Medicine and Health Sciences Commons^™

The Effect Of A Single Bout Of Physical Exertion On Expressive Language And Word Finding In Individuals With Multiple Sclerosis, Marissa A. Barrera

Dissertations, Theses, and Capstone Projects

To date, little research has been conducted on the relationship between fatigue and expressive language among Multiple Sclerosis patients (MS). This study was a response to this knowledge gap. A nonrandom, matched- subject, mixed-factor design model was used with a purposive sample of 17 individuals with MS (five had primary-progressive (PP) MS, and 12 had relapsing-remitting (RR) MS). The research design was subjected to pretesting to ensure validity. Participants were assessed on a range of language tasks after undergoing one bout of cardiovascular exercise (NuStep T5 Recumbent Cross Trainer) and asked to provide a subjective fatigue score. The expressive language …

African American Male Veterans’ Illness Representation And Reported Self-Management Practices Of High Blood Pressure, Tammie Brodie

Dissertations, Theses, and Capstone Projects

High blood pressure (HBP) is a common condition in the United States, affecting one in four American adults. Forty-one percent of African Americans have HBP compared to 27% of White Americans. African Americans develop high blood pressure at an earlier age and suffer more complications compared to other ethnic groups. Numerous studies have been conducted to find the causes and treatment for HBP in African Americans.

The purpose of this research is to explore self-management practices of African-American male veterans, who have positive HBP representation and controlled HBP. A mixed-methods approach guided the study to gain quantitative and qualitative explanatory …

Weight Loss Maintenance: Women's Experience During Perimenopause, Karren B. Liebert

Dissertations, Theses, and Capstone Projects

Women’s health may be at risk during middle age, a time when women in the United States often gain weight. Being overweight or obese during perimenopause increases a woman’s vulnerability to disabling health sequela in later life, such as cardiovascular disease, diabetes, depression and osteoarthritis, all of which increase morbidity, mortality, health care costs and decrease quality of life. Stigma and discrimination related to overweight and obesity are associated with delay and avoidance of health care, and with poorer quality health care. Weight loss often is followed by weight regain within three to five years. This qualitative study was designed …

Soluble Factors Secreted By Endothelial Cells Allow For Productive And Latent Hiv-1 Infection In Resting Cd4+ T Cells, John Henry Morris, Tran Nguyen, Abuoma Nwadike, Mackenzie L. Geels

University Faculty Publications and Creative Works

In vitro, it is difficult to infect resting CD4+ T cells with human immunodeficiency virus type 1 (HIV), but infections readily occur in vivo. Endothelial cells (ECs) interact with resting CD4+ T cells in vivo, and we found previously that EC stimulation leads to productive and latent HIV infection of resting CD4+ T cells. In this study, we further characterize the interactions between EC and resting T cells. We found that resting CD4+ T cells did not require direct contact with EC for productive and/or latent infection to occur, indicating the involvement of soluble factors. Among 30 cytokines tested in …

Matrix Metalloproteinases As Regulators Of Periodontal Inflammation, Franco Cavalla, Patricia Hernández-Ríos, Timo Sorsa, Cláudia Cristina Biguetti, Marcela Hernández

School of Podiatric Medicine Publications

Periodontitis are infectious diseases characterized by immune-mediated destruction of periodontal supporting tissues and tooth loss. Matrix metalloproteinases (MMPs) are key proteases involved in destructive periodontal diseases. The study and interest in MMP has been fuelled by emerging evidence demonstrating the broad spectrum of molecules that can be cleaved by them and the myriad of biological processes that they can potentially regulate. The huge complexity of MMP functions within the ‘protease web’ is crucial for many physiologic and pathologic processes, including immunity, inflammation, bone resorption, and wound healing. Evidence points out that MMPs assemble in activation cascades and besides their classical …

Associations Of Emergency Department Length Of Stay With Publicly Reported Quality-Of-Care Measures., Anna Marie Chang, Amber Lin, Rongwei Fu, K. John Mcconnell, Benjamin Sun

Department of Emergency Medicine Faculty Papers

OBJECTIVE: The Institute of Medicine identified emergency department (ED) crowding as a critical threat to patient safety. We assess the association between changes in publicly reported ED length of stay (LOS) and changes in quality-of-care measures in a national cohort of hospitals.

METHODS: Longitudinal analysis of 2012 and 2013 data from the American Hospital Association (AHA) Survey, Center for Medicare and Medicaid Services (CMS) Cost Reports, and CMS Hospital Compare. We included hospitals reporting Hospital Compare timeliness measure of LOS for admitted patients. We used AHA and CMS data to incorporate hospital predictors of interest. We used the method of …

Myocardial Relaxation Is Accelerated By Fast Stretch, Not Reduced Afterload, Charles S. Chung, Charles W. Hoopes, Kenneth S. Campbell

Physiology Faculty Publications

Fast relaxation of cross-bridge generated force in the myocardium facilitates efficient diastolic function. Recently published research studying mechanisms that modulate the relaxation rate has focused on molecular factors. Mechanical factors have received less attention since the 1980s when seminal work established the theory that reducing afterload accelerates the relaxation rate. Clinical trials using afterload reducing drugs, partially based on this theory, have thus far failed to improve outcomes for patients with diastolic dysfunction. Therefore, we reevaluated the protocols that suggest reducing afterload accelerates the relaxation rate and identified that myocardial relengthening was a potential confounding factor. We hypothesized that the …

Reproductive History Before And After Hiv Diagnosis: A Cross-Sectional Study In Hiv-Positive Women In Spain, Victoria Hernando, Belen Alejos, Marta Montero, M Jesús Pérez-Elias, José Ramón Blanco, Livia Giner, Juan Luis Gómez-Sirvent, Jose Antonio Iribarren, Enrique Bernal, Francisco Bolumar

Publications and Research

The aim of this study is to examine the reproductive history of human immunodeficiency virus (HIV)-positive women, before and after HIV diagnosis, to describe the characteristics of women with pregnancies after HIV diagnosis, and to assess the prevalence of mother-to-child transmission.

A cross-sectional study was performed among women within reproductive ages (18–49) selected from the cohort in the Spanish AIDS Research Network (CoRIS). A descriptive analysis of the pregnancy outcomes was made according to women’s serostatus at the moment of pregnancy and association of women’s characteristics with having pregnancy after HIV diagnosis was evaluated using logistic regression models.

Overall, 161 …

Does Mental Status Impact Therapist And Patient Communication In Emergency Department Brief Interventions Addressing Alcohol Use?, Brian Borsari, Timothy R. Apodaca, Ali Yurasek, Peter M. Monti

Manuscripts, Articles, Book Chapters and Other Papers

Motivational interviewing (MI) is often incorporated into screening, brief intervention, and referral to treatment (SBIRT) interventions in critical care settings to address alcohol and other drug use. However, cognitive status has been linked to differential response to MI sessions in emergency department (ED) settings. The current study examined one possible explanation for this differential response: whether higher versus lower mental status impacts patient response to clinician statements during MI sessions conducted in an ED. Participants were 126 patients receiving an MI-based single-session alcohol brief intervention, and 13 therapists who provided treatment. Participants completed a mental status exam (MSE) as part …

Are Soy-Based Proteins, Meals, And Diets An Effective Treatment In Reducing Waist Circumference In Overweight And Obese Adults Ages 20-75 Years?, Lisa Lin

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this evidence based medicine review is to determine whether or not soy-based proteins, meals, and diets are effective treatments in reducing waist circumference in overweight and obese adults ages 20-75 years.

Study design: Review of three published, randomized controlled trials (RCTs) published in 2003, 2007, and 2011. All English language.

Data Source: The three randomized controlled trials that used in this review were found using PubMed.

Outcomes measured: The outcomes measured were improvement of patient’s overweight and obesity status and their overall quality of life through the indication of reduced waist circumference. …

Objective Monitoring Of Insecticide-Treated Bednet Use To Improve Malaria Prevention: Smartnet Development And Validation, Paul J. Krezanoski, Data Santorino, Jeffrey Campbell, David Bangsberg

OHSU-PSU School of Public Health Faculty Publications and Presentations

Malaria is a serious health concern for three billion people worldwide, killing nearly 600,000 people a year. Insecticide-treated bednets (ITNs) are an effective and valuable tool for preventing malaria and hundreds of millions of ITNs have been distributed throughout sub-Saharan Africa. Nevertheless, our current methods for measuring ITN use are inadequate to inform malaria prevention programs. The most common method, self-reported ITN use, is limited by 1) social desirability, 2) recall and 3) sampling bias. An acceptable objective and longitudinal method of assessing adherence to ITN use would improve our ability to better understand the determinants of ITN use and …

Large-Scale Behavior-Change Initiative For Infant And Young Child Feeding Advanced Language And Motor Development In A Cluster-Randomized Program Evaluation In Bangladesh, Edward A. Frongillo Jr., Phuong H. Nguyen, Kuntal K. Saha, Tina Sanghvi, Kaosar Afsana, Raisul Haque, Jean Baker, Marie T. Ruel, Rahul Rawat, Purnima Menon

Faculty Publications

Background: Promoting adequate nutrition through interventions to improve infant and young child feeding (IYCF) has the potential to contribute to child development.

Objective: We examined whether an intensive intervention package that was aimed at improving IYCF at scale through the Alive & Thrive initiative in Bangladesh also advanced language and gross motor development, and whether advancements in language and gross motor development were explained through improved complementary feeding.

Methods: A cluster-randomized design compared 2 intervention packages: intensive interpersonal counseling on IYCF, mass media campaign, and community mobilization (intensive) compared with usual nutrition counseling and mass media campaign (nonintensive). Twenty subdistricts …

5'-Terminal Nucleotide Variations In Human Cytoplasmic Trnahisgug And Its 5'-Halves., Megumi Shigematsu, Yohei Kirino

Computational Medicine Center Faculty Papers

Transfer RNAs (tRNAs) are fundamental adapter components of translational machinery. tRNAs can further serve as a source of tRNA-derived noncoding RNAs that play important roles in various biological processes beyond translation. Among all species of tRNAs, tRNA(HisGUG) has been known to uniquely contain an additional guanosine residue at the -1 position (G-1) of its 5'-end. To analyze this -1 nucleotide in detail, we developed a TaqMan qRT-PCR method that can distinctively quantify human mature cytoplasmic tRNA(HisGUG) containing G-1, U-1, A-1, or C-1 or lacking the -1 nucleotide (starting from G1). Application of this method to the mature tRNA fraction of …

Toward A Collaborative Ai Framework For Assistive Dementia Care, Tze-Yun Leong

Research Collection School Of Computing and Information Systems

We envision an integrated framework for supporting the development and deployment of human-aware, general artificial intelligence (AI) that needs to collaborate in uncertain, changing environments. We examine the technology and system requirements of building assistive care agents for dementia or cognitive impaired patients through the continuum of care. We summarize the new AI capabilities and show examples of how an evolving, adaptive development approach would be able to support the basic functionalities and applications in a sound, practical, and scalable manner. We highlight the challenges and the opportunities involved in realizing the proposed framework, and call for future research and …

Further Advances For The Sequential Multiple Assignment Randomized Trial (Smart), Tianjiao Dai

Dissertations and Theses (Open Access)

ABSTRACT

FURTHER ADVANCES FOR THE SEQUENTIAL MULTIPLE ASSIGNMENT RANDOMIZED TRIAL (SMART)

Tianjiao Dai, M.S.

Advisory Professor: Sanjay Shete, Ph.D.

Sequential multiple assignment randomized trial (SMART) designs have been developed these years for studying adaptive interventions. In my Ph.D. study, I mainly investigate how to further improve SMART designs and optimize the interventions for each individual in the trial. My dissertation has focused on two topics of SMART designs.

1) Developing a novel SMART design that can reduce the cost and side effects associated with the interventions and proposing the corresponding analytic methods. I have developed a time-varying SMART design in …

Implementation Research On Community Health Workers’ Provision Of Maternal And Child Health Services In Rural Liberia, Peter W. Luckow, Avi Kenny, Emily White, Madeleine Ballard, Lorenzo Dorr, Kirby Erlandson, Benjamin Grant, Alice Johnson, Breanna Lorenzen, Subarna Mukherjee

Dartmouth Scholarship

OBJECTIVE:

To assess changes in the use of essential maternal and child health services in Konobo, Liberia, after implementation of an enhanced community health worker (CHW) programme.

METHODS:

The Liberian Ministry of Health partnered with Last Mile Health, a nongovernmental organization, to implement a pilot CHW programme with enhanced recruitment, training, supervision and compensation. To assess changes in maternal and child health-care use, we conducted repeated cross-sectional cluster surveys before (2012) and after (2015) programme implementation.

FINDINGS:

Between 2012 and 2015, 54 CHWs, seven peer supervisors and three clinical supervisors were trained to serve a population of 12 127 people …

Reply., Anthony M. Vintzileos Md, John C. Smulian Md, Mph

Department of Obstetrics & Gynecology

No abstract provided.

The Association Between Electronic Bullying And School Absenteeism Among High School Students In The United States, Erin Grinshteyn, Y. Tony Yang

Nursing and Health Professions Faculty Research and Publications

BACKGROUND: This study examines the relationship between exposure to electronic bullying and absenteeism as a result of being afraid. METHODS: This multivariate, multinomial regression analysis of the 2013 Youth Risk Behavior Survey data assessed the association between experiencing electronic bullying in the past year and how often students were absent in the last month due to feeling unsafe at/in transit to school. The model controlled for other predictors of school absence including demographics, physical / behavioral health, and risk factors. Missing data were multiply imputed. RESULTS: Electronic bullying was significantly associated with absences. Controlling for model covariates, the relative risk …

Re-Structuring University Hospital’S Internship Program Using Kern’S Six-Step Model Of Instructional Design, M. Tariq, Muhammad Shahzad Shamim, Amna Subhan Butt, Sana Saeed, Zia Ur Rehman, Barkat Virani, Asghar Ashraf, Irum Qamar, Farah Qamar, Raheela Mohsin Rizvi, Swaleha Tariq, Qurratulain Naeem

Department of Surgery Docs

Abstract Background: Internship is a phase of training wherein a graduate learns in the context of practice, acquiring skills under supervision so that he/she may become capable of functioning independently. We are reporting the process of curriculum restructuring for strengthening the Internship Program at this university hospital. Methodology: We used Kerns’ six-step model to evaluate and restructure the internship curriculum. Step 01: Problem Identification & General need assessment- Thorough literature review revealed Internship as the crucial year of training that needs to be fashioned around the competencies required to make good doctors

Cardio-Protection Afforded By Β-Blockade Is Maintained During Resistance Exercise, Alexander V. Ng, Jason M. Conviser, Shawn S. Rockey, D. Paul Thomas

Exercise Science Faculty Research and Publications

Objectives

Whether or not the cardio-protective effect of β-adrenergic blockade is retained during resistance exercise has not been systematically evaluated. Therefore the purpose of this study was to measure selected cardiorespiratory responses to isometric exercise involving hand-gripping, single-leg extension, or double-leg dead-lift, under placebo (control), β₁-selective (atenolol), and non-selective (propranolol) adrenergic blockade conditions.

Design

Eleven young male adults were evaluated in a randomized, double-blinded, repeated measures study design and performed all three exercise modalities at 30% of maximal voluntary contraction under placebo, atenolol and propranolol conditions.

Methods

Heart rate, systolic and diastolic blood pressure, rate-pressure product, oxygen uptake, …

Corticosterone Potentiation Of Cocaine-Induced Reinstatement Of Conditioned Place Preference In Mice Is Mediated By Blockade Of The Organic Cation Transporter 3, Jayme R. Mcreynolds, Analisa Taylor, Oliver Vranjkovic, Terra Ambrosius, Olivia Derricks, Brittany Nino, Beliz Kurtoglu, Robert A. Wheeler, David A. Baker, Paul J. Gasser, John R. Mantsch

Biomedical Sciences Faculty Research and Publications

The mechanisms by which stressful life events increase the risk of relapse in recovering cocaine addicts are not well understood. We previously reported that stress, via elevated corticosterone, potentiates cocaine-primed reinstatement of cocaine seeking following self-administration in rats and that this potentiation appears to involve corticosterone-induced blockade of dopamine clearance via the organic cation transporter 3 (OCT3). In the present study, we use a conditioned place preference/reinstatement paradigm in mice to directly test the hypothesis that corticosterone potentiates cocaine-primed reinstatement by blockade of OCT3. Consistent with our findings following self-administration in rats, pretreatment of male C57/BL6 mice with corticosterone (using …

Multilevel Modeling Of Binary Outcomes With Three-Level Complex Health Survey Data., Shafquat Rozi, Sadia Mahmud, Gillian Lancaster, Wilbur Hadden, Gregory Pappas

Community Health Sciences

Complex survey designs often involve unequal selection probabilities of clus-ters or units within clusters. When estimating models for complex survey data, scaled weights are incorporated into the likelihood, producing a pseudo likeli-hood. In a 3-level weighted analysis for a binary outcome, we implemented two methods for scaling the sampling weights in the National Health Survey of Pa-kistan (NHSP). For NHSP with health care utilization as a binary outcome we found age, gender, household (HH) goods, urban/rural status, community de-velopment index, province and marital status as significant predictors of health care utilization (p-value < 0.05). The variance of the random intercepts using scaling method 1 is estimated as 0.0961 (standard error 0.0339) for PSU level, and 0.2726 (standard error 0.0995) for household level respectively. Both esti-mates are significantly different from zero (p-value < 0.05) and indicate consid-erable heterogeneity in health care utilization with respect to households and PSUs. The results of the NHSP data analysis showed that all three analyses, weighted (two scaling methods) and un-weighted, converged to almost identical results with few exceptions. This may have occurred because of the large num-ber of 3rd and 2nd level clusters and relatively small ICC. We performed a sim-ulation study to assess the effect of varying prevalence and intra-class correla-tion coefficients (ICCs) on bias of fixed effect parameters and variance components of a multilevel pseudo maximum likelihood (weighted) analysis. The simulation results showed that the performance of the scaled weighted estimators is satisfactory for both scaling methods. Incorporating simulation into the analysis of complex multilevel surveys allows the integrity of the results to be tested and is recommended as good practice.

Childhood And Adolescent Obesity: Primary Health Care Physicians’ Perspectives From Riyadh, Saudi Arabia, Faiza Nasser Alotaibi, Majeedah Alotaibi, Shiakhah Alanazi, Hanan Al-Gethami, Deemah Alateeq, Rowaydah Mishiddi, Amna Rehana Siddiqui

Community Health Sciences

BACKGROUND & OBJECTIVES:

Primary health care (PHC) physicians are foremost to confront childhood and adolescent obesity. Our objective was to evaluate PHC Physicians perspectives for managing overweight/obesity in children and adolescents.

METHODS:

PHC services from eight public hospitals in Riyadh participated. A self-administered tool maintaining anonymity evaluated facilitators and barriers for managing overweight/obese children and adolescent patients. Physicians who 'always' recommended weight management for an overweight / obese patient during past year, by involving patient, parents, and others were classified as having positive and appropriate practice.

RESULTS:

Of the 58 respondents, 51.7% had appropriate practices. Lack of patient motivation (82.2%), …

Porous Magnesium-Based Scaffolds For Tissue Engineering, Mostafa Yazdimamaghani, Mehdi Razavi, Daryoosh Vashaee, Keyvan Moharamzadeh, Aldo R. Boccaccini, Lobat Tayebi

School of Dentistry Faculty Research and Publications

Significant amount of research efforts have been dedicated to the development of scaffolds for tissue engineering. Although at present most of the studies are focused on non-load bearing scaffolds, many scaffolds have also been investigated for hard tissue repair. In particular, metallic scaffolds are being studied for hard tissue engineering due to their suitable mechanical properties. Several biocompatible metallic materials such as stainless steels, cobalt alloys, titanium alloys, tantalum, nitinol and magnesium alloys have been commonly employed as implants in orthopedic and dental treatments. They are often used to replace and regenerate the damaged bones or to provide structural support …

Age-Dependent Absolute Abundance Of Hepatic Carboxylesterases (Ces1 And Ces2) By Lc-Ms/Ms Proteomics: Application To Pbpk Modeling Of Oseltamivir In Vivo Pharmacokinetics In Infants., Mikael Boberg, Marc Vrana, Aanchal Mehrotra, Robin E. Pearce, Andrea Gaedigk, Deepak Kumar Bhatt, J Steven Leeder, Bhagwat Prasad

Manuscripts, Articles, Book Chapters and Other Papers

The age-dependent absolute protein abundance of carboxylesterase (CES) 1 and CES2 in human liver was investigated and applied to predict infant pharmacokinetics (PK) of oseltamivir. The CES absolute protein abundance was determined by liquid chromatography-tandem mass spectrometry proteomics in human liver microsomal and cytosolic fractions prepared from tissue samples obtained from 136 pediatric donors and 35 adult donors. Two surrogate peptides per protein were selected for the quantification of CES1 and CES2 protein abundance. Purified CES1 and CES2 protein standards were used as calibrators, and the heavy labeled peptides were used as the internal standards. In hepatic microsomes, CES1 and …

Validation Of Respiratory Questionnaire For Lung Function Assessment Among An Occupational Group Of Textile Workers In Pakistan, Tanzil Jamali, Asaad Ahmed Nafees

Community Health Sciences

Objective: To determine the association of spirometric lung pattern with respiratory symptoms and to validate the American Thoracic Society respiratory questionnaire for lung function assessment among textile workers.
Methods: This cross-sectional survey was conducted from August to December 2009 among adult textile workers of Karachi. Data was collected through the American Thoracic Society Division of Lung Disease respiratory questionnaire and the lung function was assessed by using a spirometer. Results of three acceptable readings of spirogram were recorded and the best of the three readings was used for analysis. SPSS 19 was used for data analysis.
Results: There were 372 …

Moderating Effects Of Immunosuppressive Medications And Risk Factors For Post-Operative Joint Infection Following Total Joint Arthroplasty In Patients With Rheumatoid Arthritis Or Osteoarthritis, Elizabeth G. Salt, Amanda T. Wiggins, Mary Kay Rayens, Brent J. Morris, David M. Mannino, Andrew Hoellein, Ryan P. Donegan, Leslie J. Crofford

Nursing Faculty Publications

Objective—Inconclusive findings about infection risks, importantly the use of immunosuppressive medications, in patients who have undergone large-joint total joint arthroplasty challenge efforts to provide evidenced-based perioperative total joint arthroplasty recommendations to improve surgical outcomes. Thus, the aim of this study was to describe risk factors for developing a postoperative infection in patients undergoing TJA of a large joint [total hip arthroplasty, total knee arthroplasty, or total shoulder arthroplasty] by identifying clinical and demographic factors, including the use of high risk medications (i.e., prednisone and immunosuppressive medications) and diagnoses (i.e., rheumatoid arthritis [RA], osteoarthritis [OA], gout, obesity, diabetes mellitus), that …

A Randomized Controlled Pilot Trial Of Different Mobile Messaging Interventions For Problem Drinking, Frederick Muench, Katherine Van Stolk-Cooke, Alexis Kuerbis, Gertraud Stadler, Amit Baumel, Sijing Shao, James R. Mckay, Jon Morgenstern

Publications and Research

Introduction
Recent evidence suggests that text messaging may help to reduce problem drinking as an extension to in-person services, but very little is known about the effectiveness of remote messaging on problem drinking as a stand-alone intervention, or how different types of messages may improve drinking outcomes in those seeking to moderate their alcohol consumption.

Methods
We conducted an exploratory, single-blind randomized controlled pilot study comparing four different types of alcohol reduction-themed text messages sent daily to weekly drink self-tracking texts in order to determine their impact on drinking outcomes over a 12-week period in 152 participants (≈ 30 per …

A Word From The Writing Center (February 2017), Jennifer Wilson, Ms, Els

A Word From the Writing Team (Newsletter)

This issue includes:

• Writing tip
• Publishing news
• Writing Café

Mycotoxins In Sub-Saharan Africa: Present Situation, Socio-Economic Impact, Awareness, And Outlook, Patchimaporn Udomkun, Alexander Nimo Wiredu, Marcus Nagle, Ranajit Bandyopadhyay, Joachim Müller, Bernard Vanlauwe

All Peer-Reviewed Publications

Many studies have reported the occurrence of mycotoxin in human foods and animal feeds in Sub-Saharan Africa (SSA). Aflatoxins, ochratoxins, fumonisins, and zearalenone are among the most hazardous mycotoxins produced by fungal species, mainly in the genera Aspergillus, Penicillium, and Fusarium. Due to their high stability, mycotoxins are a cause of concern not only during crop production, but also in storage, transport, processing, and post-processing steps. Mycotoxin contamination is one factor that reduces the competitiveness of agricultural commodities from SSA for export. Moreover, these impurities negatively impact the health of humans and livestock which affects household security, livelihood, productivity, and …