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Surgical Education And Training During The Covid-19 Pandemic: Strategies And Solutions For Pakistan, Edward Anthony Joseph, Russell Seth Martins, Javeria Tariq, Namrah Aziz, Hina Inam, Mahim Malik 2021 Aga Khan University

Surgical Education And Training During The Covid-19 Pandemic: Strategies And Solutions For Pakistan, Edward Anthony Joseph, Russell Seth Martins, Javeria Tariq, Namrah Aziz, Hina Inam, Mahim Malik

Medical College Documents

The coronovirus disease-2019 pandemic has severely impacted surgical education and training in Pakistan and worldwide, causing problems, such as risk of infection, limited hands-on training, examination delays, and trainee redeployment to non-surgical specialties. The current review was planned to describe innovative strategies adopted by surgical training programmes worldwide in order to suggest comprehensive recommendations at the level of the College of Physicians and Surgeons Pakistan and individual institutions to counter the challenges presented by the pandemic in Pakistan. The innovative use of technology, including open-access online educational portals, virtual educational activities and simulation-based learning, can help reform education delivery during ...


Harassment And Mental Health In Surgical Training: A Pilot Survey Of Surgical Trainees In Pakistan, Russell Seth Martins, Syeda Amrah Hashmi, Hina Inam, Mahin Janjua, Mahim Malik 2021 Aga Khan University

Harassment And Mental Health In Surgical Training: A Pilot Survey Of Surgical Trainees In Pakistan, Russell Seth Martins, Syeda Amrah Hashmi, Hina Inam, Mahin Janjua, Mahim Malik

Medical College Documents

Objective: To assess harassment among surgical trainees and its effects on mental health, and to explore its association with gender.
Methods: The nationwide cross-sectional pilot study was conducted by the Association of Women Surgeons of Pakistan from July to September 2019, and included surgical trainees of either gender working in both public and private hospitals. Data was collected using an anonymous online survey form to assess harassment and self-perceived burnout and depression. Data was analysed using SPSS 22.
Results: Of the 147 respondents, 49(33.3%) were males; 98(66.6%) were females; and 118(80.3%) were residents. Workplace ...


Transfer Of Patients With St Elevation Myocardial Infarction For Primary Percutaneous Coronary Intervention During Ordinary & Pandemic Times Position Statement Of The Saudi Arabian Cardiac Intervention Society, Shukri M. Al Saif, Owayed Al Shammeri, Abdullah Alkhushail, Ramzi Almohammadi, Mohamed Kurdi 2020 Saud AlBabtain Cardiac Center, Dammam

Transfer Of Patients With St Elevation Myocardial Infarction For Primary Percutaneous Coronary Intervention During Ordinary & Pandemic Times Position Statement Of The Saudi Arabian Cardiac Intervention Society, Shukri M. Al Saif, Owayed Al Shammeri, Abdullah Alkhushail, Ramzi Almohammadi, Mohamed Kurdi

Journal of the Saudi Heart Association

Primary percutaneous coronary intervention is the most effective therapy in the management of acute ST Elevation Myocardial Infarction. Evidence recommends keeping the period from symptom onset to reperfusion to a minimum in order to preserve left ventricular function, improve outcome, and reduce mortality. The position statement describes the recommendations of the the Saudi Arabian Cardiac Intervention Society for optimal conditions and timing for the acute management of patients presenting with ST Elevation Myocardial Infarction during ordinary and pandemic times.


Sars-Cov-2 Receptors Are Expressed On Human Platelets And The Effect Of Aspirin On Clinical Outcomes In Covid-19 Patients [Preprint], Aditya Sahai, Milka Koupenova-Zamor, Jane E. Freedman, Scott Cameron 2020 Case Western Reserve University

Sars-Cov-2 Receptors Are Expressed On Human Platelets And The Effect Of Aspirin On Clinical Outcomes In Covid-19 Patients [Preprint], Aditya Sahai, Milka Koupenova-Zamor, Jane E. Freedman, Scott Cameron

COVID-19 Publications by UMMS Authors

Coronavirus disease-2019 (COVID-19) caused by SARS-CoV-2 is an ongoing viral pandemic marked by increased risk of thrombotic events. However, the role of platelets in the elevated observed thrombotic risk in COVID-19 and utility of anti-platelet agents in attenuating thrombosis is unknown. We aimed to determine if human platelets express the known SARS-CoV-2 receptor-protease axis on their cell surface and assess whether the anti-platelet effect of aspirin may mitigate risk of myocardial infarction (MI), cerebrovascular accident (CVA), and venous thromboembolism (VTE) in COVID-19. Expression of ACE2 and TMPRSS2 on human platelets were detected by immunoblotting and confirmed by confocal microscopy. We ...


Efficacy Of Pulmonary Ultrasound Compared To N-Terminal Prohormone Brain Natriuretic Peptide As A Diagnostic Tool For Congestive Heart Failure In Patients Presenting With Acute Dyspnea In The Emergency Setting, Leah Krohn, Michael Burns 2020 James Madison University

Efficacy Of Pulmonary Ultrasound Compared To N-Terminal Prohormone Brain Natriuretic Peptide As A Diagnostic Tool For Congestive Heart Failure In Patients Presenting With Acute Dyspnea In The Emergency Setting, Leah Krohn, Michael Burns

Physician Assistant Capstones, 2020-current

Objective: To determine the efficacy of using pulmonary ultrasound as a diagnostic tool in acute dyspnea of undetermined cause compared to the use of serum N-Terminal prohormone Brain Natriuretic Peptide (NT-proBNP) in the diagnosis of heart failure.

Design: Systematic literature review

Methods: Searches were conducted in PubMed and Scopus using the terms pulmonary ultrasound and congestive heart failure and studies within the last 10 years. Studies that used pulmonary ultrasound compared to BNP as a marker for the diagnosis of heart failure were included.

Results: All three studies found that the use of pulmonary ultrasound was a more specific diagnostic ...


Joint Influences Of Obesity, Diabetes, And Hypertension On Indices Of Ventricular Remodeling: Findings From The Community-Based Framingham Heart Study, Beatrice von Jeinsen, Ramachandran S. Vasan, David D. McManus, Gary F. Mitchell, Susan Cheng, Vanessa Xanthakis 2020 Boston University

Joint Influences Of Obesity, Diabetes, And Hypertension On Indices Of Ventricular Remodeling: Findings From The Community-Based Framingham Heart Study, Beatrice Von Jeinsen, Ramachandran S. Vasan, David D. Mcmanus, Gary F. Mitchell, Susan Cheng, Vanessa Xanthakis

Open Access Publications by UMMS Authors

INTRODUCTION: Obesity, hypertension, and diabetes are independently associated with cardiac remodeling and frequently co-cluster. The conjoint and separate influences of these conditions on cardiac remodeling have not been investigated.

MATERIALS AND METHODS: We evaluated 5,741 Framingham Study participants (mean age 50 years, 55% women) who underwent echocardiographic measurements of left ventricular (LV) mass (LVM), LV ejection fraction (LVEF), global longitudinal strain (GLS), mitral E/e', left atrial end-systolic (peak) dimension (LASD) and emptying fraction (LAEF). We used multivariable generalized linear models to estimate the adjusted-least square means of these measures according to cross-classified categories of body mass index (BMI ...


Retrospective Review Of Anticoagulation Regimens Used For The Prevention Of Venous Thromboembolisms In Critically Ill Patients Infected With Sars-Cov-2, Tony Nguyen, Heidi Clarke 2020 Baptist Hospital of Miami

Retrospective Review Of Anticoagulation Regimens Used For The Prevention Of Venous Thromboembolisms In Critically Ill Patients Infected With Sars-Cov-2, Tony Nguyen, Heidi Clarke

All Publications

No abstract provided.


Evaluation Of Incidence Of Thrombosis And Bleeding In Medical Floor Covid-19 Patients At A Community Hospital, Giselle Chahili, Frank C. Moreno Exposito, Heidi Clarke, Erika Dittmar 2020 Baptist Hospital of Miami

Evaluation Of Incidence Of Thrombosis And Bleeding In Medical Floor Covid-19 Patients At A Community Hospital, Giselle Chahili, Frank C. Moreno Exposito, Heidi Clarke, Erika Dittmar

All Publications

No abstract provided.


Heart Failure 30-Day Readmission Frequency, Rates, And Hf Classification, Yolanda R. Brown, Twonia M. Goyer, Margaret C. Harvey 2020 University of Tennessee Health Science Center

Heart Failure 30-Day Readmission Frequency, Rates, And Hf Classification, Yolanda R. Brown, Twonia M. Goyer, Margaret C. Harvey

Doctor of Nursing Practice Projects

30 Day Hospital Readmission Rates, Frequencies, and Heart Failure Classification for Patients with Heart Failure

Background Congestive heart failure (CHF) is the leading cause of mortality, morbidity, and disability worldwide among patients. Both the incidence and the prevalence of heart failure are age dependent and are relatively common in individuals 40 years of age and older. CHF is one of the leading causes of inpatient hospitalization readmission in the United States, with readmission rates remaining above the 20% goal within 30 days. The Center for Medicare and Medicaid Services imposes a 3% reimbursement penalty for excessive readmissions including those who ...


Assessment Of Hypertension Using Clinical Electrocardiogram Features: A First-Ever Review, Kathleen Bird, Gabriel Chan, Huiqi Lu, Heloise Greeff, John Allen, Derek Abbott, Carlo Menon, Nigel H. Lovell, Newton Howard, Wee-Shian Chan, Richard Ribon Fletcher, Aymen Alian, Rabab Ward, Mohamed Elgendi 2020 University of British Columbia

Assessment Of Hypertension Using Clinical Electrocardiogram Features: A First-Ever Review, Kathleen Bird, Gabriel Chan, Huiqi Lu, Heloise Greeff, John Allen, Derek Abbott, Carlo Menon, Nigel H. Lovell, Newton Howard, Wee-Shian Chan, Richard Ribon Fletcher, Aymen Alian, Rabab Ward, Mohamed Elgendi

Open Access Publications by UMMS Authors

Hypertension affects an estimated 1.4 billion people and is a major cause of morbidity and mortality worldwide. Early diagnosis and intervention can potentially decrease cardiovascular events later in life. However, blood pressure (BP) measurements take time and require training for health care professionals. The measurements are also inconvenient for patients to access, numerous daily variables affect BP values, and only a few BP readings can be collected per session. This leads to an unmet need for an accurate, 24-h continuous, and portable BP measurement system. Electrocardiograms (ECGs) have been considered as an alternative way to measure BP and may ...


An Investigation Into The Response Of The Us And Eu5 To The Covid-19 Disease (Convergence Of Two Pandemics: Covid-19 And Ncds), Omar Hassan 2020 CUNY New York City College of Technology

An Investigation Into The Response Of The Us And Eu5 To The Covid-19 Disease (Convergence Of Two Pandemics: Covid-19 And Ncds), Omar Hassan

Publications and Research

In late December 2019, a coronavirus disease (COVID-19) was identified in Wuhan China. COVID-19 was a result of the novel severe acute respiratory syndrome coronavirus 2 (SARA-CoV-2), which has resulted in a worldwide sudden and substantial increase in hospitalizations for pneumonia with multiorgan disease. As of October 6, 2020, SARS-CoV-2 has affected more than 200 countries, resulting in more than 35 million identified cases with more than 1 million confirmed deaths.

This is a cross-sectional, non-interventional, observational study in patients infected with the novel coronavirus (SARS-CoV-2) or Covid-19, using John Hopkins University database JHU Coronavirus map. The data collected from ...


Yap/Taz Deficiency Reprograms Macrophage Phenotype And Improves Infarct Healing And Cardiac Function After Myocardial Infarction, Masum M. Mia, Dasan Mary Cibi, Siti Aishah Abdul Ghani Binte, Weihua Song, Nicole Tee, Sujoy Ghosh, Junhao Mao, Eric N. Olson, Manvendra K. Singh 2020 Duke-NUS Medical School Singapore

Yap/Taz Deficiency Reprograms Macrophage Phenotype And Improves Infarct Healing And Cardiac Function After Myocardial Infarction, Masum M. Mia, Dasan Mary Cibi, Siti Aishah Abdul Ghani Binte, Weihua Song, Nicole Tee, Sujoy Ghosh, Junhao Mao, Eric N. Olson, Manvendra K. Singh

Open Access Publications by UMMS Authors

Adverse cardiac remodeling after myocardial infarction (MI) causes structural and functional changes in the heart leading to heart failure. The initial post-MI pro-inflammatory response followed by reparative or anti-inflammatory response is essential for minimizing the myocardial damage, healing, and scar formation. Bone marrow-derived macrophages (BMDMs) are recruited to the injured myocardium and are essential for cardiac repair as they can adopt both pro-inflammatory or reparative phenotypes to modulate inflammatory and reparative responses, respectively. Yes-associated protein (YAP) and transcriptional coactivator with PDZ-binding motif (TAZ) are the key mediators of the Hippo signaling pathway and are essential for cardiac regeneration and repair ...


Immunotherapy For Infarcts: In Vivo Postinfarction Macrophage Modulation Using Intramyocardial Microparticle Delivery Of Map4k4 Small Interfering Rna, Jun Luo, Matthew S. Weaver, Timothy P. Fitzgibbons, Myriam Aouadi, Michael P. Czech, Margaret D. Allen 2020 Benaroya Research Institute at Virginia Mason

Immunotherapy For Infarcts: In Vivo Postinfarction Macrophage Modulation Using Intramyocardial Microparticle Delivery Of Map4k4 Small Interfering Rna, Jun Luo, Matthew S. Weaver, Timothy P. Fitzgibbons, Myriam Aouadi, Michael P. Czech, Margaret D. Allen

Open Access Publications by UMMS Authors

The myeloid cells infiltrating the heart early after acute myocardial infarction elaborate a secretome that largely orchestrates subsequent ventricular wall repair. Regulating this innate immune response could be a means to improve infarct healing. To pilot this concept, we utilized (beta1,3-d-) glucan-encapsulated small interfering RNA (siRNA)-containing particles (GeRPs), targeting mononuclear phagocytes, delivered to mice as a one-time intramyocardial injection immediately after acute infarction. Findings demonstrated that cardiac macrophages phagocytosed GeRPs in vivo and had little systemic dissemination, thus providing a means to deliver local therapeutics. Acute infarcts were then injected in vivo with phosphate-buffered saline (PBS; vehicle) or ...


Patient-Centered Implementation Of Statin Therapy In Patients With Type 2 Diabetes, Giovanna P. Favarato 2020 University of the Incarnate Word

Patient-Centered Implementation Of Statin Therapy In Patients With Type 2 Diabetes, Giovanna P. Favarato

Doctor of Nursing Practice

Heart disease is the leading cause of morbidity and mortality in Americans with type 2 diabetes mellitus. The American Diabetes Association recommends statins and lifestyle modifications for all patients with type 2 diabetes mellitus for the prevention of atherosclerotic cardiovascular events. A patient-centered approach to primary prevention is encouraged, yet there are no specific instructions regarding implementation. The Statin Choice Decision Aid is a tool designed to facilitate shared decision-making between the patient and the provider in the clinical setting. The 2018 American College of Cardiology/American Heart Association guidelines for the primary prevention of atherosclerotic cardiovascular disease for patients ...


Finding The Balance​ The Effects Of Α-Cyclodextrin, 2-Hydroxypropyl-Β-Cyclodextrin, And Cholesterol Bacteroides Vulgatus And Clostridium Bolteae​, Bethany Weaver 2020 Olivet Nazarene University

Finding The Balance​ The Effects Of Α-Cyclodextrin, 2-Hydroxypropyl-Β-Cyclodextrin, And Cholesterol Bacteroides Vulgatus And Clostridium Bolteae​, Bethany Weaver

Pence-Boyce STEM Student Scholarship

Atherosclerosis is a cardiovascular disease that is characterized by the hardening of arteries through the formation of cholesterol plaques. Cyclodextrins could potentially treat atherosclerosis by shrinking plaques. These cyclic oligosaccharides can make complexes with cholesterol but have also shown toxic side effects. This study looked for potential negative effects of cyclodextrins and cholesterol on gut bacteria. It was hypothesized that Bacteroides vulgatus will have decreased growth when grown in broth with cholesterol. In contrast, Clostridium bolteae will have decreased growth when grown in broth with cyclodextrins. Due to the fact that these bacteria are anaerobic, Clostridium bolteae and Bacteroides vulgatus ...


Par1 (Protease-Activated Receptor 1) Pepducin Therapy Targeting Myocardial Necrosis In Coronary Artery Disease And Acute Coronary Syndrome Patients Undergoing Cardiac Catheterization: A Randomized, Placebo-Controlled, Phase 2 Study, Athan Kuliopulos, Paul A. Gurbel, Jeffrey J. Rade, Carey D. Kimmelstiel, Susan E. Turner, Kevin P. Bliden, Elizabeth K. Fletcher, Daniel H. Cox, Lidija Covic 2020 Tufts University

Par1 (Protease-Activated Receptor 1) Pepducin Therapy Targeting Myocardial Necrosis In Coronary Artery Disease And Acute Coronary Syndrome Patients Undergoing Cardiac Catheterization: A Randomized, Placebo-Controlled, Phase 2 Study, Athan Kuliopulos, Paul A. Gurbel, Jeffrey J. Rade, Carey D. Kimmelstiel, Susan E. Turner, Kevin P. Bliden, Elizabeth K. Fletcher, Daniel H. Cox, Lidija Covic

Open Access Publications by UMMS Authors

OBJECTIVE: Arterial thrombosis leading to ischemic injury worsens the prognosis of many patients with cardiovascular disease. PZ-128 is a first-in-class pepducin that reversibly inhibits PAR1 (protease-activated receptor 1) on platelets and other vascular cells by targeting the intracellular surface of the receptor. The TRIP-PCI (Thrombin Receptor Inhibitory Pepducin in Percutaneous Coronary Intervention) trial was conducted to assess the safety and efficacy of PZ-128 in patients undergoing cardiac catheterization with intent to perform percutaneous coronary intervention.

Approach and Results: In this randomized, double-blind, placebo-controlled, phase 2 trial, 100 patients were randomly assigned (2:1) to receive PZ-128 (0.3 or 0 ...


Supplying Pharmacist Home Visit And Anticoagulation Professional Consultation During Transition Of Care For Patients With Venous Thromboembolism, Alok Kapoor, Valentina Landyn, Joann L. Wagner, Pamela Burgwinkle, Wei Huang, Joel M. Gore, Frederick A. Spencer, Robert Goldberg, David D. McManus, Chad E. Darling, Edwin D. Boudreaux, Bruce A. Barton, Kathleen M. Mazor 2020 University of Massachusetts Medical School

Supplying Pharmacist Home Visit And Anticoagulation Professional Consultation During Transition Of Care For Patients With Venous Thromboembolism, Alok Kapoor, Valentina Landyn, Joann L. Wagner, Pamela Burgwinkle, Wei Huang, Joel M. Gore, Frederick A. Spencer, Robert Goldberg, David D. Mcmanus, Chad E. Darling, Edwin D. Boudreaux, Bruce A. Barton, Kathleen M. Mazor

Open Access Publications by UMMS Authors

OBJECTIVE: The aim of the study was to assess the feasibility, satisfaction, and effectiveness of a care transition intervention with pharmacist home visit and subsequent anticoagulation expert consultation for patients with new episode of venous thromboembolism within a not-for-profit health care network.

METHODS: We randomized patients to the intervention or control. During the home visit, a clinical pharmacist assessed medication management proficiency, asked open-ended questions to discuss knowledge gaps, and distributed illustrated medication instructions. Subsequent consultation with anticoagulation expert further filled knowledge gaps. At 30 days, we assessed satisfaction with the intervention and also measured the quality of care transition ...


Modelling The Impact Of Clot Fragmentation On The Microcirculation After Thrombectomy [Preprint], Wahbi K. El-Bouri, Andrew MacGowan, Tamás I. Józsa, Matthew J. Gounis, Stephen J. Payne 2020 University of Oxford

Modelling The Impact Of Clot Fragmentation On The Microcirculation After Thrombectomy [Preprint], Wahbi K. El-Bouri, Andrew Macgowan, Tamás I. Józsa, Matthew J. Gounis, Stephen J. Payne

University of Massachusetts Medical School Faculty Publications

Many ischaemic stroke patients who have a mechanical removal of their clot (thrombectomy) do not get reperfusion of tissue despite the thrombus being removed. One hypothesis for this ‘no-reperfusion’ phenomenon is micro-emboli fragmenting off the large clot during thrombectomy and occluding smaller blood vessels downstream of the clot location. This is impossible to observe in-vivo and so we here develop an in-silico model based on in-vitro experiments to model the effect of micro-emboli on brain tissue. Through in-vitro experiments we obtain, under a variety of clot consistencies and thrombectomy techniques, micro-emboli distributions post-thrombectomy. Blood flow through the microcirculation is modelled ...


Incident Frailty And Cognitive Impairment By Heart Failure Status In Older Patients With Atrial Fibrillation: The Sage-Af Study, Weijia Wang, Darleen M. Lessard, Jane Saczynski, Robert J. Goldberg, Alan S. Go, Tenes Paul, Ely Gracia, David D. McManus 2020 University of Massachusetts Medical School

Incident Frailty And Cognitive Impairment By Heart Failure Status In Older Patients With Atrial Fibrillation: The Sage-Af Study, Weijia Wang, Darleen M. Lessard, Jane Saczynski, Robert J. Goldberg, Alan S. Go, Tenes Paul, Ely Gracia, David D. Mcmanus

Open Access Publications by UMMS Authors

Background: Atrial fibrillation (AF) and heart failure (HF) frequently co-occur in older individuals. Among patients with AF, HF increases risks for stroke and death, but the associations between HF and incident cognition and physical impairment remain unknown. We aimed to examine the cross-sectional and prospective associations between HF, cognition, and frailty among older patients with AF.

Methods: The SAGE-AF (Systematic Assessment of Geriatric Elements in AF) study enrolled 1244 patients with AF (mean age 76 years, 48% women) from five practices in Massachusetts and Georgia. HF at baseline was identified from electronic health records using ICD-9/10 codes. At baseline ...


Conquering Hypertension In Vietnam-Solutions At Grassroots Level: Study Protocol Of A Cluster Randomized Controlled Trial, Duc A. Ha, Oanh T. Tran, Hoa L. Nguyen, German Chiriboga, Robert J. Goldberg, Van H. Phan, Cuc T. Nguyen, Giang H. Nguyen, Hien V. Pham, Thang T. Nguyen, Thanh T. Le, Jeroan J. Allison 2020 Ministry of Health

Conquering Hypertension In Vietnam-Solutions At Grassroots Level: Study Protocol Of A Cluster Randomized Controlled Trial, Duc A. Ha, Oanh T. Tran, Hoa L. Nguyen, German Chiriboga, Robert J. Goldberg, Van H. Phan, Cuc T. Nguyen, Giang H. Nguyen, Hien V. Pham, Thang T. Nguyen, Thanh T. Le, Jeroan J. Allison

Population and Quantitative Health Sciences Publications

BACKGROUND: Vietnam has been experiencing an epidemiologic transition to that of a lower-middle income country with an increasing prevalence of non-communicable diseases. The key risk factors for cardiovascular disease (CVD) are either on the rise or at alarming levels in Vietnam, particularly hypertension (HTN). Inasmuch, the burden of CVD will continue to increase in the Vietnamese population unless effective prevention and control measures are put in place. The objectives of the proposed project are to evaluate the implementation and effectiveness of two multi-faceted community and clinic-based strategies on the control of elevated blood pressure (BP) among adults in Vietnam via ...


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