Medicine and Health Sciences Commons^™

Emerging Viruses In The Felidae: Shifting Paradigms, Stephen J. O'Brien, Jennifer L. Troyer, Meredith Brown, Warren E. Johnson, Agostinho Antunes, Melody E. Roelke, Jill Pecon-Slattery

Biology Faculty Articles

The domestic cat is afflicted with multiple viruses that serve as powerful models for human disease including cancers, SARS and HIV/AIDS. Cat viruses that cause these diseases have been studied for decades revealing detailed insight concerning transmission, virulence, origins and pathogenesis. Here we review recent genetic advances that have questioned traditional wisdom regarding the origins of virulent Feline infectious peritonitis (FIP) diseases, the pathogenic potential of Feline Immunodeficiency Virus (FIV) in wild non-domestic Felidae species, and the restriction of Feline Leukemia Virus (FeLV) mediated immune impairment to domestic cats rather than other Felidae species. The most recent interpretations indicate important …

Improved Cardiac Management With A Disease Management Program Incorporating Comprehensive Lipid Profiling., John F Mcana, Neil I Goldfarb, Joseph Couto, Michelle A Henry, Gary Piefer, George M Rapier

College of Population Health Faculty Papers

The objective of this study was to evaluate the improved effectiveness of a disease management treatment protocol incorporating comprehensive lipid profiling and targeted lipid care based on lipid profile findings in patients with ischemic heart disease (IHD) or congestive heart failure (CHF) enrolled in a managed care plan. This retrospective cohort study, conducted over a 2-year period, compared outcomes between patients with a standard lipid profile to those evaluated with a comprehensive lipid profile. All adult members of the WellMed Medical Management, Inc. managed care health plan diagnosed with IHD or CHF, and continuously enrolled between July 1, 2006 and …

Health Status, Service Use And Cost Among Mainecare Children In Foster Care, Erika C. Ziller Phd, Tina Gressani, Catherine Mcguire Bs, Kimberley S. Fox Mpa, Kyra Chamberlain Ms, Rn

Population Health & Health Policy

The purpose of this study was to inform IHOC program planning with baseline data on the health care use and expenditures of MaineCare children in the foster care program in general and to compare use and costs for foster care children that receive comprehensive health assessments through the Edmund N. Ervin Pediatric Center’s Pediatric Rapid Evaluation Program (PREP), and those that do not. In 2011, other organizations including Key Clinic at Penobscot Pediatrics in Bangor and the Portland-based Spurwink Services program also began conducting comprehensive health assessments for children in foster care. However, because of the timing of this study, …

Insights From "Creating The Healthcare Workforce For The 21(St) Century" Conference., Amanda R Solis

College of Population Health Faculty Papers

No abstract provided.

Laryngeal Tuberculosis Presenting As Laryngeal Carcinoma, Anwar Suhail, Muhammad Sheharyar Ahmed, Zain-Ul-Abdeen Sobani, Shahzad Ghaffar

Section of Otolaryngology, Head & Neck Surgery

Tuberculosis (TB) accounts for the highest number of mortalities among infectious diseases worldwide. Laryngeal TB is an extremely rare presentation of TB. It has many similarities to laryngeal carcinoma, one of the three most common cancers among males in the city, with an age standardized rate of 8.6. The associated risk factors of laryngeal carcinoma i.e. smoking, paan, betel nut usage and alcohol use also tend to be concentrated in the same demographic background as that of TB, creating a diagnostic dilemma. We present a case of granulomatous laryngeal TB, in a 40 year old male, with characteristic presenting features …

Adult Laryngeal Haemangioma; A Rare Entity, Shabbir Akhtar, Adeel Ahmed Shamim, Shehzad Ghaffar, Muhammad Sheryar Ahmed, Mubasher Ikram

Section of Otolaryngology, Head & Neck Surgery

Laryngeal haemangioma is commonly seen in children. Adult laryngeal haemangiomas are rare and usually involve the supraglottic region. Most common symptom includes dysphagia, dysphonia and shortness of breath. Detailed history, fiberoptic laryngoscopy and computerized scanning may suggest benign nature of the lesion but diagnosis is only confirmed by a biopsy. In comparison to infantile haemangiomas which usually respond to propronolol, the treatment of adult laryngeal haemangiomas is always surgical removal. We present a case report of a supraglottic haemangioma in an adult male, who was treated surgically without any complications.

Surgical Outcome In Pet-Positive, Mri-Negative Patients With Temporal Lobe Epilepsy, Carla Lopinto-Khoury, Michael R. Sperling, Christopher Skidmore, Maromi Nei, James Evans, Ashwini Sharan, Scott Mintzer

Department of Neurology Faculty Papers

PURPOSE:

Fluorodeoxyglucose positron emission computed tomography (FDG-PET) hypometabolism is important for surgical planning in patients with temporal lobe epilepsy (TLE), but its significance remains unclear in patients who do not have evidence of mesial temporal sclerosis (MTS) on magnetic resonance imaging (MRI). We examined surgical outcomes in a group of PET-positive, MRI-negative patients and compared them with those of patients with MTS.

METHODS:

We queried the Thomas Jefferson University Surgical Epilepsy Database for patients who underwent anterior temporal lobectomy (ATL) from 1991 to 2009 and who had unilateral temporal PET hypometabolism without an epileptogenic lesion on MRI (PET+/MRI-). We compared …

Does International Normalized Ratio Level Predict Pulmonary Embolism?, Patricia Hansen, Benjamin Zmistowski, Camilo Restrepo, Javad Parvizi, Richard H Rothman

Rothman Institute Papers

BACKGROUND: Preventing pulmonary embolism is a priority after major musculoskeletal surgery. The literature contains discrepant data regarding the influence of anticoagulation on the incidence of pulmonary embolism after joint arthroplasty. The American College of Chest Physicians guidelines recommend administration of oral anticoagulants (warfarin), aiming for an international normalized ratio (INR) level between 2 and 3. However, recent studies show aggressive anticoagulation (INR > 2) can lead to hematoma formation and increased risk of subsequent infection.

QUESTIONS/PURPOSES: We asked whether an INR greater than 2 protects against pulmonary embolism.

PATIENTS AND METHODS: We identified 9112 patients with 10,122 admissions for joint arthroplasty …

Increasing Consumer Involvement In Medicaid Nursing Facility Reimbursement: Lessons From New York And Minnesota, Edward Alan Miller, Cynthia Rudder

Gerontology Institute Publications

Medicaid is the major purchaser of nursing home care in the United States. States design their methods of reimbursing nursing homes to achieve desired policy objectives related to facility cost and quality, access to care, payment equity, service capacity, and budgetary control. The incorporation of multiple, sometimes conflicting incentives into state reimbursement systems has resulted in enormously complex and demanding methodologies that inhibit consumer participation in state rating setting decisions. In turn, the lack of consumer involvement has the potential to result in the adoption of reimbursement systems that favor industry and government interests at the expense of issues important …

An Amulet For Trustworthy Wearable Mhealth, Jacob Sorber, Minho Shin, Ronald Peterson, Cory Cornelius, Shrirang Mare, Aarathi Prasad, Zachary Marois, Emma N. Smithayer, David Kotz

Dartmouth Scholarship

Mobile technology has significant potential to help revolutionize personal wellness and the delivery of healthcare. Mobile phones, wearable sensors, and home-based tele-medicine devices can help caregivers and individuals themselves better monitor and manage their health. While the potential benefits of this “mHealth” technology include better health, more effective healthcare, and reduced cost, this technology also poses significant security and privacy challenges. In this paper we propose \emphAmulet, an mHealth architecture that provides strong security and privacy guarantees while remaining easy to use, and outline the research and engineering challenges required to realize the Amulet vision.

Medicine In The Americas, Kristine A. Petre Mls, Cm, Ahip

Department of Education

Medicine in the Americas is a freely available, searchable collection of historical medical Americana. The collection is part of the Digital Collections repository at the National Library of Medicine’s online digital archives. This review discusses the contents, searching functions, and additional features available in the collection.

Mir-25 Targets Tnf-Related Apoptosis Inducing Ligand (Trail) Death Receptor-4 And Promotes Apoptosis Resistance In Cholangiocarcinoma., Nataliya Razumilava, Steve F. Bronk, Rory L. Smoot, Christian D. Fingas, Nathan W. Werneburg, Lewis R. Roberts, Justin L. Mott

Journal Articles: Biochemistry & Molecular Biology

It has been established that microRNA expression and function contribute to phenotypic features of malignant cells, including resistance to apoptosis. Although targets and functional roles for a number of microRNAs have been described in cholangiocarcinoma, many additional microRNAs dysregulated in this tumor have not been assigned functional roles. In this study, we identify elevated miR-25 expression in malignant cholangiocarcinoma cell lines as well as patient samples. In cultured cells, treatment with the Smoothened inhibitor, cyclopamine, reduced miR-25 expression, suggesting Hedgehog signaling stimulates miR-25 production. Functionally, miR-25 was shown to protect cells against TNF-related apoptosis-inducing ligand (TRAIL)-induced apoptosis. Correspondingly, antagonism of …

Identification And Analysis Of The Ige Binding By Parvalbumin And Other Potential Allergens In Different Fish And Frog Species, P. Lee, J. A. Nordlee, S. J. Koppelman, J. L. Baumert, Steve L. Taylor

Department of Food Science and Technology: Faculty Publications

Rationale: Serological cross-reactivity to different fish and frog species is common among fish-allergic individuals.We examined the intra- and inter-individual diversity in IgE responses of fish-allergic subjects to various fish and frog species and identified novel allergens besides parvalbumin.

Methods: Sera from 38 subjects with a clinical history of fish allergy were analyzed for IgE-binding profiles to crude extracts of 26 raw fish and frog species, and purified cod and carp parvalbumin using IgE-immunoblotting. Sera of 7 subjects showing similar IgE-binding profiles in the IgEimmmunoblotting were pooled to identify potential allergens in pilchard, herring, cod, cusk, and rainbow trout using two-dimensional …

Comparing The Validity Of 2 Physical Activity Questionnaire Formats In African-American And Hispanic Women, Louise C. Mâsse, Janet E. Fulton, Kathleen B. Watson, Susan Tortolero, Harold W. Kohl Iii, Michael C. Meyers, Steven N. Blair, William W. Wong

Faculty Publications

Background: The purpose of this study was to compare the validity of 2 physical activity questionnaire formats - one that lists activities (Checklist questionnaire) and one that assesses overall activities (Global questionnaire) by domain.

Methods: Two questionnaire formats were validated among 260 African-American and Hispanic women (age 40-70) using 3 validation standards: 1) accelerometers to validate activities of ambulation; 2) diaries to validate physical activity domains (occupation, household, exercise, yard, family, volunteer/church work, and transportation); and 3) doubly-labeled water to validate physical activity energy expenditure (DLW-PAEE).

Results: The proportion of total variance explained by the Checklist questionnaire was 38.4% with …

Hiv Testing In Women: Missed Opportunities, Wayne A. Duffus, Harley T. Davis, Michael D. Byrd, Khosrow Heidari, Terri G. Stephens, James J. Gibson

Faculty Publications

Objective: To investigate opportunities for early human immunodeficiency virus (HIV) testing on women.

Methods: A retrospective cohort study design linked case reports from HIV surveillance to several statewide health-care databases. Medical encounters occurring before the first positive HIV test (missed opportunities) were categorized by diagnosis/procedure codes to distinguish visits that were likely to have prompted an HIV test. Women were categorized as late testers (AIDS diagnosis < 12 months from first HIV test date), non-late testers (no AIDS diagnosis during study period or diagnosis of AIDS > 12 months of HIV diagnosis), of reproductive age (13-44 years old), and not of reproductive age (> 44 years old). Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were used to estimate risk …

Secrets Of Successful Short Grant Applications, Patricia S. Groves, Susan M. Rawl, Mary E. Wurzbach, Nancy Fahrenwald, Marlene Z. Cohen, Donna O. Mccarthy, Julie Zerwic, Barbara Given, Donna L. Algase, Gregory L. Alexander, Vicki Conn

College of Nursing Faculty Research and Publications

Nursing doctoral programs prepare students for research-focused careers within academic settings. The purpose of this Editorial Board Special Article is to provide PhD students and advisors with suggestions for making the most of their doctoral experience. Editorial Board members provide their individual insights on the skills and attributes students must acquire during the course of their doctoral education in order to succeed. The authors provide practical tips and advice on how to excel in a PhD program, including how to select an advisor and a dissertation committee, the importance of attending conferences to increase visibility and develop a network of …

Latent Print Examination And Human Factors: Improving The Practice Through A Systems Approach: The Report Of The Expert Working Group On Human Factors In Latent Print Analysis, David H. Kaye, Thomas Busey, Melissa R. Gische, Gerry Laporte, Scott A. Shappell, Et Al.

Publications

Fingerprints have provided a valuable method of personal identification in forensic science and criminal investigations for more than 100 years. Fingerprints left at crime scenes generally are latent prints—unintentional reproductions of the arrangement of ridges on the skin made by the transfer of materials (such as amino acids, proteins, polypeptides, and salts) to a surface. Palms and the soles of feet also have friction ridge skin that can leave latent prints. The examination of a latent print consists of a series of steps involving a comparison of the latent print to a known (or exemplar) print. Courts have accepted latent …

Evaluation Of Suitability To Mothers Of Low Literacy Level Of Websites Information On Basics Of Baby Bath Using Discern Tool, Kahabi Isangula

School of Nursing & Midwifery, East Africa

One of the challenges in Newborn care is bathing a baby especially for new parents. Baby bath as part of newborn care is of critical importance for healthier development of a baby. Increasingly, Internet resources have been publishing different information on neonatal care complementing the traditional sources. Internet information is readily available and involve no or minimal cost as far as medical costs are concerns thus new parents with access, may use internet as the main source of baby care information. The purpose of this paper is to evaluate the suitability to mothers of low literacy level, of baby bathing …

Impact Of A Dietary Supplement Containing 1,3-Dimethylamylamine On Blood Pressure And Bloodborne Markers Of Health: A 10-Week Intervention Study, Paul Whitehead, Brian Schilling, Tyler Farney, Richard Bloomer

Kinesiology and Nutrition Sciences Faculty Research

No abstract provided.

Hiv And Aids Education: The Tanzanian Case, Katherine Ellison

Social Sciences

This project takes a look at the cultural, religious, and socio-economic roles that affect the spread of education regarding HIV/AIDS in Tanzania. A personal experience in Zanzibar, Tanzania was the incentive to spark interest in teaching. HIV/AIDS is a powerful epidemic that has taken the lives away from millions. This article takes a deeper look at the transmission, stigmas, and pathways for change.

The Influence Of Antiretroviral Therapy On The Qtc Interval In An African Cohort, J. Shavadia, Reena Shah, Gerald Yonga, R. Patel, J. Stebbing, M. Nelson

Internal Medicine, East Africa

Cardiovascular disease in human immunodeficiency virus (HIV) infection encompasses a wide range of pathologic entities, including myocardial, pericardial, and endocardial disease, atherosclerosis, arrhythmias, and vasculitis. The most common manifestations of HIV-associated heart disease in sub- Saharan Africa are pericarditis, cardiomyopathy, and pulmonary hypertension [1]. Coronary artery disease, lipodystrophy, and metabolic syndrome, although common in developed countries, are traditionally thought to be less clinically significant problems in the African subcontinent [2]. It is well known that prolongation of the QTC interval can predispose patients to potentially fatal ventricular tachyarrhythmias, particularly torsades de pointes, and thus is an independent predictor of cardiovascular …

An Inside Job: Hacking Into Janus Kinase/Signal Transducer And Activator Of Transcription Signaling Cascades By The Intracellular Protozoan Toxoplasma Gondii, Eric Y. Denkers, David J. Bzik, Barbara A. Fox, Barbara A. Butcher

Dartmouth Scholarship

The intracellular protozoan Toxoplasma gondii is well known for its skill at invading and living within host cells. New discoveries are now also revealing the astounding ability of the parasite to inject effector proteins into the cytoplasm to seize control of the host cell. This review summarizes recent advances in our understanding of one such secretory protein called ROP16. This molecule is released from rhoptries into the host cell during invasion. The ROP16 molecule acts as a kinase, directly activating both signal transducer and activator of transcription 3 (STAT3) and STAT6 signaling pathways. In macrophages, an important and preferential target …

Passive Biometrics For Pervasive Wearable Devices (Poster Paper), Cory Cornelius, Zachary Marois, Jacob Sorber, Ron Peterson, Shrirang Mare, David Kotz

Dartmouth Scholarship

Wearable devices – like the FitBit, MOTOACTV, and Jawbone UP – are increasingly becoming more pervasive whether for monitoring health and fitness, personal assistance, or home automation. While pervasive wearable devices have long been researched, we are now beginning to see the fruits of this research in the form of commercial offerings. Today, many of these commercial wearable devices are closed systems that do not interoperate with other devices a person might carry. We believe, however, these commercial offerings signal the coming of wireless body-area networks that will connect these pervasive wearable devices and leverage existing devices a user already …

Salud Y Saludos: The E-News Of The College Of Health Sciences, College Of Health Sciences

College of Health Sciences

Monthly e-newsletter of the College of Health Sciences.

Dramatically Increased Musculoskeletal Ultrasound Utilization From 2000 To 2009, Especially By Podiatrists In Private Offices, Richard E. Sharpe, Levon N. Nazarian, Laurence Parker, Vijay Rao, David C. Levin

Department of Radiology Faculty Papers

PURPOSE: Over the past two decades, musculoskeletal (MSK) ultrasound has emerged as an effective means of diagnosing MSK pathologies. However, some insurance providers have expressed concern about increased MSK ultrasound utilization, possibly facilitated by the low cost and ready availability of ultrasound technology. The purpose of this study was to document trends in MSK ultrasound utilization from 2000 to 2009 within the Medicare population.

METHODS: Source data were obtained from the CMS Physician/Supplier Procedure Summary Master Files from 2000 to 2009, and records were extracted for procedures for extremity nonvascular ultrasound. We analyzed annual volume by provider type using specialties, …

Phase I Study Of Bosutinib, A Src/Abl Tyrosine Kinase Inhibitor, Administered To Patients With Advanced Solid Tumors, Adil Daud, Smitha Krishnamurthi, Mansoor Saleh, Barbara Gitlitz, Mitesh Borad, Philip Gold, Elena Chiorean, Gregory Springett, Richat Abbas, Shefali Agarwal

Haematology and Oncology, East Africa

Purpose: Bosutinib, a potent ATP-competitive, quinolinecarbonitrile Src/Abl kinase inhibitor, was tested in this first-in-human phase I trial in patients with advanced solid tumor malignancies.

Patients and Methods: This trial was conducted in 2 parts. In part 1 (dose escalation), increasing oral bosutinib doses were administered using a 3 + 3 design. In part 2 (dose expansion), approximately 30 patients each with refractory colorectal, pancreas, or non–small cell lung cancer were treated at the recommended phase II dose (RP2D). Primary efficacy endpoints for part 2 were median progression-free survival (colorectal and non–small cell lung) and median overall survival (pancreas).

Results: In …

The Formal And Informal Surgical Ethics Curriculum: Views Of Resident And Staff Surgeons In Toronto., Frazer Howard, Martin F. Mckneally, Ross E.G. Upshur, Alex V. Levin

Wills Eye Hospital Papers

BACKGROUND: Understanding what staff surgeons think surgical trainees should learn and the ethical issues that trainees need to manage can strengthen surgical ethics education.

METHODS: Participants were recruited from the 15 surgical specialty and subspecialty programs at the University of Toronto. Semistructured interviews and focus groups were conducted with 13 ethics coordinators from the surgical staff and 64 resident trainees. Data were analyzed qualitatively using modified thematic analysis.

RESULTS: All coordinators and trainees felt that ethics education was an important component of surgical training. Real cases, varying teaching methods, and teachers with applicable clinical experience were valued. Trainees identified intraprofessional …

L-Tetrahydropalamatine: A Potential New Medication For The Treatment Of Cocaine Addiction, Jia Bei Wang​, John R. Mantsch

Biomedical Sciences Faculty Research and Publications

Levo-tetrahydropalmatine (l-THP) is an active constituent of herbal preparations containing plant species of the genera Stephania and Corydalis and has been approved and used in China for a number of clinical indications under the drug name Rotundine. The pharmacological profile of l-THP, which includes antagonism of dopamine D1 and D2 receptors and actions at dopamine D3, α adrenergic and serotonin receptors, suggests that it may have utility for treating cocaine addiction. In this review, we provide an overview of the pharmacological properties of l-THP and the evidence supporting its development as an anti-addiction medication. The results …

Upper Extremity-Specific Measures Of Disability And Outcomes In Orthopaedic Surgery, Matthew V. Smith, Ryan P. Calfee, Keith M. Baumgarten, Robert H. Brophy, Rick W. Wright

Open Access Publications

No abstract provided.

Using Health Information Technology To Engage Communities In Health, Education, And Research, Lisa K. Marriott, David A. Nelson, Shauntice Allen, Karen Calhoun, Christina Eldredge, Kim S. Kimminau, Robert J. Lucero, Fernando Pineda-Reyes, Bernice B. Rumala, Arti P. Varanasi, June S. Wasser, Jackilen Shannon

School of Information Faculty Publications

The August 2011 Clinical and Translational Science Awards conference "Using IT to Improve Community Health: How Health Care Reform Supports Innovation" convened four "Think Tank" sessions. Thirty individuals, representing various perspectives on community engagement, attended the "Health information technology (HIT) as a resource to improve community health and education" session, which focused on using HIT to improve patient health, education, and research involvement. Participants discussed a range of topics using a semistructured format. This article describes themes and lessons that emerged from that session, with a particular focus on using HIT to engage communities to improve health and reduce health …