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Full-Text Articles in Medicine and Health Sciences

Biting The Hands That Feed “The Alligators”: A Case Study In Morbid Obesity Extremes, End-Of-Life Care, And Prohibitions On Harming And Accelerating The End Of Life, Michael J. Malinowski Jan 2018

Biting The Hands That Feed “The Alligators”: A Case Study In Morbid Obesity Extremes, End-Of-Life Care, And Prohibitions On Harming And Accelerating The End Of Life, Michael J. Malinowski

Journal Articles

Obesity, recognized as a disease in the U.S. and at times as a terminal illness due to associated medical complications, is an American epidemic according to the Centers for Disease Control and Prevention (“CDC”), American Heart Association (“AHA”), and other authorities. More than one third of Americans (39.8% of adults and 18.5% of children) are medically obese. This article focuses on cases of “extreme morbid obesity” (“EMO”)—situations in which death is imminent without aggressive medical interventions, and bariatric surgery is the only treatment option with a realistic possibility of success. Bariatric surgeries themselves are very high ...


Compassionate Coverage: A Patient Access Linen System, J. M. Rabin, K. C. Farner, A. H. Brody, A. Peyser, M. Kline Jan 2018

Compassionate Coverage: A Patient Access Linen System, J. M. Rabin, K. C. Farner, A. H. Brody, A. Peyser, M. Kline

Journal Articles

No abstract provided.


Changes In Balance And Joint Position Sense During A 12-Day High Altitude Trek: The British Services Dhaulagiri Medical Research Expedition, Sarah B. Clarke, Kevin Deighton, Caroline Newman, Gareth Nicholson, Liam Gallagher, Christopher J. Boos, Adrian Mellor, David R. Woods, John P. O'Hara Jan 2018

Changes In Balance And Joint Position Sense During A 12-Day High Altitude Trek: The British Services Dhaulagiri Medical Research Expedition, Sarah B. Clarke, Kevin Deighton, Caroline Newman, Gareth Nicholson, Liam Gallagher, Christopher J. Boos, Adrian Mellor, David R. Woods, John P. O'Hara

Journal Articles

Postural control and joint position sense are essential for safely undertaking leisure and professional activities, particularly at high altitude. We tested whether exposure to a 12-day trek with a gradual ascent to high altitude impairs postural control and joint position sense. This was a repeated measures observational study of 12 military service personnel (28±4 years). Postural control (sway velocity measured by a portable force platform) during standing balance, a Sharpened Romberg Test and knee joint position sense were measured, in England (113m elevation) and at 3 research camps (3619m, 4600m and 5140m) on a 12-day high altitude trek in ...


Pdz-Rhogef Is A Signaling Effector For Troy-Induced Glioblastoma Cell Invasion And Survival, Z. Ding, H. Dhruv, A. Kwiatkowska-Piwowarczyk, R. Ruggieri, J. Kloss, M. Symons, P. Pirrotte, J. M. Eschbacher, N. L. Tran, J. C. Loftus Jan 2018

Pdz-Rhogef Is A Signaling Effector For Troy-Induced Glioblastoma Cell Invasion And Survival, Z. Ding, H. Dhruv, A. Kwiatkowska-Piwowarczyk, R. Ruggieri, J. Kloss, M. Symons, P. Pirrotte, J. M. Eschbacher, N. L. Tran, J. C. Loftus

Journal Articles

© 2018 The Authors Glioblastoma multiforme (GBM) is the most common type of malignant brain tumors in adults and has a dismal prognosis. The highly aggressive invasion of malignant cells into the normal brain parenchyma renders complete surgical resection of GBM tumors impossible, increases resistance to therapeutic treatment, and leads to near-universal tumor recurrence. We have previously demonstrated that TROY (TNFRSF19) plays an important role in glioblastoma cell invasion and therapeutic resistance. However, the potential downstream effectors of TROY signaling have not been fully characterized. Here, we identified PDZ-RhoGEF as a binding partner for TROY that potentiated TROY-induced nuclear factor kappa ...


Implementation And Utilization Of Hypofractionation For Breast Cancer, P. Gilbo, L. Potters, L. Lee Jan 2018

Implementation And Utilization Of Hypofractionation For Breast Cancer, P. Gilbo, L. Potters, L. Lee

Journal Articles

© 2018 The Authors Purpose: Hypofractionation (HF) of whole breast irradiation has become a standard treatment regimen because randomized trials continue to demonstrate equivalence in survival and local control compared with conventional fractionation. In 2011, the American Society for Radiation Oncology (ASTRO) adopted clinical guidelines on the proper selection of HF. Nevertheless, utilization remains lower than predicted. We evaluate the effects of clinical directives that serve as default treatment decisions and prospective contouring rounds on the implementation of HF in a large, multicenter radiation oncology department. Methods and materials: In 2010, we implemented consensus-driven and evidence-based clinical directives to guide treatment ...


Intermediate-Risk Meningioma: Initial Outcomes From Nrg Oncology Rtog 0539, L. Rogers, P. Zhang, M. A. Vogelbaum, A. Perry, L. S. Ashby, J. M. Modi, A. M. Alleman, J. Galvin, J. P. S. Knisely, M. P. Mehta, +5 Additional Authors Jan 2018

Intermediate-Risk Meningioma: Initial Outcomes From Nrg Oncology Rtog 0539, L. Rogers, P. Zhang, M. A. Vogelbaum, A. Perry, L. S. Ashby, J. M. Modi, A. M. Alleman, J. Galvin, J. P. S. Knisely, M. P. Mehta, +5 Additional Authors

Journal Articles

No abstract provided.


Reducing Seed Waste And Increasing Value Of Dynamic Intraoperative Implantation Of Pd-103 Seeds In Prostate Brachytherapy, P. K. Taylor, A, C. Riegel Jan 2018

Reducing Seed Waste And Increasing Value Of Dynamic Intraoperative Implantation Of Pd-103 Seeds In Prostate Brachytherapy, P. K. Taylor, A, C. Riegel

Journal Articles

© 2018 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine. Several nomograms exist for ordering palladium-103 seeds for permanent prostate seed implants (PSI). Excess seeds from PSIs pose additional radiation safety risks and increase the cost of care. This study compared five nomograms to clinical data from dynamic modified-peripheral intraoperative PSI to determine (a) the cause of excess seeds and (b) the optimal nomogram for our institution. Pre- and intraoperative patient data were collected for monotherapy PSIs and compiled into a clinical database. All patients were prescribed ...


Restricted Single Isocenter For Multiple Targets Dynamic Conformal Arc (Rsimt Dca) Technique For Brain Stereotactic Radiosurgery (Srs) Planning., J. Chang, A. G. Wernicke, S. C. Pano Jan 2018

Restricted Single Isocenter For Multiple Targets Dynamic Conformal Arc (Rsimt Dca) Technique For Brain Stereotactic Radiosurgery (Srs) Planning., J. Chang, A. G. Wernicke, S. C. Pano

Journal Articles

In stereotactic radiosurgery (SRS), the multiple isocenters for multiple targets dynamic conformal arc (MIMT DCA) technique is traditionally used to treat multiple brain metastases, with one isocenter for each target. The single isocenter for multiple targets (SIMT) technique has recently been adopted to reduce the treatment time at the cost of plan quality. The objective of this study was to develop a restricted single isocenter for multiple targets DCA (RSIMT DCA) technique that can significantly reduce the treatment time but still maintain similar plan quality as the MIMT DCA technique.Treating multiple brain metastases with a single isocenter poses a ...


Integration Of Leadership Training Into A Problem/Case-Based Learning Program For First- And Second-Year Medical Students., S. B. Ginzburg, S. Deutsch, J. Bellissimo, D. E. Elkowitz, J. N.H. Stern, R. Lucito Jan 2018

Integration Of Leadership Training Into A Problem/Case-Based Learning Program For First- And Second-Year Medical Students., S. B. Ginzburg, S. Deutsch, J. Bellissimo, D. E. Elkowitz, J. N.H. Stern, R. Lucito

Journal Articles

Purpose: The evolution of health care systems in response to societal and financial pressures has changed care delivery models, which presents new challenges for physicians. Leadership training is increasingly being recognized as an essential component of medical education training to prepare physicians to meet these needs. Unfortunately, most medical schools do not include leadership training. It has been suggested that a longitudinal and integrated approach to leadership training should be sought. We hypothesized that integration of leadership training into our hybrid problem-based learning (PBL)/case-based learning (CBL) program, Patient-Centered Explorations in Active Reasoning, Learning and Synthesis (PEARLS), would be an ...


Sts/Sca/Amsect Clinical Practice Guidelines: Anticoagulation During Cardiopulmonary Bypass, L. Shore-Lesserson, R. A. Baker, V. Ferraris, P. E. Greilich, D. Fitzgerald, P. Roman, J. Hammon Jan 2018

Sts/Sca/Amsect Clinical Practice Guidelines: Anticoagulation During Cardiopulmonary Bypass, L. Shore-Lesserson, R. A. Baker, V. Ferraris, P. E. Greilich, D. Fitzgerald, P. Roman, J. Hammon

Journal Articles

© 2018 American Society of Extra-Corporeal Technology. All Rights Reserved. Despite more than a half century of "safe" cardio-pulmonary bypass (CPB), the evidence base surrounding the conduct of anticoagulation for CPB has not been organized into a succinct guideline. For this and other reasons, there is enormous practice variability relating to the use and dosing of heparin, monitoring heparin anticoagulation, reversal of anticoagulation, and the use of alternative anticoagulants. To address this and other gaps, the Society of Thoracic Surgeons (STS), the Society of Cardiovascular Anesthesiologists (SCA), and the American Society of Extracorporeal Technology (AmSECT) developed an Evidence Based Workgroup. This ...


Increased Reactive Oxygen Species And Cell Cycle Defects Contribute To Anemia In The Rasa3 Mutant Mouse Model Scat, E. S. Hartman, E. C. Brindley, J. Papoin, S. L. Ciciotte, Y. Zhao, L. L. Peters, L. Blanc Jan 2018

Increased Reactive Oxygen Species And Cell Cycle Defects Contribute To Anemia In The Rasa3 Mutant Mouse Model Scat, E. S. Hartman, E. C. Brindley, J. Papoin, S. L. Ciciotte, Y. Zhao, L. L. Peters, L. Blanc

Journal Articles

No abstract provided.


Plasma Cell Differentiation Pathways In Systemic Lupus Erythematosus, S. Malkiel, A. N. Barlev, Y. Atisha-Fregoso, J. Suurmond, B. Diamond Jan 2018

Plasma Cell Differentiation Pathways In Systemic Lupus Erythematosus, S. Malkiel, A. N. Barlev, Y. Atisha-Fregoso, J. Suurmond, B. Diamond

Journal Articles

No abstract provided.


Analysis Of Menstrual Effluent: Diagnostic Potential For Endometriosis, L. A. Warren, A. Shih, S. M. Renteira, T. Seckin, B. Blau, K. Simpfendorfer, C. N. Metz, P. K. Gregersen Jan 2018

Analysis Of Menstrual Effluent: Diagnostic Potential For Endometriosis, L. A. Warren, A. Shih, S. M. Renteira, T. Seckin, B. Blau, K. Simpfendorfer, C. N. Metz, P. K. Gregersen

Journal Articles

No abstract provided.


Identification Of Cytokine-Specific Sensory Neural Signals By Decoding Murine Vagus Nerve Activity, T. P. Zanos, H. A. Silverman, T. Levy, T. Tsaava, E. Battinelli, P. W. Lorraine, J. M. Ashe, S. S. Chavan, K. J. Tracey, C. E. Bouton Jan 2018

Identification Of Cytokine-Specific Sensory Neural Signals By Decoding Murine Vagus Nerve Activity, T. P. Zanos, H. A. Silverman, T. Levy, T. Tsaava, E. Battinelli, P. W. Lorraine, J. M. Ashe, S. S. Chavan, K. J. Tracey, C. E. Bouton

Journal Articles

© 2018 National Academy of Sciences. All Rights Reserved. The nervous system maintains physiological homeostasis through reflex pathways that modulate organ function. This process begins when changes in the internal milieu (e.g., blood pressure, temperature, or pH) activate visceral sensory neurons that transmit action potentials along the vagus nerve to the brainstem. IL-1β and TNF, inflammatory cytokines produced by immune cells during infection and injury, and other inflammatory mediators have been implicated in activating sensory action potentials in the vagus nerve. However, it remains unclear whether neural responses encode cytokine-specific information. Here we develop methods to isolate and decode specific ...


The Effect Of High Altitude On Central Blood Pressure And Arterial Stiffness, Christopher Boos, Emmanuel Vincent, Adrian Mellor, David Woods, Caroline Newman, Richard Cruttenden, Matt Barlow, Mark Cooke, Kevin Deighton, Peter Scott, Sarah B. Clarke, John O'Hara May 2017

The Effect Of High Altitude On Central Blood Pressure And Arterial Stiffness, Christopher Boos, Emmanuel Vincent, Adrian Mellor, David Woods, Caroline Newman, Richard Cruttenden, Matt Barlow, Mark Cooke, Kevin Deighton, Peter Scott, Sarah B. Clarke, John O'Hara

Journal Articles

No abstract provided.


Contextualizing The Relevance Of Basic Sciences: Small-Group Simulation With Debrief For First- And Second-Year Medical Students In An Integrated Curriculum., S. B. Ginzburg, J. Brenner, M. Cassara, T. Kwiatkowski, J. M. Willey Jan 2017

Contextualizing The Relevance Of Basic Sciences: Small-Group Simulation With Debrief For First- And Second-Year Medical Students In An Integrated Curriculum., S. B. Ginzburg, J. Brenner, M. Cassara, T. Kwiatkowski, J. M. Willey

Journal Articles

There has been a call for increased integration of basic and clinical sciences during preclinical years of undergraduate medical education. Despite the recognition that clinical simulation is an effective pedagogical tool, little has been reported on its use to demonstrate the relevance of basic science principles to the practice of clinical medicine. We hypothesized that simulation with an integrated science and clinical debrief used with early learners would illustrate the importance of basic science principles in clinical diagnosis and management of patients.Small groups of first- and second-year medical students were engaged in a high-fidelity simulation followed by a comprehensive ...


British Services Dhaulagiri Medical Research Expedition: A Unique Military And Civilian Research Collaboration, Adrian Mellor, Josh Bakker-Dyos, Marc Howard, Christopher Boos, Mark Cooke, Emmanuel Vincent, Peter Scott, John O'Hara, Sarah B. Clarke, Matt Barlow, Jamie Matu, Kevin Deighton, Caroline Newman, Richard Cruttenden, David Holdsworth, David Woods Jan 2017

British Services Dhaulagiri Medical Research Expedition: A Unique Military And Civilian Research Collaboration, Adrian Mellor, Josh Bakker-Dyos, Marc Howard, Christopher Boos, Mark Cooke, Emmanuel Vincent, Peter Scott, John O'Hara, Sarah B. Clarke, Matt Barlow, Jamie Matu, Kevin Deighton, Caroline Newman, Richard Cruttenden, David Holdsworth, David Woods

Journal Articles

No abstract provided.


Changes In Appetite, Energy Intake, Body Composition And Circulating Ghrelin Constituents During An Incremental Trekking Ascent To High Altitude, Jamie Matu, John O'Hara, Neil Hill, Sarah B. Clarke, Christopher Boos, Caroline Newman, David Holdsworth, Theocharis Ispoglou, Lauren Duckworth, David Woods, Adrian Mellor, Kevin Deighton Jan 2017

Changes In Appetite, Energy Intake, Body Composition And Circulating Ghrelin Constituents During An Incremental Trekking Ascent To High Altitude, Jamie Matu, John O'Hara, Neil Hill, Sarah B. Clarke, Christopher Boos, Caroline Newman, David Holdsworth, Theocharis Ispoglou, Lauren Duckworth, David Woods, Adrian Mellor, Kevin Deighton

Journal Articles

No abstract provided.


Neurovascular Unit Dysfunction And Blood-Brain Barrier Hyperpermeability Contribute To Schizophrenia Neurobiology: A Theoretical Integration Of Clinical And Experimental Evidence, S. Najjar, S. Pahlajani, V. De Sanctis, J. N.H. Stern, A. Najjar, D. Chong Jan 2017

Neurovascular Unit Dysfunction And Blood-Brain Barrier Hyperpermeability Contribute To Schizophrenia Neurobiology: A Theoretical Integration Of Clinical And Experimental Evidence, S. Najjar, S. Pahlajani, V. De Sanctis, J. N.H. Stern, A. Najjar, D. Chong

Journal Articles

No abstract provided.


Using Objective Structured Teaching Encounters (Ostes) To Prepare Chief Residents To Be Emotionally Intelligent Leaders, S. A. Cerrone, P. Adelman, S. Akbar, A. C. Yacht, A. Fornari Jan 2017

Using Objective Structured Teaching Encounters (Ostes) To Prepare Chief Residents To Be Emotionally Intelligent Leaders, S. A. Cerrone, P. Adelman, S. Akbar, A. C. Yacht, A. Fornari

Journal Articles

No abstract provided.


Do Medical Residents Perform Patient-Centered Medical Home Tasks? A Mixed-Methods Study, L. Block, N. Lavine, J. Verbsky, A. Sagar, M. A. Smith, S. Lane, J. Conigliaro, S. A. Chaudhry Jan 2017

Do Medical Residents Perform Patient-Centered Medical Home Tasks? A Mixed-Methods Study, L. Block, N. Lavine, J. Verbsky, A. Sagar, M. A. Smith, S. Lane, J. Conigliaro, S. A. Chaudhry

Journal Articles

No abstract provided.


Nfatc3 And Vip In Idiopathic Pulmonary Fibrosis And Chronic Obstructive Pulmonary Disease, A. M. Szema, E. Forsyth, B. Ying, S. A. Hamidi, J. J. Chen, S. Hwang, J. C. Li, D. S. Dwyer, J. M. Ramiro-Diaz, L. V. Gonzalez Bosc, +1 Additional Author Jan 2017

Nfatc3 And Vip In Idiopathic Pulmonary Fibrosis And Chronic Obstructive Pulmonary Disease, A. M. Szema, E. Forsyth, B. Ying, S. A. Hamidi, J. J. Chen, S. Hwang, J. C. Li, D. S. Dwyer, J. M. Ramiro-Diaz, L. V. Gonzalez Bosc, +1 Additional Author

Journal Articles

No abstract provided.


Microtubule-Targeting Agents Can Sensitize Cancer Cells To Ionizing Radiation By An Interphase-Based Mechanism, D. Markowitz, G. Ha, R. Ruggieri, M. Symons Jan 2017

Microtubule-Targeting Agents Can Sensitize Cancer Cells To Ionizing Radiation By An Interphase-Based Mechanism, D. Markowitz, G. Ha, R. Ruggieri, M. Symons

Journal Articles

No abstract provided.


Repurposing Mebendazole As A Replacement For Vincristine For The Treatment Of Brain Tumors, M. De Witt, A. Gamble, D. Hanson, D. Markowitz, C. Powell, S. Al Dimassi, M. Atlas, J. Boockvar, R. Ruggieri, M. Symons Jan 2017

Repurposing Mebendazole As A Replacement For Vincristine For The Treatment Of Brain Tumors, M. De Witt, A. Gamble, D. Hanson, D. Markowitz, C. Powell, S. Al Dimassi, M. Atlas, J. Boockvar, R. Ruggieri, M. Symons

Journal Articles

No abstract provided.


Saving Lives And Reducing Harm: A Cauti Reduction Program, K. A. Scanlon, C. M. Wells, L. Woolforde, A. Khameraj, J. Baumgarten Jan 2017

Saving Lives And Reducing Harm: A Cauti Reduction Program, K. A. Scanlon, C. M. Wells, L. Woolforde, A. Khameraj, J. Baumgarten

Journal Articles

No abstract provided.


Glecaprevir And Pibrentasvir For 12 Weeks For Hepatitis C Virus Genotype 1 Infection And Prior Direct-Acting Antiviral Treatment, F. Poordad, F. Felizarta, A. Asatryan, M. S. Sulkowski, R. W. Reindollar, C. S. Landis, S. C. Gordon, S. L. Flamm, D. E. Bernstein, F. J. Mensa, +6 Additional Authors Jan 2017

Glecaprevir And Pibrentasvir For 12 Weeks For Hepatitis C Virus Genotype 1 Infection And Prior Direct-Acting Antiviral Treatment, F. Poordad, F. Felizarta, A. Asatryan, M. S. Sulkowski, R. W. Reindollar, C. S. Landis, S. C. Gordon, S. L. Flamm, D. E. Bernstein, F. J. Mensa, +6 Additional Authors

Journal Articles

No abstract provided.


Combined-Modality Hypofractionated Radiotherapy For Elderly Patients With Glioblastoma: Setting A New Standard., B. A. Vellayappan, L. M. Halasz, J. P. S. Knisely, E. L. Chang, S. S. Lo Jan 2017

Combined-Modality Hypofractionated Radiotherapy For Elderly Patients With Glioblastoma: Setting A New Standard., B. A. Vellayappan, L. M. Halasz, J. P. S. Knisely, E. L. Chang, S. S. Lo

Journal Articles

No abstract provided.


Long-Term Outcome Of 487 Patients With Early-Stage Extra-Nodal Marginal Zone Lymphoma, S. Teckie, S. Qi, M. Chelius, S. Lovie, M. Hsu, A. Noy, C. Portlock, J. Yahalom Jan 2017

Long-Term Outcome Of 487 Patients With Early-Stage Extra-Nodal Marginal Zone Lymphoma, S. Teckie, S. Qi, M. Chelius, S. Lovie, M. Hsu, A. Noy, C. Portlock, J. Yahalom

Journal Articles

No abstract provided.


Novel Wavelet-Based Segmentation Of Prostate Cbct Images With Implanted Calypso Transponders., Y. Liu, Z. Saleh, Y. Song, M. Chan, X. Li, C. Shi, X. Qian, X. Tang Jan 2017

Novel Wavelet-Based Segmentation Of Prostate Cbct Images With Implanted Calypso Transponders., Y. Liu, Z. Saleh, Y. Song, M. Chan, X. Li, C. Shi, X. Qian, X. Tang

Journal Articles

Segmentation of prostate Cone Beam CT (CBCT) images is an essential step towards real-time adaptive radiotherapy (ART). It is challenging for Calypso patients, as more artifacts generated by the beacon transponders are present on the images. We herein propose a novel wavelet-based segmentation algorithm for rectum, bladder, and prostate of CBCT images with implanted Calypso transponders. For a given CBCT, a Moving Window-Based Double Haar (MWDH) transformation is applied first to obtain the wavelet coefficients. Based on a user defined point in the object of interest, a cluster algorithm based adaptive thresholding is applied to the low frequency components of ...


Screening For Depression In Cancer Patients Receiving Radiotherapy: Feasibility And Identification Of Effective Tools In The Nrg Oncology Rtog 0841 Trial, L. I. Wagner, S. L. Pugh, W. Small, J. Kirshner, K. Sidhu, M. J. Bury, A. S. Denittis, T. E. Alpert, B. F. Bloom, D. W. Bruner, +6 Additional Authors Jan 2017

Screening For Depression In Cancer Patients Receiving Radiotherapy: Feasibility And Identification Of Effective Tools In The Nrg Oncology Rtog 0841 Trial, L. I. Wagner, S. L. Pugh, W. Small, J. Kirshner, K. Sidhu, M. J. Bury, A. S. Denittis, T. E. Alpert, B. F. Bloom, D. W. Bruner, +6 Additional Authors

Journal Articles

No abstract provided.