Medical Specialties Commons^™

The Problem With Relying On Profit-Driven Models To Produce Pandemic Drugs, Ana Santos Rutschman

All Faculty Scholarship

The longstanding problems of relying on a market response to a pandemic are becoming readily apparent in the United States, which has quickly become the epicenter of the COVID-19 outbreak. The problems are particularly pronounced in pharmaceutical markets, where we are pinning our hopes for both cures and vaccines. In previous work we have shown how characteristics of healthcare markets in the United States create a divergence between the private incentives of for-profit companies and public health needs, leading to sub-optimal health outcomes in what is a uniquely market-driven healthcare system. In this Essay, written as the COVID-19 pandemic unfolds, …

PortugalʼS Response To Covid-19, Ana Santos Rutschman

All Faculty Scholarship

This essay for the Regulatory Review's special series on Comparing Nations’ Responses to COVID-19 examines the early response to the pandemic in Portugal. The essay focuses on measures adopted in connection with the declarations of state of emergency and state of calamity, as well as the treatment of migrant populations throughout the pandemic.

Mapping Misinformation In The Coronavirus Outbreak, Ana Santos Rutschman

All Faculty Scholarship

The coronavirus outbreak has sent ripples of fear and confusion across the world. These sentiments—and our collective responses to the outbreak—are made worse by rampant misinformation surrounding the new strain of the virus, COVID-2019. In this post, I survey some of the most pervasive areas of tentacular coronavirus-related misinformation that has proliferated online -- as well as the responses of social media companies like YouTube, Facebook, Pinterest and TikTok that may ultimately prove inadequate given the magnitude of the problem.

The Reemergence Of Vaccine Nationalism, Ana Santos Rutschman

All Faculty Scholarship

This short essay explores the reemergence of vaccine nationalism during the COVID-19 pandemic. The essay traces the pre-COVID origins of vaccine nationalism and explains how it can have detrimental effects on equitable access to newly developed vaccines.

Substance Use Disorder, Discrimination, And The Cares Act: Using Disability Law To Strengthen New Protections, Kelly K. Dineen, Elizabeth Pendo

All Faculty Scholarship

The COVID-19 pandemic is having devastating consequences for people with substance use disorders (SUD). SUD is a chronic health condition—like people with other chronic health conditions, people with SUD experience periods of remission and periods of exacerbation and relapse. Unlike people with most other chronic conditions, people with SUD who experience a relapse may face criminal charges and incarceration. They are chronically disadvantaged by pervasive social stigma, discrimination, and structural inequities. People with SUD are also at higher risk for both contracting the SARS-CoV-19 virus and experiencing poorer outcomes. Meanwhile, there are early indications that pandemic conditions have led to …

Protecting The Rights Of People With Disabilities, Elizabeth Pendo

All Faculty Scholarship

One in four Americans — a diverse group of 61 million people — experience some form of disability (Okoro, 2018). On average, people with disabilities experience significant disparities in education, employment, poverty, access to health care, food security, housing, transportation, and exposure to crime and domestic violence (Pendo & Iezzoni, 2019). Intersections with demographic characteristics such as race, ethnicity, gender, and LGBT status, may intensify certain inequities. For example, women with disability experience greater disparities in income, education, and employment (Nosek, 2016), and members of under-served racial and ethnic groups with disabilities experience greater disparities in health status and access …

Vaccine Hesitancy: Experimentalism As Regulatory Opportunity, Ana Santos Rutschman, Timothy L. Wiemken

All Faculty Scholarship

This symposium on patient innovation has prompted us to explore problems related to departures from official vaccination schedules. At a time in which vaccine confidence has been plummeting across the world, we argue that a more granular understanding—and ultimately a more finely tuned regulatory framework—is needed to reflect the current behavioral heterogeneity among indicated patients who choose to forego or delay administration of recommended vaccines. In particular, we focus on a phenomenon we term “vaccine staggering:” a departure from vaccination schedules in the form of delays in receiving one or more vaccines, which is motivated by the desire to boost …

Synthesis Of Radioluminescent Caf2:Ln Core, Mesoporous Silica Shell Nanoparticles For Use In X-Ray Based Theranostics, Hayden Winter, Megan J. Neufeld, Lydia Makotamo, Conroy Sun, Andrea M. Goforth

Chemistry Faculty Publications and Presentations

X-ray radiotherapy is a common method of treating cancerous tumors or other malignant lesions. The side effects of this treatment, however, can be deleterious to patient quality of life if critical tissues are affected. To potentially lower the effective doses of radiation and negative side-effects, new classes of nanoparticles are being developed to enhance reactive oxygen species production during irradiation. This report presents the synthesis and radiotherapeutic efficacy evaluation of a new nanoparticle formulation designed for this purpose, composed of a CaF₂ core, mesoporous silica shell, and polyethylene glycol coating. The construct was additionally doped with Tb and Eu …

A Simple Technique For The Management Of Refractory Gastrostomy Site Complications A Technical Innovation In Gastrostomy Tube Site Revision, Rebecca M. Rentea, Wendy Jo Svetanoff, Charlene Dekonenko, Courtney Pisano, Charles L. Snyder

Manuscripts, Articles, Book Chapters and Other Papers

Introduction

Longstanding gastrostomy sites are prone to leakage and excoriation secondary to protrusion of gastric mucosa into the tract, dilation of the site over time, and development of refractory granulation tissue. Surgical revision with creation of a new gastric and skin exit site can be difficult. We describe a technique to re-site a gastrostomy tube (GT) utilizing the existing GT site.

Materials and methods

For one patient with gastrostomy site refractory complications, we re-sited the GT using the existing site. A clamp was placed through the old GT site and was palpated through the abdominal wall. An incision over the …

Pentalogy Of Cantrell, Muhammad Khawar Sana, Rebecca M. Rentea

Manuscripts, Articles, Book Chapters and Other Papers

Pentalogy of Cantrell (POC) is a collection of five congenital midline birth anomalies that present a distinctive challenge for clinicians and surgeons. Those five defects are of the heart, pericardium, diaphragm, sternum, and abdominal wall. This condition has been divided into two categories, complete or partial. Complete, as the name indicates, refers to the presence of all five defects, while others may present with only partial defects. It is also referred to as thoracoabdominal ectopia cordis, a condition where the heart is covered by an omphalocele-like membrane. Ectopia cordis (EC) is often found in fetuses with POC. Infants usually have …

Retroperitoneal Hematoma, Christopher Mondie, Rebecca M. Rentea

Manuscripts, Articles, Book Chapters and Other Papers

Retroperitoneal hematoma is defined as bleeding into the retroperitoneal space. This clinical entity is often occult and under-recognized by clinicians and is a cause of significant morbidity and mortality. Often patients do not manifest clinically apparent signs and symptoms until a substantial amount of blood loss has occurred. It is not uncommon for patients to present in frank hemorrhagic shock due to an underlying retroperitoneal hematoma. The retroperitoneal space lies directly posterior to the peritoneal cavity. An organizational schema dividing the retroperitoneal space into three different “zones” is widely prevalent in the surgical literature. The central-medial zone (Zone I) falls …

Trend In Male Engagement In Maternal And Newborn Health Services In Ethiopia, Wubite Bekele Bogale

Dissertations and Theses @ UNI

There is a growing recognition among government and local public health systems in Ethiopia that male partners engagement and support during pregnancy and beyond can contribute to improvement in maternal and newborn health (MNH) outcomes and equitable gender roles. Men’s engagement in MNH is associated with the reduction of newborn and maternal mortality. However, in Ethiopia, there is a dearth of evidence on the trend of male engagement in MNH and the differences in male engagement between regional states. This study sought to explore the temporal trend and regional differences in male engagement in MNH in Ethiopia.

Data used for …

Rna Sequencing Of Human Peripheral Nerve In Response To Injury: Distinctive Analysis Of The Nerve Repair Pathways., Andrew S. Welleford, Jorge E. Quintero, Nader El Seblani, Eric Blalock, Sumedha Gunewardena, Steven M. Shapiro, Sean M. Riordan, Peter Huettl, Zain Guduru, John A. Stanford, Craig G. Van Horne, Greg A. Gerhardt

Manuscripts, Articles, Book Chapters and Other Papers

The development of regenerative therapies for central nervous system diseases can likely benefit from an understanding of the peripheral nervous system repair process, particularly in identifying potential gene pathways involved in human nerve repair. This study employed RNA sequencing (RNA-seq) technology to analyze the whole transcriptome profile of the human peripheral nerve in response to an injury. The distal sural nerve was exposed, completely transected, and a 1 to 2 cm section of nerve fascicles was collected for RNA-seq from six participants with Parkinson's disease, ranging in age between 53 and 70 yr. Two weeks after the initial injury, another …

Feasibility Of A Readiness Exam For Predicting Radiography Program Success: A Pilot Study, Tammy L. Webster, Sarah B. Mcbrien, Gregory M. Mehrer, Harlan R. Sayles

Internet Journal of Allied Health Sciences and Practice

ABSTRACT

Background: Research investigating predictors of academic success in rigorous health science education is valuable for curricular intervention for identified at-risk students. Various predictors of success have been investigated, but the literature is insufficient when examining anatomy and physiology readiness scores as they correlate to radiography curricular success. This pilot study assessed the correlation between readiness exam scores and programmatic course GPA to determine if the scores could be used as a metric for identifying academic success resources for incoming students. Cohorts of the radiography program at a midwestern health sciences center demonstrated a longitudinal trend of difficulty with anatomy …

Ampk In The Ventromedial Nucleus Of The Hypothalamus: A Key Regulator For Thermogenesis, Hailan Liu, Yong Xu, Fang Hu

Children’s Nutrition Research Center Staff Publications

Obesity has become a global health issue, but effective therapies remain very limited. Adaptive thermogenesis promotes weight loss by dissipating energy in the form of heat, thereby representing a promising target to counteract obesity. Notably, the regulation of thermogenesis is tightly orchestrated by complex neuronal networks, especially those in the hypothalamus. Recent evidence highlights the importance of adenosine monophosphate-activated protein kinase (AMPK) within the ventromedial nucleus of the hypothalamus (VMH) in modulating thermogenesis. Various molecules, such as GLP-1, leptin, estradiol, and thyroid hormones, have been reported to act on the VMH to inhibit AMPK, which subsequently increases thermogenesis through the …

Development Of A Rapid And Efficient Protoplast Isolation And Transfection Method For Chickpea (Cicer Arietinum), Ninghui Cheng, Paul A Nakata

Children’s Nutrition Research Center Staff Publications

Chickpea (Cicer arietinum L.) is the second most important grain legume worldwide. Recent advances in the sequencing of the chickpea genome has provided a new and valuable resource to aid efforts in gene discovery and crop trait improvement. Technical difficulties in stable chickpea transgenics and the lack of a transient expression system for rapid analysis of gene expression and function; however, has limited the usefulness of this genomic resource. As a step toward alleviating this limitation, we report here the development of a simple and efficient transient gene expression protocol. Using leaves from chickpea seedlings, we have established a …

Classify Multicategory Outcome In Patients With Lung Adenocarcinoma Using Clinical, Transcriptomic And Clinico-Transcriptomic Data: Machine Learning Versus Multinomial Models, Fei Deng, Lanlan Shen, He Wang, Lanjing Zhang

Children’s Nutrition Research Center Staff Publications

Classification of multicategory survival-outcome is important for precision oncology. Machine learning (ML) algorithms have been used to accurately classify multi-category survival-outcome of some cancer-types, but not yet that of lung adenocarcinoma. Therefore, we compared the performances of 3 ML models (random forests, support vector machine [SVM], multilayer perceptron) and multinomial logistic regression (Mlogit) models for classifying 4-category survival-outcome of lung adenocarcinoma using the TCGA. Mlogit model overall performed similar to SVM and multilayer perceptron models (micro-average area under curve=0.82), while random forests model was inferior. Surprisingly, transcriptomic data alone and clinico-transcriptomic data appeared sufficient to accurately classify the 4-category survival-outcome …

Potential Impacts Of Artificial Intelligence On Spine Imaging Interpretation And Diagnosis, David Howard Durrant

Walden Dissertations and Doctoral Studies

Spine and related disorders represent one of the most common causes of pain and disability in the United States. Imaging represents an important diagnostic procedure in spine care. Imaging studies contain actionable data and insights undetectable through routine visual analysis. Convergent advances in imaging, artificial intelligence (AI), and radiomic methods has revealed the potential of multiscale in vivo interrogation to improve the assessment and monitoring of pathology. AI offers various types of decision support through the analysis of structured and unstructured data. The primary purpose of this qualitative exploratory case study was to identify the potential impacts of AI solutions …

Caring For Children In Child Welfare Systems: A Trauma-Informed Model Of Integrated Primary Care, Jill Mcleigh, Laura Lamminen, Heidi Roman

Integrated, Trauma-Informed Care

Children involved with the child welfare system have high rates of behavioral health concerns, chronic health conditions, and developmental disabilities. Further, as a result of the complicated relationships among the court system, child protective services, and caregivers (i.e., biological, kinship, and/or foster caregivers) and the high volume of health-, behavior-, and development-related services children in care need, the services they receive tend to be fragmented and problem driven. On top of these challenges, children involved with the child welfare system have been exposed to trauma, and often more than one form of trauma. Taken together, these factors point to the …

The Efficacy Of Warm Compresses In The Treatment Of Meibomian Gland Dysfunction And Demodex Folliculorum Blepharitis, Orla Murphy, Veronica O'Dwyer, Aoife Lloyd-Mckernan

Articles

Purpose: To investigate and compare the effect of warm compresses on meibomian gland dysfunction and Demodex folliculorum blepharitis.

Methods: Forty-two subjects (13 males, 29 females; mean age of 56.45 years) enrolled and completed the two-month warm compress treatment study. Three warm compress therapies were compared: Warm face cloth, MGDRx EyeBag® and OPTASETM Moist Heat Mask. Subjects attended for four visits: baseline, two weeks, four weeks, and eight weeks. Subjective symptoms, osmolarity, non-invasive tear break-up time, ocular surface staining, Schirmer I test, meibum expressibility and clarity, and eyelash manipulation and epilation to assess for the presence of Demodex folliculorum, …

Recent Advances In Understanding And Management Of Bronchopulmonary Dysplasia, Vineet Bhandari, Mitali Sahni

School of Medicine Faculty Research

© 2020 Sahni M and Bhandari V. In the current era, the survival of extremely low-birth-weight infants has increased considerably because of new advances in technology; however, these infants often develop chronic dysfunction of the lung, which is called bronchopulmonary dysplasia (BPD). BPD remains an important cause of neonatal mortality and morbidity despite newer and gentler modes of ventilation. BPD results from the exposure of immature lungs to various antenatal and postnatal factors that lead to an impairment in lung development and aberrant growth of lung parenchyma and vasculature. However, we still struggle with a uniform definition for BPD that …

Understanding Disparities In Post-Mastectomy Breast Reconstruction Utilization In The Rural State Of Nevada, Maxwell O. Vest Md, Richard C. Baynosa Md, Shelley J. Williams Ms, Chad L. Cross Phd, Sabrina Antonio Bs

School of Medicine Faculty Research

Purpose: Despite federally mandated insurance coverage and clear benefits of breast reconstruction after mastectomy, reported rates remain low at 23-63%. We hypothesize that rates and types of reconstruction would be disproportionately lower in the rural state of Nevada. The goal of this study was to identify and understand disparities in breast reconstruction utilization in Nevada compared to the nation. Methods: Breast cancer patient information (2008-2013) was aggregated from AHRQ’s HCUP Nationwide Inpatient Sample (NIS) and the Nevada State Inpatient Database (NV SID). Chi-square analysis for two population proportions was used to determine differences between the NV SID (n=7,466) and NIS …

Health Care Professionals’ Compliance To Tracheal Suctioning Policy At A Tertiary Care Hospital, Rozina Khimani, Fauziya Ali, Salma Amin Rattani, Mohammad Sohail Awan

Department of Surgery Docs

Objective: To assess the compliance of tracheal suctioning practices against the standard guidelines of a tertiary care hospital, with regard to the participants’ professional characteristics.
Methods: Using cross sectional study design, forty health care professionals (HCPs) were assessed twice, using a quantitative structured observational design, for tracheal suctioning practices, in one of the surgical care units of the tertiary care hospital. Tracheal suctioning policy which was used as a tool, its inter-rater reliability was tested and each step showed the Kappa value of 0.65 to 1.000. Data was analyzed using epidata info version 3.5.1 and SPSS version 19.
Results: From …

Asthma-Copd Overlap: Economic Burden And Medication Adherence, Mona Nili

Graduate Theses, Dissertations, and Problem Reports (ETD)

In many older adults, asthma and chronic obstructive pulmonary disease (COPD) coexist as “Asthma-COPD overlap” (ACO). This dissertation pursued three Aims: 1) estimate the economic burden of ACO and its contributory factors; 2) evaluate the association of ACO to “cost-related medication nonadherence” (CRN); and 3) identify adherence trajectory patterns and examine the impact of initial maintenance therapies (IMT) type (inhaled corticosteroids monotherapy (ICS) vs. fixed-dose combination of ICS and long-acting beta agonist (ICS/LABA)) on adherence trajectory patterns among older adults Medicare Beneficiaries. The first and second Aims were cross-sectional studies by using Medicare Current Beneficiary Survey data. For the third …

Evidence Of Y Chromosome Long Non-Coding Rnas Involved In The Radiation Response Of Male Non-Small Cell Lung Cancer Cells, Tayvia Brownmiller

Graduate Theses, Dissertations, and Problem Reports (ETD)

Non-small cell lung cancer (NSCLC) is the number one cause of cancer related mortality in the United States and worldwide. Advanced and therapeutically resistant lung tumors contribute to the high rate of mortality from NSCLC, therefore there is a need for new methods of diagnosing and treating this disease. Long non-coding RNAs (lncRNAs) have been shown to be a crucial component of human molecular biology, regulating nearly every cellular pathway from chromatin condensation to transcription and translation. Furthermore, many lncRNAs have been classified as oncogenes or tumor suppressors, highlighting the various molecular mechanisms they are involved in regarding the formation …

Association Of Common Chronic Pain Conditions To Incident Alzheimer’S Disease And Related Dementias In Two Cohorts Of Older Medicare Beneficiaries, Sumaira Khalid

Graduate Theses, Dissertations, and Problem Reports (ETD)

Objective: The purpose of this research was to study the collective and incremental association of common non-cancer chronic pain conditions (NCPC) to risk for Alzheimer’s disease and related dementias (ADRD); to explore the potential mediating influence of mood and sleep disorders; and to assess the potential synergistic effects of NCPC’s and multimorbidity on ADRD risk. This research also aimed to study the contribution of NCPC to ADRD risk in poor, rural, underserved United States populations who suffer a disproportionate burden of ADRD risk factors. To achieve these goals, this dissertation pursued three specific aims: 1) assess the association of …

Pilot Study Of Behavioral Activation As Adjunct Treatment For Depression In Primary Care, Lindsay Ellen Toler

Graduate Theses, Dissertations, and Problem Reports (ETD)

Many individuals receiving care at a predominantly free primary health care clinic in the northern part of West Virginia are experiencing depression, and medication therapy is the most common form of management with limited resources for psychosocial treatment. Brief psychosocial therapy interventions provided by the primary care provider should be explored as an adjunct treatment for this population in the primary care setting.

A pilot study was conducted to explore the integration of behavioral activation, a brief psychosocial intervention focused on decreasing depressed behavior by increasing nondepressed behavior to reinforce corresponding improvements in mood. Eligible patients were invited to attend …

Accuracy Of Blx And Blt Guided Implants In The Edentulous Maxilla: An In Vivo Study, Benjamin Andrew Kordusky

Graduate Theses, Dissertations, and Problem Reports (ETD)

Objectives: To determine the accuracy of dental implants placed using a dual scan CBCT protocol with a SLA 3D printed mucosa supported surgical guide using a flapless surgical approach with regard to sleeve position, type of implant, and regional location in the maxillary arch.

Methods: Nine patients received 4 dental implants utilizing a fully guided, flapless approach with a mucosa supported SLA surgical guide with 3 fixation pins. Implants were immediately loaded using an attachment placed in an existing Maxillary complete denture. Accuracy of implant positions were evaluated by the Treatment Evaluation module of coDiagnostiX (DentalWings, Montreal, Canada). Statistical analysis …

Individual And Community Social Determinants Of Health Associated With Diabetes Management In A Mexican American Population, Kehe Zhang, Belinda Reininger, Miryoung Lee, Qian Xiao, Cici Bauer

Faculty, Staff and Student Publications

Background: Diabetes is a major health burden in Mexican American populations, especially among those in the Lower Rio Grande Valley (LRGV) in the border region of Texas. Understanding the roles that social determinants of health (SDOH) play in diabetes management programs, both at the individual and community level, may inform future intervention strategies.

Methods: This study performed a secondary data analysis on 1,568 individuals who participated in Salud y Vida (SyV), a local diabetes and chronic disease management program, between October 2013 and September 2018 recruited from a local clinic. The primary outcome was the reduction of hemoglobin A1C (HbA1C) …

Dynamic Prostatic And Laser-Ablated Lesion Volume Change After Transperineal Laser Ablation In Canine: Preliminary Observation And Its Clinical Significance., Rui-Qing Liu, Ji-Bin Liu, Shao-Bo Duan, Si-Guo Cheng, Zhi-Yang Chang, Hui-Cun Cao, Guang-Shao Cao, Ya-Qiong Li, Na Li, Lian-Zhong Zhang

Department of Radiology Faculty Papers

AIM: The purpose of this study is to observe the volume change of prostate and laser-ablated lesions in the canine and to explore the mechanism and clinical significance through histopathology.

MATERIALS AND METHODS: Transperineal laser ablation (TPLA) was performed under the guidance of transrectal ultrasound (TRUS) in eight canines. Two canines were sacrificed 1 day and 1 week after TPLA, respectively. The remaining six canines were sacrificed after finishing transrectal contrast-enhanced ultrasound (TR-CEUS) at three phases.

RESULTS: The prostatic volumes immediately following TPLA and 1 week later were larger than before TPLA (20.1 ± 3.9 vs 17.1 ± 3.8 ml; …