Validity and reliability of telephone administration of the patient-specific functional scale for the assessment of recovery from snakebite envenomation

OBJECTIVES: Although more than 1.8 million people survive snakebite envenomation each year, their recovery is understudied. Obtaining long-term follow-up is challenging in both high- and low-resource settings. The Patient-Specific Functional Scale (PSFS) is an easily administered, well-accepted patient-reported outcome that is validated for assessing limb recovery from snakebite envenomation. We studied whether the PSFS is valid and reliable when administered by telephone. METHODS: This is a secondary analysis of data from a randomized clinical trial. We analyzed the results of PSFS collected in-person on days 3, 7, 14, 21, and 28 and by telephone on days 10, 17, and 24. We assessed the following scale psychometric properties: (a) content validity (ceiling and floor effects), (b) internal structure and consistency (Cronbach\u27s alpha), and (c) temporal and external validity using Intraclass Correlation Coefficient (ICC). Temporal stability was assessed using Spearman\u27s correlation coefficient and agreement between adjacent in-person and telephonic assessments with Cohen\u27s kappa. Bland Altman analysis was used to assess differential bias in low and high score results. RESULTS: Data from 74 patients were available for analysis. Floor effects were seen in the early post-injury time points (median: 3 (IQR: 0, 5) at 3 days post-enrollment) and ceiling effects in the late time points (median: 9 (IQR: 8, 10). Internal consistency was good to excellent with both in-person (Cronbach α: 0.91 (95%CI 0.88, 0.95)) and telephone administration (0.81 (0.73, 0.89). Temporal stability was also good (ICC: 0.83 (0.72, 0.89) in-person, 0.80 (0.68, 0.88) telephone). A strong linear correlation was found between in-person and telephone administration (Spearman\u27s ρ: 0.83 (CI: 0.78, 0.84), consistency was assessed as excellent (Cohen\u27s κ 0.81 (CI: 0.78, 0.84), and Bland Altman analysis showed no systematic bias. CONCLUSIONS: Telephone administration of the PSFS provides valid, reliable, and consistent data for the assessment of recovery from snakebite envenomation

Electrospun nanofibers as neural guidance scaffolds

Highly-aligned electrospun PolyLactic-L-Acid (PLLA) nanofibers have been shown to promote and direct the axonal outgrowth of Central Nervous System (CNS) neurons. Aligned fibers deposited on 3D printed stages have been tested in vitro using chick Dorsal Root Ganglia (DRG\u27s), and show highly directed neurite growth with improved extension. In vivo studies on rats indicate that similar results are attained, with substantial regrowth of fully transected spinal cords. Extension of these studies to new generation of coaxial nanofiber scaffolds which allow electrical stimulation are in progress.https://digitalcommons.mtu.edu/techtalks/1018/thumbnail.jp

Regulating for Public Health: Motivations for and Efficacy of State Alcohol Regulations

Health Economics and Policy,

Sample Collection and DNA Extraction Methods for Environmental DNA Metabarcoding in Headwater Streams

DNA is found to be free and ubiquitous in the environment where it is no longer associated with the source organism, and is also known as environmental-DNA (eDNA). Methods optimized for specific environments may be able supplement insight to local taxa richness. With the advent of high throughput sequencing and the proliferation of sequence data in public repositories, insights to the biodiversity of communities at the molecular level have been possible. Thus, this study compared commonly used DNA capture (water precipitation and filtration) and extraction (MoBio\u27s PowerWater, Qiagen\u27s DNeasy Blood and Tissue Kit, and a CTAB protocol) methods in their ability to isolate eDNA for the purpose of metabarcoding a section of the ribosomal small subunit 18 S (18s) and the cytochrome oxidase I (COI) gene regions. The 18s sequence data is non-reportable due to lack of sequence quality, and MoBio\u27s PowerWater did not yield DNA suitable concentrations. CTAB and DNeasy extractions yielded successful PCR reactions and high-throughput sequencing (HTS). When combined with their respective replicates, CTAB and DNeasy were determined to have genus richness ( -diversity) of 25 and 24, respectively of benthic macroinvertebrates with 20 taxonomic determinations being shared between the two methods. After conducting Jaccard\u27s dissimilarity index and constructing ordination plots using non-metric multidimensional scaling (NMDS), this study was not able to reveal differences in the amount of taxa richness between CTAB and DNeasy, which implied extraction methods may not be a limiting factor in detected taxa richness

Investigations into Haemophilus parasuis virulence: pre-, post-, and pan-genomic perspectives

Haemophilus parasuis is the causative agent of Glysser\u27s disease in swine. Glysser\u27s disease affects swine health and producer profits but the mechanisms through which disease occurs remain unclear. The primary objective of this dissertation research was to use molecular biology techniques to investigate the molecular basis of H. parasuis pathogenesis. To this end, four projects were carried out. Firstly, we generated a draft of an H. parasuis genome, the first made available to the public. Secondly, we identified and studied the genes of two outer membrane proteins possibly associated with virulence from 35 strains of H. parasuis. Thirdly, experiments to detect H. parasuis IgA protease activity were conducted. Finally, we developed an enhanced multi-locus sequence typing (MLST) system for the characterization of H. parasuis isolates. We established a publicly accessible database where current types may be viewed and to which new sequences may be submitted. Together, these studies provide insight into the workings of H. parasuis and establish a framework upon which future studies can be based. The information presented in this dissertation advances understanding and makes progress toward the development of enhanced treatment and prevention strategies

Intravenous lidocaine for the treatment of acute pain in the emergency department

OBJECTIVE: To evaluate intravenous lidocaine’s safety and efficacy as an analgesic agent in the treatment of a variety of painful conditions presenting to the emergency department. METHODS: This case series identified seventeen patients who received lidocaine over a six month period and recorded demographic data, amount of lidocaine administered, the amount of opioid medication administered before and after lidocaine, pre- and post-lidocaine pain scores, and any qualitative descriptors of the patient’s pain recorded in the record. Side effects and adverse events were also recorded. RESULTS: Of the seven patients who had a pre- and post-lidocaine pain score recorded, the mean reduction was 3 points on a 10 point scale. Patients who received lidocaine used less opioid medication. One patient received an improperly high dose of lidocaine and suffered a brief seizure and cardiac arrest, but was quickly resuscitated. CONCLUSION: This series suggests that lidocaine may be a useful adjunct in the treatment of acutely painful conditions in the emergency department