Digital Commons Network^™

Covid-19 Ethics: Unique Aspects And A Review As Of Early 2024, Wayne X Shandera

Faculty, Staff and Students Publications

COVID-19 presents a variety of ethical challenges in a set of arenas, arenas not always considered in past pandemics. These challenges include issues related to autonomy, distributive ethics, and the establishment of policies of equity and justice. Methods are a literature review based on regular editing of an online textbook during the COVID-19 outbreak and a literature review using key ethical terms. Patients are confronted with new issues related to autonomy. Providers need to expand their concepts of ethical issues to include decisions based on proportionality and public health ethics. The public health sector needs to assess the beneficence of …

Improving Access To Exome Sequencing In A Medically Underserved Population Through The Texome Project, Blake Vuocolo, Ryan J German, Seema R Lalani, Chaya N Murali, Carlos A Bacino, Stephanie Baskin, Rebecca Littlejohn, John D Odom, Scott Mclean, Carrie Schmid, Morgan Nutter, Melissa Stuebben, Emily Magness, Olivia Juarez, Dina El Achi, Bailey Mitchell, Kevin E Glinton, Laurie Robak, Sandesh C S Nagamani, Lisa Saba, Adasia Ritenour, Lilei Zhang, Haley Streff, Katie Chan, K Jordan Kemere, Kent Carter, Texome Project, Nichole Owen, Liesbeth Vossaert, Pengfei Liu, Hugo Bellen, Michael F Wangler

Faculty, Staff and Students Publications

PURPOSE: Genomic medicine can end diagnostic odysseys for patients with complex phenotypes; however, limitations in insurance coverage and other systemic barriers preclude individuals from accessing comprehensive genetics evaluation and testing.

METHODS: The Texome Project is a 4-year study that reduces barriers to genomic testing for individuals from underserved and underrepresented populations. Participants with undiagnosed, rare diseases who have financial barriers to obtaining exome sequencing (ES) clinically are enrolled in the Texome Project.

RESULTS: We highlight the Texome Project process and describe the outcomes of the first 60 ES results for study participants. Participants received a genetic evaluation, ES, and return …

Sandwich Fairgrounds Map, Directions To 4-H Food Booth, Mikayla Cerney

UNH Cooperative Extension

No abstract provided.

Managing Hemlock In Northern New England Forests Threatened By Hemlock Woolly Adelgid And Elongate Hemlock Scale, Unh Cooperative Extension

UNH Cooperative Extension

No abstract provided.

Nh State 4-H Horse Show Entry Packet, Unh Cooperative Extension

UNH Cooperative Extension

No abstract provided.

Pharmacogenomic Biomarkers Of Angiotensin Converting Enzyme Inhibitors (Aceis) Induced Cough Among Healthy Emiratis And Multi-Ethnic Hypertensive Patients, Sahar Mohammad Altoum

Theses

Pharmacogenomics (PGx) is an emerging field that merges genetics with pharmacology. It focuses on how an individual's genetic makeup influences their response to specific medications. This relatively new area of medicine seeks to understand the genetic factors that affect drug efficacy and safety. One practical application of PGx is in the context of treatment with angiotensin-converting enzyme inhibitors (ACEIs), which are widely used medications for managing hypertension. However, ACEIs are often associated with cough as a side effect, leading to drug discontinuation and the adoption of alternative medications like Angiotensin II receptor blockers (ARBs). The prevalence of ACEIs-induced cough varies …

Mitochondrial Control Of Tumorigenicity And Immunogenicity Of Colorectal Cancer, Maram Esam Ahmed

Theses

The Methylation-controlled J protein (MCJ), also known as DNAJC15, serves as an endogenous negative regulator of mitochondrial respiration. MCJ plays a crucial role in cellular bioenergetics by regulating cellular metabolism, and its expression is inversely proportional to the extent of mitochondrial ATP production. In the current study, we aimed to investigate the relationship between MCJ expression and the tumorigenicity and immunogenicity of colon adenocarcinoma. To this aim, we utilized MCJ knockout (KO) mice to assess the impact of tumor-extrinsic MCJ expression in host cells, particularly immune cells, on anti-tumor responses. Comparing the growth of MCJ-expressing cancer cells in wild-type vs. …

Exploring Emirati High School Students' Attitude Towards Reading In L2 (English), Seba Dabik

Theses

Reading in a second language (L2) is a crucial skill for high school students as it helps to develop their second language proficiency and broadens their understanding of the world. It also holds substantial significance in both their personal and academic endeavors. Additionally, proficient L2 reading skills pave the way for promising prospects and professional opportunities. This study examines students' attitudes towards reading academically and recreationally in L2 and the factors that contribute to these attitudes. The study sample comprised of 20 grade 11 UAE national male students (16-17 years old) enrolled in a public Applied Technology School (ATS) in …

Studies On The Corrosion Of Bronze Artifacts From Sarouq Al-Hadid And Al-Qusais Archeological Sites In Dubai, Uae, Zainab Ali Salmin

Theses

This thesis compares the status of bronze artefacts from two archaeological sites in Dubai (UAE): the Sarouq Al-Hadid site (Stone Age to Early Islamic Period) and the Al- Qusais site (Late Bronze Age to Early Iron Age). The main objective of this research is to understand the two sites' environment and their influence on the corrosion of archaeological bronze artifacts found at the sites. This study uses mCed methods to comprehensively understand the corrosion behavior of bronze objects, depending on their burial environment. The two different sites presented different soil types and rates of corrosivity on the buried bronze artifacts, …

Using Self-Assessment Tools And Complementary Alternative Therapy For Chronic Migraines In Menopausal Women, Krystal Rachelle Bridwell

Electronic Theses and Dissertations

Abstract

Migraine headaches are ranked as one of the highest disabling conditions in the United States. Women who are in the perimenopausal transition phase have a higher prevalence of disabling migraines that can result in a decreased quality of life, loss of income, decreased productivity, and a higher risk for emotional difficulties. The gap in practice is the lack of education on complementary alternative medicine (CAM) and the use of a migraine diary to recognize individual symptoms as a substitute or cotherapy with pharmacologic treatments. The purpose of this scholarly project was to improve clinical practice and outcomes for perimenopausal …

Safety Project To Prevent Unintentional Retained Surgical Items, Sherri Bobo

Electronic Theses and Dissertations

Abstract

Fifty million surgeries are performed annually in the United States with an estimated 5,000 patients affected by unintentionally retained surgical items (RSIs) due to errors in the operating room. Surgical items inadvertently left inside patients may include sponges, instruments, needles, or small miscellaneous parts. It is not well understood why the surgical counting process fails to prevent the incidence of unintentional RSIs. The proposed educational curriculum was intended to enhance the knowledge and self-efficacy of surgical nurses and technicians to minimize errors and eliminate RSIs. Evidence-based strategies to complement existing knowledge of unintentional RSIs were introduced through didactic and …

Putting The Lawyer First: Framing Well-Being In Law As An Ethical Dilemma, Aric Short

Faculty Scholarship

A disturbingly high percentage of our students continue to be unwell. In the most recent and comprehensive survey of law student well-being in 2021, almost 70% of law students responded that, in the past twelve months, they believed they needed to seek help for emotional or mental health problems. Embedded screening tools in the survey suggested that 34% of respondents were clinically depressed and 54% suffered from clinical anxiety. 44% of respondents reported being drunk in the past thirty days, 33% had engaged in binge drinking in the preceding two weeks, and 38% had smoked marijuana in the past twelve …

Immigration Enforcement Creep In Immigrant & Employee Rights, Angela D. Morrison

Faculty Scholarship

As the only agency charged with enforcing the Immigration Reform and Control Act’s antidiscrimination provisions, the Immigrant and Employee Rights (“IER”) section of the Department of Justice’s Civil Rights Division plays an important role in protecting worker rights. Yet over the past decade, IER has moved from worker protection to immigration enforcement: a phenomenon this Article terms “immigration enforcement creep.”

This observation is based on ten years of data collected from IER’s settlement agreements, complaints filed, and telephone interventions. The data show that rather than protect noncitizen workers from unlawful discrimination, IER has moved its focus to enforcing immigration laws …

Associations Of Testosterone And Related Hormones With All-Cause And Cardiovascular Mortality And Incident Cardiovascular Disease In Men : Individual Participant Data Meta-Analyses, Bu B Yeap, Ross J Marriott, Girish Dwivedi, Robert J Adams, Leen Antonio, Christie M Ballantyne, Douglas C Bauer, Shalender Bhasin, Mary L Biggs, Peggy M Cawthon, David J Couper, Adrian S Dobs, Leon Flicker, David J Handelsman, Graeme J Hankey, Anke Hannemann, Robin Haring, Benjumin Hsu, Sean A Martin, Alvin M Matsumoto, Dan Mellström, Claes Ohlsson, Terence W O'Neill, Eric S Orwoll, Matteo Quartagno, Molly M Shores, Antje Steveling, Åsa Tivesten, Thomas G Travison, Dirk Vanderschueren, Gary A Wittert, Frederick C W Wu, Kevin Murray

Faculty, Staff and Students Publications

Background: Whether circulating sex hormones modulate mortality and cardiovascular disease (CVD) risk in aging men is controversial.

Purpose: To clarify associations of sex hormones with these outcomes.

Data sources: Systematic literature review to July 2019, with bridge searches to March 2024.

Study selection: Prospective cohort studies of community-dwelling men with sex steroids measured using mass spectrometry and at least 5 years of follow-up.

Data extraction: Independent variables were testosterone, sex hormone-binding globulin (SHBG), luteinizing hormone (LH), dihydrotestosterone (DHT), and estradiol concentrations. Primary outcomes were all-cause mortality, CVD death, and incident CVD events. Covariates included age, body mass index, marital status, …

Current Practices In Clinical Supervision In Primary Care, Stacy A. Ogbeide, Cory Knight, Alex Young, Deepu George, Brittany Houston, Maribeth Wicoff, Yajaira Johnson-Esparza, Gabriela Gibson-Lopez

School of Medicine Publications

The purpose of this study was to examine current clinical supervision practices within primary care settings. We used a descriptive survey design, which blends quantitative and qualitative data, and examined the current state of clinical supervision practices and approaches in primary care and the type of training the behavioral health consultants received to provide supervision to pre-licensure level behavioral health trainees. Ninety-four participants completed the survey in 2022. Seventy-one percent of respondents felt they had adequate training to be an effective integrated behavioral health (IBH) supervisor; however, most training came from sources, such as workshops, continuing education, or supervision of …

Racial And Ethnic Disparities In Cardiovascular Disease – Analysis Across Major Us National Databases, Abdul Mannan Khan Minhas, Khawaja M Talha, Dmitry Abramov, Heather M Johnson, Steve Antoine, Fatima Rodriguez, Marat Fudim, Erin D Michos, Arunima Misra, Layla Abushamat, Vijay Nambi, Gregg C Fonarow, Christie M Ballantyne, Salim S Virani

Faculty, Staff and Students Publications

Background: There are several studies that have analyzed disparities in cardiovascular disease (CVD) health using a variety of different administrative databases; however, a unified analysis of major databases does not exist. In this analysis of multiple publicly available datasets, we sought to examine racial and ethnic disparities in different aspects of CVD, CVD-related risk factors, CVD-related morbidity and mortality, and CVD trainee representation in the US.

Methods: We used National Health and Nutrition Examination Survey, National Ambulatory Medical Care Survey, National Inpatient Sample, Centers for Disease Control and Prevention Wide-Ranging OnLine Data for Epidemiologic Research, United Network for Organ Sharing, …

Chagasin From Trypanosoma Cruzi As A Molecular Scaffold To Express Epitopes Of Tsa-1 As Soluble Recombinant Chimeras, Rosa Elena Cárdenas-Guerra, Octavio Montes-Flores, Edgar Ezequiel Nava-Pintor, Gerardo Reséndiz-Cardiel, Claudia Ivonne Flores-Pucheta, Yasmín Irene Rodríguez-Gavaldón, Rossana Arroyo, Maria Elena Bottazzi, Peter J Hotez, Jaime Ortega-López

Faculty, Staff and Students Publications

Trypanosoma cruzi is the causative agent of Chagas disease, a global public health problem. New therapeutic drugs and biologics are needed. The TSA-1 recombinant protein of T. cruzi is one such promising antigen for developing a therapeutic vaccine. However, it is overexpressed in E. coli as inclusion bodies, requiring an additional refolding step. As an alternative, in this study, we propose the endogenous cysteine protease inhibitor chagasin as a molecular scaffold to generate chimeric proteins. These proteins will contain combinations of two of the five conserved epitopes (E1 to E5) of TSA-1 in the L4 and L6 chagasin loops. Twenty …

Rural Veterans With Hiv And Alcohol Use Disorder Receive Less Video Telehealth Than Urban Veterans, Alan Z Sheinfil, Giselle Day, Annette Walder, Julianna Hogan, Thomas P Giordano, Jan Lindsay, Anthony Ecker

Faculty, Staff and Students Publications

Purpose: Alcohol use disorder (AUD) is highly prevalent among Veterans with HIV. Rural Veterans with HIV are at especially high risk for not receiving appropriate treatment. This retrospective cohort cross-sectional study aimed to investigate patterns of mental health treatment utilization across delivery modality among Veterans diagnosed with HIV and AUD. It was hypothesized that rural Veterans with HIV and AUD would receive a lower rate of mental health treatment delivered via video telehealth than urban Veterans with HIV and AUD.

Methods: A national Veterans Health Association administrative database was used to identify a cohort of Veterans diagnosed with HIV and …

The Internist's Post V.1 N.4, The University Of Texas Rio Grande Valley. School Of Medicine, Jian Garcia Cruz, Diana Othon Martinez, Edgar Dorsey Trevino, Eunbee Cho, Barbara Malaga-Espinoza, Roque Mifuji, Martha Solis, Cesar Gutierrez

School of Medicine Publications

No abstract provided.

Cadherin-11 Targeted Cell-Specific Liposomes Enabled Skin Fibrosis Treatment By Inducing Apoptosis, Himanshu N Bhatt, Rimpy Diwan, Igor L Estevao, Rui Dong, Jennifer Smith, Chuan Xiao, Sandeep K Agarwal, Md Nurunnabi

Faculty, Staff and Students Publications

Continuous and aberrant activation of myofibroblasts is the hallmark of pathological fibrosis (e.g., abnormal wound healing). The deposition of excessive extracellular matrix (ECM) components alters or increases the stiffness of tissue and primarily accounts for multiple organ dysfunctions. Among various proteins, Cadherin-11 (CDH11) has been reported to be overexpressed on myofibroblasts in fibrotic tissues. Anti-apoptotic proteins such as (B cell lymphoma-2) (BCL-2) are also upregulated on myofibroblasts. Therefore, we hypothesize that CDH11 could be a targeted domain for cell-specific drug delivery and targeted inhibition of BCL-2 to ameliorate the development of fibrosis in the skin. To prove our hypothesis, we …

Convolutional Neural Networks To Study Contrast-Enhanced Magnetic Resonance Imaging-Based Skeletal Calf Muscle Perfusion In Peripheral Artery Disease, Bijen Khagi, Tatiana Belousova, Christina M Short, Addison A Taylor, Jean Bismuth, Dipan J Shah, Gerd Brunner

Faculty, Staff and Students Publications

Peripheral artery disease (PAD) is associated with impaired blood flow in the lower extremities and histopathologic changes of the skeletal calf muscles, resulting in abnormal microvascular perfusion. We studied the use of convolution neural networks (CNNs) to differentiate patients with PAD from matched controls using perfusion pattern features from contrast-enhanced magnetic resonance imaging (CE-MRI) of the skeletal calf muscles. We acquired CE-MRI based skeletal calf muscle perfusion in 56 patients (36 patients with PAD and 20 matched controls). Microvascular perfusion imaging was performed after reactive hyperemia at the midcalf level, with a temporal resolution of 409 ms. We analyzed perfusion …

Long-Term Sustained Effects Of The Look Ahead Lifestyle Intervention On Body Composition Among Adults With Type 2 Diabetes, Maxine Ashby-Thompson, Stanley Heshka, Andrea Anderson, Henry Pownall, Blandine Laferrère, Ashok Balasubramanyam, Steven B Heymsfield, Thomas A Wadden, Dympna Gallagher

Faculty, Staff and Students Publications

Objective: The objective of the study was to test whether there are sustained effects of the Look AHEAD intensive lifestyle intervention (ILI), versus diabetes support and education (DSE), on weight and body composition 12 to 16 years after randomization.

Methods: Participants were a subset of enrollees in the Look AHEAD dual-energy x-ray absorptiometry substudy who completed the final visit, composed of men (DSE = 99; ILI = 94) and women (DSE = 134; ILI = 135) with type 2 diabetes and mean (SD) age 57.2 (6.4) years and BMI 34.9 (5.1) kg/m2 at randomization. Dual-energy x-ray absorptiometry measured total and …

Efemp1 Haploinsufficiency Causes A Marfan-Like Hereditary Connective Tissue Disorder, Irman Forghani, Steven H Lang, Matthew J Rodier, Stephanie A Bivona, Alejo A Morales, Stephan Zuchner, Guney Bademci, Mustafa Tekin

Faculty, Staff and Students Publications

Phenotypic features of a hereditary connective tissue disorder, including craniofacial characteristics, hyperextensible skin, joint laxity, kyphoscoliosis, arachnodactyly, inguinal hernia, and diverticulosis associated with biallelic pathogenic variants in EFEMP1 have been previously described in four patients. Genome sequencing on a proband and her mother with comparable phenotypic features revealed that both patients were heterozygous for a stop-gain variant c.1084C>T (p.Arg362*). Complementary RNA-seq on fibroblasts revealed significantly reduced levels of mutant EFEMP1 transcript. Considering the absence of other molecular explanations, we extrapolated that EFEMP1 could be the cause of the patient's phenotypes. Furthermore, nonsense-mediated decay was demonstrated for the mutant allele …

Genetic Evaluation For Monogenic Disorders Of Low Bone Mass And Increased Bone Fragility: What Clinicians Need To Know, Emily Busse, Brendan Lee, Sandesh C S Nagamani

Faculty, Staff and Students Publications

Purpose of review: The purpose of this review is to outline the principles of clinical genetic testing and to provide practical guidance to clinicians in navigating genetic testing for patients with suspected monogenic forms of osteoporosis.

Recent findings: Heritability assessments and genome-wide association studies have clearly shown the significant contributions of genetic variations to the pathogenesis of osteoporosis. Currently, over 50 monogenic disorders that present primarily with low bone mass and increased risk of fractures have been described. The widespread availability of clinical genetic testing offers a valuable opportunity to correctly diagnose individuals with monogenic forms of osteoporosis, thus instituting …

Patient- And System-Level Factors Associated With Racial/Ethnic Disparities In The Delivery Of Guideline-Concordant Therapy Among Us Patients With Gastric Cancer, Wilson L Da Costa, Mimi C Tan, E Ramsay Camp, Aaron P Thrift

Faculty, Staff and Students Publications

Background: Disparities in gastric cancer (GC) outcomes show a higher disease burden among minorities. We aimed to evaluate the associations between sociodemographic and system-level factors and guideline-concordant treatment among GC patients.

Methods: Cohort study with GC patients in the National Cancer Data Base (2006-2018) treated with upfront resection or neoadjuvant therapy (NAT). We used logistic regression to identify associations between deviations from guideline-concordant therapy and patient- and system-level factors, and Cox regression models to assess risk of death.

Results: The cohort included 43 597 GC patients treated with endoscopic resection (8.9%), surgery only (47.1%), surgery and adjuvant therapy (20.6%), or …

Anoctamin 4 Defines Glucose-Inhibited Neurons In The Ventromedial Hypothalamus, Longlong Tu, Yanlin He, Yong Xu

Faculty, Staff and Students Publications

No abstract provided.

Neighborhood-Level Disadvantage And Delayed Adjuvant Therapy In Head And Neck Cancer, Evan M Graboyes, Joshua Lee Cagle, Salma Ramadan, Kavita Prasad, Flora Yan, John Pearce, Angela L Mazul, Jean-Sebastien Anoma, Elizabeth G Hill, Bhisham S Chera, Sidharth V Puram, Ryan Jackson, Vlad C Sandulache, Samantha Tam, Michael C Topf, Russel Kahmke, Nosayaba Osazuwa-Peters, Brian Nussenbaum, Anthony J Alberg, Katherine R Sterba, Chanita Hughes Halbert

Faculty, Staff and Students Publications

Importance: For patients with head and neck squamous cell carcinoma (HNSCC), initiation of postoperative radiation therapy (PORT) within 6 weeks of surgery is recommended by the National Comprehensive Cancer Network Guidelines and the Commission on Cancer. Although individual-level measures of socioeconomic status are associated with receipt of timely, guideline-adherent PORT, the role of neighborhood-level disadvantage has not been examined.

Objective: To characterize the association of neighborhood-level disadvantage with delays in receiving PORT.

Design, setting, and participants: This retrospective cohort study included 681 adult patients with HNSCC undergoing curative-intent surgery and PORT from 2018 to 2020 at 4 US academic medical …

Serum Extracellular Vesicle Protein Profiling For Prediction Of Corneal Transplant Rejection, Hyun Ju Lee, Eun-Hye Bae, Jong Min Choi, Hyemee Kim, Hyeon Ji Kim, Heather Barreda, Sung Yun Jung, Joo Youn Oh, Ryang Hwa Lee

Faculty, Staff and Students Publications

Background: Corneal transplantation is the most common transplant procedure worldwide. Despite immune and angiogenic privilege of the cornea, 50% to 70% of corneal transplants fail in high-risk recipients, primarily because of immune rejection. Therefore, it is crucial to identify predictive biomarkers of rejection to improve transplant survival.

Methods: In search for predictive biomarkers, we performed proteomics analysis of serum extracellular vesicles (EVs) in a fully major histocompatibility complex-mismatched (C57BL/6-to-BALB/c) murine corneal transplantation model, wherein 50% of transplants undergo rejection by day 28 following transplantation.

Results: Our time course study revealed a decrease in the number of serum EVs on day …

Generation Of A Humanized Mace2 And A Conditional Hace2 Mouse Models Permissive To Sars-Cov-2 Infection, I-Wen Song, Megan Washington, Carolina Leynes, Jason Hsu, Kempaiah Rayavara, Yangjin Bae, Nele Haelterman, Yuqing Chen, Ming-Ming Jiang, Aleksandra Drelich, Vivian Tat, Denise G Lanza, Isabel Lorenzo, Jason D Heaney, Chien-Te Kent Tseng, Brendan Lee, Ronit Marom

Faculty, Staff and Students Publications

The Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) remains a public health concern and a subject of active research effort. Development of pre-clinical animal models is critical to study viral-host interaction, tissue tropism, disease mechanisms, therapeutic approaches, and long-term sequelae of infection. Here, we report two mouse models for studying SARS-CoV-2: A knock-in mAce2F83Y,H353K mouse that expresses a mouse-human hybrid form of the angiotensin-converting enzyme 2 (ACE2) receptor under the endogenous mouse Ace2 promoter, and a Rosa26 conditional knock-in mouse carrying the human ACE2 allele (Rosa26hACE2). Although the mAce2F83Y,H353K mice were susceptible to …

Seeing Beyond Reality: Considering The Impact Of Mainstream Virtual Reality Adoption On Ocular Health And The Evolving Role Of Ophthalmologists, Venkata Soumith Jonnakuti, Benjamin Jay Frankfort

Faculty, Staff and Students Publications

No abstract provided.