Medicine and Health Sciences Commons^™

What's Happening: January 20, 2020, Maine Medical Center

What's Happening

No abstract provided.

Neurodevelopment Outcome Of Neonates Treated With Intraventricular Colistin For Ventriculitis Caused By Multiple Drug-Resistant Pathogens-A Case Series, Kashif Hussain, Muhammad Sohail Salat, Gul Ambreen, Javaid Iqbal

Department of Biological & Biomedical Sciences

Background: Multiple-drug-resistant Gram-negative bacteria (MDR-GNB)-associated neonatal ventriculitis is a life-threatening complication that needs timely diagnosis and effective treatment with broad-spectrum antimicrobials in critical-care settings. Inadequate penetration of antibiotics through the blood-brain barrier also demands an intraventricular (IVT) route of administration. This study reports mortality and neurodevelopmental sequelae of neonates till 18 months of age, who received IVT-colistin for treating MDR-GNB associated ventriculitis.
Methods: In a case series of seven neonates with ventriculitis due to MDR-GNB at NICU of Aga Khan University Hospital, Pakistan, between June 2015 and 2018, we reviewed IVT-colistin therapy in critically ill neonates. Treatment outcomes were assessed …

Ada News - 01/20/2020, American Dental Association, Publishing Division

ADA News

Established in 1970 as the official newspaper of the American Dental Association, the ADA News serves practicing dentists and others allied to the dental profession in the U.S. and internationally. It is the No. 1 source of news and information about the many benefits and services the ADA delivers to members daily as well as timely information on scientific, social, political and economic developments affecting dentistry and health care.

Review Of Alterations In Perlecan-Associated Vascular Risk Factors In Dementia, Amanda L. Trout, Ibolya Rutkai, Ifechukwude J. Biose, Gregory J. Bix

Neurology Faculty Publications

Perlecan is a heparan sulfate proteoglycan protein in the extracellular matrix that structurally and biochemically supports the cerebrovasculature by dynamically responding to changes in cerebral blood flow. These changes in perlecan expression seem to be contradictory, ranging from neuroprotective and angiogenic to thrombotic and linked to lipid retention. This review investigates perlecan's influence on risk factors such as diabetes, hypertension, and amyloid that effect Vascular contributions to Cognitive Impairment and Dementia (VCID). VCID, a comorbidity with diverse etiology in sporadic Alzheimer's disease (AD), is thought to be a major factor that drives the overall clinical burden of dementia. Accordingly, changes …

Social Values For Health Technology Assessment In Canada: A Scoping Review Of Hepatitis C Screening, Diagnosis And Treatment, Caroline O'Keefe-Markman, Kristina Dawn Lea, Christopher Mccabe, Elaine Hyshka, Tania M. Bubela

Office of the Provost

Background: Health care system decision makers face challenges in allocating resources for screening, diagnosis and treatment of hepatitis C. Approximately 240,000 individuals are infected with the hepatitis C virus (HCV) in Canada. Populations most affected by HCV include Indigenous people, people who inject drugs, immigrants and homeless or incarcerated populations as well as those born between 1946 and 1965. Curative but expensive drug regimens of novel direct acting antivirals (DAAs) are available. We aim to identify social values from academic literature for inclusion in health technology assessments.
Methods: We conducted a scoping review of academic literature to identify and analyze …

Performance Of Frax In Predicting Fractures In Us Postmenopausal Women With Varied Race And Genetic Profiles, Qing Wu, Xiangxue Xiao, Yingke Xu

School of Medicine Faculty Research

BACKGROUND: Whether the Fracture Risk Assessment Tool (FRAX) performed differently in estimating the 10-year fracture probability in women of different genetic profiling and race remained unclear. METHODS: The genomic data in the Women's Health Initiative (WHI) study was analyzed (n = 23,981). The genetic risk score (GRS) was calculated from 14 fracture-associated single nucleotide polymorphisms (SNPs) for each participant. FRAX without bone mineral density (BMD) was used to estimate fracture probability. RESULTS: FRAX significantly overestimated the risk of major osteoporotic fracture (MOF) in the WHI study. The most significant overestimation was observed in women with low GRS (predicted/observed ratio (POR): …

Spatiotemporal Epidemiology Of Varicella In Chongqing, China, 2014-2018, Hua Zhu, Han Zhao, Rong Ou, Qing Zeng, Ling Hu, Hongfang Qiu, Manoj Sharma, Mengliang Ye

Environmental & Global Health Faculty Research

Although immunization against varicella using vaccines has been proven to be significant and effective in the past decades, varicella remains a major public health concern for many developing countries. Varicella vaccination has not been introduced into routine immunization programs in China, and varicella outbreaks have continued to occur. Taking the city of Chongqing, which has a high prevalence of varicella, as an example, this study explored the spatiotemporal epidemiology of varicella. Based on the reported data of varicella cases from 1 January 2014 to 31 December 2018 in Chongqing, hot spots and space-time clusters of varicella were identified using spatial …

Medical School Watercooler Newsletter - January 19, 2020, Lindsey Lyle

Watercooler Newsletter

This is the January 19, 2020 edition of the Frederick P. Whiddon College of Medicine's newsletter - Watercooler.

Contents Include:

• Med School Café to address psoriasis
• USA medical student matches in ophthalmology residency program
• Simmons awarded Faculty Intramural Grants Research Award
• CLINIC rotations connect textbook material with real-world patients

Support For Rural Practice: Female Physicians And The Life–Career Interface, Kimberly Stutzman, Ruth Ray Karpen, Pragna Naidoo, Sarah E. Toevs, Amanda Weidner, Ed Baker, David Schmitz

Public and Population Health Faculty Publications and Presentations

Introduction: The need for family physicians in rural areas across the USA and Canada is a longstanding issue that has been well documented. Since family physicians constitute the largest population of rural practitioners, the problem has been exacerbated by a sharp decline in medical students’ interest in the field of family medicine and the aging of the current rural workforce. Previous research has shown that female physicians in rural areas need strong support networks to maintain a healthy work–life balance. The purpose of this study was to better understand the types of support they need and how they find it, …

Perceptions Of Higher Education Health Science Faculty On Debriefing After Simulation Based Activities, Maureen Ellen Johnson

Occupational Therapy Collection

Health science faculty striving to be academically competitive can adopt debriefing after simulation-based activities to help transition occupational therapy and physical therapy students from classroom skills to clinical competence. The purpose of this qualitative study was to discover the perceptions and experiences of health science faculty during and after their adoption of debriefing after simulation-based activities. The theory of diffusion and experiential learning theory were used as a conceptual framework. The research questions related to the perceptions and experiences of faculty from their training sessions and implementing debriefing sessions after simulation-based activities in their courses and how these experiences related …

National Trends In Total Hip Arthroplasty For Traumatic Hip Fractures: An Analysis Of A Nationwide All-Payer Database., Anthony J Boniello, Alexander M Lieber, Kevin Denehy, Priscilla Cavanaugh, Yehuda E Kerbel, Andrew Star

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Hemiarthroplasty (HA) has traditionally been the treatment of choice for elderly patients with displaced femoral neck fractures. Ideal treatment for younger, ambulatory patients is not as clear. Total hip arthroplasty (THA) has been increasingly utilized in this population however the factors associated with undergoing HA or THA have not been fully elucidated.

AIM: To examine what patient characteristics are associated with undergoing THA or HA. To determine if outcomes differ between the groups.

METHODS: We queried the Nationwide Inpatient Sample (NIS) for patients that underwent HA or THA for a femoral neck fracture between 2005 and 2014. The NIS …

Mitochondrial Quality Control In Age-Related Pulmonary Fibrosis., Willy Roque, Karina Cuevas-Mora, Freddy Romero

Center for Translational Medicine Faculty Papers

Idiopathic pulmonary fibrosis (IPF) is age-related interstitial lung disease of unknown etiology. About 100,000 people in the U.S have IPF, with a 3-year median life expectancy post-diagnosis. The development of an effective treatment for pulmonary fibrosis will require an improved understanding of its molecular pathogenesis and the "normal" and "pathological' hallmarks of the aging lung. An important characteristic of the aging organism is its lowered capacity to adapt quickly to, and counteract, disturbances. While it is likely that DNA damage, chronic endoplasmic reticulum (ER) stress, and accumulation of heat shock proteins are capable of initiating tissue repair, recent studies point …

Factors Associated With Initiation And Sustenance Of Stress Management Behaviors In Veterinary Students: Testing Of Multi-Theory Model (Mtm), Vinayak K. Nahak, Julia K. Wells, Robert E. Davis, Elizabeth C. Johnson, Jason W. Johnson, Manoj Sharma

Environmental & Global Health Faculty Research

Veterinary students across the United States face the challenge of stress during school every day. When managed improperly, stress can become chronic and manifest in physical and emotional consequences. The purpose of this study was to examine the utility of the multi-theory model (MTM) of health behavior change in predicting the initiation and sustenance of stress management behaviors among veterinary students. A cross-sectional design was used to study the efficacy of the MTM in predicting initiation and sustenance of stress management behaviors among veterinary students at a private College of Veterinary Medicine in the Southeast United States. Researchers collected data …

Rhoa-Rock Signaling As A Therapeutic Target In Traumatic Brain Injury, Shalaka Mulherkar, Kimberley F Tolias

Faculty, Staff and Students Publications

Traumatic brain injury (TBI) is a leading cause of death and disability worldwide. TBIs, which range in severity from mild to severe, occur when a traumatic event, such as a fall, a traffic accident, or a blow, causes the brain to move rapidly within the skull, resulting in damage. Long-term consequences of TBI can include motor and cognitive deficits and emotional disturbances that result in a reduced quality of life and work productivity. Recovery from TBI can be challenging due to a lack of effective treatment options for repairing TBI-induced neural damage and alleviating functional impairments. Central nervous system (CNS) …

Cancer Health Disparities Among African Americans: A Socioecological Approach, Seth M. Spitzley

The Hilltop Review

Research shows that health outcomes are influenced by race or ethnicity, socioeconomic status, education and literacy levels, and the physical environment (U.S. Department of Health and Human Services, 2014). The health statuses of minority groups, such as African Americans, are adversely impacted by inequality (Randall, 2009). In Kalamazoo, Michigan, the leading cause of death for all residents in Kalamazoo County was cancer, where black individuals have the highest death rate among any other racial or ethnic group. That African Americans comprise less than 11% of the population in Kalamazoo County thus suggests that African Americans are disproportionately impacted by cancer …

Δ9-Tetrahydrocannabinol Exposure During Rat Pregnancy Leads To Symmetrical Fetal Growth Restriction And Labyrinth-Specific Vascular Defects In The Placenta., Bryony V Natale, Katarina N Gustin, Kendrick Lee, Alison C Holloway, Steven R Laviolette, David R C Natale, Daniel B Hardy

Physiology and Pharmacology Publications

1 in 5 women report cannabis use during pregnancy, with nausea cited as their primary motivation. Studies show that (-)-△9-tetrahydrocannabinol (Δ9-THC), the major psychoactive ingredient in cannabis, causes fetal growth restriction, though the mechanisms are not well understood. Given the critical role of the placenta to transfer oxygen and nutrients from mother, to the fetus, any compromise in the development of fetal-placental circulation significantly affects maternal-fetal exchange and thereby, fetal growth. The goal of this study was to examine, in rats, the impact of maternal Δ9-THC exposure on fetal development, neonatal outcomes, and placental development. Dams received a daily intraperitoneal …

Utility Of Ultrasound And Mammography In Detection Of Negative Axillary Nodal Metastasis In Breast Cancer, Anam Khan, Imrana Masroor, Kumail Khandwala, Summar Un-Nisa Abbasi, Muhammad Usman Tariq

Department of Radiology

Objective: The status of axillary lymph nodes is one of the most important prognostic factors in patients with breast cancer. A precise noninvasive evaluation of axillary lymph node status preoperatively, although challenging, is vital for optimization of the treatment plan for patients. The objective of our study was to assess the utility of ultrasound and mammography in detecting the absence of axillary lymph nodal metastasis in patients of breast cancer, taking histopathology as gold standard.
Methods: A cross-sectional study was conducted in the Department of Radiology, Aga Khan University Hospital, Karachi. All female patients between 20 and 95 years of …

Protective Allele For Multiple Sclerosis Hla-Drb1*01:01 Provides Kinetic Discrimination Of Myelin And Exogenous Antigenic Peptides., Azad Mamedov, Nadezhda Vorobyeva, Ioanna Filimonova, Maria Zakharova, Ivan Kiselev, Vitalina Bashinskaya, Natalia Baulina, Alexey Boyko, Alexander Favorov, Olga Kulakova, Rustam Ziganshin, Ivan Smirnov, Alina Poroshina, Igor Shilovskiy, Musa Khaitov, Yuri Sykulev, Olga Favorova, Valentin Vlassov, Alexander Gabibov, Alexey Belogurov

Department of Microbiology and Immunology Faculty Papers

Risk of the development of multiple sclerosis (MS) is known to be increased in individuals bearing distinct class II human leukocyte antigen (HLA) variants, whereas some of them may have a protective effect. Here we analyzed distribution of a highly polymorphous HLA-DRB1 locus in more than one thousand relapsing-remitting MS patients and healthy individuals of Russian ethnicity. Carriage of HLA-DRB1*15 and HLA-DRB1*03 alleles was associated with MS risk, whereas carriage of HLA-DRB1*01 and HLA-DRB1*11 was found to be protective. Analysis of genotypes revealed the compensatory effect of risk and resistance alleles in trans. We have identified previously unknown MBP_{153−161 …}

Calcium Alkali Thiazide Syndrome, Mehboob A. Rehan Md, Asma Rashid Md, Reema Singh Md, Gabutti Cristina, Luma Mohsin Md, Tausha Allen Md, Paul Stanford Md, James Thomson Md

Internal Medicine

No abstract provided.

Evidence For The Misfolding Of The A1 Domain Within Multimeric Von Willebrand Factor In Type 2 Von Willebrand Disease, Alexander Tischer, Maria A Brehm, Venkata R Machha, Laurie Moon-Tasson, Linda M Benson, Katelynn J Nelton, Rachel R Leger, Tobias Obser, Marina Martinez-Vargas, Steven T Whitten, Dong Chen, Rajiv K Pruthi, H Robert Bergen, Miguel A Cruz, Reinhard Schneppenheim, Matthew Auton

Faculty, Staff and Students Publications

Von Willebrand factor (VWF), an exceptionally large multimeric plasma glycoprotein, functions to initiate coagulation by agglutinating platelets in the blood stream to sites of vascular injury. This primary hemostatic function is perturbed in type 2 dysfunctional subtypes of von Willebrand disease (VWD) by mutations that alter the structure and function of the platelet GPIbα adhesive VWF A1 domains. The resulting amino acid substitutions cause local disorder and misfold the native structure of the isolated platelet GPIbα-adhesive A1 domain of VWF in both gain-of-function (type 2B) and loss-of-function (type 2M) phenotypes. These structural effects have not been explicitly observed in A1 …

Association Of Flavonoids And Flavonoid-Rich Foods With All-Cause Mortality: The Blue Mountains Eye Study, Nicola P. Bondonno, Joshua R. Lewis, Lauren C. Blekkenhorst, Catherine P. Bondonno, John H. C. Shin, Kevin D. Croft, Richard J. Woodman, Germaine Wong, Wai H. Lim, Bamini Gopinath, Victoria M. Flood, Joanna Russell, Paul Mitchell, Jonathan M. Hodgson

Research outputs 2014 to 2021

Background: Higher intakes of flavonoids provide health benefits, however, the importance of each flavonoid class and which population groups may receive the greatest protection from higher flavonoid intake warrants further investigation.

Objective: To explore the associations of flavonoid and flavonoid-rich wholefood intakes with all-cause mortality and the moderating effects of early mortality risk factors.

Design: The study included 2349 participants of The Blue Mountains Eye Study, with a mean ± SD age at baseline of 64.7 ± 9.2 years. Flavonoid intake was calculated from baseline food frequency questionnaires using US Department of Agriculture food composition databases. Associations were examined using …

Does Age Affect The Association Between Race/Ethnicity And Hpv Screening: A Retrospective Cohort Study Of United States Women, Keila L. Marlin, Mph, Larissa R. Brunner Huber, Ph.D.

Journal of Health Disparities Research and Practice

Many studies have demonstrated disparities in awareness of and knowledge about human papillomavirus (HPV) among young, immigrant, and minority populations. Yet, there is a lack of existing research that has investigated the role of race/ethnicity and HPV screening, and how it varies by age. The purpose of this study was to evaluate this association using 2016 Behavioral Risk Factor Surveillance System (BRFSS) data. This study included 120,646 women who self-reported information on race/ethnicity, HPV screening, and age. Logistic regression was used to obtain odds ratios (OR) and 95% confidence intervals (CIs). A stratified analysis was conducted to determine if age …

The Prevalence Of Physical Health Problems Among Youth In The Juvenile Justice System: A Systematic Review., Wadiya A. Udell, Selina Mohammed

Journal of Health Disparities Research and Practice

Justice-involved youth suffer from a range of health problems. Using health and social science databases, we summarize findings from studies reporting rates of physical health problems among youth in the juvenile justice system published between 2006 and 2017. A total of 23 were identified, with the majority examining sexual health problems and focusing on youth confined to correctional facilities. Although fewer studies focused on non-sexual health problems and non-detained youth, findings suggest disparities across some physical health problems impacting youth within various levels of justice system involvement. Given the health risks faced by justice-involved youth and their long-term consequences, more …

The Effect Of Language Barriers On Variation And Receipt Of Early Stage Breast Cancer Treatment, Abigail R. Madans Do, Richard T. Zera Md, Phd, Rachel M. Nygaard Phd

Journal of Health Disparities Research and Practice

Background: Arriving at and implementing an appropriate patient centered treatment plan for early stage breast cancer requires significant dialogue between healthcare providers and patients. How language barriers affect this process has not been thoroughly explored in the literature. The aim of this paper is to examine the effect of language barrier on variation and receipt of early stage breast cancer treatment.

Methods: Rates of lumpectomy, mastectomy, and contralateral prophylactic mastectomy (CPM) with or without reconstruction were compared between English speaking and Low English Proficiency (LEP) cohorts. Patients with recurrent or bilateral breast cancer, male patients, and/or known genetic mutations …

Health Literacy And Patient Reported Outcomes In Orthopaedic Surgery Patients, Thiran Udawatta, Lance Flesch, Michael Eng, Jane E. Oliphant, Scott G. Kaar

Journal of Health Disparities Research and Practice

Background: Health literacy may be an important factor in patient health outcomes, however, prior research has primarily focused on primary care patients with research in orthopaedic specific populations lacking.

Questions/purposes: The purpose of this study was to examine the relationship between health literacy and patient reported outcomes in an orthopaedic patient population.

Patients and Methods: 183 patients >18 years of age who presented to our institution’s sports orthopaedic surgery clinic with shoulder or knee complaints were analyzed. The primary outcomes were physical function recorded using Patient-Reported Outcomes Measurement Information System (PROMIS) physical function and Single Assessment Numerical Evaluation (SANE) scores. …

Understanding Medical Mistrust In Black Women At Risk Of Brca 1/2 Mutations, Arnethea L. Sutton, Jun He, Erin Tanner, Megan C. Edmonds, Alesha Henderson, Alejandra Hurtado De Mendoza, Vanessa B. Sheppard

Journal of Health Disparities Research and Practice

The benefits of genetic counseling and testing for hereditary breast and/or ovarian cancer (HBOC) are well documented; however, Black women are less likely to use these services compared to White women. Mistrust of the medical system has been associated with Black women’s use of genetic counseling and testing (GCT). However, relatively little is known about the correlates of medical mistrust in Black women at increased risk of HBOC. In this study, we examined the prevalence and predictors of medical mistrust in 94 Black women at-risk of HBOC. Most women were married (48.7%) and had at least some collegiate education (57.1%). …

Context Matters: Construct Framing In Measures Of Physical Activity Engagement Among African American Women, Stephanie M. Mcclure, Travis Loux, Enbal Shacham, Eileen Gillespie, Denise Hooks-Anderson

Journal of Health Disparities Research and Practice

Assessment of psychosocial factors influencing health behavior typically privileges conceptual consistency (framing constructs similarly across contexts) over conceptual specificity (context-specific framing). Modest statistical relationships between these factors and health behaviors, and persistent racial disparities in health outcomes raise questions about whether conceptually consistent framing fully captures relevant predictors. Ethnographic studies suggest not - that perceptions influencing health behaviors are multifaceted and contextual. To test this, we added items querying contextualized predictors of intention to engage in leisure-time physical activity (LTPA) to a Theory of Planned Behavior (TPB)-based survey and examined the psychometrics of the adapted subscales. We measured internal consistency …

Substance Abuse Treatment In Correctional Versus Non-Correctional Settings: Analysis Of Racial/Ethnic And Gender Differences, George Pro, Ricky Camplain, Samantha Sabo, Julie Baldwin, Paul A. Gilbert

Journal of Health Disparities Research and Practice

Background

Alcohol and drug abuse are widespread in the US. Substance abuse treatment services are effective, but utilization of services is low, particularly among African Americans, Hispanics, and women. Substance abuse is strongly associated with incarceration, and African Americans and Hispanics make up a disproportionate percentage of individuals with substance abuse problems involved in the criminal justice system. High treatment need, low treatment uptake, and the association between substance abuse and incarceration have led, in part, to correctional institutions filling the treatment gap by increasingly providing safety-net treatment services. We sought to better understand racial/ethnic and gender differences in determinants …

Effects Of Quantitative Literacy On Healthcare Decision-Making: An Aural Context, Robert G. Root, Sonia Bhala

Numeracy

We propose a relationship between sensory modality, numerical formatting, and performance on a survey simulating healthcare decision-making. We examine the current literature on aural health literacy, and specifically aural literacy coupled with health numeracy. We then create a survey instrument called the Bhala test for this purpose and demonstrate that it is moderately internally consistent and provides results that correlate with the NUMi assessment, a widely accepted measure of health numeracy. The quantitative information provided in the Bhala test has two treatments, percentage and natural frequency formats, in an effort to determine which format is easier for subjects to use …

Plasmonic-Active Nanostructured Thin Films, Jay Bhattarai, Helal Maruf, Keith Stine

Chemistry & Biochemistry Faculty Works

Plasmonic-active nanomaterials are of high interest to scientists because of their expanding applications in the field for medicine and energy. Chemical and biological sensors based on plasmonic nanomaterials are well-established and commercially available, but the role of plasmonic nanomaterials on photothermal therapeutics, solar cells, super-resolution imaging, organic synthesis, etc. is still emerging. The effectiveness of the plasmonic materials on these technologies depends on their stability and sensitivity. Preparing plasmonics-active nanostructured thin films (PANTFs) on a solid substrate improves their physical stability. More importantly, the surface plasmons of thin film and that of nanostructures can couple in PANTFs enhancing the sensitivity. …