Medical Specialties Commons^™

Soft X-Ray And Susceptibility Based Magnetic Resonance Imaging To Map Iron Distribution In Apples: Initial Results To Model Iron Storage In Water-Deficient Or Dehydrated Biological Tissue, Subhendra N. Sarkar, Eric Lobel, Evans Lespinasse, Zoya Vinokur, Analia Basilicata, Sonia Orellana, Maria Orellana, Aaliyah Salmon, Joanna Syska, Aravis Mcbroom, Jian Wang, Anam Riaz, Jodi-Ann Douglas

Publications and Research

Radiology departments have contributed significantly to greenhouse gases including release of toxic imaging contrast media to environment. We feel Radiology also has several spectroscopy and imaging tools that may apply to monitor and support cleaner environmental goals. The current manuscript is one of the firsts to prompt Radiology to move in that direction by non invasive imaging of bio metals that are less abundant in biological tissues but play key roles as co-factors in tissue structure and function. Conventional analytical tools are mostly invasive and cannot characterize the native oxidation states of bio metals. We chose carbohydrate matrix of metal-rich …

The Global Implementation Of Dolutegravir For Hiv Treatment, Matthew L. Romo

Dissertations and Theses

Background
Dolutegravir, an integrase strand transfer inhibitor, is now recommended by international guidelines as part of preferred antiretroviral therapy (ART) regimens for people living with HIV. In low- and middle-income countries (LMICs), HIV treatment programs are transitioning from non-nucleoside reverse transcriptase inhibitors (NNRTIs) to dolutegravir because of its superior efficacy and tolerability, and high genetic barrier to HIV drug resistance. Along with the optimism surrounding widespread dolutegravir use, key questions regarding its implementation have emerged. In this dissertation, I sought to achieve the following specific aims: Aim 1: Characterize dolutegravir uptake in LMICs and identify potential disparities related to sex …

Genomic Epidemiology Of Clostridium Difficile Colonization And Transmission In An Intensive Care Unit Cohort, Brianne Ciferri

Dissertations and Theses

Abstract

Genomic epidemiology of Clostridium difficile colonization and transmission in an intensive care unit cohort

by Brianne Ciferri, MPH

Advisor: C. Mary Schooling, PhD

Introduction: Clostridiodes difficile (C. difficile) is a leading cause of healthcare associated infections (HAI) in the United States and responsible for an estimated incidence of 223,900 cases and 12,800 deaths per year^1,2. C. difficile can cause gastrointestinal illness with symptoms ranging from mild diarrheal illness to a life-threatening condition. C. difficile is an opportunistic pathogen in which spores can live in an undisturbed dormant state within the intestinal tract and become …

Racial And Ethnic Data Reported For Peanut Allergy Epidemiology Do Little To Advance Its Cause, Treatment, Or Prevention, Nigel Mark Thomas

Publications and Research

No abstract provided.

Hispanic Acculturation: Associations With Family Planning Behaviors And Attitudes, Rachel Chamberlain, Mary Fatehi, Joshua Fogel, Jacob Kulyn

Publications and Research

Introduction. The purpose of this study was to investigate the association of Hispanic acculturation in the U.S. with family planning behaviors and attitudes.

Methods. Surveys of 225 Hispanic women were collected that used acculturation measures of number of years lived in the U.S. and the Short Acculturation Scale for Hispanics (SASH), along with questions about family planning behaviors, including birth control use, sterilization, and abortion.

Results. SASH-Language statistically differed (p = 0.03) where those with ‘yes birth control’ had significantly lower English acculturation (M = 6.10, SD = 1.77) than those with ‘no birth control’ (M = 7.00, SD = …

Hips That Harm: When Medical Devices Fail Women, Sophie N. Putka

Capstones

Medical devices that save the lives of thousands of Americans each year advance at a rapid pace - but some of them consistently leave women behind. When it comes to joint replacements and even heart devices, women have worse health outcomes. Behind this preventable problem is a system that overlooks women from start to finish. Female bodies are different from male bodies, but women are often underrepresented in medical trials for device approval. Women’s participation in clinical testing for devices has increased, but there’s rarely a detailed analysis of performance by sex, and even less information on women by race …

Gender And Racial Disparity For Hospital Emergency Service Usage In Usa: A Quantitative Analysis For Various Age Groups During 2010–2017., Subhendra N. Sarkar, Anthony F. Devito, Evans Lespinasse, Faisal Khosa

Publications and Research

Background: Annually emergency department (ED) services are utilized by more than 100 million Americans making ED usage trends important determinants of healthcare quality, outcomes and cost. Previous workers have demonstrated the existence of disparity in various healthcare services in USA although a comprehensive analysis has not been undertaken. Dahlgren and Whitehead rainbow model has offered insights for multiple factors of influence on an individual’s health and focuses on the relationships among these factors. The Commission on Social Determinants of Health (CSDH; WHO initiatives) suggests that the social and environmental factors are at the root of most of the inequalities responsible …

Psychosocial Impacts And Employment Preparedness Of Participating In An Hiv Peer Program: Implications For Tailoring A Vocational Counseling Model For Plwh, Erin R. Mckinney-Prupis

Dissertations and Theses

Background:

Medical advancements in HIV care should have reduced barriers to employment for PLWH, yet in 2017 only 47.7% of PLWH reported being employed, as compared to 62.9% in the general population. Employment is a significant social determinant of health, it impacts a variety of factors related to health, including earned income, access to healthcare, and social connectedness. Quantitative and qualitative studies have identified several concerns PLWH have about entering the workforce; the most pressing being fear of losing benefits. Targeted work readiness programs for PLWH is an important approach to help PLWH overcome their unique barriers to work, such …

Investigating The Impact Of The Nursing Practice Environment (Npe) On Central Line-Associated Bloodstream Infections (Clabsi) Among Older Adults In The Intensive Care Unit (Icu), Kristen A. Cribbs

Dissertations and Theses

Background: Health care–associated infections, resulting from treatment received for medical or surgical conditions in a health care setting, represent a critical public health and patient safety issue, exacting substantial medical, social, and economic costs. The costliest among the leading causes of preventable health care-associated infections is central-line associated bloodstream infections (CLABSI), to which older adults (age 65 years and older) are particularly susceptible, especially during intensive care unit (ICU) stays. A rich body of research has empirically linked the quality of the nursing practice environment (NPE) in hospitals to both positive and negative patient outcomes; yet, surprisingly few studies have …

Prenatal Choline Supplementation During High-Fat Feeding Improves Long-Term Blood Glucose Control In Male Mouse Offspring, Hunter W. Korsmo, Kaydine Edwards, Bhoomi Dave, Chauntelle Jack-Roberts, Huanling Yu, Anjana Saxena, Marie Salvador, Moshe Dembitzer, Jaskomal Phagoora, Xinyin Jiang

Publications and Research

Maternal obesity increases the risk of metabolic dysregulation in rodent offspring, especially when offspring are exposed to a high-fat (HF), obesogenic diet later in life. We previously demonstrated that maternal choline supplementation (MCS) in HF-fed mouse dams during gestation prevents fetal overgrowth and excess adiposity. In this study, we examined the long-term metabolic influence of MCS. C57BL/6J mice were fed a HF diet with or without choline supplementation prior to and during gestation. After weaning, their pups were exposed to either a HF or control diet for 6 weeks before measurements. Prenatal and post-weaning dietary treatments led to sexually dimorphic …

Patient And Provider Perspectives On Sexual History Taking During Gynecological Care: A Pilot Study In An Academic Family Medical Setting In New York City, Ashley M. Chastain

Dissertations and Theses

Background: In the United States (US), women face a number of serious issues concerning sexual health. Current surveillance data indicates that overall rates of bacterial sexually transmitted infections (STIs) are increasing rapidly. While rates of new diagnoses have decreased, the risks of acquiring HIV are still relatively high for some females, specifically Black/African-American women. In New York City (NYC), where this dissertation research was conducted, similar HIV/STI rates exist among females of reproductive age (aged 15-44). Among women in the US, there are also high estimated rates of other sexual health problems, such as sexual anxiety, sexual dysfunction, and intimate …

Can An Exercise-Based Educational And Motivational Intervention Be Durably Effective In Changing Compliance To Physical Activity And Anthropometric Risk In People With Type 2 Diabetes? A Follow-Up Study, Francesca Gallè, Jesse C. Krakauer, Nir Krakauer, Giuliana Valerio, Giorgio Liguori

Publications and Research

Aims. A nine-month motivational exercise-based intervention was previously offered to subjects with type 2 diabetes (T2D). A year after the end of the intervention, compliance to physical activity (PA) and anthropometric indices of participants were analyzed to evaluate the durability of its effects. Methods. PA levels, expressed as total energy expenditure per week, were assessed with the International Physical Activity Questionnaire (IPAQ). Changes in Body Mass Index (BMI), A Body Shape Index (ABSI), Hip Index (HI) z-scores, the relative mortality risk related to each of these measures, and a combined Anthropometric Risk Index (ARI) were also evaluated. Results. Of a …

Effects Of Am80 Compared To Ac261066 In A High Fat Diet Mouse Model Of Liver Disease, Marta Melis, Xiao-Han Tang, Steven E. Trasino, Viral M. Patel, Daniel J. Stummer, Jose Jessurun, Lorraine J. Gudas

Publications and Research

The roles of retinoids in nonalcoholic fatty liver disease (NAFLD) remain unclear and a better understanding may lead to therapies that prevent or limit NAFLD progression. We examined the actions of retinoic acid receptor (RAR) agonists- AM80 for RARαand AC261066 for RARβ2- in a murine model of NAFLD. We fed wild type C57Bl/6 mice a chow or a 45% high fat diet (HFD) for 12 weeks, followed by 4 additional weeks with the HFD+AM80; HFD +AC261066; or HFD. The HFD+AM80 group showed greater hyperglycemia and glucose intolerance compared to other groups. Histopathological evaluation of the livers showed the highest degree …

Clinic-Based Delivery Of The Young Men’S Health Project (Ymhp) Targeting Hiv Risk Reduction And Substance Use Among Young Men Who Have Sex With Men: Protocol For A Type 2, Hybrid Implementation-Effectiveness Trial, Jeffrey T. Parsons, Tyrel Starks, Sitaji Gurung, Demetria Cain, Jonathan Marmo, Sylvie Naar

Publications and Research

Background: Young men who have sex with men (YMSM) are disproportionately at risk for HIV and sexually transmitted infections. Adapting and testing the effectiveness of the Young Men’s Health Project (YMHP), an efficacious intervention designed to reduce substance use and condomless anal sex (CAS) among YMSM, at clinics in Miami, Detroit, and Philadelphia has the potential to reduce HIV and STI disparities among urban YMSM.

Objective: This study (Adolescent Medicine Trials Network for HIV/AIDS Interventions [ATN] 145 YMHP) aims to adapt YMHP for clinic and remote delivery by existing clinic staff and compare their effectiveness in real-world adolescent HIV clinics. …

Mold, Allergic Diseases And Asthma: Assessing The Validity And Usefulness Of Indoor Air Sampling As A Tool In Providing Health Protective Advice To Occupants, William M. Sothern

Dissertations and Theses

Background: Asthma is a major health problem throughout the world, disproportionately affecting occupants of low-income housing, and exposure to damp and moldy living conditions is recognized as a significant risk factor for asthma and other respiratory diseases. However, there are no authoritative health guidance values (HGV's) for airborne mold, and current scientific thought holds that the establishment of such guidelines is not practicable. Nonetheless, environmental practitioners take air samples for mold as a routine component of their indoor environmental investigations and use the laboratory results as a tool together with other findings to guide recommendations for health protective actions. The …

Women Are Being Cut During Childbirth Without Need Or Consent, Molly Cora Enking

Capstones

An episiotomy, a surgical cut used to enlarge the vaginal opening during childbirth, can be extremely painful, hard to recover from and can increase the risk of severe complications. In 2018, episiotomies are rarely necessary, but at some U.S. hospitals they happen much more than they should. And in the course reporting this story, New York City News Service found that it is common for doctors to cut women without the mother’s consent.

https://medium.com/@mollyenking/women-are-being-cut-during-childbirth-without-need-or-consent-7677de7eddae

Age-Tastic! An Evaluation Of An Evidence-Based Intervention For Older Adults, Manoj Pardasani, Jackie Berman, Mebane Powell

Publications and Research

Background: Raising awareness of holistic health and safety among older adults is critical to enhancing their wellbeing in many cases, improving health outcomes and motivating positive behavioral changes. Age-Tastic! is a comprehensive health and safety promotion intervention that uses the concept of a competitive board game to entice older adults to participate and stay engaged.

Objective: The purpose of this study was to evaluate the impact of Age-Tastic! on the level of awareness, health literacy, self-efficacy and positive behavioral change among the participants.

Methods: A randomized control trial was conducted with 98 older adults assigned to an experimental and control …

Linking Hostile/Helpless Maternal Representations In Pregnancy And Later Child Protection Involvement: A Pilot Study, Madeleine Terry

Dissertations, Theses, and Capstone Projects

The present pilot study examined whether there are reliable indices in the narratives of pregnant women that can be used to identify child abuse and neglect potential before the birth of the child. The Hostile/Helpless (HH) Classification system (Lyons-Ruth et al., 1995-2005), which detects mental states associated with trauma, disturbances in early attachment, and severe pathology, was adapted for use with the Pregnancy Interview (PI), a semi-structured clinical interview (Slade, 2003) that assesses a woman's emotional experience of pregnancy, and quality of her developing relationship with her baby. The study sample was drawn from a replication study of the Minding …

Disparities In Pulmonary Fibrosis Care In The United States: An Analysis From The Nationwide Inpatient Sample, Adam W. Gaffney, Steffie Woolhander, David Himmelstein, Danny Mccormick

Publications and Research

Background: Idiopathic pulmonary fibrosis is a disease with high morbidity and mortality. Care for these patients, including lung transplantation, may provide significant benefits, but is resource-intensive and expensive. Disadvantaged patients with IPF may hence be at risk for receiving inferior care.

Methods: We analyzed data from the Nationwide Inpatient Sample, a database consisting of all hospitalizations from a 20% sample of US hospitals. We identified adults hospitalized with IPF between 1998 and 2011 using ICD-9 codes. We assessed the effect of insurance coverage and socioeconomic status (SES) on lung transplantation, a treatment that may improve survival. We also examined the …

Consensus On Molecular Subtypes Of High-Grade Serous Ovarian Carcinoma, Gregory M. Chen, Lavanya Kannan, Ludwig Geistlinger, Victor Kofia, Zhaleh Safikhani, Deena Ma Gendoo, Giovanni Parmigiani, Michael Birrar, Benjamin Haibe-Kains, Levi Waldron

Publications and Research

Purpose: The majority of ovarian carcinomas are of high-grade serous histology, which is associated with poor prognosis. Surgery and chemotherapy are the mainstay of treatment, and molecular characterization is necessary to lead the way to targeted therapeutic options. To this end, various computational methods for gene expression-based subtyping of high-grade serous ovarian carcinoma (HGSOC) have been proposed, but their overlap and robustness remain unknown.

Experimental Design: We assess three major subtype classifiers by meta-analysis of publicly available expression data, and assess statistical criteria of subtype robustness and classifier concordance. We develop a consensus classifier that represents the subtype classifications of …

Rates Of Developmental And Behavioral Screening Of Young Children: Implications For Health Care Policy And Practice, Shirley Berger

Dissertations and Theses

Background: The skills and capacities developed during early childhood are the foundation for a child’s future academic functioning, economic productivity, and lifelong health and mental health. When young children have developmental delays or disabilities, early identification and intervention lead to better outcomes; however, only a minority are identified before school entry. Primary care is an important setting for identification of developmental and behavioral conditions as most young children attend well-child visits regularly and parents expect developmental guidance from pediatricians. Two key pediatric preventive services are recommended: developmental monitoring/surveillance at every well-child visit and developmental screening at 9 months, 18 months, …

Involuntary Sterilization Among Hiv-Positive Garifuna Women From Honduras Seeking Asylum In The United States: Two Case Reports, Holly G. Atkinson, Deborah Ottenheimer

Publications and Research

Voluntary sterilization is one of the most widely used forms of contraception by women worldwide; however, involuntary sterilization is considered a violation of multiple human rights and grounds for asylum in the United States. Women have been disproportionately affected by this practice. We report two cases of involuntary sterilization in HIV-positive Garifuna women from Honduras who sought asylum in America and were medically evaluated at the request of their attorneys. Key lessons can be drawn from these cases with regard to the importance of medical evaluations in establishing persecution. These include the need for a detailed account of the events …

Resveratrol And Pterostilbene Exhibit Anticancer Properties Involving The Downregulation Of Hpv Oncoprotein E6 In Cervical Cancer Cells, Kaushiki Chatterjee, Dina Alsharif, Christina Mazza, Palwasha Syar, Mohamed Al Sharif, Jimmie E. Fata

Publications and Research

Cervical cancer is one of the most common cancers in women living in developing countries. Due to a lack of affordable effective therapy, research into alternative anticancer compounds with low toxicity such as dietary polyphenols has continued. Our aim is to determine whether two structurally similar plant polyphenols, resveratrol and pterostilbene, exhibit anticancer and anti-HPV (Human papillomavirus) activity against cervical cancer cells. To determine anticancer activity, extensive in vitro analyses were performed. Anti-HPV activity, through measuring E6 protein levels, subsequent downstream p53 effects, and caspase-3 activation, were studied to understand a possible mechanism of action. Both polyphenols are effective agents …

The Impact Of Sarcopenic Obesity On Inflammation, Lean Body Mass, And Muscle Strength In Elderly Women, Dahan Da Cunha Nascimento, Samuel Da Cunha Oliveira, Denis Cesar Leite Vieira, Silvana Schwerz Funghetto, Alessandro Oliveira Silva, Renato Valduga, Brad J. Schoenfeld, Jonato Prestes

Publications and Research

Objective: The objective of this study was to apply the newly standardized definition for sarcopenia from the Foundation for the National Institutes of Health (FNIH) and the current definition for obesity to 1) determine the prevalence of sarcopenic obesity (SO) in obese elderly women; 2) compare the muscle strength, lean body mass, and markers of inflammation between obese elderly women with SO and nonsarcopenic obesity (NSO), and 3) elucidate the relation- ship between appendicular lean mass adjusted for body mass index (aLM/BMI) with muscle strength, lean body mass, and obesity indices.

Methods: A total of 64 elderly obese women (age: …

Quantification Of Hiv-1 Rna Among Men Who Have Sex With Men Using An At-Home Self-Collected Dried Blood Spot Specimen: Feasibility Study, Sabina Hirshfield, Richard A. Teran, Martin J. Downing Jr., Mary Ann Chiasson, Hong-Van Tieu, Laura Dize, Charlotte A. Gaydos

Publications and Research

Background: Suboptimal antiretroviral therapy (ART) adherence and disengagement in care present significant public health challenges because of the increased probability of HIV transmission. In the United States, men who have sex with men (MSM) continue to be disproportionately affected by HIV, highlighting a critical need to engage high-risk MSM living with HIV who are not engaged or retained in care.

Objective: The aim of the study was to assess the feasibility of at-home blood self-collection and laboratory quantification of HIV-1 RNA viral load (VL) to report laboratory-based VL outcomes and compare self-reported and laboratory-reported VL

Methods: Between 2016 and 2017, …

Home-Based Pre-Exposure Prophylaxis (Prep) Services For Gay And Bisexual Men: An Opportunity To Address Barriers To Prep Uptake And Persistence, Steven A. John, H Jonathon Rendina, Christina Grov, Jeffrey T. Parsons

Publications and Research

Gay, bisexual, and other men who have sex with men (GBM) are disproportionately affected by the HIV epidemic. Despite the promise of pre-exposure prophylaxis (PrEP) in reducing HIV transmission risk, barriers for uptake and persistence exist. We sought to identify whether GBM in a nationwide cohort who have not yet initiated PrEP (n = 906) would prefer to get PrEP-related care from a primary care provider (PCP) compared to a specialist clinic or provider. We then sought to identify their level of interest and factors associated with preference for using home-based PrEP services (i.e., HB-PrEP), defined to participants as conducting …

The Gift That Keeps One Living, Scott R. Axelrod

Capstones

This long-form narrative feature article reports on the shortage of living kidney donors and those in desperate need of kidney transplants. It features interviews with doctors, transplant coordinators, patients, living kidney donors, and kidney recipients. The story culminates with my own personal experience as a kidney donor to my late dad over a decade ago. The presentation includes an extensive photo component capturing characters and elements from the story through a series of detailed portraits, photo essays, and infographics.

https://saxelrod718.wixsite.com/livingkidneydonors

Doula Services Within A Healthy Start Program: Increasing Access For An Underserved Population, Mary-Powel Thomas, Gabriela Ammann, Ellen Brazier, Philip Noyes, Aletha Maybank

Publications and Research

Purpose: Women of color in the United States, particularly in high-poverty neighborhoods, experience high rates of poor birth outcomes, including cesarean section, preterm birth, low birthweight, and infant mortality. Doula care has been linked to improvements in many perinatal outcomes, but women of color and low-income women often face barriers in accessing doula support.

Description: To address this issue, the New York City Department of Health and Mental Hygiene’s Healthy Start Brooklyn introduced the By My Side Birth Support Program in 2010. The goal was to complement other maternal home-visiting programs by providing doula support during labor and birth, along …

First Trimester Medication Abortion Practice In The United States And Canada, Heidi E. Jones, Katharine O'Connell White, Wendy V. Norman, Edith Guilbert, E. Steve Lichtenberg, Maureen Paul

Publications and Research

We conducted a cross-sectional survey of abortion facilities from professional networks in the United States (US, n = 703) and Canada (n = 94) to estimate the prevalence of medication abortion practices in these settings and to look at regional differences. Administrators responded to questions on gestational limits, while up to five clinicians per facility reported on 2012 medication abortion practice. At the time of fielding, mifepristone was not approved in Canada. 383 (54.5%) US and 78 (83.0%) Canadian facilities participated. In the US, 95.3% offered first trimester medication abortion compared to 25.6% in Canada. While 100% of providers were …

Trends In Hpv Vaccine Initiation And Completion Among Girls In Texas: Behavioral Risk Factor Surveillance System Data, 2008–2010, Tatjana Gazibara, Haomiao Jia, Erica I. Lubetkin

Publications and Research

Objective: The objective of this study was to evaluate the trend of HPV vaccine initiation and completion among girls in Texas from 2008 to 2010.

Methods: Data were obtained from the Behavioral Risk Factors Surveillance System (BRFSS) over 3 years (2008–2010). The information regarding HPV vaccination was gathered from the parents of 9- to 17-year-old daughters (choosing only 1 per household) in randomly selected households in the sample area.

Results: The highest prevalence of vaccine initiation and completion were detected in 2010 (20.9% and 9.7%, respectively). Over the study period, HPV vaccine initiation statistically significantly increased (2008, 14.9%; 2009, 20.7%; …