Digital Commons Network^™

Maximizing The Benefit-Cost Ratio Of Anthracyclines In Metastatic Breast Cancer: Case Report Of A Patient With A Complete Response To High-Dose Doxorubicin, Kevin Shee, Alan T. Kono, Susan P. D'Anna, Mark A. Seltzer, Xiaoying Lu, Todd W. Miller, Mary D. Chamberlin

Dartmouth Scholarship

Despite the clinical efficacy of anthracycline agents such as doxorubicin, dose-limiting cardiac toxicities significantly limit their long-term use. Here, we present the case of a 33-year-old female patient with extensive metastatic ER+/PR+/HER2– mucinous adenocarcinoma of the breast, who was started on doxorubicin/cyclophosphamide therapy after progressing on paclitaxel and ovarian suppressor goserelin with aromatase inhibitor exemestane. The patient was comanaged by cardiology, who carefully monitored measures of cardiac function, including EKGs, serial echocardiograms, and profiling of lipids, troponin, and pro-BNP every 2 months. The patient was treated with the cardioprotective agent dexrazoxane, and changes in cardiac markers [e.g. decreases in ejection …

Placental Epigenetics In Children’S Environmental Health, Carmen Marsit

Dartmouth Scholarship

There is a growing interest in understanding the mechanisms that drive the developmental origins of health and disease, and the role of epigenetic regulation has risen to the forefront of these studies. In particular, the placenta may be a model organ to consider as a mediator of the impact of the environment on developmental programming of children's health, as this organ plays a critical role in directing development and regulating the fetal environment. Several recent studies have begun to examine how environmental toxicant exposures can impact the placental epigenome, focusing on studies of DNA methylation and microRNA expression. This review …

Regional Implementation Of A Pediatric Cardiology Syncope Algorithm Using Standardized Clinical Assessment And Management Plans (Scamps) Methodology, Yvonne Paris, Olga H. Toro‐Salazar, Naomi S. Gauthier, Kathleen Rotondo, Lucy Arnold, Rose Hamershock, David E. Saudek, David R. Fulton, Ashley Renaud, Mark E. Alexander, New England Congenital Cardiology Association (Necca

Dartmouth Scholarship

Background:

Pediatric syncope is common. Cardiac causes are rarely found. We describe and assess a pragmatic approach to these patients first seen by a pediatric cardiologist in the New England region, using Standardized Clinical Assessment and Management Plans (SCAMPs).

Methods and Results:

Ambulatory patients aged 7 to 21 years initially seen for syncope at participating New England Congenital Cardiology Association practices over a 2.5‐year period were evaluated using a SCAMP. Findings were iteratively analyzed and the care pathway was revised. The vast majority (85%) of the 1254 patients had typical syncope. A minority had exercise‐related or more problematic symptoms. Guideline‐defined …

Center For Real Estate Quarterly, Volume 10, Number 4, Portland State University. Center For Real Estate

Center for Real Estate Quarterly

Table of Contents:
-- Can Rent Control and Rent Stabilization Solve Portland's Housing Affordability Problem? by Mackenzie Kisiel (p. 5-19)
-- State of the Economy by Andrew Crampton (p. 20-27)
-- Residential Market Analysis by Alex Joyce (p. 28-53)
-- Multifamily Market Analysis by Marc Strabic (p. 53-66)
-- Office Market Analysis by Melissa Beh (p. 67-76)
-- Industrial Market Analysis by Andrew Crampton (p. 77-81)
-- Retail Market Analysis by Melissa Beh (p. 82-91)

Arts And Jewish Experience: Exploring Diverse American Identities Through Art Syllabus, Harold Schnitzer Family Program In Judaic Studies

Judaic Studies Artist in Residence Program

Arts and Jewish Experience: Exploring Diverse American Identities through Art Syllabus. JST 431 / 431H

Pharmacology Of Dextromethorphan: Relevance To Dextromethorphan/Quinidine (Nuedexta®) Clinical Use, Charles P. Taylor, Stephen F. Traynelis, Joao Siffert, Laura E. Pope, Rae Reiko Matsumoto

Faculty Publications & Research of the TUC College of Pharmacy

Dextromethorphan (DM) has been used for more than 50 years as an over-the-counter antitussive. Studies have revealed a complex pharmacology of DM with mechanisms beyond blockade of N-methyl-D-aspartate (NMDA) receptors and inhibition of glutamate excitotoxicity, likely contributing to its pharmacological activity and clinical potential.

DM is rapidly metabolized to dextrorphan, which has hampered the exploration of DM therapy separate from its metabolites. Coadministration of DM with a low dose of quinidine inhibits DM metabolism, yields greater bioavailability and enables more specific testing of the therapeutic properties of DM apart from its metabolites. The development of the drug combination DM hydrobromide …

Determining Maximum Glycolytic Capacity Using Extracellular Flux Measurements, Shona A. Mookerjee, David G. Nicholls, Martin D. Brand

Faculty Publications & Research of the TUC College of Pharmacy

Measurements of glycolytic rate and maximum glycolytic capacity using extracellular flux analysis can give crucial information about cell status and phenotype during normal operation, development of pathology, differentiation, and malignant transformation. They are also of great use when assessing the effects of chemical or drug treatments. Here, we experimentally define maximum glycolytic capacity, demonstrate how it differs from glycolytic rate, and provide a protocol for determining the basal glycolytic rate and maximum glycolytic capacity in cells using extracellular flux measurements. The results illustrate the power of extracellular flux analysis to describe the energetics of adherent cells in culture in a …

Measurement Of The Absolute Magnitude And Time Courses Of Mitochondrial Membrane Potential In Primary And Clonal Pancreatic Beta-Cells, Akos Gerencser, Shona A. Mookerjee, Martin Jastroch, Martin D. Brand

Faculty Publications & Research of the TUC College of Pharmacy

The aim of this study was to simplify, improve and validate quantitative measurement of the mitochondrial membrane potential (ΔψM) in pancreatic β-cells. This built on our previously introduced calculation of the absolute magnitude of ΔψM in intact cells, using time-lapse imaging of the non-quench mode fluorescence of tetramethylrhodamine methyl ester and a bis-oxonol plasma membrane potential (ΔψP) indicator. ΔψM is a central mediator of glucose-stimulated insulin secretion in pancreatic β-cells. ΔψM is at the crossroads of cellular energy production and demand, therefore precise assay of its magnitude is a valuable tool to study how these processes interplay in insulin secretion. …

Review Of The Tragedy Of The Commodity: Oceans, Fisheries, And Aquaculture, Julius Mcgee

Sociology Faculty Publications and Presentations

Book review of, The Tragedy of the Commodity: Oceans, Fisheries, and Aquaculture By Stefano B. Longo, Rebecca Clausen, and Brett Clark. Rutgers University Press (June 25, 2015).

Encouraging Low-Income Households To Make Location-Efficient Housing Choices, Andrée Tremoulet, Ryan Dann, Arlie Adkins

TREC Final Reports

The purpose of this project is to develop and evaluate tools to assist Housing Choice Voucher (HCV) program participants in the Portland, OR, metro region with considering transportation needs and options when making decisions about where to live. The project consists of two elements: development of a set of tools in collaboration with the four metro-area housing authorities, and an evaluation of the effectiveness of the tools. The four housing authorities conceptualized and initiated this project, and then selected our team to fully design and complete it. Transportation costs are typically a household’s second-largest expense after housing and, on average, …

Halprin Sequence Reimagined, Andrea Villarroel, Nate Miller, Kris Decker, Foster Gough, Scott Robinson

Urban Design Workshop

The Halprin Sequence is a series of underutilized green spaces in the heart of Portland, Oregon. Once a booming attraction, as time has past and the city has grown, the Halprin Sequence has been forgotten amongst the towers. With a rich history in urban development and design, the Halprin Sequence could offer much more to the people of Portland than it is currently. The surrounding street of Fourth Avenue is also underutilized. The street is primarily used by automobiles, and the sidewalks are not pleasant to walk through.

For a green space network, the Halprin Sequence is in an ideal …

Pdxscholar Annual Report 2015, Karen Bjork, Sherry Buchanan, David Coate, Bertrand Robinson, Stacey Schlatter

Library Faculty and Staff Publications and Presentations

This report details the fifth year of operation for PDXScholar, Portland State University's institutional repository. The report covers the period between January 1, 2015 and December 31, 2015.

From Grapheme To Phonological Output: Performance Of Adults Who Stutter On A Word Jumble Task, Megann Mcgill, Harvey Sussman, Courtney T. Byrd

Speech and Hearing Sciences Faculty Publications and Presentations

Purpose

The purpose of the present study was to extend previous research by analyzing the ability of adults who stutter to use phonological working memory in conjunction with lexical access to perform a word jumble task.

Method

Forty English words consisting of 3-, 4-, 5-, and 6-letters (n = 10 per letter length category) were randomly jumbled using a web-based application. During the experimental task, 26 participants were asked to silently manipulate the scrambled letters to form a real word. Each vocal response was coded for accuracy and speech reaction time (SRT).

Results

Adults who stutter attempted to solve …

The Meanings In The Messages: How Sms Reminders And Real-Time Adherence Monitoring Improve Antiretroviral Therapy Adherence In Rural Uganda, Norma C. Ware, Emily A. Pisarski, Melanie Tam, Monique A. Wyatt, Esther Atukunda, Angella Musimenta, David Bangsberg, Jessica E. Haberer

OHSU-PSU School of Public Health Faculty Publications and Presentations

To understand how a pilot intervention combining SMS reminders with real-time adherence monitoring improved adherence to HIV antiretroviral therapy (ART) for adults initiating treatment in rural Uganda.

Design: Qualitative study, conducted with a pilot randomized controlled trial.

Methods: Sixty-two pilot intervention study participants took part in qualitative interviews on: preferences for content; frequency and timing of SMS adherence reminders; understandings and experiences of SMS reminders; and understandings and experiences of real-time adherence monitoring. Analysis of interview data was inductive and derived categories describing how participants experienced the intervention, and what it meant to them.

Results: SMS reminders prompted taking individual …

Assessing Payer Perspectives On Health Information Exchange, Dori Cross, Sunny C. Lin, Julia Adler-Milstein

OHSU-PSU School of Public Health Faculty Publications and Presentations

Objective To identify factors that impede payer engagement in a health information exchange (HIE), along with organizational and policy strategies that might effectively address the impediments.

Materials and Methods Qualitative analysis of semi-structured interviews with leaders from 17 varied payer organizations from across the country (e.g., large, national payers; state Blues plans; local Medicaid managed care plans).

Results We found a large gap between payers’ vision of what optimal HIE should be and the current approach to HIE in the United States. Notably, payers sought to be active participants in HIE efforts – both providing claims data and accessing clinical …

In Vitro Modeling Of The Interaction Between Human Epithelial Cells And Lymphocytes Upon Influenza Infection, Natalia A. Ilyushina, Pete F. Wright

Dartmouth Scholarship

Influenza viruses are a continuous threat to humans because of their ability to cross species barriers and adapt to new hosts. Data from murine studies, along with limited human data, suggest that CD8(+) cytotoxic T lymphocytes (CTL) that recognize conserved epitopes of structural influenza proteins are the main mediators of influenza virus clearance. Additionally, the fact that many CTLs recognize epitopes shared between different influenza strains offers the potential for broad cross-strain immunity. However, the mechanisms of cellular immunity against influenza viruses are poorly defined in humans, where the CTL response has been hard to measure and interpret. We developed …

Stress Granules And Rna Processing Bodies Are Novel Autoantibody Targets In Systemic Sclerosis, Michael E. Johnson, Andrew V. Grassetti, Jaclyn N. Taroni, Shawn M. Lyons, Devin Schweppe, Jessica K. Gordon, Robert F. Speira, Robert Lafyatis, Paul J. Anderson, Scott A. Gerber, Michael L. Whitfield

Dartmouth Scholarship

Autoantibody profiles represent important patient stratification markers in systemic sclerosis (SSc). Here, we performed serum-immunoprecipitations with patient antibodies followed by mass spectrometry (LC-MS/MS) to obtain an unbiased view of all possible autoantibody targets and their associated molecular complexes recognized by SSc.

Mangrove Enhancement As A Climate Change Adaptation Strategy In The Republic Of The Marshall Islands (Rmi): Potential Ecosystem Service Shifts Following Colonization, Andrew S. Harwood

Environmental Science and Management Professional Master's Project Reports

The ability of Small Island Developing States (SIDS) and Pacific Island communities to adapt to the increasing sea-levels, storm surge, saltwater intrusion, and other threats posed by global climate change is critical to the survival of many of these local communities as well as their cultures (LivingIslands.org). One of the world’s most striking examples of a nation at great risk is the Republic of the Marshall Islands (RMI) in the central Pacific Ocean. Due to a combination of factors, including the country’s extremely low elevation above sea-level (an average of 2 meters) and lack of adequate structures to provide safety …

Assessment Of Tmdl Implementation And Water Quality Status And Trends In Amazon Creek And Coyote Creek Watersheds, Stosh Zydek

Environmental Science and Management Professional Master's Project Reports

In this project, I analyzed the status and trends of water quality data describing fecal bacteria (E. coli) and DO in the Amazon and Coyote Creek watersheds of the Southern Willamette Valley, Oregon. I also examined TMDL implementation plans produced by DMAs, determined if and how implementation activities corresponded to changes in water quality, compared management and planning of DMAs in the watersheds, discussed aspects of the current TMDL, and compared state regulations and standards in other states. I concluded by making management recommendations to better facilitate future status and trend analysis.

Amazon Creek, Amazon Diversion Channel, A-3 …

Greenroof Study: Final Report, An Assessment Of Greenroof Design And Maintenance In Portland, Oregon: 2011 – 2013, Windy Carney Beck

Environmental Science and Management Professional Master's Project Reports

In 1999 the City of Portland (City) began to require that stormwater management facilities (SMF) be built when private property is newly developed or redeveloped (City Code Chapter 17.38). Proper maintenance and upkeep of SMFs is essential to ensuring they function appropriately. The City's Maintenance Inspection Program (MIP) is tasked with inspecting stormwater management facilities on private properties in order to ensure that they are being properly operated and maintained and to meet provisions of the City's NPDES Municipal Separated Storm Sewer System (MS4) permit.

Greenroofs are one type of SMF that are installed to satisfy this requirement. Understanding the …

Family Aided Community Treatment For The Treatment Of Early Psychosis: A Proof Of Concept Study, Ryan P. Melton, Cass Dykeman

Regional Research Institute for Human Services

Major psychotic disorders are one of the leading causes of disability worldwide. If these conditions are identified early and treatment promptly implemented, the prognosis is improved. This study examined the impact of a yearlong family aided community treatment (FACT) intervention upon psychiatric symptoms. Psychiatric symptom scores improved with the FACT intervention. Improved training on early recognition for mental health clinicians, implementation of a specific treatment model in community settings and policy around treatment funding allocation are implications of this study.

The Determinants Of Productivity In Medical Testing: Intensity And Allocation Of Care, Jason Abaluck, Leila Agha, Chris Kabrhel, Ali Raja, Arjun Venkatesh

Dartmouth Scholarship

A large body of research has investigated whether physicians overuse care. There is less evidence on whether, for a fixed level of spending, doctors allocate resources to patients with the highest expected returns. We assess both sources of inefficiency exploiting variation in rates of negative imaging tests for pulmonary embolism. We document enormous across-doctor heterogeneity in testing conditional on patient population, which explains the negative relationship between physicians’ testing rates and test yields. Furthermore, doctors do not target testing to the highest risk patients, reducing test yields by one third. Our calibration suggests misallocation is more costly than overuse.

Service-Learning And The Hungry And Homeless: Tangible Sensibilities Of Care Among Young Urban Adolescents, Dilafruz R. Williams

Educational Leadership and Policy Faculty Publications and Presentations

For over 20 years, Sunnyside Environmental School in Portland, Oregon has adopted service-learning as an instructional approach to engage young people with local communities. This report explores the voices of sixth through eighth graders illustrated by their Reflection Journals as they interacted with hungry and homeless individuals in the community. The human-scale connections resulted in tangible sensibilities of care evident in students’ reflections: dispelling stereotypes as students became open-minded, making a noticeable difference however small, developing compassion through new understandings, and taking action to correct social injustices in the communities where they live.

Sepsis-Review Of Screening For Sepsis By Nursing, Nurse Driven Sepsis Protocols And Development Of Sepsis Hospital Policy/Protocols, Matthew Mccaffery, Omobola Onikoyi, Dilisha Rodrigopulle, Ali Syed, Suzanne Jones, Laura Mansfield, Murali G. Krishna

Touro College of Osteopathic Medicine (Middletown) Publications and Research

Sepsis is one of the leading causes of death in the United States. In order to decrease the morbidity and mortality associated with sepsis in patients, early detection is vital, and so screening protocols have been developed. The Surviving Sepsis Campaign has developed an evidence based screening guideline that has been adapted by various institutions. Having specific criteria in detecting a septic patient is the defining factor in screening for sepsis by nursing staff. In order for the sepsis protocol to be effective, it is necessary that nursing and other front line staff be educated. Institutional barriers regarding implementation of …

Diffuse Sclerosing Papillary Carcinoma In A Pediatric Patient With Intrauterine Diagnostic Xray Exposure, Luke O'Connor, Cheryl Rosenfeld, William Inabnet

Touro College of Osteopathic Medicine (Middletown) Publications and Research

Objective: The relationship between occurrence of childhood cancer and intrauterine exposure to radiation is well known. We describe a case of diffuse sclerosing papillary carcinoma (PTC) in a pediatric patient exposed to diagnostic radiation in utero.

Methods: Clinical presentation, including radiation history and outcome, was reported.

Case Presentation: A 14 year old male was referred for a thyroid cancer consultation in 2008. His history was notable for a rapidly growing thyroid mass during the preceding 3 months and in utero exposure to radiation, in the form of multiple xrays and CT scans, at 12 weeks gestation as a result of …

Why Is Postoperative Atrial Fibrillation Difficult To Prevent And Treat: Potential Roles Of Unrecognized Magnesium Deficiency And Release Of Ceramide And Platelet-Activating Factor, Burton M. Altura, Nilank C. Shah, Gatha J. Shah, Jose Luis Perez-Albela, Bella T. Altura

Touro College of Osteopathic Medicine (Middletown) Publications and Research

Heart failure is a major cause of morbidity and mortality whose costs impose staggering health-care costs and often lengthy hospitalizations. Post-operative atrial fibrillation (POAF) represents a leading cause for heart failure, particularly after cardiac and lung surgeries. Although PAOF is a common cardiac arrhythmia, it is impossible to predict. As the worldwide population is aging, the incidence and prevalence of PAOF is growing. Identifying mechanisms for PAOF is attracting a considerable amount of research with no agreement on the mechanism(s). Our research on the heart and cardiovascular system, over the past 50-plus years, leads us to believe that major causes …

Treatment Of Pasireotide Lar-Associated Hyperglycemia In A Patient With Acromegaly, Cheryl Rosenfeld

Touro College of Osteopathic Medicine (Middletown) Publications and Research

Objective: Hyperglycemia was noted in pasireotide long-acting release (PAS LAR}-treated patients with acromegaly during clinical trials. We describe a clinical approach to hyperglycemia in a patient with acromegaly and diabetes mellitus type 2 (DM2) during PAS LAR initiation and treatment.

Methods: Clinical response to PAS LAR, including self­ monitored blood glucose (SMBG) levels, HbA1c, IGF-1, and adverse effects, was reported. Case Presentation: A 44-year-old male was referred for consultation in 2007 owing to uncontrolled DM2 despite maximum metformin (MET) dose. Testing led to a biochemical diagnosis of acromegaly. An 8-mm pituitary adenoma was seen on MRI. Transsphenoidal pituitary adenoma …

Euphoria From Drinking Alcoholic Beverages May Be Due To Reversible Constriction Of Cerebral Blood Vessels: Potential Roles Of Unrecognized Ionized Hypomagnesemia, And Release Of Ceramides And Platelet-Activating Factor, Burton M. Altura, Aimin Zhang, Nilank C. Shah, Gatha J. Shah, Asefa Gebrewold, Bella T. Altura

Touro College of Osteopathic Medicine (Middletown) Publications and Research

The authors discuss the feeling of euphoria when drinking alcohol. They summarize studies that suggest this feeling is due to blood vessel constriction, and explain why they believe that the specific mechanism that results in euphoria is the rapid, reversible release o free magnesium ions ([Mg2+]) coupled to the release of ceramides and platelet-activating factor (PAF).

Exploring The Construct Validity Of The Behavioral Rating Inventory Of Executive Function (Brief): Comparing Variance Associated With Common Method Versus Similar Constructs, Lauren K. Hoefling

All-Inclusive List of Electronic Theses and Dissertations

The Behavioral Rating Inventory of Executive Function (BRIEF) is a teacher and parent questionnaire designed to measure executive functioning (EF). Due to the role of EF in ADHD, the BRIEF is often used in assessment of ADHD. The purpose of the current study was to explore the convergence and divergence of the BRIEF with a performance-based measure of EF, behavior rating scales, an observational measure of child behavior during testing, and longer-term academic outcomes. The current study used archival data representing 105 children referred to an ADHD evaluation clinic. It was hypothesized that the BRIEF would be significantly correlated with …

Left Behind: The Dying Principle Of Family Reunification Under Immigration Law, Anita Maddali

Faculty Articles, Papers, and Other Scholarship

A key underpinning of modern U.S. immigration law is family reunification, but in practice it can privilege certain families and certain members within families. Drawing on legislative history, this Article examines the origins and objectives of the principle of family reunification in immigration law and relies on legal scholarship and sociological and anthropological research to reveal how contemporary immigration law and policy has diluted the principle for many families — particularly those who do not fit the dominant nuclear family model, those classified as unskilled, and families from oversubscribed countries — and members within families. It explores the ways in …