Medicine and Health Sciences Commons^™

The Concentration Of Total Nucleated Cells In Harvested Bone Marrow For Transplantation Has Decreased Over Time., Nicole L. Prokopishyn, Brent R. Logan, Deidre M. Kiefer, Jennifer A. Sees, Pintip Chitphakdithai, Ibrahim A. Ahmed, Paolo N. Anderlini, Amer M. Beitinjaneh, Christopher Bredeson, Jan Cerny, Saurabh Chhabra, Andrew Daly, Miguel Angel Diaz, Nosha Farhadfar, Haydar A. Frangoul, Siddhartha Ganguly, Dennis A. Gastineau, Usama Gergis, Gregory A. Hale, Peiman Hematti, Rammurti T. Kamble, Kimberly A. Kasow, Hillard M. Lazarus, Jane L. Liesveld, Hemant S. Murthy, Maxim Norkin, Richard F. Olsson, Mona Papari, Bipin N. Savani, Jeffrey Szer, Edmund K. Waller, Baldeep Wirk, Jean A. Yared, Michael A. Pulsipher, Nirali N. Shah, Galen E. Switzer, Paul V. O'Donnell, Dennis L. Confer, Bronwen E. Shaw

Manuscripts, Articles, Book Chapters and Other Papers

Bone marrow (BM) is an essential source of hematopoietic stem cell grafts for many allogeneic hematopoietic cell transplant (HCT) recipients, including adult patients (for specific diseases and transplantation strategies) and the majority of pediatric recipient. However, since the advent of granulocyte colony-stimulating factor-mobilized peripheral blood stem cell (PBSC) grafts, there has been a significant decrease in the use of BM in HCT, thought to be due mainly to the increased logistical challenges in harvesting BM compared with PBSCs, as well as generally no significant survival advantage of BM over PBSCs. The decreased frequency of collection has the potential to impact …

The Expression Of Connexin-43 By Cd11c+ Dendritic Cells Is Required To Maintain Cd4+ Foxp3+ Regulatory T Cell Population In Peripheral Lymphoid Organs, Caroline Titus Miller

Biological Sciences Theses & Dissertations

Foxp3⁺ regulatory T cells (T_R) are an immunosuppressive subset of CD4⁺ T cells that maintain homeostasis of the immune system. They are sustained by the interaction between the Major Histocompatibility Complex (MHC) molecules present on antigen presenting dendritic cells and the T Cell Receptor (TCR) expressed on T_R cells that is specific for the MHC loaded with an antigenic peptide. Here, we show that in addition to MHC/TCR interaction, Connexin-43 (Cx43) expression by dendritic cells is required to maintain the TR cell population. CD11c⁺ dendritic cells represent a major subset of antigen presenting cells. …

J Mich Dent Assoc July 2019

The Journal of the Michigan Dental Association

Every month, The Journal of the Michigan Dental Association brings news, information, and features about Michigan dentistry to our state's oral health community and the MDA’s 6,200+ members across the state. No publication reaches more Michigan dentists! This month's issue presents the 2019 MDA Award winners, outgoing MDA president Dr. Deb Peters' presidential address, and the 2019 MDA Annual Session in words and photos.

Initiating The Ketogenic Diet In Infants With Treatment Refractory Epilepsy While Maintaining A Breast Milk Diet, Jean-Baptist Lepichon, Lindsey M. Thompson, Megan Gustafson, Ahmed Abdelmoity

Manuscripts, Articles, Book Chapters and Other Papers

© 2019 The Authors

Purpose: The ketogenic diet has been found to be safe and effective in the treatment of drug resistant epilepsy in childhood. The age range of children undergoing this treatment has steadily been going down. There is strong evidence that it is a safe alternative in infants with drug resistant seizures. The American Academy of Pediatrics strongly supports continuing a breast milk diet until infants are at least six months of age. The purpose of this study is to evaluate the safety and efficacy of the ketogenic diet in infants while maintaining a breast milk diet.

Method: …

Testing Allostatic Load Factor Structures Among Adolescents: A Structural Equation Modeling Approach, Amanda L. King, Mauricio Garnier-Villarreal, Amanda M. Simanak, Norah L. Johnson

College of Nursing Faculty Research and Publications

Objectives

Allostatic load (AL) represents cumulative biological “wear and tear” that results from chronic stress exposure over time, ultimately increasing risk for chronic disease. A consensus is lacking regarding the best operationalization of AL, particularly for younger, less studied populations. The purpose of this study was to test multiple hypothesized factor structures for AL to determine the best measurement approach for adolescents.

Methods

We analyzed biologic data for 1900 adolescents aged 12‐18 from four waves (2003‐2010) of the National Health and Nutrition Examination Survey. AL indicator variables included cardiovascular (systolic BP, creatinine), metabolic (HDL, LDL, triglycerides, insulin, fasting glucose, HA1C, …

A Concept Analysis Of Parental Uncertainty In Illness Of An Infant, Kathryn J. Malin, Teresa S. Johnson

College of Nursing Faculty Research and Publications

Background:

The concept of uncertainty in illness has been well described and applied to many different areas of nursing and other disciplines. Specifically, parental uncertainty in illness of an infant is a meaningful concept that has specific attributes and implications. A current concept analysis that considers the changing healthcare setting, historical conceptual inconsistencies, and a lack of information concerning parents of infants is needed.

Purpose:

To identify essential antecedents, attributes, and consequences of parental uncertainty in illness using Rodgers' Evolutionary Concept Analysis method.

Methods:

A literature search was conducted using PubMed, CINAHL, and PsycInfo. The following keywords were used in …

Stimulus-Responsive Polymeric Nanogels As Smart Drug Delivery Systems, Sakineh Hajebi, Navid Rabiee, Mojtaba Bagherzadeh, Sepideh Ahmadi, Mohammad Rabiee, Hossein Roghani-Mamaqani, Mohammadreza Tahriri, Lobat Tayebi, Michael R. Hamblin

School of Dentistry Faculty Research and Publications

Nanogels are three-dimensional nanoscale networks formed by physically or chemically cross-linking polymers. Nanogels have been explored as drug delivery systems due to their advantageous properties, such as biocompatibility, high stability, tunable particle size, drug loading capacity, and possible modification of the surface for active targeting by attaching ligands that recognize cognate receptors on the target cells or tissues. Nanogels can be designed to be stimulus responsive, and react to internal or external stimuli such as pH, temperature, light and redox, thus resulting in the controlled release of loaded drugs. This “smart” targeting ability prevents drug accumulation in non-target tissues and …

The Influence Of Masculinity On Male Latino Adolescents’ Perceptions Regarding Dating Relationships And Dating Violence, Kristin Haglund, Ruth Ann Belknap, Lisa M. Edwards, Marcel Hernani Tassara, James C. Van Hoven, Aimee A. Woda

College of Nursing Faculty Research and Publications

In the United States, teen dating violence (TDV) is a concern across ethnic groups. Attitudes and correlates of violence differ by gender, culture, and acculturation. This study used a qualitative interpretive approach. Data were obtained in focus groups with 23 Latino male adolescents. Themes reflected contexts of participants’ lives, and definitions and nature of dating relationships and TDV. Participants described the importance of respecting dating partners, the destructive effects of TDV, and the pressure to display masculinity that can lead some young men to perpetrate TDV. These results may advance culturally relevant interventions to promote healthy relationships and prevent dating …

Moving Nursing Beyond P < .05, Matthew J. Hayat, Vincent S. Staggs, Todd A. Schwartz, Melinda Higgins, Andres Azuero, Chakra Budhathoki, Rameela Chandrasekhar, Paul Cook, Emily Cramer, Mary S. Dietrich, Mauricio Garnier-Villarreal, Alexandra Hanlon, Jinghua He, Jinxiang Hu, Myoung Jin Kim, Martina Mueller, Joseph R. Nolan, Yelena Perkhounkova, Janet Rothers, Glenna Schluck, Xiaogang Su, Thomas N. Templin, Michael T. Weaver, Qing Yang, Sangbeak Ye

College of Nursing Faculty Research and Publications

No abstract provided.

Intersectional Identities And Microaggressions: The Experience Of Transgender Females, Cory Daniel Gerwe

Counseling & Human Services Theses & Dissertations

Historically, attention given to privileged LGBT minorities such as white LGBT individuals, renders those who experience multiple minority identities as unacknowledged. There is a scarcity of research exploring the intersectional experiences of transgender individuals and how these experiences impact their mental health and well-being. For that reason, the intent of this study was to learn more about transgender females who hold additional minority statuses, their transition experiences, their circumstances, and the nature of their social environment. Specifically, I investigated trans female experiences of transitioning with a specific focus on the intersection of gender identity, race, socioeconomic status (SES), and age. …

Himmelfarb Library Liaison Letter - July 2019, The George Washington University, Himmelfarb Health Sciences Library

Himmelfarb Library Liaison Letters

No abstract provided.

The Use Of Mobile Applications To Promote Sleep In Clients With A Mental Health Diagnosis, Joanna Johnson

Nursing Capstones

Background: Disrupted sleep patterns are a common occurrence in those with a diagnosis of a mental health disorder. Unfortunately, many people are often treated for their mental health disorders solely, or prescribed additional medications to manage sleep, leaving sleep management poorly addressed in the clinical setting. There is a growing body of evidence supporting the benefits of integrating mobile applications into psychiatric clinical practice.

Objective: The purpose of this DNP project was to evaluate the benefit of utilizing mobile applications that promote relaxation prior to bedtime, in order to improve overall sleep patterns in patients with a diagnosis of a …

Optimizing Clinical Processes Using The Electronic Health Record To Improve Patient Outcomes In Primary Care, Alex Jubril

Doctoral Projects

Background: The EHR has been used to leverage clinical processes for the improvement of patient outcomes. The average users of EHR limit its uses to the minimum level required to complete the daily tasks needed, regardless of the existence of features within the EHR that are readily available to optimize clinical processes for efficiency and effectiveness.

Objectives: The objective of this project was to improve the documentation in a nurse-managed health clinic related to the patient-centered medical home (PCMH) core criteria through enhancing the EHR to foster the quality improvement metrics and reporting.

Methods: This was a quality improvement project …

Endosomal Trafficking And Exosomal Secretion Of Egfrviii, Kimiya Memarzadeh

Dissertations and Theses (Open Access)

The epidermal growth factor receptor (EGFR) variant three (EGFRvIII) mutation is linked with approximately one third of Glioblastoma Multiforme (GBM) tumors and is associated with poor patient prognosis. Persistent signaling due to a lack of the EGFR ectodomain and inefficient degradation have been suggested to underlie the tumorgenic properties of EGFRvIII. I observed that, like the parental EGFR, EGFRvIII is internalized into the intraluminal vesicles of late endosomes / multivesicular bodies (MVBs) but does not follow the canonical pathway by which wild-type EGFR is degraded following MVB fusion with lysosomes. I determined that EGFRvIII is secreted on exosomes, the intraluminal …

Interdependent Mechanisms Of Stress Susceptibility, Julie Elaine Finnell

Theses and Dissertations

Social stress is a significant risk factor for the emergence of psychiatric disorders including depression and anxiety. While there are a number of commercially available therapeutic options for the treatment of these disorders, these treatments require weeks of continuous use to produce behavioral efficacy. It has also been suggested that these traditional therapies are only marginally effective in producing complete remission, suggesting that our understanding as it pertains to the mechanisms underlying stressinduced behavioral dysfunction is still in its infancy. In the last few years, inflammation has become a major focus in the field of stress and depression as clinical …

A Qualitative Analysis Of Problematic And Non-Problematic Alcohol Use After Bariatric Surgery, Danielle L. Reaves, Joanne M. Dickson, Jason C. G. Halford, Paul Christiansen, Charlotte A. Hardman

Research outputs 2014 to 2021

OBJECTIVES: Bariatric surgery is an effective weight loss tool, but an under-communicated side effect may include the increased risk for alcohol problems. Few studies have examined contributors towards alcohol problems following surgery using a qualitative approach. Therefore, the current study aimed to generate insight informed by participants with problematic alcohol use following bariatric surgery, in comparison with participants without.

METHODS: Participants (14; females, n = 9; males, n = 5) completed semi-structured interviews using questions relating to alcohol use, relationship to food, support and surgical experiences. Thematic analysis was conducted to provide insight into the factors which influenced drinking behaviours …

Kinetics And Kinematics Of The Squat And Step-Up In Well-Trained Rugby Players, Brendyn B. Appleby, Robert U. Newton, Stuart J. Cormack

Research outputs 2014 to 2021

The purpose of this study was to compare and contrast the kinetics and kinematics of squat and step-up performance in well-trained athletes. Triaxial ground reaction force (GRF) and 3D kinematic data were collected in 4 maximal effort repetitions each at 70, 80, and 90% of 1 repetition maximum (1RM) of squat and step-up. The difference in concentric phase kinetics and kinematics between the squat and step-up was compared using effect sizes (ES ± 90% confidence limits [CLs]) classified as: less than 0.2 as trivial; 0.2-0.6 as small; 0.6-1.2 as moderate; and 1.2-2.0 as large. Where the 90% CL crossed negative …

Measuring Masculinity In Men With Chronic Disease, Stefano Occhipinti, Kirstyn Laurie, Melissa K. Hyde, Sean Martin, John Oliffe, Gary Wittert, Suzanne K. Chambers

Research outputs 2014 to 2021

The Masculinity in Chronic Disease Inventory (MCD-I) is a new measure of internalized masculine beliefs previously validated in the context of prostate cancer. The present study assessed the validity of the MCD-I in men with other chronic diseases to explore its potential for wider application. A cross-sectional survey of 633 men aged 47–93 years old (M = 68 years), of whom 68% reported ≥2 chronic conditions, was conducted. Measures included the MCD-I and Erectile Function. Exploratory and confirmatory factor analyses were performed followed by tests for discriminant validity. A five-factor structure was confirmed that explained 60% of the …

Effectiveness Of Self Instructional Module (Sim) On Knowledge Regarding Management Of Selected Poisoning In Children Among Paediatric Staff Nurses, Irene Freeda Ms, Smitha Bobby Ms, Sunita Solomon-Calvin Ms, Sophia Vinitha Ms

Manipal Journal of Nursing and Health Sciences

Background: Acute paediatric poisoning is a common medical emergency. Poisoning is one of the major causes of death among infants and toddlers in developing countries like India. Poisoning in children requires emergency intervention but, in every instance, medical evaluation is necessary to initiate appropriate action. Objectives: To assess the effectiveness of self-instructional module (SIM) on knowledge; Method: A quantitative, one group pre-test-post-test design was carried out among the purposive sample of 60 paediatric staff nurses. A structured knowledge questionnaire was used to assess the pre-test and post-test knowledge. A SIM was given on the day of the pre-test. Post-test was …

The Paediatric Nurse Practitioner: The Evolution Of A Role, Velerie Kiers, Caitlyn Shea, Elissa Ladd Dr

Manipal Journal of Nursing and Health Sciences

The paediatric nurse practitioner (PNP) is an advanced practice nursing role aimed at providing high quality care to children of all ages. Paediatric nurse practitioners are credentialed to provide a wide range of services dependent on their role as a paediatric nurse practitioner, i.e. primary care, acute care or neonatal. There are two possible paths that can be taken to become a paediatric nurse practitioner: the traditional path or apply for direct entry nursing program after completing Bachelor’s degree. This article describes the path to paediatric nurse practitioner practice.

Blunted Evoked Prouroguanylin Endocrine Secretion In Chronic Constipation., Scott A. Waldman, Renata Tenenbaum, Henry C. Foehl, Peter Winkle, Patrick Griffin

Department of Pharmacology and Experimental Therapeutics Faculty Papers

OBJECTIVES: Prouroguanylin (ProUGN) in the intestine is cleaved to form uroguanylin (UGN), which stimulates guanylate cyclase C (GUCY2C), inducing cyclic guanosine monophosphate signaling. Paracrine release regulates fluid secretion, contributing to bowel function, whereas endocrine secretion evoked by eating forms a gut-brain axis, controlling appetite. Whereas hormone insufficiency contributes to hyperphagia in obesity, its contribution to the pathophysiology of constipation syndromes remains unexplored. Here, we compared circulating ProUGN and UGN in healthy subjects and in patients with chronic idiopathic constipation (CIC) and patients with irritable bowel syndrome with constipation (IBS-C).

METHODS: Circulating ProUGN and UGN levels were measured in 60 healthy …

Nutrinews: July-August, 2019, Department Of Nutrition And Dietetics, University Of North Florida

NutriNews

This issue features The Origin of the Watermelon, Food Allergies, Small Changes toward better health, Childhood food insecurity, Does worksite wellness really benefit better health?, Reducing blood pressure with fiber

Identification Of A Novel Class Of Er-Selective Ligands Lacking Cross-Reactivity To Gper, Richard Anthony Pepermans

Biomedical Sciences ETDs

Estrogen plays multiple roles in health and disease, exerting its effects through the classical estrogen receptors (ERα and ERβ) and the G protein‑coupled estrogen receptor (GPER). Current ER‑targeting ligands, including the therapeutic ERα antagonist tamoxifen, have been shown to cross‑activate GPER. This cross‑activation is hypothesized to contribute to clinically observed endocrine resistance in breast cancer, highlighting the potential benefit of truly ER‑selective antagonists. We report the identification of a novel class of ER‑selective ligands that lack cross‑reactivity towards GPER, identifying a truly ER‑selective agonist (AB‑1) and antagonist (AB‑82P). Importantly, AB‑82P degrades a clinically relevant ERα mutant and exhibits inhibitory effects …

Faculty Entrustment Of Students In The Core Clerkships: A Comparison Between The Longitudinal Integrated Clerkship And The Block Clerkship, Robert L. Trowbridge, Marybeth D. Ford, Jenny L. Carwile, Eliza R. Bullis, Robert G. Bing-You

Journal of Maine Medical Center

INTRODUCTION: Entrustable Professional Activities (EPAs) have been proposed for use in undergraduate medical education. The ability of faculty to entrust students with EPAs may differ between Longitudinal Integrated Clerkships (LICs) and traditional block clerkships.

METHODS: Participants were core clerkship faculty, 64 in a LIC and 31 in a sequential block clerkship. We administered a web-based survey at the end of the core clerkship year to measure preceptors’ typical entrustment (on a scale of 0–10) in students for the 13 American Association of Medical Colleges Core EPAs. We compared entrustment between LIC and block faculty using a Mann-Whitney test.

RESULTS:LIC …

Biochemical And Clinical Response After Umbilical Cord Blood Transplant In A Boy With Early Childhood-Onset Beta-Mannosidosis., Troy C. Lund, Weston P. Miller, Julie B. Eisengart, Katrina Simmons, Laura Pollard, Deborah L. Renaud, David A. Wenger, Marc C. Patterson, Paul J. Orchard

Department of Neurology Faculty Papers

BACKGROUND: Deficiency in the enzyme β-mannosidase was described over three decades ago. Although rare in occurrence, the presentation of childhood-onset β-mannosidase deficiency consists of hypotonia in the newborn period followed by global development delay, behavior problems, and intellectual disability. No effective pharmacologic treatments have been available.

METHODS: We report 2-year outcomes following the first umbilical cord blood transplant in a 4-year-old boy with early childhood-onset disease.

RESULTS: We show restoration of leukocyte β-mannosidase activity which remained normal at 2 years posttransplant, and a simultaneous increase in plasma β-mannosidase activity and dramatic decrease in urine-free oligosaccharides were also observed. MRI of …

Trial Of Canakinumab, An Il-1Β Receptor Antagonist, In Patients With Inclusion Body Myositis., Michalis L Kosmidis, Dimitris Pikazis, Panayotis Vlachoyiannopoulos, Athanasios G Tzioufas, Marinos C. Dalakas

Department of Neurology Faculty Papers

Objective: To assess whether canakinumab, a monoclonal antibody against IL-1β approved for autoinflammatory diseases, is effective as target-specific therapy in patients with sporadic inclusion body myositis (sIBM).

Methods: Because in sIBM IL-1β colocalizes with amyloid precursor protein and upregulates amyloid aggregates enhancing degeneration, targeting IL-1β with canakinumab may arrest disease progression. On this basis, 5 ambulatory patients with sIBM participated in an institutional review board--approved open-labeled study with 150 mg canakinumab [4 bimonthly, then monthly subcutaneous injections] for a mean period of 15.8 months. Patients were assessed bimonthly with a manual dynamometer in 12 proximal and distal muscles and with …

Cytotoxicity And Apoptotic Mechanisms Of Different Solvent Extracts From Ipomoea Pes-Caprae On Human Nasopharyngeal Cells, Chantarawan Saengkhae, Napaporn Uawongyart, Sunantha Osiri

Chulalongkorn Medical Journal

Background: Ipomoea pes-caprae serves as a valuable medicinal plant with pharmacological activities including antioxidant, analgesic, anti-inflammatory, antispasmodic, and anticancer activities. Although some scientific literatures have demonstrated its anticancer activities, the exact mechanism has not been fully elucidated.Objectives: To study the cytotoxicity and apoptotic mechanisms of different solvent extracts from Ipomoeapes-caprae on human nasopharyngeal (KB) cells.Methods: The dried plant was macerated in hexane (Hex) or ethanol: water (EtOH). The supercritical fluidextraction process used carbon dioxide (SCO2) as the extracting solvent. Cytotoxic activity was determined byMTT assay. The apoptotic mechanism and its effect on mitochondrial membrane potential was measured byDNA agarose gel …

Characteristics And Physical Outcomes Of Kratom Users At A Substance Abuse Treatment Center, Somreudee Eaimchaloay, Rasmon Kalayasiri, Sujira Prechawit

Chulalongkorn Medical Journal

Background: Despite many disadvantages such as physical and mental disorders, family disruption, crime, etc., substance use disorder is continuously reported worldwide. Twenty - nine million people were reported to suffer from substance abuse. In addition, the survey found that only 1/6 of substance abusers throughout the world were able to access medical services. Kratom (Mitragyna speciosa Korth) has been used not only as medicine, but also as psychedelic drug for a long time.Objective: To study behavioral and physical consequences of kratom use.Methods: One hundred and six kratom users were recruited into this study at the Princess Mother NationalInstitute on Drug …

Prevalence Of Hypertension And Associated Factors Among Healthcare Workers: A Cross-Sectional Study, Patthrarawalai Sirinara, Nitt Hanprathet, Wiroj Jiamjarasrangsi

Chulalongkorn Medical Journal

Background: Hypertension is an important public health challenge in Thailand. Whether shift work and typesof working patterns in healthcare workers is linked to increased risk of high blood pressure remains controversial. The aim of this study was to quantify the prevalence of hypertension and to determine the effect of shift work and working patterns in healthcare workers of a large tertiary, university-based hospital in Bangkok, Thailand.Methods: A cross-sectional study was conducted using the annual health examination results and occupational health questionnaires of 6,014 healthcare workers at a large tertiary, university-based hospital. Sleep quality was measured using the Pittsburgh Sleep Quality …

Ecmo Support After Arterial Switch Operation: A Case Report Series From A Single Institution, Kanyarad Boonthim, Jule Namchaisiri, Vichai Benjacholamas

Chulalongkorn Medical Journal

Extracorporeal membrane oxygenators (ECMO) after arterial switch operation (ASO) is a rescue therapy forpatients who cannot wean from cardiopulmonary bypass as a bridge to recovery and/or transplantation. We,hereby, present a case report series of four patients from an institute who underwent ECMO after ASO fordextro-transposition of the great arteries (d-TGA). Two patients subsequently weaned off ECMO but only onepatient survived to discharge. ASO is a complex surgery that requires an approach of a multi-disciplinary teamwhere ECMO is a useful adjunct for recovery in difficult cases. Nevertheless, ECMO after ASO involvesdiscriminating patient selection, prompt timing to initiate and good care team …