Medicine and Health Sciences Commons^™

Detecting Discordance Enrichment Among A Series Of Two-Sample Genome-Wide Expression Data Sets, Yinglei Lai, Fanni Zhang, Tapan Nayak, Reza Modarres, Norman H. Lee, Timothy A. Mccaffrey

Epidemiology Faculty Publications

Background

With the current microarray and RNA-seq technologies, two-sample genome-wide expression data have been widely collected in biological and medical studies. The related differential expression analysis and gene set enrichment analysis have been frequently conducted. Integrative analysis can be conducted when multiple data sets are available. In practice, discordant molecular behaviors among a series of data sets can be of biological and clinical interest.

Methods

In this study, a statistical method is proposed for detecting discordance gene set enrichment. Our method is based on a two-level multivariate normal mixture model. It is statistically efficient with linearly increased parameter space when …

Willingness Of Community-Recruited Men Who Have Sex With Men In Washington, Dc To Use Long-Acting Injectable Hiv Pre-Exposure Prophylaxis., Matthew E Levy, Rudy Patrick, Jonjelyn Gamble, Anthony Rawls, Jenevieve Opoku, Manya Magnus, Michael Kharfen, Alan E Greenberg, Irene Kuo

Epidemiology Faculty Publications

Objectives

Clinical trials are currently investigating the safety and efficacy of long-acting injectable (LAI) agents as HIV pre-exposure prophylaxis (PrEP). Using National HIV Behavioral Surveillance data, we assessed the self-reported willingness of men who have sex with men (MSM) to use LAI PrEP and their preference for LAI versus daily oral PrEP.

Methods

In 2014, venue-based sampling was used to recruit MSM aged ≥18 years in Washington, DC. Participants completed an interviewer-administered survey followed by voluntary HIV testing. This analysis included MSM who self-reported negative/unknown HIV status at study entry. Correlates of being “very likely” to use LAI PrEP and …

Antibiotic Resistance And Diagnostic Tests: What You Need To Know, Antibiotic Resistance Action Center (Arac)

Antibiotic Resistance Action Center (ARAC)

No abstract provided.

Partner Build Grow: An Action Guide For Sustaining Child Development And Prevention Approaches, The Center For Health And Health Care In Schools

Center for Health and Health Care in Schools

The Action Guide is intended to facilitate the implementation of a long-term plan for sustaining child development and prevention approaches necessary to achieve better child health and education outcomes.

Clinical And Mucosal Immune Correlates Of Hiv-1 Semen Levels In Antiretroviral-Naive Men., Brendan J W Osborne, Angie K Marsh, Sanja Huibner, Kamnoosh Shahabi, Cindy Liu, Tania Contente, Nico J D Nagelkerke, Colin Kovacs, Erika Benko, Lance Price, Kelly S Macdonald, Rupert Kaul

Environmental and Occupational Health Faculty Publications

Background.

This study was done to characterize parameters associated with semen human immunodeficiency virus (HIV)-1 ribonucleic acid (RNA) viral load (VL) variability in HIV-infected, therapy-naive men. Methods.

Paired blood and semen samples were collected from 30 HIV-infected, therapy-naive men who have sex with men, and 13 participants were observed longitudinally for up to 1 year. Human immunodeficiency virus RNA, bacterial load by 16S RNA, herpesvirus (Epstein-Barr virus and cytomegalovirus [CMV]) shedding, and semen cytokines/chemokines were quantified, and semen T-cell subsets were assessed by multiparameter flow cytometry. Results.

Semen HIV RNA was detected at 93% of visits, with >50% of men …

A Qualitative Analysis Of Smokers’ Perceptions About Lung Cancer Screening, Lindsay Gressard, Amy Degroff, Thomas B. Richards, Stephanie Melillo, Julia Kish-Doto, Christina L. Heminger, Elizabeth Rohan, Kristine Allen

Prevention and Community Health Faculty Publications

Background

In 2013, the US Preventive Services Task Force (USPSTF) began recommending lung cancer screening for high risk smokers aged 55–80 years using low-dose computed tomography (CT) scan. In light of these updated recommendations, there is a need to understand smokers’ knowledge of and experiences with lung cancer screening in order to inform the design of patient education and tobacco cessation programs. The purpose of this study is to describe results of a qualitative study examining smokers’ perceptions around lung cancer screening tests.

Methods

In 2009, prior to the release of the updated USPSTF recommendations, we conducted 12 120-min, gender-specific …

The Changing Roles Of Community Health Workers, Mary-Beth Malcarney, Patricia Pittman, Leo Quigley, Naomi Seiler, Katie B. Horton

Health Workforce Research Center Publications

Community Health Workers (CHWs) have been gaining attention from policymakers because of their unique role in addressing health disparities and socioeconomic drivers of disease, and because of their potential integration into the health care delivery system. To date, there has been limited research specifically describing the variation in CHWs’ roles and relationships, and how that variation relates to management, to financing, to health system integration, and to the competencies CHWs should have in different contexts.

This report provides a snapshot of the varied landscape of CHW programs to better understand how CHWs are integrating with the health system both in …

Do Pediatric Gastroenterology Doctors Address Pediatric Obesity?, Suruchi Batra, Caitlin Yee, Bernadette Diez, Nicholas Nguyen, Michael J Sheridan, Mark Tufano, Natalie Sikka, Stacie Townsend, Suchitra Hourigan

Psychiatry and Behavioral Sciences Faculty Publications

Objectives:

To assess how often obesity is acknowledged at pediatric gastroenterology outpatient visits.

Methods:

A retrospective chart review was performed to identify obese children seen at a gastroenterology subspecialty clinic over a 1-year period of time; 132 children were identified. Demographics, obesity comorbidities, reasons for referral, diagnosis of obesity, and a plan to address obesity were abstracted. Chi-square or Fisher’s exact tests were used to examine statistical associations.

Results:

Only 49% of children were given a diagnosis of obesity. In total, 52% of children were given a body mass index reduction plan. Those diagnosed with obesity were more likely to …

Situational Analysis To Inform Development Of Primary Care And Community-Based Mental Health Services For Severe Mental Disorders In Nepal, Mangesh Angdembe, Brandon A. Kohrt, Mark Jordans, Damodar Rimal, Nagendra Luitel

Psychiatry and Behavioral Sciences Faculty Publications

Background

Nepal is representative of Low and Middle Income Countries (LMIC) with limited availability of mental health services in rural areas, in which the majority of the population resides.

Methods

This formative qualitative study explores resources, challenges, and potential barriers to the development and implementation of evidence-based Comprehensive Community-based Mental Health Services (CCMHS) in accordance with the mental health Gap Action Programme (mhGAP) for persons with severe mental health disorders and epilepsy. Focus Group Discussions (FGDs, n = 9) and Key-Informant Interviews (KIIs, n = 26) were conducted in a rural district in western Nepal. Qualitative data were coded using …

Uncorrelated Neural Firing In Mouse Visual Cortex During Spontaneous Retinal Waves, Matthew Colonnese, Jing Shen, Yasunobu Murata

Pharmacology and Physiology Faculty Publications

Synchronous firing among the elements of forming circuits is critical for stabilization of synapses. Understanding the nature of these local network interactions during development can inform models of circuit formation. Within cortex, spontaneous activity changes throughout development. Unlike the adult, early spontaneous activity occurs in discontinuous population bursts separated by long silent periods, suggesting a high degree of local synchrony. However, whether the micro-patterning of activity within early bursts is unique to this early age and specifically tuned for early development is poorly understood, particularly within the column. To study this we used single-shank multi-electrode array recordings of spontaneous activity …

From Sea To Shining Sea, And The Great Plains To Patagonia: A Review On Current Knowledge Of Diabetes Mellitus In Hispanics/Latinos In The U.S. And Latin America, Larissa Aviles-Santa, Uriyoán Colon-Ramos, Nangel Lindberg, Joseimer Mattei, Francisco Pasquel, Cynthia Perez

Global Health Faculty Publications

The last two decades have witnessed many advances in the prevention, treatment, and control of diabetes mellitus and its complications. Increased screening has led to a greater recognition of Type 2 diabetes mellitus (Type 2 DM) and prediabetes; however, Hispanics/Latinos, the largest minority group in the U.S., have not fully benefited from these advances. The Hispanic/Latino population is highly diverse in ancestries, birth places, cultures, languages, and socioeconomic backgrounds, and it populates most of the Western Hemisphere. In the U.S., the prevalence of diabetes mellitus varies among Hispanic/Latino heritage groups, being higher among Mexicans, Puerto Ricans, and Dominicans, and lower …

Repealing Federal Health Reform: Economic And Employment Consequences For States, Leighton C. Ku, Erika Steinmetz, Erin Brantley, Brian K. Bruen

Health Policy and Management Issue Briefs

Issue: The incoming Trump administration and Republicans in Congress are seeking to repeal the Affordable Care Act (ACA), likely beginning with the law’s insurance premium tax credits and expansion of Medicaid eligibility. Research shows that the loss of these two provisions would lead to a doubling of the number of uninsured, higher uncompensated care costs for providers, and higher taxes for low-income Americans.

Goal: To determine the state-by-state effect of repeal on employment and economic activity.

Methods: A multistate economic forecasting model (PI+ from Regional Economic Models, Inc.) was used to quantify for each state the effects of the federal …

Routine Screening For Silent Atrial Fibrillation, Zach Stevens

Theses and Graduate Projects

Atrial fibrillation (AF) is the most common arrhythmia and is particularly prevalent in the elderly population. It is associated with an elevated stroke risk which can be easily minimized with anticoagulation. However, AF detection is often difficult due to infrequent or absent symptoms and the first presentation of AF may be a stroke. Advances in technology have made screening for AF more feasible and accessible. Opportunistic screening with pulse palpation and confirmatory ECG is now strongly supported by the evidence and more recent studies have demonstrated that systematic screening – particularly of those with AF risk factors – may be …

Schizophrenia’S Relationship With Cardiovascular Morbidity And Mortality, Hannah Jorgensen

Theses and Graduate Projects

Premature morbidity and mortality due to cardiovascular disease (CVD) disproportionately affects individuals with schizophrenia. This research paper systematically reviews articles that examine the theories and causes of increased CVD risk in individuals with schizophrenia. The findings of the review indicate that there are biological, environmental and sociocultural components of the relationship between schizophrenia and cardiovascular disease. Inflammation from the progression of chronic schizophrenia appears to play a part. The side-effect profile of the medications used to treat schizophrenia cause CVD risk factors. The secondary and tertiary symptoms of the disease process result in problems in motivation, cognitive function and self- …

How To Choose: Enhancing Shared Decision Making In Breast Cancer Screening, Emma Hermes

Theses and Graduate Projects

Breast cancer is the most common cancer in women. Mammography screening has shown improvement in early detection leading to early treatment of breast cancer and thus reducing morbidity and mortality rates related to breast cancer. However, the contradictory guidelines put forth by the American Cancer Society, American College of Obstetricians and Gynecologists, and United States Preventive Services Task Force have posed a compelling problem in the health care system, especially for primary care providers: What guideline recommendation should be followed? Review of the three sets of guidelines, including the systematic reviews from which they were formed, and outside studies were …

Systemic Sclerosis: Clinical Manifestations, Anesthetic And Orthopedic Considerations In A Patient, Obada Hasan, Muneeba Jessar, Muhammad Ashar, Shahryar Noordin, Tashfeen Ahmad

Section of Orthopaedic Surgery

Introduction: Systemic sclerosis is a rare and progressive multisystem autoimmune disorder that is characterized pathologically by vascular abnormalities, connective tissue sclerosis and atrophy of skin and various internal organs (e.g., alimentary tract, lungs, heart, kidney, CNS), and autoantibodies. With an unknown etiology, Scleroderma is a complex polygenetic disease. A recent Genome Wide Association Study (GWAS) confirmed a strong association with the Major Histocompatibility Complex (MHC) and autoimmunity. We provide a case scenario along with a review of the systems involved and challenges physicians can face in dealing with this rare disease.
Case Presentation: Our patient, a known case of systemic …

Neurorobotics In Pakistan, Ather Enam, Muhammad Waqas

Section of Neurosurgery

No abstract provided.

Foxc1 Is Associated With Estrogen Receptor Alpha And Affects Sensitivity Of Tamoxifen Treatment In Breast Cancer., Jinhua Wang, Yali Xu, Li Li, Lin Wang, Ru Yao, Qiang Sun, Guanhua Du

Articles, Abstracts, and Reports

FOXC1 is a member of Forkhead box transcription factors that participates in embryonic development and tumorigenesis. Our previous study demonstrated that FOXC1 was highly expressed in triple-negative breast cancer. However, it remains unclear what is the relation between FOXC1 and ERα and if FOXC1 regulates expression of ERα. To explore relation between FOXC1 and ERα and discover regulation of ERα expression by FOXC1 in breast cancer, we analyzed data assembled in the Oncomine and TCGA, and found that there was significantly higher FOXC1 expression in estrogen receptor-negative breast cancer than that in estrogen receptor-positive breast cancer. Overexpression of FOXC1 reduced …

New Developments In The Treatment Of Primary Biliary Cholangitis - Role Of Obeticholic Acid., Manan A Jhaveri, Kris V Kowdley

Articles, Abstracts, and Reports

Primary biliary cholangitis (PBC) is a chronic autoimmune cholestatic liver disease that predominantly affects women in early to middle age. It is typically associated with autoantibodies to mitochondrial antigens and results in immune-mediated destruction of small and medium-sized intrahepatic bile ducts leading to cholestasis, hepatic fibrosis and may progress to cirrhosis or hepatic failure and, in some cases, hepatocellular carcinoma. The clinical presentation and the natural history of PBC have improved over the years due to recognition of earlier widespread use of ursodeoxycholic acid (UDCA); about one-third of patients show suboptimal biochemical response to UDCA with poor prognosis. Until recently, …

Sting Expression And Response To Treatment With Sting Ligands In Premalignant And Malignant Disease., Jason R Baird, Zipei Feng, Hong D Xiao, David Friedman, Ben Cottam, Bernard A Fox, Gwen Kramer, Rom S Leidner, Richard Bryan Bell, Kristina H Young, Marka R Crittenden, Michael J Gough

Articles, Abstracts, and Reports

Human papilloma virus positive (HPV+) tumors represent a large proportion of anal, vulvar, vaginal, cervical and head and neck squamous carcinomas (HNSCC) and late stage invasive disease is thought to originate from a premalignant state. Cyclic dinucleotides that activate STimulator of INterferon Genes (STING) have been shown to cause rapid regression of a range of advanced tumors. We aimed to investigate STING ligands as a novel treatment for papilloma. We tested therapies in a spontaneous mouse model of papilloma of the face and anogenital region that histologically resembles human HPV-associated papilloma. We demonstrate that STING ligands cause rapid regression of …

Post-Traumatic Stress Symptoms In Pathological Gambling: Potential Evidence Of Anti-Reward Processes, Cheryl L. Green, Ramzi W. Nahhas, Arielle A. Scoglio, Igor Elman

Population and Public Health Sciences Faculty Publications

Background: Excessive gambling is considered to be a part of the addiction spectrum. Stress-like emotional states are a key feature both of pathological gambling (PG) and of substance addiction. In substance addiction, stress symptomatology has been attributed in part to "anti-reward" allostatic neuroadaptations, while a potential involvement of anti-reward processes in the course of PG has not yet been investigated. Methods: To that end, individuals with PG (n = 22) and mentally healthy subjects (n = 13) were assessed for trauma exposure and post-traumatic stress symptomatology (PTSS) using the Life Events Checklist and the Civilian Mississippi Scale, respectively. Results: In …

Yoga And The Ability To Counteract Negative Effects Of Stress And Trauma, Allison R. Steinwand, Staci L. Born

Counseling and Human Development Faculty Publications

Many individuals today struggle with the effects of chronic stress, whether due to social and environmental factors or as a result of trauma embedded in their psychophysiology. Research has demonstrated that once an individual endures a traumatic event, there are undesirable changes that occur in the brain and body It is of the utmost importance that mental health counselors consider the relationship between the body and mind. The purpose of this paper is to describe the negative impact traumatic experiences and chronic stress has on the brain and body. Furthermore, the ways in which yoga practice can mitigate trauma symptoms …

Increasing Providers’ Adherence To Ordering Urine Microalbumin Tests, Florence Fadele

Student Theses, Dissertations and Capstones

Currently, a microalbumin urine test is an annual test for diabetic patients recommended by the American Diabetes Association, but primary care providers are not ordering the tests. This may be, in part, attributable to the fact that there are no guidelines for ordering microalbumin urine tests. The purpose of this capstone project was to assess providers' compliance in identifying the need for the microalbumin urine test for patients with diabetes, to develop evidence-based guidelines for monitoring and ordering microalbumin urine tests, and to evaluate providers' compliance. Rogers's theory of the diffusion of innovation provided the framework for this capstone project. …

The Gap In Human Resources To Deliver The Guaranteed Package Of Prevention And Health Promotion Services At Urban And Rural Primary Care Facilities In Mexico, Jacqueline Elizabeth Alcalde-Rabanal, Gustavo Nigenda, Till Bärnighausen, Hector Eduardo Velasco-Mondragon

Faculty Publications & Research of the TUC College of Osteopathic Medicine

Background: The purpose of this study was to estimate the gap between the available and the ideal supply of human resources (physicians, nurses, and health promoters) to deliver the guaranteed package of prevention and health promotion services at urban and rural primary care facilities in Mexico.

Methods: We conducted a cross-sectional observational study using a convenience sample. We selected 20 primary health facilities in urban and rural areas in 10 states of Mexico. We calculated the available and the ideal supply of human resources in these facilities using estimates of time available, used, and required to deliver health …

Evaluation Of A Course To Prepare International Students For The United States Medical Licensing Examination Step 2 Clinical Skills Exam, Rachel B. Levine, Andrew P. Levy, Robert Lubin, Sarah Halevi, Rebeca Rios, Danelle Cayea

Touro University Worldwide Publications and Research

Purpose: United States (US) and Canadian citizens attending medical school abroad often desire to return to the US for residency, and therefore must pass US licensing exams. We describe a 2-day United States Medical Licensing Examination (USMLE) step 2 clinical skills (CS) preparation course for students in the Technion American Medical School program (Haifa, Israel) between 2012 and 2016. Methods: Students completed pre- and post-course questionnaires. The paired t-test was used to measure students’ perceptions of knowledge, preparation, confidence, and competence in CS pre- and post-course. To test for differences by gender or country of birth, analysis of …

Spinal Epidural Abscess Complicated By Meningitis, Sepsis And Thrombocytopenia In A Patient Lacking Traditional Risk Factors, Christian Spano, Michael Ward, Nicole Zagelbaum

Touro College of Osteopathic Medicine (Middletown) Publications and Research

Spinal epidural abscess is a rare diagnosis with a classic triad of fever, spinal pain and neurologic deficits. Only a small proportion of patients have all three findings, making the diagnosis challenging. Here we present a case of cervical and thoracic spinal epidural abscess complicated by meningitis, sepsis and thrombocytopenia in a patient lacking traditional risk factors. The patient was initially treated non-operatively secondary to thrombocytopenia but subsequently required transfer to a tertiary care facility for surgical drainage after clinical deterioration. This case report highlights the need for a high index of suspicion and low threshold for imaging when considering …

Testing Mice At Risk Of Pancreatic Cancer For Altered Protein Pathways Found In Diabetes, Henley Cheung

Honors Undergraduate Theses

Pancreatic cancer is nearly asymptomatic, which can result in extensive grow and even metastasis to other organs before detection. When diagnosed at a late stage, the survival rate is 3%. Early detection is therefore the key to treating pancreatic cancer. Diabetes was identified as a risk factor for the development of pancreatic cancer, but the mechanism remains unknown. In this project, the objective was to delineate a link between diabetes and pancreatic cancer by examining their shared protein signaling pathways. In a previous study, hyper-activation of AKT1 resulted in a pre-diabetic phenotype and also increased upregulation of downstream phosphorylated mTOR …

Development Of A Compact Broadband Optical Parametric Oscillator For Ultra-Sensitive Molecular Detection, Sean O. Crystal

Honors Undergraduate Theses

Every gas molecule has a unique absorption spectrum that can be captured using optical spectroscopy to identify an unknown sample's composition. Frequency combs systems can provide an extremely broad mid-infrared spectrum that is very useful for molecular detection. A degenerate optical parametric oscillator (OPO) was built to generate the down-converted and shifted frequency comb spectrum. This system utilizes an ultra-short pulse 1.56µm pump laser and a never before used orientation patterned gallium-phosphide crystal. Periodically polled lithium niobate (PPLN), Gallium Arsenide (GaAs) and Gallium Phosphide are all crystals used to accomplish this task. GaP, in comparison to PPLN, has (i) a …

Depression In Low-Income Adolescents: Guidelines For School-Based Depression Intervention Programs, Gopika Hari

AUCTUS: The Journal of Undergraduate Research and Creative Scholarship

Adolescent depression is growing in interest to clinicians. In addition to the estimated 2 million cases of adolescent major depressive episodes each year, depressive symptoms in youth have become indicators of mental health complications later in life. Studies indicate that being low-income is a risk factor for depression and that socioeconomically disadvantaged teenagers are more than twice as likely to develop mental illnesses. Only an estimated 1 in 4 children with mental illnesses receive adequate help and 80% of these resources come through schools. Thus, this study focuses on establishing the importance of depression intervention programs in low-income high schools …

Synthesis And Characterization Of Ph/Temperature Dual Sensitive Multiblock Copolymer For Drug Delivery, Hyung Kyung Lee

Electronic Theses and Dissertations

The objective of this study was to develop a novel multiblock copolymer (MBCP) with temperature/pH dual-sensitivity which undergoes gelation at body temperature and degradation at acidic pH for controlled drug delivery applications. The MBCP with molecular weight of 42000 Da was synthesized by polycondensation between an acid-labile ketal linker, 2,2-bis(aminoethoxy)propane (BAP) and Pluronic® P104 using L-lysine diisocyanate ethyl ester (LDI) or 1,6-Diisocyanatohexane (HDI). The gelation temperature of 20% (w/v) MBCP was in the range of 29 to 31 ºC when tested with three different techniques: rheometer, test tube inversion method, and falling ball method. The polymer shopH-triggered degradation and drug …