Medicine and Health Sciences Commons^™

Development Of A Pediatric Model Of Nafld In Neonatal Iberian Pigs, Gabriella Veronica Hernandez, Victoria Alice Smith, Morgan Coffin, Daniel Columbus, Matthew Burd, Kimberly Sprayberry, Mark Edwards, Daniel Peterson, Darin Bennett, Robert Fanter, Christopher Kitts, Michael La Frano, Margaret Rice, Douglas Burrin, Magdalena Maj, Rodrigo Manjarin

Master's Theses

The prevalence of non-alcoholic fatty liver disease (NAFLD) in children has increased over the past decades, creating a need for animal models that recapitulate the features of the pediatric disease. Iberian pigs have a leptin-resistant phenotype characterized by hyperleptinemia, hyperphagia, and extreme adipogenesis. We hypothesized that neonatal Iberian pigs fed a high fat high-fructose (HFF) diet will develop a pattern of liver injury resembling pediatric NAFLD. In addition, we sought to determine if a mixture of probiotics would prevent the disease. Animals were fed 1 of 4 diets containing (g/kg body weight × d) 0 g fructose, 11 g fat …

Oral Rapid Hiv Testing In The Dental Setting: Experiences From Three Dental Hygiene Clinics, Anthony J. Santella, Petal Leuwaisee, Susan H. Davide, Hanna Horowitz, Bhuma Krishnamachari

Publications and Research

Background: Oral rapid HIV testing (ORHT) is implemented in the dental setting to make individuals aware of their possibly undiagnosed HIV infection. The testing process and characteristics of clients willing to receive ORHT has yet, however, to be systematically collected. Case description: Three dental hygiene clinics located in academic institutions implemented ORHT from March 2016 to April 2017. Results: 231 persons received ORHT; all had non-reactive results. Most had seen a primary care provider in the past year (n = 130), had had a previous ORHT (n = 111), and described themselves as extremely likely or likely to accept a …

The Impact Of A Brief, Bullying Bystander Intervention On Internalizing Symptoms: Is Gender A Moderator Of Intervention Effects?, Diana M. Doumas, Aida Midgett, April D. Watts

Counselor Education Faculty Publications and Presentations

The purpose of this study was to evaluate the efficacy of a brief, bystander bullying intervention on reducing internalizing symptoms among students (N = 65). Although witnessing bullying is associated with mental health risks, the majority of research on bystander interventions focuses on the impact of these programs on school-wide bullying reduction rather than improved emotional outcomes for those trained to intervene. Results indicated high school students trained in a brief, bystander bullying intervention reported greater decreases in internalizing symptoms from baseline to a 3-month follow-up compared to students in a control group. Further, gender moderated intervention effects such that …

Tumor Heterogeneity As A Predictor Of Response To Neoadjuvant Chemotherapy In Locally Advanced Rectal Cancer, Alissa Greenbaum, David R. Martin, Therese J. Bocklage, Ji-Hyun Lee, Scott A. Ness, Ashwani Rajput

Pathology and Laboratory Medicine Faculty Publications

BACKGROUND: Neoadjuvant chemoradiotherapy (nCRT) is the standard of care for locally advanced adenocarcinoma of the rectum, but it is currently unknown which patients have disease that will respond. This study tested the correlation between response to nCRT and intratumoral heterogeneity using next-generation sequencing assays.

PATIENTS AND METHODS: DNA was extracted from formalin-fixed, paraffin-embedded biopsy samples from a cohort of patients with locally advanced rectal adenocarcinoma (T3/4 or N1/2 disease) who received nCRT. High read-depth sequencing of > 400 cancer-relevant genes was performed. Tumor mutations and variant allele frequencies were used to calculate mutant-allele tumor heterogeneity (MATH) scores as measures of intratumoral …

Improving Validity And Reliability Of Homoeopathy, Raj Manchanda

Indian Journal of Research in Homoeopathy

No abstract provided.

Study Of The Psychometric Properties Of The Work Disability Diagnosis Interview (Woddi) For Workers With A Musculoskeletal Or Common Mental Disorder, Marie-José Durand, Marie-France Coutu, Éric Vaillancourt, Djamal Berbiche

Rapports de recherche scientifique

L’outil d’identification de la situation de handicap au travail (OISHT) consiste en une entrevue structurée qui a été développée pour aider les cliniciens à identifier de façon systématique les facteurs liés à l’incapacité au travail. L’OISHT est un des rares outils disponibles en réadaptation pour la clientèle en phase chronique d’incapacité au travail. Il tient compte de l’influence de différents systèmes (personnel, santé, travail, indemnisation) et a été élaboré pour les deux principales problématiques de santé associées à l’incapacité au travail, soit les troubles musculosquelettiques (TMS) et les troubles mentaux courants (TMC).

L’objectif de cette étude visait la validation de …

Workplace Practices For Healthy And Sustainable Return To Work, Iuliana Nastasia, Marie-José Durand, Marie-France Coutu, Cécile Collinge, Ana Cibotaru

Rapports de recherche scientifique

Au Québec, la Loi sur les accidents du travail et des maladies professionnelles (LATMP) établit que tout travailleur ayant subi une lésion professionnelle qui porte atteinte à son intégrité physique ou psychique a droit à la réadaptation que requiert son état en vue de sa réinsertion sociale et professionnelle. La LATMP prévoit aussi un droit de retour au travail lorsque le travailleur redevient capable d’exercer son métier. Les organisations et les travailleurs sont donc directement concernés par la mise en place de solutions de retour au travail (RaT) adéquates, durables et efficaces. Alors que la littérature récente …

Exploring The Main Effects Of Patient Activation And Provider Support For Patient Self-Management On Patient Portal Use, Linda Anne Greenspan

Dissertations and Theses

Objectives:

This dissertation was designed to: (1) explore variations in clinicians’ views about patient self-management, (2) explore variation in patient activation and (3) explore variation in patients’ and their primary care physicians’ characteristics in the use of a patient portal and the main effects of patient activation and primary care physician support for patient self-management on portal use in an understudied closed multi-specialty ambulatory center. The main hypothesis is that primary care physician support for patient self-management will be an effect modifier on the association between patient activation and patient portal use.

Setting:

The New York Hotel Trades Council and …

Analysis Of Cell-Free Circulating Tumor Dna In 419 Patients With Glioblastoma And Other Primary Brain Tumors., David E Piccioni, Achal Singh Achrol, Lesli A Kiedrowski, Kimberly C Banks, Najee Boucher, Garni Barkhoudarian, Daniel F Kelly, Tiffany Juarez, Richard B Lanman, Victoria M Raymond, Minhdan Nguyen, Judy D Truong, Annie Heng, Jaya Mini Gill, Marlon G Saria, Sandeep C Pingle, Santosh Kesari

Articles, Abstracts, and Reports

Aim: Genomically matched trials in primary brain tumors (PBTs) require recent tumor sequencing. We evaluated whether circulating tumor DNA (ctDNA) could facilitate genomic interrogation in these patients. Methods: Data from 419 PBT patients tested clinically with a ctDNA NGS panel at a CLIA-certified laboratory were analyzed. Results: A total of 211 patients (50%) had ≥1 somatic alteration detected. Detection was highest in meningioma (59%) and gliobastoma (55%). Single nucleotide variants were detected in 61 genes, with amplifications detected in ERBB2, MET, EGFR and others. Conclusion: Contrary to previous studies with very low yields, we found half of PBT patients had …

Outcomes Of Left Main Percutaneous Coronary Intervention, Nasir Rahman, Bilal Hussain, Azmina Artani

Section of Cardiology

Objective: To study the outcomes of left main percutaneous coronary artery (LMCA) revascularisation.

Study Design: A descriptive study.

Place and Duration of Study: The Aga Khan University Hospital (AKUH), Karachi, from February till July 2016.

Methodology: The study included all adult patients aged 18 years or more, who underwent percutaneous LMCA revascularisation at study centre from April 2006 till April 2015. In-hospital outcomes were ascertained of patients via charts along with telephonic follow-up for outcome ascertainment at 1-year and 5-year. Results were expressed in terms of means and standard deviation for quantitative variables and percentages for qualitative variables.

Results: Of …

Legal Remedies To Address Stigma-Based Health Inequalities In The United States: Opportunities And Challenges, Valarie K. Blake, Mark L. Hatzenbuehler

Faculty & Staff Scholarship

Stigma is an established driver of population-level health outcomes. Antidiscrimination laws can generate or alleviate stigma and, thus, are a critical component in the study of improving population health.

Currently, antidiscrimination laws are often underenforced and are sometimes conceptualized by courts and lawmakers in ways that are too narrow to fully reach all forms of stigma and all individuals who are stigmatized.

To remedy these limitations, we propose the creation of a new population-level surveillance system of antidiscrimination law and its enforcement, a central body to enforce antidiscrimination laws, as well as a collaborative research initiative to enhance the study …

Adolescent Obesity In The Past Decade: A Systematic Review Of Genetics And Determinants Of Food Choice, Eleanor T. Campbell, Alexis T. Franks, Paule V. Joseph

Publications and Research

Background and purpose: As the incidence of global obesity increases, concerns about adverse health outcomes in adolescents continues to rise. The complexity and expense of this problem require early recognition and specific preventive treatments. Knowledge of genetics and determinants of food choices contributing to adolescent obesity warrants further examination. The primary goal was to appraise the literature from the past decade (2007–2017) on the current state of food choice and genetic determinants of adolescent overweight/obesity in the United States. The secondary goal was to determine trends in the literature and areas for future research.

Methods: A systematic review of research …

Just Culture: It's More Than Policy, Linda Ann Paradiso, Nancy Sweeney

Publications and Research

Any healthcare organization’s top priority is effective and safe care. Despite this, medical error is the third-leading cause of death in the US. Hospitals are imperfect systems where nurses have competing demands and are forced to improvise and develop workarounds. Errors rarely occur in a vacuum, rather they’re a sequence of events with multiple opportunities for correction. Clinical nurses can have a significant impact on reducing errors due to their proximity to patients. When errors are identified, the events and impact on safe care need to be shared. Just culture is a safe haven that supports reporting. In a just …

Aminophylline Shortage And Current Recommendations For Reversal Of Vasodilator Stress: An Asnc Information Statement Endorsed By Scmr, Aiden Abidov, Vasken Dilsizian, Rami Doukky, W Lane Duvall, Christopher Dyke, Michael D Elliott, Fadi G Hage, Milena J Henzlova, Nils P Johnson, Ronald G Schwartz, Gregory S Thomas, Andrew J Einstein

Faculty, Staff and Student Publications

Pharmacologic reversal of serious or intolerable side effects (SISEs) from vasodilator stress is an important safety and comfort measure for patients experiencing such effects. While typically performed using intravenous aminophylline, recurrent shortages of this agent have led to a greater need to limit its use and consider alternative agents. This information statement provides background and recommendations addressing indications for vasodilator reversal, timing of a reversal agent, incidence of observed SISE with vasodilator stress, clinical and logistical considerations for aminophylline-based reversal, and alternative non-aminophylline based reversal protocols.

Quantitative Sensory Testing In Children With Sickle Cell Disease: Additional Insights And Future Possibilities., Robin E. Miller, Dawn S. Brown, Scott W. Keith, Sarah E. Hegarty, Yamaja Setty, Claudia M. Campbell, Suzanne M. Mccahan, Suhita Gayen-Betal, Hal Byck, Marie Stuart

Department of Pharmacology and Experimental Therapeutics Faculty Papers

Quantitative sensory testing (QST) is used in a variety of pain disorders to characterize pain and predict prognosis and response to specific therapies. In this study, we aimed to confirm results in the literature documenting altered QST thresholds in sickle cell disease (SCD) and assess the test-retest reliability of results over time. Fifty-seven SCD and 60 control subjects aged 8-20 years underwent heat and cold detection and pain threshold testing using a Medoc TSAII. Participants were tested at baseline and 3 months; SCD subjects were additionally tested at 6 months. An important facet of our study was the development and …

How Should We Deal With "Black Swan" Surgeons In Spine Surgery?, Jens R Chapman, Jeffrey C Wang, Karsten Wiechert

Articles, Abstracts, and Reports

No abstract provided.

Iatrogenic Bowel Injury Following Minimally Invasive Lateral Approach To The Lumbar Spine: A Retrospective Analysis Of 3 Cases., Tarush Rustagi, Emre Yilmaz, Fernando Alonso, Cameron K Schmidt, Rod J Oskouian, R Shane Tubbs, Jens R Chapman, Sarah Hopkins, Thomas A Schildhauer, Christian Fisahn

Articles, Abstracts, and Reports

Study Design: Retrospective cohort study.

Objective: Anterior approaches are often used during lumbar interbody fusion procedures. Visceral injuries (bowel injuries) are rare but represent a primary risk during anterior approaches to the lumbar spine. Left untreated, these injuries can result in significant complications. The aim of this study was to investigate the presentation and management of bowel injury cases following anterior approaches to the lumbar spine to raise the surgeon's awareness of this rare complication.

Methods: All direct anterior, oblique anterior, and transpsoas lumbar interbody fusion surgeries performed at our institution between 2012 and 2016 were analyzed retrospectively. Charts were …

Ossification Of The Mamillo-Accessory Ligament: A Review Of The Literature And Clinical Considerations., Graham Dupont, Emre Yilmaz, Joe Iwanaga, Rod J Oskouian, R Shane Tubbs

Articles, Abstracts, and Reports

Ossification of the mamillo-accessory ligament (MAL) is a misunderstood phenomenon; however, many have posited that it can result in nerve entrapment of the medial branch of the dorsal ramus causing zygapophyseal joint related low back pain. The MAL has been studied anatomically by few, yet the data indicate possible associations between ossification of this ligament and spondylosis. It has been proposed that mechanical stress upon the lumbar spine may also lead to progressive ossification of the MAL into a bony foramen.

Ossification Of The Roof Of The Porus Trigeminus With Duplicated Abducens Nerve., Graham Dupont, Juan J Altafulla, Joe Iwanaga, Koichi Watanabe, R Shane Tubbs

Articles, Abstracts, and Reports

Ossification of parts of the intracranial dura mater is common and is generally accepted as an age-related finding. Additionally, duplication of the abducens nerve along its course to the lateral rectus muscle is a known, although uncommon anatomical variant. During routine cadaveric dissection, an ossified portion of dura mater traveling over the trigeminal nerve's entrance (porus trigeminus) into the middle cranial fossa was observed unilaterally. Ipsilaterally, a duplicated abducens nerve was also observed, with a unique foramen superolateral to the entrance of Dorello's canal. To our knowledge, there has been no existing report of a simultaneous ossified roof of the …

Limited Morbidity And Possible Radiographic Benefit Of C2, Peter G Passias, Cole A Bortz, Frank Segreto, Samantha Horn, Katherine E Pierce, Haddy Alas, Avery E Brown, Renaud Lafage, Virginie Lafage, Justin S Smith, Breton Line, Robert Eastlack, Daniel M Sciubba, Eric O Klineberg, Alexandra Soroceanu, Douglas C Burton, Frank J Schwab, Shay Bess, Christopher I Shaffrey, Christopher P Ames

Articles, Abstracts, and Reports

Background: The study aims to evaluate differences in alignment and clinical outcomes between surgical cervical deformity (CD) patients with a subaxial upper-most instrumented vertebra (UIV) and patients with a UIV at C2. Use of CD-corrective instrumentation in the subaxial cervical spine is considered risky due to narrow subaxial pedicles and vertebral artery anatomy. While C2 fixation provides increased stability, the literature lacks guidelines indicating extension of CD-corrective fusion from the subaxial spine to C2.

Methods: Included: operative CD patients with baseline (BL) and 1-year postop (1Y) radiographic data, cervical UIV ≥ C2. Patients were grouped by UIV: C2 or subaxial …

First Africa Non-Communicable Disease Research Conference 2017: Sharing Evidence And Identifying Research Priorities, Kenneth Juma, Pamela A. Juma, Shukri F. Mohamed, Jared Owuor, Ann Wanyoike, David Mulabi, George Odinya, Maureen Njeru, Gerald Yonga

Imaging & Diagnostic Radiology, East Africa

Non-communicable diseases (NCDs) prevalence is rising fastest in lower income settings, and with more devastating outcomes compared to High Income Countries (HICs). While evidence is consistent on the growing health and economic consequences of NCDs in sub-Saharan Africa (SSA), specific efforts aimed at addressing NCD prevention and control remain less than optimum and country level progress of implementing evidence backed cost-effective NCD prevention approaches such as tobacco taxation and restrictions on marketing of unhealthy food and drinks is slow. Similarly, increasing interest to employ multi-sectoral approaches (MSA) in NCD prevention and policy is impeded by scarce knowledge on the mechanisms …

The Current State Of Animal Models And Genomic Approaches Towards Identifying And Validating Molecular Determinants Of Mycobacterium Tuberculosis Infection And Tuberculosis Disease, Allison N Bucsan, Smriti Mehra, Shabaana A Khader, Deepak Kaushal

2010-2019 OA Pubs

Animal models are important in understanding both the pathogenesis of and immunity to tuberculosis (TB). Unfortunately, we are beginning to understand that no animal model perfectly recapitulates the human TB syndrome, which encompasses numerous different stages. Furthermore, Mycobacterium tuberculosis infection is a very heterogeneous event at both the levels of pathogenesis and immunity. This review seeks to establish the current understanding of TB pathogenesis and immunity, as validated in the animal models of TB in active use today. We especially focus on the use of modern genomic approaches in these models to determine the mechanism and the role of specific …

Ifn-Γ: A Cytokine At The Right Time, Is In The Right Place, J. Daniel Burke, Howard A. Young

United States Public Health Resources

Interferon gamma has long been studied as a critical mediator of tumor immunity. In recent years, the complexity of cellular interactions that take place in the tumor microenvironment has become better appreciated in the context of immunotherapy. While checkpoint inhibitors have dramatically improved remission rates in cancer treatment, IFN-Γ and related effectors continue to be identified as strong predictors of treatment success. In this review, we provide an overview of the multiple immunosuppressive barriers that IFN-Γ has to overcome to eliminate tumors, and potential avenues for modulating the immune response in favor of tumor rejection.

Which Osteotomy For Osteonecrosis Of The Femoral Head And Which Patient For The Osteotomy?, Young-Kyun Lee, Beomseok Lee, Javad Parvizi, Yong-Chan Ha, Kyung-Hoi Koo

Rothman Institute Papers

Transtrochanteric curved varus osteotomy (TCVO) and transtrochanteric rotational osteotomy (TRO) are joint-preserving procedures for osteonecrosis of the femoral head. The purpose of this review is to provide up-to-date guidelines for the osteotomies. One retrospective comparison revealed that TCVO has shorter operation time, less bleeding, lower incidence of osteophyte formation, and lower rate of secondary collapse. To obtain successful results of the osteotomy, the patient should be younger than 40 years and should have a body mass index of less than 24 kg/m². The osteotomy should be performed in early stages of femoral head osteonecrosis before marked collapse of …

Positions In The N‐Methyl‐D‐Aspartate Receptor Glun2c Subunit M3 And M4 Domains Regulate Alcohol Sensitivity And Receptor Kinetics, Man Wu, Priya Katti, Yulin Zhao, Robert W. Peoples

Biomedical Sciences Faculty Research and Publications

Background

Alcohol alters synaptic transmission in the brain. The N‐methyl‐D‐aspartate (NMDA) receptor (NMDAR), a subtype of glutamate‐gated ion channel, is an important synaptic target of alcohol in the brain. We and others have previously identified 4 alcohol‐sensitive positions in the third and fourth membrane‐associated (M) domains, designated M3_1‐2and M4_1‐2, of the GluN1, GluN2A, and GluN2B NMDAR subunits. In the present study, we tested whether the corresponding positions in the GluN2C subunit also regulate alcohol sensitivity and ion channel gating.

Methods

We performed alanine‐ and tryptophan‐scanning mutagenesis in the GluN2C subunit followed by expression in HEK …

A Patient-Centered Medical Home Model For Improvement Of Healthcare For The Homeless Population: An Integrative Review, Dale Ellen Strickland

Doctoral Dissertations and Projects

The homeless population is surrounded by many obstacles while trying to obtain the essentials of life including food, water, shelter, clothes, medical care, and safety. In many areas of the United States and other countries homelessness is becoming an increasing problem. Compared to standard healthcare, the Patient-Centered Medical Home Model is offering a better experience for homeless patients. This integrated review provides a selection of published studies and information on the homeless population and the beginning of the Patient-Centered Medical Home Model to improve access and healthcare to many homeless patients. As the model is accepted by more medical professionals, …

Making Public Health History: 1969–2019, Alfredo Morabia

Publications and Research

No abstract provided.

Theileriosis In Mountain Bongo Repatriated To Kenya: A Clinical And Molecular Investigation, Richard P. Bishop, David O. Odongo, Thomas T. Dolan, Rosemary B. Dolan, Robert A. Skilton, Paul D. Sayer

All Peer-Reviewed Publications

Mountain bongo (Tragelaphus euryceros isaaci) from Kenya were exported to zoological institutions in North America and Europe in the 1970s and 1980s. In the following 20-30 years bongo numbers declined in Kenya and the Mountain Bongo Repatriation Project was launched. This resulted in 18 adult bongo, descendants of the original translocated bongo, being repatriated from the United States to Kenya in 2004. These newly arrived bongo were inadvertently exposed to heavy tick infestation on release in a conservancy on the slopes of Mount Kenya. Mortality and morbidity occurred during the third week after arrival. Theileria sp. infection was apparent from …

Host Species And Site Of Collection Shape The Microbiota Of Rift Valley Fever Vectors In Kenya, David P. Tchouassi, Ephantus J. Muturi, Samwel O. Arum, Chang Hyun Kim, Christopher J. Fields, Baldwyn Torto

All Peer-Reviewed Publications

The composition and structure of microbial communities associated with mosquitoes remain poorly understood despite their important role in host biology and potential to be harnessed as novel strategies for mosquito-borne disease control. We employed MiSeq sequencing of the 16S rRNA gene amplicons to characterize the bacterial flora of field-collected populations of Aedes mcintoshi and Aedes ochraceus, the primary vectors of Rift Valley fever (RVF) virus in Kenya. Proteobacteria (53.5%), Firmicutes (22.0%) and Actinobacteria (10.0%) were the most abundant bacterial phyla accounting for 85.5% of the total sequences. Non-metric multi-dimensional scaling plots based on Bray-Curtis dissimilarities revealed a clear grouping of …

Effect Of Motor Imagery On Children With Developmental Disabilities, J. Bonner, Ots, L. Finnegan, Ots, V. Leonard, Ots, M. Scuderi, Ots, A. Shacklett, Ots, J. Thiel, Ots, M.-C. Potvin, Phd, Otr/L

Student Papers, Posters & Projects

This systematic review provides a comprehensive summary of current research evidence with the intent to help OTs working in pediatric settings understand the potential outcomes of using MI with children with DD.