Digital Commons Network^™

Gastric Hibernoma: A Novel Location And Presentation Of A Rare Tumor., Shane P Smith, Andrew F Feczko, Matias Mihura, Jey-Hsin Chen, Alexander S Farivar

Articles, Abstracts, and Reports

We present a case of gastric hibernoma, an unusual tumor with a location novel to the literature. A 39-year-old female presented with one year of upper gastrointestinal bleeding and dysphagia. Gastroenterology performed an esophagogastroduodenoscopy with ultrasound and identified a 6 cm mass within the muscularis propria of the antrum. Computed tomography demonstrated a 9.7 × 7.8 × 4.8 cm

Symptom Clusters And Quality Of Life Trajectories In Breast Cancer Patients Before And After Chemotherapy, Gaurav Kumar

Capstone Experience: Master of Public Health

Context. Breast cancer patients experience multiple concurrent symptoms before and after chemotherapy (CTX). Physical and psychological symptoms may persist after treatment and reduce the quality of life (QOL) of survivors.

Objectives. Identify differences in prevalence and severity of symptoms at three times within 1- year of starting CTX; and identify symptom cluster and QOL trajectories over these times in breast cancer patients.

Methods. Symptoms were identified in breast cancer patients (N=219) before the start of CTX (baseline), 30 days after the last CTX, and 1-year after the first CTX. Hospital Anxiety and Depression Scale and Symptom Experience Scale …

Corticosteroid Administration To Prevent Complications Of Anterior Cervical Spine Fusion: A Systematic Review., Shayan Abdollah Zadegan, Seyed Behnam Jazayeri, Aidin Abedi, Hirbod Nasiri Bonaki, Alexander R. Vaccaro, Vafa Rahimi-Movaghar

Rothman Institute Papers

Study Design: Systematic review.

Objectives: Anterior cervical approach is associated with complications such as dysphagia and airway compromise. In this study, we aimed to systematically review the literature on the efficacy and safety of corticosteroid administration as a preventive measure of such complications in anterior cervical spine surgery with fusion.

Methods: Following a systematic literature search of MEDLINE, Embase, and Cochrane databases in July 2016, all comparative human studies that evaluated the effect of steroids for prevention of complications in anterior cervical spine surgery with fusion were included, irrespective of number of levels and language. Risk of bias was assessed …

Quality Of Life Associated With Physical Activity But Not Sedentary Time In Youth, K. Kattelmann, E. Hofer, C. Merfeld, J. Meendering, M. Olfert, J. White, S. Colby, R. Meade, L. Franzen-Castle, T. Aquirre, D. Matthews, A. White

Health and Nutritional Sciences Faculty Publications

Purpose: It has been reported that youth who engaged in more screen time had lower quality of life scores compared to those that were more physically active. Furthermore, increased sedentary behavior increases health risks particularly the risk for obesity. A cross-sectional analysis was completed to examine the relationship between healthrelated quality-of-life (HRQOL) and accelerometer-measured sedentary time (ST) and physical activity (PA) in 9-10-yearold youth who were recruited for the family-based, childhood obesity intervention, iCook 4-H. It was hypothesized that objectively measured ST would be negatively correlated and PA would be positively correlated with HRQOL.
Methods: A subset of participants (n=118) …

Obesity: Modern Medicine Vs. Lifestyle, Jenny Christianson

Physician Assistant Scholarly Project Papers

Obesity is a rising epidemic, and is one of the most common, costly and preventable health problems the world is experiencing today (Center for Disease Control and Prevention, [CDC], 2017). From this, it is important to establish an effective treatment plan that can be implemented across the nation for maximum patient benefit. Lifestyle changes such as diet and exercise are important to any health care plan and are equally necessary to reduce health risks. However, in certain patients, lifestyle changes are not enough due to the maladaptive biologic process in their brain. From this, additional treatment options need to be …

A Cross-Training Program Does Not Alter Self-Reported Physical Activity Levels In Elementary School Children, Melody L. White, Matthew S. Renfrow, Richards S. Farley, Dana K. Fuller, Brandi M. Eveland-Sayers, Jennifer L. Caputo

ETSU Faculty Works

The purpose of the study was to examine the effects of a school-based cross-training program on body mass index (BMI), attitudes toward physical activity (ATPA), and physical activity (PA) levels of children in the 4^th and 5^th grades. Children (N = 118) were divided into control (n = 60) and experimental (n = 58) groups based on class availability. While the control group continued academic classes as usual, the experimental group participated in cross-training involving resistance training (RT), calisthenics, and stretching twice a week for 10 weeks. Pre- and post-intervention measures included height, mass, ATPA, and PA. BMI …

Intestinal Permeability And Microbial Dysbiosis In Acute Coronary Syndrome (Miacs Study), Tarik Z. Alhmoud

Biomedical Sciences ETDs

Background: Acute Coronary Syndrome (ACS) is a leading cause of morbidity and mortality. Metabolic syndrome and obesity are major risk factors for atherosclerosis and ACS. Dysbiosis plays an important role in metabolic syndrome and obesity. Studies show a markedly increased risk of heart attacks in patients with high levels of the pro-atherogenic metabolite trimethylamine-N-Oxide (TMAO). TMAO is produced by the intestinal microbial flora through metabolism of dietary phospholipids; Gram-negative bacteria (Phylum Proteobacteria) is the major source of TMAO metabolism. Patients with obesity and metabolic syndrome have a defective intestinal tight-junctional (TJ) barrier, which allows paracellular permeation of luminal antigens such …

Survey Of Sensory Diet Use Among California Occupational Therapy Practitioners, Morganne Peterson, Allison Hunt, Emily White

Dissertations, Masters Theses, Capstones, and Culminating Projects

The purpose of this study was to examine the use of sensory diets in the field of occupational therapy. This study investigated the use of sensory diets among California occupational therapy practitioners. A mixed-methods design was used to collect data through an online survey. The survey was sent out to members of the Occupational Therapy Association of California (OTAC) and received 98 respondents within one month. Participants worked among various clinical settings and implemented sensory diets with various client populations. Practitioners reported using terms such as “sensory strategies,” “sensory tools,” and “sensory supports” which indicates an overall misunderstanding associated with …

Code Lite: Developing Pediatric Residents’ Resuscitation Knowledge And Skills Using A Guided Mentoring Approach, Alyssa Stoner, Jenna Miller, Jennifer Flint, Shekinah Hensley, Brian Lee, Kadriye O. Lewis

Posters

Background: Simulation-based learning is a popular training method in healthcare education. Literature supports multiple aspects of simulation-based training for technical skills and behavioral skills, however the effects of different pedagogies have not been investigated in this educational method.

Objective: Examine the effects of guided mentorship during simulation on pediatric residents’ learning experience.

The Affective Domain And The Intersection Of Learning In Emergency Medical Technician Paramedic Education, Meghan Williams

Dissertations, Theses, and Capstone Projects

Bloom identified three separate domains for learning: the psychomotor, cognitive, and affective domains. In this thesis, I propose that for paramedic education, the affective domain is not a domain to master equal to the psychomotor and cognitive domains, but must be mastered prior to the other domains in order to fully optimize learning. I propose that students must have a basic ability to apply the skills of the affective domain, and unlike the other domains, mastery of the almost the entire domain must be achieved before a student can complete the two other domains to be successful in a Paramedic …

Predicting Risk Of Hospitalisation: A Retrospective Population-Based Analysis In A Paediatric Population In Emilia-Romagna, Italy., Daniel Z. Louis, Clara A. Callahan, Mary Robeson, Mengdan Liu, Jacquelyn Mcrae, Joseph S. Gonnella, Marco Lombardi, Vittorio Maio

College of Population Health Faculty Papers

OBJECTIVES: Develop predictive models for a paediatric population that provide information for paediatricians and health authorities to identify children at risk of hospitalisation for conditions that may be impacted through improved patient care.

DESIGN: Retrospective healthcare utilisation analysis with multivariable logistic regression models.

DATA: Demographic information linked with utilisation of health services in the years 2006-2014 was used to predict risk of hospitalisation or death in 2015 using a longitudinal administrative database of 527 458 children aged 1-13 years residing in the Regione Emilia-Romagna (RER), Italy, in 2014.

OUTCOME MEASURES: Models designed to predict risk of hospitalisation or death in …

The Effect Of Napping On Sleep Quality And Quantity In Healthy And Concussed Collegiate Athletes, Katie Stephenson-Brown

Graduate Theses and Dissertations

Clinicians are increasingly prescribing a regulated sleep schedule to athletes post injury; however, baseline sleep habits of collegiate athletes are unknown. Moreover, the connection between napping and sleep quality and quantity has not been studied in collegiate athletes. Therefore, the purpose of this study is to investigate napping behaviors and their effects on sleep quantity and quality in concussed and non-concussed collegiate athletes. In a sample of 233 non-concussed collegiate athletes, 74% (172/233) of participants reported napping. Napping was not significantly associated with sleep quantity (χ 2 (2) = .23, p = .64) or quality (χ 2 (1) = .42, …

The Effect Of Cellular Dehydration On Glucose Regulation In Lean And Obese Females, Chunbo Yang

Graduate Theses and Dissertations

A chronically elevated vasopressin level has been associated with an impaired glucose regulation system in humans. A recent study in patients with diabetes suggested that low water intake is associated with impaired glucose regulation. The aim of this study was to examine the effect of hypertonic saline infusion on glucose regulation in healthy females. Thirty healthy, non-diabetic females performed a 2-h infusion followed by a 4-h oral glucose tolerance test (OGTT). Every subject participated in two trials separated by one month, in a counterbalanced order. Two trials were identical in the procedure, differing in the concentration of saline infusion, with …

Disordered Eating Risk And Body Image Dissatisfaction Of Division I Male And Female Cheerleaders, Christopher Blaszka

Graduate Theses and Dissertations

The sport of cheerleading is growing both in the high school and college setting, however there is little research on cheerleaders specifically, both sideline and competitive. It is clear that while this sport does not benefit from being affiliated with the NCAA, the athletes are still at large risk for disordered eating and eating disorders, and are in need of more accurate screening and prevention methods. With the lack of cheerleading studies in general, there is an even larger scarcity of studies that focus on males in cheerleading. The current study aims to fill the gap in the research regarding …

A Review Of Mesenchymal Stem Cell Injections For Osteoarthritis, Ammar Qureshi, Jill Goodwin, Franklin D. Shuler, Timothy Wilson-Byrne, John J. Jasko, Charles Giangarra

Marshall Journal of Medicine

Mesenchymal stem cell (MSC) injections for osteoarthritis is reviewed.

Methods- PubMed search identifying articles in English from 2003-2018 that used intra- articular injection (IA), cartilage repair, cartilage regeneration, chondral injury, adipose stem cells, bone marrow stem cells, mesenchymal stem cells, or autologous stem cells.

Results – 388 patients receiving IA MSC injections are discussed with data obtained from 10 case reports or case series, 4 randomized clinical trials (RCT), 1 cohort study, and 3 case controlled therapeutic studies.

Conclusions – MSC injections may be an effective adjunct in the management of osteoarthritis and a variety of cartilage related pathologies.

A Cytotoxic Evaluation Of A Chalcone Derivative Library On A549 Cells, Mary Elaine Kuo

Undergraduate Theses

Chalcones, a precursor to flavonoids, are chemical compounds found naturally in plants. The chalcones’ structure consists of a ketone bridge attached to two aromatic rings. Varying substituents on the aromatic rings allow for different affects, including anti-cancer properties. As a Michael acceptor, chalcones interact with pathways that cause inhibition of the initiation, promotion, and progression of cancer tumors. We have screened 32 compounds for growth inhibition in lung cells that vary the flexibility and confirmation of the 3 carbon bridge between the two aromatic rings as well as the effects of electronic modifications to the aromatic ring. We have found …

A Multi-Faceted Intervention To Improve Naloxone Co-Prescription Rates Among Primary Care Providers, Jolane S. Conklin

Evidence-Based Practice Project Reports

It is estimated that 91 Americans die every day due to opioid overdoses, with at least half of those overdoses involving an opioid prescription (CDC, 2016d). To address this issue, the U.S. Department of Health and Human Services (USDHHS) has initiated an opioid initiative, and the Centers for Disease Control and Prevention (CDC) has released a clinical guideline, both of which include a focus on increasing use of naloxone. Despite these recommendations, providers often fail to co-prescribe naloxone to patients at increased risk of opioid overdose. The purpose of this evidence-based practice (EBP) project was to evaluate the effect of …

Problems Experienced In The First Month After Discharge From A Heart Failure-Related Hospitalization, Joan S. Grant, Lucinda J. Graven, Kelly Fuller

Journal of Patient-Centered Research and Reviews

Purpose: Heart failure is a global health concern with high morbidity and mortality rates. Individuals with heart failure commonly experience problems that impact daily life. However, little is known regarding which problems are most significant during the immediate posthospitalization period. Thus, the purpose of this study was to identify high-priority problems experienced by individuals the first month after discharge from an acute care facility with a diagnosis of heart failure.

Methods: This descriptive, exploratory study was part of a 12-week randomized controlled pilot study that examined the efficacy of a coping partnership intervention (COPE-HF Partnership) between a trained research nurse …

'No Pink Ribbons': How Women's Lived Experiences With Breast Atypia Inform Decisions Involving Risk-Reducing Medications, Sarah L. Goff, Reva Kleppel, Grace Makari-Judson

Journal of Patient-Centered Research and Reviews

Purpose: Atypical hyperplasia (AH) is associated with a nearly 4-fold elevation of lifetime risk for breast cancer, and lobular carcinoma in situ (LCIS) is associated with a 7- to 8-fold risk. Women with AH/LCIS make numerous decisions in the course of treatment, including whether to take a risk-reducing medication, an option relatively few women pursue. We explored women’s decision-making processes through patient narratives in an effort to inform decision supports for AH/LCIS.

Methods: We conducted in-depth interviews with 20 English-speaking women with AH/LCIS and no subsequent diagnosis of invasive breast cancer who had enrolled in the Rays of Hope Center …

Investigating The Synergistic Effects Of Two Curcuminoids And Cisplatin On Cancer Cell Reactive Oxygen Species, Matthew Millay

Mahurin Honors College Capstone Experience/Thesis Projects

Cisplatin is an anticancer drug which can cause the production of reactive oxygen species (ROS) that kill cancer cells. Curcumin is a naturally occurring plant compound that can increase ROS levels in cancer cells and enhance the activity of cisplatin against cancer, but it exhibits poor bioavailability. We investigated whether two synthetic curcumin analogs (curcuminoids), EF-24 and CLEFMA, with anti-cancer activity and improved bioavailability, increased cisplatin’s effect against cancer. A spectrophotometric fluorescent ROS assay was used to determine if cisplatin, the curcuminoids or combinations of cisplatin with a curcuminoid affected the level of ROS in the A549 non-small cell lung …

Associations Between Feeding Practices And Growth And Neurodevelopmental Outcomes, Barbara T. Do, Nellie I. Hansen, Carla Bann, Rebecca L. Lander, Shivaprasad S. Goudar, Omrana Pasha, Elwyn Chomba, Sangappa M. Dhaded, Vanessa R. Thorsten, Jan L. Wallander, Fred J. Biasini, Richard Derman, Robert L. Goldenberg, Waldemar A. Carlo

Global Health Articles

Background

Feeding practices over the first several years of a child’s life can critically influence development. The purpose of this study was to examine associations between feeding practices and growth and neurodevelopmental outcomes at 36 months of age among children from low- and low-middle-income countries (LMIC).

Methods

We conducted a secondary analysis using data collected from children in India, Pakistan, and Zambia who were enrolled in a randomized controlled trial of a home-based early development intervention program called Brain Research to Ameliorate Impaired Neurodevelopment Home-based Intervention Trial. Qualitative dietary data collected at 36 months was used to assess the modified …

Value Of Toll-Like Receptor 3 (Tlr3) In Chronic Kidney Disease Patients With Hepatitis C Virus Infection, Aisha El-Shimy, El-Saied Shabaan, Hala Ibrahim, Iman Kamel, Tarek Fouad

Journal of Medicine in Scientific Research

Background Hepatitis C virus (HCV) infection is a severe public health problem with a worldwide predominance of 3%. An estimated 5–20% of infected patients develop cirrhosis annually, and 1–4% of them develop hepatocellular carcinoma. In Egypt, the prevalence of HCV antibody and HCV RNA are 10.0 and 7.0%, respectively, in the 15–59 years age group. In children of 1–14 years old, the prevalence of HCV antibody and HCV RNA are 0.4 and 0.2%, respectively. HCV infection is a cause of chronic kidney disease (CKD) and results in a significant problem in hemodialysis (HD) patients. Toll-like receptors (TLRs) might have an …

Evaluation Of Nutrition Intake Of Football Players, Heba S. Abdelhaliem, Hoda M. El Gezrey

Journal of Medicine in Scientific Research

Introduction Despite football being the most popular sport in Egypt, most players do not know their needed nutritional requirements. The metabolic rate and energy consumption increased dramatically in football players. Thus, nutrition plays a significant role in improving the performance and the quality of life for these players. Objective This study aimed to assess the nutritional status of 50 football players aged between 15 and 19 years in Gomhorya Club – Menoufia. Participants and methods Dietary intake was evaluated for 7 days by using dietary assessment tools (24-h recall). This data was used to determine energy, macronutrients, micronutrients, and fiber. …

Prevalence Of Prediabetes, Diabetes, And Its Associated Risk Factors Among Males In Saudi Arabia: A Population-Based Survey, Khaled K. Aldossari, Abdulrahman Aldiab, Jamaan M. Al-Zahrani, Sameer H. Al-Ghamdi, Mohammed Abdelrazik, Mohammed Ali Batais, Sundas Javad, Shanila Nooruddin, Hira Abdul Razzak, Ashraf El-Metwally

Department of Paediatrics and Child Health

Objectives: The study aims at determining the prevalence of prediabetes and diabetes and at ascertaining some concomitant risk factorsamong males in Saudi Arabia.
Methods: A population-based cross-sectional study including 381 Saudi adult males from different institutions was recruited. Odds ratios for diabetes risk and risk factors were calculated using log-binomial and multinomial logistic regression, using STATA version 12.
Results: The participants included 381 diabetic males with a median age of 45 years, average body mass index of 25 ± 40 kg/m², whereas waist circumferences ranged from 66 to 180 cm in the male study population. In addition, 27.82% …

Predictors Of Low Birth Weight And 24-Hour Perinatal Outcomes At Muhimbili National Hospital In Dar Es Salaam, Tanzania: A Five-Year Retrospective Analysis Of Obstetric Records, Benjamin Anathory Kamala, Andrew Hans Mgaya, Matilda Michael Ngarina, Hussein Kidanto

Obstetrics and Gynaecology, East Africa

Abstract

Introduction: The global prevalence of low birth weight (LBW) is 16%, representing more than 20 million infants worldwide, of which 96% are born in low-income countries. This study aimed to determine the prevalence, predictors and perinatal outcomes of LBW newborns.

Methods: We conducted a retrospective analysis of data obtained from the hospital's obstetric and neonatal database. Descriptive statistics and multivariate logistic regression were performed with 95% confidence intervals (CI).

Results: The prevalence of LBW was 21% (n = 8,011) and two-thirds of these were delivered at term. Seven percent of newborns were stillbirths and 2% died within 24hrs after …

Out Of The Shell: Exploring The Phagocytic Capabilities Of The B Cell And Isolated Lymphoid Follicle-Lie Structures In The Red-Eared Slider, Trachemys Scripta, Marc A. Ashford Jr.

Theses and Dissertations

Management of immunity is crucial for survival in all living organisms. While there is a large amount of research for established model organisms, such as the mouse model, much less is known about reptiles. When compared to immunity in mammals, we discover many differences such as susceptibility to certain pathogens, alteration of immune processes due to environmental temperature, the total absence of certain lymphoid organs contained in mammals, among many others. Despite this, the reptile has shown in many studies that they are worthy systems to study immunity in an evolutionary perspective and recent studies may show that they may …

Do Global Diets Affect The Rate Of Type 2 Diabetes?, Demetria Meyer

Honors Theses

The purpose of this study is to determine whether different global diets correlate with the increase in type 2 diabetes rates. Type 2 diabetes is the main diabetes type being looked at due to it being the one that can be maintained primarily by glycemic control, which is controlled by a good diet. Five different countries from different regions will be examined: Brazil, China, Micronesia, Nigeria, and the United States. The diets of these countries will be broken down into smaller pieces, like calories consumed each day and the percentage of macronutrients that make up the calories. Eleven food groups …

Macrophage-Derived Il-1Β/Nf-Κb Signaling Mediates Parenteral Nutrition-Associated Cholestasis., Karim C El Kasmi, Padade M Vue, Aimee L Anderson, Michael W Devereaux, Swati Ghosh, Natarajan Balasubramaniyan, Sophie A Fillon, Carola Dahrenmoeller, Ayed Allawzi, Crystal Woods, Sarah Mckenna, Clyde J Wright, Linda Johnson, Angelo D'Alessandro, Julie A Reisz, Eva Nozik-Grayck, Frederick J Suchy, Ronald J Sokol

Articles, Abstracts, and Reports

In infants intolerant of enteral feeding because of intestinal disease, parenteral nutrition may be associated with cholestasis, which can progress to end-stage liver disease. Here we show the function of hepatic macrophages and phytosterols in parenteral nutrition-associated cholestasis (PNAC) pathogenesis using a mouse model that recapitulates the human pathophysiology and combines intestinal injury with parenteral nutrition. We combine genetic, molecular, and pharmacological approaches to identify an essential function of hepatic macrophages and IL-1β in PNAC. Pharmacological antagonism of IL-1 signaling or genetic deficiency in CCR2, caspase-1 and caspase-11, or IL-1 receptor (which binds both IL-1α and IL-1β) prevents PNAC in …

Evaluating The Effectiveness Of Text Messaging And Phone Call Reminders To Minimize No Show At Pediatric Outpatient Clinics In Pakistan: Protocol For A Mixed-Methods Study, Sana Saeed, Noureen Somani, Fatima Sharif, Abdul Momin Kazi

Department of Paediatrics and Child Health

Background: Missing health care appointments without canceling in advance results in a no show, a vacant appointment slot that cannot be offered to others. No show can be reduced by reminding patients about their appointment in advance. In this regard, mobile health (mHealth) strategy is to use text messaging (short message service, SMS), which is available on all cellular phones, including cheap low-end handsets. Nonattendance for appointments in health care results in wasted resources and disturbs the planned work schedules.
Objectives: The purpose of this study is to evaluate the efficacy of the current text messaging (SMS) and call-based …

A Behavioral Lifestyle Intervention Enhanced With Multiple-Behavior Self-Monitoring Using Mobile And Connected Tools For Underserved Individuals With Type 2 Diabetes And Comorbid Overweight Or Obesity: Pilot Comparative Effectiveness Trial, Jing Wang, Chunyan Cai, Nikhil Padhye, Philip Orlander, Mohammad Zare

Faculty, Staff and Student Publications

BACKGROUND: Self-monitoring is a cornerstone of behavioral lifestyle interventions for obesity and type 2 diabetes mellitus. Mobile technology has the potential to improve adherence to self-monitoring and patient outcomes. However, no study has tested the use of a smartphone to facilitate self-monitoring in overweight or obese adults with type 2 diabetes mellitus living in the underserved community.

OBJECTIVE: The aim of this study was to examine the feasibility of and compare preliminary efficacy of a behavioral lifestyle intervention using smartphone- or paper-based self-monitoring of multiple behaviors on weight loss and glycemic control in a sample of overweight or obese adults …