Digital Commons Network^™

Predictive Factors And Prognosis Of Upper Gastrointestinal Bleeding In Gastric Cancer: A Large Population-Based Study (Ugib-Gc Trial), Anya Kiattiweerasak, Phubordee Bongkotvirawan, Natsuda Aumpan, Yoshio Yamaoka, Muhammad Miftahussurur, Ratha-Korn Vilaichone

Faculty, Staff and Students Publications

Background: Gastric cancer remains the fourth leading cause of cancer-related death worldwide. Significant number of gastric cancer patients presented with bleeding.

Objective: This study aimed to identify risk factors and overall survival rates of bleeding gastric cancer patients.

Methods: This retrospective cohort study was conducted between 2007-2022 at tertiary care center in Thailand. Clinical information, endoscopic findings and histological type were extensively reviewed and were compared between bleeders and non-bleeders. Patients were monitored for at least 5 years.

Results: There were 20,981 patients who underwent upper gastrointestinal endoscopy during study period. Total of 201 gastric cancer patients were included in …

Astrocytic-Based Controller Shifts Epileptic Activity To The Chaotic State, Mojde Nahtani, Mehdi Siahi, Javad Razjouyan

Faculty, Staff and Students Publications

Introduction: Investigating an effective controller to shift hippocampal epileptic periodicity to normal chaotic behavior will be new hope for epilepsy treatment. Astrocytes nourish and protect neurons and maintain synaptic transmission and network activity. Therefore, this study explored the ameliorating effect of the astrocyte computational model on epileptic periodicity.

Methods: Modified Morris-Lecar equations were used to model the hippocampal CA3 network. Network inhibitory parameters were employed to generate oscillation-induced epileptiform periodicity. The astrocyte controller was based on a functional dynamic mathematical model of brain astrocytic cells.

Results: Results demonstrated that the synchronization of two neural networks shifted the brain's chaotic state …

Expanding Access To Evidence-Based Psychotherapy In Va Settings: Implementation Of The Brief Cognitive Behavioral Therapy For Depression Program, Joseph Mignogna, Derrecka Boykin, Raquel D Gonzalez, Andrew Robinson, Darrell Zeno, Shubhada Sansgiry, Jennifer Broderick-Mcdaniel, Richard B Roberson, Kristen Sorocco, Jeffrey A Cully

Faculty, Staff and Students Publications

Introduction: Evidence-based psychotherapies (EBPs) are effective for mental health conditions, but access to these services remains limited and rural Veterans are particularly underserved. Specialized implementation and dissemination programs are needed to improve access to known EBPs.

Methods: The current project sought to improve access to a known EBP-brief Cognitive Behavioral Therapy for depression (Brief CBT). Diverse Veterans and those from rural settings were a focus of this work. Aligned with the RE-AIM framework, a multifaceted implementation program was used to train and support VHA providers in their use of Brief CBT in VHA mental health settings, with specific outreach efforts …

A Pregnant Patient Presents With Leakage Of Vaginal Fluid In The Second Trimester, Alison N Goulding, Jennifer R Mckinney, Diana Crabtree Sokol, Anitra D Beasley

Faculty, Staff and Students Publications

Morning Report is a time-honored tradition where physicians-in-training present cases to their colleagues and clinical experts to collaboratively examine an interesting patient presentation. The Morning Report section seeks to carry on this tradition by presenting a patient’s chief concern and story, inviting the reader to develop a differential diagnosis and discover the diagnosis alongside the authors of the case.

This report examines the story of a 43-year-old (gravida 3, para 2) woman who sought evaluation for leakage of vaginal fluid at 15 weeks of gestation. Using questions, physical examination, and testing, an illness script for the presentation emerges. As her …

The Effect Of A Plasma Next-Generation Sequencing Test On Antimicrobial Management In Immunocompetent And Immunocompromised Patients-A Single-Center Retrospective Study, Denise Marie A Francisco, Laila Woc-Colburn, Travis J Carlson, Todd Lasco, Miriam Barrett, Mayar Al Mohajer

Faculty, Staff and Students Publications

Objective: To describe the use of next-generation sequencing (NGS) and to determine whether NGS leads to changes in antimicrobial management.

Design and setting: This retrospective cohort study included patients aged ≥18 years admitted to a single tertiary-care center in Houston, Texas, with an NGS test performed between January 1, 2017, and December 31, 2018.

Patients: In total, 167 NGS tests were performed. Most patients were of non-Hispanic ethnicity (n = 129), white (n = 106), and male (n = 116), with a mean age of 52 years (SD, 16). Moreover, 61 patients were immunocompromised: solid-organ transplant (n = 30), patients …

Comparing Enacted And Perceived Parental Communication As Predictors Of Adolescents’ Emotion Regulation In Families With Harmful Versus Non-Harmful Parental Alcohol Use, Marie C. Haverfield, Jennifer A. Theiss

Faculty Research, Scholarly, and Creative Activity

Emotion regulation is an important skill that adolescents typically learn through early interactions with their primary caregivers. Associations between parental communication and adolescent emotion regulation are well-documented however, it is unclear whether the parent’s actual communication behavior or adolescents’ perceptions of the parent’s behavior is a more robust predictor of emotion regulation outcomes. This study used Baumrind’s parenting styles typology as a theoretical foundation for examining parents’ enacted responsiveness and control and adolescents’ perceptions of their parent’s responsiveness and control during conversation as competing predictors of adolescents’ self-reported emotion regulation during two parent-child interactions. Sixty parent-adolescent dyads participated in an …

Dynamic Density Functional Theory Of Multicomponent Cellular Membranes, L. G. Stanton, T. Oppelstrup, T. S. Carpenter, H. I. Ingólfsson, M. P. Surh, F. C. Lightstone, J. N. Glosli

Faculty Research, Scholarly, and Creative Activity

We present a continuum model trained on molecular dynamics (MD) simulations for cellular membranes composed of an arbitrary number of lipid types. The model is constructed within the formalism of dynamic density functional theory and can be extended to include features such as the presence of proteins and membrane deformations. This framework represents a paradigm shift by enabling simulations that can access length scales on the order of microns and time scales on the order of seconds, all while maintaining near fidelity to the underlying MD models. These length and time scales are significant for accessing biological processes associated with …

The Small Intestinal Microbiome: Vibing With Intestinal Stem Cells, Victoria Poplaski, Faith Sawyer, Sarah E Blutt

Faculty, Staff and Students Publications

The epithelial lining of the small intestine mediates its absorptive and secretory function and thus is a critical component of human health. Regeneration and renewal of the epithelium is the result of proliferation of intestinal stem cells (ISCs). Many cell types and molecular factors are known to regulate the ability of ISCs to proliferate, including adjacent neighboring epithelial cells and the underlying, supportive stromal cells. The microbiome resides in the lumen of the small intestine and is in close contact with the epithelium. Due to its proximity to ISCs, it has been hypothesized that species within the microbiome have the …

Neighborhood Market Potentials For Alcohol Use And Rates Of Child Abuse And Neglect, Bridget Freisthler, Christiana Kranich, Jennifer Price Wolf, Reiko Boyd, Paul J. Gruenewald

Faculty Research, Scholarly, and Creative Activity

Background: Alcohol use can lead to child abuse and neglect even if the person using alcohol does not use heavily. Yet relatively few measures that reflect alcohol use are available at smaller geographic units. We assess whether the estimated level of total alcohol use per capita is related to measures of child abuse and neglect that include substantiated reports of maltreatment, total entries into foster care, and alcohol-related entries into foster care. Methods: Our sample consists of 326 Census block groups in Sacramento, California over three time points (978 space–time units). Administrative data for substantiations of child abuse and neglect …

Reconfigurations In Brain Networks Upon Awakening From Slow Wave Sleep: Interventions And Implications In Neural Communication, Cassie J. Hilditch, Kanika Bansal, Ravi Chachad, Lily R. Wong, Nicholas G. Bathurst, Nathan H. Feick, Amanda Santamaria, Nita L. Shattuck, Javier O. Garcia, Erin E. Flynn-Evans

Faculty Research, Scholarly, and Creative Activity

Sleep inertia is the brief period of impaired alertness and performance experienced immediately after waking. Little is known about the neural mechanisms underlying this phenomenon. A better understanding of the neural processes during sleep inertia may offer insight into the awakening process. We observed brain activity every 15 min for 1 hr following abrupt awakening from slow wave sleep during the biological night. Using 32-channel electroencephalography, a network science approach, and a within-subject design, we evaluated power, clustering coefficient, and path length across frequency bands under both a control and a polychromatic short-wavelength-enriched light intervention condition. We found that under …

Sleep Health Education To Promote Public Health: Attitudes And Desired Learning Goals Among Social Work Students, Christine Spadola, Danielle B. Groton, Kerry Littlewood, Cassie Hilditch, Shanna Burke, Suzanne M. Bertisch

Faculty Research, Scholarly, and Creative Activity

Social workers are often front line behavioral health providers for underserved populations, many of whom experience sleep disturbances. Inadequate sleep presents a public health challenge and is associated with many adverse physical health and mental health consequences. Social workers are uniquely positioned to promote sleep health among individuals experiencing health inequities. However, sleep is rarely included as part of the curricula in social work programs in the U.S. We conducted qualitative formative research to investigate social work students’ perceptions of sleep education and desired sleep learning objectives. Twenty-five social work students were recruited via a listserv e-mail to participate in …

Versican Provides The Provisional Matrix For Uterine Spiral Artery Dilation And Fetal Growth, Yusuke Sagae, Akihito Horie, Akihiro Yanai, Tsutomu Ohara, Baku Nakakita, Yoshimi Kitawaki, Asuka Okunomiya, Hirohiko Tani, Ken Yamaguchi, Junzo Hamanishi, John P Lydon, Takiko Daikoku, Hideto Watanabe, Masaki Mandai

Faculty, Staff and Students Publications

The extracellular matrix (ECM) in the endometrium plays a crucial role in mammalian pregnancy. We have shown that versican secreted from the endometrial epithelium promotes embryo implantation. Versican is a proteoglycan, a major player in the provisional matrix, and versikine, its N-terminal fragment cleaved by ADAMTS proteinases, serves as a bioactive molecule. Here, since versican expression in the placenta was dynamically altered in humans and mice, we investigated the role of versican in pregnancy using uterine-specific Vcan deletion mice (uKO mice) and ADAMTS-resistant versican expressing mice (V1R mice). uKO mice exhibited insufficient spiral artery dilation, followed by fetal growth restriction …

Assessment Of The Cytolytic Potential Of A Multivirus-Targeted T Cell Therapy Using A Vital Dye-Based, Flow Cytometric Assay, Kiriakos Koukoulias, Penelope G Papayanni, Julia Jones, Manik Kuvalekar, Ayumi Watanabe, Yovana Velazquez, Sarah Gilmore, Anastasia Papadopoulou, Ann M Leen, Spyridoula Vasileiou

Faculty, Staff and Students Publications

Reliable and sensitive characterization assays are important determinants of the successful clinical translation of immunotherapies. For the assessment of cytolytic potential, the chromium 51 (51Cr) release assay has long been considered the gold standard for testing effector cells. However, attaining the approvals to access and use radioactive isotopes is becoming increasingly complex, while technical aspects [i.e. sensitivity, short (4-6 hours) assay duration] may lead to suboptimal performance. This has been the case with our ex vivo expanded, polyclonal (CD4+ and CD8+) multivirus-specific T cell (multiVST) lines, which recognize 5 difficult-to-treat viruses [Adenovirus (AdV), BK virus (BKV), cytomegalovirus (CMV), Epstein Barr …

Editorial: Health Effects And Pathophysiological Mechanisms Of One-Carbon Metabolism Nutrients Intake Throughout The Life Cycle, Jufen Liu, Yunping Lei, Lei Wang, Chao Guo

Faculty, Staff and Students Publications

No abstract provided.

Editorial: Insights In Neurogenomics: 2022, Aayushi Gandhi, Sarah H Elsea

Faculty, Staff and Students Publications

No abstract provided.

Editorial: Peripheral Stimulation: Neuromodulation Of The Central Nervous System Through Existing Pathways, Musa Ozturk, Julio Cesar Hernandez-Pavon, Alexander Kent, Jose L Pons, Ilknur Telkes, Arjun Tarakad

Faculty, Staff and Students Publications

No abstract provided.

Reducing Resident Fluoroscopy Radiation Exposure, Suyang Li, James Costin

Aurora GME

No abstract provided.

Automated Artifact Injection Into Sensing-Capable Brain Modulation Devices For Neural-Behavioral Synchronization And The Influence Of Device State, Michaela E Alarie, Nicole R Provenza, Jeffrey A Herron, Wael F Asaad

Faculty, Staff and Students Publications

No abstract provided.

Stereo-Eeg-Guided Network Modulation For Psychiatric Disorders: Interactive Holographic Planning, Angela M Noecker, Jeffrey Mlakar, Kelly R Bijanki, Mark A Griswold, Nader Pouratian, Sameer A Sheth, Cameron C Mcintyre

Faculty, Staff and Students Publications

Background: Connectomic modeling studies are expanding understanding of the brain networks that are modulated by deep brain stimulation (DBS) therapies. However, explicit integration of these modeling results into prospective neurosurgical planning is only beginning to evolve. One challenge of employing connectomic models in patient-specific surgical planning is the inherent 3D nature of the results, which can make clinically useful data integration and visualization difficult.

Methods: We developed a holographic stereotactic neurosurgery research tool (HoloSNS) that integrates patient-specific brain models into a group-based visualization environment for interactive surgical planning using connectomic hypotheses. HoloSNS currently runs on the HoloLens 2 platform and …

Advances In Imaging Modalities For Pediatric Brain And Spinal Cord Tumors, Thierry A G M Huisman, Rajan Patel, Stephen Kralik, Nilesh K Desai, Avner Meoded, Karen Chen, Howard L Weiner, Daniel J Curry, Maarten Lequin, Mariette Kranendonk, Gunes Orman, George Jallo

Faculty, Staff and Students Publications

Background: Neuroimaging has evolved from anatomical imaging toward a multi-modality comprehensive anatomical and functional imaging in the past decades, important functional data like perfusion-weighted imaging, permeability imaging, diffusion-weighted imaging (DWI), and diffusion tensor imaging (DTI), tractography, metabolic imaging, connectomics, event-related functional imaging, resting state functional imaging, and much more is now being offered.

Summary: Precision diagnostics has proven to be essential for precision treatment. Many minimal invasive techniques have been developed, taking advantage of digital subtraction angiography and interventional neuroradiology. Furthermore, intraoperative CT and/or MRI and more recently MR-guided focused ultrasound have complemented the diagnostic and therapeutic armamentarium.

Key messages: …

Healthcare Workers' Well-Being: A Systematic Review Of Positive Psychology Interventions, Alexandra P Townsley, Jenny Li-Wang, Rajani Katta

Faculty, Staff and Students Publications

Given persistent occupational stressors and multiple challenges in the delivery of healthcare, there is an increased focus on the well-being of healthcare workers. Responding to these challenges will require a multipronged approach, focusing on system level, organization, and individual actions. Positive psychology interventions (PPIs) represent a promising area for individual action. This systematic review indicates that PPI, delivered via many methods, holds promise for improving the well-being of healthcare workers, although there is a clear need for additional randomized controlled trials utilizing defined and standardized outcome measures. In this review, the most commonly evaluated PPIs were mindfulness-based or gratitude-based interventions. …

Depersonalizing Troubles In Institutional Interaction: Routinizing In Parent-Teacher Conferences, Danielle M. Pillet-Shore

Faculty Publications

This article advances our understanding of institutional interaction by showing when and how it can be advantageous for professionals to treat addressed-recipients as non-unique. Examining how teachers talk about children-as-students during parent-teacher conferences, this investigation illuminates several specific interactional methods that teachers use to depersonalize the focal student’s trouble, delineating as among these the novel practice of “routinizing”—citing firsthand experience with other similar cases. Analysis demonstrates how teachers use routinizing to enact their expertise, both responsively as a vehicle for attenuating and credentialing their advice-giving to parents/caregivers, and proactively to preempt parent/caregiver resistance to their student-assessments/evaluations. This research …

Editorial: Hemostasis In Ecmo And Vad, Volume Ii, Jun Teruya, Jean M Connors, Barbara Zieger

Faculty, Staff and Students Publications

No abstract provided.

Teaching Health Justice And Reimagining Narratives Of Place Through Community-Driven Science Practices, Tammie Visintainer

Faculty Research, Scholarly, and Creative Activity

This study explores how a biology teacher from a summer science program engaged high school students of color in a three-week science unit exploring community health at the intersection of history, race, place, and power. The goal of this study is to better understand what community-driven science looks like in a science classroom when a health equity unit is guided by a biology teacher who engages the socio-historical, political, and relational aspects of community structure and agency. Using student and instructor interviews, program observations, and student artifacts, I examine how the instructor's positioning as a Black woman scientist shaped her …

Alzheimer’S Disease (Ad) Knowledge In Korean Americans: Identifying Knowledge Gaps And Misconceptions And Examining Predictors Of Ad Knowledge, Sang E. Lee, Michin Hong, Banghwa L. Casado

Faculty Research, Scholarly, and Creative Activity

Objectives: This study examined Alzheimer’s disease (AD) knowledge and its predictors among Korean Americans (KAs). Design: Convenience sampling was used to recruit KAs in the Greater Washington metropolitan area. A total of 268 KAs participated in the study and completed a cross-sectional survey in 2014. Using the Alzheimer’s Disease Knowledge Scale (ADKS), overall and domain knowledge was assessed. Multiple regression analyses were conducted for overall and domain knowledge with predictors including exposure to AD, social engagement, sources and frequency of health-related information, stigmatic beliefs (pity, antipathy, and social distance), English proficiency, and education. Results: KAs reported a 59% accuracy in …

Acute Liver Failure And Unique Challenges Of Pediatric Liver Transplantation Amidst A Worldwide Cluster Of Adenovirus-Associated Hepatitis, Anna M Banc-Husu, Elizabeth A Moulton, Henry Shiau, Luz Helena Gutierrez Sanchez, Moreshwar S Desai, Dana Cerminara, Flor M Munoz, Leanne M Buffaloe, Kristen G Valencia-Deray, N Thao N Galvan, Julu Bhatnagar, Lindsey Estetter, Negar Rassaei, Sarah Reagan-Steiner, Jason Wicker, James J Dunn, Carl E Allen, Kalyani R Patel, Sanjiv Harpavat, John A Goss, Daniel H Leung

Faculty, Staff and Students Publications

Investigation into a recent cluster of acute hepatitis in children from the southeastern United States identified human adenovirus (HAdV) DNAemia in all 9 cases. Molecular genotyping in 5 of 9 (56%) children identified HAdV type 41 in all cases (100%). Importantly, 2 children from this cluster progressed rapidly to pediatric acute liver failure (PALF) and required liver transplantation. HAdV type 41, a known cause of self-limited gastroenteritis, has not previously been associated with severe cholestatic hepatitis and liver failure in healthy children. Adenovirus polymerase chain reaction assay and sequencing of amplicons performed on DNA extracted from formalin-fixed, paraffin-embedded liver tissue …

Emergency Department Presentations Of Diabetic Ketoacidosis In A Large Cohort Of Children, Lise E Nigrovic, Nathan Kuppermann, Simona Ghetti, Jeff E Schunk, Michael J Stoner, Arleta Rewers, Julie K Mcmanemy, Kimberly S Quayle, Jennifer L Trainor, Leah Tzimenatos, Jonathan E Bennett, Maria Y Kwok, Sage R Myers, Kathleen M Brown, T Charles Casper, Cody S Olsen, Nicole S Glaser

Faculty, Staff and Students Publications

Background: Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of childhood diabetes. However, the influence of demographic factors on presentation are not well-defined.

Methods: We included children from 12 centers who were < 18 years with DKA (glucose > 300 mg/dL, serum pH < 7.25, or serum bicarbonate < 15 mEq/L) enrolled in the Pediatric Emergency Care Applied Research Network (PECARN) Fluid Therapies Under Investigation in DKA (FLUID) Trial. Data were also collected for children who presented to the centers during the enrollment period but were not enrolled due to disease or treatment-related reasons. We compared demographic, clinical, and biochemical findings among children with newly and previously diagnosed diabetes and children in different age groups.

Results: Of the 1,679 DKA episodes in 1,553 children, 799 (47.5%) episodes occurred in children with newly diagnosed diabetes and 396 (23.6%) were severe (pH < 7.1). Newly diagnosed children < 6 years of age were not more likely to have severe DKA in terms of pH, but had more severe hypocarbia and higher blood urea nitrogen levels, factors previously associated with the risk of cerebral injury. Lower socioeconomic status (SES) (based on family income and maternal education level) were associated with more severe DKA in new onset children, and recurrent DKA in the previously diagnosed children.

Conclusions: Greater efforts are needed to identify the children with diabetes early and to prevent recurrent DKA, particularly among children in low-SES groups. Young children with DKA may need more intensive monitoring due to higher risk of cerebral injury.

Specialized Intensive Inpatient Rehabilitation Is Crucial And Time-Sensitive For Functional Recovery From Disorders Of Consciousness, Bei Zhang, Katherine O'Brien, Jean Woo, Bradley Chi, Colton Reeh, Sheng Li, Sunil Kothari

Faculty, Staff and Students Publications

Background: Disorders of consciousness (DoCs) after severe brain injury are considered to be conditions with dire prognosis. Despite the accumulating evidence, inpatient rehabilitation is often denied by payers referring to the Medicare/Medicaid criteria, under the assumption that such patients will not "actively" participate in therapy or make "measurable improvements."

Objective: This study aimed to report on the effectiveness and efficiency of a specialized inpatient DoC rehabilitation program based on measurable clinical parameters.

Methods: A retrospective cohort study was conducted. The cohort comprised 137 patients with DoC admitted to a specialized acute inpatient rehabilitation program between January …

Mental Health Experiences In 2021 For Adults With Disabilities Who Are Lgbt, Debra Brucker, Chris Surfus, Megan Henly

Faculty Publications

Using data from the U.S. Census Bureau’s weekly Household Pulse Survey conducted during the COVID-19 pandemic (July 21, 2021 – October 11, 2021), this study examines the prevalence of anxiety, worry, loss of interest and depression, receipt of mental health treatment, and self-reported unmet need for mental health treatment among adults with and without disabilities by lesbian, gay, bisexual, or transgender (LGBT) status. Controlling for age, educational attainment, employment, health insurance coverage, and race/ethnicity, adults with disabilities, regardless of LGBT status, had statistically significantly increased odds of anxiety, worry, loss of interest and depression, receipt of mental health treatment, and …

Mir-124-3p Target Genes Identify Globus Pallidus Role In Suicide Ideation Recovery In Borderline Personality Disorder, Macarena S Aloi, Guillermo F Poblete, John Oldham, Michelle A Patriquin, David A Nielsen, Thomas R Kosten, Ramiro Salas

Faculty, Staff and Students Publications

Borderline personality disorder (BPD) is characterized by patterns of unstable affect, unstable interpersonal relationships, and chronic suicidal tendencies. Research on the genetics, epigenetics, and brain function of BPD is lacking. MicroRNA-124-3p (miR-124-3p) was recently identified in a Genome-Wide Association Study as likely associated with BPD. Here, we identified the anatomical brain expression of genes likely modulated by miR-124-3p and compared morphometry in those brain regions in BPD inpatients vs. controls matched for psychiatric comorbidities. We isolated lists of targets likely modulated by miR-124-3p from TargetScan (v 8.0) by their preferentially conserved targeting (Aggregate PCT > 0.99, see Supplementary Table 1). …