Medicine and Health Sciences Commons^™

Interdisciplinary Workshop To Increase Collaboration Between Medical Students And Standardized Patient Instructors In Teaching Physical Diagnosis To Novices, Tanakorn Kittisarapong, Benjamin Blatt, Karen Lewis, Jennifer Owens, Larrie Greenberg

Medicine Faculty Publications

Traditionally, full-time faculty members have assumed major responsibility for teaching physical examination skills to first- and second-year medical students. Problems with faculty recruitment and adhering to a standardized way of teaching have challenged educators to seek alternatives to teaching the physical examination to novices. To address these problems, we created and implemented a novel curriculum that has standardized the teaching of physical examination skills to novice students by using standardized patient instructors and fourth-year medical students working as an interdisciplinary team (known as a dyad). Feedback after the first iteration of this course revealed confusion about roles, goals, and responsibilities …

Clinical Adjudication In Acute Kidney Injury Studies: Findings From The Pivotal Timp-2*Igfbp7 Biomarker Study, Kathleen D. Liu, Anitha Vijayan, Mitchell H. Rosner, Jing Shi, Lakhmir S. Chawla, John A. Kellum

Anesthesiology and Critical Care Medicine Faculty Publications

Background The NEPROCHECK test (Astute Medical, San Diego, CA, USA) combines urinary tissue inhibitor of metalloproteinases-2 (TIMP-2) and insulin-like growth factor binding protein 7 (IGFBP7) to identify patients at high risk for acute kidney injury (AKI). In a US Food and Drug Administration registration trial (NCT01573962), AKI was determined by a three-member clinical adjudication committee. The objectives were to examine agreement among adjudicators as well as between adjudicators and consensus criteria for AKI and to determine the relationship of biomarker concentrations and adjudicator agreement.

Methods Subjects were classified as AKI 3/3, 2/3, 1/3 or 0/3 according to the …

Putting Prep Into Practice: Lessons Learned From Early-Adopting U.S. Providers' Firsthand Experiences Providing Hiv Pre-Exposure Prophylaxis And Associated Care, S. K. Calabrese, Manya Magnus, K. H. Mayer, D. S. Krakower, A. I. Eldahan, L. A. Gaston Hawkins, +5 Additional Authors

Epidemiology Faculty Publications

Optimizing access to HIV pre-exposure prophylaxis (PrEP), an evidence-based HIV prevention resource, requires expanding healthcare providers' adoption of PrEP into clinical practice. This qualitative study explored PrEP providers' firsthand experiences relative to six commonly-cited barriers to prescription-financial coverage, implementation logistics, eligibility determination, adherence concerns, side effects, and anticipated behavior change (risk compensation)-as well as their recommendations for training PrEP-inexperienced providers. U.S.-based PrEP providers were recruited via direct outreach and referral from colleagues and other participants (2014-2015). One-on-one interviews were conducted in person or by phone, transcribed, and analyzed. The sample (n = 18) primarily practiced in the Northeastern (67%) or …

Household Clustering Of Escherichia Coli Sequence Type 131 Clinical And Fecal Isolates According To Whole Genome Sequence Analysis, James R. Johnson, Gregg Davis, Connie Clabots, Brian D. Johnston, Stephen Porter, Lance B. Price, +10 Additional Authors

Environmental and Occupational Health Faculty Publications

Background. Within-household sharing of strains from the resistance-associated H30R1 and H30Rx subclones of Escherichia coli sequence type 131 (ST131) has been inferred based on conventional typing data, but has been assessed minimally using whole genome sequence (WGS) analysis.

Methods. Thirty-three clinical and fecal isolates of ST131-H30R1 and ST131-H30Rx, from 20 humans and pets in six households, underwent WGS analysis for comparison with 52 published ST131 genomes. Phylogenetic relationships were inferred using a bootstrapped maximum likelihood tree based on core genome sequence polymorphisms. Accessory traits were compared between phylogenetically similar isolates.

Results. In the WGS-based …

A Clinical Score To Predict Dose Reductions Of Antidiabetes Medications With Intentional Weight Loss: A Retrospective Cohort Study., Ghanshyam Palamaner Subash Shantha, Anita Ashok Kumar, Vimal Ravi, Rohit C Khanna, Scott Kahan, Lawrence J Cheskin

Health Policy and Management Faculty Publications

Abstract

Background

We assessed the predictive accuracy of an empirically-derived score (weight loss, insulin resistance, and glycemic control: “WIG”) to predict patients who will be successful in reducing diabetes mellitus (DM) medication use with weight loss.

Methods

Case records of 121 overweight and obese patients with DM at two outpatient weight management centers were analyzed.

Results

Mean period of follow-up was 12.5 ± 3.5 months. To derive the “WIG” scoring algorithm, one point each was assigned to “W” (loss of 5% of initial body weight within the first 3 months of attempting weight loss), “I” (triglyceride [TGL]/highdensity lipoprotein ratio >3 …

Uchunguzi (Journal Watch/Montre De Journal) June 2016, Benjamin Wachira

Emergency Medicine, East Africa

When someone telephones for an ambulance, an interaction ensues which should be efficient and effective to facilitate a speedy dispatch of the appropriate level of vehicle, equipment and personnel to where it is needed. The process in South Africa begins with a three-part opening sequence which typically identifies the organisation, introduces the call-taker (CT) and invites the caller to proceed with the business of the call. In a recent project conducted in a South African emergency service, the researchers aimed to ascertain the impact of the CT’s identification sequence on the progression of the call and to determine whether there …

Neuromyelitis Optica (Devic’S Disease) In A 10 Years Old Boy., Dr.Farida Jan, Amber Shabir, Shahnaz Ibrahim

Pakistan Journal of Neurological Sciences (PJNS)

Neuromyelitis optica (NMO) also known as Devic’s disease is an acute demyelinating disorder combined with optic neuritis and transverse myelitis.A 10 years old boy presented in the ER with the complaints of fever and back pain for past 10 days and inability to walk for 6-7 days. He had developed urinary retention and constipation for the past 5 days along with abdominal distension. There was also blurring of vision in the left eye with only light perception and rapid afferent papillary defect was present while the right eye was normal. The provisional diagnosis was Transverse myelitis vsNeuromyelitisoptica (NMO). CSF revealed …

10-Year Pattern Of Admissions In Psychiatric Unit At A Tertiary Care Hospital In Pakistan., Raza Ur Rahman, Abdul Ghani Khan, Naila Naerm Shahbaz

Pakistan Journal of Neurological Sciences (PJNS)

To identify the pattern of psychiatric morbidity in hospitalized patients of a tertiary care unit.Design; Details of patient’s admissions from the case register of psychiatric unit were recorded retrospectively.The study was conducted in Dept. of Psychiatry Jinnah Postgraduate Medical Centre JPMC Karachi and included data of ten years. RESULTS;- TA total of 5527 patients were hospitalized during period of ten years (1995 – 2004). Among them 62.612% (n = 3461) were males and 37.38 (n = 2066) were females. The majority of patients were in the age range of 15 – 44 years. On the basis of ICD classification, mood …

Biventricular Thrombus In Hypereosinophilic Syndrome Presenting With Shortness Of Breath, Abdul Baqi, Shahan Waheed, Fateh Ali Tipoo Sultan, Aamir Hameed

Section of Cardiology

A 48 years old male presented to clinic with 12 months of low grade fever with shortness of breath which has progressively worsened with no associated weight loss, night sweats or loss of appetite. There was no prior history of chronic illness before the current illness. Laboratory workup revealed a high white blood cell count with predominant eosinophils. Chest X-ray was normal. Transthoracic echocardiography and Cardiac Magnetic Resonance showed biventricular thrombi. On further extensive workup the findings were consistent with hypereosinophilic syndrome. The patient was started on oral steroids, hydroxyurea, imatanib mesylate and oral anticoagulation. The patient responded to the …

Alternative Functions For The Multifarious Inflammasome, J. Martel, H. C. Lai, Y. F. Ko, J. D. Young, David M. Ojcius

All Dugoni School of Dentistry Faculty Articles

The inflammasome has been mainly studied in innate immune cells in which it senses microbes and cellular damage, and induces secretion of pro-inflammatory cytokines. This process induces an inflammatory response that is critical for the resolution of infections and repair of tissue damage following injury. Recent studies indicate that inflammasome complex formation also participates in many other cellular and physiological processes beyond modulation of inflammation, such as autophagy, metabolism, eicosanoids production, and phagosome maturation.

Are Rural Older Adults Benefitting From Increased State Spending On Medicaid Home And Community-Based Services?, Andrew F. Coburn Phd, Eileen Griffin Jd, Deborah Thayer Mba, Zachariah T. Croll Mph, Erika C. Ziller Phd

Long Term Services and Supports

In a shift away from institutional long term services and supports (LTSS), the federal government and states have pursued an array of strategies for expanding access to home and community-based services (HCBS) over the past few decades. Yet, little is known about variations in the availability or use of Medicaid HCBS within states, across rural and urban areas. This study used the national Medicaid Analytical Extract claims data file (2008) to examine differences in HCBS use and expenditures among rural and urban older adult Medicaid beneficiaries receiving LTSS. The study found that rural Medicaid LTSS users were less likely to …

James Mann, M.D. (1759-1832): Military Surgeon For The "Second War Of Independence"., Eliza C. Anderson, Md, Scott W. Cowan, Md, Charles J. Yeo, Md

Department of Surgery Gibbon Society Historical Profiles

The War of 1812 is remembered for the Burning of Washington, and Francis Scott Key’s “The Star Spangled Banner,” but little else. It was a poorly funded war of relatively short duration and nebulous resolution. Under such circumstances, it is understandable that the “Second War of Independence” failed to produce many notable military or medical advancements. However, one surgeon took it upon himself to recount his experiences in the field. For his dedication to the art and science of medicine, James Mann deserves recognition.

Reversibility Of Apixaban Anticoagulation With A Four-Factor Prothrombin Complex Concentrate In Healthy Volunteers., S Nagalla, Lynda Thomson, Y Oppong, B Bachman, I Chervoneva, Walter K. Kraft

Department of Pharmacology and Experimental Therapeutics Faculty Papers

It was hypothesized that the four-factor prothrombin complex concentrate (4F-PCC) Kcentra 25 unit/kg would reverse impairment of thrombin generation in healthy volunteers dosed with apixaban to steady state. In this randomized, two-period crossover, assessor-blinded trial, 12 healthy subjects received 5 mg apixaban every 12 h. Three h after the fifth dose, four-factor prothrombin complex concentrate (4F-PCC) 25 unit/kg or saline were infused. Serial blood samples were assessed for thrombin generation using PPP-reagent and PPP-reagent low, anti-Xa, PT, and PTT assays. Geometric mean ratio was calculated at 30 min postinfusion, and at 24, 48, and 72 h. Peak thrombin generation was …

Tobacco Cessation Treatment: Knowledge, Attitude And Practices Of Physician In Karachi, Pakistan: A Cross Sectional Study, Muhammad Naeem, Muhammad Irfan, Minaz Mawani, Zeeshan Waheed, Ahmed Suleman Haque, Ali Bin Sarwar Zubairi, Javaid Khan

Section of Pulmonary & Critical Care

Introduction: Tobacco smoking is a public health problem leading to substantial morbidity and mortality with around 80% of the deaths occurring in developing countries. Physician intervention has been shown to increase cessation rates. The study aims to assess knowledge, attitudes and practices of physicians in tobacco cessation treatment in Karachi Pakistan.

Methods: A descriptive cross sectional study was carried out between June to December 2013. All practicing physicians from Karachi were recruited. Survey questionnaire was distributed among randomly selected physicians after obtaining their consent. The study was approved by ethics review committee of The Aga Khan University Hospital.

Results: A …

Ikkβ Is Essential For Adipocyte Survival And Adaptive Adipose Remodeling In Obesity, Se-Hyung Park, Zun Liu, Yipeng Sui, Robert N. Helsley, Beibei Zhu, David K. Powell, Philip A. Kern, Changcheng Zhou

Clinical and Translational Science Faculty Publications

IκB kinase β (IKKβ), a central coordinator of inflammatory responses through activation of nuclear factor-κB (NF-κB), has been implicated as a critical molecular link between inflammation and metabolic disorders; however, the role of adipocyte IKKβ in obesity and related metabolic disorders remains elusive. Here we report an essential role of IKKβ in the regulation of adipose remodeling and adipocyte survival in diet-induced obesity. Targeted deletion of IKKβ in adipocytes does not affect body weight, food intake, and energy expenditure but results in an exaggerated diabetic phenotype when challenged with a high-fat diet (HFD). IKKβ-deficient mice have multiple histopathologies in visceral …

Department Of Surgery Update, June 2016, Wright State University Department Of Surgery

Department of Surgery Updates

A six page newsletter created by the Department of Surgery documenting changes to the department. This issue contains a message from the chair, a list of important dates, committee meetings, scholarly activity, and more.

Social Context Surrounding Hiv Diagnosis And Construction Of Masculinity: A Qualitative Study Of Stigma Experiences Of Heterosexual Hiv Positive Men In Southwest Nigeria, Titilayo A. Okoror, Catherine O. Falade, Mary O. Walker, Agaptus Anaele

Africana Studies Faculty Scholarship

Background: Though research has documented experiences of stigma and its effects on the lives of women living with HIV/AIDS, there is limited research on heterosexual positive HIV men experience of stigma in Nigeria. This study explored how social context surrounding HIV diagnosis impacts stigma experiences of heterosexual HIV positive men and their construction of masculinity in southwest Nigeria.

Methods: Using purposive sampling, 17 heterosexual HIV positive men were recruited through community based organization to participate in two hours focus group discussions or 45 min in-depth interviews that were audio-recorded. Without using the word stigma, discussions and interviews were guided by …

Calcium Phosphate As A Key Material For Socially Responsible Tissue Engineering, Vuk Uskoković, Victoria M. Wu

Pharmacy Faculty Articles and Research

Socially responsible technologies are designed while taking into consideration the socioeconomic, geopolitical and environmental limitations of regions in which they will be implemented. In the medical context, this involves making therapeutic platforms more accessible and affordable to patients in poor regions of the world wherein a given disease is endemic. This often necessitates going against the reigning trend of making therapeutic nanoparticles ever more structurally complex and expensive. However, studies aimed at simplifying materials and formulations while maintaining the functionality and therapeutic response of their more complex counterparts seldom provoke a significant interest in the scientific community. In this review …

Portal Hypertension, Kristi Loomis

Nursing Student Class Projects (Formerly MSN)

Chronic liver disease plagues the body with many significant complications. One of the more commonly identified complications is portal hypertension (PHT). Without intervention the elevated pressures in PHT will lead to extensive complications, and eventually death

Kentucky Special Report: State-Level Field Network Study Of The Implementation Of The Affordable Care Act, Julia Costich, Glen P. Mays

Health Management and Policy Reports

No abstract provided.

Probability Of Fallopian Tube And Ovarian Detection With Transvaginal Ultrasonography In Normal Women, Jason R. Lefringhouse, Erin Neward, Frederick R. Ueland, Lauren A. Baldwin, Rachel W. Miller, Christopher P. Desimone, Richard J. Kryscio, John R. Van Nagell, Edward J. Pavlik

Obstetrics and Gynecology Faculty Publications

Objective: Some ovarian malignancies may originate in the fallopian tube. The feasibility of ultrasonographically visualizing the fallopian tube is presented. Methods: In total, 549 normal women participated in the fallopian tube visualization trial, while ovarian visualization was studied in 43,521. Chi-square analysis, t-tests and multivariate analysis determined significance and interactions. Results: Ovaries were observed in 82.7% while fallopian tubes were detected in 77.2% of women and 85.2% of the time when an ovary was detected. Age, BMI or parity was not significantly different when one or both fallopian tubes were visualized. Elevated BMI had slightly greater influence …

The Relationship Between Food Insecurity And Weight In The United States, 2011 – 2014, Sebastián Villamizar-Santamaría

Center for Latin American, Caribbean, and Latino Studies

Introduction: This report examines the relation between weight and food insecurity in the United States between 2011 and 2014.

Methods: The data used in this report come from the Integrated Health Interview Services (IHIS) and its food security index. Weight is assessed by body mass index, and the population is divided into four weight groups based on body mass index ranges.

Results: First, food insecurity rates declined among the general population of Latinos between 2011 and 2014, however, food insecurity rates rose dramatically among underweight Latinos over that time period. Second, food insecurity rates were greatest among the obese and …

Imaging Guided Breast Interventions, Imrana Masroor, Shaista Afzal, Saira Naz Sufian

Department of Radiology

Breast imaging is a developing field, with new and upcoming innovations, decreasing the morbidity and mortality related to breast pathologies with main emphasis on breast cancer. Breast imaging has an essential role in the detection and management of breast disease. It includes a multimodality approach, i.e. mammography, ultrasound, magnetic resonance imaging, nuclear medicine techniques and interventional procedures, done for the diagnosis and definitive management of breast abnormalities. The range of methods to perform biopsy of a suspicious breast lesion found on imaging has also increased markedly from the 1990s with hi-technological progress in surgical as well as percutaneous breast biopsy …

Contemporary Data On Cardiovascular Diseases In Indians: American College Of Cardiology's Pinnacle India Quality Improvement Program, Ankur Kalra, Nathan Glusenkamp, William J. Oetgen, Salim S. Virani

Office of the Provost

No abstract provided.

A Pan-Dengue Virus Reverse Transcription-Insulated Isothermal Pcr Assay Intended For Point-Of-Need Diagnosis Of Dengue Virus Infection By Use Of The Pockit Nucleic Acid Analyzer, Yun Young Go, R. P. V. Jayanthe Rajapakse, Senanayake A. M. Kularatne, Pei-Yu Alison Lee, Keun Bon Ku, Sangwoo Nam, Pin-Hsing Chou, Yun-Long Tsai, Yu-Lun Liu, Hsiao-Fen Grace Chang, Hwa-Tang Thomas Wang, Udeni B. R. Balasuriya

Maxwell H. Gluck Equine Research Center Faculty Publications

Dengue virus (DENV) infection is considered a major public health problem in developing tropical countries where the virus is endemic and continues to cause major disease outbreaks every year. Here, we describe the development of a novel, inexpensive, and user-friendly diagnostic assay based on a reverse transcription-insulated isothermal PCR (RT-iiPCR) method for the detection of all four serotypes of DENV in clinical samples. The diagnostic performance of the newly established pan-DENV RT-iiPCR assay targeting a conserved 3′ untranslated region of the viral genome was evaluated. The limit of detection with a 95% confidence was estimated to be 10 copies of …

Systematic Replication Of The Effects Of A Supplementary, Technology-Assisted, Storybook Intervention For Preschool Children With Weak Vocabulary And Comprehension Skills, Charles R. Greenwood, Judith J. Carta, Elizabeth S. Kelley, Gabriela Guerrero, Na Young Kong, Jane Atwater, Howard Goldstein

Communication Sciences and Disorders Faculty Publications

In 2013, Spencer, Goldstein, Sherman, et al. reported the promising effects of a supplemental, technology-assisted, storybook intervention (Tier 2) containing embedded instruction targeting the oral language learning of preschool children at risk for delays. We sought to advance knowledge of the intervention by replicating it in a new sample and examining children’s responses to the narrator’s instructional prompts and associations with learning outcomes. Results indicated that children were highly successful in responding with the narrator’s task-management prompts (i.e., turn the page), particularly after the first book. Children were much less proficient in correctly responding to the narrator’s word-teaching prompts …

Activation Of Target Gene Expression In Neurons By The C. Elegans Rfx Transcription Factor, Daf-19, Katherine P. Mueller

Lawrence University Honors Projects

DAF-19, the only RFX transcription factor found in C. elegans, is required for the formation of neuronal sensory cilia. Four isoforms of the DAF-19 protein have been reported, and the m86 nonsense (null) mutation affecting all four isoforms has been shown to prevent cilia formation. Transcriptome analyses employing microarrays of L1 and adult stage worms were completed using RNA from daf-19(m86) worms and an isogenic wild type strain to identify additional putative DAF-19 target genes. Using transcriptional fusions with GFP, we compared the expression patterns of several potential gene targets using fluorescence confocal microscopy. Expression patterns were characterized in …

Assessment Of Daf-19 Related Behavioral Defects, Loraina A. Stinson

Lawrence University Honors Projects

The daf-19 gene encodes the only RFX transcription factors in C. elegans, producing at least four related protein isoforms, one of which, DAF-19C, is responsible for ciliogenesis. Previous work by Senti and Swoboda (2008) demonstrated that adult worms deficient in all four DAF-19 proteins have extremely aberrant dwelling and roaming behavior on bacterial food. Most intriguingly, the addition of cDNA encoding the DAF-19C isoform restores cilia formation, but does not fully restore wild-type dwelling and roaming behavior. We are suggesting that additional neuron functions are needed to properly execute behaviors and these neuron functions require the activity of other …

Promoting Adult Pertussis Vaccination In The Workplace, Karlen Beth Luthy, Jennifer L. Bainum, Renea L. Beckstrand, Janelle L B Macintosh, Lacey M. Eden, Brooke Saunders

Faculty Publications

Vaccines are an important disease prevention strategy among individuals of all age groups. Despite the success of vaccinations in preventing communicable diseases, adults, in particular, often have sub-optimal vaccination rates. Consequently, some vaccine-preventable diseases, such as pertussis, are still on the rise in the United States despite the availability of the Tdap vaccine. As most adults can be found in the workplace, occupational and environmental health nurses are in a unique position to encourage employers to promote adequate Tdap vaccination among their employees. As specific resources regarding Tdap vaccination are lacking, the Pertussis Prevention Toolkit was developed to help occupational …

Today - June 2016, Loma Linda University Health

TODAY

Inside this issue:

-- Two weekends of commencement ceremonies add more than 1,500 new alumni and recognize honorees
-- Loma Linda University and Siemens' PETNET Solutions, Inc. announce PET production and research facility
-- Commencement 2016 photo memories (pictorial)
-- Becker's Hospital Review names senior vice president of finance among '150 hospital and health system CFOs to know in 2016'
-- Reading day camp to take place in July
-- Another Emmy win for advancement films
-- Employees line up to sign banners of support for two Florida hospitals in the aftermath of tragic shootings
-- New patient parking structure …