Medicine and Health Sciences Commons^™

The Role Of Tgf-Β/Smad4 Signaling In Cancer, M Zhao, Lopa Mishra, C Deng

Surgery Faculty Publications

Transforming growth factor β (TGF-β) signaling pathway plays important roles in many biological processes, including cell growth, differentiation, apoptosis, migration, as well as cancer initiation and progression. SMAD4, which serves as the central mediator of TGF-β signaling, is specifically inactivated in over half of pancreatic duct adenocarcinoma, and varying degrees in many other types of cancers. In the past two decades, multiple studies have revealed that SMAD4 loss on its own does not initiate tumor formation, but can promote tumor progression initiated by other genes, such as KRAS activation in pancreatic duct adenocarcinoma and APC inactivation in colorectal cancer. In …

Surgical Management Of Symptomatic Intraluminal Duodenal Diverticulum In An Adolescent, Vivian Lam Saavedra, Timothy D. Kane, Stefany Garrity

Surgery Faculty Publications

No abstract provided.

A Primer On The Acute Management Of Intravenous Extravasation Injuries For The Plastic Surgeon, Connor Maly, Kenneth Fan, Gary F. Rogers, Benjamin Mitchell, June Amling, Kara Johnson, Laura Welch, Albert K. Oh, Jerry Chao

Surgery Faculty Publications

Intravenous therapy is a common practice among many specialties. Intravenous therapy extravasation is a potential complication to such therapy. Hospitals without a dedicated wound care team trained in these interventions will often default to plastic surgical consultation, making an understanding of available interventions essential to the initial evaluation and management of these injuries. The goal of this article was to provide plastic surgeons and health care providers with a general overview of the acute management of intravenous infiltration and extravasation injuries. Though the decision for surgical versus nonsurgical management is often a clear one for plastic surgeons, local interventions, and …

Baystate Medical Practices Annual Report - 2018, Andrew Artenstein Md

Baystate Medical Practices Annual Report

No abstract provided.

Practical Pearl: Adolescent Male Sexual Health - January 2018, Paula Braverman Md

Pediatrics Practical Pearls: Referral Guidelines for Common Problems

No abstract provided.

Clostridioides Difficile Testing Of Bedside And Shower Curtains In C Diff-Positive Patient Population Rooms, Peggy Brown Mph, Cic, Carolyn Adamo Bsn, Mba, Rn, Cic, Scott Stienecker Md, Facp, Fshea, Fidsa, Cic

Infection Control

A poster presentation for an environmental contamination project.

Research Question: Are curtains in a C diff-positive patient room a potential source of contamination and risk factor of C diff infection for subsequent patients?

Same Day Discharge For Non-Perforated Appendicitis In Children: An Updated Institutional Protocol, Tolulope A. Oyetunji Md Mph

Presentations

No abstract provided.

Community Health Worker Interventions To Promote Psychosocial Outcomes Among People Living With Hiv—A Systematic Review, H Han, K Kim, Jeanne Murphy, J Cudjoe, P Wilson, P Sharps, J Farley

Nursing Faculty Publications

Background

Community health worker (CHW) interventions are a successful strategy to promote health among HIV-negative and persons living with HIV (PLWH). Psychosocial factors are critical dimensions of HIV/AIDS care contributing to prognosis of the disease, yet it is unclear how CHW interventions improve psychosocial outcomes in PLWH. The purpose of this study was to critically appraise the types, scope, and nature of CHW interventions designed to address psychosocial outcomes in PLWH.

Methods

We performed database searches—PubMed, EMBASE, CINAHL, and Cochrane—to identify randomized controlled trials published in English before April 2017. Fourteen articles met the eligibility criteria.

Results

Half of the …

Loss Of The Intellectual Disability And Autism Gene Cc2d1a And Its Homolog Cc2d1b Differentially Affect Spatial Memory, Anxiety, And Hyperactivity, Marta Zamarbide, Adam Oaks, Heather Pond, Julia Adelman, M. Chiara Manzini

Pharmacology and Physiology Faculty Publications

Hundreds of genes are mutated in non-syndromic intellectual disability (ID) and autism spectrum disorder (ASD), with each gene often involved in only a handful of cases. Such heterogeneity can be daunting, but rare recessive loss of function (LOF) mutations can be a good starting point to provide insight into the mechanisms of neurodevelopmental disease. Biallelic LOF mutations in the signaling scaffold CC2D1Acause a rare form of autosomal recessive ID, sometimes associated with ASD and seizures. In parallel, we recently reported that Cc2d1a-deficient mice present with cognitive and social deficits, hyperactivity and anxiety. In Drosophila, loss of the only …

Optimization Of Wavelength Selection For Multispectral Image Acquisition: A Case Study Of Atrial Ablation Lesions, Huda Asfour, S. Guan, Narine Muselimyan, Luther M. Swift, Murray Loew, Narine Sarvazyan

Pharmacology and Physiology Faculty Publications

In vivo autofluorescence hyperspectral imaging of moving objects can be challenging due to motion artifacts and to the limited amount of acquired photons. To address both limitations, we selectively reduced the number of spectral bands while maintaining accurate target identification. Several downsampling approaches were applied to data obtained from the atrial tissue of adult pigs with sites of radiofrequency ablation lesions. Standard image qualifiers such as the mean square error, the peak signal-to-noise ratio, the structural similarity index map, and an accuracy index of lesion component images were used to quantify the effects of spectral binning, an increased spectral distance …

Hospital Care For Jews In Nineteenth-Century Amsterdam: The Emergence Of The First Jewish Hospitals, Jack Y. Vanderhoek

Biochemistry and Molecular Medicine Faculty Publications

In the early seventeenth century, the Jews formally established two separate communities in Amsterdam, the Portuguese Sephardi and the High German Ashkenazi congregations. Until the end of the eighteenth century, medical care for the Amsterdam indigent Jews had been controlled and regulated by the powerful Parnasim, the de facto rulers, of each community. The primary communal organizations that were exclusively responsible for medical care for the poor were the Bikur Holim societies. This approach for the care of the indigent Jewish sick became ineffective in the nineteenth century and was replaced by a hospital-based system. This essay describes how …

Absolute Lymphocyte And Neutrophil Counts In Neonatal Ischemic Brain Injury., Jessica M Povroznik, Elizabeth B Engler-Chiurazzi, Tania Nanavati, Paola Pergami

Neurology Faculty Publications

Objectives: This study aimed to identify differences in absolute neutrophils, lymphocytes, and neutrophil-to-lymphocyte ratio between neonates with two forms of ischemic brain injury, hypoxic-ischemic encephalopathy, and acute ischemic stroke, compared to controls. We also aimed to determine whether this neutrophil/lymphocyte response pattern is associated with disease severity or is a consequence of the effects of total-body cooling, an approved treatment for moderate-to-severe hypoxic-ischemic encephalopathy.

Methods: A retrospective chart review of 101 neonates with hypoxic-ischemic encephalopathy + total-body cooling (n = 26), hypoxic-ischemic encephalopathy (n = 12), acute ischemic stroke (n = 15), and transient tachypnea of the newborn (n = …

Mait Cells Are Activated In Acute Dengue Virus Infection And After In Vitro Zika Virus Infection., Dominic Paquin-Proulx, Vivian I Avelino-Silva, Bianca A N Santos, Nathália Silveira Barsotti, Fabiana Siroma, Douglas F Nixon, +Several Additional Authors

Microbiology, Immunology, and Tropical Medicine Faculty Publications

Dengue virus (DENV) and Zika virus (ZIKV) are members of the Flaviviridae and are predominantly transmitted via mosquito bites. Both viruses are responsible for a growing number of infections in tropical and subtropical regions. DENV infection can cause lethargy with severe morbidity and dengue shock syndrome leading to death in some cases. ZIKV is now linked with Guillain-Barré syndrome and fetal malformations including microcephaly and developmental disorders (congenital Zika syndrome). The protective and pathogenic roles played by the immune response in these infections is unknown. Mucosal-associated invariant T (MAIT) cells are a population of innate T cells with potent anti-bacterial …

Granulin Secreted By The Food-Borne Liver Fluke, Brandon Haugen, Shannon E Karinshak, Victoria H Mann, Anastas Popratiloff, Alex Loukas, Paul J Brindley, Michael J Smout

Microbiology, Immunology, and Tropical Medicine Faculty Publications

The liver fluke Opisthorchis viverrini is a food-borne, zoonotic pathogen endemic to Thailand and adjacent countries in Southeast Asia. The adult developmental stage of the O. viverrini parasite excretes and secretes numerous proteins within the biliary tract including the gall bladder. Lesions caused by the feeding activities of the liver fluke represent wounds that undergo protracted cycles of healing and re-injury during chronic infection, which can last for decades. Components of the excretory/secretory (ES) complement released by the worms capably drive proliferation of bile duct epithelial cells and are implicated in establishing the oncogenic milieu that leads to bile duct …

Granulin Secreted By The Food-Borne Liver Fluke Opisthorchis Viverrini Promotes Angiogenesis In Human Endothelial Cells, Brandon Haugen, Shannon Karinshak, Victoria H. Mann, Anastas Popratiloff, Alex Loukas, Paul J. Brindley, Michael J. Smout

Microbiology, Immunology, and Tropical Medicine Faculty Publications

The liver fluke Opisthorchis viverrini is a food-borne, zoonotic pathogen endemic to Thailand and adjacent countries in Southeast Asia. The adult developmental stage of the O. viverrini parasite excretes and secretes numerous proteins within the biliary tract including the gall bladder. Lesions caused by the feeding activities of the liver fluke represent wounds that undergo protracted cycles of healing and re-injury during chronic infection, which can last for decades. Components of the excretory/secretory (ES) complement released by the worms capably drive proliferation of bile duct epithelial cells and are implicated in establishing the oncogenic milieu that leads to bile duct …

Controlled Human Hookworm Infection: Accelerating Human Hookworm Vaccine Development, David Diemert, Doreen Campbell, Jill Brelsford, Caitlyn Leasure, Guangzhao Li, Naji Younes, +Several Additional Authors

Microbiology, Immunology, and Tropical Medicine Faculty Publications

Background

Controlled human hookworm infection (CHHI) is a central component of a proposed hookworm vaccination-challenge model (HVCM) to test the efficacy of candidate vaccines. Critical to CHHI is the manufacture of Necator americanus infective larvae (NaL3) according to current Good Manufacturing Practice (cGMP) and the determination of an inoculum of NaL3 that is safe and reliably induces patent infection. Methods

cGMP-grade NaL3 were produced for a phase 1 trial in 20 healthy, hookworm-naïve adults in the United States, who received either 25 or 50 NaL3. Participants were monitored for 12–18 weeks postinfection for safety, tolerability, …

Transplantation Of Schistosome Sporocysts Between Host Snails: A Video Guide., Gabriel Mouahid, Anne Rognon, Ronaldo De Carvalho Augusto, Patrick Driguez, Kathy Geyer, Shannon Karinshak, Nelia Luviano, Victoria Mann, Thomas Quack, Kate Rawlinson, George Wendt, Christoph Grunau, Hélène Moné

Microbiology, Immunology, and Tropical Medicine Faculty Publications

Schistosomiasis is an important parasitic disease, touching roughly 200 million people worldwide. The causative agents are different Schistosoma species. Schistosomes have a complex life cycle, with a freshwater snail as intermediate host. After infection, sporocysts develop inside the snail host and give rise to human dwelling larvae. We present here a detailed step-by-step video instruction in English, French, Spanish and Portuguese that shows how these sporocysts can be manipulated and transferred from one snail to another. This procedure provides a technical basis for different types of ex vivo modifications, such as those used in functional genomics studies.

Identification Of Unequally Represented Founder Viruses Among Tissues In Very Early Siv Rectal Transmission., Jian Chen, Yanqin Ren, Lance Daharsh, Lu Liu, Guobin Kang, Qingsheng Li, Qiang Wei, Yanmin Wan, Jianqing Xu

Microbiology, Immunology, and Tropical Medicine Faculty Publications

Characterizing the transmitted/founder (T/F) viruses of multi-variant SIV infection may shed new light on the understanding of mucosal transmission. We intrarectally inoculated six Chinese rhesus macaques with a single high dose of SIVmac251 (3.1 × 104 TCID50) and obtained 985 full-length env sequences from multiple tissues at 6 and 10 days post-infection by single genome amplification (SGA). All 6 monkeys were infected with a range of 2 to 8 T/F viruses and the dominant variants from the inoculum were still dominant in different tissues from each monkey. Interestingly, our data showed that a cluster of rare T/F viruses was unequally …

Comprehensive Antiretroviral Restriction Factor Profiling Reveals The Evolutionary Imprint Of The Ex Vivo And In Vivo Ifn-Β Response In Htlv-1-Associated Neuroinflammation, F Leal, S Menezes, E Costa, M Brailey, L Gama, Douglas F. Nixon, +Several Additional Authors

Microbiology, Immunology, and Tropical Medicine Faculty Publications

HTLV-1-Associated Myelopathy (HAM/TSP) is a progressive neuroinflammatory disorder for which no disease-modifying treatment exists. Modest clinical benefit from type I interferons (IFN-α/β) in HAM/TSP contrasts with its recently identified IFN-inducible gene signature. In addition, -α treatment in vivo decreases proviral load and immune activation in HAM/TSP, whereas IFN-β therapy decreases tax mRNA and lymphoproliferation. We hypothesize this "IFN paradox" in HAM/TSP might be explained by both cell type- and gene-specific effects of type I IFN in HTLV-1-associated pathogenesis. Therefore, we analyzed ex vivo transcriptomes of CD4+ T cells, PBMCs and whole blood in healthy controls, HTLV-1-infected individuals, and HAM/TSP patients. …

Sptransformer Proteins From The Purple Sea Urchin Opsonize Bacteria, Augment Phagocytosis, And Retard Bacterial Growth, H. Y. Chou, C. Lun, L. C. Smith

Microbiology, Immunology, and Tropical Medicine Faculty Publications

The purple sea urchin, Strongylocentrotus purpuratus, has a complex and robust immune system that is mediated by a number of multi-gene families including the SpTransformer (SpTrf) gene family (formerly Sp185/333). In response to immune challenge from bacteria and various pathogen-associated molecular patterns, the SpTrf genes are up-regulated in sea urchin phagocytes and express a diverse array of SpTrf proteins. We show here that SpTrf proteins from coelomocytes and isolated by nickel affinity (cNi-SpTrf) bind to Gram-positive and Gram-negative bacteria and to Baker’s yeast, Saccharomyces cerevisiae, with saturable kinetics and specificity. cNi-SpTrf opsonization of the marine bacteria, Vibrio diazotrophicus, augments phagocytosis, …

Diagnostic Performance Of Urinary Igg Antibody Detection: A Novel Approach For Population Screening Of Strongyloidiasis., Chatanun Eamudomkarn, Paiboon Sithithaworn, Christine Kamamia, Anna Yakovleva, Jiraporn Sithithaworn, Sasithorn Kaewkes, Anchalee Techasen, Watcharin Loilome, Puangrat Yongvanit, Chompunoot Wangboon, Prasert Saichua, Makoto Itoh, Jeffrey M Bethony

Microbiology, Immunology, and Tropical Medicine Faculty Publications

The diagnosis of strongyloidiasis by coprological methods has a low sensitivity, underestimating the prevalence of Strongyloides stercoralis in endemic areas. Serodiagnostic tests for strongyloidiasis have shown robust diagnostic properties. However, these methods require a blood draw, an invasive and labor-intensive sample collection method, especially in the resource-limited settings where S. stercoralis is endemic. Our study examines a urine-based assay for strongyloidiasis and compares its diagnostic accuracy with coprological and serological methods. Receiver operating characteristic (ROC) curve analyses determined the diagnostic sensitivity (D-Sn) and specificity (D-Sp) of the urine ELISA, as well as estimates its positive predictive value and diagnostic risk. …

Acute Cardiac Air Embolism, Leslie Billello, Brian Gacioch, James P. Phillips

Emergency Medicine Faculty Publications

No abstract provided.

Optimal Implementation Of Prescription Drug Monitoring Programs In The Emergency Department, Joshua Elder, Garrett Depalma, Jesse M. Pines

Emergency Medicine Faculty Publications

The opioid epidemic is the most significant modern-day, public health crisis. Physicians and lawmakers have developed methods and practices to curb opioid use. This article describes one method, prescription drug monitoring programs (PDMP), through the lens of how to optimize use for emergency departments (ED). EDs have rapidly become a central location to combat opioid abuse and drug diversion. PDMPs can provide emergency physicians with comprehensive prescribing information to improve clinical decisions around opioids. However, PDMPs vary tremendously in their accessibility and usability in the ED, which limits their effectiveness at the point of care. Problems are complicated by varying …

The Accuracy Of Point-Of-Care Ultrasound In Detecting Small Bowel Obstruction In Emergency Department, Ali Pourmand, Ubah Dimbil, A. Drake, Hamid A. Shokoohi

Emergency Medicine Faculty Publications

Radiological imaging plays an essential role in the evaluation of a patient with suspected small bowel obstruction (SBO). In a few studies, point-of-care ultrasound (POCUS) has been utilized as a primary imaging modality in patients with suspected SBO. POCUS has been shown to be an accurate tool in the diagnosis of SBO with multiple research studies noting a consistent high sensitivity with a range of 94–100% and specificity of 81–100%. Specific sonographic findings that increase the likelihood of SBO include dilatation of small bowel loops > 25 mm, altered intestinal peristalsis, increased thickness of the bowel wall, and intraperitoneal fluid accumulation. …

Simulation-Based Training In Ebola Personal Protective Equipment For Healthcare Workers: Experience From King Abdulaziz University Hospital In Saudi Arabia, Jameel Abualenain, M. Al-Alawi

Emergency Medicine Faculty Publications

Background: Millions of Muslims from across the world gather annually to perform pilgrimage. This can import unusual communicable diseases such as Ebola. Communicable diseases with a high risk of mortality necessitate special training to master the required competency to avert transmission of infections. The efficacy of simulation-based training (SBT) has been shown in such circumstances. Objective: We sought to develop an SBT program in Ebola Personal Protective Equipment (PPE) for all healthcare workers (HCWs). Methods: We conducted a quasi-experimental study at the clinical skills and simulation center at the King Abdulaziz University. An interdisciplinary committee was formed to develop this …

International Scope Of Emergency Ultrasound: Barriers In Applying Ultrasound To Guide Central Line Placement By Providers In Nairobi, Kenya, Fareen Zaver, Keith S. Boniface

Emergency Medicine Faculty Publications

Background

While ultrasound (US) use for internal jugular central venous catheter (CVC) placement is standard of care in North America, most developing countries have not adopted this practice. Previous surveys of North American physicians have identified lack of training and equipment availability as the most important barriers to the use of US. Go to:

Objective

We sought to identify perceived barriers to the use of US to guide CVC insertion in a resource-constrained environment. Go to:

Methods

Prior to an US-guided CVC placement training course conducted at the Aga Khan University Hospital in Nairobi, Kenya, physicians were asked to complete …

Fusion, 2018, George Washington University, William H. Beaumont Medical Research Honor Society

Fusion

No abstract provided.

A Web Application To Increase Interest In Treatment Among Problem Drinkers, Daniel Z. Lieberman, Sheela Kadekar, Suena W. Huang, Melissa Lausin

Psychiatry and Behavioral Sciences Posters and Presentations

Problem: Access to treatment for substance abuse disorders is limited, and practical strategies are needed to expand opportunities for individuals to receive effective interventions.

Approach: Can an automated, online program reach a hidden population of alcohol abusers who are not served by currently available treatment programs, and increase their interest in treatment?

Comparison Of Alcohol Abusers Who Seek Traditional Treatment Versus Those Who Use An Online Program, Suena Huang, Daniel Z. Lieberman

Psychiatry and Behavioral Sciences Posters and Presentations

Problem: Access to treatment for substance abuse disorders is limited, and practical strategies are needed to expand opportunities for individuals to receive effective interventions.

Approach: Can an automated, online program reach a hidden population of alcohol abusers who are not served by currently available treatment programs?

The majority of individuals with alcohol use disorders do not receive treatment. Practical strategies are needed to expand opportunities for individuals to receive effective interventions. An online program was designed to increase users’ motivation for change, and users of this program were compared to a traditional help-seeking population. Data was collected from 1,297 individuals …

Predicting User Preferences For Educational Content Based On The Results Of An Automated Evaluation For Alcohol Use Problems, Daniel Z. Lieberman, Vilmaris Quinones Cardona, Kenneth Williams

Psychiatry and Behavioral Sciences Posters and Presentations

Computer programs may be more effective than traditional selfhelp manuals because they are interactive, and can automatically modify their content to meet the specific needs of a user. Successfully predicting the type of information that will be most relevant to an individual may lead to greater engagement with the program and better outcomes. The current study tests the association of information obtained during an automated evaluation for alcohol use problems with subsequent preference for educational modules.