Digital Commons Network^™

Repair Of Bicuspid Aortic Valve In The Presence Of Endocarditis And Leaflet Perforation, William D T Kent, Hadi D Toeg, Jehangir J Appoo

The Texas Heart Institute Journal

Aortic valve repair can be a good option in younger patients who have severe aortic regurgitation. A systematic, disease-directed approach can simplify repair. This case report describes how a simplified approach can be successfully applied to complex pathologic conditions of the aortic valve.

A 49-year-old man with a bicuspid aortic valve and a history of endocarditis presented with severe aortic regurgitation and evidence of recurrent infection. Intraoperatively, we found congenital and degenerative aortic anatomy with endocarditis and perforation. We performed aortic valve repair to enable leaflet coaptation and to adjust the coaptation height. After 24 months, the patient remained well, …

Assessments Of Empathy In Medical School Admissions: What Additional Evidence Is Needed?, Mohammadreza Hojat

Department of Psychiatry and Human Behavior Faculty Papers

The Association for the Study of Medical Education (ASME) sponsored a symposium on the theme of Examin-ing the Evidence with Regard to Character, Personality and Values in Medical School Selection which was held on October 14, 2013 at the University of Sheffield Medical School in the United Kingdom. I was invited to speak about credibility issues related to personality assessments in health profession educations. To my pleasant surprise, I found the European audience receptive (more than their counterparts in the United States) to the idea of using personality assess-ments in admission decisions. There seems to be a hesita-tion among leaders …

Revealing Variations In Perception Of Mental States From Dynamic Facial Expressions: A Cautionary Note, Elisa Back, Timothy R. Jordan

All Works

Although a great deal of research has been conducted on the recognition of basic facial emotions (e.g., anger, happiness, sadness), much less research has been carried out on the more subtle facial expressions of an individual's mental state (e.g., anxiety, disinterest, relief). Of particular concern is that these mental state expressions provide a crucial source of communication in everyday life but little is known about the accuracy with which natural dynamic facial expressions of mental states are identified and, in particular, the variability in mental state perception that is produced. Here we report the findings of two studies that investigated …

Redox Pioneer: Professor Joe M. Mccord, David M. Schnell, Daret K. St Clair

Graduate Center for Nutritional Sciences Faculty Publications

Dr. Joe McCord (Ph.D. 1970) is recognized here as a Redox Pioneer because he has published at least three articles on antioxidant/redox biology as first/last author that have been cited over 1000 times and has published at least 37 articles each cited over 100 times. Dr. McCord is known for the monumental discovery of the antioxidant superoxide dismutase (SOD) while a graduate student under fellow redox pioneer Irwin Fridovich and demonstrating its necessity to aerobic life. Beyond this, McCord's career is distinguished for bridging the gap from basic science to clinical relevance by showing the application of SOD and superoxide …

Sign Language Ability In Young Deaf Signers Predicts Comprehension Of Written Sentences In English., Kathy N Andrew, Jennifer Hoshooley, Marc F Joanisse

Brain and Mind Institute Researchers' Publications

We investigated the robust correlation between American Sign Language (ASL) and English reading ability in 51 young deaf signers ages 7;3 to 19;0. Signers were divided into 'skilled' and 'less-skilled' signer groups based on their performance on three measures of ASL. We next assessed reading comprehension of four English sentence structures (actives, passives, pronouns, reflexive pronouns) using a sentence-to-picture-matching task. Of interest was the extent to which ASL proficiency provided a foundation for lexical and syntactic processes of English. Skilled signers outperformed less-skilled signers overall. Error analyses further indicated greater single-word recognition difficulties in less-skilled signers marked by a higher …

Factors Associated With Diabetes-Related Distress: Implications For Diabetes Self-Management., Jana L. Wardian Phd, Fei Sun

Journal Articles: Hospital Medicine

As 7.8% of the U.S. population is affected by diabetes, health care providers are tasked with providing resources to assist patients toward self-management. Psychosocial issues have an effect on diabetes self-care. Diabetes-related distress is associated with self-management and lower A1C. This cross-sectional study seeks to understand how demographic factors, psychological orientations, support, and diabetes management behaviors predict diabetes-related distress. This study uses data from 267 adults with Type 2 diabetes. The Diabetes Distress Scale (DDS) is a 17-item scale measuring diabetes-related distress including emotional distress, physician-related distress, regimen distress, and interpersonal distress. Hierarchical regression was conducted in four stages. The …

The Role Of Positive Alcohol Expectancies In Underage Binge Drinking Among College Students, Nicole M Mcbride, Blake Barrett, Kathleen A. Moore, Lawrence Schonfeld

Mental Health Law & Policy Faculty Publications

Objective: This study explored associations between positive alcohol expectancies, and demographics, as well as academic status and binge drinking among underage college students. Participants: A sample of 1,553 underage college students at 3 public universities and 1 college in the Southeast who completed the Core Alcohol and Drug Survey in the Spring 2013 semester. Methods: A series of bivariate analyses and logistic regression models were used to examine associations between demographic and academic status variables as well as positive alcohol expectancies with self-reported binge drinking. Positive alcohol expectancies were examined in multivariable models via 2 factors derived from principal component …

Identification Of Threshold Concepts For Biochemistry, Jennifer Loertscher, David Green, Jennifer E. Lewis, Sara Lin, Vicky Minderhout

Chemistry Faculty Publications

Threshold concepts (TCs) are concepts that, when mastered, represent a transformed understanding of a discipline without which the learner cannot progress. We have undertaken a process involving more than 75 faculty members and 50 undergraduate students to identify a working list of TCs for biochemistry. The process of identifying TCs for biochemistry was modeled on extensive work related to TCs across a range of disciplines and included faculty workshops and student interviews. Using an iterative process, we prioritized five concepts on which to focus future development of instructional materials. Broadly defined, the concepts are steady state, biochemical pathway dynamics and …

Plagiarism Of Ideas. Benjamin Rush And Charles Caldwell--A Student-Mentor Dispute, Charles T. Ambrose

Microbiology, Immunology, and Molecular Genetics Faculty Publications

No abstract provided.

Overexpression Of Dcf1 Inhibits Glioma Through Destruction Of Mitochondria And Activation Of Apoptosis Pathway, Yuqiong Xie, Qang Li, Qingbo Yang

Electrical and Computer Engineering Faculty Research & Creative Works

Gliomas are the most common brain tumors affecting the central nervous system and are associated with a high mortality rate. DCF1 is a membrane protein that was previously found to play a role in neural stem cell differentiation. In the present study, we found that overexpression of dcf1 significantly inhibited cell proliferation, migration, and invasion and dramatically promoted apoptosis in the glioblastoma U251 cell line. DCF1 deletion mutations in the functional region showed that the complete structure of DCF1 was necessary for apoptosis. Furthermore, significantly lower tumorigenicity was observed in athymic nude mice by transplanting U251 cells overexpressing dcf1. To …

Enhancing The Care Navigation Model: Potential Roles For Health Sciences Librarians, Jeffrey T. Huber, Robert M. Shapiro Ii, Heather J. Burke, Aaron Palmer

Information Science Faculty Publications

This study analyzed the overlap between roles and activities that health care navigators perform and competencies identified by the Medical Library Association's (MLA's) educational policy statement. Roles and activities that health care navigators perform were gleaned from published literature. Once common roles and activities that health care navigators perform were identified, MLA competencies were mapped against those roles and activities to identify areas of overlap. The greatest extent of correspondence occurred in patient empowerment and support. Further research is warranted to determine the extent to which health sciences librarians might assume responsibility for roles and activities that health care navigators …

Implicit Meaning In 18-Month-Old Toddlers., Luche C Delle, Samantha Durrant, Caroline Floccia, Kim Plunkett

School of Psychology

A substantial body of evidence demonstrates that infants understand the meaning of spoken words from as early as 6 months. Yet little is known about their ability to do so in the absence of any visual referent, which would offer diagnostic evidence for an adult-like, symbolic interpretation of words and their use in language mediated thought. We used the head-turn preference procedure to examine whether infants can generate implicit meanings from word forms alone as early as 18 months of age, and whether they are sensitive to meaningful relationships between words. In one condition, toddlers were presented with lists of …

Effects Of Exercise On Bmi Z-Score In Overweight And Obese Children And Adolescents: A Systematic Review With Meta-Analysis, George A Kelley, Kristi S Kelley, Russell R Pate

Faculty & Staff Scholarship

No abstract provided.

English-Learning One- To Two-Year-Olds Do Not Show A Consonant Bias In Word Learning., Caroline Floccia, Thierry Nazzi, Luche C Delle, Silvana Poltrock, Jeremy Goslin

School of Psychology

Following the proposal that consonants are more involved than vowels in coding the lexicon (Nespor, Peña & Mehler, 2003), an early lexical consonant bias was found from age 1;2 in French but an equal sensitivity to consonants and vowels from 1;0 to 2;0 in English. As different tasks were used in French and English, we sought to clarify this ambiguity by using an interactive word-learning study similar to that used in French, with British-English-learning toddlers aged 1;4 and 1;11. Children were taught two CVC labels differing on either a consonant or vowel and tested on their pairing of a third …

Phonitalia: A Phonological Lexicon For Italian., Jeremy Goslin, Claudia Galluzzi, Cristina Romani

School of Psychology

In this article, we present the first open-access lexical database that provides phonological representations for 120,000 Italian word forms. Each of these also includes syllable boundaries and stress markings and a comprehensive range of lexical statistics. Using data derived from this lexicon, we have also generated a set of derived databases and provided estimates of positional frequency use for Italian phonemes, syllables, syllable onsets and codas, and character and phoneme bigrams. These databases are freely available from phonitalia.org. This article describes the methods, content, and summarizing statistics for these databases. In a first application of this database, we also demonstrate …

Cultural Responses To Pain In Uk Children Of Primary School Age: A Mixed-Methods Study., Pary M. Azize, Ruth Endacott, Allegra Cattani, Ann Humphreys

School of Nursing and Midwifery

Pain-measurement tools are often criticized for not addressing the influence of culture and ethnicity on pain. This study examined how children who speak English as a primary or additional language discuss pain. Two methods were used in six focus group interviews with 34 children aged 4-7 years: (i) use of drawings from the Pediatric Pain Inventory to capture the language used by children to describe pain; and (ii) observation of the children's placing of pain drawings on red/amber/green paper to denote perceived severity of pain. The findings demonstrated that children with English as an additional language used less elaborate language …

Learning To Pronounce First Words In Three Languages: An Investigation Of Caregiver And Infant Behavior Using A Computational Model Of An Infant., Ian S. Howard, Piers Messum

School of Engineering, Computing and Mathematics

Words are made up of speech sounds. Almost all accounts of child speech development assume that children learn the pronunciation of first language (L1) speech sounds by imitation, most claiming that the child performs some kind of auditory matching to the elements of ambient speech. However, there is evidence to support an alternative account and we investigate the non-imitative child behavior and well-attested caregiver behavior that this account posits using Elija, a computational model of an infant. Through unsupervised active learning, Elija began by discovering motor patterns, which produced sounds. In separate interaction experiments, native speakers of English, French and …

Specific Intracellular Uptake Of Herceptin-Conjugated Cdse/Zns Quantum Dots Into Breast Cancer Cells, Seung-Jin Han, Pierson Rathinaraj, Soo-Young Park, Young-Kyoo Kim, Joon Hyung Lee, Inn-Kyu Kang, Jong-Sik Moon, Jeffrey G. Winiarz

Chemistry Faculty Research & Creative Works

Herceptin, a typical monoclonal antibody, was immobilized on the surface of CdSe/ZnS core-shell quantum dots (QDs) to enhance their specific interactions with breast cancer cells (SK-BR3). the mean size of the core-shell quantum dots (28 nm), as determined by dynamic light scattering, increased to 86 nm after herceptin immobilization. the in vitro cell culture experiment showed that the keratin forming cancer cells (KB) proliferated well in the presence of herceptin-conjugated QDs (QD-Her, 5 nmol/mL), whereas most of the breast cancer cells (SK-BR3) had died. to clarify the mechanism of cell death, the interaction of SK-BR3 cells with QD-Her was examined …

Development Of A Medical Academic Degree System In China, Lijuan Wu, Youxin Wang, Xiaoxia Peng, Manshu Song, Xiuhua Guo, Hugh Nelson, Wei Wang

Research outputs 2014 to 2021

Context: The Chinese government launched a comprehensive healthcare reform to tackle challenges to health equities. Medical education will become the key for successful healthcare reform. Purpose:We describe the current status of the Chinese medical degree system and its evolution over the last 80 years. Content: Progress has been uneven, historically punctuated most dramatically by the Cultural Revolution. There is a great regional disparity. Doctors with limited tertiary education may be licensed to practice, whereas medical graduates with advanced doctorates may have limited clinical skills. There are undefined relationships between competing tertiary training streams, the academic professional degree, and the clinical …

Improving Sexual Health In Men With Prostate Cancer: Randomised Controlled Trial Of Exercise And Psychosexual Therapies, Prue Cormie, Suzanne K. Chambers, Robert U. Newton, Robert A. Gardiner, Nigel Spry, Dennis R. Taaffe, David Joseph, M Akhlil Hamid, Peter Chong, David Hughes, Kyra Hamilton, Daniel A. Galvão

Research outputs 2014 to 2021

Background: Despite being a critical survivorship care issue, there is a clear gap in current knowledge of the optimal treatment of sexual dysfunction in men with prostate cancer. There is sound theoretical rationale and emerging evidence that exercise may be an innovative therapy to counteract sexual dysfunction in men with prostate cancer. Furthermore, despite the multidimensional aetiology of sexual dysfunction, there is a paucity of research investigating the efficacy of integrated treatment models. Therefore, the purpose of this study is to: 1) examine the efficacy of exercise as a therapy to aid in the management of sexual dysfunction in men …

A Comparison Of Aphasia Therapy Outcomes Before And After A Very Early Rehabilitation Programme Following Stroke, Erin Godecke, Natalie A. Ciccone, Andrew S. Granger, Tapan Rai, Deborah West, Angela Cream, Jade Cartwright, Graeme J. Hankey

Research outputs 2014 to 2021

Background Very early aphasia rehabilitation studies have shown mixed results. Differences in therapy intensity and therapy type contribute significantly to the equivocal results. Aims To compare a standardized, prescribed very early aphasia therapy regimen with a historical usual care control group at therapy completion (4-5 weeks post-stroke) and again at follow-up (6 months). Methods & Procedures This study compared two cohorts from successive studies conducted in four Australian acute/sub-acute hospitals. The studies had near identical recruitment, blinded assessment and data-collection protocols. The Very Early Rehabilitation (VER) cohort (N = 20) had mild-severe aphasia and received up to 20 1-h sessions …

Birth Control: To What Extent Do Women Report Being Informed And Involved In Decisions About Pregnancy And Birth Procedures?, Rachel Thompson, Yvette D. Miller

Dartmouth Scholarship

Background: Health policy, guidelines, and standards advocate giving patients comprehensive information and facilitating their involvement in health-related decision-making. Routine assessment of patient reports of these processes is needed. Our objective was to examine decision-making processes, specifically information provision and consumer involvement in decision-making, for nine pregnancy, labour, and birth procedures, as reported by maternity care consumers in Queensland, Australia.

Methods: Participants were women who had a live birth in Queensland in a specified time period and were not found to have had a baby that died since birth, who completed the extended Having a Baby in Queensland Survey, 2010 about …

Primary Care And Youth Mental Health In Ireland: Qualitative Study In Deprived Urban Areas, Dorothy Leahy, Elisabeth Schaffalitzky, Claire Armstrong, Gerard Bury, Paula Cussen-Murphy, Rachel Davis, Barbara Dooley, Blanaid Gavin, Rory Keane, Eamon Keenan, Linda Latham, David Meagher, Pat Mcgorry, Fiona Mcnicholas, Ray O'Connor, Ellen O'Dea, Veronica O'Keane, Tom P. O'Toole, Edel Reilly, Patrick Ryan, Lena Sanci, Bobby P. Smyth, Walter Cullen

Faculty Publications

BACKGROUND: Mental disorders account for six of the 20 leading causes of disability worldwide with a very high prevalence of psychiatric morbidity in youth aged 15-24 years. However, healthcare professionals are faced with many challenges in the identification and treatment of mental and substance use disorders in young people (e.g. young people's unwillingness to seek help from healthcare professionals, lack of training, limited resources etc.) The challenge of youth mental health for primary care is especially evident in urban deprived areas, where rates of and risk factors for mental health problems are especially common. There is an emerging consensus that …

Patients’ Attitudes Towards Patient Involvement In Safety Interventions: Results Of Two Exploratory Studies, Rachel Davis, Nick Sevdalis, Anna Pinto, Ara Darzi, Charles A. Vincent

Faculty Publications

BACKGROUND: In recent years, patient-focused interventions have been introduced aimed at increasing patient involvement in safety-related behaviours. However, patients' attitudes towards these interventions and comfort in participating in the recommended behaviours remain largely unexplored. OBJECTIVE: To evaluate patients' attitudes towards a video and leaflet aimed at encouraging patient involvement in safety-related behaviours. DESIGN: Two exploratory studies employing a within-subjects mixed-methods design. SETTING: Six hospital wards on an inner-city London teaching hospital. PARTICIPANTS: Medical and surgical inpatients: 80 patients in study 1 (mean age 55; 69% men) and 80 patients in study 2 (mean age 52; 60% men). INTERVENTION: Patients watched …

Occupational Injuries On Thoroughbred Horse Farms: A Description Of Latino And Non-Latino Workers' Experiences, Jennifer E. Swanberg, Jessica M. Clouser, Susan C. Westneat, Mary W. Marsh, Deborah B. Reed

Health, Behavior & Society Faculty Publications

Animal production is a dangerous industry and increasingly reliant on a Latino workforce. Within animal production, little is known about the risks or the occupational hazards of working on farms involved in various aspects of thoroughbred horse breeding. Extant research suggests that horse workers are at risk of musculoskeletal and respiratory symptoms, kicks, and other injuries. However, limited known research has examined the experiences of the industry's workers, including immigrant workers, despite their prominence and increased vulnerability. Using data collected from thoroughbred farm representatives via a phone-administered survey, a 2-hour face-to-face semi-structured interview, and farm injury logs, this article identifies …

Balancing The Presentation Of Information And Options In Patient Decision Aids: An Updated Review, Purva Abhyankar, Robert J. Volk, Jennifer Blumenthal-Barby, Paulina Bravo, Angela Buchholz, Elissa Ozanne, Dale C. Vidal, Nananda Col, Peep Stalmeier

Dartmouth Scholarship

Standards for patient decision aids require that information and options be presented in a balanced manner; this requirement is based on the argument that balanced presentation is essential to foster informed decision making. If information is presented in an incomplete/non-neutral manner, it can stimulate cognitive biases that can unduly affect individuals’ knowledge, perceptions of risks and benefits, and, ultimately, preferences. However, there is little clarity about what constitutes balance, and how it can be determined and enhanced. We conducted a literature review to examine the theoretical and empirical evidence related to balancing the presentation of information and options.

Delivering Patient Decision Aids On The Internet: Definitions, Theories, Current Evidence, And Emerging Research Areas, Aubri S. Hoffman, Robert J. Volk, Anton Saarimaki, Christine Stirling, Linda C. Li, Martin Härter, Geetanjali R. Kamath, Hilary Llewellyn-Thomas

Dartmouth Scholarship

Background: In 2005, the International Patient Decision Aids Standards Collaboration identified twelve quality dimensions to guide assessment of patient decision aids. One dimension — the delivery of patient decision aids on the Internet — is relevant when the Internet is used to provide some or all components of a patient decision aid. Building on the original background chapter, this paper provides an updated definition for this dimension, outlines a theoretical rationale, describes current evidence, and discusses emerging research areas. Methods: An international, multidisciplinary panel of authors examined the relevant theoretical literature and empirical evidence through 2012. Results: The updated definition …

Early Diagnosis And Treatment Of Invasive Pulmonary Aspergillosis In A Patient With Cystic Fibrosis, Ricardo Alberto Mosquera, Lila Estrada, Roya Mohebpour Clements, Cindy K Jon

Faculty, Staff and Student Publications

Invasive pulmonary aspergillosis is a rare and fatal complication in patients with cystic fibrosis (CF) who lack concomitant risk factors. The few documented cases in children have all resulted in deaths during hospitalisation. We present the case of a 12-year-old boy with CF who was admitted for an exacerbation which was unresponsive to antibiotic therapy. The findings on imaging raised concerns about a possible fungal infection. As a result, voriconazole therapy was started prior to his respiratory deterioration. He was later found to be β-D glucan and Aspergillus Ag galactomannan positive confirming the suspicion for invasive pulmonary aspergillosis. Three months …

Two Phase 3, Multicenter, Randomized, Placebo-Controlled Clinical Trials Of Fampridine-Sr For Treatment Of Spasticity In Chronic Spinal Cord Injury., D. D. Cardenas, J. F. Ditunno, V. Graziani, A. B. Mclain, D. P. Lammertse, P. J. Potter, M. S. Alexander, R. Cohen, A. R. Blight

Department of Rehabilitation Medicine Faculty Papers

STUDY DESIGN: Two randomized, double-blind, placebo-controlled trials.

OBJECTIVE: To evaluate the efficacy and safety of fampridine sustained-release tablets (fampridine-SR) 25 mg twice daily for moderate-to-severe spasticity in patients with chronic spinal cord injury (SCI).

SETTING: United States and Canada.

METHODS: Patients with incomplete chronic SCI were randomized to twice daily fampridine-SR 25 mg or placebo, with a 2-week single-blind placebo run-in, a 2-week titration, 12 weeks of stable dosing, 2 weeks of downward titration and 2 weeks of untreated follow-up. Co-primary end points were the change from baseline, averaged over the double-blind treatment period, for Ashworth score (bilateral knee flexors …

Cholera Vaccination Campaign Contributes To Improved Knowledge Regarding Cholera And Improved Practice Relevant To Waterborne Disease In Rural Haiti, Omowunmi Aibana, Molly F Franke, Jessica E Teng, Johanne Hilaire, Max Raymond, Louise C Ivers

Faculty, Staff and Student Publications

BACKGROUND: Haiti's cholera epidemic has been devastating partly due to underlying weak infrastructure and limited clean water and sanitation. A comprehensive approach to cholera control is crucial, yet some have argued that oral cholera vaccination (OCV) might result in reduced hygiene practice among recipients. We evaluated the impact of an OCV campaign on knowledge and health practice in rural Haiti.

METHODOLOGY/PRINCIPAL FINDINGS: We administered baseline surveys on knowledge and practice relevant to cholera and waterborne disease to every 10th household during a census in rural Haiti in February 2012 (N = 811). An OCV campaign occurred from May-June 2012 after …