Medicine and Health Sciences Commons^™

Study Protocol: Identifying Transcriptional Regulatory Alterations Of Chronic Effects Of Blast And Disturbed Sleep In United States Veterans, Molly J. Sullan, Kelly A. Stearns-Yoder, Zhaoyu Wang, Andrew J. Hoisington, Adam D. Brenoweth, Walter Carr, Yongchao Ge, Hanga Galfalvy, Fatemah Haghighi, Lisa A. Brenner

Faculty Publications

Injury related to blast exposure dramatically rose during post-911 era military conflicts in Iraq and Afghanistan. Mild traumatic brain injury (mTBI) is among the most common injuries following blast, an exposure that may not result in a definitive physiologic marker (e.g., loss of consciousness). Recent research suggests that exposure to low level blasts and, more specifically repetitive blast exposure (RBE), which may be subconcussive in nature, may also impact long term physiologic and psychological outcomes, though findings have been mixed. For military personnel, blast-related injuries often occur in chaotic settings (e.g., combat), which create challenges in the immediate assessment of …

Association Of Blast Exposure In Military Breaching With Intestinal Permeability Blood Biomarkers Associated With Leaky Gut, Qingkun Liu, Zhaoyu Wang, Shengnan Sun, Jeffrey Nemes, Lisa A. Brenner, Miciej Skotak, Christina R. Lavalle, Yongchao Ge, Walter Carr, Fatemeh Haghighi

Faculty Publications

Injuries and subclinical effects from exposure to blasts are of significant concern in military operational settings, including tactical training, and are associated with self-reported concussion-like symptomology and physiological changes such as increased intestinal permeability (IP), which was investigated in this study. Time-series gene expression and IP biomarker data were generated from “breachers” exposed to controlled, low-level explosive blast during training. Samples from 30 male participants at pre-, post-, and follow-up blast exposure the next day were assayed via RNA-seq and ELISA. A battery of symptom data was also collected at each of these time points that acutely showed elevated symptom …

Utilizing The System Engineering Trade Study Analysis Method To Analyze Patient Aeromedical Evacuation, Sara Shaghaghi, Jeremy M. Slagley, Michael E. Miller, Gaiven Varshney

Faculty Publications

The US Air Force has gone through many aeromedical patient isolation transport system designs. The first designs were developed in response to the Ebola outbreak in 2014 and, more recently, the COVID-19 pandemic. The trade study analysis part of the system engineering design method was used to analyze the historic and current aeromedical patient contamination control transport systems. A trade study is a process that evaluates alternatives based upon various “-ilities”, such as reconfigurability, flexibility, durability, cost, and more, and performs a systematic analysis to aid designers in producing a ‘good’ design alternative given the large set of possible solutions. …

Design And Characterization Of An Aerosol Test Chamber For Emergency Response Patient Contamination Control Simulation And Research, Megan L. Steele, Emily M. Spatz, George P. Lemmer, Jacob M. Denney, Casey Cooper, Jeremy M. Slagley, Robert M. Eninger

Faculty Publications

Contaminated or infected patients present a risk of cross-contamination for emergency responders, attending medical personnel and medical facilities as they enter a treatment facility. The controlled conditions of an aerosol test chamber are required to examine factors of contamination, decontamination, and cross-contamination. This study presents the design, construction, and a method for characterizing an aerosol test chamber for a full-sized manikin on a standard North Atlantic Treaty Organization litter. The methodology combined air velocity measurements, aerosol particle counts and size distributions, and computational fluid dynamics modeling to describe the chamber’s performance in three dimensions. This detailed characterization facilitates future experimental …

Shifting Our Lens: Practical Trauma-Informed Approaches For Educators, Charity Garcia, Ingrid Weiss Slikkers, Tara Bailey

Faculty Publications

No abstract provided.

The Impact Of Dieting Culture Is Different Between Sexes In Endurance Athletes: A Cross-Sectional Analysis, Austin J. Graybeal, Andreas Kreutzer, Jada L. Willis, Robyn Braun-Trocchio, Kamiah Moss, Meena Shah

Faculty Publications

Background: Frequent dieting is common in athletes attempting to achieve a body composition perceived to improve performance. Excessive dieting may indicate disordered eating (DE) behaviors and can result in clinical eating disorders. However, the current nutrition patterns that underly dieting culture are underexplored in endurance athletes. Therefore, the purpose of this study was to identify the sex differences in nutrition patterns among a group of endurance athletes.

Methods: Two-hundred and thirty-one endurance athletes (females = 124) completed a questionnaire regarding their dieting patterns and associated variables.

Results: The majority of athletes did not follow a planned diet …

Metacognition, Social Cognition, And Mentalizing In Psychosis: Are These Distinct Constructs When It Comes To Subjective Experience Or Are We Just Splitting Hairs?, P. H. Lysaker, S. Cheli, G. Dimaggio, B. Buck, K. A. Bonfils, K. Huling, C. Wiesepape, J. T. Lysaker

Faculty Publications

Research using the integrated model of metacognition has suggested that the construct of metacognition could quantify the spectrum of activities that, if impaired, might cause many of the subjective disturbances found in psychosis. Research on social cognition and mentalizing in psychosis, however, has also pointed to underlying deficits in how persons make sense of their experience of themselves and others. To explore the question of whether metacognitive research in psychosis offers unique insight in the midst of these other two emerging fields, we have offered a review of the constructs and research from each field. Following that summary, we discuss …

The Validity Of Using One Force Platform To Quantify Whole-Body Forces, Velocities, And Power During A Plyometric Push-Up, Zhanxin Sha, Boyi Dai

Faculty Publications

Background: Previous studies have typically measured velocity and power parameters during the push-up, either using one or two force platforms. The purpose of the study was to compare the force, velocity, and power parameters between the one-force-platform method and the two-force-platform method during plyometric push-ups.

Methods: Thirty-four physically active young adults participated in the study to perform the plyometric push-up. For the two-force-platform calculation method, the forces applied to the feet and hands were both measured. For the one-force-platform calculation method, the forces applied to the feet were assumed to be constant, while the forces applied to hands …

Epidemiology Of Type 2 Diabetes In The Middle East And North Africa: Challenges And Call For Action, Imad El-Kebbi, Nayda Bidikian, Layal Hneiny, Mona Nasrallah

Faculty Publications

Type 2 diabetes continues to be a serious and highly prevalent public health problem worldwide. In 2019, the highest prevalence of diabetes in the world at 12.2%, with its associated morbidity and mortality, was found in the Middle East and North Africa region. In addition to a genetic predisposition in its population, evidence suggests that obesity, physical inactivity, urbanization, and poor nutritional habits have contributed to the high prevalence of diabetes and prediabetes in the region. These risk factors have also led to an earlier onset of type 2 diabetes among children and adolescents, negatively affecting the productive years of …

Prevalence And Subgroup Comparisons Of Obesity And Severe Obesity Among Mississippi Public School Students, Lei Zhang, Xiaoshan Z. Gordy, Jerome Kolbo, Jacquelynn Johnson

Faculty Publications

This study examined the prevalence of obesity and severe obesity among Mississippi K-12 public school students and the obesity rate differences within subgroups categorized by sex, race, and grade level. Anthropometric data from a weighted, representative sample of Mississippi public school students were collected through the biennial Child and Youth Prevalence of Obesity Survey (CAYPOS). Overall prevalence rates and those of the subgroups were calculated and compared. The 2017 data indicated that overall 23.7% of Mississippi public schools students met the criterion of class I obesity, 9.1% met the criterion of class II obesity, and 3.2% met the criterion of …

Toxoplasma Gondii, Suicidal Behavior, And Intermediate Phenotypes For Suicidal Behavior, Teodor T. Postolache, Abhishek Wadhawan, Dan Rujescu, Andrew J. Hoisington, Aline Dagdag, Enrique Baca-Garcia, Christopher A. Lowry, Olaoluwa O. Okusaga, Lisa A. Brenner

Faculty Publications

Within the general literature on infections and suicidal behavior, studies on Toxoplasma gondii ( T. gondii ) occupy a central position. This is related to the parasite's neurotropism, high prevalence of chronic infection, as well as specific and non-specific behavioral alterations in rodents that lead to increased risk taking, which are recapitulated in humans by T. gondii's associations with suicidal behavior, as well as trait impulsivity and aggression, mental illness and traffic accidents. This paper is a detailed review of the associations between T. gondii serology and suicidal behavior, a field of study that started 15 years ago with our …

Propranolol Sensitizes Vascular Sarcoma Cells To Doxorubicin By Altering Lysosomal Drug Sequestration And Drug Efflux, Jhuma Saha, Jong Hyuk Kim, Clarissa N. Amaya, Caleb M. Witcher, Ali Khammanivong, Derek M. Korpela, David R. Brown, Josephine Taylor, Brad A. Bryan, Erin B. Dickerson

Faculty Publications

Angiosarcoma is a rare cancer of blood vessel–forming cells with a high patient mortality and few treatment options. Although chemotherapy often produces initial clinical responses, outcomes remain poor, largely due to the development of drug resistance. We previously identified a subset of doxorubicin-resistant cells in human angiosarcoma and canine hemangiosarcoma cell lines that exhibit high lysosomal accumulation of doxorubicin. Hydrophobic, weak base chemotherapeutics, like doxorubicin, are known to sequester within lysosomes, promoting resistance by limiting drug accessibility to cellular targets. Drug synergy between the beta adrenergic receptor (β-AR) antagonist, propranolol, and multiple chemotherapeutics has been documented in vitro, and …

Values And Other Decisional Factors Regarding Treatment Of Hypercalcaemia Of Malignancy: A Systematic Review Protocol, Aya Bassatne, Maya Rahme, Thomas Piggott, Hassan Murad, Layal Hneiny, Ghada El-Hajj Fuleihan

Faculty Publications

Introduction Hypercalcaemia of malignancy (HCM) is the second most common cause of hypercalcaemia and is associated with significant morbidity and mortality. Several treatment options are available including pharmacological therapy with bisphosphonates, denosumab, glucocorticoids and calcimimetics, as well as conventional therapy with hydration and possibly calcitonin. While guidelines have previously considered treatment effects, no guideline has yet considered a range of contextual factors impacting recommendations for the management. The aim of this study was to summarise the available evidence on important decisional factors for the development of guidelines for the treatment of HCM. These include patient’s values and preferences, cost, acceptability, …

Evaluation Of An Immunomodulatory Probiotic Intervention For Veterans With Co-Occurring Mild Traumatic Brain Injury And Posttraumatic Stress Disorder: A Pilot Study, Lisa A. Brenner, Jeri E. Forster, Kelly A. Stearns-Yoder, Christopher E. Stamper, Andrew J. Hoisington, Diana P. Brostow, Merideth Mealer, Hal S. Wortzel, Teodor T. Postolache, Christopher A. Lowry

Faculty Publications

Background: US military Veterans returned from Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND) with symptoms associated with mild traumatic brain injury [mTBI; i.e., persistent post-concussive (PPC) symptoms] and posttraumatic stress disorder (PTSD). Interventions aimed at addressing symptoms associated with both physical and psychological stressors (e.g., PPC and PTSD symptoms) are needed. This study was conducted to assess the feasibility, acceptability, and safety of a probiotic intervention, as well as to begin the process of evaluating potential biological outcomes.

Traditional Funeral And Burial Rituals And Ebola Outbreaks In West Africa: A Narrative Review Of Causes And Strategy Interventions, Chulwoo Park

Faculty Publications

Introduction: In West Africa, traditional funerals and burials have proven main contributors to the spread of infectious diseases, such as Ebola, plague, the Marburg virus, and others. Although the World Health Organization has provided guidelines for the safe burial process after learning of the culture of the afterlife in Ebola-affected areas, little effort has been made to integrate theoretical interventions and models for changing West Africans’ funeral behavior. This research was conducted to study 1) the background of traditional burial rituals, 2) interventions to contain Ebola outbreaks in West Africa, and 3) a strategic approach to future disease outbreak in …

Implementing Routine Communication About Costs Of Cancer Treatment: Perspectives Of Providers, Patients, And Caregivers, Marie Haverfield, A. E. Singer, C. Gray, A. Shelley, A. Nash, K. A. Lorenz

Faculty Publications

Objectives Rising costs in oncology care often impact patients and families directly, making communication about costs and financial impacts of treatment crucial. Cost expenditures could offer opportunities for estimation and prediction, affording personalized conversations about financial impact. We sought to explore providers’, patients’, and caregivers’ preferences towards implementing communication about cost, including when, how, and by whom such information might be provided.

Methods We conducted semi-structured phone interviews with a diverse population including 12 oncology providers, 12 patients, and 8 patient caregivers (N = 32). The constant comparative method was used to identify mutually agreed upon themes.

Results Participant groups …

Can The Fut 2 Gene Variant Have An Effect On The Body Weight Of Patients Undergoing Bariatric Surgery? - Preliminary, Exploratory Study, Natalia Komorniak, Alexandra Martynova-Van Kley, Armen Nalian, Wiktoria Wardziukiewicz, Karolina Skoniecznaa-Zydecka, Daniel Styburski, Joanna Palma, Bartosz Kowalewski, Krzysztof Kaseja, Ewa Stachowska

Faculty Publications

Background: The FUT2 gene (Se gene) encoding the enzyme α-1,2-L-fucosyltransferase 2 seems to have a significant effect on the number and type of bacteria colonizing the intestines. Methods: In a group of 19 patients after bariatric surgery, the polymorphism (rs601338) of FUT2 gene was analyzed in combination with body mass reduction, intestinal microbiome (16S RNA sequencing), and short chain fatty acids (SCFA) measurements in stools. Results: Among the secretors (Se/Se polymorphism of the FUT2 gene rs601338, carriers of GG variant), correlations between waist-hip ratio (WHR) and propionate content and an increase in Prevotella, Escherichia, Shigella, and Bacteroides were observed. On …

The Promise Of Inclusion For Female Student Health, Kate D. Romero, Kymberlee O'Brien

Faculty Publications

Despite extensive inclusion and diversity initiatives, females do not feel valued or included and still report higher stress, discrimination and microaggressions than males. Cumulative effects of social devaluation on health were examined for students at a STEM University. A sample of 292 undergraduates were asked about daily and chronic experiences of inclusion using surveys assessing personal perceived stress and subtle and overt social devaluation. Females reported significantly higher microaggressions and perceived stress, associated with lower physical and mental health. Females in high social devaluation (SD) reported lower total well-being (TWB) across several domains. An exploratory factor analyses examined factor loadings …

How Health Care Providers Can Use Digital Health Technologies To Inform Human Papillomavirus (Hpv) Decision Making And Promote The Hpv Vaccine Uptake Among Adolescents And Young Adults, Versie Johnson-Mallard, Gabrielle Darville, Rebeccah Mercado, Charkarra Anderson-Lewis, Jann Macinnes

Faculty Publications

High-risk stains of human papillomavirus (HPV) is linked to causing cancer, is highly prevalent, and has increased incidence among adolescents and young adults. However, vaccination rates are low. Health care provider recommendation is the biggest influencer toward vaccine uptake. Since more health care providers are using digital health technologies in their medical practices, this study investigated the feasibility of technology to increase informed decision making. A convenience sample of 210 students completed an online survey. Participants were 18–25 years of age (88%), female (85%), Caucasian (60%), and never been diagnosed with HPV (92.9%). Overwhelmingly, participants owned a smartphone (98.9%) and …

Discovery Of Alpha-Gal-Containing Antigens In North American Tick Species Believed To Induce Red Meat Allergy, Gary Crispell, Scott P. Commins, Stephanie A. Archer-Hartman, Shailesh Choudhary, Guha Dharmarajan, Parastoo Azadi, Shahid Karim

Faculty Publications

Development of specific IgE antibodies to the oligosaccharide galactose-α-1, 3-galactose (α-gal) following tick bites has been shown to be the source of red meat allergy. In this study, we investigated the presence of α-gal in four tick species: the lone-star tick (Amblyomma americanum), the Gulf-Coast tick (Amblyomma maculatum), the American dog tick (Dermacentor variabilis), and the black-legged tick (Ixodes scapularis) by using a combination of immunoproteomic approach and, carbohydrate analysis. Anti-α-gal antibodies identified α-gal in the salivary glands of both Am. americanum and Ix. scapularis, while Am. maculatum and De. variabilis …

Toxoplasma Gondii Igg Associations With Sleepwake Problems, Sleep Duration And Timing, Celine C. Corona, Ma Zhang, Abhishek Wadhawan, Melanie L. Daue, Maureen W. Groer, Aline Dagang, Christopher A. Lowry, Kathleen A. Ryan, Andrew J. Hoisington, John W. Stiller, Dietmar Fuchs, Braxton D. Mitchell, Teodor T. Postolache

Faculty Publications

Background: Evidence links Toxoplasma gondii (T. gondii), a neurotropic parasite, with schizophrenia, mood disorders and suicidal behavior, all of which are associated and exacerbated by disrupted sleep. Moreover, low-grade immune activation and dopaminergic overstimulation, which are consequences of T. gondii infection, could alter sleep patterns and duration. Methods: Sleep data on 833 Amish participants [mean age (SD) = 44.28 (16.99) years; 59.06% women] were obtained via self-reported questionnaires that assessed sleep problems, duration and timing. T. gondii IgG was measured with ELISA. Data were analyzed using multivariable logistic regressions and linear mixed models, with adjustment for age, sex and family …

Left Ventricular Mechanical Dyssynchrony For Cad Diagnosis: Does It Have Incremental Clinical Values?, Zhixin Jiang, Weihua Zhou

Faculty Publications

No abstract provided.

Patient Acceptance Of Remote Scribing Powered By Google Glass In Outpatient Dermatology: Cross-Sectional Study, Sandra Odenheimer, Deepika Goyal, Veena Jones, Ruth Rosenblum, Lam Ho, Albert Chan

Faculty Publications

Background: The ubiquitous use of electronic health records (EHRs) during medical office visits using a computer monitor and keyboard can be distracting and can disrupt patient-health care provider (HCP) nonverbal eye contact cues, which are integral to effective communication. Provider use of a remote medical scribe with face-mounted technology (FMT), such as Google Glass, may preserve patient-HCP communication dynamics in health care settings by allowing providers to maintain direct eye contact with their patients while still having access to the patient’s relevant EHR information. The medical scribe is able to chart patient encounters in real-time working in an offsite location, …

Redesigning The Door To Doctor (D2d) Process In Emergency Department: The Key To A Successful Patient-Centered Story, Layal Hneiny, Maryah Damlaj

Faculty Publications

Lean management, when adopted in health care settings, will influence clinicians to find better ways for providing health care services to patients. In ED’s everyday processes, lean focuses on improving the ED process flow through facilitating communication among ED staff and eliminating any unnecessary steps (wastes) along the process. An observational cross-sectional study has been conducted at the Emergency Department (ED) of the American University of Beirut- Medical Center (AUBMC), to assess the extent upon which AUBMC-ED is lean. The time it takes the patient to be examined by an attending doctor, from the moment s/he hits the ED door, …

Mediodorsal Thalamic Neurons Mirror The Activity Of Medial Prefrontal Neurons Responding To Movement And Reinforcement During A Dynamic Dnmtp Task, Rikki L.A. Miller Phd, Miranda J. Francoeur, Brett M. Gibson, Robert G. Mair

Faculty Publications

The mediodorsal nucleus (MD) interacts with medial prefrontal cortex (mPFC) to support learning and adaptive decision-making. MD receives driver (layer 5) and modulatory (layer 6) projections from PFC and is the main source of driver thalamic projections to middle cortical layers of PFC. Little is known about the activity of MD neurons and their influence on PFC during decision-making. We recorded MD neurons in rats performing a dynamic delayed nonmatching to position (dDNMTP) task and compared results to a previous study of mPFC with the same task (Onos et al., 2016). Criterion event-related responses were observed for 22% …

Why Is Family Medicine Different?, F. Matthew Mihelic, Gregory H. Blake

Faculty Publications

An understanding of the role and function of Family Medicine in the healthcare system can provide important insights for Enterprise Architecture. It is often stated that the thought process utilized by Family Medicine physicians is different from that of specialty physicians, but heretofore there has been little or no analysis of what that difference is. This article examines that difference from the perspective of the complex adaptive system that is healthcare today, and shows how it is that Family Medicine physicians perform the vital function of decreasing the entropy or disorder in the patient care system via decision loops, as …

End-Of-Life Training In Us Internal Medicine Residency Programs: A National Study, Derek Cegelka, Timothy R. Jordan, Jiunn-Jye Sheu, Joseph A. Dake, Ragheb Assaly

Faculty Publications

Background: End-of-life care is a required and important component of medical training for internal medicine residents; many of whom will go on to provide care for adults at the end-of-life stage. Although a body of past research suggests that physician training in end-of-life care needs significant improvement, a comprehensive national study of end-of-life education within US internal medicine residency programs has never been published.

Objective: To determine the status of end-of-life education in internal medicine residency programs in the United States.

Method: The study was a cross-sectional, observational study of all internal medicine Residency Program Directors in the US as …

Imaging Right Ventricular Function To Predict Outcome In Pulmonary Arterial Hypertension, Alessandro Bellofiore, Melanie Brewis, Rebecca Vanderpool, Naomi Chesler, Martin Johnson, Robert Naeije, Andrew Peacock

Faculty Publications

Right ventricular (RV) function is a major determinant of outcome in pulmonary arterial hypertension (PAH). However, uncertainty persists about the optimal method of evaluation.MethodsWe measured RV end-systolic and end-diastolic volumes (ESV and EDV) using cardiac magnetic resonance imaging and RV pressures during right heart catheterization in 140 incident PAH patients and 22 controls. A maximum RV pressure (Pmax) was calculated from the nonlinear extrapolations of early and late systolic portions of the RV pressure curve. The gold standard measure of RV function adaptation to afterload, or RV–arterial coupling (Ees/Ea) was estimated by the stroke volume (SV)/ESV ratio (volume method) or …

Survival Of High-Risk Pediatric Neuroblastoma Patients In A Developing Country, Joseph C. Easton, Sergio Gomez, Peter H. Asdahl, J. Michael Conner, Alcira B. Flynn, Claudia Ruiz, Rohit P. Ojha

Faculty Publications

Little information is available about survival of high‐risk pediatric neuroblastoma patients in developing countries. We aimed to assess survival among high‐risk pediatric neuroblastoma patients in La Plata, Argentina. Individuals eligible for our cohort were aged4 yr at diagnosis, 54% were male, and 62% had adrenal neuroblastoma. We observed 18 deaths, and the median survival time of our study population was 1.7 yr. The five‐yr overall survival probability was 24% (95% CL: 10%, 41%). In contrast, five‐yr survival of high‐risk neuroblastoma patients ranges between 23% and 76% in developed countries. Survival among high‐risk neuroblastoma patients is generally poor regardless of geographic …

Long Non-Coding Rnas As Prognostic Markers In Human Breast Cancer, Hairong Liu, Juan Li, Pratirodh Koirala, Xianfeng Ding, Binghai Chen, Yiheng Wang, Zheng Wang, Chuanxin Wang, Xu Zhang, Yin-Yuan Mo

Faculty Publications

Long non-coding RNAs (lncRNAs) have been recently shown to play an important role in gene regulation and normal cellular functions, and disease processes. However, despite the overwhelming number of lncRNAs identified to date, little is known about their role in cancer for vast majority of them. The present study aims to determine whether lncRNAs can serve as prognostic markers in human breast cancer. We interrogated the breast invasive carcinoma dataset of the Cancer Genome Atlas (TCGA) at the cBioPortal consisting of ~ 1,000 cases. Among 2,730 lncRNAs analyzed, 577 lncRNAs had alterations ranging from 1% to 32% frequency, which include …