Medical Specialties Commons^™

Blood Glucose Responses To Type, Intensity, Duration, And Timing Of Exercise, Sheri R. Colberg, Manuel J. Hernandez, Fatima Shahzad

Human Movement Studies & Special Education Faculty Publications

[First Paragraph] The Big Blue Test (BBT) is an annual initiative by the Diabetes Hands Foundation to raise awareness of the importance of physical activity in managing diabetes. Individuals with diabetes voluntarily exercise and record self-monitored blood glucose levels. During the 2012 BBT, 5,157 diabetic participants (~90% insulin users) anonymously entered exercise type, intensity, duration, time elapsed since last meal, and blood glucose readings before and after one or more bouts of exercise separately through www.BigBlueTest.org or an Iphone app.

Melatonin Supplementation Improves Glycemic Control While Lowering Oxidative Stress In Type 2 Diabetes, Carmine R. Grieco, Sheri R. Colberg, C. Thomas Somma, Andrew G. Thompson, Aaron I. Vinik

Human Movement Studies & Special Education Faculty Publications

The purpose of this investigation was to evaluate the effect of melatonin on glycemic control and oxidative stress (OS) in adults with type 2 diabetes (T2D). Fourteen subjects with T2D (10 female, 4 male; 52.5 ± 5.0 years) were randomly assigned to melatonin (MEL) or placebo groups (PLA) for 42 days, in a crossover design. Subjects ingested 10 mg of MEL or an identical placebo (PLA) 30 minutes prior to sleep. Fasting blood draws occurred at baseline, 42 days, and 84 days. Plasma malondialdehyde, a marker of OS, significantly decreased on MEL (-6.25±2.10 nmol/ml) compared to PLA (0.72±3.30, p=0.028). The …

The Big Blue Test: Effects Of 14 Minutes Of Physical Activity On Blood Glucose Levels, Sheri R. Colberg, Manuel J. Hernandez

Human Movement Studies & Special Education Faculty Publications

[First paragraph] For most with diabetes, physical activity has a blood glucose lowering effect (1). Hypoglycemia (i.e., blood glucose < 65 mg/dL) resulting from exercise is a concern, particularly for insulin users (2).

Test-Retest Reliability And Construct Validity Of The Tinetti Performance-Oriented Mobility Assessment In People With Stroke, Jennifer Canbek, George Fulk, John Echternach

Rehabilitation Sciences Faculty Publications

Background and Purpose: The Tinetti Performance-Oriented Mobility Assessment (POMA) is commonly used to measure balance ability in older adults. The purpose of this study was to determine the test-retest reliability and minimal detectable change (MDC) of the POMA and explore its cross-sectional and longitudinal construct validity for use in people early after stroke.

Methods: Participants were recruited if they had a first documented stroke and were receiving physical therapy during inpatient rehabilitation. The POMA, gait speed, and motor Functional Independence Measure (FIM) scores were collected at admission and at discharge from inpatient rehabilitation. A second trial of the POMA was …

Commentary On "The Motor Learning Strategy Instrument: Interrater Reliability Within Usual And Virtual Reality Physical Therapy Interventions", Karen M. Kott, Sharon Held

Rehabilitation Sciences Faculty Publications

No abstract provided.

Prevalence And Correlates Of Being Bullied Among In-School Adolescents In Malawi: Results From The 2009 Global School-Based Health Survey, H.W. Kubwalo, A.S. Muula, S. Siziya, S. Pasupulati, E. Rudatsikira

Community & Environmental Health Faculty Publications

Background

Physical and emotional violence against adolescents is a neglected, but growing problem globally. Violence against adolescents negatively affects the victim in terms of physical health, school attendance and performance and social adjustment. The literature on the prevalence and associated factors of bullying against adolescents is sparse in southern Africa outside South Africa. Such data are even sparser for Malawi. The current study was conducted to estimate the prevalence of self-reported bullying and its personal and social correlates.

Methods

A secondary analysis of the Malawi School-Based Student Health Survey (2009) was done. Descriptive analyses were done to describe the sample …

Correlates Of Consistent Condom Use Among Female Entertainment Workers In Shanghai, China: A Repeated Measures Analysis, Xiushi Yang, Guomei Xia

Sociology & Criminal Justice Faculty Publications

Female entertainment workers (FEWs) in China are at increased risk of HIV and other sexually transmitted infections, but correlates of their risky sexual behaviour remain poorly understood. Using data from a series of four surveys, this paper employs repeated measures analysis to identify individual and social correlates of consistent condom use among FEWs in Shanghai. Results reveal that both individual cognitive and social influence factors are statistically significant in their bivariate relationships to consistent condom use with a stable or non-stable partner; only prevention motivation and perceived self-efficacy in condom use remain significant in the multiple regressions. When individual and …

Erosive Hand Osteoarthritis Is Associated With Subclinical Atherosclerosis And Endothelial Dysfunction, Athanasios Koutroumpas, Athanasios Giannoukas, Elias Zintzaras, Ekaterini Exarchou, Aris Baliakos, Konstantinos Makaritsis, Lazaros I. Sakkas

Biological Sciences Faculty Publications

Chronic inflammatory disorders have been associated with accelerated atherosclerosis and increased cardiovascular (CV) risk. Recent evidence suggests that erosive hand osteoarthritis (EOA) has considerable inflammation; therefore, we examined the presence of subclinical atherosclerosis and endothelial dysfunction in EOA. Twenty-four patients with EOA and 24 age- and sex-matched healthy individuals without clinical OA were included in the study. No subject had a history of CV disease. Intima-media thickness (IMT) and atheromatous plaques in the common carotid and common femoral arteries were measured by Doppler ultrasonography. The endothelium-dependent, flow-mediated dilatation (FMD) and endothelium-independent, sublingual glyceryl trinitrate (NTG)-induced dilatation (NMD) of the brachial …

Assistive Technology: Fixing Humans, Petros J. Katsioloudis, Millie Jones

STEMPS Faculty Publications

The need for assistive technology--technology that assists persons with disabilities--is great. At no time has there been a greater need to provide assistive technologies than to assist the thousands of military veterans returning home from the Middle East with a range of physical and mental disabilities. Mobility impairment is a significant concern for many returning veterans. Assistive technologies are playing a major role in assisting war veterans returning with physical limitations through the loss of a limb or, in many cases, several limbs. This article presents the history and background of assistive technology and how mobile- and computer-assistive technologies can …

The Effects Of A Semi-Rigid Ankle Brace On A Simulated Isolated Subtalar Joint Instability, Julie Choisne, Matthew C. Hoch, Sebastian Bawab, Ian Alexander, Stacie I. Ringleb

Mechanical & Aerospace Engineering Faculty Publications

Subtalar joint instability is hypothesized to occur after injuries to the calcaneofibular ligament (CFL) in isolation or in combination with the cervical and the talocalcaneal interosseous ligaments. A common treatment for hindfoot instability is the application of an ankle brace. However, the ability of an ankle brace to promote subtalar joint stability is not well established. We assessed the kinematics of the subtalar joint, ankle, and hindfoot in the presence of isolated subtalar instability, investigated the effect of bracing in a CFL deficient foot and with a total rupture of the intrinsic ligaments, and evaluated how maximum inversion range of …

Late Developing Mammary Tumors And Hyperplasia Induced By A Low-Oncogenic Variant Of Mouse Mammary Tumor Virus (Mmtv) Express Genes Identical To Those Induced By Canonical Mmtv, Robert D. Bruno

School of Medical Diagnostics & Translational Sciences Publications

Background: The canonical milk-transmitted mouse mammary tumor virus (MMTV) of C3H mice (C3H-MMTV) rapidly induces tumors in 90% of infected animals by 8 months of age. Pro-viral insertions of C3H-MMTV into genomic DNA results in the overexpression of common core insertion site (CIS) genes, including Wnt1/10b, Rspo2, and Fgf3. Conversely, infection by either the endogenous Mtv-1 virus (in C3Hf) or the exogenous nodule-inducing virus (NIV) (in Balb/c NIV) induces premalignant mammary lesions and tumors with reduced incidence and longer latency than C3H-MMTV. Here, we asked whether Mtv-1/NIV affected the expression of core CIS genes.

Findings: We confirmed the presence of …

Prescribing Physical Activity To Prevent And Manage Gestational Diabetes, Sheri R. Colberg, Kristin Castorino, Lois Jovanovič

Human Movement Studies & Special Education Faculty Publications

Gestational diabetes mellitus (GDM) is the most prevalent metabolic disorder during pregnancy. Women diagnosed with GDM have a substantially greater risk of developing type 2 diabetes within 5-10 years after delivery, and the risk is increased by excess body weight. Uncontrolled hyperglycemia during pregnancy is potentially harmful to both mother and fetus, resulting in a greater need for Caesarian-section deliveries, delivery of larger infants with more excess body fat, a greater risk of infant death and stillbirth, and an elevated risk of infant hypoglycemia immediately after birth. Fortunately, engaging in physical activity prior to and during pregnancy may lower the …

Orientation-Invariant Ecg-Based Virtual Pathology Stethoscope Tracking For Standardized Patient Heart Auscultation, Nahom B. Kidane

Computational Modeling & Simulation Engineering Theses & Dissertations

Cardiac auscultation (CA), the act of listening to the heart sounds, is a critical physician's skill that provides substantial information for diagnosing many cardiovascular disorders; therefore, competent training can be a key for accurate and reliable diagnosis. The teaching of CA has been an area of recognized importance since the inception of the stethoscope. However, recent changes in health-care, such as limited student access to patients and higher reliance on competing technologies have made it challenging to teach bedside CA techniques.

Over the past few decades, standardized patients (SPs), individuals trained to portray real patients, have been widely used for …

Development And Validation Methodology Of The Nuss Procedure Surgical Planner, Krzysztof J. Rechowicz

Computational Modeling & Simulation Engineering Theses & Dissertations

Pectus excavatum (PE) is a congenital chest wall deformity which is characterized, in most cases, by a deep depression of the sternum. A minimally invasive technique for the repair of PE (MIRPE), often referred to as the Nuss procedure, has been proven to be more advantageous than many other PE treatment techniques. The Nuss procedure consists of placement of a metal bar(s) underneath the sternum, thereby forcibly changing the geometry of the ribcage. Because of the prevalence of PE and the popularity of the Nuss procedure, the demand to perform this surgery is greater than ever. Therefore, a Nuss procedure …

Analysis Of Bar Deformation Under Sternum Forces During Surgical Correction Of Pectus Excavatum In Children, Rohit N. Nikam

Mechanical & Aerospace Engineering Theses & Dissertations

Pectus excavatum (PE) also known as sunken or funnel chest is the most common chest wall deformity and affects 1 in every 1,000 children. In PE patients, the middle lower portion of the sternum is depressed producing concave appearance of the anterior part of the chest wall. This problem can be corrected with minimally invasive surgery developed by Dr. Donald Nuss in 1986. A specially made steel bar is implanted to lift the sternum to its normal position. This technique has been modified several times to improve safety and effectiveness of the bar placement and removal. One of the significant …

Alternative Therapy And Treatment Of Type 2 Diabetes, Carmine R. Grieco

Human Movement Studies & Special Education Theses & Dissertations

The rise in prevalence and incidence of type 2 diabetes mellitus (T2D) in the developing world continues unabated. Current treatment strategies, however, fall short of achieving optimal glycemic control. The aim of project I was to investigate the effect of an acute bout of a yogic breathing exercise on heart rate variability (HRV) in individuals with T2D. Project II was designed to assess the effectiveness of the neurohormone melatonin in lowering short- and long-term glucose levels, lipids and oxidative stress in T2D. Project III investigated the differential effects of two different styles of aerobic exercise on postprandial glycemia, mood and …

Synergistic Effect Of Subnanosecond Pulsed Electric Fields And Temperature On The Viability Of Biological Cells, James Thomas Camp

Electrical & Computer Engineering Theses & Dissertations

Pulsed electric fields have been used to induce a biological response in cells, and at sufficient energy, can cause cell death. By reducing the pulse duration from presently used nanosecond to subnanosecond ranges, the electric field can be delivered to biological tissue non-invasively by the use of an antenna instead of electrodes, such as needles. Studies have previously been completed in which the aim was to determine the energy density (electric field strength, number of pulses) required to induce cell death with 800 ps pulses. Based on this data, it was concluded that for pulse durations of 200 ps, with …

Anthropogenic Climate Change And Allergic Diseases, James Blando, Leonard Bielory, Viann Nguyen, Rafael Diaz, Hueiwang Anna Jeng

Community & Environmental Health Faculty Publications

Climate change is expected to have an impact on various aspects of health, including mucosal areas involved in allergic inflammatory disorders that include asthma, allergic rhinitis, allergic conjunctivitis and anaphylaxis. The evidence that links climate change to the exacerbation and the development of allergic disease is increasing and appears to be linked to changes in pollen seasons (duration, onset and intensity) and changes in allergen content of plants and their pollen as it relates to increased sensitization, allergenicity and exacerbations of allergic airway disease. This has significant implications for air quality and for the global food supply.

Novel Report Of Expression And Function Of Cd97 In Malignant Gliomas: Correlation With Wilms Tumor 1 Expression And Glioma Cell Invasiveness Laboratory Investigation, Archana Chidambaram, Helen L. Fillmore, Timothy E. Van Meter, Catherine I. Dumur, William C. Broaddus

Division of Research and Economic Development Faculty & Staff Publications

Object. The Wilms tumor 1 (WT1) protein—a developmentally regulated transcription factor—is aberrantly expressed in gliomas and promotes their malignant phenotype. However, little is known about the molecular allies that help it mediate its oncogenic functions in glioma cells.

Methods. The authors used short interfering RNA (siRNA) to suppress WT1 expression in glioblastoma (GBM) cells and evaluated the effect of this on GBM cell invasiveness. Gene expression analysis was then used to identify the candidate genes that were altered as a result of WT1 silencing. One candidate target, CD97, was then selected for further investigation into its role by suppressing …

Upper Extremity Strength Characteristics In Female Recreational Tennis Players With And Without Lateral Epicondylalgia, Ann M. Lucado, Morey J. Kolber, M. Samuel Cheng, John L. Echternach Sr.

Rehabilitation Sciences Faculty Publications

STUDY DESIGN: Descriptive, cross-sectional.

OBJECTIVES: To compare static strength characteristics of the upper extremity musculature in female recreational tennis players with lateral epicondylalgia to those of nonsymptomatic tennis players and a control group of women who did not play tennis.

BACKGROUND: There is a paucity of research describing the relationship between lateral epicondylalgia and strength characteristics of the upper extremity musculature, despite the functional relationship between the shoulder, elbow, and wrist.

METHODS: Sixty-three women were recruited into 3 groups (n = 21 per group): symptomatic tennis players (SIP) with lateral epicondylalgia, nonsymptomatic tennis players, and controls. Data collection was performed …

Two-Week Joint Mobilization Intervention Improves Self-Reported Function, Range Of Motion, And Dynamic Balance In Those With Chronic Ankle Instability, Matthew C. Hoch, Richard D. Andreatta, David R. Mullineaux, Robert A. English, Jennifer M. Medina Mckeon, Carl G. Mattacola, Patrick O. Mckeon

Human Movement Studies & Special Education Faculty Publications

We examined the effect of a 2-week anterior-to-posterior ankle joint mobilization intervention on weight-bearing dorsiflexion range of motion (ROM), dynamic balance, and self-reported function in subjects with chronic ankle instability (CAI). In this prospective cohort study, subjects received six Maitland Grade III anterior-to-posterior joint mobilization treatments over 2 weeks. Weight-bearing dorsiflexion ROM, the anterior, posteromedial, and posterolateral reach directions of the Star Excursion Balance Test (SEBT), and self-reported function on the Foot and Ankle Ability Measure (FAAM) were assessed 1 week before the intervention (baseline), prior to the first treatment (pre-intervention), 24-48 h following the final treatment (post-intervention), and 1 …

Advancing Our Understanding Of The Inheritance And Transmission Of Pectus Excavatum, Lisa Horth, Michael W. Stacey, Virginia K. Proud, Kara Segna, Chelsea Rutherford, Donald Nuss, Robert E. Kelly

Bioelectrics Publications

Pectus excavatum is the most common congenital chest wall abnormality expressed in children, yet its inheritance is poorly understood. Here we present the first comprehensive assessment of the inheritance of this disorder. After evaluating 48 pedigrees and 56 clinical traits of probands and family members, we find strong evidence of autosomal recessive, genetic control for this disorder. Additionally there is likely more than one pectus disease-associated allele, as well as a relatively large number of disease allele carriers in the human population. Some clinical traits appear important and may serve as reliable indicators for predicting the likelihood of pectus excavatum …

Bnnt- Mediated Irreversible Electroporation: It's Potential On Cancer Cells, V. Raffa, C. Riggio, M. W. Smith, K. C. Jordon, W. Cao, A. Cuschieri

Applied Research Center Publications

Irreversible lethal electroporation (IRE) is a new non-thermal ablation modality that uses short pulses of high amplitude static electric fields (up 1000V/cm) to create irreversible pores in the cell membrane, thus, causing cell death. Recently, IRE has emerged as a promising clinical modality for cancer disease treatment. Here, we investigated the responses of tumour human He La cells when subjected to IRE in the presence of BNNTs. These consist of tiny tubes of B and N atoms (arranged in hexagons) with diameters ranging from a 1 to 3 nanometres and lengths <2 μm. BNNTs have attracted wide attention because of their unique electrical properties. We speculate that BNNTs, when interacting with cells exposed to static electrical fields, amplify locally the electric field, leading to cell death. In this work, electroporation assays were performed with a commercial electroporator using the cell-specific protocol suggested by the supplier (exponential decay wave, time constant 20ms) with the specific aim to compare IRE in absence and in presence of BNNTs. We observed that BNNTs have the capacity to decrease substantially the voltage required for IRE. When cells were pulsed at 800V/cm, we observed a 2,2-fold reduction in cell survival in the presence of BNNTs compared to controls. We conclude that the death of the tumour cells exposed to IRE is strongly enhanced in the presence of BNNTs, indicating their potential therapeutic application.

Effect Of A Physician Uncertainty Reduction Intervention On Blood Pressure In Uncontrolled Hypertensives-A Cluster Randomized Trial, David J. Hyman, Valory N. Pavik, Anthony J. Greisinger, Wenyaw Chan, Jose Bayona, Carol Mansyur, Victor Simjms, James Pool

Community & Environmental Health Faculty Publications

BACKGROUND: Clinical inertia, provider failure to appropriately intensify treatment, is a major contributor to uncontrolled blood pressure (BP). Some clinical inertia may result from physician uncertainty over the patient’s usual BP, adherence, or value of continuing efforts to control BP through lifestyle changes.

OBJECTIVE: To test the hypothesis that providing physicians with uncertainty reduction tools, including 24-h ambulatory BP monitoring, electronic bottle cap monitoring, and lifestyle assessment and counseling, will lead to improved BP control.

DESIGN: Cluster randomized trial with five intervention clinics (IC) and five usual care clinics (UCC).

SETTING: Six public and 4 private primary care clinics.

PARTICIPANTS: …

Physician Review Of Workers' Compensation Case Files: Can It Affect Decision Outcomes?, Mark E. Hammett, Christopher Jankosky, John Muller, Elizabeth Hughes, Francesca Litow

Community & Environmental Health Faculty Publications

Objective: To identify common attributes of Federal workers compensation cases referred to Navy physicians for medical opinions and to determine the impact of the review on the final case decision. Methods: Retrospective case study and descriptive analysis of 258 opinion letters written by physicians on referred cases from 2006 to 2010. Results: Navy physician opinions were considered in the outcome in some of the cases, and there was a statistically significant difference between the claim acceptance rate in the study population and the total population. Worker age was correlated with certain claim types. Conclusions: There is preliminary evidence that the …

Contrasting Effects Of Errorless Naming Treatment And Gestural Facilitation For Word Retrieval In Aphasia, Anastasia M. Raymer, Beth Mchose, Kimberly G. Smith, Lisa Iman, Alexis Ambrose, Colleen Casselton

Communication Disorders & Special Education Faculty Publications

Purpose- We compared the effects of two treatments for aphasic word retrieval impairments, errorless naming treatment (ENT) and gestural facilitation of naming (GES), within the same individuals, anticipating that the use of gesture would enhance the effect of treatment over errorless treatment alone. In addition to picture naming, we evaluated results for other outcome measures that were largely untested in earlier ENT studies.

Methods- In a single participant crossover treatment design, we examined the effects of ENT and GES in eight individuals with stroke-induced aphasia and word retrieval impairments (three semantic anomia, five phonological anomia) in counterbalanced phases across participants. …

An Examination Of Factors Affecting Non-Urgent Use Of Emergency Department Services By Patients With "Universal" Healthcare, Gregory Smith Feltenberger

Health Services Research Dissertations

The purpose of this research is to examine the factors affecting non-urgent utilization of emergency department (ED) services by individuals with "universal" healthcare using the Behavioral Model of Health Services Use. Since Air Force Medical Service beneficiaries have free and unlimited use of the full-range of healthcare services, they are ideally suited for this study. The findings of this research may also apply to other populations with free or low-cost access to healthcare (i.e., universal or single-payer healthcare). Using secondary data extracted from the Air Force Medical Service's electronic health record system at several military hospitals, this study will present …

Theoretically-Driven Infrastructure For Supporting Health Care Teams Training At A Military Treatment Facility, T. Robert Turner Jr., V. Andrea Parodi

VMASC Publications

Designated a Department of Defense Team Resource Center (TRC) in 2008, Naval Medical Center Portsmouth (NMCP) currently hosts three tri-service health care teams training courses annually. Each consists of didactic learning coupled with simulation-based training exercises to provide an interactive educational experience for health care professionals. Simulated cases are developed to reinforce specific teamwork skills and behaviors, and to incorporate a variety of technologies including standardized patients, manikins, and virtual reality. The course is also the foundation of a research program designed to explore applications of modeling and simulation for enhanced team training in health care. The TRC has adopted …

Brain-Computer Interfaces In Medicine, Jerry J. Shih, Dean J. Krusienski, Johnathan R. Wolpaw

Electrical & Computer Engineering Faculty Publications

Brain-computer interfaces (BCIs) acquire brain signals, analyze them, and translate them into commands that are relayed to output devices that carry out desired actions. BCIs do not use normal neuromuscular output pathways. The main goal of BCI is to replace or restore useful function to people disabled by neuromuscular disorders such as amyotrophic lateral sclerosis, cerebral palsy, stroke, or spinal cord injury. From initial demonstrations of electroenceph-alography-based spelling and single-neuron-based device control, researchers have gone on to use electroenceph-alographic, intracortical, electrocorticographic, and other brain signals for increasingly complex control of cursors, robotic arms, prostheses, wheelchairs, and other devices. Brain-computer interfaces …

Physical Activity: The Forgotten Tool For Type 2 Diabetes Management, Sheri R. Colberg

Human Movement Studies & Special Education Faculty Publications

Individuals who are currently sedentary, unfit, or overweight can benefit metabolically from simply taking breaks from sitting. Since avoidance of sedentary behavior appears to have a large impact on glycemic management, all individuals with type 2 diabetes should be encouraged to minimally engage in greater daily movement to better manage their diabetes and body weight. In addition, engaging in physical activity of any intensity (including low-intensity ones) likely positively impacts insulin action and blood glucose control acutely. Moreover, as long as total caloric expenditure during exercise is matched (i.e., total exercise dose), daily exercise may be done every other day …