Medicine and Health Sciences Commons^™

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

Faculty, Staff and Students Publications

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

A Descriptive Study Of Racial Inequalities In Mortality From Hepatocellular Cancer Before And After Licensure Of Lifesaving Drugs For Hepatitis C Virus In The United States, Robert S Levine, Maria C Mejia, Jason L Salemi, Sandra J Gonzalez, Muktar H Aliyu, Baqar A Husaini, Roger J Zoorob, Charles H Hennekens

Faculty, Staff and Students Publications

BACKGROUND: Since 1979, mortality from hepatocellular cancer (HCC) has doubled in the United States (US). Lifesaving drugs, prohibitively expensive for some, were approved and marketed to treat hepatitis C virus (HCV), a major risk factor for HCC, beginning in 1997. After the prior introduction of other lifesaving innovations, including active retroviral drug therapy for human immunodeficiency virus and surfactant for respiratory distress syndrome of the newborn, racial inequalities in their mortalities increased in the US. In this descriptive study, we explored racial inequalities in mortality from HCC before and after licensure of HCV drugs in the US.

METHODS: The US …

Novel Therapeutic Approaches To Treat Brain Cancer Combining Cold Atmospheric Plasma, Therapeutic Prodrugs And Gold Nanoparticles, Zhonglei He

Doctoral

Glioblastoma Multiforme (GBM) makes up approximately 45% of all primary brain tumours. State of the art treatment at present involves concurrent and adjuvant temozolomide (TMZ) with radical radiotherapy which extends median survival from 12.1 months (radical radiotherapy alone) to 14.6 months according to the study of the European Organization for Research and Treatment of Cancer (EORTC) Brain Tumour and Radiotherapy Groups and the National Cancer Institute of Canada (NCIC) Clinical Trials Group. Meanwhile, National Cancer Registry Ireland presented that GBM represents over 40% of all malignant brain tumours and had the worst five-year net survival (4%) compared to overall malignant …

Efforts To Improve Diagnosis Of Bacteraemia By Reducing Blood Culture Contamination In An Emergency Department: Strategies And Outcome, Najma Shaheen, Mohammad Zeeshan, Naima Fasih, Joveria Farooqi, Kausar Jabeen, Seema Irfan

Department of Pathology and Laboratory Medicine

Objective: To assess the strategies and outcome for reducing blood culture contamination in order to improve the diagnosis of bacteraemia.
Methods: The interventional study was conducted at a tertiary care hospital in Karachi from January 1, 2013, to December 31, 2016. The blood culture contamination data related to the first year of the study was taken as the baseline pre-intervention data. Strategies were planned as intervention for improvement by consolidating training and education in the form of dedicated lectures, practising on mannequins and developing in-house video, replacing povidone with 2% chlorhexidine preparation spray plus 70% isopropyl alcohol swabs and inducting …

Expression Of Her-2/Neu In Oral Squamous Cell Carcinoma, Sana Mirza, Naila Hadi, Shahid Pervez, Sultan Zeb Khan, Sameer A. Mokeem, Tariq Abduljabbar, Nawwaf Al-Hamoudi, Fahim Vohra

Department of Pathology and Laboratory Medicine

Background: HER-2/neu is a member of the human epidermal growth factor (HER) family of transmembrane tyrosine kinases, which is significantly associated with the pathogenesis of various cancer types. The aim was to evaluate the expression of HER-2/neu in oral squamous cell carcinoma (OSCC) as a potential biomarker to target antigens for specific immunotherapy in OSCC.
Methods: One hundred and forty histologically diagnosed OSCC cases were identified. Four to five-micrometer thick formalin-fixed, paraffin-embedded tumor sections were stained with Haematoxylin and Eosin (H and E). Histological grade was assessed according to WHO/Broders classification, while tumors were staged according to the American Joint …

No Difference In Strength And Clinical Outcome Between Early And Late Repair After Achilles Tendon Rupture, Michael R Carmont, Jennifer A Zellers, Annelie Brorsson, Karin Grävare Silbernagel, Jón Karlsson, Katarina Nilsson-Helander

2020-Current year OA Pubs

PURPOSE: This retrospective study aimed to determine the patient-reported and functional outcome of patients with delayed presentation, who had received no treatment until 14 days following injury of Achilles tendon rupture repaired with minimally invasive surgery and were compared with a group of sex- and age-matched patients presenting acutely. Based on the outcomes following delayed presentation reported in the literature, it was hypothesized that outcomes would be inferior for self-reported outcome, tendon elongation, heel-rise performance, ability to return to play, and complication rates than for acutely managed patients.

METHODS: Repair was performed through an incision large enough to permit mobilisation …

Late Effects Of Clubfoot Deformity In Adolescent And Young Adult Patients Whose Initial Treatment Was An Extensive Soft-Tissue Release: Topic Review And Clinical Case Series, Jeffrey E Johnson, Thomas A Fortney, Pamela C Luk, Sandra E Klein, Jeremy J Mccormick, Matthew B Dobbs, J Eric Gordon, Perry L Schoenecker

2020-Current year OA Pubs

Children with congenital clubfoot often have residual deformity, pain, and limited function in adolescence and young adulthood. These patients represent a heterogeneous group that often requires an individualized management strategy. This article reviews the available literature on this topic while proposing a descriptive classification system based on a review of patients at our institution who underwent surgery for problems related to previous clubfoot deformity during the period between January 1999 and January 2012. Seventy-two patients (93 feet) underwent surgical treatment for the late effects of clubfoot deformity at an average age of 13 years (range 9 to 19 years). All …

Three-Dimensional Facial Morphology In Cantú Syndrome, Helen I Roessler, Kathleen Shields, Dorothy K Grange, Nine V A M Knoers, Gijs Van Haaften, Peter Hammond, Mieke M Van Haelst

2020-Current year OA Pubs

Cantú syndrome (CS) was first described in 1982, and is caused by pathogenic variants in ABCC9 and KCNJ8 encoding regulatory and pore forming subunits of ATP-sensitive potassium (K

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

2020-Current year OA Pubs

AIM: To evaluate the effect of final HbA

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

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

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

New Horizons: Covid-19 And The Burden Of Neuropsychiatric Illness In Pakistan, Ali M. Hashmi, Haider Ali Saleem

Medical College Documents

This manuscript reviews the current state of knowledge about the burden of mental illness and assesses the impact of COVID-19 illness on mental health in Pakistan. For this we analyzed secondary data obtained from the Institute of Health Metrics and Evaluation. The Global Burden of Disease (GBD) study draws from a wide range of data sources to quantify global and regional effects of a disease. We also did a literature search on the effects of COVID-19 illness on mental health and the psychosocial effects of COVID-19 and other Corona virus related illnesses such as SARS-CoV and MERS-CoV. Data from the …

Early Detection Of Mild Cognitive Impairment With In-Home Sensors To Monitor Behavior Patterns In Community-Dwelling Senior Citizens In Singapore: Cross-Sectional Feasibility Study, Iris Rawtaer, Rathi Mahendran, Ee Heok Kua, Hwee-Pink Tan, Hwee Xian Tan, Tih-Shih Lee, Tze Pin Ng

Research Collection School Of Computing and Information Systems

Background: Dementia is a global epidemic and incurs substantial burden on the affected families and the health care system. A window of opportunity for intervention is the predementia stage known as mild cognitive impairment (MCI). Individuals often present to services late in the course of their disease and more needs to be done for early detection; sensor technology is a potential method for detection.Objective: The aim of this cross-sectional study was to establish the feasibility and acceptability of utilizing sensors in the homes of senior citizens to detect changes in behaviors unobtrusively.Methods: We recruited 59 community-dwelling seniors (aged >65 years …

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

Research Collection Yong Pung How School Of Law

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

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

Research Collection Yong Pung How School Of Law

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

The Use Of Guedel Airway For Naso-Orogastric Tube Insertion In Patients With Covid-19. A Way To Minimize Aerosol Generation, Faraz Shafiq, Dileep Kumar

Department of Anaesthesia

No abstract provided.

Potential Barriers Amongst Health Care Professionals Of Pakistan In Managing Covid-19 Patients, Muhammad Irfan Ul Haq, Faraz Shafiq, Haris Sheikh

Department of Anaesthesia

Objectives: To evaluate basic knowledge of Health Care Professionals (HCPs) of Pakistan in managing COVID 19 patients. It includes information regarding infection control measures, administrative and professional support. This was followed by evaluation of psychological factor that can act as a barrier in effective management of these patients.
Methods: The survey was conducted on line using Google Form. After approval from hospital ethical committee survey link was disseminated to HCPs using social media.
Results: Four hundred fifteen HCPs were participated. Most of them were younger than 30 years and majority of them were postgraduate trainees. Results showed gaps in the …

The Effect Of Β-Caryophyllene On Isoproterenol-Induced Myocardial Infarction, Farah M. Jamal Laham

Theses

Cannabinoid type 2 receptors (CB2), a key member of the endocannabinoid system have recently emerged as a crucial therapeutic target for cardiovascular diseases (CVDs). Downregulation of CB2 receptors has been witnessed in various cancers, neurological and cardiovascular disorders. Thus, the activation of CB2 receptors may protect against ISO-induced myocardial infarction (MI) in rats. The present study investigates the cardioprotective effect of a selective cannabinoid type 2 receptor agonist β-caryophyllene (BCP), a dietary phytocannabinoid, and a natural bicyclic sesquiterpene against isoproterenol (ISO)-induced MI in rats. Male albino Wistar rats were pre-and co-treated with β-caryophyllene (50 mg/kg, orally) twice daily for 10 …

A Career Eulogy Reflective Exercise: A View Into Early Professional Identity Formation, William Crump, R. Steve Fricker, Allison Crump-Rogers

Marshall Journal of Medicine

Introduction

Beginning medical students have a very early idea of what their physician identity will be. Providing a brief structured opportunity to reflect on the end of their career can be an important first step in identity formation.

Methods

A reflective exercise was used in the summer prior to beginning medical school as each class of students at a regional rural medical school began a summer prematriculation program from 2015-2019. Students wrote what they wished to be said about them at the end of their career using a “Career Eulogy.” Identifiers were removed and narratives were coded into recurring text …

When Treating Sick Joints Harms Lungs, Ixekizumab Induced Pleural Effusion, Rami Batarseh, Kyle Smith, Mohammed Al-Ourani, Amro K. Al-Astal

Marshall Journal of Medicine

Immunological therapies have provided a multitude of new and effective treatment strategies for various disease states. While monoclonal antibody therapy benefits many patients, side effects are widely variable. here we present a case of pleural effusion complicating psoriatic arthritis treatment.

Secondary Scoliosis From A Retroperitoneal Ganglioneuroma In A 9-Year-Old Female: Case Report, Andrew J. Weaver, Keitaro Nakamoto, Daniel A. Beals

Marshall Journal of Medicine

Ganglioneuromas are rare benign tumors that tend to be asymptomatic until large enough to compress adjacent structures. These tumors are often found during childhood during evaluations for other pathologies. Retroperitoneal ganglioneuromas may be a secondary cause of scoliosis. Here, we present a case of a child who was found to have a retroperitoneal ganglioneuroma during an evaluation for scoliosis.

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The Opioid Epidemic In The United States: A Call For Practice Change In Pediatric Outpatient Surgeries, Emma Bacharach, Osama Al-Omar

Marshall Journal of Medicine

No abstract provided.

Complete Response To Stage Iv Colorectal Adenocarcinoma With Disease-Free Survival At 24 Months: Case Report And Overview Of The Literature, Madison N. Crank 6746693, Arslan Iqbal, Michael Abdelmasseh, Mohamed Alsharedi, Doreen Griswold, Alysia Browne, Juan R. Sanabria

Marshall Journal of Medicine

Over 150,000 new cases of colon cancer were diagnosed in the US in 2019. Stage and age at diagnosis are important prognostic factors for overall survival (OS). For the age group 70-79, the OS for females with poorly differentiated stage IV colon cancer at 1, 2 and 5 years after surgery is 39%, 15%, and 2%, respectively. We present a case of a 77-year-old female with significant cardiac history. She was diagnosed with stage IV colorectal cancer complicated with enteric fistula. Due to her initial performance status and comorbidities, she was not a candidate for surgery or systemic chemotherapy. Nonetheless, …

Macrophage Activation Syndrome As A Complication Of Systemic Lupus Erythematosus In An Adult Male, Rajesh Gopalarathinam, Vamsee Chirumamilla, Balachandran Vaidyanathan

Marshall Journal of Medicine

Macrophage activation syndrome (MAS) is a rare life-threatening complication that sometimes occurs in patients with systemic lupus erythematosus (SLE) and other connective tissue diseases. This syndrome is universally fatal without treatment, and therefore, prompt diagnosis and initiation of treatment is of vital importance.

Reflections On West Virginia's Early Covid-19 Experience, Stephen M. Petrany, Deb Koester, Robert Walker

Marshall Journal of Medicine

No abstract provided.

Navigating The Unknowns Of Covid-19, Larry Dial, Beth L. Hammers

Marshall Journal of Medicine

No abstract provided.

Leadership Challenges And Collaborative Opportunities Unveiled Through Covid-19, Gayle Brazeau

Marshall Journal of Medicine

No abstract provided.

Providing Dental Care In The Current Covid-19 Crisis, Raj Khanna

Marshall Journal of Medicine

Dental procedures typically generate aerosol. With the current covid19 crisis this is a serious problem for providers and patients. The commentary addresses some of the problems and possible solutions for providing dental care in the current covid-19 crisis.

The Eagle And The Phoenix, Clay Marsh

Marshall Journal of Medicine

No abstract provided.

The Covid-19 Crisis: How Rural Appalachia Is Handling The Pandemic?, Darshana T. Shah

Marshall Journal of Medicine

No abstract provided.

Creative Writing In Residency Training, Julia Fashner

HCA Healthcare Journal of Medicine

Residents compose notes for medical purposes on a daily basis. As part of wellness, I have done creative writing during didactic time with family medicine residents. I present some of the poems that have been created.

Nicaraguan Homeowner Showing Gratitude For Concrete Flooring As Part Of A Public Health Mission Trip, Breonna Kinnison

HCA Healthcare Journal of Medicine

I’m Bree Kinnison, a fourth-year medical student and aspiring psychiatrist. When I’m not studying, I enjoy painting using acrylics. This painting depicts a very fond memory of mine. After completing the medical portion of our mission trip in Nicaragua, we began our public health portion. Along with fellow students, I laid concrete flooring in this woman’s house. For all 76 years of her life, she had never experienced anything other than a dirt floor in her home. Traditional dirt flooring in Nicaraguan homes is responsible for many preventable illnesses. When shown the final product, she reached out and hugged the …