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Giancarlo Mari, Zoran Bursac, Patricia Jean Goedecke, Ramasubbareddy Dhanireddy
Objective . The objective of this study was to determine factors contributing to improvements in infant mortality rates (IMR) and composite morbidity-mortality in very-low-birth-weight (VLBW) infants after initiating a new perinatal program in 2009 at Regional One Health (ROH). VLBW infants account for 67% of infant deaths. Design . This is a pre-/postintervention cohort study of prospectively gathered data. Population . VLBW infants delivered at ROH during the 2004 to 2015 study period. Setting . ROH is a Regional Perinatal Center affiliated with the University of Tennessee Health Science Center...
2018: Global Pediatric Health
Sarah Sutherland, Rebecca Meyer
The Centers for Medicare & Medicaid Services has a national goal to increase the number of long-term care facilities reporting Clostridium difficile infection data to the Centers for Disease Control and Prevention. A partnership between the Tennessee Department of Health and the quality improvement organization, Qsource, helped facilitate successful enrollment into the National Healthcare Safety Network for nursing homes in the state of Tennessee.
April 13, 2018: American Journal of Infection Control
Melissa A Little, Robert C Klesges, Zoran Bursac, Jon O Ebbert, Jennifer P Halbert, Andrew N Dunkle, Lauren Colvin, Patricia J Goedecke, Benny Weksler
Background: Cancer survivors have a high rate of participation in cigarette-smoking cessation programs but their smoking-abstinence rates remain low. In the current study, we evaluated the readiness to quit smoking in a cancer-survivor population. Methods: Cross-sectional data survey conducted among 112 adult cancer survivors who smoked cigarettes in Tennessee. Analyses were conducted using a two-sample t -test, χ2 test, Fishers Exact test, and multivariable logistic regression with smoker's readiness to quit as the dependent variable...
March 2018: Journal of Cancer Prevention
Shiyun Jin, Xiaoping Wang, Huifang Xu
The I{\overline 1} structures of four natural Ca-rich plagioclase feldspars formed at high temperature were analysed using single-crystal neutron and X-ray diffraction. The neutron time-of-flight Laue diffractometer at the ORNL Spallation Neutron Source (Tennessee, USA) combined with a single-crystal X-ray diffraction instrument were able to reveal some new details about these already intensively studied structures. The split oxygen atoms refined from the neutron diffraction data show the underlying mechanism of Ca-Na ordering and the anisotropic P{\overline 1} ordering along the c-axis...
April 1, 2018: Acta Crystallographica Section B, Structural Science, Crystal Engineering and Materials
Ryan H Williamson, Lisa L Muller, Coy Blair
  Wildlife anesthetic protocols must offer rapid inductions and recoveries, be physiologically safe, and be minimally regulated. With this in mind, we evaluated differences in induction and recovery times and physiological parameters in 33 American black bears ( Ursus americanus) anesthetized with ketamine-xylazine (KX) or immobilized with a commercial drug combination of butorphanol, azaperone, and medetomidine (BAM). Dose was based on mass estimated from field observations. Bears were housed at Appalachian Bear Rescue, Townsend, Tennessee, US, or free-ranging within the Great Smoky Mountains National Park (Tennessee and North Carolina, US) and chemically immobilized for management purposes...
April 4, 2018: Journal of Wildlife Diseases
Rose M C Kagawa, Alvaro Castillo-Carniglia, Jon S Vernick, Daniel Webster, Cassandra Crifasi, Kara E Rudolph, Magdalena Cerdá, Aaron Shev, Garen J Wintemute
BACKGROUND: In 2016, firearms killed 38,658 people in the United States. Federal law requires licensed gun dealers, but not private parties, to conduct background checks on prospective firearm purchasers with the goal of preventing prohibited persons from obtaining firearms. Our objective was to estimate the effect of the repeal of comprehensive background check laws - requiring a background check for all handgun sales, not just sales by licensed dealers - on firearm homicide and suicide rates in Indiana and Tennessee...
April 2, 2018: Epidemiology
C G Velasquez, K S Macklin, S Kumar, M Bailey, P E Ebner, H F Oliver, F S Martin-Gonzalez, M Singh
Salmonella spp. are among the most common foodborne pathogens, and increase in the occurrence of antimicrobial drug-resistant Salmonella poses a severe risk to public health. The main objective of this study was to determine changes in Salmonella prevalence and their antimicrobial resistance on poultry farms following recommendations to changes in biosecurity practices. Four poultry farms were sampled by collecting cloacal swabs, drag swabs, and litter samples prior to recommended biosecurity changes (March-April) and post recommendations (October-November)...
March 27, 2018: Poultry Science
Julie L Ware, Karen E Schetzina, Anna Morad, Brenda Barker, Theresa A Scott, Peter H Grubb
BACKGROUND AND OBJECTIVES: Tennessee has low breastfeeding rates and has identified opportunities for improvement to enhance maternity practices to support breastfeeding mothers. We sought a 10% relative increase in the aggregate Joint Commission measure of breastfeeding exclusivity at discharge (TJC PC-05) by focusing on high-reliability (≥90%) implementation of processes that promote breastfeeding in the delivery setting. METHODS: A statewide, multidisciplinary development team reviewed evidence from the WHO-UNICEF "Ten Steps to Successful Breastfeeding" to create a consensus toolkit of process indicators aligned with the Ten Steps...
April 2, 2018: Breastfeeding Medicine: the Official Journal of the Academy of Breastfeeding Medicine
Angela Dautartas, Michael W Kenyhercz, Giovanna M Vidoli, Lee Meadows Jantz, Amy Mundorff, Dawnie Wolfe Steadman
While nonhuman animal remains are often utilized in forensic research to develop methods to estimate the postmortem interval, systematic studies that directly validate animals as proxies for human decomposition are lacking. The current project compared decomposition rates among pigs, rabbits, and humans at the University of Tennessee's Anthropology Research Facility across three seasonal trials that spanned nearly 2 years. The Total Body Score (TBS) method was applied to quantify decomposition changes and calculate the postmortem interval (PMI) in accumulated degree days (ADD)...
March 30, 2018: Journal of Forensic Sciences
Sulayman Aziz, David Sweat
BACKGROUND: Southern Non-Hispanic Black persons are disproportionately represented in the HIV epidemic. Those previously diagnosed with syphilis are at significant risk to become HIV infected within 36 months. Effective prevention strategies such as PrEP should be offered to those at highest risk to maximize prevention efforts. METHODS: HIV negative persons diagnosed with P&S syphilis during 1998 - 2014 were matched with incident HIV cases diagnosed during 1998 - 2016 in Shelby County Tennessee...
March 29, 2018: Sexually Transmitted Diseases
Caroline A Presley, Jea Young Min, Jonathan Chipman, Robert A Greevy, Carlos G Grijalva, Marie R Griffin, Christianne L Roumie
OBJECTIVES: We aimed to validate an algorithm using both primary discharge diagnosis (International Classification of Diseases Ninth Revision (ICD-9)) and diagnosis-related group (DRG) codes to identify hospitalisations due to decompensated heart failure (HF) in a population of patients with diabetes within the Veterans Health Administration (VHA) system. DESIGN: Validation study. SETTING: Veterans Health Administration-Tennessee Valley Healthcare System PARTICIPANTS: We identified and reviewed a stratified, random sample of hospitalisations between 2001 and 2012 within a single VHA healthcare system of adults who received regular VHA care and were initiated on an antidiabetic medication between 2001 and 2008...
March 25, 2018: BMJ Open
George M Testerman, Daniel C Prior, Tamie D Wells, Sarah E Rollins, Stephen L Oesch
All-terrain vehicle (ATV) safety laws, including helmet use, vary by state and are sporadically enforced. Kentucky state laws require safety helmets only for younger riders. We hypothesized that ATV riders injured in Kentucky and seen at a Tennessee trauma center would more likely be unhelmeted, have more severe head injuries, and have higher mortality rates than those injured in Virginia or Tennessee. A Trauma Registry review of 750 injured ATV riders from June 1, 2005, through June 1, 2015 examined state location of accident, helmet use, markers of injury severity, and outcomes...
February 1, 2018: American Surgeon
Justin D Gatwood, Marie Chisholm-Burns, Robert Davis, Fridtjof Thomas, Praveen Potukuchi, Adriana Hung, Csaba P Kovesdy
BACKGROUND: Medication nonadherence is a prevalent public health issue, particularly among patients with diabetes mellitus (DM), and negatively affects health outcomes. Because of the prevalence of DM among U.S. veterans, it is crucial to understand how well these patients adhere to oral antidiabetic (OAD) medication and whether certain subgroups are more likely to be nonadherent. OBJECTIVE: To assess initial OAD medication use among veterans with uncomplicated DM and determine factors associated with adherence in the first 2 years of treatment...
April 2018: Journal of Managed Care & Specialty Pharmacy
Korbinian Weigl, Hauke Thomsen, Yesilda Balavarca, Jacklyn N Hellwege, Martha J Shrubsole, Hermann Brenner
BACKGROUND & AIMS: The presence of specific single nucleotide polymorphisms (SNPs) can be used to calculate an individual's risk for colorectal cancer (CRC), called a genetic risk score (GRS). We investigated whether GRS can identify individuals with clinically relevant neoplasms in a screening colonoscopy population. METHODS: We derived a GRS based on 48 SNPs associated with CRC, identified in a comprehensive literature search. We obtained genetic data from 1043 participants (50-79 years old) in a screening colonoscopy study in Germany, recruited from 2005 through 2013 (294 with advanced neoplasms, 249 with non-advanced adenomas, and 500 without neoplasms)...
March 21, 2018: Gastroenterology
Peter F Rebeiro, Tristan D McPherson, Kathryn M Goggins, Megan Turner, Sally S Bebawy, William B Rogers, Lauren Brinkley-Rubinstein, Anna K Person, Timothy R Sterling, Sunil Kripalani, April C Pettit
Studies evaluating the association between human immunodeficiency virus (HIV) infection continuum of care outcomes [antiretroviral (ART) adherence, retention in care, viral suppression] and health literacy have yielded conflicting results. Moreover, studies from the southern United States, a region of the country disproportionately affected by the HIV epidemic and low health literacy, are lacking. We conducted an observational cohort study among 575 people living with HIV (PLWH) at the Vanderbilt Comprehensive Care Clinic (Nashville, Tennessee)...
March 20, 2018: AIDS and Behavior
Lauren Mullen, Kim Boerrigter, Nicholas Ferriero, Jeff Rosalsky, Abigail van Buren Barrett, Patrick J Murray, Andrew D Steen
Proteins constitute a particularly bioavailable subset of organic carbon and nitrogen in aquatic environments but must be hydrolyzed by extracellular enzymes prior to being metabolized by microorganisms. Activities of extracellular peptidases (protein-degrading enzymes) have frequently been assayed in freshwater systems, but such studies have been limited to substrates for a single enzyme [leucyl aminopeptidase (Leu-AP)] out of more than 300 biochemically recognized peptidases. Here, we report kinetic measurements of extracellular hydrolysis of five substrates in 28 freshwater bodies in the Delaware Water Gap National Recreation Area in the Pocono Mountains (PA, United States) and near Knoxville (TN, United States), between 2013 and 2016...
2018: Frontiers in Microbiology
Svetla Slavova, Alison Miller, Terry L Bunn, Jessica R White, David Kirschke, Tom Light, Daniel Christy, Gary Thompson, Ruth Winecker
BACKGROUND: The goal of this study was to establish and compare baseline data on the prevalence of gabapentin identified through postmortem toxicology testing among drug overdose decedents in several geographically diverse states/jurisdictions with differing levels of drug overdose fatality burdens in 2015. METHODS: Death certificates and postmortem toxicology result reports from five U.S. jurisdictions were used to identify residents who died from drug overdoses in year 2015 and to calculate prevalence rates of gabapentin in postmortem toxicology by jurisdiction...
March 10, 2018: Drug and Alcohol Dependence
Sandra N Bulens, Sarah H Yi, Maroya S Walters, Jesse T Jacob, Chris Bower, Jessica Reno, Lucy Wilson, Elisabeth Vaeth, Wendy Bamberg, Sarah J Janelle, Ruth Lynfield, Paula Snippes Vagnone, Kristin Shaw, Marion Kainer, Daniel Muleta, Jacqueline Mounsey, Ghinwa Dumyati, Cathleen Concannon, Zintars Beldavs, P Maureen Cassidy, Erin C Phipps, Nicole Kenslow, Emily B Hancock, Alexander J Kallen
In healthcare settings, Acinetobacter spp. bacteria commonly demonstrate antimicrobial resistance, making them a major treatment challenge. Nearly half of Acinetobacter organisms from clinical cultures in the United States are nonsusceptible to carbapenem antimicrobial drugs. During 2012-2015, we conducted laboratory- and population-based surveillance in selected metropolitan areas in Colorado, Georgia, Maryland, Minnesota, New Mexico, New York, Oregon, and Tennessee to determine the incidence of carbapenem-nonsusceptible A...
April 2018: Emerging Infectious Diseases
Tennessee D Park, Joshua M Enyart, Terrence E Goyke, Marna Rayl Greenberg
A 23-year-old man was transported to a trauma center after injuring himself while snowboarding. He presented with bilateral shoulder pain and associated deformity to both shoulders. His exam was otherwise unremarkable, and his x-rays confirmed bilateral shoulder dislocations. Cunningham and external rotation without sedation and analgesia techniques were unsuccessful even with local anesthesia to the joint. Subsequent bilateral reduction was successful with moderate sedation using the Milch technique. Simultaneous anterior bilateral shoulder dislocations are rare and providers may need to adjust their techniques to accommodate this unusual presentation...
February 2018: Radiology Case Reports
Jiemin Ma, Rebecca L Siegel, Eric J Jacobs, Ahmedin Jemal
INTRODUCTION: Contemporary state-specific estimates of mortality caused by cigarette smoking are important for tobacco control advocacy and healthcare planning in the U.S., but are currently lacking. METHODS: The population-attributable fraction (i.e., proportion of deaths in the population caused by smoking), number of deaths, and number of years of potential life lost because of active cigarette smoking were estimated for each state based on state-specific smoking prevalence data from the 2014 Behavioral Risk Factor Surveillance System, recently updated relative risks of smoking, and numbers of deaths from smoking-attributable diseases...
March 15, 2018: American Journal of Preventive Medicine
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