Medicine and Health Sciences Commons^™

Case Presentation On Periampullary Cancer And Ampullectomy, Tetiana Soloviova

Publications and Research

Periampullary cancer is a complex disease of heterogenous origin. This is cancer arising within 2 cm of the papilla of Vater and includes pancreatic, ampullary, biliary and duodenal cancers. Duodenal cancer has the highest estimated 5-year survival (49%), followed by ampullary cancer (45%), distal bile duct cancer (27%), and pancreatic cancer (18%). (Ray-Offor, 2019, ¶ 1)

The Moderating Effect Of Social Support On The Impact Of Perceived Loneliness On The Mental Health Of Long-Term Care Nursing Home Residents, Lindsay Nicole Stivers

Electronic Theses and Dissertations

The purpose of the present study is to examine the moderating effect of social support on the impact of loneliness on anxiety and depression in long-term care residents in nursing homes. Recent research suggests that a relationship exists between loneliness and rates of depression and anxiety in long-term care nursing home residents. The present study seeks to examine the buffering effect of social support and utilize the findings to provide suggestions for policy, practice, and research. A binary logistic regression and a series of multiple linear regressions were conducted to examine the relationships between the variables. The present study’s sample …

Heterodimeric Il-15 Delays Tumor Growth And Promotes Intratumoral Ctl And Dendritic Cell Accumulation By A Cytokine Network Involving Xcl1, Ifn-Γ, Cxcl9 And Cxcl10., Cristina Bergamaschi, Hrishikesh Pandit, Bethany A Nagy, Dimitris Stellas, Shawn M. Jensen, Jenifer Bear, Maggie Cam, Antonio Valentin, Bernard A Fox, Barbara K Felber, George N Pavlakis

Articles, Abstracts, and Reports

BACKGROUND: Interleukin-15 (IL-15) promotes growth and activation of cytotoxic CD8

METHODS: The antitumor activity of hetIL-15 produced from mammalian cells was tested in mouse tumor models (MC38 colon carcinoma and TC-1 epithelial carcinoma). The functional diversity of the immune infiltrate and the cytokine/chemokine network within the tumor was evaluated by flow cytometry, multicolor immunohistochemistry (IHC), gene expression profiling by Nanostring Technologies, and protein analysis by electrochemiluminescence and ELISA assays.

RESULTS: hetIL-15 treatment resulted in delayed primary tumor growth. Increased NK and CD8

CONCLUSIONS: Our results show that hetIL-15 administration enhances T cell entry into tumors, increasing the success rate of …

Effect Of Pembrolizumab Plus Neoadjuvant Chemotherapy On Pathologic Complete Response In Women With Early-Stage Breast Cancer: An Analysis Of The Ongoing Phase 2 Adaptively Randomized I-Spy2 Trial., Rita Nanda, Minetta C Liu, Christina Yau, Rebecca Shatsky, Lajos Pusztai, Anne Wallace, A Jo Chien, Andres Forero-Torres, Erin D Ellis, Heather Han, Amy Clark, Kathy Albain, Judy C Boughey, Nora T Jaskowiak, Anthony Elias, Claudine Isaacs, Kathleen Kemmer, Teresa Helsten, Melanie Majure, Erica Stringer-Reasor, Catherine Parker, Marie C Lee, Tufia Haddad, Ronald N Cohen, Smita Asare, Amy Wilson, Gillian L Hirst, Ruby Singhrao, Katherine Steeg, Adam Asare, Jeffrey B Matthews, Scott Berry, Ashish Sanil, Richard Schwab, W Fraser Symmans, Laura Van 'T Veer, Douglas Yee, Angela Demichele, Nola M Hylton, Michelle Melisko, Jane Perlmutter, Hope S Rugo, Donald A Berry, Laura J Esserman

Articles, Abstracts, and Reports

Importance: Approximately 25% of patients with early-stage breast cancer who receive (neo)adjuvant chemotherapy experience a recurrence within 5 years. Improvements in therapy are greatly needed.

Objective: To determine if pembrolizumab plus neoadjuvant chemotherapy (NACT) in early-stage breast cancer is likely to be successful in a 300-patient, confirmatory randomized phase 3 neoadjuvant clinical trial.

Design, Setting, and Participants: The I-SPY2 study is an ongoing open-label, multicenter, adaptively randomized phase 2 platform trial for high-risk, stage II/III breast cancer, evaluating multiple investigational arms in parallel. Standard NACT serves as the common control arm; investigational agent(s) are added to this backbone. Patients with …

Calcitonin Prescribing Criteria For The Management Of Hypercalcemia In A Community Hospital, Jessica Hernandez, Radhan Gopalani, Heidi Clarke, Joyce Lee, Alyssa Donadio

All Publications

Purpose/Background: Hypercalcemia is a clinical condition in which serum calcium levels exceed the upper limit of normal (>10.5 mg/dL). The most common causes of hypercalcemia are primary hyperparathyroidism and malignancy, however, it can also be caused by vitamin D intoxication, endocrine disorders, and immobilization due to an increase in bone resorption. First-line treatment of hypercalcemia includes hydration with intravenous (IV) normal saline and IV bisphosphonates. Calcitonin (Miacalcin®) is a synthetic hormone with a rapid onset of action and used intramuscularly (IM) or subcutaneously (SQ) as a second-line treatment in the management of hypercalcemia, specifically in severe and in symptomatic …

Pharmacological Prevention Of Atrial Fibrillation After Cardiac Surgery With And Without The Use Of Nonsteroidal Anti-Inflammatory Drugs, Laura Neubauer, Radhan Gopalani, Faaria Quadri, Mario Pascual, Heidi Clarke, Andrea Marr-Peralto

All Publications

Purpose: Atrial fibrillation after cardiac surgery (AFACS) is the most common complication following open heart procedures, with significantly increased morbidity and mortality associated with its occurrence¹. A previous study done at Baptist Hospital of Miami (BHM) showed a decrease in the incidence of AFACS from 36% to 22% after implementation of a prevention protocol that includes guideline-directed therapy with a beta-blocker and amiodarone. The protocol also includes nonsteroidal anti-inflammatory drugs (NSAIDs) modeled after a study published in 2004 that showed that NSAIDs lowered the incidence of postoperative atrial fibrillation by 65% when they were used in the postoperative …

Whole Word Vs Phoneme Error Scoring For Audiological Word Recognition Testing, Jennifer C. Arnoult

Honors Theses

The purpose of this study was to investigate a possible alternative method of scoring for word recognition testing. The current whole word scoring method is inefficient and often inconsistent with a client’s pure tone average scores, and previous research has suggested that phoneme error scoring may be a more effective and accurate scoring method. This project analyzed the audiogram and word recognition test scores of seventeen adult clients. The test used was the standard twenty-five-word list NU-6 test. The researchers analyzed the results from whole word scoring and phoneme error scoring of the same tests and compared the results to …

Hypoglycaemia Is Reduced With Use Of Inhaled Technosphere ® Insulin Relative To Insulin Aspart In Type 1 Diabetes Mellitus, E R Seaquist, L Blonde, J B Mcgill, S R Heller, D M Kendall, J B Bumpass, F M Pompilio, M L Grant

2020-Current year OA Pubs

AIM: To evaluate the effect of final HbA

METHODS: In the randomized, phase 3, multicentre AFFINITY-1 study, adults (N = 375) who had type 1 diabetes for ≥ 12 months and an HbA

RESULTS: Participants treated with Technosphere Insulin experienced statistically significantly fewer level 1 and 2 hypoglycaemic events and a lower incidence of level 3 hypoglycaemia than participants treated with insulin aspart. The lower rate of hypoglycaemia with Technosphere Insulin was observed across the range of end-of-treatment HbA

CONCLUSIONS: Participants using Technosphere Insulin experienced clinically non-inferior glycaemic control and lower hypoglycaemia rates across a range of HbA

Intimate Partner Violence Against Women In Pakistan: A Review Of Qualitative Research, Tazeen S. Ali, Rida Farhan, Michelle Ayub

Community Health Sciences

Objective: To consolidate research data and provide an insight into areas that need further research regarding intimate partner violence.
Methods: The review targeted qualitative research-based studies done in the English language and conducted in Pakistan from 2008 to 2018 regarding intimate partner violence against women. A thorough search of Google Scholar and PubMed databases was done. Data from each selected article was extracted using a data-extraction template.
Results: Of the 2,479 results, 21(0.8%) articles were selected along with 4(0.16%) texts from grey literature. An in-depth analysis led to six broad categories: experiences/perspectives of married women facing intimate partner violence; perspectives …

Associations Of Sickness Absence For Pain In The Low Back, Neck And Shoulders With Wider Propensity To Pain, David Coggon, Georgia Ntani, Karen Walker-Bone, Vanda E. Felli, Raul Harari, Lope H. Barrero, Sarah A. Felknor, Marianela Rojas, Anna Cattrell, Muhammad Masood Kadir

Community Health Sciences

Objectives: To explore the association of sickness absence ascribed to pain at specific anatomical sites with wider propensity to musculoskeletal pain.
Methods: As part of the CUPID (Cultural and Psychosocial Influences on Disability) study, potential risk factors for sickness absence from musculoskeletal pain were determined for 11 922 participants from 45 occupational groups in 18 countries. After approximately 14 months, 9119 (78%) provided follow-up information about sickness in the past month because of musculoskeletal pain, including 8610 who were still in the same job. Associations with absence for pain at specific anatomical sites were assessed by logistic regression and summarised …

Review Of The Latest Trends In Transplantation Immunology And Its Role In Mortality Reduction, Vivian Adedoye

Honor’s College Freeman Research Journal

Transplantation immunology deals with the process of moving cells, tissues, or organs, from one site to another, either within the same person or between a donor and a recipient. If an organ system fails, or becomes damaged because of disease or injury, it can be replaced with a healthy organ or tissue from a donor. The process of transplantation has become increasingly popular due to its life saving benefit. In 2015 /2016 4601 patients' lives were saved or improved by an organ transplant in the United Kingdom alone. Kidney transplants are the most common organ transplant followed by liver and …

Ubiquitination Of The Dna-Damage Checkpoint Kinase Chk1 By Traf4 Is Required For Chk1 Activation, Xinfang Yu, Wei Li, Haidan Liu, Qipan Deng, Xu Wang, Hui Hu, Zijun Y Xu-Monette, Wei Xiong, Zhongxin Lu, Ken H Young, Wei Wang, Yong Li

Faculty, Staff and Students Publications

BACKGROUND: Aberrant activation of DNA damage response (DDR) is a major cause of chemoresistance in colorectal cancer (CRC). CHK1 is upregulated in CRC and contributes to therapeutic resistance. We investigated the upstream signaling pathways governing CHK1 activation in CRC.

METHODS: We identified CHK1-binding proteins by mass spectrometry analysis. We analyzed the biologic consequences of knockout or overexpression of TRAF4 using immunoblotting, immunoprecipitation, and immunofluorescence. CHK1 and TRAF4 ubiquitination was studied in vitro and in vivo. We tested the functions of TRAF4 in CHK1 phosphorylation and CRC chemoresistance by measuring cell viability and proliferation, anchorage-dependent and -independent cell growth, and mouse …

Using The Engaging Parents In Education For Discharge (EPed) Ipad Application To Improve Parent Discharge Experience, Stacee M. Lerret, Norah L. Johnson, Michele Polfuss, Marianne E. Weiss, Karen Gralton, Carol Klingbeil, Cori A. Gibson, Mauricio Garnier-Villarreal, Sheikh Iqbal Ahamed, Riddhiman Adib, Rachel Unteutsch, Louis Pawela, Rosemary White-Traut, Kathleen J. Sawin

College of Nursing Faculty Research and Publications

Purpose

The purpose of this study was to evaluate the use of the Engaging Parents in Education for Discharge (ePED) iPad application on parent experiences of hospital discharge teaching and care coordination. Hypotheses were: parents exposed to discharge teaching using ePED will have 1) higher quality of discharge teaching and 2) better care coordination than parents exposed to usual discharge teaching. The secondary purpose examined group differences in the discharge teaching, care coordination, and 30-day readmissions for parents of children with and without a chronic condition.

Design/Methods

Using a quasi-experimental design, ePED was implemented on one …

Ape1 Promotes Pancreatic Cancer Proliferation Through Gfrα1/Src/Erk Axis-Cascade Signaling In Response To Gdnf, Yoo-Duk Choi, Ji-Yeon Jung, Minwoo Baek, Sheema Khan, Peter I. Song, Sunhyo Ryu, Joo-Yeon Koo, Subhash C. Chauhan, Andrew Tsin, Chan Choi, Won Jae Kim, Mihwa Kim

School of Medicine Publications

Pancreatic cancer is the worst exocrine gastrointestinal cancer leading to the highest mortality. Recent studies reported that aberrant expression of apurinic/apyrimidinic endodeoxyribonuclease 1 (APE1) is involved in uncontrolled cell growth. However, the molecular mechanism of APE1 biological role remains unrevealed in pancreatic cancer progression. Here, we demonstrate that APE1 accelerates pancreatic cancer cell proliferation through glial cell line-derived neurotrophic factor (GDNF)/glial factor receptor α1 (GFRα1)/Src/ERK axis-cascade signaling. The proliferation of endogenous APE1 expressed-MIA PaCa-2, a human pancreatic carcinoma cell line, was increased by treatment with GDNF, a ligand of GFRα1. Either of downregulated APE1 or GFRα1 expression using small interference …

Ethics, Ai, Mass Data And Pandemic Challenges: Responsible Data Use And Infrastructure Application For Surveillance And Pre-Emptive Tracing Post-Crisis, Mark Findlay, Jia Yuan Loke, Nydia Remolina Leon, Yum Yin, Benjamin (Tan Renyan) Tham

Research Collection Yong Pung How School Of Law

As the COVID-19 health pandemic rages governments and private companies across the globe are utilising AI-assisted surveillance, reporting, mapping and tracing technologies with the intention of slowing the spread of the virus. These technologies have the capacity to amass personal data and share for community control and citizen safety motivations that empower state agencies and inveigle citizen co-operation which could only be imagined outside such times of real and present danger. While not cavilling with the short-term necessity for these technologies and the data they control, process and share in the health regulation mission, this paper argues that this infrastructure …

International Mediation And Covid-19: The New Normal?, Nadja Alexander

Research Collection Yong Pung How School Of Law

What is the SIMC COVID-19 Protocol? The Singapore International Mediation Centre (SIMC) has just launched the SIMC COVID-19 Protocol to provide businesses with an expedited, economical and effective route to resolve any international commercial disputes during the COVID-19 pandemic period. SIMC’s Covid-19 protocol is a great example of a leading mediation service provider reaching out to a market severely disrupted by Covid-19. The option for Singaporean and international parties to mediate online means for a highly accessible, time and cost effective path to resolve disputes that have emerged in the wake of Covid-19.

Holistic Lifestyle Counseling By Physical Therapists: Current Practice And Barriers To Improvement, Savannah Grogan

Honors College Theses

Context: Unhealthy lifestyle habits are a significant risk factor for chronic disease and death in the United States of America. The healthcare system is largely focused on symptom-management and disease treatment with seemingly little regard for prevention, but physical therapists are particularly well-placed to improve patients’ health through lifestyle counseling and modification. Objectives: To assess the current state of holistic health promotion among physical therapists and to identify barriers to improving these practices. Design: An electronic survey was completed by physical therapists in and around the state of Kentucky. Descriptive statistics were used to assess participant demographics and the state …

Elective Abdominal Aortic Aneurysm Repair Complicated With Chylous Ascites, Zia Ur Rehman

Department of Surgery Docs

No abstract provided.

Do Recipients Of Cash Transfer Scheme Make The Right Decisions On Household Food Expenditure? A Study From A Rural District In Pakistan, Aminah Jahangir, Shehla Zaidi, Jai K. Das, Shifa Habib

Community Health Sciences

Objective: To assess spending by beneficiaries of Benazir Income Support Programme on monthly food commodities, and contribution of the cash grant programme on purchase of nutritious foods.
Methods: The descriptive cross-sectional survey of households enrolled in the Benazir Income Support Programme was conducted during July and August, 2013, in Matiari district of the Sindh province of Pakistan. Monthly household food expenditure on food commodities and use of the cash grant on type of food purchased was assessed through structured interviews of the beneficiaries. Results were computed in 2013 Pak rupees and converted to 2018 United States dollar. Women beneficiaries were …

Malaria Risk On Ancient Roman Roads: A Study And Application To Assessing Travel Decisions In Asia Minor By The Apostle Paul, Daniel C. Browning Jr

Master's Theses

This study models malaria risks for travelers on ancient Roman roads with the goal of providing a tool for historical assessment of travel accounts from antiquity. The project includes: identification of malaria risk factors and associated spatial datasets, malaria risk model construction, verification and validation against available pre-eradication data, overlay of ancient Roman road data, and an initial case-study application to the journeys of the Apostle Paul, as narrated in the New Testament book, Acts of the Apostles (Acts). The project is intentionally cross-disciplinary in bringing the technical capabilities of GIS to the task of evaluating nuanced textual sources for …

Radiology Of Covid-19 - Imaging The Pulmonary Damage, Saba Sohail

Department of Radiology

A large part of the world is presently in the grip of the coronavirus disease (COVID-19) by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 virus), declared a pandemic in March 2020. This document is a brief commentary of the imaging modalities used in the screening, diagnosis and management of COVID-19 pneumonia. Chest x-rays, especially portable, still form a part of majority of official guidelines, with reports of the suggestive radiologic features. The potential of CT scan and ultrasound is also realised, with earlier detection rate. Typical radiologic findings of bilateral, asymmetrical, crazy-paved ground glass opacification, consolidation, reverse halo sign, opacities, …

Diabetic Retinopathy: Targeting Bigh3 To Develop Novel Molecular Therapies, Reanna Rodriguez, Anjalee Choudhury, Daniela Gonzalez, Cristian Mercado, Andrew Tsin

School of Medicine Publications

Diabetic retinopathy (DR) is a complication of diabetes due to damage of blood vessels in the retina. Aside from being a major cause of blindness in the world, DR also has a significant impact on quality of life. Although there are methods to delay the progression of DR, there are no existing therapeutic regimens for early intervention. Thus, it is critical to develop cost-effective therapies towards preventing DR development.

Neurocognitive Impairment In Type 2 Diabetes: Evidence For Shared Genetic Aetiology, Josephine Mollon, Joanne E. Curran, Samuel R. Mathias, Emma E. M. Knowles, Phoeve Carlisle, Peter T. Fox, Rene L. Olvera, Harald Hh Goring, Amanda Rodrigue, Laura Almasy, Ravindranath Duggirala, John Blangero, David C. Glahn

School of Medicine Publications

Aims/hypothesis: Type 2 diabetes is associated with cognitive impairments, but it is unclear whether common genetic factors influence both type 2 diabetes risk and cognition.

Methods: Using data from 1892 Mexican-American individuals from extended pedigrees, including 402 with type 2 diabetes, we examined possible pleiotropy between type 2 diabetes and cognitive functioning, as measured by a comprehensive neuropsychological test battery.

Results: Negative phenotypic correlations (ρp) were observed between type 2 diabetes and measures of attention (Continuous Performance Test [CPT d']: ρp = -0.143, p = 0.001), verbal memory (California Verbal Learning Test [CVLT] recall: ρp = -0.111, p = 0.004) …

Mental Health Assessments In Icu And Acute Care, Carolynn M. Keane, Megan Altom, Taylor Harrell, Erica Smith, Danielle Woodward

Master of Occupational Therapy Student Critically Appraised Topics

The purpose of our critically appraised topic is to provide a brief summary of assessments that may be relevant to the burn unit or ICU setting, including their validity, reliability, specificity, sensitivity, and limitations. We had a total of eight articles with the following study designs: Systematic Review (2 articles), Longitudinal Study (1 article), Comparative Analysis (1 article), Correlational Analysis (2 articles) and Methodological (2 articles). These articles looked at the reliability, validity, specificity, and sensitivity of the following assessments: Abbreviated Burn Specific Anxiety Scale (A-BSPAS), Beck Depression Inventory-II, Brief Coping Orientation to Problems Experience (B-COPE), Concise Mental Health Checklist …

Prosthetic Valve Endocarditis From Trichosporon Asahii In An Immunocompetent Patient, Lizy Marial Paniagua, Deepthi Sudhakar, Lara Erika Perez, David Miranda, Pedro Urena, Igor Gregoric, Biswajit Kar, Hani Jneid, Jonalis Ramirez, David Paniagua

Faculty, Staff and Students Publications

Fungal endocarditis is a rare clinical entity. This report describes an unusual case of fungal endocarditis caused by infection with Trichosporon asahii in a 20-year-old immunocompetent man who received the diagnosis 1 year following biological aortic valve replacement. (Level of Difficulty: Beginner.)

Metabolic-Sensing Of The Skeletal Muscle Clock Coordinates Fuel Oxidation, Hongshan Yin, Weini Li, Somik Chatterjee, Xuekai Xiong, Pradip Saha, Vijay Yechoor, Ke Ma

Faculty, Staff and Students Publications

Circadian clock confers temporal control in metabolism, with its disruption leading to the development of insulin resistance. Metabolic substrate utilization in skeletal muscle is coordinated with diurnal nutrient cycles. However, whether the molecular clock is involved in this coordination is largely unknown. Using a myocyte-selective genetic ablation mouse model of the essential clock activator Bmal1, here we identify muscle-intrinsic clock as a sensor of feeding cues to orchestrate skeletal muscle oxidation required for global nutrient flux. Bmal1 in skeletal muscle responds robustly to feeding in vivo and insulin induces its expression. Muscle Bmal1 deficiency impaired the transcriptional control of glucose …

Structure And Mechanism Of Human Diacylglycerol O-Acyltransferase 1, Lie Wang, Hongwu Qian, Yin Nian, Yimo Han, Zhenning Ren, Hanzhi Zhang, Liya Hu, B V Venkataram Prasad, Arthur Laganowsky, Nieng Yan, Ming Zhou

Faculty, Staff and Students Publications

Diacylglycerol O-acyltransferase-1 (DGAT1) synthesizes triacylglycerides and is required for dietary fat absorption and fat storage in humans1. DGAT1 belongs to the superfamily of membrane-bound O-acyltransferases (MBOAT) that are found in all kingdoms of life and involved in acylation of lipids and proteins2,3. It remains unclear how human DGAT1 (hDGAT1) or other mammalian members of the MBOAT family recognize their substrates and catalyze their reactions. The absence of three-dimensional structures also hampers rational targeting of hDGAT1 for therapeutic purposes. Here we present the structure of hDGAT1 in complex with a substrate oleoyl Coenzyme A solved …

Friend Or Foe? Recent Strategies To Target Myeloid Cells In Cancer, Mehdi Chaib, Subhash C. Chauhan, Liza Makowski

School of Medicine Publications

The tumor microenvironment (TME) is a complex network of epithelial and stromal cells, wherein stromal components provide support to tumor cells during all stages of tumorigenesis. Among these stromal cell populations are myeloid cells, which are comprised mainly of tumor-associated macrophages (TAM), dendritic cells (DC), myeloid-derived suppressor cells (MDSC), and tumor-associated neutrophils (TAN). Myeloid cells play a major role in tumor growth through nurturing cancer stem cells by providing growth factors and metabolites, increasing angiogenesis, as well as promoting immune evasion through the creation of an immune-suppressive microenvironment. Immunosuppression in the TME is achieved by preventing critical anti-tumor immune responses …

Whatever Happened To Evidence-Based Practice During Covid-19?, Helene J. Krouse

School of Medicine Publications

Contemporary medical practice is grounded in rigorous scientific evidence in concert with best clinical practices and informed shared decision making with patients. During these times of uncertainty, disruption, and even anxiety, it becomes critical that we engage with our patients and communities in thoughtful dialogue and realistic expectations regarding treatments surrounding COVID-19. The hope for a “miracle” cure and urgency to return back to normal times can stimulate irrational thought and behavior and even desperate measures by individuals or groups. It becomes especially important that we continue to use reasonable, informed clinical judgment in discussing the various options with patients.

Successful Completion Of Pregnancy After Mustard Procedure For Transposition Of Great Arteries: A Rare Case From The Developing World, Muhammad Kamran Younis Memon, Ayesha Malik, Saleem Akhtar

Department of Paediatrics and Child Health

Surgical repair of transposition of great arteries has undergone various evolutionary changes over the years. The initial of these treatment options was atrial septectomy followed by atrial switch and the current preferred treatment option is arterial switch operation worldwide. Due to various reasons, like lack of medical and surgical expertise atrial switch operation was commonly in practice in developing countries until few years back. Pregnancy in a patient with history of atrial switch operation poses a unique haemodynamic challenge. We report the case of a successful pregnancy in a 26 years old lady who had undergone Mustard repair surgery in …