Health Information Technology Commons^™

Clozapine And Modified Electroconvulsive Therapy (M-Ect) In Treatment Resistant Schizophrenia (Trs) – A Case Report, Kareena Arora, Kishor M, Murali M R, Suhas K Mr

Digital Journal of Clinical Medicine

Schizophrenia is psychiatric disorder affecting less than 1% of population that can be devastating, characterized by positive, negative and cognitive symptoms. This can lead to significant functional impairment. Despite intensive and ongoing research, outcomes from best-practice treatment are often suboptimal. Unfortunately, not all the patients respond to antipsychotic medications. Overall estimates suggest that one-fifth to one-half of patients have treatment resistant schizophrenia (TRS).

TRS include failure sequential trial of two different antipsychotics with sufficient dose, duration and adherence as a minimum criterion. TRS represents major clinical challenge.

Clozapine is the only drug approved for TRS as it is the drug …

Osteochondroma At Unusual Location Causing Deformity (Metacarpal): A Rare Case Report, Pranshu S. Panwar, Prakash M, Purushothama Sastry, Gurumurthy B, Punith N, Ravi H. S

Digital Journal of Clinical Medicine

INTRODUCTION: Osteochondroma is benign tumors of bone which usually occurs in long bones. Common locations proximal tibia, distal femur and proximal humerus. Metacarpals are rarely affected.

Case Report: Patient, 10 years old/boy came to JSS hospital with complaint of swelling and deformity over left hand for 2 years. After relevant clinical examination and radiological investigation, patient was diagnosed with synostoses of 5^th metacarpal with 4^th metacarpal. Patient was taken up deformity correction and intra-op patient was diagnosed as exostoses of 5^th metacarpal. Post-op radiograph was taken. After 1-month ex-fix was removed. After 4 months follow up, deformity …

Internet Gaming Disorders Amongst Medical Undergraduates In Tamil Nadu, India - A Cross Sectional Study, Rejee Sneha Ebanezer, Sumedha K, Murugan V

Digital Journal of Clinical Medicine

Abstract

Background: Internet Gaming Disorder (IGD) or internet-related gaming addictions are characterized by severely impaired control over gaming affecting routine activities, followed by several psychological, physical and social issues. Budding medical undergraduates who are future health professionals might have positive effects on their studies and career goals when saved from internet gaming addictions. Hence, this study aimed to identify the proportion of medical undergraduate students and interns with internet gaming disorders studying in a private medical college and tertiary care hospital.

Setting: A tertiary care Hospital and Medical College, Tamil Nadu, India

Study design: Cross – sectional study.

Participants: Medical …

High Stakes And Hidden Risks: A Case Series On Pathological Gambling In Context With Affective Disorders And Substance Abuse, Avni Gupta, Namita Deka, Mahesh Kumar

Digital Journal of Clinical Medicine

Background: Pathological gambling is a non–substance-related addictive disorder, characterized by persistent preoccupation with gambling, impaired control, and continuation despite negative consequences. It is associated with financial losses, social and occupational dysfunction, and psychiatric comorbidities, including affective and substance use disorders. Although international prevalence estimates range from 1–2%, research in India remains limited, particularly with the rise of online gambling.

Methods: We report a case series of three individuals presenting to a tertiary-care psychiatry outpatient department with pathological gambling. Clinical assessments included detailed psychiatric evaluation, mental status examination, and psychometric assessments using the Hamilton Anxiety Rating Scale (HAM-A), Beck Depression Inventory …

Creating The New Normal: A Historical Approach To Understanding Marketing Agility And Its Implications Across Business, Healthcare, And Social Welfare In A Post Pandemic World, Elan Burton, Delancy Bennett, Linda Burton

Atlantic Marketing Journal

The purpose of this article is to expand our understanding of how marketing agility shapes business, healthcare, and social welfare policy and societal responses to global pandemics. We set the stage for this discussion by presenting an historical exemplar case of marketing agility during the 1918 Influenza pandemic in the US. Next, we outline a necessary conceptual revision and update to previous treatments of marketing agility relative to historical pandemics considering the recent COVID-19 pandemic. Our novel conceptualization focuses on a firm’s (business, healthcare, social welfare) prompt response to dynamic and turbulent circumstances beyond the control of the firm (Araújo …

Prevalence And Patterns Of Cardiovascular Risk Factors In Young Hypertensive Patients, *Raghu V S R Tanuku Dr., Major Venkata Shree Krishna Dr., Sreedhar Tanuku Dr

Digital Journal of Clinical Medicine

Hypertension ranks among the top ten causes of mortality, with around 4% attributed to hypertensive complications. High salt intake, Type 2 diabetes, smoking, elevated serum lipids, a sedentary lifestyle, a diet heavy in saturated fat, genetic predisposition, as well as stress are among the factors that contribute to hypertension. Hypertension affects about 1 billion people worldwide, with considerable differences between populations and ethnic groups [2]. The Framingham Heart Study indicates that a person's lifetime risk of developing hypertension is 90% if they are normotensive at age 55. According to the NHANES IV (4th National Health and Nutrition Examination Survey), the …

– Foreign Body Ingestion In Children(<12 Years) At A Tertiary Care Hospital: A Retrospective Cohort Study Studying Role Of Socioeconomic Status And Parental Supervision., Khyati Gupta, Gargi Rekhawar, Anisha Jain, Vishal D. Sawant, Sushma Save

Digital Journal of Clinical Medicine

Background- Foreign body ingestion is a long-standing problem concerning pediatric population. We aim to evaluate the correlation between the median time interval between ingestion of foreign body and arrival to the hospital with socioeconomic factors, effect of parental supervision and number of children in the family. We also aim to find out the deciding factors for proper selection of method of removal of ingested foreign bodies.

Methods- The data was collected from patient’s admission files, medical and endoscopic records. Chi-square test was used to calculate the corelation of time since ingestion with the socioeconomic status of family, method of removal …

Assessing Discharge Knowledge For Caregivers Of Newborn (Using Video Discharge Instructions As An Adjunct To Standard Written Instructions) In Covid Period – A Randomized Controlled Trial, Jayesh Yadav, Khyati Gupta, Vishal D. Sawant

Digital Journal of Clinical Medicine

Background: Studies have demonstrated that caregivers of newborn frequently face challenges in comprehending the instructions provided to them upon discharge. Video discharge instructions provide a clear and concise message and can potentially alleviate factors which have an impact on comprehension of caregivers like illiteracy, communication barriers and limited physician time. We aim to assess the impact of incorporating video-based discharge instructions on caregivers' comprehension of newborn care and post-discharge follow-up, specifically in the context of the COVID-19 pandemic.

Methods: Caregivers of newborn in the COVID times were randomized into written only and written with video discharge instruction groups; …

Comparison Of Empathy And Compassion Fatigue Among Mental Health And Non-Mental Health Professionals: A Cross-Sectional Study, Fathima Fiza K T, Anil Kakunje, Ashwini Dinkar

Digital Journal of Clinical Medicine

Background:

Empathy refers to the ability to understand and comprehend others' thoughts and emotions as if it's their own, evoked by witnessing and connecting to the other person’s emotional state. Compassion fatigue, a consequence of an empathetic reaction, is the mental and physical tiredness resulting from being a witness to the suffering of others. It can result in negative consequences ultimately affecting the quality of treatment. The purpose of the study was to compare the level of empathy and compassion fatigue among mental health, and non-mental health professionals.

Methods

A comparative cross-sectional study was conducted over one year using 88 …

A Previous Thyroidectomy- The Culprit Of Laryngospasm Several Years On!, Vyshnavi Sriram, Ashwini N, Chillara Meena

Digital Journal of Clinical Medicine

Laryngospasm is the sustained closure of the vocal cords resulting in partial or complete loss of airway patency. Among the several causes of laryngospasm, history of total thyroidectomy performed several years back, though reported, is a rare occurrence. We present here the case report of a lady with an uneventful intra operative course of a laparoscopic cholecystectomy who developed stridor and laryngospasm in the immediate post operative period. Evaluation revealed unilateral vocal cord palsy and hypocalcemia. Compensated unilateral recurrent laryngeal nerve palsy and asymptomatic hypocalcemia can exist in patients who have undergone total thyroidectomy and can result in stridor several …

Expanding A Behavioral View On Digital Health Access: Drivers And Strategies To Promote Equity, Maura M. Kepper, Lauren A. Fowler, Isabelle S. Kusters, Jean W. Davis, Manal Baqer, Sarah Sagui-Henson, Yunyu Xiao, Adati Tarfa, Jean C. Yi, Bryan Gibson, Kristin E. Heron, Nicole M. Alberts, Marissa Burgermaster, Veronica Njie-Carr, Lisa M. Klesges

Psychology Faculty Publications

The potential and threat of digital tools to achieve health equity has been highlighted for over a decade, but the success of achieving equitable access to health technologies remains challenging. Our paper addresses renewed concerns regarding equity in digital health access that were deepened during the COVID-19 pandemic. Our viewpoint is that (1) digital health tools have the potential to improve health equity if equitable access is achieved, and (2) improving access and equity in digital health can be strengthened by considering behavioral science-based strategies embedded in all phases of tool development. Using behavioral, equity, and access frameworks allowed for …

Attachment Security And Problematic Media Use In Infancy: A Longitudinal Study In The United States., Jane Shawcroft, Sarah M Coyne, Lisa Linder, Brandon N Clifford, Brandon T. Mcdaniel Phd

Health Services and Informatics Research

Media use during childhood has quickly become a norm across the United States and in other countries. One area still not well understood is the development of problematic (or maladaptive and disruptive) media use in children. This research examines the role of attachment security as a central component in the development of problematic media use over time in a sample of 248 parent-child dyads (9.50% African American, 20.66% Hispanic, 62.81% White, 2.07% Asian, 4.96% other ethnicities). We examined the relationship between attachment security and problematic media use one and 2 years later. We then constructed a mediation model examining parent …

Perceptions Of Acute Care Telemedicine Among Caregivers For Persons Living With Dementia: A Qualitative Study, Tracey Obi, Hardeep Singh, Emily Hayden, Aanand D Naik, Shan Liu, Maura Kennedy

Faculty, Staff and Student Publications

Persons living with dementia (PLWD) have high emergency department (ED) utilization. Little is known about using telemedicine with PLWD and caregivers as an alternative to ED visits for minor acute health problems. This qualitative interview-based study elicited caregivers' perspectives about the acceptability of telemedicine for acute complaints. We performed telephone interviews with 28 caregivers of PLWD from two academic EDs, one in the Northeast and another in the South. Using a combined deductive-inductive approach, we coded interview transcripts and elucidated common themes by consensus. All caregivers reported they would need to participate in the telemedicine visit to help overcome communication …

Comparing The Use And Effectiveness Of In-Person And Remote Physical Education Delivery During The Covid-19 Pandemic, Andjelka Pavlovic

Faculty, Staff and Student Publications

BACKGROUND: Physical Education is a key component to improve youth health, but there is limited information on Physical Education delivery in different formats.

PURPOSE: We compared PE formats (in-person versus remote) across evaluation aspects: weekly minutes; perceived effectiveness; and student-to-teacher ratio.

METHODS: We distributed questionnaires (2020-2021 school year) to school contacts who represented NFL Play 60 FitnessGram

RESULTS: Among 165 schools, 10% (n=17) offered in-person instruction, 31% (n=51) offered remote instruction, and 59% offered both (n=97). Results revealed higher in-person PE minutes (77.2±7.3) compared to remote minutes (67.1±14.6), but results were not significantly different (p=0.19). School contacts reported significantly more …

Political Prioritization For Digital Health And Health Equity Through Global Health Diplomacy, Vijay Kumar Chattu, Sujatha Alla, Bawa Singh

Engineering Management & Systems Engineering Faculty Publications

[Introduction] We have found the article "Digital health and health equity: How digital health can address healthcare disparities and improve access to quality care in Africa" published in the recent issue to be very relevant and interesting.¹ Qoseem et al have highlighted that there is a great need for continuous advocacy for strengthening the health systems through telehealth promotion and increasing access to healthcare services to achieve health equity.

Data Driven Trade-Off Analysis For Cybersecurity, Goskel Kucukkaya, Murat Ozer, Murat Balci, Emrah Ugurlu

Engineering Management & Systems Engineering Faculty Publications

Trade-off analysis, a specialization of systems engineering, addresses design criteria like security, cost, performance, and compliance. Monte Carlo simulations are commonly employed to generate impact scenarios for trade-off analysis combined with solution alternatives that accommodate industry-specific considerations and uncertainties. In the cyber domain, this paper proposes a methodology for data-driven trade-off analysis in cybersecurity, leveraging industry reports as primary data sources using confidentiality, integrity, and availability as trade-off analysis objectives. Distribution functions are derived to manage and model uncertainties for various industries. The approach given in this study aims to facilitate informed choices and to enhance cybersecurity decision making and …

A Comparative Analysis Of The Interpretability Of Lda And Llm For Topic Modeling: The Case Of Healthcare Apps, Omar El-Gayar, Mohammad A. Al-Ramahi, Abdullah Wahbeh, Tareq Nasralah, Ahmed El Noshokaty

All Faculty Scholarship (Archived)

This study compares the interpretability of the topics resulting from three topic modeling techniques, namely, LDA, BERTopic, and RoBERTa. Using a case study of three healthcare apps (MyChart, Replika, and Teladoc), we collected 39,999, 52,255, and 27,462 reviews from each app, respectively. Topics were generated for each app using the three topic models and labels were assigned to the resulting topics. Comparative qualitative analysis showed that BERTopic, RoBERTa, and LDA have relatively similar performance in terms of the final list of resulting topics concerning human interpretability. The LDA topic model achieved the highest rate of assigning labels to topics, but …

Technoference In Parenting And Impacts On Parent–Child Relationships And Child Development, Brandon T. Mcdaniel Phd, Lisa Linder, Mariek M.P. Vanden Abeele, Alison K. Ventura, Sarah M. Coyne, Rachel Barr

Health Services and Informatics Research

“Technoference” is a term that describes how parent media use (e.g., phone use) can interfere with parent–child relationships and interactions. Research has shown technoference effects on parents and children ranging in age from infancy to adolescence, such as decreased parent responsiveness and adverse child behavioral outcomes. However, potential benefits of parent media use have also been identified, such as media use to cope with stress, stay connected, increase breastfeeding perseverance, and seek parenting information. Technoference has only been researched for about a decade, and there are large research gaps. We propose a research agenda to parse out long-term or cumulative …

Daily Smartphone Use Predicts Parent Depressive Symptoms, But Parents' Perceptions Of Responsiveness To Their Child Moderate This Effect., Brandon T. Mcdaniel Phd, Sabrina Uva, Jessica Pater, Victor P. Cornet Ms, Michelle Drouin Phd, Jenny Radesky

Health Services and Informatics Research

INTRODUCTION: Smartphone use during caregiving has become increasingly common, especially around infants and very young children, and this use around young children has been linked with lower quality and quantity of parent-child interaction, with potential implications for child behavior, and parent-child attachment. To understand drivers and consequences of parent phone use, we were interested in the daily associations between parent phone use and depressed mood, as well as the potential for parent perceptions of their responsiveness toward their infant to alter the association between parent phone use and mood.

METHODS: In the present study, we explored associations between day-to-day changes …

Heavy Users, Mobile Gamers, And Social Networkers: Patterns Of Objective Smartphone Use In Parents Of Infants And Associations With Parent Depression, Sleep, Parenting, And Problematic Phone Use., Brandon T. Mcdaniel Phd, Jenny Radesky, Jessica Pater, Adam M Galovan, Annalise Harrison, Victor P. Cornet Ms, Lauren Reining, Alexandria Schaller, Michelle Drouin

Health Services and Informatics Research

Smartphone use during parenting is common, which may lead to distraction (also known as technoference). However, it is likely that some phone activities are less disruptive to parents and children. In this study, we explored smartphone use (via passive sensing across 8 days) within 264 parents of infants, measuring parents' application use on their phone (e.g., messaging, social media, mobile gaming, video chat) and phone use across contexts (e.g., during feeding and at bedtime). We utilized latent profile analysis to identify profiles of users, revealing five user types:

Chatting For Change: Insights Into And Directions For Using Online Peer Support Groups To Interrupt Prolonged Workplace Sitting, Ekaterina Uetova, Lucy Hederman, Dympna O'Sullivan, Robert J. Ross, Marily Oppezzo

Conference papers

Prolonged sedentary behavior and insufficient physical activity increase the risk for non-communicable diseases. Online peer support groups, driven by the widespread use of mobile phones and social media, have gained popularity among people seeking health condition management advice. This position paper examines the role of online peer support groups within a behaviour change intervention, MOV’D (Move Often eVery Day), which promotes physical activity and reduces sedentary behavior in the workplace. We conducted a thematic analysis of post-study interviews from two randomized control trials to identify the benefits and limitations of online peer support groups and provide recommendations for improvement. We …

Infusing Machine Learning And Computational Linguistics Into Clinical Notes, Funke V. Alabi, Onyeka Omose, Omotomilola Jegede

Mathematics & Statistics Faculty Publications

Entering free-form text notes into Electronic Health Records (EHR) systems takes a lot of time from clinicians. A large portion of this paper work is viewed as a burden, which cuts into the amount of time doctors spend with patients and increases the risk of burnout. We will see how machine learning and computational linguistics can be infused in the processing of taking clinical notes. We are presenting a new language modeling task that predicts the content of notes conditioned on historical data from a patient's medical record, such as patient demographics, lab results, medications, and previous notes, with the …

Factors Associated With Hepatitis C-Related Hospitalizations And Inpatient Mortality In The United States, Pre- And Post-Onset Of The Covid-19 Pandemic, Christina R. Samuel

College of Graduate Studies: Theses & Dissertations

Background: Hepatitis C is a significant public health problem in the United States and imposes a substantial burden on the healthcare system. Previous research shows that the COVID-19 pandemic response efforts have overshadowed hepatitis C testing and treatment measures in health care settings across the country. The purpose of this study was to describe and examine the factors associated with hepatitis C-related hospitalizations and inpatient mortality in the United States, pre- and post-onset of the COVID-19 pandemic. Methods: Data were obtained from the 2019-2020 National Inpatient Sample database. The study population included persons aged ≥18 years with hepatitis C-related inpatient …

Factors Affecting Users’ Satisfaction With Telehealth Apps: Analysis Of Users Reviews Using Bert, Abdullah Wahbeh, Tyler Howes, Omar El-Gayar, Raed Seetan, Mohammad A. Al-Ramahi, Ahmed Al-Omari

All Faculty Scholarship (Archived)

Telehealth mobile apps and telehealth services are increasingly used by patients, particularly, post-COVID-19. This study examines factors related to users’ satisfaction with these apps and services by analyzing reviews from actual telehealth app users. A total of 53,209 reviews were collected from nine telehealth apps on the Google Play store. Using BERT embeddings, UMAP, and HDBSCAN, topics were generated and labeled to identify these factors. Results showed that telehealth app users expressed several factors related to satisfaction with telehealth apps, which could impact the acceptability and adoption of such apps. These include usability (ease of use), usefulness, convenience and efficiency, …

Designing A Blockchain-Empowered Telehealth Artifact For Decentralized Identity Management And Trustworthy Communication: Interdisciplinary Approach, Xueping Liang, Nabid Alam, Tahmina Sultana, Eranga Bandara, Sachin Shetty

VMASC Publications

Background: Telehealth played a critical role during the COVID-19 pandemic and continues to function as an essential component of health care. Existing platforms cannot ensure privacy and prevent cyberattacks.

Objective: The main objectives of this study are to understand existing cybersecurity issues in identity management and trustworthy communication processes in telehealth platforms and to design a software architecture integrated with blockchain to improve security and trustworthiness with acceptable performance.

Methods: We improved personal information security in existing telehealth platforms by adopting an innovative interdisciplinary approach combining design science, social science, and computer science in the health care domain, with prototype …

Remote Multi-Person Heart Rate Monitoring With Smart Speakers: Overcoming Separation Constraint, Ngoc Doan Thu Tran, Dong Ma, Rajesh Krishna Balan

Research Collection School Of Computing and Information Systems

Heart rate is a key vital sign that can be used to understand an individual’s health condition. Recently, remote sensing techniques, especially acoustic-based sensing, have received increasing attention for their ability to non-invasively detect heart rate via commercial mobile devices such as smartphones and smart speakers. However, due to signal interference, existing methods have primarily focused on monitoring a single user and required a large separation between them when monitoring multiple people. These limitations hinder many common use cases such as couples sharing the same bed or two or more people located in close proximity. In this paper, we present …

Enabling Ai And Robotic Coaches For Physical Rehabilitation Therapy: Iterative Design And Evaluation With Therapists And Post-Stroke Survivors, Min Hun Lee, Daniel Siewiorek, Asim Smailagic, Alexandre Bernardino, Sergi Bermúdez I Badia

Research Collection School Of Computing and Information Systems

Artificial intelligence (AI) and robotic coaches promise the improved engagement of patients on rehabilitation exercises through social interaction. While previous work explored the potential of automatically monitoring exercises for AI and robotic coaches, the deployment of these systems remains a challenge. Previous work described the lack of involving stakeholders to design such functionalities as one of the major causes. In this paper, we present our efforts on eliciting the detailed design specifications on how AI and robotic coaches could interact with and guide patient’s exercises in an effective and acceptable way with four therapists and five post-stroke survivors. Through iterative …

Athletic Trainer's Perceptions Of And Experiences With Professional Development Approaches For Enhancing Clinical Documentation, Sarah L. Nottingham, Tricia M. Kasamatsu, Julie M. Cavallario, Cailee E. Welch Bacon

Rehabilitation Sciences Faculty Publications

Context

Little is known about how athletic trainers (ATs) learn clinical documentation, but previous studies have identified that ATs have a need for more educational resources specific to documentation.

Objective

To obtain ATs' perspectives on learning clinical documentation.

Design

Qualitative study.

Setting

Web-based audio interviews.

Patients or Other Participants

Twenty-nine ATs who completed 2 different continuing education (CE) clinical documentation modules. Participants averaged 36.2 ± 9.0 years of age and included 16 women and 13 men representing 21 US states and 8 clinical practice settings.

Data Collection and Analysis

Participants were recruited from a group of ATs who completed 1 …

Patients With Floaters: Answers From Virtual Assistants And Large Language Models

Faculty, Staff and Student Publications

OBJECTIVES: "Floaters," a common complaint among patients of all ages, was used as a query term because it affects 30% of all people searching for eye care. The American Academy of Ophthalmology website's "floaters" section was used as a source for questions and answers (www.aao.org). Floaters is a visual obstruction that moves with the movement of the eye. They can be associated with retinal detachment, which can lead to vision loss. With the advent of large language model (LLM) chatbots ChatGPT, Bard versus virtual assistants (VA), Google Assistant, and Alexa, we analyzed their responses to "floaters."

METHODS: Using AAO.org, "Public …

Post-Covid-19 Cognitive Symptoms In Patients Assisted By A Teleassistance Service: A Retrospective Cohort Study, Lívia Paula Freire Bonfim, Thais Rotsen Correa, Bruno Cabaleiro Cortizo Freire, Thais Marques Pedroso, Daniella Nunes Pereira, Luciane Kopittke, Antonio Lucio Teixeira, Milena Soriano Marcolino

Faculty, Staff and Student Publications

INTRODUCTION: Four years after the onset of the COVID-19 pandemic, the frequency of long-term post-COVID-19 cognitive symptoms is a matter of concern given the impact it may have on the work and quality of life of affected people.

OBJECTIVE: To evaluate the incidence of post-acute COVID-19 cognitive symptoms, as well as the associated risk factors.

METHODS: Retrospective cohort, including outpatients with laboratory-confirmed COVID-19 and who were assisted by a public telehealth service provided by the Telehealth Network of Minas Gerais (TNMG), during the acute phase of the disease, between December/2020 and March/2022. Data were collected through a structured questionnaire, applied …