Medicine and Health Sciences Commons^™

Phase 1 Trial Of Fruquintinib In Patients With Advanced Solid Tumors: Results Of The Dose Escalation Phase., A Wang-Gillam, H Park, H Yeckes-Rodin, Thomas Stanton, M Kosmo, S Fan, N Sauter, M Kanie

Articles, Abstracts, and Reports

Background: Fruquintinib (Fruq) is a potent, highly selective, novel vascular endothelial growth factor receptor (VEGFR) -1, -2, and -3 tyrosine kinase inhibitor. In the Phase III FRESCO trial¹ that led to the drug approval in China, Fruq improved the median overall survival in patients with metastatic colorectal cancer (mCRC) in the third line or later setting when compared to placebo (9.3 vs 6.6 months); hazard ratio 0.65 (95% CI, 0.51-0.83; P < .001),

Methods: This is a Phase 1 open-label, dose escalation/dose expansion study conducted in the US (NCT03251378). The primary objectives are to evaluate the safety and tolerability of Fruq …

No Difference In Quality Of Life (Qol) Among People Who Switched From Injectable To Oral Disease Modifying Treatment (Dmt) Compared To Those Who Stayed On Injectable In A Community Cohort: A Propensity Score Matched (Psm) Analysis, Tamela Stuchiner, Lindsay Lucas, Elizabeth Baraban, Chiayi Chen, Stanley Cohan

Articles, Abstracts, and Reports

Introduction: Since the emergence of oral DMT to the market, few studies have examined patient reported outcomes of quality of life (QoL) after switching to oral DMT.

Objective: The aim of this study was to evaluate the impact of switching from injectable to oral disease modifying treatment (DMT) on QoL among relapsing multiple sclerosis (MS) participants.

Methods: Participants registered in the Pacific Northwest Multiple Sclerosis Registry who completed at least two annual surveys between 2012 and 2018 were included. Two cohorts were identified: “switchers”, those who switched from injectable to oral DMT, and “stayers”, those who stayed on injectable DMT. …

Utilization, Safety, And Tolerability Of Ocrelizumab: Year 2 Data From The Providence Ocrelizumab Registry, Kyle E Smoot

Articles, Abstracts, and Reports

Background: Ocrelizumab (OCR), a humanized anti-CD20 monoclonal antibody, was approved in the US in 2017 for the treatment of relapsing MS (RMS) and primary progressive MS (PPMS). The Providence OCR Registry was established to monitor long-term treatment and safety outcomes.

Objective: To evaluate OCR treatment outcomes using real-world data from a diverse, community-based MS population.

Methods: Adult MS patients who have been prescribed OCR were eligible. Chart reviews at OCR start date and then every 6 months were done by a trained RN. Expanded Disability Status Scale (EDSS) scores were determined by the treating provider on the start date and …

The Impact Of Ocrelizumab On Immunoglobulin Levels And The Risk Of Infection., Kyle Smoot

Articles, Abstracts, and Reports

Background: Ocrelizumab (OCR), a CD20 antibody, was approved in the US in 2017 for the treatment of relapsing MS (RMS) and primary progressive MS (PPMS). In clinical trials, infection rates are higher in patients receiving OCR. Rituximab, which is very similar to OCR, has been reported to be associated with higher risk of infection particularly in patients with low levels of IgM or IgG.

Objective: To determine if low levels of IgM or IgG increase the risk of infection in patients treated with OCR.

Methods: MS patients in the OCR registry with at least one IgM/IgG value at doses 2, …

Reported Quality Of Life In Those On High Efficacy Compared To First Line Disease Modifying Therapies In A Community Cohort, Tamela Stuchiner, Lindsay Lucas, Elizabeth Baraban, Chiayi Chen, Stanley Cohan

Articles, Abstracts, and Reports

Introduction: In recent years, more high efficacy disease modifying treatments (DMT) have been approved and patients are placed on high efficacy DMT earlier in their disease course. Few studies have assessed the impact of high efficacy DMT on patients’ quality of life (QoL).

Objective: The study objective was to determine whether participants on high efficacy DMT reported greater impact of MS on their physical and psychological QoL than those on first line DMT using survey data from the Pacific Northwest Multiple Sclerosis Registry (PNWMSR).

Methods: This was a cross-sectional study using participants’ last annual follow up survey submitted between 2013 …

The Potential Of Pay‑For‑Success As A Financing Strategy For Evidence‑Based Practices: An Illustration With Multisystemic Therapy, Alex R. Dopp, Cameron M. Perrine, Samantha Iovan, Paula M. Lantz

Psychological Science Faculty Publications and Presentations

There is a critical need to identify strategies for financing the implementation of evidence-based practices. We illustrate the potential of pay-for-success financing (PFS)—a strategy in which private investors fund implementation and receive a return on investment from a government payer—using multisystemic therapy as an example. We argue that standard multisystemic therapy (for serious juvenile offenders) and several of its adaptations (for other complex behavioral problems in youth) would be good candidates for PFS in the right contexts. Despite some challenges for policymakers and administrators, PFS has significant potential as a financing strategy for evidence-based practices.

Bone Scintigraphy Imaging Of Cardiac Amyloidosis, Issa Menge Kuria, Samuel Gitau, Khalid Makhdomi

Imaging & Diagnostic Radiology, East Africa

Transthyretin-related cardiac amyloidosis (ATTR) amyloidosis is an aggressive, rapidly progressive, and fatal disease, for which several promising therapies are in development. This condition is frequently underdiagnosed because of the limited specificity of echocardiography and the traditional requirement for histological diagnosis. It is well known that 99mtechnetium-labeled bone scan radiotracers can localize in the myocardial amyloid deposits, but the use of this imaging modality to differentiate between the two subtypes has only lately been revisited. We report a case of a 76-year-old man with a clinical diagnosis of amyloidosis who underwent a bone scan that had features of ATTR amyloidosis. To …

Role Of Dietary Flavonoid Compounds In Driving Patterns Of Microbial Community Assembly, Kerry L. Ivey, Andrew T. Chan, Jacques Izard, Aedin Cassidy, Geraint B. Rogers, Eric B. Rimm

Department of Food Science and Technology: Faculty Publications

Flavonoids are a group of polyphenolic dietary compounds found in many different plant-based foods. There is increasing evidence that higher flavonoid intake may be causally linked to a reduced risk of cardiovascular disease and other chronic diseases. The bioactivity and bioavailability of many dietary flavonoids can be influenced by gastrointestinal microbiome metabolism. However, the role that habitual flavonoid intake plays in shaping the human gut microbiome is poorly understood. We describe an application of an ecosystem-based analytic approach to nutritional, microbiome, and questionnaire data from a cohort of more than 240 generally healthy adult males to assess the role of …

J Mich Dent Assoc September 2019

The Journal of the Michigan Dental Association

Every month, The Journal of the Michigan Dental Association brings news, information, and features about Michigan dentistry to our state's oral health community and the MDA’s 6,200+ members across the state. No publication reaches more Michigan dentists! This issue highlights evidence-based considerations for patients using Cannabis, e-cigarettes from a dental perspective, and reports from the deans at University of Detroit Mercy School of Dentistry and the University of Michigan School of Dentistry.

Rare Degs1 Variant Significantly Alters De Novo Ceramide Synthesis Pathway, Nicholas B. Blackburn, Juan M. Peralta, Satish Kumar, Ana C. Leandro, Marcio Almeida, Michael C. Mahaney, Thomas D. Dyer, Laura Almasy, John L. Vandeberg, Sarah Williams-Blangero, Ravindranath Duggirala, John Blangero, Joanne E. Curran

School of Medicine Publications

The de novo ceramide synthesis pathway is essential to human biology and health but genetic influences remain unexplored. The core function of this pathway is the generation of biologically active ceramide from its precursor, dihydroceramide. Dihydroceramides have diverse, often protective, biological roles; conversely, increased ceramide levels are biomarkers of complex disease. To explore the genetics of the ceramide synthesis pathway, we searched for deleterious nonsynonymous variants in the genomes of 1,020 Mexican Americans from extended pedigrees. We identified a Hispanic ancestry−specific rare functional variant, L175Q, in DEGS1, a key enzyme in the pathway that converts dihydroceramide to ceramide. This amino …

Research Symposium 2019 - Health Disparities: Community Engagement, The University Of Texas Rio Grande Valley. School Of Medicine

School of Medicine Publications

With the theme of “Health Disparities: Community Engagement,” this symposium aims to showcase the work done by researchers here in the Valley and beyond toward improving the health and well-being of the communities they serve and society as a whole.

Association Of Nurses’ Sanctification Of Work With Work-Related Outcomes And Patient Satisfaction, Hazel M. Ada

Loma Linda University Electronic Theses, Dissertations & Projects

Nurses working in hospitals face many intrinsic stressors, including widespread job dissatisfaction, burnout, and frustration. These challenges, in turn, may affect patient care. Nursing often attracts individuals who wish to serve others, and some may find the expression of spirituality on the job helpful in finding meaning, satisfaction, and value in their work (Kociszewski, 2004). Sanctification of work (SoW) is a promising facet of spirituality defined by researchers as an individual’s experience of their work as a manifestation of God or sacred qualities that affects their effectiveness and engagement on the job (Walker, Jones, Wuensch, Aziz, and Cope, 2008). In …

Accuracy Of Surface Area And Volume Measurements Of Teeth Determined From Cbct, Joseph Hourany

Loma Linda University Electronic Theses, Dissertations & Projects

Objective: This study compared surface area and volume measurements made from 3D scans of physical teeth and segmented teeth taken from Cone-Beam Computed Tomography (CBCT) scans of a cadaver. Methods: A cadaver specimen was imaged by CBCT and all the teeth were subsequently extracted and cleaned of any tissue. Of all the extracted teeth, sixteen single-rooted teeth were included in this study. The extracted teeth were scanned with a 3M True Definition 3rd Generation intraoral scanner (3M, ESPE) to generate a stereolithography (STL) file to serve as the control for this study and their surface area and volume measurements as …

Biomechanics And Postural Control Characteristics In Low Back Pain Subgroups During Dynamic Task, Amjad Shallan

Loma Linda University Electronic Theses, Dissertations & Projects

Dynamic balance impairments are commonly observed in people with low back pain (LBP). People with LBP have reduced lumbopelvic stability and may exhibit spinal biomechanical and postural control changes during dynamic balance. A limited number of studies are available about the spinal kinematic and postural control changes during dynamic balance in people with nonspecific chronic low back pain (NSCLBP) subgroups. Therefore, the aim of this dissertation was to compare spinal kinematics and postural control between NSCLBP subgroups and healthy individuals during dynamic balance using a modified Star Excursion Balance Test (mSEBT). Eighteen NSCLBP subjects [9 active extension pattern (AEP), 9 …

Vitamin D Status And Risk Of Incident Tuberculosis Disease: A Nested Case-Control Study, Systematic Review, And Individual-Participant Data Meta-Analysis, Omowunmi Aibana, Chuan-Chin Huang, Said Aboud, Alberto Arnedo-Pena, Mercedes C. Becerra, Juan Bautista Bellido-Blasco, Ramesh Bhosale, Roger Calderon, Rabia Hussain, Najeeha Talat Iqbal

Department of Pathology and Laboratory Medicine

Background: Few studies have evaluated the association between preexisting vitamin D deficiency and incident tuberculosis (TB). We assessed the impact of baseline vitamins D levels on TB disease risk.
Methods and Findings: We assessed the association between baseline vitamin D and incident TB in a prospective cohort of 6,751 HIV-negative household contacts of TB patients enrolled between September 1, 2009, and August 29, 2012, in Lima, Peru. We screened for TB disease at 2, 6, and 12 months after enrollment. We defined cases as household contacts who developed TB disease at least 15 days after enrollment of the index patient. …

Nursing Care For Adolescents With Cancer Relapse Receiving Palliative Care(การพยาบาลผู้ป่วยวัยรุ่นโรคมะเร็งกลับเป็นซ้ำที่ได้รับการดูแลแบบประคับประคอง), Thipkasorn Wannaphak

Journal of Nursing Research, Innovation, and Health

This article is aimed at providing nursing care for adolescents with cancer relapse receiving palliative care due to their physical and mental suffering. The relapse is considered a severe condition as the cancer cell has spread to other organs which are often incurable, depending on the patients' health. Adolescents with cancer relapse often encountered late effects from the previous treatment as well as side effects from chemotherapy in the new treatment which results in deterioration in health. Intensive treatment for patients in this group is difficult to success and also decrease the quality of patient's life. Palliative care as patients …

Health Management Of Diabetes Risk Group In Ban Muang Whan : A Qualitative Research Perspective(การจัดการสุขภาพของกลุ่มเสี่ยงโรคเบาหวานในชุมชนบ้านม่วงหวาน : มุมมองจากการศึกษาเชิงคุณภาพ), Arissara Sukwatjanee, Anchaleeporn Amatayakul

Journal of Nursing Research, Innovation, and Health

Purpose: To explore health management of diabetes risk group Design: Qualitative researchMethods: The research participants comprised of 75 people, including people, who were diabetes risk group and their families, sub-district health promoting hospital staff, community leaders, village health volunteers, monks, teachers and food vendors in Ban Muang Whan community. The research instruments included 1) the in depth-interviewed guideline, 2) the group discussion guideline, 3) the brain storm guideline, 4) the observation guideline, and 5) the field note. Data were analyzed using content analysis method. Findings: People, who were diabetes risk group, provided self-care including controlled diet, controlled body weight, exercise, …

The Effect Of Self-Care Enhancement Program On Post-Bariatric Surgery Self-Care Behaviors Among Morbid Obese Patients(ผลของโปรแกรมส่งเสริมการดูแลตนเองต่อพฤติกรรมการดูแลตนเองภายหลังการผ่าตัดลดน้ำหนักของผู้ป่วยโรคอ้วน), Sipaphan Lavasut, Rungrawee Navicharern

Journal of Nursing Research, Innovation, and Health

Purpose: 1) To study the self-care behaviors post-bariatric surgery among morbid obese patients who received the self-care enhancement program. 2) To compared the self-care behaviors post-bariatric surgery among the control group and the experimental group.Design: Quasi-experimental research.Methods: The 30 patients were male and female with morbid obese patients, aged between 18-59 years old, receiving post-bariatric surgery at King Chulalongkorn Memorial Hospital. They were hospitalized and assigned to the control and the experimental group (15 persons in each group), and matched pair by gender, age and type of operation. The experimental group received the self-care enhancement program based on Orem's self-care, …

The Effect Of Empowerment Program On Late Phase Postoperative Recovery Among Post Lumbar Spine Surgery Patients(ผลของโปรแกรมเสริมสร้างพลังอำนาจต่อการฟื้นสภาพหลังผ่าตัดระยะท้ายในผู้ป่วยที่ได้รับการผ่าตัดกระดูกสันหลังระดับเอว), Rattiya Toeysri, Pachanut Nanthaitaweekul

Journal of Nursing Research, Innovation, and Health

Purpose: To study the effects of empowerment program on late phase postoperative recovery among post lumbar spine surgery patients.Design: Quasi-experimental researchMethods: The participants were 46 patients aged 30-59 years old, under postoperative lumbar spine surgery were admitted into the Neurosurgery ward at Prasat Neurological Institute. Randomly selected and assigned into either experimental and control group comprised 23 patients in each group with matching technique for age, pain scale, and level of lumbar spine surgery. The research instruments consisted of the empowerment program base on the concept of Gibson, notebook with activity, and postoperative recovery profile for lumbar spine surgery patients. …

The Factors Related To Hiv Prevention Behavior Among Myanmarese Youth Migrant Workers(ปัจจัยที่มีความสัมพันธ์กับพฤติกรรมการป้องกันการติดเชื้อเอชไอวีของเยาวชนแรงงานข้ามชาติชาวเมียนมา), Ekkalak Faksook, Pregamol Rutchanagul, Wanalada Thongbai

Journal of Nursing Research, Innovation, and Health

Purpose: To investigate factors related to HIV preventive behaviors among Myanmarese youth migrant workers. Design: descriptive correlation research studyMethod: The sampling consisted of 120 young Myanmar migrant workers Visited to the hospital under the Department of Medical Services, Bangkok area between October and November 2018. Data were collected using a set of questionnaires. The questionnaires included questionnaires about personal information, knowledge, attitude toward HIV infection, perceived susceptibility to HIV infection, self-efficacy for HIV prevention and HIV prevention behavior. Data were analyzed using descriptive and inferential statistics. Correlations were identified using the Pearson product-moment correlation coefficient, and the point biserial correlation …

Improving Recognition And Reporting Of Adverse Drug Reactions In The Nicu: A Quality Improvement Project., Betsy Cammack, Alexandra Oschman, Tamorah R. Lewis Md Phd

Manuscripts, Articles, Book Chapters and Other Papers

Adverse drug reactions (ADRs) are under-recognized and under-reported in the Neonatal Intensive Care Unit (NICU) population, with up to 95% of all ADRs not reported. Compared with non-elderly adults, pediatric patients are 3 times more likely to experience an ADR, with varying rates from 0.6% to 16.8%. The Children's Mercy NICU has an ADR rate of 0.29% (2015). This high rate presents an opportunity to increase recognition and reporting, and improve characterization of ADRs in the NICU.

Methods: The primary aim of this quality improvement project was for 70% of patients who received specified medications (indomethacin, dexmedetomidine, fentanyl, lorazepam, dexamethasone, …

Improving The Youth Hiv Prevention And Care Cascades: Innovative Designs In The Adolescent Trials Network For Hiv/Aids Interventions, Sylvie Naar, Michael G Hudgens, Ron Brookmeyer, April Idalski Carcone, Jason Chapman, Shrabanti Chowdhury, Andrea Ciaranello, W Scott Comulada, Samiran Ghosh, Keith J Horvath, Ladrea Ingram, Sara Legrand, Cathy J Reback, Kit Simpson, Bonita Stanton, Tyrel Starks, Dallas Swendeman

Faculty, Staff and Student Publications

Dramatic decreases in HIV transmission are achievable with currently available biomedical and behavioral interventions, including antiretroviral therapy and pre-exposure prophylaxis. However, such decreases have not yet been realized among adolescents and young adults. The Adolescent Medicine Trials Network (ATN) for HIV/AIDS interventions is dedicated to research addressing the needs of youth at high risk for HIV acquisition as well as youth living with HIV. This article provides an overview of an array of efficient and effective designs across the translational spectrum that are utilized within the ATN. These designs maximize methodological rigor and real-world applicability of findings while minimizing resource …

Unraveling The Functional Role Of The Orphan Solute Carrier, Slc22a24 In The Transport Of Steroid Conjugates Through Metabolomic And Genome-Wide Association Studies, Sook Wah Yee, Adrian Stecula, Huan-Chieh Chien, Ling Zou, Elena V Feofanova, Marjolein Van Borselen, Kit Wun Kathy Cheung, Noha A Yousri, Karsten Suhre, Jason M Kinchen, Eric Boerwinkle, Roshanak Irannejad, Bing Yu, Kathleen M Giacomini

Faculty, Staff and Student Publications

Variation in steroid hormone levels has wide implications for health and disease. The genes encoding the proteins involved in steroid disposition represent key determinants of interindividual variation in steroid levels and ultimately, their effects. Beginning with metabolomic data from genome-wide association studies (GWAS), we observed that genetic variants in the orphan transporter, SLC22A24 were significantly associated with levels of androsterone glucuronide and etiocholanolone glucuronide (sentinel SNPs p-value

Pm25 Metal Constituent Exposure And Stillbirth Risk In Harris County, Texas, Amal Rammah, Kristina W Whitworth, Inkyu Han, Wenyaw Chan, Elaine Symanski

Faculty, Staff and Student Publications

There is limited evidence on the role of exposure to chemical constituents of fine particulate matter (PM

Statement On Imaging And Pulmonary Hypertension From The Pulmonary Vascular Research Institute (Pvri), David G. Kiely, David L. Levin, Paul M. Hassoun, Dunbar Ivy, Pei-Ni Jone, Jumaa Bwika, Steven M. Kawut, Jim Lordan, Angela Lungu, Jeremy A. Mazurek

Internal Medicine, East Africa

Pulmonary hypertension (PH) is highly heterogeneous and despite treatment advances it remains a life-shortening condition. There have been significant advances in imaging technologies, but despite evidence of their potential clinical utility, practice remains variable, dependent in part on imaging availability and expertise. This statement summarizes current and emerging imaging modalities and their potential role in the diagnosis and assessment of suspected PH. It also includes a review of commonly encountered clinical and radiological scenarios, and imaging and modeling-based biomarkers. An expert panel was formed including clinicians, radiologists, imaging scientists, and computational modelers. Section editors generated a series of summary statements …

Evaluation Of Prescribing Patterns Of Long-Acting Injectable Antipsychotics Within A Community Health System., Jared Netley Pharmd, Mpa, Bcps, Jamie Gaul Pharmd, Bcps, Chelsea L Ferguson Pharmd

Parkview Pharmacy Department

PURPOSE/BACKGROUND: Long-acting injectable antipsychotics (LAIAs) are used in the management of schizophrenia, bipolar disorder, and related psychiatric conditions. The efficacy of LAIAs has been established in randomized controlled trials; however, usage of LAIAs outside of randomized controlled trials may not correlate to naturalistic prescribing habits. The purpose of this analysis was to evaluate the prescribing patterns of LAIAs within our health system and identify any inconsistencies between medications' published labeling information and clinical practice.

METHODS/PROCEDURES: All patients who received a LAIA at the time of the analysis were included for review. Areas of inconsistency between the prescribed LAIA and each …

The Impact Of Simulation On Knowledge And Performance Gain Regarding Diabetic Patient Care, Aimee A. Woda, Jamie Hansen, Kristina Dreifuerst, Polly Anderson, Theresa Marie Hardy, Mauricio Garnier-Villarreal

College of Nursing Faculty Research and Publications

Background

It is essential that nurses be prepared to provide quality care for patients with diabetes, a common condition today. The purpose of this study was to evaluate the impact of a high-fidelity simulation on traditional prelicensure nursing students' knowledge and performance related to care of the diabetic patient.

Methods

This multisite, multimeasure study used a purposive, quasiexperimental [sic] pretest-posttest design.

Results

Simulation positively impacted performance change scores. Pretest scores were positively associated with simulation scores and posttest scores.

Conclusions

The findings from this study support the use of high-fidelity simulation to improve care of the diabetic patient.

Does A Professional Code Of Ethics Matter?, Kathryn Schroeter

College of Nursing Faculty Research and Publications

No abstract provided.

Preventing Delirium Takes A Village: Systematic Review And Meta-Analysis Of Delirium Preventive Models Of Care, Ariba Khan, Olga Boukrina, Mooyeon Oh-Park, Nina A. Flanagan, Maharaj Singh, K Oldham

College of Nursing Faculty Research and Publications

BACKGROUND

Each hospital day of delirium incurs greater healthcare costs, higher levels of care, greater staff burden, and higher complication rates. Accordingly, administrators are incentivized to identify models of care that reduce delirium rates and associated costs.

PURPOSE

We present a systematic review and meta-analysis of delirium prevention models of care.

DATA SOURCES

Ovid MEDLINE, CINAHL, Cochrane Database of Systematic Reviews, EMBASE, and PsycINFO.

STUDY SELECTION

Eligible models of care were defined as provider-oriented interventions involving revision of professional roles, multidisciplinary teams, and service integration. Included studies implemented multidomain, multicomponent interventions, used a validated delirium instrument, and enrolled a control …

Creation And Implementation Of A Pediatric Advanced Practice Nurse Critical Care Fellowship Program, Bonnie Stojadinovic, Christine A. Schindler, Margaret Faut Callahan, Maureen O'Brien, Tom B. Rice, Theresa Mikhailov

College of Nursing Faculty Research and Publications

Advanced practice registered nurses (APRNs) who begin their careers in the pediatric intensive care unit (PICU) may be challenged in this practice environment. Inadequate prior experience as a staff nurse, limited opportunities for clinical placements in the PICU during graduate education, and being in a fast-paced, high-acuity practice environment without prior exposure to critically ill children are practice challenges in the PICU setting. The goal of postgraduate education training programs (fellowship programs) for the acute care pediatric nurse practitioner (ACPNP) is to prepare students to become beginner practitioners who can function effectively in the acute care setting within a few …