Medicine and Health Sciences Commons^™

Anthropometric Indices For Non-Pregnant Women Of Childbearing Age Differ Widely Among Four Low-Middle Income Populations., K. Michael Hambidge, Nancy F. Krebs, Ana Garcés, Jamie E. Westcott, Lester Figueroa, Shivaprasad S. Goudar, Sangappa Dhaded, Omrana Pasha, Sumera Aziz Ali, Antoinette Tshefu, Adrien Lokangaka, Vanessa R. Thorsten, Abhik Das, Kristen Stolka, Elizabeth M. Mcclure, Rebecca L. Lander, Carl L. Bose, Richard J. Derman, Robert L. Goldenberg, Melissa Bauserman

Global Health Articles

BACKGROUND: Maternal stature and body mass indices (BMI) of non-pregnant women (NPW) of child bearing age are relevant to maternal and offspring health. The objective was to compare anthropometric indices of NPW in four rural communities in low- to low-middle income countries (LMIC).

METHODS: Anthropometry and maternal characteristics/household wealth questionnaires were obtained for NPW enrolled in the Women First Preconception Maternal Nutrition Trial. Body mass index (BMI, kg/m(2)) was calculated. Z-scores were determined using WHO reference data.

RESULTS: A total of 7268 NPW participated in Equateur, DRC (n = 1741); Chimaltenango, Guatemala (n = 1695); North Karnataka, India (n = …

Regulation And Modulation Of Human Dna Polymerase Δ Activity And Function, Marietta Y W T Lee, Xiaoxiao Wang, Sufang Zhang, Zhongtao Zhang, Ernest Y C Lee

NYMC Faculty Publications

This review focuses on the regulation and modulation of human DNA polymerase δ (Pol δ). The emphasis is on the mechanisms that regulate the activity and properties of Pol δ in DNA repair and replication. The areas covered are the degradation of the p12 subunit of Pol δ, which converts it from a heterotetramer (Pol δ4) to a heterotrimer (Pol δ3), in response to DNA damage and also during the cell cycle. The biochemical mechanisms that lead to degradation of p12 are reviewed, as well as the properties of Pol δ4 and Pol δ3 that provide insights into their functions …

Medical School Watercooler Newsletter - July 23, 2017, Lindsey Lyle

Watercooler Newsletter

This is the July 23, 2017 edition of the Frederick P. Whiddon College of Medicine's Newsletter - Watercooler.

Contents Include:

SouthMed Prep Scholars Present Research

Med School Café- Expert Advice for the Community

Natalie Fox Appointed Director of Nursing for USA Physicians Group

Dr. Di Palma Marks 30 Years with USA College of Medicine

Ventilator-Associated Pneumonia, Brittnay Adkins

Nursing Student Class Projects (Formerly MSN)

Many patients admitted to an Intensive Care Unit (ICU) are critically-ill. Those are that mechanically ventilated are also at risk for nosocomial infections that can negatively affect the patients health. Oral hygiene care, early mobilization, spontaneous breathing trials, and aspiration precautions are all interventions that many hospitals have incorporated into standard practice to prevent ventilator-associated pneumonia (VAP). The importance of these interventions are discussed; along with the pathophysiology of VAP and how healthcare providers can positively impact the millions of patients every year that are affected by nosocomial infections.

Infantile Spasms, Ashley Cash

Nursing Student Class Projects (Formerly MSN)

Infantile Spams is an epilepsy syndrome that usually appears in children between the ages of four and eight months. The spasms generally occur upon waking or right after feeding, and can occur in clusters of a hundred or more at a time (Go et al., 2012). Children with infantile spasms present with a classic, abnormal electroencephalogram. The pattern that determines if it is indeed infantile spasms is called hypsarrythmia, which is a disorganized pattern (Iype et al., 2016). Children with infantile spams will also regress in milestones and can have mental retardation. Many studies have been done to determine the …

Use Of A Team Building Activity To Teach Clinical Decision-Making Concepts To Physical Therapy Students, Robert Fuchs, Betsy J. Becker

Posters and Presentations: Physical Therapy

PURPOSE : The purpose of this research was to find out if a team building exercise carried out by student groups will facilitate learning how to make clinical decision involving concepts from the International Classification of Function (ICF).

SIGNIFICANCE: Scant literature exists regarding the concept of integrating student and expert team case-based learning with the ICF to develop clinical decision-making skills.

SUBJECTS: Subjects were 213 first-year physical therapy students in the DPT program at UNMC in the first semester of the curriculum of years 2013-2016.

METHODS AND MATERIALS: A patient case was developed which included clinical decision-making steps using concepts …

Anomalous Coronary Artery Disease, Margaret Hueckel

Nursing Student Class Projects (Formerly MSN)

Imagine living life as a healthy active individual with no known health conditions or previous illnesses, then one day experiencing life-threatening symptoms or even sudden death due to an unknown heart condition. Anomalies of the coronary arteries are not well understood and are extremely rare in the general population (Suryanarayana, 2015). This topic was chosen to explore the research and the pathophysiology behind this rare disease and to be able to understand the process at a cellular level. This project will explore the pathophysiologic process of anomalous coronary artery disease including signs and symptoms, underlying pathophysiology, significance of pathophysiology, and …

The Pathophysiology Of Athlete's Heart, Hannah E. Mckee

Nursing Student Class Projects (Formerly MSN)

Athlete's heart is a condition resulting from high intensity exercise over a long period of time. Due to the increased workload of the body, the heart creates pathophysiologic changes to compensate for the increased demand. These changes are similar to those found in the diseased heart of a person with hypertrophic cardiomyopathy. It is important to recognize athlete's heart and be able to differentiate between the pathophysiologic changes in athlete's heart and hypertrophic cardiomyopathy.

Progressive Age-Dependence And Frequency Difference In The Effect Of Gap Junctions On Active Cochlear Amplification And Hearing, Liang Zong, Jin Chen, Yan Zhu, Hong-Bo Zhao

Otolaryngology--Head & Neck Surgery Faculty Publications

Mutations of Connexin 26 (Cx26, GJB2), which is a predominant gap junction isoform in the cochlea, can induce high incidence of nonsyndromic hearing loss. We previously found that targeted-deletion of Cx26 in supporting Deiters cells and outer pillar cells in the cochlea can influence outer hair cell (OHC) electromotility and reduce active cochlear amplification leading to hearing loss, even though there are no gap junction connexin expressions in the auditory sensory hair cells. Here, we further report that hearing loss and the reduction of active amplification in the Cx26 targeted-deletion mice are progressive and different at high and low …

Chelator-Free Radiolabeling Of Serrs Nanoparticles For Whole-Body Pet And Intraoperative Raman Imaging, Matthew A. Wall, Travis Shaffer, Stefan Harmsen, Darjus-Felix Tschaharganeh, Chun-Hao Huang, Scott W. Lowe, Charles Michael Drain, Moritz F. Kircher

Publications and Research

A single contrast agent that offers whole-body non-invasive imaging along with the superior sensitivity and spatial resolution of surface-enhanced resonance Raman scattering (SERRS) imaging would allow both pre-operative mapping and intraoperative imaging and thus be highly desirable. We hypothesized that labeling our recently reported ultrabright SERRS nanoparticles with a suitable radiotracer would enable pre-operative identification of regions of interest with whole body imaging that can be rapidly corroborated with a Raman imaging device or handheld Raman scanner in order to provide high precision guidance during surgical procedures. Here we present a straightforward new method that produces radiolabeled SERRS nanoparticles for …

Is Vigorous Exercise Training Superior To Moderate For Cvd Risk After Menopause?, Julia Orri, E. M. Hughes, D. G. Mistry, A. Scala

Kinesiology (Formerly Exercise and Sport Science)

Postmenopausal women have an increased risk for cardiovascular disease through many factors, such as a sedentary lifestyle and reduced heart rate variability (HRV). Endurance training improves coronary risk but the role of exercise intensity is unclear. The purpose of this observational study was to evaluate the effects of moderate versus vigorous exercise on cardiovascular disease risk in postmenopausal women. Thirty-six postmenopausal women who self-reported training at moderate (3–5.9 METS; n = 18; age 58.9 ± 4.4yr) or vigorous intensities ( > 6 METS; n = 18; age 59.7 ± 5.2yr) participated. C-reactive protein (CRP), HRV, VO2max, and stress (Perceived Stress Survey, …

Ovarian Cysts, Vaginal Bleeding And Hypothyroidism In A 4-Year-Old Female With Down Syndrome: A Case Of Van Wyk-Grumbach Syndrome, Suniah S. Ayub, Ana Ruzic, Janice A. Taylor

Surgery Faculty Publications

Van Wyk-Grumbach Syndrome (VWGS) is a constellation of symptoms including precocious puberty without adrenarche, delayed bone age, ovarian cysts, and hypothyroidism. We report here a four-year-old Down Syndrome patient who presented for evaluation of abdominal distension, vaginal bleeding, and bilateral ovarian cysts. Her work-up and management demonstrates the importance of screening for hypothyroidism in Down Syndrome, as well as considering the diagnosis of VWGS when evaluating a patient with precocious puberty and an apparent intra-abdominal surgical process. Given the presence of ovarian masses, a surgical emergency such as ovarian torsion or rupture must be ruled out. Even when the diagnosis …

Bacterial Communities Associated With Healthy And Diseased Acropora Cervicornis (Staghorn Coral) Using High-Throughput Sequencing, Charles Walton

HCNSO Student Theses and Dissertations

Coral diseases were first noted in the 1960s and 1970s and have had major impacts globally on coral reef community structures. In the Caribbean, a major outbreak of white band disease has been considered responsible for the drastic decline of Caribbean Acroporids since the 1970s. In addition to white band disease, another more recently described condition known as rapid tissue loss (RTL) has had major impacts on Acropora cervicornis populations, specifically offshore Broward County Southeast Florida. While these diseases have contributed to the population decline, determining their etiologies has been elusive.

Coral diseases have been characterized by shifts in their …

Tumor-Targeted Delivery Of Sirna Using Fatty Acyl-Cgkrk Peptide Conjugates, Meenakshi Sharma, Naglaa Salem El-Sayed, Hung Do, Keykavous Parang, Rakesh Tiwari, Hamidreza Montazeri Aliabadi

Pharmacy Faculty Articles and Research

Tumor-targeted carriers provide efficient delivery of chemotherapeutic agents to tumor tissue. CGKRK is one of the well-known tumor targeting peptides with significant specificity for angiogenic blood vessels and tumor cells. Here, we designed fatty acyl conjugated CGKRK peptides, based on the hypothesis that hydrophobically-modified CGKRK peptide could enhance cellular permeation and delivery of siRNA targeted to tumor cells for effective silencing of selected proteins. We synthesized six fatty acyl-peptide conjugates, using a diverse chain of saturated and unsaturated fatty acids to study the efficiency of this approach. At peptide:siRNA weight/weight ratio of 10:1 (N/P ≈ 13.6), almost all the peptides …

A Comparative Analysis Of Translesion Dna Synthesis Catalyzed By A High-Fidelity Dna Polymerase, Anvesh Dasari, Tejal Deodhar, Anthony J. Berdis

Chemistry Faculty Publications

Translesion DNA synthesis (TLS) is the ability of DNA polymerases to incorporate nucleotides opposite and beyond damaged DNA. TLS activity is an important risk factor for the initiation and progression of genetic diseases such as cancer. In this study, we evaluate the ability of a high-fidelity DNA polymerase to perform TLS with 8-oxo-guanine (8-oxo-G), a highly pro-mutagenic DNA lesion formed by reactive oxygen species. Results of kinetic studies monitoring the incorporation of modified nucleotide analogs demonstrate that the binding affinity of the incoming dNTP is controlled by the overall hydrophobicity of the nucleobase. However, the rate constant for the …

Seroepidemiology Of Sarcocystis Neurona And Neospora Hughesi Infections In Domestic Donkeys (Equus Asinus) In Durango, Mexico, Cosme Alvarado-Esquivel, Daniel K. Howe, Michelle R. Yeargan, Domingo Alvarado-Esquivel, José Alfredo Zamarripa-Barboza, Jitender P. Dubey

Maxwell H. Gluck Equine Research Center Faculty Publications

There is currently no information regarding Sarcocystis neurona and Neospora hughesi infections in donkeys in Mexico. Here, we determined the presence of antibodies against S. neurona and N. hughesi in donkeys in the northern Mexican state of Durango. Serum samples of 239 domestic donkeys (Equus asinus) were assayed for S. neurona and N. hughesi antibodies using home-made enzyme-linked immunoassays; six (2.5%) of the 239 donkeys tested seropositive for S. neurona. The seroprevalence of S. neurona infection was comparable among donkeys regardless of their origin, health status, or sex. Multivariate analysis showed that seropositivity to S. neurona was …

Pcom's Math And Science Academy 2017 Graduation Ceremony Program, Pcom Office Of Admissions, Pcom Office Of Diversity And Community Relations, Pcom Department Of Biomedical Sciences

Diversity and Inclusion

Program for PCOM's Math and Science Academy Graduation Ceremony. Opening remarks by Denah Appelt, PhD; Jay Feldstein, DO; and Marcine Pickron-Davis, PhD. Guest speaker: David Addley, DO.

The Feoabc Locus Of Yersinia Pestis Likely Has Two Promoters Causing Unique Iron Regulation, Lauren O'Connor, Jacqueline D. Fetherston, Robert D. Perry

Microbiology, Immunology, and Molecular Genetics Faculty Publications

The FeoABC ferrous transporter is a wide-spread bacterial system. While the feoABC locus is regulated by a number of factors in the bacteria studied, we have previously found that regulation of feoABC in Yersinia pestis appears to be unique. None of the non-iron responsive transcriptional regulators that control expression of feoABC in other bacteria do so in Y. pestis. Another unique factor is the iron and Fur regulation of the Y. pestis feoABC locus occurs during microaerobic but not aerobic growth. Here we show that this unique iron-regulation is not due to a unique aspect of the Y. pestis …

Integrin Α6Β4 Upregulates Amphiregulin And Epiregulin Through Base Excision Repair-Mediated Dna Demethylation And Promotes Genome-Wide Dna Hypomethylation, Brittany L. Carpenter, Jinpeng Liu, Lei Qi, Chi Wang, Kathleen L. O'Connor

Markey Cancer Center Faculty Publications

Aberrant DNA methylation patterns are a common theme across all cancer types. Specific DNA demethylation of regulatory sequences can result in upregulation of genes that are critical for tumor development and progression. Integrin α6β4 is highly expressed in pancreatic carcinoma and contributes to cancer progression, in part, through the specific DNA demethylation and upregulation of epidermal growth factor receptor (EGFR) ligands amphiregulin (AREG) and epiregulin (EREG). Whole genome bisulfite sequencing (WGBS) revealed that integrin α6β4 signaling promotes an overall hypomethylated state and site specific DNA demethylation of enhancer elements within the proximal promoters of AREG and EREG. Additionally, we find …

Socioeconomic Status, Air Quality And Geographic Variation In Emergency Room Visits For Acute Bronchitis On The California Central Coast, Sean Lang-Brown, Heather W. Starnes, Gary B. Hughes

Symposium

IMPORTANCE: Analysis of geospatial variation in acute bronchitis due to socioeconomic and environmental factors can allow the efficient delivery of resources to populations most at risk.

OBJECTIVE: We sought to determine if small scale variation in socioeconomic factors and emergency room (ER) visits for acute bronchitis are associated in small cities or rural communities. We also modeled the effects of air quality on daily rates of ER visits for acute bronchitis in the context of socioeconomic factors to investigate modifying relationships.

DESIGN, SETTING, AND PARTICIPANTS: We examined ER visits for acute bronchitis in San Luis Obispo and Santa Barbara counties …

Multiparametric Immune Profiling In Hpv- Oral Squamous Cell Cancer., Zipei Feng, Daniel Bethmann, Matthias Kappler, Carmen Ballesteros-Merino, Alexander Eckert, R Bryan Bell, Allen Cheng, Tuan Bui, Rom Leidner, Walter Urba, Kent Johnson, Clifford Hoyt, Carlo Bifulco, Juergen Bukur, Claudia Wickenhauser, Barbara Seliger, Bernard A Fox

Articles, Abstracts, and Reports

Evaluation of T lymphocyte frequency provides prognostic information for patients with oral squamous cell cancer (OSCC). However, the effect of simultaneously evaluating T cell frequency and assessing suppressive elements and defects in antigen-processing machinery (APM) has not been clarified. Simultaneous characterization of CD3+, CD8+, FoxP3+, CD163+, and PD-L1+ cells using multispectral imaging was performed on sections from 119 patients with HPV- OSCC. Expression of β2-microglobulin, MHC class I heavy chain, and large multifunctional peptidase 10 was quantified, and all data were correlated with patient outcome. We found that, consistent with previous reports, high numbers of CD8+ T cells at the …

Supporting And Retaining Village Health Teams: An Assessment Of A Community Health Worker Program In Two Ugandan Districts., Daniel C Mays, Edward J O'Neil, Edison A Mworozi, Benjamin J Lough, Zachary J Tabb, Ashlyn E Whitlock, Edward M Mutimba, Zohray M Talib

Health Policy and Management Faculty Publications

Background

Uganda’s national community health worker program involves volunteer Village Health Teams (VHTs) delivering basic health services and education. Evidence demonstrates their positive impact on health outcomes, particularly for Ugandans who would otherwise lack access to health services. Despite their impact, VHTs are not optimally supported and attrition is a growing problem. In this study, we examined the support needs and existing challenges of VHTs in two Ugandan districts and evaluated specific factors associated with long-term retention. We report on findings from a standardized survey of VHTs and exploratory interviews with key stakeholders and draw conclusions that inform efforts to …

Exploring The Potential For Using Drug Indications To Prevent Look-Alike And Sound-Alike Drug Errors, Enrique Seoane-Vazquez, Rosa Rodriguez-Monguio, Saad Alqahtani, Gordon Schiff

Pharmacy Faculty Articles and Research

Background: Look-alike, sound-alike (LASA) drug names are a cause of medication errors with resulting patient harm and healthcare costs. This study assessed to which extent the use of the generic drug name, therapeutic class, health problem, and the U.S. Food and Drug Administration (FDA)-approved indications might be used to differentiate LASA drug pairs.

Research design and methods: We collected information about LASA drug pairs reported by the FDA to have look-alike sound-alike similarities. To assess potential for differentiating LASA drug pairs, we compared the following drug characteristics: generic name, therapeutic class, health problem, and FDA-approved indication.

Results: …

A Population-Specific Reference Panel Empowers Genetic Studies Of Anabaptist Populations., Liping Hou, Rachel L Kember, Jared C Roach, Jeffrey R O'Connell, David W Craig, Maja Bucan, William K Scott, Margaret Pericak-Vance, Jonathan L Haines, Michael H Crawford, Alan R Shuldiner, Francis J Mcmahon

Articles, Abstracts, and Reports

Genotype imputation is a powerful strategy for achieving the large sample sizes required for identification of variants underlying complex phenotypes, but imputation of rare variants remains problematic. Genetically isolated populations offer one solution, however population-specific reference panels are needed to assure optimal imputation accuracy and allele frequency estimation. Here we report the Anabaptist Genome Reference Panel (AGRP), the first whole-genome catalogue of variants and phased haplotypes in people of Amish and Mennonite ancestry. Based on high-depth whole-genome sequence (WGS) from 265 individuals, the AGRP contains >12 M high-confidence single nucleotide variants and short indels, of which ~12.5% are novel. These …

Reflecting Back On The Ebola Outbreak And The Future Of Bioterrorism, Christian Pedersen

Pepperdine Policy Review

In the wake of the 2014 Ebola outbreak, policy makers have focused on the public health components which led to the outbreak, the efforts to control it, and mitigate the impact of the outbreak. Some of the most enlightening aspects of the outbreak, pertain to National Security. The crisis demonstrated some crucial challenges the United States would have to plan for to effectively respond to a bioterrorist attack.

The Influence Of Sense Of Community On The Relationship Between Community Participation And Recovery For Individuals With Serious Mental Illnesses, Rachel Elizabeth Terry

Dissertations and Theses

The Community Mental Health Act of 1963 launched the deinstitutionalization movement, whereby individuals with serious mental illnesses were released from psychiatric hospitals and began living and receiving mental health care in the community (Carling, 1995). However, these actions have not necessarily integrated those individuals into all aspects of community life (Dewees, Pulice, & McCormick, 1996). This is unfortunate because people with serious mental illnesses frequently report that community integration is not only important to them, but that it also aids in reducing symptoms and promoting recovery (Townley, 2015). Although past research suggests that receiving mental health care in the community …

A Randomized Controlled Trial Of Disclosing Genetic Risk Information For Alzheimer Disease Via Telephone, Peter J. Whitehouse, Melissa Barber Butson

Faculty Scholarship

Purpose: Telephone disclosure of genetic test results can improve access to services. To date, studies of its impact have focused on return of Mendelian risk information, principally hereditary cancer syndromes.Methods: In a multisite trial of Alzheimer disease genetic risk disclosure, asymptomatic adults were randomized to receive test results in person or via telephone. Primary analyses examined patient outcomes 12 months after disclosure.Results: Data from 257 participants showed that telephone disclosure occurred 7.4 days sooner and was 30% shorter, on average, than in-person disclosure (both P < 0.001). Anxiety and depression scores were well below cutoffs for clinical concern across protocols. Comparing telephone and in-person disclosure protocols, 99% confidence intervals of mean differences were within noninferiority margins on scales assessing anxiety, depression, and test-related distress, but inconclusive about positive impact. No differences were observed on measures of recall and subjective impact. Subanalyses supported noninferiority on all outcomes among apolipoprotein E (APOE) I 4-negative participants. Subanalyses were inconclusive for APOE I 4-positive participants, although mean anxiety and depression scores were still well below cutoffs for clinical concern. Conclusion: Telephone disclosure of APOE results and risk for Alzheimer disease is generally safe and helps providers meet demands for services, even when results identify an increased risk for disease.

Comparison Of Efficacy And Safety Between First And Second Generation Drug-Eluting Stents In Patients With Stable Coronary Artery Disease: A Single-Center Retrospective Study, Ru Liu, Fei Xiong, Yuan Wen, Yuan-Liang Ma, Yi Yao, Zhan Gao, Bo Xu, Yue-Jin Yang, Shu-Bin Qiao, Run-Lin Gao, Jin-Qing Yuan

Physiology Faculty Publications

Background: Lots of trials demonstrate that second-generation drug-eluting stents (G2-DES), with their improved properties, offer significantly superior efficacy and safety profiles compared to first generation DES (G1-DES) for patients with coronary artery disease (CAD) receiving percutaneous coronary intervention (PCI). This study aimed to verify the advantage of G2-DES over G1-DES in Chinese patients with stable CAD (SCAD).

Methods: For this retrospective observational analysis, 2709 SCAD patients with either G1-DES (n = 863) or G2-DES (n = 1846) were enrolled consecutively throughout 2013. Propensity score matching (PSM) was applied to control differing baseline factors. Two-year outcomes, including major adverse …

The Evaluation Of The Effects Of The Use Of The Palliative Care Diagnosis Code On Risk-Adjusted Mortality And Hospital Ranking In Patients With Severe Sepsis, Renee D. Donohoe

Pharmaceutical Sciences ETDs

Background: The International Classification of Diseases, Ninth-Revision-Clinical Modification (ICD-9-CM) for palliative care (V66.7) has been shown to affect risk-adjusted mortality rates. This code can increase the risk of mortality when included in billing data and incorporated into risk-adjustment models (1).

Objectives: The purpose of this study is to examine variations in coding between high-performing (low mortality indices (Observed/Expected)) and low-performing (high mortality indices) hospitals by examining the use of the ICD-9-CM code for palliative care; coding of severe sepsis; and assignment of higher-weighted Medicare-Severity Diagnosis Related Group (MS-DRG) codes.

Methods: Data were obtained from the Vizient™ Clinical Database/Resource Manager (CBD/RM) …

Retrospective Analysis To Describe Associations Between Tumor Necrosis Factor Alpha Inhibitors And Copd-Related Hospitalizations, Neil A. Accortt, James B. Chung, Machaon Bonafede, Brendan L. Limone, David M. Mannino

Preventive Medicine and Environmental Health Faculty Publications

Background: Limited information exists on the impact of tumor necrosis factor inhibition on COPD exacerbations. This retrospective study characterized this impact among COPD patients with underlying autoimmune conditions, exposed to tumor necrosis factor inhibitors (TNFi) and/or non-biologic disease-modifying antirheumatic drugs (DMARDs).
Patients and methods: Adult COPD patients with ≥1 diagnosis for rheumatoid arthritis (RA), psoriasis (PsO), psoriatic arthritis (PsA), or ankylosing spondylitis (AS) before or within 6 months following the index COPD diagnosis were identified from the Truven Health MarketScan^® databases. Patients were required to have a second claim for RA, PsO, PsA, AS, or DMARD use (biologic or …