Medicine and Health Sciences Commons^™

Androgen Deprivation And Radiotherapy With Or Without Docetaxel For Localized High-Risk Prostate Cancer: Long-Term Follow-Up From The Randomized Nrg Oncology Rtog 0521 Trial, Oliver Sartor, Jeff M Michalski, Et Al.

2020-Current year OA Pubs

BACKGROUND: Intensification of therapy may improve outcomes for patients with high-risk localized prostate cancer.

OBJECTIVE: To provide long-term follow-up data from phase III RTOG 0521, which compared a combination of androgen deprivation therapy (ADT) + external beam radiation therapy (EBRT) + docetaxel with ADT + EBRT.

DESIGN, SETTING, AND PARTICIPANTS: High-risk localized prostate cancer patients (>50% of patients had Gleason 9-10 disease) were prospectively randomized to 2 yr of ADT + EBRT or ADT + EBRT + six cycles of docetaxel. A total of 612 patients were accrued, and 563 were eligible and included in the modified intent-to-treat analysis. …

Effects Of A Lpg Stove And Fuel Intervention On Adverse Maternal Outcomes: A Multi-Country Randomized Controlled Trial Conducted By The Household Air Pollution Intervention Network (Hapin), Ashley Younger, Ashley Toenjes, Lindsay Underhill, Et Al.

2020-Current year OA Pubs

Household air pollution from solid cooking fuel use during gestation has been associated with adverse pregnancy and birth outcomes. The Household Air Pollution Intervention Network (HAPIN) trial was a randomized controlled trial of free liquefied petroleum gas (LPG) stoves and fuel in Guatemala, Peru, India, and Rwanda. A primary outcome of the main trial was to report the effects of the intervention on infant birth weight. Here we evaluate the effects of a LPG stove and fuel intervention during pregnancy on spontaneous abortion, postpartum hemorrhage, hypertensive disorders of pregnancy, and maternal mortality compared to women who continued to use solid …

Framework For Quality Assurance Of Ultrahigh Dose Rate Clinical Trials Investigating Flash Effects And Current Technology Gaps, Wei Zou, Tianyu Zhao, Walter R Bosch, Et Al.

2020-Current year OA Pubs

FLASH radiation therapy (FLASH-RT), delivered with ultrahigh dose rate (UHDR), may allow patients to be treated with less normal tissue toxicity for a given tumor dose compared with currently used conventional dose rate. Clinical trials are being carried out and are needed to test whether this improved therapeutic ratio can be achieved clinically. During the clinical trials, quality assurance and credentialing of equipment and participating sites, particularly pertaining to UHDR-specific aspects, will be crucial for the validity of the outcomes of such trials. This report represents an initial framework proposed by the NRG Oncology Center for Innovation in Radiation Oncology …

Refractory Mogamulizumab-Associated Rash Responding To An Oral Janus Kinase Inhibitor, Carine M Lama, Miguel A Hernandez-Rovira, Neha Mehta-Shah, Aaron Russell, Amy C M Musiek

2020-Current year OA Pubs

No abstract provided.

Striatal Mglu5-Mediated Synaptic Plasticity Is Independently Regulated By Location-Specific Receptor Pools And Divergent Signaling Pathways, Yuh-Jiin I Jong, Yukitoshi Izumi, Steven K Harmon, Charles F Zorumski, Karen L Ómalley

2020-Current year OA Pubs

Metabotropic glutamate receptor 5 (mGlu

Location Of Pathogenic Variants In Psen1 Impacts Progression Of Cognitive, Clinical, And Neurodegenerative Measures In Autosomal-Dominant Alzheimer's Disease, Stephanie A Schultz, Eric Mcdade, Nicolas R Barthelemy, Nelly Joseph-Mathurin, Carlos Cruchaga, Charles D Chen, Tammie L S Benzinger, Anne M Fagan, Brian A Gordon, Jason J Hassenstab, Celeste M Karch, John C Morris, Richard J Perrin, Chengjie Xiong, Randall J Bateman, Et Al.

2020-Current year OA Pubs

Although pathogenic variants in PSEN1 leading to autosomal-dominant Alzheimer disease (ADAD) are highly penetrant, substantial interindividual variability in the rates of cognitive decline and biomarker change are observed in ADAD. We hypothesized that this interindividual variability may be associated with the location of the pathogenic variant within PSEN1. PSEN1 pathogenic variant carriers participating in the Dominantly Inherited Alzheimer Network (DIAN) observational study were grouped based on whether the underlying variant affects a transmembrane (TM) or cytoplasmic (CY) protein domain within PSEN1. CY and TM carriers and variant non-carriers (NC) who completed clinical evaluation, multimodal neuroimaging, and lumbar puncture for collection …

Genomic Risk For Post-Traumatic Stress Disorder In Families Densely Affected With Alcohol Use Disorders, Stacey Saenz De Viteri, Emma C Johnson, Vivia V Mccutcheon, Kathleen K Bucholz, Et Al.

2020-Current year OA Pubs

Recent genome-wide association studies (GWAS) have identified genetic markers of post-traumatic stress disorder (PTSD) in civilian and military populations. However, studies have yet to examine the genetics of PTSD while factoring in risk for alcohol dependence, which commonly co-occur. We examined genome-wide associations for DSM-IV PTSD among 4,978 trauma-exposed participants (31% with alcohol dependence, 50% female, 30% African ancestry) from the Collaborative Study on the Genetics of Alcoholism (COGA). We also examined associations of polygenic risk scores (PRS) derived from the Psychiatric Genomics Consortium (PGC)-PTSD Freeze 2 (N = 3533) and Million Veterans Program GWAS of PTSD (N = 5200) …

Loop-And-Let-Go Technique For The Management Of Symptomatic Large Colonic Lipoma, Syedreza Haider, Matthew Peller, Vladimir Lamm, Ahmad Najdat Bazarbashi

2020-Current year OA Pubs

Video 1We depict (1) identification of a large lipoma in the sigmoid colon; (2) radial echo endoscopy confirming diagnosis; (3) removal with the loop-and-let-go technique; (4) ex vivo demonstration of the technique; and (5) an interval follow-up demonstrating healing of the lesion.

Resolvin D1 Prevents Injurious Neutrophil Swarming In Transplanted Lungs, Wenjun Li, Hailey M Shepherd, Yuriko Terada, Ashley E Shay, Amit I Bery, Andrew E Gelman, Kory J Lavine, Charles N Serhan, Daniel Kreisel

2020-Current year OA Pubs

Neutrophils are the primary cell type involved in lung ischemia-reperfusion injury (IRI), which remains a frequent and morbid complication after organ transplantation. Endogenous lipid mediators that become activated during acute inflammation-resolution have gained increasing recognition for their protective role(s) in promoting the restoration of homeostasis, but their influence on early immune responses following transplantation remains to be uncovered. Resolvin D1, 7

Urine Biomarker Score Captures Response To Induction Therapy With Lupus Nephritis, Ellen M Cody, Scott E Wenderfer, Kathleen E Sullivan, Alfred H J Kim, Wesley Figg, Harneet Ghumman, Tingting Qiu, Bin Huang, Prasad Devarajan, Hermine I Brunner

2020-Current year OA Pubs

BACKGROUND: The Renal Activity Index for Lupus (RAIL) consists of urine protein assessment of neutrophil gelatinase-associated lipocalin, kidney injury molecule-1, monocyte chemotactic protein 1, adiponectin, hemopexin, and ceruloplasmin, which non-invasively identifies lupus nephritis (LN). We aimed to delineate RAIL scores with inactive versus active LN and changes over time with response to LN induction therapy.

METHODS: There were 128 pediatric patients with systemic lupus erythematosus (SLE) and age-matched healthy controls recruited in a prospective case control study, with kidney biopsy confirmation of LN. Laboratory and clinical information was recorded and urine collected at diagnosis and end of induction and during …

Survey Of How Irregularities In The Electrical System Of The Human Heart Link To Different Heart Arrhythmias, Jazmine Boloor

UNLV Theses, Dissertations, Professional Papers, and Capstones

This thesis explores the circuital pathway that a signal takes within the heart throughout a full heartbeat and provides a timing analysis. It then surveys the different pathways that could arise in the electrical system of the heart, and the associated heart diseases linked to the location of each pathway. Common heart arrhythmias such as atrioventricular nodal reentrant tachycardia, atrioventricular reentrant tachycardia, atrial flutter, and atrial fibrillation are surveyed, and their pathways are analyzed. Electrocardiograms are presented to aid in understanding of the timing analysis associated with irregularity in heart function. Finally, this thesis explores an avenue of the heartbeat …

Babywearing's Influence On Parent And Infant Heart Rates, Joo-Hee Han

UNLV Theses, Dissertations, Professional Papers, and Capstones

Babywearing is the practice of carrying an infant in a baby carrier close to the body. It provides an environment that allows the bodies of the parent and infant to be close together. The closeness of parent and infant improves the well-being and coregulation of the parent and infant, which could be estimated with heart rate (HR). Few studies have examined mother-infant dyads, but even fewer have examined father-infant dyads. This study examined mother-infant and father-infant dyads, especially for infants with neonatal abstinence syndrome (NAS). The significance of studying babywearing in this vulnerable population is that if babywearing is associated …

Examination Of Performance Validity And The Relationship To Cognition And Symptoms In Schizophrenia Spectrum Disorders, Erick A. Rogers

UNLV Theses, Dissertations, Professional Papers, and Capstones

Approximately one-in-five individuals with psychotic disorders (i.e., schizophrenia spectrum disorders [SSD]) fail performance validity indicators (PVIs) during neurocognitive testing. Ensuring the validity of neurocognitive test results is necessary if the test scores are to be of use for diagnostic consideration, intervention selection and planning, predicting outcomes, and following changes in cognition over time in response to intervention, spontaneous recovery, or disease progression. PVIs are designed to require only a minimum level of engagement with the evaluation, which means nearly everyone is expected to “pass,” even those with moderate to severe brain damage. Traditional interpretations of PVI failure suggest a noncredible …

High Risk Lung Nodule: A Multidisciplinary Approach To Diagnosis And Management, Babith J Mankidy, Ghasemirad Mohammad, Kelly Trinh, Anoop P Ayyappan, Quillan Huang, Steven Bujarski, Mohammad S Jafferji, Ravi Ghanta, Alexander N Hanania, Donald R Lazarus

Faculty, Staff and Students Publications

Pulmonary nodules are often discovered incidentally during CT scans performed for other reasons. While the vast majority of nodules are benign, a small percentage may represent early-stage lung cancer with the potential for curative treatments. With the growing use of CT for both clinical purposes and lung cancer screening, the number of pulmonary nodules detected is expected to increase substantially. Despite well-established guidelines, many nodules do not receive proper evaluation due to a variety of factors, including inadequate coordination of care and financial and social barriers. To address this quality gap, novel approaches such as multidisciplinary nodule clinics and multidisciplinary …

Management Of Asymptomatic Hypertension In The Inpatient Setting., Charles Meadows, Mehiar Elhamdani, Dial Larry, Murad Kheetan, Khaled Al-Baqain

Marshall Journal of Medicine

Hypertension is common in hospitalized patients and is most often asymptomatic. While there are no guidelines for management of such patients, aggressive blood pressure treatment, including the use of intravenous antihypertensives, is often undertaken. While evidence of benefit is lacking, emerging data suggest that treatment of asymptomatic hypertension in the inpatient setting is associated with adverse outcomes, including acute kidney injury and ischemic stroke. In addition, the intensification of a preexisting antihypertensive regimen at hospital discharge significantly increases the risk of readmission without significant improvement in outpatient hypertension control. Such a combination of a common problem with the demonstrable benefit …

Discontinuation Of Routine Postpartum Complete Blood Count In Uncomplicated Vaginal Deliveries, Tori Miller, Erin Light, Caleb Spainhower, David G. Chaffin, Jesse Cottrell

Marshall Journal of Medicine

Introduction

The aim of this prospective study is to assess the clinical utility and safety of discontinuing routine Complete Blood Count (CBC) testing in uncomplicated vaginal deliveries with a focus on identifying potential benefits, risks, and overall cost-effectiveness of this practice. This routine CBC is used to assess for postpartum anemia and the need for a blood transfusion but is currently performed regardless of initial blood count on admission or estimated blood loss during delivery. However, recent evidence suggests that routine CBC testing may not significantly impact clinical outcomes in low-risk pregnancies. In this study, we hypothesize that routine postpartum …

Return To Activity Following Acl Reconstruction With The Fertilized Acl: A Retrospective Study., Chad Lavender, Timothy Hewett, John Johnson, Richard Peluso, Tyag Patel, Shane Taylor

Marshall Journal of Medicine

Introduction

The objective of this retrospective study is to evaluate outcomes in patients who underwent the fertilized anterior cruciate ligament (ACL) reconstruction procedure. We aim to investigate the return to previous level of activity, safety, and re-rupture rates of the ACL reconstruction augmented with bone marrow concentrate, demineralized bone matrix, autograft bone, and a suture tape (the fertilized ACL).

Methods

A comprehensive review of medical records was conducted for patients treated with the fertilized ACL (FACL). Medical records of all the patients who underwent reconstruction surgery between July 2018 and January 2021 were evaluated. The inclusion criteria for the study …

A Commonly Misdiagnosed Rare Pulmonary Disease: Idiopathic Pleuroparenchymal Fibroelastosis, Yonas Raru, Amro K. Al-Astal, Saroj Sigdel

Marshall Journal of Medicine

Awareness among clinicians about Idiopathic pleuroparenchymal fibroelastosis (PPFE) is lacking and by the time patients are diagnosed with it, they were seen by multiple physicians and misdiagnosed multiple times. It is a rare condition that is characterized by fibrosis of the pleura and subpleural lung parenchyma, predominantly affecting the upper lobes. Most common cause of fibrosis in other processes is collagen predominant but in PPFE fibrosis is usually caused by elastic fibers. Verhoeff-Van Gieson stain from lung biopsies in patients who presented with fibrosis in the upper pleural and parenchymal areas will help in establishing the diagnosis by demonstrating the …

Gateways To…Literacy: A Collaborative Effort., Anna Hughes

Marshall Journal of Medicine

No abstract provided.

Dynamic Adaptations: Assessing The Integration Of Standardized Patients In Physical Therapist Assistant Education, Pamela Pologruto, Jennifer Jewell, Laura Cruz

Health Professions Education

Purpose: The purpose of this study is to investigate the use of standardized patients in the physical therapist assistant (PTA) curriculum as compared to paper-based case studies with regard to reaching higher order thinking in preparation for the clinical environment. Methods: Thirty-five participants were divided into 2 groups to participate in a discussion of a paper case scenario or engage with a standardized patient. Following the interaction, the students completed a survey related to their perceptions of the interventions along with open-ended questions intended to gain insight into application of clinical reasoning skills used during their respective intervention. Results: The …

Case Report: Apical Hypertrophic Cardiomyopathy Of An Elite Athlete In The Hong Kong Sports Institute, Bryan Lau

Journal of the Hong Kong College of Cardiology

This case report is about an elite athlete in the Hong Kong Sports Institute who was diagnosed apical hypertrophic cardiomyopathy through periodic medical assessment with history taking, physical examination, 12-lead resting ECG and subsequent imaging investigations. The challenge of differentiating pathological condition from physiological adaptation of athlete ECG was solved by using the latest international consensus which was advanced by new emerging research data.

Serum Endothelin-1 Level Among Adult Indonesian Females With Obesity: A Nested Cross-Sectional Study From Universitas Gadjah Mada Health And Demographic Surveillance System, Sleman, Indonesia, Anggoro Budi Hartopo, Maria Patricia Inggriani, Jajah Fachiroh, Fatwa Sari Tetra Dewi

Journal of the Hong Kong College of Cardiology

Background The increased obesity prevalence is seen among adult Indonesian females. Obesity is linked to increased endothelin-1 levels, which contribute to endothelial dysfunction, inflammation and insulin resistance. This study aimed to investigate the association between serum endothelin-1 levels with obesity among Indonesian females. Methods This was a cross-sectional study. The subjects were population of Universitas Gadjah Mada Health and Demographic Surveillance System (HDSS) Sleman, Indonesia. We collected venous blood, measured obesity parameters and performed the standardized questionnaire from 124 males and females. Endothelin-1 level was measured from serum by ELISA-methods. Endothelin-1 level was compared between subjects according to obesity category …

Expanding Clinical Knowledge And Awareness To Non-Benzodiazepine Treatments By Providing An Educational Intervention: A Quantitative Study, Alexander Labrador

Doctor of Nursing Practice Scholarly Project

This study examined the effectiveness of an educational intervention for healthcare clinicians to increase knowledge and awareness of non-benzodiazepine treatments for the treatment of anxiety and panic disorders. The target population were healthcare clinicians in a metropolitan area that commonly treat anxiety and panic disorders. Clinicians from different specialties were recruited to participate and evaluated on their knowledge of benzodiazepines on a 3-question pretest survey using a Likert scale. The clinician was then given a 30-minute educational intervention that covered the risks and dangers of benzodiazepines and a review of alternative, non-benzodiazepine treatment options. The clinician then self-evaluated themselves using …

Prorelaxant E-Type Prostanoid Receptors Functionally Partition To Different Procontractile Receptors In Airway Smooth Muscle, Ajay P. Nayak, Elham Javed, Dominic R. Villaba, Yinna Wang, Henry P. Morelli, Sushrut D. Shah, Nicholas Kim, Rennolds S. Ostrom, Reynold A. Pannettieri Jr., Steven S. An, Dale D. Tang, Raymond B. Penn

Pharmacy Faculty Articles and Research

Prostaglandin E2 imparts diverse physiological effects on multiple airway cells through its actions on four distinct E-type prostanoid (EP) receptor subtypes (EP1–EP4). Gs-coupled EP2 and EP4 receptors are expressed on airway smooth muscle (ASM), yet their capacity to regulate the ASM contractile state remains subject to debate. We used EP2 and EP4 subtype-specific agonists (ONO-259 and ONO-329, respectively) in cell- and tissue-based models of human ASM contraction—magnetic twisting cytometry (MTC), and precision-cut lung slices (PCLSs), respectively—to study the EP2 and EP4 regulation of ASM contraction and signaling under conditions of histamine or methacholine (MCh) stimulation. ONO-329 was superior (<0.05) to ONO-259 in relaxing MCh-contracted PCLSs (log half maximal effective concentration [logEC50]: 4.9 × 10−7 vs. 2.2 × 10−6; maximal bronchodilation ± SE, 35 ± 2% vs. 15 ± 2%). However, ONO-259 and ONO-329 were similarly efficacious in relaxing histamine-contracted PCLSs. Similar differential effects were observed in MTC studies. Signaling analyses revealed only modest differences in ONO-329– and ONO-259–induced phosphorylation of the protein kinase A substrates VASP and HSP20, with concomitant stimulation with MCh or histamine. Conversely, ONO-259 failed to inhibit MCh-induced phosphorylation of the regulatory myosin light chain (pMLC20) and the F-actin/G-actin ratio (F/G-actin ratio) while effectively inhibiting their induction by histamine. ONO-329 was effective in reversing induced pMLC20 and the F/G-actin ratio with both MCh and histamine. Thus, the contractile-agonist–dependent differential effects are not explained by changes in the global levels of phosphorylated protein kinase A substrates but are reflected in the regulation of pMLC20 (cross-bridge cycling) and F/G-actin ratio (actin cytoskeleton integrity, force transmission), implicating a role for compartmentalized signaling involving muscarinic, histamine, and EP receptor subtypes.

The Role Of The Women's Organization Of Nahdlatul Ulama (Nu) In Efforts To Control Cigarette Consumption In Indonesia, Salsabila Nadya, Isranalita Madelif Sihombing

Cities and Urban Development Journal

Background: The protection of the nation's next generation from the dangers of smoking cannot be separated from the role of women/mothers as educators and as influencers in creating a safe and comfortable environment from exposure to cigarette smoke for children to grow and develop healthily.

Aims: To analyze the role of the Nahdlatul Ulama (NU) women's organization, namely NU Young Women's Organization (Fatayat NU) and NU Female Student Association (IPPNU) in efforts to control tobacco in Indonesia.

Methods: This research is descriptive research with a method of collecting data on the results of activities owned by the Center for Social …

Improving Nursing Communication By Implementing Communication Tools In A Bsn Undergraduate Program To Improve Patient Outcomes In Practice, Christopher Jackson

Doctor of Nursing Practice Projects

Communication deficiencies were identified among baccalaureate nursing students at South College in Nashville, TN, necessitating changes needing to be made in the nursing curricula. To address the flaws, the quality improvement project proposed implementing changes in clinical assignments during clinical rotations in medical-surgical nursing courses. The project manager discussed the purpose and usage of the SBAR tool, and the students then demonstrated the use of the tool. The clinical faculty rated the students using an eight-question Likert survey to assess the students’ confidence and competency three times; the first assessment at the end of the shift without guidance from their …

Workers’ Characteristics Of Hearing Loss At Soekarno-Hatta International Airport, Indonesia, Andrew Ebeneizer Timanta, Budi Haryanto, Ririn Arminsih Wulandari

Kesmas

This study aimed to analyze the characteristics and factors of worker behavior, including age, the use of ear protection, work duration, a record of diabetes mellitus or hypertension, work rotation, and noise hazards involved in hearing loss in PT. X at Soekarno-Hatta International Airport, Indonesia. A cross-sectional study from May 2017 to June 2017 involved 73 workers in the power service area (TZ Unit) exposed to noise levels ≥85 dBA, using an audiometry test for hearing loss and Sound Level Meter for noise hazards was conducted. The Chi-square test showed a significant correlation between age (OR 8.4, 95% Cl = …

Extracellular Trna-Derived Rnas As Emerging Activators Of Endosomal Toll-Like Receptors: A Narrative Review, Justin Gumas, Yohei Kirino

Computational Medicine Center Faculty Papers

Background and Objective: The innate immune system deploys various pattern-recognition receptors (PRRs), including Toll-like receptors (TLRs), to detect the invasion of pathogens and initiate protective responses. TLR7 and TLR8 are located within the endosome of immune cells and are activated by single-stranded RNAs (ssRNAs). In addition to foreign ssRNAs from bacteria and viruses, endogenous self-ssRNAs, such as microRNAs (miRNAs), have been shown to activate TLR7 and TLR8, but such endogenous ssRNA ligands have not yet been fully elucidated. This scientific knowledge gap is partly derived from the technical limitations of standard RNA-seq, particularly its inability to capture non-miRNA-short non-coding RNAs …

Smallholder Farmers’ Health, Occupational Nutrition, And Sustainable Agriculture, Jen Fuk Liem

Occupational and Environmental Medicine Journal of Indonesia

Smallholder Farmers’ Health, Occupational Nutrition, and Sustainable Agriculture

Brominated Flame Retardants: A Literature Review Of The Toxicity Mechanisms, Clinical Manifestations, And Current Treatments, Yacobus Christian Prasetyo, Eti Nurwening Sholikhah

Occupational and Environmental Medicine Journal of Indonesia

Brominated flame retardants (BFRs) are organohalogen compounds that can inhibit fire formation and delay its spread in manufacturing materials. BFRs are known to be toxic for the environment and humans. BFRs could persist for years prolonging potential exposure and toxicity to living beings. Indonesia had begun to reduce the use, even though some of toxic BFRs are still illegally circulating. This review aims to describe some aspects of BFRs toxicity including the mechanism, its clinical manifestations, and the current possible treatments. Toxicity after BFRs exposure includes endocrine, neurodevelopmental, and genotoxicity. The toxicity is manifested into some clinical conditions such as …