Diseases Commons^™

Experiential Learning In Dietetics: Can Diabetes Camp Make A Difference?, Mallory Jean Mount

Theses, Dissertations and Capstones

This longitudinal qualitative case study explored the knowledge, perceptions, confidence, and empathy gained by dietetics students during experiential learning at a residential diabetes camp. Qualitative research methods were used to explore and understand participants’ experience of hands-on involvement with type one diabetes, and what they learned at camp that cannot be learned in a classroom. Data were collected over two years at Camp Kno-Koma, the diabetes camp of West Virginia. This study suggests that experiential learning at diabetes camp can make an important contribution to the overall education of dietetics students. One year of experiential learning was beneficial to participating …

Esophageal Crohn's Disease Unresponsive To Glucocorticoids, Tanureet Kochar, Matthew Krafft, Swapna Gayam

Faculty & Staff Scholarship

No abstract provided.

Intermittent Fasting In Weight Management, Alyse Engen

Physician Assistant Scholarly Project Posters

Obesity is associated with a variety of medical conditions that adversely affect metabolic and cardiovascular health. In order for health care providers to adequately educate and promote weight management, they need to be aware of the various dietary regimens and the efficacy and adverse effects associated with each. This literature review assesses the efficacy, metabolic benefits, and cardiovascular benefits of both intermittent energy restriction and continuous energy restriction from ten articles found on various databases within the past five years. The findings indicate that although not proven superior or inferior, intermittent energy restriction provides statistically similar results to continuous energy …

Comparing Rates Of Macrosomia And Neonatal Hypoglycemia Of Differing Treatment Modalities Of Gestational Diabetes Mellitus, Ashleigh Milbrath

Physician Assistant Scholarly Project Posters

Gestational diabetes mellitus (GDM) is a known potential complication that can occur during pregnancy. Unmanaged GDM can result in maternal hyperglycemia, which can cause increased neonatal complications, two of which are macrosomia and neonatal hypoglycemia. To prevent maternal hyperglycemia, treatment of GDM typically begins with dietary changes, home glucose monitoring, increased exercise patterns and other lifestyle modifications. However, if maternal hyperglycemia persists after two weeks of maternal lifestyle modifications, there are not current best practice guidelines established for the treatment of GDM. Historically, subcutaneous multiple daily dosed insulin (MDI) has been the gold standard for treatment after lifestyle modification. However, …

Aspirin Use Following Preeclampsia To Prevent Future Adverse Cardiovascular Outcomes, Kristi Bohlig

Physician Assistant Scholarly Project Posters

• Introduction: Preeclampsia during pregnancy warrants therapy with low dose aspirin. The purpose of this review is to investigate if these women are at increased future risk for cardiovascular morbidity and mortality, and if aspirin therapy prevents future cardiovascular events.

• Research Questions: Do women who had preeclampsia during pregnancy have increased future cardiovascular morbidity and mortality? • Does continued aspirin use in postpartum women, who had preeclampsia during pregnancy; decrease future cardiovascular morbidity and mortality?

• Research Methods: Literature review was conducted utilizing CINAHL, Dynamed plus and PubMed databases.

• Discussion: Many studies have found that preeclampsia does increase …

Embolus Prevention: Anticoagulant Therapy In Comparison To Watchman's Procedure In Patients With Atrial Fibrillation, Erik Fladmo

Physician Assistant Scholarly Project Posters

• Atrial fibrillation or A-fib is a common cardiac disease that occurs as individuals get older.

• A risk factor of atrial fibrillation is blood clot formation and dislodgement or ‘embolus’ in the left atrium.

• Current treatment methods to prevent clot formation include anticoagulants, as well as a left atrial appendage closure device, The Watchman’s device is the only FDA approved left atrial appendage closure device.

• Study results confirm the rising efficacy and cost effectiveness of Watchman’s device versus long term anticoagulant therapy as well as their adverse effects regarding placement and post procedure; however further randomized control …

Comparing Screening And Treatment Of Bacterial Vaginosis And Pregnancy Outcomes, Stephanie Severson

Physician Assistant Scholarly Project Posters

• Evidence shows that bacterial vaginosis (BV) can lead to poor perinatal outcomes.

• The goal of this project is to answer the question of which pregnant patients should be screened for BV and does identification and treatment of BV during pregnancy improve perinatal outcomes.

• Due to variability in a multitude of factors, a generalized recommendation is difficult to make. Lack of recommendations are largely due to harm of treatment in those who were misdiagnosed.

• The development of polymerase chain reaction (PCR) has the capability to reduce misdiagnosis.

• Newer studies have shown benefit of early screening and …

Comparison Of Pharmacologic Treatments For Postmenopausal Osteoporosis, Kaitlyn Wirtz

Physician Assistant Scholarly Project Posters

• The prevalence of osteoporosis in the United States in adults > 50 years of age is “more than 10 million people overall and 33 million have low bone mineral density (BMD) at the hip” (DynaMed Plus, 2018).

• To combat postmenopausal osteoporosis, two treatment options include bisphosphonates and the anti-receptor activator of nuclear factor kappa β ligand (RANKL) agent (denosumab).

• The purpose of this scholarly project is to determine if there is a statistical significance regarding safety, efficacy, and preference between bisphosphonates and denosumab.

• Three databases were searched: PubMed, CINAHL, and Cochrane Database of Systematic Reviews. Topics researched …

Toxic Environmental Risk Factors For Alzheimer's Disease: A Systematic Review, Oluwaseyi Olayinka, Olaniyi O. Olayinka, Brook T. Alemu, Muge Akpinar-Elci, George T. Grossberg

Community & Environmental Health Faculty Publications

There is growing evidence of a possible association between toxic environmental factors and Alzheimer’s disease (AD), a disabling neurodegenerative condition with no known cause. Previous reviews of toxic environmental factors for AD either focused on occupational exposures or used a non-systematic methodology. The objective of this systematic review is to assess the evidence on the link between AD and exposure to a variety of toxic environmental risk factors beyond the work environment. Structured database search was used to identify relevant studies. Twenty-nine eligible studies examining the effect of various toxic environmental agents including electromagnetic fields, solvents, pesticides, toxic metals, and …

Women And Hiv: Understanding And Addressing Stigma—Evidence From The Population Council, Population Council

HIV and AIDS

Over the last 20 years, the Population Council has carried out extensive work examining the intersection of stigma and gender and its impact on HIV-related outcomes. This brief summarizes key Population Council findings from a range of studies which elucidate the experiences of stigma among women and highlights avenues for addressing stigma to mitigate women’s risk and burden of HIV.

Glucagon-Like Peptide-1s Compared To Sulfonylureas In The Treatment Of Adults Diagnosed With Type Ii Diabetes Mellitus In Primary Care, Tracy Kirchner

Physician Assistant Scholarly Project Posters

Type II diabetes mellitus (T2DM) is a prevalent disease in our country. Bullard et al. (2018) report approximately 21 million adults have T2DM in the United States. “The total estimated cost of diagnosed diabetes in 2017 is $327 billion, including $237 billion in direct medical costs and $90 billion in reduced productivity” (Yang et al., 2018). Treatment of T2DM is individualized to each patient based on their co-morbidities, fiscal responsibility, and route of administration options. Sulfonylureas and Glucagon-like Peptide-1s (GLP-1) are two classes of antidiabetic drugs that are available for use as second line treatment options after metformin. This review …

Understanding Pseudomonas Aeruginosa Alginate Regulation And Its Link To Chronic Lung Infections In Cystic Fibrosis Patients, Roy Al Ahmar

Theses, Dissertations and Capstones

Cystic Fibrosis (CF) is a genetic disorder caused by mutations in the gene encoding Cystic Fibrosis Transmembrane Conductance Regulator (CFTR). This disorder results in thick lung secretions which compromise the patient’s immune system. Chronic lung infections with Pseudomonas aeruginosa biofilms is a major factor that contributes to poor outcome for clinical treatment. The overall hypothesis of this dissertation is that small colony variant and pyrimidine biosynthesis are linked with biofilm formation, alginate production is dependent on MucA proteolysis, rifaximin can be repurposed to treat biofilm infection and multiplex PCR can be used to rapidly measure the bacterial cell density in …

Pressure To Be Perfect: Eating Disorders In Sports, Genevieve Nitzsche

Writing Across the Curriculum

Eating disorders have become more prevalent in recent years as societal standards have gotten harsher. Typically, when people think about the type of people who develop eating disorders, the first thing that pops into their head is not athletes. There is an association between athletes and the need for great amounts of food to fuel their bodies. However, in sports such as wrestling and aesthetic sports, like gymnastics and figure skating, the emphasis of image and the pressure from their coaches can be extremely harmful to their mental health. This paper discusses specific statistics of the incidence of eating disorders …

Implementing A Discharge Navigator Reducing 30-Day Readmissions For Heart Failure And Sepsis Populations, Karen Weeks

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

A national focus for healthcare reform is preventing hospital readmissions. Thirty-day unplanned hospital readmissions impact patient outcomes and are costly to the healthcare system. This project explored the impact between the discharge navigator and 30-day unplanned readmissions for heart failure and sepsis populations in a 238-bed community hospital located in central Virginia. The primary aim of this discharge navigator project was to reduce 30-day readmissions for the heart failure and sepsis populations to meet the goals of the top quartile for like hospitals and the evaluation of cost avoidance for these readmissions. Heart failure and sepsis populations are high risks …

Imaging-Based Clusters In Former Smokers Of The Copd Cohort Associate With Clinical Characteristics: The Subpopulations And Intermediate Outcome Measures In Copd Study (Spiromics), Babak Haghighi, Sanghun Choi, Jiwoong Choi, Eric A. Hoffman, Alejandro P. Comellas, John D. Newell, Chang Hyun Lee, R. Graham Barr, Eugene Bleecker, Christopher B. Cooper, David Couper, Mei Lan Han, Nadia N. Hansel, Richard E. Kanner, Ella A. Kazerooni, Eric A.C. Kleerup, Fernando J. Martinez, Wanda O'Neal, Robert Paine, Stephen I. Rennard, Benjamin M. Smith, Prescott G. Woodruff, Ching-Long Lin

Journal Articles: Pulmonary & Critical Care Med

BACKGROUND: Quantitative computed tomographic (QCT) imaging-based metrics enable to quantify smoking induced disease alterations and to identify imaging-based clusters for current smokers. We aimed to derive clinically meaningful sub-groups of former smokers using dimensional reduction and clustering methods to develop a new way of COPD phenotyping.

METHODS: An imaging-based cluster analysis was performed for 406 former smokers with a comprehensive set of imaging metrics including 75 imaging-based metrics. They consisted of structural and functional variables at 10 segmental and 5 lobar locations. The structural variables included lung shape, branching angle, airway-circularity, airway-wall-thickness, airway diameter; the functional variables included regional ventilation, …

Tgf-Β Induces A Heart Failure Phenotype Via Fibroblasts Exosome Signaling, Hesham Basma, Adelaide N. Johanson, Kajari Dhar, Daniel R. Anderson, Fang Qiu, Stephen I. Rennard, Brian D. Lowes

Journal Articles: Pulmonary & Critical Care Med

PURPOSE: The mechanisms for persistent and progressive loss of myocardial function in advanced heart failure (HF) remain incompletely characterized. In the current study, we sought to determine the impact of TGF-β on fibroblasts transcriptional profiles and assess if exosomes from TGF-β treated fibroblasts could induce a heart failure phenotype in co-cultured cardiomyocytes.

METHOD: Normal heart fibroblasts were treated with TGF-β with a final conc. of 2.5 ng/ml in serum free media. HF fibroblasts were also obtained from patients undergoing implantation of left ventricular assist devices. Exosomes were collected using three-step ultracentrifugation. Cardiomyocytes were co-cultured with exosomes from TGF-β-treated, HF and …

Bronchoalveolar Lavage Fluid From Copd Patients Reveals More Compounds Associated With Disease Than Matched Plasma, Eitan Halper-Stromberg, Lucas Gillenwater, Charmion Cruickshank-Quinn, Wanda Kay O'Neal, Nichole Reisdorph, Irina Petrache, Yonghua Zhuang, Wassim W. Labaki, Jeffrey L. Curtis, James Wells, Stephen I. Rennard, Katherine A. Pratte, Prescott Woodruff, Kathleen A. Stringer, Katerina Kechris, Russell P. Bowler

Journal Articles: Pulmonary & Critical Care Med

Smoking causes chronic obstructive pulmonary disease (COPD). Though recent studies identified a COPD metabolomic signature in blood, no large studies examine the metabolome in bronchoalveolar lavage (BAL) fluid, a more direct representation of lung cell metabolism. We performed untargeted liquid chromatography-mass spectrometry (LC-MS) on BAL and matched plasma from 115 subjects from the SPIROMICS cohort. Regression was performed with COPD phenotypes as the outcome and metabolites as the predictor, adjusted for clinical covariates and false discovery rate. Weighted gene co-expression network analysis (WGCNA) grouped metabolites into modules which were then associated with phenotypes. K-means clustering grouped similar subjects. We detected …

It's More Than Low Bmi: Prevalence Of Cachexia And Associated Mortality In Copd, Merry-Lynn N. Mcdonald, Emiel F.M. Wouters, Erica Rutten, Richard Casaburi, Stephen I. Rennard, David A. Lomas, Marcas Bamman, Bartolome Celli, Alvar Agusti, Ruth Tal-Singer, Craig P. Hersh, Mark Dransfield, Edwin K. Silverman

Journal Articles: Pulmonary & Critical Care Med

BACKGROUND: Cachexia is associated with increased mortality risk among chronic obstructive pulmonary disease (COPD) patients. However, low body mass index (BMI) as opposed to cachexia is often used, particularly when calculating the BODE (BMI, Obstruction, Dyspnea and Exercise) index. For this reason, we examined mortality using a consensus definition and a weight-loss definition of cachexia among COPD cases and compared two new COPD severity indices with BODE.

METHODS: In the current report, the consensus definition for cachexia incorporated weight-loss > 5% in 12-months or low BMI in addition to 3/5 of decreased muscle strength, fatigue, anorexia, low FFMI and inflammation. The …

The Risk Of New-Onset Epilepsy And Refractory Epilepsy In Older Adult Stroke Survivors, Jorge G. Burneo, Tresah C. Antaya, Britney N. Allen, Andrea Belisle, Salimah Z. Shariff, Gustavo Saposnik

Neuroepidemiology Research Unit Project Summaries

Research Summary: Key Findings

• Stroke is a common cause of epilepsy in older adults, but little is known about stroke-related epilepsy or its outcomes in this population.
• 1.1% of older adult stroke survivors developed epilepsy in this study, of whom 12.9% developed refractory epilepsy, indicating that this population is particularly responsive to treatment.
• Over 85% of deaths in this population are not due to stroke or epilepsy.

Variability And Stability Of Gait In Stoke Survivors, Jemima Kennedy, Hala Osman

Undergraduate Research Posters 2019

Individuals who have survived a stroke have unstable gait due to poor balance control which jeopardizes the safety of that individual. We analyzed the stability and variability of gait before and after exercise- interventions for individuals who have survived stroke to determine the effect of these interventions on the individual as well as any correlation between measured and perceived stability. 9 randomly assigned participants participated in three exercise interventions: (a) clinical physical therapy, (b) reactive slipping, and (c) video gaming. Kinematics of the participant were obtained using motion analysis and a treadmill equipped with force plates. There was an overall …

The Right Vasopressor At The Right Time Does Early Use Of Vasopressors Decrease Morbidity And Mortality In Septic Shock, Michael Kittok

Theses and Graduate Projects

Sepsis and septic shock is a disease process that carries a high mortality rate and is responsible for a large portion of healthcare expenditures in the United States. The Surviving Sepsis Campaign has been working to decrease the mortality of sepsis since 2001. Their mission is two-fold; providing evidence based guidelines to help direct treatment, and raising awareness to healthcare providers and patients about sepsis. A main goal in treating sepsis is to reverse the hypoperfused state by giving crystalloid fluids and administering vasopressors, specifically norepinephrine, after patients have received adequate fluids. Would modifying this treatment by giving a combination …

Barriers That Prevent Initial Prescription Of Hydroxyurea In Sickle Cell Disease, Harini Halaharvi

Theses and Graduate Projects

Sickle cell disease (SCD) is one of the most common inherited red blood cell disorders, affecting millions of people worldwide. According to CDC, SCD affects approximately 100,000 Americans and is most prominent in people with ancestry from sub-Saharan Africa, Spanish- speaking regions in the Western Hemisphere (South America, the Caribbean, and Central America), Saudi Arabia, India, and Mediterranean countries such as Turkey, Greece, and Italy. 1 out of every 365 black or African-American and 1 out of every 16,300 Hispanic-American children are born with SCD.1 Approximately 6,000 Latin Americans are born with SCD annually in both US and Latin American …

Efficacy Of A Single Dose Hpv Vaccine And Its Potential Outcomes In Low-Income Countries, Brooke Schramm

Theses and Graduate Projects

Cervical cancer is a leading worldwide cause of cancer mortality in women and disproportionately burdens low-income countries. Human papillomavirus (HPV) has been proven as the primary cause of genital warts, some oropharyngeal cancers, and anogenital cancers such as cervical, vulvar, anal, and penile malignancies. HPV vaccination coupled with regular HPV screenings are major strategies for preventing HPV infections, but with high costs and infrastructure complexities associated with current vaccination and screening programs, many world regions are unable to provide protection against HPV infection and its sequalae. If unabated, cervical cancer incidence is expected to increase worldwide over the coming decades …

Physical Activity Guidelines In Patients With Hemophilia: Benefits, Barriers, And Recommendations, Chelsea Johnson

Theses and Graduate Projects

Hemophilia describes a group of genetic disorders that lead to the dysfunction of proteins involved in the clotting cascade.1 These proteins, also known as coagulation factors, are required to form clots and ultimately cessate bleeding. Although there are three distinct forms of congenital hemophilia (hemophilia A, hemophilia B, and hemophilia C), the affected proteins (factor VIII, factor IX, and factor XI, respectively), are within the same pathway leading to the formation of a clot. In condensed terms, each of these factors play a role in the ultimate activation of thrombin, which activates fibrinogen to form a fibrin clot and solidify …

Climate Change And Dengue Fever: Are They Connected?, Chelsey Rilatos

Theses and Graduate Projects

Dengue virus is the most common mosquito born disease worldwide and is an endemic infection in many tropical and subtropical habitats, especially areas where poor public health infrastructure makes it difficult to control. According to the Centers for Disease Control and Prevention (CDC), the dengue virus is a leading cause of febrile illness among travelers returning from Latin America. The dengue virus is a member of the family Flaviviridae and is transmitted to humans by the vector Aedes mosquitos, most frequently the Aedes aegypti mosquito, and secondarily by Aedes albopictus. Dengue infection results in a spectrum of clinical disease, ranging …

Development Of Luminescent Tools For Use In The Study Of Mycobacterium Tuberculosis, Krista A. Moore

Honors Undergraduate Theses

Mycobacterium tuberculosis (Mtb), the causative agent of tuberculosis, is a growing problem worldwide due to the emergence of multi-drug resistant and extensively-drug resistant strains of the bacteria. A key to combatting the spread of these strains lies in the understanding of gene expression occurring in Mtb. This study focuses on the development and optimization of a luciferase-based bioluminescent transcriptional reporter that can be used to monitor gene expression in Mtb. The luminescent signal emitted from the reporter can be measured and correlated with the level of transcription of certain genes. This study focuses specifically on a gene called whiB7 which …

Effect Of Propionic Acid-Derivative Ibuprofen On Neural Stem Call Differentiation; A Potential Link To Autism Spectrum Disorder, Aseelia Samsam

Honors Undergraduate Theses

Propionic acid (PPA) is a short chain fatty acid that is produced by the human gut microbiome. Propionate, butyrate and acetates are the end products of the fermentation of the complex carbohydrates by human gut friendly microbiome and are being used as sources of energy in our body. PPA is used as a food preservative against molds in various daily products and has been implicated in the pathogenesis of autism. In a recent study we showed that PPA in human neuronal stem cell (NSC) culture increases the astrocyte population and decreases the neuronal number and increases the inflammatory cytokines. In …

Role Of Amyloid Precursor Protein In Neuroregeneration On An In Vitro Model In Alzheimer's Patient-Specific Cell Lines, Lina S. Bedoya Martinez

Honors Undergraduate Theses

Alzheimer's disease (AD) leads to neurodegeneration resulting in cognitive and physical impairments. AD is denoted by accumulation of intracellular neurofibrillary tangles, known as tau, and extracellular plaques of the amyloid beta protein (Aβ). Aβ results from the proteolytic cleavage of the amyloid precursor protein (APP) by β- and gamma-secretases in the amyloidogenic pathway. Although, Aβ has been widely studied for neurodegeneration, the role of APP in both, the healthy and diseased conditions, has not yet been entirely understood. The function that APP has in neural stem cell (NSC) proliferation, differentiation, and migration during adult neurogenesis has been previously studied. Additionally, …

The Envelope Stress Response In Sedimentation-Resistant Escherichia Coli, Neel K. Shah

Honors Undergraduate Theses

Previous research discovered the existence of sedimentation-resistant mutants of E. coli. Genomic studies revealed that these mutants resisted sedimentation due to independent modifications to genes that influenced the Rcs signal transduction pathway, causing increased secretion of an exopolysaccharide capsule comprised primarily of colanic acid. The Rcs system is responsible for detecting envelope stressors; consequently, ampicillin and osmotic stress were used to perturb the cellular envelope and study the response of the mutants compared to wild-type cells. It was found that the overproduction of colanic acid in the mutants confers some resistance to envelope stress; however, the mutants still behaved …

Mitochondrial Superoxide Disrupts The Metabolic And Epigenetic Landscape Of Cd4, Cassandra M. Moshfegh, Christopher W. Collins, Venugopal Gunda, A. Vasanthakumar, J. Z. Cao, Pankaj K. Singh, L. A. Godley, Adam J. Case

Journal Articles: Eppley Institute

While the role of mitochondrial metabolism in controlling T-lymphocyte activation and function is becoming more clear, the specifics of how mitochondrial redox signaling contributes to T-lymphocyte regulation remains elusive. Here, we examined the global effects of elevated mitochondrial superoxide (O₂^-) on T-lymphocyte activation using a novel model of inducible manganese superoxide dismutase (MnSOD) knock-out. Loss of MnSOD led to specific increases in mitochondrial O₂^- with no evident changes in hydrogen peroxide (H₂O₂), peroxynitrite (ONOO^-), or copper/zinc superoxide dismutase (CuZnSOD) levels. Unexpectedly, both mitochondrial and glycolytic metabolism showed significant reductions …