Janak Mukherji, Dana K. Mitchell, Emily White, Breanne Burgess, Abbi E Smith, Eric A Albright, Jaffar Khan, Andrew Horvai, D. W. Clapp, Steve Angus, Steven Rhodes
Background/Objective:Neurofibromatosis type 1 (NF1) is a multisystem disorder that affects ~1/3000 newborns. Plexiform neurofibromas (PN) are present in about half of cases and can transform (lifetime risk of 8-13%) into malignant peripheral nerve sheath tumor (MPNST), a highly aggressive and metastatic sarcoma with poor survival. Unfortunately, there are currently no reliable biomarkers to identify PN at risk of undergoing malignant transformation. Our research has revealed that a subset of benign-appearing and atypical PN exhibit deregulated immune surveillance and T-cell infiltration that precede malignant transformation. In this study, we are analyzing tumor microenvironment and immune landscape in NF1-related tissue specimens to identify biomarkers of disease progression. To power these studies, this project focused on constructing a dataset of NF1-related samples to be analyzed. Methods:701 patients were identified via Cerner billing codes and pathology archives. De-identified clinical data, including presenting symptoms, relevant clinical history, pathology diagnoses, disease features, prior chemotherapeutics/radiation, prior gene profiling, and imaging features were collected. Results: We selected 86 patients with a total of 175 samples. 81% of patients had a clinical diagnosis of NF1, and 6% had a history of MPNST. Out of the 175 samples, 54 were in the head and neck, 42 in the thorax, 28 in the lower extremity, 27 in the upper extremity, 26 in the pelvis/abdomen, and 15 in the paraspinal region. The leading causes of procedures were pain (41%), growth (40%), and concern for malignancy (27%). The most common tissue diagnoses were neurofibroma (51.4%), PN (20%), and undefined-grade MPNST (11%). Out of the 46 MPNSTs, 30 were primary tumors, 4 metastases, and 12 local recurrences. Conclusion and Potential Impact:The results of this study will provide valuable insights to inform preclinical models of NF1-tumorigenesis to validate these findings and identify novel treatment approaches for individuals affected by these rare but devastating tumors.
{"title":"Deciphering the Immune Microenvironment of NF1-associated Peripheral Nerve Sheath Tumors: Identifying Early Biomarkers of Disease Progression and Malignant Transformation","authors":"Janak Mukherji, Dana K. Mitchell, Emily White, Breanne Burgess, Abbi E Smith, Eric A Albright, Jaffar Khan, Andrew Horvai, D. W. Clapp, Steve Angus, Steven Rhodes","doi":"10.18060/27748","DOIUrl":"https://doi.org/10.18060/27748","url":null,"abstract":"Background/Objective:Neurofibromatosis type 1 (NF1) is a multisystem disorder that affects ~1/3000 newborns. Plexiform neurofibromas (PN) are present in about half of cases and can transform (lifetime risk of 8-13%) into malignant peripheral nerve sheath tumor (MPNST), a highly aggressive and metastatic sarcoma with poor survival. Unfortunately, there are currently no reliable biomarkers to identify PN at risk of undergoing malignant transformation. Our research has revealed that a subset of benign-appearing and atypical PN exhibit deregulated immune surveillance and T-cell infiltration that precede malignant transformation. In this study, we are analyzing tumor microenvironment and immune landscape in NF1-related tissue specimens to identify biomarkers of disease progression. To power these studies, this project focused on constructing a dataset of NF1-related samples to be analyzed. \u0000Methods:701 patients were identified via Cerner billing codes and pathology archives. De-identified clinical data, including presenting symptoms, relevant clinical history, pathology diagnoses, disease features, prior chemotherapeutics/radiation, prior gene profiling, and imaging features were collected. \u0000Results: We selected 86 patients with a total of 175 samples. 81% of patients had a clinical diagnosis of NF1, and 6% had a history of MPNST. Out of the 175 samples, 54 were in the head and neck, 42 in the thorax, 28 in the lower extremity, 27 in the upper extremity, 26 in the pelvis/abdomen, and 15 in the paraspinal region. The leading causes of procedures were pain (41%), growth (40%), and concern for malignancy (27%). The most common tissue diagnoses were neurofibroma (51.4%), PN (20%), and undefined-grade MPNST (11%). Out of the 46 MPNSTs, 30 were primary tumors, 4 metastases, and 12 local recurrences. \u0000Conclusion and Potential Impact:The results of this study will provide valuable insights to inform preclinical models of NF1-tumorigenesis to validate these findings and identify novel treatment approaches for individuals affected by these rare but devastating tumors.","PeriodicalId":20522,"journal":{"name":"Proceedings of IMPRS","volume":"47 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139534083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Stone Chen, Theresa Doiron, Olivia Jimenez, Ali Sualeh, Jennifer Stashevsky, Mackenzie Madison, Chang-Hyundai Gil, Steven J. Miller, Michael Murphy
Abdominal aortic aneurysm (AAA) is a vascular disease process whereby the aorta expands to apoint where rupture may occur. This serious condition is diagnosed in approximately 200,000 people in the United States per year and accounts for over 15,000 deaths annually. The only medical intervention proven to reduce the risk of AAA rupture is surgical repair; however, such repair is associated with high risk of death, reduced quality of life, and high expense. AAA is caused by the weakening of the artery wall due to inflammation-induced destruction of its structural components. Our clinical data shows increased levels of circulating elastin degradation products in patients with AAA, especially smokers, compared to risk factor matched controls. This observation led us to hypothesize that an immune reaction to elastin fragments initiates the inflammatory cascade in the aorta that leads to AAA formation. To test this hypothesis, C57BL/6 mice were injected with poly(lactide-co-glycolide) nanoparticle-encapsulated IL-10 to induce immune tolerance or nanoparticle-encapsulated control ovalbumin. Injection of elastin fragments was performed 7 days later to induce an immune response. AAA of the infrarenal aorta was induced by topical application of elastase during laparotomy procedure 14 days after nanoparticle injection. Aorta diameter was measured 16 days post-operatively with Microfil. Immunologic changes were evaluated by cytokine analysis, Tr1/Th17 cell ratio inperipheral blood, and splenic Th17 and Tr1 response to elastin. Based on prior work, we expect that induction of elastin tolerance using poly(lactide-co-glycolide) nanoparticle-encapsulated IL-10 will suppress abdominal aortic aneurysm expansion and promote an anti-inflammatoryenvironment characterized by increased Tr1/Th17 cell ratio, increased levels of anti-inflammatory cytokines, and decreased pro-inflammatory cytokine expression.
{"title":"Suppression of Inflammation-induced Abdominal Aortic Aneurysm Formation by Induction of Elastin Tolerance","authors":"Stone Chen, Theresa Doiron, Olivia Jimenez, Ali Sualeh, Jennifer Stashevsky, Mackenzie Madison, Chang-Hyundai Gil, Steven J. Miller, Michael Murphy","doi":"10.18060/27734","DOIUrl":"https://doi.org/10.18060/27734","url":null,"abstract":"Abdominal aortic aneurysm (AAA) is a vascular disease process whereby the aorta expands to apoint where rupture may occur. This serious condition is diagnosed in approximately 200,000 people in the United States per year and accounts for over 15,000 deaths annually. The only medical intervention proven to reduce the risk of AAA rupture is surgical repair; however, such repair is associated with high risk of death, reduced quality of life, and high expense. AAA is caused by the weakening of the artery wall due to inflammation-induced destruction of its structural components. Our clinical data shows increased levels of circulating elastin degradation products in patients with AAA, especially smokers, compared to risk factor matched controls. This observation led us to hypothesize that an immune reaction to elastin fragments initiates the inflammatory cascade in the aorta that leads to AAA formation. To test this hypothesis, C57BL/6 mice were injected with poly(lactide-co-glycolide) nanoparticle-encapsulated IL-10 to induce immune tolerance or nanoparticle-encapsulated control ovalbumin. Injection of elastin fragments was performed 7 days later to induce an immune response. AAA of the infrarenal aorta was induced by topical application of elastase during laparotomy procedure 14 days after nanoparticle injection. Aorta diameter was measured 16 days post-operatively with Microfil. Immunologic changes were evaluated by cytokine analysis, Tr1/Th17 cell ratio inperipheral blood, and splenic Th17 and Tr1 response to elastin. Based on prior work, we expect that induction of elastin tolerance using poly(lactide-co-glycolide) nanoparticle-encapsulated IL-10 will suppress abdominal aortic aneurysm expansion and promote an anti-inflammatoryenvironment characterized by increased Tr1/Th17 cell ratio, increased levels of anti-inflammatory cytokines, and decreased pro-inflammatory cytokine expression.","PeriodicalId":20522,"journal":{"name":"Proceedings of IMPRS","volume":" 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139625233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background:The association between meal content and glycemic control is not well-understood in pregnancy, limits our ability to counsel patients regarding the optimal diet. We therefore sought to evaluate the relationship between maternal dietary content and glycemic control. Methods:This is a secondary analysis of the GDM-MOMS study, which was a randomized controlled pilot trial that compared glycemic targets in 60 pregnant individuals with GDM and either overweight or obesity. During the pilot trial, participants wore a blinded continuous glucose monitor (CGM) for two five-day periods, with the first data collection between 12-32 weeks and the second data collection between 32-36 weeks. During the time that participants wore their CGM, they also collected 3-day food diaries with detailed information regarding intake and cooking technique. These food diaries are being entered into the Nutrition Data System for Research (NDSR) software, which analyzes nutritional composition for each meal. Glycemic control as assessed by CGM will then be assessed based on maternal nutritional intake. Results:The American Diabetes Association recommends a 2,000-calorie daily diet with a minimum of 175g of carbohydrates (with 35% of the total calories coming from carbohydrates), 71g of protein, and 28g of fat. Preliminary data extracted from NDSR includes nutritional analysis of 38 daily food diaries from 14 patients. 12/38 (31.6%) food logs show consumption of less than 35% of their total calories from carbohydrates, with the other 26 consuming 36-62%. Glycemic load can be used to assess how a patient’s diet affects their glycemic levels. 25/38 (65.8%) of food logs demonstrate a daily glycemic load (GL) of 100, with the other 13 showing daily GLs rangingfrom 108-252. Conclusions and Further Directions:Further analyses will assess post-meal glycemic response using both patient-monitored glucose values and reports from their CGM to determine which types of diets allow for optimal glycemic control.
{"title":"Analysis of Nutritional Composition and Glycemic Control in Patients with Gestational Diabetes Mellitus","authors":"Evelyn McGuire, Brenda Smith, Christina Scifres","doi":"10.18060/27732","DOIUrl":"https://doi.org/10.18060/27732","url":null,"abstract":"Background:The association between meal content and glycemic control is not well-understood in pregnancy, limits our ability to counsel patients regarding the optimal diet. We therefore sought to evaluate the relationship between maternal dietary content and glycemic control. \u0000Methods:This is a secondary analysis of the GDM-MOMS study, which was a randomized controlled pilot trial that compared glycemic targets in 60 pregnant individuals with GDM and either overweight or obesity. During the pilot trial, participants wore a blinded continuous glucose monitor (CGM) for two five-day periods, with the first data collection between 12-32 weeks and the second data collection between 32-36 weeks. During the time that participants wore their CGM, they also collected 3-day food diaries with detailed information regarding intake and cooking technique. These food diaries are being entered into the Nutrition Data System for Research (NDSR) software, which analyzes nutritional composition for each meal. Glycemic control as assessed by CGM will then be assessed based on maternal nutritional intake. \u0000Results:The American Diabetes Association recommends a 2,000-calorie daily diet with a minimum of 175g of carbohydrates (with 35% of the total calories coming from carbohydrates), 71g of protein, and 28g of fat. Preliminary data extracted from NDSR includes nutritional analysis of 38 daily food diaries from 14 patients. 12/38 (31.6%) food logs show consumption of less than 35% of their total calories from carbohydrates, with the other 26 consuming 36-62%. Glycemic load can be used to assess how a patient’s diet affects their glycemic levels. 25/38 (65.8%) of food logs demonstrate a daily glycemic load (GL) of 100, with the other 13 showing daily GLs rangingfrom 108-252. \u0000Conclusions and Further Directions:Further analyses will assess post-meal glycemic response using both patient-monitored glucose values and reports from their CGM to determine which types of diets allow for optimal glycemic control.","PeriodicalId":20522,"journal":{"name":"Proceedings of IMPRS","volume":" 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139625643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kylie Wertz, Julia Amstutz, Michael Scanlon, Debra K. Litzelman
Background: Community health workers (CHWs) promote health education, address social determinants of health, and bridge the gap between healthcare systems and underserved populations, but the lack of sustainable funding remains a challenge to greater CHW utilization. Medicaid reimbursement has been identified as a promising mechanism to fund CHWs, however, state policies vary widely. A comparative policy analysis can guide future reimbursement strategies. Methods: We conducted a comparative policy analysis of Medicaid reimbursement for CHWs. State government websites and legal databases were searched utilizing keyword search terms related to CHWs and Medicaid reimbursement. We identified and analyzed relevant statutes, regulations, and administrative codes for reimbursement mechanism, rates, supervision, certification, and scope of practice. Results: 26 states currently reimburse CHWs through Medicaid; 3 states started reimbursement in the last six months. 16 states authorize payment through State Plan Amendments (SPAs), 3 use Section 1115 demonstration waivers, 10 use Medicaid managed care organization contracts, and 4 use blended strategies. 13 states require certification and supervision for reimbursement, although the supervising licensed professional can vary. The scope of practice of CHW also varies between states. There is a large range for reimbursement rates; for example, billing code 98960 currently used by 14 states varies from $9.70 in Indiana to $55.25 in Arizona for a 30 minute visit. Policy Implications: This study can inform sustainable reimbursement models through Medicaid for CHWs in Indiana and other states. An SPA may be the most expedient way for Indiana to increase reimbursement for CHWs, but its narrowness and inflexibility could hinder CHWs' positive impact. The variety of strategies currently in use demonstrates that there is no single path to sustainable financing. Protocols for a set of scoping reviews will result from this comparative analysis for more in-depth investigations of key peer-reviewed and grey literature.
{"title":"Medicaid Reimbursement for Community Health Workers: A Comparative State Policy Analysis with Implications for Indiana","authors":"Kylie Wertz, Julia Amstutz, Michael Scanlon, Debra K. Litzelman","doi":"10.18060/27824","DOIUrl":"https://doi.org/10.18060/27824","url":null,"abstract":"Background: Community health workers (CHWs) promote health education, address social determinants of health, and bridge the gap between healthcare systems and underserved populations, but the lack of sustainable funding remains a challenge to greater CHW utilization. Medicaid reimbursement has been identified as a promising mechanism to fund CHWs, however, state policies vary widely. A comparative policy analysis can guide future reimbursement strategies. \u0000Methods: We conducted a comparative policy analysis of Medicaid reimbursement for CHWs. State government websites and legal databases were searched utilizing keyword search terms related to CHWs and Medicaid reimbursement. We identified and analyzed relevant statutes, regulations, and administrative codes for reimbursement mechanism, rates, supervision, certification, and scope of practice. \u0000Results: 26 states currently reimburse CHWs through Medicaid; 3 states started reimbursement in the last six months. 16 states authorize payment through State Plan Amendments (SPAs), 3 use Section 1115 demonstration waivers, 10 use Medicaid managed care organization contracts, and 4 use blended strategies. 13 states require certification and supervision for reimbursement, although the supervising licensed professional can vary. The scope of practice of CHW also varies between states. There is a large range for reimbursement rates; for example, billing code 98960 currently used by 14 states varies from $9.70 in Indiana to $55.25 in Arizona for a 30 minute visit. \u0000Policy Implications: This study can inform sustainable reimbursement models through Medicaid for CHWs in Indiana and other states. An SPA may be the most expedient way for Indiana to increase reimbursement for CHWs, but its narrowness and inflexibility could hinder CHWs' positive impact. The variety of strategies currently in use demonstrates that there is no single path to sustainable financing. Protocols for a set of scoping reviews will result from this comparative analysis for more in-depth investigations of key peer-reviewed and grey literature.","PeriodicalId":20522,"journal":{"name":"Proceedings of IMPRS","volume":" 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139626634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background/Objective: Atrial fibrillation (AF) and venous thromboembolism (VTE) are conditions with significant morbidity and mortality when left untreated. American Heart Association guidelines changed in 2019 to make non-vitamin K antagonist oral anticoagulants (NOACs) the preferred method for preventing stroke and systemic embolism in patients with AF or history of VTE. NOACs were first introduced to the United States in 2010 and now include dabigatran, apixaban, rivaroxaban, and edoxaban. There is a dearth of research concerning the speed with which new treatments are prescribed to those in different socioeconomic status (SES) groups. We hypothesized that patients with lower SES were prescribed NOACs later than higher SES counterparts following the introduction of NOACs in 2010. Methods: The IU Cardiovascular Research Consortium/Sidus Dataset was mined for AF and VTE patients prescribed a NOAC between 2010 and 2022. The SES groups were determined using 2020 U.S. Census income data that correlated to patients’ zip codes. The yearly number ofpatients in each SES group were compared to assess for proportional uptake of NOAC prescribing. The primary outcome was the proportion of low SES to high SES prescribing over each year between 2010 and 2022. Results: Low SES patients (n=101,945) were prescribed NOACs at an average of 0.65 times the rate of high SES patients (n= 89,130) from 2010 to 2012, the first three years of NOAC market availability. Prescribing rates equilibrated in 2013 and low SES prescribing has outpaced high SES prescribing since 2021. Conclusion/Impact: Low SES patients experienced a three year delay in receiving NOAC prescriptions at the same rate as their high SES counterparts. Systemic changes, like more frequent prescribing guideline updates and improved evidence-based education amongst providers in low-income areas, could prevent a similar delay when introducing similarly transformative treatments in the future.
背景/目的：心房颤动（AF）和静脉血栓栓塞症（VTE）如不及时治疗，会导致严重的发病率和死亡率。美国心脏协会指南于 2019 年做出改变，将非维生素 K 拮抗剂口服抗凝药（NOAC）作为房颤或有 VTE 病史患者预防中风和全身性栓塞的首选方法。NOACs 于 2010 年首次引入美国，目前包括达比加群、阿哌沙班、利伐沙班和埃多沙班。关于不同社会经济地位（SES）群体接受新疗法的速度，目前还缺乏相关研究。我们假设，自 2010 年引入 NOACs 后，社会经济地位较低的患者获得 NOACs 处方的时间晚于社会经济地位较高的患者。研究方法从 IU Cardiovascular Research Consortium/Sidus Dataset 数据集中挖掘出 2010 年至 2022 年期间被处方 NOAC 的房颤和 VTE 患者。根据与患者邮政编码相关的 2020 年美国人口普查收入数据确定 SES 组别。对每个 SES 组别中每年的患者人数进行比较，以评估 NOAC 处方的使用比例。主要结果是 2010 年至 2022 年期间每年低 SES 与高 SES 的处方比例。结果2010 年至 2012 年，即 NOAC 上市的前三年，低 SES 患者（n=101,945）的 NOAC 处方率平均是高 SES 患者（n=89,130）的 0.65 倍。2013 年处方率趋于平衡，自 2021 年以来，低 SES 处方率超过了高 SES 处方率。结论/影响：低社会经济地位患者延迟三年接受 NOAC 处方的比例与高社会经济地位患者相同。系统性变革，如更频繁地更新处方指南和改善低收入地区医疗服务提供者的循证教育，可避免未来引入类似变革性治疗时出现类似的延迟。
{"title":"Delayed Prescribing of Non-Vitamin K Antagonist Oral Anticoagulants (NOACs) in Patients with Low Socioeconomic Status","authors":"Gillian Coffey, Puja Unni, James Butler","doi":"10.18060/27744","DOIUrl":"https://doi.org/10.18060/27744","url":null,"abstract":"Background/Objective: Atrial fibrillation (AF) and venous thromboembolism (VTE) are conditions with significant morbidity and mortality when left untreated. American Heart Association guidelines changed in 2019 to make non-vitamin K antagonist oral anticoagulants (NOACs) the preferred method for preventing stroke and systemic embolism in patients with AF or history of VTE. NOACs were first introduced to the United States in 2010 and now include dabigatran, apixaban, rivaroxaban, and edoxaban. There is a dearth of research concerning the speed with which new treatments are prescribed to those in different socioeconomic status (SES) groups. We hypothesized that patients with lower SES were prescribed NOACs later than higher SES counterparts following the introduction of NOACs in 2010. \u0000Methods: The IU Cardiovascular Research Consortium/Sidus Dataset was mined for AF and VTE patients prescribed a NOAC between 2010 and 2022. The SES groups were determined using 2020 U.S. Census income data that correlated to patients’ zip codes. The yearly number ofpatients in each SES group were compared to assess for proportional uptake of NOAC prescribing. The primary outcome was the proportion of low SES to high SES prescribing over each year between 2010 and 2022. \u0000Results: Low SES patients (n=101,945) were prescribed NOACs at an average of 0.65 times the rate of high SES patients (n= 89,130) from 2010 to 2012, the first three years of NOAC market availability. Prescribing rates equilibrated in 2013 and low SES prescribing has outpaced high SES prescribing since 2021. \u0000Conclusion/Impact: Low SES patients experienced a three year delay in receiving NOAC prescriptions at the same rate as their high SES counterparts. Systemic changes, like more frequent prescribing guideline updates and improved evidence-based education amongst providers in low-income areas, could prevent a similar delay when introducing similarly transformative treatments in the future.","PeriodicalId":20522,"journal":{"name":"Proceedings of IMPRS","volume":" 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139626697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hannah Dillon, B. Whittam, Richard Rink, M. Kaefer, Kirstan D Meldrum, Joshua Roth, Pankaj Dangle, Yifan Meng, Jeremy Koehlinger, R. Misseri, Konrad Szymanski
Background and Hypothesis: Children with voiding dysfunction (VD), such as incontinence or urinary frequency, may report lower quality of life (QOL) compared to their peers. QOL questionnaires which could be used in this population have several limitations. PinQ is a bladder-specific, health-related QOL questionnaire, but it was developed without stakeholder input and fails to separate symptoms from QOL. Kidscreen-10 is a generic QOL questionnaire. We aimed to understand how QOL captured using existing instruments correlates with VD severity in a cross-sectional study. We hypothesized that large differences in symptoms would correspond with large differences in bladder-specific QOL but small differences in generic QOL. Methods: We recruited children 8-18 years old with VD at a pediatric urology clinic (June-July 2023). VD included daytime incontinence, enuresis, frequency, urgency, and dysuria. We excluded children with severe developmental delay, anatomical urological abnormalities, or history ofurologic surgery. We captured demographics, symptoms (Vancouver Dysfunction Voiding Symptom Score, DVSS), and QOL (PinQ and Kidscreen-10). Questionnaire scores were compared to weighted means from previous studies. We calculated Spearman correlations and QOL differences corresponding with the reported 20-point range of DVSS scores. Results: Twenty children (11 girls) at a median age of 10 years old participated (Table 1). Mean DVSS score was 14, similar to previous studies (weighted mean: 15). PinQ scores had a moderate positive correlation with DVSS scores (r = 0.37) with a 20-point DVSS difference corresponding to a 24% difference in PinQ scores (Figure 1). Kidscreen-10 scores had a moderate negative correlation with DVSS scores (r = -0.33) with a 20-point DVSS difference corresponding to a 12% difference in Kidscreen-10 scores (Figure 2). Conclusions: Previously published QOL questionnaires have significant limitations, limiting their clinical use in the care of patients with VD. A new, patient-centered, highly specific, and sensitive healthrelated QOL questionnaire is needed.
背景与假设：与同龄人相比，患有尿失禁或尿频等排尿功能障碍（VD）的儿童的生活质量（QOL）可能较低。可用于此类人群的 QOL 问卷存在一些局限性。PinQ 是一种针对膀胱的、与健康相关的 QOL 问卷，但它在开发过程中并未征求利益相关者的意见，也未能将症状与 QOL 区分开来。Kidscreen-10 是一份通用的 QOL 问卷。我们的目的是在一项横断面研究中了解使用现有工具获得的 QOL 与 VD 严重程度的相关性。我们假设，症状的巨大差异会导致膀胱特异性 QOL 的巨大差异，但通用 QOL 的差异较小。研究方法我们在一家儿科泌尿科诊所招募了 8-18 岁患有 VD 的儿童（2023 年 6 月至 7 月）。尿失禁包括日间尿失禁、遗尿、尿频、尿急和排尿困难。我们排除了严重发育迟缓、泌尿系统解剖异常或有泌尿系统手术史的儿童。我们收集了人口统计学资料、症状（温哥华功能障碍排尿症状评分，DVSS）和 QOL（PinQ 和 Kidscreen-10）。问卷得分与以往研究的加权平均值进行了比较。我们计算了斯皮尔曼相关性以及与报告的 20 分 DVSS 评分范围相对应的 QOL 差异。结果：共有 20 名中位数年龄为 10 岁的儿童（11 名女孩）参加（表 1）。DVSS 平均分为 14 分，与之前的研究结果相似（加权平均分：15 分）。PinQ 分数与 DVSS 分数呈中度正相关（r = 0.37），20 分的 DVSS 差异对应于 24% 的 PinQ 分数差异（图 1）。Kidscreen-10 分数与 DVSS 分数呈中度负相关（r = -0.33），20 分的 DVSS 差异对应于 12% 的 Kidscreen-10 分数差异（图 2）。结论以前公布的 QOL 问卷有很大的局限性，限制了它们在 VD 患者护理中的临床应用。我们需要一种新的、以患者为中心的、高度特异性和敏感性的健康相关 QOL 问卷。
{"title":"Health-Related Quality of Life Correlates with Bladder and Bowel Dysfunction: the Need for a New Patient-Centered Questionnaire","authors":"Hannah Dillon, B. Whittam, Richard Rink, M. Kaefer, Kirstan D Meldrum, Joshua Roth, Pankaj Dangle, Yifan Meng, Jeremy Koehlinger, R. Misseri, Konrad Szymanski","doi":"10.18060/27802","DOIUrl":"https://doi.org/10.18060/27802","url":null,"abstract":"Background and Hypothesis: Children with voiding dysfunction (VD), such as incontinence or urinary frequency, may report lower quality of life (QOL) compared to their peers. QOL questionnaires which could be used in this population have several limitations. PinQ is a bladder-specific, health-related QOL questionnaire, but it was developed without stakeholder input and fails to separate symptoms from QOL. Kidscreen-10 is a generic QOL questionnaire. We aimed to understand how QOL captured using existing instruments correlates with VD severity in a cross-sectional study. We hypothesized that large differences in symptoms would correspond with large differences in bladder-specific QOL but small differences in generic QOL. \u0000Methods: We recruited children 8-18 years old with VD at a pediatric urology clinic (June-July 2023). VD included daytime incontinence, enuresis, frequency, urgency, and dysuria. We excluded children with severe developmental delay, anatomical urological abnormalities, or history ofurologic surgery. We captured demographics, symptoms (Vancouver Dysfunction Voiding Symptom Score, DVSS), and QOL (PinQ and Kidscreen-10). Questionnaire scores were compared to weighted means from previous studies. We calculated Spearman correlations and QOL differences corresponding with the reported 20-point range of DVSS scores. \u0000Results: Twenty children (11 girls) at a median age of 10 years old participated (Table 1). Mean DVSS score was 14, similar to previous studies (weighted mean: 15). PinQ scores had a moderate positive correlation with DVSS scores (r = 0.37) with a 20-point DVSS difference corresponding to a 24% difference in PinQ scores (Figure 1). Kidscreen-10 scores had a moderate negative correlation with DVSS scores (r = -0.33) with a 20-point DVSS difference corresponding to a 12% difference in Kidscreen-10 scores (Figure 2). \u0000Conclusions: Previously published QOL questionnaires have significant limitations, limiting their clinical use in the care of patients with VD. A new, patient-centered, highly specific, and sensitive healthrelated QOL questionnaire is needed.","PeriodicalId":20522,"journal":{"name":"Proceedings of IMPRS","volume":" 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139626809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background:Eosinophilic esophagitis (EoE) is a chronic inflammatory disease of the esophagus characterized by symptoms of esophageal dysfunction and 15 or more eosinophils per high-powered field (HPF) on esophageal biopsy. Treatment options for EoE include proton pump inhibitors (PPIs), topical corticosteroids (TCS), dietary elimination, and dupilumab. Dupilumab is monoclonal antibody against IL-4 and IL-13 administered subcutaneously and was granted FDA approval for EoE in adults and adolescents recently in 2022. Outcomes of real-world, clinical use of dupilumab for EoE remains unknown. Objectives:To observe outcomes in pediatric patients with EoE treated with dupilumab. Methods:A retrospective cohort study of pediatric patients prescribed dupilumab for EoE was conducted. Medical records were reviewed for demographic and clinical information as well as endoscopic and histologic findings before and after dupilumab treatment. Results:A total of 28 patients were included (mean age 15y, 71.4% male). Mean baseline maximum eosinophils/HPF was 48 ± 41. 75% of patients were treated with combination therapy of EoE with diet elimination, PPIs, or TCS prior to being prescribed dupilumab. Prior authorization for dupilumab was required in 85.7% of cases. Ten patients had follow-up endoscopy with biopsy after starting dupilumab, and among these patients the mean maximum eosinophils/HPF with dupilumab significantly improved from 44 ± 37 to 13 ± 15 (p=0.027). Among 12 patients who had follow up clinic visits, two patients reported pain or swelling at injection sites, but no otheradverse events were reported Conclusions:Dupilumab significantly improves histologic findings of EoE and is well tolerated among pediatric patients. We hope for continued monitoring of these patients to understand the clinical utility of dupilumab for EoE over time.
{"title":"Clinical Utility of Dupilumab for the Treatment of Eosinophilic Esophagitis in Pediatric Patients","authors":"Alexa Becker, Paroma Bose","doi":"10.18060/27842","DOIUrl":"https://doi.org/10.18060/27842","url":null,"abstract":"Background:Eosinophilic esophagitis (EoE) is a chronic inflammatory disease of the esophagus characterized by symptoms of esophageal dysfunction and 15 or more eosinophils per high-powered field (HPF) on esophageal biopsy. Treatment options for EoE include proton pump inhibitors (PPIs), topical corticosteroids (TCS), dietary elimination, and dupilumab. Dupilumab is monoclonal antibody against IL-4 and IL-13 administered subcutaneously and was granted FDA approval for EoE in adults and adolescents recently in 2022. Outcomes of real-world, clinical use of dupilumab for EoE remains unknown. \u0000Objectives:To observe outcomes in pediatric patients with EoE treated with dupilumab. \u0000Methods:A retrospective cohort study of pediatric patients prescribed dupilumab for EoE was conducted. Medical records were reviewed for demographic and clinical information as well as endoscopic and histologic findings before and after dupilumab treatment. \u0000Results:A total of 28 patients were included (mean age 15y, 71.4% male). Mean baseline maximum eosinophils/HPF was 48 ± 41. 75% of patients were treated with combination therapy of EoE with diet elimination, PPIs, or TCS prior to being prescribed dupilumab. Prior authorization for dupilumab was required in 85.7% of cases. Ten patients had follow-up endoscopy with biopsy after starting dupilumab, and among these patients the mean maximum eosinophils/HPF with dupilumab significantly improved from 44 ± 37 to 13 ± 15 (p=0.027). Among 12 patients who had follow up clinic visits, two patients reported pain or swelling at injection sites, but no otheradverse events were reported \u0000Conclusions:Dupilumab significantly improves histologic findings of EoE and is well tolerated among pediatric patients. We hope for continued monitoring of these patients to understand the clinical utility of dupilumab for EoE over time.","PeriodicalId":20522,"journal":{"name":"Proceedings of IMPRS","volume":" 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139625523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Reginald S Parker, Will Varner, Murad K. Nazzal, Amy Creecy, Sonali J. Karnik, Rachel J. Blosser, Elizabeth Scott, Alexander Harris, Ashlyn Morris, Hannah S. Wang, Tyler J. Margetts, Marko Dragisic, Upasana Ganguly, Jill C. Fehrenbacher, Kathryn D. Fischer, Alexandru Movila, Adrian L. Oblak, Jessica Hathaway-Schrader, Melissa A. Kacena
Alzheimer's disease (AD), fracture healing, and the gut microbiome are interconnected aspects of health that have gained significant research interest. Recent studies suggest gut dysbiosis may play a role in AD pathogenesis, potentially through the gut-brain axis, a bidirectional communication system. Moreover, the gut microbiome's role in bone health could link dysbiosis and fracture risk. Furthermore, research reports have revealed that the brain communicates with bone, termed the bone-brain axis. Despite these insights, the effect of the gut microbiome on fracture healing in AD remains largely unexplored. To uncover these connections, our study uses the AD mouse models, 3xTg and 5xFAD. We conducted osteotomies on these mice and analyzed fecal samples that were collected at different timepoints. Fecal samples are being examined via qPCR and 16s RNA analysis toidentify and quantify bacterial phyla. These findings will be linked to both AD progression, gauged through behavior and histological analyses, and fracture healing, quantified using X-ray mRUST scoring, microCT, and histology. We hypothesize that the progression of AD could alter the gut microbiome, potentially affecting fracture healing. This might occur through inflammation pathways triggered by specific gut bacteria. We may identify specific gut bacteria that play critical roles in both fracture healing and AD. We anticipate finding a shift towards pro-inflammatory bacterial phyla in the context of AD progression and during the fracture healing process. If this hypothesis is validated, it could unlock new therapeutic strategies aimed at targeting the gut microbiome to improve bone health, fracture healing, and AD progression in patients.
阿尔茨海默病（AD）、骨折愈合和肠道微生物组是相互关联的健康问题，已引起了研究人员的极大兴趣。最近的研究表明，肠道菌群失调可能通过肠道-大脑轴这一双向交流系统在阿尔茨海默病发病机制中发挥作用。此外，肠道微生物组在骨骼健康中的作用可能将菌群失调与骨折风险联系起来。此外，研究报告还揭示了大脑与骨骼之间的沟通，即骨-脑轴。尽管有了这些见解，但肠道微生物组对艾滋病患者骨折愈合的影响在很大程度上仍未得到探讨。为了揭示这些联系，我们的研究使用了 AD 小鼠模型 3xTg 和 5xFAD。我们对这些小鼠进行了截骨手术，并分析了在不同时间点采集的粪便样本。粪便样本正在通过 qPCR 和 16s RNA 分析进行检验，以确定细菌门类并对其进行量化。这些发现将与注意力缺失症的进展（通过行为和组织学分析进行衡量）和骨折愈合（通过 X 射线 mRUST 评分、microCT 和组织学进行量化）相关联。我们假设，AD 的进展会改变肠道微生物群，从而可能影响骨折愈合。这可能是通过特定肠道细菌引发的炎症途径发生的。我们可能会找出在骨折愈合和 AD 中发挥关键作用的特定肠道细菌。我们预计，在 AD 发展过程中和骨折愈合过程中，会发现向促炎细菌门类的转变。如果这一假设得到验证，它将开启以肠道微生物组为靶点的新治疗策略，从而改善患者的骨骼健康、骨折愈合和 AD 进展。
{"title":"The Potential Tripartite Connection: Alzheimer's Disease, Fracture Healing, and the Gut Microbiome","authors":"Reginald S Parker, Will Varner, Murad K. Nazzal, Amy Creecy, Sonali J. Karnik, Rachel J. Blosser, Elizabeth Scott, Alexander Harris, Ashlyn Morris, Hannah S. Wang, Tyler J. Margetts, Marko Dragisic, Upasana Ganguly, Jill C. Fehrenbacher, Kathryn D. Fischer, Alexandru Movila, Adrian L. Oblak, Jessica Hathaway-Schrader, Melissa A. Kacena","doi":"10.18060/27756","DOIUrl":"https://doi.org/10.18060/27756","url":null,"abstract":"Alzheimer's disease (AD), fracture healing, and the gut microbiome are interconnected aspects of health that have gained significant research interest. Recent studies suggest gut dysbiosis may play a role in AD pathogenesis, potentially through the gut-brain axis, a bidirectional communication system. Moreover, the gut microbiome's role in bone health could link dysbiosis and fracture risk. Furthermore, research reports have revealed that the brain communicates with bone, termed the bone-brain axis. Despite these insights, the effect of the gut microbiome on fracture healing in AD remains largely unexplored. \u0000To uncover these connections, our study uses the AD mouse models, 3xTg and 5xFAD. We conducted osteotomies on these mice and analyzed fecal samples that were collected at different timepoints. Fecal samples are being examined via qPCR and 16s RNA analysis toidentify and quantify bacterial phyla. These findings will be linked to both AD progression, gauged through behavior and histological analyses, and fracture healing, quantified using X-ray mRUST scoring, microCT, and histology. \u0000We hypothesize that the progression of AD could alter the gut microbiome, potentially affecting fracture healing. This might occur through inflammation pathways triggered by specific gut bacteria. We may identify specific gut bacteria that play critical roles in both fracture healing and AD. We anticipate finding a shift towards pro-inflammatory bacterial phyla in the context of AD progression and during the fracture healing process. If this hypothesis is validated, it could unlock new therapeutic strategies aimed at targeting the gut microbiome to improve bone health, fracture healing, and AD progression in patients.","PeriodicalId":20522,"journal":{"name":"Proceedings of IMPRS","volume":" 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139625671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Rigid silicon electrodes like Utah array grids and Neuropixel probes have been used in human and animal brain models to understand the dynamics of neural computation, treat neurodegenerative disorders, and act as brain-machine-interfaces. However, when implanted chronically, glial proliferation can rapidly disrupt the interaction between neurons and electrodes, drastically reducing recording fidelity. The development of flexible electrodes has the potential to minimize tissue damage and inflammation, which allows for long-term recordings over several months. In line with this objective, the Nano-neurotechnology Lab at Purdue University has developed a 6-µm thick, flexible, and biocompatible Parylene probe to facilitate chronic recordings in awake mice. However, flexible electrodes present a unique engineering challenge as the force required to insert into the brain causes the probe to buckle and fail during insertion. Methods and Results: Here, I designed a micropipette shuttle using a glass micropipette and custom insertion system which provided reproducible probe implantation into the cortex. The implantation device was designed in CAD software and 3D-printed for rapid prototyping. The procedure was developed on brain phantoms made of 0.6% agarose with a comparable Young’s modulus to mouse brain tissue. Utilizing 3D-printed pieces and the surface tension of diluted poly-vinyl-acrylate adhesive to align the probe to a micropipette, insertion of the electrode and retraction of the shuttle was accomplished in awake mice. Conclusion: The implications of flexible recording electrodes are extensive. Long-term implantation opens the door for understanding behavioral and learning dynamics over time. Moreover, the flexibility of these probes allows for the combination of 2-photon optical microscopy, thus enabling multi-modal investigation of neuronal physiology. A low-cost, consistent procedure is the first step in the implementation of these flexible probes for further advancements in fundamental neuroscience research and its potential applications in human and animal studies.
{"title":"Implantation of Flexible Electrodes for Simultaneous in-vivo Extracellular Recording and Two-Photon Imaging","authors":"Alec Booth, Hammad Khan, Om Kolhe, Krishna Jayant","doi":"10.18060/27949","DOIUrl":"https://doi.org/10.18060/27949","url":null,"abstract":"Introduction: Rigid silicon electrodes like Utah array grids and Neuropixel probes have been used in human and animal brain models to understand the dynamics of neural computation, treat neurodegenerative disorders, and act as brain-machine-interfaces. However, when implanted chronically, glial proliferation can rapidly disrupt the interaction between neurons and electrodes, drastically reducing recording fidelity. The development of flexible electrodes has the potential to minimize tissue damage and inflammation, which allows for long-term recordings over several months. In line with this objective, the Nano-neurotechnology Lab at Purdue University has developed a 6-µm thick, flexible, and biocompatible Parylene probe to facilitate chronic recordings in awake mice. However, flexible electrodes present a unique engineering challenge as the force required to insert into the brain causes the probe to buckle and fail during insertion. \u0000Methods and Results: Here, I designed a micropipette shuttle using a glass micropipette and custom insertion system which provided reproducible probe implantation into the cortex. The implantation device was designed in CAD software and 3D-printed for rapid prototyping. The procedure was developed on brain phantoms made of 0.6% agarose with a comparable Young’s modulus to mouse brain tissue. Utilizing 3D-printed pieces and the surface tension of diluted poly-vinyl-acrylate adhesive to align the probe to a micropipette, insertion of the electrode and retraction of the shuttle was accomplished in awake mice. \u0000Conclusion: The implications of flexible recording electrodes are extensive. Long-term implantation opens the door for understanding behavioral and learning dynamics over time. Moreover, the flexibility of these probes allows for the combination of 2-photon optical microscopy, thus enabling multi-modal investigation of neuronal physiology. A low-cost, consistent procedure is the first step in the implementation of these flexible probes for further advancements in fundamental neuroscience research and its potential applications in human and animal studies. ","PeriodicalId":20522,"journal":{"name":"Proceedings of IMPRS","volume":" 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139625984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background and Objective:In the emergency department, providers are expected to evaluate patients who have experienced strangulation resulting from sexual assault or interpersonal violence. Non-fatal strangulation can lead to significant injuries, including carotid artery dissection. Given the prevalence of strangulation injuries, providers must feel confident in their decision-making for this population. Previous educational interventions effectively improved provider knowledge of sexual assault and domestic violence patients, however, no studies have been conducted with the goal of improving provider knowledge about strangulation injuries in this population. We aimed to assess and improve emergency department provider knowledge surrounding nonfatal strangulation injuries. Project Methods:Preintervention and postintervention surveys were administered to emergency department physicians and advanced practice providers assessing both provider comfort and knowledge regarding treatment of survivors of sexual assault, domestic violence, and strangulation. Key content areas included: physician comfort in treating sexual assault survivors, understanding of trauma-informed care, satisfaction with prior training regarding nonfatal strangulation, and physician attitudes. 6 vignette-style questions designed to evaluate knowledge in clinical scenarios were also administered. A 15-minute, interactive, educational presentation was administered during the pre-existing departmental meeting. Survey responses were collected via email and data was stored in REDCAP. Preintervention and postintervention results were compared via t-tests. Results:There were 22 pre-intervention and 10 post-intervention responses. Median years of practice were 8. Survey participants tended to rate awareness of imaging recommendations and resources, decisionmaking, history taking, and use of trauma-informed care higher than preintervention participants. Postintervention participants tended to answer more clinical vignettes correctly than preintervention participants. Conclusion and Potential Impact:A 15-minute educational intervention was effective in improving provider knowledge, confidence, and comfort in treating patients who have experienced non-fatal strangulation. In the future, similar interventions may be implemented in other emergency departments to increase awareness about the evaluation and treatment of nonfatal strangulation injuries.
{"title":"Non-Fatal Strangulation Injuries: Improving Physician Knowledge and Attitudes","authors":"Sarah Pankratz, Christine Motzkus","doi":"10.18060/27755","DOIUrl":"https://doi.org/10.18060/27755","url":null,"abstract":"Background and Objective:In the emergency department, providers are expected to evaluate patients who have experienced strangulation resulting from sexual assault or interpersonal violence. Non-fatal strangulation can lead to significant injuries, including carotid artery dissection. Given the prevalence of strangulation injuries, providers must feel confident in their decision-making for this population. Previous educational interventions effectively improved provider knowledge of sexual assault and domestic violence patients, however, no studies have been conducted with the goal of improving provider knowledge about strangulation injuries in this population. We aimed to assess and improve emergency department provider knowledge surrounding nonfatal strangulation injuries. \u0000Project Methods:Preintervention and postintervention surveys were administered to emergency department physicians and advanced practice providers assessing both provider comfort and knowledge regarding treatment of survivors of sexual assault, domestic violence, and strangulation. Key content areas included: physician comfort in treating sexual assault survivors, understanding of trauma-informed care, satisfaction with prior training regarding nonfatal strangulation, and physician attitudes. 6 vignette-style questions designed to evaluate knowledge in clinical scenarios were also administered. A 15-minute, interactive, educational presentation was administered during the pre-existing departmental meeting. Survey responses were collected via email and data was stored in REDCAP. Preintervention and postintervention results were compared via t-tests. \u0000Results:There were 22 pre-intervention and 10 post-intervention responses. Median years of practice were 8. Survey participants tended to rate awareness of imaging recommendations and resources, decisionmaking, history taking, and use of trauma-informed care higher than preintervention participants. Postintervention participants tended to answer more clinical vignettes correctly than preintervention participants. \u0000Conclusion and Potential Impact:A 15-minute educational intervention was effective in improving provider knowledge, confidence, and comfort in treating patients who have experienced non-fatal strangulation. In the future, similar interventions may be implemented in other emergency departments to increase awareness about the evaluation and treatment of nonfatal strangulation injuries.","PeriodicalId":20522,"journal":{"name":"Proceedings of IMPRS","volume":"56 16","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139533327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：