Medicine and Health Sciences Commons^™

An Analysis Of The Effects Of The 2003 And 2011 Acgme Work Hour Rules On Medical Resident Satisfaction At An Independent Academic Medical Center, Rachael E. Trout

Theses, Dissertations and Capstones

The purpose of this research was to determine what effects, if any, the 2003 and 2011 ACGME work hour rules had on medical resident satisfaction at an independent academic medical center in the United States. This research analyzed results of a survey administered by an independent academic medical center utilizing its own instrument of measure. Items reviewed to determine self-perceived satisfaction included questions related to program director effectiveness, resident input, quality of life, and satisfaction with program. Four comparisons were reviewed and analyzed for statistical significance utilizing the Mann-Whitney U non-parametric test for independent samples. The results indicated neither the …

Cultural Language Variations: An Examination Of Appalachian Discourse, Katherine Ward

Theses, Dissertations and Capstones

Examinations of discourse are essential for documenting the linguistic variations of a particular culture. In turn, linguistic variations across cultures may suggest similar variations in global discourse measures. It is imperative for clinicians to first understand the framework and cultural norms of a particular dialect or language to properly identify deficits in disordered language. By first looking closely at specific aspects of discourse such as story grammar within a normative or non-brain injured population, clinicians can improve treatment protocols for working with aphasic or brain-injured clients. With Appalachia being the heart of the “stroke belt,” research in intervention strategies for …

Therapeutic Efficacy Of Cerium Oxide Nanoparticles Against Sepsis Induced Multi-Organ Dysfunction Syndrome In Sprague Dawley Rats, Nandini Durga Prasanna Kumar Manne

Theses, Dissertations and Capstones

Sepsis is a generalized term that signifies the presence of a pathogen in the blood stream to which the body responds by eliciting a systemic inflammatory response. Although sepsis is the leading cause of death in non-coronary intensive care units in United States, there are currently no FDA approved therapeutic drugs to treat this disorder. Cerium oxide nanoparticles (CeO₂) have been shown to exhibit anti-oxidant, anti-inflammatory, and anti-bacterial properties both in vitro and in vivo. Whether CeO₂ nanoparticles can be used for the treatment of sepsis is currently unclear.

To investigate whether CeO₂ nanoparticles can …

Identification And Characterization Of Downstream Effector Protein(S) Regulated By P53 And Prb, Miranda B. Carper

Theses, Dissertations and Capstones

A commonality among cancer types is the high frequency of mutations that inhibit or alter signaling of the p53 and pRb (Retinoblastoma) tumor suppressors. These genes regulate processes vital for cancer suppression such as apoptosis, senescence, and cell cycle arrest among others. Loss of both p53 and pRb promotes processes that support cancer progression and is associated with decreased patient survival and increased rates of tumor reoccurrence. Although data points to the ability of p53 and pRb to collaborate and to inhibit tumorigenesis, it remains unclear how p53 and pRb cooperate toward this task. Using RNA expression profiling, 179 p53 …

Secondhand Smoke Exposure As A Risk Factor For Perioperative Airway Complications In Pediatric Outpatient Procedures, Ashlee Denise Loudin

Theses, Dissertations and Capstones

Abstract: The purpose of this study is to assess the risk of perioperative airway complications, analyze extubation times, and PACU Length Of Stay (LOS), and their association with secondhand smoke exposure in pediatric populations receiving outpatient procedures that require general anesthesia.

Introduction: Tobacco Smoke Exposure (TSE), is well documented to cause physiologic changes in lung tissue that are associated with decreased lung function, increased risk of lower and upper respiratory tract illness, exacerbation of asthma or increased risk of asthma, increased prevalence of non-allergic bronchial hyperresponsiveness, sudden infant death syndrome, and a host of other respiratory complications in adult and …

Staff Perception Related To Family Presence During Resuscitation, Stephanie L. Herron

Nursing Theses and Capstone Projects

The purpose of this study was to examine the perception of health care professionals (staff nurses) regarding family presence during resuscitation. The sample consisted of 59 nurses of different ages and working in different departments. The Staff Perceptions of Family-Witnessed Resuscitation questionnaire was used to collect data. The relationships between participants' demographic data and perceived attitudes and beliefs were also analyzed. Many of the healthcare professionals felt that it was acceptable to have family members present during resuscitation if the patient makes clear decisions prior to the incident or if the physician makes the decision for the patient. Almost half …

Discharge Education In The Emergency Department: Are We Effectively Teaching Chest Pain Patients?, Emily Edwards Nishiyama

Nursing Theses and Capstone Projects

Millions of individuals visit the emergency department (ED) each year with complaints of chest pain. Many chest pain patients do not have an underlying condition of Acute Coronary Syndrome (ACS) but the health and well-being of these patients is indispensable. Research has indicated soaring costs, an increased demand in medical resources, and an increasingly poor quality of life for these patients after discharge. Although research encourages quality education at discharge, very few studies have been conducted on ED discharge education for non-ACS chest pain patients. Using a cross-sectional descriptive research design, this quantitative study discovered the frequency of education provided …

The Importance Of Managing Psychosocial Health: A Case Study, Mary Insana Fisher, Harold L. Merriman

Physical Therapy Faculty Publications

Managing the physical aspects of lymphedema requires an individual to be committed to daily treatment of this chronic condition. Performing manual lymph drainage, using compression bandaging or compression garments, exercising, and caring for the skin all take time and a high level of dedication. This commitment to self-care can be emotionally and psychologically exhausting.

When coupled with other emotional stressors in a patient’s life, successful treatment of lymphedema is challenging. We present a case demonstrating how the physical and psychological aspects of care interplay, and, when well-managed, can positively affect the outcome.

Breast Cancer Edge Task Force Outcomes - Clinical Measures Of Strength And Muscular Endurance: A Systematic Review, Mary Insana Fisher, Claire Davies, Christine Beuthin, Genevieve Colon, Brittany Zoll, Lucinda Pfalzer

Physical Therapy Faculty Publications

Background: Muscular strength deficits are a common morbidity following treatment for breast cancer. Accurate assessment of strength and muscular endurance following breast cancer treatments is essential in identifying deficits and planning rehabilitation strategies.

Purpose: The purpose of this systematic review was to identify strength and muscular endurance outcome measures for use with women treated for breast cancer that possess strong psychometric properties and are clinically useful.

Methods: Multiple electronic databases were searched between February and June 2013. Included studies of tools used to assess strength and muscular endurance met the following criteria: reported psychometric properties, clinically feasible methods, adults (preferably …

Test Items In The Complete And Short Forms Of The Bot-2 That Contribute Substantially To Motor Performance Assessments In Typically Developing Children 6-10 Years Of Age, Kadi Carmosino, Ashley Grzeszczak, Kaylie Mcmurray, Ali Olivo, Bo Slutz, Brittany Zoll, Betsy Donahoe-Fillmore, C. Jayne Brahler

Physical Therapy Faculty Publications

Objectives: Determine the magnitude of association between individual subtest items of the Bruininks-Oseretsky Test of Motor Proficiency, second edition (BOT-2), and the respective total subtest scores and to review items on the BOT-2 Short Form.

Background: The Bruininks-Oseretsky Test of Motor Proficiency, second edition (BOT-2), is a test used to measure gross motor proficiency in both typically developing children and children with developmental disabilities between the ages of four and twenty-one. The BOT-2 Short Form consists of fourteen test items proportionally selected from the subtests of the Complete Form. It can be used as a screening tool and takes less …

Ruptured Splenic Artery Aneurysms And The Use Of An Adapted Fast Protocol In Reproductive Age Women With Hemodynamic Collapse: Case Series, Hope T. Jackson, Silviu C. Diaconu, Patrick J. Maluso, Bruce Abell, Juliet Lee

Surgery Faculty Publications

Nontraumatic symptomatic hypotension in all patients requires prompt diagnosis and appropriate treatment for optimum outcome. The female population specifically has an expanded differential diagnosis that should be considered when these patients present with hemodynamic collapse. While the most common causes of hypotension in pregnant patients are dehydration, ruptured ectopic pregnancy, and placental and uterine abnormalities, less common nonobstetrical etiologies such as hepatic rupture and ruptured abdominal and visceral artery aneurysms should also be considered. Splenic artery aneurysms are associated with high rates of mortality and in cases of pregnancy, maternal and fetal mortality. These high rates can be attributed to …

Loss Of Nuclear Pten In Hcv-Infected Human Hepatocytes, Wenjie Bao, Liliana Florea, Ningbin Wu, Zhao Wang, Krishna K. Banaudha, Jason Qian, Laurent Houzet, Rakesh Kumar, Ajit Kumar

Surgery Faculty Publications

Background

Hepatitis C virus (HCV) infection is a major risk factor for chronic hepatitis and hepatocellular carcinoma (HCC); however, the mechanism of HCV-mediated hepatocarcinogenesis is not well understood. Insufficiency of PTEN tumor suppressor is associated with more aggressive cancers, including HCC. We asked whether viral non-coding RNA could initiate oncogenesis in HCV infected human hepatocytes. The results presented herein suggest that loss of nuclear PTEN in HCV-infected human hepatocytes results from depletion of Transportin-2, which is a direct target of viral non-coding RNA, vmr11.

Methods

The intracellular distribution of PTEN in HCV-infected cells was monitored by immunostaining and Western blots …

Hereditary Angioedema: What The Gastroenterologist Needs To Know, M. Aamir Ali, Marie L. Borum

Surgery Faculty Publications

Up to 93% of patients with hereditary angioedema (HAE) experience recurrent abdominal pain. Many of these patients, who often present to emergency departments, primary care physicians, general surgeons, or gastroenterologists, are misdiagnosed for years and undergo unnecessary testing and surgical procedures. Making the diagnosis of HAE can be challenging because symptoms and attack locations are often inconsistent from one episode to the next. Abdominal attacks are common and can occur without other attack locations. An early, accurate diagnosis is central to managing HAE. Unexplained abdominal pain, particularly when accompanied by swelling of the face and extremities, suggests the diagnosis of …

Experience With Miniaturized Cardiopulmonary Bypass In Cardiac Surgery: A Prospective Comparison Of The Novosci Ready System To Off-Pump And Conventional Coronary Artery Bypass Grafting, Dominic Emerson, Debbie Baldwin, Miguel Pinales, Michael Greenberg, Melissa Mattes, Gregory D. Trachiotis

Surgery Faculty Publications

The major source of morbidity following cardiopulmonary bypass (CPB) is the systemic inflammatory response (SIRS response) which leads to multiple derangements in different organ systems. To combat this, miniaturized cardiopulmonary bypass circuits (MCPBC) have been created to lessen the inflammatory response to CPB. Here we examine early outcomes following coronary artery bypass grafting (CABG) using a MCPBC system compared to conventional bypass techniques at a single institution. Methods: 60 consecutive patients undergoing elective CABG were prospectively enrolled. Nine patients underwent coronary artery bypass grafting (CABG) with conventional CPB (cCABG), 33 underwent off-pump CABG (OPCAB), and the remaining 18 patients underwent …

The History Of Healthcare Quality: The First 100 Years 1860-1960, Brenda Helen Sheingold, Joyce Hahn

Nursing Faculty Publications

In the 21st Century, health care systems across the world are focusing policy efforts on improving the quality of healthcare delivered to their population. In contrast, healthcare quality improvement in earlier time periods arose from a series of seemingly unrelated incidents and developments. In this paper, we sequentially review key international historical events that improved health care quality during the years 1860–1960, including innovation in health care financing, care delivery and workforce diversity. The modern nursing workforce of today continues to encounter many of these same challenges across the globe.

Using Art Therapy Techniques For Team Building In Distance Education Doctor Of Nursing Practice Student Cohorts, Brenda Helen Sheingold, E. Warson, Beverly K. Lunsford, Christine Pintz

Nursing Faculty Publications

No abstract provided.

Concordant Integrative Gene Set Enrichment Analysis Of Multiple Large-Scale Two-Sample Expression Data Sets, Yinglei Lai, Fanni Zhang, Tapan K. Nayak, Reza Modarres, Norman H. Lee, Timothy A. Mccaffrey

Pharmacology and Physiology Faculty Publications

Background

Gene set enrichment analysis (GSEA) is an important approach to the analysis of coordinate expression changes at a pathway level. Although many statistical and computational methods have been proposed for GSEA, the issue of a concordant integrative GSEA of multiple expression data sets has not been well addressed. Among different related data sets collected for the same or similar study purposes, it is important to identify pathways or gene sets with concordant enrichment.

Methods

We categorize the underlying true states of differential expression into three representative categories: no change, positive change and negative change. Due to data noise, what …

Heat Shock Factor 2 Is A Stress‐Responsive Mediator Of Neuronal Migration Defects In Models Of Fetal Alcohol Syndrome, Rachid El Fatimy, Federico Miozzo, Anne Le Mouël, Ryma Abane, Leslie Schwendimann, Délara Sabéran‐Djoneidi, Aurélie De Thonel, Illiasse Massaoudi, Liliana Paslaru, Kazue Hashimoto-Torii, Elisabeth Christians, Pasko Rakic, Pierre Gressens, Valérie Mezger

Pharmacology and Physiology Faculty Publications

Fetal alcohol spectrum disorder (FASD) is a frequent cause of mental retardation. However, the molecular mechanisms underlying brain development defects induced by maternal alcohol consumption during pregnancy are unclear. We used normal andHsf2‐deficient mice and cell systems to uncover a pivotal role for heat shock factor 2 (HSF2) in radial neuronal migration defects in the cortex, a hallmark of fetal alcohol exposure. Upon fetal alcohol exposure, HSF2 is essential for the triggering of HSF1 activation, which is accompanied by distinctive post‐translational modifications, and HSF2 steers the formation of atypical alcohol‐specific HSF1–HSF2 heterocomplexes. This perturbs the in vivo binding …

Novel Neuroprotective Gsk-3Β Inhibitor Restricts Tat-Mediated Hiv-1 Replication, Irene Guendel, Sergey N. Iordanskiy, Rachel Van Duyne, Kylene Kehn-Hall, Mohammed Saifuddin, Ravi Das, Elizabeth Jaworski, Gavin C. Sampey, Svetlana Senina, Leonard Shultz, Aarthi Narayanan, Chen Hao, Benjamin Lepene, Chen Zeng, Fatah Kashanchi

Microbiology, Immunology, and Tropical Medicine Faculty Publications

The implementation of new antiretroviral therapies targeting transcription of early viral proteins in postintegrated HIV-1 can aid in overcoming current therapy limitations. Using high-throughput screening assays, we have previously described a novel Tat-dependent HIV-1 transcriptional inhibitor named 6-bromoindirubin-3′-oxime (6BIO). The screening of 6BIO derivatives yielded unique compounds that show potent inhibition of HIV-1 transcription. We have identified a second-generation derivative called 18BIOder as an inhibitor of HIV-1 Tat-dependent transcription in TZM-bl cells and a potent inhibitor of GSK-3β kinase in vitro. Structurally, 18BIOder is half the molecular weight and structure of its parental compound, 6BIO. More importantly, we also …

Trans-Activation, Post-Transcriptional Maturation, And Induction Of Antibodies To Herv-K (Hml-2) Envelope Transmembrane Protein In Hiv-1 Infection, Henri-Alexandre Michaud, Miguel De Mulder, Devi Sengupta, Steven G. Deeks, Jeffrey N. Martin, Christopher D. Pilcher, Frederick M. Hecht, Jonah B. Sacha, Douglas F. Nixon

Microbiology, Immunology, and Tropical Medicine Faculty Publications

Background

Human Endogenous Retroviruses (HERVs) comprise about 8% of the human genome and have lost their ability to replicate or to produce infectious particles after having accumulated mutations over time. We assessed the kinetics of expression of HERV-K (HML-2) Envelope mRNA transcript and surface unit (SU) and transmembrane (TM) subunit proteins during HIV-1 infection. We also mapped the specificity of the humoral response to HERV-K (HML-2) Envelope protein in HIV-1 infected subjects at different stages of disease, and correlated the response with plasma viral load.

Results

We found that HIV-1 modified HERV-K (HML-2) Env mRNA expression, resulting in the expression …

Suppression Of Aquaporin, A Mediator Of Water Channel Control In The Carcinogenic Liver Fluke, Opisthorchis Viverrini, Sirikanda Thanasuwan, Supawadee Piratae, Paul J. Brindley, Alex Loukas, Sasithorn Kaewkes, Thewarach Laha

Microbiology, Immunology, and Tropical Medicine Faculty Publications

Background

Opisthorchiasis and Opisthorchis viverrini-associated bile duct cancer represent major public health threats in Thailand and Laos. The tegument of this food borne fluke plays pivotal roles in parasite metabolism, homeostasis and osmoregulation. Excretory/secretory products also pass from the fluke to the biliary environment, products that likely underlie pathogenesis of liver fluke infection. Aquaporins (AQPs), belong to the major intrinsic protein superfamily of integral plasma membrane channel proteins that selectively transport water across cell membranes. AQPs play key roles as water and ion transport channels through the tegument of helminth parasites.

Methods

Here, two forms of AQP mRNAs from the …

Bioclojure: A Functional Library For The Manipulation Of Biological Sequences, Jordan L. Plieskatt, Gabriel Rinaldi, Paul J. Brindley, Xinying Jia, Jeremy Potriquet, Jeffrey M. Bethony, Jason Mulvenna

Microbiology, Immunology, and Tropical Medicine Faculty Publications

Motivation: BioClojure is an open-source library for the manipulation of biological sequence data written in the language Clojure. BioClojure aims to provide a functional framework for the processing of biological sequence data that provides simple mechanisms for concurrency and lazy evaluation of large data sets.

Results: BioClojure provides parsers and accessors for a range of biological sequence formats, including UniProtXML, Genbank XML, fasta and fastq. In addition it provides wrappers for key analysis programs, including BLAST, SignalP, TMHMM and InterProScan, and parsers for analyzing their output. All interfaces leverage Clojure's functional style and emphasize laziness and composability, so that BioClojure, …

Schistosomes And Snails: A Molecular Encounter, Matty Knight, Halime D. Arican-Goktas, Wannaporn Ittiprasert, Edwin C. Odoemelam, Andre N. Miller, Joanna M. Bridger

Microbiology, Immunology, and Tropical Medicine Faculty Publications

Biomphalaria glabrata snails play an integral role in the transmission of Schistosoma mansoni, the causative agent for human schistosomiasis in the Western hemisphere. For the past two decades, tremendous advances have been made in research aimed at elucidating the molecular basis of the snail/parasite interaction. The growing concern that there is no vaccine to prevent schistosomiasis and only one effective drug in existence provides the impetus to develop new control strategies based on eliminating schistosomes at the snail-stage of the life cycle. To elucidate why a given snail is not always compatible to each and every schistosome it encounters, B. …

Circumventing Qpcr Inhibition To Amplify Mirnas In Plasma, Jordan L. Plieskatt, Yanjung Feng, Gabriel Rinaldi, Jason Mulvenna, Jeffrey M. Bethony, Paul J. Brindley

Microbiology, Immunology, and Tropical Medicine Faculty Publications

Circulating microRNAs (c-miRNAs) have be identified in saliva, urine and blood, which has led to increasing interest in their development as biomarkers for diverse diseases including cancers. One of the key advantages of c-miRNAs over other biomarkers is the ability to be amplified and quantified by quantitative PCR (qPCR). However, at phlebotomy when whole blood is dispensed into heparinized tubes, residual levels of the anti-coagulant lithium heparin may remain in the plasma and hence with RNA isolated from the plasma. This can confound the detection of c-miRNAs by qPCR because it inhibits reverse transcriptase (RT). Here we present a procedure, …

Microrna-21 Down-Regulates Rb1 Expression By Targeting Pdcd4 In Retinoblastoma, Fengmei Shen, Meng-Hsuan Mo, Shejuan An, Xiaohui Tan, Yebo Fu, M. Katayoon Rezaei, Zuoren Wang, Lin Zhang, Sidney W. Fu

Microbiology, Immunology, and Tropical Medicine Faculty Publications

Retinoblastoma (RB) is a children’s ocular cancer caused by mutated retinoblastoma 1 (Rb1) gene on both alleles. Rb1 and other related genes could be regulated by microRNAs (miRNA) via complementarily pairing with their target sites. MicroRNA-21 (miR-21) possesses the oncogenic potential to target several tumor suppressor genes, including PDCD4, and regulates tumor progression and metastasis. However, the mechanism of how miR-21 regulates PDCD4 is poorly understood in RB. We investigated the expression of miRNAs in RB cell lines and identified that miR-21 is one of the most deregulated miRNAs in RB. Using qRT-PCR, we verified the expression level of several …

Schistosome And Liver Fluke Derived Catechol-Estrogens And Helminth Associated Cancers., José M. Correia Da Costa, Nuno Vale, Maria J. Gouveia, Mónica C. Botelho, Banchob Sripa, Lúcio L. Santos, Júlio H. Santos, Gabriel Rinaldi, Paul J. Brindley

Microbiology, Immunology, and Tropical Medicine Faculty Publications

Infection with helminth parasites remains a persistent public health problem in developing countries. Three of these pathogens, the liver flukes Clonorchis sinensis, Opisthorchis viverrini and the blood fluke Schistosoma haematobium, are of particular concern due to their classification as Group 1 carcinogens: infection with these worms is carcinogenic. Using liquid chromatography-mass spectrometry (LC-MS/MS) approaches, we identified steroid hormone like (e.g., oxysterol-like, catechol estrogen quinone-like, etc.) metabolites and related DNA-adducts, apparently of parasite origin, in developmental stages including eggs of S. haematobium, in urine of people with urogenital schistosomiasis, and in the adult stage of O. viverrini. Since these kinds of …

Smokefree Moms: A Qualitative Study For The Development Of A Text-Based Intervention For Smoking Cessation In Pregnant Women, Monika Lin, Lorien C. Abroms

GW Research Days 2014

No abstract provided.

The Dual Burden Of Malnutrition: Quetzaltenango, Guatemala, Nisha Punatar, Robert C. Morrow

GW Research Days 2014

No abstract provided.

A Pilot Academic-Community Partnership To Advance The D.C. Healthy Schools Act, Nisha Narayanan, Jonathan Tatum, Margarita Ramos, Jessica Kim, Nisha Punatar, Michele L. Mietus-Snyder

GW Research Days 2014

No abstract provided.

High Dose Insulin Therapy, An Evidence Based Approach To Beta Blocker/Calcium Channel Blocker Toxicity, Christina Woodward, Ali Pourmand, Maryann Mazer-Amirshahi

Emergency Medicine Faculty Publications

Poison-induced cardiogenic shock (PICS) as a result of beta-blocker (?-blocker) or calcium channel blocker (CCB) overdose is a common and potentially life-threatening condition. Conventional therapies, including fluid resuscitation, atropine, cardiac pacing, calcium, glucagon, and vasopressors often fail to improve hemodynamic status. High-dose insulin (HDI) is an emerging therapeutic modality for PICS. In this article, we discuss the existing literature and highlight the therapeutic success and potential of HDI. Based on the current literature, which is limited primarily to case series and animal models, the authors conclude that HDI can be effective in restoring hemodynamic stability, and recommend considering its use …