Medical Specialties Commons^™

Concussion-Related Alterations In Neural Activity During Emotion Recognition: Case Studies Of Short-Term And Residual Effects, Joshua Ricker, Kylee Smith, Alexandra Schmidt, Andrea Cripps, Palguna Thalla, Howard C. Cromwell, Xin Wang

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Concussions have recently become an area of concern among the general public, but a clear understanding of their total consequence is still being developed. Symptoms of concussions are wide-ranging, encapsulating a plethora of cognitive and emotional abilities that could be affected. Concussions transiently disrupt neural activation as well as behavioral responses across multiple categories. Skills pertaining to various aspects of emotions are often affected yet have rarely been studied after concussions. We present two case studies of collegiate athletes with a history of multiple concussions. This paper highlights the case of a collegiate athlete who had obtained two previous concussions …

The Impact Grit And Achievement Goal Orientation Have On Athletic Training Students' Persistence, Hannah M. Harnar, Kimberly S. Peer, Chris A. Moser, John Cindric

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Purpose: Athletic training education continues to evolve thereby increasing the importance of student retention. Understanding student motivation through achievement goal orientation and grit scores may help support student’s persistence in an athletic training program. The purpose was to determine if a relationship exists between achievement goal orientation and grit to help provide educators a better understanding of their students’ reasons for persisting to help improve retention. Methods: An achievement goal orientation survey and grit scale were administered, and quantitative data was analyzed statistically from Commission on Accreditation of Athletic Training Education- accredited programs in good standing for the 2018-2019 …

Mindfulness Training's Effect Of Pain Outcomes In Musculoskeletal Pain: A Systematic Review, Elizabeth Cruze, Kenneth E. Games

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Purpose: Athletic trainers frequently address and treat musculoskeletal pain (MSK). Complementary and alternative techniques for treating pain are becoming more widely accepted and utilized in clinical practice. Mindfulness based stress reduction (MBSR) is a meditation-based program that is designed to help patients learn to feel things in a non-judgmental way. Previous systematic reviews on mindfulness training have focused a range of conditions including IBS, fibromyalgia, and migraines. The purpose of this systematic review was to examine if the literature supports the use of MBSR as an intervention for MSK pain. Methods: We completed a systematic review utilizing PRISMA guidelines. Inclusion …

Post Traumatic Internal Iliac Arteriovenous Fistula Presenting With Persistent Gross Hematuria., Amanda Smart, Michael Wynne, Daniel Stein

Urology Faculty Publications

No abstract provided.

Covid-19 Newsletter (Vol. 96), Center For Disaster Medicine, New York Medical College

COVID-19 Newsletter

No abstract provided.

Randomized And Non-Randomized Designs For Causal Inference With Longitudinal Data In Rare Disorders., Rima Izem, Robert Mccarter

Pediatrics Faculty Publications

In the United States, approximately 7000 rare diseases affect 30 million patients, and only 10% of these diseases have existing therapies. Sound study design and causal inference methods are essential to demonstrate the therapeutic efficacy, safety, and effectiveness of new therapies. In the rare diseases setting, several factors challenge the use of typical parallel control designs: the small patient population size, genotypic and phenotypic diversity, and the complexity and incomplete understanding of the disorder's progression. Repeated measures, when spaced appropriately relative to disease progression and exploited in design and analysis, can increase study power and reduce variability in treatment effect …

Fever In A Returning Traveler: A Case And Literature Review Of Melioidosis, Akanksha Arya, Hamadullah Shaikh, Devin Weber, Matthew Pettengill, Sean Moss

Division of Infectious Diseases and Environmental Medicine Faculty Papers

Burkholderia pseudomallei is an aerobic, motile, non-spore-forming gram-negative bacillus found in tropical endemic environments that causes the disease melioidosis. Melioidosis displays a diversity of clinical presentations ranging from septic shock to chronic latent infection, often with characteristic abscesses in multiple organs. Melioidosis is an opportunistic infection, with risk factors, including diabetes, alcohol use, chronic lung disease, and chronic renal disease, and these risk factors increase the severity of disease (Wiersinga et al., 2006) [1]. In this case report, we illustrate a case of a 32 year old man with several risk factors and recent travel to an endemic region presenting …

A Study On The Efficacy Of A Naloxone Training Program, Gillian A. Beauchamp Md, Hoonani M. Cuadrado, Seth A. Campbell Pa-C, Bennie Eliason Chw, Chase Jones Do, Aaron Fedor Do, Lauren Grantz Pharmd, Csp, Paige Roth Lsw, Marna Greenberg

Department of Emergency Medicine

Introduction: The use of naloxone to reverse a potentially fatal opioid overdose is a harm reduction strategy that reduces mortality and increases the potential for referral to substance use treatment for affected individuals. In the setting of outreach performed by a street medicine team, we aimed to determine the effectiveness of an educational intervention involving distribution of naloxone accompanied by a brief instructive session about opioids, opioid overdose, and medication administration. Methods: Our street medicine outreach team distributed 200 naloxone kits to clinicians and volunteers involved in caring for patients on ‘street rounds,’ as well as in shelters, soup kitchens, …

Return-To-Play Rates And Clinical Outcomes Of Baseball Players After Concomitant Ulnar Collateral Ligament Reconstruction And Selective Ulnar Nerve Transposition., Somnath Rao, Taylor D'Amore, Donald P. Willier, Richard J. Gawel, Robert A Jack, Steven B. Cohen, Michael G. Ciccotti

Rothman Institute Papers

Background: Injury to the ulnar collateral ligament (UCL) leading to medial elbow instability and possible ulnar neuritis is common in overhead-throwing athletes. Treatment may require UCL reconstruction (UCLR) and concomitant ulnar nerve transposition (UNT) for those with preoperative ulnar neuritis.

Purpose: To evaluate the return-to-play (RTP) rates, clinical outcomes, and rates of persistent ulnar neuritis after concomitant UCLR and UNT in a cohort of baseball players with confirmed preoperative ulnar neuritis.

Study Design: Case series; Level of evidence, 4.

Methods: Eligible patients were those who underwent concomitant UCLR and UNT at a single institution between January 2008 and June 2018 …

Multi-Vendor And Multisite Evaluation Of Cerebrovascular Reactivity Mapping Using Hypercapnia Challenge, Peiying Liu, Dengrong Jiang, Marilyn Albert, Christopher E. Bauer, Arvind Caprihan, Brian T. Gold, Steven M. Greenberg, Karl G. Helmer, Kay Jann, Gregory A. Jicha, Pavel Rodriguez, Claudia L Satizabal, Sudha Seshadri, Herpreet Singh, Jeffrey F. Thompson, Danny J. J. Wang, Hanzhang Lu

Neuroscience Faculty Publications

Cerebrovascular reactivity (CVR), which measures the ability of cerebral blood vessels to dilate or constrict in response to vasoactive stimuli such as CO2 inhalation, is an important index of the brain's vascular health. Quantification of CVR using BOLD MRI with hypercapnia challenge has shown great promises in research and clinical studies. However, in order for it to be used as a potential imaging biomarker in large-scale and multi-site studies, the reliability of CO2-CVR quantification across different MRI acquisition platforms and researchers/raters must be examined. The goal of this report from the MarkVCID small vessel disease biomarkers consortium is to evaluate …

Enhancing Cancer Care Of Rural Dwellers Through Telehealth And Engagement (Encore): Protocol To Evaluate Effectiveness Of A Multi-Level Telehealth-Based Intervention To Improve Rural Cancer Care Delivery, Tuya Pal, Pamela C. Hull, Tatsuki Koyama, Phillip Lammers, Denise Martinez, Jacob Mcarthy, Emma Schremp, Ann Tezak, Anne Washburn, Jennifer G. Whisenant, Debra L. Friedman

Markey Cancer Center Faculty Publications

BACKGROUND: Despite lower cancer incidence rates, cancer mortality is higher among rural compared to urban dwellers. Patient, provider, and institutional level factors contribute to these disparities. The overarching objective of this study is to leverage the multidisciplinary, multispecialty oncology team from an academic cancer center in order to provide comprehensive cancer care at both the patient and provider levels in rural healthcare centers. Our specific aims are to: 1) evaluate the clinical effectiveness of a multi-level telehealth-based intervention consisting of provider access to molecular tumor board expertise along with patient access to a supportive care intervention to improve cancer care …

High-Fructose, High-Fat Diet Alters Muscle Composition And Fuel Utilization In A Juvenile Iberian Pig Model Of Non-Alcoholic Fatty Liver Disease, Heather C Spooner, Stefani A Derrick, Magdalena Maj, Rodrigo Manjarín, Gabriella V Hernandez, Deepali S Tailor, Parisa S Bastani, Rob K Fanter, Marta L Fiorotto, Douglas G Burrin, Michael R La Frano, Angelos K Sikalidis, Jason M Blank

Children’s Nutrition Research Center Staff Publications

Non-alcoholic fatty liver disease (NAFLD) is a serious metabolic condition affecting millions of people worldwide. A “Western-style diet” has been shown to induce pediatric NAFLD with the potential disruption of skeletal muscle composition and metabolism. To determine the in vivo effect of a “Western-style diet” on pediatric skeletal muscle fiber type and fuel utilization, 28 juvenile Iberian pigs were fed either a control diet (CON) or a high-fructose, high-fat diet (HFF), with or without probiotic supplementation, for 10 weeks. The HFF diets increased the total triacylglycerol content of muscle tissue but decreased intramyocellular lipid (IMCL) content and the number of …

Aberrant Crosstalk Between Insulin Signaling And Mtor In Young Down Syndrome Individuals Revealed By Neuronal-Derived Extracellular Vesicles, Marzia Perluigi, Anna Picca, Elita Montanari, Riccardo Calvani, Federico Marini, Roberto Matassa, Antonella Tramutola, Alberto Villani, Giuseppe Familiari, Fabio Di Domenico, D. Allan Butterfield, Kenneth J. Oh, Emanuele Marzetti, Diletta Valentini, Eugenio Barone

Chemistry Faculty Publications

INTRODUCTION: Intellectual disability, accelerated aging, and early-onset Alzheimer-like neurodegeneration are key brain pathological features of Down syndrome (DS). Although growing research aims at the identification of molecular pathways underlying the aging trajectory of DS population, data on infants and adolescents with DS are missing.

METHODS: Neuronal-derived extracellular vesicles (nEVs) were isolated form healthy donors (HDs, n = 17) and DS children (n = 18) from 2 to 17 years of age and nEV content was interrogated for markers of insulin/mTOR pathways.

RESULTS: nEVs isolated from DS children were characterized by a significant increase in pIRS1^Ser636, a marker of …

A Biocultural Analysis Of The Impacts Of Interactions Between West Africans And Europeans During The Trans-Atlantic Trade At Elmina, Ghana, Heidi Ellen Miller

USF Tampa Graduate Theses and Dissertations

This project utilizes a biocultural approach to assess the demographics and health of the West African population from Elmina, Ghana. Elmina, selected by the Portuguese in 1482 as the site of the first European trade fort in sub-Saharan Africa, grew from a small coastal fishing village to a large settlement over the course of more than 400 years of trade and cultural entanglement. Taken over by the Dutch and then ceded to the British, the people of Elmina navigated significant cultural changes, changes and experiences that can be detected in their skeletal remains. Bioarchaeological research concerned with the effects of …

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 …

Nitrous Oxide Adaptation On Gene Expression In Breast Cancer Cells, Harsh Chheda, Estevan Ruiz Limón López, Zainab Mahmood, Ankit Sharma, Tina Tran, Uzma Abdulbaseer, Farouk Alshatti, James A. Radosevich

Chemistry and Physics Faculty Proceedings, Presentations, Speeches, Lectures

Hypothesis and Objective: Genes participating in the notch signaling pathway are influenced by exposure to high nitrous oxide (HNO) levels. Notch signaling pathway genes are responsible for regulating cell fate, differentiation, and apoptosis. Dysregulation of these genes can contribute to tumorigenesis. Alterations in the expression of these genes in MCF7 breast cancer cells could help determine the effects of the notch signaling pathway on tumorigenesis as a result of exposure to nitrous oxide.

Methods: Samples of cDNA from MCF7 and MCF7-HNO cells were used in DNA microarray analysis. Qualifying genes of interest provided a p value < .05. Differentially expressed genes (DEGs) were defined and categorized using the Gene Oncology Uniprot (GO) Molecular Function database. These cells were further analyzed using a proprietary bioinformatics analysis created by our laboratory.

Results: Exposure to HNO …

Muc1 Ectodomain Is A Flagellin-Targeting Decoy Receptor And Biomarker Operative During Pseudomonas Aeruginosa Lung Infection., Avelino C Verceles, Pavan Bhat, Zain Nagaria, Destiny Martin, Harsh Patel, Afua Ntem-Mensah, Sang W Hyun, Andrea Hahn, Jean Jeudy, Alan S Cross, Erik P Lillehoj, Simeon E Goldblum

Pediatrics Faculty Publications

No abstract provided.

Scaling A Community-Wide Campaign Intervention To Manage Hypertension And Weight Loss, Belinda M. Reininger, Lisa A. Mitchell-Bennett, Minjae Lee, Paul G. Yeh, Amanda C. Davé, Soo Kyung Park, Tianlin Xu, Alma G. Ochoa-Del Toro

Physician Assistant Studies Faculty Publications

Public health impacts can be achieved when evidence-based interventions are implemented to those most in need. Too often implementation never or slowly occurs. The community-wide campaign intervention Tu Salud ¡Si Cuenta! has evidence of improving health outcomes related to chronic disease among low-income, Latinos. Using the RE-AIM Framework, this study examined if the scaled-up version of the intervention is associated with improvements in hypertension and obesity in 12 locations. Each element of the RE-AIM framework was examined. For "Effectiveness," we examined outcomes overall and by implementing location. We used linear and logistic regression to assess if exposure in the intervention …

Class Imbalance In Out-Of-Distribution Datasets: Improving The Robustness Of The Textcnn For The Classification Of Rare Cancer Types, Kevin De Angeli, Shang Gao, Ioana Danciu, Eric B. Durbin, Xiao Cheng Wu, Antoinette Stroup, Jennifer Doherty, Stephen Schwartz, Charles Wiggins, Mark Damesyn, Linda Coyle, Lynne Penberthy, Georgia D. Tourassi, Hong Jun Yoon

School of Public Health Faculty Publications

In the last decade, the widespread adoption of electronic health record documentation has created huge opportunities for information mining. Natural language processing (NLP) techniques using machine and deep learning are becoming increasingly widespread for information extraction tasks from unstructured clinical notes. Disparities in performance when deploying machine learning models in the real world have recently received considerable attention. In the clinical NLP domain, the robustness of convolutional neural networks (CNNs) for classifying cancer pathology reports under natural distribution shifts remains understudied. In this research, we aim to quantify and improve the performance of the CNN for text classification on out-of-distribution …

Dna Damage Is Overcome By Trip13 Overexpression During Cisplatin Nephrotoxicity, Taketsugu Hama, Prashanth K.B. Nagesh, Pallabita Chowdhury, Bob M. Moore Ii, Murali M. Yallapu, Kevin R. Regner, Frank Park

School of Medicine Publications

Cisplatin is a commonly used chemotherapeutic agent to treat a wide array of cancers that is frequently associated with toxic injury to the kidney due to oxidative DNA damage and perturbations in cell cycle progression leading to cell death. In this study, we investigated whether thyroid receptor interacting protein 13 (TRIP13) plays a central role in the protection of the tubular epithelia following cisplatin treatment by circumventing DNA damage. Following cisplatin treatment, double-stranded DNA repair pathways were inhibited using selective blockers to proteins involved in either homologous recombination or non-homologous end joining. This led to increased blood markers of acute …

Daily Phonatory Activity Of Individuals With Parkinson’S Disease, Jeff Searl, Angela M. Dietsch

Department of Special Education and Communication Disorders: Faculty Publications

Purpose

This study evaluated the amount of phonatory activity of Persons with Parkinson disease (PwPD) compared to adults without Parkinson’s disease measured over 3 days. The relationship between the amount of phonatory activity and Voice Handicap Index (VHI) total score was assessed as were differences in voicing activity across 3 days of data collection.

Methods

Fifteen PwPD receiving dopaminergic medication and fifteen age and sex matched adults without Parkinson’s disease completed the VHI and then wore a VocaLog vocal monitor (VM) for 3 consecutive days. From the VM data, the number of 1-second windows with dB sound pressure level > 0 …

Low-Grade Primary Splenic Cd10-Positive Small B-Cell Lymphoma/Follicular Lymphoma, Rami Abdulbaki, Parastou Tizro, Victor E. Nava, Maria Gomes Da Silva, Joao L. Ascensao

Pathology Faculty Publications

No abstract provided.

Perspectives Of Black And Hispanic Children Living In Under-Resourced Communities On Meal Preparation And Grocery Shopping Behaviors: Implications For Nutrition Education, Chishinga Callender, Denisse Velazquez, Meheret Adera, Jayna M Dave, Norma Olvera, Tzuan A Chen, Shana Alford, Debbe Thompson

Children’s Nutrition Research Center Staff Publications

Minority children living in under-resourced communities are at the greatest risk for obesity and poor diet quality. Child involvement in meal preparation may be a helpful strategy to improve diet quality. This paper explores minority children's perspectives regarding this. Eighteen children participated in a mixed methods study (online surveys, telephone interviews). Descriptive statistics were calculated for child demographic and psychosocial factors. Thematic analysis was used to code and analyze the interviews. Most children reported having cooking experience (83%) and cooking with family (94%) and exhibited high cooking self-efficacy (21.8 ± 2.9) and positive cooking attitudes (25.7 ± 4.4). Children reported …

Construct Validity For The Self-Reported Competency And Sub-Construct Associated Characteristics Of Romanian Physicians In Autism Spectrum Disorder, Mohammad H Rahbar, Iuliana Dobrescu, Shezeen Gillani, Manouchehr Hessabi, Sori Kim, Mihaela Stancu, Florina Rad

Faculty, Staff and Student Publications

BACKGROUND: Lack of physicians' knowledge regarding mental health, including Autism Spectrum Disorder (ASD) could have adverse effects on affected individuals' health and quality of life. The purpose of this study was to provide construct validity for a modified questionnaire in order to determine the self-reported competency for underlying sub-constructs in ASD, make inferences on perceived competence in ASD based on a sample of Romanian physicians, and identify physicians' characteristics associated with these sub-domains of competency.

METHODS: For this survey, we modified a questionnaire that was used in Pakistan and Turkey, and administered it to a sample of 383 practicing physicians …

Overcoming The Covid-19 Pandemic For Dementia Research: Engaging Rural, Older, Racially And Ethnically Diverse Church Attendees In Remote Recruitment, Intervention And Assessment, Lisa Kirk Wiese, Ishan C. Williams, Nancy E. Schoenberg, James E. Galvin, Jennifer Lingler

Behavioral Science Faculty Publications

Background: Access to cognitive screening in rural underserved communities is limited and was further diminished during the COVID-19 pandemic. We examined whether a telephone-based cognitive screening intervention would be effective in increasing ADRD knowledge, detecting the need for further cognitive evaluation, and making and tracking the results of referrals.

Method: Using a dependent t-test design, older, largely African American and Afro-Caribbean participants completed a brief educational intervention, pre/post AD knowledge measure, and cognitive screening.

Results: Sixty of 85 eligible individuals consented. Seventy-percent of the sample self-reported as African American, Haitian Creole, or Hispanic, and 75% were female, with an average …

Attitudes Toward Osteopathic Medicine Scale: Development And Psychometrics, Mohammadreza Hojat Professor, Jennifer Desantis, Robert A Cain, Mark R Speicher, Lynn Bragan, Leonard H Calabrese

Department of Medicine Faculty Papers

Objective: To develop a valid and reliable instrument for measuring attitudes toward osteopathic medicine.

Methods: Participants included 5,669 first-year students from 33 U.S. colleges of osteopathic medicine, who completed an online survey at the beginning of the 2019-2020 academic year. Using data from the nationwide Project in Osteopathic Medical Education and Empathy, we developed a 13-item instrument: Attitudes Toward Osteopathic Medicine Scale (ATOMS) and demonstrated the validity and reliability of its scores. The social desirability response bias was controlled in statistical analyses.

Results: The corrected item-total score correlations were all positive and statistically significant, and the effect sizes of item …

A Community-Based Management Of Covid-19 In A Mobile Container Unit, Elena Petrova, Timothy Farinholt, Tejas P Joshi, Hannah Moreno, Mayar Al Mohajer, Shital M Patel, Joseph Petrosino, Sharmila Anandasabapathy

Faculty, Staff and Students Publications

Vaccine uptake is a multifactor measure of successful immunization outcomes that includes access to healthcare and vaccine hesitancy for both healthcare workers and communities. The present coronavirus disease (COVID-19) pandemic has highlighted the need for novel strategies to expand vaccine coverage in underserved regions. Mobile clinics hold the promise of ameliorating such inequities, although there is a paucity of studies that validate environmental infection in such facilities. Here, we describe community-based management of COVID-19 through a Smart Pod mobile clinic deployed in an underserved community area in the United States (Aldine, Harris County, TX, USA). In particular, we validate infection …

Metabolic Adaptation To The Chronic Loss Of Ca 2+ Signaling Induced By Ko Of Ip 3 Receptors Or The Mitochondrial Ca 2+ Uniporter, Michael P. Young, Zachary T Schug, David M. Booth, David I Yule, Katsuhiko Mikoshiba, György Hajnóczky, Suresh K Joseph

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Calcium signaling is essential for regulating many biological processes. Endoplasmic reticulum inositol trisphosphate receptors (IP3Rs) and the mitochondrial Ca2+ uniporter (MCU) are key proteins that regulate intracellular Ca2+ concentration. Mitochondrial Ca2+ accumulation activates Ca2+-sensitive dehydrogenases of the tricarboxylic acid (TCA) cycle that maintain the biosynthetic and bioenergetic needs of both normal and cancer cells. However, the interplay between calcium signaling and metabolism is not well understood. In this study, we used human cancer cell lines (HEK293 and HeLa) with stable KOs of all three IP3R isoforms (triple KO [TKO]) or MCU to examine metabolic and bioenergetic responses to the chronic …

Stimulating The Facial Nerve To Treat Ischemic Stroke: A Systematic Review, Turner S. Baker, Justin Robeny, Danna Cruz, Alexis Bruhat, Alfred-Marc Iloreta, Anthony Costa, Thomas James Oxley

Publications and Research

Acute ischemic stroke (AIS) is a common devastating disease that has increased yearly in absolute number of cases since 1990. While mechanical thrombectomy and tissue plasminogen activator (tPA) have proven to be effective treatments, their window-of-efficacy time is very short, leaving many patients with no viable treatment option. Over recent years there has been a growing interest in stimulating the facial nerves or ganglions to treat AIS. Pre-clinical studies have consistently demonstrated an increase in collateral blood flow (CBF) following ganglion stimulation, with positive indications in infarct size and neurological scores. Extensive human trials have focused on trans-oral electrical stimulation …

Acute Upper Gastrointestinal Bleeding–Impact Of Timing Of Endoscopy On Patient Outcomes: Impact Of Timing Of Endoscopy On Patient Outcomes, Abdullah Abbasi, Shima Ghavimi, Louis H. Lau, Cosmos Liutao Guo, Rashid Lui

Internal Medicine

Acute upper gastrointestinal bleeding (AUGIB) is one of the most common emergencies encountered by gastroenterologists across the world. Various medical and endoscopic therapies have evolved over time to improve patient outcomes. However, controversy still exists around the optimal time of endoscopy for patients with AUGIB. Recently, several studies have been published to answer this clinical question and we have reviewed one of these articles.

On 13th October 2021, @Gijournal, we discussed the latest high-impact article published to answer this clinical question. We critically appraised, ‘’Timing of endoscopy for acute upper gastrointestinal bleeding: a territory-wide cohort study’’ which was published in …