Digital Commons Network^™

Mifepristone Treatment In Four Cases Of Primary Bilateral Macronodular Adrenal Hyperplasia (Bmah)., Pejman Cohan, Honey E East, Sandi-Jo Galati, Jennifer U Mercado, Precious J Lim, Michele Lamerson, James J Smith, Anne L Peters, Kevin C J Yuen

Neurology

CONTEXT: Primary bilateral macronodular adrenal hyperplasia (BMAH) is a rare form of adrenal Cushing syndrome conventionally treated with adrenalectomy. Medical treatment is often reserved for patients not eligible for surgery. However, to date there have been few studies about the efficacy of mifepristone for the treatment of BMAH associated with hypercortisolism.

OBJECTIVE: To describe a series of patients with hypercortisolism due to BMAH treated with mifepristone from multiple medical practices.

DESIGN: We retrospectively assessed four patients treated with mifepristone for hypercortisolism due to BMAH who had either failed unilateral adrenalectomy, declined surgery, or were poor surgical candidates.

RESULTS: Mifepristone induced …

Healthcare Utilization Costs Of Emerging Adults With Mood And Anxiety Disorders In An Early Intervention Treatment Program Compared To A Matched Cohort, Ava A. John-Baptiste, Lihua Li, Wanrudee Isaranuwatchai, Elizabeth Osuch, Kelly K. Anderson

Epidemiology and Biostatistics Publications

AIM: The First Episode Mood and Anxiety Disorder Program (FEMAP) provides treatment to emerging adults with mood and anxiety disorders in an accessible, youth-friendly environment. We sought to investigate FEMAP's impact on the costs of care.

METHODS: We conducted a retrospective observational study of one-year health service costs using linked administrative datasets to compare emerging adults treated at FEMAP (FEMAP users) to propensity-score matched controls (non-users). Costs from the perspective of the Ontario Ministry of Health and Long-Term Care, included drug benefit claims, inpatient, physician and ambulatory care services. We used bootstrapping to perform unadjusted comparisons between FEMAP users and …

African American Female Law Enforcement Officers' Lived Experiences And Mentoring: A Thematic Narrative, Harold Wilson

Doctoral Dissertations

Black female officers are an underrepresented sub-group of the law-enforcement profession. The bulk of research on women’s policing has focused on the growth of women in law enforcement, barriers, sexual harassment, gender differences, why women are deterred from law enforcement, physical limitations, and instruments used during the recruitment process, and the stress endured after entry into the profession. When looking at Black female officers’ lived experience and perceptions around mentoring; research is lacking. Eight Black female officers from the San Francisco Bay Area participated in this study. Findings revealed that all of the women have faced a recurring sense of …

Reports Of Injury Risks And Reasons For Choice Of Sleep Environments For Infants And Toddlers, N J Scheers, Chauncey Dayton, Mary Batcher, Bradley T Thach

Open Access Publications

OBJECTIVE: Compare mothers' reports of injuries for infants and toddlers sleeping with crib-bumpers/mesh-liners/no-barriers and reasons for these sleep environment choices.

METHODS: A cross-sectional survey of mothers subscribing to a parenting magazine and using crib bumpers (n = 224), mesh liners (n = 262), and no barriers (n = 842). Analyses of four possible injuries (face-covered, climb-out/fall, slat-entrapment, hit-head) including multivariate logistic regression adjusted for missing data/demographics and Chi squared analyses of reasons for mothers' choices.

RESULTS: Maternal reports of finding infants/toddlers with face covered had 3.5 times higher adjusted odds (aOR) for crib bumper versus mesh liner use. Breathing difficulties …

A Consumer Neuroscience Study Of Conscious And Subconscious Destination Preference, Thomas Zoëga Ramsøy, Noela Michael, Ian Michael

All Works

© 2019, The Author(s). In studying consumer behaviors, the inclusion of neuroscience tools and methods is improving our understanding of preference formation and choice. But such responses are mostly related to the consumption of goods and services that meet an immediate need. Tourism represents a consumer behavior that is related to a more complex decision-making process, involving a stronger relationship with a future self, and choices typically being of a higher level of involvement and of a transformational type. The aim of this study was to test whether direct emotional and cognitive responses to travel destination would be indicative of …

Incense Burning Is Associated With Human Oral Microbiota Composition, Yvonne Vallès, Claire K. Inman, Brandilyn A. Peters, Laila Abdel Wareth, Abdishakur Abdulle, Habiba Alsafar, Fatme Al Anouti, Ayesha Al Dhaheri, Divya Galani, Muna Haji, Aisha Al Hamiz, Ayesha Al Hosani, Mohammed Al Houqani, Abdulla Aljunaibi, Marina Kazim, Tomas Kirchhoff, Wael Al Mahmeed, Fatma Al Maskari, Abdullah Alnaeemi, Naima Oumeziane, Ravichandran Ramasamy, Ann Marie Schmidt, Henri Vallès, Eiman Al Zaabi, Scott Sherman, Raghib Ali, Jiyoung Ahn, Richard B. Hayes

All Works

© 2019, The Author(s). Incense burning is common worldwide and produces environmental toxicants that may influence health; however, biologic effects have been little studied. In 303 Emirati adults, we tested the hypothesis that incense use is linked to compositional changes in the oral microbiota that can be potentially significant for health. The oral microbiota was assessed by amplification of the bacterial 16S rRNA gene from mouthwash samples. Frequency of incense use was ascertained through a questionnaire and examined in relation to overall oral microbiota composition (PERMANOVA analysis), and to specific taxon abundances, by negative binomial generalized linear models. We found …

Temporal And Effort Cost Decision-Making In Healthy Individuals With Subclinical Psychotic Symptoms, Damiano Terenzi, Elena Mainetto, Mariapaola Barbato, Raffaella Ida Rumiati, Marilena Aiello

All Works

© 2019, The Author(s). The value people attribute to rewards is influenced both by the time and the effort required to obtain them. Impairments in these computations are described in patients with schizophrenia and appear associated with negative symptom severity. This study investigated whether deficits in temporal and effort cost computations can be observed in individuals with subclinical psychotic symptoms (PS) to determine if this dysfunction is already present in a potentially pre-psychotic period. Sixty participants, divided into three groups based on the severity of PS (high, medium and low), performed two temporal discounting tasks with food and money and …

Cognitive Decline Over Time In Patients With Systolic Heart Failure: Insights From Warcef., Tetz C Lee, Min Qian, Yutong Liu, Susan Graham, Douglas L Mann, Koki Nakanishi, John R Teerlink, Gregory Y H Lip, Ronald S. Freudenberger Md, Ralph L Sacco, Jay P Mohr, Arthur J Labovitz, Piotr Ponikowski, Dirk J Lok, Kenji Matsumoto, Conrado Estol, Stefan D Anker, Patrick M Pullicino, Richard Buchsbaum, Bruce Levin, John L P Thompson, Shunichi Homma, Marco R Di Tullio

Department of Medicine

OBJECTIVES: This study sought to characterize cognitive decline (CD) over time and its predictors in patients with systolic heart failure (HF).

BACKGROUND: Despite the high prevalence of CD and its impact on mortality, predictors of CD in HF have not been established.

METHODS: This study investigated CD in the WARCEF (Warfarin versus Aspirin in Reduced Ejection Fraction) trial, which performed yearly Mini-Mental State Examinations (MMSE) (higher scores indicate better cognitive function; e.g., normal score: 24 or higher). A longitudinal time-varying analysis was performed among pertinent covariates, including baseline MMSE and MMSE scores during follow-up, analyzed both as a continuous variable …

Factors Affecting Acceptance Of At-Birth Point Of Care Hiv Testing Among Providers And Parents In Kenya: A Qualitative Study., Catherine Wexler, May Maloba, Melinda Brown, Natabhona Mabachi, Kathy Goggin, Brad Gautney, Beryne Odeny, Sarah Finocchario-Kessler

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: At-birth and point-of-care (POC) HIV testing are emerging strategies to streamline infant HIV diagnosis and expedite ART initiation for HIV-positive infants. The purpose of this qualitative study was to evaluate factors influencing the provision and acceptance of at-birth POC testing among both HIV care providers and parents of HIV-exposed infants in Kenya.

METHODS: We conducted semi-structured interviews with 26 HIV care providers and 35 parents of HIV-exposed infants (including 23 mothers, 6 fathers, and 3 mother-father pairs) at four study hospitals prior to POC implementation. An overview of best available evidence related to POC was presented to participants prior …

The Community Structure Of Functional Brain Networks Exhibits Scale-Specific Patterns Of Inter- And Intra-Subject Variability, Richard F Betzel, Maxwell A Bertolero, Evan M Gordon, Caterina Gratton, Nico U F Dosenbach, Danielle S Bassett

2010-2019 OA Pubs

The network organization of the human brain varies across individuals, changes with development and aging, and differs in disease. Discovering the major dimensions along which this variability is displayed remains a central goal of both neuroscience and clinical medicine. Such efforts can be usefully framed within the context of the brain's modular network organization, which can be assessed quantitatively using computational techniques and extended for the purposes of multi-scale analysis, dimensionality reduction, and biomarker generation. Although the concept of modularity and its utility in describing brain network organization is clear, principled methods for comparing multi-scale communities across individuals and time …

Associations Of Race And Ethnicity With Risk Of Developing Invasive Breast Cancer After Lobular Carcinoma In Situ, Vanessa Dania, Ying Liu, Foluso Ademuyiwa, Jason D Weber, Graham A Colditz

Open Access Publications

BACKGROUND: Lobular carcinoma in situ (LCIS) of the breast is a risk factor of developing invasive breast cancer. We evaluated the racial differences in the risks of subsequent invasive breast cancer following LCIS.

METHODS: We utilized data from the Surveillance, Epidemiology, and End Results registries to identify 18,835 women diagnosed with LCIS from 1990 to 2015. Cox proportional hazards regression was used to estimate race/ethnicity-associated hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) of subsequent invasive breast cancer.

RESULTS: During a median follow-up of 90 months, 1567 patients developed invasive breast cancer. The 10-year incidence was 7.9% for Asians, …

Six Month Abstinence Heterogeneity In The Best Quit Study., Harold S Javitz, Terry M Bush, Jennifer C Lovejoy, Alula J Torres, Tallie Wetzel, Ken P Wassum, Marcia M Tan, Nabil Alshurafa, Bonnie Spring

Articles, Abstracts, and Reports

BACKGROUND: Understanding the characteristics of smokers who are successful in quitting may help to increase smoking cessation rates.

PURPOSE: To examine heterogeneity in cessation outcome at 6 months following smoking cessation behavioral counseling with or without weight management counseling.

METHODS: 2,540 smokers were recruited from a large quitline provider and then randomized to receive proactive smoking cessation behavioral counseling without or with two versions of weight management counseling. A Classification and Regression Tree (CART) analysis was conducted to identify the individual pretreatment and treatment characteristics of groups of smokers with different quitting success (as measured by point prevalence of self-reported …

Validation Of A 5-Item Tool To Measure Patient Assessment Of Clinician Compassion In The Emergency Department, Praveen Sabapathi, Michael B Roberts, Brian M Fuller, Michael A Puskarich, Christopher W Jones, J Hope Kilgannon, Valerie Braz, Christina Creel-Bulos, Nathaniel Scott, Kristina L Tester, Anthony Mazzarelli, Stephen Trzeciak, Brian W Roberts

Open Access Publications

BACKGROUND: To test if the 5-item compassion measure (a tool previously validated in the outpatient setting to measure patient assessment of clinician compassion) is a valid and reliable tool to quantify a distinct construct (i.e. clinical compassion) among patients evaluated in the emergency department (ED).

METHODS: Cross-sectional study conducted in three academic emergency departments in the U.S. between November 2018 and April 2019. We enrolled adult patients who were evaluated in the EDs of the participating institutions and administered the 5-item compassion measure after completion of care in the ED. Validity testing was performed using confirmatory factor analysis. Cronbach's alpha …

A Rare Site Of Spread Of A Common Cancer, Sameen Khalid, Graziella Paniz, Aamer Abbass, Edgar Fischer, Gulshan Parasher, Denis Mccarthy

Pathology Research and Scholarship

Breast cancer is the most commonly diagnosed malignancy affecting women worldwide with estimated 252,710 new cases of invasive breast cancer in women in the USA in 2017. It is the second most prevalent cause of cancer-related death after lung cancer in females with an expected annual mortality rate of 16% [1]. Promotion of public awareness, screening programs, early diagnosis, intensive local treat- ment, and changes in chemotherapy regimens with endo- crine and targeted therapy account for a notable decrease in mortality. Nevertheless, these measures do not seem to have impacted the prognosis in patients with distant metastasis. Breast cancer has …

30-Day Emergency Department Revisit Rates Among Older Adults With Documented Dementia, Tyler Kent, Adriane Lesser, Juhi Israni, Ula Hwang, Christopher Carpenter, Kelly J Ko

Open Access Publications

OBJECTIVES: Published literature on national emergency department (ED) revisit rates among older adults with dementia is sparse, despite anecdotal evidence of higher ED utilization. Thus we evaluated the odds ratio (OR) of 30-day ED revisits among older adults with dementia using a nationally representative sample.

DESIGN: We assessed the frequency of claims associated with a 30-day ED revisit among Medicare beneficiaries with and without a dementia diagnosis before or at index ED visit. We used a logistic regression model controlling for dementia, age, sex, race, region, Medicaid status, transfer to a skilled nursing facility after ED, primary care physician use …

Dc-Script Deficiency Delays Mouse Mammary Gland Development And Branching Morphogenesis, Chunling Tang, Renske J E Van Den Bijgaart, Maaike W G Looman, Nina Tel-Karthaus, Annemarie M A De Graaf, Susan Gilfillan, Marco Colonna, Marleen Ansems, Gosse J Adema

Open Access Publications

Mammary glands are unique organs in which major adaptive changes occur in morphogenesis and development after birth. Breast cancer is the most common cancer and a major cause of mortality in females worldwide. We have previously identified the loss of expression of the transcription regulator DC-SCRIPT (Zfp366) as a prominent prognostic event in estrogen receptor positive breast cancer patients. DC-SCRIPT affects multiple transcriptional events in breast cancer cells, including estrogen and progesterone receptor-mediated transcription, and promotes CDKN2B-related cell cycle arrest. As loss of DC-SCRIPT expression appears an early event in breast cancer development, we here investigated the role of DC-SCRIPT …

Gene Expression Analysis To Detect Disseminated Tumor Cells In The Bone Marrow Of Triple-Negative Breast Cancer Patients Predicts Metastatic Relapse, Chidananda M Siddappa, Sreeraj G Pillai, Jackie Snider, Patsy Alldredge, Kathyrn Trinkaus, Mark A Watson, Rebecca Aft

Open Access Publications

PURPOSE: Disseminated tumor cells (DTCs) in the BM of breast cancer patients predict early disease relapse, but the molecular heterogeneity of these cells is less well characterized. Expression of a 46-gene panel was used to detect DTCs and classify patient BM samples to determine whether a composite set of biomarkers could better predict metastatic relapse.

METHODS: Using a high-throughput qRT-PCR assay platform, BM specimens collected from 70 breast cancer patients prior to neoadjuvant therapy were analyzed for the expression of 46 gene transcripts. Gene expression was scored positive (detectable) relative to a reference pool of 16 healthy female control BM …

Pharmacokinetics Of Once-Daily Extended-Release Tacrolimus Tablets Versus Twice-Daily Capsules In De Novo Liver Transplant, Derek A Dubay, Lewis Teperman, Kimi Ueda, Andrew Silverman, William Chapman, Angel E Alsina, Carmelina Tyler, Daniel R Stevens

2010-2019 OA Pubs

The pharmacokinetics of once-daily extended-release tacrolimus tablets (LCPT) in de novo liver transplantation have not been previously reported. In this phase II, randomized, open-label study, de novo liver transplant recipients were randomized to LCPT 0.07-0.13 mg/kg/day (taken once daily; n = 29) or twice-daily immediate-release tacrolimus capsules (IR-Tac) at 0.10-0.15 mg/kg/day (divided twice daily; n = 29). Subsequent doses of both drugs were adjusted to maintain tacrolimus trough concentrations of 5 to 20 ng/mL through day 90, and 5-15 ng/mL thereafter. Twenty-four-hour pharmacokinetic profiles were obtained on days 1, 7, and 14, with trough concentration and efficacy/safety monitoring through year …

Post-Acquisition Processing Confounds In Brain Volumetric Quantification Of White Matter Hyperintensities, Ahmed A. Bahrani, Omar M. Al-Janabi, Erin L. Abner, Shoshana H. Bardach, Richard J. Kryscio, Donna M. Wilcock, Charles D. Smith, Gregory A. Jicha

Neurology Faculty Publications

BACKGROUND: Disparate research sites using identical or near-identical magnetic resonance imaging (MRI) acquisition techniques often produce results that demonstrate significant variability regarding volumetric quantification of white matter hyperintensities (WMH) in the aging population. The sources of such variability have not previously been fully explored.

NEW METHOD: 3D FLAIR sequences from a group of randomly selected aged subjects were analyzed to identify sources-of-variability in post-acquisition processing that can be problematic when comparing WMH volumetric data across disparate sites. The methods developed focused on standardizing post-acquisition protocol processing methods to develop a protocol with less than 0.5% inter-rater variance.

RESULTS: A series …

From Suffrage To The Senate: Expanding Inclusion In Women's Rights To Achieve Women's Health Equality., Frances Grimstad

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Cabozantinib Versus Sunitinib For Untreated Patients With Advanced Renal Cell Carcinoma Of Intermediate Or Poor Risk: Subgroup Analysis Of The Alliance A031203 Cabosun Trial, Daniel J George, Colin Hessel, Susan Halabi, M Dror Michaelson, Olwen Hahn, Meghara Walsh, Joel Picus, Eric J Small, Shaker Dakhil, Darren R Feldman, Milan Mangeshkar, Christian Scheffold, Michael J Morris, Toni K Choueiri

Open Access Publications

Cabozantinib treatment prolonged progression-free survival (PFS) and improved objective response rate (ORR) compared with sunitinib in patients with advanced renal cell carcinoma (RCC) of intermediate or poor risk by International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) criteria in the phase II CABOSUN trial (NCT01835158). In the trial, 157 patients were randomized 1:1 to receive cabozantinib or sunitinib, stratified by IMDC risk group and presence of bone metastases. Here, PFS and ORR, both determined by independent radiology committee (IRC), were analyzed by subgroups of baseline characteristics. Cabozantinib treatment was generally associated with improved PFS and ORR versus sunitinib across subgroups, …

Las Dos Cosas Versus Exclusive Breastfeeding: A Culturally And Linguistically Exploratory Intervention Study In Hispanic Mothers Living In Kentucky, Ana Maria Linares, Diana Cartagena, Mary Kay Rayens

Nursing Faculty Publications

INTRODUCTION: Formula supplementation among infants of breastfeeding Hispanic immigrants is common practice known as las dos cosas. The purpose of this study was to assess the feasibility, effectiveness, and acceptability of a culturally and linguistically diverse intervention to promote exclusive breastfeeding (EBF) for the first 6 months.

METHODS: A sample of 39 Hispanic pregnant women was recruited and randomly assigned to intervention (n = 20) and control groups (n = 19). The intervention included a peer counselor and professional support, and mothers were followed from pregnancy to 6 months after birth.

RESULTS: After the study, women assigned to …

Immune Globulin Subcutaneous, Human - Klhw 20% For Primary Humoral Immunodeficiency: An Open-Label, Phase Iii Study, John W Sleasman, William R Lumry, Iftikhar Hussain, H James Wedner, James B Harris, Kecia L Courtney, Elsa Mondou, Jiang Lin, Mark R Stein

2010-2019 OA Pubs

No abstract provided.

Multi-Model Implementation Of Evidence-Based Care In The Treatment Of Opioid Use Disorder In Pennsylvania, Sarah Kawasaki, Erica Francis, Sara Mills, Glenn Buchberger, Ruth Hogentogler, Jennifer Kraschnewski

Project ECHO Bibliography

Pennsylvania has the third highest rate of death due to drug overdose (44.3 per 100,000) in the country, which is significantly higher than the national rate. This continues to have drastic societal impact. Medication assisted treatment (MAT), which includes opioid agonist medications, is the gold standard in treatment for OUD; however, a significant gap remains between the number of individuals in need of treatment and the number of MAT providers. Penn State Health established a system to address the opioid epidemic through the Pennsylvania Coordinated Medication Assisted Treatment program utilizing lessons learned from existing validated models. Connecting primary care sites …

Expanding Treatment For Opioid Use Disorder In Publicly Funded Primary Care Clinics: Exploratory Evaluation Of The Nyc Health + Hospitals Buprenorphine Echo Program, Babak Tofighi, Noah Isaacs, Hannah Byrnes-Enoch, Rebecca Lakew, Joshua D Lee, Carolyn Berry, Daniel Schatz

Project ECHO Bibliography

Project Extension for Community Healthcare Outcomes (Project ECHO) offers an innovative and low-cost approach to enhancing the management of complex conditions among primary care providers. The NYC Health + Hospitals Buprenorphine ECHO (H + H ECHO) program offers primary care providers (PCPs) training and support in managing opioid use disorder (OUD). This exploratory study assessed the feasibility of a 16-session video conferencing platform led by Addiction Medicine experts in improving addiction knowledge, perceived self-efficacy, and buprenorphine prescribing among PCPs located in 17 publicly-funded ambulatory care clinics. A pre- and post-training survey assessed changes in knowledge and self-efficacy. Buprenorphine prescribing patterns …

Integrated Proteogenomic Characterization Of Clear Cell Renal Cell Carcinoma, David J Clark, Yize Li, Yige Wu, Matthew A Wyczalkowski, Sunantha Sethuraman, Song Cao, Feng Chen, James J Hsieh, Li Ding, Et Al

Open Access Publications

To elucidate the deregulated functional modules that drive clear cell renal cell carcinoma (ccRCC), we performed comprehensive genomic, epigenomic, transcriptomic, proteomic, and phosphoproteomic characterization of treatment-naive ccRCC and paired normal adjacent tissue samples. Genomic analyses identified a distinct molecular subgroup associated with genomic instability. Integration of proteogenomic measurements uniquely identified protein dysregulation of cellular mechanisms impacted by genomic alterations, including oxidative phosphorylation-related metabolism, protein translation processes, and phospho-signaling modules. To assess the degree of immune infiltration in individual tumors, we identified microenvironment cell signatures that delineated four immune-based ccRCC subtypes characterized by distinct cellular pathways. This study reports a large-scale …

Dimensions Of Symptom Presentation And Scholarly Representation Of Young Females With Fragile X Syndrome, Andrew N. Snell

Intuition: The BYU Undergraduate Journal of Psychology

No abstract provided.

Burden Of Relapsing-Remitting Multiple Sclerosis On Workers In The Us: A Cross-Sectional Analysis Of Survey Data., Jacqueline A Nicholas, Batul Electricwala, Lulu K Lee, Kristen M Johnson

Neuroscience Articles

BACKGROUND: Multiple sclerosis (MS) is prevalent among working age individuals (20-60 years), leading to high burden on work productivity. Few data are available about the absenteeism and presenteeism in employed individuals with MS in comparison to non-MS personnel. This study aimed to quantify the burden of illness of employed US adults with relapsing-remitting multiple sclerosis (RRMS) and examine burden by levels of work impairment.

METHODS: A retrospective cross-sectional analysis was conducted using patient-reported responses from the US National Health and Wellness Survey (NHWS). Data from NHWS 2015-2016 were analyzed from 196 employed RRMS respondents who were matched 1:4 to employed …

Case 22-2019: A 65-Year-Old Woman With Myopathy., Marinos C. Dalakas

Department of Neurology Faculty Papers

No abstract provided.

Safety Climate, Safety Climate Strength, And Length Of Stay In The Nicu, Daniel S Tawfik, Eric J Thomas, Timothy J Vogus, Jessica B Liu, Paul J Sharek, Courtney C Nisbet, Henry C Lee, J Bryan Sexton, Jochen Profit

Faculty, Staff and Student Publications

BACKGROUND: Safety climate is an important marker of patient safety attitudes within health care units, but the significance of intra-unit variation of safety climate perceptions (safety climate strength) is poorly understood. This study sought to examine the standard safety climate measure (percent positive response (PPR)) and safety climate strength in relation to length of stay (LOS) of very low birth weight (VLBW) infants within California neonatal intensive care units (NICUs).

METHODS: Observational study of safety climate from 2073 health care providers in 44 NICUs. Consistent perceptions among a NICU's respondents, i.e., safety climate strength, was determined via intra-unit standard deviation …