Digital Commons Network^™

Clinical Factors Associated With The Non-Operative Airway Management Of Patients With Robin Sequence., Frank P Albino, Benjamin C. Wood, Kevin D Han, Sojung Yi, Mitchel Seruya, Gary F. Rogers, Albert K. Oh

Surgery Faculty Publications

BACKGROUND: The indications for surgical airway management in patients with Robin sequence (RS) and severe airway obstruction have not been well defined. While certain patients with RS clearly require surgical airway intervention and other patients just as clearly can be managed with conservative measures alone, a significant proportion of patients with RS present with a more confusing and ambiguous clinical course. The purpose of this study was to describe the clinical features and objective findings of patients with RS whose airways were successfully managed without surgical intervention.

METHODS: The authors retrospectively reviewed the medical charts of infants with RS evaluated …

Performance Of A1c Versus Ogtt For The Diagnosis Of Prediabetes In A Community-Based Screening, Jenny E. Camacho, Vallabh O. Shah, Ronald Schrader, Craig S. Wong, Mark R. Burge

Pediatrics Research and Scholarship

OBJECTIVE: Reliable identification of individuals at risk for developing diabetes is critical to instituting preventative strategies. Studies suggest that the accuracy of using hemoglobin A1c as a sole diagnostic criterion for diabetes may be variable across different ethnic groups. We postulate that there will be lack of concordance between A1c and the oral glucose tolerance test (OGTT) for diagnosing prediabetes across Hispanic and non-Hispanic white (NHW) populations.

METHODS: A total of 218 asymptomatic adults at risk for type 2 diabetes (T2D) were assessed with A1c and OGTT for the diagnosis of prediabetes. Glucose homeostasis status was assigned as no diabetes …

Exploring Health Beliefs Among Hispanic Adults With Prediabetes (Poster)., Kyle Shaak Bs, Beth Careyva M.D., Susan E. Hansen Ma, Melanie B. Johnson Mpa, Samantha A. Goodrich, Alicia Rivera, Liselly Diaz, Jessecae K. Marsh Phd, Clare Lenhart Phd, Brian Stello Md

Department of Family Medicine

No abstract provided.

The Relevance Of Sex Differences In Performance Fatigability, Sandra K. Hunter

Exercise Science Faculty Research and Publications

Performance fatigability differs between men and women for a range of fatiguing tasks. Women are usually less fatigable than men, and this is most widely described for isometric fatiguing contractions and some dynamic tasks. The sex difference in fatigability is specific to the task demands so that one mechanism is not universal, including any sex differences in skeletal muscle physiology, muscle perfusion, and voluntary activation. However, there are substantial knowledge gaps about the task dependency of the sex differences in fatigability, the involved mechanisms, and the relevance to clinical populations and with advanced age. The knowledge gaps are in part …

Ibd Live Case Series-Case 6., Dhyan Rajan, Julia B. Greer, Miguel D. Regueiro, Leonard Baidoo, David G. Binion, Hans H. Herfarth, Corey A. Siegel, Douglas J. Hartman, Francis A. Farraye, Ioannis E. Koutroubakis, Myron H. Brand, Emmanuelle D. Williams, Alka Goyal, Raymond K. Cross

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Processing Information After A Child's Cancer Diagnosis-How Parents Learn., Cheryl C. Rodgers, Kristin Stegenga, Janice S. Withycombe, Karen Sachse, Katherine Patterson Kelly

Manuscripts, Articles, Book Chapters and Other Papers

Parents of a child newly diagnosed with cancer must receive an extensive amount of information before their child's initial hospital discharge; however, little is known about best practices for providing this education. An interpretive descriptive study design was used to describe actual and preferred educational content, timing, and methods among parents of children newly diagnosed with cancer prior to their child's first hospital discharge. Twenty parents of children diagnosed with various malignancies participated in individual interviews 2 to 12 months after their child's diagnosis. Data were analyzed using constant comparative analysis. Education delivery occurred in a telling manner at diagnosis …

Association Between Prolonged Neutropenia And Reduced Relapse Risk In Pediatric Aml: A Report From The Children's Oncology Group., Lillian Sung, Richard Aplenc, Todd A. Alonzo, Robert B. Gerbing, Yi-Cheng Wang, Soheil Meshinchi, A S. Gamis

Manuscripts, Articles, Book Chapters and Other Papers

Objective was to describe the relationship between the number of sterile site infections and duration of neutropenia during the first four cycles of chemotherapy and the risk of recurrence and overall survival in children with newly diagnosed acute myeloid leukemia (AML). AAML0531 was a Children's Oncology Group randomized phase 3 clinical trial that included 1022 children with de novo AML. For this analysis, we focused on non-Down syndrome favorable and standard risk patients who completed at least 4 cycles of chemotherapy without recurrence or withdrawal during protocol therapy. Those receiving hematopoietic stem cell transplantation in first remission were excluded. Five …

Toxic Environmental Exposures And Kidney Health In Children., Darcy K. Weidemann, Virginia M. Weaver, Jeffrey J. Fadrowski

Manuscripts, Articles, Book Chapters and Other Papers

High-level exposures to a number of agents are known to have direct nephrotoxic effects in children. A growing body of literature supports the hypothesis that chronic, relatively low-level exposure to various nephrotoxicants may also increase the risk for chronic kidney disease (CKD) or accelerate its progression. In this review we highlight several environmental nephrotoxicants and their association with CKD in children and adolescents. We also discuss unique epidemiological challenges in the use of kidney biomarkers in environmental nephrotoxicology.

Vitamin D Levels In Malnourished Children Under 5 Years In A Tertiary Care Center At Muhimbili National Hospital, Dar Es Salaam, Tanzania—A Cross-Sectional Study, Nahida Z. Walli, Emmanuel K. Munubhi, Said Aboud, Karim P. Manji

Paediatrics and Child Health, East Africa

Objective: To evaluate vitamin D levels/deficiency among malnourished children < 5 years admitted at a tertiary care center, the Muhimbili National Hospital, Dar es Salaam, Tanzania. Children with malnutrition may have co-existing vitamin D deficiency (VDD), which may be severe.

Methods: Serum vitamin D and alkaline phosphatase were evaluated, and X-ray of the wrist was carried out on 134 children.

Results: VDD was found in 41 of 134 children (30.6%). The mean vitamin D level was 74.8 nmol/l. The mean alkaline phosphatase level was 176.6 U/l. Sixty-four (48%) children were found to have severe stunting, of whom 20 (31.2%) were vitamin D deficient. Marasmic children had higher odds of VDD compared with other forms of malnutrition.

Conclusion: The high prevalence of VDD in malnourished children underlines the need for active surveillance …

P70s6k1 (S6k1)-Mediated Phosphorylation Regulates Phosphatidylinositol 4-Phosphate 5-Kinase Type I Γ Degradation And Cell Invasion, Naser Jafari, Qiaodan Zheng, Liqing Li, Wei Li, Lei Qi, Jianyong Xiao, Tianyan Gao, Cai Huang

Markey Cancer Center Faculty Publications

Phosphatidylinositol 4-phosphate 5-kinase type I γ (PIPKIγ90) ubiquitination and subsequent degradation regulate focal adhesion assembly, cell migration, and invasion. However, it is unknown how upstream signals control PIPKIγ90 ubiquitination or degradation. Here we show that p70S6K1 (S6K1), a downstream target of mechanistic target of rapamycin (mTOR), phosphorylates PIPKIγ90 at Thr-553 and Ser-555 and that S6K1-mediated PIPKIγ90 phosphorylation is essential for cell migration and invasion. Moreover, PIPKIγ90 phosphorylation is required for the development of focal adhesions and invadopodia, key machineries for cell migration and invasion. Surprisingly, substitution of Thr-553 and Ser-555 …

A Novel Genetic Variant In Long Non-Coding Rna Gene Nexn-As1 Is Associated With Risk Of Lung Cancer, Hua Yuan, Hongliang Liu, Zhensheng Liu, Kouros Owzar

Dartmouth Scholarship

Lung cancer etiology is multifactorial, and growing evidence has indicated that long non-coding RNAs (lncRNAs) are important players in lung carcinogenesis. We performed a large-scale meta-analysis of690,564 SNPs in 15,531 autosomal lncRNAs by using datasets from six previously published genome-wideassociation studies (GWASs) from the Transdisciplinary Research in Cancer of the Lung (TRICL) consortiumin populations of European ancestry. Previously unreported significant SNPs (P value < 1 × 10−7) were further validated in two additional independent lung cancer GWAS datasets from Harvard University anddeCODE. In the final meta-analysis of all eight GWAS datasets with 17,153 cases and 239,337 controls, a novel risk SNP rs114020893 in the lncRNA NEXN-AS1 region at 1p31.1 remained statistically significant(odds ratio = 1.17; 95% confidence interval = 1.11–1.24; P = 8.31 × 10−9). In further in silico analysis,rs114020893 was predicted to change the secondary structure of the lncRNA. Our finding indicates that SNP rs114020893 of NEXN-AS1 at 1p31.1 may contribute to lung cancer susceptibility.

Celiac Disease Presenting As Intussusception From Giardia Lamblia, Adam R. Paul Do

Department of Pediatrics

No abstract provided.

Defining And Targeting Health Disparities In Chronic Obstructive Pulmonary Disease, Roy A. Pleasants, Isaretta L. Riley, David M. Mannino

Preventive Medicine and Environmental Health Faculty Publications

The global burden of chronic obstructive pulmonary disease (COPD) continues to grow in part due to better outcomes in other major diseases and in part because a substantial portion of the worldwide population continues to be exposed to inhalant toxins. However, a disproportionate burden of COPD occurs in people of low socioeconomic status (SES) due to differences in health behaviors, sociopolitical factors, and social and structural environmental exposures. Tobacco use, occupations with exposure to inhalant toxins, and indoor biomass fuel (BF) exposure are more common in low SES populations. Not only does SES affect the risk of developing COPD and …

Adverse Events In Continuous-Flow Lvad Recipients: Gastrointestinal Bleeding Is Still Notable?, Marija Petrovic, Sriram Nathan, Rajko Radovancevic, Indranee Rajapreyar, Kevin J. Dasher, Mehmet H. Akay, Bindu Akkanti, Pranav Loyalka, Biswajit Kar, Igor D. Gregoric

The VAD Journal

Background: The etiology and risk factors associated with gastrointestinal bleeding (GIB) in patients with continuous-flow left ventricular assist devices (CF-LVADs) are currently unknown. Therefore, we sought to assess the risk factors for GIB in these patients.

Design and Methods: This was a retrospective, non-randomized, non-controlled study at a single center. Between 2012 and 2014, 65 men and 6 women (mean age = 55 ± 12 years) underwent CF-LVAD implantation at our institution. Overall, 23.9% of patients (17/71) had at least one GIB episode. Endoscopy confirmed GIB in 13/17. Arteriovenous malformation was the major GIB source in 8/13 (61%). …

Healthy Homes, Healthy Futures: A Home Visitation Curriculum For Pediatric Residents, Kofi D. Essel, Sirisha Yalamanchi, Cara Lichtenstein, Erin Hysom

E-Learning Modules

A working knowledge of the home and neighborhood environment is critical to understanding the barriers that families face when struggling with obesity. Most doctors are only given the opportunity to address individuals with obesity in the office setting and usually describe their counseling abilities as ineffective. This focused home visitation curriculum offers a unique tool to improve residents’ understanding of the social determinants of health, how these determinants relate to obesity, and critical obesity-management skills. The curriculum requires residents to review three PowerPoint modules and an article on motivational interviewing. Residents then implement what they have learned by doing two …

Fever Of Unknown Origin In Patient After Left Ventricular Assist Device Implantation, Eugenia Raichlin, Sara Varnado, John Y. Um, Michael J. Moulton, Ronald Zolty Dr

The VAD Journal

Mechanical circulatory support (MCS) is a lifesaving procedure in patients with refractory cardiogenic shock. Despite improvement in surgical techniques, ICU care and restored hemodynamics, some patients on MCS remain severely debilitated due to multiple medical problems, including infections, respiratory failure, de-conditioning and nutritional deficits.

Here we present a case of a patient with persistent high degree fever, devastating muscle weakness, and elevated lactate dehydrogenase (LDH) level, who dramatically responded to treatment with vitamin B 12.

Hdqlife: Development And Assessment Of Health-Related Quality Of Life In Huntington Disease (Hd), N E Carlozzi, S G Schilling, J-S Lai, J S Paulsen, E A Hahn, J S Perlmutter, C A Ross, N R Downing, A L Kratz, M K Mccormack, M A Nance, K A Quaid, J C Stout, R C Gershon, R E Ready, J A Miner, S K Barton, S L Perlman, S M Rao, S Frank, I Shoulson, H Marin, M D Geschwind, P Dayalu, S M Goodnight, D Cella

Rowan-Virtua School of Osteopathic Medicine Departmental Research

PURPOSE: Huntington disease (HD) is a chronic, debilitating genetic disease that affects physical, emotional, cognitive, and social health. Existing patient-reported outcomes (PROs) of health-related quality of life (HRQOL) used in HD are neither comprehensive, nor do they adequately account for clinically meaningful changes in function. While new PROs examining HRQOL (i.e., Neuro-QoL-Quality of Life in Neurological Disorders and PROMIS-Patient-Reported Outcomes Measurement Information System) offer solutions to many of these shortcomings, they do not include HD-specific content, nor have they been validated in HD. HDQLIFE addresses this by validating 12 PROMIS/Neuro-QoL domains in individuals with HD and by using established PROMIS …

Comparative Effects Of Ballooning Intracervical Catheter And Prostaglandin Pessary On Cervical Ripening, Raheela Baloch, Qamarunissa Muhabat, Fakhrunissa Waheed, Waqarunissa Ahmed

Department of Obstetrics & Gynaecology

Labor is induced to stimulate the uterine contraction in effort to have vaginal birth. Induction may be advocated to reduce fetal or neonatal morbidity and mortality. Indication of labor needs to be considered when risk and benefits analysis indicates that delivering the baby is safe option for mother or both rather than continuing the pregnancy and when there are no clear indications for caesarean section and no contraindication for vaginal delivery.

Labrad : Vol 42, Issue 2 - October 2016, Aga Khan University Hospital, Karachi

LABRAD - Departments of Pathology & Laboratory Medicine and Radiology Archives

• Revised Nomenclature of Encapsulated Follicular Variant of Papillary Carcinoma; Now NIFTP in 2016
• Heritable Thrombophilia Screening: When & in Whom
• Massive Transfusion
• A Review of Innovance PFA-200 System
• Radiologic-Pathologic Correlation Osteogenic Tumors
• Pre Albumin or Transthyretin - A Useful Biomarker in the Assessment of Malnutrition
• Urinary Tract Infections (UTIs) in Children: A Pictorial Guide
• Validation of Test Methods in a Clinical Laboratory: A Brief Overview of the Concepts, Aims and Procedures
• Clinical Significance of Stone Composition Analysis in Urolithiasis Management

Oncolog, Volume 61, Number 10, October 2016, Laura L. Russell, Joe Munch, Bryan Tutt, Z Ahmed

OncoLog MD Anderson's Report to Physicians (All issues) Archives

• Preventing Postoperative Urinary Tract Infections in Cancer Patients: Urinary tract infections (UTIs) increase morbidity, mortality and health care costs and prolong hospitalizations for patients who require urinary catheters-especially those who undergo long, complex surgeries or procedures to treat urological or gynecological cancers. To reduce the incidence of UTIs, clinicians at The University of Texas MD Anderson Cancer Center developed a quality improvement program for surgical patients at the institution.
• Study Offers a Starting Point for Testing Immunotherapy in Rectal Cancer Patients with Deficient DNA Mismatch Repair: A recent study's findings provide a starting point for assessing the efficacy of immunotherapy …

Talin2-Mediated Traction Force Drives Matrix Degradation And Cell Invasion, Lei Qi, Naser Jafari, Xiang Li, Zaozao Chen, Liqing Li, Vesa P. Hytönen, Benjamin T. Goult, Chang-Guo Zhan, Cai Huang

Markey Cancer Center Faculty Publications

Talin binds to β-integrin tails to activate integrins, regulating cell migration, invasion and metastasis. There are two talin genes, TLN1 and TLN2, encoding talin1 and talin2, respectively. Talin1 regulates focal adhesion dynamics, cell migration and invasion, whereas the biological function of talin2 is not clear and, indeed, talin2 has been presumed to function redundantly with talin1. Here, we show that talin2 has a much stronger binding to β-integrin tails than talin1. Replacement of talin2 Ser339 with Cys significantly decreased its binding to β1-integrin tails to a level comparable to that of talin1. Talin2 localizes at invadopodia and is indispensable …

Migraine, Children's Mercy Kansas City

Clinical Pathways (Formally Known As Clinical Practice Guidelines)

No abstract provided.

The Influence Of Televised Food Commercials On Children's Food Choices: Evidence From Ventromedial Prefrontal Cortex Activations., Amanda S. Bruce, Stephen W. Pruitt, Oh-Ryeong Ha, J Bradley C Cherry, Timothy R. Smith, Jared M. Bruce, Seung-Lark Lim

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: To investigate how food commercials influence children's food choices.

STUDY DESIGN: Twenty-three children ages 8-14 years provided taste and health ratings for 60 food items. Subsequently, these children were scanned with the use of functional magnetic resonance imaging while making food choices (ie, "eat" or "not eat") after watching food and nonfood television commercials.

RESULTS: Our results show that watching food commercials changes the way children consider the importance of taste when making food choices. Children did not use health values for their food choices, indicating children's decisions were largely driven by hedonic, immediate rewards (ie, "tastiness"); however, children …

Developing Novel Machine Learning Algorithms To Improve Sedentary Assessment For Youth Health Enhancement., Gowtham Kumar Golla, Jordan A. Carlson, Jun Huan, Jacqueline Kerr, Tarrah Mitchell, Kelsey Borner

Manuscripts, Articles, Book Chapters and Other Papers

Sedentary behavior of youth is an important determinant of health. However, better measures are needed to improve understanding of this relationship and the mechanisms at play, as well as to evaluate health promotion interventions. Wearable accelerometers are considered as the standard for assessing physical activity in research, but do not perform well for assessing posture (i.e., sitting vs. standing), a critical component of sedentary behavior. The machine learning algorithms that we propose for assessing sedentary behavior will allow us to re-examine existing accelerometer data to better understand the association between sedentary time and health in various populations. We collected two …

Body Image And Quality Of Life Among Postsurgical Bariatric Patients, Amy Leigh White

Psychology Theses & Dissertations

In recent decades, bariatric surgery has become an increasingly popular intervention for the treatment of morbid obesity. Bariatric surgery leads to substantial improvements in physical health (e.g., weight loss, increased life expectancy) and psychological health (e.g., body image, quality of life). After bariatric surgery, many patients undergo subsequent surgical procedures to remove excess skin (“body contouring”), which are also associated with positive medical and psychological outcomes.

The present study sought to expand upon existing research into the psychosocial outcomes of bariatric surgery, investigate correlates of patients’ desire for body contouring, and determine whether presurgical motivations were associated with postsurgical outcomes. …

Emergency Medical Services And Public Policy In Durban, Kwazulu-Natal, John Buyske

Independent Study Project (ISP) Collection

This project seeks to explore the realities of the emergency medical system in the Durban area, particularly relative to government policy. It contextualizes its findings within the literature on public policy. Data for the project was collected via nine in-depth interviews with various professionals working in the field of emergency medical services, as well as a survey of fourteen citizens conducted in the peri-urban township of Cato Manor. This data was analyzed using qualitative methods. While every participant had different views and a different perspective on emergency services, some recurring themes and trends became evident, allowing for conclusions to be …

Continuous Care In Complex Contexts: Access To Health Services For Noncommunicable Diseases Among Syrian Refugee Women In Jordanian Host Communities, Jennifer Ostrowski

Independent Study Project (ISP) Collection

This study examines how, when and where Syrian refugee women living in a host community in central Jordan access health services related to noncommunicable diseases. Noncommunicable diseases are the leading cause of death and disability worldwide, but can be effectively managed through timely treatment. Examining access to care for these diseases in the context of humanitarian emergencies, such as war and displacement, is particularly important because they require continuous care, which may be interrupted during emergencies, and because they can cause acute complications, which may be exacerbated by emergencies (WHO, 2016).

Previous studies indicate a high burden of NCDs among …

Nutritional Status And Physical Abuse Among The Children Involved In Domestic Labour In Karachi Pakistan: A Cross-Sectional Survey., Saima Zainab, Muhammad Masood Kadir

Community Health Sciences

OBJECTIVE:

To determine the prevalence of physical abuse among domestic child labours and to assess the nutritional status by calculating the Body Mass Index of children involved in domestic labour in Karachi.

METHODS:

A cross sectional study was conducted in the squatter settlements of Karachi. Questionnaire based interviews were conducted to capture physical abuse with 385 children who worked as domestic labour in the household of their employer. The ages of the children were between 10 to 14 years belonging to both genders. The children were enrolled in study by snow-ball sampling technique.

RESULTS:

The overall prevalence of physical abuse …

Availability, Affordability, And Consumption Of Fruits And Vegetables In 18 Countries Across Income Levels: Findings From The Prospective Urban Rural Epidemiology (Pure) Study., Victoria Miller, Salim Yusuf, Clara K. Chow, Mahshid Dehgha, Daniel J. Corsi, Karen Lock, Barry Popkin, Sumathy Rangarajan, Rasha Khatib, Scott A. Lear, Prem Mony, Manmeet Kaur, Viswanathan Mohan, Krishnapillai Vijayakumar, Rajeev Gupta, Annamarie Kruger, Lungiswa Tsolekile, Noushin Mohammadifard, Omar Rahman, Annika Rosengren, Alvaro Avezum, Andrés Orlandini, Noorhassim Ismail, Patricio Lopez-Jaramillo, Afzalhussein Yusufali, Kubilay Karsidag, Romaina Iqbal, Jephat Chifamba, Solange Martinez Oakley, Farnaza Ariffin, Katarzyna Zatonska, Paul Poirier, Li Wei, Bo Jian, Chen Hui, Liuxu Xu, Bai Xiulin, Koon Teo, Andrew Mente

Community Health Sciences

BACKGROUND:

Several international guidelines recommend the consumption of two servings of fruits and three servings of vegetables per day, but their intake is thought to be low worldwide. We aimed to determine the extent to which such low intake is related to availability and affordability.

METHODS:

We assessed fruit and vegetable consumption using data from country-specific, validated semi-quantitative food frequency questionnaires in the Prospective Urban Rural Epidemiology (PURE) study, which enrolled participants from communities in 18 countries between Jan 1, 2003, and Dec 31, 2013. We documented household income data from participants in these communities; we also recorded the diversity …

Recent Strategies To Improve Community Case Management Of Diarrhea Among Children Under Five In Developing Countries, Fauziah Rabbani, Aysha Zahidie

Community Health Sciences

No abstract provided.