Medicine and Health Sciences Commons^™

Building A Statistical Model For Predicting Cancer Genes, Ivan P. Gorlov, Christopher J. Logothetis, Shenying Fang, Olga Y. Gorlova, Christopher Amos

Dartmouth Scholarship

More than 400 cancer genes have been identified in the human genome. The list is not yet complete. Statistical models predicting cancer genes may help with identification of novel cancer gene candidates. We used known prostate cancer (PCa) genes (identified through KnowledgeNet) as a training set to build a binary logistic regression model identifying PCa genes. Internal and external validation of the model was conducted using a validation set (also from KnowledgeNet), permutations, and external data on genes with recurrent prostate tumor mutations. We evaluated a set of 33 gene characteristics as predictors. Sixteen of the original 33 predictors were …

The Role Of Rate Of Force Development On Vertical Jump Performance, Christopher Mclellan, Dale Lovell, Gregory Gass

Chris McLellan

The purpose of this study was to examine a) the relationship between rate of force development (RFD) and vertical jump (VJ) performance during a counter movement jump (CMJ), and b) the reliability of RFD recorded during the CMJ and squat jump (SJ) forms of the VJ. Twenty-three physically active men aged 23 ± 3.9 years participated in the study. Subjects completed 3 unloaded CMJ and 3 unloaded SJ in random order on a force plate. The RFD was measured during CMJ and SJ movements with vertical jump displacement (VJD) measured simultaneously during the CMJ only. Subjects incorporated arm swing to …

Polysaccharopeptide Enhances The Anticancer Activity Of Doxorubicin And Etoposide On Human Breast Cancer Cells Zr-75-30, Jennifer Man-Fan Wan, Wai Hung Sit, Jimmy Chun Yu Louie

Jimmy Chun Yu Louie

In search of natural bioactive microbial compounds with adjuvant properties, we have previously showed that the polysaccharopeptide (PSP), isolated from Chinese medicinal mushroom Coriolus versicolor, was able to enhance the cytotoxicity of certain S-phase targeted-drugs on human leukemic HL-60 cells via some cell-cycle and apoptotic-dependent pathways. The present study aimed to investigate whether the synergism of mechanisms of PSP with certain chemotherapeutic drugs also applies to human breast cancer. PSP treatment enhanced the cytotoxicity of doxorubicin (Doxo), etoposide (VP-16) but not cytarabine (Ara-C). Bivariate bromodeoxyuridine (BrdUrd)/DNA flow cytometry analysis estimated a longer DNA synthesis time (Ts) for the PSP treated …

Bandemia With Normal White Blood Cell Counts Associated With Infection., Marci Drees, Narrani Kanapathippillai, Marc T Zubrow

Department of Medicine Faculty Papers

OBJECTIVE: Measuring immature white blood cell forms ("bands") has been considered clinically unnecessary. We performed this study to determine whether elevated band counts, with normal total white blood cells on admission, were associated with infection or in-hospital death.

METHODS: We performed a retrospective cohort study including all patients admitted to the Christiana Care Health System 2-hospital, 1100-bed community-based academic health system in 2009 with normal white blood cells (3800-10,800 per mm(3)) on admission who had manual differentials performed. We defined our band groups as normal (≤10% bands and other immature cells), moderate (11%-19%), or high (≥20%). Via chart review, we …

Regulatory T-Cells And Associated Pathways In Metastatic Renal Cell Carcinoma (Mrcc) Patients Undergoing Dc-Vaccination And Cytokine-Therapy, Adrian Schwarzer, Benita Wolf, Jan L. Fisher, Thomas Schwaab, Sven Olek, Udo Baron, Craig R. Tomlinson, John D. Seigne, Nancy A. Crosby, Jiang Gui, Thomas H. Hampton, Camilo E. Fadul, John A. Heaney, Marc S. Ernstoff

Dartmouth Scholarship

Purpose: To evaluate CD4+CD25+FOXP3+ T regulatory cells (TREG) and associated immune-regulatory pathways in peripheral blood lymphocytes (PBL) of metastatic renal cell carcinoma (mRCC) patients and healthy volunteers. We subsequently investigated the effects of immunotherapy on circulating TREG combining an extensive phenotype examination, DNA methylation analysis and global transcriptome analysis.

Design: Eighteen patients with mRCC and twelve volunteers (controls) were available for analysis. TREG phenotype was examined using flow cytometry (FCM). TREG were also quantified by analyzing the epigenetic status of the FOXP3 locus using methylation specific PCR. As a third approach, RNA of the PBL was hybridized to Affymetrix GeneChip …

A Comparison Of Asynchronous And Synchronous Arm Cranking During The Wingate Test, Dale Lovell, Dale Mason, Elias Delphinus, Christopher Mclellan

Chris McLellan

Purpose: The aim of this study was to compare asynchronous (ASY) arm cranking (cranks at 180° relative to each other) with synchronous (SYN) arm cranking (parallel crank setting) during the 30 s Wingate anaerobic test.

Methods: Thirty-two physically active men (aged 22.1 ± 2.4 y) completed two Wingate tests (one ASY and one SYN) separated by 4 d in a randomized counterbalanced order. The Wingate tests were completed on a modified electromagnetically braked cycle ergometer. Performance measures assessed during the two tests include peak power, mean power, minimum power, time to peak power, rate to fatigue and maximum …

Human Lens Lipids Differ Markedly From Those Of Commonly Used Experimental Animals, Jane Deeley, Todd W. Mitchell, Xiaojia Wei, Jurgen Korth, Jessica Hughes, Stephen J. Blanksby, Roger J. Truscott

Stephen Blanksby

Electrospray ionisation tandem mass spectrometry has allowed the unambiguous identification andquantification of individual lens phospholipids in human and six animal models. Using this approach ca. 100unique phospholipids have been characterised. Parallel analysis of the same lens extracts by a novel directinsertionelectron-ionization technique found the cholesterol content of human lenses to be significantlyhigher (ca. 6 times) than lenses from the other animals.The most abundant phospholipids in all the lenses examined were choline-containing phospholipids. In rat,mouse, sheep, cow, pig and chicken, thesewere present largely as phosphatidylcholines, in contrast 66% of thetotal phospholipid in Homo sapienswas sphingomyelin, with the most abundant being dihydrosphingomyelins,in …

Genetic Association Analysis Of Complex Diseases Incorporating Intermediate Phenotype Information, Yafang Li, Jian Huang, Christopher I. Amos

Dartmouth Scholarship

Genetic researchers often collect disease related quantitative traits in addition to disease status because they are interested in understanding the pathophysiology of disease processes. In genome-wide association (GWA) studies, these quantitative phenotypes may be relevant to disease development and serve as intermediate phenotypes or they could be behavioral or other risk factors that predict disease risk. Statistical tests combining both disease status and quantitative risk factors should be more powerful than case-control studies, as the former incorporates more information about the disease. In this paper, we proposed a modified inverse-variance weighted meta-analysis method to combine disease status and quantitative intermediate …

Comparison Of Selected Teaching Strategies Incorporating Simulation And Student Outcomes, Elizabeth Swanson, Anita Nicholson, Teresa Boese, Ellen Cram, Anita Stineman, Kimberly Tew

Elizabeth A. Swanson

No abstract provided.

Healthy People 2000. A Fall Prevention Program For Elderly Individuals: Exercise In Long-Term Care Settings, Deborah Schoenfelder

Deborah P. Schoenfelder

No abstract provided.

In Utero Exposures, Infant Growth, And Dna Methylation Of Repetitive Elements And Developmentally Related Genes In Human Placenta, Charlotte S. Wilhelm-Benartzi, E. Andres Houseman, Matthew A. Maccani, Graham M. Poage, Devin C. Koestler, Scott M. Langevin, Luc A. Gagne, Carolyn E. Banister, James F. Padbury, Carmen J. Marsit

Dartmouth Scholarship

BACKGROUND:

Fetal programming describes the theory linking environmental conditions during embryonic and fetal development with risk of diseases later in life. Environmental insults in utero may lead to changes in epigenetic mechanisms potentially affecting fetal development.

OBJECTIVES:

We examined associations between in utero exposures, infant growth, and methylation of repetitive elements and gene-associated DNA in human term placenta tissue samples.

METHODS:

Placental tissues and associated demographic and clinical data were obtained from subjects delivering at Women and Infants Hospital in Providence, Rhode Island (USA). Methylation levels of long interspersed nuclear element-1 (LINE-1) and the Alu element AluYb8 were determined in …

Protocol For A Randomized Controlled Trial Evaluating The Effect Of Physical Activity On Delaying The Progression Of White Matter Changes On Mri In Older Adults With Memory Complaints And Mild Cognitive Impairment: The Aibl Active Trial, E V Cyarto, N T Lautenschlager, P M Desmond, D Ames, C Szoeke, O Salvado, Matthew Sharman, Kathryn A Ellis, P M Phal, C L Masters, C C Rowe, Ralph Martins, Kay L Cox

Research outputs 2012

Background: Older adults free of dementia but with subjective memory complaints (SMC) or mild cognitive impairment (MCI) are considered at increased risk of cognitive decline. Vascular risk factors (VRF), including hypertension, heart disease, smoking, hypercholesterolemia and lack of physical activity (PA) have been identified as modifiable risk factors contributing to cognitive decline, and white matter hyperintensities (WMH) are associated with VRF, SMC and cognitive impairment. Findings from a growing number of clinical trials with older adults are providing strong evidence for the benefits of physical activity for maintaining cognitive function, but few studies are investigating these benefits in high-risk populations. …

Minimally Invasive Oesophagectomy: Current Status And Future Direction, Nick Butler, Stuart Collins, Breda Memon, Muhammed Memon

Muhammed Ashraf Memon

Background:Oesophagectomy is one of the most challenging surgeries. Potential for morbidity and mortality is high. Minimally invasive techniques have been introduced in an attempt to reduce postoperative complications and recovery times. Debate continues over whether these techniques are beneficial to morbidity and whether oncological resection is compromised. This review article will analyse the different techniques employed in minimally invasive oesophagectomy (MIO) and critically evaluate commonly reported outcome measures from the available literature.Methods:Medline, Embase, Science Citation Index, Current Contents, and PubMed databases were used to search English language articles published on MIO. Thirty-one articles underwent thorough analysis and the data were …

Traumatic Injury Rates In Meatpacking Plant Workers, Kennith Culp, M. Brooks, Kerri Rupe, C. Zwerling

Kerri A. Rupe

This was a 3-year retrospective cohort study of traumatic injuries in a midwestern pork meatpacking plant. Based on n = 5410 workers, this was a diverse workforce: Caucasian (56.6%), Hispanic (38.9%), African American (2.7%), Asian (1.1%) and Native American (0.8%). There were n = 1655 employees with traumatic injuries during this period. At 6 months of employment, the probability of injury was 33% in the harvest workers who were responsible for slaughter operations. The overall incidence injury rate was 22.76 per 100 full-time employees per year. Women experienced a higher incidence for injury than men. The risk ratio (RR) for …

Innovativeness In Nursing: A Phenomenological And Constructivist Study, Maria Joseph

Maria (Lindell) Joseph

Hospital administration and the medical field have maintained the status quo of nursing practice, in which nurses have adopted bureaucratic structures where conformity and regimentation are maintained to ensure large-scale efficiency. The lack of control to act on nursing knowledge and expert judgment is linked to work conditions of oppression, lack of autonomy, dissatisfaction, concomitant patient mortality, and morbidity. A climate of innovativeness is one strategy to reverse the negative impact caused by hospital administration and the medical field. The purpose of this phenomenological study was to explore the behavioral characteristics of lived experiences and knowledge of innovativeness among nurses …

Earthly Indifference And Human Difference - Book Review, Lesley Head

Faculty of Science, Medicine and Health - Papers: part A

Inspired by, but also in reaction to the flattened topologies of Latourian relationality, Clark puts forward the notion of radical asymmetry. 'This is the bottom line of human being: we are utterly dependent on an earth and a cosmos that is, to a large degree, indifferent to us' (p. 50). With their disciplinary connection to the physical and natural sciences, geographers arguably need this lesson less than other social scientists. We should have learned it well from geologists who, spending their working lives in deepest time, tend to have a less anthropocentric perspective than others (perhaps accounting for their disproportionate …

Literacy-Appropriate Educational Materials And Brief Counseling Improve Diabetes Self-Management, Andrea Wallace, H. Seligman, T. Davis, D. Schillinger, C. Arnold, B. Bryant-Shilliday, J. Freburger, D. Dewalt

Andrea S. Wallace

OBJECTIVE: In this pilot study, we evaluated the impact of providing patients with a literacy-appropriate diabetes education guide accompanied by brief counseling designed for use in primary care. METHODS: We provided the Living with Diabetes guide and brief behavior change counseling to 250 English and Spanish speaking patients with type 2 diabetes. Counseling sessions using collaborative goal setting occurred at baseline and by telephone at 2 and 4 weeks. We measured patients' activation, self-efficacy, diabetes distress, knowledge, and self-care at baseline and 3-month follow-up. RESULTS: Statistically significant (p

Race, Care Seeking, And Utilization For Chronic Back And Neck Pain: Population Perspectives, T. Carey, J. Freburger, G. Holmes, A. Jackman, S. Knauer, Andrea Wallace, J. Darter

Andrea S. Wallace

We analyzed a statewide survey of individuals with chronic back and neck pain to determine whether prevalence and care use varied by patient race or ethnicity. We conducted a telephone survey of a random sample of 5,357 North Carolina households in 2006. Adults with chronic (>3 months duration or >24 episodes of pain per year), impairing back or neck pain were identified and were asked to complete a survey about their health and care utilization. 837 respondents (620 white, 183 black, 34 Latino) reported chronic back or neck pain. Whites and blacks had similar rates of chronic back pain. …

Accessing Asthma Care: A Case Study Of Urban Children, Andrea Wallace

Andrea S. Wallace

The purpose of this exploratory, descriptive study was to identify factors that facilitate or impede the use of health care resources by urban children with asthma. Using an embedded case study design, the study considered the issue of health care access for urban children with asthma by focusing on attributes that impede and facilitate these children's access to health care resources. Interview, demographic, survey, and medical records data were analyzed for 34 parent-child dyads accessing asthma care in one metropolitan health care system. Interview data from 14 health care professionals were also analyzed. These findings were then compared with utilization …

Multigenerational Nursing Workforce Value Differences And Work Environment: Impact On Rns' Turnover Intentions, Amany Farag

Amany A. Farag

Despite ongoing nursing retention efforts, the national turnover rate continues to climb as high as 21% annually. Creating a climate that supports retention is among the many responsibilities of first line nurse manager. This task is challenged by the presence of multigenerational nursing workforce. Nurses from different age cohorts come to the work environment with different set of professional and generational (terminal and instrumental) values. Values are enduring beliefs about what constitutes desirable and acceptable behavior; values play a fundamental role in both decision making and meaning formation processes. Nursing literature suggested that nurses from different age cohorts may perceive …

How Prostate Cancer Patients Cope With The Effects Of Diagnosis And Treatment: Development Of The Effects Of Prostate Cancer Coping Strategies Scale, Christopher Sharpley, Vicki Bitsika, David Christie

Vicki Bitsika

Background: The elevated anxiety and depression experienced by prostate cancer (PCa) patients can impair their decision-making as well as decrease their psychological well-being and weaken relationships with partner and family. Although standardised assessment models exist for identifying the symptoms of anxiety or depression, relatively little attention has been given to identifying the causal antecedents that PCa patients encounter and that may lead to anxiety or depression, nor their own attempts to cope with those antecedents. This study investigated the coping strategies used by a sample of PCa patients in response to the specific stressors and lifestyle changes that arose from …

Common Respiratory Issues In Ambulatory Obstetrics., Kelly M Orzechowski, Richard C Miller

Department of Obstetrics and Gynecology Faculty Papers

This article reviews the diagnosis and management of the most common respiratory conditions complicating pregnancy--asthma and influenza. We also review strategies for smoking cessation in pregnancy as, in addition to exacerbating all other pulmonary conditions, smoking is the most modifiable risk factor for poor pregnancy outcome. Moreover, the obstetrician frequently encounters each of these conditions in the ambulatory setting. A thorough knowledge of the normal pregnancy-induced physiological respiratory changes combined with a comprehensive understanding of how to manage these conditions, will provide the obstetrician with the armamentarium needed to optimize health outcomes for mothers and their fetuses.

Breast Milk From Tanzanian Women Has Divergent Effects On Cell-Free And Cell-Associated Hiv-1 Infection In Vitro, Magdalena A. Lyimo, Matilda Ngarina Mosi, Molly L. Housman, Muhammad Zain-Ul-Abideen, Frederick V. Lee, Alexandra L. Howell, Ruth I. Connor

Dartmouth Scholarship

Transmission of HIV-1 during breastfeeding is a significant source of new pediatric infections in sub-Saharan Africa. Breast milk from HIV-positive mothers contains both cell-free and cell-associated virus; however, the impact of breast milk on HIV-1 infectivity remains poorly understood. In the present study, breast milk was collected from HIV-positive and HIV-negative Tanzanian women attending antenatal clinics in Dar es Salaam. Milk was analyzed for activity in vitro against both cell-free and cell-associated HIV-1. Potent inhibition of cell-free R5 and X4 HIV-1 occurred in the presence of milk from all donors regardless of HIV-1 serostatus. Inhibition of cell-free HIV-1 infection positively …

The Mre11 Nuclease Is Critical For The Sensitivity Of Cells To Chk1 Inhibition, Ruth Thompson, Ryan Montano, Alan Eastman

Dartmouth Scholarship

The Chk1 kinase is required for the arrest of cell cycle progression when DNA is damaged, and for stabilizing stalled replication forks. As a consequence, many Chk1 inhibitors have been developed and tested for their potential to enhance DNA damage-induced tumor cell killing. However, inhibition of Chk1 alone, without any additional exogenous agent, can be cytotoxic. Understanding the underlying mechanisms of this sensitivity is critical for defining which patients might respond best to therapy with Chk1 inhibitors. We have investigated the mechanism of sensitivity in U2OS osteosarcoma cells. Upon incubation with the Chk1 inhibitor MK-8776, single-stranded DNA regions (ssDNA) and …

Narrative Art And Music Intervention With Incarcerated Abused Women, Janette Taylor, M. Eliason

Janette Y. Taylor

No abstract provided.

Talking Back: Research As An Act Of Resistance And Healing For African American Women Survivors Of Intimate Male Partner Violence, Janette Taylor

Janette Y. Taylor

The purpose of this article is to use a Black feminist/ womanist framework to: (a) explore the historical factors that discourage Black women's participation in the research process; (b) demonstrate how research can be a potential avenue of resistance and healing for African American women survivors of intimate male partner violence; and (c) suggest ways for practitioners and researchers to encourage the participation of this population. Benefits from the research process emerged as three themes: (a) healing the self, (b) helping others, and (c) envisioning new life directions.

Use Of The Index Of Partner Abuse With Incarcerated Women, Janette Taylor, M. Eliason

Janette Y. Taylor

No abstract provided.

Health Status And Resources Of Rural Homeless Women And Children, Martha Craft-Rosenberg, S. Powell, Kennith Culp

Martha J. Craft-Rosenberg

The purpose of this research is to describe the health status and health resources for homeless women and children in a Midwestern rural community. A group of 31 rural homeless women in a shelter participated in the study by answering questions on the Rural Homeless Interview developed by the investigators. The findings revealed higher than expected rates of illness, accidents, and adverse life events, with the incidence ofsubstance abuse and mental illness being comparable to data from other homeless populations. The data on children were limited by lack of knowledge on the part of their mothers. Some mothers reported that …

The Relationship Between Driving Anxiety And Driving Skill: A Review Of Human Factors And Anxiety-Performance Theories To Clarify Future Research Needs, Joanne Taylor, Frank P. Deane, John Podd

Frank Deane

This article examines theory and identifies gaps in research related to the role of driving skills in driving anxiety. Increasingly, investigators have examined the clinical features of driving anxiety and the more severe situation of driving fear and phobia, but the possible involvement of driving skills has been neglected. This is surprising given the potential implications for skills training and remediation in the assessment and treatment of some of those who experience driving anxiety, fear, and phobia. The largest body of relevant research comes from the driving and human factors literature on the relationship between anxiety and driving performance. The …

Clopidogrel Hypersensitivity: Clinical Challenges And Options For Management., Kimberly L Campbell, John R Cohn, Michael P Savage

Michael P Savage M.D.

Over 90 million patients have been prescribed clopidogrel since its US FDA approval in 1997. Clopidogrel hypersensitivity affects up to 6% of patients, most commonly in the form of a pruritic rash. Symptoms are severe enough to result in drug discontinuation in 1.5% of patients. Premature discontinuation of clopidogrel is problematic following percutaneous coronary intervention because of the risk of stent thrombosis leading to myocardial infarction and death. Accordingly, the management of patients with clopidogrel hypersensitivity is of significant clinical importance. Conventional clopidogrel desensitization protocols, while successful in most patients, employ a washout period off medication to enable accurate detection …