Medicine and Health Sciences Commons^™

Science Alive, Allan Barraza, Ahjay Bhatia, Gwen Bui, Sophia Nguyen

Trick to the Treat of Internships and Research

Program Overview:

• Introduces STEM concepts to young students
• Encourage their pursuit of higher education
• Be role models
• Make friends

Cleveland Clinic Summer Scholar Program, Mahnoor Asif

Trick to the Treat of Internships and Research

Program Overview:

• The program lasts a total of 6 weeks, and you rotate through 3 different departments
• Dress code: Business professional attire + Cleveland Clinic white coat
• Every day will be different in terms of activity and length depending on your rotation site, if you have to do rounds, how early your first patient is coming into the clinic, etc. However, an average day will be from 8:30 a.m. - 5:30 p.m.

Protein Modeling, Alesa Chabbra

Trick to the Treat of Internships and Research

Program Overview:

• The program is designed to answer the question "How can modeling using protein visualization software and 3D printing best demonstrate links between protein structure and function?"
• Done in collaboration with CREST and Center for BioMolecular Modeling

The Ties That Bind: Cradling In Tajikistan, Lana B. Karasik, Catherine S. Tamis-Lemonda, Ori Ossmy, Karen E. Adolph

Publications and Research

A traditional childrearing practice—“gahvora” cradling—in Tajikistan and other parts of Central Asia purportedly restricts movement of infants’ body and limbs. However, the practice has been documented only informally in anecdotal reports. Thus, this study had two research questions: (1) To what extent are infants’ movements restricted in the gahvora? (2) How is time in the gahvora distributed over a 24-hour day in infants from 1–24 months of age? To answer these questions, we video-recorded 146 mothers cradling their infants and interviewed them using 24-hour time diaries to determine the distribution of time infants spent in the gahvora within a day …

A Learning Collaborative Approach To Improve Mental Health Service Delivery In Pediatric Primary Care., Rebecca A Baum, Divya Manda, Courtney M Brown, Samantha A Anzeljc, Melissa A King, John Duby

Ambulatory and Primary Care Articles

BACKGROUND: Pediatric primary care practitioners (PPCPs) report inadequate training in the care of children with common mental health conditions. Although additional training is needed, system changes are also necessary to support improvements in care.

METHODS: We developed the Building Mental Wellness Learning Collaborative to assist PPCPs in delivering better mental health services in primary care by targeting 5 focus areas: mental health promotion; early identification and screening; practitioner skills; collaboration and community linkages; and medication management. Aims were developed for each area.

RESULTS: Twenty-one practices and 50 practitioners completed the collaborative in 2 seven-month waves. For mental health promotion, ≥85% …

Longitudinal Screening Detects Cognitive Stability And Behavioral Deterioration In Als Patients, Susan Woolley, Ray Goetz, Pam Factor-Litvak, Jennifer Murphy, Jonathan Hupf, Catherine Lomen-Hoerth, Howard Andrews, Daragh Heitzman, Richard Bedlack, Jonathan Katz, Richard Barohn, Eric Sorenson, Bjorn Oskarsson, Americo Fernandes Filho, Edward J. Kasarskis, Tahseen Mozaffar, Sharon Nations, Andrea Swenson, Agnes Koczon-Jaremko, Georgia Christodoulou, Hiroshi Mitsumoto

Neurology Faculty Publications

Objective. To evaluate longitudinal cognitive/behavioral change over 12 months in participants enrolled in the ALS Multicenter Cohort Study of Oxidative Stress (ALS COSMOS). Methods. We analyzed data from 294 ALS participants, 134 of whom were studied serially. Change over time was evaluated controlling for age, sex, symptom duration, education, race, and ethnicity. Using multiple regression, we evaluated associations among decline in ALS Functional Rating Scale-Revised (ALSFRS-R) scores, forced vital capacity (FVC), and cognitive/behavioral changes. Change in cognitive/behavioral subgroups was assessed using one-way analyses of covariance. Results. Participants with follow-up data had fewer baseline behavior problems compared to patients …

Hyperhomocysteinemia As A Risk Factor For Vascular Contributions To Cognitive Impairment And Dementia, Brittani R. Price, Donna M. Wilcock, Erica M. Weekman

Physiology Faculty Publications

Behind only Alzheimer’s disease, vascular contributions to cognitive impairment and dementia (VCID) is the second most common cause of dementia, affecting roughly 10–40% of dementia patients. While there is no cure for VCID, several risk factors for VCID, such as diabetes, hypertension, and stroke, have been identified. Elevated plasma levels of homocysteine, termed hyperhomocysteinemia (HHcy), are a major, yet underrecognized, risk factor for VCID. B vitamin deficiency, which is the most common cause of HHcy, is common in the elderly. With B vitamin supplementation being a relatively safe and inexpensive therapeutic, the treatment of HHcy-induced VCID would seem straightforward; however, …

Reading Nutrition Labels: A Predictor Of Health And Wealth?, Barbara O'Neill, Jing Jian Xiao, Karen Ensle

Journal of Human Sciences and Extension

This study explored relationships between the practice of reading Nutrition Facts labels on food products and the frequency of performance of 19 positive health and financial practices. Data were collected using an online survey with 3,361 observations that provided a simultaneous assessment of the participating individuals’ health and financial practices. Few publicly-available instruments of this type exist. The reliability of the overall scale used in this study was .845. Support was found for three hypotheses: there are differences in demographic characteristics between those who read Nutrition Facts labels and others and respondents who reported reading nutrition labels had both higher …

Guided Goal Setting: A Feasible Obesity Prevention Behavior Change Strategy For Low-Income Parents With Young Children, Mical K. Shilts, Stephanie L. Sitnic, Lenna Ontai, Marilyn S. Townsend

Journal of Human Sciences and Extension

To reduce the risk of pediatric obesity, behaviorally-focused parental education is needed. This study examined the feasibility of guided goal setting in a pediatric obesity prevention intervention for low-income parents of young children. Parents from Head Start participated in a six-week nutrition, activity, and parenting intervention that included guided goal setting (N = 47). At each session, data were collected on goal selection, effort, and attainment. Pre- and postintervention data were collected on nutrition, activity, and child feeding behaviors (n = 24). A subset of parents completed in-depth interviews (n = 20). Parents reported a high level of goal effort …

Initiative 427: Nebraska Medicaid Expansion, J. David Aiken

Cornhusker Economics

This article summarizes information regarding Initiative 427–the Medicaid expansion question on the November 6, 2018 ballot. It reprints the actual ballot language and the Nebraska Secretary of State’s summary of arguments for and against Initiative 427.

Background. Originally Medicaid covered the elderly, the disabled, children in low-income families, and low-income pregnant women. In 2010 Medicaid coverage was expanded by Congress to include the working poor. In 2012 the U.S. Supreme Court ruled that the provision of the Affordable Care Act (ACA) requiring states to expand Medicaid was unconstitutional. This made it a state option whether or not to expand Medicaid. …

Src-Family Kinase-Cbl Axis Negatively Regulates Nlrp3 Inflammasome Activation., I-Che Chung, Sheng-Ning Yuan, Chun-Nan Ouyang, Hsin-Chung Lin, Kuo-Yang Huang, Yu-Jen Chen, An-Ko Chung, Ching-Liang Chu, David M. Ojcius, Yu-Sun Chang, Lih-Chyang Chen

All Dugoni School of Dentistry Faculty Articles

Activation of the NLRP3 inflammasome is crucial for immune defense, but improper and excessive activation causes inflammatory diseases. We previously reported that Pyk2 is essential for NLRP3 inflammasome activation. Here we show that the Src-family kinases (SFKs)-Cbl axis plays a pivotal role in suppressing NLRP3 inflammasome activation in response to stimulation by nigericin or ATP, as assessed using gene knockout and gene knockdown cells, dominant active/negative mutants, and pharmacological inhibition. We reveal that the phosphorylation of Cbl is regulated by SFKs, and that phosphorylation of Cbl at Tyr371 suppresses NLRP3 inflammasome activation. Mechanistically, Cbl decreases the level of phosphorylated Pyk2 …

Heat Shock Protein 40 And Immune Function In Altered Gravity, Amber M. Paul, Brooke D. Shepard, Sharmila Bhattacharya

Publications

In space, astronauts are more susceptible to pathogens, viral reactivation and immunosuppression, which poses limits to their health and the mission. Interestingly, during space flight, stress-inducible heat shock proteins (HSP) are robustly induced, and the overexpression of HSPs have been implicated in immune dysregulation, therefore HSPs may be critically involved in regulating immune homeostasis. HSP40/DNAJ1 plays a major role in proper protein translation and folding. Its loss of function has been implicated in susceptibility to microbial infection, while its overexpression has been implicated in autoimmunity, collectively suggesting its complicated, but necessary, role in maintaining immunological function. To determine the role …

Involuntary Termination From Substance Use Disorder Treatment: Unknown Phantoms, Red Flags, And Unexplained Medical Data, Izaak L. Williams

Journal of Human Services: Training, Research, and Practice

In the United States, all treatment programs receiving public funds are required by law to regularly submit admission and discharge data, inclusive of the forced/involuntary termination or administrative discharge of clients, to their local state authorities. In some states, this requirement even extends to programs not receiving public funds. The aim of collecting discharge data—collected under the auspices of the Substance Abuse and Mental Health Services Association [SAMHSA]—is to assist state and county authorities, funders, and accreditors to monitor recovery-focused program performance. However, investigation here undertaken shows that published discharge data from many state treatment settings are perennially and grossly …

Selective Stimulability In The Speech And Language Assessment Of Bilingual Children With Selective Mutism, Elizabeth Harbaugh , M.S., Ccc-Slp, Raul F. Prezas , Ph.D., Ccc-Slp, Robin L. Edge , Ph.D., Ccc-Slp

Journal of Human Services: Training, Research, and Practice

English Language Learners (ELLs) with Selective Mutism (SM) mirror their typically developing, bilingual peers who are going through the silent period. The silent period is a normal phenomenon characterized by decreased expressive language and a general lack of communication that is temporary. Understanding second language acquisition and differentiating SM from the silent period, however, is critical to reduce over- and under-identification of children for services. Whereas bilingual children with SM do not speak in either of their languages, bilingual children in the silent period are only silent in their second language. Although limited information exists regarding assessment and treatment for …

Examining Symptom Trajectories That Predict Worse Outcomes In Post-Cabg Patients, Ming-Fen Tsai, Shiow-Luan Tsay, Debra K. Moser, Tsuey-Yuan Huang, Feng-Chun Tsai

Nursing Faculty Publications

Background: Coronary artery bypass grafting is one of the most common interventional revascularisation procedures used to treat coronary artery disease worldwide. With a wide variability in postoperative cardiac symptoms, identification of symptom trajectories during the 3-month postoperative recovery period may improve clinicians’ abilities to support symptom recovery.

Aims: To identify distinct trajectories of cardiac symptoms seen over time in a cohort of patients during the 3-month post-coronary artery bypass grafting period, and determine clinical characteristics associated with different symptom trajectories postoperatively.

Methods: A prospective trial used the cardiac symptom survey to determine patient symptoms at baseline prior to surgery, and …

Cancer Patient Experience Using Integrative Health Techniques, Spencer R. Bockover

USF Tampa Graduate Theses and Dissertations

Objective:

From a patient-centered perspective, this study sought to explore cancer patient experiences using integrative health techniques, while undergoing or after having completed conventional cancer therapy.

Methods:

Recruitment and data collection both occurred within the Supportive Care Medicine Department of a comprehensive cancer center in the southeastern United States. The primary collection method was semi-structured interviews, of which 13 were conducted.

Results:

Patients using integrative therapies experienced a variety of physical and mental/emotional benefits from their chosen therapy, such as management of lymphedema and nerve damage, increased mobility, and improved self-confidence.

Conclusion:

Integrative therapies can provide many benefits to patients …

Neutrophil To Lymphocyte Ratio: A Prognostic Indicator For Astronaut Health, Amber M. Paul, Siddhita D. Mhatre, Egle Cekanaviciute, Ann-Sofie Schreurs, Candice G.T. Tahimic, Ruth K. Globus, Brian Crucian, Sharmila Bhattacharya

Publications

Short-term and long-term spaceflight missions can cause immune system dysfunction in astronauts. Recent studies indicate elevated white blood cells (WBC) and polymorphonuclear neutrophils (PMN) in astronaut blood, along with unchanged or reduced lymphocyte counts, and reduced T cell function, during short-(days) and long-(months) term spaceflight. A high PMN to lymphocyte ratio (NLR) can acts as a strong predictor of poor prognosis in cancer, and as a biomarker for subclinical inflammation in humans and chronic stress in mouse models, however, the NLR has not yet been identified as a predictor of astronaut health during spaceflight. For this, complete blood cell count …

Potential Role Of Csf Cytokine Profiles In Discriminating Infectious From Non-Infectious Cns Disorders., Danielle Fortuna, D. Craig Hooper, Amity L. Roberts, Larry A. Harshyne, Michelle Nagurney, Mark T. Curtis

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Current laboratory testing of cerebrospinal fluid (CSF) does not consistently discriminate between different central nervous system (CNS) disease states. Rapidly distinguishing CNS infections from other brain and spinal cord disorders that share a similar clinical presentation is critical. New approaches focusing on aspects of disease biology, such as immune response profiles that can have stimulus-specific attributes, may be helpful. We undertook this preliminary proof-of-concept study using multiplex ELISA to measure CSF cytokine levels in various CNS disorders (infections, autoimmune/demyelinating diseases, lymphomas, and gliomas) to determine the potential utility of cytokine patterns in differentiating CNS infections from other CNS diseases. Both …

Developing A Backup Plan: Implementing A Career-Planning Course For Undergraduate Biology Majors., Julianne M. Winters, Haizhi Wang, Laura E. Duwel, Elizabeth A. Spudich, Jennifer S. Stanford

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Career-planning courses are known to be effective career interventions for undergraduates, but their effect on developing alternate career plans was previously unknown. Forming alternate career plans increases the likelihood that students have viable career options available to them upon graduation because it encourages students to realistically consider multiple possibilities. Here we describe a one-term career-planning course developed in the context of an undergraduate biology curriculum. We assessed whether this course promoted development of primary and alternate career plans using a pre/post survey. We saw a significant increase in the percentage of students indicating they had plans aimed at achieving primary …

The Influence Of Body Mass Index On Survival And Length Of Stay In Patients With Septic Shock, Yasir Jawaid, Waseem Ahmed, Damir Kusmic, Aman Ajmeri, Kanaan Mansoor, Cristie Mannino, Thomas Judge, Larry E. Carter, Akash V. Ajmera

Marshall Journal of Medicine

Background: Obesity is one of the most widespread epidemics of our time. In fact, currently 65.7% of US adults age 20 and older are overweight, while 30.6% are obese. It has been well-established that obesity has numerous adverse effects on long-term health, however the specific effect on patients treated for sepsis and septic shock is unclear. Body Mass Index (BMI) is a measure of total body fat content and surrogate marker for obesity. In our study, we aimed to identify if BMI was an independent risk factor for poor survival or increased length of stay (LOS) in patients with sepsis. …

Perceptions Of Specialties And Primary Care Careers: Findings From West Virginia Medical Student And Resident Focus Groups, April L. Vestal, Laura Boone, Robert Walker, A. Brianna Sheppard, Dakota Morris, Ashley J. Noland

Marshall Journal of Medicine

The purpose of this study was to improve the understanding of how perceptions of practicing specific medical specialties contribute to career decisions. Participants included medical students and residents from training programs in West Virginia. Focus groups were conducted between September 2013 and February 2015. Thematic content analysis of focus group interviews was used to identify phrases indicating perceptions of person- versus technique-oriented personality medical specialties.

“Self-focused” and “other-focused” themes emerged within person-oriented comments. Factors affecting “self”, including work/life balance and salary and practice environment, made certain specialties more appealing. Technique-oriented comments included working in a hospital setting, performing technical procedures, …

Optimizing Quality Of Care By Patient Satisfaction For The Department Of Orthopaedics - A Survey Study, Milad Modarresi, Ammar Qureshi, Rodrigo Aguilar, Meghan Anderson, Felix Cheung

Marshall Journal of Medicine

Introduction: Hospital Consumer Assessment of Healthcare Providers and System (HCAHPS) has provided a standardized survey method in order to evaluate the patient’s satisfaction on the care they are provided. While overall patient satisfaction is clearly a multidimensional concept, the HCAHPS survey covers 8 domains of health care. This study tries to identify and establish the main determinants to patient’s level of satisfaction during their visit to Cabell Huntington Hospital Orthopaedics department.

Methods: Data was collected from surveys handed in 3 consecutive months; June, July and August of 2013. Sixteen questions were selected from HCAHPS that were appraised to be relevant …

Predicting Adverse Outcomes In End Stage Renal Disease: Machine Learning Applied To The United States Renal Data System, Zeid Khitan, Alexis D. Jacob, Courtney Balentine, Adam N. Jacob, Juan R. Sanabria, Joseph I. Shapiro

Marshall Journal of Medicine

We examined machine learning methods to predict death within six months using data derived from the United States Renal Data System (USRDS). We specifically evaluated a generalized linear model, a support vector machine, a decision tree and a random forest evaluated within the context of K-10 fold validation using the CARET package available within the open source architecture R program. We compared these models with the feed forward neural network strategy that we previously reported on with this data set.

Applying A Research Ethics Review Processes In Rural Practice-Based Research, Adam D. Baus, Tracy L. Hendershot, Martha Cook Carter, Laura K. Boone

Marshall Journal of Medicine

Introduction: Partnering with rural primary care in practice-based research allows researchers access to a vital segment of the health care sector and a window into some of the most vulnerable, high-risk, high-need patient populations. The readiness for rural primary care to fully embrace research partnerships, however, is often tempered by ethical questions in conducting research in close-knit settings. This research provides practices with a refined decision support tool for evaluating the fit of research opportunities for their unique practices.

Materials and Methods: A two-phase effort was conducted to glean insight from currently available literature on ethical considerations in practice-based research …

Outcomes Of Transcutaneous Aortic Valve Replacement Among High Risk Wv Sample Population., George M. Yousef, Julia Poe, Cameron Killmer, Basel Edris, Jason Mader, Ellen A. Thompson, Daniel Snavely, Silvestre Cansino, Joseph I. Shapiro, Mark A. Studeny

Marshall Journal of Medicine

Introduction:Transcatheter aortic valve replacement (TAVR) is a relatively new strategy for replacing the aortic valve. We elected to review our early experience to see if we could identify clinical characteristics at baseline or immediately following the procedure that would predict death within one year.

Methods:Charts for all patients assigned to receive TAVR procedure at St Mary’s medical center, Huntington, West Virginia between April, 2013 till November, 2016 were identified and reviewed. A total of seventy-two (72) cases were included.

Results: All cause mortality rate at index hospitalization, 30 days, and 12 months was 5.6%(N=4), 6.9%(N=5), 19.4%(N=14) respectively. Stroke …

Nadolol In Pregnancy: A Medical Student’S Reflection On Her Pregnancy, Rebecca King-Mallory, Shawndra Barker, Kaitlin Mcgrogan, Adam M. Franks

Marshall Journal of Medicine

Hypertension is a common concern during pregnancy. Beta-blockers are one potential treatment, but third trimester exposure has correlated with an increased risk of perinatal events. Nadolol, a nonselective beta blocker, has properties that differ from those of its selective counterparts, including longer half-life, decreased protein binding, and renal excretion in the unchanged form. There is very limited data on the use of nadolol during pregnancy, and its safety has not been completely evaluated. This case study documents the perinatal outcomes of nadolol use throughout a medical student’s pregnancy and explores the experience in obtaining and undergoing medical care.

Diagnosis Of A Centronuclear Myopathy Case In Appalachia 20 Years From Symptom Onset., Christopher Burrell, Zachary Wilson, Dominika Lozowska

Marshall Journal of Medicine

Dynamin 2 (DMN2) mutations cause centronuclear myopathy (CNM) and Charcot Marie Tooth (CMT). Herein we discuss the details of a patient's case of adult onset CNM. We also highlight the unique features of this case with regards to the importance of electromyography (EMG), muscle biopsy and genetic testing in identifying CNM, as well as potential for improving outcomes by having a high index or suspicion and emphasizing better access to healthcare in underserved areas.

Ignorance Is Not An Option, Tamela J. White

Marshall Journal of Medicine

Health literacy is a vital component in the design of public health interventions. Public understanding of health literacy and its role in attaining down stream and outcomes is not only a necessity but a moral mandate.

Leaving A Legacy, Jay Lakhani

Marshall Journal of Medicine

No abstract provided.

The Future Of Personalized Care: Humanism Meets Artificial Intelligence, Darshana T. Shah

Marshall Journal of Medicine

Another exciting year for the Marshall Journal of Medicine has passed, giving us the opportunity to both reflect on the accomplishments of the past year and summarize recent developments. The readership distribution of the Marshall Journal of Medicine spans the globe, including over 169 countries and 32,000 plus downloads. We continue to expand our scope by incorporating new submission categories such as “At the ‘Heart’ of Healthcare” and “Machine Learning in Rural Health.” This issue particularly propels us forward with a focus on the humanism of health care.