Medicine and Health Sciences Commons^™

Mucopolysaccharidosis Type I Newborn Screening: Best Practices For Diagnosis And Management., Lorne A. Clarke, Andrea M. Atherton, Barbara K. Burton, Debra L. Day-Salvatore, Paige Kaplan, Nancy D. Leslie, C Ronald Ronald Scott, David W. Stockton, Janet A. Thomas, Joseph Muenzer

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Evaluating The Accountable Health Communities Demonstration Project., Laura Gottlieb, Jeffrey D. Colvin, Eric Fleegler, Danielle Hessler, Arvin Garg, Nancy Adler

Manuscripts, Articles, Book Chapters and Other Papers

Despite substantial evidence documenting the social patterning of disease, relatively little information is available on how the health care system can best intervene on social determinants to impact individual and population health. Announced in January 2016, the Centers for Medicare and Medicaid Innovation's (CMMI) Accountable Health Communities (AHC) initiative provides an important opportunity to improve the evidence base around integrated social and medical care delivery. To maximize learning from this large-scale demonstration, comprehensive evaluation efforts should focus on effectiveness and implementation research by supporting local, regional, and national studies across a range of outcomes. Findings from this demonstration could transform …

External Cardioversion Of Supraventricular Tachycardia In Omphalo-Thoracopagus Conjoined Twins., M Rizwan Afzal, Lindsey Malloy-Walton, Svjetlana Tisma-Dupanovic, Andrea L. Miles, Sanket Shah, John Papagiannis

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

The Art And Skill Of Delivering Culturally Responsive Trauma-Focused Cognitive Behavioral Therapy In Tanzania And Kenya., Briana Woods-Jaeger, Christine M. Kava, Christopher F. Akiba, Leah Lucid, Shannon Dorsey

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: This study explored the facilitators, barriers, and strategies used to deliver a child mental health evidence-based treatment (EBT), trauma-focused cognitive behavioral therapy (TF-CBT), in a culturally responsive manner. In low- and middle-income countries most individuals with mental health problems do not receive treatment due to a shortage of mental health professionals. One approach to addressing this problem is task-sharing, in which lay counselors are trained to deliver mental health treatment. Combining this approach with a focus on EBT provides a strategy for bridging the mental health treatment gap. However, little is known about how western-developed EBTs are delivered in …

Assessment Of Dietary Intake Of Children With Chronic Kidney Disease., Wun Fung Hui, Aisha Betoko, Jonathan D. Savant, Alison G. Abraham, Larry A. Greenbaum, Bradley A. Warady, Marva M. Moxey-Mims, Susan L. Furth

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: Our aim was to characterize the nutrient intake of children with chronic kidney disease (CKD) relative to recommended intake levels.

METHODS: We conducted a cross-sectional study of dietary intake assessed by Food Frequency Questionnaire (FFQ) in The North American Chronic Kidney Disease in Children (CKiD) prospective cohort study. Nutrient intake was analyzed to estimate the daily consumption levels of various nutrients and compared with national guidelines for intake.

RESULTS: There were 658 FFQs available for analysis; 69.9 % of respondents were boys, with a median age [Interquartile range (IQR)] of 11 years (8-15). Median daily sodium, potassium, and phosphorus …

Childhood Obesity: The Role Of The Mental Health Professional, Barry Panzer

NYMC Faculty Publications

This work consists of two major components: understanding the nature of childhood obesity and providing clinical services. Factors responsible for the current epidemic will be outlined, as will the current definition of the disorder. Statistical data regarding the epidemiology of weight disorders in childhood will be provided in order to give a perspective of the problem. Various obesity trajectories and their differential diagnostic and treatment issues will be thoroughly explored. The intervention section intends to help clinicians to evaluate salient factors in assessing the obese child and to identify appropriate goals and treatment methods. The course will provide vital information …

Longitudinal Cardiovascular Outcomes Of Sleep Disordered Breathing In Children: A Meta-Analysis And Systematic Review., Zarmina Ehsan, Stacey L. Ishman, Thomas R. Kimball, Nanhua Zhang, Yuanshu Zou, Raouf S. Amin

Manuscripts, Articles, Book Chapters and Other Papers

Objectives: The presence of sleep disordered breathing (SDB) is known to impact long-term cardiovascular morbidity in adults; however, the long-term effects in children are poorly understood. We aimed to systematically review and synthesize studies published to date on the long-term effects of SDB in children.

Study Design: Meta-analysis and systematic review using PubMed, CINAHL, Embase, and Scopus (all indexed years).

Methods: We searched for English-language articles containing original human data from prospective studies, with ≥7 participants, in children ≤18 years of age. Data regarding study design, demographics, clinical characteristics, outcomes, level of evidence, and risk of bias were obtained. Articles …

Ethical Concerns When Minors Act As Standardized Patients., Erwin Jiayuan Khoo, Robert Schremmer, Douglas S. Diekema, John Lantos

Manuscripts, Articles, Book Chapters and Other Papers

When minors are asked to assist medical educators by acting as standardized patients (SPs), there is a potential for the minors to be exploited. Minors deserve protection from exploitation. Such protection has been written into regulations governing medical research and into child labor laws. But there are no similar guidelines for minors' work in medical education. This article addresses the question of whether there should be rules. Should minors be required to give their informed consent or assent? Are there certain practices that could cause harm for the children who become SPs? We present a controversial case and ask a …

A Structured Blood Conservation Program In Pediatric Cardiac Surgery, A Budak, Kevin Mccusker, S Gunaydin

NYMC Faculty Publications

OBJECTIVE: The limitation of alternative transfusion practices in infants increases the benefits of blood conservation. We analyzed the efficacy of a structured program to reduce transfusions and transfusion-associated complications in cardiac surgery

PATIENTS AND METHODS: Our pediatric surgery database was reviewed retrospectively, comparing outcomes from two different time periods, after the implementation of an effective blood conservation program beginning in March 2014. A total of 214 infants (8.1±3.4 months) who underwent biventricular repair utilizing CPB (Group 1 – Blood conservation) were studied in a 12-month period (March 2014-February 2015) after the implementation of the new program, and compared with 250 …

Pnaktide Attenuates Steatohepatitis And Atherosclerosis By Blocking Na/K-Atpase/Ros Amplification In C57bi6 And Apoe Knockout Mice Fed A Western Diet, Komal Sodhi, K Srikanthan, P Goguet-Rubio, A Nichols, A Mallick, A Nawab, R Martin, P Shah, M Chaudhry, S Sigdel, M El-Hamdani, J Liu, Z Xie, Nader Abraham, J Shapiro

NYMC Faculty Publications

We have previously reported that the alpha1 subunit of sodium potassium adenosine triphosphatase (Na/K-ATPase), acts as a receptor and an amplifier for reactive oxygen species, in addition to its distinct pumping function. On this background, we speculated that blockade of Na/K-ATPase-induced ROS amplification with a specific peptide, pNaKtide, might attenuate the development of steatohepatitis. To test this hypothesis, pNaKtide was administered to a murine model of NASH: the C57Bl6 mouse fed a "western" diet containing high amounts of fat and fructose. The administration of pNaKtide reduced obesity as well as hepatic steatosis, inflammation and fibrosis. Of interest, we also noted …

Instructive Role Of The Microenvironment In Preventing Renal Fibrosis, Kei Matsumoto, Jun Chen, Yujiro Kida, Brian Ratliff, Hong Zhao, Zbigniew Darzynkiewicz, Michael Goligorsky

NYMC Faculty Publications

Accumulation of myofibroblasts is a hallmark of renal fibrosis. A significant proportion of myofibroblasts has been reported to originate via endothelial-mesenchymal transition. We initially hypothesized that exposing myofibroblasts to the extract of endothelial progenitor cells (EPCs) could reverse this transition. Indeed, in vitro treatment of transforming growth factor-beta1 (TGF-beta1)-activated fibroblasts with EPC extract prevented expression of alpha-smooth muscle actin (alpha-SMA); however, it did not enhance expression of endothelial markers. In two distinct models of renal fibrosis-unilateral ureteral obstruction and chronic phase of folic acid-induced nephropathy-subcapsular injection of EPC extract to the kidney prevented and reversed accumulation of alpha-SMA-positive myofibroblasts and …

A Review Of Echocardiograms In Hypertensive Patients Greater Than 60 Years In A Community Based Family Medicine Program, Shideh Doroudi, Michael Delisi, Vincent Debari

NYMC Faculty Publications

Background: Heart disease as a result of Hypertension is known to occur. Anatomical and functional changes of the heart can easily be detected by echocardiography, which is a safe and readily available study. Objectives: The aims of this study were to evaluate the prevalence of common echocardiographic changes in chronic hypertensive patients and to compare these changes in male and female populations. Design/methods: The study was a community-based cross-sectional study, on 227 hypertensive patients, 60 years and older, seen in St. Joseph's Family Medicine at Clifton, with integrated clinical and echocardiographic data. Results: Study population consisted of 227 hypertensive patients, …

"They Are Friendly But They Don't Want To Be Friends With You": A Narrative Inquiry Into Chinese Nursing Students' Learning Experiences In Australia, Carol Wang, Lisa Whitehead, Sara J. Bayes

Research outputs 2014 to 2021

There is increasing interest in the phenomena of international student mobility and the growing global demand for skilled nurses. Little is known, however, about the learning experiences of Chinese nursing students at Australian universities. This study begins to address this gap. A narrative inquiry methodology was employed. In-depth interviews and focus group discussions, along with field notes and observations were conducted with six Chinese undergraduate nursing students studying undergraduate nursing in Western Australia. Chinese nursing students in Australia experienced fear and anxiety, driven by unfamiliarity with the hospital environment, education methods, and assessment expectations. Clinical placement experiences in Australian health …

Total Volume And Composition Of Fluid Intake And Mortality In Older Women: A Cohort Study, Wai H. Lim, Germaine Wong, Joshua R. Lewis, Charmaine E. Lok, Kevan R. Polkinghorne, Jonathan M. Hodgson, Ee M. Lim, Richard L. Prince

Research outputs 2014 to 2021

Objectives:

The health benefits of ‘drinking at least 8 glasses of water a day” in healthy individuals are largely unproven. We aimed to examine the relationship between total fluid and the sources of fluid consumption, risk of rapid renal decline, cardiovascular disease (CVD) mortality and all-cause mortality in elderly women.

Design, setting and participants:

We conducted a longitudinal analysis of a population-based cohort study of 1055 women aged ≥70 years residing in Australia.

Main outcome measures The associations between total daily fluid intake (defined as total volume of beverage excluding alcohol and milk) and the types of fluid (water, …

Using Ranked Auxiliary Covariate As A More Efficient Sampling Design For Ancova Model: Analysis Of A Psychological Intervention To Buttress Resilience, Rajai Jabrah, Hani Samawi, Robert Vogel, Haresh Rochani, Daniel Linder

Biostatistics: Faculty Publications

Drawing a sample can be costly or time consuming in some studies. However, it may be possible to rank the sampling units according to some baseline auxiliary covariates, which are easily obtainable, and/or cost efficient. Ranked set sampling (RSS) is a method to achieve this goal. In this paper, we propose a modified approach of the RSS method to allocate units into an experimental study that compares L groups. Computer simulation estimates the empirical nominal values and the empirical power values for the test procedure of comparing L different groups using modified RSS based on the regression approach in analysis …

Identification And Characterization Of Microrna Differentially Expressed In Macrophages Exposed To Porphyromonas Gingivalis Infection, Olivier Huck, J Al-Hashemi, L Poidevin, O Poch, J Davideau, H Tenenbaum, Salomon Amar

NYMC Faculty Publications

MicroRNAs (miRNAs) are short, noncoding RNAs involved in the regulation of several processes associated with inflammatory diseases and infection. Bacterial infection modulates miRNA expression to subvert any innate immune response. In this study we analyzed, using microarray analysis, the bacterial modulation of miRNAs in bone marrow-derived macrophages (BMMs) in which activity was induced by infection with Porphyromonas gingivalis The expression of several miRNAs was modulated 3 h postinfection (at a multiplicity of infection of 25). A bioinformatic analysis was performed to further identify pathways related to the innate immune host response under the influence of selected miRNAs. To assess the …

Gene Networks Activated By Specific Patterns Of Action Potentials In Dorsal Root Ganglia Neurons, P Lee, J Cohen, Dumitru Iacobas, Sanda Iacobas, R Fields

NYMC Faculty Publications

Gene regulatory networks underlie the long-term changes in cell specification, growth of synaptic connections, and adaptation that occur throughout neonatal and postnatal life. Here we show that the transcriptional response in neurons is exquisitely sensitive to the temporal nature of action potential firing patterns. Neurons were electrically stimulated with the same number of action potentials, but with different inter-burst intervals. We found that these subtle alterations in the timing of action potential firing differentially regulates hundreds of genes, across many functional categories, through the activation or repression of distinct transcriptional networks. Our results demonstrate that the transcriptional response in neurons …

Myocardial Metastasis From Cervical Carcinoma Causing Left Anterior Descending Coronary Artery Occlusion And St-Segment-Elevation Myocardial Infarction, G Wagman, Wilbert Aronow, Howard Cooper

NYMC Faculty Publications

No abstract provided.

Gvhd After Umbilical Cord Blood Transplantation For Acute Leukemia: An Analysis Of Risk Factors And Effect On Outcomes, Y Chen, T Wang, Michael T. Hemmer, A Alousi, J Pidala, Mitchell Cairo, C Cutler

NYMC Faculty Publications

Using the Center for International Blood and Marrow Transplant Research (CIBMTR) registry, we analyzed 1404 umbilical cord bloodtransplantation (UCBT) patients (single (<18 years)=810, double (⩾18 years)=594) with acute leukemia to define the incidence of acuteGvHD (aGvHD) and chronic GvHD (cGvHD), analyze clinical risk factors and investigate outcomes. After single UCBT, 100-day incidence of grade II-IV aGvHD was 39% (95% confidence interval (CI), 36-43%), grade III-IV aGvHD was 18% (95% CI, 15-20%) and 1-year cGvHD was 27% (95% CI, 24-30%). After double UCBT, 100-day incidence of grade II-IV aGvHD was 45% (95% CI, 41-49%), grade III-IV aGvHD was 22% (95% CI, 19-26%) and …

Determinants Of Neonatal Mortality In Rural And Urban Nigeria: Evidence From A Population-Based National Survey, Emmanuel O. Adewuyi, Yun Zhao

Research outputs 2014 to 2021

Background: Significant reduction in the global burden of neonatal mortality was achieved through the millennium development goals. In Nigeria, however, only a marginal reduction was realized. This study assesses the rural–urban differences in neonatal mortality rate (NMR) and the associated risk factors in Nigeria.

Methods: The dataset from the 2013 Nigeria demographic and health survey (NDHS), disaggregated by rural–urban residence (n = 20 449 and 9935, respectively), was explored using univariate, bivariate, and multivariable analysis. Complex samples analysis was applied to adjust for the unequal selection probabilities due to the multi-stage cluster sampling method used in the 2013 NDHS. The …

Twin Chorionicity And Prospective Stillbirth Risk: Experience At A Tertiary Care Hospital, Shazia Masheer, Zaheena Islam, Dhanwanti Dileep, Shama Munim

Department of Obstetrics & Gynaecology

Objective: To determine the prospective risk of stillbirth, perinatal death and neonatal morbidities in twins.

Methods: This retrospective cohort study was conducted at the Aga Khan University Hospital, Karachi, and comprised cases of twin pregnancies from January 2001 to December 2012. . Cases of both monochorionic diamniotic and dichorionic diamniotic twin pregnancies were included. SPSS 19 was used for data analysis.

Results: Of the 394 cases, 84(21.3%) were monochorionic diamniotic twins and 310(78.7%) were dichorionic diamniotic twins. There were no cases of stillbirth beyond 30 and 34 weeks in monochorionic and dichorionic twins, respectively. Neonatal mortality stood reduced beyond 36 …

Nutrinews, Volume 26, March 2017, Department Of Nutrition And Dietetics, University Of North Florida

NutriNews

This issue features Student Spotlight, Updated Diabetes Guidelines, Chia Seeds & Weight Loss

Marriage And Family Therapy And The Law: Discovering Systemic Common Ground, Jason C. Richards

Loma Linda University Electronic Theses, Dissertations & Projects

Many important decisions regarding couples and families are made by the legal system. However, this system’s adversarial nature often results in relational losses for clients, even when one “wins” a case. Some believe a solution may exist in legally-minded marriage and family therapists, who, as experts in family systems theory, are in a unique position to help facilitate healing in a flawed, but well-meaning family court system (Brooks & Madden, 2012; Madden, 2008). However, the literature reveals that new therapists may lack appropriate legal knowledge when they graduate, suggesting a need for different preparation by marriage and family therapy programs …

Nursing Advising Using A Mooc: A Case Study, Sandra G. Nadelson, Louis S. Nadelson, Morgan Scadden, Lesa Minnick, Heather Thomas

Current Issues in Emerging eLearning

Advanced technology has moved online courses from being available to exclusively to elite students to literally being open to the general public. The proliferation of Massive Open Online Courses (MOOCs) has led to expanding public access to a wide range of information including careers in health care fields. Our group developed a MOOC to assist people from around the world who are interested in pursuing a career in nursing get the information they need to be successful in the nursing program and in the profession of nursing. In this article, we describe course content, who the students were who enrolled …

High Resolution Time-Course Mapping Of Early Transcriptomic, Molecular And Cellular Phenotypes In Huntington's Disease Cag Knock-In Mice Across Multiple Genetic Backgrounds., Seth A Ament, Jocelynn R Pearl, Andrea Grindeland, Jason St Claire, John C Earls, Marina Kovalenko, Tammy Gillis, Jayalakshmi Mysore, James F Gusella, Jong-Min Lee, Seung Kwak, David Howland, Min Young Lee, David Baxter, Kelsey Scherler, Kai Wang, Donald Geman, Jeffrey B Carroll, Marcy E Macdonald, George Carlson, Vanessa C Wheeler, Nathan D Price, Leroy Hood

Articles, Abstracts, and Reports

Huntington's disease is a dominantly inherited neurodegenerative disease caused by the expansion of a CAG repeat in the HTT gene. In addition to the length of the CAG expansion, factors such as genetic background have been shown to contribute to the age at onset of neurological symptoms. A central challenge in understanding the disease progression that leads from the HD mutation to massive cell death in the striatum is the ability to characterize the subtle and early functional consequences of the CAG expansion longitudinally. We used dense time course sampling between 4 and 20 postnatal weeks to characterize early transcriptomic, …

Motivating And Demotivating Factors For Community Health Workers Engaged In Maternal, Newborn And Child Health Programs In Low And Middle-Income Countries: A Systematic Review., Leah Shipton, Aysha Zahidie, F. Rabbani

Community Health Sciences

This systematic review aimed to synthesize primary research on motivating factors of community health workers (CHWs) for maternal, neonatal, and child health (MNCH) in low and middle-income countries (LMICs). Peer-reviewed literatures were systematically searched in five databases. Identified studies were then screened and selected for inclusion. The eligibility criteria were reported primary qualitative, quantitative, or mixed methods research, with participants being CHWs in LMICs who address MNCH, which investigated motivation or related concepts of retention, attrition, and performance. A thematic synthesis process was used to analyze findings of motivating factors, reported by included studies. Seventeen qualitative, quantitative, or mixed methods …

Understanding Increasing College Anxiety: The Need For Anxiety Awareness Campaigns, Taylor Mosher

Journalism

The following study investigates national trends toward increasing anxiety among the college student demographic with particular attention paid to the ways in which public awareness campaigns may be implemented as a method for reducing stigma, increasing awareness of anxiety conditions, and connecting students to critical resources.

In order to improve understanding surrounding student anxiety, the following research was conducted in two parts. First, secondary national research was conducted analyzing relevant literature surrounding anxiety trends among college students, the response of universities across the nation, and potential methods by which to relieve student anxiety. Following the conclusion of this research, primary …

A Case Of Hashimoto’S Encephalopathy In A Patient With Lithium Toxicity, Saba Zaidi, Bashir A. Soomro, Dr Imran Chaudary, Fasiha Sohail

Pakistan Journal of Neurological Sciences (PJNS)

Hashimoto’s encephalopathy is a rare neurological disorder of unknown etiology. We presented, a case of middle aged male with bipolar disorder on Lithium carbonate for 30 years, admitted with altered behavior for 2 weeks and high Lithium levels. He was admitted with the suspicion of Lithium toxicity. EEG showed generalized epileptiform discharges. MRI brain revealed frontal cortical atrophy. CSF detailed report was normal. Further workup showed a high TSH level and positive anti-TPO (anti thyroid peroxidase) antibodies. Based on clinical picture, raised antibodies and no discernible cause, diagnosis of probable Hashimoto’s encephalopathy was made. He received pulse of methylprednisolone for …

Role Of Neuroradiology In Predicting Outome In Spontaneous Intracerebral Hemorrhage, Sumaira Nabi, Mazhar Badshah, Shahzad Ahmed, Ali Zohair Nomani

Pakistan Journal of Neurological Sciences (PJNS)

Spontaneous intracerebral hemorrhage (ICH) accounts for 8-13% of all strokes and is associated with a high mortality and morbidity. Western studies have identified various clinical and radiological factors which help in predicting outcome in patients with spontaneous ICH. Materials and methods: A consecutive series of 100 patients diagnosed with spontaneous ICH admitted to the neurology department were enrolled from 1stJanuary to 30th June, 2014.Radiological parameters on CT brain (plain) were recorded. In-hospital outcome was measured at the end of 7 days of hospital stay in terms of survival or mortality. Different radiological parameters and their effect on outcome were compared …

Frequency Of Miller Fisher Variant Of Guillain Barré Syndrome At A Tertiary Care Hospital, Karachi, Kiran Waqar, Sadaf Nasir, Khalid Sher, Meraj Fatima, Abdul Malik

Pakistan Journal of Neurological Sciences (PJNS)

Miller fisher syndrome is generally considered a rare but important variant of Guillain Barré Syndrome (GBS) having geographically variable incidence. Patients with this clinical syndrome are often misdiagnosed and mismanaged due to lack of awareness on the part of physician. Objective: To determine frequency of Miller fisher syndrome (MFS), variant of GBS in patients presenting to a tertiary care hospital in Karachi. Methods: This descriptive cross sectional study was conducted in the Department of Neurology, Jinnah Postgraduate Medical Centre (JPMC), Karachi. The duration was from April, 2014 to April, 2016 (two years). A total of 100 patients were included in …