Medicine and Health Sciences Commons^™

Association Between Hypertensive Disorders And Fetal Growth Abnormalities In Class Ii And Iii Obese Women, Mary Ferrante, Bs, Rebekah Mccurdy, Md, Mph

Phase 1

Introduction: Studies have shown that hypertension in pregnancy can lead to small for gestational age newborns while obesity can lead to large for gestational age newborns. However, little research has been done to study the influence of both disorders on birthweight.

Objective: To assess the effect of both maternal obesity and a hypertensive disorder on neonatal birthweight and to identify the specific growth abnormality(s) present if a discrepancy exists. We hypothesize that obese women diagnosed with hypertensive disorders are more likely to deliver neonates with growth abnormalities compared to obese women without hypertensive disorders.

Methods: This is a …

Bova Is Superior To Spesi In Identification Of High Risk Pulmonary Embolism Patients, J. Dibello, P. Khaing, E. Gupta, C. Au, T. Chengsupanimit, B. K. Awsare, M. Baram, F. M. West, G. C. Kane

Phase 1

Introduction: Prognostic models exist for the purpose of stratifying patients with acute pulmonary embolism. Of these, the Pulmonary Embolism Severity Index (PESI) and the simplified PESI (sPESI) are the most well-known, although more recent composite models, like the BOVA score, are now being studied and implemented. Comparative efficacy of these scores to predict long term mortality is not well established.

Methods: We performed a retrospective analysis of all consecutive patients diagnosed with PE using computed tomography scan from 2014-2016 at an urban tertiary-referral medical center. Cox proportional hazard analyses were performed to compare the performance of two prognostic …

Emergency Medicine Palliative Care Access (Empalla): Preliminary Data From A Multi-Center Randomized Controlled Trial, Abigail M. Schmucker, Ba, Deborah J. Shim, Bs, Corita R. Grudzen, Md, Mshs, Jeanne Cho, Mph, Keith Goldfeld, Drph

Phase 1

Introduction: Emergency department (ED)-initiated palliative care has been shown to improve patient-centered outcomes in older adults with serious illnesses, but the optimal modality for providing such interventions is unknown. The EMPallA trial compares nurse-led, telephonic case management with specialty, outpatient palliative care on: 1) patient quality of life (QOL); 2) healthcare utilization; 3) loneliness and symptom burden; and 4) caregiver strain, QOL, and bereavement.

Objective: Summarize preliminary demographic and QOL data for the EMPallA cohort.

Methods: A pragmatic, parallel, two-arm randomized controlled trial is enrolling 1350 ED patients across 9 EDs over 3 years to compare the effectiveness of palliative …

Gen-1 Immunotherapy For The Treatment Of Ovarian Cancer, Premal H Thaker, Nicholas Borys, Jason Fewell, Khursheed Anwer

2010-2019 OA Pubs

GEN-1 is a gene-based immunotherapy, comprising a human IL-12 gene expression plasmid and a synthetic plasmid delivery system, delivered intraperitoneally (ip.) to produce local and persistent levels of a pleiotropic immunocytokine, IL-12, at the tumor site in patients with advanced ovarian cancer. The goal of local and persistent IL-12 delivery is to remodel the highly immunosuppressive tumor microenvironment to favor immune stimulation while avoiding serious systemic toxicities, a major limitation of recombinant IL-12 therapy. Safe and sustained local production of IL-12 and related immunocytokines at the tumor site could produce potentially more favorable immunological changes in the tumor microenvironment and …

Economic Evaluation Of Concussion Programs In The State Of Idaho: The Collective Potential Of Prevention And Clinical Care, Susie Bergeron, Hilary Flint, Zeynep Hansen

Economics Faculty Publications and Presentations

Concussion, or mild traumatic brain injury especially among young children, teenagers, and young adults, is a significant problem in Ada County, Idaho, and the United States. Although much has been learned about concussion, considerable controversy and gaps in knowledge still exist in many areas of research, leading to variation in concussion assessment, treatment and management protocols. Health systems can positively impact concussion outcomes through community education and outreach, and provision of timely, coordinated, evidence-based clinical care. Collectively, these measures serve to reduce concussion incidence (primary prevention), enable more timely recognition of concussion by parents, coaches, and teachers of youth athletes …

College Of Health Sciences E-Newsletter, February 2019, Irvin B. Harrell (Editor)

Ellmer College of Health Sciences Newsletters

February 2019 issue of Old Dominion University's College of Health Sciences Newsletter.

Decrease In Population And Increase In Welfare Of Community Cats In A Twenty-Three Year Trap-Neuter-Return Program In Key Largo, Fl: The Orcat Program, Rachael Kreisler, Heather Cornell, Julie Levy

Management - TNR

The objective of this study was to evaluate the effect of a long-term (23-year) trap-neuter-return program on the population size of community cats in the Ocean Reef Community and to describe the demographic composition and outcome of enrolled cats. A retrospective study was performed using both cat census data collected between 1999 and 2013 as well as individual medical records for cats whose first visit occurred between 3/31/1995 and 12/31/2017. Medical record entries were reviewed to determine program inputs, cat outcomes, retroviral disease prevalence, and average age of first visit, sterilization, and death through 6/11/2018. Change over time was analyzed …

Massive Hemoptysis Due To Recurrence Of Bronchial To Pulmonary Vascular Malformation: A Case Report, Chelsey White, Pedro Ottaviano, Nancy Munn, Yousef Shweihat, Fuad Zeid

Internal Medicine

Bronchial dieulafoy lesions are quite rare with relatively few case reports in the literature. Symptoms may vary but the lesion is often associated with hemoptysis and may present as massive hemoptysis. We present a case of a 69-year-old male with a recurrent episode of hemoptysis three years after treatment for a bronchial dieulafoy lesion. The bronchoscopy done three years prior during an initial episode of hemoptysis showed a visible dieulafoy deep within a subsegmental branch of the right lower lobe. This case is unique because there are no other reports within the literature of a delayed recurrence several years after …

Use Of Beta-Antagonists For Cardioprotection During Chemotherapy In Oncology Patients, Nicole Streich

Physician Assistant Scholarly Project Papers

No abstract provided.

The History And Future Of Digital Health In The Field Of Behavioral Medicine., Danielle Arigo, Danielle E Jake-Schoffman, Kathleen Wolin, Ellen Beckjord, Eric B Hekler, Sherry L Pagoto

College of Science & Mathematics Departmental Research

Since its earliest days, the field of behavioral medicine has leveraged technology to increase the reach and effectiveness of its interventions. Here, we highlight key areas of opportunity and recommend next steps to further advance intervention development, evaluation, and commercialization with a focus on three technologies: mobile applications (apps), social media, and wearable devices. Ultimately, we argue that future of digital health behavioral science research lies in finding ways to advance more robust academic-industry partnerships. These include academics consciously working towards preparing and training the work force of the twenty first century for digital health, actively working towards advancing methods …

Opioid Consumption After Orthopedic Surgery: Prospective Randomized Trial On The Effects Of Preoperative Counseling, Sage Vincent, Taylor Paskey, Elizabeth Critchlow, Erica Mann, Talia Chapman, Md, Kristin Sandrowski, Md, Asif Ilyas, Md

Phase 1

Introduction: Recently, there have been increases in morbidity and mortality associated with opioid medications. Physician overprescribing, particularly within orthopedics, contributes to large quantities of leftover opioids, leading to an increased risk of non-medical opioid use and abuse.

Objective: To understand the role of preoperative patient counseling on postoperative opioid consumption, a prospective randomized study was done, with the idea that patients receiving counseling would take fewer opioids than their control counterparts.

Methods: Patients undergoing elective outpatient orthopedic surgery at Jefferson affiliate hospitals were enrolled over a 3-month period. Patients were randomized to a control group or to receive preoperative counseling …

Direct Anterior Approach Utilizing A Bikini Incision Has Less Wound Related Complications In Patients With High Bmi, Taylor Paskey, Bs, Jorge Manrique, Md, Majd Tarabichi, Md, Camilo Restrepo, Md, Carol Foltz, Phd, William J. Hozack, Md

Phase 1

Introduction: Direct anterior approach (DAA) total hip arthroplasty (THA) can be performed through a traditional vertical skin incision, situating the proximal incision at the hip flexion crease, or a horizontal (bikini) skin incision, situating the incision slightly distal and parallel to the hip flexion crease. The dissection beyond the subcutaneous layer is identical for both methods.

Objective: The purpose of this study was to compare these approaches, performed by an experienced single surgeon, in terms of overall wound complications and patient-reported esthetics 6-months post-operatively. It was hypothesized that the bikini incision would result in less wound complications and …

Association Between Perceived Physical Activity And Cognitive Function In Older Adults, Paul D. Loprinzi, Emily Frith

Faculty and Student Publications

© The Author(s) 2018. There is irrefutable evidence that regular participation in physical activity is favorably associated with numerous positive health outcomes, including cognitive function. Emerging work suggests that perceived physical activity, independent of actual physical activity behavior, is inversely associated with mortality risk. In this study, we evaluate whether perceived physical activity, independent of actual physical activity, is associated with cognitive function, a robust indicator of mortality risk. Data from the cross-sectional 1999–2002 National Health and Nutrition Examination Survey were employed (N = 2352; 60+ years of age). Actual physical activity was assessed via a validated survey. Perceived physical …

Fluctuation Of Primary Motor Cortex Excitability During Cataplexy In Narcolepsy, Bei Huang, Zhenying Qian, Zongwen Wang, Jihui Zhang, Kun Chen, Tao Xu, Jijun Wang, David F. Cechetto, Zhongxin Zhao, Huijuan Wu

Anatomy and Cell Biology Publications

Objective Cataplexy is a complicated and dynamic process in narcolepsy type 1 (NT1) patients. This study aimed to clarify the distinct stages during a cataplectic attack and identify the changes of the primary motor cortex (PMC) excitability during these stages. Methods Thirty-five patients with NT1 and 29 healthy controls were recruited to this study. Cataplectic stages were distinguished from a cataplectic attack by video-polysomnogram monitoring. Transcranial magnetic stimulation motor-evoked potential (TMS-MEP) was performed to measure the excitability of PMC during quiet wakefulness, laughter without cataplexy, and each cataplectic stage. Results Based on the video and electromyogram observations, a typical cataplectic …

Multicentre, Randomised Clinical Trial Of Paediatric Concussion Assessment Of Rest And Exertion (Pedcare): A Study To Determine When To Resume Physical Activities Following Concussion In Children., Andrée-Anne Ledoux, Nicholas J Barrowman, Kathy Boutis, Adrienne Davis, Sarah Reid, Gurinder Sangha, Ken J Farion, Kevin Belanger, Mark S Tremblay, Keith Owen Yeates, Carol Dematteo, Nick Reed, Roger Zemek

Paediatrics Publications

INTRODUCTION:
Rest until symptom-free, followed by a progressive stepwise return to activities, is often prescribed in the management of paediatric concussions. Recent evidence suggests prolonged rest may hinder recovery, and early resumption of physical activity may be associated with more rapid recovery postconcussion. The primary objective is to determine whether the early reintroduction of non-contact physical activity beginning 72 hours postinjury reduces postconcussive symptoms at 2 weeks in children following an acute concussion as compared with a rest until asymptomatic protocol.

METHODS AND ANALYSIS:
This study is a randomised clinical trial across three Canadian academic paediatric emergency departments. A total …

Priorities, Barriers, And Facilitators Towards International Guidelines For The Delivery Of Supportive Clinical Care During An Ebola Outbreak: A Cross-Sectional Survey, Marie Claude Battista, Christine Loignon, Lynda Benhadj, Elysee Nouvet, Srinivas Murthy, Robert Fowler, Neill K.J. Adhikari, Adnan Haj-Moustafa, Alex P. Salam, Adrienne K. Chan, Sharmistha Mishra, Francois Couturier, Catherine Hudon, Peter Horby, Richard Bedell, Michael Rekart, Jan Hajek, Francois Lamontagne

Health Studies Publications

© 2019 by the authors. Licensee MDPI, Basel, Switzerland. During the Ebola outbreak, mortality reduction was attributed to multiple improvements in supportive care delivered in Ebola treatment units (ETUs). We aimed to identify high-priority supportive care measures, as well as perceived barriers and facilitators to their implementation, for patients with Ebola Virus Disease (EVD). We conducted a cross-sectional survey of key stakeholders involved in the response to the 2014–2016 West African EVD outbreak. Out of 57 email invitations, 44 responses were received, and 29 respondents completed the survey. The respondents listed insufficient numbers of health workers (23/29, 79%), improper tools …

Dynamics Of Spontaneous Alpha Activity Correlate With Language Ability In Young Children., Elaine Yuen Ling Kwok, Janis Oram Cardy, Brian L Allman, Prudence Allen, Björn Herrmann

Health and Rehabilitation Sciences Publications

Early childhood is a period of tremendous growth in both language ability and brain maturation. To understand the dynamic interplay between neural activity and spoken language development, we used resting-state EEG recordings to explore the relation between alpha oscillations (7-10 Hz) and oral language ability in 4- to 6-year-old children with typical development (N = 41). Three properties of alpha oscillations were investigated: a) alpha power using spectral analysis, b) flexibility of the alpha frequency quantified via the oscillation's moment-to-moment fluctuations, and c) scaling behavior of the alpha oscillator investigated via the long-range temporal correlation in the alpha-amplitude time course. …

Dynamic Light Scattering Optical Coherence Tomography To Probe Motion Of Subcellular Scatterers., Nico J J Arezza, Marjan Razani, Michael C Kolios

Medical Biophysics Publications

Optical coherence tomography (OCT) is used to provide anatomical information of biological systems but can also provide functional information by characterizing the motion of intracellular structures. Dynamic light scattering OCT was performed on intact, control MCF-7 breast cancer cells and cells either treated with paclitaxel to induce apoptosis or deprived of nutrients to induce oncosis. Autocorrelations (ACs) of the temporal fluctuations of OCT intensity signals demonstrate a significant decrease in decorrelation time after 24 h in both the paclitaxel-treated and nutrient-deprived cell groups but no significant differences between the two groups. The acquired ACs were then used as input for …

The Effect Of Implant Linking And Ligament Integrity On Humeral Loading Of A Convertible Total Elbow Arthroplasty, James R. Brownhill, J. Whitcomb Pollock, Louis M. Ferreira, James A. Johnson, Graham J.W. King

Bone and Joint Institute

© 2017 The British Elbow & Shoulder Society. Background: Both unlinked and linked total elbow arthroplasty (TEA) implants have been employed with no consensus as to the optimal design. The present study aimed to evaluate the effect of collateral ligament integrity and implant linkage on wear-inducing loads in a convertible TEA. Methods: Eight fresh frozen upper extremities were tested in an elbow motion simulator. A convertible TEA with an instrumented humeral stem was inserted using computer navigation. Elbow kinematics and humeral loading were recorded with the TEA both linked and unlinked. The collateral ligaments were then sectioned and testing was …

Significant Cost Savings And Similar Patient Outcomes Associated With Early Discharge Following Total Knee Arthroplasty, Jacquelyn Marsh, Lyndsay Somerville, James L. Howard, Brent A. Lanting

Bone and Joint Institute

© 2019 Joule Inc. or its licensors. Background: A substantial portion of the cost of total knee arthroplasty (TKA) results from the postoperative inpatient length of stay (LOS). Considering the annual increase in TKAs, reducing LOS represents a potential for cost savings. We sought to compare in-hospital costs and patient-reported outcomes for an early discharge protocol compared with the standard LOS following TKA. Methods: We conducted a retrospective matched cohort study, matching patients on age, sex, body mass index and preoperative Western Ontario & McMaster Universities Osteoarthritis Index (WOMAC) score. We compared costs associated with time in the operating room, …

Understanding The Patellofemoral Joint In Total Knee Arthroplasty, Jacob Matz, Brent A. Lanting, James L. Howard

Bone and Joint Institute

© 2019 Joule Inc. or its licensors. Total knee arthroplasty (TKA) is one of the most successful procedures in orthopedic surgery. Nevertheless, postoperative patellofemoral complications remain a challenging problem, affecting a substantial proportion of patients. Complications involving the patellofemoral joint (PFJ) can occur in both resurfaced and nonresurfaced patellae. Types of PFJ complications include anterior knee pain, maltracking, fracture, avascular necrosis and patellar clunk. The causes of patellofemoral complications can be categorized into patient-, surgeon- and implant-related factors. Patient characteristics such as female sex, young age, depression and increased body mass index have been linked with increased complications. Important technical …

Obtaining And Maintaining Cortical Hand Representation As Evidenced From Acquired And Congenital Handlessness, Daan B. Wesselink, Fiona Mz Van Den Heiligenberg, Naveed Ejaz, Harriet Dempsey-Jones, Lucilla Cardinali, Aurelie Tarall-Jozwiak, Jörn Diedrichsen, Tamar R. Makin

Brain and Mind Institute Researchers' Publications

© Lukinova et al. A key question in neuroscience is how cortical organisation relates to experience. Previously we showed that amputees experiencing highly vivid phantom sensations maintain cortical representation of their missing hand (Kikkert et al., 2016). Here, we examined the role of sensory hand experience on persistent hand representation by studying individuals with acquired and congenital hand loss. We used representational similarity analysis in primary somatosensory and motor cortex during missing and intact hand movements. We found that key aspects of acquired amputees’ missing hand representation persisted, despite varying vividness of phantom sensations. In contrast, missing hand representation of …

Unmet Need For Mental Health Services Among People Screened But Not Admitted To An Early Psychosis Intervention Program, Jordan Edwards, Ross Norman, Paul Kurdyak, Arlene G. Macdougall, Lena Palaniyappan, Cindy Lau, Kelly K. Anderson

Brain and Mind Institute Researchers' Publications

Information is lacking on people screened for early psychosis intervention (EPI) but not admitted to the program. Using health administrative data, we constructed a retrospective cohort of incident cases of psychosis in the catchment of an EPI program. Use of mental health services was compared between people screened and not admitted with an EPI-admitted group. The non-admitted group had higher rates of subsequent emergency department visits, psychiatric hospitalizations, and involuntary admissions. These patterns are indicative of unmet need, and people screened but not admitted to EPI may benefit from protocols to improve transitions of care with other service providers.

Developmental Trajectories For The Early Clinical Assessment Of Balance By Gross Motor Function Classification System Level For Children With Cerebral Palsy., Alyssa Laforme Fiss, Sarah Westcott Mccoy, Doreen Bartlett, Lisa Avery, Steven E Hanna, On Track Study Team

Physical Therapy Publications

Background: Children with cerebral palsy (CP) characteristically present with impairments in balance. Currently, the pattern and timing of the development of balance ability have not been described for children with CP of varying Gross Motor Function Classification System (GMFCS) levels.

Objective: The purpose of this study was to document longitudinal developmental trajectories in a measure of balance, the Early Clinical Assessment of Balance (ECAB) scores, along with age-specific reference percentiles and the amount of change typical over a 1-year period for children within different GMFCS levels.

Design: The design was a longitudinal cohort study.

Methods: Participants included 708 children with …

A Propensity-Matched Analysis Of Outcomes For Patients With M2 Branch Occlusions At Endovascular Stroke Centers, R. Ovando, L. Lucas, Elizabeth Baraban, Jason Tarpley

Articles, Abstracts, and Reports

Introduction: Endovascular therapy (EVT) for Emergent Large Vessel Occlusion (ELVO) is recommended for patients with acute proximal MCA (M1 segment) occlusions (Class I, level A evidence), but the benefits of EVT are uncertain in patients with M2 and more distal occlusions. The purpose of this study was to compare the efficacy and outcomes of EVT-treated M2 ELVOs with EVT-treated M1 ELVOs, and to examine the outcomes of EVT-treated M2 ELVO patients with those whose M2 ELVOs were not treated.

Methods: Data were obtained from a multi-hospital system of patients from January 2014 and May 2018. Two propensity score (PS)-based nearest-neighbor …

Knockdown Of Heterochromatin Protein 1 Binding Protein 3 Recapitulates Phenotypic, Cellular, And Molecular Features Of Aging., Sarah M Neuner, Shengyuan Ding, Catherine C Kaczorowski

Faculty Research 2019

Identifying genetic factors that modify an individual's susceptibility to cognitive decline in aging is critical to understanding biological processes involved and mitigating risk associated with a number of age-related disorders. Recently, heterochromatin protein 1 binding protein 3 (Hp1bp3) was identified as a mediator of cognitive aging. Here, we provide a mechanistic explanation for these findings and show that targeted knockdown of Hp1bp3 in the hippocampus by 50%-75% is sufficient to induce cognitive deficits and transcriptional changes reminiscent of those observed in aging and Alzheimer's disease brains. Specifically, neuroinflammatory-related pathways become activated following Hp1bp3 knockdown in combination with a robust decrease …

The Global State Of The Genetic Counseling Profession., Maryann Abacan, Lamia Alsubaie, Kristine Barlow-Stewart, Beppy Caanen, Christophe Cordier, Eliza Courtney, Emeline Davoine, Janice Edwards, Niby J Elackatt, Kate Gardiner, Yue Guan, Lian-Hua Huang, Charlotta Ingvoldstad Malmgren, Sahil Kejriwal, Hyon J Kim, Deborah Lambert, Paulina Araceli Lantigua-Cruz, Juliana M H Lee, Marianne Lodahl, Åshild Lunde, Shelley Macaulay, Ivan Macciocca, Sonia Margarit, Anna Middleton, Ramona Moldovan, Joanne Ngeow, Alexandra J Obregon-Tito, Kelly E Ormond, Milena Paneque, Karen Powell, Kunal Sanghavi, Diana Scotcher, Jenna Scott, Clara Serra Juhé, Shiri Shkedi-Rafid, Tina-Marié Wessels, Sook-Yee Yoon, Catherine Wicklund

Faculty Research 2019

The profession of genetic counseling (also called genetic counselling in many countries) began nearly 50 years ago in the United States, and has grown internationally in the past 30 years. While there have been many papers describing the profession of genetic counseling in individual countries or regions, data remains incomplete and has been published in diverse journals with limited access. As a result of the 2016 Transnational Alliance of Genetic Counseling (TAGC) conference in Barcelona, Spain, and the 2017 World Congress of Genetic Counselling in the UK, we endeavor to describe as fully as possible the global state of genetic …

Enhancing The Efficacy Of Glycolytic Blockade In Cancer Cells Via Rad51 Inhibition., John J Wilson, Kin-Hoe Chow, Nathan J Labrie, Jane Branca, Thomas J. Sproule, Bryant R A Perkins, Elise E Wolf, Mauro W Costa, Grace Stafford, Christine Rosales, Kevin D Mills, Derry C. Roopenian, Muneer G. Hasham

Faculty Research 2019

Targeting the early steps of the glycolysis pathway in cancers is a well-established therapeutic strategy; however, the doses required to elicit a therapeutic effect on the cancer can be toxic to the patient. Consequently, numerous preclinical and clinical studies have combined glycolytic blockade with other therapies. However, most of these other therapies do not specifically target cancer cells, and thus adversely affect normal tissue. Here we first show that a diverse number of cancer models - spontaneous, patient-derived xenografted tumor samples, and xenografted human cancer cells - can be efficiently targeted by 2-deoxy-D-Glucose (2DG), a well-known glycolytic inhibitor. Next, we …

Technical And Regulatory Considerations For Taking Liquid Biopsy To The Clinic: Validation Of The Jax Plasmamonitor, Bridgette Sisson, Jasmina Uvalic, Kevin Kelly, Pavalan Selvam, Andrew N Hesse, Guruprasad Ananda, Harshpreet Chandok, Daniel Bergeron, Lauren Holinka, Honey V Reddi

Faculty Research 2019

The standard of care in oncology has been genomic profiling of tumor tissue biopsies for the treatment and management of disease, which can prove to be quite challenging in terms of cost, invasiveness of procedure, and potential risk for the patient. As the number of available drugs in oncology continues to increase, so too does the demand for technologies and testing applications that can identify genomic alterations targetable by these new therapies. Liquid biopsies that use a blood draw from the diseased patient may offset the many disadvantages of the invasive procedure. However, as with any new technology or finding …

Developing Kinesthetic Classrooms To Promote Active Learning, Brian Culp

Faculty Articles

The use of kinesthetic movement in the classroom toward improving health and educational outcomes among youth has been a topic of discourse in recent years. School initiatives that have infused movement as part of the curriculum have shown to increase efficiency in learning, while decreasing stress and contributing to a positive classroom climate. One question that is worthy of exploration pertains to how future professionals in the fields of physical education and health can promote kinesthetic movement in schools and communities. This article discusses how a university kinesthetic classroom prepares future professionals to be advocates for school health using active …