Medicine and Health Sciences Commons^™

Cold Exposure Induces Dynamic, Heterogeneous Alterations In Human Brown Adipose Tissue Lipid Content, Crystal L. Coolbaugh, Bruce M. Damon, Emily C. Bush, E Brian Welch, Theodore F. Towse

Peer Reviewed Articles

Brown adipose tissue undergoes a dynamic, heterogeneous response to cold exposure that can include the simultaneous synthesis, uptake, and oxidation of fatty acids. The purpose of this work was to quantify these changes in brown adipose tissue lipid content (fat-signal fraction (FSF)) using fat-water magnetic resonance imaging during individualized cooling to 3 °C above a participant’s shiver threshold. Eight healthy men completed familiarization, perception-based cooling, and MRI-cooling visits. FSF maps of the supraclavicular region were acquired in thermoneutrality and during cooling (59.5 ± 6.5 min). Brown adipose tissue regions of interest were defined, and voxels were grouped into FSF decades …

Reduced Doses Of Direct Oral Anticoagulation Are Safe In Atrial Fibrillation Patients With Mild Thrombocytopenia, Matthew Gross

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Janion-Sadowska A, Papuga-Szela E, Łukaszuk R, et al. Non–Vitamin K Antagonist Oral Anticoagulants in Patients with Atrial Fibrillation and Thrombocytopenia. Journal of Cardiovascular Pharmacology. 2018;72(3):153-160. doi: 10.1097/fjc.0000000000000607

Nsaid Use Increases Risk Of Miscarriage In Early Pregnancy, Leigh Durudogan

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Li D, Ferber J, Odouli R, Quesenberry C. Use of nonsteroidal anti-inflammatory drugs during pregnancy and the risk of miscarriage. Am J Ob Gyn. 2018; 219(3): 275.e1–275.e8. doi: 10.1016/j.ajog.2018.06.002.

Fecal Microbiota Therapy In Recurrent And Refractory Clostridium Difficile Infections Has Been Associated With Positive Results In Immunocompromised Patients, Eric Applebach

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Kelly CR, Ihunnah C, Fischer M, et al. Fecal microbiota transplant for treatment of Clostridium difficile infection in immunocompromised patients. The American Journal of Gastroenterology, 2014;109(7):1065-71. doi: 10.1038/ajg.2014.133

Convening Of Academic Medical-Legal Partnership: Law School Clinical Faculty, Health Justice Alliance

HJA Scholarship

On September 18, 2019, the Georgetown University Health Justice Alliance (HJA), with generous support from the Winer Family Foundation, brought together a group of clinical law faculty from across the country, all of whom use the medical-legal partnership (MLP) model to teach law students to work interprofessionally to address the health harming legal needs of vulnerable patients. This Report provides background on medical-legal partnerships and the law school clinic model, describes the substance discussed during each session of the convening, and includes a summary of key findings and ideas for innovation as well as areas for future exploration.

Sample Dnp Project Criteria, Ann M. Mayo Rn, Dnsc, Faan

School of Nursing and Health Science: Faculty Scholarship

These sample criteria for Doctorate of Nursing Practice (DNP) projects will be helpful to DNP faculty and students alike. Many nursing faculty teaching in DNP programs have never conducted an Evidence-based Practice Project and so the criteria are meant to be a guide for their learning and help to differentiate DNP projects from research. Research criteria should not be used for DNP project planning or evaluation. Students will benefit from the criteria as they plan and carry out their projects. Criteria should be supplemented by reading examples of strong EBP projects. Readers should critique such publications using the DNP criteria …

Slc36a1-Mtorc1 Signaling Drives Acquired Resistance To Cdk4/6 Inhibitors., Akihiro Yoshida, Yiwen Bu, Shuo Qie, John Wrangle, E. Ramsay Camp, E. Starr Hazard, Gary Hardiman, Renée De Leeuw, Karen E. Knudsen, J. Alan Diehl

Department of Cancer Biology Faculty Papers

The cyclin-dependent kinase 4/6 (CDK4/6) kinase is dysregulated in melanoma, highlighting it as a potential therapeutic target. CDK4/6 inhibitors are being evaluated in trials for melanoma and additional cancers. While beneficial, resistance to therapy is a concern, and the molecular mechanisms of such resistance remain undefined. We demonstrate that reactivation of mammalian target of rapamycin 1 (mTORC1) signaling through increased expression of the amino acid transporter, solute carrier family 36 member 1 (SLC36A1), drives resistance to CDK4/6 inhibitors. Increased expression of SLC36A1 reflects two distinct mechanisms: (i) Rb loss, which drives SLC36A1 via reduced suppression of E2f; (ii) fragile X …

The Cost-Effectiveness Of Neonatal Versus Prenatal Screening For Congenital Toxoplasmosis, Christine Binquet, Catherine Lejeune, Valérie Seror, François Peyron, Anne-Claire Bertaux, Olivier Scemama, Catherine Quantin, Sophie Béjean, Eileen Stillwaggon, Martine Wallon

Economics Faculty Publications

Congenital Toxoplasmosis (CT) can have severe consequences. France, Austria, and Slovenia have prenatal screening programs whereas some other countries are considering universal screening to reduce congenital transmission and severity of infection in children. The efficiency of such programs is debated increasingly as seroprevalence among pregnant women and incidence of congenital toxoplasmosis show a steady decrease. In addition, uncertainty remains regarding the effectiveness of pre- and postnatal treatments.

Comparison Of Lumbar Laminectomy Alone, Lumbar Laminectomy And Fusion, Stand-Alone Anterior Lumbar Interbody Fusion, And Stand-Alone Lateral Lumbar Interbody Fusion For Treatment Of Lumbar Spinal Stenosis: A Review Of The Literature., Manan Shah, Bradley Kolb, Emre Yilmaz, Dia R Halalmeh, Marc D Moisi

Articles, Abstracts, and Reports

Lumbar spinal stenosis is defined as narrowing of the lumbar spinal canal, which causes compression of the spinal cord and nerves. Spinal stenosis can cause leg pain and potentially back pain that can affect the quality of life. Ultimately, surgical decompression is required to alleviate the symptoms. In this review, we first utilize several important studies to compare lumbar laminectomy alone versus lumbar laminectomy and fusion. We also compare the effectiveness of more novel surgical approaches, stand-alone anterior lumbar interbody fusion (ALIF), and stand-alone lateral lumbar interbody fusion (LLIF). These techniques have their own advantages and disadvantages in which many …

Identifying The Prevalence Of Sensory Processing Dysfunction In A Post-Concussion Population And It's Relationship With Quality Of Life And Functional Indicators, Stephen Van Lew

Seton Hall University Dissertations and Theses (ETDs)

Background: Approximately 10-20% of individuals who sustain a concussion will experience post-concussion syndrome, defined as symptomology beyond the traditional 7-10-day concussion recovery period. A particular area of symptomology, sensory processing deficits was explored in this study to ascertain the prevalence of these deficits along with possible associations with QOL and everyday functional outcomes. Methods: This study was a prospective, cross-sectional, quantitative study using a consecutive and convenience sampling model. The research participants were recruited from an outpatient occupational therapy program at an academic medical center. Normative data from two different sensory processing outcome tools were used in the analysis. …

Estimated Cardiorespiratory Fitness Is Associated With Reported Depression In College Students, Sharon Jalene, Jennifer Pharr, Guogen Shan, Brach Poston

Integrated Health Sciences Faculty Research

Depression is a serious but treatable health issue that affects college students at an alarming rate. Improved cardiorespiratory fitness (CRF) decreases depression risk and severity but this relationship has not been fully evaluated in the college student population. Non-exercise estimated CRF (eCRF) could be used to identify students at risk for or suffering from depression. This study investigated the associations of depression and eCRF in college students. Participants (N = 437) completed a survey which included demographic and student-status questions, eCRF variables, and a validated depression instrument. Descriptive, chi-square, t-test, regression, and odds ratio analyses were employed. Depression was associated …

International Consensus Statement On The Psychosocial And Policy-Related Approaches To Mental Health Awareness Programmes In Sport, Gavin Breslin, Andy Smith, Brad Donohue, Paul Donnelly, Stephen Shannon, Tandy Jane Haughey, Stewart A. Vella, Christian Swann, Stewart Cotterill, Tadhg Macintyre, Tim Rogers, Gerard Leavey

Psychology Faculty Research

Background: Research focused on mental health in sport has revealed a need to develop evidence-supported mental health practices that are sensitive to sport culture, particularly for non-elite athletes. A consensus statement was produced to assist effective mental health awareness in sport and guide programme implementation in this rapidly emerging field. Method: The AGREE Reporting Checklist 2016 was used in two international expert consultation meetings, followed by two online surveys. Experts from 10 countries and over 30 organisations contributed. Results: Six objectives were agreed: (1) to define mental health awareness and service implementation constructs for inclusion in programmes delivered in sporting …

Heme And Hemoglobin Utilization By Mycobacterium Tuberculosis., Avishek Mitra, Ying-Hui Ko, Gino Cingolani, Michael Niederweis

Department of Biochemistry and Molecular Biology Faculty Papers

Iron is essential for growth of Mycobacterium tuberculosis (Mtb), but most iron in the human body is stored in heme within hemoglobin. Here, we demonstrate that the substrate-binding protein DppA of the inner membrane Dpp transporter is required for heme and hemoglobin utilization by Mtb. The 1.27 Å crystal structure of DppA shows a tetrapeptide bound in the protein core and a large solvent-exposed crevice for heme binding. Mutation of arginine 179 in this cleft eliminates heme binding to DppA and prevents heme utilization by Mtb. The outer membrane proteins PPE36 and PPE62 are also required for heme and hemoglobin …

Xpert® Mtb/Rif Assay On Formalin-Fixed Paraffin-Embedded Tissues In The Diagnosis Of Extrapulmonary Tuberculosis, Allan Njau, Samuel Gakinya, Shahin Sayed, Zahir Moloo

Pathology, East Africa

Background: Diagnosis of extrapulmonary tuberculosis continues to be a challenge due to the complexity of the causative organism and the wide array of pathologic features seen in this infection. Xpert MTB/RIF can be used on fresh or frozen tissue specimens for diagnosis of tuberculosis with good results. However, there is little data on its use with formalin-fixed paraffin-embedded (FFPE) tissues.

Objectives: The aim of this study was to demonstrate the potential utility of Xpert MTB/RIF and to compare its performance to Ziehl-Neelsen staining for the detection of Mycobacterium tuberculosis from FFPE tissues using histological features from haematoxylin and eosin staining …

Intravenous Iodinated Contrast Is Not Associated With Acute Kidney Injury In Adult Patients With Nephrotic Syndrome, Andrew Bacyinski

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Tao SM, Kong X, Schoepf UJ, et al. Acute kidney injury in patients with nephrotic syndrome undergoing contrast-enhanced CT for suspected venous thromboembolism: a propensity score-matched retrospective cohort study. European Radiology. 2018;28(4):1585-1593. doi: 10.1007/s00330-017-5109-0

The Make ‘Em Well Project -Rewards And Recognition Phase, Diann M. Krywko

Journal of Wellness

The Make ‘EM Well Project- Rewards and Recognition

Background: Physicians report high burnout levels and difficulty finding joy in work, causing a healthcare system crisis. Our institution assessed burnout by administering the Areas of Work-life (AWS) and Maslach Burnout Inventory™ (MBI) Surveys. Emergency Medicine (EM) results were alarming. Effectively rewarding and recognizing employees requires understanding different appreciation languages. Administrators should understand what enhances and detracts from joy in the workplace. This study describes the “Make ‘EM Well Project” and its focus on Rewards and Recognition (RR).

Methods: Two surveys were sent to EM providers including faculty, residents, fellows, and advanced …

Sipuleucel-T (Provenge®): Therapeutic Use And Financial Implications, Courtney Porter, Joshua Ilenin, Lisa Berni, Ashley Overy, Karen L. Kier

Pharmacy and Wellness Review

Although mortality rates have been declining, prostate cancer accounts for a large percentage of cancer diagnoses around the world. Sipuleucel-T (Provenge®), an autologous cellular immunotherapy targeted against the antigen expressed in most prostate cancers, has been shown to increase the median survival rate of castration-resistant prostate cancer. Even so, the therapeutic risks and benefits, as well as financial implications, all currently play a role in the governmental decision to reimburse for this new therapy.

An Update On Gestational Diabetes, Jamie L. Amero, Jennifer L. Bauer, Sarah M. Webb, Ryan A. Fischer, Lindsey A. Hallman, Sandra L. Hrometz

Pharmacy and Wellness Review

Gestational diabetes is a concern for a large number of pregnant women due to the potential for long-term complications for both the mother and the fetus. With the increasing prevalence of obesity and diabetes in the general public, the number of pregnant women with undiagnosed type 2 diabetes mellitus has also increased. In order to adequately educate their patients, it is important for pharmacists to be aware of the general practices of treating gestational diabetes. This review will highlight recent updates to initial screening, the criteria for diagnosing gestational diabetes, and current management strategies.

Treatment Options For Seasonal Affective Disorder, Lauren D. Bajbus, Amanda M. Meyer, Kristen M. Quertinmont, Sarah E. Drake, Alison L. Huet, Shane Martin

Pharmacy and Wellness Review

Many patients who have undiagnosed Seasonal Affective Disorder (SAD) may come into the pharmacy to try to self-treat their symptoms with over-the-counter and herbal drugs. Often, patients don't recognize their symptoms as a true depressive disorder since they are not constant. The pharmacist has the opportunity to talk to these patients, educate them on the disease state and explain that they do have options, both pharmacologic and non-pharmacologic. It also is important for pharmacists to point out any interactions that the herbal or over-the-counter medications may have with other medications and to refer patients to their physician for further treatment. …

The Pharmacogenetics Of Opioid Pain Management, Maryanne Ventura, Lauren Desko, Kimberly Gathers, Ashley Overy, David Kisor

Pharmacy and Wellness Review

High rates of interpatient variability in drug metabolism and drug response for nearly all medications lead to the hypothesis that assessment of an individual patient's genotype with respect to their ability metabolize certain drugs can be a useful tool in predicting a patient's responsiveness to certain medications. Evaluating patients using pharmacogenomics as a basis for assessment could allow pharmacists to decide which treatment options would be most efficacious in a given patient and, thereby, have significant impact in the clinical setting. This holds true especially in the case of prodrugs, which require in vivo activation to an active or more …

Pediatric Poisoning: Overview, Treatment, And Prevention, Margaret Rowland, Taylor Gauthier, Kaitlin Sanders, Caitlin Swann, David Bright

Pharmacy and Wellness Review

Pediatric poisoning remains a common and preventable occurrence in the United States. Every year, prescription and over-the-counter medications account for a significant portion of documented poison exposures. Frequent causes of overdose in children include improper medication storage and caregiver or physician dosing error. As easily accessible medication experts, pharmacists have an opportunity to counsel patients in an effort to decrease these preventable poisoning cases. Because children frequently ingest products prescribed for adult use, pharmacist should relay safety considerations to all patients, regardless of age. This article provides a general review of toxicity concerns, discusses clinical implications of common medications resulting …

Healthy People 2020: Identifying Roles For Pharmacists In Public Health, Ellen Hazelet, Aisha Oliver, Katherine Salay, Breanne Rizzo, Alison L. Huet, Natalie Dipietro

Pharmacy and Wellness Review

Healthy People, sponsored by the United States Department of Health and Human Services, utilizes evidence-based medicine to create objectives addressing significant preventable health issues. The vision of Healthy People is to improve the quality and length of life free from preventable disease, disability, injury and death. Based on objectives outlined by Healthy People 2020 (HP 2020) pharmacists can play a role in public awareness, collaborate with other health care professionals and help achieve goals set forth by HP 2020. Based on the expertise and accessibility of the pharmacist, pharmacists can impact nine of the 13 new focus areas pf HP …

Prescription Drug Manufacturer Attempts To Prevent Abuse Of Controlled Substances, Amanda R. Hoersten, Nathaniel Hedrick, Lacey Shumate, H. Paige Stewart, Caitlin Swann, Michael Milks

Pharmacy and Wellness Review

In the United States, prescription drug abuse is on the rise. This trend has impacted the makers of OxyContin®, as well as the manufacturers of other controlled substances,to reevaluate how they formulate their products, resulting in medications, that are more difficult to abuse. These abuse-deterrent formulations utilize physical, chemical and aversion barriers, specific delivery systems, and prodrug technology to prevent abuse. Additionally, some manufacturers have implemented the use of risk-management campaigns and education programs, to reduce the misuse of their products. Working together with prescription drug manufacturers, pharmacists play an important role in preventing abuse and educating patients on the …

Will New Mrsa Guidelines Make A Difference In Clinical Outcomes? A Comparison Of United States And United Kingdom Guidelines And Outcomes, Kelly Fargo, Erica Schoenberger, Kristen Thatcher, Lindsey Hallman, Andrew Roecker, Tarek Mahfouz

Pharmacy and Wellness Review

As of February 2011, the Infectious Disease Society of America (IDSA) published the first guidelines assessing the treatment of methicillin-resistant Staphylococcus aureus (MRSA) infections. S. aureus is present in the environment and is also located on the skin's surface. MRSA can cause a variety of clinical syndromes presenting with different symptoms that vary with the type and stage of the infection. MRSA is also classified into community-acquired MRSA (CA-MRSA) and hospital-acquired (HA-MRSA), both of which possess different treatment options and strategies. Due to the complex treatment of MRSA, as well the concern over the development of resistance, suggested treatment guidelines …

Letter To The Editor, Olivia Hiddleson

Pharmacy and Wellness Review

No abstract provided.

Pharmacy Colleges: A Highly Controversial Test, Tana M. Peterman, Brieann Miller

Pharmacy and Wellness Review

As substance abuse continues to be problematic on college campuses across the United States, pharmacy colleges in particular are faced with the challenge of deterring drug abuse among their students. Many pharmacy schools are considering the adoption of student drug -screening policies in hopes of discouraging abuse, directing impaired students to treatment, and, ultimately, protecting the public. However, these policies are being met with apprehension in regards to added costs, Fourth Amendment rights violations, and privacy concerns. Drug-screening policies continue to be an issue of deliberation for pharmacy colleges, requiring much consideration and care.

Bs In Neurosciences, Joanna Burkhardt

Library Impact Statements

No abstract provided.

The Presence Of A Cmv Immunodominant Allele In The Recipient Is Associated With Increased Survival In Cmv Positive Patients Undergoing Haploidentical Hematopoietic Stem Cell Transplantation, Dolores Grosso, Benjamin Leiby, Matthew Carabasi, Joanne Filicko-O'Hara, Sameh Gaballa, William O'Hara, John L Wagner, Neal Flomenberg

Kimmel Cancer Center Papers, Presentations, and Grand Rounds

Specific major histocompatibility (MHC) class I alleles dominate anti-CMV responses in a hierarchal manner. These CMV immunodominant (IMD) alleles are associated with a higher magnitude and frequency of cytotoxic lymphocyte responses as compared to other human leukocyte antigen (HLA) alleles. CMV reactivation has been associated with an increased incidence of graft-vs.-host disease and non-relapse mortality, as well as protection from relapse in HLA-matched HSCT settings. Less is known about the impact of CMV reactivation on these major outcomes after haploidentical (HI) HSCT, an increasingly applied therapeutic option. In HI HSCT, the efficiency of the immune response is decreased due …

2019 September 17 - Medical Student Education Committee Minutes, Medical Student Education Committee, East Tennessee State University

Medical Student Education Committee Minutes

No abstract provided.

Double-Crested Cormorant Colony Effects On Soil Chemistry, Vegetation Structure And Avian Diversity, Leah Moran Veum, Brian S. Dorr, Katie C. Hanson-Dorr, R.J. Moore, Scott A. Rush

United States Department of Agriculture Wildlife Services: Staff Publications

Effects of Double-crested Cormorants (Phalacrocorax auritus) on vegetation, soil chemistry and tree health have been documented from their breeding colonies in the northern breeding grounds of Canada and the United States (U.S.) but not for areas within the southeastern United States where breeding activity is relatively novel. We compared vegetation and tree metrics such as structure diversity, and soil chemistry among colony islands, uninhabited islands, and abandoned colony islands within Guntersville Reservoir, a temperate forest ecosystem. Avian diversity and community structure were also quantified on these islands. Concentrations of potassium (K), phosphorus (P) and nitrate (NO3 −) in soil were …