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An Unusual Cause of Sepsis: Capnocytophaga canimorsus, Capnocytophaga
Full text linkSeptic shock can be caused by numerous different pathogens. A few of the more common causes are Streptococcus Pneumoniae, Staphylococcus Aureus, Escherichia Coli, Pseudomonas Aeruginosa, and Candida Albicans. Although these are the pathogens involved in the majority of septic shock cases, it is imperative to take the entire clinical picture into account when treating a patient with septic shock. Here we will discuss a seemingly unimpressive dog bite leading to Capnocytophaga canimorsus bacteremia, septic shock and end organ failure
Influences and Implications of Medical Mistrust on Healthcare Behaviors in a Low Health Outcomes County in the State of New Jersey
Full text linkMedical mistrust is an ongoing concern in the United States, with patient confidence in both individual practitioners and institutions decreasing sharply in recent years. Atlantic County, New Jersey has some of the worst health outcomes in the state and is below the national average. This study sought to investigate medical mistrust by recruiting participants to complete a survey and/or health screening at 12 food pantry distribution events throughout Atlantic County (N = 124). The mean score for the Medical Mistrust Index was 19.06 (SD = 5.6) for participants who reported receiving the annual influenza vaccine and 16.05 (SD = 4.7) for participants who did not report receiving the vaccine (p = 0.002). Participants who reported an Excellent self-perception of overall (M = 13.7, SD = 4.6) and dental health (M = 14.6, SD = 5.5) had significantly less trust relative to their counterparts. There was no significant difference in self-perception of mental health and trust. While not statistically significant, a positive correlation was observed between trust and the number of healthcare information sources used: participants reporting use of 1 source had the lowest trust (M = 16.82, SD = 5.73), while those using 2 (M = 17.86, SD = 4.48; p =.509), 3 (M = 17.33, SD = 0.87; p =.536), or ≥ 4 sources (M = 19.38, SD = 3.97; p =.086) showed progressively higher trust. Our findings highlight the responsibility of improving medical mistrust falls on both providers and patients to take agency of their care
Toll-like Receptor 6 in Chronic Stress: Exercise and miRNA-Mediated Regulation of Neuroinflammatory Mechanisms of Resilience
No full textToll-like receptors (TLRs) modulate downstream inflammatory signaling by inducing the synthesis of a variety of pro-inflammatory cytokines. Increased TLR levels are associated with elevated incidence of chronic stress-induced neuropsychiatric disorders, while reduced TLR expression is observed with therapeutic interventions like antidepressant treatment and exercise. Exercise inhibits neuroinflammation, reduces TLR expression and offsets the impact of chronic stress. This led us to hypothesize that the reduction of TLR signaling can promote resilience to chronic stress and could be a primary mechanism through which exercise induces resilience. First, we observed that voluntary wheel running promoted resilience to the behavioral effects of unpredictable chronic mild stress in male and female mice. We then identified TLR6 as a potential target, as reduced levels were measured in the hippocampi of exercised males resilient to chronic stress. Two miRNAs, miR-124 and miR-126, predicted to target TLR6 were upregulated in the hippocampi of male exercised mice. We identified miR-124 and miR-126 as critical regulators of TLR6 that can knock down its expression in vitro. We further observed a significant TLR6 knockdown in mice subjected to AAV-mediated hippocampal injections of miR-124 or miR-126. Finally, we observed that male mice exposed to unpredictable chronic mild stress post-injection with miR-124 or miR-126 were resilient to the physiological and behavioral effects of chronic stress. Our results suggest that TLR6 could be an important therapeutic target for the treatment of chronic stress-induced disorders
EXPERIENCES OF MOTHER-SPECIAL EDUCATORS WITH A DISABLED CHILD: A NARRATIVE INQUIRY ANALYSIS
No full textWomen who are both special educators and mothers of one or more children with disabilities are uniquely positioned in both mothering and disability discourse. In narratives about mothering, having a child with a disability shifts the mothering discourse away from meeting the expectations of good mothering towards deficit-oriented perspectives of both the mother and their child. In narratives about disability, mothers are expected to align with broader societal views that disability is a problem that needs to be fixed. In this study, I used a narrative inquiry approach to ask mothers and special educators to share their stories about mothering, teaching, and navigating the special education system. The 12 mother-special educators in this study embraced the expectations of intensive mothering but broadly rejected the dominant narrative of “disability as deficit” for their children and students. They described a mix of role conflicts and benefits based on their dual-role identity. They also had unique insights about the roles of parents in special education broadly and advocacy in particular. The mothers’ recommendations included positioning mothers who are also special educators as advocacy experts, moving towards an understanding of disability as a welcome form of identity, and the need for increased understanding about disability
LEADING THE WAY FOR BETTER STEM EDUCATION: PERCEIVED LEADERSHIP, SELF-EFFICACY, AND COMMITMENT AMONG STEM TEACHERS
Full text linkThis study investigated the relationships among leadership, self-efficacy, and commitment in STEM high school teachers. Grounded in social cognitive theory (Bandura, 1986) and self-determination Theory (Deci & Ryan, 1985), the study was guided by three hypotheses: (1) STEM teachers perceived leadership is significantly related to self-efficacy; (2) STEM teachers perceived leadership is significantly related to commitment to teaching; and (3) self-efficacy mediates the relationship between STEM teachers perceived leadership and commitment. This study employed a quantitative cross-sectional research approach that specifically used descriptive correlational design to examine possible relationships among perceived leadership, self-efficacy, and commitment in STEM high school teachers using data collected from valid and reliable measures. Data were collected from 63 STEM educators from an urban district through an online survey. Results confirmed all three hypotheses: (1) a significant positive correlation between teacher leadership and self-efficacy, (2) a significant positive correlation between teacher leadership and commitment, and (3) a significant partial mediation of self-efficacy on the relationship between teacher leadership and commitment. These findings underscore the importance of enhancing leadership and self-efficacy among STEM high school teachers to improve professional commitment, student outcomes, and school culture among others
ASSESSMENT OF ENTREPRENEURIAL MINDSET IN UNDERGRADUATE ENGINEERING STUDENTS USING QUANTIATIVE, QUALITATIVE, AND MULTI-METHODS APPROACHES
Full text linkThe Entrepreneurial Mindset (EM) has been acknowledged as beneficial for engineers entering the workforce in a constantly advancing society. With an EM, professional engineers are better equipped to be innovative, creative, and translate ideas into reality. However, assessing how students develop an EM has been plagued with difficulties, mainly due to the discrepancy in EM definitions between different fields. This dissertation applies three EM assessment methods guided by one theoretical framework: the Triad of EM, which contextualizes EM into cognitive, behavioral, and emotional dimensions. Chapter 3 of this work analyzes EM across multiple years of an undergraduate engineering curriculum using a self-report survey, the ESEMA. Chapter 4 uses both quantitative and qualitative methods to categorically analyze first year and senior students’ EM concept maps. Finally, Chapter 5 of this work uses the qualitative method of narrative inquiry to formulate and assess biomedical engineering research students’ stories of their engineering experiences and identify how these stories capture EM elements. This dissertation found that students mainly focus their understanding of EM within the cognitive and behavioral dimensions, and only touch on the emotional dimension in their personal stories. Therefore, educators and researchers should consider emphasizing the importance of emotional EM elements in future engineering EM interventions
Reevaluating Informed Consent: Integrating Shared Decision-Making into Spinal Surgery for Better Patient Outcomes.
Full text linkStudy Design: Narrative review.
Objectives: The objectives of this study were to answer the following questions: (1) What is the quality of informed consent in spine surgery, including both neurosurgery and orthopaedic spine surgery? (2) What limitations impede the ability of surgeons to engage in effective shared decision-making (SDM) and obtain adequate informed consent? (3) What strategies and solutions may improve the quality of informed consent and SDM? (4) What factors decrease the incidence of litigation in spine surgery?
Methods: N/A.
Results: SDM is a collaborative process where patients are involved in their treatment choices through open communication about risks, alternatives, and postoperative expectations. Informed consent is a vital component of this process, ensuring that patients are fully informed and empowered to make decisions based on their values and preferences. This review highlights the current state of informed consent within the context of SDM in spine surgery and explores how enhancing this process can improve patient outcomes, reduce dissatisfaction, and decrease litigation. By emphasizing patient autonomy and improving the quality of risk communication, SDM fosters better physician-patient relationships and more positive clinical outcomes.ConclusionsOrthopaedic surgery and neurosurgery are highly litigated specialties, with failure to obtain informed consent frequently cited in lawsuits. These legal challenges are costly and time-consuming for both physicians and patients. Integrating SDM into the informed consent process can help mitigate these issues, leading to improved patient satisfaction and fewer legal disputes
Exploring Mindfulness Meditation in Managing Elevated Blood Pressure and Heart Rate in Debilitating Cardiovascular Disease: A Systematic Review and Meta-Analysis
Full text linkCardiovascular disease (CVD) is a leading cause of morbidity and mortality in the US, with elevated blood pressure (BP) significantly contributing to its progression. Mindfulness meditation has emerged as a high-value preventative care strategy for managing BP and heart rate (HR); however, its specific effects on managing BP and HR in individuals with debilitating CVD remain poorly understood. This project aims to evaluate the effectiveness of mindfulness meditation on HR, systolic blood pressure (SBP), and diastolic blood pressure (DBP) in this population. Following PRISMA 2020 guidelines, we employed a tailored Boolean string to search PubMed, Embase, Web of Science, Cochrane Library, and Scopus. Twelve articles met our inclusion criteria. Random effects meta-analyses revealed that mindfulness meditation reduced SBP (d = -0.38, p \u3c 0.01), DBP (d = -0.42, p \u3c 0.01), and HR (d = -0.64, p = 0.01) in individuals with debilitating CVD and elevated blood pressure. Control groups showed no significant changes in SBP (d = -0.10, p = 0.10), DBP (d = 0.17, p = 0.27), and HR (d = -0.00, p = 0.95). Heterogeneity across SBP (I2 = 0.55), DBP (I2 = 0.85), and HR (I2 = 0.86) was high, highlighting variability across studies. Overall, our results suggest that mindfulness meditation may help manage BP in individuals with debilitating CVD and elevated BP, potentially by promoting parasympathetic activity and reducing sympathetic drive. Further research is needed to elucidate the physiological mechanisms by which mindfulness meditation influences BP and HR in individuals with CVD and elevated BP
Cardiovascular Effects of GLP-1 Receptor Agonists in Non-Diabetic Adults With Obesity: A Systematic Literature Review
Full text linkBackground: Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in individuals with obesity. GLP-1 receptor agonists, initially developed for glycemic control in diabetes, are now approved for weight loss in non-diabetic populations. Recent clinical trials suggest these agents may also offer direct cardiovascular benefits.
Objective: This literature review aims to evaluate the cardiovascular effects of GLP-1 receptor agonists, specifically semaglutide, liraglutide, and tirzepatide, in non-diabetic adults with overweight or obesity.
Methods: A systematic search was conducted in January 2025 using PubMed as the primary database, supplemented by Google Scholar and Embase. Clinical trials were selected based on predefined inclusion criteria, requiring cardiovascular outcomes beyond weight loss in non-diabetic populations. Fifteen eligible studies were analyzed.
Results: GLP-1 agonists demonstrated improvements in several cardiovascular domains, including reductions in NT-proBNP, CRP, and structural cardiac abnormalities, as well as enhanced functional status measured by NYHA class or KCCQ-CSS. Semaglutide showed the most consistent benefits across endpoints. A strong association was observed between greater weight loss (≥10%) and NT-proBNP reduction, suggesting a potential mechanistic link.
Conclusion: GLP-1 receptor agonists, especially semaglutide, show promise as cardioprotective agents in non-diabetic adults with obesity. However, more dedicated trials with longer follow-up are needed to validate these benefits and optimize patient selection
Miller Fisher Variant of Guillain- Barré Syndrome
No full textWe present a case of a man in his 50s who was evaluated in the emergency department for right facial droop, myalgias, and right lower extremity weakness. The patient required multiple interdisciplinary specialists for treatment and diagnosis of Guillain-Barré Syndrome (GBS). The differential for weakness and facial droop is primarily aimed at ruling out an irreversible neurological cause while investigating a potential infectious etiology. Multiple variants of GBS exist and clinical presentations can vary, including the Miller Fisher Variant. This variant features a unique presentation, affecting the corticobulbar tract, evident with the ptosis commonly seen following a gastrointestinal infection