Digital Commons Network^™

Altered White Matter Microstructure Is Associated With Social Cognition And Psychotic Symptoms In 22q11.2 Microdeletion Syndrome, M. Jalbrzikowski, J. E. Villalon-Reina, K. H. Karlsgodt, D. Senturk, C. Chow, P. M. Thompson, C. E. Bearden

Journal Articles

22q11.2 Microdeletion Syndrome (22q11DS) is a highly penetrant genetic mutation associated with a significantly increased risk for psychosis. Aberrant neurodevelopment may lead to inappropriate neural circuit formation and cerebral dysconnectivity in 22q11DS, which may contribute to symptom development. Here we examined: (1) differences between 22q11DS participants and typically developing controls in diffusion tensor imaging (DTI) measures within white matter tracts; (2) whether there is an altered age-related trajectory of white matter pathways in 22q11DS; and (3) relationships between DTI measures, social cognition task performance, and positive symptoms of psychosis in 22q11DS and typically developing controls. Sixty-four direction diffusion weighted imaging …

The Relation Between Diabetes Self-Efficacy And Psychological Distress Among Older Adults: Do Racial And Ethnic Differences Exist?, G. Kim, Ruth Shim, K. L. Ford, T. A. Baker

Journal Articles

OBJECTIVE: This study examined racial/ethnic differences in the relationship between diabetes self-efficacy and psychological distress among older adults with diabetes mellitus. METHOD: Adults aged 60 or older with a diagnosis of diabetes mellitus (N = 3,067) were drawn from the 2009 California Health Interview Survey (CHIS). Hierarchical multiple regression analyses were conducted. RESULTS: After controlling for covariates, African Americans and those with higher levels of diabetes self-efficacy tended to have lower levels of psychological distress. Significant interactions were found in the Hispanic/Latino and Asian groups: The effect of diabetes self-efficacy on psychological distress was greater for Hispanics/Latinos and Asians than …

Biological Insights From 108 Schizophrenia-Associated Genetic Loci, S. Ripke, B. M. Neale, A. Corvin, J. T. R. Walters, K. H. Farh, T. Lencz, A. K. Malhotra, Consortium Psychiat Genomics, Conso Psychosis Endophenotypes Int, Consor Wellcome Trust Case-Control, +292 Additional Authors

Journal Articles

Schizophrenia is a highly heritable disorder. Genetic risk is conferred by a large number of alleles, including common alleles of small effect that might be detected by genome-wide association studies. Here we report a multi-stage schizophrenia genome-wide association study of up to 36,989 cases and 113,075 controls. We identify 128 independent associations spanning 108 conservatively defined loci that meet genome-wide significance, 83 of which have not been previously reported. Associations were enriched among genes expressed in brain, providing biological plausibility for the findings. Many findings have the potential to provide entirely new insights into aetiology, but associations at DRD2 and …

Default Mode Network Connectivity And Reciprocal Social Behavior In 22q11.2 Deletion Syndrome, M. J. Schreiner, K. H. Karlsgodt, L. Q. Uddin, C. Chow, E. Congdon, M. Jalbrzikowski, C. E. Bearden

Journal Articles

22q11.2 deletion syndrome (22q11DS) is a genetic mutation associated with disorders of cortical connectivity and social dysfunction. However, little is known about the functional connectivity (FC) of the resting brain in 22q11DS and its relationship with social behavior. A seed-based analysis of resting-state functional magnetic resonance imaging data was used to investigate FC associated with the posterior cingulate cortex (PCC), in (26) youth with 22qDS and (51) demographically matched controls. Subsequently, the relationship between PCC connectivity and Social Responsiveness Scale (SRS) scores was examined in 22q11DS participants. Relative to 22q11DS participants, controls showed significantly stronger FC between the PCC and …

Functional Development In Clinical High Risk Youth: Prediction Of Schizophrenia Versus Other Psychotic Disorders, S. I. Tarbox, J. Addington, K. S. Cadenhead, T. D. Cannon, B. Cornblatt, D. O. Perkins, L. J. Seidman, M. T. Tsuang, E. F. Walker, S. W. Woods, +2 Additional Authors

Journal Articles

This study evaluates premorbid social and academic functioning in clinical high-risk individuals as predictors of transition to schizophrenia versus another psychotic disorder. Participants were 54 individuals enrolled in phase one of the North American Prodrome Longitudinal Study who over two and a half years of follow-up met criteria for schizophrenia/schizophreniform disorder (n=28) or another psychotic disorder (n=26). Social and academic functioning in childhood, early adolescence, and late adolescence was assessed at baseline using the Cannon-Spoor Premorbid Adjustment Scale. Social maladjustment in late adolescence predicted significantly higher odds of transition to schizophrenia versus another psychotic disorder independent of childhood and early …

Improving Low-Dose Blood-Brain Barrier Permeability Quantification Using Sparse High-Dose Induced Prior For Patlak Model, R. Fang, K. Karlsson, T. Chen, P. C. Sanelli

Journal Articles

Blood-brain barrier permeability (BBBP) measurements extracted from the perfusion computed tomography (PCT) using the Patlak model can be a valuable indicator to predict hemorrhagic transformation in patients with acute stroke. Unfortunately, the standard Patlak model based PCT requires excessive radiation exposure, which raised attention on radiation safety. Minimizing radiation dose is of high value in clinical practice but can degrade the image quality due to the introduced severe noise. The purpose of this work is to construct high quality BBBP maps from low-dose PCT data by using the brain structural similarity between different individuals and the relations between the high- …

Does The Location Of The Arterial Input Function Affect Quantitative Ctp In Patients With Vasospasm?, B. J. Shin, N. Anumula, S. Hurtado-Rua, P. Masi, R. Campbell, R. Spandorfer, A. Ferrone, T. Caruso, A. Gupta, P. C. Sanelli, +2 Additional Authors

Journal Articles

BACKGROUND AND PURPOSE: In recent years, there has been increasing use of CTP imaging in patients with aneurysmal SAH to evaluate for vasospasm. Given the critical role of the arterial input function for generation of accurate CTP data, several studies have evaluated the effect of varying the arterial input function location in patients with acute stroke. Our aim was to determine the effect on quantitative CTP data when the arterial input function location is distal to significant vasospasm in patients with aneurysmal SAH. MATERIALS AND METHODS: A retrospective study was conducted of patients with aneurysmal SAH admitted from 2005 to …

Prevention And Control Of Haemophilus Influenzae Type B Disease: Recommendations Of The Advisory Committee On Immunization Practices (Acip), E. C. Briere, L. Rubin, P. L. Moro, A. Cohn, T. Clark, N. Messonnier

Journal Articles

This report compiles and summarizes all recommendations from CDC's Advisory Committee on Immunization Practices (ACIP) regarding prevention and control of Haemophilus influenzae type b (Hib) disease in the United States. As a comprehensive summary of previously published recommendations, this report does not contain any new recommendations; it is intended for use by clinicians, public health officials, vaccination providers, and immunization program personnel as a resource. ACIP recommends routine vaccination with a licensed conjugate Hib vaccine for infants aged 2 through 6 months (2 or 3 doses, depending on vaccine product) with a booster dose at age 12 through 15 months. …

Pediatric Trainees' Engagement In The Online Nutrition Curriculum: Preliminary Results, K. O. Lewis, G. R. Frank, R. Nagel, T. L. Turner, C. L. Ferrell, S. G. Sangvai, R. Donthi, J. D. Mahan

Journal Articles

Background: The Pediatric Nutrition Series (PNS) consists of ten online, interactive modules and supplementary educational materials that have utilized web-based multimedia technologies to offer nutrition education for pediatric trainees and practicing physicians. The purpose of the study was to evaluate pediatric trainees' engagement, knowledge acquisition, and satisfaction with nutrition modules delivered online in interactive and non-interactive formats. Methods: From December 2010 through August 2011, pediatric trainees from seventy-three (73) different U. S. programs completed online nutrition modules designed to develop residents' knowledge of counseling around and management of nutritional issues in children. Data were analyzed using SPSS version 19. Both …

Pediatric Emergency Medical Care In Yerevan, Armenia: A Knowledge And Attitudes Survey Of Out-Of-Hospital Emergency Physicians, Aline A. Baghdassarian, Ross I. Donaldson, Andrew D. Depiero, Nancy L. Chernett, Harsh Sule

Emergency Medicine Publications

Background

Out-of-hospital emergency care is at an early stage of development in Armenia, with the current emergency medical services (EMS) system having emergency physicians (EPs) work on ambulances along with nurses. While efforts are underway by the Ministry of Health and other organizations to reform the EMS system, little data exists on the status of pediatric emergency care (PEC) in the country. We designed this study to evaluate the knowledge and attitudes of out-of-hospital emergency physicians in pediatric rapid assessment and resuscitation, and identify areas for PEC improvement.

Methods

We distributed an anonymous, self-administered Knowledge and Attitudes survey to a …

The Healthy Brain Initiative, Edward F. Ansello

Director's Editorials from Age in Action

Cognitive health is being recognized increasingly as a vital part of overall health and central to aging well. The CDC and Alzheimer's Association have published a revised framework for translating science to practice in public health, with particular focus on the role that state and local public health agencies can play to improve cognitive health and to recognize and report cognitive impairment.

Remembering Through Music: Music Therapy And Dementia, Melissa Owens

Case Studies from Age in Action

Educational Objectives

1. Define music therapy and its benefits with older adults with dementia and related disorders/ diseases.

2. Describe active and passive music therapy interventions and strategies for older adult populations.

3. Identify the ways a non-musician can use music to engage older adults and mitigate some symptoms of dementia.

Do Emergency Department Patients Receive A Pathological Diagnosis? A Nationally Representative Sample., Leana S. Wen, Janice A. Espinola, Joshua M. Kosowsky, Carlos A. Camargo Jr

Emergency Medicine Faculty Publications

No abstract provided.

Minor Gynecologic Surgery: A Review Of The Training Experience And Skill Building Opportunities For Providers In Low And Middle Income Countries, Rachel Marie Clark, Leslie Siriya Bradford, Jessica Opoku-Anane, Joseph Ngonzi, Ferdous Islam, Mithila Faruque, Annekathryn Goodman

Obstetrics and Gynecology Faculty Publications

Purpose: Minor gynecologic surgery is the cornerstone of gynecologic evaluation and intervention in countries with a well-established medical infrastructure. Surgical training and exposure to minor procedures are not available in low and middle-income countries due to the complex challenges of patient delay and lack of access to healthcare, physician shortages, and the lack of ancillary services such as pathology and radiology. This paper reviews current training statistics, the international literature on minor gynecologic surgery and training strategies.

Methods: PubMed searches using MESH terms cone biopsy, dilation and curettage, and loop electrosurgical excision procedure were performed. Statistics of minor …

Working Together For Global Health Goals: The United States Agency For International Development And Faith-Based Organizations, Clydette L. Powell

Pediatrics Faculty Publications

For many years, and before the term “FBO” was used for faith-based organizations, the United States Agency for International Development (USAID) has supported the work of FBOs in global health and development. The Agency has long recognized the impact of FBOs within that development space, because these organizations are often well positioned to reach the hard-to-reach and to go the last mile because of their strong ties to the community. Moreover, FBOs deliver a substantial percentage of the health services in some developing countries. Faith partners, whether Catholic, Protestant, Buddhist, Hindu, Muslim, or other, have an important role to play …

Community Engagement As A Process And An Outcome Of Developing Culturally Grounded Health Communication Interventions: An Example From The Decide Project, Angela L. Palmer-Wackerly, Jessica Krok, Phokeng M. Dailey, Linda Kight, Janice L. Krieger

Department of Communication Studies: Faculty Publications

Community engagement is a process often used in developing effective health communication interventions, especially in traditionally underserved cultural contexts. While the potentially positive outcomes of community engagement are well established, the communication processes that result in engagement with cultural groups are less apparent. The focus on the outcomes of engagement at the expense of describing how engagement occurs makes it difficult for methods to be improved upon and replicated by future studies. The purpose of the current manuscript is to illustrate the process of achieving community engagement through the development of a culturally grounded health communication intervention. We offer practical …

Does The Direct Anterior Approach In Tha Offer Faster Rehabilitation And Comparable Safety To The Posterior Approach?, J. A. Rodriguez, A. J. Deshmukh, P. A. Rathod, M. L. Greiz, P. P. Deshmane, M. S. Hepinstall, A. S. Ranawat

Journal Articles

Newer surgical approaches to THA, such as the direct anterior approach, may influence a patient's time to recovery, but it is important to make sure that these approaches do not compromise reconstructive safety or accuracy. We compared the direct anterior approach and conventional posterior approach in terms of (1) recovery of hip function after primary THA, (2) general health outcomes, (3) operative time and surgical complications, and (4) accuracy of component placement. In this prospective, comparative, nonrandomized study of 120 patients (60 direct anterior THA, 60 posterior THAs), we assessed functional recovery using the VAS pain score, timed up and …

Health-Related Quality Of Life (Hrqol) In Cystine Compared With Non-Cystine Stone Formers, F. Modersitzki, L. Pizzi, M. Grasso, D. S. Goldfarb

Journal Articles

Cystinuria is a genetic cause of recurrent kidney stones which may be more recurrent and larger than more common non-cystine stones. They may have a greater impact on health-related quality of life (HRQoL). We measured this impact by surveying HRQoL in patients with stones, comparing non-cystine stone formers (NCSF) to cystine stone formers (CYSF) and both groups to normative values of the US population. We used SF-36v2 via an internet instrument. CYSF patients were recruited via cystinuria-related websites, two patient advocacy groups, and an active endourology practice. NCSF patients were recruited from the same practice and by email. Total n …

Corticocortical Evoked Potentials Reveal Projectors And Integrators In Human Brain Networks, C. J. Keller, C. J. Honey, L. Entz, S. Bickel, D. M. Groppe, E. Toth, I. Ulbert, F. A. Lado, A. D. Mehta

Journal Articles

The cerebral cortex is composed of subregions whose functional specialization is largely determined by their incoming and outgoing connections with each other. In the present study, we asked which cortical regions can exert the greatest influence over other regions and the cortical network as a whole. Previous research on this question has relied on coarse anatomy (mapping large fiber pathways) or functional connectivity (mapping inter-regional statistical dependencies in ongoing activity). Here we combined direct electrical stimulation with recordings from the cortical surface to provide a novel insight into directed, inter-regional influence within the cerebral cortex of awake humans. These networks …

O-020 Modifying Flow In The Ica Bifurcation: Pipeline Deployment From The Supraclinoid Ica Extending Into The M1 Segment: Clinical And Anatomical Results, E. Nossek, D. J. Chalif, S. Chakraborty, A. Setton

Journal Articles

BACKGROUND: Utility of the pipeline embolization device (PED) extending to the M1 segment as well as its clinical and flow consequences at the ICA bifurcation, has not clearly described. We describe clinical and anatomical flow modifications results at the ICA bifurcation. METHODS: In this retrospective analysis of patients treated for distal supraclinoid carotid aneurysms, a single PED was deployed from the proximal M1 segment to the distal supraclinoid carotid. Flow assessment prior to the procedure, to predict the competence of the ACA/AcomA complex, was achieved by formal DSA angiography and occasional manual cross compression. In all cases a single PED …

Terror Medicine As Part Of The Medical School Curriculum, L. A. Cole, K. Wagner, S. Scott, N. D. Connell, A. Cooper, C. A. Kennedy, B. Natal, S. Lamba

Journal Articles

Terror medicine, a field related to emergency and disaster medicine, focuses on medical issues ranging from preparedness to psychological manifestations specifically associated with terrorist attacks. Calls to teach aspects of the subject in American medical schools surged after the 2001 jetliner and anthrax attacks. Although the threat of terrorism persists, terror medicine is still addressed erratically if at all in most medical schools. This paper suggests a template for incorporating the subject throughout a 4-year medical curriculum. The instructional framework culminates in a short course for fourth year students, such as one recently introduced at Rutgers New Jersey Medical School, …

Carotid-Cavernous Fistula As A Mimicker Of Myasthenia Gravis, A. Eswar, H. D. Pomeranz, S. M. Vishnubhakat, M. Oller-Cramsie

Journal Articles

BACKGROUND: A carotid-cavernous fistula (CCF) is an abnormal communication between the carotid arterial system and the cavernous sinus. Common symptoms of CCFs include proptosis and ophthalmoplegia, but fluctuating diplopia and presence of ptosis are not typical. CASE DESCRIPTION: We present an unusual case of CCF with fluctuating binocular diplopia and ptosis, mimicking myasthenia gravis. Electrodiagnostic testing, which included repetitive nerve stimulation and single-fiber electromyography, was normal. Magnetic resonance imaging of the brain and orbits was initially normal, but later magnetic resonance angiography revealed enlargement of the left superior ophthalmic vein along with a left CCF. Patient underwent a successful left …

Abnormal Metabolic Network Activity In Rem Sleep Behavior Disorder, F. Holtbernd, J. F. Gagnon, R. B. Postuma, Y. Ma, C. C. Tang, A. Feigin, V. Dhawan, J. P. Soucy, D. Eidelberg, J. Montplaisir, +1 Additional Author

Journal Articles

OBJECTIVE: To determine whether the Parkinson disease-related covariance pattern (PDRP) expression is abnormally increased in idiopathic REM sleep behavior disorder (RBD) and whether increased baseline activity is associated with greater individual risk of subsequent phenoconversion. METHODS: For this cohort study, we recruited 2 groups of RBD and control subjects. Cohort 1 comprised 10 subjects with RBD (63.5 +/- 9.4 years old) and 10 healthy volunteers (62.7 +/- 8.6 years old) who underwent resting-state metabolic brain imaging with (18)F-fluorodeoxyglucose PET. Cohort 2 comprised 17 subjects with RBD (68.9 +/- 4.8 years old) and 17 healthy volunteers (66.6 +/- 6.0 years old) …

Network Modulation Following Sham Surgery In Parkinson's Disease, J. H. Ko, A. Feigin, P. Mattis, C. C. Tang, Y. L. Ma, V. Dhawan, M. J. During, M. G. Kaplitt, D. Eidelberg

Journal Articles

Patient responses to placebo and sham effects are a major obstacle to the development of therapies for brain disorders, including Parkinson's disease (PD). Here, we used functional brain imaging and network analysis to study the circuitry underlying placebo effects in PD subjects randomized to sham surgery as part of a double-blind gene therapy trial. Metabolic imaging was performed prior to randomization, then again at 6 and 12 months after sham surgery. In this cohort, the sham response was associated with the expression of a distinct cerebello-limbic circuit. The expression of this network increased consistently in patients blinded to treatment and …

Angiopoietin-2: A Key To Understanding Sepsis And Its Pulmonary Sequelae?, J. Y. Lee, E. J. Miller

Journal Articles

No abstract provided.

Dose-Escalation Of Human Anti-Interferon-Alpha Receptor Monoclonal Antibody Medi-546 In Subjects With Systemic Sclerosis: A Phase 1, Multicenter, Open Label Study, A. Goldberg, T. Geppert, E. Schiopu, T. Frech, V. Hsu, R. W. Simms, S. L. Peng, Y. H. Yao, N. Elgeioushi, S. Yoo, +2 Additional Authors

Journal Articles

Introduction: Type I interferons (IFNs) are implicated in the pathogenesis of systemic sclerosis (SSc). MEDI-546 is an investigational human monoclonal antibody directed against the type I IFN receptor. This Phase 1 study evaluated the safety/tolerability, pharmacokinetics (PK), immunogenicity, and pharmacodynamics (PD) of single and multiple intravenous doses of MEDI-546 in adults with SSc. Methods: Subjects (>= 18 years) with SSc were enrolled in an open-label, dose-escalation study to receive single (0.1, 0.3, 1.0, 3.0, 10.0, or 20.0 mg/kg), or 4 weekly intravenous doses (0.3, 1.0, or 5.0 mg/kg/week) of MEDI-546. Subjects were followed for 12 weeks. Safety assessments included …

The Gut Microbiota Influences Blood-Brain Barrier Permeability In Mice, V. Braniste, M. Al-Asmakh, C. Kowal, F. Anuar, A. Abbaspour, M. Toth, A. Korecka, B. T. Volpe, B. Diamond, S. Pettersson, +8 Additional Authors

Journal Articles

Pivotal to brain development and function is an intact blood-brain barrier (BBB), which acts as a gatekeeper to control the passage and exchange of molecules and nutrients between the circulatory system and the brain parenchyma. The BBB also ensures homeostasis of the central nervous system (CNS). We report that germ-free mice, beginning with intrauterine life, displayed increased BBB permeability compared to pathogen-free mice with a normal gut flora. The increased BBB permeability was maintained in germ-free mice after birth and during adulthood and was associated with reduced expression of the tight junction proteins occludin and claudin-5, which are known to …

Identification Of Stage-Specific Genes Associated With Lupus Nephritis And Response To Remission Induction In (Nzb X Nzw)F1 And Nzm2410 Mice, R. Bethunaickan, C. C. Berthier, W. J. Zhang, R. Eksi, H. D. Li, Y. F. Guan, M. Kretzler, A. Davidson

Journal Articles

Objective. To elucidate the molecular mechanisms involved in renal inflammation during the progression, remission, and relapse of nephritis in murine lupus models using transcriptome analysis. Methods. Kidneys from (NZB x NZW)F1 (NZB/NZW) and NZM2410 mice were harvested at intervals during the disease course or after remission induction. Genome-wide expression profiles were obtained from microarray analysis of perfused kidneys. Real-time polymerase chain reaction (PCR) analysis for selected genes was used to validate the microarray data. Comparisons between groups using SAM, and unbiased analysis of the entire data set using singular value decomposition and self-organizing maps were performed. Results. Few changes in …

Impact On House Staff Evaluation Scores When Changing From A Dreyfus- To A Milestone-Based Evaluation Model: One Internal Medicine Residency Program's Findings, K. A. Friedman, S. Balwan, F. Cacace, K. Katona, S. Sunday, S. Chaudhry

Journal Articles

Purpose: As graduate medical education (GME) moves into the Next Accreditation System (NAS), programs must take a critical look at their current models of evaluation and assess how well they align with reporting outcomes. Our objective was to assess the impact on house staff evaluation scores when transitioning from a Dreyfus-based model of evaluation to a Milestone-based model of evaluation. Milestones are a key component of the NAS. Method: We analyzed all end of rotation evaluations of house staff completed by faculty for academic years 2010-2011 (pre-Dreyfus model) and 2011-2012 (post-Milestone model) in one large university-based internal medicine residency training …

Iso-66, A Novel Inhibitor Of Macrophage Migration Inhibitory Factor, Shows Efficacy In Melanoma And Colon Cancer Models, K. Ioannou, K. F. Cheng, G. V. Crichlow, A. I. Birmpilis, E. J. Lolis, O. E. Tsitsilonis, Y. Al-Abed

Journal Articles

Macrophage migration inhibitory factor (MIF) is a pleiotropic pro-inflammatory cytokine, which possesses a contributing role in cancer progression and metastasis and, thus, is now considered a promising anticancer drug target. Many MIF-inactivating strategies have proven successful in delaying cancer growth. Here, we report on the synthesis of ISO-66, a novel, highly stable, small-molecule MIF inhibitor, an analog of ISO-1 with improved characteristics. The MIF:ISO-66 co-crystal structure demonstrated that ISO-66 ligates the tautomerase active site of MIF, which has previously been shown to play an important role in its biological functions. In vitro, ISO-66 enhanced specific and non-specific anticancer immune responses, …