Medicine and Health Sciences Commons^™

Effectiveness Of High-Intensity Interval Training For Fitness And Mobility Post Stroke: A Systematic Review., Joshua C. Wiener, Amanda Mcintyre, Scott Janssen, Jeffrey Ty Chow, Cristina Batey, Robert Teasell

Epidemiology and Biostatistics Publications

OBJECTIVE: To evaluate the evidence on the effectiveness of high-intensity interval training (HIIT) in improving fitness and mobility post stroke. TYPE: Systematic review.

LITERATURE SURVEY: Medline, Embase, CINAHL, PsycINFO, and Scopus were searched for articles published in English up to January 2018.

METHODOLOGY: Studies were included if the sample was adult human participants with stroke, the sample size was ≥3, and participants received >1 session of HIIT. Study and participant characteristics, treatment protocols, and results were extracted.

SYNTHESIS: Six studies with a total of 140 participants met inclusion criteria: three randomized controlled trials and three pre-post studies. HIIT protocols ranged …

Methodological Consensus On Clinical Proton Mrs Of The Brain: Review And Recommendations, Martin Wilson, Ovidiu Andronesi, Peter B. Barker, Robert Bartha, Alberto Bizzi, Patrick J. Bolan, Kevin M. Brindle, In Young Choi, Cristina Cudalbu, Ulrike Dydak, Uzay E. Emir, Ramon G. Gonzalez, Stephan Gruber, Rolf Gruetter, Rakesh K. Gupta, Arend Heerschap, Anke Henning, Hoby P. Hetherington, Petra S. Huppi, Ralph E. Hurd, Kejal Kantarci, Risto A. Kauppinen, Dennis W.J. Klomp, Roland Kreis, Marijn J. Kruiskamp, Martin O. Leach, Alexander P. Lin, Peter R. Luijten, Małgorzata Marjańska, Andrew A. Maudsley, Dieter J. Meyerhoff, Carolyn E. Mountford

Medical Biophysics Publications

© 2019 International Society for Magnetic Resonance in Medicine Proton MRS (1H MRS) provides noninvasive, quantitative metabolite profiles of tissue and has been shown to aid the clinical management of several brain diseases. Although most modern clinical MR scanners support MRS capabilities, routine use is largely restricted to specialized centers with good access to MR research support. Widespread adoption has been slow for several reasons, and technical challenges toward obtaining reliable good-quality results have been identified as a contributing factor. Considerable progress has been made by the research community to address many of these challenges, and in this paper a …

An Educational Intervention On Daily Chlorhexidine Gluconate Bathing And Central Venous Catheter Infection Rates In The Pediatric Population: A Quality Improvement Initiative., Jennifer Cothern

Doctor of Nursing Practice Papers

The use of Central Venous Catheters (CVCs) in the healthcare setting is essential to patient survivability. While convenient, the utilization of such devices places patients at risk for Central Line- Associated Bloodstream Infections (CLABSI). The US spends nearly $2 billion dollars annually treating CLABSIs. The utilization of CLABSI bundles has shown to be effective in infection prevention. Daily bathing with Chlorhexidine Gluconate (CHG) is recommended by the Centers for Disease Control and Prevention (CDC) and is often included in CLABSI bundles. In an attempt to reduce the incidence of CLABSIs at a metropolitan pediatric hospital in the Southern US, a …

A Flavor Perception Game Designed To Introduce Basic Chemical Sensation Of Taste Modalities To Undergraduate Nursing And Exercise Sciences Students, Angela L. Mahaffey

Nursing: School of Nursing Faculty Publications and Other Works

The Flavor Perception Game was designed with the goals of developing an interactive and hands-on activity, providing a platform to review chemical senses of the five tastes, promoting student investment in the course material, and providing a basis for discussion on chemical senses of the five tastes. Knowledge of taste sensation is useful for nursing and exercise sciences students, as human physiology is integral to both baccalaureate curricula. The game is inexpensive, easy to incorporate into a 50-minute lecture period, and free of chocolate allergens. Student participants (N=34) tasted three candies and completed a voluntary anonymous poll regarding their detection …

Narratives Of Expert Speech-Language Pathologists: Defining Clinical Expertise And Supporting Knowledge Transfer, Natalie F. Douglas, Katie Squires, Jacqueline Hinckley, Erline V. Nakano

HPD Articles

Clinical expertise is a component of evidence-based practice; however, relatively little attention has been paid to this phenomenon in the professional literature of speech-language pathology. This may have negative impacts on the training of pre-professional and novice speech-language pathologists. The purpose of this study was to examine professional narratives of expert Speech-Language Pathologists (SLPs) to consider applications for knowledge transfer between expert clinicians and novice clinicians. Collection of the professional narratives of 10 expert SLPs were obtained through in-depth interviews. Interviews were transcribed and coded for themes. Themes that impacted expertise in SLP included: training; work sites; individual and clinician …

Office Of Equity Diversity Report Annual Report Fy 2018-19, Children's Mercy Hospital

Equity & Diversity Annual Reports

A report on equity and diversity at Children's Mercy Hospitals & Clinics, in the care it provides, the people it serves, and in its workforce. Specifically discusses the Equity & Diversity Leadership Structure, Employee Demographics, Patient Demographics, and the work being done to help realize the great potential that lies ahead.

Meox2 Haploinsufficiency Accelerates Axonal Degeneration In Dba/2j Glaucoma., Rebecca A Buchanan, Kate E Foley, Keating W. Pepper, Alaina M Reagan, Kelly J Keezer, Amanda A Hewes, Cory A Diemler, Christoph Preuss, Ileana Soto, Simon W M John, Gareth R Howell

Faculty Research 2019

Purpose: Glaucoma is a complex disease with major risk factors including advancing age and increased intraocular pressure (IOP). Dissecting these earliest events will likely identify new avenues for therapeutics. Previously, we performed transcriptional profiling in DBA/2J (D2) mice, a widely used mouse model relevant to glaucoma. Here, we use these data to identify and test regulators of early gene expression changes in DBA/2J glaucoma.

Methods: Upstream regulator analysis (URA) in Ingenuity Pathway Analysis was performed to identify potential master regulators of differentially expressed genes. The function of one putative regulator, mesenchyme homeobox 2 (Meox2), was tested using a combination of …

Rapid Growth Is A Dominant Predictor Of Hepcidin Suppression And Declining Ferritin In Gambian Infants., Andrew E Armitage, Schadrac C Agbla, Modupeh Betts, Ebrima A Sise, Momodou W Jallow, Ellen Sambou, Bakary Darboe, Archibald Worwui, George M. Weinstock, Martin Antonio, Sant-Rayn Pasricha, Andrew M Prentice, Hal Drakesmith, Momodou K Darboe, Brenda Anna Kwambana-Adams

Faculty Research 2019

Iron deficiency and iron deficiency anemia are highly prevalent in low-income countries, especially among young children. Hepcidin is the major regulator of systemic iron homeostasis. It controls dietary iron absorption, dictates whether absorbed iron is made available in circulation for erythropoiesis and other iron-demanding processes, and predicts response to oral iron supplementation. Understanding how hepcidin is itself regulated is therefore important, especially in young children. We investigated how changes in iron-related parameters, inflammation and infection status, seasonality, and growth influenced plasma hepcidin and ferritin concentrations during infancy using longitudinal data from two birth cohorts of infants in rural Gambia (n=114 …

An In Vitro Enrichment Strategy For Formulating Synergistic Synbiotics, Car Reen Kok, David Fabian Gomez Quintero, Clement Niyirora, Devin Rose, Amanda Li, Robert Hutkins

Food for Health: Publications

ABSTRACT Research on the role of diet on gut and systemic health has led to considerable interest toward identifying novel therapeutic modulators of the gut microbiome, including the use of prebiotics and probiotics. However, various host responses have often been reported among many clinical trials. This is in part due to competitive exclusion as a result of the absence of ecological niches as well as host mediated constraints via colonization resistance. In this research, we developed a novel in vitro enrichment (IVE) method for isolating autochthonous strains that can function as synergistic synbiotics and overcome these constraints. The method relied …

It’S All About Trust And Respect: Cultural Competence And Cultural Humility In Mobile Health Clinic Services For Underserved Minority Populations, Arelis Moore De Peralta, Melinda Gillispie, Catherine Mobley, Lynette M. Gibson

Publications

To explore participants' perceptions of cultural competence and cultural humility in mobile health clinic (MHC) service delivery, using the Cultural Competence Model (CCM) as an organizing framework. Methods. We conducted five focus groups with an ethnically diverse group of English-and Spanish-speaking men and women, ages 20–67, residing in five underserved neighborhoods in a Southeastern U.S. city. Data analysis followed a thematic approach and iterative qualitative content analysis. Results. Participants expressed a desire for well-trained and caring staff who practice cultural humility. Conclusions. By applying the CCM's five-pronged constellation of cultural abilities, health care personnel could ultimately be more responsive to …

Post–Modern Epidemiology: When Methods Meet Matter, George Davey Smith

United States Public Health Resources

In the last third of the 20th century, etiological epidemiology within academia in high-income countries shifted its primary concern from attempting to tackle the apparent epidemic of noncommunicable diseases to an increasing focus on developing statistical and causal inference methodologies. This move was mutually constitutive with the failure of applied epidemiology to make major progress, with many of the advances in understanding the causes of noncommunicable diseases coming from outside the discipline, while ironically revealing the infectious origins of several major conditions. Conversely, there were many examples of epidemiologic studies promoting ineffective interventions and little evident attempt to account for …

Durvalumab In Combination With Olaparib In Patients With Relapsed Sclc: Results From A Phase Ii Study, Anish Thomas, Rasa Vilimas, Christopher Trindade, Rebecca Erwin-Cohen, Nitin Roper, Liqiang Xi, Venkatesh Krishnasamy, Elliot Levy, Andy Mammen, Samantha Nichols, Yuanbin Chen, Vamsidhar Velcheti, Faye Yin, Eva Szabo, Yves Pommier, Seth M. Steinberg, Jane B. Trepel, Mark Raffeld, Howard A. Young, Javed Khan, Stephen Hewitt, Jung Min Lee

United States Public Health Resources

Purpose: Despite high tumor mutationburden, immune checkpoint blockade has limited efficacy in SCLC. We hypothesized that poly (ADP-ribose) polymerase inhibition could render SCLC more susceptible to immune checkpoint blockade. Methods: A single-arm, phase II trial (NCT02484404) enrolled patients with relapsed SCLC who received durvalumab, 1500 mg every 4 weeks, and olaparib, 300 mg twice a day. The primary outcome was objective response rate. Correlative studies included mandatory collection of pretreatment and during-treatment biopsy specimens, which were assessed to define SCLC immunephenotypes: desert (CD8-positive T-cell prevalence low), excluded (CD8-positive T cells in stroma immediately adjacent/within tumor), and inflamed (CD8-positive T cells …

Perceptions Of Immigration Among Nonmetropolitan Nebraskans: Nebraska Rural Poll Research Report 19-2, Rebecca Vogt, Cheryl Burkhart-Kriesel, Randolph Cantrell, Bradley Lubben, L. J. Mcelravy, Timothy Meyer, Jason L. Weigle

Rural Futures Institute: Publications

The percent of Nebraska’s population that is foreign born has steadily increased during the past decade. In fact, its growth in foreign born population since 2010 ranks in the top 10 among all states. Given these changes, are rural Nebraskans aware of recent immigrants in their community? How do they perceive immigrants and their impacts on rural Nebraska? How do they view various immigration policies? This paper provides a detailed analysis of these questions. This report details 1,776 responses to the 2019 Nebraska Rural Poll, the 24th annual effort to understand rural Nebraskans’ perceptions. Respondents were asked a series of …

Leaving Against Medical Advice From In-Patients Departments Rate, Reasons And Predicting Risk Factors For Re-Visiting Hospital Retrospective Cohort From A Tertiary Care Hospital, Obada Hasan, Muhammad Adil Samad, Hamza Khan, Maryam Sarfraz, Shahryar Noordin, Tashfeen Ahmad, Gul Nowshad

Section of Orthopaedic Surgery

Background: Approximately 1% to 2% of hospitalized patients get discharged or leave from the hospital against medical advice and up to 26% in some centers. They have higher readmission rate and risk of complications than patients who receive complete care. In this study we aimed to determine the rate of leave against medical advice (LAMA) and reasons for the same across different in-patient departments of a tertiary care hospital.
Methods: Retrospective cohort study on patients admitted in all departments at our institute over a 1-year period. All patients who were admitted to an in-patient ward at the hospital and who …

Predictors Of An Increased Length Of Stay Following Total Knee Arthroplasty: Survey Report, Azeem Tariq Malik, Syed Hamza Mufarrih, Arif Ali, Shahryar Noordin

Section of Orthopaedic Surgery

Objective: To find various preoperative, intraoperative and postoperative factors that predict an increased length of stay in patients following total knee arthroplasty.
Methods: The retrospective cohort study was conducted at the Aga Khan University Hospital, Karachi, and comprised record of patients regardless of gender, co-morbids and age who had undergone a unilateral or bilateral total knee arthroplasty between January 2007 and December 2015. An increased length of stay was defined as ≥75th centile (≥11 days).
Results: Of the 577 patients, 448(77.6%) were women. Overall, 311(53.9%) patients were aged 56-70 years. Of the total, 100(17.3%) patients stayed for at least 11 …

Timing Of Postoperative Magnetic Resonance Imaging (Mri) Following Glioma Resection: Shattering The 72 Hour Window, Syed Sarmad Bukhari, Muhammad Shahzad Shamim, Fatima Mubarak

Section of Neurosurgery

Extent of enhancing tumour resection is correlated with progression free survival following glioma surgery. Historically, a contrast enhanced MRI has been recommended within 72 hours following surgery to evaluate for residual disease. This theoretical window was established amidst conflicting evidence to avoid reactive enhancement. Recent studies with better designs and better imaging quality have sought to challenge this window with a more pragmatic method of evaluating residual disease.

Knowledge Of Women Of Childbearing Age Regarding Preconception Counseling, Allison Britt, Shelby Jackson, Jessica Mcgee, Jenna Pugh

MSN Research Projects

The purpose of the current research study was to assess the knowledge of women of childbearing age regarding key components of preconception counseling and look at relationships between demographics and knowledge of preconception health care.

Compliance Of Primary Care Providers With Knee Osteoarthritis Guidelines, Komalben Desai, Catherine Elridge, Ashley Barber, Melissa Floyd

MSN Research Projects

The purpose of this study was to determine the compliance of primary care providers with AAOS guidelines of knee osteoarthritis (OA) and identify the most commonly used management options chosen by primary care providers for knee osteoarthritis.

Abnormal Involuntary Movement Scale In Tardive Dyskinesia: Minimal Clinically Important Difference, Martha Sajatovic

Faculty Scholarship

Background: A minimal clinically important difference has not been established for the Abnormal Involuntary Movement Scale in patients with tardive dyskinesia. Valbenazine is a vesicular monoamine transporter 2 inhibitor approved for the treatment of tardive dyskinesia in adults. Efficacy in randomized, double-blind, placebo-controlled trials was defined as the change from baseline in Abnormal Involuntary Movement Scale total score (sum of items 1-7). Objectives: To estimate an minimal clinically important difference for the Abnormal Involuntary Movement Scale using valbenazine trial data and an anchor-based method. Methods: Data were pooled from three 6-week double-blind, placebo-controlled trials: KINECT (NCT01688037), KINECT 2 (NCT01733121), and …

Generalized Anxiety Disorder: Management Practices Among Primary Care Providers In Northern Mississippi, Jennifer Bolen, Grace Henson, Sabrina Mcclain, Al Rayburn, Benjamin Spencer

MSN Research Projects

The purpose of this research was twofold. First, the research revealed the practices among primary care providers in northern Mississippi for treating GAD whether psychotherapy, pharmacological, or a combination. The specific modalities of psychotherapy and pharmacotherapy were listed. Second, the research revealed that these management practices are consistent with contemporary evidence-based research.

Are Health Care Providers Educating 1 Heir Patients On Proper Storage And Disposal Of Electronic Nicotine Devices?, Larisa Bell, Shada Breeze Chunn, Kaitlyn Smith, Tammy Steele

MSN Research Projects

The purpose of our research is to determine if healthcare providers are educating patients on the proper storage and disposal of electronic nicotine devices and the associated liquids.

Recombinant Zoster Vaccine (Shingrix) Knowledge And Practices Of Primary Care Providers In Mississippi, Leigh Gault, Casie Brown, Mackinzie Lee, Kimberly Word

MSN Research Projects

The purpose of this study was to determine Mississippi primary care providers' (PCP) knowledge and practices of the Centers for Disease Control and Prevention's (CDC) Advisory Committee on Immunization Practices (ACIP) recommendations for administering the Shingrix vaccine to immunocompetent adults aged 50 years and older.

A Phenomenological Investigation Of Women’S Infertility And Miscarriage Grief Experiences, Tristan Mcbain

Dissertations

Infertility and miscarriage are reproductive losses that often produce grief reactions in affected women. This phenomenological study investigated the grief experiences of infertility and miscarriage through the ambiguous loss and disenfranchised grief frameworks in order to better understand both the obscurity of reproductive loss and how the resulting grief may be invalidated.

Sixteen women volunteered to participate in this study and each fell into one of the following three categories: women affected by infertility without miscarriage (4); women affected by miscarriage without infertility (4); and women affected by infertility and miscarriage (8). A phenomenological hermeneutic approach was utilized to uncover …

Proteomic Evaluation And Cytotoxicity Of Red Maple (Acer Rubrum) Leaves, Saud Alshammari

Pharmaceutical Sciences (MS) Theses

Red maple (Acer rubrum), also known as swamp, water or soft maple, is endemic to eastern and central North America and was widely used as traditional medicine by the first peoples. Commercially, its well-known products include maple syrup and high-quality lumber. The potential medicinal benefits of phenolic compounds extracted from the red maple plant, such as glucitol-core containing gallotannins, include antioxidant, and antiglycation effects as well as their importance in cosmetic applications. Plant-derived proteins and peptides are important biomolecules; however to date, there is no published data on the identification of proteins/peptides from red maple leaves. Therefore, the …

Altering The Regiospecificity Of C6 Indole Prenyltransferase Enzymes Towards Drug Development, Ahmed R. Aoun

Pharmaceutical Sciences (MS) Theses

Prenyltransferase (PT) biocatalysts are late-stage tailoring enzymes that modify natural products. PTs catalyze the attachment of prenyl moieties to natural product acceptors using pyrophosphate donors. This prenyl modification in small molecules leads to changes in structural and biological activities. Understanding the structural insights as well as the mechanisms by which PTs function allows us to utilize PTs as a unique approach towards drug development. PriB PT is an example of aromatic PTs that has been characterized previously as a L-tryptophan (L-Trp) C6 C-prenyltransferase (C6-C-PT). Analysis of PriB binding pocket, highlighted key residues that might play an important …

Cancer Cell Population Growth Kinetics At Low Densities Deviate From The Exponential Growth Model And Suggest An Allee Effect., Kaitlyn E Johnson, Grant Howard, William Mo, Michael K Strasser, Ernesto A B F Lima, Sui Huang, Amy Brock

Articles, Abstracts, and Reports

Most models of cancer cell population expansion assume exponential growth kinetics at low cell densities, with deviations to account for observed slowing of growth rate only at higher densities due to limited resources such as space and nutrients. However, recent preclinical and clinical observations of tumor initiation or recurrence indicate the presence of tumor growth kinetics in which growth rates scale positively with cell numbers. These observations are analogous to the cooperative behavior of species in an ecosystem described by the ecological principle of the Allee effect. In preclinical and clinical models, however, tumor growth data are limited by the …

Identification Of Policy Priorities To Address The Burden Of Smokeless Tobacco In Pakistan: A Multimethod Analysis, Kamran Siddiqi, Ziauddin Islam, Zohaib Khan, Faraz Siddiqui, Masuma Mishu, Omara Dogar, Vandana Shah, Javaid Khan, Subhash Pokhrel, Romaina Iqbal

Section of Pulmonary & Critical Care

Introduction: We assessed the magnitude of smokeless tobacco (ST) use in Pakistan and identified policy gaps to help ascertain short-, medium-, and long-term priorities. We then elicited stakeholders' views as to which of these identified priorities are most important.
Methods: In a multimethod study, we: analyzed Global Tobacco Surveillance System data sets to estimate ST consumption and disease burden; conducted a documentary review to identify gaps in policies to control ST in comparison with smoking; elicited stakeholders' views in an interactive workshop to identify a set of policy options available to address ST burden in Pakistan; and ranked policy …

Appropriate Therapeutic Drug Monitoring Of Biologic Agents For Patients With Inflammatory Bowel Diseases., Konstantinos Papamichael, Adam S. Cheifetz, Gil Y. Melmed, Peter M. Irving, Niels Vande Casteele, Patricia L. Kozuch, Laura E. Raffals, Leonard Baidoo, Brian Bressler, Shane M. Devlin, Jennifer Jones, Gilaad G. Kaplan, Miles P. Sparrow, Fernando S Velayos, Thomas Ullman, Corey A. Siegel

Division of Gastroenterology and Hepatology Faculty Papers

BACKGROUND & AIMS: Therapeutic drug monitoring (TDM) is widely available for biologic therapies in patients with inflammatory bowel disease (IBD). We reviewed current data and provided expert opinion regarding the clinical utility of TDM for biologic therapies in IBD.

METHODS: We used a modified Delphi method to establish consensus. A comprehensive literature review was performed regarding the use of TDM of biologic therapy in IBD and presented to international IBD specialists. Subsequently, 28 statements on the application of TDM in clinical practice were rated on a scale of 1 to 10 (1 = strongly disagree and 10 = strongly agree) …

Non-Viral Transfection Efficiencies For The Advancement Of Car-T Therapy., Emily M Murphy

Electronic Theses and Dissertations

Leukemias are the most common form of childhood cancer making up 30% of total pediatric oncological cases, and Acute Lymphoblastic Leukemia (ALL) makes up a significant portion (12%) of the total pediatric cancer diagnoses. In 2017, the FDA approved a successful immunotherapy called CAR-T therapy for the treatment of pediatric B-cell ALL. This therapy includes a CAR (chimeric antigen receptor) that is loaded into the T-cell and expressed. Currently, the loading of the CAR utilizes viral transduction, but consistency issues lead to adverse symptoms in the patients. Better methods of transduction/transfection are being studied in order to improve these consistency …

Characterizing The Role Of Extracellular Matrix In Non-Small Cell Lung Carcinoma Metastasis Using A 3d Microenvironment Mimetic In-Vitro Culture System., Douglas John Owulaku Saforo

Electronic Theses and Dissertations

Lung cancer is the leading cause of cancer related death in the United States and worldwide. Five-year survival rates for non-small cell lung carcinoma patients have not improved in decades, and a majority of patients succumb to metastasis. Identification of therapeutic targets for metastatic disease is essential for the development of novel therapies. However, current 2-dimensional (2D) in vitro models are not reflective of the tumor microenvironment (TME) and are inadequate in identifying therapeutic targets. We adapted a 3-dimensional (3D) extracellular matrix (ECM) in vitro model to a hypoxic incubator to approximate physiological hypoxia of the TME in a microenvironment …