Digital Commons Network^™

The Clinical Phenotype Of Motor Neurone Disease In A Kenyan Hospital – Based Population, Effie Nailah Kamadi

Master of Medicine in Internal Medicine

Introduction: Motor Neurone Disease (MND) is a rare, disabling and incurable illness marked by relentless degeneration of motor neurons with loss of voluntary motor function and eventual death. In the West, patient demographics and clinical characteristics are well documented. Available African research is mostly for North, West and South Africa with a knowledge gap existing on the East African illness. This study characterized MND phenotype in a Kenyan population.

Objectives: To describe the clinical phenotype and outcomes of MND in a Kenyan hospital-based population.

Methods: The medical charts of all adult MND patients assessed at AKUHN between …

The Prevalence And The Predictors Of Diabetes Distress In Patients With Type 2 Diabetes Attending Diabetes Clinics At A Tertiary Private Hospital In Nairobi, Kenya., Soulthy Azamkhan Mohamed

Master of Medicine in Family Medicine

Background Diabetes distress encompasses a spectrum of emotional and psychological challenges faced by individuals managing diabetes, including anxiety, stress, depression, frustration, and feelings of helplessness. This distress arises from the constant demands of monitoring blood sugar levels, managing medications, adhering to dietary restrictions, engaging in regular physical activity, and navigating potential complications. Social and emotional factors such as stigma, discrimination, and concerns about future health further contribute to this burden. Factors like fear of hypoglycemia, financial strain, fluctuating blood sugar levels, anxiety about complications, and impacts on personal relationships exacerbate diabetes distress. Left unaddressed, diabetes distress can lead to poor …

Dementia In A Resource-Constrained Sub-Saharan African Setting: A Comprehensive Retrospective Analysis Of Prevalence, Risk Factors, And Management At The Only Neuropsychiatric Facility In Northeastern Nigeria, Ibrahim Abdu Wakawa, Umar Baba Musami, Suleiman Hamidu Kwairanga, Placidus Nwankuba Ogualili, Mohammed Yusuf Mahmood, Muhammad Abba Fugu, Mohammed Mala Gimba, Muktar Mohammed Allamin, Zaharadeen Umar Abbas, Chinedu Momoh

Brain and Mind Institute

INTRODUCTION: Dementia prevalence is increasing in sub-Saharan Africa, poten-tially due to population growth and aging. Resource-constrained settings such asNortheastern Nigeria face challenges in dementia management.

METHODS: We assessed dementia burden and management at the Federal Neuropsy-chiatric Hospital Maiduguri, the only neuropsychiatric facility in Northeastern Nigeria.This retrospective analysis included patient records from 1999 to 2023 for individuals60 year of age and older with a dementia diagnosis.

RESULTS: Of the 1216 cases reported, Alzheimer’s disease (60.5%) was the mostcommon subtype, followed by vascular dementia (24.5%). Hypertension (41.6%) wasthe most frequent comorbidity. Memory loss was present in all cases, whereasbehavioral …

Applications Of Archaeal Antioxidant Coenzyme M As An Agricultural Biostimulant, Jeremy Hunter Brown

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

As the demand to meet global food security goals continue to increase, the need to increase efficiency and productivity of agricultural output also rises. This calls for innovative and cost-effective methods for improving plant growth and yield. Here we explore how antioxidants, molecules that inhibit oxidation and are necessary for redox based signaling and redox homeostasis, can be utilized as chemical biostimulants. Specifically, we investigated Coenzyme M, an antioxidant from archaea that holds potential economic advantages over other antioxidants. Chapter 1 provides a comprehensive review of antioxidants and how exogenously application of them affects plant growth and biology, highlighting the …

Spotting And Responding To Health Misinformation And Disinformation, Michael J. Mcgee, Jean-Philippe Berteau

Open Educational Resources

Three one-hour lessons. In these lessons students will learn to identify health misinformation which spreads rapidly through social media, search engines, and online platforms. By generating false health news stories with AI and critically analyzing them, students will develop essential skills for public health literacy and ethical responsibility. These activities equip future health professionals with the tools to discern evidence-based information from deceptive content and provide guidance to ensure accurate and authentic communication in the field.

Assessment Of Parents’ Awareness About The Care Of Their Neonates With Neural Tube Defects, Asmaa Salah Khamis, Hayam Salah Tanatwy, Safaa Salah Ismail

Nursing

Background: Neural Tube Defects are one of the most congenital anomalies of the Central Nervous System that may happen in the neonatal period. Aim of the study: this study aimed to assess parents’ awareness about the care of their neonates with neural tube defects. Research design: A descriptive study design was used. Setting: the study was conducted at the outpatient clinic for pediatric Neurology at Ain Shams Educational Hospital. Methods: A convenient sample of 40 parents accompanied by their neonates who suffered from neural tube defects. Tools: Data was collected using three tools. Tool (I) A structured questionnaire sheet composed …

A Study Of Secondary Traumatic Stress In Health Care Professionals In Long-Term Care., Bethany Proudfoot

Doctor of Social Work Capstone Projects

Secondary traumatic stress (STS) is a significant concern for healthcare professionals in long-term care (LTC) settings. This study explores the impact of STS on clinical staff, addressing the research question: How has STS affected employees within the LTC sector, and what resources or support can be provided to mitigate its effects? The study utilized a mixed-methods approach, combining survey data from clinical staff across five LTC facilities in Ohio, incorporating the survey data measuring levels of STS and qualitative responses. Findings revealed that 64% of participants experienced high to severe levels of STS, with symptoms including anxiety, depression, sleep disturbances, …

Insulin Receptor Responsiveness Governs Tgfβ-Induced Hepatic Stellate Cell Activation: Insulin Resistance Instigates Liver Fibrosis, Wang-Hsin Lee, Evelyn A. Bates, Zachary A. Kipp, Sally Pauss, Genesee J. Martinez, Cheavar A. Blair, Terry D. Hinds Jr.

Markey Cancer Center Faculty Publications

The insulin receptor (INSR) has been shown to be hyperactive in hepatic stellate cells (HSCs) in humans and rodents with liver fibrosis. To explore HSC cellular mechanisms that INSR regulates during pro-fibrotic stimulation, we used CRISPR-Cas9 technology. We knocked out a portion of the INSR gene in human LX2 HSC cells (INSRe5- 8 KO) that regulates insulin responsiveness but not the insulin-like growth factor (IGF) or transforming growth factor-β (TGFβ) signaling. The INSRe5- 8 KO HSCs had significantly higher cell growth, BrdU incorporation, and lower TP53 expression that suppresses growth, and they also exhibited increased migration compared to the Scramble …

Exploring Oxylipins In Host–Microbe Interactions And Their Impact On Infection And Immunity, Robert J. Neff, Christopher D. Radka

Markey Cancer Center Faculty Publications

Plasma lipids are essential components of biological systems, transported through interactions with proteins to maintain cellular functions. These lipids exist in various forms, such as fatty acids, glycerolipids, glycerophospholipids, sphingolipids, sterols, and prenol lipids, derived from dietary intake, adipose tissue, and biosynthesis. While the association between certain fatty acids and cardiovascular diseases has been widely recognized, polyunsaturated fatty acids (PUFAs) exhibit cardioprotective effects, reducing risks of arrhythmias and heart-related mortality. This is due to their role in the production of eicosanoids, which modulate inflammation. Chronic inflammation, particularly in obesity, is significantly influenced by fatty acids, with saturated fatty acids promoting …

Caloric Restriction And Telomere Preservation In Tert Knockout Adipocyte Progenitors Does Not Rescue Mice From Metabolic Dysfunction Due To A Tert Function In Adipocyte Mitochondria, Zhanguo Gao, Yongmei Yu, Kristin Eckel-Mahan, Mikhail G Kolonin

The Brown Foundation: Institute of Molecular Medicine

Inactivation of telomerase (TERT) in adipocyte progenitor cells (APC) expedites telomere attrition, and the onset of diabetes in mice fed high-fat diet (HFD), which promotes APC over-proliferation and replicative senescence. Here, we show that time-restricted feeding or caloric restriction in the postnatal development of mice subsequently subjected to HFD prevents telomere attrition but not glucose intolerance. This metabolic effect of dietary intervention was not observed for mice with TERT KO in endothelial or myeloid cells. To characterize the telomere-independent effects of TERT in the APC lineage, we analyzed mice with TERT knockout in mature adipocytes (AD-TERT-KO), which do not proliferate …

Namai Zambia: Final Study Technical Report, Nachela Chelwa

Sexual and Reproductive Health, Rights, and Choices

No abstract provided.

The Wellness Connection March 2025, Roger Williams University School Of Law Office Of Student Life

Life of the Law School (1993- )

No abstract provided.

The Predictors Of Success For Pre-Licensure Bsn Students: An Exploratory Analysis Of Assessment Methods, Nihimu Nkechinyere Evulukwu

Doctor of Nursing Practice Projects

Background

Success in the National Council Licensure Examination (NCLEX-RN) on the first attempt is essential for continued program accreditation, sustainability, and maintaining the national nurse workforce. Admission policies and assessment methods contribute to student enrollment and success. This Doctor of Nursing Practice (DNP) project evaluated the admission requirements of cognate and overall GPAs and assessment requirements of Health Education System Incorporated (HESI) scores in the School of Nursing to determine the best predictors of the first-time NCLEX-RN pass rates. This project aimed to determine whether the use of admission requirements in the School of Nursing Bachelor of Science in Nursing …

March 2025, Swosu Bulldog Wellness Committee

SWOSU BULLDOG WELLNESS

Colorectal cancer awareness!

March is National Nutrition Month!

Spring word find activity!

The Efficacy Of The Minimally Invasive Lumbar Decompression (Mild®) Procedure: A Prisma-Compliant Systemic Review And Meta-Analysis, Xin-Yu Zhang, Jian-Li Zhao, Ya-Jing Wang, Jie Luan, Hong-Qi Lin, Dajie Wang

Department of Anesthesiology Faculty Papers

BACKGROUND: Lumbar spinal stenosis is the most common cause for spinal surgery of older adults. It is associated with pain in the legs and back as well as impaired ambulation. Minimally Invasive Lumbar Decompression (MILD®, Vertos Medical) is a percutaneous, image-guided lumbar decompression technique for central canal stenosis secondary to a hypertrophied ligamentum flavum. However, whether MILD can achieve adequate beneficial results in patients with lumbar spinal stenosis remains undetermined.

OBJECTIVE: To assess the efficacy and complications of MILD for lumbar spinal stenosis.

STUDY DESIGN: A systematic review and meta-analysis.

METHODS: Electronic databases were searched to identify all clinical trials …

Altered Thermal Preference By Preoptic Estrogen Receptor Alpha Neurons In Postpartum Females, Bing Feng, Yue Deng, Jonathan C Bean, Qingzhuo Liu, Benjamin P Eappen, Yang He, Kristine M Conde, Hailan Liu, Yongjie Yang, Longlong Tu, Mengjie Wang, Yongxiang Li, Na Yin, Hesong Liu, Junying Han, Darah Ave Threat, Nathan Xu, Taylor Smiley, Pingwen Xu, Lulu Chen, Tianshu Zeng, Yanlin He, Chunmei Wang

Faculty, Staff and Students Publications

OBJECTIVE: This study aims to investigate how reproductive experience (RE) alters thermal preference and thermoregulation in female mice, with a focus on estrogen receptor alpha (ERα)-expressing neurons in the preoptic area (POA).

METHODS: Thermal preference and body temperature were measured in female mice with and without RE, and virgin female mice with selective deletion of ERα from the POA (ERα

RESULTS: We showed that female mice prefer a cooler environment starting from late pregnancy and persisting long term postpartum. Female mice with RE (>4 weeks post-weaning) displayed lower body temperature and a lower thermal preferred temperature, and lost preference …

High-Dose Methotrexate Usage Without Drug-Level Monitoring In Advanced Pediatric Mature B-Cell Non-Hodgkin Lymphoma In A Resource-Limited Setting In Malawi, Apatsa Matatiyo, Zoe Mwale, Grace Chirwa, Watipaso Wanda, Atupele Miranda Mpasa, Stella Wachepa, Minke H W Huibers, Steve Martin, Tamiwe Tomoka, Maurice Mulenga, Yuri Fedoriw, Gugulethu Mapurisa, Julie M Gastier Foster, Nader El-Mallawany, Katherine D Westmoreland, Peter Wasswa, Carl E Allen, Nmazuo Ozuah

Faculty, Staff and Students Publications

Purpose: Excellent survival for advanced (stages II with high lactate dehydrogenase, III, and IV) pediatric mature B-cell non-Hodgkin lymphoma (MB-NHL) has been achieved with intensive regimens, but adoption in sub-Saharan Africa is limited by inadequate supportive care. We provide real-world data on treating advanced MB-NHL with high-dose methotrexate (HD-MTX; ≥1,000 mg/m2/cycle) where real-time serum MTX monitoring is unavailable.

Methods: We identified two cohorts-a retrospective (January 2017-December 2020) cohort treated with 1,000 or 3,000 mg/m2/cycle of HD-MTX and a prospective (July 2022-July 2023) cohort-with a modified LMB96 protocol containing 3,000 mg/m2/cycle of HD-MTX. All doses of HD-MTX were given over 3 …

Rising Mortality Rates Linked To Type-2 Diabetes And Obesity In The United States: An Observational Analysis From 1999 To 2022, Hira Javaid, Areeba Ahsan, Zain Ali Nadeem, Raheel Ahmed, Mahboob Alam, Mamas A Mamas, Marat Fudim, Gregg C Fonarow

Faculty, Staff and Students Publications

Background: The prevalence of type 2 diabetes (T2D) and obesity are increasing in the United States. However, population-level data for mortality trends due to T2D and obesity are limited. This study aims to assess these death trends among adults in the United States categorized by sex, race, and geographical location.

Methods: We queried the CDC-WONDER database for multiple cause of death data of adults aged ≥25 years. The crude mortality rates (CMR), age-adjusted mortality rates (AAMRs), annual percent change (APC), and the average APC (AAPC) along with a 95% confidence interval (CI) were analyzed.

Results: From 1999 to 2022, a …

Exploration Of Cytokines And Microbiome Among Males And Females With Diarrhea-Predominant Irritable Bowel Syndrome, Kevin Cain, Pamela Barney, Tor Savidge, Robert J Shulman, Margaret Heitkemper, Kendra Kamp

Faculty, Staff and Students Publications

Background: Whether pathophysiological factors differ between males and females with irritable bowel syndrome-diarrhea (IBS-D) remains to be tested. To better understand potential sex differences, males with IBS-D were compared to naturally cycling females and to females with IBS-D taking hormonal contraception on plasma levels of cytokines and gut microbiome characteristics.

Methods: Males and females with Rome III IBS-D completed questionnaires and kept a daily symptom diary for 28 days. Blood and stool samples were collected between days 3 and 8 of the daily diary (estrogen-dominant days in naturally cycling females). Blood samples were analyzed for lipopolysaccharide (LPS)-stimulated and unstimulated cytokine …

Modeling The Kinetics Of Interorgan Arginine Metabolism During Bacterial Sepsis In Swine

Faculty, Staff and Students Publications

No abstract provided.

Inappropriate Laboratory Testing: Significant Waste Quantified By A Large-Scale Year-Long Study Of Medicare And Commercial Payer Reimbursement

Faculty, Staff and Students Publications

Context.—: Laboratory testing, beyond what is essential for managing health, is considered low-value care, posing patient risks and wasting resources. Measuring excess testing on a national level is crucial to identify waste and optimize healthcare resource allocation for maximum impact.

Objective.—: To measure inappropriate laboratory testing and its cost across Medicare and many US commercial payers.

Design.—: A retrospective analysis on 2019 claims data measured the frequency of 4 commonly used laboratory tests among 64 million individuals with Medicare and 168 million with commercial insurance. Tests included 25-hydroxy vitamin D, prostate-specific antigen, lipid panel, and hemoglobin A1c. Clinical guidelines, medical …

Epidemiology Of Diagnostic Errors In Pediatric Emergency Departments Using Electronic Triggers, Sarah J Parker, James Chamberlain, Richard M Ruddy, Elizabeth R Alpern, Jacqueline Corboy, Andrew Krack, Brandon Ku, Daphne Morrison Ponce, Asha S Payne, Elizabeth Freiheit, Gregor Horvath, Giselle Kolenic, Michele Carney, Nicole Klekowski, Karen J O'Connell, Hardeep Singh

Faculty, Staff and Students Publications

Objectives: We applied three electronic triggers to study frequency and contributory factors of missed opportunities for improving diagnosis (MOIDs) in pediatric emergency departments (EDs): return visits within 10 days resulting in admission (Trigger 1), care escalation within 24 h of ED presentation (Trigger 2), and death within 24 h of ED visit (Trigger 3).

Methods: We created an electronic query and reporting template for the triggers and applied them to electronic health record systems of five pediatric EDs for visits from 2019. Clinician reviewers manually screened identified charts and initially categorized them as "unlikely for MOIDs" or "unable to rule …

Early Life Epigenetics And Childhood Outcomes: A Scoping Review

Faculty, Staff and Students Publications

Epigenetics is the study of changes in gene expression, without a change in the DNA sequence that are potentially heritable. Epigenetic mechanisms such as DNA methylation, histone modifications, and small non-coding RNA (sncRNA) changes have been studied in various childhood disorders. Causal links to maternal health and toxin exposures can introduce epigenetic modifications to the fetal DNA, which can be detected in the cord blood. Cord blood epigenetic modifications provide evidence of in-utero stressors and immediate postnatal changes, which can impact both short and long-term outcomes in children. The mechanisms of these epigenetic changes can be leveraged for prevention, early …

Rural–Urban Differences In Substance Use During Pregnancy, Emma Kathryn Boswell, Olivia M. Hinds, Cassie Odahowski Phd, Mph, Elizabeth L. Crouch, Peiyin Hung Ph.D, Christina M. Andrews Ph.D.

Faculty Publications

Purpose: Drug overdoses are now a leading cause of pregnancy-related deaths in the United States. Despite evidence of rural–urban disparities in substance use, there has not yet been a nationally representative examination of rural–urban differences in perinatal substance use. This study provides a comprehensive examination of rural–urban disparities in perinatal substance use. Methods: This study uses cross-sectional data to examine 3499 pregnant women from the 2015–2019 National Survey on Drug Use and Health (NSDUH). Rural (nonmetro)–urban (metro) differences in past-month tobacco use, alcohol use, binge drinking, illicit drug use, and marijuana use were examined using Rao–Scott chi-square tests and multivariable …

The Relationship Between Irritable Bowel Syndrome And Metabolic Syndrome: A Systematic Review And Meta‐Analysis Of 49,662 Individuals, Yomna E. Dean, Jose J. Loayza Pintado, Samah S. Rouzan, Lucy L. Nale, Ahmed Abbas, Abdulla Aboushaira, Farah Alkasajy, Ahmed A. Ghanem, Vinayak Mahesh Patil, Yana Gordeyeva

School of Medicine Publications

Background

Studies have shown mixed results regarding the association between irritable bowel syndrome (IBS) and metabolic syndrome (MS); This study aimed to assess the susceptibility of IBS patients to MS and its individual components.

Methods

PubMed, Scopus, Embase, and Web of Science were searched on 1/1/2023. Eligible studies were screened, and data on study characteristics, IBS diagnostic criteria, and metabolic syndrome components were extracted. Data were analysed in RevMan 5.4, with results reported as relative risk (RR) or mean difference (MD) and 95% confidence intervals. Statistical significance was set at p <  0.05.

Results

IBS was associated with an increased risk of …

Quantitative Profiling Ph Heterogeneity Of Acidic Endolysosomal Compartments Using Fluorescence Lifetime Imaging Microscopy, Dinghuan Deng, Youchen Guan, Ayse Sena Mutlu, Baiping Wang, Shihong Max Gao, Hui Zheng, Meng C Wang

Center on Aging Staff Publications

The endolysosomal system plays a crucial role in maintaining cellular homeostasis and promoting organism fitness. The pH of its acidic compartments is a crucial parameter for proper function, and it is dynamically influenced by both intracellular and environmental factors. Here, we present a method based on fluorescence lifetime imaging microscopy (FLIM) for quantitatively analyzing the pH profiles of acidic endolysosomal compartments in diverse types of primary mammalian cells and in live organism Caenorhabditis elegans. This FLIM-based method exhibits high sensitivity in resolving subtle pH differences, thereby revealing heterogeneity within a cell and across cell types. This method enables rapid …

Revisiting Diagnostics: High Priority Tuberculosis Diagnostic Tests That Fill An Unmet Need: What We Need And What We Do Not Need, Dumitru Chesov, Keertan Dheda, Francesca Saluzzo

Faculty, Staff and Students Publications

No abstract provided.

Causes Of Mortality In The Congenital Disorders Of Glycosylation, Fernando Scaglia, Christina Lam, Eva Morava, Austin Larson, Andrew C Edmondson

Faculty, Staff and Students Publications

Congenital Disorders of Glycosylation (CDG) are a group of some 200 genetic disorders with PMM2-CDG being the most common disease. These disorders individually remain rare with poorly understood natural history (NH) and causes of mortality. We established a NH study for CDG and collected both prospective and retrospective data on CDG outcomes. In the current data set analysis on deceased patients, we describe the clinical phenotype and causes of death for thirty-seven individuals with various genetic causes of CDG. About a third of this cohort were affected with PMM2-CDG. All of the patients presented with multisystem features with involvement of …

The Cross-Sectional Association Between Lifestyle Behaviors And Breast And Cervical Cancer Screening Among Hispanic Women Along The Texas-Mexico Border, David R Lairson

Faculty, Staff and Student Publications

Objective: Lifestyle behaviors may influence timely cancer screening, but their relationship is unknown among Hispanic women who have low cancer screening rates.

Methods: We used Cameron County Hispanic Cohort data from 2014 to 2022 to evaluate the relationship between lifestyle and compliance with mammography and Papanicolaou (Pap) screening guidelines ("up-to-date") among Hispanic women along the Texas-Mexico border. The 2018 World Cancer Research Fund scoring system characterized cancer-preventive lifestyle adherence. Multivariable logistic regression assessed the association between lifestyle behaviors and mammography and, separately, Pap screening.

Results: Among 385 age-eligible women for mammography and 412 age-eligible women for Pap test screening, up-to-date …

Overexpression And Biophysical And Functional Characterization Of A Recombinant Fgf21, Phuc Phan, Jason Hoang, Thallapuranam Krishnaswamy Suresh Kumar

Chemistry & Biochemistry Faculty Publications and Presentations

Fibroblast growth factor 21 (FGF21) is an endocrine FGF that plays a vital role in regulating essential metabolic pathways. FGF21 increases glucose uptake by cells, promotes fatty acid oxidation, reduces blood glucose levels, and alleviates metabolic diseases. However, detailed studies on its stability and biophysical characteristics have not been reported. Herein, we present the overexpression, biophysical characterization, and metabolic activity of a soluble recombinant FGF21 (rFGF21). The far-UV circular dichroism spectra of rFGF21 show a negative trough at 215 nm, indicating that the protein’s backbone predominantly adopts a β sheet conformation. rFGF21 shows intrinsic tyrosine fluorescence at 305 nm. Thermal …