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Intelligibility Of Electrolarynx Speech Using A Novel Hands-Free Actuator, Brian Madden, Mark Nolan, Ted Burke, James Condron, Eugene Coyle

Conference Papers

During voiced speech, the larynx provides quasi-periodic acoustic excitation of the vocal tract. In most electrolarynxes, mechanical vibrations are produced by a linear electromechanical actuator, the armature of which percusses against a metal or plastic plate at a frequency within the range of glottal excitation. In this paper, the intelligibility of speech produced using a novel hands-free actuator is compared to speech produced using a conventional electrolarynx. Two able-bodied speakers (one male, one female) performed a closed response test containing 28 monosyllabic words, once using a conventional electrolarynx and a second time using the novel design. The resulting audio recordings …

Cilostazol Versus Aspirin For Secondary Prevention Of Vascular Events After Stroke Of Arterial Origin, Ayeesha Kamran Kamal, Imama Naqvi, Muhammad R Husain, Bhojo A Khealani

Section of Neurology

Background:Aspirin is widely used for secondary prevention after stroke. Cilostazol has shown promise as an alternative to aspirin in Asian people with stroke. ObjectiveS: To determine the relative effectiveness and safety of cilostazol compared directly with aspirin in the prevention of stroke and other serious vascular events in Patients at high vascular risk for subsequent stroke, those with previous transient ischaemic attack (TIA) or ischaemic stroke of arterial origin. SEARCH STRATEGY: We searched the Cochrane Stroke Group Trials Register (last searched September 2010), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2009, Issue 4), MEDLINE (1950 …

Neuroinflammation Leads To Region-Dependent Alterations In Astrocyte Gap Junction Communication And Hemichannel Activity., Nikolay Karpuk, Maria Burkovetskaya, Teresa Fritz, Amanda Angle, Tammy Kielian

Journal Articles: Pathology and Microbiology

Inflammation attenuates gap junction (GJ) communication in cultured astrocytes. Here we used a well-characterized model of experimental brain abscess as a tool to query effects of the CNS inflammatory milieu on astrocyte GJ communication and electrophysiological properties. Whole-cell patch-clamp recordings were performed on green fluorescent protein (GFP)-positive astrocytes in acute brain slices from glial fibrillary acidic protein-GFP mice at 3 or 7 d after Staphylococcus aureus infection in the striatum. Astrocyte GJ communication was significantly attenuated in regions immediately surrounding the abscess margins and progressively increased to levels typical of uninfected brain with increasing distance from the abscess proper. Conversely, …

Teens Texting And Consequences: A Brief Review, Archana Srinivas, Megan White, Hatim A. Omar

Pediatrics Faculty Publications

The aim of this paper is to summarize the current literature on texting use amongst adolescents. A brief overview will be presented on the prevalence of texting among teenagers, the use of texting for sexting and cyberbullying as well as the dangers of texting while driving. This paper will serve as a brief overview of these topics in order to bring to light the emerging challenges that texting presents to the mental and physical well-being of adolescents in an effort to evoke further discussion regarding the need for increasing awareness and education to parents, educators, law makers and health care …

Com Outlook Winter 2011, College Of Osteopathic Medicine

COM Outlook

No abstract provided.

Medical Education Digest, Vol. 13 No. 1 (January/February 2011), Nova Southeastern University

Medical Education Digest

No abstract provided.

The Cns Microvascular Pericyte: Pericyte-Astrocyte Crosstalk In The Regulation Of Tissue Survival, Drew Bonkowski, Vladimir Katyshev, Roumen D. Balabanov, Andre Borisov, Paula Dore-Duffy

Wayne State University Associated BioMed Central Scholarship

Abstract

The French scientist Charles Benjamin Rouget identified the pericyte nearly 140 years ago. Since that time the role of the pericyte in vascular function has been difficult to elucidate. It was not until the development of techniques to isolate and culture pericytes that scientists have begun to understand the true impact of this unique cell in the maintenance of tissue homeostasis. In the brain the pericyte is an integral cellular component of the blood-brain barrier and, together with other cells of the neurovascular unit (endothelial cells, astrocytes and neurons) the pericyte makes fine-tuned regulatory adjustments and adaptations to promote …

Early Versus Later Rhythm Analysis In Patients With Out-Of-Hospital Cardiac Arrest, Ian G. Stiell, Graham Nichol, Brian G. Leroux, Thomas D. Rea, Joseph P. Ornato, Judy Powell, James Christenson, Clifton W. Callaway, Peter J. Kudenchuk, Tom P. Aufderheide, Ahamed H. Idris, Mohamud R. Daya, Henry E. Wang, Laurie J. Morrison, Daniel Davis, Douglas Andrusiek, Shannon Stephens, Sheldon Cheskes, Robert H. Schmicker, Ray Fowler, Christian Vaillancourt, David Hostler, Dana Zive, Ronald G. Pirrallo, Gary M. Vilke, George Sopko, Myron Weisfeldt

Emergency Medicine Publications

Background

In a departure from the previous strategy of immediate defibrillation, the 2005 resuscitation guidelines from the American Heart Association–International Liaison Committee on Resuscitation suggested that emergency medical service (EMS) personnel could provide 2 minutes of cardiopulmonary resuscitation (CPR) before the first analysis of cardiac rhythm. We compared the strategy of a brief period of CPR with early analysis of rhythm with the strategy of a longer period of CPR with delayed analysis of rhythm.

Methods

We conducted a cluster-randomized trial involving adults with out-of-hospital cardiac arrest at 10 Resuscitation Outcomes Consortium sites in the United States and Canada. Patients …

A Trial Of An Impedance Threshold Device In Out-Of-Hospital Cardiac Arrest, Tom P. Aufderheide, Graham Nichol, Thomas D. Rea, Siobhan P. Brown, Brian G. Leroux, Paul E. Pepe, Peter J. Kudenchuk, Jim Christenson, Mohamud R. Daya, Paul Dorian, Clifton W. Callaway, Ahamed H. Idris, Douglas Andrusiek, Shannon W. Stephens, David Hostler, Daniel Davis, James V. Dunford, Ronald G. Pirrallo, Ian G. Stiell, Catherine M. Clement, Alan Craig, Lois Van Ottingham, Terri A. Schmidt, Henry E. Wang, Myron L. Weistfeldt, Joseph P. Ornato, George Sopko

Emergency Medicine Publications

Background

The impedance threshold device (ITD) is designed to enhance venous return and cardiac output during cardiopulmonary resuscitation (CPR) by increasing the degree of negative intrathoracic pressure. Previous studies have suggested that the use of an ITD during CPR may improve survival rates after cardiac arrest.

Methods

We compared the use of an active ITD with that of a sham ITD in patients with out-ofhospital cardiac arrest who underwent standard CPR at 10 sites in the United States and Canada. Patients, investigators, study coordinators, and all care providers were unaware of the treatment assignments. The primary outcome was survival to …

Falls, Edward F. Ansello

Director's Editorials from Age in Action

Falls are common, affecting about one third of community-dwelling adults over age 65 and about half over age 80. The risk factors for falling are complex, and falls may themselves be a signal for other troubling conditions. When fear of falling emerges as an issue for some elders, they are likely to reduce their activities, thinking that this will reduce their risk, and isolation and depression can ensue. There are teaching roles for nurses, physicians, and physical therapists in sharing with other professions how to assess gait, vision, or dizziness.

Habilitation Therapy In Dementia Care, Paul Raia

Case Studies from Age in Action

Educational Objectives

1. To describe the goal of Habilitation Therapy and how it differs from other methods of dementia care, including rehabilitation.

2. To identify areas or domains in which we have opportunities to bring about and sustain positive emotions.

3. To discuss four communication strategies to use with mid- to laterstage Alzheimer’s patients.

Predictors Of Postoperative Respiratory Failure In Patients Receiving Anesthesia, Marty Henley

Theses, Dissertations and Capstones

Introduction: Postoperative Respiratory failure has been identified as a prevention quality indicator by The Agency for Health Research and Quality (AHRQ). Postoperative Respiratory Failure is associated with increased length of stay, increased costs and increased morbidity and mortality. Unfortunately, current research is limited regarding scoring methods which are predictive for postoperative respiratory failure. This retrospective case control study was conducted to determine if the various tools of evaluation of risk currently available and to determine if any are predictive of the risk of developing postoperative respiratory failure.

Methodology: The design of this research was a retrospective case control study conducted …

Holistic Comfort And Bereavement Of Families Receiving Prenatal Hospice Support During The Loss Of An Unborn Child With Lethal Anomalies, Sally S. Smith

Nursing Theses and Capstone Projects

The purpose of this descriptive study was to explore the grieving process and coping mechanism of families that was faced with the impeding loss of their unborn child. Grief is a very lonely process.

The aim of this research is to examine how parents cope with the lost of an unborn child with the aid of perinatal hospices. Giving families a broader range of options in regards to continuing their pregnancy. Each family has a right to choice what option is right for them. Choices should be in the hands of the family in regards to continuing with their pregnancy …

Knee Range Of Motion: Reliability And Agreement Of 3 Measurement Methods, Paul G. Peters, Michael A. Herbenick, Philip A. Anloague, Ronald J. Markert, L. Joseph Rubino

Physical Therapy Faculty Publications

We conducted a study to compare 3 methods of measuring knee range of motion: visual estimation by physicians, hand goniometry by physical therapists, and radiographic goniometry. We hypothesized that reliability would be high within and across all techniques. We found intrarater and interrater reliability to be satisfactory for visual estimation, hand goniometry, and radiographic goniometry. Interrater reliability across methods did not agree satisfactorily. Between-methods differences in estimating knee range of motion may result from variations in technique among physicians and physical therapists.

2011 Cancer Care Annual Report, Children's Mercy Hospital

Cancer Center Annual Reports

Annual report of cancer care and oncology services at the Children's Mercy Hospital, Kansas City MO, a pediatric medical center.

Efficacy And Safety Of Once-Daily Aclidinium In Chronic Obstructive Pulmonary Disease, Paul W. Jones, Stephen I. Rennard, Alvar Agusti, Pascal Chanez, Helgo Magnussen, Leonardo Fabbri, James F. Donohue, Eric D. Bateman, Nicholas J. Gross, Rosa Lamarca, Cynthia Caracta, Esther Garcia Gil

Journal Articles: Pulmonary & Critical Care Med

BACKGROUND: The long-term efficacy and safety of aclidinium bromide, a novel, long-acting muscarinic antagonist, were investigated in patients with moderate to severe chronic obstructive pulmonary disease (COPD).

METHODS: In two double-blind, 52-week studies, ACCLAIM/COPD I (n=843) and II (n=804), patients were randomised to inhaled aclidinium 200 μg or placebo once-daily. Patients were required to have a post-bronchodilator forced expiratory volume in 1 second (FEV1)/forced vital capacity ratio of ≤70% and FEV1< 80% of the predicted value. The primary endpoint was trough FEV1 at 12 and 28 weeks. Secondary endpoints were health status measured by St George's Respiratory Questionnaire (SGRQ) and time to first moderate or severe COPD exacerbation.

RESULTS: At 12 and 28 weeks, aclidinium improved trough FEV1 versus placebo in ACCLAIM/COPD I (by 61 and 67 mL; both p< 0.001) and ACCLAIM/COPD II (by 63 and 59 mL; both p< 0.001). More patients had a SGRQ improvement≥4 units at 52 weeks with aclidinium versus placebo in ACCLAIM/COPD I (48.1% versus 39.5%; p=0.025) and ACCLAIM/COPD II (39.0% versus 32.8%; p=0.074). The time to first exacerbation was significantly delayed by aclidinium in ACCLAIM/COPD II (hazard ratio [HR] 0.7; 95% confidence interval [CI] 0.55 to 0.92; p=0.01), but not ACCLAIM/COPD I (HR 1.0; 95% CI 0.72 to 1.33; p=0.9). Adverse events were minor in both studies.

CONCLUSION: Aclidinium is effective and well tolerated …

Graduate Medical Education 2010 Annual Report, Children's Mercy Hospital

GME Annual Reports

Annual report of the Children's Mercy Hospital Graduate Medical Education department, including pediatric residency, internal medicine/pediatrics residency, fellowship programs, medical students, continuing medical education, and library services.

Pharmacotherapy And Pregnancy: Highlights From The Third International Conference For Individualized Pharmacotherapy In Pregnancy, David M. Haas, Beverly Gallauresi, Kristine Shields, Deborah S. Zeitlin, Shannon M. Clark, Mary F. Herbert, Zhaoxia Ren, Srikanth C. Nallani, Eric M. Meslin, Karen B. Feibus, Gideon Koren, W. Scott Goebel, Thomas Easterling, Scott C. Denne, David A. Flockhart, Jamie L. Renbarger

Scholarship and Professional Work – COPHS

To address provider struggles to provide evidence-based, rational drug therapy to pregnant women, this third Conference was convened to highlight the current progress and research in the field. Speakers from academic centers, industry, and governmental institutions spoke about: the Food and Drug Administration’s role in pregnancy pharmacology and the new labeling initiative; drug registries in pregnancy; the pharmacist’s role in medication use in pregnancy; therapeutic areas such as preterm labor, gestational diabetes, nausea and vomiting in pregnancy, and hypertension; breast-feeding and medications; ethical challenges for consent in pregnancy drug studies; the potential for cord blood banks; and concerns about the …

Mccraken Knows Ulcers And Parasitic Worms, Aldemaro Romero Jr.

Publications and Research

No abstract provided.

Can Law Improve Prevention And Treatment Of Cancer?, Roger Magnusson, Lawrence O. Gostin, David Studdert

O'Neill Institute Papers

The December 2011 issue of Public Health (the Journal of the Royal Society for Public Health) contains a symposium entitled: Legislate, Regulate, Litigate? Legal approaches to the prevention and treatment of cancer. This symposium explores the possibilities for using law and regulation – both internationally and at the national level – as the policy instrument for preventing and improving the treatment of cancer and other leading non-communicable diseases (NCDs). In this editorial, we argue that there is an urgent need for more legal scholarship on cancer and other leading NCDs, as well as greater dialogue between lawyers, public health practitioners …

Maine Pediatric And Family Practice Survey Chartbook: Improving Health Outcomes For Children, Martha Elbaum Williamson Mpa, Kimberley S. Fox Mpa, Al Leighton Ba, Stuart Bratesman Mpp

Population Health & Health Policy

As part of the IHOC initiative, the Muskie School of Public Service at the University of Southern Maine surveyed pediatric and family practices about how they use data, clinical guidelines and office systems to monitor and improve children’s healthcare quality. The purpose of the survey is to provide baseline information about quality improvement activities in primary care practices serving children in Maine. Survey data will be used to inform IHOC activities and to monitor changes over time. The web-based survey was conducted in the winter of 2011-2012 and sent to practice managers at a sample of 168 practice sites, of …

Children's Mercy Hospital Annual Report 2010, Children's Mercy Hospital

Children's Mercy Annual Reports

Annual report for The Children's Mercy Hospital in Kansas City MO, a pediatric medical center.

Equity & Diversity 2010 Annual Report, Children's Mercy Hospital

Equity & Diversity Annual Reports

A report on equity and diversity at Children's Mercy Hospitals & Clinics, in the care it provides, the people it serves, and in its workforce. Specifically discusses the Equity & Diversity Council, The Office of Equity and Diversity, the Patient and Family Experience, Community Engagement, International Connections, Health Literacy, Interpreter Services, Quality Indicators and Health Outcomes, and Education and Training.

Social Mobilization Strategy, Family Advancement For Life And Health (Falah)

Reproductive Health

This document outlines social mobilization strategies at the national and community levels of the Family Advancement for Life and Health (FALAH) project in Pakistan. The project aims to improve the health and well-being of women, men, and their children through tackling the major obstacles in adoption of birth spacing to improve maternal and child health outcomes and family well-being, by increasing knowledge of the benefits of birth spacing as well as knowledge, increased demand for, and effective use of contraceptive methods. The strategy aims to achieve a significant increase in couples’ knowledge and understanding of the need for and benefits …

How Integration Of Daily Operations Leads To Success During An Emergency, David J. Wojs Jr., Chs, Cdp, Ccm

Department of Emergency Medicine

No abstract provided.

Patient Safety In Nursing Homes, Kali Thomas

USF Tampa Graduate Theses and Dissertations

Safety of residents has gained increased popularity in recent years following a report from the Institute of Medicine attributing 98,000 hospital deaths each year to errors by staff. As a result, regulatory agencies, advocates, and health care providers have shifted their focus to understanding patient safety and developing a culture that promotes safety. However, nursing homes lag behind other health care providers in their adoption of a patient safety culture and understanding what factors affect safety in resident care. These insights are needed to ensure that nursing home residents receive the safe care.

The purpose of this dissertation is to …

Isoniazid-Induced Severe Hepatotoxicity: An Infrequent But Preventable Cause Of Liver Failure In Children Treated For Latent Tuberculosis Infection, Dan Desrochers, Regino P. González-Peralta, Daniel T. Mcclenathan, Michael J. Wilsey Jr, Allah Haafiz

Pediatrics Faculty Publications

Isoniazid (INH) monotherapy has gained widespread acceptance as an efficacious therapy for latent tuberculosis infection (LTBI) especially in low-prevalence settings. Although INH related hepatotoxicity is well recognized, progression to severe liver dysfunction requiring care at a transplant center remains unpredictable. We report the management of a five year-old girl who developed progressive liver failure due to INH prophylaxis. This highlights the potential severity of INH related hepatic injury and underscores the significance of vigilant clinical monitoring throughout the duration of the therapy in children.

The State Of Emergency Care In The Republic Of Kenya, Benjamin Wachira, Ian Martin

Family Medicine, East Africa

Approximately 580,000 km2 in size, the Republic of Kenya is as big as Botswana but only half the size of countries like South Africa, Mali, and Angola. Kenya is comprised of eight provinces: Central, Coast, Eastern, Nairobi, North Eastern, Nyanza, Rift Valley, and Western. The 2009 census revealed a population of over 38 million people, with a population density of approximately 66 persons per square kilometre. Majority of the population (68%) lives in rural areas, as compared with the sub-Saharan African average of approximately 62%. With a gross domestic product (GDP) per capita of US $1,600 in 2010, Kenya is …

P-Dat: Lessons From Patients With Disabilities, Casey R. Bonaquist Do, Sweety Jain Md, Alex Garder

Department of Family Medicine

No abstract provided.

Targeted Identification Of Metastasis-Associated Cell-Surface Sialoglycoproteins In Prostate Cancer, Lifang Yang, Julius O. Nyalwidhe, Sigi Guo, Richard R. Drake, O. John Semmes

Bioelectrics Publications

Covalent attachment of carbohydrates to proteins is one of the most common post-translational modifications. At the cell surface, sugar moieties of glycoproteins contribute to molecular recognition events involved in cancer metastasis. We have combined glycan metabolic labeling with mass spectrometry analysis to identify and characterize metastasis-associated cell surface sialoglycoproteins. Our model system used syngeneic prostate cancer cell lines derived from PC3 (N2, nonmetastatic, and ML2, highly metastatic). The metabolic incorporation of AC₄ManNAz and subsequent specific labeling of cell surface sialylation was confirmed by flow cytometry and confocal microscopy. Affinity isolation of the modified sialic-acid containing cell surface proteins …