Medicine and Health Sciences Commons^™

Evaluating The Health Impact Of Centeringpregnancy Program Versus Traditional Prenatal Care In Midland Obstetric Clinics And Validating Selected Item On Birth Certificate, Oluwatosin A. Momodu

Theses and Dissertations

The primary focus of this dissertation is to evaluate the health impact of the CenteringPregnancy (CP) program versus traditional prenatal care (TPNC) on important maternal outcomes of pregnancy. This is looked at in two outcomes-gestational weight gain (GWG) and pregnancy induced hypertension (PIH). The specific aims are to examine the: (1) effects of CenteringPregnancy program versus traditional prenatal care on gestational weight gain (GWG); (2) effects of CenteringPregnancy program versus traditional prenatal care on pregnancy induced hypertension (PIH).

Birth certificate (BC) data were linked to hospital discharge records of women who delivered in midland’s obstetric clinics of South Carolina between …

Food Choice Decision-Making Among School-Going Adolescents Amidst The Nutrition Transition In Urban Accra, Ghana, Krystal Krsna Rampalli

Theses and Dissertations

Like many countries of the world, Ghana is experiencing a nutrition transition and rising non-communicable diseases. Adolescents are susceptible to diet-related health risks as they experience significant physical and psychological changes, which are happening in tandem with food environment changes, including widespread proliferation of large portion and package sizes of energy-dense, nutrient-poor foods. Both local and multinational food and beverage companies have encouraged consumption of their products through various marketing tactics targeted directly to adolescents. Some of these tactics include the use of characters or celebrity endorsement, promotional discounts, and appeal to sociocultural values, including messages about body size preferences. …

Pre-Exposure Prophylaxis (Prep) Knowledge, Willingness To Use & Uptake Among Black Heterosexual Men, Akeen Lowell Hamilton

Theses and Dissertations

INTRODUCTION: Pre-exposure prophylaxis (PrEP) is a pill, taken orally, that has been shown to be effective at reducing the chance that someone who is HIV-negative and at-risk for HIV will contract the disease during sexual intercourse with someone who is living with HIV. One demographic group that has been under-researched is Black heterosexual men. This dissertation presents research on evaluating the heterosexual Black men’s awareness of, prior use, and network of friends/family’s perceived interest in learning more about PrEP.

METHODS: Two-hundred and six Black heterosexual men living in Brooklyn, New York City, were surveyed about their sexual behaviors and PrEP …

Utilization Of Remote Sensing To Analyze Aedes Mosquito Egg Abundance With Combined Weather Variables In Two Southeastern Coastal Cities, Danielle M. Johnson

Theses and Dissertations

Several vector-borne diseases have recently resurfaced, and many have suddenly spread to new areas in the United States (U.S.) due to climate change and tropicalization. Two vectors of public health importance are Aedes aegyptiand Aedes albopictus. The Southeastern region of the U.S. appears to be a preferential ecological niche for both Aedes species. Aedes aegyptiand Aedes albopictus are highly susceptible to environmental conditions, such as humidity, precipitation, temperature. Remote sensing technology has proven to be useful for estimating vector populations. Miami-Dade County is an established hotspot for disease transmission. Charleston County is newly vulnerable due to similar …

Variations In Er Stress And Unfolded Protein Response Predict Disease Susceptibility, Youwen Zhang

Theses and Dissertations

Numerous studies linked endoplasmic reticulum (ER) stress and unfolded protein response (UPR) to physiological responses to stress and various human pathologies, including metabolic disorders. Although variability in stress responses among individuals has been widely recognized, how such variations in the UPR affect susceptibility to diseases remains unknown. Using outbred deer mice as a model, we explored the consequences of the differential propensity to UPR at the transcriptomic, cellular, and organismic level.

Initially, we analyzed the correlation between several UPR-related genes in primary fibroblasts, at the whole transcriptome level, after ER stress induction. The analysis of correlated transcripts revealed that their …

The Development Of Novel Cdk8 And Cdk19 Inhibitors And Degraders As Potential Anti-Cancer Agents, Li Zhang

Theses and Dissertations

CDK8 and its homolog CDK19 are essential for transcription regulation and their dysregulation has been identified in numerous diseases, especially in cancers. CDK8 and CDK19 have been implicated in cancer development through their kinase activity and kinase independent functions. Despite the existing CDK8/19 inhibitors, there is still a need to develop novel CDK8/19 inhibitors with improved potency and PK profile. It is also necessary to develop CDK8/19 degraders that are able to eliminate the kinase-independent functions. Although two CDK8-degrading PROteolysis Activating Chimeras (PROTACs) have been reported, they have limited CDK8 degradation efficacy and no effect on CDK19. PROTACs with improved …

The Association Of Antidepressants Use With Healthcare Utilization, Patient-Reported Outcomes, And Alzheimer's Disease And Related Dementias (Adrd) Among Medicare Beneficiaries With Depression, Abdulrahman Abdullah A Alnijadi

Theses and Dissertations

Background: Depression and Alzheimer's Disease and Related Dementias (ADRD) are common among older adults. Currently, depression is recognized as one of the risk factors for ADRD. There is conflicting evidence on the association between depression and ADRD. Inadequate detection, diagnosis, and management of depression appear to pose a significant risk to the quality of life and healthcare utilization among older adults. To date, there are few studies on the impact of depression on self-reported healthcare utilization and self-reported health outcomes among Medicare beneficiaries.

Objectives: The aims of this study were to (1) quantify the association between depression and ADRD, quality …

Treatment-Free Survival After Discontinuation Of Immune Checkpoint Inhibitors In Metastatic Renal Cell Carcinoma: A Systematic Review And Meta-Analysis, Alice Tzeng, Tony H. Tzeng, Moshe C. Ornstein

School of Medicine Faculty Publications

While immune checkpoint inhibitors (ICI) can lead to sustained responses in metastatic renal cell carcinoma (mRCC), the optimal duration of therapy remains unknown. We aimed to examine treatment-free survival (TFS) in objective responders who discontinued ICI and to explore factors that may impact objective response rate (ORR) and TFS. MEDLINE/PubMed, Embase, and the Cochrane Library were searched for prospective studies reporting individual outcomes after ICI discontinuation in patients with mRCC. Pooled ORR and TFS were estimated using random-effects meta-analyses, and associations between ICI regimen type or treatment line and ORR or TFS were evaluated. Sixteen cohorts comprising 1833 patients treated …

How I Treat Neuroendocrine Tumors, Aasems Jacob, Gaby Gabriel, Robert A. Ramirez, Yi Zarn Wang, Lowell Anthony, Aman Chauhan

School of Medicine Faculty Publications

No abstract provided.

Multiple Sclerosis And Its Symptom Management Through Supplementation And Dietary Planning, Lindsey J. Davis

Selected Honors Theses

Multiple Sclerosis (MS) is an autoimmune, neuroinflammatory disorder that is characterized by the breakdown of myelinated axons in the Central and Peripheral Nervous Systems. It is a potentially debilitating autoimmune disease that affects almost 1 million people in the United States, and nearly 2.5 million people worldwide. The precise etiology of MS is still being researched, but much progress has been made towards understanding the molecular mechanisms and impactful ways to treat this disease. While there is still no cure, new treatment plans are constantly being orchestrated in effort to alleviate the burden that MS carries. Combination treatment plans have …

Application Of Single-Cell Rna Sequencing Technology In Liver Diseases: A Narrative Review., Lian He, Anjing Lu, Lin Qin, Qianru Zhang, Hua Ling, Daopeng Tan, Yuqi He

PCOM Scholarly Works

Objective: This review aimed to summarize the application of single-cell transcriptome sequencing technology in liver diseases.

Background: The increasing application of single-cell ribonucleic acid (RNA) sequencing (scRNA-seq) in life science and biomedical research has greatly improved our understanding of cellular heterogeneity in immunology, oncology, and developmental biology. scRNA-seq has proven to be a powerful tool for identifying and classifying cell subsets, characterizing rare or small cell subsets and tracking cell differentiation along the dynamic cell stages. Globally, liver disease has high rates of morbidity and mortality, and its exact pathological mechanism remains unclear, current treatment options are limited to clearance …

Bone Mineral Density Changes Associated With Pregnancy, Lactation, And Medical Treatments In Premenopausal Women And Effects Later In Life., Nelson B Watts, Neil Binkley, Charlotte D Owens, Ayman Al-Hendy, Elizabeth E Puscheck, Mohamad Shebley, William Schlaff, Md, James A Simon

Department of Obstetrics and Gynecology Faculty Papers

Bone mineral density (BMD) changes during the life span, increasing rapidly during adolescence, plateauing in the third decade of life, and subsequently entering a phase of age-related decline. In women, menopause leads to accelerated bone loss and an increase in fracture risk. Between peak bone mass attainment and menopause, BMD is generally stable and the risk of fracture is typically low. This time period is marked by life events such as pregnancy and lactation, which transiently decrease BMD, yet their long-term effects on fracture risk are less certain. BMD may also be altered by exposure to medications that affect bone …

Mask, The Drosophila Ankyrin Repeat And Kh Domain-Containing Protein, Affects Microtubule Stability, Daniel Martinez, Mingwei Zhu, Jessie J. Guidry, Niles Majeste, Hui Mao, Sarah T. Yanofsky, Xiaolin Tian, Chunlai Wu

School of Medicine Faculty Publications

Proper regulation of microtubule (MT) stability and dynamics is vital for essential cellular processes, including axonal transportation and synaptic growth and remodeling in neurons. In the present study, we demonstrate that the Drosophila ankyrin repeat and KH domain-containing protein Mask negatively affects MT stability in both larval muscles and motor neurons. In larval muscles, loss-of-function of mask increases MT polymer length, and in motor neurons, loss of mask function results in overexpansion of the presynaptic terminal at the larval neuromuscular junctions (NMJs). mask genetically interacts with stathmin (stai), a neuronal modulator of MT stability, in the regulation of axon transportation …

Clinical Use Of Lactate Measurements: Reply, Richard M. Pino, Jaskaran Singh

School of Medicine Faculty Publications

No abstract provided.

Processes Used By Mothers In Opioid Recovery To Manage The Needs Of The Maternal-Infant Dyad: A Grounded Theory Study, Nicole M. Mattson

Dissertations (1934 -)

Maternal opioid use during pregnancy and the postpartum period has significant impact on the mother and infant. Maternal well-being and early maternal-infant contact can impact the early attachment and bonding of the dyad. Additionally, the stigma surrounding opioid use in pregnancy can have detrimental effects on the dyad during pregnancy and in the postpartum period. Theory driven nursing interventions to promote mother-infant dyadic care for pairs impacted by maternal opioid use disorder (OUD) are needed. First, it was necessary to understand the current processes used by mothers with OUD to manage the unique needs of their dyad. The purpose of …

Advances In Optical Gastrointestinal Endoscopy: A Technical Review, Yubo Tang, Sharmila Anandasabapathy, Rebecca Richards-Kortum

Faculty, Staff and Students Publications

Optical endoscopy is the primary diagnostic and therapeutic tool for management of gastrointestinal (GI) malignancies. Most GI neoplasms arise from precancerous lesions; thus, technical innovations to improve detection and diagnosis of precancerous lesions and early cancers play a pivotal role in improving outcomes. Over the last few decades, the field of GI endoscopy has witnessed enormous and focused efforts to develop and translate accurate, user-friendly, and minimally invasive optical imaging modalities. From a technical point of view, a wide range of novel optical techniques is now available to probe different aspects of light-tissue interaction at macroscopic and microscopic scales, complementing …

Transmission Event Of Sars-Cov-2 Delta Variant Reveals Multiple Vaccine Breakthrough Infections, Timothy Farinholt, Harsha Doddapaneni, Xiang Qin, Vipin Menon, Qingchang Meng, Ginger Metcalf, Hsu Chao, Marie-Claude Gingras, Vasanthi Avadhanula, Paige Farinholt, Charu Agrawal, Donna M Muzny, Pedro A Piedra, Richard A Gibbs, Joseph Petrosino

Faculty, Staff and Students Publications

BACKGROUND: This study aims to identify the causative strain of SARS-CoV-2 in a cluster of vaccine breakthroughs. Vaccine breakthrough by a highly transmissible SARS-CoV-2 strain is a risk to global public health.

METHODS: Nasopharyngeal swabs from suspected vaccine breakthrough cases were tested for SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) by qPCR (quantitative polymerase chain reaction) for Wuhan-Hu1 and alpha variant. Positive samples were then sequenced by Swift Normalase Amplicon Panels to determine the causal variant. GATK (genome analysis toolkit) variants were filtered with allele fraction ≥80 and min read depth 30x.

RESULTS: Viral sequencing revealed an infection cluster of …

Close Friendships At Work Are Lifelines That Have Frayed During The Pandemic, Kenneth Tai

Research Collection Lee Kong Chian School Of Business

We have gone from having lunch with colleagues and meeting after work to eating hurriedly at our desks at home. The change in relationships at work also affects our productivity, argues SMU’s Kenneth Tai.

Reinvigorating A Technical Countering Weapons Of Mass Destruction Distance Learning Graduate Certificate Program, James C. Petrosky, Gaiven Varshney, Jeremy Slagley, Sara Shaghaghi

Faculty Publications

Current Countering Weapons of Mass Destruction (CWMD) demands can be divided broadly into policy and science. The science of chemical, biological, and radiological/nuclear weapons informs the limits of development, production, employment, operation, detection, risk characterization, human and material protection, and medical intervention. In short, the science of weapons of mass destruction (WMD) should precede and inform the development of policy. It is to this end that the Air Force Institute of Technology (AFIT) CWMD program was re-established, providing a technical educational option for practitioners to understand the science behind a very technically challenging subject.

Desirability Of Outcome Ranking For The Management Of Antimicrobial Therapy (Door Mat) Reveals Improvements In The Treatment Of Bloodstream Infections Caused By Escherichia Coli And Klebsiella Pneumoniae In Patients From The Veterans Health Administration, Federico Perez, Brigid M. Wilson, Elie Saade, Robin L.P. Jump, Robert A. Bonomo

Faculty Scholarship

Background: Reductions in the use of broad-spectrum antibiotics is a cornerstone of antimicrobial stewardship. We aim to demonstrate use of the Desirability of Outcome Ranking Approach for the Management of Antimicrobial Therapy (DOOR MAT) to evaluate the treatment of Escherichia coli and Klebsiella pneumoniae bloodstream infections in patients from the Veterans Health Administration (VHA) across a decade. Methods: Using electronic records, we determined empiric and definitive antibiotic treatments, clinical characteristics, and 30-day mortality of patients with monomicrobial E. coli and K. pneumoniae bloodstream infections hospitalized in VHA medical centers from 2009 to 2018. Focusing on patients treated with parenteral β-lactams …

Mandating Covid-19 Vaccine For Nursing Home Staff: An Ethical Obligation, Robin L.P. Jump

Faculty Scholarship

No abstract provided.

Themes, Communities And Influencers Of Online Probiotics Chatter: A Retrospective Analysis From 2009-2017, Santosh Vijaykumar, Aravind Sesagiri Raamkumar, Kristofor Mccarty, Cuthbert Mutumbwa, Jawwad Mustafa, Cyndy Au

Research Collection Lee Kong Chian School Of Business

We build on recent examinations questioning the quality of online information about probiotic products by studying the themes of content, detecting virtual communities and identifying key influencers in social media using data science techniques. We conducted topic modelling (n = 36,715 tweets) and longitudinal social network analysis (n = 17,834 tweets) of probiotic chatter on Twitter from 2009–17. We used Latent Dirichlet Allocation (LDA) to build the topic models and network analysis tool Gephi for building yearly graphs. We identified the top 10 topics of probiotics-related communication on Twitter and a constant rise in communication activity. However the number of …

Neuron-Specific Mitochondrial Oxidative Stress Results In Epilepsy, Glucose Dysregulation And A Striking Astrocyte Response, Ruth E Fulton, Jennifer N Pearson-Smith, Christopher Q Huynh, Timothy Fabisiak, Li-Ping Liang, Stefanos Aivazidis, Brigit A High, Georgia Buscaglia, Timothy Corrigan, Robert Valdez, Takahiko Shimizu, Manisha N Patel

Faculty, Staff and Students Publications

Mitochondrial superoxide (O2.−) production is implicated in aging, neurodegenerative disease, and most recently epilepsy. Yet the specific contribution of neuronal O2.− to these phenomena is unclear. Here, we selectively deleted superoxide dismutase-2 (SOD2) in neuronal basic helix-loop-helix transcription factor (NEX)-expressing cells restricting deletion to a subset of excitatory principle neurons primarily in the forebrain (cortex and hippocampus). This resulted in nSOD2 KO mice that lived into adulthood (2-3 months) with epilepsy, selective loss of neurons, metabolic rewiring and a marked mitohormetic gene response. Surprisingly, expression of an astrocytic gene, glial fibrillary acidic protein (GFAP) was significantly increased relative …

Crisis Preparedness In Acute And Intensive Treatment Settings: Lessons Learned From A Year Of Covid-19, Jarrod M Leffler, Cassandra L Esposito, Elisabeth A Frazier, Michelle A Patriquin, Meredith K Reiman, Alysha D Thompson, Carl Waitz

Staff and Researcher Publications

The impact of COVID-19 changed the use and delivery of health care services, requiring an abrupt shift in treatment and staffing models 1,2. This is particularly salient in youth acute and intensive treatment services (AITS), including inpatient psychiatric hospitals (IPH), intensive outpatient programs (IOP), and partial hospitalization programs (PHP), because of challenging issues of maintaining high-quality care and a safe therapeutic milieu during increased demand for acute services,3 all while limiting transmission of COVID-19 on locked units, in close quarters, and for youths traveling back and forth to day-programs. Over the past year, AITS adapted and evolved without the ability …

Adjuvant Platinum-Based Chemotherapy In Radically Resected Adrenocortical Carcinoma: A Cohort Study, Otilia Kimpel, Sara Bedrose, Felix Megerle, Alfredo Berruti, Massimo Terzolo, Matthias Kroiss, Knut Mai, Olaf M Dekkers, Mouhammed Amir Habra, Martin Fassnacht

Faculty, Staff and Students Publications

BACKGROUND: After radical resection, patients with adrenocortical carcinoma (ACC) frequently experience recurrence and, therefore, effective adjuvant treatment is urgently needed. The aim of the study was to investigate the role of adjuvant platinum-based therapy.

METHODS: In this retrospective multicentre cohort study, we identified patients treated with adjuvant platinum-based chemotherapy after radical resection and compared them with patients without adjuvant chemotherapy. Recurrence-free and overall survival (RFS/OS) were investigated in a matched group analysis and by applying a propensity score matching using the full control cohort (n = 268). For both approaches, we accounted for immortal time bias.

RESULTS: Of the 31 …

Cellular Regeneration As A Potential Strategy To Treat Cardiac Conduction Disorders, Satadru K Lahiri, Mohit M Hulsurkar, Xander Ht Wehrens

Faculty, Staff and Students Publications

Loss of atrioventricular conduction system (AVCS) cells due to either inherited or acquired deficits leads to conduction diseases, which can deteriorate into fatal cardiac arrhythmias and sudden death. In this issue of the JCI, Wang et al. constructed a mouse model of atrioventricular block (AVB) by inducing AVCS cell-specific injury using the Cx30.2 enhancer to drive expression of diphtheria toxin fragment A. AVCS cell ablation in adult mice led to irreversible AVB. jkjkIn contrast, AVCS cell injury in neonatal mice was followed by spontaneous recovery in a subset of mice, revealing a limited postnatal time window during which the regeneration …

Prevention And Screening Of Hpv Malignancies, Kristina R Dahlstrom, Andrew T Day, Erich M Sturgis

Faculty, Staff and Students Publications

It is estimated that 5% of the global cancer burden, or approximately 690,000 cancer cases annually, is attributable to human papillomavirus (HPV). Primary prevention through prophylactic vaccination is the best option for reducing the burden of HPV-related cancers. Most high-income countries (HICs) have introduced the HPV vaccine and are routinely vaccinating adolescent boys and girls. Unfortunately, although they suffer the greatest morbidity and mortality due to HPV-related cancers, many lower- and middle-income countries (LMICs) have been unable to initiate and sustain vaccination programs. Secondary prevention in the form of screening has led to substantial declines in cervical cancer incidence in …

Pancreatic Differentiation Of Stem Cells Reveals Pathogenesis Of A Syndrome Of Ketosis-Prone Diabetes, Diane Yang, Sanjeet Patel, Wojciech J Szlachcic, Jolanta Chmielowiec, Diane Scaduto, Nagireddy Putluri, Arun Sreekumar, James Suliburk, Michael Metzker, Ashok Balasubramanyam, Malgorzata Borowiak

Faculty, Staff and Students Publications

Genetic analysis of an adult patient with an unusual course of ketosis-prone diabetes (KPD) and lacking islet autoantibodies demonstrated a nucleotide variant in the 5′-untranslated region (UTR) of PDX1, a β-cell development gene. When differentiated to the pancreatic lineage, his induced pluripotent stem cells stalled at the definitive endoderm (DE) stage. Metabolomics analysis of the cells revealed that this was associated with leucine hypersensitivity during transition from the DE to the pancreatic progenitor (PP) stage, and RNA sequencing showed that defects in leucine-sensitive mTOR pathways contribute to the differentiation deficiency. CRISPR/Cas9 manipulation of the PDX1 variant demonstrated that it …

Hyperkalemia Management In The Emergency Department: An Expert Panel Consensus, Zubaid Rafique, Frank Peacock, Terra Armstead, Jason J Bischof, Joanna Hudson, Matthew R Weir, James Neuenschwander

Faculty, Staff and Students Publications

Hyperkalemia is a common electrolyte abnormality identified in the emergency department (ED) and potentially fatal. However, there is no consensus over the potassium threshold that warrants intervention or its treatment algorithm. Commonly used medications are at best temporizing measures, and the roles of binders are unclear in the emergent setting. As the prevalence of comorbid conditions altering potassium homeostasis rises, hyperkalemia becomes more common, and hence there is a need to standardize management. A panel was assembled to synthesize the available evidence and identify gaps in knowledge in hyperkalemia treatment in the ED. The panel was composed of 7 medical …

A Systematic Review Of The Use Of St John's Wort For Smoking Cessation In Adults, Namrata Walia, Sandra Gonzalez, Roger Zoorob

Faculty, Staff and Students Publications

St. John's wort (SJW) has been researched and clinically used for treating various psychiatric disorders, including depression. Few clinical trials have studied its use in smoking cessation. This systematic review provides comprehensive evidence of the studies conducted to date. Five databases were searched for randomized controlled trials (RCTs) that evaluated the effectiveness of SJW for smoking cessation in adults. The trials included the use of SJW alone, or along with nicotine replacement therapy, chromium, or behavioral therapies. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used to report this systematic review. Overall, four RCTs met the eligibility …