Digital Commons Network^™

Potential Impact Of Prescribing Metformin According To Egfr Rather Than Serum Creatinine, Delphine S. Tuot, Feng Lin, Michael G. Shlipak, Vanessa Grubbs, Chi-Yuan Hsu, Jerry Yee, Vahakn Shahinian, Rajiv Saran, Sharon Saydah, Desmond E. Williams, Neil R. Powe

Nephrology Articles

OBJECTIVE: Many societies recommend using estimated glomerular filtration rate (eGFR) rather than serum creatinine (sCr) to determine metformin eligibility. We examined the potential impact of these recommendations on metformin eligibility among U.S. adults.

RESEARCH DESIGN AND METHODS: Metformin eligibility was assessed among 3,902 adults with diabetes who participated in the 1999-2010 National Health and Nutrition Examination Surveys and reported routine access to health care, using conventional sCr thresholds (eligible if

RESULTS: Among adults with sCr above conventional cutoffs, MDRD eGFR ≥45 mL/min/1.73 m(2) was most common among men (adjusted odds ratio [aOR] 33.3 [95% CI 7.4-151.5] vs. women) and non-Hispanic …

Employment Status And Participation In Cardiac Rehabilitation: Does Encouraging Earlier Enrollment Improve Attendance?, Quinn R. Pack, Ray W. Squires, Claudia Valdez-Lowe, Mouhamad Mansour, Randal J. Thomas, Steven J. Keteyian

Cardiology Articles

PURPOSE: For patients hospitalized for a cardiac event, an earlier appointment to outpatient cardiac rehabilitation (CR) increases participation. However, it is unknown what effect hastening CR enrollment might have among employed patients planning to return to work (RTW).

METHODS: Using 2 complementary data sets from Henry Ford Hospital (HFH) and Mayo Clinic, we assessed when employed patients eligible for CR anticipated a RTW, the impact of an earlier appointment on CR enrollment, and the effect of employment status on the number of CR sessions attended. Patients at HFH attended CR at either 8 or 42 days (through randomization), whereas Mayo …

Effect Of Mycophenolate Mofetil On The White Blood Cell Count And The Frequency Of Infection In Systemic Lupus Erythematosus., Ananta Subedi, Laurence S. Magder, Michelle Petri

Department of Medicine Faculty Papers

Leukopenia is a common manifestation of SLE. Addition of immunosuppressive therapy in a SLE patient who is already leukopenic is a clinical concern. It could worsen leukopenia, increase the risk of infection, or both. The aim of this study was to analyze the immediate effect of mycophenolate mofetil on the white blood cell count and the rate of infection in SLE patients. Two hundred and forty-four patients within the Hopkins Lupus Cohort who were newly started on mycophenolate mofetil were included in the study. The white blood cell count and interval infection history on the day mycophenolate mofetil was started …

Workplace Safety Concerns Among Co-Workers Of Responder Returning From Ebola-Affected Country, Benjamin P. Chan, Elizabeth R. Daly, Elizabeth A. Talbot

Dartmouth Scholarship

We surveyed public health co-workers regarding attitudes toward a physician who returned to New Hampshire after volunteering in the West African Ebola outbreak. An unexpectedly large (18.0%) proportion of staff expressed discomfort with the Ebola responder returning to work. Employers should take proactive steps to address employee fears and concerns.

Validation Of Maximal Heart Rate Prediction Equations Based On Sex And Physical Activity Status, Stephen J. Roy, J.L. Mccrory

International Journal of Exercise Science

International Journal of Exercise Science 8(4): 318-330, 2015. The purpose of the study was to determine if measured maximal heart rate (HR_max) was affected by sex or aerobic training status, and to determine the accuracy of three common clinical age-prediction maximal heart rate regression equations used to predict HR_max: HR_max = 220 – age, HR_max = 226 – age, and HR_max = 208 – (0.7 ∙ age). Fifty-two participants in total, 30 of which were in the active group (15 M, 15 F) and 22 subjects in the sedentary group (9 M, …

Dynapenic Obesity And The Effect On Long-Term Physical Function And Quality Of Life: Data From The Osteoarthritis Initiative, John A. Batsis, Alicia J. Zbehlik, Dawna Pidgeon, Stephen J. Bartels

Dartmouth Scholarship

Obesity is associated with functional impairment, institutionalization, and increased mortality risk in elders. Dynapenia is defined as reduced muscle strength and is a known independent predictor of adverse events and disability. The synergy between dynapenia and obesity leads to worse outcomes than either independently. We identified the impact of dynapenic obesity in a cohort at risk for and with knee osteoarthritis on function.

Success And The Other[Ed] Woman: Examining The Persistence Of Female Students From Saudi Arabia, Dawn M. Winters

Dissertations

With the influx of international students on American campuses, it is imperative that universities seek solutions to unique challenges surrounding their retention. More specifically, because women from Saudi Arabia are accustomed to highly-structured gendered practices in their home country that diametrically oppose those in the United States, they represent a sub-group within a sub-group of the often-generalized international students. Relatively few studies have been conducted regarding the academic persistence of specific groups of international students. The goal of this narrative analysis was to examine the salutogenic aspects of the persistence of Saudi women using Vincent Tinto’s (1997) revised model of …

Down Syndrome With Complete Atrioventricular Septal Defect, Hypertrophic Cardiomyopathy, And Pulmonary Vein Stenosis, Guruprasad Mahadevaiah, Manoj Gupta, Ravi Ashwath

The Texas Heart Institute Journal

The prevalence of congenital heart disease in infants with Down syndrome is 40%, compared with 0.3% in children who have normal chromosomes. Atrioventricular and ventricular septal defects are often associated with chromosomal aberrations, such as in trisomy 21, whereas hypertrophic cardiomyopathy is chiefly thought to be secondary to specific gene mutations. We found only one reported case of congenital hypertrophic cardiomyopathy and atrioventricular septal defect in an infant with Down syndrome. Here, we report atrioventricular septal defect, hypertrophic cardiomyopathy, and pulmonary vein stenosis in a neonate with Down syndrome-an apparently unique combination. In addition, we discuss the relevant medical literature.

Protecting Ourselves From Harm: Voices Of Aging Farmers, Deborah B. Reed, Deborah T. Claunch

Nursing Faculty Publications

Senior farmers suffer the highest fatality risk of any age group in agriculture. The purpose of this exploratory study was to develop a "voice" for senior farmers by examining aging farmers' and their families' perspectives of farm work, associated injury risks, and methods to decrease those risks. Focus groups and personal interviews were used to collect data from 81 participants across seven U.S. states. The findings reflect the collective and verified voice of the study group. The Health Belief Model was applied and revealed differences between farmers and their family members; however, the need and desire to continue self-directed work …

Risk Factors For Hemorrhoids On Screening Colonoscopy, Anne F. Peery, Robert S. Sandler, Joseph A. Galanko, Robert S. Bresalier, Jane C. Figueiredo, Dennis J. Ahnen, Elizabeth L. L. Barry, John A. Baron

Dartmouth Scholarship

Background: Constipation, a low fiber diet, sedentary lifestyle and gravidity are commonly assumed to increase the risk of hemorrhoids. However, evidence regarding these factors is limited. We examined the association between commonly cited risk factors and the prevalence of hemorrhoids. Methods: We performed a cross sectional study of participants who underwent a colonoscopy in a colorectal adenoma prevention trial and who had a detailed assessment of bowel habits, diet and activity. The presence of hemorrhoids was extracted from the subjects’ colonoscopy reports. We used logistic regression to estimate odds ratios and 95% confidence intervals while adjusting for age and sex. …

Computerized Adaptive Tests Detect Change Following Orthopaedic Surgery In Youth With Cerebral Palsy., M J Mulcahey, Mary D Slavin, Pengsheng Ni, Lawrence C Vogel, Scott H Kozin, Stephen M Haley, Alan M Jette

Department of Occupational Therapy Faculty Papers

BACKGROUND: The Cerebral Palsy Computerized Adaptive Test (CP-CAT) is a parent-reported outcomes instrument for measuring lower and upper-extremity function, activity, and global health across impairment levels and a broad age range of children with cerebral palsy (CP). This study was performed to examine whether the Lower Extremity/Mobility (LE) CP-CAT detects change in mobility following orthopaedic surgery in children with CP.

METHODS: This multicenter, longitudinal study involved administration of the LE CP-CAT, the Pediatric Outcomes Data Collection Instrument (PODCI) Transfer/Mobility and Sports/Physical Functioning domains, and the Timed "Up & Go" test (TUG) before and after elective orthopaedic surgery in a convenience …

The Fate Of Spacers In The Treatment Of Periprosthetic Joint Infection., Miguel M Gomez, Timothy L Tan, Jorge Manrique, Gregory K Deirmengian, Javad Parvizi Md

Rothman Institute Papers

BACKGROUND: Two-stage exchange arthroplasty remains the preferred method to treat periprosthetic joint infection. The aim of this study was to investigate the clinical course of periprosthetic joint infection following resection arthroplasty and insertion of a spacer.

METHODS: Our institutional database was used to identify 504 cases of periprosthetic joint infection (326 knees and 178 hips) treated with resection arthroplasty and spacer insertion as part of a two-stage exchange arthroplasty. A review of the patient charts was performed to extract information relevant to the objectives of this study that included the details of the clinical course following resection arthroplasty.

RESULTS: The …

A Comparison Of A Multistate Inpatient Ehr Database To The Hcup Nationwide Inpatient Sample., Jonathan P Deshazo, Mark A Hoffman

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: The growing availability of electronic health records (EHRs) in the US could provide researchers with a more detailed and clinically relevant alternative to using claims-based data.

METHODS: In this study we compared a very large EHR database (Health Facts©) to a well-established population estimate (Nationwide Inpatient Sample). Weighted comparisons were made using t-value and relative difference over diagnoses and procedures for the year 2010.

RESULTS: The two databases have a similar distribution pattern across all data elements, with 24 of 50 data elements being statistically similar between the two data sources. In general, differences that were found are consistent …

Gm1 Ganglioside In Parkinson's Disease: Pilot Study Of Effects On Dopamine Transporter Binding., Jay S. Schneider, Franca Cambi, Stephen M. Gollomp, Hiroto Kuwabara, James R. Brašić, Benjamin E. Leiby, Stephanie Sendek, Dean F. Wong

Department of Pharmacology and Experimental Therapeutics Faculty Papers

OBJECTIVE: GM1 ganglioside has been suggested as a treatment for Parkinson's disease (PD), potentially having symptomatic and disease modifying effects. The current pilot imaging study was performed to examine effects of GM1 on dopamine transporter binding, as a surrogate measure of disease progression, studied longitudinally.

METHODS: Positron emission tomography (PET) imaging data were obtained from a subset of subjects enrolled in a delayed start clinical trial of GM1 in PD [1]: 15 Early-start (ES) subjects, 14 Delayed-start (DS) subjects, and 11 Comparison (standard-of-care) subjects. Treatment subjects were studied over a 2.5 year period while Comparison subjects were studied over 2 …

Comparative Effectiveness Of Injury Prevention Programs In Female Adolescent Athletes, Jessica C. Martinez

Doctoral Dissertations

Injury prevention programs (IPP) decrease injury rates and improve movement-based risk factors, but many coaches do not adopt them. The time required for these programs is frequently reported as a barrier to program adoption. It is not known if a shorter duration IPP can improve movement technique in a manner thought to reduce the risk of injury. To examine if a shorter duration IPP is able to elicit improvements in movement technique similar to the F11+ program in female, high school athletes. A secondary aim was to assess high-risk (LESS ≥ 5) participants’ response to the intervention. A randomized controlled …

The Life Course Of Female Homicide Offenders: A Mixed Methods Analysis, Alesa Ray Liles

Theses and Dissertations

Although research on female offending has grown in the past few decades, the criminal justice system has remained inadequate in addressing and responding to the needs of women. Researchers have just begun to study the lives of women independently of men to uncover the similarities, and more importantly, differences. The limited research that is available on the life histories of female offenders, particularly female homicide offenders, shows there are events and experiences that play a significant role in the lives of these women. To increase knowledge on the individual factors that lead to female offending, this dissertation sought to incorporate …

Mountain Pine Beetles Use Volatile Cues To Locate Host Limber Pine And Avoid Non-Host Great Basin Bristlecone Pine, Curtis A. Gray, Justin B. Runyon, Michael J. Jenkins, Andrew D. Giunta

Wildland Resources Faculty Publications

The tree-killing mountain pine beetle (Dendroctonus ponderosae Hopkins) is an important disturbance agent of western North American forests and recent outbreaks have affected tens of millions of hectares of trees. Most western North American pines (Pinus spp.) are hosts and are successfully attacked by mountain pine beetles whereas a handful of pine species are not suitable hosts and are rarely attacked. How pioneering females locate host trees is not well understood, with prevailing theory involving random landings and/or visual cues. Here we show that female mountain pine beetles orient toward volatile organic compounds (VOCs) from host limber pine (Pinus flexilis …

The Muscular Female Athlete: Negotiating Conflicting Identities And Bodies, Kelsey J. Mischke

Journal of Undergraduate Research at Minnesota State University, Mankato

Competing assumptions, expectations, and discourses surrounding the institution of sports, femininity, and the feminine body create a conflicting paradox for female athletes. Existing research was investigated to examine the ways in which female athletes negotiate their conflicting roles in society and how they feel about their muscular bodies. Feminist theory, gender-role conflict theory, and identity work are used. Results show athletes employ apologetic behaviors, defensive othering, and create fluid identities in response to experiencing gender-role conflict. In terms of their bodies, female athletes feel differing sentiments dependent on environment, reject conflicting messages about their body, and/or reject their musculature. Due …

How Clinicians Feel About Working With Spouses Of The Chronically Ill, Douglas Ingram

NYMC Faculty Publications

Clinicians who provide psychotherapy to spouses or partners of the chronically ill were solicited through listserves of psychodynamic and other organizations. The current report excluded those therapists working with spouses of dementia patients. Interviews were conducted with clinicians who responded. The interviews highlight the challenges commonly encountered by psychotherapeutic work with this cohort of therapy patients. A comparison is drawn that shows both overlap and distinctions between the experiences of those therapists engaging with spouses of chronically ill patients without a dementing process and those working with spouses of chronically ill patients who do suffer from a dementing process.

Positional Differences In Reactive Hyperemia Provide Insight Into Initial Phase Of Exercise Hyperemia., Jeffrey L Jasperse, J Kevin Shoemaker, Eric J Gray, Philip S Clifford

Kinesiology Publications

Studies have reported a greater blood flow response to muscle contractions when the limb is below the heart compared with above the heart, and these results have been interpreted as evidence for a skeletal muscle pump contribution to exercise hyperemia. If limb position affects the blood flow response to other vascular challenges such as reactive hyperemia, this interpretation may not be correct. We hypothesized that the magnitude of reactive hyperemia would be greater with the limb below the heart. Brachial artery blood flow (Doppler ultrasound) and blood pressure (finger-cuff plethysmography) were measured in 10 healthy volunteers. Subjects lay supine with …

Speckle-Tracking Echocardiographic Measures Of Right Ventricular Function Correlate With Improvement In Exercise Function After Percutaneous Pulmonary Valve Implantation., Shahryar M. Chowdhury, Ziyad M. Hijazi, John T. Fahey, John F. Rhodes, Saibal Kar, Raj Makkar, Michael Mullen, Qi-Ling Cao, Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Speckle-tracking echocardiographic (STE) measures of right ventricular (RV) function appear to improve after transcatheter pulmonary valve implantation (TPVI). Measures of exercise function, such as ventilatory efficiency (the minute ventilation [VE]/carbon dioxide production [VCO2] slope), have been shown to be prognostic of mortality in patients who may require TPVI. The aim of this study was to evaluate the correlation between STE measures of RV function and changes in VE/VCO2 after TPVI.

METHODS: Speckle-tracking echocardiography and cardiopulmonary exercise testing were performed at baseline and 6 months after TPVI in 24 patients from four centers. Conventional echocardiographic measures of RV function were …

Testosterone Might Not Be Necessary To Support Female Aggression In Incubating Northern Cardinals, M. Susan Devries, Caitlin P. Winters, Jodie M. Jawor

Faculty Publications

Testosterone's (T) influence on male aggression has been well established in many vertebrate species, but the impact of T on female aggressive behaviour is poorly understood. Among birds, a link between T and female aggression is plausible, as females of many species exhibit a seasonal peak in T concentrations at the onset of breeding when social instability is greatest and they may have circulating T through much of the breeding season. However, investigations examining the relationship between T and female aggression are few and have yielded conflicting results, with experimentally or endogenously elevated T supporting aggressive behaviour in females of …

Recurrent Streptococcus Equi Subsp. Zooepidemicus Bacteremia In An Infant, Joshua R. Watson, Amy Leber, Sridhar Velineni, John F. Timoney, Monica I. Ardura

Maxwell H. Gluck Equine Research Center Faculty Publications

We describe a case of an infant with recurrent bacteremia caused by Streptococcus equi subsp. zooepidemicus, likely transmitted from mother to infant. Our case highlights the importance of an epidemiological history and molecular diagnostics in ascertaining insights into transmission, pathogenesis, and optimal management.

Novel Human Abcc9/Sur2 Brain-Expressed Transcripts And An Eqtl Relevant To Hippocampal Sclerosis Of Aging, Peter T. Nelson, Wang-Xia Wang, Bernard R. Wilfred, Angela Wei, James Dimayuga, Qingwei Huang, Eseosa T. Ighodaro, Sergey C. Artiushin, David W. Fardo

Sanders-Brown Center on Aging Faculty Publications

ABCC9 genetic polymorphisms are associated with increased risk for various human diseases including hippocampal sclerosis of aging. The main goals of this study were 1 > to detect the ABCC9 variants and define the specific 3′ untranslated region (3′UTR) for each variant in human brain, and 2 > to determine whether a polymorphism (rs704180) associated with risk for hippocampal sclerosis of aging pathology is also associated with variation in ABCC9 transcript expression and/or splicing. Rapid amplification of ABCC9 cDNA ends (3′RACE) provided evidence of novel 3′ UTR portions of ABCC9 in human brain. In silico and experimental studies were performed focusing on …

Human Ips Cell-Derived Astrocyte Transplants Preserve Respiratory Function After Spinal Cord Injury., Ke Li, Elham Javed, Daniel Scura, Tamara J. Hala, Suneil Seetharam, Aditi Falnikar, Jean-Philippe Richard, Ashley Chorath, Nicholas J. Maragakis, Megan C. Wright, Angelo C. Lepore

Department of Neuroscience Faculty Papers

Transplantation-based replacement of lost and/or dysfunctional astrocytes is a promising therapy for spinal cord injury (SCI) that has not been extensively explored, despite the integral roles played by astrocytes in the central nervous system (CNS). Induced pluripotent stem (iPS) cells are a clinically-relevant source of pluripotent cells that both avoid ethical issues of embryonic stem cells and allow for homogeneous derivation of mature cell types in large quantities, potentially in an autologous fashion. Despite their promise, the iPS cell field is in its infancy with respect to evaluating in vivo graft integration and therapeutic efficacy in SCI models. Astrocytes express …

Locomotor Adaptation Is Influenced By The Interaction Between Perturbation And Baseline Asymmetry After Stroke., Christine M. Tyrell, Erin Helm, Darcy S. Reisman

Department of Physical Therapy Faculty Papers

Stroke survivors without cerebellar involvement retain the ability to adapt to the split-belt treadmill; however it has been suggested that their rate of adaptation may be slowed compared to those who are neurologically intact. Depending on limb placement, the split-belt treadmill can be configured to either exaggerate baseline asymmetry, or reduce it, which may affect the behavior of adaptation or de-adaptation. The objectives of this study were to characterize the rate and magnitude of locomotor (de)adaptation in chronic stroke survivors compared to healthy matched subjects, and to evaluate whether exaggeration or reduction of baseline asymmetry impact the responses. Seventeen stroke …

Truncating Mutation In The Autophagy Gene Uvrag Confers Oncogenic Properties And Chemosensitivity In Colorectal Cancers, Shanshan He, Zhen Zhao, Yongfei Yang, Douglas O'Connell, Xiaowei Zhang, Soohwan Oh, Binyun Ma, Joo-Hyung Lee, Tian Zhang, Bino Varghese, Janae Yip, Sara Dolatshahi Pirooz, Ming Li, Yong Zhang, Guo-Min Li, Sue Ellen Martin, Keigo Machida, Chengyu Liang

Toxicology and Cancer Biology Faculty Publications

Autophagy-related factors are implicated in metabolic adaptation and cancer metastasis. However, the role of autophagy factors in cancer progression and their effect in treatment response remain largely elusive. Recent studies have shown that UVRAG, a key autophagic tumour suppressor, is mutated in common human cancers. Here we demonstrate that the cancer-related UVRAG frameshift (FS), which does not result in a null mutation, is expressed as a truncated UVRAG^FS in colorectal cancer (CRC) with microsatellite instability (MSI), and promotes tumorigenesis. UVRAG^FS abrogates the normal functions of UVRAG, including autophagy, in a dominant-negative manner. Furthermore, expression of UVRAG^FS can …

Intracellular Listeria Monocytogenes Comprises A Minimal But Vital Fraction Of The Intestinal Burden Following Foodborne Infection, Grant S. Jones, Kate M. Bussell, Tanya Myers-Morales, Abigail M. Fieldhouse, Elsa N. Bou Ghanem, Sarah E. F. D'Orazio

Microbiology, Immunology, and Molecular Genetics Faculty Publications

Listeria monocytogenes is a highly adaptive bacterium that replicates as a free-living saprophyte in the environment as well as a facultative intracellular pathogen that causes invasive foodborne infections. The intracellular life cycle of L. monocytogenes is considered to be its primary virulence determinant during mammalian infection; however, the proportion of L. monocytogenes that is intracellular in vivo has not been studied extensively. In this report, we demonstrate that the majority of wild-type (strain EGDe) and mouse-adapted (InlA^m-expressing) L. monocytogenes recovered from the mesenteric lymph nodes (MLN) was extracellular within the first few days after foodborne infection. In addition, …

Noncontact Diffuse Correlation Tomography Of Human Breast Tumor, Lian He, Yu Lin, Chong Huang, Daniel Irwin, Margaret M. Szabunio, Guoqiang Yu

Biomedical Engineering Faculty Publications

Our first step to adapt our recently developed noncontact diffuse correlation tomography (ncDCT) system for three-dimensional (3-D) imaging of blood flow distribution in human breast tumors is reported. A commercial 3-D camera was used to obtain breast surface geometry, which was then converted to a solid volume mesh. An ncDCT probe scanned over a region of interest on the mesh surface and the measured boundary data were combined with a finite element framework for 3-D image reconstruction of blood flow distribution. This technique was tested in computer simulations and in vivo human breasts with low-grade carcinoma. Results from computer simulations …

Association Between Arsenic Exposure From Drinking Water And Longitudinal Change In Blood Pressure Among Heals Cohort Participants, Jieying Jiang, Mengling Liu, Faruque Parvez, Binhuan Wang, Fen Wu, Mahbub Eunus, Sripal Bangalore, Jonathan D. Newman, Alauddin Ahmed, Tariqul Islam, Muhammed Rakibuz-Zaman, Rabiul Hasan, Golam Sarwar, Diane Levy, Vesna Slavkovich, Maria Argos, Molly Scannell Bryan, Shohreh F. Farzan, Richard B. Hayes, Joseph H. Graziano, Habibul Ahsan, Yu Chen

Dartmouth Scholarship

Background:

Cross-sectional studies have shown associations between arsenic exposure and prevalence of high blood pressure; however, studies examining the relationship of arsenic exposure with longitudinal changes in blood pressure are lacking.

Method:

We evaluated associations of arsenic exposure in relation to longitudinal change in blood pressure in 10,853 participants in the Health Effects of Arsenic Longitudinal Study (HEALS). Arsenic was measured in well water and in urine samples at baseline and in urine samples every 2 years after baseline. Mixed-effect models were used to estimate the association of baseline well and urinary creatinine-adjusted arsenic with annual change in blood pressure …