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Depresi Pada Populasi Lanjut Usia Yang Menjalani Hemodialisis, Edward Faisal Dec 2021

Depresi Pada Populasi Lanjut Usia Yang Menjalani Hemodialisis, Edward Faisal

Jurnal Penyakit Dalam Indonesia

Menurut laporan tahunan European Renal Association–European Dialysis and Transplant Association (ERA-EDTA), pasien yang menjalani transplantasi ginjal dari tahun 2014 sampai 2018 memiliki kesempatan hidup hanya setengah dari usia dengan sisa fungsi ginjal yang ditransplantasikan, sedangkan untuk pasien yang dilakukan hemodialisis (HD) adalah 70% lebih pendek.


The Relationship Of Subjective Global Assessment (Sga) With Energy Intake, Protein, Hand Grip Strength And Body Mass Index In Chronic Kidney Disease (Ckd) Patients With Continuous Ambulatory Peritoneal Dialysis (Capd), Yudhi Adrianto, Ni Made Hustrini, Triyani Kresnawan, Annisa Eka Amelia, Fitri Hudayani Dec 2021

The Relationship Of Subjective Global Assessment (Sga) With Energy Intake, Protein, Hand Grip Strength And Body Mass Index In Chronic Kidney Disease (Ckd) Patients With Continuous Ambulatory Peritoneal Dialysis (Capd), Yudhi Adrianto, Ni Made Hustrini, Triyani Kresnawan, Annisa Eka Amelia, Fitri Hudayani

Jurnal Penyakit Dalam Indonesia

Introduction. Energy and protein intake in chronic kidney disease (CKD) with continuous ambulatory peritoneal dialysis (CAPD) therapy plays an important role in balancing hypercatabolic conditions. Unbalanced intake will result in energy and protein deficits which are increasing the risk of muscle catabolism, decreasing body mass index (BMI), and malnutrition. Subjective global assessment (SGA) as the gold standard in nutritional assessment is needed in assessing nutritional status and determining malnutrition, therefore nutritional intervention can be delivered and improve CAPD patients’ quality of life. This study was conducted to determine the relationship between SGA with energy and protein intake, hand grip strength, …


The Role Of Physical Activity In Older Adults And Practical Intervention, Se Won Lee, Rebecca Patel, Bryan Werner, Ji Won Yoo, Timothy Tiu Dec 2021

The Role Of Physical Activity In Older Adults And Practical Intervention, Se Won Lee, Rebecca Patel, Bryan Werner, Ji Won Yoo, Timothy Tiu

HCA Healthcare Journal of Medicine

Physical inactivity (PI), defined as not meeting guidelines for physical activity beyond baseline daily living activities, is common among older adults (age 65 and older) and contributes to increased morbidity, increased mortality and increased health care spending. Understanding the clinical impact of PI on common medical conditions among older adults will help primary care physicians (PCPs) to educate these patients successfully. Physical activity and exercise are effective in the primary and secondary prevention of chronic diseases that can lead to physical impairments, disability and/or premature death. Physical activity and exercise have been shown to improve cognitive dysfunction and painful musculoskeletal …


Consequential Surgeries Limit Recurrence Of Skin Malignancies In Xeroderma Pigmentosum: A Case Report, Ahmad Kurnia, Diani Kartini, Novinda Herwirastri, Zoya M. Adyasa Dec 2021

Consequential Surgeries Limit Recurrence Of Skin Malignancies In Xeroderma Pigmentosum: A Case Report, Ahmad Kurnia, Diani Kartini, Novinda Herwirastri, Zoya M. Adyasa

The New Ropanasuri Journal of Surgery

Xeroderma Pigmentosum (XP) is a rare inherited skin malignancy with no causative treatment options. Reporting a 23-year-old woman with xeroderma pigmentosum who underwent several surgical tumor removals followed by further five procedures to apply tissue expander, facial resurfacing using full-thickness skin grafts with a donor from abdominal. The next series was tumor resection in the chin, forehead, nasal reconstruction, tumor removal on bilateral third digits, and defect closure. No recurrence after nine years of postoperative monitoring with an aesthetically acceptable result.


Factors Affecting Renal Function On Ileostomy In Dr. Cipto Mangunkusumo General Hospital: A Cross-Sectional Study, Lam Sihardo, Agi S. Putranto Dec 2021

Factors Affecting Renal Function On Ileostomy In Dr. Cipto Mangunkusumo General Hospital: A Cross-Sectional Study, Lam Sihardo, Agi S. Putranto

The New Ropanasuri Journal of Surgery

Introduction. Every year, about 30—60 ileostomy with various underlying diseases and indications were created in Dr. Cipto Mangunkusumo General Hospital (CMGH). There were a lot of complications attributable to these creations; one is the decline of renal function. The study goal was to find out factors influencing the renal function of ileostomy in CMGH.

Method. A cross-sectional study was conducted using medical records in April – May 2021. Samples were taken using the purposive sampling method. Inclusion criteria include male or female patients who underwent ileostomy closure in CMGH in the last four years with complete BMI, ileostomy creation and …


Single-Cell Analysis Of Aneurysmal Aortic Tissue In Patients With Marfan Syndrome Reveals Dysfunctional Tgf-Β Signaling, Ashley Dawson, Yanming Li, Yang Li, Pingping Ren, Hernan G. Vasquez, Chen Zhang, Kimberly R. Rebello, Waleed Ageedi, Alon R. Azares, Aladdein Burchett Mattar, Mary Burchett Sheppard, Hong S. Lu, Joseph S. Coselli, Lisa A. Cassis, Alan Daugherty, Ying H. Shen, Scott A. Lemaire Dec 2021

Single-Cell Analysis Of Aneurysmal Aortic Tissue In Patients With Marfan Syndrome Reveals Dysfunctional Tgf-Β Signaling, Ashley Dawson, Yanming Li, Yang Li, Pingping Ren, Hernan G. Vasquez, Chen Zhang, Kimberly R. Rebello, Waleed Ageedi, Alon R. Azares, Aladdein Burchett Mattar, Mary Burchett Sheppard, Hong S. Lu, Joseph S. Coselli, Lisa A. Cassis, Alan Daugherty, Ying H. Shen, Scott A. Lemaire

Saha Cardiovascular Research Center Faculty Publications

The molecular and cellular processes leading to aortic aneurysm development in Marfan syndrome (MFS) remain poorly understood. In this study, we examined the changes of aortic cell populations and gene expression in MFS by performing single-cell RNA sequencing (scRNA seq) on ascending aortic aneurysm tissues from patients with MFS (n = 3) and age-matched non-aneurysmal control tissues from cardiac donors and recipients (n = 4). The expression of key molecules was confirmed by immunostaining. We detected diverse populations of smooth muscle cells (SMCs), fibroblasts, and endothelial cells (ECs) in the aortic wall. Aortic tissues from MFS showed alterations …


Resting-State Functional Mri Metrics In Patients With Chronic Mild Traumatic Brain Injury And Their Association With Clinical Cognitive Performance., Faezeh Vedaei, Andrew B. Newberg, Md, Mahdi Alizadeh, Jennifer Muller, Shiva Shahrampour, Devon Middleton, Ms, George Zabrecky, Nancy Wintering, Anthony J. Bazzan Md, Daniel A. Monti, Md, Feroze Mohamed, Phd Dec 2021

Resting-State Functional Mri Metrics In Patients With Chronic Mild Traumatic Brain Injury And Their Association With Clinical Cognitive Performance., Faezeh Vedaei, Andrew B. Newberg, Md, Mahdi Alizadeh, Jennifer Muller, Shiva Shahrampour, Devon Middleton, Ms, George Zabrecky, Nancy Wintering, Anthony J. Bazzan Md, Daniel A. Monti, Md, Feroze Mohamed, Phd

Department of Radiology Faculty Papers

Mild traumatic brain injury (mTBI) accounts for more than 80% of people experiencing brain injuries. Symptoms of mTBI include short-term and long-term adverse clinical outcomes. In this study, resting-state functional magnetic resonance imaging (rs-fMRI) was conducted to measure voxel-based indices including fractional amplitude of low-frequency fluctuation (fALFF), regional homogeneity (ReHo), and functional connectivity (FC) in patients suffering from chronic mTBI; 64 patients with chronic mTBI at least 3 months post injury and 40 healthy controls underwent rs-fMRI scanning. Partial correlation analysis controlling for age and gender was performed within mTBI cohort to explore the association between rs-fMRI metrics and neuropsychological …


Through The Lens: Youth Experiences With Cancer In Rural Appalachian Kentucky Using Photovoice, Katie Gaines, Courtney Martin, Chris Prichard, Nathan L. Vanderford Dec 2021

Through The Lens: Youth Experiences With Cancer In Rural Appalachian Kentucky Using Photovoice, Katie Gaines, Courtney Martin, Chris Prichard, Nathan L. Vanderford

Markey Cancer Center Faculty Publications

Rural Appalachian Kentucky experiences disproportionately high cancer incidence and mortality rates. This cancer burden is due to social determinants of health and cultural factors prominent in the region. The firsthand experiences of community members—especially young people—can highlight these factors and identify areas for improvement. The purpose of this study was to encourage Appalachian Kentucky youth to consider determinants of cancer and visualize the effects that cancer has on their families or communities by asking them to take photographs of cancer-related objects around them. Content analysis was performed on 238 photographs submitted by 25 students, and photographs were organized into themes, …


Personalized Nutrition As A Key Contributor To Improving Radiation Response In Breast Cancer, Anuradha A. Shastri, Joseph Lombardo, Samantha C Okere, Stephanie Higgins, Brittany C Smith, Tiziana Deangelis, Ajay Palagani, Kamryn Hines, Daniel A. Monti, Stella Volpe, Edith P. Mitchell, Nicole L Simone Dec 2021

Personalized Nutrition As A Key Contributor To Improving Radiation Response In Breast Cancer, Anuradha A. Shastri, Joseph Lombardo, Samantha C Okere, Stephanie Higgins, Brittany C Smith, Tiziana Deangelis, Ajay Palagani, Kamryn Hines, Daniel A. Monti, Stella Volpe, Edith P. Mitchell, Nicole L Simone

Department of Radiation Oncology Faculty Papers

Understanding metabolic and immune regulation inherent to patient populations is key to improving the radiation response for our patients. To date, radiation therapy regimens are prescribed based on tumor type and stage. Patient populations who are noted to have a poor response to radiation such as those of African American descent, those who have obesity or metabolic syndrome, or senior adult oncology patients, should be considered for concurrent therapies with radiation that will improve response. Here, we explore these populations of breast cancer patients, who frequently display radiation resistance and increased mortality rates, and identify the molecular underpinnings that are, …


Genetic Contributors Of Incident Stroke In 10,700 African Americans With Hypertension: A Meta-Analysis From The Genetics Of Hypertension Associated Treatments And Reasons For Geographic And Racial Differences In Stroke Studies, Nicole D. Armstrong, Vinodh Srinivasasainagendra, Amit Patki, Rikki M. Tanner, Bertha A. Hidalgo, Hemant K. Tiwari, Nita A. Limdi, Ethan M. Lange, Leslie A. Lange, Donna K. Arnett, Marguerite R. Irvin Dec 2021

Genetic Contributors Of Incident Stroke In 10,700 African Americans With Hypertension: A Meta-Analysis From The Genetics Of Hypertension Associated Treatments And Reasons For Geographic And Racial Differences In Stroke Studies, Nicole D. Armstrong, Vinodh Srinivasasainagendra, Amit Patki, Rikki M. Tanner, Bertha A. Hidalgo, Hemant K. Tiwari, Nita A. Limdi, Ethan M. Lange, Leslie A. Lange, Donna K. Arnett, Marguerite R. Irvin

Epidemiology and Environmental Health Faculty Publications

Background: African Americans (AAs) suffer a higher stroke burden due to hypertension. Identifying genetic contributors to stroke among AAs with hypertension is critical to understanding the genetic basis of the disease, as well as detecting at-risk individuals.

Methods: In a population comprising over 10,700 AAs treated for hypertension from the Genetics of Hypertension Associated Treatments (GenHAT) and Reasons for Geographic and Racial Differences in Stroke (REGARDS) studies, we performed an inverse variance-weighted meta-analysis of incident stroke. Additionally, we tested the predictive accuracy of a polygenic risk score (PRS) derived from a European ancestral population in both GenHAT and REGARDS AAs …


Late-Life Exercise Mitigates Skeletal Muscle Epigenetic Aging, Kevin A. Murach, Andrea L. Dimet-Wiley, Yuan Wen, Camille R. Brightwell, Christine M. Latham, Cory M. Dungan, Christopher S. Fry, Stanley J. Watowich Dec 2021

Late-Life Exercise Mitigates Skeletal Muscle Epigenetic Aging, Kevin A. Murach, Andrea L. Dimet-Wiley, Yuan Wen, Camille R. Brightwell, Christine M. Latham, Cory M. Dungan, Christopher S. Fry, Stanley J. Watowich

Center for Muscle Biology Faculty Publications

There are functional benefits to exercise in muscle, even when performed late in life, but the contributions of epigenetic factors to late-life exercise adaptation are poorly defined. Using reduced representation bisulfite sequencing (RRBS), ribosomal DNA (rDNA) and mitochondrial-specific examination of methylation, targeted high-resolution methylation analysis, and DNAge™ epigenetic aging clock analysis with a translatable model of voluntary murine endurance/resistance exercise training (progressive weighted wheel running, PoWeR), we provide evidence that exercise may mitigate epigenetic aging in skeletal muscle. Late-life PoWeR from 22–24 months of age modestly but significantly attenuates an age-associated shift toward promoter hypermethylation. The epigenetic age of muscle …


Post-Transplant Hepatic Graft Fibrosis In Pediatric Liver-Inclusive Transplant Recipients, Hanh D. Vo Dec 2021

Post-Transplant Hepatic Graft Fibrosis In Pediatric Liver-Inclusive Transplant Recipients, Hanh D. Vo

Theses & Dissertations

Hepatic graft fibrosis is a common histologic finding following pediatric liver transplant (LT) that may affect the long-term graft outcome. Hence, it is essential to identify hepatic graft fibrosis at a stage where fibrosis is not yet clinically apparent but has the potential for progression to initiate appropriate intervention and prevent its progression. Liver biopsy is the gold standard for fibrosis staging, but it is invasive, requires general anesthesia in children, and has potential complications. Our long-term goal is to implement non-invasive tests to assess and monitor the progression of hepatic graft fibrosis in liver-inclusive transplant children. The work presented …


Glad To Be Out. I Was Running Out Of Womb: A Study Of Omega-6 And Omega-3 Fatty Acid Metabolites At Delivery And Their Relationship To Infant Growth, Prematurity, And Admission To The Neonatal Intensive Care Unit, Maranda Thompson Dec 2021

Glad To Be Out. I Was Running Out Of Womb: A Study Of Omega-6 And Omega-3 Fatty Acid Metabolites At Delivery And Their Relationship To Infant Growth, Prematurity, And Admission To The Neonatal Intensive Care Unit, Maranda Thompson

Theses & Dissertations

Normal pregnancy relies on inflammation for implantation, placentation, and parturition, but uncontrolled it can lead to poor infant outcomes. Maternal diet is one modifiable factor that can impact inflammation. Omega-3 and omega-6 fatty acids have been shown to be metabolized into bioactive metabolites that effect inflammation. The presence and importance of these metabolites at the time of delivery are not well understood. Therefore, the purpose of this dissertation was to first quantify omega-3 and omega-6 metabolites in maternal plasma, cord plasma, and placental tissue. Then the relationships between metabolites and infant outcomes, including birth weight percentile, length percentile, head circumferences …


The Effect Of Platelet Rich Plasma On The Treatment Of Androgenetic Alopecia Compared To Placebo, Mackenzie D. Comstock, Hannah E. Stephenson Dec 2021

The Effect Of Platelet Rich Plasma On The Treatment Of Androgenetic Alopecia Compared To Placebo, Mackenzie D. Comstock, Hannah E. Stephenson

Physician Assistant Capstones, 2020-current

Objective: To assess the efficacy of plasma rich proteins (PRP) compared to placebo in the treatment of androgenetic alopecia (AGA).

Design: Systematic literature review

Methods: Searches were done in PubMed utilizing the terms PRP, plasma rich protein, autologous activated PRP, autologous activated plasma rich protein, androgenetic alopecia, placebo, hair count, hair density, hair follicles, hair loss, therapeutic effect, growth factors, dermatology, and regenerative medicine. Articles were excluded if they were published before 2013, involved animal studies, compared minoxidil only in their research, included only female participants, non-English articles, studies with no quantifiable data, review research articles, and injections besides the …


The Ecology Of Mental Health And The Impact Of Barriers On Mental Health Service Utilization, Alisha Aggarwal Dec 2021

The Ecology Of Mental Health And The Impact Of Barriers On Mental Health Service Utilization, Alisha Aggarwal

Theses & Dissertations

Mental health has emerged as a major public health concern in recent times with several disparities and barriers related to adequate health service utilization. Different age groups experience diverse symptoms and face distinct barriers in accessing and utilizing healthcare. Policies like Mental Health Parity and Addiction Equity Act and the Patient Protection and Affordable Care Act were launched to improve insurance coverage and delivery of mental health services. However, a large gap of unmet needs exists for adequate mental health service utilization in the country. This dissertation aims to describe the financial and non-financial barriers to mental health service utilization …


Role Of Serum Amyloid A In Abdominal Aortic Aneurysm And Related Cardiovascular Diseases, Preetha Shridas, Avery C. Patrick, Lisa R. Tannock Dec 2021

Role Of Serum Amyloid A In Abdominal Aortic Aneurysm And Related Cardiovascular Diseases, Preetha Shridas, Avery C. Patrick, Lisa R. Tannock

Internal Medicine Faculty Publications

Epidemiological data positively correlate plasma serum amyloid A (SAA) levels with cardiovascular disease severity and mortality. Studies by several investigators have indicated a causal role for SAA in the development of atherosclerosis in animal models. Suppression of SAA attenuates the development of angiotensin II (AngII)-induced abdominal aortic aneurysm (AAA) formation in mice. Thus, SAA is not just a marker for cardiovascular disease (CVD) development, but it is a key player. However, to consider SAA as a therapeutic target for these diseases, the pathway leading to its involvement needs to be understood. This review provides a brief description of the pathobiological …


The Efficacy Of Plant-Based Dietary Program In Patients With Diabetes: A Pilot Study, Reuben Adatorwovor, Nisha Sharma, Dakota Mccoy, Sharon Wasserstrom, Matthew Robinson, Jacquelyn Nyenhuis, Sowmya Suryanarayanan Dec 2021

The Efficacy Of Plant-Based Dietary Program In Patients With Diabetes: A Pilot Study, Reuben Adatorwovor, Nisha Sharma, Dakota Mccoy, Sharon Wasserstrom, Matthew Robinson, Jacquelyn Nyenhuis, Sowmya Suryanarayanan

Biostatistics Faculty Publications

Dietary choices play a key role in insulin sensitivity among diabetes patients. An 8-week pilot study was conducted to evaluate whether a mostly plant-based dietary program will lead to improvement in biochemical markers in adults with diabetes. The dietary program included educational presentations, weekly cooking demonstrations and small group discussions. A sample of thirty-two adults with diabetes (types 1 and 2) were recruited and seventeen (53%) completed the study. Matched-pair tests and Fishers exact tests were used to compare the changes in means and proportion of the participants’ responses. There were changes in HbA1c, lipids, CRP (mg/L), cholesterol (mg/dL), HDL …


Self-Measured Blood Pressure Monitoring: A Patient Empowerment Project, Alison Cusmano Dec 2021

Self-Measured Blood Pressure Monitoring: A Patient Empowerment Project, Alison Cusmano

Doctor of Nursing Practice Final Manuscripts

Hypertension is a public health issue estimated to affect 112 million adults by 2030. Primary care patients in an outpatient clinic in Southern California with elevated blood pressure readings in the office did not have an organized system for close follow-up. The purpose of this evidence-based project (EBP) was to educate patients on self-measured blood pressure monitoring (SMBP), Dietary Approaches to Stop Hypertension (DASH), diet interventions, and healthy weight loss to improve hypertension rates. Through these interventions, patients developed an understanding of their systolic and diastolic blood pressure goals. Nurse practitioners, medical assistants, and licensed vocational nurses screened for high …


Health-Related Quality Of Life In Children And Adolescents With Chronic Kidney Diseases At Sohag, Egypt: A Case–Control Study, Ahmed M. Hegab, Eman Abdel-Baset Mohamed, Fouad M. A. Yousef, Rasha Gamal-El-Din Abu-El-Goud Dec 2021

Health-Related Quality Of Life In Children And Adolescents With Chronic Kidney Diseases At Sohag, Egypt: A Case–Control Study, Ahmed M. Hegab, Eman Abdel-Baset Mohamed, Fouad M. A. Yousef, Rasha Gamal-El-Din Abu-El-Goud

Journal of Medicine in Scientific Research

Background and objectives Chronic kidney diseases (CKD) have multiple complications that could impair the quality of life in the affected children and their families. This study aimed to assess the health-related quality of life (HRQOL) and detect factors affecting it in children with CKD and their families at Sohag, Egypt. Patients and methods The study included 113 children and adolescents with CKD stages 1–5, aged 2–18 years old, attending the pediatric nephrology outpatient clinic and the pediatric dialysis unit at Sohag University Hospital. Two hundred twenty-six children were in the control-group age and sex matched to cases with urinary-system condition …


Prognostic Effect Of Glycated Hemoglobin In Acute Myocardial Infarction, Mohamad El Bordy, Nadia Youssef Riad Dec 2021

Prognostic Effect Of Glycated Hemoglobin In Acute Myocardial Infarction, Mohamad El Bordy, Nadia Youssef Riad

Journal of Medicine in Scientific Research

Background Impaired glucose tolerance and even prediabetic states have a crucial role as risk factors among several different risk factors in acute myocardial infarction (AMI). Some recent studies have shown that poor diabetes management, diagnosed by glycated hemoglobin (HbA1C), has poor prognostic value regarding future cardiovascular events, whereas other studies recommend that it is the blood glucose level at admission that predicts short-term mortality after AMI and not the HbA1C level. Aim The target of this research is to detect the correlation between the level of HbA1C and risk factors in the patients with AMI and its value regarding the …


Vitamin D And Vitamin D-Binding Protein In Type 1 Diabetes Mellitus, Eman R. Amer, Gehan F. Oreby, Sahar H. Quashwa Dec 2021

Vitamin D And Vitamin D-Binding Protein In Type 1 Diabetes Mellitus, Eman R. Amer, Gehan F. Oreby, Sahar H. Quashwa

Journal of Medicine in Scientific Research

Background and aim Type 1 diabetes mellitus (T1DM) is an autoimmune disease caused by destruction of pancreatic islet βcells, leading to absolute insulin deficiency. The D vitamins are a group of sterols that have a hormone-like function, which bind to vitamin D receptor. Vitamin D (25(OH) D) deficiency is involved in the induction of autoimmune destruction of β-cells and onset of T1DM. The majority of circulating 25(OH) D is bound to vitamin D-binding protein (VDBP), which protects it from biodegradation, limits its access to target tissues, and helps its reabsorption from the kidneys. VDBP also binds fatty acids, activates macrophages, …


The Efficacy Of The Low-Fodmap Diet To Alleviate Symptoms Of Irritable Bowel Syndrome In Adults: A Systematic Review, Jacqueline Nicole Rustom Dec 2021

The Efficacy Of The Low-Fodmap Diet To Alleviate Symptoms Of Irritable Bowel Syndrome In Adults: A Systematic Review, Jacqueline Nicole Rustom

Theses and Dissertations

Irritable bowel syndrome (IBS) is a functional bowel disorder with 6.5% worldwide prevalence that causes gas production, abdominal distension, and abdominal pain or discomfort. This systematic review describes efficacy of the Low-Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols (FODMAP) diet (Low-FODMAP diet or LFD) to alleviate IBS symptoms using the PRISMA guidelines. Nine randomized controlled trials (RCT) and one non-RCT consecutive controlled study published between 2015 to 2019 were identified using PubMed and CENTRAL. Included studies involved adult IBS participants with symptoms of abdominal pain, constipation, and/or diarrhea. A total of 530 participants completed the interventions from the 10 studies included …


Generating Evidence From Contextual Clinical Research In Low- To Middle Income Countries: A Roadmap Based On Theory Of Change, Babar Hasan, Muneera Rasheed, Asra Wahid, Raman Krishna Kumar, Liesl Zuhlke Dec 2021

Generating Evidence From Contextual Clinical Research In Low- To Middle Income Countries: A Roadmap Based On Theory Of Change, Babar Hasan, Muneera Rasheed, Asra Wahid, Raman Krishna Kumar, Liesl Zuhlke

Department of Paediatrics and Child Health

Along with inadequate access to high-quality care, competing health priorities, fragile health systems, and conflicts, there is an associated delay in evidence generation and research from LMICs. Lack of basic epidemiologic understanding of the disease burden in these regions poses a significant knowledge gap as solutions can only be developed and sustained if the scope of the problem is accurately defined. Congenital heart disease (CHD), for example, is the most common birth defect in children. The prevalence of CHD from 1990 to 2017 has progressively increased by 18.7% and more than 90% of children with CHD are born in Low …


Dementia Risk Reduction: Why Haven't The Pharmacological Risk Reduction Trials Worked? An In-Depth Exploration Of Seven Established Risk Factors, Ruth Peters, John Breitner, Sarah James, Gregory A. Jicha, Pierre-Francois Meyer, Marcus Richards, A. David Smith, Hussein N. Yassine, Erin L. Abner, Atticus H. Hainsworth, Patrick G. Kehoe, Nigel Beckett, Christopher Weber, Craig Anderson, Kaarin J. Anstey, Hiroko H. Dodge Dec 2021

Dementia Risk Reduction: Why Haven't The Pharmacological Risk Reduction Trials Worked? An In-Depth Exploration Of Seven Established Risk Factors, Ruth Peters, John Breitner, Sarah James, Gregory A. Jicha, Pierre-Francois Meyer, Marcus Richards, A. David Smith, Hussein N. Yassine, Erin L. Abner, Atticus H. Hainsworth, Patrick G. Kehoe, Nigel Beckett, Christopher Weber, Craig Anderson, Kaarin J. Anstey, Hiroko H. Dodge

Neurology Faculty Publications

Identifying the leading health and lifestyle factors for the risk of incident dementia and Alzheimer's disease has yet to translate to risk reduction. To understand why, we examined the discrepancies between observational and clinical trial evidence for seven modifiable risk factors: type 2 diabetes, dyslipidemia, hypertension, estrogens, inflammation, omega-3 fatty acids, and hyperhomocysteinemia. Sample heterogeneity and paucity of intervention details (dose, timing, formulation) were common themes. Epidemiological evidence is more mature for some interventions (eg, non-steroidal anti-inflammatory drugs [NSAIDs]) than others. Trial data are promising for anti-hypertensives and B vitamin supplementation. Taken together, these risk factors highlight a future need …


Hypothalamic Steroid Receptor Coactivator-2 Regulates Adaptations To Fasting And Overnutrition, Yongjie Yang, Yanlin He, Hailan Liu, Wenjun Zhou, Chunmei Wang, Pingwen Xu, Xing Cai, Hesong Liu, Kaifan Yu, Zhou Pei, Ilirjana Hyseni, Makoto Fukuda, Qingchun Tong, Jianming Xu, Zheng Sun, Bert W O'Malley, Yong Xu Dec 2021

Hypothalamic Steroid Receptor Coactivator-2 Regulates Adaptations To Fasting And Overnutrition, Yongjie Yang, Yanlin He, Hailan Liu, Wenjun Zhou, Chunmei Wang, Pingwen Xu, Xing Cai, Hesong Liu, Kaifan Yu, Zhou Pei, Ilirjana Hyseni, Makoto Fukuda, Qingchun Tong, Jianming Xu, Zheng Sun, Bert W O'Malley, Yong Xu

Faculty, Staff and Students Publications

The neuroendocrine system coordinates metabolic and behavioral adaptations to fasting, including reducing energy expenditure, promoting counterregulation, and suppressing satiation and anxiety to engage refeeding. Here, we show that steroid receptor coactivator-2 (SRC-2) in pro-opiomelanocortin (POMC) neurons is a key regulator of all these responses to fasting. POMC-specific deletion of SRC-2 enhances the basal excitability of POMC neurons; mutant mice fail to efficiently suppress energy expenditure during food deprivation. SRC-2 deficiency blunts electric responses of POMC neurons to glucose fluctuations, causing impaired counterregulation. When food becomes available, these mutant mice show insufficient refeeding associated with enhanced satiation and discoordination of anxiety …


Decreasing Pre-Procedural Fasting Times: A Benchmark Study, Sheila Gasparek Dec 2021

Decreasing Pre-Procedural Fasting Times: A Benchmark Study, Sheila Gasparek

MSN Capstone Projects

On a busy Surgical Trauma unit, scheduled procedures and operations are often delayed for priority emergent cases. Patients admitted to the unit with delayed procedures often endure extended fasting times beyond the six-hour intention of standard nothing by mouth (NPO) after midnight fasting order. With prolonged fasting times, patients inquire about pending surgery times and dietary options. Some providers may allow ice chips, but most doctors prefer patients to remain NPO in case Operating Room availability opens for surgery, leaving already anxious and uncomfortable patients more frustrated as prolonged fasting affects patients’ physical and psychological well-being (Anderson & Comrie, 2009). …


Bile Acid Profiling Reveals Distinct Signatures In Undernourished Children With Environmental Enteric Dysfunction, Xueheng Zhao, Kenneth D R. Setchell, Rong Huang, Indika Mallawaarachchi, Lubaina Ehsan, Edward Dobrzykowski Iii, Junfang Zhao, Sana Syed, Najeeha Talat Iqbal, Junaid Iqbal, Kamran Sadiq, Sheraz Ahmed, Syed Asad Ali Dec 2021

Bile Acid Profiling Reveals Distinct Signatures In Undernourished Children With Environmental Enteric Dysfunction, Xueheng Zhao, Kenneth D R. Setchell, Rong Huang, Indika Mallawaarachchi, Lubaina Ehsan, Edward Dobrzykowski Iii, Junfang Zhao, Sana Syed, Najeeha Talat Iqbal, Junaid Iqbal, Kamran Sadiq, Sheraz Ahmed, Syed Asad Ali

Department of Paediatrics and Child Health

Background: Intestinal inflammation and malabsorption in environmental enteric dysfunction (EED) are associated with early childhood growth faltering in impoverished settings worldwide.
Objectives: The goal of this study was to identify candidate biomarkers associated with inflammation, EED histology, and as predictors of later growth outcomes by focusing on the liver-gut axis by investigating the bile acid metabolome.
Methods: Undernourished rural Pakistani infants (n = 365) with weight-for-height Z score (WHZ) < -2 were followed up to the age of 24 mo and monitored for growth, infections, and EED. Well-nourished local children (n = 51) were controls, based on consistent WHZ > 0 and height-for-age Z score (HAZ) > -1 on 2 consecutive visits at 3 and 6 mo. Serum bile acid (sBA) profiles were measured by tandem MS at the ages of 3-6 …


Using The Behaviour Change Wheel Program Planning Model To Design Games For Health: Development Study, Michael C Robertson, Tom Baranowski, Debbe Thompson, Karen M Basen-Engquist, Maria Chang Swartz, Elizabeth J Lyons Dec 2021

Using The Behaviour Change Wheel Program Planning Model To Design Games For Health: Development Study, Michael C Robertson, Tom Baranowski, Debbe Thompson, Karen M Basen-Engquist, Maria Chang Swartz, Elizabeth J Lyons

Faculty, Staff and Students Publications

BACKGROUND: Games for health are a promising approach to health promotion. Their success depends on achieving both experiential (game) and instrumental (health) objectives. There is little to guide game for health (G4H) designers in integrating the science of behavior change with the art of game design.

OBJECTIVE: The aim of this study is to extend the Behaviour Change Wheel program planning model to develop Challenges for Healthy Aging: Leveraging Limits for Engaging Networked Game-Based Exercise (CHALLENGE), a G4H centered on increasing physical activity in insufficiently active older women.

METHODS: We present and apply the G4H Mechanics, Experiences, and Change (MECHA) …


Qualitative Exploration Of Feasibility And Acceptability Of The Modified Atkins Diet Therapy For Children With Drug Resistant Epilepsy In Kenya, Pauline Samia, Violet Naanyu, J. Helen Cross, Richard Idro, Paul Boon, Jo Wilmshurst, Stanley Luchters Dec 2021

Qualitative Exploration Of Feasibility And Acceptability Of The Modified Atkins Diet Therapy For Children With Drug Resistant Epilepsy In Kenya, Pauline Samia, Violet Naanyu, J. Helen Cross, Richard Idro, Paul Boon, Jo Wilmshurst, Stanley Luchters

Paediatrics and Child Health, East Africa

Purpose: Approximately one-third of children with epilepsy have clinical syndromes characterized by drug resistance. Modified Atkins dietary therapy (MADT) can reduce seizures and improve health out- comes for these children. This intervention is yet to be consistently offered as standard of care in sub- Saharan Africa.

Objectives: This study aimed to assess feasibility and acceptability of MADT for children with drug- resistant epilepsy and identify enabling strategies for implementation and adherence to the MADT. Methods: This qualitative inquiry utilized in-depth interviews with purposively selected caregivers and adolescent patients having used MADT for drug-resistant epilepsy. A qualified team consisting …


Metabolic Syndrome And Acute Respiratory Distress Syndrome In Hospitalized Patients With Covid-19, Joshua L Denson, Aaron S Gillet, Yuanhao Zu, Margo Brown, Thaidan Pham, Yilin Yoshida, Franck Mauvais-Jarvis, Ivor S Douglas, Mathew Moore, Kevin Tea, Andrew Wetherbie, Rachael Stevens, John Lefante, Jeffrey G Shaffer, Donna Lee Armaignac, Katherine Belden, Margit Kaufman, Smith F Heavner, Valerie C Danesh, Sreekanth R Cheruku, Catherine A St Hill, Karen Boman, Neha Deo, Vikas Bansal, Vishakha K Kumar, Allan J Walkey, Rahul Kashyap, Society Of Critical Care Medicine Discovery Viral Infection And Respiratory Illness Universal Study (Virus): Covid-19 Registry Investigator Group Dec 2021

Metabolic Syndrome And Acute Respiratory Distress Syndrome In Hospitalized Patients With Covid-19, Joshua L Denson, Aaron S Gillet, Yuanhao Zu, Margo Brown, Thaidan Pham, Yilin Yoshida, Franck Mauvais-Jarvis, Ivor S Douglas, Mathew Moore, Kevin Tea, Andrew Wetherbie, Rachael Stevens, John Lefante, Jeffrey G Shaffer, Donna Lee Armaignac, Katherine Belden, Margit Kaufman, Smith F Heavner, Valerie C Danesh, Sreekanth R Cheruku, Catherine A St Hill, Karen Boman, Neha Deo, Vikas Bansal, Vishakha K Kumar, Allan J Walkey, Rahul Kashyap, Society Of Critical Care Medicine Discovery Viral Infection And Respiratory Illness Universal Study (Virus): Covid-19 Registry Investigator Group

Division of Infectious Diseases and Environmental Medicine Faculty Papers

Importance: Obesity, diabetes, and hypertension are common comorbidities in patients with severe COVID-19, yet little is known about the risk of acute respiratory distress syndrome (ARDS) or death in patients with COVID-19 and metabolic syndrome.

Objective: To determine whether metabolic syndrome is associated with an increased risk of ARDS and death from COVID-19.

Design, setting, and participants: This multicenter cohort study used data from the Society of Critical Care Medicine Discovery Viral Respiratory Illness Universal Study collected from 181 hospitals across 26 countries from February 15, 2020, to February 18, 2021. Outcomes were compared between patients with metabolic syndrome (defined …