Medical Specialties Commons^™

Mcph1: A Novel Case Report And A Review Of The Literature, Stefano Giuseppe Caraffi, Marzia Pollazzon, Muhammad Farooq, Ambrin Fatima, Lars Allan Larsen, Roberta Zuntini, Manuela Napoli, Livia Garavelli

Department of Biological & Biomedical Sciences

Microcephaly primary hereditary (MCPH) is a congenital disease characterized by nonsyndromic reduction in brain size due to impaired neurogenesis, often associated with a variable degree of intellectual disability (ID). The genetic etiology of MCPH is heterogeneous and comprises more than 20 loci, nearly all following a recessive inheritance pattern. The first causative gene identified, MCPH1 or Microcephalin, encodes a centrosomal protein that modulates chromosome condensation and cell cycle progression. It is also involved in DNA damage response and telomere maintenance in the nucleus. Despite numerous studies on MCPH1 function, MCPH1-affected individuals are rare and the available clinical reports are …

Patterns Of Amygdala Region Pathology In Late-Nc: Subtypes That Differ With Regard To Tdp-43 Histopathology, Genetic Risk Factors, And Comorbid Pathologies, Matthew D. Cykowski, Anithachristy S. Arumanayagam, Suzanne Z. Powell, Andreana L. Rivera, Erin L. Abner, Gustavo C. Roman, Joseph C. Masdeu, Peter T. Nelson

Sanders-Brown Center on Aging Faculty Publications

Transactive response (TAR) DNA-binding protein 43 kDa (TDP-43) pathology is a hallmark of limbic-predominant agerelated TDP-43 encephalopathy (LATE). The amygdala is afected early in the evolution of LATE neuropathologic change (LATE-NC), and heterogeneity of LATE-NC in amygdala has previously been observed. However, much remains to be learned about how LATE-NC originates and progresses in the brain. To address this, we assessed TDP-43 and other pathologies in the amygdala region of 184 autopsied subjects (median age=85 years), blinded to clinical diagnoses, other neuropathologic diagnoses, and risk genotype information. As previously described, LATE-NC was associated with older age at death, cognitive impairment, …

Targeted Osmotic Lysis: A Novel Approach To Targeted Cancer Therapies, Harry J. Gould, Dennis Paul

School of Medicine Faculty Publications

The conventional treatment of cancer has been based on the delivery of non-selective toxins and/or ionizing energy that affect both the cancer and normal tissues in the hope of destroying the offending disease before killing the patient. Unfortunately, resistance often develops to these treatments and patients experience severe, dose-limiting adverse effects that reduce treatment efficacy and compromise quality of life. Recent advances in our knowledge of the biology of tumor cells and their microenvironment, the recognition of surface proteins that are unique to specific cancers and essential to cell growth and survival and signaling pathways associate with invasion and metastasis …

Spata7 Is Required For Maintenance Of The Retinal Connecting Cilium, Jiaxiong Lu, Kaitlyn Xiong, Xinye Qian, Jongsu Choi, Yoon-Kyung Shim, Jacob Burnett, Graeme Mardon, Rui Chen

Faculty, Staff and Students Publications

SPATA7, an early onset LCA3 retinal disease gene, encodes a putative scaffold protein that is essential for the proper assembly of the connecting cilium (CC) complex in photoreceptors. Previous studies have shown that SPATA7 interacts with other photoreceptor-specific ciliary proteins, such as RPGR and RPGRIP1, and maintains the integrity of CC integrity. However, although it is known that Spata7 is required for early formation of the CC, it is unclear if Spata7 is also required for the maintenance of the CC. To investigate Spata7 function in the retina at the adult stage, loss of function was induced in the …

Fall Risk Prediction Model For Older Men And Women Based On Ambulatory Physical Activity Level – A Cross-Sectional Population-Based Study From The Oporto Region, Paulo Jorge Quintela Cardoso-Carmo, Adjane Maria Pontes César, Manuel Rubim Silva Santos, Maria Joana Mesquita Barbosa De Carvalho

Baltic Journal of Health and Physical Activity

Introduction. Falls among the elderly are an important community health problem due to its high incidence, functional and social repercussion. Dissimilar results arose in recent studies concerning fall risk and physical activity levels. This study measures the association between physical activity (PA) levels, and fall risk (FR), investigates which levels of PA are influential in FR and presents a fall risk prediction models for the elderly. Material and Methods. One hundred and seventy elderly adults (72.34 ± 6.70 years old, 124 female), completed Performance-Orientated-Mobility-Assessment; PA was assessed by accelerometry. Pearson’s correlation verified the association between FR, Age, and PA. Multiple …

Self-Reported Arm Function Is Associated With Stress And Fear Of Physical Activity Among Women Treated For Breast Cancer, Mary Insana Fisher, Anne Fleischer, Kimberly Ulmer, Megan Mcclure, Renee Waldron, Lynn Difede

Physical Therapy Faculty Publications

Background: Self-reported upper extremity function and objective measures are not strongly associated with each other in women treated for breast cancer (BC). It is not known if the lack of relationship between self-reported upper extremity function and objective measurements may be influenced by perceived levels of stress and fear of physical activity. The purpose of this study was to investigate the relationships between self-reported upper extremity function and the following: perceived stress levels (PS), fear of physical activity (FPA), health-related quality of life (HRQOL), and objective measures of upper extremity function among women treated for BC.

Methods: This cross-sectional observational …

A Literature Review On Red Meat Consumption Contribution As A Risk Factor For Type 2 Diabetes, Wendy Ireland, Rebekah Davis

The Graduate School Posters

Diabetes continues to be a major health concern for public health officials. The incidence of diabetes has grown in the past two decades producing more than 37 million Americans who live with diabetes (about 1 in 10), and approximately 90-95% of Americans have type 2 diabetes ¹. It is estimated that in 2030 cases of diabetes will rise to 439 million ². Risk factors contribute to the likelihood of developing type 2 diabetes and other health concerns ³. Reducing risk factors like a sedentary lifestyle and a high red meat consumption diet has shown to improve the …

Effects Of Covid-19 In The Status Of Childhood Obesity In The United States: A Literature Review, Ana Cruz

The Graduate School Posters

Introduction: The main hypothesis is that COVID-19 affects the prevalence of childhood obesity in the United States due the precautions needed to contain the pandemic.

Methods: The methods used in this semi-systematic literature review includes web-based research from the following sources: Centers for Disease Control and Prevention, Google Scholar, ResearchGate, and EBSCOhost. The search was limited to children ages 5 to 19 years old with diagnosed obesity.

Results: The review found that COVID-19 pandemic has greatly increased the rate of childhood obesity in the United States due to changes in diet, increased screen time, and less physical activity.

Discussion: There …

Multisystem Inflammatory Syndrome In Children (Mis-C): Emergency Department, Children's Mercy Kansas City

Clinical Pathways (Formally Known As Care Process Models)

No abstract provided.

Parental Perspectives On The Transfer Process For Critically Ill Children, Saoirse Cameron, Anna C. Gunz

Paediatrics Publications

Objective: To understand parental stressors and identify potential stress-mitigators during interfacility transfer of critically ill children. Methods: Descriptive qualitative multi-case study using semi-structured interviews. This study involved caregivers of patients admitted to the Paediatric Critical Care Unit at Children’s Hospital, London Health Sciences Centre transported from outlying hospitals. Study participants were recruited through purposeful sampling. Interviews were recorded, transcribed verbatim and manually de-identified. Coding was performed by two independent coders using a standard method of content analysis to identify common themes. Results: Themes were identified and reached saturation after twelve interviews were completed. Children were admitted primarily from Northwestern and …

Sex-Specific Alterations In Hepatic Cholesterol Metabolism In Low Birth Weight Adult Guinea Pigs., Ousseynou Sarr, Katherine E Mathers, Christina Vanderboor, Kristina Wiggers, Aditya Devgan, Daniel B Hardy, Lin Zhao, Timothy Regnault

Paediatrics Publications

BACKGROUND: Intrauterine growth restriction and low birth weight (LBW) have been widely reported as an independent risk factor for adult hypercholesterolaemia and increased hepatic cholesterol in a sex-specific manner. However, the specific impact of uteroplacental insufficiency (UPI), a leading cause of LBW in developed world, on hepatic cholesterol metabolism in later life, is ill defined and is clinically relevant in understanding later life liver metabolic health trajectories.

METHODS: Hepatic cholesterol, transcriptome, cholesterol homoeostasis regulatory proteins, and antioxidant markers were studied in UPI-induced LBW and normal birth weight (NBW) male and female guinea pigs at 150 days.

RESULTS: Hepatic free and …

Psychosocial Outcomes Of Orthopedic Injuries: An Analysis Of The Relationship Between The Athlete And The Athletic Trainer, Hannah Barnett

Honors Projects

An analysis on the impact of the level of social support from athletic trainers on the outcomes of orthopedic injuries in athletes. The foundational model for this research is Wiese-Bjornstal’s Integrated Model (1998). This model examines the effect of athletes’ emotional responses on their recovery. Social support from the athletic trainer can help mediate negative emotional responses and encourage positive emotional responses, which is why social support is crucial to recovery. Athletes with higher levels of perceived social support from their athletic trainers had more success with rehabilitation. This report consists of a review of the existing literature on psychosocial …

Adolescent Hiv Pre Exposure Prophylaxis Prescribing Practices Among Family Medicine Physicians: Limited Immediate Uptake, Marshal Miller, E. Cooper, S. Elsesser, A. Cunningham

Department of Family & Community Medicine Posters

This study aims to:

• Examine the adolescent PrEP prescribing practices and knowledge of family medicine physicians.
• Begin to identify areas that might be key targets for interventions which may lead to increased adolescent PrEP prescribing uptake.

Knowledge And Practices Regarding Standard Precautions For Infection Control Among Nurses Working At A Public, Tertiary Care Hospital Islamabad, Pakistan, Samina Yasmeen, Tazeen Saeed Ali, Wardah Khalid, Zohra Kurji, Shair Muhammad Hazara, Shahzad Bashir

School of Nursing & Midwifery

Introduction: To protect patients and healthcare providers from healthcare-associated infections (HAIs), standard precautions have been promoted universally. Nurses are the forefront force in patient care; therefore, evidence-based and up to date knowledge and practices can play a vital role in helping nurses apply standard precautions (SPs).
Methods: The analytical cross-sectional study design was used. Through purposive sampling, the data were collected from 320 nurses, via, a self-administered questionnaire, from April to May 2017, from a public tertiary level hospital in Islamabad. The validity and reliability of each section was established. Mean and standard deviation were computed for continuous variables’ whereas; …

Urinary Incontinence: Understanding The Silent Plight Of Women, Yasmin Nadeem Parpio, Anmol Minaz, Sonia Ijaz Haider

School of Nursing & Midwifery

Urinary incontinence (UI) is defined as the complaint of involuntary loss of urine. UI affects both men and women but is more common in women. It has been identified as a World Health Organization priority. The burden related to UI at local, national, and global levels is huge and its impact in terms of physical, social, mental, and financial aspects makes it a concerning issue. However, there exist several barriers in terms of knowledge and attitude in seeking healthcare among women experiencing UI. This calls upon a multi-disciplinary approach involving professionals from different disciplines and tackling it with collaborative and …

Self-Reported Sexual Behavior In A Pediatric Gender Clinic Sample, Mirae J. Fornander, Anna Egan, Christine Moser

Posters

Introduction Previous studies of transgender/gender diverse (TGD) youth indicate differences in rates of sexual behaviors between TGD youth and their cisgender peers. However, few studies have reported the sexual behavior and preferences of TGD youth in a large clinic sample, and no studies, to our knowledge, have utilized questionnaires that do not assume the sex or gender of one’s sexual partner. The current study aims to explore the self-reported sexual behavior of TGD youth presenting for gender-affirming medical care. Methods Retrospective chart review of 589 patients (ages 12-22, M= 15.92, SD= 1.54; 72.9% assigned female sex at birth (SAB)) presenting …

Financial Outcomes By Severity Across Children's Hospitals, Jonathan Hartley, Jessica L. Bettenhausen, Matt Hall, James Gay, David C. Synhorst, Jessica L. Markham

Presentations

Background: Hospitalizations represent a significant driver of healthcare costs for children. Little is known about how payor type and the severity of children cared for on the pediatric medical inpatient floor impact a hospital’s financial outcomes. Objective: The primary objective of this study is to compare financial outcomes of pediatric hospitalizations to the medical inpatient floor across patient severity quartiles. Secondary objectives included financial outcomes stratified by payor type across severity quartiles. Methods: Retrospective cohort study included children aged 0-18 years discharged during calendar year 2019 from hospitals that reported clinical information to the Pediatric Health Information System database and …

New Insights Into The Genetic Etiology Of Alzheimer’S Disease And Related Dementias, Céline Bellenguez, Fahri Küçükali, Iris Jansen, Luca Kleineidam, Sonia Moreno-Grau, Najaf Amin, Adam C. Naj, Rafael Campos-Martin, David W. Fardo, Yuriko Kastumata, Erin L. Abner, Radb, Gr@Ace, Degesco, Eadi, Gerad, Demgene, Finngen, Adgc, Charge

Sanders-Brown Center on Aging Faculty Publications

Characterization of the genetic landscape of Alzheimer’s disease (AD) and related dementias (ADD) provides a unique opportunity for a better understanding of the associated pathophysiological processes. We performed a two-stage genome-wide association study totaling 111,326 clinically diagnosed/‘proxy’ AD cases and 677,663 controls. We found 75 risk loci, of which 42 were new at the time of analysis. Pathway enrichment analyses confirmed the involvement of amyloid/tau pathways and highlighted microglia implication. Gene prioritization in the new loci identified 31 genes that were suggestive of new genetically associated processes, including the tumor necrosis factor alpha pathway through the linear ubiquitin chain assembly …

Parental Teach Back In The Ed Setting For Non-English Speaking Families, Rohan Akhouri

Presentations

90 million Americans have low health literacy1.in Missouri 35% of adults have prose literacy at or below basic skill level2. Literacy, more specifically health literacy, is a modifiable social determinant of health that has a large impact on patient care and outcome. Poor health literacy in adults is associated with a higher number of ED visits and worse health outcomes3,4. Teach back is a method used in multiple pediatric and adult settings, shown to improve patient outcomes and comfort with discharge instructions5. There is limited data regarding teach back in non-English speaking patients and its efficacy with this group of …

Outpatient Emergency Preparedness, Mary Haywood

Presentations

It is commonly believed that medical emergencies do not present to general pediatric offices. However, it has been estimated that 0.9-42 emergencies per office site/year occur. The most common presentations are respiratory in nature. However, children can also present with dehydration, seizure, psychiatric or behavioral complaints. Despite this, most offices are not prepared to handle these presentations for various reasons. Multiple studies have showed that preparedness in inpatient settings is improved with education, implementation, or protocols and deliberate practice with mock codes. However, there have been few studies in the outpatient setting. One study utilized simulation as a tool to …

Identifying Predictive Factors For Patients Transferred From Floor To Picu Within 24 Hours Of Admission By A Pediatric Critical Care Transport Team, Gina Patel, Lisa Carney, Brian S. Olsen, Jennifer Flint

Posters

Abstract Objectives: Appropriate triage and disposition during transport can reduce the need for unplanned transfers to the pediatric intensive care unit (PICU) within 24 hours of admission. The pediatric early warning score (PEWS) is utilized to monitor for inpatient clinical deterioration and acuity during transport at our hospital. We sought to determine predictive factors of patients admitted to the inpatient ward who required PICU transfer within 24 hours following transport by Children’s Mercy Critical Care Transport (CMCCT) team. We hypothesized patients with respiratory illness and PEWS > 4 during interfacility transport are at higher risk of PICU transfer within 24 hours …

Ultrasound Guided Peripheral Iv Access Curriculum For The Pediatric Emergency Department: A Pilot Study., Samuel Dillman, Frances Turcotte Benedict, Christopher S. Kennedy

Posters

Ultrasound Guided Peripheral IV Access Curriculum for the Pediatric Emergency Department: a pilot study. Background: Up to 50% of children have difficult venous access. Studies in the Pediatric Emergency department (PED) have shown that ultrasound guided peripheral IV (USGPIV) access has decreased IV access time and ED length of stay.  Barriers for use include lack of training and comfort with the procedure. Objectives/Goal: Our objectives are to pilot and evaluate USGPIV training for Pediatric Emergency Medicine (PEM) physicians and nurses.  Methods/Design: The course included a 4-hour, hands-on session with US IV training using a blue phantom task trainer in conjunction …

Mindfulness Bundle Impact On Nurse Burnout Study, Gisele Nicole Bazan, Jamie Roney, Kelsey Sawyer, Tiffany Patterson, Michelle Bradberry, Deborah Wambui Kamau, Cynthia L. Grissman, Sahar Mihandoust, Randall Stennett, Joann D. Long

Articles, Abstracts, and Reports

Purpose:

Nurse burnout is a widespread problem globally. Nurse burnout is not only exacerbating nurses’ physical and mental health, but also affects patient satisfaction as well as hospital performance. Due to negative outcomes of nurse burnout, high turnover rates, and excessive costs of hiring nurses, there is a growing body of literature about factors leading to burnout and interventions to control and reduce nurse burnout. Nurses working in Intensive Care Units (ICU) designated for SARS-CoV-2 infected patients during the height of the 2020 pandemic reported experiencing higher than usual levels of emotional exhaustion (EE), depersonalization (DP), physiological signs of stress …

Using An Existing Clinical Practice Guideline To Develop And Implement An Adult Ecmo Program During A Global Pandemic, Brandy Pitts, Midge Vaughan, Jamie Roney

Articles, Abstracts, and Reports

Background: COVID-19 extracorporeal membrane oxygenation (ECMO) specific treatment guidelines were released by the National Institute for Health and the World Health Organization in 2020 for adults with acute respiratory distress syndrome (ARDS). With 42% of COVID‐19 infected patients developing ARDS pneumonia, medical centers increased ECMO treatment capacity to meet pandemic-related demand. The rising treatment demands in adult populations led organizations to implement strategies to increase ECMO treatment availability in adult intensive care units.

Purpose: The purpose of this project was to deploy an evidence-based adult ECMO program in a surgical intensive care unit (SICU) by March 2020.

Methods/Approach: This …

Spending On Public Benefit Programs And Exposure To Adverse Childhood Experiences, Megan Collins, Matt Hall, P J. Chung, Jessica L. Markham, Jessica L. Bettenhausen, L M. Plencer, Molly Krager, Kathyrn Kyler, D Bard, Kayla R. Heller, Roxana Guggenmous, Jordan Keys, Henry T. Puls

Presentations

Background: Adverse childhood experiences (ACEs) have been shown to be associated with poor health outcomes, and children living in poverty are more likely to experience ACEs. Our objective was to estimate the association between spending on benefit programs and cumulative exposure to ACEs among children. Methods: This cross-sectional study examined state and federal spending, at the state-level, on 5 categories of public benefit programs: cash, housing, and in-kind assistance; housing infrastructure; childcare assistance; refundable Earned Income Tax Credit; and Medical Assistance Programs (e.g., Medicaid). The primary exposure was median annual spending per person living below the federal poverty limit across …

The Correlation Between Vaccine Hesitancy And Privilege: Exploring The Degree To Which Education And Income Foster Resistance To Vaccination Efforts, Sophie Goldenberg

Independent Study Project (ISP) Collection

Vaccine hesitancy is a public health issue of growing concern. Extensive pre-existing literature offers several explanations and conflicting viewpoints regarding reluctance toward vaccinations. However, minimal research has been done exploring the upstream social determinants driving vaccine hesitancy. Utilizing academic and gray literature and interviews with experts in the field, this study addresses this gap in knowledge with the research question: To what extent does privilege impact vaccine hesitancy and resistance? Vaccine hesitancy appears globally and is particularly concerning given the re-emergence of vaccine-preventable diseases (VPDs). Additionally, due to inconsistent causes, vaccine hesitancy is difficult to combat. In referencing the history …

A Case Series Of Three Patients With Rare Pantalar Dislocation, Marissa Mogavero, Andrew Robitaille, Lawrence M. Fallat

Articles

Total talar dislocations are rare, significant surgical challenges for foot and ankle surgeons. These dislocations can be very difficult to manually close-reduce, requiring immediate surgical intervention secondary to arterial impingement, pain and risk of skin necrosis attributable to skin tenting. In this case series, we report on three patients who presented to the emergency room following a traumatic ankle injury. Ankle radiographs and computed tomography (CT) scans were obtained, revealing pantalar dislocations. Closed reduction utilizing Charnley’s principles was attempted in the emergency room through manual accentuation of the deformity, traction and reduction. Closed reduction was unsuccessful in all three patients …

18 Fdg Pet/Ct Imaging In Carcinoma Cesophagus, Maseeh Uz Zaman, Nosheen Fatima

Department of Radiology

No abstract provided.

Effect Of Sensory Neuropathy On The Predictive Value Of Inflammatory Biomarkers For Osteomyelitis In Diabetic And Nondiabetic Patients With Foot Infections, Easton Ryan, Junho Ahn, Dane K. Wukich, Javier La Fontaine, Andrew Crisologo, Matthew Malone, Orhan Oz, Lawrence A. Lavery

School of Podiatric Medicine Publications

Objective: To investigate the predictive value of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) in persons with and without diabetes with osteomyelitis (OM).

Methods: We evaluated 455 patients in a retrospective cohort study of patients admitted to the hospital with diabetic foot OM (n = 177), diabetic foot soft-tissue infections (STIs) (n = 176), nondiabetic OM (n = 51), and nondiabetic STIs (n = 51). Infection diagnosis was determined through bone culture, histopathologic examination for OM, and/or imaging (magnetic resonance imaging/single-photon emission computed tomography) for STI. The optimal cutoff values of ESR and CRP in predicting OM were determined …

Improving Heart Failure Patient Referrals To The Center For Advanced Heart Failure & Pulmonary Vascular Disease At Hartford Hospital: A Quality Improvement Project, Dawn M. Surprenant

DNP Projects

Significance and Background: According to the Health Resources & Services Administration (2021), health literacy is the degree to which individuals have the capacity to process and understand basic health information to make appropriate health decisions. Low health literacy is prevalent in populations such as older adults, minorities, and in individuals with lower socioeconomic status and living in medical underserved areas. Recommendations are to access health literacy in cardiac patients, especially in the acute care setting to improve health outcomes upon discharge.

Purpose: To determine whether a health literacy assessment in hospitalized congested heart failure patients, before discharge, will affect referral …