Digital Commons Network^™

Economic Disadvantage During Childhood, Obesity, And Diabetes Across Three Birth Cohorts Of Older Mexicans, Jesús-Daniel Zazueta-Borboa, Rafael Samper-Ternent, Rebeca Wong, Neil Mehta

Faculty, Staff and Student Publications

OBJECTIVES: Diabetes prevalence has increased markedly in Mexico. We examined the individual and joint contributions of economic disadvantage during childhood (EDDC) and elevated body weight on diabetes prevalence in 3 cohorts of Mexican adults.

METHODS: Data on those 60-69 years old from the 1930-1939, 1940-1949, and 1950-1959 birth cohorts in Waves 1 (2001), 3 (2012), and 5 (2018) of the Mexican Health and Aging Study were used. EDDC was defined as the absence of a toilet in the household before age 10. Body mass status was defined using self-reported perceived body image at age 50. Diabetes was based on respondent …

The Life And Discoveries Of Yellapragada Subbarow, Nikhil R, Varuni Pragya, Subramanian Ramaswamy, Shiva Prasad B N, Mahabaleshwar Mamadapur

Digital Journal of Clinical Medicine

Dr. Yellapragada Subbarow was a researcher, teacher, and a wizard of wonder drugs who constantly made efforts in the discoveries/ inventions such as vitamins, anti-vitamins, antibiotics, and many more by disentangling the mysteries of nature for the betterment of the people. He inspired the youngsters to take up the challenges and to stand up above mediocrity. The reward for his achievement was delayed. The article describes a true humanist's journey, discoveries, and his achievements that are largely unknown to date.

Obstructive Sleep Apnea And Obesity: How Weight Loss Improves Sleep Apnea Severity And Quality Of Life - An Integrative Review, Hannah Wilson, Neda Akbarshahi

Master's Projects

Introduction: With the growing prevalence of OSA due to the obesity epidemic, there is an urgent need to update treatment regimens. While CPAP continues to be the gold standard of OSA care, challenges with adherence and limited access to effective weight management strategies often impede care. The complex bidirectional relationship between obesity and OSA highlights the importance of addressing weight management in this patient population to help mitigate cardiometabolic risks. Personalized weight loss therapies should be integrated into standard OSA treatment regimens to reduce OSA severity, reduce comorbid conditions, and improve quality of life.

Aim: The objective of this integrative …

The Inclusion Of Soybean Co-Products In Ruminant Supplements On Health And Reproductive Efficiency, Kirsten Midkiff

Graduate Theses and Dissertations

Soybeans are a vital commodity for Arkansas and the United States, with co-products such as soybean meal having wide popularity in animal feeds due to high protein content and palatability. Soybean meal primarily is utilized in diets for swine and poultry operations with a small market in the beef cattle industry, likely due to the increased costs that are associated with the product. On the other hand, soybean oil is a product from the production of soybean meal that is not as widely used in the livestock industry as most of the oil produced is used for industrial purposes. Additionally, …

Maturity-Onset Diabetes Of The Young: A Proposal For Updated Nomenclature, Mustafa Tosur

Faculty, Staff and Students Publications

Given the contemporary understanding of diabetes genetics, the term "maturity-onset diabetes of the young (MODY)" warrants renaming. I propose adopting the term "monogenic diabetes" in conjunction with the specific gene name.

Measuring Treatment Burden In People With Type 2 Diabetes Mellitus (T2dm): A Mixed-Methods Systematic Review, Kai Lin, Mi Yao, Xinxin Ji, Rouyan Li, Lesley Andrew, Jacques Oosthuizen, Moira Sim, Yongsong Chen

Research outputs 2022 to 2026

Background: Measuring treatment burden is important for the effective management of Type 2 Diabetes Mellitus (T2DM) care. The purpose of this systematic review was to identify the most robust approach for measuring treatment burden in people with T2DM based on existing evidence. Methods: Articles from seven databases were retrieved. Qualitative, quantitative, and mixed-methods studies examining treatment burden in adults with T2DM and/or reporting relevant experiences were included. A convergent segregated approach with a mixed-methods design of systematic review was employed, creating a measurement framework in a narrative review for consistent critical appraisal. The quality of included studies was assessed using …

Evaluation Of Stress Ulcer Prophylaxis In Pediatric General Medicine Patients After Transfer From The Intensive Care Unit And At Discharge, Lamees Loubani, Jenna W Bartlett, Brent Mothner, Rathi Asaithambi, Surin Lee

Faculty, Staff and Students Publications

OBJECTIVES: The primary aim of this study was to determine continuation rates of stress ulcer prophylaxis (SUP) upon transfer from a pediatric intensive care unit (PICU) to a general medicine unit and upon hospital discharge. The secondary aim was to identify patient characteristics or concomitant medications that were associated with continuation of SUP at transfer from the PICU.

METHODS: This retrospective chart review included patients who were initiated on acid suppression for SUP in the PICU between June 2021 and May 2022 and subsequently transferred to a general medicine unit prior to discharge. Patients were excluded if they were receiving …

Assessing The Predictive Power Of Nutritional Indices On All-Cause And Cardiovascular Mortality In Hemodialysis Patients: A Longitudinal Study, Qian Wang, Zengchun Ye, Jialing Rao, Wenbo Zhao, Jianqiang Liu, Yanru Chen, Juncheng Xiang, Xin Zhen, Jiawen Li, Yunfang Zhang, Xianrui Dou, Zhaoyong Hu, Jun Zhang, Hui Peng

Faculty, Staff and Students Publications

BACKGROUND AND HYPOTHESIS: The prognostic value of nutritional scoring tools in assessing the relationship between nutritional status and prognosis in hemodialysis patients is unclear. This multicenter retrospective cohort study compared the Prognostic Nutritional Index (PNI), Controlling Nutritional Status scores (CONUT), and Geriatric Nutritional Risk Index (GNRI) for predictive accuracy of all-cause and cardiovascular mortality, especially the impact of dynamic changes over time on prognosis.

METHODS: Hemodialysis patients from four hospitals were included. Laboratory data and nutrition scores were collected at the initiation of dialysis, and at 6th, 12th, and 18th months after dialysis initiation. A joint model analyzed the relationship …

American Society For Metabolic And Bariatric Surgery Review Of Body Composition, Jonathan Carter, Farah Husain, Pavlos Papasavas, Salvatore Docimo, Vance Albaugh, Laura Aylward, Cynthia Blalock, Sue Benson-Davies

School of Medicine Faculty Publications

Although the body mass index (BMI) has been used as a measure of obesity for decades, it is now possible to measure adiposity more directly with technologies that can quantitate body fat and other tissues. The purpose of this review is to understand body composition, describe the different ways to measure it, review changes in body composition after metabolic and bariatric surgery (MBS), and provide guidance on how providers can introduce measurements of body composition into their everyday practice.

American Society For Metabolic And Bariatric Surgery Review Of The Body Mass Index, Jonathan Carter, Farah Husain, Pavlos Papasavas, Salvatore Docimo, Vance Albaugh, Laura Aylward, Cynthia Blalock, Sue Benson-Davies

School of Medicine Faculty Publications

The body mass index was first described almost 200 years ago and has since been used as a measure of obesity. This review describes the history, advantages, disadvantages, and alternatives to the body mass index in the care of the metabolic and bariatric surgical patient.

Fgf21 Acts In The Brain To Drive Macronutrient-Specific Changes In Behavioral Motivation And Brain Reward Signaling, Md Shahjalal H. Khan, Sora Q. Kim, Robert C. Ross, Florina Corpodean, Redin A. Spann, Diana A. Albarado, Sun O. Fernandez-Kim, Blaise Clarke, Hans Rudolf Berthoud, Heike Münzberg, David H. Mcdougal, Yanlin He, Sangho Yu, Vance L. Albaugh, Paul L. Soto, Christopher D. Morrison

School of Medicine Faculty Publications

Objective: Dietary protein restriction induces adaptive changes in food preference, increasing protein consumption over carbohydrates or fat. We investigated whether motivation and reward signaling underpin these preferences. Methods and Results: In an operant task, protein-restricted male mice responded more for liquid protein rewards, but not carbohydrate, fat, or sweet rewards compared to non-restricted mice. When the number of responses required to access protein reward varied, protein-restricted mice exhibited higher operant responses at moderate to high response requirements. The protein restriction-induced increase in operant responding for protein was absent in Fgf21-KO mice and mice with neuron-specific deletion of the FGF21 co-receptor …

Emerging Diagnostics And Therapeutics For Non-Alcoholic Fatty Liver Disease, Kiarra Krulikowski, Jake Darbhanga, Suzanne Riskin

HCA-NSU MD Research Day

Introduction: The obesity epidemic has pushed fatty liver disease to the forefront of the 21st century. Disease identification can be done invasively with a liver biopsy or noninvasively through elastography and measurements of biomarkers. Presently, there are no FDA-approved drugs on the market to treat the disease. Alternative medicinal treatments have been investigated, which include altering the intestinal microbiota and consuming anti-inflammatory, herbal-based, vitamin-based, and plant-based medications. Methods: In this study, multiple databases were used to identify articles pertaining to fatty liver disease (FLD). All articles gathered from the databases were peer-reviewed and less than 10 years old to ensure …

Nourishing Skin Health: The Impact Of A Balanced Diet On Chronic Inflammatory Skin Conditions, Archana Banda

HCA-NSU MD Research Day

Objective: This study was conducted to determine the influence a balanced diet has on the outcome of specific dermatologic conditions notably psoriasis, atopic dermatitis, and rosacea. Background: Nutritional status is pivotal in shaping holistic wellness, which extends to skin health. Adequate nutrition can prevent the worsening of inflammatory conditions. Methods: A literature review was conducted to analyze how specific dietary habits for selected chronic inflammatory cutaneous conditions influence the presentation and overall clinical outcome. Results: The analysis indicates a higher incidence of flare-ups with diets heavily consisting of carbohydrates, red meat, alcohol, and fats. Specific diets, such as the Western …

The Complex Relationship Between Tuberculosis And Hyperglycemia, Michelle Byers, Elizabeth Guy

Faculty, Staff and Students Publications

Hyperglycemia and tuberculosis are dual global pandemics. Each has a propulsive and amplifying effect on the other, and, because of this, we must consider hyperglycemia and tuberculosis together. Hyperglycemia is immunosuppressive and increases the risk of tuberculosis by threefold. It also leads to a more advanced presentation of pulmonary tuberculosis, thus increasing the likelihood of being smear positive and having cavitating lesions, and it impacts the duration and outcomes of treatment, with an increased one year mortality seen in patients with tuberculosis and diabetes. Additionally, any degree of hyperglycemia can have an impact on susceptibility to tuberculosis, and this effect …

Cutaneous Adverse Effects From Diabetes Devices In Pediatric Patients With Type 1 Diabetes Mellitus: Systematic Review, Alicia Podwojniak, Joseph Flemming, Isabella J Tan, Hira Ghani, Zachary Neubauer, Anne Jones

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Continuous glucose monitoring (CGM) and continuous subcutaneous insulin infusions (CSIIs) are the current standard treatment devices for type 1 diabetes (T1D) management. With a high prevalence of T1D beginning in pediatrics and carrying into adulthood, insufficient glycemic control leads to poor patient outcomes. Dermatologic complications such as contact dermatitis, lipodystrophies, and inflammatory lesions are among those associated with CGM and CSII, which reduce glycemic control and patient compliance.

OBJECTIVE: This systematic review aims to explore the current literature surrounding dermatologic complications of CGM and CSII as well as the impact on patient outcomes.

METHODS: A systematic review of the …

Identification Of Atypical Pediatric Diabetes Mellitus Cases Using Electronic Medical Records, Marcela F Astudillo, William E Winter, Liana K Billings, Raymond Kreienkamp, Ashok Balasubramanyam, Maria J Redondo, Mustafa Tosur

Faculty, Staff and Students Publications

INTRODUCTION: There are no established methods to identify children with atypical diabetes for further study. We aimed to develop strategies to systematically ascertain cases of atypical pediatric diabetes using electronic medical records (EMR).

RESEARCH DESIGN AND METHODS: We tested two strategies in a large pediatric hospital in the USA. Strategy 1: we designed a questionnaire to rule out typical diabetes and applied it to the EMR of 100 youth with diabetes. Strategy 2: we built three electronic queries to generate reports of three atypical pediatric diabetes phenotypes: unknown type, type 2 diabetes (T2D) diagnosed(AbNegT1D).

RESULTS: Strategy 1 identified six cases …

Protein Consumption And Risk Of Cvd Among Us Adults: The Multi-Ethnic Study Of Atherosclerosis (Mesa), Ji Yun Tark, Ruosha Li, Bing Yu, Alexis C Wood, Nikhil S Padhye, Marcia C De Oliveira Otto

Faculty, Staff and Students Publications

BACKGROUND: Although some randomized trials have reported beneficial effects of protein intake on cardiometabolic risk factors, evidence from prospective studies have not supported a strong link between protein intake and cardiovascular disease (CVD) risk. It is also unclear whether diversity in protein intake plays a role in CVD risk.

OBJECTIVE: We investigated prospective associations of (1) protein intake, overall and by food source and (2) diversity of protein sources with risk of CVD, coronary heart disease (CHD), and stroke.

METHODS: In a multi-ethnic cohort of 5879 U.S. adults (45-84 years), who were free of CVD at baseline, protein intake was …

Lupin Root Diseases - Diagnosis And Management, Department Of Primary Industries And Regional Development, Western Australia

Grains and other field crops factsheets

Root, hypocotyl and stem base diseases can be significant problems in lupin crops, reducing stand density, plant vigour and yield. Root disease is present in nearly all narrow leafed lupin (Lupinus angustifolius) paddocks but in the majority of paddocks has only a small impact on crop development. However, in paddocks where high levels of root rot occurs, plant establishment, seedling vigour and crop yield can be significantly affected.

When a root disease is present in a crop very little can be done to manage it in that cropping season. It is therefore vital that the cause is correctly identified to …

Impact Of Diabetes Self-Management Education On Hemoglobin A1c Levels In The Rural Patient Population, Barbara Adomakomensah Sarpong

Electronic Theses and Dissertations

The global prevalence of type 2 diabetes is one of the greatest health threats in society, especially in the rural population. Rural healthcare data analysis has proved a need for type 2 diabetes control education. Despite the existence of helpful diabetes control interventions, rural diabetes patients still struggle to maintain healthy behaviors, with about 60% of the patients recording hemoglobin A1c levels above 9. Many suffer severe conditions (e.g., stroke, kidney failure, and heart attacks) because of poor management of the condition. The project examined the impact of diabetes self-management education on hemoglobin A1c levels in the rural patient population. …

First Interim Results From Fine-Real: A Prospective, Non-Interventional, Phase 4 Study Providing Insights Into The Use And Safety Of Finerenone In A Routine Clinical Settingfirst Interim Results From Fine-Real: A Prospective, Non-Interventional, Phase 4 Study Providing Insights Into The Use And Safety Of Finerenone In A Routine Clinical Setting, Susanne B Nicholas, Ricardo Correa-Rotter, Nihar R Desai, Lixin Guo, Sankar D Navaneethan, Kevin M Pantalone, Christoph Wanner, Stefanie Hamacher, Samuel T Fatoba, Andrea Horvat-Broecker, Antonio Garreta-Rufas, Alain Gay, Martin Merz, David C Wheeler

Center for Medical Ethics and Health Policy Staff Publications

Background: Finerenone, a selective non-steroidal mineralocorticoid receptor antagonist, improves kidney and cardiovascular outcomes in patients with chronic kidney disease (CKD) associated with type 2 diabetes (T2D). The FINE-REAL study (NCT05348733) aims to evaluate the characteristics and treatment patterns of participants treated with finerenone in clinical practice.

Methods: FINE-REAL is a prospective, single-arm, non-interventional study of patients initiated on finerenone as part of their routine care in accordance with country-approved labels. The study, initiated in June 2022, is expected to be completed by January 2028. The cutoff for this pre-specified interim analysis was June 13, 2023.

Results: Participants were …

The Role Of Bone In Energy Metabolism: A Focus On Osteocalcin, Cassandra Smith, Xuzhu Lin, Lewan Parker, Bu B. Yeap, Alan Hayes, Itamar Levinger

Research outputs 2022 to 2026

Understanding the mechanisms involved in whole body glucose regulation is key for the discovery of new treatments for type 2 diabetes (T2D). Historically, glucose regulation was largely focused on responses to insulin and glucagon. Impacts of incretin-based therapies, and importance of muscle mass, are also highly relevant. Recently, bone was recognized as an endocrine organ, with several bone proteins, known as osteokines, implicated in glucose metabolism through their effects on the liver, skeletal muscle, and adipose tissue. Research efforts mostly focused on osteocalcin (OC) as a leading example. This review will provide an overview on this role of bone by …

Economic And Humanistic Burden Of Rheumatoid Arthritis: Results From The Us National Survey Data 2018-2020, Yinan Huang, Jieni Li, Sandeep Krishna Agarwal

Faculty, Staff and Students Publications

OBJECTIVE: Our objective was to estimate the economic and humanistic burden among US adults with rheumatoid arthritis (RA).

METHODS: This study analyzed results from the Medical Expenditure Panel Survey from 2018 to 2020. Adults (aged ≥18 years) self-reporting with RA or with the presence of the International Classification of Disease, 10th Revision clinical modification codes were identified. Healthcare expenditures (inpatient care, outpatient care, emergency department, office visits, prescription medications, home health, and others) were measured. The Short Form 12 Health Survey physical component summary (PCS), mental component summary (MCS), activities of daily living (ADL), and instrumental ADL (IADL) were measured. …

Trends And Disparities In Coronary Artery Disease And Obesity-Related Mortality In The United States From 1999-2022, Mushood Ahmed, Hira Javaid, Aimen Shafiq, Zain Ali Nadeem, Areeba Ahsan, Abdullah Nofal, Raheel Ahmed, Mahboob Alam, Marat Fudim, Gregg C Fonarow, Mamas A Mamas

Faculty, Staff and Students Publications

BACKGROUND: Almost half of the US adult population has obesity, which predisposes to atherosclerosis and can lead to poor prognosis in coronary artery disease (CAD). We aim to identify CAD and obesity-related mortality trends among adults in the United States stratified by age, sex, race and geographical location.

METHODS: The CDC-WONDER database was used to extract death certificate data for adults aged ≥ 25 years. Crude mortality rates (CMR) and age-adjusted mortality rates (AAMRs) per 100,000 persons were calculated, and temporal trends were described by calculating annual percent change (APC) and the average APC (AAPC) in the rates using Joinpoint …

Paraneoplastic Acral Vascular Syndrome In A Patient With Advanced Oropharyngeal Squamous Cell Carcinoma; Case Report And Literature Review, Ancuța Năstac, Lucian Negreanu, Alexandru Constantinescu, Octavian Andronic, Andreea Dobromirescu

Journal of Mind and Medical Sciences

Paraneoplastic acral vascular syndrome (PAVS) is a captivating enigma in the landscape of oncological pathology, characterized by vascular disturbances of the extremities. PAVS is linked to rapidly progressing trajectory and understanding the intricate interplay between cancer and this vascular dysfunction is imperative for timely diagnosis. We describe the case of a 45-year-old cachectic male who presented at the ICU with bilateral tumefied, cyanotic digits, accompanied by acute pain and numbness in both hands. A Digital Angiography described complete obstruction of the digital arteries. Imaging showed a laterocervical tumor mass with pulmonary metastases. This form of digital ischemia likely stems from …

Challenges In Diagnosing Nasopharyngeal Tumors, Alexandru Aristide Alexe, Mihai Victor Lupascu, Haldun Septar, Anca Pantea Stoian, Andra Iulia Suceveanu, Viorel Gherghina, Iuliana Cindea, Alina Doina Nicoara, Laura Mazilu, Razvan Hainarosie, Felix Voinea, Adrian Paul Suceveanu

Journal of Mind and Medical Sciences

Malignant nasopharyngeal tumors account for approximately 4% of ENT malignant tumor pathology and 1% of all cancers. The diagnosis of nasopharyngeal tumors is often late, the reason being the location in a silent anatomical region in terms of symptomatology and accessibility. Thus, approximately 70% of newly diagnosed patients with nasopharyngeal carcinoma unfortunately present with the condition in an advanced local stage. The early signs and symptoms are varied (nasal obstruction, hearing loss, otalgia, headache) and are usually ignored by the patient and even by the doctor in the initial stage of nasopharyngeal tumor evolution. Approximately 5% of patients have systemic …

Assessment Of Psycho-Emotional Symptoms In Cancer Patients In An Oncology-Palliative Care Department From Romania, Roxana Andreea Rahnea-Nita, Laura-Florentina Rebegea, Elena Gabriela Valcu, Mihaela Dumitru, Radu Valeriu Toma, Mihai Georgescu, Georgia Luiza Serbanescu, Maria Alexandra Barbu, Georgiana Bianca Constantin, Gabriela Rahnea-Nita

Journal of Mind and Medical Sciences

Introduction. Anxiety and depression have an increased prevalence in cancer patients, especially in those in an advanced stage of the disease. These disorders have a major impact on the social life, existential concerns and quality of life of cancer patients. Materials and Methods. A number of 114 consecutive patients were included in the study (in a period of 2 weeks) who were screened for anxiety, depression and for other common symptoms, using Hospital Anxiety and Depression Scale (HADS) and Edmonton Symptom Assessment System (ESAS). Results. Regarding the age - the abnormal level of anxiety and depression: the percentage of patients …

Telomeres Are Shorter In Portuguese Obese Adults, Catarina Duarte, Maria Teresa Braz, Ana Marques-Ramos, José Silva-Nunes, Luisa Veiga, Miguel Brito

Journal of Mind and Medical Sciences

Obesity is a clinical condition characterized by an abnormal accumulation of adipose tissue with an increased risk of developing illnesses such as type 2 diabetes, cardiovascular disease, and cancer. In obesity, the secretion of proinflammatory adipokines contributes to oxidative stress that can lead to a decline in the length of telomeres. Telomeres are structures of repetitive sequences delimiting the chromosomes, that plays a crucial role in maintaining their integrity and stability and, thus, its shortening is associated with cellular senescence and possible apoptosis. Although some studies indicate that obesity is associated with shorter telomeres, others contradict this data. Accordingly, the …

Micro Life, David Burton

HCA Healthcare Journal of Medicine

Painting is what I do to slow my brain and relax my body after a busy day at the hospital. Nothing puts me directly into a flow state like slowly moving acrylic paint across a canvas. This piece titled “Micro Life” depicts the diversity of life constantly surrounding us at the microbiological level everywhere we go. As a strong believer in nutrition and a healthy lifestyle, I know how important our microbiome is to healthy digestion and a properly functioning immune system. On the other side, I have witnessed the devastating effects dangerous microorganisms can have on our already compromised …

Factors Influencing Iron Intake Among Female Students In Universitas Indonesia, Kristina Adjie, Triyanti Triyanti

Indonesian Journal of Public Health Nutrition (IJPHN)

This study aims to determine the differences in iron intake among female college students based on consumption factors (animal-based side dishes, plant-based side dishes, vegetables, fruits, Ultra Processed Food) and individual factors (attitude towards red meat consumption, social media influence, nutrition knowledge, allowance, type of residence). The design of this study is cross-sectional, involving 147 undergraduate regular students from the Faculty of Public Health class of 2021, 2022, and 2023. Respondents were selected based on simple random sampling, and data collection was conducted online using Zoom. The research questionnaire was administered using Google Forms and Spreadsheets for the Semi Quantitative …

The Relationship Between Snacking And Sugar, Salt, Fat Intake On Nutritional Status Of Adolescents Of Smkn 30 Jakarta, Khoirul Anwar, Syifa Aulia Putri

Indonesian Journal of Public Health Nutrition (IJPHN)

Excessive consumption of sugar, salt, and fat including from snacks can increase the risk of obesity or being overweight. The objective of this study to analyze the relationship between snacking and sugar, salt, and fat intake on nutritional status in adolescents. This design is cross-sectional with a sample of 90 grade X students at SMKN 30 Jakarta. The data collected include physical activity data using the Global Physical Activity Questionnaire (GPAQ), snacking habit data, frequency of sugar, salt, and fat consumption using the SQ-FFQ. The results of the correlation test showed that there was a significant relationship between snacking habits …