-Analysis, Nihr Global Health Research Unit On Global Surgery, Globalsurg Collaborative

Faculty, Staff and Student Publications

OBJECTIVE: This study aimed to determine whether remote wound reviews using telemedicine can be safely upscaled, and if standardized assessment tools are needed.

BACKGROUND: Surgical site infection (SSI) is the most common complication of surgery worldwide, and frequently occurs after hospital discharge. Evidence to support implementation of telemedicine during postoperative recovery will be an essential component of pandemic recovery.

METHODS: The primary outcome of this study was SSI reported up to 30 days after surgery (SSI), comparing rates reported using telemedicine (telephone and/or video assessment) to those with in-person review. The first part of this study analyzed primary data from …

Development Of 5g-Based Remote Ultrasound Education: Current Status And Future Trends, Jiaojiao Ma, Xinying Jia, Guanghan Li, Dandan Guo, Xuehua Xi, Tongtong Zhou, Ji-Bin Liu, Bo Zhang

Department of Radiology Faculty Papers

The rapid advancement of 5G technology has opened new possibilities for remote ultrasound education, offering the potential to enhance training, real-time consultation, and quality control for primary ultrasound doctors. The 5G remote ultrasound education has the potential to revolutionize the way primary ultrasound doctors are trained and supported, ultimately leading to improved patient care and outcomes. By understanding the current status and development trends of this cutting-edge educational approach, the medical community can better prepare for and contribute to its ongoing evolution. Looking towards the future, the development trends in 5G remote ultrasound education are expected to revolve around continuous …

Machine Learning-Based Aggression Detection In Children With Adhd Using Sensor-Based Physical Activity Monitoring, Catherine Park, Mohammad Dehghan Rouzi, Md Moin Uddin Atique, M G Finco, Ram Kinker Mishra, Griselda Barba-Villalobos, Emily Crossman, Chima Amushie, Jacqueline Nguyen, Chadi Calarge, Bijan Najafi

Center on Aging Staff Publications

Aggression in children is highly prevalent and can have devastating consequences, yet there is currently no objective method to track its frequency in daily life. This study aims to investigate the use of wearable-sensor-derived physical activity data and machine learning to objectively identify physical-aggressive incidents in children. Participants (n = 39) aged 7 to 16 years, with and without ADHD, wore a waist-worn activity monitor (ActiGraph, GT3X+) for up to one week, three times over 12 months, while demographic, anthropometric, and clinical data were collected. Machine learning techniques, specifically random forest, were used to analyze patterns that identify physical-aggressive incident …