Medicine and Health Sciences Commons^™

A Simplified Score To Quantify Comorbidity In Copd, Nirupama Putcha, Milo A. Puhan, M. Bradley Drummond, Meilan K. Han, Elizabeth A. Regan, Nicola A. Hanania, Carlos H. Martinez, Marilyn Foreman, Surya P. Bhatt, Barry Make, Joe Ramsdell, Dawn L. Demeo, R. Graham Barr, Stephen I. Rennard, Fernando Martinez, Edwin K. Silverman, James Crapo, Robert A. Wise, Nadia N. Hansel

Journal Articles: Pulmonary & Critical Care Med

IMPORTANCE: Comorbidities are common in COPD, but quantifying their burden is difficult. Currently there is a COPD-specific comorbidity index to predict mortality and another to predict general quality of life. We sought to develop and validate a COPD-specific comorbidity score that reflects comorbidity burden on patient-centered outcomes.

MATERIALS AND METHODS: Using the COPDGene study (GOLD II-IV COPD), we developed comorbidity scores to describe patient-centered outcomes employing three techniques: 1) simple count, 2) weighted score, and 3) weighted score based upon statistical selection procedure. We tested associations, area under the Curve (AUC) and calibration statistics to validate scores internally with outcomes …

A Divisive Shuffling Approach (Vista) For Gene Expression Analysis To Identify Subtypes In Chronic Obstructive Pulmonary Disease, Jörg Menche, Amitabh Sharma, Michael H. Cho, Ruth J. Mayer, Stephen I. Rennard, Bartolome Celli, Bruce E. Miller, Nick Locantore, Ruth Tal-Singer, Soumitra Ghosh, Chris Larminie, Glyn Bradley, John H. Riley, Alvar Agusti, Edwin K. Silverman, Albert-László Barabási

Journal Articles: Pulmonary & Critical Care Med

BACKGROUND: An important step toward understanding the biological mechanisms underlying a complex disease is a refined understanding of its clinical heterogeneity. Relating clinical and molecular differences may allow us to define more specific subtypes of patients that respond differently to therapeutic interventions.

RESULTS: We developed a novel unbiased method called diVIsive Shuffling Approach (VIStA) that identifies subgroups of patients by maximizing the difference in their gene expression patterns. We tested our algorithm on 140 subjects with Chronic Obstructive Pulmonary Disease (COPD) and found four distinct, biologically and clinically meaningful combinations of clinical characteristics that are associated with large gene expression …

Perfluorinated Compounds, Thyroid Function, And Neuropsychological Status In Older Residents Of Upper Hudson River Communities, Srishti Shrestha

Legacy Theses & Dissertations (2009 - 2024)

Perfluorinated compounds (PFCs) are widespread in the environment. Minimal data exist regarding the neurotoxicity and thyroid disruptive property of PFCs in aging populations and the possible mediating effects of thyroid hormones (THs). In this study, we assessed associations among PFCs, thyroid function, and neuropsychological status, and determined if the neurotoxic effects of PFCs are mediated by changes in THs in an aging population. We measured perfluorooctanoic acid (PFOA), perfluorooctane sulfonate (PFOS), thyroid stimulating hormone (TSH), total thyroxine (T4), free T4 (fT4), and total triiodothyronine (T3) in serum and performed neuropsychological tests in men and women aged 55-74 years and living …

Examining The Risk And Protective Factors That Influence Falls Among Native American Older Adults, Kelly Winjum

Legacy Theses & Dissertations (2009 - 2024)

The risk factors for falls and the adverse outcomes of falls have been well documented among the general older adult population. However, fall frequency, fall risk factors, and fall outcomes have rarely been studied among minority groups specifically. Furthermore, to date there are no known studies that exclusively examine falls among Native American older adults. The purpose of this study is to examine falls among Native American older adults, in order to understand the risk and protective factors for falling among this population, and to develop recommendations for intervention. The theoretical framework of the Disablement Process guides this study. The …

Relationships Between Breastfeeding, Maternal Cigarette Smoking During Pregnancy, And The Cognitive Functioning Of Akwesasne Mohawk Adolescents Exposed To Environmental Pollution, Georgia Brooke

Legacy Theses & Dissertations (2009 - 2024)

Previous research has suggested that breastfeeding is beneficial for children's health and that maternal cigarette smoking during pregnancy is harmful for children's health. However, there is not a consensus in the existing literature about whether or not these two maternal behaviors impact the cognitive development of children. Furthermore, understanding the role of breastfeeding in children's development is complicated by the fact that breastfeeding transmits toxicants that are stored in the mother's body, including polychlorinated biphenyls (PCBs), to the infant. Existing research suggests that PCBs negatively impact children's cognitive functioning. The current study examined relationships between breastfeeding, maternal cigarette smoking during …

A Mixed Methods Study Of Shared Epistemic Agency In Team Projects In An Online Baccalaureate Nursing Course, Suzanne Hayes

Legacy Theses & Dissertations (2009 - 2024)

This study explores the role of instructional design in the development of shared epistemic agency (SEA) when RN to BSN nursing students collaborate to complete a team project in an online course. Paavola & Hakkarainen's (2005) trialogical model of learning is used to design a learning activity where teams create a shared knowledge object, a co-authored patient interprofessional care plan to support group knowledge creation. The study addresses the following research questions:

Exposure Assessment And Risk Management Of Engineered Nanoparticles : Investigation In Semiconductor Wafer Processing, Michele Shepard

Legacy Theses & Dissertations (2009 - 2024)

Engineered nanomaterials (ENMs) are currently used in hundreds of commercial products and industrial processes, with more applications being investigated. Nanomaterials have unique properties that differ from bulk materials. While these properties may enable technological advancements, the potential risks of ENMs to people and the environment are not yet fully understood. Certain low solubility nanoparticles are more toxic than their bulk material, such that existing occupational exposure limits may not be sufficiently protective for workers. Risk assessments are currently challenging due to gaps in data on the numerous emerging materials and applications as well as method uncertainties and limitations.

A Population-Based Case-Control Study Of The Association Between Extreme Heat Events And Neural Tube Defects And Oral Clefts, Aida Soim

Legacy Theses & Dissertations (2009 - 2024)

With climate change it is expected that extreme weather events will become more frequent and longer in duration. The health consequences of maternal exposure during pregnancy to extreme heat events are not well understood in spite of biological plausibility for adverse effects suggested by prior findings. There is very limited research that explores the relationship between extreme heat events and birth defects. The overall goal of this line of research was to determine whether heatwaves (HW) are associated with two major classes of birth defects: neural tube defects (NTDs) and oral clefts. One component of this project aimed to describe …

Initiation And Completion Of Adjuvant Chemotherapy Among Colorectal Cancer Patients, Ashar Ata

Legacy Theses & Dissertations (2009 - 2024)

Introduction: For regionally advanced colorectal cancers resection followed by adjuvant chemotherapy (ACT) is the recommended treatment. Despite consensus on benefits, studies have shown that a significant proportion of patients do not initiate it. Among those who initiate the survival benefits of chemotherapy cannot be fully realized without completed treatment. Without supplementing treatment information from insurance claims cancer registries are inadequate for assessment of ACT utilization. This study was aimed at measuring the initiation and completion of ACT among colorectal cancer patients and identifying the associated factors.

Correlation Of Ischemia-Modified Albumin With Sofa And Apache Ii Scores In Preoperative Patients With Colorectal Cancer, Masaaki Katoh, Kazuhiko Kotani, Alejandro Gugliucci, Hisanaga Horie, Russell Caccavello, Mamoru Takeuchi

Faculty Publications & Research of the TUC College of Osteopathic Medicine

Purpose. Critical illnesses are assessed according to the sequential organ failure assessment (SOFA) and acute physiology and chronic health evaluation (APACHE) II. Circulating ischemia-modified albumin (IMA) is a biomarker generated under ischemic and oxidative conditions and may reflect disease severity in preoperative patients. This study investigated the correlations of IMA with SOFA and APACHE II scores in inpatients admitted for colorectal surgery. Methods.We examined 27 patients with advanced colorectal cancers (mean age 69 years, men/women = 15/12). Correlations between SOFA and APACHE II scores in addition to preoperative serum IMA and C-reactive protein (CRP) levels were analyzed. Results …

How To Identify At-Risk Medical Students Based On Learning Style, Personality Indicator, And Learning Strategy Tests—A Mixed Method For A Pilot Study, Amina Sadik, Leticia Rojas

College of Osteopathic Medicine (TUN) Publications and Research

The number of students experiencing academic difficulty continues to be a prevalent and serious issue among medical schools worldwide. While some studies have investigated the causes of underperformance, none have identified markers of “at-risk” students. This study used three diagnostic tests to determine possible identifying characteristics of students performing at different levels. Our results indicate that students with a Diverging learning style may struggle in medical school and need to be guided toward a learning style that is more suitable to their career paths. Learning and Study Strategies Inventory (LASSI) reveals that low performing students need assistance honing their test-taking …

Nanoparticle Encapsidation Of Flock House Virus By Auto Assembly Of Tobacco Mosaic Virus Coat Protein, Payal D. Maharaj, Jyothi K. Mallajosyula, Gloria Lee, Phillip Thi, Yiyang Zhou, Christopher M. Kearney, Alison A. Mccormick

Faculty Publications & Research of the TUC College of Pharmacy

Tobacco Mosaic virus (TMV) coat protein is well known for its ability to self-assemble into supramolecular nanoparticles, either as protein discs or as rods originating from the ~300 bp genomic RNA origin-of-assembly (OA). We have utilized TMV self-assembly characteristics to create a novel Flock House virus (FHV) RNA nanoparticle. FHV encodes a viral polymerase supporting autonomous replication of the FHV genome, which makes it an attractive candidate for viral transgene expression studies and targeted RNA delivery into host cells. However, FHV viral genome size is strictly limited by native FHV capsid. To determine if this packaging restriction could be eliminated, …

Involvement Of Sigma-1 Receptors In The Antidepressant-Like Effects Of Dextromethorphan, Linda Nguyen, Matthew J. Robson, Jason R. Healy, Anna L. Scandinaro, Rae Reiko Matsumoto

Faculty Publications & Research of the TUC College of Pharmacy

Dextromethorphan is an antitussive with a high margin of safety that has been hypothesized to display rapid-acting antidepressant activity based on pharmacodynamic similarities to the N-methyl-D-aspartate (NMDA) receptor antagonist ketamine. In addition to binding to NMDA receptors, dextromethorphan binds to sigma-1 (s1) receptors, which are believed to be protein targets for a potential new class of antidepressant medications. The purpose of this study was to determine whether dextromethorphan elicits antidepressant-like effects and the involvement of s1 receptors in mediating its antidepressant-like actions. The antidepressant-like effects of dextromethorphan were assessed in male, Swiss Webster mice using the forced swim test. Next, …

Standardized Field Sobriety Test: False Positive Test Rate Among Sober Subjects, Keith Yoshizuka, Paul J. Perry, Greta Upton, Ingrid C. Lopes, Eric Ip

Faculty Publications & Research of the TUC College of Pharmacy

The Standardized Field Sobriety Test (SFST) is a series of exercises that a law enforcement officer gives to a driver suspected of driving under the influence of alcohol. The original research that demonstrated a high correlation between failure of the SFST and a high blood alcohol concentration did not utilize a standard control group to validate that the failure of the SFST was not a characteristic of the population at large. This study examined a series of drug naive subjects to determine the rate of failure of the SFST to accurately distinguish a suspect with high blood alcohol content from …

Cardiac Troponin Assessment Following Atrial Fibrillation Ablation: Implications For Chest Pain Evaluation, Jason C. Rubenstein, Jason T. Jacobson, Jeffrey J. Goldberger, Rod Passman, Alan H. Kadish, Michael H. Kim

Office of the President Publications and Research

Background: The range of elevation of troponin I (tI) that is within expected limits from left atrial radiofrequency ablation for atrial fibrillation (AF) is not well described, though such information may be of clinical value.

Objectives: Identify the expected range of tI values post-atrial fibrillation (AF) ablation.

Methods: 31 patients undergoing AF ablation had a single tI level drawn the day following the procedure. Clinical variables were also collected, such as ablation type and radiofrequency (RF) time.

Results: Paroxysmal AF was present in 23 patients, and 8 had chronic AF. The average RF time was 2627.8 …

Risk Perceptions Of Cardiovascular Disease In College Students, Antonia Kolas

All Graduate Theses, Dissertations, and Other Capstone Projects

College students oftentimes underestimate their risk perception of cardiovascular disease (CVD). This study examined undergraduate students' perception of efficacy and perception of threat of cardiovascular disease. A paper survey was distributed to three undergraduate student classes (n = 127; 66.9% female; 33.1% male; 83.5% White/Caucasian; M age = 20.00). This 17-item survey assessed demographics, perception of general health, perception of efficacy of cardiovascular disease, and perception of threat of cardiovascular disease. Analyses included Cronbach's alpha, descriptive, frequencies, and independent sample t-test. College students have a higher perception of efficacy (M = 24.45 out of 30.00; SD = 4.35) and a …

Spirits And Syringes: Malaria As An Epidemic, A Spiritual Punishment, And An Act Of War, Kelly Blair 14

Honor Scholar Theses

None.

Los Sistemas De Sa Iud: Una Comparacion Entre Illinois, Ee.Uu. Y Cataluna, Espana (A Comparison Of Healthcare Systems In Illinois, Usa And Catalonia, Spain), Jennifer Boll

Honors Projects

This project focuses on the differences in healthcare systems in Illinois, United States and Catalonia, Spain. The research includes a literature review on the different systems and the fundamental differences in how care is delivered. An investigation of the major differences in the cultural and political approaches to health care and how the systems provide for their patients is part of the study. Another focus is the treatment of Spanish-speaking patients in hospitals in Illinois and also the treatment of patients who speak Castilian (traditional Spanish) in hospitals in Catalan-speaking Barcelona. This comparison displays the importance of language in the …

Evidence-Based Practice In Action: Ensuring Quality Of Pediatric Assessment Frequency, Katelyn Mcdonald

Honors Projects

Optimal head to toe assessment frequency in hospitalized pediatric patients is unknown. Although pediatric patients have many accommodations based on their age, developmental state, and varied needs, healthcare professionals have not published any research regarding the optimal frequency for registered nurses to perform head-to-toe assessments in hospitalized pediatric patients. Healthcare professionals must make decisions based on evidence-based practice. A change in pediatric assessment intervals was proposed at a Midwestern regional medical center. The purpose of this pilot study was to ensure patient safety and staff satisfaction following a policy change in head-to-toe assessment frequency Chart audits were performed on all …

Development Of A Measure Of Nurse Vigilance From The Patient ' S Perspective: A Content Validity Study, Jennifer Boll

Honors Projects

Problem: Since the landmark Institute of Medicine report, To Err is Human, was published in 1999, patient safety has become a major concern in healthcare systems. Although attention is being given to patient safety and preventing patient morbidity and mortality, experts indicate that little progress has been made in decreasing healthcare errors. Vigilance is a phenomenon often identified in the literature as a means to promote patient safety and well-being. Purpose: The aim of this study was to establish content validity in a newly developed instrument designed to measure nurse vigilance from a patient perspective. Method: Generated 130 items and …

School Nurse Job Satisfaction, Provision Of Health Education, And Student Attendence, Molly G. Guenette

Honors Projects

School nurses have a large scope of practice (American Nurses Association [ANA] & National Association of School Nurses [NASN], 2011). However, school administrators often misunderstand, and therefore under appreciate, the school nurses' role (Junious et al., 2004). In addition, few schools meet the 1 :750 nurse to student ratio recommended by the NASN and the ANA (2011); high nurse to student ratios negatively affect school nurses' job satisfaction (Maughn & Adams, 2011). Several studies found that interventions by the school nurse positively impacted students (Bonauito, 2007; Denny et al., 2012), while others have linked the presence of a school nurse …

The Human–Hookworm Assemblage: Contingency And The Practice Of Helminthic Therapy, Sophia Anne Strosberg

Theses and Dissertations--Geography

Through a qualitative analysis of the use of intestinal parasites for treating immune system disorders, this research illustrates how contingency emerges in the context of the human relationship to hookworms. The affect of the human–nonhuman relationship is an important part of understanding the direction of evolutionary medicine today, and has implications for the politics of biological health innovations. The shift from the bad parasite to a parasite that at least sometimes heals, discursively and materially, has opened new spaces for patients to change the way they relate to medical knowledge, medical professionals, and pharmaceutical companies. Hookworms are banned by the …

Dabigatran And Warfarin For Stroke Prevention In Atrial Fibrillation: Use, Switching, And Clinical Effects Following New Market Entry In Real-World Patients, Julie C. Lauffenburger '03

Doctoral Dissertations

Patients with atrial fibrillation frequently benefit from anticoagulation to prevent stroke and systemic embolism. For decades, warfarin was the primary oral anticoagulant option despite its narrow therapeutic index requiring monitoring and drug-drug interactions. Dabigatran’s recent availability provides practical advantages including no monitoring and fewer interactions; however, it lacks a convenient reversal agent for bleeding events. Currently, it is unclear what factors have driven anticoagulant utilization since dabigatran’s introduction, and little real-world evidence on the agents’ comparative effectiveness and safety is available. The objectives were to describe dabigatran and warfarin’s utilization and switching patterns and assess their comparative effectiveness and safety. …

Pretreatment Of Scenedesmus Sp. Biomass As A Potential Anaerobic Digestion Substrate, Xinyi E, Czarena Crofcheck

Biosystems and Agricultural Engineering Faculty Publications

Algal biomass can be a potential substrate for anaerobic digestion. However, raw algae cells show a resistance to biological degradation, resulting in a slower methane production rate. Varying thermal and chemical pretreatments of algal biomass were investigated in an attempt to increase soluble organic matter (SOM) yield, which would result in enhanced methane production during subsequent anaerobic digestion. Scenedesmus sp. was harvested using three different procedures: with flocculation, with flocculation and drying, and without flocculation or drying. For all pretreatments and algae types, fluorescence micrographs were obtained to visually confirm the degradation of the algal cell walls. A complete 2 …

Carbocyclodipeptides As Modified Nucleosides: Synthesis And Anti- Hiv Activities, Bhupender S. Chhikara, M. Sudershan Rao, V. Kameshwara Rao, Anil Kumar, Karen W. Buckheit, Robert W. Buckheit Jr., Keykavous Parang

Pharmacy Faculty Articles and Research

A new class of nucleoside analogues were synthesized using cyclic dipeptides and modified 2′-deoxyfuranoribose sugars to introduce flexibility by peptides in place of common nucleoside bases and to determine their biological properties. The synthesis was carried out by coupling of a protected ribose sugar with synthesized dipeptides in the presence of hexamethyldisilazane and trimethylsilyltriflate. The final products were characterized by NMR and high-resolution MS-TOF spectroscopy. The compounds were evaluated for anti-HIV activities. 1-(4-Azido-5-(hydroxymethyl)tetrahydrofuran-2-yl)-3,6-diisopropylpiperazine-2,5-dione (compound 14) containing 3- and 6-isopropyl groups in the base and 3′-azide (EC50 = 1.96 μmol/L) was the most potent compound among all of the synthesized analogs.

Runner Identity And Sponsorship: Evaluating The Rock ‘N’ Roll Marathon, Nancy L. Lough, Jennifer Pharr, Jason O. Owen

Environmental & Global Health Faculty Research

The economic value of participation sport has been reported to eclipse spectator sport significantly. However, scholars have acknowledged the relative lack of research on this important segment of the sport market. The purpose of this study was to analyze the relationship between runner identity and race sponsor effectiveness. Surveys were sent to participants in the Las Vegas Rock ‘n’ Roll Marathon. The survey was constructed to measure runner identity, and sponsor effectiveness as interpreted through rates of recognition, recall and purchase intention. Runners were divided into three groups based on their runner identity score. Of the predictive variables, only runner …

Oncolog, Volume 59, Number 01, January 2014, Joe Munch, Jill Delsigne, M. Yeoman

OncoLog MD Anderson's Report to Physicians (All issues) Archives

• Addressing Fertility Issues in Cancer Patients: For some newly diagnosed cancer patients, whether they will be able to have children after treatment is the furthest question from their minds-until the risks of therapy bring it front-and-center
• INBRIEF: Intensity-Modulated Proton Therapy May Reduce Side Effects of Oropharyngeal Carcinoma Treatment
• Medical Advances Improve Bile Duct Cancer Treatment: Cholangiocarcinoma, the most common bile duct cancer, is a clinically silent disease in its early stages; patients usually present with advanced disease, which carries a poor prognosis
• HOUSE CALL: Weight Loss Tips for Breast Cancer Survivors-Losing excess weight has multiple benefits

Validating Indicators Of The Quality Of Maternal Health Care: Final Report, Kenya, Charlotte E. Warren, James Kelly Kimani, Jackline Kivunaga, Brian Mdawida, Charity Ndwiga, Katharine Mccarthy, Ann K. Blanc

Reproductive Health

Despite widespread use, the majority of indicators proposed as measures of the quality of maternal health services have not been sufficiently validated. To accurately track progress toward national and global maternal health goals, the present study sought to validate and identify a set of maternal health indicators that can be practically applied in facility and population-based surveys. To evaluate indicators, the study employed a facility-based design. The study was conducted in public/government hospital facilities in Kenya and Mexico. Participants included women aged 15–49 who underwent labor and delivery at participating study facilities and the providers who attended them. Women’s self-report …

Achieving Mdgs 4 And 5 In Punjab: The Role Of Family Planning, Population Council

Reproductive Health

This brief focuses on the policy options available to the Punjab government to affect the province’s population growth by 2050 and its potential to achieve MDGs 4 and 5. Maternal mortality is a leading cause of death among women of reproductive age in Punjab—about 16 percent of the deaths in this age group are pregnancy-related. Approximately 6,000 women die each year in Punjab due to pregnancy-related factors. Pregnancies that occur too early, too late, or too frequently increase the risk of maternal death. Lowering fertility rates by increasing the use of family planning can help reduce pregnancy-related deaths. The good …

Training Manual On Basic Monitoring And Evaluation Of Social And Behavior Change Communication Health Programs, Praween Kumar Agrawal, Kumudha Aruldas, M.E. Khan

Reproductive Health

Social and behavior change communication (SBCC) interventions are key for addressing social and cultural barriers and achieving goals laid out for health programs. Often these interventions are not evidence based and monitoring and evaluation (M&E) is limited. Lack of trained and skilled human resources for M&E has been a limitation in general. A serious effort is needed to build the capacity of M&E personnel to monitor and evaluate performance of SBCC interventions in terms of reach and effectiveness among intended audiences. The Improving Healthy Behaviors Program of FHI360 aims to provide technical assistance to strengthen capacities to monitor and evaluate …