Ohio State Research Articles

The Effects of Repetitive Head Impact Exposure on Mental Health Symptoms Following Traumatic Brain Injury.

This study aimed to characterize the types and timing of repetitive head impact (RHI) exposures in individuals with moderate to severe traumatic brain injury (TBI) and to examine the effects of RHI exposures on mental health outcomes. TBI Model Systems National Database. 447 patients with moderate to severe TBI who reported RHI exposure between 2015 and 2022. Secondary data analysis. RHI exposures reported on the Ohio State University TBI Identification Method (OSU TBI-ID) were characterized by exposure category, duration, and timing relative to the index TBI. Mental health outcomes were evaluated at the 5-year follow-up assessment using the Patient Health Questionnaire-9 (PHQ-9) for depression symptoms and the Generalized Anxiety Disorder-7 (GAD-7) for anxiety symptoms. The majority of RHI exposures were sports-related (61.1%), followed by other causes (20.8%; including falls), repetitive violence/assault (18.8%), and military exposures (6.7%). Males predominantly reported sports and military exposures, while a larger proportion of females reported violence and falls. Sports exposures were most common before the index TBI, while exposures from falls and violence/abuse were most common after TBI. RHI exposures occurring after the index TBI were associated with higher levels of depression (β = 5.05; 95% CI, 1.59-8.50) and anxiety (β = 4.53; 95% CI, 1.02-8.05) symptoms than exposures before the index TBI. The findings emphasize the need to consider RHI exposures and their interaction with TBI when assessing mental health outcomes. Understanding the prevalence and challenges associated with RHI post-TBI can inform targeted interventions and improve the well-being of individuals with TBI. Preventive measures and ongoing care should be implemented to address the risks posed by RHI, particularly in individuals with prior TBI, especially surrounding fall and violence/abuse prevention.

Carotid Blowout after Standard Fractionation Re-irradiation: The Ohio State University Experience

Carotid Blowout after Standard Fractionation Re-irradiation: The Ohio State University Experience

Abstracts from the 2023 Occupational Therapy Summit of Scholars Conference, Ohio State University, June 22-24, 2023

Abstracts from the 2023 Occupational Therapy Summit of Scholars Conference, Ohio State University, June 22-24, 2023

Prevalence of Electrographic Seizures in Hospitalized Patients With Altered Mental Status With No Significant Seizure Risk Factors Who Underwent Continuous EEG Monitoring: A Retrospective Study.

The objective of this study is to evaluate the prevalence of electrographic seizures in hospitalized patients with altered mental status and no significant risk factors for seizures. We retrospectively reviewed over a six-year period (2013-2019) the medical records of all adults admitted at Ohio State University Wexner Medical Center (OSUWMC), who underwent continuous electroencephalography (cEEG) monitoring for > 48 hours. Our primary objective was to identify the prevalence of electrographic seizures in patients with altered mental status and no significant acute or remote risk factors for seizures. A total of 1966 patients were screened for the study, 1892 were excluded (96.2%) and 74 patients met inclusion criteria. Electrographic seizures were identified in seven of 74 patients (9.45%). We found a significant correlation between electrographic seizures and a history of hepatic cirrhosis, n= 4 (57%), (p=0.035), acute chronic hepatic failure during admission, 71% (n=5), (p=0.027), and hyperammonemia (p =0.009). In this retrospective study of patients with altered mental status and no significant acute or remote risk factors for seizures who underwent cEEG monitoring for > 48 hours, electrographic seizures were identified in 9.45%. Electrographic seizures were associated with hepatic dysfunction and hyperammonemia. Based on our results, cEEG monitoring should be considered in patients with altered mental status and hepatic dysfunction even in the absence of other seizure risk factors.

Neurobehavioral Symptoms in Spanish-Speaking Individuals With Subconcussive Injuries.

To examine whether exposure to high-risk events causing injury to the head or neck has an effect on neurobehavioral symptoms in the absence of an alteration of consciousness in Spanish-speakers. Web-based survey. Seven hundred forty-eight individuals from Spain and Latin America, aged 18 to 65 years, with 10 years or more of education. Thirty-nine participants failed quality checks and were excluded. Seven hundred nine participants were included in the analyses. Cross-sectional study. Subconcussive exposure was defined as endorsing exposure to one or more high-risk scenarios in the absence of any alteration of consciousness. Three injury groups were derived: No Head Injury, Subconcussive Exposure, and traumatic brain injury (TBI). The Subconcussive Exposure group was further divided into Single and Multiple Exposures. Two analyses were conducted: the effect of lifetime exposure to injury (No Head Injury, Subconcussive Exposure, TBI) on neurobehavioral symptoms; the effect of Subconcussive Exposure Frequency (No Head Injury, Single Exposure, Multiple Exposures) on neurobehavioral symptoms. Spanish Ohio State University Traumatic Brain Injury Identification Method Self-Administered-Brief (OSU TBI-ID SAB); Neurobehavioral Symptom Inventory (NSI). There was a significant effect for Injury group on the NSI partial eta-squared (η p2 = 0.053) and a significant effect of Exposure Frequency group on the NSI (η p2 = 0.40). Individuals with subconcussive exposures reported significantly more neurobehavioral symptoms than those with no history of head injury and significantly less symptoms than those with TBI. Individuals with multiple subconcussive exposures reported significantly more neurobehavioral symptoms than those with single and no exposure. This research expands the utility of the OSU-TBI-ID SAB as a lifetime TBI history assessment tool to one capable of evaluating subconcussive exposure dosing effects in Spanish-speakers. Such an index may facilitate establishment of subconcussive exposure prevalence rates worldwide, leading to improved understanding of the chronic effects of high-risk exposures.

Production of OSU G5P[7] Porcine Rotavirus Expressing a Fluorescent Reporter via Reverse Genetics.

Rotaviruses are a significant cause of severe, potentially life-threatening gastroenteritis in infants and the young of many economically important animals. Although vaccines against porcine rotavirus exist, both live oral and inactivated, their effectiveness in preventing gastroenteritis is less than ideal. Thus, there is a need for the development of new generations of porcine rotavirus vaccines. The Ohio State University (OSU) rotavirus strain represents a Rotavirus A species with a G5P[7] genotype, the genotype most frequently associated with rotavirus disease in piglets. Using complete genome sequences that were determined via Nanopore sequencing, we developed a robust reverse genetics system enabling the recovery of recombinant (r)OSU rotavirus. Although rOSU grew to high titers (~107 plaque-forming units/mL), its growth kinetics were modestly decreased in comparison to the laboratory-adapted OSU virus. The reverse genetics system was used to generate the rOSU rotavirus, which served as an expression vector for a foreign protein. Specifically, by engineering a fused NSP3-2A-UnaG open reading frame into the segment 7 RNA, we produced a genetically stable rOSU virus that expressed the fluorescent UnaG protein as a functional separate product. Together, these findings raise the possibility of producing improved live oral porcine rotavirus vaccines through reverse-genetics-based modification or combination porcine rotavirus vaccines that can express neutralizing antigens for other porcine enteric diseases.

Quality of obturation and the behavior of children treated under nitrous oxide conscious sedation: A double-blinded split-mouth randomized clinical trial

Abstract Aim: Our aim is to assess the quality of obturation and behavior of the children treated with and without nitrous oxide sedation and also to investigate the association between the quality of obturation and the behavior of children. Materials and Methods: A double-blinded split-mouth randomized clinical trial was conducted in 60 teeth. A total of 30 children aged 4–8 years in need of pulpectomy in bilateral mandibular molars were selected. On the first appointment, the children were assigned to protocol A, where the pulpectomy was performed without nitrous oxide inhalation sedation (NOIS). In the second visit, the children were allocated to protocol B, where pulpectomy was done in the contralateral molar under NOIS. The obturation quality and behavior of the children were graded according Coll and Sadrian criteria and Ohio State University Behavior Rating Scale, respectively. The data were assessed with descriptive statistics, Chi-square test, and Wilcoxin signed-rank test. Results: The quality of obturation and the behavior of the children were significantly better under conscious sedation (P = 0.000). Also, there was a significant association noted between the behavior of the children and quality of obturation (P = 0.0.012). Children exhibiting quiet behavior favored optimal fill, while in children showing cry alone or struggle , it was more of under-fill. In children showing both struggle and cry, more of over-fill pattern of obturation was noticed. Conclusion: Nitrous oxide sedation enhances the obturation quality and children’s behavior. Furthermore, there is a clear association between children’s behavior and obturation quality, regardless of whether nitrous oxide sedation is used or not.

Head injury and associated disability in adults undergoing pre-sentencing assessment by criminal justice social work

Although evidence indicates that head injury (HI) is prevalent in prisoners, little is known about HI in defendants during the Court process. This study assesses history of HI and persisting sequelae in defendants undergoing Criminal Justice Social Work (CJSW) assessment for Court.A cross sectional, between subjects design was used. HI history was assessed using the Ohio State University TBI Identification-Method and disability with the Glasgow Outcome Scale-Extended in 46 adult defendants undergoing a CJSW assessment in Scotland. Assessments of mental health, cognitive function, effort on tests and dysexecutive behaviour were also carried out. Comparisons were made between defendants with and without significant HI.Significant HI (SHI) was found in 33/46 (72%) participants and 39% (13/33) of these had persisting disability. Those with SHI were more likely to have moderate-severe mental health difficulties, problematic alcohol or drug use and impairment on the Dysexecutive Questionnaire. Group differences were not found on cognitive tests or in offending history. No CJSW report identified HI.Disability, psychological distress, dysexecutive behaviour and potentially harmful substance use are more common in defendants with SHI. Training and a screening process for HI in CJSW assessments is needed to inform Court disposals and interventions.

Court rules against plaintiffs

Case name: Meola, et al. v. The Ohio State University, No. 23AP‐180 (Ohio Ct. App. 10/19/23).

Pseudo-differential operators on the circle, Bernoulli polynomials

We show how the classical polylogarithm function Lis(z)\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\ extrm{Li}_s(z)$$\\end{document} and its relatives, the Hurwitz zeta function and the Lerch function are all of a spectral nature, and can explain many properties of the complex powers of the Laplacian on the circle and of the distribution (x+i0)s\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$(x+i 0)^s$$\\end{document}. We also make a relation with a result of Keiper [Fractional Calculus and its relationship to Riemann’s zeta function, Master of Science, Ohio State University, Mathematics (1975)].

Postacute Care for Medicare Advantage Enrollees Who Switched to Traditional Medicare Compared With Those Who Remained in Medicare Advantage

Medicare Advantage (MA) plans receive capitated per enrollee payments that create financial incentives to provide care more efficiently than traditional Medicare (TM); however, incentives could be associated with MA plans reducing use of beneficial services. Postacute care can improve functional status, but it is costly, and thus may be provided differently to Medicare beneficiaries by MA plans compared with TM. To estimate the association of MA compared with TM enrollment with postacute care use and postdischarge outcomes. This was a cohort study using Medicare data on 4613 hospitalizations among retired Ohio state employees and 2 comparison groups in 2015 and 2016. The study investigated the association of a policy change with use of postacute care and outcomes. The policy changed state retiree health benefits in Ohio from a mandatory MA plan to subsidies for either supplemental TM coverage or an MA plan. After policy implementation, approximately 75% of retired Ohio state employees switched to TM. Hospitalizations for 3 high-volume conditions that usually require postacute rehabilitation were assessed. Data from the Medicare Provider Analysis and Review files were used to identify all hospitalizations in short-term acute care hospitals. Difference-in-difference regressions were used to estimate changes for retired Ohio state employees compared with other 2015 MA enrollees in Ohio and with Kentucky public retirees who were continuously offered a mandatory MA plan. Data analyses were performed from September 1, 2019, to November 30, 2023. Enrollment in Ohio state retiree health benefits in 2015, after which most members shifted to TM. Received care in an inpatient rehabilitation facility, skilled nursing facility, or home health, or any postacute care; the occurrence of any hospital readmission; the number of days in the community during the 30 days after hospital discharge; and mortality. The study sample included 2373 hospitalizations for Ohio public retirees, 1651 hospitalizations for other Humana MA enrollees in Ohio, and 589 hospitalizations for public retirees in Kentucky. After the 2016 policy implementation, the percentage of hospitalizations covered by MA decreased by 70.1 (95% CI, -74.2 to -65.9) percentage points (pp), inpatient rehabilitation facility admissions increased by 9.7 (95% CI, 4.7 to 14.7) pp, use of only home health or skilled nursing facility care fell by 8.6 (95% CI, -14.6 to -2.6) pp, and days in the community fell by 1.6 (95% CI, -2.9 to -0.3) days for Ohio public retirees compared with other Humana MA enrollees in Ohio. There was no change in 30-day mortality or hospital readmissions; similar results were found by comparisons using Kentucky public retirees as a control group. The findings of this cohort study indicate that after a change in retiree health benefits, most Ohio public retirees shifted from MA to TM and received more intensive postacute care with no significant change in measured short-term postdischarge outcomes. Future work should consider additional measures of postacute functional status over a longer follow-up period.

Cretaceous–Palaeogene lobsters, Hoploparia stokesi (Weller, 1903), from Antarctica: historical review, and transfer of specimens from the United States Polar Rock Repository

The nephropid lobster Hoploparia stokesi (Weller 1903a) is widely distributed among the islands of the Antarctic Peninsula, where it occurs in strata of Cretaceous (Campanian–Maastrichtian) to Palaeogene (Paleocene) age. Specimens of H. stokesi collected during expeditions in the 1980s that were in the collection of the United States Polar Rock Repository at The Ohio State University have been transferred to the Orton Geological Museum, joining other geological collections from Antarctica. Some of the transferred specimens are voucher specimens described or illustrated in earlier published work.

Did court dismiss wrongful death claim involving off‐campus fraternity?

A member of the Ohio State University's Phi Kappa Psi fraternity attended a party at the off‐campus fraternity house.

Identification of SARS-CoV-2 variants in indoor dust.

Environmental surveillance of pathogens underlying infectious disease is critical to ensure public health. Recent efforts to track SARS-CoV-2 have utilized wastewater sampling to infer community trends in viral abundance and variant composition. Indoor dust has also been used for building-level inferences, though to date no sequencing data providing variant-scale resolution have been reported from dust samples, and strategies to monitor circulating variants in dust are needed to help inform public health decisions. In this study, we demonstrate that SARS-CoV-2 lineages can be detected and sequenced from indoor bulk dust samples. We collected 93 vacuum bags from April 2021 to March 2022 from buildings on The Ohio State University's (OSU) Columbus campus, and the dust was used to develop and apply an amplicon-based whole-genome sequencing protocol to identify the variants present and estimate their relative abundances. Three variants of concern were detected in the dust: Alpha, Delta, and Omicron. Alpha was found in our earliest sample in April 2021 with an estimated frequency of 100%. Delta was the primary variant present from October of 2021 to January 2022, with an average estimated frequency of 91% (±1.3%). Omicron became the primary variant in January 2022 and was the dominant strain in circulation through March with an estimated frequency of 87% (±3.2%). The detection of these variants on OSU's campus correlates with the circulation of these variants in the surrounding population (Delta p<0.0001 and Omicron p = 0.02). Overall, these results support the hypothesis that dust can be used to track COVID-19 variants in buildings.

In Case You Haven't Heard…

Could mental health be worse in teens who come from large families? Researchers from The Ohio State University seem to think so based on research that found teens with a greater number of siblings reported poorer mental health than those who came from smaller families, Fox News reported. The large‐scale study published last month in the Journal of Family Issues. It included more than 9,400 eighth graders in China and more than 9,100 children of the same age in the U.S. The participants in both countries answered various questions about their mental health. Based on the responses, among the Chinese teens, the ones with no siblings were found to have the best mental health. In the U.S., teens with no siblings or just one sibling had the best mental health. The researchers did not analyze the quality of sibling relationships, which could have a direct impact on mental health, said Doug Downey, lead author of the study and professor of sociology at The Ohio State University. At this point, Downey said, it is too early to recommend any changes in human behavior based on these findings.

The ACGIH TLV for lifting: Estimated TLVs for torso asymmetry beyond 30 degrees.

The American Conference of Governmental Industrial Hygienists (ACGIH) Threshold Limit Values (TLVs) for Lifting is a manual material handling (MMH) assessment method to identify weight limits that nearly all workers may be exposed to without developing work-related low back disorders (LBD). However, this assessment method only applies to lifting with the torso within 30° asymmetry of the sagittal plane. Estimate TLV weight limits while lifting with torso asymmetry greater than 30° beyond the sagittal plane. Lifting tasks were performed from various horizontal and vertical locations, at torso asymmetry angles of 0°, 15°, 30°, 45°, 60°, 75° and 90°, using ACGIH identified TLVs. Validated MMH assessment methods (NIOSH Lifting Equation, Ohio State University LBD Risk Model) were utilized to estimate TLVs at torso asymmetries greater than 30°. The current ACGIH TLVs resulted in low- to moderate-risk risk levels for torso asymmetries from 0° to 30°, and the risk incrementally increased as torso asymmetry increased to 90°. With the intention to keep the risk levels to that found at 30° torso asymmetry, lower TLV weight limits in the vertical and horizontal zones investigated were estimated for torso asymmetries from 45° to 90°. The resulting adjusted TLVs were consistent with weight limits identified for similar lifting conditions from other assessment methods that account for torso asymmetry. This research found current ACGIH-defined TLVs possess less than high-risk for LBD, and provided guidance to practitioners for reduced TLVs when torso asymmetry is greater than 30° from the sagittal plane.

Measuring Chief Resident Skill and Entrustment Progression in An Operative Coaching Program: Four Years’ Experience

Operative coaching (OC) may facilitate improvement of surgery residents' competencies by optimizing learning and teaching. We investigated how residents' operative skills and prospective entrustment (PE) progress throughout the chief year in our OC program, how OC is perceived by participants, and how OC may facilitate learning and teaching. This is a mixed-methods study conducted within the Ohio State University Wexner Medical Center General Surgery residency. Validated performance evaluations with procedural-specific skill, general skill (GS), step-specific guidance required (SSG) (an autonomy measure), and PE measures completed by chiefs, faculty coaches, and attending surgeons from 7/2018 to 6/2022 were reviewed. We also interviewed OC participants to understand their experience. Descriptive statistical and qualitative content analysis were applied. 441 evaluations from 147 OC cases completed by 22 chiefs, 5 faculty coaches, and 24 attendings were included. Overall, resident GS (p = 0.036), SSG (p = 0.023), and PE (p = 0.002) significantly improved throughout the year. PE significantly correlated (all p < 0.0001) with SSG (r = 0.73), followed by procedural-specific skill (r = 0.59), then GS (r = 0.57). On average, chiefs underestimated their surgical skills while attendings overestimated autonomy they permitted to residents. Chiefs, coaches, and attendings reached consensus on chiefs' PE upon graduation. Five graduated chiefs and 5 attendings were interviewed. Chiefs described OC as effective in improving their self-regulated learning and particularly valued 3 OC elements: neutral authentic feedback, third-party real-time observation, and actionable feedback. Attendings noted OC promoted their engagement in skills assessment and teaching. Our findings suggest chief residents' skills, autonomy, and PE progress steadily along their OC journey. Despite differences in residents', coaches', and attendings' perceptions of skill, measures of autonomy reliably correlate with entrustment. OC promotes resident learning, faculty teaching, and assessment of resident skills, autonomy, and PE in the OR.

Testing the feasibility of mobile ecological momentary assessment for symptom burden and management among metastatic cancer patients.

Individuals who have metastatic cancer experience substantial physical and psychological distress (e.g., pain, depression, anxiety) from their disease and its treatment compared to patients with less advanced disease. As the burden of symptoms varies over time, ecological momentary assessment (EMA) may be used to better understand patients' symptom trajectories, complimenting traditional longitudinal data collection methods. However, few have used EMA in patients with metastatic disease. The current study adds to the existing literature by exploring interrelated, common cancer-related symptoms of pain, anxiety, and depression and use of cannabis-based products, opioid medications, other (nonopioid) pain medications, and medications for anxiety or depression. An eight-day prospective observational feasibility study was conducted among 50 patients with metastatic cancer recruited from seven solid cancer clinics at The Ohio State University Comprehensive Cancer Center. Participants completed a week of interval-contingent mobile EMA, administered daily at 9 a.m., 3 p.m., and 8 p.m., and a comprehensive interviewer-administered questionnaire on Day 8. Participants were queried on their symptom burden and management strategies (i.e., use of medications and cannabis). We considered EMA to be feasible if a priori retention (80%) and adherence goals (75%) were met. Seventy-nine percent of eligible patients contacted enrolled in the study (n = 50 of 63). Among those enrolled, 92% were retained through Day 8 and 80% completed >90% of EMAs, exceeding a priori objectives. Participants' average pain, anxiety, and depressive symptoms across the week of EMA ranged from 1.7 to 1.8 (1 to 5 scale). Symptoms varied little by day or time of administration. On Day 8, significant proportions of participants reported past-week use of medications and cannabis for symptom management. Participants exceeded a priori adherence and retention objectives, indicating that mobile EMA is feasible among metastatic cancer patients, addressing a gap in the existing literature and informing future research. Restricting eligibility to participants with a minimum cutoff of symptom burden may be warranted to increase observations of symptom variability and provide opportunities for future health interventions. Future research is needed to test the acceptability and quality of data over a longer study period in this patient population.

Natural rubber – Increasing diversity of an irreplaceable renewable resource

This paper discusses the importance of introducing domestic natural rubber production and presents the rediscovery of a rubber-producing species, Scorzonera tau-saghyz or “mountain gum”, originally discovered in 1929 on the Karatau mountains in Kazakhstan. This plant could potentially also be cultivated in the U.S. In this exploratory work, roots (2–5 years old) were harvested on June 16, 2021 from wild strands in the Karatau mountains, Kumantas ridge, and Saraba, Kazakhstan, and processed at the Ohio State University. The rubber extraction method was based on an indigenous method in Kazakhstan to make natural chewing gum. Water extraction followed by purification yielded 16.2 wt% rubber from the dry roots, in comparison with 4–8 wt% from most rubber dandelion (Taraxacum kok-saghyz) plants, also a potential domestic rubber producing plant. High-resolution size exclusion chromatography was used to analyze rubber samples. The molecular weights and gel and oligomer contents were very similar to the rubber from Hevea brasiliensis, the current commercial source of natural rubber. More detailed investigations of this very interesting rubber-producing plant are in progress.

Gamma-ray Spectroscopy in Low-Power Nuclear Research Reactors

Gamma-ray spectroscopy is an effective technique for radioactive material characterization, routine inventory verification, nuclear safeguards, health physics, and source search scenarios. Gamma-ray spectrometers typically cannot be operated in the immediate vicinity of nuclear reactors due to their high flux fields and their resulting inability to resolve individual pulses. Low-power reactor facilities offer the possibility to study reactor gamma-ray fields, a domain of experiments hitherto poorly explored. In this work, we present gamma-ray spectroscopy experiments performed with various detectors in two reactors: The EPFL zero-power research reactor CROCUS, and the neutron beam facility at the Ohio State University Research Reactor (OSURR). We employed inorganic scintillators (CeBr3), organic scintillators (trans-stilbene and organic glass), and high-purity germanium semiconductors (HPGe) to cover a range of typical—and new—instruments used in gamma-ray spectroscopy. The aim of this study is to provide a guideline for reactor users regarding detector performance, observed responses, and therefore available information in the reactor photon fields up to 2 MeV. The results indicate several future prospects, such as the online (at criticality) monitoring of fission products (like Xe, I, and La), dual-particle sensitive experiments, and code validation opportunities.