Medicine and Health Sciences Commons^™

Combination Octreotide, Midodrine, And Albumin May Improve Survival In Patients With Hepatorenal Syndrome, But The Evidence Is Weak, Jacob Szafranski

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Skagen C, Einstein M, Lucey MR, Said A. Combination treatment with octreotide, midodrine, and albumin improves survival in patients with type 1 and type 2 hepatorenal syndrome. J Clin Gastroenterol. 2009 Aug;43(7):680-5. doi: 10.1097/MCG.0b013e318188947c

We Have No Real Evidence Related To Anticoagulation Plus Aspirin For Stroke Prevention In Atrial Fibrillation, Yuxiang Wang

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Flaker GC, Gruber M, Connolly SJ, et al. Risks and benefits of combining aspirin with anticoagulant therapy in patients with atrial fibrillation: an exploratory analysis of stroke prevention using an oral thrombin inhibitor in atrial fibrillation (SPORTIF) trials. Am Heart J. 2006;152:967-973. doi: 10.1016/j.ahj.2006.06.024

Manage Terminal Ileum Diverticulitis Comparably To Diverticulitis Elsewhere, James Yip

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Park HC, Lee BH. The management of terminal ileum diverticulitis. Am Surg. 2009 Dec;75(12):1199-202.

From The Editor, James Peter Meza

Clinical Research in Practice: The Journal of Team Hippocrates

With this issue of the Journal, we expand types of submissions to include generalizable knowledge in the form of brief reports and original research.

Recurrent Pneumonia Among Japanese Adults: Disease Burden And Risk Factors, Tomoko Ishifuji, Eiichiro Sando, Norihiro Kaneko, Motoi Suzuki, Paul E. Kilgore, Koya Ariyoshi, Konosuke Morimoto, Naoto Hosokawa, Makito Yaegashi, Masahiro Aoshima, Adult Pneumonia Study Group - Japan (Apsg-J)

Department of Pharmacy Practice

Background: In Japan and other societies with rapidly aging populations, recurrent pneumonia (RP) is a major clinical problem yet only limited information exists regarding the burden of this disease.

Methods: A prospective study of adult pneumonia was conducted to investigate the incidence of RP and potential risk factors. From February 1, 2012 to January 31, 2013, patients aged ≥ 15 years who were diagnosed with pneumonia were prospectively enrolled in a representative community hospital located in central Japan. Patients were followed for one-year to evaluate the recurrence of pneumonia and characteristics associated with RP. Cox proportional hazards models were constructed …

Implementing Comprehensive School Physical Activity Programs: A Wayne State University Case Study, Erin E. Centeio, Nate Mccaughtry

Kinesiology, Health and Sport Studies

Comprehensive school physical activity programs (CSPAPs) have been highlighted by numerous public health and education agencies for their potential to improve the health and academic achievement of American youth. A CSPAP integrates physical activity throughout the school environment before, during and after school by engaging educators, children, families and community organizations. As the design, implementation and evaluation of effective CSPAP programs has inched forward, so has the call for physical education teacher education (PETE) programs to prepare the next generation of physical educators with the skills and knowledge needed to one day lead CSPAP efforts in K-12 schools. The purpose …

Functional Analysis Of Rad6 In Brca1 Wild Type And Brca1 Mutant Triple Negative Breast Cancer Drug Response, Brittany Haynes

Wayne State University Dissertations

TNBCs account for 15-20% of all breast and are unsuitable for common targeted therapies as they lack expression of estrogen, progesterone, and Her2/neu receptors. Cisplatin, a DNA damaging agent, is currently under clinical investigation for treatment of TNBCs and paclitaxel, a mitotic spindle poison, is a first-line treatment option for this disease. While both agents elicit therapeutic benefit BRCA1 mutation status, toxicity, and resistance are limiting factors. Rad6 functions as an E2 ubiquitin conjugating protein and its enzymatic activity is critical for its cellular function. Rad6 is known to play a critical role in the translesion synthesis (TLS) damage response …

Mechanisms Of Hormonal Regulation Of Invasiveness And Metastasis Of Luminal Breast Cancer, Thomas Mcfall

Wayne State University Dissertations

ABSTRACT

MECHANISMS OF HORMONAL REGULATION OF INVASIVENESS AND METASTASIS OF LUMINAL BREAST CANCER

By

THOMAS MCFALL

December 2017

Advisor: Dr. Manohar Ratnam

Major: Cancer Biology

Degree: Doctor of Philosophy

Over 20% of breast cancer cases present with distal metastasis and they are predominantly of luminal subtypes. As luminal breast cancer is relatively indolent, it is believed that progression to metastasis must occur over many years, generally well into post-menopausal years. Unfortunately, very little is known about the mechanisms by which these hormone receptor positive tumors metastasize, likely in part due to their slow metastatic rates in animal model systems as …

Utility Of Ultrasound/Photoacoustic Imaging For Accurate Catheter Tracking And Temperature Monitoring During Endovenous Laser Ablation, Ayushi Jharia, Keerthana Palani, Yan Yan

Research Opportunities for Engineering Undergraduates (ROEU) Program 2016-17

Laser ablation is a treatment method that uses light energy through a catheter inserted into a vein to induce localized heat to close the diseased blood vessels. Ultrasound (US) imaging has been used for catheter visualization and tracking. US has limitations for tracking the accurate location of the fiber tip inside small perforating veins such as angular dependency and comet tail artifacts. We propose a robust and accurate method for fiber tip tracking using combined US and Photoacoustic (PA) imaging to overcome the existing limitations.

Detroit Food Metrics Report 2017, Alex B. Hill, Amy Kuras

Urban Studies and Planning Faculty Research Publications

This report provides a snapshot of data and information on Detroit’s food system as well as trends over time. The report includes a broad range of programs and initiatives that local organizations, the Detroit Food Policy Council, and the City of Detroit are undertaking to address food insecurity, increase healthy food access and awareness, and support a more sustainable and just food system.

Arab American Adolescents’ Bullying Experiences And Effects On Their Perceived Stress And Health, Maha Albdour

Wayne State University Dissertations

This study is intended to examine the bullying experience among Arab American adolescents and effects on their perceived stress and health. Adolescents who are vulnerable or marginalized might be at higher risk for bullying. Arab American adolescents have not been included in research studies examining bullying and described as the invisible population.

The Neuman System Model, which focuses on wellness of adolescents in relation to environmental stress, guided this study. Bullying is a tension producing stressor, operationally defined as repeated attacks or intimidation that cause fear, distress or harm and perceived power imbalance between bully and victim. Perceived stress is …

Middle School And High School Students Who Stutter: A Qualitative Investigation Of School Experiences, Tiffany Cobb

Wayne State University Dissertations

ABSTRACT

MIDDLE SCHOOL AND HIGH SCHOOL STUDENTS WHO STUTTER: A QUALITATIVE INVESTIGATION OF SCHOOL EXPERIENCES

by

TIFFANY COBB

MAY 2017

Advisor: Dr. Derek Daniels

Major: Speech-Language Pathology

Degree: Doctor of Philosophy

Purpose: The purpose of this study was to explore and further understand the ways in which middle school and high school students perceive their school experiences within the school environment.

School has an important impact on the social development of children (Milsom, 2006). Learning is not done individually as classrooms are inherently social places. This suggests that students do not learn alone, but rather in the presence of many …

Assessing Parent Invovlment In Applied Behavior Analysis Treatment For Children With Autism, Krista Marie Clancy

Wayne State University Dissertations

The purpose of this study was to compare two groups of parents whose children participated in ABA on their levels of stress, self-efficacy, treatment acceptability, and parents’ level of involvement in their children’s treatment, and to assess variables that may explain variance in parent involvement. Parents in the treatment group participated in a voluntary parent training (n=18) and the comparison group were parents who elected not to participate in the voluntary training (n=22). This was a quasi-experimental design study where parents and their therapists completed a survey regarding parents’ involvement in their children’s treatment programs. Additional parent measures collected as …

Brain Connectivity After Concussion, Armin Iraji

Wayne State University Dissertations

Mild traumatic brain injury (mTBI) accounts for over one million emergency visits in the United States each year. While most mTBI patients have normal findings in clinical neuroimaging, alterations in brain structure and functional connectivity have frequently been reported. In this study, we investigated the large-scale brain structural and functional connectivity using diffusion MRI and resting-state fMRI data. Data from 40 mTBI patients was acquired at the acute stage (within 24 hrs after injury). 35 patients returned for data acquisition at a follow-up (4-6 weeks after injury). Data was also collected from a cohort of 58 healthy subjects, 36 of …

Understanding The Mechanism Of Oxidative Stress Generation By Oxidized Dopamine Metabolites: Implications In Parkinson's Disease, Nihar Mehta

Wayne State University Dissertations

Oxidation of dopamine to toxic metabolites is considered to be one of the prime factors involved in the death of dopaminergic neurons in Parkinson’s disease. Some dopamine oxidation products have the capability to redox cycle in the presence of molecular oxygen, further contributing to oxidative stress. Therefore, our aim here was to study the redox cycling of dopamine oxidized metabolites and elucidate the underlying mechanism by which they cause oxidative stress.

Redox reactions involve transfer of one or more electrons between two compounds

resulting in either oxidation or reduction. In redox cycling, a compound undergoes

alternate oxidation and reduction, transferring …

Clinical Applications Of Advanced Rotational Radiation Therapy, Adrian Nalichowski

Wayne State University Dissertations

Purpose: With a fast adoption of emerging technologies, it is critical to fully test and understand its limits and capabilities. In this work we investigate new graphic processing unit (GPU) based treatment planning algorithm and its applications in helical tomotherapy dose delivery. We explore the limits of the system by applying it to challenging clinical cases of total marrow irradiation (TMI) and stereotactic radiosurgery (SRS). We also analyze the feasibility of alternative fractionation schemes for total body irradiation (TBI) and TMI based on reported historical data on lung dose and interstitial pneumonitis (IP) incidence rates.

Methods and Materials: An anthropomorphic …

Anti-Cancer Effects Of Tocotrienols In Nsclc, Lichchavi Raj Raj

Wayne State University Dissertations

Lung cancer is one of the leading causes of death among cancers, with non-small cell lung cancer (NSCLC) accounting for 80-85% of all lung cancers and a five-year survival rate of 5 % at stage IIIB. Delta-tocotrienol (δT) including other tocotrienol isomers has been shown to exhibit anti-tumor activity via inhibition of different signaling pathways in tumors including NSCLC. Previously we reported that δT reduced cell invasion via inhibition of the Notch-1 and NF-κb pathway.

Matrix metallopeptidase 9 (MMP9) dependent cell migration and invasion are key processes in cancer metastasis. Hence, its suppression is a promising strategy for cancer therapeutics. …

Measuring The Effectiveness Of Benefit-Provisioning And Cost-Inflicting Mate Retention Tactics Through Relationship Outcomes, Tara Delecce

Wayne State University Dissertations

Mate retention has received much less research attention compared to mate choice and attraction. Even the research that has been done on mate retention often only aims to identify what constitutes as mate retention tactics. In the current studies, the effectiveness of mate retention strategies is explored by measuring relationship outcomes of tactics unlike previous research that measures effectiveness through perceptions of relationship satisfaction. In Study 1, individuals who have experienced a nonmarital breakup reported on their own and their ex-partners’ mate retention tactics before the breakup to see which ones predicted the outcome of relationship dissolution. Tests for moderation …

The Effects Of Bone Marrow Adipocytes On Metabolic Regulation In Metastatic Prostate Cancer, Jonathan Diedrich

Wayne State University Dissertations

Bone is a preferential site of metastasis from prostate cancer (PCa). Although there have been many advances in therapeutic options for patients suffering from metastatic PCa, this disease remains incurable with an estimated five-year survival of 33%. To design effective therapeutic interventions for metastatic PCa, it is essential that we elucidate the molecular mechanisms responsible for tumor cell adaptation to and the ability to thrive within the bone metastatic niche. Age and obesity, conditions that increase adipocyte numbers in bone marrow, are risk factors for skeletal metastases from PCa; therefore, our laboratory is focused on the interactions between marrow adipocytes …

Rituals Reproducing Race: African American Women's Feminine Hygiene Practices, Shared Experiences, And Power, Angela K. Guy-Lee

Wayne State University Dissertations

This dissertation is an exploration of the role African American women’s feminine hygiene practices, namely vaginal douching, plays in the creation and reproduction of race. Compared to their white and Latina counterparts, African American women are the most likely to engage in this practice. Vaginal douching is associated with myriad reproductive and sexual health problems. These problems include but are not limited to recurrent yeast infections, bacterial vaginosis, disrupting healthy vaginal microbiomes, and spontaneous preterm birth; of which African American women experience disproportionately. Although racial differences in vaginal douching are well documented, little is known about the impetus for African …

Pet Imaging Of Early Therapeutic Response In Solid Tumors, Stephanie J. Blocker

Wayne State University Dissertations

An important pillar of precision medicine for oncology is the ability to identify patients who respond to treatment early into their therapy. Positron emission tomography (PET) allows physicians and researchers to measure changes in tumor behavior prior to noticeable differences in morphology.

Objective: Determine the utility of multiple tracers for PET in assessing early changes in tumor activity that result from treatment.

Methods: Two tracers for PET were studied. 64Cu-labeled liposomes were used to assess changes in liposome delivery two solid colon tumors early into treatment with bevacizumab (Bev). 18F-FMAU thymidine analog (1-(2'-deoxy-2'-fluoro-beta-D-arabinofuranosyl)thymine), was utilized to detect early response to …

New Mechanism Based Approaches For Treating Prostate Cancer, Rayna Rosati

Wayne State University Dissertations

Prostate cancer (PC) is generally dependent on the androgen signaling axis for tumor growth. PC is managed by androgen deprivation therapy (ADT). The tumors then frequently progress by restoring ADT-resistant AR signaling through mechanisms such as intratumoral androgen synthesis, overexpression of AR, expression of splice variants of AR and alteration in the balance of AR co-regulators. This stage of progression is termed castrate recurrent prostate cancer (CRPC). Moreover, ADT has many major undesirable acute and chronic side effects on various normal tissues. Therefore a more strategic therapy approach is one that would disrupt a functional arm of AR signaling critical …

Neuropharmacological Investigation Of Stress And Nicotine Self-Administration Among Current Cigarette Smokers, Eric Woodcock

Wayne State University Dissertations

ABSTRACT

NEUROPHARMACOLOGICAL INVESTIGATION OF STRESS AND NICOTINE SELF-ADMINISTRATION AMONG CURRENT CIGARETTE SMOKERS

by

ERIC ANDREW WOODCOCK

August 2017

Advisor: Dr. Mark K. Greenwald

Major: Neuroscience (Translational)

Degree: Doctor of Philosophy

Nicotine use, especially cigarette smoking, is a significant public health problem. Existing pharmacotherapies attenuate nicotine craving and withdrawal symptoms. However, the majority of patients relapse within the first year of treatment. Treatment studies indicate a commonly cited precipitant to smoking relapse is stress. Pharmacotherapies do not attenuate, and may exacerbate, the effects of acute stress. Experimental studies (preclinical and clinical) indicate that acute stress potentiates drug-seeking behavior across drugs of …

Use Of The Research Readiness Self-Assessment (Rrsa) To Evaluate Medical Students’ Competencies In Finding And Evaluating Online Health Information (Poster Presented At Mhsla Annual Conference), Katherine G. Akers, Laventra E. Danquah, Ella Hu, Sandra Martin, Wendy Wu, Patricia Vinson

Library Scholarly Publications

To maintain awareness of current medical evidence and clinical practice guidelines in order to provide the best possible patient care, physicians must be able to locate, critically evaluate, synthesize, and make clinical decisions based on health information from multiple digital sources. Concerningly, however, medical students and junior doctors have been found to exhibit poor information literacy skills, including an inability to conduct efficient literature searches, find randomized controlled trials and systematic reviews, or evaluate study quality. Here, we describe our medical library’s experience in administering the Health version of the Research Readiness Self-Assessment (RRSA) tool to two cohorts of first-year …

Reusable Medical Equipment Inventory Assessment At A Detroit Medical Center, Tannaz Khaleghi

Wayne State University Theses

In recent years an outstanding growth has been observed in utilizing various medical devices due to growing demand. When both the quantity and quality into account, the price of medical devices becomes a critical factor to maintain cost/profit balances in financial systems. As a result healthcare systems should put more emphasis on how many of the trays they buy and store as their inventory due to high costs. Adequate levels of reusable medical equipment (RME) inventory is crucial for many healthcare systems

due to the RME equipment being expensive. On the other, the RME availability for vital departments such as …

Synaptotagmin C2b Ca2+-Binding Loops Impose Distinct Exocytosis Phenotypes, Michael W. Schmidtke

Wayne State University Theses

Regulated exocytosis from chromaffin cells in the adrenal medulla plays a critical role in maintaining organismal homeostasis. In the absence of stress, these cells release physiologically relevant substances into the blood stream only in limited quantities, whereas stressful conditions result in a rapid deluge of signaling molecules used, for example, to increase heart rate and pain tolerance. Although the cellular mechanisms governing the switch from low-level to stress-induced secretion are not well understood, recent evidence has implicated the exocytotic Ca2+-sensing protein Synaptotagmin (Syt) in this role.

Two isoforms of Syt are expressed in chromaffin cells (Syt-1 and Syt-7), and each …

Analysis Of The Secondary Neurodegenerative Consequences Of Primary Oligodendrocyte Stress Through The Use Of The Novel Obiden Mouse Model, Daniel Zdzislaw Radecki

Wayne State University Dissertations

The work of this project was to develop, test and characterize a potential novel mouse model of the neurodegenerative disease Multiple Sclerosis (MS). Historically, MS has been identified as a primary autoimmune disease of the central nervous system (CNS). However, treatments based on this view have met with limited success, and in most cases, fail to prevent progression of MS from mild to moderate and severe forms. Original observations regarding axonal and neuronal pathology in the white and gray matter of the CNS were rediscovered in the 1990s. These observations indicated that even in the absence of the immune system, …

Online Health Information Gathering And Health Service Utilization By Emergency Department Patients With Acute, Non-Urgent Illness Symptoms, Joanne Yastik

Wayne State University Dissertations

ABSTRACT

ONLINE HEALTH INFORMATION GATHERING AND HEALTH SERVICE UTILIZATION BY EMERGENCY DEPARTMENT PATIENTS WITH ACUTE, NON-URGENT ILLNESS SYMPTOMS

by

JOANNE M. YASTIK

May 2017

Advisor: Dr. Deborah Schutte

Major: Nursing

Degree: Doctor of Philosophy

Statement of the Problem: The influence of the Internet on our global society cannot be overstated. One of the most utilized areas on the Internet is the quest for health information (Bouche & Migeot, 2008; Goldman & Macpherson, 2006; Warner & Procaccino, 2007, Seckin, 2014). To date, little is known on how this information is being used or whether there is a link between online health …

Change In Processing Speed And Its Associations With Cerebral White Matter Microstructure, Muzamil Arshad

Wayne State University Dissertations

The decline of cognition with age is one of the most feared aspects of aging, while the slowing of responses, or reduced processing speed, is one of the most reliable aspects of aging. Slowing of processing has been hypothesized to affect other domains of cognition as well. Despite the well-known slowing-age relationship and central position processing speed plays in theories of cognitive aging the neurobiological mechanisms which underpin slowing is unclear. If we could identify the biology associated with processing speed we could then attempt to develop interventions to mitigate the effects of age on those variables. In turn we …

Preparing To Parent: Mindfulness In Expectant Parents Exposed To Adversity, Laurel Marie Hicks

Wayne State University Dissertations

Expectant parents who have been exposed to psychosocial risk encounter deleterious psychological (Ashley et al., 2016), and physiological (V. H. Pereira, Campos, & Sousa, 2017) effects. This not only affects the parent-to-be, but also may affect the developing fetus (E. P. Davis et al., 2011) and is linked to poorer infant development (Lefmann & Combs-Orme, 2014). However, not all risk-exposed individuals experience this, many are resilient and still thrive in the face of adversity. Understanding potential risk and resiliency factors in expectant parents is advantageous, so tailored interventions can be devised to improve outcomes. One potential resiliency factor, mindfulness, is …