Medicine and Health Sciences Commons^™

The Effect Of Depression And Antidepressants On Cost, Survival And Adherence To Hormone Therapy In Breast Cancer, Virginia Noxon

Theses and Dissertations

Introduction: Breast cancer patients with a depression diagnosis before or after cancer diagnosis have increased cost, shorter survival time and reduced adherence to hormone therapy. Treating depression in these patients should improve these outcomes; however, there is scarce literature on this topic. Currently, no study has determined the association of concurrent depression while adjusting for a history of depression or treating depression with antidepressants with cost, survival and adherence to hormone therapy. This study has two objectives: 1) to determine the association of concurrent depression with cost, survival and adherence to hormone therapy adjusting for a history of depression 2) …

Engagement In A Diverse Urban Community To Describe Community Residents’ Perceptions Of Pharmacists As Immunizers, Anthony J. Pattin, Zachary Rowe, Paul Kilgore, Nada Farhat, Stephen Kaurala, Linda Kaljee

Department of Pharmacy Practice

Objective: To describe the perceptions of pharmacist-delivered vaccination services among community members that live in a diverse urban metropolitan area and to identify potential strategies to improve the use of vaccines provided by pharmacists.

Design: Qualitative study. Setting: Metropolitan urban diverse community in Wayne County, MI.

Participants: Individuals 50 years of age and older that reside in a defined urban metropolitan community.

Intervention: Four, 45-minute, focus group discussions were conducted to gather the experiences and perceptions of participants around pharmacists that immunize. A focus group guide was developed to facilitate focus group sessions.

Main Outcome Measures: Focus group discussions were …

Predictors Of Neonatal Abstinence Syndrome In Buprenorphine Exposed Newborn: Can Cord Blood Buprenorphine Metabolite Levels Help?, Darshan Shah, Stacy Brown, Nick Hagemeier, Shimin Zheng, Amy Kyle, Jason Pryor, Nilesh Dankhara, Piyuesh Singh

ETSU Faculty Works

Background

Buprenorphine is a semi-synthetic opioid used for the treatment of opioid dependence. Opioid use, including buprenorphine, has been increasing in recent years, in the general population and in pregnant women. Consequently, there has been a rise in frequency of neonatal abstinence syndrome (NAS), associated with buprenorphine use during pregnancy. The purpose of this study was to investigate correlations between buprenorphine and buprenorphine-metabolite concentrations in cord blood and onset of NAS in buprenorphine exposed newborns.

Methods

Nineteen (19) newborns who met inclusion criteria were followed after birth until discharge in a double-blind non-intervention study, after maternal consent. Cord blood and …

A Randomized, Double-Blind, Placebo-Controlled Phase Ii Trial Investigating The Safety And Immunogenicity Of Modified Vaccinia Ankara Smallpox Vaccine (Mva-Bn®) In 56-80-Year-Old Subjects, Richard N. Greenberg, Christine M. Hay, Jack T. Stapleton, Thomas C. Marbury, Eva Wagner, Eva Kreitmeir, Siegfried Röesch, Alfred Von Krempelhuber, Philip Young, Richard Nichols, Thomas P. Meyer, Darja Schmidt, Josef Weigl, Garth Virgin, Nathaly Arndtz-Wiedemann, Paul Chaplin

Internal Medicine Faculty Publications

Background Modified Vaccinia Ankara MVA-BN^® is a live, highly attenuated, viral vaccine under advanced development as a non-replicating smallpox vaccine. In this Phase II trial, the safety and immunogenicity of Modified Vaccinia Ankara MVA-BN^® (MVA) was assessed in a 56–80 years old population.

Methods MVA with a virus titer of 1 x 10⁸ TCID₅₀/dose was administered via subcutaneous injection to 56–80 year old vaccinia-experienced subjects (N = 120). Subjects received either two injections of MVA (MM group) or one injection of Placebo and one injection of MVA (PM group) four weeks apart. Safety was evaluated …

High Activity Mutants Of Butyrylcholinesterase For Cocaine Hydrolysis, Chang-Guo Zhan, Fang Zheng, Wenchao Yang, Liu Xue, Shurong Hou

Pharmaceutical Sciences Faculty Patents

Butyrylcholinesterase (BChE) polypeptide variants of the presently-disclosed subject matter have enhanced catalytic efficiency for (−)-cocaine, as compared to wild-type BChE. Pharmaceutical compositions of the presently-disclosed subject matter include a BChE polypeptide variant having an enhanced catalytic efficiency for (−)-cocaine. A method of the presently-disclosed subject matter for treating a cocaine-induced condition includes administering to an individual an effective amount of a BChE polypeptide variant, as disclosed herein, to lower blood cocaine concentration.

Delinking Investment In Antibiotic Research And Development From Sales Revenues: The Challenges Of Transforming A Promising Idea Into Reality, Kevin Outterson, Unni Gopinathan, Charles Clift, Anthony So, Chantal Morel, John-Arne Røttingen

Faculty Scholarship

1. The current business model for antibiotics is plagued by market failures and perverse incentives that both work against conservation efforts and provide insufficient rewards to drive the development of much-needed new treatments for resistant infection.

2. Many new incentive mechanisms have been proposed to realign incentives and support innovation and conservation over the long term. The most promising of these are based on the idea of delinking rewards from sales volume of the antibiotic — the notion of “delinkage.”

3. Some critical design issues for delinkage remain, such as how to secure access to badly needed new products when …

Less Drugs But Lots Of Drug News To Open 2016, Rodney Richmond

Faculty Research ​and Publications

No abstract provided.

Role Of Histidine 547 Of Human Dopamine Transporter In Molecular Interaction With Hiv-1 Tat And Dopamine Uptake, Yaxia Yuan, Pamela M. Quizon, Wei-Lun Sun, Jianzhuang Yao, Jun Zhu, Chang-Guo Zhan

Molecular Modeling and Biopharmaceutical Center Faculty Publications

HIV-1 Tat plays an important role in HIV-associated neurocognitive disorders (HAND) by disrupting neurotransmission including dopamine uptake by human dopamine transporter (hDAT). Previous studies have demonstrated that HIV-1 Tat directly binds to hDAT and some amino-acid mutations that attenuate the hDAT-Tat binding also significantly decreased dopamine uptake activity of hDAT. This combined computational-experimental study demonstrates that histidine-547 (H547) of hDAT plays a crucial role in the hDAT-Tat binding and dopamine uptake by hDAT, and that the H547A mutation can not only considerably attenuate Tat-induced inhibition of dopamine uptake, but also significantly increase the V_max of hDAT for dopamine uptake. …

Modeling And Re-Engineering Of Azotobacter Vinelandii Alginate Lyase To Enhance Its Catalytic Efficiency For Accelerating Biofilm Degradation, Chul Ho Jang, Yu Lan Piao, Xiaoqin Huang, Eun Jeong Yoon, So Hee Park, Kyoung Lee, Chang-Guo Zhan, Hoon Cho

Molecular Modeling and Biopharmaceutical Center Faculty Publications

Alginate is known to prevent elimination of Pseudomonas aeruginosa biofilms. Alginate lyase (AlgL) might therefore facilitate treatment of Pseudomonas aeruginosa-infected cystic fibrosis patients. However, the catalytic activity of wild-type AlgL is not sufficiently high. Therefore, molecular modeling and site-directed mutagenesis of AlgL might assist in enzyme engineering for therapeutic development. AlgL, isolated from Azotobacter vinelandii, catalyzes depolymerization of alginate via a β-elimination reaction. AlgL was modeled based on the crystal structure template of Sphingomonas AlgL species A1-III. Based on this computational analysis, AlgL was subjected to site-directed mutagenesis to improve its catalytic activity. The k_cat/K …

June 2016, Randy Curry, Cindy Brooks

RURAL ROCKS

Rural Rocks, the Rural Health Network newsletter by the SWOSU College of Pharmacy

Associative Spike Timing-Dependent Potentiation Of The Basal Dendritic Excitatory Synapses In The Hippocampus In Vivo., Thomas K Fung, Clayton S Law, L Stan Leung

Physiology and Pharmacology Publications

Spike timing-dependent plasticity in the hippocampus has rarely been studied in vivo. Using extracellular potential and current source density analysis in urethane-anesthetized adult rats, we studied synaptic plasticity at the basal dendritic excitatory synapse in CA1 after excitation-spike (ES) pairing; E was a weak basal dendritic excitation evoked by stratum oriens stimulation, and S was a population spike evoked by stratum radiatum apical dendritic excitation. We hypothesize that positive ES pairing-generating synaptic excitation before a spike-results in long-term potentiation (LTP) while negative ES pairing results in long-term depression (LTD). Pairing (50 pairs at 5 Hz) at ES intervals of -10 …

Calcium Phosphate As A Key Material For Socially Responsible Tissue Engineering, Vuk Uskoković, Victoria M. Wu

Pharmacy Faculty Articles and Research

Socially responsible technologies are designed while taking into consideration the socioeconomic, geopolitical and environmental limitations of regions in which they will be implemented. In the medical context, this involves making therapeutic platforms more accessible and affordable to patients in poor regions of the world wherein a given disease is endemic. This often necessitates going against the reigning trend of making therapeutic nanoparticles ever more structurally complex and expensive. However, studies aimed at simplifying materials and formulations while maintaining the functionality and therapeutic response of their more complex counterparts seldom provoke a significant interest in the scientific community. In this review …

National Trends In Off-Label Use Of Atypical Antipsychotics In Children And Adolescents In The United States, Minji Sohn, Daniela C. Moga, Karen Blumenschein, Jeffery C. Talbert

Pharmacy Practice and Science Faculty Publications

The objectives of the study were as follows: to examine the national trend of pediatric atypical antipsychotic (AAP) use in the United States; to identify primary mental disorders associated with AAPs; to estimate the strength of independent associations between patient/provider characteristics and AAP use. Data are from the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey. First, average AAP prescription rates among 4 and 18-year-old patients between 1993 and 2010 were estimated. Second, data from 2007 to 2010 were combined and analyzed to identify primary mental disorders related to AAP prescription. Third, a multivariate logistic …

Gene Delivery Using Calcium Phosphate Nanoparticles: Optimization Of The Transfection Process And The Effects Of Citrate And Poly(L-Lysine) As Additives, Mohammed A. Khan, Victoria M. Wu, Shreya Ghosh, Vuk Uskoković

Pharmacy Faculty Articles and Research

Despite the long history of nanoparticulate calcium phosphate (CaP) as a non-viral transfection agent, there has been limited success in attempts to optimize its properties for transfection comparable in efficiency to that of viral vectors. Here we focus on the optimization of: (a) CaP nanoparticle precipitation conditions, predominantly supersaturation and Ca/P molar ratios; (b) transfection conditions, mainly the concentrations of the carrier and plasmid DNA; (c) the presence of surface additives, including citrate anion and cationic poly(l-lysine) (PLL). CaP nanoparticles significantly improved transfection with plasmid DNA encoding enhanced green fluorescent protein (eGFP) in pre-osteoblastic MC3T3-E1 cells compared to a commercial …

Commencement Program 2016, Loma Linda University

Commencement Programs

CONTENTS

1 | Message from the President

3 | 2016 Events of Commencement

5 | The Academic Procession

7 | Significance of Academic Regalia

9 | The Good Samaritan

10 | University History Highlights

12 | Loma Linda University Song - "Healing Love"

13 | The Speakers

21 | The University Honorees

36 | The School Honorees

56 | The President's Award Recipients

66 | The Program

• School of Medicine, 67
• School of Pharmacy, 90
• School of Dentistry, 98
• School of Allied Health Professions - Allied Health Studies, Cardiopulmonary Sciences, Clinical Laboratory Science, Health Informatics and Information Management, Nutrition and …

Impact Of A Hospital’S Antibiotic Stewardship Team On Fluoroquinolone Use At A Long- Term Care Facility, Christine L. Rahme, Helen M. Jacoby, Lisa M. Avery

Pharmacy Faculty/Staff Publications

The primary objective of this study was to assess whether a hospital-based antimicrobial stewardship team (H-AST) from an unaffiliated hospital could decrease inappropriate fluoroquinolone use at a local, long-term care facility (LTCF). The H-AST created a multi-faceted intervention campaign that included antibiogram development, provider and family education, and a telephone hotline. Pre- and post-intervention mean defined daily doses per 1000 resident days for antimicrobials were calculated to determine the impact of the campaign. The campaign resulted in a 38.70% decrease in ciprofloxacin utilization, a 16.20% decrease in total FQ consumption, and an 11.68% in total antibiotic consumption. In addition, during …

Evaluation Of The Effectiveness Of A Prescription Drug Abuse Prevention Curriculum For College Students, Danielle M. Colangelo, Alexis K. Sepulveda

Kinesiology and Public Health

The recreational use of prescription drugs has been increasingly common in university communities (Office of National Drug Control Policy, 2015). Students may abuse prescription drugs to get high, study longer or sleep. A survey conducted by Kinesiology students used snowball sampling to assess the number of Cal Poly students recreationally using prescription drugs and their knowledge of prescription drug abuse (Colangelo & Sepulveda, 2015). The assessment showed 30.7% of students had abused prescription drugs in the last six months. There was an increase in abuse between college freshmen (19.2%), college sophomores (41.4%) and juniors (44.3%) (Colangelo & Sepulveda, 2015). This …

Summer Dehydration, Rodney Richmond

Faculty Research ​and Publications

No abstract provided.

Inadequate Sedation During Therapeutic Paralysis: Use Of Bispectral Index In Critically Ill Patients, Chelsea L. Tasaka, Jeremiah J. Duby, Komal Pandya, Machelle D. Wilson, Kimberly A. Hardin

Pharmacy Practice and Science Faculty Publications

Background Patients receiving therapeutic paralysis may experience inadequate sedation due to intrinsic limitations of behavioral sedation assessment. Bispectral index (BIS™) provides an objective measure of sedation; however, the role of BIS™ is not well defined in intensive care unit (ICU) patients on neuromuscular blocking agents (NMBA).

Objective The aim of this study was to delineate the relationship between BIS™ and level of sedation for critically ill patients during therapeutic paralysis.

Methods This was a retrospective observational study conducted in ICU patients receiving continuous infusion NMBA and BIS™ monitoring. The primary endpoint was the correlation of BIS™ < 60 during therapeutic paralysis with a Richmond Agitation Sedation Score (RASS) of −4 to −5 (i.e., deep or unarousable sedation) at the time of emergence from therapeutic paralysis.

Results Thirty-one patients were …

The Hiv-1 Tat Protein Is Monomethylated At Lysine 71 By The Lysine Methyltransferase Kmt7, Ibraheem Ali, Holly Ramage, Daniela Boehm, Lynnette M. A. Dirk, Naoki Sakane, Kazuki Hanada, Sara Pagans, Katrin Kaehlcke, Katherine Aull, Leor Weinberger, Raymond Trievel, Martina Schnoelzer, Masafumi Kamada, Robert L. Houtz, Melanie Ott

Horticulture Faculty Publications

The HIV-1 transactivator protein Tat is a critical regulator of HIV transcription primarily enabling efficient elongation of viral transcripts. Its interactions with RNA and various host factors are regulated by ordered, transient post-translational modifications. Here, we report a novel Tat modification, monomethylation at lysine 71 (K71). We found that Lys-71 monomethylation (K71me) is catalyzed by KMT7, a methyltransferase that also targets lysine 51 (K51) in Tat. Using mass spectrometry, in vitro enzymology, and modification-specific antibodies, we found that KMT7 monomethylates both Lys-71 and Lys-51 in Tat. K71me is important for full Tat transactivation, as KMT7 knockdown impaired the transcriptional activity …

Prior Binge Ethanol Exposure Potentiates The Microglial Response In A Model Of Alcohol-Induced Neurodegeneration, Simon Alex Marshall, Chelsea Rhea Geil Nickell, Kimberly Nixon

Pharmaceutical Sciences Faculty Publications

Excessive alcohol consumption results in neurodegeneration which some hypothesize is caused by neuroinflammation. One characteristic of neuroinflammation is microglial activation, but it is now well accepted that microglial activation may be pro- or anti-inflammatory. Recent work indicates that the Majchrowicz model of alcohol-induced neurodegeneration results in anti-inflammatory microglia, while intermittent exposure models with lower doses and blood alcohol levels produce microglia with a pro-inflammatory phenotype. To determine the effect of a repeated binge alcohol exposure, rats received two cycles of the four-day Majchrowicz model. One hemisphere was then used to assess microglia via immunohistochemistry and while the other was used …

Teaching Communication Skills To Medical And Pharmacy Students Through A Blended Learning Course, Rick Hess, Nicholas E. Hagemeier, Reid Blackwelder, Daniel Rose, Nasar Ansari, Tandy Branham

ETSU Faculty Works

Objective. To evaluate the impact of an interprofessional blended learning course on medical and pharmacy students’ patient-centered interpersonal communication skills and to compare precourse and postcourse communication skills across first-year medical and second-year pharmacy student cohorts.

Methods. Students completed ten 1-hour online modules and participated in five 3-hour group sessions over one semester. Objective structured clinical examinations (OSCEs) were administered before and after the course and were evaluated using the validated Common Ground Instrument. Nonparametric statistical tests were used to examine pre/postcourse domain scores within and across professions.

Results. Performance in all communication skill domains increased significantly for all students. …

Did A Physician-Targeted Intervention That Reduced Potentially Inappropriate Prescribing To Elderly Patients Also Reduce Related Hospitalizations?, Jacquelyn Mcrae, Pharmd, Sarah E. Hegarty, Pharmd, M. Alcusky, A. Vegesna, S. Varga, S. W. Keith, S. Del Canale, M. Lombardi, Vittorio Maio, Pharmd, Msph

College of Population Health Posters

Objectives:

To determine whether a general practitioner focused intervention aimed at decreasing PIM prescribing in the elderly can decrease the risk of PIM-related hospitalizations.

Poster presented at 2016 ISPOR conference in Washington DC.

Hiv Vaccines: Progress, Limitations And A Crispr/Cas9 Vaccine, Omar A. Garcia Martinez

Biology: Student Scholarship & Creative Works

ABSTRACT: The HIV-1 pandemic continues to thrive due to ineffective HIV-1 vaccines. Historically, the world’s most infectious diseases, such as polio and smallpox, have been eradicated or have come close to eradication due to the advent of effective vaccines. Highly active antiretroviral therapy is able to delay the onset of AIDS but can neither rid the body of HIV-1 proviral DNA nor prevent further transmission. A prophylactic vaccine that prevents the various mechanisms HIV-1 has to evade and attack our immune system is needed to end the HIV-1 pandemic. Recent advances in engineered nuclease systems, like the CRISPR/Cas9 system, have …

Radiation-Enhanced Therapeutic Targeting Of Galectin-1 Enriched Malignant Stroma In Triple Negative Breast Cancer, Meenakshi Upreti, Amar Jyoti, Sara E. Johnson, Elden P. Swindell, Dana L. Napier, Pallavi Sethi, Ryan Chan, Jonathan M. Feddock, Heidi L. Weiss, Thomas V. O'Halloran, B. Mark Evers

Pharmaceutical Sciences Faculty Publications

Currently there are no FDA approved targeted therapies for Triple Negative Breast Cancer (TNBC). Ongoing clinical trials for TNBC have focused primarily on targeting the epithelial cancer cells. However, targeted delivery of cytotoxic payloads to the non-transformed tumor associated-endothelium can prove to be an alternate approach that is currently unexplored. The present study is supported by recent findings on elevated expression of stromal galectin-1 in clinical samples of TNBC and our ongoing findings on stromal targeting of radiation induced galectin-1 by the anginex-conjugated arsenic-cisplatin loaded liposomes using a novel murine tumor model. We demonstrate inhibition of tumor growth and metastasis …

Improving Collaboration Between Pharmacists And Physicians, Paras Patel

BU Well

Physicians and pharmacists have differing but complementary roles that can optimize patient care when structured effectively. Unfortunately, these two professionals are not collaborating well enough, as patient outcomes, especially in relation to medication adherence, continue to decline. Coordinated care of patients can improve by expanding bidirectional communication and sharing additional patient information with each other. It will be necessary to continue to promote collaborative care in the educational and training stages of these professionals’ careers to build trust and understanding of professional scope. Ultimately, the healthcare infrastructure will have to continue to progress to make collaboration more available and valuable …

An N Of One: My Review Of Management Of Type 1 Diabetes, Myself As Patient, Jarred Daugherty

BU Well

As technology has advanced, so has the management of diabetes. Insulin, the essential medication for type 1 diabetes, is marketed in an array of formulations and devices. Continuous glucose monitors (CGM) can be inserted to measure blood glucose every 5 minutes. The rise of social media has given diabetics online support groups, where they can share their story and learn from others overcoming similar challenges. So, how well do the current diabetes management strategies work? My name Is Jarred and I’m a type 1 diabetic. I have tried many of these products and this article is a review of my …

Block Copolymer Based Magnetic Nanoclusters For Cancer-Theranostics: Synthesis, Characterization And In Vitro Evaluation, Hemant M. Vishwasrao

Theses & Dissertations

“There is plenty of room at the bottom”. In this visionary lecture in 1959 Prof. Richard Feynman spoke of the interesting ramifications of working with matter at the atomic scale. Since then, scientists have worked relentlessly towards realizing his vision. The influence of nanobiotechnology on material science and polymer chemistry has given rise to a new field called ‘theranostics’, combining drug delivery and diagnostics within the same nanostructures, thereby enabling simultaneous diagnosis, targeted drug delivery and continued therapy monitoring. Iron oxide nanoparticles (MNPs) are one such class of MRI contrast agents that can be converted into theranostic nanomedicines for cancer …

Factors And Outcomes Associated With Potentially Inappropriate Medication Use In Rural Community-Dwelling Older Adults, Marcia Y. Shade

Theses & Dissertations

Potentially inappropriate medications (PIMs) use in older adults is a significant public health concern. The use of PIMs to avoid may lead to negative outcomes such as adverse drug events. Prior conceptual analysis of PIMs use and observation of health-related factors in rural adults led to the design of this dissertation study. A sample was recruited from a population of rural community-dwelling older adults to examine the following specific aims: 1) Describe the use of PIMs to avoid, 2) Explore individual demographic characteristics (age, gender, income, education, and rural home location), health experience (comorbidity, number of medications and health providers), …

Ssri Use In Pregnancy And Congenital Heart Defects: A Meta-Analysis Of Population Based Cohort Studies, Elizabeth A. Kowalik

Senior Honors Projects

The American College of Obstetricians and Gynecologists estimate that 10-23% of pregnant women in the US face depression at some point during their pregnancy. However, no clear recommendations regarding the treatment of depression in pregnancy are available. Antidepressants are commonly used during pregnancy without clear evidence of their safety. A study of 1,106,757 women in 47 states found that 89,980 (8.1%) had taken an antidepressant at some point during their pregnancy. The Centers for Disease Control and Prevention (CDC) found that 298 (4.5%) of 6582 women in 10 states between the years of 1998 and 2005 had taken an antidepressant …