Medicine and Health Sciences Commons^™

Can Including Time Delay In Epidemic Models Significantly Improve Predictions Concerning Intervention Strategies?, Adrienna N. Bingham, Leah Shaw

Biology and Medicine Through Mathematics Conference

No abstract provided.

Low Energy Defibrillation By Synchronization; 90 % Less Energy Compared To One Shock., Flavio H. Fenton, Yanyan Ji, Ilija Uzelac, Niels Otani, Elizabeth M. Cherry

Biology and Medicine Through Mathematics Conference

No abstract provided.

A Topological Analysis Of Targeted In-111 Up- Take In Spect Images Of Murine Tumors., David Damiano

Biology and Medicine Through Mathematics Conference

No abstract provided.

Needle In The Haystack: Combining Intravital Imaging And Mathematical Modeling To Understand How Vaccine-Induced T Cells Find Malaria-Infected Cells In Murine Livers, Vitaly V. Ganusov, Ian Cockburn, Reka Kelemen

Biology and Medicine Through Mathematics Conference

No abstract provided.

Mathematical Analysis And Simulations Involving Chemotherapy And Surgery On Large Human Tumours Under A Suitable Cell-Kill Functional Response, Diego S. Rodrigues

Biology and Medicine Through Mathematics Conference

No abstract provided.

General Models For Ecological Drivers Of Poverty, Calistus Ngeh Ngonghala

Biology and Medicine Through Mathematics Conference

No abstract provided.

The Association Between Sleep Problems, Sleep Medication Use, And Falls In Community-Dwelling Older Adults: Results From The Health And Retirement Study 2010, Yaena Min, Pramit A. Nadpara, Patricia W. Slattum

Pharmacotherapy and Outcomes Science Publications

Background. Very few studies have assessed the impact of poor sleep and sleep medication use on the risk of falls among community-dwelling older adults. The objective of this study was to evaluate the association between sleep problems, sleep medication use, and falls in community-dwelling older adults. Methods. The study population comprised a nationally representative sample of noninstitutionalized older adults participating in the 2010 Health and Retirement Study. Proportion of adults reporting sleep problems, sleep medication use, and fall was calculated. Multiple logistic regression models were constructed to examine the impact of sleep problems and sleep medication use on …

Promoting Cognitive Support Technology Use And Employment Success Among Postsecondary Students With Traumatic Brain Injuries, Phillip Rumrill, Eileen Elias, Deborah J. Hendricks, Karen Jacobs, Anne Leopold, Amanda Nardone, Elaine Sampson, Marcia Scherer, Callista Stauffer, Brian T. Mcmahon

Physical Medicine and Rehabilitation Publications

OBJECTIVE: This article applies positive psychology principles to the purpose and objectives of a five-year, federally-funded initiative to provide cognitive support technology (CST) training and career preparatory services for undergraduate college students with mild and moderate traumatic brain injuries (TBI).

METHODS: A total of 48 students with TBI have participated in the project during its first 18 months of operation - 14 of whom are military veterans with disabilities who were in the Iraq and/or Afghanistan theaters.

CONCLUSION: Positive psychology interventions such as Best Possible Self, Intensely Positive Experiences, and Asset-based Assessments provide a framework for examining the activities of …

Major Depression As A Complex Dynamic System, Angélique O. J. Cramer, Claudia D. Van Borkulo, Erik J. Giltay, Han L. J. Van Der Maas, Kenneth S. Kendler, Marten Scheffer, Denny Borsboom

Psychiatry Publications

In this paper, we characterize major depression (MD) as a complex dynamic system in which symptoms (e.g., insomnia and fatigue) are directly connected to one another in a network structure. We hypothesize that individuals can be characterized by their own network with unique architecture and resulting dynamics. With respect to architecture, we show that individuals vulnerable to developing MD are those with strong connections between symptoms: e.g., only one night of poor sleep suffices to make a particular person feel tired. Such vulnerable networks, when pushed by forces external to the system such as stress, are more likely to end …

Sex Differences In Hiv Effects On Visual Memory Among Substance-Dependent Individuals, Michael K. Keutmann, Raul Gonzalez, Pauline M. Maki, Leah H. Rubin, Jasmin Vassileva, Eileen M. Martin

Psychiatry Publications

HIV’s effects on episodic memory have not been compared systematically between male and female substance-dependent individuals. We administered the Brief Visuospatial Memory Test–Revised (BVMT–R) to 280 substance-dependent HIV+ and HIV– men and women. Groups were comparable on demographic, substance use, and comorbid characteristics. There were no significant main effects of sex or HIV serostatus on BVMT–R performance, but HIV+ women performed significantly more poorly on delayed recall. This effect was most prominent among cocaine-dependent HIV+ women. Our findings are consistent with recent speculation that memory impairment may be more common among HIV+ women, particularly those with a history of cocaine …

Metabolism And Metabolic Inhibition Of Xanthotoxol In Human Liver Microsomes, Zhongnv Ma, Xianbao Shi, Gang Zhang, Feng Guo, Lina Shan, Jiqun Cai

Medicinal Chemistry Publications

Cytochrome p450 (CYP450) enzymes are predominantly involved in Phase I metabolism of xenobiotics. In this study, the CYP450 isoforms involved in xanthotoxol metabolism were identified using recombinant CYP450s. In addition, the inhibitory effects of xanthotoxol on eight CYP450 isoforms and its pharmacokinetic parameters were determined using human liver microsomes. CYP1A2, one of CYP450s, played a key role in the metabolism of xanthotoxol compared to other CYP450s. Xanthotoxol showed stronger inhibition on CYP3A4 and CYP1A2 compared to other isoenzymes with the IC50 of 7.43 μM for CYP3A4 and 27.82 μM for CYP1A2. The values of inhibition kinetic parameters (Ki) were 21.15 …

Repeated Low-Dose Organophosphate Dfp Exposure Leads To The Development Of Depression And Cognitive Impairment In A Rat Model Of Gulf War Illness, Laxmikant Deshpande, Kristin Phillips

Neurology Publications

Approximately 175,000 to 250,000 of the returning veterans from the 1991 Persian Gulf War exhibit chronic multi-symptom illnesses that includes neurologic co-morbidities such as depression, anxiety and cognitive impairments. Amongst a host of causative factors, exposure to low levels of the nerve agent Sarin has been strongly implicated for expression of Gulf War Illness (GWI). Nerve agents similar to pesticides are organophosphate (OP) compounds. There is evidence from civilian population that exposure to OPs such as in agricultural workers and nerve agents such as the survivors and first-responders of the Tokyo subway Sarin gas attack suffer from chronic neurological problems …

Cryptosporidium Priming Is More Effective Than Vaccine For Protection Against Cryptosporidiosis In A Murine Protein Malnutrition Model, Luther A. Bartelt, David T. Bolick, Glynis L. Kolling, James K. Roche, Edna I. Zaenker, Ana M. Lara, Francisco Jose Noronha, Carrie A. Cowardin, John H. Moore, Jerrold R. Turner, Cirle A. Warren, Gregory A. Buck, Richard L. Guerrant

Biochemistry and Molecular Biology Publications

Cryptosporidium is a major cause of severe diarrhea, especially in malnourished children. Using a murine model of C. parvum oocyst challenge that recapitulates clinical features of severe cryptosporidiosis during malnutrition, we interrogated the effect of protein malnutrition (PM) on primary and secondary responses to C. parvum challenge, and tested the differential ability of mucosal priming strategies to overcome the PM-induced susceptibility. We determined that while PM fundamentally alters systemic and mucosal primary immune responses to Cryptosporidium, priming with C. parvum (106 oocysts) provides robust protective immunity against re-challenge despite ongoing PM. C. parvum priming restores mucosal Th1-type effectors (CD3+CD8+CD103+ T-cells) …

Constitutive Association Of Tie1 And Tie2 With Endothelial Integrins Is Functionally Modulated By Angiopoietin-1 And Fibronectin, Annamarie C. Dalton, Tomer Shlamkovitch, Niv Papo, William A. Barton

Biochemistry and Molecular Biology Publications

Functional cross-talk between Tie2 and Integrin signaling pathways is essential to coordinate endothelial cell adhesion and migration in response to the extracellular matrix, yet the mechanisms behind this phenomenon are unclear. Here, we examine the possibility that receptor cross-talk is driven through uncharacterized Tie-integrin interactions on the endothelial surface. Using a live cell FRET-based proximity assay, we monitor Tie-integrin receptor recognition and demonstrate that both Tie1 and Tie2 readily associate with integrins α5ß1 and αVß3 through their respective ectodomains. Although not required, Tie2-integrin association is significantly enhanced in the presence of the extracellular component and integrin ligand fibronectin. In vitro …

Midterm Follow Up For Knee Replacement: How Well Do We Follow Our Patients?, Micah Mabe, William Jiranek Md, Gregory Golladay Md

MD Student Summer Research Fellowship Program Posters

The lost to follow up rate specifically for five year post surgical UKAs is significantly higher for this population subset than the most recent published average as seen in a meta analysis review (Callahan et al. 1995). Follow up visits allow for proper assessment of complications such as wear and osteolysis which need early intervention to improve long-term outcomes and reduce the overall cost of care (Bhandari et al. 2012). Eleven patients, 27.5% of those that were lost to follow up, were without a correct or working phone number, which presents a significant barrier to care. Maintaining updated patient contact …

Impact Of Morbid Obesity On Left Ventricular Assist Device Support And Heart Transplantation, Sophia Cohen, Daniel Tang Md

MD Student Summer Research Fellowship Program Posters

Morbidly obese patients requiring LVAD support encounter higher postoperative complications and wait longer for heart transplantation, however heart transplant and graft survival is comparable. Our study suggests that carefully selected morbidly obese patients should undergo LVAD placement and heart transplantation. However, our study was limited by a very small sample size and by the biases inherent to a retrospective data analysis.

Barriers, Perceptions And Compliance: Hand Hygiene In The Operating Room & Endoscopy Suite, Laura Pederson Bs, Gonzalo Bearman Md Mph Facp, Michael Stevens Md Mph

MD Student Summer Research Fellowship Program Posters

Despite poor observed HH compliance, the majority of OR and EPR respondents are aware of HH policies and the benefits in reducing HAIs There is adequate access to foam in the OR/EPR and it is physically tolerated Although HH practices are encouraged in both areas, OR/EPR managers poorly role model HH OR nurses are empowered HH advocates, knowledgeable of the benefits of HH and may serve as change agents to improve HH compliance Hospitals promoting HH in the OR/EPR should: Be knowledgeable of perceptions and barriers across services Increase the awareness/education of HH to all providers Empower employees to address …

Hypertension Comorbidity Exacerbates Cardiotoxicity Of Anti-Cancer Drugs: Evidences And Promising Novel Therapeutic Strategies, Robin K. Kuriakose, Rakesh Kukreja, Lei Xi

MD Student Summer Research Fellowship Program Posters

No abstract provided.

Underuse And Potential Detrimental Effect Of Radiotherapy In The Management Of Ureteral Cancer, Reza Nabavizadeh, Mashya Abbassi, Emma C. Fields Md

MD Student Summer Research Fellowship Program Posters

Ureteral cancer is extremely rare, with only 3530 cases predicted in 2016. Therefore, published studies on ureteral cancers are limited to single-institution retrospective studies, which have not elucidated a clear recommendation on the best treatment modality. Large cancer databases such as the Surveillance, Epidemiology, and End Results program (SEER) are ideal for providing data for these rare cancers. Epidemiological studies using the SEER database with large sample sizes (13,800) found rising incidence of ureteral cancer over the past 30 years with worsened outcomes in older patients, males, and patients with regional/distant spread. However, to date, these studies have not used …

Can Plan Recommendations Improve The Coverage Decisions Of Vulnerable Populations In Health Insurance Marketplaces?, Andrew J. Barnes, Yaniv Hanoch, Thomas Rice

Health Administration Publications

Objective

The Affordable Care Act’s marketplaces present an important opportunity for expanding coverage but consumers face enormous challenges in navigating through enrollment and re-enrollment. We tested the effectiveness of a behaviorally informed policy tool—plan recommendations—in improving marketplace decisions.

Study Setting

Data were gathered from a community sample of 656 lower-income, minority, rural residents of Virginia.

Study Design

We conducted an incentive-compatible, computer-based experiment using a hypothetical marketplace like the one consumers face in the federally-facilitated marketplaces, and examined their decision quality. Participants were randomly assigned to a control condition or three types of plan recommendations: social normative, physician, and government. …

Accountable Care Organizations And Transaction Cost Economics, Stephen S. Farnsworth Mick, Patrick D. Shay

Health Administration Publications

Using a Transaction Cost Economics (TCE) approach, this paper explores which organizational forms Accountable Care Organizations (ACOs) may take. A critical question about form is the amount of vertical integration that an ACO may have, a topic central to TCE. We posit that contextual factors outside and inside an ACO will produce variable transaction costs (the non-production costs of care) such that the decision to integrate vertically will derive from a comparison of these external versus internal costs, assuming reasonably rational management abilities. External costs include those arising from environmental uncertainty and complexity, small numbers bargaining, asset specificity, frequency of …

Time-Course Analysis Of Brain Regional Expression Network Responses To Chronic Intermittent Ethanol And Withdrawal: Implications For Mechanisms Underlying Excessive Ethanol Consumption, Maren L. Smith, Marcelo F. Lopez, Kellie Archer, Aaron R. Wolen, Howard C. Becker, Michael F. Miles

Pharmacology and Toxicology Publications

Long lasting abusive consumption, dependence, and withdrawal are characteristic features of alcohol use disorders (AUD). Mechanistically, persistent changes in gene expression are hypothesized to contribute to brain adaptations leading to ethanol toxicity and AUD. We employed repeated chronic intermittent ethanol (CIE) exposure by vapor chamber as a mouse model to simulate the cycles of ethanol exposure and withdrawal commonly seen with AUD. This model has been shown to induce progressive ethanol consumption in rodents. Brain CIE-responsive expression networks were identified by microarray analysis across five regions of the mesolimbic dopamine system and extended amygdala with tissue harvested from 0-hours to …

Decreased Interleukin-4 Release From The Neurons Of The Locus Coeruleus In Response To Immobilization Stress, Hyun-Ju Lee, Hyun-Jung Park, Angela Starkweather, Kyungeh An, Insop Shim

School of Nursing Publications

It has been demonstrated that immobilization (IMO) stress affects neuroimmune systems followed by alterations of physiology and behavior. Interleukin-4 (IL-4), an anti-inflammatory cytokine, is known to regulate inflammation caused by immune challenge but the effect of IMO on modulation of IL-4 expression in the brain has not been assessed yet. Here, it was demonstrated that IL-4 was produced by noradrenergic neurons in the locus coeruleus (LC) of the brain and release of IL-4 was reduced in response to IMO. It was observed that IMO groups were more anxious than nontreated groups. Acute IMO (2 h/day, once) stimulated secretion of plasma …

Wses Classification And Guidelines For Liver Trauma, Federico Coccolini, Fausto Catena, Ernest E. Moore, Rao Ivatury, Walter Biffl, Andrew Peitzman, Raul Coimbra, Sandro Rizoli, Yoram Kluger, Fikri M. Abu-Zidan, Marco Ceresoli, Giulia Montori, Massimo Sartelli, Dieter Weber, Gustavo Fraga, Noel Naidoo, Frederick A. Moore, Nicola Zanini, Luca Ansaloni

Surgery Publications

The severity of liver injuries has been universally classified according to the American Association for the Surgery of Trauma (AAST) grading scale. In determining the optimal treatment strategy, however, the haemodynamic status and associated injuries should be considered. Thus the management of liver trauma is ultimately based on the anatomy of the injury and the physiology of the patient. This paper presents the World Society of Emergency Surgery (WSES) classification of liver trauma and the management Guidelines.

Wses Guidelines For The Management Of Acute Left Sided Colonic Diverticulitis In The Emergency Setting, Massimo Sartelli, Fausto Catena, Luca Ansaloni, Federico Coccolini, Ewen A. Griffiths, Fikri M. Abu-Zidan, Salomone Di Saverio, Jan Ulrych, Yoram Kluger, Ofir Ben-Ishay, Frederick A. Moore, Rao R. Ivatury, Raul Coimbra, Andrew B. Peitzman, Ari Leppaniemi, Gustavo P. Fraga, Ronald V. Maier, Osvaldo Chiara, Jeffry Kashuk, Boris Sakakushev, Dieter G. Weber, Rifat Latifi, Walter Biffl, Miklosh Bala, Aleksandar Karamarkovic, Kenji Inaba, Carlos A. Ordonez, Andreas Hecker, Goran Augustin, Zaza Demetrashvili, Renato Bessa Melo, Sanjay Marwah, Sanoop K. Zachariah, Vishal G. Shelat, Michael Mcfarlane, Miran Rems, Carlos Augusto Gomes, Mario Paulo Faro, Gerson Alves Pereira Júnior, Ionut Negoi, Yunfeng Cui, Norio Sato, Andras Vereczkei, Giovanni Bellanova, Arianna Birindelli, Isidoro Di Carlo, Kenneth Y. Kok, Mahir Gachabayov, Georgios Gkiokas, Konstantinos Bouliaris, Elif Çolak, Arda Isik, Daniel Rios-Cruz, Rodolfo Soto, Ernest E. Moore

Surgery Publications

Acute left sided colonic diverticulitis is one of the most common clinical conditions encountered by surgeons in acute setting. A World Society of Emergency Surgery (WSES) Consensus Conference on acute diverticulitis was held during the 3rd World Congress of the WSES in Jerusalem, Israel, on July 7th, 2015. During this consensus conference the guidelines for the management of acute left sided colonic diverticulitis in the emergency setting were presented and discussed. This document represents the executive summary of the final guidelines approved by the consensus conference.

Wses Jerusalem Guidelines For Diagnosis And Treatment Of Acute Appendicitis, Salomone Di Saverio, Arianna Birindelli, Micheal D. Kelly, Fausto Catena, Dieter G. Weber, Massimo Sartelli, Michael Sugrue, Mark De Moya, Carlos Augusto Gomes, Aneel Bhangu, Ferdinando Agresta, Ernest E. Moore, Kjetil Soreide, Ewen Griffiths, Steve De Castro, Jeffry Kashuk, Yoram Kluger, Ari Leppaniemi, Luca Ansaloni, Manne Andersson, Federico Coccolini, Raul Coimbra, Kurinchi S. Gurusamy, Fabio Cesare Campanile, Walter Biffl, Osvaldo Chiara, Fred Moore, Andrew B. Peitzman, Gustavo P. Fraga, David Costa, Ronald V. Maier, Sandro Rizoli, Zsolt J. Balogh, Cino Bendinelli, Roberto Cirocchi, Valeria Tonini, Alice Piccinini, Gregorio Tugnoli, Elio Jovine, Roberto Persiani, Antonio Biondi, Thomas Scalea, Philip Stahel, Rao Ivatury, George Velmahos, Roland Andersson

Surgery Publications

Acute appendicitis (AA) is among the most common cause of acute abdominal pain. Diagnosis of AA is challenging; a variable combination of clinical signs and symptoms has been used together with laboratory findings in several scoring systems proposed for suggesting the probability of AA and the possible subsequent management pathway. The role of imaging in the diagnosis of AA is still debated, with variable use of US, CT and MRI in different settings worldwide. Up to date, comprehensive clinical guidelines for diagnosis and management of AA have never been issued. In July 2015, during the 3rd World Congress of the …

Role Of Tissue And Systemic Hypoxia In Obesity And Type 2 Diabetes, Lei Xi, Chin-Moi Chow, Xingxing Kong

Internal Medicine Publications

Human lifestyle in most modern and developing societies has dramatically changed over past decades. Physical inactivity along with unrestricted access to calorie dense foods has established an “obesogenic” environment and contributed to a serious epidemic of obesity and type 2 diabetes (T2D), associated with increased morbidity and mortality. In 2005 a population-based study conducted by Reichmuth et al. of University of Wisconsin with a cross-sectional and longitudinal analysis identified that among 1387 participants the odds ratio for T2D with an apnea-hypopnea index (AHI) > 15 versus an AHI < 5 was 2.30 (1.28–4.11; p < 0.01) after adjustment for age, sex, and body habitus. Therefore it has been assumed that intermittent hypoxic periods associated with obstructive sleep apnea (OSA) may play a pathogenic role in inducing insulin resistance and T2D. At organ/tissue levels, in 2007–2009 Ye and colleagues first proposed a central role played by adipose tissue hypoxia resulting from adipocyte expansion in promoting chronic inflammation, adiponectin reduction, adipocyte dysfunction, and death in obese individuals. This group of researchers later identified the mediator roles played by hypoxia inducible factor 1α (HIF-1α) and other hypoxia-triggered signaling mechanisms that may promote free fatty acid release and inhibit glucose uptake in adipocytes by inhibition of the insulin-signaling pathway and induction of cell death.

Development And Pilot Of A Checklist For Management Of Acute Liver Failure In The Intensive Care Unit, Oren K. Fix, Iris Liou, Constantine J. Karvellas, Daniel R. Ganger, Kinberly A. Forde, Ram M. Subramanian, Alice Boylan, James Hanje, R. Todd Stravitz, William M. Lee, Acute Liver Failure Study Group

Internal Medicine Publications

Introduction

Acute liver failure (ALF) is an ideal condition for use of a checklist. Our aims were to develop a checklist for the management of ALF in the intensive care unit (ICU) and assess the usability of the checklist among multiple providers.

Methods

The initial checklist was developed from published guidelines and expert opinion. The checklist underwent pilot testing at 11 academic liver transplant centers in the US and Canada. An anonymous, written survey was used to assess the usability and quality of the checklist. Written comments were used to improve the checklist following the pilot testing period.

Results

We …

Intravenous Vitamin C Administered As Adjunctive Therapy For Recurrent Acute Respiratory Distress Syndrome, Amit Bharara, Catherine Grossman, Daniel Grinnan, Aamer Syed, Bernard Fisher, Christine Dewilde, Ramesh Natarajan, Alpha A. (Berry) Fowler

Internal Medicine Publications

This case report summarizes the first use of intravenous vitamin C employed as an adjunctive interventional agent in the therapy of recurrent acute respiratory distress syndrome (ARDS). The two episodes of ARDS occurred in a young female patient with Cronkhite-Canada syndrome, a rare, sporadically occurring, noninherited disorder that is characterized by extensive gastrointestinal polyposis and malabsorption. Prior to the episodes of sepsis, the patient was receiving nutrition via chronic hyperalimentation administered through a long-standing central venous catheter. The patient became recurrently septic with Gram positive cocci which led to two instances of ARDS. This report describes the broad-based general critical …

Regulation Of Reactive Oxygen Species And The Antioxidant Protein Dj-1 In Mastocytosis, Do-Kyun Kim, Michael A. Beaven, Joseph M. Kulinski, Avanti Desai, Geethani Bandara, Yun Bai, Calman Prussin, Lawrence B. Schwartz, Hirsh Komarow, Dean D. Metcalfe, Ana Olivera

Internal Medicine Publications

Neoplastic accumulation of mast cells in systemic mastocytosis (SM) associates with activating mutations in the receptor tyrosine kinase KIT. Constitutive activation of tyrosine kinase oncogenes has been linked to imbalances in oxidant/antioxidant mechanisms in other myeloproliferative disorders. However, the impact of KIT mutations on the redox status in SM and the potential therapeutic implications are not well understood. Here, we examined the regulation of reactive oxygen species (ROS) and of the antioxidant protein DJ-1 (PARK-7), which increases with cancer progression and acts to lessen oxidative damage to malignant cells, in relationship with SM severity. ROS levels were increased in both …