Medicine and Health Sciences Commons^™

Falls Risk Screening In Community-Dwelling Older Adults, Austyn Byasse, Kevin Joines, Rachel Cundy, Carlos Navia, Virginia Edwards, Rachel Lineback, Cindy Zablotny, Theresa Raudsepp

Student-Faculty Research - College of Physical Therapy

Purpose: To determine a way to reduce clinician burden in the identification of individuals at risk for falls.

Evidence That Brain-Reactive Autoantibodies Contribute To Chronic Neuronal Internalization Of Exogenous Amyloid-Β1-42 And Key Cell Surface Proteins During Alzheimer's Disease Pathogenesis, Eric L Goldwaser, Nimish K Acharya, Hao Wu, George A Godsey, Abhirup Sarkar, Cassandra A Demarshall, Mary C Kosciuk, Robert G Nagele

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Blood-brain barrier (BBB) permeability is a recognized early feature of Alzheimer's disease (AD). In the present study, we examined consequences of increased BBB permeability on the development of AD-related pathology by tracking selected leaked plasma components and their interactions with neurons in vivo and in vitro. Histological sections of cortical regions of postmortem AD brains were immunostained to determine the distribution of amyloid-β1-42 (Aβ42), cathepsin D, IgG, GluR2/3, and alpha7 nicotinic acetylcholine receptor (α7nAChR). Results revealed that chronic IgG binding to pyramidal neurons coincided with internalization of Aβ42, IgG, GluR2/3, and α7nAChR as well as lysosomal compartment expansion in these …

Transcriptomic Analysis Implicates Necroptosis In Disease Progression And Prognosis In Myelodysplastic Syndromes, Guillermo Montalban-Bravo, Caleb Class, Irene Ganan-Gomez, Rashmi Kanagal-Shamanna, Koji Sasaki, Guillaume Richard-Carpentier, Kiran Naqvi, Yue Wei, Hui Yang, Kelly A. Soltysiak, Kelly Chien, Carlos Bueso-Ramos, Kim-Anh Do, Hagop Kantarjian, Guillermo Garcia-Manero

Scholarship and Professional Work – COPHS

Myelodysplastic syndromes (MDS) are characterized by ineffective hematopoiesis and cytopenias due to uncontrolled programmed cell death. The presence of pro-inflammatory cytokines and constitutive activation of innate immunity signals in MDS cells suggest inflammatory cell death, such as necroptosis, may be responsible for disease phenotype. We evaluated 64 bone marrow samples from 55 patients with MDS or chronic myelomonocytic leukemia (CMML) obtained prior to (n=46) or after (n=18) therapy with hypomethylating agents (HMAs). RNA from sorted bone marrow CD34+ cells was isolated and subject to amplification and RNA-Seq. Compared to healthy controls, expression levels of MLKL (CMML: 2.09 log2FC, p=0.0013; MDS: …

Kitchen Concentrations Of Fine Particulate Matter And Particle Number Concentration In Households Using Biomass Cookstoves In Rural Honduras, Megan L. Benka-Coker, Jennifer L. Peel, John Volckens, Nicholas Good, Kelsey R. Bilsback, Christian L'Orange, Casey Quinn, Bonnie N. Young, Sarah Rajkumar, Ander Wilson, Jessica Tryner, Sebastian Africano, Anibal B. Osorto Pinel, Maggie L. Clark

Health Sciences Faculty Publications

Cooking and heating with solid fuels results in high levels of household air pollutants, including particulate matter (PM); however, limited data exist for size fractions smaller than PM2.5 (diameter less than 2.5 μm). We collected 24-h time-resolved measurements of PM2.5 (n = 27) and particle number concentrations (PNC, average diameter 10–700 nm) (n = 44; 24 with paired PM2.5 and PNC) in homes with wood-burning traditional and Justa (i.e., with an engineered combustion chamber and chimney) cookstoves in rural Honduras.

The median 24-h PM2.5 concentration (n = 27) was 79 μg/m3 (interquartile range [IQR]: 44–174 μg/m3); traditional (n = 15): …

Predictors Of Bicuspid Aortic Valve-Associated Aortopathy In Childhood: A Report From The Mibava Consortium, Michael Grattan, Andrea Prince, Rawan K Rumman, Conall Morgan, Michele Petrovic, Amanda Hauck, Luciana Young, Anders Franco-Cereceda, Bart Loeys, Salah A Mohamed, Harry Dietz, Seema Mital, Chun-Po Steve Fan, Cedric Manlhiot, Gregor Andelfinger, Luc Mertens

Paediatrics Publications

BACKGROUND: Bicuspid aortic valve (BAV) is the most prevalent congenital heart defect affecting 1% to 2% of the population. It is associated with ascending aorta dilatation. Valve morphology, aortic stenosis (AS), and aortic insufficiency (AI) have been proposed as potential risk factors; however, evaluating their role is difficult, as these factors are inherently related. The aim of this study was to determine whether BAV morphology and dysfunction are independent determinants for ascending aorta dilatation in pediatric patients.

METHODS: A multicenter, retrospective, cross-sectional study of pediatric BAV patients followed since 2004 was performed. Imaging data were assessed for BAV morphology, severity …

Bulging Anterior Fontanelle And Dense Bones In An Infant., Camilla Raya Halgren, Jenna Lakhani, Samantha Colaiacovo, Chitra Prasad

Paediatrics Publications

No abstract provided.

Blau Syndrome And Early-Onset Sarcoidosis: A Six Case Series And Review Of The Literature., Ayşenur Paç Kisaarslan, Betül Sözeri̇, Nihal Şahi̇n, Sümeyra Özdemi̇r Çi̇çek, Zübeyde Gündüz, Erkan Demi̇rkaya, Afig Berdeli̇, Serdal Sadet Özcan, Hakan Porazoğlu, Ruhan Düşünsel

Paediatrics Publications

Objectives: This study aims to discuss the clinical, laboratory and genetic findings, and treatment options for six patients who were diagnosed with Blau syndrome (BS)/early-onset sarcoidosis (EOS).

Patients and methods: The study included four patients (2 males,2 females; mean age 7 years; range 4 to 10 years) with EOS and two siblings (1 male, 1 female; mean age 10 years; range, 9 to 11 years) with BS. Age, age of initial symptoms, age of diagnosis; articular involvement, presence of uveitis, dermatitis, or fever, other organ involvement, laboratory findings, results of metabolic tests for mucopolysaccharidosis and mucolipidosis, results of genetic, pathologic, …

Osteochondritis Dissecans In Pediatric Patients With Juvenile Idiopathic Arthritis., Bradley C Jackson, Debra L Bartley, Roberta A Berard

Paediatrics Publications

No abstract provided.

Impressions On Reliability And Students’ Perceptions Of Learning In A Peer-Based Osce, Rishad Khan, Saad Chahine, Steven Macaluso, Ricardo Viana, Caitlin Cassidy, Thomas Miller, Debra Bartley, Michael Payne

Paediatrics Publications

Background: Peer assessment of performance in the objective structured clinical examination (OSCE) is emerging as a learning instrument. While peers can provide reliable scores, there may be a trade-off with students’ learning. The purpose of this study is to evaluate a peer-based OSCE as a viable assessment instrument and its potential to promote learning and explore the interplay between these two roles. Methods: A total of 334 medical students completed an 11-station OSCE from 2015 to 2016. Each station had 1–2 peer examiners (PE) and one faculty examiner (FE). Examinees were rated on a 7-point scale across 5 dimensions: Look, …

Labour Progression In Obese Women: Are Women With Increased Body Mass Index Having Unnecessary Cesarean Sections?, Caroline Shenouda, Aloka Wijesooriya, Amanda Toufeili, Michael R Miller, Debbie Penava, Barbra De Vrijer

Obstetrics & Gynaecology Publications

OBJECTIVE: This study sought to determine whether obese pregnant women undergo cesarean sections without an adequate trial of labour. This may affect future birth and pregnancy outcomes.

METHODS: A retrospective analysis was done on 526 parturients at Victoria Hospital in London, Ontario. Women were categorized according to parity and pre-pregnancy body mass index (BMI; normal weight, BMI 18.5-24.9 kg/m

RESULTS: Obese class II and III primiparous women required an additional 1.62 and 2.67 hours (P = 0.012), respectively, to reach a dilation of 10 cm compared with their normal weight counterparts; obese class II and III multiparous women required an …

Outsmarting Ebola Through Stronger National Health Systems, Obidimma Ezezika, Alpha Kabinet Keita

Health Studies Publications

Letter to the Editor

An Expert Consensus Statement On The Management Of Large Chondral And Osteochondral Defects In The Patellofemoral Joint, Jorge Chahla, Betina B. Hinckel, Adam B. Yanke, Jack Farr, William D. Bugbee, James L. Carey, Brian J. Cole, Dennis C. Crawford, James E. Fleischli, Alan Getgood, Andreas H. Gomoll, Simon Gortz, Allan E. Gross, Deryk G. Jones, Aaron J. Krych, Christian Lattermann, Bert R. Mandelbaum, Peter R. Mandt, Tom Minas, Raffy Mirzayan, Timothy S. Mologne, John D. Polousky, Matthew T. Provencher, Scott A. Rodeo, Oleg Safir, Seth Lawrence Sherman, Eric D. Strauss, Sabrina M. Strickland, Christopher J. Wahl, Riley J. Williams

Bone and Joint Institute

© The Author(s) 2020. Background: Cartilage lesions of the patellofemoral joint constitute a frequent abnormality. Patellofemoral conditions are challenging to treat because of complex biomechanics and morphology. Purpose: To develop a consensus statement on the functional anatomy, indications, donor graft considerations, surgical treatment, and rehabilitation for the management of large chondral and osteochondral defects in the patellofemoral joint using a modified Delphi technique. Study Design: Consensus statement. Methods: A working group of 4 persons generated a list of statements related to the functional anatomy, indications, donor graft considerations, surgical treatment, and rehabilitation for the management of large chondral and osteochondral …

Basal Forebrain Volume Reliably Predicts The Cortical Spread Of Alzheimer's Degeneration, Sara Fernández-Cabello, Martin Kronbichler, Koene R.A. Van Dijk, James A. Goodman, R. Nathan Spreng, Taylor W. Schmitz

Brain and Mind Institute Researchers' Publications

© The Author(s) (2020). Published by Oxford University Press on behalf of the Guarantors of Brain. Alzheimer's disease neurodegeneration is thought to spread across anatomically and functionally connected brain regions. However, the precise sequence of spread remains ambiguous. The prevailing model used to guide in vivo human neuroimaging and non-human animal research assumes that Alzheimer's degeneration starts in the entorhinal cortices, before spreading to the temporoparietal cortex. Challenging this model, we previously provided evidence that in vivo markers of neurodegeneration within the nucleus basalis of Meynert (NbM), a subregion of the basal forebrain heavily populated by cortically projecting cholinergic neurons, …

Do Infants Have A Sense Of Numerosity? A P-Curve Analysis Of Infant Numerosity Discrimination Studies, Rachael E. Smyth, Daniel Ansari

Brain and Mind Institute Researchers' Publications

Research demonstrating that infants discriminate between small (e.g., 1 vs. 3 dots) and large numerosities (e.g., 8 vs. 16 dots) is central to theories concerning the origins of human numerical abilities. To date, there has been no quantitative meta-analysis of the infant numerical competency data. Here, we quantitatively synthesize the evidential value of the available literature on infant numerosity discrimination using a meta-analytic tool called p-curve. In p-curve the distribution of available p-values is analyzed to determine whether the published literature examining particular hypotheses contains evidential value. p-curves demonstrated evidential value for the hypotheses that infants can discriminate between both …

Effect Of Dual-Tasking On Walking And Cognitive Demands In Adults With Alzheimer's Dementia Experienced In Using A 4-Wheeled Walker, Susan W. Hunter, Humberto Omana, Edward Madou, Walter Wittich, Keith D Hill, Andrew M Johnson, Alison Divine, Jeffrey D Holmes

Physical Therapy Publications

BACKGROUND: Learning to walk with a 4-wheeled walker increases cognitive demands in people with Alzheimer's dementia (AD). However, it is expected that experience will offset the increased cognitive demand. Current research has not yet evaluated gait in people with AD experienced in using a 4-wheeled walker under complex gait situations.

RESEARCH QUESTION: What is the effect of dual-task testing on the spatial-temporal gait parameters and cognitive performance of people with AD experienced with a 4-wheeled walker?

METHODS: Twenty-three adults with mild to moderate AD (87.4 ± 6.2 years, 48 % female) and at least 6 months of walker use experience …

A Significant Of Vitamin D And Other Parameters In Patients With Multiple Sclerosis In Baghdad, Huda Jaber, Amal R. Farhan, Usama Altimari, Azhar Abed Flayyih

Al-Nisour Journal for Medical Sciences

Background: Multiple Sclerosis patients (MS) were suffering from several neurological defect. Vitamin D deficiency increase the severity of MS disease. The aim of this study is to evaluate Vitamin D in Multiple Sclerosis patients (MS). Methodology: Current study enrolled thirty patients suffering from MS, they were diagnosed by physician. For comparison thirty healthy individuals participated in this work. Vitamin D and liver function tests were measured. Result: A highly significant decrease in Vitamin D level (12.44±5.6 ng/ml) in MS patients when compared to control (32 ± 6.4 ng/ml), and significant increase liver function tests in MS disease as compare with …

Study The Relationship Between Hemoglobin (Hb) And Erythrocyte Sedimentation Rate (Esr) In A Group Of Iraqi Patients In Baghdad, Lubna Muhi Rasoul

Al-Nisour Journal for Medical Sciences

The erythrocyte sedimentation rate (ESR) remains a commonly measured indicator of disease, but it is subjected to several non-disease influences. The hemoglobin concentration (Hb) and ESR were measured in 35 consecutive patients (20men; 15 women) from Al Karama Hospital and Yarmouk Hospital. An inverse correlation was found between Hb and ESR throughout the range of measured Hb, and in particular there was a significant difference in the median ESR of patients in the highest and lowest quartile for non-anemic Hb. These results indicate that correct clinical analysis of an ESR result should take into account the Hb, both in anemic …

Himmelfarb Library Liaison Letter - March 2020, George Washington University, Himmelfarb Health Sciences Library

Himmelfarb Library Liaison Letters

No abstract provided.

Application Of Protection Motivation Theory To Clinical Trial Enrolment For Pediatric Chronic Conditions, Stephanie P. Brooks, Tania M. Bubela

Office of the Provost

Background: Parents of children living with chronic but manageable conditions hope for improved therapies or cures, including Advanced Therapy Medicinal Products (ATMPs). Multiple pediatric clinical trials for ATMPs are underway, but the risk profile of ATMPs for chronic conditions is largely unknown and likely different than for terminal pediatric illnesses. Applying Protection Motivation Theory modified to the context of pediatric ATMP clinical trial enrollment, our study analyses information needs of parents of children living with chronic manageable conditions: Type 1 Diabetes (T1D) or Inherited Retinal Diseases (IRD).
Methods: We conducted semi-structured interviews with 15 parents of children living with T1D …

Efficacy Of Liraglutide In Clinical Practice: Single Centre Experience, Owais Rashid, Sumerah Jabeen, Adeel Khoja, Najmul Islam

Section of Diabetes, Endocrinology and Metabolism

Background and objective: GLP-one receptor agonists are amongst the unique antidiabetes medications that have significant metabolic and cardiovascular benefits in addition to glucose lowering effect. To best of our knowledge, there is no published data on efficacy of liraglutide use among Pakistani population.Our objective was to ascertain the efficacy of liraglutide use among type two diabetes patients.
Methods: This retrospective study was conducted at the Endocrinology Clinics of Aga Khan University Hospital (AKUH) Karachi, Pakistan during the period from July 01, 2016 to 30th June, 2017. Liraglutide was prescribed to 68 obese type two diabetes patients with uncontrolled diabetes taking …

Adherence To Universal Precautions And Associated Factors Among Nurses Caring For Critically Ill Patients In Dar Es Salaam Tanzania, Salma A. Wibonela, Columba Mbekenga, Fatina B. Ramadhani, Ally Mwanga, Pedro Palangyo

School of Nursing & Midwifery, East Africa

Background: Globally, it is known that heath care workers particularly in critical care settings are at higher risk of occupational exposure to infections. Surveillance systems to monitor body fluid exposure have been established in developed world. However, such systems are not available and consequently, exposure to body fluids is rarely reported, documented and monitored in many African countries.

Objectives: To assess knowledge, practice and factors influencing adherence of Universal Precautions of infection prevention among nurses at Muhimbili national hospital and Muhimbili orthopaedic institute Dar es salaam Tanzania.

Design: Quantitative cross-sectional and observational study. SPSS was used for data …

Cardiac Interventions In Patients With Achondroplasia: A Systematic Review., Amrita Sukhavasi, Thomas J O'Malley, Elizabeth J Maynes, Jae Hwan Choi, Jonathan S Gordon, Kevin Phan, Vakhtang Tchantchaleishvili

Jefferson Hospital Staff Papers and Presentations

Patients with achondroplasia and other causes of dwarfism suffer from increased rates of cardiovascular disease relative to the remainder of the population. Few studies have examined these patients when undergoing cardiac surgery or percutaneous intervention. This systematic review examines the literature to determine outcomes following cardiac intervention in this unique population. An electronic search was performed in the English literature to identify all reports of achondroplasia, dwarfism, and cardiac intervention. Of the 5,274 articles identified, 14 articles with 14 cases met inclusion criteria. Patient-level data was extracted and analyzed. Median patient age was 55.5 [interquartile ranges (IQR), 43.8, 59.8] years, …

Neurological Involvement In Covid-19 Infections; Pathophysiology, Presentation And Outcome., Dureshahwar Kanwar, Muhammad Imran, Mohammad Wasay

Pakistan Journal of Neurological Sciences (PJNS)

Severe acute respiratory syndrome corona virus 2 (SARS CoV 2) seems to display an increasing affinity for the nervous system. The ongoing pandemic has made evident that diverse neurological manifestations may occur with COVID 19. Headache and dizziness remain the most common symptoms however stroke, seizures, encephalopathy, neuropathy and skeletal muscle injury may be seen. An increasing number of patients report initial anosmia and ageusia. Tendency for serious illness is believed to be in the elderly or people with a history of diabetes, high blood pressure and heart disease. Many patients on immunosuppressive therapies such as multiple sclerosis, myasthenia gravis …

Family Medicine In Tanzania: Seize The Moment, Riaz Ratansi, Bernhard M. Gaede

Faculty of Health Sciences, East Africa

In the context of addressing the pressing health needs for the global population, the World Health Organization has repeatedly called for universal health coverage (UHC) to be prioritised by its member countries. This is to be achieved through a high-quality primary health care (PHC) approach that provides comprehensive and integrated generalist care as close to where people live as well as links the clinical care to health promotion and disease prevention. In this paper, we argue for the introduction of family medicines as a critical player in the healthcare system of Tanzania to strengthen the strategies towards UHC. The paper …

Nephron Sparing Surgery For Renal Tumors-Comparison Of Off-Clamp Partial Nephrectomy With Hilar Clamping, Imran K. Jalbani, Syed Muhammad Nazim, Maria Ahmed, Farhat Abbas

Section of Urology

Background and objective: Open partial nephrectomy (PN) is still considered gold standard procedure for T1 localized renal tumors. Conventional technique involves clamping of the renal artery with or without vein however, renal ischemia produces a certain level of damage to the kidneys. This study aims to investigate potential effect of off-clamp vs. hilar clamping PN on renal function.
Methods: This is a retrospective cohort study of patients who underwent unilateral, open partial nephrectomy for renal tumors b/w January 2009 December 2016 at our institution. A total of 90 partial nephrectomies were performed of which 65 cases were eligible for analysis. …

S-Seco-Porphyrazine As A New Member Of The Seco-Porphyrazine Family – Synthesis, Characterization And Photocytotoxicity Against Cancer Cells, Dariusz T. Mlynarczyk, Jaroslaw Piskorz, Lukasz Popenda, Magdalena Stolarska, Wojciech Szczolko, Krystyna Konopka, Stefan Jurga, Lukasz Sobotta, Jadwiga Mielcarek, Nejat Düzgüneş, Tomasz Goslinski

All Dugoni School of Dentistry Faculty Articles

An important subgroup within the porphyrazine (Pz) family constitutes seco-porphyrazines, in the chemical structure of which one pyrrole unit is opened in the oxidative process. So far, there are only limited data on N-seco- and C-seco-Pzs. Here, the synthesis of a novel member of the Pzs seco-family, represented by an S-seco-tribenzoporphyrazine analogue, 22,23-bis(4-(3,5-dibutoxycarbonylphenoxy)butylsulfanyl)tribenzo[b,g,l]-22,23-dioxo-22,23-seco-porphyrazinato magnesium(II), is reported, with moderate 34% yield. The new derivative was characterized using NMR spectroscopy, UV–Vis spectroscopy, and mass spectrometry. In the photochemical study performed following the indirect chemical method with 1,3-diphenylisobenzofuran, S-seco-Pz revealed a high singlet oxygen quantum yield of 0.27 in DMF. Potential photocytotoxicity of …

Primary Intracranial Malignant Melanoma, Ummey Hani, Dr Saqib Kamran Bakhshi, Muhammad Shahzad Shamim

Section of Neurosurgery

Primary intracranial malignant melanoma (PIMM) are rare brain tumours; more infrequent than melanomas metastasizing to the brain or those extending to the brain from adjacent structures such as the orbit. Complete surgical excision with adjuvant chemotherapy and radiation remains the mainstay of treatment. Herein, we have reviewed the literature to find the treatment modalities for PIMMs that can lead to longer overall survivals and better patient outcomes.

Primary Sclerosing Cholangitis: Epidemiology, Genetics, Diagnosis, And Current Management., Eric Gochanour, Channa Jayasekera, Kris V Kowdley

Articles, Abstracts, and Reports

http://aasldpubs.onlinelibrary.wiley.com/hub/journal/10.1002/(ISSN)2046-2484/video/15-3-reading-gochanour a video presentation of this article http://aasldpubs.onlinelibrary.wiley.com/hub/journal/10.1002/(ISSN)2046-2484/video/15-3-interview-kowdley an interview with the author.

Enthesitis In Psoriatic Arthritis (Part 3): Clinical Assessment And Management., Philip Mease

Articles, Abstracts, and Reports

Enthesitis is a common clinical feature of PsA, which is characterized by inflammation at the site of insertion of tendons, ligaments and joint capsule fibres into bone. Enthesitis is relatively unique to the spondyloarthritides, setting this group of diseases apart from other rheumatological conditions. The pathophysiological underpinnings of this clinical domain, and the imaging assessment of it, are described in accompanying articles in this supplement. The focus of this article is on the assessment of enthesitis by physical examination, the impact of enthesitis on function and quality of life, the impact of concomitant FM on clinical assessment, and the evidence …

Impact Of Traffic, Poverty And Facility Ownership On Travel Time To Emergency Care In Nairobi, Kenya, Maya S. Fraser, Benjamin Wachira, Abraham D. Flaxman, Aaron Y. Lee, Herbert C. Duber

Emergency Medicine, East Africa

Background: In many low and middle-income countries (LMICs), timely access to emergency healthcare services is limited. In urban settings, traffic can have a significant impact on travel time, leading to life-threatening delays for time-sensitive injuries and medical emergencies. In this study, we examined travel times to hospitals in Nairobi, Kenya, one of the largest and most congested cities in the developing world.

Methods: We used a network approach to estimate average minimum travel times to different types of hospitals (e.g. ownership and level of care) in Nairobi under both congested and uncongested traffic conditions. We also examined the correlation between …