Digital Commons Network^™

Implementation Of A Computer-Based Communication System For Psychiatry Residents, Daniel Z. Lieberman M.D.

Jefferson Journal of Psychiatry

In order to encourage different kinds of communication among residents who were located at a number of geographically separate sites, a computerized communication system was implemented. Priority was placed on both richness of features and ease of use. Residents were able to send private email, join public conferences, and access databases of information. The system was initially used by a large number of residents, and usage patterns are described. The introduction to information technology that residents gained from the system led to other computer projects, and an interest in the resources of the Internet.

Replacement Gastrostomy Tube Causing Acute Pancreatitis: Case Series With Review Of Literature, Anish M. Shah, Nihar Shah Md, Joseph R. Depasquale

Gastroenterology

Context Percutaneous endoscopic gastrostomy (PEG) feedings are generally considered safe with few serious complications. Acute pancreatitis is a rare complication associated with replacement percutaneous endoscopic gastrostomy tubes.

Case report We report two cases of acute pancreatitis induced by migrated replacement percutaneous endoscopic gastrostomy tubes.

Conclusions Migration of a balloon into the duodenum can result in external manipulation of the ampulla of Vater thereby disturbing the flow of pancreatic secretions leading to acute pancreatitis. Recognition of this complication is important and should be included as potential etiology of acute pancreatitis in patients receiving percutaneous endoscopic gastrostomy feedings. Periodic examination and documentation …

Schools As Potential Vaccination Venue For Vaccines Outside Regular Epi Schedule: Results From A School Census In Pakistan., Sajid Bashir Soofi, Inam-Ul Haq, M. Imran Khan, Muhammad Bilal Siddiqui, Mushtaq Mirani, Rehman Tahir, Imtiaz Hussain, Mahesh K Puri, Zamir Hussain Suhag, Asif R Khowaja, Abdul Razzaq Lasi, John D Clemens, Michael Favorov, R. Leon Ochiai, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: Vaccines are the most effective public health intervention. Expanded Program on Immunization (EPI) provides routine vaccination in developing countries. However, vaccines that cannot be given in EPI schedule such as typhoid fever vaccine need alternative venues. In areas where school enrolment is high, schools provide a cost effective opportunity for vaccination. Prior to start of a school-based typhoid vaccination program, interviews were conducted with staff of educational institutions in two townships of Karachi, Pakistan to collect baseline information about the school system and to plan a typhoid vaccination program. Data collection teams administered a structured questionnaire to all schools …

Purging Of Memories From Conscious Awareness Tracked In The Human Brain, Benjamin Levy, Michael C. Anderson

Psychology

Understanding the neural basis of conscious experience and its regulation are fundamental goals of science. While recent research has made substantial progress in identifying the neural correlates of conscious experiences, it remains unclear how individuals exert control over the contents of awareness. In particular, can a memory that has entered the aware state be purged from consciousness if it is not currently desired? Here we tracked the correlates of consciousness in humans using functional magnetic resonance imaging and demonstrated the involvement of a downregulation mechanism that purges contents from conscious awareness. When individuals tried to prevent the retrieval of a …

Ensembles Of Human Mtl Neurons "Jump Back In Time" In Response To A Repeated Stimulus, M. W. Howard, Indre Viskontas, K. H. Shankar, I. Fried

Psychology

Episodic memory, which depends critically on the integrity of the medial temporal lobe (MTL), has been described as ‘‘mental time travel’’ in which the rememberer ‘‘jumps back in time.’’ The neural mechanism underlying this ability remains elusive. Mathematical and computational models of performance in episodic memory tasks provide a specific hypothesis regarding the computation that supports such a jump back in time. The models suggest that a representation of temporal context, a representation that changes gradually over macroscopic periods of time, is the cue for episodic recall. According to these models, a jump back in time corresponds to a stimulus …

Geriatric Home Makeover, Edward F. Ansello

Director's Editorials from Age in Action

Houses pose substantial risks for falling. Over half of all falls by older adults happen in their homes. Reducing hazards in the home addresses just one set of contributing risk factors involved in older adults falling.

The Cyclin-Like Protein Spy1/Ringo Promotes Mammary Transformation And Is Elevated In Human Breast Cancer, Mohammad Al Sorkhy, Rosa-Maria Ferraiuolo, Espanta Jalili, Agnes Malysa, Andreea R. Fratiloiu, Bonnie F. Sloane, Lisa A. Porter

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

Spy1 is a novel 'cyclin-like' activator of the G1/S transition capable of enhancing cell proliferation as well as inhibiting apoptosis. Spy1 protein levels are tightly regulated during normal mammary development and forced overexpression in mammary mouse models accelerates mammary tumorigenesis.

Methods

Using human tissue samples, cell culture models and in vivo analysis we study the implications of Spy1 as a mediator of mammary transformation and breast cancer proliferation.

Results

We demonstrate that this protein can facilitate transformation in a manner dependent upon the activation of the G2/M Cdk, Cdk1, and the subsequent inhibition of the anti-apoptotic regulator FOXO1. …

A Systematic Selection Method For The Development Of Cancer Staging Systems, Yunzhi Lin, Richard Chappell, Mithat Gonen

Memorial Sloan-Kettering Cancer Center, Dept. of Epidemiology & Biostatistics Working Paper Series

The tumor-node-metastasis (TNM) staging system has been the anchor of cancer diagnosis, treatment, and prognosis for many years. For meaningful clinical use, an orderly, progressive condensation of the T and N categories into an overall staging system needs to be defined, usually with respect to a time-to-event outcome. This can be considered as a cutpoint selection problem for a censored response partitioned with respect to two ordered categorical covariates and their interaction. The aim is to select the best grouping of the TN categories. A novel bootstrap cutpoint/model selection method is proposed for this task by maximizing bootstrap estimates of …

The Fairfax County Hoarding Task Force, Michael Congleton

Case Studies from Age in Action

Educational Objectives

1. Describe the reasons for forming the Fairfax County Hoarding Task Force.

2. Explain the organizational makeup of the Hoarding Task Force.

3. Understand the risk factors in hoarding and what is being done to address them.

Mouse Rc/Btb2, A Member Of The Rcc1 Superfamily, Localizes To Spermatid Acrosomal Vesicles, Jiannan Wang, Maria E. Teves, Xuening Shen, David R. Nagarkatti-Gude, Rex A. Hess, Scott C. Henderson, Jerome F. Strauss Iii, Zhibing Zhang

Obstetrics and Gynecology Publications

Mouse RC/BTB2 is an unstudied protein of the RCC1 (Regulator of Chromosome Condensation) superfamily. Because of the significant remodeling of chromatin that occurs during spermiogenesis, we characterized the expression and localization of mouse RC/BTB2 in the testis and male germ cells. The Rc/btb2 gene yields two major transcripts: 2.3 kb Rc/btb2-s, present in most somatic tissues examined; and 2.5 kb Rc/btb2-t, which contains a unique non-translated exon in its 5′-UTR that is only detected in the testis. During the first wave of spermatogenesis, Rc/btb2-t mRNA is expressed from day 8 after birth, reaching highest levels of expression at day …

Risk Factors For Ventilator-Associated Pneumonia In The Adult Trauma Patient: A Retrospective Case-Control Study From A Level I Trauma Center, Summer L. Chapman

Theses, Dissertations and Capstones

Introduction: Ventilator-Associated Pneumonia (VAP) continues to be a common complication among the adult trauma population. Little advancements have been made to decrease the incidence, suggesting further research is needed to establish modifiable risk factors. The purpose of this study was to test for an associated link between prehospital intubation and the development of VAP in the adult trauma patient.

Methodology: A retrospective, case-control study design was utilized. The sample included 494 adult trauma patients who required endotracheal intubation and mechanical ventilation for a minimum of 24 hours. All patients presented as a priority one or two trauma to the Charleston …

Down-Regulation Of The Transcription Factor Snail In The Placentas Of Patients With Preeclampsia And In A Rat Model Of Preeclampsia, Larissa Federova, Cara Gatto-Weis, Sleiman Smaili, Nauman Khurshid, Joseph I. Shapiro M.D., Deepak Malhorta, Terrence Horrigan

Biochemistry and Microbiology

Background: Placental malfunction in preeclampsia is believed to be a consequence of aberrant differentiation of trophoblast lineages and changes in utero-placental oxygenation. The transcription factor Snail, a master regulator molecule of epithelial-mesenchymal transition in embryonic development and in cancer, is shown to be involved in trophoblast differentiation as well. Moreover, Snail can be controlled by oxidative stress and hypoxia. Therefore, we examined the expression of Snail and its downstream target, e-cadherin, in human normal term, preterm and preeclamptic placentas, and in pregnant rats that developed preeclampsia-like symptoms in the response to a 20- fold increase in sodium intake.

Methods: Western …

Extraskeletal Effects Of Vitamin D: Potential Impact On Wv Disease Morbidity And Mortality, Franklin D. Shuler, Dana Lycans, Elias Salloum

Orthopaedics

Vitamin D is an essential nutrient and a secosteroid hormone that regulates many physiologic processes beyond calcium and bone homeostasis. These "extraskeletal" effects are impacted by the circulating levels of the storage form of vitamin D, 25-hydroxyvitamin D3. Levels of vitamin D can be detected after completing a simple 25(OH)D blood test. Vitamin D deficiency (< 30 ng/mL) is associated with a higher risk of many chronic diseases including, but not limited to, fourteen types of cancers, type 1 and 2 diabetes mellitus, obesity, cardiovascular disease, hypertension, stroke, and asthma. This article explores the association between vitamin D deficiency and the burden of chronic diseases in West Virginia.

The Effect Of Education On Healthcare Personnel's Knowledge Of Lymphedema Detection And Prevention, Dolly Wilson

Nursing Theses and Capstone Projects

Secondary lymphedema (SLE) is a serious problem for many of the 2.6 million breast cancer survivors in the United States. It is estimated that 28 - 38% of breast cancer survivors develop lymphedema. The five-year incidence ranges from 43% to 94% (Armer, 2010). The purpose of this study was to evaluate the effectiveness of an education program on healthcare personnel's knowledge of the risk of and preventive measures for upper limb lymphedema in breast cancer patients. A sample of healthcare personnel (N = 32) included both trained healthcare personnel and ancillary staff who are employed in a single oncology center …

Reasons For Low Pandemic H1n1 2009 Vaccine Acceptance Within A College Sample, Russell D. Ravert, Linda Y. Fu

Pediatrics Faculty Publications

This study examined health beliefs associated with novel influenza A (H1N1) immunization among US college undergraduates during the 2009-2010 pandemic. Undergraduates (ages 18–24 years) from a large Midwestern University were invited to complete an online survey during March, 2010, five months after H1N1 vaccines became available. Survey items measured H1N1 vaccine history and H1N1-related attitudes based on the health belief literature. Logistic regression was used to identify attitudes associated with having received an H1N1 vaccine, and thematic analysis of student comments was conducted to further understand influences on vaccine decisions. Among the 296 students who participated in the survey, 15.2% …

Normal Pressure Hydrocephalus: How Can It Be Told Apart From Neurodegenerative Diseases Of The Elderly?, Raphael C. Zohn

The Science Journal of the Lander College of Arts and Sciences

Normal pressure hydrocephalus (NPH) affects more of the older population than people recognize. The underestimation of this neurological condition is due in most part to the overlap of its symptoms to other forms of dementia as well as many other geriatric conditions. The objective of this paper was to research and contrast various methods of differentiation in the diagnosis of normal pressure hydrocephalus as well as find pretreatment indicators of successful surgery. Methods included reviewing of articles and studies done to evaluate which symptoms are most commonly presented in normal pressure hydrocephalus and their subtle differences from the symptoms of …

Posttraumatic Stress Disorder Prevalence And Risk Of Recurrence In Acute Coronary Syndrome Patients: A Meta-Analytic Review., D. Edmondson, S. Richardson, L. Falzon, K. W. Davidson, M. A. Mills, Y. Neria

Journal Articles

BACKGROUND: Acute coronary syndromes (ACS; myocardial infarction or unstable angina) can induce posttraumatic stress disorder (PTSD), and ACS-induced PTSD may increase patients' risk for subsequent cardiac events and mortality.

OBJECTIVE: To determine the prevalence of PTSD induced by ACS and to quantify the association between ACS-induced PTSD and adverse clinical outcomes using systematic review and meta-analysis.

DATA SOURCES: Articles were identified by searching Ovid MEDLINE, PsycINFO, and Scopus, and through manual search of reference lists.

METHODOLOGY/PRINCIPAL FINDINGS: Observational cohort studies that assessed PTSD with specific reference to an ACS event at least 1 month prior. We extracted estimates of the …

A Study Of Emergency Room Utilization Related To Poorly Controlled Asthma In Pediatrics, Leistey T. Wortman

Nursing Theses and Capstone Projects

Asthma is a disease of the respiratory system, which causes swelling and narrowing of the airways. Asthma is commonly seen in children. It is the leading cause of hospital stays and school absences. Hospitalization accounts for the single largest portion of the direct health care costs for asthma, estimated at nearly $18 billion a year (Everage, et al, 2010). Children with asthma may be able to breathe normally most of the time but when they encounter a substance that can cause problems (a "trigger"); an asthma attack (exacerbation) can occur (PubMed Health, 2011). The purpose of this study is to …

Novel Electronic Refreshers For Cardiopulmonary Resuscitation: A Randomized Controlled Trial, Stephen Magura, Michael G. Miller, Timothy J. Michael, Robert J. Bensley, J. Burkhardt, A. C. Puente, C. Sullins

Human Performance and Health Education Faculty Research

Background: Currently the American Red Cross requires that individuals renew their cardiopulmonary resuscitation (CPR) certification annually; this often requires a 4- to 8-hour refresher course. Those trained in CPR often show a decrease in essential knowledge and skills within just a few months after training. New electronic means of communication have expanded the possibilities for delivering CPR refreshers to members of the general public who receive CPR training. The study’s purpose was to determine the efficacy of three novel CPR refreshers - online website, e-mail and text messaging – for improving three outcomes of CPR training - skill retention, confidence …

Examining Fatigue In Copd: Development, Validity And Reliability Of A Modified Version Of Facit-F Scale, Khaled Al-Shair, Hana Muellerova, Janelle Yorke, Stephen I. Rennard, Emiel F.M. Wouters, Nicola A. Hanania, Amir Sharafkhaneh, Jørgen Vestbo, Eclipse Investigators

Journal Articles: Pulmonary & Critical Care Med

INTRODUCTION: Fatigue is a disruptive symptom that inhibits normal functional performance of COPD patients in daily activities. The availability of a short, simple, reliable and valid scale would improve assessment of the characteristics and influence of fatigue in COPD.

METHODS: At baseline, 2107 COPD patients from the ECLIPSE cohort completed the Functional Assessment of Chronic Illness Therapy Fatigue (FACIT-F) scale. We used well-structured classic method, the principal components analysis (PCA) and Rasch analysis for structurally examining the 13-item FACIT-F.

RESULTS: Four items were less able to capture fatigue characteristics in COPD and were deleted. PCA was applied to the remaining …

Health Disparities Experienced By People With Disabilities In The United States: A Behavioral Risk Factor Surveillance System Study, Jennifer Renee Pharr, Timothy J. Bungum

School of Public Health Faculty Research

The Americans with Disabilities Act became law in 1990; since then research has shown that people with disabilities continue to experience barriers to health care. The purpose of this study was to compare utilization of preventive services, chronic disease rates, and engagement in health risk behaviors of participants with differing severities of disabilities to those without disabilities. This study was a secondary analysis of 2010 data collected in the Behavioral Risk Factor Surveillance System national survey in the United States. Rao Chi square test and logistic regression were employed. Participants with disabilities had significantly higher adjusted odds ratios for all …

Novel Report Of Expression And Function Of Cd97 In Malignant Gliomas: Correlation With Wilms Tumor 1 Expression And Glioma Cell Invasiveness Laboratory Investigation, Archana Chidambaram, Helen L. Fillmore, Timothy E. Van Meter, Catherine I. Dumur, William C. Broaddus

Division of Research and Economic Development Faculty & Staff Publications

Object. The Wilms tumor 1 (WT1) protein—a developmentally regulated transcription factor—is aberrantly expressed in gliomas and promotes their malignant phenotype. However, little is known about the molecular allies that help it mediate its oncogenic functions in glioma cells.

Methods. The authors used short interfering RNA (siRNA) to suppress WT1 expression in glioblastoma (GBM) cells and evaluated the effect of this on GBM cell invasiveness. Gene expression analysis was then used to identify the candidate genes that were altered as a result of WT1 silencing. One candidate target, CD97, was then selected for further investigation into its role by suppressing …

Nonsteroidal Anti-Inflammatory Drugs Are An Important Cause Of Acute Kidney Injury In Children, Jason M. Misurac, Chad A. Knoderer, Jeffrey D. Leiser, Corina Nilescu, Amy C. Wilson, Sharon P. Andreoli

Scholarship and Professional Work – COPHS

Objective

To characterize nonsteroidal anti-inflammatory drug (NSAID)-associated acute kidney injury (AKI) in children.

Study design

We conducted a retrospective chart review of children diagnosed with AKI through the use of International Classification of Diseases, Ninth Revision diagnosis code 584.5 or 584.9 from January 1999 to June 2010. Medical records were reviewed to confirm the diagnosis of AKI and to quantify NSAID administration. Pediatric RIFLE criteria were used to codify AKI. Patients were not classified as having NSAID-associated AKI if they had a diagnosis explaining AKI or comorbid clinical conditions predisposing to AKI development.

Results

Patients (N = 1015) were identified …

Graduate Medical Education 2011-2012 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.

A Randomized Placebo-Controlled Trial Of Varenicline For Smoking Cessation Allowing Flexible Quit Dates, Stephen I. Rennard, John Hughes, Paul M. Cinciripini, Eva Kralikova, Tobias Raupach, Carmen Arteaga, Lisa B. St Aubin, Cristina Russ, The Flexible Quit Date Study Group

Journal Articles: Pulmonary & Critical Care Med

INTRODUCTION: Current smoking cessation guidelines recommend setting a quit date prior to starting pharmacotherapy. However, providing flexibility in the date of quitting may be more acceptable to some smokers. The objective of this study was to compare varenicline 1 mg twice daily (b.i.d.) with placebo in subjects using a flexible quit date paradigm after starting medication.

METHODS: In this double-blind, randomized, placebo-controlled international study, smokers of ≥10 cigarettes/day, aged 18-75 years, and who were motivated to quit were randomized (3:1) to receive varenicline 1 mg b.i.d. or placebo for 12 weeks. Subjects were followed up through Week 24. Subjects were …

Medical Education Digest, Vol. 14 No. 1 (January/February 2012), Nova Southeastern University

Medical Education Digest

No abstract provided.

Consumption Of High Ω-3 Fatty Acid Diet Suppressed Prostate Tumorigenesis In C3(1) Tag Mice, Juliana A. Akinsete, Gabriela Ion, Theodore R. Witte, W. Elaine Hardman

Biochemistry and Microbiology

Prostate cancer incidence and mortality are high in the Western world and high ω-6/ω-3 PUFA in the Western diet may be a contributing factor. We investigated whether changing from a diet that approximates ω-6 fat content of the Western diet to a high ω-3 fat diet at adulthood might reduce prostate cancer risk. Female SV 129 mice that had consumed a high ω-6 diet containing corn oil for 2 weeks were bred with homozygous C3(1)Tag transgenic male mice. All male offspring were weaned to the corn oil diet (CO) until postpuberty when half of the male offspring were transferred to …

Feasibility And Compliance With Daily Home Ecg Monitoring Of The Qt Interval In Heart Transplant Recipients, Erik V. Carter, Kathleen T. Hickey, David M. Pickham, Lynn V. Doering, Belinda Chen, Patricia R. E. Harris, Barbara J. Drew

Collected Faculty Scholarship

About 13% of adult heart transplant recipients do not survive to one year and a major cause of death is acute cellular allograft rejection.^1,2 According to the 2009 annual United States data published from the International Society for Heart Lung Transplantation Registry, acute rejection occurs in 25 – 35% of transplant recipients within the first year following transplant surgery.³ In order to detect the early stages of rejection so that more aggressive and early immunosuppressant therapy can be initiated, frequent biopsies of heart tissue are performed (typically, weekly or every other week in the first 3 months and …

Children's Mercy Hospital Annual Report 2011, 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.

The Fit-Hansa Demonstrates Reliability And Convergent Validity Of Functional Performance In Patients With Shoulder Disorders, Prajyot Kumta, Joy C. Macdermid, Saurabh Mehta, Paul W. Stratford

Physical Therapy Faculty Research

Study

DesignPsychometric study design.

Objectives

To assess the test-retest reliability and convergent validity of the Functional Impairment Test-Hand and Neck/Shoulder/Arm (FIT-HaNSA) in patients with shoulder disorders.

Background

Performance tests that assess functional ability of patients with shoulder disorders can provide useful information for making clinical or return-to-activity decisions. No performance-based shoulder test has yet demonstrated sufficient relevance or clinical measurement properties. The FIT-HaNSA examines upper extremity performance during repetitive tasks that emphasize shoulder reaching and static postures and, therefore, has greater relevance for assessing performance.

Methods

Thirty-six patients with shoulder disorders and 65 healthy controls were recruited for the study. …