Medicine and Health Sciences Commons^™

Adaptive Behaviors In Toddlers Under Two With Autism Spectrum Disorders, Rhea Paul, Rebecca Loomis, Katarzyna Chawarska

Communication Disorders Faculty Publications

The Vineland Adaptive Behavior Scale was administered to 54 children diagnosed with autism spectrum disorder (ASD) before age 2, and a matching group of 18 toddlers with developmental delay (DD). The group with ASD was more impaired on all scales of the Vineland than DD peers. When 18 ASD/DD pairs very closely matched on age, verbal and nonverbal development were selected, differences were found only on Vineland Receptive Communication and Daily Living. Correlation analyses to explore connection of these areas of difference with cognition and autistic symptoms suggested that Vineland Daily Living scores were significantly correlated with nonverbal ability and …

Managing The Innovation Supply Chain To Maximize Personalized Medicine., Scott A. Waldman, Andre Terzic

Department of Pharmacology and Experimental Therapeutics Faculty Papers

Personalized medicine epitomizes an evolving model of care tailored to the individual patient. This emerging paradigm harnesses radical technological advances to define each patient's molecular characteristics and decipher his or her unique pathophysiological processes. Translated into individualized algorithms, personalized medicine aims to predict, prevent, and cure disease without producing therapeutic adverse events. Although the transformative power of personalized medicine is generally recognized by physicians, patients, and payers, the complexity of translating discoveries into new modalities that transform health care is less appreciated. We often consider the flow of innovation and technology along a continuum of discovery, development, regulation, and application …

Corticosterone Administration Up-Regulated Expression Of Norepinephrine Transporter And Dopamine Β-Hydroxylase In Rat Locus Coeruleus And Its Terminal Regions, Yan Fan, Ping Ping Chen, Ying Li, Kui Cui, Daniel M. Noel, Elizabeth D. Cummins, Daniel J. Peterson, Russell W. Brown, Meng-Yang Zhu

ETSU Faculty Works

Stress has been reported to activate the locus coeruleus (LC)-noradrenergic system. In this study, corticosterone (CORT) was orally administrated to rats for 21 days to mimic stress status. In situ hybridization measurements showed that CORT ingestion significantly increased mRNA levels of norepinephrine transporter (NET) and dopamine β-hydroxylase (DBH) in the LC region. Immunofluorescence staining and western blotting revealed that CORT treatment also increased protein levels of NET and DBH in the LC, as well as NET protein levels in the hippocampus, the frontal cortex and the amygdala. However, CORT-induced increase in DBH protein levels only appeared in the hippocampus and …

Spectrum Of Acquired Demyelinating Disorders Of The Central Nervous System In Adults In A Tertiary Care Hospital, Muhammad Athar Javed, Dr Qamar Zaman, Dr Naveed Alam, Ather Enam

Pakistan Journal of Neurological Sciences (PJNS)

Acquired demyelinating disorders of the central nervous system are diverse group of conditions characterized by destruction or disturbance of myelin sheath in the central nervous system i.e. brain and spinal cord. These vary in their causes, clinical presentations, and prognosis.

Factors Associated With Tuberculin Skin Test Positivity Prevalence In U.S. Medical Laboratory Microbiologists, Julie Ann West

Walden Dissertations and Doctoral Studies

Prior research has indicated that healthcare personnel (HCP) who work in areas where Mycobacterium tuberculosis poses an occupational hazard are at high risk of tuberculin skin test (TST) positivity and subsequent conversion to active tuberculosis (TB). U.S. medical laboratory microbiologists confront similar hazards but have not been studied outside of the HCP aggregate. The purpose of this study was to fill this gap by examining the relationships between the predictor variables of self-reported history of bacille Calmette-Guerin (BCG) immunization, place of birth, and years of laboratory experience and the outcomes of self-reported lifetime TST positivity, preventive treatment noninitiation, and barriers …

Characteristics Of Acute Care Utilization Of A Delaware Adult Sickle Cell Disease Patient Population., Nina Anderson, Jennifer L. Bellot, Oluseyi Senu-Oke, Samir K. Ballas

Department of Nursing papers and presentations

Sickle cell disease (SCD) is an inherited blood disorder that is chronic in nature and manifests itself through many facets of the patient's life. Comprehensive specialty centers have the potential to reduce health care costs and improve the quality of care for patients who have chronic medical conditions such as heart failure and SCD. The purpose of this practice inquiry was to analyze de-identified data for acute care episodes involving SCD in order to create a detailed picture of acute care utilization for adult patients in Delaware with SCD from 2007 to 2009. Gaining a better understanding of acute care …

Using Accreditation Standards As A Framework To Evaluate And Improve A Community-Based Diabetes Self-Management Education Program., Neva White, Mary Lou Manning, Rickie Brawer, James Plumb

Department of Nursing papers and presentations

Diabetes self-management education is an essential component of diabetes clinical management, and community-based programs are an effective intervention for improving glycemic control among adults living with diabetes. The National Standards for Diabetes Self-Management Education and Support are designed to define quality diabetes self-management education and support, and to assist diabetes educators to provide evidence-based education and self-management support. These standards are used in the field for recognition and accreditation. This article presents the results of a program evaluation conducted by the Center for Urban Health at the Thomas Jefferson University and Hospital, examines the outcomes of the community-based diabetes self-management …

Does Integrated Behavioral Health Care Reduce Mental Health Disparities For Latinos? Initial Findings, Ana J. Bridges, Arthur R. Andrews Iii, Bianca T. Villalobos, Freddie A. Pastrana, Timothy A. Cavell, Debbie Gomez

Psychological Science Faculty Publications

Integrated behavioral health care (IBHC) is a model of mental health care service delivery that seeks to reduce stigma and service utilization barriers by embedding mental health professionals into the primary care team. This study explored whether IBHC service referrals, utilization, and outcomes were comparable for Latinos and non-Latino White primary care patients. Data for the current study were collected from 793 consecutive patients (63.8% Latino; M age = 29.02 years [SD = 17.96]; 35.1% under 18 years; 65.3% women; 54.3% uninsured) seen for behavioral health services in 2 primary care clinics during a 10.5 month period. The most common …

Impact Of Hiv On Cd8+ T Cell Cd57 Expression Is Distinct From That Of Cmv And Aging, Sulggi A. Lee, Elizabeth Sinclair, Hiroyu Hatano, Priscilla Y. Hsue, Lorrie Epling, Frederick M. Hecht, David Bangsberg, Jeffrey N. Martin, Joseph M. Mccune, Steven G. Deeks, Peter Hunt

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Chronic antigenic stimulation by cytomegalovirus (CMV) is thought to increase ‘‘immunosenesence’’ of aging, characterized by accumulation of terminally differentiated CD28- CD8+ T cells and increased CD57, a marker of proliferative history. Whether chronic HIV infection causes similar effects is currently unclear.

Methods: We compared markers of CD8+ T cell differentiation (e.g., CD28, CD27, CCR7, CD45RA) and CD57 expression on CD28- CD8+ T cells in healthy HIV-uninfected adults with and without CMV infection and in both untreated and antiretroviral therapy (ART)-suppressed HIV-infected adults with asymptomatic CMV infection.

Results: Compared to HIV-uninfected adults without CMV (n = 12), those with asymptomatic …

The Dynamic Relationship Between Social Support And Hiv-Related Stigma In Rural Uganda, Sae Takada, Sheri D. Weiser, Elias Kumbakumba, Conrad Muzoora, Jeffrey N. Martin, Peter Hunt, Jessica E. Haberer, Annet Kawuma, David Bangsberg, Alexander C. Tsai

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background—Cross-sectional studies show that human immunodeficiency virus (HIV) stigma is negatively correlated with social support.

Purpose—The purpose of this study is to examine the bidirectional relationship between social support and HIV stigma.

Methods—We collected quarterly data from a cohort of 422 people living with HIV in Uganda, followed for a median of 2.1 years. We used multilevel regression to model the contemporaneous and 3-month-lagged associations between social support and both enacted and internalized stigma.

Results—Lagged enacted stigma was negatively correlated with emotional and instrumental social support, and lagged instrumental social support was negatively correlated with enacted stigma. Internalized stigma and …

Metabolic Reprogramming Induced By Ketone Bodies Diminishes Pancreatic Cancer Cachexia, Surendra K. Shukla, Teklab Gebregiworgis, Vinee Purohit, Nina V. Chaika, Venugopal Gunda, Prakash Radhakrishnan, Kamiya Mehla, Iraklis I. Pipinos, Robert Powers, Fang Yu, Pankaj K. Singh

Robert Powers Publications

Background: Aberrant energy metabolism is a hallmark of cancer. To fulfill the increased energy requirements, tumor cells secrete cytokines/factors inducing muscle and fat degradation in cancer patients, a condition known as cancer cachexia. It accounts for nearly 20% of all cancer-related deaths. However, the mechanistic basis of cancer cachexia and therapies targeting cancer cachexia thus far remain elusive. A ketogenic diet, a high-fat and low-carbohydrate diet that elevates circulating levels of ketone bodies (i.e., acetoacetate, β-hydroxybutyrate, and acetone), serves as an alternative energy source. It has also been proposed that a ketogenic diet leads to systemic metabolic changes. Keeping in …

Social Media Guidelines And Best Practices: Recommendations From The Council Of Residency Directors Social Media Task Force., Malford T Pillow, Laura Hopson, Michael Bond, Daniel Cabrera, Leigh Patterson, David Pearson, Harsh P. Sule Md, Felix Ankel, Madonna Fernández-Frackelton, R. Hall, Jason A Kegg, Donald Norris, Katrin Takenaka

Department of Emergency Medicine Faculty Papers

Social media has become a staple of everyday life among over one billion people worldwide. A social networking presence has become a hallmark of vibrant and transparent communications. It has quickly become the preferred method of communication and information sharing. It offers the ability for various entities, especially residency programs, to create an attractive internet presence and "brand" the program. Social media, while having significant potential for communication and knowledge transfer, carries with it legal, ethical, personal, and professional risks. Implementation of a social networking presence must be deliberate, transparent, and optimize potential benefits while minimizing risks. This is especially …

Optimal Control In The Treatment Of Retinitis Pigmentosa, Erika T. Camacho, Luis A. Melara, Cristina Villalobos, Stephen Wirkus

School of Mathematical & Statistical Sciences Faculty Publications

Numerous therapies have been implemented in an effort to minimize the debilitating effects of the degenerative eye disease Retinitis Pigmentosa (RP), yet none have provided satisfactory long-term solution. To date there is no treatment that can halt the degeneration of photoreceptors. The recent discovery of the RdCVF protein has provided researchers with a potential therapy that could slow the secondary wave of cone death. In this work, we build on an existing mathematical model of photoreceptor interactions in the presence of RP and incorporate various treatment regiments via RdCVF. Our results show that an optimal control exists for the administration …

Molecular Characterization Of Vim Carbapenemases In The Arabian Peninsula, Nour Yahfoufi

Theses

The emergence and global spread of carbapenem resistant Enterobacteriaceae is alarming world-wide phenomenon that also affects the Middle East due to limited treatment options for such infections and their common association with high level of fatality. The most important mechanism of such resistance is caused by the production of various carbapenemase enzymes. In the Arabian Peninsula, so far, NDM and OXA48-like carbapenemases have been reported, while elsewhere other enzymes, e.g. VIM, IMP and KPC are also commonly found. Our aim was to systematically look for the VIM-type carbapenemases among local isolates and to characterize their genetic background.

Initially, screening isolates …

Direct Control Of Visual Perception With Phase-Specific Modulation Of Posterior Parietal Cortex, Andrew Jaegle, Tony Ro

Publications and Research

We examined the causal relationship between the phase of alpha oscillations (9–12 Hz) and conscious visual perception using rhythmic TMS (rTMS) while simultaneously recording EEG activity. rTMS of posterior parietal cortex at an alpha frequency (10 Hz), but not occipital or sham rTMS, both entrained the phase of subsequent alpha oscillatory activity and produced a phase-dependent change on subsequent visual perception, with lower discrimination accuracy for targets presented at one phase of the alpha oscillatory waveform than for targets presented at the opposite phase. By extrinsically manipulating the phase of alpha before stimulus presentation, we provide direct evidence that the …

A Prospective, Multicenter, Phase I Matched-Comparison Group Trial Of Safety, Pharmacokinetics, And Preliminary Efficacy Of Riluzole In Patients With Traumatic Spinal Cord Injury., Robert G Grossman, Michael G Fehlings, Ralph F Frankowski, Keith D Burau, Diana S L Chow, Charles Tator, Angela Teng, Elizabeth G Toups, James Harrop, Bizhan Aarabi, Christopher I Shaffrey, Michele M Johnson, Susan J Harkema, Maxwell Boakye, James D Guest, Jefferson R Wilson

Department of Neurosurgery Faculty Papers

A prospective, multicenter phase I trial was undertaken by the North American Clinical Trials Network (NACTN) to investigate the pharmacokinetics and safety of, as well as obtain pilot data on, the effects of riluzole on neurological outcome in acute spinal cord injury (SCI). Thirty-six patients, with ASIA impairment grades A-C (28 cervical and 8 thoracic) were enrolled at 6 NACTN sites between April 2010 and June 2011. Patients received 50 mg of riluzole PO/NG twice-daily, within 12 h of SCI, for 14 days. Peak and trough plasma concentrations were quantified on days 3 and 14. Peak plasma concentration (Cmax) and …

Food Environment And Socioeconomic Status Influence Obesity Rates In Seattle And In Paris, Adam Drewnowski, Anne Vernez Moudon, Junfeng Jiao, Anju Aggarwal, Helene Charreire, Basile Chaix

Research Collection College of Integrative Studies

OBJECTIVE: To compare the associations between food environment at the individual level, socioeconomic status (SES) and obesity rates in two cities: Seattle and Paris. METHODS: Analyses of the SOS (Seattle Obesity Study) were based on a representative sample of 1340 adults in metropolitan Seattle and King County. The RECORD (Residential Environment and Coronary Heart Disease) cohort analyses were based on 7131 adults in central Paris and suburbs. Data on sociodemographics, health and weight were obtained from a telephone survey (SOS) and from in-person interviews (RECORD). Both studies collected data on and geocoded home addresses and food shopping locations. Both studies …

A Multi-Center, Two-Arm, Single-Blind Randomized Trial Of Two Different Intravenous Fluids During Labor (Poster)., Lisa M. Dapuzzo-Argiriou Md, John C. Smulian Md, Mph, Meredith Rochon Md, Luisa Galdi Do, Jessika Kissling Md, Peter F. Schnatz Do, George Neubert Md, Angel Gonzalez-Rios Md, James Airoldi Md, Mary Anne Carrillo Md, Jaimie Maines Md, Allen R. Kunselman Ms, John Repke Md, Richard S. Legro Md

Department of Obstetrics & Gynecology

No abstract provided.

Validation Of Patient And Nurse Short Forms Of The Readiness For Hospital Discharge Scale And Their Relationship To Return To The Hospital, Marianne E. Weiss, Linda L. Costa, Kathleen Bobay, Olga Yakusheva

College of Nursing Faculty Research and Publications

Objective: To validate patient and nurse short forms for discharge readiness assessment and their associations with 30-day readmissions and emergency department (ED) visits.

Data Sources/Study Setting: A total of 254 adult medical-surgical patients and their discharging nurses from an Eastern US tertiary hospital between May and November, 2011. Study Design Prospective longitudinal design, multinomial logistic regression analysis.

Data Collection/Extraction Methods: Nurses and patients independently completed an eight-item Readiness for Hospital Discharge Scale on the day of discharge. Patient characteristics, readmissions, and ED visits were electronically abstracted.

Principal Findings: Nurse assessment of low discharge readiness was associated with a six- to …

Utilizing Fast Spin Echo Mri To Reduce Image Artifacts And Improve Implant/Tissue Interface Detection In Refractory Parkinson’S Patients With Deep Brain Stimulators, Subhendra N. Sarkar, Pooja R. Sarkar, Efstathios Papavassiliou, Rafael Rojas

Publications and Research

Introduction. In medically refractory Parkinson’s disease (PD) deep-brain stimulation (DBS) is an effective therapeutic tool. Postimplantation MRI is important in assessing tissue damage and DBS lead placement accuracy. We wanted to identify which MRI sequence can detectDBS leads with smallest artifactual signal void, allowing better tissue/electrode edge conspicuity.

Methods. Using an IRB approved protocol 8 advanced PDpatientswere imagedwithinMRconditional safety guidelines at lowRF power (SAR ≤ 0.1 W/kg) in coronal plane at 1.5T by various sequences.The image slices were subjectively evaluated for diagnostic quality and the lead contact diameters were compared to identify a sequence least affected by metallic leads.

Results …

Exploring The Atomic Structure And Conformational Flexibility Of A 320 Å Long Engineered Viral Fiber Using X-Ray Crystallography., Anshul Bhardwaj, Sherwood R Casjens, Gino Cingolani

Department of Biochemistry and Molecular Biology Faculty Papers

Protein fibers are widespread in nature, but only a limited number of high-resolution structures have been determined experimentally. Unlike globular proteins, fibers are usually recalcitrant to form three-dimensional crystals, preventing single-crystal X-ray diffraction analysis. In the absence of three-dimensional crystals, X-ray fiber diffraction is a powerful tool to determine the internal symmetry of a fiber, but it rarely yields atomic resolution structural information on complex protein fibers. An 85-residue-long minimal coiled-coil repeat unit (MiCRU) was previously identified in the trimeric helical core of tail needle gp26, a fibrous protein emanating from the tail apparatus of the bacteriophage P22 virion. Here, …

Candida Albicans Als5p Amyloid In Host-Microbe Interactions: A Ceanorhabditis Elegans Study, Michael Bois

Dissertations, Theses, and Capstone Projects

Candida albicans, a dimorphic fungus and an opportunistic pathogen, possesses a myriad of adherence factors including members of the agglutinin-like sequence (Als) family of mannoproteins. The adhesin Als5p mediates adhesion to many substrates, and is upregulated during commensal interactions, but is downregulated during active C. albicans infections[1]. An amyloid forming core sequence at residues 325-331 has been shown to be important for Als5p function, because a single amino acid substitution at position 326 (V326N) greatly reduces Als5p-mediated adherence[2]. We evaluated the role of Als5p in host-microbe interactions, using Caenorhabditis elegans as a host model and feeding them Saccharomyces cerevisiae expressing …

Understanding Workplace Reciprocity Of Emergency Nurses: A Qualitative Study, Christine M. Corcoran

Dissertations, Theses, and Capstone Projects

Emergency nurses work with other health care providers under uncertain conditions to provide care to patients with all kinds of illnesses and afflictions from all walks of life. Despite implications that they must work together to accomplish their tasks, there are few studies that explore the relationships among emergency department personnel. Furthermore, there are even fewer that focus on the way emergency nurses work together to provide care to their patients. The purpose of the study was to understand the lived experience of workplace reciprocity of emergency nurses through the use of a qualitative phenomenological method. Nurses with three or …

An Ethnobotanical, Ecological And Lc-Ms-Based Chemometric Investigation Of Phaleria Nisidai, A Traditional Adaptogen Containing Diterpene Esters From Palau, Micronesia, Daniel Kulakowski

Dissertations, Theses, and Capstone Projects

An ethnobotanical, ecological and LC-MS-based chemometric investigation of Phaleria nisidai, a traditional adaptogen containing diterpene esters from Palau, Micronesia

Palau is a country with a rich heritage of traditional medicine still being practiced. One of the most popular and respected remedies in Palau is a tea made from fresh leaves of Phaleria nisidai Kaneh. (Thymelaeaceae). Interviews conducted to determine the use of this plant revealed that it is employed non-specifically to treat a variety of general health concerns. Its use as a prophylactic to keep away sickness, as a 'system cleaner', as well as for strength and energy indicate …

Vegf Treatment During Status Epilepticus Alters Long-Term Hippocampal Astrocyte Morphology: A Detailed Description Of Astrocyte Morphology And Glutamate Transporter Patterns With And Without Administration Of Vegf And Seizure Induction, Janice Rene Lenzer

Dissertations, Theses, and Capstone Projects

VEGF treatment during pilocarpine-induced status epilepticus (SE) causes enduring preservation of behavioral function in rats in the absence of enduring neuroprotection (Nicoletti et al., 2010). In addition, VEGF treatment reduces hyperexcitability in hippocampal slices without altering neuronal membrane properties (McCloskey et al, 2005). Combined, these data suggest the possibility that other cells or mechanisms could be involved in the beneficial effects of VEGF during SE. Our laboratory is interested in the potential contribution of astrocytes to these effects. Astrocytes are not only reported to contribute to epileptiform discharges in the hippocampus (Tian et al., 2005; Kang et al., 2005) but …

Neurophysiological Bases Of Frequency Discrimination In Children With Auditory Processing Disorder Or Specific Language Impairment, Christine Rota-Donahue

Dissertations, Theses, and Capstone Projects

The purpose of this study was to determine if 10-12 year old children with Auditory Processing Disorder (APD) or Specific Language Impairment (SLI) could discriminate three different frequency changes behaviorally and electrophysiologically. Behavioral frequency discrimination and event-related potentials were examined using a 1000Hz pure tone base frequency. Typically developing children and children with APD or SLI differed in in their detection of frequency changes: behavioral results were below chance level and the MMN amplitude was smaller in the impaired population. Slight differences between children with APD and children with SLI were also found that might shed light on the controversy …

Growth Of Nasal And Laryngeal Airways In Children: Implications In Breathing And Inhaled Aerosol Dynamics, Jinxiang Xi, Xiuhua Si, Yue Zhou, Jong Won Kim

University Faculty Publications and Creative Works

BACKGROUND: The human respiratory airway undergoes dramatic growth during infancy and childhood, which induces substantial variability in air flow pattern and particle deposition. However, deposition studies have typically focused on adult subjects, the results of which cannot be readily extrapolated to children. We developed models to quantify the growth of human nasallaryngeal airways at early ages, and to evaluate the impact of that growth on breathing resistance and aerosol deposition. METHODS: Four image-based nasal-laryngeal models were developed from 4 children, ages 10 days, 7 months, 3 years, and 5 years, and were compared to a nasallaryngeal model of a 53-year-old …

Temperature, Hypoxia, And Mycobacteriosis: Effects On Adult Striped Bass Morone Saxatilis Metabolic Performance, Dominique Lapointe, Wolfgang K. Vogelbein, Mary C. Fabrizio, David T. Gauthier, Richard W. Brill

Biological Sciences Faculty Publications

Mycobacteriosis, a chronic bacterial disease of fishes, is prevalent in adult striped bass from Chesapeake Bay (USA). Although environmental factors may play a role in disease expression, the interaction between the disease and environmental stress remains unexplored. We therefore examined the individual and interactive effects of elevated temperature, hypoxia, and mycobacteriosis on the metabolism of wild-caught adult striped bass from Chesapeake Bay using respirometry. Because the spleen is the primary target organ of mycobacteriosis in striped bass, we hypothesized that the disease interferes with the ability of fish to increase their hemato crit in the face of increasing oxygen demands. …

Outcome-Driven Thresholds For Ambulatory Pulse Pressure In 9938 People Recruited From 11 Populations, Yu-Mei Gu, Lutgarde Thijs, Yan Li, Kei Asayama, José Boggia, Tine W. Hansen, Yan-Ping Liu, Takayoshi Ohkubo, Kristina Björklund-Bodegård, Gladys E. Maestre

School of Medicine Publications

Evidence-based thresholds for risk stratification based on pulse pressure (PP) are currently unavailable. To derive outcome-driven thresholds for the 24–h ambulatory PP, we analyzed 9938 people randomly recruited from 11 populations (47.3% women). After age stratification (≥60 years) and using average risk as reference, we computed multivariable-adjusted hazard ratios (HRs) to assess risk by tenths of the PP distribution or risk associated with stepwise increasing (+1 mm Hg) PP levels. All adjustments included mean arterial pressure. Among 6028 younger participants (68,853 person-years), the risk of cardiovascular (HR, 1.58; P=0.011) or cardiac (HR, 1.52; P=0.056) events increased only in the top …

Using Otoacoustic Emissions To Evaluate Efferent Auditory Function In Humans, Simon Henin

Dissertations, Theses, and Capstone Projects

The auditory system continually adapts to changes in the acoustic environment over short periods of time. This fine-tuning of its dynamics is mediated in part by the medial olivocochlear (MOC) bundle, a neural feedback loop which aids in the regulation of cochlear micro-mechanics. The ability to measure the response of the MOC system in humans may provide significant insight into unique cochlear functions, such as its sharp frequency selectivity and wide dynamic range. In humans the efferent system can be investigated non-invasively using otoacoustic emissions (OAEs). However, how OAEs can best be used to evaluate efferent function, the pitfalls associated …