Digital Commons Network^™

The Relationship Between The Metabolic Responsiveness To A High-Fat Meal And An Acute Bout Of Moderateintensity Exercise Among Postpartum Women, Apoorva Tadakaluru

Masters Theses & Specialist Projects

Background: There has been very little research regarding the metabolic health of women during the postpartum period. Metabolic flexibility is the physiological ability to alter substrate oxidation in response to substrate availability and is a good indicator of overall metabolic health. Metabolic flexibility can be assessed by placing metabolic demands on the body and observing metabolic responsiveness- two examples of such metabolic stressors are lipid oxidation rates in response to a high-fat meal and as well as exercise. However, it is unknown whether postpartum women will respond similarly to these two different types of metabolic stressors. This information will allow …

Characteristics Of Correctly Identified Pediatric Obesity And Overweight Status And Management In An Academic General Pediatric Clinic, Ana Morais, Joseph Kelly, James E. Bost, Susma Vaidya

GW Research Days 2016 - 2020

Objective: The goals of this study were to identify and characterize the rates of documentation and guideline-based management of overweight and obese children within an academic pediatric clinic.

Population/Methods: Overweight, obese, and severely obese children were identified from 7,422 well child visits in 2016 within a primary care clinic that cares for a primarily urban, minority (80% African American), and Medicaid (85%) population until the age of 12. During this 1-year study, there were 79 pediatric residents, 19 attending pediatricians, and 5 nurse practitioners who treated patients. Through a retrospective electronic medical record review, diagnosis and treatment including counseling, …

Evaluation Of Group Movement Programs (Plié And Paired Plié) For People With Memory Loss, Alzheimer’S Disease Or Dementia, Martin Blanco, Deborah Barnes

GW Research Days 2016 - 2020

Today, one in ten people ages 65 and older have Alzheimer’s dementia. This serious condition often causes great suffering among affected individuals and their families, and there are no medications that stop or slow the disease. It is therefore important to evaluate alternative interventions that may benefit both patients and their care partners. Preventing Loss of Independence through Exercise (PLIÉ) and Paired PLIÉ are group movement programs that combine neuroscience and integrative medicine for individuals with dementia. We analyzed data from [N=39] anonymous evaluation surveys performed as part of two ongoing randomized control trials. Survey data included general questions on …

Disparities In Diabetes Rates And Quality Of Care Within Immigrants In The Usa, Anyun Chatterjee, Martin Blanco, George Gray

GW Research Days 2016 - 2020

Immigrants to the USA present an interesting opportunity to test the classical public health question of the impact of place on a health outcome. Diabetes is a prevalent disease in the USA which is slated to rise in rate in the future. Currently, 9.4% of the country is diabetic, and another 28% of the country is prediabetic. We posed the question - is this impact felt disproportionately by immigrants as they live in the US for a decade or more? Our preliminary literature search indicated that this has not been studied extensively, although the impact of American fast food on …

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

Faculty of Health Sciences, East Africa

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 birth. …

Pediatric Type Ii Diabetes Mellitus: Examining The Upward Trend, Allison Foering

Senior Honors Theses

In recent years, there has been a significant increase in pediatric onset of type II diabetes. This paper will examine elements contributing to this trend. Type II diabetes will be discussed, including related pathophysiology, manifestations, diagnosis, and complications, with differentiation between adult and pediatric onset. Possible prevention and treatment methods appropriate for pediatric patients will also be discussed, along with possible outcomes in pediatric patients that could result from this disease. Overall, this paper will provide insight on the causes of this growing trend, and ways to improve the risks imposed on pediatric patients.

Palliative Surgical Gastrostomy Under Ultrasound‑Guided Bilateral Rectus Sheath Blocks In A Head And Neck Cancer Patient, Saima Rashid, Faisal Shamim,, Maha Khan, Robyna Khan

Department of Anaesthesia

No abstract provided.

Effects Of A Phase Ii Cardiac Rehabilitation Program On Patient Depression, Michael R. Legal, Dnp, Msn-Ed, Rn, Ccrn-K

Doctor of Nursing Practice Projects

Background: Screening for depression upon intake and completion of a Phase II cardiac rehabilitation (CR) program may influence the type of interventions implemented by CR staff and reduce depression.

Objectives: We examined patients before and after a Phase II CR program who self-reported as depressed using the CES-D score and also assessed scores by procedure, gender and age. We further identified the types of interventions used for those who were depressed.

Methods: We conducted a pre-post intervention study. Using a convenience sample, data were collected on CES-D scores before and after the program and by type of procedure, gender, and …

Preparing Nursing Students To Respond To Disasters: Faculty Perspectives, Melissa Jayne Freshwater

Dissertations

This mixed methods study explored emergency preparedness and disaster response in the concept-based learning curriculum adopted by the Alabama Community College System (ACCS) in 2016. The concept-based curriculum employs active learning in lieu of the traditional lecture-style teaching methods.

This study addressed the problem that educators may be unfamiliar with this content and are unsure how to present this material to students. The purpose of this study was to gain insight on teaching methodologies, to better prepare nursing students on this content.

Kolb’s 1984 Experiential Learning Theory was the framework that parallels closely with this curriculum. Kolb emphasizes four stages …

Endocrinologists' Opinions Of Diabetology As A Primary Care Subspecialty., Amber M Healy, Jay H Shubrook, Frank L Schwartz, Doyle M Cummings, Almond J Drake, Robert J Tanenberg

Ambulatory and Primary Care Articles

IN BRIEF This study was conducted to ascertain the opinions of endocrinologists about diabetes care as it relates to the health care provider workforce. A survey was administered to endocrinologists in the Planning Research in Inpatient Diabetes and Planning Research in Outpatient Diabetes (PRIDE/PROUD) group and given to attendees of the American Diabetes Association (ADA) Scientific Sessions special interest group whose focus was primary care. The majority of respondents agreed that there is a need for more providers to be trained to take care of patients with diabetes and that more trained providers are needed, and almost half agreed that …

Household Chores As The Main Source Of Physical Activity: Perspectives Of Pregnant Pakistani Women, Zahra Hoodbhoy, Rahat Qureshi, Romaina Iqbal, Qamarunissa Muhabat

Department of Paediatrics and Child Health

Objective: To understand the level of physical activity in pregnant women and to identify perceived facilitators and barriers faced by them.
Methods: This cross-sectional study was conducted from January to June 2016 at Aga Khan Maternity and Child Care Centre, Hyderabad, Pakistan, and comprised pregnant women attending the antenatal clinics. They were administered the pregnancy physical activity questionnaire while additional questions were asked to assess perceived barriers and facilitators in pregnancy. SPSS 19 was used for data analysis.
Results: Of the 455 subjects, 179(36%) were physically active. Their median metabolic equivalent of task hours per week was 14.65 (interquartile …

Prevalence And Predictors Of Low Serum 25-Hydroxyvitamin D Among Female African-American Breast Cancer Survivors, Patricia M. Sheean, Claudia Arroyo, Jennifer Woo, Melinda Stolley

Nursing: School of Nursing Faculty Publications and Other Works

Background:

African-American breast cancer survivors commonly demonstrate low serum 25-hydroxyvitamin D (25(OH)D). Decreased cutaneous conversion, high levels of adiposity, and even breast cancer treatment may influence vitamin D status. Previous investigations have analyzed African-American women in aggregate with other breast cancer survivors and have not comprehensively addressed these influential factors.

The Impact Of Advance Directives On The Intensity Of Care Received In The Acute Care Setting In Older Adults, Marsha Helen Tyacke

Dissertations (1934 -)

The proportion of older adults in the U.S. is rapidly increasing. One-third of Medicare expenditures occur in the final year of life, with nearly half resulting from acute exacerbations of chronic, progressive diseases(Riley & Lubitz, 2010). Older adults prefer comfort over life-sustaining care, and decreased intensity of care is associated with improved quality of life at the end-of-life (EOL). Advance directives (ADs) have been proposed as mechanisms to improve congruence between patient wishes and EOL care; however, the impact of ADs on care delivered in the acute care setting at the EOL for this population is unclear. A retrospective, correlation …

Plasma Inflammatory Cytokines And Survival Of Pancreatic Cancer Patients., A. Babic, N. Schnure, N. P. Neupane, M. M. Zaman, N. Rifai, M. W. Welch, L. K. Brais, D. A. Rubinson, V. Morales-Oyarvide, C. Yuan, S. Zhang, E. M. Poole, B. M. Wolpin, M. H. Kulke, D. A. Barbie, K. Wong, C. S. Fuchs, K. Ng

Department of Medical Oncology Faculty Papers

OBJECTIVES: Inflammation and inflammatory conditions have been associated with pancreatic cancer risk and progression in a number of clinical, epidemiological, and animal model studies. The goal of the present study is to identify plasma markers of inflammation associated with survival of pancreatic cancer patients, and assess their joint contribution to patient outcome.

METHODS: We measured circulating levels of four established markers of inflammation (C-reactive protein (CRP), interleukin-6 (IL-6), soluble tumor necrosis factor receptor type II (sTNF-RII), and macrophage inhibitory cytokine-1 (MIC-1)) in 446 patients enrolled in an ongoing prospective clinic-based study. Hazard ratios (HRs) and 95% confidence intervals (CI) for …

Unmodifiable Variables Related To Thyroid Cancer Incidence, Cornelia Nitipir, Lucian Alecu, Iulian Slavu, Raluca Tulin, Radu C. Jecan, Cristina Orlov, Silviu Pituru, Dana L. Stanculeanu, Razvan Hainarosie, Anca P. Stoian, Adrian Tulin

Journal of Mind and Medical Sciences

The incidence of thyroid cancer is significantly different between male and female patients. Thyroid cancer is also the only form of cancer where age can be considered a staging variable. Identifying biological prognostic factors such as age or sex is important as it helps select an optimal personalized therapy. The present analysis is an observational, prospective study that enrolled all patients with thyroid disease who were operated upon at a single center. The study aimed to determine the most frequent age at presentation, the predominance of one sex over the other, the incidence of malignant thyroid disease, and the relative …

Does Sex Of The Patient Play A Role In Survival For Msi Colorectal Cancer?, Adrian Tulin, Iulian Slavu, Raluca Tulin, Lucian Alecu, Radu C. Jecan, Cristina Orlov, Cristian I. Iaciu, Dana L. Stanculeanu, Razvan Hainarosie, Silviu Pituru, Anca Pantea Stoian, Cornelia Nitipir

Journal of Mind and Medical Sciences

Microsatellite instability (MSI) is a feature of colorectal tumors that develops as a result of inactivation of the DNA mismatch repair system. It is found in about 15% of all colorectal cancers and is an important prognostic molecular marker when assessing patients with colorectal cancer. It can influence prognosis and treatment decisions in both the advanced and early stages. Although in early stages this marker suggests a favorable prognosis and presents an important argument against adjuvant treatment in stage II disease, in metastatic stages it no longer associated with such an optimistic outcome. The present trial is a prospective, single-center …

Vascular Neurocognitive Disorders And The Vascular Risk Factors, Carmen V. Albu, Vlad Padureanu, Mihail V. Boldeanu, Ana M. Bumbea, Anca S. Enescu, Dana M. Albulescu, Cristian A. Silosi, Aurelia Enescu

Journal of Mind and Medical Sciences

Dementias are clinical neurodegenerative diseases characterized by permanent and progressive transformation of cognitive functions such as memory, learning capacity, attention, thinking, language, passing judgments, calculation or orientation. Dementias represent a relatively frequent pathology, encountered at about 10% of the population of 65-year olds and 20% of the population of 80-year olds.

This review presents the main etiological forms of dementia, which include Alzheimer form of dementia, vascular dementia, dementia associated with alpha-synucleionopathies, and mixed forms. Regarding vascular dementia, the risk factors are similar to those for an ischemic or hemorrhagic cerebrovascular accident: arterial hypertension, diabetes mellitus, dyslipidemia, smoking, obesity, age, …

Association Between Thyroid Status And Glucose Intolerance Inhyperthyroid Patients, Wismandari Wisnu, Pradana Soewondo, Imam Subekti

Jurnal Penyakit Dalam Indonesia

Introduction. The most common endocrinopathy in adults are diabetes mellitus (DM) and thyroid disease. Hyperthyroidism decreases blood glucose control and increased the need of insulin. However, the mechanism of abnormal glucose metabolism in hyperthyroidism is not fully understood. This study aims to determine the relationship of thyroid status with incidence of glucose intolerance in hyperthyroid patients compared to hyperthyroid patients who have achieved clinical status of eutyroid and normal population. Methods. This study was cross sectional design in outpatients with hyperthyroidism in hyperthyroid and euthyroid/subclinical hyperthyroid status, and healthy volunteers who had matching age and sex. An oral glucose test …

Comorbidities In Aging Patients With Sickle Cell Disease., Samir K. Ballas

Cardeza Foundation for Hematologic Research

Sickle cell disease (SCD) in general and sickle cell anemia in particular is a highly complex disorder both at the molecular and clinical levels. Although the molecular lesion is a single-point mutation, the sickle gene is pleiotropic in nature causing multiple phenotypic expressions that constitute the various complications of the disease. Moreover, despite the fact that SCD is a chronic malady, its manifestations are both acute and chronic. The former include, among other things, the recurrent vaso-occlusive crises (its hallmark) and acute chest syndrome. The chronic complications include most commonly avascular necrosis and leg ulcers. Currently, survival of patients with …

Apolipoprotein-Defined Lipoprotein Subclasses, Serum Apolipoproteins, And Carotid Intima-Media Thickness In T1d, Arpita Basu, Alicia J. Jenkins, Julie A. Stoner, Ying Zhang, Richrd L. Klein

Kinesiology and Nutrition Sciences Faculty Research

Circulating apolipoprotein-defined lipoprotein subclasses (ADLS) and apolipoproteins predict vascular events in the general and type 2 diabetes populations, but data in T1D are limited. We examined associations of ADLS, serum apolipoproteins, and conventional lipids with carotid intima-media thickness (IMT) measured contemporaneously and 6 years later in 417 T1D participants [men: n = 269, age 42 +/- 6 y (mean +/- SD); women: n = 148, age 39 +/- 8 y] in the Epidemiology of Diabetes Interventions and Complications study, the follow-up of the Diabetes Control and Complications Trial (DCCT). Date were analyzed by multiple linear regression stratified by sex, and …

Evaluation Of Vaccine Derived Poliovirus Type 2 Outbreak Response Options: A Randomized Controlled Trial, Karachi, Pakistan, Ali Faisal Saleem Dr, Mohammad Tahir Yousafzai, Ondrej Mach, Asia Khan, Farheen Quadri, William C. Weldon, M. Steven Oberste, Syed S. Zaidi, Muhammad M. Alam, Anita K. M. Zaidi

Department of Paediatrics and Child Health

Background: Outbreaks of circulating vaccine derived polioviruses type 2 (cVDPV2) remain a risk to poliovirus eradication in an era without live poliovirus vaccine containing type 2 in routine immunization. We evaluated existing outbreak response strategies recommended by the World Health Organization (WHO) for control of cVDPV2 outbreaks.
Methods: Seronegative children for poliovirus type 2 (PV2) at 22 weeks of life were assigned to one of four study groups and received respectively (1) one dose of trivalent oral poliovirus vaccine (tOPV); (2) monovalent OPV 2 (mOPV2); (3) tOPV together with a dose of inactivated poliovirus vaccine (IPV); or (4) mOPV2 with …

Women's Experiences Of Mistreatment During Childbirth: A Comparative View Of Home- And Facility-Based Births In Pakistan, Waqas Hameed, Bilal Iqbal Avan

Community Health Sciences

Introduction: Respectful and dignified healthcare is a fundamental right for every woman. However, many women seeking childbirth services, especially those in low-income countries such as Pakistan, are mistreated by their birth attendants. The aim of this epidemiological study was to estimate the prevalence of mistreatment and types of mistreatment among women giving birth in facility- and home-based settings in Pakistan in order to address the lack of empirical evidence on this topic. The study also examined the association between demographics (socio-demographic, reproductive history and empowerment status) and mistreatment, both in general and according to birth setting (whether home- or facility-based). …

Effect Of Stem Cell And Vitamin E For The Reduction Of Liver Fibrosis, Sulaiman Shams, Salman Khan, Muhammad Ayaz, Haider Ali Khan, Hammad Hassan

Centre for Regenerative Medicine & Stem Cell Research

Liver disease is seventh leading cause of death worldwide. In the past, liver transplantation was thought to be the only treatment for the last stage liver disease but currently stem cells therapy is an alternative method for the treatment of liver disease. So mesenchymal stem cells (MSCs) transplantation is one of the best tool for treatment of liver disease. The aim of the current study was to investigate the combined effect of vitamin E (Vit E) and MSCs on liver fibrosis. Liver damage was induced in male albino mice intraperitoneally with carbon tetrachloride (CCl4) twice a week for six weeks. …

Acute Loss Of Iron-Sulfur Clusters Results In Metabolic Reprogramming And Generation Of Lipid Droplets In Mammalian Cells, Daniel R. Crooks, Nunziata Maio, Andrew N. Lane, Michal Jarnik, Richard M. Higashi, Ronald G. Haller, Ye Yang, Teresa Whei-Mei Fan, W. Marston Linehan, Tracey A. Rouault

Center for Environmental and Systems Biochemistry Faculty Publications

Iron–sulfur (Fe-S) clusters are ancient cofactors in cells and participate in diverse biochemical functions, including electron transfer and enzymatic catalysis. Although cell lines derived from individuals carrying mutations in the Fe-S cluster biogenesis pathway or siRNA-mediated knockdown of the Fe-S assembly components provide excellent models for investigating Fe-S cluster formation in mammalian cells, these experimental strategies focus on the consequences of prolonged impairment of Fe-S assembly. Here, we constructed and expressed dominant–negative variants of the primary Fe-S biogenesis scaffold protein iron–sulfur cluster assembly enzyme 2 (ISCU2) in human HEK293 cells. This approach enabled us to study the early metabolic reprogramming …

Continuous Training And Certification In Neonatal Resuscitation In Remote Areas Using A Multi-Platform Information And Communication Technology Intervention, Compared To Standard Training: A Randomized Cluster Trial Study Protocol, Carlos Alberto Delgado, Enrique M. Gómez Pomar, Pablo Velásquez, Víctor Sánchez, Roberto Shimabuku, Luis Huicho, Rcpneoperu Study Group

Pediatrics Faculty Publications

Background: About 10% of all newborns may have difficulty breathing and require support by trained personnel. In Peru, 90% of deliveries occur in health facilities. However, there is not a national neonatal resuscitation and certification program for the public health sector. In addition, the Andes and the Amazon regions concentrate large rural remote areas, which further limit the implementation of training programs and the accomplishment of continuous certification. Neonatal resuscitation training through the use of Information, Communication and Technology (ICT) tools, running on computers, tablets or mobile phones, may overcome such limitations. This strategy allows online and offline access …

Calnexin Is Necessary For T Cell Transmigration Into The Central Nervous System, Amber M. Paul, Joanna Jung, Paul Eggleton, Alison Robinson, Jessica Wang, Nick Gutowski

Publications

In multiple sclerosis (MS), a demyelinating inflammatory disease of the CNS, and its animal model (experimental autoimmune encephalomyelitis; EAE), circulating immune cells gain access to the CNS across the blood-brain barrier to cause inflammation, myelin destruction, and neuronal damage. Here, we discovered that calnexin, an ER chaperone, is highly abundant in human brain endothelial cells of MS patients. Conversely, mice lacking calnexin exhibited resistance to EAE induction, no evidence of immune cell infiltration into the CNS, and no induction of inflammation markers within the CNS. Furthermore, calnexin deficiency in mice did not alter the development or function of the immune …

Serum Anti-Flagellin And Anti-Lipopolysaccharide Immunoglobulins As Predictors Of Linear Growth Faltering In Pakistani Infants At Risk For Environmental Enteric Dysfunction, Sana Syed, Najeeha Talat Iqbal, Kamran Sadiq, Jennie Z. Ma, Tauseef Akhund, Shahida Qureshi, Kerri Gosselin, Andrew Gewirtz, Christopher P. Duggan, Syed Asad Ali

Department of Paediatrics and Child Health

Background: Environmental Enteric Dysfunction (EED) in children from low-income countries has been linked to linear growth declines. There is a critical need to identify sensitive and early EED biomarkers.
Objective: Determine whether levels of antibodies against bacterial components flagellin (flic) and lipopolysaccharide (LPS) predict poor growth.
Design/Methods: In a prospective birth cohort of 380 children in rural Pakistan blood and stool samples were obtained at ages 6 and 9 months. Linear mixed effects models were used to examine longitudinal associations between quartiles of anti-flic and anti-LPS antibodies and changes in LAZ, WAZ and WLZ scores. Spearman's correlations were measured between …

Association Of Obesity And Thyroid Cancer At A Tertiary Care Hospital In Pakistan, Adnan Ali, Yumna Mirza, Urooj Faizan, Nida Zahid, Muhammad S. Awan

Section of General Surgery

Objective: Thyroid cancer (TC) is one of the most common endocrine malignancies with a rapidly increasing worldwide presence. In Pakistan, it is more prevalent in females than males and has an incidence rate of 2.1%. Obesity and excess body mass index (BMI) has been linked to several cancers and is thought to be a risk factor for TC. We aim to investigate the incidence of TC in our population and understand it's correlation with obesity.
Subjects: The study was a retrospective case series conducted in the years 2000 to 2014, at the Aga Khan University Hospital (AKUH), Karachi, Pakistan where …

Reprogrammed Lipid Metabolism In Bladder Cancer With Cisplatin Resistance., Min Young Lee, Austin Yeon, Muhammad Shahid, Eunho Cho, Vikram Sairam, Robert Figlin, Khae-Hwan Kim, Jayoung Kim

Articles, Abstracts, and Reports

Due to its tendency to recur and acquire chemoresistance quickly, bladder cancer (BC) remains to be an elusive and difficult disease. Patients with recurrent and chemoresistant BC have an extremely poor prognosis. One possible approach that may provide insightful and valuable information regarding resistance mechanisms is looking into the lipid metabolism of BC cells. Metabolism of lipids is essential for cancer cells and is associated with the regulation of a variety of key cellular processes and functions. This study conducted a comparative lipidomic profiling of two isogenic human T24 bladder cancer cell lines, one of which is clinically characterized as …

Serum Tumour Necrosis Factor Alpha In Osteopenic And Osteoporotic Postmenopausal Females: A Cross-Sectional Study In Pakistan, Rafat Murad, Zahra Shezad, Saara Ahmed, Mussarat Ashraf, Murad Qadir, Rehana Rehman

Department of Biological & Biomedical Sciences

Objective: To compare biochemical parameters serum tumour necrosis factor alpha, calcium, magnesium, bone-specific alkaline phosphatase and vitamin D in postmenopausal women.
Methods: This cross-sectional study was carried out from June 2015 to July 2016 at Jinnah Medical and Dental College, Karachi, and comprised postmenopausal women. Bone mineral density done by dual energy X-ray absorptiometryscan categorised subjects by World Health Organisation classification into normal (T score > -1) osteopenic (T score between -1 and -2.5) and osteoporotic (T score < -2.5). Biochemical parameters like tumour necrosis alpha, calcium, magnesium, bone-specific alkaline phosphatase and vitamin D were measured by solid phase enzyme amplified sensitivity immunoassay method. SPSS 16 was used to analyse the data.
Results: Of the 146 women, 34(23%) were normal, 93(67%) were osteopenic and 19(13%) were osteoporotic. There was significant difference in mean body mass …