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Insulin Regulates Glucose Consumption And Lactate Production Through Reactive Oxygen Species And Pyruvate Kinase M2., Qi Li, Xue Liu, Yu Yin, Ji-Tai Zheng, Cheng-Fei Jiang, Jing Wang, Hua Shen, Chong-Yong Li, Min Wang, Ling-Zhi Liu, Bing-Hua Jiang

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Although insulin is known to regulate glucose metabolism and closely associate with liver cancer, the molecular mechanisms still remain to be elucidated. In this study, we attempt to understand the mechanism of insulin in promotion of liver cancer metabolism. We found that insulin increased pyruvate kinase M2 (PKM2) expression through reactive oxygen species (ROS) for regulating glucose consumption and lactate production, key process of glycolysis in hepatocellular carcinoma HepG2 and Bel7402 cells. Interestingly, insulin-induced ROS was found responsible for the suppression of miR-145 and miR-128, and forced expression of either miR-145 or miR-128 was sufficient to abolish insulin-induced PKM2 expression. …

Network Analysis Of Circular Permutations In Multidomain Proteins Reveals Functional Linkages For Uncharacterized Proteins., Donald Adjeroh, Yue Jiang, Bing-Hua Jiang, Jie Lin

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Various studies have implicated different multidomain proteins in cancer. However, there has been little or no detailed study on the role of circular multidomain proteins in the general problem of cancer or on specific cancer types. This work represents an initial attempt at investigating the potential for predicting linkages between known cancer-associated proteins with uncharacterized or hypothetical multidomain proteins, based primarily on circular permutation (CP) relationships. First, we propose an efficient algorithm for rapid identification of both exact and approximate CPs in multidomain proteins. Using the circular relations identified, we construct networks between multidomain proteins, based on which we perform …

Pancreatic Lymphangioma, Shaista Afzal, Imrana Masroor, Gulnaz Shafqat

Department of Radiology

Lymphangioma develops as a consequence of lymphatic malformation and blockage of lymphatic flow. Pancreatic lymphangioma is a rare benign tumour which can grow reasonably large prior to manifestation of symptoms. On imaging, it appears as a complex multiseptated cystic mass. However, this appearance is not diagnostic and overlaps with cystic pancreatic neoplasm. We present a case of pancreatic lymphangioma incidentally discovered in an elderly lady who was managed conservatively since surgery could not be performed as the patient was high risk for surgery. Imaging findings along with follow-up of the case and review of literature is presented.

Making Space For Dying: Portraits Of Living With Dying, Elise Lark

Antioch University Dissertations & Theses

In Making Space for Dying: Portraits of Living with Dying, I describe the everyday lived experience of dying and the care culture within freestanding, community-based, end-of-life residences (CBEOLR) utilizing portraiture and arts-based research. I craft four case studies into “portraits,” based on interviews, on-site visits, up-close observation, and field notes. In the person-centered portraits, I reveal the inner landscape of two terminally ill women, with data represented in poetry. In the place-centered portraits, I “map” the social topography of two CBEOLRs to illustrate how lives and care of the dying are emplaced, from the perspectives of community leaders, …

Culturable Aerobic And Facultative Anaerobic Intestinal Bacterial Flora Of Black Cobra (Naja Naja Karachiensis) In Southern Pakistan, Junaid Iqbal, Mehwish Sagheer, Nazneen Tabassum, Ruqaiyyah Siddiqui, Naveed Ahmed Khan

Department of Biological & Biomedical Sciences

Using morphological analysis and biochemical testing, here for the first time, we determined the culturable gut bacterial flora (aerobes and facultative anaerobes) in the venomous Black Cobra (Naja naja karachiensis) from South Asia. The findings revealed that these snakes inhabit potentially pathogenic bacteria including Serratia marcescens, Pseudomonas aeruginosa, Shewanella putrefaciens, Aeromonas hydrophila, Salmonella sp., Moraxella sp., Bacillus sp., Ochrobactrum anthropi, and Providencia rettgeri. These findings are of concern, as injury from snake bite can result in wound infections and tissue necrosis leading to sepsis/necrotizing fasciitis and/or expose consumers of snake meat/medicine in the community to infections.

Mothering And The Functional Self: A Hermeneutic Exploration Of Texts On Perinatal Mood And Anxiety Disorders, Kathleen M. Pape

Antioch University Dissertations & Theses

Mothering is a rich and complex experience involving challenging tasks, a developing relationship with one's child, and socially defined roles. How mothering is viewed varies depending on the cultural norms and historical era under consideration. This study is a textual interpretation of three books written about perinatal mental health, especially how those texts describe the challenges and struggles of birthing and mothering. I develop understandings about how clinicians respond to those issues and in the process understand themselves, their practices, and their sociocultural roles. I consider the shape of the current social terrain that brings to light the experiences of …

Factors In Optimal Collaboration Between Psychologists And Primary Healthcare Physicians, Margaret A. Drewlo

Antioch University Dissertations & Theses

This survey study explored factors in optimal collaboration between registered psychologists and primary healthcare physicians (PHCP). With rising costs of healthcare, healthcare funding cuts, and changes in the way healthcare delivery is perceived, interprofessional collaboration is timely to explore. In particular, the attitudes of registered psychologists about salient factors noted in the collaboration literature, such as education and training, accessibility, and communication factors are important to the practice of psychology. As part of the exploratory nature of the study, questions about gender and hierarchy were also presented. While most data were quantitative, qualitative data were gathered on 6 of the …

Using Management Information System To Evaluate Quality Of Care At Tertiary Care Hospital’S Stroke Centre, Abdul Malik, A. Zafar, F. S. Khan

Pakistan Journal of Neurological Sciences (PJNS)

To find out the average length of stay, the rate of I/V catheter cellulites, the rate of bed sores among patients in stroke centre and determine the mortality rates. Methodology: This is a descriptive study, carried out at a tertiary care hospital over the period of six months. Data was analyzed by SPSS version 15.0. Result: Total numbers of patients were 36 from January 1 to June 30, 2007 at Stroke Center Liaquat National Hospital. The mean length of stay was 8.17 ±5.81 days. Patients had cellulitis (intravenous) 97.2%, only 2.8% of patients did not develop. The rate of bed …

Delay In Diagnosis Of Motor Neuron Disease. A Tertiary Care Experience, Hazim Brohi, Naveed Uddin Ahmed, Rajesh Khatri, Ishaq Asghar

Pakistan Journal of Neurological Sciences (PJNS)

Motor Neuron Disease is a progressive neurological disorder with poor prognosis. Inability to correctly recognize the disease, leads to undue agony and diagnostic dilemma. Studies have been done to look at the average duration taken to diagnose the disease from the onset of symptoms. The literature shows that latency from symptom onset to diagnosis range from 10.6–17.5 months. No such study has been conducted in our region. We reviewed 62 patients referred to the neurophysiology lab from year 2009 to 2013 with quarry of MND. Only 40 patients were identified to fulfill the El Escorial criteria for MND. The median …

Crossed Cerebellar Diaschisis In Partial Status Epilepticus, Sahrish Aieshah Kazi, Rehmani Aniqah Jawad, Rashed Nazir, Shahid Ahmed Shah, Arsalan Ahmad

Pakistan Journal of Neurological Sciences (PJNS)

Crossed cerebellar diaschisis is a phenomena described as decrease in metabolism in the cerebellar hemisphere contralateral to the supratentorial lesion. A 61 year old man presented with status epilepticus. CT Brain showed small acute hemorrhage in left parietal lobe.MRI revealed diffusion restriction in right cerebral and left cerebellar hemispheres with hyperintensities on T2WI and FLAIR. However, CT perfusion was suggestive of increased perfusion in these areas. Periictal EEG showed frequent bursts of higher voltage spike and wave discharges over the right hemisphere. He was treated with IV antiepileptics. But he continued to deteriorate, and expired at 10th day of admission.

Neurostimulation For Refractory Primary Chronic Headache Disorders: A Review, Bindu Yoga, Modar Khalil, Hassan Zafar, Fayyaz Ahmed

Pakistan Journal of Neurological Sciences (PJNS)

Headache is the commonest symptom seen in both primary and secondary care. Vast majority are primary i.e. for which no underlying cause has been detected. Tension Headaches, Migraine and Cluster Headaches are the most common primary headache disorders in the population. Although most of the primary headache disorders can be satisfactorily treated with both acute and preventive medications, those that are refractory to conventional treatment pose a great challenge to the headache physician. Moreover some patients are not able to use traditional treatment due to intolerance and co-morbidities. Neurostimulation is a treatment modality that has been used in other neurological …

Neurosurgery Literature Highlights & Psychiatry Literature Highlights, Muhammad Waqas Shaiq, Muhammad Shahzad Shamim

Pakistan Journal of Neurological Sciences (PJNS)

Today, a great challenge of our profession is to envision how we will deliver exemplary neurosurgical care in the future. To accomplish this requires anticipating how economic, political, and societal influences will affect our ability to provide the highest quality of patient care in an arena that will look increasingly different from today's world of medicine. Already, our profession is battling a relentless assault as numerous sectors implement change that impacts us and our community every day. Surviving this requires an effective strategy that will involve significant cultural change.

Space-Time Statistical Analysis Of Malaria Morbidity Incidence Cases In Ghana: A Geostatistical Modelling Approach, Simon K. Appiah

Theses: Doctorates and Masters

Malaria is one of the most prevalent and devastating health problems worldwide. It is a highly endemic disease in Ghana, which poses a major challenge to both the public health and socio-economic development of the country. Major factors accounting for this situation include variability in environmental conditions and lack of prevention services coupled with host of other socio-economic factors. Ghana’s National Malaria Control Programme (NMCP) risk assessment measures have been largely based on household surveys which provided inadequate data for accurate prediction of new incidence cases coupled with frequent incomplete monthly case reports. These raise concerns about annual estimates on …

Role Of Physical Exercise In Reducing Depression And Improving Mental Health In Cancer Survivors, Gregory Levin

Theses: Doctorates and Masters

Cancer survivors are more than twice as likely as the general population to suffer the debilitating effects of depression. This comorbid condition is associated with several negative consequences, such as reduction in compliance with cancer treatments, and hastened mortality. Recent research has examined the therapeutic effect of exercise on depression and reported excellent results of similar magnitude to those achieved with pharmacotherapy or psychological intervention. However, no research, to date, has examined the effectiveness of exercise on reducing depression in depressed cancer survivors. In order to address this important question this thesis reviewed previous literature in the area of cancer …

Plasma Insulin-Degrading Enzyme: Characterisation And Evaluation As A Potential Biomarker For Alzheimer's Disease, Michelle Tegg

Theses: Doctorates and Masters

Alzheimer’s disease (AD) is increasing in prevalence due to increasing lifespan and altered lifestyle. It is the fourth major cause of death in Western countries, resulting in significant economic and social impact (Von Strauss, et al., 1999; Goate, 1997). There are no blood biomarkers currently accepted for the diagnosis of AD, and the identification of suitable biomarkers would eventually reduce the necessity for invasive, expensive and slow diagnostic procedures, as well as facilitate prognostic studies. An AD blood test would decrease the need for delaying diagnosis due to ambivalent presentation, and allow therapeutic intervention to commence at an earlier …

Homebirth In Wa: Why Women Make This Choice, Colleen Ball

Theses: Doctorates and Masters

Background: Homebirths in Western Australia (WA) account for approximately 0.8% of all births. Two consecutive reports from the Perinatal and Infant Mortality Monitoring Committee found increased rates of perinatal mortality in homebirths and recommended a prospective cohort study to assess mortality and morbidity outcomes for women with planned home births in WA. The Homebirth in WA Study, of which this thesis is a component, has been funded by a directed research grant.

Aim: The aim of this study was to explore the specific reasons why women in WA choose homebirth. Research on homebirths is focused on perinatal outcomes and …

Identification Of Plasma Lipid Biomarkers In Alzheimer's Disease, Rhona Creegan

Theses: Doctorates and Masters

Alzheimer’s disease (AD), the commonest form of dementia, is a chronic, progressive neurodegenerative disease which manifests clinically as a slow global decline in cognitive function, including deterioration of memory, reasoning, abstraction, language and emotional stability, culminating in a patient with end-stage disease, totally dependent on custodial care. With an ageing population, there is predicted to be a marked increase in the number of people diagnosed with AD in the coming decades, making this a significant challenge to socio-economic policy and aged care. Currently there is no cure for AD and while current therapies may temporarily ameliorate symptoms, death usually occurs …

Leukopenia Management In Thymoglobulin Treated Renal Transplant Recipients, Lynsey S. Biondi Md, Michael J. Moritz Md, Janelle Cyprich

Department of Surgery

No abstract provided.

Research Brief: "Suicides In The Military: The Post-Modern Combat Veteran And The Hemingway Effect", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This brief is about current suicide prevention interventions within the military. In policy and practice, practitioners should monitor the wellness of aging veterans and ensure that a support system exists for their veteran patients, while veterans should participate in social events with other veterans; the VA and DoD should implement programs to ensure that veterans have feelings of belongingness and the VA should monitor veterans' well-being for 2-3 years after service during transitions. Suggestions for future research include examining the communities and veteran service organizations that produce the most useful support for veterans with mental health problems.

Combating Resistance To Epidermal Growth Factor Recpetor Inhibitors In Triple Negative Breast Cancer, Julie Marie Madden

Wayne State University Dissertations

Triple negative breast cancer (TNBC) patients suffer from a highly malignant and aggressive cancer that lacks an effective targeted therapeutic. Although many TNBCs, both in vitro and in vivo, have increased expression of epidermal growth factor receptor (EGFR), EGFR targeted inhibitors, such as gefitinib (GEF), have yet to demonstrate efficacy. Using mass spectrometry to identify pathways that remain activated in the presence of GEF, we found that components of the mTOR signaling pathway remain phosphorylated. While inhibiting mTOR with temsirolimus (TEM) decreased mTOR signaling, EGFR signaling pathways remained activated and the TNBC cell lines continued to proliferate. However, dual treatment …

Pathway Profiling Of Replicative And Induced Senescence, Maggie Purcell

Wayne State University Dissertations

Senescence is a permanent withdrawal from cell cycle that occurs naturally in cells in response to the shortening of telomeres. This natural "clock" serves to limit the number of cell divisions and therefore protects the cell from potentially carcinogenic mutations. However, senescence also occurs in response to external stresses to the cell, which is known as induced senescence. This study compares the mechanisms of natural senescence, a response to the shortening of telomeres during replication, with induced senescence by using various drugs to induce senescence: 5-aza-2-deoxycytidine (a demethylating agent), Adriamycin (a chemotherapeutic drug), and H2O2 (an agent causing oxidative stress). …

Influence Of Social Class Perceptions On Attributions Among Mental Health Practitioners, Mindi Thompson, Jacob Diestelmann, Odessa Cole, Abiola O. Keller, Takuya Minami

Physician Assistant Studies Faculty Research and Publications

Objective: A vignette-based study assessed the influence of social class attributions toward a hypothetical client's difficulty. Method: 188 licensed mental health professionals who were recruited through professional listservs completed an online survey after reviewing one of two versions of a vignette describing a hypothetical client that varied based on social class cues. Results: As expected, this sample of licensed mental health practitioners detected social class differences based on the descriptors of the hypothetical client across the two vignettes. These perceived social class differences, however, did not impact participants' attributions toward the client for causing or solving her problems, level of …

Gender Differences In Self-Esteem In Young Adolescents Of Karachi, Shelina Bhamani, Sabeen Jamil, Falak Zehra Mohsin

Department of Obstetrics & Gynaecology

The purpose of this research was to explore the self-esteem trends in adolescents of Karachi, Pakistan with regard to gender differences. The insights from previous literature helped to form the hypothesis that there will be a significant gender difference on the self-esteem of adolescents variable. There were a total 224 (96 male and 126 female) adolescents chosen for this study and the Multidimensional Self-Esteem Scale: a 36 item and a 3 Likert response scale was adapted for this study with the consent of the author. The data analysis revealed that there is a significant gender difference on the variable of …

Evaluating The Effects Of An Educational Lifestyle Modification Intervention On Blood Pressure In Adults With Prehypertension, Andrea M. Patterson

UNF Graduate Theses and Dissertations

The purpose of this project was to evaluate the effectiveness of an educational lifestyle modification (LM) intervention on blood pressure (BP) among adults with prehypertension. Prehypertension is a precursor to hypertension (HTN) and is a public epidemic in the United States. Approximately 68 million (31%) U.S. adult’s aged ≥18 years have hypertension. Hypertension can cause significant target organ damage, lead to coronary heart disease, heart failure, stroke, and kidney failure. Early identification and the primary treatment of persons with prehypertension with LM have the potential to minimize the progression and delay the onset of comorbidities associated with hypertension. This quality …

Investigating The Role Of Dachshund Homolog 1 (Dach1) And Mir-200b In Group 4 Medulloblastoma Pathogenesis, Courtney George

Theses : Honours

Medulloblastoma is the most common malignant childhood brain tumour, and the most significant cause of childhood cancer-related mortality. Recently four core molecular medulloblastoma sub-groups have been identified, with distinct pathogenesis and responses to therapies. Current therapies, do not account for this molecular variation, and many patients may receive inappropriate treatment. To address this, targeted therapies for each molecular sub-group would be ideal. Unfortunately, for the more aggressive Group 3 and Group 4 subgroups, the underlying mechanisms of pathogenesis remain poorly understood. The current challenge is to identify the key tumour suppressors or oncogenes involved in Group 3 and Group 4 …

Right Ventricular Perforation: A Rare Complication Of Pulmonary Artery Catheterization, Khalid Ahsan, Mohammad Hamid, Saulat H. Fatimi, Ijaz Hidayat

Department of Anaesthesia

A 70 years old male underwent Coronary Artery Bypass and Graft (CABG) surgery. After induction, a Pulmonary Artery Catheter (PAC) was inserted via right IJV with some difficulty in achieving PA tracing. During distal RCA anastomosis, surgeon noticed PAC tip coming out of Right Ventricular (RV) surface. Resistance was felt on trying to pull PAC, so it was left there. Cardiac surgeon then opened the Right Atrium (RA) and pulled out the catheter. Multiple attempts during insertion of PA catheter should always raise the suspicion of PAC tip slipping back into the RV. It should be closely monitored during surgery …

A Nonrigid Registration Method For Correcting Brain Deformation Induced By Tumor Resection, Yixun Liu, Chengjun Yao, Fotis Drakopoulos, Jinsong Wu, Liangfu Zhou, Nikos Chrisochoides

Computer Science Faculty Publications

Purpose: This paper presents a nonrigid registration method to align preoperative MRI with intraoperative MRI to compensate for brain deformation during tumor resection. This method extends traditional point-based nonrigid registration in two aspects: (1) allow the input data to be incomplete and (2) simulate the underlying deformation with a heterogeneous biomechanical model.

Methods: The method formulates the registration as a three-variable (point correspondence, deformation field, and resection region) functional minimization problem, in which point correspondence is represented by a fuzzy assign matrix; Deformation field is represented by a piecewise linear function regularized by the strain energy of a heterogeneous biomechanical …

Achieving High-Value Cardiac Imaging: Challenges And Opportunities., David H Wiener

Division of Cardiology Faculty Papers

Cardiac imaging is under intense scrutiny as a contributor to health care costs, with multiple initiatives under way to reduce and eliminate inappropriate testing. Appropriate use criteria are valuable guides to selecting imaging studies but until recently have focused on the test rather than the patient. Patient-centered means are needed to define the true value of imaging for patients in specific clinical situations. This article provides a definition of high-value cardiac imaging. A paradigm to judge the efficacy of echocardiography in the absence of randomized controlled trials is presented. Candidate clinical scenarios are proposed in which echocardiography constitutes high-value imaging, …

A Review Of Critical Care Management Of Maternal Sepsis, Madiha Hashmi, Fazal Hameed Khan

Department of Anaesthesia

Sepsis is a leading cause of preventable maternal mortality in developing countries due to poverty, home deliveries by untrained persons in unhygienic conditions, limited access to healthcare facilities and lack of availability of antibiotics. Recent confidential enquiries into maternal deaths from the developed nations have revealed an increase in maternal mortality secondary to genital tract sepsis and provision of suboptimal critical care. Early recognition of critical illness in obstetric patients, involvement of intensive care teams earlier and provision of same standard of critical care to pregnant women as non-pregnant patients while being mindful of the altered maternal physiology and fetal …

Assessment Of Apparent Diffusion Coefficient Values As Predictor Of Aggressiveness In Peripheral Zone Prostate Cancer: Comparison With Gleason Score, Shayan Sirat Maheen Anwar, Zahid Anwar Khan, Rana Shoaib Hamid, Fahd Haroon, Raza Sayani, Madiha Beg, Yasir Jamil Khattak

Department of Radiology

Purpose. To determine association between apparent diffusion coefficient value on diffusion-weighted imaging and Gleason score in patients with prostate cancer. Methods. This retrospective case series was conducted at Radiology Department of Aga Khan University between June 2009 and June 2011. 28 patients with biopsy-proven prostate cancer were included who underwent ultrasound guided sextant prostate biopsy and MRI. MRI images were analyzed on diagnostic console and regions of interest were drawn. Data were entered and analyzed on SPSS 20.0. ADC values were compared with Gleason score using one-way ANOVA test. Results. In 28 patients, 168 quadrants were biopsied and 106 quadrants …