Medicine and Health Sciences Commons^™

Discerning Suicide In Drug Intoxication Deaths: Paucity And Primacy Of Suicide Notes And Psychiatric History, Ian Rh Rockett, Eric D. Caine, Hilary S. Connery, Gail D'Onofrio, David J. Gunnell, Ted R. Miller, Kurt B. Nolte, Mark S. Kaplan, Nestor D. Kapusta, Christa L. Lilly, Lewis S. Nelson, Sandra L. Putnam, Steven Stack, Peeter Varnik, Lynne R. Webster, Haomiao Jia

Faculty & Staff Scholarship

Objective

A paucity of corroborative psychological and psychiatric evidence may be inhibiting detec- tion of drug intoxication suicides in the United States. We evaluated the relative importance of suicide notes and psychiatric history in the classification of suicide by drug intoxication versus firearm (gunshot wound) plus hanging/suffocation—the other two major, but overtly violent methods.

Methods

This observational multilevel (individual/county), multivariable study employed a general- ized linear mixed model (GLMM) to analyze pooled suicides and undetermined intent deaths, as possible suicides, among the population aged 15 years and older in the 17 states participating in the National Violent Death Reporting System …

Palatine Tonsil Stenting Of The Airway As Determined By Drug-Induced Sleep Endoscopy, Habib G. Zalzal, Steven Coutras

Faculty & Staff Scholarship

Objective. To demonstrate lateral pharyngeal wall collapse and increased apnea-hypopnea index in a child posttonsillectomy. Background. Some children have worsening of their sleep symptoms after tonsillectomy for obstructive sleep apnea. This case report demonstrates an open airway on drug-induced sleep endoscopy (DISE) in a child with tonsillar hypertrophy followed by more pronounced airway obstruction related to lateral pharyngeal wall collapse after tonsillectomy. Case Presentation. A 7-year- old boy presented with obstructive sleep apnea and underwent workup with DISE. Following adenotonsillectomy and subsequent lingual tonsillectomy with epiglottopexy, the patient’s sleep apnea symptoms and polysomnogram results worsened. Subsequent DISE showed a more …

Ex Vivo Evaluation Of Secretion-Clearing Device In Reducing Airway Resistance Within Endotracheal Tubes, Christopher Waters, R. Constance Wiener, Hamed M. Motlagh

Faculty & Staff Scholarship

Background. Secretions accumulate in endotracheal tubes’ (ETT) lumens upon their placement in patients. The secretions impact airway resistance and pressure. Secretions potentiate prolonged mechanical ventilation and ventilator-associated pneumonia. Our primary objective in this study was to evaluate an ETT-clearing device (ETT-CD) in its ability to remove secretions from ex vivo ETT lumens. Methods. Forty ETTs, obtained from intensive care patients at extubation, were individually placed into a ventilator field performance testing simulator at 37°C. The pressure drop through the ETTs was measured at a flow rate of 60 L/min before and after cleaning with the ETT-CD and compared with unused, …

Hcn2 Channels In The Ventral Tegmental Area Regulate Behavioral Responses To Chronic Stress, Peng Zhong, Casey R. Vickstrom, Xiaojie Liu, Ying Hu, Laikang Yu, Han-Gang Yu, Qing-Song Liu

Faculty & Staff Scholarship

Dopamine neurons in the ventral tegmental area (VTA) are powerful regulators of depression-related behavior. Dopamine neuron activity is altered in chronic stress-based models of depression, but the underlying mechanisms remain incompletely understood. Here, we show that mice subject to chronic mild unpredictable stress (CMS) exhibit anxiety- and depressive-like behavior, which was associated with decreased VTA dopamine neuron firing in vivo and ex vivo. Dopamine neuron firing is governed by voltage-gated ion channels, in particular hyperpolarization- activated cyclic nucleotide-gated (HCN) channels. Following CMS, HCN-mediated currents were decreased in nucleus accumbens-projecting VTA dopamine neurons. Furthermore, shRNA-mediated HCN2 knockdown in the VTA was …

Breast Cancer Development In A Transgender Male Receiving Testosterone Therapy, Nadia Barghouthi, Jennifer Turner, Jessica Perini

Faculty & Staff Scholarship

Context. To describe a case of invasive ductal carcinoma of the breast in a transgender male receiving testosterone therapy for gender-affirming treatment. Case Description. A 28-year-old transgender male receiving intramuscular testosterone was found to have a breast mass on ultrasound after self-exam revealed a palpable breast lump. Ultrasound-guided breast biopsy revealed estrogen receptor/progesterone receptor (ER/PR) negative, human epidermal growth factor receptor-2 (HER-2) positive, invasive ductal carcinoma of the left breast. He underwent neoadjuvant and adjuvant chemotherapy along with bilateral mastectomy. At patient request, his testosterone injections were permanently discontinued. Conclusion. Fewer than 20 cases of breast cancer in transgender male …

Prior Exposure To Corticosterone Markedly Enhances And Prolongs The Neuroinflammatory Response To Systemic Challenge With Lps, Kimberly A. Kelly, Lindsay T. Michalovicz, Julie V. Miller, Vincent Castranova, Diane B. Miller, James P. O'Callaghan

Faculty & Staff Scholarship

Systemic exposure to the inflammagen and bacterial endotoxin lipopolysaccharide (LPS) has been widely used to evaluate inflammation and sickness behavior. While many inflam- matory conditions occur in the periphery, it is well established that peripheral inflammation can affect the brain. Neuroinflammation, the elaboration of proinflammatory mediators in the CNS, commonly is associated with behavioral symptoms (e.g., lethargy, anhedonia, anorexia, depression, etc.) termed sickness behavior. Stressors have been shown to inter- act with and alter neuroinflammatory responses and associated behaviors. Here, we exam- ined the effects of the stress hormone, corticosterone (CORT), as a stressor mimic, on neuroinflammation induced with a …

Masculine Traits And Depressive Symptoms In Older And Younger Men And Women, Elizabeth C. Price, Jeffrey J. Gregg, Merideth D. Smith, Amy Fiske

Faculty & Staff Scholarship

Evidence suggests that men who strongly endorse masculine traits display an atypical presentation of depression, including more externalizing symptoms (e.g., anger or substance use), but fewer typical, internalizing symptoms (e.g., depressed mood or crying). This phenomenon has not been adequately explored in older adults or women. The current study used the externalizing subscale of the Masculine Depression Scale in older and younger men and women to detect atypical symptoms. It was predicted that individuals who more strongly endorsed masculine traits would have higher scores on the measure of externalizing symptoms relative to a measure of typical depressive symptoms Center for …

Cost Effect Of Surgeon And Patient Discretion In Regard To Cataract Surgery, Tyler D. Oostra, Thomas F. Mauger

Faculty & Staff Scholarship

Purpose: The purpose of this study is to examine the cost effect of surgeon and patient discretion in regard to cataract surgery and how this affects population health care costs. Methods: A model of cataract progression was created from preexisting published data and combined with mortality data and Medicare cataract statistics to estimate the effect of mortality on decreasing the rate of cataract surgery if surgery was delayed until any cataract progression occurred.

Results: Five-year cataract progression rates were determined for a given patient age, sex, and type of cataract. Combined with 5-year death rates, delaying surgery until progression occurred …

Anomalous Origin Of A Right Coronary Artery From Pulmonary Artery, Muhammad Shabbir Rawala, S. Tahira Shah Naqvi, Kinaan Farhan, Muhammad Yasin, Syed Bilal Rizvi

Faculty & Staff Scholarship

Congenital defects of the coronary arteries are noted in 0.2–1.4% of the general population. The first case of an anomalous origin of right coronary artery from pulmonary artery (ARCAPA) was described by Brooks in 1885. ARCAPA has an overall incidence of 0.002% in the general population. Most of the cases are asymptomatic; however, it can lead to serious complications such as heart failure, ischemia, and sudden death. A 57-year-old man presented to the cardiologist’s office with complaints of shortness of breath and fatigue. The patient also had a previous history of coronary stents and heart failure. Initially, he was evaluated …

Perfluoroalkyl Substances And Kidney Function In Chronic Kidney Disease, Anemia, And Diabetes, Baqiyyah N. Conway, Ashley N. Badders, Tina Costacou, John M. Arthur, Kim E. Innes

Faculty & Staff Scholarship

Background: Anemia often complicates chronic kidney disease (CKD), leading to insufficient tissue oxygenation and hypoxic injury, the factor thought to underlie progression from CKD to renal failure. Perfluorocarbons are potent oxygen transporters used in organ preservation and synthetic blood development. Data are scarce on their relationship with kidney function, especially in diabetes where anemia and hypoxia are more prevalent. We investigated the relationship of perfluoroalkyl acids (PFAS) with kidney function and variation by diabetes and anemia status.

Methods: Data on 53,650 adults (5,210 with diabetes) were obtained from the C8 Health Project. CKD was defined as an estimated glomerular filtration …

Vegetarian Diet And Cardiometabolic Risk Among Asian Indians In The United States, Ranjita Misra, Padmini Balagopal, Sudha Raj, Thakor G. Patel

Faculty & Staff Scholarship

Research studies have shown that plant-based diets confer cardiovascular and metabolic health benefits. Asian Indians (AIs) in the US (who have often followed plant-based diets) have elevated risk for chronic diseases such as diabetes, metabolic syndrome, and obesity suggesting ethnic vulnerability that imply genetic and/or lifestyle causative links. This study explored the association between this ethnic group and diabetes, obesity, and metabolic syndrome after controlling for demographics, acculturation, family history of diabetes, and lifestyle and clinical risk factors. The sample comprised of 1038 randomly selected adult AIs in seven US sites. Prevalence and metabolic syndrome was estimated, and obesity was …

Hepatology Mentorship: A Bold Idea, Christina C. Lindenmeyer, Elizabeth May

Faculty & Staff Scholarship

No abstract provided.

Assessment Of Pain-Related Fear In Individuals With Chronic Painful Conditions, Manasi M. Mittinty, Daniel W. Mcneil, David S. Brennan, Cameron L. Randall, Murthy N. Mittinty, Lisa Jamieson

Faculty & Staff Scholarship

Background: Heightened fear and anxiety related to pain may result in emotional and behavioral avoidance responses causing disability, distress, and depression. Fear and anxiety associated with pain can potentially change the course of the pain experience. It is plausible that fear and anxiety related to pain affect the duration and frequency of pain experienced by the patient. Aim: The study aimed to examine the applicability of the Fear of Pain Questionnaire-III (FPQ-III) in identifying who are likely to report longer duration and greater frequency of pain experience. Methods: To test this hypothesis, a cross-sectional study was conducted with 579 individuals …

First Uses Of Haart 300 Rings For Aortic Valve Repair In Poland – 4 Case Studies, Jacek H. Juscinski, Andrzej Koprowski, Magdalena Kotackowska, Maciej M. Kowalik, Jan A. Rogowski, James S. Rankin

Faculty & Staff Scholarship

Introduction: Aortic valve reconstructions using geometric an- nuloplasty rings HAART 300/200 open new era in aortic valve surgery. The HAART technology resizes, reshapes, stabilizes and simplifies aortic valve repair. The HAART aortic repair rings are designed to be implanted directly into aortic annulus (un- der aortic valve leaflets).

Aim: We present first in Poland 4 cases of aortic valve recon- structions using geometric annuloplasty rings HAART 300. Material and methods: Two patients had type IA aortic insuf- ficiency (due to El-Khoury classification) – they were treated by HAART 300 ring insertion and ascending aorta prosthesis implantation. Third patient, Marfan with …

Qualitative Case Study Of Needle Exchange Programs In The Central Appalachian Region Of The United States, Stephen M. Davis, Danielle Davidov, Alfgeir L. Kristjansson, Keith Zullig, Adam Baus, Melanie Fisher

Faculty & Staff Scholarship

Background

The Central Appalachian region of the United States is in the midst of a hepatitis C virus epi- demic driven by injection of opioids, particularly heroin, with contaminated syringes. In response to this epidemic, several needle exchange programs (NEP) have opened to pro- vide clean needles and other supplies and services to people who inject drugs (PWID). How- ever, no studies have investigated the barriers and facilitators to implementing, operating, and expanding NEPs in less populous areas of the United States.

Methods

This qualitative case study consisted of interviews with program directors, police chiefs, law enforcement members, and PWID …

Cone Phosphodiesterase-6Γ’ Subunit Augments Cone Pde6 Holoenzyme Assembly And Stability In A Mouse Model Lacking Both Rod And Cone Pde6 Catalytic Subunits, Wen-Tao Deng, Saravanan Kolandaivelu, Astra Dinculescu, Jie Li, Ping Zhu, Vince A. Chiodo, Visvanathan Ramamurthy, William W. Hauswirth

Faculty & Staff Scholarship

Rod and cone phosphodiesterase 6 (PDE6) are key effector enzymes of the vertebrate phototransduction pathway. Rod PDE6 consists of two catalytic subunits PDE6α and PDE6β and two identical inhibitory PDE6γ subunits, while cone PDE6 is composed of two identical PDE6α’ catalytic subunits and two identical cone-specific PDE6γ’ inhibitory subunits. Despite their prominent function in regulating cGMP levels and therefore rod and cone light response properties, it is not known how each subunit contributes to the functional differences between rods and cones. In this study, we generated an rd10/cpfl1 mouse model lacking rod PDE6β and cone PDE6α’ subunits. Both rod and …

Sphingomyelin And Gm1 Influence Huntingtin Binding To, Disruption Of, And Aggregation On Lipid Membranes, Maxmore Chaibva, Xiang Gao, Pranav Jain, Warren A. Campbell, Shelli L. Frey, Justin Legleiter

Faculty & Staff Scholarship

Huntington disease (HD) is an inherited neurodegenerative disease caused by the expansion beyond a critical threshold of a polyglutamine (polyQ) tract near the N- terminus of the huntingtin (htt) protein. Expanded polyQ promotes the formation of a variety of oligomeric and fibrillar aggregates of htt that accumulate into the hallmark proteina- ceous inclusion bodies associated with HD. htt is also highly associated with numerous cellular and subcellular membranes that contain a variety of lipids. As lipid homeostasis and metabolism abnormalities are observed in HD patients, we investigated how varying both the sphingomyelin (SM) and ganglioside (GM1) contents modifies the interactions …

Pinch Testing Positions Among Certified Hand Therapists: A Cross-Sectional Survey, Sueann R. Woods, Christa Lilly

Faculty & Staff Scholarship

Background: Pinch strength is indicative of later functional hand use following injury to hand. However, we believe clinicians (and more specifically CHTs) currently do not use a consistent measurement of pinch grip, despite availability of a “gold standard” of current (2015) ASHT standards for measuring pinch grip.

Methods: This cross-sectional survey (N = 175, 35% response) was designed to determine whether CHTs adhere to the standardized testing position for palmar pinch strength as recommended by the ASHT.

Results: Results determined that only 5.7% (n = 10) of the CHTs surveyed complete the entire ASHT standardized testing …

Effects Of Signal Bandwidth And Noise On Individual Speaker Identification, Jeremy C. Schwartz, Ashtyn T. Whyte, Mohanad Al-Nuaimi, Jeremy J. Donai

Faculty & Staff Scholarship

Two experiments were conducted to evaluate the effects of increasing spectral bandwidth from 3 to 10 kHz on individual speaker recognition in noisy conditions (þ5, 0, and 5 dB signal-to-noise ratio). Experiment 1 utilized h(Vowel)d (hVd) signals, while experiment 2 utilized sentences from the Rainbow Passage. Both experiments showed significant improvements in individual speaker identification in the 10 kHz bandwidth condition (6% for hVds; 10% for sentences). These results coincide with the extant machine recognition literature demonstrating significant amounts of individual speaker information present in the speech signal above approximately 3–4 kHz. Cues from the highfrequency region for speaker identity …

Biomimetic Layer-By-Layer Self-Assembly Of Nanofilms, Nanocoatings, And 3d Scaffolds For Tissue Engineering, Shichao Zhang, Malcolm Xing, Bingyun Li

Faculty & Staff Scholarship

Achieving surface design and control of biomaterial scaffolds with nanometer- or micrometer-scaled functional films is critical to mimic the unique features of native extracellular matrices, which has significant technological implications for tissue engineering including cell-seeded scaffolds, microbioreactors, cell assembly, tissue regeneration, etc. Compared with other techniques available for surface design, layer-by-layer (LbL) self-assembly technology has attracted extensive attention because of its integrated features of simplicity, versatility, and nanoscale control. Here we present a brief overview of current state-of-the-art research related to the LbL self-assembly technique and its assembled biomaterials as scaffolds for tissue engineering. An overview of the LbL self-assembly …

Implementation Of A Collaborative Hiv And Hepatitis C Screening Program In Appalachian Urgent Care Settings, Carmen N. Burrell, Melinda J. Sharon, Stephen M. Davis, Elena M. Wojcik, Ian B.K Martin

Faculty & Staff Scholarship

Introduction: With the current hepatitis C (HCV) epidemic in the Appalachian region and the risk of human immunodeficiency virus (HIV) co-infection, there is a need for increased secondary prevention efforts. The purpose of this study was to implement routine HIV and HCV screenings in the urgent care setting through the use of an electronic medical record (EMR) to increase a provider’s likelihood of testing eligible patients.

Methods: From June 2017 through May 2018, EMR-based HIV and HCV screenings were implemented in three emergency department-affiliated urgent care settings: a local urgent care walk-in clinic; a university-based student health services center; and …

Emergency Department Visits For Sexual Assault By Emerging Adults: Is Alcohol A Factor?, Allison Tadros, Melinda J. Sharon, Shelley M. Hoffman, Danielle M. Davidov

Faculty & Staff Scholarship

Introduction: Emerging adults (18-25 years of age) are at increased risk for sexual assault. There is little Emergency Department (ED) data on sexual assaults that involve alcohol among this population. The purpose of this study was to analyze ED visits for sexual assault and determine if alcohol consumption by the patient was noted.

Methods: This study was a retrospective chart review of patients aged 18-25 presenting to an ED in a college town over a four-year period. Extracted variables included age, gender, delay in seeking care, sexual assault nurse examiner (SANE) evaluation, and alcohol consumption by the patient. For analysis …

The Humanistic And Economic Burden Associated With Anxiety And Depression Among Adults With Comorbid Diabetes And Hypertension, Kimberly Wallace, Xiaohui Zhao, Ranjita Misra, Usha Sambamoorthi

Faculty & Staff Scholarship

We conducted a retrospective cross-sectional study to estimate the humanistic and economic burden associated with depression and anxiety among adults with comorbid diabetes and hypertension. Pooled data from the 2013 and 2015 Medical Expenditure Panel Survey were used to include adults (≥18 years old) who were alive and diagnosed with both diabetes and hypertension during the observation period. We assessed the humanistic burden with health-related quality of life (HRQoL) and economic burden with the total annual healthcare expenditures. Depending on the presence/absence of depression and anxiety, the study sample was divided into four groups (i.e., no depression/anxiety, depression only, anxiety …

Assessment Of A Mouse Xenograft Model Of Primary Colorectal Cancer With Special Reference To Perfluorooctane Sulfonate, Jeffrey H. Wimsatt, Caitlin Montgomery, Laurel S. Thomas, Charity Savard, Rachel Tallman, Kim Innes, Nezar Jrebi

Faculty & Staff Scholarship

Colorectal cancer ranks third among the most commonly diagnosed cancers in the United States. Current therapies have a range of side effects, and the development of a reliable animal model to speed the discovery of safe effective preventative therapies would be of great value. A cross-sectional study in a large Appalachian population recently showed an association between low circulating levels of perfluorooctane sulfonate (PFOS) and a reduced prevalence of colorectal cancer. A study using APCmin(C57BL/6J-ApcMin/J) mice prone to familial adenomatous polyposis found PFOS was protective when exposure occurred during tumor development. To test the possible benefit of PFOS on spontaneous …

Acute Effects Of Diets Rich In Almonds And Walnuts On Endothelial Function, Ravindra Bhardwaj, Harvinder Dod, Manjinder S. Sandhu, Rohil Bedi, Sachin Dod, Gregory Konat, H.K. Chopra, Rakesh Sharma, Abnash C. Jain, Navin Nanda

Faculty & Staff Scholarship

Objective: Omega-3 fatty acids, especially alpha-linolenic acid (ALA), which are present in nuts may reduce cardiovascular disease (CVD) risk, by changing vascular inflammation and improving endothelial dysfunction. The objective of the study was to evaluate the acute effects of two different diets, one containing walnuts and the other almonds on endothelial function.

Methods: Twenty-seven overweight volunteers underwent a randomized 2-period, crossover, controlled intervention study. The subjects were given either walnut or almond diets which varied in monounsaturated fatty acid (MUFA) and polyunsaturated fatty acid (PUFA) content. The walnut diet provided 23.1% energy from PUFA and the almond diet provided 7.6% …

Psychometric Properties Of The Difficulties In Emotion Regulation Scale (Ders) And Its Short Forms In Adults With Emotional Disorders, Lauren S. Hallion, Shari A. Steinmann, David F. Tolin, Gretchen J. Diefenbach

Faculty & Staff Scholarship

Objective: The Difficulties in Emotion Regulation Scale (DERS) is a widely used self- report measure of subjective emotion ability, as defined by a prominent clinically derived model of emotion regulation (Gratz and Roemer, 2004). Although the DERS is often used in treatment and research settings for adults with emotional (i.e., anxiety, mood, obsessive-compulsive, or trauma-related) disorders, its psychometric properties are not well-characterized in this population.

Method: We examined the psychometric properties of the DERS and three popular short forms (DERS-16; DERS-18; and DERS-SF) in a large (N = 427) sample of treatment-seeking adults with one or more DSM-5 emotional disorders. …

Farnesylation Of The Transducin G Protein Gamma Subunit Is A Prerequisite For Its Ciliary Targeting In Rod Photoreceptors, Celine Brooks, Joseph Murphy, Marycharmain Belcastro, Daniel Heller, Saravanan Kolandaivelu, Oleg Kisselev, Maxim Sokolov

Faculty & Staff Scholarship

Primary cilia are microtubule-based organelles, which protrude from the plasma membrane and receive a wide range of extracellular signals. Various cilia use G protein-coupled receptors (GPCRs) for the detection of these signals. For instance, vertebrate rod photoreceptors use their cilia (also called outer segments) as antennae detecting photons by GPCR rhodopsin. Rhodopsin recognizes incoming light and activates its G protein, transducin, which is composed of three subunits α, β, and γ. Similar to all G protein γ subunits, the transducin Gγ1 subunit undergoes C-terminal prenylation resulting in the addition of an isoprenoid farnesyl; however, the significance of this posttranslational modification …

State-Level Variability In Veteran Reliance On Veterans Health Administration And Potentially Preventable Hospitalizations: A Geospatial Analysis, Drew A. Helmer, Mazhgan Rowneki, Xue Feng, Chin-Lin Tseng, Danielle Rose, Orysya Soroka, Dennis Fried, Nisha Jani, Leonard M. Pogach, Usha Sambamoorthi

Faculty & Staff Scholarship

Most Veterans who use the Veterans Health Administration (VHA) also utilize private-sector health care providers. To better inform local and regional health care planning, we assessed the association between reliance on VHA ambulatory care and total and system-specific preventable hospitalization rates (PHRs) at the state level. We conducted a retrospective dynamic cohort study using Veterans with diabetes mellitus, aged 66 years or older, and dually enrolled in VHA and Medicare parts A and B from 2004 to 2010. While controlling for median age and proportion of males, we measured the association between reliance on VHA ambulatory care and PHRs at …