Medicine and Health Sciences Commons^™

Microfluidic Platform For Electrophysiological Recordings From Host-Stage Hookworm And Ascaris Suum Larvae: A New Tool For Anthelmintic Research, Janis Weeks, William Roberts, Kristin Robinson, Melissa Keaney, Jon Vermiere, Joseph Urban, Shawn Lockery, John M. Hawdon

Microbiology, Immunology, and Tropical Medicine Faculty Publications

The screening of candidate compounds and natural products for anthelmintic activity is important for discovering new drugs against human and animal parasites. We previously validated in Caenorhabditis elegans a microfluidic device (‘chip’) that records non-invasively the tiny electrophysiological signals generated by rhythmic contraction (pumping) of the worm's pharynx. These electropharyngeograms (EPGs) are recorded simultaneously from multiple worms per chip, providing a medium-throughput readout of muscular and neural activity that is especially useful for compounds targeting neurotransmitter receptors and ion channels. Microfluidic technologies have transformedC. elegans research and the goal of the current study was to validate hookworm andAscaris …

Blog And Podcast Watch: Pediatric Emergency Medicine, Fareen Zaver, Michael Hansen, C. Leibner, A. Little, M. Lin

Emergency Medicine Faculty Publications

Introduction: By critically appraising open access, educational blogs and podcasts in emergency medicine (EM) using an objective scoring instrument, this installment of the ALiEM (Academic Life in Emergency Medicine) Blog and Podcast Watch series curated and scored relevant posts in the specific areas of pediatric EM.

Methods: The Approved Instructional Resources - Professional (AIR-Pro) series is a continuously building curriculum covering a new subject area every two months. For each area, six EM chief residents identify 3-5 advanced clinical questions. Using FOAMsearch.net to search blogs and podcasts, relevant posts are scored by eight reviewers from the AIR-Pro Board, which is …

Feasibility Of An Ed-To-Home Intervention To Engage Patients: A Mixed-Methods Investigation, Jessica Schumacher, Barbara J. Lutz, Allyson Hall, Jesse M. Pines, Andrea Jones, Phyllis Hendry, Colleen Kalynych, Donna L. Carden

Emergency Medicine Faculty Publications

Introduction: Older, chronically ill patients with limited health literacy are often under-engagedin managing their health and turn to the emergency department (ED) for healthcare needs. Wetested the impact of an ED-initiated coaching intervention on patient engagement and follow-updoctor visits in this high-risk population. We also explored patients’ care-seeking decisions. Methods: We conducted a mixed-methods study including a randomized controlled trial andindepth interviews in two EDs in northern Florida. Participants were chronically ill older EDpatients with limited health literacy and Medicare as a payer source. Patients were assignedto an evidencebased coaching intervention (n= 35) or usual post-ED care (n= 34). Qualitativeinterviews …

Spontaneous Subarachnoid Hemorrhage: A Systematic Review And Meta-Analysis Describing The Diagnostic Accuracy Of History, Physical Examination, Imaging, And Lumbar Puncture With An Exploration Of Test Thresholds., Christopher R Carpenter, Adnan M Hussain, Michael J Ward, Gregory J Zipfel, Susan Fowler, Jesse M Pines, Marco L A Sivilotti

Emergency Medicine Faculty Publications

BACKGROUND: Spontaneous subarachnoid hemorrhage (SAH) is a rare, but serious etiology of headache. The diagnosis of SAH is especially challenging in alert, neurologically intact patients, as missed or delayed diagnosis can be catastrophic.

OBJECTIVES: The objective was to perform a diagnostic accuracy systematic review and meta-analysis of history, physical examination, cerebrospinal fluid (CSF) tests, computed tomography (CT), and clinical decision rules for spontaneous SAH. A secondary objective was to delineate probability of disease thresholds for imaging and lumbar puncture (LP).

METHODS: PubMed, Embase, Scopus, and research meeting abstracts were searched up to June 2015 for studies of emergency department patients …

Airway Secretory Micrornaome Changes During Rhinovirus Infection In Early Childhood., M. Gutierrez, J. Gomez, Geovanny Perez, Krishna Pancham, Dinesh K. Pillai, M. Giri, S. Ferrante, Robert J. Freishtat, Mary C. Rose, Diego A. Preciado, Gustavo Nino

Pediatrics Faculty Publications

BACKGROUND:

Innate immune responses are fine-tuned by small noncoding RNA molecules termed microRNAs (miRs) that modify gene expression in response to the environment. During acute infections, miRs can be secreted in extracellular vesicles (EV) to facilitate cell-to-cell genetic communication. The purpose of this study was to characterize the baseline population of miRs secreted in EVs in the airways of young children (airway secretory microRNAome) and examine the changes during rhinovirus (RV) infection, the most common cause of asthma exacerbations and the most important early risk factor for the development of asthma beyond childhood.

METHODS:

Nasal airway secretions were obtained from …

Cyp2c44 Gene Disruption Exacerbated Pulmonary Hypertension And Heart Failure In Female But Not Male Mice, Sachindra R. Joshi, Anand Lakhkar, Vidhi Dhagia, Ariadne Zias, Vasiliki Soldatos, Kaori Oshima, Houli Jiang, Katherine Gotlinger, Jorge H Capdevila, Michal L. Schwartzman, Ivan F. Mcmurtry, Sachin A. Gupte

NYMC Faculty Publications

Epoxyeicosatrienoicacids (EETs), synthesized from arachidonic acid by epoxygenases of the CYP2C and CYP2J gene subfamilies, contribute to hypoxic pulmonary vasoconstriction (HPV) in mice. Despite their roles in HPV, it is controversial whether EETs mediate or ameliorate pulmonary hypertension (PH). A recent study showed that deficiency of Cyp2j did not protect male and female mice from hypoxia-induced PH. Since CYP2C44 is a functionally important epoxygenase, we hypothesized that knockout of the Cyp2c44 gene would protect both sexes of mice from hypoxia-induced PH. We tested this hypothesis in wild-type (WT) and Cyp2c44 knockout (Cyp2c44 (-/-)) mice exposed to normoxia (room air) and …

221 Newborn-Screened Neonates With Medium-Chain Acyl-Coenzyme A Dehydrogenase Deficiency: Findings From The Inborn Errors Of Metabolism Collaborative, K Bentler, S Zhai, S Elsbecker, G Arnold, B Burton, J Vockley, C Cameron, S Hiner, M Edick, S Berry, J Thomas, M Dodge, R Singh, S Lakshman, David Kronn, Inborn Errors Of Metabolism Collaborative

NYMC Faculty Publications

Introduction: There is limited understanding of relationships between genotype, phenotype and other conditions contributing to health in neonates with medium-chain acyl-coenzyme A dehydrogenase deficiency (MCADD) identified through newborn screening. Methods: Retrospective analysis of comprehensive data from a cohort of 221 newborn-screened subjects identified as affected with MCADD in the Inborn Errors of Metabolism-Information System (IBEM-IS), a long term follow-up database of the Inborn Errors of Metabolism Collaborative, was performed. Results: The average age at notification of first newborn screen results to primary care or metabolic providers was 7.45 days. The average octanoylcamitine (C8) value on first newborn screen was 11.2 …

Extramedullary Hematopoiesis Presented As Cytopenia And Massive Paraspinal Masses Leading To Cord Compression In A Patient With Hereditary Persistence Of Fetal Hemoglobin, Tasleem Katchi, Krishna Kolandaivel, Pallavi Khattar, Taliya Farooq, Humayun Islam, Delong Liu

NYMC Faculty Publications

BACKGROUND: Extramedullary hematopoeisis (EMH) can occur in various physiological and pathologic states. The spleen is the most common site of EMH.

CASE PRESENTATION: We report a case with hereditary persistence of fetal hemoglobin with extramedullary hematopoiesis presented as cord compression and cytopenia secondary to multi-paraspinal masses.

CONCLUSION: Treatment can be a challenge. Relapse is a possibility.

Evaluating Isolation Behaviors By Nurses Using Mobile Computer Workstations At The Bedside., Elizabeth L. Beam, Shawn G. Gibbs, Angela L. Hewlett, Peter C. Iwen, Suzanne L. Nuss, Philip W. Smith

Journal Articles: College of Nursing

This secondary analysis from a larger mixed methods study with a sequential explanatory design investigates the clinical challenges for nurses providing patient care, in an airborne and contact isolation room, while using a computer on wheels for medication administration in a simulated setting. Registered nurses, who regularly work in clinical care at the patient bedside, were recruited as study participants in the simulation and debriefing experience. A live volunteer acted as the standardized patient who needed assessment and intravenous pain medication. The simulation was video recorded in a typical hospital room to observe participating nurses conducting patient care in an …

Outpatient Antibiotic Prescribing Among United States Nurse Practitioners And Physician Assistants., Guillermo V Sanchez, Adam L Hersh, Daniel J Shapiro, James F. Cawley, Lauri A Hicks

Prevention and Community Health Faculty Publications

We examined US nurse practitioner (NP) and physician assistant (PA) outpatient antibiotic prescribing. Antibiotics were more frequently prescribed during visits involving NP/PA visits compared with physician-only visits, including overall visits (17% vs 12%, P < .0001) and acute respiratory infection visits (61% vs 54%, P < .001). Antibiotic stewardship interventions should target NPs and PAs.

Resource Guide For Addiction And Mental Health Care Consumers: Answering Questions About Insurance Coverage And Parity For Addiction And Mental Health Care Services, Lucy C. Hodder, Michele D. Merritt, Margaret H. Schmidt, Jacqueline Botchman, Caitlyn Ebert, Marguerite Corvini, Kate Crary, Bridget Drake

Law Faculty Scholarship

Navigating the maze of health insurance coverage can be difficult. For individuals with addiction or mental illness, the process of getting treatment approved and paid for by health insurance can be overwhelming. As a result, many people give up when their health insurance company denies coverage for needed services. This Guide can help people learn how to access health insurance and use their coverage to pay for treatment. This Guide also provides a basic explanation of consumers’ rights under the federal Mental Health Parity and Addiction Equity Act.

Himmelfarb Headlines -September / October 2016, George Washington University, Himmelfarb Health Sciences Library

Himmelfarb Headlines (2009 - present)

No abstract provided.

Ada Code Of Ethics (September 2016), American Dental Association

Code of Ethics

The ADA Code of Ethics has three main components: The Principles of Ethics, the Code of Professional Conduct and the Advisory Opinions. Contents may also include: Amendment to ADA Principles of Ethics and Code of Professional Conduct and Insert for the ADA Principles of Ethics and Code of Professional Conduct. The most current issue is available on the ADA’s website.

Microrna-140 Is Elevated And Mitofusin-1 Is Downregulated In The Right Ventricle Of The Sugen5416/Hypoxia/Normoxia Model Of Pulmonary Arterial Hypertension, Sachindra Raj Joshi, Vidhi Dhagia, Salina Gairhe, John G. Edwards, Ivan F. Mcmurtry, Sachin A. Gupte

NYMC Faculty Publications

Heart failure, a major cause of morbidity and mortality in patients with pulmonary arterial hypertension (PAH), is an outcome of complex biochemical processes. In this study, we determined changes in microRNAs (miRs) in the right and left ventricles of normal and PAH rats. Using an unbiased quantitative miR microarray analysis, we found 1) miR-21-5p, miR-31-5 and 3p, miR-140-5 and 3p, miR-208b-3p, miR-221-3p, miR-222-3p, miR-702-3p, and miR-1298 were upregulated (>2-fold; P < 0.05) in the right ventricle (RV) of PAH compared with normal rats; 2) miR-31-5 and 3p, and miR-208b-3p were upregulated (>2-fold; P < 0.05) in the left ventricle plus septum (LV+S) of PAH compared with normal rats; 3) miR-187-5p, miR-208a-3p, and miR-877 were downregulated (>2-fold; P < 0.05) in the RV of PAH compared with normal rats; and 4) no miRs were up- or downregulated with >2-fold in LV+S compared with RV of PAH and normal. Upregulation of miR-140 and miR-31 in the hypertrophic RV was further confirmed by quantitative PCR. …

Mice With A Heterozygous Lrp6 Deletion Have Impaired Fracture Healing, Travis A. Burgers, Juan F. Vivanco, Juraj Zahatnansky, Andrew J. Vander Moren, James J. Mason, Bart O. Williams

Mechanical Engineering Faculty Publications

Bone fracture non-unions, the failure of a fracture to heal, occur in 10%–20% of fractures and are a costly and debilitating clinical problem. The Wnt/β-catenin pathway is critical in bone development and fracture healing. Polymorphisms of linking low-density lipoprotein receptor-related protein 6 (LRP6), a Wnt-binding receptor, have been associated with decreased bone mineral density and fragility fractures, although this remains controversial. Mice with a homozygous deletion of Lrp6 have severe skeletal abnormalities and are not viable, whereas mice with a heterozygous deletion have a combinatory effect with Lrp5 to decrease bone mineral density. As fracture healing closely models embryonic skeletal …

Hifocap: An Android App For Wearable Health Devices, Yoonsik Cheon, Rodrigo A. Romero

Departmental Technical Reports (CS)

Android is becoming a platform for mobile health-care devices and apps. However, there are many challenges in developing soft real-time, health-care apps for non-dedicated mobile devices such as smartphones and tablets. In this paper we share our experiences in developing the HifoCap app, a mobile app for receiving electroencephalogram (EEG) wave samples from a wearable device, visualizing the received EEG samples, and transmitting them to a cloud storage server. The app is network and data-intensive. We describe the challenges we faced while developing the HifoCap app---e.g., ensuring the soft real-time requirement in the presence of uncertainty on the Android platform---along …

Treatment Considerations For Skeletal Class Iii Orthognathic Surgery, Janeta Chavanavesh, Kanok Soratesn

Chulalongkorn University Dental Journal

Class III malocclusion treatment is challenging to orthodontists because of its genetic basis and tendency for relapse following treatment. In adult patients, this malocclusion can be treated by either camouflage or combined orthodontic and surgical treatment. Since there are complexity in several aspects for Class III malocclusion, particularly in the case where the surgery is required, the aim of this review was to gather information concerning the etiologies, treatment strategies, and treatment considerations, especially for the orthognathic surgical treatment of skeletal Class III patients.

Effect Of Various Chemical Post Surface Treatments On The Microtensile Bond Strength Of Fiber Posts, Siriporn Arunpraditkul, Wacharasak Tumrasvin, Sariya Saoraya, Kamolporn Wattanasirmkit

Chulalongkorn University Dental Journal

Background/Objectives To evaluate the microtensile bond strength (μTBS) between epoxy-based or dimethacrylate-based fiber posts and resin cores after various post surface treatments. Materials and methods Eighty DT light (DT) and forty FRC Postec Plus (FRC) posts were divided into 8 groups; group 1: silanization (S), group 2: silanization and application of bonding agent (SB), groups 3, 5, 7: etching with 37% phosphoric acid for 1 minute (P), 30% hydrogen peroxide for 10 minutes (H30), 35% hydrogen peroxide for 1 minute (H35), respectively, followed by S, groups 4, 6, 8: etched as in groups 3, 5, and 7, but followed by …

Localized Juvenile Spongiotic Gingival Hyperplasia: A Case Report, Chanekrid Oupadissakoon, Narissaporn Chaiprakit, Weerachai Singhatanadgit

Chulalongkorn University Dental Journal

Localized juvenile spongiotic gingival hyperplasia (LJSGH) is a recently discovered oral lesion in children and young adults, which can be misdiagnosed with gingivitis associated with dental plaque and other well recognized reactive lesions. Clinically, JSGH presents as bright red gingival overgrowth with papillary surface, most commonly at attached and marginal gingivae of the upper anterior region. Differential diagnoses may include pyogenic granuloma, peripheral giant cell granuloma, peripheral ossifying fibroma and hyperplastic gingival inflammation. Histologically distinctive, JSGH is characterized by non-keratinizing stratified squamous epithelium with papillary architecture, intense neutrophilic exocytosis and spongiosis. The objectives of the present case report were to …

A Swing Arm Design Dental Surveyor, Vichet Chindavanig

Chulalongkorn University Dental Journal

The objective was to design and fabricate a dental surveyor using fewer complicated custom made industrial metal parts, thus minimizing production cost. The product design allows working with dental casts of varied dimensions. Current products were analyzed using machine design synthesis. The components of the new surveyor design are predominantly prefabricated objects. The formulation method is comparable with an inverse kinematic engineering approach. A swing arm dental surveyor design was found to be efficient for general dental use at a lower production cost. This article describes the design and assembling method of a dental surveyor made from local common products …

Imaging Right Ventricular Function To Predict Outcome In Pulmonary Arterial Hypertension, Alessandro Bellofiore, Melanie Brewis, Rebecca Vanderpool, Naomi Chesler, Martin Johnson, Robert Naeije, Andrew Peacock

Faculty Publications

Right ventricular (RV) function is a major determinant of outcome in pulmonary arterial hypertension (PAH). However, uncertainty persists about the optimal method of evaluation.MethodsWe measured RV end-systolic and end-diastolic volumes (ESV and EDV) using cardiac magnetic resonance imaging and RV pressures during right heart catheterization in 140 incident PAH patients and 22 controls. A maximum RV pressure (Pmax) was calculated from the nonlinear extrapolations of early and late systolic portions of the RV pressure curve. The gold standard measure of RV function adaptation to afterload, or RV–arterial coupling (Ees/Ea) was estimated by the stroke volume (SV)/ESV ratio (volume method) or …

Farm Animal Welfare And Human Health, Alan M. Goldberg

Agribusiness Collection

The paper examines the relationship between farm animal welfare, industrial farm animal production, and human health consequences. The data suggest that when the animal welfare of land-based farm animals is compromised, there are resulting significant negative human health consequences due to environmental degradation, the use of non-therapeutic levels of antibiotics for growth promotion, and the consequences of intensification. This paper accepts that even if meat and fish consumption is reduced, meat and fish will be part of the diet of the future. Industrial production modified from the current intensified systems will still be required to feed the world in 2050 …

Implementation Of Survivorship Care Plans At Three Health System-Based Cancer Centers In A Rural State, Mary Isaacson, Polly Hulme, Jenna Cowan, Jennifer Kerkvliet, Mary Minton

College of Nursing Faculty Publications

The purpose of this project is to describe the development and implementation of cancer SCPs at three health systems’ cancer centers in a rural state. Collectively, these centers serve most cancer patients residing in SD, making the partnership across the cancer centers innovative. Each of the three health systems and their affiliated cancer centers is unique in its history, culture, and infrastructure. In addition, each cancer center was at a different point in the development and implementation of SCPs at the time of this project. Therefore, a description of the processes, successes, and challenges involved in the development and implementation …

Chemotherapy Used To Halt Lower Gi Bleeding In A Rare Case Of Metastatic Choriocarcinoma To The Gi Tract, Ralph Kamel, Talal Seoud, Teniola Oluwadamilola, Michael Karass, Emily Grossniklaus, Gabriela Oprea-Ilies, Daniel A. Goldstein, Sanjay Jain

NYMC Student Publications

Choriocarcinoma, a nonseminomatous germ cell tumor, is a rare type of testicular malignancy that tends to occur in young males. It is, however, exceedingly rare for choriocarcinoma to involve the GI tract. In this article, we present a rare case of a 31-year-old male, diagnosed with choriocarcinoma of the left testes, along with several metastases to distant sites. The patient presented with headaches and severe lower GI bleeding due to metastases to the GI tract, which was eventually controlled with systemic chemotherapy, while requiring several units of packed RBCs during his admission to the hospital. An extensive literature review found …

The Implementation Of Alternative Pain Control Methods By Dental Hygienists, Alejandra Valadez Rodriguez

Mahurin Honors College Capstone Experience/Thesis Projects

As a dental hygienist, it is important to understand new concepts and techniques that can contribute to a more comfortable setting for patients who experience dental anxiety. Alternative pain control methods can assist in alleviating patient anxiety, therefore, providing a more efficient and relaxed clinical atmosphere for both patient and clinician. Some of the methods discussed are: guided imagery, deep breathing, muscle relaxation, hypnosis, acupressure, essential oil diffusion, audio distraction, and visual stimuli. After reviewing the literature the researcher found that dental anxiety affects patient compliance, their overall health, and willingness to attend regular dental visits. The purpose of this …

Analyzing The Regionalized Awareness Of Distraction Osteogenesis, Ali Weinzapfel

Mahurin Honors College Capstone Experience/Thesis Projects

There are multiple treatment options available to initiate bone growth within the oral cavity. Distraction osteogenesis is a surgical dental procedure performed to initiate new bone growth in the maxillofacial region. This procedure is an important advancement to dental professionals because of the minimal complications and great outcome of bone growth it offers. As dentistry is always evolving, it is imperative to relay current trends to other professionals within the field of dentistry. The goal of this research was to analyze the regionalized awareness of distraction osteogenesis. A survey was conducted among dentists in Kentucky and Tennessee with multiple questions …

Role Of Diffusion Tensor Imaging In Prognostication And Treatment Monitoring In Niemann-Pick Disease Type C1, Meghann Lau, Ryan Lee, Robin Miyamoto, Eun Sol Jung, Nicole Farhat, Shoko Yoshida, Susumu Mori, Andrea L. Gropman, Eva Baker, Forbes Porter

Neurology Faculty Publications

Niemann-Pick Disease, type C1 (NPC1) is a rapidly progressive neurodegenerative disorder characterized by cholesterol sequestration within late endosomes and lysosomes, for which no reliable imaging marker exists for prognostication and management. Cerebellar volume deficits are found to correlate with disease severity and diffusion tensor imaging (DTI) of the corpus callosum and brainstem, which has shown that microstructural disorganization is associated with NPC1 severity. This study investigates the utility of cerebellar DTI in clinical severity assessment. We hypothesize that cerebellar volume, fractional anisotropy (FA) and mean diffusivity (MD) negatively correlate with NIH NPC neurological severity score (NNSS) and motor severity subscores. …

Prospective Evaluation Of The Influence Of Iterative Reconstruction On The Reproducibility Of Coronary Calcium Quantification In Reduced Radiation Dose 320 Detector Row Ct., Andrew D Choi, Eric S Leifer, Jeannie Yu, Sujata M Shanbhag, Kathie Bronson, Andrew E Arai, Marcus Y Chen

Radiology Faculty Publications

BACKGROUND: Coronary artery calcium (CAC) predicts coronary heart disease events and is important for individualized cardiac risk assessment. This report assesses the interscan variability of CT for coronary calcium quantification using image acquisition with standard and reduced radiation dose protocols and whether the use of reduced radiation dose acquisition with iterative reconstruction (IR; "reduced-dose/IR ") allows for similar image quality and reproducibility when compared to standard radiation dose acquisition with filtered back projection (FBP; "standard-dose/FBP") on 320-detector row computed tomography (320-CT).

METHODS: 200 consecutive patients (60 ± 9 years, 59% male) prospectively underwent two standard- and two reduced-dose acquisitions (800 …

Design, Development And Evaluation Of A Compact Telerobotic Catheter Navigation System., Mohammad Ali Tavallaei, Daniel Gelman, Michael Konstantine Lavdas, Allan C Skanes, Douglas L Jones, Jeffrey S Bax, Maria Drangova

Medical Biophysics Publications

BACKGROUND: Remote catheter navigation systems protect interventionalists from scattered ionizing radiation. However, these systems typically require specialized catheters and extensive operator training.

METHODS: A new compact and sterilizable telerobotic system is described, which allows remote navigation of conventional tip-steerable catheters, with three degrees of freedom, using an interface that takes advantage of the interventionalist's existing dexterity skills. The performance of the system is evaluated ex vivo and in vivo for remote catheter navigation and ablation delivery.

RESULTS: The system has absolute errors of 0.1 ± 0.1 mm and 7 ± 6° over 100 mm of axial motion and 360° of …

Response To: Letter To The Editor Regarding: The Expanding Phenotype Of Melas Caused By The M.3291 T > C Trna Mutation E Kelland, C. A. Rupar, Asuri N. Prasad, K. Y. Tay, A. Downie And C. Prasad (1) By Josef Finsterer, Md, Phd [1], Sinda Zarrouk-Mahjoub, Phd [2] [1] Krankenanstalt Rudolfstiftung, Vienna [2] Genomics Platform, Pasteur Institute Of Tunis, Tunisia, E. Kelland, C. A. Rupar, Asuri N. Prasad, K. Y. Tay, A. Downie, C. Prasad

Bone and Joint Institute

No abstract provided.