Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons^™

Empagliflozin In The Treatment Of Type 2 Diabetes: Evidence To Date, Jay H. Shubrook, Babak Baradar Bokaie, Sarah E. Adkins

Faculty Publications & Research of the TUC College of Osteopathic Medicine

In the last decade, researchers have gained a greater understanding of the pathophysiologic mechanisms of type 2 diabetes as a chronic and progressive disease. One of the more recent treatment targets is the kidney. The kidneys become maladaptive in diabetes by increasing the reabsorption of glucose above the normal physiologic renal threshold. This discovery has led to the development of the sodium/glucose cotransporter 2 inhibitors (SGLT2). These agents readjust the renal threshold for glucose reabsorption to a lower level and decrease glucose reabsorption, while increasing urinary glucose when the glucose is above the renal threshold and subsequently lowering plasma glucose. …

The Effect Of Statin Therapy On Heart Failure Events: A Collaborative Meta-Analysis Of Unpublished Data From Major Randomized Trials, David Preiss, Ross T. Campbell, Heather M. Murray, Ian Ford, Chris J. Packard, Naveed Sattar, Michael B. Clearfield

Faculty Publications & Research of the TUC College of Osteopathic Medicine

Aims: The effect of statins on risk of heart failure (HF) hospitalization and HF death remains uncertain. We aimed to establish whether statins reduce major HF events.

Methods and results: We searched Medline, EMBASE, and the Cochrane Central Register of Controlled Trials for randomized controlled endpoint statin trials from 1994 to 2014. Collaborating trialists provided unpublished data from adverse event reports. We included primary- and secondary-prevention statin trials with >1000 participants followed for >1 year. Outcomes consisted of first non-fatal HF hospitalization, HF death and a composite of first non-fatal HF hospitalization or HF death. HF events occurring(MI) were excluded. …

What To Do After Basal Insulin: 3 Tx Strategies For Type 2 Diabetes, Lubaina Presswala, Jay H. Shubrook

Faculty Publications & Research of the TUC College of Osteopathic Medicine

While many family physicians have become comfortable with using once-daily basal insulin such as glargine or detemir, what to do after basal insulin is much more complex. This review builds upon an earlier article in this journal, “Insulin for type 2 diabetes: How and when to get started,” by explaining 3 strategies to consider when basal insulin alone isn't enough.

Insulin Pumps: Beyond Basal-Bolus, Richard Millstein, Nancy Mora Becerra, Jay H. Shubrook

Faculty Publications & Research of the TUC College of Osteopathic Medicine

Insulin pumps are a major advance in diabetes management, making insulin dosing easier and more accurate and providing great flexibility, safety, and efficacy for people who need basal-bolus insulin therapy. They are the preferred treatment for people with type 1 diabetes and many with type 2 diabetes who require insulin. This article reviews the basics of how insulin pumps work, who benefits from a pump, and how to manage inpatients and outpatients on insulin pumps.

Effect Of Tai Chi Exercise Combined With Mental Imagery Theory In Improving Balance In A Diabetic And Elderly Population, Abdulrahman Alsubiheen, Jerrold S. Petrofsky, Noha S. Daher, Everett Lohman, Edward Balbas

College of Health & Human Services (TUN) Publications and Research

BACKGROUND: One of the effects of diabetes mellitus (DM), peripheral neuropathy, affects the sensation in the feet and can increase the chance of falling. The purpose of the study was to investigate the effect of 8 weeks of Tai Chi (TC) training combined with mental imagery (MI) on improving balance in people with diabetes and an age matched control group.
MATERIAL AND METHODS: Seventeen healthy subjects and 12 diabetic sedentary subjects ranging from 40–80 years of age were recruited. All subjects in both groups attended a Yang style of TC class using MI strategies, 2 sessions a week …

Joint Attention Intervention With Assisting Parent­ Mediated Techniques To Increase A Toddler With Autism Spectrum Disorders' Use Of Joint Attention: A Single Case Study, Rebecca Schulz

All Graduate Theses, Dissertations, and Other Capstone Projects

Attention Intervention (JAI) conducted by graduate researcher, parent, and caregiver, would change the use of joint attention (JA) by a three-year-old suspected of having Autism Spectrum Disorder (ASD). The participant was a three-­year-­old child suspected of having ASD. Intervention was conducted twice per week for 30-45 minute duration by the student graduate researcher at a university clinic under the supervisor of Dr. Bonnie Berg, CCC­SLP. The parent and child's caregiver were trained in JAI and implemented the intervention daily in the home environment. The author's research question was, "Will the use of a JAI parent­mediated intervention model increase the JA …

Treating Acute Migraines: Triptans Vs. Antiemetics, Samuel Reisman

The Science Journal of the Lander College of Arts and Sciences

Influential American medical organizations and publications have published guidelines for the treatment of acute migraine headaches that omit antiemetics, usually suggesting triptans as the first line of treatment. A review of the few comparative studies directly contrasting clinical outcomes of triptans and antiemetics in the treatment of acute migraines suggest that both treatment options are relatively equal in efficaciousness. The added burden of triptan usage, including an added risk of adverse effects and a high cost per dose, would seem to warrant an antiemetic-first approach to migraine treatment, as recommended by several international health communities. Possible reasons for the prominent …

Transposon Based Gene Therapy As A Treatment For Cancer, Jacob Stauber

The Science Journal of the Lander College of Arts and Sciences

Gene therapy is the use of genes to treat or prevent diseases. Diseases such as cancer, which are difficult to treat using conventional methods, can be treated using gene therapy. The transport of the therapeutic transgene can be accomplished using viral or non-viral methods. However, widespread use of viral vectors is limited due to its high cost of manufacture and safety concern. Non-viral vectors are limited in their effectiveness. The use of transposons such as the Sleeping Beauty transposon system can effectively deliver the transgene with less concern than viral vectors. This review discusses the various vectors and treatment strategies …

Is Proton Beam Therapy More Effective Than Intensity-Modulated Radiotherapy In Prostate Cancer Treatment?, Daniel Zelefsky

The Science Journal of the Lander College of Arts and Sciences

Prostate cancer is the most common form of cancer found in American males. Breaking technological advances in prostate cancer treatment continue to develop to help fight this disease, one such is proton beam therapy. Proton beam therapy is theorized to spare even more healthy tissue than photon radiotherapy because it delivers a majority of its radiation during the Bragg peak. Since this technology is substantially costlier than any other form of radiation therapy, physicians are assessing its effectiveness and determining if it is worth the cost. Currently, there is no significant difference seen in patient quality of life between recipients …

Is The Neuraminidase Inhibitor Tamiflu Effective In The Treatment Of Influenza?, Eliyakim Hershkop

The Science Journal of the Lander College of Arts and Sciences

Influenza is a disease that has caused the deaths of tens of millions people in the last century alone. The influenza neuraminidase protein is essential in the mechanism infection. It enables the virus to leave the infected cell and proliferate. Antiviral neuraminidase inhibitor drugs can be used for treatment. The drug Tamiflu is the standard of care for both treatment and prophylaxis of influenza. The Cochrane reports of 2009 and 2014 conclude that evidence is lacking to support this. Numerous bodies disagree. Cochrane also question the accuracy and credibility of many studies and agencies in support of Tamiflu. This paper …

Biological Therapy In The Treatment Of Ulcerative Colitis, Tzipora Glanzman

The Science Journal of the Lander College of Arts and Sciences

Ulcerative colitis (UC), a subdivision of inflammatory bowel disease, is a chronic disease of the large intestines. Ulcerative colitis is normally a lifelong chronic illness with times of intense flairs and remission. During a flare, the lining of the colon becomes inflamed, and develops small ulcers causing patients to experience rectal bleeding, vomiting, anemia and diarrhea. The treatment options available to treat colitis are very small, causing many patients to need a total colectomy with in the first five years of their diagnosis. However, recent advancement in bio-technology has led to the development of a large array of new therapeutic …

Oncology Section Edge Task Force On Breast Cancer Outcomes: A Systematic Review Of Outcome Measures For Functional Mobility, Mary Insana Fisher, Jeannette Lee, Claire Davies, Hannah Geyer, Genevieve Colon, Lucinda Pfalzer

Physical Therapy Faculty Publications

Background: Breast cancer treatments in women with breast cancer often result in physical impairments that lead to activity limitations and participation restrictions. These limitations and restrictions manifest in impaired functional mobility skills that may impact survivorship. Thus, evaluation of functional mobility is an important part of survivorship care.

Purpose: To identify functional mobility outcome measures that possess strong psychometric properties and are clinically useful for examination of women treated for breast cancer.

Methods: Multiple electronic databases were searched for articles published after 1995. Studies were included if they reported psychometric properties, used clinically feasible methods, were performed on adults, and …

The Effects Of Home-Based Pilates In Healthy College-Age Females, Betsy Donahoe-Fillmore, Mary Insana Fisher, C. Jayne Brahler

Physical Therapy Faculty Publications

Objectives: To quantify and determine the effects of Pilates on core endurance, hamstring flexibility, balance, body composition/mass and perceived stress level in healthy college age females.

Study Design: Randomized controlled trial design.

Background: Emerging research on the Pilates technique is inconclusive regarding benefits to core endurance, flexibility, balance, body mass, and perceived stress.

Methods and Measures: Female college students (n=57; 18-35 years old) were randomly assigned to a Pilates group, who exercised at home with a DVD, or a control group who did not engage in Pilates practice. Core endurance, hamstring flexibility, balance, body composition and stress measurements were taken …

Diffuse Optical Measurements Of Head And Neck Tumor Hemodynamics For Early Prediction Of Chemo-Radiation Therapy Outcomes, Lixin Dong

Theses and Dissertations--Biomedical Engineering

Chemo-radiation therapy is a principal modality for the treatment of head and neck cancers, and its efficacy depends on the interaction of tumor oxygen with free radicals. In this study, we adopted a novel hybrid diffuse optical instrument combining a commercial frequency-domain tissue oximeter (Imagent) and a custom-made diffuse correlation spectroscopy (DCS) flowmeter, which allowed for simultaneous measurements of tumor blood flow and blood oxygenation. Using this hybrid instrument we continually measured tumor hemodynamic responses to chemo-radiation therapy over the treatment period of 7 weeks. We also explored monitoring dynamic tumor hemodynamic changes during radiation delivery. Blood flow data analysis …

Use Of Swine Small Intestine Submucosa As A Dermal Suture, Paige E. Black

PCOM Biomedical Studies Student Scholarship

The purpose of this preliminary study is to determine if swine small intestine submucosa (SIS) can be used to create a suture that will perform comparably to commercially available chromic gut sutures when placed into a wound in rat dermis. This study is part of an ongoing collaboration that has explored SIS as a biologic scaffold in various tissues and surgical procedures. In this study, eight Sprague-dawley rats were divided into two groups, each receiving a full thickness skin wound between the scapula, made by a 5mm biopsy punch. The wound was then closed with commercially available chromic gut suture, …

Defining Young In The Context Of Prostate Cancer, Suzanne Chambers, Anthony Lowe, Melissa Hyde, Leah Zajdlewicz, Robert F. Gardiner, David Sandoe, Jeff Dunn

Research outputs 2014 to 2021

The experience of prostate cancer is for most men a major life stress with the psychological burden of this disease falling more heavily on those who are younger. Despite this, being young as it applies to prostate cancer is not yet clearly defined with varied chronological approaches applied. However, men’s responses to health crises are closely bound to life course and masculinities from which social roles emerge. This paper applied qualitative methodology (structured focus groups and semistructured interviews with expert informants) using interpretative phenomenological analysis to define what it means to be young and have prostate cancer. Structured focus groups …

Association Of Systemic Lupus Erythematosus Associates With Decreased Immunosuppressive Potential Of The Igg Glycome, Franco Vukovic, Jasminka Krištić, Ivan Gudelj, Maria Teruel, Toma Keser, Marija Pezer, Maja Pučić-Baković, Jerko Štambuk, Irena Trbojević-Akmačić, Clara Barrios, Tamara Pavić, Cristina Menni, Youxin Wang, Yong Zhou, Liufu Cui, Haicheng Song, Qiang Zeng, Xiuhua Guo, Bernardo A. Pons-Estel, Paul Mckeigue, Alan Leslie Patrick, Olga Gornik, Tim D. Spector, Miroslav Harjaček, Marta Alarcon-Riquelme, Miriam Molokhia, Wei Wang, Gordan Lauc

Research outputs 2014 to 2021

Objective: Glycans attached to the Fc portion of IgG are important modulators of IgG effector functions. Interindividual differences in IgG glycome composition are large and they associate strongly with different inflammatory and autoimmune diseases. IKZF1, HLA–DQ2A/B, and BACH2 genetic loci that affect IgG glycome composition show pleiotropy with systemic lupus erythematosus (SLE), indicating a potentially causative role of aberrant IgG glycosylation in SLE. We undertook this large multicenter case–control study to determine whether SLE is associated with altered IgG glycosylation. Methods: Using ultra-performance liquid chromatography analysis of released glycans, we analyzed the composition of the IgG glycome in 261 SLE …

Analysis Of Protein Expression For Potential Biomarkers In Human Pancreatic Tumor Cell Lines, Jade Ashley Simpson

Honors Program Theses

Pancreatic cancer is an aggressive cancer of the pancreas that has been shown to have extremely low survival rates. It can be quite lethal because of its asymptomatic early stages and inability to detect cancer at the cellular level. Once diagnosed, the cancer will have usually spread or metastasized beyond surgical resection. Thus, research is focused on finding potential biomarkers in tumor cell lines to help in earlier diagnosis of this disease leading to better treatment options. Previous work using bioinformatics data suggest several cellular genes including, CTHCR1, EPPK1, AHNAK2, and IGHG3, can be potential biomarkers for pancreatic cancer. The …

Low Cost Shear And Pressure Sensor, Kyle L. Rohrig, Phaethon D. Kotantoulas, Brandon J. Lloyd, Hazim H. Abualola, Tao Ruan

Williams Honors College, Honors Research Projects

Elevated pressure and shearing stresses at the foot-shoe interface are believed to play a role in diabetic foot ulceration. The main goal of this project was to design a simple insole that could distinguish between sites of high pressure and sites of excessive shearing stresses at the foot-shoe interface. Wear patterns that relate specifically to shear and pressure acting on the plantar surface of a patient’s foot also needed to be exhibited. The team used reflective tape that was applied to the surface to various types of insoles to look for visible wear patterns. These wear patterns were identified by …

The Feasibility Of Implementing A Novel Electrical Stimulation Device In The Self-Management Of Hand Burn Pain, Katrina Liddiard

Theses : Honours

Burns are widely acknowledged as one of the most painful injuries experienced, and poorly controlled pain following burn injury has been linked to reduced psychological adjustment, lower quality of life, and increased risk of developing a chronic pain state. Transcutaneous electrical nerve stimulation has been used for pain relief in a range of medical conditions, and may have the potential to reduce pain and analgesic consumption for burns patients. The burn care environment presents unique challenges to the introduction of new interventions, and the feasibility of introducing a novel form of electrical stimulation into this environment has not been tested. …

Off-Label Use Of Transmucosal Ketamine As A Rapidacting Antidepressant: A Retrospective Chart Review, Linda Nguyen, Patrick J. Marshalek, Cory B. Weaver, Kathy J. Cramer, Scott E. Pollard, Rae Reiko Matsumoto

Faculty Publications & Research of the TUC College of Pharmacy

Objective: This study evaluated the effectiveness and safety of subanesthetic doses of ketamine using an off-label, transmucosal administration route in patients with treatment-resistant depression.

Methods: A retrospective chart review was conducted to identify patients who met the inclusion criteria for treatment-resistant major depressive disorder. Seventeen such patients who received subanesthetic doses of ketamine were included. Patient demographics, efficacy (drug refill, clinician notes), side effects, and concurrent medications were assessed.

Results: Benefit from low-dose transmucosal ketamine was noted in 76% of subjects (average age 48 years, 88% female), with a dose duration lasting 7–14 days. No notable side …

Insomnia And Exacerbation Of Anxiety Associated With High-Epa Fish Oil Supplements After Successful Treatment Of Depression, Lauren B. Blanchard, Gordon C. Mccarter

Faculty Publications & Research of the TUC College of Pharmacy

A 54-year-old male consulted his general practitioner for increasing general anxiety and mild panic attacks despite effective treatment for recurrent major depressive disorder, which included a fish oil supplement enriched in eicosapentaenoic acid (EPA). The patient would awaken suddenly at night with shortness of breath and overwhelming worry. During the daytime, he felt a general, nonspecific anxiety and frequently experienced sympathetic activation upon confronting routine challenges. He also experienced dyspnea-induced feelings of panic. He reported that he stopped taking the fish oil supplements after several more months of symptoms, and his anxiety and insomnia then largely disappeared. Several weeks later, …

Program Active Ii: Design And Methods For A Multi-Center Community-Based Depression Treatment For Rural And Urban Adults With Type 2 Diabetes, Mary De Groot, Jay H. Shubrook, Frank Schwartz, W. Guyton Hornsby Jr., Yegan Pillay, Chandan Saha

Faculty Publications & Research of the TUC College of Osteopathic Medicine

Objective: Depression affects one in four adults with type 2 diabetes (T2DM) and is associated with worsened diabetes complications, increased health care costs and early mortality. Rural and low-income urban areas, including the Appalachian region, represent an epicenter of the T2DM epidemic. Program ACTIVE II is a comparative effectiveness treatment trial designed to test whether a combination of cognitive behavioral therapy (CBT) and community-based exercise (EXER) will offer greater improvements in diabetes and depression outcomes compared to individual treatment approaches and usual care (UC). The secondary aims are to assess changes in cardiovascular risk factors across groups and to …

Guidelines For The Standardization Of Preanalytic Variables For Blood-Based Biomarker Studies In Alzheimer's Disease Research, Sid O'Bryant, Veer Gupta, Kim Henriksen, Melissa Edwards, Andreas Jeromin, Simone Lista, Chantal Bazenet, Holly Soares, Simon Lovestone, Harald Hampel, Thomas Montine, Kaj Blennow, Tatiana Foroud, Maria Carrillo, Neill Graff-Radford, Christoph Laske, Monique Breteler, Leslie Shaw, John Q. Trojanowski, Nicole Schupf, Robert A. Rissman, Anne M. Fagan, Pankaj Oberoi, Robert Umek, Michael W. Weiner, Paula Grammas, Holly Posner, Ralph Martins

Research outputs 2014 to 2021

The lack of readily available biomarkers is a significant hindrance toward progressing to effective therapeutic and preventative strategies for Alzheimer's disease (AD). Blood-based biomarkers have potential to overcome access and cost barriers and greatly facilitate advanced neuroimaging and cerebrospinal fluid biomarker approaches. Despite the fact that preanalytical processing is the largest source of variability in laboratory testing, there are no currently available standardized preanalytical guidelines. The current international working group provides the initial starting point for such guidelines for standardized operating procedures (SOPs). It is anticipated that these guidelines will be updated as additional research findings become available. The statement …

Abcb5 Identifies Immunoregulatory Dermal Cells, Tobias Schatton, Jun Yang, Sonja Kleffel, Mayuko Uehara, Steven R. Barthel, Christoph Schlapbach, Qian Zhan, Stephen Dudeney, Hansgeorg Mueller, Nayoung Lee, Juliane C. De Vries, Barbara Meier, Seppe Vander Beken, Mark M. Kluth, Christoph Ganss, Arlene H. Sharpe, Ana Maria Waaga-Gasser, Mohamed H. Sayegh, Reza Abdi, Karin Scharffetter-Kochanek, George F. Murphy, Thomas S. Kupper, Natasha Y. Frank, Markus H. Frank

Research outputs 2014 to 2021

Cell-based strategies represent a new frontier in the treatment of immune-mediated disorders. However, the paucity of markers for isolation of molecularly defined immunomodulatory cell populations poses a barrier to this field. Here, we show that ATP-binding cassette member B5 (ABCB5) identifies dermal immunoregulatory cells (DIRCs) capable of exerting therapeutic immunoregulatory functions through engagement of programmed cell death 1 (PD-1). Purified Abcb5+ DIRCs suppressed T cell proliferation, evaded immune rejection, homed to recipient immune tissues, and induced Tregs in vivo. In fully major-histocompatibility-complex-mismatched cardiac allotransplantation models, allogeneic DIRCs significantly prolonged allograft survival. Blockade of DIRC-expressed PD-1 reversed the inhibitory effects of …

Accurate Modelling And Positioning Of A Magnetically-Controlled Catheter Tip, Vi T. H. Le

Theses: Doctorates and Masters

This thesis represents the initial phase of a proposed operator and patient friendly method designed to semi-automate the positioning and directing of an intravascular catheter in the human heart using a variable electromagnetically induced field to control a catheter tip equipped with three tiny fixed magnets oriented in XYZ planes. Here we demonstrate a comprehensive mathematical model which accurately calculates the magnetic field generated by the electromagnet system, and the magnetic torques and forces exerted on a three-magnet tip catheter. From this we have developed an iterative predictive computer algorithm to show the displacement and deflection of the catheter tip. …

Evaluation Of A Modified Food Frequency Questionnaire To Measure Lignans In Australian Men And Women, Ying Qi Winnie Li

Theses: Doctorates and Masters

Phytoestrogens are plant compounds that possess estrogenic and biological properties that have been postulated to protect against chronic diseases. Isoflavonoids and lignans are two main classes of phytoestrogen that have been investigated for their estrogenic efficacy and occurrence in the human diet. Isoflavonoids are found in soy and related products, whereas lignans are found in a wider range of plant-based foods, such as cereals, vegetables, fruits, legumes, nuts and seeds; and in beverages such as tea, coffee and wine. In Western populations with low dietary intake of soy products, compared to the Asian counterparts, lignans could be a more important …

Segmental Musculoskeletal Examinations Using Dual-Energy X-Ray Absorptiometry (Dxa): Positioning And Analysis Considerations, Nicolas H. Hart, Sophia Nimphius, Tania Spiteri, Jodie L. Cochrane, Robert U. Newton

Research outputs 2014 to 2021

Musculoskeletal examinations provide informative and valuable quantitative insight into muscle and bone health. DXA is one mainstream tool used to accurately and reliably determine body composition components and bone mass characteristics in-vivo. Presently, whole body scan models separate the body into axial and appendicular regions, however there is a need for localised appendicular segmentation models to further examine regions of interest within the upper and lower extremities. Similarly, in-consistencies pertaining to patient positioning exist in the litera-ture which influence measurement precision and analysis out-comes highlighting a need for standardised procedure. This paper provides standardised and reproducible: 1) positioning and analysis …

The Effect Of Music Therapy Interaction On Child And Parental Preoperative Anxiety In Parents Of Children Undergoing Day Surgery, Christopher R. Millett

Theses and Dissertations--Music

Young children who experience high levels preoperative anxiety often exhibit distress behaviors, experience more surgical complications, and are at a higher risk for developing a variety of negative postoperative consequences. A significant factor in pediatric preoperative anxiety is the level of anxiety present in their caregivers. Music therapy interventions addressing a variety of procedural outcomes have been met with success. The purpose of this study was to investigate the comparative effectiveness of two music therapy interventions on reducing preoperative anxiety in young pediatric surgical patients and their caregivers.

A total of 40 pediatric patient and caregiver dyads were included in …

Drug Interactions With Glutaredoxin Orthologues, Kahlilah R. Napper, Thomas C. Leeper, Ram Khattri, Daniel Morris, Caroline Davis

Williams Honors College, Honors Research Projects

Glutaredoxin, an enzymatic protein, is an important component of cell viability and function. It catalyzes reactions involved in DNA synthesis and innate immunity [1,4]. Glutaredoxin is also essential in antibiotic resistance in pathogenic bacterial species. Pseudomonas aeruginosa in particular is responsible for infecting the lung tissue of its human hosts, resulting in the development of pneumonia and cystic fibrosis [3]. Because glutaredoxin is pertinent in cell proliferation of eukaryotic and bacterial cells alike, medicinal fragments that take advantage of the subtle differences in protein structure of the orthologous proteins can be synthesized and enhanced to bind bacterial glutaredoxins, without inhibiting …