Faculty Publications and Presentations

Permanent URI for this collectionhttps://hdl.handle.net/2152.5/1369

This collection contains publications and presentations created by UT Southwestern faculty and encourages the open access of scholarly activity.

The Library welcomes submissions of materials to this collection, and all submissions will be publicly available through the repository. Copyright of submitted materials remains with the copyright holder.

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Recent Submissions

Now showing 1 - 11 of 11
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    Promoting Employee Engagement in the Healthcare Setting Using Neuroaesthetics: A Pilot Initiative
    (2024-04-26) Garduno Rapp, Estefanie; Bosler, Katherine; Crawford, Michelle; Valdez, Jovana; Crothers, Courtney; Cook, Allyson H.; Farmer, Suzanne
    BACKGROUND: Healthcare professionals face numerous stressors in their roles, including heavy workloads and patient care responsibilities, which can impact their mental health. Neuroaesthetics, the scientific study of how contemplating artwork affects the brain, has shown that integrating art into hospital environments can boost morale among patients, staff, and visitors and potentially aid in healing processes and clinical outcomes. Providing activities like engaging with visual arts can promote resilience in the workplace and support overall employee well-being and engagement. OBJECTIVE: Our aim was to enhance workplace appreciation and employee engagement by offering a neuroaesthetics experience to 30 healthcare professionals. METHODS: We conducted a study with 30 healthcare professionals, including physicians, nurses, and administrators, at the University of Texas Southwestern Medical Center (UTSW). Participants were invited to take part in specialized art tours organized by Women in Art and the UTSW curator. These tours were held in the scientific and clinical buildings of UTSW, allowing participants to directly engage with strategically placed artworks in their professional environment. During the tours, participants received detailed explanations about the artworks, learned about the selection processes, engaged in discussions about color usage, and explored various artistic mediums. After the tours, participants completed an anonymous survey via REDCap to assess their perceptions of the tour's impact on workplace appreciation and well-being. The survey gathered qualitative data through written feedback about their experiences and quantitative data using a rating scale from 0 to 10 to measure overall tour satisfaction. RESULTS: Of the 30 participants 97 responded that the art tour enhanced their appreciation for the workplace and 70% of employees rated their art experience as a 10 on a scale from of 0-10. CONCLUSIONS: Our findings suggest that activities promoting resilience in the workplace can enhance employee engagement and foster a positive work environment. To capitalize on these benefits, future efforts should focus on expanding participation in similar initiatives, such as conducting more art tours and increasing awareness about them on campus.
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    Building and Deploying a Cloud Environment for Hosting Custom Application Development Services Within an Academic Tertiary Center
    (2023-09-15) Garduno Rapp, Estefanie; Hanna, John J.; Reeder, Jonathan
    SIGNIFICANCE: The 21st Century Cures Act (Cures Act) is designed to help accelerate medical product development and bring new innovations and advances to patients who need them faster and more efficiently. Patients can now access their health information including radiology or pathology reports in near real-time. However, a few tools exist to allow patients to interpret these findings. OBJECTIVE: To design an application that enhances patient understanding of diagnostic descriptions by translating medical reports into lay terms. As well as, building and hosting an environment for custom application development services in our academic center. METHODS: We developed a web-based application in java that utilizes open AI to translate medical reports to layman terms. Posteriorly, we deployed our application within Microsoft Azure by building a static web app resource. Subsequently, through Visual Studio Code which was connected to our GitHub account. We downloaded an extension specifically designed to work with Azure to build and deploy static apps. By doing so, we were able to set up an authentication function that only allows access within our hospital network. RESULTS: The application can successfully translate medical jargon into layman terms and the deployment in azure enabled us to implement real-time changes whenever we pushed modifications in GitHub. CONCLUSIONS: The project was a proof of concept to demonstrate the possibilities of leveraging our organization's cloud services for development and hosting purposes. This demonstration serves as an illustration of the broader potential we have for building and hosting applications that can drive development towards a more patient-focused healthcare system within our hospital. By doing so, we facilitated a playground for medical professionals to develop meaningful tools that can bridge the gap between patients understanding and diagnostic information. KEYWORDS: Web-based applications; cloud services; digital technologies.
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    Predicting Heart Disease Through Supervised Machine Learning Algorithms
    (2022-09-09) Garduno Rapp, Estefanie
    INTRODUCTION: Heart disease may present in a variety of forms including rhythm-disturbances, pump-failure, silent ischemia, angina, and sudden death among others. Early diagnosis is a crucial step to decrease serious cardiac events. Machine Learning (ML) is a promising tool to improve healthcare diagnostics and risk prediction in highly relevant and common illnesses such as cardiovascular disease. OBJECTIVE: To develop and evaluate three effective machine learning-supervised models to diagnose heart disease based on individual features. METHODS: We developed three machine learning models (Elastic net, logistic regression, and random forest) to identify individuals with heart disease. The discovery dataset used for model development included 303 subjects (138 with heart disease and 165 controls) and 14 predictor variables (including traditional cardiovascular risk factors). The outcome variable was the diagnosis of heart disease. The discovery dataset was split into training (70%), validation (10%), and testing (20%) subsets. Model development for elastic net and random forest was accomplished using the training and validation splits, whereas logistic regression was fit using only the training split. We selected hyperparameters for the elastic net model through cross validation and selected the predictors for logistic regression by backward stepwise selection. We calculated predictions using the testing split and evaluated the performance of the classifier based on the area under the receiver-operating-characteristic curve (AUC). Lastly, we used an external validation dataset (n=295, 107 cases and 188 controls) to make predictions. RESULTS: In the testing dataset, the elastic net model achieved AUC of 90% and accuracy of 86%; the logistic regression AUC was 95% and accuracy of 90%. For the random forest model, the Out-of-Box error was 25.21%; the number of variables used at each split were 3 and the accuracy in the testing test was 83%. When the model was confronted with an external validation dataset, the accuracy was 77%. CONCLUSION: We developed three models to evaluate ML performance with a discrete dataset. The logistic regression model outperformed the other models with an accuracy of 90% and an AUC of 95%. The final model included 6 variables: Sex, heart rate, exercise induced ST depression, and typical and atypical anginal pain and non-anginal pain. Future work on boosting techniques is required to improve the accuracy of the predictive model. Additionally, developing a comparison analysis between these ML models and conventional clinical approaches may help elucidate the net benefit.
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    Definition of Anisocoria in Neurocritical Patients
    (2023-05-12) Saju, Ciji; Barnes, Arianna; Kuramatsu, Joji B.; Marshall, Jade L.; Obinata, Hirofumi; Puccio, Ava M.; Yokobori, Shoji; Prasad, Sidarrth; Olson, Daiwai M.
    INTRODUCTION: Anisocoria, defined as the absolute difference in left and right pupil diameter, is an important clinical finding. However, the definition of anisocoria varies and clinicians have limited reliability in estimating pupil size through subjective measurements. Using a quantitative pupillometer (QP) increases the accuracy and consistency in pupil measurement. OBJECTIVES: The primary objective of this study is to examine the presence of anisocoria at rest, and anisocoria after exposure to light, using QP in a cohort of Neuroscience intensive care unit (NSICU) patients. The secondary objective is to explore anisocoria using different cutpoints for differences in size. MATERIALS & METHODS: Retrospective analysis from an international registry was queried to obtain the first paired QP measurement from patients admitted to one of 4 US and 2 international NSICUs. DISCUSSION/RESULTS: Sample size includes 5769 patients with a mean age of 57.5 (17.6%) years. Of these, 2,558 (51.5%) were female, 3,669 (75.5%) were White, and 4,369 (89.2%) were non-Hispanic. Hospital length of stay was a median of 6 (3 to 14) days, and the median ICU length of stay was (1 to 8) days. Using the smallest cutpoint of > 0.5 mm, anisocoria was present at rest in 1,642 (28.2%) and after light stimulus in 885 (15.3%) observations (P<.0001). Using the largest cut-point of > 2.0 mm anisocoria was present at rest in 79 (1.4%) of our sample and after light stimulus in 74 (1.3%) observations (P<.0001). SUMMARY/CONCLUSION: There is a statistically significant difference in anisocoria before and after exposing the pupil to light. This difference persists across anisocoria cutpoints ranging from 0.5 to 2.0mm. Future study should examine anisocoria before and after light exposure for association with radiological or clinical findings.
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    A Multisite Qualitative Analysis of Barriers and Facilitators to Adopting Tenecteplase
    (2023-05-11) Prasad, Sidarrth; Olson, Daiwai M.; Gebreyohanns, Mehari; Jones, Erica; Aguilera, Veronica; Ifejika, Nneka L.; The Lone Star Stroke Research Consortium
    INTRODUCTION: Tenecteplase (TNK) is an emerging treatment for acute ischemic stroke (AIS) being adopted in place of alteplase (ALT). Compared to ALT, TNK has a longer half-life, shorter administration time, lower cost, and similarly high efficacy in treating large vessel occlusion. Nevertheless, there are barriers to TNK adoption as a treatment for AIS. OBJECTIVES: The objective of this study is to identify thematic barriers and facilitators to TNK implementation at hospitals within the state of Texas. MATERIALS & METHODS: This qualitative research study uses a phenomenological approach with hermeneutic cycling. After initial question development, subsequent questions were identified during each hermeneutic cycle in preparation for the next interview. Using purposive sampling, we interviewed stroke coordinators and physicians associated with the Lone Star Stroke Research Consortium, a statewide research network in Texas. The consortium is comprised of participants from 6 hub hospitals and 28 spoke hospitals including both community-based facilities to Comprehensive Stroke Centers. Interviews lasting 20-40 minutes were recorded and transcribed verbatim. Transcribed material was dissected and grouped into cohesive themes. Each stage of thematic analysis required consensus from the research team to proceed to the next interview. Sampling ended when saturation was reached. RESULTS: Saturation was reached after four interviews. Three themes and eight sub-themes were identified. The theme Evidence had three sub-themes: Pro-Con Balance, Fundamental Knowledge, and Pharmacotherapeutics. The theme Process flow had four sub-themes: Proactive, Reflective self-doubt, Change Process Barriers, and Parameter Barriers. The theme Consensus had one sub-theme: Getting Buy-In. CONCLUSION: Through qualitative interviewing, we identified themes and sub-themes in an effort to understand barriers and facilitators faced by hospitals when transitioning from ALT to TNK. The next study will use implementation science techniques and will involve designing an implementation toolkit informed by the data from this study. It is anticipated that this toolkit will be used in a prospective interventional block randomized study.
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    Evaluation of a Student-Run Smoking Cessation Program in a Dallas Homeless Population
    (2020-11-06) Sotelo, Jesus; Lue, Brian; Garigipati, Priya; Rossopoulos, Thanos; Min, Jennifer; Pagels, Patti; Day, Philip; Gimpel, Nora
    BACKGROUND: Tobacco use has been shown to be modifiable risk factor for myriad chronic conditions and diseases. Amongst all smokers, homeless men continue to have high relative rates of smoking; it is estimated that 75% of homeless men use tobacco, compared to the general population. Given such high rates, targeted interventions for helping homeless men cease tobacco usage need to be developed. While most adult smokers will try to quit at least once, homeless individuals face very specific barriers to quitting. UT Southwestern medical students are addressing the disparity of tobacco use among the homeless men through a smoking cessation program in Dallas, Texas. Medical student volunteers, under the supervision of faculty, provide coaching and education for homeless men concerning smoking cessation and their general health. This study aims to demonstrate that this program improves tobacco cessation outcomes for homeless men in Dallas. A secondary objective of this project is to evaluate the efficacy of the smoking cessation efforts over time. METHODS: The smoking cessation program is conducted at a men’s homeless shelter in Dallas, Texas. The structure of the program involves weekly smoking-related health topic discussions led by a medical student. In addition, medical student volunteers lead individual and group coaching session via motivational interviewing. Data collected include addiction levels, willingness to quit, and CO levels, measured weekly. Paired t-tests in these categories, along with class attendance, retention, and use of nicotine replacement therapy are measured. RESULTS: Retention rates among participants improved from 11% in 2017 to 28% in 2018. 2019 saw a slight decrease in total number of visits; however, the difference in the average number of participants between 2018 and 2019 was not statistically significant. Returning clients reported higher willingness to quit scores and quit rates, verified by average CO values. CONCLUSIONS: The results of this study demonstrate that under the supervision of faculty, medical students are able to create a sustainable and effective smoking cessation program among underserved populations. Future directions include improved data collection to address longitudinal quality improvement.
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    Biomedical Ethics 2.0: Redefining the Meaning of Disease, Patient and Treatment
    (Springer Nature Limited, 2020-04-17) Grinnell, Frederick
    The foundations of biomedical ethics were established in the 2nd half of the 20th century, but issues associated with medical practice continue to evolve from new technologies. Recent progress in genomics and genome engineering has changed the meaning of the basic words of medicine -- disease, patient and treatment.
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    Lean On Me: Proactive Multi-Disciplinary Support Services Introduction for New Patient/Family Education
    (2018-05-30) Credeur, Catherine; Adams, Olivia; Vu, Lan; Hardi, Shelli; Stock, Christina; Bishop, Christofer
    This poster describes an interdisciplinary education process utilizing staff social worker, dietitian, and music therapist and our students along with peer survivor volunteers from a national patient organization education. This weekly program is designed to give new pancreatic patients of the Simmons Cancer Center a proactive introduction to the Supportive Services staff and the resources of the Pancreatic Cancer Action Network.
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    Metastatic Penile Melanoma
    (2018-04-08) Maredia, Navin; Goenka, Anamika
    Melanoma, the most serious skin cancer and the sixth most common cancer in North America, is associated with UV light radiation from sun exposure. The majority of melanomas develop on sun-exposed areas, but melanoma can also occur on non-sun exposed areas. This case Illustrates the importance of doing a thorough physical exam, formulating an extensive differential diagnosis, and identifying possible cognitive biases that may lead to misdiagnosis.