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A Review Of Stellate Ganglion Block As An Adjunctive Treatment Modality, Kennedy Kirkpatrick, Mashfee H Khan, Yi Deng, Krishna B Shah

Faculty, Staff and Students Publications

Peripheral nerve blocks are becoming increasingly used as adjunctive treatment modalities for a variety of conditions refractory to medical management. Right or left stellate ganglion blocks (SGB) are a specific type of peripheral nerve block that target the sympathetic blockade of neuronal impulses using the injection of local anesthetic and steroids into nerve bundles in the cervical area. This review article is intended to summarize the common uses of stellate ganglion blocks and explain the procedural technique, which has evolved with technological advances in ultrasonography. The similarities between these disease processes are centered around sympathetic hyperactivity. This sympathetic overdrive state …

Affare Fatto 2!, Susanna Nocchi, Silvia Bertoni

Books/Book Chapters

Taster. List of contents and first unit of a book for students of Italian as a foreign language.

Affare fatto! 2 is the second volume of a course aimed at learners of Italian who want to reach an intermediate level of competence in the language (B1/B1+ of the CEFR). The book offers material that can be used to attain competences in Italian for Business and for Professional Communication.

Affare fatto! 2 can be used as a textbook in a university course, as a book for professionals who work in Italy or with Italian partners, and as a textbook for those …

Comparison Of Postoperative Outcomes Of Laparoscopic Vs Open Inguinal Hernia Repair, Jennie Meier, Audrey Stevens, Miles Berger, Konstantinos I Makris, Athanasios Bramos, Joan Reisch, C Munro Cullum, Simon C Lee, Celette Sugg Skinner, Herbert Zeh, Cynthia J Brown, Courtney J Balentine

Faculty, Staff and Students Publications

Importance: Advocates of laparoscopic surgery argue that all inguinal hernias, including initial and unilateral ones, should be repaired laparoscopically. Prior work suggests outcomes of open repair are improved by using local rather than general anesthesia, but no prior studies have compared laparoscopic surgery with open repair under local anesthesia.

Objective: To evaluate postoperative outcomes of open inguinal hernia repair under general or local anesthesia compared with laparoscopic repair.

Design, setting, and participants: This retrospective cohort study identified 107 073 patients in the Veterans Affairs Surgical Quality Improvement Program database who underwent unilateral initial inguinal hernia repair from 1998 to 2019. …

Primary Central Nervous System Germ Cell Tumors In Children And Young Adults: A Review Of Controversies In Diagnostic And Treatment Approach, Kee Kiat Yeo, Sumanth Nagabushan, Girish Dhall, Mohamed S Abdelbaki

2020-Current year OA Pubs

Primary central nervous system (CNS) germ cell tumors (GCT) are a rare heterogenous group of cancers, arising most commonly in the second decade of life. Through several clinical trials conducted around the world by various groups, the treatment approach for CNS GCT has advanced substantially with generally improved overall outcomes. In recent years, the goal of clinical trials has been focused on reduction of the radiotherapy burden and minimization of long-term toxicity. This review summarizes the current diagnostic and treatment regimens for CNS GCT, examines the controversies associated with these approaches, gaps in contemporary knowledge, and underscores the challenges we …

Interview No. 1751, Hernandez

Combined Interviews

Hernandez began working at Farah on April of 1972. Everyone at Farah left 2 moths after and she mentioned that those two months were enough for her to know what was right and what was wrong. Hernandez saw and experience many unjust things in those two months. She didn’t know how bad the situation inside the company was until she started to work there and realized that what the people were saying was right and even worse than what they described it as.

The worse part of the Farah company were the managers and their lack of experience in retail …

Interview No. 1753, Sanchez

Combined Interviews

Sanchez began working at Farah on April of 1969. Everyone at Farah hated their job and at first, she didn’t know why but 2 months after entering she realize what was right and what was wrong. As many others Farah workers on Paisano were tired of the unjust treatment and bad wage, Sanchez felt the exact same way in just a week of getting hired.

At first, she thought that it was so easy the hiring process and that Farah hired anyone who was willing to work. Soon after Sanchez realized that Farah hired many people, because of the amount …

Interview No. 1758, Saucido

Combined Interviews

Her last name is Saucido and she was working at Farah and she was part of the strike. Some of her duties at Farah was cutting and cleaning which was a very demanding job. She says that before the union there was no one that could help them and they thought that the union was going to make things better for them, but it wasn’t that way. When they were working, they will have supervisors that were making sure you did your job correctly, but sometimes they were extremely demanding and they will fire many people for either taking long …

Interview No. 1752, Valenzuela

Combined Interviews

Her last name is Valenzuela and she was born and raised in El Paso, Texas. After she graduated from high school, she got her first fulltime job at Farah. She was working in setting pockets, that involved a lot of hard work and many hours of work. The training that she was, was how to use the machine but like her many other people wants trained well. She says that many supervisors where over them all day long. She says that thru out the day they get 2 breaks from their job and they can rest on site and can …

Interview No. 1762, Leyva Bustamante

Combined Interviews

In April of 1970, Leyva started working at Farah. Everyone at Farah despised their job, and she didn't understand why at first, but after two months, she realized what was right and what was wrong. Leyva, like many other Farah employees on Paisano, was fed up with the unfair treatment and low pay after only a week on the job.

She initially assumed that the hiring process was simple and that Farah employed anyone who was willing to work. Soon after, Leyva recognized that Farah had employed a large number of individuals, and that they needed to balance the number …

Interview No. 1777, Tarango

Combined Interviews

Tarangos fathers’ parents were from Mexico and they passed away when she was very little. She never got to meet them. Her grandparent where from Leon Guanajuato, Mexico as well as his dad. Tarango mentioned that most of his family on her dads’ side were shoe makers back in Mexico, which was all he talked about to Tarango about. Sometimes he would talk about God or the Bible, but mostly about the shoe repair shop they had in Mexico. When Tarango’s dad came to the United States in the 1911 and he didn’t know English very well, but he managed …

Interview No. 1780, Arieta

Combined Interviews

Arieta started off her interview by mentioning that she had always wanted to study to be a nurse. Her husband didn’t believe in her because she was 30 when she began trying to get into nursing. She even mentioned that she felt old to be studying, but she really wanted to be somebody and have a life other than just being a housewife.

Arieta was tired of being at home and not knowing anything about the world. She ended up not being a nurse because at that time they started to ask for people to have a high school degree …

Interview No. 1779, Del Palacio

Combined Interviews

Del Palacio was a worker at Farah during the 1970’s. She first started to work for the company when the working conditions were not as bad. Soon things in the company starting to go South. Her quota became higher and higher every week and she was not able to meet the quota many times. Her boss didn’t care if it was literally impossible to complete that many tasks in a short period of time, he just wanted the work done no matter what.

Many of the workers at Farah during that time lived in Ciudad Juarez, Mexico. Those workers had …

Interview No. 1784, Hernandez

Combined Interviews

She was born in Alamogordo, New Mexico, May 12, 1929. She had a very big family and she got to meet her grandmother and she was living in Ciudad Juarez, so they moved from Alamogordo to Juarez to be with her. Her grandmother used to have a son that had an accident in a mine, and they got a lot of money for compensation, but the son of her uncle spent everything. She was only 6 years old, and her grandmother died when she was 10 years old, they weren’t living with her, but they lived close, so they visit …

Interview No. 1785, Telles

Combined Interviews

Audio Unintelligible

Myostatin And Follistatin As Monitoring And Prognostic Biomarkers In Dysferlinopathy, Ursula Moore, Alan Pestronk, Et Al.

2020-Current year OA Pubs

Myostatin is a myokine which acts upon skeletal muscle to inhibit growth and regeneration. Myostatin is endogenously antagonised by follistatin. This study assessed serum myostatin and follistatin concentrations as monitoring or prognostic biomarkers in dysferlinopathy, an autosomal recessively inherited muscular dystrophy. Myostatin was quantified twice with a three-year interval in 76 patients with dysferlinopathy and 38 controls. Follistatin was quantified in 62 of these patients at the same timepoints, and in 31 controls. Correlations with motor function, muscle fat fraction and contractile cross-sectional area were performed. A regression model was used to account for confounding variables. Baseline myostatin, but not …

Final Findings From The Control Trial: Strategies To Reduce The Incidence And Severity Of Neratinib-Associated Diarrhea In Patients With Her2-Positive Early-Stage Breast Cancer, Arlene Chan, Ron Bose, Et Al.

2020-Current year OA Pubs

BACKGROUND: Neratinib is an irreversible pan-HER tyrosine kinase inhibitor approved for HER2-positive early-stage and metastatic breast cancer. Diarrhea is the most frequent side effect and the most common reason for early discontinuation. The phase II CONTROL trial investigated antidiarrheal prophylaxis or neratinib dose escalation (DE) for prevention of diarrhea. We present complete study results including final data for two DE strategies.

METHODS: Patients who completed trastuzumab-based adjuvant therapy received neratinib 240 mg/day for 1 year. Early cohorts investigated mandatory prophylaxis with loperamide, then additional budesonide or colestipol. Final cohorts assessed neratinib DE over the first 2 (DE1) or 4 weeks …

Relationship Between Electrode Position And Temporal Modulation Sensitivity In Cochlear Implant Users: Are Close Electrodes Always Better?, Ning Zhou, Xuyang Shi, Omkar Dixit, Jill B Firszt, Timothy A Holden

2020-Current year OA Pubs

Temporal modulation sensitivity has been studied extensively for cochlear implant (CI) users due to its strong correlation to speech recognition outcomes. Previous studies reported that temporal modulation detection thresholds (MDTs) vary across the tonotopic axis and attributed this variation to patchy neural survival. However, correlates of neural health identified in animal models depend on electrode position in humans. Nonetheless, the relationship between MDT and electrode location has not been explored. We tested 13 ears for the effect of distance on modulation sensitivity, specifically targeting the question of whether electrodes closer to the modiolus are universally beneficial. Participants in this study …

Lgmdd1 Natural History And Phenotypic Spectrum: Implications For Clinical Trials, Andrew R Findlay, Sarah E Robinson, Stephanie Poelker, Michelle Seiffert, Rocio Bengoechea, Conrad C Weihl

2020-Current year OA Pubs

OBJECTIVE: To delineate the full phenotypic spectrum and characterize the natural history of limb girdle muscular dystrophy type D1 (LGMDD1).

METHODS: We extracted age at clinical events of interest contributing to LGMDD1 disease burden via a systematic literature and chart review. Manual muscle testing and quantitative dynamometry data were used to estimate annualized rates of change. We also conducted a cross-sectional observational study using previously validated patient-reported outcome assessments (ACTIVLIM, PROMIS-57) and a new LGMDD1 questionnaire. Some individuals underwent repeat ACTIVLIM and LGMDD1 questionnaire assessments at 1.5 and 2.5 years.

RESULTS: A total of 122 LGMDD1 patients were included from …

Early Intervention And Intensive Management Of Patients With Diabetes, Cardiorenal, And Metabolic Diseases, Yehuda Handelsman, Samuel Klein, Et Al.

2020-Current year OA Pubs

Increasing rates of obesity and diabetes have driven corresponding increases in related cardiorenal and metabolic diseases. In many patients, these conditions occur together, further increasing morbidity and mortality risks to the individual. Yet all too often, the risk factors for these disorders are not addressed promptly in clinical practice, leading to irreversible pathologic progression. To address this gap, we convened a Task Force of experts in cardiology, nephrology, endocrinology, and primary care to develop recommendations for early identification and intervention in obesity, diabetes, and other cardiorenal and metabolic diseases. The recommendations include screening and diagnosis, early interventions with lifestyle, and …

The Diagnosis Of Severe Combined Immunodeficiency: Implementation Of The Pidtc 2022 Definitions, Christopher C Dvorak, Jeffrey J Bednarski, Et Al.

2020-Current year OA Pubs

BACKGROUND: Shearer et al in 2014 articulated well-defined criteria for the diagnosis and classification of severe combined immunodeficiency (SCID) as part of the Primary Immune Deficiency Treatment Consortium's (PIDTC's) prospective and retrospective studies of SCID.

OBJECTIVE: Because of the advent of newborn screening for SCID and expanded availability of genetic sequencing, revision of the PIDTC 2014 Criteria was needed.

METHODS: We developed and tested updated PIDTC 2022 SCID Definitions by analyzing 379 patients proposed for prospective enrollment into Protocol 6901, focusing on the ability to distinguish patients with various SCID subtypes.

RESULTS: According to PIDTC 2022 Definitions, 18 of 353 …

Human Cardiac Pericytes Are Susceptible To Sars-Cov-2 Infection, Brittany D Brumback, Oleksandr Dmytrenko, Ashley N Robinson, Adam L Bailey, Pan Ma, Jing Liu, Stephanie C Hicks, Sherwin Ng, Gang Li, David M Zhang, Catherine E Lipovsky, Chieh-Yu Lin, Michael S Diamond, Kory J Lavine, Stacey L Rentschler

2020-Current year OA Pubs

COVID-19 is associated with serious cardiovascular complications, with incompletely understood mechanism(s). Pericytes have key functions in supporting endothelial cells and maintaining vascular integrity. We demonstrate that human cardiac pericytes are permissive to SARS-CoV-2 infection in organotypic slice and primary cell cultures. Viral entry into pericytes is mediated by endosomal proteases, and infection leads to up-regulation of inflammatory markers, vasoactive mediators, and nuclear factor kappa-B-dependent cell death. Furthermore, we present evidence of cardiac pericyte infection in COVID-19 myocarditis patients. These data demonstrate that human cardiac pericytes are susceptible to SARS-CoV-2 infection and suggest a role for pericyte infection in COVID-19.

Using Digital Technologies To Facilitate Social Inclusion During The Covid‐19 Pandemic: Experiences Of Co‐Resident And Non‐Co‐Resident Family Carers Of People With Dementia From Determind‐C19, B Hicks, Determind Team

Peninsula Medical School

Background The COVID-19 pandemic triggered rapid and unprecedented changes in the use of digital technologies to support people's social inclusion. We examined whether and how co-resident and non-co-resident family carers of people with dementia engaged with digital technologies during this period. Methods Throughout November 2020-February 2021, we interviewed 42 family carers of people with dementia from our DETERMIND-C19 cohort. Preliminary analysis was conducted through Framework analysis, followed by an inductive thematic analysis. Findings Digital technologies served as a Facilitator for social inclusion by enabling carers to counter the effects of the differing restrictions imposed on them so they could remain …

Extending Outbreak Investigation With Machine Learning And Graph Theory: Benefits Of New Tools With Application To A Nosocomial Outbreak Of A Multidrug-Resistant Organism, Andrew Atkinson, Benjamin Ellenberger, Vanja Piezzi, Tanja Kaspar, Luisa Salazar-Vizcaya, Olga Endrich, Alexander B Leichtle, Jonas Marschall

2020-Current year OA Pubs

OBJECTIVE: From January 1, 2018, until July 31, 2020, our hospital network experienced an outbreak of vancomycin-resistant enterococci (VRE). The goal of our study was to improve existing processes by applying machine-learning and graph-theoretical methods to a nosocomial outbreak investigation.

METHODS: We assembled medical records generated during the first 2 years of the outbreak period (January 2018 through December 2019). We identified risk factors for VRE colonization using standard statistical methods, and we extended these with a decision-tree machine-learning approach. We then elicited possible transmission pathways by detecting commonalities between VRE cases using a graph theoretical network analysis approach.

RESULTS: …

Late-Nc Staging In Routine Neuropathologic Diagnosis: An Update, Peter T Nelson, Katherine E Schwetye, Et Al.

2020-Current year OA Pubs

An international consensus report in 2019 recommended a classification system for limbic-predominant age-related TDP-43 encephalopathy neuropathologic changes (LATE-NC). The suggested neuropathologic staging system and nomenclature have proven useful for autopsy practice and dementia research. However, some issues remain unresolved, such as cases with unusual features that do not fit with current diagnostic categories. The goal of this report is to update the neuropathologic criteria for the diagnosis and staging of LATE-NC, based primarily on published data. We provide practical suggestions about how to integrate available genetic information and comorbid pathologies [e.g., Alzheimer's disease neuropathologic changes (ADNC) and Lewy body disease]. …

Dexamethasone To Prevent Everolimus-Induced Stomatitis (Alliance Mist Trial: A221701), Kathryn J Ruddy, David Zahrieh, Jun He, Blake Waechter, Julianne L Holleran, Lionel D Lewis, Selina Chow, Jan Beumer, Matthias Weiss, Nikolaos Trikalinos, Bryan Faller, Maryam Lustberg, Hope S Rugo, Charles Loprinzi

2020-Current year OA Pubs

mTOR inhibitors such as everolimus may cause oral stomatitis, often a dose-limiting toxicity. Prior clinical research has suggested that a dexamethasone mouth rinse might help prevent and/or treat this. Alliance A221701 was a randomized phase III trial of patients initiating 10 mg daily oral everolimus that compared dexamethasone mouthwash taken preventively (initial dexamethasone group) versus therapeutically (initial placebo group) to assess two coprimary endpoints: the incidence of mTOR inhibitor-associated stomatitis (mIAS), and the area under the curve (AUC) of mIAS-associated pain over an 8-week treatment period. A Fisher's exact test was used to compare the incidences while a Wilcoxon rank-sum …

Clinical Importance Of Clonal Hematopoiesis In Metastatic Gastrointestinal Tract Cancers, Bill H Diplas, Kelly Bolton, Et Al.

2020-Current year OA Pubs

IMPORTANCE: Clonal hematopoiesis (CH) has been associated with development of atherosclerosis and leukemia and worse survival among patients with cancer; however, the association with cancer therapy efficacy, in particular immune checkpoint blockade (ICB), and toxicity has not yet been established. Given the widespread use of ICB and the critical role hematopoietic stem cell-derived lymphocytes play in mediating antitumor responses, CH may be associated with therapeutic efficacy and hematologic toxicity.

OBJECTIVE: To determine the association between CH and outcomes, hematologic toxicity, and therapeutic efficacy in patients with metastatic gastrointestinal tract cancers being treated with systemic therapy, both in the first-line metastatic …

Fixed-Dose Combination Therapy-Based Protocol Compared With Free Pill Combination Protocol: Results Of A Cluster Randomized Trial, Olutobi A Sanuade, Mark D Huffman, Et Al.

2020-Current year OA Pubs

Fixed-dose combination (FDC) therapy is recommended for hypertension management in Nigeria based on randomized trials at the individual level. This cluster-randomized trial evaluates effectiveness and safety of a treatment protocol that used two-drug FDC therapy as the second and third steps for hypertension control compared with a protocol that used free pill combinations. From January 2021 to June 2021, 60 primary healthcare centers in the Federal Capital Territory of Nigeria were randomized to a protocol using FDC therapy as second and third steps compared with a protocol that used the same medications in free pill combination therapy for these steps. …

Titan Success: Faculty Behind The Scenes, February, Thorpe Center

Publications from the Associate Deans

No abstract provided.

Understanding And Improving Older People’S Well-Being Through Social Prescribing Involving The Cultural Sector: Interviews From A Realist Evaluation, Jordan Gorenberg, Stephanie Tierney, Geoff Wong, Amadea Turk, Sebastien Libert, Caroline Potter, Kathryn Eccles, Shona Forster, Kerryn Husk, Helen J. Chatterjee, Emma Webster, Beth Mcdougall, Harriet Warburton, Lucy Shaw, Kamal R. Mahtani

Peninsula Medical School

Social prescribing is a non-clinical approach to addressing social, environmental, and economic factors affecting how people feel physical and/or emotionally. It involves connecting people to ?community assets? (e.g., local groups, organizations, and charities) that can contribute to positive well-being. We sought to explain in what ways, for whom, and why the cultural sector can support social prescribing with older people. We conducted semi-structured interviews with 28 older people (aged 60+) and 25 cultural sector staff. The following nine concepts, developed from interview data, progressed the understanding of tailoring cultural offers, which came from our previous realist review?immersion, buddying, café culture, …

Forgotten Brother Reuben Lewis: Missouri River Fur Trader And Indian Agent For The Arkansas Cherokees, Jay H. Buckley, Deveney Reber

Faculty Publications

Reuben Lewis was born in 1777, the fourth and youngest child of William Lewis and Lucy Meriwether. Their oldest child, Jane, married and lived out her days at Locust Hill, the family estate in Virginia. The Lewis’ second child, baby Lucinda, died in infancy. Their third child, Meriwether – the closest in age and friendship to Reuben – became the famous first half of the Lewis and Clark Expedition which explored the uncharted West before he met his tragic and mysterious death on the Natchez Trace in Tennessee. While Reuben’s life has been rightly overshadowed by his older brother Meriwether’s …