Medicine and Health Sciences Commons^™

Reduced Neutrophil Count In People Of African Descent Is Due To A Regulatory Variant In The Duffy Antigen Receptor For Chemokines Gene, David Reich, Michael A. Nalls, W H Linda Kao, Ermeg L. Akylbekova, Arti Tandon, Nick Patterson, James Mullikin, Wen-Chi Hsueh, Ching-Yu Cheng, Josef Coresh, Eric Boerwinkle, Man Li, Alicja Waliszewska, Julie Neubauer, Rongling Li, Tennille S. Leak, Lynette Ekunwe, Joe C. Files, Cheryl L. Hardy, Joseph M. Zmuda, Herman A. Taylor, Elad Ziv, Tamara B. Harris, James G. Wilson

Faculty, Staff and Student Publications

Persistently low white blood cell count (WBC) and neutrophil count is a well-described phenomenon in persons of African ancestry, whose etiology remains unknown. We recently used admixture mapping to identify an approximately 1-megabase region on chromosome 1, where ancestry status (African or European) almost entirely accounted for the difference in WBC between African Americans and European Americans. to identify the specific genetic change responsible for this association, we analyzed genotype and phenotype data from 6,005 African Americans from the Jackson Heart Study (JHS), the Health, Aging and Body Composition (Health ABC) Study, and the Atherosclerosis Risk in Communities (ARIC) Study. …

Isolated Polyethylene Exchange Versus Acetabular Revision For Polyethylene Wear, Camilo Restrepo, Elie Ghanem, Carrie Houssock, Mathew Austin, Javad Parvizi, William J. Hozack

Department of Orthopaedic Surgery Faculty Papers

Polyethylene wear and osteolysis are not uncommon in THA mid- and long-term. In asymptomatic patients the dilemma faced by the orthopaedic surgeon is whether to revise the cup and risk damage to the supporting columns and even pelvic discontinuity or to perform isolated polyethylene exchange and risk a high rate of postoperative recurrent instability and dislocation that will necessitate further surgery. We retrospectively reviewed 62 patients (67 hips) who underwent revision arthroplasty for polywear and osteolysis. Thirty-six hips had isolated polyethylene exchange, while 31 had full acetabular revision. The minimum followup was 2 years (mean, 2.8 years; range, 2-5 years). …

Comparative Efficacy Of 2 Topical Anesthetics For The Placement Of Orthodontic Temporary Anchorage Devices, Derek S Reznik, Arthur H Jeske, Jung-Wei Chen, Jeryl English

Faculty, Staff and Student Publications

This study compared the effectiveness of topical benzocaine 20% versus a combination of lidocaine, tetracaine, and phenylephrine in providing sufficient analgesia for the placement of orthodontic temporary anchorage devices (TADs). The 2 topical anesthetics were tested against each other bilaterally using a randomized, double-blind, crossover design. The agents were left in place for the amount of time prescribed by the manufacturer. The TAD was then placed, and each subject rated the degree of pain on a Heft-Parker visual analogue scale. A pulse oximeter was used to record the preoperative and postoperative pulse rates. Statistically significant differences in perceived pain (P …

High-Resolution Analysis Of Dna Copy Number Alterations In Patients With Primary Open-Angle Glaucoma., Khaled K Abu-Amero, Ali Hellani, Patrick Bender, George L. Spaeth, Jonathan Myers, L Jay Katz, Marlene Moster, Thomas M Bosley

Wills Eye Hospital Papers

PURPOSE: To determine whether patients with isolated primary open-angle glaucoma (POAG) have evidence of chromosomal copy number alterations.

METHODS: Twenty-seven Caucasian and African-American POAG patients and 12 ethnically matched controls were carefully screened for possible glaucoma and tested for chromosomal copy number alterations using high resolution array comparative genomic hybridization.

RESULTS: No POAG patient had evidence of chromosomal copy number alterations when compared to normal ethnically matched controls. Additionally, there was no evidence of somatic mosaicism in any tested POAG patient.

CONCLUSIONS: Chromosomal deletions and/or duplications were not detected in POAG patients as compared to controls. Other chromosomal imbalances such …

The Comparison Of Volunteer Work And Regular Exercise For The Promotion Of Health Among The Aged, Wen-Ming Chang, Shih-Wei Chou, Wei-Hsien Hong, Wen-Chung Tsai, Jyh-Yuh Ke, M. K. Wong

Rehabilitation Practice and Science

The aging of Taiwan's population is creating a heavy burden on the government's public finances allocated for elderly health care. The purpose of this research is to compare health promotion behavior among the aged; these included hospital volunteers, those undertaking Tai Ji, those who swam or those who took no specific exercise.This study recruited a total of 136 subjects who lived in the community and the total included 59 males and 77 females. They could be divided into four groups: (1) the hospital volunteer group; (2) the Tai Ji group; (3) the swimming group and (4) the general elderly control …

Scan-Rescan And Intra-Observer Variability Of Magnetic Resonance Imaging Of Carotid Atherosclerosis At 1.5 T And 3.0 T, Arvin Vidal, Yves Bureau, Trevor Wade, J David Spence, Brian K Rutt, Aaron Fenster, Grace Parraga

Medical Biophysics Publications

Carotid atherosclerosis measurements for eight subjects at baseline and 14 +/- 2 days later were examined using 1.5 T and 3.0 T magnetic resonance imaging (MRI). A single observer blinded to field strength, subject and timepoint manually segmented carotid artery wall and lumen boundaries in randomized images in five measurement trials. Mean increases in the signal-to-noise ratios (SNR) for T1-weighted images acquired at 3.0 T compared to 1.5 T were 90% (scan) and 80% (rescan). Despite significantly improved SNR and contrast-to-noise ratios (CNR) for images acquired at 3.0 T, vessel wall volume (VWV) intra-observer variability was not significantly different using …

Intracerebral Hemorrhage For The Palliative Care Provider: What You Need To Know., B Brent Simmons, Susan M Parks

Department of Family & Community Medicine Faculty Papers

Intracerebral hemorrhage (ICH) makes up 10%-30% of all strokes. Palliative care providers are often asked to get involved with ICH cases to aid with development of short-term and long-term goals. Prognosis can be calculated using the ICH score (based on Glasgow Coma Score score, ICH volume, presence of intraventricular hemorrhage, age, and location of origin) or the Essen score (based on age, NIH Stroke Scale [NIHSS], and level of consciousness). Do-not-resuscitate (DNR) status is important to discuss with families. Expert consensus states DNR is appropriate if the patient has two of the following: severe stroke, life-threatening brain damage, or significant …

Focus On Rna Isolation: Obtaining Rna For Microrna (Mirna) Expression Profiling Analyses Of Neural Tissue, Wang-Xia Wang, Bernard R. Wilfred, Donald A. Baldwin, R. Benjamin Isett, Na Ren, Arnold J. Stromberg, Peter T. Nelson

Sanders-Brown Center on Aging Faculty Publications

MicroRNAs (miRNAs) are present in all known plant and animal tissues and appear to be somewhat concentrated in the mammalian nervous system. Many different miRNA expression profiling platforms have been described. However, relatively little research has been published to establish the importance of 'upstream' variables in RNA isolation for neural miRNA expression profiling. We tested whether apparent changes in miRNA expression profiles may be associated with tissue processing, RNA isolation techniques, or different cell types in the sample. RNA isolation was performed on a single brain sample using eight different RNA isolation methods, and results were correlated using a conventional …

3d Mprage Improves Classification Of Cortical Lesions In Multiple Sclerosis, F Nelson, A Poonawalla, P Hou, J S Wolinsky, P A Narayana

Faculty, Staff and Student Publications

BACKGROUND: Gray matter lesions are known to be common in multiple sclerosis (MS) and are suspected to play an important role in disease progression and clinical disability. A combination of magnetic resonance imaging (MRI) techniques, double-inversion recovery (DIR), and phase-sensitive inversion recovery (PSIR), has been used for detection and classification of cortical lesions. This study shows that high-resolution three-dimensional (3D) magnetization-prepared rapid acquisition with gradient echo (MPRAGE) improves the classification of cortical lesions by allowing more accurate anatomic localization of lesion morphology.

METHODS: 11 patients with MS with previously identified cortical lesions were scanned using DIR, PSIR, and 3D MPRAGE. …

Increasing Appropriateness Of Hospital Admissions In The Emilia-Romagna Region Of Italy., Daniel Louis, Francesco Taroni, Rita Melotti, Carol Rabinowitz, Maria Vizioli, Monica Fiorini, Joseph Gonnella

Department of Family & Community Medicine Faculty Papers

OBJECTIVES: The Emilia-Romagna region of Italy has reduced the number of available hospital beds and introduced financial incentives to curb hospital use. The goal of this study was to assess the impact of these policies on changes over time in the number of acute hospital admissions classified in diagnosis related groups (DRGs) that could be treated safely and effectively in alternative, less costly settings.

METHODS: The assessment of the appropriate site of care was based on analysis of hospital discharge data for all hospitals for the selected diagnosis related groups in the Emilia-Romagna region for 2001 to 2005. The necessity …

Repression Of The Sumo-Specific Protease Senp1 Induces P53-Dependent Premature Senescence In Normal Human Fibroblasts, Kristin E. Yates, Gregory A. Korbel, Michael Shtutman, Igor Roninson, Daniel Dimaio

Faculty Publications

The proliferative lifespan of normal somatic human cells in culture terminates in a permanent growth-arrested state known as replicative senescence. In this study, we show that RNA interference-mediated repression of the genes encoding the small ubiquitin-related modifier (SUMO)-specific proteases, Senp1, Senp2, and Senp7, induced low passage primary human fibroblasts to senesce rapidly. Following Senp1 repression, we observed a global increase in sumoylated proteins and in the number and size of nuclear SUMO-containing promyelocytic leukemia (PML) bodies. SUMO/PML bodies also increased during replicative senescence. p53 transcriptional activity was enhanced towards known p53 target genes following repression of Senp1, and inhibition of …

Characterization Of The Inflammatory Cells In Ascending Thoracic Aortic Aneurysms In Patients With Marfan Syndrome, Familial Thoracic Aortic Aneurysms, And Sporadic Aneurysms, Rumin He, Dong-Chuan Guo, Wei Sun, Christina L Papke, Senthil Duraisamy, Anthony L Estrera, Hazim J Safi, Chul Ahn, L Maximilian Buja, Frank C Arnett, Jingwu Zhang, Yong-Jian Geng, Dianna M Milewicz

Faculty, Staff and Student Publications

OBJECTIVE: This study sought to characterize the inflammatory infiltrate in ascending thoracic aortic aneurysm in patients with Marfan syndrome, familial thoracic aortic aneurysm, or nonfamilial thoracic aortic aneurysm.

BACKGROUND: Thoracic aortic aneurysms are associated with a pathologic lesion termed "medial degeneration," which is described as a noninflammatory lesion. Thoracic aortic aneurysms are a complication of Marfan syndrome and can be inherited in an autosomal dominant manner of familial thoracic aortic aneurysm.

METHODS: Full aortic segments were collected from patients undergoing elective repair with Marfan syndrome (n = 5), familial thoracic aortic aneurysm (n = 6), and thoracic aortic aneurysms (n …

Overexpression Of Matrix Metalloproteinase 9 In Tumor Epithelial Cells Correlates With Colorectal Cancer Metastasis., David S Zuzga, Ahmara Vivian Gibbons, Peng Li, Wilhelm Johannes Lubbe, Inna Chervoneva, Giovanni Mario Pitari

Department of Pharmacology and Experimental Therapeutics Faculty Papers

Colorectal cancer mortality largely reflects metastasis, the spread of the disease to distant organs. Matrix metalloproteinase 9 (MMP-9) is a key regulator of metastasis and a target for anticancer strategies in colon cancer. Here, the overexpression of MMP-9 in pure tumor epithelial, but nor stromal, cell populations was associated with metastatic progression of colorectal cancer, as defined by reverse transcriptase-polymerase chain reaction (qRT-PCR) and confirmed by immunostaining. Thus, cancer cell MMP-9 represents a novel, selective prognostic and predictive factor that may be exploited for more effective disease stage stratification and therapeutic regimen selection in patients with colorectal cancer.

The Dose-Response Of Nitrous Oxide In Postoperative Nausea In Patients Undergoing Gynecologic Laparoscopic Surgery: A Preliminary Study., Boris Mraovic, Tatjana Simurina, Zdenko Sonicki, Neven Skitarelic, Tong J. Gan

Department of Anesthesiology Faculty Papers

BACKGROUND: Whether nitrous oxide (N(2)O) increases the incidence of postoperative nausea and vomiting (PONV) after laparoscopic gynecologic surgery is still controversial, which may be due to the administration of different concentrations of inspired N(2)O. We investigated whether N(2)O results in a dose-response increase in PONV. METHODS: Patients undergoing gynecologic laparoscopic surgery were randomized to receive 30% oxygen with air (G0, n = 46), 50% N(2)O with oxygen (G50, n = 46), or 70% N(2)O with oxygen (G70, n = 45). A standardized general anesthetic was used with no PONV prophylaxis. Known risk factors for PONV were controlled. Metoclopramide was used …

Genetic Variation In Genes For The Xenobiotic-Metabolizing Enzymes Cyp1a1, Ephx1, Gstm1, Gstt1, And Gstp1 And Susceptibility To Colorectal Cancer In Lynch Syndrome, Mala Pande, Christopher I Amos, Daniel R Osterwisch, Jinyun Chen, Patrick M Lynch, Russell Broaddus, Marsha L Frazier

Faculty, Staff and Student Publications

Individuals with Lynch syndrome are predisposed to cancer due to an inherited DNA mismatch repair gene mutation. However, there is significant variability observed in disease expression likely due to the influence of other environmental, lifestyle, or genetic factors. Polymorphisms in genes encoding xenobiotic-metabolizing enzymes may modify cancer risk by influencing the metabolism and clearance of potential carcinogens from the body. In this retrospective analysis, we examined key candidate gene polymorphisms in CYP1A1, EPHX1, GSTT1, GSTM1, and GSTP1 as modifiers of age at onset of colorectal cancer among 257 individuals with Lynch syndrome. We found that subjects heterozygous for CYP1A1 I462V …

Mapping And Quantifying Hyperpolarized 3he Magnetic Resonance Imaging Apparent Diffusion Coefficient Gradients, Andrea Evans, David G Mccormack, Giles Santyr, Grace Parraga

Medical Biophysics Publications

We measured hyperpolarized 3He magnetic resonance imaging (MRI) apparent diffusion coefficients (ADC) and quantified ADC gradients in each three-by-three voxel region of interest (ROI). Such local ADC gradients can be represented in vector maps showing the magnitude (|G3x3|) and direction of ADC gradients, providing a qualitative visualization tool and quantitative measurement of airway and air space heterogeneity. Twenty-four subjects (15 male, mean age=67+/-7 yr) with global initiative for chronic obstructive lung disease (GOLD) stage II (n=9, mean age 68+/-6 yr), GOLD stage III chronic obstructive pulmonary disease (COPD; n=7, mean age 67+/-8 yr), and age-matched healthy volunteers (n=8, mean age …

Quantification Of Carotid Vessel Wall And Plaque Thickness Change Using 3d Ultrasound Images, Bernard Chiu, Micaela Egger, J David Spence, Grace Parraga, Aaron Fenster

Medical Biophysics Publications

Quantitative measurements of carotid plaque burden progression or regression are important in monitoring patients and in evaluation of new treatment options. 3D ultrasound (US) has been used to monitor the progression or regression of carotid artery plaques. This paper reports on the development and application of a method used to analyze changes in carotid plaque morphology from 3D US. The technique used is evaluated using manual segmentations of the arterial wall and lumen from 3D US images acquired in two imaging sessions. To reduce the effect of segmentation variability, segmentation was performed five times each for the wall and lumen. …

The Minimally Invasive Treatment Of Ureteropelvic Junction Obstruction: A Review Of Our Experience During The Last Decade., Brent V. Yanke, Costas D. Lallas, Christopher Pagnani, David E. Mcginnis, Demetrius H. Bagley

Department of Urology Faculty Papers

PURPOSE: The minimally invasive treatment of ureteropelvic junction obstruction has evolved during the last decade from endoscopic to laparoscopic and robotic. We review our 10-year experience with ureteropelvic junction obstruction, and report on our experience and followup.

MATERIALS AND METHODS: We reviewed all patients treated during the last 10 years. There were 294 procedures performed with complete records on 273 patients including 128 retrograde endopyelotomies, 116 laparoscopic pyeloplasties and 29 robotic pyeloplasties. Technique for each procedure is reviewed. Statistical analysis was performed on all results. Variables evaluated were gender, age (younger than 41 vs 41 years or older), …

Correction: Molecular Subsets In The Gene Expression Signatures Of Scleroderma Skin, Ausra Milano, Sarah A. Pendergrass, Jennifer L. Sargent, Lacy K. George, Timothy H. Mccalmont, M. Kari Connolly, Michael L. Whitfield

Dartmouth Scholarship

Background: Scleroderma is a clinically heterogeneous disease with a complex phenotype. The disease is characterized by vascular dysfunction, tissue fibrosis, internal organ dysfunction, and immune dysfunction resulting in autoantibody production. Methodology and Findings: We analyzed the genome-wide patterns of gene expression with DNA microarrays in skin biopsies from distinct scleroderma subsets including 17 patients with systemic sclerosis (SSc) with diffuse scleroderma (dSSc), 7 patients with SSc with limited scleroderma (lSSc), 3 patients with morphea, and 6 healthy controls. 61 skin biopsies were analyzed in a total of 75 microarray hybridizations. Analysis by hierarchical clustering demonstrates nearly identical patterns of gene …

Freesurfer-Initiated Fully-Automated Subcortical Brain Segmentation In Mri Using Large Deformation Diffeomorphic Metric Mapping., Ali R Khan, Lei Wang, Mirza Faisal Beg

Brain and Mind Institute Researchers' Publications

Fully-automated brain segmentation methods have not been widely adopted for clinical use because of issues related to reliability, accuracy, and limitations of delineation protocol. By combining the probabilistic-based FreeSurfer (FS) method with the Large Deformation Diffeomorphic Metric Mapping (LDDMM)-based label-propagation method, we are able to increase reliability and accuracy, and allow for flexibility in template choice. Our method uses the automated FreeSurfer subcortical labeling to provide a coarse-to-fine introduction of information in the LDDMM template-based segmentation resulting in a fully-automated subcortical brain segmentation method (FS+LDDMM). One major advantage of the FS+LDDMM-based approach is that the automatically generated segmentations generated are …

Usefulness Of Baseline Lipids And C-Reactive Protein In Women Receiving Menopausal Hormone Therapy As Predictors Of Treatment-Related Coronary Events., Paul Bray, Joseph C Larson, Andrea Z Lacroix, Joann Manson, Marian C Limacher, Jacques E Rossouw, Norman L Lasser, William E Lawson, Marcia L Stefanick, Robert D Langer, Karen L Margolis

Cardeza Foundation for Hematologic Research

Blood lipids and high-sensitivity C-reactive protein (hs-CRP) are altered by hormone therapy. The goal of the present study was to determine whether lipids and hs-CRP have predictive value for hormone therapy benefit or risk for coronary heart disease events in postmenopausal women without previous cardiovascular disease. A nested case-control study was performed in the Women's Health Initiative hormone trials. Baseline lipids and hs-CRP were obtained from 271 incident patients with coronary heart disease (cases) and 707 controls. In a combined trial analysis, favorable lipid status at baseline tended to predict better coronary heart disease outcomes when using conjugated equine estrogen …

Muc4 And Muc5ac Are Highly Specific Tumour-Associated Mucins In Biliary Tract Cancer., W. R. Matull, F. Andreola, A. Loh, Z. Adiguzel, M. Deheragoda, U. Qureshi, Surinder K. Batra, D. M. Swallow, S. P. Pereira

Journal Articles: Biochemistry & Molecular Biology

Alterations in epithelial mucin expression are associated with carcinogenesis, but there are few data in biliary tract cancer (BTC). In pancreatic malignancy, MUC4 is a diagnostic and prognostic tumour marker, whereas MUC5AC has been proposed as a sensitive serological marker for BTC. We assessed MUC4 and MUC5AC expression in (i) prospectively collected bile and serum specimens from 72 patients with biliary obstruction (39 BTC) by real-time reverse transcriptase-PCR (qPCR) and western blot analysis, and (ii) 79 archived biliary tissues (69 BTC) by immunohistochemistry. In bile, MUC4 protein was detected in 27% of BTC and 29% of primary sclerosing cholangitis (PSC) …

Early Diagnosis Of Pancreatic Cancer: Neutrophil Gelatinase-Associated Lipocalin As A Marker Of Pancreatic Intraepithelial Neoplasia., N. Moniaux, S. Chakraborty, M. Yalniz, J. Gonzalez, Valerie K. Shostrom, J. Standop, Subodh M. Lele, Michel M. Ouellette, Parviz M. Pour, Aaron Sasson, R. E. Brand, Michael A. Hollingsworth, Maneesh Jain, Surinder K. Batra

Journal Articles: Biochemistry & Molecular Biology

Pancreatic cancer is a highly lethal malignancy with a dismal 5-year survival of less than 5%. The scarcity of early biomarkers has considerably hindered our ability to launch preventive measures for this malignancy in a timely manner. Neutrophil gelatinase-associated lipocalin (NGAL), a 24-kDa glycoprotein, was reported to be upregulated nearly 27-fold in pancreatic cancer cells compared to normal ductal cells in a microarray analysis. Given the need for biomarkers in the early diagnosis of pancreatic cancer, we investigated the expression of NGAL in tissues with the objective of examining if NGAL immunostaining could be used to identify foci of pancreatic …

Lead-Associated Endocarditis: The Important Role Of Methicillin-Resistant Staphylococcus Aureus., Arnold J. Greenspon, Eugene S. Rhim, George Mark, Joseph Desimone, Reginald T. Ho

Division of Cardiology Faculty Papers

BACKGROUND: Infection is a potentially life-threatening complication of cardiac device implantation. Lead-associated endocarditis (LAE) may be the most serious complication since it is associated with a high mortality. METHODS: The medical records of patients referred to our institution for the treatment of LAE between 1999 and 2007 were reviewed. RESULTS: A total of 51 of 107 patients referred for device-related infections met the criteria for LAE. Of these, 19 occurred within 6 months of their most recent procedure (early), while the remaining 32 occurred more than 6 months later (mean = 31.9 months post procedure). Devices included pacemakers in 33 …

Robotic Dismembered Pyeloplasty In A Horseshoe Kidney After Failed Endopyelotomy., Mark L. Pe, Steven N. Sterious, Ji-Bin Liu, Costas D. Lallas

Department of Urology Faculty Papers

We report our experience performing a robot-assisted dismembered pyeloplasty on a patient with a ureteropelvic junction obstruction in a horseshoe kidney and a prior history of endopyelotomy. We provide 18-month follow-up demonstrating that robotic pyeloplasty is a reasonable second treatment option for patients with horseshoe kidneys with failed prior endourological management.

Drinking-Water Arsenic Exposure Modulates Gene Expression In Human Lymphocytes From A U.S. Population, Angeline S. Andrew, David A. Jewell, Rebecca A. Mason, Michael L. Whitfield, Jason H. Moore, Margaret R. Karagas

Dartmouth Scholarship

Background:

Arsenic exposure impairs development and can lead to cancer, cardiovascular disease, and diabetes. The mechanism underlying these effects remains unknown. Primarily because of geologic sources of contamination, drinking-water arsenic levels are above the current recommended maximum contaminant level of 10 μg/L in the northeastern, western, and north central regions of the United States.

Objectives:

We investigated the effects of arsenic exposure, defined by internal biomarkers at levels relevant to the United States and similarly exposed populations, on gene expression.

Methods:

We conducted separate Affymetrix microarray-based genomewide analyses of expression patterns. Peripheral blood lymphocyte samples from 21 controls interviewed (1999–2002) …

Retinal Pigment Epithelial Tears After Intravitreal Bevacizumab Injection For Exudative Age-Related Macular Degeneration., Sunir Garg, Roy Brod, David Kim, R Gary Lane, Joseph Maguire, David Fischer

Wills Eye Hospital Papers

PURPOSE: To determine the incidence of and the risk factors for the development of retinal pigment epithelial (RPE) tears after intravitreal bevacizumab (Avastin) injection for the treatment of exudative age-related macular degeneration (AMD).

METHODS: A retrospective, multicentre, consecutive interventional case series of all patients with subfoveal exudative AMD treated with intravitreal bevacizumab between August 2005 and April 2007. The main outcome measures were pre- and post-RPE tear visual acuity and choroidal neovascular membrane lesion types, incidence of tears and time from first injection until development of the tear.

RESULTS: A total of 920 eyes with exudative AMD were treated with …

Using Built Environment Characteristics To Predict Walking For Exercise, Gina S. Lovasi, Anne V. Moudon, Amber L. Pearson, Philip M. Hurvitz, Eric B. Larson, David S. Siscovick, Ethan M. Berke

Dartmouth Scholarship

Environments conducive to walking may help people avoid sedentary lifestyles and associated diseases. Recent studies developed walkability models combining several built environment characteristics to optimally predict walking. Developing and testing such models with the same data could lead to overestimating one's ability to predict walking in an independent sample of the population. More accurate estimates of model fit can be obtained by splitting a single study population into training and validation sets (holdout approach) or through developing and evaluating models in different populations. We used these two approaches to test whether built environment characteristics near the home predict walking for …

Surgical Versus Nonsurgical Therapy For Lumbar Spinal Stenosis., James N Weinstein, Tor D Tosteson, Jon D Lurie, Anna N A Tosteson, Emily Blood, Brett Hanscom, Harry Herkowitz, Frank Cammisa, Todd Albert, Scott D Boden, Alan Hilibrand, Harley Goldberg, Sigurd Berven, Howard An

Rothman Institute Papers

BACKGROUND: Surgery for spinal stenosis is widely performed, but its effectiveness as compared with nonsurgical treatment has not been shown in controlled trials.

METHODS: Surgical candidates with a history of at least 12 weeks of symptoms and spinal stenosis without spondylolisthesis (as confirmed on imaging) were enrolled in either a randomized cohort or an observational cohort at 13 U.S. spine clinics. Treatment was decompressive surgery or usual nonsurgical care. The primary outcomes were measures of bodily pain and physical function on the Medical Outcomes Study 36-item Short-Form General Health Survey (SF-36) and the modified Oswestry Disability Index at 6 weeks, …

Surgical Versus Nonsurgical Therapy For Lumbar Spinal Stenosis., James N Weinstein, Tor D Tosteson, Jon D Lurie, Anna N A Tosteson, Emily Blood, Brett Hanscom, Harry Herkowitz, Frank Cammisa, Todd J Albert, Scott D Boden, Alan Hilibrand, Harley Goldberg, Sigurd Berven, Howard An

Rothman Institute Papers

BACKGROUND: Surgery for spinal stenosis is widely performed, but its effectiveness as compared with nonsurgical treatment has not been shown in controlled trials.

METHODS: Surgical candidates with a history of at least 12 weeks of symptoms and spinal stenosis without spondylolisthesis (as confirmed on imaging) were enrolled in either a randomized cohort or an observational cohort at 13 U.S. spine clinics. Treatment was decompressive surgery or usual nonsurgical care. The primary outcomes were measures of bodily pain and physical function on the Medical Outcomes Study 36-item Short-Form General Health Survey (SF-36) and the modified Oswestry Disability Index at 6 weeks, …