Medical Specialties Commons^™

Neutrophil To Lymphocyte Ratio: A Prognostic Indicator For Astronaut Health, Amber M. Paul, Siddhita D. Mhatre, Egle Cekanaviciute, Ann-Sofie Schreurs, Candice G.T. Tahimic, Ruth K. Globus, Brian Crucian, Sharmila Bhattacharya

Publications

Short-term and long-term spaceflight missions can cause immune system dysfunction in astronauts. Recent studies indicate elevated white blood cells (WBC) and polymorphonuclear neutrophils (PMN) in astronaut blood, along with unchanged or reduced lymphocyte counts, and reduced T cell function, during short-(days) and long-(months) term spaceflight. A high PMN to lymphocyte ratio (NLR) can acts as a strong predictor of poor prognosis in cancer, and as a biomarker for subclinical inflammation in humans and chronic stress in mouse models, however, the NLR has not yet been identified as a predictor of astronaut health during spaceflight. For this, complete blood cell count …

Potential Role Of Csf Cytokine Profiles In Discriminating Infectious From Non-Infectious Cns Disorders., Danielle Fortuna, D. Craig Hooper, Amity L. Roberts, Larry A. Harshyne, Michelle Nagurney, Mark T. Curtis

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Current laboratory testing of cerebrospinal fluid (CSF) does not consistently discriminate between different central nervous system (CNS) disease states. Rapidly distinguishing CNS infections from other brain and spinal cord disorders that share a similar clinical presentation is critical. New approaches focusing on aspects of disease biology, such as immune response profiles that can have stimulus-specific attributes, may be helpful. We undertook this preliminary proof-of-concept study using multiplex ELISA to measure CSF cytokine levels in various CNS disorders (infections, autoimmune/demyelinating diseases, lymphomas, and gliomas) to determine the potential utility of cytokine patterns in differentiating CNS infections from other CNS diseases. Both …

Forecast Or Fall: Prediction's Importance To Postural Control, Chris J. Dakin, David A.E. Bolton

Kinesiology and Health Science Faculty Publications

To interact successfully with an uncertain environment, organisms must be able to respond to both unanticipated and anticipated events. For unanticipated events, organisms have evolved stereotyped motor behaviors mapped to the statistical regularities of the environment, which can be trigged by specific sensory stimuli. These 'reflexive' responses are more or less hardwired to prevent falls and represent, maybe, the best available solution to maintaining posture given limited available time and information. With the gift of foresight, however, motor behaviors can be tuned or prepared in advance, improving the ability of the organism to compensate for, and interact with, the changing …

Mediterranean Diet Adherence And Rate Of Cerebral Aβ-Amyloid Accumulation: Data From The Australian Imaging, Biomarkers And Lifestyle Study Of Ageing, Stephanie Rainey-Smith, Yian Gu, Samantha Gardener, James D Doecke, Victor L Villemagne, Belinda M Brown, Kevin Taddei, Simon M Laws, Hamid R. Sohrabi, Michael Weinborn, David Ames, Christopher Fowler, S Lance Macaulay, Paul Maruff, Colin L Masters, Olivier Salvado, Christopher C Rowe, Nikolaos Scarmeas, Ralph N. Martins

Research outputs 2014 to 2021

Accumulating research has linked Mediterranean diet (MeDi) adherence with slower cognitive decline and reduced Alzheimer's disease (AD) risk. However, no study to-date has examined the relationship between MeDi adherence and accumulation of cerebral Aβ-amyloid (Aβ; a pathological hallmark of AD) in older adults. Cognitively normal healthy control participants of the Australian Imaging, Biomarkers and Lifestyle (AIBL) Study of Ageing completed the Cancer Council of Victoria Food Frequency Questionnaire at baseline, which was used to construct a MeDi score for each participant (score range 0-9; higher score indicating higher adherence). Cerebral Aβ load was quantified by Pittsburgh Compound B positron emission …

Conference Proceedings: Aurora Scientific Day 2018

Journal of Patient-Centered Research and Reviews

This journal supplement includes selected abstracts from among the more than 50 presented at the 44th annual Aurora Scientific Day research symposium. Held May 25, 2018, in Milwaukee, Wisconsin, Aurora Scientific Day provides a forum for original research conducted by faculty, fellows, residents, and other allied health professionals affiliated with Aurora Health Care, an integrated health system with hospitals and clinics in Wisconsin and Illinois.

Stress-Induced Heat Shock Protein 40 And Immune Function In Altered Gravity, Amber M. Paul, Brooke D. Shepard, Sharmila Bhattacharya

Publications

In space, astronauts are more susceptible to pathogens, viral reactivation and immunosuppression, which poses limits to their health and the mission. Interestingly, during space flight, stress-inducible heat shock proteins (HSP) are robustly induced, and the overexpression of HSPs have been implicated in immune dysregulation, therefore HSPs may be critically involved in regulating immune homeostasis. HSP40/DNAJ1 plays a major role in proper protein translation and folding. Its loss of function has been implicated in susceptibility to microbial infection, while its overexpression has been implicated in autoimmunity, collectively suggesting its complicated, but necessary, role in maintaining immunological function. To determine the role …

Manipulation Of Human Verticality Using High-Definition Transcranial Direct Current Stimulation, Taiza E. G. Santos, Diandra B. Favoretto, Iman Ghodratti Toostani, Diego C. Nascimento, Brunna P. Rimoli, Eduardo Bergonzoni, Tenysson Will Lemos, Dennis Quangvinh Truong, Alexandre C. B. Delbem, Bahador Makkiabadi, Renato Moraes, Francisco Louzada, Marom Bikson, Joao P. Leite, Dylan J. Edwards

Publications and Research

Background: Using conventional tDCS over the temporo-parietal junction (TPJ) we previously reported that it is possible to manipulate subjective visual vertical (SVV) and postural control. We also demonstrated that high-definition tDCS (HD-tDCS) can achieve substantially greater cortical stimulation focality than conventional tDCS. However, it is critical to establish dose-response effects using well-defined protocols with relevance to clinically meaningful applications.

Objective: To conduct three pilot studies investigating polarity and intensity-dependent effects of HD-tDCS over the right TPJ on behavioral and physiological outcome measures in healthy subjects. We additionally aimed to establish the feasibility, safety, and tolerability of this stimulation protocol.

Methods: …

Dual Inhibition Of Bcl-2/Bcl-Xl And Xpo1 Is Synthetically Lethal In Glioblastoma Model Systems, Enyuan Shang, Yiru Zhang, Chang Shu, Chiaki Tsuge Ishida, Elena Bianchetti, Mike-Andrew Westhoff, Georg Karpel-Massler, Markus D. Siegelin

Publications and Research

XPO1 has recently emerged as a viable treatment target for solid malignancies, including glioblastoma (GBM), the most common primary malignant brain tumor in adults. However, given that tumors become commonly resistant to single treatments, the identification of combination therapies is critical. Therefore, we tested the hypothesis that inhibition of anti-apoptotic Bcl-2 family members and XPO1 are synthetically lethal. To this purpose, two clinically validated drug compounds, the BH3-mimetic, ABT263, and the XPO1 inhibitor, Selinexor, were used in preclinical GBM model systems. Our results show that inhibition of XPO1 reduces cellular viability in glioblastoma cell cultures. Moreover, addition of ABT263 significantly …

Leukemia Inhibitory Factor Modulates The Peripheral Immune Response In A Rat Model Of Emergent Large Vessel Occlusion, Stephanie M. Davis, Lisa A. Collier, Edric D. Winford, Christopher C. Leonardo, Craig T. Ajmo Jr., Elspeth A. Foran, Timothy J. Kopper, John C. Gensel, Keith R. Pennypacker

Neurology Faculty Publications

Background: The migration of peripheral immune cells and splenocytes to the ischemic brain is one of the major causes of delayed neuroinflammation after permanent large vessel stroke. Other groups have demonstrated that leukemia inhibitory factor (LIF), a cytokine that promotes neural cell survival through upregulation of antioxidant enzymes, promotes an anti-inflammatory phenotype in several types of immune cells. The goal of this study was to determine whether LIF treatment modulates the peripheral immune response after stroke.

Methods: Young male (3 month) Sprague-Dawley rats underwent sham surgery or permanent middle cerebral artery occlusion (MCAO). Animals were administered LIF (125 μg/kg) or …

Cd133 Expression In Glioblastoma Multiforme: A Literature Review, Syed Ijlal Ahmed, Gohar Javed, Altaf Ali Laghari, Syeda Beenish Bareeqa, Saba Farrukh, Shajeeah Zahid, Syeda Sana Samar, Kashif Aziz

Section of Neurosurgery

Glioblastoma, also known as glioblastoma multiforme (GBM), is the most common primary brain tumor. Extensive research has been carried out to discover the factors associated with the course and progression of GBM. CD133 is a glycoprotein antigen found in normal and malignant tissues. CD133 has been recognized as a marker for the growth of cancer cells. The association between this tissue marker and GBM is being investigated. The aim of this review was to evaluate the role of CD133 as a tumor marker for the prognosis of GBM.

The Limbic System And Christian Sanctification, Tony N. Jelsma

Faculty Work Comprehensive List

"Even when our limbic system conveys strong motivations to act in a particular way, we still have the ability and responsibility to think and act in a manner that pleases God."

Posting about the complexity of the human brain from In All Things - an online journal for critical reflection on faith, culture, art, and every ordinary-yet-graced square inch of God’s creation.

https://inallthings.org/the-limbic-system-and-christian-sanctification/

The Sleep Quality Using Pittsburgh Sleep Quality Index., Khushbakht Khan Awan, Muhammad Talha Farooq, Pashma Farooq, Muhammad Yasir Tarar

Pakistan Journal of Neurological Sciences (PJNS)

Good quality and enough sleep are necessary for the proper cognitive performance of medical students. There is a wide prevalence of sleep disturbances among Pakistani medical students and there is a need to spread awareness regarding the problems concerning sleep patterns. OBJECTIVE: To determine the quality of sleep among first and final year medical students. METHODOLOGY: It’s a cross sectional study conducted at Services Institute of Medical College Lahore from the 10th May to 15th June 2016.A total of 300 Male and female medical students of first and final year were administered PSQI and their socio-demographic profile along with academic …

Trunk Control And Gross Motor Outcomes After Body Weight Supported Treadmill Training In Young Children With Severe Cerebral Palsy: A Non-Experimental Case Series, Megan Flores, Carolyn P Da Silva

Physical Therapy Collection

OBJECTIVE: To explore the impact of a body weight supported treadmill training (BWSTT) intervention on postural control and gross motor function in three young children with cerebral palsy (CP) classified as Gross Motor Function Classification System (GMFCS) levels IV or V.

METHOD: Children (N = 3) between the ages of 2-3 years who were diagnosed with CP classified as GMFCS levels IV and V participated in BWSTT three times per week. The Segmental Assessment of Trunk Control (SATCo) and the gross motor function measure (GMFM-66) were assessed before and after the 6-week intervention.

RESULTS: Final testing revealed …

Third Ventricular Tumors: A Comprehensive Literature Review, Syed Ijlal Ahmed, Gohar Javed, Altaf Ali Laghari, Syeda Benish Bareeqa, Kashif Aziz, Mehreen Khan, Syeda Sana Samar, Raja Azhar Humera, Alizay Rashid Khan, Muhammad Osama Farooqui, Amir Shahbaz

Section of Neurosurgery

Third ventricle tumors are uncommon and account for 0.6 - 0.9% of all the brain tumors. Tumors of the third ventricle are classified into primary tumors, such as colloid cysts, choroid plexus papillomas, and ependymomas, or secondary tumors, such as craniopharyngiomas, optic nerve gliomas, pineal tumors, and meningiomas. Third ventricular tumors are uncommon, and their treatment involves significant morbidity and mortality. The colloid cyst has a better surgical outcome and many approaches are available to achieve a complete cure. Choroid plexus papilloma is also a common tumor documented with its treatment majorly based on surgical resection. In addition to multiple …

Outcome Of Decompressive Craniectomy In Traumatic Closed Head Injury, Altaf Ali Laghari, Muhammad Ehsan Bari, Muhammad Waqas, Syed Ijlal Ahmed, Karim Rizwan Nathani, Wardah Moazzam

Section of Neurosurgery

Objective: The aim of the current study was to observe functional outcomes of patients undergoing decompressive craniectomy (DC) for raised intracranial pressure (ICP) after blunt head injury and to assess possible predictive factors.
Methodology: This study was a prospective cohort study which was conducted at Aga Khan University Hospital, Karachi over a period of 2 years (January 2015-December 2016). Adult patients, aged between 15 and 65 years of both genders undergoing DC during the study period were selected. Outcomes of DC were assessed at an interval of 3 months following injury using the Glasgow outcome score. The data were analyzed …

Tumour Treating Fields (Ttfs) For Recurrent And Newly Diagnosed Glioblastoma Multiforme, Farhan Ahmed, Muhammad Shahzad Shamim

Section of Neurosurgery

In the last decade, significant advances have been made in Glioblastoma Multiforme treatment with the novel use of alternating electrical fields, also termed as tumour treating fields (TTFs). This modality has shown promising results in recurrent and newly diagnosed GBM patients, and according to some, may soon be considered an addition to the previously known 'trifecta' of GBM standard of care, i.e., surgery, chemo and radiation therapy.Here we review the existing data on TTF for both recurrent and newly diagnosed GBM. This review does not discuss the limitations of TTF, especially from compliance and cost point of view.

The Global Dilemma: Standardization Of Nonoperative Treatment., Karsten Wiechert, Jeffrey C Wang, Jens R Chapman

Articles, Abstracts, and Reports

No abstract provided.

A Real-World Comparison Of Relapse Rates, Healthcare Costs And Resource Use Among Patients With Multiple Sclerosis Newly Initiating Subcutaneous Interferon Beta-1a Versus Oral Disease-Modifying Drugs., James D Bowen, Chris M Kozma, Megan M Grosso, Amy L Phillips

Articles, Abstracts, and Reports

Background: Administrative-claims data enable comparative effectiveness assessment using large numbers of patients treated in real-world settings.

Objective: To evaluate real-world relapses, healthcare costs and resource use in patients with MS newly initiating subcutaneous interferon beta-1a (sc IFNβ-1a) v. oral disease-modifying drugs (DMDs: dimethyl fumarate, fingolimod, teriflunomide).

Methods: Patients from an administrative claims database (1 Jan 2012-31 Dec 2015) were selected if they: were 18-63 years old; had an MS diagnosis; had newly initiated sc IFNβ-1a, dimethyl fumarate, fingolimod, or teriflunomide (first claim = index); had no evidence of DMD 12-months pre-index; and had 12-month eligibility pre- and post-index. Relapse was …

Manifestations Of Hypomelanosis Of Ito, Ana C. Albuja, Arpan Shrivastava, Gulam Q. Khan

Neurology Faculty Publications

No abstract provided.

Coordination Of Inpatient And Outpatient Care For Neurology Patients Undergoing Epilepsy Monitoring, Sara Schrock, Michelle Beane, Kathryn Cope, Mark Parker, Suneela Nayak, Ruth Hanselman, Stephen Tyzik, Amy Sparks, Brendan Lilley

Operations Transformation

ORGANIZING A SYSTEM TO CONSOLIDATE EPILEPSY REFERRALS TO AN OUTPATIENT NEUROLOGY PRACTICE

An outpatient neurology practice was experiencing delayed or lost referrals for epilepsy monitoring. This delay was leading many patients to suffer unnecessary and unmanaged seizures and, in some cases, frequent trips to the emergency department.

As a result, a team consisting of the neurology practice and neuro-navigators used baseline metrics to demonstrate the current state of the problem and conducted a root cause analysis that outlined several causes. A number of countermeasures were initiated with the goal of decreasing referral misses.

Post the initiation of two KPIs, a …

Strategies To Increase Early Discharges To Decrease Hospital Length Of Stay And Avoidable Patient Days For Neuro-Spine Patients, Corey Fravert, Joy Moody, Mark Parker, Suneela Nayak, Stephen Tyzik, Ruth Hanselman, Amy Sparks

Operations Transformation

STRATEGIES TO INCREASE MORNING DISCHARGES IN AN ACADEMIC TERTIARY HOSPITAL

Delays in patient discharge result in numerous negative impacts on the health care system. Amongst those are a reduced patient flow and satisfaction, long wait times, and physician/ staff frustration.

An inpatient neurotrauma unit initiated a performance improvement project that utilized a multidisciplinary approach to identify barriers to discharge and coordinate a discharge plan focused on neurospine patients.

A root cause analysis was conducted to collect reasons that these patients were not discharged by 11:00am. As a result of the findings, 4 performance improvement plans were created. Subsequent data collection …

Understanding Water Diffusion In Experimental Spinal Cord Injury Remote From Injury Epicenter, Alice Motovylyak

Dissertations (1934 -)

Diffusion tensor imaging (DTI) has demonstrated success as a biomarker of spinal cord injury (SCI) severity as shown from numerous preclinical studies. However, artifacts from stabilization hardware at the lesion have precluded its use for longitudinal assessments. Previous research has documented ex vivo diffusion changes in the spinal cord both caudal and rostral to the injury epicenter. The aim of this dissertation was to quantify the structural changes that lead to different diffusion measures in the rat cervical spinal cord after a thoracic contusion injury in an attempt to find a biomarker of injury. Animals received a thoracic contusion injury …

Translational Evaluation Of Acid/Base And Electrolyte Alterations In Rodent Model Of Focal Ischemia, Sarah R. Martha, Lisa A. Collier, Stephanie M. Davis, Hilary A. Seifert, Christopher C. Leonardo, Craig T. Ajmo, Elspeth A. Foran, Justin F. Fraser, Keith R. Pennypacker

Neurology Faculty Publications

BACKGROUND AND PURPOSE: Acid/base and electrolytes could provide clinically valuable information about cerebral infarct core and penumbra. We evaluated associations between acid/base and electrolyte changes and outcomes in 2 rat models of stroke, permanent, and transient middle cerebral artery occlusion.

METHODS: Three-month old Sprague-Dawley rats underwent permanent or transient middle cerebral artery occlusion. Pre- and post-middle cerebral artery occlusion venous samples for permanent and transient models provided pH, carbon dioxide, oxygen, glucose, and electrolyte values of ionized calcium, potassium, and sodium. Multiple regression determined predictors of infarct volume from these values, and Kaplan-Meier curve analyzed morality between permanent and transient …

Statistical Analysis Plan (Sap) For The Very Early Rehabilitation In Speech (Verse) After Stroke Trial: An International 3-Arm Clinical Trial To Determine The Effectiveness Of Early, Intensive, Prescribed, Direct Aphasia Therapy, Erin Godecke, Tapan Rai, Dominique A Cadilhac, Elizabeth Armstrong, Sandy Middleton, Natalie Ciccone, Anne Whitworth, Miranda L Rose, Audrey Holland, Fiona Ellery, Graeme J Hankey, Julie Bernhardt

Research outputs 2014 to 2021

Background Limited evidence exists to support very early intensive aphasia rehabilitation after stroke. VERSE is a PROBE trial designed to determine whether two types of intensive aphasia therapy, beginning within 14 days of acute stroke, provide greater therapeutic and cost-effectiveness than usual care. Objective To publish the detailed statistical analysis plan for the VERSE trial prior to unblinding. This statistical analysis plan was based on the published and registered VERSE trial protocol and was developed by the blinded steering committee and management team, led by the trial statistician. This plan was developed using outcome measures and trial data collection forms. …

Bath-Related Headache, Aliza Kumpinsky, Stephanie J. Nahas

Department of Neurology Faculty Papers

PURPOSE OF REVIEW: The purpose of this review is to summarize the most up-to-date literature on bath-related headache, a rare disorder.

RECENT FINDINGS: Initially described in middle-aged Asian women, it is now reported in a wider demographic. More information is available about the pathophysiology of bath-related headache, including its classification as a subtype of reversible cerebral vasoconstriction syndrome (RCVS). Nimodipine can be effective in patients both with and without vasospasm. Bath-related headache is a rare form of thunderclap headache. Although its mechanism is still unclear, it is associated with vasospasm and RCVS. Controlled trials investigating the use of nimodipine and …

Comprehensive Review Of Spinal Neurenteric Cysts With A Focus On Histopathological Findings., Woong Kee Baek, Stefan Lachkar, Joe Iwanaga, Rod J Oskouian, Marios Loukas, W Jerry Oakes, R Shane Tubbs

Articles, Abstracts, and Reports

Among the occult spinal dysraphisms, neurenteric cysts (NECs) are rare and are thought to arise due to a failure of the separation of the primitive endoderm and ectoderm. Patients experience various neurological symptoms depending on the location of the lesion. As the epithelial morphology of NECs share similarities with other intracranial and intraspinal cystic growths, the definitive diagnosis of NEC can be made after a histochemical analysis with endodermal markers. Complete resection is associated with the lowest disease recurrence rate.

Tranexamic Acid For Significant Traumatic Brain Injury (The Crash-3 Trial): Statistical Analysis Plan For An International, Randomised, Double-Blind, Placebo-Controlled Trial, Ian Roberts, Antonio Belli, Amy Brenner, Rizwana Chaudhri, Bukola Fawole, Tim Harris, Rashid Jooma, Abda Mahmood, Temitayo Shokunbi, Haleema Shakur, Crash-3 Trial Collaborators

Section of Neurosurgery

Background: Worldwide, traumatic brain injury (TBI) kills or hospitalises over 10 million people each year. Early intracranial bleeding is common after TBI, increasing the risk of death and disability. Tranexamic acid reduces blood loss in surgery and death due to bleeding in trauma patients with extra-cranial injury. Early administration of tranexamic acid in TBI patients might limit intracranial bleeding, reducing death and disability. The CRASH-3 trial aims to provide evidence on the effect of tranexamic acid on death and disability in TBI patients. We will randomly allocate about 13,000 TBI patients (approximately 10,000 within 3 hours of injury) to an …

Sparse Recurrent Excitatory Connectivity In The Microcircuit Of The Adult Mouse And Human Cortex., Stephanie C Seeman, Luke Campagnola, Pasha A Davoudian, Alex Hoggarth, Travis A Hage, Alice Bosma-Moody, Christopher A Baker, Jung Hoon Lee, Stefan Mihalas, Corinne Teeter, Andrew L Ko, Jeffrey G Ojemann, Ryder P Gwinn, Daniel L Silbergeld, Charles Cobbs, John Phillips, Ed Lein, Gabe Murphy, Christof Koch, Hongkui Zeng, Tim Jarsky

Articles, Abstracts, and Reports

Generating a comprehensive description of cortical networks requires a large-scale, systematic approach. To that end, we have begun a pipeline project using multipatch electrophysiology, supplemented with two-photon optogenetics, to characterize connectivity and synaptic signaling between classes of neurons in adult mouse primary visual cortex (V1) and human cortex. We focus on producing results detailed enough for the generation of computational models and enabling comparison with future studies. Here, we report our examination of intralaminar connectivity within each of several classes of excitatory neurons. We find that connections are sparse but present among all excitatory cell classes and layers we sampled, …

A Median Artery Of The Corpus Callosum., Juan J Altafulla, Emily A Simonds, Graham Dupont, Stefan Lachkar, Zachary Litvack, Joe Iwanaga, R Shane Tubbs

Articles, Abstracts, and Reports

The anterior communicating artery is one of the main components of the vascular network that delivers blood to the brain. Therefore, a good understanding of the normal anatomy and its variations is important to neurologists, neurosurgeons, and other health care providers dealing with the central nervous system. Here, we present a case of a median artery of the corpus callosum found in a cadaver, with consideration of cerebral hemodynamics implications.

New Functions For The Proprioceptive System In Skeletal Biology, Ronen Blecher, Lia Heinemann-Yerushalmi, Eran Assaraf, Nitzan Konstantin, Jens R. Chapman, Timothy C. Cope, Guy S. Bewick, Robert W. Banks, Elazar Zelzer

Neuroscience, Cell Biology & Physiology Faculty Publications

Muscle spindles and Golgi tendon organs (GTOs) are two types of sensory receptors that respond to changes in length or tension of skeletal muscles. These mechanosensors have long been known to participate in both proprioception and stretch reflex. Here, we present recent findings implicating these organs in maintenance of spine alignment as well as in realignment of fractured bones. These discoveries have been made in several mouse lines lacking functional mechanosensors in part or completely. In both studies, the absence of functional spindles and GTOs produced a more severe phenotype than that of spindles alone. Interestingly, the spinal curve phenotype, …