Medicine and Health Sciences Commons^™

Intertrochanteric Hip Fractures In Octogenarian Patients: Do We Need To Rethink Fixation Strategy?, Shahryar Noordin, Shahbano 1, Tashfeen Ahmad, Idrees Shah

Department of Surgery Docs

Abstract

OBJECTIVE:

To compare outcomes in octogenarians with younger patients up to 1 year after undergoing dynamic hip screw fixation for intertrochanteric fractures to see the effectiveness of the implant.

METHODS:

The retrospective case-control study was conducted at The Aga Khan University and comprised records of patients who underwent dynamic hip screw surgery between January 1, 2010, and December 31, 2012. They were divided into two groups based on their age:. Group A <80 years; and Group B > 80 years. All patients had a one-year follow-up> Data including mortality, morbidity, radiological healing time, postoperative ambulatory status and Harris hip score were recorded.

RESULTS:

Of the …

Nursing Students’ Perceptions Of How Working As Nursing Assistants Impacts Their Education, Jerry Harvey

Doctoral Dissertations and Projects

The purpose of this phenomenological study was to develop an understanding of how working as a nursing assistant impacts the ability of nursing students to meet the high demands of school during their junior year of a Baccalaureate of Science in Nursing (BSN) pre-licensure program. Benner’s Novice to Expert Theory, Situated Learning Theory, and the Johari Window Communication Model each suggested that immersing oneself in the culture of nursing would have positive outcomes for the student working as a nursing assistant. A qualitative phenomenological design was used to explore the following research questions: (a) What are the unique experiences of …

Cancer In Louisiana: 2009-2013, Volume 31, Supplement 1, Louisiana Tumor Registry, Lauren Maniscalco, Christina Lefante, Mei-Chin Hsieh, Patricia Andrews, Lisa Pareti, Brent Mumphrey, Diane Ferguson, Beth A. Schmidt, Xiangrong Li, Lisa Peterson, Mary O'Flarity, Mary Anne Lynch, Xiao-Cheng Wu

Policy & Position Papers

Mission:

To collect and report complete, high-quality, and timely population-based cancer data in Louisiana to support cancer research, control, and prevention.

Vision:

To reduce suffering and death from cancer using information collected by the Louisiana Tumor Registry.

History:

Cancer registration in Louisiana began in 1947 at the Charity Hospital Tumor Registry in New Orleans. In 1974, as part of its Surveillance, Epidemiology and End Results (SEER) Program, the National Cancer Institute provided funds for a population-based cancer incidence and survival registry covering Jefferson, Orleans, and St. Bernard parishes. Five years later, the Louisiana Tumor Registry (LTR) was transferred to the …

A Phase I Dose-Escalation Study Of The Braf Inhibitor Vemurafenib In Combination With The Mtor Inhibitor Everolimus In Subjects With Advanced Cancer, Javier Munoz

Dissertations and Theses (Open Access)

Vemurafenib has been approved in the United States for the treatment of relapsed or refractory BRAF mutation positive malignant melanoma and is being investigated in various other malignancies. The RAS/RAF/MEK/ERK (MAPK) pathway is critical to cell proliferation in many human cancers. The mTOR inhibitors are well known to exert profound anticancer effects across malignancies through inhibition of the PTEN/PI3K/AKT/mTOR (mTOR) pathway. We hypothesize that the toxicity profile of the combination of vemurafenib and everolimus will be well tolerated. The primary objective is to find the maximum tolerated dose (MTD) and the toxicity of the combination of vemurafenib and everolimus following …

The Impact Of Cortical State On Neural Coding And Behavior, Charles Beaman

Dissertations and Theses (Open Access)

The brain is never truly silent – up to 80% of its energy budget is expended during ongoing activity in the absence of sensory input. Previous research has shown that sensory neurons are not exclusively influenced by external stimuli but rather reflect interactions between sensory inputs and the ongoing activity of the brain. Yet, whether fluctuations in the state of cortical networks influence sensory coding in neural circuits and the behavior of the animal are unknown. To shed light on this issue, we conducted multi-unit electrophysiology experiments in visual areas V1 and V4 of behaving monkeys. First, we studied the …

Development Of An In Silico Kir Genotyping Algorithm And Its Application To Population And Cancer Immunogenetic Analyses, Howard Rosoff

Dissertations and Theses (Open Access)

Gene content determination and variant calling in the complex KIR genomic region are useful for immune system function analysis, pathogenesis and disease risk factor elucidation, immunotherapy development, evolutionary investigations, and human migration modeling. Sequence-specific oligonucleotide and sequence-specific primer PCR methods are the de facto standards for KIR presence/absence identification, but the current platforms are unsuitable for SNP calling, impractical for KIR typing large cohorts of DNA samples, and inapplicable for typing repositories in which sequence data, but not cells or cell analytes, are available. Alternative typing methods, such as in silico sequence-based typing, can address the problems associated with amplicon-based …

Investigating The Roles Of Δnp63 As A Suppressor Of Migration, Invasion, And Metastasis, Ramon E. Flores Gonzalez

Dissertations and Theses (Open Access)

Cancer is one of the leading causes of death and disease in the world. Considerable resources are spent to study and understand cancer, with the hope of developing new treatments and eventually cures that will help millions of people. Efforts to understand cancer are hindered by its inherent complexity and instability. Nonetheless, understanding the basics of tumor development and progression are the key to focused on studying the role of ΔNp63 in cancer, a p53 family member known to be involved in epithelial development, microRNA biogenesis, and stem cell maintenance. Using the strength of in vivo mouse models, we found …

Clinical Significance Of Homologous Recombination Deficiency Score Testing In Endometrial Cancer, Jean M. Hansen

Dissertations and Theses (Open Access)

Objectives: Homologous recombination deficiency (HRD) score is related to chemotherapy response in breast and ovarian cancers. The role of HRD is unknown in endometrial cancer. We examined the relationship between HRD score and survival in a cohort of endometrial cancer patients and with tumor growth using murine orthotopic models.

Methods: TCGA was queried to determine frequency and clinical significance of alterations in the HR pathway in endometrial cancer. 137 formalin-fixed paraffin-embedded endometrioid adenocarcinoma patient samples were tested for HRD score, microsatellite instability (MSI) and high mutation load (HML) using a next generation sequencing assay targeting the coding regions of 43 …

Development Of Rational Combination Therapy With Parp Inhibitors And Kinase Inhibitors In Tnbc, Wen-Hsuan Yu

Dissertations and Theses (Open Access)

Poly (ADP-ribose) polymerase inhibitors (PARPi) emerge as potential targeting drugs for BRCA-deficient cancers including triple negative breast cancer (TNBC). However, it has been reported that a subgroup of patients even with BRCA mutation fails to respond to PARPi in multiple clinical trials. In this study, we identified c-Met, a tyrosine kinase, phosphorylates PARP1 at Y907 and that the phosphorylation increases PARP1 activity, thereby rendering cancer cells resistant to PARPi. The combination of c-Met inhibitors (METi) and PARPi has a synergistic effect for c-Met overexpressed TNBC in vitro and in vivo. In addition to c-Met, through functional analysis, we found …

Development And Implementation Of An Anthropomorphic Head & Neck Phantom For The Assessment Of Proton Therapy Treatment Procedures, Daniela Branco

Dissertations and Theses (Open Access)

Proton therapy has been used to treat cancer for more than 50 years, and over the past decade, its use has grown rapidly. One of the main goals of modern radiation therapy is to deliver a high dose to the planning target volume (PTV) with minimal exposure and damage to the surrounding healthy tissue. Protons offer a unique advantage over photon radiotherapy in that they deposit dose over a finite range, in contrast to the more gradual energy deposition of photon and electron beams. At present, 23 proton centers are in operation in the United States and another 13 centers …

Define The Epigenetic Profiles And Subtype-Specific Genes Of Breast Cancer, Wenqian Li

Dissertations and Theses (Open Access)

Molecular profiling has identified 5 distinct subtypes of breast cancer, luminal A, luminal B, HER2-enriched, basal-like, and claudin-low breast cancer. These 5 subtypes correlate with hormone response, patient prognosis, and response to therapy. Although steady state gene expression patterns have been explored using expression microarrays, very little is known about the initial, disease-driving transcriptional changes in these cancers or epigenetic changes associated with the differential gene expression signatures. Defining these changes may provide new insights into the mechanisms by which these subtypes arise, as well as new avenues for breast cancer prevention, diagnosis, and treatment. Using Chromatin Immunoprecipitation sequencing and …

Interrogating Dux4 Mrna 3′ End Processing, Natoya J. Peart

Dissertations and Theses (Open Access)

Double Homeobox 4, Dux4, is the leading candidate gene for Facioscapulohumeral Dystrophy (FSHD). FSHD is the third most common muscular dystrophy, and is characterized by progressive muscle weakness primarily in the upper body. In individuals diagnosed with FSHD, Dux4 is inappropriately expressed in somatic cells due to two conditions. The first is hypomethylation of the subtelomeric D4Z4 repeats on chromosome 4. Each D4Z4 repeat on chromosome 4 is 3.3kb in length and contains the open reading frame for Dux4. Hypomethylation of the D4Z4 repeats primarily occurs due to contraction of the repeats from 11-100 (typical numbers in the healthy population) …

Tnf Signaling During Tissue Damage-Induced Nociceptive Sensitization In Drosophila, Juyeon Jo

Dissertations and Theses (Open Access)

Tumor necrosis factor (TNF) signaling is required for inflammatory nociceptive sensitization in both Drosophila and vertebrates. In Drosophila larval model of nociceptive sensitization, UV irradiation in results in epidermal apoptosis and thermal allodynia. TNF/Eiger is produced from dying epidermal cells and acts its receptor in nociceptive sensory neurons to induce thermal allodynia. Inhibition of TNF signaling results in attenuation of nociceptive sensitization whereas epidermal apoptosis still occurs in the absence of TNF. Major gaps in this model are the precise relationship between apoptotic cell death and production of TNF/Eiger, downstream signaling mediators for TNFR/Wengen, and target genes that alter nociceptive …

Potentially Inappropriate Medication Use In Older Patient With Breast And Colorectal Cancer, Meghan S. Karuturi

Dissertations and Theses (Open Access)

Our objective was to determine predictors of potentially inappropriate medication (PIM) use and its impact on outcomes (including ER visits, hospitalization, all cause death, and composite of three) in breast and colorectal cancer patients receiving chemotherapy. We used data from the SEER database linked to Medicare claims. Our cohort included patients ≥ 66 years diagnosed with of Stage II/III breast or colorectal cancer between 7/1/2007-12/31/2009. Baseline PIM was defined using the Drugs to Avoid in the Elderly list (DAE) or Beers criteria. Univariate and multivariable logistic regression were used to determine the associations of baseline PIMs with different covariates. Event-free …

An Automated Syringe Pump System For Improving The Reproducibility Of Dynamic Hyperpolarized Mri Phantoms, Harlee G. Harrison

Dissertations and Theses (Open Access)

AN AUTOMATED SYRINGE PUMP SYSTEM FOR IMPROVING THE REPRODUCIBILITY OF DYNAMIC HYPERPOLARIZED MRI PHANTOMS

Harlee Grace Harrison, B.S.

Advisory Professor: James Bankson, Ph.D.

Magnetic Resonance Imaging (MRI) is a powerful tool in the diagnosis of cancer due to its ability to provide good soft tissue contrast and image resolution without the use of ionizing radiation. The use of hyperpolarized pyruvate as a contrast agent for tumor metabolism during MR scans has the potential to provide information about tumor metabolism in vivo that is not available from traditional imaging measurements or any other method. Hyperpolarization is achieved through dynamic nuclear polarization. …

Measurement Of The Electron Return Effect Using Presage Dosimeter, Gye Won Choi

Dissertations and Theses (Open Access)

MR-guided radiation therapy (MRgRT) provides benefits such as superior soft tissue contrast, no imaging dose, and functional imaging capacities, but it also has concerns to be addressed. The electron return effect (ERE) refers to dose enhancement at the interface between different media, caused when radiation is delivered in the magnetic field. The ERE poses clinical concerns in MRgRT because it significantly enhances the dose at interfaces, and the intensity and pattern of the dose enhancement depends on many factors. The ERE results in a complex pattern of dose enhancement over a three-dimensional (3D) volume around tissue interfaces inside the patient …

Epigenetic Modulation In Braf Mutated Metastatic Colorectal Cancer, Van Morris

Dissertations and Theses (Open Access)

Introduction: BRAF V600E mutations are associated with poor clinical outcomes for patients with metastatic colorectal cancer (mCRC). Unlike other tumors with the same mutation, BRAF inhibitors are ineffective as monotherapy. CRC tumors with BRAF V600E mutations are associated with global hypermethylation, which may turn off tumor suppressor gene expression. We studied demethylation in BRAF V600E mCRC to restore sensitivity to BRAF inhibitors.

Methods: Tumor databanks were investigated for genes differentially expressed according to BRAF mutation status to identify genes which may be particularly susceptible to epigenetic influence. Mouse xenograft models of BRAFV600E mCRC were treated with vemurafenib or azacitidine, alone …

The Immune Microenvironment Of Microsatellite Instable Endometrial Cancer, Janelle B. Pakish

Dissertations and Theses (Open Access)

Limited treatment options are available for patients with advanced and recurrent endometrial cancer (EC) should standard chemotherapy fail. Recent studies in other tumor types have shown that tumors with high microsatellite instability (MSI-H) have increased immunogenicity and response to immunotherapy treatments compared to microsatellite stable (MSS) tumors. Patients with MSI-H EC may also benefit from these therapies; however, the tumor immune microenvironment in MSI-H EC has not yet been well described.

In order to evaluate the immune microenvironment of MSI-H EC, multiple approaches were used, including analysis of large publically available datasets and detailed characterization of patient tumor samples. Uterine …

Employing T Cells For Antigen Presentation: Role Of Ny-Eso-1+ T-Apc Vaccine In Multiple Myeloma, Krina K. Patel

Dissertations and Theses (Open Access)

Introduction: Cellular therapy has shown great potential in early phase clinical trials with persistence of effector cells appearing to lead to improved outcomes. Combined immunotherapy with NY-ESO-1⁺ CAR T cells (TCR mimetic) and an NY-ESO-1 specific T-APC vaccine in myeloma patients may lead to enhanced anti-myeloma efficacy due to improved persistence of the CAR T cells.

Materials and Methods: Using the Sleeping Beauty transposon/transposase system, an NY-ESO-1⁺ TCR and CAR were created as effector cells. Vaccine was produced by electroporation of the NY-ESO-1 gene into T cells to make T cell antigen presenting cells (T-APC). Costimulatory …

Understanding The Mechanism And Extent Of Vlse Recombination In Borrelia Burgdorferi Using Next-Generation Sequencing, Surabhi Tyagi

Dissertations and Theses (Open Access)

B. burgdorferi, the causative agent of Lyme disease, have an elaborate antigenic variation system that involves varying the sequence of vlsE. Previous studies have shown that vlsE antigenic variation occurs continuously inside mammalian hosts. Variation has not been shown previously to occur in in vitro or in ticks. We hypothesized that the induction of vlsE recombination requires contact with dense arrays of host tissue cells and/or ECM components. To test this hypothesis, two methods, quantitative PCR and high-throughput sequencing were used determine the extent and nature of vlsE recombination within mouse tissues and in vitro model systems. Using these …

Novel Mechanisms Of Β-Adrenergic Signaling In Prostate Cancer Progression, Mohit Hulsurkar

Dissertations and Theses (Open Access)

Prostate cancer is the second leading cause of cancer death among American men. The American Cancer Society estimates that 180,890 men will be will be diagnosed with prostate cancer in 2016 in the USA. (http://www.cancer.org/cancer/prostatecancer/detailedguide/prostate-cancer-key-statistics). Androgen deprivation therapy (ADT) is the standard treatment for early stage prostate cancer. But most patients relapse with aggressive variants of prostate cancer, with survival time between 1-3 years. In order to develop cure for such aggressive variants of prostate cancer, our present understanding of the mechanisms underlying its progression needs to be advanced.

Recently, it has been found that activation of β-adrenergic signaling pathway …

Encapsulated Contrast Agent Markers For Mri-Based Post-Implant Dosimetry, Tze Yee Lim

Dissertations and Theses (Open Access)

Low-dose-rate prostate brachytherapy involves the implantation of tiny radioactive seeds into the prostate to treat prostate cancer. The current standard post-implant imaging modality is computed tomography (CT). On CT images, the radioactive seeds can be distinctively localized but delineation of the prostate and surrounding soft tissue is poor. Magnetic resonance imaging (MRI) provides better prostate and soft tissue delineation, but seed localization is difficult. To aid with seed localization, MRI markers with encapsulated contrast agent that provide positive-contrast on MRI images (Sirius MRI markers; C4 Imaging, Houston, TX) have been proposed to be placed adjacent to the negative-contrast seeds. This …

The Ferber Method And Other Behavioral Sleep Training Methods: Do They Disrupt Attachment And Impact Physical And Psychological Wellbeing?, Bobbi Smith

Nursing Masters

The Ferber Method is a behavioral method for sleep training infants and young children that is also known as the “cry it out” method. Behavioral methods of sleep training is often recommended by pediatricians. However, many parents, sleep specialists, psychologists, and experts in infant mental health, find these methods controversial. Supporters of behavioral sleep training claim that it teaches children to “self soothe” and learn to regulate their own emotions. Those against the Ferber Method and other behavioral techniques claim that they not only cause infants and children distress, but they also teach them that their needs will not be …

Hispanic Bilingual Learners' Perceptions And Educational Experiences Of Spanish-Speaking In South Texas, Isela B. Stephens

Theses and Dissertations

The present study focuses on a subset of data obtained from a larger interdisciplinary project, Proyecto Posible, which investigates how sociocultural and instructional factors predict positive outcomes among Spanish- and English-speaking Hispanic bilingual learners. As one part of Proyecto Posible, interviewers asked learners to speak in their language of preference about their experiences in school and feelings developed during interactions with others, as bilinguals. This study examines the qualitative component on bilingual learners’ perceptions of their own language proficiency in English and Spanish, perceptions of language use across a broad range of contexts including school, home, and community, …

A Comparison Of Stride Length And Lower Extremity Kinematics During Barefoot And Shod Running In Well Trained Distance Runners, Peter Francis, James Ledingham, Sarah B. Clarke Phd, Dj Collins, Philip Jakeman

Journal Articles

Stride length, hip, knee and ankle angles were compared during barefoot and shod running on a treadmill at two speeds. Nine well-trained (1500m time: 3min:59.80s ± 14.7 s) male (22 ±3 years; 73 ±9 kg; 1.79 ±0.4 m) middle distance (800 m – 5,000 m) runners performed 2 minutes of running at 3.05 m·s^-1 and 4.72 m·s^-1 on an treadmill. This approach allowed continuous measurement of lower extremity kinematic data and calculation of stride length. Statistical analysis using a 2X2 factorial ANOVA revealed speed to have a main effect on stride length and hip angle and footwear to …

Global Burden Of Maternal And Congenital Syphilis In 2008 And 2012: A Health Systems Modelling Study, N. Saman Wijesooriya, Roger W. Rochat, Mary L. Kamb, Prasad Turlapati, Marleen Temmerman, Nathalie Broutet, Lori M. Newman

Obstetrics and Gynaecology, East Africa

Background: In 2007, WHO launched a global initiative for the elimination of mother-to-child transmission of syphilis (congenital syphilis). An important aspect of the initiative is strengthening surveillance to monitor progress towards elimination. In 2008, using a health systems model with country data inputs, WHO estimated that 1·4 million maternal syphilis infections caused 520 000 adverse pregnancy outcomes. To assess progress, we updated the 2008 estimates and estimated the 2012 global prevalence and cases of maternal and congenital syphilis.

Methods: We used a health systems model approved by the Child Health Epidemiology Reference Group. WHO and UN databases provided inputs on …

Accuracy And Precision Of Occlusal Contacts Of Stereolithographic Casts Mounted By Digital Interocclusal Registrations, Jason T. Krahenbuhl, Seok-Hwan Cho, Jon Patrick Irelan, Naveen K. Bansal

Mathematics, Statistics and Computer Science Faculty Research and Publications

Statement of problem

Little peer-reviewed information is available regarding the accuracy and precision of the occlusal contact reproduction of digitally mounted stereolithographic casts.

Purpose

The purpose of this in vitro study was to evaluate the accuracy and precision of occlusal contacts among stereolithographic casts mounted by digital occlusal registrations.

Material and methods

Four complete anatomic dentoforms were arbitrarily mounted on a semi-adjustable articulator in maximal intercuspal position and served as the 4 different simulated patients (SP). A total of 60 digital impressions and digital interocclusal registrations were made with a digital intraoral scanner to fabricate 15 sets of mounted stereolithographic …

Endothelial Hspa12b Is A Novel Protein For The Preservation Of Cardiovascular Function In Polymicrobial Sepsis Via Exosome Mir-126, Xia Zhang

Electronic Theses and Dissertations

Sepsis is the most frequent cause of mortality in most intensive care units. Cardiovascular dysfunction is a major complication associated with sepsis, with high mortality rates up to 70%. Currently, there is no effective treatment approach for sepsis.

The integrity of the endothelium is fundamental for the homeostasis of the cardiovascular system. Sepsis induces endothelial cell injury which is the key factor for multiple organ failure. The increased expression of adhesion molecules and chemokines in endothelial cell promotes leukocytes infiltration into the tissue. The loss of tight junction proteins and increased permeability of the endothelial cells will provoke tissue hypoxia …

The Combined Effects Of Leptin And Coenzyme Q10 In Ameliorating Obesity- Induced Infertility In Female Rats, Adekunle Adedeji

Electronic Theses and Dissertations

Infertility is one of the major problems of obesity. Studies have shown that administration of leptin reversed obesity-induced infertility in rats and mice. Coenzyme Q₁₀ (CoQ₁₀) is an antioxidant and also supplies the energy needed for ovulation and embryo development. We hypothesized that leptin when combined with CoQ₁₀ could greatly improve obesity-induced infertility. The results showed a significant decrease in food intake, body weight, and the regular estrous cycle was restored after treatment with leptin+CoQ₁₀. There was a significant increase (p10 significantly (p10 can improve fertility in obese infertile female rats. This study could …

Study Design Of A Cluster-Randomized Controlled Trial To Evaluate A Large-Scale Distribution Of Cook Stoves And Water Filters In Western Province, Rwanda, Corey L. Nagel, Miles Kirby, Laura D. Zambrano, Ghislaine Rosa, Christina K. Barstow, Evan A. Thomas, Thomas Clasen

Mechanical and Materials Engineering Faculty Publications and Presentations

Background: In Rwanda, pneumonia and diarrhea are the first and second leading causes of death, respectively, among children under five. Household air pollution (HAP) resultant from cooking indoors with biomass fuels on traditional stoves is a significant risk factor for pneumonia, while consumption of contaminated drinking water is a primary cause of diarrheal disease. To date, there have been no largescale effectiveness trials of programmatic efforts to provide either improved cookstoves or household water filters at scale in a low-income country. In this paper we describe the design of a clusterrandomized trial to evaluate the impact of a national-level program …