Medicine and Health Sciences Commons^™

Pots: Educating School Nurses, Stephanie Sherwood

Doctoral Dissertations and Scholarly Projects

The project used educational modules as a means for providing knowledge about postural orthostatic tachycardia (POTS) to school nurses. It evaluated knowledge of symptoms and the referral process. A pre and post-test were used immediately prior to and following an educational module to determine gained knowledge about POTS. Participants completed a survey evaluating their perceived knowledge and comfort level to evaluate POTS symptoms and refer patients for further evaluation. One hundred percent of participants demonstrated improvement in their post-test score confirming knowledge gained in all participants. All participants reported that the modules helped them about POTS, and they felt confident …

2017 October 17 - Medical Student Education Committee Minutes, Medical Student Education Committee, East Tennessee State University

Medical Student Education Committee Minutes

No abstract provided.

Symptomatic Choledocholithiasis After Cholecystectomy, Joseph Spataro, Mazen Tolaymat, Charles Kistler, Michael Jacobs, Jeffrey Fitch, Monjur Ahmed

Department of Medicine Posters

Background

• Clinical manifestations of choledocholithiasis include biliary colic, obstructive jaundice, pancreatitis, and acute cholangitis
• Secondary common bile duct (CBD) stones are common when the gallbladder is intact or after recent cholecystectomy (CCY) whereas recurrent stones develop >3 years after surgery1,2
• Patients with retained CBD stones after CCY may be asymptomatic for years and there is limited data on their pattern of presentation
• Despite known predisposing conditions and risk factors for recurrent biliary disease, the role of intraoperative cholangiography (IOC) during CCY remains controversial

Poster presented at: World Congress of Gastroenterology at ACG 2017 in Orlando Florida, United States.

Mri Of Suspected Appendicitis During Pregnancy: Interradiologist Agreement, Indeterminate Interpretation And The Meaning Of Non-Visualization Of The Appendix, Richard Tsai, Constantine Raptis, Kathryn J. Fowler, Joseph W. Owen, Vincent M. Mellnick

Radiology Faculty Publications

Objective: To determine the degree of interradiologist agreement between the MRI features of appendicitis during pregnancy, the outcomes associated with an indeterminate interpretation and the negative predictive value of non-visualization of the appendix.

Methods: Our study was approved by the institutional review board at the Washington University in St. Louis, Missouri (WUStL) and was HIPAA (Health Insurance Portability and Accountability Act of 1996)-compliant. The informed consent requirement was waived. Cases of suspected appendicitis during pregnancy evaluated using MRI were retrospectively identified using search queries. Scans were re-reviewed by two radiologists (7 and 9 years experience, respectively) to evaluate the interradiologist …

Compositions And Methods Of Modulating 15-Pgdh Activity, Sanford Markowitz, James K. V. Willson, Bruce A. Posner, Joseph Ready, Yongyou Zhang, Hsin-Hsiung Tai, Monika Antczak, Stanton Gerson, Kibeom Bae, Sung Yeun Yang, Amar Desai

Pharmaceutical Sciences Faculty Patents

Compounds and methods of modulating 15-PGDH activity, modulating tissue prostaglandin levels, treating disease, diseases disorders, or conditions in which it is desired to modulate 15-PGDH activity and/or prostaglandin levels include 15-PGDH inhibitors and 15-PGDH activators described herein.

Differentiation And Protective Capacity Of Virus-Specific Cd8, Vesselin T. Tomov, Olesya Palko, Chi Wai Lau, Ajinkya Pattekar, Yuhang Sun, Ralitza Tacheva, Bertram Bengsch, Sasikanth Manne, Gabriela L. Cosma, Laurence C. Eisenlohr, Timothy J. Nice, Herbert W. Virgin, E. John Wherry

Department of Microbiology and Immunology Faculty Papers

Noroviruses can establish chronic infections with active viral shedding in healthy humans but whether persistence is associated with adaptive immune dysfunction is unknown. We used genetically engineered strains of mouse norovirus (MNV) to investigate CD8⁺ T cell differentiation during chronic infection. We found that chronic infection drove MNV-specific tissue-resident memory (Trm) CD8⁺ T cells to a differentiation state resembling inflationary effector responses against latent cytomegalovirus with only limited evidence of exhaustion. These MNV-specific Trm cells remained highly functional yet appeared ignorant of ongoing viral replication. Pre-existing MNV-specific Trm cells provided partial protection against chronic infection but largely ceased …

A Latent Propriospinal Network Can Restore Diaphragm Function After High Cervical Spinal Cord Injury, Jared M. Cregg, Kevin A. Chu, Lydia E. Hager, Rachel S. J. Maggard, Daimen R. Stoltz, Michaela Edmond, Warren J. Alilain, Polyxeni Philippidou, Lynn T. Landmesser, Jerry Silver

Spinal Cord and Brain Injury Research Center Faculty Publications

Spinal cord injury (SCI) above cervical level 4 disrupts descending axons from the medulla that innervate phrenic motor neurons, causing permanent paralysis of the diaphragm. Using an ex vivo preparation in neonatal mice, we have identified an excitatory spinal network that can direct phrenic motor bursting in the absence of medullary input. After complete cervical SCI, blockade of fast inhibitory synaptic transmission caused spontaneous, bilaterally coordinated phrenic bursting. Here, spinal cord glutamatergic neurons were both sufficient and necessary for the induction of phrenic bursts. Direct stimulation of phrenic motor neurons was insufficient to evoke burst activity. Transection and pharmacological manipulations …

Nanoparticle Delivery Of Mir-34a Eradicates Long-Term-Cultured Breast Cancer Stem Cells Via Targeting C22orf28 Directly, Xiaoti Lin, Weiyu Chen, Fengqin Wei, Binhua P. Zhou, Mien-Chie Hung, Xiaoming Xie

Molecular and Cellular Biochemistry Faculty Publications

Rationale: Cancer stem cells (CSCs) have been implicated as the seeds of therapeutic resistance and metastasis, due to their unique abilities of self-renew, wide differentiation potentials and resistance to most conventional therapies. It is a proactive strategy for cancer therapy to eradicate CSCs. Methods: Tumor tissue-derived breast CSCs (BCSC), including XM322 and XM607, were isolated by fluorescence-activated cell sorting (FACS); while cell line-derived BCSC, including MDA-MB-231.SC and MCF-7.SC, were purified by magnetic-activated cell sorting (MACS). Analyses of microRNA and mRNA expression array profiles were performed in multiple breast cell lines. The mentioned nanoparticles were constructed following the standard molecular cloning …

Comparisons Of Perceived Training Doses In Champion Collegiate-Level Male And Female Cross-Country Runners And Coaches Over The Course Of A Competitive Season, Kyle Barnes

Open Access Publishing Support Funded Articles

Background: Session rating of perceived exertion (sRPE) is a practical tool for coaches to assess internal training load of their athletes. In a sport like cross-country running, that is individual in nature, but has a team training and competition component, information about the association between external and internal load is lacking. Furthermore, there is a need for studies that examine perception of training doses across multiple training cycles including the competitive season as well as between male and female athletes.

Methods: Session RPE, duration, and training load (TL_RPE = sRPE × duration) of 25 highly trained male …

Initial Experience Of A Community Gastroenterology Practice With Ultra-Slim Colonoscopy: A Case Series., Rajesh Essrani Md, Patrick Hickey Do, Hiral N. Shah Md, Paola Blanco Md

Department of Medicine

No abstract provided.

Unusual Case Of Obstructive Jaundice (Poster)., Rajesh Essrani Md, Eric Nellis Md, Patrick Hickey Do, Hiral N. Shah Md

Department of Medicine

No abstract provided.

Effect Of Oral Semaglutide Compared With Placebo And Subcutaneous Semaglutide On Glycemic Control In Patients With Type 2 Diabetes: A Randomized Clinical Trial., Melanie Davies, Thomas R. Pieber, Marie-Louise Hartoft-Nielsen, Oluf K.H. Hansen, Serge Jabbour, Julio Rosenstock

Department of Medicine Faculty Papers

Importance: Glucagon-like peptide-1 (GLP-1) receptor agonists are effective therapies for the treatment of type 2 diabetes and are all currently available as an injection.

Objectives: To compare the effects of oral semaglutide with placebo (primary) and open-label subcutaneous semaglutide (secondary) on glycemic control in patients with type 2 diabetes.

Design, Setting, and Patients: Phase 2, randomized, parallel-group, dosage-finding, 26-week trial with 5-week follow-up at 100 sites (hospital clinics, general practices, and clinical research centers) in 14 countries conducted between December 2013 and December 2014. Of 1106 participants assessed, 632 with type 2 diabetes and insufficient glycemic control using diet and …

Sex Differential In 15-Hydroxyprostaglandin Dehydrogenase Levels In The Lumen Of Human Intracranial Aneurysms., Nohra Chalouhi, Pascal Jabbour, Mario Zanaty, Robert M. Starke, James Torner, Daichi Nakagawa, David M. Hasan

Department of Neurosurgery Faculty Papers

BACKGROUND: Aspirin is a promising medical therapy for the prevention of intracranial aneurysm (IA) rupture. Recently, we found that men have a better response to aspirin than women. The purpose of this study was to determine whether a sex differential exists in the level of 15-hydroxyprostaglandin dehydrogenase (15-PGDH) in the lumen of human IAs.

METHODS AND RESULTS: Consecutive patients undergoing coiling or stent-assisted coiling for a saccular IA at our institution were enrolled. Two samples (A and B) were collected from IA lumens, and the plasma level of 15-PGDH was measured using an ELISA-based method. The study included 38 patients, …

Optimizing Fresh Specimen Staining For Rapid Identification Of Tumor Biomarkers During Surgery., Connor W. Barth, Jasmin M. Schaefer, Vincent M. Rossi, Scott C. Davis, Summer L. Gibbs

Dartmouth Scholarship

Rationale: Positive margin status due to incomplete removal of tumor tissue during breast conserving surgery (BCS) is a prevalent diagnosis usually requiring a second surgical procedure. These follow-up procedures increase the risk of morbidity and delay the use of adjuvant therapy; thus, significant efforts are underway to develop new intraoperative strategies for margin assessment to eliminate re-excision procedures. One strategy under development uses topical application of dual probe staining and a fluorescence imaging strategy termed dual probe difference specimen imaging (DDSI). DDSI uses a receptor-targeted fluorescent probe and an untargeted, spectrally-distinct fluorescent companion imaging agent topically applied to fresh resected …

The Role Of B Cell Targeting In Chronic Graft-Versus-Host Disease., Ruben Rhoades, Md, Sameh Gaballa, Md

Department of Medical Oncology Faculty Papers

Chronic graft-versus-host disease (cGVHD) is a leading cause of late morbidity and mortality following allogeneic stem cell transplantation. Current therapies, including corticosteroids and calcineurin inhibitors, are only effective in roughly 50% of cases; therefore, new treatment strategies are under investigation. What was previously felt to be a T cell disease has more recently been shown to involve activation of both T and B cells, as well as a number of cytokines. With a better understanding of its pathophysiology have come more expansive preclinical and clinical trials, many focused on B cell signaling. This report briefly reviews our current understanding of …

Role Of 68ga-Dodatate Pet/Ct In Staging And Management Of Gastroenteropancreatic Neuroendocrine Tumor Management - A Case Series Report., Abdul Aleem Mbbs, Patrick Hickey Do, Shashin Shah Md, Hiral N. Shah Md

Department of Medicine

No abstract provided.

No Gastrointestinal Bleed Too Obscure: A Case Series Report Of Small Bowel Phlebectasias., Abdul Aleem Md, Anam Malik Md, Patrick Hickey Do, Anastasia Shnitser Md

Department of Medicine

No abstract provided.

Myoblasts And Macrophages Are Required For Therapeutic Morpholino Antisense Oligonucleotide Delivery To Dystrophic Muscle., James S Novak, Marshall W Hogarth, Jessica F Boehler, Marie Nearing, Maria C Vila, Raul Heredia, Alyson A Fiorillo, Aiping Zhang, Yetrib Hathout, Eric P Hoffman, Jyoti K Jaiswal, Kanneboyina Nagaraju, Sebahattin Cirak, Terence A Partridge

Pediatrics Faculty Publications

Exon skipping is a promising therapeutic strategy for Duchenne muscular dystrophy (DMD), employing morpholino antisense oligonucleotides (PMO-AO) to exclude disruptive exons from the mutant DMD transcript and elicit production of truncated dystrophin protein. Clinical trials for PMO show variable and sporadic dystrophin rescue. Here, we show that robust PMO uptake and efficient production of dystrophin following PMO administration coincide with areas of myofiber regeneration and inflammation. PMO localization is sustained in inflammatory foci where it enters macrophages, actively differentiating myoblasts and newly forming myotubes. We conclude that efficient PMO delivery into muscle requires two concomitant events: first, accumulation and retention …

Ada News - 10/16/2017, American Dental Association, Publishing Division

ADA News

Established in 1970 as the official newspaper of the American Dental Association, the ADA News serves practicing dentists and others allied to the dental profession in the U.S. and internationally. It is the No. 1 source of news and information about the many benefits and services the ADA delivers to members daily as well as timely information on scientific, social, political and economic developments affecting dentistry and health care.

“First, Do No Harm”: Old And New Paradigms In Prehospital Resuscitation In The Aquatic Domain, John H. Pearn, Richard Charles Franklin

International Journal of Aquatic Research and Education

The balance between benefit and risk is central to the work of all those involved in aquatic services. The Hippocratic exhortation of Primum non nocere, “First, do no harm,” has a history of over 2000 years. Superficially, all would support this dictum, but harm can result from inaction. The balance between no or little intervention on the one hand and proactive intervention with iatrogenic risk on the other is complex and enduring. Risk implies that one does not have all the information available to know the exact likelihood of an outcome, a common situation involving rescue, first aid, and …

Knowledge, Attitudes, And Behaviours Of New Zealand Youth In Surf Beach Environments, Stacey M. Willcox-Pidgeon, Bridget Kool, Kevin Moran Ph.D.

International Journal of Aquatic Research and Education

New Zealand youth are over-represented in drowning statistics yet little is known about their understanding of water safety, especially in surf beach context. This study aimed to ascertain current youth surf safety knowledge, specifically rip current awareness, explore self-reported competencies and confidence when surf swimming, and examine youth behaviour when at the beach. A cross-sectional survey was conducted among senior high school students (n = 599) in Auckland, New Zealand. Over half (58%) reported they were unable to swim > 100 m in a pool. Males and students of European-New Zealand and Maori (New Zealand’s indigenous population) heritage were most …

A 6-Month Open-Label Extension Study Of Vortioxetine In Pediatric Patients With Depressive Or Anxiety Disorders., Robert L Findling, Adelaide S Robb, Melissa P Delbello, Michael Huss, Nora K Mcnamara, Elias H Sarkis, Russell E Scheffer, Lis H Poulsen, Grace Chen, Ole M Lemming, Philippe Auby

Psychiatry and Behavioral Sciences Faculty Publications

OBJECTIVES: In this 6-month open-label extension (OLE) of NCT01491035 (a 14-day, open-label, pharmacokinetic/safety lead-in study), the long-term safety and tolerability of vortioxetine (5-20 mg/day) were investigated in children and adolescents with a DSM-IV-TR™ diagnosis of depressive or anxiety disorder in the United States or Germany. The study also was designed to provide data to inform dose selection and titration in future pediatric studies with vortioxetine.

METHODS: Safety evaluations included spontaneously reported adverse events (AEs), the Columbia Suicide Severity Rating Scale (C-SSRS), and the Pediatric Adverse Events Rating Scale (PAERS; clinician administered). Clinical effectiveness was determined by Clinical Global Impressions. Comorbid …

Measuring Australian Children’S Water Safety Knowledge: The National Water Safety Quiz, Amy E. Peden, Richard Charles Franklin, Justin Scarr

International Journal of Aquatic Research and Education

Water safety knowledge levels of Australian children are poorly understood. Royal Life Saving developed an online National Water Safety Quiz (NWSQ) as an interactive means of determining water safety knowledge amongst Australian primary school children (ages 5 to 12 years). Over a period of 8 months, a total of 4,215 children participated in the NWSQ. The NWSQ identified areas of water safety where knowledge was poor including the topics of CPR, swimming, and river safety. Children achieved a better result as they aged. Females out-performed males overall and specifically from ages 10-12 years. Children from independent schools performed better. This …

What's Happening: October 16, 2017, Maine Medical Center

What's Happening

No abstract provided.

Leadership For Public Health 3.0: A Preliminary Assessment Of Competencies For Local Health Department Leaders, Emmanuel D. Jadhav, James W. Holsinger Jr., Billie W. Anderson, Nicholas Homant

Health Management and Policy Faculty Publications

Background: The foundational public health services model V1.0, developed in response to the Institute of Medicine report For the Public’s Health: Investing in a Healthier Future identified important capabilities for leading local health departments (LHDs). The recommended capabilities include the organizational competencies of leadership and governance, which are described as consensus building among internal and external stakeholders. Leadership through consensus building is the main characteristic of Democratic Leadership. This style of leadership works best within the context of a competent team. Not much is known about the competency structure of LHD leadership teams. The objectives of this study characterize …

Spinal Excitability Changes After Transspinal And Transcortical Paired Associative Stimulation In Humans, Maria Knikou

Publications and Research

Paired associative stimulation (PAS) produces enduring neuroplasticity based on Hebbian associative plasticity. This study established the changes in spinal motoneuronal excitability by pairing transcortical and transspinal stimulation. Transcortical stimulation was delivered after (transspinal-transcortical PAS) or before (transcortical-transspinal PAS) transspinal stimulation. Before and after 40 minutes of each PAS protocol, spinal neural excitability was assessed based on the amplitude of the transspinal-evoked potentials (TEPs) recorded from ankle muscles of both legs at different stimulation intensities (recruitment input-output curve). Changes in TEPs amplitude in response to low-frequency stimulation and paired transspinal stimuli were also established before and after each PAS protocol. TEP …

Symptoms And Causes Of Foamy Bloat In Cattle, Zachary Christman

Department of Agronomy and Horticulture: Dissertations, Theses, and Student Research

The bovine stomach normally produces gases such as ammonia, carbon dioxide and methane. However when these gases become trapped in the bovine stomach because of a thick, frothy or foamy liquid it is called bloat. Cattle bloat is a very old condition and goes by many names but is primarily trapped gas within the bovine stomach. Readily digested feedstuff such as highly processed grain diets or an overabundance of fresh immature alfalfa often leads to a vast amount of small particles and carbohydrates in the rumen; this is the major cause of foamy bloat. Severe bloat causes death by suffocation …

Webinar: Achieving Health Equity For Lgbt People, Pcom Office Of Diversity And Community Relations, Pcom Department Of Professional Development And Online Learning

Diversity and Inclusion

Hosted webinar up-to-date information about helping LGBT people access healthcare and highlighting the issues and disparities some LGBT people face.

A Socio-Ecological Analysis Of Childhood Obesity And School Nutrition Policies And Practices In Select Elementary And Middle Schools On The Navajo Reservation, Regina S. Eddie

Nursing ETDs

Navajo and other American Indian children are most affected by overweight and obesity in comparison to their US counterparts, and schools have become a focal setting for prevention interventions. The study applied an ecological and a cultural framework to analyze the various factors that influence the food choices available to students and the impact of these choices on childhood obesity. The overall purpose of this descriptive study was to examine and describe how schools that participate in the National School Lunch Program (NSLP) are contributing to the diets of Navajo students since the passage of the Healthy Hunger Free Kids …

“My Hands Are Tied”: Nurses’ Perception Of Organizational Culture In Kenyan Private Hospitals, Gladys Mbuthia, Sharon Brownie, Eleanor Holroyd

School of Nursing & Midwifery, East Africa

It is estimated that by 2030 the global shortage of nurses and midwives will be 7.6 million, with African countries among the most adversely affected. Within this context, it is important to understand the specific organizational factors that contribute to registered nurses (RNs)’ decisions to remain or leave their workplaces in East Africa. The aim of this study was to commence exploration of these factors by exploring nurses’ perceptions of organizational culture of selected private hospitals in Kenya. A small-scale exploratory qualitative approach was employed, with eight nurses undertaking semi-structured interviews. There were five female and three male nurses. All …