Medicine and Health Sciences Commons^™

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 …

Coinfection With Lichtheimia Corymbifera And Aspergillus Flavus In An Immune-Competent Patient Mimicking As Pulmonary-Renal Syndrome, Ali Bin Sarwar Zubairi, Farah Idress, Kauser Jabeen, Saima Kamal, Afia Zafar

Department of Medicine

Lichtheimia corymbifera and Aspergillus flavus pulmonary coinfection has been rarely reported in immune-competent patients. We report case of a young male who presented with clinical features of pulmonary-renal syndrome and was later diagnosed to have bilateral polymicrobial fungal lung infection.

Barriers And Perceptions Regarding Code Status Discussion With Families Of Critically Ill Patients In A Tertiary Care Hospital Of A Developing Country: A Cross-Sectional Study, Ahsan A. Syed, Aysha Almas, Quratulain Naeem, Umer F. Malik, M. Tariq

Department of Medicine

Background: In Asian societies including Pakistan, a complex background of illiteracy, different familial dynamics, lack of patient’s autonomy, religious beliefs, and financial constraints give new dimensions to code status discussion. Barriers faced by physicians during code status discussion in these societies are largely unknown.
Aim: To determine the barriers and perceptions in discussion of code status by physicians.
Design: Questionnaire-based cross-sectional study.
Setting and participants: This study was conducted in the Department of Medicine of The Aga Khan University Hospital, Karachi, Pakistan. A total of 134 physicians who had discussed at least five code statuses in their lifetime were included. …

Establishment And Development Of The Intestinal Microbiota Of Preterm Infants In A Lebanese Tertiary Hospital, Tarek Itani, Carole Ayoub Moubareck, Imad Melki, Clotilde Rousseau, Irène Mangin, Marie José Butel, Dolla Karam Sarkis

All Works

© 2016 The Authors The establishment and development of the intestinal microbiota is known to be associated with profound short- and long-term effects on the health of full-term infants (FTI), but studies are just starting for preterm infants (PTI). The data also mostly come from western countries and little information is available for the Middle East. Here, we determined the composition and dynamics of the intestinal microbiota during the first month of life for PTI (n = 66) and FTI (n = 17) in Lebanon. Fecal samples were collected weekly and analyzed by quantitative PCR (q-PCR) and temporal temperature gradient …

Implicit Family Process Rules Specific To Eating-Disordered Families, Mallory Rebecca Wolfgramm

Theses and Dissertations

Family environment is a significant factor in the development of eating disorders in young-adult females. Clinical experience, research and theories about eating disorders indicate that constrictive implicit process rules within a family are correlated with eating-disordered families. This study identified implicit family process rules that are unique to eating-disordered families and how well these rules predict membership in eating-disordered and non-eating-disordered families. One hundred and two families (51 eating-disordered and 51 comparison families) participated in the study. Mothers, fathers, young-adult female children, and siblings in each family completed the Family Implicit Rules Profile (FIRP). The design included cluster analysis of …

Feticide And Us Law, Gerard V. Bradley

Journal Articles

That abortion kills someone with a right-to-life has become easier to see since Roe v. Wade. Progress in scientific research and medical practice has made both birth and viability unrealistic criteria for demarcating between human life, which demands moral respect, and merely “potential life” which does not have moral or legal equivalency with maternal interest. The Eighth Circuit recently criticized the use of viability as a litmus test because it “tied a state’s interest in unborn children to developments in obstetrics, not to developments in the unborn.” The near-ubiquity of sonograms has probably done more than intellectual arguments to …

Strategies For Successful Stroke Survey., Erin M. Conahan Rn, Cnrn, Claranne Mathiesen Rn, Msn, Cnrn

Patient Care Services / Nursing

No abstract provided.

Challenges To Smartphone Applications For Melanoma Detection, Jordan V. Wang, Lance W. Chapman, Matthew S. Keller

Department of Dermatology and Cutaneous Biology Faculty Papers

This commentary addresses the emerging market for health-related smartphone applications. Specific to dermatology, there has been a significant increase not only in applications that promote skin cancer awareness and education but also in those meant for detection. With evidence showing that 365 dermatology-related applications were available in 2014--up from 230 in 2012--and that 1 in 5 patients under the age of 50 have used a smartphone to help diagnose a skin problem, there is clearly a large subset of patients participating in this growing trend. Therefore, we are obligated to take a closer look into this phenomenon. Studies have shown …

Parental Perception And Childhood Obesity: Contributors To Incorrect Perception, Hiba Ashraf, Nida Ilyas Shamsi, Ruhma Ashraf

Medical College Documents

Objectives: To determine parental recognition of their child's weight, and to identify the contributing reasons for incorrect perception.

Method: This cross-sectional study was conducted from April to October 2010 at Aga Khan University Hospital, Karachi, and comprised parents of healthy children aged 5-14 years. An interviewer-based pre-tested questionnaire consisting of socio-demographic details, anthropometric measurements, and parental perception about their child's weight was administered. Data was analysed using SPSS 21. Both univariate and multivariate logistic regression were applied to assess for the risk factors associated with incorrect parental perception.

Results: Parents of a total of 330 eligible children …

Treatment Outcomes For Inpatients With Obsessive-Compulsive Personality Disorder: An Open Comparison Trial, Ryan Smith, Christopher Shepard, Anika Wiltgen, Katrina Rufino, J Christopher Fowler

Staff and Researcher Publications

Background: The current case-control study compared rates of clinically significant and reliable change in psychopathology and global functioning, prevalence of clinical deterioration, and rates of symptom remission among adult patients with obsessive compulsive personality disorder OCPD (n=52) and well-matched inpatients with any other personality disorder (n=56) and no personality disorder (n=53).

Methods: Propensity score matching (PSM) was utilized to select patients matched on specific criteria present in the OCPD group. Multivariate analysis of variance models measured differences in admission functioning and RCI change across depression and anxiety severity, emotion dysregulation and suicidal ideation.

Results: Patients diagnosed with OCPD admit to …

Fare Thee Well, Dr Cooley, Herbert L Fred, James T Willerson

The Texas Heart Institute Journal

No abstract provided.

Clinical Risk Factors For Infective Endocarditis In Staphylococcus Aureus Bacteremia, Vincent Bryan D Salvador, Bikash Chapagain, Astha Joshi, Debra J Brennessel

The Texas Heart Institute Journal

Crucial to the management of staphylococcal bacteremia is an accurate evaluation of associated endocarditis, which has both therapeutic and prognostic implications. Because the clinical presentation of endocarditis can be nonspecific, the judicious use of echocardiography is important in distinguishing patients at high risk of developing endocarditis. In the presence of high-risk clinical features, an early transesophageal echocardiogram is warranted without prior transthoracic echocardiography.

The purpose of this study was to investigate the clinical risk factors for staphylococcal infective endocarditis that might warrant earlier transesophageal echocardiography and to describe the incidence of endocarditis in cases of methicillin-resistant and methicillin-sensitive Staphylococcus aureus …

Titanium Plug Closure After Heartware Ventricular Assist Device Explantation In A 15-Year-Old Girl: First Us Experience, Diego A Lara, Aamir Jeewa, Barbara A Elias, Elizabeth O Mccullum, Susan W Denfield, William J Dreyer, Iki Adachi

The Texas Heart Institute Journal

We describe the case of a teenage girl with anthracycline-induced cardiomyopathy who received a HeartWare ventricular assist device and underwent successful device explantation after cardiac recovery. During device support, the patient's cardiac function returned to normal. Twelve months after implantation, we explanted the device via repeat median sternotomy. To close the hole in the left ventricular apex and preserve the sewing ring in case future device support is needed, we used a German-manufactured titanium plug, developed specifically for this purpose. To our knowledge, this is the first use of this plug in the United States. The patient recovered uneventfully and …

Percutaneous Valvuloplasty For Bioprosthetic Tricuspid Valve Stenosis, Gaurav Rana, Rohit Malhotra, Anjali Sharma, Nikolaos Kakouros

The Texas Heart Institute Journal

Percutaneous transcatheter tricuspid balloon valvuloplasty (PTTBV) is an accepted treatment option for symptomatic severe native tricuspid valve stenosis, although surgical tricuspid valve replacement remains the treatment of choice. There have been few reports of successful PTTBV for bioprosthetic tricuspid valve stenosis. We present case reports of 3 patients from our hospital experience. Two of the 3 cases were successful, with lasting clinical improvement, whereas the 3rd patient failed to show a reduction in valve gradient. We describe the standard technique used for PTTBV. We present results from a literature review that identified 16 previously reported cases of PTTBV for bioprosthetic …

Cancer Antigen 125 Is Associated With Length Of Stay In Patients With Acute Heart Failure, Hakki Kaya, Recep Kurt, Osman Beton, Ali Zorlu, Hasan Yucel, Hakan Gunes, Didem Oguz, Mehmet Birhan Yilmaz

The Texas Heart Institute Journal

Length of stay is the primary driver of heart-failure hospitalization costs. Because cancer antigen 125 has been associated with poor morbidity and mortality rates in heart failure, we investigated the relationship between admission cancer antigen 125 levels and lengths of stay in heart-failure patients. A total of 267 consecutive patients (184 men, 83 women) with acute decompensated heart failure were evaluated prospectively. The median length of stay was 4 days, and the patients were classified into 2 groups: those with lengths of stay ≤4 days and those with lengths of stay >4 days. Patients with longer lengths of stay had …

Combined Genome-Wide Linkage And Targeted Association Analysis Of Head Circumference In Autism Spectrum Disorder Families, M. Woodbury-Smith, D. A. Bilder, J. Morgan, L. Jerominski, T. Darlington, Thomas D. Dyer, A. D. Paterson, H. Coon

School of Medicine Publications

Background: It has long been recognized that there is an association between enlarged head circumference (HC) and autism spectrum disorder (ASD), but the genetics of HC in ASD is not well understood. In order to investigate the genetic underpinning of HC in ASD, we undertook a genome-wide linkage study of HC followed by linkage signal targeted association among a sample of 67 extended pedigrees with ASD.

Methods: HC measurements on members of 67 multiplex ASD extended pedigrees were used as a quantitative trait in a genome-wide linkage analysis. The Illumina 6K SNP linkage panel was used, and analyses were carried …

Cynomolgus Macaques Naturally Infected With Trypanosoma Cruzi-I Exhibit An Overall Mixed Pro-Inflammatory/Modulated Cytokine Signature Characteristic Of Human Chagas Disease, Danielle Marquete Vitelli-Avelar, Renato Sathler-Avelar, Armanda Moreira Mattoso-Barbosa, Nicolas Gouin, Marcelo Perdigão-De-Oliveira, Leydiane Valério-Dos-Reis, Ronaldo Peres Costa, Silvana Maria Elói-Santos, Jane F. Vandeberg, John Vandeberg

School of Medicine Publications

Background: Non-human primates have been shown to be useful models for Chagas disease. We previously reported that natural T. cruzi infection of cynomolgus macaques triggers clinical features and immunophenotypic changes of peripheral blood leukocytes resembling those observed in human Chagas disease. In the present study, we further characterize the cytokine-mediated microenvironment to provide supportive evidence of the utility of cynomolgus macaques as a model for drug development for human Chagas disease.

Methods and findings: In this cross-sectional study design, flow cytometry and systems biology approaches were used to characterize the ex vivo and in vitro T. cruzi-specific functional cytokine signature …

The Midwest Interprofessional Practice, Education, And Research Center: A Regional Approach To Innovations In Interprofessional Education And Practice, Jean Nagelkerk, Peter Coggan, Brenda Pawl, Margaret Thompson

Open Access Publishing Support Funded Articles

New models for delivering health care services are essential to the development of an environment where interprofessional teams work together collaboratively to provide quality care to communities. This article describes the history and development of the Midwest Interprofessional Practice, Education, and Research Center (MIPERC), a unique partnership among academic institutions, health professionals from multiple disciplines, and diverse practice partners. The Center provides an inter-institutional infrastructure for the development and implementation of interprofessional education and practice. As part of the infrastructure, a model has been developed as a guiding framework for the Center emphasizing the core competency domains of the Institute …

State-Dependent And -Independent Effects Of Dialyzing Excitatory Neuromodulator Receptor Antagonists Into The Ventral Respiratory Column, Thomas M. Langer Iii, Suzanne E. Neumueller, Emma Crumley, Nicholas J. Burgraff, Sawan Talwar, Matthew R. Hodges, Lawrence Pan, Hubert V. Forster

Physical Therapy Faculty Research and Publications

Unilateral dialysis of the broad-spectrum muscarinic receptor antagonist atropine (50 mM) into the ventral respiratory column [(VRC) including the pre-Bötzinger complex region] of awake goats increased pulmonary ventilation (V̇i) and breathing frequency (f), conceivably due to local compensatory increases in serotonin (5-HT) and substance P (SP) measured in effluent mock cerebral spinal fluid (mCSF). In contrast, unilateral dialysis of a triple cocktail of antagonists to muscarinic (atropine; 5 mM), neurokinin-1, and 5-HT receptors does not alter V̇i or f, but increases local SP. Herein, we tested hypotheses that 1) local compensatory 5-HT and SP responses to 50 mM atropine …

Aids Awareness Interventions For Women: The Role Of Voluntary Organizations In The Secunderabad And Hyderabad Region Of Southwestern India, G.S. Chayadevi, Bindu A. Bambah

Journal of International Women's Studies

In this paper, we examine the role of Voluntary organizations (VO’s) in combating the incidence of HIV/AIDS and Sexually Transmitted Diseases among Female Sex Workers in Hyderabad and Secundrabad. These are twin cities in the newly formed state of Telangana state in the southwestern region of India, called the Deccan Plateau. We trace the evolution of VO’s towards becoming agents of information and prevention of AIDS in the region. Our focus is on how VOs’ interventions impact the prevention of HIV among female sex workers. The activities that contribute towards this aim are sexual health, counseling, medication and continuous health …

Reproductive Health And Human Rights: Lessons From Ireland, Tanya Saroj Bakhru

Journal of International Women's Studies

The years between 2008-2013 were a period of economic austerity and ideological turmoil in Ireland. Alongside the tragic death of Savita Halappanavar, a woman who died in 2012 due to complications resulting from her refused request for an abortion in an Irish hospital, economic, political and ideological forces converged to promote a tipping point in the demand for full sexual and reproductive rights for women in Ireland. Within this temporal moment, a “convergence of various economic, political and ideological forces that make possible the emergence of specific kinds of practices” (Barndt, 2008, p. 36), the Irish Family Planning Association …

Holocaust Remembrance Day Presentation Available In The Jefferson Digital Commons, Daniel G. Kipnis, Msi

Jefferson Digital Commons News

A commemoration of the Holocaust was held at Thomas Jefferson University on January 27, the anniversary of the day that prisoners were liberated from the Auschwitz-Birkenau concentration camp in 1945. The program “Nazi Medicine, the Holocaust, and the Problem of Collective Evil”, featured a presentation by Salvatore Mangione, MD, Associate Professor of Medicine, Sidney Kimmel Medical College. Mangione discussed why study of the horrors of the Holocaust is especially important for medicine. A recording of the presentation, Group Thinking and the Roots of Collective Evil Implications for Health Care, is available in the Jefferson Digital Commons.

Safety And Improvement Of Movement Function After Stroke With Atomoxetine: A Pilot Randomized Trial, Andrea Ward, Cheryl Carrico, Elizabeth Powell, Philip M. Westgate, Laurie Nichols, Anne Fleischer, Lumy Sawaki

Physical Medicine and Rehabilitation Faculty Publications

Background: Intensive, task-oriented motor training has been associated with neuroplastic reorganization and improved upper extremity movement function after stroke. However, to optimize such training for people with moderate-to-severe movement impairment, pharmacological modulation of neuroplasticity may be needed as an adjuvant intervention.

Objective: Evaluate safety, as well as improvement in movement function, associated with motor training paired with a drug to upregulate neuroplasticity after stroke.

Methods: In this double-blind, randomized, placebo-controlled study, 12 subjects with chronic stroke received either atomoxetine or placebo paired with motor training. Safety was assessed using vital signs. Upper extremity movement function was assessed using Fugl-Meyer Assessment, …

Quality Control By Isoleucyl-Trna Synthetase Of Bacillus Subtilis Is Required For Efficient Sporulation, Elizabeth Kermgard, Zhou Yang, Annika-Marisa Michel, Rachel Simari, Jacqueline Wong, Michael Ibba, Beth A. Lazazzera

Biology, Chemistry, and Environmental Sciences Faculty Articles and Research

Isoleucyl-tRNA synthetase (IleRS) is an aminoacyl-tRNA synthetase whose essential function is to aminoacylate tRNA^Ile with isoleucine. Like some other aminoacyl-tRNA synthetases, IleRS can mischarge tRNA^Ile and correct this misacylation through a separate post-transfer editing function. To explore the biological significance of this editing function, we created a ileS(T233P) mutant of Bacillus subtilis that allows tRNA^Ile mischarging while retaining wild-type Ile-tRNA^Ile synthesis activity. As seen in other species defective for aminoacylation quality control, the growth rate of the ileS(T233P) strain was not significantly different from wild-type. When the ileS(T233P) strain was assessed for its ability to promote …

Get A Grip: Analysis Of Muscle Activity And Perceived Comfort In Using Stylus Grips, Evanda Vanease Henry

Theses

The design of handwriting instruments has been based primarily on touch, feel, aesthetics, and muscle exertion. Previous studies make it clear that different pen characteristics have to be considered along with hand-instrument interaction in the design of writing instruments. This should include pens designed for touch screens and computer based writing surfaces. Hence, this study focuses primarily on evaluating grip style’s impact on user comfort and muscle activity associated with handgrip while using a stylus-pen.

Surface EMG measures were taken approximate to the adductor pollicis, flexor digitorum, and extensor indicis of eight participants while they performed writing, drawing, and point-and-click …

Novel Experimental Method For The Determination Of The Minimum Agitation Speed For Solids Suspension In Flat-Bottomed Stirred Tank Reactors, Shriarjun Shastry

Theses

Knowledge of the minimum agitation speed, Njs, required to suspend finely divided solids in vessels stirred by an impeller is a critical parameter to properly operate industrial tanks in a large number of industrial operations. The most common experimental approach to measure N_js is that of Zwietering’s (Chem. Eng. Sci., 1958, 8, 244-253), consisting of visually inspecting the tank bottom and visually determining the impeller agitation speed at which the solids are observed to rest on the tank bottom for no more than 1-2 seconds before being swept away. This method is quite reliable, but a method …

Trait Anxiety And Economic Risk Avoidance Are Not Necessarily Associated: Evidence From The Framing Effect, Ruolei Gu, Runguo Wu, Lucas S. Broster, Yang Jiang, Rui Xu, Qiwei Yang, Pengfei Xu, Yue-Jia Luo

Behavioral Science Faculty Publications

According to previous literature, trait anxiety is related to the tendency to choose safety options during risk decision-making, that is, risk avoidance. In our opinion, anxious people’s risk preference might actually reflect their hypersensitivity to emotional information. To examine this hypothesis, a decision-making task that could elicit the framing effect was employed. The framing effect indicates that risk preference could be modulated by emotional messages contained in the description (i.e., frame) of options. The behavioral results have showed the classic framing effect. In addition, individual level of trait anxiety was positively correlated with the framing effect size. However, trait anxiety …

The Slow Food Movement: A 'Big Tent' Ideology, Mark N. Wexler, Judy Oberlander, Arjun Shankar

Journal of Ideology

The Slow Food Movement (SFM) has been characterized as a reminder of the centrality of the kitchen in the “good old days”. It has also been referred to as a poor use of science posing as a rallying point for the beleaguered middle class trying to reclaim psychological territory lost to the fast-paced commercialization of what was once private or leisure time. This paper argues that both these criticisms contain more than a kernel of truth. However, each misses the mark when it comes to explaining the relative successes of SFM. In this paper, we explore SFM’s basic ideological premises. …

Novel Compound, 84f2, Inhibits Calmodulin Deficient Ryr2, Robert Carl Klipp

Dissertations and Theses

The cardiac ryanodine receptor (RyR2) plays a key role in excitation-contraction coupling (ECC). Mutations in RyR2 are known to be linked to the arrhythmogenic disorder, catecholaminergic polymorphic ventricular tachycardia (CPVT), a deadly disease which is characterized by a leak of calcium from sarcoplasmic reticulum and a decrease in calmodulin (CaM) binding. A novel drug, 84F2, shown to inhibit arrhythmias in RyR2-R176Q heterozygous CPVT mouse hearts (2.5 µg/kg), decrease spark frequency in cells derived from CPVT mice (IC₅₀ = 35 nM), and inhibit RyR2 single channel activity at low nanomolar concentrations (IC₅₀ = 8 nM). When CaM is added …