Medicine and Health Sciences Commons^™

International Society Of Sports Nutrition Position Stand: Diets And Body Composition, Alan A. Aragon, Brad J. Schoenfeld, Robert Wildman, Susan Kleiner, Trisha Vandusseldorp, Lem Taylor, Conrad P. Earnest, Paul J. Arciero, Colin Wilborn, Douglas S. Kalman, Jeffrey R. Stout, Darryn S. Willoughby, Bill Campbell, Shawn M. Arent, Laurent Bannock, Abbie E. Smith-Ryan, Jose Antonio

Publications and Research

Position Statement: The International Society of Sports Nutrition (ISSN) bases the following position stand on a critical analysis of the literature regarding the effects of diet types (macronutrient composition; eating styles) and their influence on body composition. The ISSN has concluded the following. 1) There is a multitude of diet types and eating styles, whereby numerous subtypes fall under each major dietary archetype. 2) All body composition assessment methods have strengths and limitations. 3) Diets primarily focused on fat loss are driven by a sustained caloric deficit. The higher the baseline body fat level, the more aggressively the caloric deficit …

Self-Reported Racial/Ethnic Discrimination And Bronchodilator Response In African American Youth With Asthma, Sonia Carlson, Luisa N. Borrell, Celeste Eng, Myngoc Nguyen, Shannon Thyne, Michael A. Lenoir, Nadine Burke-Harris, Esteban G. Burchard, Neeta Thakur

Publications and Research

Importance Asthma is a multifactorial disease composed of endotypes with varying risk profiles and outcomes. African Americans experience a high burden of asthma and of psychosocial stress, including racial discrimination. It is unknown which endotypes of asthma are vulnerable to racial/ethnic discrimination.

Objective We examined the association between self-reported racial/ethnic discrimination and bronchodilator response (BDR) among African American youth with asthma ages 8 to 21 years (n = 576) and whether this association varies with tumor necrosis factor alpha (TNF-α) level.

Materials and methods Self-reported racial/ethnic discrimination was assessed by a modified Experiences of Discrimination questionnaire as none or any. …

An Intravaginal Ring That Releases Three Antiviral Agents And A Contraceptive Blocks Shiv-Rt Infection, Reduces Hsv-2 Shedding, And Suppresses Hormonal Cycling In Rhesus Macaques, Nina Derby, Meropi Aravantinou, Jessica Kenney, Shweta R. Ugaonkar, Asa Wesenberg, Jolanta Wilk, Larisa Kizima, Aixa Rodriguez, Shimin Zhang, Olga Mizenina, Keith Levendosky, Michael L. Cooney, Samantha Seidor, Agegnehu Gettie, Brooke Grasperge, James Blanchard, Michael Piatak Jr., Jeffery D. Lifson, José Fernández-Romero, Thomas M. Zydowsky, Melissa Robbiani

Publications and Research

Women globally need access to multipurpose prevention technologies (MPTs) that prevent human immunodeficiency virus (HIV), sexually transmitted infections that increase HIV acquisition/transmission risk, and unintended pregnancy. Seeking an MPTwith activity against HIV, herpes simplex virus-2 (HSV-2), and human papillomavirus (HPV), we developed a prototype intravaginal ring (IVR), the MZCL IVR, which released the antiviral agents MIV-150, zinc acetate, and carrageenan (MZC for short) and the contraceptive levonorgestrel (LNG). Previously, we showed that an MZC gel has potent activity against immunodeficiency viruses, HSV-2, and HPVand that the MZCL (MZC with LNG) IVR releases all four components in macaques in vivo at …

How Much Are Ecuadorians Willing To Pay To Reduce Maternal Mortality? Results From A Pilot Study On Contingent Valuation, Maria-Isabel Roldos, Phaedra Corso, Justin Engel

Publications and Research

Context:

There is an established association between the provision of health care services and maternal mortality. In Ecuador, little is known if the societal value is greater than the resources expended in preventive medicine.

Aims:

The purpose of this research is to investigate Ecuadorians’ willingness to pay to prevent maternal death and disabilities due to complications of care during childbirth in the context of universal coverage.

Methods and Materials:

The study elicited a “contingent” market on morbidity and mortality outcomes, specific to Ecuador’s epidemiologic profiles between a hypothetical market that included a 50% reduction in the risk of maternal mortality …

Acute Memory And Psychotomimetic Effects Of Cannabis And Tobacco Both ‘Joint’ And Individually: A Placebo-Controlled Trial, C. Hindocha, T. P. Freeman, J. X. Xia, N. D. C. Shaban, H. V. Curran

Publications and Research

Background. Cannabis and tobacco have contrasting cognitive effects. Smoking cannabis with tobacco is prevalent in many countries and although this may well influence cognitive and mental health outcomes, the possibility has rarely been investigated in human experimental psychopharmacological research.

Method. The individual and interactive effects of cannabis and tobacco were evaluated in 24 non-dependent cannabis and tobacco smokers in a randomized, placebo-controlled, double-blind, 2 (cannabis, placebo) × 2 (tobacco, placebo) crossover design. Verbal memory (prose recall), working memory (WM) performance including maintenance, manipulation and attention (N-back), psychotomimetic, subjective and cardiovascular measures were recorded on each of four sessions.

Results. Cannabis …

Synchronized And Mixed Outbreaks Of Coupled Recurrent Epidemics, Muhua Zheng, Ming Zhao, Byungjoon Min, Zonghua Liu

Publications and Research

Epidemic spreading has been studied for a long time and most of them are focused on the growing aspect of a single epidemic outbreak. Recently, we extended the study to the case of recurrent epidemics (Sci. Rep. 5, 16010 (2015)) but limited only to a single network. We here report from the real data of coupled regions or cities that the recurrent epidemics in two coupled networks are closely related to each other and can show either synchronized outbreak pattern where outbreaks occur simultaneously in both networks or mixed outbreak pattern where outbreaks occur in one network but do not …

Offering Self-Administered Oral Hiv Testing As A Choice To Truck Drivers In Kenya: Predictors Of Uptake And Need For Guidance While Self-Testing, Elizabeth A. Kelvin, Gavin George, Eva Mwai, Eston N. Nyaga, Joanne E. Mantell, Matthew L. Romo, Jacob O. Odhiambo, Kaymarlin Govender

Publications and Research

We assessed predictors of choosing self-administered oral HIV testing in the clinic with supervision versus the standard provider-administered blood test when offered the choice among 149 Kenyan truck drivers, described the types of guidance participants needed during self-testing and predictors of needing guidance. Overall, 56.38% of participants chose the self-test, 23.49% the provider-administered test, and 20.13% refused testing. In the adjusted regression models, each additional unit on the fatalism and self-efficacy scales was associated with 0.97 (p = 0.003) and 0.83 (p = 0.008) times lower odds of choosing the self-test, respectively. Overall, 52.38% of self-testers did so correctly without …

Modulation Of Estrogen Related Receptor Alpha Activity By The Kinesin Kif17, Am Pramodh Bandara Seneviratne, Zeynep Turan, Aurelie Hermant, Patrick Lecine, William O. Smith, Jean-Paul Borg, Fanny Jaulin, Geri Kreitzer

Publications and Research

Estrogen-related receptor alpha (ERR1) is an orphan nuclear receptor that can bind transcriptional co-activators constitutively. ERR1 expression correlates with poor patient outcomes in breast cancer, heightening interest in this nuclear receptor as a therapeutic target. Because ERR1 has no known regulatory ligand, a major challenge in targeting its activity is to find cellular or synthetic modulators of its function. We identified an interaction between ERR1 and KIF17, a kinesin-2 family microtubule motor, in a yeast-2-hybrid screen. We confirmed the interaction using in vitro biochemical assays and determined that binding is mediated by the ERR1 ligand-binding/AF2 domain and the KIF17 C-terminal …

Transcranial Direct Current Stimulation And Sports Performance, Dylan J. Edwards, Mar Cortes, Susan Wortman-Jutt, David Putrino, Marom Bikson, Gary Thickbroom, Alvaro Pascual-Leone

Publications and Research

No abstract provided.

Zika Virus-Like Particle (Vlp) Based Vaccine, Héléne Boigard, Alexandra Alimova, George R. Martin, Al Katz, Paul Gottlieb, Jose M. Galarza

Publications and Research

The newly emerged mosquito-borne Zika virus poses a major public challenge due to its ability to cause significant birth defects and neurological disorders. The impact of sexual transmission is unclear but raises further concerns about virus dissemination. No specific treatment or vaccine is currently available, thus the development of a safe and effective vaccine is paramount. Here we describe a novel strategy to assemble Zika virus-like particles (VLPs) by co-expressing the structural (CprME) and non-structural (NS2B/NS3) proteins, and demonstrate their effectiveness as vaccines. VLPs are produced in a suspension culture of mammalian cells and self-assembled into particles closely resembling Zika …

How Income And Food Prices Influence Global Dietary Intakes By Age And Sex: Evidence From 164 Countries, Andrew Muhammad, Anna D'Souza, Birgit Meade, Renata Micha, Dariush Mozaffarian

Publications and Research

Background While income and prices are key drivers of dietary choices, how their influence varies by food category, nation, and demographics is not well established. Based on intake data for 164 countries and 11 food categories, we examined how income and food prices relate to food intake globally, including by world region, age, and sex.

Methods We used 2010 intake data from the Global Dietary Database, the first database of consumption estimates for major food categories by country, age, and sex. We combined these data with national per capita GDP and food price data. We estimated intake responsiveness to income …

Encouraging Medicare Advantage Enrollees To Switch To Higher Quality Plans: Assessing The Effectiveness Of A ‘‘Nudge’’ Letter, Benjamin L. Howell, Partha Deb, Sai Ma, Rachel O. Reid, Jesse Levy, Gerald F. Riley, Patrick H. Conway, William H. Shrank

Publications and Research

There are considerable quality differences across private Medicare Advantage insurance plans, so it is important that beneficiaries make informed choices. During open enrollment for the 2013 coverage year, the Centers for Medicare & Medicaid Services sent letters to beneficiaries enrolled in low-quality Medicare Advantage plans (i.e., plans rated less than 3 stars for at least 3 consecutive years by Medicare) explaining the stars and encouraging them to reexamine their choices. To understand the effectiveness of these low-cost, behavioral ‘‘nudge’’ letters, we used a beneficiary-level national retrospective cohort and performed multivariate regression analysis of plan selection during the 2013 open enrollment …

The Relationship Between Just Culture, Trust And Patient Safety, Linda Ann Paradiso, Nancy Sweeney

Publications and Research

PROBLEM: Medical errors are now considered to be the third leading cause of death in the United States, estimated at more than 250,000 deaths per year. The Institute of Medicine’s landmark report, To Err is Human, identified that errors are not the fault of individuals, but systems, processes, and various conditions. In healthcare, the cornerstone of the process by which we learn from errors has been voluntary reporting. The primary barrier to reporting errors is the negative response from administrators, and the potential risk of disciplinary action. An environment of trust and fairness is known as “Just Culture” and …

A Study Of Cultural Competence And Implicit Bias Amongst Healthcare Students, Jerry Strklja, Natalia Dembowska, Zoya Vinokur, Elaine Leinung

Publications and Research

Cultural competence is defined as the ability of providers and organizations to effectively deliver equitable and unbiased health care that meet the social, cultural, and linguistic needs of a culturally diverse patient body. By 2050, minority populations will increase to 48 percent of the U.S. population and Hispanics will represent 24.4 percent of the total population (U.S. Census, 2010). This demographic shift brings challenges and opportunities to universities and organizations alike to create policies and curriculums that foster quality health care amongst students, while also contributing to the eradication of implicit biases that may unwittingly perpetuate healthcare disparities amongst racial …

Stability Of Synthetic Cathinones In Oral Fluid Samples, Briana Miller, Jiyoung Kim, Marta Concheiro

Publications and Research

Synthetic cathinones are new stimulant drugs derived from cathinone that have been sold as “legal highs” worldwide. These compounds can elicit powerful effects such as delusions, hallucinations as well as other potentially dangerous behavior. New analogs with varying effects and potencies are constantly introduced in the market to evade legislation, and they are not detected by routine screening and confirmation methods. Oral fluid is an alternative matrix of increasing interest in forensic toxicology. Its collection is non-invasive and easily supervised, and positive drug findings typically reflect recent drug exposure. The focus of this research was to develop a method for …

Characteristics Of Online Treatment Seekers Interested In A Text Messaging Intervention For Problem Drinking: Adults 51 And Older Versus Middle-Aged And Younger Adults, Alexis Kuerbis, Katherine Van Stolk-Cooke, Frederick J. Muench

Publications and Research

According to the Institute of Medicine, the vast older adult population is estimated to have mental health and substance use disorders at unprecedented rates and will place high demand on an unprepared healthcare system. Online and mobile health interventions, such as text messaging, could provide an alternative form of frontline intervention that could alleviate some of the burden on the healthcare system; however, it remains unknown what are characteristics of adults over 50 who might be interested in a mobile health behavioral intervention and how they may differ from their younger counterparts. To explore the characteristics of those interested in …

Legal Mapping Analysis Of State Telehealth Reimbursement Policies, Kate E. Trout, Sankeerth Rampa, Fernando A. Wilson, Jim P. Stimpson

Publications and Research

Background: There exists rapid growth and inconsistency in the telehealth policy environment, which makes it difficult to quantitatively evaluate the impact of telehealth reimbursement and other policies without the availability of a legal mapping database. Introduction: We describe the creation of a legal mapping database of state-level policies related to telehealth reimbursement of healthcare services. Trends and characteristics of these policies are presented.

Materials and Methods: Information provided by the Center for Connected Health Policy was used to identify state-wide laws and regulations regarding telehealth reimbursement. Other information was retrieved using: (1) LexisNexis database, (2) Westlaw database, and (3) retrieval …

Worldwide Use Of Triclosan: Can Dentistry Do Without This Antimicrobial?, Diana V. Macri

Publications and Research

No abstract provided.

Harlem Hospital's Journey To Patient Navigation, Christine W. Thorpe

Publications and Research

This essay discusses the history of 20th century black migration to Harlem, New York and the utilization of Harlem Hospital. This examination is based on New York newspaper articles in the 1920’s. They tell the story, from a journalist’s perspective, of the challenges African Americans experienced in their interactions with Harlem Hospital. The implicit communication of segregation of Harlem Hospital at that time is connected to the development of patient navigation in the 1970’s. The creation of patient navigation will be discussed in the context of historical health disparities that are increasingly manifested today.

Impact Of Health Policy Changes On Emergency Medicine In Maryland Stratified By Socioeconomic Status, Laura Pimentel, David Anderson, Bruce Golden, Edward Wasil, Fermin Barreuto, Jon M. Hirshon

Publications and Research

Introduction: On January 1, 2014, the financing and delivery of healthcare in the state of Maryland (MD) profoundly changed. The insurance provisions of the Patient Protection and Affordable Care Act (ACA) began implementation and a major revision of MD’s Medicare waiver ushered in a Global Budget Revenue (GBR) structure for hospital reimbursement. Our objective was to analyze the impact of these policy changes on emergency department (ED) utilization, hospitalization practices, insurance profiles, and professional revenue. We stratified our analysis by the socioeconomic status (SES) of the ED patient population.

Methods: We collected monthly mean data including patient volume, hospitalization percentages, …

Use Of Dimensional Analysis In An Associate Degree Nursing Program, Bridget Maley, Patricia Ford Garofalo

Publications and Research

The aim of this retrospective study was to show the use of dimensional analysis increased associate degree nursing students’ mathematical computation competency and may reduce nursing medication errors in practice. A recent report compiled by Mackary and Daniel from John Hopkins, stated that medical error is the third leading cause of death in the United States [1]. The most commonly cited estimate of annual deaths from medical error in the United States is a 1999 Institute of Medicine (IOM) report which is possibly limited and now outdated [2]. Medication errors contribute to patients’ deaths, whereas nurses administer either incorrect medication, …

Unique Synergistic Formulation Of Curcumin, Epicatechin Gallate And Resveratrol, Tricurin, Suppresses Hpv E6, Eliminates Hpv+ Cancer Cells, And Inhibits Tumor Progression, Sumit Mukherjee, Priya Ranjan Debata, Rahman Hussaini, Kaushiki Chatterjee, Juliet N. E. Baidoo, Samay Sampat, Anita Szerszen, Joseph P. Navarra, Jimmie Fata, Elena Severinova, Probal Banerjee, Mario R. Castellanos

Publications and Research

Curcumin (from curry) (C) is highly potent against cervical cancer cells (CCC), but poor bioavailability has limited its clinical use. Similar natural polyphenols resveratrol (from grapes) (R), and epicatechin gallate (from green tea) (E) also display activity against CCC. By treating CCC (HeLa) with C, E, or R, or combinations of these compounds, we computed combination indices and observed a strong synergism among C, E, and R at the unique molar ratio 4:1:12.5. This combination, named as TriCurin, rapidly down regulated HPV18 E6 and NF-kB expression while concomitantly inducing the tumor suppressor protein p53 in HeLa cells. In the mouse …

Whose Expertise Is It? Evidence For Autistic Adults As Critical Autism Experts, Kristen Gillespie-Lynch, Steven K. Kapp, Patricia J. Brooks, Jonathan Pickens, Ben Schwartzman

Publications and Research

Autistic and non-autistic adults’ agreement with scientific knowledge about autism, how they define autism, and their endorsement of stigmatizing conceptions of autism has not previously been examined. Using an online survey, we assessed autism knowledge and stigma among 636 adults with varied relationships to autism, including autistic people and nuclear family members. Autistic participants exhibited more scientifically based knowledge than others. They were more likely to describe autism experientially or as a neutral difference, and more often opposed the medical model. Autistic participants and family members reported lower stigma. Greater endorsement of the importance of normalizing autistic people was associated …

Mirnas Associated With Prostate Cancer Risk And Progression, Hung N. Luu, Hui-Yi Lin, Karina Dalsgaard Sorensen, Olorunseun O. Ogunwobi, Nagi Kumar, Ganna Chornokur, Catherine Phelan, Dominique Jones, Lacreis Kidd, Jyotsna Batra, Kosj Yamoah, Anders Berglund, Robert J. Rounbehler, Mihi Yang, Sang Haak Lee, Nahyeon Kang, Seung Joon Kim, Jong Y. Park, Giuliano Di Pietro

Publications and Research

Prostate cancer is the most common malignancy among men in the US. Though considerable improvement in the diagnosis of prostate cancer has been achieved in the past decade, predicting disease outcome remains a major clinical challenge. Recent expression profiling studies in prostate cancer suggest microRNAs (miRNAs) may serve as potential biomarkers for prostate cancer risk and disease progression. miRNAs comprise a large family of about 22-nucleotide-long non-protein coding RNAs, regulate gene expression post-transcriptionally and participate in the regulation of numerous cellular processes. In this review, we discuss the current status of miRNA in studies evaluating the disease progression of prostate …

Development And Validation Of Measures To Evaluate Adolescents' Knowledge About Human Papillomavirus (Hpv), Involvement In Hpv Vaccine Decision-Making, Self-Efficacy To Receive The Vaccine And Fear And Anxiety, A. S. Forster, K. A. Mcbride, C. Davies, T. Stoney, H. Marshall, K. Mcgeechan, Spring C. Cooper, S. R. Skinner

Publications and Research

Objectives: We describe the development and validation of measures of human papillomavirus (HPV)/HPV vaccination knowledge, fear/anxiety about vaccination, involvement in HPV vaccine decision-making, and self-efficacy with regard to getting the vaccine, designed to evaluate the efficacy of an intervention to affect these domains (collectively termed the HAVIQ: HPV Adolescent Vaccine Intervention Questionnaire). Study design: Literature search, cognitive interviews and cross-sectional survey.

Methods: A literature search identified existing items that were modified for the present measures. Experts reviewed draft measures for face and content validity. Cognitive interviews with adolescents were also used to assess content validity. Adolescents completed the measures and …

Effects Of Cetp Inhibition With Anacetrapib On Metabolism Of Vldl-Tg And Plasma Apolipoproteins C-Ii, C-Iii, And E, John S. Millar, Michael E. Lassman, Tiffany Thomas, Rajasekhar Ramakrishnan, Patricia Jumes, Richard L. Dunbar, Emil M. Degoma, Amanda L. Baer, Wahida Karmally, Daniel S. Donovan, Hashmi Rafeek, John A. Wagner, Stephen Holleran, Joseph Obunike, Yang Liu, Soumia Aoujil, Taylor Standiford, David E. Gutstein, Henry N. Ginsberg, Daniel J. Rader, Gissette Reyes-Soffer

Publications and Research

Cholesteryl ester transfer protein (CETP) mediates the transfer of HDL cholesteryl esters for triglyceride (TG) in VLDL/LDL. CETP inhibition, with anacetrapib, increases HDL-cholesterol, reduces LDL-cholesterol, and lowers TG levels. This study describes the mechanisms responsible for TG lowering by examining the kinetics of VLDL-TG, apoC-II, apoC-III, and apoE. Mildly hypercholesterolemic subjects were randomized to either placebo (N = 10) or atorvastatin 20 mg/qd (N = 29) for 4 weeks (period 1) followed by 8 weeks of anacetrapib, 100 mg/qd (period 2). Following each period, subjects underwent stable isotope metabolic studies to determine the fractional catabolic rates (FCRs) and production rates …

Identifying Inequities In Maternal And Child Health Through Risk Stratification To Inform Health Systems Strengthening In Northern Togo, Katharine J. Mccarthy, Sandra Braganza, Kevin Fiori, Christophe Gbeleou, Vivien Kpakpo, Andrew Lopez, Jennifer Schechter, Alicia Singham Goodwin, Heidi E. Jones

Publications and Research

Objective
In Togo, substantial progress in maternal and child health is needed to reach global development goals. To better inform clinic and community-based health services, this study identifies factors associated with maternal and child health care utilization in the Kara region of Northern Togo.

Methods
We conducted a population-representative household survey of four health clinic catchment areas of 1,075 women of reproductive age in 2015. Multivariable logistic regression was used to model individual and structural factors associated with utilization of four maternal and child health services. Key outcomes were: facility-based delivery, maternal postnatal health check by a health professional within …

Longitudinal Associations Between Body Mass Index, Physical Activity, And Healthy Dietary Behaviors In Adults: A Parallel Latent Growth Curve Modeling Approach, Youngdeok Kim, Jung-Min Lee, Jungyoon Kim, Emily Dhurandhar, Ghada Soliman, Nizar K. Wehbi, James Canedy

Publications and Research

Background Physical activity (PA) and healthy dietary behaviors (HDB) are two well-documented lifestyle factors influencing body mass index (BMI). This study examined 7-year longitudinal associations between changes in PA, HDB, and BMI among adults using a parallel latent growth curve modeling (LGCM).

Methods We used prospective cohort data collected by a private company (SimplyWell LLC, Omaha, NE, USA) implementing a workplace health screening program. Data from a total of 2,579 adults who provided valid BMI, PA, and HDB information for at least 5 out of 7 follow-up years from the time they entered the program were analyzed. PA and HDB …

Vestibular Activation Habituates The Vasovagal Response In The Rat, Bernard Cohen, Giorgio P. Martinelli, Yongqing Xiang, Theodore Raphan, Sergei B. Yakushin

Publications and Research

Vasovagal syncope is a significant medical problem without effective therapy, postulated to be related to a collapse of baroreflex function. While some studies have shown that repeated static tilts can block vasovagal syncope, this was not found in other studies. Using anesthetized, male Long–Evans rats that were highly susceptible to generation of vasovagal responses, we found that repeated activation of the vestibulosympathetic reflex (VSR) with ±2 and ±3 mA, 0.025 Hz sinusoidal galvanic vestibular stimulation (sGVS) caused incremental changes in blood pressure (BP) and heart rate (HR) that blocked further generation of vasovagal responses. Initially, BP and HR fell ≈20–50 …

Beta Oscillatory Changes And Retention Of Motor Skills During Practice In Healthy Subjects And In Patients With Parkinson’S Disease, Aaron B. Nelson, Clara Moisello, Jing Lin, Priya Panday, Serena Ricci, Andrea Canessa, Alessandro Di Rocco, Angelo Quartarone, Giuseppe Frazzitta, Ioannis U. Isaias, Giulio Tononi, Chiara Cirelli, M. Felice Ghilardi

Publications and Research

Recently we found that modulation depth of beta power during movement increases with practice over sensory-motor areas in normal subjects but not in patients with Parkinson’s disease (PD). As such changesmight reflect use-dependentmodifications, we concluded that reduction of beta enhancement in PD represents saturation of cortical plasticity. A few questions remained open: What is the relation between these EEG changes and retention of motor skills? Would a second task exposure restore beta modulation enhancement in PD? Do practice-induced increases of beta modulation occur within each block? We thus recorded EEG in patients with PD and age-matched controls in two consecutive …