Medicine and Health Sciences Commons^™

Updated Genes, Lifestyles, And Their Interactions For Human Longevity, Brenda Bin Su, Alexis Villafranca, Chunxiang Mao, Stephanie Hernandez, Stephanie Lozano, Masoud M. Zarei, Kesheng Wang, Saraswathy Nair, Chun Xu

Health & Biomedical Sciences Faculty Publications

Healthy aging is the prolonging of optimal wellbeing during the progressive decline in physiological functions that are necessary for survival. Two important components of aging include an individual’s genetic makeup and lifestyle choices such as diet and exercise. Genetic factors are responsible for the functional physiology of the body including cell maintenance, metabolism and apoptosis. The individual effects of genes and lifestyle choices on aging are reported mainly in Caucasian populations, with very limited studies in minority populations. In this review, we included the effects of genes and environment and the interaction between them on aging in Hispanic population in …

Gen-Z Ambassadors: Students Supporting Persons With Alzheimer’S Disease And Their Caregivers In The Rio Grande Valley, Sofia G. Homes, Samantha R. Woo, Ashley G. Caldera, Sergio N. Gonzalez-Eymard, Rosa V. Pirela, Francisco Fernandez, Gladys E. Maestre

School of Medicine Publications

Background: Youth participation in policy, research, education and community development initiatives is a right embedded in the United Nations Convention on the Rights of the Child (UNCRC, General Assembly, 1989). However, avenues for youth participation in health promotion and care remains limited. Our Ambassadors program prepares high-school students on the Texas-Mexico border to understand and empathize with persons with Alzheimer’s disease (PwAD) and to empower their family and caregivers, consummating the UNCRC in the service of transformative community change actions.

Methods: Our long-term objective is youth participation, defined as practices that involve collaboration between students and various community stakeholders …

Urban Partnerships To Address Health Literacy In High Need Populations, Abiola O. Keller, Amy Vuyk, Joshua Knox

College of Nursing Faculty Research and Publications

Low health literacy disproportionately affects racial and ethnic minority communities and lower-income socioeconomic groups. To address this critical determinant of health inequity, two nonprofit organizations, Repairers of the Breach, a day shelter for individuals experiencing homelessness, and Bread of Healing a neighborhood-based clinic serving individuals with low incomes, partnered with researchers at Marquette University to implement and evaluate an evidence-supported health literacy program. The partnership delivered the curriculum in seven one-hour sessions over seven weeks. The program attendees were predominantly African American men and women from 19–73 years old. Most participants had formal education ranging from elementary school to some …

The Use Of Halo Gravity Traction In The Treatment Of Severe Early Onset Spinal Deformity, Sravisht Iyer, Henry Ofori Duah, Irene Wulff, Henry O. Tutu, Rufai Mahmud, Kwadwo P. Yankey, Harry Akoto, Oheneba Boachie-Adjei

College of Nursing Faculty Research and Publications

Study Design. 

Retrospective Review of Prospective cohort.

Objective. 

To describe the feasibility of preoperative halo gravity traction (HGT) with subsequent growing rod/guided growth (GR/GG) placement in early onset spinal deformity (EOSD).

Summary of Background Data. 

In children with severe EOSD, primary implantation of GR/GG constructs is not always possible. We describe a staged protocol with preoperative HGT followed by GR/GG implantation.

Methods. 

EOSD patients treated with HGT prior to GR/GG implantation were included. HGT used traction up to 50% body weight for 4 to 29 weeks. Pulmonary function tests (PFTs) were performed before and after HGT. Coronal Cobb (CC) and …

Practical Guidance For Engaging Patients In Health Research, Treatment Guidelines And Regulatory Processes: Results Of An Expert Group Meeting Organized By The World Health Organization (Who) And The European Society For Clinical And Economic Aspects Of Osteoporosis, Osteoarthritis And Musculoskeletal Diseases (Esceo), Maarten De Wit, Cyrus Cooper, Peter Tugwell, Nathalie Bere, John Kirwan, Philip G. Conaghan, Charlotte Roberts, Isabelle Aujoulat, Nasser Al-Daghri, Islene Arajujo De Carvalho, Mary Barker, Nicola Bedlington, Maria Luisa Brandi, Olivier Bruyère, Nansa Burlett, Philippe Halbout, Mickaël Hiligsmann, Famida Jiwa, John A. Kanis, Andrea Laslop, Wendy Lawrence, Daniel Pinto, Concepción Prieto Yerro, Véronique Rabenda, René Rizzoli, Marieke Scholte-Voshaar, Mila Vlaskovska, Jean-Yves Reginster

Physical Therapy Faculty Research and Publications

There is increasing emphasis on patient-centred research to support the development, approval and reimbursement of health interventions that best meet patients’ needs. However, there is currently little guidance on how meaningful patient engagement may be achieved. An expert working group, representing a wide range of stakeholders and disciplines, was convened by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) and the World Health Organization (WHO). Through a structured, collaborative process the group generated practical guidance to facilitate optimal patient engagement in clinical development and regulatory decisions. Patient engagement is a relational process. The …

Anesthetic Considerations For Patients Under The Influence Of Marijuana And/Or Cannabidiol: Anesthesia Interactions And Implications, Alexa Schimmel

Nurse Anesthesia MSNA Student Capstones

This manuscript investigates the use of marijuana, including edibles and cannabidiol (CBD), and its effects on anesthesia. This topic of research is very recent without an abundance of information. Various articles discuss the route of marijuana use including inhalation, ingestible and extracts of the plant, including CBD. For this manuscript, the term marijuana will pertain to both inhaled and ingested marijuana unless otherwise noted; ingestible marijuana is also known as edibles. This manuscript explains the mechanism of action of marijuana and CBD, the general guidelines for the use and how each affect the administration and impact of anesthesia.

Augmented Mean Arterial Blood Pressure And Vasopressor Selection In Patients With Spinal Cord Injury, Jayme Schroeder

Nurse Anesthesia MSNA Student Capstones

Blood pressure management in the acute period following spinal cord injury is a critical concern; one that anesthesia and critical care providers are often able to directly measure and regulate. It has been hypothesized that supraphysiologic blood pressure maintenance during this acute phase may improve recovery, however there is limited high-quality evidence to reinforce and guide management. Based on included prospective and retrospective studies, which provide the highest level of evidence available, The American Association of Neurologic Surgeons does provide the following level III recommendation: MAP goals of 85–90 mm Hg for 5–7 days post-injury should be considered. With regard …

Carbon Dioxide Embolisms During Laparoscopic Surgery, Leanne M. Jobin

Nurse Anesthesia MSNA Student Capstones

With the advancement of technology over the past few decades, laparoscopic surgery has significantly increased in popularity among many surgical subspecialties including: general surgery, gynecology, and urology. Many procedures that traditionally required open access with large incisions have been replaced with laparoscopic approaches as it offers many advantages such as, faster recovery, less postoperative pain, and shorter hospital stays. Despite its many advantages, it creates numerous anesthesia challenges and considerations when caring for patients undergoing laparoscopic procedures. Among these challenges, are carbon dioxide embolisms. This manuscript involves research and previous case studies that were conducted on carbon dioxide embolisms during …

Wrap-Around Services To Older Adults With Dementia: Collaboration, Education, And Prevention As A Model For Integration Of Primary Care And Neurobehavioral Health, Gladys E. Maestre, Francisco Fernandez

School of Medicine Publications

Background: Medical care in the Rio Grande Valley (RGV) is fragmented and difficult to navigate, especially for older adults with cognitive decline and dementia. The communities are eager to have a new healthcare delivery system that integrate community-based aging services to provide integrated, team collaborative better health care in our communities. The University of Texas RGV School of Medicine, in collaboration with its affiliates in the regional healthcare systems, is a partner providing comprehensive care across the life-cycle bridging science, social services and patient care. Our interprofessional team collaborative emphasizes safe, appropriate, and effective neurobehavioral care, employing evidence-based medicine in …

The Role Of T-Cell Protein Tyrosine Phosphatase In Epithelial Carcinogenesis, Liza D. Morales, Anna K. Archbold, Serena Olivarez, Thomas J. Slaga, John Digiovanni, Dae Joon Kim

School of Medicine Publications

T-cell protein tyrosine phosphatase (TC-PTP, encoded by PTPN2) is a non-receptor PTP that is mostly highly expressed in hematopoietic tissues. TC-PTP modulates a variety of physiological functions including cell cycle progression, cell survival and proliferation, and hematopoiesis through tyrosine dephosphorylation of its target substrates, such as EGFR, JAK1, JAK3, STAT1, and STAT3. Studies with whole or tissue-specific loss of TC-PTP function transgenic mice have shown that TC-PTP has crucial roles in the regulation of the immune response, insulin signaling, and oncogenic signaling. More recently, generation of epidermal-specific TC-PTP-deficient mice for use in multistage skin carcinogenesis bioassays demonstrated that TC-PTP …

Investigation Of Precise Molecular Mechanistic Action Of Tobacco-Associated Carcinogen ‘Nnk’ Induced Carcinogenesis: A System Biology Approach, Ad Anukriti, Anupam Dhasmana, Swati Uniyal, Pallavi Somvanshi, Uma Bhardwaj, Meenu Gupta, Shafiul Haque, Mohtashim Lohani, Dhruv Kumar, Janne Ruokolainen, Kavindra Kumar Kesari

School of Medicine Publications

Cancer is the second deadliest disease listed by the WHO. One of the major causes of cancer disease is tobacco and consumption possibly due to its main component, 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK). A plethora of studies have been conducted in the past aiming to decipher the association of NNK with other diseases. However, it is strongly linked with cancer development. Despite these studies, a clear molecular mechanism and the impact of NNK on various system-level networks is not known. In the present study, system biology tools were employed to understand the key regulatory mechanisms and the perturbations that will happen in the …

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. …

A Triphenylethylene Nonsteroidal Serm Attenuates Cervical Cancer Growth, Neeraj Chauhan, Diane M. Maher, Murali M. Yallapu, Bilal B. Hafeez, Man M. Singh, Subhash C. Chauhan, Meena Jaggi

School of Medicine Publications

Selective estrogen receptor modulator drug molecules of triphenylethylene family have gained considerable attention as anti-cancer agents. Despite recent advances in screening and development of HPV vaccines, cervical cancer remains one of the deadliest malignancies as advanced stage metastatic disease is mostly untreatable, thus warrants newer therapeutic strategies. Ormeloxifene (ORM) is a well-known SERM of triphenylethylene family that has been approved for human use, thus represents an ideal molecule for repurposing. In this study, we for the first time have demonstrated the anti-cancerous properties of ormeloxifene in cervical cancer. Ormeloxifene efficiently attenuated tumorigenic and metastatic properties of cervical cancer cells via …

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. …

The Bidirectionality Of Impulsivity And Alcohol Use: An Ecological Momentary Examination Among Emerging Adults, Amy L. Stamates

Psychology Theses & Dissertations

Impulsivity is a robust risk factor for alcohol use among emerging adults (i.e., 18 to 25), but significant gaps remain in our understanding of the way that impulsivity relates to alcohol harms. Most prior research has been limited to between-level differences; thus, within-person variability in impulsivity at the momentary level and its bidirectional association with alcohol use has not been examined. Consequently, the present research used a 14-day ecological momentary assessment (EMA) design to: (1) determine momentary impulsivity as a predictor of subsequent alcohol use and problems; (2) examine the influence of alcohol use on subsequent impulsivity; (3) test socio-cognitive …

Gene Expression Across Mammalian Organ Development, Margarida Cardoso-Moreira, Jean Halbert, Delphine Valloton, Britta Velten, Chunyan Chen, Yi Shao, Angélica Liechti, Kelly Ascenção, Coralie Rummel, John L. Vandeberg

School of Medicine Publications

The evolution of gene expression in mammalian organ development remains largely uncharacterized. Here we report the transcriptomes of seven organs (cerebrum, cerebellum, heart, kidney, liver, ovary and testis) across developmental time points from early organogenesis to adulthood for human, macaque, mouse, rat, rabbit, opossum and chicken. Comparisons of gene expression patterns identified developmental stage correspondences across species, and differences in the timing of key events during the development of the gonads. We found that the breadth of gene expression and the extent of purifying selection gradually decrease during development, whereas the amount of positive selection and expression of new genes …

Mite (Mmc Institute For Teaching Excellence) Highlights

Journal of Maine Medical Center

No abstract provided.

2018 Year In Review - Maine Medical Center Research Institute

Journal of Maine Medical Center

No abstract provided.

Costas T. Lambrew Research Retreat At Maine Medical Center - Abstracts From 2019

Journal of Maine Medical Center

No abstract provided.

Maine Medical Center Quality And Safety Storyboards: Operational Excellence As Platform For Improvement

Journal of Maine Medical Center

Physician and other healthcare learners and clinicians must prepare to assume an active role in the design, implementation, and improvement of emerging models of health care delivery while concurrently improving quality, workflow efficiency and safety. While these expectations are building, few practicing clinicians have training or experience with these challenges. Maine Medical Center’s Operational Excellence Team builds on a framework of Lean Thinking, the Model for Improvement* and PDSA cycles** to advance improvement capacity among care teams across our organization. Interprofessional Teams are coached to use proven tools and techniques to identify and remove barriers to care and establish sustainable …

Tufts University School Of Medicine Mary Y Lee, Md, Medical Education Day Poster Abstracts

Journal of Maine Medical Center

The following abstracts represent posters of Tufts University School of Medicine (TUSM) research and innovation projects in medical education (in progress and completed).

The goal of this conference is to promote faculty educational research and provide faculty development with opportunities to engage in cutting-edge topics in medical education. Faculty have the opportunity to show their scholarly medical education work to TUSM's community through posters and oral presentations, and participate in educational workshops.

EDUCATIONAL OBJECTIVES

To have participants:

1) Share their work on medical education research with TUSM's community.

2) Analyze new trends in today's health professionals' education.

3) Select in …

Poster Presentations From The 2018 Maine Medical Center Research Institute (Mmcri) Summer Student Research Program

Journal of Maine Medical Center

The following posters were presented as part of the 2018 MMCRI Summer Student Research Program. This program offers undergraduates and medical students a unique opportunity to conduct research in diverse clinical and biomedical science fields during the summer months. During the paid ten-week program, students participate in mentored independent research projects either in our state-of-the-art research facility, or working with physicians in a hospital setting to impact patient care or the outcome of treatment. Students also attend lectures and workshops featuring topics including bioethics, animal use in biomedical science and scientific presentation skills, and have the opportunity to attend presentations …

Time-Out In Madrid: Considering The Role Of Time-Outs In Clinical Practice, Colin T. Phillips

Journal of Maine Medical Center

No abstract provided.

Medical Professionalism: Who Needs It?, Daniel C. Bryant

Journal of Maine Medical Center

Anecdotal and public opinion evidence that respect for physicians may be decreasing could be explained by a decline, or perceived decline, in medical professionalism. Causes for the latter are discussed, and physician embrace of “the new professionalism” is suggested.

Increasing Actual And Perceived Burden Of Tick-Borne Disease In Maine, Robert P. Smith Md Mph, Carol A. Mccarthy Md, Susan P. Elias Phd

Journal of Maine Medical Center

Introduction: The burden of tick-borne disease (TBD) in Maine has steadily increased since the first case of Lyme disease was reported in the late 1980s. The emergence of five different agents of TBD in Maine has been challenging and confusing for clinicians and the public.

Methods: We reviewed the ecology of emerging of tick -borne disease, then reviewed risk factors for tick bites and tick-borne disease in Maine. We then compared the burden of TBD versus community-acquired comparison infections in terms of hospitalizations, deaths, and media attention.

Results and Discussion: In Maine, risk of exposure to bites from the vector …

A Case Report Of Water Hemlock Poisoning, Blue Butterfield, Alicia Bond Md, Dan Meyer, Gary Diperna, Tamas Peredy Md

Journal of Maine Medical Center

Introduction: Water hemlock poisoning is an uncommon cause of seizures, gastrointestinal upset, and renal failure. This poisoning occurs infrequency and is likely to go unrecognized without a proper history and consideration in the differential diagnosis.

Clinical Findings: A 23-year-old male with an unremarkable past medical history presented to the emergency department after being found unresponsive at a farm where he was employed. He had several tonic-clonic seizures en route. Initial evaluation was unremarkable and included toxicology screening, lumbar puncture, and brain imaging.

Main diagnoses, therapeutics, interventions, and outcomes: The patient was treated with broad-spectrum antibiotics and antivirals with a suspected …

Signs Of Psychosis Leading To A Diagnosis Of Progressive Multifocal Leukoencephalopathy: A Case Report, Bryan L. Walker, Christina Holt Md, Msc

Journal of Maine Medical Center

Introduction: Progressive multifocal leukoencephalopathy (PML) is a rare demyelinating process of the central nervous system that occurs in in the setting of severe immunocompromise. Patients with PML develop varying focal neurological deficits and mental status changes that have not been well-described previously.

Clinical findings: We present a patient who was found by security wandering the lobby of this hospital. He was oriented only to self and unable to state a reason for presentation. Medical records were limited and included a visit to an outside hospital that documented a past medical history of HIV infection. He exhibited multiple signs of psychosis …

Increased 18f-Fdg-Pet Uptake In Granulomatosis With Polyangiitis: Case Report And Review Of The Literature, Rama El-Yafawi, Patricia Cantlin, Thomas E. Van Der Kloot

Journal of Maine Medical Center

We present an unusual case of granulomatosis with polyangiitis (GPA), which initially presented as a large lung mass, without renal or other systemic features. The lung mass was most concerning for malignancy, and positron emission tomography (PET) further supported this concern, with intense uptake in the mass as well as in mediastinal and hilar lymph nodes. Biopsies however were non-diagnostic, and the patient developed acute kidney injury with active urinary sediment, leading to a definitive diagnosis of GPA. With supportive care and treatment directed at GPA, she was ultimately able to discontinue hemodialysis, and the lung mass resolved. This case …

Rationale And Design Of An Endocrinology Education Program For Primary Care In Maine: Initiation Of Mainehealth Endo Echo Maine, Irwin Brodsky, Joan Ingram, Stacy O'Brien, Tho Ngo, Charles T. Winchell

Journal of Maine Medical Center

Introduction: Population health and quality of care initiatives for the management of common endocrine disorders often include algorithmic and protocol-driven workflows in primary care practices. Endo ECHO is a division of Project ECHO at University of New Mexico that engages primary care clinicians in didactic presentations and case discussions to augment conceptual (experiential, nuanced) rather than algorithmic (rote) learning.

Research Design and Methods: MaineHealth Endo ECHO was designed using the Project ECHO model. Project ECHO® is an interactive learning opportunity that uses video conferencing to connect specialty and primary care to share best practices for delivering care. Using …

Bringing Upstairs Care Downstairs; Integration Of Rehabilitation Medicine, Care Management, And The Hospital Elder Life Program (Help) Into An Emergency Department., Robert Anderson, Molly Anderson, Rhonda Babine, Farid Feghali, Elizabeth Dunstan, Matthew Glazer, Susan Horton, Stephanie O'Brien, Elizabeth Pontius, David Smith, Megan Viens, Heather Williams

Journal of Maine Medical Center

Introduction: Services such as physical therapy (PT), occupational therapy (OT), speech-language pathology (SLP), social work (SW), care management, and elder life specialists have long been an established part of care for patients admitted to Maine Medical Center (MMC) but not for patients in the Emergency Department (ED). Methods and Results: Driven in part by changes in Medicare reimbursement models, care management established a presence in the Emergency Department (ED) in 2003 with a focus on care planning and cost avoidance. In recent years PT, OT, SLP, SW, and the Hospital Elder Life Program (HELP) have increased their ED involvement substantially. …