Medicine and Health Sciences Commons^™

Hypoxia-Inducible Factor–1Α–Dependent Induction Of Mir122 Enhances Hepatic Ischemia Tolerance, Cynthia Ju, Meng Wang, Eunyoung Tak, Boyun Kim, Christoph Emontzpohl, Yang Yang, Xiaoyi Yuan, Huban Kutay, Yafen Liang, David R Hall, Wasim A Dar, J Steve Bynon, Peter Carmeliet, Kalpana Ghoshal, Holger K Eltzschig

Faculty, Staff and Student Publications

Hepatic ischemia and reperfusion (IR) injury contributes to the morbidity and mortality associated with liver transplantation. microRNAs (miRNAs) constitute a family of noncoding RNAs that regulate gene expression at the posttranslational level through the repression of specific target genes. Here, we hypothesized that miRNAs could be targeted to enhance hepatic ischemia tolerance. A miRNA screen in a murine model of hepatic IR injury pointed us toward the liver-specific miRNA miR122. Subsequent studies in mice with hepatocyte-specific deletion of miR122 (miR122loxP/loxP Alb-Cre+ mice) during hepatic ischemia and reperfusion revealed exacerbated liver injury. Transcriptional studies implicated hypoxia-inducible factor-1α (HIF1α) in the induction …

Hypoxia-Inducible Factor-Dependent Induction Of Myeloid-Derived Netrin-1 Attenuates Natural Killer Cell Infiltration During Endotoxin-Induced Lung Injury, Nathaniel K Berg, Jiwen Li, Boyun Kim, Tingting Mills, Guangsheng Pei, Zhongming Zhao, Xiangyun Li, Xu Zhang, Wei Ruan, Holger K Eltzschig, Xiaoyi Yuan

Faculty, Staff and Student Publications

Sepsis and sepsis-associated lung inflammation significantly contribute to the morbidity and mortality of critical illness. Here, we examined the hypothesis that neuronal guidance proteins could orchestrate inflammatory events during endotoxin-induced lung injury. Through a targeted array, we identified netrin-1 as the top upregulated neuronal guidance protein in macrophages treated with lipopolysaccharide (LPS). Furthermore, we found that netrin-1 is highly enriched in infiltrating myeloid cells, particularly in macrophages during LPS-induced lung injury. Transcriptional studies implicate hypoxia-inducible factor HIF-1α in the transcriptional induction of netrin-1 during LPS treatment. Subsequently, the deletion of netrin-1 in the myeloid compartment (Ntn1

Changes In Exercise And Musculoskeletal Symptoms Of Novice Nurses: A One-Year Follow-Up Study, Judith Dianne Pugh, Lucy Gelder, Kylie Cormack, Anne M. Williams, Diane E. Twigg, Margaret Giles, Anthony J. Blazevich

Research outputs 2014 to 2021

Background

Nursing is a high-risk occupation for work-related musculoskeletal disorders and many nursing students have a history of musculoskeletal symptoms.

Aims

To quantify (1) changes in exercise and musculoskeletal symptoms from pre-registration to 12-month registered nurses, and (2) the best predictor of severity of musculoskeletal symptoms from measures of the five physical fitness components and exercise participation.

Methods

In this longitudinal study, August 2013 to April 2015, 62 (55.9%) of 111 nursing students fitness tested completed questionnaires measuring nursing work history, exercise, and musculoskeletal symptoms at baseline and 12 months post-registration.

Findings

Nurses’ exercise participation declined post-registration and 38.0% were …

Epilogue: Reflections From International Mentors Of The Quality Improvement Training Programme In India, Karl Lorenz, Sydney Dy, Michelle Denatale, Michael W. Rabow, Odette Spruijt, Karen Anderson, Meera Agar, Jake Mickelsen, Nandini Vallath

Research outputs 2014 to 2021

The article collates the narratives of experiences of the international faculty who mentored the quality improvement teams from India since 2017.

Quantitative Endophenotypes As An Alternative Approach To Understanding Genetic Risk In Neurodegenerative Diseases, Fabiana H G Farias, Bruno A Benitez, Carlos Cruchaga

2020-Current year OA Pubs

Endophenotypes, as measurable intermediate features of human diseases, reflect underlying molecular mechanisms. The use of quantitative endophenotypes in genetic studies has improved our understanding of pathophysiological changes associated with diseases. The main advantage of the quantitative endophenotypes approach to study human diseases over a classic case-control study design is the inferred biological context that can enable the development of effective disease-modifying treatments. Here, we summarize recent progress on biomarkers for neurodegenerative diseases, including cerebrospinal fluid and blood-based, neuroimaging, neuropathological, and clinical studies. This review focuses on how endophenotypic studies have successfully linked genetic modifiers to disease risk, disease onset, or …

Thrombotic Microangiopathy Following Onasemnogene Abeparvovec For Spinal Muscular Atrophy: A Case Series, Deepa H Chand, Craig Zaidman, Kapil Arya, Rachel Millner, Michelle A Farrar, Fiona E Mackie, Natalie L Goedeker, Vikas R Dharnidharka, Raja Dandamudi, Sandra P Reyna

2020-Current year OA Pubs

Spinal muscular atrophy is treated with onasemnogene abeparvovec, which replaces the missing survival motor neuron 1 gene via an adeno-associated virus vector. As of July 1, 2020, we had identified 3 infants who developed thrombotic microangiopathy following onasemnogene abeparvovec. Early recognition and treatment of drug-induced thrombotic microangiopathy may lessen mortality and morbidity.

Modified Full-Face Snorkel Mask As Covid-19 Personal Protective Equipment: Quantitative Results, Kyle Nicholson, Ashley Henke-Adams, Daniel M Henke, Alexxai V Kravitz, Hiram A Gay

2020-Current year OA Pubs

The COVID-19 crisis has resulted in a shortage of personal protective equipment (PPE). Adapting commercially available full-faced snorkel masks has been proposed as an alternative to narrow the gap in PPE. An advantage of the full-faced snorkel mask design is that it serves two critical purposes: eye and face protection, and high quality air filtration to protect against SARS-CoV-2. We performed quantitative testing on various full-faced snorkel masks with 3D printed adapters that accept commercially available particulate filters, and report on a design that passed Occupational Safety and Health Administration (OSHA) full-facepiece respirator standards.

Enteroscopy-Assisted Ercp With Needle-Knife Stricturoplasty Of A Strictured Hepaticojejunostomy, Michael J Weaver, Koushik K Das, Vladimir M Kushnir

2020-Current year OA Pubs

No abstract provided.

Abem Content Areas Of Em Resident On Shift Evidence-Based Medicine Questions, Shreyas Kudrimoti Ba, Estelle Cervantes Ba, Kashyap Kaul Do, Phillip Sgobba Bs, Mbs, William Spinosi Do, Dawn M. Yenser C-Tagme, Joseph B. Zackary Md, Bryan G. Kane Md

USF-LVHN SELECT

No abstract provided.

Substance Use Behaviors And Associated Psychosocial Characteristics Of Homeless Youth, Nina Liu Bs, Jeffrey Downen Bs, Ms, Brittany Gaudet Bs, Msph, Taylor Jarvill Ba, Cecilia E. Zemanek Bs, Amy B. Smith Phd, Hoonani M. Cuadrado Mspas, Pa-C, Marna R. Greenberg Do, Mph, Facep

USF-LVHN SELECT

No abstract provided.

Signet-Ring Cutaneous Metastasis Presenting With Massive Anasarca, Neel Raval, Leonid Shmuylovich, John Strickley, Tiffany Y Chen, Ilana S Rosman, Amy Musiek

2020-Current year OA Pubs

No abstract provided.

Momentum: Momelotinib Vs Danazol In Patients With Myelofibrosis Previously Treated With Jaki Who Are Symptomatic And Anemic, Srdan Verstovsek, Stephen T Oh, Et Al

2020-Current year OA Pubs

Hallmark features of myelofibrosis (MF) are cytopenias, constitutional symptoms and splenomegaly. Anemia and transfusion dependency are among the most important negative prognostic factors and are exacerbated by many JAK inhibitors (JAKi). Momelotinib (MMB) has been investigated in over 820 patients with MF and possesses a pharmacological and clinical profile differentiated from other JAKi by inhibition of JAK1, JAK2 and ACVR1. MMB is designed to address the complex drivers of iron-restricted anemia and chronic inflammation in MF and should improve constitutional symptoms and splenomegaly while maintaining or improving hemoglobin in JAKi-naive and previously JAKi-treated patients. The MOMENTUM Phase III study is …

Influence Of Pennsylvania Liquor Store Closures During The Covid-19 Pandemic On Features Of Alcohol Withdrawal Syndrome Consultations, Alexandra Amaducci Do, Ali Yazdanyar Do, Derek J. Fikse Do, Jasdip Kaur Bs, Andrew L. Koons Do, Gillian A. Beauchamp Md, Robert D. Cannon Do, Ryan M Surmaitis Do, Matthew D. Cook Do, Kenneth D. Katz Md

Department of Emergency Medicine

No abstract provided.

Evali During The Covid-19 Pandemic: A Needle In The Ground Glass, Derek J. Fikse Do, Matthew Nimmo Do, Alexandra Amaducci Do, Kenneth D. Katz Md

Department of Emergency Medicine

No abstract provided.

Examining The Relationship Of Physical Activity, Inflammation & Adiposity On Physical Function With Gender Differences, Jeanne Hlebichuk

Dissertations (1934 -)

Older adults are a rapidly growing segment of the population in the United States. The ability to maintain physical function declines with age and is a critical factor that contributes to living independently. Physical activity has been shown to slow declines in physical function and decrease chronic inflammation. Increases in adipose tissue and decreases in muscle mass are associated with aging. The increase in adipose tissue produces inflammatory markers that can negatively impact older adults’ health. Males and females’ biological changes with aging have been hypothesized to differ. The purposes of this study were to :1) examine the relationship between …

Examining Social Factors In Self-Management For Older Adults Living Alone, Margaret Salinas

Dissertations (1934 -)

Older adults living alone are a rapidly growing and often vulnerable segment of the population. Patient activation is an established predictor of self-management engagement, ability, and behaviors, and may be impacted by many factors, including social factors such as loneliness, social isolation, and neighborhood conditions. However, relationships among these social factors and environmental factors and patient activation are unclear. Using the Individual and Family Self-Management Theory, the purpose of this cross-sectional study was to examine the factor structure and bivariate correlations of loneliness, social isolation, neighborhood conditions and to test the effect of these factors on patient activation using self-efficacy …

The Limping Child, Bob Wiley, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Learning Objectives

• Review the definition of limp
• Describe the approach to initial evaluation of a limping child, including key items in the history and physical exam
• Appreciate the broad differential that one must keep when evaluating a limping child
• Understand the different types of limp and how they can be used to formulate a differential
• Recognize red flag signs and symptoms which require more urgent evaluation
• Use cases to demonstrate some of the common presentations that are seen by the GP

Connecting Healthcare – Leveraging Technology To Promote Value-Based Care In The Emergency Department, Ahnna Michelle Jackson

Doctoral Dissertations and Projects

The emergency department is a fast-paced and complex environment that serves hundreds of thousands of people a day across the state of Georgia. The establishment of a culture of value-based care in the emergency department is attainable but often falls short when the staff cannot properly leverage the technology available to them. Framed by the Complex Adaptive Theory and The Input/Throughput/Output Model of ED Patient Flow, the purpose of this qualitative case study was to explore how emergency department leaders and staff could better leverage technology to develop and sustain a culture of value-based care. The 30 participants in this …

Improving Advanced Care Planning Through Proper Implementation Of The Polst Paradigm: An Integrative Review, Charles Hunter Shomo Ii

Doctoral Dissertations and Projects

End of life planning is critical to ensure enactment of patient wishes, ethical patient treatment, and improved family acceptance of death. As such, this project addressed integration of reviewed literature of advanced planning directives to influence end-of-life care. Implementation guidelines and incorporation of the Physician Orders for Life Sustaining Treatment (POLST) paradigm was the central focus of this project. Addressing best implementation practices of the POLST paradigm should increase advanced care planning and ultimately positively impact patient and surrogate decisions regarding end of life management and care. Completion of this integrative review has provided substantial implicative evidence regarding best practice …

Mechanisms, Diagnosis, Prevention And Management Of Perioperative Opioid-Induced Hyperalgesia, Sylvia H Wilson, Kevin M Hellman, Dominika James, Adam C Adler, Arvind Chandrakantan

Faculty, Staff and Students Publications

Opioid-induced hyperalgesia (OIH) occurs when opioids paradoxically enhance the pain they are prescribed to ameliorate. To address a lack of perioperative awareness, we present an educational review of clinically relevant aspects of the disorder. Although the mechanisms of OIH are thought to primarily involve medullary descending pathways, it is likely multifactorial with several relevant therapeutic targets. We provide a suggested clinical definition and directions for clinical differentiation of OIH from other diagnoses, as this may be confusing but is germane to appropriate management. Finally, we discuss prevention including patient education and analgesic management choices. As prevention may serve as the …

Single-Cell Transcriptomics Identifies Limbal Stem Cell Population And Cell Types Mapping Its Differentiation Trajectory In Limbal Basal Epithelium Of Human Cornea, De-Quan Li, Sangbae Kim, Jin-Miao Li, Qianmiao Gao, Jongsu Choi, Fang Bian, Jiaoyue Hu, Yun Zhang, Jin Li, Rong Lu, Yumei Li, Stephen C Pflugfelder, Hongyu Miao, Rui Chen

Faculty, Staff and Students Publications

PURPOSE: This study aimed to uncover novel cell types in heterogenous basal limbus of human cornea for identifying LSC at single cell resolution.

METHODS: Single cells of human limbal basal epithelium were isolated from young donor corneas. Single-cell RNA-Sequencing was performed using 10x Genomics platform, followed by clustering cell types through the graph-based visualization method UMAP and unbiased computational informatic analysis. Tissue RNA in situ hybridization with RNAscope, immunofluorescent staining and multiple functional assays were performed using human corneas and limbal epithelial culture models.

RESULTS: Single-cell transcriptomics of 16,360 limbal basal cells revealed 12 cell clusters belonging to three lineages. …

The Impact Of Covid-19 On Kidney Transplantation And The Kidney Transplant Recipient – One Year Into The Pandemic, Pascale Khairallah, Nidhi Aggarwal, Ahmed A Awan, Chandan Vangala, Medha Airy, Jenny S Pan, Bhamidipati V R Murthy, Wolfgang C Winkelmayer, Venkat Ramanathan

Faculty, Staff and Students Publications

The COVID‐19 pandemic has significantly changed the landscape of kidney transplantation in the United States and worldwide. In addition to adversely impacting allograft and patient survival in postkidney transplant recipients, the current pandemic has affected all aspects of transplant care, including transplant referrals and listing, organ donation rates, organ procurement and shipping, and waitlist mortality. Critical decisions were made during this period by transplant centers and individual transplant physicians taking into consideration patient safety and resource utilization. As countries have begun administering the COVID vaccines, new and important considerations pertinent to our transplant population have arisen. This comprehensive review focuses …

Serotonergic Therapy In Epilepsy, Frank Gilliam, Hrvoje Hećimović, Matthew S. Gentry

School of Medicine Publications

Purpose of review

The serotonergic system is implicated in multiple aspects of epilepsy, including seizure susceptibility, sudden unexpected death in epilepsy (SUDEP), and comorbid depression. Despite the complexity of serotonin’s effects on various neuronal networks, ongoing research provides considerable insight into the role of serotonin in human epilepsy. This review explores the potential roles of serotonergic therapies to improve clinical outcomes in epilepsy.

Recent findings

In recent decades research has markedly increased our knowledge of the diverse effects of serotonin on brain function. Animal models of epilepsy have identified the influence of serotonin on seizure threshold in specific brain regions, …

A Millifluidic Perfusion Cassette For Studying The Pathogenesis Of Enteric Infections Using Ex-Vivo Organoids, Reid L Wilson, Sarah A Hewes, Anubama Rajan, Shih-Ching Lin, Carolyn Bomidi, Takanori Iida, Mary K Estes, Anthony W Maresso, K Jane Grande-Allen

Faculty, Staff and Students Publications

To generate physiologically-relevant experimental models, the study of enteric diarrheal diseases is turning increasingly to advanced in vitro models that combine ex vivo, stem cell-derived "organoid" cell lines with bioengineered culture environments that expose them to mechanical stimuli, such as fluid flow. However, such approaches require considerable technical expertise with both microfabrication and organoid culture, and are, therefore, inaccessible to many researchers. For this reason, we have developed a perfusion system that is simple to fabricate, operate, and maintain. Its dimensions approximate the volume and cell culture area of traditional 96-well plates and allow the incorporation of fastidious primary, stem …

Immunomodulatory And Anticancer Activities Of Hyacinthus Orientalis L.: An In Vitro And In Vivo Study, Lina T. Al Kury, Zainab Taha, Wamidh H. Talib

All Works

Hyacinthus orientalis L. (family Hyacinthaceae) is traditionally used to treat different diseases including cancer. In this study, the anticancer and immunomodulatory effects of this plant were evaluated. Hydroalcoholic extract was prepared, and different solvent fractions were obtained using solvent–solvent extraction. In the anticancer part, MTT assay and caspase-3 ELISA kits were used to measure the antiproliferative and apoptosis induction ability for each extract, respectively. In the immunomodulatory part, lymphocyte proliferation assay and cytokines detection kit were used to measure the effect of extracts of acquired immunity. Phagocytosis and pinocytosis induction were used to evaluate the effect of extracts on the …

Clinical And Economic Burden Of Stroke Among Young, Midlife, And Older Adults In The United States, 2002-2017, Safi U Khan, Muhammad Zia Khan, Muhammad U Khan, Muhammad Shahzeb Khan, Mamas A Mamas, Muhammad Rashid, Ron Blankstein, Salim S Virani, Michelle C Johansen, Michael D Shapiro, Michael J Blaha, Miguel Cainzos-Achirica, Farhaan S Vahidy, Khurram Nasir

Faculty, Staff and Students Publications

OBJECTIVE: To assess trends of stroke hospitalization rates, inpatient mortality, and health care resource use in young (aged ≤44 years), midlife (aged 45-64 years), and older (aged ≥65 years) adults.

PATIENTS AND METHODS: We studied the National Inpatient Sample database (January 1, 2002 to December 31, 2017) to analyze stroke-related hospitalizations. We identified data using the

RESULTS: Of 11,381,390 strokes, 79% (n=9,009,007) were ischemic and 21% (n=2,372,383) were hemorrhagic. Chronic diseases were more frequent in older adults; smoking, alcoholism, and migraine were more prevalent in midlife adults; and coagulopathy and intravenous drug abuse were more common in young patients with …

Using The Schmahmann Syndrome Scale To Assess Cognitive Impairment In Young Adults With Metabolic Syndrome: A Hypothesis-Generating Report, Eithan Kotkowski, Larry R. Price, Cheasequah J. Blevins, Crystal Franklin, Mary Woolsey, Ralph A. Defronzo, John Blangero, Ravindranath Duggirala, David C. Glahn, Jeremy Schmahmann, Peter T. Fox

School of Medicine Publications

The posterior cerebellum is the most significantly compromised brain structure in individuals with metabolic syndrome (MetS) (Kotkowski et al., 2019). In light of this, we hypothesized that cognitive decline reported in patients with MetS is likely related to posterior cerebellar atrophy. In this study, we performed a post-hoc analyses using T1-weighted magnetic resonance imaging (MRI), diffusion tensor imaging (DTI) in the form of voxel-wise tract-based spatial statistics (TBSS), biometric, and psychometric data from young participants with (n = 52, aged 18–35 years) and without MetS (n = 52, aged 18–35 years). To test the predictive value of components …

Bipolar Multiplex Families Have An Increased Burden Of Common Risk Variants For Psychiatric Disorders, Till F.M. Andlauer, Jose Guzman-Parra, Fabian Streit, Jana Strohmaier, Ney Alliey Rodriguez

School of Medicine Publications

Multiplex families with a high prevalence of a psychiatric disorder are often examined to identify rare genetic variants with large effect sizes. In the present study, we analysed whether the risk for bipolar disorder (BD) in BD multiplex families is influenced by common genetic variants. Furthermore, we investigated whether this risk is conferred mainly by BD-specific risk variants or by variants also associated with the susceptibility to schizophrenia or major depression. In total, 395 individuals from 33 Andalusian BD multiplex families (166 BD, 78 major depressive disorder, 151 unaffected) as well as 438 subjects from an independent, BD case/control cohort …

Severe Hyponatremia Following Cystoscopy And Urethral Dilation: An Unusual Late Complication, Mir Ibrahim Sajid, Shanila Ahmed, Noman Ali

Medical College Documents

No abstract provided.

Use Of Simulation Based Technology In Pre-Clinical Years Improves Confidence And Satisfaction Among Medical Students, Muhammad Bilal Mirza, Anjiya Sulaiman, Satwat Hashmi, Samar Zaki, Rehana Rehman, Rozmeen Akbar

Medical College Documents

Objective: To determine perception of medical students about learning from integrated simulated clinical skill sessions as part of the undergraduate curriculum.
Methods: The cross-sectional study was conducted at the Centre for Innovation in Medical Education, Aga Khan University (AKU), Karachi, from July 2018 to February 2019, and comprised first year medical students undertaking the Respiration and Circulation module of the curriculum. Quantitative data was collected using a questionnaire and the responses were assessed on a five-point Likert scale. Data was analysed using SPSS 21. Qualitative data was gathered through focused group discussion with students and an in-depth interview with the …