Medicine and Health Sciences Commons^™

Localized Jnk Signaling Regulates Organ Size During Development., Helen Rankin Willsey, Xiaoyan Zheng, José Carlos Pastor-Pareja, A Jeremy Willsey, Philip A Beachy, Tian Xu

Anatomy and Regenerative Biology Faculty Publications

A fundamental question of biology is what determines organ size. Despite demonstrations that factors within organs determine their sizes, intrinsic size control mechanisms remain elusive. Here we show that Drosophila wing size is regulated by JNK signaling during development. JNK is active in a stripe along the center of developing wings, and modulating JNK signaling within this stripe changes organ size. This JNK stripe influences proliferation in a non-canonical, Jun-independent manner by inhibiting the Hippo pathway. Localized JNK activity is established by Hedgehog signaling, where Ci elevates dTRAF1 expression. As the dTRAF1 homolog, TRAF4, is amplified in numerous cancers, these …

Effects Of A Mindfulness-Based Weight Loss Intervention In Adults With Obesity: A Randomized Clinical Trial., Jennifer Daubenmier, Patricia J Moran, Jean Kristeller, Michael Acree, Peter Bacchetti, Margaret E Kemeny, Douglas F. Nixon, +11 Additional Authors

Microbiology, Immunology, and Tropical Medicine Faculty Publications

OBJECTIVE: To determine whether adding mindfulness-based eating and stress management practices to a diet-exercise program improves weight loss and metabolic syndrome components.

METHODS: In this study 194 adults with obesity were randomized to a 5.5-month program with or without mindfulness training and identical diet-exercise guidelines. Intention-to-treat analyses with multiple imputation were used for missing data. The primary outcome was 18-month weight change.

RESULTS: Estimated effects comparing the mindfulness to control arm favored the mindfulness arm in (a) weight loss at 12 months, -1.9 kg (95% CI: -4.5, 0.8; P = 0.17), and 18 months, -1.7 kg (95% CI: -4.7, 1.2; …

Phylogenetic Organization Of Bacterial Activity., Ember M Morrissey, Rebecca L Mau, Egbert Schwartz, J Gregory Caporaso, Paul Dijkstra, Natasja Van Gestel, Benjamin J Koch, Cindy M. Liu, Michaela Hayer, Theresa A Mchugh, Jane C Marks, Lance B. Price, Bruce A Hungate

Environmental and Occupational Health Faculty Publications

Phylogeny is an ecologically meaningful way to classify plants and animals, as closely related taxa frequently have similar ecological characteristics, functional traits and effects on ecosystem processes. For bacteria, however, phylogeny has been argued to be an unreliable indicator of an organism's ecology owing to evolutionary processes more common to microbes such as gene loss and lateral gene transfer, as well as convergent evolution. Here we use advanced stable isotope probing with (13)C and (18)O to show that evolutionary history has ecological significance for in situ bacterial activity. Phylogenetic organization in the activity of bacteria sets the stage for characterizing …

Cord Blood Methylmercury And Fetal Growth Outcomes In Baltimore Newborns: Potential Confounding And Effect Modification By Omega-3 Fatty Acids, Selenium, And Sex, Ellen M Wells, Julie B Herbstman, Yu Hong Lin, Jeffery Jarrett, Carl P Verdon, Cynthia Ward, Kathleen L Caldwell, Joseph R Hibbeln, Frank R Witter, Rolf U Halden, Lynn R. Goldman

Environmental and Occupational Health Faculty Publications

BACKGROUND: Methylmercury (MeHg) may affect fetal growth; however, prior research often lacked assessment of mercury speciation, confounders, and interactions.

OBJECTIVE: Our objective was to assess the relationship between MeHg and fetal growth as well as the potential for confounding or interaction of this relationship from speciated mercury, fatty acids, selenium, and sex.

METHODS: This cross-sectional study includes 271 singletons born in Baltimore, Maryland, 2004-2005. Umbilical cord blood was analyzed for speciated mercury, serum omega-3 highly unsaturated fatty acids (n-3 HUFAs), and selenium. Multivariable linear regression models controlled for gestational age, birth weight, maternal age, parity, prepregnancy body mass index, smoking, …

The Role Of Primary Care Providers In Patient Activation And Engagement In Self-Management: A Cross-Sectional Analysis, Carmen Alvarez, Jessica L. Greene, Judith H. Hibbard, Valerie Overton

Nursing Faculty Publications

Background

The increasing burden of chronic illness highlights the importance of self-care and shifts from hierarchical and patriarchal models to partnerships. Primary care providers (PCPs) play an important role in supporting patients in self-management, enabling activation and supporting chronic care. We explored the extent to which PCPs’ beliefs about the importance of the patients’ role relate to the frequency in which they report engaging in collaborative and partnership-building behaviors with patients.

Methods

PCPs’ beliefs were measured using the Clinician Support for Patient Activation Measure (CS-PAM). We also assessed whether PCPs’ CS-PAM scores were positively associated with changes in their patients’ …

Lipidomic Dataset Of Plasma From Patients Infected With Wild Type And Nef-Deficient Hiv-1 Strain., Peter Meikle, Hann Low, Melissa J Churchill, Michael Bukrinsky, Dmitri Sviridov

Microbiology, Immunology, and Tropical Medicine Faculty Publications

Previous in vitro and in vivo studies demonstrated that HIV protein nef plays a key role in impairing cellular and systemic cholesterol metabolism in HIV disease, but clinical support for these findings is lacking. Here we present the data of comparative lipidomic analysis (330 lipid species) of plasma samples from HIV-negative subjects, patients infected with WT HIV-1 strain and patients infected with nef-deficient strain of HIV-1. We determine which effects of HIV on plasma lipidome are explained by the presence of nef. The data can be used to evaluate cardiovascular risk in HIV disease and to assess the role of …

Physician Quality Reporting System Program Updates And The Impact On Emergency Medicine Practice., Jennifer L Wiler, Michael Granovsky, Stephen V Cantrill, Richard Newell, Arjun K Venkatesh, Jeremiah D Schuur

Emergency Medicine Faculty Publications

In 2007, the Centers for Medicaid and Medicare Services (CMS) created a novel payment program to create incentives for physician's to focus on quality of care measures and report quality performance for the first time. Initially termed "The Physician Voluntary Reporting Program," various Congressional actions, including the Tax Relief and Health Care Act of 2006 (TRHCA) and Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) further strengthened and ensconced this program, eventually leading to the quality program termed today as the Physician Quality Reporting System (PQRS). As a result of passage of the Affordable Care Act of 2010, …

Himmelfarb Library Liaison Letter - March 2016, George Washington University, Himmelfarb Health Sciences Library

Himmelfarb Library Liaison Letters

No abstract provided.

Himmelfarb Headlines - February/March 2016, George Washington University, Himmelfarb Health Sciences Library

Himmelfarb Headlines (2009 - present)

News and information about Himmelfarb Health Sciences Library of interest to users. Includes articles on new RefWorks features, GW Research Days, and our new Metadata and Scholarly Publishing Librarian.

Optimizing Electrocardiogram Interpretation And Catheterization Laboratory Activation In St-Segment Elevation Myocardial Infarct, Alexander E. Sullivan, Mortada Shams, Marco A. Mercader, Jacob Varghese, Abudureyimu Shajidan, Bassel Hassouna, Vimala V. Jayanthi

GW Research Days 2016 - 2020

Background: To achieve the 90-minute reperfusion goal in ST-segment elevation myocardial infarction (STEMI) care, providers must diagnose STEMIs from electrocardiograms (ECGs) obtained upon emergency room arrival and appropriately activate the catheterization lab. To enhance early STEMI care, we sought to improve medical student STEMI recognition and diagnostic accuracy with a teaching module we designed and developed.

Methods: Through a literature review, we identified evidenced-based criteria for classic STEMI patterns, STEMI-equivalents with non-classic STEMI patterns including hyperacute T-waves, STEMI with existing left bundle branch block (LBBB) and Wellens’ syndrome and non-ischemic STEMI-mimics such as known LBBB, pericarditis, ventricular aneurysm, …

Circulating Mirna Biomarkers In Early Breast Cancer Detection Following Mammography, Alexa Lean, Jialu Lucy Yang, Xiaohui Tan, Christine B. Teal, Rachel F. Brem, Sidney W. Fu

GW Research Days 2016 - 2020

The currently accepted stepwise model of breast tumorigenesis assumes a gradual transition from normal breast epithelial cells to atypical ductal hyperplasia (ADH), to ductal carcinoma in situ (DCIS) and then to invasive ductal carcinoma (IDC). Percutaneous core needle biopsy (CNB) is the standard technique following an abnormal mammographic finding. However, CNB is less reliable in differentiating simple ADH (sADH) from ADH component coexisted with advanced lesions such as DCIS and/or IDC (cADH). Therefore, to identify and validate novel reliable molecular biomarkers is essential in order to improve the efficiency of therapeutic recommendations, as well as to minimize anxiety and unnecessary …

Teaching Internal Medicine Residents About Genetics: One Topic At A Time - Breast Cancer, Maria Henry, Andrew Nance, Charles Macri

GW Research Days 2016 - 2020

Background: Currently, the field of medicine is experiencing rapid changes in genetics and genomics information. While medical school curricula all include some genetics education, the content may vary from one school to another, leaving Internal Medicine (IM) residents with different skills and knowledge. In an IM residency where residents come from different medical schools, presenting an organized genetics curriculum may have value. Patients expect their physicians to be knowledgeable and current about their specific disease, including the genetic components and expect that they can inform them about terminology, inheritance, diagnostic testing, risks and benefits of testing. Physicians will need …

Spectral Changes Caused By Radiofrequency Ablation Of Cardiac Tissue, Mohammed Aljishi, Huda Asfour, Luther Swift, Narine Muselimyan, Marco A. Mercader, Narine Sarvazyan

GW Research Days 2016 - 2020

New diagnostic catheters can be developed by delivering and acquiring light through a small fiberoptic bundle. This can provide a useful real time feedback guidance to observe tissue damage caused by thermal injury used to treat cardiac arrhythmias. Yet, little is known about the exact spectral changes caused by radiofrequency ablation (RFA) in different types of cardiac tissue. We hypothesized that the most sensitive optical ranges for characterizing thermal injury can be revealed by comparing spectral information from different areas of the heart before and after RF ablation. Freshly excised porcine hearts were used to acquire and analyze excitation emission …

(Video) Income-Related Inequalities In Utilization Of Health Services Among Private Health Insurance Beneficiaries In Brazil, Heitor Werneck

GW Research Days 2016 - 2020

Brazil’s 1988 health reform created the Unified Health System (SUS). SUS is a universal health system that emulates British National Health Service, featuring an open-ended benefit package and a major goal of health equity. An unforeseen consequence of the reform was that former beneficiaries of the social health insurance sought to sustain their privileged access to health services through private health insurance. Despite achievements in expanding healthcare access and improved health outcomes, recurring opinion polls suggest that Brazilians are skeptical about SUS’ capacity to delivery timely and quality health services, making private insurance a priority to most households. The literature …

(Video) Maternal Depression And Child Externalizing Behaviors, Julia Gruspier, Shannon Shisler, Rina C. Eiden

GW Research Days 2016 - 2020

About 10.97% of women with children aged 1 to 4 years old are identified with depression. Children of mothers with depression are more likely to exhibit externalizing behavior problems, and these problems have been reported to appear more frequently in male children. We examined the association between maternal depression and externalizing behavior in toddlers, and whether child sex moderated these effects, as previous studies have shown child behavior to be linked to both child sex and maternal depression. The sample included 186 mother/child dyads (95 male children) who were recruited in the first trimester of pregnancy from an urban hospital. …

Maternal Leisure-Time Physical Activity And Risk Of Preterm Birth: A Systematic Review Of The Literature, Mira Kahn, Loretta Dipietro, Kimberly Robien

GW Research Days 2016 - 2020

Background: Preterm birth is a leading cause of infant death and regular physical activity may reduce the risk for preterm birth because of its beneficial effects on pregnancy complications such as preeclampsia, excessive weight gain, and gestational diabetes. On average, however, pregnant women report lower levels of physical activity compared with those who are not pregnant. This systematic review examined low, moderate and vigorous leisure-time physical activity (LTPA) during pregnancy and the outcome of preterm birth.

Methods: Key words related to preterm birth and physical activity were used to search relevant databases (Medline, Cochrane, CINAHL, Sports Discuss and Scopus). Studies …

Racial And Ethnic Disparities In Health Care: An Examination Of State Inpatient Databases In The Utilization Of And Outcomes Following Total Knee Arthroplasty, Alexis W. Lan, Wei Zhang, Yan Ma

GW Research Days 2016 - 2020

Title: Racial and Ethnic Disparities in Health Care: An Examination of State Inpatient Databases in the Utilization of and Outcomes following Total Knee Arthroplasty

Background: The U.S. population is becoming more racially and ethnically diverse yet disparities in health care still exist. One area of medical care in which racial disparities have been identified is total knee arthroplasty (TKA)¬—an efficacious and cost-effective treatment option for individuals with advanced arthritis of the knee. Previous studies have documented that racial and ethnic minorities tend to have higher rates of adverse health outcomes and face more barriers utilizing the procedure. However, these studies …

A Systematic Review Of Coal Fired Power Plant Proximity And Local Socioeconomic Status Trends And Outcomes, Oshane Mcrae, Peter Lapuma

GW Research Days 2016 - 2020

Among the significant sources of energy, coal based energy bears the largest share (42%) of the electricity produced in the United States. Already existing coal fired power plants are the largest emitter of carbon dioxide emissions in the United States. Among the cumulative emissions contributed by the industrial sector, significant portions are from coal fired power plants. Coal-fired power plants emit 66% of sulfur oxides, 40% of carbon dioxide, 33% of mercury and 22% of nitrogen oxides in the U.S. and are linked as risk factors to respiratory diseases, cardiovascular diseases and other ailments shown to impact environmental and human …

Pregnant Women’S Health Consequences Following Exposure To Pbdes, Alison Chiaramonte, Ami R. Zota

GW Research Days 2016 - 2020

PBDEs (Polybrominated diphenyl ethers) are chemicals introduced by industry in the 1970s to serve as flame-retardants on common consumer products like electronics, plastics, and foam in furniture. They are also suspected to disrupt thyroid activity during pregnancy, which is a time of increased demand on the thyroid gland. Maternal thyroid fluctuations and disease as a result of exposure to PBDEs are therefore a concern. This systematic review aimed to capture all of the relevant peer-reviewed literature investigating the association between PBDEs and maternal thyroid activity. Use of the PRISMA checklist (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), a best …

Predictors Of Malnutrition In Different Geographic Regions Of Peru, Elizabeth Lacroix

GW Research Days 2016 - 2020

Malnutrition is responsible for over 3 million childhood deaths each year. Those who survive early nutritional deficiencies and the subsequent growth failure face life-long consequences, including long-term deficits in cognitive development, decreased academic achievement, and reduced economic opportunities later in life. Low height for age, or stunting, indicates chronic malnutrition, while low weight for height (wasting) indicates acute malnutrition. Caloric deficiencies, micronutrient deficiencies, intestinal parasites, and diarrheal diseases all directly contribute to acute and chronic undernutrition.

Peru is an ethnically and geographically diverse country that has experienced great economic growth and dramatic health improvements in the last decade. Nationally, stunting …

Promotion Of Drinking Water Among Latino Immigrant Youth, Nicole Barrett, Allison Elkins, Uriyoan Colón-Ramos, Ivonne Rivera, W. Douglas Evans, Mark Edberg

GW Research Days 2016 - 2020

Objective: To design an innovative intervention to increase drinking water behaviors among Latino immigrant youth.

Methods: We conducted two rounds of focus groups, totaling 10 sessions (n=61), with Latino immigrant youth, aged 6-18 years, living in Langley Park, Maryland. Participants were stratified into focus groups by age group (elementary, middle, and high school) and language preference (Spanish and English). A professional, bilingual-speaking moderator used a semistructured discussion guide to examine: (1) what youth preferred to drink in different settings and why, (2) their reactions to promotional messages, (3) slogans that would entice them to drink more water in school and …

Consumption Of Low-Calorie Sweeteners In The United States 2009-12, Yichen Jin, Allison C. Sylvetsky, Jean A. Welsh, Kristina I. Rother, Sameera A Talegawkar

GW Research Days 2016 - 2020

We have previously demonstrated that low-calorie sweetener (LCS) consumption increased in the United States (US) between 1999 and 2008 (from 9% to 15 % in kids and from 27% to 32% in adults), but little is known about current consumption. We therefore analyzed National Health and Nutrition Examination Survey (NHANES) data collected in 2011-12 and compared LCS consumption patterns across socio-demographic subgroups. Dietary sources of LCS were identified using NHANES food descriptions. Prevalence of consumption nationally and by age, race, gender, socio-economic status, educational attainment, were estimated using two 24-hour dietary recalls. F-tests were used to evaluate differences in consumption …

Smoking Characteristics And Psychiatric Comorbidities Of Pregnant Smokers: An Analysis Of Quit4baby Randomized Controlled Trial, Shawn Chiang, Lorien C. Abroms, Jennifer M. Schindler-Ruwisch, Leah E. Leavitt

GW Research Days 2016 - 2020

Background: Text messaging or short message service (SMS) programs have been shown to be effective in helping adult smokers quit smoking (Abroms et al., 2014). However, to our knowledge, no prior research has examined psychiatric comorbidities associated with smoking in the text messaging context. The risk of smoking has been shown to increase as a function of the number of psychiatric illnesses with which a person is diagnosed (Aubin, Rollema, Svensson, & Winterer, 2012). The current study examined this association and other correlates of smoking-psychiatric comorbidity in a sample of U.S. pregnant smokers enrolled in Quit4Baby, a smoking cessation text …

Using Biofeedback In Hiv+ Patients, Domenique Escobar, Mikhail Kogan, Randi Abramson

GW Research Days 2016 - 2020

Background - The prevalence of HIV in Washington, DC is estimated to be at least 3%, triple what the World Health Organization defines as an epidemic. Even at that conservative estimate, the number of people living with HIV in the District of Columbia is the highest in the nation. Individuals living with HIV face stigma, anxiety, stress and depression, among a host of other physical and mental effects. Stress has a significant impact on the immune system and a biofeedback program can be of benefit to patients undergoing any stress. Biofeedback is a technique that trains people to improve their …

Clinical Public Health Integration In Medical School Curriculum: Transitioning Medical Student Training From Medical Problems To Health Solutions, Ashtin Jeney, Bridget C. Huysman, Jamie Majdi, Kent Aje, Madeline Taskier, David K. Popiel, Lawrence R. Deyton, Karla Bartholomew

GW Research Days 2016 - 2020

The current chronic disease burden, growing health disparities, and evolution of our healthcare system require that medical students be equipped with basic public health education to effectively manage patients, navigate the healthcare system, and advocate for health(1,2,3,4,5,6). The Institute of Medicine and the AAMC emphasize the need for physicians to be trained in public health(1,8). The inaugural year of the revised curriculum at The George Washington University School of Medicine and Health Sciences (GW SMHS) represented a first step at the institution to integrate clinical public health into medical education. As part of this process, the Clinical Public Health (CLiPH) …

Otolaryngology For Internal Medicine: Increasing Exposure To Otolaryngology Using Computer Assisted Instruction, Arielle Thal, Philip Zapanta

GW Research Days 2016 - 2020

It has been well identified in previous literature that there is a lack of otolaryngology teaching for general practitioners. There is not currently a standardized curriculum for otolaryngology in undergraduate medical education or during residency for those pursuing a general field such as Emergency Medicine, Internal Medicine, Pediatrics or Family Medicine. While the need for more exposure to otolaryngology within these fields has been well documented, as 25% of primary care complaints are otolaryngology related, little has been done to identify the best method for educational intervention. Important topics for inclusion in such a curriculum have been identified and methods …

Volume Averaging Of Spectral-Domain Optical Coherence Tomography Impacts Retinal Segmentation In Children, Carmelina Trimboli-Heidler, Kelly Vogt, Robert A. Avery

GW Research Days 2016 - 2020

Purpose: To determine the influence of volume averaging on retinal layer thickness measures acquired with spectral-domain optical coherence tomography (SD-OCT) in children.

Methods: Macular SD-OCT images were acquired using three different volume acquisition settings (i.e., ART 1, 3, and 9 volumes) in children enrolled in a prospective OCT study. Total retinal, retinal nerve fiber layer, ganglion cell layer, inner plexiform layer, inner nuclear layer, and outer plexiform layer thicknesses were measured around an ETDRS grid using beta version automated segmentation software for the Spectralis. The magnitude of manual segmentation required to correct the automated segmentation was classified as …

Single Nucleotide Polymorphisms In Cldn14 And Smoc1 Affecting Bone Mineral Density Influence Other Musculoskeletal Traits, Christopher Payette, Courtney Sprouse, Cara Goerlich, Heather A. Gordish-Dressman, Thomas Lynch, Heather Flynn, Leticia M. Ryan, Eric P. Hoffman, Monica J. Hubal, Paul D. Thompson, Theodore J. Angelopoulos, Paul M. Gordon, Niall M. Moyna, Linda S. Pescatello, Paul S. Visich, Robert F. Zoeller, Laura L. Tosi

GW Research Days 2016 - 2020

Background: A recent genome-wide association study (GWAS) identified novel genes influencing bone mineral density (BMD). This three stage GWAS identified two novel loci: rs227425 in the SPARC-Related Modular Calcium Binding 1 gene (SMOC1) was significantly associated with BMD and rs170183 in the claudin 14 (CLDN14) gene was significantly associated with BMD in females.

Objective: The purpose of this study was to determine if two novel single nucleotide polymorphisms (SNPs) known to affect BMD are associated with other musculoskeletal traits.

Methods/Design :The Bone Health Cohort consists of 150 African-American participants enrolled at Children’s National Health System as part of …

Medical Student Competency In Wound Care Guidelines, Sophia Akhiyat, Sean Mcnish, Kara S. Couch, Victoria K. Shanmugam

GW Research Days 2016 - 2020

Chronic wounds that have failed to heal after 3 months of appropriate wound care affect approximately 6.5 million people in the US with a prevalence of 1% and costs estimated at $25 billion per year. Medical students currently receive limited wound care training, yet to effectively manage chronic wounds, providers must both understand the biology of healing, and also remain up-to-date with wound care guidelines published by the Agency for Healthcare Research and Quality (AHRQ). The purpose of this student-led project was to investigate medical students' knowledge and comfort with wound care guidelines.

Severity Of Pain Is Not Associated With Urgency Of Diagnosis In Ed Patients With Abdominal Pain, Ryan Brunetti, Caitlin David, Lorna Richards, Melissa J. Mccarthy, Andrew C. Meltzer

GW Research Days 2016 - 2020

Background

Abdominal Pain is the most common cause of visits to US Emergency Departments (EDs) and the causes range from urgent to non-urgent diagnoses. Distinguishing urgent versus non-urgent causes of abdominal pain is done through the use of clinical exam, lab studies and diagnostic imaging such as CT scans. There are no validated clinical decision rules to assist physicians in discriminating urgent from non-urgent causes of abdominal pain or which patient needs a CT scan. There is controversy regarding the use of CT scans for patients with abdominal pain due to the increased cost, radiation exposure and length of stay. …