Medicine and Health Sciences Commons^™

Launching A Novel Preclinical Infrastructure: Comparative Oncology Trials Consortium Directed Therapeutic Targeting Of Tnfα To Cancer Vasculature, Melissa C. Paoloni, Anita Tandle, Christina Mazcko, Engy Hanna, Stefan Kachala, Amy Leblanc, Shelley Newman, David Vail, Carolyn Henry, Douglass Thamm, Karin Sorenmo, Amin Hajitou, Renata Pasqualini, Wadih Arap, Chand Khanna, Steven K. Libutti

United States Public Health Resources

Background: Under the direction and sponsorship of the National Cancer Institute, we report on the first pre-clinical trial of the Comparative Oncology Trials Consortium (COTC). The COTC is a novel infrastructure to integrate cancers that naturally develop in pet dogs into the development path of new human drugs. Trials are designed to address questions challenging in conventional preclinical models and early phase human trials. Large animal spontaneous cancer models can be a valuable addition to successful studies of cancer biology and novel therapeutic drug, imaging and device development.

Methodology/Principal Findings: Through this established infrastructure, the first trial of …

The Role Of Glutamate And Its Receptors In Mesocorticolimbic Dopaminergic Regions In Opioid Addiction, Yuan Guo, Hui-Ling Wang, Xiao-Hui Xiang, Yan Zhao

United States Public Health Resources

Accumulating evidence suggests that glutamate, as one of the most important excitatory neurotransmitters in the brain, plays a key role in drug addiction including opioid addiction. There is substantial evidence for glutamatergic projections into mesocorticolimbic dopaminergic neurons, which are associated with opioid psychological dependence and are also the key regions of enhancement effect. Glutamate may be involved in the process of opioid addiction not only by acting on its ionotropic and metabotropic glutamate receptors that activate several signal transduction pathways, but also by interacting with other neurotransmitters or neuropeptides such as opioids, dopamine, y-aminobutyric acid and substance P in the …

Comparison Of Video Laryngoscopy Technologies, C. Chiesa, N. Miljkovic, N. Schulte, J. B. Callahan, Jr., D. J. Miller, B. H. Boedeker

United States Public Health Resources

Indirect laryngoscopy allows practitioners to “see around the corner” of a patient’s airway during intubation. Inadequate airway management is a major contributor to patient injury, morbidity and mortality. The purpose of the present study was to evaluate the video quality of commercially available video laryngoscopy systems. A team of four investigators at the University of Nebraska at Omaha and the Peter Kiewit Institute performed intubation simulations using a number of video laryngoscopy systems. Testing was done with a Laerdal Difficult Airway Manikin (Laerdal Medical Corp., Wappingers Falls, NY) in a setting that simulated difficult airways, adverse lighting conditions and various …

Children's Behavioral Traits And Risk Of Injury: Analyses From A Case-Control Study Of Agricultural Households, Kathleen F. Carlson, Susan G. Gerberich, Bruce H. Alexander, Ann S. Masten, Timothy R. Church, John M. Shutske, Andrew D. Ryan, Colleen M. Renier

United States Public Health Resources

Problem: Children on family agricultural operations have high risk of injury. The association between children's behavioral traits and their risk of injury is not well understood. Method: Data from the Regional Rural Injury Study-II were used to assess behavioral risk factors for injury to children ages six to <20 years. A total of 379 injury events (cases) and 1,562 randomly selected controls were identified. Adjusted odds ratios (OR) and 95% confidence intervals (CI), calculated using logistic regression, were used to estimate injury risk in reference to behavioral traits. Results: Injury risks were greater for children with high levels of depressive symptoms (OR=1.9, CI=1.0-3.7) and aggression (OR=1.6, CI=0.9-2.7), and low levels of careful/cautious behavior (OR=1.8, CI=1.1-2.9). Children with low levels of self-regulation had reduced risks (OR=0.4, CI=0.2-0.8). Discussion: Results suggest that children's behaviors affect their risk of agricultural injury. Additional research …

Carbon Tetrachloride-Induced Liver Damage In Asialoglycoprotein Receptor-Deficient Mice, Shana R. Dalton, Serene M.L. Lee, Rachel N. King, Amin A. Nanji, Kusum K. Kharbanda, Carol A. Casey, Benita L. Mcvicker

United States Public Health Resources

The asialoglycoprotein (ASGP) receptor is an abundant hepatocyte-specific receptor involved in receptor-mediated endocytosis. This receptor’s abundance and function is decreased by chronic ethanol administration prior to the appearance of pathology such as necrosis or inflammation. Hence, this study aimed to determine if ASGP receptor function is required to protect against liver injury by utilizing a knockout mouse model lacking functional ASGP receptor in the setting of carbon tetrachloride (CCl₄) hepatotoxicity. Briefly, ASGP receptor-deficient (RD) mice and wild-type (WT) mice were injected with 1 ml/kg body weight of CCl₄. In the subsequent week, mice were monitored for …

Nitric Oxide Inhibits Insulin-Degrading Enzyme Activity And Function Through S-Nitrosylation, Crystal M. Cordes, Robert G. Bennett, Gerri L. Siford, Frederick G. Hamel

United States Public Health Resources

Insulin-degrading enzyme (IDE) is responsible for the degradation of a number of hormones and peptides, including insulin and amyloid β (Aβ). Genetic studies have linked IDE to both type 2 diabetes and Alzheimer’s disease. Despite its potential importance in these diseases, relatively little is known about the factors that regulate the activity and function of IDE. Protein S-nitrosylation is now recognized as a redox-dependent, cGMP-independent signaling component that mediates a variety of actions of nitric oxide (NO). Here we describe a mechanism of inactivation of IDE by NO. NO donors decreased both insulin and Aβ degrading activities of IDE. Insulin-degrading …

Proteomics Reveal A Concerted Upregulation Of Methionine Metabolic Pathway Enzymes, And Downregulation Of Carbonic Anhydrase-Iii, In Betaine Supplemented Ethanol-Fed Rats, Kusum K. Kharbanda, Vasanthy Vigneswara, Benita L. Mcvicker, Anna U. Newlaczyl, Kevin Bailey, Dean Tuma, David E. Ray, Wayne G. Carter

United States Public Health Resources

We employed a proteomic profiling strategy to examine the effects of ethanol and betaine diet supplementation on major liver protein level changes. Male Wistar rats were fed control, ethanol or betaine supplemented diets for 4 weeks. Livers were removed and liver cytosolic proteins resolved by onedimensional and two-dimensional separation techniques. Significant upregulation of betaine homocysteine methyltransferase-1, methionine adenosyl transferase-1, and glycine N-methyltransferase were the most visually prominent protein changes observed in livers of rats fed the betaine supplemented ethanol diet. We hypothesise that this concerted upregulation of these methionine metabolic pathway enzymes is the protective mechanism by which betaine restores …

Identification Of Francisella Tularensis Subsp. Tularensis A1 And A2 Infections By Real-Time Polymerase Chain Reaction, Claudia R. Molins, Jennifer K. Carlson, Jana Coombs, Jeannine M. Petersen

United States Public Health Resources

Francisella tularensis subsp. tularensis (type A) is subdivided into clades A1 and A2. Human tularemia infections caused by A1 and A2 differ with respect to clinical outcome; A1 infections are associated with a higher case fatality rate. In this study, we develop and evaluate TaqMan polymerase chain reaction (PCR) assays for identification of A1 and A2. Both assays were shown to be specific to either A1 or A2, with sensitivities of 10 genomic equivalents. Real-time PCR results for identification of A1 and A2 were in complete agreement with results obtained by pulsed field gel electrophoresis analysis or conventional PCR when …

Building Trusted Relationships With Female Street Sex Workers: A Nontraditional Approach, Sandra Finn

Theses and Graduate Projects

This project develops a model for community health nurses to use to connect with African American street sex workers. Women involved in street prostitution are not only marginalized by society, but also healthcare systems. In understanding the importance of building relationships and rapport with women involved in street sex work I chose to use Reiki and a spiritually attuned environment to interact with a group of women. A support group unfolded as well as a bond I created with the participants that helped to bridge the gap for the women between them and health care systems, legal and government organizations. …

Theory, Research & Practice Of A Comprehensive Teen Sexuality Education Curriculum, Dawn M. Bowker

Theses and Graduate Projects

Rates of sexually transmitted disease (STD), teen pregnancy, and teen births are higher in the United States than in most other industrialized countries (Kohler, 2008; Manhart, 2006; Teitelman, 2004; Terry-Humen, 2006). Five years ago, a Christian based, sexuality retreat curriculum was initiated that focused on teen knowledge, attitudes, and beliefs about sexuality. The developmentally appropriate curriculum promoted an increased awareness of self and issues influencing sexuality. The goal was to create a common language and a better understanding of the way adolescent males and females think and behave in matters of sexuality. This paper presents an evaluative retrospective analysis of …

Shoulder Impingement Syndrome: Outcome Of Arthroscopic Subacromial Decompression, Attiq Ur Rehman, Muhammad Abdul Wajid, Tashfeen Ahmad

Section of Orthopaedic Surgery

Objective: To describe the outcome of cases with subacromial impingement syndrome managed with arthroscopic subacromial decompression.
Study Design: Quasi-experimental study.
Place and Duration of Study: Section of Orthopaedics, Department of Surgery, The Aga Khan University Hospital, Karachi from April 2005 to March 2006.
Methodology: Thirty patients with impingement syndrome who underwent arthroscopic subacromial decompression after failed conservative treatment were included. The Constant and Murley shoulder scoring system was used for the clinical assessment of pain and function pre-operatively and 1, 6 and 24 weeks postoperatively.
Results: The postoperatively significant improvement was observed in the Constant and Murley scores in all …

Rhizopus Necrotizing Fasciitis Of Caesarean Wound: A Rare Life Threatening Condition, Abdul Rehman Alvi, Ghina Shamsi

Section of General Surgery

Mucormycosis is a rare cause of necrotizing fasciitis in immunocompromised patients. We report a young female, who developed rhizopus necrotizing fasciitis of caesarean wound. The lady died secondary to non-responding sepsis and irreversible multi-organ failure. High index of suspicion can lead to early diagnosis by frozen section of histopathology and fungal culture technique. Aggressive surgical debridement and intravenous anti-fungal medication is the main stay of treatment. A delay in diagnosis and treatment may cause multi-organ failure leading to high mortality.

Non-Traumatic Right Hepatic Artery Pseudoaneurysm: An Unusual Cause Of Hemobilia And Obstructive Jaundice, Abdul Rehman Alvi, Shahida Bibi, Ziaur Rehman, Salma Khan

Section of General Surgery

Most hepatic artery pseudoaneurysms (HAPA) are post traumatic, and non-traumatic pseudoaneurysm is rarely reported. It is a potentially life threatening vascular disorder and difficult to diagnose before rupture. Early diagnosis and prompt nonoperative intervention of this lesion could be life saving. The authors report the case of a patient with hemobilia caused by ruptured right hepatic artery pseudoaneurysm and subsequently developed right hepatic duct stricture, which has not been reported previously. This patient was successfully treated with endovascular stent graft of pseudoaneurysm and endoscopic stenting of right hepatic duct stricture.

Vaccination With Mycobacterium Bovis Bcg Strains Danish And Pasteur In White-Tailed Deer (Odocoileus Virginianus) Experimentally Challenged With Mycobacterium Bovis, M. V. Palmer, T. C. Thacker, W. R. Waters

Michigan Bovine Tuberculosis Bibliography and Database

Wildlife reservoirs of Mycobacterium bovis represent serious obstacles to the eradication of tuberculosis in domestic livestock and the cause for many faltering bovine tuberculosis eradication programs. One approach in dealing with wildlife reservoirs of disease is to interrupt inter-species and intraspecies transmission through vaccination of deer or cattle. To evaluate the efficacy of BCG vaccination in white-tailed deer, 35 deer were assigned to one of three groups; one s.c. dose of 10⁷ CFU of M. bovis BCG Pasteur (n = 12); 1 s.c. dose of 10⁷ CFU of M. bovis BCG Danish (n = 11); or unvaccinated deer …

Severe Road Traffic Injuries In Kenya, Quality Of Care And Access, William Macharia, F. Muli-Musiime, V. Nantulya, Erastus K. Njeru

Paediatrics and Child Health, East Africa

Background: Road traffic injuries (RTI) are on increase in developing countries. Health care facilities are poorly equipped to provide the needed services.

Objective: Determine access and quality of care for RTI casualties in Kenya.

Design: Cross-sectional survey

Setting: 53 large and medium size private, faith-based and public hospitals.

Participants: In-patient road traffic crash casualties and health personnel in the selected hospitals were interviewed on availability of emergency care and resources. Onsite verification of status was undertaken.

Results: Out of 310 RTI casualties interviewed, 72.3%, 15.6% and 12.2% were in public, faith-based and private hospitals, respectively. Peak age of the injured …

In Vitro And In Vivo Anthelmintic Activity Of Terminalia Arjuna Bark, Hafiz Allah Bachaya, Zafar Iqbal, Muhammad Nisar Khan, Abdul Jabbar, Anwar Hassan Gilani, Islam-Ud Din

Department of Biological & Biomedical Sciences

The present study was carried out to evaluate the anthelmintic activity of Terminalia arjuna (Roxb.) bark locally used as an anthelmintic. Lethal median concentration (LC50 values) of methanolic extract of T. arjuna bark in egg hatch and larval development tests against Haemonchus contortus ova and larva were found to be 645.65 and 467.74 μg mL-1, respectively. Inadult motility assay, efficacy of the extract was evident by the mortality of H. contortus at different hours post exposure. Invivo results revealed maximum (87.3%) egg count percent reduction (ECR) in sheep treated with crude methanolic extract @ 3 g kg-1 body …

Evaluation Of Hiv Counseling And Testing In Anc Settings And Adherence To Short Course Antiretroviral Prophylaxis For Pmtct In Francistown, Botswana, Carolyn Baek, Tracy Creek, Lee Ann Jones, Louis Apicella, Jennifer Redner, Naomi Rutenberg

HIV and AIDS

The vast majority of children infected with HIV are the result of mother-to-child transmission (MTCT) of the virus during pregnancy, labor, or breastfeeding. Botswana is one of the first countries in the developing world with a national prevention program (PMTCT) to reduce vertical transmission. The Horizons Program of the Population Council, in collaboration with the Centers for Disease Control and Prevention (CDC) and Premiere Personnel in Botswana, conducted an evaluation to describe the adherence of pregnant women to the current PMTCT regimen. The report recommends standardizing post-test counseling content through the use of job aids and adapting existing WHO materials, …

Commercial Sex Workers In Five Ethiopian Cities: A Baseline Survey For Usaid Targeted Hiv Prevention Program For Most-At-Risk Populations, Woldemariam Girma, Annabel Erulkar

HIV and AIDS

This report presents findings from a baseline survey of commercial sex workers (CSWs) that was undertaken in five Ethiopian cities. 2,050 CSWs were interviewed for the survey. CSW were disproportionally young and came from extremely disadvantaged backgrounds. Most respondents also cited negative working standards from another profession, or family responsibilities as reasons leading to sex work. Condom use was very high but use may be inconsistent or over-reported and should be studied further. Findings also propose additional advocacy for positive peer support groups, more HIV testing for at-risk populations, and addressing violence among CSWs and other Ethiopian women.

The Afford Health Marketing Initiative In Uganda: Mid-Term Evaluation, Oleksandr Rohozynsky, Christie Billingsley, Annette Bongiovanni

HIV and AIDS

AFFORD is a five-year (2005–10) social marketing initiative financed by the United States Agency for International Development (USAID)/Uganda. It supports the Uganda Ministry of Health’s strategic plan to promote positive health-care-seeking behavior and reduce the shortage of health products and services related to family planning and reproductive health; child health; malaria prevention and treatment; and HIV prevention, care, and treatment. AFFORD seeks to achieve the sustainable marketing of products and services that prevent transmission of HIV, malaria, and diarrheal diseases; to help couples plan their families; and to help people living with HIV enjoy improved quality of life. Target groups …

Final Evaluation Of The Project For Expanding The Role Of Networks Of People Living With Hiv/Aids, Young-Mi Kim, John Lukwago, Stella Neema

HIV and AIDS

In July 2006, the International HIV/AIDS Alliance launched a three-year project on Expanding the Role of Networks of People Living with HIV/AIDS in Uganda. The project, which is funded by the United States Agency for International Development (USAID)/Uganda, sought to increase the involvement of people living with HIV/AIDS (PHA) in the HIV/AIDS response and to improve access to and utilization of prevention, treatment, care, and support services for PHA households. USAID/Uganda commissioned an evaluation of the project’s design, strategies, and performance in order to improve its implementation and learn from its successes and challenges. The study was a cross-sectional descriptive …

Formative Evaluation: Presidential Initiative On Aids Strategy For Communication To Youth, Netsayi N. Mudege, Chi-Chi Undie

HIV and AIDS

HIV prevention programming is increasingly taking place in school settings, which provide an expansive population of young people and offer immense potential for impact on the lives of this target group. The Presidential Initiative on AIDS Strategy for Communication to Youth (PIASCY) is a school-based program that has sought to address the HIV/AIDS epidemic in Uganda in a holistic manner since 2002, targeting young people, school personnel, parents, and the wider community. A formative evaluation was conducted by the African Population and Health Research Center in February 2009 to provide an understanding of: the extent to which PIASCY is achieving …

The Overlooked Epidemic: Addressing Hiv Prevention And Treatment Among Men Who Have Sex With Men In Sub-Saharan Africa, National Aids Control Council Of Kenya, Population Council

HIV and AIDS

Globally, less than 1 out of 20 men who have sex with men (MSM) has access to HIV prevention and care. UNAIDS has estimated that at least 5 to 10 percent of all HIV infections globally occur through male-to-male sexual activity. In spite of the high risk of HIV infection and evidence of extensive sexual networks, national HIV programs in Africa have been slow to address MSM in prevention and treatment efforts. To address these issues, the Population Council and the National AIDS Control Council of Kenya convened a meeting on May 14–15, 2008. The goals of the meeting were …

Technical Assistance To The Uganda Aids Commission For Operationallisation Of The Performance Monitoring And Management Plan, Frederick Makumbi, Roy Mayega, David Kisitu, Juliet Sekandi, Denis A. Bwesigye, Robert Miller, Sam Kalibala

HIV and AIDS

The Uganda AIDS Commission (UAC) has committed to rolling out and making operational a new National Performance Monitoring and Management Plan (PMMP) to monitor and evaluate the national response to the HIV/AIDS epidemic. The PMMP has at its core the collection and processing of 58 national indicators, 47 district output indicators, and 22 outcome indicators covering prevention, care, treatment, and social support. The rollout is challenging because at least seven organizations must collaborate at the national level, and appropriate staff at the district level need to be in place and trained in new procedures of data collection. In addition, these …

Family Centred Approach For Hiv Services: Pilot Study In South Africa, Meredith Sheehy, Nomtandazo Patricia Mini, Tonicah Maphanga, Scott E. Kellerman

HIV and AIDS

In 2003, UNICEF estimated that nearly 250,000 children were infected with HIV in South Africa. While scale-up of prevention of mother-to-child transmission (PMTCT) programs has improved testing and care for perinatally infected infants, uptake of these services remains low in much of sub-Saharan Africa and few HIV infected children are diagnosed and receive services through PMTCT programs. With support from USAID/PEPFAR, the Horizons Program adapted a family-centered model for children and families in need of broader-reaching HIV diagnostic services in South Africa. The Family Centered Approach (FCA) pilot intervention was designed to expand access to HIV testing for family members …

The Adolescent Experience In-Depth: Using Data To Identify And Reach The Most Vulnerable Young People—Cambodia 2005, Population Council

Poverty, Gender, and Youth

“The Adolescent Experience In-Depth: Using Data to Identify and Reach the Most Vulnerable Young People: Cambodia 2005” is part of a series of Population Council guides that draw principally on data from the Demographic and Health Surveys to provide decisionmakers at all levels—from governments, nongovernmental organizations, and advocacy groups—with evidence on the situation of adolescent girls and boys and young women aged 10–24 years. The data are presented in graphs, tables, and maps (wherever possible), providing multiple formats to make the information accessible to a range of audiences. Section I is the Foreword. Section II offers brief technical notes specific …

Ensuring Education For All In Bihar: Highlighting The Obstacles, International Institute For Population Sciences (Iips), Population Council

Poverty, Gender, and Youth

The extent to which India will be able to successfully harness its demographic dividend depends significantly on the situation of its youth, notably on the levels of education and market-oriented skills they attain. While many states have made progress on the education front, many other states, including Bihar, have lagged behind. Looking at the current educational situation of youth in Bihar, this policy brief argues that significant investments in terms of appropriate policies and programs are required to enable the state to: achieve the Millennium Development Goals of universal primary education and elimination of gender disparity in primary and secondary …

Adolescent Girls In Urban Ethiopia: Vulnerability And Opportunity, Abebaw Ferede, Annabel Erulkar

Poverty, Gender, and Youth

In 2008, the Population Council undertook a survey of out-of-school, adolescent girls (aged 10 to 19) in slum areas of urban Ethiopia—a population that is highly vulnerable to HIV infection. The survey serves as a baseline for HIV prevention programs designed and implemented jointly by the Ministry of Youth and Sports, Regional Bureaus of Youth and Sports, and the Population Council. This study provided valuable direction for programmers interested in supporting adolescent girls, particularly early adolescent (10 to 14 years old) and out-of-school girls who are highly vulnerable and in need of dedicated attention. Special efforts are needed to support …

Regulation Of Alginate Production Of Pseudomonas Aeruginosa Pseudomonas Aeruginosa, Fredrick Heath Damron

Theses, Dissertations and Capstones

Pseudomonas aeruginosa (P.a.) is a major threat to the health and well being of a person living with cystic fibrosis (CF). P.a. is capable of conversion to mucoidy or alginate overproducing phenotype. Mucoidy facilitates the chronic infection of P.a. infection in the CF lung. Mutations in the anti-sigma factor mucA, result in activation of the sigma factor AlgU which promotes expression of alginate through the alginate biosynthetic operon. However, P.a. can produce alginate independent of mucA mutation via a mechanism known as regulated proteolysis. Proteases AlgW and MucP can degrade MucA to liberate and activate AlgU. In this dissertation, two …

Variables In Health Care Policy Making: Resolving A Quandary, George P. Smith Ii

Scholarly Articles

Contemporary debate in health care resource management is tied to a central moral issue: how to achieve the optimum level of reasonable or appropriate treatment based on the medical condition of each patient. Failure to tackle and resolve this issue in a confident and forthright manner ensures that the present approach to health care decision-making will continue in a state of indecisiveness if not, indeed, lethargy. Undergirding this moral issue is the foundational economic dilemma of controlling costs while limiting access to health care resources. Crafting a just solution to an equitable distribution of finite health care resources is, indeed, …

Four-Country Surveillance Of Intestinal Intussusception And Diarrhoea In Children, Shally Awasthi, Girdhar Agarwal, Vikas Mishra, Vijay Laxmi Nag, Hesham Fathey El Sayed, Antonio Da Cunha, Alvaro Madeiro, Dipty Jain, William Macharia, James Ndung'u, Saumya Awasthi, Ashish Wakhlu

Paediatrics and Child Health, East Africa

Aim: Establishment of baseline epidemiology of intussusception in developing countries has become a necessity with the possibility of reintroduction of rotavirus vaccine. The current study assessed the seasonal trend in cases admitted with intussusceptions and dehydrating acute watery diarrhoea in children aged 2 months to 10 years.

Methods: In a prospective surveillance study, teaching and research hospital sites in India (Lucknow and Nagpur), Brazil (Fortazela), Egypt (Ismailia) and Kenya (Nairobi) established a surveillance where a network of hospitals with surgical facilities catered to a reference population of about 1-2 million for reporting of intussusception. One large hospital per site also …