Medicine and Health Sciences Commons^™

Biosimilars: Potential Implications For Clinicians, Misty G. Eleryan, Sophia Akhiyat, Monica Rengifo-Pardo, Alison Ehrlich

Dermatology Faculty Publications

With the expiration of patent protection for several biologics looming, the production of highly similar therapeutic agents has begun to emerge on the pharmaceutical market. These alternative drugs are referred to as biosimilars. Many anticipate that the introduction of these agents will result in a reduction in health care costs, which may create a more affordable biopharmaceutical market and also improve patient access. In contrast to generics, which are exact copies of their original products, biosimilars are not identical to their reference products. Due to concern about the safety and efficacy of biosimilars, separate regulatory approval pathways have been developed …

Utilizing Electronic Health Records To Predict Acute Kidney Injury Risk And Outcomes: Workgroup Statements From The 15th Adqi Consensus Conference, Scott M. Sutherland, Lakhmir S. Chawla, Sandra Kane-Gill, Raymond K. Hsu, Andrew A. Kramer, Stuart A. Goldstein, John A Kellum, Claudio Ronco, Sean M. Bagshaw, On Behalf Of The 15 Adqi Consensus Group

Anesthesiology and Critical Care Medicine Faculty Publications

The data contained within the electronic health record (EHR) is “big” from the standpoint of volume, velocity, and variety. These circumstances and the pervasive trend towards EHR adoption have sparked interest in applying big data predictive analytic techniques to EHR data. Acute kidney injury (AKI) is a condition well suited to prediction and risk forecasting; not only does the consensus definition for AKI allow temporal anchoring of events, but no treatments exist once AKI develops, underscoring the importance of early identification and prevention. The Acute Dialysis Quality Initiative (ADQI) convened a group of key opinion leaders and stakeholders to consider …

Herpetic Stromal Keratitis Following Selective Laser Trabeculoplasty, Nisha Chadha, David A. Belyea, Sanjeev Grewal

Ophthalmology Faculty Publications

This is a case report describing two cases of disciform corneal edema following uncomplicated selective laser trabeculoplasty (SLT) thought to be secondary to herpes simplex virus (HSV) given the presence of a dendrite, decreased corneal sensation, corneal thinning, and response to therapy with oral and topical antivirals. Corneal edema after SLT treatment has been reported before, but the etiology has been unclear. Our cases highlight HSV as a likely etiology, which may help with prevention and better management of such cases in the future.

A Comparison Of Right Ventricular Volumes In Children And Adults With Repaired Tetralogy Of Fallot - Including And Excluding Right Ventricular Trabeculations, James D. Enos, Jacob Hartz, Rachel Quinn, Lasya Gaur, Russell Cross, Laura J. Olivieri

Pediatrics Posters and Presentations

No abstract provided.

Human Herpesvirus Multiplex Ddpcr Detection In Brain Tissue From Low- And High-Grade Astrocytoma Cases And Controls., Cheng-Te Major Lin, Emily C. Leibovitch, M. Isabel Almira-Suarez, Steven Jacobson

Pathology Faculty Publications

BACKGROUND: Glioblastoma (GBM) is a fatal CNS malignancy, representing 50 % of all gliomas with approximately 12-18 months survival time after initial diagnosis. Recently, the human herpesvirus cytomegalovirus (CMV) has been suggested to have an oncogenic role, yet this association remains controversial. In addition, human herpesvirus 6 (HHV-6) and Epstein-Barr virus (EBV) have also been associated with low-grade gliomas, but few studies have examined HHV-6 and EBV in glioblastomas. Droplet digital PCR (ddPCR) is a highly precise diagnostic tool that enables the absolute quantification of target DNA. This study examines the association between multiple human herpesviruses and astrocytomas.

METHODS: This …

Spatial And Temporal Homogeneity Of Driver Mutations In Diffuse Intrinsic Pontine Glioma., Hamid Nikbakht, Eshini Panditharatna, Leonie G Mikael, Rui Li, Tenzin Gayden, Alan Siu, Javad Nazarian, + 17 More

Neurological Surgery Faculty Publications

Diffuse Intrinsic Pontine Gliomas (DIPGs) are deadly paediatric brain tumours where needle biopsies help guide diagnosis and targeted therapies. To address spatial heterogeneity, here we analyse 134 specimens from various neuroanatomical structures of whole autopsy brains from nine DIPG patients. Evolutionary reconstruction indicates histone 3 (H3) K27M-including H3.2K27M-mutations potentially arise first and are invariably associated with specific, high-fidelity obligate partners throughout the tumour and its spread, from diagnosis to end-stage disease, suggesting mutual need for tumorigenesis. These H3K27M ubiquitously-associated mutations involve alterations in TP53 cell-cycle (TP53/PPM1D) or specific growth factor pathways (ACVR1/PIK3R1). Later oncogenic alterations arise in sub-clones and often …

Neurosurgery Concepts: Key Perspectives On Intrathecal Fluorescein For Detecting Intraoperative Cerebrospinal Fluid Leak During Endoscopic Endonasal Surgery, Spinal Intraarterial Chemotherapy, Oligoastrocytoma Classification By In Situ Molecular Genetics, And Prenatal Myelomeningocele Closure And The Need For Cerebrospinal Fluid Shunt Placement., Anand V Germanwala, Winward Choy, Jonathan H. Sherman, Sandi Lam, Isaac Yang, Zachary A Smith

Neurological Surgery Faculty Publications

No abstract provided.

Supersilac Quantitative Proteome Profiling Of Murine Middle Ear Epithelial Cell Remodeling With Nthi, Stephanie Val, Katelyn Burgett, Kristy J. Brown, Diego A. Preciado

Pediatrics Faculty Publications

Background

Chronic Otitis Media with effusion (COME) develops after sustained inflammation and is characterized by secretory middle ear epithelial metaplasia and effusion, most frequently mucoid. Non-typeable Haemophilus influenzae (NTHi), the most common acute Otitis Media (OM) pathogen, is postulated to promote middle ear epithelial remodeling in the progression of OM from acute to chronic. The goals of this study were to examine histopathological and quantitative proteomic epithelial effects of NTHi challenge in a murine middle ear epithelial cell line.

Methods

NTHi lysates were generated and used to stimulate murine epithelial cells (mMEEC) cultured at air-liquid interface over 48 hours– …

Bedside Teaching: An Underutilized Tool In Medical Education, Mohammed Garout, Abudelah Nuqali, Ahmad Alhazmi, Hani Almoallim

Medicine Faculty Publications

No abstract provided.

An Individual With Human Immunodeficiency Virus, Dementia, And Central Nervous System Amyloid Deposition, Raymond Scott Turner, Melanie Chadwick, Wesley A Horton, Gary L. Simon, Xiong Jiang, Giuseppe Esposito

Medicine Faculty Publications

Human immunodeficiency virus (HIV)-associated neurocognitive disorder (HAND) is found in 30%-50% of individuals with HIV infection. To date, no HIV+ individual has been reported to have a positive amyloid PET scan. We report a 71-year-old HIV+ individual with HAND. Clinical and neuropsychologic evaluations confirmed a progressive mild dementia. A routine brain MRI was normal for age. [18F]Fluorodeoxyglucose-PET revealed mild hypermetabolism in bilateral basal ganglia and hypometabolism of bilateral parietal cortex including the posterior cingulate/precuneus. Resting state functional MRI revealed altered connectivity as found with individuals with mild AD. CSF examination revealed a low Aβ42/tau index but a low phospho-tau. An …

The Synergistic Roles Of Cholecystokinin B And Dopamine D5 Receptors On The Regulation Of Renal Sodium Excretion., Xiaoliang Jiang, Wei Chen, Xing Liu, Zihao Wang, Yunpeng Liu, Robin A Felder, John J Gildea, Pedro A. Jose, Chuan Qin, Zhiwei Yang

Medicine Faculty Publications

Renal dopamine D1-like receptors (D1R and D5R) and the gastrin receptor (CCKBR) are involved in the maintenance of sodium homeostasis. The D1R has been found to interact synergistically with CCKBR in renal proximal tubule (RPT) cells to promote natriuresis and diuresis. D5R, which has a higher affinity for dopamine than D1R, has some constitutive activity. Hence, we sought to investigate the interaction between D5R and CCKBR in the regulation of renal sodium excretion. In present study, we found D5R and CCKBR increase each other's expression in a concentration- and time-dependent manner in the HK-2 cell, the specificity of which was …

Trimethylamine N-Oxide: The Good, The Bad And The Unknown, Manuel T. Velasquez, Ali Ramezani, Alotaibi Manal, Dominic S. Raj

Medicine Faculty Publications

Trimethylamine N-oxide (TMAO) is a small colorless amine oxide generated from choline, betaine, and carnitine by gut microbial metabolism. It accumulates in the tissue of marine animals in high concentrations and protects against the protein-destabilizing effects of urea. Plasma level of TMAO is determined by a number of factors including diet, gut microbial flora and liver flavin monooxygenase activity. In humans, a positive correlation between elevated plasma levels of TMAO and an increased risk for major adverse cardiovascular events and death is reported. The atherogenic effect of TMAO is attributed to alterations in cholesterol and bile acid metabolism, activation …

Fixing Medicaid To "Fix Society": Extending Medicaid Coverage Of Gender-Affirming Healthcare To Transgender Youth, Henry Parr

Fordham Urban Law Journal

No abstract provided.

Relationship Of Routine Inadequate Sleep Duration And Periodontitis In A Nationally Representative Sample, R Constance Wiener

Faculty & Staff Scholarship

Purpose. Previous research has indicated the public health impact of inadequate sleep duration on health, potentially through an immune-inflammation mechanism. This mechanism also has a role in periodontitis. The purpose of this study is to determine if there is an association of routine inadequate sleep and periodontitis.Methods. Data from merged National Health and Nutrition Examination Survey years 2009-10 and 2011-12 were the data source for the study. The key outcome was periodontitis (yes, no), and the key variable of interest was usual sleep on weekday or workday nights. Chi square and logistic regression procedures were conducted. The study included 3,740 …

Association Of Alanine Aminotransferase And Periodontitis: A Cross-Sectional Analysis—Nhanes 2009–2012, R Constance Wiener

Faculty & Staff Scholarship

Objective. Alanine Aminotransferase is an enzyme associated with not only liver diseases, liver conditions, and metabolic syndrome, but also inflammation. Periodontitis is associated with increased cytokines and other markers of inflammation. The purpose of this study is to determine if an independent association between Alanine Aminotransferase and periodontitis exists. Methods. Data from the 2009-2010 and 2011-2012 National Health and Nutrition Surveys (NHANES) were combined. Data concerning periodontitis and Alanine Aminotransferase were extracted and analyzed with Rao Scott Chi-square and logistic regressions. Serum Alanine Aminotransferase was dichotomized at 40 units/liter, and periodontitis was dichotomized to the presence or absence of periodontitis. …

Association Of Breastfeeding And The Federal Poverty Level: National Survey Of Family Growth, 2011–2013, R Constance Wiener

Faculty & Staff Scholarship

Breastfeeding is strongly endorsed in the Healthy People 2020 goals; however, there remain many disparities in breastfeeding prevalence. The purpose of this study was to examine the association between breastfeeding and the Federal Poverty Level in the United States. Data from 5,397 women in the National Survey of Family Growth 2011–2013 survey were included in this study. The data were analyzed for descriptive features and logistic regressions of the Federal Poverty Level on breastfeeding. There were 64.1% of women who reported breastfeeding. Over one-third (35.2%) of women reported having a household income of 0–99% of the Federal Poverty Level. There …

Association Of Blood Lead Levels In Children 0–72 Months With Living In Mid-Appalachia: A Semiecologic Study, R Constance Wiener

Faculty & Staff Scholarship

Introduction: Lead exposure in children remains a significant public health issue, although many advances have been made. The Mid-Appalachia area (Kentucky, New York, Ohio, Pennsylvania, and West Virginia) is 89-91% rural with a population density of 16-21 people/km2 (41-54 people/mi2). Mid-Appalachia has significant health disparities including concerns for the consequences of greater lead exposure to children due to mining and industrial footprints, and existing older housing. The purpose of this study is to compare the reported blood lead levels of screened children, aged 0-72 months in Mid-Appalachia, to the children in the USA in general.
Methods: Data from the Centers …

Smoking And Heberden Nodes: Analysis Of Data From The Osteoarthritis Initiative, R Constance Wiener

Faculty & Staff Scholarship

Purpose. Dental hygienists, dentists, and other workforce providers who depend upon their hands for employment are acutely aware of the need to protect their hands to ensure a successful career. Recent research has suggested that smoking may be protective of hand osteoarthritis. The purpose of this study is to determine the association between smoking and Heberden’s nodes. Methods. Data from the Osteoarthritis Initiative were used in a cross-sectional, secondary data analysis of self-reported current smoking/never smoking and the presence/absence of Heberden’s nodes, the hard enlargements of the joints nearest the fingertips (distal interphalangeal joints). Analyses included descriptive statistics, Chi-square associations …

Adolescent Light Cigarette Smoking Patterns And Adult Cigarette Smoking, R Constance Wiener

Faculty & Staff Scholarship

Purpose. Light cigarette smoking has had limited research. The purpose of this study was to examine the relationship between light smoking in adolescence with smoking in adulthood. Methods. National Longitudinal Study of Adolescent Health data, Waves I and IV, were analyzed. Previous month adolescent smoking of 1–5 cigarettes/day (cpd) (light smoking); 6–16 cpd (average smoking); 17 or more cpd (heavy smoking); and nonsmoking were compared with the outcome of adult smoking. Results. At baseline, 15.9% of adolescents were light smokers, 6.8% were average smokers, and 3.6% were heavy smokers. The smoking patterns were significantly related to adult smoking. In logistic …

Providing Daily Oral Infection Control To Persons Dependent On Others For Activities Of Daily Living: A Semi-Qualitative Descriptive Study, R Constance Wiener

Faculty & Staff Scholarship

Background

The purpose of this study is to evaluate caregiver assessment of the ease of use of a specially designed toothbrush for providing daily oral infection control (toothbrushing) to persons dependent upon others for activities of daily living.

Method

Eighty-eight caregivers accepted surveys and multi-surface toothbrushes to provide daily oral infection control to the person to whom they assisted. They were asked to evaluate the ease of use of the multi-surface toothbrush, and provide comments about it.

Results

There were 30 surveys returned (34.1% response rate). In terms of the ease of use, 90.0% of the caregivers agreed (63.3% strongly …

Improving Hiv Surveillance Data For Public Health Action In Washington, Dc: A Novel Multiorganizational Data-Sharing Method, Joanne Ocampo, J. C. Smart, Adam Allston, Reshma Bhattacharjee, Sahithi Boggavarapu, Amanda D. Castel, +13 More

GW Biostatistics Center

Background: The National HIV/AIDS Strategy calls for active surveillance programs for human immunodeficiency virus (HIV) to more accurately measure access to and retention in care across the HIV care continuum for persons living with HIV within their jurisdictions and to identify persons who may need public health services. However, traditional public health surveillance methods face substantial technological and privacy-related barriers to data sharing.

Objective: This study developed a novel data-sharing approach to improve the timeliness and quality of HIV surveillance data in three jurisdictions where persons may often travel across the borders of the District of Columbia, Maryland, and Virginia. …

Skin Collagen Fluorophore Lw-1 Versus Skin Fluorescence As Markers For The Long-Term Progression Of Subclinical Macrovascular Disease In Type 1 Diabetes., David R Sell, Wanjie Sun, Xiaoyu Gao, Christopher Strauch, John M. Lachin, Patricia A Cleary, Saul Genuth, Ddit/Edic Research Group, Vincent M Monnier

GW Biostatistics Center

BACKGROUND: Skin collagen Long Wavelength Fluorescence (LWF) is widely used as a surrogate marker for accumulation of advanced glycation end-products. Here we determined the relationship of LWF with glycemia, skin fluorescence, and the progression of complications during EDIC in 216 participants from the DCCT.

METHODS: LW-1 and collagen-linked fluorescence (CLF) were measured by either High Performance Liquid Chromatography (HPLC) with fluorescence detection (LW-1) or total fluorescence of collagenase digests (CLF) in insoluble skin collagen extracted from skin biopsies obtained at the end of the DCCT (1993). Skin intrinsic fluorescence (SIF) was noninvasively measured on volar forearm skin at EDIC year …

D-Dimer Levels Before Hiv Seroconversion Remain Elevated Even After Viral Suppression And Are Associated With An Increased Risk Of Non-Aids Events, Matthew S Freiberg, Ionut Bebu, Russell Tracy, Kaku So-Armah, Jason Okulicz, Anuradha Ganesan, Adam Armstrong, Thomas O'Bryan, David Rimland, Amy C Justice, Brian K Agan

GW Biostatistics Center

The mechanism underlying the excess risk of non-AIDS diseases among HIV infected people is unclear. HIV associated inflammation/hypercoagulability likely plays a role. While antiretroviral therapy (ART) may return this process to pre-HIV levels, this has not been directly demonstrated. We analyzed data/specimens on 249 HIV+ participants from the US Military HIV Natural History Study, a prospective, multicenter observational cohort of >5600 active duty military personnel and beneficiaries living with HIV. We used stored blood specimens to measure D-dimer and Interleukin-6 (IL-6) at three time points: pre-HIV seroconversion, ≥6 months post-HIV seroconversion but prior to ART initiation, and ≥6 months post-ART …

Generalized Confidence Intervals And Fiducial Intervals For Some Epidemiological Measures., Ionut Bebu, G. Luta, T. Mathew, B. K. Agan

GW Biostatistics Center

For binary outcome data from epidemiological studies, this article investigates the interval estimation of several measures of interest in the absence or presence of categorical covariates. When covariates are present, the logistic regression model as well as the log-binomial model are investigated. The measures considered include the common odds ratio (OR) from several studies, the number needed to treat (NNT), and the prevalence ratio. For each parameter, confidence intervals are constructed using the concepts of generalized pivotal quantities and fiducial quantities. Numerical results show that the confidence intervals so obtained exhibit satisfactory performance in terms of maintaining the coverage probabilities …

Significance Of Epicardial And Intrathoracic Adipose Tissue Volume Among Type 1 Diabetes Patients In The Dcct/Edic: A Pilot Study., Sirous Darabian, Jye-Yu C Backlund, Patricia A Cleary, Nasim Sheidaee, Ionut Bebu, John M. Lachin, Matthew J Budoff, Dcct/Edic Research Group

GW Biostatistics Center

Introduction

Type 1 diabetes (T1DM) patients are at increased risk of coronary artery disease (CAD). This pilot study sought to evaluate the relationship between epicardial adipose tissue (EAT) and intra-thoracic adipose tissue (IAT) volumes and cardio-metabolic risk factors in T1DM.

Method

EAT/IAT volumes in 100 patients, underwent non-contrast cardiac computed tomography in the Diabetes Control and Complications Trial /Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study were measured by a certified reader. Fat was defined as pixels’ density of -30 to -190 Hounsfield Unit. The associations were assessed using–Pearson partial correlation and linear regression models adjusted for gender and age …

Lymphoblastoid Cell Lines As A Tool To Study Inter-Individual Differences In The Response To Glucose., Michael A Grassi, Vidhya R Rao, Siquan Chen, Dingcai Cao, Xiaoyu Gao, Patricia A. Cleary, R Stephanie Huang, Andrew D Paterson, Rama Natarajan, Jalees Rehman, Timothy S Kern

GW Biostatistics Center

BACKGROUND: White blood cells have been shown in animal studies to play a central role in the pathogenesis of diabetic retinopathy. Lymphoblastoid cells are immortalized EBV-transformed primary B-cell leukocytes that have been extensively used as a model for conditions in which white blood cells play a primary role. The purpose of this study was to investigate whether lymphoblastoid cell lines, by retaining many of the key features of primary leukocytes, can be induced with glucose to demonstrate relevant biological responses to those found in diabetic retinopathy.

METHODS: Lymphoblastoid cell lines were obtained from twenty-three human subjects. Differences between high and …

Himmelfarb Library Annual Report 2016, George Washington University, Himmelfarb Health Sciences Library

Himmelfarb Library Annual Report

No abstract provided.

“Hot Moms”: Sexual Objectification And Motherhood, Danae Nunez

Honors Program Theses

The purpose of the current study was to explore the sexual objectification of mothers, with an emphasis on understanding women’s perceptions of and feelings about the commonly used term “hot mom” and how sociocultural appearance-related ideals and pressures may affect mothers and mothers-to-be. We hypothesized that feeling greater pressure to be a “hot mom” yet failing to meet standards of what a “hot mom” is would be related to higher levels of self-objectification, body dissatisfaction, appearance anxiety, and eating disturbance, as well as lower self-esteem and a more negative view of the concept itself. A total of 92 female participants …

Quality Of Life And Athletic Participation Assessment In Children And Adolescents With Congenital Heart Disease, Kayla Stuckey

Honors Program Theses

Just under 1% of infants are born with a heart defect [congenital heart disease (CHD)], and as a result of treatment and early diagnosis, 85% of these children survive into adulthood. Few studies have investigated the quality of life, global happiness, and athletic participation in pediatric populations, especially with respect to those who have CHD. In 2010, the number of people aged 0-18 years who had CHD was estimated to be between 1,905,000 and 2,102,000, and there are varying qualities of life that these children experience based on disease severity. In addition to patients who are born with CHD, children …

Reliability And Concurrent Validity Of An Alternative Method Of Lateral Lumbar Range Of Motion In Athletes, Mark D. Hecimovich, Jeffrey J. Herbert

Faculty Publications

Background: Cricket bowling involves combined spinal movements of side bending and rotation and, consequently, injury to the low back is a common problem. Therefore the assessment of lumbar spine kinematics has become a routine component in preseason screening. This includes static measurement of lateral spinal flexion as asymmetrical range of motion may predispose an athlete to low back injury.

Objectives: This study examined intra-rater reliability and concurrent validity of the fingertip-to-floor distance test (FFD) when compared to a criterion range of motion measure.

Methods: Thirty-four junior-level cricket players aged 13‑16 years were recruited. Lumbar spine lateral flexion …