Digital Commons Network^™

A Critical Analysis Of Infant Mortality In Kalamazoo County, Audrey Jensen

Honors Theses

The following is a review of the state of infant and fetal health in Kalamazoo County in the 21st century. Since infant health is a marker for the effectiveness of health care, this review will analyze the leading causes of infant mortality in Kalamazoo County. Statistical indicators show that Kalamazoo County falls below both state and national IMR averages. The leading causes of infant mortality in Kalamazoo are considered preventable infant deaths. Therefore, this review will make recommendations for the reduction of IMR through the improvement of preventative prenatal healthcare practices.

Developmental And Cultural Perspectives On Children’S Postoperative Pain Management At Home, Brooke N. Jenkins, Michelle A. Fortier

Psychology Faculty Articles and Research

Outpatient surgery is extremely common in children, and approximately 4 million children experience significant pain after surgery in the USA each year. Management of children's postoperative pain in the home setting is suboptimal and is impacted by characteristics of children and parents, as well as the larger family and cultural context. In particular, developmental status of the child, parental beliefs regarding pain expression and analgesic use in children, cultural values and language barriers can affect management of children's postoperative pain. Targeting the myriad barriers to children's pain management by capitalizing upon the use of tailored interventions may help bridge the …

Engineered Plga Nanoparticles For Delivery Of Sirna In Mcf-7 Breast Cancer Cells, Sydney Pong, Samit Shah, Vivek Gupta

Student Scholar Symposium Abstracts and Posters

Small interfering RNAs have been an emerging medical treatment for molecular based diseases as they are capable of gene-specific knockdown. Appropriate and efficient delivery remains one of the biggest challenges in the development of siRNA as an anti-cancer treatment. Nanoparticles containing siRNA were characterized and the efficacy of various peptides in the transfection of the nanoparticles were tested. A gene silencing assay was developed in order to determine the effect of siRNA therapeutics on gene functionality in breast cancer cells.

Toxicity And Cosmesis Outcomes For Single Fraction Intra-Operative Electron Radiotherapy (Ioert) For Breast Cancer, Monica Hanna, Robert Ash, Wesley Babaran, Michele M. Carpenter, Afshin Forouzannia, Jay K. Harness, Brian Kaltenecker, Snehith Maddula, Venita Williams, Lawrence Wagman

Student Scholar Symposium Abstracts and Posters

Background: Adjuvant radiation therapy is proven to reduce local recurrence in patients with early stage breast cancer. To reduce toxicity, improve geographic accuracy, and reduce treatment time, IOERT can be utilized as an alternative to external beam radiation therapy. The study’s objective was to determine the short term toxicity and cosmesis profile of single fraction IOERT given as definitive treatment in a community setting. Materials and Methods: From Mar 2012 to Jul 2014, 84 patients (3 bilateral), ages 45-91 y.o. with stage 0-II were treated with IOERT (Mobetron, IntraOp Medical, Sunnyvale, CA). A single 21 Gy fraction was administered to …

Molecular Insights Into Prostate Field Cancerization: Telomere Length, Egr-­‐1 Expression, And Regulation Of Mic-­‐1, Pdgf-­‐A, And Fas, Emily Frisch, Kristin Gabriel, Marco Bisoffi

Student Scholar Symposium Abstracts and Posters

The diagnosis of prostate cancer (adenocarcinoma) relies on screening for elevated prostate-specific antigen (PSA) in blood samples and on digital rectal examination (DRE). With high PSA levels and/or abnormal DRE, physicians recommend a biopsy, which often misses the location of the adenocarcinoma and results in false negatives. Previous studies have shown expression of the key transcription factor early growth response 1 (EGR-1), the pro-survival factor macrophage inhibitor cytokine 1 (MIC-1), and the growth stimulatory platelet derived growth factor A (PDGF-A) to be up-regulated in histologically normal tissues 1 centimeter adjacent to prostate adenocarcinomas. We hypothesize that tumors emerge from “field …

The Impact Of Prenatal Stress On The Development Of Limbic System Structures, Alyssa Murray

Honors Theses

Stress in early life is well documented as detrimental for the brain’s developmental trajectory, while prenatal stress is minimally explored. In the prenatal period, the placenta prevents much of the mother’s cortisol from reaching the fetus, but the fetus is still exposed to some maternal cortisol, and exposure increases with increasing stress. One neural structure particularly susceptible to stress is the hippocampus. The goal of this review is to address the role prenatal stress may play in damaging the hippocampus, a structure integral to learning and memory functions. Correlations between prenatal stress and a reduction in volume and function of …

Spontaneous Asj-2j Mutant Mouse As A Model For Generalized Arterial Calcification Of Infancy: A Large Deletion/Insertion Mutation In The Enpp1 Gene., Qiaoli Li, C Herbert Pratt, Louise A Dionne, Heather Fairfield, Son Yong Karst, John P Sundberg, Jouni Uitto, Yin Tintut

Department of Dermatology and Cutaneous Biology Faculty Papers

Generalized arterial calcification of infancy (GACI), an autosomal recessive disorder caused by mutations in the ENPP1 gene, manifests with extensive mineralization of the cardiovascular system. The affected individuals in most cases die within the first year of life, and there is currently no effective treatment for this disorder. In this study, we characterized a spontaneous mutant mouse, asj-2J, as a model for GACI. These mice were identified as part of a phenotypic deviant search in a large-scale production colony of BALB/cJ mice at The Jackson Laboratory. They demonstrated a characteristic gait due to stiffening of the joints, with phenotypic similarity …

Kallikrein Family Proteases Klk6 And Klk7 Are Potential Early Detection And Diagnostic Biomarkers For Serous And Papillary Serous Ovarian Cancer Subtypes., Ayala Tamir, Ushma Jag, Sreeja Sarojini, Craig Schindewolf, Takemi Tanaka, Rajendra Gharbaran, Hiren Patel, Anil Sood, Wei Hu, Ruzeen Patwa, Patrick Blake, Polina Chirina, Jin Oh Jeong, Heejin Lim, Andre Goy, Andrew Pecora, K Stephen Suh

Department of Medicine Faculty Papers

BACKGROUND: Early detection of ovarian cancer remains a challenge due to widespread metastases and a lack of biomarkers for early-stage disease. This study was conducted to identify relevant biomarkers for both laparoscopic and serum diagnostics in ovarian cancer.

METHODS: Bioinformatics analysis and expression screening in ovarian cancer cell lines were employed. Selected biomarkers were further validated in bio-specimens of diverse cancer types and ovarian cancer subtypes. For non-invasive detection, biomarker proteins were evaluated in serum samples from ovarian cancer patients.

RESULTS: Two kallikrein (KLK) serine protease family members (KLK6 and KLK7) were found to be significantly overexpressed relative to normal …

Toward An Improved Understanding Of The Ionizing Radiation Induced Dna Damage/Response Networks In Human Malignancies., Daphne A Haas-Kogan, David R Raleigh, Adam Paul Dicker

Department of Radiation Oncology Faculty Papers

No abstract provided.

Neuroprotective Effects Of Retinal Ganglion Cells By Specific Alpha 7 Nicotine Acetylcholine Receptor Agonists And An Acetylcholineesterase Inhibitor, Sara Kaliszak

Honors Theses

In previous studies from this lab, an alpha7 nACh receptor was found to successfully modulate retinal ganglion cell neuroprotection against glutamate assault when bound to nicotinic acetylcholine receptors, or if an alpha7 nicotinic acetylcholine agonist, such as PNU-282987 was used in in vitro models (Wehrwein et al., 2004; Iwamoto et al., 2013). These in vitro studies support the hypothesis that activation of alpha7 nicotinic ACh receptors triggers neuroprotection against loss of retinal ganglion cells normally induced by excessive glutamate insult. The results from these in vitro studies instigated an in vivo study in our lab using a rat glaucoma model. …

Integrative Therapy Use For Management Of Side Effects And Toxicities Experienced By Pediatric Oncology Patients, Shana Jacobs

Pediatrics Faculty Publications

Integrative Therapies (IT), otherwise known as Complementary and Alternative Medicine, are widely used among pediatric oncology patients, despite a paucity of available evidence. This review summarizes surveys that describe the prevalence of IT use by pediatric oncology patients, both during therapy and in survivorship, as well as the modalities being used. Additionally, the evidence that exists for specific treatments that appear to be efficacious in controlling specific symptoms is described. Finally, there are recommendations for practitioners on how to best counsel patients about IT use.

Hiv Drug Resistance Among Infants And Children In South Africa: How Efficient Is Genotypic Testing?, Ellen Hendrix

Independent Study Project (ISP) Collection

Background: South Africa has the largest prevalence of HIV infection. This epidemic impacts adults as well as the pediatric population. The presence of drug-resistant mutations to antiretroviral therapies among infants and children is on the rise. Few studies have been conducted on this topic. Objective: The study aims to determine whether drug resistance testing in the form of genotypic testing is cost-effective when deciding whether to switch to a new HIV antiretroviral therapy following drug failure. Method: An interactive research approach is taken by collecting primary data from experts in this field. Secondary sources including guidelines from the World Health …

Development Of A Thin-Film Porous-Microelectrode Array (P-Mea) For Electrical Stimulation Of Engineered Cardiac Tissue., Hiren Vrajlal Trada 1977-

Electronic Theses and Dissertations

Electrical stimulation has been increasingly used by research groups to enhance and increase maturation of cells in an engineered cardiac tissue (ECT). Current methods are based on using off-the-shelf wires or electrodes to deliver a stimulus voltage to the in-vitro tissue in culture medium. A major issue with this approach is the generation of byproducts in the medium due to the voltage levels required, which are typically in the range of 5V-10V. No solution currently exists that can accomplish electrical stimulation of cells in an ECT at a low voltage level. Therefore, in this study a novel, porous, thinfilm, microelectrode …

Suppression Of Invasion And Metastasis Of Triple-Negative Breast Cancer Lines By Pharmacological Or Genetic Inhibition Of Slug Activity., Giovanna Ferrari-Amorotti, Claudia Chiodoni, Fei Shen, Sara Cattelani, Angela Rachele Soliera, Gloria Manzotti, Giulia Grisendi, Massimo Dominici, Francesco Rivasi, Mario Paolo Colombo, Alessandro Fatatis, Bruno Calabretta

Department of Cancer Biology Faculty Papers

Most triple-negative breast cancers (TNBCs) exhibit gene expression patterns associated with epithelial-to-mesenchymal transition (EMT), a feature that correlates with a propensity for metastatic spread. Overexpression of the EMT regulator Slug is detected in basal and mesenchymal-type TNBCs and is associated with reduced E-cadherin expression and aggressive disease. The effects of Slug depend, in part, on the interaction of its N-terminal SNAG repressor domain with the chromatin-modifying protein lysine demethylase 1 (LSD1); thus, we investigated whether tranylcypromine [also known as trans-2-phenylcyclopropylamine hydrochloride (PCPA) or Parnate], an inhibitor of LSD1 that blocks its interaction with Slug, suppresses the migration, invasion, and metastatic …

Diagnostic Issues And Clinical Spectrum Of Childhood Degenerative Brain Diseases, Tipu Sultan, Ashfa Ameer Khan, Muhammad Arshad Khawaja, Zia Ur Rahman, Ahsan Waheed Rathore

Pakistan Journal of Neurological Sciences (PJNS)

To find out the spectrum of clinical presentation and typesof neurodegenerative disorders of childhoodin tertiary care child neurology centre of Pakistan. To find out the role of brain imaging in the diagnosis of degenerative brain disorders in children. Methods: It will bea retrospective, descriptive study conducted at department of paediatric neurology,The Children’s Hospital, Institute of child health, Lahore, Pakistanfrom January 1st,2004 to December 31,2013 (10 years). A total of 22,737 patients were admitted in the Paediatric Neurology department in the above said period. Out of them 366 children fulfilled the inclusion criteria. History, clinical examination and relevant investigations were evaluated …

Development And Characterization Of An Autologous Whole Cell Breast Cancer Vaccine, Samantha Leigh Kurtz

Graduate Theses and Dissertations

Approximately 40,000 women will die from breast cancer in the United States in 2014. About 90% of these deaths will be due to metastases, rather than the primary tumor and majority of metastases are due to the recurrence and progression of non-metastatic disease. Current adjuvant treatments, such as chemotherapy and radiation, have severe side effects and may result in overtreatment and drug resistance.

Since greater than 90% of patients are diagnosed between stages I-III and have minimal residual disease after treatment, there is an opportunity to treat patients with an autologous breast cancer vaccine. Autologous vaccines under development have a …

Site-Specific Mutation Of The Sensor Kinase Gras In Staphylococcus Aureus Alters The Adaptive Response To Distinct Cationic Antimicrobial Peptides, Ambrose L. Cheung, Arnold S. Bayer, Michael R. Yeaman, Yan Q. Xiong, Alan J. Waring, Guido Memmi, Niles Donegan

Dartmouth Scholarship

The Staphylococcus aureus two-component regulatory system, GraRS, is involved in resistance to killing by distinct host defense cationic antimicrobial peptides (HD-CAPs). It is believed to regulate downstream target genes such as mprF and dltABCD to modify the S. aureus surface charge. However, the detailed mechanism(s) by which the histidine kinase, GraS, senses specific HD-CAPs is not well defined. Here, we studied a well-characterized clinical methicillin-resistant S. aureus (MRSA) strain (MW2), its isogenic graS deletion mutant (ΔgraS strain), a nonameric extracellular loop mutant (ΔEL strain), and four residue-specific ΔEL mutants (D37A, P39A, P39S, and D35G D37G D41G strains). The ΔgraS and …

Dynamic Hip Screw Fixation For Inter-Trochanteric Fractures: Determinants Of Outcomes, Adil Aijaz Shah, Santosh Kumar, Abdull Rehman

Department of Surgery Docs

bstract

OBJECTIVE:

To evaluate factors associated with revision of dynamic hip screw implant in patients undergoing the procedure for the fixation of intertrochanteric fractures.

METHODS:

The retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised records of patients who had undergone dynamic hip screw fixation surgery between 2008 and 2012. Medical records and data for all patients were obtained from the medical records office. For all patients, the record files were systematically reviewed using a structured, pre-defined data extraction sheet. SPSS 20 was used statistical analysis.

RESULTS:

Out of 317 patients who had undergone the procedure, …

Designing A Mechanical Linkage Capable Of Decreasing Force Transfer From The Facemask To The Protective Helmet When Loading Occurs, Levi Hansen

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction

Sports that involve extensive personal contact have a high incidence of injury. The introduction of regulations mandating the use of personal protective equipment in these sports is the most common injury control strategy (Marshall et al., 2002). Negligible attention has been paid to the mechanical linkage between the facemask and helmet as a means of reducing force transfer from the facemask, through the helmet, and to the head and or neck of the athlete.

Methods

A novel prototype mechanical linkage of reasonable simplicity that provides 360° of freedom in motion capable of decreasing force transfer from the facemask to …

The Impact Of Inflammatory And Immune Response-Related Genetic Variants On Prostate Cancer Risk Among Men Of African Descent., Dominique Zilpha Jones

Electronic Theses and Dissertations

Background: In the U.S., prostate cancer (PCA) metastasis is associated with a 5-yr survival rate of 29% and disproportionately affects men of African descent. Single nucleotide polymorphisms (SNPs) may serve as genetic markers to identify individuals at high risk of developing PCA. Methods: We examined main and joint effects of 119 inflammatory and immune response-associated SNPs among men of African descent (535 controls, 279 cases) via logistic regression (LR) and entropy-based-multi-factor dimensionality reduction (MDR) modeling. Results: MDR yielded highly synergistic [(TLR10, TLR6 and IRF3), (TLR2, IRAK4), (IL1R2, IL10, IL10RA)] interaction …

Modulation Of The Ovarian Cancer Humoral Response By Tumor-Derived Exosomes., Carolyn Denise Roberson

Electronic Theses and Dissertations

The pathogenesis of epithelial ovarian cancer is complicated by its diagnosis during the latter stages of the disease resulting from lack of symptoms or from presence of symptoms that mimic other conditions. Because of the often fatal prognosis by the time of actual detection, efforts are being made to better understand the host immune response to ovarian cancer. In this study, the contributions of the humoral immune response were investigated by focusing on the role of tumor-derived exosomes and their ability to modulate humoral immune responses. First, ovarian cancer patient-derived free circulating antibodies were investigated for immunoreactivity to patient antigen. …

Pattern And Outcome Of Epilepsy At Department Of Neurology At Cmc Teaching Hospital Larkana, Alam Ibrahim Siddiqui, Badaruddin Junejo, Lal Chander Dhingra, Anila Mumtaz

Pakistan Journal of Neurological Sciences (PJNS)

Epilepsy is third most common chronic neurological disease. Mortality is 2-3% more common in epilepsy patients than in general population. World wide survey have shown that epilepsy responds to treatment in about 70 % of epileptic patients and three fourth of the affected people do not get the treatment they need. So objective of our study was to know the outcome and pattern of epilepsy at Department of Neurology CMC teaching hospital Larkana ,so that in next step we could know which factors could reduce the morbitity and mortality due to epilepsy hence could prevent complications due to epilepsy. Total …

A Clinical Approach To Disorders Of Speech, Apoorva Pauranik

Pakistan Journal of Neurological Sciences (PJNS)

Disorders of speech and communication, including Aphasia (mainly post stroke) are a major community health burden in terms of DALY (Disability Adjusted Life Years). Unfortunately they are relatively neglected with huge treatment gap. Traditionally aphasia related lesion sites have been grouped with reference to Rolandic & Sylvian fissures. However the theoretical models of language and speech organization in brain have undergone major conceptual shifts due to advances in cognitive neuropsychology, linguistics and functional neuro-imaging. Much more widely distributed overlapping neural networks are understood to be actively involved in various communication activities. The notion of speech centers or areas is somewhat …

Use Of Fresh Parental Fibular Allograft For Reconstruction Of Skeletal Defects After Limb Salvage Surgery, Muhammad Masood Kadir, Raza Askari, Sher Baz

Department of Surgery Docs

Abstract

OBJECTIVE:

To share early experience with paediatric patients having undergone skeletal reconstruction after limb salvage surgery.

METHODS:

A reterorespective audit study was conducted at Aga Khan University Hospital, Karachi, from 1994 to 2011 An audit of the institutional tumour registry was done and relevant cases of paediatric patients having undergone skeletal reconstruction after limbsalvage surgery were tracked. Outcomes were objectively assessed through Musculoskeletal Tumour Society score. International Society of Limb Salvage grading was used to measure union of the graft to the host bone.

RESULTS:

Of the total 9 patients, 5(55.6%) were males and 4(44.4%) were females with an …

Self-Regulation Theory And Self-Monitoring Of Blood Glucose Behavior In Type 2 Diabetes Mellitus., Jennifer E. F. Ward

Electronic Theses and Dissertations

The present study examined self-monitoring of blood glucose (SMBG) as part of a selfregulatory process of health decision-making using the Self-Regulation Model of illness perceptions, or Common Sense Model. Participants were N=185 individuals with type 2 diabetes from a specialty diabetes clinic prescribed subcutaneous insulin or other injectable diabetes medication at least daily. Collected information included both medical chart data and self-report questionnaires completed prior receiving lab results. Self-care burden was generally high; the modal prescribed times per day of injecting insulin was 4 with modal SMBG recommendations of 3-4 times per day. Participants reported high adherence to prescribed medication …

Biomarker Discovery Of Liver Diseases Using Mass Spectrometry-Based Metabolomics., Xue Shi

Electronic Theses and Dissertations

Metabolomics has emerged as one of the latest of the "-omics" disciplines that can detect metabolite biomarkers in biological samples. The diverse characteristics of metabolites make the analytical platform challenging in metabolomics. Two bioanalytical platforms were developed in this study to investigate metabolite abundance changes under different biological conditions. We first developed a bioanalytical platform that coupled linear trap quadruple - Fourier transform ion cyclotron mass spectrometer (LTQ-FTICR MS) with direct infusion chip-based nano-electrospray ionization (DI-nESI) and applied it to study polychlorinated biphenyls (PCB) effects on non-alcoholic fatty liver disease (NAFLD). We also employed this platform in conjunction with in …

Is Postpartum Depression A Disease Of Modern Civilization?, Jennifer Hahn-Holbrook, Martie Haselton

Psychology Faculty Articles and Research

Access to calorie-dense foods, medicine, and other comforts has made modern humans healthier than our prehistoric ancestors in many respects. However, the epidemics of obesity, diabetes, and cardiovascular disease suggest that there are also drawbacks to modern living. Here, we address the question of whether the dramatic cultural changes that have occurred over the past century have inflated rates of postpartum depression, adding postpartum depression to the list of diseases of modern civilization. We review evidence from cross-cultural, epidemiological, and experimental studies documenting associations between postpartum depression and modern patterns of early weaning, diets deficient in essential fatty acids, low …

Our Experience With Van Nes Rotationplasty For Locally Advanced Lower Extremity Tumours, Raza Askari, Masood Umer, Mohsin-E-Azam, Haroon Rashid

Department of Surgery Docs

Abstract

OBJECTIVE:

To present an early experience with the time-tested technique of Van Ness Rotationplasty to save distal lmbs.

METHODS:

Van Nes Rotationplasty for locally advanced lower extremity tumours. A reterorespective audit was conducted at Aga Khan University Hospital, Karachi, and comprised cases of bone and soft tissue sarcoma who underwent Van Ness Rotationplasty over seven years from January 2005 to December 2011. Demographic data, family history, past history, co-morbids, date since diagnosis, duration of symptoms, type of tumour, metastasis, pre-op and post-op functional status, recurrence and survival were collected.

RESULTS:

Of the 351 cases of bone and soft tissue …

Development Of A Translational, Tissue-Engineered Approach To Replacement Of Myocardial Infarct Scar Tissue, Jason Schulte

All Dissertations

Myocardial infarction (MI) affects nearly 600,000 individuals each year, and the resulting damage initiates a pathophysiological progression towards congestive heart failure (CHF). A shortage of donor organs precludes heart transplantation as a practical solution, and neither surgical intervention nor stem cell therapy have yielded consistent and sufficiently positive results in clinical investigation. To prevent CHF, prospective therapies must target the cause of the maladaptive cardiac remodeling which precedes it--the nonfunctional, dyskinetic infarct scar--and aim to replace it with functional cardiac muscle. Tissue engineering holds promise for the development of novel therapies to either halt or reverse post-MI cardiac remodeling. However, …

The End Of An Era: The Cancer Stem Cell Hypothesis And Its Therapeutic Implications, Emily Paton

Independent Study Project (ISP) Collection

Cancer, a leading cause of death in many developed countries, has become a global health burden. Much of the drain on healthcare systems has resulted from the high cost and ineffectiveness of conventional cancer treatments, which often lead to cancer relapse or metastasis. The failures of chemotherapy, radiation, and surgery have been elucidated by the cancer stem cell (CSC) hypothesis, which postulates that a small percentage of tumor cells drive tumorigenesis. These cells can sustain cancer through their capacity to self-renew and differentiate into specialized tumor cell types, similar to how healthy stem cells maintain healthy tissues. Conventional cancer treatments …